Liabilities / Assets
64th percentile
Higher debt load relative to assets than 64% of similar nonprofits.
Patient Safety Movement Foundation
990 • Fiscal year 2016 • EIN 46-2730379
Siviq Scores
Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.
0.22x
Liabilities / Revenue
41st percentile
Higher debt load relative to revenue than 41% of similar nonprofits.
Net Margin
85th percentile
Higher net margin than 85% of similar nonprofits.
Top Officer Pay
88th percentile
Higher top officer pay than 88% of similar nonprofits.
Top officer pay equals 5.6% of source-year revenue.
Asset Growth
98th percentile
Faster asset growth than 98% of similar nonprofits.
Revenue Growth
92nd percentile
Faster revenue growth than 92% of similar nonprofits.
Balance Sheet
Assets
$941,533
No earlier filing loaded for comparison.
Net Assets
$729,926
No earlier filing loaded for comparison.
Liabilities
$211,607
No earlier filing loaded for comparison.
Revenue And Expenses
Revenue
$3,206,765
No earlier filing loaded for comparison.
Expenses
$2,273,742
No earlier filing loaded for comparison.
Net Income
$933,023
No earlier filing loaded for comparison.
Historical Trend
Jump To
Filing Snapshot
- Filing Period
- Apr 1, 2015 to Mar 31, 2016
- Signed
- Jan 9, 2017
- Return Version
- 2015v3.0
- Gross Receipts
- $3,206,765
Mission and Program Overview
Mission
The patient safety movement is connecting people, ideas and technology to confront the large scale problem of more than 200,000 preventable patient deaths in u.s. Hospitals and 4,800,000 worldwide, each year by providing actionable ideas and innovations that can (con sch o) transform the process of care, dramatically improve patient safety and help eliminate patient preventable deaths. We are doing this one solution, one commitment, one hospital, one act of kindness and love, and one patient at a time. The psmf is helping to break down silos that exist between hospitals, healthcare technology companies, patient advocates, patients, the government and all the stakeholders affected in healthcare - all of us. Together we are pushing towards zero preventable deaths by 2020.
The Patient Safety Movement Foundation (PSMF) is committed to working with hospitals, medical technology companies, and patient advocates to unite the healthcare ecosystem and eliminate the more than 200,000 preventable hospital deaths by 2020 that occur every year in the United States.
Balance Sheet Detail
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Cash and Non-Interest-Bearing Accounts | $240,378 | $779,553 | ▲ $539,175 |
| Accounts Receivable | - | $135,000 | - |
| Prepaid Expenses and Deferred Charges | $25,000 | $26,980 | ▲ $1,980 |
| Total Assets | $265,378 | $941,533 | ▲ $676,155 |
| Liabilities | |||
| Accounts Payable and Accrued Expenses | $468,475 | $211,607 | ▼ $256,868 |
| Total Liabilities | $468,475 | $211,607 | ▼ $256,868 |
| Net Assets / Fund Balance | |||
| Unrestricted Net Assets | $-203,097 | $729,926 | ▲ $933,023 |
| Total Net Assets Fund Balance | $-203,097 | $729,926 | ▲ $933,023 |
| Total Liabilities and Net Assets / Fund Balance | $265,378 | $941,533 | ▲ $676,155 |
Compensation and Service Providers
Employees
| Name | Title | Full / Part Time | Base | Other | Total |
|---|---|---|---|---|---|
| Jim Bialick - See Sch O | President, DirECTOR | FT | $150,000 | $30,138 | $180,138 |
Board Members and Trustees
| Name | Title |
|---|---|
| Joe E Kiani | Chairman, Director |
| Charles Miceli | Director |
| DAvid Mayer MD | Director |
| Jim Messina- start July 2015 | Director |
| Michael AE Ramsay MD | Director |
| Robin Betts | Director |
| Steven Moreau- Start July 2015 | Director |
| Mark P De Raad | Secretary, Treasurer |
Highest Paid Contractors
| Contractor | Services | Location | Compensation |
|---|---|---|---|
| Stungun Productions Inc | Production for January 2015 summit | 1793 Lafayette Street 100, Santa Clara, CA 95050 | $634,666 |
| Lyon & Associates | Publicity | 3525 Del Mar Heights Rd 789, San Diego, CA 92130 | $222,682 |
| - | Media for Jan 2015 summit | 3366 N Torrey Pines Court 110, La Jolla, CA 92037 | $135,053 |
Revenue and Support
Revenue Composition
- Contributions and Grants
- $3,128,240
- Program Service Revenue
- $78,525
- Investment Income
- $0
- Other Revenue
- $0
- All Other Contributions
- $3,128,240
- Change in Net Assets
- $933,023
Audited Revenue Reconciliation
- Revenue per Audited Statements
- $3,206,765
- Revenue Not Reported on Financial Statements
- $0
- Revenue Not Reported on Form 990
- $90,000
- Total Revenue per Audited Statements
- $3,296,765
- Total Revenue per Form 990
- $3,206,765
Expenses and Functional Allocation
Major Expense Lines
| Line Item | Amount |
|---|---|
| Other Expenses | $2,006,643 |
| Salaries, Compensation, and Employee Benefits | $267,099 |
| Grants and Similar Amounts Paid | $0 |
| Professional Fundraising Fees | $0 |
| Total Fundraising Expense | $0 |
Functional Expense Allocation
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Travel | $277,116 | - | - | $277,116 |
| Current Officers, Directors, Trustees, and Key Employees | $145,292 | $25,640 | - | $170,932 |
| Fees for Services Other | $122,376 | $8,205 | - | $130,581 |
| All Other Expenses | $91,264 | $29,312 | - | $120,576 |
| Other Expenses | $95,000 | $5,306 | - | $95,000 |
| Other Salaries and Wages | $57,907 | $13,055 | - | $70,962 |
| Information Technology | - | $24,702 | - | $24,702 |
| Conferences and Meetings | $21,561 | - | - | $21,561 |
| Payroll Taxes | $13,296 | $2,343 | - | $15,639 |
| Fees for Services Accounting | - | $15,000 | - | $15,000 |
| Other Employee Benefits | $7,499 | $2,067 | - | $9,566 |
| Fees for Services Legal | - | $6,729 | - | $6,729 |
| Insurance | - | $3,898 | - | $3,898 |
| Total Functional Expenses | $2,130,255 | $143,487 | $0 | $2,273,742 |
Audited Expense Reconciliation
| Line Item | Amount |
|---|---|
| Total Expenses per Audited Statements | $2,363,742 |
| Expenses per Audited Statements | $2,273,742 |
| Total Expenses per Form 990 | $2,273,742 |
| Expenses Not Reported on Form 990 | $90,000 |
| Expenses Not Reported on Financial Statements | $0 |
Fundraising, Events, and Gaming
- Fundraising activities
- No
- Gaming activities
- No
- Professional fundraiser used
- No
Fundraising and Gaming Totals
| Line Item | Amount |
|---|---|
| Professional Fundraising Fees | $0 |
Political and Lobbying Activity
- Political campaign activity
- No
- Lobbying activity
- No
- Subject to proxy tax
- No
Insider Transactions and Loans
Interested-Person Transactions
| Interested Party | Relationship | Description | Shared Revenue | Amount |
|---|---|---|---|---|
| - | See Part V | Consulting services to PSMF | No | $51,440 |
Governance and Compliance
Governance Checklist
- Compiled or reviewed by an accountant
- No
- Annual disclosure for covered persons
- Yes
- Audit committee
- Yes
- Backup withholding compliance
- Yes
- Business relationship with family members
- No
- Business relationship with organization members
- No
- Material changes to governing documents
- No
- Compensation from other sources disclosed
- No
- CEO compensation reviewed
- No
- Other officer compensation reviewed
- No
- Conflict-of-interest policy
- Yes
- Audited financial statements prepared
- No
- Key decisions subject to board approval
- No
- Management duties delegated
- No
Governance Explanations
Form 990, Part VI, Section A, line 2
“Director Joe Kiani is an officer and director of Masimo Corporation and secretary & Treasurer Mark De Raad is an officer of Masimo Corporation.”
Form 990, Part VI, Section A, line 5
“During July 2016, PSMF discovered that one of its volunteers had created a separate company and convinced PSMF to engage such company to perform website search engine optimization (SEO) services under his direction. The volunteer failed to disclose this conflict of interest, and upon further investigation, it was later determined that such SEO services may never have been performed. The total potential amount of this fraud is currently estimated at $184,720. PSMF is currently pursuing potential recovery of such amounts from its insurance carrier, subject to applicable deductibles. In response to this potential fraud, PSMF is also reviewing its internal controls over the approval and engagement of service providers, including the vetting process for "new vendors".”
Form 990, Part VI, Section B, line 11
“Form 990 was reviewed by PSMF management and representatives, including its Vice President, Secretary & treasurer, and outside accounting/administrative service provider, as well as the members of its board of directors.”
Form 990, Part VI, Section B, line 12C
“On an annual basis, all board members and officers are required to sign a conflict of interest policy statment stating they have read the conflict of interest policy and have disclosed all known conflicts.”
Form 990, Part VI, Section B, line 15
“The compensation for Jim Bialick was based on negotiations between him and the board chair prior to him becoming the president and joining the board. During the year, a compensation committee was formed. They will have significant responsibilites in detemining the next president's compensation. Part VI, question 15(b) was answered no as there are no other officers or key employees (as defined in Form 990 instructions) who received compensation during the year.”
Form 990, Part VI, Section C, line 19
“PSMF governing documents, conflict of interest policies, and audited financial statements are available upon request.”
Form 990, Part VII, Section A, line 1(A):
“JIM BIALICK WAS PRESIDENT OF PSMF UNTIL FEBRUARY 5, 2016. HE REMAINED AS A DIRECTOR AFTER SUCH TIME. From the time he served only as a director, HE AVERAGED 1 HOUR A WEEK.”
Filing and Contact Details
Filer
- Filer Name
- Patient Safety Movement Foundation
- EIN
- 46-2730379
- Phone
- 9492977792
- Address
- 52 DISCOVERY, IRVINE, CA 92618
Signing Officer
- Name
- Mark P De Raad
- Title
- Secretary and Treasurer
- Phone
- 9492977792
- Signed
- 2017-01-09
- Discuss with paid preparer
- Yes
Organization Details
- Principal Officer
- Joe Kiani
- Formed
- 2013
- Legal Domicile
- De
- Voting Board Members
- 8
- Independent Board Members
- 6
- Employees
- 2
- Volunteers
- 25
Preparer
- Firm
- Michael Berry CPa
- Address
- PO Box 5045, Culver City, CA 90230
- Preparer
- Michael Berry
- Phone
- 3107454027
Supplemental Narrative
Additional Explanations
Form 990, Part V, Line 2(A):
“All payroll and related employer costs for PSMF's employees are processed through a third party professional employer organization (PEO) and paid/reimbursed by PSMF.”
Financial Statement Notes
Part X, Line 2:
“THE FOUNDATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC") EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. THE FOUNDATION IS RECOGNIZED BY THE FRANCHISE TAX BOARD AS HAVING TAX EXEMPT STATUS UNDER SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE. THE FOUNDATION HAD NO UNRECOGNIZED TAX BENEFITS OR LIABILITIES AS OF MARCH 31, 2016 AND 2015. THE FOUNDATION FILES AN EXEMPT ORGANIZATION RETURN IN THE UNITED STATES FEDERAL JURISDICTION AND WITH THE FRANCHISE TAX BOARD IN THE STATE OF CALIFORNIA. ALL TAX FILINGS ARE SUBJECT TO TAX EXAMINATIONS BY TAXING AUTHORITIES. FOR PURPOSES OF THE above TAX PROVISION FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS, PATIENT SAFETY MOVEMENT FOUNDATION (PSMF) IS REFERRED TO AS "THE FOUNDATION."”
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| IRS990/Desc | 0 | Annual ConferenceDescription: Building on last year's success, PSMF hosted the 4th annual World Patient Safety, Science & Technology Summit which generated new hospital commitments, healthcare technology pledges and solutions to help reduce preventable patient deaths in U.S. hospitals by 2020. The January 2016 Summit featured keynote addresses from leading political figures, plenary sessions with healthcare luminaries, as well as announcements from organizations making their own commitments to ZERO preventable deaths by 2020. (continue, Sch O) Accomplishments: More than 1,600 hospitals and healthcare organizations publicly committed to implement safety solutions that will save lives. These commitments represent efforts that will save around 25,000 lives in 2016. Nearly 50 healthcare technology companies signed the Open Data Pledge stating that they would not proactively block connections from other technologies or charge for information exchange with the purpose of allowing access to their products' output data for the improvement of patient safety. This year's attendees discussed two new actionable patient safety solutions (APSS) addressing: -Airway Safety-Optimizing Obstetric SafetyThese APSS are available for viewing and download: http://patientsafetymovement.org/apss/ |
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| IRS990/MissionDesc | 0 | The Patient Safety Movement is connecting people, ideas and technology to confront the large scale problem of more than 200,000 preventable patient deaths in U.S. hospitals and 3,000,000 worldwide, each year by providing actionable ideas and innovations that can transform the process of care, dramatically improve patient safety and help eliminate patient preventable deaths. We are doing this one solution, one commitment, one hospital, one act of kindness and love, and one patient at a time. The PSMF is helping to break down silos that exist between hospitals, healthcare technology companies, patient advocates, patients, the government and all the stakeholders affected in healthcare - all of us. Together we are pushing towards zero preventable deaths by 2020. |
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| IRS990/PrepaidExpensesDefrdChargesGrp/EOYAmt | 0 | 26980 |
| IRS990/PrincipalOfficerNm | 0 | Joe Kiani |
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| IRS990/ProgSrvcAccomActy2Grp/Desc | 0 | Other Program ActivitiesPSMF continued its thought leadership activities through earned media placement in key markets, social media activity, and speaking engagements before leading hospitals and organizations throughout the U.S., with the goal of soliciting more commitments to action.PSMF also produced three short-form documentaries highlighting preventable medical errors and how they impact patients and families as well as one documentary highlighting how a hospital can implement solutions to ensure that previous tragedies do not happen again. These documentaries are freely available at: patientsafetymovement.org/patient-storiesThe PSMF has organized and activated 15 workgroups that are focused on the update and revision of all Actionable Patient Safety Solutions as well as the creation or assignment of metrics to authoritatively quantify how commitments are saving lives through the reduction of preventable deaths. These multidisciplinary workgroups are made up of relevant subject matter experts and key opinion leaders on the PSMF steering committee as well as industry leaders and patient advocates. The workgroups are designed to ensure that the PSMF APSS remain clinically valid and the workgroups will function in perpetuity. |
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| IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt | 0 | THE ORGANIZATION'S INItial YEAR FOR THE YEAR ENDING MARCH 31, 2014 WAS A SHORT YEAR. |
| IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc | 0 | Sch A, part II |
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| IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt | 0 | THE FOUNDATION IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC") EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. THE FOUNDATION IS RECOGNIZED BY THE FRANCHISE TAX BOARD AS HAVING TAX EXEMPT STATUS UNDER SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE. THE FOUNDATION HAD NO UNRECOGNIZED TAX BENEFITS OR LIABILITIES AS OF MARCH 31, 2016 AND 2015. THE FOUNDATION FILES AN EXEMPT ORGANIZATION RETURN IN THE UNITED STATES FEDERAL JURISDICTION AND WITH THE FRANCHISE TAX BOARD IN THE STATE OF CALIFORNIA. ALL TAX FILINGS ARE SUBJECT TO TAX EXAMINATIONS BY TAXING AUTHORITIES. FOR PURPOSES OF THE above TAX PROVISION FOOTNOTE IN THE AUDITED FINANCIAL STATEMENTS, PATIENT SAFETY MOVEMENT FOUNDATION (PSMF) IS REFERRED TO AS "THE FOUNDATION." |
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| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm | 0 | Jim Bialick - See Sch O |
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| IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/RelationshipDescriptionTxt | 0 | See Part V |
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| IRS990ScheduleL/BusTrInvolveInterestedPrsnGrp/TransactionDesc | 0 | Consulting services to PSMF |
| IRS990ScheduleL/SupplementalInformationDetail/ExplanationTxt | 0 | PRIOR TO JIM MESSINA BECOMING A DIRECTOR OF PSMF IN JULY 2015, THE MESSINA GROUP, INC., OF WHICH JIM MESSINA IS THE PRESIDENT, PROVIDED CONSULTING SERVICES TO PSMF. NO SUCH SERVICES WERE PROVIDED TO PSMF BY THE MESSINA GROUP AFTER HE JOINED THE PSMF BOARD OF DIRECTORS. |
| IRS990ScheduleL/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | Part IV |
| IRS990/ScheduleORequiredInd | 0 | 1 |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 0 | All payroll and related employer costs for PSMF's employees are processed through a third party professional employer organization (PEO) and paid/reimbursed by PSMF. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 1 | Director Joe Kiani is an officer and director of Masimo Corporation and secretary & Treasurer Mark De Raad is an officer of Masimo Corporation. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 2 | During July 2016, PSMF discovered that one of its volunteers had created a separate company and convinced PSMF to engage such company to perform website search engine optimization (SEO) services under his direction. The volunteer failed to disclose this conflict of interest, and upon further investigation, it was later determined that such SEO services may never have been performed. The total potential amount of this fraud is currently estimated at $184,720. PSMF is currently pursuing potential recovery of such amounts from its insurance carrier, subject to applicable deductibles. In response to this potential fraud, PSMF is also reviewing its internal controls over the approval and engagement of service providers, including the vetting process for "new vendors". |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 3 | Form 990 was reviewed by PSMF management and representatives, including its Vice President, Secretary & treasurer, and outside accounting/administrative service provider, as well as the members of its board of directors. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 4 | On an annual basis, all board members and officers are required to sign a conflict of interest policy statment stating they have read the conflict of interest policy and have disclosed all known conflicts. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 5 | The compensation for Jim Bialick was based on negotiations between him and the board chair prior to him becoming the president and joining the board. During the year, a compensation committee was formed. They will have significant responsibilites in detemining the next president's compensation. Part VI, question 15(b) was answered no as there are no other officers or key employees (as defined in Form 990 instructions) who received compensation during the year. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 6 | PSMF governing documents, conflict of interest policies, and audited financial statements are available upon request. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 7 | JIM BIALICK WAS PRESIDENT OF PSMF UNTIL FEBRUARY 5, 2016. HE REMAINED AS A DIRECTOR AFTER SUCH TIME. From the time he served only as a director, HE AVERAGED 1 HOUR A WEEK. |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | Form 990, Part V, Line 2(a): |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | Form 990, Part VI, Section A, line 2 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 2 | Form 990, Part VI, Section A, line 5 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 3 | Form 990, Part VI, Section B, line 11 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 4 | Form 990, Part VI, Section B, line 12c |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 5 | Form 990, Part VI, Section B, line 15 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 6 | Form 990, Part VI, Section C, line 19 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 7 | Form 990, Part VII, Section A, line 1(a): |
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| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingNACd | 1 | N/A |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt | 0 | THE MASIMO FOUNDATION FOR ETHICS INNOVATION AND COMPETition IN HEALTHCARE |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt | 1 | Patient Safety movement coalition incorporated |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN | 0 | 010956020 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN | 1 | 463194443 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt | 0 | 501(c)(3) |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt | 1 | 501(c)(4) |
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| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd | 1 | DE |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt | 0 | Grant making |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt | 1 | Advocacy |
Document Assets
No mirrored PDF or thumbnail assets are attached yet.
Filings
Displayed year
2016 • Form 990Detailed filing. Detailed filing data is available for this year.
- Assets
- $941,533
- Liabilities
- $211,607
- Net assets
- $729,926
- Revenue
- $3,206,765
- Expenses
- $2,273,742
- Net income
- $933,023