2024-02-09T10:44:31-06:00 2023-06-30 454084437 WARREN AVERETT LLC 2500 ACTON ROAD BIRMINGHAM AL 35243 990 2022-07-01 237313346 UNIVERSITY MEDICAL SERVICE ASSOCIATION INC UNIV 8139742120 12901 BRUCE B DOWNS BLVD FA MDC6 TAMPA FL 336124742 STEVE OMLI CFO, USF HEALTH 8139742196 2024-02-08 1 STEVE OMLI 0 MEGAN RANDOLPH P00989558 2059794100 2024-02-08 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z STEVE OMLI 12901 BRUCE B DOWNS BLVD FA MDC62 TAMPA FL 336124742 370177489 0 X N/A X 1973 FL SUPPORT THE UNIVERSITY OF SOUTH FLORIDA'S COLLEGE OF MEDICINE IN RESEARCH AND EDUCATION. 13 1 892 0 0 0 116803519 113084736 230587323 232599345 3316857 1263917 19268210 23185639 369975909 370133637 231297577 267999637 0 0 86230643 85942886 0 0 0 20464999 21334011 337993219 375276534 31982690 -5142897 237672384 218757009 137566595 118619696 100105789 100137313 UNIVERSITY MEDICAL SERVICE ASSOCIAITON, INC., SUPPORTS THE UNIVERSITY OF SOUTH FLORIDA'S COLLEGE OF MEDICINE IN RESEARCH AND EDUCATION. 0 0 267999637 267999637 255784984 DURING ITS FISCAL YEAR ENDED JUNE 30, 2023, UNIVERSITY MEDICAL SERVICE ASSOCIAITON, INC., ("UMSA", "THE ORGANIZATION") CONTINUED ITS SUPPORT OF THE UNIVERSITY OF SOUTH FLORIDA'S ("USF") COLLEGE OF MEDICINE BY PROVIDING FUNDS TO SUPPORT MEDICAL EDUCATION AND RESEARCH. DISBURSEMENTS WERE MADE ON BEHALF OF THE COLLEGE OF MEDICINE'S CLINICAL DEPARTMENTS FOR SUPPORT OF THEIR FACULTY AND CLINICAL SUPPORT STAFF. 267999637 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 25 0 1 892 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X X MELODY MACZKO 8139749040 12901 BRUCE B DOWNS BLVD TAMPA FL 33612 CHARLES LOCKWOOD MD BOARD CHAIR 1.00 40.00 X 0 1596962 72748 HARRY VAN LOVEREN MD DIRECTOR 1.00 40.00 X 0 1147147 59292 STEPHEN LIGGETT MD DIRECTOR 1.00 40.00 X 0 879912 58959 TAPAN PADHYA MD DIRECTOR 1.00 40.00 X 0 695856 56327 RAMESH AYYALA MD DIRECTOR 1.00 40.00 X 0 694686 62623 JAMES GRICHNIK DIRECTOR 1.00 40.00 X 0 676991 52199 JOHN T SINNOTT MD DIRECTOR 1.00 40.00 X 0 643328 70880 RICHARD SOBIERAY DIRECTOR 1.00 40.00 X 0 642974 38139 PATRICIA EMMANUEL DIRECTOR 1.00 40.00 X 0 496646 53827 ERIC CORIS MD DIRECTOR 1.00 40.00 X 0 398935 47799 KEVIN SNEED PHARMD DIRECTOR 1.00 40.00 X 0 328515 34287 UDAY MURTHY DIRECTOR 1.00 40.00 X 0 292924 33670 NISHIT S PATEL MD CHIEF MEDICAL INFORMATION 10.00 40.00 X 0 535190 54994 TERRI ASHMEADE MD CHIEF QUALITY OFFICER 10.00 40.00 X 0 445766 52108 ALISHA OZMERAL CFO, ASSOC EXECUTIVE DIR 40.00 0.00 X 0 282186 13137 RENEE DUBAULT CEO, ASSOC EXECUTIVE DIRECTOR 40.00 0.00 X 0 259427 22005 MARK MOSELEY MD CHIEF CLINICAL OFFICER, US 10.00 40.00 X 0 249596 30987 PUYA ALIKHANI MD PHYSICIAN 10.00 40.00 X 0 1877596 55405 MICHAEL A CAMPANELLI MD PHYSICIAN 10.00 40.00 X 0 1374380 50347 DARWIN N ANG MD PHYSICIAN 10.00 40.00 X 0 978445 57190 JAYSON A SACK MD PHYSICIAN 10.00 40.00 X 0 844208 43918 HAL MULLIS DIRECTOR 1.00 0.00 X 0 0 0 0 15341670 1020841 0 0 1 0 FLORIDA ORTHOPAEDIC 13020 N TELECOM PKWY TEMPLE TERRACE FL 336370925 PROFESSIONAL MEDICAL SERVICES 1104692 MANHATTAN CONSTRUCTION COMPANY 5405 CYPRESS CENTER DR STE 200 TAMPA FL 33609 CONSTRUCTION SERVICES 947281 PINNACLE HEALTH GROUP PO BOX 467902 ATLANTA GA 311467902 RECRUITMENT SERVICES 817843 FRIEDRICH WATKINS OF TAMPA LLC 5521 W CYPRESS ST STE 104 TAMPA FL 33607 CONSTRUCTION SERVICES 554683 JETT MEDICAL STAFFING LLC 22 PEPPER BUSH CIR SAVANNAH GA 31411 MEDICAL STAFFING SERVICES 546273 11 1589247 111439489 56000 113084736 PATIENT SERVICE REVENUE 621110 232599345 232599345 232599345 1307769 1307769 43852 -43852 -43852 -43852 OTHER OPERATING REVENUES 621110 23185639 23185639 23185639 370133637 255784984 0 1263917 267999637 267999637 78786491 78786491 7156395 7156395 413652 413652 436810 436810 760680 760680 1096119 1096119 5225373 5225373 266627 266627 2588567 2588567 7113854 7113854 383085 383085 DATA PROCESSING SERVICE 3049244 3049244 375276534 267999637 107276897 0 27197700 21735747 7444339 8485896 13180707 17141582 96574892 70088441 1175183 1130339 3526007 2717794 118129217 48603261 63750591 69525956 23759325 26054173 1063640 1877081 237672384 218757009 66580039 55319293 3730849 475046 67255707 62825357 137566595 118619696 X 100105789 100137313 100105789 100137313 237672384 218757009 -5142897 1818801 3355620 0 X X 0 1 X 1 0 X 76144324 79757487 101007817 116803519 113084736 486797883 76144324 79757487 101007817 116803519 113084736 486797883 486797883 422099 1067894 534405 829635 1307769 4161802 13777645 21025497 15645763 19268210 23185639 92902754 583862439 1110467350 0.83380 0.82750 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 84278364 29492077 54786287 7719130 4163794 3555336 11485576 8770310 2715266 14646147 6177080 8469067 69525956 FINANCING OBLIGATIONS - USF FIN CORP 40750000 CAPITAL LEASES PAYABLE 456667 ACCRUED RENT 27334 DEFERRED LEASE RECEIVABLE 20872645 DEFERRED COMPENSATION 718711 62825357 X 359087263 1818801 1818801 357268462 12865175 12865175 370133637 362411359 0 362411359 12865175 12865175 375276534 PART X, LINE 2: THE ASSOCIATION PERIODICALLY ASSESSES WHETHER IT HAS INCURRED INCOME TAX EXPENSE OR RELATED INTEREST OR PENALTIES, WHICH ARE RECOGNIZED IN INCOME TAX EXPENSE IN ACCORDANCE WITH ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ASSOCIATION DID NOT IDENTIFY ANY UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2023. PART XI, LINE 4B - OTHER ADJUSTMENTS INTEREST EXPENSE AND OTHER NON OPERATING EXPENSE SHOWN AS OFFSET TO REVENUE ON AUDITED FINANCIAL STATEMENTS. PART XII, LINE 4B - OTHER ADJUSTMENTS INTEREST EXPENSE AND OTHER NON OPERATING EXPENSE SHOWN AS OFFSET TO REVENUE ON AUDITED FINANCIAL STATEMENTS. FORM 990, PART XI, LINE 8 THE ASSOCIATION HAS RESTATED ITS NET POSITION AS OF JULY 1, 2022, TO REFLECT THE CORRECTION OF AN ERROR RELATED TO THE ACCOUNTING FOR A CONTRACT WITH THE UNIVERSITY OF SOUTH FLORIDA (USF). IT WAS DETERMINED THAT PREVIOUSLY RECORDED REVENUES RELATED TO THE CONTRACT WERE UNDERSTATED BY APPROXIMATELY $9,568,000 AND RELATED EXPENSES WERE UNDERSTATED BY APPROXIMATELY $6,212,000 RESULTING IN AN INCREASE TO NET POSITION AS OF JULY 1, 2022, OF APPROXIMATELY $3,356,000. THE AMOUNT RECORDED AS DUE TO USF AND INCLUDED IN ACCOUNTS PAYABLE ON THE COMBINED STATEMENT OF NET POSITION AS OF JUNE 30, 2022, WAS OVERSTATED BY APPROXIMATELY $3,356,000. 1 USF COLLEGE OF MEDICINE 12910 BRUCE B DOWNS BLVD FA MDC62 TAMPA FL 33612 510526334 267999637 0 N/A N/A SALARIES & OPERATING EXPENSES 0 1 PART I, LINE 2: PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS ALL EXPENDITURES ARE PAID BY THIS ORGANIZATION WITH DOCUMENTATION FOR EXPENSES ALONG WITH AN INVOICE. 0 0 0 0 0 0 0 0 0 CHARLES LOCKWOOD MD BOARD CHAIR 0 1596962 0 0 0 0 0 37437 0 35311 0 1669710 0 0 HARRY VAN LOVEREN MD DIRECTOR 0 1147147 0 0 0 0 0 30104 0 29188 0 1206439 0 0 STEPHEN LIGGETT MD DIRECTOR 0 879912 0 0 0 0 0 29776 0 29183 0 938871 0 0 TAPAN PADHYA MD DIRECTOR 0 695856 0 0 0 0 0 29500 0 26827 0 752183 0 0 RAMESH AYYALA MD DIRECTOR 0 694686 0 0 0 0 0 28519 0 34104 0 757309 0 0 JAMES GRICHNIK DIRECTOR 0 676991 0 0 0 0 0 28519 0 23680 0 729190 0 0 JOHN T SINNOTT MD DIRECTOR 0 643328 0 0 0 0 0 42978 0 27902 0 714208 0 0 RICHARD SOBIERAY DIRECTOR 0 642974 0 0 0 0 0 16954 0 21185 0 681113 0 0 PATRICIA EMMANUEL DIRECTOR 0 496646 0 0 0 0 0 26521 0 27306 0 550473 0 0 ERIC CORIS MD DIRECTOR 0 398935 0 0 0 0 0 22276 0 25523 0 446734 0 0 KEVIN SNEED PHARMD DIRECTOR 0 328515 0 0 0 0 0 14431 0 19856 0 362802 0 0 UDAY MURTHY DIRECTOR 0 292924 0 0 0 0 0 13814 0 19856 0 326594 0 0 NISHIT S PATEL MD CHIEF MEDICAL INFORMATION 0 535190 0 0 0 0 0 27818 0 27176 0 590184 0 0 TERRI ASHMEADE MD CHIEF QUALITY OFFICER 0 445766 0 0 0 0 0 25861 0 26247 0 497874 0 0 ALISHA OZMERAL CFO, ASSOC EXECUTIVE DIR 0 282186 0 0 0 0 0 13094 0 43 0 295323 0 0 RENEE DUBAULT CEO, ASSOC EXECUTIVE DIRECTOR 0 259427 0 0 0 0 0 12037 0 9968 0 281432 0 0 MARK MOSELEY MD CHIEF CLINICAL OFFICER, US 0 249596 0 0 0 0 0 13515 0 17472 0 280583 0 0 PUYA ALIKHANI MD PHYSICIAN 0 1877596 0 0 0 0 0 26794 0 28611 0 1933001 0 0 MICHAEL A CAMPANELLI MD PHYSICIAN 0 1374380 0 0 0 0 0 26266 0 24081 0 1424727 0 0 DARWIN N ANG MD PHYSICIAN 0 978445 0 0 0 0 0 27555 0 29635 0 1035635 0 0 JAYSON A SACK MD PHYSICIAN 0 844208 0 0 0 0 0 25666 0 18252 0 888126 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S AUDIT COMMITTEE SERVES AS A SUB-COMMITTEE OF THE BOARD OF DIRECTORS FOR THE PURPOSES OF REVIEWING THE ORGANIZATION'S FORM 990. THE 990 IS DISTRIBUTED TO THE AUDIT COMMITTEE AND BOARD OF DIRECTORS PRIOR TO FILING THE FORM WITH THE IRS. THE AUDIT COMMITTEE IS ALSO BRIEFED ON THE FORM 990 BY THE CFO OF USF HEALTH AND THE CFO OF USF HEALTH PHYSCIANS GROUP. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS, THE ORGANIZATION DISTRIBUTES ITS CONFLICT OF INTEREST POLICY TO ITS BOARD OF DIRECTORS. EACH BOARD MEMBER IS REQUIRED TO SIGN AN ACKNOWLEDGEMENT WHICH STATES THAT HE/SHE HAS RECEIVED, READ, UNDERSTANDS AND AGREES TO COMPLY WITH THE POLICY. THAT ACKNOWLEDGEMENT IS KEPT ON FILE IN THE EXECUTIVE DIRECTOR'S OFFICE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PROVIDES COPIES OF FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS TO MEMBERS OF THE GENERAL PUBLIC UPON RECEIPT OF A WRITTEN REQUEST. FORM 990, PART XII, LINE 2C THE AUDIT COMMITTEE OF UNIVERSITY MEDICAL SERVICE ASSOCIATION, INC. IS RESPONSIBLE FOR THE SELECTION OF THE ORGANIZATION'S INDEPENDENT AUDITORS. THE AUDIT COMMITTEE MAINTAINS COMMUNICATION WITH THE INDEPENDENT AUDITORS, AS NECESSARY, DURING THE AUDIT AND IS RESPONSIBLE FOR REVIEWING AND APPROVING THE AUDITED FINANCIAL STATEMENTS. UNIVERSITY OF SOUTH FLORIDA 4202 E FOWLER AVE TAMPA FL 33620 593102112 EDUCATION FL 170B LINE 2 N/A 0 USF COLLEGE OF MEDICINE ASF 12901 BRUCE B DOWNS BLVD FA MDC62 TAMPA FL 33612 510526334 PAYROLL FL 501(C)(3) LINE 5 USF 0 USF MEDICAL SERVICES SUPPORT CORP 12901 BRUCE B DOWNS BLVD FA MDC62 TAMPA FL 33612 592944683 EDUCATION FL 501(C)(3) LINE 5 USF 0 USF HEALTH SERVICES SUPPORT ORG 12901 BRUCE B DOWNS BLVD FA MDC62 TAMPA FL 33612 593431802 EDUCATION FL 501(C)(3) LINE 5 USF 0 USF HEALTH PROF CONFERENCING CORP 124 S FRANKLIN STREET TAMPA FL 33602 161765073 HR SERVICE FL 501(C)(3) LINE 5 USF 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 1 1 0 0 UNIVERSITY OF SOUTH FLORIDA P 104778391 FMV - CASH UNIVERSITY OF SOUTH FLORIDA Q 22493346 FMV - CASH USF COLLEGE OF MEDICINE ASF J 257603 FMV - CASH USF HEALTH PROF CONFERENCING CORP P 154778890 FMV - CASH USF COLLEGE OF MEDICINE ASF P 1005735 FMV - CASH USF COLLEGE OF MEDICINE ASF Q 1589247 FMV - CASH USF FINANCING CORP K 4481543 FMV - CASH