2020-10-23T15:37:06-05:00 2018-06-30 ERNST & YOUNG US LLP 2005 MARKET STREET SUITE 700 PHILADELPHIA PA 19103 990 2017-07-01 461787308 SB CLINICAL PRACTICE MANAGEMENT PLAN INC % SB CLINICAL PRAC MGMT PLAN I SBCL 6314442055 PO BOX 1554 STONY BROOK NY 11790 TODD GRIFFIN MD PRESIDENT & DIRECTOR 6314442055 2020-10-22 true JAMES L ZIESCHE P01264584 2154485336 173.68.23.158 26308520191335000076 2019-05-13 P 770194AAF055F9EA87E64CA02E08FE540289067F 047C777BBD395ADD529156C75D94AFF56594489C 2017 2021-01-29 14:40:06Z X Todd Griffin MD PO BOX 1554 STONY BROOK NY 11790 219290072 false X N/A X 2013 NY RESPONSIBLE FOR THE COLLECTION AND DISBURSEMENT OF MEMBERS' CLINICAL PRACTICE INCOME. 18 0 0 0 0 0 0 0 206789111 219204716 205997 50358 0 0 206995108 219255074 0 0 0 0 91531120 97960133 0 0 0 103062160 114394510 194593280 212354643 12401828 6900431 108459479 115620845 108459479 115620845 0 0 A CLINICAL PRACTICE MANAGEMENT PLAN FOR THE MANAGEMENT OF THE CLINICAL PRACTICE OF FACULTY MEMBERS AT THE MEDICAL SCHOOL AT THE STATE UNIVERSITY OF NEW YORK AT STONY BROOK. false false 207456636 219204716 COLLECTION AND DISBURSEMENT OF MEMBERS' CLINICAL PRACTICE INCOME. 207456636 true false false false false false false false false false true false false true true false false true false false true false false false false false false false false true false false false false false false false false false false false false false true true true false false true 3 0 true 0 false true CJ false false false false false false false false X 18 0 false false false false false false false true true false false true true true true true true false false false NY X SB CLINICAL PRAC MGMT PLAN I 6314442055 PO BOX 1554 STONY BROOK NY 11790 MARGARET M MCGOVERN MD PHD CHAIRPERSON (TERM 5/1/2018) 0.0 50.0 X X 0 857692 102340 KENNETH R SHROYER MD PHD VICE CHAIRPERSON 0.0 50.0 X X 0 532785 65539 RAPHAEL DAVIS MD SECRETARY 0.0 50.0 X X 0 1366173 82432 MARK TALAMINI MD CHAIRPERSON 0.0 50.0 X X 0 915909 50570 CARLOS DE LOS SANTOS DIRECTOR 0.0 50.0 X 0 113859 45769 EVAN JONES MD-MPH DIRECTOR 0.0 50.0 X 0 1084049 69329 MARK C HENRY MD DIRECTOR 0.0 50.0 X 0 639901 88173 VINCENT W YANG MD PHD DIRECTOR 0.0 50.0 X 0 620269 54889 DENNIS CHOI MD PHD DIRECTOR 0.0 50.0 X 0 519184 41585 TODD GRIFFIN MD DIRECTOR 0.0 50.0 X 0 624132 75091 PATRICK SIBONY MD DIRECTOR(TERM 03/01/18) 0.0 50.0 X 0 559127 79192 WESLEY CARRION MD DIRECTOR 0.0 50.0 X 0 343070 46086 IRIS A GRANEK MD DIRECTOR 0.0 50.0 X 0 313524 46174 RAMIN V PARSEY MD PHD DIRECTOR 0.0 50.0 X 0 706443 44410 MARK E SCHWEITZER MD DIRECTOR 0.0 50.0 X 0 754364 41038 WAYNE WALTZER MD DIRECTOR 0.0 50.0 X 0 807830 79711 TONG J GAN DIRECTOR 0.0 50.0 X 0 885464 48840 SAMUEL RYU DIRECTOR 0.0 50.0 X 0 743752 83573 CAROLYN MILANA MD DIRECTOR 0.0 50.0 X 0 331035 53049 ROBERT HONKANEN MD DIRECTOR 0.0 50.0 X 0 732342 65011 JEFFREY TRILLING MD FMR DIRECTOR (TERM 12/12/16) 0.0 50.0 X 0 239379 49997 0 13690283 1312798 0 true true false J BOISEN CONSULTING LLC 12223 HERSHEY BEACH GALVESTON TX 77554 CONSULTING SERVICES 258512 1 0 MANAGEMENT FEES 900099 219204716 219204716 219204716 23922 23922 0 0 0 0 0 61434 34998 26436 26436 26436 0 0 0 0 0 0 0 0 0 0 219255074 219204716 50358 0 0 0 0 0 0 71649142 68066685 3582457 0 26310991 24995441 1315550 0 0 664451 664451 131905 131905 0 0 10611 10611 38136883 38136883 434664 434664 4211482 4211482 4921906 4921906 0 11494063 11494063 1983596 1983596 0 0 715562 715562 0 4324052 4324052 25440303 25440303 MEDICAL EXPENSES 12741928 12741928 CLINICAL PRACTICE RESEARCH 5257807 5257807 DUES AND LICENSE FEES 2163943 2163943 REPAIRS AND MAINTENANCE 1761354 1761354 212354643 207456636 4898007 0 8363661 7185157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2189384 2346474 53367097 21450854 32889957 31916243 4343833 4349450 0 0 0 0 0 0 60672644 69823521 108459479 115620845 2708165 3917182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105751314 111703663 108459479 115620845 X 0 0 0 0 0 0 0 0 108459479 115620845 X 6900431 -10207 -6890224 X false true X true X 0 0 0 0 0 0 158851365 173045014 173384254 206789111 219204716 931274460 0 0 0 158851365 173045014 173384254 206789111 219204716 931274460 0 117138586 131722944 160637642 152787116 172515704 734801992 117138586 131722944 160637642 152787116 172515704 734801992 196472468 148186 135359 130485 166416 23922 604368 0 148186 135359 130485 166416 23922 604368 0 0 158999551 173180373 173514739 206955527 219228638 931878828 X 0.00000 31240295 5596576 25643720 11380981 7412560 3968422 10745820 8441719 2304101 31916243 ADVANCES TO UFPCS 64056250 ADVANCES - HOSPITAL 1267271 ADVANCES - NICOLLS INDEMNITY 4500000 69823521 0 CLINICAL PRACTICE RESERVE 94352616 CAPITAL LEASE 17351047 111703663 X Central America and the Caribbean Investments 4500000 4500000 4500000 true false true false false false X false false false false false false false false false MARGARET M MCGOVERN MD PHD CHAIRPERSON (TERM 5/1/2018) 0 713897 0 140082 0 3713 0 72705 0 29635 0 960032 0 0 KENNETH R SHROYER MD PHD VICE CHAIRPERSON 0 516750 0 12935 0 3100 0 50934 0 14605 0 598324 0 0 RAPHAEL DAVIS MD SECRETARY 0 1250375 0 112698 0 3100 0 66578 0 15854 0 1448605 0 0 MARK TALAMINI MD CHAIRPERSON 0 912809 0 0 0 3100 0 37800 0 12770 0 966479 0 0 CARLOS DE LOS SANTOS DIRECTOR 0 113859 0 0 0 0 0 24000 0 21769 0 159628 0 0 EVAN JONES MD-MPH DIRECTOR 0 604107 0 476842 0 3100 0 55327 0 14002 0 1153378 0 0 MARK C HENRY MD DIRECTOR 0 534776 0 102025 0 3100 0 69883 0 18290 0 728074 0 0 JEFFREY TRILLING MD FMR DIRECTOR (TERM 12/12/16) 0 235730 0 3649 0 0 0 35295 0 14702 0 289376 0 0 VINCENT W YANG MD PHD DIRECTOR 0 616038 0 1131 0 3100 0 42022 0 12867 0 675158 0 0 DENNIS CHOI MD PHD DIRECTOR 0 516084 0 0 0 3100 0 28410 0 13175 0 560769 0 0 TODD GRIFFIN MD DIRECTOR 0 543932 0 77100 0 3100 0 64104 0 10987 0 699223 0 0 PATRICK SIBONY MD DIRECTOR(TERM 03/01/18) 0 556027 0 0 0 3100 0 64052 0 15140 0 638319 0 0 WESLEY CARRION MD DIRECTOR 0 297970 0 42000 0 3100 0 30074 0 16012 0 389156 0 0 IRIS A GRANEK MD DIRECTOR 0 310614 0 0 0 2910 0 35047 0 11127 0 359698 0 0 RAMIN V PARSEY MD PHD DIRECTOR 0 703343 0 0 0 3100 0 31800 0 12610 0 750853 0 0 MARK E SCHWEITZER MD DIRECTOR 0 726264 0 25000 0 3100 0 27823 0 13215 0 795402 0 0 WAYNE WALTZER MD DIRECTOR 0 716995 0 87735 0 3100 0 64726 0 14985 0 887541 0 0 TONG J GAN DIRECTOR 0 648553 0 233811 0 3100 0 37030 0 11810 0 934304 0 0 SAMUEL RYU DIRECTOR 0 665652 0 75000 0 3100 0 68761 0 14812 0 827325 0 0 CAROLYN MILANA MD DIRECTOR 0 294366 0 33650 0 3019 0 40640 0 12409 0 384084 0 0 ROBERT HONKANEN MD DIRECTOR 0 602500 0 126742 0 3100 0 50026 0 14985 0 797353 0 0 FORM 990, PART VI, QUESTION 11B AN ELECTRONIC VERSION OF FORM 990 WAS PROVIDED TO THE OFFICERS AND DIRECTORS PRIOR TO FILING. MANAGEMENT PERFORMS A REVIEW OF FORM 990 PRIOR TO FILING, ADDRESSING ANY QUESTIONS MADE BY THE GOVERNING BODY. FORM 990, PART VI, QUESTION 12C SB CLINICAL PRACTICE MANAGEMENT PLAN, INC. HAS ADOPTED THE SAME CONFLICT OF INTEREST POLICY AS ITS MEMBER UFPCS. THE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT SB CLINICAL PRACTICE MANAGEMENT PLAN, INC.'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE ORGANIZATION OR MIGHT RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OF COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. COMPLIANCE WITH THIS POLICY IS MONITORED THROUGH INTERNAL PAYMENT POLICIES AND ANNUAL REPRESENTATIONS. THE REVIEWS, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: A. WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. B. WHETHER PARTNERSHIPS, JOINT VENTURES, AND ARRANGEMENTS WITH MANAGEMENT ORGANIZATIONS CONFORM TO THE ORGANIZATION'S WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE INVESTMENT OR PAYMENT FOR GOODS AND SERVICES, FURTHER EDUCATIONAL PURPOSES AND DO NOT RESULT IN INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT OR IN AN EXCESS BENEFIT TRANSACTION. A VOTING MEMBER OF THE GOVERNING BOARD WHO HAS A COMPENSATION CONFLICT IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. IF THERE ARE VIOLATIONS TO THE POLICY, THE COMMITTEE OR GOVERNING BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, QUESTION 19 NO DOCUMENTS AVAILABLE TO THE PUBLIC. Form 990, Part XI, Line 9 ALLOCATION TO CLINICAL PRACTICE RESERVE = $-6,731,224 DISPOSAL OF ASSETS = $- 159,000 LINE 9 TOTAL CHANGE IN NET ASSETS = $-6,890,224 Amended Return: Form 990, Part VII, Section A, and Form 990, Schedule J compensation information were inadvertently excluded from the original Form 990 filed with the IRS. After realizing the omittance, SB CLINICAL PRACTICE MANAGEMENT PLAN, INC. immediately and with good faith amended Form 990. On this amended form 990, Part VII Section A and Schedule J were completed accurately to report the compensation paid to officers, directors, and a former director in the calendar year 2017. Amounts reported as received from other than disqualified persons reported on Form 990, Schedule A, Part III, Line 7b, columns (b),(c),(d), and (e) have been revised. The total amount excluded on Line 8, Column (f), public support, increased from $637,710,652 to $734,801,992. This did not affect the organization's public support percentage for 2017 as the organization was in its fifth year as a section 501(c)(3) organization, and did not have to calculate its public support percentage in 2017. FORM 990 PART IX LINE 11G DESCRIPTION:OTHER OPERATING TOTAL FEES:13237381 FORM 990 PART IX LINE 11G DESCRIPTION:SCHOOL OF MEDICINE CHARGE TOTAL FEES:24899502 NEW YORK STATE 1 COMMERCE PLZ 99 WASHINGTON ALBANY NY 12231 146013200 GOVERNMENT NY 501(C)(1) N/A NA false STONY BROOK ANAESTHESIOLOGY UFPC PO BOX 1554 STONY BROOK NY 11790 112553515 HEALTHCARE NY 501(C)(3) 10 NYS false STONY BROOK DERMATOLOGY ASSOCIATES UFPC PO BOX 1554 STONY BROOK NY 11790 113011790 HEALTHCARE NY 501(C)(3) 10 NYS false STONY BROOK CLIN PRACT MGMT REALTY CORP PO BOX 1554 STONY BROOK NY 11790 113285712 RLTY HOLDING NY 501(C)(25) N/A CPMP true STONY BROOK SURGICAL HOLDING CORP PO BOX 1554 STONY BROOK NY 11790 116434538 RLTY HOLDING NY 501(C)(25) N/A CPMP true STONY BROOK EMERGENCY PHYSICIANS UFPC PO BOX 1554 STONY BROOK NY 11790 113066770 HEALTHCARE NY 501(C)(3) 10 NYS false SB Family and Preventive Medicine UFPC PO BOX 1554 STONY BROOK NY 11790 112552321 HEALTHCARE NY 501(C)(3) 10 NYS false STONY BROOK INTERNISTS UFPC PO BOX 1554 STONY BROOK NY 11790 112558775 HEALTHCARE NY 501(C)(3) 10 NYS false NEW YORK SPINE AND BRAIN SURGERY UFPC PO BOX 1554 STONY BROOK NY 11790 112645930 HEALTHCARE NY 501(C)(3) 10 NYS false NEUROLOGY ASSOC OF STONY BROOK UFPC PO BOX 1554 STONY BROOK NY 11790 112587430 HEALTHCARE NY 501(C)(3) 10 NYS false UNIV ASSOC IN OBST & GYNECOLOGY UFPC PO BOX 1554 SOTNY BROOK NY 11790 112569522 HEALTHCARE NY 501(C)(3) 10 NYS false STONY BROOK PATHOLOGISTS UFPC PO BOX 1554 STONY BROOK NY 11790 112647243 HEALTHCARE NY 501(C)(3) 10 NYS false STONY BROOK OPHTHALMOLOGY UFPC PO BOX 1554 STONY BROOK NY 11790 112658697 HEALTHCARE NY 501(C)(3) 10 NYS false STONY BROOK ORTHOPAEDIC ASSOCIATES UFPC PO BOX 1554 STONY BROOK NY 11790 112593061 HEALTHCARE NY 501(C)(3) 10 NYS false STONY BROOK CHILDREN'S SERVICE UFPC PO BOX 1554 STONY BROOK NY 11790 112571524 HEALTHCARE NY 501(C)(3) 10 NYS false STONY BROOK PSYCHIATRIC ASSOCIATES UFPC PO BOX 1554 STONY BROOK NY 11790 112590096 HEALTHCARE NY 501(C)(3) 10 NYS false STONY BROOK RADIATION ONCOLOGY UFPC PO BOX 1554 STONY BROOK NY 11790 112664726 HEALTHCARE NY 501(C)(3) 10 NYS false STONY BROOK SURGICAL ASSOCIATES UFPC PO BOX 1554 STONY BROOK NY 11790 112552333 HEALTHCARE NY 501(C)(3) 10 NYS false STONY BROOK UROLOGY UFPC PO BOX 1554 STONY BROOK NY 11790 112644371 HEALTHCARE NY 501(C)(3) 10 NYS false STONY BROOK RADIOLOGY PO BOX 1554 STONY BROOK NY 11790 112548304 HEALTHCARE NY 501(C)(3) 10 NYS false SB HLTHCARE IPA LLC PO BOX 1554 STONY BROOK NY 11790 113499101 HEALTHCARE NY SB CPMP RELATED 0 0 false 0 true 1.00000 Nicolls Indemnity Solutions SPC 27 HOSPITAL RD CAYMAN CORP CTR GRAND CAYMAN CJ KY1-9008 981378568 SELF-INSURANCE CJ CPMP C-CORP 419118 34903385 1.00000 true false false false false false false false false false false true true false false false false true false Stony Brook Surgical Holding Corporation L 295420 Stony Brook CPMP Realty Corporation M 88666 Nicolls Indemnity Solutions SPC L 419118