2019-08-09T11:02:02-05:00 2018-09-30 454084437 WARREN AVERETT LLC 2500 ACTON ROAD BIRMINGHAM AL 35243 990 2017-10-01 630649108 UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION PC UNIV 2057319600 PO BOX 55407 BIRMINGHAM AL 35255 MICHAEL HECKMAN CFO 2057319600 2019-08-06 1 MEGAN RANDOLPH P00989558 2059794100 2019-07-25 209.136.244.2 2019-08-06 10:11:26 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 FB607EF1B5208E0D89484CB45BEF5289F5FB76B8 2017 2019-02-21 02:37:17Z KEITH A JONES MD PO BOX 55407 BIRMINGHAM AL 35255 764291340 0 X N/A X 1973 AL COORDINATE AND DELIVER PATIENT CARE IN A GROUP PRACTICE SETTING. 18 10 3870 117 0 317752 0 0 578575450 624761633 8830722 12825612 46313271 41489496 633719443 679076741 48797457 42952748 0 0 447521135 503230012 0 0 0 132902073 136180035 629220665 682362795 4498778 -3286054 904135090 901660322 503376445 488184628 400758645 413475694 COORDINATE AND DELIVER PATIENT CARE IN A GROUP PRACTICE SETTING WITHIN THE ACADEMIC ENVIRONMENT OF THE UNIVERSITY OF ALABAMA AT BIRMINGHAM. 0 0 572304376 42952748 624956235 OPERATION OF A NONPROFIT PHYSICIAN GROUP PRACTICE CLOSELY AFFILIATED WITH THE UNIVERSITY OF ALABAMA AT BIRMINGHAM. HSF CONSISTS OF ALMOST 1,407 FACULTY, FELLOWS AND PHYSICIANS OFFERING SERVICES IN 33 SPECIALTIES. THESE SERVICES ARE REINFORCED BY THE RESEARCH AND EDUCATIONAL PROGRAMS OF UAB'S ACADEMIC HEALTH CENTER, RESULTING IN STATE-OF-THE-ART CARE. 572304376 1 0 0 1 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 337 0 1 3870 1 1 1 0 0 0 0 0 0 0 0 0 X 18 10 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MICHAEL F HECKMAN CFO 2057319600 500 22ND ST SOUTH STE 500 BIRMINGHAM AL 35233 CHARLES E ADAIR DIRECTOR 4.00 0.00 X 1200 0 0 JOHN R THOMAS DIRECTOR 3.00 0.00 X 900 0 0 CHARLES D PERRY JR DIRECTOR 4.00 0.00 X 1200 0 0 MIMI HEAD DIRECTOR 3.00 0.00 X 900 0 0 DONALD M JAMES DIRECTOR 1.00 0.00 X 300 0 0 VAN L RICHEY DIRECTOR 3.00 0.00 X 900 0 0 TIM LEWIS DIRECTOR 4.00 0.00 X 1200 0 0 JEFFREY A BAYER DIRECTOR 2.00 0.00 X 600 0 0 CT FITZPATRICK DIRECTOR 0.00 0.00 X 0 0 0 JAMES OUTLAND DIRECTOR 2.00 0.00 X 600 0 0 SELWYN M VICKERS MD DIRECTOR/PHYSICIAN 50.00 0.00 X 101610 1280271 135742 CHERI L CANON MD DIRECTOR/PHYSICIAN 50.00 0.00 X 512842 253919 100146 MITCHELL B COHEN MD DIRECTOR/PHYSICIAN 50.00 0.00 X 327190 274556 101484 HERBERT CHEN MD DIRECTOR/PHYSICIAN 50.00 0.00 X 882994 200731 99402 DAVID G STANDAERT MD DIRECTOR/PHYSICIAN 50.00 0.00 X 104262 426328 79193 ISSAC W FERNIANY PHD DIRECTOR/CEO UAB HS 0.00 50.00 X 0 1712948 228387 CHARLES S LANDEFELD MD DIRECTOR/PHYSICIAN 50.00 0.00 X 425785 253863 108705 JAMES M MARKERT DIRECTOR/PHYSICIAN 50.00 0.00 X 803861 340160 130959 KEITH A JONES MD PRESIDENT 50.00 0.00 X 383689 391097 142814 JASON DANIEL VICE PRESIDENT 50.00 0.00 X 137167 162540 53906 PATRICIA J PRITCHETT PAST EXECUTIVE VICE PRESIDENT 50.00 0.00 X 293788 242070 71813 MICHAEL F HECKMAN CFO 50.00 0.00 X 292726 0 41386 TERRY C FRY SECRETARY 50.00 0.00 X 225953 0 27335 JAMES E DAVIES MD PROFESSOR/PHYSICIAN 60.00 0.00 X 1495462 39482 63196 HIMANSHU AGGARWAL MD PROFESSOR/PHYSICIAN 60.00 0.00 X 858020 0 59691 CONWAY C HUANG MD PROFESSOR/PHYSICIAN 60.00 0.00 X 1101811 89032 71597 KEVIN L SUBLETT PROFESSOR/PHYSICIAN 60.00 0.00 X 871944 0 35235 ROBERT J DABAL PROFESSOR/PHYSICIAN 60.00 0.00 X 847065 50140 61925 9673969 5717137 1612916 1168 0 1 0 BRASFIELD & GORRIE INC PO BOX 11407 BIRMINGHAM AL 35246 GENERAL CONTRACTOR 5419341 DOSTER CONSTRUCTION CO INC 2100 INTERNATIONAL PARK DR BIRMINGHAM AL 35243 GENERAL CONTRACTOR 3939991 IRON MOUNTAIN RECORDS MANAGEMENT PO BOX 27128 NEW YORK NY 10087 RECORD MANAGEMENT 1415619 THERACOM CONSULTING SERVICES 9717 KEY WEST AVENUE ROCKVILLE MD 20850 CONSULTANTS 1087229 PLATINUM AIR SERVICE LLC 5404 BEAMIN DEW LOOP LAND OLAKES FL 34638 AIR SERVICE 1082405 59 NET PATIENT REVENUE 900099 478609134 478609134 HEALTHCARE SERVICES 900099 120524049 120524049 ORGAN/TISSUE REC 900099 25628450 25628450 624761633 4430241 4430241 3610 3610 32763972 0 32763972 32763972 32763972 91340242 2266118 83026549 2188050 8313693 78068 8391761 8391761 GAIN ON EQUITY IN PLTF 900099 8297214 8297214 GAIN ON EQUITY IN CAC 900099 233708 233708 MISCELLANEOUS INCOME 900099 194602 194602 8725524 679076741 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22388304 11204402 46626483 34926718 11699765 68656356 35130899 33525457 173946286 POOLED INVESTMENTS - CASH EQUIVALENTS 2379793 F POOLED INVESTMENTS - ACCRUED INCOME 242779 F DEFERRED COMP. INVESTMENTS - CASH EQUIVALENTS 1686683 F INVESTMENT IN TRUST FUND 80945345 F INVESTMENT IN CACC, LLC 3684429 F CERTIFICATES OF DEPOSIT 8308667 F 97247696 DEFERRED COMPENSATION 149643467 POST RETIREMENT LIABILITIES 28148586 177792053 X 705517144 13744001 2259102 16003103 689514041 -10437300 -10437300 679076741 692800095 0 692800095 -10437300 -10437300 682362795 PART V, LINE 4: THE FOUNDATION'S BOARD-DESIGNATED ENDOWMENTS CONSIST OF THREE FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE NORMAL SPENDING POLICY FOR THE GENERAL ENDOWMENT FUND IS TO DISTRIBUTE BETWEEN 3.5 PERCENT AND 6.5 PERCENT OF THE FUND, SUBJECT TO ANNUAL RECOMMENDATION BY THE FOUNDATION'S INVESTMENT COMMITTEE TO THE BOARD. THIS SPENDING POLICY IS CONSISTENT WITH THE FOUNDATION'S OBJECTIVE TO MAINTAIN THE PURCHASING POWER OF ENDOWMENT ASSETS, AS WELL AS TO PROVIDE ADDITIONAL REAL GROWTH THROUGH INVESTMENT RETURNS. PART X, LINE 2: THE FOUNDATION IS RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3). THE FOUNDATION HAS ADOPTED THE PROVISIONS OF THE ACCOUNTING STANDARDS CODIFICATION RELATING TO UNCERTAINTY IN INCOME TAXES. THIS GUIDANCE REQUIRES ENTITIES TO ASSESS THEIR UNCERTAIN TAX POSITIONS FOR THE LIKELIHOOD THAT THEY WOULD BE OVERTURNED UPON INTERNAL REVENUE SERVICE (IRS) EXAMINATION OR UPON EXAMINATION BY STATE TAXING AUTHORITIES. THE FOUNDATION HAS DETERMINED THAT IT DOES NOT HAVE ANY POSITIONS AT SEPTEMBER 30, 2018, THAT IT WOULD BE UNABLE TO SUBSTANTIATE. THE FOUNDATION HAS FILED ITS NOT-FOR-PROFIT TAX RETURNS FOR ALL YEARS THROUGH SEPTEMBER 30, 2017. YEARS ENDED SEPTEMBER 30, 2015, AND SUBSEQUENT REMAIN SUBJECT TO AUDIT BY TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN NET PENSION AND OTHER POSTRETIREMENT BENEFIT OBLIGATIONS 2,259,102. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT (INCOME) LOSS FROM DEFERRED COMPENSATION ASSETS -10,492,427. EXPENSES SHOWN AS A REDUCTION TO INCOME ON BOOKS 55,127. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT (INCOME) LOSS FROM DEFERRED COMPENSATION ASSETS -10,492,427. EXPENSES SHOWN AS A REDUCTION TO INCOME ON BOOKS 55,127. 1 UNIVERSITY OF ALABAMA AT BIRMINGHAM 1530 3RD AVENUE SOUTH BIRMINGHAM AL 35294 636005396 POLITICAL SUB 42952748 N/A N/A TO FUND RESEARCH PROJECTS 1 0 PART I, LINE 2: THE GRANTS PROVIDED TO UAB GO THROUGH HSF APPROVAL PROCESS. THE REQUEST COMES IN TO HSF CONTROLLER WHO PREPARES A "UAB TRANSFERS & CONTRIBUTION REQUEST AND APPROVES PAYMENT. THE REQUEST CONSIST OF THE DEPARTMENT, DATE, AMOUNT YTD EXPENSE AND VARIANCES TO BUDGET. ALL GRANT REQUISITIONS REGARDLESS OF AMOUNTS ARE THEN SENT TO THE HSF CFO FOR APPROVAL AND THEN TO THE EXECUTIVE VICE PRESIDENT FOR FINAL APPROVAL. THE GRANTS ARE ALSO MONITORED WITH THE AMOUNT PROVIDED VERSUS THE AMOUNT BUDGETED FOR THE FISCAL YEAR. X X 1 1 X X 0 0 0 1 0 0 0 1 0 SELWYN M VICKERS MD DIRECTOR/PHYSICIAN 46039 743481 0 223237 55571 313553 7167 104843 21031 9301 129808 1394415 0 134834 CHERI L CANON MD DIRECTOR/PHYSICIAN 422394 252981 89096 0 1352 938 35235 43279 25156 1842 573233 299040 0 0 MITCHELL B COHEN MD DIRECTOR/PHYSICIAN 272234 270530 51905 0 3051 4026 35235 56277 12305 1487 374730 332320 0 0 HERBERT CHEN MD DIRECTOR/PHYSICIAN 711553 200000 169100 0 2341 731 35235 45735 24259 979 942488 247445 0 0 DAVID G STANDAERT MD DIRECTOR/PHYSICIAN 43498 423595 60697 0 67 2733 6525 72399 18635 2677 129422 501404 0 0 ISSAC W FERNIANY PHD DIRECTOR/CEO UAB HS 0 725147 0 368000 0 619801 0 204000 0 24387 0 1941335 0 280581 CHARLES S LANDEFELD MD DIRECTOR/PHYSICIAN 334083 248405 86837 916 4865 4542 35235 63650 3045 11063 464065 328576 0 0 JAMES M MARKERT DIRECTOR/PHYSICIAN 666902 338134 132826 0 4133 2026 35235 66992 33817 2259 872913 409411 0 0 KEITH A JONES MD PRESIDENT 298669 388412 83430 0 1590 2685 35235 86543 22371 3021 441295 480661 0 0 JASON DANIEL VICE PRESIDENT 106440 162200 30608 0 119 340 5044 27700 22269 892 164480 191132 0 0 PATRICIA J PRITCHETT PAST EXECUTIVE VICE PRESIDENT 190434 196706 102353 0 1001 45364 25442 35475 12759 0 331989 277545 0 45364 MICHAEL F HECKMAN CFO 239686 0 51028 0 2012 0 31710 0 11997 0 336433 0 0 0 TERRY C FRY SECRETARY 195576 0 30011 0 366 0 8807 0 20463 0 255223 0 0 0 JAMES E DAVIES MD PROFESSOR/PHYSICIAN 968459 38400 525000 1000 2003 82 35235 6829 27152 814 1557849 47125 0 0 HIMANSHU AGGARWAL MD PROFESSOR/PHYSICIAN 822736 0 0 0 35284 0 35235 0 29255 0 922510 0 0 0 CONWAY C HUANG MD PROFESSOR/PHYSICIAN 1099651 88566 0 150 2160 316 35235 12112 6912 24803 1143958 125947 0 0 KEVIN L SUBLETT PROFESSOR/PHYSICIAN 786708 0 80649 0 4587 0 35235 0 5949 0 913128 0 0 0 ROBERT J DABAL PROFESSOR/PHYSICIAN 757546 50000 87950 0 1569 140 35235 8534 24054 275 906354 58949 0 0 PART I, LINE 1A DISCRETIONARY SPENDING ACCOUNTS: SOME EMPLOYED PHYSICIANS (INCLUDING PHYSICIAN DIRECTORS) HAVE ACCESS TO PROFESSIONAL DEVELOPMENT FUNDS WHICH ARE USED TO ADVANCE THEIR PROFESSIONAL SKILLS. AMOUNTS ARE SPENT ON COMPUTER EQUIPMENT, JOURNALS, SUBSCRIPTIONS AND TRAVEL EXPENSES TO ATTEND CONFERENCES AND LECTURES. ALL REQUESTS FOR REIMBURSEMENT ARE REVIEWED FOR COMPLIANCE WITH CURRENT POLICY AND IRS GUIDANCE BEFORE THEY ARE PAID. SOCIAL CLUB DUES: A FEW PHYSICIAN LEADERS (INCLUDING SOME PHYSICIAN DIRECTORS) ARE MEMBERS OF SOCIAL/BUSINESS CLUBS. THEY UTILIZE THESE FACILITIES FOR BUSINESS MEETINGS AND EVENTS DURING THE YEAR. ALL REQUESTS FOR REIMBURSEMENT ARE REVIEWED FOR COMPLIANCE WITH CURRENT POLICY AND IRS GUIDANCE BEFORE THEY ARE PAID. PART I, LINE 5 MANY OF OUR EMPLOYED PHYSICIANS (INCLUDING SOME DIRECTORS) HAVE INCENTIVE PLANS THAT PAY ADDITIONAL AMOUNTS BASED ON ACHIEVING SPECIFIC CLINICAL, ACADEMIC AND RESEARCH MEASURES. THESE INCENTIVE PLANS ARE REVIEWED ANNUALLY WITH THE COMPENSATION COMMITTEE. SOME OF THESE PLANS MAKE PAYMENTS BASED ON CLINICAL PRODUCTIVITY. PART I, LINE 7 MANY OF OUR EMPLOYED PHYSICIANS (INCLUDING SOME DIRECTORS) HAVE INCENTIVE PLANS THAT PAY ADDITIONAL AMOUNTS BASED ON ACHIEVING SPECIFIC CLINICAL, ACADEMIC AND RESEARCH MEASURES. THESE INCENTIVE PLANS ARE REVIEWED ANNUALLY WITH THE COMPENSATION COMMITTEE. A THE MEDICAL CLINIC BOARD OF THE CITY OF BIRMINGHAM - UAHSF 621375181 NONEAVAIL 2015-11-01 20000000 FINANCING CAPITAL ASSETS 0 0 0 B UAB MEDICINE FINANCE AUTHORITY 814143656 NONEAVAIL 2017-05-11 38680000 PRIOR ISSUE REFUND 0 0 0 C UAB MEDICINE FINANCE AUTHORITY 814143656 902562CK1 2017-05-11 135545000 PRIOR ISSUE REFUND 0 0 0 A 20000000 20000000 2018 0 0 1 1 B 38680000 38680000 2015 0 0 1 1 C 135545000 135545000 2015 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 0 B 0 0 0 1 0 0 0 0 0 C 0 0 0 1 0 0 0 0 0 A 1 B 1 C 1 SELWYN VICKERS CHAIRMAN OF BOARD RECRUITING LOAN X 250000 4167 0 1 1 4167 FORM 990, PART VI, SECTION A, LINE 3 NAVIGANT CYMETRIX CORPORATION IS ENGAGED TO PERFORM MANAGEMENT DUTIES INCLUDING REVENUE CYCLE PERFORMANCE REPORTING AND ANALYTICS, TRAINING AND SUPERVISION OF REVENUE CYCLE PERSONNEL, AND RECOMMENDING UPDATES TO REVENUE CYCLE POLICIES AND PROCEDURES. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PROVIDED TO THE BOARD FOR REVIEW AND IS AN AGENDA ITEM AT THE REGULARLY SCHEDULED BOARD MEETING OPEN FOR ANY DISCUSSION BEFORE THE RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, PRINCIPAL OFFICERS AND COMMITTEE MEMBERS WITH BOARD DELEGATED POWERS ANNUALLY SIGN THE CONFLICT OF INTEREST CERTIFICATE. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE MEETS ANNUALLY TO ENSURE THAT INDIVIDUAL COMPENSATION FOR PHYSICIANS, OFFICERS AND OTHER EXECUTIVES IS REASONABLE AND APPROPRIATE FOR A NON-PROFIT ORGANIZATION. THE COMPENSATION COMMITTEE PRESENTS AN ANNUAL REPORT TO THE BOARD OF DIRECTORS FOR THEIR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 AS A GENERAL RULE, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. ANY WRITTEN REQUEST BY THE PUBLIC WOULD BE REVIEWED AND ACTED UPON BY THE BOARD. FORM 990, PART XI, LINE 9: CHANGE IN NET PENSION AND OTHER POST RETIRMENT BENEFIT OBLIGATIONS 2,259,102. FORM 990, PART XI, LINE 2C THE BOARD OF DIRECTORS HAS A SEPARATE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS FUNCTION HAS NOT CHANGED FROM PRIOR YEARS. UAB HEALTH SYSTEM 500 22ND STREET SOUTH SUITE 408 BIRMINGHAM AL 35233 631182994 HEALTHCARE MANAGEMENT AL 501(C)(3) LINE 7 N/A 0 UNIVERSITY OF ALABAMA AT BIRMINGHAM 1530 3RD AVENUE SOUTH BIRMINGHAM AL 35294 636005396 PUBLIC UNIVERSITY AL POLITICAL SUB N/A N/A 0 UAB MEDICINE FINANCE AUTHORITY 1901 SIXTH AVENUE NORTH SUITE 1500 BIRMINGHAM AL 35203 814143656 MEDICAL FINANCING AL POLITICAL SUB N/A N/A 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 UNIVERSITY OF ALABAMA AT BIRMINGHAM B 35458000 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM K 4464000 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM P 43229000 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM Q 67246000 FMV - CASH UAB HEALTH SYSTEM P 5346000 FMV - CASH UAB HEALTH SYSTEM Q 11777000 FMV - CASH