UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACILITY INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACILITY INC (EIN 20-1304472)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-07-17
- IRS object ID
- 201931989349300848
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-07-17T14:51:11-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE SEAGATE SUITE 2650 | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 436041558 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201304472 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL | BusinessNameLine1Txt |
| Business Name Line2 | FACULTY INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIV | BusinessNameControlTxt |
| Phone | 4193837124 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3355 GLENDALE AVENUE 3RD FLOOR | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43614 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HAITHAM M ELSAMALOTY | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4193837124 | PhoneNum |
| Signature | 2019-04-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KAREN GRIES | PreparerPersonNm |
| PTIN | P00078514 | PTIN |
| Phone | 4192443711 | PhoneNum |
| Preparation | 2019-07-17 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-07-17 | IPDt |
| IP Tm | 09:47:37 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | BBA58EB6E7F87D04A815B4FA9AD717FA41A89180 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | D96076016A1D85786C0DD27C05D232F375DC2AFE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KRISTOPHER BRICKMAN MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3355 GLENDALE AVENUE 3RD FLOOR | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43614 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $101,669,385 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HUMAN CONDITION THROUGH EXCELLENCE IN PATIENT CARE AND MEDICAL DISCOVERY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 31 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 593 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $26,358,701 | PYContributionsGrantsAmt |
| CY Contributions Grants | $361,160 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $104,197,742 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $97,651,296 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$7,476 | PYInvestmentIncomeAmt |
| CY Investment Income | -$7,206 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,559,053 | PYOtherRevenueAmt |
| CY Other Revenue | $3,565,297 | CYOtherRevenueAmt |
| PY Total Revenue | $133,108,020 | PYTotalRevenueAmt |
| CY Total Revenue | $101,570,547 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $200,977 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $620,650 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $78,284,722 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $85,263,071 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $25,338,324 | PYOtherExpensesAmt |
| CY Other Expenses | $18,455,520 | CYOtherExpensesAmt |
| PY Total Expenses | $103,824,023 | PYTotalExpensesAmt |
| CY Total Expenses | $104,339,241 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $29,283,997 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,768,694 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $73,317,685 | TotalAssetsBOYAmt |
| Total Assets EOY | $73,700,437 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $20,602,583 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $23,783,758 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $52,715,102 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $49,916,679 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO IMPROVE THE HUMAN CONDITION THROUGH EXCELLENCE IN PATIENT CARE AND MEDICAL DISCOVERY | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $93,983,771 | ExpenseAmt |
| Grant | $620,650 | GrantAmt |
| Revenue | $94,526,670 | RevenueAmt |
| Desc | FACULTY PRACTICE PLAN FOR THE UNIVERSITY OF TOLEDO TO PROVIDE HEALTH CARE SERVICES AS AN INTEGRAL COMPONENT OF THE ACADEMIC AND RESEARCH MISSION OF THE UNIVERSITY. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,331,163 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,124,626 | RevenueAmt |
| Desc | CAPTIVE INSURANCE- WRITING OR FUNDING MEDICAL MALPRACTICE INSURANCE AND REINSURANCE FOR UNIVERSITY OF TOLEDO AND UNIVERSITY OF TOLEDO PHYSICIANS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $97,314,934 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 46 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 593 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 31 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KANDY JUSTICE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4193837124 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3355 GLENDALE AVE THIRD FLOOR | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43614 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (45 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| COOPER CHRISTOPHER MD | ||||||||||
| PRESIDENT, UTMAC | 20.00 | 20.00 | Yes (X) | Yes (X) | $229,534 | $477,670 | $106,913 | |||
| BRICKMAN KRISTOPHER MD | ||||||||||
| PRESIDENT, UTP; SECRETARY, UTMAC | 20.00 | 20.00 | Yes (X) | Yes (X) | $407,276 | $173,890 | $77,982 | |||
| DWORKIN LANCE MD | ||||||||||
| VICE PRESIDENT, UTP | 20.00 | 20.00 | Yes (X) | Yes (X) | $265,000 | $410,000 | $102,575 | |||
| ELSAMALOTY HAITHAM MD | ||||||||||
| TREASURER, UTP | 20.00 | 20.00 | Yes (X) | Yes (X) | $385,745 | $148,975 | $74,557 | |||
| HEJEEBU SRINI DO | ||||||||||
| SECRETARY, UTP | 20.00 | 20.00 | Yes (X) | Yes (X) | $242,582 | $86,577 | $67,236 | |||
| PYLES BRYAN T | ||||||||||
| TREASURER, UTMAC | 20.00 | 20.00 | Yes (X) | Yes (X) | $0 | $219,299 | $77,551 | |||
| HENDERSON PATRICIA L | ||||||||||
| ASST SECRETARY, UTMAC | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| BRUNICARDI FRANCIS MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $413,923 | $410,000 | $114,945 | ||||
| CASABIANCA ANDREW MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $174,797 | $218,112 | $79,139 | ||||
| CHEN CHANGHU MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $495,285 | $191,017 | $87,198 | ||||
| EBRAHEIM NABIL MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $1,450,474 | $233,597 | $89,602 | ||||
| MRAK ROBERT MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $236,756 | $193,250 | $73,375 | ||||
| MUKUNDAN DEEPA MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $99,252 | $100,391 | $28,943 | ||||
| SINDHWANI PUNEET MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $392,337 | $200,335 | $84,898 | ||||
| VAN HOOK JAMES MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $251,586 | $225,000 | $75,377 | ||||
| SINGH TANVIR MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $341,362 | $142,884 | $76,902 | ||||
| SPEER LINDA MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $117,696 | $214,850 | $61,797 | ||||
| TIETJEN GRETCHEN MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $249,150 | $204,838 | $82,340 | ||||
| WROBLEWSKI MARY BETH MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $46,036 | $115,016 | $39,959 | ||||
| SKIE MARTIN MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $509,690 | $105,647 | $71,673 | ||||
| SCHROEDER JASON MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $609,974 | $41,565 | $62,717 | ||||
| LACH JOSEPH MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $130,994 | $26,530 | $39,761 | ||||
| ATALLAHM JOSEPH MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $807,806 | $133,698 | $75,266 | ||||
| BOOTH ROBERT MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $182,437 | $118,803 | $52,781 | ||||
| GRIDER STEPHEN MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $227,771 | $95,509 | $65,904 | ||||
| MOLONEY BRYAN MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $330,000 | $183,848 | $82,604 | ||||
| KHOURI SAMER MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $289,991 | $107,209 | $71,845 | ||||
| KAW DINKAR MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | Yes (X) | $337,630 | $77,097 | $62,054 | ||||
| BARBEE DANIEL | ||||||||||
| MANAGER, UTMAC | 0.00 | 40.00 | Yes (X) | $0 | $325,335 | $48,270 | ||||
| ELLIS MICHAEL MD | ||||||||||
| MANAGER, UTMAC | 0.00 | 40.00 | Yes (X) | $155,295 | $118,303 | $40,119 | ||||
| ALEXANDER GORDAN | ||||||||||
| CHIEF PHYSICIAN EXECUTIVE | 40.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| BISHOP KATHY | ||||||||||
| CFO | 40.00 | 0.00 | Yes (X) | $116,037 | $0 | $21,279 | ||||
| LAWERA GARY | ||||||||||
| COO | 40.00 | 0.00 | $337,229 | $0 | $40,500 | Yes (X) | ||||
| ZAIDI SAYED FAZAL ABBAS MD | ||||||||||
| PHYSICIAN | 20.00 | 20.00 | $842,657 | $95,509 | $99,333 | Yes (X) | ||||
| JUMAA MOUHAMMAD MD | ||||||||||
| PHYSICIAN | 20.00 | 20.00 | $796,495 | $95,509 | $83,641 | Yes (X) | ||||
| ELGAFY HOSSEIN MD | ||||||||||
| PHYSICIAN | 20.00 | 20.00 | $675,502 | $74,403 | $77,630 | Yes (X) | ||||
| NAZZAL MUNIER MD | ||||||||||
| PHYSICIAN | 20.00 | 20.00 | $621,545 | $178,172 | $135,164 | Yes (X) | ||||
| GEHLING DANIEL | ||||||||||
| PHYSICIAN | 20.00 | 20.00 | $617,409 | $31,836 | $64,817 | Yes (X) | ||||
| BIESZCZAD JACOB MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | $348,769 | $43,150 | $66,551 | Yes (X) | ||||
| BLUMER PHD MD JEFFREY | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | $42,692 | $63,988 | $16,446 | Yes (X) | ||||
| FARRELL MD STEVEN J | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | $208,405 | $118,919 | $55,702 | Yes (X) | ||||
| SKEEL ROLAND T MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | $165,000 | $86,807 | $47,911 | Yes (X) | ||||
| SODEMAN THOMAS C MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | $203,865 | $152,675 | $68,058 | Yes (X) | ||||
| TALMAGE LANCE MD | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | $25,308 | $101,408 | $28,390 | Yes (X) | ||||
| TAMBURRINO MD MARIJO | ||||||||||
| TRUSTEE, UTP | 20.00 | 20.00 | $8,077 | $185,394 | $18,089 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $14,389,369 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,527,015 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,897,794 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 193 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| TRG HEALTHCARE LLC | |||||
| 1835 MARKET ST SUITE 555 | PHILADELPHIA | PA | 19103 | INTERIM MANAGEMENT/CEO SERVICES | $975,164 |
| BARONE BROTHERS LLC | |||||
| 4841 MONROE ST SUITE 101 | TOLEDO | OH | 43623 | RENT | $386,670 |
| DFG WATERVILLE RETAIL LLC | |||||
| 10100 WATERVILLE ST | WHITEHOUSE | OH | 43571 | RENT | $198,497 |
| FUSION HEALTHCARE STAFFING | |||||
| 870 EAST 9400 SOUTH SUITE 200 | SANDY | UT | 84094 | HEALTHCARE STAFFING | $185,061 |
| EASTMAN & SMITH LTD | |||||
| ONE SEAGATE 24TH FLOOR | TOLEDO | OH | 43699 | LEGAL SERVICES | $148,070 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $361,160 | RelatedOrganizationsAmt |
| Total Contributions | $361,160 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE | 621110 | $94,526,670 | $94,526,670 |
| UTMAC INVESTMENT INCOME | 621110 | $1,795,447 | $1,795,447 |
| UTMAC INSURANCE PREMIUMS | 621110 | $1,329,179 | $1,329,179 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $97,651,296 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $91,632 | TotalRevenueColumnAmt |
| Exclusion | $91,632 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $98,838 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$98,838 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$98,838 | TotalRevenueColumnAmt |
| Exclusion | -$98,838 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 999999 | BusinessCd |
| Total Revenue Column | $3,565,297 | TotalRevenueColumnAmt |
| Exclusion | $3,565,297 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,565,297 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $101,570,547 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $97,651,296 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,558,091 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $620,650 | TotalAmt |
| Program Services | $620,650 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,386,719 | TotalAmt |
| Program Services | $7,386,719 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,238,995 | TotalAmt |
| Program Services | $60,691,430 | ProgramServicesAmt |
| Management And General | $3,547,565 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,968,015 | TotalAmt |
| Program Services | $7,622,490 | ProgramServicesAmt |
| Management And General | $345,525 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,974,041 | TotalAmt |
| Program Services | $1,666,603 | ProgramServicesAmt |
| Management And General | $2,307,438 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,695,301 | TotalAmt |
| Program Services | $1,457,959 | ProgramServicesAmt |
| Management And General | $237,342 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,739 | TotalAmt |
| Program Services | $131,739 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,013 | TotalAmt |
| Management And General | $194,013 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,656,498 | TotalAmt |
| Program Services | $7,656,498 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,112 | TotalAmt |
| Program Services | $134,112 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $475,685 | TotalAmt |
| Program Services | $461,414 | ProgramServicesAmt |
| Management And General | $14,271 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,485 | TotalAmt |
| Program Services | $152,485 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,135,639 | TotalAmt |
| Program Services | $1,010,719 | ProgramServicesAmt |
| Management And General | $124,920 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,129,080 | TotalAmt |
| Program Services | $1,129,080 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $447,310 | TotalAmt |
| Program Services | $447,310 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $776,196 | TotalAmt |
| Program Services | $776,196 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| UTMAC EXPENSES | $3,331,163 | $3,331,163 | |
| CLINIC COSTS | $1,712,100 | $1,712,100 | |
| PHARMACEUTICALS | $673,033 | $673,033 | |
| EQUIPMENT RENTAL & REPA | $374,618 | $187,309 | $187,309 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,849 | TotalAmt |
| Program Services | $65,925 | ProgramServicesAmt |
| Management And General | $65,924 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,339,241 | TotalAmt |
| Program Services | $97,314,934 | ProgramServicesAmt |
| Management And General | $7,024,307 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,960,290 | BOYAmt |
| EOY | $10,060,146 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $10,445,992 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,236,294 | BOYAmt |
| EOY | $15,062,809 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,925,919 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,862 | BOYAmt |
| EOY | $50,005 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,156 | BOYAmt |
| EOY | $245,739 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,230,579 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,194,534 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,079,553 | BOYAmt |
| EOY | $1,036,045 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $34,632,340 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,751 | BOYAmt |
| EOY | $27,751 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,908,779 | BOYAmt |
| EOY | $213,691 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,317,685 | BOYAmt |
| EOY | $73,700,437 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,450,928 | BOYAmt |
| EOY | $13,426,386 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $451,453 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,151,655 | BOYAmt |
| EOY | $9,905,919 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,602,583 | BOYAmt |
| EOY | $23,783,758 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,715,102 | BOYAmt |
| EOY | $49,916,679 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,715,102 | BOYAmt |
| EOY | $49,916,679 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,317,685 | BOYAmt |
| EOY | $73,700,437 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,768,694 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$29,729 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type3 Func Int | Yes (X) | SupportingOrgType3FuncIntInd |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY OF TOLEDO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 346401483 | EIN |
| Organization Type | 5 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Form990 Sch A Type3 Sprt Org All Form990SchAType3SprtOrgAllGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timely Provided Documents | 0 | TimelyProvidedDocumentsInd |
| Officers Close Relationship | Yes (1) | OfficersCloseRelationshipInd |
| Supported Org Voice Investment | Yes (1) | SupportedOrgVoiceInvestmentInd |
Form990 Sch A Type3 Func Int Form990SchAType3FuncIntGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Governmental Entity | Yes (X) | GovernmentalEntityInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE A, PAGE 5, LINE 1C | THE ORGANIZATION SERVES AS THE FACULTY PRACTICE PLAN FOR THE UNIVERSITY OF TOLEDO TO PROVIDE HEALTH CARE SERVICES AS AN INTEGRAL COMPONENT OF THE ACADEMIC AND RESEARCH MISSION OF THE UNIVERSITY. |
| SCHEDULE A, PAGE 5, SECTION D LINE 3 | UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY, INC. (UTP) HAS ONLY ONE CLASS OF MEMBER, AND ONLY ONE MEMBER, THE UNIVERSITY OF TOLEDO. THE SOLE MEMBER, UNIVERSITY OF TOLEDO HAS A SIGNIFICANT VOICE IN THE ACTIVITIES AND OPERATIONS OF UTP. ACT ON ITS BEHALF AS THE SOLE MEMBER OF THE ORGANIZATION. THE SOLE MEMBER OF UTP HAS THE POWER TO NOMINATE, ELECT AND REMOVE THE BOARD OF DIRECTORS OF THE CORPORATION; APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION AND CODE OF REGULATIONS OF THE CORPORATION; AND EXERCISE SUCH OTHER POWERS AS ARE NECESSARY, APPROPRIATE, AND CONSISTENT WITH LAW AND WITH THE ARTICLES OF INCORPORATION AND THE CODE OF REGULATIONS OF THE CORPORATION. THE FOLLOWING ACTIONS REQUIRE PRIOR APPROVAL OF THE SOLE MEMBER: (A) ANY CHANGE IN THE PURPOSE OR MISSION OF THE CORPORATION; (B) ANY CHANGE IN THE CODE OF REGULATIONS OR ARTICLES OF INCORPORATION OF THE CORPORATION; (C) ANY MERGER OR CONSOLIDATION OF THE CORPORATION WITH AN UNRELATED ENTITY; (D) THE PROPOSED SALE OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS; (E) ANY BORROWING OF FUNDS BY THE CORPORATION (EXCLUDING TRADE PAYABLES OR OTHER ORDINARY COURSE INDEBTEDNESS) IN EXCESS OF ITS GENERAL OPERATING LINE OF CREDIT IN AN AMOUNT TO BE ESTABLISHED ON AN ANNUAL BASIS BY APPROVAL OF THE BOARD OR ANY LOAN OF FUNDS BY THE CORPORATION; (F) ANY MATERIAL CHANGES IN THE CORPORATION'S PROFESSIONAL LIABILITY INSURANCE COVERAGE, INCLUDING CHANGES IN THE PARTIES PROVIDING SUCH COVERAGE; AND (G) THE DISSOLUTION OR LIQUIDATION OF THE CORPORATION. |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,230,579 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,194,534 | DepreciationAmt |
| Book Value | $1,036,045 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,036,045 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| LOSSES AND LOSS ADJUSTMENT EXPENSES - UTMAC | $9,681,272 |
| LOSSES AND CLAIMS HANDLING FEES PAYABLE - UTMAC | $224,647 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $9,905,919 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $95,876,905 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$29,729 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$206,537 | OtherRevenueAmt |
| Revenue Not Reported | -$236,266 | RevenueNotReportedAmt |
| Revenue Subtotal | $96,113,171 | RevenueSubtotalAmt |
| Other Revenues Not Included | $5,457,376 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $5,457,376 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $101,570,547 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $98,675,336 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $98,675,336 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $5,663,905 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $5,663,905 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $104,339,241 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | LOSS ON UTMAC -206,537. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | UTMAC INCOME 3,124,626. CLINIC COSTS 1,712,100. DONATIONS TO UTF 397,539. DISTRIBUTIONS TO UT/UTMAC 223,111. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | CLINIC COSTS 1,712,100. DONATIONS TO UTF 397,539. DISTRIBUTIONS TO UT/UTMAC 223,111. UTMAC EXPENSES 3,331,163. ROUNDING -8. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| UNIVERSITY OF TOLEDO FOUNDATION | ||||||||
| 4510 DORR ST MS 820 | TOLEDO | OH | 43615 | 346555110 | 501(C)(3) | $126,992 | FMV | SUPPORT FOR THE UNIVERSITY OF TOLEDO FOUNDATION |
| UNIVERSITY OF TOLEDO | ||||||||
| 2801 W BANCROFT ST | TOLEDO | OH | 43614 | 346401483 | SECTION 115 | $493,658 | FMV | SUPPORT FOR THE UNIVERSITY OF TOLEDO |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION MONITORS THE USE OF GRANT FUNDS IN THE UNITED STATES BY ONLY DONATING TO THE RELATED ORGANIZATIONS LISTED UNDER SCHEDULE R. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | 0 | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (42 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COOPER CHRISTOPHER MD | ||||||||||||||
| PRESIDENT, UTMAC | $229,534 | $477,670 | $0 | $0 | $0 | $0 | $34,430 | $56,085 | $0 | $16,398 | $263,964 | $550,153 | $0 | $0 |
| BRICKMAN KRISTOPHER MD | ||||||||||||||
| PRESIDENT, UTP; SECRETARY, UTMAC | $384,653 | $173,890 | $22,623 | $0 | $0 | $0 | $40,500 | $24,345 | $0 | $13,137 | $447,776 | $211,372 | $0 | $0 |
| DWORKIN LANCE MD | ||||||||||||||
| VICE PRESIDENT, UTP | $250,000 | $410,000 | $15,000 | $0 | $0 | $0 | $39,750 | $57,400 | $0 | $5,425 | $304,750 | $472,825 | $0 | $0 |
| ELSAMALOTY HAITHAM MD | ||||||||||||||
| TREASURER, UTP | $20,633 | $148,975 | $365,112 | $0 | $0 | $0 | $40,500 | $15,259 | $2,400 | $16,398 | $428,645 | $180,632 | $0 | $0 |
| HEJEEBU SRINI DO | ||||||||||||||
| SECRETARY, UTP | $36,080 | $86,577 | $206,502 | $0 | $0 | $0 | $36,897 | $12,074 | $1,900 | $16,365 | $281,379 | $115,016 | $0 | $0 |
| PYLES BRYAN T | ||||||||||||||
| TREASURER, UTMAC | $0 | $219,299 | $0 | $0 | $0 | $0 | $0 | $30,702 | $0 | $46,849 | $0 | $296,850 | $0 | $0 |
| BRUNICARDI FRANCIS MD | ||||||||||||||
| TRUSTEE, UTP | $363,923 | $410,000 | $50,000 | $0 | $0 | $0 | $40,500 | $57,400 | $0 | $17,045 | $454,423 | $484,445 | $0 | $0 |
| CASABIANCA ANDREW MD | ||||||||||||||
| TRUSTEE, UTP | $174,797 | $218,112 | $0 | $0 | $0 | $0 | $38,146 | $30,186 | $0 | $10,807 | $212,943 | $259,105 | $0 | $0 |
| CHEN CHANGHU MD | ||||||||||||||
| TRUSTEE, UTP | $495,285 | $191,017 | $0 | $0 | $0 | $0 | $40,500 | $26,742 | $0 | $19,956 | $535,785 | $237,715 | $0 | $0 |
| EBRAHEIM NABIL MD | ||||||||||||||
| TRUSTEE, UTP | $43,097 | $233,597 | $1,407,377 | $0 | $0 | $0 | $40,500 | $32,704 | $0 | $16,398 | $1,490,974 | $282,699 | $0 | $0 |
| MRAK ROBERT MD | ||||||||||||||
| TRUSTEE, UTP | $210,555 | $193,250 | $26,201 | $0 | $0 | $0 | $35,513 | $27,055 | $0 | $10,807 | $272,269 | $231,112 | $0 | $0 |
| MUKUNDAN DEEPA MD | ||||||||||||||
| TRUSTEE, UTP | $77,469 | $100,391 | $21,783 | $0 | $0 | $0 | $14,888 | $14,055 | $0 | $0 | $114,140 | $114,446 | $0 | $0 |
| SINDHWANI PUNEET MD | ||||||||||||||
| TRUSTEE, UTP | $392,337 | $200,335 | $0 | $0 | $0 | $0 | $40,500 | $28,000 | $0 | $16,398 | $432,837 | $244,733 | $0 | $0 |
| VAN HOOK JAMES MD | ||||||||||||||
| TRUSTEE, UTP | $251,586 | $225,000 | $0 | $0 | $0 | $0 | $40,500 | $0 | $34,877 | $0 | $326,963 | $225,000 | $0 | $0 |
| SINGH TANVIR MD | ||||||||||||||
| TRUSTEE, UTP | $549 | $142,884 | $340,813 | $0 | $0 | $0 | $40,500 | $20,004 | $0 | $16,398 | $381,862 | $179,286 | $0 | $0 |
| SPEER LINDA MD | ||||||||||||||
| TRUSTEE, UTP | $117,696 | $214,850 | $0 | $0 | $0 | $0 | $17,654 | $30,079 | $0 | $14,064 | $135,350 | $258,993 | $0 | $0 |
| TIETJEN GRETCHEN MD | ||||||||||||||
| TRUSTEE, UTP | $153,000 | $204,838 | $96,150 | $0 | $0 | $0 | $37,372 | $28,677 | $0 | $16,291 | $286,522 | $249,806 | $0 | $0 |
| WROBLEWSKI MARY BETH MD | ||||||||||||||
| TRUSTEE, UTP | $44,766 | $115,016 | $1,270 | $0 | $0 | $0 | $6,978 | $16,102 | $481 | $16,398 | $53,495 | $147,516 | $0 | $0 |
| SKIE MARTIN MD | ||||||||||||||
| TRUSTEE, UTP | $5,001 | $105,647 | $504,689 | $0 | $0 | $0 | $40,500 | $14,775 | $0 | $16,398 | $550,190 | $136,820 | $0 | $0 |
| SCHROEDER JASON MD | ||||||||||||||
| TRUSTEE, UTP | $609,974 | $41,565 | $0 | $0 | $0 | $0 | $40,500 | $5,819 | $0 | $16,398 | $650,474 | $63,782 | $0 | $0 |
| LACH JOSEPH MD | ||||||||||||||
| TRUSTEE, UTP | $87,231 | $26,530 | $43,763 | $0 | $0 | $0 | $19,649 | $3,714 | $0 | $16,398 | $150,643 | $46,642 | $0 | $0 |
| ATALLAHM JOSEPH MD | ||||||||||||||
| TRUSTEE, UTP | $666 | $133,698 | $807,140 | $0 | $0 | $0 | $40,500 | $18,368 | $0 | $16,398 | $848,306 | $168,464 | $0 | $0 |
| BOOTH ROBERT MD | ||||||||||||||
| TRUSTEE, UTP | $161,199 | $118,803 | $21,238 | $0 | $0 | $0 | $27,366 | $16,623 | $0 | $8,792 | $209,803 | $144,218 | $0 | $0 |
| GRIDER STEPHEN MD | ||||||||||||||
| TRUSTEE, UTP | $223,820 | $95,509 | $3,951 | $0 | $0 | $0 | $36,135 | $13,371 | $0 | $16,398 | $263,906 | $125,278 | $0 | $0 |
| MOLONEY BRYAN MD | ||||||||||||||
| TRUSTEE, UTP | $330,000 | $183,848 | $0 | $0 | $0 | $0 | $40,500 | $25,739 | $0 | $16,365 | $370,500 | $225,952 | $0 | $0 |
| KHOURI SAMER MD | ||||||||||||||
| TRUSTEE, UTP | $289,991 | $107,209 | $0 | $0 | $0 | $0 | $40,500 | $14,947 | $0 | $16,398 | $330,491 | $138,554 | $0 | $0 |
| KAW DINKAR MD | ||||||||||||||
| TRUSTEE, UTP | $64,035 | $77,097 | $273,595 | $0 | $0 | $0 | $40,500 | $10,747 | $0 | $10,807 | $378,130 | $98,651 | $0 | $0 |
| BARBEE DANIEL | ||||||||||||||
| MANAGER, UTMAC | $0 | $325,335 | $0 | $0 | $0 | $0 | $0 | $31,872 | $0 | $16,398 | $0 | $373,605 | $0 | $0 |
| ELLIS MICHAEL MD | ||||||||||||||
| MANAGER, UTMAC | $155,295 | $118,303 | $0 | $0 | $0 | $0 | $23,294 | $16,516 | $0 | $309 | $178,589 | $135,128 | $0 | $0 |
| LAWERA GARY | ||||||||||||||
| COO | $292,729 | $0 | $44,500 | $0 | $0 | $0 | $40,500 | $0 | $0 | $0 | $377,729 | $0 | $0 | $0 |
| ZAIDI SAYED FAZAL ABBAS MD | ||||||||||||||
| PHYSICIAN | $492,308 | $95,509 | $350,349 | $0 | $0 | $0 | $40,500 | $42,435 | $0 | $16,398 | $883,157 | $154,342 | $0 | $0 |
| JUMAA MOUHAMMAD MD | ||||||||||||||
| PHYSICIAN | $492,308 | $95,509 | $304,187 | $0 | $0 | $0 | $40,500 | $26,743 | $0 | $16,398 | $836,995 | $138,650 | $0 | $0 |
| ELGAFY HOSSEIN MD | ||||||||||||||
| PHYSICIAN | $7,839 | $74,403 | $667,663 | $0 | $0 | $0 | $40,500 | $20,732 | $0 | $16,398 | $716,002 | $111,533 | $0 | $0 |
| NAZZAL MUNIER MD | ||||||||||||||
| PHYSICIAN | $3,354 | $178,172 | $618,191 | $0 | $0 | $0 | $40,500 | $78,266 | $0 | $16,398 | $662,045 | $272,836 | $0 | $0 |
| GEHLING DANIEL | ||||||||||||||
| PHYSICIAN | $4,880 | $31,836 | $612,529 | $0 | $0 | $0 | $40,500 | $4,457 | $0 | $19,860 | $657,909 | $56,153 | $0 | $0 |
| BIESZCZAD JACOB MD | ||||||||||||||
| TRUSTEE, UTP | $21,610 | $43,150 | $327,159 | $0 | $0 | $0 | $40,500 | $6,041 | $0 | $20,010 | $389,269 | $69,201 | $0 | $0 |
| BLUMER PHD MD JEFFREY | ||||||||||||||
| TRUSTEE, UTP | $42,692 | $63,988 | $0 | $0 | $0 | $0 | $6,404 | $5,754 | $0 | $4,288 | $49,096 | $74,030 | $0 | $0 |
| FARRELL MD STEVEN J | ||||||||||||||
| TRUSTEE, UTP | $896 | $118,919 | $207,509 | $0 | $0 | $0 | $31,261 | $16,649 | $0 | $7,792 | $239,666 | $143,360 | $0 | $0 |
| SKEEL ROLAND T MD | ||||||||||||||
| TRUSTEE, UTP | $155,000 | $86,807 | $10,000 | $0 | $0 | $0 | $24,750 | $12,153 | $0 | $11,008 | $189,750 | $109,968 | $0 | $0 |
| SODEMAN THOMAS C MD | ||||||||||||||
| TRUSTEE, UTP | $150,362 | $152,675 | $53,503 | $0 | $0 | $0 | $30,580 | $21,080 | $0 | $16,398 | $234,445 | $190,153 | $0 | $0 |
| TALMAGE LANCE MD | ||||||||||||||
| TRUSTEE, UTP | $25,308 | $101,408 | $0 | $0 | $0 | $0 | $3,796 | $13,787 | $0 | $10,807 | $29,104 | $126,002 | $0 | $0 |
| TAMBURRINO MD MARIJO | ||||||||||||||
| TRUSTEE, UTP | $8,077 | $185,394 | $0 | $0 | $0 | $0 | $1,212 | $16,877 | $0 | $0 | $9,289 | $202,271 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | CERTAIN INDIVIDUALS IN PART VII DO HAVE HEALTH OR SOCIAL CLUB DUES PAID BY UTP. |
| PART I, LINE 1B | UTP DOES NOT HAVE A POLICY REGARDING THE PAYMENT OR REIMBURSEMENT OF THE EXPENSES DESCRIBED ON LINE 1A. PAYMENT OR REIMBURSEMENT IS BASED UPON THE BUSINESS PURPOSE OF SUCH REQUEST AND APPROVED BY APPROPRIATE INDIVIDUAL(S) WITHIN UTP. |
| PART I, LINE 5 | MANY PHYSICIANS ON STAFF DO RECEIVE COMPENSATION COMPUTED ON SERVICES RENDERED/COLLECTIONS RECEIVED. FOR THIS COMPENSATION, ESTABLISHED FORMULAS AND COMPUTATIONS ARE UTILIZED TO DETERMINE THE COMPENSATION. |
| PART I, LINE 7 | MANY PHYSICIANS ON STAFF DO RECEIVE NON-FIXED PAYMENTS BASED ON ACHIEVING VARIOUS MEASURABLES AND GOALS WITHIN THEIR PRACTICE. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHWEST EMERGENCY SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | ENTITY MORE THAN 35% OWNED BY KRISTOPHER BRICKMAN, M.D., PRESIDENT | RelationshipDescriptionTxt |
| Transaction | $209,491 | TransactionAmt |
| Transaction | BILLING AND MANAGEMENT SERVICES | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | UTMAC, LLC DELEGATES AUTHORITY TO STRATEGIC RISK SOLUTIONS WHICH SERVES AS THE CAPTIVE MANAGER. STRATEGIC RISK SOLUTIONS RECEIVED $53,000 AS COMPENSATION FOR CAPTIVE MANAGEMENT SERVICES. |
| FORM 990, PART VI, SECTION A, LINE 6 | UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY, INC. (UTP) HAS ONLY ONE CLASS OF MEMBER, AND ONLY ONE MEMBER, THE UNIVERSITY OF TOLEDO, EXERCISING ALL MEMBER RIGHTS. THE REPRESENTATIVES OF THE UNIVERSITY OF TOLEDO ACT ON ITS BEHALF AS THE SOLE MEMBER OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION HAS ONLY ONE CLASS OF MEMBERS, AND ONLY ONE MEMBER, THE UNIVERSITY OF TOLEDO, EXERCISING ALL MEMBER RIGHTS. THE REPRESENTATIVES OF THE UNIVERSITY OF TOLEDO ACT ON ITS BEHALF AS THE SOLE MEMBER OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE ORGANIZATION HAS ONE MEMBER, THE UNIVERSITY OF TOLEDO, WHICH EXERCISES ALL MEMBER RIGHTS THROUGH THE ACTIONS OF ITS AUTHORIZED REPRESENTATIVES. THE SOLE MEMBER HAS THE POWER TO NOMINATE, ELECT AND REMOVE THE BOARD OF DIRECTORS OF THE CORPORATION; APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION AND CODE OF REGULATIONS OF THE CORPORATION; AND EXERCISE SUCH OTHER POWERS AS ARE NECESSARY, APPROPRIATE, AND CONSISTENT WITH LAW AND WITH THE ARTICLES OF INCORPORATION AND THE CODE OF REGULATIONS OF THE CORPORATION. THE FOLLOWING ACTIONS REQUIRE PRIOR APPROVAL OF THE SOLE MEMBER: (A) ANY CHANGE IN THE PURPOSE OR MISSION OF THE CORPORATION; (B) ANY CHANGE IN THE CODE OF REGULATIONS OR ARTICLES OF INCORPORATION OF THE CORPORATION; (C) ANY MERGER OR CONSOLIDATION OF THE CORPORATION WITH AN UNRELATED ENTITY; (D) THE PROPOSED SALE OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS; (E) ANY BORROWING OF FUNDS BY THE CORPORATION (EXCLUDING TRADE PAYABLES OR OTHER ORDINARY COURSE INDEBTEDNESS) IN EXCESS OF ITS GENERAL OPERATING LINE OF CREDIT IN AN AMOUNT TO BE ESTABLISHED ON AN ANNUAL BASIS BY APPROVAL OF THE BOARD OR ANY LOAN OF FUNDS BY THE CORPORATION; (F) ANY MATERIAL CHANGES IN THE CORPORATION'S PROFESSIONAL LIABILITY INSURANCE COVERAGE, INCLUDING CHANGES IN THE PARTIES PROVIDING SUCH COVERAGE; AND (G) THE DISSOLUTION OR LIQUIDATION OF THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION'S FORM 990 IS PREPARED BY AN OUTSIDE PUBLIC ACCOUNTING FIRM BASED ON INFORMATION PROVIDED BY MANAGEMENT. ONCE A DRAFT RETURN IS AVAILABLE, IT IS PROVIDED TO MANAGEMENT FOR THEIR REVIEW. ANY CHANGES NOTED BY MANAGEMENT ARE INCORPORATED INTO THE RETURN BEFORE THE DOCUMENT IS PROVIDED TO THE BOARD PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | UTP DOES HAVE A CONFLICT OF INTEREST POLICY THAT IT FOLLOWS WHEN ADDRESSING POTENTIAL CONFLICTS. ALL OFFICERS, DIRECTORS, OR TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE CONFLICTS OF INTERESTS WHICH MAY ARISE. SHOULD AN INDIVIDUAL HAVE A CONFLICT OF INTEREST, THE INDIVIDUAL IDENTIFIED WITH THE CONFLICT MAY NOT VOTE ON SUCH ISSUE BEFORE GOVERNANCE. UNIVERSITY OF TOLEDO PHYSICIANS, LLC. AND UTP PATHOLOGY SERVICES, LLC FOLLOWS THE SAME CONFLICT OF INTEREST POLICY THAT WAS ADOPTED BY UTP LLC. UNIVERSITY OF TOLEDO MEDICAL ASSURANCE COMPANY, LLC HAS A SIMILAR CONFLICT OF INTEREST POLICY THAT IS FOLLOWED BY ALL UTMAC MANAGERS. THE POLICY REQUIRES SIMILAR DISCLOSURES AS NOTED ABOVE. |
| FORM 990, PART VI, SECTION B, LINE 15 | WHEN DETERMINING COMPENSATION FOR THE PRESIDENT/CEO OF THE VARIOUS ENTITIES, GOVERNANCE UTILIZES COMPARABILITY DATA. COMPENSATION LEVELS ARE REVIEWED BY CHAIRMAN AND COMPENSATION COMMITTEE OF THE BOARD. THIS PROCESS IS THE UTILIZED FOR ALL OFFICERS AND EMPLOYEES PLUS APPLIES TO ALL ORGANIZATIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART VII - BOARD OF DIRECTOR LISTING | FOR THE PURPOSE OF THE PART VII REPORTING, THE TRUSTEES OF UNIVERSITY OF TOLEDO PHSICIANS CLINICAL FACULTY, INC. (UTP) SERVE AS GOVERNANCE FOR UNIVERSITY OF TOLEDO PHSICIANS, LLC AND UTP PATHOLOGY SERVICES, LLC. THE SOLE MEMBER OF EACH OF THE LLCS IS UTP. UNIVERSITY OF TOLEDO MEDICAL ASSURANCE COMPANY, LLC (UTMAC) GOVERNANCE IS DESIGNATED IN PART VII OF THE FORM 990. UTP IS ALSO THE SOLE MEMBER OF UTMAC. |
| PART VII, COMPENSATION INFORMATION | THE INTERIM CEO OF THE ORGANIZATION IS CONTRACTED THROUGH A SERVICE CONTRACT WITH TRG HEALTHCARE LLC. HE IS NOT AN EMPLOYEE OF UTP. REMUNERATION PAID TO TRG HEALTHCARE LLC IS REPORTED IN PART VII SECTION B. |
| PART VI LINE 13 - WRITTEN WHISLTLEBLOWER POLICY | NEITHER UTP NOR UTMAC HAS YET ADOPTED A WRITTEN WHISTLEBLOWER POLICY. |
| PART VI LINE 14 - DOCUMENT RETENTION AND DESTRUCTION POLICY | UTMAC HAS NOT YET ADOPTED A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| UNIVERSITY OF TOLEDO PHYSICIANS LLC | |||||||||
| 3355 GLENDALE AVE 3RD FLOOR | TOLEDO | OH | 43614 | 341127097 | DISREGARDED ENTITY FORMED TO CARRY OUT PURPOSES OF MEMBER | OH | $95,811,306 | $23,604,844 | 100 UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY INC |
| UTP PATHOLOGY SERVICES LLC | |||||||||
| 3355 GLENDALE AVE 3RD FLOOR | TOLEDO | OH | 43614 | 264032238 | DISREGARDED ENTITY FORMED TO CARRY OUT PURPOSES OF MEMBER | OH | $2,280,661 | $0 | 100 UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY INC |
| UNIVERSITY OF TOLEDO MEDICAL ASSURANCE COMPANY LLC | |||||||||
| 159 BANK ST 4TH FLOOR | BURLINGTON | VT | 05401 | DISREGARDED ENTITY FORMED TO CARRY OUT PURPOSES OF MEMBER | VT | $3,124,626 | $39,595,383 | 100 UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY INC | |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| TOLEDO AREA MEDICAL FOUNDATION | ||||||||||
| 3355 GLENDALE AVE 3RD FLOOR | TOLEDO | OH | 43614 | 341308939 | FINANCIAL SUPPORT TO UNIV. OF TOLEDO PHYSICIANS CLINICAL FACULTY | OH | 501(C) | LINE 12C, III-FI | N/A | 0 |
| UNIVERSITY OF TOLEDO | ||||||||||
| 2801 W BANCROFT MS 319 | TOLEDO | OH | 43606 | 346401483 | A PUBLIC INSTITUTION OF HIGHER EDUCATION | OH | SECTION 115 | N/A | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| REGIONAL CENTER FOR SLEEP MEDICINE OF TOLEDO LLC | ||||||||||||
| 3450 W CENTRAL AVE STE 118 | TOLEDO | OH | 43606 | 264665939 | SLEEP CENTER | OH | N/A | RELATED | $27,750 | 0 | 0 | 0.05000 |
| NORTHWEST OHIO ACO LLC | ||||||||||||
| 4235 SECOR ROAD | TOLEDO | OH | 43614 | 455444018 | ACCOUNTABLE CARE ORGANIZATION | OH | N/A | RELATED | 0 | 0 | 0.40000 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | Yes (1) | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Comments