2017-11-13T17:03:07-06:00 2017-06-30 621517792 Pershing Yoakley & Associates P C 2220 Sutherland Ave Knoxville TN 37919 990 2016-07-01 611566097 Central Florida Clinical Practice Organization Inc CENT 4078824806 6850 Lake Nona Blvd Health Sciences Orlando FL 32827 William F Merck II Treasurer 4078824806 2017-11-13 1 Deborah O Ernsberger P00364912 8656730844 12.29.248.130 2017-11-13 17:03:06 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 3F53249C5077106C4F63AD39F3763F8640CF5E02 2016 2017-02-10 21:41:12Z Deborah C German 6850 Lake Nona Blvd Health Sciences Orlando FL 32827 4249059 0 X N/A X 2008 FL The Corporation was formed to support and further the charitable activities of the University of Central Florida by promoting and supporting medical education, research and patient care. 10 1 0 0 0 0 0 0 3117129 4242613 -10000 0 2427 6446 3109556 4249059 0 0 0 0 0 0 0 0 0 1407659 1580411 1407659 1580411 1701897 2668648 3343000 5767975 109159 302488 3233841 5465487 X TO SUPPORT AND FURTHER THE CHARITABLE ACTIVITIES OF THE UNIVERSITY OF CENTRAL FLORIDA BY PROMOTING AND SUPPORTING MEDICAL EDUCATION, RESEARCH AND PATIENT CARE. 0 0 1386553 4242613 Central Florida Clinical Practice Organization, Inc. (CFCPO) was created to assist the University of Central Florida College of Medicine in carrying out its charitable and educational activities. CFCPO supports the business operations of the University's College of Medicine clinical mission. CFCPO collects, receives and administers the clinically related revenues and distributes that revenue in accordance with the College of Medicine Faculty Practice Plan adopted pursuant to Florida Board of Governors Regulation 6C-9.017 (Faculty Practice Plan) and University of Central Florida Regulation 10.001. CFCPO funds are applied and disbursed to cover operating expenses of the College of Medicine Clinical Mission and support the mission and objectives of the University of Central Florida College of Medicine. CFCPO's activities are an integral part of the University of Central Florida's exempt activities. 1386553 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 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 8 0 1 0 0 0 0 0 0 0 0 0 0 0 X 10 1 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 0 0 0 0 0 X Jeanette C Schreiber JD 4072661000 6850 Lake Nona Blvd Orlando FL 32827 Deborah C German MD Chair 2.00 40.00 X X 0 618739 30052 William F Merck II Treasurer 2.00 40.00 X X 0 350764 47998 Jeanette C Schreiber JD MSW Secretary 2.00 40.00 X X 0 288924 39575 A Dale Whittaker PhD Director 2.00 40.00 X 0 457095 40204 Mary Lou Sole PhD RN CCNS CNL director 2.00 40.00 X 0 263769 41411 David Noel MBA CMPE director 2.00 40.00 X 0 260222 42858 Edward Ross MD Director 2.00 40.00 X 0 398692 50891 Shazia Beg MD Director 2.00 40.00 X 0 185043 34966 Clarence Brown MD Director 2.00 0.00 X 0 0 0 Rema Gupta MD Director 2.00 40.00 X 0 238029 41852 Bernard Gros MD Former Director 2.00 40.00 X 0 339636 41007 Ray Gilley former Director 2.00 0.00 X 0 0 0 Marcia Katz MD Vice-Chair 2.00 40.00 X 0 14655 1169 0 3415568 411983 0 0 1 0 Cerner PO Box 412702 Kansas City MO 64141 EHR Hosting Services 181115 1 Patient Care Revenue 621110 3473125 3473125 Other Revenue 900099 769488 769488 4242613 6446 0 6446 6446 6446 4249059 4242613 0 6446 X 39755 39755 239385 239385 154103 154103 91389 91389 206895 206895 145415 145415 16170 16170 10488 10488 74202 74202 medical supplies 529307 529307 Miscellaneous 47523 47523 Bank Charges 25779 25779 1580411 1386553 193858 0 2767459 5190655 314956 248543 35643 24739 28209 78088 687747 597431 152132 90316 44601 135634 3343000 5767975 109159 121338 9902 0 171248 109159 302488 X 0 0 0 0 3233841 5465487 3233841 5465487 3343000 5767975 X 2668648 -437002 X 0 1 X 1 0 X 1414462 1628694 1810244 3117129 4242613 12213142 1414462 1628694 1810244 3117129 4242613 12213142 0 0 0 12213142 1414462 1628694 1810244 3117129 4242613 12213142 1.00000 1.00000 0.00000 X 687747 597431 90316 90316 Due to Affiliates 171248 171248 X 4249059 0 4249059 0 4249059 1580411 0 1580411 0 1580411 Part X, Line 2: The CFCPO is exempt from federal income taxes under Internal Revenue Code Section 501(c)(3) and is exempt from state income taxes. Accordingly, no provision for income taxes has been included in the accompanying financial statements and there were no uncertain tax positions as of June 30, 2017 and 2016. 0 0 0 0 0 0 0 0 0 Deborah C German MD Chair 0 567770 0 45950 0 5019 0 21147 0 8905 0 648791 0 0 William F Merck II Treasurer 0 326099 0 24665 0 0 0 26077 0 21921 0 398762 0 0 Jeanette C Schreiber JD MSW Secretary 0 288124 0 800 0 0 0 21391 0 18184 0 328499 0 0 A Dale Whittaker PhD Director 0 396638 0 50800 0 9657 0 20977 0 19227 0 497299 0 0 Mary Lou Sole PhD RN CCNS CNL director 0 262969 0 800 0 0 0 21126 0 20285 0 305180 0 0 David Noel MBA CMPE director 0 259422 0 800 0 0 0 20835 0 22023 0 303080 0 0 Edward Ross MD Director 0 397892 0 800 0 0 0 31549 0 19342 0 449583 0 0 Shazia Beg MD Director 0 184243 0 800 0 0 0 14895 0 20071 0 220009 0 0 Rema Gupta MD Director 0 237229 0 800 0 0 0 19267 0 22585 0 279881 0 0 Bernard Gros MD Former Director 0 338836 0 800 0 0 0 21485 0 19522 0 380643 0 0 Form 990, Part VII and Schedule J, Part II Board members are compensated by the University of Central Florida for services to the College of Medicine and receive no compensation as board members of CFCPO. Form 990, Part VI, Section A, line 7a One member of the Unversity of Central Florida Board of Trustees is appointed by the chair of the University of Central Florida Board of Trustees to serve as a member of the CFCPO board of directors. The clinical faculty of the University of Central Florida College of Medicine elects three members of the CFCPO Board of Directors. Form 990, Part VI, Section B, line 11b The tax return is prepared by an unrelated, independent accounting firm and then is submitted to internal management and the audit committee for review. Form 990, Part VI, Section B, line 12c The directors and officers are required to disclose annually all conflicts and potential conflicts in writing. If a potential conflict is disclosed, the material facts will be reviewed to determine if a conflict exists. Because of their other roles, the directors and officers of the organization are also subject to the conflict of interest policies of the University of Central Florida and have the responsibility to comply with Sections 112.311 - 112.326 of the Florida Statutes, Code of Ethics for Public Officers and Employees. Form 990, Part VI, Section C, line 19 The conflict of interest policy, in addition to other governing policies, is available upon request. All corporate policies and corporate financial statements are also available upon request. Form 990, Part IX, line 11g Other Fees: Program service expenses 239,385. Management and general expenses 0. Fundraising expenses 0. Total expenses 239,385. Form 990, Part XI, line 9: Transfer to the University of Central Florida College of Medicine -437,002. UCF Medical Center LLC 6850 Lake Nona Blvd Orlando FL 32827 453078111 Medical Services (Inactive) FL Central Florida Clinical Practice Organization Inc University of Central Florida 12424 Research Pky Orlando FL 32826 592924021 Education FL 115 N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 University of Central Florida College of Medicine O 437002 Cash