UNIVERSITY PHYSICIAN GROUP: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- UNIVERSITY PHYSICIAN GROUP (EIN 38-3474766)
- Tax period
- 2015-10-01 to 2016-09-30
- Filed
- 2017-08-15
- IRS object ID
- 201722279349302132
- Schema version
- 2015v3.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-08-15T10:58:14-05:00 | ReturnTs |
| Tax Period End | 2016-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RSM US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 S WACKER DRIVE STE 800 | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 383474766 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY PHYSICIAN GROUP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIV | BusinessNameControlTxt |
| Phone | 2485815668 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1560 E MAPLE NO 400 | AddressLine1Txt |
| City | TROY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48083 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFFERY P KOHLITZ | PersonNm |
| Person Title | VP OF FINANCE/CFO | PersonTitleTxt |
| Phone | 2485815930 | PhoneNum |
| Signature | 2017-08-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WAYNE HARDER | PreparerPersonNm |
| PTIN | P00294296 | PTIN |
| Phone | 3126343400 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JACK SOBEL MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1560 E MAPLE NO 400 | AddressLine1Txt |
| City | TROY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48083 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $218,751,671 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WSUPGDOCS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 1645 | TotalEmployeeCnt |
| Total Volunteers | 67 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $195,839,027 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $211,293,437 | CYProgramServiceRevenueAmt |
| PY Investment Income | $98,679 | PYInvestmentIncomeAmt |
| CY Investment Income | $101,208 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,707,359 | PYOtherRevenueAmt |
| CY Other Revenue | $7,330,651 | CYOtherRevenueAmt |
| PY Total Revenue | $197,645,065 | PYTotalRevenueAmt |
| CY Total Revenue | $218,725,296 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $141,348,794 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $130,672,567 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $66,600,329 | PYOtherExpensesAmt |
| CY Other Expenses | $89,056,404 | CYOtherExpensesAmt |
| PY Total Expenses | $207,949,123 | PYTotalExpensesAmt |
| CY Total Expenses | $219,728,971 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$10,304,058 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,003,675 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $68,418,727 | TotalAssetsBOYAmt |
| Total Assets EOY | $108,791,541 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,876,197 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $67,183,768 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $50,542,530 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $41,607,773 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $131,243,932 | ExpenseAmt |
| Revenue | $154,611,358 | RevenueAmt |
| Desc | PROVIDE MEDICAL SERVICES AND EDUCATIONAL OPPORTUNITIES FOR NUMEROUS DEPARTMENTS AT LOCAL AREA HOSPITALS AND FOR WAYNE STATE UNIVERSITY FACULTY, FELLOWS AND RESIDENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $50,208,582 | ExpenseAmt |
| Revenue | $63,986,355 | RevenueAmt |
| Desc | COORDINATE PROFESSIONAL AND ADMINISTRATIVE SERVICES PROVIDED TO HOSPITALS AND OTHER HEALTH CARE INSTITUTIONS AND PATIENTS; SPONSOR & CONDUCT ACTIVITIES SUPPORTING THE ACEDEMIC PROGRAMS OF THE SCHOOL OF MEDICINE (UNDER-GRADUATE AND GRADUATE TEACHING PROGRAMS, RECRUITING HIGH QUALITY FACULTY MEMBERS, AND PROVIDING PUBLIC ACCESS TO ADVANCED HEALTH CARE SERVICES.) | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $149,717 | ExpenseAmt |
| Revenue | $0 | RevenueAmt |
| Desc | ESTABLISH AND CONDUCT REGULATORY COMPLIANCE PROGRAMS COVERING ALL DEPARTMENTS OF THE CORPORATION APPLICABLE TO HEALTH CARE SERVICES FURNISHED TO TEACHING PATIENTS AND TO OTHERS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $181,602,231 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | 0 | 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 | 0 | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 251 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1645 | 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFFERY KOHLITZ | PersonNm |
| Phone | 2485815930 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1560 E MAPLE STE 400 | AddressLine1Txt |
| City | TROY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48083 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| JACK SOBEL MD | |||||||||
| CHAIRPERSON | 40.00 | 0.00 | Yes (X) | Yes (X) | $357,281 | $0 | $30,116 | ||
| LIZABEH ARDISANA | |||||||||
| VICE CHAIR | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| WAEL SAKR MD | |||||||||
| SECRETARY | 40.00 | 0.00 | Yes (X) | Yes (X) | $371,210 | $0 | $30,110 | ||
| BASIM DUBAYBO MD | |||||||||
| TREASURER | 40.00 | 0.00 | Yes (X) | Yes (X) | $277,552 | $0 | $30,309 | ||
| LAWRENCE HORN MD | |||||||||
| CLINICAL CHAIR-BOARD MEMBER | 40.00 | 0.00 | Yes (X) | $96,075 | $0 | $0 | |||
| DAVID ROSENBERG MD | |||||||||
| CLINICAL CHAIR-BOARD MEMBER | 40.00 | 0.00 | Yes (X) | $406,444 | $0 | $32,557 | |||
| DONALD WEAVER MD | |||||||||
| CLINICAL CHAIR-BOARD MEMBER | 40.00 | 0.00 | Yes (X) | $241,841 | $0 | $27,248 | |||
| MICHAEL CHER MD | |||||||||
| CLINICAL CHAIR-BOARD MEMBER | 40.00 | 0.00 | Yes (X) | $140,659 | $0 | $15,764 | |||
| GEROLD BEPLER MD | |||||||||
| CLINICAL CHAIR-BOARD MEMBER | 40.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| CARLA WALKER-MILLER | |||||||||
| COMMUNITY BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MAHA FREIJ | |||||||||
| COMMUNITY BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL BUSUITO MD | |||||||||
| COMMUNITY BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| RICHARD BROWN DO | |||||||||
| COMMUNITY BOARD MBR(AS OF 10/01/15) | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| SCOTT THORNTON | |||||||||
| COMMUNITY BOARD MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK JURZYCH MD | |||||||||
| CLNCL CHR-BOARD MBR(UNTIL 01/04/16) | 40.00 | 0.00 | Yes (X) | $794,702 | $0 | $30,396 | |||
| LISA KEANE | |||||||||
| PRESIDENT (AS OF 01/04/16) | 40.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| SAFWAN BADR MD | |||||||||
| CMO (AS OF 10/1/2015) | 40.00 | 0.00 | Yes (X) | $308,967 | $0 | $30,252 | |||
| JEFFERY KOHLITZ | |||||||||
| VP FINANCE (AS OF 08/22/16) | 40.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DIANE K STILLER | |||||||||
| CFO/COO (UNTIL 05/31/16) | 40.00 | 0.00 | Yes (X) | $232,343 | $0 | $41,860 | |||
| KENNETH P LEE CPA | |||||||||
| EXEC DIR/TREASURER (UNTIL 01/03/16) | 1.00 | 0.00 | Yes (X) | $268,447 | $0 | $49,895 | |||
| OMAR KHAN MD | |||||||||
| CEO (UNTIL 01/04/16) | 40.00 | 0.00 | Yes (X) | $434,861 | $0 | $27,196 | |||
| LUAY HADDAD | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $947,530 | $0 | $48,773 | Yes (X) | |||
| ASHEESH TEWARI | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $923,849 | $0 | $27,280 | Yes (X) | |||
| JOHN WEBBER | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $637,696 | $0 | $30,309 | Yes (X) | |||
| JOFFER HAKIM | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $603,499 | $0 | $53,527 | Yes (X) | |||
| HAZEM ELTAHAWY | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $612,559 | $0 | $30,309 | Yes (X) | |||
| JOHN FLACK MD MPH | |||||||||
| FORMER SECRETARY | 1.00 | 0.00 | $123,601 | $0 | $13,953 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $7,779,116 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $549,854 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 341 | 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 |
|---|---|---|---|---|---|
| HENRY FORD HEALTH SYSTEM | |||||
| 2799 W GRAND BLVD | DETROIT | MI | 48202 | MEDICAL SERVICES | $8,754,012 |
| UNIVERSITY PEDIATRICIANS | |||||
| 7457 E CAD BLVD SUITE 200 | CLARKSTON | MI | 48348 | MEDICAL SERVICES | $8,437,970 |
| ST JOHN EMERGENCY PHYSICIANS PC | |||||
| 17717 MASONIC BLVD | FRASER | MI | 48026 | MEDICAL SERVICES | $4,070,742 |
| MEDICAL CENTER EMERGENCY SERVICES | |||||
| 39300 W TWELVE MILE ROAD SUITE 10 | FARMINGTON | MI | 483312989 | MEDICAL SERVICES | $3,300,427 |
| ANESTHESIA SERVICES PC | |||||
| PO BOX 1009 | JACKSON | MI | 49204 | MEDICAL SERVICES | $2,521,494 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 25 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUES | 900099 | $154,611,358 | $154,611,358 |
| ADMIN & CLINICAL SVCS SUPPORT | 900099 | $55,908,665 | $55,908,665 |
| RENTAL INCOME | 900099 | $773,414 | $773,414 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $211,293,437 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $127,583 | TotalRevenueColumnAmt |
| Exclusion | $127,583 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $26,375 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$26,375 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$26,375 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$26,375 | RelatedOrExemptFuncIncomeAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,330,651 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,330,651 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $7,330,651 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $218,725,296 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $218,597,713 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $127,583 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,840,903 | TotalAmt |
| Program Services | $1,840,903 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,958,806 | TotalAmt |
| Program Services | $100,031,926 | ProgramServicesAmt |
| Management And General | $9,926,880 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,546,964 | TotalAmt |
| Program Services | $3,094,755 | ProgramServicesAmt |
| Management And General | $452,209 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,935,010 | TotalAmt |
| Program Services | $7,077,500 | ProgramServicesAmt |
| Management And General | $1,857,510 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,390,884 | TotalAmt |
| Program Services | $5,202,959 | ProgramServicesAmt |
| Management And General | $1,187,925 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $325,386 | TotalAmt |
| Program Services | $30,670 | ProgramServicesAmt |
| Management And General | $294,716 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,381,114 | TotalAmt |
| Program Services | $17,185,365 | ProgramServicesAmt |
| Management And General | $4,195,749 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,052,987 | TotalAmt |
| Program Services | $1,857,953 | ProgramServicesAmt |
| Management And General | $1,195,034 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,335 | TotalAmt |
| Program Services | $148,948 | ProgramServicesAmt |
| Management And General | $55,387 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,667,876 | TotalAmt |
| Program Services | $7,149,520 | ProgramServicesAmt |
| Management And General | $4,518,356 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,007 | TotalAmt |
| Program Services | $67,497 | ProgramServicesAmt |
| Management And General | $35,510 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $375,559 | TotalAmt |
| Program Services | $341,728 | ProgramServicesAmt |
| Management And General | $33,831 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,257 | TotalAmt |
| Management And General | $70,257 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,070,193 | TotalAmt |
| Program Services | $1,183,395 | ProgramServicesAmt |
| Management And General | $1,886,798 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,538,957 | TotalAmt |
| Program Services | $262,953 | ProgramServicesAmt |
| Management And General | $6,276,004 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PRACTICE EXPENSE | $12,061,757 | $12,054,847 | $6,910 |
| FUND FOR MEDICAL RESEAR | $11,188,521 | $11,045,709 | $142,812 |
| BAD DEBT | $10,760,866 | $10,760,866 | |
| INTERCOMPANY | $4,146,377 | $4,146,377 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,109,212 | TotalAmt |
| Program Services | $2,264,737 | ProgramServicesAmt |
| Management And General | $1,844,475 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,728,971 | TotalAmt |
| Program Services | $181,602,231 | ProgramServicesAmt |
| Management And General | $38,126,740 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,301,647 | BOYAmt |
| EOY | $32,374,658 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,365,487 | BOYAmt |
| EOY | $44,581,989 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,655,841 | BOYAmt |
| EOY | $1,416,138 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $28,373,774 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $22,949,719 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,315,445 | BOYAmt |
| EOY | $5,424,055 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,332,307 | BOYAmt |
| EOY | $13,333,057 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $448,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $11,661,644 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,418,727 | BOYAmt |
| EOY | $108,791,541 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,258,189 | BOYAmt |
| EOY | $12,177,530 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,315,649 | BOYAmt |
| EOY | $54,837,144 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $302,359 | BOYAmt |
| EOY | $169,094 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,876,197 | BOYAmt |
| EOY | $67,183,768 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,542,530 | BOYAmt |
| EOY | $41,607,773 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,542,530 | BOYAmt |
| EOY | $41,607,773 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,418,727 | BOYAmt |
| EOY | $108,791,541 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,003,675 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$6,391,803 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$1,539,279 | 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $193,423,807 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $194,932,690 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $189,185,088 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $197,546,386 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $218,624,088 | CurrentTaxYearAmt |
| Total | $993,712,059 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $193,423,807 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $194,932,690 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $189,185,088 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $197,546,386 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $218,624,088 | CurrentTaxYearAmt |
| Total | $993,712,059 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $993,712,059 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,035 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,182 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,896 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $117,583 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $127,583 | CurrentTaxYearAmt |
| Total | $270,279 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,035 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,182 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,896 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $117,583 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $127,583 | CurrentTaxYearAmt |
| Total | $270,279 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $193,431,842 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $194,941,872 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $189,192,984 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $197,663,969 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $218,751,671 | CurrentTaxYearAmt |
| Total | $993,982,338 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99970 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99980 | PublicSupportPY509Pct |
| Investment Income CY | 0.00030 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $49,500 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $49,500 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE LOBBYING EFFORT IS TO CREATE A CONTINUED AWARENESS WITH LAWMAKERS OF THE ONGOING NEED TO SUSTAIN THE MEDICAID ENHANCEMENT PAYMENT PROGRAM. THE GOAL OF THE PROGRAM IS TO OFFER ACCESS TO HIGH QUALITY MEDICAL CARE FOR THOSE MEDICAID PATIENTS SEEN BY THE PHYSICIANS AND OTHER HEALTH CARE PROVIDERS OF UNIVERSITY PHYSICIAN GROUP. THIS PROGRAM PROVIDES ADDITIONAL PAYMENTS TO PHYSICIANS, ABOVE THE PUBLISHED MEDICAID FEE SCREENS, AS AN INCENTIVE TO SEE MEDICAID PATIENTS AND THE OTHER UNDER-SERVED MEMBERS OF THE COMMUNITY. | ExplanationTxt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,200,816 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,810,333 | DepreciationAmt |
| Book Value | $1,390,483 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,172,958 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,139,386 | DepreciationAmt |
| Book Value | $4,033,572 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,424,055 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| UNIVERSITY PHYSICIAN SVCS | $10,735,175 | C |
| OHS/UPG VENTURES | $1,797,624 | C |
| OAKLAND PHYSICIAN SURGERY CENTER | $780,008 | C |
| OAKWOOD ACO | $20,250 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $13,333,057 | TotalBookValueProgramRltdAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| RELATED PARTY | $2,630,000 |
| INSURANCE RECOVERIES | $9,031,644 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $11,661,644 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAPITAL LEASE OBLIGATIONS | Desc |
| Amt | $169,094 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $169,094 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | IN A DETERMINATION LETTER DATED MARCH 22, 2001, THE INTERNAL REVENUE SERVICE HELD THAT THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE CODE. THE ORGANIZATION IS SUBJECT TO TAX ON ANY UNRELATED BUSINESS INCOME. THE ORGANIZATION AND ITS SUBSIDIARIES FILE INCOME TAX RETURNS IN THE U.S. FEDERAL JURISDICTION AND VARIOUS STATE AND LOCAL JURISDICTIONS. FEDERAL, STATE AND LOCAL TAX RETURNS GENERALLY REMAIN OPEN FOR EXAMINATION BY THE VARIOUS TAXING AUTHORITIES FOR A PERIOD OF THREE TO FOUR YEARS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | 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 | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JACK SOBEL MD | ||||||||||||||
| CHAIRPERSON | $353,264 | $0 | $0 | $0 | $4,017 | $0 | $29,150 | $0 | $966 | $0 | $387,397 | $0 | $0 | $0 |
| WAEL SAKR MD | ||||||||||||||
| SECRETARY | $350,000 | $0 | $21,210 | $0 | $0 | $0 | $29,150 | $0 | $960 | $0 | $401,320 | $0 | $0 | $0 |
| BASIM DUBAYBO MD | ||||||||||||||
| TREASURER | $276,778 | $0 | $0 | $0 | $774 | $0 | $29,150 | $0 | $1,159 | $0 | $307,861 | $0 | $0 | $0 |
| DAVID ROSENBERG MD | ||||||||||||||
| CLINICAL CHAIR-BOARD MEMBER | $331,444 | $0 | $75,000 | $0 | $0 | $0 | $29,150 | $0 | $3,407 | $0 | $439,001 | $0 | $0 | $0 |
| DONALD WEAVER MD | ||||||||||||||
| CLINICAL CHAIR-BOARD MEMBER | $162,055 | $0 | $77,500 | $0 | $2,286 | $0 | $26,351 | $0 | $897 | $0 | $269,089 | $0 | $0 | $0 |
| MICHAEL CHER MD | ||||||||||||||
| CLINICAL CHAIR-BOARD MEMBER | $44,536 | $0 | $95,842 | $0 | $281 | $0 | $15,442 | $0 | $322 | $0 | $156,423 | $0 | $0 | $0 |
| MARK JURZYCH MD | ||||||||||||||
| CLNCL CHR-BOARD MBR(UNTIL 01/04/16) | $792,457 | $0 | $0 | $0 | $2,245 | $0 | $29,150 | $0 | $1,246 | $0 | $825,098 | $0 | $0 | $0 |
| SAFWAN BADR MD | ||||||||||||||
| CMO (AS OF 10/1/2015) | $301,190 | $0 | $7,196 | $0 | $581 | $0 | $29,150 | $0 | $1,102 | $0 | $339,219 | $0 | $0 | $0 |
| DIANE K STILLER | ||||||||||||||
| CFO/COO (UNTIL 05/31/16) | $221,155 | $0 | $10,000 | $0 | $1,188 | $0 | $25,808 | $0 | $16,052 | $0 | $274,203 | $0 | $0 | $0 |
| KENNETH P LEE CPA | ||||||||||||||
| EXEC DIR/TREASURER (UNTIL 01/03/16) | $266,161 | $0 | $0 | $0 | $2,286 | $0 | $29,150 | $0 | $20,745 | $0 | $318,342 | $0 | $0 | $0 |
| OMAR KHAN MD | ||||||||||||||
| CEO (UNTIL 01/04/16) | $399,717 | $0 | $35,144 | $0 | $0 | $0 | $26,431 | $0 | $765 | $0 | $462,057 | $0 | $0 | $0 |
| LUAY HADDAD | ||||||||||||||
| PHYSICIAN | $345,619 | $0 | $601,147 | $0 | $764 | $0 | $29,150 | $0 | $19,623 | $0 | $996,303 | $0 | $0 | $0 |
| ASHEESH TEWARI | ||||||||||||||
| PHYSICIAN | $923,849 | $0 | $0 | $0 | $0 | $0 | $26,500 | $0 | $780 | $0 | $951,129 | $0 | $0 | $0 |
| JOHN WEBBER | ||||||||||||||
| PHYSICIAN | $499,118 | $0 | $137,750 | $0 | $828 | $0 | $29,150 | $0 | $1,159 | $0 | $668,005 | $0 | $0 | $0 |
| JOFFER HAKIM | ||||||||||||||
| PHYSICIAN | $584,507 | $0 | $18,337 | $0 | $655 | $0 | $29,150 | $0 | $24,377 | $0 | $657,026 | $0 | $0 | $0 |
| HAZEM ELTAHAWY | ||||||||||||||
| PHYSICIAN | $612,379 | $0 | $0 | $0 | $180 | $0 | $29,150 | $0 | $1,159 | $0 | $642,868 | $0 | $0 | $0 |
| JOHN FLACK MD MPH | ||||||||||||||
| FORMER SECRETARY | $48,139 | $0 | $0 | $0 | $75,462 | $0 | $13,545 | $0 | $408 | $0 | $137,554 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE POSITIONS ARE HIRED AS PART OF A COLLABORATIVE PROCESS WITH WAYNE STATE UNIVERSITY AND THE HIRING PROCESS INCLUDES FORMAL OFFER LETTER APPROVED BY THE WSU BOARD OF GOVERNORS AS WELL AS THE UPG BOARD. |
| PART I, LINE 4A | PURSUANT TO THE TERMS OF A SEVERANCE AGREEMENT BETWEEN UNIVERSITY PHYSICAN GROUP AND JOHN FLACK, THE ORGANIZATION PAID JOHN FLACK $75,000 OF SEVERANCE IN CALENDAR YEAR 2015 THAT WAS TREATED AS TAXABLE. |
| PART I, LINE 5 | THE ORGANIZATION MAKES PAYMENTS TO SOME PHYSICIANS (WHO ARE ALSO BOARD MEMBERS) FOR DIRECT COMPENSATION THAT ARE BASED ON REVENUES AS PART OF INCENTIVE-BASED COMPENSATION. |
| PART I, LINE 6 | THE ORGANIZATION MAKES PAYMENTS TO SOME PHYSICIANS (WHO ARE ALSO BOARD MEMBERS) FOR DIRECT COMPENSATION THAT ARE BASED ON EARNINGS AS PART OF INCENTIVE-BASED COMPENSATION. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 | TO FURNISH MEDICAL CARE AND RELATED SERVICES IN AN ACADEMIC HEALTH CARE SETTING THROUGH EMPLOYED LICENSED PHYSICIANS HOLDING FACULTY APPOINTMENTS IN CLINICAL DEPARTMENTS AT THE WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE AND THROUGH OTHER APPROPRIATELY LICENSED PHYSICIANS AND HEALTH PROFESSIONALS. |
| FORM 990, PART III, LINE 1 | TO FURNISH MEDICAL CARE AND RELATED SERVICES IN AN ACADEMIC HEALTH CARE SETTING THROUGH EMPLOYED LICENSED PHYSICIANS HOLDING FACULTY APPOINTMENTS IN CLINICAL DEPARTMENTS AT THE WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE AND THROUGH OTHER APPROPRIATELY LICENSED PHYSICIANS AND HEALTH PROFESSIONALS. |
| FORM 990, PART VI, SECTION A, LINE 4 | DURING FISCAL YEAR 2016 THE ORGANIZATION AMENDED ITS BYLAWS TO SHIFT ITS FOCUS FROM A COMMUNITY FOCUSED BOARD TO A CHAIR FOCUSED BOARD. THE BOARD CHAIR IS NOW THE DEAN OF THE WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE INSTEAD OF A COMMUNITY MEMBER. DUE TO THE SHIFT IN FOCUS, THE ENTIRE COMMITTEE AND SUBCOMMITTE STRUCTURE WAS REVAMPED AS WELL. |
| FORM 990, PART VI, SECTION B, LINE 11 | ORGANIZATION'S PROCESS TO REVIEW FORM 990: THE ORGANIZATION'S CFO REVIEWS A DRAFT OF THE 990 AND REVIEWS THE FINAL COPY OF THE RETURN BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE UPG FINANCE DEPARTMENT SENT OUT EMAIL NOTIFICATIONS TO THE PRACTICE ADMINISTRATORS WITH INSTRUCTIONS TO THEIR RESPECTIVE DEPARTMENT CHAIRS ASKING THEM TO RESPOND FOR ANY POTENTIAL CONFLICTS OF INTEREST WITH UPG. UPG DID NOT HAVE A FORMALLY ASSIGNED CHIEF COMPLIANCE OFFICER IN FISCAL 2016, HOWEVER, ANY DISCLOSURES WERE REVIEWED BY THE CFO TO DETERMINE WHETHER THERE ARE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | FORM 990, PART VI, LINE 15A HIRING PROCESS FOR TOP OFFICIALS: THE POSITIONS ARE HIRED AS PART OF A COLLABORATIVE PROCESS WITH WAYNE STATE UNIVERSITY AND THE HIRING PROCESS INCLUDES FORMAL OFFER LETTERS/CONTRACTS APPROVED BY THE WSU BOARD OF GOVERNORS AS WELL AS THE UPG BOARD. FORM 990, PART VI, LINE 15B COMPENSATION PROCESS FOR CORPORATE OFFICERS: COMPENSATION IS DETERMINED AS PART OF A COLLABORATIVE PROCESS WITH WAYNE STATE UNIVERSITY AND THE HIRING PROCESS INCLUDES FORMAL OFFER LETTER APPROVED BY THE WSU BOARD OF GOVERNORS AS WELL AS THE UPG BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS DISCLOSURE EXPLANATION: NO DOCUMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9: | NET ASSET TRANSFER TO MAPLE SURGERY CENTER -1,257,634. NET ASSET TRANSFER -281,645. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY ANESTHESIA SERVICES LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1560 E MAPLE STE 400 | AddressLine1Txt |
| City | TROY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48083 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 455505859 | EIN |
| Primary Activities | ANESTHESIA | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Total Income | $196,162,175 | TotalIncomeAmt |
| End Of Year Assets | $107,319,823 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPG | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FUND FOR MEDICAL RESEARCH & EDUCATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1560 E MAPLE STE 400 | AddressLine1Txt |
| City | TROY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48083 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382319524 | EIN |
| Primary Activities | MEDICAL | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 11C, III-FI | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OPSC DBA MAPLE SURGERY CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1560 E MAPLE STE 400 | AddressLine1Txt |
| City | TROY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48083 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454916090 | EIN |
| Primary Activities | MEDICAL | PrimaryActivitiesTxt |
| Legal Domicile State | MI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPG | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $1,006,049 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $2,074,150 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (1) | GeneralOrManagingPartnerInd |
| Ownership | 0.80410 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| UNIVERSITY PHYSICIANS SERVICES | |||||||||
| 1560 E MAPLE STE 400 | TROY | MI | 48083 | 383386347 | MEDICAL | MI | UPG | C | Yes (1) |
| OHSUPG VENTURES | |||||||||
| 1560 E MAPLE STE 400 | TROY | MI | 48083 | 205072681 | MEDICAL | MI | UPG | C | Yes (1) |
| 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 | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | 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 | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OAKLAND PHYSICIAN SURGERY CENTER LLC (OPSC) | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | R | TransactionTypeTxt |
| Involved | $1,257,634 | InvolvedAmt |
| Method Of Amount Determination | CASH | MethodOfAmountDeterminationTxt |
Comments