2015-02-12T17:10:38-06:00 2014-06-30 261659234 CW ASSOCIATES CPAS 700 BISHOP STREET SUITE 1040 HONOLULU HI 96813 990 2013-07-01 990307152 UNIVERSITY CLINICAL EDUCATION & RESEARCH ASSOCIATES (UCERA) UNIV 8084694961 677 ALA MOANA BOULEVARD NO 1001 HONOLULU HI 96813 DR ARNAR MAGNUSSON CHIEF EXECUTIVE OFFICER 8084694961 2015-02-12 1 MARK A HAYES P00085205 8085311040 2013 2016-03-07 17:11:31Z DR ARNAR MAGNUSSON 677 ALA MOANA BOULEVARD NO 1001 HONOLULU HI 96813 37769937 0 X WWW.UCERA.ORG X 1993 HI TO PROVIDE FUNDING TO BUILD AND SUSTAIN THE INFRASTRUCTURE OF THE JOHN A. BURNS SCHOOL OF MEDICINE AND ITS DEPARTMENTS; FUND RESEARCH, EDUCATION, AND SCHOLARLY DEVELOPMENT; PROVIDE ADDITIONAL RESOURCES TO RECRUIT, RETAIN, AND DEVELOP QUALIFIED FACULTY AT THE UNIVERSITY OF HAWAII; PROVIDE CLINICAL TRAINING AND EDUCATION TO STUDENTS OF THE UNIVERSITY OF HAWAII; AND PROVIDE HEALTH CARE TO THE GENERAL PUBLIC, WITH SPECIAL ATTENTION TO THE POOR AND OTHER UNDERSERVED POPULATIONS OF HAWAII AND THE PACIFIC REGION. 19 6 286 13 0 0 361083 610819 28682295 28834250 22081 114700 70533 83347 29135992 29643116 0 0 0 0 16648987 17434419 0 0 23659 10435522 10026402 27084509 27460821 2051483 2182295 17702496 20581444 4237241 4721503 13465255 15859941 X UCERA IS A NON-PROFIT ORGANIZATION ESTABLISHED TO FURTHER THE MISSION AND VISION OF THE JOHN A. BURNS SCHOOL OF MEDICINE AT THE UNIVERSITY OF HAWAII (JABSOM). IT CONTRIBUTES TO JABSOM'S GOAL OF IMPROVING THE HEALTH CARE STATUS OF THE CITIZENS OF HAWAII AND THE PACIFIC BY SUPPORTING THE EDUCATION, RESEARCH AND CLINICAL ACTIVITIES OF THE SCHOOL. IT SUPPORTS FINANCIAL DIVERSIFICATION OF THE SCHOOL BY DEVELOPING REVENUE GENERATING INITIATIVES IN COLLABORATION WITH HOSPITALS, GOVERNMENT AGENCIES AND OTHER ENTITIES. 0 0 18775689 28561507 CLINICAL AND PROFESSIONAL SERVICES - 1) PROVIDE HEALTH CARE TO THE GENERAL PUBLIC, WITH SPECIAL ATTENTION TO THE POOR AND OTHER UNDERSERVED POPULATIONS OF HAWAII AND THE PACIFIC REGION. 2) SPECIALTY CLINICS - MULTI-SPECIALTY FACULTY PRACTICE AT CLINICS LOCATED AT VARIOUS SITES INCLUDING: GOLD BOND BUILDING (677 ALA MOANA BLVD, HONOLULU, HI 96813); 1319 PUNAHOU STREET, SUITE 800, 801, 900; 94-235 HANAWAI CIRCLE, WAIPAHU, HI 96797; QUEEN'S OUTPATIENT CENTER; PHYSICIAN'S OFFICE BUILDINGS AT QUEEN'S; LEAHI HOSPITAL; MOLOKAI GENERAL HOSPITAL. PROVIDE PHYSICIANS ON THE UNIVERSITY OF HAWAII FACULTY WITH A BASE OF OB/GYN, ENDOCRINE, INTERNAL MEDICINE, GERIATRIC, SURGICAL, AND PSYCHIATRIC PATIENTS FROM WHICH THEY CAN EDUCATE MEDICAL STUDENTS AND RESIDENTS. 3) QUEEN'S HOSPITAL AND HAWAII PACIFIC HEALTH/KAPIOLANI HOSPITAL/WAHIAWA GENERAL CONTRACTS - PROVIDE FACULTY MEMBERS TO TREAT PATIENTS AND TO PROVIDE SPECIALTY CLINICAL SERVICES TO HOSPITALS. 4) VETERAN'S ADMINISTRATION SPECIALTY CLINICS - PROVIDE SPECIALIST PHYSICIANS TO TREAT PATIENTS AT THE VA MEDICAL & REGIONAL OUTPATIENT CLINIC. THIS POPULATION TENDS TO BE INDIGENT AND UNDERSERVED. THE VA CLINIC IS ALSO A TEACHING SITE FOR THE UNIVERSITY OF HAWAII JOHN A. BURNS SCHOOL OF MEDICINE AND PROVIDES A BASE OF TEACHING PATIENTS. 2956039 MEDICAL SCHOOL AND FACULTY SUPPORT - IN GENERAL, PROVIDES FUNDING TO BUILD AND SUSTAIN THE INFRASTRUCTURE OF THE UNIVERSITY OF HAWAII JOHN A. BURNS SCHOOL OF MEDICINE AND ITS DEPARTMENTS. PROVIDE ADDITIONAL RESOURCES TO RECRUIT, RETAIN, AND DEVELOP QUALIFIED FACULTY AT THE UNIVERSITY OF HAWAII MEDICAL SCHOOL. 889421 EDUCATIONAL SUPPORT - 1) IN GENERAL, PROVIDE EDUCATION AND CLINICAL TRAINING FOR THE UNIVERSITY OF HAWAII MEDICAL SCHOOL STUDENTS. 2) INTERNATIONAL TRAINING PROGRAM (INL-FS) - PROVIDE INTERNATIONAL MEDICAL STUDENTS AND RESIDENTS WITH U.S. TRAINING EXPERIENCES AT THE UNIVERSITY OF HAWAII JOHN A. BURNS SCHOOL OF MEDICINE. 3) OFFICE OF MEDICAL EDUCATION (OME-ME) - PROVIDE SIMULATED PATIENTS FOR CLINICAL SKILLS TRAINING AND EXAMINATIONS FOR SCHOOL OF MEDICINE STUDENTS AND RESIDENTS. 632717 306323 RESEARCH SUPPORT - UCERA HAS A QUEEN'S MEDICAL CENTER CONTRACT TO CONDUCT CARDIOVASCULAR RESEARCH AND EDUCATION CONSULTING FOR ABOUT 6 HOURS PER WEEK. THERE WAS NO OTHER RESEARCH ACTIVITY THROUGH UCERA IN FISCAL YEAR 2013. UCERA IS IN POSITION TO ACCOMODATE RESEARCH ACTIVITIES THAT REQUIRE HIPAA COMPLIANT HANDLING OF PROTECTED HEALTH INFORMATION (PHI). 632717 306323 23253866 1 1 0 0 0 0 0 0 0 1 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 1 0 1 0 0 0 0 1 0 0 0 1 60 0 286 1 0 0 0 0 0 0 0 0 0 0 X 19 6 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 HI X JOSEPH ADRIANO 8084694959 677 ALA MOANA BOULEVARD NO 1001 HONOLULU HI 96813 X JERRIS HEDGES CHAIR 10.00 X X 0 0 0 DIRK YOSHIZAWA VICE CHAIR 1.00 X X 0 0 0 JAMES BURNS SECRETARY 1.00 X X 0 0 0 MICHAEL ERNE TREASURER 1.00 X X 0 0 0 KHENG SEE ANG DIRECTOR 1.00 X 0 0 0 EUGENE BAL III DIRECTOR 1.00 X 0 0 0 MARY BOLAND DIRECTOR 1.00 X 0 0 0 ANTHONY PS GUERRERO DIRECTOR/EMPLOYEE 20.00 X 108060 0 3468 ROSANNE HARRIGAN DIRECTOR 1.00 X 0 0 0 ALLEN L HIXON DIRECTOR/EMPLOYEE 9.00 X 108542 0 2875 SATORU IZUTSU DIRECTOR/EMPLOYEE 20.00 X 91680 0 212 JOSEPH KAHOLOKULA DIRECTOR 1.00 X 0 0 0 ANNE KATEKARU DIRECTOR 1.00 X 0 0 0 KAMAL MASAKI DIRECTOR/EMPLOYEE 5.00 X 33467 0 752 KENNETH NAKAMURA DIRECTOR 1.00 X 0 0 0 ALAN SCHILLER DIRECTOR 1.00 X 0 0 0 SUSAN STEINEMANN DIRECTOR/EMPLOYEE 32.00 X 240118 0 8854 ELIZABETH TAM DIRECTOR 1.00 X 0 0 0 IVICA ZALUD DIRECTOR/EMPLOYEE 48.00 X 234608 0 7173 PATRICIA AL BLANCHETTE CEO UNTIL 1-13-14/EMPLOYEE 40.00 X 248979 0 10338 ARNAR MAGNUSSON CEO/CMO/EMPLOYEE 40.00 X 100258 0 247 JOSEPH ADRIANO CFO/EMPLOYEE 40.00 X 130033 0 5850 LAUREN KWAK IN HOUSE COUNSEL CHIEF COMPLIANCE OFFICER 40.00 X 74213 0 14936 MARGUERITE LISA BARTHOLOMEW EMPLOYEE 40.00 X 302157 0 5818 JANET BURLINGAME EMPLOYEE 40.00 X 326251 0 8009 BARRY CARLTON EMPLOYEE 40.00 X 362061 0 7854 MICHAEL CARNEY EMPLOYEE 40.00 X 366765 0 13887 ROBERT J KIM EMPLOYEE 40.00 X 325320 0 16738 3052512 0 107011 40 0 1 0 UH OFFICE OF RESEARCH SVC 2530 DOLE ST SAKAMAKI D-200 HON HI 96822 PHYSICIAN/ADMIN COMP 5196488 HILO MEDICAL CENTER 1190 WAIANUENUE AVENUE HILO HI 96720 PHYSICIAN/ADMIN COMP 384871 KAEO RAD LLC 4348 WAIALAE AVENUE HONOLULU HI 96816 IT MANAGEMENT SERVICES 267671 KAPIOLANI MEDICAL CENTER FOR WOMEN AND C 1319 PUNAHOU STREET HONOLULU HI 96826 TECHNICAL SERVICES 164286 HAWAII RESIDENCY PROGRAM INC 1356 LUSITANA STREET 5TH FLOOR51 HONOLULU HI 96813 ADMIN COMPENSATION 112326 5 610819 330050 610819 SPECIALTY CLINICS 621400 16288919 16288919 HAWAII PACIFIC HEALTH 621110 5900514 5900514 QUEENS MEDICAL CENTER 621110 5193262 5193262 OTHER CONTRACTS 900099 1145232 1145232 FEES AND CONTRACT FROM GOVERNMENT 900099 306323 306323 28834250 66805 66805 49767 0 49767 49767 49767 8174716 8126821 47895 47895 47895 NON-OPERATING INCOME 900099 33580 33580 33580 29643116 28867830 0 164467 1621966 1371855 248516 1595 13725370 11653904 2057371 14095 263001 216815 46186 850791 595014 255777 973291 818848 154443 4436 4436 57015 57015 14346 14346 388485 352249 35696 540 670842 549390 120766 686 1430102 1021287 406506 2309 438820 408820 29831 169 190039 149969 39844 226 100899 5054 95304 541 PURCHASED SERVICES 5813115 5261098 548899 3118 BAD DEBT EXPENSE 605442 605442 MISCELLANEOUS EXPENSE 246878 197446 49161 271 DUES AND MEMBERSHIP 65983 46675 19199 109 27460821 23253866 4183296 23659 27175 1175 10126752 7511380 3513761 3454276 562621 581710 3102367 1857866 1078941 1244501 1981033 7710976 412213 77426 17702496 20581444 2688836 3443180 923191 1548405 355132 4237241 4721503 X 13085410 15499182 279583 260497 100262 100262 13465255 15859941 17702496 20581444 2182295 212391 0 X 0 1 X 1 0 X 460366 149287 796293 361083 610820 2377849 26274147 29883097 29948734 28682295 28834250 143622523 26734513 30032384 30745027 29043378 29445070 146000372 10000 10000 10000 200 204 30404 0 10000 10000 10000 200 204 30404 145969968 74104 52355 57726 82409 116572 383166 74104 52355 57726 82409 116572 383166 117136 127709 165631 9753 33580 453809 26925753 30212448 30968384 29135540 29595222 146837347 0.99410 0.99350 0.00260 0.00330 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: NON-OPERATING INCOME - 2009 AMOUNT: $ 117,136. 2011 AMOUNT: $ 9,750. 2012 AMOUNT: $ 9,753. 2013 AMOUNT: $ 33,580. OTHER REVENUE - 2010 AMOUNT: $ 127,709. 2011 AMOUNT: $ 155,881. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 100262 100262 100262 100262 0.00000 1.00000 0.00000 0 0 820762 100372 720390 2281605 1757494 524111 1244501 DUE TO JABSOM 355132 355132 X 29860246 212390 212390 29647856 14346 -19086 -4740 29643116 27446475 0 27446475 14346 14346 27460821 PART V, LINE 4: DURING THE YEAR ENDED JUNE 30, 2013, UCERA RECEIVED A PERMANENTLY RESTRICTED CONTRIBUTION AMOUNTING TO $100,262 TO CREATE AN ENDOWMENT TO SUPPORT THE CLINICAL WORK OF PATRICIA BLANCHETTE, M.D. AS LONG AS SHE IS AFFILIATED WITH UCERA, OR IF SHE NO LONGER HAS SUCH AFFILIATION, TO SUPPORT THE GENERAL CLINICAL WORK OF UCERA. THE PERMANENTLY RESTRICTED CONTRIBUTION WAS HELD IN AN OPERATING CASH ACCOUNT AT JUNE 30, 2013 AND INVESTED IN MARKETABLE SECURITIES IN JUNE 30, 2014. PART X, LINE 2: U.S. GAAP REQUIRES UNCERTAIN TAX POSITIONS TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS IF THEY ARE MORE LIKELY THAN NOT TO FAIL UPON REGULATORY EXAMINATION. MANAGEMENT HAS EVALUATED UCERA'S TAX POSITIONS AS OF JUNE 30, 2014 AND 2013 AND FOR THE YEARS THEN ENDED BY REVIEWING ITS INCOME TAX RETURNS AND CONFERRING WITH ITS TAX ADVISORS, AND DETERMINED THAT UCERA HAD NO UNCERTAIN TAX POSITIONS REQUIRED TO BE REPORTED IN ACCORDANCE WITH SUCH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. SUCH RETURNS ARE GENERALLY OPEN FOR EXAMINATION BY TAXING AUTHORITIES UNTIL THE STATUTES OF LIMITATIONS EXPIRE. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE TAX YEARS PRIOR TO 2010. PART XI, LINE 4B - OTHER ADJUSTMENTS: DECREASE IN TEMPORARILY RESTRICTED NET ASSETS -19,086. X X X 0 0 0 0 0 0 0 0 0 SUSAN STEINEMANN DIRECTOR/EMPLOYEE 201861 0 38119 0 138 0 7237 0 1617 0 248972 0 0 0 IVICA ZALUD DIRECTOR/EMPLOYEE 159676 0 74794 0 138 0 6814 0 359 0 241781 0 0 0 PATRICIA AL BLANCHETTE CEO UNTIL 1-13-14/EMPLOYEE 248750 0 0 0 229 0 7536 0 2802 0 259317 0 0 0 MARGUERITE LISA BARTHOLOMEW EMPLOYEE 134937 0 167130 0 90 0 5523 0 295 0 307975 0 0 0 JANET BURLINGAME EMPLOYEE 227892 0 98269 0 90 0 7650 0 359 0 334260 0 0 0 BARRY CARLTON EMPLOYEE 39720 0 322246 0 95 0 7650 0 204 0 369915 0 0 0 MICHAEL CARNEY EMPLOYEE 269377 0 97250 0 138 0 7650 0 6237 0 380652 0 0 0 ROBERT J KIM EMPLOYEE 280260 0 45000 0 60 0 7650 0 9088 0 342058 0 0 0 ELMER TAM JR MEMBER OF KAEO RAD FAMILY MEMBER OF ELIZABETH TAM, M.D., CURRENT DIRECTOR 296997 SERVICES AS CHIEF INFORMATION OFFICER (CONSULTANT). THE PAYMENT TO ELMER TAM, JR. IS TO HIS COMPANY, KAEO RAD, LLC, SOME OF WHICH HE USES TO PAY FOR PERSONNEL COST AND OTHER OPERATING COST OF THE COMPANY. 0 X 1 330050 COST BASIS 0 0 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRBUTIONS RECEIVED FORM 990, PART I, LINE 6, DESCRIPTION OF VOLUNTEERS: THE ONLY VOLUNTEERS UTILIZED BY UCERA ARE THE VOLUNTEER BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION REVISED ITS BYLAWS REGARDING VOTING BY PROXIES, THE RANKING OF CLINICAL UNITS, AND THE ADDITION OF A MECHANISM IN THE NEXT BYLAWS REVISION TO ENSURE EQUAL PARTICIPANT, REPRESENTATION, AND ENGAGEMENT FROM ALL DEPARTMENTS. FORM 990, PART VI, SECTION B, LINE 11 THE CFO REVIEWS IN DETAIL THE INFORMATION, FIGURES, AND OTHER DETAILS OF THE FORM 990, AND PRESENTS THE FORM 990 TO THE FINANCE COMMITTEE. THE BOARD APPROVES THE 990 PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES THE BOARD MEMBERS ATTESTATION FOR ANY CONFLICT OF INTEREST ON THE MONTHLY BOARD MEETING. ON AN ANNUAL BASIS THE BOARD MEMBERS SIGN A CONFLICT OF INTEREST STATEMENT AND ARE PROVIDED WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD AND COMPENSATION COMMITTEE. NATIONAL COMPARATORS ARE USED, INCLUDING THE MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA), ASSOCIATION OF THE AMERICAN MEDICAL COLLEGES (AAMC), AND SULLIVAN & COTTER COMPENSATION BENCHMARKS. THIS PROCESS IS DOCUMENTED IN THE PERSONNEL FILE AND WAS LAST UNDERTAKEN IN 2011. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, LINE 1A: REPORTABLE COMPENSATION FROM RELATED ORGANIZATION: MEMBERS OF THE UCERA BOARD ARE NOT COMPENSATED FOR THEIR SERVICE AS BOARD MEMBERS. UCERA BOARD MEMBERS (GUERRERO, HIXON, IZUTSU, MASAKI, STEINEMANN, AND ZALUD) ARE ALSO UCERA EMPLOYEES AND ARE COMPENSATED BY UCERA FOR THEIR WORK AS EMPLOYEES. UCERA BOARD MEMBERS (DRS. BOLAND, GUERRERO, HARRIGAN, HEDGES, HIXON, IZUTSU, KAHOLOKULA, MASAKI, NAKAMURA, SCHILLER, STEINEMANN, TAM, AND ZALUD) ARE EMPLOYEES OF RELATED ORGANIZATIONS, THE UNIVERSITY OF HAWAII (UH) JOHN A. BURNS SCHOOL OF MEDICINE AND THE UH SCHOOL OF NURSING, AND ARE COMPENSATED DIRECTLY BY UH FOR THEIR PROFESSIONAL SERVICES AS UH EMPLOYEES. UNIVERSITY OF HAWAII JOHN A BURNS SCHOOL OF MEDICINE 651 ILALO STREET MEB 223 HONOLULU HI 96813 996000354 MEDICAL SCHOOL HI N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 UNIVERSITY OF HAWAII JOHN A BURNS SCHOOL OF MEDICINE P 5390331 CASH UNIVERSITY OF HAWAII JOHN A BURNS SCHOOL OF MEDICINE Q 112231 ACCRUAL FORM 990, SCHEDULE R, PART V, LINE 2(1): REIMBURSEMENT PAID TO JABSOM FOR SALARIES, FRINGE BENEFITS, AND MALPRACTICE INSURANCE. FORM 990, SCHEDULE R, PART V, LINE 2(2): REIMBURSEMENT TO BE PAID BY JABSOM FOR RENT.