2014-05-15T09:21:10-05:00 2013-06-30 341145015 WILLIAM VAUGHAN COMPANY 145 CHESTERFIELD LANE MAUMEE OH 435373836 990 2012-07-01 201304472 UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY INC UNIV 4193837100 3355 GLENDALE AVENUE 3RD FLOOR TOLEDO OH 43614 HAITHAM M ELSAMALOTY MD 4193837100 2014-05-14 1 JACK C HAGMEYER P00051646 4198911040 2012 2015-11-30 17:44:51Z KRISTOPHER BRICKMAN MD 3355 GLENDALE AVENUE 3RD FLOOR TOLEDO OH 43614 81203986 0 X N/A X 2004 OH PROMOTE, ENHANCE, SUPPLEMENT AND ASSIST IN THE PERFORMANCE OF THE MEDICAL AND HEALTH EDUCATION PROGRAMS AND SERVICES OF THE UNIVERSITY OF TOLEDO. 25 0 472 0 0 0 0 0 77828434 78608413 83 -3576 997949 2581520 78826466 81186357 5100 36450 0 0 53116112 59402184 0 0 0 22280973 17723657 75402185 77162291 3424281 4024066 20699738 24131341 9786922 9194459 10912816 14936882 PROMOTE, ENHANCE, SUPPLEMENT AND ASSIST IN THE PERFORMANCE OF THE MEDICAL AND HEALTH EDUCATION PROGRAMS AND SERVICES OF THE UNIVERSITY OF TOLEDO. 0 0 72990266 36450 81189933 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. 72990266 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 64 0 1 472 1 0 0 0 0 0 0 0 0 0 0 X 25 0 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 OH X X TAMMY SCARBOROUGH 4193837100 3355 GLENDALE AVE THIRD FLOOR TOLEDO OH 43614 BLUMER PHD MD JEFFREY 20.00 20.00 X 220000 195000 110506 BOOTH JR MD ROBERT L 20.00 20.00 X 153491 111886 66017 BRICKMAN MD KRISTOPHER 20.00 20.00 X X 358488 174150 109375 CASABIANCA MD ANDREW B 20.00 20.00 X 248240 140632 96981 COOPER MD CHRISTOPHER J 20.00 20.00 X 231376 321213 156594 EBRAHEIM MD NABIL 20.00 20.00 X 1921202 220124 125777 ELMER MD LAWRENCE W 20.00 20.00 X 51524 106291 55130 ELSAMALOTY MD HAITHAM M 20.00 20.00 X X 364200 78660 76748 FARRELL MD STEVEN J 20.00 20.00 X 222426 114121 77147 FRENCH MD LINDA M 20.00 20.00 X 115000 180116 89505 GOLD MD JEFFREY P 20.00 20.00 X X 166100 463057 138332 HAMMERSLEY MD JEFFREY R 20.00 20.00 X 159549 111463 71957 KIMMEL MD SANFORD R 20.00 20.00 X 84208 139646 60499 LYNN MD CHRISTOPHER K 20.00 20.00 X X 72550 117774 59282 MANAHAN MD KELLY 20.00 20.00 X 408930 95000 71557 MARCO MD ALAN P 20.00 20.00 X 200714 187041 106231 MRAK MD ROBERT 20.00 20.00 X 210000 182103 106173 NAZZAL MD MUNIER MS 20.00 20.00 X 475774 166357 106679 SELMAN MD STEVEN H 20.00 20.00 X 290000 206876 120915 SKIE MD MARTIN 20.00 20.00 X 607352 99449 83002 TAMBURRINO MD MARIJO 20.00 20.00 X 15000 203688 74878 TIETJEN MD GRETCHEN E 20.00 20.00 X 150000 193648 91329 WOLDENBERG MD LEE S 20.00 20.00 X 356909 176989 102918 ZELENOCK MD GERALD B 20.00 20.00 X X 290000 208260 114506 CHEN MD CHANGHU 20.00 20.00 X 0 0 0 SOHN MD DAVID 20.00 20.00 X 581653 52530 66181 ELGAFY MD HOSSEIN 20.00 20.00 X 671927 64786 79646 MUSTAPHA MD ABDUL AZIM 20.00 20.00 X 500563 73877 73834 ATALLAH MD JOSEPH 20.00 20.00 X 559503 118245 89346 SCHWANN MD THOMAS 20.00 20.00 X 450000 160409 102806 10136679 4663391 2683851 146 0 1 0 WALID MAHMOUD MD 546 TROON RD HOLLAND OH 43528 EMERGENCY ROOM COVERAGE 106518 1 PATIENT SERVICE 621110 78465014 78465014 DIALYSIS CENTER AND ACO 621110 143399 143399 78608413 68 68 13985 17629 -3644 -3644 -3644 MEANINGFUL USE REVENUE 900099 2010800 2010800 MISCELLANEOUS 900099 537030 537030 REFUND OF INTEREST ON EMPLOYER FI 900099 33690 33690 2581520 81186357 81189933 0 -3576 36450 36450 8060461 8060461 44172768 41270387 2902381 5062733 4828180 234553 698232 348677 349555 1407990 1180204 227786 57332 57332 43350 43350 1344976 1344976 750232 715660 34572 521118 430153 90965 1311322 1311322 148415 148415 2608336 2608336 PHARMACEUTICALS AND LAB 6870607 6870607 MCO CLINICAL COST AND D 1622483 1622483 MEANINGFUL USE PAYMENT 900000 900000 MISCELLANEOUS 554859 265996 288863 990627 990627 77162291 72990266 4172025 0 9129029 11474786 10215453 11196255 80618 86343 139139 55712 1037526 572108 474070 465418 455429 646827 206000 206000 20699738 24131341 2649388 1784887 7137534 7409572 9786922 9194459 X 10912816 14936882 10912816 14936882 20699738 24131341 4024066 0 X X 0 1 X 1 0 X X 0 0 0 UNIVERSITY OF TOLEDO 340967014 6 1 1 1 36450 1 36450 1037526 572108 465418 465418 ACCRUED EXPENSES 6791515 ACCRUED PENSION 618057 7409572 1 UNIVERSITY OF TOLEDO 3000 ARLINGTON AVE TOLEDO OH 43614 340967014 501(C)(3) 36450 FMV SUPPORT FOR THE UNIVERSITY OF TOLEDO MEDICAL CENTER PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION MONITORS THE USE OF GRANT FUNDS IN THE UNITED STATES BY ONLY DONATING TO THE RELATED ORGANIZATIONS LISTED UNDER SCHEDULE R. 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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 CHANGE 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 11 DISTRIBUTED TO BOARD OF DIRECTORS FOR REVIEW BEFORE SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS, OR TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE CONFLICTS OF INTERESTS, WHICH IS SPECIFIED IN EACH EMPLOYMENT CONTRACT, INCLUDING NON-COMPETE REQUIREMENT. FORM 990, PART VI, SECTION B, LINE 15 USE COMPARIBILITY DATA. REVIEWED BY CHAIRMAN AND COMPENSATION COMMITTEE OF THE BOARD. PROCESS IS THE SAME FOR OTHER OFFICERS AND EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS IN WHICH THE COMMITTEE RESPONSIBLE FOR OVERSIGHT OF THE AUDITED FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM PRIOR YEAR. 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