2014-01-20T17:09:08-06:00 2013-06-30 261659234 CW ASSOCIATES CPAS 700 BISHOP STREET SUITE 1040 HONOLULU HI 96813 990 2012-07-01 990307152 UNIVERSITY CLINICAL EDUCATION & RESEARCH ASSOCIATES (UCERA) UNIV 8084694961 677 ALA MOANA BOULEVARD NO 1001 HONOLULU HI 96813 DR ARNAR MAGNUSSON 8084694961 2014-01-20 1 MARK A HAYES P00085205 8085311040 2012 2015-11-30 17:44:51Z DR ARNAR MAGNUSSON 677 ALA MOANA BOULEVARD NO 1001 HONOLULU HI 96813 31208856 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 6 280 16 0 0 796293 361083 29948734 28682295 6040 22081 217522 70533 30968589 29135992 0 0 0 0 17611390 16648987 0 0 23184 10678876 10435522 28290266 27084509 2678323 2051483 15226164 17702496 3802874 4237241 11423290 13465255 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 19024556 28229505 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. 2641853 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. 936770 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. 351788 462543 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). 351788 462543 22954967 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 58 0 280 1 0 0 0 0 0 0 0 0 0 0 X 19 6 0 0 0 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 HEDGES JERRIS 10.00 X X 0 0 0 TAM ELIZABETH 1.00 X X 0 0 0 BURNS JAMES 1.00 X X 0 0 0 ERNE MICHAEL 1.00 X X 0 0 0 IZUTSU SATORU 20.00 X 87860 0 0 HARRIGAN ROSANNE 1.00 X 0 0 0 HIXON ALLEN L 20.00 X 70052 0 2099 MASAKI KAMAL 2.00 X 0 0 0 KAHOLOKULA JOSEPH 1.00 X 0 0 0 ZALUD IVICA 48.00 X 243722 0 6573 SCHILLER ALAN 1.00 X 0 0 0 NAKAMURA KENNETH 1.00 X 0 0 0 GUERRERO ANTHONY PS 20.00 X 69023 0 2070 STEINEMANN SUSAN 21.00 X 247009 0 8540 BOLAND MARY 1.00 X 0 0 0 HOLZMAN JOHN 1.00 X 0 0 0 KATEKARU ANNE 1.00 X 0 0 0 ANG KHENG SEE 1.00 X 0 0 0 YOSHIZAWA DIRK 1.00 X 0 0 0 HIGA JILL 1.00 X X 0 0 0 KILLEEN JEFFREY 1.00 X 0 0 0 SAUVAGE LYNNAE 40.00 X 354131 0 5787 TAKANISHI DANNY 15.00 X 100498 0 0 MAGNUSSON ARNAR 16.00 X 100258 0 0 BLANCHETTE PATRICIA AL 40.00 X 248978 0 9986 ADRIANO JOSEPH 40.00 X 130033 0 5157 KWAK LAUREN IN HOUSE COUNSEL 40.00 X 12000 0 360 CASSADY SHARMINI K FORMER IN HOUSE 40.00 X 162884 0 18107 CARNEY MICHAEL 40.00 X 357936 0 19270 LORENZO CEDRIC SF 40.00 X 335868 0 7505 BURLINGAME JANET 40.00 X 319859 0 7918 KIM ROBERT J 40.00 X 306315 0 16890 TERADA KEITH 40.00 X 275763 0 9092 3422189 0 119354 42 0 1 0 UH OFFICE OF RESEARCH SVC 2530 DOLE ST SAKAMAKI D-200 HON HI 96822 PHYSICIAN/ADMIN COMP 3497782 KAEO RAD LLC 4348 WAIALAE AVENUE HONOLULU HI 96816 IT MANAGEMENT SERVICES 275235 HAWAII RESIDENCY PROGRAM INC 1356 LUSITANA STREET 5TH FLOOR51 HONOLULU HI 96813 ADMIN COMPENSATION 108467 3 361083 100262 361083 SPECIALTY CLINICS 621400 15595679 15595679 HAWAII PACIFIC HEALTH 621110 5654350 5654350 QUEENS MEDICAL CENTER 621110 5612501 5612501 OTHER CONTRACTS 900099 1357222 1357222 FEES AND CONTRACT FROM GOVERNMENT 900099 462543 462543 28682295 21629 21629 60780 0 60780 60780 60780 2073316 2072864 452 452 452 NON-OPERATING INCOME 900099 9753 9753 9753 29135992 28692048 0 82861 1863136 1562312 298899 1925 12820361 10792560 2014036 13765 249151 204925 44226 817604 543152 274452 898735 745031 153704 33781 33781 57485 57485 1619 1619 156962 146023 10366 573 634577 508756 125116 705 1456709 1050798 403637 2274 289527 271269 18156 102 268817 200815 67621 381 133436 44352 88585 499 PURCHASED SERVICES 7174164 6711134 460436 2594 MISCELLANEOUS EXPENSE 172262 139020 32996 246 DUES AND MEMBERSHIP 56183 34820 21243 120 27084509 22954967 4106358 23184 27000 27175 9039060 10126752 3786760 3513761 539323 562621 2746768 1667827 1282202 1078941 1981033 551819 412213 15226164 17702496 3132810 2688836 393388 0 276676 1548405 3802874 4237241 X 11061760 13085410 361530 279583 100262 11423290 13465255 15226164 17702496 2051483 -9518 0 X 0 1 X 1 0 X 648029 460366 149287 796293 361083 2415058 24790162 26274147 29883097 29948734 28682295 139578435 25438191 26734513 30032384 30745027 29043378 141993493 10000 10000 10000 200 30200 0 10000 10000 10000 200 30200 141963293 207800 74104 52355 57726 82409 474394 207800 74104 52355 57726 82409 474394 117136 127709 165631 9753 420229 25645991 26925753 30212448 30968384 29135540 142888116 0.99350 0.99120 0.00330 0.00470 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: NON-OPERATING INCOME - 2009 AMOUNT: $ 117,136. 2011 AMOUNT: $ 9,750. 2012 AMOUNT: $ 9,753. OTHER REVENUE - 2010 AMOUNT: $ 127,709. 2011 AMOUNT: $ 155,881. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 100262 100262 1.00000 0 0 708060 59311 648749 2038708 1608516 430192 1078941 DUE TO JABSOM 1548405 1548405 X 29106540 -9518 -9518 29116058 1619 18315 19934 29135992 27082890 0 27082890 1619 1619 27084509 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: 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 SUBSEQUENT TO YEAR-END. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE 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 POSTIONS AS OF JUNE 30, 2013 AND 2012 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. THE INCOME TAX RETURNS ARE OPEN FOR EXAMINATION BY THE TAXING AUTHORITIES UNTIL THE STATUTES OF LIMITATIONS EXPIRE. PART XI, LINE 4B - OTHER ADJUSTMENTS: DECREASE IN TEMPORARILY RESTRICTED NET ASSETS -81,947. INCREASE IN PERMANENTLY RESTRICTED NET ASSETS 100,262. X X X 0 0 0 0 0 0 0 0 0 ZALUD IVICA 190510 0 53212 0 0 0 6573 0 0 0 250295 0 0 0 STEINEMANN SUSAN 231245 0 15764 0 0 0 7340 0 1200 0 255549 0 0 0 SAUVAGE LYNNAE 162177 0 191954 0 0 0 5787 0 0 0 359918 0 0 0 BLANCHETTE PATRICIA AL 248978 0 0 0 0 0 7536 0 2450 0 258964 0 0 0 CASSADY SHARMINI K FORMER IN HOUSE 162884 0 0 0 0 0 5047 0 13060 0 180991 0 0 0 CARNEY MICHAEL 320722 0 37214 0 0 0 9186 0 10084 0 377206 0 0 0 LORENZO CEDRIC SF 298516 0 37352 0 0 0 0 0 7505 0 343373 0 0 0 BURLINGAME JANET 239544 0 80315 0 0 0 7918 0 0 0 327777 0 0 0 KIM ROBERT J 306315 0 0 0 0 0 9252 0 7638 0 323205 0 0 0 TERADA KEITH 231496 0 44267 0 0 0 7892 0 1200 0 284855 0 0 0 ELMER TAM JR MEMBER OF KAEO RAD FAMILY MEMBER OF ELIZABETH TAM, M.D., CURRENT OFFICER/DIRECTOR 267470 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 100262 FAIR MARKET VALUE 0 0 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTIONS: PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS 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 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, ZALUD, STEINEMANN, SAUVAGE (TERM ENDED 12/14/12), AND TAKANISHI (TERM ENDED 6/22/13)) ARE ALSO UCERA EMPLOYEES AND ARE COMPENSATED BY UCERA FOR THEIR WORK AS EMPLOYEES. UCERA BOARD MEMBERS (DRS. BOLAND, HARRIGAN, HEDGES, IZUTSU, KAHOLOKULA, SCHILLER, MASAKI, NAKAMURA, HIXON, ZALUD, STEINEMANN, AND TAM) 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 4473501 CASH UNIVERSITY OF HAWAII JOHN A BURNS SCHOOL OF MEDICINE Q 356743 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.