2013-02-21T21:58:32-06:00 2012-06-30 261659234 CW ASSOCIATES CPAS 700 BISHOP STREET SUITE 1040 HONOLULU HI 96813 990 2011-07-01 990307152 UNIVERSITY CLINICAL EDUCATION & RESEARCH ASSOCIATES (UCERA) UNIV 8084694961 677 ALA MOANA BOULEVARD NO 1001 HONOLULU HI 96813 PATRICIA BLANCHETTE 8084694961 2013-02-21 1 MARK A HAYES P00085205 8085311040 2011 2016-02-25 16:41:14Z PATRICIA BLANCHETTE 677 ALA MOANA BOULEVARD NO 1001 HONOLULU HI 96813 30984408 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 6 281 16 0 0 149287 796293 29883097 29948734 2316 6040 177748 217522 30212448 30968589 0 0 0 0 17871978 17611390 0 0 34444 10338878 10678876 28210856 28290266 2001592 2678323 12831846 15226164 4086879 3802874 8744967 11423290 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 25163411 29689549 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; 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. 928034 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. 895089 EDUCATIONAL SUPPORT - 1) IN GENERAL, PROVIDE EDUCATION AND CLINICAL TRAINING FOR THE UNIVERSITY OF HAWAII MEDICAL SCHOOL STUDENTS. 2) INTERNATIONAL TRAINING PROGRAM - 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 - PROVIDE SIMULATED PATIENTS FOR CLINICAL SKILLS TRAINING AND EXAMINATIONS FOR SCHOOL OF MEDICINE STUDENTS AND RESIDENTS. 305508 424816 RESEARCH SUPPORT - THESE ARE RESEARCH STUDIES THAT FOCUS ON ADULT OBESITY, CARDIOVASCULAR HEALTH, AIDS CLINICAL RESEARCH AND OVERALL MEDICAL STUDY. 305508 424816 27292042 1 1 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 1 0 1 0 0 0 0 1 0 0 0 0 1 66 0 281 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 1 0 HI X THE ORGANIZATION 8084694961 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 HIGA JILL 1.00 X X 0 0 0 HARRIGAN ROSANNE 1.00 X 0 0 0 MASAKI KAMAL 1.00 X 0 0 0 NAKAMURA KENNETH 1.00 X 0 0 0 KATEKARU ANNE 1.00 X 0 0 0 ANG KHENG SEE 1.00 X 0 0 0 KILLEEN JEFFREY 1.00 X 0 0 0 BOLAND MARY 1.00 X 0 0 0 HOLZMAN JOHN 1.00 X 0 0 0 ERNE MICHAEL 1.00 X 0 0 0 KAHOLOKULA JOSEPH 1.00 X 0 0 0 IZUTSU SATORU 20.00 X 0 0 0 SAUVAGE LYNNAE 48.00 X 230257 0 4320 HIXON ALLEN L 16.00 X 100925 0 3533 GUERRERO ANTHONY PS 4.00 X 36327 0 159 TAKANISHI DANNY 17.00 X X 70000 0 437 PALAFOX NEAL 1.00 X 0 0 0 INKINEN KATHRYN 1.00 X 0 0 0 BLANCHETTE PATRICIA AL 40.00 X 249665 0 7869 ADRIANO JOSEPH 40.00 X 132213 0 4577 MAGNUSSON ARNAR 16.00 X 100000 0 472 CASSADY SHARMINI K 40.00 X 176256 0 6256 CARNEY MICHAEL 40.00 X 402834 0 16174 LORENZO CEDRIC SF 40.00 X 359022 0 6414 HEMMINGS DAPHNE E 40.00 X 348034 0 10235 INOUYE DAVID S 40.00 X 346057 0 6450 HAYASHI MICHAEL S 40.00 X 345626 0 14459 2897216 0 81355 43 0 1 0 UH OFFICE OF RESEARCH SVC 2530 DOLE ST SAKAMAKI D-200 HON HI 96822 PHYSICIAN/ADMIN COMP 6148835 KAEO RAD LLC 4348 WAIALAE AVENUE HONOLULU HI 96816 IT MANAGEMENT SERVICES 273801 HAWAII RESIDENCY PROGRAM INC 1356 LUSITANA STREET 5TH FLOOR51 HONOLULU HI 96813 ADMIN COMPENSATION 109842 3 796293 585000 796293 SPECIALTY CLINICS 621400 14598838 14598838 QUEENS MEDICAL CENTER 621110 7629792 7629792 HAWAII PACIFIC HEALTH 621110 5512146 5512146 OTHER CONTRACTS 900099 1783142 1783142 FEES AND CONTRACT FROM 900099 424816 424816 29948734 5835 5835 51891 0 51891 51891 51891 16024 15819 205 205 205 OTHER REVENUE 900099 155881 155881 NON-OPERATING INCOME 900099 9750 9750 165631 30968589 30114365 0 57931 1183423 1002242 180019 1162 14429868 12231786 2183554 14528 246953 204748 42205 844393 625674 218719 906753 749062 157691 59788 59788 55078 55078 155988 149914 5395 679 634672 452192 181455 1025 1395398 942425 450430 2543 318686 269159 49249 278 241611 173585 67644 382 132053 39329 92203 521 PURCHASED SERVICES 7357856 6833185 521725 2946 MISCELLANEOUS EXPENSE 269940 197828 61851 10261 DUES AND MEMBERSHIP 57806 36579 21108 119 ALLOCATION OF COSTS 0 3384334 -3384334 28290266 27292042 963780 34444 26871 27000 7908473 9039060 3537855 3786760 282529 539323 2681211 1399009 873181 1282202 98000 104937 551819 12831846 15226164 2440627 3132810 520455 393388 1125797 276676 4086879 3802874 X 8289683 11061760 455284 361530 8744967 11423290 12831846 15226164 2678323 0 X 0 1 1 X 0 X 1021280 648029 460366 149287 796293 3075255 23755489 24790162 26274147 29883097 29948734 134651629 24776769 25438191 26734513 30032384 30745027 137726884 10000 10000 10000 30000 137310 137310 137310 10000 10000 10000 167310 137559574 255753 207800 74104 52355 57726 647738 255753 207800 74104 52355 57726 647738 117136 127709 165631 410476 25032522 25645991 26925753 30212448 30968384 138785098 0.99120 0.98930 0.00470 0.00640 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: NON-OPERATING INCOME OTHER REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 708060 33277 674783 1973151 1365732 607419 1282202 DUE TO JABSOM 276676 276676 30968589 28290266 2678323 2678323 30477343 0 30477343 491246 491246 30968589 28290266 0 28290266 0 28290266 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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 THE UCERA'S TAX POSTIONS AS OF JUNE 30, 2012 AND 2011 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 OPEN FOR EXAMINATION UNTIL THE STATUTE OF LIMITATIONS EXPIRES. PART XII, LINE 4B - OTHER ADJUSTMENTS: DECREASE IN TEMPORARILY RESTRICTED NET ASSETS -93,754. DONATED LEASEHOLD IMPROVEMENTS 585,000. X X X 0 0 0 0 0 0 0 0 0 SAUVAGE LYNNAE 123425 0 106832 0 0 0 3703 0 617 0 234577 0 0 0 BLANCHETTE PATRICIA AL 238165 0 11500 0 0 0 7211 0 658 0 257534 0 0 0 CASSADY SHARMINI K 167881 0 8375 0 0 0 5061 0 1195 0 182512 0 0 0 CARNEY MICHAEL 265493 0 137341 0 0 0 7700 0 8474 0 419008 0 0 0 LORENZO CEDRIC SF 297241 0 61781 0 0 0 0 0 6414 0 365436 0 0 0 HEMMINGS DAPHNE E 309550 0 38484 0 0 0 9700 0 535 0 358269 0 0 0 INOUYE DAVID S 299583 0 46474 0 0 0 0 0 6450 0 352507 0 0 0 HAYASHI MICHAEL S 297833 0 47793 0 0 0 8051 0 6408 0 360085 0 0 0 ELMER TAM JR MEMBER OF KAEO RAD FAMILY MEMBER OF ELIZABETH TAM, M.D., CURRENT OFFICER/DIRECTOR 274345 SERVICES AS CHIEF INFORMATION OFFICER (CONSULTANT). THE PAYMENT TO ELMER TAM, JR. IS TO HIS COMPANY, KAEO RAD, LLC, OF WHICH HE PAYS FOR PERSONNEL COST AND OTHER OPERATING COST OF THE COMPANY. 0 X LH IMPRVMNT 1 585000 ACTUAL COST 0 0 1 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS. 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 FINANCE REVIEWS THE INFORMATION, FIGURES AND OTHER DETAILS OF FORM 990. THE CHIEF FINANCIAL OFFICER PRESENTS THE FORM 990 TO THE FINANCE COMMITTEE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS SIGN ANNUALLY A CONFLICT OF INTEREST STATEMENT AND ARE PROVIDED WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD REVIEWS COMPENSATION USING NATIONAL COMPARATORS INCLUDING THE MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA), ASSOCIATION OF AMERICAN MEDICAL COLLEGES (AAMC), AND SULLIVAN & COTTER COMPENSATION BENCHMARKS. 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, DRS. SAUVAGE, TAKANISHI, AND HIXON) ARE ALSO UCERA EMPLOYEES AND ARE COMPENSATED BY UCERA FOR THEIR WORK AS EMPLOYEES. UCERA BOARD MEMBERS (DRS. BOLAND, HARRIGAN, HEDGES, IZUTSU, KAHOLOKULA, KILLEEN, MASAKI, NAKAMURA, PALAFOX, SAUVAGE, TAKANISHI, 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 1 1 0 0 UNIVERSITY OF HAWAII JOHN A BURNS SCHOOL OF MEDICINE O 6354740 CASH UNIVERSITY OF HAWAII JOHN A BURNS SCHOOL OF MEDICINE P 407123 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.