2013-12-12T15:15:14-06:00 2013-06-30 352123203 KSM BUSINESS SERVICES INC PO BOX 40857 INDIANAPOLIS IN 462400857 990 2012-07-01 237328642 UNIVERSITY PEDIATRIC ASSOCIATES INC UNIV 3172741201 550 NORTH MERIDIAN STREET NO 228 INDIANAPOLIS IN 46202 DR D WADE CLAPP 3172741201 2013-11-26 1 TERRY O'NEIL P00737156 3175802000 2013-11-26 2012 2015-11-30 17:44:51Z DR D WADE CLAPP 550 N MERIDIAN ST SUITE 228 INDIANAPOLIS IN 46202 95923951 0 X N/A X 1973 IN THE ORGANIZATION'S PRIMARY EXEMPT PURPOSE IS TO ENGAGE ACTIVELY AND CONTINUOUSLY IN MEDICAL RESEARCH AND TO PROVIDE MEDICAL EDUCATION AND MEDICAL RESEARCH IN CONJUNCTION WITH SERVING AS AN AUXILIARY TO THE OPERATION OF THE DEPARTMENT OF PEDIATRICS OF INDIANA UNIVERSITY SCHOOL OF MEDICINE AND ITS HOSPITALS. 16 16 376 0 0 0 2422306 2346861 69539580 77394398 1820089 1317719 366062 465596 74148037 81524574 33804332 36481581 0 0 8933596 11758335 0 0 0 39344512 42139256 82082440 90379172 -7934403 -8854598 30459111 22916086 0 0 30459111 22916086 X THE ORGANIZATION'S PRIMARY EXEMPT PURPOSE IS TO ENGAGE ACTIVELY AND CONTINUOUSLY IN MEDICAL RESEARCH AND TO PROVIDE MEDICAL EDUCATION AND MEDICAL RESEARCH IN CONJUNCTION WITH SERVING AS AN AUXILIARY TO THE OPERATION OF THE DEPARTMENT OF PEDIATRICS OF INDIANA UNIVERSITY SCHOOL OF MEDICINE AND ITS HOSPITALS. 0 0 36222744 36222744 39473869 VARIOUS CONTRIBUTIONS TO INDIANA UNIVERSITY FOUNDATION AND INDIANA UNIVERSITY SCHOOL OF MEDICINE 258837 258837 282069 CHARITABLE CONTRIBUTIONS TO VARIOUS MEDICAL INSTITUTIONS 83478 90970 THE ORGANIZATION PROVIDES ADMINISTRATIVE AND COLLECTION SERVICES FOR INDIANA UNIVERSITY FACULTY AND PHYSICIANS 34882274 38013086 PHYSICIAN CONTRACTS FOR RESEARCH, EDUCATION, AND PATIENT CARE 34882274 38013086 71447333 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 11 0 1 376 1 0 0 0 0 0 0 0 0 0 0 X 16 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 0 1 1 IN X HELEN BRODY ADMINISTRATIVE DIRECTO 3172741211 550 NORTH MERIDIAN STREET INDIANAPOLIS IN 46204 DR RANDALL L CALDWELL 40.00 X X 209981 0 0 DR D WADE CLAPP 40.00 X X 181888 0 0 DR HOWARD EIGEN 40.00 X 357500 0 0 DR ROBERT J FALLON 40.00 X 160803 0 6500 DR SHARON P ANDREOLI 40.00 X 99021 0 0 DR ERICA A EUGSTER 40.00 X 131363 0 4920 DR DAVID A INGRAM JR 40.00 X X 307190 0 8000 DR EUGENIA P MOLLESTION 40.00 X 252708 0 4920 DR JOHN C CHRISTENSON 40.00 X 161451 0 8000 DR STEPHANIE DAVIS 40.00 X 210000 0 11420 DR ABIGAIL F KLEMSZ 40.00 X 189858 0 9000 DR VAUGHN I RICKERT 40.00 X 117507 0 8000 DR MARA NITU 40.00 X 312000 0 9000 DR KATHLEEN O'NEILL 40.00 X 176667 0 8167 DR JAMES A LEMONS 40.00 X 208160 0 0 DR RICHARD L SCHREINER 40.00 X 87793 0 0 DR ALVARO J TORI 40.00 X 320000 0 0 DR ALEXANDRE T ROTTA 40.00 X 351333 0 0 DR MARK RIGBY 40.00 X 403000 0 0 DR SHEKHAR RAJ 40.00 X 389500 0 0 DR DAVID HERTZ 40.00 X 350285 0 0 4978008 0 77927 154 0 1 0 1 2346861 2346861 PATIENT SERVICES 621110 77394398 77394398 77394398 453251 453251 15263845 14399377 864468 864468 864468 ROC SURGERY CENTER K-1 621400 396000 396000 GAIN FROM JOINT VENTURE 621400 69596 69596 465596 81524574 77859994 0 1317719 36481581 36481581 5055935 5055935 4959777 4959777 1742623 1742623 46437 46437 37118 37118 1831302 394862 1436440 364835 364835 1302453 1302453 340419 340419 PHYSICIAN CONTRACTS 34570890 34570890 OUTSIDE SERVICE EXPENSE 1874168 1874168 MALPRACTICE INSURANCE 1070125 1070125 MISCELLANEOUS 612761 612761 88748 88748 90379172 71447333 18931839 0 5896014 2511332 3123078 945052 2501997 2178026 21967769 18013801 93331 212927 30459111 22916086 0 0 X 30459111 22916086 30459111 22916086 30459111 22916086 -8854598 1311573 0 X X 0 1 X 1 1 1 X 1108741 1396376 1749541 2422306 2346861 9023825 1108741 1396376 1749541 2422306 2346861 9023825 9023825 1160495 946270 924962 803349 476094 4311170 13334995 339205741 0.67670 0.54130 X 2805822 849049 1956773 317256 96003 221253 2178026 X 82836147 1311573 1311573 81524574 0 81524574 90379172 0 90379172 0 90379172 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: UPA IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS. IN ADDITION, UPA HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE NOT TO BE A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE INTERNAL REVENUE CODE. THERE WAS NO UNRELATED BUSINESS INCOME FOR THE YEARS ENDED JUNE 30, 2013 AND 2012. UPA FILES U.S. FEDERAL AND STATE OF INDIANA INFORMATION RETURNS. UPA IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE OF INDIANA TAX EXAMINATIONS BY TAX AUTHORITIES FOR FISCAL YEARS BEFORE 2010. 1 INDIANA UNIV FOUNDATION S STATE ROAD 46 BLOOMINGTON IN 47401 356018940 501(C)(3) 36222744 TO PROVIDE MEDICAL EDUCATION AND MEDICAL RESEARCH IN CONJUNCTION WITH SERVING AS AN AUXILIARY TO THE OPERATION OF THE DEPARTMENT OF PEDIATRICS OF INDIANA UNIVERSITY SCHOOL OF MEDICINE AND ITS HOSPITALS. VARIOUS MEDICAL PROGRAMS S STATE ROAD 46 BLOOMINGTON IN 47401 258837 TO PROVIDE MEDICAL EDUCATION AND MEDICAL RESEARCH IN CONJUNCTION WITH SERVING AS AN AUXILIARY TO THE OPERATION OF THE DEPARTMENT OF PEDIATRICS OF INDIANA UNIVERSITY SCHOOL OF MEDICINE AND ITS HOSPITALS. 4 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: TERESA HUTCHISON RECEIVES REQUESTS FROM PEDIATRIC DEPARTMENTS TO SET UP PURCHASE ORDERS FOR PHYSICIANS UPA SALARIES ON FEDERAL AND NON-FEDERAL GRANTS. TERESA HUTCHISON THEN REQUESTS PURCHASE ORDERS WITH APPROVAL GOING THROUGH THE REQUESTING DEPARTMENT. ONCE APPROVAL OF THE PURCHASE ORDER IS RECEIVED, TERESA BILLS BASED ON THE IU SALARY PERCENTAGE CHARGED TO THE ACCOUNT. THE REQUESTING DEPARTMENT MONITORS THE OVERALL SPENDING OF THE GRANT ACCOUNTS. THE BILLING OF THE SALARY BY TERESA CANNOT EXCEED THE AMOUNT OF THE INITIAL PURCHASE ORDER. X X 0 0 0 0 0 0 0 0 0 DR RANDALL L CALDWELL 209981 0 0 0 0 0 0 0 0 0 209981 0 0 0 DR D WADE CLAPP 181888 0 0 0 0 0 0 0 0 0 181888 0 0 0 DR HOWARD EIGEN 357500 0 0 0 0 0 0 0 0 0 357500 0 0 0 DR ROBERT J FALLON 160803 0 0 0 0 0 6500 0 0 0 167303 0 0 0 DR DAVID A INGRAM JR 307190 0 0 0 0 0 8000 0 0 0 315190 0 0 0 DR EUGENIA P MOLLESTION 252708 0 0 0 0 0 4920 0 0 0 257628 0 0 0 DR JOHN C CHRISTENSON 161451 0 0 0 0 0 8000 0 0 0 169451 0 0 0 DR STEPHANIE DAVIS 210000 0 0 0 0 0 11420 0 0 0 221420 0 0 0 DR ABIGAIL F KLEMSZ 189858 0 0 0 0 0 9000 0 0 0 198858 0 0 0 DR MARA NITU 312000 0 0 0 0 0 9000 0 0 0 321000 0 0 0 DR KATHLEEN O'NEILL 176667 0 0 0 0 0 8167 0 0 0 184834 0 0 0 DR JAMES A LEMONS 208160 0 0 0 0 0 0 0 0 0 208160 0 0 0 DR ALVARO J TORI 320000 0 0 0 0 0 0 0 0 0 320000 0 0 0 DR ALEXANDRE T ROTTA 351333 0 0 0 0 0 0 0 0 0 351333 0 0 0 DR MARK RIGBY 403000 0 0 0 0 0 0 0 0 0 403000 0 0 0 DR SHEKHAR RAJ 389500 0 0 0 0 0 0 0 0 0 389500 0 0 0 DR DAVID HERTZ 350285 0 0 0 0 0 0 0 0 0 350285 0 0 0 SUPPLEMENTAL INFORMATION PART III COMPENSATION RELATES TO MEDICAL SERVICES PROVIDED, NOT AS COMPENSATION FOR SERVING ON THE BOARD. FORM 990, PART VI, SECTION B, LINE 11 FORM 990, WHICH IS PREPARED BY A CPA FIRM, IS REVIEWED IN DETAIL BY THE ORGANIZATION'S BUSINESS MANAGER, ADMINISTRATOR AND OTHER ACCOUNTING PERSONNEL. IN ADDITION, FORM 990 IS PRESENTED TO THE BOARD OF DIRECTOR'S FOR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C UPA BOARD REVIEWS AND MONITORS ALL COMPLIANCE IN ACCORDANCE WITH UPA'S CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15A UPA BOARD WILL VOTE AND DETERMINE THE COMPENSATION BASED ON EXTERNAL AND INTERNAL FACTORS. FORM 990, PART VI, SECTION C, LINE 18 AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR. ROC SURGERY LLC 340 WEST 10TH STREET INDIANAPOLIS IN 46202 271497960 AMBULATORY SURGERY CENTER PERFORMING ONLY OUTPATIENT PROCEDURES IN RELATED 396000 275000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0