2012-03-01T20:54:15-06:00 2011-06-30 CW ASSOCIATES CPAS 700 BISHOP STREET SUITE 1040 HONOLULU HI 96813 990 2010-07-01 990307152 UNIVERSITY CLINICAL EDUCATION & RESEARCH ASSOCIATES (UCERA) UNIV 8084694961 677 ALA MOANA BOULEVARD NO 1001 HONOLULU HI 96813 PATRICIA BLANCHETTE 8084694961 2012-03-01 1 MARK A HAYES 8085311040 2010 2016-02-24 21:20:13Z PATRICIA BLANCHETTE 677 ALA MOANA BOULEVARD NO 1001 HONOLULU HI 96813 30212448 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. 18 7 279 8 0 0 460366 149287 26391283 29883097 8867 2316 65237 177748 26925753 30212448 0 0 0 0 14225833 17871978 0 0 24747 11341857 10338878 25567690 28210856 1358063 2001592 9305721 12831846 2562346 4086879 6743375 8744967 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 24810156 29768841 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. 1498482 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. 267331 241965 RESEARCH SUPPORT - PROJECT TITLE - THE EFFECT OF INTERACTIVE SIMULATIONS ON EXERCISE ADHERENCE WITH OVERWEIGHT AND OBESE ADULTS. THE SPECIFIC AIM OF THE STUDY IS TO EXAMINE THE EFFECT OF EXERCISE AUGMENTED WITH INTERACTIVE VIDEO GAMES COMPARED WITH EXERCISE WITHOUT SUCH ENHANCEMENT IN THE TREATMENT OUTCOMES OF OBESE AND OVERWEIGHT ACTIVE DUTY MILITARY PERSONNEL. 770593 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) DEAN-STANDARDIZED PATIENTS - PROVIDE SIMULATED PATIENTS FOR CLINICAL SKILLS TRAINING AND EXAMINATIONS FOR SCHOOL OF MEDICINE STUDENTS AND RESIDENTS. 4) SPORTS MEDICINE TRAINING - PROVIDE PHYSICIANS, STAFF AND TRAINING FACILITIES FOR UNIVERSITY OF HAWAII STUDENT HEALTH CARE CENTERS AND FOR SPORTS MEDICINE TRAINING. ALL TRAINING TO BE COORDINATED WITH THE CHAIRPERSON OF THE DEPARTMENT OF FAMILY PRACTICE. 770593 27346562 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 50 0 279 1 0 0 0 0 0 0 0 0 0 1 0 X 18 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 HI X X JOSEPH ADRIANO 8084694959 677 ALA MOANA BLVD 1001 HONOLULU HI 96813 X LYNNAE SAUVAGE 48.00 X 261846 0 6413 ROSEANNE HARRIGAN 1.00 X 0 0 0 JERRIS HEDGES 10.00 X X 0 0 0 DANNY TAKANISHI 17.00 X X 70069 0 150 ELIZABETH TAM 1.00 X X 0 0 0 JAMES BURNS 1.00 X X 0 0 0 KAMAL MASAKI 1.00 X 0 0 0 ANTHONY PS GUERRERO 4.00 X 30284 0 106 JEFFREY KILLEEN 1.00 X 0 0 0 MARY BOLAND 1.00 X 0 0 0 JOSEPH K KAHOLOKULA 1.00 X 8184 0 246 KENNETH NAKAMURA 1.00 X 0 0 0 KHENG SEE ANG 1.00 X 0 0 0 KATHRYN INKINEN 1.00 X 0 0 0 THOMAS DRISKILL JR 1.00 X 0 0 0 JILL HIGA 1.00 X 0 0 0 JOHN HOLZMAN 1.00 X 0 0 0 SATORU IZUTSU 1.00 X 0 0 0 RAUL RUDOY 1.00 X 0 0 0 NEAL PALAFOX 1.00 X 0 0 0 KALANI BRADY 1.00 X 32980 0 1153 PATRICIA BLANCHETTE 40.00 X 230439 0 7511 ARNAR MAGNUSSON 16.00 X 100600 0 0 BARRY CARLTON 58.00 X 277104 0 8635 JANET BURLINGAME 42.00 X 275583 0 7811 KEITH TERADA 48.00 X 294329 0 8562 CAESAR M URSIC 40.00 X 296469 0 574 ANDREW W TAN 40.00 X 279522 0 12072 2157409 0 53233 38 0 1 0 UH OFFICE OF RESEARCH SVC 2530 DOLE ST SAKAMAKI D-200 HON HI 96822 PHYSICIAN/ADMIN COMP 6951426 KAEO RAD LLC 4348 WAIALAE AVENUE HONOLULU HI 96816 IT MANAGEMENT SERVICES 232279 KING AND SPALDING LLP PO BOX 116133 ATLANTA GA 303686133 LEGAL SERVICES 185120 3 11846 137441 149287 SPECIALTY CLINICS 621400 14194622 14194622 QUEENS MEDICAL CENTER 621110 5755227 5755227 HAWAII PACIFIC HEALTH 621110 5250575 5250575 OTHER CONTRACTS 900099 4440708 4440708 FEES AND CONTRACT FROM 900099 241965 241965 29883097 2316 2316 50039 50039 50039 50039 OTHER REVENUE 900099 127709 127709 127709 30212448 30010806 0 52355 754921 648076 106110 735 15166914 13018419 2133446 15049 238136 206007 32129 833701 598968 234733 878306 729712 148594 8578 8578 55281 55281 132902 131245 1268 389 610629 415343 194126 1160 1376795 946987 427261 2547 268204 240342 27697 165 29 29 239859 184981 54552 326 146925 51364 94994 567 PURCHASED SERVICES 7200535 6691055 506455 3025 MISCELLANEOUS EXPENSE 255549 142627 112251 671 DUES AND MEMBERSHIP 43592 24541 18938 113 ALLOCATION OF COSTS 0 3316894 -3316894 28210856 27346562 839548 24747 25870 26871 4319127 7908473 3459947 3537855 341830 282529 2030580 1157399 983085 873181 98000 98000 77862 104937 9305721 12831846 1818671 3194958 743675 891921 2562346 4086879 X 6186689 8289683 556686 455284 6743375 8744967 9305721 12831846 2001592 0 X 0 1 1 X 0 X 990236 1021280 648029 460366 149287 3269198 20303974 23755489 24790162 26274147 29883097 125006869 21294210 24776769 25438191 26734513 30032384 128276067 10000 10000 20000 161564 137310 298874 161564 137310 10000 10000 318874 127957193 232850 255753 207800 74104 52355 822862 232850 255753 207800 74104 52355 822862 117136 127709 244845 21527060 25032522 25645991 26925753 30212448 129343774 0.98930 0.98870 0.00640 0.00760 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MEDICAL BILLING SETTLEMENT OTHER REVENUE RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 123060 23493 99567 1907520 1133906 773614 873181 30212448 28210856 2001592 0 2001592 30313850 101402 101402 30212448 0 30212448 28210856 0 28210856 0 28210856 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: MANAGEMENT HAS EVALUATED THE UCERA'S TAX POSITIONS AS OF JUNE 30, 2011 AND 2010 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 2D - OTHER ADJUSTMENTS: DECREASE IN TEMPORARILY RESTRICTED NET ASSETS 101,402. PART V, COLUMN (B) PRIOR YEAR & COLUMN (C) TWO YEARS BACK: AMOUNTS HAVE BEEN RESTATED TO PROPERLY PRESENT ENDOWMENT FUNDS. X 0 0 0 0 0 0 0 0 0 LYNNAE SAUVAGE 261846 0 0 0 0 0 6413 0 0 0 268259 0 0 0 PATRICIA BLANCHETTE 230439 0 0 0 0 0 7511 0 0 0 237950 0 0 0 BARRY CARLTON 277104 0 0 0 0 0 8635 0 0 0 285739 0 0 0 JANET BURLINGAME 275583 0 0 0 0 0 7811 0 0 0 283394 0 0 0 KEITH TERADA 294329 0 0 0 0 0 8562 0 0 0 302891 0 0 0 CAESAR M URSIC 296469 0 0 0 0 0 574 0 0 0 297043 0 0 0 ANDREW W TAN 279522 0 0 0 0 0 11835 0 237 0 291594 0 0 0 ELMER TAM JR MEMBER OF KAEO RAD FAMILY MEMBER OF ELIZABETH TAM, M.D., CURRENT OFFICER/DIRECTOR 259142 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 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, SEC. A, LINE 1A, REPORTABLE COMP. FROM RELATED ORG. MEMBERS OF THE UCERA BOARD ARE NOT COMPENSATED FOR THEIR SERVICE AS BOARD MEMBERS. UCERA BOARD MEMBERS (GUERRERO, DRS. KAHOLOKULA, SAUVAGE, TAKANISHI) 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 4840117 CASH UNIVERSITY OF HAWAII JOHN A BURNS SCHOOL OF MEDICINE P 57573 ACCRUAL FORM 990, SCHEDULE R, PART V, NUMBER 2, LINE 1: REIMBURSEMENT PAID TO JABSOM FOR SALARIES, FRINGE BENEFITS, AND MALPRACTICE INSURANCE. FORM 990, SCHEDULE R, PART V, NUMBER 2, LINE 2: REIMBURSEMENT PAID BY JABSOM FOR RENT.