FLORIDA MEDICAL PRACTICE PLAN INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- FLORIDA MEDICAL PRACTICE PLAN INC (EIN 57-1234883)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-04-19
- IRS object ID
- 201201109349300515
- Schema version
- 2010v3.7
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule D
- Schedule F
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-04-19T15:47:33-05:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PURVIS GRAY & COMPANY | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 443 EAST COLLEGE AVENUE | AddressLine1 |
| City | TALLAHASSEE | City |
| State | FL | State |
| ZIP Code | 32301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 571234883 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA MEDICAL PRACTICE PLAN INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FLOR | NameControl |
| Phone | 8506452827 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1115 WEST CALL STREET | AddressLine1 |
| City | TALLAHASSEE | City |
| State | FL | State |
| ZIP Code | 32306 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN P FOGARTY MD | Name |
| Title | PRESIDENT, FMPP | Title |
| Phone | 8506452827 | Phone |
| Date Signed | 2012-03-23 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RYAN M TUCKER CPA | Name |
| Phone | 8502247144 | Phone |
| Date Prepared | 2012-04-11 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JOHN P FOGARTY | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1115 WEST CALL STREET | AddressLine1 |
| City | TALLAHASSEE | City |
| State | FL | State |
| ZIP Code | 32306 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 8713880 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2006 | YearFormation |
| State Legal Domicile | FL | StateLegalDomicile |
| Activity Or Mission Description | THE PURPOSES OF FLORIDA MEDICAL PRACTICE PLAN ARE TO: 1) FURTHER THE EDUCATION, SERVICE, AND RESEARCH MISSIONS OF THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE, A COMPONENT OF THE FLORIDA STATE UNIVERSITY BOARD OF TRUSTEES; AND 2) ENABLE FACULTY TO MAINTAIN CLINICAL COMPETENCE, FULFILL CERTIFICATION REQUIREMENTS, SHARE EXPERTISE WITH OTHER HEALTH CARE PROVIDERS, AND SERVE AS CLINICAL TEACHERS FOR STUDENTS AND RESIDENTS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3777837 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 8709858 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2506 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4022 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 3780343 | TotalRevenuePriorYear |
| Total Revenue Current Year | 8713880 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 20000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 50000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 6119246 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3602038 | OtherExpensePriorYear |
| Other Expenses Current Year | 1996515 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 3622038 | TotalExpensesPriorYear |
| Total Expenses Current Year | 8165761 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 158305 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 548119 | RevenuesLessExpensesCY |
| Total Assets BOY | 1606314 | TotalAssetsBOY |
| Total Assets EOY | 2341360 | TotalAssetsEOY |
| Total Liabilities BOY | 748408 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 935335 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 857906 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1406025 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE PURPOSES OF FLORIDA MEDICAL PRACTICE PLAN ARE TO: 1) FURTHER THE EDUCATION, SERVICE, AND RESEARCH MISSIONS OF THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE, A COMPONENT OF THE FLORIDA STATE UNIVERSITY BOARD OF TRUSTEES; AND 2) ENABLE FACULTY TO MAINTAIN CLINICAL COMPETENCE, FULFILL CERTIFICATION REQUIREMENTS, SHARE EXPERTISE WITH OTHER HEALTH CARE PROVIDERS, AND SERVE AS CLINICAL TEACHERS FOR STUDENTS AND RESIDENTS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 8150023 | Expense |
| Grants | 50000 | Grants |
| Revenue | 8709858 | Revenue |
| Description | PERFORMED PROFESSIONAL SERVICES IN SUPPORT OF: 1) AN AFFILIATION AGREEMENT WITH A HOSPITAL FOR GRADUATE MEDICAL EDUCATION PROGRAMS, AND 2) AGREEMENTS WITH HEALTH DEPARTMENTS, CLINICS, AND OTHERS FOR PATIENT CARE. | Description |
| Total Program Service Expense | 8150023 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | false | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | true | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 4 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | SHARON WOODALL | NamePerson |
| Telephone Number | 8506452827 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1115 WEST CALL STREET | AddressLine1 |
| City | TALLAHASSEE | City |
| State | FL | State |
| ZIP Code | 32306 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (11 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| JOHN P FOGARTY MD | ||||||
| PRESIDENT | 1.00 | X | X | 0 | 365209 | 44369 |
| LAWRENCE G ABELE PHD | ||||||
| DIRECTOR | 1.00 | X | 0 | 302039 | 42392 | |
| JOHN R CARNAGHI MED | ||||||
| DIRECTOR | 1.00 | X | 0 | 293053 | 47028 | |
| ALMA B LITTLES MD | ||||||
| SEC/TREASURE | 1.00 | X | X | 0 | 264068 | 41821 |
| DANIEL J VAN DURME MD | ||||||
| VICE PRESIDE | 1.00 | X | X | 0 | 248627 | 40728 |
| KENNETH V BRUMMEL-SMITH MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 247001 | 44198 | |
| HAROLD BLAND MD | ||||||
| DIRECTOR | 1.00 | X | 0 | 221301 | 39185 | |
| ROBERT BRADLEY PHD | ||||||
| DIRECTOR | 1.00 | X | 0 | 218854 | 33100 | |
| RICHARD S NOWAKOWSKI PHD | ||||||
| DIRECTOR | 1.00 | X | 0 | 178289 | 28286 | |
| JANINE EDWARDS PHD | ||||||
| DIRECTOR | 1.00 | X | 0 | 127608 | 13443 | |
| RICARDO GONZALEZ-ROTHI | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp Frm Rltd Orgs | 2466049 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 374550 | TotalOtherCompensation |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| FSU COLLEGE OF MEDICINE SELF INSURAN | |||||
| 1115 W CALL STREET | TALLAHASSEE | FL | 32306 | SELF INSURANCE | 487016 |
| DIVISION OF STATE GROUP INSURANCE | |||||
| PO BOX 5450 | TALLAHASSEE | FL | 32314 | HEALTH INSURANC | 172724 |
| THERACOM | |||||
| 1127 BRYN MAWR AVENUE | REDLANDS | CA | 92374 | CLINIC SUPPLIES | 168499 |
| COVENTRY HEALTH CARE OF FLORIDA | |||||
| PO BOX 6552 | CAROL STREAM | IL | 60197 | HEALTH INSURANC | 132703 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| CLINICAL REVENUE | 624100 | 8410497 | 8410497 |
| MEDICAID REVENUE | 624100 | 299361 | 299361 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 8709858 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4022 | TotalRevenueColumn |
| Exclusion | $4,022 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8713880 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8709858 | RelatedOrExemptFunctionIncome |
| Exclusion | $4,022 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50000 | Total |
| Program Services | 50000 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5591860 | Total |
| Program Services | 5591860 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 299962 | Total |
| Program Services | 299962 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17739 | Total |
| Program Services | 17739 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 209685 | Total |
| Program Services | 209685 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 338499 | Total |
| Program Services | 338499 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30 | Total |
| Management And General | 30 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 111963 | Total |
| Program Services | 111963 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8343 | Total |
| Management And General | 8343 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7365 | Total |
| Management And General | 7365 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11216 | Total |
| Program Services | 11216 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1129433 | Total |
| Program Services | 1129433 | ProgramServices |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| MEDICAL SUPPLIES | 366525 | 366525 |
| PROGRAM FEES | 13378 | 13378 |
| OTHER | 9763 | 9763 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8165761 | Total |
| Program Services | 8150023 | ProgramServices |
| Management And General | 15738 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 790818 | BOY |
| EOY | 1168180 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 660267 | BOY |
| EOY | 925384 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45717 | BOY |
| EOY | 109410 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 109512 | BOY |
| EOY | 138386 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1606314 | BOY |
| EOY | 2341360 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 54760 | BOY |
| EOY | 51840 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 693648 | BOY |
| EOY | 883495 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 748408 | BOY |
| EOY | 935335 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 857906 | BOY |
| EOY | 1406025 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 857906 | BOY |
| EOY | 1406025 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1606314 | BOY |
| EOY | 2341360 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 548119 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA STATE UNIVERSITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 591961248 | EIN |
| Type Of Organization | 2 | TypeOfOrganization |
| Listed In Governing Doc | true | ListedInGoverningDoc |
| Supported Organization Notified | true | SupportedOrganizationNotified |
| Organized In US | true | OrganizedInUS |
| Amount | $6,552,765 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 6552765 | SumOfAmounts |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | FLORIDA STATE UNIVERSITY AUXILIARY | Description |
| Amount | $883,495 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 883495 | TotalOfAmounts |
| Total Revenue | 8713880 | TotalRevenue |
| Total Expenses | 8165761 | TotalExpenses |
| Excess Or Deficit For Year | 548119 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 548119 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 8713880 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 8713880 | RevenueSubtotal |
| Total Revenue Per Form990 | 8713880 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 8165761 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 8165761 | ExpensesSubtotal |
| Total Expenses Per Form990 | 8165761 | TotalExpensesPerForm990 |
Schedule F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintained |
Accts Actvs Out US Table AcctsActvsOutUSTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | CENTRAL AMERICA AND THE CARIBBEAN | Region |
| Type Of Activities Conducted | PROGRAM SERVICE | TypeOfActivitiesConducted |
| Specific Services Provided | MEDICAL MISSION TRIP | SpecificServicesProvided |
| Total Expenditures | 10008 | TotalExpenditures |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Amount Spent | 10008 | SubtotalAmountSpent |
| Total Amount Spent | 10008 | TotalAmountSpent |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | false | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA STATE UNIVERSITY FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | INNOVATION PARK 2010 LEVY AVENUE | AddressLine1 |
| City | TALLAHASSEE | City |
| State | FL | State |
| ZIP Code | 32306 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 596152180 | EINOfRecipient |
| IRC Section | 501 | IRCSection |
| Amount Of Cash Grant | 50000 | AmountOfCashGrant |
| Purpose Of Grant | CONTRIBUTION | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs |
|---|---|---|---|---|---|
| JOHN P FOGARTY MD | |||||
| 351248 | 10500 | 3461 | 28577 | 15792 | 409578 |
| LAWRENCE G ABELE PHD | |||||
| 289138 | 8851 | 4050 | 27000 | 15392 | 344431 |
| JOHN R CARNAGHI MED | |||||
| 271423 | 8277 | 13353 | 28667 | 18361 | 340081 |
| ALMA B LITTLES MD | |||||
| 255410 | 7800 | 858 | 26406 | 15415 | 305889 |
| DANIEL J VAN DURME MD | |||||
| 240754 | 7350 | 523 | 25417 | 15311 | 289355 |
| KENNETH V BRUMMEL-SMITH MD | |||||
| 237350 | 7350 | 2301 | 25423 | 18775 | 291199 |
| HAROLD BLAND MD | |||||
| 181681 | 5601 | 34019 | 22612 | 16573 | 260486 |
| ROBERT BRADLEY PHD | |||||
| 209391 | 6339 | 3124 | 24629 | 8471 | 251954 |
| RICHARD S NOWAKOWSKI PHD | |||||
| 161044 | 6900 | 10345 | 17119 | 11167 | 206575 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TALLAHASSEE MEMORIAL HEALTHCARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | COMMON DIRECTOR | Relationship |
| Amount Of Transaction | 72166 | AmountOfTransaction |
| Description Of Transaction | CLINICAL SERVICES | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | THE PURPOSES OF FLORIDA MEDICAL PRACTICE PLAN ARE TO: 1) FURTHER THE EDUCATION, SERVICE, AND RESEARCH MISSIONS OF THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE, A COMPONENT OF THE FLORIDA STATE UNIVERSITY BOARD OF TRUSTEES; AND 2) ENABLE FACULTY TO MAINTAIN CLINICAL COMPETENCE, FULFILL CERTIFICATION REQUIREMENTS, SHARE EXPERTISE WITH OTHER HEALTH CARE PROVIDERS, AND SERVE AS CLINICAL TEACHERS FOR STUDENTS AND RESIDENTS. |
| ADDITIONAL INFORMATION | FORM 990 | FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES: THE FLORIDA MEDICAL PRACTICE PLAN, INC. DOES NOT HAVE EMPLOYEES. THE SALARIES AND BENEFITS REPORTED ON THE STATEMENT OF FUNCTIONAL EXPENSES ARE SALARIES AND BENEFITS REIMBURSED TO FLORIDA STATE UNIVERSITY. OTHER REIMBURSEMENTS TO FLORIDA STATE UNIVERSITY INCLUDE MANAGEMENT FEES AND INSURANCE EXPENSES. |
| RELATED PARTY INFORMATION AMONG OFFICERS | FORM 990, PAGE 6, PART VI, LINE 2 | LAWRENCE G. ABELE, PH.D. JOHN R. CARNAGHI, M.ED. DIRECTOR DIRECTOR ON 3 OTHER FSU BOARDS TOGETHER |
| SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS | FORM 990, PAGE 6, PART VI, LINE 4 | THE BYLAWS: ARTICLE I. MEMBERSHIP: THE BOARD OF DIRECTORS MEMBERSHIP WAS AMENDED TO INCLUDE THE PROVOST OF THE FLORIDA STATE UNIVERSITY OR DESIGNEE AND THE SENIOR VICE PRESIDENT OF FINANCE AND ADMINISTRATION OR DESIGNEE. THE ASSOCIATE DEAN FOR ACADEMIC AFFAIRS OF THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE WAS REPLACED WITH THE SENIOR ASSOCIATE DEAN FOR MEDICAL EDUCATION AND ACADEMIC AFFAIRS OF THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE. ARTICLE III. SECTION 1. THIS SECTION WAS AMENDED TO DESIGNATE JUNE AS THE MONTH OF THE ANNUAL MEETING. ARTICLES OF INCORPORATION: ARTICLE IV WAS AMENDED TO STATE "THE CORPORATION SHALL HAVE NO MEMBERS". |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE FINAL FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS THROUGH ELECTRONIC MAIL PRIOR TO SUBMITTAL TO THE INTERNAL REVENUE SERVICE. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | ANY DIRECTOR, PRINCIPAL, OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, IS COVERED UNDER THE POLICY. ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST MUST BE DISCLOSED TO THE DIRECTORS, AND THE DIRECTORS WILL DECIDE IF A CONFLICT OF INTEREST EXISTS. IF A MEMBER FAILS TO DISCLOSE A CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION FOR THE ORGANIZATION'S TOP OFFICIAL IS DETERMINED BY FAIR MARKET VALUE, SALARY SURVEYS AND A SALARY RANGE PROVIDED BY FLORIDA STATE UNIVERSITY, THE SUPPORTED ORGANIZATION. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION FOR THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES IS DETERMINED BY FAIR MARKET VALUE, SALARY SURVEYS AND A SALARY RANGE PROVIDED BY FLORIDA STATE UNIVERSITY, THE SUPPORTED ORGANIZATION. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTERST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| RELATED ORGANIZATIONS | FORM 990, PAGE 7, PART VII | EACH BOARD MEMBER SPENDS AT LEAST 40 HOURS A WEEK DEVOTED TO FLORIDA STATE UNIVERSITY BUSINESS. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA STATE UNIVERSITY | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | A2201 UNIVERSITY CENTER | AddressLine1 |
| City | TALLAHASSEE | City |
| State | FL | State |
| ZIP Code | 32306 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 591961248 | EIN |
| Primary Activities | UNIVERSITY | PrimaryActivities |
| Legal Domicile State | FL | LegalDomicileState |
| Exempt Code Section | 501C3 | ExemptCodeSection |
| Public Charity Status | 2 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | false | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA STATE UNIVERSITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | O | TransactionType |
| Amount Involved | 6372474 | AmountInvolved |
| Method Of Amt Determination | CASH | MethodOfAmtDetermination |
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