2012-04-19T15:47:33-05:00 2011-06-30 PURVIS GRAY & COMPANY 443 EAST COLLEGE AVENUE TALLAHASSEE FL 32301 990 2010-07-01 571234883 FLORIDA MEDICAL PRACTICE PLAN INC FLOR 8506452827 1115 WEST CALL STREET TALLAHASSEE FL 32306 JOHN P FOGARTY MD 8506452827 2012-03-23 true RYAN M TUCKER CPA 8502247144 2012-04-11 2010 2016-02-24 21:20:13Z JOHN P FOGARTY 1115 WEST CALL STREET TALLAHASSEE FL 32306 8713880 false X X 2006 FL 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. 9 0 0 0 0 3777837 8709858 2506 4022 0 3780343 8713880 20000 50000 0 6119246 0 0 3602038 1996515 3622038 8165761 158305 548119 1606314 2341360 748408 935335 857906 1406025 X 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. false false 8150023 50000 8709858 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. 8150023 true false false false false false false false false false false false false false true false true true false false true false false false false false false true false true false false false false false false false true false false false false false true true true false false true 4 0 0 false false false false false false X 9 0 true false true false false false false true true false false true true true true true true true true false X SHARON WOODALL 8506452827 1115 WEST CALL STREET TALLAHASSEE FL 32306 X JOHN P FOGARTY MD 1.00 X X 0 365209 44369 LAWRENCE G ABELE PHD 1.00 X 0 302039 42392 JOHN R CARNAGHI MED 1.00 X 0 293053 47028 ALMA B LITTLES MD 1.00 X X 0 264068 41821 DANIEL J VAN DURME MD 1.00 X X 0 248627 40728 KENNETH V BRUMMEL-SMITH MD 1.00 X 0 247001 44198 HAROLD BLAND MD 1.00 X 0 221301 39185 ROBERT BRADLEY PHD 1.00 X 0 218854 33100 RICHARD S NOWAKOWSKI PHD 1.00 X 0 178289 28286 JANINE EDWARDS PHD 1.00 X 0 127608 13443 RICARDO GONZALEZ-ROTHI 1.00 X 0 0 0 2466049 374550 false true false 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 4 CLINICAL REVENUE 624100 8410497 8410497 MEDICAID REVENUE 624100 299361 299361 8709858 4022 4022 8713880 8709858 4022 50000 50000 5591860 5591860 299962 299962 17739 17739 209685 209685 338499 338499 30 30 111963 111963 8343 8343 7365 7365 11216 11216 1129433 1129433 MEDICAL SUPPLIES 366525 366525 PROGRAM FEES 13378 13378 OTHER 9763 9763 8165761 8150023 15738 0 790818 1168180 660267 925384 45717 109410 109512 138386 1606314 2341360 54760 51840 693648 883495 748408 935335 X 857906 1406025 857906 1406025 1606314 2341360 548119 X false true true X false X X X X false false false FLORIDA STATE UNIVERSITY 591961248 2 true true true 6552765 1 6552765 false false false false false false false false false false FLORIDA STATE UNIVERSITY AUXILIARY 883495 883495 8713880 8165761 548119 548119 8713880 8713880 8713880 8165761 8165761 8165761 false CENTRAL AMERICA AND THE CARIBBEAN PROGRAM SERVICE MEDICAL MISSION TRIP 10008 10008 10008 false FLORIDA STATE UNIVERSITY FOUNDATION INNOVATION PARK 2010 LEVY AVENUE TALLAHASSEE FL 32306 596152180 501 50000 CONTRIBUTION 1 X X X X false false false false false false false false false 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 TALLAHASSEE MEMORIAL HEALTHCARE COMMON DIRECTOR 72166 CLINICAL SERVICES false 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. FLORIDA STATE UNIVERSITY A2201 UNIVERSITY CENTER TALLAHASSEE FL 32306 591961248 UNIVERSITY FL 501C3 2 N/A false false false false false false false false false false false false false true true true false false false FLORIDA STATE UNIVERSITY O 6372474 CASH