LMC PHYSICIAN SERVICES PC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
LMC PHYSICIAN SERVICES PC (EIN 11-3192423)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-14
IRS object ID
201213199349302291
Schema version
2011v1.2
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-14T11:23:00-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1TWO JERICHO PLAZAAddressLine1
CityJERICHOCity
StateNYState
ZIP Code11753ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN113192423EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LMC PHYSICIAN SERVICES PCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLMCPNameControl
Phone7186307611Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 55TH STREET NO 2-36AddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11220ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameALAN SICKLESName
TitlePRESIDENTTitle
Phone7186307611Phone
Date Signed2012-11-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone5169187000Phone
Date Prepared2012-11-12DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonALAN SICKLESNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1150 55TH STREET NO 2-36AddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11220ZIPCode
FieldValueIRS element (for citing)
Gross Receipts17526527GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1994YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionSEE SCHEDULE O.ActivityOrMissionDescription
Nbr Voting Members Governing Body1NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees125TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year14626089ProgramServiceRevenuePriorYear
Program Service Revenue CY16699442ProgramServiceRevenueCY
Investment Income Prior Year2358InvestmentIncomePriorYear
Investment Income Current Year2146InvestmentIncomeCurrentYear
Other Revenue Prior Year504216OtherRevenuePriorYear
Other Revenue Current Year824939OtherRevenueCurrentYear
Total Revenue Prior Year15132663TotalRevenuePriorYear
Total Revenue Current Year17526527TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year16745001SalariesEtcPriorYear
Salaries Etc Current Year18909138SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year5050463OtherExpensePriorYear
Other Expenses Current Year5075390OtherExpensesCurrentYear
Total Expenses Prior Year21795464TotalExpensesPriorYear
Total Expenses Current Year23984528TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-6662801RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-6458001RevenuesLessExpensesCY
Total Assets BOY2071478TotalAssetsBOY
Total Assets EOY3122537TotalAssetsEOY
Total Liabilities BOY1612654TotalLiabilitiesBOY
Total Liabilities EOY1687708TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY458824NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1434829NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE O.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense22116354Expense
Revenue16699442Revenue
DescriptionSEE SCHEDULE O.Description
Total Program Service Expense22116354TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109618NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees125NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members1NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ALAN SICKLESBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7186307611TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1150 55TH STREETAddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11220ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (5 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
ALAN SICKLES MD
PRESIDENT40.00XX46589808193
MICHAEL GERLING MD
PHYSICIAN40.001224591028886X
FAUSTO VINCES DO
PHYSICIAN40.00569747028637X
SALMAN AZHAR MD
PHYSICIAN40.00645757016398X
STEVEN SCALFANIMD
PHYSICIAN22.00383205023899X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3289198TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation106013TotalOtherCompensation
Number Individuals GT100 K54NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MD EVERYWHERE
26 CENTRAL AVENUEHAUPPAUGENY11788BILLING & AUDIT SERVICES865238
OTOLARYNGOLOGY ASSOCIATES
7333 6TH AVEBROOKLYNNY11209PHYSICIAN SERVICES227609
LOCUMTENENSCOM
PO BOX 405547ATLANTAGA303845547LOCUM TENENS223520
GPK COLORECTAL SURGERY PLLC
23 FOSTER AVENUESTATEN ISLANDNY10314PHYSICIAN SERVICES145110
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE REVENUDescription
Business Code621110BusinessCode
Total Revenue Column16699442TotalRevenueColumn
Related Or Exempt Function Income16699442RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue16699442TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2146TotalRevenueColumn
Exclusion$2,146ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
STAFFING REIMBURSEMENT757856$757,856
MISCELLANEOUS REVENUE67083$67,083
FieldValueIRS element (for citing)
Total Other Revenue824939TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column17526527TotalRevenueColumn
Related Or Exempt Function Income16699442RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$827,085ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total16830580Total
Program Services16339651ProgramServices
Management And General490929ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total370833Total
Program Services352013ProgramServices
Management And General18820ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total849891Total
Program Services772045ProgramServices
Management And General77846ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total857834Total
Program Services818560ProgramServices
Management And General39274ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total207641Total
Management And General207641ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total16642Total
Management And General16642ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total339Total
Management And General339ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total874979Total
Program Services874979ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total2744Total
Management And General2744ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total735756Total
Program Services735756ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total374359Total
Program Services374359ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1643Total
Program Services1643ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total37446Total
Program Services37446ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total1806883Total
Program Services1806883ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
BILLING EXPENSES865238865238
COLLECTION FEES6349663496
BANK FEES5424854248
ANSWERING SERVICES30193019

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total30957Total
Management And General30957ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total23984528Total
Program Services22116354ProgramServices
Management And General1868174ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY37BOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY624124BOY
EOY775795EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY605399BOY
EOY644785EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY374829BOY
EOY528165EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis543711LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec164122LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY154399BOY
EOY379589EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY312690BOY
EOY794203EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2071478BOY
EOY3122537EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1247040BOY
EOY1472768EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY365614BOY
EOY214940EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1612654BOY
EOY1687708EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY458824BOY
EOY1434829EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY458824BOY
EOY1434829EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2071478BOY
EOY3122537EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-6458001ReconcilationRevenueExpenses
Reconcilation Other Changes7434006ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Certification CheckboxXCertificationCheckbox
Written IRS DeterminationXWrittenIRSDetermination
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1LUTHERAN MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
EIN111839567EIN
Type Of OrganizationHOSPITALTypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$695,390Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts695390SumOfAmounts

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis290737OtherCostOrOtherBasis
Depreciation4425Depreciation
Book Value286312BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis248115OtherCostOrOtherBasis
Depreciation156699Depreciation
Book Value91416BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4859OtherCostOrOtherBasis
Depreciation2998Depreciation
Book Value1861BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings379589TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATES609595
DUE FROM THIRD PARTY PAYORS184608
FieldValueIRS element (for citing)
Total Book Value Other Assets794203TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO AFFILIATESDescription
Amount$214,940Amount
FieldValueIRS element (for citing)
Total Of Amounts214940TotalOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ALAN SICKLES MD
3252920139862074404908032850474091000
MICHAEL GERLING MD
517167069056601685801190001698601253477000
FAUSTO VINCES DO
56349706250000121740164630598384000
SALMAN AZHAR MD
4203530210963014441010970054280662155000
STEVEN SCALFANIMD
367125000160800107010131980407104000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 7ReturnReference
ExplanationBONUS INFORMATION THE ORGANIZATION'S EMPLOYED PHYSICIANS ARE ELIGIBLE TO RECEIVE A BONUS BASED ON THE TERMS OF THEIR INDIVIDUAL CONTRACTS. THE EMPLOYED PHYSICIANS' CONTRACTS PROVIDE FOR A FIXED ANNUAL SALARY FOR EACH PHYSICIAN; HOWEVER, THAT SALARY MAY BE SUPPLEMENTED IF, ON AN ANNUAL BASIS, THE PHYSICIAN'S PROFESSIONAL FEE COLLECTIONS EXCEED A DEFINED THRESHOLD. THE PHYSICIAN IS ELIGIBLE TO RECEIVE A BONUS (DETERMINED WITHIN NINETY DAYS FOLLOWING THE END OF THE YEAR). THE PHYSICIANS' CONTRACTS SPECIFY THAT NO COMPENSATION PAYMENTS MAY EXCEED THE FAIR MARKET VALUE OF THE SERVICES PROVIDED BY THE PHYSICIAN.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990, PART I, LINE 1HEALTHCARE PROVIDER OF PHYSICIAN SERVICES IN CONJUNCTION WITH, AND IN SUPPORT OF, LUTHERAN MEDICAL CENTER.
ORGANIZATION'S MISSIONFORM 990, PART III, LINE 1LMC PHYSICIAN SERVICES, PC ("PC") IS FORMED FOR THE SOLE PURPOSE OF PROMOTING HEALTH FOR THE BENEFIT OF THE COMMUNITY BY SERVING A LARGE AND INDEFINITE CLASS. THE ORGANIZATION PROMOTES HEALTH BY ENGAGING IN THE PROFESSION OF MEDICINE AND PROVIDING MEDICAL SERVICES, IN A MANNER THAT IS EXCLUSIVELY CHARITABLE WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE PROVISION OF MEDICAL SERVICES HAS BEEN CARRIED ON SINCE THE INCEPTION OF THE ORGANIZATION IN 1994. THE PC OPERATES IN SUPPORT OF LUTHERAN MEDICAL CENTER. LUTHERAN MEDICAL CENTER IS A NOT-FOR-PROFIT CORPORATION ORGANIZED UNDER THE LAWS OF THE STATE OF NEW YORK, AND A CHARITABLE, TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. LUTHERAN MEDICAL CENTER IS AN ACUTE CARE HOSPITAL THAT CONDUCTS CHARITABLE AND HOSPITAL ACTIVITIES. THE PC PROVIDES PROFESSIONAL MEDICAL SERVICES TO PATIENTS, WITHOUT REGARD FOR THE PATIENT'S ABILITY TO PAY. THE ORGANIZATION HAS ADOPTED THE CHARITY CARE POLICY OF LUTHERAN MEDICAL CENTER.
PROGRAM SERVICE STATEMENTFORM 990, PART III, LINE 4ALUTHERAN MEDICAL CENTER PHYSICIAN SERVICES, PC IS A PROFESSIONAL CORPORATION THAT PROVIDES MULTI-SPECIALTY MEDICAL AND SURGICAL SERVICES TO LUTHERAN MEDICAL CENTER AND THE SURROUNDING SOUTHWEST BROOKLYN COMMUNITIES. MANY OF THE PC'S EMPLOYED PHYSICIANS ALSO PROVIDE SERVICES TO THE LUTHERAN FAMILY HEALTH CENTER CLINICS, LOCATED AT LUTHERAN MEDICAL CENTER AND, A SATELLITE OFFICE LOCATED IN BAY RIDGE. MAJOR SPECIALTIES REPRESENTED BY EMPLOYEES OF THE PC ARE AS FOLLOWS: MEDICINE- INTERNAL MEDICINE, CARDIOLOGY, NEUROLOGY, PHYSICAL MEDICINE AND REHABILITATION; MEDICAL ONCOLOGY, RHEUMATOLOGY, ENDOCRINOLOGY; SURGERY- THORACIC, VASCULAR, HAND/PLASTIC, UROLOGY, OPHTHALMOLOGY, ORTHOPEDICS, GENERAL/TRAUMA, BARIATRIC; OBGYN- REPRODUCTIVE ENDOCRINOLOGY, UROLOGICAL GYN; GYN ONCOLOGY; BEHAVIORAL HEALTH- PSYCHIATRY AND SUBSTANCE ABUSE. IN 2011, MORE THAN 202,600 VISITS AND PROCEDURES WERE PERFORMED ON LUTHERAN MEDICAL CENTER PATIENTS, WITHOUT REGARD FOR THE PATIENT'S ABILITY TO PAY.
FORM 990, PART IV, LINE 12BLMC PHYSICIANS SERVICES, P.C. IS INCLUDED IN A COMBINED AUDITED FINANCIAL STATEMENT FOR THE YEAR ENDING DECEMBER 31ST, 2010. THE COMBINED FINANCIAL STATEMENTS ARE PREPARED IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES IN THE UNITED STATES OF AMERICA ("GAAP"). THE COMBINED FINANCIAL STATEMENTS INCLUDE THE ACCOUNTS OF LUTHERAN MEDICAL CENTER AND ALL OF ITS AFFILIATED ORGANIZATIONS. PER THE INSTRUCTIONS TO THE FORM 990, THE ORGANIZATION IS REQUIRED TO RESPOND "YES" TO PART IV, QUESTION 12B IF THE ORGANIZATION IS PART OF A CONSOLIDATED FINANCIAL STATEMENT. SINCE SELECTING "YES" TO THIS QUESTION MAY BE MISCONSTRUED, THE TAXPAYER IS ATTACHING THIS EXPLANATION TO ITS FORM 990.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION IS A PROFESSIONAL SERVICE CORPORATION ("PC") WITH ONE SHAREHOLDER. UNDER APPLICABLE NYS LAW, ONLY A LICENSED PHYSICIAN MAY HOLD SHARES IN THE PC. DR. ALAN SICKLES, IS THE SOLE SHAREHOLDER OF THE PC, AND PURSUANT TO A SHAREHOLDER AGREEMENT AMONG DR. SICKLES, THE PC AND THE MEDICAL CENTER, THE SHAREHOLDER HAS VERY LIMITED AUTHORITY. IN PARTICULAR, THE SHAREHOLDER MAY NOT TRANSFER OR ENCUMBER THE SHARES OR DECLARE DISTRIBUTIONS WITHOUT THE EXPRESS CONSENT OF THE MEDICAL CENTER.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE SHAREHOLDER HAS THE AUTHORITY TO APPOINT THE DIRECTORS AND OFFICERS OF THE PC.
FORM 990, PART VI, SECTION A, LINE 7BPURSUANT TO THE SHAREHOLDER AGREEMENT, DR. ALAN SICKLES HAS LIMITED AUTHORITY AND ALL DECISIONS ARE CONTROLLED BY LUTHERAN MEDICAL CENTER.
FORM 990, PART VI, SECTION A, LINE 8BTHE ORGANIZATION HAS ANSWERED THIS QUESTION "NO" AS THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS REVIEWED BY THE VICE PRESIDENT OF FINANCE OF THE ORGANIZATION'S PARENT ORGANIZATION, LUTHERAN MEDICAL CENTER. A COPY OF THE FORM 990 IS PROVIDED TO THE SOLE DIRECTOR, DR. ALAN SICKLES, FOR HIS COMMENT AND REVIEW.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION OPERATES UNDER THE CONFLICT OF INTEREST POLICY OF ITS PARENT ORGANIZATION, LUTHERAN MEDICAL CENTER. THE PRESIDENT AND SOLE DIRECTOR, DR. ALAN SICKLES, IS REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST ON TWO ANNUAL SURVEY/QUESTIONNAIRES SUBMITTED TO THE MEDICAL CENTER'S GENERAL COUNSEL. ONE OF THE QUESTIONNAIRES PERTAINS TO HIS ROLE AS A SENIOR EXECUTIVE FOR LUTHERAN MEDICAL CENTER AND THE OTHER, MORE COMPREHENSIVE, QUESTIONNAIRE PERTAINS TO HIS ROLE AS PRESIDENT AND SOLE DIRECTOR FOR LMC PHYSICIAN SERVICES, PC. THE TWO SUBMITTED QUESTIONNAIRES ARE REVIEWED BY THE MEDICAL CENTER'S GENERAL COUNSEL TO ENSURE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15SENIOR MANAGEMENT AT THE PARENT ORGANIZATION, LUTHERAN MEDICAL CENTER, REGULARLY REVIEWS VARIOUS OBJECTIVE DATA SOURCES THAT FACTOR INTO COMPENSATION FOR EMPLOYED AND CONTRACTED PHYSICIANS AND GROUPS PROVIDING SERVICES TO THE ORGANIZATION. THESE SOURCES INCLUDE NATIONAL AND REGIONAL SURVEY SAMPLES BY PHYSICIAN CLINICAL SPECIALTY, AS PUBLISHED BY SULLIVAN COTTER AND AS PURCHASED FROM OTHER CONSULTANTS, WHICH GUIDE THE ESTABLISHMENT OF FAIR MARKET VALUE FOR EACH PHYSICIAN'S/GROUP'S COMPENSATION LEVEL IN THE ORGANIZATION. WITH RESPECT TO CERTAIN PHYSICIANS WHO MIGHT BE CONSIDERED "LUMINARIES" OR WHOSE COMPENSATION FALLS INTO AN OUTLIER CATEGORY IN THE CLINICAL SPECIALTY, LMC SEEKS ADVICE AND OPINIONS FROM OUTSIDE CONSULTANTS WHO SPECIALIZE IN THIS WORK.
FORM 990, PART VI, SECTION C, LINE 19THE TAXPAYER MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC BY RETAINING A COPY OF EACH AT ITS HEAD OFFICES. ANY INDIVIDUAL REQUESTING A COPY OF THESE DOCUMENTS IS PROVIDED THAT COPY ON THE SAME BUSINESS DAY. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION DOES NOT OBTAIN AUDITED FINANCIAL STATEMENTS SO THESE ARE NOT MADE AVAILABLE TO THE PUBLIC. THE SOLE PHYSICIAN-SHAREHOLDER OF LMC PHYSICIAN SERVICES, P.C. RECEIVES HER COMPENSATION THROUGH THE ORGANIZATION'S PARENT ORGANIZATION, LUTHERAN MEDICAL CENTER. THE LUTHERAN MEDICAL CENTER BOARD OF TRUSTEES ENGAGES SULLIVAN COTTER & ASSOCIATES, INC. TO PROVIDE ANNUAL REPORTS AND SUPPORTING DATA RELATIVE TO EXECUTIVE COMPENSATION. THE COMPENSATION COMMITTEE, ACTING ON BEHALF OF THE FULL LUTHERAN BOARD OF TRUSTEES, RECEIVES AND REVIEWS THESE REPORTS WHICH CONTAIN: A) A MARKET ANALYSIS OF THE TOTAL COMPENSATION LEVELS OF SENIOR EXECUTIVES IN RELATION TO THEIR PEERS IN THE MARKETPLACE; B) A REVIEW OF CURRENT COMPENSATION AND BENEFIT PLAN DESIGNS TO ENSURE COMPETITIVENESS TO THE MARKETPLACE; AND C) COMPLIANCE WITH STATE AND/OR FEDERAL REGULATIONS. THE COMPENSATION COMMITTEE RELIES UPON THE DATA AND RECOMMENDATIONS PROVIDED BY SULLIVAN COTTER & ASSOCIATES TO DETERMINE THE COMPENSATION LEVEL OF THE CEO. FOR THE OTHER KEY EXECUTIVE POSITIONS, THE CEO RECOMMENDS ADJUSTMENTS TO THE COMMITTEE WHO, IN TURN, REVIEW THESE RECOMMENDATIONS UTILIZING THE SULLIVAN COTTER & ASSOCIATES REPORTS AND APPROVES, DISAPPROVES OR ALTERS THE PROPOSALS OF THE CEO FOR THE OTHER SENIOR EXECUTIVES.
FORM 990, PART VI, LINES 13 & 14THE ORGANIZATION OPERATES UNDER THE WHISTLEBLOWER AND DOCUMENT RETENTION POLICY OF ITS PARENT ORGANIZATION, LUTHERAN MEDICAL CENTER
CHANGES IN NET ASSETS OR FUND BALANCES:FORM 990, PART XI, LINE 5:TRANSFERS OF NET ASSETS FROM RELATED ENTITIES 7,434,005. ROUNDING 1. TOTAL TO FORM 990, PART XI, LINE 5: 7,434,006.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1LUTHERAN MEDICAL CENTERBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1150 55TH STREETAddressLine1
CityBROOKLYNCity
StateNYState
ZIP Code11220ZIPCode
FieldValueIRS element (for citing)
EIN111839567EIN
Primary ActivitiesHOSPITALPrimaryActivities
Legal Domicile StateNYLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status3PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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