2012-11-06T13:45:02-06:00 2011-12-31 310800053 CLARK SCHAEFER HACKETT & CO 150 E CAMPUS VIEW BLVD SUITE 100 COLUMBUS OH 43235 990 2011-01-01 341817218 OHIO PHYSICIANS HEALTH PROGRAM OHIO 6148419690 5900 ROCHE DRIVE STE 440 COLUMBUS OH 43229 DAVID D GOLDBERG DO 6148419690 2012-10-15 1 SHARON R REISMAN P00280235 6148852208 2012-10-15 2011 2016-02-24 21:20:13Z KELLEY M LONG 5900 ROCHE DRIVE SUITE 440 COLUMBUS OH 43229 930389 0 X WWW.OPHP.ORG X 1995 OH TO FACILITATE THE HEALTH & WELLBEING OF HEALTHCARE PROFESSIONALS IN ORDER TO ENHANCE PATIENT CARE AND SAFETY. 13 13 5 100 0 0 672867 499829 116891 105285 28974 50766 6652 9250 825384 665130 0 0 0 0 527799 373884 25412 22702 52503 199706 306284 752917 702870 72467 -37740 1182237 1129622 10246 12200 1171991 1117422 TO FACILITATE THE HEALTH AND WELLBEING OF HEALTHCARE PROFESSIONALS IN ORDER TO ENHANCE PATIENT SAFETY. 0 0 551444 105285 CONSULTATION & INTERVENTION: THE OHIO PHYSICIANS HEALTH PROGRAM (OPHP) IS A CONFIDENTIAL RESOURCE THAT ASSISTS PHYSICIANS AND OTHER HEALTHCARE PROFESSIONALS WHO MAY BE AFFECTED BY SUBSTANCE USE DISORDERS OR OTHER ISSUES IMPACTING THEIR HEALTH AND WELL-BEING. OPHP AIMS TO PROVIDE EDUCATION ON REGULATORY GUIDELINES AND OHIO'S "ONE-BITE" RULE. THE ORGANIZATION HELD EDUCATION PROGRAMS THROUGHOUT THE STATE OF OHIO. IN 2011, THERE WERE 438 ACTIVE CASES, 156 SIGNED AGREEMENTS, AND 140 NEW REFERRALS. PRINTED MATERIALS WERE MAILED OR DISTRIBUTED INCLUDING THE NEWSLETTER AND THE ANNUAL REPORT. 551444 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 5 0 1 5 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 OH X KELLEY LONG 6148419690 5900 ROCHE DRIVE SUITE 440 COLUMBUS OH 43229 RAYMOND MAZZOTTA 1.00 X X 0 0 0 FARSHID AFSARIFARD PHD 1.00 X 0 0 0 MARTHA BETHEA CPA 1.00 X X 0 0 0 GEORGE HARDING IV MD 1.00 X 0 0 0 JAMES W KELLER MD 1.00 X 0 0 0 MARGARET L TONDOW MSN 1.00 X 0 0 0 BRUCE WALL MD MMM 1.00 X 0 0 0 PATRICIA J DAVIDSON MD FAAP 1.00 X 0 0 0 CHRISTINA DELOS-REYES MD 1.00 X 0 0 0 RONALD L MILLER MD 1.00 X 0 0 0 STEVEN W CLAY DO 1.00 X 0 0 0 MARK HATCHER JD 1.00 X 0 0 0 DAVID D GOLDBERG DO 8.00 X 63000 0 1494 PETER D ROGERS MDMPH FASM 40.00 X 69969 0 23303 132969 0 24797 0 1 0 0 0 403828 96001 499829 ADMINISTRATIVE FEES 561000 84475 84475 TOXICOLOGY FEES 541380 20810 20810 105285 30944 30944 285081 265259 19822 19822 19822 HONORARIA 900099 9250 9250 9250 665130 134357 0 30944 157766 137223 20082 461 216118 187977 27509 632 18311 13874 2958 1479 13545 11107 1625 813 22702 22702 10920 10920 1273 1273 58252 49403 2565 6284 27625 19338 5525 2762 18568 18568 6793 6459 334 7743 5807 1936 15537 13207 2330 CONTRACT LABOR 76655 51660 21215 3780 RESOURCE DEVELOPMENT 37877 24621 13256 COMPUTER SERVICES 8508 6381 2127 BAD DEBT EXPENSE 1714 1714 2963 2832 131 702870 551444 98923 52503 57829 29223 14984 24304 80603 38853 15112 11262 70054 49005 22404 21049 985981 999607 5324 5324 1182237 1129622 10246 12200 10246 12200 X 1170656 1116087 1335 1335 1171991 1117422 1182237 1129622 X -37740 -16829 X X 0 1 1 X 0 X 653274 679581 668742 672867 499829 3174293 653274 679581 668742 672867 499829 3174293 3174293 21449 29659 21933 29184 30944 133169 21020 4950 2800 6652 9250 44672 3352134 1128882 0.94690 0.94750 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4218 825 3393 65836 48180 17656 21049 INVESTMENTS 999607 F 999607 665130 702870 -37740 -16829 -16829 -54569 654638 -10492 -10492 665130 0 665130 709207 6337 6337 702870 0 702870 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION ADOPTED THE NEW ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES GUIDANCE ON JANUARY 1, 2009. THESE PROVISIONS CLARIFY THE ACCOUNTING AND RECOGNITION FOR INCOME TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE ORGANIZATION'S INCOME TAX RETURNS. THE ORGANIZATION'S INCOME TAX FILINGS ARE SUBJECT TO AUDIT BY VARIOUS TAXING AUTHORITIES. THE ORGANIZATION'S OPEN AUDIT PERIODS ARE 2007-2010. THE ORGANIZATION'S POLICY WITH REGARD TO INTEREST AND PENALTY IS TO RECOGNIZE INTEREST THROUGH INTEREST EXPENSE AND PENALTIES THROUGH OTHER EXPENSE. IN EVALUATING THE ORGANIZATION'S TAX PROVISIONS AND ACCRUALS, FUTURE TAXABLE INCOME, AND THE REVERSAL OF TEMPORARY DIFFERENCES, INTERPRETATIONS AND TAX PLANNING STRATEGIES ARE CONSIDERED. THE ORGANIZATION BELIEVES ITS ESTIMATES ARE APPROPRIATE BASED ON THE CURRENT FACTS AND CIRCUMSTANCES. PART XII LINE 2D: THIS IS THE IN-KIND CONTRIBUTION OF LEGAL FEES FROM BAKER & HOSTETLER, LLP. PART XIII, LINE 2D: THIS IS THE IN-KIND CONTRIBUTION OF LEGAL FEES FROM BAKER & HOSTETLER, LLP. X X X X X 1 NICOLE L MOHAR 200 WESTWIND DRIVE AVON LAKE OH 44012 TO PROVIDE FUNDRAISING & FUND DEVELOPMENT SERVICES 0 92338 22702 69636 92338 22702 69636 OH X X 1 0 0 0 0 0 0 0 0 PETER D ROGERS MDMPH FASM 69969 0 0 0 0 0 5598 0 17705 0 93272 0 0 0 PART I, LINE 4A PETER D. ROGERS, M.D., MPH, FASM; $30,834 SEVERANCE PAY; $14,467 SEVERANCE BENEFITS FORM 990, PART VI, SECTION B, LINE 11 THE RETURN IS PREPARED BY CLARK, SCHAEFER, HACKETT & CO. OHIO PHYSICIANS HEALTH PROGRAM RECEIVES A DRAFT COPY WHICH IS GIVEN TO THE CHAIRMAN OF THE AUDIT/FINANCE COMMITTEE FOR REVIEW AND APPROVAL. ONCE APPROVED, A FINAL RETURN IS PREPARED AND FILED. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, DIRECTORS, OR TRUSTEES KEEP THE OPERATIONS MANAGER UPDATED OF ANY EMPLOYMENT, MEMBERSHIP, AND COMMITTEE INVOLVEMENT THAT COULD COMPROMISE THE CONFLICT OF INTEREST POLICY AT EACH BOARD MEETING OR AS NEEDED. THE ORGANIZATION HAS A COMPENSATION COMMITTEE WITHIN THE BOARD OF TRUSTEES. THESE INDIVIDUALS MEET AND DISCUSS ANY CHANGES OR ADJUSTMENTS THAT NEED TO BE MADE AND PROVIDE THE CHANGE TO THE OPERATIONS MANAGER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES THEIR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -16,829. THE PROCESS FOR OVERSIGHT OF THE AUDIT AND REVIEW OF THE 990 HAS NOT CHANGED FROM THE PRIOR YEAR. DDD