STONY BROOK ANESTHESIOLOGY UNIVERSITY FACULTY PRACTICE CORP: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
STONY BROOK ANESTHESIOLOGY UNIVERSITY FACULTY PRACTICE CORP (EIN 11-2553515)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-09
IRS object ID
201101299349301640
Schema version
2009v1.7
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-09T16:43:39-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 2600AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN112553515EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Stony Brook AnaesthesiologyBusinessNameLine1
Business Name Line2University Faculty Practice CorporationBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSTONNameControl
Phone6314442055Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1554AddressLine1
CityStony BrookCity
StateNYState
ZIP Code11790ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePeter GlassName
TitlePresidentTitle
Date Signed2011-05-09DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817000Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonPeter S A Glass MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO Box 1554AddressLine1
CityStony BrookCity
StateNYState
ZIP Code11790ZIPCode
FieldValueIRS element (for citing)
Gross Receipts24746202GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web Siten/aWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1980YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionProvide clinical instruction to and supervision of medical school students, interns and residents and, incident thereto, rendering professional services.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees53TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year22347664ProgramServiceRevenuePriorYear
Program Service Revenue CY24722206ProgramServiceRevenueCY
Investment Income Prior Year39217InvestmentIncomePriorYear
Investment Income Current Year23996InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year22386881TotalRevenuePriorYear
Total Revenue Current Year24746202TotalRevenueCurrentYear
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 Year14544803SalariesEtcPriorYear
Salaries Etc Current Year15940492SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year7025851OtherExpensePriorYear
Other Expenses Current Year8433752OtherExpensesCurrentYear
Total Expenses Prior Year21570654TotalExpensesPriorYear
Total Expenses Current Year24374244TotalExpensesCurrentYear
Revenues Less Expenses Prior Year816227RevenuesLessExpensesPriorYear
Revenues Less Expenses CY371958RevenuesLessExpensesCY
Total Assets BOY816227TotalAssetsBOY
Total Assets EOY1188185TotalAssetsEOY
Total Liabilities BOY816227TotalLiabilitiesBOY
Total Liabilities EOY1188185TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY0NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY0NetAssetsOrFundBalancesEOY
Mission DescriptionProvide clinical instruction to and supervision of medical school students, interns and residents and, incident thereto, rendering professional services.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense22582868Expense
Revenue24722206Revenue
DescriptionThe organization provides services in the field of Anaesthesiology to patients and provides clinical instruction to and supervision of School of Medicine students and Hospital residents.Description
Total Program Service Expense22582868TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
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Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedfalseBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109617NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees53NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCLINICAL PRACTICE MGMT PLANNamePerson
Telephone Number6314442055TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 1554AddressLine1
CityStony BrookCity
StateNYState
ZIP Code11790ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
Peter S A Glass
President & Director50.0XX47331015764155512
Steven Vitkun
Secretary & Director50.0XX1160388416933946
Robert Katz
Director50.0X3026106551845843
Kenneth Rosenfeld
Anaesthesiologist50.042291911190452899X
F Barry Florence
Anaesthesiologist50.033657917530051971X
Slawomir Olesak
Anaesthesiologist50.03863554639241948X
Daryn Moller
Anaesthesiologist50.03774005068341679X
Ronald Jasiewicz
Anaesthesiologist50.03767144406142436X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2791925TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs735668TotalReportableCompFrmRltdOrgs
Total Other Compensation366234TotalOtherCompensation
Number Individuals GT100 K50NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

FieldValueIRS element (for citing)
Name PersonPivotHealthNamePerson

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15500 Maryland WayAddressLine1
CityBRENTWOODCity
StateTNState
ZIP Code37027ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesPatient Satis SurveyDescriptionOfServices
Compensation159142Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient Service RevenueDescription
Business Code621111BusinessCode
Total Revenue Column24722206TotalRevenueColumn
Related Or Exempt Function Income24722206RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue24722206TotalProgramServiceRevenue

Investment Income InvestmentIncome

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Total Revenue Column23996TotalRevenueColumn
Exclusion$23,996ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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Royalties Revenue RoyaltiesRevenue

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Net Gain Or Loss Investments NetGainOrLossInvestments

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Net Income From Fundraising Events NetIncomeFromFundraisingEvents

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Net Income From Gaming NetIncomeFromGaming

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Net Income Or Loss NetIncomeOrLoss

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Total Revenue TotalRevenue

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Total Revenue Column24746202TotalRevenueColumn
Related Or Exempt Function Income24722206RelatedOrExemptFunctionIncome
Exclusion$23,996ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

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Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

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Total0Total

Foreign Grants ForeignGrants

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Total0Total

Benefits To Members BenefitsToMembers

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Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

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Total967514Total
Program Services919138ProgramServices
Management And General48376ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

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Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total13094235Total
Program Services13094235ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1300898Total
Program Services1300898ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total15874Total
Program Services15874ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total561971Total
Program Services561971ProgramServices

Fees For Services Management FeesForServicesManagement

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Total8300000Total
Program Services6557000ProgramServices
Management And General1743000ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

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Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total122454Total
Program Services122454ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total884Total
Program Services884ProgramServices

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Pension admin fees1203412034
All other expenses-1620-1620

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total24374244Total
Program Services22582868ProgramServices
Management And General1791376ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY816227BOY
EOY1188185EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY816227BOY
EOY1188185EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY816227BOY
EOY1188185EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY816227BOY
EOY1188185EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY816227BOY
EOY1188185EOY
FieldValueIRS element (for citing)
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years20171437CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years22240337CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year22347664CurrentTaxYearMinus1Year
Current Tax Year24722206CurrentTaxYear
Total89481644Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years20171437CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years22240337CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year22347664CurrentTaxYearMinus1Year
Current Tax Year24722206CurrentTaxYear
Total89481644Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year60126CurrentTaxYear
Total60126Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year60126CurrentTaxYear
Total60126Total
FieldValueIRS element (for citing)
Public Support Total50989421518PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years45608CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years40973CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year39217CurrentTaxYearMinus1Year
Current Tax Year23996CurrentTaxYear
Total149794Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years45608CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years40973CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year39217CurrentTaxYearMinus1Year
Current Tax Year23996CurrentTaxYear
Total149794Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years20217045CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years22281310CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year22386881CurrentTaxYearMinus1Year
Current Tax Year24746202CurrentTaxYear
Total89631438Total
FieldValueIRS element (for citing)
First5 Years509XFirst5Years509

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
First Class Or Charter TravelXFirstClassOrCharterTravel
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation SurveyXCompensationSurvey
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 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
Peter S A Glass
4079381576416162903743000277032780950101318545000
Steven Vitkun
11450084169001538000142851966113032310383000
Robert Katz
26145265518388740228400028930169133315408243100
Kenneth Rosenfeld
3410751119048013201712000291612373845208013564200
F Barry Florence
2745801753005469807301000246522731936123120261900
Slawomir Olesak
277367463921070330195500028281136664146366005800
Daryn Moller
246687506831291070160700028842128374062426352000
Ronald Jasiewicz
258032440611171210156100029066133704057805743100

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Supplemental Compensation InformationNon-Fixed PaymentsEmployees are reimbursed for business expenses that relate to the practice of medicine. The total amount reimbursable in a given fiscal year is determined by the respective Chairperson. All reimbursements are subject to approval by the Chairperson or their designee. For an expense to be eligible for reimbursement, it must be allowable "in accordance with generally accepted accounting principles and allowable to a practitioner as a deductible cost or expense under current federal Internal Revenue Service guidelines." Documentation of expenses follows IRS guidelines. Expenses are not processed unless they have complete documentation. Expenditures that are over $5,000, unprecedented, or unusual, will require prior approval from the Purchasing and Asset Management Committee.
First Class/Business Class travelSchedule J, Part I, 1aFirst class and business class travel was provided to UFPC Presdient Peter S. A. Glass, MD, who was reimbursed for the cost of airfare and miles upgrade to first and business class for an international meeting. The amount reimbursed was not treated as taxable compensation. This benefit is subject to the guidelines for nonfixed payments. Employees are reimbursed for business expenses that relate to the practice of medicine. The total amount reimbursable in a given fiscal year is determined by the respective Chairperson. All reimbursements are subject to approval by the Chairperson or their designee. For an expense to be eligible for reimbursement, it must be allowable "in accordance with generally accepted accounting principles and allowable to a practitioner as a deductible cost or expense under current federal Internal Revenue Service guidelines." Documentation of expenses follows IRS guidelines. Expenses are not processed unless they have complete documentation. Expenditures that are over $5,000, unprecedented, or unusual, require prior approval from the Purchasing and Asset Management Committee. First class/business class airfare is considered unusual and therefore must be approved by the Purchasing and Asset Management Committee.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Describe the Process used by Management &/or Governing Body to Review 990Form 990, Part VI, Question 11An electronic version of Form 990 was provided to the officers and directors prior to filing. Management perfoms a review for Form 990 prior to filing, addressing any questions made by the governing body.
Description of Process to Monitor Transactions for Conflicts of InterestForm 990, Part VI, Question 12cThe purpose of the conflict of interest policy is to protect the UFPC's interest when it is contemplating entering into a transaction or arrangement that might benefit the private interest of an officer or director of the UFPC or might result in a possible excess benefit transaction. In connection with any actual or possible conflict of interest, an interested person must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of committees with governing board delegated powers considering the proposed transaction or arrangement. After disclosure of the financial interest and all material facts, and after any discussion with the interested person, he/she shall leave the governing board or committee meeting while the determination of a conflict of interest is discussed and voted upon. The remaining board of committee members shall decide if a conflict of interest exists. Compliance with this policy is monitored through internal payment policies and annual representations. The reviews, at a minimum, include the following subjects: a. Whether compensation arrangements and benefits are reasonable, based on competent survey information, and the result of arm's length bargaining. b. Whether partnerships, joint ventures, and arrangements with management organizations conform to the UFPC's written policies, are properly recorded, reflect reasonable investment or payment for goods and services, further educational purposes and do not result in inurement, impermissible private benefit or in an excess benefit transaction. A voting member of the governing board who has a compensation conflict is precluded from voting on matters pertaining to that member's compensation. If there are violations to the policy, the committee or governing board shall take appropriate disciplinary and corrective action.
Offices & Positions for Which Process was Used, & Year Process was BegunForm 990, Part VI, Question 15a and bBegan at inception: Each Physician is a member of the School of Medicine's faculty and a New York State employee providing services at the University, and reports to the Chairman of his/her department and the Dean of the School of Medicine, who in turn reports to the President of the University. The Dean of the School of Medicine is responsible for hiring and terminating each Physician, determining each Physician's Compensation (which is subject to the limitations in Article XVI as described below), and also appoints the Chairperson of the School of Medicine's Department of Anaesthesiology, (i) who is one of the directors; and (ii) who in turn selects its other two directors. Consequently, the directors must act in a manner which will not jeopardize their employment with the Medical School and the University in order to remain on the board. As a result, New York State, through the SUNY system, the University, the Medical School, and CPMP (as explained below) exercises substantial control over operations, which are also subject to originating documents (i.e., Certificate of Reincorporation and bylaws), which state the purpose as furthering the University's educational mission. All Physicians enter into employment arrangements with the UFPC. As a result, each Physician receives compensation and benefits from the UFPC and the State of New York (because such physician is also a University employee). The Dean of the School of Medicine determines each Physician's compensation, in consultation with such physician's departmental chairperson. Documentation regarding such compensation determination is maintained by the Dean's office. Each Physician is compensated based on traditional factors such as training, experience, qualifications, and general market conditions. Subject to the limitations described below, employment agreements with Physicians typically allow an individual physician to receive non-fixed compensation, based on amounts collected which are attributable to such physician's direct patient care services. The organization generally determines a Physician's compensation to equal an amount between the 50th and 75th percentile of comparable physician compensation, as reported in the Association of American Medical College's (the "AAMC's") compensation data reference materials. Each Physician is also subject to Article XVI, which at all times governs such Physician's compensation. Under the terms of Article XVI, the maximum amount of compensation payable to any physician (including compensation from all other source exclusive of fringe benefits) is not to exceed 250% of that individual's maximum state basic annual salary for his/her academic rank (the "250% Rule"). In special circumstances relating to recruitment, the University President (or his/her designee) may authorize an Physician to receive greater than 250% of the maximum state basic annual salary for such physician's rank, provided that such compensation is in the best interest of the University and the Hospital. Such additional compensation shall not extend beyond a two year period. Also, with the approval of the Chancellor of the SUNY system (or his/her designee) the maximum allowable compensation payable to a Physician may exceed 275% of such individual's maximum state basic annual salary (e.g., in the case of physicians providing services in difficult to retain specialties). In making recommendations with respect to such exceptions to the "250% Rule", the President of the University considers the competition for physicians in a particular specialty as indicated by the AAMC's compensation data, and other revenue generated by the physician's clinical activities. Such exceptions, pursuant to the terms of Article XVI, shall not exceed 5% of the total number of physicians on a system-wide basis. Also, subject to the terms of Article XVI, a portion of each Physician's compensation may be used to purchase a retirement benefit for the benefit of Physicians.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen PublicForm 990, Part VI, Question 19All governing documents will not be disclosed outside of the organization. The conflict of interest policy and financial statements also will not be disclosed outside of the organization.
Hours devoted to related organizationForm 990, Part VIIThe mission of the reporting organization is to support the educational mission of the State University of New York School of Medicine at Stony Brook (the "Medical School") by providing clinical instruction to and supervision of Medical School students, interns and residents and, incident thereto, rendering professional services. Each physician is an employee of the reporting organization and a New York State employee providing services as a member of the the Medical School's faculty. Hours worked by the physicians listed in Part VII relate to the entire mission of the reporting organization which includes supporting the mission of the Medical School.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (22 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
New York State
One Commerce Plaza 99 Washington AAlbanyNY12231146013200GovernmentNY501 c 1N/ANA
Stony Brook Dermatology Associates UFPC
PO Box 1554Stony BrookNY11790113011790HealthcareNY501 c 39NYS
Stony Brook Emergency Physicians UFPC
PO Box 1554Stony BrookNY11790113066770HealthcareNY501 c 39NYS
Stony Brook Family Medical Group UFPC
PO Box 1554Stony BrookNY11790112552321HealthcareNY501 c 39NYS
Stony Brook Internists UFPC
PO Box 1554Stony BrookNY11790112558775HealthcareNY501 c 39NYS
New York Spine and Brain Surgery UFPC
PO Box 1554Stony BrookNY11790112645930HealthcareNY501 c 39NYS
Neurology Assoc of Stony Brook UFPC
PO Box 1554Stony BrookNY11790112587430HealthcareNY501 c 39NYS
Univ Assoc in Obst & Gynecology UFPC
PO Box 1554Stony BrookNY11790112569522HealthcareNY501 c 39NYS
Stony Brook Pathologists UFPC
PO Box 1554Stony BrookNY11790112647243HealthcareNY501 c 39NYS
Stony Brook Preventive Med Srvc UFPC
PO Box 1554Stony BrookNY11790112822992HealthcareNY501 c 39NYS
Stony Brook Ophthalmology UFPC
PO Box 1554Stony BrookNY11790112658697HealthcareNY501 c 39NYS
Stony Brook Orthopaedic Associates UFPC
PO Box 1554Stony BrookNY11790112593061HealthcareNY501 c 39NYS
Stony Brook Children's Service UFPC
PO Box 1554Stony BrookNY11790112571524HealthcareNY501 c 39NYS
Stony Brook Psychiatric Associates UFPC
PO Box 1554Stony BrookNY11790112590096HealthcareNY501 c 39NYS
Stony Brook Radiation Oncology UFPC
PO Box 1554Stony BrookNY11790112664726HealthcareNY501 c 39NYS
Stony Brook Radiology UFPC
PO Box 1554Stony BrookNY11790112548304HealthcareNY501 c 39NYS
Stony Brook Surgical Associates UFPC
PO Box 1554Stony BrookNY11790112552333HealthcareNY501 c 39NYS
Stony Brook Urology UFPC
PO Box 1554Stony BrookNY11790112644371HealthcareNY501 c 39NYS
Stony Brook Clin Pract Mgmt Realty UFPC
PO Box 1554Stony BrookNY11790113285712Rlty HoldingNY501 c 25N/ANYS
Stony Brook Surgical Holding Corp UFPC
PO Box 1554Stony BrookNY11790116434538Rlty HoldingNY501 c 25N/ANYS
Stony Brook University Physicians UFPC
PO Box 1554Stony BrookNY11790113559055Support SvcsNY501 c 39NYS
Clinical Practice Management Plan
PO Box 1554Stony BrookNY11790Mgmt ActivityNY501 C 1N/ANA

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Stony Brook Healthcare IPA LLCBusinessNameLine1
FieldValueIRS element (for citing)
EIN113499101EIN
Primary ActivityHealthcarePrimaryActivity
Legal Domicile StateNYLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnerfalseGeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
Suffolk Psychiatric Services PC
PO Box 1554Stony BrookNY11790113115689managed Hlth svcNYNAC corp
Stony Brook Physicians PC
PO Box 1554Stony BrookNY11790201611829medical svcsNYNAc corp
Healthcare Management Services Inc
PO Box 1554Stony BrookNY11790113247917medical svcsNYNAc corp
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
State of New York
k307588
Clinical Practice Management Plan
l8300000

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