2011-08-15T13:24:39-05:00 2010-09-30 WarrenAverettKimbrough & MarinoLLC 2500 Acton Road Birmingham AL 35243 990 2009-10-01 630649108 UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION PC UNIV 2057319600 PO BOX 55407 BIRMINGHAM AL 352555407 MICHAEL HECKMAN 2057319600 2011-08-10 1 2059794100 2009 2016-02-24 21:20:13Z REID F JONES PO BOX 55407 BIRMINGHAM AL 352555407 797999851 0 X N/A X 1973 AL COORDINATE AND DELIVER PATIENT CARE IN A GROUP PRACTICE SETTING. 19 10 3320 32 0 0 0 0 464565068 459215027 -9522037 8138241 3557674 3536465 458600705 470889733 20539314 21331867 0 0 265436730 273025985 0 0 0 198062347 174069696 484038391 468427548 -25437686 2462185 682673060 720020682 372015853 393906283 310657207 326114399 COORDINATE AND DELIVER PATIENT CARE IN A GROUP PRACTICE SETTING. 0 0 383096409 21331867 459864380 Operation of a nonprofit physician group practice closely affiliated with the University of Alabama at Birmingham. HSF consists of almost 1,060 Faculty, Fellows and Physicians offering services in 33 specialties. These services are reinforced by the research and educational programs of UAB's Academic Health Center, resulting in State-of-the-Art care. 383096409 1 0 0 1 0 0 0 0 1 1 1 0 0 1 1 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 233 0 1 3320 1 0 0 0 0 0 0 0 0 0 19 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MICHAEL F HECKMAN 2057319600 500 22ND ST SOUTH STE 500 BIRMINGHAM AL 35233 CHARLES E ADAIR 5.00 X 1200 0 0 NEAL R BERTE 5.00 X 1200 0 0 DONALD M JAMES 5.00 X 1200 0 0 CHARLES D PERRY JR 5.00 X 1200 0 0 VAN L RICHEY 3.00 X 900 0 0 JEROME C ROSE 5.00 X 1200 0 0 JAMES T STEPHENS 3.00 X 900 0 0 LEE J STYSLINGER III 2.00 X 600 0 0 CHARLES D MCCRARY 0.00 X 0 0 0 THOMAS H LOWDER 5.00 X 1200 0 0 SERGIO B STAGNO MD 50.00 X 292504 211546 90863 AMIE B Jackson MD 50.00 X 245248 224273 81440 JAMEs A Bonner MD 50.00 X 277584 320699 130804 KIRBY I BLAND MD 50.00 X 642763 218884 85528 ROBERT R RICH MD 50.00 X 0 650719 189038 EDWARD ABRAHAM MD 50.00 X 168982 346949 88462 ISAAC W FERNIANY PHD 50.00 X 0 764604 174045 BRUCE R KORF MD 50.00 X 57801 362904 78353 RAY L WATTS MD 50.00 X X 355433 289333 91279 REID F JONES 50.00 X 251731 282100 89662 PATRICIA J PRITCHETT 50.00 X 245887 0 30061 MICHAEL F HECKMAN 50.00 X 212649 0 41753 ROBERT J CERFOLIO MD 60.00 X 1041918 61755 59531 MARK N Hadley MD 60.00 X 930548 55484 56788 DAVID C MCGIFFIN MD 60.00 X 886106 89974 93020 REES E OLIVER MD 60.00 X 691105 31861 49021 CARL COGHILL MD 60.00 X 743921 43990 55067 7053780 3955075 1484715 593 0 1 0 Assistmed Inc 7095 Hollywood Blvd Suite 690 Los Angeles CA 90028 Transcription ServiceS 2197400 Eason Graham & SandNer P O Box 530487 Birmingham AL 35253 Building Management 1140500 PLATINUM AIR SERVICE LLC 26840 SHOREGRASS DRIVE WESLEY CHAPEL FL 33543 AIR SERVICE 988900 Trust Building Services INC 267 West Valley Ave Birmingham AL 35209 Housekeeping ServiceS 628000 IRON MOUNTAIN RECORDS MANAGEMENT P O BOX 27128 NEW YORK NY 100877128 RECORD MANAGEMENT 523000 29 NET PATIENT REVENUE 900099 385078391 385078391 HEALTHCARE SERVICES 900099 57492678 57492678 ORGAN/TISSUE REC 900099 16643958 16643958 459215027 7628045 7628045 2887112 2887112 2887112 2887112 327554792 65522 326986400 123718 568392 -58196 510196 510196 MISCELLANEOUS INCOME 900099 649353 649353 649353 470889733 459864380 0 11025353 21331867 21331867 7595271 6389454 1205817 219151995 173801600 45350395 2527823 1460932 1066891 33135575 23720366 9415209 10615321 7308297 3307024 351060 351060 357170 357170 3806260 3090891 715369 791236 791236 5569283 4269514 1299769 3315726 3315726 45094 45094 5270466 2823368 2447098 2196263 1472318 723945 235890 80482 155408 3843803 3843803 14160721 3701194 10459527 5898481 5898481 MEDICAL, SURGICAL AND L 56674851 56674851 BAD DEBT 33558299 33558299 SUPPORT SERVICES PRIMAR 28313879 28313879 REPAIRS AND MAINTENANCE 3909107 3909107 MISCELLANEOUS EXPENSE 1391993 1391993 4380114 1930689 2449425 468427548 383096409 85331139 0 508268 343704 42062016 45881903 45353180 42213386 605643 945800 1328248 325513 1482611 1995959 270384705 132618918 139627891 137765787 368659197 396335398 67619739 77094431 15426267 17118801 682673060 720020682 58214854 69221301 182990000 180490000 130810999 144194982 372015853 393906283 X 310657207 326114399 310657207 326114399 682673060 720020682 X 0 1 1 X 1 1 X 409473579 429898445 437353335 464565068 459215027 2200505454 409473579 429898445 437353335 464565068 459215027 2200505454 0 0 0 2200505454 18820748 30264139 5688035 6960785 10515157 72248864 18820748 30264139 5688035 6960785 10515157 72248864 55719 55400 510856 535076 649353 1806404 428350046 460217984 443552226 472060929 470379537 2274560722 0.96740 0.96100 0.03180 0.03840 X 61615 0 61615 468365932 468427547 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 53860 41063 51250 61615 207788 250000 250000 250000 250000 1000000 1500000 53860 41063 51250 61615 207788 166028256 5465439 15183749 3000000 183677444 179149163 -2920907 10200000 166028256 1.00000 0.00000 0.00000 0 0 28163186 28163186 132628851 53083588 79545263 18059701 9753514 8306187 69413829 58161542 11252287 22119138 11620274 10498864 137765787 CASH AND CASH EQUIVALENTS 15224473 F POOLED INVESTMENTS - CASH EQUIVALENTS 10844111 F POOLED INVESTMENTS - ACCRUED INCOME 383130 F DEFERRED COMP. INVESTMENTS - CASH EQUIVALENTS 5901320 F investment in trust fund 44741397 F 77094431 DEFERRED COMPENSATION 118890251 OTHER LIABILITIES 580106 POST RETIREMENT LIABILITIES 24724625 144194982 470889733 468427548 2462185 17935801 -4940795 12995006 15457191 461217571 17935801 -27607963 -9672162 470889733 0 470889733 445760379 0 445760379 22667168 22667168 468427547 Part V, Line 4: Description of Intended Use of Endowment Funds: THE FOUNDATION'S BOARD-DESIGNATED ENDOWMENTS CONSIST OF THREE FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE NORMAL SPENDING POLICY FOR THE GENERAL ENDOWMENT FUND IS TO DISTRIBUTE BETWEEN 3.5 PERCENT AND 6.5 PERCENT OF THE FUND, SUBJECT TO ANNUAL APPROVAL BY THE FOUNDATION'S INVESTMENT COMMITTEE. THIS SPENDING POLICY IS CONSISTENT WITH THE FOUNDATION'S OBJECTIVE TO MAINTAIN THE PURCHASING POWER OF ENDOWMENT ASSETS, AS WELL AS TO PROVIDE ADDITIONAL REAL GROWTH THROUGH INVESTMENT RETURNS. Part XI, Line 8 - Other Adjustments: OTHER COMPREHENSIVE LOSS-ADOPTION OF SFAS NO. 158: -4591362. CHANGE IN FMV OF INTEREST RATE SWAP RECORDED DIRECTLY TO EQUITY: -349433. Part XII, Line 2d - Other Adjustments: OTHER COMPREHENSIVE LOSS-ADOPTION OF SFAS NO. 158: -4591362. CHANGE IN FMV OF INTEREST RATE SWAP RECORDED DIRECTLY TO EQUITY: -349433. PENSION INCOME OFFSET AGAINST EXPENSES FOR TAX PURPOSES: 9005161. INVESTMENT INCOME OFFSET AGAINST EXPENSES FOR TAX PURPOSES: 2576587. CLASSIFICATION OF INCOME/EXPENSES DIFFERENT FOR TAX PURPOSES THAN AUDIT: -34248916. Part XIII, Line 4b - Other Adjustments: PENSION INCOME OFFSET AGAINST EXPENSES FOR TAX PURPOSES: -9005161. INVESTMENT INCOME OFFSET AGAINST EXPENSES FOR TAX PURPOSES: -2576587. CLASSIFICATION OF INCOME/EXPENSES DIFFERENT FOR TAX PURPOSES THAN AUDIT: 34248916. Sub-Saharan Africa 0 3 PROGRAM SERVICES PROVISION OF PHYSICIANS SERVICES IN ZAMBIA 22000 0 3 22000 1 UNIVERSITY OF ALABAMA AT BIRMINGHAM 1530 3RD AVENUE SOUTH BIRMINGHAM AL 35294 636005396 POLITICAL SUB 21331867 0 N/A N/A TO FUND RESEARCH PROJECTS 1 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: The grants provided to UAB go through HSF approval process. The request comes in to HSF Controller who prepares a "UAB Transfers & Contribution Request" and approves payment. The request consist of the Department, Date, Amount YTD Expense and Variances to Budget. All Grant requisitions regardless of amounts are then sent to the HSF CFO for approval and then to the Executive Vice President for final approval. The grants are also monitored with the amount provided vERsUS the amount budgeted for the fiscal year. X X 1 1 X X 0 0 0 1 0 0 0 1 0 SERGIO B STAGNO MD 188848 209457 100600 0 3056 2089 33594 36379 20532 3553 346630 251478 0 0 AMIE B Jackson MD 244468 201721 0 21402 780 1150 27459 34759 21827 1202 294534 260234 0 0 JAMEs A Bonner MD 276728 319702 0 0 856 997 27889 48835 54884 2955 360357 372489 0 0 KIRBY I BLAND MD 631615 208664 0 5000 11148 5220 31973 37164 20211 3216 694947 259264 0 0 ROBERT R RICH MD 0 636441 0 0 0 14278 0 182146 0 7886 0 840751 0 0 EDWARD ABRAHAM MD 168146 344430 0 0 836 2519 19496 53525 17168 2050 205646 402524 0 0 ISAAC W FERNIANY PHD 0 540842 0 206902 0 16860 0 162442 0 11603 0 938649 0 0 BRUCE R KORF MD 57636 360382 0 0 165 2522 7258 55468 16292 2144 81351 420516 0 0 RAY L WATTS MD 353364 239808 0 47000 2069 2525 28884 47173 18895 1429 403212 337935 0 0 REID F JONES 250300 169312 0 112111 1431 677 27435 54095 10720 0 289886 336195 0 0 PATRICIA J PRITCHETT 212880 0 32400 0 607 0 27441 0 4816 0 278144 0 0 0 MICHAEL F HECKMAN 183125 0 29000 0 524 0 24717 0 18991 0 256357 0 0 0 ROBERT J CERFOLIO MD 1039650 61568 0 0 2268 187 31973 10777 23626 933 1097517 73465 0 0 MARK N Hadley MD 571561 55241 357555 0 1432 243 31973 9593 19712 333 982233 65410 0 0 DAVID C MCGIFFIN MD 869238 88121 12000 1000 4868 853 31973 15514 48447 1090 966526 106578 0 0 REES E OLIVER MD 292587 31827 398390 0 128 34 28331 5468 16497 189 735933 37518 0 0 CARL COGHILL MD 345005 43816 398390 0 526 174 29131 7528 20281 260 793333 51778 0 0 Part I, Line 1a DISCRETIONARY SPENDING ACCOUNTS: Some employed physicians (including physician directors) have access to professional development funds which are used to advance their professional skills. Amounts are spent on computer equipment, journals, subscriptions and travel expenses to attend conferences and lectures. All requests for reimbursement are reviewed for compliance with current policy and IRS guidance before they are paid. SOCIAL CLUB DUES: A few physician leaders (including some physician directors) are members of social/business clubs. They utilize these facilities for business meetings and events during the year. All requests for reimbursement are reviewed for compliance with current policy and IRS guidance before they are paid. Part I, Line 5 Many of our employed physicians (including some Directors) have incentive plans that pay additional amounts based on achieving specific clinical, academic and research measures. These incentive plans are reviewed annually with the Compensation Committee. Some of these plans make payments based on clinical productivity. Part I, Line 7 Many of our employed physicians (including some Directors) have incentive plans that pay additional amounts based on achieving specific clinical, academic and research measures. These incentive plans are reviewed annually with the Compensation Committee. THE MEDICAL CLINIC BOARD OF THE CITY OF BIRMINGHAM - UAHSF 621375181 091041JS3 2005-09-01 20000000 FINANCED THE ACQUISITION OF VARIOUS MEDICAL EQUIPMENT 0 0 THE MEDICAL CLINIC BOARD OF THE CITY OF BIRMINGHAM - UAHSF 621375181 091041JT1 2007-03-01 40000000 FINANCED THE CONSTRUCTION OF A MEDICAL FACILITY/PURCHASED EQUIPMENT 0 0 20000000 20000000 2008 0 0 1 1 40000000 15224473 24775527 0 0 0 1 0 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 0.00000 0.00000 0.00000 1 1 1 0 0 0 0 1 1 0 0 0 0 Form 990, Part VI, Section B, line 11 Form 990 is provided to the Governance Committee of the Board for review and is an agenda item at the regularly scheduled Board Meeting open for any discussion before the return is filed. Form 990, Part VI, Section B, line 12c DIRECTORS, PRINCIPAL OFFICERS AND COMMITTEE MEMBERS WITH BOARD DELEGATED POWERS ANNUALLY SIGN THE CONFLICT OF INTEREST CERTIFICATE. Form 990, Part VI, Section B, line 15 The Compensation Committee meets annually to ensure that individual compensation for physicians, officers and other executives is reasonable and appropriate for a non-profit organization. The Compensation Committee presents an annual report to the Board of Directors for their approval. Form 990, Part VI, Section C, line 19 AS A GENERAL RULE, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. ANY WRITTEN REQUEST BY THE PUBLIC WOULD BE REVIEWED AND ACTED UPON BY THE BOARD. 990, PART XI, LINE 2C THE BOARD OF DIRECTORS HAS A SEPARATE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS FUNCTION HAS NOT CHANGED FROM PRIOR YEARS. UAB HEALTH SYSTEM 500 22ND STREET SOUTH SUITE 408 BIRMINGHAM AL 35233 631182994 HEALTHCARE MANAGEMENT AL 501(C)(3) 170(B)(1)(A)VI N/A UNIVERSITY OF ALABAMA AT BIRMINGHAM 1530 3RD AVENUE SOUTH BIRMINGHAM AL 35294 636005396 PUBLIC UNIVERSITY AL POLITICAL SUB N/A N/A MEDICAL ADVANCEMENT FOUNDATION PO BOX 55407 BIRMINGHAM AL 352555407 630884469 FUNDRAISING AND MANAGEMENT FUNCTIONS AL 501(C)(3) TYPE I SUPPORT ORG N/A 0 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 1 UNIVERSITY OF ALABAMA AT BIRMINGHAM B 21331867 UNIVERSITY OF ALABAMA AT BIRMINGHAM J 516000 UNIVERSITY OF ALABAMA AT BIRMINGHAM N 678312 UNIVERSITY OF ALABAMA AT BIRMINGHAM Q 28366688 UNIVERSITY OF ALABAMA AT BIRMINGHAM R 14019000 UAB HEALTH SYSTEM Q 5332000 UAB HEALTH SYSTEM R 10789000