2024-05-01T15:40:29-05:00 2023-06-30 410746749 CLIFTONLARSONALLEN LLP 8390 EAST CRESCENT PARKWAY SUITE 300 GREENWOOD VILLAGE CO 80111 990 2022-07-01 201304472 UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY INC UNIV 4193837138 4510 DORR STREET TOLEDO OH 43615 JOHN E HUBER CHIEF ADMIN. & FINANCE OFFICER 4193837138 2024-04-30 1 JOHN HUBER XXX-XX-XXXX 1 SARAH HINTZ P00492291 3037795710 2024-04-30 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JOHN E HUBER 4510 DORR STREET TOLEDO OH 43615 135740351 0 X N/A X 2004 OH TO IMPROVE THE HUMAN CONDITION THROUGH EXCELLENCE IN PATIENT CARE AND MEDICAL DISCOVERY. 21 0 730 0 0 0 113310 119714 114013337 114840587 226693 -1284039 1533427 1092370 115886767 114768632 1694652 1055921 0 0 98592161 101286111 0 0 0 20139540 23689146 120426353 126031178 -4539586 -11262546 67778090 73311307 31769068 45933083 36009022 27378224 TO IMPROVE THE HUMAN CONDITION THROUGH EXCELLENCE IN PATIENT CARE AND MEDICAL DISCOVERY. 0 0 118153284 1055921 114840587 FACULTY PRACTICE PLAN FOR THE UNIVERSITY OF TOLEDO TO PROVIDE HEALTH CARE SERVICES AS AN INTEGRAL COMPONENT OF THE ACADEMIC AND RESEARCH MISSION OF THE UNIVERSITY.CAPTIVE INSURANCE- WRITING OR FUNDING MEDICAL MALPRACTICE INSURANCE AND REINSURANCE FOR UNIVERSITY OF TOLEDO AND UNIVERSITY OF TOLEDO PHYSICIANS. 118153284 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 1 39 0 1 730 1 0 0 0 0 0 0 0 0 0 0 0 0 X 21 0 0 0 1 0 1 1 1 1 1 0 1 1 1 1 1 1 0 1 1 1 1 1 OH X MINDY WARD 4193837138 4510 DORR ST TOLEDO OH 43615 X NAZZAL MUNIER MD PRESIDENT, UTP (7/22-5/23) 20.00 20.00 X X 643304 147996 129726 KHOURI SMAIR MD VICE PRESIDENT UTP (7/22-5/23) 40.00 0.00 X X 476002 0 72750 ALI IMRAN MD TREASURER, UTP (7/22-5/23) 20.00 20.00 X X 296470 242883 172811 SCHROEDER JASON MD SECRETARY, UTP (7/22-5/23) 20.00 20.00 X X 770504 48508 137118 AKPUNONU BASIL MD TRUSTEE, UTP 20.00 20.00 X 333779 172405 148842 CASABIANCA ANDREW MD TRUSTEE, UTP 20.00 20.00 X 361143 128373 144633 DAVIS WILLIAM DDS TRUSTEE, UTP 20.00 20.00 X 175000 15722 146012 DWORKIN LANCE MD TRUSTEE, UTP 20.00 20.00 X 250477 415224 140420 EBRAHEIM NABIL MD TRUSTEE, UTP (THROUGH JAN. 2023) 20.00 20.00 X 1155531 171191 156592 FEDERMAN DOUGLAS TRUSTEE, UTP 20.00 20.00 X 163889 75378 80340 EL-ZAWAHRY AHMED MD TRUSTEE, UTP 20.00 20.00 X 422500 24729 91618 GOHARA AMIR TRUSTEE, UTP 40.00 0.00 X 160500 0 30495 GRIDER STEPHEN MD TRUSTEE, UTP 20.00 20.00 X 186897 161520 139447 HINCH BRYAN MD TRUSTEE, UTP 20.00 20.00 X 217653 84384 139706 JENKINS KIMBERLY MD TRUSTEE, UTP 20.00 20.00 X 393897 254043 178010 MAHMOOD ASIF MD TRUSTEE, UTP 20.00 20.00 X 570467 51816 117359 MATUS CORAL MD TRUSTEE, UTP 20.00 20.00 X 110927 138763 74116 MCCULLUMSMITH CHERYL MD TRUSTEE, UTP (THROUGH APRIL 2023) 20.00 20.00 X 218444 233420 137233 MOUSSA MOHAMAD MD TRUSTEE, UTP 20.00 20.00 X 178411 122813 99872 MUKUNDAN DEEPA MD TRUSTEE, UTP 20.00 20.00 X 75500 134795 91115 SAUNDERS WILLIAM III MD TRUSTEE, UTP 40.00 0.00 X 423114 0 66250 SINDHWANI PUNEET MD TRUSTEE, UTP 20.00 20.00 X 390500 176284 160801 SKIE MARTIN MD TRUSTEE, UTP 20.00 20.00 X 716544 73230 134841 SPEER LINDA MD TRUSTEE, UTP 20.00 20.00 X 166643 145993 150223 VAN HOOK CATHERINE MD TRUSTEE, UTP 20.00 20.00 X 190500 107059 88945 VAN HOOK JAMES MD TRUSTEE, UTP 20.00 20.00 X 330500 285604 153245 SWAINE RICHARD TRUSTEE, UTP 20.00 20.00 X 0 358524 106639 PYLES BRYAN T INTERIM CFO, UTP (FORMER) 20.00 20.00 X X 0 112027 31787 COOPER CHRISTOPHER MD CHAIRMAN, UTP (7/22-5/23) 20.00 20.00 X 267539 467949 192318 BRICKMAN KRISTOPHER MD CHIEF PHYSICIAN EXECUTIVE 20.00 20.00 X 400500 157330 140567 HUBER JOHN CHIEF FINANCIAL OFFICER 40.00 0.00 X 186782 0 35354 CHACKO PAUL PHYSICIAN 40.00 0.00 X 1206790 20324 84467 BURGESS RICHARD PHYSICIAN 40.00 0.00 X 994985 219 116122 GEHLING DANIEL PHYSICIAN 40.00 0.00 X 834065 10637 116566 MASROOR SAQIB PHYSICIAN 40.00 0.00 X 824007 15991 106349 ELGAFY HOSSEIN PHYSICIAN 40.00 0.00 X 735168 63732 114806 HEJEEBU SRINI DO SECRETARY, UTP (FORMER) 40.00 0.00 X 311837 67893 135747 BOSWELL MARK MD TRUSTEE, UTP (FORMER) 20.00 20.00 X 280428 131444 86906 CHAUDHURI PRABIR MD TRUSTEE, UTP (FORMER) 20.00 20.00 X 71688 128373 89805 CHEN CHANGHU MD TRUSTEE, UTP (FORMER) 20.00 20.00 X 0 94322 86424 DOMINIAK NICOLE MD TRUSTEE, UTP (FORMER) 20.00 20.00 X 205500 0 36990 FARRELL MD STEVEN J TRUSTEE, UTP (FORMER) 40.00 0.00 X 203158 46055 37397 KAW DINKAR MD TRUSTEE, UTP (FORMER) 40.00 0.00 X 305023 45734 182951 KOLTZ BROOKE MD TRUSTEE, UTP (FORMER) 20.00 20.00 X 101008 41960 105539 SINGH TANVIR MD TRUSTEE, UTP (FORMER) 40.00 0.00 X 505929 0 72750 SKEEL ROLAND T MD TRUSTEE, UTP (FORMER) 40.00 0.00 X 161651 101613 114229 SODEMAN THOMAS C MD TRUSTEE, UTP (FORMER) 40.00 0.00 X 145400 47250 57156 TALMAGE LANCE MD TRUSTEE, UTP (FORMER) 40.00 0.00 X 0 111474 126380 TIETJEN GRETCHEN MD TRUSTEE, UTP(FORMER) 40.00 0.00 X 0 96721 59573 17120554 5531705 5419342 273 1 1 0 ECG CONSULTING GROUP 11512 EL CAMINO REAL-SUITE 200 SAN DIEGO CA 92130 CONSULTING SERVICES 750521 ZOTEC PARTNERS 11460 N MERIDIAN ST CARMEL IN 46032 BILLING SERVICES 363378 EASTMAN AND SMITH LTD ONE SEAGATE 24TH FLOOR TOLEDO OH 43699 LEGAL SERVICES 284265 SURGICAL DIRECTIONS LLC PO BOX 7163 CAROL STREAM IL 60601 CONSULTING 169553 CLIFTON LARSON ALLEN LLP 220 S 6TH ST STE 300 MINNEAPOLIS MN 55402 AUDIT AND FINANCIAL SERVICES 164546 7 119714 119714 PATIENT SERVICE 621110 99989695 99989695 UPL REVENUE 621110 10586688 10586688 UTMAC INSURANCE PREMIUMS 525100 2492574 2492574 PERFORMANCE INCENTIVE PAYMENTS 621110 1798525 1798525 UTMAC INVESTMENT INCOME 523000 -26895 -26895 114840587 283729 283729 19378348 25603 20942432 29287 -1564084 -3684 -1567768 -1567768 MISCELLANEOUS REVENUE 900099 700053 700053 UTMC ATHENA REVENUE 561439 392317 392317 1092370 114768632 114840587 0 -191669 1055921 1055921 11792635 11792635 2876373 2876373 74465136 70078699 4386437 6682550 6359031 323519 4853296 2038384 2814912 616121 529864 86257 522242 522242 129415 129415 34553 34553 9955644 9955644 43375 43375 1003742 973628 30114 2343762 2343762 702517 625240 77277 557184 557184 495165 495165 2120478 2120478 2014659 2014659 UTMAC EXPENSES 2224841 2224841 DUES AND LICENSES 492819 492819 PHARMACEUTICALS 417019 417019 MEDICAL SUPPLIES 312975 312975 318756 159378 159378 126031178 118153284 7877894 0 11622533 13195197 6700812 1191756 16152068 17800852 20966 88087 126685 131697 311473 10639087 2293001 12501167 8346086 20560760 23723679 0 8615579 67778090 73311307 12107441 21962051 318350 483022 4086356 19343277 19401654 31769068 45933083 X 36009022 27378224 36009022 27378224 67778090 73311307 -11262546 2247877 383871 0 X X 0 1 X 1 0 X X X 1 UNIVERSITY OF TOLEDO 346401483 2 1 1055921 0 1 1055921 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 SCHEDULE A, SECTION A, LINE 2: THE ORGANIZATION IS OPERATING FOR THE BENEFIT OF THE UNIVERSITY OF TOLEDO AND ITS MEDICAL SCHOOL, A PUBLIC UNIVERSITY. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 172562 46094 126468 2829013 1672901 1156112 7637512 574006 7063506 8346086 PATIENT RECORDS 243704 RIGHT OF USE ASSET 8371875 8615579 LOSSES AND LOSS ADJUSTMENT EXPENSES - UTMAC 10161085 LOSSES AND CLAIMS HANDLING FEES PAYABLE - UTMAC 120963 RIGHT OF USE LEASE LIABILITY 9119606 19401654 X 115673014 2247877 -1254253 993624 114679390 89242 89242 114768632 124401813 0 124401813 1629365 1629365 126031178 PART X, LINE 2: EFFECTIVE JUNE 29, 2022, UNIVERSITY OF TOLEDO DENTISTS, LLC CONVERTED TO A NONPROFIT LIMITED LIABILITY COMPANY. THIS CONVERSION CREATED A TAXABLE EVENT, AND AS SUCH UNIVERSITY OF TOLEDO DENTISTS, LLC HAD A TAX LIABILITY AS OF JUNE 30, 2022 OF $110,000. UNIVERSITY OF TOLEDO DENTISTS, LLC ADHERES TO THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. UNIVERSITY OF TOLEDO DENTISTS, LLC EVALUATED ITS TAX POSITIONS AND DETERMINED THAT NO UNCERTAIN TAX POSITIONS EXIST AS OF JUNE 30, 2023. PART XI, LINE 2D - OTHER ADJUSTMENTS: GAIN ON UTMAC 240,838. GAIN ON DAVIS DENTAL 45,032. INTEREST EXPENSES INCLUDED IN EXPENSES -484,202. GRANTS PAID INCLUDED WITH EXPENSES -1,055,921. PART XI, LINE 4B - OTHER ADJUSTMENTS: UT DENTIST OTHER NONOPERATING EXPENSES 78,279. CAPITAL LEASE 10,963. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANTS PAID INCLUDED WITH EXPENSES 1,055,921. CAPITAL LEASE EXPENSE 10,963. INTEREST EXPENSE 484,202. UT DENTIST OTHER NONOPERATING EXPENSES 78,279. 1 UNIVERSITY OF TOLEDO 2801 W BANCROFT ST TOLEDO OH 43614 346401483 STATE OF OHIO 1055921 0 N/A N/A SUPPORT FOR THE UNIVERSITY OF TOLEDO 1 0 PART I, LINE 2: THE ORGANIZATION MONITORS THE USE OF GRANT FUNDS IN THE UNITED STATES BY ONLY DONATING TO THE RELATED ORGANIZATIONS LISTED ON SCHEDULE R. 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PART I, LINE 1B UTP DOES NOT HAVE A POLICY REGARDING THE PAYMENT OR REIMBURSEMENT OF THE EXPENSES DESCRIBED ON LINE 1A. PAYMENT OR REIMBURSEMENT IS BASED UPON THE BUSINESS PURPOSE OF SUCH REQUEST AND APPROVED BY APPROPRIATE INDIVIDUAL(S) WITHIN UTP. PART I, LINE 5 PHYSICIANS ON THE BOARD ARE OFTEN PAID BASED ON CASH COLLECTIONS FOR SERVICES PERFORMED. PART I, LINE 7 MANY PHYSICIANS ON STAFF DO RECEIVE NON-FIXED PAYMENTS BASED ON ACHIEVING VARIOUS MEASURABLES AND GOALS WITHIN THEIR PRACTICE. FORM 990, PART VI, SECTION A, LINE 1A THE BOARD WILL ESTABLISH AN EXECUTIVE COMMITTEE WHICH WILL CONSIST OF BOARD MEMBERS WHO ARE EMPOWERED TO TRANSACT THE DAY-TO-DAY MANAGEMENT AND BUSINESS OF THE CORPORATION PURSUANT TO THE POLICIES, PROCEDURES AND RULES OF THE CORPORATION. THE EXECUTIVE COMMITTEE WILL ACT ON BEHALF OF THE BOARD OF DIRECTORS BETWEEN MEETINGS OF THE BOARD. A QUORUM FOR A MEETING OF THE EXECUTIVE COMMITTEE WILL BE A MAJORITY OF ITS MEMBERS. FORM 990, PART VI, SECTION A, LINE 4 THE CODE OF REGULATIONS WAS UPDATED TO MORE ACCURATELY GOVERN THE ORGANIZATION TO ACHEIVE ITS MISSION AND PURPOSE. FORM 990, PART VI, SECTION A, LINE 6 UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY, INC. (UTP) HAS ONLY ONE CLASS OF MEMBER, AND ONLY ONE MEMBER, THE UNIVERSITY OF TOLEDO, EXERCISING ALL MEMBER RIGHTS. THE REPRESENTATIVES OF THE UNIVERSITY OF TOLEDO ACT ON ITS BEHALF AS THE SOLE MEMBER OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER THE UNIVERSITY OF TOLEDO HAS THE POWER TO NOMINATE, ELECT AND REMOVE THE BOARD OF DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER, THE UNIVERSITY OF TOLEDO HAS THE AUTHORITY TO APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION AND CODE OF REGULATIONS OF THE CORPORATION; AND EXERCISE SUCH OTHER POWERS AS ARE NECESSARY, APPROPRIATE, AND CONSISTENT WITH LAW AND WITH THE ARTICLES OF INCORPORATION AND THE CODE OF REGULATIONS OF THE CORPORATION. THE FOLLOWING ACTIONS REQUIRE PRIOR APPROVAL OF THE SOLE MEMBER: (A) ANY CHANGE IN THE PURPOSE OR MISSION OF THE CORPORATION; (B) ANY CHANGE IN THE CODE OF REGULATIONS OR ARTICLES OF INCORPORATION OF THE CORPORATION; (C) ANY MERGER OR CONSOLIDATION OF THE CORPORATION WITH AN UNRELATED ENTITY; (D) THE PROPOSED SALE OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION'S ASSETS; (E) ANY BORROWING OF FUNDS BY THE CORPORATION (EXCLUDING TRADE PAYABLES OR OTHER ORDINARY COURSE INDEBTEDNESS) IN EXCESS OF ITS GENERAL OPERATING LINE OF CREDIT IN AN AMOUNT TO BE ESTABLISHED ON AN ANNUAL BASIS BY APPROVAL OF THE BOARD OR ANY LOAN OF FUNDS BY THE CORPORATION; (F) ANY MATERIAL CHANGES IN THE CORPORATION'S PROFESSIONAL LIABILITY INSURANCE COVERAGE, INCLUDING CHANGES IN THE PARTIES PROVIDING SUCH COVERAGE; AND (G) THE DISSOLUTION OR LIQUIDATION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S FORM 990 IS PREPARED BY AN OUTSIDE PUBLIC ACCOUNTING FIRM BASED ON INFORMATION PROVIDED BY MANAGEMENT. ONCE A DRAFT RETURN IS AVAILABLE, THE DRAFT 990 IS REVIEWED WITH THE BOARD OF DIRECTORS AT A MEETING, AND ALL MEMBERS ARE EMAILED A COPY. FORM 990, PART VI, SECTION B, LINE 12C UTP DOES HAVE A CONFLICT OF INTEREST POLICY THAT IT FOLLOWS WHEN ADDRESSING POTENTIAL CONFLICTS. ALL OFFICERS, DIRECTORS, OR TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE CONFLICTS OF INTERESTS WHICH MAY ARISE. SHOULD AN INDIVIDUAL HAVE A CONFLICT OF INTEREST, THE INDIVIDUAL IDENTIFIED WITH THE CONFLICT MAY NOT VOTE ON SUCH ISSUE BEFORE GOVERNANCE. UNIVERSITY OF TOLEDO PHYSICIANS, LLC. AND UTP PATHOLOGY SERVICES, LLC FOLLOWS THE SAME CONFLICT OF INTEREST POLICY THAT WAS ADOPTED BY UTP LLC. UNIVERSITY OF TOLEDO MEDICAL ASSURANCE COMPANY, LLC HAS A SIMILAR CONFLICT OF INTEREST POLICY THAT IS FOLLOWED BY ALL UTMAC MANAGERS. THE POLICY REQUIRES SIMILAR DISCLOSURES AS NOTED ABOVE. ANY DISCUSSION DELIBERATION OR DECISION RELATED TO A POTENTIAL CONFLICT OF INTEREST IS DOCUMENTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION B, LINE 15 WHEN DETERMINING COMPENSATION FOR THE PRESIDENT/CEO OF THE VARIOUS ENTITIES, GOVERNANCE UTILIZES COMPARABILITY DATA. COMPENSATION LEVELS ARE REVIEWED BY CHAIRMAN AND COMPENSATION COMMITTEE OF THE BOARD. THIS PROCESS IS UTILIZED FOR ALL OFFICERS AND EMPLOYEES PLUS APPLIES TO ALL ORGANIZATIONS. COMPENSATION IS REVIEWED ANNUALLY AND WAS LAST COMPLETED IN 2022. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON REQUEST. FROM 990, PART VII - BOARD OF DIRECTOR LISTING FOR THE PURPOSE OF THE PART VII REPORTING, THE TRUSTEES OF UNIVERSITY OF TOLEDO PHSICIANS CLINICAL FACULTY, INC. (UTP) SERVE AS GOVERNANCE FOR UNIVERSITY OF TOLEDO PHSICIANS, LLC AND UTP PATHOLOGY SERVICES, LLC. THE SOLE MEMBER OF EACH OF THE LLCS IS UTP. UNIVERSITY OF TOLEDO MEDICAL ASSURANCE COMPANY, LLC (UTMAC) GOVERNANCE IS DESIGNATED IN PART VII OF THE FORM 990. UTP IS ALSO THE SOLE MEMBER OF UTMAC. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. PART VI LINE 13 - WRITTEN WHISTLEBLOWER POLICY NEITHER UTP NOR UTMAC HAS YET ADOPTED A WRITTEN WHISTLEBLOWER POLICY. UNIVERSITY OF TOLEDO PHYSICIANS LLC 3355 GLENDALE AVE 3RD FLOOR TOLEDO OH 43614 341127097 DISREGARDED ENTITY FORMED TO CARRY OUT PURPOSES OF MEMBER OH 110966914 62528735 100 UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY INC UTP PATHOLOGY SERVICES LLC 3355 GLENDALE AVE 3RD FLOOR TOLEDO OH 43614 264032238 DISREGARDED ENTITY FORMED TO CARRY OUT PURPOSES OF MEMBER OH 0 0 100 UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY INC UNIVERSITY OF TOLEDO MEDICAL ASSURANCE COMPANY LLC 159 BANK ST 4TH FLOOR BURLINGTON VT 05401 384021534 DISREGARDED ENTITY FORMED TO CARRY OUT PURPOSES OF MEMBER VT 2465679 21184448 100 UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY INC UNIVERSITY OF TOLEDO DENTISTS INC 4510 DORR ST TOLEDO OH 43615 341274989 DENTAL SERVICES OH 1917844 666360 100 UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY INC UNIVERSITY OF TOLEDO 2801 W BANCROFT MS 319 TOLEDO OH 43606 346401483 A PUBLIC INSTITUTION OF HIGHER EDUCATION OH N/A 0 REGIONAL CENTER FOR SLEEP MEDICINE OF TOLEDO LLC 3450 W CENTRAL AVE STE 118 TOLEDO OH 43606 264665939 SLEEP CENTER OH N/A RELATED 0 0 0.05000 0 1 1 0 0 1 0 0 0 0 1 1 1 1 1 1 1 0 0 UNIVERSITY OF TOLEDO C 119714 CASH UNIVERSITY OF TOLEDO B 1055921 CASH