STONY BROOK EMERGENCY PHYSICIANS UNIVERSITY FACULTY PRACTICE CORPOR: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- STONY BROOK EMERGENCY PHYSICIANS UNIVERSITY FACULTY PRACTICE CORPOR (EIN 11-3066770)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-12
- IRS object ID
- 202301329349302230
- Schema version
- 2021v4.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-12T08:49:43-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE MANHATTAN WEST | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 113066770 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STONY BROOK EMERGENCY PHYSICIANS | BusinessNameLine1Txt |
| Business Name Line2 | University Faculty Practice Corporation | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % SB CLINICAL PRAC MGMT PLAN I | InCareOfNm |
| Business Name Control | STON | BusinessNameControlTxt |
| Phone | 6314442055 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1554 | AddressLine1Txt |
| City | Stony Brook | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11790 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Adam Singer | PersonNm |
| Person Title | DIRECTOR & PRESIDENT | PersonTitleTxt |
| Phone | 6314442055 | PhoneNum |
| Signature | 2023-05-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Adam | PersonFirstNm |
| Person Last | Singer | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| PTIN | P01962945 | PTIN |
| Phone | 2127734931 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Adam Singer MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1554 | AddressLine1Txt |
| City | Stony Brook | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11790 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $27,387,444 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | n/a | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | Provide clinical instruction to and supervision of medical school students, interns and residents and, incident thereto, rendering professional services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 78 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $35,397 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $24,409,948 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $27,346,778 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $5,269 | CYOtherRevenueAmt |
| PY Total Revenue | $24,409,948 | PYTotalRevenueAmt |
| CY Total Revenue | $27,387,444 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $16,626,975 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,042,940 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,010,349 | PYOtherExpensesAmt |
| CY Other Expenses | $10,265,579 | CYOtherExpensesAmt |
| PY Total Expenses | $24,637,324 | PYTotalExpensesAmt |
| CY Total Expenses | $26,308,519 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$227,376 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,078,925 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,500,270 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,297,351 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,500,270 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,297,351 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $0 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE CLINICAL INSTRUCTION TO AND SUPERVISION OF MEDICAL SCHOOL STUDENTS, INTERNS AND RESIDENTS AND, INCIDENT THERETO, RENDERING PROFESSIONAL SERVICES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $24,303,193 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $27,346,778 | RevenueAmt |
| Desc | The organization provides services in the field of Emergency Medicine to patients and provides clinical instruction to and supervision of School of Medicine students and Hospital residents. | Desc |
| Total Program Service Expenses | $24,303,193 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 78 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SB CLINICAL PRAC MGMT PLAN I | PersonNm |
| Phone | 6314442055 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1554 | AddressLine1Txt |
| City | Stony Brook | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11790 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MARK C HENRY | ||||||||
| President & Director | 40.0 | 10.0 | Yes (X) | Yes (X) | $387,175 | $223,743 | $96,695 | |
| Asa Viccellio | ||||||||
| Secretary/Director/Treasurer | 40.0 | 10.0 | Yes (X) | Yes (X) | $301,020 | $273,042 | $100,219 | |
| Adam Singer | ||||||||
| Emergency Physician | 40.0 | 10.0 | $407,869 | $94,899 | $71,443 | Yes (X) | ||
| BRIAN MCMAHON | ||||||||
| Emergency Physician | 40.0 | 10.0 | $417,504 | $76,135 | $73,062 | Yes (X) | ||
| STUART CHALE | ||||||||
| Emergency Physician | 40.0 | 10.0 | $378,742 | $82,452 | $69,777 | Yes (X) | ||
| ANDREW WACKETT | ||||||||
| Emergency Physician | 40.0 | 10.0 | $321,610 | $122,000 | $73,349 | Yes (X) | ||
| Scott Johnson | ||||||||
| Director | 40.0 | 10.0 | Yes (X) | $350,609 | $77,254 | $67,624 | ||
| LAWRENCE SCHIFF | ||||||||
| Emergency Physician | 40.0 | 10.0 | $325,658 | $106,215 | $63,570 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,890,187 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,055,740 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $615,739 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 47 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | None | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contractor Address | ContractorAddress |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $35,397 | GovernmentGrantsAmt |
| All Other Contributions | $0 | AllOtherContributionsAmt |
| Total Contributions | $35,397 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621111 | BusinessCd |
| Total Revenue Column | $27,346,778 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,346,778 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $27,346,778 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INTEREST (COMMON PAYMASTER, CLAIMS) | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $5,269 | TotalRevenueColumnAmt |
| Exclusion | $5,269 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $5,269 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,387,444 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,346,778 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $5,269 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,156,520 | TotalAmt |
| Program Services | $1,098,694 | ProgramServicesAmt |
| Management And General | $57,826 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,613,733 | TotalAmt |
| Program Services | $12,613,733 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,465,486 | TotalAmt |
| Program Services | $1,465,486 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,856 | TotalAmt |
| Program Services | $69,856 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $737,345 | TotalAmt |
| Program Services | $737,345 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,250,000 | TotalAmt |
| Program Services | $8,302,500 | ProgramServicesAmt |
| Management And General | $1,947,500 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,554 | TotalAmt |
| Program Services | $15,554 | ProgramServicesAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CORPORATION TAX | Desc |
| Total | $25 | TotalAmt |
| Program Services | $25 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,308,519 | TotalAmt |
| Program Services | $24,303,193 | ProgramServicesAmt |
| Management And General | $2,005,326 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,500,270 | BOYAmt |
| EOY | $4,297,351 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,500,270 | BOYAmt |
| EOY | $4,297,351 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,500,270 | BOYAmt |
| EOY | $4,297,351 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,500,270 | BOYAmt |
| EOY | $4,297,351 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,500,270 | BOYAmt |
| EOY | $4,297,351 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,078,925 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$1,078,925 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $391,276 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $35,397 | CurrentTaxYearAmt |
| Total | $426,673 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,563,820 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22,517,874 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,397,789 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,409,948 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $27,346,778 | CurrentTaxYearAmt |
| Total | $113,236,209 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,563,820 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22,517,874 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,789,065 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,409,948 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $27,382,175 | CurrentTaxYearAmt |
| Total | $113,662,882 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,017,604 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,059,572 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,554,341 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,275,400 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,395,465 | CurrentTaxYearAmt |
| Total | $33,302,382 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,017,604 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,059,572 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,554,341 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,275,400 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,395,465 | CurrentTaxYearAmt |
| Total | $33,302,382 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $80,360,500 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,017 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,039 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $27,626 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,269 | CurrentTaxYearAmt |
| Total | $58,951 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,017 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,039 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $27,626 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,269 | CurrentTaxYearAmt |
| Total | $58,951 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $2,147,397 | CurrentTaxYearMinus2YearsAmt |
| Total | $2,147,397 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,566,837 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22,540,913 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $21,964,088 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,409,948 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $27,387,444 | CurrentTaxYearAmt |
| Total | $115,869,230 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.69354 | PublicSupportCY509Pct |
| Public Support PY509 | 0.70850 | PublicSupportPY509Pct |
| Investment Income CY | 0.00051 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00070 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK C HENRY | ||||||||||||||
| President & Director | $302,664 | $223,743 | $81,901 | $0 | $2,610 | $0 | $37,523 | $33,066 | $5,022 | $21,084 | $429,720 | $277,893 | $0 | $0 |
| Asa Viccellio | ||||||||||||||
| Secretary/Director/Treasurer | $289,892 | $273,042 | $8,518 | $0 | $2,610 | $0 | $34,200 | $40,461 | $4,474 | $21,084 | $339,694 | $334,587 | $0 | $0 |
| Scott Johnson | ||||||||||||||
| Director | $314,068 | $77,254 | $33,931 | $0 | $2,610 | $0 | $34,440 | $10,043 | $2,057 | $21,084 | $387,106 | $108,381 | $0 | $0 |
| Adam Singer | ||||||||||||||
| Emergency Physician | $397,611 | $94,899 | $7,648 | $0 | $2,610 | $0 | $34,200 | $13,740 | $2,419 | $21,084 | $444,488 | $129,723 | $0 | $0 |
| BRIAN MCMAHON | ||||||||||||||
| Emergency Physician | $307,567 | $76,135 | $107,327 | $0 | $2,610 | $0 | $39,552 | $9,898 | $2,528 | $21,084 | $459,584 | $107,117 | $0 | $0 |
| STUART CHALE | ||||||||||||||
| Emergency Physician | $309,967 | $82,452 | $66,165 | $0 | $2,610 | $0 | $34,032 | $11,873 | $2,788 | $21,084 | $415,562 | $115,409 | $0 | $0 |
| ANDREW WACKETT | ||||||||||||||
| Emergency Physician | $295,168 | $122,000 | $23,832 | $0 | $2,610 | $0 | $34,680 | $15,860 | $1,725 | $21,084 | $358,015 | $158,944 | $0 | $0 |
| LAWRENCE SCHIFF | ||||||||||||||
| Emergency Physician | $323,048 | $106,215 | $0 | $0 | $2,610 | $0 | $34,200 | $7,649 | $637 | $21,084 | $360,495 | $134,948 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 1 | THE AMOUNTS REIMBURSED WERE 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. AIRFARE WAS PROVIDED TO PHYSICIAN MARK HENRY, MD, WHO WAS REIMBURSED FOR THE COST AS NOTED BELOW. * FIRST CLASS ROUND TRIP TO AUSTIN, TX FOR AN ER CODING CONFERENCE. |
| SCHEDULE J, PART 1, LINE 7 | THE OFFICERS RECEIVED COMPENSATION OVER BASE SALARY INCLUDING THE BONUS DETERMINED AT THE ORGANIZATIONS DISCRETION OR BASED SPECIFICALLY ON BONUS PLANS SET BY THE ENTITY, DETERMINED AS REASONABLE. THIS BENEFIT IS SUBJECT TO THE GUIDELINES FOR NONFIXED PAYMENTS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, QUESTION 11B | AN ELECTRONIC VERSION OF FORM 990 WAS PROVIDED TO THE OFFICERS AND DIRECTORS PRIOR TO FILING. MANAGEMENT PERFORMS A REVIEW of FORM 990 PRIOR TO FILING, ADDRESSING ANY QUESTIONS MADE BY THE GOVERNING BODY. |
| FORM 990, PART VI, QUESTION 12C | THE 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. |
| FORM 990, PART VI, QUESTIONS 15A & 15B | BEGAN 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 EMERGENCY MEDICINE, (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 SB Clinical Practice Management Plan Inc (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 A 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. |
| FORM 990, PART VI, QUESTION 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART VII | THE 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 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. |
| FORM 990, PART XI, LINE 9 | Cash transfer to SB Clinical Practice Management Plan, Inc. = $-1,078,925. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| New York State | ||||||||||
| 1 Commerce Plz 99 Washington Ave | Albany | NY | 12231 | 146013200 | Government | NY | 501(C)(1) | N/A | NA | false |
| Stony Brook Urology UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112644371 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| Stony Brook Anaesthesiology UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112553515 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| Stony Brook Dermatology Associates UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 113011790 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| Stony Brook Clin Pract Mgmt Realty | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 113285712 | Rlty Holding | NY | 501(C)(25) | N/A | CPMP | false |
| Stony Brook Surgical Holding Corp | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 116434538 | Rlty Holding | NY | 501(C)(25) | N/A | CPMP | false |
| SB Clinical Practice Management Plan Inc | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 461787303 | Mgmt Activity | NY | 501(C)(3) | 10 | NA | false |
| SB Family and Preventive Medicine UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112552321 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| Stony Brook Internists UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112558775 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| New York Spine and Brain Surgery UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112645930 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| Neurology Assoc of Stony Brook UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112587430 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| Univ Assoc in Obst & Gynecology UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112569522 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| Stony Brook Pathologists UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112647243 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| Stony Brook Ophthalmology UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112658697 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| Stony Brook Orthopaedic Associates UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112593061 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| Stony Brook Children's Service UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112571524 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| Stony Brook Psychiatric Associates UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112590096 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| Stony Brook Radiation Oncology UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112664726 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| Stony Brook Radiology UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112548304 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
| Stony Brook Surgical Associates UFPC | ||||||||||
| PO Box 1554 | Stony Brook | NY | 11790 | 112552333 | Healthcare | NY | 501(C)(3) | 10 | NYS | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SB HLTHCARE IPA LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1554 | AddressLine1Txt |
| City | STNY BRK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11790 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 113499101 | EIN |
| Primary Activities | healthcare | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CPMP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | Related | PredominantIncomeTypeTxt |
| Share Of Total Income | $0 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $0 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | false | DisproportionateAllocationsInd |
| UBI Code V | $0 | UBICodeVAmt |
| Ownership | 0.00000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NICOLLS INDEMNITY SOLUTIONS SP | BusinessNameLine1Txt |
Foreign Address ForeignAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 27 HOSPITAL RD | AddressLine1Txt |
| City | CAYMAN CORP CT | CityNm |
| Country | CJ | CountryCd |
| Foreign Postal | KYI-900 | ForeignPostalCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | SELF-INSURANCE | PrimaryActivitiesTxt |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountryCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C CORP | EntityTypeTxt |
| Share Of Total Income | $0 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $0 | ShareOfEOYAssetsAmt |
| Ownership | 0.00000 | OwnershipPct |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | State of New York | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | L | TransactionTypeTxt |
| Involved | $9,668,932 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |