2023-04-26T16:11:06-05:00 2022-06-30 410746749 CLIFTONLARSONALLEN LLP 8390 EAST CRESCENT PARKWAY SUITE 300 GREENWOOD VILLAGE CO 80111 990 2021-07-01 201304472 UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY INC UNIV 4193837100 4510 DORR STREET TOLEDO OH 43615 JOHN E HUBER CHIEF ADMIN & FINANCIAL OFF. 4193837100 2023-04-18 1 JOHN HUBER XXX-XX-XXXX SARAH HINTZ P00492291 3037795710 2023-04-18 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z LANCE DWORKIN MD 4510 DORR STREET TOLEDO OH 43615 119563160 0 X N/A X 2004 OH TO IMPROVE THE HUMAN CONDITION THROUGH EXCELLENCE IN PATIENT CARE AND MEDICAL DISCOVERY. 22 0 691 0 0 0 3573734 113310 111404227 114013337 256124 226693 1169791 1533427 116403876 115886767 1613072 1694652 0 0 87979590 98592161 0 0 0 19553765 20139540 109146427 120426353 7257449 -4539586 66626181 67778090 23509256 31769068 43116925 36009022 TO IMPROVE THE HUMAN CONDITION THROUGH EXCELLENCE IN PATIENT CARE AND MEDICAL DISCOVERY. 0 0 113403900 1694652 114013337 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. 113403900 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 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 0 0 1 35 0 1 691 1 0 0 0 0 0 0 0 0 0 0 0 0 X 22 0 0 1 0 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 STREET TOLEDO OH 43615 X AKPUNONU BASIL MD TRUSTEE, UTP 20.00 20.00 X 301759 170713 144716 ALI IMRAN MD TREASURER, UTP 20.00 20.00 X X 280768 237951 170767 DAVIS WILLIAM DDS TRUSTEE, UTP 20.00 20.00 X 86981 4601 109873 DWORKIN LANCE MD TRUSTEE, UTP 20.00 20.00 X 247798 402417 145364 EBRAHEIM NABIL MD TRUSTEE, UTP 20.00 20.00 X 1243821 166905 181987 EL-ZAWAHRY AHMED MD TRUSTEE, UTP 20.00 20.00 X 397200 24194 88282 FEDERMAN DOUGLAS TRUSTEE, UTP 20.00 20.00 X 155760 69164 82807 GOHARA AMIR TRUSTEE, UTP 20.00 20.00 X 147072 176755 96467 GRIDER STEPHEN MD TRUSTEE, UTP 20.00 20.00 X 152536 162795 137463 HINCH BRYAN MD TRUSTEE, UTP 20.00 20.00 X 247038 81948 142344 JENKINS KIMBERLY MD TRUSTEE, UTP 20.00 20.00 X 336377 195216 155878 KHOURI SMAIR MD VICE PRESIDENT UTP 20.00 20.00 X X 388572 72624 127180 MAHMOOD ASIF MD TRUSTEE, UTP 20.00 20.00 X 590200 51405 107878 MCCULLUMSMITH CHERYL MD TRUSTEE, UTP 20.00 20.00 X 169358 223401 133749 MUKUNDAN DEEPA MD TRUSTEE, UTP 20.00 20.00 X 52200 121840 77501 NAZZAL MUNIER MD PRESIDENT, UTP 20.00 20.00 X X 788058 144731 127692 PYLES BRYAN T INTERIM CFO, UTP (THRU 4/1/22) 20.00 20.00 X 0 223127 97669 SAUNDERS WILLIAM III MD TRUSTEE, UTP 20.00 20.00 X 354960 24206 100908 SCHROEDER JASON MD SECRETARY, UTP 20.00 20.00 X X 651413 54857 138024 SINDHWANI PUNEET MD TRUSTEE, UTP 20.00 20.00 X 367200 173303 157567 SKIE MARTIN MD TRUSTEE, UTP 20.00 20.00 X 642686 79020 124696 SPEER LINDA MD TRUSTEE, UTP 20.00 20.00 X 145347 143598 150646 VAN HOOK JAMES MD TRUSTEE, UTP 20.00 20.00 X 317200 273532 156810 BRICKMAN KRISTOPHER MD CHIEF PHYSICIAN EXECUTIVE 20.00 20.00 X 379008 154207 138117 COOPER CHRISTOPHER MD CHAIRMAN, UTP 20.00 20.00 X 274891 455801 195604 HUBER JOHN E CHIEF FINANCIAL OFFICER (AS OF 4/22) 20.00 20.00 X 0 0 0 CHACKO PAUL PHYSICIAN 40.00 0.00 X 778130 19745 76301 GEHLING DANIEL PHYSICIAN 40.00 0.00 X 796263 6872 116457 HANNA MAGED PHYSICIAN 40.00 0.00 X 662565 20176 101675 MASROOR SAQIB PHYSICIAN 40.00 0.00 X 909045 16893 110904 OSMAN MOHAMED PHYSICIAN 40.00 0.00 X 904573 24224 103197 BOOTH ROBERT MD TRUSTEE, UTP (FORMER) 40.00 0.00 X 32450 19047 18562 BOSWELL MARK MD TRUSTEE, UTP (FORMER) 20.00 20.00 X 300858 175997 102348 CASABIANCA ANDREW MD TRUSTEE, UTP (FORMER) 20.00 20.00 X 309683 157764 174091 CHAUDHURI PRABIR MD TRUSTEE, UTP (FORMER) 20.00 20.00 X 47437 92802 98052 DOMINIAK NICOLE MD TRUSTEE, UTP (FORMER) 20.00 20.00 X 192254 34214 58572 ELSAMALOTY HAITHAM MD TRUSTEE, UTP (FORMER) 20.00 20.00 X 6138 206700 138388 FARRELL STEVEN J MD TRUSTEE, UTP (FORMER) 40.00 0.00 X 222819 46699 140029 HEJEEBU SRINI DO SECRETARY, UTP (FORMER) 40.00 0.00 X 321304 66133 132900 KAW DINKAR MD TRUSTEE, UTP (FORMER) 40.00 0.00 X 280085 42672 138431 KOLTZ BROOKE MD TRUSTEE, UTP (FORMER) 20.00 20.00 X 62950 15718 37506 LYNN CHRISTOPHER K MD TRUSTEE, UTP (FORMER) 40.00 0.00 X 0 49537 38844 SINGH TANVIR MD TRUSTEE, UTP (FORMER) 40.00 0.00 X 647165 99267 153752 SKEEL ROLAND T MD TRUSTEE, UTP (FORMER) 40.00 0.00 X 174647 74549 70711 SODEMAN THOMAS C MD TRUSTEE, UTP (FORMER) 40.00 0.00 X 130202 90210 140911 WROBLEWSKI MARY BETH MD TRUSTEE, UTP (FORMER) 40.00 0.00 X 48323 92687 78902 15545094 5240217 5320522 252 1 1 0 SELLERS DORSEY & ASSOC LLC 1635 MARKET ST SUITE 301 PHILADELPHIA PA 19103 CONSULTING SERVICES 586331 CLIFTONLARSONALLEN LLP 220 S 6TH ST SUITE 300 MINNEAPOLIS MN 55402 AUDIT AND FINANCIAL SERVICES 168808 EXECUTIVE CONSULTING GROUP 11512 EL CAMINO REAL SAN DIEGO CA 92130 CONSULTING SERVICES 166435 ISCRIBE MD LLC PO BOX 351357 TOLEDO OH 43635 MEDICAL RECORDS TRANSCRIPTION SERVICES 141120 EASTMAN & SMITH LTD ONE SEAGATE 24TH FLOOR TOLEDO OH 43699 LEGAL SERVICES 134523 6 113310 113310 PATIENT SERVICE 621110 97614793 97614793 UPL REVENUE 621110 12433090 12433090 UTMAC INSURANCE PREMIUMS 525100 2221875 2221875 PERFORMANCE INCENTIVE PAYMENTS 621110 2172657 2172657 UTMAC INVESTMENT INCOME 523000 -429078 -429078 114013337 319431 319431 3583655 3676393 -92738 -92738 -92738 UTMC ATHENA REVENUE 900099 1004608 1004608 MISCELLANEOUS REVENUE 900099 528819 528819 1533427 115886767 114013337 0 1760120 1694652 1694652 9593312 9593312 3283375 3283375 73901128 69631346 4269782 7165955 6829859 336096 3433450 1357528 2075922 1214941 1044849 170092 219488 219488 81943 81943 29537 29537 10956178 10956178 64432 64432 586990 568494 18496 273554 273554 357068 317791 39277 524424 524424 438626 438626 1366647 1366647 1804812 1804812 UTMAC EXPENSES 1691789 1691789 DUES AND LICENSES 605820 605820 PHARMACEUTICALS 548535 548535 MEDICAL SUPPLIES 364121 364121 225576 112788 112788 120426353 113403900 7022453 0 6053989 11622533 28172237 6700812 13733569 16152068 4961955 20966 101185 88087 546607 131697 16283334 3782167 1424004 12501167 11632635 20560760 66626181 67778090 14137386 12107441 328382 318350 9043488 19343277 23509256 31769068 X 43116925 36009022 43116925 36009022 66626181 67778090 -4539586 -2238180 -330137 0 X X 0 1 X 1 0 X X 1 UNIVERSITY OF TOLEDO 346401483 2 1 1694652 0 1 1694652 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X SCHEDULE A, PAGE 5, LINE 1C THE ORGANIZATION SERVES AS THE 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. SCHEDULE A, PAGE 5, SECTION D, LINE 3 UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY, INC. (UTP) HAS ONLY ONE CLASS OF MEMBER, AND ONLY ONE MEMBER, THE UNIVERSITY OF TOLEDO. THE SOLE MEMBER, UNIVERSITY OF TOLEDO HAS A SIGNIFICANT VOICE IN THE ACTIVITIES AND OPERATIONS OF UTP. ACT ON ITS BEHALF AS THE SOLE MEMBER OF THE ORGANIZATION. THE SOLE MEMBER OF UTP HAS THE POWER TO NOMINATE, ELECT AND REMOVE THE BOARD OF DIRECTORS OF THE CORPORATION; 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 LIABILITYINSURANCE COVERAGE, INCLUDING CHANGES IN THE PARTIES PROVIDING SUCH COVERAGE; AND (G) THE DISSOLUTION OR LIQUIDATION OF THE CORPORATION. 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 70272 30396 39876 2354568 1424237 930331 13858494 2327534 11530960 12501167 LOSSES AND LOSS ADJUSTMENT EXPENSES - UTMAC 9410652 LOSSES AND CLAIMS HANDLING FEES PAYABLE - UTMAC 159825 RIGHT OF USE LEASE LIABILITY 9772800 19343277 109772211 -2238180 -382463 -2620643 112392854 3493913 3493913 115886767 116601284 0 116601284 3825069 3825069 120426353 PART XI, LINE 2D - OTHER ADJUSTMENTS: GAIN ON UTMAC 101,008. LOSS ON DAVIS DENTAL -51,307. INTEREST EXPENSES INCLUDED IN EXPENSES -432,164. PART XI, LINE 4B - OTHER ADJUSTMENTS: UTMAC INCOME 1,792,797. UT MISSION SUPPORT 1,694,652. CAPITAL LEASE 6,464. PART XII, LINE 4B - OTHER ADJUSTMENTS: UT MISSION SUPPORT 1,694,652. UTMAC EXPENSES 1,691,789. CAPITAL LEASE EXPENSE 6,464. INTEREST EXPENSE 432,164. 1 UNIVERSITY OF TOLEDO 2801 W BANCROFT ST TOLEDO OH 43614 346401483 STATE OF OHIO 1694652 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. X 0 1 X X X 0 0 0 1 0 0 0 1 0 EBRAHEIM NABIL MD TRUSTEE, UTP 63000 166905 1180821 0 0 0 43500 84337 0 54150 1287321 305392 0 0 NAZZAL MUNIER MD PRESIDENT, UTP 0 144731 788058 0 0 0 43500 44450 2955 36787 834513 225968 0 0 MASROOR SAQIB PHYSICIAN 710154 16893 198891 0 0 0 43500 4200 26000 37204 978545 58297 0 0 OSMAN MOHAMED PHYSICIAN 0 24224 904573 0 0 0 43500 4972 19500 35225 967573 64421 0 0 COOPER CHRISTOPHER MD CHAIRMAN, UTP 272191 455801 2700 0 0 0 41234 61849 0 92521 316125 610171 0 0 GEHLING DANIEL PHYSICIAN 0 6872 796263 0 0 0 43500 22592 19500 30865 859263 60329 0 0 SINGH TANVIR MD TRUSTEE, UTP (FORMER) 0 99267 647165 0 0 0 43500 38348 20902 51002 711567 188617 0 0 CHACKO PAUL PHYSICIAN 500500 19745 277630 0 0 0 18070 4239 19500 34492 815700 58476 0 0 SKIE MARTIN MD TRUSTEE, UTP 24842 79020 617844 0 0 0 43500 34387 0 46809 686186 160216 0 0 SCHROEDER JASON MD SECRETARY, UTP 648713 54857 2700 0 0 0 43500 31942 19376 43206 714289 130005 0 0 DWORKIN LANCE MD TRUSTEE, UTP 225098 402417 22700 0 0 0 40977 34509 25379 44499 314154 481425 0 0 HANNA MAGED PHYSICIAN 0 20176 662565 0 0 0 43500 4302 19500 34373 725565 58851 0 0 MAHMOOD ASIF MD TRUSTEE, UTP 572000 51405 18200 0 0 0 43500 9827 19500 35051 653200 96283 0 0 VAN HOOK JAMES MD TRUSTEE, UTP 304500 273532 12700 0 0 0 43500 34509 26000 52801 386700 360842 0 0 SINDHWANI PUNEET MD TRUSTEE, UTP 364500 173303 2700 0 0 0 43500 29031 26000 59036 436700 261370 0 0 ALI IMRAN MD TREASURER, UTP 248056 237951 32712 0 0 0 43500 39562 17921 69784 342189 347297 0 0 JENKINS KIMBERLY MD TRUSTEE, UTP 307806 195216 28571 0 0 0 43500 33365 19500 59513 399377 288094 0 0 BRICKMAN KRISTOPHER MD CHIEF PHYSICIAN EXECUTIVE 376308 154207 2700 0 0 0 43500 25187 24192 45238 446700 224632 0 0 CASABIANCA ANDREW MD TRUSTEE, UTP (FORMER) 263787 157764 45896 0 0 0 43500 54739 26000 49852 379183 262355 0 0 AKPUNONU BASIL MD TRUSTEE, UTP 284480 170713 17279 0 0 0 43500 27593 26000 47623 371259 245929 0 0 KHOURI SMAIR MD VICE PRESIDENT UTP 361644 72624 26928 0 0 0 43500 12992 26000 44688 458072 130304 0 0 BOSWELL MARK MD TRUSTEE, UTP (FORMER) 298158 175997 2700 0 0 0 43500 27708 3039 28101 347397 231806 0 0 MCCULLUMSMITH CHERYL MD TRUSTEE, UTP 142971 223401 26387 0 0 0 26458 34509 7029 65753 202845 323663 0 0 HEJEEBU SRINI DO SECRETARY, UTP (FORMER) 9820 66133 311484 0 0 0 43500 19105 28100 42195 392904 127433 0 0 EL-ZAWAHRY AHMED MD TRUSTEE, UTP 394500 24194 2700 0 0 0 43500 4302 26000 14480 466700 42976 0 0 SAUNDERS WILLIAM III MD TRUSTEE, UTP 240893 24206 114067 0 0 0 43500 5652 19500 32256 417960 62114 0 0 HINCH BRYAN MD TRUSTEE, UTP 121000 81948 126038 0 0 0 39981 35751 19500 47112 306519 164811 0 0 KAW DINKAR MD TRUSTEE, UTP (FORMER) 24500 42672 255585 0 0 0 43500 37440 26000 31491 349585 111603 0 0 GRIDER STEPHEN MD TRUSTEE, UTP 149148 162795 3388 0 0 0 26780 27215 26000 57468 205316 247478 0 0 SPEER LINDA MD TRUSTEE, UTP 142647 143598 2700 0 0 0 25402 53687 23996 47561 194745 244846 0 0 GOHARA AMIR TRUSTEE, UTP 144372 176755 2700 0 0 0 22980 28555 6128 38804 176180 244114 0 0 FARRELL STEVEN J MD TRUSTEE, UTP (FORMER) 1454 46699 221365 0 0 0 33423 69368 0 37238 256242 153305 0 0 SODEMAN THOMAS C MD TRUSTEE, UTP (FORMER) 127502 90210 2700 0 0 0 20794 62354 8424 49339 159420 201903 0 0 ELSAMALOTY HAITHAM MD TRUSTEE, UTP (FORMER) 0 206700 6138 0 0 0 921 73659 0 63808 7059 344167 0 0 PYLES BRYAN T INTERIM CFO, UTP (THRU 4/1/22) 0 223127 0 0 0 0 0 31268 0 66401 0 320796 0 0 SKEEL ROLAND T MD TRUSTEE, UTP (FORMER) 155500 74549 19147 0 0 0 26197 12438 0 32076 200844 119063 0 0 FEDERMAN DOUGLAS TRUSTEE, UTP 134060 69164 21700 0 0 0 24046 12088 4544 42129 184350 123381 0 0 DOMINIAK NICOLE MD TRUSTEE, UTP (FORMER) 189554 34214 2700 0 0 0 29730 5964 5946 16932 227930 57110 0 0 MUKUNDAN DEEPA MD TRUSTEE, UTP 49500 121840 2700 0 0 0 11730 19689 26000 20082 89930 161611 0 0 CHAUDHURI PRABIR MD TRUSTEE, UTP (FORMER) 44737 92802 2700 0 0 0 7906 45412 5271 39463 60614 177677 0 0 WROBLEWSKI MARY BETH MD TRUSTEE, UTP (FORMER) 37957 92687 10366 0 0 0 7630 22034 2543 46695 58496 161416 0 0 DAVIS WILLIAM DDS TRUSTEE, UTP 85481 4601 1500 0 0 0 6524 55276 0 48073 93505 107950 0 0 KOLTZ BROOKE MD TRUSTEE, UTP (FORMER) 61000 15718 1950 0 0 0 12368 2623 19500 3015 94818 21356 0 0 LYNN CHRISTOPHER K MD TRUSTEE, UTP (FORMER) 0 49537 0 0 0 0 0 9407 0 29437 0 88381 0 0 BOOTH ROBERT MD TRUSTEE, UTP (FORMER) 30500 19047 1950 0 0 0 4868 3532 0 10162 37318 32741 0 0 PART I, LINE 1A CHRISTOPHER COOPER, MD WAS REIMBURSED $7,191 FOR COUNTRY CLUB DUES, WHICH WAS INCLUDED IN HIS TAXABLE WAGES. 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 MANY PHYSICIANS ON STAFF DO RECEIVE COMPENSATION COMPUTED ON SERVICES RENDERED/COLLECTIONS RECEIVED. FOR THIS COMPENSATION, ESTABLISHED FORMULAS AND COMPUTATIONS ARE UTILIZED TO DETERMINE THE COMPENSATION. 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 3 UTMAC, LLC DELEGATES AUTHORITY TO STRATEGIC RISK SOLUTIONS WHICH SERVES AS THE CAPTIVE MANAGER. STRATEGIC RISK SOLUTIONS RECEIVED $56,903 AS COMPENSATION FOR CAPTIVE MANAGEMENT SERVICES. 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, IT IS PROVIDED TO MANAGEMENT FOR THEIR REVIEW. ANY CHANGES NOTED BY MANAGEMENT ARE INCORPORATED INTO THE RETURN BEFORE THE DOCUMENT IS PROVIDED TO THE BOARD PRIOR TO FILING WITH THE IRS. 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. FORM 990, PART X RESTATEMENT EFFECTIVE JULY 1, 2021, UTPCF ADOPTED NEW ACCOUNTING GUIDANCE FOR LEASES. THE GUIDANCE REQUIRES LESSEES TO RECOGNIZE A RIGHT-TO-USE ASSET AND CORRESPONDING LEASE LIABILITY AND LESSORS TO RECOGNIZE A LEASE RECEIVABLE AND CORRESPONDING DEFERRED INFLOW OF RESOURCES FOR ALL LEASES WITH TERMS GREATER THAN TWELVE MONTHS. IN JUNE 2017, THE GOVERNMENTAL ACCOUNTING STANDARDS BOARD (GASB) ISSUED GASB STATEMENT NO. 87, LEASES. THIS STANDARD REQUIRES THE RECOGNITION OF CERTAIN LEASE ASSETS AND LIABILITIES FOR LEASES THAT PREVIOUSLY WERE CLASSIFIED AS OPERATING LEASES AND AS INFLOWS OF RESOURCES OR OUTFLOWS OF RESOURCES RECOGNIZED BASED ON THE PAYMENT PROVISIONS OF THE CONTRACT. IT ESTABLISHES A SINGLE MODEL FOR LEASES ACCOUNTING BASED ON THE FOUNDATIONAL PRINCIPLE THAT LEASES ARE FINANCINGS OF THE RIGHT TO USE AN UNDERLYING ASSET. UNDER THIS STANDARD, A LESSEE IS REQUIRED TO RECOGNIZE A LEASE LIABILITY AND AN INTANGIBLE RIGHT-TO-USE ASSET, AND A LESSOR IS REQUIRED TO RECOGNIZE A LEASE RECEIVABLE AND A DEFERRED INFLOW OF RESOURCES. UTPCF ADOPTED THE REQUIREMENTS OF THE GUIDANCE EFFECTIVE JULY 1, 2021 AND HAS APPLIED THE PROVISIONS OF THIS STANDARD TO THE BEGINNING OF THE EARLIEST COMPARATIVE PERIOD (JUNE 30, 2021). UNIVERSITY OF TOLEDO PHYSICIANS LLC 3355 GLENDALE AVE 3RD FLOOR TOLEDO OH 43614 341127097 DISREGARDED ENTITY FORMED TO CARRY OUT PURPOSES OF MEMBER OH 113363449 37230513 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 DISREGARDED ENTITY FORMED TO CARRY OUT PURPOSES OF MEMBER VT 1792797 20105989 100 UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY INC UNIVERSITY OF TOLEDO DENTISTS INC 4510 DORR ST TOLEDO OH 43615 341274989 DENTAL SERVICES OH 0 0 100 UNIVERSITY OF TOLEDO PHYSICIANS CLINICAL FACULTY INC TOLEDO AREA MEDICAL FOUNDATION 3355 GLENDALE AVE 3RD FLOOR TOLEDO OH 43614 341308939 FINANCIAL SUPPORT TO UNIV. OF TOLEDO PHYSICIANS CLINICAL FACULTY OH 501(C)(3) LINE 12C, III-FI N/A 0 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 NORTHWEST OHIO ACO LLC 4235 SECOR ROAD TOLEDO OH 43614 455444018 ACCOUNTABLE CARE ORGANIZATION OH N/A RELATED 0 0 0.40000 0 0 1 0 0 1 0 0 0 0 1 1 1 1 1 1 1 0 0 FORM 990, SCHEDULE R, PART I: 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. PRIOR TO BECOMING A NONPROFIT, UNIVERSITY OF TOLEDO DENTISTS, LLC WAS A TAXABLE FOR-PROFIT CORPORATION AND FILED FOR 1120 ANNUALLY. THERE WAS NO DEFERRED TAX ASSETS OR LIABILITIES AND THE TAX LIABILITY FOR FISCAL YEAR ENDING JUNE 30, 2021, IS IMMATERIAL.