2020-11-16T10:25:45-06:00 2019-12-31 621804252 WATKINS UIBERALL PLLC 1661 AARON BRENNER DR STE 300 MEMPHIS TN 38120 990 2019-01-01 621162462 UT MEDICAL GROUP INC UTME 9018668015 1407 UNION AVENUE NO 700 MEMPHIS TN 38104 SHANNON TACKER CEO 9018668015 2020-11-13 1 BENJAMIN D COLLINS P01307180 9017612720 216.136.84.170 2020-11-13 15:25:12 CS P 631EA8AB8171549DAC36E865A5B6E8498775A2C4 AB4E6503D7988AF3FD7CF24DB4848D76C9A29F8D 2019 2021-01-29 14:40:06Z SHANNON TACKER 1407 UNION AVENUE NO 700 MEMPHIS TN 38104 79350880 0 X WWW.UTMEDICALGROUP.COM X 1983 TN DELIVERY OF HEALTH CARE BY THE FACULTY PHYSICIANS OF THE UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER COLLEGE OF MEDICINE. 9 9 695 0 0 0 0 0 72158305 77599664 73298 222193 1840056 1529023 74071659 79350880 186086 322396 0 0 46445953 50179314 0 0 0 30528895 30605865 77160934 81107575 -3089275 -1756695 39025304 46543175 13920891 22720075 25104413 23823100 X THE MISSION OF UT MEDICAL GROUP, INC. IS TO DELIVER HIGH QUALITY HEALTH AND MEDICAL SERVICES THROUGH: - LEADING EDGE CLINICAL PRACTICE IN AN ACADEMIC SETTING, - EXCELLENCE IN SERVICE AND SATISFACTION, AND - AVAILABILITY, ACCESSIBILITY, AND CONVENIENCE FOR THE PATIENT IN SUPPORT OF THE COLLEGE OF MEDICINE OF THE UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER. 0 0 69626366 322396 78460757 UT MEDICAL GROUP, INC. IS A NONPROFIT EDUCATIONAL, RESEARCH AND CHARITABLE ORGANIZATION INCORPORATED IN THE STATE OF TENNESSEE WHOSE ACTIVITIES ENCOMPASS THE DELIVERY OF HEALTH CARE BY THE FACULTY OF THE COLLEGE OF MEDICINE OF THE UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER. THE GROUP OPERATES UNDER AN AFFILIATION AGREEMENT WITH UTHSC AND PROVIDES COMPREHENSIVE, HIGH QUALITY, MULTI-SPECIALTY HEALTH CARE TO ALL PATIENTS WHILE FULFILLING THE ACADEMIC, TEACHING, AND RESEARCH RESPONSIBILITIES OF THE PROFESSIONAL EMPLOYEES (FACULTY PHYSICIANS).THE GROUP BEGAN THE YEAR WITH TEN CLINICAL DEPARTMENTS AND CERTAIN ANCILLARY AND ADMINISTRATIVE DEPARTMENTS. THE CLINICAL DEPARTMENTS INCLUDED DERMATOLOGY, FAMILY MEDICINE, INTERVENTIONAL RADIOLOGY, MEDICINE, NEONATOLOGY, NEUROLOGY, OPTHAMOLOGY, PLASTIC SURGERY, PSYCHIATRY, AND SURGERY.THE MEDICAL SERVICES PROVIDED BY THE GROUP ARE AVAILABLE TO THE COMMUNITY AS A WHOLE WITHOUT REGARD TO ABILITY TO PAY. MEDICARE, MEDICAID, AND TENNCARE PATIENTS ARE ACCEPTED. THE GROUP HAS AN AGREEMENT WITH REGIONAL ONE, THE PUBLIC SAFETY NET HOSPITAL OF SHELBY COUNTY, TENNESSEE, THAT PROVIDES FOR THE DELIVERY OF PROFESSIONAL SERVICES TO INDIGENT PATIENTS, BOTH INPATIENT AND OUTPATIENT. IN ADDITION TO PATIENTS FROM SHELBY COUNTY, THE FACULTY PHYSICIANS AND OTHER PROFESSIONAL EMPLOYEES OF THE GROUP PROVIDE HEALTH CARE SERVICES TO OUT-OF-STATE RESIDENTS AND RESIDENTS OF FOREIGN COUNTIRES WHO HAVE LIMITED INCOMES. DURING THE PERIOD, APPROXIMATELY 34 PERCENT OF THE GROUP'S SERVICES WERE PROVIDED TO PATIENTS WITH TENNCARE, MEDICAID, OR NO INSURANCE COVERAGE. ANOTHER 25 PERCENT WERE PROVIDED TO MEDICATE PATIENTS.THE PROFESSIONAL EMPLOYEES OF THE GROUP ARE DEDICATED TO THE MEDICAL TRAINING AND EDUCATION OF HEALTH PROFESSIONALS IN CONJUNCTION WITH THE UTHSC COLLEGE OF MEDICINE. ALTHOUGH EDUCATIONAL ACTIVITIES ARE FUNDED PRIMARILY THROUGH THE UTHSC COLLEGE OF MEDICINE, THE GROUP MAKES SIGNIFICAN CONTRIBUTIONS TO THIS EFFORT WITH BOTH PERSONNEL AND FINANCIAL RESOURCES. DURING THE YEAR, FACULTY PHYSICIANS WERE INVOLVED IN THE EDUCATION OF PRIMARILY THE 3RD AND 4TH YEAR MEDICAL STUDENTS (300 OF THE 600 MEDICAL STUDENTS).ALSO IN CONJUNCTION WITH THE UTHSC COLLEGE OF MEDICINE, THE PROFESSIONAL EMPLOYEES OF THE GROUP ENGAGE IN PROGRAMS OF MEDICAL RESEARCH AND EDUCATION THAT PROMOTE THE LONG-TERM HEALTH AND WELFARE OF PATIENTS AND THE GENERAL PUBLIC. THE RESEARCH PROGRAMS FOCUS ON PREVENTION AND TREATMENT OF ILLNESSES AS WELL AS EFFECTS OF DRUGS AND MEDICATIONS ON A VARIETY OF DISEASES AND MEDICAL CONDITIONS.WHILE SERVING AS THE FACULTY PRACTICE PLAN OF THE UTHSC COLLEGE OF MEDICINE, THE LONG-TERM COMMITMENT OF THE GROUP IS TO CONTINUE TO PROVIDE MEDICAL SERVICES TO ANY AND ALL PATIENTS AND TO PROMOTE GOOD HEALTH THROUGH RESEARCH AND EDUCATION.THE RANGE/TYPE OF SERVICES PROVIDED BY THE CLINICAL DEPARTMENTS INCLUDES PRIMARY CARE, SPECIALTY CONSULTATIONS, SUBSPECIALTY PROCEDURES AND DIAGNOSTIC EVALUATIONS, AND SURGICAL PROCEDURES. HEALTH CARE SERVICES ARE DELIVERED IN NUMEROUS HOSPITAL AND CLINIC SETTINGS, INCLUDING INPATIENT AND OUTPATIENT CARE AT THE REGIONAL MEDICAL CENTER AT MEMPHIS (REGIONAL ONE), LE BONHEUR CHILDREN'S HOSPITAL, MEMPHIS VA MEDICAL CENTER, METHODIST UNIVERSITY HOSPITAL, ST. JUDE CHILDREN'S RESEARCH HOSPITAL, ST. FRANCIS HOSPITAL, BAPTIST MEMORIAL HOSPITALS, AND OTHER LOCAL COMMUNITY HOSPITALS. THE GROUP'S FACULTY PHYSICIANS PROVIDE HEALTH CARE SERVICES TO PATIENTS OF THE CENTERS OF EXCELLENCE AT THE MED. THE CENTERS OF EXCELLENCE INCLUDE THE TRAUMA CENTER, BURN CENTER, WOUND CARE CENTER, NEWBORN CENTER, ADULT SPECIAL CARE, AND SICKLE CELL CENTER. 69626366 1 0 0 0 0 0 0 0 0 0 1 0 0 1 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 1 0 0 0 1 94 0 695 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X X MICHAEL DURR 9018668117 1407 UNION AVE STE 700 MEMPHIS TN 38104 ROBERT CANADA DIRECTOR 40.00 X 344556 0 0 SHANNON TACKER PRESIDENT/CEO/TREASURER 40.00 X X 0 0 0 MUNEEZA KHAN DIRECTOR 40.00 X 30992 0 0 TEJESH PATEL DIRECTOR 40.00 X 574465 0 0 AJAY JAYANTILAL TALATI SECRETARY 40.00 X 458909 0 0 SCOTT STROME CHAIRMAN OF THE BOARD 40.00 X X 113466 0 0 JON MCCULLERS DIRECTOR 2.00 X 0 0 0 KENNARD BROWN DIRECTOR 2.00 X 0 0 0 G NICHOLAS VERNE DIRECTOR 40.00 X 58882 0 0 ANTHONY FERRARA DIRECTOR 2.00 X 0 0 0 DAVID SHIBATA DIRECTOR 2.00 X 0 0 0 M BOYD GILLESPIE DIRECTOR 2.00 X 0 0 0 ROBERT WALLACE PHYSICIAN 40.00 X 820553 0 0 WILLIAM HICKERSON PHYSICIAN 40.00 X 671231 0 0 DAVID SCHWARTZ PHYSICIAN 40.00 X 540075 0 0 SAI VELAMURI VENKATA PHYSICIAN 40.00 X 513461 0 0 M BARRY RANDALL PHYSICIAN 40.00 X 537909 0 0 ANDREW BOTSCHNER FORMER CEO 40.00 X 604579 0 0 5269078 0 0 10 1 1 0 UNIVERSITY OF TENNESSEE 62 S DUNLAP MEMPHIS TN 38163 OVERHEAD, UHS SERVICES, MISSION SUPPORT 2342411 NEXTGEN HEALTHCARE PO BOX 809390 CHICAGO IL 60680 BILLING & COLLECTIONS 1844817 PARTNERS CENTRAL BUSINESS OFFICE 1407 UNION AVE STE 200 MEMPHIS TN 38104 BILLING & COLLECTIONS 1263205 COMPHEALTH PO BOX 972651 DALLAS TX 75397 LOCUM TENENS HEALTHCARE JOBS 577541 DINSMORE & SHOHL LLP PO BOX 639038 CINCINNATI OH 45263 LEGAL FIRM 476884 5 PROGRAM SERVICE 621110 77599664 77599664 77599664 222193 222193 667930 0 667930 667930 667930 INVESTMENT IN UTMG DERMATOPATHOLO 900000 793005 793005 INVESTMENT IN UTMG NEPHROLOGY LLC 900000 101074 101074 INVESTMENT IN PCBO LLC 900000 18413 18413 -51399 -51399 861093 79350880 78460757 0 890123 X 322396 322396 1574945 1380449 194496 44996296 39276410 5719886 1150841 1020833 130008 2457232 2071552 385680 637151 91390 545761 10331951 9096900 1235051 445395 371406 73989 244577 211731 32846 1901590 1558497 343093 157674 32006 125668 196526 81183 115343 1320952 871955 448997 3797880 3086511 711369 DRUGS AND MEDICAL SUPPL 7608983 7608983 REPAIRS & MAINTENANCE 1572564 601302 971262 OVERHEAD 1001846 1001846 MOVING EXPENSE 546319 406148 140171 842457 534868 307589 81107575 69626366 11481209 0 152980 161163 13026824 13485237 11622976 13447992 143000 862103 787798 27947524 15092639 5437156 12854885 7923265 5663100 39025304 46543175 9336755 12316992 121268 0 2251316 8899109 2211552 1503974 13920891 22720075 X 25104413 23823100 25104413 23823100 39025304 46543175 X -1756695 475382 X 0 1 X 1 0 X 675000 675000 9352535 155977 9196558 3050785 2674366 376419 14280794 12262296 2018498 588410 588410 12854885 OTHER RECEIVABLES 226072 OTHER LONG-TERM ASSETS 5437028 5663100 DUE TO MSO 1503974 1503974 0 UNIVERSITY OF TENNESSEE 910 MADISON AVE MEMPHIS TN 38163 626001636 501(C)(3) 322396 FURTHER THE ORGANIZATION'S EXEMPT PURPOSE 0 0 0 0 0 0 0 0 0 ROBERT CANADA DIRECTOR 344556 0 0 0 0 0 0 0 0 0 344556 0 0 0 TEJESH PATEL DIRECTOR 574465 0 0 0 0 0 0 0 0 0 574465 0 0 0 AJAY JAYANTILAL TALATI SECRETARY 458909 0 0 0 0 0 0 0 0 0 458909 0 0 0 ROBERT WALLACE PHYSICIAN 820553 0 0 0 0 0 0 0 0 0 820553 0 0 0 WILLIAM HICKERSON PHYSICIAN 671231 0 0 0 0 0 0 0 0 0 671231 0 0 0 DAVID SCHWARTZ PHYSICIAN 540075 0 0 0 0 0 0 0 0 0 540075 0 0 0 SAI VELAMURI VENKATA PHYSICIAN 513461 0 0 0 0 0 0 0 0 0 513461 0 0 0 M BARRY RANDALL PHYSICIAN 537909 0 0 0 0 0 0 0 0 0 537909 0 0 0 ANDREW BOTSCHNER FORMER CEO 604579 0 0 0 0 0 0 0 0 0 604579 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 ACCORDING TO ARTICLE II, SECTION1 OF THE BYLAWS: THOSE PHYSICIANS WHO ARE DULY LICENSED TO PRACTICE MEDICINE IN THE STATE OF TENNESSEE AND THOSE CLINICAL PSYCHOLOGISTS WHO ARE DULY LICENSED IN THE STATE OF TENNESSEE, WHO HAVE BEEN APPOINTED TO FACULTY OF THE UTHSC COLLEGE OF MEDICINE, WHO ARE FULL-TIME EMPLOYEES PURSUANT TO WRITTEN EMPLOYMENT AGREEMENTS WITH THE GROUP AND WHO HAVE OBTAINED AND MAINTAIN CREDENTIALED STATUS AS A PRACTITIONER OF THE GROUP IN ACCORDANCE WITH THE POLICIES OF THE BOARD OF DIRECTORS AND THE GROUP'S PROVIDER CREDENTIALING AND ENROLLMENT DEPARTMENT, SHALL BE MEMBERS OF THE GROUP. FORM 990, PART VI, SECTION A, LINE 7A ACCORDING TO THE BYLAWS: THE MEMBERS OF THE GROUP ANNUALLY SHALL ELECT THE MEMBER DIRECTORS WHO WILL SERVE ON THE BOARD OF DIRECTORS AT AN ELECTION HELD IN ACCORDANCE WITH SECTION 3.3 OF ARTICLE III OF THE BYLAWS. FORM 990, PART VI, SECTION A, LINE 7B ACCORDING TO THE BYLAWS: THE MEMBERS SHALL ALSO HAVE THE RIGHT TO APPROVE OR DISAPPROVE THE DECISION OF THE BOARD OF DIRECTORS TO MERGE, LIQUIDATE, DISSOLVE OR TERMINATE THE GROUP, BY A VOTE OF 2/3 OF THE MEMBERS PRESENT OR REPRESENTED AT SUCH MEETING. THE MEMBERS SHALL ALSO HAVE THE RIGHT TO VOTE UPON SUCH MATTERS AS MAY BE PRESENTED TO THEM FROM TIME TO TIME BY THE BOARD OF DIRECTORS OR UPON SUCH MATTERS AS MAY BE PRESENTED BY A MAJORITY OF THE MEMBERS PRESENT OR REPRESENTED AT ANY ANNUAL OR SPECIAL MEETING OF THE MEMBERS; PROVIDED, HOWEVER, THAT ANY SUCH MATTERS ARE NOT VESTED EXCLUSIVELY, DIRECTLY OR INDIRECTLY, WITH THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B UTMG'S BOARD OF DIRECTORS HAS DELEGATED THE 990 REVIEW PROCESS TO THE AUDIT, FINANCE, AND BUDGET COMMITTEE, WHICH IS A COMMITTEE OF THE BOARD. THIS COMMITTEE REVIEWS UTMG'S 990 AND 990-T AND APPROVES THE RETURNS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE OFFICERS AND DIRECTORS OF UTMG RECEIVED UTMG'S CONFLICT OF INTEREST POLICY AND A FORM TO COMPLETE AND SIGN ACKNOWLEDGING THAT THEY HAVE READ, UNDERSTAND, AND AGREE TO COMPLY WITH THE CONFLICE OF INTEREST POLICY. IN THE EVENT A POTENTIAL CONFLICT OF INTEREST WITH ANY OFFICER OR DIRECTOR ARISES, THE PROCESS FOR DISCLOSING THE ACTUAL OR POSSIBLE CONFLICT, DETERMINING IF ONE EXISTS, AND ADDRESSING A CONFLICT IS INCLUDED IN THE CONFLICT OF INTEREST POLICY AND IS FOLLOWED. FORM 990, PART VI, SECTION B, LINE 15 ACCORDING TO THE BYLAWS, THE COMPENSATION COMMITTEE OF THE UTMG BOARD OF DIRECTORS IS RESPONSIBLE FOR "APPROVING THE COMPENSATION OF THE EXECUTIVE STAFF AND APPLICABLE DIRECTORS OF THE GROUP. THE COMPENSATION COMMITTEE SHALL AT THE DIRECTION OF THE BOARD OF DIRECTORS REVIEW THE SYSTEM OF COMPENSATION OF THE GROUP'S MEMBERS AND OTHER PROFESSIONAL EMPLOYEES. THE COMPENSATION COMMITTEE IS COMPOSED OF THREE (3) VOTING MEMBERS, ALL OF WHOM ARE INDEPENDENT, OUTSIDE DIRECTORS AND THREE (3) NONVOTING MEMBERS, INCLUDING THE CHAIRMAN OF THE BOARD AND TWO OTHER DIRECTORS. DURING THE REPORTING PERIOD, THE COMPENSATION COMMITTEE MET AS OFTEN AS NEEDED AND, UTILIZING COMPENSATION MARKET SURVEY DATA, REVIEWED AND APPROVED SALARIES OF THE CHIEF EXECUTIVE OFFICER, OTHER EXECUTIVE OFFICERS, AND KEY EMPLOYEES. ACTIONS OF THE COMMITTEE WERE DOCUMENTED CONTEMPORANEOUSLY. FORM 990, PART VI, SECTION C, LINE 19 FORMS 1023, 990, AND 990-T ARE MADE AVAILABLE UPON REQUEST. PAPER COPIES OF THE SPECIFIC DOCUMENTS ARE FORWARDED TO THE REQUESTING INDIVIDUALS. FORMS 990 AND 990-T ARE ALSO AVAILABLE ON GUIDESTAR.ORG. THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. PAPER COPIES OF THE SPECIFIC DOCUMENTS ARE FORWARDED TO THE REQUESTING INDIVIDUALS. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABALE TO THOSE ENTITIES WITH A BUSINESS NEED. FORM 990, PART IX, LINE 11G MARKETING CONSULTANTS: PROGRAM SERVICE EXPENSES 5,339,027. MANAGEMENT AND GENERAL EXPENSES 724,859. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,063,886. MEDICAL/BILLING/CLERICAL SERVICES: PROGRAM SERVICE EXPENSES 3,757,873. MANAGEMENT AND GENERAL EXPENSES 510,192. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,268,065. FORM 990, PART XI, LINE 9: ADJUSTMENT FOR LLC & NONCONTROLLING INTERESTS 475,382. UNIVERSITY PRACTICE MANAGEMENT 1407 UNION AVE STE 700 MEMPHIS TN 38104 273733656 PROVIDES BILLING & ADMIN SERVICES TO OTHER ACADEMIC MEDICAL PRACTICES TN UTMG VASCULAR ACCESS PHYSICIANS LLC 1407 UNION AVE STE 700 MEMPHIS TN 38104 460928187 VASCULAR ACCESS CENTER TN MSC PROPERTIES LLC 1407 UNION AVE STE 700 MEMPHIS TN 38104 832779010 REAL ESTATE TN MSC GENERAL PARTNER LLC 1407 UNION AVE STE 700 MEMPHIS TN 38104 832737333 HOLDING COMPANY TN MSC LIMITED PARTNER LLC 1407 UNION AVE STE 700 MEMPHIS TN 38104 832747899 HOLDING COMPANY TN MSC MANAGEMENT LLC 1407 UNION AVE STE 700 MEMPHIS TN 38104 832758229 MANAGEMENT COMPANY TN UTHSC COLLEGE OF MEDICINE 910 MADISON AVE MEMPHIS TN 38163 626001636 TN 170(C) 0 INTERVENTIONAL ASSOCIATES OF MEMPHIS PC 1407 UNION AVE STE 700 MEMPHIS TN 38104 201082435 TN 501(C)(3) LINE 1 0 UTMG NEPHROLOGY LLC 1407 UNION AVE STE 700 MEMPHIS TN 38104 271561248 TN RELATED 0 0 0.80000 UTMG DERMATOPATHOLOGY LLC 1407 UNION AVE STE 700 MEMPHIS TN 38104 461168283 TN RELATED 0 0 0.67330 MEMPHIS SURGERY CENTER LTD LP 1407 UNION AVE STE 700 MEMPHIS TN 38104 621218330 TN RELATED 0 0 0.76010 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0