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FAYETTE PHYSICIAN NETWORK INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
FAYETTE PHYSICIAN NETWORK INC (EIN 45-5440305)
Tax period
2018-07-01 to 2019-06-30
Filed
2019-12-06
IRS object ID
201913409349300001
Schema version
2018v3.1
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

FieldValueIRS element (for citing)
Return2019-12-06T07:05:22-06:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN455440305EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FAYETTE PHYSICIAN NETWORK INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% CORPORATE ACCOUNTINGInCareOfNm
Business Name ControlFAYEBusinessNameControlTxt
Phone4126472345PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 GRANT STREET 58TH FL CORP TAXAddressLine1Txt
CityPITTSBURGHCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15219ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonROBERT BLOSATPersonNm
Person TitleTREASURERPersonTitleTxt
Phone4126472345PhoneNum
Signature2019-12-03SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address128.147.28.67IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id25115620193405000000FederalOriginalSubmissionId
Federal Original Submission Id2019-12-06FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id231EC4D7168BEF6AFB68A704FA695A7F80752940AtSubmissionCreationDeviceId
At Submission Filing Device Id231EC4D7168BEF6AFB68A704FA695A7F80752940AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-04-17 16:48:07ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRobert BlosatPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1C/O 600 GRANT ST CORPTAX 58FLAddressLine1Txt
CityPITTSBURGHCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15219ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$22,835,889GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2012FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionFAYETTE PHYSICIANS NETWORK, INC. OPERATES MEDICAL PRACTICES THAT PROVIDE MEDICAL SERVICES PRIMARILY TO THE RESIDENTS OF FAYETTE COUNTY PENNSYLVANIA AND SURROUNDING AREAS.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$21,544,060PYProgramServiceRevenueAmt
CY Program Service Revenue$22,835,889CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$21,544,060PYTotalRevenueAmt
CY Total Revenue$22,835,889CYTotalRevenueAmt
PY Grants And Similar Paid$20,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$23,554,387PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$25,328,061CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$16,370,919PYOtherExpensesAmt
CY Other Expenses$18,338,984CYOtherExpensesAmt
PY Total Expenses$39,945,306PYTotalExpensesAmt
CY Total Expenses$43,667,045CYTotalExpensesAmt
PY Revenues Less Expenses-$18,401,246PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$20,831,156CYRevenuesLessExpensesAmt
Total Assets BOY$4,461,207TotalAssetsBOYAmt
Total Assets EOY$2,458,453TotalAssetsEOYAmt
Total Liabilities BOY$8,544,234TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,806,264TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$4,083,027NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$4,347,811NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionFAYETTE PHYSICIAN NETWORK,INC. OPERATES MEDICAL PRACTICES THAT PROVIDE MEDICAL SERVICES PRIMARILY TO THE RESIDENTS OF FAYETTE COUNTY PENNSYLVANIA AND SURROUNDING AREAS. THE AREA IT SERVES IS LOCATED IN A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. SEE SCHEDULE O.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$40,916,377ExpenseAmt
Revenue$22,835,889RevenueAmt
DescSEE SCHEDULE O.Desc
Total Program Service Expenses$40,916,377TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document71IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCORPORATE ACCOUNTINGPersonNm
Phone4126472345PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 GRANT STREET 58TH FLOORAddressLine1Txt
CityPITTSBURGHCityNm
State AbbreviationPAStateAbbreviationCd
ZIP15219ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Steven Handy
Chairman1.01.0Yes (X)Yes (X)$0$0$0
Robert Blosat
TREASURER1.01.0Yes (X)Yes (X)$0$0$0
Linda Burstynowicz
Board Member1.01.0Yes (X)$0$0$0
Marshall Webster MD
Board Member1.01.0Yes (X)$0$0$0
Barbara Weiss
Board Member1.01.0Yes (X)$0$0$0
Mike Grace
President1.01.0Yes (X)Yes (X)$0$0$0
Mark Dillion J 101218
Secretary1.01.0Yes (X)Yes (X)$0$0$0
Dorothy Knight
Executive Administrator40.00.0$0$183,497$20,977Yes (X)
Babak Movassaghi MD
Physician40.00.0$585,603$0$0Yes (X)
Vivek Sharma MD
Physician40.00.0$494,455$0$0Yes (X)
Brandon Ball MD
PHYSICIAN40.00.0$463,157$0$0Yes (X)
Josef Vanek MD
Physician40.00.0$469,527$0$0Yes (X)
Earl Moss MD
Physician40.00.0$448,954$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,461,696TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$183,497TotReportableCompRltdOrgAmt
Total Other Compensation$20,977TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K51IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (true)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Staff Care Inc
PO Box 281923ATLANTAGA30384Physician Services$750,999
Fusion Healthcare Staffing LLC
PO Box 202056DALLASTX753202056Physician Services$706,467
WPA EMERGENCY MEDICINE STAFFING LL
513 RT 259LIGONIERPA15658Physician Services$116,649
Locum Tenenscom
PO Box 405547ATLANTAGA303845547Physician Services$100,266
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
PATIENT CARE REVENUE621110$22,622,349$22,622,349$0$0
PROGRAM SERVICE REVENUE621110$213,540$213,540
FieldValueIRS element (for citing)
Total Program Service Revenue$22,835,889TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$22,835,889TotalRevenueColumnAmt
Related Or Exempt Func Income$22,835,889RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$22,485,355TotalAmt
Program Services$22,225,280ProgramServicesAmt
Management And General$260,075ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$220,101TotalAmt
Program Services$217,555ProgramServicesAmt
Management And General$2,546ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,612,222TotalAmt
Program Services$1,593,574ProgramServicesAmt
Management And General$18,648ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,010,383TotalAmt
Program Services$998,696ProgramServicesAmt
Management And General$11,687ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$62,328TotalAmt
Management And General$62,328ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$42,058TotalAmt
Program Services$42,058ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$8,046TotalAmt
Program Services$8,046ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$386,663TotalAmt
Program Services$294,388ProgramServicesAmt
Management And General$92,275ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$8,492TotalAmt
Program Services$8,492ProgramServicesAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$667,577TotalAmt
Program Services$667,577ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$44,694TotalAmt
Program Services$43,340ProgramServicesAmt
Management And General$1,354ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,134TotalAmt
Program Services$1,134ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$111,906TotalAmt
Program Services$111,906ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,005,844TotalAmt
Program Services$993,707ProgramServicesAmt
Management And General$12,137ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
PURCHASED SERVICES$3,283,300$1,276,252$2,007,048
OTHER MISC. EXPENSE$10,487,740$10,205,170$282,570$0
SUPPLIES$81,654$81,654
BAD DEBT$1,622,111$1,622,111

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$525,437TotalAmt
Program Services$525,437ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$43,667,045TotalAmt
Program Services$40,916,377ProgramServicesAmt
Management And General$2,750,668ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,675BOYAmt
EOY$3,675EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,698,255BOYAmt
EOY-$153,055EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,884,548BOYAmt
EOY$1,474,084EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$350,090BOYAmt
EOY$383,708EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,072,867LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,348,639LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$524,639BOYAmt
EOY$724,228EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$25,813EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,461,207BOYAmt
EOY$2,458,453EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,921,995BOYAmt
EOY$2,156,174EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$91,453BOYAmt
EOY$133,589EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,530,786BOYAmt
EOY$4,516,501EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,544,234BOYAmt
EOY$6,806,264EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$4,083,027BOYAmt
EOY-$4,347,811EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$4,083,027BOYAmt
EOY-$4,347,811EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,461,207BOYAmt
EOY$2,458,453EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$20,831,156ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$20,566,372OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$328,632OtherCostOrOtherBasisAmt
Depreciation$39,383DepreciationAmt
Book Value$289,249BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$878,266OtherCostOrOtherBasisAmt
Depreciation$718,088DepreciationAmt
Book Value$160,178BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$802,186OtherCostOrOtherBasisAmt
Depreciation$591,167DepreciationAmt
Book Value$211,019BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$63,782OtherCostOrOtherBasisAmt
Book Value$63,782BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$724,228TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
OTHER CURRENT LIABILITIES$267,222
DUE TO EXEMPT AFFILIATES$4,249,279
FieldValueIRS element (for citing)
Total Liability$4,516,501TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Dorothy Knight
Executive Administrator$0$165,013$0$7,750$0$10,734$0$13,934$0$7,043$0$204,474$0$0
Babak Movassaghi MD
Physician$584,002$1,601$585,603
Vivek Sharma MD
Physician$492,299$2,156$494,455
Brandon Ball MD
PHYSICIAN$458,027$5,130$463,157
Josef Vanek MD
Physician$456,654$12,873$469,527
Earl Moss MD
Physician$442,341$6,613$448,954

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule JFormAndLineReferenceDesc
ExplanationPart I, Question 7 Fayette Physician Network, Inc. provides incentive compensation as part of its total compensation program for key employees. This component is based upon the accomplishment of predetermined performance goals and objectives which focus on the achievement of multiple annual and three year individual and group performance criteria in the context of appropriate risk taking. These criteria directly support Fayette Physician Network, Inc.'s mission and include: patient quality and satisfaction, community benefits, operational and financial strength, leadership development, and strategic business initiatives among others.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part III Statement of Program Service AccomplishmentsFayette Physicians Network, Inc. (the Network) was formed on June 5, 2012 as a Pennsylvania non-stock, nonprofit corporation. It is comprised of 65 providers at 10 locations. The Network has at all times since its formation been organized and operated for charitable purposes within the meaning of the Internal Revenue Code Section 501(c)(3). The Network is organized and operated to own and operate medical practices that serve the patients of Fayette County Pennsylvania and surrounding areas. As stated in its Articles of Incorporation, the Network shall be operated exclusively for exempt purposes within the meaning of Section 501(c)(3) of the Internal Revenue Code. Specifically, the purpose of the Network is to own and operate medical practices in Fayette County, Pennsylvania. The Network is made of up 4 divisions: Fayette Anesthesia Providers, Fayette Medical Associates, Fayette Specialty Associates, and Hospital Care Associates. The practices provide medical services to residents throughout Fayette County Pennsylvania and surrounding areas to relieve conditions relating to, and to promote the interests of, the health of these various communities. Medical services are provided to the residents of these underserved communities regardless of their ability to pay. The Network is also involved in community education through the Uniontown Hospital (Hospital). These events are open to the public free of charge. They are advertised both on the Hospitals website and in a newspaper that is widely read throughout Fayette County. The practices physicians are critical to these events as they contribute their expertise by serving as speakers, free of charge. Consistent with its charitable mission to meet the health care needs of the residents of the community without regard to their ability to pay, the Networks physician practices adhere to the generous charity care program of the Fayette Regional Health System, called the Safety Net Access Program (SNAP). The SNAP policy is centered on the principle that medically necessary services will be rendered gratuitously to patients that demonstrate financial need and the provision of charity is viewed as the core of the Network, physician practices and the Fayette Regional Health Systems charitable purpose.
Part VI Governance, Management, and DisclosureSection A: Governing Body and Management Question 6: Fayette Physician Network, Inc. has two exempt entity members, UPMC Community Medicine, Inc. and Fayette Regional Health System. Question 7A: The two exempt entity members, UPMC Community Medicine, Inc. and Fayette Regional Health System, have the ability to appoint 3 board members each to Fayette Physician Network, Inc. as stipulated in the by-laws of Fayette Physician Network, Inc. Question 7B: UPMC Community Medicine and Fayette Regional Health System, as the members of Fayette Physician Network, Inc., have the right to approve certain actions and transactions of Fayette Physician Network, Inc. The specific transactions that are subject to the approval of the members are stipulated in the By-laws.
Section B: PoliciesQuestion 11: A full copy of the form 990 was provided to each Board of Directors member prior to filing. Question 12c: Fayette Physician Network, Inc. requires all of its key employees and non-employed personnel to comply with its conflict of interest policies when they engage in Fayette Physician Network, Inc.-related business. This COI policy is that of its exempt member UPMC Community Medicine, Inc. People covered by the policies include: -Fayette Physician Network, Inc. entity board members, board committee members, and corporate officers -Fayette Physician Network, Inc. physicians and non-physician employees who hold a position of influence These people are required to complete a questionnaire at least annually. An electronic form has been developed to capture the data from the questionnaire and to monitor completion. The information, along with other data, is used to capture individual and institutional relationships so that potential conflicts of interest can be identified. If a potential conflict is identified regarding a specific activity the corporate compliance department, with the assistance of the legal department of UPMC, would evaluate the activity in relation to the potential conflict. If a perceived or actual conflict is determined to exist and a decision is made to proceed with the activity, a written plan designed to prevent the conflict from influencing decisions related to the activity is developed.
Part VI Governance, Management, and DisclosureSection A: Governing Body and Management Question 4: As of June 27, 2019 UPMC Community Medicine, Inc. transferred its 50% membership interest in Fayette Physician Network, Inc. to Fayette Regional Health System (Fayette) making Fayette the sole member of Fayette Physician Network, Inc. as of this date. Section C: Disclosure Question 19: Upon request, management determines public disclosure applicability.
PART VII AND SCHEDULE JSECTION A, OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES. The disclosure for compensation is based on total calendar year 2018 amounts.
PART VIISECTION B INDEPENDENT CONTRACTORS The disclosure for independent contractors is based on total calendar year 2018 information.
Part XI, Reconciliation of Net AssetsReconciliation of Net Assets Line 9: Other Changes in Net Assets. The amount of $20,566,372 Other Changes in Net Assets represents the transfer from exempt member organizations. Part XI Reconciliation of Net Assets Transfers from Exempt Members 20,566,372 TOTAL 20,566,372