2016-02-24T18:33:16-06:00 2015-06-30 KPMG LLP 1918 Eighth Avenue Suite 2900 Seattle WA 98101 990 2014-07-01 930608012 UNIVERSITY MEDICAL GROUP % JOHN KULAWIEC UNIV 5034948423 1706 NW 24th AVENUE PORTLAND OR 97296 THOMAS M HECKLER COO 5034948423 2016-02-16 true SUE W ROBISON P00560072 2069134000 2014 2016-08-17 19:52:53Z TOM HECKLER 1706 NW 24TH AVE 29166 PORTLAND OR 97296 15539599 false X N/A X 1998 OR UNIVERSITY MEDICAL GROUP IS ORGANIZED AND AT ALL TIMES WILL BE OPERATED FOR THE BENEFIT OF OREGON HEALTH & SCIENCE UNIVERSITY TO PROVIDE ADMINISTRATIVE AND MANAGMENT SERVICES 9 0 156 0 0 0 0 13798957 15536381 3497 3218 0 0 13802454 15539599 0 0 0 0 10198276 10172048 0 0 0 4309718 4799250 14507994 14971298 -705540 568301 7156815 7855350 1977439 2107676 5179376 5747674 THE SOLE PURPOSE OF UNIVERSITY MEDICAL GROUP IS TO PROVIDE A VARIETY OF ADMINISTRATIVE AND MANAGEMENT SERVICES TO OREGON HEALTH & SCIENCE UNIVERSITY FACULTY PRACTICE PLAN. THESE SERVICES INCLUDE BILLING, COLLECTION, HUMAN RESOURCES, PAYROLL, AND ACCOUNTING SERVICES false false 14923985 15536381 UNIVERSITY MEDICAL GROUP (UMG) IS ORGANIZED AND OPERATED EXCLUSIVELY TO SUPPORT THE CHARITABLE, EDUCATIONAL, AND SCIENTIFIC MISSIONS OF OREGON HEALTH & SCIENCE UNIVERSITY (OHSU). THE SOLE PURPOSE OF UMG IS TO PROVIDE A VARIETY OF SERVICES TO OHSU, INCLUDING PROFESSIONAL FEE BILLING AND COLLECTION AND REVENUE CYCLE MANAGEMENT. UMG PROVIDED BILLING AND COLLECTION SERVICES FOR 1,482 OHSU CLINICIANS DURING FY 2015. 14923985 true false false false false false false false false true false false false true false true true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 10 0 156 true false false false false false false false false false false X 9 0 false false false false false false false true true false false true true true true false true false false false OR X JOHN KULAWIEC 5034948423 2055 NW SAVIER STREET 201 PORTLAND OR 97209 Richardson Mark A Director-Chairman 0.3 50.0 X 0 912283 67894 Balaji Seshadri Director 0.3 50.0 X 0 277816 31430 Halvorson Stephanie Director 0.3 50.0 X 0 164516 19407 Kaufman John Director 0.3 50.0 X 0 558440 68080 Keepers George Director 0.3 50.0 X 0 422724 52995 Anderson Sharon Director 0.3 50.0 X 0 441779 39893 Coakley Fergus Director 0.3 50.0 X 0 663274 35534 Crawford Dennis Director 0.3 50.0 X 0 564731 50205 Zaman Atif Director 0.3 50.0 X 0 406293 37135 Heckler Thomas M Chief Executive Officer 4.0 40.0 X 33025 314800 40326 Navigato Matthew L Chief Operating Officer 50.0 25.0 X 203746 78888 31097 Norrish Jennifer Operations Manager 40.0 0.0 X 143107 0 15244 Bickle Tammy Assistant Director 40.0 0.0 X 140263 0 16787 Johnson Jessica Operations Manager 40.0 0.0 X 136327 0 15290 Duncan Barbara Information Service Manager 40.0 0.0 X 132839 0 14876 Searls Angela Human Resource Manager 40.0 0.0 X 128574 0 13572 Flint Paul Former Director 0.0 50.0 X 0 617156 39067 Caughey Aaron Former Director 0.0 50.0 X 0 538544 38805 Yackel Thomas Former Director 0.0 50.0 X 0 298939 57984 Cigarroa Joaquin Former Director 0.0 50.0 X 0 451247 64694 Thomas Charles Former Director 0.0 50.0 X 0 584291 50538 Hunter John Former Director 0.0 50.0 X 0 728318 46218 Saultz John Former Director 0.0 50.0 X 0 323585 39273 Nicholson Stacy Former Director 0.0 50.0 X 0 411861 42306 Burchiel Kim Former Director 0.0 50.0 X 0 885575 57165 Nichols Mark Former Director 0.0 50.0 X 0 97681 2820 Koh Jeffrey Former Director 0.0 50.0 X 0 369639 50250 Wilson David Former Director 0.0 50.0 X 0 745406 90850 917881 10857786 1129735 6 true true false NCO FINANCIAL SYSTEM 500 N FRANKLIN TURNPIKE RAMSEY NJ 07446 CUSTOMER SERVICE 658494 CLAIMLOGIC INC 3535 NW 58TH STREET SUITE 1010 OKLAHOMA CITY OK 73112 CLAIMS PROCESSING 105543 2 0 BILLING FEES 339110 15263019 15263019 0 0 GRANTS & REIMBURSEMENTS 339110 273362 273362 0 0 15536381 3218 0 0 3218 0 0 0 0 0 0 0 0 0 0 15539599 15536381 0 3218 0 0 0 0 273158 240088 33070 0 7141440 7141440 453692 449724 3968 1695065 1687505 7560 608693 605978 2715 0 14319 14319 88176 88176 0 0 0 918675 918675 0 149061 149061 0 0 508467 508467 56789 56789 0 47198 47198 0 0 155677 155677 29324 29324 Data Processing 1230546 1230546 0 0 Training 1214319 1214319 0 0 Printing, Postage, Supplies 245247 245247 0 0 Communications 125055 125055 0 0 16397 16397 14971298 14923985 47313 0 1349983 2667133 3678729 3106504 0 0 1550275 1599614 0 0 0 0 0 0 0 0 59506 60875 1937615 1516391 518322 421224 0 0 0 0 0 0 0 0 0 0 7156815 7855350 1541232 1537960 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436207 569716 1977439 2107676 X 5179376 5747674 0 0 0 0 5179376 5747674 7156815 7855350 568301 -3 X false true X true false X X 1 OREGON HEALTH & SCIENCE UNIVERSITY 931176109 6 true 14815621 0 1 14815621 true false false false false false false false false false false false false false false true false AMOUNT OF SUPPORT SEE SCHEDULE O, STATEMENT 1 DESCRIPTION OF SUPPORT SEE SCHEDULE O, STATEMENT 2 226414 87547 138867 1711202 1428845 282357 421224 0 DUE TO AFFILIATES 387532 DEFERRED RENT OBLIGATION 182184 569716 15539599 15539599 15539599 14971298 14971298 14971298 X X false false false false false false false false false Richardson Mark A Director-Chairman 0 738490 0 155313 0 18480 0 65598 0 2296 0 980177 0 0 Balaji Seshadri Director 0 257446 0 0 0 20370 0 31200 0 230 0 309246 0 0 Halvorson Stephanie Director 0 144146 0 0 0 20370 0 18754 0 653 0 183923 0 0 Kaufman John Director 0 466983 0 72977 0 18480 0 65598 0 2482 0 626520 0 0 Keepers George Director 0 384244 0 20000 0 18480 0 47005 0 5990 0 475719 0 0 Anderson Sharon Director 0 420860 0 20000 0 919 0 31200 0 8693 0 481672 0 0 Coakley Fergus Director 0 610890 0 32014 0 20370 0 24830 0 10704 0 698808 0 0 Crawford Dennis Director 0 545363 0 1170 0 18198 0 42198 0 8007 0 614936 0 0 Zaman Atif Director 0 383223 0 2700 0 20370 0 36400 0 735 0 443428 0 0 Flint Paul Former Director 0 481123 0 40000 0 96033 0 31200 0 7867 0 656223 0 0 Caughey Aaron Former Director 0 489672 0 30222 0 18650 0 24830 0 13975 0 577349 0 0 Yackel Thomas Former Director 0 249675 0 34108 0 15156 0 52000 0 5984 0 356923 0 0 Cigarroa Joaquin Former Director 0 361617 0 68105 0 21525 0 52000 0 12694 0 515941 0 0 Thomas Charles Former Director 0 543921 0 20000 0 20370 0 36400 0 14138 0 634829 0 0 Hunter John Former Director 0 667579 0 38140 0 22599 0 29198 0 17020 0 774536 0 0 Saultz John Former Director 0 284805 0 20025 0 18755 0 35579 0 3694 0 362858 0 0 Nicholson Stacy Former Director 0 391234 0 0 0 20627 0 41600 0 706 0 454167 0 0 Burchiel Kim Former Director 0 845205 0 20000 0 20370 0 52000 0 5165 0 942740 0 0 Nichols Mark Former Director 0 84921 0 0 0 12760 0 0 0 2820 0 100501 0 0 Koh Jeffrey Former Director 0 349249 0 0 0 20390 0 46800 0 3450 0 419889 0 0 Wilson David Former Director 0 701700 0 20000 0 23706 0 82771 0 8079 0 836256 0 0 Heckler Thomas M Chief Executive Officer 33025 256470 0 37960 0 20370 4115 29198 0 7013 37140 351011 0 0 Navigato Matthew L Chief Operating Officer 168844 67738 26027 11150 8875 0 23384 7534 0 179 227130 86601 0 0 Norrish Jennifer Operations Manager 119250 0 7780 0 16077 0 15244 0 0 0 158351 0 0 0 Bickle Tammy Assistant Director 125587 0 14305 0 371 0 16787 0 0 0 157050 0 0 0 Johnson Jessica Operations Manager 118171 0 9248 0 8908 0 15290 0 0 0 151617 0 0 0 COMPENSATION FROM UNRELATED ORGANIZATIONS SCHEDULE J, PART II A PORTION OF THOMAS M. HECKLER'S BASE COMPENSATION AND DEFERRED COMPENSATION ARE PAID BY OREGON HEALTH & SCIENCE UNIVERSITY (OHSU). OHSU AND UNIVERSITY MEDICAL GROUP HAVE A SHARED SERVICE AGREEMENT WHEREBY UNIVERSITY MEDICAL GROUP PROVIDES OHSU WITH MANAGEMENT, STAFFING AND OTHER SERVICES. MR. HECKLER'S BASE COMPENSATION AND DEFERRED COMPENSATION ARE INCLUDED IN THE SHARED SERVICES AGREEMENT FEE THAT OHSU PAYS TO UNIVERSITY MEDICAL GROUP. A PORTION OF MATTHEW L. NAVIGATO'S BASE COMPENSATION AND DEFERRED COMPENSATION ARE PAID BY OREGON HEALTH & SCIENCE UNIVERSITY (OHSU). OHSU AND UNIVERSITY MEDICAL GROUP HAVE A SHARED SERVICE AGREEMENT WHEREBY UNIVERSITY MEDICAL GROUP PROVIDES OHSU WITH MANAGEMENT, STAFFING AND OTHER SERVICES. MR NAVIGATO'S BASE COMPENSATION AND DEFERRED COMPENSATION ARE INCLUDED IN THE SHARED SERVICES AGREEMENT FEE THAT OHSU PAYS TO UNIVERSITY MEDICAL GROUP. PROCESS TO REVIEW FORM 990 FORM 990, PART VI, LINE 11B AN OUTSIDE ACCOUNTING FIRM PREPARED THE FEDERAL FORM 990. THE CONTROLLER AND THE CHIEF EXECUTIVE OFFICER (CEO) OF UNIVERSITY MEDICAL GROUP (UMG) REVIEW THE FORM 990. THE CEO REPORTS THE ORGANIZATION'S OPERATING AND FINANCIAL RESULTS TO THE UMG BOARD OF DIRECTORS. THE FEDERAL FORM 990 IS ALSO PROVIDED TO THE UMG BOARD OF DIRECTORS PRIOR TO FILING. CONFLICT OF INTEREST DISCLOSURE FORM 990, PART VI, LINE 12C AN INSTITUTIONAL CONFLICT OF INTEREST (ICOI) MAY EXIST WHEN UMG BOARD OF DIRECTOR MEMBERS OR EXECUTIVES HAVE EXTERNAL RELATIONSHIPS OR FINANCIAL INTEREST (HEREINAFTER DEFINED AS SIGNIFICANT FINANCIAL INTERESTS) IN A COMPANY OR ORGANIZATION THAT HAS SIGNIFICANT BUSINESS TRANSACTIONS WITH THE ORGANIZATION. THESE DUAL RELATIONSHIPS MAY INTERFERE, OR APPEAR TO INTERFERE, WITH THE OBLIGATION TO ACT IN THE ORGANIZATION'S BEST INTEREST. BECAUSE THE APPEARANCE OF A CONFLICT MAY BE AS DAMAGING TO THE PUBLIC TRUST AS AN ACTUAL CONFLICT, POTENTIAL CONFLICTS MUST BE DISCLOSED, EVALUATED, AND MANAGED WITH THE SAME THOROUGHNESS AS ACTUAL CONFLICTS. THE INTEGRITY PROGRAM OVERSIGHT COUNCIL (IPOC) IS THE BOARD-DESIGNATED BODY TO REVIEW POTENTIAL ICOI'S AS DESCRIBED ABOVE. POTENTIAL ICOI'S WILL BE IDENTIFIED THROUGH THE EXECUTIVE AND BOARD MEMBER CONFLICT OF INTEREST DISCLOSURES AND OTHER SOURCES. THIS POLICY APPLIES TO ALL UMG BOARD OF DIRECTORS MEMBERS AND UMG EXECUTIVES. UMG BOARD OF DIRECTORS MEMBERS AND UMG EXECUTIVES SHALL DISCLOSE TO THE IPOC ANNUALLY, ON A FORM APPROVED BY THE IPOC, RELATIONSHIPS AND CIRCUMSTANCES THAT COULD, TO THE BEST OF THE EXECUTIVE'S KNOWLEGE, POSE A POTENTIAL OR ACTUAL CONFLICT OF INTEREST UNDER THIS POLICY. IF THE IPOC BELIEVES A DISCLOSURE POSES A POTENTIAL OR ACTUAL CONFLICT, IT SHALL INDICATE TO THE UMG BOARD OF DIRECTORS MEMBER OR UMG EXECUTIVE HOW TO DISPOSE OF OR MANAGE THE CONFLICT. DISCLOSURES ARE DUE ANNUALLY. IF THE RESPONSES TO ANY OF THE QUESTIONS CHANGE DURING THE YEAR, THE DISCLOSURE FORM MUST BE REVISED AND RESUBMITTED. ANY REAL OR APPARENT ICOI MUST BE REVIEWED BY THE IPOC, WHICH MAY IMPOSE MANAGEMENT CONDITIONS INCLUDING, BUT NOT LIMITED TO: A. ENSURING THAT INSTITUTIONAL FINANCIAL INTERESTS AND INVESTMENTS ARE BEING MANAGED BY INDIVIDUALS/DEPARTMENTS THAT ARE NOT INVOLVED IN PURCHASING, PROCUREMENT, CONTRACTING, RESEARCH, OR OTHER OPERATIONS DECISIONS AND OVERSIGHT; B. REQUIRING PUBLIC DISCLOSURE OF THE INSTITUTIONAL COI IN PUBLICATIONS, PRESENTATIONS, OR OTHER PUBLIC ANNOUNCEMENTS; C. IMPOSING AN ESCROW PERIOD FOR REALIZING A FINANCIAL GAIN (CASHING OUT); D. DIVESTING THE FINANCIAL INTEREST; E. REASSIGNING, REMOVING, OR OTHERWISE MAKING A FIREWALL FOR EXECUTIVES WHO MAY BE CONFLICTED OR PERCEIVED AS NOT HAVING "CLEAN HANDS" FOR ANY BUSINESS DECISIONS OR ACTIVITIES INVOLVING ANY ENTITY WITH WHICH THE EXECUTIVE HAS A SIGNIFICANT FINANCIAL INTEREST; F. NOTIFICATION TO A DONOR THAT GIFTS TO UMG WILL NOT BE TAKEN INTO ACCOUNT FOR FUTURE BUSINESS RELATIONSHIPS, OR REFUSAL OR RETURN OF GIFTS, ENTERTAINMENT, OR OTHER PREREQUISITES FROM AN ENTITY THAT HAS A BUSINESS RELATIONSHIP WITH UMG OR IN WHICH UMG AND/OR AN EXECUTIVE HAS AN INVESTMENT; AND/OR G. OTHER MANAGEMENT PLANS THAT THE IPOC MAY DESIGN. ICOI MANAGEMENT IS IN ADDITION TO ANY MANAGEMENT THAT MIGHT APPLY FOR INDIVIDUAL CONFLICTS OF INTEREST. PROCESS TO DETERMINE COMPENSATION Form 990, Part VI, Line 15A & 15B The compensation for the University Medical Group COO, also serving as the OHSU Director of Enterprise Revenue Cycle, was derived by data gathered from Milliman Healthcare salary survey and the Academic Association of Medical Colleges (AAMC)-APPD Annual Salary Survey. Along with MBL Group, a compensation consultancy, utilizing their larger databases and other sources, the UMG CEO and OHSU Hospital CFO determined the base pay level. For incentive compensation, formulaic components consistent with the OHSU Management Incentive Program (MIP) were used to define the bonus amount based upon the rollup of various revenue cycle performance goals across both UMG and OHSU. The CEO and Hospital CFO presented the performance evaluation, bonus goal results and a base compensation & bonus proposal to the Dean of the OHSU School of Medicine and the OHSU Executive Vice President for their collective approval. The compensation for the University Medical Group CEO, who also holds the position of OHSU Senior Associate Dean, is based on time allocated to efforts devoted to the University Medical Group revenue cycle. As of January 2009, it was determined that this effort represented approximately 10% of total time spent. Compensation from University Medical Group remains fixed based upon this percentage of his OHSU base pay at that time. OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE FORM 990, PART VI, LINE 19 WHILE FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION, UNIVERSITY MEDICAL GROUP WILL PROVIDE THESE DOCUMENTS UPON REQUEST. STATEMENT 1 AMOUNT OF SUPPORT SCHEDULE A, PART I, LINE 11H, COLUMN VII TOTAL FUNCTIONAL EXPENSES FORM 990 PART IX $14,971,298 DEPRECIATION FORM 990 PART IX LINE 22 $ (155,677) ---------------- TOTAL SUPPORT PROVIDED TO OREGON HEALTH & SCIENCE UNIV $14,815,621 STATEMENT 2 DESCRIPTION OF SUPPORT SCHEDULE A, PART I, LINE 11H, COLUMN VII UNIVERSITY MEDICAL GROUP IS ORGANIZED AND OPERATED TO PROVIDE ADMINISTRATIVE AND MANAGEMENT SERVICES TO OREGON HEALTH & SCIENCE UNIVERSITY. TOTAL SUPPORT OF $14,815,621 CONSISTS OF VARIOUS EXPENSES PAID ON BEHALF OF OREGON HEALTH & SCIENCE UNIVERSITY. SEE FORM 990, PART IX FOR ADDITIONAL DETAIL. OREGON HEALTH & SCIENCE UNIVERSITY 3181 SW SAM JACKSON PARK ROAD PORTLAND OR 97239 931176109 HOSP & UNIV. OR NA false false false false false true false false false false false false true false false true true true false false