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FLORIDA MEDICAL PRACTICE PLAN INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
FLORIDA MEDICAL PRACTICE PLAN INC (EIN 57-1234883)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-05-14
IRS object ID
201521349349307147
Schema version
2013v4.0
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)
Return2015-05-14T15:23:10-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN590548468PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PURVIS GRAY & COMPANY LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1443 EAST COLLEGE AVENUEAddressLine1
CityTALLAHASSEECity
StateFLState
ZIP Code32301ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN571234883EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FLORIDA MEDICAL PRACTICE PLAN INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlFLORBusinessNameControlTxt
Phone8506452827PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11115 WEST CALL STREETAddressLine1
CityTALLAHASSEECity
StateFLState
ZIP Code32306ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN P FOGARTY MDPersonNm
Person TitlePRESIDENT, FMPPPersonTitleTxt
Phone8506452827PhoneNum
Signature2015-05-06SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRYAN M TUCKER CPAPreparerPersonNm
PTINP00524189PTIN
Phone8502247144PhoneNum
Preparation2015-05-06PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJOHN P FOGARTYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11115 WEST CALL STREETAddressLine1
CityTALLAHASSEECity
StateFLState
ZIP Code32306ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$12,065,166GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MED.FSU.EDU/FMPPWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2006FormationYr
Legal Domicile StateFLLegalDomicileStateCd
Activity Or MissionTHE PURPOSES OF FLORIDA MEDICAL PRACTICE PLAN ARE TO: 1) FURTHER THE EDUCATION, SERVICE, AND RESEARCH MISSIONS OF THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE, A COMPONENT OF THE FLORIDA STATE UNIVERSITY BOARD OF TRUSTEES; AND 2) ENABLE FACULTY TO MAINTAIN CLINICAL COMPETENCE, FULFILL CERTIFICATION REQUIREMENTS, SHARE EXPERTISE WITH OTHER HEALTH CARE PROVIDERS, AND SERVE AS CLINICAL TEACHERS FOR STUDENTS AND RESIDENT PHYSICIANS.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$11,811,302PYProgramServiceRevenueAmt
CY Program Service Revenue$12,052,714CYProgramServiceRevenueAmt
PY Investment Income$6,970PYInvestmentIncomeAmt
CY Investment Income$4,390CYInvestmentIncomeAmt
PY Other Revenue$5,212PYOtherRevenueAmt
CY Other Revenue$8,062CYOtherRevenueAmt
PY Total Revenue$11,823,484PYTotalRevenueAmt
CY Total Revenue$12,065,166CYTotalRevenueAmt
PY Grants And Similar Paid$43,250PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$78,759CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$9,328,122PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,290,514CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,028,862PYOtherExpensesAmt
CY Other Expenses$2,018,157CYOtherExpensesAmt
PY Total Expenses$11,400,234PYTotalExpensesAmt
CY Total Expenses$12,387,430CYTotalExpensesAmt
PY Revenues Less Expenses$423,250PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$322,264CYRevenuesLessExpensesAmt
Total Assets BOY$3,993,965TotalAssetsBOYAmt
Total Assets EOY$3,701,473TotalAssetsEOYAmt
Total Liabilities BOY$1,650,610TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,680,382TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,343,355NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,021,091NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE PURPOSES OF FLORIDA MEDICAL PRACTICE PLAN ARE TO: 1) FURTHER THE EDUCATION, SERVICE, AND RESEARCH MISSIONS OF THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE, A COMPONENT OF THE FLORIDA STATE UNIVERSITY BOARD OF TRUSTEES; AND 2) ENABLE FACULTY TO MAINTAIN CLINICAL COMPETENCE, FULFILL CERTIFICATION REQUIREMENTS, SHARE EXPERTISE WITH OTHER HEALTH CARE PROVIDERS, AND SERVE AS CLINICAL TEACHERS FOR STUDENTS AND RESIDENT PHYSICIANS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$12,240,716ExpenseAmt
Grant$78,759GrantAmt
Revenue$12,060,776RevenueAmt
DescPERFORMED PROFESSIONAL SERVICES IN SUPPORT OF: 1) AN AFFILIATION AGREEMENT WITH A HOSPITAL FOR GRADUATE MEDICAL EDUCATION PROGRAMS, AND 2) AGREEMENTS WITH HEALTH DEPARTMENTS, CLINICS, AND OTHERS FOR PATIENT CARE.Desc
Total Program Service Expenses$12,240,716TotalProgramServiceExpensesAmt
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 EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesYes (true)ForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
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 EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document12IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
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
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
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 CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDAWN SNYDERPersonNm
Phone8506452827PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11115 WEST CALL STREETAddressLine1
CityTALLAHASSEECity
StateFLState
ZIP Code32306ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
JOHN P FOGARTY MD
PRESIDENT2.0040.00Yes (X)Yes (X)$0$387,511$33,852
GARNETT S STOKES PHD
DIRECTOR0.5040.00Yes (X)$0$336,482$19,570
RICARDO GONZALEZ-ROTHI MD
DIRECTOR1.0040.00Yes (X)$0$288,937$33,576
ALMA B LITTLES MD
SEC/TREASURE1.0040.00Yes (X)Yes (X)$0$266,877$33,943
DANIEL J VAN DURME MD
VICE PRESIDE1.0040.00Yes (X)Yes (X)$0$264,430$33,975
KENNETH V BRUMMEL-SMITH MD
DIRECTOR1.0040.00Yes (X)$0$253,635$36,392
LESLIE M BEITSCH MD JD
DIRECTOR1.0040.00Yes (X)$0$239,631$31,129
RICHARD S NOWAKOWSKI PHD
DIRECTOR1.0040.00Yes (X)$0$235,846$28,042
DAVID COBURN
DIRECTOR0.5040.00Yes (X)$0$194,096$17,814
KYLE CLARK MBA
VICE PRESIDE1.0040.00Yes (X)Yes (X)$0$106,600$12,401
FieldValueIRS element (for citing)
Tot Reportable Comp Rltd Org$2,574,045TotReportableCompRltdOrgAmt
Total Other Compensation$280,694TotalOtherCompensationAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
FSU COLLEGE OF MEDICINE SELF INSURAN
PO BOX 112735GAINESVILLEFL32611MALPRACTICE INS$503,180
BLUE CROSS BLUE SHIELD OF FLORIDA
PO BOX 44144JACKSONVILLEFL32231HEALTH INSURANC$221,157
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CLINICAL REVENUE624100$11,845,428$11,845,428
MEDICAID REVENUE624100$207,286$207,286
FieldValueIRS element (for citing)
Total Program Service Revenue$12,052,714TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,390TotalRevenueColumnAmt
Exclusion$4,390ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCREDIT CARD REBATEDesc
Total Revenue Column$8,062TotalRevenueColumnAmt
Exclusion$8,062ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$8,062OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,065,166TotalRevenueColumnAmt
Related Or Exempt Func Income$12,052,714RelatedOrExemptFuncIncomeAmt
Exclusion$12,452ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$78,759TotalAmt
Program Services$78,759ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$8,988,229TotalAmt
Program Services$8,988,229ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$428,527TotalAmt
Program Services$428,527ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$503,724TotalAmt
Program Services$503,724ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$370,034TotalAmt
Program Services$370,034ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$117,322TotalAmt
Program Services$117,322ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$21,500TotalAmt
Management And General$21,500ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$295,998TotalAmt
Program Services$295,998ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$13,203TotalAmt
Management And General$13,203ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$112,011TotalAmt
Management And General$112,011ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$55,858TotalAmt
Program Services$55,858ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$20,900TotalAmt
Program Services$20,900ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$142,721TotalAmt
Program Services$142,721ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$789,345TotalAmt
Program Services$789,345ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
MEDICAL SUPPLIES$281,456$281,456
TRAINING$68,444$68,444
MEMBERSHIPS/LICENSURE$41,985$41,985
REGISTRATION FEES$35,070$35,070

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$22,344TotalAmt
Program Services$22,344ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$12,387,430TotalAmt
Program Services$12,240,716ProgramServicesAmt
Management And General$146,714ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,091,416BOYAmt
EOY$2,146,051EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,767,462BOYAmt
EOY$1,295,610EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$43,386BOYAmt
EOY$59,502EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$65,624BOYAmt
EOY$162,298EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$26,077BOYAmt
EOY$38,012EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,993,965BOYAmt
EOY$3,701,473EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$101,438BOYAmt
EOY$90,520EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,549,172BOYAmt
EOY$1,589,862EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,650,610BOYAmt
EOY$1,680,382EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY$2,343,355BOYAmt
EOY$2,021,091EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,343,355BOYAmt
EOY$2,021,091EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,993,965BOYAmt
EOY$3,701,473EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$322,264ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
CertificationYes (X)CertificationInd
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1FLORIDA STATE UNIVERSITYBusinessNameLine1
FieldValueIRS element (for citing)
EIN591961248EIN
Organization Type2OrganizationTypeDesc
Governing Document ListedYes (true)GoverningDocumentListedInd
Supported Org NotifiedYes (true)SupportedOrgNotifiedInd
US OrganizedYes (true)USOrganizedInd
Support$10,346,590SupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$10,346,590SupportSumAmt

Schedule D IRS990ScheduleD

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescFLORIDA STATE UNIVERSITY AUXILIARYDesc
Amt$1,589,862Amt
FieldValueIRS element (for citing)
Total Liability$1,589,862TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$12,062,572TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$12,062,572RevenueSubtotalAmt
Other Revenues Not Included$2,594OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,594RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$12,065,166TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$12,384,836TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$12,384,836ExpensesSubtotalAmt
Other Expenses Not Included$2,594OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,594ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$12,387,430TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 4, PART XI, LINE 4BCLASSIFY BAD DEBTS AS EXPENSE 2,594
SCHEDULE D, PAGE 4, PART XII, LINE 4BBAD DEBT EXPENSE 2,594

Schedule F IRS990ScheduleF

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintainedInd

Account Activities Outside US AccountActivitiesOutsideUSGrp (3 entries)

RegionRegionTxtType Of Activities ConductedTypeOfActivitiesConductedTxtSpecific Services ProvidedSpecificServicesProvidedTxtRegion Total ExpendituresRegionTotalExpendituresAmt
CENTRAL AMERICA AND THE CARIBBEANPROGRAM SERVICEMEDICAL MISSION TRIP$11,305
EAST ASIA AND THE PACIFICEDUCATIONEDUCATIONAL RELATION$9,135
SOUTH ASIAREIMBURSEMENTREIMBURSE RESIDENT$1,239
FieldValueIRS element (for citing)
Subtotal Spent$21,679SubtotalSpentAmt
Total Spent$21,679TotalSpentAmt
Transfer To Foreign CorpfalseTransferToForeignCorpInd
Interest In Foreign TrustfalseInterestInForeignTrustInd
Foreign Corp OwnershipfalseForeignCorpOwnershipInd
Passive Foreign Investmest CofalsePassiveForeignInvestmestCoInd
Foreign PartnershipfalseForeignPartnershipInd
Boycott CountriesfalseBoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE F, PAGE 1, PART I, LINE 3FormAndLineReferenceDesc
ExplanationCENTRAL AMERICA AND THE CARIBBEAN 11,305 0 EAST ASIA AND THE PACIFIC 9,135 0 SOUTH ASIA 1,239 0ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1FLORIDA STATE UNIVERSITY FOUNDATIONBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1INNOVATION PARK 2010 LEVY AVENUEAddressLine1
CityTALLAHASSEECity
StateFLState
ZIP Code32306ZIPCode
FieldValueIRS element (for citing)
Recipient EIN596152180RecipientEIN
IRC Section501C3IRCSectionDesc
Cash Grant$73,247CashGrantAmt
Purpose Of GrantCONTRIBUTIONPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
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 PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmt
JOHN P FOGARTY MD
PRESIDENT$387,267$244$17,611$16,241$421,363
GARNETT S STOKES PHD
DIRECTOR$330,238$244$17,303$2,267$356,052$6,000
RICARDO GONZALEZ-ROTHI MD
DIRECTOR$288,693$244$17,665$15,911$322,513
ALMA B LITTLES MD
SEC/TREASURER$266,633$244$16,542$17,401$300,820
DANIEL J VAN DURME MD
VICE PRESIDENT$259,297$244$17,398$16,577$298,405$4,889
KENNETH V BRUMMEL-SMITH MD
DIRECTOR$253,391$244$16,591$19,801$290,027
LESLIE M BEITSCH MD JD
DIRECTOR$222,912$244$14,760$16,369$270,760$16,475
RICHARD S NOWAKOWSKI PHD
DIRECTOR$235,602$244$15,609$12,433$263,888
DAVID COBURN
DIRECTOR$143,846$2,250$17,764$50$211,910$48,000

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART IIIFormAndLineReferenceDesc
ExplanationTHROUGH THE RELATED ORGANIZATION THAT EMPLOYS THEM, ONE OF THE INDIVIDUALS REPORTED IN PART VII OF FORM 990 AND IN SCHEDULE J (FORM 990) PARTICIPATES IN THE FLORIDA RETIREMENT SYSTEM (FRS), A MULTI-EMPLOYER RETIREMENT SYSTEM CREATED UNDER CHAPTER 121 OF THE FLORIDA STATUTES AND ADMINISTERED BY THE FLORIDA DIVISION OF RETIREMENT. AS STATED ON THE WEBSITE OF FRS, IT IS FUNDED BY CONTRIBUTIONS PAID BY EMPLOYERS, BASED ON A PERCENTAGE OF THE EMPLOYEES' SALARIES AND A THREE PERCENT CONTRIBUTION BY THE EMPLOYEE. THE RATE OF CONTRIBUTIONS REQUIRED IS DETERMINED BY AN ACTUARIAL CONSULTING FIRM TO ASSURE COMPLIANCE WITH THE REQUIREMENTS OF THE CONSTITUTION OF THE STATE OF FLORIDA. THE INSTRUCTIONS FOR FORM 990 INDICATE THAT PART VII AND SCHEDULE J SHOULD INCLUDE A REASONABLE ESTIMATE OF THE INCREASE IN THE ACTUARIAL VALUE OF ANY QUALIFIED OR NONQUALIFIED RETIREMENT ACCRUALS UNDER A DEFINED BENEFIT PLAN. FRS HAS STATED THAT SUCH INFORMATION CURRENTLY IS NOT AVAILABLE FOR PARTICIPANTS IN ITS PLAN. THEREFORE, THE AMOUNTS REPORTED IN PART VII AND SCHEDULE J, AS APPROPRIATE, INCLUDE THE CONTRIBUTION PAID BY THE RELATED ORGANIZATION AS ITS CONTRIBUTION ON BEHALF OF THE NAMED INDIVIDUAL. THIS AMOUNT IS CONSIDERED THE BEST REASONABLE ESTIMATE OF INFORMATION REQUIRED IN THIS FORM 990 AND RELATED SCHEDULES.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSIONTHE PURPOSES OF FLORIDA MEDICAL PRACTICE PLAN ARE TO: 1) FURTHER THE EDUCATION, SERVICE, AND RESEARCH MISSIONS OF THE FLORIDA STATE UNIVERSITY COLLEGE OF MEDICINE, A COMPONENT OF THE FLORIDA STATE UNIVERSITY BOARD OF TRUSTEES; AND 2) ENABLE FACULTY TO MAINTAIN CLINICAL COMPETENCE, FULFILL CERTIFICATION REQUIREMENTS, SHARE EXPERTISE WITH OTHER HEALTH CARE PROVIDERS, AND SERVE AS CLINICAL TEACHERS FOR STUDENTS AND RESIDENT PHYSICIANS.
FORM 990FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES: THE FLORIDA MEDICAL PRACTICE PLAN, INC. DOES NOT HAVE EMPLOYEES. THE SALARIES AND BENEFITS REPORTED ON THE STATEMENT OF FUNCTIONAL EXPENSES ARE SALARIES AND BENEFITS REIMBURSED TO FLORIDA STATE UNIVERSITY. OTHER REIMBURSEMENTS TO FLORIDA STATE UNIVERSITY INCLUDE MANAGEMENT FEES AND INSURANCE EXPENSES.
FORM 990, PAGE 6, PART VI, LINE 2ALMA B. LITTLES, M.D. JOHN P. FOGARTY, M.D. DIRECTOR DIRECTOR ON AMA COUNCIL TOGETHER ALMA B. LITTLES, M.D. DANIEL J. VAN DURME, M.D. DIRECTOR DIRECTOR ON FAFP BOARD TOGETHER ALMA B. LTTILES, M.D. GARNETT S. STOKES, PH.D. DIRECTOR DIRECTOR ON FSU ATHLETIC BOARD TOGETHER GARNETT S. STOKES, PH.D. KYLE CLARK, MBA DIRECTOR DIRECTOR ON 3 OTHER FSU BOARDS TOGETHER GARNETT S. STOKES, PH.D. DAVID COBURN DIRECTOR DIRECTOR ON 3 OTHER FSU BOARDS TOGETHER
FORM 990, PAGE 6, PART VI, LINE 11BA COPY OF THE FINAL FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS THROUGH ELECTRONIC MAIL PRIOR TO SUBMITTAL TO THE INTERNAL REVENUE SERVICE.
FORM 990, PAGE 6, PART VI, LINE 12CANY DIRECTOR, PRINCIPAL, OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, IS COVERED UNDER THE POLICY. ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST MUST BE DISCLOSED TO THE DIRECTORS, AND THE DIRECTORS WILL DECIDE IF A CONFLICT OF INTEREST EXISTS. IF A MEMBER FAILS TO DISCLOSE A CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION.
FORM 990, PAGE 6, PART VI, LINE 15ACOMPENSATION FOR THE ORGANIZATION'S TOP OFFICIAL IS DETERMINED BY FAIR MARKET VALUE, SALARY SURVEYS AND A SALARY RANGE PROVIDED BY FLORIDA STATE UNIVERSITY, THE SUPPORTED ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 15BCOMPENSATION FOR THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES IS DETERMINED BY FAIR MARKET VALUE, SALARY SURVEYS AND A SALARY RANGE PROVIDED BY FLORIDA STATE UNIVERSITY, THE SUPPORTED ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTERST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VIIPART VII SECTION A SEE ADDITIONAL INFORMATION ON SCHEDULE J REGARDING THE DEFINED BENEFIT PLAN.
FORM 990, PART XI, LINE 9CLASSIFY BAD DEBTS AS EXPENSE -2,594 BAD DEBT EXPENSE 2,594

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1FLORIDA STATE UNIVERSITYBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1A2201 UNIVERSITY CENTERAddressLine1
CityTALLAHASSEECity
StateFLState
ZIP Code32306ZIPCode
FieldValueIRS element (for citing)
EIN591961248EIN
Primary ActivitiesUNIVERSITYPrimaryActivitiesTxt
Legal Domicile StateFLLegalDomicileStateCd
Exempt Code Section501C3ExemptCodeSectionTxt
Public Charity Status2PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
FLORIDA STATE UNIVERSITY
O$10,237,761CASH
FLORIDA STATE UNIVERSITY
M$108,829CASH