2015-08-06T15:03:29-05:00 2014-09-30 454084437 WARREN AVERETT LLC 2500 ACTON ROAD BIRMINGHAM AL 35243 990 2013-10-01 630649108 UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION P C UNIV 2057319600 PO BOX 55407 BIRMINGHAM AL 35255 MICHAEL HECKMAN CFO 2057319600 2015-07-16 1 JC ROUSE P00081132 2059794100 2013 2016-02-25 16:41:14Z PATRICIA PRITCHETT PO BOX 55407 BIRMINGHAM AL 35255 656580754 0 X N/A X 1973 AL COORDINATE AND DELIVER PATIENT CARE IN A GROUP PRACTICE SETTING. 18 10 3565 93 0 0 0 0 489179756 510197043 18249978 26635230 13112594 15108420 520542328 551940693 23183571 24949115 0 0 327879132 349513145 0 0 0 159483701 157521954 510546404 531984214 9995924 19956479 799349220 845185796 435590426 463107332 363758794 382078464 COORDINATE AND DELIVER PATIENT CARE IN A GROUP PRACTICE SETTING WITHIN THE ACADEMIC ENVIRONMENT OF THE UNIVERSITY OF ALABAMA AT BIRMINGHAM. 0 0 432585628 24949115 510414443 OPERATION OF A NONPROFIT PHYSICIAN GROUP PRACTICE CLOSELY AFFILIATED WITH THE UNIVERSITY OF ALABAMA AT BIRMINGHAM. HSF CONSISTS OF ALMOST 1,176 FACULTY, FELLOWS AND PHYSICIANS OFFERING SERVICES IN 33 SPECIALTIES. THESE SERVICES ARE REINFORCED BY THE RESEARCH AND EDUCATIONAL PROGRAMS OF UAB'S ACADEMIC HEALTH CENTER, RESULTING IN STATE-OF-THE-ART CARE. 432585628 1 0 0 1 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 248 0 1 3565 1 0 0 0 0 0 0 0 0 0 0 X 18 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MICHAEL F HECKMAN CFO 2057319600 500 22ND ST SOUTH STE 500 BIRMINGHAM AL 35233 CHARLES E ADAIR DIRECTOR 4.00 X 1200 0 0 NEAL R BERTE DIRECTOR 4.00 X 1200 0 0 CHARLES D PERRY JR DIRECTOR 3.00 X 900 0 0 LEE J STYSLINGER III DIRECTOR 1.00 X 300 0 0 THOMAS H LOWDER DIRECTOR 0.00 X 0 0 0 DONALD M JAMES DIRECTOR 4.00 X 1200 0 0 VAN L RICHEY DIRECTOR 4.00 X 1200 0 0 MIMI HEAD DIRECTOR 4.00 X 1200 0 0 TIM LEWIS DIRECTOR 4.00 X 1200 0 0 WILLIAM C HAZELRIG DIRECTOR 0.00 X 0 0 0 SELWYN M VICKERS MD DIRECTOR/PHYSICIAN 50.00 X 18017 148635 28658 AMIE B MCLAIN MD DIRECTOR/PHYSICIAN 50.00 X 328895 218070 85318 SERGIO B STAGNO MD DIRECTOR/PHYSICIAN 50.00 X 392102 223906 103238 KIRBY I BLAND MD DIRECTOR/PHYSICIAN 50.00 X 767576 220215 84253 DAVID G STANDAERT MD DIRECTOR/PHYSICIAN 50.00 X 87324 360769 72340 ISSAC W FERNIANY MD DIRECTOR/CEO UAB HS 0.00 50.00 X 0 1222637 174922 WILLIAM W ANDREWS MD DIRECTOR/PHYSICIAN 50.00 X 389967 334274 106464 CHARLES S LANDEFELD MD DIRECTOR/PHYSICIAN 50.00 X 303079 221404 62412 JAMES A BONNER PRESIDENT 50.00 X 455279 353865 99090 PATRICIA PRITCHETT EXECUTIVE VICE PRESIDENT 50.00 X 280877 86580 52584 MICHAEL F HECKMAN CFO 50.00 X 261156 0 46010 ROBERT J CERFOLIO MD PROFESSOR/PHYSICIAN 60.00 X 911770 78727 85387 CONWAY C HUANG MD PROFESSOR/PHYSICIAN 60.00 X 823656 76876 61441 DAVID C MCGIFFIN MD PROFESSOR/PHYSICIAN 60.00 X 863058 93593 61280 JAMES K KIRKLIN MD PROFESSOR/PHYSICIAN 60.00 X 849525 306866 118060 MARK N HADLEY MD PROFESSOR/PHYSICIAN 60.00 X 775305 70805 60445 7515986 4017222 1301902 766 0 1 0 IRON MOUNTAIN RECORDS MANAGEMENT P O BOX 530487 BIRMINGHAM AL 35253 RECORD MANAGEMENT 1616603 DOSTER CONSTRUCTION CO INC 2100 INTERNATIONAL PARK DRIVE BIRMINGHAM AL 35243 CONSTRUCTION MANAGEMENT 1386757 EASON GRAHAM & SANDER P O BOX 530487 BIRMINGHAM AL 35253 BUILDING MANAGEMENT 1332000 PLATINUM AIR SERVICE LLC 26840 SHOREGRASS DRIVE WESLEY CHAPEL FL 33543 AIR SERVICE 1098007 CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64177 CONSULTANT 612395 44 NET PATIENT REVENUE 900099 371419769 371419769 HEALTHCARE SERVICES 900099 120997404 120997404 ORGAN/TISSUE REC 900099 17779870 17779870 510197043 4224243 4224243 6959109 0 6959109 6959109 6959109 114980927 12070121 96100424 8539637 18880503 3530484 22410987 22410987 GAIN ON EQUITY IN PLTF 900099 7197612 7197612 GAIN ON EQUITY IN CAC 900099 734299 734299 MISCELLANEOUS INCOME 900099 217400 217400 8149311 551940693 510414443 0 41526250 24949115 24949115 3777937 2656591 1121346 287046166 234759857 52286309 614281 440448 173833 44933250 33114852 11818398 13141511 9592218 3549293 32620 32620 397722 397722 369439 369439 70714 70714 3088708 3088708 2158726 1598827 559899 872836 872836 5541694 3786365 1755329 4044476 4044476 45000 45000 7663687 3032655 4631032 3109419 1910914 1198505 602656 314005 288651 4002720 4002720 11340723 3866937 7473786 16998530 16998530 SUPPORT SERVICES PRIMAR 30338597 30338597 BAD DEBT 28752553 28752553 MEDICAL, SURGICAL AND L 20217997 20217997 PROVIDER BASE CHARGEBAC 4257252 4257252 13615885 8973649 4642236 531984214 432585628 99398586 0 18167 9673 27715688 16415787 45719712 43030538 1403040 20655429 353220 75701 3541296 9982533 283067686 136813784 153422416 146253902 451635737 478789404 91767495 102974897 23772449 26997932 799349220 845185796 88422038 102143693 200685000 202023574 146483388 158940065 435590426 463107332 X 363758794 382078464 363758794 382078464 799349220 845185796 X 19956479 4549668 -6186477 X X 0 1 X 1 1 1 X 459215027 428974914 452831672 489179756 510197043 2340398412 459215027 428974914 452831672 489179756 510197043 2340398412 0 0 0 2340398412 10515157 9600120 6264280 6811184 11183352 44374093 10515157 9600120 6264280 6811184 11183352 44374093 649353 664666 835395 10256175 8149311 20554900 470379537 439239700 459931347 506247115 529529706 2405327405 0.97300 0.98040 0.01840 0.01810 X 70714 70714 531913500 531984214 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 35290 31323 48547 70714 185874 250000 250000 250000 250000 1000000 1500000 35290 31323 48547 70714 185874 207293345 18551670 11460010 214385005 192858403 26434942 12000000 207293345 173460816 23840501 4442914 192858403 183677444 1760952 -3977580 8000000 173460816 166028256 5465439 15183749 3000000 183677444 1.00000 0.00000 0.00000 0 0 28163186 28163186 137759097 69235325 68523772 28208552 14654497 13554055 43578660 29581748 13996912 45358191 23342214 22015977 146253902 CASH AND CASH EQUIVALENTS 8472117 F POOLED INVESTMENTS - CASH EQUIVALENTS 17672825 F POOLED INVESTMENTS - ACCRUED INCOME 299333 F DEFERRED COMP. INVESTMENTS - CASH EQUIVALENTS 6682972 F INVESTMENT IN TRUST FUND 62282469 F INVESTMENT IN CACC, LLC 1894393 F CERTIFICATES OF DEPOSIT 5670788 F 102974897 DEFERRED COMPENSATION 132559479 POST RETIREMENT LIABILITIES 26380586 158940065 X 531106933 4549668 -25383428 -20833760 551940693 0 551940693 512787263 0 512787263 19196951 19196951 531984214 PART V, LINE 4: THE FOUNDATION'S BOARD-DESIGNATED ENDOWMENTS CONSIST OF THREE FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE NORMAL SPENDING POLICY FOR THE GENERAL ENDOWMENT FUND IS TO DISTRIBUTE BETWEEN 3.5 PERCENT AND 6.5 PERCENT OF THE FUND, SUBJECT TO ANNUAL RECOMMENDATION BY THE FOUNDATION'S INVESTMENT COMMITTEE TO THE BOARD. THIS SPENDING POLICY IS CONSISTENT WITH THE FOUNDATION'S OBJECTIVE TO MAINTAIN THE PURCHASING POWER OF ENDOWMENT ASSETS, AS WELL AS TO PROVIDE ADDITIONAL REAL GROWTH THROUGH INVESTMENT RETURNS. PART X, LINE 2: THE FOUNDATION IS RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3). THE FOUNDATION HAS ADOPTED THE PROVISIONS OF THE ACCOUNTING STANDARDS CODIFICATION RELATING TO UNCERTAINTY IN INCOME TAXES. THIS GUIDANCE REQUIRES ENTITIES TO ASSESS THEIR UNCERTAIN TAX POSITIONS FOR THE LIKELIHOOD THAT THEY WOULD BE OVERTURNED UPON INTERNAL REVENUE SERVICE (IRS) EXAMINATION OR UPON EXAMINATION BY STATE TAXING AUTHORITIES. THE FOUNDATION HAS DETERMINED THAT IT DOES NOT HAVE ANY POSITIONS AT SEPTEMBER 30, 2014, THAT IT WOULD BE UNABLE TO SUBSTANTIATE. THE FOUNDATION HAS FILED ITS NOT-FOR-PROFIT TAX RETURNS FOR ALL YEARS THROUGH SEPTEMBER 30, 2013. YEARS ENDED SEPTEMBER 30, 2010, AND SUBSEQUENT REMAIN SUBJECT TO AUDIT BY TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: OTHER COMPREHENSIVE LOSS-ADOPTION OF SFAS NO. 158 -6,186,477. PENSION INCOME OFFSET AGAINST EXPENSES FOR TAX PURPOSES 9,580,331. CLASSIFICATION OF INCOME/EXPENSES DIFFERENT FOR TAX PURPOSES THAN AUDIT -24,729. BAD DEBT EXPENSE OFFSET AGAINST REVENUES FOR AUDIT PURPOSES -28,752,553. PART XII, LINE 4B - OTHER ADJUSTMENTS: PENSION INCOME OFFSET AGAINST EXPENSES FOR TAX PURPOSES -9,580,331. CLASSIFICATION OF INCOME/EXPENSES DIFFERENT FOR TAX PURPOSES THAN AUDIT 24,729. BAD DEBT EXPENSE OFFSET AGAINST REVENUES FOR AUDIT PURPOSES 28,752,553. 1 UNIVERSITY OF ALABAMA AT BIRMINGHAM 1530 3RD AVENUE SOUTH BIRMINGHAM AL 35294 636005396 POLITICAL SUB 24949115 N/A N/A TO FUND RESEARCH PROJECTS 1 0 PART I, LINE 2: THE GRANTS PROVIDED TO UAB GO THROUGH HSF APPROVAL PROCESS. THE REQUEST COMES IN TO HSF CONTROLLER WHO PREPARES A "UAB TRANSFERS & CONTRIBUTION REQUEST" AND APPROVES PAYMENT. THE REQUEST CONSIST OF THE DEPARTMENT, DATE, AMOUNT YTD EXPENSE AND VARIANCES TO BUDGET. ALL GRANT REQUISITIONS REGARDLESS OF AMOUNTS ARE THEN SENT TO THE HSF CFO FOR APPROVAL AND THEN TO THE EXECUTIVE VICE PRESIDENT FOR FINAL APPROVAL. THE GRANTS ARE ALSO MONITORED WITH THE AMOUNT PROVIDED VERSUS THE AMOUNT BUDGETED FOR THE FISCAL YEAR. X X 1 1 X X 0 0 0 1 0 0 0 1 0 SELWYN M VICKERS MD DIRECTOR/PHYSICIAN 8761 137413 0 10769 9256 453 0 22065 4087 3850 22104 174550 0 0 AMIE B MCLAIN MD DIRECTOR/PHYSICIAN 254192 214043 73253 0 1450 4027 33278 33243 20724 1624 382897 252937 0 0 SERGIO B STAGNO MD DIRECTOR/PHYSICIAN 217910 221048 62542 500 111650 2358 46824 34876 19951 4672 458877 263454 0 0 KIRBY I BLAND MD DIRECTOR/PHYSICIAN 656212 208439 104690 4000 6674 7776 33278 33382 18900 3794 819754 257391 0 0 DAVID G STANDAERT MD DIRECTOR/PHYSICIAN 34996 359400 52317 0 11 1369 5885 50255 16008 2318 109217 413342 0 0 ISSAC W FERNIANY MD DIRECTOR/CEO UAB HS 0 633822 0 390000 0 198815 0 160041 0 21883 0 1404561 0 0 WILLIAM W ANDREWS MD DIRECTOR/PHYSICIAN 299091 329573 88278 100 2598 4601 33278 52315 6448 18921 429693 405510 0 0 CHARLES S LANDEFELD MD DIRECTOR/PHYSICIAN 246376 189400 54620 30400 2083 1604 8156 45568 10477 1507 321712 268479 0 0 JAMES A BONNER PRESIDENT 339245 350584 115000 0 1034 3281 33278 46534 20819 3381 509376 403780 0 0 PATRICIA PRITCHETT EXECUTIVE VICE PRESIDENT 204608 86230 75248 0 1021 350 28989 18094 4877 2463 314743 107137 0 0 MICHAEL F HECKMAN CFO 203303 0 50842 0 7011 0 29312 0 18722 0 309190 0 0 0 ROBERT J CERFOLIO MD PROFESSOR/PHYSICIAN 908902 78362 0 0 2868 365 33278 35320 21999 1569 967047 115616 0 0 CONWAY C HUANG MD PROFESSOR/PHYSICIAN 511925 76666 310662 0 1069 210 33278 12709 7778 12986 864712 102571 0 0 DAVID C MCGIFFIN MD PROFESSOR/PHYSICIAN 732123 77381 12500 0 118435 16212 33278 12806 4736 15602 901072 122001 0 0 JAMES K KIRKLIN MD PROFESSOR/PHYSICIAN 640098 300227 0 3600 209427 3039 63090 47192 11934 2035 924549 356093 0 0 MARK N HADLEY MD PROFESSOR/PHYSICIAN 441378 70217 331295 0 2632 588 33278 10968 19878 938 828461 82711 0 0 PART I, LINE 1A DISCRETIONARY SPENDING ACCOUNTS: SOME EMPLOYED PHYSICIANS (INCLUDING PHYSICIAN DIRECTORS) HAVE ACCESS TO PROFESSIONAL DEVELOPMENT FUNDS WHICH ARE USED TO ADVANCE THEIR PROFESSIONAL SKILLS. AMOUNTS ARE SPENT ON COMPUTER EQUIPMENT, JOURNALS, SUBSCRIPTIONS AND TRAVEL EXPENSES TO ATTEND CONFERENCES AND LECTURES. ALL REQUESTS FOR REIMBURSEMENT ARE REVIEWED FOR COMPLIANCE WITH CURRENT POLICY AND IRS GUIDANCE BEFORE THEY ARE PAID. SOCIAL CLUB DUES: A FEW PHYSICIAN LEADERS (INCLUDING SOME PHYSICIAN DIRECTORS) ARE MEMBERS OF SOCIAL/BUSINESS CLUBS. THEY UTILIZE THESE FACILITIES FOR BUSINESS MEETINGS AND EVENTS DURING THE YEAR. ALL REQUESTS FOR REIMBURSEMENT ARE REVIEWED FOR COMPLIANCE WITH CURRENT POLICY AND IRS GUIDANCE BEFORE THEY ARE PAID. PART I, LINE 5 MANY OF OUR EMPLOYED PHYSICIANS (INCLUDING SOME DIRECTORS) HAVE INCENTIVE PLANS THAT PAY ADDITIONAL AMOUNTS BASED ON ACHIEVING SPECIFIC CLINICAL, ACADEMIC AND RESEARCH MEASURES. THESE INCENTIVE PLANS ARE REVIEWED ANNUALLY WITH THE COMPENSATION COMMITTEE. SOME OF THESE PLANS MAKE PAYMENTS BASED ON CLINICAL PRODUCTIVITY. PART I, LINE 7 MANY OF OUR EMPLOYED PHYSICIANS (INCLUDING SOME DIRECTORS) HAVE INCENTIVE PLANS THAT PAY ADDITIONAL AMOUNTS BASED ON ACHIEVING SPECIFIC CLINICAL, ACADEMIC AND RESEARCH MEASURES. THESE INCENTIVE PLANS ARE REVIEWED ANNUALLY WITH THE COMPENSATION COMMITTEE. PART II, LINE 6: FOR FISCAL YEAR 2014 COMPENSATION FOR DR. ISSAC W. FERNIANY INCLUDES $185,199 WHICH IS A ONE-TIME PAYMENT FROM HIS TEBA RETIREMENT PLAN. A THE MEDICAL CLINIC BOARD OF THE CITY OF BIRMINGHAM - UAHSF 621375181 NONEAVAIL 2011-09-07 210490000 PRIOR ISSUE REFUND AND FINANCING 0 0 0 A 210490000 31527883 8472117 1 1 0 1 A 0 1 0 0 0.01440 0.00000 0.01440 0 1 0.01430 0 1 A 0 0 0 1 1 0 0 0 0 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: THE MEDICAL CLINIC BOARD OF THE CITY OF BIRMINGHAM - UAHSF DATE THE REBATE COMPUTATION WAS PERFORMED: 09/30/2014 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS PROVIDED TO THE BOARD FOR REVIEW AND IS AN AGENDA ITEM AT THE REGULARLY SCHEDULED BOARD MEETING OPEN FOR ANY DISCUSSION BEFORE THE RETURN IS FILED. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, PRINCIPAL OFFICERS AND COMMITTEE MEMBERS WITH BOARD DELEGATED POWERS ANNUALLY SIGN THE CONFLICT OF INTEREST CERTIFICATE. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE MEETS ANNUALLY TO ENSURE THAT INDIVIDUAL COMPENSATION FOR PHYSICIANS, OFFICERS AND OTHER EXECUTIVES IS REASONABLE AND APPROPRIATE FOR A NON-PROFIT ORGANIZATION. THE COMPENSATION COMMITTEE PRESENTS AN ANNUAL REPORT TO THE BOARD OF DIRECTORS FOR THEIR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 AS A GENERAL RULE, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. ANY WRITTEN REQUEST BY THE PUBLIC WOULD BE REVIEWED AND ACTED UPON BY THE BOARD. FORM 990, PART XI, LINE 9: OTHER COMPREHENSIVE INCOME/LOSS -6,186,477. 990, PART XI, LINE 2C THE BOARD OF DIRECTORS HAS A SEPARATE COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS FUNCTION HAS NOT CHANGED FROM PRIOR YEARS. UAB HEALTH SYSTEM 500 22ND STREET SOUTH SUITE 408 BIRMINGHAM AL 35233 631182994 HEALTHCARE MANAGEMENT AL 501(C)(3) LINE 7 N/A 0 UNIVERSITY OF ALABAMA AT BIRMINGHAM 1530 3RD AVENUE SOUTH BIRMINGHAM AL 35294 636005396 PUBLIC UNIVERSITY AL POLITICAL SUB N/A N/A 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 1 0 UNIVERSITY OF ALABAMA AT BIRMINGHAM B 24949115 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM J 786100 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM N 321509 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM Q 15545490 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM R 44549000 FMV - CASH UAB HEALTH SYSTEM Q 6185000 FMV - CASH UAB HEALTH SYSTEM R 11511000 FMV - CASH