2014-08-11T16:42:50-05:00 2013-09-30 454084437 WARREN AVERETT LLC 2500 ACTON ROAD BIRMINGHAM AL 35243 990 2012-10-01 630649108 UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION PC UNIV 2057319600 PO BOX 55407 BIRMINGHAM AL 35255 MICHAEL HECKMAN 2057319600 2014-08-05 1 JC ROUSE P00081132 2059794100 2012 2015-11-30 17:44:51Z REID F JONES PO BOX 55407 BIRMINGHAM AL 35255 615781205 0 X N/A X 1973 AL COORDINATE AND DELIVER PATIENT CARE IN A GROUP PRACTICE SETTING. 18 10 3588 87 0 0 0 0 452831672 489179756 9850812 18249978 3663638 13112594 466346122 520542328 21478207 23183571 0 0 307154260 327879132 0 0 0 141118531 159483701 469750998 510546404 -3404876 9995924 778440619 799349220 452122984 435590426 326317635 363758794 COORDINATE AND DELIVER PATIENT CARE IN A GROUP PRACTICE SETTING. 0 0 413682467 23183571 489763545 OPERATION OF A NONPROFIT PHYSICIAN GROUP PRACTICE CLOSELY AFFILIATED WITH THE UNIVERSITY OF ALABAMA AT BIRMINGHAM. HSF CONSISTS OF ALMOST 1,115 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. 413682467 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 1 267 0 1 3588 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 2057319600 500 22ND ST SOUTH STE 500 BIRMINGHAM AL 35233 CHARLES E ADAIR 3.00 X 900 0 0 NEAL R BERTE 4.00 X 1200 0 0 CHARLES D PERRY JR 3.00 X 900 0 0 LEE J STYSLINGER III 1.00 X 300 0 0 THOMAS H LOWDER 2.00 X 600 0 0 DONALD M JAMES 2.00 X 600 0 0 VAN L RICHEY 3.00 X 900 0 0 MIMI HEAD 3.00 X 900 0 0 TIM LEWIS 4.00 X 1200 0 0 CHARLES D MCCRARY 0.00 X 0 0 0 RAY L WATTS MD 50.00 X 138214 667401 188437 AMIE B MCLAIN MD 50.00 X 280863 215863 85940 SERGIO B STAGNO MD 50.00 X 305363 226815 94697 KIRBY I BLAND MD 50.00 X 666374 220726 82479 KEITH A JONES MD 50.00 X 250891 304580 117226 ISSAC W FERNIANY MD 50.00 X 0 1342699 161278 WILLIAM W ANDREWS MD 50.00 X 322574 334390 104604 SETH LANDEFELD 50.00 X 83584 83268 15020 JAMES A BONNER 50.00 X 952887 345362 127008 REID F JONES 50.00 X 410951 228889 91614 PATRICIA PRITCHETT 50.00 X 290775 0 32987 MICHAEL F HECKMAN 50.00 X 260016 0 43599 ROBERT J CERFOLIO MD 60.00 X 919928 74885 83098 DEVIN ECKHOFF 60.00 X 793579 59321 58368 DAVID C MCGIFFIN MD 60.00 X 1502747 101265 66574 JAMES K KIRKLIN MD 60.00 X 860111 293252 128162 GEORGE N KAY MD 60.00 X 10308110 13225 130837 18354467 4511941 1611928 702 0 1 0 EASON GRAHAM & SANDNER P O BOX 530487 BIRMINGHAM AL 35253 BUILDING MANAGEMENT 2607259 CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64117 CONSULTING SERVICES 2226799 PLATINUM AIR SERVICE LLC 26840 SHOREGRASS DRIVE WESLEY CHAPEL FL 33543 AIR SERVICE 2111156 DOSTER CONSTRUCTION CO INC 2100 INTERNATIONAL PARK DR BIRMINGHAM AL 35243 CONSTRUCTION MANAGEMENT 1579792 SANTA ROSA CONSULTING LLC 25900 W 11 MILE ROAD SUITE 100 SOUTHFIELD MI 48034 CONSULTING SERVICES 1314738 28 NET PATIENT REVENUE 900099 382603390 382603390 HEALTHCARE SERVICES 900099 90300771 90300771 ORGAN/TISSUE REC 900099 16275595 16275595 489179756 3954765 3954765 2856419 0 2856419 2856419 2856419 109463624 70466 95024080 214797 14439544 -144331 14295213 14295213 GAIN ON EQUITY IN PLTF 900099 8900770 8900770 GAIN ON EQUITY IN CAC 900099 771616 771616 MISCELLANEOUS INCOME 900099 583789 583789 10256175 520542328 489763545 0 30778783 23183571 23183571 4357951 2311940 2046011 266328744 216588754 49739990 2256533 1311630 944903 42502937 31067975 11434962 12432967 8973506 3459461 80600 80600 481728 481728 380626 380626 48547 48547 2701148 2701148 3000327 2476867 523460 711728 711728 5523574 3879324 1644250 4335511 4335511 53000 53000 6788053 2852771 3935282 2961188 1833279 1127909 510585 222332 288253 4358511 4358511 16710065 5985160 10724905 12473063 12473063 BAD DEBT 32315602 32315602 SUPPORT SERVICES PRIMAR 25848065 25848065 MEDICAL, SURGICAL AND L 25463568 25463568 REPAIRS AND MAINTENANCE 4710273 4710273 10027939 4965981 5061958 510546404 413682467 96863937 0 112569 18167 23043859 27715688 42299540 45719712 1018005 1403040 356172 353220 2764279 3541296 314278405 160855989 154969658 153422416 448841827 451635737 90438563 91767495 14596147 23772449 778440619 799349220 86152925 88422038 205615001 200685000 160355058 146483388 452122984 435590426 X 326317635 363758794 326317635 363758794 778440619 799349220 X 9995924 15075221 12370014 X X 0 1 X 1 1 1 X 464565068 459215027 428974914 452831672 489179756 2294766437 464565068 459215027 428974914 452831672 489179756 2294766437 0 0 0 2294766437 6960785 10515157 9600120 6264280 6811184 40151526 6960785 10515157 9600120 6264280 6811184 40151526 535076 649353 664666 835395 10256175 12940665 472060929 470379537 439239700 459931347 506247115 2347858628 0.97740 0.98150 0.01710 0.01710 X 48547 48547 510497857 510546404 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 61615 35290 31323 48547 176775 250000 250000 250000 250000 1000000 1500000 61615 35290 31323 48547 176775 192858403 26434942 12000000 207293345 173460816 23840501 4442914 192858403 183677444 1760952 -3977580 8000000 173460816 166028256 5465439 15183749 3000000 183677444 179149163 -2920907 10200000 166028256 1.00000 0.00000 0.00000 0 0 28163186 28163186 137177025 65103002 72074023 27189433 14148212 13041221 74708256 62304123 12404133 47040505 19300652 27739853 153422416 CASH AND CASH EQUIVALENTS 17100161 F POOLED INVESTMENTS - CASH EQUIVALENTS 4775891 F POOLED INVESTMENTS - ACCRUED INCOME 260690 F DEFERRED COMP. INVESTMENTS - CASH EQUIVALENTS 6472552 F INVESTMENT IN TRUST FUND 59356885 F INVESTMENT IN CACC, LLC 1160094 F CERTIFICATES OF DEPOSIT 2641222 F 91767495 DEFERRED COMPENSATION 125518081 POST RETIREMENT LIABILITIES 20965307 146483388 X 527702046 15075221 -7915503 7159718 520542328 0 520542328 490260887 0 490260887 20285517 20285517 510546404 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: 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. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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, 2013, THAT IT WOULD BE UNABLE TO SUBSTANTIATE. THE FOUNDATION HAS FILED ITS NOT-FOR-PROFIT TAX RETURNS FOR ALL YEARS THROUGH SEPTEMBER 30, 2012. YEARS ENDED SEPTEMBER 30, 2010, AND SUBSEQUENT REMAIN SUBJECT TO AUDIT BY TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: OTHER COMPREHENSIVE INCOME-ADOPTION OF SFAS NO. 158 11,599,056. CHANGE IN FMV OF INTEREST RATE SWAP RECORDED DIRECTLY TO EQUITY 770,958. PENSION INCOME OFFSET AGAINST EXPENSES FOR TAX PURPOSES 12,264,201. CLASSIFICATION OF INCOME/EXPENSES DIFFERENT FOR TAX PURPOSES THAN AUDIT 537,500. BAD DEBT EXPENSE OFFSET AGAINST REVENUES FOR AUDIT PURPOSES -32,315,602. INVESTMENT INCOME OFFSET AGAINST REVENUE FOR TAX PURPOSES -771,616. PART XII, LINE 4B - OTHER ADJUSTMENTS: PENSION INCOME OFFSET AGAINST EXPENSES FOR TAX PURPOSES -12,264,201. CLASSIFICATION OF INCOME/EXPENSES DIFFERENT FOR TAX PURPOSES THAN AUDIT -537,500. BAD DEBT EXPENSE OFFSET AGAINST REVENUES FOR AUDIT PURPOSES 32,315,602. INVESTMENT INCOME OFFSET AGAINST REVENUE FOR TAX PURPOSES 771,616. 1 UNIVERSITY OF ALABAMA AT BIRMINGHAM 1530 3RD AVENUE SOUTH BIRMINGHAM AL 35294 636005396 POLITICAL SUB 23183571 0 N/A N/A TO FUND RESEARCH PROJECTS 1 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, 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 RAY L WATTS MD 8202 663282 130012 0 0 4119 2013 170417 15573 1937 155800 839755 0 0 AMIE B MCLAIN MD 279413 214043 0 0 1450 1820 32625 32239 23002 1621 336490 249723 0 0 SERGIO B STAGNO MD 179388 221606 27800 0 98175 5209 34298 33742 24029 4110 363690 264667 0 0 KIRBY I BLAND MD 656404 208045 0 2200 9970 10481 32625 32058 19108 4185 718107 256969 0 0 KEITH A JONES MD 250169 302429 0 750 722 1401 32625 68292 16993 3138 300509 376010 0 0 ISSAC W FERNIANY MD 0 623219 0 713600 0 5880 0 155881 0 5397 0 1503977 0 0 WILLIAM W ANDREWS MD 299976 329862 20000 100 2598 4428 32625 50736 7462 18273 362661 403399 0 0 SETH LANDEFELD 82890 63133 0 19600 694 535 0 12464 2356 501 85940 96233 0 0 JAMES A BONNER 307809 343961 0 0 645078 1401 32625 51920 42611 3336 1028123 400618 0 0 REID F JONES 226421 225227 182653 0 1877 3662 29823 54859 9121 0 449895 283748 0 0 PATRICIA PRITCHETT 230443 0 59664 0 668 0 30367 0 4848 0 325990 0 0 0 MICHAEL F HECKMAN 194794 0 52960 0 12262 0 26540 0 19005 0 305561 0 0 0 ROBERT J CERFOLIO MD 867049 74578 50000 0 2879 307 32625 33880 21819 1545 974372 110310 0 0 DEVIN ECKHOFF 380741 56385 139121 2700 273717 236 32625 8966 19619 868 845823 69155 0 0 DAVID C MCGIFFIN MD 1016667 99023 9500 700 476580 1542 32625 16302 6444 18160 1541816 135727 0 0 JAMES K KIRKLIN MD 515828 285902 0 2200 344283 5150 77063 43364 12490 1962 949664 338578 0 0 GEORGE N KAY MD 50435 10925 179760 2300 10077915 0 112129 0 23558 550 10443797 13775 9366920 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. SUPPLEMENTAL INFORMATION PART III FOR FISCAL YEAR 2013 COMPENSATION FOR DR. GEORGE N. KAY INCLUDES $9,366,920 WHICH IS A ONE-TIME PAYMENT FROM HIS DEFERRED COMPENSATION PLAN. FOR FISCAL YEAR 2013 COMPENSATION FOR DR. ISSAC W. FERNIANY INCLUDES $338,165 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 22598198 17100161 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 SCHEDULE K PART IV, ARBITRAGE, LINE 2C DATE REBATE COMPUTATION PERFORMED ISSUER NAME: THE MEDICAL CLINIC BOARD OF THE CITY OF BIRMINGHAM - UAHSF DATE THE REBATE COMPUTATION WAS PERFORMED: 04/01/2013 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: OTHER COMPREHENSIVE INCOME-ADOPTION OF SFAS NO. 158 11,599,056. CHANGE IN FMV OF INTEREST RATE SWAP RECORDED DIRECTLY TO EQUITY 770,958. 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 1 0 0 1 0 0 0 1 0 0 1 1 0 UNIVERSITY OF ALABAMA AT BIRMINGHAM B 23183571 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM J 608000 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM N 316840 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM Q 6616160 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM R 27166000 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM G 2100000 APPRAISED VALUE UAB HEALTH SYSTEM Q 6004000 FMV - CASH UAB HEALTH SYSTEM R 9677000 FMV - CASH