FLORIDA MEDICAL PRACTICE PLAN INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- FLORIDA MEDICAL PRACTICE PLAN INC (EIN 57-1234883)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-14
- IRS object ID
- 201431349349305468
- Schema version
- 2012v2.3
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-14T13:49:53-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PURVIS GRAY & COMPANY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 443 EAST COLLEGE AVENUE | AddressLine1 |
| City | TALLAHASSEE | City |
| State | FL | State |
| ZIP Code | 32301 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 571234883 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA MEDICAL PRACTICE PLAN INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FLOR | NameControl |
| Phone | 8506452827 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1115 WEST CALL STREET | AddressLine1 |
| City | TALLAHASSEE | City |
| State | FL | State |
| ZIP Code | 32306 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN P FOGARTY MD | Name |
| Title | PRESIDENT, FMPP | Title |
| Phone | 8506452827 | Phone |
| Date Signed | 2014-04-22 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RYAN M TUCKER CPA | Name |
| Phone | 8502247144 | Phone |
| Date Prepared | 2014-05-09 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JOHN P FOGARTY | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1115 WEST CALL STREET | AddressLine1 |
| City | TALLAHASSEE | City |
| State | FL | State |
| ZIP Code | 32306 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 11823484 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.MED.FSU.EDU/FMPP | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2006 | YearFormation |
| State Legal Domicile | FL | StateLegalDomicile |
| Activity Or Mission Description | THE 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 RESIDENTS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 9366824 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 11811302 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 5425 | InvestmentIncomePriorYear |
| Investment Income Current Year | 6970 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 5212 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 9372249 | TotalRevenuePriorYear |
| Total Revenue Current Year | 11823484 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 5500 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 43250 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6669077 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9328122 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2183591 | OtherExpensePriorYear |
| Other Expenses Current Year | 2028862 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 8858168 | TotalExpensesPriorYear |
| Total Expenses Current Year | 11400234 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 514081 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 423250 | RevenuesLessExpensesCY |
| Total Assets BOY | 3212259 | TotalAssetsBOY |
| Total Assets EOY | 3993965 | TotalAssetsEOY |
| Total Liabilities BOY | 1292154 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1650610 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1920105 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2343355 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE 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 RESIDENTS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 11339817 | Expense |
| Grants | 43250 | Grants |
| Revenue | 11816514 | Revenue |
| Description | PERFORMED 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. | Description |
| Total Program Service Expense | 11339817 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | false | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | true | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 7 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DAWN SNYDER | NamePerson |
| Telephone Number | 8506452827 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1115 WEST CALL STREET | AddressLine1 |
| City | TALLAHASSEE | City |
| State | FL | State |
| ZIP Code | 32306 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (11 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|---|
| JOHN P FOGARTY MD | |||||||
| PRESIDENT | 2.00 | 40.00 | X | X | 0 | 382235 | 27936 |
| GARNETT S STOKES PHD | |||||||
| DIRECTOR | 0.50 | 40.00 | X | 0 | 327675 | 18516 | |
| JOHN R CARNAGHI MED | |||||||
| DIRECTOR | 1.00 | 40.00 | X | 0 | 288892 | 33922 | |
| RICARDO GONZALEZ-ROTHI MD | |||||||
| DIRECTOR | 1.00 | 40.00 | X | 0 | 284885 | 27309 | |
| ALMA B LITTLES MD | |||||||
| SEC/TREASURE | 1.00 | 40.00 | X | X | 0 | 263857 | 29251 |
| DANIEL J VAN DURME MD | |||||||
| VICE PRESIDE | 1.00 | 40.00 | X | X | 0 | 248307 | 29859 |
| KENNETH V BRUMMEL-SMITH MD | |||||||
| DIRECTOR | 1.00 | 40.00 | X | 0 | 246283 | 29422 | |
| RICHARD S NOWAKOWSKI PHD | |||||||
| DIRECTOR | 1.00 | 40.00 | X | 0 | 232529 | 23335 | |
| LESLIE M BEITSCH MD JD | |||||||
| DIRECTOR | 1.00 | 40.00 | X | 0 | 212666 | 23686 | |
| JANINE EDWARDS PHD | |||||||
| DIRECTOR | 1.00 | 40.00 | X | 0 | 200418 | 19965 | |
| DAVID COBURN | |||||||
| DIRECTOR | 0.50 | 40.00 | X | 0 | 29672 | 1471 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp Frm Rltd Orgs | 2717419 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 264672 | TotalOtherCompensation |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| FSU COLLEGE OF MEDICINE SELF INSURAN | |||||
| 1115 W CALL STREET | TALLAHASSEE | FL | 32306 | SELF INSURANCE | 491530 |
| BLUE CROSS BLUE SHIELD OF FLORIDA | |||||
| PO BOX 44144 | JACKSONVILLE | FL | 32231 | HEALTH INSURANC | 122648 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Info In Schedule O Part VIII | X | InfoInScheduleOPartVIII |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| CLINICAL REVENUE | 624100 | 11559458 | 11559458 |
| MEDICAID REVENUE | 624100 | 251844 | 251844 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 11811302 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6970 | TotalRevenueColumn |
| Exclusion | $6,970 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CREDIT CARD REBATE | Description |
| Total Revenue Column | 5212 | TotalRevenueColumn |
| Exclusion | $5,212 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 5212 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11823484 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11811302 | RelatedOrExemptFunctionIncome |
| Exclusion | $12,182 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43250 | Total |
| Program Services | 43250 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8237729 | Total |
| Program Services | 8237729 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 294678 | Total |
| Program Services | 294678 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 438781 | Total |
| Program Services | 438781 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 356934 | Total |
| Program Services | 356934 | ProgramServices |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 300806 | Total |
| Program Services | 300806 | ProgramServices |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20500 | Total |
| Management And General | 20500 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 136547 | Total |
| Program Services | 136547 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8627 | Total |
| Management And General | 8627 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31290 | Total |
| Management And General | 31290 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6637 | Total |
| Program Services | 6637 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59465 | Total |
| Program Services | 59465 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 957237 | Total |
| Program Services | 957237 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| MEDICAL SUPPLIES | 375906 | 375906 |
| OTHER | 80548 | 80548 |
| PROGRAM FEES | 33083 | 33083 |
| BAD DEBT EXPENSE | 18216 | 18216 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11400234 | Total |
| Program Services | 11339817 | ProgramServices |
| Management And General | 60417 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1567878 | BOY |
| EOY | 2091416 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1406219 | BOY |
| EOY | 1767462 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40810 | BOY |
| EOY | 43386 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 147923 | BOY |
| EOY | 65624 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 49429 | BOY |
| EOY | 26077 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3212259 | BOY |
| EOY | 3993965 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 70681 | BOY |
| EOY | 101438 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1221473 | BOY |
| EOY | 1549172 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1292154 | BOY |
| EOY | 1650610 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1920105 | BOY |
| EOY | 2343355 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1920105 | BOY |
| EOY | 2343355 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3212259 | BOY |
| EOY | 3993965 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 423250 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA STATE UNIVERSITY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 591961248 | EIN |
| Type Of Organization | 2 | TypeOfOrganization |
| Listed In Governing Doc | true | ListedInGoverningDoc |
| Supported Organization Notified | true | SupportedOrganizationNotified |
| Organized In US | true | OrganizedInUS |
| Amount | $9,678,293 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 9678293 | SumOfAmounts |
Schedule D IRS990ScheduleD
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | FLORIDA STATE UNIVERSITY AUXILIARY | Description |
| Amount | $1,549,172 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1549172 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 11805268 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 11805268 | RevenueSubtotal |
| Other Revenues Not Included | 18216 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 18216 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 11823484 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 11382018 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 11382018 | ExpensesSubtotal |
| Other Expenses Not Included | 18216 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 18216 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 11400234 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| REVENUE AMOUNTS INCLUDED ON RETURN - OTHER | SCHEDULE D, PAGE 4, PART XI, LINE 4B | CLASSIFY BAD DEBTS AS EXPENSE 18,216 |
| EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER | SCHEDULE D, PAGE 4, PART XII, LINE 4B | BAD DEBT EXPENSE 18,216 |
Schedule F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintained |
Accts Actvs Out US Table AcctsActvsOutUSTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | CENTRAL AMERICA AND THE CARIBBEAN | Region |
| Type Of Activities Conducted | PROGRAM SERVICE | TypeOfActivitiesConducted |
| Specific Services Provided | MEDICAL MISSION TRIP | SpecificServicesProvided |
| Total Expenditures | 18159 | TotalExpenditures |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Amount Spent | 18159 | SubtotalAmountSpent |
| Total Amount Spent | 18159 | TotalAmountSpent |
| Transfer To Foreign Corp | false | TransferToForeignCorp |
| Interest In Foreign Trust | false | InterestInForeignTrust |
| Own Foreign Corp | false | OwnForeignCorp |
| Passive Foreign Invest Co | false | PassiveForeignInvestCo |
| Foreign Partnership | false | ForeignPartnership |
| Boycott Countries | false | BoycottCountries |
Form990 Schedule F Part V Form990ScheduleFPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ACTIVITIES PER REGION | Identifier |
| Return Reference | SCHEDULE F, PAGE 1, PART I, LINE 3 | ReturnReference |
| Explanation | CENTRAL AMERICA AND THE CARIBBEAN 18,159 0 | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | false | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA STATE UNIVERSITY FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | INNOVATION PARK 2010 LEVY AVENUE | AddressLine1 |
| City | TALLAHASSEE | City |
| State | FL | State |
| ZIP Code | 32306 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 596152180 | EINOfRecipient |
| IRC Section | 501C3 | IRCSection |
| Amount Of Cash Grant | 42750 | AmountOfCashGrant |
| Purpose Of Grant | CONTRIBUTION | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| TitleTitle | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs |
|---|---|---|---|---|---|---|
| JOHN P FOGARTY MD | ||||||
| PRESIDENT | 382235 | 15121 | 12815 | 410171 | ||
| GARNETT S STOKES PHD | ||||||
| DIRECTOR | 321675 | 18277 | 239 | 346191 | 6000 | |
| JOHN R CARNAGHI MED | ||||||
| DIRECTOR | 279487 | 19194 | 14728 | 322814 | 6563 | 2842 |
| RICARDO GONZALEZ-ROTHI MD | ||||||
| DIRECTOR | 284885 | 14494 | 12815 | 312194 | ||
| ALMA B LITTLES MD | ||||||
| SECTREASURER | 263857 | 16436 | 12815 | 293108 | ||
| DANIEL J VAN DURME MD | ||||||
| VICE PRESIDENT | 248307 | 17044 | 12815 | 278166 | ||
| KENNETH V BRUMMEL-SMITH MD | ||||||
| DIRECTOR | 245083 | 16607 | 12815 | 275705 | 1200 | |
| RICHARD S NOWAKOWSKI PHD | ||||||
| DIRECTOR | 232529 | 16000 | 7335 | 255864 | ||
| LESLIE M BEITSCH MD JD | ||||||
| DIRECTOR | 212666 | 10871 | 12815 | 236352 | ||
| JANINE EDWARDS PHD | ||||||
| DIRECTOR | 200418 | 13913 | 6052 | 220383 | ||
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE J, PART III | ReturnReference |
| Explanation | THROUGH 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. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990 - ORGANIZATION'S MISSION | THE 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 RESIDENTS. |
| ADDITIONAL INFORMATION | FORM 990 | FORM 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. |
| RELATED PARTY INFORMATION AMONG OFFICERS | FORM 990, PAGE 6, PART VI, LINE 2 | GARNETT S. STOKES, PH.D. JOHN R. CARNAGHI, M.ED. DIRECTOR DIRECTOR ON 3 OTHER FSU BOARDS TOGETHER GARNETT S. STOKES, PH.D. DAVID COBURN DIRECTOR DIRECTOR ON 3 OTHER FSU BOARDS TOGETHER ALMA 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 |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE FINAL FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS THROUGH ELECTRONIC MAIL PRIOR TO SUBMITTAL TO THE INTERNAL REVENUE SERVICE. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | ANY 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. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION 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. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION 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. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTERST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| ADDITIONAL INFORMATION | FORM 990, PART VIII | PART VII SECTION A SEE ADDITIONAL INFORMATION ON SCHEDULE J REGARDING THE DEFINED BENEFIT PLAN. |
| RECONCILIATION OF CHANGES - OTHER | FORM 990, PART XI, LINE 9 | CLASSIFY BAD DEBTS AS EXPENSE -18,216 BAD DEBT EXPENSE 18,216 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLORIDA STATE UNIVERSITY | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | A2201 UNIVERSITY CENTER | AddressLine1 |
| City | TALLAHASSEE | City |
| State | FL | State |
| ZIP Code | 32306 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 591961248 | EIN |
| Primary Activities | UNIVERSITY | PrimaryActivities |
| Legal Domicile State | FL | LegalDomicileState |
| Exempt Code Section | 501C3 | ExemptCodeSection |
| Public Charity Status | 2 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | false | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| FLORIDA STATE UNIVERSITY | ||
| O | 9584478 | CASH |
| FLORIDA STATE UNIVERSITY | ||
| M | 93900 | CASH |