2013-08-09T13:02:35-05:00 2012-09-30 050409384 KAHN LITWIN RENZA & CO LTD 951 NORTH MAIN STREET PROVIDENCE RI 02904 990 2011-10-01 050486254 UNIVERSITY EMERGENCY MEDICINE FOUNDATION UNIV 4015191602 593 EDDY STREET NO 2ND FL PROVIDENCE RI 02903 BRIAN ZINK 4014445826 2013-08-08 1 DEBORAH A HOPKINS P00167843 4012742001 2011 2016-02-24 21:20:13Z BRIAN ZINK 593 EDDY STREET NO 2ND FL PROVIDENCE RI 02903 44291360 0 X WWW.UEMF.ORG X 1995 RI EXCEPTIONAL EMERGENCY MEDICAL CARE, EDUCATION, RESEARCH AND SERVICE TO PEOPLE OF RI AND BEYOND. 10 2 213 0 0 0 0 0 37625606 40249176 91316 134486 0 0 37716922 40383662 251900 82500 0 0 31520897 34853292 0 0 0 4170440 5133350 35943237 40069142 1773685 314520 11595629 12590354 5445328 5750811 6150301 6839543 X TO PROVIDE EXCEPTIONAL EMERGENCY MEDICAL CARE, EDUCATION, RESEARCH, AND SERVICE TO THE PEOPLE OF RHODE ISLAND AND BEYOND. 0 0 36904389 82500 40249176 THE UNIVERSITY EMERGENCY MEDICINE FOUNDATION PROVIDES EMERGENCY MEDICAL SERVICES, CONDUCTS MEDICAL RESEARCH AND EDUCATES MEDICAL RESIDENTS, FELLOWS, MEDICAL STUDENTS AND OTHERS. THE FOUNDATION PROVIDES THESE SERVICES THROUGH AFFILIATIONS WITH RHODE ISLAND HOSPITAL (RIH), HASBRO CHILDREN'S HOSPITAL (HASBRO), AND THE MIRIAM HOSPITAL (TMH), WOMEN AND INFANTS HOSPITAL AND THE PROVIDENCE VETERANS ADMINISTRATION HOSPITAL.UNIVERSITY EMERGENCY MEDICINE FOUNDATION (UEMF) IS THE ACADEMIC EMERGENCY MEDICINE PHYSICIAN PRACTICE PLAN OF THE DEPARTMENT OF EMERGENCY MEDICINE AT THE ALPERT MEDICAL SCHOOL OF BROWN UNIVERSITY, LIFESPAN'S RHODE ISLAND HOSPITAL, AND THE MIRIAM HOSPITAL. WITH MORE THAN 90 FULL TIME PHYSICIANS AND 25 MID-LEVEL PROVIDERS, UEMF PROVIDES EMERGENCY DEPARTMENT STAFFING FOR RHODE ISLAND HOSPITAL, THE REGION'S ONLY LEVEL I TRAUMA CENTER; HASBRO CHILDREN'S HOSPITAL, THE STATE'S ONLY CHILDREN'S SPECIALTY HOSPITAL; AND THE MIRIAM HOSPITAL, WHICH IS A LEADING COMMUNITY TEACHING HOSPITAL. ALL UEMF MEMBER PHYSICIANS ARE BOARD CERTIFIED IN EMERGENCY MEDICINE OR PEDIATRIC EMERGENCY MEDICINE. IN FISCAL YEAR 2012, UEMF PROVIDED EMERGENCY MEDICAL CARE TO 218,164 PATIENTS. IN ADDITION, 98 RESIDENTS AND FELLOWS RECEIVED TEACHING, 2,739 INDIVIDUALS RECEIVED TRAINING IN A SIMULATION CENTER, AND 92 RESIDENTS AND 45 MEDICAL STUDENTS FROM OTHER DEPARTMENTS ROTATED THROUGH THE EMERGENCY DEPARTMENT TO RECEIVE EDUCATION SERVICES. 36904389 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 25 0 213 1 0 0 0 0 0 0 0 0 0 0 X 10 2 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 1 1 1 0 RI X KEITH NEAL 4015191602 18 IMPERIAL PLACE UNIT 10 PROVIDENCE RI 02903 BRIAN ZINK 40.00 X X 552902 0 56292 ANTHONY NAPOLI 40.00 X X 278767 0 54093 SUSAN DUFFY 40.00 X X 257774 0 54754 BRIAN CLYNE 40.00 X 290923 0 53422 CATHERINE CUMMINGS 40.00 X 258177 0 51683 ILSE JENOURI 40.00 X 266622 0 52986 MIHIR KAMAT 40.00 X 285153 0 53533 MATTHEW KOPP 40.00 X 268405 0 53941 JAMES MONTI 40.00 X 263656 0 53993 DAVID PORTELLI 40.00 X 296435 0 53992 JOHN MURPHY 1.00 X 0 0 0 GLENN TUNG 1.00 X 0 0 0 GARY BUBLY 40.00 X 319170 0 56568 FRANCIS SULLIVAN 40.00 X 347868 0 45460 GREGORY JAY 40.00 X 350065 0 55035 DANIEL SAVITT 40.00 X 344662 0 55195 KENNETH WILLIAMS 40.00 X 312142 0 54816 4692721 0 805763 99 0 1 0 0 PATIENT SERVICES 621400 34865328 34865328 TEACHING AND ADMIN REV 621400 2946898 2946898 RESEARCH GRANTS 621400 2433108 2433108 OTHER INCOME 621400 3842 3842 40249176 130733 130733 3911451 3907698 3753 3753 3753 40383662 40249176 0 134486 82500 82500 4116367 3910549 205818 24129344 22646529 1482815 3035216 2849488 185728 2181719 2048322 133397 1390646 1307207 83439 20030 20030 31895 31895 92202 34798 57404 160053 94233 65820 23177 11589 11588 123513 123513 15275 15275 9155 9155 110751 110751 83738 69223 14515 MALPRACTICE INSURANCE 1764931 1764931 RESEARCH CONTRIBUTIONS 791066 791066 OUTSIDE SERVICES 501011 501011 SCRIBES 403392 403392 1003161 755381 247780 40069142 36904389 3164753 0 1189148 1099956 425814 623546 190938 180721 834918 258652 454067 576266 2136942 2576411 7198720 7533454 11595629 12590354 5445328 5750811 5445328 5750811 X 6150301 6839543 6150301 6839543 11595629 12590354 X 314520 374722 X 1 0 1 X 0 X 350000 47638 302362 59856 13115 46741 425062 197899 227163 576266 MONEY MARKET 7533454 C 7533454 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE FOUNDATION IS A SUPPORTING ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 509(A)(3) OF THE INTERNAL REVENUE CODE. AUTHORITATIVE GUIDANCE REQUIRES THE EVALUATION OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN THE COURSE OF PREPARING THE TAX RETURNS OF THE FOUNDATION TO DETERMINE WHETHER THE TAX POSITIONS ARE "MORE LIKELY THAN NOT" TO BE SUSTAINED BY THE APPLICABLE TAXING AUTHORITY. TAX POSITIONS NOT DEEMED TO MEET THE "MORE LIKELY THAN NOT" THRESHOLD WOULD BE RECORDED AS A TAX BENEFIT OR EXPENSE IN THE CURRENT YEAR. THE FOUNDATION ANNUALLY FILES INTERNAL REVENUE SERVICE (IRS) FORM 990, REPORTING VARIOUS INFORMATION THAT THE IRS USES TO MONITOR THE ACTIVITIES OF TAX EXEMPT ENTITIES. THESE TAX RETURNS ARE SUBJECT TO REVIEW BY THE TAXING AUTHORITIES AND ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. THE FOUNDATION CURRENTLY HAS NO TAX EXAMINATIONS IN PROGRESS. MANAGEMENT BELIEVES THE FOUNDATION OPERATES IN A MANNER CONSISTENT WITH ITS TAX EXEMPT STATUS AT BOTH THE FEDERAL AND STATE LEVEL. 0 BROWN UNIVERSITY OFFICE OF BIOMEDICAL ADVANCEMENT PO BOX G-ADV PROVIDENCE RI 02912 050258937 501(C)(3) 60000 SUPPORT FOR THE CONSTRUCTION OF THE NEW BROWN MEDICAL SCHOOL BUILDING HASBRO CHILDREN'S HOSPITAL CO RHODE ISLAND HOSPITAL 2004 TANKA GALA PO BOX H PROVIDENCE RI 02901 050258954 501(C)(3) 5000 SPONSORSHIP FOR HASBRO CHILDREN'S HOSPITAL GOLF TOURNAMENT & LUNCHEON RHODE ISLAND HOSPITAL FOUNDATION LIFESPAN DEVELOPMENT OFFICEPO BOX H H PROVIDENCE RI 02901 050468736 501(C)(3) 11500 BRONZE SPONSORSHIP FOR THE HCH BALL AND DONATION TO THE PRESIDENT'S PURSUIT OF EXCELLENCE DINNER THE MIRIAM HOSPITAL FOUNDATION LIFESPAN DEVELOPMENT OFFICEPO BOX H H PROVIDENCE RI 02901 050377502 501(C)(3) 5000 BRONZE SPONSORSHIP FOR THE 2012 MIRIAM HOSPITAL WINE & DINE 4 1 X X X X 0 0 0 0 0 0 0 0 0 BRIAN ZINK 552902 0 0 0 0 0 32500 0 23792 0 609194 0 0 0 ANTHONY NAPOLI 278767 0 0 0 0 0 32500 0 21593 0 332860 0 0 0 SUSAN DUFFY 257774 0 0 0 0 0 32500 0 22254 0 312528 0 0 0 BRIAN CLYNE 290923 0 0 0 0 0 32500 0 20922 0 344345 0 0 0 CATHERINE CUMMINGS 258177 0 0 0 0 0 32500 0 19183 0 309860 0 0 0 ILSE JENOURI 266622 0 0 0 0 0 32500 0 20486 0 319608 0 0 0 MIHIR KAMAT 285153 0 0 0 0 0 32500 0 21033 0 338686 0 0 0 MATTHEW KOPP 268405 0 0 0 0 0 32500 0 21441 0 322346 0 0 0 JAMES MONTI 263656 0 0 0 0 0 32500 0 21493 0 317649 0 0 0 DAVID PORTELLI 296435 0 0 0 0 0 32500 0 21492 0 350427 0 0 0 GARY BUBLY 319170 0 0 0 0 0 32500 0 24068 0 375738 0 0 0 FRANCIS SULLIVAN 347868 0 0 0 0 0 32500 0 12960 0 393328 0 0 0 GREGORY JAY 350065 0 0 0 0 0 32500 0 22535 0 405100 0 0 0 DANIEL SAVITT 344662 0 0 0 0 0 32500 0 22695 0 399857 0 0 0 KENNETH WILLIAMS 312142 0 0 0 0 0 32500 0 22316 0 366958 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE FOLLOWING PHYSICIANS ARE ELIGIBLE TO JOIN THE FOUNDATION AS MEMBERS, THOSE WHO: ARE MEMBERS OF THE STAFF ASSOCIATION OF RHODE ISLAND HOSPITAL (RIH) AND THE MIRIAM HOSPITAL (TMH), AND HOLD PROFESSIONAL STAFF APPOINTMENTS WITHIN THE DEPARTMENT OF EMERGENCY MEDICINE AT RIH OR THE DIVISION OF EMERGENCY MEDICINE AT TMH, AND EITHER HOLD A FACULTY APPOINTMENT IN THE BROWN UNIVERSITY MEDICAL SCHOOL (BROWN) OR HAVE BEEN EMPLOYED BY THE FOUNDATION FOR LESS THAN ONE YEAR AND HAVE AGREED TO APPLY FOR A BROWN FACULTY APPOINTMENT, AND ARE APPROVED BY THE RIH CHIEF OF THE DEPARTMENT OF EMERGENCY MEDICINE AND THE FOUNDATION'S BOARD OF DIRECTORS, AND WILL BE EMPLOYED BY THE FOUNDATION TO CONDUCT THEIR PRACTICE OF MEDICINE EXCLUSIVELY ON BEHALF OF THE FOUNDATION, UNLESS OTHERWISE RECOMMENDED BY THE PRESIDENT AND APPROVED BY THE BOARD, AND WILL BE BOARD CERTIFIED OR BOARD ELIGIBLE IN EMERGENCY MEDICINE OR PEDIATRIC EMERGENCY MEDICINE, UNLESS OTHERWISE RECOMMENDED BY THE PRESIDENT AND APPROVED BY THE BOARD. EACH SUCH ELIGIBLE PHYSICIAN WHO HAS IN EFFECT AN EMPLOYMENT AGREEMENT WITH THE FOUNDATION SHALL BE A MEMBER OF THE FOUNDATION AS LONG AS THE EMPLOYMENT AGREEMENT IS IN A FORM APPROVED BY THE BOARD AND THE CHIEF OF EMERGENCY MEDICINE (RIH). FORM 990, PART VI, SECTION A, LINE 7A THE BOARD OF DIRECTORS SHALL BE COMPRISED OF: THE CHIEF OF EMERGENCY MEDICINE, EX OFFICIO, WITH VOTING RIGHTS; THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF LIFESPAN CORPORATION, A RI NON-PROFIT CORPORATION WHICH IS THE SOLE MEMBER OF RHODE ISLAND HOSPITAL, THE MIRIAM HOSPITAL, AND OTHER NON-PROFIT HEALTH CARE PROVIDERS, OR HIS/HER DESIGNEE, EX OFFICIO, WITH VOTING RIGHTS; THE DEAN OF MEDICINE OF BROWN UNIVERSITY MEDICAL SCHOOL OR HIS/HER DESIGNEE, EX OFFICIO, WITH VOTING RIGHTS; UP TO 8 MEMBERS ELECTED BY THE MEMBERS AT AN ANNUAL MEETING OR ANY SPECIAL MEETING HELD IN LIEU THEREOF BASED ON NOMINATIONS MADE BY THE NOMINATING COMMITTEE (EACH AN AT-LARGE DIRECTOR); AND UP TO 2 INDIVIDUALS ELECTED BY THE BOARD WHO ARE NOT EMPLOYED BY THE ORGANIZATION AND ARE NOT NECESSARILY PHYSICIANS, BASED ON NOMINATIONS FROM THE NOMINATING COMMITTEE (EACH AN "OUTSIDE DIRECTOR"). EACH MEMBER SHALL BE ENTITLED TO ONE VOTE AT ANNUAL AND SPECIAL MEETINGS OF THE MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THERE WILL BE AN ANNUAL MEETING OF THE MEMBERS HELD IN THE MONTH OF DECEMBER EACH YEAR. THERE MAY ALSO BE SPECIAL MEETINGS OF THE MEMBERS, WHICH CAN BE CALLED BY THE PRESIDENT, BY THE BOARD, OR BY 2/3 VOTE OF THE MEMBERS ENTITLED TO VOTE. THERE ARE REQUIREMENTS FOR PROVIDING NOTICE OF THE MEETINGS TO THE MEMBERS. EACH MEMBER SHALL BE ENTITLED TO ONE VOTE. VACANCIES IN THE BOARD OR IN ANY CORPORATE OFFICE MAY BE FILLED BY ELECTION BY THE REMAINING DIRECTORS AT ANY REGULAR OR SPECIAL MEETING, BUT IF A VACANCY EXISTS AT THE TIME OF ANY MEMBERS' MEETING, IT SHALL BE FILLED BY ELECTION AT SAID MEETING. AN AT-LARGE DIRECTOR MAY BE REMOVED FROM OFFICE WITH OR WITHOUT CAUSE AT ANY ANNUAL, REGULAR, OR SPECIAL MEETING OF MEMBERS BY VOTE OF AT LEAST 2/3 OF THE MEMBERS ENTITLED TO VOTE IN THE ELECTION OF SUCH DIRECTORS AND PRESENT IN PERSON OR BY PROXY AT A MEETING IN WHICH A QUORUM (MAJORITY) IS PRESENT, OR FOR CAUSE BY A VOTE OF A MAJORITY OF THE DIRECTORS THEN IN OFFICE AND PRESENT AT A MEETING IN WHICH A QUORUM IS PRESENT; PROVIDED, HOWEVER, THAT A DIRECTOR MAY BE REMOVED FOR CAUSE ONLY AFTER REASONABLE NOTICE AND OPPORTUNITY TO BE HEARD BEFORE THE BODY PROPOSING TO REMOVE HIM. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY THE EXTERNAL AUDITORS AND REVIEWED BY MANAGEMENT AND THE AUDIT COMMITTEE OF THE BOARD. REVISIONS, CORRECTIONS, ETC. ARE MADE AS NECESSARY. ONCE ALL ARE SATISFIED WITH THE FORM, IT IS FINALIZED AND A COPY IS SENT TO ALL BOARD MEMBERS. A REVIEW IS CONDUCTED AT A BOARD OF TRUSTEES MEETING PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS PROVIDED TO ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES. THESE PEOPLE ARE ASKED TO REVIEW THE POLICY AND SIGN A STATEMENT INDICATING THAT THEY UNDERSTAND THE POLICY, HAVE REPORTED ALL POTENTIAL CONFLICTS DURING THE PAST YEAR IN ACCORDANCE WITH THE POLICY AND WILL REPORT ALL POTENTIAL CONFLICTS DURING THE COMING YEAR. ALL POTENTIAL CONFLICTS ARE EVALUATED BY THE BOARD TO DETERMINE IF A CONFLICT ACTUALLY EXISTS. (AN ATTORNEY IS PRESENT AT EACH BOARD MEETING). IN THOSE INSTANCES WHERE THE POTENTIAL TRANSACTION IS A CONFLICT THE BOARD EXAMINES THE TRANSACTION AND A VOTE IS TAKEN (WITH THOSE INVOLVED RECUSING THEMSELVES) AS TO WHETHER THE ORGANIZATION WILL ENTER INTO THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 AN INDEPENDENT COMPENSATION COMMITTEE CONDUCTS A PERFORMANCE REVIEW AND EVALUATION OF ALL MEMBER COMPENSATION, INCLUDING THE PRESIDENT. THIS PROCESS INVOLVES THE EVALUATION OF THE INDIVIDUAL AND A REVIEW OF COMPENSATION OF COMPARABLE POSITIONS OBTAINED FROM PUBLISHED SURVEYS OF INDUSTRY DATA. THE COMMITTEE'S DELIBERATION AND DECISION IS NOTED IN THE MINUTES OF THE MEETING. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS (ARTICLES OF INCORPORATION AND BY-LAWS, INCLUDING ITS CONFLICT OF INTEREST POLICY) AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. THE ORGANIZATION WILL MAIL COPIES UPON REQUEST OR PROVIDE COPIES TO THOSE WHO COME TO THE ADMINISTRATIVE OFFICE DURING NORMAL BUSINESS HOURS. THE ORGANIZATION CHARGES FOR THE COPIES IN ACCORDANCE WITH IRS REGULATIONS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 374,722.