2012-08-09T15:39:29-05:00 2011-09-30 WARREN AVERETT LLC 2500 ACTON ROAD BIRMINGHAM AL 35243 990 2010-10-01 630649108 UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION PC UNIV 2057319600 PO BOX 55407 BIRMINGHAM AL 352555407 MICHAEL HECKMAN 2057319600 2012-07-18 1 2059794100 2010 2016-02-24 21:20:13Z REID F JONES PO BOX 55407 BIRMINGHAM AL 352555407 588697724 0 X N/A X 1973 AL COORDINATE AND DELIVER PATIENT CARE IN A GROUP PRACTICE SETTING. 19 10 3324 54 0 0 0 0 459215027 428974914 8138241 12728048 3536465 3519461 470889733 445222423 21331867 20232982 0 0 273025985 285679513 0 0 0 174069696 141272706 468427548 447185201 2462185 -1962778 720020682 741462304 393906283 432255452 326114399 309206852 COORDINATE AND DELIVER PATIENT CARE IN A GROUP PRACTICE SETTING. 0 0 359833115 20232982 429639580 OPERATION OF A NONPROFIT PHYSICIAN GROUP PRACTICE CLOSELY AFFILIATED WITH THE UNIVERSITY OF ALABAMA AT BIRMINGHAM. HSF CONSISTS OF ALMOST 1,068 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. 359833115 1 0 0 1 0 0 0 0 1 1 1 0 0 1 1 1 0 0 1 1 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 0 1 333 0 1 3324 1 0 0 0 0 0 0 0 0 0 0 X 19 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 5.00 X 1200 0 0 NEAL R BERTE 5.00 X 1200 0 0 DONALD M JAMES 5.00 X 1200 0 0 CHARLES D PERRY JR 5.00 X 1200 0 0 VAN L RICHEY 3.00 X 900 0 0 JEROME C ROSE 5.00 X 1200 0 0 JAMES T STEPHENS 3.00 X 600 0 0 LEE J STYSLINGER III 2.00 X 600 0 0 CHARLES D MCCRARY 0.00 X 0 0 0 THOMAS H LOWDER 5.00 X 1200 0 0 AMIE B JACKSON MD 50.00 X 246355 226649 86395 JAMES A BONNER MD 50.00 X 300812 321870 138158 KIRBY I BLAND MD 50.00 X 641031 216029 86341 ANUPAM AGARWAL MD 50.00 X 32170 164651 47971 EDWARD ABRAHAM MD 50.00 X 163358 347843 93409 ISAAC W FERNIANY PHD 50.00 X 0 873509 148323 WILLIAM W ANDREWS MD 50.00 X 330996 297850 103881 RAY L WATTS MD 50.00 X 257476 380915 122295 KEITH A JONES MD 50.00 X 231033 286844 97146 SERGIO B STAGNO MD 50.00 X 201638 211832 85070 REID F JONES 50.00 X 249428 310104 81793 PATRICIA J PRITCHETT 50.00 X 246788 0 34593 MICHAEL F HECKMAN 50.00 X 218027 0 45944 ROBERT J CERFOLIO MD 60.00 X 980932 62282 65504 MARK N HADLEY MD 60.00 X 930837 55953 57238 DAVID C MCGIFFIN MD 60.00 X 833364 90539 93403 JAMES K KIRKLIN MD 60.00 X 795891 250737 100412 CONWAY C HUANG MD 60.00 X 757523 81270 51540 7426959 4178877 1539416 617 0 1 0 ASSISTMED INC 7095 HOLLYWOOD BLVD SUITE 690 LOS ANGELES CA 90028 TRANSCRIPTION SERVICES 1843572 SANTA ROSA CONSULTING LLC 25900 W 11 MILE ROAD SUITE 100 SOUTHFIELD MI 48034 CONSULTING SERVICES 1775811 EASON GRAHAM & SANDNER P O BOX 530487 BIRMINGHAM AL 35253 BUILDING MANAGEMENT 1327353 PLATINUM AIR SERVICE LLC 26840 SHOREGRASS DRIVE WESLEY CHAPEL FL 33543 AIR SERVICE 1069740 SECURITY ENGINEERS INC 1617 3RD AVENUE N BIRMINGHAM AL 35203 SECURITY ENGINEERS 469232 16 NET PATIENT REVENUE 900099 354496946 354496946 HEALTHCARE SERVICES 900099 59377084 59377084 ORGAN/TISSUE REC 900099 15100884 15100884 428974914 6741773 6741773 3552 3552 2854795 2854795 2854795 2854795 149441150 16874 143338480 136821 6102670 -119947 5982723 5982723 MISCELLANEOUS INCOME 900099 664666 664666 664666 445222423 429639580 0 15582843 20232982 20232982 3417200 2328801 1088399 233425434 187074774 46350660 2819078 1497587 1321491 35280008 25377832 9902176 10737793 7367137 3370656 400506 400506 374525 374525 4713895 4059246 654649 728576 728576 6019907 4717262 1302645 3108692 3108692 42000 42000 5033901 2757588 2276313 3200334 1605833 1594501 324457 133559 190898 3716143 3716143 13414915 3653826 9761089 8342919 8342919 BAD DEBT 29305908 29305908 MEDICAL, SURGICAL AND L 24874486 24874486 SUPPORT SERVICES PRIMAR 18216724 18216724 LOSS ON EQUITY IN PLTF 5980164 5980164 REPAIRS AND MAINTENANCE 4720411 4720411 8754243 4435384 4318859 447185201 359833115 87352086 0 343704 258528 45881903 72740082 42213386 40100789 945800 1099801 325513 329760 1995959 1513706 287433726 143933057 137765787 143500669 396335398 378679036 77094431 91902551 17118801 11337382 720020682 741462304 69221301 82270539 180490000 210490000 144194982 139494913 393906283 432255452 X 326114399 309206852 326114399 309206852 720020682 741462304 X -1962778 -14944769 X X 0 1 1 X 1 1 X 429898445 437353335 464565068 459215027 428974914 2220006789 429898445 437353335 464565068 459215027 428974914 2220006789 0 0 0 2220006789 30264139 5688035 6960785 10515157 9600120 63028236 30264139 5688035 6960785 10515157 9600120 63028236 55400 510856 535076 649353 664666 2415351 460217984 443552226 472060929 470379537 439239700 2285450376 0.97140 0.96740 0.02760 0.03180 X 35290 0 35290 447149911 447185201 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 41063 51250 61615 35290 189218 250000 250000 250000 250000 1000000 1500000 41063 51250 61615 35290 189218 183677444 1760952 -3977580 8000000 173460816 166028256 5465439 15183749 3000000 183677444 179149163 -2920907 10200000 166028256 1.00000 0.00000 0.00000 0 0 28163186 28163186 137627781 57021341 80606440 19098436 11159077 7939359 71387925 62624265 8763660 31156398 13128374 18028024 143500669 CASH AND CASH EQUIVALENTS 39698349 F POOLED INVESTMENTS - CASH EQUIVALENTS 12643427 F POOLED INVESTMENTS - ACCRUED INCOME 273098 F DEFERRED COMP. INVESTMENTS - CASH EQUIVALENTS 5439248 F INVESTMENT IN TRUST FUND 33848429 F 91902551 DEFERRED COMPENSATION 116197067 POST RETIREMENT LIABILITIES 23297846 139494913 445222423 447185201 -1962778 -18225986 3281217 -14944769 -16907547 423738983 -18225986 -3257454 -21483440 445222423 0 445222423 440646530 0 440646530 6538671 6538671 447185201 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 APPROVAL BY THE FOUNDATION'S INVESTMENT COMMITTEE. 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: 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, 2011, THAT IT WOULD BE UNABLE TO SUBSTANTIATE. THE FOUNDATION HAS FILED ITS NOT-FOR-PROFIT TAX RETURNS FOR ALL YEARS THROUGH SEPTEMBER 30, 2010. YEARS ENDED SEPTEMBER 30, 2008, AND SUBSEQUENT REMAIN SUBJECT TO AUDIT BY TAXING AUTHORITIES. PART XI, LINE 8 - OTHER ADJUSTMENTS: OTHER COMPREHENSIVE LOSS-ADOPTION OF SFAS NO. 158 1,700,586. CHANGE IN FMV OF INTEREST RATE SWAP RECORDED DIRECTLY TO EQUITY 1,580,631. PART XII, LINE 2D - OTHER ADJUSTMENTS: OTHER COMPREHENSIVE LOSS-ADOPTION OF SFAS NO. 158 1,700,586. CHANGE IN FMV OF INTEREST RATE SWAP RECORDED DIRECTLY TO EQUITY 1,580,631. PENSION INCOME OFFSET AGAINST EXPENSES FOR TAX PURPOSES -534,840. INVESTMENT INCOME OFFSET AGAINST EXPENSES FOR TAX PURPOSES -5,980,164. CLASSIFICATION OF INCOME/EXPENSES DIFFERENT FOR TAX PURPOSES THAN AUDIT -23,667. PART XIII, LINE 4B - OTHER ADJUSTMENTS: PENSION INCOME OFFSET AGAINST EXPENSES FOR TAX PURPOSES 534,840. INVESTMENT INCOME OFFSET AGAINST EXPENSES FOR TAX PURPOSES 5,980,164. CLASSIFICATION OF INCOME/EXPENSES DIFFERENT FOR TAX PURPOSES THAN AUDIT 23,667. SUB-SAHARAN AFRICA 0 3 PROGRAM SERVICES PROVISION OF PHYSICIANS SERVICES IN ZAMBIA 22000 3 0 3 22000 0 22000 0 0 0 0 0 0 1 UNIVERSITY OF ALABAMA AT BIRMINGHAM 1530 3RD AVENUE SOUTH BIRMINGHAM AL 35294 636005396 POLITICAL SUB 20232982 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 AMIE B JACKSON MD 245607 202227 0 23262 748 1160 31973 35515 21357 1205 299685 263369 0 0 JAMES A BONNER MD 279953 320506 20000 0 859 1364 31973 52551 54348 2959 387133 377380 0 0 KIRBY I BLAND MD 633808 208279 0 2400 7223 5350 31973 37406 19320 3601 692324 257036 0 0 ANUPAM AGARWAL MD 29128 163946 3042 0 0 705 4297 29506 313 15169 36780 209326 0 0 EDWARD ABRAHAM MD 162519 345293 0 0 839 2550 22180 55564 17289 2055 202827 405462 0 0 ISAAC W FERNIANY PHD 0 607467 0 255588 0 10454 0 143208 0 6195 0 1022912 0 0 WILLIAM W ANDREWS MD 304304 295220 25000 200 1692 2430 31973 53004 6934 16653 369903 367507 0 0 RAY L WATTS MD 256010 354746 0 23000 1466 3169 31973 74914 17759 1444 307208 457273 0 0 KEITH A JONES MD 230360 285796 0 0 673 1048 30884 50601 16859 2753 278776 340198 0 0 SERGIO B STAGNO MD 199256 209737 600 0 1782 2095 26721 37171 21286 3806 249645 252809 5100 0 REID F JONES 248062 180776 0 128651 1366 677 31973 42095 10127 2201 291528 354400 0 0 PATRICIA J PRITCHETT 213778 0 32400 0 610 0 31973 0 4688 0 283449 0 0 0 MICHAEL F HECKMAN 188501 0 29000 0 526 0 28895 0 18887 0 265809 0 0 0 ROBERT J CERFOLIO MD 979024 62086 0 0 1908 196 31973 16563 22870 935 1035775 79780 0 0 MARK N HADLEY MD 530225 55702 399085 0 1527 251 31973 9858 19964 334 982774 66145 0 0 DAVID C MCGIFFIN MD 780329 88471 49000 1200 4035 868 31973 15972 47844 1481 913181 107992 0 0 JAMES K KIRKLIN MD 791258 238566 0 8200 4633 3971 49973 43314 11973 1421 857837 295472 0 0 CONWAY C HUANG MD 623566 81090 133251 0 706 180 31973 14372 5232 5322 794728 100964 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. THE MEDICAL CLINIC BOARD OF THE CITY OF BIRMINGHAM - UAHSF 621375181 091041JS3 2005-09-01 20000000 FINANCED THE ACQUISITION OF VARIOUS MEDICAL EQUIPMENT 0 0 0 THE MEDICAL CLINIC BOARD OF THE CITY OF BIRMINGHAM - UAHSF 621375181 091041JT1 2007-03-01 40000000 FINANCED THE CONSTRUCTION OF A MEDICAL FACILITY/PURCHASED EQUIPMENT 0 0 0 THE MEDICAL CLINIC BOARD OF THE CITY OF BIRMINGHAM - UAHSF 621375181 NONEAVAIL 2011-09-07 210490000 PRIOR ISSUE REFUND AND FINANCED CAPITAL IMPROVEMENTS 0 0 0 20000000 2008 0 0 1 1 40000000 30301651 9698349 0 0 0 1 210490000 180490000 30000000 1 1 0 1 0 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 0.00000 0.00000 0.00000 1 1 1 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 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 5: NET UNREALIZED LOSSES ON INVESTMENTS: -18,225,986. OTHER COMPREHENSIVE LOSS-ADOPTION OF SFAS NO. 158 1,700,586. CHANGE IN FMV OF INTEREST RATE SWAP RECORDED DIRECTLY TO EQUITY 1,580,631. TOTAL TO FORM 990, PART XI, LINE 5: -14,944,769. 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) 170(B)(1)(A)VI 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 MEDICAL ADVANCEMENT FOUNDATION PO BOX 55407 BIRMINGHAM AL 352555407 630884469 FUNDRAISING AND MANAGEMENT FUNCTIONS AL 501(C)(3) TYPE I SUPPORT ORG N/A 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 1 UNIVERSITY OF ALABAMA AT BIRMINGHAM B 20232981 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM J 494000 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM N 736790 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM Q 27432210 FMV - CASH UNIVERSITY OF ALABAMA AT BIRMINGHAM R 18358000 FMV - CASH UAB HEALTH SYSTEM Q 5332000 FMV - CASH UAB HEALTH SYSTEM R 8624000 FMV - CASH