Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Jewish Physician Group Inc
Employer identification number
61-1352729
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
200,000
99,601
283,905
158,891
120,819
863,216
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
27,034,976
39,574,825
72,384,966
89,335,569
96,909,350
325,239,686
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
27,234,976
39,674,426
72,668,871
89,494,460
97,030,169
326,102,902
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
326,102,902
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
27,234,976
39,674,426
72,668,871
89,494,460
97,030,169
326,102,902
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
617
1,500
21,107
45,505
70,253
138,982
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
617
1,500
21,107
45,505
70,253
138,982
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
27,235,593
39,675,926
72,689,978
89,539,965
97,100,422
326,241,884
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
99.957 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
99.921 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
0.043 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
0.079 %
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Jewish Physician Group Inc
Employer identification number
61-1352729
Identifier
Return Reference
Explanation
MEMBERS OF THE ORGANIZATION
FORM 990, PART VI, SECTION A, LINE 6
------------------------- Jewish Physician Group, Inc. is a Kentucky Nonstock Corporation whose sole corporate member is Jewish Hosptial & St. Mary's HealthCare, Inc.- a related non-profit corporation.
ELECTION OF MEMBERS OF THE GOVERNING BODY
FORM 990, PART VI, SECTION A, LINE 7A
------------------------- The amended and restated by-laws of the corporation state there shall be nine members of the Board of Directors. Two of those members shall be the Chief Medical Officer and the Chief Operating Officer of Jewish Hospital & St. Mary's HealthCare, Inc., JPG's sole Corporate Member. Additionally, the President and Chief Executive Officer of JPG, the Chairperson of the Board, and the Vice Chairperson of the Board are appointed by the Chief Executive Officer of JHSMH.
APPROVAL OF DECISIONS OF THE GOVERNING BODY
FORM 990, PART VI, SECTION A, LINE 7B
------------------------- The following matters, if previously approved by the Board or any Committee of the Board, shall also require the prior approval of the Corporate Member to be effective: Approval of the annual operating and capital budgets of JPG; Approval of any financial expenditure which deviate from any line item of JPG's annual operating or capital budgets by more than $500,000; Approval of the sale, lease, mortgage, or other transfer or encumbrance of the real property of JPG; Approval of any sale, lease, mortgage or other transfer or encumbrance of the personal property and assets of JPG if the sum of any such transfers in any year exceeds $500,000; Approval of the merger, acquisition, consolidation, liquidation or dissolution of JPG; Approval of the adoption, approval and amendment of salaries and other compensation (including the award of any incentive compensation) and benefits and the other terms of employment (including compensation plans, formulas and philosophy) or engagement of the officers and employees, including physician employees of JPG, and physicians who are independent contractors for JPG; Approval of any borrowing or lending of money or the creation of indebtedness through the guaranty of another's debt or similar action; Approval of any giving, seeking or receiving and oversight of administration or use of grants and other contributions and gifts; Approval of the commencement or settlement of claims or litigation in excess of a threshold amount; Approval of the appointment and removal of directors of the board of JPG; Approval of the creation, ownership or acquisition of, or affiliation with, any other organization; Approval of the alteration, amendment or repeal of the Bylaws of JPG; Approval of the alteration, amendment or repeal of the Articles of Incorporation of JPG; Approval of the adoption or modification of any strategic plan, business plan, or mission plan of JPG; Approval of any material changes in the scope of services offered by JPG, including the range of physician specialties employed by or contracted by JPG; Approval of the addition of any new corporate members; and Approval of the adoption, modification or repeal of policies of JPG pertaining to charity care and nondiscrimination against Medicare and Medicaid patients. In addition, the 2008 bylaws revisions added the following statement relating to the rights and powers reserved to the sole corporate member, JHSMH: "In addition to the rights reserved to the Corporate Member pursuant to these Bylaws, the Corporate Member is granted authority to unilaterally take any action on behalf of, or with respect to, the Corporation which is not inconsistent with Kentucky law and which is required to maintain the federal and state tax exemptions of the Corporation and the Corporate Member, to not result in the Corporation having more than an insubstantial amount of unrelated business activities, and to result in the Corporation acting in furtherance of its and the Corporate Member's tax exempt purposes. In all cases, these determinations shall be made by the Corporate Member in its discretion reasonably exercised based on the advice of legal counsel or upon any reasonable ground, including, without limitation, a request or direction of any legislative, administrative, regulatory or judicial agency having authority with respect to the subject matter under consideration."
REVIEW OF FORM 990
FORM 990, PART VI, SECTION B, LINE 11
------------------------- A complete copy of the final Form 990 is provided to the Jewish Hospital & St. Mary's Healthcare, Inc. board members at their October meeting and any questions are addressed. The Form 990 is presented to the JHSMH board members as JHSMH has significant control over TPG through the reserved powers outlined on Part VI, question 6 and 7b.
PROCESS FOR DETERMINING COMPENSATION
FORM 990, PART VI, SECTION B, LINE 15A & 15B
------------------------- Debbie Molnar is the President of Jewish Physician Group, Inc. ("JPG") Katie Wood is Vice President of JPG. Debbie and Katie are both employed by Jewish Hospital & St. Mary's Healthcare. Their compensation is reviewed and approved by Jewish Hospital & St. Mary's HealthCare, Inc. The following review and approval process is used by Jewish Hospital & St. Mary's HealthCare, Inc. (JHSMH). The Management Review Committee consists of approximately 9 members of JHSMH's Board, and is responsible for review and approval of top management compensation. During 2010, the Committee consisted of independent directors. The full committee addressed the overall compensation philosophy and how the organization's goals can be furthered by the structure of compensation. The independent Management Review Committee and all independent members of the full Board approved maximum compensation levels for all Disqualified Persons. Non-independent directors did not participate in the discussion or vote on compensation levels for individuals. The Management Review Committee retained an outside compensation consultant from a national firm to advise it regarding reasonable compensation levels, and relied on the consultant's opinion that compensation levels are reasonable. The Committee receives a market review on each Disqualified Person from the compensation consultant. The Management Review Committee approved the peer group of similar entitles used to measure comparable compensation levels. The Management Review Committee follows the process necessary to obtain the rebuttable presumption that compensation levels are reasonable, including contemporaneous documentation of decisions. Physician Compensation --------------------- Physician Compensation is overseen by the Physician Transaction Committee of the Jewish Hospital & St. Mary's Helathcare ("JHSMH") Board. The Physician Transaction Committee has been established as a subcommittee of the JHSMH Finance Committee and is comprised of board members from JHSMH, JPG's sole corporate member. All members of the Physician Transaction Committee are independent. The Physician Transaction Committee is responsible for ensuring transactions between JPG and physicians, which includes compensation, are conducted at arms length and fair market value. Each physician employee of JPG who provides medical services does so pursuant to a Physician Employment Agreement. Physician compensation levels under the Employment Agreement are based on national industry standards (Medical Group Management Association). In addition, certain bonuses paid to JPG physicians take into account the productivity of each individual physician. Physicians are not penalized for providing charity care. Thus, the compensation arrangement does not have the potential for reducing the charitable services JPG provides. Physician Compensation is reviewed annually by an independent compensation consultant for reasonableness. Outcomes from this review are presented to the Physician Transaction Committee for approval. The Physician Transaction Committee retained an outside compensation consultant to advise it regarding reasonable compensation levels, and relied on the consultant's opinion that compensation levels are reasonable. The Committee receives a market review on each Physician from the compensation consultant. The Physician Transaction Committee follows the process necessary to obtain the rebuttable presumption that compensation levels are reasonable, including contemporaneous documentation of decisions.
MAKING DOCUMENTS AVAILABLE TO THE PUBLIC
FORM 990, PART VI, SECTION B, LINE 19
------------------------- Jewish Physician Group, Inc. f/k/a The Physician Group at Jewish Hospital & St. Mary's HealthCare, Inc. ("JPG") does not make its governing documents, conflict of interest policy or financial statements available to the general public.
Hours worked for Related Organizations
FORM 990, PART VII, SECTION A
------------------------- Debbie Molnar and Lynn Simon are both Key Employees of Jewish Hospital & St. Mary's Healthcare, Inc., the sole corporate member of Jewish Physician Group. Debbie and Lynn work an average of 50 hours per week for Jewish Hospital & St. Mary's HealthCare, Inc.
MONITORING THE CONFLICT OF INTEREST POLICY
FORM 990, PART VI, SECTION B, LINE 12C
------------------------- Annual Statements ------------------- Each trustee, director, officer and member of a committee with board delegated powers of JPG, shall annually sign a statement, which affirms that such person: Has received a copy of JPG's conflicts of interest policy, Has read and understands this policy, Has agreed to comply with this policy, and Understands that JPG is a charitable organization and that in order to maintain its federal tax exemption it must engage primarily in activities that accomplish one or more of its tax-exempt purpose. Annual Questionnaire -------------------- Each trustee, director, officer and member of a committee with board delegated powers of JPG, and key employee of JPG, shall annually complete a Conflicts of Interest Questionnaire. Completion of the annual questionnaire is coordinated by JHSMH's General Counsel and JHSMH's Corporate Compliance Officer. Periodic Reviews -------------------- To ensure that each of the JPG operates in a manner consistent with its charitable purposes and that it does not engage in activities that could jeopardize its status as an organization exempt from federal income tax, periodic reviews shall be conducted. The periodic reviews shall, at a minimum, include the following subjects: Whether compensation arrangements and benefits are reasonable and are the result of arm's-length bargaining. Whether acquisitions of physician practices and other provider services result in inurement or impermissible private benefit. Whether partnership and joint venture arrangements and arrangements with management service organizations and physician hospital organizations conform to written policies, are properly recorded, reflect reasonable payments for goods and services, further such JPG's charitable purposes and do not result in inurement or impermissible private benefit. Whether agreements to provide health care and agreements with other health care providers, employees, and third party payors further JPG's charitable purposes and does not result in inurement or impermissible private benefit. In conducting such periodic reviews, JPG may, but need not, use outside advisors. If outside experts are used, their use shall not relieve the governing board of its responsibility for ensuring that periodic reviews are conducted.
RECONCILIATION OF NET ASSETS
FORM 990, PART XI, LINE 5
------------------------- OTHER CHANGES IN NET ASSETS: UNREALIZED LOSS $90,994
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:DEBBIE MOLNAR TITLE:President HOURS:35
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.