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
Morton Plant Mease Primary Care Inc
Employer identification number
59-3140335
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.") .
10,751,646
10,790,383
14,366,222
12,028,371
15,656,809
63,593,431
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......
29,895,816
33,527,698
35,024,654
37,698,286
37,972,890
174,119,344
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.
40,647,462
44,318,081
49,390,876
49,726,657
53,629,699
237,712,775
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
0
0
0
0
0
0
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..
0
0
0
0
0
0
8
Public Support (Subtract line 7c from line 6.)
237,712,775
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...
40,647,462
44,318,081
49,390,876
49,726,657
53,629,699
237,712,775
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
709
539
68,025
47,213
23,913
140,399
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
980
13
0
0
0
993
c
Add lines 10a and 10b.
1,689
552
68,025
47,213
23,913
141,392
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.)
238,792
21,422
37,181
297,395
13
Total support (Add lines 9, 10c, 11 and 12.).
40,887,943
44,340,055
49,496,082
49,773,870
53,653,612
238,151,562
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
99.816 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
99.732 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
0.059 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
0.051 %
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
Morton Plant Mease Primary Care Inc
Employer identification number
59-3140335
Identifier
Return Reference
Explanation
Part III and Part VI
Form 990, Part III, Program Services All of our offices are community based and located to enhance patient access to quality medical care. Through our affiliation with BayCare and Morton Plant Mease Healthcare, we provide our patients with access to inpatient and outpatient services at facilities that are nationally recognized for quality of care and services. Our 90 plus board certified primary care physicians performed 355,511 visits in 2010. During this period we provided nearly $473,000 in charity care to the community and donated more than 2,000 hours of free medical care and education in furtherance of our mission. Our physicians volunteer, without compensation at community based organizations such as Hope International Orphanage, the Sickle Cell Anemia Foundation, the American Cancer Society and the Clearwater Free Clinic. MPMPC also provides the clinical environment for the Turley Family Practice Residency Program, which in affiliation with the University of South Florida provides the faculty instruction of new Family Medicine Residents. Given the shortage of primary care physicians nationally, this is critical to improving the community's access to quality care as many of these residents stay in the community or are employed by MPMPC upon completion of their residency. In furtherance of our mission to improve the care of all we serve, MPMPC continues to expend significant resources on improvements in patient quality care and safety. The MPMPC Patient Quality and Safety committee, formed in 2007, comprised of physician volunteers, continue to oversee the group's efforts in clinical protocol development and safety related programs. As a direct result of this Committee's efforts, MPMPC as a group has received NCQA recognition of its Diabetic patients. In addition, the majority of MPMPC physicians have received individual recognition by the NCQA for the quality of their Heart and Stroke care. With our clinical protocol chart reviews in the areas of Diabetes, Hypertension, Hyperlipidemia, Mammogram Screening, Depression Screening, Vaccine administration, Colo-Rectal Cancer and Abdominal Aortic Aneurysm screening, and our group-wide adoption of an electronic medical record, we are confident that our group's clinical outcomes are amount the best in the country. In 2010, MPMPC began the process of NCQA recognition as a Patient Centered Medical Home and to-date, all offices have been submitted and all have received that highest lever (III) recognition by NCQA. Our MPMPC Patient Satisfaction scores benchmarked in the highest percentile of all group practices surveyed. Form 990, Part VI, Question 2 - Description of Family or Business Relationship Stephen Mason and Glenn Waters are Board members of the Organization, as well as Board members of a taxable entity, which is an affiliate of the filing Organization. Form 990, Part VI, Question 6 - Description of Classes of Members or Stockholders The MPMPC bylaws state that the member of MPMPC is Morton Plant Mease Health Care, Inc. Form 990, Part VI, Question 7a - Description of Classes of Persons and the Nature of Their Rights The Articles of Incorporation state that the Member (MPMHC) shall appoint directors for MPMPC. Form 990, Part VI, Question 7b - Descr Classes of Persons, Decisions Requiring Appr & Type of Voting Rights The taxpayer is a Participant, as defined in the Second Restated Joint Operating Agreement dated as of May 23, 2006, as amended (the "JOA"). Under the JOA, BayCare health System, Inc. is responsible for the operations of the Participants. The JOA Participants include the taxpayer and other hospitals and non-hospital organizations. Notice of the JOA was previously provided to the Internal Revenue Service by letter dated July 1, 1997. The MPMPC's Operating Budget and Capital Budget are approved by its Member, MPMHC. Any major corporate restructures are also approved by its Member. Form 990, Part VI, Question 11b - Describe the Process used by Management &/or Governing Body to Review 990 The Form 990 is prepared by the organization and reviewed by the CFO, as well as the organization's paid preparer. A final copy of the Form 990 was reviewed by a subcommittee of the Board of Directors. Prior to filing, a final copy of the Form 990 will be made available to the entire Board. Form 990, Part VI, Question 12c - Description of Process to Monitor Transactions for Conflicts of Interest Morton Plant Mease Primary Care, Inc. has two separate conflict of interest procedures; one that relates to Board members and another that relates to non-board member employees. Both groups are required on an annual basis to complete, sign and file an annual disclosure statement detailing existing or potential conflicts of interests. For Board members, the review of conflicts or potential conflicts occurs at the Board or committee level. After disclosure of the Board Member's or Committee Member's actual or potential conflict, the following procedures for addressing the conflict of interest will be adhered to by each Board and all Committees with Board delegated powers, without exception: 1. The interested Director or Committee member shall leave the Board or Committee meeting while the conflict of interest issue is discussed. 2. The remaining Board or Committee Members shall decide if a conflict of interest exists. 3. If a conflict of interest is deemed to exist: a. The Chairperson of the Board or Committee shall, if appropriate, appoint a disinterested individual or committee to investigate the proposed transaction or arrangement. b. The Board or Committee shall determine whether the BayCare entity can obtain a more advantageous transaction or arrangement with reasonable efforts from an individual or entity that would not give rise to a conflict of interest. c. If a more advantageous transaction or arrangement is not reasonably available, the Board or Committee shall determine whether the transaction or arrangement is in the BayCare entity's best interest, and whether the transaction is fair and reasonable to BayCare. An interested Director or Committee Member shall not vote, participate in, influence or attempt to influence any determination or proceedings. The Director or Committee Member may, however, respond to questions posed by the Board or Committee regarding the contract or transaction. Any such contract or transaction must be authorized by a vote of at least two-thirds (2/3) of the Directors or Committee Members entitled to vote at a meeting at which a quorum was present. Any interested Director or Committee Member may not be counted in determining the existence of a quorum. For employees, the review of conflicts of interest or potential conflicts goes to the Conflict of Interest Determination Committee. This committee consists of BayCare Chief Compliance Officer, the Corporate Responsibility Officers, and the BayCare Vice President of Team Resources. This committee shall determine if an actual conflict exists and any action required to address the conflict of interest situation. and any action required to address the conflict of interest situation.
Part VI and Part VII
Form 990, Part VI, Question 15a & 15b - Process used for Compensation Review and Approval The organization uses an independent compensation committee, appointed by the Board of Directors. The Compensation Committee's purpose is to provide oversight for the organization's executive compensation program, review and approve compensation and benefits for all "disqualified persons" subject to the Intermediate Sanctions regulations issued under Section 4958 of the Internal Revenue Code (including the Chief Executive Officer, Chief Administrative Officer & CFO, other system and entity executives, and other disqualified persons as defined in the Intermediate Sanctions regulations (i.e., voting members of the governing body, family members, former officers)), and establish the compensation philosophy for all other executives. This committee engages nationally recognized compensation consultants to assist them in review of executive compensation. The compensation consultants provide a review of each vice president and above in the system to determine if that employee's compensation is reasonable when compared against market standards. The data reviewed comes from compensation studies that include comparable compensation for similarly qualified persons in functionally comparable positions at similarly situated organizations. The organization keeps contemporaneous minutes of the compensation committees meetings and decisions. External consultants review compensation every other year the last review occurring in 2009, but the compensation committee regularly monitors compensation and all other procedures are followed annually. Form 990, Part VI, Question 19 - How and If the Governing Documents, Conflict of Interest Policy and Financial Statements are Made Available to the Public Morton Plant Mease Primary Care, Inc does not make its financial statements, governing documents or conflict of interest policy available to the public. Form 990, Part VII, Section A, Column B - Estimated hours worked by officers, directors, trustees, key employees, and highest compensated employees at related entities: Carl Tremonti - Morton Plant Hospital Association, Inc. - 1 Carl Tremonti - Morton Plant Mease Health Care, Inc. - 45 Carl Tremonti - Morton Plant Mease Health Services, Inc. - 1 Carl Tremonti - St. Anthony's Hospital, Inc. - 1 Carl Tremonti - St. Anthony's Professional Buildings & Services, Inc. - 1 Carl Tremonti - Trustees of Mease Hospital, Inc. - 1 Donald Pocock - Morton Plant Mease Health Care, Inc. - 45 Donald Pocock - Morton Plant Mease Health Services, Inc. - 1 Glenn Waters - BayCare Alliant Hospital, Inc. - 0 Glenn Waters - BayCare Home Care, Inc. - 1 Glenn Waters - Morton Plant Hospital Association, Inc. - 1 Glenn Waters - Morton Plant Mease Health Care, Inc. - 45 Glenn Waters - Morton Plant Mease Health Services, Inc. - 1 Glenn Waters - Trustees of Mease Hospital, Inc. - 1 James Harper - Morton Plant Mease Health Services, Inc. - 1 Odalys Lara - BayCare Health System, Inc. - 1 Odalys Lara - Morton Plant Hospital Association, Inc. - 1 Odalys Lara - Morton Plant Mease Health Care, Inc. - 1 Odalys Lara - Trustees of Mease Hospital, Inc. - 1 Pat Ryan - Morton Plant Hospital Association, Inc. - 1 Pat Ryan - Morton Plant Mease Health Care, Inc. - 1 Pat Ryan - Morton Plant Mease Health Services, Inc. - 1 Pat Ryan - Trustees of Mease Hospital, Inc. - 1 Stephen Mason - BayCare Health System, Inc. - 45 Stephen Mason - BayCare Home Care, Inc. - 1 Stephen Mason - Morton Plant Hospital Association, Inc. - 1 Stephen Mason - Morton Plant Mease Health Care, Inc. - 1 Stephen Mason - St. Anthony's Hospital, Inc. - 1 Stephen Mason - St. Joseph's Health Care Center, Inc. - 1 Stephen Mason - Trustees of Mease Hospital, Inc. - 1 William Price - Morton Plant Hospital Association, Inc. - 1 William Price - Morton Plant Mease Health Care, Inc. - 1 William Price - Trustees of Mease Hospital, Inc. - 1
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.