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
UNIVERSITY OF VIRGINIA PHYSICIANS GROUP
Employer identification number
54-1124769
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.") .
4,910,756
5,109,844
4,135,717
4,060,047
6,477,955
24,694,319
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......
245,351,858
250,943,424
274,947,924
290,514,862
301,853,212
1,363,611,280
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.
250,262,614
256,053,268
279,083,641
294,574,909
308,331,167
1,388,305,599
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.)
1,388,305,599
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...
250,262,614
256,053,268
279,083,641
294,574,909
308,331,167
1,388,305,599
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
6,475,346
3,295,821
172,444
455,720
11,174
10,410,505
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
1,345,315
1,283,068
1,098,388
1,344,847
2,153,180
7,224,798
c
Add lines 10a and 10b.
7,820,661
4,578,889
1,270,832
1,800,567
2,164,354
17,635,303
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.)
11,959,455
11,469,612
15,316,990
14,434,192
15,938,637
69,118,886
13
Total support (Add lines 9, 10c, 11 and 12.).
270,042,730
272,101,769
295,671,463
310,809,668
326,434,158
1,475,059,788
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
94.119 %
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
93.920 %
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
1.196 %
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
1.470 %
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
UNIVERSITY OF VIRGINIA PHYSICIANS GROUP
Employer identification number
54-1124769
Identifier
Return Reference
Explanation
Description of Relationships
Form 990, Part VI, Question 2
Directors, officers, key employees or members of their family may receive health care services from a member of the board as a physician of the Group. These services are provided in the normal course of business and all such individuals are charged for the services rendered.
Describe the Process used by Management &/or Governing Body to Review 990
Form 990, Part VI, Question 11b
Upon receipt of the draft tax return from the tax professionals, management in the finance department review the return in detail and agree the amount and information disclosed with supporting documentation. After review of the draft return by the Director of Finance and the CFO, copies of the return are emailed to the Board of Directors prior to filing the return with the IRS.
Description of Process to Monitor Transactions for Conflicts of Interest
Form 990, Part VI, Question 12c
Employees should contact Human Resources regarding situations which may potentially represent a conflict of interest. If necessary, the Chief of Human Resources will consult with Corporate Counsel to determine whether a conflict of interest is present. In addition to the policy, UPG mails questionnaires to Board members and key employees asking about potential relationships with one and another as part of the tax return preparation process.
Document retention and destruction policy
Form 990, Part VI, Question 14
The organization does have a written document RETENTION and DESTRUCTION policy that was implemented March 1991. This policy is currently being updated and will be approved by the Board of Directors or designated committee once completed.
Offices & Positions for Which Process was Used
Form 990, Part VI, Question 15a
After review by the Dean of the School of Medicine and the Chairman of the University of Virginia Physicians Group Board of Directors, the CEO's compensation is discussed by the University of Virginia Physicians Group Compensation Committee, which is comprised of the public members of the Board of Directors. Changes are communicated in writing to the Chief of Human Resources and documentation is retained in the CEO's personnel file maintained in the Human Resources department. In addition, the Faculty Practice Plan Executive Staff Compensation survey and other relevant survey sources are utilized as a benchmark regarding the CEO's compensation. The documentation, signed by the Chairman of the Board, is maintained in Human Resources in the employee's file once it is received. Minutes of the University of Virginia Physicians Group Compensation Committee are maintained to document the committee's decision. The year the process was last undertaken was FYE 6/30/11.
Offices & Positions for Which Process was Used
Form 990, Part VI, Question 15b
UPG reviews compensation of all administrative employees on a two year cycle. Both the job description as well as comparable market data are analyzed. The Group participates in multiple salary surveys including Towers Watson, APPD, the Virginia Society for Healthcare and Human Resources and Comp Data. In addition to those survey sources, the Medical Group Management Association survey data is reviewed as appropriate. The CEO, based on data presented by the Human Resources Office, reviews data and approves changes for Officer positions after review by the University of Virginia Physicians Group Compensation Committee. For other administrative staff positions, including key employees, not approved by the compensation committee, compensation data is reviewed and discussed by the CEO and other officers, with the final approval by the CEO. This review is completed during the annual budget cycle and at any time a non-budgeted salary request is made. The Dean of the School of Medicine and the Provost review the compensation for the clinical faculty. The year the process was last undertaken was FYE 6/30/11.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen Public
Form 990, Part VI, Question 19
UPG makes its governing documents, conflicts of interest policy and financial statements available upon request. These documents are not posted publicly.
Average Hours Per Week Devoted To Related Organizations
FORM 990, Part VII, Section A, Column (B)
RODNEY E DEANE JR CPA - VIRGINIA UROLOGIC FOUNDATION - .04 HOURS STEVEN T DEKOSKY MD - UNIVERSITY OF VIRGINIA - 55 HOURS ROBERT S GIBSON MD - UNIVERSITY OF VIRGINIA - 19 HOURS R EDWARD HOWELL - UNIVERSITY OF VIRGINIA - 60 HOURS IRVING KRON MD - UNIVERSITY OF VIRGINIA - 25 HOURS DANIEL F MCCARTER MD - UNIVERSITY OF VIRGINIA - 19 HOURS STEPHEN T MCLEAN - VIRGINIA UROLOGIC FOUNDATION - .26 HOURS RAYMOND F MORGAN MD - UNIVERSITY OF VIRGINIA - 12 HOURS LAWRENCE H PHILLIPS II MD - UNIVERSITY OF VIRGINIA - 23 HOURS MITCHELL H ROSNER MD - UNIVERSITY OF VIRGINIA - 23 HOURS BRADLEY E HAWS - UNIVERSITY OF VIRGINIA - 36.5 HOURS - VIRGINIA UROLOGIC FOUNDATION - 0.5 HOURS ERIC J STRUCKO - VIRGINIA UROLOGIC FOUNDATION - 1 HOURS J COREY FEIST - VIRGINIA UROLOGIC FOUNDATION - 1 HOURS ABHINAV B CHHABRA MD - UNIVERSITY OF VIRGINIA - 12 HOURS DAVID R DIDUCH MD - UNIVERSITY OF VIRGINIA - 7 HOURS NEAL F KASSELL MD - UNIVERSITY OF VIRGINIA - 7 HOURS JOHN A KERN MD - UNIVERSITY OF VIRGINIA - 12 HOURS TIMOTHY M SCHMITT MD - UNIVERSITY OF VIRGINIA - 9 HOURS MICHAEL O THORNER MD - UNIVERSITY OF VIRGINIA - 48 HOURS SHARON L HOSTLER MD - UNIVERSITY OF VIRGINIA - 48 HOURS ARTHUR GARSON JR MD - UNIVERSITY OF VIRGINIA - 49 HOURS WILLIAM D STEERS - UNIVERSITY OF VIRGINIA - 13 HOURS JOHN B HANKS MD - UNIVERSITY OF VIRGINIA - 22 HOURS
OTHER CHANGES IN FUND BALANCE OR NET ASSETS
FORM 990, PART XI, LINE 5
CRP Realized Gains $ 1,720,364 Impairment loss on property acquisition (3,991,834) Unrealized gain on investments 13,975,261 Change in pension plan assets & benefit oblig 9,922,000 Change in temporarily restricted net assets (2,605,894) Change in SWAP value 230,554 ----------- $19,250,451
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.