Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2011 and ending 06-30-2012
BCheck if applicable:
CName of organization
EVMS Academic Physicians and Surgeons
Health Services Foundation
Doing Business As
EVMS Health Services
 
Number and street (or P.O. box if mail is not delivered to street address)
4111 Monarch Way
 
Room/suite
City or town, state or country, and ZIP + 4
NORFOLK, VA23508
D Employer identification number

52-1576648
E Telephone number

G Gross receipts $ 71,083,969
F Name and address of principal officer:
James F Lind Jr
4111 Monarch Way
Norfolk,VA23508
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.evmshealthservices.org
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1989
M State of legal domicile: VA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE ORGANIZATION SUPPORTS CLINICAL PRACTICE AND RESEARCH AT EVMS IN CONJUNCTION WITH PROVIDING FACULTY THE OPPORTUNITY TO TEACH IN A PHYSICIAN GROUP PRACTICE SETTING WITHIN AN ACADEMIC ENVIRONMENT.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 17
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 5
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 705
6 Total number of volunteers (estimate if necessary) .... 6 3
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 58,747,182 70,082,801
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 150,037 149,315
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 9,748,665 851,853
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 68,645,884 71,083,969
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,867,420 1,819,085
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 40,647,431 42,473,225
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 25,390,634 26,721,169
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 67,905,485 71,013,479
19 Revenue less expenses. Subtract line 18 from line 12....... 740,399 70,490
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 17,821,447 18,248,004
21 Total liabilities (Part X, line 26)............. 10,696,123 11,052,190
22 Net assets or fund balances. Subtract line 21 from line 20..... 7,125,324 7,195,814
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III .........
1
Briefly describe the organization’s mission: SEE SCHEDULE O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 59,955,542 including grants of $ 1,819,085 ) (Revenue $ 70,934,654 )
OVER 180 PHYSICIANS AND OTHER PROVIDERS REPRESENT 20 SPECIALTIES IN PRIMARY CARE, MEDICAL AND SURGICAL CARE AND RADIATION ONCOLOGY WITH FULL-TIME CLINICAL PRACTICES. OUR OFFICES ARE LOCATED THROUGHOUT THE GREATER HAMPTON ROADS REGION, WITH MOST SPECIALTIES AVAILABLE ON THE CAMPUS OF EVMS. FOUNDATION PHYSICIANS AND OTHER PROVIDERS SUPPORT PATIENTS THROUGH COMPREHENSIVE SERVICES, AWARD-WINNING MEDICAL RESEARCH, SPECIALIZED PATIENT CARE PROGRAMS IN CANCER, DIABETES, GERIATRICS, TRAUMA AND WOMEN'S HEALTH AND COLLABORATION WITH NATIONAL AND INTERNATIONAL PARTNERS DEVELOPING MEDICAL TECHNOLOGIES FOR THE FUTURE. WE PRIDE OURSELVES ON STAYING UP TO DATE ON THE LATEST AND SAFEST THERAPIES, TREATMENTS AND TECHNOLOGY. OUR PRACTICES USE AN ELECTRONIC HEALTH RECORD, OR EHR, THAT ALLOWS US TO SERVE OUR PATIENTS FASTER AND BETTER. THE EHR REPLACES THE OLD PAPER MEDICAL CHART WITH SECURE COMPUTERIZED RECORDS WITH ADDED BENEFITS SUCH AS ELECTRONIC PRESCRIBING AND REMOTE ACCESS TO PATIENT MEDICAL INFORMATION. OUR PHYSICIANS CAN VIEW SECURE MEDICAL RECORDS ANYTIME FROM ANYWHERE TO SAFELY PROVIDE AFTER-HOURS OR EMERGENCY CARE. OUR VALUES OF EXCELLENCE, INTEGRITY, TEAMWORK AND SERVICE DRIVE US TO PROVIDE PATIENT-CENTERED QUALITY HEALTHCARE TO THE PATIENTS THAT WE SERVE.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 59,955,542
Form 990 (2011)
Form 990 (2011)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? ........
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment....................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements.
20b
 
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II.........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1.....................
34
 
No
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2...
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2...........
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V .........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
705
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2011)
Form 990 (2011)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI .........
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
17
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
5
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
Yes
 
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
DWIGHT MOULIN
4111 MONARCH WAY
NORFOLK,VA23508
(757) 451-6200
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) L D BRITT MD
Director
 60.0 X           651,055 0 240
(2) ALFRED ABUHAMAD MD
Director
 60.0 X           754,588 0 24,419
(3) MARK R BABASHANIAN
DIRECTOR
 3.0 X           0 0 0
(4) RICHARD BIKOWSKI MD
DIRECTOR
 60.0 X           187,102 0 5,283
(5) Richard V Homan MD
Board Chairman
 10.0 X   X       0 0 0
(6) JAMES F LIND JR
CEO
 60.0 X   X       337,568 0 8,565
(7) Stephen Deutsch MD PHD
Officer - Treasurer
 60.0 X   X       334,587 0 25,742
(8) Antonio Quidgley Nevares MD
Director
 60.0 X           249,265 0 1,041
(9) Antoinette Hood MD
Secretary
 60.0 X   X       119,798 0 5,523
(10) Wiliam Van Buren
Director
 3.0 X           0 0 0
(11) Richard Zoretic
Director
 3.0 X           0 0 0
(12) Shannon McCole MD
Director
 60.0 X           134,638 0 140
(13) Conrad Shumadine
Director
 3.0 X           0 0 0
(14) Jerry Nadler MD
Director
 60.0 X           407,987 0 8,341
(15) Barry Strasnick MD
Medical Director
 60.0 X   X       746,323 0 22,240
(16) Christine Matson MD
Director
 60.0 X           252,761 0 24,982
(17) Mark Sinesi MD
Director
 60.0 X           981,401 0 921
Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Scott Williams MD
Assistant Professor
 60.0         X   761,889 0 24,842
(19) Sergio Oehninger MD
Professor
 60.0         X   407,332 0 5,500
(20) Bonnie Dattel MD
Professor
 60.0         X   394,627 0 9,966
(21) Joseph K Han MD
Associate Professor
 60.0         X   430,011 0 25,631
(22) Paul Kim MD
Assistant Professor
 60.0         X   501,190 0 16,580
(23) Thomas Grant MD
Professor
 60.0           X 178,696 0 8,933
(24) Jerry Morewitz MD
Professor
 60.0           X 208,705 0 6,742












1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 8,039,523 0 225,631
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet142
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Weatherby Locums Inc
PO Box 972633
DALLAS,TX753972633 		Medical Staffing 460,806
JAMES CARRAWAY MD PC
7218 SHIRLAND AVENUE
NORFOLK,VA23505 		MED/PLASTIC SURGERY 324,135
ROSS BARRETT PC
1921 GREY FRIARS ROAD
VIRGINIA BEACH,VA23456 		MED/SPEECH Pathology 220,741
Medical Temporaries Inc
840 First Colonial Road Suite 102A
VIRGINIA BEACH,VA23451 		Temporary Staffing 185,214
David Gilbert MD
2737 River Road
Virginia Beach,VA23454 		MED/SURGERY 105,000
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet6
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 0
Program Service Revenue Business Code
2a PATIENT SERVICES 900,099 59,852,327 59,852,327    
b STATE INDIGENT CARE APPROPRIATION 900,099 787,464 787,464    
c CONTRACT BILLING 900,099 9,443,010 9,443,010    
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 70,082,801
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 149,315     149,315
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss)..........MediumBullet 0      
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0 0 0 0
Miscellaneous Revenue Business Code
11a MISCELLANEOUS 900,099 851,853 851,853    
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 851,853
12 Total revenue. See Instructions....MediumBullet 71,083,969 70,934,654 0 149,315
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 1,819,085 1,819,085
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 3,012,985 2,517,612 495,373  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 33,667,016 27,546,604 6,120,412  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,195,582 956,466 239,116  
9 Other employee benefits ....... 2,662,138 2,129,710 532,428  
10 Payroll taxes ........... 1,935,504 1,548,403 387,101  
11 Fees for services (non-employees):        
a Management ...... 1,285,179 1,028,143 257,036  
b Legal ......... 74,786   74,786  
c Accounting ........... 82,585   82,585  
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 0      
g Other .......... 51,074 40,859 10,215  
12 Advertising and promotion .... 213,917 171,134 42,783  
13 Office expenses ....... 3,068,518 2,454,814 613,704  
14 Information technology ...... 917,239 733,791 183,448  
15 Royalties .. 0      
16 Occupancy ........... 2,806,218 2,244,975 561,243  
17 Travel ............ 346,599 277,279 69,320  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 0      
20 Interest ........... 1,792 1,434 358  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 905,338 724,270 181,068 0
23 Insurance .............. 852,366 681,893 170,473  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a BAD DEBT EXPENSE 10,383,116 10,383,116    
b PURCHASED SERVICES 1,937,082 1,549,666 387,416  
c SHARED SERVICES 550,000 550,000    
d REPAIRS AND MAINTENANCE 386,035 308,828 77,207  
e
f All other expenses 2,859,325 2,287,460 571,865  
25 Total functional expenses. Add lines 1 through 24f 71,013,479 59,955,542 11,057,937 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 3,600 1 3,700
2 Savings and temporary cash investments ....... 3,044,895 2 2,076,740
3 Pledges and grants receivable, net ......... 0 3 0
4 Accounts receivable, net ......... 9,053,993 4 9,755,704
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 0 5 0
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L .......... 0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 0 8 0
9 Prepaid expenses and deferred charges ............ 265,364 9 278,025
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 15,772,716
b Less: accumulated depreciation. ..... 10b 12,460,561 2,827,535 10c 3,312,155
11 Investments—publicly traded securities .......... 0 11 0
12 Investments—other securities. See Part IV, line 11 ...... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ......... 0 14 0
15 Other assets. See Part IV, line 11 ........... 2,626,060 15 2,821,680
16 Total assets. Add lines 1 through 15 (must equal line 34)... 17,821,447 16 18,248,004
Liabilities 17 Accounts payable and accrued expenses . 4,577,442 17 4,191,135
18 Grants payable .......... 0 18 0
19 Deferred revenue .......... 0 19 0
20 Tax-exempt bond liabilities .......... 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 6,118,681 25 6,861,055
26 Total liabilities. Add lines 17 through 25..... 10,696,123 26 11,052,190
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 75,297 27 75,297
28 Temporarily restricted net assets ..... 7,050,027 28 7,120,517
29 Permanently restricted net assets ..... 0 29 0
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 7,125,324 33 7,195,814
34 Total liabilities and net assets/fund balances ..... 17,821,447 34 18,248,004
Form 990 (2011)
Form 990 (2011)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI .........
1
Total revenue (must equal Part VIII, column (A), line 12) ...
1
71,083,969
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
71,013,479
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
70,490
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
7,125,324
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
 
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
7,195,814
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2011)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
EVMS Academic Physicians and Surgeons
Health Services Foundation
Employer identification number

52-1576648
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
f
g
(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
(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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
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...... 57,841,921 58,063,529 62,053,928 67,122,457 70,082,801 315,164,636
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. 57,841,921 58,063,529 62,053,928 67,122,457 70,082,801 315,164,636
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.)           315,164,636
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
9 Amounts from line 6... 57,841,921 58,063,529 62,053,928 67,122,457 70,082,801 315,164,636
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 310,897 188,637 118,961 150,037 149,315 917,847
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b. 310,897 188,637 118,961 150,037 149,315 917,847
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.) 1,087,884 953,097 1,441,210 1,373,391 851,853 5,707,435
13 Total support (Add lines 9, 10c, 11 and 12.). 59,240,702 59,205,263 63,614,099 68,645,885 71,083,969 321,789,918
14
Section C. Computation of Public Support Percentage
15
15
97.941 %
16
16
86.881 %
Section D. Computation of Investment Income Percentage
17
17
0.285 %
18
18
0.376 %
19a
b
20
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2011

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
EVMS Academic Physicians and Surgeons
Health Services Foundation
Employer identification number

52-1576648
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....        
b Contributions ........        
c Net investment earnings, gains, and losses ...        
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........ 		       
f Administrative expenses ....        
g End of year balance ......        
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................        
c Leasehold improvements ............   2,274,904 1,058,832 1,216,072
d Equipment ................   13,471,672 11,401,729 2,069,943
e Other .................   26,140 0 26,140
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 3,312,155
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) CSV OF LIFE INSURANCE 2,821,680








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 2,821,680
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes 0
ACCRUED PHYSICIAN COMPENSATION 4,130,301
DUE TO EVMS 1,157,656
PAYABLE TO EVMS CHAIRMAN FUND 606,362
PAYABLE TO DEAN'S FUND OF EVMS 544,010
NOTE PAYABLE TO EVMS 422,726




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 6,861,055
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 71,083,969
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 71,013,479
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 70,490
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8  
9 Total adjustments (net). Add lines 4 through 8 ......................... 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 70,490
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 71,083,969
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3 71,083,969
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 71,083,969
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 71,013,479
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3 71,013,479
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 71,013,479
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
SCHEDULE D, PART XIV   THE INTERNAL REVENUE SERVICE HAS DETERMINED AND INFORMED THE ORGANIZATION BY LETTER DATED JANUARY 29, 1993 THAT IT QUALIFIES AS A NOT-FOR-PROFIT CORPORATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM FEDERAL INCOME TAX PURSUANT TO SECTION 501(A) OF THE IRC. THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ASC TOPIC 740. THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE ANY LIABILITY FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ASC TOPIC 740.
Schedule D (Form 990) 2011

Additional Data


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Software Version:  




Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
EVMS Academic Physicians and Surgeons
Health Services Foundation
Employer identification number
52-1576648
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) EASTERN VIRGINIA MEDICAL SCHOOL358 Mowbray Arch
Norfolk,VA23507 		54-6055378 501(c)(3) 606,362       Chairman's Funds
(2) EASTERN VIRGINIA MEDICAL SCHOOL358 Mowbray Arch
Norfolk,VA23507 		54-6055378 501(c)(3) 1,212,723       Dean's Fund




















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2011

Schedule I (Form 990) 2011
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
Schedule I, Part 1, Line 2   THE FOUNDATION OPERATES IN ACCORDANCE WITH THE TERMS OF AN AFFILIATION AGREEMENT BETWEEN EASTERN VIRGINIA MEDICAL SCHOOL (EVMS) AND THE FOUNDATION (EVMS HEALTH SERVICES). THE AFFILIATION AGREEMENT SPECIFIES THAT THE EXCESS OF REVENUES OVER EXPENSES WILL BE AVAILABLE FOR DISTRIBUTION AS FOLLOWS: 20% TO THE DEAN'S FUND OF EVMS AND 10% TO THE CHAIR FUND OF EVMS.
Schedule I (Form 990) 2011


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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
EVMS Academic Physicians and Surgeons
Health Services Foundation
Employer identification number

52-1576648
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
 
No
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) Thomas Grant MD (i)
(ii)		 171,242
0 		7,067
0 		387
0 		0
0 		8,933
0 		187,629
0 		0
0
(2) Jerry Morewitz MD (i)
(ii)		 194,819
0 		7,292
0 		6,594
0 		0
0 		6,742
0 		215,447
0 		0
0
(3) L D BRITT MD (i)
(ii)		 420,943
0 		227,140
0 		2,972
0 		0
0 		240
0 		651,295
0 		0
0
(4) ALFRED ABUHAMAD MD (i)
(ii)		 572,535
0 		171,596
0 		10,457
0 		16,500
0 		7,919
0 		779,007
0 		0
0
(5) RICHARD BIKOWSKI MD (i)
(ii)		 178,420
0 		8,295
0 		387
0 		0
0 		5,283
0 		192,385
0 		0
0
(6) JAMES F LIND JR (i)
(ii)		 329,981
0 		0
0 		7,587
0 		0
0 		8,565
0 		346,133
0 		0
0
(7) Stephen Deutsch MD PHD (i)
(ii)		 322,065
0 		3,125
0 		9,397
0 		22,000
0 		3,742
0 		360,329
0 		0
0
(8) Antonio Quidgley Nevares MD (i)
(ii)		 188,277
0 		60,396
0 		592
0 		0
0 		1,041
0 		250,306
0 		0
0
(9) Jerry Nadler MD (i)
(ii)		 406,000
0 		0
0 		1,987
0 		0
0 		8,341
0 		416,328
0 		0
0
(10) Barry Strasnick MD (i)
(ii)		 382,357
0 		363,759
0 		207
0 		22,000
0 		240
0 		768,563
0 		0
0
(11) Christine Matson MD (i)
(ii)		 252,167
0 		0
0 		594
0 		22,000
0 		2,982
0 		277,743
0 		0
0
(12) Mark Sinesi MD (i)
(ii)		 841,805
0 		138,929
0 		667
0 		0
0 		921
0 		982,322
0 		0
0
(13) Scott Williams MD (i)
(ii)		 652,942
0 		108,532
0 		415
0 		16,500
0 		8,342
0 		786,731
0 		0
0
(14) Sergio Oehninger MD (i)
(ii)		 199,542
0 		204,403
0 		3,387
0 		0
0 		5,500
0 		412,832
0 		0
0
(15) Bonnie Dattel MD (i)
(ii)		 235,015
0 		157,251
0 		2,361
0 		0
0 		9,966
0 		404,593
0 		0
0
(16) Joseph K Han MD (i)
(ii)		 106,657
0 		322,812
0 		542
0 		16,500
0 		9,131
0 		455,642
0 		0
0
(17) Paul Kim MD (i)
(ii)		 500,950
0 		0
0 		240
0 		16,500
0 		80
0 		517,770
0 		0
0
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule J (Form 990) 2011

Additional Data


Software ID:  
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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.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
EVMS Academic Physicians and Surgeons
Health Services Foundation
Employer identification number

52-1576648
Identifier Return Reference Explanation
FORM 990, PART III, LINE 1 - ORGANIZATION'S MISSION   THE EVMS ACADEMIC PHYSICIANS AND SURGEONS HEALTH SERVICES FOUNDATION (THE "FOUNDATION") EXISTS TO FURTHER THE MISSION AND GOALS OF THE EASTERN VIRGINIA MEDICAL SCHOOL ("EVMS"), A BODY POLITIC AND CORPORATE AND A POLITICAL SUBDIVISION OF THE COMMONWEALTH OF VIRGINIA. THE FOUNDATION WILL FOCUS ON THE ADMINISTRATION OF THE CLINICAL PRACTICE OF EVMS FACULTY MEMBERS WHILE STRIVING TO ENHANCE THE CAPACITY OF THE FACULTY OF EVMS TO PROVIDE EXCELLENCE IN THEIR EDUCATION, RESEARCH, AND SERVICE ROLES. IT ASPIRES TO HELP EVMS TO ATTRACT AND RETAIN THE BEST CLINICAL FACULTY AVAILABLE IN EACH OF THE SEVERAL CLINICAL/EDUCATIONAL DEPARTMENTS OF EVMS BY SUPPORTING CLINICAL PRACTICE AND RESEARCH, IN CONJUNCTION WITH TEACHING, UNDER WORKING CONDITIONS COMPARABLE TO THOSE PREVAILING IN COMPARABLE ACADEMICALLY ORIENTED MEDICAL CENTERS WITHIN THE COMMONWEALTH OF VIRGINIA AND ELSEWHERE. THE FOUNDATION WILL SPONSOR THE CLINICAL PRACTICE OF MEDICINE IN THE ACADEMIC SETTING TO PROVIDE THE FACULTY THE OPPORTUNITY TO TEACH EXCELLENCE IN HEALTH CARE DELIVERY TO STUDENTS AT ALL LEVELS OF TRAINING. THE FOUNDATION'S SUPPORT OF THE MEDICAL PRACTICE ACTIVITIES WILL ADDITIONALLY PROVIDE AN IMPROVED ENVIRONMENT, WHICH ALLOWS FOR THE PROVISION OF TRULY EXCELLENT PATIENT SERVICE. IN ITS CLINICAL AND RESEARCH ACTIVITIES, THE FOUNDATION WILL ASSIST EVMS IN ASSEMBLING A FACULTY WHICH CONSTITUTES A CRITICAL MASS OF TALENTED CLINICIANS DEDICATED TO REINFORCING EACH OTHER'S ABILITY TO PERFORM CLINICAL SERVICES, AND TO EDUCATE STUDENTS OF MEDICINE AND THE HEALING ARTS TO PERFORM AT THE HIGHEST STANDARDS OF EXCELLENCE AND EVER TO UPHOLD AND ENHANCE THE REPUTATION OF EVMS AND EACH OF ITS DEPARTMENTS.
FORM 990, PART VI, SECTION A, LINE 4.   CHANGES TO GOVERNING DOCUMENTS. IN SEPTEMBER 2011 THE BOARD OF DIRECTORS APPROVED AND ADOPTED THE AMENDED FIFTH RESTATED BYLAWS, ALONG WITH THE AMENDED ARTICLES OF INCORPORATION, OF THE EVMS ACADEMIC PHYSICIANS AND SURGEONS HEALTH SERVICES FOUNDATION. THE MAJOR CHANGE TO THE BYLAWS WAS TO RECONSTITUTE THE BOARD OF DIRECTORS AND TO ESTABLISH A NEW COMMITTEE STRUCTURE. THE BOARD COMPOSITION HAS BEEN CHANGED TO INCLUDE FOUR (4) OR FIVE (5) EX-OFFICIO DIRECTORS, NINE (9) CLINICAL DEPARTMENT CHAIR DIRECTORS (EX-OFFICIO), AND THREE (3) PUBLIC DIRECTORS. THE EX-OFFICIO DIRECTORS INCLUDE THE DEAN/PROVOST OF EVMS WHO SHALL BE THE CHAIRMAN OF THE BOARD; THE MEDICAL DIRECTOR OF THE FOUNDATION; THE QUALITY OFFICER OF THE FOUNDATION; THE CEO OF THE FOUNDATION; AND THE VICE PRESIDENT FOR ADMINISTRATION AND FINANCE OF EVMS. THE OFFICER POSITION OF PRESIDENT HAS BEEN ELIMINATED AND REPLACED WITH A MEDICAL DIRECTOR. THE NEW COMMITTEE STRUCTURE INCLUDES THE COORDINATING COMMITTEE (REPLACES THE EXECUTIVE COMMITTEE AS AN ADVISORY COMMITTEE TO THE BOARD); THE QUALITY/PATIENT SAFETY COMMITTEE; THE NOMINATING COMMITTEE; AND OTHER COMMITTEES (OPERATING COMMITTEES) AS THE BOARD DEEMS DESIRABLE. THE ARTICLES OF INCORPORATION WERE REVISED TO BE CONSISTENT WITH THE REVISED BYLAWS AS WELL AS TO CONFORM TO CURRENT DAY PRACTICES.
FORM 990, PART VI, SECTION A, LINE 9.   ADDRESSES OF DIRECTORS THAT CANNOT BE REACHED AT THE ORGANIZATION'S MAILING ADDRESS: WILLIAM VAN BUREN KAUFMAN & CANOLES, PC 150 W. MAIN STREET, SUITE 2100 NORFOLK, VA. 23510 RICHARD ZORETIC AMERIGROUP 4425 CORPORATION LANE VIRGINIA BEACH, VA. 23462 CONRAD SHUMADINE WILCOX & SAVAGE 440 MONTICELLO AVE., SUITE 2200 NORFOLK, VA. 23510
FORM 990, PART VI, SECTION B, LINE 11   EVMS ACADEMIC PHYSICIANS AND SURGEONS HEALTH SERVICES FOUNDATION (EVMS HEALTH SERVICES) ENGAGES THE INDEPENDENT ACCOUNTING FIRM KPMG TO ASSIST WITH THE REVIEW AND FILING OF THE 990 RETURN. EVMS HEALTH SERVICES PROVIDES THE DATA TO KPMG FOR COMPLETION OF THE 990 RETURN. THE RETURN IS REVIEWED BY THE DIRECTOR OF FINANCE AND CHIEF EXECUTIVE OFFICER OF EVMS HEALTH SERVICES PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINES 12A, 12B AND 12C   EVMS ACADEMIC PHYSICIANS AND SURGEONS HEALTH SERVICES FOUNDATION (EVMS HEALTH SERVICES) ADOPTS AND CONFORMS TO THE CONFLICTS OF INTEREST AND COMMITMENT POLICY OF THE EASTERN VIRGINIA MEDICAL SCHOOL. EVMS EMPLOYEES WHO CONDUCT EVMS RELATED ACTIVITIES, INCLUDING FACULTY WHO CONDUCT PROFESSIONAL CLINICAL SERVICES THROUGH EVMS HEALTH SERVICES, ARE COVERED INDIVIDUALS UNDER THE EVMS POLICY. DISCLOSURES BY COVERED INDIVIDUALS ARE REQUIRED ON AN ANNUAL BASIS AND ARE TO BE UPDATED IF ENTERING INTO A NEW ARRANGEMENT THAT COULD POSE A CONFLICT (EVMS DISCLOSURE OF EXTERNAL FINANCIAL AND TIME COMMITMENTS FORM). THE INITIAL DISCLOSURE IS MADE TO THE CHAIR OR TO THE HEAD OF THE COVERED INDIVIDUAL'S DEPARTMENT. THE REVIEW AND MANAGEMENT PROCESS BEGINS WITH THE DEPARTMENT CHAIR/HEAD AND INCLUDES THE INSTITUTIONAL DESIGNATED AUTHORITY AND THE INSTITUTIONAL CONFLICT OF INTEREST COMMITTEE. THE CONFLICT OF INTEREST COMMITTEE IS THE FINAL AUTHORITY FOR DETERMINING IF A CONFLICT OF INTEREST EXISTS. ANY VIOLATION OF THE CONFLICT OF INTEREST POLICY IS CONSIDERED A VIOLATION OF EVMS INSTITUTIONAL POLICY AND SUBJECT TO DISCIPLINARY PROCEDURES, INCLUDING SANCTIONS UP TO AND INCLUDING SUSPENSION AND DISMISSAL. ADDITIONALLY, EMPLOYEES IN VIOLATION OF THIS POLICY WHO HAVE RECEIVED FINANCIAL BENEFIT ARE LIABLE FOR REPAYMENT OF ANY AND ALL FINANCIAL BENEFITS THAT RESULTED FROM THE VIOLATION.
FORM 990, PART VI, SECTION B, LINES 15A AND 15B   MANAGEMENT COMPENSATION IS REVIEWED BY THE EVMS ACADEMIC PHYSICIANS AND SURGEONS HEALTH SERVICES FOUNDATION (EVMS HEALTH SERVICES) BOARD OF DIRECTORS. THE BOARD CONSIDERS COMPARABILITY DATA FROM THE MGMA, AAMC AND OTHER COMPENSATION DATA RESOURCES IN ITS REVIEW. THE CEO OF EVMS HEALTH SERVICES HAS A WRITTEN CONTRACT. KEY EMPLOYEES OF EVMS HEALTH SERVICES ARE THE CLINICAL DEPARTMENT CHAIRS OF EVMS WHO HAVE DUAL EMPLOYMENT CONTRACTS WITH EVMS AND EVMS HEALTH SERVICES.
FORM 990, PART VI, SECTION C, LINE 19   THE GOVERNING DOCUMENTS OF EVMS ACADEMIC PHYSICIANS AND SURGEONS HEALTH SERVICES FOUNDATION, INCLUDING FORM 990 RETURNS, ARE MADE AVAILABLE TO THE PUBLIC FOR INSPECTION UPON RECEIPT OF A FORMAL WRITTEN REQUEST. THE FOUNDATION DOES NOT MAKE ITS ANNUAL FINANCIAL STATEMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

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