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. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
UNIVERSITY OF MARYLAND FACULTY PHYSICIANS INC
Employer identification number
52-1299563
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 supported organization?
................
11g(i)
No
(ii)
A family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
A 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
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 monetary support
Yes
No
Yes
No
Yes
No
(A)
UOM ANESTHESIOLOGY ASSOCIATES PA
521076158
12
Yes
Yes
Yes
0
(B)
UOM DERMATOLOGISTS PA
521726248
12
Yes
Yes
Yes
0
(C)
UOM DIAGNOSTIC IMAGING SPECIALISTS PA
521136675
12
Yes
Yes
Yes
0
(D)
UOM EMERGENCY MEDICINE ASSOCIATES PA
521403415
12
Yes
Yes
Yes
550,000
(E)
UOM EYE ASSOCIATES PA
526148737
12
Yes
Yes
Yes
378,667
(F)
UOM FAMILY MEDICINE SPECIALISTS PA
521274266
12
Yes
Yes
Yes
185,000
(G)
UOM NEUROLOGY ASSOCIATES PA
521138284
12
Yes
Yes
Yes
0
(H)
UOM NEUROSURGERY ASSOCIATES PA
522004514
12
Yes
Yes
Yes
0
(I)
UOM OBSTETRICAL AND GYNECOLOGICAL ASSOCIATES PA
520913438
12
Yes
Yes
Yes
0
(J)
UOM ONCOLOGY ASSOCIATES PA
521949649
12
Yes
Yes
Yes
210,000
(K)
UOM PATHOLOGY ASSOCIATES PA
521297269
12
Yes
Yes
Yes
0
(L)
UOM PHYSICAL THERAPY ASSOCIATES PA
521557797
12
Yes
Yes
Yes
0
(M)
UOM PSYCHIATRY ASSOCIATES PA
520995961
12
Yes
Yes
Yes
0
(N)
UOM RADIATION ONCOLOGY ASSOCIATES PA
521266476
12
Yes
Yes
Yes
0
(O)
UOM SURGICAL ASSOCIATES PA
521557551
12
Yes
Yes
Yes
976,320
(P)
UOM ORTHOPAEDIC ASSOCIATES PA
522122145
12
Yes
Yes
Yes
0
(Q)
UOM ORTHOPAEDIC TRAUMA ASSOCIATES PA
522381867
12
Yes
Yes
Yes
0
(R)
SHOCK TRAUMA ASSOCIATES PA
521119350
12
Yes
Yes
Yes
0
(S)
UOM PEDIATRIC ASSOCIATES PA
521182593
12
Yes
Yes
Yes
0
(T)
UOM PHYSICIANS PA
521103228
12
Yes
Yes
Yes
0
(U)
UOM OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY PA
352249021
12
Yes
Yes
Yes
0
(V)
MARYLAND MEDICINE PA
521908496
12
Yes
Yes
Yes
0
Total
2,299,987
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
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 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2013.
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—2012.
If the organization did not check a 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—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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......
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.
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.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
..
13
Total support. (Add lines 9, 10c, 11, and 12.)..
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 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
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—2012.
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013
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.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
UNIVERSITY OF MARYLAND FACULTY PHYSICIANS INC
Employer identification number
52-1299563
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 6
THE ENTITY IS A MARYLAND CORPORATION WHOSE STOCKHOLDERS ARE PHYSICIANS AND MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7A
THE STOCKHOLDERS ELECT THE PRESIDENT OF THE ENTITY WHO IS A MEMBER OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11
THE ENTITY RECEIVES A COPY OF THE 990 AND A REPRESENTATIVE OF THE GOVERNING BODY APPROVES IT BEFORE SIGNING THE ELECTRONIC FILING AUTHORIZATION.
FORM 990, PART VI, SECTION B, LINE 12C
AS PART OF THEIR EMPLOYMENT BY THE UNIVERSITY OF MARYLAND FACULTY PHYSICIANS, INC. (FPI) AND THE FACULTY PRACTICES OF THE UNIVERSITY OF MARYLAND (PAS), EMPLOYEES AND FACULTY ARE REQUIRED TO FOLLOW THE MEDICAL SERVICE PLAN. MSP POLICY #37 LISTS THE REQUIREMENTS OF COMPLIANCE AND GOOD BUSINESS PRACTICES. AS PART OF THE MSP POLICY #37, FPI ALSO MAINTAINS A CORPORATE COMPLIANCE PLAN, WHICH DETAILS EXPECTATIONS AROUND CONFLICT OF INTEREST SITUATIONS AND BILLING RESPONSIBILITIES. FPI RELIES ON THE GOOD FAITH OF ITS EMPLOYEES IN THE EXERCISE OF THEIR RESPONSIBILITIES. ALL BUSINESS JUDGMENTS ON BEHALF OF FPI SHOULD BE MADE BY ITS EMPLOYEES ON THE BASIS OF SUCH TRUST AND IN FPI'S BEST INTERESTS. FPI FULLY RESPECTS THE RIGHTS OF EMPLOYEES TO PRIVACY IN THEIR PERSONAL AFFAIRS AND FINANCIAL ACTIVITIES. THE PURPOSE OF THIS POLICY IS TO PROVIDE GUIDANCE TO EMPLOYEES IN AVOIDING SITUATIONS IN THEIR PERSONAL ACTIVITIES WHICH ARE, OR APPEAR TO BE, IN CONFLICT WITH THEIR RESPONSIBILITIES TO FPI. ALTHOUGH IT IS IMPRACTICAL TO ATTEMPT TO DEFINE EVERY SITUATION WHICH MIGHT BE CONSIDERED A CONFLICT OF INTEREST, GENERALLY SPEAKING, A CONFLICT EXISTS WHEN AN EMPLOYEE'S PERSONAL INTERESTS OR ACTIVITIES MAY INFLUENCE HIS OR HER JUDGMENT IN THE PERFORMANCE OF HIS OR HER DUTY TO FPI. THERE MAY BE CASES WHERE SUCH CONFLICTS ARE MORE THEORETICAL THAN REAL, BUT EMPLOYEES SHOULD BE CONCERNED ABOUT POSSIBLE CONFLICTS AND REVIEW AND DISCLOSE THIS SITUATION IN LIGHT OF THE FOLLOWING GUIDELINES. A MAJOR FOCUS OF THE CORPORATE COMPLIANCE PLAN IS CURRENTLY ON CODING, BILLING, AND DOCUMENTATION COMPLIANCE AND ENSURING THAT REGULATIONS ARE BEING FOLLOWED. HOWEVER, COMPLIANCE GOES BEYOND AVOIDING PENALTIES. OUR TOTAL CORPORATE COMPLIANCE PLAN INCLUDES A FULL RANGE OF ISSUES, INCLUDING: - EMPLOYMENT CONTRACTS - CONFLICTS OF INTEREST - PATIENT CONFIDENTIALITY - RECORDS RETENTION - CONTRACTS AND BUSINESS RELATIONSHIPS (INCLUDING PROFESSIONAL SERVICE AGREEMENTS) - WAIVERS OF CO-PAYMENTS, COINSURANCE AND DEDUCTIBLES, AND MORE. WHILE THE COMPLIANCE OFFICE WILL MAKE EVERY EFFORT TO PROVIDE APPROPRIATE COMPLIANCE INFORMATION TO ALL EMPLOYEES, AND TO RESPOND TO ALL INQUIRIES, NO EDUCATIONAL AND TRAINING PROGRAM, HOWEVER COMPREHENSIVE, CAN ANTICIPATE EVERY SITUATION THAT MAY PRESENT COMPLIANCE ISSUES. RESPONSIBILITY FOR COMPLIANCE WITH THE CORPORATE COMPLIANCE PLAN, INCLUDING THE DUTY TO SEEK GUIDANCE WHEN IN DOUBT, RESTS WITH EACH EMPLOYEE. THE ABOVE INFORMATION IS DISCUSSED WITH EACH NEW EMPLOYEE AND FACULTY MEMBER UPON HIRE. ANNUAL CORPORATE COMPLIANCE TRAINING TOUCHES ON THE ABOVE AS WELL.
FORM 990, PART VI, SECTION B, LINE 15
THE PROCESS OF DETERMINING SALARY IS THE SAME FOR ALL OF FPI'S POSITIONS, INCLUDING THE EXECUTIVE CLASS. EXECUTIVE CLASS POSITIONS INCLUDE FPI'S CHIEF CORPORATE OFFICER (CCO) AND OTHER SENIOR STAFF MEMBERS (CFO, CIO, CHRO, COO). FPI CONDUCTS AN ANNUAL MARKET REVIEW. THE MARKET REVIEW INCLUDES A REVIEW OF ALL ESTABLISHED POSITIONS AND THEIR SALARY LEVELS WITHIN RELEVANT MARKETS, CONSISTENT WITH JOB CONTENT, RESPONSIBILITIES, AND REQUIREMENTS. THE FOLLOWING COMPENSATION SURVEYS ARE USED AS BENCHMARKS: WATSON WYATT, MHHRA AND AAMC. FPI'S BENEFITS AND COMPENSATION MANAGER REVIEWS THE MARKET ANALYSIS AND COMPLETES AN INTERNAL EQUITY REVIEW. FOR EXECUTIVE CLASS POSITIONS, SALARY RECOMMENDATIONS ARE THEN PRESENTED TO FPI'S PRESIDENT (THE DEAN OF THE MEDICAL SCHOOL) FOR APPROVAL. FPI ENGAGES AN OUTSIDE CONSULTING FIRM TO CONFIRM THE ADEQUACY OF SALARY GRADES AND BENCHMARKS AT THE INDIVIDUAL POSITION LEVEL.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:
UNREALIZED GAIN ON INTEREST SWAPS 32,352. LOSS FROM JOINT VENTURE 294,507.
FORM 990, PART XI, LINE 2C: THE PROCESS FOR SELECTING THE AUDITORS HAS
NOT CHANGED FROM THE PRECEDING YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.