Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (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 VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 0 | 0 | 0 | 0 | 0 | 0 |
| 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 | 74,207,279 | 72,467,646 | 70,223,053 | 70,923,901 | 74,325,401 | 362,147,280 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | 0 | |||||
| 6 | Total. Add lines 1 through 5 | 74,207,279 | 72,467,646 | 70,223,053 | 70,923,901 | 74,325,401 | 362,147,280 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 362,147,280 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 74,207,279 | 72,467,646 | 70,223,053 | 70,923,901 | 74,325,401 | 362,147,280 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 140,943 | 144,231 | 163,882 | 153,820 | 155,565 | 758,441 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 140,943 | 144,231 | 163,882 | 153,820 | 155,565 | 758,441 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 1,446,256 | 1,826,513 | 2,267,392 | 2,363,844 | 2,469,971 | 10,373,976 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 75,794,478 | 74,438,390 | 72,654,327 | 73,441,565 | 76,950,937 | 373,279,697 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2019 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| 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 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 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 CONRAD SHUMADINE WILCOX & SAVAGE 440 MONTICELLO AVE., SUITE 2200 NORFOLK, VA 23510 MARK BABASHANIAN 721 FAIRFAX AVE. NORFOLK, VA 23507 |
| FORM 990, PART VI, SECTION B, LINE 11 | EVMS ACADEMIC PHYSICIANS AND SURGEONS HEALTH SERVICES FOUNDATION (EVMS MEDICAL GROUP) ENGAGES THE INDEPENDENT ACCOUNTING FIRM KPMG TO ASSIST WITH REVIEW AND FILING OF THE 990 RETURN. EVMS MEDICAL GROUP 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 MEDICAL GROUP PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINES 12A, 12B AND 12C | EVMS ACADEMIC PHYSICIANS AND SURGEONS HEALTH SERVICES FOUNDATION (EVMS MEDICAL GROUP) 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 MEDICAL GROUP, 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 MEDICAL GROUP) BOARD OF DIRECTORS. THE BOARD CONSIDERS COMPARABILITY DATA FROM THE MGMA, AAMC AND OTHER COMPENSATION DATA RESOURCES IN ITS REVIEW. THE CEO OF EVMS MEDICAL GROUP HAS A WRITTEN CONTRACT. KEY EMPLOYEES OF EVMS MEDICAL GROUP ARE THE CLINICAL DEPARTMENT CHAIRS OF EVMS WHO HAVE DUAL EMPLOYMENT CONTRACTS WITH EVMS AND EVMS MEDICAL GROUP. |
| 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. |
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