2024-08-14T08:10:01-05:00 2023-09-30 PWC US TAX LLP 655 NEW YORK AVENUE NW SUITE 1100 WASHINGTON DC 20001 990 2022-10-01 630810661 CAPSTONE HEALTH SERVICES FOUNDATION PC % ALLISON ARENDALE CAPS 2053485203 PO BOX 870326 TUSCALOOSA AL 354870326 ALLISON ARENDALE SECRETARY/TREASURER 2053485203 2024-08-13 true MICHAEL D HOFFMAN P01345551 2024141000 2024-08-13 2022 2024-08-08 14:25:15Z KAREN BURGESS PO BOX 870326 TUSCALOOSA AL 354870326 40105997 false X N/A X 1981 AL THE FOUNDATION WAS ORGANIZED AS A NON-PROFIT CORPORATION DEDICATED TO PROVIDING AN ORGANIZATION AND FRAMEWORK TO DEVELOP AND FURNISH PATIENT CARE. 12 5 133 5 0 0 0 0 36484613 39937809 39724 168188 0 0 36524337 40105997 0 0 0 0 19247900 22595167 0 0 0 16165816 15522899 35413716 38118066 1110621 1987931 31622404 40047489 4412208 10051753 27210196 29995736 X THE FOUNDATION WAS ORGANIZED AS A NON-PROFIT CORPORATION DEDICATED TO PROVIDING AN ORGANIZATION AND FRAMEWORK TO DEVELOP AND FURNISH PATIENT CARE THROUGH THE UNIVERSITY MEDICAL CENTER, AND IS EMPLOYED TO SUPPORT THE EDUCATIONAL PROGRAMS OF THE UNIVERSITY OF ALABAMA COLLEGE OF COMMUNITY HEALTH SCIENCES (CCHS). CCHS'S MISSION IS TO IMPROVE AND PROMOTE THE HEALTH OF INDIVIDUALS AND COMMUNITIES IN ALABAMA AND THE REGION THROUGH LEADERSHIP IN MEDICAL EDUCATION AND PRIMARY CARE, THE PROVISION OF HIGH QUALITY, ACCESSIBLE HEALTH CARE SERVICES, AND SCHOLARSHIP. false false 28632125 0 39937809 THE FOUNDATION IS DEDICATED TO PROVIDING AN ORGANIZATION AND FRAMEWORK TO DEVELOP AND FURNISH PATIENT CARE, WITHOUT REGARD FOR THE PATIENTS' ABILITY TO PAY, THROUGH ITS OUTPATIENT CLINIC CARE, THE UNIVERSITY MEDICAL CENTER. THE FOUNDATION ALSO PROVIDES ASSISTANCE TO THE UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE, TUSCALOOSA PROGRAM, AND THE COLLEGE OF COMMUNITY HEALTH SCIENCES. THE CLINIC REPRESENTS EIGHT MEDICAL SPECIALITIES, INCLUDING FAMILY MEDICINE, INTERNAL MEDICINE, OBSTETRICS AND GYNECOLOGY, PEDIATRICS, PSYCHIATRY, NEUROLOGY, SPORTS MEDICINE, HOSPITALIST MEDICINE, AND SURGERY, AS WELL AS THE FACULTY STAFF CLINIC AND WELLNESS CLINIC. THE FOUNDATION ALSO OPERATES CLINICAL COMPONENTS OF, OR RELATING TO, THE STUDENT HEALTH CENTER, THE TUSCALOOSA FAMILY MEDICINE RESIDENCY PROGRAM AND ITS 48 RESIDENTS, APPROXIMATELY 65 MEDICAL STUDENTS, FELLOWSHIPS IN SPORTS MEDICINE, HOSPITALIST MEDICINE, EMERGENCY MEDICINE, GERIATRICS, OBSTETRICS AND PSYCHIATRY, AND COMMUNITY-BASED CLINICAL WORK UNDER CONTRACT, OR IN AFFILIATION WITH, A VARIETY OF PARTNERS/COLLABORATORS. 28632125 true false false false false false false false false true false false true true false true false false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 37 0 true 133 true false false false false false false false false false false false false X 12 5 false false false false false false false true true false false true true true true true true true true false X ALLISON ARENDALE 2053485327 850 PETER BRYCE BLVD TUSCALOOSA AL 35401 SELWYN VICKERS MD BOARD MEMBER/DEAN MED SCHOOL 1.0 3.25 X 0 1787304 122539 STUART BELL BOARD MEMBER/PRESIDENT UA 1.0 40.0 X 0 855595 224458 SHUAIB MOHAMED HOSPITALIST 40.0 0.0 X 575040 0 51754 RICHARD FRIEND BOARD MEMBER/DEAN-CCHS 10.0 40.0 X 180020 318889 83849 JONATHAN SHERRILL HOSPITALIST 40.0 0.0 X 509033 0 45813 MONICA BUI HOSPITALIST 40.0 0.0 X 490002 0 44100 MATTHEW FAJACK BOARD MEMBER/VP FINANCE UA 1.0 39.0 X 0 448537 68591 JAMIE LOWTHER HOSPITALIST 40.0 0.0 X 466981 0 42028 HARITHA GUTTIKONDA HOSPITALIST 40.0 0.0 X 414050 0 37264 KAREN BURGESS PRESIDENT 10.0 40.0 X 86585 228896 70622 THOMAS WEIDA BOARD MEMBER/ASSOCIATE DEAN 10.0 40.0 X 70317 220848 53433 GRIER STEWART FORMER FACULTY REPRESENTATIVE 0.0 40.0 X 84749 150545 53659 RAY STEWART VICE PRESIDENT 10.0 40.0 X 81065 139166 50541 DRAKE LAVENDER FACULTY REPRESENTATIVE 10.0 40.0 X 75970 136293 51242 ALLISON ARENDALE SECRETARY/TREASURER 10.0 40.0 X 0 171262 55458 JOSEPH BROWN BOARD MEMBER 1.0 39.0 X 0 83420 19718 CHARLES JONES BOARD MEMBER 1.0 0.0 X 0 0 0 CHRIS MCGEE BOARD MEMBER 1.0 0.0 X 0 0 0 CYNTHIA ALMOND BOARD MEMBER 1.0 0.0 X 0 0 0 MARK WILLIAMS BOARD MEMBER 1.0 0.0 X 0 0 0 ANGELA HAMITER BOARD MEMBER 1.0 0.0 X 0 0 0 3033812 4540755 1075069 50 true true false 0 0 HEALTH CARE SERVICES 621610 39588636 39588636 0 0 UA STUDENT HEALTH CENTER 900099 349173 349173 0 0 39937809 168188 0 0 168188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40105997 39937809 0 168188 0 0 0 0 3825527 2869145 956382 0 0 15360912 11520684 3840228 0 467689 350767 116922 0 2139155 1604366 534789 0 801884 601413 200471 0 0 0 74781 56086 18695 0 139140 104355 34785 0 0 0 0 7122064 5341548 1780516 0 152528 114396 38132 0 0 872431 654323 218108 0 0 62297 46723 15574 0 197309 147982 49327 0 0 0 196838 196838 0 690209 517657 172552 0 844967 633725 211242 0 SUPPLIES 3167325 2375494 791831 0 BAD DEBT EXPENSE 764815 764815 0 0 LICENSES AND FEES 317663 238247 79416 0 PROFESSIONAL DEVELOPMENT/CME 232441 174331 58110 0 688091 516068 172023 38118066 28632125 9485941 0 6875 6575 10881724 9923350 0 0 4021015 5861671 0 0 0 0 1105147 2641838 627031 618448 2022429 28718 2876446 1903445 1074768 973001 8041910 10426226 0 0 0 0 0 0 3841505 9567662 31622404 40047489 1415068 3387614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2997140 6664139 4412208 10051753 X 27210196 29995736 0 0 27210196 29995736 31622404 40047489 1987931 797609 X false true X true false X 1342696 895812 446884 1533750 1007633 526117 973001 DUE FROM AFFILIATES 276203 RIGHT OF USE ASSET 9291459 9567662 0 LONG TERM LEASE LIABILITES 6664139 6664139 40138791 797609 -764815 32794 40105997 40105997 37353251 37353251 764815 764815 38118066 PART X, LINE 2: THE FOUNDATION HAS BEEN DETERMINED TO BE A TAX EXEMPT ORGANIZATION BY THE INTERNAL REVENUE SERVICE UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE FOUNDATION IS NOT A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE INTERNAL REVENUE CODE. THE FOUNDATION HAD NO UNCERTAIN TAX POSITIONS AT SEPTEMBER 30, 2023 AND 2022. AS SUCH, NO INTEREST OR PENALTIES WERE RECOGNIZED IN THE STATEMENTS OF REVENUES, EXPENSES AND CHANGES IN NET POSITION RELATED TO UNCERTAIN TAX POSITIONS. PART XI, LINE 2D: PROVISION FOR BAD DEBT: ($764,815) PART XII, LINE 4B: PROVISION FOR BAD DEBT: $764,815 X true true X false false false false false false false false false DRAKE LAVENDER FACULTY REPRESENTATIVE 72470 136026 3500 0 0 267 6837 23880 0 20525 82807 180698 0 0 MATTHEW FAJACK BOARD MEMBER/VP FINANCE UA 0 437949 0 0 0 10588 0 52323 0 16268 0 517128 0 0 SELWYN VICKERS MD BOARD MEMBER/DEAN MED SCHOOL 0 894496 0 603460 0 289348 0 90527 0 32012 0 1909843 0 0 STUART BELL BOARD MEMBER/PRESIDENT UA 0 850570 0 0 0 5025 0 138030 0 86428 0 1080053 0 0 THOMAS WEIDA BOARD MEMBER/ASSOCIATE DEAN 65817 217369 4500 0 0 3479 6329 36362 0 10742 76646 267952 0 0 ALLISON ARENDALE SECRETARY/TREASURER 0 170266 0 0 0 996 0 31842 0 23616 0 226720 0 0 GRIER STEWART FORMER FACULTY REPRESENTATIVE 80749 149708 4000 0 0 837 7627 27545 0 18487 92376 196577 0 0 KAREN BURGESS PRESIDENT 82255 228002 4330 0 0 894 7793 41664 0 21165 94378 291725 0 0 RICHARD FRIEND BOARD MEMBER/DEAN-CCHS 180020 317522 0 0 0 1367 16202 49730 0 17917 196222 386536 0 0 SHUAIB MOHAMED HOSPITALIST 542540 0 32500 0 0 0 51754 0 0 0 626794 0 0 0 RAY STEWART VICE PRESIDENT 77595 138696 3470 0 0 470 7296 24093 0 19152 88361 182411 0 0 MONICA BUI HOSPITALIST 457502 0 32500 0 0 0 44100 0 0 0 534102 0 0 0 HARITHA GUTTIKONDA HOSPITALIST 381550 0 32500 0 0 0 37264 0 0 0 451314 0 0 0 JAMIE LOWTHER HOSPITALIST 434481 0 32500 0 0 0 42028 0 0 0 509009 0 0 0 JONATHAN SHERRILL HOSPITALIST 476533 0 32500 0 0 0 45813 0 0 0 554846 0 0 0 SCHEDULE J, PART I, LINE 1A: DISCRETIONARY SPENDING ACCOUNTS: THE DOCTORS ARE ALLOWED TO SPEND $4,000 PER YEAR FOR CONTINUING MEDICAL EDUCATION EXPENSES, CLASSES, AND TRAVEL. SCHEDULE J, PART I, LINE 1A: EXPENSE REIMBURSEMENT POLICY: IMMEDIATE SUPERVISORS FOR EVERY POSITION ARE ADVISED AND APPROVE ANY CHANGES TO COMPENSATION. THE DEAN AND OFFICERS PROVIDE FINAL APPROVAL FOR ALL POSITIONS WITHIN THE FOUNDATION. THE BOARD APPROVES ANY CHANGES TO THE DEAN'S SALARY. FORM 990, PART VI, LINE 11B: CAPSTONE HEALTH SERVICES FOUNDATION, PC'S ("CHSF"THE FOUNDATION") FORM 990 IS PREPARED BY PWC US TAX, LLP. AFTER THE FORM 990 IS PREPARED, IT IS REVIEWED BY THE DIRECTOR OF FINANCE. FORM 990, PART VI, LINE 12C: THE BOARD ADOPTED THE UNIVERSITY OF ALABAMA'S CONFLICT OF INTEREST POLICY, WHICH IS A STRINGENT POLICY. THE CONFLICT OF INTEREST POLICY APPLIES TO OFFICERS AND EMPLOYEES OF THE ORGANIZATION, AS WELL AS BOARD MEMBERS. THIS POLICY WAS REVIEWED WITH THE BOARD. THE DISCLOSURES ARE REVIEWED WITH THE EXECUTIVE COMMITTEE AND WITH THE EXTERNAL AUDIT FIRM. IF A CONFLICT ARISES, IT IS REVIEWED BY THE EXECUTIVE COMMITTEE AND, IF NECESSARY, A REVIEW IS CONDUCTED BY THE ENTIRE BOARD. FORM 990, PART VI, LINES 15A & 15B: THE HR COORDINATOR IN PARTNERSHIP WITH THE CFO RECOMMEND SALARY AND COMPENSATION PACKAGES TO THE DEAN AND OTHER FOUNDATION LEADERSHIP MEMBERS FOR FINAL APPROVAL. THE PRESIDENT IN CONJUNCTION WITH UA SENIOR LEADERSHIP APPROVE ANY CHANGES TO THE DEAN'S SALARY. A COMPARISON AGAINST BENCHMARK SURVEYS (MGMA AND AAMC) IS CONDUCTED EVERY TWO TO THREE YEARS. FORM 990, PART VI, LINE 19: THE FOUNDATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FROM THE OFFICE OF THE TREASURER OF THE ORGANIZATION. FORM 990 PART IX LINE 11G DESCRIPTION:AGENCY SERVICES TOTAL FEES:7122064 SEE PART VII NA SEE PART VII NA false false false false false false false false false false true false true true true true false false false FORM 990, SCHEDULE R, PART II - NAMES OF RELATED ORGANIZATIONS: THE ATTACHED LIST OF ENTITIES ARE FOUNDATIONS OR SUBSIDIARIES AFFILIATED WITH THE UNIVERSITY OF ALABAMA SYSTEM AND ITS VARIOUS CAMPUSES. SOME OF THESE ENTITIES MAY NOT MEET THE IRS DEFINITION OF "RELATED ORGANIZATION" FOR PURPOSES OF SCHEDULE R. THEY ARE INCLUDED, HOWEVER, ON THIS ATTACHED STATEMENT FOR PURPOSES OF COMPLETENESS AND TRANSPARENCY. ALABAMA CARE NETWORK MID-STATE (EXEMPT) ALABAMA CARE NETWORK SOUTHEAST (EXEMPT) ALABAMA ENGINEERING FOUNDATION, INC. (EXEMPT) ALABAMA PHYSICIAN NETWORK, LLC (LLC) CAMPUS HOSPITALITY SERVICES, LLC (LLC) CAPSTONE EDUCATIONAL AND RESEARCH FOUNDATION (EXEMPT) CAPSTONE HEALTH SERVICES FOUNDATION, P.C. (EXEMPT) COMMERCIAL REAL ESTATE, LLC (LLC) COOPER GREEN MERCY HEALTH SERVICES AUTHORITY, AN AFFILIATE OF UAB MEDICINE ENTERPRISE (C CORP) COOPER GREEN REHABILITATION SERVICES (EXEMPT) CRIMSON TIDE FOUNDATION (EXEMPT) GORGAS MEMORIAL INSTITUTE OF TROPICAL AND PREVENTATIVE MEDICINE, INC. (C CORP) MEDICAL TOWERS, INC. (C CORP) MEDICAL WEST HOSPITAL AUTHORITY, AN AFFILIATE OF UAB MEDICINE ENTERPRISE (EXEMPT) RIDGECREST STUDENT HOUSING, LLC (LLC) SOUTHERN RESEARCH INSTITUTE (EXEMPT) THE 1831 FOUNDATION (EXEMPT) THE ALABAMA "A" CLUB EDUCATIONAL AND CHARITABLE FOUNDATION (EXEMPT) THE ALUMNI ASSOCIATION OF THE UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE (EXEMPT) THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ALABAMA (EXEMPT) THE CAPSTONE FOUNDATION (EXEMPT) THE HEALTH CARE AUTHORITY FOR BAPTIST HEALTH, AN AFFILIATE OF UAB MEDICINE ENTERPRISE (C CORP) THE KIRKLIN CLINIC, INC. (C CORP) THE NATIONAL ALUMNI ASSOCIATION OF THE UNIVERSITY OF ALABAMA (EXEMPT) THE NATIONAL ALUMNI SOCIETY OF THE UNIVERSITY OF ALABAMA AT BIRMINGHAM (EXEMPT) THE UAB DIABETES TRUST FOUNDATION (EXEMPT) THE UAB EDUCATIONAL FOUNDATION (EXEMPT) THE UAB RESEARCH FOUNDATION (EXEMPT) THE UNIVERSITY FOUNDATION (EXEMPT) THE UNIVERSITY OF ALABAMA "A" CLUB ALUMNI ASSOCIATION (EXEMPT) THE UNIVERSITY OF ALABAMA DONOR ADVISED FUND (EXEMPT) THE UNIVERSITY OF ALABAMA IN HUNTSVILLE PUBLIC EDUCATION BUILDING AUTHORITY (EXEMPT) THE UNIVERSITY OF ALABAMA IN HUNTSVILLE RESEARCH AND TECHNOLOGY CORPORATION (EXEMPT) THE UNIVERSITY OF ALABAMA LAW SCHOOL FOUNDATION (EXEMPT) THE UNIVERSITY OF ALABAMA OPHTHALMOLOGY SERVICES FOUNDATION (EXEMPT) THE VALLEY FOUNDATION (EXEMPT) THE WORKPLACE, INC. (C CORP) TRITON HEALTH SYSTEMS, LLC (LLC) UA-ASU-TSU EDUCATIONAL RADIO CORPORATION (EXEMPT) UAB ATHLETICS FOUNDATION (EXEMPT) UAB CALLAHAN EYE HOSPITAL AUTHORITY (EXEMPT) UAB HEALTH SYSTEM AUTHORITY (EXEMPT) UAB HOSPITAL MANAGEMENT, LLC (LLC) UAB MEDICINE ENTERPRISE (EXEMPT) UAB MEDICINE FINANCE AUTHORITY (C CORP) UAB-SVCHS, INC. (EXEMPT) UNIVERSITY OF ALABAMA HEALTH SERVICES FOUNDATION, P.C. (EXEMPT) UNIVERSITY OF ALABAMA HUNTSVILLE FOUNDATION (EXEMPT) VIVA HEALTH ADMINISTRATION, LLC (LLC) VIVA HEALTH INSURANCE COMPANY (C CORP) VIVA HEALTH, INC. (EXEMPT)