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ObjectId: 202102259349300815 - Submission: 2021-08-13
TIN: 63-1182994
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
19
Open to Public Inspection
Name of the organization
UAB HEALTH SYSTEM
Employer identification number
63-1182994
Part I
Identification of Disregarded Entities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
(1)
ALABAMA PHYSICIAN NETWORK LLC
500 22ND ST S STE 504
BIRMINGHAM
,
AL
35233
63-1182994
HEALTHCARE
AL
0
0
UABHS
Part II
Identification of Related Tax-Exempt Organizations.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
SEE PART VII
NA
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Page 2
Schedule R (Form 990) 2019
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
SEE PART VII
NA
Schedule R (Form 990) 2019
Page 3
Schedule R (Form 990) 2019
Page
3
Part V
Transactions With Related Organizations.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
Yes
e
Loans or loan guarantees by related organization(s)
............................
1e
No
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
Yes
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
Yes
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
Yes
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
No
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
Yes
o
Sharing of paid employees with related organization(s)
............................
1o
Yes
p
Reimbursement paid to related organization(s) for expenses
............................
1p
Yes
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
Yes
s
Other transfer of cash or property from related organization(s)
............................
1s
Yes
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
Schedule R (Form 990) 2019
Page 4
Schedule R (Form 990) 2019
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership.
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2019
Page 5
Schedule R (Form 990) 2019
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference
Explanation
SCHEDULE R, PART II
THE ATTACHED LIST OF ENTITIES ARE FOUNDATIONS OR SUBSIDIARIES AFFILIATED WITH THE UNIVERSITY OF ALABAMA SYSTEM AND ITS VARIOUS CAMPUSES. SOME OF THESE ENTITLES 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 CENTRAL (EXEMPT) ALABAMA CARE NETWORK EAST (EXEMPT) ALABAMA CARE NETWORK MID-STATE (EXEMPT) ALABAMA CARE NETWORK SOUTHEAST (EXEMPT) ALABAMA CARE PLAN (EXEMPT) ALABAMA ENGINEERING FOUNDATION, INC. (EXEMPT) ALABAMA PHYSICIAN NETWORK, LLC (LLC) ALUMNI OF FARRAH ORDER OF JURISPRUDENCE AND ORDER OF THE COIF (EXEMPT) CAMPUS HOSPITALITY SERVICES, LLC (LLC) CAPSTONE EDUCATIONAL AND RESEARCH FOUNDATION (EXEMPT) CAPSTONE HEALTH SERVICES FOUNDATION, P.C. (EXEMPT) CARE NETWORK OF ALABAMA, INC. (EXEMPT) COMMERCIAL REAL ESTATE, LLC (LLC) COOPER GREEN MERCY HEALTH SERVICES AUTHORITY, AN AFFILIATE OF UAB HEALTH SYSTEM (C CORP) CRIMSON TIDE FOUNDATION (EXEMPT) EMINENT SCHOLARS 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 HEALTH SYSTEM (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 HEALTH SYSTEM (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 (EXEMPT) UAB HEALTH SYSTEM AUTHORITY (EXEMPT) UAB HOSPITAL MANAGEMENT, LLC (LLC) 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, INC. (EXEMPT)
Schedule R (Form 990) 2019
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