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BIRMINGHAM, Alabama — Jonathan Dunning came to Birmingham Bloom Affliction for the Abandoned — one of the nation’s beat medical clinics for the abandoned — from accession bounded nonprofit in the 1990s and bound rose to the top.

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Named controlling administrator in 1998 and again CEO, Dunning was by abounding accounts able at accepting federal grants and accretion the clinic’s services.

In 2006, while CEO, Dunning began basic a arrangement of clandestine companies that offered bloom affliction services, such as accommodating announcement and administration consulting. Those businesses began landing affairs with Birmingham Bloom Affliction and accession nonprofit bloom affliction clinic, Central Alabama Comprehensive Bloom in Tuskegee. For two years, Dunning accompanying served as CEO of both the Tuskegee dispensary and Birmingham Bloom Care.

In a four-year period, the Birmingham and Tuskegee clinics paid added than $2 actor to Dunning’s companies — best of that to Dunning’s Synergy Medical Solutions — for assorted services, according to a analysis of the clinics’ tax filings from 2007 to 2010, the latest filing available.

By 2008, his aftermost year as CEO for both clinics, Dunning had formed a absolute acreage aggregation and bought one of the barrio endemic by Birmingham Bloom Affliction and busy amplitude aback to the bloom affliction organization.

While the boards of admiral accustomed these deals, lath associates beneath to say whether they accustomed bids. The behest process, nonprofit experts say, is the best way to ensure cost-effective use of nonprofit and aborigine money. Additionally, Dunning’s buying of those clandestine companies was not appear during those four years on either of the bloom clinics’ tax filings, alleged Anatomy 990s.

According to Internal Acquirement Service rules, an alignment charge address business affairs with “interested parties,” which accommodate accepted or above admiral and companies they own, if all payments absolute added than $100,000 during the tax year. Payments to Dunning’s companies exceeded that bulk for several years.

Birmingham Bloom Care’s operations and Dunning’s roles with both the dispensary and his clandestine businesses accept appear at a cost:

* Concerned that Dunning’s focus on his claimed businesses was acerbic the clinic’s mission to bear bloom affliction to the poor, one of Birmingham Bloom Care’s founders has distanced himself from the organization.

* Citation problems with chain of care, amid added issues, one of the organization’s longtime arch partners, the University of Alabama at Birmingham, has burst connections.

* The Tuskegee clinic, which had apprenticed with Birmingham Bloom Affliction for administration consulting, is now suing them, gluttonous its own banking annal and added abstracts “after experiencing abundant problems and issues with BHC’s administration practices.”

* And at a time aback Jefferson County debates the fate of Cooper Green Mercy Hospital and how to bear bloom affliction to the indigent, Birmingham Bloom Care, with six clinics in and about Birmingham, plays no cogent role in that conversation.

“I am acutely afflicted and afflicted by Birmingham Bloom Care’s accident of association trust, its abandonment from a charge to the abandoned and under-served in Birmingham, its disability to allure and absorb committed medical staff, and the suspicion surrounding its circuitous business activities,” said Dr. Max Michael, administrator of the Department of Accessible Bloom at UAB.

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Michael was there in 1985, aback Birmingham Bloom Care, originally alleged Birmingham Bloom Affliction for the Homeless, was allotment of a 19-city pilot activity seeded by Robert Wood Johnson Foundation and Pew Memorial Assurance money. It is now one of about 1,200 appointed Federally Qualified Bloom Clinics nationwide.

From 2003 until 2009, assorted departments at UAB entered into affairs with Birmingham Bloom Affliction to coact on bloom affliction delivery, including the School of Nursing, the Division of General Internal Medicine, the Department of Obstetrics and Gynecology and the Department of Optometry.

But by 2011 those relationships had all concluded for assorted reasons, including “operational issues that abnormally afflicted commitment of affliction by UAB adroitness and residents,” according to a annual from UAB agent Clinton Colemenares.

“Staff about-face created problems with chain of care, and abridgement of able staffing fabricated it difficult for patients to agenda appointments,” Colmenares said.

Colemenares said the operational issues included bare advice apropos bloom advice of patients, as able-bodied as delayed payments and no payment.

Birmingham Bloom Affliction currently owes UAB added than $300,000, Colemenares said.

In a accounting acknowledgment to questions submitted by The Birmingham News in writing, the Birmingham Bloom Affliction lath of admiral said it “ended its acknowledged accord with UAB afterwards the goals set alternating with UAB bootless to materialize. BHC spent a ample bulk of money on renovations, accessories and physician licenses, and paid a cogent anniversary casework arrangement bulk to UAB … Banking capacity of BHC’s accord are kept confidential.”

Michael helped align some of those UAB collaborations and formed as medical administrator of Birmingham Bloom Affliction from its birth until 2009, aback he resigned.

“My abandonment was the aftereffect of the accretion questions about the motivations of the organization’s leadership,” Michael said.

Today, Dunning is no best CEO of either the Birmingham or Tuskegee clinics but he continues a cardinal of business affairs with Birmingham Bloom Care, and his absolute acreage companies own at atomic three barrio in which Birmingham Bloom Affliction rents or affairs to hire space.

Dunning, a 48-year-old Birmingham built-in who owns houses in Mountain Brook and Hoover, according to acreage records, beneath to be interviewed on the record. He said acquaintance agreements amid his companies and Birmingham Bloom Affliction don’t acquiesce it.

Birmingham Bloom Affliction lath administrator Flora Blackledge said the lath was acquainted of Dunning’s business arrange and accustomed them.

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“We accept affairs with alfresco folks,” she said. “It aloof so happens Jonathan is involved.”

She referred added questions to the organization’s attorney, Ken Dowdy, who asked for questions in autograph to be advised by himself, BHC agents and the board.

“The lath is absolutely acquainted of BHC’s accord with the above CEO and the Synergy companies,” according to their accounting response. “An absolute CPA close prepares BHC’s Anatomy 990 anniversary year. Any conflicts or abeyant conflicts are vetted by BHC’s accumulated acknowledged admonition and resolved.”

Central Alabama Comprehensive Bloom administration and CACH’s lath administrator Macon County Commissioner Louis Maxwell beneath to altercate its deals with BHC, citation the awaiting accusation amid the two clinics.

Escalating salaries

A analysis of accompaniment and federal annal and added abstracts shows that, in accession to the assorted business deals amid Dunning’s companies and the nonprofits he ran, Dunning additionally was cartoon ascent salaries for his CEO jobs.

In 2007, Birmingham Bloom Affliction paid CEO Dunning $193,004 in bacon and benefits, additional a $6,000 bulk account, for 40 hours a week. At the aforementioned time, Central Alabama Comprehensive Bloom paid Dunning $105,959 and a $6,000 bulk annual as CEO for 20 hours a anniversary of work.

That aforementioned year he drew accession $33,000 bacon as CEO of a clandestine nonprofit he founded, Integrated Bloom Systems, which on tax forms was listed as “related” to BHC through “common membership, administering bodies, trustees, officers, etc.” (Integrated Bloom Systems was attenuated in 2008 and Dunning formed a new, for-profit aggregation alleged Integrated Bloom Systems Alliance.)

For 2008, Dunning’s aftermost year as CEO of the two clinics, he got a about $100,000 accession from Birmingham Bloom Care, to $290,000, as appear to the IRS on the clinic’s Anatomy 990. His bacon from Central Alabama Comprehensive Bloom rose to $132,001, the Anatomy 990 for that dispensary showed.

From Integrated Bloom Systems, he accustomed $50,000 in salary, according to the Anatomy 990 for that nonprofit.

Dunning’s absolute pay from the three nonprofits in 2008: $472,001.

The Integrated Bloom Systems job was for four hours of assignment a week, according to its tax filing.

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“I would catechism alive four hours a anniversary for $50,000,” said Shannon Ammons, a nonprofit adviser with Blackfish Strategies, currently assassin as acting administrator at the Alabama Association of Nonprofits. “I would catechism the budgetary albatross of that.”

In its statement, the BHC lath said it was acquainted of Dunning’s bifold roles, as CEO of BHC and CACH.

“This circumstantial appliance followed recommendations by Bloom Resources & Casework Administration (HRSA) consultants and it was accustomed in autograph by HRSA officials, with the ability and approval of both organization’s boards and accumulated acknowledged counsel.”

According to BHC’s tax filing for 2008, advantage for all cadre “is accustomed by allegory study.”

A Birmingham News atom analysis of the 2008 tax filings of added Federally Qualified Bloom Clinics in Alabama with beyond acquirement streams than Birmingham Bloom Affliction begin that their CEO salaries were appreciably lower than Dunning’s. Birmingham Bloom Affliction had $6.1 actor in absolute acquirement in 2008.

In Tuscaloosa, the CEO of Whatley Bloom Services, with $11.4 actor in revenue, fabricated $151,784 in 2008. In Montgomery, Bloom Casework Inc., with $14.9 actor in revenue, paid the CEO $174,058. In Gadsden, Quality of Life, with $13.9 actor in revenue, paid the CEO $202,775. And in Mobile, Franklin Primary Bloom Center, with $19.5 actor in acquirement — added than three times the admeasurement of Birmingham Bloom Care’s that year — paid the CEO $225,276.

Disclosure questions

The annal additionally appearance Dunning’s companies accomplishing business with Birmingham Bloom Affliction and Central Alabama Comprehensive Bloom afterwards advice that Dunning was complex in those clandestine companies on the tax filings for either organization. The tax forms ask whether a “current or above officer, director, trustee or key employee” has a business accord with the alignment added than their job.

To answer, one checks the box “Yes” or “No.” The IRS rules say you charge address affairs accretion for the year $100,000 or added with accepted or above officers, or companies in which the accepted of above administrator controls added than 35 percent interest. (The dollar beginning to activate advertisement afore 2008 was absolutely lower). Assimilation affidavit appearance Dunning as sole administrator and buyer of bisected the banal of Synergy Medical Solutions aback congenital in 2006. The added bisected of the banal was “reserved by the corporation.”

For the years 2007, 2008 and 2009, the “No” boxes were arrested on the Anatomy 990s for both of the clinics aback Dunning’s clandestine companies had added than $100,000 in business with the clinics.

Failure to book a actual anatomy can advance to fines by the IRS of $100 per day, up to $50,000, for any one return, according to IRS rules.

In 2007, Birmingham Bloom Affliction had a $158,676 arrangement with Synergy Medical Solutions for announcement casework while Dunning was CEO.

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Ammons said Anatomy 990 disclosures are there for the accessible — and the IRS. Aloof because the lath is acquainted of who owns the businesses doesn’t accommodate an alibi for not advice on a Anatomy 990, she said.

In 2008, Birmingham Bloom Affliction paid Synergy Medical Solutions $246,324 for announcement services.

In 2009 Central Alabama Comprehensive Bloom paid Synergy Medical Solutions $548,700 for “medical food and equipment,” and BHC paid Synergy Medical Solutions $654,384 for “contracted casework — management.” Dunning had larboard by this time as CEO of both clinics. Business affairs with “former officers” and their companies are accountable to the acknowledgment aback the added thresholds are met, according to the IRS rules.

In June 2011, Central Alabama Comprehensive Bloom concluded a $225,000 per year administration arrangement with Birmingham Bloom Affliction and accepted its annal aback from the BHC and from Dunning’s companies listed as “Synergy Medical Solitions, Inc., all capacity of Synergy Medical Solutions, Inc. and Integrated Bloom Systems of Alabama.”

Then, beforehand this year, afterwards not accepting all the annal it requested, Central Alabama Comprehensive Bloom sued Birmingham Bloom Affliction in Jefferson County Circuit Court, according to cloister documents. A adjudicator in February issued a acting abstinent adjustment adjoin Birmingham Bloom Care, acclimation the bloom affliction alignment to burden from “disposing of, destroying, altering deleting, overwriting, allurement or encumbering” the annal of Central Alabama Comprehensive Health.

In the lawsuit, Central Alabama Comprehensive Bloom said Birmingham Bloom Affliction alleges that Birmingham Bloom Affliction “has wrongfully and illegally withheld CACH’s banking abstracts and business records.”

Birmingham Bloom Affliction denied the allegations in a cloister filing. That case is still pending.

Surplus kit

Federal admission abstracts action a close-up of how accession one of Dunning’s companies, Synergy Bloom Link, accomplished a arrangement with both the Birmingham and Tuskegee clinics.

In 2009, the clinics anniversary wrote about identical admission applications to buy and administer emergency adversity kits to their audience — the poor and homeless.

The federal Bloom Resources and Casework Administration (HRSA) accepted anniversary dispensary $331,650 to buy and administer 3,000 kits in anniversary city.

In about-face anniversary dispensary apprenticed with Synergy Bloom Link for the admission bulk — $331,650 each. For the money, Synergy Bloom Link’s arrangement said it would do three things:

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* Bear the kits, alleged SHEP kits for Safety and Bloom Emergency Preparedness, absolute aboriginal aid items, a flashlight, a hand-crank radio and a whistle, amid added things.

* Add and accommodate abutment for an cyberbanking “smart card,” an ATM-like bash agenda that is declared to accommodate burning medical advice for the patient.

* Train dispensary agents “to apparatus and abutment the SHEP kits articles and accompanying equipment.”

Synergy Bloom Link again bought the kits for $35.71 apiece, according to a cancellation from the supplier — or, for anniversary clinic, $107,130 for its 3,000 kits. The aggregation again answerable anniversary dispensary $181,650, a aberration of $74,520 on anniversary contract. Synergy Bloom Link additionally answerable anniversary dispensary $150,000 for the cyberbanking “smart” cards, arresting the blow of anniversary of the clinics’ $331,650 grants. Synergy’s amount for the acute cards is not clear.

The BHC board, in its statement, said it did not apperceive how abundant Synergy paid for the kits. The lath said BHC “completed its obligations beneath the grants” — yet according to the admission application, the kits were to be all broadcast by March 2010.

And as of three weeks ago, added than 2,000 of them sat in accumulator in Birmingham. As afresh as May 23, dozens of the kits were actuality accustomed to attendees of a bloom fair captivated at Birmingham Bloom Care’s Metro clinic, 2430 Seventh Ave. N., in city Birmingham. Attendees accustomed the kits afterwards accouterment some medical history.

For a while in 2010 and 2011, fliers begin in dispensary cat-and-mouse apartment at Birmingham Bloom Affliction proclaimed that the kits were for auction for $79.95 each, with a $15 abatement for Medicaid patients.

Indigent affliction alternatives

Since 2008 Birmingham Bloom Affliction has accustomed added than $14 actor in federal money from assorted capacity of the Department of Bloom and Human Services, mostly from HRSA. The dispensary appear $11 actor in acquirement on its aftermost tax filing in 2010.

According to acreage and accompaniment assimilation records, Dunning’s aggregation Synergy Absolute Acreage Holdings in 2008 purchased from Birmingham Bloom Affliction the old McCollough Facial Surgery Dispensary architecture at 1600 20th St. S. on Birmingham’s Southside. Synergy now rents amplitude in that architecture to Birmingham Bloom Care. Birmingham Bloom Affliction additionally rents amplitude from Dunning’s aggregation at 140 N. 24th St. — Physicians Plaza, which Dunning bought in 2010 afterwards the old Physicians Carraway Medical Center closed. The BHC board, in its statement, says BHC “pays fair bazaar hire on all of its busy properties.”

With its arrangement of clinics, Birmingham Bloom Care’s appliance and banking bloom seems abnormally important as Jefferson County debates the fate of financially disturbing Cooper Green Mercy Hospital and the affliction of the indigent, said Dr. Stefan Kertesz, an accessory assistant at UAB and a doctor at the Birmingham Veterans Affairs Medical Center.

Kertesz specializes in bloom affliction for the abandoned and formed at Birmingham Bloom Affliction in 2008 as a apprenticed physician. During that time, Kertesz said he argued with Dunning over a abstraction Kertesz was about to publish, which showed the abandoned in Birmingham accept beneath admission to bloom care.

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Kertesz said a abstracted 2010 analysis showed the abandoned still use Birmingham Bloom Affliction added than added bloom affliction providers, but the abandoned patients begin bigger bloom affliction admission at a smaller, religious-based nonprofit alleged M-Power Ministries than at Birmingham Bloom Care.

“It’s actual bright that Birmingham Bloom Affliction charcoal a actual accordant actor in the affliction of the homeless,” Kertesz said. “But it could and should be alike added so.

“It was arresting to me that a baby religious alms was advised easier to admission by the abandoned than a ample Federally Qualified Bloom Center which receives targeted funds for the affliction of homeless.”

Hannah Wolfson contributed to this report. Join the chat by beat to animadversion or email Mike Oliver at [email protected]   

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