2023-11-09T16:37:32-06:00 2022-12-31 341884125 CBIZ MHM LLC 4722 N 24TH ST STE 300 PHOENIX AZ 85016 990 2022-01-01 208106540 DISTRICT MEDICAL GROUP INC DIST 6024705000 2929 EAST THOMAS ROAD PHOENIX AZ 85016 CRAIG JONES CHIEF FINANCIAL OFFICER 6024705000 2023-11-09 1 CRAIG JONES 999009999 1 AMY A O'LOUGHLIN P00869687 6022646835 2023-11-09 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DMG DR KOTE CHUNDU 2929 EAST THOMAS ROAD PHOENIX AZ 85016 224119846 0 X WWW.DMGAZ.ORG X 2006 AZ OPERATE A FACULTY PRACTICE PLAN FOR THE BENEFIT OF THE MARICOPA COUNTY SPECIAL HEALTHCARE DISTRICT, DBA VALLEYWISE HEALTH, WHICH WAS CREATED TO PROVIDE MEDICAL EDUCATION PROGRAMS, EMERGENCY AND OTHER SERVICES TO THE MEDICALLY UNDERSERVED. 9 5 897 0 0 0 496714 500 198145950 216485321 61935 -81786 637809 452243 199342408 216856278 186440 186411 0 0 148943698 145895121 0 0 0 45545621 67178976 194675759 213260508 4666649 3595770 83064972 102743186 29019359 45149689 54045613 57593497 X WE ARE DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF INDIVIDUALS IN ARIZONA THROUGH AN INTEGRATED MEDICAL GROUP PRACTICE BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH AND COMMUNITY SERVICE. 0 0 172045343 186411 200597558 ESTABLISHED IN 1993, BY 2010 OUR 350+ PROVIDER MULTI-SPECIALTY GROUP PRACTICE EVOLVED INTO DISTRICT MEDICAL GROUP, INC. (DMG), A PHYSICIAN-CENTRIC, PHYSICIAN-LED, NOT-FOR-PROFIT HEALTHCARE ORGANIZATION, AND ONE OF THE LARGEST MEDICAL OFFICES IN THE PHOENIX AREA. OUR MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF INDIVIDUALS IN THE PHOENIX AREA THROUGH THIS INTEGRATED GROUP PRACTICE, FOCUSING ON PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE. WE STRIVE TO ENSURE THAT OUR PATIENTS HAVE EQUAL ACCESS TO THE HIGHEST QUALITY, SAFEST CARE IN THE MOST APPROPRIATE SETTINGS, REGARDLESS OF A PATIENT'S ABILITY TO PAY. WE SEEK TO CREATE AND SUPPORT NEW PROGRAMS AND SERVICES THAT REFLECT THE NEEDS OF ALL PATIENTS, ACROSS ALL SPECTRUMS OF LIFE- FROM BIRTH TO THE ELDERLY, INCLUDING THE MOST VULNERABLE, THE POOR AND THE UNDERSERVED. THE HEART OF OUR MISSION IS PROVIDING EXCEPTIONAL AND COMPASSIONATE MEDICAL CARE WITH NO RESTRICTIONS TO OUR ENTIRE COMMUNITY. DMG WITH ITS AFFILIATES COMPRISE 70 CLINICAL SITES, MORE THAN 500 PHYSICIANS, 200 NON-PHYSICIAN PROVIDERS, AND OVER 70 ANCILLARY CLINIC STAFF. IN 2022, DESPITE THE LINGERING EFFECTS OF THE COVID-19 PANDEMIC, DMG SERVED PATIENT VOLUMES OF CLOSE TO 20,000 AS INPATIENT, OVER 475,000 AS OUTPATIENT, AND ALMOST 90,000 EMERGENCY VISITS. DURING 2022 DMG'S DIRECT ECONOMIC OUTPUT, INCLUDING THE SERVICE ECONOMY, IS ESTIMATED AT OVER $178 MILLION. THE INDIRECT ECONOMIC BENEFIT TO THE COMMUNITY IS SIGNIFICANTLY MORE.DISTRICT MEDICAL GROUP STAFFS THE VALLEYWISE HEALTH SYSTEM, WHICH INCLUDES A 325-BED ACUTE CARE HOSPITAL, THREE INPATIENT PSYCHIATRIC HOSPITALS TOTALING MORE THAN 340 BEDS, TWO EMERGENCY DEPARTMENTS, NINE FAMILY HEALTH CENTERS THROUGHOUT THE VALLEY AND TWO LARGE DIAGNOSTIC CENTERS. DMG ALSO STAFFS THE INTERNATIONALLY RENOWNED ARIZONA BURN CENTER, THE 2ND LARGEST IN THE US, ADMITTING OVER 1,675 PATIENTS/YEAR AND SERVING MORE THAN 8,000 PATIENTS/YEAR IN AN OUTPATIENT SETTING; THE VERIFIED AMERICAN COLLEGE OF SURGEONS LEVEL I TRAUMA CENTER, AND LEVEL 2 PEDIATRIC TRAUMA CENTER; AND THE ARIZONA CHILDREN'S CENTER, A NACHRI-CERTIFIED CHILDREN'S HOSPITAL, CARING FOR CHILDREN THROUGH THE PEDIATRIC EMERGENCY DEPARTMENT, PEDIATRIC INTENSIVE CARE UNIT, THE NEONATAL INTENSIVE CARE UNIT, AND THE PEDIATRIC INPATIENT AREAS, WITH A DEDICATED AREA FOR PEDIATRIC PROCEDURAL SEDATIONS. AMONG OTHER INNOVATIVE PROGRAMS THAT DMG PROVIDES IS THE REFUGEE WOMEN'S HEALTH CLINIC, THE FIRST OF ITS KIND IN ARIZONA, PROVIDING CULTURALLY GROUNDED HEALTHCARE TO THE GROWING REFUGEE AND IMMIGRANT COMMUNITY. THROUGH AFFILIATION WITH VALLEYWISE HEALTH SYSTEM, THE UNIVERSITY OF ARIZONA - COLLEGE OF MEDICINE PHOENIX, AND THE CREIGHTON UNIVERSITY ARIZONA HEALTH EDUCATION ALLIANCE, WE ARE A RECOGNIZED LEADER IN PROVIDING HIGH QUALITY, INNOVATIVE MEDICAL CARE DELIVERED IN A FISCALLY RESPONSIBLE AND COST-EFFECTIVE MANNER. AS THE LARGEST TEACHING FACULTY IN PHOENIX, WE ANNUALLY TRAIN OVER 230 RESIDENTS AND FELLOWS, ANOTHER 60 IN AFFILIATED PROGRAMS, AND SUPERVISE CLOSE TO 500 MEDICAL STUDENT ROTATIONS. A MAJORITY OF DMG PHYSICIANS HOLD FACULTY POSITIONS WITH THE UNIVERSITY OF ARIZONA - COLLEGE OF MEDICINE PHOENIX AND/OR CREIGHTON UNIVERSITY, PARTICIPATING IN CLINICAL LECTURES AND OTHER ACADEMIC EVENTS, AND ACTIVELY TEACHING AND SUPPORTING SCHOLARSHIP AND RESEARCH ACTIVITIES. IN RECENT YEARS WE HAVE BEEN INVOLVED IN A SIGNIFICANT NUMBER OF ACTIVE RESEARCH PROJECTS, INCLUDING INDUSTRY-SPONSORED AND NIH GRANTS. EXAMPLES OF OUR INVOLVEMENT INCLUDE:DYNAMICS OF SEROLOGICAL RESPONSES TO SARS-COV-2 INFECTION: LONGITUDINAL SEROSURVEILLANCE AND SERO-PROTECTION STUDIESPREVALENCE OF PATHOGENS IN SYNOVIAL FLUID OBTAINED FROM EMERGENCY DEPARTMENT PATIENTS AND CLINICAL AND LABORATORY FEATURES OF PATIENTS DIAGNOSED WITH SEPTIC ARTHRITISA PIVOTAL STUDY TO ASSESS THE SAFETY AND EFFECTIVENESS OF NOVOSORB BIODEGRADABLE TEMPORIZING MATRIX (BTM) IN THE TREATMENT OF SEVERE BURN SKIN INJURIESTHE ACUTE BURN RESUSCITATION MULTICENTER PROSPECTIVE TRIAL - 2 (ABRUPT 2)EVALUATION OF THE CLINICAL PERFORMANCE OF THE PAXGENE BLOOD CCFDNA TUBE IN COMPARISON TO THE BD VACUTAINER K2EDTA TUBE USING THE THERASCREEN PIK3CA RGQ PCR KITPSYCHIATRY BOOTCAMP: ENHANCING INCOMING RESIDENT CONFIDENCE AND KNOWLEDGECOVID-19 VARIANTS AND MORBIDITY AND MORTALITYINTERSECTING GLOBAL EPIDEMICS RIGHT AT HOME: UNDERSTANDING THE IMPACT OF INTIMATE PARTNER VIOLENCE AMONG HIV-POSITIVE WOMEN AND THEIR ENGAGEMENT IN THE HIV CONTINUUM OF CARESARS-COV-2 GENOMIC SEQUENCING OF HOSPITAL CASESAN OPEN, NON-COMPARATIVE, MULTI-CENTER INVESTIGATION TO EVALUATE PERFORMANCE AND SAFETY OF EXUFIBER AG+ AND EXUFIBER ON PARTIAL THICKNESS BURNSANALYSIS OF EXTRACELLULAR VESICLE COMPOSITION IN DIABETIC KIDNEY DISEASE (DKD)AN ADAPTIVE, RANDOMIZED, CONTROLLED TRIAL EVALUATING THE EFFECTIVENESS OF PERMEADERM AS COMPARED TO MEPILEX AG USED AS STANDARD OF CARE IN THE TREATMENT OF ADULT AND PEDIATRIC PARTIAL THICKNESS BURNSA PHASE 2, OPEN-LABEL, RANDOMIZED, ACTIVE-CONTROLLED PILOT STUDY OF INVESTIGATIONAL DRUG, MW-III VERSUS SILVADENE CREAM 1% (SILVER SULFADIAZINE) TOPICALLY APPLIED TO SECOND-DEGREE THERMAL BURNS IN ADULTSCLINICAL TRIAL TO ASSESS THE EFFICACY OF MICROLYTE MATRIX ON THE HEALING OF SURGICALLY CREATED PARTIAL THICKNESS DONOR SITE WOUNDS ON PATIENTS REQUIRING SPLIT-THICKNESS SKIN GRAFTINGNATIENS: A PHASE III RANDOMIZED STUDY TO DETERMINE THE MECHANISMS AND OPTIMAL MANAGEMENT OF STEVENS-JOHNSON SYNDROME AND TOXIC EPIDERMAL NECROLYSISDISPARITIES IN TELEMEDICINE USE AND HEALTHCARE UTILIZATION PATTERNS DURING THE COVID-19 PANDEMICDMG BELIEVES THAT CREATING AN INSTITUTIONAL CULTURE OF SCHOLARSHIP AND PROMOTING CLINICAL RESEARCH IMPROVES THE HEALTH AND WELL-BEING OF ALL OUR PATIENTS AND THEIR COMMUNITIES. DMG PHYSICIANS ARE FREQUENT CONTRIBUTORS TO NATIONAL PEER-REVIEWED PUBLICATIONS AND PRESENTERS AT NATIONAL MEDICAL CONFERENCES AND WORKSHOPS, HOLDING ACTIVE LEADERSHIP POSITIONS IN STATE, NATIONAL, AND INTERNATIONAL MEDICAL SOCIETIES. DMG PROVIDERS AND EMPLOYEES FURNISH SIGNIFICANT ASSISTANCE AND PERSONAL RESOURCES TO THE COMMUNITY AS WELL AS OUTLYING AREAS THROUGH SCREENINGS, IMMUNIZATIONS, AND INFORMATION/ACCESS TO INTEGRATED SERVICES AT HEALTH FAIRS; THROUGH COMMUNITY OUTREACH EVENTS HIGHLIGHTING PRENATAL SCREENINGS, REHABILITATION, HOSPICE, SENIOR CARE, TRANSPORTATION AND CARE COORDINATION; THROUGH BACK-TO-SCHOOL AND HOLIDAY CLINICS FOR CHILDREN AND STUDENTS; THROUGH CHILDHOOD AND ADOLESCENT OBESITY CLINICS; AND THROUGH SEMINARS PROMOTING EXERCISE AND NUTRITION IN OUR PARTNERSHIPS WITH LOCAL SCHOOLS. DMG PHYSICIANS VOLUNTEER THEIR TIME SEEING PATIENTS AT THE ARIZONA STATE HEALTH DEPARTMENT, THE CRISIS NURSERY, ST. VINCENT DE PAUL, THE RED CROSS AND SCORES OF NONPROFIT AGENCIES, CENTERS AND CLINICS ACROSS THE COUNTY AND THE STATE. AWARENESS AND SENSITIVITY TO THE HISTORICAL, CULTURAL, AND TRADITIONAL MORES OF THE LARGE HISPANIC AND VARIED NATIVE AMERICAN POPULATIONS ACROSS ARIZONA IS A HALLMARK OF DMG'S LONGSTANDING COMMITMENT TO MAKING HEALTHCARE SERVICES AND INFORMATION ACCESSIBLE AND EFFECTIVE FOR EVERYONE, BENEFITING THE ENTIRE COMMUNITY. NATIONALLY AND INTERNATIONALLY, DMG'S PHYSICIANS HAVE BEEN ON THE SCENE WHEREVER MEDICAL HELP IS NEEDED, BRINGING THEIR CLINICAL EXPERTISE TO COMBAT HOSPITALS IN WAR-TORN AREAS, TO RELIEF EFFORTS IN THIS COUNTRY AND ABROAD, AND IN DAY-TO-DAY MEDICAL CRISES AND EMERGENCIES IN THE U.S. AND MANY COUNTRIES IN AFRICA AND ASIA. WORKING WITH DOCTORS WITHOUT BORDERS, THE RED CROSS, OTHER RELIEF AGENCIES, AND EVEN ON THEIR OWN, DMG'S PHYSICIANS HAVE MADE A DIFFERENCE AND BEEN GRATEFULLY RECOGNIZED FOR THEIR EFFORTS AND CONTRIBUTIONS, TO THE EXTENT OF RECEIVING THE "CITIZEN SERVICE ABOVE SELF" AWARD FROM THE CONGRESSIONAL MEDAL OF HONOR FOUNDATION. DMG CONTRIBUTES REGULARLY THROUGH COMMUNITY HEALTH IMPROVEMENT SERVICES, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, CASH AND IN-KIND CONTRIBUTIONS, AND COMMUNITY BENEFITING ACTIVITIES. 20911194 15887763 THE CHILDREN'S REHABILITATIVE SERVICES (CRS) PROGRAM STARTED IN 1929 TO PROVIDE MEDICAL SERVICES TO CHILDREN WHO HAVE SOME OF THE MOST SERIOUS HEALTH CONDITIONS AND WHO ARE ENROLLED IN THE ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM (MEDICAID). THE PROGRAM IN TOTAL SERVES OVER 20,000 MEMBERS STATEWIDE WITH THE DMG LOCATION SERVING APPROXIMATELY 14,000 CHILDREN, INCLUDING TELEMEDICINE VISITS AND FIELD CLINICS SERVING THE OUTLYING COMMUNITIES. THE CRS MULTI-SPECIALTY INTERDISCIPLINARY CLINIC (MSIC) WAS DESIGNED TO UNIQUELY MEET THE HEALTH CARE REQUIREMENTS OF SPECIAL NEEDS CHILDREN BY OFFERING NEARLY ALL SPECIALTY, PRIMARY CARE, AND BEHAVIORAL HEALTH SERVICES IN A SINGLE LOCATION. THE DMG CRS CLINIC PROVIDES A FULL SPECTRUM OF PEDIATRIC SPECIALTY CARE WHERE PHYSICIANS, THERAPISTS, NUTRITIONISTS, CHILD LIFE SPECIALISTS, SOCIAL WORKERS AND A HOST OF OTHERS CAN ALL WORK TOGETHER PROVIDING VITAL MEDICAL CARE, BEHAVIORAL HEALTH CARE AND SUPPORT SERVICES UNDER ONE ROOF AND ON ONE FLOOR IN A SPACE SPECIFICALLY DESIGNED FOR THIS PURPOSE. USING A SINGLE ELECTRONIC MEDICAL RECORD, THE DMG CRS CLINIC IMPROVES EFFICIENCY AND COMMUNICATION BETWEEN THE HEALTH CARE PROVIDERS, WITH THE GOAL OF IMPROVING CARE WHILE BETTER MANAGING COSTS. 192956537 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 229 0 1 897 1 0 0 0 0 0 0 0 0 0 0 1 0 X 9 5 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X CRAIG JONES 6024705000 2929 E THOMAS ROAD PHOENIX AZ 85016 PHYLLIS BIEDESS COMMUNITY BOARD MEMBER, VICE PRESIDENT 0.50 X X 14739 0 0 TOM MANOS COMMUNITY BOARD MEMBER 0.50 X 14739 0 0 JAMES MAROVICH COMMUNITY BOARD MEMBER 0.50 X 16739 0 0 WILLIAM PUTNAM COMMUNITY BOARD MEMBER 0.50 X 14739 0 0 ALAN RAWLS COMMUNITY BOARD MEMBER 0.50 X 14739 0 0 DR DAN HOBOHM BD. CHAIR, PATH CHAIR, VP OF QUALITY 65.00 X X 573703 0 30816 DR KOTE CHUNDU BD. MEMBER, PRESIDENT & CEO 65.00 X X 1383709 0 88554 DR DAVID WISINGER BD. MEMBER, CMO, INT. MEDICINE CHAIR 65.00 X X 471734 0 85607 DR DEAN COONROD BD. MEMBER, SECRETARY, OBGYN CHAIR 60.00 X X 454586 0 104404 CRAIG JONES CFO, TREASURER 50.00 X 264736 0 52355 DR NAFTALY ATTIAS ORTHOPEDICS CHAIR 60.00 X 741462 0 82908 DR DANIEL GRIDLEY RADIOLOGY CHAIR 60.00 X 622348 0 81571 DR BRENDA GENTZ ANESTHESIA CHAIR 60.00 X 532048 0 46894 DR JEFFREY STOWELL EMERGENCY MEDICINE CHAIR 60.00 X 444261 0 76184 DR SYDNEY VAIL SURGERY CHAIR 35.00 X 395872 0 42962 DR CAROL OLSON PSYCHIATRY CHAIR 60.00 X 390806 0 97332 DR JODI CARTER PEDIATRICS CHAIR 60.00 X 388728 0 41961 DR IMAN FEIZ-ERFAN DIRECTOR OF NEUROSURGERY 70.00 X 1549608 0 72341 DR MICHAEL SOCHACKI ORTHOPEDIC SURGEON 60.00 X 689684 0 79911 DR ELLIOT MENDELSOHN ORTHOPEDIC SURGEON 60.00 X 625424 0 43832 DR WILLIAM ROMANO SECTION HEAD, INTERVENTIONAL RADIOLOGY 60.00 X 610262 0 40546 DR JOHN GREEN ORTHOPEDIC SURGEON 60.00 X 551996 0 46401 DR DAVID BRODKIN FORMER KEY EE, PEDIATRIC PHYSICIAN 40.00 X 223233 0 63935 DR DANY QUAN FORMER KEY EE, DIRECTOR - MEDICAL TOXICOLOGY 20.00 X 196318 0 29761 11186213 0 1208275 405 1 1 0 R1 RCM INC PO BOX 734735 CHICAGO IL 606734735 BILLING SERVICES 2357872 COMPHEALTH PO BOX 972651 DALLAS TX 753972651 PHYSICIAN LOCUM & RECRUITMENT SERVICES 909288 CERNER HEALTHCARE SOLUTIONS INC PO BOX 959156 ST LOUIS MO 631959156 TECHNOLOGY SERVICES 598130 VVC HOLDING CORP PO BOX 840952 DALLAS TX 752840952 TECHNOLOGY & BILLING SERVICES 563373 PHOENIX CHILDRENS HOSPITAL 1919 E THOMAS ROAD PHOENIX AZ 850167710 PHYSICIAN SERVICES 553431 38 500 500 PATIENT SERVICES 621110 216485321 216485321 216485321 49537 49537 7132243 2 7132243 131325 0 -131323 -131323 -131323 OTHER INCOME 900003 452243 452243 452243 216856278 216485321 0 370457 186411 186411 8084483 5910497 2173986 111008236 105773360 5234876 9109521 8640642 468879 11214782 10574146 640636 6478099 6082287 395812 535548 535548 297406 297406 90150 90150 15646617 11096455 4550162 127687 127687 788991 512844 276147 86763 86763 2446818 2439133 7685 50343 50343 18501 18501 1473845 527573 946272 4463368 4198126 265242 BAD DEBT 35058786 35058786 MAINTENANCE CONTRACTS 3505680 495533 3010147 RECRUITMENT 684946 684946 MEDICAL SUPPLIES 516878 516878 1386649 943866 442783 213260508 192956537 20303971 0 41649996 38518084 6132016 4200000 23541157 33192386 46636 13925 937707 1632372 18286551 13051741 6612881 5234810 2960580 2776995 475000 4164457 444208 0 264791 13010157 83064972 102743186 24095286 28317643 4924073 16832046 29019359 45149689 X 54045613 57593497 54045613 57593497 83064972 102743186 3595770 -47886 0 X X 0 1 X 1 0 X 1000 500 3356037 496716 500 3854753 167801841 183062598 206692086 198145950 216485321 972187796 167802841 183063098 210048123 198642666 216485821 976042549 0 0 0 976042549 110612 277913 2076001 61935 49537 2575998 110612 277913 2076001 61935 49537 2575998 130018 123440 317769 637809 452243 1661279 168043471 183464451 212441893 199342410 216987601 980279826 0.99570 0.99570 0.00260 0.00280 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2018 AMOUNT: $ 130,018. 2019 AMOUNT: $ 123,440. 2020 AMOUNT: $ 317,769. 2021 AMOUNT: $ 637,809. 2022 AMOUNT: $ 452,243. 350000 350000 4107901 1379622 2728279 3157838 2672461 485377 10641655 8999658 1641997 29157 29157 5234810 DEPOSITS 248536 OTHER ASSETS 11255 RIGHT OF USE ASSETS 12750366 13010157 EMPLOYER RETIREMENT PLAN LIABILITY 540391 ESCHEAT LIABILITY 30375 457(B) LIABILITY 2776995 RIGHT-OF-USE ASSETS AND OPERATING LEASE LIABILITY 13484285 16832046 X PART X, LINE 2: DISTRICT QUALIFIES AS A TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC"). IN ADDITION, DISTRICT QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170 OF THE IRC AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. INCOME DETERMINED TO BE UNRELATED BUSINESS TAXABLE INCOME WOULD BE TAXABLE. THE COMPANY EVALUATES THEIR UNCERTAIN TAX POSITIONS, IF ANY, ON A CONTINUAL BASIS THROUGH REVIEW OF THEIR POLICIES AND PROCEDURES, REVIEW OF THEIR REGULAR TAX FILINGS, AND DISCUSSIONS WITH OUTSIDE EXPERTS. AT DECEMBER 31, 2022, THE COMPANY DID NOT HAVE ANY UNCERTAIN TAX POSITIONS. 1 CREIGHTON UNIVERSITY ARIZONA HEALTH EDUCATION ALLIANCE 3100 N CENTRAL AVE FL 7 PHOENIX AZ 85012 831300808 501C(3) 117651 0 OPERATING SUPPORT VALLEYWISE HEALTH FOUNDATION 2901 E CAMELBACK ROAD SUITE 202 PHOENIX AZ 85016 860777567 501C(3) 25000 0 GENERAL SUPPORT UA FOUNDATION 1111 N CHERRY AVE PO BOX 210109 PHOENIX AZ 85721 866050388 501C(3) 15000 0 WHITE COAT CEREMONY CREIGHTON UNIVERSITY 2500 CALIFORNIA PLAZA OMAHA NE 68154 470376583 501C(3) 10000 0 WHITE COAT CEREMONY 4 4 PART I, LINE 2: DMG GENERALLY GIVES GRANTS TO WELL ESTABLISHED ORGANIZATIONS THAT IT IS FAMILIAR WITH AND WHICH ARE INVOLVED IN ACTIVITIES CLOSELY ALIGNED TO DMG'S MISSION. ACCORDINGLY, THE COMPANY DOES NOT FEEL POST GRANT MONITORING TO BE PRACTICAL OR NECESSARY FOR THESE TYPES OF GRANTS. X X X X X X 0 0 0 0 0 0 0 1 0 DR IMAN FEIZ-ERFAN DIRECTOR OF NEUROSURGERY 1023906 0 5000 0 520702 0 36600 0 35741 0 1621949 0 0 0 DR KOTE CHUNDU BD. MEMBER, PRESIDENT & CEO 1047952 0 330000 0 5757 0 61000 0 27554 0 1472263 0 0 0 DR NAFTALY ATTIAS ORTHOPEDICS CHAIR 618428 0 11000 0 112034 0 36600 0 46308 0 824370 0 0 0 DR MICHAEL SOCHACKI ORTHOPEDIC SURGEON 466490 0 8000 0 215194 0 36600 0 43311 0 769595 0 0 0 DR DANIEL GRIDLEY RADIOLOGY CHAIR 490978 0 5000 0 126370 0 36600 0 44971 0 703919 0 0 0 DR ELLIOT MENDELSOHN ORTHOPEDIC SURGEON 475360 0 6800 0 143264 0 33550 0 10282 0 669256 0 0 0 DR WILLIAM ROMANO SECTION HEAD, INTERVENTIONAL RADIOLO 445376 0 5000 0 159886 0 27450 0 13096 0 650808 0 0 0 DR DAN HOBOHM BD. CHAIR, PATH CHAIR, VP OF QUALITY 403434 0 5000 0 165269 0 18300 0 12516 0 604519 0 0 0 DR JOHN GREEN ORTHOPEDIC SURGEON 471664 0 53000 0 27332 0 27450 0 18951 0 598397 0 0 0 DR BRENDA GENTZ ANESTHESIA CHAIR 445176 0 5000 0 81872 0 27450 0 19444 0 578942 0 0 0 DR DEAN COONROD BD. MEMBER, SECRETARY, OBGYN CHAIR 393848 0 5000 0 55738 0 61000 0 43404 0 558990 0 0 0 DR DAVID WISINGER BD. MEMBER, CMO, INT. MEDICINE CHAIR 398163 0 5000 0 68571 0 61000 0 24607 0 557341 0 0 0 DR JEFFREY STOWELL EMERGENCY MEDICINE CHAIR 363250 0 5000 0 76011 0 36600 0 39584 0 520445 0 0 0 DR CAROL OLSON PSYCHIATRY CHAIR 353657 0 5000 0 32149 0 61000 0 36332 0 488138 0 0 0 DR SYDNEY VAIL SURGERY CHAIR 367584 0 5000 0 23288 0 36600 0 6362 0 438834 0 0 0 DR JODI CARTER PEDIATRICS CHAIR 363032 0 0 0 25696 0 6100 0 35861 0 430689 0 0 0 CRAIG JONES CFO, TREASURER 257004 0 5000 0 2732 0 32421 0 19934 0 317091 0 0 0 DR DAVID BRODKIN FORMER KEY EE, PEDIATRIC PHYSICIAN 152807 0 5000 0 65426 0 27823 0 36112 0 287168 0 0 0 DR DANY QUAN FORMER KEY EE, DIRECTOR - MEDICAL TO 128051 0 6500 0 61767 0 23786 0 5975 0 226079 0 0 0 PART I, LINE 3 DMG MAINTAINS A COMPENSATION PLAN APPROVED BY THE BOARD OF DIRECTORS, AND OVERSEEN BY THE COMPENSATION COMMITTEE. THE VOTING RIGHTS OF THE COMPENSATION COMMITTEE, IN REGARDS TO COMPENSATION OF DMG EMPLOYEES, ARE VESTED ENTIRELY IN THE COMMUNITY DIRECTORS (NON-EMPLOYEE DIRECTORS). THERE IS A WRITTEN POLICY GOVERNING THE PERSONNEL ACTION COMMITTEE, WHICH OVERSEES THE DAY TO DAY ADMINISTRATION OF THE COMPENSATION PLAN. THERE IS ALSO A WRITTEN POLICY FOR PROVIDERS WHO EARN COMPENSATION IN EXCESS OF BASE SALARY. PART I, LINE 7 THE MAJORITY OF BONUS AND INCENTIVE COMPENSATION IS BASED ON EMPLOYEE CONTRACTS AND APPROVED WRITTEN COMPENSATION PLANS. ANNUALLY THE COMPANY CONSIDERS WHETHER A COMPANY-WIDE BONUS FOR ALL EMPLOYEES IS POSSIBLE BASED ON OVERALL COMPANY FINANCIAL PERFORMANCE FOR THE YEAR. THIS AMOUNT IS APPROVED BY THE COMPENSATION COMMITTEE AND AMOUNTS ARE DETERMINED BY THE TYPE OF EMPLOYEE AND THE FULL-TIME EQUIVALENT STATUS WITHIN THE COMPANY. SCHEDULE J, PART II, B (III): OTHER REPORTABLE COMPENSATION THIS INCLUDES ADDITIONAL PAY FOR SERVICES PERFORMED OUTSIDE AND/OR IN ADDITION TO THEIR BASE CONTRACTUAL REQUIREMENTS. FORM 990, PART VI, SECTION A, LINE 7A THE 4 PHYSICIAN DIRECTORS OF THE BOARD ARE ELECTED BY THE BOARD, WHICH CONSISTS OF A MAJORITY OF COMMUNITY BOARD MEMBERS, AFTER BEING NOMINATED BY THE DIVISION CHAIRS. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE DRAFT IS SENT TO EACH OF THE BOARD MEMBERS. INPUT FROM THE BOARD MEMBERS IS INCORPORATED INTO THE DRAFT, WHICH IS THEN REVIEWED BY THE CFO AND THE CONTROLLER. AN OUTSIDE ACCOUNTING FIRM IS CONSULTED ROUTINELY. THE UPDATED DRAFT IS SENT TO THE BOARD MEMBERS AND THEN SIGNED AND FORWARDED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY AND PROCEDURE IS REVIEWED WITH THE BOARD ANNUALLY, AND THE CONFLICT OF INTEREST DISCLOSURE STATEMENT IS COMPLETED ANNUALLY, AND RETAINED BY THE CHIEF COMPLIANCE OFFICER. ANY POTENTIAL CONFLICTS OF INTEREST IDENTIFIED FROM THE DISCLOSURE STATEMENTS ARE REVIEWED BY THE EXECUTIVE COMMITTEE AND THE ORGANIZATION'S LEGAL COUNSEL, IF NEEDED, AND UNRESOLVED POTENTIAL CONFLICTS ARE NOTED SO THAT ACTUAL CONFLICTS OF INTEREST ARE AVOIDED. FORM 990, PART VI, SECTION B, LINE 15 WITH GUIDANCE FROM AN OUTSIDE (INDEPENDENT) COMPENSATION CONSULTANT, THE EXECUTIVE COMMITTEE REVIEWS AND MAKES RECOMMENDATIONS TO THE BOARD ON THE COMPENSATION OF THE CEO. SAID COMPENSATION IS DETERMINED BASED ON SURVEY DATA AND COMPARISON FROM THE CEO COMPENSATION REPORTED BY SIMIALR ORGANIZATIONS ON THEIR IRS FORM 990. A MAJORITY OF THE MEMBERSHIP OF BOTH THE EXECUTIVE COMMITTEE AND THE BOARD CONSISTS OF COMMUNITY BOARD MEMBERS (THEY ARE INDEPENDENT, AND NOT EMPLOYED BY DMG). SUCH DISCUSSIONS AND ACTIONS ARE REFLECTED IN THE MINUTES OF DULY CONSTITUED MEETINGS OF THE COMMITTEE AND THE BOARD. THE COMPENSATION OF THE OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED BASED ON SURVEY DATA PRODUCED BY MGMA, A NATIONALLY RECOGNIZED MEDICAL GROUP MANAGEMENT ASSOCIATION. FORM 990, PART VI, SECTION C, LINE 19 DMG MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC THROUGH WRITTEN REQUESTS RECEIVED AT THE CORPORATE OFFICE. THE REQUEST IS TO BE REVIEWED BY THE APPROPRIATE CORPORATE OFFICER, WHO WILL OVERSEE THE FULFILLING OF THE REQUEST. 990 PART XII, LINE 2C: THE AUDIT COMMITTEE'S PROCESS OF APPROVING THE INDEPENDENT AUDITOR AND REVIEWING THE RESULTS OF THE ANNUAL AUDIT REMAINS THE SAME AS IN PREVIOUS YEARS. DMG INSURANCE COMPANY INC 2929 E THOMAS RD PHOENIX AZ 85016 261262665 PURE CAPTIVE INSURER AZ 501(C)(3) LINE 12A, I DISTRICT MEDICAL GROUP INC 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 DMG INSURANCE COMPANY INC R 5757605 CASH DMG INSURANCE COMPANY INC L 144783 ESTIMATE PART V, LINE 2(L) THE AMOUNT PRESENTED REPRESENTS AN ESTIMATED COST OF PERSONNEL TIME PROVIDED BY EMPLOYEES OF THE PARENT TO THE SUBSIDIARY. THE AMOUNT WAS BASED ON AN ESTIMATED OF ANNUAL HOURS PARENT EMPLOYEES DEDICATED TO MANAGING THE SUBSIDIARY. THE PARENT ABSORBED THESE COSTS, WHICH ARE INCLUDED IN PART IX OF FORM 990, AND WAS NOT REIMBUSED BY THE SUBSIDIARY. PART V, LINE 2(R) THIS AMOUNT REPRESENTS TOTAL PREMIUMS PAID TO THE SUBSIDIARY FOR PROFESSIONAL LIABILITY AND GENERAL LIABILITY INSURANCE COVERAGE. PORTIONS OF THIS AMOUNT ARE INCLUDED ON FORM 990, PART IX, LINE 23 - INSURANCE EXPENSE AND FORM 990, PART X, LINE 9 - PREPAID EXPENSES AND DEFERRED CHARGES. SCHEDULE R, LINE 1(L): PERSONNEL OF THE PARENT PERFORM ADMINISTRATIVE FUNCTIONS FOR THE SUBSIDIARY. THESE FUNCTIONS INCLUDE CASE MANAGEMENT, ACCOUNTING AND OVERALL ORGANIZATION MANAGEMENT. THE PARENT IS NOT REIMBURSED BY THE SUBSIDIARY FOR THESE COSTS.