Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MERITER MEDICAL GROUP INC
Employer identification number
05-0545222
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
No
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
(1)
MERITER HOSPITAL INC
390806367
7
Yes
Yes
Yes
0
Total
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
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.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(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. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
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......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
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.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
MERITER MEDICAL GROUP INC
Employer identification number
05-0545222
Identifier
Return Reference
Explanation
NEW PROGRAM SERVICES
FORM 990, PART III, LINE 2
NEW SERVICES -MERITER MEDICAL GROUP ADDED THE FOLLOWING PROGRAMS TO OUR PORTFOLIO OF SERVICES IN 2010: ADULT AND CHILD/ADOLESCENT PSYCHIATRISTS PROVIDE PROGRAM LEADERSHIP AND CLINICAL SERVICES FOR MERITER HOSPITAL INPATIENT ADULT AND CHILD/ADOLESCENT PROGRAMS. ORTHOPEDIC SERVICES PROVIDED THROUGH OUR AMBULATORY CLINIC WITH THE SERVICES OF TWO ORTHOPEDIC SURGEONS AS WELL AS ADVANCE PRACTITIONERS. MMG EXPANDED TO A FULL COMPLEMENT OF PRIMARY CARE PROVIDERS IN 2010 WITH THE ADDITION OF FAMILY MEDICINE AND PEDIATRICS PHYSICIANS AT OUR PRIMARY CARE CLINICS. INTERVENTIONAL SPINE SERVICES PROVIDE SERVICES THROUGH MERITER HOSPITAL AS WELL AS OUR ORTHOPEDIC CLINIC. WOMEN HEARTCARE PROVIDES COMPREHENSIVE CARE FOR WOMEN TO PREVENT OR BETTER LIVE WITH HEART DISEASE. TWO FEMALE PRACTITIONERS - AN ADVANCED NURSE PRACTITIONER AND HEALTH PSYCHOLOGIST ASSIST WOMEN TO MAKE LASTING LIFELONG CHANGES.
FORM 990, PART VI, SECTION A, LINE 1
FORM 990, PART VI, SECTION A, LINE 1: THE RESPONSE TO FORM 990 PART VI, SECTION A, QUESTION 1B RELATES TO THE SEVEN MEMBERS OF THE BOARD OF DIRECTORS OF MERITER MEDICAL GROUP, EACH OF WHOM IS AN EMPLOYEE WITHIN THE MERITER HEALTH SERVICES SYSTEM. THIS EMPLOYMENT RELATIONSHIP CLASSIFIES THEM AS NOT INDEPENDENT. THESE INDIVIDUALS ARE APPOINTED TO THE BOARD OF DIRECTORS OF MERITER MEDICAL GROUP BY MERITER HOSPITAL, AS THE SOLE VOTING MEMBER. MAJOR VOTES OF MMG, ON SIGNIFICANT ACTIONS DESCRIBED IN SCHEDULE O FOR PART VI, SECTION A, QUESTION 7A, ARE PERFORMED BY MERITER HOSPITAL AS THE SOLE VOTING MEMBER. THE BOARD OF DIRECTORS OF THE HOSPITAL CONTAINS 19 VOTING MEMBERS OF WHOM 15 ARE INDEPENDENT.
FORM 990, PART VI, SECTION A, LINE 4
THE LEGAL NAME CHANGED IN JANUARY OF 2010 FROM MERITER CLINICS, INC TO MERITER MEDICAL GROUP, INC. THE NEW GOVERNANCE STRUCTURE EXPANDED TO NINE BOARD MEMBERS: FOUR MMG PROVIDERS, THREE EX-OFFICIO AND 2 COMMUNITY MEMBERS FROM THE MERITER HOSPITAL BOARD. THE AMENDED BY-LAWS ALSO INCLUDE ADDITIONAL ITEMS REQUIRING APPROVAL THE BOARD OF MERITER HOSPITAL, AND THE ARTICLES OF INCORPORATION INCLUDE MORE DETAILED PROVISIONS FOR DISSOLUTION OF THE CORPORATION THAN WERE PREVIOUSLY INCLUDED.
FORM 990, PART VI, SECTION A, LINE 6
MERITER HOSPITAL IS THE SOLE VOTING MEMBER OF MERITER MEDICAL GROUP.
FORM 990, PART VI, SECTION A, LINE 7A
MERITER HOSPITAL IS THE SOLE VOTING MEMBER OF MERITER MEDICAL GROUP AND, AS SUCH, THE HOSPITAL BOARD ELECTS THE MEMBERS OF THE MERITER MEDICAL GROUP BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B
THE FOLLOWING ACTIONS REQUIRE THE PRIOR AUTHORIZATION OR APPROVAL OF THE MH BOARD AS VOTING MEMBER OF THE CORPORATION: A) MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION; B) AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OF THE CORPORATION; C) SALE, LEASE, EXCHANGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE CORPORATION; D) THE ESTABLISHMENT, FORMATION, ACQUISITION, MERGER, CONSOLIDATION OR DISSOLUTION OF ANY SUBSIDIARY CORPORATION OF THE CORPORATION; E) THE ADOPTION OF THE AGGREGATE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; F) THE ADOPTION OF STRATEGIC PLANS AND AMENDMENTS TO THE SAME; G) THE ADOPTION OF PHYSICIAN COMPENSATION PLANS AND AMENDMENTS TO THE SAME; H) AGGREGATE BORROWING FOR PERIODS OF ONE YEAR OR LESS IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE VOTING MEMBER FROM TIME TO TIME, AND AGGREGATE BORROWING FOR PERIODS OF MORE THAN ONE YEAR IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE VOTING MEMBER FROM TIME TO TIME; I) PURCHASE SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, AND ENCUMBRANCE OF ANY ASSET WITH A VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE VOTING MEMBER FROM TIME TO TIME, NOT PREVIOUSLY INCLUDED IN THE CAPITAL BUDGET; AND J) THE APPOINTMENT OF THE INDEPENDENT AUDITOR AND CORPORATE COUNSEL
FORM 990, PART VI, SECTION B, LINE 11
MERITER CONTRACTS WITH AN OUTSIDE PUBLIC ACCOUNTING FIRM TO PREPARE ALL INCOME TAX RETURNS. MERITER'S ACCOUNTING DEPARTMENT STAFF COMPLETES AND THE CORPORATE CONTROLLER REVIEWS THE COMPREHENSIVE TAX ORGANIZER PROVIDED BY THE TAX FIRM. THE CORPORATE CONTROLLER AND THE TAX FIRM WORK TOGETHER TO PREPARE TAX RETURNS TO REFLECT INFORMATION THAT AFFECTS THE FORM 990. TWO WEEKS PRIOR TO FILING, THE RETURNS WILL BE POSTED TO THE BOARD GOVERNANCE INTERNAL WEB SITE ACCOMPANIED BY A MEMO HIGHLIGHTING THE KEY POINTS OF INTEREST FOR THE FILING YEAR AND CONTAINING THE ANTICIPATED FILING DATE IN ADDITION TO PROVIDING CONTACT INFORMATION FOR FURTHER INQUIRY BY THE BOARD.
FORM 990, PART VI, SECTION B, LINE 12C
YES, THE MERITER MEDICAL GROUP BOARD OF DIRECTORS CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. ON A PROACTIVE BASIS, DECLARATIONS OF POTENTIAL CONFLICTS OF INTEREST ARE SIGNED WHEN EACH DIRECTOR JOINS THE BOARD AND ANNUALLY THEREAFTER. THE CEO AND BOARD CHAIR MONITOR THE POTENTIAL CONFLICTS DISCLOSED BY BOARD MEMBERS AND MANAGE ATTENDANCE AT MEETINGS AND PARTICIPATION IN VOTES ACCORDING TO THE ISSUE ON THE AGENDA. INDIVIDUAL DIRECTORS ALSO MONITOR THEIR POTENTIAL CONFLICTS AND RECUSE THEMSELVES FROM BOARD DISCUSSION AND/OR VOTES AS REQUIRED BY THE CIRCUMSTANCES. THE PROCESS OF MANAGING CONFLICTS OF INTEREST IS RECORDED IN THE MEETING MINUTES.
FORM 990, PART VI, SECTION B, LINE 15
MHS BOARD OF DIRECTORS APPROVE PHYSICIAN AND EXECUTIVE COMPENSATION PHILOSOPHY AND STRATEGY FOR MERITER MEDICAL GROUP. THE BOARD OF DIRECTORS AUTHORIZES A SUB-COMMITTEE OF THE BOARD TO MAKE COMPENSATION DECISIONS WHILE RETAINING OVERSIGHT OF SAID COMMITTEE. AN EXTERNAL HUMAN RESOURCES CONSULTING FIRM IS ENGAGED BY THE BOARD OF DIRECTORS' SUB-COMMITTEE. THIS FIRM COLLECTS AND REVIEWS ALL ORGANIZATIONAL INFORMATION, COMPENSATION DATA, AND BACKGROUND INFORMATION MATCHING ALL PHYSICIAN AND EXECUTIVE POSITIONS TO SURVEY BENCHMARKS. USING THIS INFORMATION THE CONSULTING FIRM PRODUCES ESTIMATED MARKET VALUES FOR EACH PHYSICIAN AND EXECUTIVE AND RECOMMENDS ANY NECESSARY CHANGES WITH PHYSICIAN AND EXECUTIVE COMPENSATION TO THE BOARD COMMITTEE FOR THEIR DECISION. COMPENSATION FOR NON-EXECUTIVES IS DETERMINED BY THE MERITER COMPENSATION COMMITTEE.
FORM 990, PART VI, SECTION C, LINE 18
FORM 1023 WOULD BE AVAILABLE UPON REQUEST FROM ADMINISTRATION.
FORM 990, PART VI, SECTION C, LINE 19
AS PRIVATE CORPORATIONS, THE GOVERNING DOCUMENTS ARE NOT MADE PUBLIC. THE CONFLICT OF INTEREST POLICY IS NOT GENERALLY MADE PUBLIC, BUT WOULD BE DISCLOSED TO INTERESTED PARTIES IN THE CONTEXT OF ANY ISSUE THAT MIGHT ARISE. FINANCIAL INFORMATION CONTAINED WITHIN THE 990S IS AVAILABLE TO THE PUBLIC ON GUIDESTAR AND ARE AVAILABLE UPON REQUEST OF ADMINISTRATION.
FORM 990, PART VII: HOURS FROM RELATED ORGANIZATION
ALL MERITER HEALTH SERVICES SYSTEM EMPLOYEES REPORTED ON THIS FORM 990 WORK, ON AVERAGE, A MINIMUM OF 40 HOURS PER WEEK BUT IN MOST CASES MORE THAN 40 HOURS PER WEEK.
CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 5:
OCI PENSION ADJUSTMENT -204,432. TOTAL TO FORM 990, PART XI, LINE 5: -204,432.
FORM 990, PART XII, LINE 2A& B:
MERITER MEDICAL GROUP, INC. IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS FOR MERITER HOSPITAL, INC. AND MERITER HEALTH SERVICES, INC.
FORM 990, PART XII, LINE 2C
THERE HAS BEEN NO CHANGE IN THE REVIEW PROCEDURE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.