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
DISTRICT MEDICAL GROUP INC
Employer identification number
20-8106540
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)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
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
Total
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.
0
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..
0
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
0 %
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.") .
2,376,819
217,234
2,594,053
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......
117,454,124
117,454,124
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.
2,376,819
117,671,358
120,048,177
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.)
120,048,177
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...
2,376,819
117,671,358
120,048,177
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
12,671
12,671
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
12,671
12,671
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.)
9,541
9,541
13
Total support (Add lines 9, 10c, 11 and 12.).
120,070,389
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
0 %
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
0 %
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
OTHER INCOME PART III, LINE 12; DESCRIPTION: MISC. NON-OPERATING INCOME; 2010: 9541.;
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
10000104
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
DISTRICT MEDICAL GROUP INC
Employer identification number
20-8106540
Identifier
Return Reference
Explanation
Pt VI-A, Line 7a
The 4 Physician Directors of the Board are elected by the Board, after
being nominated by the Division Chairs, and after that nomination is
ratified by a majority vote of all of the physicians who have been
employed by DMG at a .8 FTE or higher for at least one year.
Pt VI-A, Line 8b
The only committee authorized to act on behalf of the Board is the executive
committee. Minutes are not kept of the executive committe meetings, however
any action of the executive commitee is required to be ratified by the Board at its
next regularly scheduled meeting, of which minutes are kept.
Pt VI-B, Line 11a
Once prepared, the draft of the form 990 is reviewed by the tax/non-
profit partner of a large public accounting firm (the firm has substantial
non-profit experience). In addition, a copy of the draft is sent to
each of the Board Members. The form is updated based on suggested
revisions, and then each page is reviewed by the CFO and the Controller
prior to signing and forwarding to the IRS.
Pt VI-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.
Pt VI-B, Line 15
The compensation of the CEO, and other officers, is determined based
on survey data produced by MGMA, a nationally recognized medical
group management association. The results of the survey are presented
to and reviewed by the Compensation Committee, and approved by only the
Community Board Members of the committee(independent, and not employed
by DMG). Such discussions and actions are reflected in the minutes of
a duly constituted meeting of the committee.
.
Pt VI-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.
.
Part III, Line 4a
Established in 1993, by 2010 our 350+ provider multi-specialty group
practice evolved into District Medical Group, Inc. (DMG), a locally
owned, not-for-profit healthcare organization; the second largest in
Arizona. Our mission is to improve the health and well-being of
individuals in the Phoenix area and the entire state of Arizona 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 patients ability to pay. We
support and seek to create 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
Part III, Line 4a
medical care with no restrictions to our entire community. DMG with
(cont.)
its affiliates comprise 38 clinical sites, approximately 700 providers,
and 182 non-provider employees. In 2010, DMG served approximately
25,000 inpatients, 467,000 outpatients, and 74,000 emergency/urgent
care visits. During 2010 DMGs direct economic output, including the
service economy, is estimated at $117 million. The indirect economic
benefit to the community is significantly more.
.
District Medical Group staffs the Maricopa Integrated Health System,
which includes a 450 bed acute care hospital, a 200 bed inpatient
psychiatric hospital, eleven family health centers throughout the
valley and a large diagnostic center. DMG also staffs the internationally
renowned Arizona Burn Center, the 2nd largest in the US, admitting 950
patients/year and serving 4,000 patients/year in the outpatient burn
clinic; the verified American College of Surgeons Level I trauma center,
and Level 2 pediatric trauma center; and the Arizona Childrens Center,
a NACHRI-certified childrens hospital, caring for over 19,000 patients/
year between 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 DMG provides are the Refugee Womens Health
Clinic, the first of its kind in Arizona, providing culturally-grounded
healthcare to the growing refugee and immigrant community, and the
Mariposa: Wings to Safety, whose focus is on victims and families
affected by domestic violence and sexual abuse.
.
Through our formal affiliation and partnership with Maricopa Integrated
Part III, Line 4a
Health System (MIHS) and the University of Arizona College of Medicine,
(cont.)
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 225
residents and fellows, another 60 in affiliated programs, and supervise
600 medical student rotations. A majority of DMG physicians hold faculty
positions with the University of Arizona College of Medicine, giving
and attending clinical lectures and other academic events, and actively
teaching and supporting scholarship and research activities. In 2010
alone, we were involved in over 140 active research projects, including
industry-sponsored and NIH grants. Some of these were: an observational
prospective study to assess RSV respiratory events among premature
infants (32-35 weeks gestational age) an outcome and risk tracking
study; a multi-center, randomized, double-blind, parallel group, active-
controlled study to evaluate the efficacy and safety of LCZ696 compared
to enalapril on morbidity and mortality in patients with chronic heart
failure and reduced ejection fraction (PARADIGM); Green Tea Extract in
Preventing Cervical Cancer in Patients With Human Papillomavirus and
Low-Grade Cervical Intraepithelial Neoplasia; Strategies using Off-
Patent antibiotics for Methicillin-Resistant Staphylococcus aureus
("STOP MRSA") - A Phase IIB, multi-center, randomized, double-blind
clinical trial; and a Phase 2b/3, multi-center, randomized, double-blind,
placebo controlled trial to Evaluate the Safety and Efficacy of
Pagibaximab Injection in Very Low Birth Weight (VLBW) Neonates for the
Prevention of Staphylococcal Sepsis.
.
DMG believes that creating an institutional culture of scholarship and
Part III, Line 4a
promoting clinical research improves the health and well-being of all
(cont.)
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 national and international medical societies. DMG providers
and employees furnish significant assistance and personal resources to
the community as well as outlying areas through health fairs with
screenings, immunizations, information and access to integrated services;
community outreach events highlighting prenatal screenings,
rehabilitation, hospice, senior care, transportation and care
coordination; back-to-school and holiday clinics for children and
students; childhood and adolescent obesity clinics; and 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 DMGs longstanding
commitment to making healthcare services and information accessible and
effective for everyone, benefiting the entire community. Nationally and
internationally, DMGs physicians have been on the scene wherever
medical help is needed, bringing their clinical expertise to combat
hospitals in war-torn Iraq and Afghanistan, relief efforts in New
Orleans, the devastation in Haiti, day to day medical crises and
emergencies in many countries in Africa and Asia. Working with Doctors
without Borders, the Red Cross, other relief agencies, and even on their
Part III, Line 4a
own, DMGs physicians have made a difference and been gratefully
(cont.)
recognized for their efforts and contributions, to the extent of
receiving the Citizen Service Above Self award from the Congressional
Medal of Honor Foundation. Through community health improvement
services, health professions education, subsidized health services,
research, cash and in-kind contributions, and community benefiting
activities, DMG contributed $18,048,230 in 2010.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.