Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (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...... | 125,955,321 | 129,261,726 | 122,503,241 | 119,890,496 | 142,841,938 | 640,452,722 |
| 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. | 125,955,321 | 129,261,726 | 122,503,241 | 119,890,496 | 142,841,938 | 640,452,722 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support (Subtract line 7c from line 6.) | 640,452,722 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 125,955,321 | 129,261,726 | 122,503,241 | 119,890,496 | 142,841,938 | 640,452,722 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 278,837 | 184,771 | 168,550 | 276,604 | 908,762 | |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 278,837 | 184,771 | 168,550 | 276,604 | 908,762 | |
| 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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 126,234,158 | 129,446,497 | 122,671,791 | 120,167,100 | 142,841,938 | 641,361,484 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| STATEMENT 1: DESCRIPTION OF ORGANIZATION'S MISSION | FORM 990, PART I, LINE 1, AND PART III, LINE 1 WE ARE COMMITTED TO IMPROVING THE HEALTH OF OUR PATIENTS BY DELIVERING EXCELLENT AND COMPASSIONATE MEDICAL CARE. WE PROVIDE COORDINATED PRIMARY CARE AND SPECIALTY SERVICES WHILE RESPECTING PATIENT CONFIDENTIALITY AND PRIVACY. WE STRIVE TO IMPROVE OUR CARE AND SERVICE BY ASSESSING THE NEEDS AND EXPECTATIONS OF OUR PATIENTS. OUR DEPARTMENTS ARE COMMITTED TO MEETING THESE NEEDS AND EXPECTATIONS WITH REGARD TO ACCESS, QUALITY AND SERVICE. WE ARE COMMITTED TO PROVIDING AN ENVIRONMENT THAT PROMOTES SAFETY FOR STAFF AND PATIENTS AND THAT FACILITATES OPTIMUM PARTICIPATION, PERFORMANCE, SATISFACTION AND QUALITY CARE. WE ARE COMMITTED TO THE ORGANIZATION'S STRENGTH. INTERNALLY, WE WILL MONITOR AND IMPROVE OUR CLINICAL, FINANCIAL, ADMINISTRATIVE AND INFORMATION SYSTEM PERFORMANCE. EXTERNALLY, WE WILL BUILD ALLIANCES WITH OTHERS WHO SHARE OUR VISION. |
| FORM 990, PART III, LINE 3 | EFFECTIVE FEBRUARY 27, 2014, DMA ENTERED INTO AN AGREEMENT WITH MEDICAL CARE OF BOSTON MANAGEMENT CORPORATION, D/B/A AFFILIATED PHYSICIANS GROUP ("APG") TO FORM DEDHAM MEDICAL URGENT CARE CENTER AFFILIATED WITH BETH ISRAEL DEACONESS MEDICAL CENTER, LLC. THE PURPOSE OF THE NEW ENTITY IS TO PROVIDE URGENT CARE SERVICES TO RESIDENTS WITHIN THE EXISTING COVERAGE AREA OF DMA. THE SERVICES ARE LOCATED AT THE DMA NORWOOD SITE AND ARE PROVIDED BY BETH ISRAEL DEACONESS MEDICAL CENTER EMERGENCY ROOM PHYSICIANS. DMA IS A 65% MEMBER AND APG IS A 35% MEMBER OF THE DEDHAM MEDICAL URGENT CARE CENTER AFFILIATED WITH BETH ISRAEL DEACONESS MEDICAL CENTER, LLC. THE BOARD IS COMPRISED OF SIX DIRECTORS, THREE EACH FROM DMA AND APG. |
| FORM 990, PART VI, SECTION A, LINE 2 | DMA IS THE GENERAL PARTNER OF DEDHAM MEDICAL ASSOCIATES PARTNERSHIP ("DMAP") AND HAS A DIRECT OWNERSHIP INTEREST OF 5.0%. 36.23% OF THE TOTAL OWNERSHIP OF DMAP IS HELD BY CURRENT AND FORMER TRUSTEES, OFFICERS AND KEY EMPLOYEES LISTED IN FORM 990, PART VII, SEC. A. ON DECEMBER 23, 2014, DMAP SOLD ITS PROPERTY TO DMA, WHICH DMA HAD BEEN LEASING, AND DISTRIBUTED ALL OF ITS ASSETS TO ITS PARTNERS. |
| FORM 990, PART VI, SECTION A, LINE 6 | DEDHAM MEDICAL ASSOCIATES, INC. ("DMA") HAS TWO CLASSES OF MEMBERS: THE CORPORATE MEMBER (ATRIUS HEALTH, INC.) - THE CORPORATE MEMBER CAN BE REMOVED ONLY IF DMA IS REMOVED, BY THE CORPORATE MEMBER, AS A PARTICIPATING ORGANIZATION IN THE ATRIUS HEALTH SYSTEM. THE CORPORATE MEMBER HAS CERTAIN DEFINED APPROVAL RIGHTS OF THE ACTIONS OF THE CORPORATION. THE PHYSICIAN MEMBERS - THE PHYSICIAN MEMBERS ARE NOT MEMBERS OF THE CORPORATION WITHIN THE MEANING OF CHAPTER 180 OF THE MASSACHUSETTS GENERAL LAWS. ELECTION OF NEW PHYSICIAN MEMBERS REQUIRES AN AFFIRMATIVE VOTE OF 80% OF THE THEN-CURRENT PHYSICIAN MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE CORPORATE MEMBER ELECTS SEVEN (7) PRACTICE TRUSTEES AND MAY REMOVE ANY TRUSTEE ELECTED BY CORPORATE MEMBER WITH OR WITHOUT CAUSE. THE PHYSICIAN MEMBERS ELECT TWO (2) PRACTICE TRUSTEES AND TWO (2) COMMUNITY TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | MOST MAJOR DECISIONS OF THE BOARD MUST BE APPROVED BY DMA'S CORPORATE MEMBER. THE CORPORATE MEMBER MUST APPROVE ALL BUDGETS, PLANS, AND MATERIAL CHANGES; APPROVE ALL PROGRAM CHANGES; APPROVE ANY AMENDMENT TO THE ARTICLES OF ORGANIZATION AND OR BY-LAWS; APPROVE COMPENSATION STRUCTURES AND RANGES FOR DMA'S TRUSTEES, PHYSICIANS, SENIOR MANAGERS AND OTHER PROFESSIONALS; AND, IN GENERAL APPROVE ANY OTHER ACTIONS NOT IN THE NORMAL COURSE OF BUSINESS. IN ADDITION TO POWERS PROVIDED BY LAW, THE ARTICLES OF ORGANIZATION AND DMA'S BY-LAWS, THE CORPORATE MEMBER HAS AUTHORITY TO: (A) LEVY ASSESSMENTS TO COVER THE CORPORATE MEMBER'S COSTS OF OPERATIONS; (B) APPROVE, OR DISAPPROVE, THE SELECTION AND REMOVAL OF SEVEN OUT OF THE NINE TRUSTEES; AND, (C) ACT AS DMA'S EXCLUSIVE AGENT FOR PURPOSES OF NEGOTIATING PAYOR CONTRACTS FOR DMA AND THE OTHER PARTICIPATING ORGANIZATIONS AS DEFINED IN THE CORPORATE MEMBER'S BY-LAWS. UPON DISSOLUTION OF DMA, THE NET ASSETS OF DMA WILL BE DISPOSED OF TO ATRIUS HEALTH, INC. PROVIDED IT IS THEN EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. |
| FORM 990, PART VI, SECTION B, LINE 11 | ATRIUS HEALTH ENGAGED AN OUTSIDE TAX/ACCOUNTING FIRM TO REVIEW AND PREPARE THE FORM 990 FOR DEDHAM MEDICAL. AN INTERNAL TEAM AT DEDHAM MEDICAL INCLUDING STAFF FROM ACCOUNTING AND HUMAN RESOURCES DEPARTMENTS WORK CLOSELY WITH THE OUTSIDE FIRM TO PREPARE THE DOCUMENT. IN ADDITION, THE DEDHAM MEDICAL BOARD OF TRUSTEES AND THE ATRIUS HEALTH AUDIT & COMPLIANCE COMMITTEE JOINTLY OVERSEE THE PREPARATION OF DEDHAM MEDICAL'S 990. EFFECTIVE JULY 1, 2015 DEDHAM MEDICAL WAS MERGED INTO ATRIUS HEALTH, INC. THE ATRIUS HEALTH BOARD RECEIVES A FINAL DRAFT OF THE 990 AND FORMALLY REVIEWS AND APPROVES THE ENTIRE DOCUMENT BEFORE FILING. IN ADDITION, MATERIAL ISSUES (IF ANY) WITH THE DEDHAM MEDICAL 990 WOULD BE HIGHLIGHTED IN THE OUTSIDE FIRM'S PRESENTATION TO THE ATRIUS HEALTH AUDIT & COMPLIANCE COMMITTEE BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | DMA HAS A COMPREHENSIVE COMPLIANCE PROGRAM WHICH IS MONITORED BY THE AUDIT AND COMPLIANCE COMMITTEE AND COMPLIANCE OFFICER. THE NATURE OF THE POTENTIAL OR ACTUAL CONFLICT DETERMINES THE LEVEL(S) AT WHICH A DETERMINATION OF POTENTIAL CONFLICT MAY EXIST. AN INDIVIDUAL INVOLVED WITH A POTENTIAL CONFLICT MAY BE PROHIBITED FROM BEING IN ATTENDANCE AT ANY MEETINGS AT WHICH THE MATTER IS DISCUSSED AND MAY NOT BE ALLOWED TO VOTE ON THE MATTER. ALL MEMBERS OF THE BOARD, DMA'S OFFICERS AND SENIOR MANAGERS ARE REQUIRED TO ANNUALLY REVIEW, COMPLETE AND CERTIFY COMPLIANCE WITH DMA'S CONFLICT OF INTEREST POLICY. IN ADDITION ALL NEW HIRES (IN THE CATEGORIES DESCRIBED) ARE REQUIRED TO READ AND ACKNOWLEDGE RECEIPT OF DMA'S CODE OF CONDUCT. THE CONFLICT OF INTEREST POLICY STATES "AS A GENERAL RULE, CONFLICTS OF INTEREST ARE NOT PERMITTED." DMA'S POLICY PROVIDES FOR EXCEPTIONS IF DISCLOSED PROMPTLY AND APPROVED BY THE APPROPRIATE LEVEL OF MANAGEMENT. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION: DMA'S PRESIDENT, ALL OF ITS STATUTORY OFFICERS AND ITS PHYSICIAN MEMBERS ARE EMPLOYED BY DMA AS PRACTICING PHYSICIANS. FOR THE PHYSICIANS, THE KEY CRITERIA IN DETERMINING COMPENSATION IS THE PHYSICIAN'S PRODUCTIVITY. THE COMPENSATION RANGES FOR THE PHYSICIANS ARE REVIEWED BY THE COMPENSATION PERSONNEL EMPLOYED BY THE CORPORATE MEMBER. THE COMPENSATION PAID TO PHYSICIANS IS CONSISTENT WITH THE ANALYSIS OF NATIONALLY RECOGNIZED COMPENSATION CONSULTANTS REGARDING MARKET COMPETITIVENESS AND REASONABLENESS OF THE COMPENSATION, INCLUDING DEFINING COMPENSATION THRESHOLDS THAT, IF EXCEEDED, REQUIRE FURTHER REVIEW AND APPROVAL OR MODIFICATION AS APPROPRIATE BY DMA AND ULTIMATELY THE CORPORATE MEMBER'S COMPENSATION COMMITTEE. STIPENDS ARE AWARDED TO THE OFFICERS OF DMA'S BOARD TO COMPENSATE FOR THE TIME REQUIRED TO ACCOMPLISH THOSE ADMINISTRATIVE DUTIES. ALL MAJOR DECISIONS OF THE BOARD MUST BE APPROVED BY DMA'S CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL STATEMENTS ARE ATTACHED TO THE MA FORM PC FILED WITH THE ATTORNEY GENERAL'S OFFICE, WHICH IS OPEN TO PUBLIC INSPECTION. THE ARTICLES OF ORGANIZATION ARE AVAILABLE AT THE MASSACHUSETTS SECRETARY OF STATE'S OFFICE, INCLUDING ON-LINE. OTHER GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE NOT GENERALLY AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | OUTSIDE UTILIZATION CHARGES (CAPITATION CONTRACTS): PROGRAM SERVICE EXPENSES 61,776,917. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 61,776,917. CONTRACTED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 3,081,737. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,081,737. OTHER: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 636,341. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 636,341. |
| FORM 990, PART XI, LINE 2C | THERE WAS NO CHANGE TO THE OVERSIGHT OF THE YEAR-END AUDIT OR THE SELECTION PROCESS OF THE INDEPENDENT ACCOUNTANT DURING THE TAX YEAR. |
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