2013-11-11T12:00:13-06:00 2012-12-31 580692043 MAULDIN & JENKINS LLC 200 GALLERIA PKWY SE STE 1700 ATLANTA GA 303395946 990 2012-01-01 300211350 PHYSICIAN'S INSTITUTE FOR EXCELLENCE IN MEDICINE INC PHYS 6783039290 1849 THE EXCHANGE NO 200 ATLANTA GA 303392027 DONALD J PALMISANO JR 6783039290 2013-11-08 1 JEFF T FUCITO P00120748 7709558600 2013-11-08 X 2012 2016-03-07 17:11:31Z DONALD J PALMISANO JR 1849 THE EXCHANGE NO 200 ATLANTA GA 303392027 724356 0 X HTTP://WWW.PHYSICIANSINSTITUTE.ORG/ X 2003 GA TO IMPROVE PATIENT SAFETY AND ACHIEVE CLINICAL IMPROVEMENTS FOR GEORGIA PHYSICIANS AND THEIR PATIENTS. 8 8 2 8 0 0 812102 563478 91179 145805 5265 1485 0 13588 908546 724356 418516 291852 0 0 310266 252125 0 0 0 508441 381964 1237223 925941 -328677 -201585 992974 603703 319371 203158 673603 400545 X TO IMPROVE PATIENT SAFETY AND ACHIEVE CLINICAL IMPROVEMENTS FORGEORGIA PHYSICIANS AND THEIR PATIENTS. 0 0 243625 123297 3000 PARTNERSHIP FOR ADULT VACCINATION AND EDUCATION (PAVE)AS A PART OF NATIONAL COLLABORATIVE, PAVE RECEIVED AN EDUCATIONAL GRANT FROM GLAXOSMITHKLINE TO INCREASE THE NUMBER OF ELIGIBLE PERSONS WHO RECEIVE ALL OF THE ADULT VACCINES CURRENTLY RECOMMENDED BY THE US CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES (ACIP). THE PHYSICIANS' INSTITUTE IS SUPPORTING EIGHT ORGANIZATIONS TO OFFER CME ACTIVITIES AND TO RECRUIT PHYSICIANS TO PARTICIPATE IN THE PERFORMANCE IMPROVEMENT COMPONENT OF THE PROJECT. AN ARRAY OF RESOURCES ARE PROVIDED TO PARTICIPANTS. 172105 114108 IMPROVING THE PRIMARY CARE TREATMENT OF ATRIAL FIBRILLATION - BLOCK GRANTSAS PART OF A NATIONAL COLLABORATIVE, THE ATRIAL FIBRILLATION INITIATIVE RECEIVED AN EDUCATIONAL GRANT FROM THE BRISTOL-MYERS SQUIBB/PFIZER PARTNERSHIP. THE MISSION OF THE EVOLUTION OF ANTICOAGULATION MANAGEMENT (TEAM) INITIATIVE IS TO REDUCE STROKE, PULMONARY EMBOLISM, AND OTHER COMPLICATIONS ASSOCIATED WITH THROMBUS FORMATION THROUGH EFFECTIVE CONTINUING EDUCATION THAT RESULTS IN OPTIMAL ANTICOAGULATION MANAGEMENT TARGETING PRIMARY CARE PHYSICIANS AND THEIR TEAMS. AS PART OF THIS NATIONAL INITIATIVE, THE PHYSICIANS' INSTITUTE IS SUPPORTING AND MANAGING 46 EDUCATIONAL ACTIVITIES THROUGH 14 GRANTEES IN 10 STATES 79698 19342 10000 HEALTH INFORMATION TECHNOLOGY - MEANINGFUL USETHE PHYSICIANS' INSTITUTE WAS AWARDED A GRANT FROM THE PHYSICIANS' FOUNDATION TO USE A PERFORMANCE IMPROVEMENT (PI) APPROACH TO ASSIST PHYSICIAN PRACTICES IN THE ADOPTION OF ELECTRONIC MEDICAL RECORDS AND TO QUALIFY FOR MEANINGFUL USE (FINANCIAL INCENTIVES FOR DEMONSTRATING THE DELIVERY OF QUALITY CARE) AS DESCRIBED IN THE HITECH ACT. THE PHYSICIANS' INSTITUTE USED A MIX OF EDUCATIONAL ACTIVITIES TO SUPPORT EIGHT GEORGIA PHYSICIAN PRACTICES THROUGH THE PROVISION OF TOOLS, RESOURCES, AND CONSULTING SERVICES IN THE CONTEXT OF AN EDUCATIONAL PROCESS THAT AWARDS CME CREDIT. THE PHYSICIANS' INSTITUTE CONTINUED WITH EDUCATIONAL ACTIVITIES FOR BOTH MAG AND GAFP RELATED TO ACHIEVING MEANINGFUL USE STAGE 2 FOR GEORGIA PHYSICIANS AND THEIR TEAMS. ADDITIONAL WEB-BASED RESOURCES WERE MADE AVAILABLE TO PROVIDERS. 141310 35105 132805 ALL OTHER GRANT PROGRAMS AND ACTIVITIES 141310 35105 132805 636738 1 1 0 0 0 0 0 0 0 0 0 0 0 0 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 1 0 1 10 0 1 2 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 GA X SALLY-ANNE JACOBS 6783039290 1849 THE EXCHANGE SE SUITE 200 ATLANTA GA 30339 WALKER L RAY MD 0.50 X X 0 0 0 JOHN S ANTALIS MD 0.50 12.50 X 0 0 0 WILLIAM A BORNSTEIN MD 0.50 X 0 0 0 JACK M CHAPMAN MD 0.50 X X 0 0 0 HOWARD MAZIAR MD 0.50 X 0 0 0 JAMES R MORROW MD 0.50 X 0 0 0 ALAN L PLUMMER MD 0.50 X X 0 0 0 RICHARD S SIMMONS MD 0.50 X 0 0 0 DONALD J PALMISANO JR EX-OFFICIO 0.50 48.00 X 0 222400 28796 ROBERT ADDLETON 37.50 X 112000 0 12666 112000 222400 41462 1 0 1 0 0 563478 563478 FEES & REGISTRATIONS 611430 145805 145805 145805 1485 1485 REFUNDED SUBGRANTS 900099 13588 13588 13588 724356 145805 0 15073 X 291852 291852 206331 206331 12000 12000 18585 18585 15209 15209 190325 187982 2343 4642 1502 3140 2701 2701 20048 19744 304 14727 14396 331 1541 1541 OTHER EXPENSE/CREDIT CA 69387 68471 916 PROGRAM MANAGEMENT 36460 36460 OCCUPANCY & SALARY REIM 25000 25000 ACCREDITATION FEES 16900 13600 3300 233 30 203 925941 636738 289203 0 793502 580453 199472 23250 992974 603703 72760 29461 165534 36667 81077 137030 319371 203158 X 123437 137615 550166 262930 673603 400545 992974 603703 X -201585 -71473 X X 0 1 X 1 0 X X X 0 0 0 MEDICAL ASSOCIATION OF GEORGIA INC 580605267 501(C)(6) 1 1 1 6000 1 6000 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO RELATED ENTITIES 137030 137030 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THERE ARE NO UNCERTAIN TAX LIABILITIES REPORTED ON THE CONSOLIDATED AUDITED FINANCIALS UNDER FIN 48(ASC 740-10). 1 AMERICAN COLLEGE OF PHYSICIANS PO BOX 1487 FLOWERY BRANCH GA 30542 521289373 14550 PARTNERSHIP FOR ADULT VACCINATION AND EDUCATION. ANNE WHITE MD PC 909 NORTH FIFTH AVE ROME GA 30165 582544839 5542 TO SUPPORT ATTENDANCE AT MEETINGS BUMC WEBB ROBERTS CENTER 3500 GASTON AVE DALLAS TX 75246 751837454 9000 IMPROVING THE PRIMARY CARE TREATMENT OF ATRIAL FIBRILLATION. DES MOINES UNIVERSITY 3200 GRAND AVE DES MOINES IA 50312 420730347 8910 IMPROVING THE PRIMARY CARE TREATMENT OF ATRIAL FIBRILLATION. GA ACADEMY OF FAMILY PHYSICIAN 3760 LAVISTA RD TUCKER GA 30084 586044158 31800 IMPROVING THE PRIMARY CARE TREATMENT OF ATRIAL FIBRILLATION. GALEN PUBLISHING DBA ASIM 166 W MAIN ST SOMERVILLE NJ 08876 223720202 20250 IMPROVING THE PRIMARY CARE TREATMENT OF ATRIAL FIBRILLATION. HEALTHCARE PERFORMANCE CONSULT 2321 STOCKTON DRIVE FLEMING ISLAND FL 33002 562357759 9690 OUTCOME INTERVIEWS INTERSTATE POSTGRADUATE MEDICAL PO BOX 5474 MADISON WI 53705 390368317 8493 KIDNEY TRANSPLANT NA PROJECT KENTUCKY HEART FOUNDATION 2201 LEXINGTON AVE ASHLAND KY 41101 260791997 24000 IMPROVING THE PRIMARY CARE TREATMENT OF ATRIAL FIBRILLATION. MEDICAL ASSOCIATION OF GEORGIA 1849 THE EXCHANGE SE ATLANTA GA 30339 260791997 6000 TO SUPPORT ACHIEVING MEANINGFUL USE FOR HOD MEMORIAL HERMANN HOSPITAL SYSTEM 909 FORSTWOOD SUITE 22058 HOUSTON TX 77024 580605267 9000 LETTER OF AGREEMENT MISSISSIPPI ACADEMY OF FAMILY 133 EXECUITVE DR MADISON MS 39110 741152597 15000 PAVE AGREEMENT MISSISSIPPI OSTEOPATHIC MEDICAL P O BOX 16890 JACKSON MS 39236 640757040 28500 IMPROVING THE PRIMARY CARE TREATMENT OF ATRIAL FIBRILLATION. NE GA HEALTH SYSTEM 2150 LIMESTONE PKWY SUITE 115 GAINSVILLE GA 30501 581694098 8910 IMPROVING THE PRIMARY CARE TREATMENT OF ATRIAL FIBRILLATION. ROCKFORD HEALTH SYSTEM 2350 N ROCKTON AVE ROCKFORD IL 61103 362167847 9000 IMPROVING THE PRIMARY CARE TREATMENT OF ATRIAL FIBRILLATION. ST ANTHONY HOSPITAL FOUNDATION 826 NW 11ST OKLAHOMA CITY OK 73106 736104300 8550 LETTER OF AGREEMENT ST FRANCIS MEDICAL CENTER FOUNDATION 3630 E IMPERIAL HWY LYNWOOD CA 90033 953190773 8194 LETTER OF AGREEMENT THE UNIVERSITY OF MONTANA 32 CAMPUS DR MISSOULA MT 59812 816001713 11213 MONTANA ADULT VACCINATION RATE IMPROVEMENT CONSORTIUM. UNIVERSITY OF ARIZONA HEALTHCARE 2030 E SPEEDWAY BLVD TUCSON AZ 85719 742652689 20000 FINAL RECONCILIATION VISTA HEALTH SYSTEM 1324 N SHERIDAN RD WAUKEGAN IL 60085 203978521 15000 LETTER OF AGREEMENT WHITE MEMORIAL MEDICAL CENTER 1720 CESAR E CHAVEZ AVE LA CA 90033 453760201 9000 LETTER OF AGREEMENT YANKTON RURAL AREA HEALTH EDUCAION 1000 W 4TH ST YANKTON SD 57078 466000364 11250 LETTER OF AGREEMENT 12 10 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: FOR EACH GRANT THERE IS AN RFP THAT STATES THE REQUIREMENTS AND RESPONSIBILITIES FOR THAT SPECIFIC GRANT. A REVIEW TEAM USES SELECTION CRITERIA TO REVIEW THE GRANT APPLICATIONS. ADDITIONAL INFORMATION MAY BE REQUESTED. THERE ARE SPENDING GUIDELINES FOR GRANT FUNDS. ALL UNSPENT FUNDS MUST BE RETURNED. ONCE A GRANT IS AWARDED, AN AGREEMENT MUST BE SIGNED BY THE GRANTEE. A GRANT PROJECT MANAGER CONTACTS GRANTEES ON A MONTHLY BASIS TO ENSURE THAT THEY ARE COMPLYING AND MAKING PROGRESS. IN THE END, A STRUCTURED FINAL REPORT MUST BE SUBMITTED AND A FINANCIAL RECONCILIATION REPORT. 75% OF THE GRANT IS PAID UPFRONT. RECONCILIATION DETERMINES AMOUNT DUE AT THE END. FINAL REPORT MUST BE APPROVED BEFORE A FINAL CHECK IS ISSUED. 1 X 0 0 0 0 0 0 0 0 0 DONALD J PALMISANO JR EX-OFFICIO 0 222400 0 0 0 0 0 0 0 28796 0 251196 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE DIRECTOR OF OPERATIONS AND THE TREASURER REVIEW THE RETURN. ONCE THEY APPROVE THE RETURN, IT IS SIGNED AND MAILED BY THE EXECUTIVE DIRECTOR. IN ADDITION, THE BOARD REVIEWS THE RETURNS BEFORE THEY ARE FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT COVERS ODTKE. BOARD MEMBERS ARE GIVEN THE POLICY WHEN APPOINTED. ONCE THE POLICY IS UNDERSTOOD, IT IS SIGNED BY THE BOARD MEMBERS. DURING BOARD MEETINGS, LEGAL COUNSEL ASKS IF THERE ARE ANY CONFLICTS OF INTEREST. IF ONE ARISES, THE BOARD MEMBER MAY BE ASKED TOLEAVE THE MEETING AND ABSTAIN FROM VOTING. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. OTHER FEES FORM 990, PART IX, LINE 11G PAYROLL SERVICE FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 843. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 843. CONSULTANTS: PROGRAM SERVICE EXPENSES 187,982. MANAGEMENT AND GENERAL EXPENSES 1,500. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 189,482. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: EXPENSE REFUND OF GRANTS -71,473. FORM 990, PART XII LINE 2C THERE HAVE BEEN NO CHANGES TO THE AUDITOR SELECTION PROCESS, NOR OVERSIGHT OF THE FINANCIAL STATEMENTS. FORM 990 PART V LINE 2A THE ORGANIZATION HAS TWO EMPLOYEES WHOSE PAYROLL IS HANDLED BY AN EMPLOYEE LEASING COMPANY. THE ORGANIZATION DOES NOT PROCESS ANY PAYROLL. MEDICAL ASSOCIATION OF GEORGIA 1849 THE EXCHANGE SE STE 200 ATLANTA GA 30339 580605267 PROMOTE ART AND SCIENCE OF MEDICINE GA 501(C)(6) N/A 0 MEDICAL ASSOCIATION OF GEORGIA FOUNDATION 1849 THE EXCHANGE SE STE 200 ATLANTA GA 30339 586066431 SUPPPORT MAG GA 501(C)(3) LINE 11A, I MEDICAL ASSOCIATION OF GEORGIA 0 GEORGIA MEDICAL POLITICAL ACTION COMMITTEE 1849 THE EXCHANGE SE STE 200 ATLANTA GA 30339 580939391 PROMOTE MEDICAL PROFESSION GA 527 MEDICAL ASSOCIATION OF GEORGIA 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 MEDICAL ASSOCIATION OF GA O 246637 ACTUAL COST INCURRED MEDICAL ASSOCIATION OF GA P 306033 ACTUAL COST INCURRED