2012-11-07T07:57:42-06:00 2011-12-31 580692043 MAULDIN & JENKINS LLC 200 GALLERIA PARKWAY SE SUITE 1700 ATLANTA GA 303395946 990 2011-01-01 300211350 PHYSICIAN'S INSTITUTE FOR EXCELLENCE IN MEDICINE INC PHYS 6783039290 1849 THE EXCHANGE NO 200 ATLANTA GA 303392027 DONALD J PALISANO 6783039290 2012-11-05 1 JEFF T FUCITO P00120748 7709558600 X 2011 2016-02-24 21:20:13Z DONALD J PALMISANO 1849 THE EXCHANGE NO 200 ATLANTA GA 303392027 908546 0 X HTTP://WWW.PHYSICIANSINSTITUTE.ORG/ X 2003 GA TO IMPROVE PATIENT SAFETY AND ACHIEVE CLINICAL IMPROVEMENTS FOR GEORGIA PHYSICIANS AND THEIR PATIENTS. 10 10 3 10 0 0 1564181 812102 69520 91179 9581 5265 0 0 1643282 908546 493769 418516 0 0 267631 310266 0 0 0 798077 508441 1559477 1237223 83805 -328677 1491385 992974 142506 319371 1348879 673603 TO IMPROVE PATIENT SAFETY AND ACHIEVE CLINICAL IMPROVEMENTS FORGEORGIA PHYSICIANS AND THEIR PATIENTS. 0 0 870762 418516 91179 CEASE SMOKING TODAY - INDIAN HEALTH COMMUNITIESAS A PART OF A NATIONAL COLLABORATIVE SUPPORTED BY AN INDEPENDENT EDUCATIONAL GRANT FROM PFIZER, THE PHYSICIANS' INSTITUTE UTILIZED A TRAIN-THE-TRAINER APPROACH TO MOTIVATIONAL INTERVIEWING/PATIENT COMMUNICATIONS TO FOCUS ON SMOKING CESSATION IN MEDICAL COMMUNITIES. THE PHYSICIANS' INSTITUTE PROVIDED SUPPORT AND COORDINATION FOR A TWO 2-DAY INTENSIVE MOTIVATIONAL INTERVIEWING WORKSHOPS IN ARIZONA FOR THE INDIAN HEALTH COMMUNITY IN COLLABORATION WITH UNIVERSITY OF ARIZONA HEALTHCARE PARTNERSHIP. 870762 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 0 1 9 0 1 3 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 GA X SALLY-ANNE ALLPASS 6783039290 1849 THE EXCHANGE SE SUITE 200 ATLANTA GA 30339 WALKER L RAY MD 0.00 X X 0 0 0 JOHN S ANTALIS MD 0.00 X 0 0 0 WILLIAM A BORNSTEIN MD 0.00 X 0 0 0 JACK M CHAPMAN MD 0.00 X X 0 0 0 HOWARD MAZIAR MD 0.00 X 0 0 0 JACQUELINE FINCHER MD 0.00 X 0 0 0 JAMES R MORROW MD 0.00 X 0 0 0 ALAN L PLUMMER MD 0.00 X X 0 0 0 RICHARD S SIMMONS MD 0.00 X 0 0 0 DAVID A COOK EX-0FFICIO 1.00 X 0 32719 25168 DONALD J PLAMISANO JR EX-OFFICIO 1.00 X 0 206953 33716 ROBERT ADDLETON 40.00 X 121389 0 16847 121389 239672 75731 1 0 1 0 0 812102 812102 FEES & REGISTRATIONS 611430 91179 91179 91179 5265 5265 908546 91179 0 5265 418516 418516 262905 262905 14785 14785 14504 14504 18072 18072 8500 8500 282591 279727 2864 9765 2322 7443 17202 17202 34264 33036 1228 29534 28282 1252 1541 1541 OTHER EXPENSE/CREDIT CA 65771 65319 452 OCCUPANCY & SALARY REIM 25000 25000 PROGRAM MANAGEMENT 20858 20858 AUDIO VISUAL 5500 5500 7915 7915 1237223 870762 366461 0 1281094 793502 210000 199472 291 1491385 992974 18772 72760 46920 165534 76814 81077 142506 319371 X 69843 123437 1279036 550166 1348879 673603 1491385 992974 X -328677 -346599 X X 0 1 1 X 0 X X X 0 0 0 MEDICAL ASSOCIATION OF GEORGIA INC 580605267 501(C)(6) 1 1 1 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO RELATED ENTITIES 81077 81077 1 UNIVERSITY OF ARIZONA PARTNERSHIP 2030 E SPEEDWAY STE 120 TUCSON AZ 85719 742652689 501(C)(3) 5000 INDIAN HEALTH PROJECT NORTHWEST COMMUITY HOSPITAL FOUNDATION 3060 SALT CREEK LANE ARLINGTON HEIGHTS IL 60005 363125193 501(C)(3) 5175 CHRONIC PAIN PROJECT ST ANTHONY HOSPITAL 1000 LEE STREET OKLAHOMA CITY OK 73102 730657693 7500 TOBACCO CESSATION PROJECT SALEM VA MEDICAL CENTER 1970 ROANOKE BLVD SALEM VA 24153 541622309 7500 TOBACCO CESSATION PROJECT CME ENTERPRISE 630 W CARMEL DRIVE SUITE 260 CARMEL IN 46032 201380466 13082 TOBACCO CESSATION CONTENT CONTRACT AMERICAN SOC TRANSPLANTATION 15000 COMMERCE PARKWAY SUITE C MOUNT LAUREL NJ 08054 421182936 501(C)(3) 21810 KIDNEY NEEDS ASSESSMENT PROJECT INTERSTATE POSTGRADUATE MEDICAL PO BOX 5474 MADISON WI 53705 390368317 501(C)(3) 6750 KIDNEY NEEDS ASSESSMENT PROJECT AMERICAN SOC TRANSPLANTATION 15000 COMMERCE PARKWAY SUITE C MOUNT LAUREL NJ 08054 421182936 501(C)(3) 7270 KIDNEY NEEDS ASSESSMENT PROJECT AMERICAN UROLOGICAL ASSOCIATION 1000 CORPORATE BOULEVARD LINTHICUM MD 21090 430691437 501(C)(3) 19675 KIDNEY NEEDS ASSESSMENT PROJECT HEALTHCARE PERFORMANCE 2321 STOCKTON DRIVE FLEMING ISLAND FL 32003 562357759 38113 KIDNEY NEEDS ASSESSMENT PROJECT UNIVERSITY OF ARIZONA PARTNERSHIP 2030 E SPEEDWAY STE 120 TUCSON AZ 85719 742652689 501(C)(3) 180000 INDIAN HEALTH PROJECT 6 4 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 1 0 DONALD J PLAMISANO JR EX-OFFICIO 0 177830 0 700 0 28423 0 12948 0 20768 0 240669 0 0 PART I, LINE 7 PERFORMANCE BONUSES FROM THE ORGANIZATION: ROBERT ADDLETON 22,107 ADELE COHEN 19,416 PERFORMANCE BONUSES FROM RELATED ORGANIZATION: DAVID COOK 15,000 DONALD PALMISANO 700 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: PRIOR PERIOD ADJUSTMENTS: -273,329. REFUND OF GRANT REVENUES -73,270. TOTAL TO FORM 990, PART XI, LINE 5: -346,599. 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 THREE 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 1 0 0 1 1 1 0 0 0