2011-08-15T13:19:41-05:00 2010-09-30 DELOITTE TAX LLP 424 CHURCH STREET SUITE 2400 NASHVILLE TN 372192396 990 2009-10-01 620850498 DIALYSIS CLINIC INC DIAL 6153273061 1633 CHURCH STREET No 500 NASHVILLE TN 37203 JAMES E ATTRILL JR 6153273061 2011-08-15 1 6152591800 2009 2016-02-24 21:20:13Z JAMES E ATTRILL JR 1633 CHURCH STREET No 500 NASHVILLE TN 37203 584708459 0 X www.dciinc.org X 1971 TN TO INITIATE AND PROVIDE COMPREHENSIVE CARE FOR PATIENTS WITH END-STAGE RENAL DISEASE. 4 0 5546 0 7526440 744480 0 553784457 576341644 2322608 1436580 4103438 4922080 560210503 582700304 0 0 250990765 260733194 0 0 313050273 301325343 564041038 562058537 -3830535 20641767 428977270 453879589 85626689 90144521 343350581 363735068 The primary responsibility of DCI is to perceive, initiate, and provide comprehensive patient care. We serve society by providing care for patients with end-stage renal disease. Our goal is complete patient rehabilitation. We recognize the patient as an individual resulting from his or her genetics, life experience, habits, beliefs, and emotions; and as a member of his or her family and the community. The application of comprehensive care is on a personal level. We become acquainted with our patient as a person and seek to understand his or her problems and needs, physical, emotional, spiritual, and social. Please see Schedule O, Pg. 26 0 0 382422378 549442551 The dialysis division is the principal activity of our company and is primarily involved with providing kidney dialysis and related services for insured and uninsured patients. Renal dialysis is not an elective medical procedure, but a life-sustaining treatment for people living with kidney failure. Providing these medically-necessary treatments furthers our exempt purpose of providing quality outpatient care for all patients with end-stage renal disease, which includes the application of the company resources for scientific and educational purposes for the prevention, early detection, and treatment of renal disease. During FYE 9/30/10, 2,045,946 dialysis procedures were performed. A significant portion of our dialysis charges are covered by Medicare and state Medicaid programs while the remaining costs are paid by third party insurers and charity care. Charity care is provided to patients who meet certain criteria under our charity care policy without charge or at amounts less than our established rates. 11528259 18837040 The lab division provides specialized laboratory testing and diagnostic procedures for dialysis facilities and patients with kidney disease and renal failure. A variety of laboratory tests to analyze diffused toxins from the blood are necessary to monitor the clinical course of patients and the overall effectiveness of renal dialysis. These tests are necessary in the treatment of renal disease, and furthers our exempt purpose of providing quality care for patients with chronic renal disease by continually improving our processes in measuring levels of kidney function to produce optimal patient outcomes. For FYE 9/30/10, 1,796,661 patient tests were performed. 7446941 212704 The supply and pharmacy division provide medical supplies, including but not limited to nutritional supplements, drugs and home dialysis supplies for both DCI facilities and through contractual relationships with other dialysis providers. A primary focus of the Supply division is to promote and facilitate home dialysis. 3602014 research expenditures 3602014 404999592 1 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 894 0 5546 1 1 1 0 0 0 0 0 0 0 0 4 0 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 1 1 CA IN MA NM NY X X MR ANDY PARKER 6153420479 1633 CHURCH STREET SUITE 500 NASHVILLE TN 37203 DR KEITH JOHNSON 0.00 X 0 35163 11712 NANCY JOHNSON 0.00 X 0 0 0 DOUG JOHNSON 40.00 X 79886 0 2698 JAMES PERRY 40.00 X X 222441 0 24400 JAMES E ATTRILL 40.00 X 231935 0 56809 WILLIAM E WOOD 40.00 X 198180 0 60402 JOE SWEARINGEN 40.00 X 117097 0 35557 HAROLD WHETSTONE 40.00 X 614300 0 17070 MOSTAFA AMR 40.00 X 323405 0 25240 DOUGLAS REINHARD 40.00 X 322447 0 64049 CHRISTINA YNARES 40.00 X 284745 0 26496 SADIQ AHMED 40.00 X 253153 0 23248 2647589 35163 347681 67 0 1 0 WR NEWMAN & ASSOCIATES INC 2854 LOGAN STREET NASHVILLE TN 37211 CONSTRUCTION 6426151 ECC GROUP INC 642 OUTWATER LANE LODI NJ 07644 CONSTRUCTION 1070441 SEPTAGON CONSTRUCTION 113 EAST THIRD STREET SEDALIA MO 65301 CONSTRUCTION 971884 JACK FREEMAN AND ASSOC 311 22ND AVENUE NORTH NASHVILLE TN 37203 CONSTRUCTION 620386 KPMG PO BOX 120001 DALLAS TX 75312 CONSULTING 313180 10 DIALYSIS & MEDICAL 621400 511449429 511373243 76186 HOME PATIENT 621610 46055174 46055174 0 LABORATORY 621500 18837041 12869429 5967612 576341644 1772395 1772395 3806055 1168343 2637712 2637712 2637712 459803 795618 -335815 -335815 -335815 76186 44194 31992 31992 MANAGEMENT FEES 541610 1589192 1311153 278039 RESEARCH REVENUES 541700 284825 284825 R/O CONTRACT FEES 541610 16200 16200 362159 238862 123297 2252376 582700304 570536708 7526440 4637156 2647589 861304 1786285 203251938 153047076 50204862 3231432 2422597 808835 37161912 23064983 14096929 14440323 10838195 3602128 1174164 1174164 343796 343796 4260305 3775903 484402 2544804 2544804 1024405 665863 358542 11101276 7874628 3226648 3228810 283654 2945156 182181 148882 33299 90536 90536 20568000 7396138 13171862 3168185 3168185 DRUGS 115847179 115847179 MEDICAL SUPPLIES 52082399 52082399 BAD DEBT 34277293 34277293 UTILITIES 8842823 2529629 6313194 REPAIRS AND MAINTENANCE 7588315 4171992 3416323 35000872 19989170 15011702 562058537 404999592 157058945 0 53092126 87265711 20564720 20612729 111311570 103446360 15243359 13122482 2502352 2469842 479188067 276503110 200869620 202684957 1402315 1164358 18289123 17575260 5531653 5333934 170432 203956 428977270 453879589 16090967 11551731 17304264 17099998 52231458 61492792 85626689 90144521 X 0 0 751580 1501580 342599001 362233488 343350581 363735068 428977270 453879589 X 0 1 0 X 0 X 8645 8645 562049892 562058537 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 11092 8645 19737 250000 250000 250000 250000 1000000 1500000 30661563 30661563 190158170 100907895 89250275 91389987 55360535 36029452 148289385 120234680 28054705 18688962 18688962 202684957 ACCRUED PAYROLL 26291001 OTHER CURRENT LIABILITIES 1758437 OTHER NOTES PAYABLE 19681618 SICK-PAY RETIREMENT PAYABLE 7724360 OTHER TAXES 15330 DEFERRED RENT 5817780 CURRENT MATURITIES ON L.T. DEBT 204266 61492792 X X 0 1 0 0 0 0 0 0 0 JAMES PERRY 222441 0 0 0 0 0 0 0 24400 0 246841 0 0 0 JAMES E ATTRILL 231935 0 0 0 0 0 40482 0 16327 0 288744 0 0 0 WILLIAM E WOOD 198180 0 0 0 0 0 39232 0 21170 0 258582 0 0 0 JOE SWEARINGEN 117097 0 0 0 0 0 19019 0 16538 0 152654 0 0 0 HAROLD WHETSTONE 614300 0 0 0 0 0 0 0 17070 0 631370 0 0 0 MOSTAFA AMR 323405 0 0 0 0 0 0 0 25240 0 348645 0 0 0 DOUGLAS REINHARD 322447 0 0 0 0 0 45600 0 18449 0 386496 0 0 0 CHRISTINA YNARES 284745 0 0 0 0 0 0 0 26496 0 311241 0 0 0 SADIQ AHMED 253153 0 0 0 0 0 0 0 23248 0 276401 0 0 0 Form 990, Part VI, Section A, line 2 KEITH JOHNSON, MD - SPOUSE NANCY JOHNSON - SPOUSE DOUGLAS JOHNSON - SON Form 990, Part VI, Section B, line 11 Form 990 is reviewed by the President and Treasurer prior to releasing its information to an independent accounting firm for review. The Form 990 is then presented to the Board where an opportunity is given to review and make changes prior to the filing. Form 990, Part VI, Section B, line 12c The conflict of interest policy is contained in the company's written standards of conduct that require acknowledgement of compliance by key employees. The company maintains an active compliance department to monitor and enforce policies. Form 990, Part VI, Section B, Line 15: The company utilizes comparability data for determining compensation. No independent review of this data was conducted during the year. Form 990, Part VI, Section C, line 19 The company has not publicized governing documents, conflict of interest policies, and financial statements. From Schedule O, Pg. 25 DESCRIPTION OF ORGANIZATION MISSION: As of 2010, DCI employs approximately 5,000 people and provides dialysis care to over 13,000 patients in more than 200 clinics located in 27 states throughout the United States. DCI, serving as the largest non-profit dialysis provider in the US, is noted for providing quality care. The United States Renal Data System (USRDS) 2010 Atlas notes that DCI has lower hospitalization and mortality rates than other providers. "Hospitalization ratios are very similar across the large groups, though lower in DCI units. By unit affiliation, DCI continues to have the lowest ratios for both hospitalization and mortality." DCI offers all modalities of End Stage Renal Disease (ESRD) treatment, which include in-center hemodialysis, in-center self-care hemodialysis, home hemodialysis, continuous ambulatory peritoneal dialysis, and continuous cycling peritoneal dialysis. In 2010 DCI provided a total of 2,212,862 treatments. DCI was established as a nonprofit corporation, hopefully to generate funds for research in order that the methods for treatment of ESRD patients might be improved. We are not content to dialyze the next group of patients in the same imperfect way that the last group was dialyzed without at least making the attempt to better the patient's lot through research. As a corollary to this, education of ESRD health care professionals is another goal to which DCI resources are dedicated to support. DCIs research commitment includes providing a collaborative relationship in the conduct of clinical trials between DCI clinics, Physician/Investigators, and the Pharmaceutical Industry. In an effort to facilitate the best care and make available to our patients state of the art clinical studies, DCI has established the Office of Clinical Research. Our experience in clinical research is a valuable resource for Nephrology Physician/Investigators. We have expert knowledge in Federal Regulations, HIPAA, Medicare Clinical Trial Policy, Good Clinical Practice, and Federal Wide Assurances. Our office provides all of the resources necessary to conduct clinical trials in an efficient, safe manner, while instilling industry best practices and producing quality data. As a non-profit 501(c)(3) organization, DCI dedicates a significant portion of all monies generated to be utilized for kidney related research, education and other uses consistent with the company charter. Such programs might involve research studies, training, education, clinical, and patient care activities. In 2010, DCI contributed over three and a half million dollars to research, over $200,000 to education, and over two and a half million dollars to development. Such contributions have a diverse and potentially powerful impact on society. For example, in 2010 DCI contributed one million dollars toward the establishment of a research chair in the University of Pittsburgh School of Medicines Renal- Electrolyte Division. This donation will aid members of the Renal-Electrolyte Division within the University of Pittsburgh in the continuation of their dynamic research program allowing for the study of kidney/epithelial cell structure and function in health or disease states, utilizing the tools of physiology, cellular and molecular biology, biochemistry, cell signaling, genetics, and clinical epidemiology. DCI also contributed $160,000 toward funding the research project, Enhancing the Prevalence of Arteriovenous (AVF) Placement and First Fistula Maturation and Access Within a Community of Hemodialysis Subjects. The primary goal of the study is to increase AVF first use rate, the preferred access with less complications, from below 25% to above 45% and decrease tunneled central venous catheter prevalence, which is the least desirable type of access due to the risk for infection and lower blood flow rates. This research study is significant to the renal population because dialysis access procedures and complications represent approximately 20% of hospitalizations for dialysis patients and costs over one billion dollars annually in the United States. DCI also provided $83,500 in funding for a study investigating The Types, Rates, and Risk Factors for Infection in Patients on Dialysis and the Associated Cardiovascular Outcomes. This is an especially important study because among the 25 million American patients with stage 2 through 5 chronic kidney disease (CKD), cardiovascular disease causes a disproportionately high mortality risk. Patients with CKD are more likely to die (often of cardiovascular causes) than to progress to dialysis. (Sarnak MJ, Levey AS. Cardiovascular disease and chronic renal disease: a new paradigm. Am J Kidney Dis 2000). In 2010 an additional $32,000 was added to DCIs prior contributions of over $2,000,000 to study kidney disease in the Zuni Indian Tribe. This project provides a unique opportunity to advance the understanding of risk factors for the susceptibility and/or progression of renal disease while researching the epidemic of kidney disease within the Zuni Indian Pueblo. $100,000 was donated to the Medical University of South Carolina (MUSC) Renal Disease Biomarkers Center of Economic Excellence (COEE). DCIs contribution will aid the COEE in Renal Disease Biomarkers in their effort to develop ways to identify, isolate, and interpret the specific protein molecules that could yield in early diagnosis of both acute and chronic kidney diseases. DCI is also a loyal supporter of the local and national kidney foundations which provide resources to the dialysis community. DCI created and maintains a fund specifically to provide grants and research support for young investigators in the field of kidney disease. The DCI Paul Teschan Research Fund (PTRF) utilizes a peer review process to fund scientific applications for students and young investigators who otherwise would have limited access to research resources. Approximately $250,000 was donated by the PTRF in 2010 to support these research studies. To heighten public awareness regarding kidney disease, DCI maintains a Pre-End Stage Renal Disease education program that is free to the general public. In support of the pediatric patient, DCI established Camp Okawehna in 1975. Camp Okawehna is a week long summer camp in the Nashville area that offers on-site peritoneal and hemodialysis treatments to about 100 children who otherwise would not be able to enjoy a childhood camp experience. DCI employees volunteer their time to provide assistance in every facet of the camp experience. Campers come from Tennessee, Texas, Missouri, South Carolina, and Alabama to the grounds of Camp O. DCI also supports the education of high school students interested in medical professions. Since 2002, DCI has partnered with the Glencliff High School to identify Juniors and Seniors who express an interest in the health profession. A DCI Coordinator partners with the science teachers to become involved in the delivery of the curriculum. Students who express an interest in learning more about dialysis are given an opportunity to work in a DCI facility as patient care technicians interns during summer break. Since 1998, DCI has sponsored a summer internship for pre-medical students in the clinical area of organ transplantation. Over the last 13 years, the summer internship program has expanded to 11 cities all across the United States, and has given over 130 students the opportunity to expand their knowledge of the medical field. The internship includes shadowing physicians on rounds in the hospital, observing and assisting in an outpatient/clinic facility, observing the coordination of a transplant, and scrubbing in during transplant and surgical operations. In addition, students visit the local Organ Procurement Organization (OPO) and HLA lab. Participants may have the opportunity to complete data collection for the transplant service or work on a clinical research project. The purpose of this internship is to expose the student to hospital and outpatient environments, as well as to specific areas of medicine such as surgery and clinical research. These experiences are designed to encourage students to pursue a career in medicine. DCI recognizes the rewards of higher education and has supported that endeavor since 1995 through the DCI Scholarship Program. In 2010, DCI awarded a total of $18,000 in scholarships among six recipients. 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