JENKINS CLINIC INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
JENKINS CLINIC INC (EIN 20-1812839)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-05-09
IRS object ID
201141299349301144
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-09T12:57:42-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1FRAZIER & DEETER LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1600 PEACHTREE STREET SUITE 1900AddressLine1
CityATLANTACity
StateGAState
ZIP Code30308ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN201812839EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MALIZIA CLINIC INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMALINameControl
Phone4042409700Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11800 HOWELL MILL ROAD No 500AddressLine1
CityATLANTACity
StateGAState
ZIP Code30318ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDR ANTHONY A MALIZIA JRName
TitlePRESIDENT/DIRECTORTitle
Phone4042409700Phone
Date Signed2011-05-09DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAMES F FRAZIER JRName
Phone4042537500Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonANTHONY A MALIZIA JRNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11800 HOWELL MILL ROAD No 500AddressLine1
CityATLANTACity
StateGAState
ZIP Code30318ZIPCode
FieldValueIRS element (for citing)
Gross Receipts2581837GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.maliziaclinic.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2004YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionTHE MALIZIA CLINIC, INC. IS A GEORGIA NON-PROFIT CORPORATION, ORGANIZED TO DELIVER THE HIGHEST POSSIBLE LEVEL OF MEDICAL AND SURGICAL CARE FOR UROLOGIC CONDITIONS; TRAIN EXPERIENCED SURGEONS IN ADVANCED DIAGNOSTIC AND SURGICAL PROCEDURES; CONDUCT CLINICAL RESEARCH; AND DESIGN SURGICAL DEVICES AND INSTRUMENTS.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees16TotalNbrEmployees
Total Nbr Volunteers1TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year778502ContributionsGrantsPriorYear
Contributions Grants Current Year1283426ContributionsGrantsCurrentYear
Program Service Revenue Prior Year133049ProgramServiceRevenuePriorYear
Program Service Revenue CY1282045ProgramServiceRevenueCY
Investment Income Prior Year31089InvestmentIncomePriorYear
Investment Income Current Year3138InvestmentIncomeCurrentYear
Other Revenue Current Year13228OtherRevenueCurrentYear
Total Revenue Prior Year942640TotalRevenuePriorYear
Total Revenue Current Year2581837TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year637552SalariesEtcPriorYear
Salaries Etc Current Year2471678SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year39339TotalFundrsngExpCurrentYear
Other Expense Prior Year1531615OtherExpensePriorYear
Other Expenses Current Year3289034OtherExpensesCurrentYear
Total Expenses Prior Year2169167TotalExpensesPriorYear
Total Expenses Current Year5760712TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1226527RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-3178875RevenuesLessExpensesCY
Total Assets BOY9346682TotalAssetsBOY
Total Assets EOY6996227TotalAssetsEOY
Total Liabilities BOY277374TotalLiabilitiesBOY
Total Liabilities EOY1110288TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY9069308NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5885939NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MALIZIA CLINIC, INC. IS A GEORGIA NON-PROFIT CORPORATION, ORGANIZED TO DELIVER THE HIGHEST POSSIBLE LEVEL OF MEDICAL AND SURGICAL CARE FOR UROLOGIC CONDITIONS; TRAIN EXPERIENCED SURGEONS IN ADVANCED DIAGNOSTIC AND SURGICAL PROCEDURES; CONDUCT CLINICAL RESEARCH; AND DESIGN SURGICAL DEVICES AND INSTRUMENTS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense5031522Expense
Revenue1290773Revenue
DescriptionMEDICAL PRACTICE AND CHARITY CARE: THE CLINIC OFFERS PATIENT-CENTERED UROLOGIC CARE. THE CLINIC'S PHYSICIANS EACH HAVE A SUBSPECIALTY INTEREST AND EXPERTISE IN UROLOGY AND UROLOGIC SURGERY. ALTHOUGH THE SURGEONS WILL SPECIALIZE IN COMPLEX TECHNICALLY ADVANCED SURGERIES FOR BOTH MALE AND FEMALE PATIENTS, THEY WILL ALSO PERFORM SIMPLE AND ROUTINE PROCEDURES. IN ADDITION, THE CLINIC DEDICATES A PORTION OF ITS TIME TO CHARITY CARE AS DETERMINED THROUGH A DESIGNATED COMMITTEE OF REPRESENTATIVES FROM VARIED RELIGIOUS ORGANIZATIONS. THIS MODEL FOR PATIENT-CENTERED UROLOGIC CARE IS NOT DEPENDENT ON HIGH VOLUME; RATHER, PHILANTHROPIC SUPPORT WILL BE ADDED TO FUNDS PROVIDED BY PRIVATE AND GOVERNMENTAL HEALTH INSURANCE PROGRAMS AND GRANTS IN A MIX APPROPRIATE FOR TAX EXEMPT, CHARITABLE ORGANIZATIONS. THE SELECTION OF INDIGENT PATIENTS WILL BE THROUGH THE CHARITY CARE COMMITTEE.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense123669Expense
Revenue4500Revenue
DescriptionRESEARCH PROGRAMS AND AN ANNUAL SURGICAL INVENTION CONVENTION: THE CLINIC CONDUCTS RESEARCH PROGRAMS THAT ARE CLINICALLY FOCUSED WITH EMPHASIS ON ADVANCING SURGICAL TECHNIQUES AND PROCEDURES, SURGICAL INSTRUMENT DESIGN AND DEVELOPMENT THROUGH JOINT RESEARCH PROJECTS WITH THE TRANSLATIONAL RESEARCH INSTITUTE FOR BIOMEDICAL ENGINEERING AND SCIENCE (TRIBES) AT THE GEORGIA INSTITUTE OF TECHNOLOGY, AND PATIENT TREATMENT PROTOCOLS. THE CLINIC CONDUCTS SCIENTIFIC MEDICAL RESEARCH DIRECTED AT TECHNIQUES TO PRESERVE URINARY CONTROL AND ERECTILE ABILITY, PROSCAR FOR ADVANCED BPH TREATMENT, AND ANETHESIA TECHNIQUES COMBINED WITH INCISIONAL WOUND BLOCK TO ELIMINATE POST OPERATIVE PAIN. THE DIRECTORS ALSO EXAMINED AND REVIEWED THE FEASIBILITY OF ESTABLISHING CLINICAL OPERATIONS. RECENTLY, THE CLINIC HAS COMPLETED THE APPLICATION PROCESS AND ANTICIPATES RECEIVING ITS CONTINUING MEDICAL EDUCATION (CME) CERTIFICATION IN JULY 2011. THE CLINIC HAS FILED FOR PATENTS AND TRADEMARKS REGARDING THE DEVELOPMENT OF A NEW VASCULAR/PEDICLE LIGATION DEVICE (CLIP) AND APPLICATOR FOR USE IN ROBOTIC SURGERY, AS WELL AS THE BIODEGRADABLE VESICO-URETHREAL ANASTAMODIC PROJECT FOR RADICAL PROSTATECTOMY.THE CLINIC HAS REVIEWED 16,000 CHARTS WITH PATIENT IDENTIFICATION WHICH HAS LED TO THE FOLLOWING THREE CLINICAL STUDIES: DOES INITIAL ANTIBIOTIC TREATMENT OF ELEVATED PSA'S ELIMINATE THE NEED FOR IMMEDIATE PROSTATE BIOPSIES?; SHOULD ANTIBIOTIC THERAPY FOR ELEVATED PSA'S ON FINASTERIDE (PROSCAR) BE THE INITIAL STEP IN MANAGEMENT BEFORE CONSIDERING PROSTATE BIOPSY?; AND PATIENTS ON FINASTERIDE WHO LATER DEVELOP PROSTATE CANCER - CLINICAL FOLLOW UP.ALSO, THE CLINIC HAS PARTNERED WITH THE GEORGIA INSTITUTE OF TECHNOLOGY TO HOST AN ANNUAL SURGICAL INVENTION CONVENTION TO TRANSFORM IDEAS INTO THE MEDICAL PRODUCTS OF TOMORROW. FURTHER, THE CONVENTION SERVES TO TAP INTO NEW IDEAS, LATEST THINKING, PROVEN STRATEGIES AND KEY CONNECTIONS TO TAKE NEW CONCEPTS INTO COMMERCIALIZATION. THE CLINIC'S SECOND ANNUAL SURGICAL INVENTION CONVENTION IS SCHEDULED FOR APRIL 7-8, 2011 AND HAS EXPANDED TO OFFER A TWO-DAY COURSE FOR UROLOGISTS, GYNOCOLOGISTS, COLORECTAL AND GENERAL SURGEONS AND BIOMEDICAL ENGINEERS TO IDENTIFY NEEDS TO AID IN SURGICAL PROCEDURES AND IMPROVE PATIENT CARE. THIS COURSE WILL PROVIDE INSTRUCTION ABOUT THE PROCESS, DESIGN AND DEVELOPMENT OF A MEDICAL DEVICE, INSTRUMENT OR PRODUCT.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense38665Expense
Revenue0Revenue
DescriptionEDUCATION AND ADVANCED TRAINING FOR EXPERIENCED SURGEONS: THE CLINIC OFFERS ADVANCED POST-GRADUATE TRAINING FOR EXPERIENCED SURGEONS THAT IS NOT CURRENTLY AVAILABLE IN ACADEMIC MEDICAL CENTERS OR LIMITED CONTINUING MEDICAL EDUCATION PROGRAMS. THIS IS ADVANCED TRAINING FOR PHYSICIANS WHO HAVE BEEN IN PRIVATE PRACTICE FOR SEVERAL YEARS BUT WHO ARE RARELY GIVEN THE OPPORTUNITY TO RECEIVE HANDS-ON TRAINING TO UPDATE THEIR SURGICAL SKILLS OR TO DEVELOP NEW SKILLS.THE CLINIC ALSO OFFERS QUARTERLY GRAND ROUNDS DURING SATURDAY CONFERENCES FROM 8:30-10:30 AM, WHERE EXPERTS IN THE FIELD PRESENT A REVIEW THEIR CHOSEN TOPIC. VISITING PROFESSORS HAVE INCLUDED DR. VIPUL PATEL (CELEBRATION, FLORIDA); DR. ERIC KLEIN (CLEVELAND CLINIC); DR. HERBERT LEPOR (NYU), AND DR. H. BALLENTINE CARTER (JOHNS HOPKINS).Description
FieldValueIRS element (for citing)
Total Program Service Expense5193856TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109611NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees16NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledGAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledNCStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1heather hallBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4042409700TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11800 HOWELL MILL ROAD SUITE 500AddressLine1
CityATLANTACity
StateGAState
ZIP Code30318ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
howard m jenkins
chairman10.00XX000
dan cathy
vice chairman10.00XX000
robert w fisher
SECRETARY/DIRECTOR10.00XX000
robert martin
TREASURER/DIRECTOR10.00XX000
ANTHONY A MALIZIA JR MD
PRESIDENT/DIRECTOR40.00XX420770057667XX
judge g conley ingram
director10.00X000
BERNARD MARCUS
DIRECTOR10.00X000
FREDERICK S SLAGLE
Director10.00X000
DR GIL FOSTER
CLINIC DOCTOR40.00323109050525XX
DR RAY PAK
CLINIC DOCTOR40.00395000048896XX
DR JAIME WONG
CLINIC DOCTOR40.00312708032751XX
DR JAMES GOODLET
CLINIC DOCTOR40.00275577038443X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1727164TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation228282TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
POINT B
1001 EUCLID AVENUEATLANTAGA30307MARKETING & WEBSITE DESIGN334221
MEDICAL MANAGEMENT ASSOCIATES
3330 CUMBERLAND BLVD STE 200ATLANTAGA30339MEDICAL CONSULTING190003
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
All Other Contributions1283426AllOtherContributions
Total Contributions1283426TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICE FEES62111012775451277545
INVENTION CONVENTION F62111045004500
FieldValueIRS element (for citing)
Total Program Service Revenue1282045TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3138TotalRevenueColumn
Exclusion$3,138ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
REIMBURSED EXPENSES6211101320113201
OTHER INCOME6211102727
FieldValueIRS element (for citing)
Total Other Revenue13228TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column2581837TotalRevenueColumn
Related Or Exempt Function Income1295273RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$3,138ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total420770Total
Program Services294539ProgramServices
Management And General105193ManagementAndGeneral
Fundraising21038Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1932853Total
Program Services1910353ProgramServices
Management And General22500ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total118055Total
Program Services115898ProgramServices
Management And General1852ManagementAndGeneral
Fundraising305Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total229695Total
Program Services149302ProgramServices
Management And General80393ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total110062Total
Program Services35222ProgramServices
Management And General74840ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total128795Total
Management And General128795ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total4070Total
Management And General4070ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total28661Total
Program Services25895ProgramServices
Management And General2766ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total778508Total
Program Services749126ProgramServices
Management And General14691ManagementAndGeneral
Fundraising14691Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total27577Total
Program Services26908ProgramServices
Management And General669ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total29370Total
Program Services28658ProgramServices
Management And General712ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total418261Total
Program Services407189ProgramServices
Management And General10149ManagementAndGeneral
Fundraising923Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total41158Total
Program Services41158ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total13100Total
Program Services11100ProgramServices
Management And General2000ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total628434Total
Program Services625180ProgramServices
Management And General2983ManagementAndGeneral
Fundraising271Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total276022Total
Program Services255428ProgramServices
Management And General18742ManagementAndGeneral
Fundraising1852Fundraising

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
CONTRACT LABOR145624112574330500
MEDICAL SUPPLIES10981010981000
LAB FEES736437364300
REPAIRS & MAINTENANCE470394589811410
RESEARCH EXPENSES420584205800

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total157147Total
Program Services133917ProgramServices
Management And General22971ManagementAndGeneral
Fundraising259Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5760712Total
Program Services5193856ProgramServices
Management And General527517ManagementAndGeneral
Fundraising39339Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY35424BOY
EOY64446EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3405355BOY
EOY1157579EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY2593632BOY
EOY578301EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY146123BOY
EOY226420EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY78035BOY
EOY144965EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5679046LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec870868LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3030975BOY
EOY4808178EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY20832BOY
EOY16338EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY36306BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY9346682BOY
EOY6996227EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY203580BOY
EOY192009EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY73794BOY
EOY918279EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY277374BOY
EOY1110288EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY7368532BOY
EOY5233363EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1700776BOY
EOY652576EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9069308BOY
EOY5885939EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9346682BOY
EOY6996227EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years241633CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10517187CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years640373CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year729238CurrentTaxYearMinus1Year
Current Tax Year1283426CurrentTaxYear
Total13411857Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years241633CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10517187CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years640373CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year729238CurrentTaxYearMinus1Year
Current Tax Year1283426CurrentTaxYear
Total13411857Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total10885843AmountsSubstContributorsTotal
Public Support Total1702526014PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4093CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3743CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years44859CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year31089CurrentTaxYearMinus1Year
Current Tax Year3138CurrentTaxYear
Total86922Total
FieldValueIRS element (for citing)
Total Support13498779TotalSupport
Gross Receipts From Admissions Etc1410594GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.18710PublicSupportPertcentage170
Public Support Pertcent Prior Year0.17210PublicSupportPertcentPriorYear
Ten Percent Test Current YearXTenPercentTestCurrentYear
Facts And Circumstances TestPURSUANT TO REG 1.170A-9T(F)(3), THE CLINIC NORMALLY RECEIVES SUBSTANTIAL SUPPORT FROM CONTRIBUTIONS MADE DIRECTLY BY THE GENERAL PUBLIC AND IS CONSIDERED PUBLICLY SUPPORTED DUE TO THE TEN PERCENT FACTS AND CIRCUMSTANCES TEST. IN ADDITION, THE CLINIC IS ACTIVELY PURSUING NEW AND ADDITIONAL PUBLIC & GOVERNMENTAL SUPPORT ON A CONTINUAL BASIS. THE CLINIC OFFERS CHARITY CARE TO INDIGENT PATIENTS THAT ARE UNABLE TO AFFORD THE APPROPRIATE CARE. FURTHERMORE, THE CLINIC IS ACTIVELY INVOLVED IN RESEARCHING INNOVATIVE TECHNIQUES AND PROCEDURES, SURGICAL INSTRUMENT DESIGN AND DEVELOPMENT THROUGH JOINT RESEARCH PROJECTS AND PATIENT TREATMENT PROTOCOLS OF UROLOGIC CARE. THE CLINIC IMPLEMENTED THE INNAGURAL INVENTION CONVENTION TO TRANSFORM IDEAS INTO THE MEDICAL PRODUCTS OF TOMORROW. THE CONVENTION SERVES TO TAP INTO NEW IDEAS, THE LATEST THINKING, PROVEN STRATEGIES AND KEY CONNECTIONS TO TAKE NEW CONCEPTS INTO COMMERCIALIZATION. FINALLY, THE CLINIC OFFERS EDUCATION AND ADVANCED TRAINING FOR PHYSICIANS WHO HAVE BEEN IN PRIVATE PRACTICE FOR SEVERAL YEARS BUT WHO ARE RARELY GIVEN THE OPPORTUNITY TO RECEIVE HANDS-ON TRAINING TO UPDATE THEIR SURGICAL SKILLS OR TO DEVELOP NEW SKILLS. THROUGH THE CONTINUED INCREASE AND FURTHERANCE OF CURRENT PROGRAM SERVICES AND SUPPORT FROM GROSS RECEIPTS DERIVED FROM THE ACTIVITES RELATED TO ITS EXEMPT FUNCTIONS, THE CLINIC IS RECEIVING INCREASED SUPPORT FROM THE PUBLIC TO ACHIEVE AND FURTHER THE ORGANIZATION'S MISSION. BASED ON THE CONSISTENT INCREASE AND FURTHERANCE OF CURRENT PROGRAM SERVICES AND THE INCREASE OF SUPPORT FROM THE PUBLIC, THE BOARD ANTICIPATES CONTINUED GROWTH OF THE CLINIC'S PUBLIC SUPPORT PERCENTAGE.IN 2009 & 2008, THE CLINIC SATISFIED THE TEN PERCENT FACTS AND CIRCUMSTANCES TEST WITH PUBLIC SUPPORT 18.71% & 17.21% RESPECTIVELY.FactsAndCircumstancesTest

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2741605OtherCostOrOtherBasis
Depreciation205163Depreciation
Book Value2536442BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2282133OtherCostOrOtherBasis
Depreciation531027Depreciation
Book Value1751106BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis655308OtherCostOrOtherBasis
Depreciation134678Depreciation
Book Value520630BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4808178TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ACCRUED VACATION PAYABLE$27,897
DEFERRED RENT$890,382
FieldValueIRS element (for citing)
Total Of Amounts918279TotalOfAmounts
Total Revenue2581837TotalRevenue
Total Expenses5760712TotalExpenses
Excess Or Deficit For Year-3178875ExcessOrDeficitForYear
Net Unrealized GL On Investments-4494NetUnrealizedGLOnInvestments
Total Adjustments-4494TotalAdjustments
Excess Or Deficit Per FS-3183369ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt2577343TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-4494NetUnrealizedGainsInvestments
Revenue Not Rptd F990-4494RevenueNotRptdF990
Revenue Subtotal2581837RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9902581837TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt5760712TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal5760712ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9905760712TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart X:Identifier
Return ReferenceDescription of Uncertain Tax Positions Under FIN 48:ReturnReference
ExplanationEFFECTIVE OCTOBER 1, 2009, THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITY, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE ORGANIZATION IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE IRC. TAX YEARS THAT REMAIN SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTIONS DATE BACK TO THE YEAR ENDED SEPTEMBER 30, 2007. AS OF SEPTEMBER 30, 2010, THERE ARE NO KNOWN ITEMS WHICH WOULD RESULT IN A MATERIAL ACCRUAL RELATED TO FEDERAL OR STATE TAX POSITIONS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ANTHONY A MALIZIA JR MD
420770000000057667047843703303330
DR GIL FOSTER
3231090000000505250373634000
DR RAY PAK
3950000000000488960443896000
DR JAIME WONG
3127080000000327510345459000
DR JAMES GOODLET
2755770000000384430314020000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section B, line 11AFTER THE FORM 990 IS PREPARED BY AN OUTSIDE CPA FIRM, FRAZIER & DEETER, LLC, THE FORM IS REVIEWED BY THE PRESIDENT, ANTHONY A. MALIZIA, JR., MD. ONCE THE FORM HAS BEEN EXAMINED, INCLUDING THE ACCOMPANYING SCHEDULES AND STATEMENTS, AND IS DEEMED TO THE BEST OF KNOWLEDGE AND BELIEF TO BE TRUE, CORRECT, AND COMPLETE, THE PRESIDENT PRESENTS THE FORM TO THE BOARD OF DIRECTORS FOR THEIR REVIEW AND APPROVAL. UPON APPROVAL, THE PRESIDENT SIGNS AND MAILS THE FORM APPROPRIATELY.
Form 990, Part VI, Section B, line 12cTHE OFFICERS AND DIRECTORS OF THE ORGANIZATION RECEIVE A CONFLICT OF INTEREST POLICY TO REVIEW AND SIGN ANNUALLY. THE COPIES ARE MAINTAINED AND INTERNALLY REVIEWED BY THE CLINIC.
Form 990, Part VI, Section B, line 15OFFICER'S COMPENSATION is REVIEWED AND determined BY THE COMPENSATION COMMITTEE BASED ON COMPARABILITY DATA AND CONSULTATION WITH A COMPENSATION EXPERT. THE COMPENSATION COMMITTEE RECOMMENDS THE SALARIES FOR APPROVAL TO THE BOARD OF DIRECTORS.
Form 990, Part VI, Section C, line 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 2C, COMMITTEE FOR THE OVERSIGHT OF THE AUDIT: THE ORGANIZATION HAS IN PLACE A FINANCE COMMITTEE COMPRISED OF INDEPENDENT DIRECTORS AND THE TREASURER. THIS COMMITTEE OVERSEES THE ANNUAL AUDIT OF THE FINANCIAL STATEMENTS AND ANNUALLY ENGAGES AN INDEPENDENT AUDITOR. THE INDEPENDENT AUDITOR REPORTS DIRECTLY TO THE AUDIT COMMITTEE, AND THE AUDIT COMMITTEE REPORTS DIRECTLY TO THE BOARD OF DIRECTORS.

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