2011-05-09T12:57:42-05:00 2010-09-30 FRAZIER & DEETER LLC 600 PEACHTREE STREET SUITE 1900 ATLANTA GA 30308 990 2009-10-01 201812839 MALIZIA CLINIC INC MALI 4042409700 1800 HOWELL MILL ROAD No 500 ATLANTA GA 30318 DR ANTHONY A MALIZIA JR 4042409700 2011-05-09 1 JAMES F FRAZIER JR 4042537500 2009 2016-02-24 21:20:13Z ANTHONY A MALIZIA JR 1800 HOWELL MILL ROAD No 500 ATLANTA GA 30318 2581837 0 X www.maliziaclinic.org X 2004 GA THE 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. 8 7 16 1 0 0 778502 1283426 133049 1282045 31089 3138 13228 942640 2581837 0 0 637552 2471678 0 39339 1531615 3289034 2169167 5760712 -1226527 -3178875 9346682 6996227 277374 1110288 9069308 5885939 THE 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. 0 0 5031522 1290773 MEDICAL 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. 123669 4500 RESEARCH 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. 38665 0 EDUCATION 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). 5193856 1 1 0 0 0 0 0 0 0 1 1 0 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 0 0 0 0 1 11 0 16 1 0 0 0 0 0 0 0 0 0 8 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 GA NC X heather hall 4042409700 1800 HOWELL MILL ROAD SUITE 500 ATLANTA GA 30318 howard m jenkins 10.00 X X 0 0 0 dan cathy 10.00 X X 0 0 0 robert w fisher 10.00 X X 0 0 0 robert martin 10.00 X X 0 0 0 ANTHONY A MALIZIA JR MD 40.00 X X X X 420770 0 57667 judge g conley ingram 10.00 X 0 0 0 BERNARD MARCUS 10.00 X 0 0 0 FREDERICK S SLAGLE 10.00 X 0 0 0 DR GIL FOSTER 40.00 X X 323109 0 50525 DR RAY PAK 40.00 X X 395000 0 48896 DR JAIME WONG 40.00 X X 312708 0 32751 DR JAMES GOODLET 40.00 X 275577 0 38443 1727164 0 228282 5 1 1 0 POINT B 1001 EUCLID AVENUE ATLANTA GA 30307 MARKETING & WEBSITE DESIGN 334221 MEDICAL MANAGEMENT ASSOCIATES 3330 CUMBERLAND BLVD STE 200 ATLANTA GA 30339 MEDICAL CONSULTING 190003 2 1283426 1283426 PATIENT SERVICE FEES 621110 1277545 1277545 INVENTION CONVENTION F 621110 4500 4500 1282045 3138 3138 REIMBURSED EXPENSES 621110 13201 13201 OTHER INCOME 621110 27 27 13228 2581837 1295273 0 3138 420770 294539 105193 21038 1932853 1910353 22500 118055 115898 1852 305 229695 149302 80393 110062 35222 74840 128795 128795 4070 4070 28661 25895 2766 778508 749126 14691 14691 27577 26908 669 29370 28658 712 418261 407189 10149 923 41158 41158 13100 11100 2000 628434 625180 2983 271 276022 255428 18742 1852 CONTRACT LABOR 145624 112574 33050 0 MEDICAL SUPPLIES 109810 109810 0 0 LAB FEES 73643 73643 0 0 REPAIRS & MAINTENANCE 47039 45898 1141 0 RESEARCH EXPENSES 42058 42058 0 0 157147 133917 22971 259 5760712 5193856 527517 39339 35424 64446 3405355 1157579 2593632 578301 146123 226420 78035 144965 5679046 870868 3030975 4808178 20832 16338 36306 0 9346682 6996227 203580 192009 73794 918279 277374 1110288 X 7368532 5233363 1700776 652576 9069308 5885939 9346682 6996227 X 0 1 1 X 0 X 241633 10517187 640373 729238 1283426 13411857 241633 10517187 640373 729238 1283426 13411857 10885843 2526014 4093 3743 44859 31089 3138 86922 13498779 1410594 0.18710 0.17210 X PURSUANT 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. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2741605 205163 2536442 2282133 531027 1751106 655308 134678 520630 4808178 ACCRUED VACATION PAYABLE 27897 DEFERRED RENT 890382 918279 2581837 5760712 -3178875 -4494 -4494 -3183369 2577343 -4494 -4494 2581837 0 2581837 5760712 0 5760712 0 5760712 Part X: Description of Uncertain Tax Positions Under FIN 48: EFFECTIVE 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. X X X X X 0 0 0 0 0 0 0 0 0 ANTHONY A MALIZIA JR MD 420770 0 0 0 0 0 0 0 57667 0 478437 0 330333 0 DR GIL FOSTER 323109 0 0 0 0 0 0 0 50525 0 373634 0 0 0 DR RAY PAK 395000 0 0 0 0 0 0 0 48896 0 443896 0 0 0 DR JAIME WONG 312708 0 0 0 0 0 0 0 32751 0 345459 0 0 0 DR JAMES GOODLET 275577 0 0 0 0 0 0 0 38443 0 314020 0 0 0 Form 990, Part VI, Section B, line 11 AFTER 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 12c THE 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 15 OFFICER'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 19 THE 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.