SOUTHERN CALIFORNIA MEDICAL CENTER INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHERN CALIFORNIA MEDICAL CENTER INC (EIN 26-2602821)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-04-14
- IRS object ID
- 202111049349301966
- Schema version
- 2019v5.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-04-14T22:11:35-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 330783700 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PDM LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3460 TORRANCE BLVD STE 200 | AddressLine1Txt |
| City | TORRANCE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90503 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 262602821 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHERN CALIFORNIA MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 8186506700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14550 HAYNES ST | AddressLine1Txt |
| City | VAN NUYS | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91411 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHEILA BUSHERI | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8186506700 | PhoneNum |
| Signature | 2021-04-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANTHONY P BOZANIC CPA | PreparerPersonNm |
| PTIN | P01314417 | PTIN |
| Phone | 3105404118 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHEILA BUSHERI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14550 HAYNES ST | AddressLine1Txt |
| City | VAN NUYS | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91411 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,350,187 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SCMEDCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2008 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO OPERATE A STATE-LICENSED COMMUNITY HEALTH CLINIC IN EL MONTE, PICO RIVERA, POMONA, AND VAN NUYS, CA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 116 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,162,631 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,671,009 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,363,091 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,679,178 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,000 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $11,529,722 | PYTotalRevenueAmt |
| CY Total Revenue | $12,350,187 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,581,769 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,478,723 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,839,890 | PYOtherExpensesAmt |
| CY Other Expenses | $3,592,131 | CYOtherExpensesAmt |
| PY Total Expenses | $9,421,659 | PYTotalExpensesAmt |
| CY Total Expenses | $10,070,854 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,108,063 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,279,333 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,829,498 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,313,220 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,384,649 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,589,038 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,444,849 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,724,182 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO DELIVER THE HIGHEST QUALITY OF HEALTH CARE WITH THE FOCUS ON THE UNDERSERVED AND LOW INCOME POPULATION OF EL MONTE, PICO RIVERA, POMONA, AND VAN NUYS, CA. THE GOAL IS TO CREATE HEALTHY AND HAPPY FAMILIES BY FOCUSING ON EDUCATION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,633,008 | ExpenseAmt |
| Revenue | $10,679,178 | RevenueAmt |
| Desc | THE ORGANZATION IS A FEDERALLY QUALIFIED HEALTH CLINIC THAT PROVIDES AND OPERATES QUALITY HEALTH CARE SERVCIES FROM CLINICS LOCATED IN EL MONTE, PICO RIVERA, POMONA, AND VAN NUYS. SERVICES INCLUDE GENERAL MEDICAL CARE, PHYSICALS, IMMUNIZATIONS, WELL CHILD CHECK-UPS, SPECIALIST REFERRALS, FAMILY CARE PRACTITIONERS, PRIMARY CARE, FAMILY/INTERNAL CARE MEDICINE, PEDIATRICS, DENTAL, PHYSICAL THERAPY, NUTRITION EDUCATION, MENTAL HEALTH AND OBSTETRICS/GYNECOLOGY TO LOCAL COMMUNITIES WITH A FOCUS ON EDUCATION AND PREVENTION. THE ORGANIZATION CONTRACTS DIRECTLY OR INDIRECTLY WITH GOVERNMENTAL AGENCIES AND RECEIVES GRANTS TO SUPPORT SERVICE DELIVERY AND SPECIAL PROGRAMS. NO CLIENT IS TURNED AWAY DUE TO THE INABILITY TO PAY. | Desc |
| Total Program Service Expenses | $8,633,008 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 57 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 116 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OMAR KADER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8186506700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14550 HAYNES ST | AddressLine1Txt |
| City | VAN NUYS | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91411 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| NAVEED TORIAN | |||||||
| CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| HAMID HAMEDI | |||||||
| VICE CHAIR | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LOURDES MARTINEZ | |||||||
| TREASURER/SECRETARY | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROSA ESTORGA | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARIA AHUMADA | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SANAZ AZADBADI | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KOUROSH KAMALI | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WENDY CAMACHO | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK MENDEZ | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MATTHEW MATIN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MOHAMMAD RESEKHI MD | |||||||
| CMO/FOUNDER | 40.00 | Yes (X) | $374,099 | $0 | $9,384 | ||
| SHEILA BUSHERI | |||||||
| CEO/FOUNDER | 40.00 | Yes (X) | $182,009 | $0 | $6,274 | ||
| OMAR KADER | |||||||
| CFO/COO | 40.00 | Yes (X) | $164,570 | $0 | $6,274 | ||
| NONA AHANKOOB MD | |||||||
| MEDICAL DOCTOR | 40.00 | $219,005 | $0 | $6,274 | Yes (X) | ||
| PEDRAM KOHAN MD | |||||||
| MEDICAL DOCTOR | 40.00 | $183,136 | $0 | $0 | Yes (X) | ||
| JOHN C PETITT MD | |||||||
| MEDICAL DOCTOR | 40.00 | $199,667 | $0 | $0 | Yes (X) | ||
| DAMIAN ROBLEDO | |||||||
| LCSW | 40.00 | $139,701 | $0 | $4,996 | Yes (X) | ||
| LIEN TRAN | |||||||
| PHYSICIAN ASSISTANT | 40.00 | $119,638 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,581,825 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $33,202 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MODERN HR | |||||
| 7590 N GLENOAKS BLVD | BURBANK | CA | 91504 | HUMAN RESOURCE CONSULTING | $2,297,256 |
| MCLAREN LLC | |||||
| 6700 VALJEAN AVE | VAN NUYS | CA | 91406 | RENT | $441,400 |
| HYECO HEATING & AIR CONDITIONING | |||||
| 9900 GLENOAKS BLVD | SUN VALLEY | CA | 91352 | REPAIRS AND MAINTENANCE | $256,500 |
| NEXTGEN HEALTHCARE INC | |||||
| 18111 VON KARMAN AVE SUITE 800 | IRVINE | CA | 92612 | SOFTWARE | $148,358 |
| MCKESSON CORPORATION | |||||
| 2800 E PHILADELPHIA ST | ONTARIO | CA | 91761 | MEDICAL SUPPLIES | $143,781 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,671,009 | GovernmentGrantsAmt |
| Total Contributions | $1,671,009 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SVC REVENUE | 621110 | $7,411,830 | $7,411,830 |
| CAPITATION | 621110 | $1,434,582 | $1,434,582 |
| 340B SERVICES | 621110 | $1,242,551 | $1,242,551 |
| OTHER PROGRAM SERVICES | 621110 | $305,065 | $305,065 |
| PRIVATE INSURANCE AND SELF PAY | 621110 | $285,150 | $285,150 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,679,178 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,350,187 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,679,178 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,211,023 | TotalAmt |
| Program Services | $1,029,370 | ProgramServicesAmt |
| Management And General | $181,653 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,543,999 | TotalAmt |
| Program Services | $3,862,399 | ProgramServicesAmt |
| Management And General | $681,600 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $300,025 | TotalAmt |
| Program Services | $255,021 | ProgramServicesAmt |
| Management And General | $45,004 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $423,676 | TotalAmt |
| Program Services | $360,125 | ProgramServicesAmt |
| Management And General | $63,551 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $721,177 | TotalAmt |
| Program Services | $679,893 | ProgramServicesAmt |
| Management And General | $41,284 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,170 | TotalAmt |
| Program Services | $106,170 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $461,171 | TotalAmt |
| Program Services | $368,937 | ProgramServicesAmt |
| Management And General | $92,234 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $892,203 | TotalAmt |
| Program Services | $725,283 | ProgramServicesAmt |
| Management And General | $166,920 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,535 | TotalAmt |
| Program Services | $90,028 | ProgramServicesAmt |
| Management And General | $22,507 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,997 | TotalAmt |
| Program Services | $5,598 | ProgramServicesAmt |
| Management And General | $1,399 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $498,956 | TotalAmt |
| Program Services | $399,165 | ProgramServicesAmt |
| Management And General | $99,791 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $182,794 | TotalAmt |
| Program Services | $146,235 | ProgramServicesAmt |
| Management And General | $36,559 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $501,067 | $501,067 | |
| LABORATORY FEES | $82,341 | $82,341 | |
| TAXES AND LICENSES | $26,720 | $21,376 | $5,344 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,070,854 | TotalAmt |
| Program Services | $8,633,008 | ProgramServicesAmt |
| Management And General | $1,437,846 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,694,302 | BOYAmt |
| EOY | $4,917,148 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,326,056 | BOYAmt |
| EOY | $1,039,096 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $360,050 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,205,512 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,237,839 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $797,869 | BOYAmt |
| EOY | $1,967,673 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,271 | BOYAmt |
| EOY | $29,253 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,829,498 | BOYAmt |
| EOY | $8,313,220 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,184,649 | BOYAmt |
| EOY | $530,311 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $851,400 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,000 | BOYAmt |
| EOY | $207,327 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,384,649 | BOYAmt |
| EOY | $1,589,038 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,444,849 | BOYAmt |
| EOY | $6,724,182 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,444,849 | BOYAmt |
| EOY | $6,724,182 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,829,498 | BOYAmt |
| EOY | $8,313,220 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,279,333 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,304,451 | OtherCostOrOtherBasisAmt |
| Depreciation | $32,611 | DepreciationAmt |
| Book Value | $1,271,840 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,051,749 | OtherCostOrOtherBasisAmt |
| Depreciation | $591,689 | DepreciationAmt |
| Book Value | $460,060 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $788,266 | OtherCostOrOtherBasisAmt |
| Depreciation | $583,482 | DepreciationAmt |
| Book Value | $204,784 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $61,046 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,057 | DepreciationAmt |
| Book Value | $30,989 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,967,673 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ACCRUED THIRD PARTY LIABILITY | Desc |
| Amt | $207,327 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $207,327 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $12,350,187 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $12,350,187 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $12,350,187 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,070,854 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,070,854 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,070,854 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION RECOGNIZES THE IMPACT OF TAX POSITIONS IN THE FINANCIAL STATEMENTS IF THAT POSITION IS MORE LIKELY THAN NOT OF BEING SUSTAINED ON AUDIT, BASED ON TECHNICAL MERITS OF THE POSITION. THE ORGANIZATION HAS NOT RECORDED ANY UNCERTAIN TAX POSITIONS. THE ORGANIZATION RECOGNIZES POTENTIAL ACCRUED INTEREST AND PENALTIES FOR UNCERTAIN TAX POSITIONS IN INCOME TAX EXPENSE. DURING THE YEAR ENDED JUNE 30, 2020, THE ORGANIZATION DID NOT RECOGNIZE ANY AMOUNT IN POTENTIAL INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MOHAMMAD RESEKHI MD | ||||||||||||||
| CMO/FOUNDER | $374,099 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $9,384 | $0 | $383,483 | $0 | $0 | $0 |
| SHEILA BUSHERI | ||||||||||||||
| CEO/FOUNDER | $182,009 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $6,274 | $0 | $188,283 | $0 | $0 | $0 |
| OMAR KADER | ||||||||||||||
| CFO/COO | $164,570 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $6,274 | $0 | $170,844 | $0 | $0 | $0 |
| NONA AHANKOOB MD | ||||||||||||||
| MEDICAL DOCTOR | $219,005 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $6,274 | $0 | $225,279 | $0 | $0 | $0 |
| PEDRAM KOHAN MD | ||||||||||||||
| MEDICAL DOCTOR | $183,136 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $183,136 | $0 | $0 | $0 |
| JOHN C PETITT MD | ||||||||||||||
| MEDICAL DOCTOR | $199,667 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $199,667 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHEILA BUSHERI AND MOHAMMED RASEKHI | PersonNm |
| Relationship With Org | CEO AND CMO | RelationshipWithOrgTxt |
| Loan Purpose | NOTE RECEIVABLE. MATURITY DATE: DUE ON DEMAND, INTEREST RATE: 0% | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $430,050 | OriginalPrincipalAmt |
| Balance Due | $360,050 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $360,050 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| SHEILA BUSHERI AND MOHAMMED RASEKHI | |||
| CEO AND CMO | $120,960 | PICO RIVERA, LLC, OWNED BY THE CEO AND CMO, LEASES A BUILDING TO THE ORGANIZATION | 0 |
| SHEILA BUSHERI AND MOHAMMED RASEKHI | |||
| CEO AND CMO | $471,978 | MCLAREN, LLC, OWNED BY THE CEO AND CMO, LEASES A BUILDING TO THE ORGANIZATION | 0 |
| SHEILA BUSHERI AND MOHAMMED RASEKHI | |||
| CEO AND CMO | $23,570 | UNIVERSAL DIAGNOSTIC LABORATORY, OWNED BY THE CEO AND CMO, LEASES SPACE FROM THE ORGANIZATION | 0 |
| SHEILA BUSHERI AND MOHAMMED RASEKHI | |||
| CEO AND CMO | $26,381 | UNIVERSAL DIAGNOSTIC LABORATORY, OWNED BY THE CEO AND CMO, PROVIDES LABORATORY SERVICES TO THE ORGANIZATION | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | THE CEO AND CMO ARE MARRIED. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE TAX RETURN IS PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW AND APPROVAL BEFORE IT IS FILED. THE ORGANIZATION ALSO DISTRIBUTES A COPY OF THE TAX RETURN TO THE BOARD OF DIRECTORS FOR INFORMATION ONLY. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD OF DIRECTORS MEMBERS SIGN THE CONFLICT OF INTEREST STATEMENTS CONFIRMING THAT THEY UNDERSTAND THE CONFLICT OF INTEREST POLICY. THE SECRETARY OF THE BOARD MONITORS THIS PROCEDURE TO ASSURE THAT THERE ARE NO CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS APPROVES THE SALARIES, WAGES, AND OTHER COMPENSATION PAID TO TOP MANAGEMENT EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION PROVIDES ANY GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | THERE HAVE BEEN NO CHANGES IN OVERSIGHT OR THE SELECTION PROCESS DURING THE YEAR. |