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PACIFIC NEUROSCIENCE INSTITUTE FOUNDATION: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
PACIFIC NEUROSCIENCE INSTITUTE FOUNDATION (EIN 47-5552178)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-16
IRS object ID
202023219349306382
Schema version
2019v5.1
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)
Return2020-11-16T12:55:11-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN951777440PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1GREEN HASSON & JANKS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110990 WILSHIRE BLVD 16TH FLOORAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP900243929ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN475552178EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PACIFIC NEUROSCIENCE INSTITUTEBusinessNameLine1Txt
Business Name Line2FOUNDATIONBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlPACIBusinessNameControlTxt
Phone3105827450PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12125 ARIZONA AVEAddressLine1Txt
CitySANTA MONICACityNm
State AbbreviationCAStateAbbreviationCd
ZIP90404ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMELISSA B COLEMAN ESQPersonNm
Person TitleVICE PRESIDENTPersonTitleTxt
Phone3105827450PhoneNum
Signature2020-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLIZBETH G NEVAREZPreparerPersonNm
PTINP01399868PTIN
Phone3108731600PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address75.82.225.227IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-11-15IPDt
IP Tm18:13:35IPTm
IP TimezonePSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id6A5B9BBBC0C15FAE84D58941C3D029285B6C5672AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMELISSA B COLEMAN ESQPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12125 ARIZONA AVEAddressLine1Txt
CitySANTA MONICACityNm
State AbbreviationCAStateAbbreviationCd
ZIP90404ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$7,030,351GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PACIFICNEUROSCIENCEINSTITUTE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2015FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTO PROMOTE ADVANCES IN NEUROSCIENCE CLINICAL CARE AND RESEARCH THROUGH NOVEL TREATMENT APPROACHES THAT OPTIMIZE BRAIN HEALTH AND QUALITY OF LIFE, TO TRAIN THE NEXT GENERATION OF NEUROSCIENTISTS AND CLINICIANS, AND TO EDUCATE PATIENTS AND THE COMMUNITY AT LARGE ON VITAL NEUROSCIENCE ISSUES.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee7TotalEmployeeCnt
Total Volunteers13TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,003,853PYContributionsGrantsAmt
CY Contributions Grants$7,001,807CYContributionsGrantsAmt
PY Program Service Revenue$26,685PYProgramServiceRevenueAmt
CY Program Service Revenue$28,333CYProgramServiceRevenueAmt
PY Investment Income$82PYInvestmentIncomeAmt
CY Investment Income$211CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$3,030,620PYTotalRevenueAmt
CY Total Revenue$7,030,351CYTotalRevenueAmt
PY Grants And Similar Paid$240,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,516,055CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$502,307PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,986,247CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$85,717CYTotalFundraisingExpenseAmt
PY Other Expenses$2,301,692PYOtherExpensesAmt
CY Other Expenses$2,130,006CYOtherExpensesAmt
PY Total Expenses$3,043,999PYTotalExpensesAmt
CY Total Expenses$5,632,308CYTotalExpensesAmt
PY Revenues Less Expenses-$13,379PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,398,043CYRevenuesLessExpensesAmt
Total Assets BOY$5,515,222TotalAssetsBOYAmt
Total Assets EOY$7,787,547TotalAssetsEOYAmt
Total Liabilities BOY$236,481TotalLiabilitiesBOYAmt
Total Liabilities EOY$247,135TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$5,278,741NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,540,412NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO FUNDAMENTALLY ADVANCE NEUROSCIENCE CLINICAL CARE THROUGH NOVEL TREATMENT APPROACHES THAT OPTIMIZE BRAIN HEALTH AND QUALITY OF LIFE, TO TRAIN THE NEXT GENERATION OF NEUROSCIENTISTS AND CLINICIANS, AND TO EDUCATE PATIENTS AND THE COMMUNITY AT LARGE ON VITAL NEUROSCIENCE ISSUES.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,459,582ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescTHE PACIFIC BRAIN HEALTH CENTER IS DEDICATED TO PROVIDING COMPREHENSIVE AND HOLISTIC CARE TO PATIENTS WITH DEMENTIA AND ASSOCIATED NEUROLOGICAL DISORDERS, AS WELL AS PROBLEMS OF MEMORY LOSS, DEPRESSION, ANXIETY AND ADDICTION.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,773,726ExpenseAmt
Grant$1,516,055GrantAmt
Revenue$28,333RevenueAmt
DescSUPPORT OF THE EDUCATION AND COLLABORATION OF NEUROSCIENTISTS AND CLINICIANS REGARDING TECHNIQUES FOR THE OPTIMIZATION OF BRAIN HEALTH.EDUCATING AND INFORMING THE PUBLIC ABOUT NEW DEVELOPMENTS IN NEUROSCIENCE RESEARCH, TREATMENTS AND CLINICAL TRIALS.PRODUCTION OF EDUCATIONAL VIDEOS AND IMAGES TO ADVANCE AND EDUCATE THE PUBLIC AND CLINICIANS REGARDING NEW AND IMPROVED NEUROSCIENCE TECHNIQUES.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$5,233,308TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan OutstandingYes (1)LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntYes (1)BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document19IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee7EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonHOWARD R KRAUSS MDPersonNm
Phone3105827450PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12125 ARIZONA AVENUEAddressLine1Txt
CitySANTA MONICACityNm
State AbbreviationCAStateAbbreviationCd
ZIP90404ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerInd
SARAH MCEWEN
DIRECTOR OF RESEARCH40.000.00Yes (X)$202,531$0$16,738
KARTER WHITE
ADMINSTRATIVE DIRECTOR40.000.00$121,117$0$7,305Yes (X)
RITA JETHANI
TITLE40.000.00$100,796$0$4,369Yes (X)
DANIEL F KELLY MD
PRESIDENT & CEO10.002.00$0$0$0Yes (X)Yes (X)
CHESTER F GRIFFITHS MD
CHAIRPERSON8.002.00$0$0$0Yes (X)Yes (X)
HOWARD R KRAUSS MD
CFO3.001.00$0$0$0Yes (X)Yes (X)
SANTOSH KESARI MD
SECRETARY4.001.00$0$0$0Yes (X)Yes (X)
DONNA TUTTLE
BOARD MEMBER1.001.00$0$0$0Yes (X)
CAROLE SCHWARTZ
BOARD MEMBER1.001.00$0$0$0Yes (X)
JAE GOODMAN
BOARD MEMBER1.001.00$0$0$0Yes (X)
CARLA MANN WOODS
BOARD MEMBER1.000.00$0$0$0Yes (X)
BLAINE LOURD
BOARD MEMBER1.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$424,444TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$28,412TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PACIFIC NEUROSCIENCE INSTITUTE MEDICAL GBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line12125 ARIZONA AVENUEAddressLine1Txt
CitySANTA MONICACityNm
State AbbreviationCAStateAbbreviationCd
ZIP90404ZIPCd
FieldValueIRS element (for citing)
ServicesRESEARCH & ADMINSTRATIVE SERVICESServicesDesc
Compensation$2,062,571CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
All Other Contributions$7,001,807AllOtherContributionsAmt
Total Contributions$7,001,807TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROGRAM EVENT INCOMEDesc
Business900099BusinessCd
Total Revenue Column$28,333TotalRevenueColumnAmt
Related Or Exempt Func Income$28,333RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$28,333TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$211TotalRevenueColumnAmt
Exclusion$211ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,030,351TotalRevenueColumnAmt
Related Or Exempt Func Income$28,333RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$211ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,516,055TotalAmt
Program Services$1,516,055ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$202,531TotalAmt
Program Services$189,183ProgramServicesAmt
Management And General$5,339ManagementAndGeneralAmt
Fundraising$8,009FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,613,142TotalAmt
Program Services$1,506,832ProgramServicesAmt
Management And General$42,524ManagementAndGeneralAmt
Fundraising$63,786FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$130,151TotalAmt
Program Services$128,238ProgramServicesAmt
Fundraising$1,913FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$40,423TotalAmt
Program Services$40,423ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$140,542TotalAmt
Management And General$140,542ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$29,051TotalAmt
Management And General$29,051ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$175,768TotalAmt
Program Services$118,256ProgramServicesAmt
Management And General$57,512ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$24,147TotalAmt
Program Services$23,349ProgramServicesAmt
Fundraising$798FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$16,584TotalAmt
Program Services$6,751ProgramServicesAmt
Management And General$9,311ManagementAndGeneralAmt
Fundraising$522FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$260,336TotalAmt
Program Services$256,184ProgramServicesAmt
Management And General$4,152ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$132,000TotalAmt
Program Services$124,000ProgramServicesAmt
Management And General$5,000ManagementAndGeneralAmt
Fundraising$3,000FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$5,704TotalAmt
Program Services$5,471ProgramServicesAmt
Fundraising$233FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$3,532TotalAmt
Program Services$2,991ProgramServicesAmt
Management And General$252ManagementAndGeneralAmt
Fundraising$289FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$103,114TotalAmt
Program Services$82,491ProgramServicesAmt
Management And General$15,467ManagementAndGeneralAmt
Fundraising$5,156FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,115TotalAmt
Management And General$1,115ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
RESEARCH EXPENSE$1,189,242$1,189,242
DUES AND SUBSCRIPTIONS$16,535$14,464$1,941$130
COMMUNITY OUTREACH AND$16,400$14,519$1,881
MEDICAL RECORDS AND SUP$1,573$1,573

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$14,363TotalAmt
Program Services$13,286ProgramServicesAmt
Management And General$1,077ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,632,308TotalAmt
Program Services$5,233,308ProgramServicesAmt
Management And General$313,283ManagementAndGeneralAmt
Fundraising$85,717FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$97,458BOYAmt
EOY$542,624EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$235,713BOYAmt
EOY$1,307,257EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$10,899BOYAmt
EOY$5,945EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$16,400LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,778LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$15,902BOYAmt
EOY$12,622EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$217,670BOYAmt
EOY$117,836EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$4,937,580BOYAmt
EOY$5,801,263EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,515,222BOYAmt
EOY$7,787,547EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$236,481BOYAmt
EOY$166,677EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
EOY$80,458EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$236,481BOYAmt
EOY$247,135EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$341,161BOYAmt
EOY$1,739,149EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,937,580BOYAmt
EOY$5,801,263EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,278,741BOYAmt
EOY$7,540,412EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,515,222BOYAmt
EOY$7,787,547EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,398,043ReconcilationRevenueExpnssAmt
Prior Period Adjustments-$55PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$863,683OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS Audited0FSAuditedInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$749,455CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,266,968CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,003,853CurrentTaxYearMinus1YearAmt
Current Tax Year$7,001,807CurrentTaxYearAmt
Total$12,022,083TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$749,455CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,266,968CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,003,853CurrentTaxYearMinus1YearAmt
Current Tax Year$7,001,807CurrentTaxYearAmt
Total$12,022,083TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$12,022,083PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$55CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$74CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$82CurrentTaxYearMinus1YearAmt
Current Tax Year$211CurrentTaxYearAmt
Total$422TotalAmt
FieldValueIRS element (for citing)
Total Support$12,022,505TotalSupportAmt
Gross Receipts Rltd Activities$54,991GrossReceiptsRltdActivitiesAmt
First5 Years170Yes (X)First5Years170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$16,400OtherCostOrOtherBasisAmt
Depreciation$3,778DepreciationAmt
Book Value$12,622BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,622TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescBENEFICIAL INTEREST IN ASSETS HELD BY SJHCFDesc
Book Value$5,801,263BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$5,801,263TotalBookValueOtherAssetsAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1JOHN WAYNE CANCER INSTITUTEBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12200 SANTA MONICA BLVDAddressLine1Txt
CitySANTA MONICACityNm
State AbbreviationCAStateAbbreviationCd
ZIP90404ZIPCd
FieldValueIRS element (for citing)
Recipient EIN954291515RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$1,516,055CashGrantAmt
Purpose Of GrantRESEARCH SUPPORTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationPACIFIC NEUROSCIENCE INSTITUTE FOUNDATION MONITORS THE USE OF THE GRANTS THROUGH ONGOING COMMUNICATION WITH THE GRANTEE ORGANIZATION.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonSARAH MCEWENPersonNm
TitleDIRECTOR OF RESEARCHTitleTxt
Base Compensation Filing Org$202,531BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$16,738DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$219,269TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

FieldValueIRS element (for citing)
PersonDANIEL F KELLY MD DFK INCPersonNm
Relationship With OrgPRESIDENT AND CEO OF THE FOUNDATIONRelationshipWithOrgTxt
Loan PurposeOPERATIONS LOANLoanPurposeTxt
Loan To OrganizationYes (X)LoanToOrganizationInd
Original Principal$80,458OriginalPrincipalAmt
Balance Due$80,458BalanceDueAmt
Default0DefaultInd
Board Or Committee ApprovalYes (1)BoardOrCommitteeApprovalInd
Written Agreement0WrittenAgreementInd
FieldValueIRS element (for citing)
Total Balance Due$80,458TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PACIFIC NEUROSCIENCE INSTITUTE MEDICAL GROUP INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionOWNED BY 4 OFFICERS OF THE FOUNDATIONRelationshipDescriptionTxt
Transaction$2,062,571TransactionAmt
TransactionTHE ORGANIZATION CONTRACTED WITH PNIMG, INC. TO PROVIDE RESEARCH AND ADMINISTRATIVE SERVICES TO THE ORGANIZATION.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2LAUNCHING OF "TRIP" (TREATMENT RESEARCH AND PSYCHODELICS) PROGRAM IN THE PACIFIC BRAIN HEALTH CENTER.
FORM 990, PART VI, SECTION A, LINE 2THE OFFICERS AND DIRECTORS OF THE ORGANIZATION ARE ALSO: I) MEMBERS AND MANAGERS IN PACIFIC NEUROSCIENCE INSTITUTE, LLC; AND II) SHAREHOLDERS, OFFICERS AND DIRECTORS IN A PROFESSIONAL MEDICAL CORPORATION (PACIFIC NEUROSCIENCE INSTITUTE MEDICAL GROUP, INC.).
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION HAS TWO MEMBERS PACIFIC NEUROSCIENCE INSTITUTE, LLC AND SAINT JOHN'S HEALTH CENTER FOUNDATION
FORM 990, PART VI, SECTION A, LINE 7ATHE MEMBERS ELECT THE GOVERNING BODY OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7BTHE MEMBERS HAVE THE AUTHORITY TO APPROVE THE GOVERNING BODY'S DECISION TO FILL A VACANCY ON THE GOVERNING BODY IF SUCH VACANCY WAS CREATED BY REMOVAL OF A DIRECTOR, AND TO APPROVE THE AMENDMENT OF THE BY-LAWS.
FORM 990, PART VI, SECTION A, LINE 8BTHIS QUESTION IS NOT APPLICABLE SINCE THE ORGANIZATION HAS NO COMMITTEES FORMED.
FORM 990, PART VI, SECTION B, LINE 11BAN ELECTRONIC COPY OF THE FORM 990 AND ITS SUPPORTING SCHEDULES WERE DISTRIBUTED TO THE ORGANIZATION'S GOVERNING BODY FOR REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION'S GOVERNING BODY PERIODICALLY REVIEWS ACTIVITIES IN WHICH IT AND MEMBERS OF ITS GOVERNING BODY ARE PARTICIPATING TO ENSURE THAT ANY AND ALL ARRANGEMENTS (AND ESPECIALLY THOSE WHICH MAY APPEAR TO POSE A CONFLICT OF INTEREST) ARE PROPERLY DOCUMENTED AND REFLECT REASONABLE AND SUPPORTABLE ECONOMIC COMPONENTS SO AS TO NOT RESULT IN INUREMENT, IMPERMISSIBLE PRIVATE BENEFITS OR EXCESS BENEFIT TRANSACTIONS.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:CHANGE IN BENEFICIAL INTEREST IN ASSETS HELD BY AFFILIATE 863,683.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1SAINT JOHN'S HEALTH CENTER FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12121 SANTA MONICA BLVDAddressLine1Txt
CitySANTA MONICACityNm
State AbbreviationCAStateAbbreviationCd
ZIP90404ZIPCd
FieldValueIRS element (for citing)
EIN956100079EIN
Primary ActivitiesNON-PROFIT/FUNDRAISINGPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 7PublicCharityStatusTxt
Controlled Organization0ControlledOrganizationInd

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PACIFIC NEUROSCIENCE INSTITUTE LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line111645 WILSHIRE BLVD 6TH FLAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90064ZIPCd
FieldValueIRS element (for citing)
EIN472490586EIN
Primary ActivitiesMANAGEMENT/INVESTMENTPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Predominant Income TypeN/APredominantIncomeTypeTxt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd