THE LOS ANGELES FREE CLINIC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- THE LOS ANGELES FREE CLINIC (EIN 95-2539105)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-06-08
- IRS object ID
- 202031609349301403
- Schema version
- 2018v3.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-06-08T16:32:05-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 951777440 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREEN HASSON & JANKS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10990 WILSHIRE BLVD 16TH FLOOR | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 900243929 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 952539105 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE LOS ANGELES FREE CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LOSA | BusinessNameControlTxt |
| Phone | 3236538622 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8405 BEVERLY BOULEVARD | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90048 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MURIEL NOUWEZEM | PersonNm |
| Person Title | INTERIM CEO & CFO | PersonTitleTxt |
| Phone | 3236538622 | PhoneNum |
| Signature | 2020-05-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LIZBETH NEVAREZ | PreparerPersonNm |
| PTIN | P01399868 | PTIN |
| Phone | 3108731600 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 108.233.72.19 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-05-20 | IPDt |
| IP Tm | 21:01:29 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 1E5C2E37194314C3A47C760AEAFDC059525B6175 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SABAN COMMUNITY CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MURIEL NOUWEZEM | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8405 BEVERLY BOULEVARD | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90048 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $29,355,771 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SABANCOMMUNITYCLINIC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1967 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO SERVE AS A MEDICAL HOME TO THE MOST VULNERABLE MEMBERS OF OUR COMMUNITY BY PROVIDING AFFORDABLE QUALITY HEALTH CARE IN A CARING ENVIRONMENT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 18 | VotingMembersIndependentCnt |
| Total Employee | 266 | TotalEmployeeCnt |
| Total Volunteers | 134 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $9,663,064 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,085,473 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,892,795 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,931,483 | CYProgramServiceRevenueAmt |
| PY Investment Income | $365,690 | PYInvestmentIncomeAmt |
| CY Investment Income | $569,003 | CYInvestmentIncomeAmt |
| PY Other Revenue | $31,936 | PYOtherRevenueAmt |
| CY Other Revenue | $103,458 | CYOtherRevenueAmt |
| PY Total Revenue | $23,953,485 | PYTotalRevenueAmt |
| CY Total Revenue | $26,689,417 | 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 | $17,420,957 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,160,648 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $921,974 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,477,518 | PYOtherExpensesAmt |
| CY Other Expenses | $9,174,204 | CYOtherExpensesAmt |
| PY Total Expenses | $25,898,475 | PYTotalExpensesAmt |
| CY Total Expenses | $27,334,852 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,944,990 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$645,435 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $22,150,105 | TotalAssetsBOYAmt |
| Total Assets EOY | $23,203,220 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,891,910 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,064,197 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $17,258,195 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $16,139,023 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO SERVE AS A MEDICAL HOME TO THE MOST VULNERABLE MEMBERS OF OUR COMMUNITY BY PROVIDING AFFORDABLE QUALITY HEALTH CARE IN A CARING ENVIRONMENT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,884,396 | ExpenseAmt |
| Revenue | $11,664,335 | RevenueAmt |
| Desc | PRIMARY CARE SERVICESPRIMARY CARE SERVICES ARE PROVIDED THROUGH WAC CLINIC (WALLIS ANNENBERG CENTER), BEVERLY CLINIC, AND MARK S. TAPER CLINIC .THE CLINICS PROVIDE PRIMARY CARE SERVICES FOR ADULTS AND CHILDREN, WHICH INCLUDES HEALTH MAINTENANCE SERVICES SUCH AS PHYSICAL EXAMS, PAP SMEARS AND BREAST EXAMS; DIAGNOSIS AND TREATMENT OF CHRONIC CONDITIONS SUCH AS DIABETES, HYPERTENSION AND ASTHMA; FAMILY PLANNING SERVICES, HIV TESTING AND COUNSELING, AND TESTING AND TREATMENT OF OTHER SEXUALLY TRANSMITTED DISEASES; CANCER SCREENING AND BLOOD PRESSURE SCREENING. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,026,664 | ExpenseAmt |
| Revenue | $5,000,231 | RevenueAmt |
| Desc | DENTAL CLINIC -THE DENTAL CLINIC DELIVERS SERVICES TO BOTH CHILDREN AND ADULTS OF ALL AGES. SERVICES INCLUDE DIAGNOSTIC VISITS SUCH AS ORAL EXAMS WITH X-RAYS; RESTORATIVE PROCEDURES SUCH AS FILLINGS AND STAINLESS STEEL CROWNS FOR CHILDREN; EXTRACTIONS, PULPOTOMIES AND ROOT CANALS, DENTURES, EMERGENCY AND PALLIATIVE CARE, AND SUCH PREVENTIVE CARE AS TEETH CLEANINGS, SEALANTS, SILVER DIAMINE FLUORIDE, CARIES RISK ASSESSMENT WITH SELF-MANAGEMENT GOALS, ORAL HYGIENE EDUCATION AND NUTRITION COUNSELING. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,226,578 | ExpenseAmt |
| Revenue | $1,266,917 | RevenueAmt |
| Desc | BEHAVIORAL HEALTH -THE BEHAVIORAL HEALTH DEPARTMENT OPERATES AT ALL CLINIC SITES TO PROVIDE CASE MANAGEMENT AND SHORT TERM COUNSELING SERVICES TO PEOPLE OF ALL AGES. CASE MANAGEMENT INCLUDES CARE COORDINATION, REFERRALS AND LINKAGE TO RESSOURCES; SHORT-TERM COUNSELING INCLUDES DEPRESSION SCREENING, INDIVIDUAL AND COUPLES COUNSELING, AND FAMILY COUNSELING; GROUP COUNSELING INCLUDES WEIGT LOSS AND HEALTHLY LIVING, MINDFULNESS MEDITATION, HARM-REDUCTION, WOMEN'S TRAUMA. LIMITED PSYCHIATRIC SERVICES ARE ALSO AVAILABLE. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,049,061 | ExpenseAmt |
| Desc | ELIGIBILITY AND ENROLLMENT -THE ELIGIBILITY AND ENROLLMENT DEPARTMENT PROVIDES HEALTH INSURANCE AND PROGRAM ELIGIBILITY SERVICES TO PEOPLE OF ALL AGES, AT ALL THREE CLINIC SITES AS WELL AS AT COMMUNITY MEETINGS, HEALTH FAIRS AND OTHER PUBLIC EVENTS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,049,061 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $23,186,699 | 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 |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | Yes (1) | 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 | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 30 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 266 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 18 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MURIEL NOUWEZEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3233371707 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8405 BEVERLY BOULEVARD | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90048 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| RUSSELL ALEXANDER-OROZCO | ||||||||||
| CO-CHAIR | 8.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| ROBERT BRODER | ||||||||||
| CO-CHAIR | 8.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| ANGELA L JONES | ||||||||||
| VICE CHAIR | 2.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL ZIERING JD | ||||||||||
| TREASURER | 2.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JOANNE DIETCH | ||||||||||
| SECRETARY | 2.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JESSE BRONNER | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| CELIA A BRUGMAN | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| CAROL W BUITRAGO | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| ERIC JUNG MD | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| MINERVA LOPEZ | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| MICHAEL MCBRIDE | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| PEGGY B MILES MD FACP | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| INGRID PALMER | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| LUIS PARDO | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| MITCHELL PINDUS | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD K RIFENBARK JD | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| KAREN SANCHEZ | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| JUDD ZINBERG CCIM | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| MURIEL NOUWEZEM | ||||||||||
| INTERIM CEO & CFO | 40.00 | 0.00 | Yes (X) | $248,441 | $0 | $16,442 | ||||
| DAVID LUNA | ||||||||||
| CHIEF MEDICAL OFFICER | 40.00 | 0.00 | $310,163 | $0 | $16,676 | Yes (X) | ||||
| YANINA QUEEN | ||||||||||
| DIRECTOR OF PEDIATRICS | 40.00 | 0.00 | $236,422 | $0 | $4,496 | Yes (X) | ||||
| ARMEN ARSHAKYAN | ||||||||||
| CHIEF MEDICAL OFFICER | 40.00 | 0.00 | $232,493 | $0 | $18,011 | Yes (X) | ||||
| EMANUEL EMIL MKRTICHIAN | ||||||||||
| CHIEF INFORMATION OFFICER | 40.00 | 0.00 | $232,090 | $0 | $20,332 | Yes (X) | ||||
| FARSHID FARAROOY | ||||||||||
| PHYSICIAN PT | 40.00 | 0.00 | $229,672 | $0 | $23,579 | Yes (X) | ||||
| CHRISTOPHER BRYCHEL | ||||||||||
| PHYSICIAN/CLINICAL CHAMPION | 40.00 | 0.00 | $215,362 | $0 | $8,475 | Yes (X) | ||||
| JULIE ANNE HUDMAN | ||||||||||
| CEO (UNTIL JUNE 1, 2018) | 40.00 | 0.00 | $128,646 | $0 | $16,985 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,833,289 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $124,996 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OCHIN | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1881 SW NAITO PARKWAY | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | EPIC SYSTEM MAINTENANCE | ServicesDesc |
| Compensation | $552,165 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $1,700 | FundraisingAmt |
| Related Organizations | $49,315 | RelatedOrganizationsAmt |
| Government Grants | $3,747,889 | GovernmentGrantsAmt |
| All Other Contributions | $4,286,569 | AllOtherContributionsAmt |
| Total Contributions | $8,085,473 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $17,931,483 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,931,483 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,931,483 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $252,111 | TotalRevenueColumnAmt |
| Exclusion | $252,111 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,982,696 | SecuritiesAmt |
| Other | $550 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,432,808 | SecuritiesAmt |
| Other | $233,546 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $549,888 | SecuritiesAmt |
| Other | -$232,996 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $316,892 | TotalRevenueColumnAmt |
| Exclusion | $316,892 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $1,700 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| SETTLEMENT | 900099 | $55,211 | $55,211 |
| MISCELLANEOUS | 900099 | $48,247 | $48,247 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $103,458 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,689,417 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,931,483 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $672,461 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $487,147 | TotalAmt |
| Program Services | $432,208 | ProgramServicesAmt |
| Management And General | $44,327 | ManagementAndGeneralAmt |
| Fundraising | $10,612 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,830,432 | TotalAmt |
| Program Services | $13,161,811 | ProgramServicesAmt |
| Management And General | $1,346,383 | ManagementAndGeneralAmt |
| Fundraising | $322,238 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $202,181 | TotalAmt |
| Program Services | $178,404 | ProgramServicesAmt |
| Management And General | $19,172 | ManagementAndGeneralAmt |
| Fundraising | $4,605 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,584,253 | TotalAmt |
| Program Services | $1,397,938 | ProgramServicesAmt |
| Management And General | $150,235 | ManagementAndGeneralAmt |
| Fundraising | $36,080 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,056,635 | TotalAmt |
| Program Services | $937,023 | ProgramServicesAmt |
| Management And General | $96,079 | ManagementAndGeneralAmt |
| Fundraising | $23,533 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $501,430 | TotalAmt |
| Management And General | $501,430 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,120 | TotalAmt |
| Management And General | $74,120 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,364 | TotalAmt |
| Management And General | $44,364 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,525,920 | TotalAmt |
| Program Services | $1,020,348 | ProgramServicesAmt |
| Management And General | $277,247 | ManagementAndGeneralAmt |
| Fundraising | $228,325 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,574 | TotalAmt |
| Program Services | $59,863 | ProgramServicesAmt |
| Management And General | $18,760 | ManagementAndGeneralAmt |
| Fundraising | $8,951 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $856,461 | TotalAmt |
| Program Services | $695,152 | ProgramServicesAmt |
| Management And General | $108,600 | ManagementAndGeneralAmt |
| Fundraising | $52,709 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,124,215 | TotalAmt |
| Program Services | $967,556 | ProgramServicesAmt |
| Management And General | $123,985 | ManagementAndGeneralAmt |
| Fundraising | $32,674 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,793,678 | TotalAmt |
| Program Services | $1,524,983 | ProgramServicesAmt |
| Management And General | $166,123 | ManagementAndGeneralAmt |
| Fundraising | $102,572 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,641 | TotalAmt |
| Program Services | $55,563 | ProgramServicesAmt |
| Management And General | $11,562 | ManagementAndGeneralAmt |
| Fundraising | $1,516 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,930 | TotalAmt |
| Program Services | $86,765 | ProgramServicesAmt |
| Management And General | $27,191 | ManagementAndGeneralAmt |
| Fundraising | $12,974 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,211 | TotalAmt |
| Management And General | $72,211 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $591,252 | TotalAmt |
| Program Services | $534,274 | ProgramServicesAmt |
| Management And General | $48,136 | ManagementAndGeneralAmt |
| Fundraising | $8,842 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $310,299 | TotalAmt |
| Program Services | $286,527 | ProgramServicesAmt |
| Management And General | $19,265 | ManagementAndGeneralAmt |
| Fundraising | $4,507 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| PROGRAM SUPPLIES | $1,662,295 | $1,619,417 | $5,265 | $37,613 |
| SUBSCRIPTIONS & MEMBERS | $113,177 | $77,364 | $24,245 | $11,568 |
| STAFF & VOLUNTEER RECRU | $71,458 | $48,846 | $15,308 | $7,304 |
| STAFF APPRECIATION | $66,608 | $45,531 | $14,269 | $6,808 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,571 | TotalAmt |
| Program Services | $57,126 | ProgramServicesAmt |
| Management And General | $17,902 | ManagementAndGeneralAmt |
| Fundraising | $8,543 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,334,852 | TotalAmt |
| Program Services | $23,186,699 | ProgramServicesAmt |
| Management And General | $3,226,179 | ManagementAndGeneralAmt |
| Fundraising | $921,974 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $553,724 | BOYAmt |
| EOY | $418,873 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,890 | BOYAmt |
| EOY | $3,977 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,183,717 | BOYAmt |
| EOY | $1,549,767 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,985,476 | BOYAmt |
| EOY | $3,219,628 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,167 | BOYAmt |
| EOY | $114,027 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $180,667 | BOYAmt |
| EOY | $197,640 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $13,319,672 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,149,136 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,719,875 | BOYAmt |
| EOY | $7,170,536 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,295,170 | BOYAmt |
| EOY | $8,511,792 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,018,547 | BOYAmt |
| EOY | $1,694,285 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,872 | BOYAmt |
| EOY | $322,695 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,150,105 | BOYAmt |
| EOY | $23,203,220 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,193,892 | BOYAmt |
| EOY | $3,530,091 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $417,879 | BOYAmt |
| EOY | $342,426 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $600,000 | BOYAmt |
| EOY | $3,191,680 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $680,139 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,891,910 | BOYAmt |
| EOY | $7,064,197 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,158,100 | BOYAmt |
| EOY | $4,755,432 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,021,812 | BOYAmt |
| EOY | $11,305,308 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,283 | BOYAmt |
| EOY | $78,283 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,258,195 | BOYAmt |
| EOY | $16,139,023 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,150,105 | BOYAmt |
| EOY | $23,203,220 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$645,435 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$423,101 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$50,636 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,527,046 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,088,947 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,368,142 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,663,064 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,085,473 | CurrentTaxYearAmt |
| Total | $40,732,672 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,527,046 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,088,947 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,368,142 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,663,064 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,085,473 | CurrentTaxYearAmt |
| Total | $40,732,672 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $573,792 | SubstantialContributorsTotAmt |
| Public Support Total170 | $40,158,880 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $647,136 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $453,678 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $277,574 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $272,803 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $252,111 | CurrentTaxYearAmt |
| Total | $1,903,302 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $16,721 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $77,526 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $46,858 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $31,936 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $103,458 | CurrentTaxYearAmt |
| Total | $276,499 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $42,912,473 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $65,132,265 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.93580 | PublicSupportCY170Pct |
| Public Support PY170 | 0.92900 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,744,843 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $383,846 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $442,172 | OtherExpendituresAmt |
| End Year Balance | $9,686,517 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,280,203 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $780,890 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,316,250 | OtherExpendituresAmt |
| End Year Balance | $9,744,843 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,717,603 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,060,445 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $497,845 | OtherExpendituresAmt |
| End Year Balance | $11,280,203 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,785,906 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$544,162 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $524,141 | OtherExpendituresAmt |
| End Year Balance | $10,717,603 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,151,450 | BeginningYearBalanceAmt |
| Contributions | $41,783 | ContributionsAmt |
| Investment Earnings Or Losses | $212,340 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $619,667 | OtherExpendituresAmt |
| End Year Balance | $11,785,906 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.00810 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.99190 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,407,981 | OtherCostOrOtherBasisAmt |
| Book Value | $1,407,981 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,411,609 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,027,865 | DepreciationAmt |
| Book Value | $3,383,744 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $702,769 | OtherCostOrOtherBasisAmt |
| Depreciation | $64,474 | DepreciationAmt |
| Book Value | $638,295 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,518,987 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,056,797 | DepreciationAmt |
| Book Value | $462,190 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,278,326 | OtherCostOrOtherBasisAmt |
| Book Value | $1,278,326 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,170,536 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $1,156,265 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FOREIGN OFFSHORE INVESTMENT | Desc |
| Book Value | $538,020 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $1,694,285 | TotalBookValueSecuritiesAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, PART V | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION HAS ADOPTED AN ENDOWMENT INVESTMENT POLICY, APPROVED BY THE BOARD, FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THESE ENDOWMENT ASSETS OVER THE LONG TERM. THE INVESTMENT POLICY ESTABLISHES AN ACHIEVABLE RETURN OBJECTIVE THROUGH DIVERSIFICATION OF ASSET CLASSES. THE OBJECTIVE IS TO GROW THE AGGREGATE PORTFOLIO VALUE, NET OF SPENDING, AT THE RATE OF INFLATION OVER THE INVESTMENT HORIZON. | ExplanationTxt |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, | RegionTxt |
| Offices | 0 | OfficesCnt |
| Employee | 0 | EmployeeCnt |
| Type Of Activities Conducted | INVESTMENT | TypeOfActivitiesConductedTxt |
| Region Total Expenditures | $538,020 | RegionTotalExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continuation Total Office | 0 | ContinuationTotalOfficeCnt |
| Continuation Total Employee | 0 | ContinuationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $538,020 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $538,020 | TotalSpentAmt |
| Transfer To Foreign Corp | 0 | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | 0 | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MURIEL NOUWEZEM | ||||||||||||||
| INTERIM CEO & CFO | $248,441 | $0 | $0 | $0 | $0 | $0 | $9,250 | $0 | $7,192 | $0 | $264,883 | $0 | $0 | $0 |
| DAVID LUNA | ||||||||||||||
| CHIEF MEDICAL OFFICER | $310,163 | $0 | $0 | $0 | $0 | $0 | $8,940 | $0 | $7,736 | $0 | $326,839 | $0 | $0 | $0 |
| YANINA QUEEN | ||||||||||||||
| DIRECTOR OF PEDIATRICS | $226,357 | $0 | $10,065 | $0 | $0 | $0 | $1,134 | $0 | $3,362 | $0 | $240,918 | $0 | $0 | $0 |
| ARMEN ARSHAKYAN | ||||||||||||||
| CHIEF MEDICAL OFFICER | $217,759 | $0 | $14,734 | $0 | $0 | $0 | $0 | $0 | $18,011 | $0 | $250,504 | $0 | $0 | $0 |
| EMANUEL EMIL MKRTICHIAN | ||||||||||||||
| CHIEF INFORMATION OFFICER | $227,388 | $0 | $4,702 | $0 | $0 | $0 | $4,009 | $0 | $16,323 | $0 | $252,422 | $0 | $0 | $0 |
| FARSHID FARAROOY | ||||||||||||||
| PHYSICIAN PT | $222,483 | $0 | $7,189 | $0 | $0 | $0 | $6,639 | $0 | $16,940 | $0 | $253,251 | $0 | $0 | $0 |
| CHRISTOPHER BRYCHEL | ||||||||||||||
| PHYSICIAN/CLINICAL CHAMPION | $213,085 | $0 | $2,277 | $0 | $0 | $0 | $0 | $0 | $8,475 | $0 | $223,837 | $0 | $0 | $0 |
| JULIE ANNE HUDMAN | ||||||||||||||
| CEO (UNTIL JUNE 1, 2018) | $128,646 | $0 | $0 | $0 | $0 | $0 | $4,983 | $0 | $12,002 | $0 | $145,631 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PROVIDED BONUSES AS FOLLOW: MEDICAL PROVIDER QUARTERLY INCENTIVES -PROVIDERS WHO REACH CERTAIN METRICS OUTLINED BY THE CHIEF MEDICAL OFFICER QUALIFY FOR A QUARTERLY INCENTIVE BONUS. PERFORMANCE EVALUATIONS- ONE TIME BONUSES DISTRIBUTED TO EMPLOYEES IN LIEU OF A MERIT INCREASE IN DECEMBER 2018 FOR THOSE WHO WERE ELIGIBLE BASED OFF THEIR PERFORMANCE REVIEWS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTE IS COMPOSED OF 1) ROBERT BRODER, CO-CHAIR 2) RUSSELL ALEXANDER-OROZCO, CO-CHAIR 3) ANGELA JONES, VICE CHAIR 4) JOANNE DIETCH, SECRETARY 5) MICHAEL ZIERING, TREASURER |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS PREPARED BY AN OUTSIDE CPA FIRM AND THEN REVIEWED AND APPROVED BY THE CEO AND INTERIM CEO. WHEN THE CEO AND COO/CFO HAVE COMPLETED THEIR REVIEW, THE RETURN IS PRESENTED TO THE FULL BOARD OF DIRECTORS BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, BOARD MEMBERS COMPLETE CONFLICT OF INTEREST DOCUMENTS AND SIGN THEM. THESE DOCUMENTS ARE FILED WITH THE EXECUTIVE OFFICE. ANY CONFLICTS THAT SHOULD ARISE ARE REVIEWED BY THE BOARD EXECUTIVE COMMITTEE OR THE CORPORATTE COMPLIANCE OFFICER. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE THAT FUNCTIONS AS A COMPENSATION COMMITTEE WHICH HIRES AN INDEPENDENT CONSULTANT. THIS CONSULTANT PERFORMS SALARY SURVEYS FOR THE CHIEF EXECUTIVE OFFICER(S) AND OTHER KEY EMPLOYEES INDEPENDENTLY, WITHOUT PARTICIPATION OF INTERESTED PERSONS. THE COMPENSATION IS BASED UPON THESE SALARY SURVEYS AND SUBJECT TO BOARD APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | BAD DEBT EXPENSE -50,636. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAFC HOLLYWOOD CENTER ENDOWMENT CORP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8405 BEVERLY BLVD | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90048 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 954323238 | EIN |
| Primary Activities | PROVIDE FINANCIAL SUPPORT TO LOS ANGELES FREE CLINIC | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE LOS ANGELES FREE CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |