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GRACELIGHT COMMUNITY HEALTH: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
GRACELIGHT COMMUNITY HEALTH (EIN 95-3702136)
Tax period
2017-07-01 to 2018-06-30
Filed
2019-05-14
IRS object ID
201911349349304841
Schema version
2017v2.3
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)
Return2019-05-14T12:47:25-05:00ReturnTs
Tax Period End2018-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN954557617PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Harrington Group CPAs LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1234 East Colorado Blvd Suite M150AddressLine1Txt
CityPasadenaCityNm
State AbbreviationCAStateAbbreviationCd
ZIP91101ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN953702136EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1QueensCare Health CentersBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlQUEEBusinessNameControlTxt
Phone3236694305PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1950 South Grand Avenue 2nd Flr SAddressLine1Txt
CityLos AngelesCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90015ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBarbara B HinesPersonNm
Person TitlePresident & CEOPersonTitleTxt
Phone3236694305PhoneNum
Signature2019-05-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSean E Cain CPAPreparerPersonNm
PTINP01612986PTIN
Phone6264036801PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address209.133.35.227IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-05-14IPDt
IP Tm10:47:12IPTm
IP TimezonePDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdC2C22B4F1B9AA0772E09E87A4EA864779F63AD2AAtSubmissionCreationDeviceId
At Submission Filing Device Id0B4F3B71C2EC911E577D967EDC65E3E555B204ACAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBarbara B HinesPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1950 South Grand Avenue 2nd Flr SAddressLine1Txt
CityLos AngelesCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90015ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$32,777,747GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.queenscarehealthcenters.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1925FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionQueensCare Health Centers ("the Centers") directly and indirectly provides medical, dental and vision care services to underserved and neglected populations in Los Angeles County, including the uninsured, indigent, elderly and children.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee286TotalEmployeeCnt
Total Volunteers15TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$23,737NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,560,320PYContributionsGrantsAmt
CY Contributions Grants$4,035,160CYContributionsGrantsAmt
PY Program Service Revenue$24,171,043PYProgramServiceRevenueAmt
CY Program Service Revenue$26,169,357CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$172,215CYInvestmentIncomeAmt
PY Other Revenue$3,476,363PYOtherRevenueAmt
CY Other Revenue$2,401,015CYOtherRevenueAmt
PY Total Revenue$32,207,726PYTotalRevenueAmt
CY Total Revenue$32,777,747CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$16,327,264PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$18,916,584CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$9,189,064PYOtherExpensesAmt
CY Other Expenses$9,688,357CYOtherExpensesAmt
PY Total Expenses$25,516,328PYTotalExpensesAmt
CY Total Expenses$28,604,941CYTotalExpensesAmt
PY Revenues Less Expenses$6,691,398PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$4,172,806CYRevenuesLessExpensesAmt
Total Assets BOY$29,588,347TotalAssetsBOYAmt
Total Assets EOY$33,605,939TotalAssetsEOYAmt
Total Liabilities BOY$1,359,974TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,205,515TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$28,228,373NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$32,400,424NetAssetsOrFundBalancesEOYAmt
MissionQueensCare Health Centers ("the Centers") directly and indirectly provides medical, dental and vision care services to underserved and neglected populations in Los Angeles County.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$21,836,853ExpenseAmt
Revenue$28,570,372RevenueAmt
DescQueensCare Health Centers provides directly and through Q/QHC Healthcare Partners, medical, dental and vision services to underserved populations, including the uninsured, indigent, elderly and children. During this fiscal year, QueensCare Health Centers provided services to Approximately 25,000 patients which accounted for more than 112,000 visits.Desc
Total Program Service Expenses$21,836,853TotalProgramServiceExpensesAmt
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
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
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 Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document53IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee286EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
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
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Arthur DoiBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3236694317PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1950 South Grand Avenue 2nd Flr SAddressLine1Txt
CityLos AngelesCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90015ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Jay Guerena
Chair2.002.00Yes (X)Yes (X)$0$1,500$0
Marina Aronoff
Vice Chair2.00Yes (X)Yes (X)$0$0$0
Yasmin Garcia
Secretary2.00Yes (X)Yes (X)$0$0$0
Jorge Blanco
Director2.00Yes (X)$0$0$0
Jacquelyn P Pantoja
Director2.00Yes (X)$0$0$0
Mary Ramos
Director2.00Yes (X)$0$0$0
Manuel Romero
Director2.00Yes (X)$0$0$0
Martha Arias
Director2.00Yes (X)$0$0$0
Serina Demirians
Director2.00Yes (X)$0$0$0
Harry Kram MD
Director2.00Yes (X)$0$0$0
Shirley Daniels
Director2.00Yes (X)$0$0$0
William Chim
Director2.00Yes (X)$0$0$0
Jeffrey Hermann
Director2.002.00Yes (X)$0$0$0
Allan Michelena
Director2.002.00Yes (X)$0$2,150$0
Matthew Wells
Director2.00Yes (X)$0$0$0
Barbara B Hines
President & CEO20.0020.00Yes (X)$294,094$62,283$42,882
Gary C Grubbs
CFO(term end 7/17)8.0032.00Yes (X)$0$273,004$17,623
Anitha Lakshmi Mullangi
Chief Medical Officer(term end 10/17)40.00Yes (X)$163,766$0$11,848
John Nguyen MD
Chief Medical Officer(term start 12/17)40.00Yes (X)$3,288$0$0
Eloisa Perard
CAO40.00Yes (X)$0$94,038$3,933
Chad Vargas
COO40.00Yes (X)$120,156$0$13,155
Arthur Doi
VP Accounting & Finance40.00Yes (X)$0$139,571$23,125
Jennifer Polzin
COO (Term end 10/1740.00Yes (X)$0$146,796$11,660
Maria T Lim Heya
Physician40.00$229,206$0$29,831Yes (X)
Yung Soon Ahn
Physician40.00$217,151$0$19,997Yes (X)
Moe Aung MD
Physician40.00$203,251$0$19,646Yes (X)
Moe Kyi MD
Physician40.00$197,903$0$27,719Yes (X)
Eric Celo
Physician40.00$193,040$0$11,023Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,621,855TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$719,342TotReportableCompRltdOrgAmt
Total Other Compensation$232,442TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K32IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
University of So Cal School of Pharmacy
1985 Zonal Ave PSC 700ALos AngelesCA90089Pharmacist Services$471,895
Quest Diagnostics Inc
PO Box 5068Los AngelesCA90074Medical Laboratories Services$256,597
Ryan K Lee MD
222 West Eulalia Street Suite 211GlendaleCA91204Independent Contractor$194,228
Justinder S Malhotra MD
PO Box 811424Los AngelesCA90081Independent Contractor$110,935
Progressive Dental Studio
1110 North Orchard DriveBurbankCA91506Dental Lab Services$109,547
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Government Grants$3,980,782GovernmentGrantsAmt
All Other Contributions$54,378AllOtherContributionsAmt
Total Contributions$4,035,160TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue621400$21,625,586$21,625,586
Q/QHC Healthcare Partners621400$4,543,771$4,543,771
FieldValueIRS element (for citing)
Total Program Service Revenue$26,169,357TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$172,215TotalRevenueColumnAmt
Exclusion$172,215ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOther incomeDesc
Business621400BusinessCd
Total Revenue Column$2,401,015TotalRevenueColumnAmt
Related Or Exempt Func Income$2,401,015RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,401,015OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$32,777,747TotalRevenueColumnAmt
Related Or Exempt Func Income$28,570,372RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$172,215ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$928,699TotalAmt
Management And General$928,699ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$13,213,196TotalAmt
Program Services$11,023,350ProgramServicesAmt
Management And General$2,189,846ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$668,317TotalAmt
Program Services$556,350ProgramServicesAmt
Management And General$111,967ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,092,812TotalAmt
Program Services$2,597,215ProgramServicesAmt
Management And General$495,597ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,013,560TotalAmt
Program Services$843,507ProgramServicesAmt
Management And General$170,053ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$27,085TotalAmt
Program Services$4,828ProgramServicesAmt
Management And General$22,257ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$80,037TotalAmt
Management And General$80,037ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$607,010TotalAmt
Program Services$519,425ProgramServicesAmt
Management And General$87,585ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$219,811TotalAmt
Management And General$219,811ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$82,147TotalAmt
Program Services$70,121ProgramServicesAmt
Management And General$12,026ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,197,530TotalAmt
Program Services$1,669ProgramServicesAmt
Management And General$1,195,861ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,317,203TotalAmt
Program Services$888,576ProgramServicesAmt
Management And General$428,627ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$63,743TotalAmt
Program Services$14,435ProgramServicesAmt
Management And General$49,308ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$539,714TotalAmt
Program Services$448,988ProgramServicesAmt
Management And General$90,726ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$117,385TotalAmt
Program Services$59,902ProgramServicesAmt
Management And General$57,483ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Pharmaceuticals$1,210,351$1,210,351
Purchased services$1,117,138$934,246$182,892
Physician Fees$967,071$967,071
Medical & Other supplie$562,007$545,254$16,753

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,580,125TotalAmt
Program Services$1,151,565ProgramServicesAmt
Management And General$428,560ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$28,604,941TotalAmt
Program Services$21,836,853ProgramServicesAmt
Management And General$6,768,088ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,170BOYAmt
EOY$4,170EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,753,464BOYAmt
EOY$9,088,021EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,815,790BOYAmt
EOY$354,999EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,615,214BOYAmt
EOY$6,744,804EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$10,974,470BOYAmt
EOY$10,974,470EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$100,023BOYAmt
EOY$145,077EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$339,802BOYAmt
EOY$385,613EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$7,930,505LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,072,892LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,222,166BOYAmt
EOY$857,613EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,987,162BOYAmt
EOY$5,758,164EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY-$223,914BOYAmt
EOY-$706,992EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$29,588,347BOYAmt
EOY$33,605,939EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,359,974BOYAmt
EOY$1,205,515EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,359,974BOYAmt
EOY$1,205,515EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$28,218,650BOYAmt
EOY$32,390,701EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,723BOYAmt
EOY$9,723EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$28,228,373BOYAmt
EOY$32,400,424EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$29,588,347BOYAmt
EOY$33,605,939EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$4,172,806ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$755NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,722BeginningYearBalanceAmt
End Year Balance$9,722EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,722BeginningYearBalanceAmt
End Year Balance$9,722EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$69,382BeginningYearBalanceAmt
Other Expenditures$59,660OtherExpendituresAmt
End Year Balance$9,722EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$219,953BeginningYearBalanceAmt
Other Expenditures$150,571OtherExpendituresAmt
End Year Balance$69,382EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$847,310BeginningYearBalanceAmt
Contributions$333,763ContributionsAmt
Other Expenditures$961,120OtherExpendituresAmt
End Year Balance$219,953EndYearBalanceAmt
FieldValueIRS element (for citing)
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,372,562OtherCostOrOtherBasisAmt
Depreciation$1,141,117DepreciationAmt
Book Value$231,445BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,557,943OtherCostOrOtherBasisAmt
Depreciation$5,931,775DepreciationAmt
Book Value$626,168BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$857,613TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescTreasury securitiesDesc
Book Value$5,758,164BookValueAmt
Method ValuationCMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$5,758,164TotalBookValueSecuritiesAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:QueensCare Health Centers ("the Centers") intends to use its endowment funds to support healthcare related activities.
Part X, Line 2:The Centers is exempt from taxation under Internal Revenue Code Section 501(c)(3) and California Revenue and Taxation Code Section 23701d. Generally accepted accounting principles provide accounting and disclosure guidance about positions taken by an organization in its tax returns that might be uncertain. Management has considered its tax positions and believes that all of the positions taken by the Centers in its federal and state exempt organization tax returns are more likely than not to be sustained upon examination. The Centers' returns are subject to examination by federal and state taxing authorities, generally for three and four years, respectively, after they are filed.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
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 (10 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Barbara B Hines
President & CEO$294,094$56,739$0$0$0$5,544$17,267$3,884$15,182$6,549$326,543$72,716$0$0
Gary C Grubbs
CFO(term end 7/17)$0$270,126$0$0$0$2,878$0$13,076$0$4,547$0$290,627$0$0
Anitha Lakshmi Mullangi
Chief Medical Officer(term end 10/17$163,363$0$0$0$403$0$9,489$0$2,359$0$175,614$0$0$0
Arthur Doi
VP Accounting & Finance$0$138,178$0$0$0$1,393$0$8,555$0$14,570$0$162,696$0$0
Jennifer Polzin
COO (Term end 10/17$0$146,271$0$0$0$525$0$8,946$0$2,714$0$158,456$0$0
Maria T Lim Heya
Physician$228,240$0$0$0$966$0$13,851$0$15,980$0$259,037$0$0$0
Yung Soon Ahn
Physician$214,379$0$0$0$2,772$0$12,835$0$7,162$0$237,148$0$0$0
Moe Aung MD
Physician$202,831$0$0$0$420$0$12,280$0$7,366$0$222,897$0$0$0
Moe Kyi MD
Physician$197,483$0$0$0$420$0$12,152$0$15,567$0$225,622$0$0$0
Eric Celo
Physician$191,270$0$0$0$1,770$0$11,023$0$0$0$204,063$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 3Pursuant to that certain Amended and Restated Partnership Agreement, QueensCare Health Centers and QueensCare formed Q/QHC Healthcare Partners to jointly operate five community health centers located in the greater Los Angeles area. QueensCare's responsibilities under the terms of that Agreement include supervision of medical treatments, measuring outcomes, providing day-to-day management for the operation of Q/QHC Healthcare Partners and on-site management of the Centers' personnel to include hiring, training, and discharging the Centers' personnel. Form 990, Part VII, Section A, Hours of Officers: Director Allan Michelena devoted approximately two hours of his time per week to a related organization, QueensCare, serving as a director of QueensCare. Board Chairman Jay Guerena devoted approximately two hours of his time per week to QueensCare serving as a director of QueensCare. CEO Barbara B. Hines devoted approximately 8 hours of her time per week serving as QueensCare's CEO. CFO Gary C. Grubbs also devoted approximately 32 hours of his time per week serving as QueensCare's Chief Financial Officer. Director Jeffrey Hermann devoted approximately two hours of his time per week to QueensCare, serving as a director of QueensCare.
Form 990, Part VI, Section B, line 11bFollowing preparation of a final draft of the Form 990 by the organization's tax preparers, the organization's CEO and VP Accounting & Finance review, analyze and discuss the final draft to better ensure its accuracy and completeness. After the return is filed, the CEO and VP Accounting & Finance review and discuss material aspects and details of the return at the next regularly scheduled meeting of the Board of Directors.
Form 990, Part VI, Section B, line 12cThe organization's Board members, corporate officers, and staff are subject to a written conflicts of interest policy. Pursuant to that policy, each such person is required to identify any transaction with the organization in which the person has (or may have) a financial interest. If a conflict (or potential conflict) is identified, the Board, excluding any involved Board members, carefully reviews the terms of the transaction and makes a determination as to whether the transaction is fair and reasonable to the organization under all the facts and circumstances. The organization monitors and enforces compliance with this policy by: (i) discussing such issues at its annual meeting; (ii) requiring all covered persons to annually provide written certification of their compliance with the policy; and (iii) carefully reviewing all material transactions to identify potential or real conflicts.
Form 990, Part VI, Section B, line 15aA Compensation Committee comprised of independent Board members formulates a proposed compensation level for the CEO by reviewing general compensation data for similarly situated organizations. Following such a review, the Compensation Committee presents its findings and recommendations to the Board at which Board members are provided with the opportunity to ask questions. Based on the findings and recommendations of the Compensation Committee, a Board vote is taken to establish the new compensation level for the CEO. Deliberations of the Compensation Committee and the Board are recorded in the organization's minute book. The evaluation, review, and recommendation process was last undertaken by the Compensation Committee in April 2017 and its findings and recommendations with regard to the CEO's compensation level were approved by the Board in September 2017.
Form 990, Part VI, Section C, line 19The organization's annual information return (Form 990) is available on a third-party website (GuideStar). The organization provides copies of its governing documents, its conflict of interest policy, as well as its three most recent Forms 990 to any interested person that makes a request for such documents.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
QueensCare
950 S Grand Ave 2nd Fl SouthLos AngelesCA90015951644040Healthcare for the poorCA501(c)(3)Line 7St Joseph's Health Support Alliance0
QueensCare Health Centers Foundation
950 S Grand Ave 2nd Fl SouthLos AngelesCA90015463366321Support QHC missionCA501(c)(3)Line 7QueensCare Health Centers0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1QQHC Healthcare PartnersBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1950 S Grand Ave 2nd Fl SouthAddressLine1Txt
CityLos AngelesCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90015ZIPCd
FieldValueIRS element (for citing)
EIN260502255EIN
Primary ActivitiesTo operate & Manage Healthcare ClinincsPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Predominant Income TypeRelatedPredominantIncomeTypeTxt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing PartnerYes (1)GeneralOrManagingPartnerInd
Ownership0.60000OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
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 OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (9 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
QueensCare
C$8,889Accrual
QueensCare
O$197,011Accrual
QueensCare
P$508,761Accrual
QueensCare
Q$215,251Accrual
QueensCare Health Centers Foundation
K$215,000Accrual
QQHC Healthcare Partners
B$6,797,378Accrual
QQHC Healthcare Partners
J$4,531,786Accrual
QQHC Healthcare Partners
L$11,359,429Accrual
QueensCare Health Centers Foundation
S$78,962Accrual