PEDIATRIC AND FAMILY MEDICAL CENTER: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- PEDIATRIC AND FAMILY MEDICAL CENTER (EIN 95-1690966)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-10
- IRS object ID
- 201921309349305412
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-10T18:00:34-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 330700332 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VASQUEZ & CO LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 655 N CENTRAL AVE STE 1550 | AddressLine1Txt |
| City | GLENDALE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 951690966 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEDIATRIC & FAMILY MEDICAL CENTER | BusinessNameLine1Txt |
| Business Name Line2 | DBA EISNER HEALTH | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PEDI | BusinessNameControlTxt |
| Phone | 2137475542 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1530 SOUTH OLIVE STREET | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90015 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EUGENE VEKSLER | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 2137475542 | PhoneNum |
| Signature | 2019-05-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LYNN D BOSTER | PreparerPersonNm |
| PTIN | P00440365 | PTIN |
| Phone | 2138731700 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 12.246.196.18 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-09 | IPDt |
| IP Tm | 16:09:04 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 1D28454CB9351EBB41F41CE8F1F3659ED1FF0C12 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 25D4679CBD63AF40F0B427329F599593086348EB | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | WARREN J BRODINE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1530 S OLIVE STREET | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90015 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $49,636,333 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.EISNERHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1920 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | IMPROVE THE PHYSICAL, SOCIAL, AND EMOTIONAL WELL-BEING OF LOS ANGELES FAMILIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 564 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,572,946 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,185,931 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $39,519,469 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $43,289,849 | CYProgramServiceRevenueAmt |
| PY Investment Income | $649 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,901 | CYInvestmentIncomeAmt |
| PY Other Revenue | $155,435 | PYOtherRevenueAmt |
| CY Other Revenue | $92,297 | CYOtherRevenueAmt |
| PY Total Revenue | $46,248,499 | PYTotalRevenueAmt |
| CY Total Revenue | $49,570,978 | 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 | $32,382,274 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $34,283,702 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $602,068 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,005,556 | PYOtherExpensesAmt |
| CY Other Expenses | $12,823,933 | CYOtherExpensesAmt |
| PY Total Expenses | $44,387,830 | PYTotalExpensesAmt |
| CY Total Expenses | $47,107,635 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,860,669 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,463,343 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $29,536,986 | TotalAssetsBOYAmt |
| Total Assets EOY | $31,413,146 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,491,108 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,903,925 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $24,045,878 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $26,509,221 | NetAssetsOrFundBalancesEOYAmt |
| Mission | EISNER HEALTH IS A QUALITY-FOCUSED, FEDERALLY QUALIFIED NONPROFIT COMMUNITY HEALTH CENTER DEDICATED TO IMPROVING THE PHYSICAL, SOCIAL, AND EMOTIONAL WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE, REGARDLESS OF INCOME. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $30,065,397 | ExpenseAmt |
| Revenue | $34,425,004 | RevenueAmt |
| Desc | MEDICAL CARE- PHYSICAL EXAMS- IMMUNIZATIONS- GYNECOLOGY SERVICES- COUNSELING- PREVENTATIVE MEDICINE- DIAGNOSIS AND MANAGEMENT OF ACUTE AND CHRONIC DISEASES- DIAGNOSIS AND CARE DURING PREGNANCY- OFFICE DERMATOLOGY TOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 38,124. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,288,948 | ExpenseAmt |
| Revenue | $5,233,691 | RevenueAmt |
| Desc | DENTAL CARE- PREVENTATIVE DENTAL EXAMS- DIAGNOSIS AND TREATMENT OF DENTAL AND GUM PROBLEMS- ORTHODONTIC SERVICESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 10,008. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,093,217 | ExpenseAmt |
| Revenue | $3,801,700 | RevenueAmt |
| Desc | MENTAL HEALTH CARE, PHARMACEUTICAL SERVICES, AND OPTOMETRY SERVICES- INDIVIDUAL THERAPY- FAMILY THERAPY- GROUP THERAPY- CASE MANAGEMENT- WORKSHOPS- PARENTING CLASSES- DISPENSING PHARMACEUTICALS TO PATIENTS- SUPPLYING CLINICAL DEPARTMENTS- OPTOMETRY SERVICES TOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 1,528(757 MENTAL HEALTH, 771 OPTOMETRY). | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $38,447,562 | 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 | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 59 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 564 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| 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 | SERGEY NAVOLNEV | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2137475542 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1530 SOUTH OLIVE STREET | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90015 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| STANLEY P BERKMAN | ||||||||
| BOARD CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| IAN C WIENER ESQ | ||||||||
| BOARD TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| IRMA AVILA | ||||||||
| BOARD SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ALEJANDRA ROSAS | ||||||||
| CONSUMER BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CAROLINA LIZAMA | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RUPERT GRANT | ||||||||
| VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ED MATHEWS | ||||||||
| CONSUMER VICE-CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| KEVIN ROSSI | ||||||||
| IMMEDIATE PAST CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARTINE SINGER | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DEE SHAW | ||||||||
| MEMBER AT-LARGE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| VICTOR AGUIRRE | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WARREN J BRODINE | ||||||||
| PRESIDENT & CEO | 40.00 | Yes (X) | $273,487 | $0 | $26,366 | |||
| CHONA DE LEON | ||||||||
| VP/COO | 40.00 | Yes (X) | $267,649 | $0 | $20,553 | |||
| EUGENE VEKSLER | ||||||||
| VP BUSINESS DEV'T & CFO | 40.00 | Yes (X) | $205,650 | $0 | $12,358 | |||
| DEBORAH LERNER | ||||||||
| VP CHIEF MEDICAL OFFICER | 40.00 | Yes (X) | $270,659 | $0 | $14,450 | |||
| KAREN BOSTON | ||||||||
| PHYSICIAN/ACTING DIRECTOR OF ADULT | 40.00 | $195,587 | $0 | $12,073 | Yes (X) | |||
| LAILA AL-MARAYATI | ||||||||
| DIRECTOR OF OB SERVICE | 40.00 | $244,299 | $0 | $13,952 | Yes (X) | |||
| LUIS LOPEZ | ||||||||
| DIRECTOR OF PEDIATRICS | 40.00 | $247,537 | $0 | $13,779 | Yes (X) | |||
| ANTHONY PICKETT | ||||||||
| PHYSICIAN (OB/GYN) | 40.00 | $278,165 | $0 | $14,501 | Yes (X) | |||
| NICOLAS DIKIO | ||||||||
| PHYSICIAN (OB/GYN) | 40.00 | $251,137 | $0 | $14,415 | Yes (X) | |||
| LILIAN MORRIS | ||||||||
| PHYSICIAN (OB/GYN) | 40.00 | $272,540 | $0 | $11,024 | Yes (X) | |||
| DANNY DAN | ||||||||
| PHYSICIAN (OB/GYN) | 40.00 | $277,218 | $0 | $14,501 | Yes (X) | |||
| AHMAD KHALIFA | ||||||||
| PHYSICIAN (OB/GYN) | 40.00 | $252,432 | $0 | $14,251 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,036,360 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $182,223 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 82 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| RPS CAPITAL INVESTMENTS | |||||
| 15477 VENTURA BLVD STE 202 | SHERMAN OAKS | CA | 91403 | OFFICE RENT | $816,026 |
| PEOPLE 20 GLOBAL LLC | |||||
| PO BOX 31001-1288 | PASADENA | CA | 91110 | TEMPORARY LABOR | $452,921 |
| GRAND AVENUE MEDICAL JOINT VENTURE | |||||
| 135 N LOS ROBLES STE 600 | PASADENA | CA | 91101 | OFFICE RENT | $436,787 |
| SP IV LOKER I LLC | |||||
| 600 WASHINGTON AVE STE 1100 | ST LOUIS | MO | 63101 | OFFICE RENT | $370,742 |
| QUEST DIAGNOSTICS | |||||
| 8511 FALLBROOK AVE 2ND FLR | WEST HILLS | CA | 91304 | LABS | $271,215 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $173,714 | FundraisingAmt |
| Related Organizations | $124,759 | RelatedOrganizationsAmt |
| Government Grants | $3,956,182 | GovernmentGrantsAmt |
| All Other Contributions | $1,931,276 | AllOtherContributionsAmt |
| Total Contributions | $6,185,931 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE FEES | 624110 | $41,111,861 | $41,111,861 |
| INCENTIVES | 624110 | $2,177,988 | $2,177,988 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $43,289,849 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,901 | TotalRevenueColumnAmt |
| Exclusion | $2,901 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $22,646 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $173,714 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $65,355 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$42,709 | TotalRevenueColumnAmt |
| Exclusion | -$42,709 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $135,006 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $135,006 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $135,006 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,570,978 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $43,424,855 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$39,808 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,704,868 | TotalAmt |
| Program Services | $1,704,868 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,320,453 | TotalAmt |
| Program Services | $22,610,528 | ProgramServicesAmt |
| Management And General | $4,380,866 | ManagementAndGeneralAmt |
| Fundraising | $329,059 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $794,495 | TotalAmt |
| Program Services | $648,410 | ProgramServicesAmt |
| Management And General | $135,439 | ManagementAndGeneralAmt |
| Fundraising | $10,646 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,497,410 | TotalAmt |
| Program Services | $2,092,157 | ProgramServicesAmt |
| Management And General | $376,941 | ManagementAndGeneralAmt |
| Fundraising | $28,312 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,966,476 | TotalAmt |
| Program Services | $1,648,126 | ProgramServicesAmt |
| Management And General | $293,602 | ManagementAndGeneralAmt |
| Fundraising | $24,748 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,484,130 | TotalAmt |
| Program Services | $1,889,370 | ProgramServicesAmt |
| Management And General | $544,589 | ManagementAndGeneralAmt |
| Fundraising | $50,171 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,656 | TotalAmt |
| Program Services | $525 | ProgramServicesAmt |
| Management And General | $42,262 | ManagementAndGeneralAmt |
| Fundraising | $4,869 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,264,922 | TotalAmt |
| Program Services | $2,101,271 | ProgramServicesAmt |
| Management And General | $163,651 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,150 | TotalAmt |
| Program Services | $30,872 | ProgramServicesAmt |
| Management And General | $32,303 | ManagementAndGeneralAmt |
| Fundraising | $975 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,277 | TotalAmt |
| Program Services | $53,200 | ProgramServicesAmt |
| Management And General | $77 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,303,441 | TotalAmt |
| Program Services | $1,303,441 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,760 | TotalAmt |
| Program Services | $115,596 | ProgramServicesAmt |
| Management And General | $130,164 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $1,847,286 | $1,636,066 | $205,817 | $5,403 |
| MEDICAL SUPPLIES | $934,309 | $934,309 | ||
| MILEAGE & PARKING | $561,152 | $469,870 | $86,191 | $5,091 |
| COMPUTER EXPENSES | $528,957 | $434,866 | $93,006 | $1,085 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,488,893 | TotalAmt |
| Program Services | $774,087 | ProgramServicesAmt |
| Management And General | $1,573,097 | ManagementAndGeneralAmt |
| Fundraising | $141,709 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,107,635 | TotalAmt |
| Program Services | $38,447,562 | ProgramServicesAmt |
| Management And General | $8,058,005 | ManagementAndGeneralAmt |
| Fundraising | $602,068 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $135,801 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $811,044 | BOYAmt |
| EOY | $189,837 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,056,071 | BOYAmt |
| EOY | $1,984,063 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,978,600 | BOYAmt |
| EOY | $11,879,286 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $307,238 | BOYAmt |
| EOY | $474,181 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $478,623 | BOYAmt |
| EOY | $697,000 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $29,080,872 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $14,180,423 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,744,239 | BOYAmt |
| EOY | $14,900,449 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $869,823 | BOYAmt |
| EOY | $869,823 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $291,348 | BOYAmt |
| EOY | $282,706 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,536,986 | BOYAmt |
| EOY | $31,413,146 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,716,814 | BOYAmt |
| EOY | $3,928,160 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,774,294 | BOYAmt |
| EOY | $975,765 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,491,108 | BOYAmt |
| EOY | $4,903,925 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,087,038 | BOYAmt |
| EOY | $25,336,318 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $958,840 | BOYAmt |
| EOY | $1,172,903 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,045,878 | BOYAmt |
| EOY | $26,509,221 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,536,986 | BOYAmt |
| EOY | $31,413,146 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,463,343 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $952,246 | OtherCostOrOtherBasisAmt |
| Book Value | $952,246 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $19,853,673 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,526,795 | DepreciationAmt |
| Book Value | $12,326,878 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,386,668 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,004,071 | DepreciationAmt |
| Book Value | $1,382,597 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $888,285 | OtherCostOrOtherBasisAmt |
| Depreciation | $649,557 | DepreciationAmt |
| Book Value | $238,728 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,900,449 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $49,570,978 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $49,570,978 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $49,570,978 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $47,107,635 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $47,107,635 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $47,107,635 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE CORPORATION QUALIFIES AS A TAX EXEMPT ORGANIZATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAXATION CODE 23701D. THE CORPORATION HAS EVALUATED ITS TAX POSITIONS AND THE CERTAINTY AS TO WHETHER THOSE POSITIONS WILL BE SUSTAINED IN THE EVENT OF AN AUDIT BY TAXING AUTHORITIES AT THE FEDERAL AND STATE LEVELS. THE PRIMARY TAX POSITIONS EVALUATED RELATE TO THE CORPORATIONS CONTINUED QUALIFICATION AS A TAX-EXEMPT ORGANIZATION AND WHETHER THERE ARE UNRELATED BUSINESS INCOME ACTIVITIES THAT WOULD BE TAXABLE. MANAGEMENT HAS DETERMINED THAT ALL INCOME TAX POSITIONS WILL MORE LIKELY THAN NOT (>50%) BE SUSTAINED UPON POTENTIAL AUDIT OR EXAMINATION; THEREFORE, NO DISCLOSURE OF UNCERTAIN INCOME TAX POSITIONS ARE REQUIRED. THE CORPORATION FILES INFORMATION RETURNS IN THE US FEDERAL JURISDICTION AND THE STATE OF CALIFORNIA. WITH FEW EXCEPTIONS, THE CORPORATION IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2013. | ExplanationTxt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | PROMISE OF CARE | Event1Nm |
| Gross Receipts Event1 | $196,360 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $173,714 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $22,646 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $489 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $24,315 | RentFacilityCostsEvent1Amt |
| Other Direct Expenses Event1 | $40,551 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $196,360 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $173,714 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $22,646 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $489 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $24,315 | RentFcltyCostsTotalEventsAmt |
| Oth Direct Expnss Total Events | $40,551 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $65,355 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$42,709 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WARREN J BRODINE | ||||||||||||||
| PRESIDENT & CEO | $273,487 | $0 | $0 | $0 | $0 | $0 | $20,115 | $0 | $6,251 | $0 | $299,853 | $0 | $0 | $0 |
| CHONA DE LEON | ||||||||||||||
| VP/COO | $267,649 | $0 | $0 | $0 | $0 | $0 | $14,302 | $0 | $6,251 | $0 | $288,202 | $0 | $0 | $0 |
| EUGENE VEKSLER | ||||||||||||||
| VP BUSINESS DEV'T & CFO | $205,650 | $0 | $0 | $0 | $0 | $0 | $6,173 | $0 | $6,185 | $0 | $218,008 | $0 | $0 | $0 |
| DEBORAH LERNER | ||||||||||||||
| VP CHIEF MEDICAL OFFICER | $270,659 | $0 | $0 | $0 | $0 | $0 | $8,199 | $0 | $6,251 | $0 | $285,109 | $0 | $0 | $0 |
| KAREN BOSTON | ||||||||||||||
| PHYSICIAN/ACTING DIRECTOR OF ADULT | $195,587 | $0 | $0 | $0 | $0 | $0 | $6,139 | $0 | $5,934 | $0 | $207,660 | $0 | $0 | $0 |
| LAILA AL-MARAYATI | ||||||||||||||
| DIRECTOR OF OB SERVICE | $244,299 | $0 | $0 | $0 | $0 | $0 | $7,701 | $0 | $6,251 | $0 | $258,251 | $0 | $0 | $0 |
| LUIS LOPEZ | ||||||||||||||
| DIRECTOR OF PEDIATRICS | $247,537 | $0 | $0 | $0 | $0 | $0 | $7,528 | $0 | $6,251 | $0 | $261,316 | $0 | $0 | $0 |
| ANTHONY PICKETT | ||||||||||||||
| PHYSICIAN (OB/GYN) | $278,165 | $0 | $0 | $0 | $0 | $0 | $8,250 | $0 | $6,251 | $0 | $292,666 | $0 | $0 | $0 |
| NICOLAS DIKIO | ||||||||||||||
| PHYSICIAN (OB/GYN) | $251,137 | $0 | $0 | $0 | $0 | $0 | $8,164 | $0 | $6,251 | $0 | $265,552 | $0 | $0 | $0 |
| LILIAN MORRIS | ||||||||||||||
| PHYSICIAN (OB/GYN) | $272,540 | $0 | $0 | $0 | $0 | $0 | $8,176 | $0 | $2,848 | $0 | $283,564 | $0 | $0 | $0 |
| DANNY DAN | ||||||||||||||
| PHYSICIAN (OB/GYN) | $277,218 | $0 | $0 | $0 | $0 | $0 | $8,250 | $0 | $6,251 | $0 | $291,719 | $0 | $0 | $0 |
| AHMAD KHALIFA | ||||||||||||||
| PHYSICIAN (OB/GYN) | $252,432 | $0 | $0 | $0 | $0 | $0 | $8,000 | $0 | $6,251 | $0 | $266,683 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY THE CFO, THEN IT IS GIVEN TO ALL BOARD MEMBERS FOR FINAL REVIEW PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUAL QUESTIONAIRES ARE GIVEN TO ALL DIRECTORS AND OFFICERS. THE GOVERNANCE COMMITTEE THEN REVIEWS THE QUESTIONAIRE TO ENSURE THE COMPLIANCE OF THE CONFLICT OF INTEREST POLICY. IF A CONFLICT ARISES, IT IS RESOLVED THROUGH BOARD DISCUSSION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE GOVERNANCE COMMITTEE USES INDEPENDENT CONSULTANT AND A COMPENSATION SURVEY STUDY IN ORDER TO DETERMINE THE COMPENSATION FOR THE CEO, OFFICERS, AND KEY EMPLOYEES. ONCE THE COMPENSATION IS DETERMINED, IT IS PRESENTED TO THE ENTIRE BOARD FOR APPROVAL INDEPENDENTLY, WITHOUT THE PARTICIPATION OF INTERESTED PERSONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEDIATRIC & FAMILY MEDICAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1530 S OLIVE STREET | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90015 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 954116680 | EIN |
| Primary Activities | TO HOLD & INVEST ASSETS ON BEHALF OF PEDIATRIC & FAMILY MEDICAL CENTER | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12C, III-FI | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | 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 | 0 | 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 |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEDIATRIC & FAMILY MEDICAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $124,759 | InvolvedAmt |
| Method Of Amount Determination | BOOK | MethodOfAmountDeterminationTxt |