2018-05-14T17:28:55-05:00 2017-06-30 954557617 Harrington Group CPAs LLP 234 East Colorado Blvd Suite M150 Pasadena CA 91101 990 2016-07-01 951644040 QueensCare QUEE 3236694305 950 South Grand Avenue 2nd Fl South Los Angeles CA 90015 Barbara B Hines President/CEO 3236694305 2018-05-14 1 Sean E Cain CPA P01612986 6264036801 2016 2022-09-23 18:48:47Z Barbara B Hines 950 South Grand Avenue 2nd Fl South Los Angeles CA 90015 114591737 0 X www.queenscare.org X 1936 CA QueensCare provides a continuum of high quality medical and hospital care to the medically underserved (indigent, unisured, underinsured) residents of Los Angeles County. 16 15 66 0 0 0 442610 388000 163976 121755 12417108 29401512 2980841 3590945 16004535 33502212 10030757 8690254 0 0 2807965 3376595 0 0 0 6648812 6702785 19487534 18769634 -3482999 14732578 378706941 399442875 8259435 7907634 370447506 391535241 X QueensCare provides a continuum of high quality medical and hospital care to the medically underserved (indigent, uninsured, underinsured) residents of Los Angeles County. 0 0 4509531 QueensCare operates jointly with QueensCare Health Centers to provide a network of 5 freestanding family healthcare centers in areas of Los Angeles County that are medically underserved. The health centers provide services to all patients without regard to ability to pay. Each health center is an approved medicaid and medicare provider. The clinics provide free medical care for those who do not have the financial resources or coverage by health plans, insurance or government programs. The clinics provide preventive, diagnostic, and follow-up medical and dental care to the residents of low-income communities. During 2016-2017, the health centers served appoximately 25,000 patients which accounted for 100,000 visits. 7691577 4526577 To support the operation of the QueensCare Health Centers and to further the organization's exempt purpose of providing medical care to the underprivileged and indigent residents of Los Angeles County, QueensCare provides the following medical care support services in coordination with the services provided by the health centers: inpatient and outpatient healthcare services; contract with specialist to provide all fields of medical care. QueensCare provides funding for perinatal service for high-risk pregnancies. 4559568 4163677 121755 QueensCare operates 6 direct care divisions: 1) The Pastoral Care Division provides spiritual care to inpatients and staff at Hollywood Presbyterian Medical Center. During FY 2017, the chaplains visited with 77,016 patients, performed 1,028 anointing and discussed Advance Directives with 267 patients and their families; 2) QueensCare Health and Faith Partnership (QHFP) is the largest parish nurse program in California. There are 16 parish nurses and 5 community health workers. Together they provide immunizations, health screening, CPR training, and parenting classes at the various partner sites including, churches, food pantries, synagogues, senior nutrition sites, the Braille Institute and schools. In addition, QHFP help plan and participated in 583 outreach events and sponsored health fairs; 3) The Mobile Dental Program - QueensCare together with USC School of Dentistry provides mobile dental clinic services at LAUSD's elementary schools. In 2017, QueensCare provided services at 11 schools and served 2,064 children and provided 14,763 visits. In addition, QueensCare provided oral hygiene presentations and instructions to every child in every school visited and distributed 2,200 oral hygiene kits; 4) QueensCare provides mobile vision program to low-income communities through LAUSD. The mobile vision program was offered at 24 LAUSD middle schools and 2 Catholic schools. Total of 2,120 prescriptions were written by QueensCare's optometrist and 1,717 glasses were provided the students at no cost; 5) The Mental Health Program which provided services to 215 children between the ages of 5 and 18 and their families. The children are referred by QueensCare Health Centers, LAUSD, and QHFP because of trauma experienced, as well as other issues; and 6) Charitable Division - The Charitable Board met twice in 2017 and approved 39 grants amounting to $2.0 million were approved. In addition, the Charitable Board also approved 25 scholarships and funded 14 area hospitals with Emergency Medical Services grants amounting to another $2.0 million. 16760676 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 90 0 1 66 1 0 0 0 0 0 0 0 0 0 0 X 16 15 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 CA X X Faith Lee VIce President 3236694345 950 South Grand Avenue 2nd Fl South Los Angeles CA 90015 David Walsh Chair 4.00 2.00 X X 6000 0 0 Bettie J Woods Vice Chair 3.00 2.00 X X 3800 0 0 Sister Judy Murphy CSJ Secretary 10.00 10.00 X X 40500 7250 0 Steven Aronoff Director 2.00 X 4000 0 0 Barbara Bice Director 2.00 X 1650 0 0 Denise Partamian Forgette Director 2.00 X 3400 0 0 Jay Guerena Director 2.00 2.00 X 4050 1250 0 Fran Inman Director 2.00 X 1500 0 0 Tim Lefevre Director(term start 1/17) 2.00 X 500 0 0 Rev Michael Mata Director 2.00 X 0 0 0 Allan Michelena Director 2.00 2.00 X 2000 1000 0 Msgr J Murphy Director 2.00 X 6750 0 0 Gene A Nuziard Director 2.00 2.00 X 5000 750 0 Lois Saffian Director 2.00 X 3400 0 0 Dr Richard E Yoo Director 2.00 X 1000 0 0 Barbara B Hines President & CEO 8.00 32.00 X X 50572 245137 43860 Gary Grubbs CFO 32.00 8.00 X 257062 0 25792 Alan DeJong Director Risk Management 40.00 X 119936 0 27147 Liz Hoang Director HR 40.00 X 164900 0 14710 Arthur Doi Controller 40.00 X 120295 0 25244 Jennifer K Polzin COO 40.00 X 127934 0 10902 Kathy Williamson Director of Operations 40.00 X 119722 0 9115 1043971 255387 156770 6 0 1 0 USC School of Dentisty 1149 S Hill Street Ste H550 Los Angeles CA 90015 Pediatric Dentistry 475090 Canterbury Consulting 660 Newport Center Dr Ste 300 Newport Beach CA 92660 Investment Mgmt Fee 126213 2 388000 388000 Mental Health Project 124100 119150 119150 QHFP Health Screening 900099 2605 2605 121755 5617283 5617283 6207548 2625848 3581700 3581700 3581700 102247906 78463677 23784229 23784229 23784229 Other income 900099 9245 9245 9245 33502212 121755 0 32992457 4163677 4163677 4526577 4526577 500333 500333 2041175 1721738 319437 119180 99508 19672 558986 404990 153996 156921 129932 26989 224618 94100 130518 261927 261927 44241 44241 713219 584695 128524 115357 73108 42249 36476 21696 14780 110949 37431 73518 226231 131236 94995 37043 35559 1484 34239 10523 23716 62935 18971 43964 90580 1896 88684 K-1 Expenses - Q/QHC He 4509531 4509531 Other expense 235439 195508 39931 18769634 16760676 2008958 0 5921602 3377011 492567 0 98151000 14957000 48186171 83194000 278492253 265238864 44839000 47452000 775348 181000 378706941 399442875 3236707 4154836 3381716 2876634 729574 164 911438 876000 8259435 7907634 X 369791018 390878047 656488 657194 370447506 391535241 378706941 399442875 X 14732578 6356034 -877 X 0 1 X 1 0 X Form 990, Schedule A, Part I QueensCare is recognized as a hospital described in section 170(b)(1)(A)(iii) of the Internal revenue Code because its principal purpose is to provide medical care through neighborhood medical clinics and health centers. QueensCare is not licensed to operate a hospital. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 656487 707 657194 655000 1487 656487 655000 655000 655000 655000 655000 655000 1.00000 0 0 20703000 20703000 70818000 13346935 57471065 4480000 249609 4230391 1545000 1360456 184544 605000 605000 83194000 Alt. Mutual Fund Inv. 36279000 F Closely held securities 11173000 F 47452000 Workers compensation liability 876000 876000 X Part V, Line 4: QueensCare intends to use its endowment funds for healthcare related activities. Part X, Line 2: The Organization 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 Organization in its federal and state exempt organization tax returns are more likely than not to be sustained upon examination. The Organization returns are subject to examination by federal and state taxing authorities, generally for three and four years, respectively, after they are filed. 1 1736 Family Crisis Center 2116 Arlington Ave Suite 200 Los Angeles CA 90018 953989251 501(c)3 40000 To fund outpatient healthcare services A Place Called Home 2830 South Central Avenue Los Angeles CA 90011 954427291 501(c)3 100000 To fund outpatient healthcare services Alliance For Housing and Healing 825 Colorado Blvd Los Angeles CA 90041 954147364 501(c)3 25000 To provide health related education or outreach to underserved populations residing in Los Angeles County Amanecer Community Counseling Center 1200 Wilshire Blvd Suite 608 Los Angeles CA 90017 953076578 501(c)3 75000 To fund outpatient healthcare services Asian Pacific AIDS Intervention Team 611 S Kingsley Drive Los Angeles CA 90005 953842506 501(c)3 25000 To provide health related education or outreach to underserved populations residing in Los Angeles County Beverly Hospital 309 W Beverly Blvd Los Angeles CA 90640 237429685 12932 To fund emergency room services provided to uninsured patients residing in Los Angeles County Blind Childrens Center 4120 Marathon Street Los Angeles CA 90029 951656369 501(c)3 65000 To fund outpatient healthcare services California Hospital 1401 S Grand Avenue Los Angeles CA 90015 941196203 501(c)3 3831 To fund emergency room services provided to uninsured patients residing in Los Angeles County California Hospital Med Ctr 1401 S Grand Avenue Los Angeles CA 90015 941196203 501(c)3 51172 To fund transportation to/from hospitals and doctors appointments Care Harbor Los Angeles 18436 Hawthorne Blvd Ste 204 Torrance CA 90504 272984870 501(c)3 25000 To fund outpatient healthcare services Cedars-Sinai Medical Center 8700 Beverly Blvd Los Angeles CA 90048 951644600 501(c)3 26342 To fund emergency room services provided to uninsured patients residing in Los Angeles County Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles CA 90027 951690977 501(c)3 203554 To fund emergency room services provided to uninsured patients residing in Los Angeles County CLARE Foundation 909 Pico Boulevard Santa Monica CA 90405 237076166 501(c)3 85000 To provide health related education or outreach to underserved populations residing in Los Angeles County Complete Care Community Health Center 2928 E Cesar Chavez Avenue Los Angeles CA 90033 731663091 501(c)3 90000 To fund outpatient healthcare services East LA Women's Center 1431 South Atlantic Boulevard Los Angeles CA 90022 510204577 501(c)3 20000 To provide health related education or outreach to underserved populations residing in Los Angeles County Eisner Pediatric and Family Medical Center 1530 South Olive Street Los Angeles CA 90015 651690966 501(c)3 100000 To fund outpatient healthcare services Exceptional Children's Foundation 8740 W Washington Boulevard Culver City CA 90232 951690988 501(c)3 100000 To fund outpatient healthcare services Glendale Memorial Hospital and Health Center 1420 South Central Avenue Glendale CA 91204 941196203 501(c)3 33527 To fund emergency room services provided to uninsured patients residing in Los Angeles County Good Samaritan Hospital 1225 Wilshire Blvd Los Angeles CA 90017 951656366 501(c)3 538820 To fund emergency room services provided to uninsured patients residing in Los Angeles County Good Samaritan Hospital 1225 Wilshire Blvd Los Angeles CA 90017 951656366 501(c)3 68000 To fund transportation to/from hospitals and doctors appointments Good Shepherd Shelter 2561 West Venice Blvd Los Angeles CA 90019 951652906 501(c)3 20000 To provide health related education or outreach to underserved populations residing in Los Angeles County Hollywood Presbyterian Medical Center 1300 N Vermont Avenue Los Angeles CA 90027 300284087 372145 To fund emergency room services provided to uninsured patients residing in Los Angeles County Hope of the Valley 11134 Sepulveda Boulevard Mission Hills CA 91345 272053273 501(c)3 50000 To fund outpatient healthcare services KHEIR 3727 W 6th Street Ste 210 Los Angeles CA 90020 954074660 501(c)3 50000 To fund transportation to/from hospitals and doctors appointments Know the Glow 528 Palisades Drive Ste 199 Pacific Palisades CA 90272 954302067 501(c)3 32500 To provide directly and indirectly linguist access at non profits and other qualified recipients LACUSC Medical Center 1200 N State Street Los Angeles CA 90033 956000927 501(c)3 4790 To fund emergency room services provided to uninsured patients residing in Los Angeles County Little Sisters of the Poor 2100 South Western Avenue San Pedro CA 90732 951972847 501(c)3 100000 To fund outpatient healthcare services Los Angeles LGBT Center 1625 N Schrader Blvd Los Angeles CA 90028 953567895 501(c)3 90000 To fund outpatient healthcare services Los Angeles Youth Network 1853 Taft Avenue Hollywood CA 90028 953953979 501(c)3 25000 To fund outpatient healthcare services MEND (Meet Each Need with Dignity) 10641 San Fernando Road Pacoima CA 91331 237306337 501(c)3 50000 To fund outpatient healthcare services MLK Jr Community Health Foundation 1680 E 120th Street Los Angeles CA 90059 454433505 501(c)3 100000 To provide health related education or outreach to underserved populations residing in Los Angeles County Monterey Park Hospital 900 S Atlantic Blvd Monterey Park CA 91754 510519163 1916 To fund emergency room services provided to uninsured patients residing in Los Angeles County My Friend's Place PO Box 3867 Los Angeles CA 90078 954834034 501(c)3 50000 To provide health related education or outreach to underserved populations residing in Los Angeles County Olympia Medical Center 5900 W Olympica Blvd Los Angeles CA 90036 421643090 80943 To fund emergency room services provided to uninsured patients residing in Los Angeles County PATH Inc 340 North Madison Avenue Los Angeles CA 90004 953950196 501(c)3 50000 To provide health related education or outreach to underserved populations residing in Los Angeles County Project Angel Food 922 Vine Street Los Angeles CA 90038 954115863 501(c)3 50000 To provide health related education or outreach to underserved populations residing in Los Angeles County Sherman Oaks Hospital 4929 Van Nuys Blvd Los Angeles CA 91403 202546649 20116 To fund emergency room services provided to uninsured patients residing in Los Angeles County South Central LAMP 4425 South Central Avenue Los Angeles CA 90011 953877793 501(c)3 30000 To provide health related education or outreach to underserved populations residing in Los Angeles County St John of God Retirement and Care Center 5701 South Hoover Street Los Angeles CA 90037 954067758 501(c)3 50000 To provide health related education or outreach to underserved populations residing in Los Angeles County St Vincent Medcial Center 2131 West Third Street Los Angeles CA 90057 912154438 501(c)3 534989 To fund emergency room services provided to uninsured patients residing in Los Angeles County Step Up On Second 1328 Second Street Second Street CA 90401 954109386 501(c)3 65000 To fund outpatient healthcare services The Children's Bureau 1910 Magnolia Avenue Los Angeles CA 90007 951690975 501(c)3 15000 To provide health related education or outreach to underserved populations residing in Los Angeles County The Salvation Army 2737 Sunset Boulevard Los Angeles CA 90026 951656360 501(c)3 20000 To provide health related education or outreach to underserved populations residing in Los Angeles County UCLA Ronald Reagan Medical Center 757 Westwood Plaza Los Angeles CA 90095 956006143 501(c)3 55558 To fund emergency room services provided to uninsured patients residing in Los Angeles County Universal Community Health Center 2810 S San Pedro Street Los Angeles CA 90011 270600887 501(c)3 90000 To fund outpatient healthcare services Vista Del Mar Child & Family Services 3200 Motor Avenue Los Angeles CA 90034 951647832 501(c)3 30000 To fund outpatient healthcare services WeSPARK Cancer Support Center 13520 Ventura Boulevard Los Angeles CA 91423 954785462 501(c)3 18000 To provide health related education or outreach to underserved populations residing in Los Angeles County Westside Family Health Center 1711 Ocean Park Blvd Santa Monica CA 90405 952931931 501(c)3 100000 To fund outpatient healthcare services White Memorial Medical Center 1720 Ceasar E Chavez Ave Los Angeles CA 90033 953760201 501(c)3 10537 To fund emergency room services provided to uninsured patients residing in Los Angeles County Women's Shelter of Long Beach PO Box 32107 Long Beach CA 90832 951644058 501(c)3 30000 To provide health related education or outreach to underserved populations residing in Los Angeles County Worksite Wellness 5955 S Western Avenue Los Angeles CA 90047 550802354 501(c)3 50000 To provide health related education or outreach to underserved populations residing in Los Angeles County YMCA of Metropolitan Los Angeles 625 S New Hampshire Avenue Los Angeles CA 90005 951644052 501(c)3 15000 To provide health related education or outreach to underserved populations residing in Los Angeles County Young and Healthy 136 West Peoria Street Pasadena CA 91103 954527969 501(c)3 70000 To fund outpatient healthcare services 48 5 Scholarships 27 232130 N/A Inpatient Care Assistance 408 4294447 N/A Part I, Line 2: QueensCare monitors the use of grants it makes by requiring each grantee to supply QueensCare with regular reports that describe how such grantee is using QueensCare's grant funds. In addition, QueensCare often visits a grantee's premises to ensure that the grantee is conducting programs that further QueensCare's charitable mission. QueensCare also requires each grantee to provide QueensCare with a copy of their annual financial reports. X X X X 0 0 0 0 0 0 0 0 0 Barbara B Hines President & CEO 45028 245137 0 0 5544 0 3371 14609 25880 0 79823 259746 0 0 Gary Grubbs CFO 252128 0 0 0 4934 0 14976 0 10816 0 282854 0 0 0 Liz Hoang Director HR 163955 0 0 0 945 0 8198 0 6512 0 179610 0 0 0 Form 990, Part VI, Section A, line 6 St. Joseph's Health Support Alliance, a California non-profit, nonstock, public benefit corporation described in Section 501(c)(3) of the Internal Revenue Code, is the sole corporate member of QueensCare. Form 990, Part VI, Section A, line 7a In its capacity as QueensCare's sole corporate member, St. Joseph's Health Support Alliance has the authority to appoint, remove, and replace each of the members of QueensCare's Board of Directors. Form 990, Part VI, Section A, line 7b St. Joseph's Health Support Alliance, as QueensCare's sole corporate member, has the right to approve certain fundamental transactions, such as amendments to by-laws, QueensCare's Articles of Incorporation or resolutions to dissolve QueensCare's corporate existence. Form 990, Part VI, Section B, line 11b Following preparation of a final draft of the Form 990 by the organization's tax preparers, the organization's CEO and CFO review, analyze and discuss the final draft to better ensure its accuracy and completeness. After the return is filed, the CEO and CFO 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 12c The 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 15a A 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 January 2017. Director Jay Guerena devoted approximately two hours of his time per week to related organizations; QueensCare Health Centers(QHC)and St. Joseph's Health Support Alliance (SJHSA) in his capacity as Director for QHC and SJHSA. Sr. Murphy also provided services to QueensCare as an independent contractor for which she was compensated. Director Allan Michelena devoted approximately 2 hours of his time per week to related organizations; QueensCare Health Centers(QHC) and St. Joseph's Health Support Alliance (SJHSA) in his capacity as Director for QHC and SJHSA. Director David Walsh devoted approximately two hours of his time per week to related organizations; QueensCare Health Centers(QHC)and St. Joseph's Health Support Alliance (SJHSA) in his capacity as Director for QHC and SJHSA. CEO Barbara Hines devoted approximately 32 hours of her time per week to QHC in her capacity as QHC's CEO. QueensCare's CFO, Gary Grubbs, also devoted approximately 8 hours of his time to QHC as its Chief Financial Officer. Director Gene Nuziard devoted approximately 2 hours of his time per week to related organizations; QueensCare Health Centers(QHC)and St. Joseph's Health Support Alliance (SJHSA) in his capacity as Director for QHC and SJHSA. Form 990, Part VI, Section C, line 19 The 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. Form 990, Part XI, line 9: Balancing matter -877. Bridge Street 1525 Bridge Street Yuba CA 95993 951644040 Rental Real Estate CA 1747136 11095051 QueensCare Airway Diego LLC 10132 Airway Road San Diego CA 92154 951644040 Rental Real Estate CA 2388024 20722791 QueensCare QLV - HD LLC 855 Dorrell Lane Las Vegas NV 89086 951644040 Rental Real Estate NV 670000 12862225 QueensCare QLV - INO LLC 6880 North 5th Street Las Vegas NV 89084 951644040 Rental Real Estate NV 158722 3674039 QueensCare QLV - HDR LLC 861 South Rainbow Blvd Las Vegas NV 89145 Rental Real Estate NV 679180 23069703 QueensCare QOR - FXG LLC 20750 Brinson Blvd Bend OR 97701 Rental Real Estate OR 564485 12672586 QueensCare St Joseph's Health Support Alliance 950 South Grand Ave 2nd Fl South Los Angeles CA 90015 940831115 to support QueensCare CA 501(c)(3) Line 12c, III-FI 0 QueensCare Health Centers 950 South Grand Ave 2nd Fl South Los Angeles CA 90015 953702136 provide medical service to the indigent CA 501(c)(3) Line 3 0 Queen of Angels Hollywood Presbyterian Foundation 950 South Grand Ave 2nd Fl South Los Angeles CA 90015 953403582 to support QueensCare CA 501(c)(3) Line 12a, I 1 QQHC Healthcare Partners 950 South Grand Ave 2nd Fl South Los Angeles CA 90015 260502255 To operate and manage Healthcare Clinics CA N/A Related -4509532 13264 0 1 0.40000 0 1 1 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 QQHC HEALTHCARE PARTNERS B 4519792 ACCRUAL ST JOSEPH'S HEALTH SUPPORT ALLIANCE C 300000 ACCRUAL ST JOSEPH'S HEALTH SUPPORT ALLIANCE Q 26727 ACCRUAL QUEENSCARE HEALTH CENTER O 264208 ACCRUAL QUEENSCARE HEALTH CENTER P 279861 ACCRUAL QUEENSCARE HEALTH CENTER Q 696609 ACCRUAL QUEEN OF ANGELS HOLLYWOOD PRESBYTERIAN FOUNDATION C 88323 ACCRUAL QUEEN OF ANGELS HOLLYWOOD PRESBYTERIAN FOUNDATION Q 13223 ACCRUAL QUEENSCARE HEALTH CENTER B 88323 ACCRUAL