2017-05-11T19:41:21-05:00 2016-06-30 954557617 Harrington Group CPAs LLP 234 East Colorado Blvd Suite M150 Pasadena CA 91101 990 2015-07-01 951644040 QueensCare QUEE 3236694304 950 South Grand Avenue 2nd Fl South Los Angeles CA 90015 Gary C Grubbs CFO 3236694304 2017-05-11 1 Sean E Cain CPA P01612986 6264036801 2015 2021-01-29 14:40:06Z Barbara B Hines 950 South Grand Avenue 2nd Fl South Los Angeles CA 90015 89093588 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 55 0 0 1672790 458087 442610 149959 163976 27787288 12417108 368236 2980841 28763570 16004535 9512940 10030757 0 0 3209893 2807965 0 0 0 7629164 6648812 20351997 19487534 8411573 -3482999 405373441 378706941 12629634 8259435 392743807 370447506 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 4462839 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 2015-2016, the health centers served appoximately 29,000 patients which accounted for 108,000 visits. QueensCare also provides mobile vision and dental programs to low-income school communities through LAUSD, the local school district, with vision screenings and 4 mobile, fully equipped dental vans. In partnership with the health centers, QueensCare provides funding for a perinatal service for high-risk pregnancies. 9115620 6903735 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; and pastoral care to all faiths. 799942 29324 QueensCare Health and Faith Partnership provides the largest parish nurse program in California. 17 full-time and part-time registered nurses and 7 staff provide immunizations, health screenings, cardio-pulmonoary resuscitation training, and parenting classes. The program is also designed to provide poor and underpriviledged residents of Los Angeles County with information regarding cancer prevention, prenatal care, nutrition, and other health education programs. The partnership expanded its services by establishing a mental health program for children traumatized by violence. The QueensCare Health and Faith Partneship is located in 64 parishes, churches and food banks throughout low-income communities in Los Angeles County. QueensCare also provided bilingual access and translation services throughout its healthcare delivery system, as well as transportation assistance to and from the parishes, the clinics, hospitals, and specialists. 3321673 3127022 134652 3321673 3127022 134652 17700074 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 55 1 1 1 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 Gary C Grubbs CFO 3236694304 950 South Grand Avenue 2nd Fl South Los Angeles CA 90015 David Walsh Chair 10.00 2.00 X X 7250 450 0 Bettie J Woods Vice Chair 10.00 2.00 X X 3900 0 0 Sister Judy Murphy CSJ Secretary 10.00 10.00 X X 47750 0 0 Steven Aronoff Director 2.00 X 4250 0 0 Barbara Bice Director 2.00 X 2500 0 0 Denise Partamian Forgette Director 2.00 X 4300 0 0 Jay Guerena Director 2.00 2.00 X 4450 1850 0 Fran Inman Director 2.00 X 1750 0 0 Rev Michael Mata Director 2.00 X 1250 0 0 Allan Michelena Director 2.00 2.00 X 3000 1600 0 Msgr J Murphy Director 2.00 X 8000 0 0 Gene A Nuziard Director 2.00 2.00 X 5500 1250 0 Lois Saffian Director 2.00 X 4550 0 0 Dr Richard E Yoo Director 2.00 X 2000 0 0 Joan Sanders Baker Director until 6/2015 2.00 X 2000 0 0 Barbara B Hines President & CEO 8.00 32.00 X X 119900 168994 43637 Gary Grubbs CFO 32.00 8.00 X 135307 65687 26521 Alan DeJong Director Risk Management 40.00 X 117541 0 30644 Liz Hoang Director HR 40.00 X 137008 0 24489 Maeflor T Padilla Corp. Audit & Compliance 40.00 X 120071 0 14520 Arthur Doi Controller 40.00 X 114834 0 27944 847111 239831 167755 6 0 1 0 USC School of Dentisty 1149 S Hill Street Ste H550 Los Angeles CA 90015 Pediatric Dentistry 470675 Canterbury Consulting 660 Newport Center Dr Ste 300 Newport Beach CA 92660 Investment Mgmt Fee 142593 2 442610 442610 Mental Health Project 124100 134652 134652 QHFP Health Screening 900099 29324 29324 163976 6760233 6760233 3606548 758235 2848313 2848313 2848313 68487693 9500000 64961267 7369551 3526426 2130449 5656875 5656875 Other income 900099 132528 132528 132528 16004535 163976 0 15397949 5177022 5177022 4853735 4853735 401141 401141 1701242 1357894 343348 99712 83200 16512 484461 384391 100070 121409 102461 18948 344929 108000 236929 136608 136608 33370 33370 883079 715176 167903 83690 47667 36023 16747 9024 7723 135623 35336 100287 101947 86235 15712 18405 16987 1418 33446 12452 20994 71154 15202 55952 99790 69570 30220 K-1 Expenses - Q/QHC He 4462839 4462839 Other expense 209935 145633 64302 Stipends 17250 17250 19487534 17700074 1787460 0 11983280 5921602 104287 668956 492567 61374038 13187867 52495319 48186171 293401137 278492253 46457000 44839000 263462 775348 405373441 378706941 4821600 3236707 2890301 3381716 729574 3930542 987191 911438 12629634 8259435 X 392088807 369791018 655000 656488 392743807 370447506 405373441 378706941 -3482999 -18813303 0 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. QueensCare is not licensed to operate a hospital. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 655000 1487 656487 655000 655000 655000 655000 655000 655000 655000 655000 1.00000 0 0 13472525 13472525 41891922 11662006 30229916 4480118 223121 4256997 1529473 1302740 226733 48186171 Alt. Mutual Fund Inv. 35162710 F Closely held securities 9676290 F 44839000 Workers compensation liability 911438 911438 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 Aids Project LA 611 S Kingsley Drive Los Angeles CA 90005 953804256 501(C)3 200000 To help further outreach Alliance for Housing & Healing 825 Colorado Blvd Los Angeles CA 90041 954147364 501(C)3 50000 To help further outreach American Red Cross 11355 Ohio Avenue Los Angeles CA 90025 530196605 501(C)3 50000 To help further outreach Ava's Heart 9461 Charleville Blvd Ste 589 Beverly Hills CA 90212 453266322 501(C)3 10000 To help further outreach Beverly Hospital 309 W Beverly Blvd Montebello CA 90640 237429685 7012 To help further outreach Breathe LA 5858 Wilshire Blvd Los Angeles CA 90036 951641451 501(C)3 40000 To help further outreach California Hospital Medical Center 1401 S Grand Avenue Los Angeles CA 90015 941196203 501(C)3 85427 $65,000 grant for Education & Outreach; $20,427 for Emergency Medical Services. Cancer Support Community Pasadena 76 East Del Mar Blvd Ste 215 Pasadena CA 91105 954201985 501(C)3 35000 To help further outreach CAST 5042 Wilshire Blvd Ste 5 Los Angeles CA 90036 100008533 501(C)3 125000 To help further outreach Children's Hospital 4650 Sunset Blvd Los Angeles CA 90027 951690977 501(C)3 186585 $100,000 grant for Transportation; $86,585 grant for Emergency Medical Services. Children's Institute 2121 West Temple Street Los Angeles CA 90026 951641424 501(C)3 75000 To help further outreach Chinatown Service Center 767 N Hill Street Ste 400 Los Angeles CA 900122381 952918844 501(C)3 100000 To help further outreach CSU Northridge Foundation 18111 Nordhoff Street Northridge CA 913308265 956196006 501(C)3 42000 To help further outreach Covenant House California 1325 North Western Avenue Los Angeles CA 90027 133391210 501(C)3 50000 To help further outreach Esperanza Community Housing Corp 3655 S Grand Ave Ste 280 Los Angeles CA 90007 954230345 501(C)3 95172 To help further outreach Five Acres 760 W Mountain View Street Altadena CA 91001 951647810 501(C)3 35000 To help further outreach Glendale Memorial Hospital 1420 South Central Avenue Glendale CA 91204 941196203 501(C)3 64634 To help further outreach Good Samaritan Hospital 1225 Wilshire Blvd Los Angeles CA 90017 951656366 501(C)3 432012 To help further outreach Hollywood Presbyterian Med Center 1300 N Vermont Avenue Los Angeles CA 90027 300284087 565854 To help further outreach LA Christian Health Centers 311 Winston Street Los Angeles CA 90013 954315734 501(C)3 100000 To help further outreach LAC-USC Medical Center 1200 N State Stre INPT T Los Angeles CA 90033 956000927 501(C)3 412805 To help further outreach Los Angeles Community Hospital 4081 E Olympic Blvd Los Angeles CA 90023 954691839 501(C)3 24695 To help further outreach National Kidney Foundation 15490 Ventura BlvdSuite 210 Sherman Oaks CA 91403 131673104 501(C)3 30000 To help further outreach MEND 10641 San Fernando Road Pacoima CA 91331 237306337 501(C)3 50000 To help further outreach Monterey Park Hospital 900 S Atlantic Blvd Monterey Park CA 91754 510519163 501(C)3 2439 To help further outreach No Limits 9801 Washington Blvd 2N Culver City CA 90232 954603048 501(C)3 50000 To help further outreach Olympia Medical Center 5900 W Olympica Blvd Los Angeles CA 90036 421643090 96037 To help further outreach Orthopaedic Institute for Children 403 West Adams Blvd Los Angeles CA 90007 951644604 501(C)3 47000 To help further outreach Pepperdine University 24255 Pacific Coast Highway Malibu CA 90263 951644037 501(C)3 50000 To help further outreach Program for Torture Victims 3550 Wilshire Blvd Ste 1906 Los Angeles CA 90010 954492477 501(C)3 75000 To help further outreach Saban Community Clinic 8405 Beverly Blvd Los Angeles CA 900483401 952539105 501(C)3 100000 To help further outreach Salvation Army 2737 Sunset Blvd Los Angeles CA 90026 951656360 501(C)3 55000 To help further outreach Sherman Oaks Hospital 4929 Van Nuys Blvd Sherman Oaks CA 91403 202546649 7012 To help further outreach South Central Family Health Center 4425 South Central Avenue Los Angeles CA 900113629 953877793 501(C)3 100000 To help further outreach Southern California Counseling Ctr 5615 W Pico Blvd Los Angeles CA 900193871 952430665 501(C)3 50000 To help further outreach Southern California Hospital 3828 Delmas Terrace Culver City CA 90232 954690845 501(C)3 28049 To help further outreach Southern California Public Radio 474 S Raymond Avenue Pasadena CA 91105 954765734 501(C)3 50000 To help further outreach St Anne's Maternity Home 155 N Occidental Blvd Los Angeles CA 90026 951691306 501(C)3 23500 To help further outreach St Barnabas Senior Services 675 S Carondelete Street Los Angeles CA 90057 951641435 501(C)3 50000 To help further outreach St John's Well Child & Family Ctrs 5701 South Hoover Street Los Angeles CA 90037 954067758 501(C)3 100000 To help further outreach St Vincent Medical Center 2131 West Third Street Los Angeles CA 90057 912154438 501(C)3 382317 $125,000 grant for transportation; $257,317 grant for emergency medical services. Step Up on Second 1328 Second Street Santa Monica CA 90401 954109386 501(C)3 65000 To help further outreach Strength in Support 26938 Marbella Mission Viejo CA 92691 461896501 501(C)3 15000 To help further outreach THE Health & Wellness Centers 3834 South Western Avenue Los Angeles CA 90062 237351622 501(C)3 100000 To help further outreach Tierra del Sol Foundation 9919 Sunland Blvd Sunland CA 90049 952671260 501(C)3 25000 To help further outreach UCLA Ron Reagan Med Ctr 757 Westwood Plaza Los Angeles CA 90095 956006143 501(C)3 32317 To help further outreach USC Keck School of Medicine 1975 Zonal Avenue KAM 500 Los Angeles CA 90033 951642394 501(C)3 300000 To help further outreach USC Ostrow School of Dentistry 925 West 34th Street Los Angeles CA 90089 951642394 501(C)3 50000 To help further outreach USC Verdugo Hills Hospital 1812 Verdugo Blvd Glendale CA 91208 953247823 501(C)3 7317 To help further outreach weSPARK Cancer Support Center 13520 Ventura Boulevard Studio City CA 91423 954785462 501(C)3 50000 To help further outreach White Memorial Medical Center 1720 Ceasar E Chavez Ave Los Angeles CA 90033 953760201 501(C)3 5488 To help further outreach 47 4 Scholarships 35 353850 N/A Inpatient Care Assistance 323 4831000 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 114356 168994 0 0 5544 0 7582 10140 25915 0 153397 179134 0 0 Gary Grubbs CFO 130373 65687 0 0 4934 0 8096 3942 14483 0 157886 69629 0 0 Liz Hoang Director HR 136063 0 0 0 945 0 8506 0 15983 0 161497 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 11 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 2016 and its findings and recommendations with regard to the CEO's compensation level were approved by the Board in October 2016. 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. Bridge Street 1525 Bridge Street Yuba CA 95993 951644040 Rental Real Estate CA 367032 11608866 QueensCare Greenfield Apartments QC-LLC 1640 S Greenfield Circle NE Grand Rapids MI 49505 951644040 Rental Real Estate MI 2130449 0 QueensCare HPMB LLC 1300 N Vermont Ave Los Angeles CA 90027 951644040 Rental Real Estate CA 609962 0 QueensCare Airway Diego LLC 10132 Airway Road San Diego CA 92154 951644040 Rental Real Estate CA 1695029 21350241 QueensCare QLV - HD LLC 855 Dorrell Lane Las Vegas NV 89086 951644040 Rental Real Estate NV 565577 12149529 QueensCare QLV - INO LLC 6880 North 5th Street Las Vegas NV 89084 951644040 Rental Real Estate NV 133987 3522691 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 11c, 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 11a, 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 -4462839 3004 0 1 0.40000 0 1 1 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 QQHC HEALTHCARE PARTNERS B 4462839 ACCRUAL ST JOSEPH'S HEALTH SUPPORT ALLIANCE C 315000 ACCRUAL ST JOSEPH'S HEALTH SUPPORT ALLIANCE Q 12000 ACCRUAL QUEENSCARE HEALTH CENTER O 278974 ACCRUAL QUEENSCARE HEALTH CENTER P 452166 ACCRUAL QUEENSCARE HEALTH CENTER Q 840525 ACCRUAL QUEEN OF ANGELS HOLLYWOOD PRESBYTERIAN FOUNDATION C 127610 ACCRUAL QUEEN OF ANGELS HOLLYWOOD PRESBYTERIAN FOUNDATION Q 9542 ACCRUAL QUEENSCARE HEALTH CENTER B 108059 ACCRUAL