2015-01-27T10:58:09-06:00 2014-06-30 951777440 GREEN HASSON & JANKS LLP 10990 WILSHIRE BLVD 16TH FLOOR LOS ANGELES CA 900243929 990 2013-07-01 951690966 PEDIATRIC & FAMILY MEDICAL CENTER DBA EISNER PEDIATRIC & FAMILY MEDICAL CENTER PEDI 2137461037 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 HERB SCHULTZ PRESIDENT/CEO 2137461037 2015-01-14 1 RICHARD L RUVELSON P00234075 3108731600 2013 2016-03-07 17:11:31Z EISNER PEDIATRICS & FAMILY MED CENTER HERB SCHULTZ 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 25407865 0 X WWW.PEDCENTER.ORG X 1920 CA IMPROVE THE PHYSICAL, SOCIAL & EMOTIONAL WELL-BEING OF LOS ANGELES FAMILIES 12 12 347 0 0 0 7837509 4845794 19676168 20551998 1695 1137 13254 8936 27528626 25407865 0 0 0 0 16955943 18461724 0 0 211631 6990504 7218970 23946447 25680694 3582179 -272829 23789189 22936073 3335048 2727449 20454141 20208624 EISNER PEDIATRIC & FAMILY MEDICAL CENTER IS A QUALITY-FOCUSED, COMMUNITY HEALTH CENTER DEDICATED TO IMPROVING THE PHYSICAL, SOCIAL AND EMOTIONAL WELL-BEING OF LOW AND MODERATE INCOME RESIDENTS OF DOWNTOWN AND CENTRAL LOS ANGELES, REGARDLESS OF THEIR ABILITY TO PAY. 0 0 15764144 16409557 MEDICAL CARE- PHYSICAL EXAMS - IMMUNIZATIONS - GYNECOLOGY SERVICES - COUNSELING - PREVENTATIVE MEDICINE- DIAGNOSIS AND MANAGEMENT OF ACUTE AND CHRONIC DISEASES- DIAGNOSIS AND CARE DURING PREGNANCY- OFFICE DERMATOLOGYTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 28,931. 3271355 3029103 DENTAL CARE- PREVENTATIVE DENTAL EXAMS- DIAGNOSIS AND TREATMENT OF DENTAL AND GUM PROBLEMS- ORTHODONTIC SERVICESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 6,948. 2388918 1113338 MENTAL HEALTH CARE- INDIVIDUAL THERAPY - FAMILY THERAPY - GROUP THERAPY - CASE MANAGEMENT - WORKSHOPS - PARENTING CLASSESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 368. 21424417 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 38 0 347 1 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X EUGENE VEKSLER 2137461037 1530 SOUTH OLIVE ST LOS ANGELES CA 90015 VICTOR AGUIRRE MEMBER 1.00 X 0 0 0 DAVID BENAVIDEZ MEMBER 1.00 X 0 0 0 JERRY GATES MEMBER 1.00 X 0 0 0 NORMA IBARRA MEMBER 1.00 X 0 0 0 LOREN J KOSMONT MEMBER 1.00 X 0 0 0 KEVIN KROEKER MEMBER 1.00 X 0 0 0 ALEJANDRA ROSAS MEMBER 1.00 X 0 0 0 MARGARET PETERSON MEMBER 1.00 X 0 0 0 KEVIN ROSSI CHAIRPERSON 1.00 X X 0 0 0 EDWARD MATTHEWS VICE CHAIR 1.00 X X 0 0 0 IRMA AVILA SECRETARY 1.00 X X 0 0 0 IAN WIENER TREASURER 1.00 X X 0 0 0 CARL E COAN PRESIDENT/CEO 40.00 5.00 X 271423 0 40449 CHONA DE LOAN VICE PRESIDENT/COO 40.00 X 251122 0 12626 LAILA AL-MARAYATI DIRECT OF OB SERVICES 40.00 X 211560 0 11825 LUIS LOPEZ DIRECTOR OF PEDIATRICS 40.00 X 207174 0 11342 LAWRENCE YEE DIRECTOR OF ADULT SERVICES 40.00 X 197510 0 11370 JOHN PHAM DIRECTOR OF DENTAL 40.00 X 152396 0 9652 DEBORAH LERNER CHIEF MEDICAL OFFICER 40.00 X 207331 0 11349 HIRAM WILLIAMS PHYSICIAN 40.00 X 199316 0 11142 PENELOPE VELASCO PHYSICIAN 40.00 X 180776 0 10810 AHMAD KHALIFA PHYSICIAN 40.00 X 195776 0 10958 IAN TILLEY PHYSICIAN 40.00 X 170859 0 10206 2245243 0 151729 35 0 1 0 QUEST DIAGNOSTICS 8511 FALLBROOK AVENUE 2ND FL WEST HILLS CA 91304 LABORATORY EXPENSES 314431 ELLIS BEESLEY MD 1127 WILSHIRE BLVD 707 LOS ANGELES CA 90017 NEW-BORN EXAMS 118087 DAVIS WRIGHT TREMAINE LLP 1201 3RD AVENUE STE 2200 SEATTLE WA 98101 LEGAL SERVICES 105987 3 124252 3281215 1440327 4845794 PATIENT SERVICE FEES 624110 20551998 20551998 20551998 1137 1137 8936 0 8936 8936 8936 25407865 20551998 0 10073 1422393 1197618 213361 11414 13587852 11486137 1998811 102904 347694 269008 72694 5992 1951952 1650032 287138 14782 1151833 972533 168838 10462 37418 37418 62921 62921 1746770 1584316 131239 31215 22277 10007 11790 480 263033 173618 83485 5930 162397 118154 43617 626 589191 508261 80930 294597 253265 39391 1941 41508 27649 13641 218 31223 9554 21669 1204920 1204920 206996 159611 47385 MEDICAL SUPPLIES 1463149 1463149 CLINIC MAINTENANCE 141790 52091 89699 BUILDING MAINTENANCE 118940 31007 87933 SUBSCRIPTIONS 76332 28271 44823 3238 755508 225216 507863 22429 25680694 21424417 4044646 211631 303471 274881 779954 850095 1396456 1378467 5382755 5176758 206931 344864 23883285 9087773 15583384 14795512 63667 57000 72571 58496 23789189 22936073 2592099 2402834 742949 324615 3335048 2727449 X 19662845 19693130 791296 515494 20454141 20208624 23789189 22936073 X -272829 27312 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 952246 952246 17461781 5491094 11970687 4867726 3215082 1652644 601532 381597 219935 14795512 25407865 0 25407865 0 25407865 25653382 -27312 -27312 25680694 0 25680694 PART XII, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT RECOVERY -27,312. X X 0 0 0 0 0 0 0 1 0 CARL E COAN PRESIDENT/CEO 246423 0 25000 0 0 0 35369 0 5080 0 311872 0 0 0 CHONA DE LOAN VICE PRESIDENT/COO 226122 0 25000 0 0 0 7546 0 5080 0 263748 0 0 0 LAILA AL-MARAYATI DIRECT OF OB SERVICES 208685 0 2875 0 0 0 6745 0 5080 0 223385 0 0 0 LUIS LOPEZ DIRECTOR OF PEDIATRICS 204674 0 2500 0 0 0 6262 0 5080 0 218516 0 0 0 LAWRENCE YEE DIRECTOR OF ADULT SERVICES 197510 0 0 0 0 0 6290 0 5080 0 208880 0 0 0 JOHN PHAM DIRECTOR OF DENTAL 152396 0 0 0 0 0 4572 0 5080 0 162048 0 0 0 DEBORAH LERNER CHIEF MEDICAL OFFICER 197581 0 9750 0 0 0 6269 0 5080 0 218680 0 0 0 HIRAM WILLIAMS PHYSICIAN 197066 0 2250 0 0 0 6062 0 5080 0 210458 0 0 0 PENELOPE VELASCO PHYSICIAN 178901 0 1875 0 0 0 5730 0 5080 0 191586 0 0 0 AHMAD KHALIFA PHYSICIAN 171526 0 24250 0 0 0 5878 0 5080 0 206734 0 0 0 IAN TILLEY PHYSICIAN 165109 0 5750 0 0 0 5126 0 5080 0 181065 0 0 0 PART I, LINE 7 STAFF BONUSES ARE DISCUSSED AND REQUIRE APPROVAL BY SENIOR MANAGEMENT. THERE ARE SEVERAL CRITERIA FOR ADMINISTERING BONUSES. SENIOR MANAGEMENT MAY GET A BONUS BASED ON THE DEGREE OF MEETING THEIR SET GOALS FOR THE PAST FISCAL YEAR. OTHER STAFF, WHO ARE AT THE TOP OF THEIR JOB'S SALARY RANGE, MAY BE GIVEN A BONUS BASED ON THEIR PERFORMANCE RATING. THE PERCENTAGE OF THE BONUS CAN BE UP TO AND EQUIVALENT TO A 3% RAISE. HOWEVER, THERE MAY BE EXCEPTIONS WHERE THE BONUS IS MORE THAN 3%. OTHER STAFF, WHO HAVE DEMONSTRATED A PERFORMANCE OVER AND BEYOND HIS OR HER JOB EXPECTATIONS MAY GET A BONUS IN ADDITION TO THE RAISE IF THE SUPERVISOR FEELS THAT THE STAFF DESERVES MORE THAN THE 3% RAISE. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS GIVEN TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL QUESTIONNAIRES ARE GIVEN TO ALL DIRECTORS AND OFFICERS. THE GOVERNANCE COMMITTEE THEN REVIEWS THE QUESTIONNAIRES 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 AN 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 THEN IT IS PRESENTED TO THE ENTIRE BOARD FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: BAD DEBT RECOVERY 27,312. FORM 990, PART XII, LINE 2C NO CHANGES WERE MADE TO THE FINANCIAL STATEMENT REPORTING PROCESS. PEDIATRIC & FAMILY MEDICAL FOUNDATION 1530 S OLIVE ST LOS ANGELES CA 90015 954116680 TO HOLD AND INVEST ASSETS ON BEHALF OF PEDIATRIC & FAMILY MEDICAL CENTER CA 501(C)(3) 509(A)(3) TYPE I N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PEDIATRIC & FAMILY MEDICAL FOUNDATION C 124252 FMV