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PEDIATRIC AND FAMILY MEDICAL CENTER: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
PEDIATRIC AND FAMILY MEDICAL CENTER (EIN 95-1690966)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-02-13
IRS object ID
201300449349301600
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-02-13T16:17:20-06:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN951777440EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1GREEN HASSON & JANKS LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110990 WILSHIRE BLVD 16TH FLOORAddressLine1
CityLOS ANGELESCity
StateCAState
ZIP Code900243929ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN951690966EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PEDIATRIC & FAMILY MEDICAL CENTER DBABusinessNameLine1
Business Name Line2EISNER PEDIATRIC & FAMILY MEDICAL CENTERBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlPEDINameControl
Phone2137461037Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11530 SOUTH OLIVE STREETAddressLine1
CityLOS ANGELESCity
StateCAState
ZIP Code90015ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCARL E COANName
TitlePRESIDENT/CEOTitle
Phone2137461037Phone
Date Signed2013-02-06DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRICHARD L RUVELSONName
PTINP00234075PTIN
Phone3108731600Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1EISNER PEDIATRICS & FAMILY MED CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonCARL E COANNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11530 SOUTH OLIVE STREETAddressLine1
CityLOS ANGELESCity
StateCAState
ZIP Code90015ZIPCode
FieldValueIRS element (for citing)
Gross Receipts24539907GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.PEDCENTER.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1920YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionIMPROVE THE PHYSICAL, SOCIAL & EMOTIONAL WELL-BEING OF LOS ANGELES FAMILIESActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees306TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3544029ContributionsGrantsPriorYear
Contributions Grants Current Year5944814ContributionsGrantsCurrentYear
Program Service Revenue Prior Year15391779ProgramServiceRevenuePriorYear
Program Service Revenue CY18458789ProgramServiceRevenueCY
Investment Income Prior Year9248InvestmentIncomePriorYear
Investment Income Current Year2784InvestmentIncomeCurrentYear
Other Revenue Prior Year131883OtherRevenuePriorYear
Other Revenue Current Year133520OtherRevenueCurrentYear
Total Revenue Prior Year19076939TotalRevenuePriorYear
Total Revenue Current Year24539907TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year14721064SalariesEtcPriorYear
Salaries Etc Current Year16066235SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year405394TotalFundrsngExpCurrentYear
Other Expense Prior Year4258895OtherExpensePriorYear
Other Expenses Current Year6239152OtherExpensesCurrentYear
Total Expenses Prior Year18979959TotalExpensesPriorYear
Total Expenses Current Year22305387TotalExpensesCurrentYear
Revenues Less Expenses Prior Year96980RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2234520RevenuesLessExpensesCY
Total Assets BOY17089107TotalAssetsBOY
Total Assets EOY20508832TotalAssetsEOY
Total Liabilities BOY2197594TotalLiabilitiesBOY
Total Liabilities EOY3442212TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY14891513NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY17066620NetAssetsOrFundBalancesEOY
Mission DescriptionEISNER 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense14128823Expense
Revenue15416365Revenue
DescriptionMEDICAL 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 25,507.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2433816Expense
Revenue1954722Revenue
DescriptionDENTAL CARE- PREVENTATIVE DENTAL EXAMS- DIAGNOSIS AND TREATMENT OF DENTAL AND GUM PROBLEMS- ORTHODONTIC SERVICESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 6,133.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1706668Expense
Revenue1087702Revenue
DescriptionMENTAL HEALTH CARE- INDIVIDUAL THERAPY - FAMILY THERAPY - GROUP THERAPY - CASE MANAGEMENT - WORKSHOPS - PARENTING CLASSESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 276.Description
FieldValueIRS element (for citing)
Total Program Service Expense18269307TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109631NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees306NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1EUGENE VEKSLERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2137461037TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11530 SOUTH OLIVE STAddressLine1
CityLOS ANGELESCity
StateCAState
ZIP Code90015ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
LOREN KOSMONT
MEMBER1.00X000
NORMA IBARRA
MEMBER1.00X000
CARMELA GALVAN
MEMBER1.00X000
VICTOR AGUIRRE
MEMBER1.00X000
ROBYN HILL-AVERY
MEMBER1.00X000
KEVIN ROSSI
MEMBER1.00X000
ALEJANDRA ROSAS
MEMBER1.00X000
JENNIFER LYNCH
CHAIRPERSON1.00X000
DAVID CHERNEK
VICE CHAIR1.00X000
EDWARD MATTHEWS
SECRETARY1.00X000
JEFFREY WANG
TREASURER1.00X000
CARL E COAN
PRESIDENT/CEO40.00253666039895X
CHONA DE LEON
VICE PRESIDENT/COO40.00230073012818X
LAWRENCE YEE
PHYSICIAN40.00199908012093X
LUIS LOPEZ
PHYSICIAN40.00204937011715X
LAILA AL-MARAYATI
PHYSICIAN40.00192575011884X
DEBORAH LERNER
CMO40.00201786011595X
AHMAD KHALIFA
PHYSICIAN40.00171698011239X
HIRAM WILLIAMS
PHYSICIAN40.00161874010250X
BECKY MURPHY
CLINICAL DIRECTOR40.00151263010156X
OFFER HO
CIO40.00143526010174X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1911306TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation141819TotalOtherCompensation
Number Individuals GT100 K29NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
KCS WEST
901 CORPORATE CENTER DRIVE 3RD FLMONTEREY PARKCA91754CONSTRUCTION (DENTAL)761423
BIRBA
2350 HYPERION AVENUELOS ANGELESCA90027CONSTRUCTION (DENTAL)361499
ALL'S WELL
PO BOX 29048GLENDALECA91209TEMPORARY LABOR209611
QUEST DIAGNOSTICS
8511 FALLBROOK AVENUE 2ND FLWEST HILLSCA91304LABORATORY EXPENSES185933
MAGUIRE THOMAS PARTNERS
240 WEST VENICE BLVDLOS ANGELESCA90015PARKING181797
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K
Related Organizations82885RelatedOrganizations
Government Grants4598049GovernmentGrants
All Other Contributions1263880AllOtherContributions
Total Contributions5944814TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE FEESDescription
Business Code624110BusinessCode
Total Revenue Column18458789TotalRevenueColumn
Related Or Exempt Function Income18458789RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue18458789TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2784TotalRevenueColumn
Exclusion$2,784ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real9000Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real9000Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column9000TotalRevenueColumn
Exclusion$9,000ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
DEBT FORGIVENESS90009995000$95,000
MISCELLANEOUS INCOME90009929520$29,520
FieldValueIRS element (for citing)
Total Other Revenue124520TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column24539907TotalRevenueColumn
Related Or Exempt Function Income18458789RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$136,304ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1139429Total
Program Services946096ProgramServices
Management And General174051ManagementAndGeneral
Fundraising19282Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total12117308Total
Program Services10061308ProgramServices
Management And General1850947ManagementAndGeneral
Fundraising205053Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total367795Total
Program Services280027ProgramServices
Management And General66191ManagementAndGeneral
Fundraising21577Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1444745Total
Program Services1199609ProgramServices
Management And General220688ManagementAndGeneral
Fundraising24448Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total996958Total
Program Services831485ProgramServices
Management And General148214ManagementAndGeneral
Fundraising17259Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total106329Total
Program Services38573ProgramServices
Management And General67756ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total58701Total
Management And General58701ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1587216Total
Program Services1496639ProgramServices
Fundraising90577Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total16018Total
Program Services5836ProgramServices
Management And General8382ManagementAndGeneral
Fundraising1800Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total271629Total
Program Services178442ProgramServices
Management And General86864ManagementAndGeneral
Fundraising6323Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total241663Total
Program Services151800ProgramServices
Management And General89735ManagementAndGeneral
Fundraising128Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total542781Total
Program Services482079ProgramServices
Management And General60702ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total264116Total
Program Services226763ProgramServices
Management And General34810ManagementAndGeneral
Fundraising2543Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total41268Total
Program Services26291ProgramServices
Management And General14457ManagementAndGeneral
Fundraising520Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total86214Total
Program Services56ProgramServices
Management And General86158ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total870687Total
Program Services870687ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total183343Total
Program Services148410ProgramServices
Management And General34933ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES10617041061704
CLINIC MAINTENANCE1194522888890564
BUILDING MAINTENANCE1144003032284078
SUBSCRIPTIONS7619022083494954612

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total597441Total
Program Services182209ProgramServices
Management And General403960ManagementAndGeneral
Fundraising11272Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total22305387Total
Program Services18269307ProgramServices
Management And General3630686ManagementAndGeneral
Fundraising405394Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY42907BOY
EOY30058EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1455529BOY
EOY1268627EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY687696BOY
EOY1206660EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2992515BOY
EOY4373286EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY49131BOY
EOY190087EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis20121124LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec6822240LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY11678261BOY
EOY13298884EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY77000BOY
EOY68667EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY106068BOY
EOY72563EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY17089107BOY
EOY20508832EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1368146BOY
EOY2296894EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY734028BOY
EOY1145318EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY95000BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY420BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2197594BOY
EOY3442212EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY14274182BOY
EOY16499752EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY617331BOY
EOY566868EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14891513BOY
EOY17066620EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY17089107BOY
EOY20508832EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2234520ReconcilationRevenueExpenses
Reconcilation Other Changes-59413ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis952246OtherCostOrOtherBasis
Book Value952246BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis14849035OtherCostOrOtherBasis
Depreciation4403058Depreciation
Book Value10445977BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3952377OtherCostOrOtherBasis
Depreciation2078764Depreciation
Book Value1873613BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis367466OtherCostOrOtherBasis
Depreciation340418Depreciation
Book Value27048BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings13298884TotalOfBookValueLandBuildings
Total Revenue24539907TotalRevenue
Total Expenses22305387TotalExpenses
Excess Or Deficit For Year2234520ExcessOrDeficitForYear
Other-$59,413OtherAmount
Total Adjustments-59413TotalAdjustments
Excess Or Deficit Per FS2175107ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt24539907TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal24539907RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99024539907TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt22364800TotExpensesEtcAuditedFinclStmt
Other Expenses Included59413OtherExpensesIncluded
Expenses Not Rptd F99059413ExpensesNotRptdF990
Expenses Subtotal22305387ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99022305387TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierExplanationExplanation
PART XI, LINE 8 - OTHER ADJUSTMENTS:BAD DEBT -59,413.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:BAD DEBT 59,413.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
CARL E COAN
23366602000000000398950293561000
CHONA DE LEON
20807302200000000128180242891000
LAWRENCE YEE
1999080000000120930212001000
LUIS LOPEZ
2024370250000000117150216652000
LAILA AL-MARAYATI
1889500362500000118840204459000
DEBORAH LERNER
1922160957000000115950213381000
AHMAD KHALIFA
15307301862500000112390182937000
HIRAM WILLIAMS
1549990687500000102500172124000
BECKY MURPHY
1432570800600000101560161419000
OFFER HO
1384260510000000101740153700000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS GIVEN TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CANNUAL 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 15THE 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 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 5:BAD DEBT -59,413. TOTAL TO FORM 990, PART XI, LINE 5: -59,413.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CNO CHANGES WERE MADE TO THE FINANCIAL STATEMENT REPORTING PROCESS.FINANCIAL STATEMENTS AND REPORTING

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1PEDIATRIC & FAMILY MEDICAL FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11530 S OLIVE STAddressLine1
CityLOS ANGELESCity
StateCAState
ZIP Code90015ZIPCode
FieldValueIRS element (for citing)
EIN954116680EIN
Primary ActivitiesTO HOLD AND INVEST ASSETS ON BEHALF OF PEDIATRIC & FAMILY MEDICAL CENTERPrimaryActivities
Legal Domicile StateCALegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status509(A)(3) TYPE IPublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1PEDIATRIC AND FAMILY MEDICAL FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeCTransactionType
Amount Involved82885AmountInvolved
Method Of Amt DeterminationBOOKMethodOfAmtDetermination