2024-05-13T18:34:30-05:00 2023-06-30 910189318 MOSS ADAMS LLP 21700 OXNARD ST STE 300 WOODLAND HILLS CA 91367 990 2022-07-01 812455970 MARTIN LUTHER KING JR COMMUNITY MEDICAL FOUNDATION MART 4245296755 2251 WEST ROSECRANS AVENUE 18 COMPTON CA 90222 STEVEN CIAMPA INTERIM CFO 4245296755 2024-05-06 1 STEVEN CIAMPA 999009999 1 LAUREN A HAVERLOCK P00545829 8185771900 2024-05-06 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z STEVE CIAMPA 2251 WEST ROSECRANS AVENUE 18 COMPTON CA 90222 27875579 0 X WWW.MLKCMG.ORG X 2016 CA TO FACILITATE ACCESS TO HEALTHCARE AND PROMOTE THE HEALTH AND WELLBEING OF THE LOW INCOME, DISADVANTAGED COMMUNITIES OF SOUTH LOS ANGELES. 9 9 0 9 0 0 1254824 4645000 25685711 22489673 0 0 264464 740906 27204999 27875579 2082392 0 0 0 6626165 7304979 0 0 0 25667305 28964516 34375862 36269495 -7170863 -8393916 36479093 47612970 49374030 68901823 -12894937 -21288853 X TO INCREASE ACCESS TO HIGH QUALITY MEDICAL SERVICES OUTSIDE OF THE HOSPITAL CONTEXT, WITH A PARTICULAR FOCUS ON CARING FOR PATIENTS WITH CHRONIC MEDICAL CONDITIONS. 0 0 33970278 0 22489673 VOLUME PATIENT CLINIC VISITS WERE 40,848 INCLUDING 281 COVID19 VACCINATION VISITS. MLKCMF COLLABORATED THIS PAST YEAR IN AN INNOVATIVE DESIGN FOR THE TREATMENT OF MENTAL HEALTH, PHYSICAL HEALTH AND SUBSTANCE ABUSE DISORDERS. THE INTEGRATED DESIGN FOR BEHAVIORAL HEALTH BEGINS WITH AN ASSESSMENT AT THE FIRST POINT OF PATIENT CONTACT ESTABLISHING POTENTIAL LINKS BETWEEN A CHRONIC MEDICAL CONDITION AND A BEHAVIORAL HEALTH CONCERN. THIS ALLOWS FOR AN EARLY INTERVENTION OF A BEHAVIORAL HEALTH TEAM FOLLOWING THE PATIENT FROM INPATIENT CARE TO APPROPRIATE LONG-TERM SUPPORT CARE AND RESOURCES IN AN OUTPATIENT SETTING. THE TOTAL BEHAVIORAL HEALTHS VISITS WERE 2,766. MLKCMF'S ONGOING ENHANCED CARE MANAGEMENT PROGRAM IS A STATEWIDE MEDICAID BENEFIT. THE GOAL OF THIS PROGRAM IS TO PROVIDE A WHOLE PERSON APPROACH TO CARE THAT ADDRESSES BOTH CLINICAL AND NON-CLINICAL NEEDS OF HIGH-NEED MEDICAID BENEFICIARIES. BENEFICIARIES HAVE A SINGLE LEAD CARE MANAGER WHO COORDINATES CARE AND SERVICES AMONG THE PHYSICAL, BEHAVIORAL, DENTAL, DEVELOPMENTAL, AND SOCIAL SERVICES DELIVERY SYTEMS, MAKING IT EASIER FOR THEM TO GET THE RIGHT CARE AT THE RIGHT TIME.MLKCMF'S PROVIDES DIABETES MANAGEMENT TO PATIENTS INCLUDING EDUCATION AND CLASSES AVAILABLE TO THE COMMUNITY. CARE COORDINATORS ASSIST PATIENTS WITH ONGOING ENROLLMENT IN HEALTH COVERAGE VIA EDUCATION AND NAVIGATION SERVICES. THEY ALSO ASSIST WITH THE EVALUATION OF SOCIAL DETERMINANTS OF HEALTH IN THE PATIENT POPULATION AND CONNECTING PATIENTS WITH RESOURCES TO ADDRESS THEIR NEEDS. MLKCMF CONTINUES THE LACTATION CLNIC, WHICH SUPPORTS IMPROVED MATERNAL AND INFANT HEALTH IN SOUTH LOS ANGELES BY INCREASING THE PERCENTAGE OF WOMEN IN THE SERVICE AREA WHO EXCLUSIVELY BREASTFEED THEIR INFANTS UNTIL THEY REACH SIX MONTHS OF AGE. 33970278 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 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 8 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 0 0 0 CA X STEVE CIAMPA 4243388717 1680 E 120TH STREET LOS ANGELES CA 90059 MANUEL A ABASCAL JD CHAIR 6.00 10.00 X X 0 0 0 PAUL KING VICE CHAIR 3.00 7.00 X X 0 0 0 MICHAEL MADDEN SECRETARY 3.00 3.00 X X 0 0 0 JAMES YOSHIOKA TREASURER 3.00 3.00 X X 0 0 0 GEORGINA R GARCIA RN BOARD MEMBER 3.00 3.00 X 0 0 0 ROBERT MARGOLIS MD BOARD MEMBER 3.00 5.00 X 0 0 0 IAN MORRISON BOARD MEMBER 3.00 3.00 X 0 0 0 CYNTHIA PATTON BOARD MEMBER 3.00 3.00 X 0 0 0 KEDAR MATE MD BOARD MEMBER 3.00 3.00 X 0 0 0 KURT STAUDER PRES. OF MEDICAL GROUP FDN 40.00 8.00 X 0 249008 10144 JOHN FISHER MD CHIEF MEDICAL OFFICER 1.00 41.00 X 0 677573 32446 LISSA OWEN MANAGER OF REVENUE CYCLE 40.00 0.00 X 120563 0 23207 NANCY TORRES MANAGER POPULATION HEALTH AMBULATORY 40.00 0.00 X 108661 0 22640 229224 926581 88437 2 0 1 0 THE REGENTS OF THE UNIVERSITY OF CALIFOR 1680 E 120TH STREET LOS ANGELES CA 90059 HOSPITALIST / INTENSIVIST PHYSICIANS 8775628 MARTIN LUTHER KING JR HEALTH ASSOCIATE 1680 E 120TH STREET LOS ANGELES CA 90059 STAFFING SERVICES 8234829 HUBMD PC 104 OLIVE STREET UNIT 100 REDLANDS CA 92373 UROLOGY PHYSICIANS 769613 HALL DYNAMICS DBA MYRON L HALL 9301 WILSHIRE BOULEVARD NO 404 BEVERLY HILLS CA 90210 PODIATRY PHYSICIAN 254750 NEURO INDUSTRIAL MEDICAL GROUP 223 N GARFIELD AVENUE 302 MONTEREY PARK CA 91754 NEUROLOGIST 180310 6 4645000 4645000 CALL COVERAGE 621990 10968080 10968080 NET PATIENT SERV. REV. 621990 6585115 6585115 SUPPORT SERVICES 621990 1680379 1680379 SB SUPPLEMENTAL FUNDING 561499 1630552 1630552 CAPITATION REVENUE 621990 1082275 1082275 543272 543272 22489673 OTHER OPERATING REVENUE 561499 740906 740906 740906 27875579 22489673 0 740906 X 5268120 4886378 381742 143338 143338 1450348 1405340 45008 443173 411006 32167 803365 2625 800740 34803 2654 32149 12285 12285 26266046 25421221 844825 123316 123316 78830 78830 10402 10402 705029 705029 1817 1817 7978 7978 MEDICAL SUPPLIES 737816 737816 REPAIRS AND MAINTENANCE 133833 133833 DUES AND SUBSCRIPTIONS 34168 23768 10400 EMPLOYEE EXPENSE REIMB. 8046 5651 2395 6782 570 6212 36269495 33970278 2299217 0 1157024 1572719 4919917 5876262 103882 387722 30298270 39776267 36479093 47612970 7070887 6495857 42303143 62405966 49374030 68901823 X -13956009 -22074121 1061072 785268 -12894937 -21288853 36479093 47612970 -8393916 0 X 0 1 X 1 1 1 X 4329484 9524494 7050197 1254824 4645000 26803999 11615171 14991574 18778547 25685711 22489673 93560676 15944655 24516068 25828744 26940535 27134673 120364675 0 8432942 10632006 11478469 11418876 10375820 52338113 8432942 10632006 11478469 11418876 10375820 52338113 68026562 41212 291400 19795 264464 740906 1357777 15985867 24807468 25848539 27204999 27875579 121722452 0.55890 0.54650 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2018 AMOUNT: $ 41,212. 2019 AMOUNT: $ 291,400. 2020 AMOUNT: $ 19,795. 2021 AMOUNT: $ 264,464. 2022 AMOUNT: $ 740,906. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE FROM HOSPITAL 37932291 RIGHT-OF-USE LEASE ASSET 1843976 39776267 PROMISSORY NOTE TO MLKCH 300000 DUE TO MLKCH 60122896 RIGHT-OF-USE LEASE LIABILITY 1983070 62405966 X PART X, LINE 2: THE COMPANY RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED UPON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON SETTLEMENT. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2023 AND 2022. THE COMPANY IS SUBJECT TO INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR ALL YEARS SINCE INCEPTION FOR FEDERAL AND STATE TAX FILINGS. 0 1 0 0 0 0 0 0 0 JOHN FISHER MD CHIEF MEDICAL OFFICER 0 519341 0 152232 0 6000 0 12200 0 20246 0 710019 0 0 KURT STAUDER PRES. OF MEDICAL GROUP FDN 0 158335 0 90673 0 0 0 9150 0 994 0 259152 0 0 PART I, LINE 4B DR. JOHN FISHER PARTICIPATES IN THE MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (THE "PLAN") EFFECTIVE AS OF JANUARY 1, 2020 (THE "ADOPTION DATE"). HE RECEIVED THE FOLLOWING DISTRIBUTION DURING 2022: DR. JOHN FISHER: $43,645 FORM 990, PART VI, SECTION A, LINE 3 MARTIN LUTHER KING, JR.-LOS ANGELES HEALTHCARE CORPORATION PERFORMS THE NON-MEDICAL ADMINISTRATIVE, CLERICAL, AND SUPPORT STAFF FUNCTIONS, SPECIFICALLY INCLUDING RECEPTION AND PATIENT SCHEDULING, AND ALL OTHER NECESSARY AND APPROPRIATE NON-PROFESSIONAL SERVICES RELATING TO THE OPERATION OF A MEDICAL FOUNDATION. FORM 990, PART VI, SECTION A, LINE 6 AS OF APRIL 1, 2020, THE ORGANIZATION SHALL HAVE ONE (1) MEMBER ("MEMBER") WITHIN THE MEANING OF SECTION 5056 OF THE CALIFORNIA NONPROFIT CORPORATION LAW, NAMELY, MARTIN LUTHER KING, JR.-LOS ANGELES HEALTHCARE CORPORATION. SAID MEMBER SHALL HAVE AND BE ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT CORPORATION LAW, AS AMENDED, AND UNDER ALL APPLICABLE LAWS, INCLUDING ALL VOTING RIGHTS AND THE POWER TO ELECT THE BOARD OF DIRECTORS OF THIS ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A AS OF APRIL 1, 2020, MARTIN LUTHER KING, JR.-LOS ANGELES HEALTHCARE CORPORATION, THE SOLE MEMBER OF THIS ORGANIZATION UNDER THE CALIFORNIA NONPROFIT CORPORATION LAW, HAS ALL CORRESPONDING STATUTORY RIGHTS AND POWERS OF MEMBERSHIP. IN ADDITION, THE MEMBER HAS THE POWER (WHICH ARE TERMED THE "RESERVED POWERS" OF THE MEMBER) TO TAKE OR APPROVE THE FOLLOWING ACTIONS: (A) APPROVE OR CHANGE THE PURPOSES OF THIS ORGANIZATION; (B) AUTHORIZE THE AMENDMENT OF THE BYLAWS AND ARTICLES OF INCORPORATION OF THIS ORGANIZATION; (C) AUTHORIZE THE BOARD OF DIRECTORS TO AMEND THE BYLAWS, ARTICLES OF INCORPORATION OR OTHER ORGANIZATIONAL DOCUMENTS OF ANY AFFILIATE CONTROLLED BY THIS ORGANIZATION; (D) APPROVE THE FORMATION, MERGER, DISSOLUTION, CONSOLIDATION, DIVESTITURE, CLOSURE, CHANGE IN MEMBERSHIP OR CONTROL AND REORGANIZATION OF EACH DIRECT AFFILIATE CONTROLLED BY THIS ORGANIZATION; (E) FIX THE NUMBER, AND APPOINT AND REMOVE THE DIRECTORS OF THIS ORGANIZATION; (F) APPROVE THE MERGER, CONSOLIDATION, REORGANIZATION OR DISSOLUTION OF THIS ORGANIZATION AND THE DISPOSITION OF THE ASSETS OF THIS ORGANIZATION UPON DISSOLUTION; (G) APPROVE THE ACQUISITION, SALE, LEASE, MORTGAGE, TRANSFER OR OTHER ALIENATION OF REAL OR PERSONAL PROPERTY OF THIS ORGANIZATION; (H) APPROVE THE ORGANIZATION'S ENTERING INTO ANY JOINT VENTURE OR OTHER MATERIAL TRANSACTION; (I) APPROVE THE CAPITAL AND OPERATING BUDGETS OF THIS ORGANIZATION OR ANY AFFILIATE CONTROLLED BY THIS ORGANIZATION; (J) APPROVE GENERAL POLICIES CONCERNING QUALITY OF CARE OBJECTIVES FOR THIS ORGANIZATION IN FURTHERANCE OF CONSISTENCY AMONG ITS AFFILIATES; (K) ESTABLISH POLICIES AND PROCEDURES CONCERNING FINANCE AND RESOURCES FOR THIS ORGANIZATION AND APPROVE ANY PROPOSED ARRANGEMENTS THAT ARE INCONSISTENT WITH SUCH POLICIES OR PROCEDURES; (L) ESTABLISH CRITERIA FOR THE LONG-RANGE FINANCIAL AND STRATEGIC PLANS OF THIS ORGANIZATION AND APPROVE ANY SUCH PLANS; (M) ESTABLISH AN INTERNAL AUDITING PROGRAM AND APPROVE ANY MATERIAL ELEMENT OF THE INTERNAL AUDITING PROGRAM FOR THIS ORGANIZATION THAT IS INCONSISTENT WITH THE INTERNAL AUDITING PROGRAM ESTABLISHED BY THE MEMBER; (N) APPROVE THE TRANSFER OF FUNDS, BY GIFT OR LOAN, BETWEEN THIS ORGANIZATION AND ONE (1) OR MORE OTHER AFFILIATES OF MLK-LA AND THIS ORGANIZATION TO ANY PERSON OR ENTITY OTHER THAN IN ACCORDANCE WITH CERTAIN THRESHOLDS; AND (O) APPROVE ANY OTHER ACTION BY THIS ORGANIZATION OR ANY AFFILIATE CONTROLLED BY THIS ORGANIZATION THAT HAS BEEN ESTABLISHED BY RESOLUTION OF THE MEMBER AS REQUIRING ITS APPROVAL, INCLUDING, BUT NOT LIMITED TO, ANY APPROVALS OF AUTHORITY NECESSARY TO ENSURE COMPLIANCE WITH ANY CREDIT AGREEMENT, MASTER INDENTURE OR LOAN AGREEMENT TO WHICH THIS ORGANIZATION OR ANY AFFILIATE CONTROLLED BY THIS ORGANIZATION IS A PARTY. FORM 990, PART VI, SECTION A, LINE 7B AS OF APRIL 1, 2020, THE BYLAWS AND ARTICLES OF INCORPORATION MAY BE AMENDED ONLY BY THE THE ORGANIZATION'S SOLE MEMBER, MARTIN LUTHER KING, JR.-LOS ANGELES HEALTHCARE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE TAX PREPARER IN CONJUNCTION WITH THE ACCOUNTING AND FINANCE STAFF OF MARTIN LUTHER KING, JR.-LOS ANGELES HEALTHCARE CORPORATION. UPON COMPLETION, THE FORM 990 IS THEN DISTRIBUTED TO THE ORGANIZATION'S PRESIDENT/TREASURER/SECRETARY FOR REVIEW AND COMMENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, OFFICER, AND MEMBER OF A COMMITTEE HAVING POWERS DELEGATED BY THE GOVERNING BOARD SHALL, PRIOR TO THEIR ELECTION AND ANNUALLY THEREAFTER, SIGN AND SUBMIT A CONFLICT OF INTEREST STATEMENT. IN THE EVENT A CONFLICT OF INTEREST MAY OCCUR, INTERESTED PERSONS ARE REQUIRED UNDER THE POLICY TO DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST TO THE ORGANIZATION'S GOVERNING BOARD OR TO A DULY AUTHORIZED COMMITTEE OF THE GOVERNING BOARD CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT, AND ARE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS OF THE TRANSACTION. AFTER DISCLOSURE OF THE POTENTIAL CONFLICT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE INTERESTED PERSON SHALL LEAVE THE MEETING OF THE GOVERNING BOARD OR COMMITTEE WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT COMPENSATE ITS PRESIDENT OR ANY ADDITIONAL OFFICERS OR KEY EMPLOYEES; RATHER, THESE INDIVIDUALS ARE COMPENSATED BY A RELATED ORGANIZATION. AS SUCH, PART VI, SECTION B, LINE 15A AND 15B HAVE BEEN MARKED "NO" AS MANDATED BY THE FORM 990 INSTRUCTIONS. UPON HIRING OF THE CURRENT MEDICAL FOUNDATION CEO, THE HOSPITAL BOARD ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM TO ASSIST THEM IN DETERMINING APPROPRIATE COMPENSATION FOR SUCH AN INDIVIDUAL. AFTER CONSULTATION WITH THE COMPENSATION CONSULTING FIRM, WHICH COMPILED SALARY SURVEYS FOR SIMILAR INDUSTRY ORGANIZATIONS, THE HOSPITAL BOARD SET THE COMPENSATION FOR THE CEO. THE HOSPITAL BOARD ALSO REVIEWS THE COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES OF THE HOSPITAL WITH EXTERNAL COMPENSATION INFORMATION ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G MEDICAL PHYSICIANS: PROGRAM SERVICE EXPENSES 20,916,126. MANAGEMENT AND GENERAL EXPENSES 301,174. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,217,300. CONSULTING FEES: PROGRAM SERVICE EXPENSES 156,478. MANAGEMENT AND GENERAL EXPENSES 104,713. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 261,191. MEDICAL THERAPISTS: PROGRAM SERVICE EXPENSES 17,393. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,393. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,306,830. MANAGEMENT AND GENERAL EXPENSES 114,610. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,421,440. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,024,394. MANAGEMENT AND GENERAL EXPENSES 324,328. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,348,722. MARTIN LUTHER KING JR-LOS ANGELES HEALTHCARE CORPORATION 1680 E 120TH STREET LOS ANGELES CA 90059 274658935 HOSPITAL CA 501(C)(3) LINE 3 N/A 0 MARTIN LUTHER KING JR COMMUNITY HEALTH FOUNDATION 1680 E 120TH STREET LOS ANGELES CA 90059 454433505 CHARITABLE FOUNDATION CA 501(C)(3) LINE 7 MLKCH 0 MARTIN LUTHER KING JR HEALTH ASSOCIATES 1680 E 120TH STREET LOS ANGELES CA 90059 844327369 MEDICAL SERVICES CA 501(C)(3) LINE 3 MLKCH 0 0 0 1 0 1 0 0 0 0 1 1 1 1 1 1 1 0 1 1