2024-05-24T09:40:16-05:00 2023-12-31 410746749 CLIFTONLARSONALLEN LLP 1188 PADRE DRIVE STE 101 SALINAS CA 93901 990 2023-01-01 863477976 JERRY RUBIN FOUNDATION FOR CANCER CARE JERR 8316424041 5 HARRIS COURT BUILDING T 201 MONTEREY CA 939405750 JOHN HAUSDORFF PRESIDENT 8316424041 2024-05-22 1 JOHN HAUSDORFF 999009999 1 KIELY HOLCOMB CPA P01430569 8317596300 2024-05-22 2 AAL1 IAL1 2023 2023-04-26 12:10:37Z VALERIA WAREHAM 5 HARRIS COURT BUILDING T 201 MONTEREY CA 939405750 210808 0 X WWW.JERRYRUBINFOUNDATIONFORCANCERCARE.ORG X 2021 CA TO PROVIDE FINANCIAL AND OTHER ASSISTANCE AND SUPPORT TO CANCER PATIENTS. 3 3 3 5 0 0 0 210808 0 0 0 0 0 0 0 210808 0 0 0 0 0 32756 0 0 6413 0 139970 0 172726 0 38082 55735 93766 51 0 55684 93766 X THE FOUNDATION IS FORMED (I) TO PROVIDE FINANCIAL AND OTHER ASSISTANCE AND SUPPORT TO CANCER PATIENTS, INCLUDING, WITHOUT LIMITATION, PROGRAMS DESIGNED TO MEET THE PSYCHOLOGICAL AND EMOTIONAL NEEDS OF CANCER PATIENTS; (II) TO PROVIDE EDUCATIONAL PROGRAMS FOR MEDICAL PROFESSIONALS WITH RESPECT TO THE DIAGNOSIS, TREATMENT AND MANAGEMENT OF CANCER; (III) TO ESTABLISH COMMUNITY-BASED EDUCATIONAL INITIATIVES TO PROMOTE THE EARLY DETECTION OF CANCER AND AN INTEGRATED APPROACH TO CANCER TREATMENT; (IV) TO PROVIDE SUPPORT GROUPS FOCUSED ON CANCER PATIENTS, CAREGIVERS AND THE BEREAVED, AND (V) TO PROVIDE SUCH OTHER PROGRAMS AS WILL ASSIST CANCER PATIENTS DURING THEIR BATTLE WITH CANCER AND WITH END OF LIFE. 0 0 122565 THE JERRY RUBIN FOUNDATION WAS ESTABLISHED IN DECEMBER 2021 TO ASSIST CANCER PATIENTS THROUGHOUT THEIR CANCER JOURNEY. ADDITIONALLY, IT IS STRUCTURED TO HELP PATIENTS WITH END-OF-LIFE CARE.THE FOUNDATION CONTINUES TO RECEIVE FINANCIAL SUPPORT FROM THE HOSPICE GIVING FOUNDATION. ADDITIONALLY, THE PHYSICIANS OF PACIFIC CANCER CARE DONATED $100,000 TO THE FOUNDATION. THERE ARE MULTIPLE MONTHLY DONATIONS COMING IN FROM THE COMMUNITY AND WE CONTINUE TO APPLY FOR ADDITIONAL GRANTS TO INCREASE OUR FUNDING FOR OUR PROGRAMS.THE HOSPICE FACILITY WE'VE DEVELOPED IS CALLED JERRY'S PLACE. THIS FACILITY OPENED IN DECEMBER 2022. WE'VE HAD 14 TOTAL RESIDENTS TO DATE: SIX MALES AND EIGHT FEMALES. THE DIAGNOSES THE RESIDENTS HAVE HAD INCLUDE PARKINSONS, CANCER, HEART DISEASE, LEWY BODY, STROKE AND SEPSIS. REFERRALS HAVE COME FROM THREE LOCAL HOSPITALS AND FIVE DIFFERENT HOSPICE AGENCIES. THE AGE RANGE OF THE RESIDENTS IS 60-95 YEARS OLD. THE AVERAGE LENGTH OF STAY AT JERRY'S PLACE IS 30 DAYS AND THERE HAVE BEEN TWO LIVE DISCHARGES FROM JERRY'S PLACE DUE TO EXTENDED PROGNOSIS. RESIDENTS OF JERRY'S PLACE HAVE ALL BEEN FROM MONTEREY COUNTY INCLUDING CARMEL VALLEY, KING CITY, MARINA, PACIFIC GROVE, SALINAS, SEASIDE AND WATSONVILLE. THE FOUNDATION HAS 2 EMPLOYEES TO OVERSEE THE OPERATIONS OF JERRY'S PLACE. THE EMPLOYEES ARE BOTH PART-TIME AND HAVE INCREASED THEIR HOURS FROM 10 PER WEEK EACH TO 15+ HOURS PER WEEK OVER THE PAST YEAR. WE HAVE A PROGRAM MANAGER WHO MEETS WITH ALL THE HOSPICE AGENCIES AND HOSPITALS REGARDING OUR SERVICES. THIS POSITION OVERSEES ALL INCOMING REFERRALS AND MANAGES ALL RESIDENT ADMISSIONS. THE SECOND POSITION IS A FOUNDATION SERVICES COORDINATOR. THIS POSITION DOES GRANT WRITING, MARKETING, & HELPS THE PROGRAM MANAGER WITH EVENTS. BOTH POSITIONS ALSO SPEND TIME AT JERRY'S PLACE WITH THE PATIENTS AND THEIR FAMILIES.WE HAVE ALSO BEGUN ACCEPTING FINANCIAL ASSISTANCE APPLICATIONS FROM PATIENTS NEEDING HELP WITH FINANCES DURING ACTIVE TREATMENT. THEY MUST MEET FINANCIAL REQUIREMENTS AND CAN ACCESS UP TO $1,500 PER YEAR FOR BASIC LIVING EXPENSES SUCH AS RENT, GAS, CHILDCARE, FOOD, AND UTILITIES. THESE FUNDS CANNOT BE USED FOR PAYMENT OF MEDICAL BILLS OR INSURANCE PREMIUMS.JERRY'S PLACE IS BECOMING MORE VISIBLE WITHIN THE COMMUNITY, AND WE ANTICIPATE CONTINUING TO GROW TO OUTLYING AREAS. WE WILL BE LOOKING FOR ADDITIONAL PARTNERSHIPS WHERE WE MIGHT BE ABLE TO OPEN UP ADDITIONAL BEDS FOR END-OF-LIFE CARE IN OTHER COMMUNITIES WITHIN MONTEREY COUNTY. 122565 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3 0 1 3 1 0 0 0 0 0 0 0 0 0 0 0 0 X 3 3 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X X VALERIA WAREHAM 8316424041 5 HARRIS COURT BUILDING T SUITE 201 MONTEREY CA 939405750 X JOHN HAUSDORFF MD PRESIDENT 1.00 X X 0 0 0 ROGER SHIFFMAN MD VICE PRESIDENT 0.50 X X 0 0 0 M ZACH KOONTZ MD TREAS/SECRETARY 1.00 X X 0 0 0 VALERIA WAREHAM EXECUTIVE DIR. 12.00 X 0 0 0 0 0 0 0 0 0 0 0 210808 210808 210808 0 0 0 29144 29144 572 572 3040 3040 1223 1223 2363 2363 3930 3930 246 246 454 454 118790 118790 1776 1776 PRINTING & COPYING 8196 3484 4712 POSTAGE 1701 1701 PAYROLL PROCESSING FEES 700 700 BUSINESS REGISTRATION F 300 300 291 291 172726 122565 43748 6413 55735 93766 55735 93766 51 0 51 0 X 55684 93766 55684 93766 55735 93766 38082 0 X 0 0 0 X 750 72050 210808 283608 750 72050 210808 283608 43656 239952 283608 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED FORM 990, PART VI, SECTION A, LINE 1A THE BOARD OF DIRECTORS MAY, BY RESOLUTION ADOPTED BY A MAJORITY OF THE NUMBER OF DIRECTORS THEN IN OFFICE, PROVIDED THAT A QUORUM IS PRESENT, CREATE ONE OR MORE COMMITTEES, EACH CONSISTING OF TWO OR MORE DIRECTORS, TO SERVE AT THE PLEASURE OF THE BOARD OF DIRECTORS. APPOINTMENTS TO SUCH COMMITTEES SHALL BE BY A MAJORITY VOTE OF THE NUMBER OF DIRECTORS THEN IN OFFICE, PROVIDED A QUORUM IS PRESENT. THE BOARD OF DIRECTORS MAY APPOINT ONE OR MORE DIRECTORS AS ALTERNATE MEMBERS OF ANY SUCH COMMITTEE, WHO MAY REPLACE ANY ABSENT MEMBER AT ANY MEETING OF THE COMMITTEE. ANY SUCH COMMITTEE SHALL HAVE ALL THE AUTHORITY OF THE BOARD OF DIRECTORS TO THE EXTENT PROVIDED IN THE BOARD RESOLUTION OR RESOLUTIONS CREATING AND EMPOWERING THE COMMITTEE; PROVIDED THAT, NO COMMITTEE MAY DO ANY OF THE FOLLOWING: (A) TAKE ANY FINAL ACTION ON ANY MATTER THAT, UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, REQUIRES THE APPROVAL OF THE MEMBERS OR APPROVAL OF A MAJORITY OF MEMBERS OF A NONPROFIT PUBLIC BENEFIT CORPORATION (NOTWITHSTANDING THAT THIS CORPORATION HAS NO MEMBERS); (B) ELECT DIRECTORS OR FILL VACANCIES ON THE BOARD OF DIRECTORS; (C) FIX ANY COMPENSATION FOR THE DIRECTORS FOR SERVING ON THE BOARD OF DIRECTORS OR ANY COMMITTEE OF THE BOARD OF DIRECTORS; (D) AMEND OR REPEAL BYLAWS OR ADOPT NEW BYLAWS; (E) AMEND OR REPEAL ANY RESOLUTION OR ACTION TAKEN BY THE BOARD OF DIRECTORS THAT BY ITS EXPRESS TERMS IS NOT SO AMENDABLE OR REPEALABLE; (F) CREATE ANY OTHER COMMITTEES OFTHE BOARD OF DIRECTORS OR APPOINT THE MEMBERS OF COMMITTEES OF THE BOARD OF DIRECTORS, INCLUDING ANY APPOINTMENTS TO FILL VACANCIES ON COMMITTEES OF THE BOARD OF DIRECTORS; (G) EXPEND CORPORATE FUNDS TO SUPPORT A NOMINEE FOR DIRECTOR; OR, (H) APPROVE ANY CONTRACT OR TRANSACTION IN WHICH ONE OR MORE DIRECTORS HAS A DIRECT OR INDIRECT MATERIAL FINANCIAL INTEREST, EXCEPT AS SPECIAL APPROVAL IS PROVIDED FOR IN 5233(D)(3). ANY COMMITTEE, THAT IS NOT COMPRISED ENTIRELY OF MEMBERS OF THE BOARD OF DIRECTORS, SHALL NOT EXERCISE THE AUTHORITY OF THE BOARD OF DIRECTORS BUT SHALL ACT IN AN ADVISORY CAPACITY AS TO ALL ACTIONS THAT REQUIRE APPROVAL OF THE BOARD OF DIRECTORS OR THAT WOULD ORDINARILY BE APPROVED THE BOARD OF DIRECTORS GIVEN THE MATERIALITY OF SUCH ACTION. FORM 990, PART VI, SECTION B, LINE 11B LINE 11B EXPLANATION - THE PRESIDENT AND TREASURER ARE HEREBY APPOINTED AS A COMMITTEE OF THE BOARD WITH AUTHORITY OF THE BOARD TO REVIEW THE IRS FORM 990, FTB FORM 199, AG FORM RRF-1 AND ANY OTHER REQUIRED FILINGS TO BE FILED BY THE CORPORATION ON AN ANNUAL BASIS, AND SUCH COMMITTEE IS AUTHORIZED AND DIRECTED TO REVIEW SUCH FORMS (AS MAY BE PREPARED BY THE CERTIFIED PUBLIC ACCOUNTANTS ENGAGED BY THE CORPORATION) ON AN ANNUAL BASIS PRIOR TO THE FILING OF SUCH FORMS. FORM 990, PART VI, SECTION B, LINE 12C INTERESTED PERSON - AN "INTERESTED PERSON" SHALL MEAN ANY DIRECTOR, OFFICER, KEY EMPLOYEE OR ANY COMMITTEE MEMBER REGARDLESS OF WHETHER SUCH PERSON IS A DIRECTOR, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST IN A CONTEMPLATED TRANSACTION OR ARRANGEMENT. CONFLICT OF INTEREST. A CONFLICT OF INTEREST MAY EXIST WHEN AN INTERESTED PERSON HAS, DIRECTLY OR INDIRECTLY, A FINANCIAL INTEREST IN ANY TRANSACTION OR ARRANGEMENT UNDER CONSIDERATION BY ANY OFFICER, THE BOARD OR ANY COMMITTEE. DUTY TO DISCLOSE. A. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST FULLY DISCLOSE ALL MATERIAL FACTS RELATED TO THE RELATIONSHIPS AND/OR FINANCIAL OR OTHER INTERESTS THAT GIVE RISE TO THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST. SUCH DISCLOSURE SHALL BE MADE TO THE BOARD OR ANY OFFICER(S) CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. B. IF A DIRECTOR, OFFICER, KEY EMPLOYEE OR COMMITTEE MEMBER BECOMES AWARE OF ANY POTENTIAL CONFLICT OF INTEREST RELATED TO ANOTHER DIRECTOR, OFFICER, KEY EMPLOYEE OR COMMITTEE MEMBER, HE OR SHE SHALL BRING IT TO THE ATTENTION OF THE PRESIDENT, TREASURER/CHIEF FINANCIAL OFFICER OR THE SECRETARY IMMEDIATELY. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS. THE BOARD MAY DETERMINE THAT THE FINANCIAL OR OTHER INTEREST IS NOT MATERIAL AND THAT, THEREFORE, THERE IS NO ACTUAL OR POTENTIAL CONFLICT OF INTEREST. IF THE BOARD DETERMINES THAT THERE IS NO ACTUAL OR POTENTIAL CONFLICT OF INTEREST, NO VOTE OF THE BOARD SHALL BE REQUIRED TO PROCEED WITH THE TRANSACTION OR ARRANGEMENT. IF THE BOARD DETERMINES THAT AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST EXISTS, THE BOARD MAY AUTHORIZE OR APPROVE THE TRANSACTION OR ARRANGEMENT PURSUANT TO THE PROCEDURES SET FORTH IN THE NEXT SECTION. PROCEDURES FOR ADDRESSING A CONFLICT OF INTEREST. IF THE BOARD DETERMINES THAT THERE IS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, THE BOARD SHALL PROCEED AS FOLLOWS: A. THE INTERESTED PERSON(S) SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND VOTE ON, THE TRANSACTION OR ARRANGEMENT, PROVIDED THAT SUCH INTERESTED PERSON(S) SHALL BE GIVEN THE OPPORTUNITY TO ADDRESS THE MEETING WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT BEFORE LEAVING THE MEETING. B. THE BOARD MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT BEFORE VOTING ON SUCH TRANSACTION OR ARRANGEMENT. C. THE BOARD, ACTING IN GOOD FAITH, MAY AUTHORIZE OR APPROVE THE TRANSACTION OR ARRANGEMENT BY VOTE OF A MAJORITY OF THE DIRECTORS THEN IN OFFICE WITHOUT COUNTING THE VOTE OF ANY DIRECTOR WHO HAS A MATERIAL FINANCIAL INTEREST IN THE TRANSACTION OR ARRANGEMENT (ALTHOUGH SUCH DIRECTOR(S) MAY BE COUNTED IN DETERMINING THE PRESENCE OF A QUORUM) AFTER DETERMINING THE FOLLOWING: I. THAT THE BOARD HAS KNOWLEDGE OF ALL MATERIAL FACTS CONCERNING THE TRANSACTION OR ARRANGEMENT AND THE FINANCIAL INTEREST OF ANY INTERESTED PERSON IN SUCH TRANSACTION OR ARRANGEMENT; II. THAT THE BOARD IS ACTING IN GOOD FAITH; III. THAT THE CORPORATION IS ENTEREING INTO THE TRANSACTION FOR ITS OWN BENEFIT; IV. THAT THE TRANSACTION IS (OR WAS) FAIR AND REASONABLE TO THE CORPORATION AT THE TIME THE CORPORATION WILL (OR DID) ENTER INTO IT; AND, V. THAT, AFTER REASONABLE INVESTIGATION UNDER THE CIRCUMSTANCES, THE CORPORATION CANNOT OBTAIN A MORE ADVANTAGEOUS ARRANGEMENT WITH REASONABLE EFFORT UNDER THE CIRCUMSTANCES. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION'S GOVERNING DOCUMENTS AND ITS IRS FORM 990 ARE AVAILABLE ON THE WEBSITE OF THE OFFICE OF THE CALIFORNIA ATTORNEY GENERAL.