2023-03-06T17:59:40-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 1188 PADRE DRIVE STE 101 SALINAS CA 93901 990EZ 2022-01-01 863477976 JERRY RUBIN FOUNDATION FOR CANCER CARE JERR 8316424041 5 HARRIS COURT BUILDING T 201 MONTEREY CA 939405750 M ZACH KOONTZ MD SECRETARY/TREASURER 8316424041 2023-03-03 1 M ZACH KOONTZ MD 999009999 0 KIELY HOLCOMB CPA P01430569 8317596300 2023-03-01 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z X WWW.JERRYRUBINFOUNDATIONFORCANCERCARE.ORG X X 72050 X 72050 72050 1407 4041 9669 1969 17086 54964 720 0 55684 X 720 55735 720 55735 0 51 720 55684 X THE FOUNDATION IS FORMED 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, TO PROVIDE EDUCATIONAL PROGRAMS FOR MEDICAL PROFESSIONALS WITH RESPECT TO THE DIAGNOSIS, TREATMENT AND MANAGEMENT OF CANCER, TO ESTABLISH COMMUNITY-BASED EDUCATIONAL INITIATIVES TO PROMOTE THE EARLY DETECTION OF CANCER AND AN INTEGRATED APPROACH TO CANCER TREATMENT, TO PROVIDE SUPPORT GROUPS FOCUSED ON CANCER PATIENTS, CAREGIVERS AND THE BEREAVED, AND TO PROVIDE SUCH OTHER PROGRAMS AS WILL ASSIST CANCER PATIENTS DURING THEIR BATTLE WITH CANCER AND WITH END OF LIFE. 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 RECEIVED A $20,000 DONATION FROM A GRATEFUL PATIENT WHO FELT STRONGLY ABOUT OUR MISSION AND WHO HAD DR. JERRY RUBIN AS HER PHYSICIAN AT ONE POINT DURING HER CARE. WE ALSO RECEIVED A $200,000 GRANT FROM THE HOSPICE GIVING FOUNDATION TO BE USED TOWARD THE ESTABLISHMENT OF A LOCAL HOSPICE CARE FACILITY.THE HOSPICE FACILITY WE'VE DEVELOPED IS CALLED JERRY'S PLACE. WE RENT 2 PRIVATE ROOMS AND A SHARED BATH FROM MARIPOSA ASSISTED LIVING IN SEASIDE. THESE ROOMS WILL BE USED FOR PATIENTS WHO DON'T HAVE THE ABILITY TO DIE IN PEACE AND COMFORT. WE ADMITTED OUR FIRST PATIENT ON DECEMBER 21, 2022, A 95 YEAR OLD WHO WAS AT END OF LIFE WITH NO PLACE TO GO. HE DIED PEACEFULLY THE FIRST WEEK IN JANUARY. HE WAS ABLE TO SPEND THE HOLIDAY SEASON, WITH HIS WIFE AND GRANDSON BY HIS SIDE, IN JERRY'S PLACE. WE ARE CURRENTLY EVALUATING ADDITIONAL PATIENTS FOR ELIGIBILITY TO STAY AT JERRY'S PLACE. THIS IS THE ONLY FACILITY OF ITS TYPE IN MONTEREY COUNTY AND SURROUNDING COUNTIES. IT IS A TRIBUTE TO DR. JERRY RUBIN'S WORK AND HIS LEGACY. DR. RUBIN WORKED WITH LOCAL REPRESENTATIVES AND POLITICIANS TO CONVINCE MEDICARE TO RECOGNIZE HOSPICE CARE AS A PAID BENEFIT ON A NATIONAL BASIS. IT IS TRULY FITTING THAT THIS FACILITY, AND THIS FOUNDATION, BE NAMED IN HIS HONOR.THE FOUNDATION HAS ALSO HIRED 2 EMPLOYEES TO OVERSEE THE OPERATIONS OF JERRY'S PLACE. THE EMPLOYEES ARE BOTH PARTTIME (10 HOURS PER WEEK). WE HAVE A PROGRAM COORDINATOR WHO MEETS WITH ALL THE HOSPICE AGENCIES AND HOSPITALS REGARDING OUR SERVICES. THIS POSITION ALSO HANDLES THE INCOMING PATIENT REFERRALS. THE SECOND POSITION IS A VOLUNTEER COORDINATOR. THIS POSITION RECRUITS, TRAINS AND DEPLOYS VOLUNTEERS AS NEEDED TO PROVIDE A VARIETY OF SERVICES FOR OUR PATIENTS./RESIDENTS. BOTH POSITIONS ALSO SPEND TIME AT JERRY'S PLACE WITH THE PATIENTS ANDTHEIR FAMILIES.WE WILL BE GROWING JERRY'S PLACE OVER THE NEXT YEAR AS WELL AS DEVELOPING ADDITIONAL PATIENT ASSISTANCE PROGRAMS THROUGH THE FOUNDATION. THERE WILL BE A CONCERTED FUNDRAISING CAMPAIGN DURING 2023 TO ENSURE OUR SUSTAINABILITY AND SUCCESS FOR THE FUTURE. 0 17086 17086 JOHN HAUSDORFF MD PRESIDENT 12.00 0 0 0 ROGER SHIFFMAN MD VICE PRESIDENT 0.50 0 0 0 M ZACH KOONTZ MD TREAS/SECRETARY 1.00 0 0 0 VALERIA WAREHAM EXECUTIVE DIR. 15.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CA VALERIA WAREHAM 5 HARRIS COURT BUILDING T SUITE 201 MONTEREY CA 939405750 8316424041 0 0 0 0 0 0 0 0 0 0 NONE NONE 1 X 750 72050 72800 750 72050 72800 72800 72800 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES DESCRIPTION: PAYROLL TAXES. AMOUNT: 143. DESCRIPTION: ADVERTISING. AMOUNT: 428. DESCRIPTION: OFFICE EXPENSE. AMOUNT: 304. DESCRIPTION: INSURANCE. AMOUNT: 1,094. TOTAL TO FORM 990-EZ, LINE 16: 1,969. FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES DESCRIPTION: PAYROLL CLEARING. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 51.