2023-05-15T12:15:39-05:00 2022-06-30 910189318 MOSS ADAMS LLP 21700 OXNARD ST STE 300 WOODLAND HILLS CA 91367 990 2021-07-01 812455970 MARTIN LUTHER KING JR COMMUNITY MEDICAL FOUNDATION MART 4245296755 2251 WEST ROSECRANS AVENUE 18 COMPTON CA 90222 MITCHELL THOMAS CHIEF FINANCIAL OFFICER 4245296755 2023-05-10 1 MITCHELL THOMAS 999009999 LAUREN A HAVERLOCK P00545829 8185771900 2023-05-10 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z MITCHELL THOMAS 2251 WEST ROSECRANS AVENUE 18 COMPTON CA 90222 27204999 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 8 0 0 7050197 1254824 18778547 25685711 0 0 19795 264464 25848539 27204999 0 2082392 0 0 5757608 6626165 0 0 0 26077344 25667305 31834952 34375862 -5986413 -7170863 26901023 36479093 32625097 49374030 -5724074 -12894937 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 30528442 2082392 25685711 VOLUME PATIENT CLINIC VISITS WERE 46,449 INCLUDING 7,813 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 3,026. MLKCMF ESTABLISHED THE ENHANCED CARE MANAGEMENT PROGRAM, WHICH IS A STATEWIDE MEDI-CAL BENEFIT. THE GOAL OF THIS PROGRAM IS TO PROVIDE WHOLE PERSON APPROACH TO CARE THAT ADDRESSES BOTH CLINICAL AND NON-CLINICAL NEEDS OF HIGH-NEED MEDI-CAL BENEFICIARIES. BENEFICIARIES WILL HAVE A SINGLE LEAD CARE MANAGER WHO WILL COORDINATE 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 ESTABLISHED 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 INFANT UNTIL THEY REACH SIX MONTHS OF AGE. 30528442 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 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 10 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 MITCHELL THOMAS 4243388717 1680 E 120TH STREET LOS ANGELES CA 90059 KURT STAUDER PRES. OF MEDICAL GROUP FDN 40.00 8.00 X X 0 246503 0 MANUAL 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 SAMANTHA GARIBAY MANAGER SITE ADMINISTRATOR 40.00 X 126911 0 29070 TARICK JACKSON MANAGER SITE ADMINISTRATOR 40.00 X 112729 0 6679 LISSA OWEN MANAGER OF REVENUE CYCLE 40.00 X 115555 0 22001 NANCY TORRES MANAGER POPULATION HEALTH AMBULATORY 40.00 X 103245 0 21674 458440 246503 79424 4 0 1 0 THE REGENTS OF THE UNIVERSITY OF CALIFOR 1680 E 102TH STREET LOS ANGELES CA 90095 HOSPITALIST / INTENSIVIST PHYSICIANS 11481930 HUBMD PC 104 OLIVE STREET UNIT 100 REDLANDS CA 92373 UROLOGY PHYSICIANS 728276 HALL DYNAMICS DBA MYRON L HALL DPM 9301 WILSHIRE BLVD 404 BEVERLY HILLS CA 90210 PODIATRY PHYSICIAN 294438 STACIA MILLS MD A PROFESSIONAL CORP 1744 N AVE 45 LOS ANGELES CA 90041 PSYCHIATRY 202603 NEURO INDUSTRIAL MEDICAL GROUP INC 223 N GARFIELD AVE 302 MONTEREY PARK CA 91754 NEUROLOGIST 195560 5 1181824 73000 1254824 CALL COVERAGE 621990 11058349 11058349 NET PATIENT SERV. REV. 621990 6425225 6425225 SB SUPPLEMENTAL FUNDING 561499 4891657 4891657 SUPPORT SERVICES 621990 1725568 1725568 CAPITATION REVENUE 621990 1044987 1044987 539925 539925 25685711 OTHER OPERATING REVENUE 561499 264464 264464 264464 27204999 25685711 0 264464 X 2082392 2082392 4762616 3298683 1463933 99855 52644 47211 1355874 935443 420431 407820 280645 127175 801851 801851 11209 2790 8419 2100 2100 23318707 22544017 774690 177769 177769 62654 59854 2800 8720 8720 687440 687440 1785 1785 MEDICAL SUPPLIES 551062 551062 DUES AND SUBSCRIPTIONS 15259 2587 12672 INSTRUMENT/MINOR EQUIP. 10540 10540 EMPLOYEE EXPENSE REIMB. 10249 3665 6584 7960 7960 34375862 30528442 3847420 0 489205 1157024 3856467 4919917 248528 103882 22306823 30298270 26901023 36479093 2934776 7070887 29690321 42303143 32625097 49374030 X -10564024 -13956009 4839950 1061072 -5724074 -12894937 26901023 36479093 -7170863 0 X 0 1 X 1 1 1 X 1701956 4329484 9524494 7050197 1254824 23860955 2430137 11615171 14991574 18778547 25685711 73501140 4132093 15944655 24516068 25828744 26940535 97362095 0 1858880 8432942 10632006 11478469 11418876 43821173 1858880 8432942 10632006 11478469 11418876 43821173 53540922 41212 291400 19795 264464 616871 4132093 15985867 24807468 25848539 27204999 97978966 0.54650 0.53860 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. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE FROM HOSPITAL 30298270 30298270 PROMISSORY NOTE TO MLKCH 300000 PHYSICIANS SALARY GUARANTEE LIABILITY 148387 DUE TO MLKCH 41854756 42303143 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, 2022 AND 2021. THE COMPANY IS SUBJECT TO INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR ALL YEARS SINCE INCEPTION FOR FEDERAL AND STATE TAX FILINGS. 1 MARTIN LUTHER KING JR LOS ANGELES HEALTHCARE CORPORATION 1680 E 120TH STREET LOS ANGELES CA 90059 274658935 501(C)(3) 2082392 0 PPE, SAFETY NET INITIATIVE, PROVIDER RECRUITMENT PROGRAM, JORDAN DOWNS COMMUNITY AND VACCINE INITIATIVE 1 PART I, LINE 2: DURING THE JUNE 30, 2022 FISCAL YEAR, FUNDS GRANTED TO MARTIN LUTHER KING JR., LOS ANGELES HEALTHCARE CORPORATION WERE MONITORED BY OVERLAPPING GOVERNANCE. 0 0 0 0 0 0 0 0 0 KURT STAUDER PRES. OF MEDICAL GROUP FDN 0 226503 0 20000 0 0 0 0 0 0 0 246503 0 0 SAMANTHA GARIBAY MANAGER SITE ADMINISTRATOR 119766 0 7145 0 0 0 3735 0 25335 0 155981 0 0 0 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 21,386,747. MANAGEMENT AND GENERAL EXPENSES 320,343. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,707,090. CONSULTING FEES: PROGRAM SERVICE EXPENSES 200,039. MANAGEMENT AND GENERAL EXPENSES 182,371. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 382,410. MEDICAL THERAPISTS: PROGRAM SERVICE EXPENSES 68,790. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 68,790. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 498,911. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 498,911. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 389,530. MANAGEMENT AND GENERAL EXPENSES 271,976. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 661,506. 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 N/A 0 0 0 1 0 1 0 0 0 0 1 1 1 1 1 1 1 0 1 1