2022-05-12T11:51:00-05:00 2021-06-30 910189318 MOSS ADAMS LLP 21700 OXNARD ST STE 300 WOODLAND HILLS CA 91367 990 2020-07-01 812455970 MARTIN LUTHER KING JR COMMUNITY MEDICAL FOUNDATION MART 4245296755 2251 WEST ROSECRANS AVENUE NO 18 COMPTON CA 90222 MITCHELL THOMAS CHIEF FINANCIAL OFFICER 4245296755 2022-05-10 1 MITCHELL THOMAS 999009999 LAUREN A HAVERLOCK P00545829 8185771900 2022-05-10 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z MITCHELL THOMAS 2251 WEST ROSECRANS AVENUE NO 18 COMPTON CA 90222 25848539 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. 8 8 17 0 0 0 9524494 7050197 14991576 18778547 0 0 291400 19795 24807470 25848539 0 0 0 0 6226777 5757608 0 0 0 18442152 26077344 24668929 31834952 138541 -5986413 3795647 4594200 3533308 10318274 262339 -5724074 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 28324200 18778547 MARTIN LUTHER KING COMMUNITY MEDICAL FOUNDATION (MLKCMF) IS A TEAM OF PHYSICIANS PASSIONATELY COMMITTED TO IMPROVING THE HEALTH OF THE SOUTH LOS ANGELES COMMUNITY. MLKCMF IS MADE UP OF HIGHLY TRAINED SPECIALISTS WORKING TOGETHER TO PROVIDE THE CARE AND MANAGEMENT OF CHRONIC CONDITIONS SUCH AS DIABETES, HEART DISEASE, MEN'S AND WOMEN'S HEALTH, PODIATRY, UROLOGY, INFECTIOUS DISEASE, PRIMARY CARE, DIGESTIVE DISEASE, LUNG DISEASE, GENERAL SURGERY, MENTAL AND BEHAVIORAL HEALTH, ADDICTION MEDICINE, INTERNAL MEDICINE, AND PEDIATRICS. MLKCMF WORKS WITH EVERY PATIENT TO PROVIDE HELP WITH DISEASE PREVENTION, WELLNESS PLANS, HEALTH EDUCATION AND SELF-MANAGEMENT PROGRAMS, AND CONNECTIONS TO HEALTH SERVICES AND RESOURCES. DURING FY2021, MLKCMF INCREASED THE NUMBER OF PHYSICIANS AND EXPANDED THE CLINIC SPACE TO ACCOMMODATE LARGER PATIENT VOLUME PATIENT CLINIC VISITS WERE 51,794 INCLUDING 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. 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. 28324200 1 1 0 0 0 0 0 0 0 0 0 0 0 0 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 13 0 1 17 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 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 X MANUAL A ABASCAL JD CHAIR 6.00 8.00 X X 0 0 0 PAUL KING VICE CHAIR 3.00 5.00 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 3.00 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 LAURIE GALLAGHER DIRECTOR OF AMBULATORY OPERATIONS 40.00 0.00 X 178565 0 6355 TARICK JACKSON SITE ADMINISTRATOR 40.00 0.00 X 117133 0 3575 LISSA OWEN MANAGER 40.00 0.00 X 110160 0 22557 405858 0 32487 3 0 1 0 THE REGENTS OF THE UNIVERSITY OF CALIFOR 1680 E 102TH STREET LOS ANGELES CA 90095 HOSPITALIST / INTENSIVIST PHYSICIANS 9085493 HUBMD PC 104 OLIVE STREET UNIT 100 REDLANDS CA 92373 UROLOGY PHYSICIANS 695820 ARIEL MALAMUD MD 2307 GUTHRIE DRIVE LOS ANGELES CA 90034 GASTROENTEROLOGY PHYSICIAN 257870 FARAMARZ TEHRANI MD 639 N BROADWAY 647 LOS ANGELES CA 90012 GASTROENTEROLOGY PHYSICIAN 257128 HALL DYNAMICS DBA MYRON L HALL DPM 9301 WILSHIRE BLVD 404 BEVERLY HILLS CA 90210 PHYSICIAN SERVICES 238163 7 7050197 7050197 CALL COVERAGE 621990 11114663 11114663 NET PATIENT SERV. REV. 621990 4837117 4837117 SUPPORT SERVICES 621990 1592942 1592942 CAPITATION REVENUE 621990 539730 539730 PROP 56 PAYMENTS 621990 529495 529495 164600 164600 18778547 OTHER OPERATING REVENUE 900099 19795 19795 19795 25848539 18778547 0 19795 X 4079790 3040465 1039325 101556 55692 45864 1229522 908082 321440 346740 259858 86882 729668 5250 724418 68537 9684 58853 625 625 23820337 22842793 977544 184218 185 184033 45382 43350 2032 694220 694220 45 45 1820 1820 5190 5190 MEDICAL SUPPLIES 387743 387743 DUES AND SUBSCRIPTIONS 70152 13297 56855 INSTRUMENT/MINOR EQUIP. 18703 18703 RECRUITING EXPENSE 15000 15000 35704 29833 5871 31834952 28324200 3510752 0 697252 489205 1716825 3856467 62574 248528 1318996 0 3795647 4594200 2013350 2934776 1519958 7383498 3533308 10318274 X -4380897 -10564024 4643236 4839950 262339 -5724074 3795647 4594200 -5986413 0 X 0 1 X 1 0 X 1701956 4329484 9524494 7050197 22606131 377250 2430137 11615171 14991574 18778547 48192679 377250 4132093 15944655 24516068 25828744 70798810 0 324629 1858880 8432942 10632006 11230395 32478852 324629 1858880 8432942 10632006 11230395 32478852 38319958 41212 291400 19795 352407 377250 4132093 15985867 24807468 25848539 71151217 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. SCHEDULE A, PART III THE ORGANIZATION'S 2015 TAX YEAR WAS A SHORT-YEAR, AS THIS WAS THE FIRST YEAR THE ORGANIZATION HAD FORMED. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 PROMISSORY NOTE TO MLKCH 300000 PHYSICIANS SALARY GUARANTEE LIABILITY 1312156 DUE TO MLK HEALTH ASSOCIATES 515073 DUE TO MLKCH 5256269 7383498 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, 2021 AND 2020. THE COMPANY IS SUBJECT TO INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR ALL YEARS SINCE INCEPTION FOR FEDERAL AND STATE TAX FILINGS. 0 0 0 0 0 0 0 0 0 LAURIE GALLAGHER DIRECTOR OF AMBULATORY OPERATIONS 154549 0 22249 0 1767 0 5217 0 1138 0 184920 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. 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 19,501,110. MANAGEMENT AND GENERAL EXPENSES 223,386. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,724,496. CONSULTING FEES: PROGRAM SERVICE EXPENSES 234,622. MANAGEMENT AND GENERAL EXPENSES 217,683. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 452,305. MEDICAL THERAPISTS: PROGRAM SERVICE EXPENSES 8,273. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,273. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,118,842. MANAGEMENT AND GENERAL EXPENSES 14,400. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,133,242. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 979,946. MANAGEMENT AND GENERAL EXPENSES 522,075. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,502,021. 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