2022-04-21T17:15:29-05:00 2021-06-30 951777440 GREEN HASSON & JANKS LLP 700 SOUTH FLOWER STREET SUITE 3300 LOS ANGELES CA 90017 990 2020-07-01 952769432 VENICE FAMILY CLINIC VENI 3103928630 604 ROSE AVENUE VENICE CA 90291 ELIZABETH B FORER CEO 3103928630 2022-04-20 1 ELIZABETH FORER 999009999 LIZBETH G NEVAREZ P01399868 3108731600 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z ELIZABETH B FORER 604 ROSE AVENUE VENICE CA 90291 64178050 0 X HTTP://WWW.VENICEFAMILYCLINIC.ORG/ X 1970 CA TO PROVIDE QUALITY PRIMARY HEALTH CARE TO PEOPLE IN NEED. 21 21 435 937 0 0 29438260 33915091 29017288 28694912 152080 587327 0 0 58607628 63197330 0 0 0 0 44128618 44121563 0 0 2678932 12828003 15586703 56956621 59708266 1651007 3489064 47529034 54664856 8125950 11283840 39403084 43381016 TO PROVIDE QUALITY PRIMARY HEALTH CARE TO PEOPLE IN NEED. 0 0 49815243 28694912 VFC SERVES AS A MEDICAL HOME, PROVIDING COORDINATED AND COMPREHENSIVE PRIMARY CARE, SPECIALTY CARE, AND ENABLING SERVICES FOR LOW-INCOME, UNINSURED, AND HOMELESS FAMILIES AND INDIVIDUALS. IT SERVES EVERYONE FROM INFANTS, CHILDREN, AND TEENS TO ADULTS AND SENIORS. VFC OFFERS A VARIETY OF SERVICES INCLUDING: MEDICAL PRIMARY AND SPECIALTY CARE, DENTAL, INTEGRATIVE MEDICINE, VISION SERVICES, PHARMACY, SUBSTANCE USE SERVICES, BEHAVIORAL HEALTH AND FOOD PROGRAMMING. VFC ALSO PROVIDES TREATMENT AND COUNSELING SERVICES TO HIV PATIENTS THROUGH ITS COMMON GROUND PROGRAM. VFC PROVIDES HEALTH CARE ON SIX DAYS AND FOUR EVENINGS PER WEEK. VFC'S PRIMARY SERVICE AREA INCLUDES VENICE, SANTA MONICA, PALMS, MAR VISTA, INGLEWOOD, CULVER CITY AND WEST LOS ANGELES, ALL IN LOS ANGELES COUNTY. 49815243 1 1 0 1 0 0 0 1 0 1 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 72 0 1 435 1 0 0 0 0 0 0 0 0 0 0 0 0 X 21 21 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 CA X ANDREA BLACKBIRD 3106647941 604 ROSE AVENUE VENICE CA 90291 ELIZABETH B FORER CHIEF EXECUTIVE OFFICER 40.00 1.00 X 302834 0 92183 DESPINA G KAYICHIAN CHIEF MEDICAL OFFICER 40.00 0.00 X 298700 0 97550 KAREN C LAMP SENIOR PHYSICIAN 38.00 0.00 X 260985 0 82316 MARGARITA LOEZA STAFF PHYSICIAN 40.00 0.00 X 260541 0 78921 JOHN ARTHUR ROOHAN CLINICAL SITE DIRECTOR 40.00 0.00 X 260000 0 81832 ANITA MARIA ZAMORA DEPUTY DIR/CHIEF OPERATIONS OFFICER 40.00 0.00 X 243000 0 77101 COLEY MARVIN KING STAFF PHYSICIAN 40.00 0.00 X 240934 0 47203 BLANCA ANDRES SENIOR PHYSICIAN 40.00 0.00 X 240621 0 77228 NAVEENA PONNUSAMY CHIEF DEVELOPMENT OFFICER 40.00 0.00 X 240444 0 75972 CHARLES Q HUYNH ASSOCIATE PHYSICIAN DIPLOMATE 40.00 0.00 X 239995 0 50023 ANDREA B BLACKBIRD CHIEF FINANCIAL OFFICER 40.00 1.00 X 238413 0 78692 GILMORE SEISOON CHUNG STAFF PHYSICIAN 40.00 0.00 X 229617 0 49336 RIAN WELLINGTON RUTHERFORD CLINICAL SITE DIRECTOR 40.00 0.00 X 228657 0 46118 SHARON NG DIRECTOR OF PHARMACY SVCS 40.00 0.00 X 193800 0 61111 JASON VU HUA CHIEF INFORMATION OFFICER 40.00 0.00 X 177228 0 56224 STACEY ANN SCARBOROUGH DIR. OF HUMAN RESOURCES & HEAD START 40.00 0.00 X 172536 0 56069 JOAN HERMAN BOARD CHAIR 2.00 2.00 X X 0 0 0 JOHN GERESI IMMEDIATE PAST BOARD CHAIR 2.00 2.00 X X 0 0 0 JEFFREY E SINAIKO TREASURER 2.00 2.00 X X 0 0 0 MICHAEL ST PIERRE SECRETARY 2.00 0.00 X X 0 0 0 KEN BASCOM BOARD MEMBER 2.00 0.00 X 0 0 0 OLGA CARRASCO BOARD MEMBER 2.00 0.00 X 0 0 0 DIANA CARSOLA BOARD MEMBER 2.00 0.00 X 0 0 0 MAYER B DAVIDSON MD BOARD MEMBER 2.00 2.00 X 0 0 0 SYLVIA FIGUEROA BOARD MEMBER 2.00 2.00 X 0 0 0 SUSAN FLEISCHMAN BOARD MEMBER 2.00 2.00 X 0 0 0 WILLIAM FLUMENBAUM BOARD MEMBER 2.00 2.00 X 0 0 0 MARK GAVENS BOARD MEMBER 2.00 2.00 X 0 0 0 SHARON GELFAND BOARD MEMBER 2.00 0.00 X 0 0 0 ALLAN GORDON BOARD MEMBER 2.00 0.00 X 0 0 0 TARYN KEANE BOARD MEMBER 2.00 0.00 X 0 0 0 CAROLINA MONGE BOARD MEMBER 2.00 0.00 X 0 0 0 MITCH DEL MONICO BOARD MEMBER 2.00 0.00 X 0 0 0 NEIL H PARKER MD BOARD MEMBER 2.00 2.00 X 0 0 0 PATRICIA RAMIREZ BOARD MEMBER 2.00 0.00 X 0 0 0 NADIA SHAHEEN BOARD MEMBER 2.00 0.00 X 0 0 0 CARMEN THOMAS-PARIS BOARD MEMBER 2.00 0.00 X 0 0 0 3828305 0 1107879 25 0 1 0 RANDSTAD US LP PO BOX 894217 LOS ANGELES CA 90189 STAFFING SERVICES 552375 BROTHERS MAINTENANCE SERVICES PO BOX 3283 WHITTIER CA 90605 CLEANING SERVICE 500251 PEOPLE 20 GLOBAL INC PO BOX 31001-1288 PASADENA CA 91110 STAFFING SERVICES 280892 GIANT TECHNOLOGY 10366 CIRCULO DE JUAREZ FOUNTAIN VALLEY CA 92708 SQL PROGRAMMER 128400 GREEN HASSON & JANKS LLP 700 S FLOWER STREET SUITE 3300 LOS ANGELES CA 92129 ACCOUNTING SERVICES 105100 5 2500000 17227792 14187299 2889839 33915091 THIRD PARTY REIMBURSEMENT 621400 23051521 23051521 MEDI-CAL PHARMACY 900099 5643391 5643391 28694912 255120 255120 1312927 980720 332207 332207 332207 63197330 28694912 0 587327 3487402 2909816 394214 183372 28547052 23764977 3278311 1503764 4205830 3534490 451465 219875 7881279 6623258 845998 412023 42805 42805 71943 71943 118999 118999 1716627 1119322 519592 77713 33458 6351 4618 22489 1027192 858631 151170 17391 1145307 533584 545258 66465 2076339 1794656 208708 72975 49920 35187 10404 4329 57277 40177 11878 5222 66721 66721 876258 694662 172661 8935 232334 201950 19895 10489 PHARMACEUTICAL SUPPLIES 2395300 2395300 PARTICIPANT SUPPLIES/AC 2311476 2309049 2427 DONATED FOOD 1929257 1929257 MED SUP & WASTE REMOVAL 443426 438320 5106 992064 626256 291918 73890 59708266 49815243 7214091 2678932 1402 1402 11706071 5699296 7269540 12389942 2377654 6990962 270027 271857 260870 284261 22180368 14337090 7506109 7843278 7984274 6217380 8011787 12616587 2141300 2349891 47529034 54664856 1453850 1535912 3075828 6672100 6672100 8125950 11283840 X 25003037 23500388 14400047 19880628 39403084 43381016 47529034 54664856 X 3489064 2632710 -2158297 14455 X 0 1 X 1 0 X 18705895 15571302 17845497 29438260 33915091 115476045 18705895 15571302 17845497 29438260 33915091 115476045 8696024 106780021 104279 125905 409836 222133 255120 1117273 116593318 147527839 0.91580 0.95510 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 21111 0 0 21111 0 PART II-B, LINE 1: DURING THE 2020-2021 FISCAL YEAR, VENICE FAMILY CLINIC'S IN-HOUSE ADVOCACY TEAM AND ITS PUBLIC POLICY COMMITTEE, BOTH COMPRISED OF STAFF AND BOARD MEMBERS, ADDRESSED HEALTH CARE POLICY ISSUES AT THE LOCAL, STATE AND FEDERAL LEVELS. ON THE FEDERAL LEVEL, WE WORKED TO EDUCATE OUR ELECTED OFFICIALS ABOUT COVID SERVICE NEEDS INCLUDING PPE, TESTING, AND VACCINES ALONG WITH THE IMPORTANCE OF EQUITABLE DISTRIBUTION AND ACCESS. WE ALSO EDUCATED THEM ON COVID'S IMPACT ON HEALTH CARE SERVICES AND THE IMPORTANCE FOR FLEXIBILITY IN PROGRAMS LIKE MEDICAID/MEDICARE AND THE ABILITY TO MOVE IN-PERSON VISITS TO TELEHEALTH. ON THE STATE LEVEL, VENICE FAMILY CLINIC PARTICIPATED IN ADVOCACY WITH COMMUNITY CLINIC ASSOCIATION OF LOS ANGELES COUNTY AND CALIFORNIA PRIMARY CARE ASSOCIATION ON THE IMPORTANCE OF BOTH AUDIO AND VIDEO TELEHEALTH FOR MEDI-CAL PATIENTS. WE ALSO ADVOCATED FOR EQUITY IN COVID VACCINE DISTRIBUTION TO ENSURE ACCESS FOR LOWER INCOME COMMUNITIES. LOCALLY, OVER THE PAST YEAR, VENICE FAMILY CLINIC WORKED CLOSELY WITH THE MAYOR'S OFFICE, OUR LOCAL COUNCILMEMBER'S OFFICE, SEVERAL OF OUR LONGTIME COMMUNITY PARTNERS AND MEMBERS OF OUR COMMUNITY EXPERIENCING HOMELESSNESS TO ADDRESS ISSUES RELATED TO INCREASING RESOURCES FOR THE LARGE AND GROWING UNHOUSED POPULATION IN VENICE AND SURROUNDING COMMUNITIES. THE GOAL OF ALL OF VENICE FAMILY CLINIC'S ADVOCACY EFFORTS IS TO INCREASE ACCESS TO AND QUALITY OF CARE FOR THE MEDICALLY UNDERSERVED, THEREBY FURTHERING THE CLINIC'S MISSION TO PROVIDE QUALITY PRIMARY HEALTH CARE TO PEOPLE IN NEED. 21000 0 5667486 50000 1868129 -302265 7283350 5918387 50000 -7100 -293801 5667486 6184965 50000 180189 -496765 5918387 5816199 50000 560879 -242113 6184965 5240862 50000 775581 -250244 5816199 0.00000 0.70326 0.29674 0 0 1116512 1116512 8768386 5867700 2900686 9091315 5942762 3148553 3204155 2526628 677527 7843278 UCLA EIP FUND 7283350 F UCLA STIP FUND 5333237 F 12616587 X PART V, LINE 4: INTEREST/DIVIDEND INCOME FROM THE CLINIC'S ENDOWMENT FUNDS ARE USED TO PAY FOR THE SALARIES & BENEFITS OF PHYSICIANS AND OTHER PROVIDERS. PART X, LINE 2: THE VENICE FAMILY CLINIC RECOGNIZES THE IMPACT OF TAX POSITIONS IN THE CONSOLIDATED FINANCIAL STATEMENTS IF THAT POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. DURING THE YEAR ENDED JUNE 30, 2021, THE VENICE FAMILY CLINIC PERFORMED AN EVALUATION OF UNCERTAIN TAX POSITIONS AND DID NOT IDENTIFY ANY MATTERS THAT WOULD REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS OR WHICH MIGHT HAVE AN EFFECT ON ITS TAX-EXEMPT STATUS. X X 0 0 0 0 0 0 0 0 0 ELIZABETH B FORER CHIEF EXECUTIVE OFFICER 302834 0 0 0 0 0 49415 0 42768 0 395017 0 0 0 DESPINA G KAYICHIAN CHIEF MEDICAL OFFICER 298700 0 0 0 0 0 52292 0 45258 0 396250 0 0 0 KAREN C LAMP SENIOR PHYSICIAN 260985 0 0 0 0 0 44126 0 38190 0 343301 0 0 0 MARGARITA LOEZA STAFF PHYSICIAN 260541 0 0 0 0 0 42306 0 36615 0 339462 0 0 0 JOHN ARTHUR ROOHAN CLINICAL SITE DIRECTOR 260000 0 0 0 0 0 43866 0 37966 0 341832 0 0 0 ANITA MARIA ZAMORA DEPUTY DIR/CHIEF OPERATIONS OFFICER 243000 0 0 0 0 0 41330 0 35771 0 320101 0 0 0 COLEY MARVIN KING STAFF PHYSICIAN 240934 0 0 0 0 0 25303 0 21900 0 288137 0 0 0 BLANCA ANDRES SENIOR PHYSICIAN 240621 0 0 0 0 0 41398 0 35830 0 317849 0 0 0 NAVEENA PONNUSAMY CHIEF DEVELOPMENT OFFICER 240444 0 0 0 0 0 40725 0 35247 0 316416 0 0 0 CHARLES Q HUYNH ASSOCIATE PHYSICIAN DIPLOMATE 239995 0 0 0 0 0 26815 0 23208 0 290018 0 0 0 ANDREA B BLACKBIRD CHIEF FINANCIAL OFFICER 238413 0 0 0 0 0 42183 0 36509 0 317105 0 0 0 GILMORE SEISOON CHUNG STAFF PHYSICIAN 229617 0 0 0 0 0 26447 0 22889 0 278953 0 0 0 RIAN WELLINGTON RUTHERFORD CLINICAL SITE DIRECTOR 228657 0 0 0 0 0 24722 0 21396 0 274775 0 0 0 SHARON NG DIRECTOR OF PHARMACY SVCS 193800 0 0 0 0 0 32759 0 28352 0 254911 0 0 0 JASON VU HUA CHIEF INFORMATION OFFICER 177228 0 0 0 0 0 30139 0 26085 0 233452 0 0 0 STACEY ANN SCARBOROUGH DIR. OF HUMAN RESOURCES & HEAD START 172536 0 0 0 0 0 30056 0 26013 0 228605 0 0 0 X 1 960582 FMV X 1 1929257 ESTIMATE 0 1 0 PART I, COLUMN (B): NONCASH CONTRIBUTIONS ARE LISTED BY NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION A, LINE 8B THIS QUESTION IS NOT APPLICABLE AS THE ORGANIZATION DOES NOT HAVE A COMMITTEE WITH THE AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE INFORMATIONAL RETURN IS PREPARED BY OUTSIDE ACCOUNTANTS AND IS REVIEWED BY THE AUDIT COMMITTEE. ONCE APPROVED BY THE AUDIT COMMITTEE, THE RETURN IS THEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ELECTRONIC FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL QUESTIONNAIRES ARE GIVEN TO BOARD MEMBERS TO DISCLOSE ANY CONFLICTS. IF A CONFLICT IS DISCLOSED IN THE ANNUAL QUESTIONNAIRE, THE INDIVIDUAL WILL BE ASKED TO RECUSE THEMSELVES FROM ANY CONVERSATIONS PERTAINING TO THIS CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD HIRES, OVERSEES, AND ANNUALLY EVALUATES THE PERFORMANCE AND COMPENSATION OF THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION INDEPENDENTLY, WITH THE CEO'S PARTICIPATION. THE CFO & OTHER KEY EMPLOYEES' COMPENSATION IS BASED UPON SKILL SET & MARKET RATE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN VALUE IN BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUSTS 14,455. VENICE FAMILY CLINIC FOUNDATION 604 ROSE AVENUE VENICE CA 90291 273484548 TO SUPPORT VENICE FAMILY CLINIC CA 501(C)(3) LINE 7 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0