2021-04-20T11:23:27-05:00 2020-06-30 954557617 Harrington Group CPAs LLP 234 East Colorado Blvd Suite M150 Pasadena CA 91101 990 2019-07-01 951644040 QueensCare QUEE 3236694305 950 South Grand Avenue 2nd Fl Sou Los Angeles CA 90015 Barbara B Hines President/CEO 3236694305 2021-04-20 1 Sean E Cain CPA P01612986 6264036801 2019 2022-09-23 18:48:47Z Barbara B Hines 950 South Grand Avenue 2nd Fl South Los Angeles CA 90015 17116254 0 X www.queenscare.org X 1936 CA QueensCare provides a continuum of high quality medical and hospital care to the medically underserved (indigent, uninsured, underinsured) residents of Los Angeles County. 14 14 67 0 0 0 328496 462337 196929 184224 7442060 6213369 4393158 4829023 12360643 11688953 9846567 9084573 0 0 3186864 3318464 0 0 0 6932569 6778970 19966000 19182007 -7605357 -7493054 415731432 414197762 13025947 15730000 402705485 398467762 X QueensCare provides a continuum of high quality medical and hospital care to the medically underserved (indigent, uninsured, underinsured) residents of Los Angeles County. 0 0 4500000 QueensCare operates jointly with QueensCare Health Centers to provide a network of 5 freestanding family healthcare centers in areas of Los Angeles County that are medically underserved. The health centers provide services to all patients without regard to ability to pay. Each health center is an approved medicaid and medicare provider. The clinics provide free medical care for those who do not have the financial resources or coverage by health plans, insurance or government programs. The clinics provide preventive, diagnostic, and follow-up medical and dental care to the residents of low-income communities. During 2019-2020, the health centers served approximately 23,000 patients which accounted for 93,000 visits. 6653534 4504280 To support the operation of QueensCare Health Centers and to further the organization's exempt purpose of providing medical care to the underprivileged and indigent residents of Los Angeles County, QueensCare provides medical care support services in coordination with the services provided by the health centers, including inpatient, outpatient, nursing, outreach and mental healthcare services. 5956672 4580293 184224 QueensCare operates 4 divisions: 1) The Pastoral Care Division provides spiritual care to inpatients and staff at Hollywood Presbyterian Medical Center. During FY 2020, the chaplains visited over 25,000 patients. Over 615 patients received the anointing of the sick; Counseled 305 patients on advance healthcare directives, completing 29 such directives; Mass is offered Monday through Friday in chapel at Hollywood Presbyterian Medical Center (HPMC), program staff began tracking Mass attendance at HPMC this year, counting 2,025 attendees;2) QueensCare Health and Faith Partnership (QHFP) is the largest parish nurse program in California. There are 6 parish nurses and 5 community health workers. Together they provide immunizations, health screening, CPR training, and parenting classes at the various partner sites including, churches, food pantries, synagogues, senior nutrition sites, the Braille Institute and schools. During FY 2020, QHFP partnered with an average of nearly 19 sites provided direct services to 5,156 patients, in addition to screenings and education 3,809 patients during outreach events; 3) Direct Healthcare Division, comprised of the following: a) The Mobile Dental Program - QueensCare together with USC School of Dentistry provides mobile dental clinic services at LAUSD's elementary schools. In FY 2020, QueensCare provided services at 8 schools, served 989 patients, and completed approximately 3,184 appointments. Total procedures of 9,701 was completed, which would have cost families/insurance a total of $429,589; b) Mobile Vision Program - QueensCare provides mobile vision services to low-income communities through LAUSD. The mobile vision program served 28 schools during FY 2020. Total of 1,873 prescriptions were written by QueensCare's optometrist and 1,509 glasses were provided the students at no cost; c) Mental Health Program - QueensCare provided $182,195 in mental health services to 35 children and their families under a contract with Children's Hospital Los Angeles. The children are referred by QueensCare Health Centers, LAUSD, and QHFP because of trauma experienced, as well as other issues; d) Inpatient Program - QueensCare contracts with local non-profit acute care hospitals to provide inpatient care to medically indigent patients; e) Q-QHC Healthcare Partners - A partnership, described previously with QueensCare Health Centers to provide ambulatory care to low income, underserved patients in LA County; and 4) Charitable Division - The Charitable Board met three times during FY 2020 to review the large volume of grant applications and approved 40 grants amounting to $2.7 million. In addition, the Charitable Board also approved 29 scholarships and funded 13 area hospitals with Emergency Medical Services grants amounting to another $2 million. 17110206 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 98 0 1 67 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 CA X X Faith Lee Vice President 3236694345 950 South Grand Avenue 2nd Fl South Los Angeles CA 90015 Bettie J Woods Chair 10.00 X X 5900 0 0 Steven Aronoff Vice Chair 2.00 X X 1900 0 0 Alan Cushman Secretary 10.00 X X 2700 0 0 Allan Michelena Director 2.00 X 2250 750 0 Denise Partamian Forgette Director 2.00 X 6800 750 0 Edward Avila Director 2.00 X 4200 0 0 Fr Michael Stechmann Director 2.00 X 2450 0 0 Frances Inman Director 2.00 X 2300 0 0 Gene A Nuziard Director 2.00 X 3000 500 0 Javier Guerena Director 2.00 X 3600 1750 0 Jeff Hermann Director 2.00 X 0 0 0 Joseph Bui Director 2.00 X 0 0 0 Lois Saffian Director 2.00 X 3050 0 0 Rev Michael Mata Director 4.00 X 2050 0 0 Barbara B Hines CEO 40.00 X 211008 211134 29521 Eloisa Perard CAO 40.00 X 235705 0 15487 Faith Lee VP-Finance & Accounting(Q) 40.00 X 161523 0 15674 Alan G De Jong Director Risk Management 40.00 X 131959 0 14163 Arthur V Doi VP-Finance & Accounting(QHC) 40.00 X 171650 0 21820 Maryam Sesay Director of Operations 40.00 X 111473 0 13164 1063518 214884 109829 8 0 1 0 Goldman Sachs & Co LLC 2121 Avenue of the Stars Suite 260 Los Angeles CA 90067 Investment Mgmt. 1038255 USC School of Dentistry 1149 S Hill Street Ste H550 Los Angeles CA 90015 Pediatric Dentistry 549096 Alliant Insurance Services Inc 1301 Dove Street Ste 200 Newport Beach CA 92660 Insurance 170442 BJ's Maintenance & Painting 21500 Lassen Street No 141 Chatsworth CA 91311 Janetorial Services 144604 Affinity Nonprofits 2001 K Street NW Ste 625 North Washington DC 20006 Insurance 141059 7 331860 130477 462337 Mental Health Project 124100 182195 182195 QHFP Health Screening 900099 2029 2029 184224 6804670 2940670 3864000 3864000 3864000 8700000 2486631 6213369 6213369 6213369 Retained real estate 900099 733000 733000 Other income 900099 232023 232023 965023 11688953 184224 0 11042392 4580293 4580293 4504280 4504280 605858 165315 440543 1862684 1585444 277240 86937 79205 7732 586726 465837 120889 176259 132384 43875 185550 60200 125350 239821 239821 46500 46500 694156 528243 165913 110283 62643 47640 19418 14056 5362 114959 15721 99238 302356 221334 81022 11908 9614 2294 43752 23405 20347 90683 73648 17035 156853 6631 150222 K-1 Expenses - Q/QHC He 4500000 4500000 Covid-19 expenses 139979 139979 Other expense 122752 81953 40799 19182007 17110206 2071801 0 8522027 7864723 98177000 20710000 79585000 77467000 300191760 328136256 27159742 0 272903 729783 415731432 414197762 8830132 10632000 3345234 2843000 0 731000 850581 1524000 13025947 15730000 X 402048998 397784759 656487 683003 402705485 398467762 415731432 414197762 -7493054 3255719 -388 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 683003 683003 683003 683003 657194 25809 683003 656487 707 657194 655000 1487 656487 1.00000 0 0 20703000 20703000 74179000 18358166 55820834 1121000 288355 832645 2174000 2063479 110521 77467000 Workers compensation liability 1524000 1524000 X Part V, Line 4: QueensCare intends to use its endowment funds for healthcare related activities. Part X, Line 2: The Organization is exempt from taxation under Internal Revenue Code Section 501(c)(3) and California Revenue and Taxation Code Section 23701d. Generally accepted accounting principles provide accounting and disclosure guidance about positions taken by an organization in its tax returns that might be uncertain. Management has considered its tax positions and believes that all of the positions taken by the Organization in its federal and state exempt organization tax returns are more likely than not to be sustained upon examination. The Organization returns are subject to examination by federal and state taxing authorities, generally for three and four years, respectively, after they are filed. 1 American Red Cross Los Angeles Region 1450 S Central Avenue Los Angeles CA 90021 530196605 501(c)3 80000 To provide funding for health related materials/services provided by organization. Asian Pacific AIDS Intervention Team (Special Services for Groups) 3055 Wilshire Blvd Ste 300 Los Angeles CA 90034 951716914 501(c)3 35000 To provide health related education or outreach to underserved populations residing in Los Angeles. Beverly Hospital 309 W Beverly Blvd Los Angeles CA 90640 237429685 501(c)3 6413 To fund emergency room services provided to uninsured patients residing in Los Angeles. Bienestar Human Services 5326 E Beverly Blvd Los Angeles CA 90022 954505737 501(c)3 30000 To provide health related education or outreach to underserved populations residing in Los Angeles. Blind Childrens Center 4120 Marathon Street Los Angeles CA 90029 951656369 501(c)3 65000 To fund outpatient healthcare services. California State University-Los Angeles Auxiliary Services Inc 5151 State University Drive Los Angeles CA 900328502 954016653 501(c)3 50000 To provide funding for health related materials/services provided by organization. Cancer Support Community Los Angeles 1990 South Bundy Dr Ste 100 Los Angeles CA 90025 330287070 501(c)3 25000 To provide health related education or outreach to underserved populations residing in Los Angeles. Care Harbor 18436 Hawthorne Blvd Ste 204 Torrance CA 90504 272984870 501(c)3 25000 To fund outpatient healthcare services. ChapCare 455 W Montana Street Pasadena CA 91103 954536824 501(c)3 150000 To fund outpatient healthcare services. Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles CA 90027 951690977 501(c)3 376935 To fund emergency room services provided to uninsured patients residing in Los Angeles. City of Hope 1500 East Duarte Road Duarte CA 91010 953435919 501(c)3 150000 To fund outpatient healthcare services. Covenant House California 1325 N Western Avenue Los Angeles CA 90027 133391210 501(c)3 50000 To fund outpatient healthcare services. El Centro de Amistad 566 S Brand Blvd San Fernando CA 91340 953498639 501(c)3 25000 To fund outpatient healthcare services. Five Acres 760 W Mountain View Street Altadena CA 91001 951647810 501(c)3 35000 To fund outpatient healthcare services. Glendale Memorial Hospital and Health Center 1420 South Central Avenue Glendale CA 91204 941196203 501(c)3 56004 To fund emergency room services provided to uninsured patients residing in Los Angeles. Good Samaritan Hospital 1225 Wilshire Blvd Los Angeles CA 90017 951656366 501(c)3 521554 To fund emergency room services provided to uninsured patients residing in Los Angeles. Hollywood Community Housing Corporation 5020 Santa Monica Blvd Los Angeles CA 90029 954198215 501(c)3 30000 To fund health related services provided AIDS patients. Hollywood Presbyterian Medical Center 1300 N Vermont Avenue Los Angeles CA 90027 300284087 301396 To fund emergency room services provided to uninsured patients residing in Los Angeles. Hunger Action Los Angeles 961 S Mariposa Ave Ste 205 Los Angeles CA 90006 205142259 501(c)3 10000 To provide health related education or outreach to underserved populations residing in Los Angeles. Huntington Memorial Hospital 100 West California Blvd Pasadena CA 91109 951644036 501(c)3 10260 To fund emergency room services provided to uninsured patients residing in Los Angeles. Jewish Free Loan Association 6505 Wilshire Blvd Ste 715 Los Angeles CA 90048 951691014 501(c)3 60000 To provide funding for health related materials/services provided by organization. LA's BEST 200 N Spring St Ste M-120 Los Angeles CA 90012 954311058 501(c)3 35000 To provide health related education or outreach to underserved populations residing in Los Angeles. LACUSC Medical Center 1200 N State Street Los Angeles CA 90033 956000927 501(c)3 41469 To fund emergency room services provided to uninsured patients residing in Los Angeles. Los Angeles Christian Health Centers 202 W 1st Street Ste 4-0435 Los Angeles CA 90012 954315734 501(c)3 150000 To fund outpatient healthcare services. Los Angeles LGBT Center 1118 N McCadden Place Los Angeles CA 90038 953567895 501(c)3 150000 To fund outpatient healthcare services. Monterey Park Hospital 900 S Atlantic Blvd Monterey Park CA 91754 510519163 855 To fund emergency room services provided to uninsured patients residing in Los Angeles. My Friend's Place PO Box 3867 Hollywood CA 90078 954834034 501(c)3 50000 To provide health related education or outreach to underserved populations residing in Los Angeles. Olympia Medical Center 5900 W Olympica Blvd Los Angeles CA 90036 421643090 86785 To fund emergency room services provided to uninsured patients residing in Los Angeles. Partners in Care Foundation 732 Mott Street Ste 150 San Fernando CA 91340 953954057 501(c)3 125000 To provide health related education or outreach to underserved populations residing in Los Angeles. Peer Health Exchange 3055 Wilshire Blvd Ste 300 Los Angeles CA 90010 562374305 501(c)3 10000 To provide health related education or outreach to underserved populations residing in Los Angeles. Pepperdine University 24255 Pacific Coast Highway Malibu CA 902634151 951644037 501(c)3 50000 To fund outpatient healthcare services. Program for Torture Victims 3550 Wilshire Blvd Ste 1906 Los Angeles CA 90010 954492477 501(c)3 75000 To fund outpatient healthcare services. Providence St Joseph Medical Center 501 S Buena Vista Street Burbank CA 91505 953544872 501(c)3 34628 To fund emergency room services provided to uninsured patients residing in Los Angeles. Saban Community Clinic 8405 Beverly Blvd Los Angeles CA 90048 952359105 501(c)3 100000 To fund outpatient healthcare services. Sherman Oaks Hospital 4929 Van Nuys Blvd Los Angeles CA 91403 202546649 501(c)3 20948 To fund emergency room services provided to uninsured patients residing in Los Angeles. Southern California Counseling Center 5615 W Pico Blvd Los Angeles CA 90019 952430665 501(c)3 70000 To fund outpatient healthcare services. St Anne's 155 N Occidental Blvd Los Angeles CA 90026 951691306 501(c)3 80000 To fund vehicle purchased to transport patirens to/from residence and hospitals/doctors' offices. St John of God Retirement & Care Ctr 2468 S St Andrews Place Los Angeles CA 90018 954067758 501(c)3 19500 To provide funding for health related materials/services provided by organization. St Vincent Medcial Center 2131 West Third Street Los Angeles CA 90057 912154438 501(c)3 519854 To fund emergency room services provided to uninsured patients residing in Los Angeles. Teen Line PO Box 48750 Los Angeles CA 90048 953760982 501(c)3 16000 To provide health related education or outreach to underserved populations residing in Los Angeles. The Salvation Army 2737 Sunset Blvd Los Angeles CA 90026 951656360 501(c)3 66000 To fund health related services provided AIDS patients. Tierra del Sol Foundation 9919 Sunland Blvd Sunland CA 91040 952671260 501(c)3 50000 To provide funding for health related materials/services provided by organization. Venice Family Clinic 604 Rose Avenue Venice CA 90291 952769432 501(c)3 150000 To fund outpatient healthcare services. ViaCare Community Health Center 501 South Atlantic Blvd East Los Angeles CA 90022 800699156 501(c)3 125000 To fund outpatient healthcare services. Vista del Mar Child & Family Services 3200 Motor Avenue Los Angeles CA 90034 951647832 501(c)3 150000 To fund outpatient healthcare services. Wayfinder Family Services 5300 Angeles Vista Blvd Los Angeles CA 90043 951977659 501(c)3 75000 To fund outpatient healthcare services. White Memorial Medical Center 1720 Ceasar E Chavez Avenue Los Angeles CA 90033 953760201 501(c)3 66692 To fund emergency room services provided to uninsured patients residing in Los Angeles. Women's Shelter of Long Beach PO Box 32107 Long Beach CA 90832 951644058 501(c)3 40000 To provide health related education or outreach to underserved populations residing in Los Angeles. Worksite Wellness LA 5955 S Western Avenue Los Angeles CA 90047 550802354 501(c)3 50000 To provide health related education or outreach to underserved populations residing in Los Angeles. Young & Healthy 136 West Peoria Street Pasadena CA 91103 954527969 501(c)3 70000 To fund outpatient healthcare services. Youth Mentoring Connection 4103 W Adams Blvd Los Angeles CA 90018 954845105 501(c)3 10000 To fund outpatient healthcare services. 48 3 Nuziard Scholarships 29 273500 N/A Inpatient Care Assistance 154 4230780 N/A Part I, Line 2: QueensCare monitors the use of grants it makes by requiring each grantee to supply QueensCare with regular reports that describe how such grantee is using QueensCare's grant funds. In addition, QueensCare often visits a grantee's premises to ensure that the grantee is conducting programs that further QueensCare's charitable mission. QueensCare also requires each grantee to provide QueensCare with a copy of their annual financial reports. X X X X X 0 0 0 0 0 0 0 0 0 Barbara B Hines CEO 211008 211134 0 0 0 0 17785 0 11736 0 240529 211134 0 0 Eloisa Perard CAO 235705 0 0 0 0 0 15487 0 0 0 251192 0 0 0 Faith Lee VP-Finance & Accounting(Q) 161523 0 0 0 0 0 9516 0 6158 0 177197 0 0 0 Arthur V Doi VP-Finance & Accounting(QHC) 171650 0 0 0 0 0 10084 0 11736 0 193470 0 0 0 Form 990, Part VI, Section A, line 6 St. Joseph's Health Support Alliance, a California non-profit, nonstock, public benefit corporation described in Section 501(c)(3) of the Internal Revenue Code, is the sole corporate member of QueensCare. Form 990, Part VI, Section A, line 7a In its capacity as QueensCare's sole corporate member, St. Joseph's Health Support Alliance has the authority to appoint, remove, and replace each of the members of QueensCare's Board of Directors. Form 990, Part VI, Section A, line 7b St. Joseph's Health Support Alliance, as QueensCare's sole corporate member, has the right to approve certain fundamental transactions, such as amendments to by-laws, QueensCare's Articles of Incorporation or resolutions to dissolve QueensCare's corporate existence. Form 990, Part VI, Section B, line 11b Following preparation of a final draft of the Form 990 by the organization's tax preparers, the organization's CEO and CFO review, analyze and discuss the final draft to better ensure its accuracy and completeness. After the return is filed, the CEO and VP of Finance & Accounting review and discuss material aspects and details of the return at the next regularly scheduled meeting of the Board of Directors. Form 990, Part VI, Section B, line 12c The organization's Board members, corporate officers, and staff are subject to a written conflicts of interest policy. Pursuant to that policy, each such person is required to identify any transaction with the organization in which the person has (or may have) a financial interest. If a conflict (or potential conflict) is identified, the Board, excluding any involved Board members, carefully reviews the terms of the transaction and makes a determination as to whether the transaction is fair and reasonable to the organization under all the facts and circumstances. The organization monitors and enforces compliance with this policy by: (i) discussing such issues at its annual meeting; (ii) requiring all covered persons to annually provide written certification of their compliance with the policy; and (iii) carefully reviewing all material transactions to identify potential or real conflicts. Form 990, Part VI, Section B, line 15a A Compensation Committee comprised of independent Board members formulates a proposed compensation level for the CEO by reviewing recommendation of an independent compensation consultant and general compensation data for similarly situated organizations. Following such a review, the Compensation Committee presents its findings and recommendations to the Board at which Board members are provided with the opportunity to ask questions. Based on the findings and recommendations of the Compensation Committee, a Board vote is taken to establish the new compensation level for the CEO. Deliberations of the Compensation Committee and the Board are recorded in the organization's minute book. The evaluation, review, and recommendation process were last undertaken by the Compensation Committee in May 2020 and its findings and recommendations with regard to the CEO's compensation level were approved by the Board in September 2020. Director Jay Guerena devoted approximately two hours of his time per week to related organizations; QueensCare Health Centers (QHC) and St. Joseph's Health Support Alliance (SJHSA) in his capacity as Director for QHC and SJHSA. Director Allan Michelena devoted approximately 2 hours of his time per week to related organizations; QueensCare Health Centers (QHC) and St. Joseph's Health Support Alliance (SJHSA) in his capacity as Director for QHC and SJHSA. Director Denise Partamian Forgette devoted approximately two hours of her time per week to related organizations, St. Joseph's Health Support Alliance (SJHSA) in her capacity as Director for SJHSA. CEO Barbara Hines devoted approximately 20 hours of her time per week to QHC in her capacity as QHC's CEO. Director Gene Nuziard devoted approximately 2 hours of his time per week to a related organization, St. Joseph's Health Support Alliance (SJHSA) in his capacity as Director for SJHSA. Form 990, Part VI, Section C, line 19 The organization's annual information return (Form 990) is available on a third-party website (GuideStar). The organization provides copies of its governing documents, its conflict of interest policy, as well as its three most recent Forms 990 to any interested person that makes a request for such documents. Bridge Street 1525 Bridge Street Yuba CA 95993 951644040 Rental Real Estate CA 581713 9813367 QueensCare Airway Diego LLC 10132 Airway Road San Diego CA 92154 951644040 Rental Real Estate CA 1810585 19926547 QueensCare QLV - HD LLC 855 Dorrell Lane Las Vegas NV 89086 951644040 Rental Real Estate NV 712810 14900816 QueensCare QLV - INO LLC 6880 North 5th Street Las Vegas NV 89084 951644040 Rental Real Estate NV 154259 4108809 QueensCare QLV - HDR LLC 861 South Rainbow Blvd Las Vegas NV 89145 951644040 Rental Real Estate NV 925462 21889991 QueensCare QOR - FXG LLC 20750 Brinson Blvd Bend OR 97701 951644040 Rental Real Estate OR 483600 11987998 QueensCare St Joseph's Health Support Alliance 950 South Grand Ave 2nd Fl South Los Angeles CA 90015 940831115 to support QueensCare CA 501(c)(3) Line 12d, III-O 0 QueensCare Health Centers 950 South Grand Ave 2nd Fl South Los Angeles CA 90015 953702136 provide medical service to the indigent CA 501(c)(3) Line 3 0 Queen of Angels Hollywood Presbyterian Foundation 950 South Grand Ave 2nd Fl South Los Angeles CA 90015 953403582 to support QueensCare CA 501(c)(3) Line 12b, II 1 QQHC Healthcare Partners 950 South Grand Ave 2nd Fl South Los Angeles CA 90015 260502255 To operate and manage Healthcare Clinics CA N/A Related 4500000 0 1 0.40000 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 QQHC HEALTHCARE PARTNERS B 4500000 ACCRUAL ST JOSEPH'S HEALTH SUPPORT ALLIANCE C 240000 ACCRUAL ST JOSEPH'S HEALTH SUPPORT ALLIANCE Q 21070 ACCRUAL QUEENSCARE HEALTH CENTER O 240000 ACCRUAL QUEENSCARE HEALTH CENTER P 494095 ACCRUAL QUEENSCARE HEALTH CENTER Q 547415 ACCRUAL QUEEN OF ANGELS QUEENSCARE FOUNDATION Q 47986 ACCRUAL QUEENSCARE HEALTH CENTER C 20000 ACCRUAL