2021-08-12T14:03:22-05:00 2020-09-30 813071614 TALLEY LLP 600 CITY PARKWAY WEST 650 ORANGE CA 92868 990 2019-10-01 270179192 THE CENTER FOR COMPREHENSIVE CARE AND DIAGNOSIS OF INHERITED BLOOD DISORDERS CENT 6572328122 2670 N MAIN STREET SUITE 150 SANTA ANA CA 92705 DIANE J NUGENT MD PRESIDENT 6572328122 2021-08-10 1 A TROY ABERCROMBIE P02004351 7148672200 2021-08-09 2019 2022-09-23 18:48:47Z CENTER FOR INHERITED BLOOD DISORDERS DIANE J NUGENT MD 2670 N MAIN STREET SUITE 150 SANTA ANA CA 92705 68646232 0 X CIBD-CA.ORG X 2009 CA PROVIDE COMPREHENSIVE CARE FOR PATIENTS WITH RARE, CHRONIC INHERITED BLOOD DISORDERS. 7 7 48 9 0 0 1176467 1753405 70667869 66293230 240377 599597 0 0 72084713 68646232 1091411 1257143 0 0 4048109 5095664 0 0 0 46813485 64868428 51953005 71221235 20131708 -2575003 56670406 56342926 5301969 7549492 51368437 48793434 TO IMPROVE HEALTH AND LONGEVITY AND LOWER COSTS OF CARE; BY PROVIDING EDUCATION, SUPPORT, AND SERVICES TO DELIVER COMPREHENSIVE CARE FOR PATIENTS AND THEIR FAMILIES WITH RARE, CHRONIC INHERITED BLOOD DISORDERS. 0 0 69193946 1257143 66293230 THE CENTER FOR COMPREHENSIVE CARE AND DIAGNOSTICS OF INHERITED BLOOD DISORDERS (CIBD) IS A COMMUNITY BASED CLINIC THAT PROVIDES COMPREHENSIVE CARE FOR CHILDREN AND ADULTS WITH RARE, CHRONIC INHERITED BLOOD DISORDERS UTILIZING THE COMPREHENSIVE CARE MODEL. AS A SAFETY NET CLINIC, CIBD PROVIDES INCREASED ACCESS TO SUBSPECIALITY CARE THROUGH A MULTIDISCIPLINARY TEAM APPROACH. THROUGH PHARMACY SERVICES AND INNOVATIVE HEALTH INFORMATION TECHNOLOGY, CIBD IS ABLE TO EDUCATE PATIENTS AND FAMILIES AS WELL AS MONITOR AND DRIVE DOWN COST OF CARE THROUGH THE 340B PROGRAM. 69193946 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 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 0 0 0 0 1 18 0 1 48 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X MICHAEL WARDEN 6572328122 2670 N MAIN STREET SUITE 150 SANTA ANA CA 92705 DIANE J NUGENT MD PRESIDENT/CHAIRPERSON 5.00 X X 0 0 0 AMIT SONI VICE PRESIDENT 5.00 X X 0 0 0 KATHIE BIRSCHBACH SECRETARY 1.00 X X 0 0 0 BARRY STATON TREASURER 1.00 X X 0 0 0 MARY BROWN DIRECTOR 0.50 X 0 0 0 RANDALL CURTIS DIRECTOR 1.00 X 0 0 0 BERTIL GLADER MD PHD DIRECTOR 1.00 X 0 0 0 SAMANTHA CHAN PHARMACY MANAGER 40.00 X 181376 0 13221 NINA HWANG PHYSICIAN 32.00 X 172312 0 21129 BARRY STATON CHIEF EXECUTIVE OFFICER 40.00 X 293937 0 31049 MATT CIANCIULLI DIRECTOR OF CLINIC 40.00 X 163146 0 13194 VANESSA SALINAS LUNA PHYSICIAN 40.00 X 186243 0 22350 MICHAEL WARDEN CHIEF FINANCIAL OFFICER 40.00 X 146691 0 12823 1143705 0 113766 6 0 1 0 SICKLE CELL FOUNDATION OF SOUTHERN CALIF 3602 INLAND EMPIRE BLVD SUITE B220 ONTARIO CA 91764 CONTRACTUAL SERVICES 3141113 CHILDREN'S HOPSITAL ORANGE COUNTY 1201 W LA VETA AVE ORANGE CA 92868 CONTRACTUAL SERVICES 1077922 PEDIATRIC SUBSPECIALTIES 1201 W LA VETA AVE ORANGE CA 92868 CONTRACTUAL SERVICES 285983 RED CHIP ENTERPRISES 18009 SKY PARK CIRCLE SUITE G IRVINE CA 92614 BILLING SERVICES 221600 APOGENICS 8775 CENTRE PARK DRIVE 701 COLUMBIA MD 21045 CONTRACTUAL SERVICES 149399 5 1753405 1753405 FACTOR REPLACEMENT 621990 39799192 39799192 WHOLESALE PHARMACY 621990 25279632 25279632 ALL OTHER PROGRAM SERVICE REVENUE 900099 552902 552902 CONTRACT PHAMARCY SERVICES 900099 491410 491410 FEES FOR SERVICE CONTRACTS 900099 170094 170094 66293230 599597 599597 68646232 66293230 0 599597 1257143 1257143 181377 181377 4062184 3051974 1010210 120566 91864 28702 423179 322438 100741 308358 234951 73407 130153 33953 96200 160741 41932 118809 19390 5058 14332 516542 398293 118249 550056 437040 113016 29563 18754 10809 32334 27390 4944 116231 81708 34523 PHARMACEUTICAL COSTS 58092991 58092991 SICKLE CELL DISEASE CEN 2808742 2808742 PURCHASED SERVICES 2411685 2108338 303347 71221235 69193946 2027289 0 665082 3617286 34824400 42277259 14728180 441166 3961941 7292225 2251927 2524054 112618 97012 733997 691818 74513 42179 51745 51745 56670406 56342926 5301969 6809492 740000 5301969 7549492 X 15207198 15469441 36161239 33323993 51368437 48793434 56670406 56342926 -2575003 0 X X 0 1 X 1 1 1 X 1598922 1887299 1301992 1176467 1753405 7718085 33426975 41012713 59959865 70667869 66293230 271360652 35025897 42900012 61261857 71844336 68046635 279078737 0 0 0 279078737 11076 14805 19765 240377 599597 885620 11076 14805 19765 240377 599597 885620 35036973 42914817 61281622 72084713 68646232 279964357 0.99680 0.99880 0.00320 0.00120 X 193263 192294 969 540734 499524 41210 42179 X 68646232 0 68646232 0 68646232 71221235 0 71221235 0 71221235 PART X, LINE 2: THE ORGANIZATION WILL RECOGNIZE THE IMPACT OF TAX POSITIONS IN THE FINANCIAL STATEMENTS IF THAT POSITION IS MORE LIKELY THAN NOT OF BEING SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. TO DATE, THE ORGANIZATION HAS NOT RECORDED ANY UNCERTAIN TAX POSITIONS. THE ORGANIZATION RECOGNIZES POTENTIAL ACCRUED INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS IN INCOME TAX EXPENSE. THE ORGANIZATION DID NOT RECOGNIZE ANY AMOUNT IN POTENTIAL INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE FOLLOWING SUMMARIZES THE OPEN TAX YEARS FOR EACH MAJOR JURISDICTION: JURISDICTION OPEN TAX YEAR FEDERAL 2016-2019 STATE 2015-2019 1 CHILDREN'S HOSPITAL AND RESEARCH CENTER AT OAKLAND 5700 MARTIN LUTHER KING JR WAY OAKLAND CA 94609 940382330 501(C)(3) 31848 SUBCONTRACT HRSA GRANTHEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM CHILDREN'S HOSPITAL LOS ANGELES 4650 SUNSET BLVD MS 54 LOS ANGELES CA 90027 951690977 501(C)(3) 39082 SUBCONTRACT HRSA GRANTHEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM CHILDREN'S HOSPITAL LOS ANGELES 4650 SUNSET BLVD MS 54 LOS ANGELES CA 90027 951690977 501(C)(3) 50339 SUBCONTRACT CDC/ATHN GRANTPUBLIC HEALTH SURVEILLANCE VALLEY CHILDREN'S HOSPITAL OF CENTRAL CALIFORNIA 9300 VALLEY CHILDRENS PLACE MADREA CA 92636 941294954 501(C)(3) 12342 SUBCONTRACT HRSA GRANTHEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM VALLEY CHILDREN'S HOSPITAL 9300 VALLEY CHILDRENS PLACE MADREA CA 92636 941294954 501(C)(3) 30615 SUBCONTRACT CDC/ATHN GRANTPUBLIC HEALTH SURVEILLANCE KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN 1319 PUNAHOU STREET HONOLULU HI 96826 990177350 501(C)(3) 32932 SUBCONTRACT HRSA GRANTHEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN 1319 PUNAHOU STREET HONOLULU HI 96826 990177350 501(C)(3) 16000 SUBCONTRACT CDC/ATHN GRANTPUBLIC HEALTH SURVEILLANCE LUCILE PACKARD CHILDREN'S HOSPITAL AT STANFORD 1000 WELCH RD SUITE 300 MC5798 PALO ALTO CA 94304 941156365 501(C)(3) 40340 SUBCONTRACT HRSA GRANTHEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM LUCILE PACKARD CHILDREN'S HOSPITAL AT STANFORD 1000 WELCH RD SUITE 300 MC5798 PALO ALTO CA 94304 941156365 501(C)(3) 23439 SUBCONTRACT CDC/ATHN GRANTPUBLIC HEALTH SURVEILLANCE ORTHOPAEDIC HOSPITAL 2400 SOUTH FLOWER ST LOS ANGELES CA 90007 951644604 501(C)(3) 52501 SUBCONTRACT HRSA GRANTHEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM ORTHOPAEDIC HOSPITAL 2400 SOUTH FLOWER ST LOS ANGELES CA 90007 951644604 501(C)(3) 27540 SUBCONTRACT CDC/ATHN GRANTPUBLIC HEALTH SURVEILLANCE PEDIATRIC SUBSPECIALTY FACULTY 1010 WEST LA VETA AVE SUITE 670 ORANGE CA 92868 330930025 38496 SUBCONTRACT HRSA GRANTHEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM PEDIATRIC SUBSPECIALTY FACULTY 1010 WEST LA VETA AVE SUITE 670 ORANGE CA 92868 330930025 8198 SUBCONTRACT CDC/ATHN GRANTPUBLIC HEALTH SURVEILLANCE PEDIATRIC SUBSPECIALTY FACULTY 1010 WEST LA VETA AVE SUITE 670 ORANGE CA 92868 330930025 3846 SUBCONTRACT HRSA GRANTSICKLE CELL TREATMENT DEMONSTRATION PROGRAM PEDIATRIC SUBSPECIALTY FACULTY 1010 WEST LA VETA AVE SUITE 670 ORANGE CA 92868 330930025 1923 SUBCONTRACT QUEENS CARELA COUNTY ADULTS LIVING WITH SICKLE CELL DISEASE PEDIATRIC SUBSPECIALTY FACULTY 1010 WEST LA VETA AVE SUITE 670 ORANGE CA 92868 330930025 57690 SUBCONTRACT CALIFORNIA DEPARTMENT OF PUBLIC HEALTH NETWORKING CALIFORNIA FOR SICKLE CELL CARE (NCSCC) RADY CHILDREN'S HOSPITAL - SAN DIEGO 3020 CHILDRENS WAY SAN DIEGO CA 92123 951691313 501(C)(3) 7071 SUBCONTRACT HRSA GRANTHEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM RADY CHILDREN'S HOSPITAL - SAN DIEGO 3020 CHILDRENS WAY SAN DIEGO CA 92123 951691313 501(C)(3) 19996 SUBCONTRACT CDC/ATHN GRANTPUBLIC HEALTH SURVEILLANCE THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (DAVIS) 2360 STOCKTON BLVD SUITE 1100 SACRAMENTO CA 95817 946036494 501(C)(3) 38823 SUBCONTRACT HRSA GRANTHEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (DAVIS) 2360 STOCKTON BLVD SUITE 1100 SACRAMENTO CA 95817 946036494 501(C)(3) 28097 SUBCONTRACT CDC/ATHN GRANTPUBLIC HEALTH SURVEILLANCE THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (UCSD) 200 W ARBOR DRIVE MC8651 SAN DIEGO CA 92103 956006144 501(C)(3) 31578 SUBCONTRACT HRSA GRANTHEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (UCSD) 200 W ARBOR DRIVE MC8651 SAN DIEGO CA 92103 956006144 501(C)(3) 16879 SUBCONTRACT CDC/ATHN GRANTPUBLIC HEALTH SURVEILLANCE THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (UCSD) 200 W ARBOR DRIVE MC8651 SAN DIEGO CA 92103 956006144 501(C)(3) 17385 SUBCONTRACT CALIFORNIA DEPARTMENT OF PUBLIC HEALTH NETWORKING CALIFORNIA FOR SICKLE CELL CARE (NCSCC) THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (UCSF) 650 MOFFITT BOX 0106 SAN FRANCISCO CA 94143 946036493 501(C)(3) 53999 SUBCONTRACT HRSA GRANTHEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (UCSF) 650 MOFFITT BOX 0106 SAN FRANCISCO CA 94143 946036493 501(C)(3) 51992 SUBCONTRACT CDC/ATHN GRANTPUBLIC HEALTH SURVEILLANCE THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (UCSF) 650 MOFFITT BOX 0106 SAN FRANCISCO CA 94143 946036493 501(C)(3) 102240 SUBCONTRACT HRSA GRANTSICKLE CELL TREATMENT DEMONSTRATION PROGRAM THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (UCSF) 650 MOFFITT BOX 0106 SAN FRANCISCO CA 94143 946036493 501(C)(3) 107100 SUBCONTRACT CALIFORNIA DEPARTMENT OF PUBLIC HEALTH NETWORKING CALIFORNIA FOR SICKLE CELL CARE (NCSCC) SICKLE CELL DISEASE FOUNDATION OF CALIFORNIA 3602 INLAND EMPIRE BLVD SUITE B220 ONTARIO CA 91764 956155962 501(C)(3) 94941 SUBCONTRACT HRSA GRANTSICKLE CELL TREATMENT DEMONSTRATION PROGRAM SICKLE CELL DISEASE FOUNDATION OF CALIFORNIA 3602 INLAND EMPIRE BLVD SUITE B220 ONTARIO CA 91764 956155962 501(C)(3) 283844 SUBCONTRACT QUEENS CARELA COUNTY ADULTS LIVING WITH SICKLE CELL DISEASE SICKLE CELL DISEASE FOUNDATION OF CALIFORNIA 3602 INLAND EMPIRE BLVD SUITE B220 ONTARIO CA 91764 956155962 501(C)(3) 2748742 SUBCONTRACT CALIFORNIA DEPARTMENT OF PUBLIC HEALTH NETWORKING CALIFORNIA FOR SICKLE CELL CARE (NCSCC) SICKLE CELL DISEASE FOUNDATION OF CALIFORNIA 3602 INLAND EMPIRE BLVD SUITE B220 ONTARIO CA 91764 956155962 501(C)(3) 13586 GLOBAL BLOOD THERAPEUTICSSTRENGTHENING ACCESS TO SICKLE CELL CARE IN CALIFORNIA THE UNIVERSITY OF ARIZONA 1303 E UNIVERSITY BLVD BOX 3 TUCSON AZ 857190521 742652689 501(C)(3) 21463 SUBCONTRACT HRSA GRANTSICKLE CELL TREATMENT DEMONSTRATION PROGRAM OREGON HEALTH AND SCIENCE UNIVERSITY 3181 SW SAM JACKSON PARK ROAD PORTLAND OR 972013011 931176109 501(C)(3) 15592 SUBCONTRACT HRSA GRANTSICKLE CELL TREATMENT DEMONSTRATION PROGRAM SEATTLE CHILDREN'S HOSPITAL 2101 E YESLER WAY SEATTLE WA 98122 910564748 501(C)(3) 22042 SUBCONTRACT HRSA GRANTSICKLE CELL TREATMENT DEMONSTRATION PROGRAM HEMOSTASIS AND THROMBOSIS CENTER OF NV 8352 W WARM SPRINGS RD SUITE 200 LAS VEGAS NV 89113 822793154 501(C)(3) 27473 SUBCONTRACT HRSA GRANTHEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM HEMOSTASIS AND THROMBOSIS CENTER OF NV 8352 W WARM SPRINGS RD SUITE 200 LAS VEGAS NV 89113 822793154 501(C)(3) 36858 SUBCONTRACT CDC/ATHN GRANTPUBLIC HEALTH SURVEILLANCE HEMOSTASIS AND THROMBOSIS CENTER OF NV 8352 W WARM SPRINGS RD SUITE 200 LAS VEGAS NV 89113 822793154 501(C)(3) 15427 SUBCONTRACT HRSA GRANTSICKLE CELL TREATMENT DEMONSTRATION PROGRAM UNIVERSITY OF COLORADO 13121 E 17TH AVENUE C-222 ROOM L28-3211 AURORA CO 800452571 846000555 501(C)(3) 22161 SUBCONTRACT HRSA GRANTSICKLE CELL TREATMENT DEMONSTRATION PROGRAM PHOENIX CHILDREN'S HOSPITAL 1919 E THOMAS RD PHOENIX AZ 850167710 860422559 501(C)(3) 18924 SUBCONTRACT HRSA GRANTSICKLE CELL TREATMENT DEMONSTRATION PROGRAM 34 5 PART I, LINE 2: THE ORGANIZATION MONITORS THE USE OF GRANT FUNDS IN THE UNITED STATES BY ENTERING INTO SUBCONTRACT AGREEMENTS THAT ARE ON A COST REIMBURSEMENT BASIS. GRANTEES ARE REQUIRED TO SUBMIT COPIES OF INVOICES PRIOR TO DISBURSEMENT OF THE GRANT FUNDS. THERE ARE NO ADVANCE PAYMENTS PERMITTED. X X X X X 0 0 0 0 0 0 0 0 0 SAMANTHA CHAN PHARMACY MANAGER 181376 0 0 0 0 0 6676 0 6545 0 194597 0 0 0 NINA HWANG PHYSICIAN 172312 0 0 0 0 0 6801 0 14328 0 193441 0 0 0 BARRY STATON CHIEF EXECUTIVE OFFICER 293937 0 0 0 0 0 9000 0 22049 0 324986 0 0 0 MATT CIANCIULLI DIRECTOR OF CLINIC 163146 0 0 0 0 0 5953 0 7241 0 176340 0 0 0 VANESSA SALINAS LUNA PHYSICIAN 186243 0 0 0 0 0 7003 0 15347 0 208593 0 0 0 MICHAEL WARDEN CHIEF FINANCIAL OFFICER 146691 0 0 0 0 0 5535 0 7288 0 159514 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B A DRAFT COPY OF FORM 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY AND BOARD OF DIRECTORS TO REVIEW AND APPROVE BEFORE IT WAS ELECTRONICALLY FILED BY THE CPA FIRM. FORM 990, PART VI, SECTION B, LINE 12C CIBD'S CONFLICT OF INTEREST POLICIES ARE REVIEWED ON A REGULAR BASIS AND PROVIDED TO THE OFFICERS AND DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES INCLUDES A COMPENSATION REVIEW AND APPROVAL BY AN INDEPENDENT RECRUITING FIRM. THE FIRM ANALYZES COMPARABILITY DATA AND THEN PROVIDES THE ORGANIZATION WITH A RANGE OF COMPENSATION. THE FINAL COMPENSATION IS DECIDED BY THE PRESIDENT. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES TAX FORMS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. THE TAX FORMS ARE ALSO AVAILABLE ON GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTERST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.