PEDIATRIC AND FAMILY MEDICAL CENTER: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
PEDIATRIC AND FAMILY MEDICAL CENTER (EIN 95-1690966)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-13
IRS object ID
202141339349306554
Schema version
2019v5.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-05-13T21:08:25-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN330700332PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1VASQUEZ & CO LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1655 N CENTRAL AVE STE 1550AddressLine1Txt
CityGLENDALECityNm
State AbbreviationCAStateAbbreviationCd
ZIP91203ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN951690966EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PEDIATRIC & FAMILY MEDICAL CENTERBusinessNameLine1Txt
Business Name Line2DBA EISNER HEALTHBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlPEDIBusinessNameControlTxt
Phone2137475542PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11530 SOUTH OLIVE STREETAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90015ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWARREN J BRODINEPersonNm
Person TitlePRESIDENT/CEOPersonTitleTxt
Phone2137475542PhoneNum
Signature2021-05-07SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLYNN D BOSTERPreparerPersonNm
PTINP00440365PTIN
Phone2138731700PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerWARREN J BRODINEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11530 S OLIVE STREETAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90015ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$54,185,931GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.EISNERHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1920FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionIMPROVE THE PHYSICAL, SOCIAL, AND EMOTIONAL WELL-BEING OF LOS ANGELES FAMILIES.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee565TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$6,052,474PYContributionsGrantsAmt
CY Contributions Grants$6,701,819CYContributionsGrantsAmt
PY Program Service Revenue$44,048,097PYProgramServiceRevenueAmt
CY Program Service Revenue$47,234,521CYProgramServiceRevenueAmt
PY Investment Income$3,706PYInvestmentIncomeAmt
CY Investment Income$4,325CYInvestmentIncomeAmt
PY Other Revenue$264,928PYOtherRevenueAmt
CY Other Revenue$226,992CYOtherRevenueAmt
PY Total Revenue$50,369,205PYTotalRevenueAmt
CY Total Revenue$54,167,657CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$34,659,981PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$35,428,324CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$167,960CYTotalFundraisingExpenseAmt
PY Other Expenses$15,375,646PYOtherExpensesAmt
CY Other Expenses$16,861,532CYOtherExpensesAmt
PY Total Expenses$50,035,627PYTotalExpensesAmt
CY Total Expenses$52,289,856CYTotalExpensesAmt
PY Revenues Less Expenses$333,578PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,877,801CYRevenuesLessExpensesAmt
Total Assets BOY$33,752,523TotalAssetsBOYAmt
Total Assets EOY$43,286,777TotalAssetsEOYAmt
Total Liabilities BOY$6,909,724TotalLiabilitiesBOYAmt
Total Liabilities EOY$14,552,265TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$26,842,799NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$28,734,512NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionEISNER HEALTH IS A QUALITY-FOCUSED, FEDERALLY QUALIFIED NONPROFIT COMMUNITY HEALTH CENTER DEDICATED TO IMPROVING THE PHYSICAL, SOCIAL, AND EMOTIONAL WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE, REGARDLESS OF INCOME.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant ChangeYes (1)SignificantChangeInd
Expense$32,993,042ExpenseAmt
Revenue$39,864,864RevenueAmt
DescMEDICAL CARE- PHYSICAL EXAMS- IMMUNIZATIONS- GYNECOLOGY SERVICES- COUNSELING- PREVENTATIVE MEDICINE- DIAGNOSIS AND MANAGEMENT OF ACUTE AND CHRONIC DISEASES- DIAGNOSIS AND CARE DURING PREGNANCY- OFFICE DERMATOLOGY TOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 41,218.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$4,304,817ExpenseAmt
Revenue$3,807,805RevenueAmt
DescDENTAL CARE- PREVENTATIVE DENTAL EXAMS- DIAGNOSIS AND TREATMENT OF DENTAL AND GUM PROBLEMS- ORTHODONTIC SERVICESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 9,572.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$3,434,545ExpenseAmt
Revenue$3,616,160RevenueAmt
DescMENTAL HEALTH CARE, PHARMACEUTICAL SERVICES, AND OPTOMETRY SERVICES- INDIVIDUAL THERAPY- FAMILY THERAPY- GROUP THERAPY- CASE MANAGEMENT- WORKSHOPS- PARENTING CLASSES- DISPENSING PHARMACEUTICALS TO PATIENTS- SUPPLYING CLINICAL DEPARTMENTS- OPTOMETRY SERVICES, DIETARY SERVICES, OTHER ENABLING SERVICES TOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 5,108 (953 MENTAL HEALTH, 456 DIETARY, 1,074 OPTOMETRY, 2,625 ENABLING).Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$40,732,404TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document51IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee565EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SERGEY NAVOLNEVBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2137475542PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11530 SOUTH OLIVE STREETAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90015ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
STANLEY P BERKMAN
CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
IAN C WIENER ESQ
TREASURER1.00Yes (X)Yes (X)$0$0$0
IRMA AVILA
SECRETARY1.00Yes (X)Yes (X)$0$0$0
ALEJANDRA ROSAS
BOARD MEMBER1.00Yes (X)$0$0$0
VICTOR AGUIRRE
BOARD MEMBER1.00Yes (X)$0$0$0
RUPERT GRANT
VICE CHAIRMAN1.00Yes (X)$0$0$01.00
ED MATHEWS
CONSUMER VICE-CHAIR1.00Yes (X)Yes (X)$0$0$0
KEVIN ROSSI
IMMEDIATE PAST CHAIR1.00Yes (X)$0$0$01.00
MARTINE SINGER
BOARD MEMBER1.00Yes (X)$0$0$0
WARREN J BRODINE
PRESIDENT & CEO40.00Yes (X)$305,881$0$24,693
CHONA DE LEON
VP/COO40.00Yes (X)$267,736$0$25,641
SERGEY NAVOLNEV
CFO40.00Yes (X)$117,784$0$9,868
DEBORAH LERNER
VP CHIEF MEDICAL OFFICER40.00Yes (X)$277,034$0$20,186
KAREN BOSTON
DIRECTOR OF ADULTS40.00$205,427$0$12,729Yes (X)
LUIS LOPEZ
DIRECTOR OF PEDIATRICS40.00$285,142$0$14,694Yes (X)
NATHANA LURVEY
DIRECTOR OF OB/GYN40.00$266,895$0$9,431Yes (X)
DANNY DAN
PHYSICIAN (OB/GYN)40.00$290,124$0$14,694Yes (X)
AHMAD KHALIFA
PHYSICIAN (OB/GYN)40.00$274,392$0$14,694Yes (X)
ANTHONY PICKETT
PHYSICIAN (OB/GYN)40.00$327,849$0$14,694Yes (X)
NICOLAS DIKIO
PHYSICIAN (OB/GYN)40.00$266,121$0$14,690Yes (X)
LILIAN MORRIS
PHYSICIAN (OB/GYN)40.00$284,406$0$11,248Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,168,791TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$187,262TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K85IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
RPS CAPITAL INVESTMENTS
15477 VENTURA BLVD STE 202SHERMAN OAKSCA91403OFFICE RENT$896,949
HEALTH INFORMATION TECHNOLOGY CARE LLC
1310 REDWOOD WAY STE 125PETALUMACA94954IT SERVICES$597,171
SP IV LOKER I LLC
600 WASHINGTON AVE STE 1100ST LOUISMO63101OFFICE RENT$443,615
GRAND AVENUE MEDICAL JOINT VENTURE
135 N LOS ROBLES STE 600PASADENACA91101OFFICE RENT$427,465
PEOPLE 20 GLOBAL LLC
PO BOX 31001-1288PASADENACA91110TEMPORARY LABOR$392,058
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Government Grants$4,630,197GovernmentGrantsAmt
All Other Contributions$2,071,622AllOtherContributionsAmt
Total Contributions$6,701,819TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE FEES624110$46,049,047$46,049,047
PATIENT INCENTIVES624110$1,185,474$1,185,474
FieldValueIRS element (for citing)
Total Program Service Revenue$47,234,521TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,325TotalRevenueColumnAmt
Exclusion$4,325ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$72,500FundraisingGrossIncomeAmt
Fundraising Direct Expenses$18,274FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$54,226TotalRevenueColumnAmt
Exclusion$54,226ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business900099BusinessCd
Total Revenue Column$172,766TotalRevenueColumnAmt
Related Or Exempt Func Income$172,766RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$172,766OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$54,167,657TotalRevenueColumnAmt
Related Or Exempt Func Income$47,407,287RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$58,551ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,725,899TotalAmt
Program Services$1,725,899ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$30,791,082TotalAmt
Program Services$25,711,421ProgramServicesAmt
Management And General$4,987,977ManagementAndGeneralAmt
Fundraising$91,684FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$894,842TotalAmt
Program Services$729,873ProgramServicesAmt
Management And General$162,372ManagementAndGeneralAmt
Fundraising$2,597FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,016,501TotalAmt
Program Services$1,690,756ProgramServicesAmt
Management And General$319,797ManagementAndGeneralAmt
Fundraising$5,948FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$1,554TotalAmt
Management And General$1,554ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,361,283TotalAmt
Program Services$2,797,561ProgramServicesAmt
Management And General$2,521,757ManagementAndGeneralAmt
Fundraising$41,965FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$72,102TotalAmt
Management And General$72,102ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,444,088TotalAmt
Program Services$2,260,942ProgramServicesAmt
Management And General$183,146ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$56,638TotalAmt
Program Services$42,699ProgramServicesAmt
Management And General$13,939ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$82,538TotalAmt
Program Services$44,567ProgramServicesAmt
Management And General$37,971ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,440,636TotalAmt
Program Services$1,440,636ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$394,564TotalAmt
Program Services$264,496ProgramServicesAmt
Management And General$130,068ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
SUPPLIES$1,963,897$1,662,811$300,282$804
MEDICAL SUPPLIES$921,960$921,960
MAINTENANCE AGREEMENT$669,426$157,014$512,412
MILEAGE & PARKING$636,774$459,922$175,896$956

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,816,072TotalAmt
Program Services$821,847ProgramServicesAmt
Management And General$1,970,219ManagementAndGeneralAmt
Fundraising$24,006FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$52,289,856TotalAmt
Program Services$40,732,404ProgramServicesAmt
Management And General$11,389,492ManagementAndGeneralAmt
Fundraising$167,960FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$304,994BOYAmt
EOY$6,465,905EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$515,613BOYAmt
EOY$2,164,707EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,725,633BOYAmt
EOY$1,432,867EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$13,019,662BOYAmt
EOY$15,383,690EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$328,668BOYAmt
EOY$321,035EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$584,459BOYAmt
EOY$588,171EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$32,479,020LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$16,949,533LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$16,004,337BOYAmt
EOY$15,529,487EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$127,813BOYAmt
EOY$252,036EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$869,823BOYAmt
EOY$869,823EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$271,521BOYAmt
EOY$279,056EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$33,752,523BOYAmt
EOY$43,286,777EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,111,822BOYAmt
EOY$5,654,858EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,797,902BOYAmt
EOY$1,773,500EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$7,123,907EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,909,724BOYAmt
EOY$14,552,265EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$25,480,299BOYAmt
EOY$28,073,887EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,362,500BOYAmt
EOY$660,625EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$26,842,799BOYAmt
EOY$28,734,512EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$33,752,523BOYAmt
EOY$43,286,777EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,877,801ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$13,912NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$952,246OtherCostOrOtherBasisAmt
Book Value$952,246BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,074,484OtherCostOrOtherBasisAmt
Depreciation$8,876,045DepreciationAmt
Book Value$13,198,439BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,401,529OtherCostOrOtherBasisAmt
Depreciation$8,035,052DepreciationAmt
Book Value$1,366,477BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$50,761OtherCostOrOtherBasisAmt
Depreciation$38,436DepreciationAmt
Book Value$12,325BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$15,529,487TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
PAYCHECK PROTECTION PROGRAM LOAN PAYABLE$5,590,000
LINE OF CREDIT PAYABLE$1,500,000
OBLIGATION FROM ASSET ACQUISITION$33,907
FieldValueIRS element (for citing)
Total Liability$7,123,907TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$54,180,015TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$13,912NetUnrealizedGainsInvstAmt
Revenue Not Reported$13,912RevenueNotReportedAmt
Revenue Subtotal$54,166,103RevenueSubtotalAmt
Investment Expenses Not Incld$1,554InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$1,554RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$54,167,657TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$52,288,302TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$52,288,302ExpensesSubtotalAmt
Investment Expenses Not Incld2$1,554InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$1,554ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$52,289,856TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE CORPORATION QUALIFIES AS A TAX EXEMPT ORGANIZATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAXATION CODE 23701D. THE CORPORATION HAS EVALUATED ITS TAX POSITIONS AND THE CERTAINTY AS TO WHETHER THOSE POSITIONS WILL BE SUSTAINED IN THE EVENT OF AN AUDIT BY TAXING AUTHORITIES AT THE FEDERAL AND STATE LEVELS. THE PRIMARY TAX POSITIONS EVALUATED RELATE TO THE CORPORATIONS CONTINUED QUALIFICATION AS A TAX-EXEMPT ORGANIZATION AND WHETHER THERE ARE UNRELATED BUSINESS INCOME ACTIVITIES THAT WOULD BE TAXABLE. MANAGEMENT HAS DETERMINED THAT ALL INCOME TAX POSITIONS WILL MORE LIKELY THAN NOT (>50%) BE SUSTAINED UPON POTENTIAL AUDIT OR EXAMINATION; THEREFORE, NO DISCLOSURE OF UNCERTAIN INCOME TAX POSITIONS ARE REQUIRED. THE CORPORATION FILES INFORMATION RETURNS IN THE US FEDERAL JURISDICTION AND THE STATE OF CALIFORNIA. WITH FEW EXCEPTIONS, THE CORPORATION IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2015.ExplanationTxt

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsYes (X)MailSolicitationsInd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1PROMISE OF CAREEvent1Nm
Gross Receipts Event1$72,500GrossReceiptsEvent1Amt
Gross Revenue Event1$72,500GrossRevenueEvent1Amt
Other Direct Expenses Event1$18,274OtherDirectExpensesEvent1Amt
Gross Receipts Total$72,500GrossReceiptsTotalAmt
Gross Revenue Total Events$72,500GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$18,274OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$18,274DirectExpenseSummaryEventsAmt
Net Income Summary$54,226NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
WARREN J BRODINE
PRESIDENT & CEO$305,881$0$0$0$0$0$18,399$0$6,294$0$330,574$0$0$0
CHONA DE LEON
VP/COO$267,736$0$0$0$0$0$19,347$0$6,294$0$293,377$0$0$0
DEBORAH LERNER
VP CHIEF MEDICAL OFFICER$277,034$0$0$0$0$0$17,400$0$2,786$0$297,220$0$0$0
KAREN BOSTON
DIRECTOR OF ADULTS$205,427$0$0$0$0$0$6,435$0$6,294$0$218,156$0$0$0
LUIS LOPEZ
DIRECTOR OF PEDIATRICS$285,142$0$0$0$0$0$8,400$0$6,294$0$299,836$0$0$0
NATHANA LURVEY
DIRECTOR OF OB/GYN$266,895$0$0$0$0$0$8,007$0$1,424$0$276,326$0$0$0
DANNY DAN
PHYSICIAN (OB/GYN)$290,124$0$0$0$0$0$8,400$0$6,294$0$304,818$0$0$0
AHMAD KHALIFA
PHYSICIAN (OB/GYN)$274,392$0$0$0$0$0$8,400$0$6,294$0$289,086$0$0$0
ANTHONY PICKETT
PHYSICIAN (OB/GYN)$327,849$0$0$0$0$0$8,400$0$6,294$0$342,543$0$0$0
NICOLAS DIKIO
PHYSICIAN (OB/GYN)$266,121$0$0$0$0$0$8,400$0$6,290$0$280,811$0$0$0
LILIAN MORRIS
PHYSICIAN (OB/GYN)$284,406$0$0$0$0$0$8,400$0$2,848$0$295,654$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 3WE HAD SEVERAL SIGNIFICANT CHANGES OCCUR AT THE TAIL-END OF FISCAL 2019-2020 DRIVEN BY THE COVID-19 PANDEMIC. WE WERE FORCED TO CLOSE ALL OUR SCHOOL-BASED LOCATIONS. WE HAD TO REDUCE OUR DENTAL SERVICES TO EMERGENCY ONLY (WE HAVE SINCE RESTORED THE SERVICE OFFERING, BUT AT A REDUCED CAPACITY). AND WE HAD TO SHUT DOWN OUR OPTOMETRY & DERMATOLOGY FOR SEVERAL MONTHS BETWEEN APRIL AND JUNE 2020. ON THE OTHER HAND, WE BEGAN TO OFFER TELEHEALTH SERVICES, INCLUDING VIDEO-BASED AND TELEPHONIC MODALITIES.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS REVIEWED BY THE CFO, THEN IT IS GIVEN TO ALL BOARD MEMBERS FOR FINAL REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CANNUAL QUESTIONAIRES ARE GIVEN TO ALL DIRECTORS AND OFFICERS. THE GOVERNANCE COMMITTEE THEN REVIEWS THE QUESTIONAIRE TO ENSURE THE COMPLIANCE OF THE CONFLICT OF INTEREST POLICY. IF A CONFLICT ARISES, IT IS RESOLVED THROUGH BOARD DISCUSSION.
FORM 990, PART VI, SECTION B, LINE 15THE GOVERNANCE COMMITTEE USES INDEPENDENT CONSULTANT AND A COMPENSATION SURVEY STUDY IN ORDER TO DETERMINE THE COMPENSATION FOR THE CEO, OFFICERS, AND KEY EMPLOYEES. ONCE THE COMPENSATION IS DETERMINED, IT IS PRESENTED TO THE ENTIRE BOARD FOR APPROVAL INDEPENDENTLY, WITHOUT THE PARTICIPATION OF INTERESTED PERSONS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GOUTSIDE PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 2,670,204. MANAGEMENT AND GENERAL EXPENSES 2,499,137. FUNDRAISING EXPENSES 41,501. TOTAL EXPENSES 5,210,842. PAYROLL PROCESSING FEE: PROGRAM SERVICE EXPENSES 127,357. MANAGEMENT AND GENERAL EXPENSES 22,620. FUNDRAISING EXPENSES 464. TOTAL EXPENSES 150,441.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1PEDIATRIC & FAMILY MEDICAL FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11530 S OLIVE STREETAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90015ZIPCd
FieldValueIRS element (for citing)
EIN954116680EIN
Primary ActivitiesTO HOLD & INVEST ASSETS ON BEHALF OF PEDIATRIC & FAMILY MEDICAL CENTERPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 12C, III-FIPublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1PEDIATRIC & FAMILY MEDICAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeCTransactionTypeTxt
Involved$107,540InvolvedAmt
Method Of Amount DeterminationBOOKMethodOfAmountDeterminationTxt

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