2020-05-04T18:59:07-05:00 2019-06-30 910189318 MOSS ADAMS LLP 10960 WILSHIRE BLVD SUITE 1100 LOS ANGELES CA 90024 990 2018-07-01 812455970 MARTIN LUTHER KING JR COMMUNITY MEDICAL GROUP MART 4245296755 2251 WEST ROSECRANS AVENUE NO 18 COMPTON CA 90222 JOHN FISHER MD PRESIDENT/SECRETARY/TREASURER 4245296755 2020-04-27 1 LAUREN A HAVERLOCK P00545829 3104770450 2020-04-27 172.90.17.200 2020-04-27 20:47:41 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 45A0DEE88EBA5BC01B2D6E064F66B43F0304238A 2018 2020-11-06 18:47:13Z JOHN FISHER MD 2251 WEST ROSECRANS AVENUE NO 18 COMPTON CA 90222 15985867 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. 1 0 10 0 0 0 1701956 4329484 2430137 11615171 0 0 0 41212 4132093 15985867 0 0 0 0 1864799 2800535 0 0 0 2751109 12210173 4615908 15010708 -483815 975159 621966 2429371 1473327 2305573 -851361 123798 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 13432408 11615171 MARTIN LUTHER KING COMMUNITY MEDICAL GROUP (MLKCMG) IS A TEAM OF PHYSICIANS PASSIONATELY COMMITTED TO IMPROVING THE HEALTH OF THE SOUTH LOS ANGELES COMMUNITY. MLKCMG 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. MLKCMG 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 FY2019, MLKCMG INCREASED THE NUMBER OF PHYSICIANS AND EXPANDED THE CLINIC SPACE TO ACCOMMODATE LARGER PATIENT VOLUME PATIENT CLINIC VISITS WERE 11,008. MLKCMG 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. 13432408 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 14 0 1 10 1 0 0 0 0 0 0 0 0 0 0 0 0 X 1 0 0 0 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 JOHN FISHER MD PRESIDENT/SECRETARY/TREASURER 3.00 40.00 X X 0 502166 17707 ANCIL PHILIP MD GENERAL SURGEON 40.00 0.00 X 385455 0 11775 ALAN KAPLAN MD PHYSICIAN - UROLOGY 40.00 0.00 X 466597 0 17226 JUAN CABRALES MD PHYSICIAN - FAMILY MEDICINE 40.00 0.00 X 246994 0 13135 YAMANDA EDWARDS MD PHYSICIAN - FAMILY MEDICINE 40.00 0.00 X 205370 0 22074 ADAN ROMERO MD PHYSICIAN - FAMILY MEDICINE 40.00 0.00 X 245659 0 13532 1550075 502166 95449 11 0 1 0 THE REGENTS OF THE UNIVERSITY OF CALIFOR 1680 E 102TH STREET LOS ANGELES CA 90095 PHYSICIAN SERVICES 566115 FARAMARZ TEHRANI MD 639 N BROADWAY 647 LOS ANGELES CA 90012 PHYSICIAN SERVICES 355416 ARIEL MALAMUD MD 2307 GUTHRIE DRIVE LOS ANGELES CA 90034 PHYSICIAN SERVICES 257710 JEAN MULLER MD 26827 HYLE ROAD RANCHO PALOS VERDES CA 90275 PHYSICIAN SERVICES 163879 HALL DYNAMICS DBA MYRON L HALL DPM 9301 WILSHIRE BLVD 404 BEVERLY HILLS CA 90210 PHYSICIAN SERVICES 144200 7 4329484 4329484 CALL COVERAGE 621990 7639837 7639837 NET PATIENT SERV. REV. 621990 3022370 3022370 SUPPORT SERVICES 621990 816757 816757 MEDICAL DIRECTORSHIP 621990 136207 136207 11615171 OTHER OPERATING REVENUE 900099 41212 41212 41212 15985867 11615171 0 41212 X 2483117 2483117 87396 87396 100910 100910 129112 129112 351433 351433 134018 134018 5000 5000 10106664 9145810 960854 5856 5856 1446366 1446366 32781 32781 36778 36778 DUES AND SUBSCRIPTIONS 47358 47358 EMPLOYEE EXPENSE REIMB. 22925 22925 MEDICAL SUPPLIES 6916 6916 EDUCATION 6772 6772 7306 7306 15010708 13432408 1578300 0 318995 403975 291019 1911450 11952 32610 0 81336 621966 2429371 385648 1436586 1087679 868987 1473327 2305573 X -851361 -851361 975159 -851361 123798 621966 2429371 975159 0 X 0 1 X 1 0 X 0 1701956 4329484 6031440 377250 2430137 11615171 14422558 0 0 0 0 0 0 377250 4132093 15944655 20453998 0 0 0 20453998 0 0 0 0 0 0 41212 41212 377250 4132093 15985867 20495210 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2018 AMOUNT: $ 41,212. 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 568987 868987 X PART X, LINE 2: THE ORGANIZATION 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, 2019 OR 2018. THE ORGANIZATION 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 JOHN FISHER MD PRESIDENT/SECRETARY/TREASURER 0 375046 0 121120 0 6000 0 8250 0 9457 0 519873 0 0 ANCIL PHILIP MD GENERAL SURGEON 350374 0 35081 0 0 0 1107 0 10668 0 397230 0 0 0 ALAN KAPLAN MD PHYSICIAN - UROLOGY 432139 0 34458 0 0 0 14513 0 2713 0 483823 0 0 0 JUAN CABRALES MD PHYSICIAN - FAMILY MEDICINE 228099 0 18895 0 0 0 9813 0 3322 0 260129 0 0 0 YAMANDA EDWARDS MD PHYSICIAN - FAMILY MEDICINE 190279 0 15091 0 0 0 8326 0 13748 0 227444 0 0 0 ADAN ROMERO MD PHYSICIAN - FAMILY MEDICINE 228815 0 16844 0 0 0 6014 0 7518 0 259191 0 0 0 PART I, LINE 3 THE ORGANIZATION RELIED ON MARTIN LUTHER KING, JR.-LOS ANGELES HEALTHCARE CORPORATION, A RELATED ORGANIZATION, TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT, WHICH INCLUDED REVIEW OF HIS COMPENSATION BY THE BOARD OF DIRECTORS WHO UTILIZED EXTERNAL MARKET COMPENSATION INFORMATION. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS SHAREHOLDERS, WHO SHALL BE LIMITED TO INDIVIDUALS THAT ARE: (I) LICENSED OR OTHERWISE AUTHORIZED TO ENGAGE IN THE PRACTICE OF MEDICINE IN THE STATE OF CALIFORNIA, AND (II) ARE EMPLOYEES OR CONTRACTORS OF MARTIN LUTHER KING, JR.-LOS ANGELES HEALTHCARE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A THE SHAREHOLDERS OF THE CORPORATION MAY ELECT THE MEMBERS OF THE BOARD OF DIRECTORS FROM AMONG QUALIFIED NOMINEES DESIGNATED BY MARTIN LUTHER KING, JR.-LOS ANGELES HEALTHCARE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B THE BYLAWS, ARTICLES OF INCORPORATION, AND CAPTIVE PROFESSIONAL CORPORATION DOCUMENTS MAY BE AMENDED ONLY BY THE AFFIRMATIVE VOTE OF A MAJORITY OF THE OUTSTANDING SHARES ENTITLED TO VOTE, OR BY THE WRITTEN CONSENT OF SHAREHOLDERS ENTITLED TO VOTE SUCH SHARES. IN EITHER CASE, SUCH AMENDMENTS ARE SUBJECT TO THE APPROVAL OF 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 8,707,489. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,707,489. CONSULTING FEES: PROGRAM SERVICE EXPENSES 438,321. MANAGEMENT AND GENERAL EXPENSES 960,854. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,399,175. 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 0 0 1 0 1 0 0 0 0 0 0 1 1 1 1 0 0 0 0