2020-06-08T16:32:05-05:00 2019-06-30 951777440 GREEN HASSON & JANKS LLP 10990 WILSHIRE BLVD 16TH FLOOR LOS ANGELES CA 900243929 990 2018-07-01 952539105 THE LOS ANGELES FREE CLINIC LOSA 3236538622 8405 BEVERLY BOULEVARD LOS ANGELES CA 90048 MURIEL NOUWEZEM INTERIM CEO & CFO 3236538622 2020-05-20 1 LIZBETH NEVAREZ P01399868 3108731600 108.233.72.19 2020-05-20 21:01:29 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 1E5C2E37194314C3A47C760AEAFDC059525B6175 2018 2021-01-29 14:40:06Z SABAN COMMUNITY CLINIC MURIEL NOUWEZEM 8405 BEVERLY BOULEVARD LOS ANGELES CA 90048 29355771 0 X WWW.SABANCOMMUNITYCLINIC.ORG X 1967 CA TO SERVE AS A MEDICAL HOME TO THE MOST VULNERABLE MEMBERS OF OUR COMMUNITY BY PROVIDING AFFORDABLE QUALITY HEALTH CARE IN A CARING ENVIRONMENT. 18 18 266 134 0 0 9663064 8085473 13892795 17931483 365690 569003 31936 103458 23953485 26689417 0 0 0 0 17420957 18160648 0 0 921974 8477518 9174204 25898475 27334852 -1944990 -645435 22150105 23203220 4891910 7064197 17258195 16139023 X TO SERVE AS A MEDICAL HOME TO THE MOST VULNERABLE MEMBERS OF OUR COMMUNITY BY PROVIDING AFFORDABLE QUALITY HEALTH CARE IN A CARING ENVIRONMENT. 0 0 16884396 11664335 PRIMARY CARE SERVICESPRIMARY CARE SERVICES ARE PROVIDED THROUGH WAC CLINIC (WALLIS ANNENBERG CENTER), BEVERLY CLINIC, AND MARK S. TAPER CLINIC .THE CLINICS PROVIDE PRIMARY CARE SERVICES FOR ADULTS AND CHILDREN, WHICH INCLUDES HEALTH MAINTENANCE SERVICES SUCH AS PHYSICAL EXAMS, PAP SMEARS AND BREAST EXAMS; DIAGNOSIS AND TREATMENT OF CHRONIC CONDITIONS SUCH AS DIABETES, HYPERTENSION AND ASTHMA; FAMILY PLANNING SERVICES, HIV TESTING AND COUNSELING, AND TESTING AND TREATMENT OF OTHER SEXUALLY TRANSMITTED DISEASES; CANCER SCREENING AND BLOOD PRESSURE SCREENING. 3026664 5000231 DENTAL CLINIC -THE DENTAL CLINIC DELIVERS SERVICES TO BOTH CHILDREN AND ADULTS OF ALL AGES. SERVICES INCLUDE DIAGNOSTIC VISITS SUCH AS ORAL EXAMS WITH X-RAYS; RESTORATIVE PROCEDURES SUCH AS FILLINGS AND STAINLESS STEEL CROWNS FOR CHILDREN; EXTRACTIONS, PULPOTOMIES AND ROOT CANALS, DENTURES, EMERGENCY AND PALLIATIVE CARE, AND SUCH PREVENTIVE CARE AS TEETH CLEANINGS, SEALANTS, SILVER DIAMINE FLUORIDE, CARIES RISK ASSESSMENT WITH SELF-MANAGEMENT GOALS, ORAL HYGIENE EDUCATION AND NUTRITION COUNSELING. 2226578 1266917 BEHAVIORAL HEALTH -THE BEHAVIORAL HEALTH DEPARTMENT OPERATES AT ALL CLINIC SITES TO PROVIDE CASE MANAGEMENT AND SHORT TERM COUNSELING SERVICES TO PEOPLE OF ALL AGES. CASE MANAGEMENT INCLUDES CARE COORDINATION, REFERRALS AND LINKAGE TO RESSOURCES; SHORT-TERM COUNSELING INCLUDES DEPRESSION SCREENING, INDIVIDUAL AND COUPLES COUNSELING, AND FAMILY COUNSELING; GROUP COUNSELING INCLUDES WEIGT LOSS AND HEALTHLY LIVING, MINDFULNESS MEDITATION, HARM-REDUCTION, WOMEN'S TRAUMA. LIMITED PSYCHIATRIC SERVICES ARE ALSO AVAILABLE. 1049061 ELIGIBILITY AND ENROLLMENT -THE ELIGIBILITY AND ENROLLMENT DEPARTMENT PROVIDES HEALTH INSURANCE AND PROGRAM ELIGIBILITY SERVICES TO PEOPLE OF ALL AGES, AT ALL THREE CLINIC SITES AS WELL AS AT COMMUNITY MEETINGS, HEALTH FAIRS AND OTHER PUBLIC EVENTS. 1049061 23186699 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 30 0 1 266 1 0 0 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MURIEL NOUWEZEM 3233371707 8405 BEVERLY BOULEVARD LOS ANGELES CA 90048 RUSSELL ALEXANDER-OROZCO CO-CHAIR 8.00 1.00 X X 0 0 0 ROBERT BRODER CO-CHAIR 8.00 1.00 X X 0 0 0 ANGELA L JONES VICE CHAIR 2.00 1.00 X X 0 0 0 MICHAEL ZIERING JD TREASURER 2.00 1.00 X X 0 0 0 JOANNE DIETCH SECRETARY 2.00 1.00 X X 0 0 0 JESSE BRONNER DIRECTOR 1.00 0.00 X 0 0 0 CELIA A BRUGMAN DIRECTOR 1.00 0.00 X 0 0 0 CAROL W BUITRAGO DIRECTOR 1.00 0.00 X 0 0 0 ERIC JUNG MD DIRECTOR 1.00 0.00 X 0 0 0 MINERVA LOPEZ DIRECTOR 1.00 0.00 X 0 0 0 MICHAEL MCBRIDE DIRECTOR 1.00 0.00 X 0 0 0 PEGGY B MILES MD FACP DIRECTOR 1.00 0.00 X 0 0 0 INGRID PALMER DIRECTOR 1.00 0.00 X 0 0 0 LUIS PARDO DIRECTOR 1.00 0.00 X 0 0 0 MITCHELL PINDUS DIRECTOR 1.00 0.00 X 0 0 0 RICHARD K RIFENBARK JD DIRECTOR 1.00 0.00 X 0 0 0 KAREN SANCHEZ DIRECTOR 1.00 0.00 X 0 0 0 JUDD ZINBERG CCIM DIRECTOR 1.00 0.00 X 0 0 0 MURIEL NOUWEZEM INTERIM CEO & CFO 40.00 0.00 X 248441 0 16442 DAVID LUNA CHIEF MEDICAL OFFICER 40.00 0.00 X 310163 0 16676 YANINA QUEEN DIRECTOR OF PEDIATRICS 40.00 0.00 X 236422 0 4496 ARMEN ARSHAKYAN CHIEF MEDICAL OFFICER 40.00 0.00 X 232493 0 18011 EMANUEL EMIL MKRTICHIAN CHIEF INFORMATION OFFICER 40.00 0.00 X 232090 0 20332 FARSHID FARAROOY PHYSICIAN PT 40.00 0.00 X 229672 0 23579 CHRISTOPHER BRYCHEL PHYSICIAN/CLINICAL CHAMPION 40.00 0.00 X 215362 0 8475 JULIE ANNE HUDMAN CEO (UNTIL JUNE 1, 2018) 40.00 0.00 X 128646 0 16985 1833289 0 124996 19 1 1 0 OCHIN 1881 SW NAITO PARKWAY PORTLAND OR 97201 EPIC SYSTEM MAINTENANCE 552165 1 1700 49315 3747889 4286569 8085473 PATIENT SERVICE REVENUE 900099 17931483 17931483 17931483 252111 252111 2982696 550 2432808 233546 549888 -232996 316892 316892 0 1700 0 0 SETTLEMENT 900099 55211 55211 MISCELLANEOUS 900099 48247 48247 103458 26689417 17931483 0 672461 487147 432208 44327 10612 14830432 13161811 1346383 322238 202181 178404 19172 4605 1584253 1397938 150235 36080 1056635 937023 96079 23533 501430 501430 74120 74120 44364 44364 1525920 1020348 277247 228325 87574 59863 18760 8951 856461 695152 108600 52709 1124215 967556 123985 32674 1793678 1524983 166123 102572 68641 55563 11562 1516 126930 86765 27191 12974 72211 72211 591252 534274 48136 8842 310299 286527 19265 4507 PROGRAM SUPPLIES 1662295 1619417 5265 37613 SUBSCRIPTIONS & MEMBERS 113177 77364 24245 11568 STAFF & VOLUNTEER RECRU 71458 48846 15308 7304 STAFF APPRECIATION 66608 45531 14269 6808 83571 57126 17902 8543 27334852 23186699 3226179 921974 553724 418873 63890 3977 2183717 1549767 1985476 3219628 20167 114027 180667 197640 13319672 6149136 6719875 7170536 8295170 8511792 2018547 1694285 128872 322695 22150105 23203220 3193892 3530091 417879 342426 600000 3191680 680139 0 4891910 7064197 X 5158100 4755432 12021812 11305308 78283 78283 17258195 16139023 22150105 23203220 X -645435 -423101 -50636 X 0 1 X 1 1 1 X 7527046 7088947 8368142 9663064 8085473 40732672 7527046 7088947 8368142 9663064 8085473 40732672 573792 40158880 647136 453678 277574 272803 252111 1903302 16721 77526 46858 31936 103458 276499 42912473 65132265 0.93580 0.92900 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9744843 383846 442172 9686517 11280203 780890 2316250 9744843 10717603 1060445 497845 11280203 11785906 -544162 524141 10717603 12151450 41783 212340 619667 11785906 0.00810 0.99190 0 0 1407981 1407981 7411609 4027865 3383744 702769 64474 638295 2518987 2056797 462190 1278326 1278326 7170536 1156265 F FOREIGN OFFSHORE INVESTMENT 538020 F 1694285 FORM 990, PART V THE ORGANIZATION HAS ADOPTED AN ENDOWMENT INVESTMENT POLICY, APPROVED BY THE BOARD, FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THESE ENDOWMENT ASSETS OVER THE LONG TERM. THE INVESTMENT POLICY ESTABLISHES AN ACHIEVABLE RETURN OBJECTIVE THROUGH DIVERSIFICATION OF ASSET CLASSES. THE OBJECTIVE IS TO GROW THE AGGREGATE PORTFOLIO VALUE, NET OF SPENDING, AT THE RATE OF INFLATION OVER THE INVESTMENT HORIZON. CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENT 538020 0 0 0 0 0 0 538020 0 538020 0 0 0 0 0 0 X X X X X 0 0 0 0 0 0 0 1 0 MURIEL NOUWEZEM INTERIM CEO & CFO 248441 0 0 0 0 0 9250 0 7192 0 264883 0 0 0 DAVID LUNA CHIEF MEDICAL OFFICER 310163 0 0 0 0 0 8940 0 7736 0 326839 0 0 0 YANINA QUEEN DIRECTOR OF PEDIATRICS 226357 0 10065 0 0 0 1134 0 3362 0 240918 0 0 0 ARMEN ARSHAKYAN CHIEF MEDICAL OFFICER 217759 0 14734 0 0 0 0 0 18011 0 250504 0 0 0 EMANUEL EMIL MKRTICHIAN CHIEF INFORMATION OFFICER 227388 0 4702 0 0 0 4009 0 16323 0 252422 0 0 0 FARSHID FARAROOY PHYSICIAN PT 222483 0 7189 0 0 0 6639 0 16940 0 253251 0 0 0 CHRISTOPHER BRYCHEL PHYSICIAN/CLINICAL CHAMPION 213085 0 2277 0 0 0 0 0 8475 0 223837 0 0 0 JULIE ANNE HUDMAN CEO (UNTIL JUNE 1, 2018) 128646 0 0 0 0 0 4983 0 12002 0 145631 0 0 0 PART I, LINE 7 THE ORGANIZATION PROVIDED BONUSES AS FOLLOW: MEDICAL PROVIDER QUARTERLY INCENTIVES -PROVIDERS WHO REACH CERTAIN METRICS OUTLINED BY THE CHIEF MEDICAL OFFICER QUALIFY FOR A QUARTERLY INCENTIVE BONUS. PERFORMANCE EVALUATIONS- ONE TIME BONUSES DISTRIBUTED TO EMPLOYEES IN LIEU OF A MERIT INCREASE IN DECEMBER 2018 FOR THOSE WHO WERE ELIGIBLE BASED OFF THEIR PERFORMANCE REVIEWS. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTE IS COMPOSED OF 1) ROBERT BRODER, CO-CHAIR 2) RUSSELL ALEXANDER-OROZCO, CO-CHAIR 3) ANGELA JONES, VICE CHAIR 4) JOANNE DIETCH, SECRETARY 5) MICHAEL ZIERING, TREASURER FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY AN OUTSIDE CPA FIRM AND THEN REVIEWED AND APPROVED BY THE CEO AND INTERIM CEO. WHEN THE CEO AND COO/CFO HAVE COMPLETED THEIR REVIEW, THE RETURN IS PRESENTED TO THE FULL BOARD OF DIRECTORS BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, BOARD MEMBERS COMPLETE CONFLICT OF INTEREST DOCUMENTS AND SIGN THEM. THESE DOCUMENTS ARE FILED WITH THE EXECUTIVE OFFICE. ANY CONFLICTS THAT SHOULD ARISE ARE REVIEWED BY THE BOARD EXECUTIVE COMMITTEE OR THE CORPORATTE COMPLIANCE OFFICER. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE THAT FUNCTIONS AS A COMPENSATION COMMITTEE WHICH HIRES AN INDEPENDENT CONSULTANT. THIS CONSULTANT PERFORMS SALARY SURVEYS FOR THE CHIEF EXECUTIVE OFFICER(S) AND OTHER KEY EMPLOYEES INDEPENDENTLY, WITHOUT PARTICIPATION OF INTERESTED PERSONS. THE COMPENSATION IS BASED UPON THESE SALARY SURVEYS AND SUBJECT TO BOARD APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: BAD DEBT EXPENSE -50,636. LAFC HOLLYWOOD CENTER ENDOWMENT CORP 8405 BEVERLY BLVD LOS ANGELES CA 90048 954323238 PROVIDE FINANCIAL SUPPORT TO LOS ANGELES FREE CLINIC CA 501(C)(3) LINE 12A, I THE LOS ANGELES FREE CLINIC 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0