2019-04-30T15:49:44-05:00 2018-06-30 910189318 MOSS ADAMS LLP 10960 WILSHIRE BLVD SUITE 1100 LOS ANGELES CA 90024 990 2017-07-01 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 2019-04-26 1 LAUREN A HAVERLOCK P00545829 3104770450 2019-04-26 12.129.7.100 2019-04-26 18:02:28 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 32BFBF1104AA8EEBC72962A0CCB0C2C16BC479E3 2017 2019-02-21 02:37:17Z X JOHN FISHER MD 2251 WEST ROSECRANS AVENUE NO 18 COMPTON CA 90222 4132093 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 6 0 0 0 0 1701956 377250 2430137 0 0 0 0 377250 4132093 0 0 0 0 105411 1864799 0 0 0 639385 2751109 744796 4615908 -367546 -483815 64311 621966 431857 1473327 -367546 -851361 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 3762493 2430137 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 FY2018, MLKCMG PROVIDED MEDICAL SERVICES TO 3,425 LOW-INCOME AND UNDERPRIVILEGED INDIVIDUALS. 3762493 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 5 0 1 6 1 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 490642 17326 ANCIL PHILIP MD GENERAL SURGEON 40.00 0.00 X 207229 0 3555 ALAN KAPLAN MD PHYSICIAN - UROLOGY 40.00 0.00 X 194943 0 2560 JUAN CABRALES MD PHYSICIAN - FAMILY MEDICINE 40.00 0.00 X 127003 0 3368 529175 490642 26809 3 0 1 0 THE REGENTS OF THE UNIVERSITY OF CALIFOR 10833 LA CONTE AVE LOS ANGELES CA 90095 PHYSICIAN SERVICES 214600 FARAMARZ TEHRANI MD 639 N BROADWAY 647 LOS ANGELES CA 90012 PHYSICIAN SERVICES 143453 2 1701956 1701956 CALL COVERAGE 621990 1293350 1293350 NET PATIENT SERV. REV. 621990 529936 529936 SUPPORT SERVICES 621990 484064 484064 MEDICAL DIRECTORSHIP 621990 122787 122787 2430137 4132093 2430137 0 0 X 1681081 1681081 34126 34126 52764 52764 96828 96828 245074 245074 4000 4000 1617595 1199317 418278 102589 102589 12824 12824 693844 693844 2796 2796 9280 9280 11592 11592 DUES AND SUBSCRIPTIONS 19942 19942 EMPLOYEE EXPENSE REIMB. 17666 17666 REPAIRS AND MAINTENANCE 3280 3280 MEDICAL SUPPLIES 1253 1253 9374 9374 4615908 3762493 853415 0 38674 318995 25637 291019 0 11952 64311 621966 35007 385648 396850 1087679 431857 1473327 X -367546 -851361 -367546 -851361 64311 621966 -483815 0 X 0 1 X 1 0 X 0 0 1701956 1701956 0 377250 2430137 2807387 0 0 0 0 0 0 377250 4132093 4509343 0 0 0 4509343 0 0 0 0 0 0 377250 4132093 4509343 X SCHEDULE A, PART III THE ORGANIZATION'S 2015 TAX YEAR WAS A SHORT-YEAR, AS THIS WAS THE FIRST YEAR THE ORGANIZATION HAD FORMED. 0 DUE TO MLKCH 79922 PROMISSORY NOTE TO MLKCH 300000 PHYSICIANS SALARY GUARANTEE LIABILITY 707757 1087679 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, 2018 OR 2017. 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 363730 0 120912 0 6000 0 8100 0 9226 0 507968 0 0 ANCIL PHILIP MD GENERAL SURGEON 207229 0 0 0 0 0 0 0 3555 0 210784 0 0 0 ALAN KAPLAN MD PHYSICIAN - UROLOGY 194943 0 0 0 0 0 2560 0 0 0 197503 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 1,199,317. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,199,317. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 171,624. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 171,624. CONSULTING FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 212,230. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 212,230. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 34,424. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,424. 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