2019-04-30T19:21:59-05:00 2018-06-30 954557617 Harrington Group CPAs LLP 234 East Colorado Blvd Suite M150 Pasadena CA 91101 990 2017-07-01 951644040 QueensCare QUEE 3236694305 950 South Grand Avenue 2nd Fl South Los Angeles CA 90015 Barbara B Hines President/CEO 3236694305 2019-04-30 1 Sean E Cain CPA P01612986 6264036801 209.133.35.227 2019-04-30 17:21:48 PD P C2C22B4F1B9AA0772E09E87A4EA864779F63AD2A 0B4F3B71C2EC911E577D967EDC65E3E555B204AC 2017 2019-02-21 02:37:17Z Barbara B Hines 950 South Grand Avenue 2nd Fl South Los Angeles CA 90015 23958983 0 X www.queenscare.org X 1936 CA QueensCare provides a continuum of high quality medical and hospital care to the medically underserved (indigent, unisured, underinsured) residents of Los Angeles County. 15 15 57 0 0 0 388000 1245000 121755 194368 29401512 5936372 3590945 4278786 33502212 11654526 8690254 9695094 0 0 3376595 3231042 0 0 0 6702785 6770760 18769634 19696896 14732578 -8042370 399442875 407190264 7907634 10485960 391535241 396704304 X QueensCare provides a continuum of high quality medical and hospital care to the medically underserved (indigent, uninsured, underinsured) residents of Los Angeles County. 0 0 4543771 QueensCare operates jointly with QueensCare Health Centers to provide a network of 5 freestanding family healthcare centers in areas of Los Angeles County that are medically underserved. The health centers provide services to all patients without regard to ability to pay. Each health center is an approved medicaid and medicare provider. The clinics provide free medical care for those who do not have the financial resources or coverage by health plans, insurance or government programs. The clinics provide preventive, diagnostic, and follow-up medical and dental care to the residents of low-income communities. During 2017-2018, the health centers served appoximately 25,000 patients which accounted for 112,000 visits. 7574081 4671027 To support the operation of QueensCare Health Centers and to further the organization's exempt purpose of providing medical care to the underprivileged and indigent residents of Los Angeles County, QueensCare provides medical care support services in coordination with the services provided by the health centers, including inpatient, outpatient, nursing, outreach and mental healthcare services. 5599300 5024067 194368 QueensCare operates 4 divisions: 1) The Pastoral Care Division provides spiritual care to inpatients and staff at Hollywood Presbyterian Medical Center. During FY 2018, the chaplains visited over 40,000 patients. Over 950 patients received the anointing of the sick; five were baptized; 30 were helped with Advance Directives; and 98 patients were attended by chaplains during a Code Blue; 2) QueensCare Health and Faith Partnership (QHFP) is the largest parish nurse program in California. There are 16 parish nurses and 5 community health workers. Together they provide immunizations, health screening, CPR training, and parenting classes at the various partner sites including, churches, food pantries, synagogues, senior nutrition sites, the Braille Institute and schools. In addition, QHFP helped plan and participated in 627 outreach events and sponsored health fairs; 3) Direct Healthcare Division, comprised of the following: a) The Mobile Dental Program - QueensCare together with USC School of Dentistry provides mobile dental clinic services at LAUSD's elementary schools. In 2018, QueensCare provided services at 11 schools and served 1,869 children and provided 12,960 visits. In addition, QueensCare provided oral hygiene presentations and instructions to every child in every school visited and distributed 2,200 oral hygiene kits; b) Mobile Vision Program - QueensCare provides mobile vision services to low-income communities through LAUSD. The mobile vision program was offered at 24 LAUSD middle schools and 2 Catholic schools. Total of 1,900 prescriptions were written by QueensCare's optometrist and 1,921 glasses were provided the students at no cost; c) Mental Health Program - QueensCare provided services to 300 children between the ages of 5 and 18 and their families. The children are referred by QueensCare Health Centers, LAUSD, and QHFP because of trauma experienced, as well as other issues; d) Inpatient Program - QueensCare contracts with local non-profit acute care hospitals to provide inpatient care to medically indigent patients; e) Q-QHC Healthcare Partners - A partnership, described previously with QueensCare Health Centers to provide ambulatory care to low income, underserved patients in LA County; and 4) Charitable Division - The Charitable Board increased it meeting frequency during FY 2018 to three meetings and approved 30 grants amounting to $2.8 million. In addition, the Charitable Board also approved 28 scholarships and funded 14 area hospitals with Emergency Medical Services grants amounting to another $2.0 million. 17717152 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 0 1 94 0 1 57 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 CA X X Faith Lee Vice President 3236694345 950 South Grand Avenue 2nd Fl South Los Angeles CA 90015 Bettie J Woods Chair 3.00 2.00 X X 3950 0 0 Steven Aronoff Vice Chair 2.00 2.00 X X 4250 0 0 Alan Cushman Secretary 10.00 10.00 X X 2750 0 0 Sister Judy Murphy Secretary 10.00 10.00 X X 23250 4650 0 Allan Michelena Director 2.00 2.00 X 2150 1750 0 Denise Partamian Forgette Director 2.00 2.00 X 3900 500 0 Edward Avila Director 2.00 X 1000 0 0 Fr Michael Stechmann Director 2.00 X 0 0 0 Frances Inman Director 2.00 X 2150 0 0 Gene A Nuziard Director 2.00 2.00 X 3750 750 0 Javier Guerena Director 2.00 2.00 X 3050 1500 0 Jeff Hermann Director 2.00 X 0 0 0 Joseph Bui Director 2.00 X 750 0 0 Lois Saffian Director 2.00 X 2800 0 0 Rev Michael Mata Director 4.00 X 2650 0 0 Barbara B Hines CEO 8.00 32.00 X X 62283 294094 42882 Eloisa Perard CAO 40.00 X 94038 0 3933 Gary Grubbs President & CFO (term end 7/18) 40.00 X 243004 0 17622 Alan G De Jong Director Risk Management 40.00 X 127116 0 23816 Faith Lee VP-Finance & Accounting(Q) 40.00 X 135023 0 15456 Kathy Williamson Director of Operations 40.00 X 120416 0 9893 Wendy Johnson Parish Nurse Manager 40.00 X 101998 0 21149 940278 303244 134751 5 0 1 0 Goldman Sachs & Co LLC 2121 Avenue of the Stars Suite 260 Los Angeles CA 90067 Investment Mgmt. 869239 USC School of Dentisty 1149 S Hill Street Ste H550 Los Angeles CA 90015 Pediatric Dentistry 487396 BJ'S Maintenance and Painting 21500 Lassen Street No 141 Chatsworth CA 91311 Janetorial service 128584 Seyfarth Shaw LLP 3807 Collection Center Drive Chicago IL 606035577 Legal services 122354 Guy Rounsaville Jr 948 Tournament Drive Hillsborough CA 94010 Legal services 120000 5 1245000 1245000 Mental Health Project 124100 191884 191884 QHFP Health Screening 900099 2484 2484 194368 84023 84023 7422960 3156806 4266154 4266154 4266154 15000000 9147651 5852349 5852349 5852349 Other income 900099 12632 12632 12632 11654526 194368 0 10215158 4759067 4759067 4936027 4936027 387917 67843 320074 2036365 1609520 426845 108023 93180 14843 546223 433691 112532 152514 125410 27104 200435 61300 139135 255901 255901 43750 43750 696870 578956 117914 224876 95612 129264 32099 24096 8003 149702 30364 119338 182659 141920 40739 33666 28958 4708 38512 12621 25891 80930 49393 31537 110086 11525 98561 K-1 Expenses - Q/QHC He 4543771 4543771 Other expense 177503 113898 63605 19696896 17717152 1979744 0 3377011 7612546 98497000 16860000 83194000 81637000 265238864 270399718 47452000 47452000 181000 89000 399442875 407190264 4154836 6038960 2876634 3521000 164 876000 926000 7907634 10485960 X 390878047 396021301 657194 683003 391535241 396704304 399442875 407190264 -8042370 13211433 0 X 0 1 X 1 0 X Form 990, Schedule A, Part I: QueensCare is recognized as a hospital described in section 170(b)(1)(A)(iii) of the Internal revenue Code because its principal purpose is to provide medical care through neighborhood medical clinics and health centers. QueensCare is not licensed to operate a hospital. 657194 25809 683003 656487 707 657194 655000 1487 656487 655000 655000 655000 655000 1.00000 0 0 20703000 20703000 70818000 15328089 55489911 4480000 268835 4211165 2496000 1263076 1232924 81637000 Alt. Mutual Fund Inv. 36279000 F Closely held securities 11173000 F 47452000 Workers compensation liability 926000 926000 X Part V, Line 4: QueensCare intends to use its endowment funds for healthcare related activities. Part X, Line 2: The Organization is exempt from taxation under Internal Revenue Code Section 501(c)(3) and California Revenue and Taxation Code Section 23701d. Generally accepted accounting principles provide accounting and disclosure guidance about positions taken by an organization in its tax returns that might be uncertain. Management has considered its tax positions and believes that all of the positions taken by the Organization in its federal and state exempt organization tax returns are more likely than not to be sustained upon examination. The Organization returns are subject to examination by federal and state taxing authorities, generally for three and four years, respectively, after they are filed. 1 Alcoholism Center for Women 1147 South Alvarado Street Los Angeles CA 90006 237428537 501(c)3 25000 To provide health related education or outreach to underserved populations residing in Los Angeles. Alta Los Angeles Community Hospital 4081 E Olympic Blvd Los Angeles CA 90023 954691839 4533 To fund emergency room services provided to uninsured patients residing in Los Angeles. American Red Cross 11355 Ohio Avenue Los Angeles CA 90025 530196605 501(c)3 50000 To provide funding for health related materials/services provided by organization. APLA Health & Wellness 611 South Kingsley Drive Los Angeles CA 90005 953842506 501(c)3 110000 To fund health related services provided AIDS patients. Beverly Hospital 309 W Beverly Blvd Los Angeles CA 90640 237429685 7555 To fund emergency room services provided to uninsured patients residing in Los Angeles. BREATHE California of LA County 5858 Wilshire Blvd Suite 300 Los Angeles CA 90036 951641451 501(c)3 50000 To provide health related education or outreach to underserved populations residing in Los Angeles. CAST 5042 Wilshire Blvd Suite 586 Los Angeles CA 90036 100008533 501(c)3 95000 To provide health related education or outreach to underserved populations residing in Los Angeles. Cancer Support Community Pasadena 76 East Del Mar Blvd Suite 215 Pasadena CA 91105 954201985 501(c)3 35000 To provide health related education or outreach to underserved populations residing in Los Angeles. Care Harbor Los Angeles 18436 Hawthorne Blvd Ste 204 Torrance CA 90504 272984870 501(c)3 25000 To fund outpatient healthcare services. Chapcare 455 W Montana Street Pasadena CA 91103 954536824 501(c)3 75000 To fund outpatient healthcare services. Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles CA 90027 951690977 501(c)3 452276 To fund emergency room services provided to uninsured patients residing in Los Angeles. CIBD 2670 N Main Street Suite 100 Santa Ana CA 92705 270179192 501(c)3 855657 To provide health related education or outreach to underserved populations residing in Los Angeles. Covenant House California 1325 North Western Avenue Los Angeles CA 90027 133391210 501(c)3 50000 To fund outpatient healthcare services. Exceptional Children's Foundation 8740 W Washington Boulevard Culver City CA 90232 951690988 501(c)3 125000 To fund outpatient healthcare services. Five Acres 760 W Mountain View Street Altadena CA 91001 951647810 501(c)3 35000 To fund outpatient healthcare services. Glendale Memorial Hospital and Health Center 1420 South Central Avenue Glendale CA 91204 941196203 501(c)3 55400 To fund emergency room services provided to uninsured patients residing in Los Angeles. Good Samaritan Hospital 1225 Wilshire Blvd Los Angeles CA 90017 951656366 501(c)3 481991 To fund emergency room services provided to uninsured patients residing in Los Angeles. Hillsides 940 Avenue 64 Pasadena CA 91105 951644002 501(c)3 60000 To fund outpatient healthcare services. Hollywood Presbyterian Medical Center 1300 N Vermont Avenue Los Angeles CA 90027 300284087 286576 To fund emergency room services provided to uninsured patients residing in Los Angeles. Jewish Free Loan Association 6505 Wilshire Boulevard Suite 715 Los Angeles CA 90048 951691014 501(c)3 60000 To provide funding for health related materials/services provided by organization. LACUSC Medical Center 1200 N State Street Los Angeles CA 90033 956000927 501(c)3 44321 To fund emergency room services provided to uninsured patients residing in Los Angeles. Monterey Park Hospital 900 S Atlantic Blvd Monterey Park CA 91754 510519163 5036 To fund emergency room services provided to uninsured patients residing in Los Angeles. Olympia Medical Center 5900 W Olympica Blvd Los Angeles CA 90036 421643090 110299 To fund emergency room services provided to uninsured patients residing in Los Angeles. Orthapedic Institute For Children 403 W Adams Boulevard Los Angeles CA 90007 951644604 501(c)3 45000 To fund outpatient healthcare services. Pepperdine University 24255 Pacific Coast Highway Malibu CA 90263 951644037 501(c)3 50000 To fund outpatient healthcare services. Program for Torture Victims 1325 North Western Avenue Los Angeles CA 90027 133391210 501(c)3 75000 To fund outpatient healthcare services. Providence St Joseph Medical Center 501 S Buena Vista Street Burbank CA 91505 953544872 501(c)3 37774 To fund emergency room services provided to uninsured patients residing in Los Angeles. Saban Community Clinic 8405 Beverly Boulevard Los Angeles CA 90048 952359105 501(c)3 75000 To fund outpatient healthcare services. Sherman Oaks Hospital 4929 Van Nuys Blvd Los Angeles CA 91403 202546649 13095 To fund emergency room services provided to uninsured patients residing in Los Angeles. Southern California Counseling Center 5615 W Pico Boulevard Los Angeles CA 90019 952430665 501(c)3 65000 To fund outpatient healthcare services. Southern California Hospital of Culver City 3828 Delmar Terrace Culver City CA 90232 954690845 14102 To fund emergency room services provided to uninsured patients residing in Los Angeles. Southern California Public Radio 474 S Raymond Avenue Pasadena CA 91105 954765734 501(c)3 50000 To provide health related education or outreach to underserved populations residing in Los Angeles. St Anne's 155 N Occidental Boulevard Los Angeles CA 90026 951691306 501(c)3 147000 To fund vehicle purchased to transport patients to/from residence and hospitals/doctors' offices. St Barnabas Senior Services 675 S Carondelet Street Los Angeles CA 90057 951641435 501(c)3 50000 To provide health related education or outreach to underserved populations residing in Los Angeles. St Jon Well Child & Family Center 808 W 58th Street Los Angeles CA 90037 954067758 501(c)3 75000 To fund outpatient healthcare services. St Vincent Medcial Center 2131 West Third Street Los Angeles CA 90057 912154438 501(c)3 381261 To fund emergency room services provided to uninsured patients residing in Los Angeles. St Vincent Medcial Center 2131 West Third Street Los Angeles CA 90057 912154438 501(c)3 100000 To fund transportation program provided by hospital for its patients to transport patients to/from residence and hospitals/doctors' offices. The Trevor Project 8704 Santa Monica Boulevard Suite 200 West Hollywood CA 90069 954681287 501(c)3 100000 To fund outpatient healthcare services. Tierra del Sol Foundation 9919 Sunland Boulevard Sunland CA 90049 952671260 501(c)3 25000 To provide funding for health related materials/services provided by organization. UCLA Mobile Clinic Project 11980 San Vicente Boulevard Suite 102 Los Angeles CA 90049 952250801 501(c)3 25000 To fund outpatient healthcare services. UCLA Ronald Reagan Medical Center 757 Westwood Plaza Los Angeles CA 90095 956006143 501(c)3 57416 To fund emergency room services provided to uninsured patients residing in Los Angeles. VIP Community Mental Health Center 1721 Griffin Avenue Los Angeles CA 90031 300017808 501(c)3 100000 To fund outpatient healthcare services. Weingart Center Association 566 S San Pedro Street Los Angeles CA 90013 956054617 501(c)3 50000 To fund outpatient healthcare services. White Memorial Medical Center 1720 Ceasar E Chavez Ave Los Angeles CA 90033 953760201 501(c)3 50365 To fund emergency room services provided to uninsured patients residing in Los Angeles. Worksite Wellness 5955 S Western Avenue Los Angeles CA 90047 550802354 501(c)3 50000 To provide health related education or outreach to underserved populations residing in Los Angeles. Young and Healthy 136 West Peoria Street Pasadena CA 91103 954527969 501(c)3 70000 To fund outpatient healthcare services. 39 7 Scholarships 28 265000 N/A Inpatient Care Assistance 129 4753000 N/A Part I, Line 2: QueensCare monitors the use of grants it makes by requiring each grantee to supply QueensCare with regular reports that describe how such grantee is using QueensCare's grant funds. In addition, QueensCare often visits a grantee's premises to ensure that the grantee is conducting programs that further QueensCare's charitable mission. QueensCare also requires each grantee to provide QueensCare with a copy of their annual financial reports. X X X X X 0 0 0 0 0 0 0 0 0 Barbara B Hines CEO 62283 294094 0 0 0 0 3884 17267 6549 15182 72716 326543 0 0 Gary Grubbs President & CFO (term end 7/18) 213004 0 0 0 30000 0 0 0 17622 0 260626 0 0 0 Alan G De Jong Director Risk Management 125163 0 0 0 1953 0 7836 0 15980 0 150932 0 0 0 Faith Lee VP-Finance & Accounting(Q) 132803 0 0 0 2220 0 7769 0 7687 0 150479 0 0 0 Gary Grubbs Former CFO 30000 Consultation services 0 Form 990, Part VI, Section A, line 6 St. Joseph's Health Support Alliance, a California non-profit, nonstock, public benefit corporation described in Section 501(c)(3) of the Internal Revenue Code, is the sole corporate member of QueensCare. Form 990, Part VI, Section A, line 7a In its capacity as QueensCare's sole corporate member, St. Joseph's Health Support Alliance has the authority to appoint, remove, and replace each of the members of QueensCare's Board of Directors. Form 990, Part VI, Section A, line 7b St. Joseph's Health Support Alliance, as QueensCare's sole corporate member, has the right to approve certain fundamental transactions, such as amendments to by-laws, QueensCare's Articles of Incorporation or resolutions to dissolve QueensCare's corporate existence. Form 990, Part VI, Section B, line 11b Following preparation of a final draft of the Form 990 by the organization's tax preparers, the organization's CEO and CFO review, analyze and discuss the final draft to better ensure its accuracy and completeness. After the return is filed, the CEO and VP of Finance & Accounting review and discuss material aspects and details of the return at the next regularly scheduled meeting of the Board of Directors. Form 990, Part VI, Section B, line 12c The organization's Board members, corporate officers, and staff are subject to a written conflicts of interest policy. Pursuant to that policy, each such person is required to identify any transaction with the organization in which the person has (or may have) a financial interest. If a conflict (or potential conflict) is identified, the Board,excluding any involved Board members, carefully reviews the terms of the transaction and makes a determination as to whether the transaction is fair and reasonable to the organization under all the facts and circumstances. The organization monitors and enforces compliance with this policy by: (i) discussing such issues at its annual meeting; (ii) requiring all covered persons to annually provide written certification of their compliance with the policy; and (iii) carefully reviewing all material transactions to identify potential or real conflicts. Form 990, Part VI, Section B, line 15a A Compensation Committee comprised of independent Board members formulates a proposed compensation level for the CEO by reviewing recomendation of an independent compensation consultant and general compensation data for similarly situated organizations. Following such a review, the Compensation Committee presents its findings and recommendations to the Board at which Board members are provided with the opportunity to ask questions. Based on the findings and recommendations of the Compensation Committee, a Board vote is taken to establish the new compensation level for the CEO. Deliberations of the Compensation Committee and the Board are recorded in the organization's minute book. The evaluation, review, and recommendation process was last undertaken by the Compensation Committee in May 2018 and its findings and recommendations with regard to the CEO's compensation level were approved by the Board in January 2019. Director Jay Guerena devoted approximately two hours of his time per week to related organizations; QueensCare Health Centers(QHC)and St. Joseph's Health Support Alliance (SJHSA) in his capacity as Director for QHC and SJHSA. Sr. Murphy also provided services to QueensCare as an independent contractor for which she was compensated. Director Allan Michelena devoted approximately 2 hours of his time per week to related organizations; QueensCare Health Centers(QHC) and St. Joseph's Health Support Alliance (SJHSA) in his capacity as Director for QHC and SJHSA. Director Denise Partamian Forgette devoted approximately two hours of her time per week to related organizations; QueensCare Health Centers(QHC)and St. Joseph's Health Support Alliance (SJHSA) in her capacity as Director for QHC and SJHSA. CEO Barbara Hines devoted approximately 32 hours of her time per week to QHC in her capacity as QHC's CEO. Director Gene Nuziard devoted approximately 2 hours of his time per week to a related organization; St. Joseph's Health Support Alliance (SJHSA) in his capacity as Director for SJHSA. Form 990, Part VI, Section C, line 19 The organization's annual information return (Form 990) is available on a third-party website (GuideStar). The organization provides copies of its governing documents, its conflict of interest policy, as well as its three most recent Forms 990 to any interested person that makes a request for such documents. Bridge Street 1525 Bridge Street Yuba CA 95993 951644040 Rental Real Estate CA 498916 10858947 QueensCare Airway Diego LLC 10132 Airway Road San Diego CA 92154 951644040 Rental Real Estate CA 1722414 20718276 QueensCare QLV - HD LLC 855 Dorrell Lane Las Vegas NV 89086 951644040 Rental Real Estate NV 645928 13509153 QueensCare QLV - INO LLC 6880 North 5th Street Las Vegas NV 89084 951644040 Rental Real Estate NV 199294 3819332 QueensCare QLV - HDR LLC 861 South Rainbow Blvd Las Vegas NV 89145 Rental Real Estate NV 904833 22968267 QueensCare QOR - FXG LLC 20750 Brinson Blvd Bend OR 97701 Rental Real Estate OR 497034 12618400 QueensCare St Joseph's Health Support Alliance 950 South Grand Ave 2nd Fl South Los Angeles CA 90015 940831115 to support QueensCare CA 501(c)(3) Line 12d, III-O 0 QueensCare Health Centers 950 South Grand Ave 2nd Fl South Los Angeles CA 90015 953702136 provide medical service to the indigent CA 501(c)(3) Line 3 0 Queen of Angels Hollywood Presbyterian Foundation 950 South Grand Ave 2nd Fl South Los Angeles CA 90015 953403582 to support QueensCare CA 501(c)(3) Line 12b, II 1 QQHC Healthcare Partners 950 South Grand Ave 2nd Fl South Los Angeles CA 90015 260502255 To operate and manage Healthcare Clinics CA N/A Related -4543771 1279 0 1 0.40000 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 QQHC HEALTHCARE PARTNERS B 4543771 ACCRUAL ST JOSEPH'S HEALTH SUPPORT ALLIANCE C 245000 ACCRUAL ST JOSEPH'S HEALTH SUPPORT ALLIANCE Q 23170 ACCRUAL QUEENSCARE HEALTH CENTER O 223200 ACCRUAL QUEENSCARE HEALTH CENTER P 488210 ACCRUAL QUEENSCARE HEALTH CENTER Q 673820 ACCRUAL QUEEN OF ANGELS HOLLYWOOD PRESBYTERIAN FOUNDATION C 1000000 ACCRUAL QUEEN OF ANGELS HOLLYWOOD PRESBYTERIAN FOUNDATION Q 4210 ACCRUAL QUEENSCARE HEALTH CENTER B 8850 ACCRUAL