2018-05-14T15:35:26-05:00 2017-06-30 910189318 Moss Adams LLP 10960 Wilshire Blvd Suite 1100 Los Angeles CA 90024 990 2016-07-01 454433505 Martin Luther King Jr Community Health Foundation MART 4243388686 1680 E 120th Street Los Angeles CA 90059 Dyan Sublett President 4243388686 2018-05-14 1 Lauren A Haverlock P00545829 3104770450 2018-05-10 2016 2022-09-23 18:48:47Z Dyan Sublett 1680 E 120th Street Los Angeles CA 90059 4093970 0 X www.mlk-chf.org X 2011 CA To gather and steward resources in support of the mission, vision and values of the Martin Luther King, Jr. Community Hospital and the community it serves. The Foundation supports initiatives that will create an impact in health access, and provides resources for Hospital services and programs. With the Hospital, the Foundation works to ensure postive long-term health outcomes for the South Los Angeles community. 11 10 3 12 0 0 5245500 3877750 0 0 100750 184927 -231886 -248785 5114364 3813892 4892 4152875 0 0 546705 736722 0 72571 164019 838764 663280 1390361 5625448 3724003 -1811556 16456841 17597012 12276596 15228140 4180245 2368872 SEE SCHEDULE O 0 0 5169236 4152875 The Foundation: (1) Launched the advanced care clinic, which is the first outpatient practice site for the hospital-affiliated MLK Community Medical Group, with $1 million+ in philanthropic resources; (2) Supported expansion of patient services with philanthropic support by funding the build-out of an endoscopy suite and CT scan; (3) Launched Transitions to Practice, a nurse training program, with $500,000+ in philanthropic support; (4) Expanded the Board of Directors with executives in the entertainment industry and civic foundation sector; and (5) Sold out Sharing the Dream, the fourth annual fundraising lunch at the Los Angeles Music Center, in support of the Hospital and community health programs. 5169236 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 6 0 1 3 1 0 0 0 0 0 1 1 0 0 0 0 X 11 10 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 0 0 1 0 0 CA X Linda Perry 4243388686 1680 E 120th Street Los Angeles CA 90059 X Manual A Abascal JD Chairperson 2.00 6.00 X X 0 0 0 John E Korbara Vice Chairperson 2.00 0.00 X X 0 0 0 ROBERT MARGOLIS MD SECRETARY 2.00 3.00 X X 0 0 0 Denise Pines Treasurer 2.00 0.00 X X 0 0 0 Brad Armstrong Board Member 2.00 0.00 X 0 0 0 Dr Elaine Batchlor Board Member 2.00 40.00 X 0 617016 7950 BRUCE CORWIN Board Member 2.00 0.00 X 0 0 0 PAUL KING Board Member 2.00 3.00 X 0 0 0 Chris Nee Board Member 2.00 0.00 X 0 0 0 Larry M Rosen Board Member 2.00 0.00 X 0 0 0 Kyle Walton Board Member 2.00 0.00 X 0 0 0 DYAN SUBLETT PRESIDENT 40.00 0.00 X 342528 0 28859 342528 617016 36809 0 0 1 0 RM Design Studio Inc 4207 SE Woodstock Blvd 522 Portland OR 972066267 Marketing and Communications 189307 1 413220 1834376 625000 1005154 3877750 187240 187240 2313 -2313 -2313 -2313 28980 413220 277765 -248785 -248785 3813892 0 0 -63858 4152875 4152875 367936 183968 183968 283885 283885 51036 51036 33865 33865 4838 4838 2813 2813 72571 72571 232548 131974 100574 386714 295266 91448 26053 26053 6195 6195 1579 1579 2540 2540 5625448 5169236 292193 164019 406660 198932 2861742 90 1327277 1983122 11666795 15194725 500 88423 25047 11436 91657 13611 102210 118109 16456841 17597012 10445 33415 12266151 15194725 12276596 15228140 X -380733 444782 4560978 1924090 4180245 2368872 16456841 17597012 -1811556 183 0 X 0 1 X 1 0 X 4063850 6918343 1478600 5245500 3877750 21584043 4063850 6918343 1478600 5245500 3877750 21584043 7803269 13780774 683 2592 631 101217 187240 292363 21876406 0.62990 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 25047 11436 13611 13611 Due to MLK Healthcare Corporation 15194725 15194725 X Part X, Line 2: THE FOUNDATION 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 ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2017 OR 2016. THE FOUNDATION IS SUBJECT TO INCOME TAX EXAMINATION BY TAXING AUTHORITIES FOR ALL YEARS SINCE INCEPTION FOR FEDERAL AND STATE TAX FILINGS. X X X X 1 Firefly Inc 2205 Moreno Drive Los Angeles CA 90039 Grant Writing 0 0 72571 -72571 72571 -72571 CA Sharing the Dream 442200 413220 28980 146001 58921 1200 71643 442200 413220 28980 146001 58921 1200 71643 277765 -248785 1 Martin Luther King Jr-Los Angeles Healthcare Corporation 1680 E 120th Street Los Angeles CA 90059 274658935 501(c)(3) 4152875 General Support 1 0 Part I, Line 2: The organization requires reports from Martin Luther King, Jr.-Los Angeles Healthcare Corporation (MLK-LA HC), the organization's sole grantee; these reports detail out the amount of grants given to to MLK-LA HC, as well as how MLK-LA HC has utilized those funds in its operations. X X 0 0 0 0 0 0 0 0 0 Dr Elaine Batchlor Board Member 0 440960 0 165016 0 11040 0 7950 0 0 0 624966 0 0 DYAN SUBLETT PRESIDENT 282880 0 59036 0 612 0 7950 0 20909 0 371387 0 0 0 Form 990, Part III, Line 1, Description of Organization Mission: To gather and steward resources in support of the mission, vision and values of the Martin Luther King, Jr. Community Hospital and the community it serves. The Foundation supports initiatives that will create an impact in health access, and provides resources for Hospital services and programs. With the Hospital, the Foundation works to ensure postive long-term health outcomes for the South Los Angeles community. Form 990, Part VI, Section A, line 4 During the 6/30/2017 tax year, the Foundation revised its bylaws such that the Board of Directors shall consist of a minimum of five directors (previously, the bylaws called for a minimum of three directors). Additionally, the Foundation revised its bylaws such that each officer shall be elected to hold office for a term of two years (previously, the bylaws provided for a one year term). Form 990, Part VI, Section A, line 6 Martin Luther King, Jr.-Los Angeles Healthcare Corporation (MLK-LA HC) is the organization's sole corporate member. Form 990, Part VI, Section A, line 7a The members of the Board of Directors shall be appointed by the sole corporate member, Martin Luther King, Jr.-Los Angeles Healthcare Corporation (MLK-LA HC). Form 990, Part VI, Section A, line 7b The following governance decisions must be submitted to and receive approval of MLK-LA HC, the organization's sole corporate member: (i) the amendment, or restatement of the Corporation's Articles of Incorporation or Bylaws, (ii) the merger, consolidation, or dissolution of the Corporation, and (iii) the borrowing of funds exceeding $20,000. Form 990, Part VI, Section B, line 11b The Form 990 will be provided electronically to the Board for their review prior to filing with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c ALL BOARD MEMBERS AND OFFICERS, INCLUDING THE FOUNDATION PRESIDENT, READ THE POLICY AND ANNUALLY COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT FOR MEMBERS OF THE BOARD AND OFFICERS. POTENTIAL CONFLICTS, AS THEY ARE DISCLOSED, ARE BROUGHT BEFORE THE BOARD, DISCUSSED (AFTER THE PERSON WITH THE DISCLOSED POTENTIAL CONFLICT LEAVES THE BOARD MEETING), AND RESOLVED TO THE BOARD'S SATISFACTION. BOARD MEMBERS, OFFICERS, AND THE PRESIDENT CAN UPDATE THEIR CONFLICTS OF INTEREST DISCLOSURE AND CERTIFICATION FORM AT ANY TIME AND SUBMIT IT TO THE SECRETARY OF THE BOARD. Form 990, Part VI, Section B, line 15a Based upon market research and recent salary surveys conducted by industry organizations, the Board established the compensation of the Foundation President and reviews it annually. Form 990, Part VI, Section C, line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A, COLUMN B and Schedule J: DR. ELAINE BATCHLOR IS A MEMBER OF THE BOARD OF MARTIN LUTHER KING, JR. COMMUNITY HEALTH FOUNDATION. SHE DEVOTES AN AVERAGE OF TWO HOURS PER WEEK RELATING TO HER ACTIVITIES ASSOCIATED WITH SERVING ON THE BOARD OF DIRECTORS. THE REPORTABLE COMPENSATION ON FORM 990, PART VII AND SCHCEDULE J IS RELATED TO HER POSITION OF CHIEF EXECUTIVE OFFICER OF MARTIN LUTHER KING, JR.-LOS ANGELES HEALTHCARE CORPORATION AND IS UNRELATED TO THE AVERAGE NUMBER OF HOURS PER WEEK SHE DEVOTES TO MARTIN LUTHER KING, JR. COMMUNITY HEALTH FOUNDATION. MARTIN LUTHER KING JR-LOS ANGELES (MLK-LA) HEALTHCARE CORP 1680 E 120th Street LOS ANGELES CA 90059 274658935 HOSPITAL CA 501(c)(3) 3 N/A 0 MARTIN LUTHER KING JR COMMUNITY MEDICAL GROUP 1680 E 120th Street LOS ANGELES CA 90059 812455970 Healthcare for Low Income Populations CA 501(c)(3) 10 N/A 0 0 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0