2018-05-15T14:09:56-05:00 2017-06-30 951777440 Green Hasson & Janks LLP 10990 Wilshire Blvd 16th Floor Los Angeles CA 900243929 990 2016-07-01 952769432 VENICE FAMILY CLINIC VENI 3103928630 604 Rose Avenue Venice CA 90291 Elizabeth B Forer CEO 3103928630 2018-05-14 1 Lizbeth G Nevarez P01399868 3108731600 38.186.35.254 2018-05-14 14:13:08 PD P F9C10BE61D25E315D3C70BCF97B7FFDFBFC33783 E2029FBCA1BC56D940BBE3EBD2C246F8BE1416D0 2016 2021-01-29 14:40:06Z Elizabeth B Forer 604 Rose Avenue Venice CA 90291 48968530 0 X http://www.venicefamilyclinic.org/ X 1970 CA To provide quality primary health care to people in need. 19 19 333 916 0 0 21188376 18705895 22401482 27868154 68032 235414 -16380 -22850 43641510 46786613 0 0 0 0 25747841 29467145 0 0 1793906 10144563 9436546 35892404 38903691 7749106 7882922 28243419 36652136 1185629 1572148 27057790 35079988 X To provide quality primary health care to people in need. 0 0 31810862 27868154 VFC SERVES AS A MEDICAL HOME, PROVIDING COORDINATED AND COMPREHENSIVE MEDICAL, DENTAL AND MENTAL HEALTH SERVICES THAT INCLUDE PEDIATRICS, GENERAL ADULT MEDICINE, WOMEN'S, SENIOR, HOMELESS AND CHRONIC CARE SERVICES, PRENATAL CARE, SPECIALTY CLINICS IN CARDIOLOGY, DERMATOLOGY, EAR, NOSE AND THROAT, GASTROENTEROLOGY, GYNECOLOGY, NEUROLOGY, OPHTHALMOLOGY, OPTOMETRY, ORTHOPEDICS AND PODIATRY, behavioral health and substance abuse services. VFC also PROVIDES treatment and counseling services to HIV patients through its Common Ground Program. VFC provides HEALTH CARE ON SIX DAYS AND FOUR EVENINGS PER WEEK. VFC PROVIDES SERVICES PRIMARILY TO PEOPLE OF LOW INCOME, UNEMPLOYED AND HOMELESS. VFC'S PRIMARY SERVICE AREA INCLUDES VENICE, SANTA MONICA, PALMS, MAR VISTA, INGLEWOOD, CULVER CITY AND WEST LOS ANGELES, ALL IN LOS ANGELES COUNTY. VFC TRAINS MEDICAL RESIDENTS FROM ELEVEN RESIDENCY PROGRAMS. APPROXIMATELY 916 PEOPLE VOLUNTEERED IN FISCAL YEAR 2017, INCLUDING APPROXIMATELY 243 PHYSICIANS. THE CLINIC ESTIMATES THAT IT RECEIVED 61,614 TOTAL VOLUNTEER HOURS, INCLUDING 3,493 GENERAL AND ADMINISTRATIVE VOLUNTEER HOURS; SUCH GENERAL AND ADMINISTRATIVE HOURS ARE NOT REPRESENTED IN THE FINANCIAL STATEMENTS IN ACCORDANCE WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA. 31810862 1 1 0 1 0 0 0 1 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 66 0 1 333 1 0 0 0 0 0 1 1 0 0 0 0 X 19 19 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 CA X Andrea Blackbird 3106647941 604 Rose Avenue Venice CA 90291 JEFFREY E SINAIKO CHAIR 2.00 2.00 X X 0 0 0 WILLIAM FLUMENBAUM IMMEDIATE PAST CHAIR 2.00 2.00 X X 0 0 0 STEWART SERADSKY TREASURER 2.00 0.00 X X 0 0 0 JOHN GERESI CHAIR ELECT 2.00 2.00 X X 0 0 0 Michael St Pierre SECRETARY 2.00 0.00 X X 0 0 0 MAYER B DAVIDSON MD BOARD MEMBER 2.00 2.00 X 0 0 0 PAULA DAVIS BOARD MEMBER 2.00 0.00 X 0 0 0 JENIFER ANISMAN BOARD MEMBER 2.00 0.00 X 0 0 0 KEN BASCOM BOARD MEMBER 2.00 0.00 X 0 0 0 NEIL H PARKER MD BOARD MEMBER 2.00 2.00 X 0 0 0 PAUL SABEN BOARD MEMBER 2.00 0.00 X 0 0 0 OLGA CARRASCO BOARD MEMBER 2.00 0.00 X 0 0 0 NADIA SHAHEEN BOARD MEMBER 2.00 0.00 X 0 0 0 CARMEN THOMAS-PARIS BOARD MEMBER 2.00 0.00 X 0 0 0 LEISA WU BOARD MEMBER 2.00 2.00 X 0 0 0 DiAna Carsola BOARD MEMBER 2.00 0.00 X 0 0 0 LoEtte Loshak BOARD MEMBER 2.00 0.00 X 0 0 0 Edith J Madrid BOARD MEMBER 2.00 0.00 X 0 0 0 Edgar R Champney BOARD MEMBER 2.00 0.00 X 0 0 0 ELIZABETH B FORER Chief Executive Officer 40.00 1.00 X 197811 0 64128 ANDREA BLACKBIRD Chief Financial Officer 40.00 1.00 X 167933 0 47737 KAREN CLAMP Associate Medical Director 40.00 0.00 X 188747 0 62234 MARGARITA LOEZA Chief Medical Information Officer 40.00 0.00 X 165418 0 59280 BLANCA ANDRES Associate Medical Director 36.00 0.00 X 175832 0 54979 SHARON NG Director of Pharmacy 40.00 0.00 X 160031 0 64268 BARBARA F GROTTS Nurse Practitioner 46.00 0.00 X 176966 0 57335 ZARIN TEJANI Physician 40.00 0.00 X 169831 0 50552 JESSICA ANNE STROIK Physician 45.00 0.00 X 166235 0 49777 GILMORE SEISOON CHUNG Physician 47.00 0.00 X 161997 0 52587 GOLI MIRZAIE Physician 46.00 0.00 X 161596 0 47500 1892397 0 610377 43 0 1 0 Gluck Development Company Inc 26901 Agoura Rd Ste 100 Calabasas CA 91301 Construction 790587 Jensen Zigman Construction Co Inc 10020 National Blvd los Angeles CA 90034 Construction 776614 Brothers Maintenance Services PO Box 3283 Whittier CA 90605 Cleaning service 348426 Randstad US LP PO Box 894217 Los Angeles CA 90189 Staffing Services 263572 Houston Tyner Architects 2630 Sepulveda blvd torrance CA 90505 Construction 195539 7 1413266 9457655 7834974 887583 18705895 Third Party Reimbursement 621400 19634273 19634273 Medi-Cal Pharmacy 900099 8233881 8233881 27868154 104279 104279 1932054 1800919 131135 131135 131135 348148 1413266 358148 -10000 -10000 10000 22850 -12850 -12850 46786613 27868154 0 212564 1742198 1452928 198036 91234 19318686 15919461 2365362 1033863 2720228 2331047 253968 135213 4183100 3584626 390546 207928 1502933 1287909 140318 74706 5108 5108 76900 76900 65400 65400 965121 659921 287252 17948 1105 194 390 521 445542 244646 126600 74296 431897 259350 160504 12043 1588012 1299901 267987 20124 193400 147618 41186 4596 31945 31945 811895 668789 143106 305016 275 304734 7 Pharmaceutical supplies 3024935 3024935 Licenses, Fees and Dues 469401 96779 313029 59593 Med Sup & waste removal 386654 376159 10495 0 other program expenses 217121 217101 20 417094 239223 116037 61834 38903691 31810862 5298923 1793906 802 802 3081610 1392095 6414040 6834873 6412451 9715222 303912 295685 103231 88297 20642071 12129262 6401498 8512809 5271213 9537799 254662 274554 28243419 36652136 239472 1198954 837639 250000 53976 0 54542 123194 1185629 1572148 X 13573609 21418656 8362124 8489275 5122057 5172057 27057790 35079988 28243419 36652136 X 7882922 653384 -514108 X 0 1 X 1 1 1 X 23659163 20472644 20726494 21188376 18705895 104752572 23659163 20472644 20726494 21188376 18705895 104752572 10599838 94152734 264442 9351155 238595 53304 104279 10011775 98585 196325 95551 390461 115154808 80173442 0.81760 0.82030 X Schedule A, Part II Venice Family Clinic is exempt under 509(a)(1) and 170(b)(1)(a)(iii). The organization has made an election to complete Schedule A, Part II, Section A. Public Support. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 42610 0 0 42610 0 Part II-B, Line 1: During the 2016-2017 Fiscal Year, Venice Family Clinic's Advocacy Team, comprised of staff, Board members and volunteers addressed health care policy issues at the local, state and national level. On the federal level we worked to educate our elected officials about the needs of the medically underserved and the providers treating them. We also worked to preserve the Affordable Care Act so that it would not be repealed and replaced as all of our patients rely on this law which provides insurance coverage to people with low incomes. We described to our legislators how the Affordable Care Act has dramatically improved access to care and the quality of care for the nation's most vulnerable people. In California, Venice Family Clinic participated in the California Primary Care Associations Day at the Capitol and visited elected officials in Sacramento, California. A key issue addressed this year was the possible loss of the 340B pharmaceutical program which provides low cost drugs for purchase to community health centers and allows our patients to receive their medicine at no or low cost. Venice Family Clinic also continued to participate in a group organized by the California Primary Care Association that focused on payment reform and moving to a system in which Medi-Cal payments will pay for value based care. Locally, Venice Family Clinic focused on working with the Community Clinic Association of Los Angeles County on specific county and city programs that will address the needs of our homeless patients. New city and county funding created by a bond measure and a parcel tax will provide more housing and supportive services for homeless people in Los Angeles. In addition, the Clinic continued to participate in Venice Forward and also an effort through a smaller community group to create restrooms for homeless people in Venice, working directly with Councilmember Mike Bonin on these efforts. 21000 0 5240862 50000 775581 250244 5816199 5731858 50000 -262704 278292 5240862 6560040 150000 288739 1266921 5731858 5707178 500000 625509 272647 6560040 5178737 200000 544036 215595 5707178 0.00000 0.88930 0.11070 0 0 1116512 1116512 7689840 5208732 2481108 8570708 4410261 4160447 3265011 2510269 754742 8512809 ucla eip fund 5816199 F ucla stip fund 3721600 F 9537799 due to affiliate vfcf 123194 123194 Part V, Line 4: Interest/Dividend income from the Clinic's endowment funds are used to pay for the salaries & benefits of Physicians and other providers. Silver Circle 1599061 1270088 328973 71400 45755 111878 1482 108458 Holiday Movie 162353 143178 19175 790 18385 1761414 1413266 348148 71400 45755 112668 1482 126843 358148 -10000 X X 0 0 0 0 0 0 0 0 0 ELIZABETH B FORER Chief Executive Officer 197811 0 0 0 0 0 27694 0 36434 0 261939 0 0 0 ANDREA BLACKBIRD Chief Financial Officer 167933 0 0 0 0 0 23511 0 24226 0 215670 0 0 0 KAREN CLAMP Associate Medical Director 188747 0 0 0 0 0 26425 0 35809 0 250981 0 0 0 MARGARITA LOEZA Chief Medical Information Officer 165418 0 0 0 0 0 23159 0 36121 0 224698 0 0 0 BLANCA ANDRES Associate Medical Director 175832 0 0 0 0 0 24617 0 30362 0 230811 0 0 0 SHARON NG Director of Pharmacy 160031 0 0 0 0 0 22404 0 41864 0 224299 0 0 0 BARBARA F GROTTS Nurse Practitioner 176966 0 0 0 0 0 24775 0 32560 0 234301 0 0 0 ZARIN TEJANI Physician 169831 0 0 0 0 0 23776 0 26776 0 220383 0 0 0 JESSICA ANNE STROIK Physician 166235 0 0 0 0 0 23273 0 26504 0 216012 0 0 0 GILMORE SEISOON CHUNG Physician 161997 0 0 0 0 0 22680 0 29907 0 214584 0 0 0 GOLI MIRZAIE Physician 161596 0 0 0 0 0 22623 0 24877 0 209096 0 0 0 X 9 634865 fmv X 2 158468 fmv X auction items 82 71400 sales price X Airline Tickets 1 22850 FMV 0 1 1 Part I, Column (b): NON CASH DONATIONS ARE LISTED BY TOTAL NUMBER OF DONOR CONTRIBUTIONS. Part I, Line 32b: Venice Family Clinic has an agreement in place GiveSmart, a mobile bidding and event management company to help facilitate the fundraising side of Silver Circle. Form 990, Part VI, Section A, line 8b This question is not applicable to the filing organization. there is no committee with the authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b THE INFORMATIONAL RETURN IS PREPARED BY OUTSIDE ACCOUNTANTS AND IS REVIEWED BY THE AUDIT COMMITTEE. ONCE APPROVED BY THE AUDIT COMMITTEE, THE RETURN IS THEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ELECTRONIC FILING. Form 990, Part VI, Section B, line 12c annual questionnaires are given to board members to disclose any conflicts. If a conflict is disclosed in the annual questionnaire, the individual will be asked to recuse themselves from any conversations pertaining to this conflict. Form 990, Part VI, Section B, line 15 THE BOARD HIRES, OVERSEES, AND ANNUALLY EVALUATES THE PERFORMANCE AND COMPENSATION OF THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION INDEPENDENTLY, WITH THE CEO's PARTICIPATION. THE CFO & OTHER KEY EMPLOYEES' COMPENSATION IS BASED UPON SKILL SET & MARKET RATE. IT IS THEN REVIEWED AND APPROVED BY a COMPENSATION COMMITTEE. Form 990, Part VI, Section C, line 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part XI, line 9: Change in Value on Beneficial Interest in Charitable Remainder Trusts 10,892. Bad debt expense -525,000. venice family clinic foundation 604 rose avenue venice CA 90291 273484548 to support Venice Family clinic CA 501(c)(3) Line 7 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0