2017-05-11T13:12:21-05:00 2016-06-30 954557617 Harrington Group CPAs LLP 234 East Colorado Blvd Suite M150 Pasadena CA 91101 990 2015-07-01 953702136 QueensCare Health Centers QUEE 3236694304 950 South Grand Avenue 2nd Flr S Los Angeles CA 90015 Gary C Grubbs CFO 3236694304 2017-05-11 1 Sean E Cain CPA P01612986 6264036801 2015 2021-01-29 14:40:06Z Barbara B Hines 950 South Grand Avenue 2nd Flr S Los Angeles CA 90015 24313221 0 X www.queenscarehealthcenters.org X 1925 CA QueensCare Health Centers ("the Centers") directly and indirectly provides medical, dental and vision care services to underserved and neglected populations in Los Angeles County, including the uninsured, indigent, elderly and children. 15 15 248 0 0 0 5982315 3760790 17367549 18617706 0 0 1068094 1934725 24417958 24313221 0 0 0 0 13448848 14573912 0 0 0 8059483 8731114 21508331 23305026 2909627 1008195 23231823 23033222 2527594 1497000 20704229 21536222 QueensCare Health Centers ("the Centers") directly and indirectly provides medical, dental and vision care services to underserved and neglected populations in Los Angeles County. 0 0 16077821 18617706 QueensCare Health Centers provides directly and through Q/QHC Healthcare Partners, medical, dental and vision services to underserved populations, including the uninsured, indigent, elderly and children. During this fiscal year, QueensCare Health Centers provided services to Approximately 29,000 patients which accounted for more than 108,000 visits. 16077821 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 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 1 1 0 0 1 130 0 1 248 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 CA X Gary C Grubbs 3236694304 950 South Grand Avenue 2nd Flr S Los Angeles CA 90015 Allan Michelena Chair 2.00 2.00 X X 600 3000 0 Jay Guerena Vice Chair 2.00 2.00 X X 600 4450 0 Jorge Blanco Director 2.00 2.00 X 200 0 0 Shirley Daniels Director 2.00 X 550 0 0 Archbishop Vatche Hovsepian Director 2.00 X 200 0 0 Jacquelyn P Pantoja Director 2.00 X 400 0 0 Frank Rey de Perea Director (resigned 7/2015) 2.00 X 600 0 0 Heidy C Campos Director 2.00 X 0 0 0 Mary Ramos Director 2.00 X 250 0 0 Manuel Romero Director 2.00 X 300 0 0 Willy Ruiz Director 2.00 X 200 0 0 Margarita Duarte Tucker Director, Secretary (resigned 7/2015) 2.00 X X 300 0 0 Martha Arias Director 2.00 2.00 X 0 0 0 Naomi A Mancilla Director 2.00 X 0 0 0 Serina Demirians Director 2.00 X 0 0 0 David Walsh Director 2.00 2.00 X 450 0 0 Marina Aronoff Director 2.00 2.00 X 200 0 0 Barbara B Hines President & CEO 32.00 8.00 X 168994 119900 43637 Gary C Grubbs CFO 8.00 32.00 X 65687 135307 26521 Tom T Gladfelter MD Chief Medical Officer 40.00 X 250456 0 24199 Alejandro A Armstrong COO 40.00 X 192435 0 39655 Maria T Lim Heya Physician 40.00 X 203513 0 15983 Yung Soon Ahn Physician 40.00 X 197471 0 7124 Eric Celo Physician 40.00 X 195638 0 0 Silverio Arano Physician 40.00 X 188717 0 0 Claudia Ramos-Smulevich Physician 40.00 X 175139 0 16118 1642900 262657 173237 28 0 1 0 Medical Professionals PO Box 910569 San Diego CA 92191 Contract Workers 705488 University of So Cal School of Pharmacy 1985 Zonal Ave PSC 700A Los Angeles CA 90089 Pharmacist Services 601108 Quest Diagnostics Inc PO Box 5068 Los Angeles CA 90074 Medical Laboratories Services 253643 Grendel Construction Inc 423 Molino Street Los Angeles CA 90013 Construction Services 175482 BJ's Maintenance and Painting 21500 Lassen Street 141 Chatsworth CA 91311 Maintenance Services 141267 9 3604866 155924 3760790 Net Patient Revenue 621400 14154867 14154867 Q/QHC Healthcare Partners 621400 4462839 4462839 18617706 Other income 621400 1934725 1934725 1934725 24313221 18617706 0 1934725 651742 651742 10320129 8130850 2189279 422672 291761 130911 2379800 1790459 589341 799569 624174 175395 53692 4656 49036 24540 24540 738259 534447 203812 80505 27017 53488 67634 54158 13476 1010094 22557 987537 1293852 364437 929415 73481 12205 61276 748631 526833 221798 133020 84952 48068 Purchased services 1147702 923948 223754 Physician Fees 755872 755872 Pharmaceuticals 578451 578451 Miscellaneous 458424 100232 358192 1566957 1250812 316145 23305026 16077821 7227205 0 4470 4570 4301090 4788914 380900 785986 4006497 4002192 10974470 10974470 62325 112910 227122 410554 7625513 5800801 2479344 1824712 795605 128914 23231823 23033222 1858638 1004433 668956 492567 2527594 1497000 X 20634846 21526499 69383 9723 20704229 21536222 23231823 23033222 1008195 -176202 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 69382 59660 9722 219953 150571 69382 847310 333763 961120 219953 1029194 896008 1077892 847310 1094486 1672440 1737732 1029194 1.00000 0 0 1369900 927928 441972 6255613 4872873 1382740 1824712 X Part V, Line 4: QueensCare Health Centers ("the Centers") intends to use its endowment funds to support healthcare related activities. Part X, Line 2: The Centers 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 Centers in its federal and state exempt organization tax returns are more likely than not to be sustained upon examination. The Centers' returns are subject to examination by federal and state taxing authorities, generally for three and four years, respectively, after they are filed. X X X X 0 0 0 0 0 0 0 0 0 Barbara B Hines President & CEO 168994 114356 0 0 0 5544 10140 7582 0 25915 179134 153397 0 0 Gary C Grubbs CFO 65687 130373 0 0 0 4934 3942 8096 0 14483 69629 157886 0 0 Tom T Gladfelter MD Chief Medical Officer 244585 0 0 0 5871 0 14938 0 9261 0 274655 0 0 0 Alejandro A Armstrong COO 189726 0 0 0 2709 0 12178 0 27477 0 232090 0 0 0 Maria T Lim Heya Physician 202555 0 0 0 958 0 0 0 15983 0 219496 0 0 0 Yung Soon Ahn Physician 194786 0 0 0 2685 0 0 0 7124 0 204595 0 0 0 Eric Celo Physician 194763 0 0 0 875 0 0 0 0 0 195638 0 0 0 Silverio Arano Physician 187050 0 0 0 1667 0 0 0 0 0 188717 0 0 0 Claudia Ramos-Smulevich Physician 173555 0 0 0 1584 0 0 0 16118 0 191257 0 0 0 Form 990, Part VI, Section A, line 3 Pursuant to that certain Amended and Restated Partnership Agreement, QueensCare Health Centers and QueensCare formed Q/QHC Healthcare Partners to jointly operate five community health centers located in the greater Los Angeles area. QueensCare's responsibilities under the terms of that Agreement include supervision of medical treatments, measuring outcomes, providing day-to-day management for the operation of Q/QHC Healthcare Partners and on-site management of the Centers' personnel to include hiring, training, and discharging the Centers' personnel. Form 990, Part VII, Section A, Hours of Officers: Board Chairman Allan Michelena devoted approximately two hours of his time per week to a related organization, QueensCare, serving as a director of QueensCare. Vice Chair Jay Guerena devoted approximately two hours of his time per week to QueensCare serving as a director of QueensCare. Archbishop Hovsepian devoted approximately two hours of his time per week to a related organization, QueensCare, serving as member of QueensCare's Charitable Committee. Director, David Walsh devoted approximately two hours of his time per week to a related organization, QueensCare serving as a director on QueensCare Board. CEO Barbara B. Hines devoted approximately 8 hours of her time per week serving as QueensCare's CEO. CFO Gary C. Grubbs also devoted approximately 32 hours of his time per week serving as QueensCare's Chief Financial Officer. Form 990, Part VI, Section B, line 11 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 CFO 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 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 April 2016 and its findings and recommendations with regard to the CEO's compensation level were approved by the Board in October 2016. 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. QueensCare 950 S Grand Ave 2nd Fl South Los Angeles CA 90015 951644040 Healthcare for the poor CA 501(c)(3) Line 7 St Joseph's Health Support Alliance 0 QueensCare Health Centers Foundation 950 S Grand Ave 2nd Fl South Los Angeles CA 90015 463366321 Support QHC mission CA 501(c)(3) Line 7 QueensCare Health Centers 0 QQHC Healthcare Partners 950 S Grand Ave 2nd Fl South Los Angeles CA 90015 260502255 To operate & Manage Healthcare Clinincs CA N/A Related -6694259 4507 0 1 0.60000 0 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 1 QueensCare C 108059 Accrual QueensCare O 278934 Accrual QueensCare P 840525 Accrual QueensCare Q 452166 Accrual QueensCare Health Centers Foundation K 215000 Accrual QQHC Healthcare Partners B 6693295 Accrual QQHC Healthcare Partners J 4462839 Accrual QQHC Healthcare Partners L 11157098 Accrual QueensCare Health Centers Foundation S 115327 Accrual