2017-05-09T11:37:06-05:00 2016-06-30 951777440 GREEN HASSON & JANKS LLP 10990 WILSHIRE BLVD 16TH FLOOR LOS ANGELES CA 900243929 990 2015-07-01 951690966 PEDIATRIC & FAMILY MEDICAL CENTER PEDI 2137461037 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 CHONA DE LEON INTERIM CEO 2137461037 2017-04-10 1 LAUREN A HAVERLOCK P00545829 3108731600 2015 2021-01-29 14:40:06Z EISNER PEDIATRIC & FAMILY MED CENTER CHONA DE LEON 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 39596800 0 X WWW.EISNERHEALTH.ORG X 1920 CA IMPROVE THE PHYSICAL, SOCIAL & EMOTIONAL WELL-BEING OF LOS ANGELES FAMILIES. 13 13 413 13 0 0 7030923 8204519 21763959 31389874 1045 765 8000 1642 28803927 39596800 0 0 0 0 20462190 27233353 0 0 244688 8107770 10733367 28569960 37966720 233967 1630080 24207228 27681218 3241867 5585743 20965361 22095475 X EISNER PEDIATRIC & FAMILY MEDICAL CENTER IS A QUALITY-FOCUSED, COMMUNITY HEALTH CENTER DEDICATED TO IMPROVING THE PHYSICAL, SOCIAL AND EMOTIONAL WELL-BEING OF LOW AND MODERATE INCOME RESIDENTS OF DOWNTOWN AND CENTRAL LOS ANGELES, REGARDLESS OF THEIR ABILITY TO PAY. 0 0 23090562 25916966 MEDICAL CARE- PHYSICAL EXAMS- IMMUNIZATIONS- GYNECOLOGY SERVICES- COUNSELING- PREVENTATIVE MEDICINE- DIAGNOSIS AND MANAGEMENT OF ACUTE AND CHRONIC DISEASES- DIAGNOSIS AND CARE DURING PREGNANCY- OFFICE DERMATOLOGY TOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 27,512. 4562063 3844710 DENTAL CARE- PREVENTATIVE DENTAL EXAMS- DIAGNOSIS AND TREATMENT OF DENTAL AND GUM PROBLEMS- ORTHODONTIC SERVICESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 10,441. 2956506 1628198 MENTAL HEALTH CARE & PHARMACEUTICAL SERVICES- INDIVIDUAL THERAPY - FAMILY THERAPY - GROUP THERAPY - CASE MANAGEMENT - WORKSHOPS - PARENTING CLASSES- DISPENSING PHARMACEUTICALS TO PATIENTS- SUPPLYING CLINICAL DEPARTMENTS- OPTOMETRY SERVICES TOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 397. 30609131 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 61 0 1 413 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X EUGENE VEKSLER 2137461037 1530 SOUTH OLIVE ST LOS ANGELES CA 90015 KEVIN ROSSI BOARD CHAIR 1.00 1.00 X X 0 0 0 EDWARD MATTHEWS VICE CHAIR 1.00 0.00 X X 0 0 0 IAN WIENER TRESURER 1.00 0.00 X X 0 0 0 IRMA AVILA SECRETARY 1.00 0.00 X X 0 0 0 NORMA IBARRA MEMBER 1.00 1.00 X 0 0 0 VICTOR AGUIRRE MEMBER 1.00 0.00 X 0 0 0 RUPERT GRANT MEMBER 1.00 1.00 X 0 0 0 LOREN J KOSMONT MEMBER 1.00 0.00 X 0 0 0 TRENT STAMP MEMBER 1.00 1.00 X 0 0 0 ALEJANDRA ROSAS MEMBER 1.00 0.00 X 0 0 0 MARGARET PETERSON MEMBER 1.00 0.00 X 0 0 0 DAVID BENAVIDEZ MEMBER 1.00 0.00 X 0 0 0 STAN BERKMAN MEMBER 1.00 0.00 X 0 0 0 HERB SCHULTZ PRESIDENT/CEO 40.00 5.00 X 291315 0 29658 CHONA DE LEON VP/COO 40.00 0.00 X 272269 0 23097 EUGENE VEKSLER VP / CFO 40.00 0.00 X 186941 0 11550 DEBORAH LERNER VP / CHIEF MEDICAL OFFICER 40.00 0.00 X 211379 0 6838 LUIS LOPEZ DIRECTOR OF PEDIATRICS 40.00 0.00 X 255095 0 13627 LAILA AL-MARAYATI DIRECTOR OF OB SERV. 40.00 0.00 X 243398 0 13630 LAWRENCE YEE DIRECTOR OF ADULT MEDICINE 40.00 0.00 X 217030 0 12829 HIRAM WILLIAMS PHYSICIAN 40.00 0.00 X 204224 0 12163 PENELOPE VELASCO PHYSICIAN 40.00 0.00 X 204011 0 12389 AHMAD KHALIFA PHYSICIAN 40.00 0.00 X 188260 0 11582 BECKY MURPHY VP CLINICAL SERVICES 40.00 0.00 X 184365 0 11508 IAN TILLEY PHYSICIAN 40.00 0.00 X 177827 0 11264 2636114 0 170135 49 0 1 0 QUEST DIAGNOSTICS 8511 FALLBROOK AVENUE 2ND FL WEST HILLS CA 91304 LABORATORY EXPENSES 219191 ELLIS BEESLEY MD 1127 WILSHIRE BLVD 707 LOS ANGELES CA 90017 NEW-BORN EXAMS 133172 NATIONAL BUILDING LLC 13050 TOM WHITE WAY NORWALK CA 90650 JANITORIAL SERVICES 108915 3 383811 4140819 3679889 38341 8204519 PATIENT SERVICE FEES 624110 31389874 31389874 31389874 765 765 1642 0 1642 1642 1642 39596800 31389874 0 2407 1801358 1466765 322625 11968 20114333 16387988 3588297 138048 458877 366957 91883 37 3293978 2683742 587629 22607 1564807 1296728 257878 10201 126239 126239 71363 71363 2047125 1580043 416456 50626 25669 4257 21412 293973 189980 101098 2895 347089 215821 131144 124 1981617 1751914 229689 14 405146 313348 90677 1121 60133 25778 34355 41102 41040 62 1349318 1349318 175620 115689 59505 426 MEDICAL SUPPLIES 2325216 2325216 MAINTENANCE AGREEMENTS 329528 84483 243944 1101 CLINIC MAINTENANCE 196789 103593 93196 BUILDING MAINTENANCE 168236 65405 102831 789204 241066 542618 5520 37966720 30609131 7112901 244688 884864 426560 1294233 99759 1697442 2890504 4652228 6636955 187006 561548 1098594 26892825 11603909 14918366 15288916 780089 198547 272835 24207228 27681218 2438985 3869479 802882 1716264 3241867 5585743 X 19999704 21156575 965657 938900 20965361 22095475 24207228 27681218 X 1630080 -499966 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 952246 952246 18620042 6413982 12206060 6448342 4695771 1752571 872195 494156 378039 15288916 39596800 0 39596800 0 39596800 38466686 499966 499966 37966720 0 37966720 PART XII, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT RECOVERY 499,966. X X 0 0 0 0 0 0 0 1 0 HERB SCHULTZ PRESIDENT/CEO 261795 0 29520 0 0 0 23729 0 5929 0 320973 0 0 0 CHONA DE LEON VP/COO 250758 0 21511 0 0 0 17168 0 5929 0 295366 0 0 0 EUGENE VEKSLER VP / CFO 173441 0 13500 0 0 0 5621 0 5929 0 198491 0 0 0 DEBORAH LERNER VP / CHIEF MEDICAL OFFICER 208586 0 38 0 2755 0 6419 0 419 0 218217 0 0 0 LUIS LOPEZ DIRECTOR OF PEDIATRICS 208462 0 46633 0 0 0 7698 0 5929 0 268722 0 0 0 LAILA AL-MARAYATI DIRECTOR OF OB SERV. 242500 0 898 0 0 0 7701 0 5929 0 257028 0 0 0 LAWRENCE YEE DIRECTOR OF ADULT MEDICINE 210610 0 6420 0 0 0 6900 0 5929 0 229859 0 0 0 HIRAM WILLIAMS PHYSICIAN 203724 0 500 0 0 0 6234 0 5929 0 216387 0 0 0 PENELOPE VELASCO PHYSICIAN 198086 0 5925 0 0 0 6460 0 5929 0 216400 0 0 0 AHMAD KHALIFA PHYSICIAN 171510 0 16750 0 0 0 5653 0 5929 0 199842 0 0 0 BECKY MURPHY VP CLINICAL SERVICES 174855 0 9510 0 0 0 5579 0 5929 0 195873 0 0 0 IAN TILLEY PHYSICIAN 173252 0 4575 0 0 0 5335 0 5929 0 189091 0 0 0 PART I, LINE 7 STAFF BONUSES ARE DISCUSSED AND REQUIRE APPROVAL BY SENIOR MANAGEMENT. THERE ARE SEVERAL CRITERIA FOR ADMINISTERING BONUSES. SENIOR MANAGEMENT MAY GET A BONUS BASED ON THE DEGREE OF MEETING THEIR SET GOALS FOR THE PAST FISCAL YEAR. OTHER STAFF, WHO ARE AT THE TOP OF THEIR JOB'S SALARY RANGE, MAY BE GIVEN A BONUS BASED ON THEIR PERFORMANCE RATING. THE PERCENTAGE OF THE BONUS CAN BE UP TO AND EQUIVALENT TO A 3% RAISE. HOWEVER, THERE MAY BE EXCEPTIONS WHERE THE BONUS IS MORE THAN 3%. OTHER STAFF, WHO HAVE DEMONSTRATED A PERFORMANCE OVER AND BEYOND HIS OR HER JOB EXPECTATIONS MAY GET A BONUS IN ADDITION TO THE RAISE IF THE SUPERVISOR FEELS THAT THE STAFF DESERVES MORE THAN THE 3% RAISE. X 24 38341 FMV 0 0 0 PART I, COLUMN (B): NON CASH DONATIONS ARE LISTED BY TOTAL NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE CFO, THEN IT IS GIVEN TO ALL THE BOARD MEMBERS FOR FINAL REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL QUESTIONNAIRES ARE GIVEN TO ALL DIRECTORS AND OFFICERS. THE GOVERNANCE COMMITTEE THEN REVIEWS THE QUESTIONNAIRES TO ENSURE THE COMPLIANCE OF THE CONFLICT OF INTEREST POLICY. IF A CONFLICT ARISES IT IS RESOLVED THROUGH BOARD DISCUSSION. FORM 990, PART VI, SECTION B, LINE 15 THE GOVERNANCE COMMITTEE USES AN INDEPENDENT CONSULTANT AND A COMPENSATION SURVEY STUDY IN ORDER TO DETERMINE THE COMPENSATION FOR THE CEO, OFFICERS, AND KEY EMPLOYEES. ONCE THE COMPENSATION IS DETERMINED, IT IS PRESENTED TO THE ENTIRE BOARD FOR APPROVAL INDEPENDENTLY, WITHOUT THE PARTICIPATION OF INTERESTED PERSONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: BAD DEBT RECOVERY -499,966. PEDIATRIC & FAMILY MEDICAL FOUNDATION 1530 S OLIVE ST LOS ANGELES CA 90015 954116680 TO HOLD AND INVEST ASSETS ON BEHALF OF PEDIATRIC & FAMILY MEDICAL CENTER CA 501(C)(3) 509(A)(3) TYPE II 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0