2017-05-15T16:41:36-05:00 2016-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2015-07-01 454433505 MARTIN LUTHER KING JR COMMUNITY HEALTH FOUNDATION MART 4243388686 1680 E 120TH STREET LOS ANGELES CA 90059 DYAN SUBLETT PRESIDENT 4243388686 2017-05-09 1 RENIE BURBANK P00159653 4159561500 2015 2021-01-29 14:40:06Z DYAN SUBLETT 1680 E 120TH STREET LOS ANGELES CA 90059 5375697 0 X 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. 10 9 3 15 0 0 1478600 5245500 0 0 631 100750 -229674 -231886 1249557 5114364 3050615 4892 0 0 459829 546705 0 0 117218 548444 838764 4058888 1390361 -2809331 3724003 596739 16456841 121997 12276596 474742 4180245 X SEE SCHEDULE O 0 0 942844 4892 SEE SCHEDULE O(1) $1.45 MILLION GOAL ACHIEVED FOR START UP OF HOSPITAL'S ADVANCED CARE CLINIC; (2) $7 MILLION IN TOTAL FUNDS RAISED FOR GENERAL SUPPORT, HOSPITAL CAPITAL AND COMMUNITY HEALTH PROGRAM PURPOSES; (3) LAUNCHED EXPANSION OF HOSPITAL SERVICES WITH GIFT OF $2.8 MILLION TO FUND BUILD-OUT OF PROCEDURE LABS; (4)EXPANDED BOARD OF DIRECTORS TO INCLUDE SENIOR LEADERS IN THE HEALTH AND PHILANTHROPY SECTORS; (5)SOLD OUT LIVING THE DREAM, THIRD ANNUAL FUNDRAISING LUNCH AT THE LOS ANGELES MUSIC CENTER, IN SUPPORT OF HOSPITAL AND COMMUNITY HEALTH PROGRAMS. 942844 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 19 0 1 3 1 0 0 0 0 0 1 1 0 0 0 0 X 10 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 1 0 0 CA X ZULMA VITALICH 4243388686 1680 E 120TH STREET LOS ANGELES CA 90059 X MANUAL A ABASCAL JD CHAIRPERSON 2.00 6.00 X X 0 0 0 DR ROBERT MARGOLIS SECRETARY 2.00 3.00 X X 0 0 0 PAUL KING TREASURER 2.00 3.00 X X 0 0 0 BRAD ARMSTRONG BOARD MEMBER 2.00 0.00 X 0 0 0 BRUCE CORWIN BOARD MEMBER 2.00 0.00 X 0 0 0 JOHN KOBARA BOARD MEMBER 2.00 0.00 X 0 0 0 CANDACE BOND MCKEEVER BOARD MEMBER (THRU 6/1/16) 2.00 0.00 X 0 0 0 DENISE PINES BOARD MEMBER 2.00 0.00 X 0 0 0 LARRY ROSEN BOARD MEMBER 2.00 0.00 X 0 0 0 KYLE WALTON BOARD MEMBER 2.00 0.00 X 0 0 0 STEVE YSLAS BOARD MEMBER (THRU 10/1/15) 2.00 0.00 X 0 0 0 DR ELAINE BATCHLOR BOARD MEMBER 2.00 40.00 X 0 606719 12920 DYAN SUBLETT PRESIDENT 40.00 0.00 X 295937 0 42063 295937 606719 54983 1 0 1 0 RM DESIGN STUDIO INC 7344 SE 45TH AVE PORTLAND OR 97206 MARKETING AND COMMUNICATIONS 189307 1 2500 596673 50000 4596327 5245500 101217 101217 467 -467 -467 -467 28980 596673 260866 -231886 -231886 5114364 0 0 -131136 X 4892 4892 392046 196023 196023 100630 100630 17189 17189 36840 36840 5079 5079 14229 14229 254832 140685 114147 314179 296167 18012 37778 37778 410 410 2550 2550 977 977 2102 2102 821 821 PURCHASED SERVICES 140287 41081 99206 GRANTWRITING FEES 65520 65520 1390361 942844 330299 117218 61077 406660 112201 2861742 6790 1327277 102210 0 11666795 44502 500 100553 8896 72169 91657 300000 0 596739 16456841 47997 10445 74000 12266151 121997 12276596 X 449682 -380733 25060 4560978 474742 4180245 596739 16456841 3724003 -18500 0 X 0 1 X 1 0 X 4063850 6918343 1478600 5245500 17706293 4063850 6918343 1478600 5245500 17706293 7514569 10191724 683 2592 631 101217 105123 17811416 107650 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 100553 8896 91657 91657 DUE TO MLK-LA HOSPITAL 12266151 12266151 X PART X, LINE 2: THE COMPANY 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, 2016 OR 2015. THE COMPANY IS SUBJECT TO INCOME TAX EXAMINATION BY TAXING AUTHORITIES FOR ALL YEARS SINCE INCEPTION FOR FEDERAL AND STATE TAX FILINGS. BUILDING THE DREAM 625653 596673 28980 104259 37535 2100 116972 625653 596673 28980 104259 37535 2100 116972 260866 -231886 X X X X 0 0 0 0 0 0 0 1 0 DR ELAINE BATCHLOR BOARD MEMBER 0 427620 0 179000 0 99 0 2670 0 10250 0 619639 0 0 DYAN SUBLETT PRESIDENT 275000 0 0 0 20937 0 35300 0 6763 0 338000 0 0 0 PART I, LINE 7 MANAGEMENT OF THE HOSPITAL IS ELIGIBLE TO EARN AN ANNUAL INCENTIVE AMOUNT UNDER THE ORGANIZATION'S PERFORMANCE PROGRAM. THE PROGRAM INCLUDES ACHIEVING INDIVIDUAL AND ORGANIZATIONAL GOALS. 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 6 MARTIN LUTHER KING, JR.-LOS ANGELES (MLK-LA) HEALTHCARE CORP IS 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 (MLK-LA) HEALTHCARE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN GOVERNANCE ACTIONS AND DECISIONS ARE SUBJECT TO APPROVAL BY THE SOLE CORPORATE MEMBER, MARTIN LUTHER KING, JR.-LOS ANGELES (MLK-LA) HEALTHCARE CORPORATION AS DESCRIBED IN THE ORGANIZATION'S BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF 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 FOUNDATION PRESIDENT READ THE POLICY AND ANNUALLY COMPLETE A CONFLICTS 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 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 FOR 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 IS RELATED TO HER POSITION AS THE CHIEF EXECUTIVE OFFICER AT MARTIN LUTHER KING, JR.-LOS ANGELES HEALTHCARE CORPORATION AND WAS UNRELATED TO THE AVERAGE NUMBER OF HOURS PER WEEK SHE DEVOTED TO MARTIN LUTHER KING JR COMMUNITY HEALTH FOUNDATION. FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 140,685. MANAGEMENT AND GENERAL EXPENSES 114,147. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 254,832. 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 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0