2016-04-28T20:15:22-05:00 2015-06-30 951777440 GREEN HASSON & JANKS LLP 10990 WILSHIRE BLVD 16TH FLOOR LOS ANGELES CA 900243929 990 2014-07-01 951690966 PEDIATRIC & FAMILY MEDICAL CENTER PEDI 2137461037 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 HERB SCHULTZ PRESIDENT/CEO 2137461037 2016-04-07 1 LAUREN A HAVERLOCK P00545829 3108731600 2014 2016-08-17 19:52:53Z EISNER PEDIATRICS & FAMILY MED CENTER HERB SCHULTZ 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 28803927 0 X WWW.PEDCENTER.ORG X 1920 CA IMPROVE THE PHYSICAL, SOCIAL & EMOTIONAL WELL-BEING OF LOS ANGELES FAMILIES. 13 13 384 13 0 0 4845794 7030923 20551998 21763959 1137 1045 8936 8000 25407865 28803927 0 0 0 0 18461724 20462190 0 0 197791 7218970 8107770 25680694 28569960 -272829 233967 22936073 24207228 2727449 3241867 20208624 20965361 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 17112055 17417846 MEDICAL CARE- PHYSICAL EXAMS - IMMUNIZATIONS - GYNECOLOGY SERVICES - COUNSELING - PREVENTATIVE MEDICINE- DIAGNOSIS AND MANAGEMENT OF ACUTE AND CHRONIC DISEASES- DIAGNOSIS AND CARE DURING PREGNANCY- OFFICE DERMATOLOGYTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 27,863. 3680873 3515233 DENTAL CARE- PREVENTATIVE DENTAL EXAMS- DIAGNOSIS AND TREATMENT OF DENTAL AND GUM PROBLEMS- ORTHODONTIC SERVICESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 8,060. 2854589 830881 MENTAL HEALTH CARE & PHARMACEUTICAL SERVICES- INDIVIDUAL THERAPY - FAMILY THERAPY - GROUP THERAPY - CASE MANAGEMENT - WORKSHOPS - PARENTING CLASSES- DISPENSING PHARMACEUTICALS TO PATIENTS- SUPPLYING CLINICAL DEPARTMENTSTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 417. 23647517 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 0 0 0 0 0 1 0 0 0 1 47 0 1 384 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 (STARTED 08/14) 40.00 5.00 X 79296 0 8069 CARL COAN PRESIDENT / CEO (UNTIL 08/14) 40.00 5.00 X 250303 0 39398 EUGENE VEKSLER CFO 40.00 X 149289 0 10108 CHONA DE LEON VP / COO 40.00 X 242176 0 12882 LAILA AL-MARAYATI DIRECTOR OF OB SERV. 40.00 X 222634 0 12702 LUIS LOPEZ DIRECTOR OF PEDIATRICS 40.00 X 216986 0 12179 LAWRENCE YEE DIRECTOR OF ADULT 40.00 X 205455 0 12146 JOHN PHAM DIRECTOR OF DENTAL 40.00 X 153950 0 10236 DEBORAH LERNER CHIEF MEDICAL OFFICER 40.00 X 222641 0 12362 AHMAD KHALIFA PHYSICIAN 40.00 X 193872 0 11513 PENELOPE VELASCO PHYSICIAN 40.00 X 193227 0 11639 HIRAM WILLIAMS PHYSICIAN 40.00 X 191984 0 11469 IAN TILLEY PHYSICIAN 40.00 X 182645 0 11096 2504458 0 175799 39 0 1 0 QUEST DIAGNOSTICS 8511 FALLBROOK AVENUE 2ND FL WEST HILLS CA 91304 LABORATORY EXPENSES 225844 ELLIS BEESLEY MD 1127 WILSHIRE BLVD 707 LOS ANGELES CA 90017 NEW-BORN EXAMS 104201 2 1409926 3533417 2087580 7030923 PATIENT SERVICE FEES 624110 21763959 21763959 21763959 1045 1045 8000 0 8000 8000 8000 28803927 21763959 0 9045 1709061 1432525 262301 14235 15106271 12671816 2312496 121959 375900 307921 62028 5951 2063290 1730781 315851 16658 1207668 1017184 179699 10785 71486 71486 65052 65052 1616153 1432946 170501 12706 40030 19767 20110 153 309235 212195 92942 4098 265728 196997 67174 1557 783606 654653 128928 25 282798 225619 55652 1527 44037 24813 18485 739 9573 2996 6577 1173486 1173486 207074 155125 51949 MEDICAL SUPPLIES 1899084 1899084 BUILDING MAINTENANCE 141051 46237 94814 CLINIC MAINTENANCE 140821 50564 90257 SUBSCRIPTIONS 124528 29847 94666 15 934028 362961 563684 7383 28569960 23647517 4724652 197791 274881 884864 850095 1294233 1378467 1697442 5176758 4652228 344864 561548 25172958 10254592 14795512 14918366 57000 58496 198547 22936073 24207228 2402834 2438985 324615 802882 2727449 3241867 X 19693130 19999704 515494 965657 20208624 20965361 22936073 24207228 X 233967 522770 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 952246 952246 17589636 5967540 11622096 5936044 3865048 2070996 695032 422004 273028 14918366 28803927 0 28803927 0 28803927 28047190 -522770 -522770 28569960 0 28569960 PART XII, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT RECOVERY -522,770. X X 0 0 0 0 0 0 0 1 0 CARL COAN PRESIDENT / CEO (UNTIL 08/14) 225303 0 25000 0 0 0 33781 0 5617 0 289701 0 0 0 EUGENE VEKSLER CFO 149289 0 0 0 0 0 4491 0 5617 0 159397 0 0 0 CHONA DE LEON VP / COO 220176 0 22000 0 0 0 7265 0 5617 0 255058 0 0 0 LAILA AL-MARAYATI DIRECTOR OF OB SERV. 221009 0 1625 0 0 0 7085 0 5617 0 235336 0 0 0 LUIS LOPEZ DIRECTOR OF PEDIATRICS 204710 0 12276 0 0 0 6562 0 5617 0 229165 0 0 0 LAWRENCE YEE DIRECTOR OF ADULT 202675 0 2780 0 0 0 6529 0 5617 0 217601 0 0 0 JOHN PHAM DIRECTOR OF DENTAL 151340 0 2610 0 0 0 4619 0 5617 0 164186 0 0 0 DEBORAH LERNER CHIEF MEDICAL OFFICER 199681 0 22960 0 0 0 6745 0 5617 0 235003 0 0 0 AHMAD KHALIFA PHYSICIAN 166872 0 27000 0 0 0 5896 0 5617 0 205385 0 0 0 PENELOPE VELASCO PHYSICIAN 185227 0 8000 0 0 0 6022 0 5617 0 204866 0 0 0 HIRAM WILLIAMS PHYSICIAN 191359 0 625 0 0 0 5852 0 5617 0 203453 0 0 0 IAN TILLEY PHYSICIAN 176070 0 6575 0 0 0 5479 0 5617 0 193741 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. 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 522,770. 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 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 PEDIATRIC & FAMILY MEDICAL FOUNDATION C 1409926 FMV