2016-05-13T11:59:12-05:00 2015-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2014-07-01 454433505 MARTIN LUTHER KING JR COMMUNITY HEALTH FOUNDATION MART 4243388686 1680 E 120TH STREET LOS ANGELES CA 90059 DYAN SUBLETT PRESIDENT 2136222344 2016-05-13 1 RENIE BURBANK P00159653 4159561500 2014 2016-08-17 19:52:53Z DYAN SUBLETT 1680 E 120TH STREET LOS ANGELES CA 90059 1513441 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. 7 5 3 6 0 0 6918343 1478600 0 0 2592 631 -177624 -229674 6743311 1249557 3950000 3050615 0 0 469855 459829 0 0 0 389591 548444 4809446 4058888 1933865 -2809331 5532167 596739 2248094 121997 3284073 474742 X SEE SCHEDULE O 0 0 3775458 3050615 SEE SCHEDULE O(1) $8 MILLION GOAL ACHIEVED FOR HEALTHY BABIES HEALTHY BEGINNINGS CAPITAL CAMPAIGN TO EXPAND HOSPITAL OBSTETRIC SERVICES; (2) OVER $12 MILLION IN TOTAL FUNDS RAISED FOR GENERAL SUPPORT, HOSPITAL CAPITAL AND COMMUNITY HEALTH PROGRAM PURPOSES; (3) EXPANSION OF BOARD OF DIRECTORS TO INCLUDE SENIOR LEADERS IN THE TECHNOLOGY AND ENTERTAINMENT INDUSTRY SECTORS; (4) SOLD OUT CELEBRATING THE DREAM, SECOND ANNUAL FUNDRAISING LUNCH IN SUPPORT OF HOSPITAL AND COMMUNITY HEALTH PROGRAMS, RAISING NEARLY $1 MILLION AND EXCEEDING 600 GUESTS; (5) LAUNCHED FOUNDATION'S ONLINE GIVING PROGRAM. 3775458 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 9 0 1 3 1 0 0 0 0 0 0 0 0 0 0 X 7 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 0 0 CA X ZULMA VITALICH 2136222344 1680 E 120TH STREET LOS ANGELES CA 90059 X LINDA GRIEGO CHAIRPERSON (THRU 03/2015) 2.00 0.00 X X 0 0 0 PAUL KING TREASURER 2.00 3.00 X X 0 0 0 DR ROBERT MARGOLIS SECRETARY 2.00 3.00 X X 0 0 0 MANUAL A ABASCAL JD CHAIRPERSON 2.00 6.00 X X 0 0 0 DR ELAINE BATCHLOR BOARD MEMBER 2.00 40.00 X 0 411862 15007 BRUCE CORWIN BOARD MEMBER 2.00 0.00 X 0 0 0 CANDACE BOND MCKEEVER BOARD MEMBER 2.00 0.00 X 0 0 0 STEVE YSLAS BOARD MEMBER 2.00 0.00 X 0 0 0 DYAN SUBLETT PRESIDENT 40.00 0.00 X 275002 0 17364 275002 411862 32371 1 0 1 0 PRODUCTION ELEMENTS INC 5777 WEST PICO BLVD LOS ANGELES CA 90019 EVENT DESIGN & PRODUCTION SERVICES 228033 RITA A MINJAREZ 6211 N VANCOUVER AVE PORTLAND CA 97217 MARKETING AND COMMUNICATIONS 132108 2 896282 100000 482318 8000 1478600 631 631 34210 896282 263884 -229674 -229674 1249557 0 0 -229043 3050615 3050615 321744 160872 160872 110293 110293 1748 1748 4891 4891 21153 21153 30607 30607 15107 15107 345490 273490 72000 16825 16825 54539 54539 7200 7200 3179 3179 2564 2564 2569 2569 4844 4844 GRANTWRITING FEES 65520 65520 4058888 3775458 283430 0 252209 61077 5261623 112201 0 6790 4201 44502 78964 6795 14134 72169 0 300000 5532167 596739 73094 47997 2175000 74000 2248094 121997 X 1931193 449682 1352880 25060 3284073 474742 5532167 596739 -2809331 0 X X 0 1 X 1 0 X 4063850 6918343 1478600 12460793 4063850 6918343 1478600 12460793 7029901 5430892 683 2592 631 3906 12464699 78670 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 78964 6795 72169 72169 DUE FROM HOSPITAL 300000 300000 DUE TO HOSPITAL 74000 74000 X 1587441 74000 263884 337884 1249557 0 1249557 4396772 74000 263884 337884 4058888 0 4058888 PART X, LINE 2: THE FOUNDATION IS A NONPROFIT CALIFORNIA CORPORATION AND IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC") AND SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE, EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. FOR THE YEAR AND PERIOD ENDED JUNE 30, 2015 AND 2014 RESPECTIVELY, NO PROVISION FOR UNRELATED BUSINESS INCOME TAXES IS REQUIRED. THE FOUNDATION HAS NO UNRECOGNIZED TAX BENEFITS OR LIABILITIES AS OF JUNE 30, 2015 AND 2014. BUILDING THE DREAM 930492 896282 34210 30702 48703 2200 182279 930492 896282 34210 30702 48703 2200 182279 263884 -229674 1 MLK JR-LOS ANGELES HEALTHCARE CORP 1680 E 120TH STREET LOS ANGELES CA 90059 274658935 501(C)(3) 500000 EQUIPMENT AND CONSTRUCTION FOR MRI FOR THE HOSPITAL MLK JR-LOS ANGELES HEALTHCARE CORP 1680 E 120TH STREET LOS ANGELES CA 90059 274658935 501(C)(3) 100000 PURCHASE OF ARTWORK FOR THE HOSPITAL MLK JR-LOS ANGELES HEALTHCARE CORP 1680 E 120TH STREET LOS ANGELES CA 90059 274658935 501(C)(3) 2450615 CONSTRUCTION AND EQUIPMENT FOR THE HOSPITAL'S EXPANDED OB UNIT 1 PART I, LINE 2: THE PROCEDURES RANGE FROM THE MONTHLY FINANCIAL REPORTING, WHICH WE RECONCILE WITH THE HOSPITAL, TO THE INTERIM AND FINAL REPORTS THAT WE PROVIDE TO EACH FUNDER. ALL REPORTS CONTAIN FINANCIAL DETAIL IN THE BUDGET THAT CAN BE TIED BY AUDIT TO EXPENDITURES. FURTHERMORE, EACH DESIGNATED GIFT IS SEGREGATED IN ITS OWN ACCOUNT ON THE HOSPITAL SIDE. PART II, LINE 1(H) THE PURPOSE OF THE GRANT WAS FOR EQUIPMENT AND CONSTRUCTION FOR THE MRI FOR THE HOSPITAL; FOR THE PURCHASE OF ARTWORK FOR THE HOSPITAL; AND FOR THE CONSTRUCTION AND EQUIPPING THE HOSPITAL'S EXPANDED OB UNIT. X X X X 0 0 0 0 0 0 0 0 0 DR ELAINE BATCHLOR BOARD MEMBER 0 405554 0 0 0 6308 0 0 0 15007 0 426869 0 0 DYAN SUBLETT PRESIDENT 275002 0 0 0 0 0 8250 0 9114 0 292366 0 0 0 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 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 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 XII, LINE 2C: AUDIT COMMITTEE AND OVERSIGHT - THERE WERE NO CHANGES TO THE PROCESS FROM THE PRIOR YEAR. 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0