2016-05-16T11:30:51-05:00 2015-09-30 952302617 SINGERLEWAK LLP 2050 MAIN STREET 7TH FLOOR IRVINE CA 92614 990 2014-10-01 270179192 THE CENTER FOR COMPREHENSIVE CARE AND DIAGNOSIS OF INHERITED BLOOD DISORDERS CENT 7145865336 2670 N MAIN ST SUITE 150 SANTA ANA CA 92705 DIANE J NUGENT MD PRESIDENT 7145865336 2016-05-12 1 LIOR TEMKIN CPA P00748170 9492618600 2016-05-05 2014 2016-08-17 19:52:53Z CENTER FOR INHERITED BLOOD DISORDERS (CIBD) DIANE J NUGENT MD 2670 N MAIN ST SUITE 150 SANTA ANA CA 92705 29552169 0 X CIBD-CA.ORG X 2009 CA PROVIDE COMPREHENSIVE CARE FOR PATIENTS WITH RARE, CHRONIC INHERITED BLOOD DISORDERS. 7 7 22 7 0 0 979356 1755441 24822141 27793103 67 3625 0 0 25801564 29552169 692081 1223610 0 0 1626038 2226741 0 0 0 22037061 24191328 24355180 27641679 1446384 1910490 6314022 7692170 3080824 2548482 3233198 5143688 TO IMPROVE HEALTH AND LONGEVITY AND LOWER COSTS OF CARE; BY PROVIDING EDUCATION, SUPPORT, AND SERVICES TO DELIVER COMPREHENSIVE CARE FOR PATIENTS AND THEIR FAMILIES WITH RARE, CHRONIC INHERITED BLOOD DISORDERS. 0 0 26990416 1223610 27793103 THE CENTER FOR COMPREHENSIVE CARE AND DIAGNOSTICS OF INHERITED BLOOD DISORDERS (CIBD) IS A COMMUNITY BASED CLINIC THAT PROVIDES COMPREHENSIVE CARE FOR CHILDREN AND ADULTS WITH RARE, CHRONIC INHERITED BLOOD DISORDERS UTILIZING THE COMPREHENSIVE CARE MODEL. AS A SAFETY NET CLINIC, CIBD PROVIDES INCREASED ACCESS TO SUBSPECIALTY CARE THROUGH A MULTIDISCIPLINARY TEAM APPROACH. THROUGH PHARMACY SERVICES AND INNOVATIVE HEALTH INFORMATION TECHNOLOGY, CIBD IS ABLE TO EDUCATE PATIENTS AND FAMILIES AS WELL AS MONITOR AND DRIVE DOWN COST OF CARE THROUGH THE 340B PROGRAM. 26990416 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 23 0 1 22 1 0 0 0 0 0 0 0 0 0 0 X 7 7 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X MARY PHAM 7145865336 2670 N MAIN STREET SUITE 150 SANTA ANA CA 92705 DIANE J NUGENT MD PRESIDENT/CHAIRMAN 5.00 X X 0 0 0 AMIT SONI VICE PRESIDENT 1.00 X X 0 0 0 KATHIE BIRSCHBACH SECRETARY 3.00 X X 0 0 0 BARRY STATON TREASURER 1.00 X X 0 0 0 MARY BROWN DIRECTOR 0.50 X 0 0 0 RANDALL CURTIS DIRECTOR 1.00 X 0 0 0 BERTIL GLADER MD PHD DIRECTOR 0.50 X 0 0 0 MARY PHAM COO/CCO 40.00 X 220998 0 0 ANGIE VU PHARMACIST 40.00 X 131561 0 0 352559 0 0 2 0 1 0 CHOC CHILDRENS HOSPITAL 1201 W LA VETA AVE ORANGE CA 92868 CONTRACTUAL SERVICES 1198691 CHILDREN'S HOSPITAL AND RESEARCH CENTER 5700 MARTIN LUTHER KING J WAY OAKLAND CA 94609 CONTRACTUAL SERVICES 877901 RED CHIP ENTERPRISES 18009 SKY PARK CIRCLE SUITE G IRVINE CA 92614 BILLING SERVICES 230798 THE REGENTS UCLA PO BOX 957089 1125 MURPHY HALL 40 LOS ANGELES CA 90095 CONTRACTUAL SERVICES 182273 THE REGENTS UCI SCHOOL OF MEDICINE 101 THE CITY DRIVE SOUTH CITY TOWE ORANGE CA 92868 PHYSICIAN CONTRACTUAL SERVICES 159444 10 1623462 131979 1755441 FACTOR REPLACEMENT 621990 25831394 25831394 CONTRACT PHARMACY SERVICES 900099 1589867 1589867 NET PATIENT SERVICES 621400 199962 199962 CONFERENCE REVENUES 900099 158600 158600 FEES FOR SERVICE CONTRACTS 900099 13280 13280 27793103 3625 3625 29552169 27793103 0 3625 1223610 1223610 234037 166166 67871 1621396 1441105 180291 61254 44333 16921 174206 111764 62442 135848 105321 30527 6975 800 6175 59989 59989 46298 46298 7245 5929 1316 299711 212816 86895 64145 48622 15523 245605 203300 42305 100816 75641 25175 187142 165097 22045 93825 82322 11503 78514 56229 22285 PHARMACEUTICAL COSTS 21031946 21031946 PURCHASED SERVICES 1969117 1969117 27641679 26990416 651263 0 1329668 1727602 132013 773210 257404 834005 3708569 3319422 671679 683068 71174 74175 545270 292540 110557 252730 32958 27958 6314022 7692170 3073324 2536444 7500 12038 3080824 2548482 X 3151228 5061718 81970 81970 3233198 5143688 6314022 7692170 1910490 0 X X 0 1 X 1 1 1 X 1833294 1158304 908043 979356 1755441 6634438 10319238 14875864 20569417 24822141 27793103 98379763 12152532 16034168 21477460 25801497 29548544 105014201 0 0 0 105014201 13148 707 107 67 3625 17654 13148 707 107 67 3625 17654 12165680 16034875 21477567 25801564 29552169 105031855 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 165350 36109 129241 379920 256431 123489 252730 UNEARNED GRANT REVENUE 12038 12038 X 29552169 0 29552169 0 29552169 27641679 0 27641679 0 27641679 PART X, LINE 2: THE ORGANIZATION WILL RECOGNIZE THE IMPACT OF TAX POSITIONS IN THE FINANCIAL STATEMENTS IF THAT POSITION IS MORE LIKELY THAN NOT OF BEING SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. TO DATE, THE ORGANIZATION HAS NOT RECORDED ANY UNCERTAIN TAX POSITIONS. THE ORGANIZATION RECOGNIZES POTENTIAL ACCRUED INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS IN INCOME TAX EXPENSE. THE ORGANIZATION DID NOT RECOGNIZE ANY AMOUNT IN POTENTIAL INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE FOLLOWING SUMMARIZES THE OPEN TAX YEARS FOR EACH MAJOR JURISDICTION: JURISDICTION OPEN TAX YEAR FEDERAL 2011-2014 STATE 2010-2014 1 CHILDREN'S HOSPITAL AND RESEARCH CENTER AT OAKLAND 5700 MARTIN LUTHER KING JR WAY OAKLAND CA 94609 940382330 501(C)(3) 35387 SUBCONTRACT HRSA GRANT - HEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM CHILDREN'S HOSPITAL LOS ANGELES 4650 SUNSET BLVD MS 54 LOS ANGELES CA 90027 951690977 501(C)(3) 32438 SUBCONTRACT HRSA GRANT - HEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM CHILDREN'S HOSPITAL LOS ANGELES 4650 SUNSET BLVD MS 54 LOS ANGELES CA 90027 951690977 501(C)(3) 25743 SUBCONTRACT CDC/ATHN GRANT - PUBLIC HEALTH SURVEILLANCE CHILDREN'S HOSPITAL OF CENTRAL CALIFORNIA 9300 VALLEY CHILDRENS PLACE MADERA CA 92636 941294954 501(C)(3) 11304 SUBCONTRACT HRSA GRANT - HEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM CHILDREN'S HOSPITAL AND RESEARCH CENTER AT OAKLAND 5700 MARTIN LUTHER KING JR WAY OAKLAND CA 94609 940382330 501(C)(3) 15333 SUBCONTRACT CDC/ATHN GRANT - PUBLIC HEALTH SURVEILLANCE HEMOPHILIA TREATMENT CENTER OF NEVADA 3121 S MARYLAND PARKWAY 200 LAS VEGAS NV 89109 260286469 501(C)(3) 20604 SUBCONTRACT HRSA GRANT - HEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM HEMOPHILIA TREATMENT CENTER OF NEVADA 3121 S MARYLAND PARKWAY 200 LAS VEGAS NV 89109 260286469 501(C)(3) 27644 SUBCONTRACT CDC/ATHN GRANT - PUBLIC HEALTH SURVEILLANCE KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN 1319 PUNAHOU STREET HONOLULU HI 96826 990177350 501(C)(3) 32804 SUBCONTRACT HRSA GRANT - HEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM KAPI'OLANI MEDICAL CENTER FOR WOMEN AND CHILDREN 1319 PUNAHOU STREET HONOLULU HI 96826 990177350 501(C)(3) 10276 SUBCONTRACT CDC/ATHN GRANT - PUBLIC HEALTH SURVEILLANCE LUCILE PACKARD CHILDREN'S HOSPITAL AT STANFORD 1000 WELCH RD SUITE 300MC5798 PALO ALTO CA 94304 941156365 501(C)(3) 29586 SUBCONTRACT HRSA GRANT - HEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM LUCILE PACKARD CHILDREN'S HOSPITAL AT STANFORD 1000 WELCH RD SUITE 300 MC5798 PALO ALTO CA 94304 941156365 501(C)(3) 13704 SUBCONTRACT CDC/ATHN GRANT - PUBLIC HEALTH SURVEILLANCE ORTHOPAEDIC HOSPITAL 2400 SOUTH FLOWER ST LOS ANGELES CA 90007 951644604 501(C)(3) 64978 SUBCONTRACT HRSA GRANT - HEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM ORTHOPAEDIC HOSPITAL 2400 SOUTH FLOWER ST LOS ANGELES CA 90007 951644604 501(C)(3) 20529 SUBCONTRACT CDC/ATHN GRANT - PUBLIC HEALTH SURVEILLANCE PEDIATRIC SUBSPECIALTY FACULTY 1010 WEST LA VETA AVE SUITE 670 ORANGE CA 92868 330930025 34589 SUBCONTRACT HRSA GRANT - HEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM PEDIATRIC SUBSPECIALTY FACULTY 1010 WEST LA VETA AVE SUITE 670 ORANGE CA 92868 330930025 16473 SUBCONTRACT CDC/ATHN GRANT - PUBLIC HEALTH SURVEILLANCE RADY CHILDREN'S HOSPITAL - SAN DIEGO 3020 CHILDRENS WAY SAN DIEGO CA 92123 951691313 501(C)(3) 5643 SUBCONTRACT HRSA GRANT - HEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM RADY CHILDREN'S HOSPITAL - SAN DIEGO 3020 CHILDRENS WAY SAN DIEGO CA 92123 951691313 501(C)(3) 13527 SUBCONTRACT CDC/ATHN GRANT - PUBLIC HEALTH SURVEILLANCE THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (DAVIS) 2360 STOCKTON BLVD SUITE 1100 SACRAMENTO CA 95817 946036494 501(C)(3) 47672 SUBCONTRACT HRSA GRANT - HEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (DAVIS) 2360 STOCKTON BLVD SUITE 1100 SACRAMENTO CA 95817 946036494 501(C)(3) 20111 SUBCONTRACT CDC/ATHN GRANT - PUBLIC HEALTH SURVEILLANCE THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (UCLA) 10883 LE CONTE AVE ROOM A2-410 MDCC MDCC LOS ANGELES CA 90095 956006143 501(C)(3) 55432 SUBCONTRACT HRSA GRANT - HEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (UCLA) 10883 LE CONTE AVE ROOM A2-410 MDCC MDCC LOS ANGELES CA 90095 956006143 501(C)(3) 55623 SUBCONTRACT CDC/ATHN GRANT - PUBLIC HEALTH SURVEILLANCE THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (UCLA) 10883 LE CONTE AVE ROOM A2-410 MDCC MDCC LOS ANGELES CA 90095 956006143 501(C)(3) 31299 SUBCONTRACT HRSA GRANT - SICKLE CELL TREATMENT DEMONSTRATION PROGRAM THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (UCSD) 200 W ARBOR DRIVE MC8651 SAN DIEGO CA 92103 956006144 501(C)(3) 28420 SUBCONTRACT HRSA GRANT - HEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (UCSF) 650 MOFFITT BOX 0106 SAN FRANCISCO CA 94143 946036493 501(C)(3) 50676 SUBCONTRACT HRSA GRANT - HEMOPHILIA REGIONAL COMPREHENSIVE CARE PROGRAM THE REGENTS OF THE UNIVERSITY OF CALIFORNIA (UCSF) 650 MOFFITT BOX 0106 SAN FRANCISCO CA 94143 946036493 501(C)(3) 6208 SUBCONTRACT CDC/ATHN GRANT - PUBLIC HEALTH SURVEILLANCE SICKLE CELL DISEASE FOUNDATION OF CALIFORNIA 3602 INLAND EMPIRE BLVD SUITE B220 ONTARIO CA 91764 956155962 501(C)(3) 129317 SUBCONTRACT HRSA GRANT - SICKLE CELL TREATMENT DEMONSTRATION PROGRAM ALLIANCE FOR CHILDHOOD DISEASES 3121 S MARYLAND PARKWAY SUITE 601 LAS VEGAS NV 89109 260286469 501(C)(3) 18750 SUBCONTRACT HRSA GRANT - SICKLE CELL TREATMENT DEMONSTRATION PROGRAM THE UNIVERSITY OF ARIZONA 1303 E UNIVERSITY BLVD BOX 3 TUCSON AZ 85719 742652689 501(C)(3) 6978 SUBCONTRACT HRSA GRANT - SICKLE CELL TREATMENT DEMONSTRATION PROGRAM CHILDREN'S HOSPITAL AND RESEARCH CENTER AT OAKLAND 5700 MARTIN LUTHER KING JR WAY OAKLAND CA 94609 940382330 501(C)(3) 52756 SUBCONTRACT HRSA GRANT - SICKLE CELL TREATMENT DEMONSTRATION PROGRAM PEDIATRIC SUBSPECIALTY FACULTY 1010 WEST LA VETA AVE SUITE 670 ORANGE CA 92868 330930025 11154 SUBCONTRACT HRSA GRANT - SICKLE CELL TREATMENT DEMONSTRATION PROGRAM 14 1 PART I, LINE 2: THE ORGANIZATION MONITORS THE USE OF GRANT FUNDS IN THE UNITED STATES BY ENTERING INTO SUBCONTRACT AGREEMENTS THAT ARE ON A COST REIMBURSEMENT BASIS. GRANTEES ARE REQUIRED TO SUBMIT COPIES OF INVOICES PRIOR TO DISBURSEMENT OF THE GRANT FUNDS. THERE ARE NO ADVANCE PAYMENTS PERMITTED. X X X X X 0 0 0 0 0 0 0 0 0 MARY PHAM COO/CCO 220998 0 0 0 0 0 0 0 0 0 220998 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DOES NOT HAVE A CFO ON STAFF, INSTEAD USES AN OUTSOURCE CFO COMPANY. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT COPY OF FORM 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY, BOARD OF DIRECTORS, AND THE CHIEF OPERATING OFFICER TO REVIEW AND APPROVE BEFORE IT WAS ELECTRONICALLY FILED BY THE CPA FIRM. FORM 990, PART VI, SECTION B, LINE 12C CIBD'S CONFLICT OF INTEREST POLICIES ARE REVIEWED ON A REGULAR BASIS AND PROVIDED TO THE OFFICERS AND DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES INCLUDES A COMPENSATION REVIEW AND APPROVAL BY AN INDEPENDENT RECRUITING FIRM. THE FIRM ANALYZES COMPARABILITY DATA AND THEN PROVIDES THE ORGANIZATION WITH A RANGE OF COMPENSATION. THE FINAL COMPENSATION IS DECIDED BY THE PRESIDENT. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION MAKES TAX FORMS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. THE TAX FORMS ARE ALSO AVAILABLE ON GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 2C: THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT ASSUMES RESPONSIBILTY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT.