2015-05-14T13:29:58-05:00 2014-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2013-07-01 274658935 MARTIN LUTHER KING JR-LOS ANGELES HEALTHCARE CORPORATION MART 4243388000 1680 E 120TH STREET LOS ANGELES CA 90059 MITCHELL THOMAS CFO 4243388000 2015-05-14 1 RENIE BURBANK P00159653 4159561500 2013 2016-02-25 16:41:14Z MITCHELL THOMAS 1680 E 120TH STREET LOS ANGELES CA 90059 25501872 0 X WWW.MLKCOMMUNITYHOSPITAL.ORG X 2010 CA THE SPECIFIC PURPOSE OF THIS CORPORATION IS TO ORGANIZE AND OPERATE A GENERAL ACUTE CARE HOSPITAL AND TO PROVIDE HIGH QUALITY HOSPITAL INPATIENT, OUTPATIENT, AND EMERGENCY HEALTH CARE AND SUCH ADDITIONAL HEALTH CARE SERVICES AS ARE DESIRABLE TO MEET THE NEEDS OF THE SOUTH LOS ANGELES COMMUNITY, WHICH INCLUDES INDIGENT, MEDI-CAL, MEDI-CAL MANAGED CARE, AND UNDERSERVED POPULATIONS, AMONG OTHERS, AND TO CONTRACT WITH, AMONG OTHERS, PUBLIC AND PRIVATE ENTITIES PROVIDING MANAGED CARE PROGRAMS FOR MEDI-CAL BENEFICIARIES IN LOS ANGELES COUNTY, PARTICULARLY SOUTH LOS ANGELES. 8 7 7 8 0 0 18251146 25433104 0 0 88130 68768 0 0 18339276 25501872 0 0 0 0 589445 1790344 0 0 0 11611153 13238127 12200598 15028471 6138678 10473401 19027234 302164678 12639540 285272427 6387694 16892251 MARTIN LUTHER KING JR.-LOS ANGELES HEALTHCARE CORPORATION PROVIDES HIGH QUALITY HEALTH EDUCATION, PREVENTION, AND MEDICAL TREATMENT FOR A DIVERSE POPULATION. 0 0 13412226 THE ORGANIZATION IS CURRENTLY IN THE DEVELOPMENT STAGE AND EXPECTS TO BE FULLY OPERATIONAL IN 2015. 13412226 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 23 0 1 7 1 0 0 0 0 0 0 0 0 0 0 X 8 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 0 0 CA X DR ELAINE BATCHLOR 4243388000 1680 E 120TH ST LOS ANGELES CA 90059 MANUAL A ABASCAL JD CHAIRMAN 6.00 0.00 X X 0 0 0 PAUL KING VICE CHAIRMAN 3.00 2.00 X X 0 0 0 MICHAEL MADDEN SECRETARY 3.00 0.00 X X 0 0 0 JAMES YOSHIOKA TREASURER 3.00 0.00 X X 0 0 0 GEORGINA R GARCIA RN BOARD MEMBER 3.00 0.00 X 0 0 0 ROBERT MARGOLIS MD BOARD MEMBER 3.00 2.00 X 0 0 0 ROBERT TRANQUADA MD BOARD MEMBER 3.00 0.00 X 0 0 0 IAN MORRISON BOARD MEMBER 3.00 0.00 X 0 0 0 DR ELAINE BATCHLOR CHIEF EXECUTIVE OFFICER 40.00 2.00 X 400000 0 25793 SAJID AHMED CHIEF INFO/INNOVATION OFF'R 40.00 0.00 X 227644 0 16944 KEITH BRADOWSKI CHF OPS OFF'R/CHF NURSING OFF'R 40.00 0.00 X 170641 0 6391 JOHN FISHER CHIEF MEDICAL OFFICER 40.00 0.00 X 119615 0 6745 917900 0 55873 4 0 1 0 TOP TIER CONSULTING PO BOX 2126 THOUSAND OAKS CA 913604343 IT CONSULTING & INTERIM MGMT SRVCS 4463857 THE CAMDEN GROUP 100 N SEPULVEDA BLVD STE 600 EL SEGUNDO CA 90245 INTERIM MANAGEMENT SERVICES/CONSULTING 3899811 CLEO ENTERPRISES LLC 34 CALLE CASTILLO SAN CLEMENTE CA 92673 CONSULTING SERVICES 748677 HMC ARCHITECTS 3546 CONCOURS ST ONTARIO CA 91764 ARCHITECURAL SERVICES 620710 INFOR US INC 13560 MORRIS RD STE 4100 ALPHARETTA GA 300048995 IT CONSULTING SERVICES 403208 12 3950000 21483104 25433104 68768 68768 25501872 0 0 68768 1213758 606879 606879 355213 355213 134154 134154 87219 53858 33361 8069421 8069421 799903 799903 48833 48833 264325 264325 3416562 3416562 385597 385597 93430 93430 22210 22210 7565 7565 127269 127269 3012 3012 15028471 13412226 1616245 0 3605182 21427914 3500017 2763520 27547 1764922 263432709 0 6129210 263432709 5765278 10600613 0 2175000 19027234 302164678 1875318 8121822 9878321 27395217 885901 249755388 12639540 285272427 X 6387694 13040533 3851718 6387694 16892251 19027234 302164678 10473401 31156 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 263432709 263432709 263432709 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, 2014. X X X X 0 0 0 0 0 0 0 0 0 DR ELAINE BATCHLOR CHIEF EXECUTIVE OFFICER 400000 0 0 0 0 0 0 0 25793 0 425793 0 0 0 SAJID AHMED CHIEF INFO/INNOVATION OFF'R 227644 0 0 0 0 0 0 0 16944 0 244588 0 0 0 KEITH BRADOWSKI CHF OPS OFF'R/CHF NURSING OFF'R 170641 0 0 0 0 0 0 0 6391 0 177032 0 0 0 THE CAMDEN GROUP BOARD MEMBER OF MLK IS CHAIRMAN OF THE CAMDEN GRP/DAVITA HEALTHCARE PRTNER 3899811 PROVISION OF INTERIM MANAGEMENT SERVICES AND OTHER CONSULTING SERVICES 0 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 MLK-LA DRAFTED AND ADOPTED ITS CONFLICT OF INTEREST POLICY EARLY IN ITS EXISTENCE. ALL BOARD MEMBERS AND OFFICERS, INCLUDING THE CEO AND ALL INTERIM OFFICERS READ THE POLICY AND COMPLETED 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, INTERIM TEAM MEMBERS 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 THE BOARD OVERSEES THE MLK- LA COMPENSATION PROGRAMS ENSURING THEIR REASONABLENESS AND COMPETITIVENESS. THE BOARD ADHERES TO THE FOLLOWING PRINCIPLES: -THEY WILL HAVE INDEPENDENT, DISINTERESTED BOARD MEMBERS OVERSEEING AND MAKING DECISIONS REGARDING COMPENSATION. -THEY WILL USE INDEPENDENT SOURCES OF DATA AND HAVE THE REASONABLENESS AND COMPETITIVENESS OF OUR PROGRAMS REVIEWED BY AN OUTSIDE ADVISOR. -THEY WILL DOCUMENT THE MEETINGS OF THE BOARD TO ACT AS A RECORD OF OUR DISCUSSIONS, THE DATA WE REVIEW AND THE DECISIONS OR RECOMMENDATIONS WE MAKE. THE BOARD WILL FULLY REVIEW AND APPROVE ALL EXECUTIVE COMPENSATION ISSUES REGARDING COMPENSATION PHILOSOPHY, EXECUTIVE COMPENSATION PROGRAM DESIGN AND SPECIFIC COMPENSATION ADJUSTMENTS FOR THE CEO. THE CEO WILL BE RESPONSIBLE FOR ADMINISTERING THE EXECUTIVE COMPENSATION PROGRAM FOR ALL OTHER EXECUTIVES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANZATION IS NOT MAKING THESE DOCUMENTS AVAILABLE AT THIS TIME. FORM 990, PART XII, LINE 2C AUDIT COMMITTEE AND OVERSIGHT - THE ORGANIZATION'S FIRST YEAR OF OPERATIONS IS EXPECTED TO COMMENCE IN 2015; THEREFORE, THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR. FORM 990, PART IV, LINE 20A THE ORGANIZATION IS CURRENTLY IN THE DEVELOPMENT STAGE AND EXPECTS TO BE FULLY OPERATIONAL IN 2015. THEREFORE, WE HAVE MARKED "NO" TO 990, PART IV, LINE 20 AS THE HOSPITAL FACILITY IS NOT CURRENTLY IN OPERATION. MARTIN LUTHER KING JR COMMUNITY HEALTH FOUNDATION 515 S FLOWER STREET STE 1610 LOS ANGELES CA 90071 454433505 CHARITABLE FOUNDATION CA 501(C)(3) 7 N/A 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 MLK COMMUNITY HEALTH FOUNDATION C 3950000 FMV