2014-02-12T15:41:36-06:00 2013-06-30 951777440 GREEN HASSON & JANKS LLP 10990 WILSHIRE BLVD 16TH FLOOR LOS ANGELES CA 900243929 990 2012-07-01 951690966 PEDIATRIC & FAMILY MEDICAL CENTER DBA EISNER PEDIATRIC & FAMILY MEDICAL CENTER PEDI 2137461037 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 CARL E COAN 2137461037 2014-01-29 1 RICHARD L RUVELSON P00234075 3108731600 2012 2015-11-30 17:44:51Z EISNER PEDIATRICS & FAMILY MED CENTER CARL E COAN 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 27528626 0 X WWW.PEDCENTER.ORG X 1920 CA IMPROVE THE PHYSICAL, SOCIAL & EMOTIONAL WELL-BEING OF LOS ANGELES FAMILIES 12 12 314 0 0 0 5944814 7837509 18458789 19676168 2784 1695 133520 13254 24539907 27528626 0 0 0 0 16066235 16955943 0 0 406341 6239152 6990504 22305387 23946447 2234520 3582179 20508832 23789189 3442212 3335048 17066620 20454141 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 14916067 16234368 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 26,992. 2808986 2300663 DENTAL CARE- PREVENTATIVE DENTAL EXAMS- DIAGNOSIS AND TREATMENT OF DENTAL AND GUM PROBLEMS- ORTHODONTIC SERVICESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 7,183. 2124416 1141137 MENTAL HEALTH CARE- INDIVIDUAL THERAPY - FAMILY THERAPY - GROUP THERAPY - CASE MANAGEMENT - WORKSHOPS - PARENTING CLASSESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 277. 19849469 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 1 0 0 0 0 1 0 0 0 1 33 0 314 1 0 0 0 0 0 0 0 0 X 12 12 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 VICTOR AGUIRRE 1.00 X 0 0 0 DAVID BENAVIDEZ 1.00 X 0 0 0 JERRY GATES 1.00 X 0 0 0 NORMA IBARRA 1.00 X 0 0 0 LOREN J KOSMONT 1.00 X 0 0 0 KEVIN KROEKER 1.00 X 0 0 0 CRAIG MYERS 1.00 X 0 0 0 ALEJANDRA ROSAS 1.00 X 0 0 0 KEVIN ROSSI 1.00 X X 0 0 0 EDWARD MATTHEWS 1.00 X X 0 0 0 IRMA AVILA 1.00 X X 0 0 0 JEFFREY WANG 1.00 X X 0 0 0 CARL E COAN 40.00 X 261030 0 39669 CHONA DE LEON 40.00 X 244535 0 12434 LAWRENCE YEE 40.00 X 205243 0 11637 LUIS LOPEZ 40.00 X 204700 0 11250 LAILA AL-MARAYATI 40.00 X 201408 0 11589 JOHN PHAM 40.00 X 150398 0 9598 DEBORAH LERNER 40.00 X 201673 0 11164 AHMAD KHALIFA 40.00 X 199855 0 11087 DAVID ENGEL 40.00 X 165245 0 10095 HIREN PATEL 36.00 X 162526 0 9962 IAN TILLEY 32.00 X 158050 0 9827 2154663 0 148312 31 0 1 0 QUEST DIAGNOSTICS 8511 FALLBROOK AVENUE 2ND FL WEST HILLS CA 91304 LABORATORY EXPENSES 266042 1 390000 6469455 978054 62742 7837509 PATIENT SERVICE FEES 624110 19676168 19676168 19676168 1695 1695 13254 0 13254 13254 13254 27528626 19676168 0 14949 1393628 1164252 204863 24513 12255601 10280423 1787950 187228 320530 245600 54315 20615 1900629 1594314 277280 29035 1085555 907213 158049 20293 102745 102745 60948 60948 1777614 1692863 21574 63177 50380 18750 16085 15545 261436 167654 86055 7727 242704 185617 52635 4452 602923 538093 64830 310224 273058 35053 2113 45897 29493 15018 1386 44416 6605 37811 1072278 1072278 221633 175668 45965 MEDICAL SUPPLIES 1200028 1200028 CLINIC MAINTENANCE 135272 45686 89586 SUBSCRIPTIONS 100184 23851 63484 12849 BUILDING MAINTENANCE 96413 19200 77213 665409 208823 439178 17408 23946447 19849469 3690637 406341 30058 303471 1268627 779954 1206660 1396456 4373286 5382755 190087 206931 23472902 7889518 13298884 15583384 68667 63667 72563 72571 20508832 23789189 2296894 2592099 1145318 742949 3442212 3335048 X 16499752 19662845 566868 791296 17066620 20454141 20508832 23789189 X 3582179 -194658 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 952246 952246 17461781 4937660 12524121 4527562 2601386 1926176 531313 350472 180841 15583384 27528626 0 27528626 0 27528626 24141105 194658 194658 23946447 0 23946447 PART XII, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT 194,658. X X 0 0 0 0 0 0 0 1 0 CARL E COAN 240197 0 20833 0 0 0 34583 0 5086 0 300699 0 0 0 CHONA DE LEON 221535 0 23000 0 0 0 7348 0 5086 0 256969 0 0 0 LAWRENCE YEE 205243 0 0 0 0 0 6551 0 5086 0 216880 0 0 0 LUIS LOPEZ 201700 0 3000 0 0 0 6164 0 5086 0 215950 0 0 0 LAILA AL-MARAYATI 199283 0 2125 0 0 0 6503 0 5086 0 212997 0 0 0 JOHN PHAM 150398 0 0 0 0 0 4512 0 5086 0 159996 0 0 0 DEBORAH LERNER 191813 0 9860 0 0 0 6078 0 5086 0 212837 0 0 0 AHMAD KHALIFA 187855 0 12000 0 0 0 6001 0 5086 0 210942 0 0 0 DAVID ENGEL 148745 0 16500 0 0 0 5009 0 5086 0 175340 0 0 0 HIREN PATEL 157151 0 5375 0 0 0 4876 0 5086 0 172488 0 0 0 IAN TILLEY 156675 0 1375 0 0 0 4741 0 5086 0 167877 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. X EQUIPMENT 1 62742 FMV 0 0 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTIONS: PART I, COLUMN (B): NON CASH CONTRIBUTIONS ARE LISTED BY TOTAL NUMBER OF DONORS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS GIVEN TO ALL BOARD MEMBERS FOR 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 THEN IT IS PRESENTED TO THE ENTIRE BOARD FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: BAD DEBT -194,658. FINANCIAL STATEMENTS AND REPORTING FORM 990, PART XII, LINE 2C NO CHANGES WERE MADE TO THE FINANCIAL STATEMENT REPORTING PROCESS. 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 I N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PEDIATRIC & FAMILY MEDICAL FOUNDATION C 390000 FMV