2013-02-13T16:17:20-06:00 2012-06-30 951777440 GREEN HASSON & JANKS LLP 10990 WILSHIRE BLVD 16TH FLOOR LOS ANGELES CA 900243929 990 2011-07-01 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 2013-02-06 1 RICHARD L RUVELSON P00234075 3108731600 2011 2016-03-07 17:11:31Z EISNER PEDIATRICS & FAMILY MED CENTER CARL E COAN 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 24539907 0 X WWW.PEDCENTER.ORG X 1920 CA IMPROVE THE PHYSICAL, SOCIAL & EMOTIONAL WELL-BEING OF LOS ANGELES FAMILIES 11 11 306 0 0 0 3544029 5944814 15391779 18458789 9248 2784 131883 133520 19076939 24539907 0 0 0 0 14721064 16066235 0 0 405394 4258895 6239152 18979959 22305387 96980 2234520 17089107 20508832 2197594 3442212 14891513 17066620 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 14128823 15416365 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 25,507. 2433816 1954722 DENTAL CARE- PREVENTATIVE DENTAL EXAMS- DIAGNOSIS AND TREATMENT OF DENTAL AND GUM PROBLEMS- ORTHODONTIC SERVICESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 6,133. 1706668 1087702 MENTAL HEALTH CARE- INDIVIDUAL THERAPY - FAMILY THERAPY - GROUP THERAPY - CASE MANAGEMENT - WORKSHOPS - PARENTING CLASSESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 276. 18269307 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 0 1 31 0 306 1 0 0 0 0 0 0 0 0 X 11 11 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 LOREN KOSMONT 1.00 X 0 0 0 NORMA IBARRA 1.00 X 0 0 0 CARMELA GALVAN 1.00 X 0 0 0 VICTOR AGUIRRE 1.00 X 0 0 0 ROBYN HILL-AVERY 1.00 X 0 0 0 KEVIN ROSSI 1.00 X 0 0 0 ALEJANDRA ROSAS 1.00 X 0 0 0 JENNIFER LYNCH 1.00 X 0 0 0 DAVID CHERNEK 1.00 X 0 0 0 EDWARD MATTHEWS 1.00 X 0 0 0 JEFFREY WANG 1.00 X 0 0 0 CARL E COAN 40.00 X 253666 0 39895 CHONA DE LEON 40.00 X 230073 0 12818 LAWRENCE YEE 40.00 X 199908 0 12093 LUIS LOPEZ 40.00 X 204937 0 11715 LAILA AL-MARAYATI 40.00 X 192575 0 11884 DEBORAH LERNER 40.00 X 201786 0 11595 AHMAD KHALIFA 40.00 X 171698 0 11239 HIRAM WILLIAMS 40.00 X 161874 0 10250 BECKY MURPHY 40.00 X 151263 0 10156 OFFER HO 40.00 X 143526 0 10174 1911306 0 141819 29 0 1 0 KCS WEST 901 CORPORATE CENTER DRIVE 3RD FL MONTEREY PARK CA 91754 CONSTRUCTION (DENTAL) 761423 BIRBA 2350 HYPERION AVENUE LOS ANGELES CA 90027 CONSTRUCTION (DENTAL) 361499 ALL'S WELL PO BOX 29048 GLENDALE CA 91209 TEMPORARY LABOR 209611 QUEST DIAGNOSTICS 8511 FALLBROOK AVENUE 2ND FL WEST HILLS CA 91304 LABORATORY EXPENSES 185933 MAGUIRE THOMAS PARTNERS 240 WEST VENICE BLVD LOS ANGELES CA 90015 PARKING 181797 6 82885 4598049 1263880 5944814 PATIENT SERVICE FEES 624110 18458789 18458789 18458789 2784 2784 9000 0 9000 9000 9000 DEBT FORGIVENESS 900099 95000 95000 MISCELLANEOUS INCOME 900099 29520 29520 124520 24539907 18458789 0 136304 1139429 946096 174051 19282 12117308 10061308 1850947 205053 367795 280027 66191 21577 1444745 1199609 220688 24448 996958 831485 148214 17259 106329 38573 67756 58701 58701 1587216 1496639 90577 16018 5836 8382 1800 271629 178442 86864 6323 241663 151800 89735 128 542781 482079 60702 264116 226763 34810 2543 41268 26291 14457 520 86214 56 86158 870687 870687 183343 148410 34933 MEDICAL SUPPLIES 1061704 1061704 CLINIC MAINTENANCE 119452 28888 90564 BUILDING MAINTENANCE 114400 30322 84078 SUBSCRIPTIONS 76190 22083 49495 4612 597441 182209 403960 11272 22305387 18269307 3630686 405394 42907 30058 1455529 1268627 687696 1206660 2992515 4373286 49131 190087 20121124 6822240 11678261 13298884 77000 68667 106068 72563 17089107 20508832 1368146 2296894 734028 1145318 95000 0 420 0 2197594 3442212 X 14274182 16499752 617331 566868 14891513 17066620 17089107 20508832 X 2234520 -59413 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 952246 952246 14849035 4403058 10445977 3952377 2078764 1873613 367466 340418 27048 13298884 24539907 22305387 2234520 -59413 -59413 2175107 24539907 0 24539907 0 24539907 22364800 59413 59413 22305387 0 22305387 PART XI, LINE 8 - OTHER ADJUSTMENTS: BAD DEBT -59,413. PART XIII, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT 59,413. X X 0 0 0 0 0 0 0 0 0 CARL E COAN 233666 0 20000 0 0 0 0 0 39895 0 293561 0 0 0 CHONA DE LEON 208073 0 22000 0 0 0 0 0 12818 0 242891 0 0 0 LAWRENCE YEE 199908 0 0 0 0 0 0 0 12093 0 212001 0 0 0 LUIS LOPEZ 202437 0 2500 0 0 0 0 0 11715 0 216652 0 0 0 LAILA AL-MARAYATI 188950 0 3625 0 0 0 0 0 11884 0 204459 0 0 0 DEBORAH LERNER 192216 0 9570 0 0 0 0 0 11595 0 213381 0 0 0 AHMAD KHALIFA 153073 0 18625 0 0 0 0 0 11239 0 182937 0 0 0 HIRAM WILLIAMS 154999 0 6875 0 0 0 0 0 10250 0 172124 0 0 0 BECKY MURPHY 143257 0 8006 0 0 0 0 0 10156 0 161419 0 0 0 OFFER HO 138426 0 5100 0 0 0 0 0 10174 0 153700 0 0 0 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 5: BAD DEBT -59,413. TOTAL TO FORM 990, PART XI, LINE 5: -59,413. 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 PEDIATRIC AND FAMILY MEDICAL FOUNDATION C 82885 BOOK