2013-05-15T11:13:14-05:00 2012-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET 9TH FLOOR SAN FRANCISCO CA 94105 990 2011-07-01 274658935 MARTIN LUTHER KING JR-LOS ANGELES HEALTHCARE CORPORATION MART 4242069406 12012 COMPTON AVE BOX 4-110 LOS ANGELES CA 90059 JAMES YOSHIOKA 4242069406 2013-05-14 1 RENIE BURBANK P00159653 4159561500 2011 2016-02-24 21:20:13Z JAMES YOSHIOKA 12012 COMPTON AVE BOX 4-110 LOS ANGELES CA 90059 6250032 0 X N/A X 2010 CA SEE SCHEDULE O. 7 7 0 0 0 0 605556 4451789 0 0 3479 93375 0 0 609035 4545164 0 0 0 0 0 0 0 0 0 606600 4527945 606600 4527945 2435 17219 10672625 17384758 10670189 17313364 2436 71394 MARTIN LUTHER KING JR.-LOS ANGELES HEALTHCARE CORPORATION PROVIDES HIGH QUALITY HEALTH EDUCATION, PREVENTION, AND MEDICAL TREATMENT FOR A DIVERSE POPULATION. 0 0 4527945 0 THE ORGANIZATION IS CURRENTLY IN THE DEVELOPMENT STAGE AND EXPECTS TO BE FULLY OPERATIONAL IN EARLY 2014. 4527945 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 5 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 0 0 CA X MELAYNE YOCUM 4242069406 4733 TORRANCE BLVD 419 TORRANCE CA 90503 X MANUAL A ABASCAL JD 6.00 X 0 0 0 PAUL KING 3.00 X 0 0 0 MICHAEL MADDEN 3.00 X 0 0 0 JAMES YOSHIOKA 3.00 X 0 0 0 GEORGINA R GARCIA RN 3.00 X 0 0 0 ROBERT MARGOLIS MD 3.00 X 0 0 0 ROBERT TRANQUADA MD 3.00 X 0 0 0 0 0 0 0 0 0 0 HOOPER LUNDY & BOOKMAN 1875 CENTURY PARK EAST STE 1600 LOS ANGELES CA 90067 LEGAL SERVICES 362282 MELAYNE YOCUM 4733 TORRANCE BLVD 419 TORRANCE CA 90503 INTERIM MANAGEMENT SERVICES 328013 THE CAMDEN GROUP 100 N SEPULVEDA BLVD STE 600 EL SEGUNDO CA 90245 CONSULTING SERVICES 133314 MILAGRO COMMUNICATIONS 249 NORTH BRAND BLVD 581 GLENDALE CA 91203 CONSULTING SERVICES 122763 4 4451789 4451789 88623 88623 1709620 1704868 4752 4752 4752 4545164 0 0 93375 3965826 3965826 341373 341373 34541 34541 5348 5348 12038 12038 952 952 23311 23311 27750 27750 FISCAL INTERMEDIARY FEE 71153 71153 MEMBERSHIP DUES AND SUB 20594 20594 TELEPHONE 20141 20141 OTHER COSTS 4918 4918 4527945 0 4527945 0 30000 1202812 9947014 16126439 685205 0 10406 42695 12812 0 0 12812 10672625 17384758 88963 1183927 10581226 16129437 10670189 17313364 X 2436 71394 2436 71394 10672625 17384758 X 17219 51739 X X 0 1 0 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 12812 12812 12812 4545164 4527945 17219 51739 51739 68958 4545164 0 4545164 0 4545164 4527945 0 4527945 0 4527945 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: 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, 2012. ORGANIZATION'S MISSION PART I SUMMARY THE SPECIFIC PURPOSE OF THIS CORPORATION IS TO ORGANIZE AND OPERATE A GENERAL ACUTE CARE HOSPITAL (THE "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. 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 INTERIM CEO 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 AS A NEW START UP ENTITY, WHEN THE BOARD BEGAN THE PROCESS TO ENGAGE AN INTERIM CEO, THEY ENGAGED THE SERVICES OF A SEARCH FIRM TO ASSIST THEM IN DETERMINING THE COMPENSATION FOR SUCH AN INDIVIDUAL. BASED UPON RECENT SALARY SURVEYS PERFORMED BY INDUSTRY ORGANIZATIONS, THE COMPENSATION WAS SET FOR THE INTERIM CEO. THE BOARD MADE THIS DETERMINATION AFTER CONSULTATION WITH THE EXECUTIVE SEARCH FIRM AND REVIEWING THE SALARY SURVEY DATA THEY PROVIDED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 51,739. AUDIT COMMITTEE AND OVERSIGHT FORM 990, PART XII, LINE 2C THE ORGANIZATION'S FIRST YEAR OF OPERATIONS IS EXPECTED TO COMMENCE IN 2014; THEREFORE, THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR. OPERATION OF HOSPITAL FORM 990, PART IV, LINE 20A THE ORGANIZATION IS CURRENTLY IN THE DEVELOPMENT STAGE AND EXPECTS TO BE FULLY OPERATIONAL IN 2014. THEREFORE, WE HAVE MARKED "NO" TO 990, PART IV, LINE 20 AS THE HOSPITAL FACILITY IS NOT CURRENTLY IN OPERATION.