LOMA LINDA UNIVERSITY PATHOLOGY MEDICAL GROUP INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
LOMA LINDA UNIVERSITY PATHOLOGY MEDICAL GROUP INC (EIN 95-4083895)
Tax period
2012-07-01 to 2013-06-30
Filed
2013-11-07
IRS object ID
201343119349302044
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-07T18:10:08-06:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN770549163EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SOREN MCADAM CHRISTENSON LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12068 ORANGE TREE LANE SUITE 100AddressLine1
CityREDLANDSCity
StateCAState
ZIP Code92374ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN954083895EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LOMA LINDA UNIVERSITY PATHOLOGY MEDICAL GROUP INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLOMANameControl
Phone9095806422Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1740AddressLine1
CityLOMA LINDACity
StateCAState
ZIP Code923540240ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBRIAN BULL MDName
TitleDIRECTOR/PRESIDENTTitle
Phone9095586422Phone
Date Signed2013-11-01DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKIRK G STITTName
PTINP00167187PTIN
Phone9097982222Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBRIAN BULL MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line111234 ANDERSON STAddressLine1
CityLOMA LINDACity
StateCAState
ZIP Code92354ZIPCode
FieldValueIRS element (for citing)
Gross Receipts11683769GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1986YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionCOORDINATION OF THE CLINICAL PRACTICE PROGRAM OF THE CLINICAL FACULTY OF THE PATHOLOGY DEPARTMENT OF THE LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE IN THEIR UNIVERSITY SPONSORED AND UNIVERSITY AUTHORIZED FACULTY PRACTICE ACTIVITY AND TO ENHANCE THEIR EDUCATION AND RESEARCH ENDEAVORS. THE PROMOTION OF HEALTH BY THE PERFORMANCE OF MEDICAL CARE SERVICES FOR THE PUBLIC WITHOUT PROFIT TO ANY INDIVIDUAL.ActivityOrMissionDescription
Nbr Voting Members Governing Body5NbrVotingMembersGoverningBody
Nbr Independent Voting Members3NbrIndependentVotingMembers
Total Nbr Employees31TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2012000ContributionsGrantsPriorYear
Contributions Grants Current Year3049160ContributionsGrantsCurrentYear
Program Service Revenue Prior Year9339858ProgramServiceRevenuePriorYear
Program Service Revenue CY8430351ProgramServiceRevenueCY
Investment Income Prior Year57323InvestmentIncomePriorYear
Investment Income Current Year76758InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year127500OtherRevenueCurrentYear
Total Revenue Prior Year11409181TotalRevenuePriorYear
Total Revenue Current Year11683769TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year73221GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY80170GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6691609SalariesEtcPriorYear
Salaries Etc Current Year6397747SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4972652OtherExpensePriorYear
Other Expenses Current Year4837082OtherExpensesCurrentYear
Total Expenses Prior Year11737482TotalExpensesPriorYear
Total Expenses Current Year11314999TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-328301RevenuesLessExpensesPriorYear
Revenues Less Expenses CY368770RevenuesLessExpensesCY
Total Assets BOY6177562TotalAssetsBOY
Total Assets EOY6575142TotalAssetsEOY
Total Liabilities BOY1202660TotalLiabilitiesBOY
Total Liabilities EOY1231470TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4974902NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5343672NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionCOORDINATION OF THE CLINICAL PRACTICE PROGRAM OF THE CLINICAL FACULTY OF THE PATHOLOGY DEPARTMENT OF THE LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE IN THEIR UNIVERSITY SPONSORED AND UNIVERSITY AUTHORIZED FACULTY PRACTICE ACTIVITY AND TO ENHANCE THEIR EDUCATION AND RESEARCH ENDEAVORS. THE PROMOTION OF HEALTH BY THE PERFORMANCE OF MEDICAL CARE SERVICES FOR THE PUBLIC WITHOUT PROFIT TO ANY INDIVIDUAL.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense7526276Expense
Grants80170Grants
Revenue8046216Revenue
DescriptionPATIENT CARE ACCOMPLISHMENT 49,167 CLIENTS SERVED ($38,330 CHARITY CARE) ACTIVITY ACCOMPLISHMENT PROVIDE MEDICAL CARE TO ALL THE SICK AND INJURED WHO MAY COME FOR DIAGNOSIS, TREATMENT, AND CARE WITHOUT REGARD TO RACE, COLOR, CREED, SEX, AGE OR ABILITY TO PAY.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense1934325Expense
Revenue284077Revenue
DescriptionTEACHING ACCOMPLISHMENT; PROVIDED PROFESSORS TO TEACH PATHOLOGY, IMMUNOLOGY, RELIGION, HISTOLOGY, CELLULAR AND MOLECULAR BIOLOGY COURSES TO LLU SCHOOL OF MEDICINE AND LLU SCHOOL OF ALLIED HEALTH FOR TRAINING DOCTORS, CYTOLOGIST AND CLINICAL LABORATORY SCIENTISTSDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense1127025Expense
Revenue227558Revenue
DescriptionRESEARCH AND CTTR PROGRAM ACCOMPLISHMENT PROVIDED SUBSCRIPTION "A" (232 SUBSCRIBERS), SUBSCRIPTION "B" (152 SUBSCRIBERS) AND SUBSCRIPTION "C" 66 SUBSCRIBERS) IN ADDITION, THE CTTR PROGRAM HOSTED TWO SEPARATE SEMINARS TO 266 PARTICIPANTS; ACTIVITY OBJECTIVE - THE GROUP GIVES LECTURES AND PUBLISH INFORMATION CONCERNING PATHOLOGICAL PROBLEMS AND RESEARCH RESULTS IN ORDER TO EDUCATE MEDICAL PROFESSIONALS ON SUCH PROBLEMS; THEY PUBLISHED 18 RESEARCH ABSTRACTS, 32 ARTICLES IN PEER REVIEW MEDICAL JOURNALS AND PUBLISHED 12 WEB-BASED PUBLICATIONS; THEY WROTE 2 BOOK CHAPTERS AND 1 BOOK REVIEW. THEY SERVED AS PRIMARY INVESTIGATOR ON 12 PROJECTS AND AS CO-INVESTIGATORS ON 20 PROJECTS.Description
FieldValueIRS element (for citing)
Total Program Service Expense10587626TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations1MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10969NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees31NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form8899 Filed0Form8899Filed
Form1098 C Filed0Form1098CFiled
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members5NbrVotingGoverningBodyMembers
Number Independent Voting Members3NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ATTN LISA PREVITE LOMA LINDA UNIV PATHOLOGY MEDICALBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9095585170TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11911 WEST PARK AVEAddressLine1
CityREDLANDSCity
StateCAState
ZIP Code92373ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (11 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
RICARDO PEVERINI MD
CHAIRPERSON1.00X000
BRIAN BULL MD
DIRECTOR/PRESIDENT30.00X219527017299X
DARRYL HEUSTIS MD
DIRECTOR/CFO40.00X216343024068X
DAVID HINSHAW MD
DIRECTOR1.00X000
LEONARD WERNER MD
DIRECTOR1.00X000
JEFF CAO MD
SECRETARY40.00205632040564X
MIA PEREZ MD
PHYSICIAN50.00222956037564X
GEORGE SAUKEL MD
PHYSICIAN50.00240678039116X
CRAIG ZUPPAN MD
PHYSICIAN50.00271531043729X
JUN WANG MD
PHYSICIAN50.00234786043254X
KEVIN THOMPSON MD
PHYSICIAN50.00239766037754X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1851219TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation283348TotalOtherCompensation
Number Individuals GT100 K23NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LOMA LINDA UNIVERSITY HEALTH CARE
11175 CAMPUS STREET ROOM 11120LOMA LINDACA92350EMPLOYEE LEASING & MEDICAL BILLING3589144
IM TECHNOLOGIES INC
613 VIA HORQUILLAPALOS VERDES ESTATESCA90274HISTOCOMPATIBILITY LAB SUPERVISION125000
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
All Other Contributions3049160AllOtherContributions
Total Contributions3049160TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT REVENUE - NET62150055164865516486
DIRECTORS' FEES62150021205322120532
SALARY AND LEASED LABOR REIMBURSE621500397638397638
CTTR AND TEACHING621500243555243555
CAPITATION621500152140152140
FieldValueIRS element (for citing)
Total Program Service Revenue8430351TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column76758TotalRevenueColumn
Exclusion$76,758ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMEANINGFUL USE EMR INCENTIVEDescription
Business Code621500BusinessCode
Total Revenue Column127500TotalRevenueColumn
Related Or Exempt Function Income127500RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue127500TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column11683769TotalRevenueColumn
Related Or Exempt Function Income8557851RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$76,758ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total80170Total
Program Services80170ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total723433Total
Program Services445832ProgramServices
Management And General277601ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total4388039Total
Program Services4388039ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total644178Total
Program Services610935ProgramServices
Management And General33243ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total391388Total
Program Services377479ProgramServices
Management And General13909ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total250709Total
Program Services238150ProgramServices
Management And General12559ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total34093Total
Program Services7910ProgramServices
Management And General26183ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total53408Total
Program Services45396ProgramServices
Management And General8012ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total37478Total
Program Services31683ProgramServices
Management And General5795ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total169030Total
Program Services160222ProgramServices
Management And General8808ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total139222Total
Program Services139222ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total158711Total
Program Services153628ProgramServices
Management And General5083ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CONTRACT LABOR27341822411566322616
FEE ASSESSMENT649375649375
EDUCATION & RESEARCH323852323852
PURCHASED MEDICAL SERVI146030146030

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total391701Total
Program Services378137ProgramServices
Management And General13564ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total11314999Total
Program Services10587626ProgramServices
Management And General727373ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY308131BOY
EOY179769EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY110300BOY
EOY110396EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1092935BOY
EOY1098078EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY9850BOY
EOY6126EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis3690684LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec878412LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY2937830BOY
EOY2812272EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1623926BOY
EOY2200631EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY94590BOY
EOY167870EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6177562BOY
EOY6575142EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1144859BOY
EOY1165970EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY57801BOY
EOY65500EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1202660BOY
EOY1231470EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4831556BOY
EOY5204826EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY143346BOY
EOY138846EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4974902BOY
EOY5343672EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6177562BOY
EOY6575142EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses368770ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (2 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
LLU SCHOOL OF MEDICINE
9518160092011$68,670
LLU MEDICAL CENTER
9535226793011$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs2TotalNumberOfSupportedOrgs
Sum Of Amounts68670SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis713400OtherCostOrOtherBasis
Book Value713400BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2022681OtherCostOrOtherBasis
Depreciation150366Depreciation
Book Value1872315BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis237796OtherCostOrOtherBasis
Depreciation118918Depreciation
Book Value118878BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis591465OtherCostOrOtherBasis
Depreciation489878Depreciation
Book Value101587BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis125342OtherCostOrOtherBasis
Depreciation119250Depreciation
Book Value6092BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2812272TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionLLU FOUNDATION INVESTMENT POOLSDescription
Book Value2200631BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities2200631TotalOfBookValueSecurities
Tot Revenue Etc Audited Fincl Stmt11683769TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal11683769RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99011683769TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt11314999TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal11314999ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99011314999TotalExpensesPerForm990

Schedule F IRS990ScheduleF

FieldValueIRS element (for citing)
Grant Records Maintained1GrantRecordsMaintained
Subtotal Number Of Offices0SubtotalNumberOfOffices
Subtotal Number Of Employees0SubtotalNumberOfEmployees
Cont Number Of Offices0ContNumberOfOffices
Cont Number Of Employees0ContNumberOfEmployees
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees0TotalNumberOfEmployees
Subtotal Amount Spent0SubtotalAmountSpent
Cont Amount Spent0ContAmountSpent
Total Amount Spent0TotalAmountSpent

Grants To Orgs Outside US GrantsToOrgsOutsideUS

FieldValueIRS element (for citing)
RegionEUROPE (INCLUDING ICELAND & GREENLAND) -Region
Purpose Of Grant2013 RED CELLS GORDON RESEARCH SEMINAR AND RED CELLS GORDON RESEARCH CONFERENCE.PurposeOfGrant
Amount Of Cash Grant10000AmountOfCashGrant
Manner Of Cash DisbursementCASH PAYMENTMannerOfCashDisbursement
FieldValueIRS element (for citing)
Total Number Of501c3 Orgs0TotalNumberOf501c3Orgs
Total Number Of Other Orgs1TotalNumberOfOtherOrgs
Transfer To Foreign Corp0TransferToForeignCorp
Interest In Foreign Trust0InterestInForeignTrust
Own Foreign Corp0OwnForeignCorp
Passive Foreign Invest Co0PassiveForeignInvestCo
Foreign Partnership0ForeignPartnership
Boycott Countries0BoycottCountries

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
11175 CAMPUS STREET CP A-1108LOMA LINDACA92350951816009501(C)(3)68670EDUCATIONAL
ADVENTIST HEALTH INTERNATIONAL
11060 ANDERSON STREETLOMA LINDACA92350330940020501(C)(3)1500EDUCATIONAL

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
BRIAN BULL MD
DIRECTOR/PRESIDENT219527000000017299023682601661620
DARRYL HEUSTIS MD
DIRECTOR/CFO216343000002250001568024041102299920
JEFF CAO MD
SECRETARY2056320000022500018064024619602325530
MIA PEREZ MD
PHYSICIAN2229560000017000020564026052002337700
GEORGE SAUKEL MD
PHYSICIAN2406780000022500016616027979402496300
CRAIG ZUPPAN MD
PHYSICIAN2715310000022500021229031526002539700
JUN WANG MD
PHYSICIAN2347860000022500020754027804002480610
KEVIN THOMPSON MD
PHYSICIAN2397660000017000020754027752002387700

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATIONS TAX RETURNS ARE HAND DELIVERED TO EACH MEMBER OF THE BOARD OF DIRECTORS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CBECAUSE THIS IS AN ACADEMIC HEALTH CENTER WITH INTERLOCKING BOARDS THERE ARE CONFLICT OF INTEREST POLICIES THAT COVER THE ENTIRE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 15EVERY QUARTER THE CEO, CFO, AND SECRETARY REVIEW THE COMPENSATION OF EVERY EMPLOYEE AGAINST A MATRIX.
FORM 990, PART VI, SECTION C, LINE 19AVAILABLE UPON REQUEST
THERE HAVE NOT BEEN ANY CHANGES IN THE CURRENT YEAR IN REGARDS TO THE ORGANIZATION HAVING A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
11175 CAMPUS STLOMA LINDACA92354951816009SCHOOL OF MEDICINECA501(C)(3)170(B)(1)(A)(I)N/A0
LOMA LINDA UNIVERSITY MEDICAL CENTER
11175 CAMPUS STLOMA LINDACA92354953522679HOSPITALCA501(C)(3)170(B)(1)(A)(V)N/A0
LOMA LINDA UNIVERSITY HEALTH CARE
11175 CAMPUS STLOMA LINDACA92354330364239HEALTH CARE MANAGEMENT SERVICE ORGANIZATIONCA501(C)(3)509(A)(3) TYPE IN/A0
ADVENTIST HEALTH SYSTEMS LOMA LINDA
11175 CAMPUS STLOMA LINDACA92354953484589CHURCHCA501(C)(3)170(B)(1)(A)(I)N/A0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (13 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
B68670CASH
LOMA LINDA UNIVERSITY HEALTH CENTER
N587125CASH
LOMA LINDA UNIVERSITY HEALTH CENTER
K95592CASH
LOMA LINDA UNIVERSITY HEALTH CENTER
O2864020CASH
LOMA LINDA UNIVERSITY HEALTH CENTER
P14969CASH
LOMA LINDA UNIVERSITY HEALTH CENTER
L152140CASH
LOMA LINDA UNIVERSITY MEDICAL CENTER
L2120532CASH
LOMA LINDA UNIVERSITY MEDICAL CENTER
O163957CASH
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
C3049160CASH
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
O144000CASH
ADVENTIST HEALTH SYSTEMS LOMA LINDA
P484922CASH
LOMA LINDA UNIVERSITY MEDICAL CENTER
P95097CASH
LOMA LINDA UNIVERSITY HEALTH CENTER
S191631CASH

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