2022-05-13T17:17:14-05:00 2021-06-30 330700332 VASQUEZ & CO LLP 655 N CENTRAL AVE STE 1550 GLENDALE CA 91203 990 2020-07-01 951690966 PEDIATRIC & FAMILY MEDICAL CENTER DBA EISNER HEALTH PEDI 2137461037 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 WARREN J BRODINE PRESIDENT/CEO 2137475542 2022-05-13 1 WARREN BRODINE 999009999 REGINA PRINCE CPA P00576936 2138731700 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z WARREN J BRODINE 1530 S OLIVE ST LOS ANGELES CA 90015 65853789 0 X WWW.EISNERHEALTH.ORG X 1920 CA EISNER HEALTH IS A QUALITY-FOCUSED FEDERALLY QUALIFIED HEALTH CENTER DEDICATED TO IMPROVING THE PHYSICAL, SOCIAL AND EMOTIONAL WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE, REGARDLESS OF INCOME. 9 9 509 9 0 0 6701819 17045650 47234521 48735240 4325 21373 226992 0 54167657 65802263 0 0 0 0 35428324 35522797 0 0 269897 16861532 17052600 52289856 52575397 1877801 13226866 43286777 50940781 14552265 8899081 28734512 42041700 X EISNER HEALTH IS A QUALITY-FOCUSED, FEDERALLY QUALIFIED NONPROFIT COMMUNITY HEALTH CENTER DEDICATED TO IMPROVING THE PHYSICAL, SOCIAL, AND EMOTIONAL WELL-BEING OF PEOPLE IN THE COMMUNITIES WE SERVE, REGARDLESS OF INCOME. 0 0 34197207 42364404 MEDICAL CARE- PHYSICAL EXAMS- IMMUNIZATIONS- GYNECOLOGY SERVICES- COUNSELING- PREVENTATIVE MEDICINE- DIAGNOSIS AND MANAGEMENT OF ACUTE AND CHRONIC DISEASES- DIAGNOSIS AND CARE DURING PREGNANCY- OFFICE DERMATOLOGY TOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 36,496.SEE SCHEDULE O 3490505 2865241 DENTAL CARE- PREVENTATIVE DENTAL EXAMS- DIAGNOSIS AND TREATMENT OF DENTAL AND GUM PROBLEMS- ORTHODONTIC SERVICESTOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 7,912. 3360283 3505595 MENTAL HEALTH CARE, PHARMACEUTICAL SERVICES, AND OPTOMETRY SERVICES- INDIVIDUAL THERAPY- FAMILY THERAPY- GROUP THERAPY- CASE MANAGEMENT- WORKSHOPS- PARENTING CLASSES- DISPENSING PHARMACEUTICALS TO PATIENTS- SUPPLYING CLINICAL DEPARTMENTS- OPTOMETRY SERVICES, DIETARY SERVICES, OTHER ENABLING SERVICES TOTAL NUMBER OF PATIENTS SERVED DURING THE YEAR WAS 4,481 (949 MENTAL HEALTH, 532 DIETARY, 1,013 OPTOMETRY, 2,087 ENABLING). 41047995 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 53 0 1 509 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 CA X SERGEY NAVOLNEV 2137475542 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 STANLEY P BERKMAN CHAIRMAN 1.00 2.00 X X 0 0 0 IAN C WIENER ESQ TREASURER 1.00 X X 0 0 0 IRMA AVILA SECRETARY 1.00 X X 0 0 0 ALEJANDRA ROSAS BOARD MEMBER 1.00 X 0 0 0 VICTOR AGUIRRE BOARD MEMBER 1.00 X 0 0 0 RUPERT GRANT VICE CHAIRMAN 1.00 1.00 X X 0 0 0 ED MATHEWS CONSUMER VICE-CHAIR 1.00 X X 0 0 0 KEVIN ROSSI IMMEDIATE PAST CHAIR 1.00 1.00 X 0 0 0 MARTINE SINGER BOARD MEMBER 1.00 X 0 0 0 WARREN J BRODINE PRESIDENT & CEO 40.00 2.00 X 335349 0 24844 CHONA DE LEON SR. VP/COO (RETIRED 02/26/21) 40.00 X 288237 0 23844 SERGEY NAVOLNEV CFO 40.00 X 171666 0 17470 MONICA GUTIERREZ-MCCARTHY VP/COO (STARTED 03/29/21) 40.00 X 0 0 0 KAREN BOSTON DIRECTOR OF ADULTS 40.00 X 178315 0 11944 LUIS LOPEZ DIRECTOR OF PEDIATRICS 40.00 X 250775 0 14018 DEBORAH LERNER VP CHIEF MEDICAL OFFICER 40.00 X 278449 0 20336 NATHANA LURVEY DIRECTOR OF OB/GYN 40.00 X 312817 0 8550 DANNY DAN PHYSICIAN (OB/GYN) 40.00 X 349988 0 14844 LILIAN MORRIS PHYSICIAN (OB/GYN) 40.00 X 332670 0 8550 ANTHONY PICKETT PHYSICIAN (OB/GYN) 40.00 X 312892 0 14844 NICOLAS DIKIO PHYSICIAN (OB/GYN) 40.00 X 261976 0 14534 EMILIANO CHAVIRA PHYSICIAN (OB/GYN) 40.00 X 275858 0 8449 3348992 0 182227 81 0 1 0 HEALTH INFORMATION TECHNOLOGY CARE LLC 1310 REDWOOD WAY STE 125 PETALUMA CA 94954 IT SERVICES 892338 RPS CAPITAL INVESTMENTS 15477 VENTURA BLVD STE 202 SHERMAN OAKS CA 91403 OFFICE RENT 710208 GRAND AVENUE MEDICAL JOINT VENTURE 135 N LOS ROBLES STE 600 PASADENA CA 91101 OFFICE RENT 461825 SP IV LOKER I LLC 600 WASHINGTON AVE STE 1100 ST LOUIS MO 63101 OFFICE RENT 393694 GREG FACKTOR & ASSOCIATES 316 N ROSSMORE AVE STE 505 LOS ANGELES CA 90004 CONSULTING 392058 10 137874 14148970 2758806 229611 17045650 NET PATIENT SERVICE REVENUES 624190 37076787 37076787 CAPITATION 624190 6542547 6542547 MEDICAL CONTRACTUAL SERVICES 624190 4048567 4048567 PATIENT INCENTIVES 624190 794521 794521 OTHER PROGRAM REVENUE 624190 272818 272818 48735240 21373 21373 51526 137874 51526 0 65802263 48735240 0 21373 X 1939461 1621624 308581 9256 28922931 24246752 4534966 141213 861618 679897 179625 2096 1912429 1603233 299859 9337 1886358 1577756 299320 9282 103184 103184 112990 112990 2901 2901 3502387 1732517 1742059 27811 40509 6885 33624 2213501 1399822 811031 2648 4063537 2680659 1382878 284415 251307 32213 895 28376 19512 8824 40 108856 57883 50973 1259167 1259167 1098259 966342 131917 TEMPORARY LABOR 1629691 1460640 169051 MEDICAL SUPPLIES 906146 906146 COMPUTER EXPENSES 471281 64574 404263 2444 SECURITY 326929 30765 296164 900471 482514 353082 64875 52575397 41047995 11257505 269897 6465905 635559 2164707 12438924 1432867 2692682 15383690 17236186 321035 580494 588171 764034 33200962 18208700 15529487 14992262 252036 460279 869823 869823 279056 270538 43286777 50940781 5654858 6560747 1164742 1773500 1173592 7123907 0 14552265 8899081 X 28073887 40391610 660625 1650090 28734512 42041700 43286777 50940781 13226866 80322 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 952246 952246 22185608 9632219 12553389 10063108 8576481 1486627 14992262 X 66327441 80322 565205 645527 65681914 2901 117448 120349 65802263 52572496 0 52572496 2901 2901 52575397 PART X, LINE 2: EISNER AND ITS AFFILIATE ARE NONPROFIT CORPORATIONS EXEMPT FROM THE PAYMENT OF INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701D. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES. THE ORGANIZATION HAS EVALUATED ITS TAX POSITIONS AND THE CERTAINTY AS TO WHETHER THOSE POSITIONS WILL BE SUSTAINED IN THE EVENT OF ANY AUDIT BY TAXING AUTHORITIES AT THE FEDERAL AND STATE LEVELS. THE PRIMARY TAX POSITIONS EVALUATED RELATE TO THE ORGANIZATION'S CONTINUED QUALIFICATION AS A TAX-EXEMPT ORGANIZATION AND WHETHER THERE ARE UNRELATED BUSINESS INCOME ACTIVITIES THAT WOULD BE TAXABLE. MANAGEMENT HAS DETERMINED THAT ALL INCOME TAX POSITIONS WILL MORE LIKELY THAN NOT BE SUSTAINED UPON POTENTIAL AUDIT OR EXAMINATION; THEREFORE, NO DISCLOSURES OF UNCERTAIN INCOME TAX POSITIONS ARE REQUIRED. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT INCOME FROM AFFILIATES 565,205. PART XI, LINE 4B - OTHER ADJUSTMENTS: INTERCOMPANY REVENUE 117,448. X VIRTUAL GALA FUNDRAISER 189400 137874 51526 817 17075 33634 189400 137874 51526 817 17075 33634 51526 0 X X 0 0 0 0 0 0 0 0 0 DANNY DAN PHYSICIAN (OB/GYN) 349265 0 400 0 323 0 8550 0 6294 0 364832 0 0 0 WARREN J BRODINE PRESIDENT & CEO 287246 0 34200 0 13903 0 18550 0 6294 0 360193 0 0 0 LILIAN MORRIS PHYSICIAN (OB/GYN) 329227 0 400 0 3043 0 8550 0 0 0 341220 0 0 0 ANTHONY PICKETT PHYSICIAN (OB/GYN) 312228 0 400 0 264 0 8550 0 6294 0 327736 0 0 0 NATHANA LURVEY DIRECTOR OF OB/GYN 298476 0 3850 0 10491 0 8550 0 0 0 321367 0 0 0 CHONA DE LEON SR. VP/COO (RETIRED 02/26/21) 255630 0 24916 0 7691 0 17550 0 6294 0 312081 0 0 0 DEBORAH LERNER VP CHIEF MEDICAL OFFICER 244286 0 26291 0 7872 0 17550 0 2786 0 298785 0 0 0 EMILIANO CHAVIRA PHYSICIAN (OB/GYN) 274420 0 400 0 1038 0 8449 0 0 0 284307 0 0 0 NICOLAS DIKIO PHYSICIAN (OB/GYN) 261261 0 400 0 315 0 8244 0 6290 0 276510 0 0 0 LUIS LOPEZ DIRECTOR OF PEDIATRICS 218098 0 30170 0 2507 0 7724 0 6294 0 264793 0 0 0 KAREN BOSTON DIRECTOR OF ADULTS 171092 0 4988 0 2235 0 5650 0 6294 0 190259 0 0 0 SERGEY NAVOLNEV CFO 151143 0 20000 0 523 0 11176 0 6294 0 189136 0 0 0 X 1 7867 AVE. PRICE ON VALUATION X 1 182244 REPLACEMENT COST X COMPUTER 1 39500 COMPARABLE SALES 0 0 0 FORM 990 PART III LINE 4A PEDIATRIC AND FAMILY MEDICAL CENTER, DOING BUSINESS AS EISNER HEALTH (EISNER OR THE CENTER), IS A FEDERALLY QUALIFIED NON-PROFIT COMMUNITY HEALTH CENTER DEDICATED TO IMPROVING THE PHYSICAL, SOCIAL, AND EMOTIONAL WELL-BEING OF PEOPLE IN THE COMMUNITIES THEY SERVE. EISNER PROVIDES A WIDE RANGE OF SERVICES TO LOW AND MODERATE-INCOME RESIDENTS OF LOS ANGELES COUNTY, REGARDLESS OF THEIR ABILITY TO PAY. IT IS ALSO CERTIFIED AS A MEDI-CAL PROVIDER AND PROVIDES PEDIATRIC AND ADULT SERVICES SUCH AS PRENATAL CARE, CHILDHOOD EDUCATION, DENTAL AND ANCILLARY SERVICES, INCLUDING AN ONSITE PHARMACY, AS WELL AS CASE MANAGEMENT AND SOCIAL WORK. EISNER ALSO OPERATES A FAMILY PRACTICE RESIDENCY PROGRAM IN COOPERATION WITH THE PROHEALTH PARTNERS AND DIGNITY HEALTH DBA CALIFORNIA HOSPITAL MEDICAL CENTER AND PROVIDES PROFESSIONAL MEDICAL OBSTETRICS/GYNECOLOGY (OB/GYN) SERVICES TO MARTIN LUTHER KING COMMUNITY HOSPITAL PATIENTS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CFO, THEN IT IS GIVEN TO ALL BOARD MEMBERS FOR FINAL REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY COVERING THE BOARD OF DIRECTORS, OFFICERS AND EXECUTIVE MANAGEMENT. THIS CONFLICT OF INTEREST POLICY ESTABLISHES PROCEDURES TO IDENTIFY AND DEAL WITH THE CIRCUMSTANCES AND RELATIONSHIPS AFFECTING DIRECTORS AND MANAGERS OF EISNER THAT MAY GIVE RISE TO ACTUAL OR PERCEIVED CONFLICTS OF INTEREST. IT DOES SO BY: (A) IDENTIFYING SPECIFIC TYPES OF TRANSACTIONS AND RELATIONSHIPS WHICH ARE MOST LIKELY TO RAISE QUESTIONS OF CONFLICT OF INTEREST FOR SUCH INDIVIDUALS; AND (B) ESTABLISHING PROCEDURES FOR DISCLOSURE AND RESOLUTION OF POTENTIAL CONFLICTS THAT ARE DESIGNED TO: (1) PROTECT BOTH THE INDIVIDUALS SUBJECT TO THE POLICY AND EISNER FROM LEGAL AND OTHER COMPLICATIONS THAT MIGHT OTHERWISE ARISE; AND (2) PRESERVE THE ABILITY OF PERSONS SUBJECT TO THE POLICY TO EFFECTIVELY SERVE EISNER, NOTWITHSTANDING THE EXISTENCE OF OTHER RELATIONSHIPS BETWEEN SUCH INDIVIDUALS (OR CLOSE FAMILY MEMBERS) AND OTHER ORGANIZATIONS THAT MAY BE IDENTIFIED AS POTENTIAL CONFLICTING INTERESTS. THE EISNER'S BOARD OF DIRECTORS MUST APPROVE ANY TRANSACTION IN WHICH A DIRECTOR OR MANAGER OR A RELATED PERSON OR ORGANIZATION HAS A MATERIAL FINANCIAL INTEREST ACCORDING TO THE FOLLOWING PROCEDURE: 1. ANY DIRECTOR OR MANAGER WHO BECOMES AWARE THAT HE OR SHE (OR RELATED PERSON OR ORGANIZATION) HAS A MATERIAL FINANCIAL INTEREST IN ANY AGENCY TRANSACTION SHALL PROMPTLY NOTIFY EISNER'S PRESIDENT OR THE CHAIRMAN OF THE BOARD OF DIRECTORS. 2. THE PRESIDENT AND CHAIRMAN OF THE BOARD SHALL TAKE STEPS TO ASSURE THAT THE PROPOSED TRANSACTION IS NOT ENTERED INTO UNTIL SUCH TIME AS THE SPECIAL REVIEWER COMMITTEE (SRC) OR BOARD OF DIRECTORS HAS REVIEWED AND APPROVED THE TRANSACTION AND ANY NECESSARY CONSULTATION WITH LEGAL COUNSEL HAVE BEEN OBTAINED. 3. THE INDIVIDUAL HAVING SUCH CONFLICT SHALL MAKE FULL DISCLOSURE TO THE SRC OR THE BOARD OF THE MATERIAL FACTS OF THE TRANSACTION AND HIS OR HER INTEREST (OR THE INTEREST OF ANY RELATED PERSON OR ORGANIZATION THEREIN PRIOR TO ACTION BY THE SRC OR BOARD WITH RESPECT TO SUCH TRANSACTION. 4. BEFORE APPROVING SUCH TRANSACTION, THE SRC OR BOARD SHALL DETERMINE IN GOOD FAITH, AFTER REASONABLE INVESTIGATION THAT THE TRANSACTION IS FAIR AND REASONABLE; EISNER COULD NOT HAVE OBTAINED A MORE ADVANTAGEOUS ARRANGEMENT WITH REASONABLE EFFORT UNDER THE CIRCUMSTANCES; AND THE TRANSACTION IS IN THE BEST INTEREST OF EISNER. 5. THE SRC OR THE BOARD MUST THEN APPROVE THE TRANSACTION BY A MAJORITY OF VOTE OF THE SRC OR THE BOARD MEMBERS THEN IN OFFICE, WITHOUT COUNTING THE VOTE OF ANY INTERESTED DIRECTOR. THE CONSEQUENCES OF ANY VIOLATION MAY RESULT IN THE TAKING OF APPROPRIATE DISCIPLINARY ACTION UP TO AND INCLUDING DISCHARGE FROM THE BOARD OR EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS HAS A PROCESS FOR REVIEWING AND APPROVING THE COMPENSATION OF THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES ON A REGULAR BASIS TO DETERMINE IT IS FAIR AND REASONABLE WITH THE GOAL OF RETAINING EMPLOYEES AT COMPENSATION LEVELS WITHIN APPROPRIATE MARKET RANGE. THE GOVERNANCE COMMITTEE OF THE BOARD RELIED ON A COMPENSATION STUDY CONDUCTED BY AN INDEPENDENT VALUATION FIRM IN DETERMINING THEIR RECOMMENDATIONS. THE RESULTS OF THE STUDY WERE PRESENTED TO THE FULL BOARD BY THE GOVERNANCE COMMITTEE, AND THE FULL BOARD VOTED ON THE COMPENSATION OFFERED TO THE CEO, CFO, AND OTHER KEY EMPLOYEES. THE ORGANIZATION'S BOARD OF DIRECTORS CONTEMPORANEOUSLY DOCUMENTED ITS DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS, INCLUDING WHO WAS PRESENT, HOW THEY VOTED, A DESCRIPTION OF THE COMPARABILITY DATE AND HOW IT WAS OBTAINED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G OUTSIDE PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 1,013,320. MANAGEMENT AND GENERAL EXPENSES 404,448. FUNDRAISING EXPENSES 21,597. TOTAL EXPENSES 1,439,365. PAYROLL PROCESSING FEE: PROGRAM SERVICE EXPENSES 159,081. MANAGEMENT AND GENERAL EXPENSES 28,980. FUNDRAISING EXPENSES 894. TOTAL EXPENSES 188,955. CONSULTANT: PROGRAM SERVICE EXPENSES 560,116. MANAGEMENT AND GENERAL EXPENSES 1,308,631. FUNDRAISING EXPENSES 5,320. TOTAL EXPENSES 1,874,067. FORM 990, PART IX, LINE 24E LAB & X-RAY EXPENSES: PROGRAM SERVICE EXPENSES 282,623. MANAGEMENT AND GENERAL EXPENSES 1,867. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 284,490. COMMUNITY/EMPLOYEE RELATIONS: PROGRAM SERVICE EXPENSES 20,789. MANAGEMENT AND GENERAL EXPENSES 149,319. FUNDRAISING EXPENSES 64,119. TOTAL EXPENSES 234,227. SUBSCRIPTION: PROGRAM SERVICE EXPENSES 43,245. MANAGEMENT AND GENERAL EXPENSES 152,145. FUNDRAISING EXPENSES 242. TOTAL EXPENSES 195,632. TAXES & LICENSES: PROGRAM SERVICE EXPENSES 77,336. MANAGEMENT AND GENERAL EXPENSES 19,673. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 97,009. EQUIPMENT REPAIRS: PROGRAM SERVICE EXPENSES 51,900. MANAGEMENT AND GENERAL EXPENSES 8,564. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 60,464. MISCELLANEOUS EXPENSES: PROGRAM SERVICE EXPENSES 6,621. MANAGEMENT AND GENERAL EXPENSES 21,514. FUNDRAISING EXPENSES 514. TOTAL EXPENSES 28,649. PEDIATRIC & FAMILY MEDICAL FOUNDATION 1530 S OLIVE STREET LOS ANGELES CA 90015 954116680 SUPPORTING ORGANIZATION CA 501(C)(3) LINE 12B, II EISNER HEALTH 1 PLUNUM HEALTH 1530 S OLIVE STREET LOS ANGELES CA 90015 831653397 SUPPORTING ORGANIZATION CA 501(C)(3) LINE 12A, I EISNER HEALTH 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PEDIATRIC & FAMILY MEDICAL FOUNDATION C 117448 BOOK