2025-05-09T14:48:37-05:00 2024-06-30 954557617 Harrington Group CPAs LLP 2698 Mataro Street Pasadena CA 91107 990 2023-07-01 953403582 QueensCare Health Alliance QUEE 3236694305 950 SOUTH GRAND AVENUE 2ND FL SOUT LOS ANGELES CA 90015 Barbara B Hines President/CEO 3236694304 2025-05-09 1 1 Sean E Cain CPA P01612986 6264036801 2023 2025-03-06 01:10:19Z Barbara B Hines 950 SOUTH GRAND AVENUE 2ND FL SOUTH LOS ANGELES CA 90015 0 0 X N/A X 1978 CA The mission of QueensCare Health Alliance is to provide healthcare to low-income residents of the County of Los Angeles and primarily to QueensCare's Primary and Secondary Service Areas and for other related purposes. 14 13 0 3 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 0 0 X Prior to January 1, 2024, the organization provided financial support to QueensCare, a California non-profit public benefit corporation, to further QueensCare's mission of providing accessible healthcare for uninsured and low-income working individuals and families. Since January 1, 2024, the organization has initiated the process of obtaining licenses to operate mobile clinics that were previously operated by a general partnership of which QueensCare was a general partner. 0 0 Support to QueensCare, a California non-profit public benefit corporation, providing accessible healthcare for uninsured and low-income working individuals and families. Since January 1, 2024, the organization has initiated the process of obtaining licenses to operate mobile clinics that were previously operated by a general partnership of which QueensCare was a general partner. 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 14 13 0 1 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 CA X X FAITH LEE 3236694345 950 SOUTH GRAND AVENUE 2ND FL SOUTH LOS ANGELES CA 90015 Alan Cushman Chair 0.10 10.00 X X 0 10000 0 Frances Inman Vice Chair 0.10 10.00 X X 0 7250 0 Barry Peterson Secretary 0.10 10.00 X X 0 4250 0 Steven Aronoff Director 0.10 2.00 X 0 7500 0 Edward Avila Director 0.10 2.00 X 0 7250 0 Joseph Bui Director 0.10 2.00 X 0 0 0 Haley English Director 0.10 2.00 X 0 6000 0 Javier Guerena Director 0.10 6.00 X 0 8000 0 Jeff Hermann Director 0.10 4.00 X 0 0 0 Rev Michael Mata Director 0.10 4.00 X 0 5000 0 Allan Michelena Director 0.10 6.00 X 0 4250 0 Denise Partamian Forgette Director 0.10 4.00 X 0 10500 0 Bettie J Woods Director 0.10 2.00 X 0 6000 0 Barbara B Hines CEO 0.10 40.00 X X 0 528804 41434 0 604804 41434 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 0 0 0 0 0 X 0 0 0 X Schedule A, Part I, line 3: The organization was originally described as a supporting organization under section 509(a)(3) of the Internal Revenue Code (the Code). Beginning in early 2024, the organization began preparing to assume the responsibility for operating mobile clinics designed to serve low income residents of Los Angeles, CA. It has submitted license applications to operate the clinics with the California Department of Public Health and will commence operation of the outpatient mobile clinics in early 2025 when it finally obtains the necessary licenses. Consequently, it now qualifies for public charity status as a hospital described in sections 509(a)(1) and 170(b)(1)(A)(iii) of the Code. See Treas. Reg. section 1.170-9(d)(1)(A)(2). Therefore, it has requested reclassification to this public charity status through Form 8940. 0 0 0 0 0 0 0 0 0 Barbara B Hines CEO 0 528804 0 0 0 0 0 29011 0 12423 0 570238 0 0 Part I, Line 3 A Compensation Committee comprised of independent Board members formulates a proposed compensation level for the CEO by reviewing recommendation of an independent compensation consultant and general compensation data for similarly situated organizations. Following such a review, the Compensation Committee presents its findings and recommendations to the Board at which Board members are provided with the opportunity to ask questions. Based on the findings and recommendations of the Compensation Committee, a Board vote is taken to establish the new compensation level for the CEO. Deliberations of the Compensation Committee and the Board are recorded in the organization's minute book. The evaluation, review, and recommendation process were last undertaken by the Compensation Committee in May 2024 and its findings and recommendations with regard to the CEO's compensation level were approved by the Board in September 2024. Form 990, Part VI, Section A, line 3 The organization delegates control over management duties to QueensCare, a California non-profit corporation which is its sole corporate member. Form 990, Part VI, Section A, line 6 QueensCare, a California non-profit, public benefit corporation is the organization's sole corporate member. Form 990, Part VI, Section A, line 7a As its sole member, QueensCare has the power and authority to appoint the organization's Board of Directors. Form 990, Part VI, Section A, line 7b In addition to the power to elect its Board of Directors QueensCare has the authority to amend the organization's Bylaws and to oversee and approve other corporate actions. Form 990, Part VI, Section B, line 11b The final draft of the organization's Form 990 is reviewed for accuracy and completeness by the organization's CEO and by the CFO of QueensCare. Details of the return are discussed at the organization's next regularly scheduled Board meeting. Form 990, Part VI, Section B, line 12c The organization's Board members and corporate officers are subject to a conflict of interest policy. Pursuant to that policy, each such person is required to identify any transaction with the organization in which the person has (or may have) a financial interest. If a conflict (or potential conflict) is identified, the Board, excluding any involved Board members carefully reviews the terms of the transaction and makes a determination as to whether the transactions is fair and reasonable to the organization under all the facts and circumstances. The organization monitors and enforces compliance with this policy by: (i) discussing such issues at its annual meeting; (ii) requiring all covered persons to annually provide written certification of their compliance with the policy; and (iii) carefully reviewing all material transactions to identify potential or real conflicts. Form 990, Part VI, Section C, line 19 The organization's annual financial report is available upon request. The organization provides copies of its governing documents, its conflict of interest policy, as well as its three most recent Forms 990 to any interested person that makes a request for such documents. The organization's Forms 990 for its three most recent years are also available on a third party's website, guidestar.org. QueensCare 950 South Grand Avenue 2nd Floor So Los Angeles CA 90015 951644040 CA 501(c) Line 3 St Joseph's Health Support Alliance 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0