2025-11-17T09:13:48-06:00 2024-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2024-01-01 942422439 PACIFIC VISION FOUNDATION PACI 4153931225 711 VAN NESS AVENUE 260 SAN FRANCISCO CA 94102 JAMES CHANG INTERIM CEO 4153931225 2025-11-14 1 1 MICHAEL LUMSDEN P01262236 4159561500 2025-11-14 2024 2025-03-06 01:10:19Z JAMES CHANG 711 VAN NESS AVENUE 260 SAN FRANCISCO CA 94102 5738394 0 X WWW.PACIFICVISIONFOUNDATION.ORG X 1977 CA PVF IS DEDICATED TO EXCELLENT EYE CARE FOR ALL REGARDLESS OF ABILITY TO PAY. 17 14 8 20 -510299 0 1403148 1684939 0 195000 298410 453612 -215503 -632701 1486055 1700850 166663 0 0 0 1172379 1402836 0 0 325562 794831 1097768 2133873 2500604 -647818 -799754 44996012 44359285 23657874 23505963 21338138 20853322 EXCELLENT EYE CARE FOR ALL REGARDLESS OF ABILITY TO PAY. PACIFIC VISION FOUNDATION IS DEDICATED TO IMPROVING HEALTH EQUITY IN EYE HEALTH AND VISION IN COLLABORATION WITH A COMMUNITY OF PHYSICIANS AND OTHER PARTNERS PROVIDING CARE AND TRAINING. 0 0 591444 0 195000 PVF'S MISSION IS TO SUPPORT THE HIGHEST QUALITY OF EYECARE FOR ALL MEMBERS OF OUR COMMUNITY, REGARDLESS OF ABILITY TO PAY. WE WORK TO ACCOMPLISH OUR MISSION THROUGH DEVELOPMENT AND SUPPORT OF THE PACIFIC VISION EYE INSTITUTE. IN PARTICULAR, PVF SUPPORTS THE CALIFORNIA PACIFIC MEDICAL CENTER (CPMC) OPHTHALMOLOGY RESIDENCY PROGRAM, AND THE RETINA FELLOWSHIP PROGRAM WHOSE RESIDENTS, FELLOWS, AND FACULTY PROVIDE EYE CARE TO LOW INCOME AND UNINSURED PATIENTS. PVF ALSO SUBSIDIZES EYE SURGERIES FOR LOW-INCOME PATIENTS AT THE PACIFIC VISION SURGERY CENTER WHICH OPENED IN 2020. 591444 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 0 1 7 0 1 8 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 17 14 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X JAMES CHANG 4153931225 711 VAN NESS AVENUE 260 SAN FRANCISCO CA 94102 ROBERT TOMASELLO CHAIR 2.00 X X 0 0 0 LENARD WEISS VICE CHAIR & SECRETARY 2.00 X X 0 0 0 SUZANNE DAGGERT CPA TREASURER 2.00 X X 0 0 0 BRUCE E SPIVEY MD CHAIR EMERITUS 2.00 X 0 0 0 DAVID C CUNEO CPA DIRECTOR 2.00 X 0 0 0 KEVIN DENNY MD DIRECTOR 2.00 X 32400 0 0 ANNE FUNG MD DIRECTOR 2.00 X 0 0 0 WAYNE E FUNG MD DIRECTOR (THRU 9/2024) 2.00 X 0 0 0 BERND KUTZSCHER MD DIRECTOR 2.00 X 0 0 0 RICHARD LEE MD DIRECTOR 2.00 X 0 0 0 ROBERT A NELSON MD MBA DIRECTOR 2.00 X 0 0 0 JOHN POSEY DIRECTOR 2.00 X 0 0 0 KRISTA RAMONAS MD DIRECTOR (THRU 7/2024) 2.00 X 0 0 0 LEE K SCHWARTZ MD DIRECTOR (THRU 7/2024)) 2.00 X 0 0 0 GAURAV K SHAH MD DIRECTOR 2.00 X 0 0 0 RONA SILKISS MD FACS DIRECTOR 2.00 X 0 0 0 ERIC W SPIVEY DIRECTOR 2.00 X 0 0 0 ROBERT G WEBSTER JR MD DIRECTOR 2.00 X 0 0 0 VERNON G WONG MD DIRECTOR 2.00 X 0 0 0 STEVEN R YOUNG BCO DIRECTOR 2.00 X 0 0 0 VIVEKA RYDELL-ANDERSON JD MSC CHIEF EXECUTIVE OFFICER 40.00 X 315000 0 29829 JAMES CHANG CHIEF FINANCIAL OFFICER 40.00 X 231935 0 6998 STEPHANIE TWERDAHL DEVELOPMENT DIRECTOR (THRU 9/2024) 40.00 X 131818 0 11551 ZHENG YONG YU SENIOR ACCOUNTANT 35.00 X 101816 0 4413 DONNA CURRY ADMINISTRATIVE ASSISTANT 40.00 X 108000 0 26786 920969 0 79577 5 0 1 0 0 1684939 1684939 PROGRAM MANAGEMENT FEES 541900 195000 195000 195000 453612 453612 3400227 4037544 -637317 -637317 -510299 -127018 MISCELLANEOUS REVENUE 900099 4616 4616 4616 1700850 195000 -510299 331210 583762 583762 726973 285408 222012 219553 11944 11944 22531 22531 57626 38722 18904 25503 25503 39600 39600 225229 11632 213597 75307 75307 43876 43876 27583 38 27545 1523 1523 20360 20360 CHARITY CARE 294366 294366 PROV FOR CREDIT LOSS 214977 214977 EVENTS 87105 87105 TAXES, LICENSES, & FEES 1316 1316 41023 41023 2500604 591444 1583598 325562 1045699 953695 15521 15711 1485106 1328349 233046 310239 696875 505000 150215 193412 36498084 10172269 27321044 26325815 7540507 7824993 2670000 2730000 3837999 4172071 44996012 44359285 1882716 1008766 21589645 22339594 185513 157603 23657874 23505963 X 5824192 5156043 15513946 15697279 21338138 20853322 44996012 44359285 -799754 314938 0 X 0 1 X 1 0 X 7413303 2132280 703305 1403148 1684939 13336975 7413303 2132280 703305 1403148 1684939 13336975 4876342 8460633 1388301 888888 508971 1037756 1131277 4955193 153458 208500 194830 195000 4616 756404 19048572 195000 0.44420 0.43470 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2020 AMOUNT: $ 153,458. 2021 AMOUNT: $ 208,500. 2022 AMOUNT: $ 194,830. 2023 AMOUNT: $ 195,000. 2024 AMOUNT: $ 4,616. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6392548 28432 594665 452633 6563012 6264080 51200 419886 342618 6392548 6660551 80000 -310589 165882 6264080 6332062 469312 140823 6660551 1826055 4506007 6332062 0.00000 0.88770 0.11230 0 0 6000000 6000000 30131054 9953558 20177496 218711 218711 0 148319 148319 26325815 INVESTMENT IN PACIFIC VISION SURGERY CENTER LLC (PVSC) 2730000 C 2730000 DUE FROM PVSC 2999987 DEFERRED RENT RECEIVABLE 1069527 LEASE COMMISSIONS 102557 4172071 SECURITY DEPOSITS 157603 157603 X PART V, LINE 4: ENDOWMENT FUNDS ARE INTENDED TO SUPPORT THE ORGANIZATION'S ACTIVITIES IN PROVIDING EXCELLENT EYE CARE FOR ALL, REGARDLESS OF ABILITY TO PAY, INCLUDING TRAINING EYE PHYSICIANS/SURGEONS AND GRANTMAKING. PART X, LINE 2: THE FOUNDATION IS ORGANIZED AS A CALIFORNIA NONPROFIT CORPORATION AND HAS BEEN DETERMINED TO BE EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND SECTION 23701D OF THE CALIFORNIA REVENUE AND TAXATION CODE. IN ADDITION, THE INTERNAL REVENUE SERVICE HAS DETERMINED THE FOUNDATION IS NOT A PRIVATE FOUNDATION. MANAGEMENT EVALUATED THE FOUNDATION'S TAX POSITIONS AND CONCLUDED THAT THE FOUNDATION HAD MAINTAINED ITS TAX-EXEMPT STATUS AND HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE CONSOLIDATED FINANCIAL STATEMENTS. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. X X 1 0 0 0 0 0 0 0 0 VIVEKA RYDELL-ANDERSON JD MSC CHIEF EXECUTIVE OFFICER 315000 0 0 0 0 0 9450 0 20379 0 344829 0 0 0 JAMES CHANG CHIEF FINANCIAL OFFICER 231935 0 0 0 0 0 6958 0 40 0 238933 0 0 0 PART I, LINE 4A DURING THE 2024 TAX YEAR, STEPHANIE TWERDAHL RECEIVED A TAXABLE SEVERANCE PAYMENT OF $22,317. KEVIN DENNY MD BOARD MEMBER 129943 LEASED OFFICE SPACE 0 LEE K SCHWARTZ MD BOARD MEMBER 209962 LEASED OFFICE SPACE 0 RONA SILKISS MD FACS BOARD MEMBER 55710 LEASED OFFICE SPACE 0 FORM 990, PART VI, SECTION A, LINE 2 BRUCE SPIVEY AND ERIC SPIVEY HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT TAX ACCOUNTANT, IN CONJUNCTION WITH THE ORGANIZATION'S ACCOUNTING AND FINANCE DEPARTMENT. A DRAFT IS REVIEWED BY THE CFO; ADJUSTMENTS ARE MADE, AS NECESSARY. A COMPLETE COPY OF THE FORM 990 IS THEN PROVIDED TO THE GOVERNING BODY FOR REVIEW AND COMMENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ALL DIRECTORS, OFFICERS, KEY EMPLOYEES, OR MEMBER OF A COMMITTEE COVERED BY THE CONFLICT OF INTEREST POLICY. SHOULD A POTENTIAL CONFLICT OF INTEREST ARISE, DETERMINATIONS ARE MADE BY EITHER CEO (FOR EMPLOYEES) OR MEMBERS OF THE BOARD (IN THE CASE OF A CONFLICT OF INTEREST INVOLVING THE CEO). IN EITHER CASE, CONFLICTED INDIVIDUALS ARE NOT ALLOWED TO PARTICIPATE ON THE DELIBERATION OR VOTE INVOLVING THE POTENTIAL TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS DETERMINES COMPENSATION FOR THE CEO AND AND OTHER SENIOR MANAGEMENT OFFICIALS BASED ON A REVIEW OF SALARY SURVEYS FOR SIMILARLY SITUATED INDIVIDUALS IN SIMILAR ORGANIZATIONS, TAKING INTO ACCOUNT COST-OF-LIVING GEOGRAPHIC LOCATION. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST IN THE CONTROLLER'S OFFICE. SFOC LLC 711 VAN NESS AVENUE SUITE 260 SAN FRANCISCO CA 94102 452209678 REAL ESTATE RENTAL CA -478835 28369103 PACIFIC VISION FOUNDATION PACIFIC VISION SURGERY CENTER LLC 711 VAN NESS AVENUE SUITE 260 SAN FRANCISCO CA 94102 833286106 VISION SURGERY CENTER CA PACIFIC VISION FOUNDATION RELATED -774462 11236394 0 0 0.91000 0 0 0 1 0 0 0 0 0 1 0 1 0 1 0 0 0 1 0 PACIFIC VISION SURGERY CENTER LLC D 2999987 BOOK VALUE PACIFIC VISION SURGERY CENTER LLC J 982091 BOOK VALUE PACIFIC VISION SURGERY CENTER LLC L 150000 BOOK VALUE PACIFIC VISION SURGERY CENTER LLC R 294366 BOOK VALUE SCHEDULE R, PART V, LINE 2: TRANSACTION R FOR FOR $294,366 REPRESENTS THE COST OF CHARITY CARE EXPENSES COVERED BY PACIFIC VISION FOUNDATION FOR LOW-INCOME INDIVIDUALS TO RECEIVE NECESSARY EYE SURGERIES AT PACIFIC VISION SURGERY CENTER, LLC.