2025-05-15T14:52:48-05:00 2024-06-30 910189318 MOSS ADAMS LLP 21700 OXNARD ST STE 300 WOODLAND HILLS CA 91367 990 2023-07-01 844327369 MARTIN LUTHER KING JR HEALTH ASSOCIATES MART 2126343084 1680 E 120TH STREET LOS ANGELES CA 90059 JOHN FISHER MD PRESIDENT 2126343084 2025-05-14 1 1 LAUREN A HAVERLOCK P00545829 8185771900 2025-05-14 2023 2025-03-06 01:10:19Z JOHN FISHER MD 1680 E 120TH STREET LOS ANGELES CA 90059 9023794 0 X N/A X 2019 CA TO PROVIDE HIGH-QUALITY MEDICAL AND PREVENTIVE CARE AND HEALTH EDUCATION TO ADDRESS THE SPECIFIC NEEDS OF THE INDIGENT, UNDERSERVED AND DISADVANTAGED COMMUNITIES OF SOUTH LOS ANGELES, REGARDLESS OF CITIZENSHIP OR ABILITY TO PAY. 1 0 35 0 0 0 0 0 8941470 9023794 0 0 0 0 8941470 9023794 0 0 0 0 8555198 8630565 0 0 0 346202 405504 8901400 9036069 40070 -12275 1059754 1243147 1058033 1253701 1721 -10554 X TO PROVIDE HIGH-QUALITY MEDICAL AND PREVENTIVE CARE AND HEALTH EDUCATION TO ADDRESS THE SPECIFIC NEEDS OF THE INDIGENT, UNDERSERVED AND DISADVANTAGED COMMUNITIES OF SOUTH LOS ANGELES, REGARDLESS OF CITIZENSHIP OR ABILITY TO PAY. 0 0 9032769 9023794 THE MEDICAL GROUP'S PRIMARY FUNCTION IS PROVIDE THE PROFESSIONAL STAFF FOR THE MLK MEDICAL FOUNDATION'S CLINICS. THE MLK MEDICAL FOUNDATION, A NONPROFIT CORPORATION WITH SECTION 501(C)(3) TAX-EXEMPT STATUS, IS RESPONSIBLE FOR OPERATING THE CLINICAL FACILITIES THAT PROVIDE PROFESSIONAL MEDICAL SERVICES, WITH MULTIPLE CLINIC LOCATIONS. THE MEDICAL GROUP CURRENTLY PROVIDES PATIENT CARE AT THE MLK MEDICAL FOUNDATION'S THREE CLINIC SITE LOCATIONS IN LOS ANGELES COUNTY, CALIFORNIA. THE MLK MEDICAL FOUNDATION BILLS AND COLLECTS FOR THE HEALTHCARE SERVICES RENDERED AT ITS CLINICS BY PHYSICIANS EMPLOYED BY THE MEDICAL GROUP.THE MEDICAL GROUP PROVIDES PROFESSIONAL MEDICAL SERVICES ONLY FOR PATIENTS OF THE MLK MEDICAL FOUNDATION. THE MEDICAL GROUP GENERALLY DOES NOT HAVE ANY OTHER ACTIVITIES. THE PROFESSIONAL SERVICES AGREEMENT BETWEEN THE MEDICAL GROUP AND THE MLK MEDICAL FOUNDATION EXPRESSLY REQUIRES FOR THE MEDICAL GROUP TO EXCLUSIVELY CARE FOR PATIENTS AT MLK MEDICAL FOUNDATION, AND NOT TO PROVIDE PROFESSIONAL MEDICAL OR ANY OTHER SERVICES TO ANY OTHER PARTIES.THE MEDICAL GROUP EMPLOYS AND CONTRACTS WITH PHYSICIANS DULY LICENSED IN THE STATE OF CALIFORNIA AND HEALTHCARE PROFESSIONALS, SUCH AS NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS, TO RENDER GENERAL MEDICAL SERVICES AND TREATMENT. THE MLK MEDICAL FOUNDATION OFFERS BOTH PRIMARY AND SPECIALTY CARE. THE MEDICAL GROUP'S PHYSICIANS TREATING PATIENTS AT THE MLK MEDICAL FOUNDATION'S CLINICS INCLUDE PHYSICIANS LICENSED TO PRACTICE FAMILY MEDICINE, INFECTIOUS DISEASES, GENERAL SURGERY, VASCULAR SURGERY, PULMONOLOGY, PSYCHIATRY, ENDOCRINOLOGY, RHEUMATOLOGY AND ADDICTION MEDICINE.IN ADDITION TO CARING FOR PATIENTS AT THE MLK MEDICAL FOUNDATION'S CLINICS, THE MEDICAL GROUP'S PHYSICIANS ALSO PROVIDE CALL COVERAGE AT THE HOSPITAL, SERVING THE ESSENTIAL FUNCTION OF ENSURING THAT THE HOSPITAL HAS ACCESS TO ALL PHYSICIAN SPECIALTY PRACTICES WHEN PATIENTS NEED IT. FOR THEIR WORK AT BOTH THE CLINICS AND THE HOSPITAL, THE MEDICAL GROUP'S PHYSICIANS HAVE A CLOSE AND SYNERGIZED RELATIONSHIP WITH THE HOSPITAL TO PREVENT GAPS IN CARE THAT CAN ARISE BETWEEN THE CARE THAT PATIENTS RECEIVES WITHIN HOSPITALS AND OUTSIDE. THIS STREAMLINING OF HEALTHCARE WITHIN AND OUTSIDE HOSPITAL DOORS IS ESSENTIAL TO BEST SERVING PATIENTS AND MAXIMIZING POSITIVE HEALTH OUTCOMES, IN PARTICULAR GIVEN THE CHALLENGES FACING THIS COMMUNITY, SUCH AS CHRONIC DISEASES (E.G., DIABETES AND COPD) FOR WHICH INDIVIDUALS REQUIRE HIGH LEVELS OF CARE FROM MULTIPLE HEALTHCARE PROVIDERS AND OFTEN INVOLVE PERIODIC CARE WITHIN THE HOSPITAL. THE MEDICAL GROUP'S PHYSICIANS ARE ALL ON THE HOSPITAL'S MEDICAL STAFF, WITH ADMITTING PRIVILEGES AT THE HOSPITAL.THE MEDICAL GROUP WAS FORMED TO SUPPORT THE MARTIN LUTHER KING JR - LOS ANGELES HEALTHCARE CORPORATIONS' (HOSPITAL) MISSION AND EFFORTS TO PROVIDE HIGH QUALITY CLINICAL HEALTHCARE SERVICES OUTSIDE OF THE HOSPITAL FOR THE INDIGENT, DISADVANTAGED COMMUNITIES SERVED BY THE HOSPITAL. PROVIDING MEDICAL CARE IN THE COMMUNITY OUTSIDE OF THE HOSPITAL WALLS IS AN INTEGRAL PART OF THE MISSION TO SERVE THE LOCAL COMMUNITY BY INCREASING ACCESS TO HIGH QUALITY MEDICAL SERVICES OUTSIDE OF THE HOSPITAL CONTEXT, AND WITH A PARTICULAR FOCUS ON THE MAJOR NEED WITHIN THE LOCAL COMMUNITY TO CARE FOR PATIENTS WITH CHRONIC MEDICAL CONDITIONS. THE HOSPITAL'S MISSION TO "PROVIDE COMPASSIONATE, COLLABORATIVE, QUALITY CARE AND IMPROVE THE HEALTH OF OUR COMMUNITY" EXTENDS BEYOND THE WALLS OF THE HOSPITAL, INCLUDING PROMOTING AND MAINTAINING THE COMMUNITY'S HEALTH ALONG THE ENTIRE CONTINUUM OF CARE. 9032769 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 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 35 1 0 0 0 0 0 0 0 0 0 0 0 0 X 1 0 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 CA X STEVEN CIAMPA 4243388717 1680 E 120TH STREET LOS ANGELES CA 90059 JOHN FISHER MD PRESIDENT 1.00 40.00 X X 0 592751 35921 WILLIAM BAILEY MD MEDICAL PRACTIONER 40.00 0.00 X 468417 0 32317 PATRICK MEEHAN MD MEDICAL PRACTIONER 40.00 0.00 X 466488 0 17371 DAVID TOBEY MD MEDICAL PRACTIONER 40.00 0.00 X 458518 0 15916 MOHAMAD ABDELFATTAH MD MEDICAL PRACTIONER 40.00 0.00 X 417737 0 28852 JAMES PINNEY MD MEDICAL PRACTIONER 40.00 0.00 X 409951 0 19682 2221111 592751 150059 22 0 1 0 0 PROFESSIONAL SERVICES 621990 9023794 9023794 9023794 9023794 9023794 0 0 6994714 6994714 263274 263274 989564 989564 383013 383013 3300 3300 44100 44100 1523 1523 257433 257433 EMPLOYEE REIMBURSEMENT 41862 41862 DUES & SUBSCRIPTIONS 31242 31242 EDUCATION 25644 25644 LICENSES & TAXES 400 400 9036069 9032769 3300 0 3001 2338 1036414 1232082 20339 8727 1059754 1243147 1036414 1232082 21619 21619 1058033 1253701 X 1721 -10554 1721 -10554 1059754 1243147 -12275 0 X 0 1 X 1 0 X 0 DUE TO HOSPITAL 21619 21619 9023794 0 9023794 0 9023794 9036069 0 9036069 0 9036069 0 1 0 0 0 0 0 0 0 JOHN FISHER MD PRESIDENT 0 541798 0 44953 0 6000 0 13200 0 22721 0 628672 0 0 WILLIAM BAILEY MD MEDICAL PRACTIONER 433921 0 34496 0 0 0 13200 0 19117 0 500734 0 0 0 PATRICK MEEHAN MD MEDICAL PRACTIONER 425754 0 40734 0 0 0 13200 0 4171 0 483859 0 0 0 DAVID TOBEY MD MEDICAL PRACTIONER 412961 0 45557 0 0 0 13200 0 2716 0 474434 0 0 0 MOHAMAD ABDELFATTAH MD MEDICAL PRACTIONER 380479 0 37258 0 0 0 13200 0 15652 0 446589 0 0 0 JAMES PINNEY MD MEDICAL PRACTIONER 373455 0 36496 0 0 0 13200 0 6482 0 429633 0 0 0 PART I, LINE 4B DR. JOHN FISHER PARTICIPATES IN THE MARTIN LUTHER KING, JR. COMMUNITY HOSPITAL SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (THE "PLAN") EFFECTIVE AS OF JANUARY 1, 2020 (THE "ADOPTION DATE"). HE RECEIVED THE FOLLOWING DISTRIBUTION DURING 2023: DR. JOHN FISHER: $44,953 FORM 990, PART VI, SECTION A, LINE 6 DR. JOHN FISHER, MD, MBA IS THE SOLE SHAREHOLDER, DIRECTOR AND OFFICER OF THE MEDICAL GROUP. HE IS ALSO THE CMO OF THE MLK COMMUNITY HOSPITAL AND THE MLK MEDICAL FOUNDATION. HE IS EMPLOYED AND COMPENSATED BY THE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE TAX PREPARER IN CONJUNCTION WITH THE ACCOUNTING AND FINANCE STAFF OF MARTIN LUTHER KING, JR. HEALTH ASSOCIATES. UPON COMPLETION, THE FORM 990 IS THEN DISTRIBUTED TO THE ORGANIZATION'S PRESIDENT/TREASURER/SECRETARY FOR REVIEW AND COMMENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR, OFFICER, AND MEMBER OF A COMMITTEE HAVING POWERS DELEGATED BY THE GOVERNING BOARD SHALL, PRIOR TO THEIR ELECTION AND ANNUALLY THEREAFTER, SIGN AND SUBMIT A CONFLICT OF INTEREST STATEMENT. IN THE EVENT A CONFLICT OF INTEREST MAY OCCUR, INTERESTED PERSONS ARE REQUIRED UNDER THE POLICY TO DISCLOSE THE EXISTENCE OF ANY FINANCIAL INTEREST TO THE ORGANIZATION'S GOVERNING BOARD OR TO A DULY AUTHORIZED COMMITTEE OF THE GOVERNING BOARD CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT, AND ARE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS OF THE TRANSACTION. AFTER DISCLOSURE OF THE POTENTIAL CONFLICT AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE INTERESTED PERSON SHALL LEAVE THE MEETING OF THE GOVERNING BOARD OR COMMITTEE WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT COMPENSATE DR. FISHER, ITS SOLE OFFICER AND DIRECTOR OF THE MEDICAL GROUP. HOWEVER, THE MEDICAL GROUP PAYS COMPENSATION TO THE PHYSICIANS IT EMPLOYS, WHO HAVE VARYING SPECIALTIES. ALLIED HEALTH PROFESSIONALS ("AHPS") HAVE NOT BEEN HIRED TO DATE, ALTHOUGH ARE ANTICIPATED TO LIKELY BE HIRED IN THE FUTURE. FOR ALL EMPLOYEES, THE MEDICAL GROUP TAKES STEPS TO ENSURE THAT COMPENSATION IT PAYS IS REASONABLE AND NOT HIGHER THAN FAIR MARKET VALUE BASED ON THE PARTICULAR FACTS AND CIRCUMSTANCES, INCLUDING TO UTILIZE MARKET COMPENSATION DATA REFLECTING MARKET DATA FOR THE VARIOUS PHYSICIAN PRACTICE AREAS IN THE MEDICAL GROUP'S GEOGRAPHIC REGION. IN ADDITION, THE PSA BETWEEN THE MEDICAL GROUP AND THE MLK MEDICAL FOUNDATION ENDEAVORS TO ENSURE THAT COMPENSATION PAID BY THE MEDICAL GROUP TO ITS OWN EMPLOYEES IS REASONABLE, IN SUPPORT OF BOTH ENTITIES' TAX-EXEMPT MISSIONS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. MARTIN LUTHER KING JR COMMUNITY MEDICAL FOUNDATION 2251 WEST ROSECRANS AVENUE SUITE 18 COMPTON CA 90222 812455970 CHARITABLE FOUNDATION CA 501(C)(3) LINE 10 MLKCH 0 MARTIN LUTHER KING JR-LOS ANGELES HEALTHCARE CORPORATION 1680 E 120TH STREET LOS ANGELES CA 90059 274658935 HOSPITAL CA 501(C)(3) LINE 3 N/A 0 MARTIN LUTHER KING JR COMMUNITY HEALTH FOUNDATION 1680 E 120TH STREET LOS ANGELES CA 90059 454433505 CHARITABLE FOUNDATION CA 501(C)(3) LINE 7 MLKCH 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1 1 1 0 1 1