Form 990 for tax year 2022
Filed by PEDIATRIC AND FAMILY MEDICAL FOUNDATION.
Totals
- Total revenue
- $44,188
- Total expenses
- $115,572
- Contributions and grants received
- $0
- Grants paid
- $101,470
- Program service revenue
- $0
- Investment income
- $44,188
- Other revenue
- $0
- Total assets, end of year
- $2,297,043
- Total liabilities, end of year
- $0
- Net assets or fund balances, end of year
- $2,297,043
- Program services expenses (Part IX)
- $101,470
- Management and general expenses
- $14,102
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $101,470
Program services were 87.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Line items
Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.
Revenue
Part VIII, the statement of revenue.
-
3 · Investment income
total $44,188 · excluded $44,188
Functional expenses
Part IX, the statement of functional expenses.
-
1 · Grants to domestic organizations and governments
total $101,470 · program services $101,470
-
11f · Fees: investment management
total $14,102 · management and general $14,102
Balance sheet
Part X, book values.
-
11 · Investments: publicly traded securities
beginning of year $2,134,263 · end of year $2,297,043
-
27 · Net assets without donor restrictions
beginning of year $2,134,263 · end of year $2,297,043
Mission and programs · 2022
Mission
THE SPECIFIC PURPOSES OF THIS CORPORATION IS TO OPERATE EXCLUSIVELY FOR THE BENEFIT AND SUPPORT OF THE GOALS AND OBJECTIVES OF PEDIATRIC AND FAMILY MEDICAL CENTER.
Activities or mission (Part I)
TO OPERATE EXCLUSIVELY FOR THE BENEFIT AND SUPPORT OF THE GOALS AND OBJECTIVES OF THE PEDIATRIC AND FAMILY MEDICAL CENTER.
-
DURING THE YEAR, THE ORGANIZATION SUPPORTED PEDIATRIC AND FAMILY MEDICAL CENTER, DBA: EISNER HEALTH, WHICH IS A FREE STANDING LICENSED COMMUNITY CLINIC AND CERTIFIED AS A MEDI-CAL PROVIDER.
Expenses $101,470 · Grants $101,470
As filed on the 2022 return.
Listed in Part VII
-
Rupert GrantRUPERT GRANT
BOARD TREASURER
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Joshua EnglanderJOSHUA ENGLANDER
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
Alexes DegenfelderALEXES DEGENFELDER
BOARD CHAIR
- Total calculated
- $0
- Hours/week
- 1
-
Chris IsolaCHRIS ISOLA
BOARD SECRETARY
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Pejman SalimpourPEJMAN SALIMPOUR
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
Kevin B KroekerKEVIN B KROEKER
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
Kevin RossiKEVIN ROSSI
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Stan BerkmanSTAN BERKMAN
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Trent StampTRENT STAMP
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
Warren J BrodineWARREN J BRODINE
PRESIDENT/CEO
- Total calculated
- $408,448
- From this org
- $0
- From related orgs
- $385,635
- Other
- $22,813
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $336,484 related
- Bonus
- $0 + $6,127 related
- Other
- $0 + $43,024 related
- Deferred
- $0 + $22,650 related
- Nontaxable benefits
- $0 + $163 related
- Filer's total
- $0 + $408,448 related
-
Shireen MotivalaSHIREEN MOTIVALA
BOARD MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
Sergey NavolnevSERGEY NAVOLNEV
CFO
- Total calculated
- $252,110
- From this org
- $0
- From related orgs
- $229,352
- Other
- $22,758
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $188,350 related
- Bonus
- $0
- Other
- $0 + $41,002 related
- Deferred
- $0 + $15,888 related
- Nontaxable benefits
- $0 + $6,870 related
- Filer's total
- $0 + $252,110 related
Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.
Schedule J
Answered yes
None.
Answered no
- 4a · Severance or change-of-control payment
- 4b · Supplemental nonqualified retirement plan
- 4c · Equity-based compensation arrangement
- 5a · Pay contingent on this organization's revenues
- 5b · Pay contingent on a related organization's revenues
- 6a · Pay contingent on this organization's net earnings
- 6b · Pay contingent on a related organization's net earnings
- 7 · Other non-fixed payments
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- PART I, LINE 3
- THE FOUNDATION DOES NOT UNDERTAKE ANY COMPENSATION PROCEDURES BECAUSE THE FOUNDATION DOES NOT COMPENSATE ANY EMPLOYEES. THE OFFICERS ARE COMPENSATED BY THE RELATED ORGANIZATION, PEDIATRIC & FAMILY MEDICAL CENTER. THE GOVERNANCE COMMITTEE OF THE RELATED ORGANIZATION USES AN INDEPENDENT CONSULTANT AND A COMPENSATION SURVEY STUDY IN ORDER TO DETERMINE THE COMPENSATION FOR THE CEO, OFFICERS, AND KEY EMPLOYEES. ONCE THE COMPENSATION IS DETERMINED, IT IS THEN PRESENTED TO THE ENTIRE BOARD FOR APPROVAL INDEPENDENTLY, WITHOUT THE PARTICIPATION OF INTERESTED PERSONS.
Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.
Grants on this return
-
PEDIATRIC AND FAMILY MEDICAL CENTER
$101,470
TO SUPPORT GOALS AND OBJECTIVES OF EISNER HEALTH.
Related organizations on this return
Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.
-
PEDIATRIC AND FAMILY MEDICAL CENTER
501(C)(3) · COMMUNITY CLINIC · CA
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 10 May 2024
- IRS schema version
- 2022v5.0
- Source object
- 202431359349304148
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