2024-08-06T13:53:39-05:00 2023-09-30 135565207 KPMG LLP 301 MAIN STREET SUITE 2150 BATON ROUGE LA 70801 990EZ 2022-10-01 953643829 PIH HEALTH ADULT DAY HEALTHCARE PIHH 5626980811 12401 WASHINGTON BOULEVARD WHITTIER CA 90602 VID SHIVARAMAN CFO 5626980811 2024-08-01 1 0 BRITTANY ELLISER P01284594 2139724000 2024-07-22 2022 2024-08-08 14:25:15Z X X N/A X X 0 X 0 25 25 -25 -2792881 0 -2792906 X 0 0 2792881 2792906 -2792881 -2792906 X PROMOTING THE HEALTH OF THE COMMUNITY THROUGH THE OPERATION OF AN ADULT DAY HEALTH CARE CENTER. PIH HEALTH ADULT DAY HEALTHCARE HAS CEASED ITS OPERATION AS OF OCTOBER 2, 2014. THE ORGANIZATION IS INACTIVE AT THE END OF THE REPORTING TAX YEAR AND SHALL REMAIN INACTIVE UNTIL DEEMED OTHERWISE. THERE IS NO IMMEDIATE PLAN TO DISSOLVE THE ORGANIZATION. 0 0 0 JAMES WEST CHAIR 0.10 0 0 0 PEGGY CHULACK SECRETARY 0.10 0 0 0 VID SHIVARAMAN TREASURER 0.10 0 0 0 BRIAN SMOLSKIS AS OF 92823 SYSTEM COO 0.10 0 0 0 ROSALIO LOPEZ MD SYSTEM CSO/CMO 0.10 0 0 0 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 CA MARK KAWAUCHI 12102 WASHINGTON BOULEVARD WHITTIER CA 90606 5626980811 0 0 0 0 0 1 0 0 0 0 0 NONE NONE 1 X X 5 PIH HEALTH GOOD SAMARITAN HOSPITAL 951656366 3 0 0 0 PIH HEALTH FOUNDATION 953761274 7 0 0 0 PIH HEALTH DOWNEY HOSPITAL 951903935 3 0 0 0 PIH HEALTH WHITTIER HOSPITAL 951934652 3 0 0 0 PIH HEALTH PHYSICIANS 953942828 10 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PART IV, SECTION A, LINE 1: PIH HEALTH ADULT DAY HEALTHCARE HAS A HISTORIC AND CONTINUING RELATIONSHIP WITH ITS SUPPORTED ORGANIZATIONS, AS THE ENTITIES ARE ALL MEMBERS OF AN INTEGRATED HEALTHCARE SYSTEM. THE SYSTEM IS CONTROLLED BY PIH HEALTH INC., THE SOLE MEMBER OF PIH HEALTH ADULT DAY HEALTHCARE. THE SUPPORTED ORGANIZATIONS OF PIH HEALTH ADULT DAY HEALTHCARE ARE DESIGNATED BY CLASS OR PURPOSE WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986 ("THE CODE") BY CONDUCTING OR SUPPORTING ACTIVITIES FOR THE BENEFIT OF, PERFORMING THE FUNCTIONS OF, OR CARRYING OUT THE PURPOSES OF QUALIFIED ORGANIZATIONS PROMOTING THE HEALTH OF THE COMMUNITY WITHIN THE MEANING OF SECTION 501(C)(3) OF THE CODE. PART IV, SECTION C, LINE 1: THE MAJORITY OF THE BOARD OF DIRECTORS OF PIH HEALTH ADULT DAY HEALTHCARE ALSO SERVE AS OFFICERS OF ITS SOLE MEMBER PIH HEALTH, INC. AS OFFICERS OF ITS SOLE MEMBER, THE INDIVIDUALS WHO COMPRISE THE MAJORITY OF THE BOARD OF DIRECTORS OF PIH HEALTH ADULT DAY HEALTHCARE ALSO SHARE IN THE RESPONSIBILITY OF MANAGING, SUPERVISING AND CONTROLLING BOTH SUPPORTING AND SUPPORTED ORGANIZATION(S). FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES DESCRIPTION: LICENSES & FEES. AMOUNT: 25. FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES DESCRIPTION: INTERCOMPANY PAYABLES. BEG. OF YEAR AMOUNT: 2,792,881. END OF YEAR AMOUNT: 2,792,881. DESCRIPTION: OTHER LIABILITIES. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 25. THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.