Civic Intelligence

Physicians Medical Forum

990 • Fiscal year 2017 • EIN 30-0086728

Jul 01, 2016 to Jun 30, 2017 • Filed on Nov 15, 2017

Organization ProfileN/A
6114 LaSalle AveOakland, CA 94611

(510) 562-5560

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on this filing.

Source year 2017

Liabilities / Revenue

56th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

2017 filings • 501(c)3 • <$500k nonprofits • Source year 2017

Net Margin

27th percentile

-6.8%

Higher net margin than 27% of similar nonprofits.

2017 filings • 501(c)3 • <$500k nonprofits • Source year 2017

Top Officer Pay

95th percentile

$64,000

Higher top officer pay than 95% of similar nonprofits.

Top officer pay equals 27.4% of source-year revenue.

2017 filings • 501(c)3 • <$500k nonprofits • Source year 2017

Asset Growth

Score unavailable

No value available

A valid growth rate could not be computed from the available filing history.

Annualized from 2016 to 2017

Revenue Growth

28th percentile

-15%

Faster revenue growth than 28% of similar nonprofits.

2017 filings • 501(c)3 • <$500k nonprofits • Annualized from 2016 to 2017

Balance Sheet
Liabilities / AssetsScore unavailable

Assets

Flat

$0

Flat from 2016

Net Assets

Flat

$0

Flat from 2016

Liabilities

Flat

$0

Flat from 2016

Revenue And Expenses
Liabilities / Revenue56th percentileNet Margin27th percentile

Revenue

Down

$233,176

Down $40,424 (-15%) from 2016

Expenses

Down

$248,924

Down $26,922 (-9.8%) from 2016

Net Income

Down

-$15,748

Down $13,502 (-601%) from 2016

Historical Trend

Balance Sheet Trend

Asset GrowthScore unavailable

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$1.5M$1.0M$500K$0-$500K-$1.0MAssets 2013: $467,523Liabilities 2013: $0Net Assets 2013: $467,5232013Assets 2014: $279,339Liabilities 2014: $0Net Assets 2014: $279,3392014Assets 2015: $0Liabilities 2015: $0Net Assets 2015: $02015Assets 2016: $0Liabilities 2016: $0Net Assets 2016: $02016Assets 2017: $0Liabilities 2017: $0Net Assets 2017: $02017Assets 2018: $0Liabilities 2018: $0Net Assets 2018: $02018Assets 2019: $0Liabilities 2019: $0Net Assets 2019: $02019Assets 2020: $152,732Liabilities 2020: $0Net Assets 2020: $152,7322020Assets 2021: $234,282Liabilities 2021: $0Net Assets 2021: $234,2822021Assets 2022: $144,909Liabilities 2022: $0Net Assets 2022: $144,9092022Assets 2023: $438,110Liabilities 2023: -$612,925Net Assets 2023: $1,051,0352023Assets 2024: $379,254Liabilities 2024: $18,320Net Assets 2024: $360,9342024

Highlighted filing

2017

Assets$0
Liabilities$0
Net Assets$0
Open 2017 Filing

Operations Trend

Revenue Growth28th percentile

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$600K$400K$200K$0-$200KExpenses 2013: $329,8492013Revenue 2014: $370,450Expenses 2014: $472,152Net Income 2014: -$101,7022014Revenue 2015: $115,500Expenses 2015: $189,798Net Income 2015: -$74,2982015Revenue 2016: $273,600Expenses 2016: $275,846Net Income 2016: -$2,2462016Revenue 2017: $233,176Expenses 2017: $248,924Net Income 2017: -$15,7482017Revenue 2018: $114,551Expenses 2018: $250,941Net Income 2018: -$136,3902018Revenue 2019: $310,000Expenses 2019: $277,934Net Income 2019: $32,0662019Revenue 2020: $0Expenses 2020: $180,455Net Income 2020: -$180,4552020Revenue 2021: $115,350Expenses 2021: $146,807Net Income 2021: -$31,4572021Revenue 2022: $368,662Expenses 2022: $346,476Net Income 2022: $22,1862022Revenue 2023: $313,192Expenses 2023: $202,154Net Income 2023: $111,0382023Revenue 2024: $205,067Expenses 2024: $254,158Net Income 2024: -$49,0912024

Highlighted filing

2017

Revenue$233,176
Expenses$248,924
Net Income-$15,748
Open 2017 Filing
Jump To
Filing Snapshot
Filing Period
Jul 1, 2016 to Jun 30, 2017
Signed
Nov 15, 2017
Return Version
2016v3.0
Gross Receipts
$233,176
Mission and Program Overview

Mission

Encourage the recruitment and

Encourage the recruitment and retention of African American physicians, and thereby help to eliminate health disparities, improve access to care and improve the quality of life and medical care for citizens in the Northern CA Bay Area

Balance Sheet Detail
LineBeginningEndChange
Assets
Total Assets$0$0→ $0
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Total Net Assets Fund Balance$0$0→ $0
Total Liabilities and Net Assets / Fund Balance$0$0→ $0
Compensation and Service Providers
Top Officer Pay95th percentile

Employees

NameTitleFull / Part TimeBaseTotal
Stalfana Bello BroadheadExecutive DirectorFT$64,000$64,000

Board Members and Trustees

NameTitle
Albert L Brooks MdPresident
Carol Miller MdDirector
Kathryn Malone MdDirector
Renee Navarro MdDirector
Thurman Hunt MdDirector
Renee Navarro Md-
Warren J Strudwick MdChief financial Officer
Michelle Shute MdSecretary
Revenue and Support

Revenue Composition

Contributions and Grants
$233,176
Program Service Revenue
$0
Investment Income
$0
Other Revenue
$0
All Other Contributions
$233,176
Change in Net Assets
$-15,748

Noncash Contribution Practices

Property subject to holding requirements
No
Reviewed unusual noncash gifts
Yes
Third parties used for noncash contributions
No
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$163,364
Salaries, Compensation, and Employee Benefits$85,560
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Conferences and Meetings$78,786$0$0$78,786
Current Officers, Directors, Trustees, and Key Employees$57,600$6,400$0$64,000
Occupancy$31,973$3,553$0$35,526
Fees for Services Management$19,815$0$0$19,815
Payroll Taxes$11,632$1,293$0$12,925
Other Employee Benefits$5,329$3,306$0$8,635
Other Expenses$4,000$0$0$4,000
Office Expenses$0$3,829$0$3,829
Fees for Services Accounting$0$3,600$0$3,600
Travel$0$2,357$0$2,357
Total Functional Expenses$218,675$30,249$0$248,924
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
Yes
Annual disclosure for covered persons
Yes
Audit committee
Yes
Backup withholding compliance
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No
Filing and Contact Details

Filer

Filer Name
Physicians Medical Forum
EIN
30-0086728
Phone
5105625560
Address
6114 LaSalle Ave, Oakland, CA 94611

Signing Officer

Name
Warren Strudwick Md
Title
Board Officer
Phone
5105625560
Signed
2017-11-15
Discuss with paid preparer
Yes

Organization Details

Principal Officer
Stalfana Bello
Formed
2002
Legal Domicile
CA
Voting Board Members
9
Independent Board Members
0
Employees
1
Volunteers
25

Preparer

Firm
Grigsby Finance and Tax Services
Address
8050 Hansom Drive, Oakland, CA 94605
Preparer
Mittie Grigsby
Phone
5106384878
Supplemental Narrative

Additional Explanations

Pt VI, Line 7A

“Acct prepares return; reviewed by E, Pres & CFO”

Pt VI, Line 12C

“Annual reviews are completed with legal review”

Pt VI, Line 15A

“business attorney recommendation based on non-profit model”

Pt VI, Line 19

“Interest parties contact org; appt is set for review”

Pt XI

“Net change in investment income”

Pt VI, Line 15B

“Review performed by board members”

Pt V, Line 3B

“Organization does not have this type of income”

Pt V, Line 14B

“organization does not have this type of service”

Pt VI, Line 11B

“Organization did not have this type of income”

Form 990, Part III, Line 4D

“1. Increased the outreach, education, scholarships 131279. 195000. 0.”

Raw XML Appendix389 raw XML fields

This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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IRS990/ProgSrvcAccomActy2Grp/Desc0RECRUITMENT OF AFRICAN AMERICAN RESIDENTS AND MEDICAL STUDENTS THAT UPON THEIR COMPLETION OF THEIR ENDUCATION AND TRAINING, TO PURSE CAREERS AS PHYSICIANS AND REMAIN IN OR COME TO ALAMEDA, CONTRA COSTA OR SAN FRANCISCO COUNTIES AND NORTHERN CA BAY AREA TO PRACTICE MEDICINE.
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IRS990/ProgSrvcAccomActy3Grp/Desc0TO MAINTAIN STRATEGIC OPERATONS, OUTREACH, EDUCATION AND FUND DEVELOPMENT TO SUPPORT THE ORGANIZATIONS' VISION, MISSION, GOALS AND OBJECTIVES OF AFRICAN AMERICANS PHYSICIANS, RESIDENTS, MEDICAL STUDENTS AND PIPELINE PROGRAMS PURSING CAREERS AS PHYSICIANS IN ALAMEDA, CONTRA COSTA AND SAN FRANCISCO COUNTIES AND NORTHERN CA BAY AREA
IRS990/ProgSrvcAccomActy3Grp/ExpenseAmt08611
IRS990/ProgSrvcAccomActyOtherGrp/Desc01. Increased the outreach, education, scholarships and mentoring of African American/Black and and mentoring of African American/Black and and mentoring of African American/Black and and mentoring of African American/Black and and mentoring of African American/Black and and mentoring of African American/Black and
IRS990/ProgSrvcAccomActyOtherGrp/Desc13. PARTNERING WITH PRINCETON REVIEW'S WESTERN REGION 3. PARTNERING WITH PRINCETON REVIEW'S WESTERN REGION 3. PARTNERING WITH PRINCETON REVIEW'S WESTERN REGION 3. PARTNERING WITH PRINCETON REVIEW'S WESTERN REGION 3. PARTNERING WITH PRINCETON REVIEW'S WESTERN REGION 3. PARTNERING WITH PRINCETON REVIEW'S WESTERN REGION
IRS990/ProgSrvcAccomActyOtherGrp/Desc2EXPANDED OPPORTUNITIES SCHOLARSHIPS AND INTERNSHIPS EXPANDED OPPORTUNITIES SCHOLARSHIPS AND INTERNSHIPS
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IRS990ScheduleA/PublicSupportPY509Pct00.99700
IRS990ScheduleA/PublicSupportTotal170Amt00
IRS990ScheduleA/PublicSupportTotal509Amt01927050
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IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus1YearAmt0463600
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt0512500
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt0480450
IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus4YearsAmt0275500
IRS990ScheduleA/Total509Grp/TotalAmt01927050
IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt01933342
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IRS990ScheduleB/ContributorInformationGrp/ContributorNum0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine10RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine20RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/City0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/State0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/ZIPCode0RESTRICTED
IRS990ScheduleB/ContributorInformationGrp/TotalContributionsAmt0RESTRICTED
IRS990/ScheduleBRequiredInd0true
IRS990/ScheduleJRequiredInd0false
IRS990ScheduleM/AnyPropertyThatMustBeHeldInd0false
IRS990ScheduleM/ReviewProcessUnusualNCGiftsInd0true
IRS990ScheduleM/ThirdPartiesUsedInd0false
IRS990/ScheduleORequiredInd0true
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt0Acct prepares return; reviewed by E, Pres & CFO
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt1Annual reviews are completed with legal review
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt2business attorney recommendation based on non-profit model
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt3Interest parties contact org; appt is set for review
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt4Net change in investment income
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt5Review performed by board members
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt6Organization does not have this type of income
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt7organization does not have this type of service
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt8Organization did not have this type of income
IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt91. Increased the outreach, education, scholarships 131279. 195000. 0.
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc0Pt VI, Line 7a
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc1Pt VI, Line 12c
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc2Pt VI, Line 15a
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc3Pt VI, Line 19
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc4Pt XI
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc5Pt VI, Line 15b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc6Pt V, Line 3b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc7Pt V, Line 14b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc8Pt VI, Line 11b
IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc9Form 990, Part III, Line 4d
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IRS990/SignificantNewProgramSrvcInd0false
IRS990/StatesWhereCopyOfReturnIsFldCd0CA
IRS990/SubjectToProxyTaxInd0false
IRS990/TaxablePartyNotificationInd0false
IRS990/TaxExemptBondsInd0false
IRS990/TempOrPermanentEndowmentsInd0false
IRS990/TerminateOperationsInd0false
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IRS990/TotalAssetsGrp/BOYAmt00
IRS990/TotalAssetsGrp/EOYAmt00
IRS990/TotalCompGreaterThan150KInd0false
IRS990/TotalContributionsAmt0233176
IRS990/TotalEmployeeCnt01
IRS990/TotalFunctionalExpensesGrp/FundraisingAmt00
IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt030249
IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt0218675
IRS990/TotalFunctionalExpensesGrp/TotalAmt0248924
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IRS990/TotalLiabilitiesGrp/EOYAmt00
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IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt00
IRS990/TotalOtherProgSrvcExpenseAmt0131279
IRS990/TotalOtherProgSrvcGrantAmt0195000
IRS990/TotalProgramServiceExpensesAmt0218675
IRS990/TotalReportableCompFromOrgAmt064000
IRS990/TotalRevenueGrp/TotalRevenueColumnAmt0233176
IRS990/TotalVolunteersCnt025
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IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt00
IRS990/TransactionWithControlEntInd0false
IRS990/TravelGrp/FundraisingAmt00
IRS990/TravelGrp/ManagementAndGeneralAmt02357
IRS990/TravelGrp/ProgramServicesAmt00
IRS990/TravelGrp/TotalAmt02357
IRS990/TypeOfOrganizationCorpInd0X
IRS990/UnrelatedBusIncmOverLimitInd0false
IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt06114 La Salle
IRS990/USAddress/CityNm0Oakland
IRS990/USAddress/StateAbbreviationCd0CA
IRS990/USAddress/ZIPCd094611
IRS990/VotingMembersGoverningBodyCnt09
IRS990/VotingMembersIndependentCnt00
IRS990/WebsiteAddressTxt0N/A
IRS990/WhistleblowerPolicyInd0true
ReturnHeader/BuildTS02017-02-10 21:41:12Z
ReturnHeader/BusinessOfficerGrp/DiscussWithPaidPreparerInd0true
ReturnHeader/BusinessOfficerGrp/PersonNm0WARREN STRUDWICK MD
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0BOARD OFFICER
ReturnHeader/BusinessOfficerGrp/PhoneNum05105625560
ReturnHeader/BusinessOfficerGrp/SignatureDt02017-11-15
ReturnHeader/Filer/BusinessName/BusinessNameLine1Txt0Physicians Medical Forum
ReturnHeader/Filer/BusinessNameControlTxt0PHYS
ReturnHeader/Filer/EIN0300086728
ReturnHeader/Filer/PhoneNum05105625560
ReturnHeader/Filer/USAddress/AddressLine1Txt06114 LaSalle Ave
ReturnHeader/Filer/USAddress/CityNm0Oakland
ReturnHeader/Filer/USAddress/StateAbbreviationCd0CA
ReturnHeader/Filer/USAddress/ZIPCd094611
ReturnHeader/FilingSecurityInformation/AtSubmissionCreationDeviceId0E4A8D100C216F022B8EBAAA751A3291AFCDF126A
ReturnHeader/FilingSecurityInformation/AtSubmissionFilingDeviceId0E4A8D100C216F022B8EBAAA751A3291AFCDF126A
ReturnHeader/FilingSecurityInformation/FilingLicenseTypeCd0P
ReturnHeader/FilingSecurityInformation/IPAddress/IPv4AddressTxt0108.91.28.40
ReturnHeader/FilingSecurityInformation/IPDt02017-11-15
ReturnHeader/FilingSecurityInformation/IPTimezoneCd0PS
ReturnHeader/FilingSecurityInformation/IPTm020:41:36
ReturnHeader/PreparerFirmGrp/PreparerFirmName/BusinessNameLine1Txt0Grigsby Finance and Tax Services
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/AddressLine1Txt08050 Hansom Drive
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/CityNm0Oakland
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/StateAbbreviationCd0CA
ReturnHeader/PreparerFirmGrp/PreparerUSAddress/ZIPCd094605
ReturnHeader/PreparerPersonGrp/PhoneNum05106384878
ReturnHeader/PreparerPersonGrp/PreparerPersonNm0MITTIE GRIGSBY
ReturnHeader/PreparerPersonGrp/SelfEmployedInd0X
ReturnHeader/ReturnTs02017-11-15T20:41:59-08:00
ReturnHeader/ReturnTypeCd0990
ReturnHeader/TaxPeriodBeginDt02016-07-01
ReturnHeader/TaxPeriodEndDt02017-06-30
ReturnHeader/TaxYr02016

Document Assets

No mirrored PDF or thumbnail assets are attached yet.

Filings

Displayed year

2017 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$0
Liabilities
$0
Net assets
$0
Revenue
$233,176
Expenses
$248,924
Net income
-$15,748
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.38$0.02$0.36$0.21$0.25$0.05
2023XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.44$0.61$1.05$0.31$0.20$0.11
2022Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.14$0.00$0.14$0.37$0.35$0.02
2021XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.23$0.00$0.23$0.12$0.15$0.03
2020XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.15$0.00$0.15$0.00$0.18$0.18
2019Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.00$0.00$0.00$0.31$0.28$0.03
2018XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.00$0.00$0.00$0.11$0.25$0.14
2017Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.00$0.23$0.25$0.02
2016XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$0.00$0.00$0.00$0.27$0.28$0.00
2015Detailed filing. Detailed filing data is available for this year.$0.00$0.00$0.00$0.12$0.19$0.07
2014Detailed filing. Detailed filing data is available for this year.$0.28$0.00$0.28$0.37$0.47$0.10
2013Facts available. Structured filing facts are available, but richer extracted sections are limited.$0.47$0.00$0.47$0.33