Civic Intelligence

Physicians Medical Forum

990 • Fiscal year 2021 • EIN 30-0086728

Jul 01, 2020 to Jun 30, 2021 • Filed on Nov 03, 2021

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

56th percentile

0.00x

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

2021 filings • 501(c)3 • <$500k nonprofits • Source year 2021

Liabilities / Revenue

56th percentile

0.00x

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

2021 filings • 501(c)3 • <$500k nonprofits • Source year 2021

Net Margin

16th percentile

-27%

Higher net margin than 16% of similar nonprofits.

2021 filings • 501(c)3 • <$500k nonprofits • Source year 2021

Top Officer Pay

77th percentile

$0

Higher top officer pay than 77% of similar nonprofits.

Top officer pay equals 0.0% of source-year revenue.

2021 filings • 501(c)3 • <$500k nonprofits • Source year 2021

Asset Growth

81st percentile

53%

Faster asset growth than 81% of similar nonprofits.

2021 filings • 501(c)3 • <$500k nonprofits • Annualized from 2020 to 2021

Revenue Growth

Score unavailable

No value available

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

Annualized from 2020 to 2021

Balance Sheet
Liabilities / Assets56th percentile

Assets

Up

$234,282

Up $81,550 (+53%) from 2020

Net Assets

Up

$234,282

Up $81,550 (+53%) from 2020

Liabilities

Flat

$0

Flat from 2020

Revenue And Expenses
Liabilities / Revenue56th percentileNet Margin16th percentile

Revenue

Up

$115,350

Up $115,350 from 2020

Expenses

Down

$146,807

Down $33,648 (-19%) from 2020

Net Income

Up

-$31,457

Up $148,998 (+83%) from 2020

Historical Trend

Balance Sheet Trend

Asset Growth81st percentile

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

2021

Assets$234,282
Liabilities$0
Net Assets$234,282
Open 2021 Filing

Operations Trend

Revenue GrowthScore unavailable

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

2021

Revenue$115,350
Expenses$146,807
Net Income-$31,457
Open 2021 Filing
Jump To
Filing Snapshot
Filing Period
Jul 1, 2020 to Jun 30, 2021
Signed
Nov 3, 2021
Return Version
2020v4.1
Gross Receipts
$115,350
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 education

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments in Publicly Traded Securities$152,732$224,303▲ $71,571
Cash and Non-Interest-Bearing Accounts-$9,979-
Total Assets$152,732$234,282▲ $81,550
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$152,732$234,282▲ $81,550
Total Net Assets Fund Balance$152,732$234,282▲ $81,550
Total Liabilities and Net Assets / Fund Balance$152,732$234,282▲ $81,550
Compensation and Service Providers
Top Officer Pay77th percentile

Board Members and Trustees

NameTitle
Albert L Brooks MDPresident
Kathryn Malone MDVice-President
Alden McDonald MDDirector
Renee Navarro MDDirector
Thurman Hunt MDDirector
Stalfana Bello Broadhead MPAExecutive Director
Warren Strudwick MDChief Financial Officer
Carol Miller MDSecretary
Revenue and Support

Revenue Composition

Contributions and Grants
$115,350
Program Service Revenue
$0
Investment Income
$0
Other Revenue
$0
All Other Contributions
$5,810
Change in Net Assets
$-31,457

Noncash Contribution Practices

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

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$85,412
Other Expenses$61,395
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Current Officers, Directors, Trustees, and Key Employees$63,900$7,100$0$71,000
Information Technology$11,256$0$0$11,256
Other Employee Benefits$7,659$1,210$0$8,869
Fees for Services Legal$2,771$4,814$0$7,585
Payroll Taxes$4,989$554$0$5,543
Fees for Services Accounting$0$5,107$0$5,107
Other Expenses$0$4,020$0$4,020
Occupancy$3,798$221$0$4,019
Insurance$0$2,918$0$2,918
Office Expenses$1,670$1,180$0$2,850
Total Functional Expenses$118,142$28,665$0$146,807
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 35% controlled entity
No
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 J StrudwickJr MD
Title
Board Officer
Phone
5105625560
Signed
2021-11-03

Organization Details

Principal Officer
Stalfana Bello Broadhead
Formed
2002
Legal Domicile
CA
Voting Board Members
8
Independent Board Members
8
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 0. 0. 0.”

Raw XML AppendixShowing 400 of 409 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/Desc0The Physicians Medical Forum (PMF) "Doctors On Board" Program (DOB) and Community Health Ambassadors Internship (CHA) are pipeline programs to encourage and support African American and underrepresented minority high school, college/university, community college and post baccalaureate students who want to become physicians. Students received information on applying for medical school, MCAT prep, financial aid, mock primary care & surgery clinics, workshops on writing personal statements, interviewing and skill building sessions. High School students also network and are mentored by medical students, residents, physicians, educator and community mentors. PMF also provide scholarships, stipends other access to financial resources, networks and mentoring to medical students & residents. Additionally, PMF engages in programs and initiatives with physicians and educators on health policy and community wellness.
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IRS990/Form990PartVIISectionAGrp/TitleTxt0Executive Director
IRS990/Form990PartVIISectionAGrp/TitleTxt1President
IRS990/Form990PartVIISectionAGrp/TitleTxt2Vice-President
IRS990/Form990PartVIISectionAGrp/TitleTxt3Chief Financial Officer
IRS990/Form990PartVIISectionAGrp/TitleTxt4Secretary
IRS990/Form990PartVIISectionAGrp/TitleTxt5Director
IRS990/Form990PartVIISectionAGrp/TitleTxt6Director
IRS990/Form990PartVIISectionAGrp/TitleTxt7Director
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IRS990/MissionDesc0To encourage and inspire the education, training and resources for recruitment and retention of African American/Black and underrepresented minority physicians; and to provide infrastructure and support for them to succeed which will thereby help to eliminate health disparities, improve health equity and access in medical care for people in Northern California Oakland/San Francisco Bay Area
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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.
IRS990/ProgSrvcAccomActy2Grp/ExpenseAmt00
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IRS990/ProgSrvcAccomActy3Grp/Desc0To maintain strategic operatons, outreach, education and fund development to support the organizations' vision, mission, goals and strategies of African Americans physicians, residents, medical students and pipeline programs high school students pursuing careers to become physicians in Alameda, Contra Costa and San Francisco counties and Northern CA Bay Area
IRS990/ProgSrvcAccomActy3Grp/ExpenseAmt00
IRS990/ProgSrvcAccomActy3Grp/GrantAmt00
IRS990/ProgSrvcAccomActy3Grp/RevenueAmt00
IRS990/ProgSrvcAccomActyOtherGrp/Desc01. Increased the outreach, education, scholarships and mentoring of African American/Black and underrepresented minorities interested in medicine and becoming doctors. 2. Updated database indentifying schools by county an in all Northern California (public, charter, religious, private, etc.
IRS990/ProgSrvcAccomActyOtherGrp/Desc13. Partnering with Princeton Review to provide students at a reduced rate, the required MCAT Prep College Courses, Interview and Writing Personal Statement, tutors,on-line courses, and coaching to students preparing applications to medical students.
IRS990/ProgSrvcAccomActyOtherGrp/Desc2Expanded Opportunities Scholarships, special projects and and Internships for students.
IRS990/ProgSrvcAccomActyOtherGrp/ExpenseAmt00
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IRS990ScheduleA/GiftsGrantsContrisRcvd509Grp/CurrentTaxYearMinus4YearsAmt0195000
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IRS990ScheduleB/ContributorInformationGrp/ContributorUSAddress/AddressLine10RESTRICTED
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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 0. 0. 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/TypeOfOrganizationCorpInd0X
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IRS990/UponRequestInd0X
IRS990/USAddress/AddressLine1Txt06114 La Salle
IRS990/USAddress/CityNm0Oakland
IRS990/USAddress/StateAbbreviationCd0CA
IRS990/USAddress/ZIPCd094611
IRS990/VotingMembersGoverningBodyCnt08
IRS990/VotingMembersIndependentCnt08
IRS990/WebsiteAddressTxt0N/A
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ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/AuthenticationAssuranceLevelCd0AAL1
ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/FederatedAssuranceLevelCd0FAL1
ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/IdentityAssuranceLevelCd0IAL1
ReturnHeader/AdditionalFilerInformation/TrustedCustomerGrp/TrustedCustomerCd03
ReturnHeader/BuildTS02022-09-23 18:48:47Z
ReturnHeader/BusinessOfficerGrp/PersonNm0Warren J StrudwickJr MD
ReturnHeader/BusinessOfficerGrp/PersonTitleTxt0Board Officer
ReturnHeader/BusinessOfficerGrp/PhoneNum05105625560
ReturnHeader/BusinessOfficerGrp/SignatureDt02021-11-03
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/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/PreparationDt02021-11-12

Document Assets

No mirrored PDF or thumbnail assets are attached yet.

Filings

Displayed year

2021 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$234,282
Liabilities
$0
Net assets
$234,282
Revenue
$115,350
Expenses
$146,807
Net income
-$31,457
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
2021Detailed filing. Detailed filing data is available for this year.$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
2017XML pending. An XML filing is linked for this year, but detailed extraction is still pending.$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