2024-04-30T12:56:30-05:00 2022-12-31 952302617 SLBIGGS A DIVISION OF SINGERLEWAK LLP 10960 WILSHIRE BLVD SUITE 1100 LOS ANGELES CA 90024 990 2022-01-01 953823550 MONTEBELLO COMMUNITY HEALTH SERVICES IN MONT 3104773924 SLBIGGS 10960 WILSHIRE BLVD 1100 LOS ANGELES CA 90024 HOWARD M EHRENBERG TRUSTEE 3104773924 2024-04-30 1 HOWARD EHRENBERG 999009999 1 SAMUEL BIGGS P00078192 3104773924 2024-04-30 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z HOWARD M EHRENBERG 1526319 0 X N/A X 1983 CA TO SUPPORT BEVERLY COMMUNITY HOSPITAL ASSOCIATION (BCHA), A 501 (C) (3) CORPORATION. 15 14 0 0 0 0 0 0 248754 248754 0 0 187247 -13680 436001 235074 0 0 0 0 0 0 0 0 0 130697 0 130697 0 305304 235074 14178593 14317250 3537174 3440757 10641419 10876493 MONTEBELLO COMMUNITY HEALTH SERVICES, INC. (MCHS) WAS ESTABLISHED FOR THE EXCLUSIVE BENEFIT OF BEVERLY COMMUNITY HOSPITAL ASSOCIATION (BCHA), WHICH MAY INCLUDE PERFORMING ACTIVITIES FOR, OR SERVICES TO, BCHA AND ITS AFFILIATES. 0 0 MCHS OPERATES A MEDICAL OFFICE BUILDING, A HEALTH CENTER, AND CERTAIN RENTAL PROPERTIES ON BEHALF OF BEVERLY COMMUNITY HOSPITAL ASSOCIATION (BCHA), AND LEASES A PORTION OF THESE RENTAL PROPERTIES TO BCHA. 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 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 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X DANIEL WAY 3238375190 309 WEST BEVERLY BOULEVARD MONTEBELLO CA 90640 ALICE CHENG FACHE PRESIDENT & CEO 3.00 40.00 X X 0 0 0 SABBIR DADABHAI SVP OF FINANCE/CFO (THRU 7 3.00 40.00 X X 0 0 0 HOUSAHANG S ABD MAA MSA PHD SVP OF FINANCE/CFO (START 3.00 40.00 X X 0 0 0 MONICA THORNHILL-JOYNES MD BOARD MEMBER/CHIEF OF STAF 2.00 2.00 X X 0 0 0 LYLA EDDINGTON EDD RN CHAIRPERSON 2.00 2.00 X X 0 0 0 CARLOS MANUEL HARO PHD 1ST VICE CHAIRPERSON 2.00 2.00 X X 0 0 0 RENEE D MARTINEZ 2ND VICE CHAIRPERSON 2.00 2.00 X X 0 0 0 JOHN HSU CPM CCIM TREASURER 2.00 2.00 X X 0 0 0 GAUTAM GANGULY MD SECRETARY 2.00 2.00 X X 0 0 0 RICHARD L ADAMS II BOARD MEMBER 2.00 2.00 X X 0 0 0 GARY R EINSTEIN ESQ BOARD MEMBER 2.00 2.00 X X 0 0 0 JULIE FRANCE MSNED RN BOARD MEMBER 2.00 3.00 X X 0 0 0 GOHARIK GABRIEL BOARD MEMBER 2.00 3.00 X X 0 0 0 DENTON BUTHRIE CPA BOARD MEMBER (THROUGH 6/20 2.00 2.00 X X 0 0 0 RALPH HANSEN DMD BOARD MEMBER 2.00 2.00 X X 0 0 0 AZIZ KHAN MD BOARD MEMBER 2.00 2.00 X X 0 0 0 ROSEMARY OROZCO BOARD MEMBER 2.00 2.00 X X 0 0 0 ALMA PEREZ SPHR BOARD MEMBER 2.00 2.00 X X 0 0 0 PAMALA SAKAMOTO BOARD MEMBER 2.00 2.00 X X 0 0 0 0 0 0 0 1 0 0 0 RENTAL REVENUE FROM SUPPORTED ORG 531390 248754 248754 248754 1277565 1291245 -13680 -13680 -13680 235074 235074 0 0 0 0 0 0 2017820 842791 12070 17473397 9114437 8247302 8358960 3792 3792 58503 3 3839106 5111704 14178593 14317250 174126 138093 3363048 3302664 3537174 3440757 X 10641419 10876493 10641419 10876493 14178593 14317250 235074 0 X 0 0 0 X X 1 BEVERLY COMMUNITY HOSPITAL ASSOCIATION 951816005 3 1 0 248754 1 0 248754 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 PART I, LINE 12G, COLUMN (VI) THE ORGANIZATION OWNS PROPERTY, WHICH IS LEASED TO BEVERLY COMMUNITY HOSPITAL ASSOCIATION (THE SUPPORTED ORGANIZATION) FOR USE WITHIN ITS OPERATIONS. PART IV, SECTION A, LINE 6 THE ORGANIZATION COLLECTS RENTAL INCOME FOR THE USE OF FACILITIES FROM UNRELATED THIRD PARTIES, ALL OF WHOM HELP TO PROMOTE THE GREATER HEALTH OF THE SURROUNDING BEVERLY COMMUNITY. 6880683 6880683 3994992 3574578 420414 5888093 5334690 553403 205169 205169 0 504460 504460 8358960 OTHER ASSETS 5111704 5111704 OTHER LIABILITIES 3302664 3302664 PART X, LINE 2 THE CORPORATION RECOGNIZES THE TAX EXPENSE OR PROPVISION FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE-LIKELY-THAN-NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THA THAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. 0 0 0 0 0 0 0 0 0 FORM 990 MONTEBELLO COMMUNITY HEALTH SERVICES, INC. NOTES TO FEDERAL/STATE TAX RETURNS FEIN: 95-3823550 GENERAL ON APRIL 19, 2023, THE DEBTOR, MONTEBELLO COMMUNITY HEALTH SERVICES, INC., FILED A VOLUNTARY PETITION UNDER CHAPTER 11 OF THE UNITED STATES BANKRUPTCY CODE (CASE NO. 2:23-BK-12360 SK). SUBSEQUENT TO THIS DATE, HOWARD EHRENBERG WAS APPOINTED TRUSTEE TO ADMINISTER THE AFFAIRS OF THE BANKRUPTCY ESTATE. ASSETS OF THE ESTATE THE ASSETS OF THE BUSINESS. OTHER EXPENSES INCLUDE CERTAIN ADMINISTRATIVE COSTS AND SIMILAR OTHER ITEMS INCURRED BY THE TRUSTEE. CERTAIN OTHER INCURRED AND UNPAID LIABILITIES OF THE BANKRUPTCY ESTATE INCLUDE TRUSTEE, LEGAL AND ACCOUNTING EXPENSES WHICH HAVE BEEN ACCRUED. ANY REMAINING EXPENSES AND NON-DEDUCTED FEES WILL BE PAID AT THE CONCLUSION OF THE CASE, WHICH IS ANTICIPATED TO CLOSE DURING 2024. ACCOUNTING RECORDS IN CONNECTION WITH THE TAXPAYER'S INSOLVENCY, MANY ACCOUNTING RECORDS WERE NOT ADEQUATELY MAINTAINED AND/OR WERE NOT PROVIDED TO THE TRUSTEE. RECORDS AND INFORMATION NECESSARY TO PROVIDE A COMPLETE AND ACCURATE ACCOUNTING ARE NOT AVAILABLE AND CANNOT BE RECONSTRUCTED. CONSEQUENTLY, NO ASSURANCE CAN BE PROVIDED BY EITHER THE TRUSTEE OR THE TAX PREPARER THAT THE RETURNS BEING FILED ACCURATELY REFLECT ALL TRANSACTIONS OF THE DEBTOR AND HIS RELATED TAX LIABILITY. TO THE EXTENT THAT ACCOUNTING TRANSACTIONS, RECORDS AND OTHER INFORMATION WERE AVAILABLE OR COULD BE RECONSTRUCTED; SUCH INFORMATION HAS BEEN INCLUDED HEREIN AND USED AS THE BASIS FOR COMPUTATION OF THE TAXPAYER'S INCOME TAX LIABILITY. FORM 990 TAX RETURN FYE 12/31/22 ON SEPTEMBER 6, 2023, ALL ASSETS AND BUSINESS OPERATIONS OF THIS TAXPAYER AND ITS RELATED ENTITIES, BEVERLY COMMUNITY HOSPITAL ASSOCIATION AND BEVERLY HOSPITAL FOUNDATION, WERE SOLD AND OPERATIONS OF THE HOSPITAL WERE TERMINATED. AS SUCH, FORMER EMPLOYEES WERE NOT AVAILABLE TO PROVIDE ACCOUNTING RECORDS AND INFORMATION REQUIRED TO PREPARE A COMPLETE TAX RETURN WITH ASSURANCE OF ALL ACCURACY. CONSEQUENTLY, THE ATTACHED TAX RETURN HAS BEEN PREPARED WITH INFORMATION AVAILABLE, BUT NO ASSURANCE OF COMPLETE ACCURACY IS PROVIDED BY EITHER THE TRUSTEE, HIS COUNSEL OR TAX PREPARER. THIS CASE IS STILL BEING ADMINISTERED BY THE TRUSTEE. FORM 990 FIDUCIARY BANKRUPTCY TAX RETURN: MONTEBELLO COMMUNITY HEALTH SERVICES, INC. FEIN: 95-3823550 FYE: 12/31/22 TRUSTEE AND TAX PREPARER STATEMENT RELEVANT TO INFORMATION CONTAINED IN THIS RETURN ON APRIL 19, 2023, THE ABOVE-MENTIONED TAXPAYER FILED A VOLUNTARY PETITION UNDER CHAPTER 11 OF THE UNITED STATES BANKRUPTCY CODE (CASE NO. CASE NO. 2:23-BK-12360 SK). THIS CASE IS BEING JOINTLY ADMINISTERED WITH BEVERLY HOSPITAL FOUNDATION AND BEVERLY HOSPITAL FOUNDATION. THEREAFTER, HOWARD EHRENBERG WAS APPOINTED TRUSTEE TO ADMINISTER THE AFFAIRS OF THE BANKRUPTCY ESTATE. THIS TAX RETURN HAS BEEN PREPARED FROM AVAILABLE RECORDS OF THE DEBTOR AND FROM THE ACCOUNTING RECORDS PROVIDED TO THE CHAPTER 11 BANKRUPTCY TRUSTEE. CONCERNING THE DEBTOR'S INSOLVENCY, MANY ACCOUNTING RECORDS WERE NOT ADEQUATELY MAINTAINED AND/OR WERE NOT PROVIDED TO THE TRUSTEE. RECORDS AND INFORMATION NECESSARY TO PROVIDE A COMPLETE AND ACCURATE ACCOUNTING ARE NOT AVAILABLE AND CANNOT BE RECONSTRUCTED. CONSEQUENTLY, NEITHER THE TAX PREPARER NOR THE TRUSTEE CAN PROVIDE ANY ASSURANCE THAT THIS RETURN ACCURATELY REFLECTS ALL TRANSACTIONS OF THE TAXPAYER AND THE RELATED TAX LIABILITY. TO THE EXTENT, HOWEVER, THAT ACCOUNTING TRANSACTIONS, RECORDS AND OTHER INFORMATION WERE AVAILABLE OR COULD BE RECONSTRUCTED, SUCH INFORMATION HAS BEEN INCLUDED HEREIN AND USED AS THE BASIS FOR COMPUTATION OF TAXPAYER'S INCOME TAX LIABILITY. ADDITIONALLY, DUE TO TAXPAYER'S BANKRUPTCY, COMPLETE INFORMATION NECESSARY TO PREPARE TAXPAYER'S ACCOUNTING AND TAX RETURNS WAS NOT AVAILABLE TO TIMELY FILE THESE TAX RETURNS. BECAUSE OF THIS, IT WAS IMPOSSIBLE TO PREPARE TAX RETURNS FOR THE ESTATE UNTIL THIS DATE. THEREFORE, NO PENALTIES OR INTEREST FOR LATE FILING AS WELL AS LATE PAYMENT SHOULD BE ASSESSED AND SHOULD BE WAIVED FOR REASONABLE CAUSE. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS 15 VOTING MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7A THE OFFICERS AND DIRECTORS OF THE ORGANIZATION HAVE THE POWER TO ELECT AND VOTE TO APPOINT THE MEMBERS OF THE GOVERNING BODY FORM 990, PART VI, SECTION B, LINE 11B TH EORGANIZATION PROVIDED FORM 990 TO TRUSTEE AND MEMEBERS OF THE ORGANIZATION AND GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION FOLLOWS AND IMPLEMENTS A SCREENING PROCESS TO MONITOR AND ENFORCE COMPLIANCE WITH CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION KEEPS RECORDS AVAILABLE UPON REQUEST UNDER A RECORD'S CUSTODIAN, DANIEL WAY PHONE NO. (323) 837-5190 BEVERLY COMMUNITY HOSPITAL ASSOCIATION 309 WEST BEVERLY BOULEVARD MONTEBELLO CA 90640 951816005 NON-PROFIT HOSPITAL CA 501(C)(3) LINE 3 N/A 1 BEVERLY HOSPITAL FOUNDATION 309 WEST BEVERLY BOULEVARD MONTEBELLO CA 90640 237429685 FUNDRAISING FOR BCHA CA 501(C)(3) LINE 7 BEVERLY COMMUNITY HOSPITAL ASSOCIATION 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 BEVERLY COMMUNITY HOSPITAL ASSOCIATION A BOOK VALUE BEVERLY COMMUNITY HOSPITAL ASSOCIATION D BOOK VALUE BEVERLY COMMUNITY HOSPITAL ASSOCIATION E BOOK VALUE