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Nonprofiteer
← GOOD SAMARITAN MEDICAL CENTER FOUNDATION

Form 990 for tax year 2023

Filed by GOOD SAMARITAN MEDICAL CENTER FOUNDATION.

Totals

Total revenue
$982,682
Total expenses
$1,231,087
Contributions and grants received
$893,769
Grants paid
$684,423
Program services expenses (Part IX)
$721,816
Management and general expenses
$412,262
Fundraising expenses
$97,009
Program service expenses (Part III)
$721,816

Program services were 58.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • DAWN ANUSZKIEWICZ

    DIRECTOR

    Total calculated
    $805,644
    From this org
    $0
    From related orgs
    $557,039
    Other
    $248,605
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $449,752 related
    Bonus
    $0 + $102,393 related
    Other
    $0 + $4,894 related
    Deferred
    $0 + $221,067 related
    Nontaxable benefits
    $0 + $27,538 related
    Filer's total
    $0 + $805,644 related

  • EDWARD PYUN MD

    DIRECTOR

    Total calculated
    $613,438
    From this org
    $0
    From related orgs
    $567,394
    Other
    $46,044
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $493,714 related
    Bonus
    $0 + $46,761 related
    Other
    $0 + $26,919 related
    Deferred
    $0 + $14,508 related
    Nontaxable benefits
    $0 + $31,536 related
    Filer's total
    $0 + $613,438 related

  • STEVEN HANKINS

    DIRECTOR

    Total calculated
    $542,040
    From this org
    $0
    From related orgs
    $374,616
    Other
    $167,424
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $334,255 related
    Bonus
    $0 + $24,054 related
    Other
    $0 + $16,307 related
    Deferred
    $0 + $165,641 related
    Nontaxable benefits
    $0 + $1,783 related
    Filer's total
    $0 + $542,040 related

  • JANET BONNER

    EXECUTIVE DIRECTOR FOUNDATION

    Total calculated
    $233,226
    From this org
    $0
    From related orgs
    $192,109
    Other
    $41,117
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $169,780 related
    Bonus
    $0 + $15,519 related
    Other
    $0 + $6,810 related
    Deferred
    $0 + $26,118 related
    Nontaxable benefits
    $0 + $14,999 related
    Filer's total
    $0 + $233,226 related

  • CATHERINE LAZER MD

    DIRECTOR

    Total calculated
    $9,225
    From this org
    $0
    From related orgs
    $9,225
    Other
    $0
    Hours/week
    1

  • TOM ALFORD

    PAST CHAIR 1/1-7/31/23

    Total calculated
    $0
    Hours/week
    1

  • SCOTT BUSCH

    CHAIR

    Total calculated
    $0
    Hours/week
    1

  • LOUIS CICIO

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • DALE CLINGNER

    SECRETARY

    Total calculated
    $0
    Hours/week
    1

  • BEVERLEY DAHAN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • BOB DAVIS

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • CORY DUVALL

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 50 related

  • JEFF LEFTWICH MD

    DIRECTOR 4/19-12/31/23

    Total calculated
    $0
    Hours/week
    1

  • MIKE MEINTS

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • KYLE MENDENHALL

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JASON PAPPAS

    DIRECTOR 9/1-12/31/23

    Total calculated
    $0
    Hours/week
    1

  • MARY BETH QUIRAM

    DIRECTOR 1/1-10/31/23

    Total calculated
    $0
    Hours/week
    1

  • WYMAN ROBB

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • JANET ROSS

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • ANNIE SIMMONS

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • MAX STITCH ESQ

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

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 — 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
COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT ARE PAID BY A RELATED ORGANIZATION, SCL HEALTH - FRONT RANGE, INC. COMPENSATION FOR THE OFFICERS AND SENIOR MANAGEMENT IS MANAGED BY THE INTERMOUNTAIN HEALTH CARE, INC. BOARD COMPENSATION COMMITTEE (COMMITTEE) ON BEHALF OF SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM, INC. AND ALL OF ITS AFFILIATES. THE COMMITTEE REVIEWS AND APPROVES COMPENSATION ARRANGEMENTS OF THE OFFICERS AND SENIOR MANAGEMENT AND MAKES RECOMMENDATIONS TO INTERMOUNTAIN HEALTH CARE, INC.'S BOARD FOR APPROVAL OF ANY CHANGES. THE COMMITTEE'S REVIEW IS CONDUCTED IN A MANNER THAT IS INTENDED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE INTERMEDIATE SANCTIONS RULES OF INTERNAL REVENUE CODE SECTION 4958. THE COMMITTEE CONDUCTS THE REVIEW WITH THE ASSISTANCE OF AN EXPERIENCED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT HAS DEEP NATIONAL EXPERTISE IN HEALTH SYSTEMS' EXECUTIVE COMPENSATION PROGRAMS AND LEVELS. THE COMMITTEE OBTAINS AND RELIES UPON CURRENT, COMPARABLE MARKET DATA FOR PEER ORGANIZATIONS PRIOR TO MAKING COMPENSATION RELATED DECISIONS. THE INFORMATION REVIEWED INCLUDES COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY COMPARABLE POSITIONS, THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA SERVED BY INTERMOUNTAIN HEALTH CARE, INC. AND CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. THE BOARD PLACES A HIGH PRIORITY ON THE NEED TO RECURIT AND RETAIN A STRONG LEADERSHIP TEAM AND TO CREATE A HIGHLY MOTIVATED AND ENGAGED WORKFORCE. COMPENSATION LEVELS FOLLOW IRS GUIDELINES AND ARE SUBJECT TO IRS OVERSIGHT. AS PART OF THE REVIEW PROCESS, INTERMOUNTAIN HEALTH CARE, INC. USES THE FOLLOWING IN ESTABLISHING THE COMPENSATION OF OFFICERS AND SENIOR MANAGEMENT. 1) COMPENSATION COMMITTEE 2) INDEPENDENT COMPENSATION CONSULTANT 3) FORM 990 OF OTHER ORGANIZATIONS 4) COMPENSATION SURVEYS AND STUDIES 5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE THE ITEMS LISTED ABOVE SUPPORT THE COMPENSATION COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED TO ITS OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD.
PART I, LINE 4
PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN A RELATED ORGANIZATION PROVIDES NONQUALIFIED DEFERRED COMPENSATION PLANS (NQDC) KNOWN AS SUPPLEMENTAL EXECUTIVE RETIREMENT PROGRAM (SERP) FOR EXECUTIVES (SENIOR MANAGEMENT) TO COMPENSATE FOR REGULATORY IMPOSED LIMITATIONS IN QUALIFIED RETIREMENT PLANS AND TO PROVIDE A BENEFIT CONSISTENT WITH OTHER NOT- FOR- PROFIT HEALTH SYSTEMS. THESE PLANS ENABLE THE EXECUTIVE TO EARN BENEFITS DURING EACH YEAR THAT THEY PARTICIPATE. IN 2014, IN AN EFFORT TO REDUCE LONG-TERM COSTS AND HAVE GREATER CONTROL OVER FINANCIAL RISK, THE SERP WAS CONVERTED FROM A DEFINED BENEFIT (DB) TO A DEFINED CONTRIBUTION (DC) DESIGN. CERTAIN MEMBERS OF SENIOR MANAGEMENT WHOSE BENEFITS WERE CONVERTED FROM DB TO DC WOULD HAVE BEEN DISPROPORTIONATELY AND NEGATIVELY AFFECTED BY THE CHANGE, SO THE COMMITTEE DETERMINED IT WOULD BE APPROPRIATE TO GRANT "TRANSITION CREDITS" IN ORDER TO MITIGATE THE NEGATIVE IMPACT OF THE CHANGE ON THEIR RETIREMENT BENEFITS. THIS IS A COMMON APPROACH EMPLOYED BY OTHER ORGANIZATIONS UNDERGOING A SIMILAR TRANSITION. THE TRANSITION CREDITS VEST IN ACCORDANCE WITH THE TERMS OF THE DC SERP (I.E., AFTER THREE YEARS) AND ARE PAID TO THE EXECUTIVE UPON VESTING. NQDC SERP PLANS STARTING IN 2014 STARTING IN 2014, THE RELATED ORGANIZATION'S NQDC SERP PLAN PROVIDED A BENEFIT TO ELIGIBLE PARTICIPANTS BASED ON A PERCENTAGE OF THEIR BASE COMPENSATION. THE VESTING PERIOD IS ROLLING 3 YEARS OR WHEN THE PARTICIPANT IS AGE 65 OR OLDER. THERE WERE NO CONTRIBUTIONS TO THIS PLAN BEFORE JANUARY 1, 2014. ANY DISTRIBUTIONS FROM THIS PLAN ARE REPORTED BELOW. CERTAIN PARTICIPANTS ARE VESTED OR BECAME VESTED IN THE PLAN DURING 2023. VESTED AMOUNTS ARE PAYABLE TO THE RECIPIENT UPON THE END OF EMPLOYMENT. THE VESTED AMOUNTS ARE TAXABLE TO THE RECIPIENT IN THE CURRENT YEAR. THE TAXABLE AMOUNTS ARE INCLUDED ON THE RECIPIENT'S W-2. THE AMOUNTS WITHDRAWN FROM THE NQDC SERP PLANS IN 2023 WERE: NONE.
SCHEDULE J - ADDITIONAL OFFICER AND BOARD DISCLOSURES
INTERMOUNTAIN HEALTH CARE, INC. AND RELATED TAX-EXEMPT ORGANIZATIONS ADHERE TO GOVERNANCE EXCELLENCE STANDARDS INCLUDING ACCOUNTABILITY. IN KEEPING WITH INTERMOUNTAIN HEALTH CARE, INC.'S CORE VALUE OF STEWARDSHIP, INTERMOUNTAIN HEALTH CARE, INC.'S BOARD COMPENSATION COMMITTEE (COMMITTEE) HAS RETAINED THE SERVICES OF AN INDEPENDENT COMPENSATION ADVISOR. THE COMPENSATION ADVISOR IS RESPONSIBLE FOR ADVISING THE COMMITTEE ON ALL MATTERS RELATING TO EXECUTIVE COMPENSATION INCLUDING SUPPORTING THE COMMITTEE'S EFFORTS TO ENSURE THAT THE LEVEL OF COMPENSATION PROVIDED OFFICERS AND SENIOR MANAGEMENT IS REASONABLE, APPROPRIATE AND CONSISTENT WITH THE PAY PHILOSOPHY SET BY THE BOARD. THE SISTERS WHO SERVE AS OFFICERS AND/OR BOARD MEMBERS ARE MEMBERS OF THE SISTERS OF CHARITY OF LEAVENWORTH (A RELIGIOUS ORDER OF WOMEN). THE SISTERS HAVE TAKEN VOWS OF POVERTY AND RECEIVE NO COMPENSATION, EXPENSE ACCOUNT ALLOWANCE, OR CONTRIBUTIONS TO BENEFIT PLANS FOR THEIR SERVICES TO THE HEALTH CARE SYSTEM. HOWEVER, A PAYMENT IS MADE DIRECTLY TO THE SISTERS OF CHARITY OF LEAVENWORTH FOR THE SERVICES OF THOSE WHO PERFORM PROFESSIONAL, ADMINISTRATIVE, AND OTHER SUCH SERVICES.

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

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.

Provenance

Return type
form_990
Tax year
2023
Filed
6 November 2024
IRS schema version
2023v5.1
Source object
202443129349301954

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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