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Nonprofiteer
← GOOD SAMARITAN HOSPITAL FOUNDATION

Form 990 for tax year 2022

Filed by GOOD SAMARITAN HOSPITAL FOUNDATION.

Totals

Total revenue
$1,849,366
Total expenses
$532,718
Contributions and grants received
$1,830,002
Grants paid
$0
Program service revenue
$0
Investment income
$16,684
Other revenue
$2,680
Total assets, end of year
$9,486,100
Total liabilities, end of year
$1,150,750
Net assets or fund balances, end of year
$8,335,350
Program services expenses (Part IX)
$473,821
Management and general expenses
$12,133
Fundraising expenses
$46,764
Program service expenses (Part III)
$473,821

Program services were 88.9% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • DANIEL DEBARBA

    EVP & CFO THRU 8/5/2022

    Total calculated
    $1,411,216
    From this org
    $0
    From related orgs
    $1,103,144
    Other
    $308,072
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $626,446 related
    Bonus
    $0 + $350,000 related
    Other
    $0 + $126,698 related
    Deferred
    $0 + $274,411 related
    Nontaxable benefits
    $0 + $33,661 related
    Filer's total
    $0 + $1,411,216 related

  • RUTH HENNESSEY

    PRESIDENT/CAO

    Total calculated
    $1,221,305
    From this org
    $0
    From related orgs
    $1,037,879
    Other
    $183,426
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $666,635 related
    Bonus
    $0 + $170,000 related
    Other
    $0 + $201,244 related
    Deferred
    $0 + $164,167 related
    Nontaxable benefits
    $0 + $19,259 related
    Filer's total
    $0 + $1,221,305 related

  • PATRICK MINICUS

    EVP & CFO AS OF 12/12/2022

    Total calculated
    $875,086
    From this org
    $0
    From related orgs
    $805,216
    Other
    $69,870
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $607,424 related
    Bonus
    $0 + $180,000 related
    Other
    $0 + $17,792 related
    Deferred
    $0 + $21,411 related
    Nontaxable benefits
    $0 + $48,459 related
    Filer's total
    $0 + $875,086 related

  • JOHN VULLO

    FORMER OFFICER

    Total calculated
    $758,320
    From this org
    $0
    From related orgs
    $689,791
    Other
    $68,529
    Hours/week
    2

    Schedule J breakdown matched by us

    Base
    $0 + $686,975 related
    Bonus
    $0
    Other
    $0 + $2,816 related
    Deferred
    $0 + $21,167 related
    Nontaxable benefits
    $0 + $47,362 related
    Filer's total
    $0 + $758,320 related

  • MARGARET MAHER

    SVP& CHIEF DEVELOPMENT OFFICER

    Total calculated
    $496,942
    From this org
    $0
    From related orgs
    $473,197
    Other
    $23,745
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $397,391 related
    Bonus
    $0 + $74,000 related
    Other
    $0 + $1,806 related
    Deferred
    $0 + $19,978 related
    Nontaxable benefits
    $0 + $3,767 related
    Filer's total
    $0 + $496,942 related

  • CHARLES FERRARO

    CHAIRMAN

    Total calculated
    $0
    Hours/week
    2

  • THOMAS MCATEER

    TRUSTEE

    Total calculated
    $0
    Hours/week
    2

  • KATHLEEN GIAMO

    TRUSTEE

    Total calculated
    $0
    Hours/week
    2

  • EILEEN LA MENDOLA

    TRUSTEE

    Total calculated
    $0
    Hours/week
    2

  • MICHAEL VIRGILIO

    TRUSTEE

    Total calculated
    $0
    Hours/week
    2

  • SALVATORE CAPITANO

    TRUSTEE RESIGNED 3/11/2022

    Total calculated
    $0
    Hours/week
    2

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, and on a Form 990-PF Part VIII's — 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

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 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 - METHODS TO ESTABLISH COMPENSATION BY RELATED ORGANIZATION
THE FOLLOWING METHODS ARE USED BY A RELATED ORGANIZATION TO ESTABLISH COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, FORM 990 OF OTHER ORGANIZATIONS, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN
THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN C. DANIEL DEBARBA $253,000 PARTICIPATION IN THE PLAN RUTH HENNESSEY $143,000 PARTICIPATION IN THE PLAN THE DEFERRED COMPENSATION IN COLUMN C FOR THESE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NON-QUALIFIED RETIREMENT PLANS. THE FOLLOWING INDIVIDUALS VESTED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III). THESE AMOUNTS INCLUDE A TAX GROSS UP. RUTH HENNESSY $176,818 VESTED IN PLAN. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2022 FORM W-2, BOX 5 AS TAXABLE WAGES BECAUSE THEY ARE VESTED, BUT ARE NOT DISTRIBUTED UNTIL RETIREMENT.

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

No itemized grants to organizations 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.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2022
Filed
9 November 2023
IRS schema version
2022v5.0
Source object
202303179349309290

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