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Nonprofiteer
← SAMARITAN PACIFIC HEALTH SERVICES INC

Form 990 for tax year 2022

Filed by SAMARITAN PACIFIC HEALTH SERVICES INC.

Totals

Total revenue
$151,534,327
Total expenses
$134,438,954
Contributions and grants received
$4,405,491
Grants paid
$79,744
Program service revenue
$146,889,662
Investment income
-$84,179
Other revenue
$323,353
Total assets, end of year
$109,302,157
Total liabilities, end of year
$24,674,061
Net assets or fund balances, end of year
$84,628,096
Program services expenses (Part IX)
$120,689,491
Management and general expenses
$13,734,754
Fundraising expenses
$14,709
Program service expenses (Part III)
$120,689,491

Program services were 89.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • DOUGLAS BOYSEN

    BOARD CHAIR / CEO SHS

    Total calculated
    $1,577,367
    From this org
    $0
    From related orgs
    $1,512,954
    Other
    $64,413
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,045,442 related
    Bonus
    $0 + $380,053 related
    Other
    $0 + $87,459 related
    Deferred
    $0 + $24,620 related
    Nontaxable benefits
    $0 + $39,793 related
    Filer's total
    $0 + $1,577,367 related

  • KELLEY KAISER

    BRD VICE CHAIR / CAO SHS

    Total calculated
    $558,912
    From this org
    $0
    From related orgs
    $496,145
    Other
    $62,767
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $402,834 related
    Bonus
    $0 + $85,255 related
    Other
    $0 + $8,056 related
    Deferred
    $0 + $24,620 related
    Nontaxable benefits
    $0 + $38,147 related
    Filer's total
    $0 + $558,912 related

  • RALPH BREITENSTEIN MD

    BOARD SECRETARY

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • JOHN BAKER

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • STEPHEN BURNS MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • SUSAN WOODRUFF

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • JERRY ROBBINS MD

    BOARD MEMBER

    Total calculated
    $47,819
    From this org
    $0
    From related orgs
    $46,880
    Other
    $939
    Hours/week
    1 + 2 related

  • LINDA MOLLINO

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • REBECCA AUSTEN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • LESLEY OGDEN MD

    CEO / CEO SNLH

    Total calculated
    $552,412
    From this org
    $0
    From related orgs
    $498,041
    Other
    $54,371
    Hours/week
    20 + 20 related

    Schedule J breakdown matched by us

    Base
    $0 + $388,943 related
    Bonus
    $0 + $88,660 related
    Other
    $0 + $20,438 related
    Deferred
    $0 + $24,620 related
    Nontaxable benefits
    $0 + $29,751 related
    Filer's total
    $0 + $552,412 related

  • DANIEL SMITH

    SVP / CFO

    Total calculated
    $701,981
    From this org
    $0
    From related orgs
    $638,044
    Other
    $63,937
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $492,567 related
    Bonus
    $0 + $104,160 related
    Other
    $0 + $41,317 related
    Deferred
    $0 + $24,620 related
    Nontaxable benefits
    $0 + $39,317 related
    Filer's total
    $0 + $701,981 related

  • JANE RUSSELL

    VP COO

    Total calculated
    $336,989
    From this org
    $306,732
    From related orgs
    $0
    Other
    $30,257
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $260,061
    Bonus
    $24,454
    Other
    $22,217
    Deferred
    $24,620
    Nontaxable benefits
    $5,637
    Filer's total
    $336,989

  • SAM JONES

    VP PATIENT CARE SERVICES

    Total calculated
    $277,954
    From this org
    $219,569
    From related orgs
    $0
    Other
    $58,385
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $196,680
    Bonus
    $18,110
    Other
    $4,779
    Deferred
    $16,763
    Nontaxable benefits
    $41,622
    Filer's total
    $277,954

  • DAVID LARSEN MD

    PHYSICIAN

    Total calculated
    $579,446
    From this org
    $516,963
    From related orgs
    $0
    Other
    $62,483
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $486,985
    Bonus
    $28,631
    Other
    $1,347
    Deferred
    $24,620
    Nontaxable benefits
    $37,863
    Filer's total
    $579,446

  • DOUGLAS WILSON MD

    PHYSICIAN

    Total calculated
    $515,717
    From this org
    $457,719
    From related orgs
    $0
    Other
    $57,998
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $406,397
    Bonus
    $48,486
    Other
    $2,836
    Deferred
    $18,520
    Nontaxable benefits
    $39,478
    Filer's total
    $515,717

  • BREWSTER KELLOGG DO

    MEDICAL DIRECTOR

    Total calculated
    $437,286
    From this org
    $373,877
    From related orgs
    $0
    Other
    $63,409
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $347,366
    Bonus
    $0
    Other
    $26,511
    Deferred
    $24,620
    Nontaxable benefits
    $38,789
    Filer's total
    $437,286

  • ERIN GUILIANO LICHY DO

    PHYSICIAN

    Total calculated
    $485,940
    From this org
    $430,314
    From related orgs
    $0
    Other
    $55,626
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $319,511
    Bonus
    $85,286
    Other
    $25,517
    Deferred
    $24,620
    Nontaxable benefits
    $31,006
    Filer's total
    $485,940

  • NATHANIEL UECKER MD

    PHYSICIAN

    Total calculated
    $432,883
    From this org
    $398,619
    From related orgs
    $0
    Other
    $34,264
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $339,453
    Bonus
    $20,000
    Other
    $39,166
    Deferred
    $0
    Nontaxable benefits
    $34,264
    Filer's total
    $432,883

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

  • 1a · Health or social club dues or initiation fees
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 4b · Supplemental nonqualified retirement plan
  • 5a · Pay contingent on this organization's revenues

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 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 1A
IN CONNECTION WITH ITS EMPLOYEE WELLNESS PROGRAM, THE ORGANIZATION HAS A GYM/FITNESS FACILITY BENEFIT THAT IS AVAILABLE TO ALL EMPLOYEES WHO WORK AT LEAST 32 HOURS PER MONTH. EMPLOYEES CAN USE THEIR WELLNESS BENEFIT AT EITHER NON-SAMARITAN OR SAMARITAN (SAMFIT) GYM/FITNESS FACILITIES. IF AN EMPLOYEE PARTICIPATES AT A NON-SAMARITAN GYM, REIMBURSEMENT IS MADE FOR FEES. REIMBURSEMENT DOES NOT EXCEED $300 PER YEAR AND IS INCLUDED IN THEIR TAXABLE WAGES SUBJECT TO FEDERAL/STATE WITHHOLDING TAX. NO PERSONS LISTED ON PART VII USED THE NON-SAMARITAN GYM REIMBURSEMENT DURING THE FILING YEAR. IF EMPLOYEES USE THEIR WELLNESS BENEFIT AT A SAMARITAN (SAMFIT) GYM/FITNESS FACILITY, THEN THE ANNUAL COST OF EMPLOYEE MEMBERSHIP, $300, IS INCLUDED IN THE EMPLOYEE'S TAXABLE WAGES SUBJECT TO FEDERAL/STATE WITHHOLDING TAX. TWO BOARD MEMBERS, TWO KEY EMPLOYEES, AND ONE OFFICER USED THE SAMARITAN (SAMFIT) GYM/FITNESS FACILITY BENEFIT DURING THE FILING YEAR.
PART I, LINE 3
THE CHIEF EXECUTIVE OFFICER IS EMPLOYED AND PAID BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION CONDUCTS A COMPENSATION ANALYSIS EACH YEAR TO COMPARE COMPENSATION OF ALL PAID POSITIONS TO MARKET SURVEYS OF COMPENSATION FOR SIMILAR POSITIONS IN OTHER ORGANIZATIONS. PERIODICALLY, THE RELATED ORGANIZATION WILL ALSO USE WRITTEN EMPLOYMENT CONTRACTS, FORM 990 OF OTHER ORGANIZATIONS, AND INDEPENDENT COMPENSATION CONSULTANTS TO DETERMINE THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER.
PART I, LINE 4B
A RELATED ORGANIZATION MAINTAINS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. HOWEVER, NO PERSONS LISTED IN PART VII OF FORM 990 ACCRUED DEFERRED COMPENSATION BENEFITS OR RECEIVED ANY PAYMENTS FROM THESE PLANS DURING THE FILING YEAR.
PART I, LINE 5
VARIOUS PHYSICIAN COMPENSATION METHODOLOGIES ARE UTILIZED AND, DEPENDING ON SPECIALTY, RELATIVE VALUE UNITS (RVU'S) MAY BE USED IN DETERMINING A PORTION OF OR ALL OF THEIR COMPENSATION.

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.

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
2 November 2023
IRS schema version
2022v5.0
Source object
202343149349303024

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