Skip to content
Nonprofiteer
← SAMARITAN EMERGENCY MEDICAL SERVICES PC

Form 990 for tax year 2022

Filed by SAMARITAN EMERGENCY MEDICAL SERVICES PC.

Totals

Total revenue
$0
Total expenses
$416
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$0
Other revenue
$0
Total assets, end of year
$736,709
Total liabilities, end of year
$617,948
Net assets or fund balances, end of year
$118,761
Program services expenses (Part IX)
$0
Management and general expenses
$416
Fundraising expenses
$0
Program service expenses (Part III)
$0

Program services were 0.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 3 · Investment income

    total $0

  • 4 · Income from investment of tax-exempt bond proceeds

    total $0

  • 5 · Royalties

    total $0

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 6d · Net rental income or loss

    total $0

  • 7d · Net gain or loss

    total $0

  • 8a · Fundraising events: gross income

    $0

  • 8b · Fundraising events: direct expenses

    $0

  • 8c · Net income from fundraising events

    total $0

  • 9a · Gaming: gross income

    $0

  • 9b · Gaming: direct expenses

    $0

  • 9c · Net income from gaming

    total $0

  • 10a · Gross sales of inventory

    $0

  • 10b · Cost of goods sold

    $0

  • 10c · Net income from sales of inventory

    total $0

  • 11e · Other revenue, total

    $0

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $0

  • 2 · Grants to domestic individuals

    total $0

  • 3 · Grants to foreign organizations and individuals

    total $0

  • 4 · Benefits paid to or for members

    total $0

  • 5 · Compensation of officers, directors and key employees

    total $0

  • 6 · Compensation of disqualified persons

    total $0

  • 7 · Other salaries and wages

    total $0

  • 8 · Pension plan contributions

    total $0

  • 9 · Other employee benefits

    total $0

  • 10 · Payroll taxes

    total $0

  • 11a · Fees: management

    total $0

  • 11b · Fees: legal

    total $0

  • 11c · Fees: accounting

    total $0

  • 11d · Fees: lobbying

    total $0

  • 11e · Fees: professional fundraising services

    total $0

  • 11f · Fees: investment management

    total $0

  • 11g · Fees: other

    total $0

  • 12 · Advertising and promotion

    total $0

  • 13 · Office expenses

    total $0

  • 14 · Information technology

    total $0

  • 15 · Royalties

    total $0

  • 16 · Occupancy

    total $0

  • 17 · Travel

    total $0

  • 18 · Travel or entertainment for public officials

    total $0

  • 19 · Conferences, conventions and meetings

    total $0

  • 20 · Interest

    total $0

  • 21 · Payments to affiliates

    total $0

  • 22 · Depreciation, depletion and amortization

    total $0

  • 23 · Insurance

    total $0

  • 24a · Other expenses: BANK FEES

    total $416 · program services $0 · management and general $416 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $2,782,524 · end of year $736,709

  • 2 · Savings and temporary cash investments

    beginning of year $0 · end of year $0

  • 3 · Pledges and grants receivable

    beginning of year $0 · end of year $0

  • 4 · Accounts receivable

    beginning of year $407 · end of year $0

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $0 · end of year $0

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $0 · end of year $0

  • 12 · Investments: other securities

    beginning of year $0 · end of year $0

  • 13 · Investments: program-related

    beginning of year $0 · end of year $0

  • 14 · Intangible assets

    beginning of year $0 · end of year $0

  • 15 · Other assets

    beginning of year $0 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $52,580 · end of year $53,810

  • 18 · Grants payable

    beginning of year $0 · end of year $0

  • 19 · Deferred revenue

    beginning of year $0 · end of year $0

  • 20 · Tax-exempt bond liabilities

    beginning of year $0 · end of year $0

  • 21 · Escrow or custodial account liability

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0 · end of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $2,611,174 · end of year $564,138

  • 27 · Net assets without donor restrictions

    beginning of year $119,177 · end of year $118,761

  • 28 · Net assets with donor restrictions

    beginning of year $0 · end of year $0

Mission and programs · 2022

Mission

SAMARITAN EMERGENCY MEDICAL SERVICES PC IS A MEMBER OF CATHOLIC HEALTH. WE, AT CATHOLIC HEALTH, HUMBLY JOIN TOGETHER TO BRING CHRIST'S HEALING MISSION AND THE MISSION OF MERCY OF THE CATHOLIC CHURCH EXPRESSED IN CATHOLIC HEALTH CARE TO OUR COMMUNITIES. I-CARE VALUES INTEGRITY: WE ARE WHO WE SAY WE ARE AND ACT IN ACCORDANCE WITH THE SPLENDOR OF TRUTH OF OUR CATHOLIC MORAL TEACHING AND OUR CATHOLIC VALUES. COMPASSION: WE HAVE COMPASSION FOR OUR PATIENTS, SEE THE SUFFERING CHRIST IN THEM, STRIVE TO ALLEVIATE SUFFERING AND SERVE THE SPIRITUAL, PHYSICAL AND EMOTIONAL NEEDS OF OUR PATIENTS. ACCOUNTABILITY: WE TAKE RESPONSIBILITY FOR OUR ACTIONS AND THEIR CONSEQUENCES. RESPECT: WE HONOR THE SANCTITY OF LIFE AT EVERY STAGE OF LIFE AND THE DIGNITY OF EVERY PERSON, AND INCORPORATE ALL THE PRINCIPLES OF CATHOLIC SOCIAL TEACHING IN OUR RELATIONSHIPS AND ADVOCACY. EXCELLENCE: WE SEEK THE GLORY OF GOD IN THE COMPASSIONATE SERVICE OF OUR PATIENTS, AND WE STRIVE TO DO THE BEST THAT CAN BE DONE, WHATEV

Activities or mission (Part I)

WE, AT CH, HUMBLY JOIN TOGETHER TO BRING CHRIST'S HEALING MISSION AND THE MISSION OF MERCY OF THE CATHOLIC CHURCH EXPRESSED IN CATHOLIC HEALTH CARE TO OUR COMMUNITIES.

  • THROUGH MAY OF 2014, SAMARITAN EMERGENCY MEDICAL SERVICES MANAGED THE EMERGENCY ROOM OF GOOD SAMARITAN UNIVERSITY HOSPITAL, A PREMIER HEALTHCARE FACILITY PROVIDING QUALITY HEALTHCARE SERVICES TO THE SOUTH SHORE OF LONG ISLAND. EFFECTIVE MAY 2014 THE MANAGEMENT OF THE EMERGENCY ROOM WAS OUTSOURCED BUT THIS ENTITY CONTINUES TO SUPPORT THE EXEMPT OPERATIONS OF THE HOSPITAL

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Donald Teplitz

    CHIEF MED OFFICER

    Total calculated
    $740,788
    From this org
    $0
    From related orgs
    $686,059
    Other
    $54,729
    Hours/week
    50

    Schedule J breakdown matched by us

    Base
    $0 + $606,600 related
    Bonus
    $0 + $75,000 related
    Other
    $0 + $4,459 related
    Deferred
    $0 + $21,167 related
    Nontaxable benefits
    $0 + $33,562 related
    Filer's total
    $0 + $740,788 related

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

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 - 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'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.

  • BIPO HOLDINGS LLC

    N/A · PHYSICIAN ASS · NY

    Directly controlled by NA

  • IDHC LLC

    N/A · HEALTH SERVIC · PA

    Directly controlled by NA

  • BEACON HEALTH PTNRS

    N/A · HEALTHCARE · NY

    Directly controlled by NA

  • WISDOM GARDENS LP

    N/A · SR HOUSING · NY

    Directly controlled by NA

  • CHS PHYSICIAN PARTNERS ACO LLC

    N/A · HEALTHCARE · NY

    Directly controlled by NA

  • LONG ISLAND HEALTHCARE NETWORK

    N/A · CONTRACTING · NY

    Directly controlled by NA

Related corporations and trusts

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

  • RADIOLOGY CONSULTING OF LONG ISLANDPLLC

    C-CORP · HEALTHCARE SV · NY

    Directly controlled by GOOD SAMARITAN

  • SAMARITAN PEDIATRIC SERVICES PC

    C-CORP · HEALTHCARE SV · NY

    Directly controlled by GOOD SAMARITAN

  • SAMARITAN MEDICAL SERVICES PC

    C-CORP · HEALTHCARE SV · NY

    Directly controlled by GOOD SAMARITAN

  • SOUTHWEST SUFFOLK MEDICAL PC

    C-CORP · HEALTHCARE SV · NY

    Directly controlled by GOOD SAMARITAN

  • CARDIAC EKG INTERPRETATION PC

    C-CORP · HEALTHCARE SV · NY

    Directly controlled by GOOD SAMARITAN

  • LI REGIONAL ARTHRITIS & OSTEOPOROSIS CAR

    C-CORP · HEALTHCARE SV · NY

    Directly controlled by GOOD SAMARITAN

  • SAMARITAN MANAGEMENT SERVICES

    C-CORP · HEALTHCARE SV · NY

    Directly controlled by CHSLI

  • ADVANCED REHABILIATION MEDICINE PLLC

    C-CORP · HEALTHCARE SV · NY

    Directly controlled by STCHARLES HOSP

  • ST FRANCIS CARDIAC PREVENTION SERVICES

    C-CORP · HEALTHCARE SV · NY

    Directly controlled by STFRANCIS HOSP

  • SOUTH SHORE PRACTICE MANAGEMENT

    C-CORP · HEALTHCARE SV · NY

    Directly controlled by SAMARITAN MGMT

  • SAMARITAN HOME CARE AMERICA

    C-CORP · HEALTHCARE SV · NY

    Directly controlled by SAMARITAN MGMT

  • MERCY INTERNAL MEDICINE PC

    C-CORP · HEALTHCARE SV · NY

    Directly controlled by MERCY MED CTR

  • LONG ISLAND EMERGENCY CARE PC

    S-CORP · PHYSICIAN SVC · NY

    Directly controlled by MERCY MED CTR

  • MY CHS RX INC

    C-CORP · PHARMACY · NY

    Directly controlled by CHSLI

Provenance

Return type
form_990
Tax year
2022
Filed
9 November 2023
IRS schema version
2022v5.0
Source object
202323179349310002

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

The source document this was parsed from is served over the API, which is where bulk and document access live.