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Nonprofiteer
← PIH HEALTH GOOD SAMARITAN HOSPITAL

Form 990 for tax year 2024

Filed by PIH HEALTH GOOD SAMARITAN HOSPITAL.

Totals

Total revenue
$360,502,530
Total expenses
$429,946,057
Contributions and grants received
$17,735,583
Grants paid
$3,055,493
Program service revenue
$320,227,054
Investment income
$11,895,738
Other revenue
$10,644,155
Total assets, end of year
$685,780,667
Total liabilities, end of year
$344,389,192
Net assets or fund balances, end of year
$341,391,475
Program services expenses (Part IX)
$396,145,799
Management and general expenses
$33,674,246
Fundraising expenses
$126,012
Program service expenses (Part III)
$396,145,799

Program services were 92.1% 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.

  • 1d · Related organizations

    $2,939

  • 1e · Government grants (contributions)

    $16,632,855

  • 1f · All other contributions, gifts and grants

    $1,099,789

  • 1g · Noncash contributions included above

    $25,676

  • 2a · Program service revenue: PATIENT REVENUE

    total $254,897,000 · related or exempt $254,897,000

  • 2b · Program service revenue: HOSPITAL FEE PROGRAM

    total $61,009,820 · related or exempt $61,009,820

  • 2c · Program service revenue: LAMBERT RADIOLOGY

    total $2,423,323 · related or exempt $2,423,323

  • 2d · Program service revenue: FOOD SERVICES

    total $1,848,911 · related or exempt $1,848,911

  • 2e · Program service revenue: RENTAL INCOME FROM AFFILIATES

    total $48,000 · related or exempt $48,000

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $9,411,620 · excluded $9,411,620

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7a · Gross sales of assets other than inventory

    securities $15,776,623 · other assets $26,558

  • 7b · Less cost or other basis and sales expenses

    securities $13,319,063

  • 7c · Gain or loss

    securities $2,457,560 · other assets $26,558

  • 7d · Net gain or loss

    total $2,484,118 · excluded $2,484,118

  • 11a · Other revenue: PARKING LOT

    total $2,470,477 · unrelated business $80,328 · excluded $2,390,149

  • 11b · Other revenue: VIVITY EARNING DISTRIBUTIONS

    total $629,664 · excluded $629,664

  • 11c · Other revenue: PHYSICIAN MANAGEMENT SERVICES

    total $47,100 · unrelated business $47,100

  • 11d · All other revenue

    total $7,496,914 · related or exempt $0 · unrelated business $29,434 · excluded $7,467,480

  • 11e · Other revenue, total

    $10,644,155

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $3,055,493 · program services $3,055,493

  • 5 · Compensation of officers, directors and key employees

    total $424,149 · program services $296,904 · management and general $127,245

  • 7 · Other salaries and wages

    total $130,993,032 · program services $126,996,814 · management and general $3,996,218

  • 8 · Pension plan contributions

    total $5,328,768 · program services $5,179,129 · management and general $149,639

  • 9 · Other employee benefits

    total $25,639,329 · program services $23,850,726 · management and general $1,788,603

  • 10 · Payroll taxes

    total $10,851,010 · program services $10,751,122 · management and general $99,888

  • 11d · Fees: lobbying

    total $86,999 · management and general $86,999

  • 11f · Fees: investment management

    total $177,350 · management and general $177,350

  • 11g · Fees: other

    total $112,211,651 · program services $95,072,507 · management and general $17,139,144 · fundraising $0

  • 12 · Advertising and promotion

    total $335,053 · program services $575 · management and general $334,478

  • 16 · Occupancy

    total $2,881,498 · program services $2,881,498

  • 20 · Interest

    total $21,647 · program services $21,647

  • 22 · Depreciation, depletion and amortization

    total $8,172,497 · program services $5,447,185 · management and general $2,725,312

  • 23 · Insurance

    total $5,136,387 · program services $1,758,344 · management and general $3,378,043

  • 24a · Other expenses: SUPPLIES

    total $62,042,632 · program services $61,757,937 · management and general $284,695

  • 24b · Other expenses: HOSPITAL FEE PROGRAM

    total $38,918,191 · program services $38,918,191

  • 24c · Other expenses: UTILITIES

    total $6,714,098 · program services $6,712,926 · management and general $1,172

  • 24d · Other expenses: OTHER EXPENSE

    total $16,956,273 · program services $13,444,801 · management and general $3,385,460 · fundraising $126,012

  • 24e · All other expenses

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

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $4,268,938 · end of year $1,642,558

  • 3 · Pledges and grants receivable

    beginning of year $1,643,091 · end of year $1,645,814

  • 4 · Accounts receivable

    beginning of year $95,411,919 · end of year $74,364,348

  • 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

  • 8 · Inventories for sale or use

    beginning of year $5,331,206 · end of year $6,036,616

  • 9 · Prepaid expenses and deferred charges

    beginning of year $2,904,864 · end of year $3,135,646

  • 10a · Land, buildings and equipment: cost or other basis

    $412,789,410

  • 10b · Land, buildings and equipment: accumulated depreciation

    $46,843,645

  • 10c · Land, buildings and equipment, net

    beginning of year $322,274,868 · end of year $365,945,765

  • 11 · Investments: publicly traded securities

    beginning of year $103,061,276 · end of year $152,349,380

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $67,988,358 · end of year $80,660,540

  • 17 · Accounts payable and accrued expenses

    beginning of year $76,420,683 · end of year $71,655,464

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $120,470,986 · end of year $272,733,728

  • 27 · Net assets without donor restrictions

    beginning of year $329,457,526 · end of year $263,835,893

  • 28 · Net assets with donor restrictions

    beginning of year $76,535,325 · end of year $77,555,582

Mission and programs · 2024

Mission

WE PROVIDE HIGH-QUALITY HEALTHCARE, WITHOUT DISCRIMINATION, AND CONTRIBUTE TO THE HEALTH AND WELL-BEING OF OUR COMMUNITIES IN AN ETHICAL, SAFE AND FISCALLY PRUDENT MANNER, IN RECOGNITION OF OUR CHARITABLE PURPOSE.

Activities or mission (Part I)

PROVIDE HIGH-QUALITY HEALTHCARE, WITHOUT DISCRIMINATION, AND CONTRIBUTE TO THE HEALTH AND WELL-BEING.

  • FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS: FINANCIAL ASSISTANCE, ALSO KNOWN AS CHARITY CARE, IS DEFINED AS FREE OR DISCOUNTED HEALTH SERVICES PROVIDED TO INDIVIDUALS WHO CANNOT AFFORD TO PAY AND WHO MEET THE ELIGIBILITY CRITERIA OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PIH HEALTH GOOD SAMARITAN HOSPITAL OFFERS A GENEROUS FINANCIAL ASSISTANCE PROGRAM, PROVIDING CHARITY CARE TO THOSE WITH FAMILY INCOME(S) AT OR BELOW 400% OF FEDERAL POVERTY LEVEL GUIDELINES. THE HOSPITAL HAS A POLICY TO TREAT EMERGENCY AND CERTAIN OTHER PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. UNDER THE CHARITY CARE POLICY, CHARITY CARE MAY BE PROVIDED TO PEOPLE WHO ARE UNINSURED OR UNDERINSURED AND CANNOT AFFORD TO PAY FOR THEIR OWN MEDICAL CARE. IN PROVIDING SERVICES TO THOSE PATIENTS PARTICIPATING IN MEANS-TESTED GOVERNMENT HEALTH PROGRAMS, SUCH AS MEDI-CAL, PIH HEALTH GOOD SAMARITAN HOSPITAL REALIZES A COLLECTIVE NET LOSS EACH FISCAL YEAR DUE TO THE SHORTFALL CREATED WHEN THE PAYMENTS RECEIVED FROM THESE PROGRAMS ARE LESS THAN THE COST OF CARING FOR PUBLIC PROGRAM BENEFICIARIES. NUMBER OF PERSONS SERVED BY FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS: 41,342

    Expenses $196,376,007 · Revenue $116,176,350

  • PATIENT CARE: FOUNDED IN 1885, PIH HEALTH GOOD SAMARITAN HOSPITAL IS THE OLDEST HOSPITAL IN LOS ANGELES. IT BECAME PART OF PIH HEALTH IN DECEMBER 2019. AS A NONPROFIT, 408-BED ACUTE CARE HOSPITAL, THE DOWNTOWN LOS ANGELES CAMPUS INCLUDES A HOSPITAL AND A MEDICAL OFFICE BUILDING, WHICH PROVIDE COMPASSIONATE HEALTHCARE SERVICES TO MEET THE NEEDS OF OUR PATIENTS, THEIR FAMILIES, AND A GROWING AND DIVERSE COMMUNITY. PATIENT CARE IN FISCAL YEAR 2024-2025 EMPLOYEES - 1,455 VOLUNTEERS - 263 NUMBER OF EMERGENCY DEPARTMENT (ED) VISITS - 45,793 NUMBER OF BIRTHS - 1,103 MEDICAL STAFF - 611

    Expenses $178,204,513 · Grants $3,055,493 · Revenue $193,390,664

  • OTHER COMMUNITY BENEFIT SERVICES: COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED SERVICES, RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT ARE COMPRISED OF THE FOLLOWING: COMMUNITY HEALTH IMPROVEMENT SERVICES: DEFINED AS COMMUNITY HEALTH IMPROVEMENT ACTIVITIES, WHICH EXTEND BEYOND PATIENT CARE ACTIVITIES. THIS CATEGORY INCLUDES COMMUNITY HEALTH EDUCATION, COMMUNITY SOCIAL SERVICE HELPLINE, MEDICATION-ASSISTED TREATMENT PROGRAM, MEDI-CAL ELIGIBILITY WORKERS AND TRANSPORTATION SERVICES. SNAPSHOT OF OUTCOMES: * 29,040 COMMUNITY MEMBERS WERE REACHED THROUGH A VARIETY OF COMMUNITY HEALTH IMPROVEMENT ACTIVITIES. HEALTH PROFESSIONS EDUCATION: THIS CATEGORY INCLUDES INTERNSHIP, EXTERNSHIP, PRECEPTORSHIP, AND MENTORING PROGRAMS (EMPLOYEES EXCLUDED) , SUPPORTING THE NEXT GENERATION OF HEALTHCARE PROVIDERS BY EDUCATING AND MENTORING STUDENTS IN CLINICAL, ANCILLARY, AND ADMINISTRATIVE SETTINGS. SNAPSHOT OF OUTCOMES: * 77 MEDICAL RESIDENTS, NURSING AND ANCILLARY PROFESSIONS STUDENTS WERE PROVIDED WITH MENTORSHIP, INTERNSHIP AND TRAINING OPPORTUNITIES. SUBSIDIZED HEALTH SERVICES: SUBSIDIZED SERVICES ARE CLINICAL PROGRAMS, WHICH ARE PROVIDED DESPITE A FINANCIAL LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF FINANCIAL ASSISTANCE, BAD DEBT AND MEDI-CAL SHORTFALLS. NEVERTHELESS, THE SERVICE IS PROVIDED BECAUSE IT MEETS AN IDENTIFIED COMMUNITY NEED AND, IF NO LONGER OFFERED, WOULD EITHER BE UNAVAILABLE IN THE AREA OR FALL TO THE RESPONSIBILITY OF GOVERNMENT OR ANOTHER NONPROFIT ORGANIZATION TO PROVIDE. PIH HEALTH GOOD SAMARITAN HOSPITAL SUBSIDIZED EMERGENCY DEPARTMENT OPERATIONS. SNAPSHOT OF OUTCOMES: * $2,541,622 IN EXPENSES WERE INCURRED IN SUBSIDIZED SERVICES IN FISCAL YEAR 2024-2025 RESEARCH: RESEARCH THAT MAY BE REPORTED AS COMMUNITY BENEFIT INCLUDES CLINICAL AND COMMUNITY HEALTH RESEARCH AS WELL AS STUDIES ON HEALTHCARE DELIVERY THAT ARE GENERALIZABLE AND SHARED WITH THE PUBLIC. PIH HEALTH GOOD SAMARITAN HOSPITAL HAS BEEN OFFERING CLINICAL TRIALS AND RESEARCH STUDIES AIMED AT IMPROVING HEALTH. SNAPSHOT OF OUTCOMES: * OVER $228,061 IN EXPENSES HAVE BEEN INCURRED IN RESEARCH IN FISCAL YEAR 2024-2025 CASH & IN-KIND CONTRIBUTIONS: THIS CATEGORY INCLUDES FUNDS AND IN-KIND SERVICES DONATED BY PIH HEALTH GOOD SAMARITAN HOSPITAL TO COMMUNITY ORGANIZATIONS OR TO THE COMMUNITY-AT-LARGE FOR A COMMUNITY BENEFIT PURPOSE. THESE DONATIONS INCLUDE IN-KIND HOURS CONTRIBUTED BY STAFF TO THE COMMUNITY ORGANIZATIONS WHILE ON PIH HEALTH WORK TIME, THE COST OF OFFICE AND MEETING SPACE PROVIDED TO COMMUNITY GROUPS, AND THE DONATIONS OF EQUIPMENT, MEDICATIONS, SUPPLIES AND SERVICES. SNAPSHOT OF OUTCOMES: $42,450 IN EXPENSES HAVE BEEN INCURRED IN THE CASH AND IN-KIND CONTRIBUTIONS CATEGORY IN FISCAL YEAR 2024-2025. TOTAL NUMBER OF PERSONS SERVED BY OTHER COMMUNITY BENEFIT SERVICES: 75,471 FOR ADDITIONAL INFORMATION, PLEASE REFER TO PIH HEALTH'S COMMUNITY BENEFIT REPORT AT PIHHEALTH.ORG/CBAANNUALREPORT

    Expenses $21,565,279 · Revenue $10,660,040

As filed on the 2024 return.

Listed in Part VII

  • ALEX ALVAREZ

    DIRECTOR & VICE CHAIR

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • CHARLOTTE WEAVER PHD

    DIRECTOR & CHAIR

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • PAUL TREINEN

    DIRECTOR & SECRETARY

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • WILLIAM ROTH

    DIRECTOR & TREASURER

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • DEBORAH MEDRANO

    DIRECTOR (AS OF 12/13/2024)

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • JEFFREY HAMAR

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • KENTON WOODS

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • MARISSA GOLDBERG

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.5 + 4.5 related

  • MELANIE BATISTE

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • MOEZ KHORSANDI DO

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.5

  • PATRICK MONROE

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • PETER GREANEY MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • REGINE LAWTON

    DIRECTOR (AS OF 12/13/2024)

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • RICHARD ATWOOD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.5 + 7.5 related

  • SCOTT KROG

    DIRECTOR (AS OF 12/13/2024)

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • SCOTT SOUTHRON

    DIRECTOR (AS OF 12/13/2024)

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • THURSO BARENDSE

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • TRACEA SARALIEV

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.5 + 6 related

  • WESLEY HEARTFIELD MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1.5

  • IRENA ZUANIC

    CNO & CO-SITE ADMIN

    Total calculated
    $596,230
    From this org
    $0
    From related orgs
    $477,595
    Other
    $118,635
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $394,660 related
    Bonus
    $0
    Other
    $0 + $82,935 related
    Deferred
    $0 + $93,721 related
    Nontaxable benefits
    $0 + $24,914 related
    Filer's total
    $0 + $596,230 related

  • JAMES WEST

    SYSTEM PRESIDENT & CEO

    Total calculated
    $1,663,779
    From this org
    $0
    From related orgs
    $1,623,596
    Other
    $40,183
    Hours/week
    10 + 42.2 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,603,998 related
    Bonus
    $0
    Other
    $0 + $19,598 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $21,883 related
    Filer's total
    $0 + $1,663,779 related

  • PEGGY CHULACK

    SYSTEM CAO & ASST SECRETARY

    Total calculated
    $1,515,125
    From this org
    $0
    From related orgs
    $1,481,245
    Other
    $33,880
    Hours/week
    10 + 42.2 related

    Schedule J breakdown matched by us

    Base
    $0 + $872,084 related
    Bonus
    $0
    Other
    $0 + $609,161 related
    Deferred
    $0 + $18,300 related
    Nontaxable benefits
    $0 + $15,580 related
    Filer's total
    $0 + $1,515,125 related

  • ROSALIO LOPEZ MD

    SYSTEM CSO/CMO

    Total calculated
    $1,396,488
    From this org
    $0
    From related orgs
    $1,344,833
    Other
    $51,655
    Hours/week
    10 + 36 related

    Schedule J breakdown matched by us

    Base
    $0 + $987,835 related
    Bonus
    $0
    Other
    $0 + $356,998 related
    Deferred
    $0 + $41,300 related
    Nontaxable benefits
    $0 + $10,355 related
    Filer's total
    $0 + $1,396,488 related

  • VID SHIVARAMAN

    SYSTEM CFO & ASST TREASURER

    Total calculated
    $1,085,954
    From this org
    $0
    From related orgs
    $870,104
    Other
    $215,850
    Hours/week
    10 + 42.2 related

    Schedule J breakdown matched by us

    Base
    $0 + $862,548 related
    Bonus
    $0
    Other
    $0 + $7,556 related
    Deferred
    $0 + $190,785 related
    Nontaxable benefits
    $0 + $25,065 related
    Filer's total
    $0 + $1,085,954 related

  • JASON FISCHER

    VP, OPERATONS FOR PHGSH

    Total calculated
    $575,020
    From this org
    $0
    From related orgs
    $484,256
    Other
    $90,764
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $292,015 related
    Bonus
    $0
    Other
    $0 + $192,241 related
    Deferred
    $0 + $84,709 related
    Nontaxable benefits
    $0 + $6,055 related
    Filer's total
    $0 + $575,020 related

  • MOHAMMED GHONIM

    REGIONAL VP (THRU 12/06/2024)

    Total calculated
    $596,939
    From this org
    $0
    From related orgs
    $501,701
    Other
    $95,238
    Hours/week
    15 + 25 related

    Schedule J breakdown matched by us

    Base
    $0 + $431,232 related
    Bonus
    $0
    Other
    $0 + $70,469 related
    Deferred
    $0 + $93,850 related
    Nontaxable benefits
    $0 + $1,388 related
    Filer's total
    $0 + $596,939 related

  • IRA MEISELMAN

    DIRECTOR MANAGED CARE

    Total calculated
    $347,902
    From this org
    $311,334
    From related orgs
    $0
    Other
    $36,568
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $306,887
    Bonus
    $0
    Other
    $4,447
    Deferred
    $17,627
    Nontaxable benefits
    $18,941
    Filer's total
    $347,902

  • JING CHEUNG

    RN

    Total calculated
    $267,005
    From this org
    $247,537
    From related orgs
    $0
    Other
    $19,468
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $247,537
    Bonus
    $0
    Other
    $0
    Deferred
    $12,395
    Nontaxable benefits
    $7,073
    Filer's total
    $267,005

  • KATHLEEN YOSHIMURA

    DIRECTOR, LAB AND PATHOLOGY

    Total calculated
    $281,154
    From this org
    $249,158
    From related orgs
    $0
    Other
    $31,996
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $243,271
    Bonus
    $0
    Other
    $5,887
    Deferred
    $14,897
    Nontaxable benefits
    $17,099
    Filer's total
    $281,154

  • MATILDA HERNANDEZ

    DEPT SUPERVISOR-12HR

    Total calculated
    $323,921
    From this org
    $291,167
    From related orgs
    $0
    Other
    $32,754
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $291,167
    Bonus
    $0
    Other
    $0
    Deferred
    $15,655
    Nontaxable benefits
    $17,099
    Filer's total
    $323,921

  • TRACEY COGHLAN

    CLINICAL DIRECTOR

    Total calculated
    $278,117
    From this org
    $250,786
    From related orgs
    $0
    Other
    $27,331
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $244,899
    Bonus
    $0
    Other
    $5,887
    Deferred
    $10,232
    Nontaxable benefits
    $17,099
    Filer's total
    $278,117

  • BRIAN SMOLSKIS

    FORMER - SYSTEM COO

    Total calculated
    $1,106,036
    From this org
    $0
    From related orgs
    $1,089,063
    Other
    $16,973
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $1,089,063 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $16,973 related
    Filer's total
    $0 + $1,106,036 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

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 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)

SCHEDULE J, PART I, LINE 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION
COMPENSATION FOR THE CEO WAS ESTABLISHED AND PAID BY PIH HEALTH WHITTIER HOSPITAL (PHWH), A RELATED ORGANIZATION. PHWH USED THE FOLLOWING TO ESTABLISH THE CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) FORM 990 OF OTHER ORGANIZATIONS; 4) COMPENSATION SURVEY OR STUDY; 5) APPROVAL BY THE BOARD.
SCHEDULE J, PART I, LINE 4A SEVERANCE OR CHANGE-OF-CONTROL PAYMENT
BRIAN SMOLSKIS RECEIVED A SEVERANCE PAYMENT DURING THE CALENDAR YEAR. THE PAYMENT IS INCLUDED IN PART VII, COLUMN D (E) AND SCHEDULE J, PART II, COLUMN B(III). THE TERMS AND CONDITIONS OF THE CONFIDENTIAL SEVERANCE AGREEMENT ARE AVAILABLE TO THE INTERNAL REVENUE SERVICE UPON REQUEST.
SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN
PIH HEALTH INC. AND ITS AFFILIATES PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR CERTAIN EXECUTIVES. THE FOLLOWING INDIVIDUALS PARTICIPATE IN THE PLAN: JAMES WEST PEGGY CHULACK ROSALIO LOPEZ VID SHIVARAMAN IRENA ZUANIC MOHAMMED GHONIM JASON FISCHER THE FOLLOWING AMOUNTS BECAME VESTED OR WERE PAID-OUT IN 2024 AND ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III): PEGGY CHULACK $600,326 IRENA ZUANIC $74,976 MOHAMMED GHONIM $62,037 ROSALIO LOPEZ $338,214 BRIAN SMOLSKIS $197,952

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 corporations and trusts

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

Provenance

Return type
form_990
Tax year
2024
Filed
15 August 2026
IRS schema version
2024v5.1
Source object
202622269349300012

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