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Nonprofiteer
← GOOD SAMARITAN FOUNDATION-DAYTON

Form 990 for tax year 2022

Filed by GOOD SAMARITAN FOUNDATION-DAYTON.

Totals

Total revenue
$754,168
Total expenses
$612,121
Contributions and grants received
$433,870
Grants paid
$292,670
Program service revenue
not reported
Investment income
not reported
Other revenue
not reported
Total assets, end of year
not reported
Total liabilities, end of year
not reported
Net assets or fund balances, end of year
not reported
Program services expenses (Part IX)
$365,988
Management and general expenses
$98,302
Fundraising expenses
$147,831
Program service expenses (Part III)
$365,988

Program services were 59.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • JENNY M LEWIS

    PRESIDENT/SYS VP OF PHILANTHROPY

    Total calculated
    $390,884
    From this org
    $0
    From related orgs
    $345,322
    Other
    $45,562
    Hours/week
    13.33 + 26.67 related

    Schedule J breakdown matched by us

    Base
    $0 + $261,652 related
    Bonus
    $0 + $80,626 related
    Other
    $0 + $3,044 related
    Deferred
    $0 + $17,633 related
    Nontaxable benefits
    $0 + $27,929 related
    Filer's total
    $0 + $390,884 related

  • MILINDA S NIMMO ZABRAMBA

    TRUSTEE

    Total calculated
    $383,599
    From this org
    $0
    From related orgs
    $347,845
    Other
    $35,754
    Hours/week
    0.5 + 39.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $310,006 related
    Bonus
    $0 + $16,500 related
    Other
    $0 + $21,339 related
    Deferred
    $0 + $9,356 related
    Nontaxable benefits
    $0 + $26,398 related
    Filer's total
    $0 + $383,599 related

  • GEORGE T BRODERICK JR MD

    TRUSTEE

    Total calculated
    $137,040
    From this org
    $0
    From related orgs
    $137,040
    Other
    $0
    Hours/week
    0.5

  • KENNETH M WATSON SR

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    0.5

  • JO ANNE REILING

    BOARD VICE-CHAIR

    Total calculated
    $0
    Hours/week
    0.5

  • FATHER BENJAMIN SPEARE-HARDY II

    BOARD SECRETARY

    Total calculated
    $0
    Hours/week
    0.5

  • DIANE ANDERSON DO

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • SUZANNE DONOVAN SC

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • RICHARD T FERGUSON

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • PAMELA A PHELPS

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • ANN SCHUERMAN

    TRUSTEE (TO AUG)

    Total calculated
    $0
    Hours/week
    0.5

  • CHARLENE J SIMS

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • J MICHAEL SIMS

    BOARD TREASURER

    Total calculated
    $727,946
    From this org
    $0
    From related orgs
    $677,602
    Other
    $50,344
    Hours/week
    0.5 + 39.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $355,741 related
    Bonus
    $0 + $138,119 related
    Other
    $0 + $183,742 related
    Deferred
    $0 + $19,235 related
    Nontaxable benefits
    $0 + $31,109 related
    Filer's total
    $0 + $727,946 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

  • 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
COMPENSATION FOR THE GSF-DAYTON CEO IS REVIEWED AND APPROVED BY PREMIER, WITH WHICH GSF-DAYTON IS AN AFFILIATE.
PART I, LINE 4B
DUE TO RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE CODE, CERTAIN PERSONS ARE LIMITED IN THE AMOUNT OF BENEFIT THAT CAN BE EARNED UNDER A QUALIFIED RETIREMENT PLAN. LIKE MANY EMPLOYERS, GOOD SAMARITAN FOUNDATION-DAYTON (GSF-DAYTON) AND ITS AFFILIATED ORGANIZATIONS COMPENSATE FOR THIS LIMITATION AND SUPPLEMENT THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. GSF-DAYTON SUPPLEMENTS THE AFFECTED EXECUTIVES THROUGH A PENSION RESTORATION PLAN AND A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE BENEFITS UNDER THESE SUPPLEMENTAL NONQUALIFIED PLANS ARE SUBJECT TO MULTI-YEAR VESTING AND A PARTICIPANT CAN FORFEIT BENEFITS EARNED IF VESTING REQUIREMENTS ARE NOT SATISFIED. UNDER THE TERMS OF THE SUPPLEMENTAL PLANS, AND BECAUSE OF TAX RULES PERTAINING TO TAXATION OF THE EARNED BENEFITS UPON VESTING, CERTAIN INDIVIDUALS RECEIVED A PAYOUT OF THE CUMULATIVE VESTED BENEFITS UNDER THEIR SUPPLEMENTAL PLAN DURING 2022. THE INDIVIDUAL LISTED BELOW HAS MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN AND RECEIVED THE ASSOCIATED PAYMENT IN 2022: J. MICHAEL SIMS $156,921. BASED ON THE GUIDANCE PROVIDED IN THE INSTRUCTIONS TO THE FORM 990, ANY PAYMENTS TO THE PARTICIPANTS RELATED TO THESE PLANS THAT WERE MADE WITHIN 2-1/2 MONTHS AFTER THE END OF THE ORGANIZATION'S TAX YEAR ARE NOT TREATED AS DEFERRED COMPENSATION FOR PURPOSES OF SCHEDULE J. SUCH AMOUNTS ARE PROPERLY REPORTED AS COMPENSATION FOR FORM 990 PURPOSES WHEN INCLUDED IN THE PARTICIPANTS' FORM W-2 WAGES.

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
14 November 2023
IRS schema version
2022v5.0
Source object
202323189349311197

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