Form 990 for tax year 2024
Filed by MEDICAL STAFF OF GOOD SAMARITAN HOSPITAL MEDICAL CENTER.
Totals
- Total revenue
- $274,758
- Total expenses
- $338,523
- Contributions and grants received
- $0
- Grants paid
- $130,000
- Program service revenue
- $274,733
- Investment income
- $25
- Other revenue
- $0
- Total assets, end of year
- $454,234
- Total liabilities, end of year
- $0
- Net assets or fund balances, end of year
- $454,234
- Program services expenses (Part IX)
- $330,220
- Management and general expenses
- $8,303
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $330,220
Program services were 97.5% 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.
-
2a · Program service revenue: Membership Dues & Assessments
total $274,733 · related or exempt $274,733
-
3 · Investment income
total $25 · related or exempt $25
-
4 · Income from investment of tax-exempt bond proceeds
total $0
-
5 · Royalties
total $0
-
6d · Net rental income or loss
total $0
-
7d · Net gain or loss
total $0
-
8c · Net income from fundraising events
total $0
-
9c · Net income from gaming
total $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 $130,000 · program services $130,000
-
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 $47,500 · program services $47,500
-
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 $3,943 · management and general $3,943
-
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 $824 · management and general $824
-
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: MEETINGS AND CATERING
total $69,600 · program services $69,600
-
24b · Other expenses: CONTINUING MEDICAL EDUCATION
total $38,202 · program services $38,202
-
24c · Other expenses: STAFF PARTIES AND EVENTS
total $29,415 · program services $29,415
-
24d · Other expenses: AWARDS AND APPRECIATION GIFTS
total $13,453 · program services $13,453
-
24e · All other expenses
total $5,586 · program services $2,050 · management and general $3,536
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $517,999 · end of year $454,234
-
2 · Savings and temporary cash investments
end of year $0
-
3 · Pledges and grants receivable
end of year $0
-
4 · Accounts receivable
end of year $0
-
5 · Loans and receivables from officers and key people
end of year $0
-
6 · Loans and receivables from disqualified persons
end of year $0
-
7 · Other notes and loans receivable
end of year $0
-
8 · Inventories for sale or use
end of year $0
-
9 · Prepaid expenses and deferred charges
end of year $0
-
10c · Land, buildings and equipment, net
end of year $0
-
11 · Investments: publicly traded securities
end of year $0
-
12 · Investments: other securities
end of year $0
-
13 · Investments: program-related
end of year $0
-
14 · Intangible assets
end of year $0
-
15 · Other assets
end of year $0
-
27 · Net assets without donor restrictions
beginning of year $517,999 · end of year $454,234
Mission and programs · 2024
Mission
The purpose of the organization is:To insure that all patients admitted to or treated in any of the facilities, departments or services of Good Samaritan Hospital Medical Center, 1000 Montauk Highway, West Islip, NY 11795 (the Hospital) receive appropriate care consistent with community standards;To insure the professional performance of all practitioners authorized to practice in the Hospital through the appropriate delineation of the clinical privileges that each practitioner may exercise in the Hospital and through an ongoing review and evaluation of each practitioners performance in the Hospital;To provide an appropriate educational setting that will maintain scientific standards and that will lead to continuous advancement in professional knowledge and skill;To initiate and maintain rules and regulations for governance of the Medical Staff of the Hospital (Medical Staff) subject to the approval of the Governing Body of Trustees of Good Samaritan Hospital Medical Center (Governing
Activities or mission (Part I)
The primary purpose of the organization is to insure that all patients admitted to or treated in Good Samaritan Hospital Medical Center, 1000 Montauk Highway, West Islip, NY 11795 (the Hospital)receive appropriate care consistent with community standards.
-
TO CONTRIBUTE MONIES TO THE GOOD SAMARITAN HOSPITAL FUND. SUCH MONIES PURCHASE NECESSARY EQUIPMENT FOR THE HOSPITAL WHICH FURTHER THE QUALITY OF MEDICAL CARE TO ALL PATIENTS TREATED IN THE HOSPITAL.
Expenses $130,000
-
ARRANGE FOR medical staff meetings AND SOCIALS. Medical staff meetings AND SOCIALS ARE CONDUCTED THROUGHOUT THE YEAR. THe meetings, lectures AND SOCIALS help TO FURTHER THE COMPENTENCY AND COMRADARE OF THE MEDICAL STAFF THEREBY fURTHERING QUALITY MEDICAL CARE TO ALL PATIENTS TREATED IN THE HOSPITAL.
Expenses $99,015
-
to appoint, reappoint, or revoke appointment to the Good Samaritan Hospital Medical Center's ("the Hospital") Medical Staff. SUCH APPOINTMENTS ARE CONDUCTED THROUGHOUT THE YEAR. THE APPOINTMENT PROCESS IS CONDUCTED THROUGH EXAMINATION OF THE PROFESSIONAL'S COMPETENCE,ETHICS AND CHARACTER INCLUDING EXAMINATION OF REFERENCES, BACKGROUND CHECKS AND APPRAISAL'S FROM THE CLINICAL DEPARTMENT IN WHICH PRIVILEGES ARE SOUGHT. THIS PROCESS HELPS TO FURTHER THE COMPENTENCY AND CREDENTIALS OF THE MEDICAL STAFF THEREBY FURTHERING QUALITY MEDICAL CARE TO ALL PATIENTS TREATED IN THE HOSPITAL.
Expenses $47,500
-
Provide continuing medical educational opportunities as are compatible with the professional, physical and fiscal resources available in the Hospital. Such medical continuing medical educational is designed to lead to the on-going advancement of the professional skills and knowledge of all health professionals at good samaritan hospital
Expenses $38,202
-
Provide small awards / appreciation / gifts to medical staff. Such awards / appreciation gifts are given to applicable medical staff members. The awarding of awards to the medical staff helps with staff morale thereby furthering the quality of care at good samaritan hospital
Expenses $13,453
-
TO ARRANGE AND PAY FOR GUEST LECTURERS IN CONNECTION WITH MEDICAL GROUND ROUNDS. MEDICAL GROUND ROUNDS ARE AN IMPORTANT TOOL FOR FURTHERING THE COMPENTENCY AND CREDENTIALS OF THE MEDICAL STAFF THEREBY FURTHERING QUALITY MEDICAL CARE TO ALL PATIENTS TREATED IN THE HOSPITAL.
Expenses $2,050
As filed on the 2024 return. The filer continues this part on Schedule O, which is not shown here.
Listed in Part VII
-
William McCormick MDWILLIAM MCCORMICK MD
President
- Total calculated
- $30,000
- From this org
- $30,000
- From related orgs
- $0
- Other
- $0
- Hours/week
- 5
-
Jeffrey M Nakhjavan DoJEFFREY M NAKHJAVAN DO
Treasurer
- Total calculated
- $10,000
- From this org
- $10,000
- From related orgs
- $0
- Other
- $0
- Hours/week
- 5
-
Edison G Gavilanes MDEDISON G GAVILANES MD
Vice President
- Total calculated
- $7,500
- From this org
- $7,500
- From related orgs
- $0
- Other
- $0
- Hours/week
- 5
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.
Grants on this return
-
$130,000
DONATION TO HOSPITAL
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.
-
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
501(C)(3) · HOSPITAL · NY
Directly controlled by CATHOLIC HEALTH SERVICES OF LONG ISLAND
Provenance
- Return type
- form_990
- Tax year
- 2024
- Filed
- 21 May 2025
- IRS schema version
- 2024v5.1
- Source object
- 202511419349300416
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