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Nonprofiteer
← GOOD SAMARITAN FOUNDATION-DAYTON

Form 990 for tax year 2023

Filed by GOOD SAMARITAN FOUNDATION-DAYTON.

Totals

Total revenue
$1,430,128
Total expenses
$654,551
Contributions and grants received
$605,019
Grants paid
$212,520
Program service revenue
$0
Investment income
$830,850
Other revenue
-$5,741
Total assets, end of year
$13,088,472
Total liabilities, end of year
$146,678
Net assets or fund balances, end of year
$12,941,794
Program services expenses (Part IX)
$321,268
Management and general expenses
$126,137
Fundraising expenses
$207,146
Program service expenses (Part III)
$321,268

Program services were 49.1% 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.

  • 1a · Federated campaigns

    $1,716

  • 1c · Fundraising events

    $95,812

  • 1d · Related organizations

    $13,750

  • 1f · All other contributions, gifts and grants

    $493,741

  • 1g · Noncash contributions included above

    $52,859

  • 3 · Investment income

    total $205,441 · excluded $205,441

  • 7a · Gross sales of assets other than inventory

    securities $7,201,106

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

    securities $6,575,697

  • 7c · Gain or loss

    securities $625,409

  • 7d · Net gain or loss

    total $625,409 · excluded $625,409

  • 8a · Fundraising events: gross income

    $5,100

  • 8a · Fundraising events: contributions included on line 1c

    $95,812

  • 8b · Fundraising events: direct expenses

    $10,841

  • 8c · Net income from fundraising events

    total -$5,741 · excluded -$5,741

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $196,520 · program services $196,520

  • 2 · Grants to domestic individuals

    total $16,000 · program services $16,000

  • 7 · Other salaries and wages

    total $305,275 · program services $76,319 · management and general $76,319 · fundraising $152,637

  • 9 · Other employee benefits

    total $39,734 · program services $9,934 · management and general $9,934 · fundraising $19,866

  • 10 · Payroll taxes

    total $16,847 · program services $4,212 · management and general $4,212 · fundraising $8,423

  • 11f · Fees: investment management

    total $21,545 · management and general $21,545

  • 11g · Fees: other

    total $25,170 · program services $6,293 · management and general $6,293 · fundraising $12,584

  • 13 · Office expenses

    total $4,907 · program services $1,227 · management and general $1,227 · fundraising $2,453

  • 14 · Information technology

    total $7,901 · program services $1,975 · management and general $1,975 · fundraising $3,951

  • 16 · Occupancy

    total $1,920 · management and general $1,440 · fundraising $480

  • 17 · Travel

    total $331 · fundraising $331

  • 24a · Other expenses: SPECIAL EVENTS

    total $11,492 · program services $2,873 · management and general $2,873 · fundraising $5,746

  • 24b · Other expenses: DUES AND SUBSCRIPTIONS

    total $1,277 · program services $319 · management and general $319 · fundraising $639

  • 24c · Other expenses: MINOR EQUIPMENT

    total $36 · fundraising $36

  • 24e · All other expenses

    total $5,596 · program services $5,596

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $100,819 · end of year $90,387

  • 3 · Pledges and grants receivable

    beginning of year $192,583 · end of year $261,795

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

    $0

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

    $0

  • 10c · Land, buildings and equipment, net

    beginning of year $7,315 · end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $7,381,796 · end of year $8,622,885

  • 12 · Investments: other securities

    beginning of year $4,212,705 · end of year $4,038,405

  • 15 · Other assets

    beginning of year $75,000 · end of year $75,000

  • 17 · Accounts payable and accrued expenses

    beginning of year $32,342 · end of year $30,006

  • 25 · Other liabilities

    beginning of year $19,259 · end of year $116,672

  • 27 · Net assets without donor restrictions

    beginning of year $2,345,422 · end of year $2,318,297

  • 28 · Net assets with donor restrictions

    beginning of year $9,573,195 · end of year $10,623,497

Mission and programs · 2023

Mission

INSPIRE PHILANTHROPY TO ENHANCE THE HEALTH AND WELL-BEING OF THE GREATER DAYTON COMMUNITIES AND THE HEALTHCARE PROFESSIONALS WHO CARE FOR THEM.

Activities or mission (Part I)

SEE PART III, LINE 1

  • MOTHERS EMPOWERED PROVIDES HIGH-QUALITY, COMPREHENSIVE PRENATAL CARE AND PARENTING EDUCATION TO PREGNANT WOMEN IN GREATER DAYTON WHO ARE AT RISK OF LOSING A BABY TO INFANT MORTALITY. MOTHERS EMPOWERED IS A COLLABORATION BETWEEN LIFESTAGES CENTERS FOR WOMEN, A LOCAL OB/GYN PRACTICE, AND GOOD SAMARITAN FOUNDATION-DAYTON. THE PROGRAM IS COMPRISED OF AN RN PROGRAM COORDINATOR, A PART TIME MEDICAL ASSISTANT, AND A CERTIFIED NURSE MIDWIFE. THESE HEALTH CARE PROFESSIONALS PROVIDE THE EVIDENCE-BASED, BEST-PRACTICE "CENTERINGPREGNANCY" GROUP MODEL OF PRENATAL CARE. PREGNANT MOTHERS ARE GROUPED BY DUE DATE, SO THEY GO THROUGH THE SAME STAGE OF PREGNANCY TOGETHER, LEARNING ABOUT THEIR NEW BABIES WHILE FORMING FRIENDSHIPS WITH OTHER MOMS AND BUILDING TRUSTING RELATIONSHIPS WITH THEIR MEDICAL PROVIDERS. IN 2023, 60 WOMEN WERE SERVED.

    Expenses $37,614 · Grants $37,614

  • GOOD SAMARITAN FOUNDATION-DAYTON IS COMMITTED TO SUPPORTING ONCOLOGY PATIENTS AT MIAMI VALLEY HOSPITAL NORTH DURING THEIR CANCER JOURNEY. IN 2023, 852 CANCER PATIENTS WERE TREATED WITH 3,699 TOTAL CANCER RELATED VISITS AT THE NORTH CAMPUS. THE NORTH CAMPUS IS THE BUSIEST IN THE PREMIER HEALTH SYSTEM FOR BREAST SCREENING AND DIAGNOSTICS ALONG WITH LUNG LOW DOSE CT CANCER SCREENING. GOOD SAMARITAN FOUNDATION-DAYTON PROVIDES FINANCIAL ASSISTANCE FOR ESSENTIALS, SUCH AS RENT, UTILITIES, TRANSPORTATION TO TREATMENT, AND MEDICATION TO BREAST CANCER PATIENTS EXPERIENCING FINANCIAL HARDSHIP. ONCOLOGY PATIENTS ALSO RECEIVE THERAPEUTIC PILLOWS TO COMFORT THEM POST-SURGERY PROCEDURES AND FINANCIAL SUPPORT FOR LYMPHEDEMA GARMENTS TO AID IN THE MANAGEMENT OF THE CONDITION AS A RESULT OF CANCER TREATMENTS. IN ADDITION, ALL CANCER PATIENTS ARE GIVEN THE OPPORTUNITY TO PARTICIPATE IN SPECIALIZED EXERCISE CLASSES AT ANY POINT IN THE CANCER CARE CONTINUUM FROM DIAGNOSIS TO SURVIVORSHIP. THE CLASSES ARE DELIVERED BY A CERTIFIED EXERCISE ONCOLOGY INSTRUCTOR AND INDIVIDUALIZED FOR EACH PATIENT'S HEALTH STATUS AND GOALS.

    Expenses $34,094 · Grants $34,094

  • PREMIER HEALTH WAS A SUB AWARDEE FOR FUNDING FROM THE OHIO DEPARTMENT OF HEALTH FOR THE COMPREHENSIVE CARE FOR SUBSTANCE USE IN OHIO EMERGENCY DEPARTMENTS (CCOED) GRANT. THE CCOED GRANT HAS THREE OVERARCHING GOALS FOCUSED ON TREATING SUBSTANCE USE DISORDER AND OPIOID USE DISORDER:1) IDENTIFYING PATIENTS WITH OPIOID USE DISORDER BY IMPLEMENTING A SCREENING PROCESS IN OUR EMERGENCY DEPARTMENTS.2) MANAGING OPIOID USE DISORDER BY IMPLEMENTING EVIDENCE-BASED PRACTICES IN OUR EMERGENCY MEDICINE.3) TRANSITIONING PATIENTS TO LONG-TERM CARE AND SUPPORTIVE SERVICES USING INNOVATIVE PROCESSES THAT IMPROVE PATHWAYS TO TREATMENT.PREMIER HEALTH HAS IMPLEMENTED SEVERAL INNOVATIVE APPROACHES FOR TREATING SUBSTANCE USE DISORDER AND ADDICTION MEDICINE WITH THIS GRANT. PREMIER HEALTH WAS THE FIRST IN THE MIAMI VALLEY REGION TO HIRE A SUBSTANCE USE NAVIGATOR (SUN). THE SUN WORKS WITH PATIENTS IN THE EMERGENCY DEPARTMENT TO COMPLETE CHEMICAL DEPENDENCY ASSESSMENTS AND PROVIDE LINKAGES TO CARE, PLACEMENT IN TREATMENT FACILITIES, AND OTHER WRAPAROUND SERVICES WITH WARM HANDOFFS.IN 2023, MORE THAN 41,000 PATIENTS WERE SCREENED IN MIAMI VALLEY HOSPITAL NORTH'S EMERGENCY DEPARTMENT FOR SUBSTANCE USE DISORDER. IN 2023, 267 PATIENTS HAVE BEEN TREATED BY SUBSTANCE USE NAVIGATORS, AND THE PROGRAM DISTRIBUTED MORE THAN 15 NALOXONE KITS.

    Expenses $22,576 · Grants $22,576

  • THIS NUMBER REPRESENTS THE BALANCE OF TOTAL EXPENDITURES OF TEMPORARILY RESTRICTED FUNDS FOR RELATED HOSPITALS NET OF PROGRAMS DESCRIBED IN SERVICE ACCOMPLISHMENTS.

    Expenses $226,984 · Grants $118,236

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Jenny M Lewis

    PRESIDENT/SYS VP OF PHILANTHROPY

    Total calculated
    $417,573
    From this org
    $0
    From related orgs
    $361,379
    Other
    $56,194
    Hours/week
    13.33 + 26.67 related

    Schedule J breakdown matched by us

    Base
    $0 + $286,243 related
    Bonus
    $0 + $71,848 related
    Other
    $0 + $3,288 related
    Deferred
    $0 + $26,583 related
    Nontaxable benefits
    $0 + $29,611 related
    Filer's total
    $0 + $417,573 related

  • Milinda S Nimmo Zabramba

    TRUSTEE

    Total calculated
    $190,534
    From this org
    $0
    From related orgs
    $170,263
    Other
    $20,271
    Hours/week
    0.5 + 39.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $155,078 related
    Bonus
    $0 + $4,500 related
    Other
    $0 + $10,685 related
    Deferred
    $0 + $8,489 related
    Nontaxable benefits
    $0 + $11,782 related
    Filer's total
    $0 + $190,534 related

  • Jo Anne Reiling

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    0.5

  • Fr Benjamin Speare-Hardy II

    BOARD SECRETARY

    Total calculated
    $0
    Hours/week
    0.5

  • George T Broderick Jr MD

    BOARD VICE-CHAIR

    Total calculated
    $0
    Hours/week
    0.5

  • Diane Anderson Do

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • Alec Carnes

    TRUSTEE (FROM FEB)

    Total calculated
    $0
    Hours/week
    0.5

  • Suzanne Donovan Sc

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • Charles Ellington

    TRUSTEE (FROM FEB)

    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

  • Charlene J Sims

    TRUSTEE

    Total calculated
    $0
    Hours/week
    0.5

  • Marianne Weber

    TRUSTEE (FROM AUG)

    Total calculated
    $0
    Hours/week
    0.5

  • J Michael Sims

    BOARD TREASURER

    Total calculated
    $714,006
    From this org
    $0
    From related orgs
    $659,279
    Other
    $54,727
    Hours/week
    0.5 + 39.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $370,642 related
    Bonus
    $0 + $66,308 related
    Other
    $0 + $222,329 related
    Deferred
    $0 + $22,390 related
    Nontaxable benefits
    $0 + $32,337 related
    Filer's total
    $0 + $714,006 related

  • Christina E Knowles

    DIR-DEVELOPMENT

    Total calculated
    $137,068
    From this org
    $115,133
    From related orgs
    $0
    Other
    $21,935
    Hours/week
    40

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 2023. THE INDIVIDUAL LISTED BELOW HAS MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN AND RECEIVED THE ASSOCIATED PAYMENT IN 2023: J. MICHAEL SIMS $193,261. 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.

  • SWEITZER STREET LLC

    EXCLUDED · REAL ESTATE · OH

    Directly controlled by MVHE INC

  • SWEITZER MOB LLC

    EXCLUDED · REAL ESTATE · OH

    Directly controlled by MVHE INC

Related corporations and trusts

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

  • MVHE INC

    C · PHYSICIAN SVCS · OH

    Directly controlled by PREMIER HEALTH HOLDING CO

  • PREMIER HEALTH SPECIALISTS

    C · PHYSICIAN SVCS · OH

    Directly controlled by PREMIER HEALTH HOLDING CO

  • SAMARITAN FAMILY CARE

    C · PHYSICIAN SVCS · OH

    Directly controlled by PREMIER HEALTH HOLDING CO

  • AFTER HOURS FAMILY CARE

    C · HEALTH CARE · OH

    Directly controlled by UPPER VALLEY PROFESSIONAL CORP

  • UVMC MANAGEMENT CORP

    C · MANAGEMENT COMPANY · OH

    Directly controlled by PREMIER HEALTH

  • PREMIER HEALTH URGENT CARE INC

    C · URGENT CARE · OH

    Directly controlled by PREMIER HEALTH HOLDING CO

  • PREMIER HEALTH INT'L INSURANCE

    C · INSURANCE · BD

    Directly controlled by PREMIER HEALTH

  • PREMIER HEALTH PLAN INC

    C · HEALTH INSURANCE · OH

    Directly controlled by PREMIER HEALTH INSURING CO

  • GOOD SAMARITAN HOSPITAL

    C · HOSPITAL · OH

    Directly controlled by PREMIER HEALTH

  • PREMIER HEALTH ACO OF OHIO

    C · MEDICARE ACO · OH

    Directly controlled by PREMIER HEALTH

  • PREMIER HEALTH HOLDING CO

    C · HOLDING CO · OH

    Directly controlled by PREMIER HEALTH

  • PREMIER HEALTH INSURING CO

    C · HEALTH INSURANCE · OH

    Directly controlled by PREMIER HEALTH

Provenance

Return type
form_990
Tax year
2023
Filed
14 November 2024
IRS schema version
2023v5.1
Source object
202443199349316384

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