Totals
- Total revenue
- $2,270,400
- Total expenses
- $1,551,658
- Contributions and grants received
- $0
- Grants paid
- $0
- Program services expenses (Part IX)
- $1,551,658
- Management and general expenses
- $0
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $1,551,658
Program services were 100.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Listed in Part VII
-
JAMES WEST
DIRECTOR & CHAIR
- Total calculated
- $2,402,376
- From this org
- $0
- From related orgs
- $2,046,653
- Other
- $355,723
- Hours/week
- 1.5 + 50.7 related
Schedule J breakdown matched by us
- Base
- $0 + $1,506,821 related
- Bonus
- $0
- Other
- $0 + $539,832 related
- Deferred
- $0 + $335,520 related
- Nontaxable benefits
- $0 + $20,325 related
- Filer's total
- $0 + $2,402,498 related
-
ROSALIO LOPEZ MD
SYSTEM CSO/CMO
- Total calculated
- $1,160,581
- From this org
- $0
- From related orgs
- $1,114,134
- Other
- $46,447
- Hours/week
- 1.5 + 44.7 related
Schedule J breakdown matched by us
- Base
- $0 + $907,438 related
- Bonus
- $0
- Other
- $0 + $206,696 related
- Deferred
- $0 + $36,700 related
- Nontaxable benefits
- $0 + $9,869 related
- Filer's total
- $0 + $1,160,703 related
-
PEGGY CHULACK
DIRECTOR & SECRETARY
- Total calculated
- $1,188,124
- From this org
- $0
- From related orgs
- $995,412
- Other
- $192,712
- Hours/week
- 1.5 + 50.7 related
Schedule J breakdown matched by us
- Base
- $0 + $826,709 related
- Bonus
- $0
- Other
- $0 + $168,703 related
- Deferred
- $0 + $178,274 related
- Nontaxable benefits
- $0 + $14,760 related
- Filer's total
- $0 + $1,188,446 related
-
BRIAN SMOLSKIS THRU 9282023
SYSTEM COO
- Total calculated
- $1,253,853
- From this org
- $0
- From related orgs
- $1,034,811
- Other
- $219,042
- Hours/week
- 1.5 + 46.2 related
Schedule J breakdown matched by us
- Base
- $0 + $838,304 related
- Bonus
- $0
- Other
- $0 + $196,507 related
- Deferred
- $0 + $196,657 related
- Nontaxable benefits
- $0 + $22,507 related
- Filer's total
- $0 + $1,253,975 related
-
VID SHIVARAMAN
DIRECTOR & TREASURER
- Total calculated
- $900,280
- From this org
- $0
- From related orgs
- $749,812
- Other
- $150,468
- Hours/week
- 1.5 + 50.7 related
Schedule J breakdown matched by us
- Base
- $0 + $681,460 related
- Bonus
- $0
- Other
- $0 + $68,352 related
- Deferred
- $0 + $141,186 related
- Nontaxable benefits
- $0 + $9,404 related
- Filer's total
- $0 + $900,402 related
-
ANITA CHOU
FORMER DIRECTOR
- Total calculated
- $119,028
- From this org
- $0
- From related orgs
- $119,014
- Other
- $14
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $0 + -$14 related
- Bonus
- $0
- Other
- $0 + $119,028 related
- Deferred
- $0
- Nontaxable benefits
- $0 + $14 related
- Filer's total
- $0 + $119,028 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 — 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)
- PART I, LINES 4A-B
- ANITA CHOU RECEIVED SEVERANCE PAYMENTS DURING THE CALENDAR YEAR. THE PAYMENTS INCLUDED IN PART VII, COLUMN E AND SCHEDULE J, PART II, COLUMN B(III). THE TERMS AND CONDITIONS OF THE CONFIDENTIAL SEVERANCE AGREEMENTS ARE AVAILABLE TO THE INTERNAL REVENUE SERVICES UPON REQUEST.
- PART 1, LINE 3:
- 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 ORGAANIZATIONS; (4) COMPENSATION SURVEY OR STUDY; (5) APPROVAL BY THE BOARD.
- PART I, LINE 4B:
- PIH HEALTH INC. AND ITS AFFILIATES PROVIDE A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR CERTAIN EXECUTIVES. THE FOLLOWING INDIVIDUALS PARTICIPATE IN THE PLAN: JAMES WEST PEGGY CHULACK ROSALIO LOPEZ BRIAN SMOLSKIS VID SHIVARAMAN THE FOLLOWING AMOUNTS BECAME VESTED OR WERE PAID-OUT IN 2022 AND ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B) (III) : JAMES WEST - $517,243 BRIAN SMOLSKIS - $188,312 PEGGY CHULACK - $120,897 VID SHIVARAMAN - $61,131
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.
-
501(C)(3) · FUNDRAISING · CA · controlled entity
Directly controlled by PIH HEALTH INC
-
501(C)(3) · HEALTHCARE · CA · controlled entity
Directly controlled by PIH HEALTH INC
-
501(C)(3) · HEALTHCARE · CA · controlled entity
Directly controlled by PIH HEALTH INC
-
501(C)(3) · SUPPORT OF TAX-EXEMPT AFFILIATES · CA
-
PIH HEALTH ADULT DAY HEALTHCARE
501(C)(3) · HEALTHCARE · CA · controlled entity
Directly controlled by PIH HEALTH INC
-
PIH HEALTH GOOD SAMARITAN HOSPITAL
501(C)(3) · HEALTHCARE · CA · controlled entity
Directly controlled by PIH HEALTH INC
-
GOOD SAMARITAN INSTITUTE FOR RESEARCH AND EDUCATION
501(C)(3) · RESEARCH · CA · controlled entity
Directly controlled by PIH HEALTH GOOD SAMARITAN HOSPITAL
-
501(C)(3) · HEALTHCARE · CA · controlled entity
Directly controlled by PIH HEALTH INC
-
501(C)(3) · HEALTHCARE · CA · controlled entity
Directly controlled by PIH HEALTH INC
-
ORTHOPEDIC INSTITUTE OF THE GOOD SAMARITAN HOSPITAL
501(C)(3) · RESEARCH · CA · controlled entity
Directly controlled by PIH HEALTH GOOD SAMARITAN HOSPITAL
-
501(C)(3) · HEALTHCARE · CA · controlled entity
Directly controlled by PIH HEALTH GOOD SAMARITAN HOSPITAL
-
GOOD SAMARITAN MEDICAL OFFICE BUILDING INC
501(C)(3) · MEDICAL OFFICES · CA · controlled entity
Directly controlled by PIH HEALTH GOOD SAMARITAN HOSPITAL
-
501(C)(3) · GRANTS INCOME TO GOOD SAMARITAN HOSPITAL · CA · controlled entity
Directly controlled by PIH HEALTH GOOD SAMARITAN HOSPITAL
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 31 July 2024
- IRS schema version
- 2022v5.0
- Source object
- 202402199349300830
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