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Nonprofiteer
← SAMARITAN NORTH LINCOLN HOSPITAL

Form 990 for tax year 2023

Filed by SAMARITAN NORTH LINCOLN HOSPITAL.

Totals

Total revenue
$94,624,460
Total expenses
$91,518,850
Contributions and grants received
$2,546,918
Grants paid
$78,596
Program service revenue
$91,826,861
Investment income
$177,348
Other revenue
$73,333
Total assets, end of year
$70,971,244
Total liabilities, end of year
$28,184,011
Net assets or fund balances, end of year
$42,787,233
Program services expenses (Part IX)
$82,189,442
Management and general expenses
$9,324,137
Fundraising expenses
$5,271
Program service expenses (Part III)
$82,189,442

Program services were 89.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • DOUGLAS BOYSEN

    BOARD CHAIR / CEO SHS

    Total calculated
    $1,623,482
    From this org
    $0
    From related orgs
    $1,555,091
    Other
    $68,391
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,075,482 related
    Bonus
    $0 + $388,770 related
    Other
    $0 + $90,839 related
    Deferred
    $0 + $26,592 related
    Nontaxable benefits
    $0 + $41,799 related
    Filer's total
    $0 + $1,623,482 related

  • KELLEY KAISER

    BRD VICE CHAIR / CAO SHS

    Total calculated
    $583,787
    From this org
    $0
    From related orgs
    $517,020
    Other
    $66,767
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $399,610 related
    Bonus
    $0 + $94,085 related
    Other
    $0 + $23,325 related
    Deferred
    $0 + $26,592 related
    Nontaxable benefits
    $0 + $40,175 related
    Filer's total
    $0 + $583,787 related

  • DARRELL ORTON MD

    BOARD MEMBER / PHYSICIAN

    Total calculated
    $18,528
    From this org
    $18,528
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • ANN BUTLER

    BOARD SECRETARY / TREASURER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • RICHARD TOWNSEND

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • CHRIS CHANDLER

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • TERRY BUGGENHAGEN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • STUART PRITCHARD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • JUNE CHRISMAN

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • DANIEL SMITH

    SVP / CFO

    Total calculated
    $747,521
    From this org
    $0
    From related orgs
    $679,354
    Other
    $68,167
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $510,893 related
    Bonus
    $0 + $119,250 related
    Other
    $0 + $49,211 related
    Deferred
    $0 + $26,592 related
    Nontaxable benefits
    $0 + $41,575 related
    Filer's total
    $0 + $747,521 related

  • LESLEY OGDEN MD

    CEO / CEO SPHS

    Total calculated
    $574,802
    From this org
    $0
    From related orgs
    $516,902
    Other
    $57,900
    Hours/week
    19 + 21 related

    Schedule J breakdown matched by us

    Base
    $0 + $400,932 related
    Bonus
    $0 + $93,395 related
    Other
    $0 + $22,575 related
    Deferred
    $0 + $26,592 related
    Nontaxable benefits
    $0 + $31,308 related
    Filer's total
    $0 + $574,802 related

  • VIRGINIA RIFFLE

    VP COO

    Total calculated
    $304,894
    From this org
    $253,928
    From related orgs
    $0
    Other
    $50,966
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $196,820
    Bonus
    $20,330
    Other
    $36,778
    Deferred
    $19,288
    Nontaxable benefits
    $31,678
    Filer's total
    $304,894

  • DENISE MOLAND

    VP PATIENT CARE SERVICES

    Total calculated
    $230,946
    From this org
    $193,798
    From related orgs
    $0
    Other
    $37,148
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $152,224
    Bonus
    $18,952
    Other
    $22,622
    Deferred
    $13,354
    Nontaxable benefits
    $23,794
    Filer's total
    $230,946

  • PETER FOX DO

    PHYSICIAN

    Total calculated
    $577,957
    From this org
    $524,438
    From related orgs
    $0
    Other
    $53,519
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $492,320
    Bonus
    $0
    Other
    $32,118
    Deferred
    $12,160
    Nontaxable benefits
    $41,359
    Filer's total
    $577,957

  • STEVEN ANDESCAVAGE DO

    MEDICAL DIRECTOR

    Total calculated
    $501,463
    From this org
    $434,435
    From related orgs
    $0
    Other
    $67,028
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $411,905
    Bonus
    $0
    Other
    $22,530
    Deferred
    $26,592
    Nontaxable benefits
    $40,436
    Filer's total
    $501,463

  • DALE STOGNER CRNA

    CHIEF CRNA

    Total calculated
    $469,671
    From this org
    $403,471
    From related orgs
    $0
    Other
    $66,200
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $375,137
    Bonus
    $0
    Other
    $28,334
    Deferred
    $26,592
    Nontaxable benefits
    $39,608
    Filer's total
    $469,671

  • ALI KHAKI MD

    PHYSICIAN

    Total calculated
    $442,471
    From this org
    $409,368
    From related orgs
    $0
    Other
    $33,103
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $383,351
    Bonus
    $0
    Other
    $26,017
    Deferred
    $26,592
    Nontaxable benefits
    $6,511
    Filer's total
    $442,471

  • ABIGAIL PITTARD MD

    PHYSICIAN

    Total calculated
    $431,032
    From this org
    $392,965
    From related orgs
    $0
    Other
    $38,067
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $366,349
    Bonus
    $0
    Other
    $26,616
    Deferred
    $0
    Nontaxable benefits
    $38,067
    Filer's total
    $431,032

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

  • 1a · Health or social club dues or initiation fees
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 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 1A
IN CONNECTION WITH ITS EMPLOYEE WELLNESS PROGRAM, THE ORGANIZATION HAS A GYM/FITNESS FACILITY BENEFIT THAT IS AVAILABLE TO ALL EMPLOYEES WHO WORK AT LEAST 32 HOURS PER MONTH. EMPLOYEES CAN USE THEIR WELLNESS BENEFIT AT EITHER NON-SAMARITAN OR SAMARITAN (SAMFIT) GYM/FITNESS FACILITIES. IF AN EMPLOYEE PARTICIPATES AT A NON-SAMARITAN GYM, REIMBURSEMENT IS MADE FOR FEES. REIMBURSEMENT DOES NOT EXCEED $300 PER YEAR AND IS INCLUDED IN THEIR TAXABLE WAGES SUBJECT TO FEDERAL/STATE WITHHOLDING TAX. NO PERSONS LISTED IN PART VII USED THE NON-SAMARITAN GYM REIMBURSEMENT BENEFIT DURING THE FILING YEAR. IF EMPLOYEES USE THEIR WELLNESS BENEFIT AT A SAMARITAN (SAMFIT) GYM/FITNESS FACILITY, THEN THE ANNUAL COST OF EMPLOYEE MEMBERSHIP, $300, IS INCLUDED IN THE EMPLOYEE'S TAXABLE WAGES SUBJECT TO FEDERAL/STATE WITHHOLDING TAX. TWO BOARD MEMBERS, ONE HIGHEST PAID EMPLOYEE, AND ONE OFFICER USED THE SAMARITAN (SAMFIT) GYM/FITNESS FACILITY BENEFIT DURING THE FILING YEAR.
PART I, LINE 3
THE CHIEF EXECUTIVE OFFICER IS EMPLOYED AND PAID BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION CONDUCTS A COMPENSATION ANALYSIS EACH YEAR TO COMPARE COMPENSATION OF ALL PAID POSITIONS TO MARKET SURVEYS OF COMPENSATION FOR SIMILAR POSITIONS IN OTHER ORGANIZATIONS. PERIODICALLY, THE RELATED ORGANIZATION WILL ALSO USE WRITTEN EMPLOYMENT CONTRACTS, FORM 990 OF OTHER ORGANIZATIONS, AND INDEPENDENT COMPENSATION CONSULTANTS TO DETERMINE THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER.
PART I, LINE 4B
A RELATED ORGANIZATION MAINTAINS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS. HOWEVER, NO PERSONS LISTED IN PART VII OF FORM 990 ACCRUED DEFERRED COMPENSATION BENEFITS OR RECEIVED ANY PAYMENTS FROM THESE PLANS DURING THE FILING YEAR.

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
2023
Filed
11 November 2024
IRS schema version
2023v5.1
Source object
202423179349304962

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