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Nonprofiteer
← GOOD SHEPHERD HOSPITAL INC

Form 990 for tax year 2022

Filed by GOOD SHEPHERD HOSPITAL INC.

Totals

Total revenue
$0
Total expenses
$0
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$0
Other revenue
$0
Total assets, end of year
$0
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$0
Program services expenses (Part IX)
$0
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
$0

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.

  • 3 · Investment income

    total $0

  • 4 · Income from investment of tax-exempt bond proceeds

    total $0

  • 5 · Royalties

    total $0

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 6d · Net rental income or loss

    total $0

  • 7d · Net gain or loss

    total $0

  • 8a · Fundraising events: gross income

    $0

  • 8b · Fundraising events: direct expenses

    $0

  • 8c · Net income from fundraising events

    total $0

  • 9a · Gaming: gross income

    $0

  • 9b · Gaming: direct expenses

    $0

  • 9c · Net income from gaming

    total $0

  • 10a · Gross sales of inventory

    $0

  • 10b · Cost of goods sold

    $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 $0

  • 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 $0

  • 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 $0

  • 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 $0

  • 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

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $0 · end of year $0

  • 2 · Savings and temporary cash investments

    beginning of year $0 · end of year $0

  • 3 · Pledges and grants receivable

    beginning of year $0 · end of year $0

  • 4 · Accounts receivable

    beginning of year $0 · end of year $0

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 7 · Other notes and loans receivable

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $0 · end of year $0

  • 9 · Prepaid expenses and deferred charges

    beginning of year $0 · end of year $0

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $0

  • 11 · Investments: publicly traded securities

    beginning of year $0 · end of year $0

  • 12 · Investments: other securities

    beginning of year $0 · end of year $0

  • 13 · Investments: program-related

    beginning of year $0 · end of year $0

  • 14 · Intangible assets

    beginning of year $0 · end of year $0

  • 15 · Other assets

    beginning of year $0 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $0 · end of year $0

  • 18 · Grants payable

    beginning of year $0 · end of year $0

  • 19 · Deferred revenue

    beginning of year $0 · end of year $0

  • 20 · Tax-exempt bond liabilities

    beginning of year $0 · end of year $0

  • 21 · Escrow or custodial account liability

    beginning of year $0 · end of year $0

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 23 · Secured mortgages and notes payable

    beginning of year $0 · end of year $0

  • 24 · Unsecured notes and loans payable

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $0 · end of year $0

  • 27 · Net assets without donor restrictions

    beginning of year $0 · end of year $0

  • 28 · Net assets with donor restrictions

    beginning of year $0 · end of year $0

Mission and programs · 2022

Mission

THE GOOD SHEPHERD HOSPITAL, INC. PROVIDES SERVICES TO PATIENTS QUALIFYING UNDER THE CHARITY POLICY AND PROVIDES QUALITY TERTIARY HEALTH SERVICES TO THE RESIDENTS OF NORTHEAST TEXAS.

Activities or mission (Part I)

THE GOOD SHEPHERD HOSPITAL, INC. IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL DEDICATED TO CREATING A HEALTHIER FUTURE FOR THE RESIDENTS OF LONGVIEW AND NORTHEAST TEXAS.

  • ATTACHMENT 1

As filed on the 2022 return.

Listed in Part VII

  • Jeff Puckett

    DIRECTOR

    Total calculated
    $8,975,275
    From this org
    $0
    From related orgs
    $6,548,766
    Other
    $2,426,509
    Hours/week
    11 + 29 related

    Schedule J breakdown matched by us

    Base
    not reported + $3,121,353 related
    Bonus
    not reported + $2,702,700 related
    Other
    not reported + $724,713 related
    Deferred
    not reported + $2,412,440 related
    Nontaxable benefits
    not reported + $14,069 related
    Filer's total
    not reported + $8,975,275 related
  • Chris Glenney

    DIRECTOR

    Total calculated
    $1,849,968
    From this org
    $0
    From related orgs
    $1,403,929
    Other
    $446,039
    Hours/week
    24 + 16 related

    Schedule J breakdown matched by us

    Base
    not reported + $956,519 related
    Bonus
    not reported + $446,760 related
    Other
    not reported + $650 related
    Deferred
    not reported + $431,192 related
    Nontaxable benefits
    not reported + $14,847 related
    Filer's total
    not reported + $1,849,968 related
  • Steven Keuer MD

    DIRECTOR

    Total calculated
    $1,520,254
    From this org
    $0
    From related orgs
    $1,293,582
    Other
    $226,672
    Hours/week
    18 + 22 related

    Schedule J breakdown matched by us

    Base
    not reported + $684,550 related
    Bonus
    not reported + $410,841 related
    Other
    not reported + $198,191 related
    Deferred
    not reported + $209,400 related
    Nontaxable benefits
    not reported + $17,272 related
    Filer's total
    not reported + $1,520,254 related
  • Mark Anderson MD

    DIRECTOR

    Total calculated
    $1,204,984
    From this org
    $0
    From related orgs
    $933,102
    Other
    $271,882
    Hours/week
    12 + 28 related

    Schedule J breakdown matched by us

    Base
    not reported + $683,470 related
    Bonus
    not reported + $249,632 related
    Other
    not reported
    Deferred
    not reported + $199,056 related
    Nontaxable benefits
    not reported + $72,826 related
    Filer's total
    not reported + $1,204,984 related
  • Todd Hancock

    PRESIDENT/CEO

    Total calculated
    $1,135,912
    From this org
    $0
    From related orgs
    $865,919
    Other
    $269,993
    Hours/week
    5

    Schedule J breakdown matched by us

    Base
    not reported + $618,406 related
    Bonus
    not reported + $246,863 related
    Other
    not reported + $650 related
    Deferred
    not reported + $250,042 related
    Nontaxable benefits
    not reported + $19,951 related
    Filer's total
    not reported + $1,135,912 related
  • Jason Adams

    STAFF (THRU 10/19)

    Total calculated
    $819,001
    From this org
    $0
    From related orgs
    $674,084
    Other
    $144,917
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    not reported + $445,694 related
    Bonus
    not reported + $228,006 related
    Other
    not reported + $384 related
    Deferred
    not reported + $121,795 related
    Nontaxable benefits
    not reported + $23,122 related
    Filer's total
    not reported + $819,001 related
  • Scott Smith MD

    BOARD DIRECTOR (DEPT(11/2021)

    Total calculated
    $644,620
    From this org
    $0
    From related orgs
    $621,000
    Other
    $23,620
    Hours/week
    9 + 31 related

    Schedule J breakdown matched by us

    Base
    not reported + $310,500 related
    Bonus
    not reported
    Other
    not reported + $310,500 related
    Deferred
    not reported + $7,444 related
    Nontaxable benefits
    not reported + $16,176 related
    Filer's total
    not reported + $644,620 related
  • Ken Cunningham

    STAFF (thru 12/2020)

    Total calculated
    $643,137
    From this org
    $0
    From related orgs
    $564,773
    Other
    $78,364
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    not reported + $363,170 related
    Bonus
    not reported + $140,893 related
    Other
    not reported + $60,710 related
    Deferred
    not reported + $58,603 related
    Nontaxable benefits
    not reported + $19,761 related
    Filer's total
    not reported + $643,137 related
  • Michael Cheek

    DIR. (Thru 12/2020) / CFO

    Total calculated
    $568,508
    From this org
    $0
    From related orgs
    $495,760
    Other
    $72,748
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    not reported + $302,540 related
    Bonus
    not reported + $129,936 related
    Other
    not reported + $63,284 related
    Deferred
    not reported + $61,054 related
    Nontaxable benefits
    not reported + $11,694 related
    Filer's total
    not reported + $568,508 related
  • Andria Cardinalli-Stein MD

    BOARD DIRECTOR

    Total calculated
    $488,706
    From this org
    $0
    From related orgs
    $476,506
    Other
    $12,200
    Hours/week
    14 + 26 related

    Schedule J breakdown matched by us

    Base
    not reported + $381,926 related
    Bonus
    not reported + $94,130 related
    Other
    not reported + $450 related
    Deferred
    not reported + $12,200 related
    Nontaxable benefits
    not reported
    Filer's total
    not reported + $488,706 related
  • John McDonald

    MEDICAL STAFF (thru 12/2020)

    Total calculated
    $343,569
    From this org
    $0
    From related orgs
    $329,084
    Other
    $14,485
    Hours/week
    5

    Schedule J breakdown matched by us

    Base
    not reported + $265,410 related
    Bonus
    not reported + $62,331 related
    Other
    not reported + $1,343 related
    Deferred
    not reported + $12,200 related
    Nontaxable benefits
    not reported + $2,285 related
    Filer's total
    not reported + $343,569 related
  • Sister Rosanne Popp MD

    BOARD DIRECTOR

    Total calculated
    $234,651
    From this org
    $0
    From related orgs
    $231,979
    Other
    $2,672
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    not reported + $209,945 related
    Bonus
    not reported + $3,500 related
    Other
    not reported + $18,534 related
    Deferred
    not reported + $317 related
    Nontaxable benefits
    not reported + $2,355 related
    Filer's total
    not reported + $234,651 related
  • Jamie Jack Dowell

    SECRETARY (DEPT 12/2020)

    Total calculated
    $143,249
    From this org
    $0
    From related orgs
    $135,657
    Other
    $7,592
    Hours/week
    5 + 35 related

    Schedule J breakdown matched by us

    Base
    not reported + $118,392 related
    Bonus
    not reported + $16,634 related
    Other
    not reported + $631 related
    Deferred
    not reported + $5,493 related
    Nontaxable benefits
    not reported + $2,099 related
    Filer's total
    not reported + $143,249 related
  • Amanda Smith

    SECRETARY

    Total calculated
    $58,961
    From this org
    $0
    From related orgs
    $48,820
    Other
    $10,141
    Hours/week
    25 + 15 related
  • Bill Chen PhD

    DIRECTOR

    Total calculated
    $19,699
    From this org
    $0
    From related orgs
    $19,699
    Other
    $0
    Hours/week
    12 + 38 related
  • Joe Bob Burgin

    DIRECTOR

    Total calculated
    $0
    Hours/week
    15 + 25 related
  • Randy Childress

    DIRECTOR

    Total calculated
    $0
    Hours/week
    9 + 31 related
  • Jean Coleman

    DIRECTOR

    Total calculated
    $0
    Hours/week
    12 + 28 related
  • Shannon Dacus

    CHAIR

    Total calculated
    $0
    Hours/week
    7 + 33 related
  • Sister Rita Fanning

    DIRECTOR

    Total calculated
    $0
    Hours/week
    8 + 32 related
  • Mike Hallum

    DIRECTOR

    Total calculated
    $0
    Hours/week
    5 + 35 related
  • Fred Harris Jr

    DIRECTOR

    Total calculated
    $0
    Hours/week
    24 + 16 related
  • Sonja Yates Hubbard

    DIRECTOR

    Total calculated
    $0
    Hours/week
    11 + 29 related
  • Jeb Jones

    DIRECTOR

    Total calculated
    $0
    Hours/week
    17 + 23 related
  • Sister Guadalupe Ruiz

    DIRECTOR

    Total calculated
    $0
    Hours/week
    9 + 31 related
  • Preston Smith

    DIRECTOR

    Total calculated
    $0
    Hours/week
    19 + 21 related
  • Joe Bob Joyce

    DIRECTOR (THRU 12/2022)

    Total calculated
    $0
    Hours/week
    6 + 34 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

  • 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)

FORM 990, SCHEDULE J, PART I, LINE 3
THE FILING ORGANIZATION'S PRESIDENT/CEO IS AN EMPLOYEE OF CHRISTUS HEALTH, A RELATED ORGANIZATION. AS A RESULT, COMPENSATION IS ESTABLISHED AT THE CHRISTUS HEALTH LEVEL AND THE FILING ORGANIZATION DOES NOT HAVE A ROLE IN IMPLEMENTING THE METHODS USED TO ESTABLISH COMPENSATION OR IN DETERMINING THE PRESIDENT/CEO COMPENSATION. CHRISTUS HEALTH USES AN EXECUTIVE COMPENSATION COMMITTEE TO ESTABLISH AND APPROVE THE COMPENSATION OF THE FILING ORGANIZATION'S CEO/EXECUTIVE DIRECTOR. THIS COMMITTEE USES AN INDEPENDENT COMPENSATION CONSULTANT WHO PERFORMS BI-ANNUAL COMPENSATION SURVEY. THE FILING ORGANIZATION DOES NOT HAVE THE AUTHORITY TO DETERMINE AND IMPLEMENT THE METHODS USED TO ESTABLISH SUCH COMPENSATION.
FORM 990, SCHEDULE J, PART II, COLUMN C
DEFERRED COMPENSATION DEFERRED COMPENSATION INCLUDES EXECUTIVE DEFERRED INCOME ACCOUNT, SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN, EMPLOYER CONTRIBUTION TO 403(B) MATCHED SAVINGS PLAN, PENSION RESTORATION PLAN AND ESTIMATED PENSION BENEFITS UNDER CHRISTUS HEALTH CASH BALANCE PLAN. ESTIMATED PENSION BENEFITS WERE CALCULATED BASED ON THE PROVISIONS OF THE CURRENT CASH BALANCE PLAN AT 6% OF PENSIONABLE EARNINGS. SOME ASSOCIATES ARE GRANDFATHERED UNDER AN EARLIER PENSION PLAN. THESE GRANDFATHERED PARTICIPANTS, BASED ON COMPUTATION AT THE TIME OF THEIR RETIREMENT, WILL RECEIVE THE LARGER OF THE RETIREMENT BENEFIT COMPUTED UNDER THE CASH BALANCE PLAN COMPARED TO THE PREVIOUS PENSION PLAN. DUE TO THE COMPLEXITY OF CALCULATION AN ACCURATE BENEFIT COST FOR GRANDFATHERED PARTICIPANTS, THE FORM 990 REPORTS AS PENSION BENEFITS THEIR ANNUAL ESTIMATED CASH BALANCE PLAN ACCRUAL.
FORM 990, SCHEDULE J, PART II
W-2 COMPENSATION MAY INCLUDE PAYMENTS RELATED TO COMPENSATION DEFERRED IN PRIOR YEARS. DEFERED COMPENSATION MAY INCLUDE DEFERRALS OF CURRENT YEAR COMPENSATION UNDER EXECUTIVED DEFERRED INCOME ACCOUNT, SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN AND PENSION RESTORATION PLAN.
FORM 990, SCHEDULE J, PART II, COLUMN B (II)
BONUS AND INCENTIVE COMPENSATION MAY INCLUDE AMOUNTS THAT WERE DEFERRED IN A PRIOR YEAR BUT PAID OUT IN CALENDAR YEAR 2022.
FORM 990, SCHEDULE J, PART I, LINE 4A
SEVERANCE PAYMENTS THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING CALENDAR YEAR 2022: SCOTT SMITH, MD: $300,000
FORM 990, SCHEDULE J, PART I, QUESTION 4B
COMPENSATION REPORTED AS DEFERRED IN A PRIOR FORM 990 DEFERRED COMPENSATION INCLUDES EXECUTIVE DEFERRED INCOME ACCOUNT, SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN, AND PENSION RESTORATION PLAN. ESTIMATED PENSION BENEFITS WERE CALCULATED BASED ON THE PROVISIONS OF THE CURRENT PENSION RESTORATION PLAN AT 6% OF PENSIONABLE EARNINGS WHICH ARE OVER THE IRS LEGISLATIVE COMPENSATION LIMIT. SOME ASSOCIATES ARE GRANDFATHERED UNDER AN EARLIER LEGACY PENSION PLAN. IF A PARTICIPANT HAS PROTECTED PENSION BENEFITS UNDER SUCH LEGACY PLANS, HIS/HER PERCENTAGE IS ZERO UNDER THE SUPPLEMENTAL EXECUTIVE RETIREMENT AND RETENTION PLAN, AS THE PROTECTED BENEFIT IS ALREADY EQUAL TO OR BETTER THAN CURRENT MARKET.

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.

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.

  • GSHS CUSTOMER SERVICE BUILDING

    RENTAL · TX

    Directly controlled by GSMC

Related corporations and trusts

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

  • GSHS ENTERPRISES INC

    C-CORP · HEALTHCARE · TX · controlled entity

    Directly controlled by GSMC

  • GOOD SHEPHERD HEALTH NETWORK

    C-CORP · INACTIVE · TX · controlled entity

    Directly controlled by HOSPITAL

  • GS PHYSICIAN SERVICES INC

    C-CORP · MEDICAL SERVI · TX · controlled entity

    Directly controlled by GSHS ENTERPRISE

  • GSHS CUSTOMER SERVICE BUILDING LLC

    C CORP · RENTAL · TX · controlled entity

    Directly controlled by GSMC

Provenance

Return type
form_990
Tax year
2022
Filed
6 May 2024
IRS schema version
2022v5.0
Source object
202431289349302618

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