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Nonprofiteer
← GOOD SAMARITAN NURSING CENTER INC

Form 990 for tax year 2022

Filed by GOOD SAMARITAN NURSING CENTER INC.

Totals

Total revenue
$73,000
Total expenses
$0
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$0
Other revenue
$73,000
Total assets, end of year
$127,203
Total liabilities, end of year
$4,635
Net assets or fund balances, end of year
$122,568
Program services expenses (Part IX)
$0
Management and general expenses
$0
Fundraising expenses
$0
Program service expenses (Part III)
not reported

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.

  • 6a · Gross rents

    real property $73,000

  • 6b · Less rental expenses

    real property $0

  • 6c · Rental income or loss

    real property $73,000

  • 6d · Net rental income or loss

    total $73,000 · excluded $73,000

Balance sheet

Part X, book values.

  • 4 · Accounts receivable

    end of year $7,203

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

    $120,000

  • 10c · Land, buildings and equipment, net

    beginning of year $120,000 · end of year $120,000

  • 17 · Accounts payable and accrued expenses

    beginning of year $17,333 · end of year $0

  • 25 · Other liabilities

    beginning of year $4,151 · end of year $4,635

  • 27 · Net assets without donor restrictions

    beginning of year $98,516 · end of year $122,568

Mission and programs · 2022

Mission

PROVISION OF LONG TERM CARE AND REHABILITATIVE SERVICES.

  • GOOD SAMARITAN NURSING CENTER, INC OPERATED A 147-BED COMPREHENSIVE CARE FACILITY LOCATED ON THE GOOD SAMARITAN HOSPITAL CAMPUS. THE FACILITY PROVIDED LONG-TERM CARE ASSISTANCE TO ITS RESIDENTS, 75% OF WHOM WERE STATE OF MARYLAND ASSISTANCE RECIPIENTS. IN ADDITION TO THESE SERVICES, THE ORGANIZATION OFFERED INTERGENERATIONAL PROGRAMMING FOR THE RESIDENTS THAT WAS DRAWN FROM SCHOOLS, DAY CARE CENTERS, ETC. IN ADDITION, THE ORGANIZATION PROVIDED ACTIVITIES WHERE THE COMMUNITY WAS WELCOMED TO JOIN IN, SUCH AS ITS RESPITE CARE PROGRAM, IN WHICH CAREGIVERS IN THE COMMUNITY WERE PROVIDED AN OPPORTUNITY TO HAVE A VACATION OR BREAK FROM CARING FOR A LOVED ONE AT HOME.

As filed on the 2022 return.

Listed in Part VII

  • Bradley Chambers

    PRESIDENT/DIRECTOR

    Total calculated
    $1,687,034
    From this org
    $0
    From related orgs
    $1,630,034
    Other
    $57,000
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $855,645 related
    Bonus
    $0 + $774,389 related
    Other
    $0
    Deferred
    $0 + $23,845 related
    Nontaxable benefits
    $0 + $33,155 related
    Filer's total
    $0 + $1,687,034 related

  • Art Sivaslian

    DIRECTOR

    Total calculated
    $727,003
    From this org
    $0
    From related orgs
    $703,067
    Other
    $23,936
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $407,687 related
    Bonus
    $0 + $295,380 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $23,936 related
    Filer's total
    $0 + $727,003 related

  • Oliver M Johnson II

    SECRETARY

    Total calculated
    $1,904,904
    From this org
    $0
    From related orgs
    $1,863,212
    Other
    $41,692
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $921,230 related
    Bonus
    $0 + $941,982 related
    Other
    $0
    Deferred
    $0 + $8,700 related
    Nontaxable benefits
    $0 + $32,992 related
    Filer's total
    $0 + $1,904,904 related

  • Deana Stout

    TREASURER

    Total calculated
    $586,998
    From this org
    $0
    From related orgs
    $535,082
    Other
    $51,916
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $359,677 related
    Bonus
    $0 + $175,405 related
    Other
    $0
    Deferred
    $0 + $30,423 related
    Nontaxable benefits
    $0 + $21,493 related
    Filer's total
    $0 + $586,998 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

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Form 990 of other organizations
  • 3 · Written employment contract
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 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)

SCHEDULE J, PART III
BRADLEY CHAMBERS' COMPENSATION IS FOR SERVICES PROVIDED AS PRESIDENT TO BOTH MEDSTAR GOOD SAMARITAN HOSPITAL AND MEDSTAR UNION MEMORIAL HOSPITAL. DEANA STOUT'S COMPENSATION IS FOR SERVICES PROVIDED AS CFO AT MEDSTAR HARBOR HOSPITAL, MEDSTAR FRANKLIN SQUARE MEDICAL CENTER, MEDSTAR GOOD SAMARITAN HOSPITAL AND MEDSTAR UNION MEMORIAL HOSPITAL.

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.

  • MEDSTAR SHAH MSO LLC

    N/A · MGMT SVCS · MD

  • 22590 SHADY COURT LLC

    N/A · REAL ESTATE · MD

  • 24035 THREE NOTCH ROAD LLC

    N/A · REAL ESTATE · MD

  • 37767 MARKET DRIVE LLC

    N/A · REAL ESTATE · MD

  • 26840 POINT LOOKOUT ROAD LLC

    N/A · REAL ESTATE · MD

  • MONTGOMERY COMMUNITY MRI LP

    N/A · MRI SCREENING · MD

  • PHYSIOTHERAPY ASSOCIATES NRH REHAB LLC

    N/A · PHYSIOTHERAPY · PA

  • PHYSICIAN IMAGING OF WASHINGTON HOSPITAL CENTER LLC

    N/A · RADIOLOGY SVC · TN

  • FRANKLIN IMAGING LLC

    N/A · IMAGING · MD

  • 10 ST PATRICK'S DRIVE LLC

    N/A · REAL ESTATE · MD

  • MEDSTAR ENDOSCOPY CTR AT LUTHERVILLELLC

    N/A · SURGERY · MD

  • CAPITAL ENDOSCOPY LLC

    N/A · SURGERY · MD

  • 4240 ALTAMONT PLACE LLC

    N/A · REAL ESTATE · MD

  • MEDSTAR ENDOSCOPY CENTER-SILVER SPRING LLC

    N/A · SURGERY · MD

Related corporations and trusts

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

  • MEDSTAR PHARMACIES INC

    C · DRUG SALES · MD

  • EXTENCARE INC

    C · MEDICAL SVCS · MD

  • HELIX RESOURCES MANAGEMENT INC

    C · ADMIN SVCS · MD

  • HELIXCARE PROPERTIES LLC

    C · MEDICAL SVCS · MD

  • PARKWAY VENTURES INC

    C · HOLDING CO. · MD

  • PHYSICIANS ADMINISTRATIVE SERVICES INC

    C · BILLING SVCS · MD

  • MEDSTAR FAMILY CHOICE INC

    C · MANAGED CARE · MD

  • MEDSTAR ENTERPRISES INC

    C · ADMIN SERVICE · MD

  • SITEL INC

    C · EDUCATIONAL · MD

  • STAR BILLING INC

    C · BILLING SVCS · MD

  • WASHINGTON RISK NETWORK MANAGEMENT INC

    C · MEDICAL SVCS · MD

  • WASHINGTON HOSPITAL CENTER PHYSICIAN HOS

    C · MEDICAL SVCS · DC

  • MEDSTAR PHYSICIAN PARTNERS INC

    C · MEDICAL SVCS · MD

  • FRANKLIN SQUARE DRIVE LAND CONDO ASSOCIA

    C · CONDOMINIUMS · MD

  • MGH DIVERSIFIED SERVICES INC

    C · MEDICAL SVCS · MD

  • ST MARYS HEALTH ALLIANCE INC

    C · MEDICAL SVCS · MD

  • GREENSPRING FINANCIAL INSURANCE LIMITED

    C · INSURANCE · CJ

  • ST MARY'S CONDO ASSOCIATION

    C · CONDOMINIUMS · MD

  • MEDSTAR HEALTH MASTER RETIREMENT TRUST

    C · INVESTMENTS · CJ

  • MEDSTAR HEALTH INC - INVESTMENT FUND I

    C · INVESTMENTS · CJ

Provenance

Return type
form_990
Tax year
2022
Filed
2 May 2024
IRS schema version
2022v5.0
Source object
202401289349300015

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