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Nonprofiteer
← ST MARYS GOOD SAMARITAN HOSPITAL INC

Form 990 for tax year 2024

Filed by ST MARYS GOOD SAMARITAN HOSPITAL INC.

Totals

Total revenue
$41,634,133
Total expenses
$38,153,531
Contributions and grants received
$298,359
Grants paid
$15,973
Program service revenue
$37,344,905
Investment income
$871,218
Other revenue
$3,119,651
Total assets, end of year
$82,465,440
Total liabilities, end of year
$35,336,476
Net assets or fund balances, end of year
$47,128,964
Program services expenses (Part IX)
$30,127,679
Management and general expenses
$8,025,852
Fundraising expenses
$0
Program service expenses (Part III)
$30,127,679

Program services were 79.0% 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.

  • 1d · Related organizations

    $149,968

  • 1e · Government grants (contributions)

    $148,391

  • 2a · Program service revenue: NET PATIENT SERVICE REVENUE

    total $37,344,905 · related or exempt $37,344,905

  • 3 · Investment income

    total $681,501 · excluded $681,501

  • 7a · Gross sales of assets other than inventory

    securities $189,717

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

    securities $0

  • 7c · Gain or loss

    securities $189,717

  • 7d · Net gain or loss

    total $189,717 · excluded $189,717

  • 10a · Gross sales of inventory

    $53,234

  • 10b · Cost of goods sold

    $30,067

  • 10c · Net income from sales of inventory

    total $23,167 · excluded $23,167

  • 11a · Other revenue: OTHER RELATED REVENUE

    total $2,957,904 · related or exempt $2,957,904

  • 11b · Other revenue: CAFETERIA REVENUE

    total $138,580 · excluded $138,580

  • 11e · Other revenue, total

    $3,096,484

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $15,973 · program services $15,973

  • 6 · Compensation of disqualified persons

    total $255,467 · program services $129,142 · management and general $126,325

  • 7 · Other salaries and wages

    total $12,851,459 · program services $12,750,361 · management and general $101,098

  • 9 · Other employee benefits

    total $2,219,111 · program services $2,179,872 · management and general $39,239

  • 10 · Payroll taxes

    total $950,742 · program services $934,488 · management and general $16,254

  • 11f · Fees: investment management

    total $32,025 · management and general $32,025

  • 11g · Fees: other

    total $9,029,257 · program services $2,351,407 · management and general $6,677,850

  • 12 · Advertising and promotion

    total $45,605 · program services $17,948 · management and general $27,657

  • 13 · Office expenses

    total $291,729 · program services $159,650 · management and general $132,079

  • 14 · Information technology

    total $78,783 · program services $78,783

  • 16 · Occupancy

    total $1,054,420 · program services $1,044,079 · management and general $10,341

  • 17 · Travel

    total $5,126 · program services $3,333 · management and general $1,793

  • 19 · Conferences, conventions and meetings

    total $1,821 · program services $171 · management and general $1,650

  • 20 · Interest

    total $1,306,251 · program services $1,306,251

  • 22 · Depreciation, depletion and amortization

    total $1,882,070 · program services $1,875,203 · management and general $6,867

  • 24a · Other expenses: MEDICAL SUPPLIES EXP

    total $4,019,507 · program services $4,019,507

  • 24b · Other expenses: BAD DEBT EXPENSE

    total $2,274,631 · program services $2,274,631

  • 24c · Other expenses: I/C PURCHASE SERVICES

    total $1,112,314 · program services $295,480 · management and general $816,834

  • 24d · Other expenses: EQUIPMENT MAINTENANCE

    total $643,158 · program services $643,158

  • 24e · All other expenses

    total $84,082 · program services $48,242 · management and general $35,840

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $360,490 · end of year $104,146

  • 4 · Accounts receivable

    beginning of year $6,366,925 · end of year $5,097,175

  • 8 · Inventories for sale or use

    beginning of year $702,803 · end of year $640,106

  • 9 · Prepaid expenses and deferred charges

    beginning of year $54,519 · end of year $75,929

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

    $49,076,893

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

    $23,731,293

  • 10c · Land, buildings and equipment, net

    beginning of year $26,967,432 · end of year $25,345,600

  • 11 · Investments: publicly traded securities

    beginning of year $30,003,332 · end of year $35,461,863

  • 12 · Investments: other securities

    beginning of year $12,858,570 · end of year $15,197,941

  • 15 · Other assets

    beginning of year $236,069 · end of year $542,680

  • 17 · Accounts payable and accrued expenses

    beginning of year $2,905,704 · end of year $2,366,669

  • 25 · Other liabilities

    beginning of year $33,753,667 · end of year $32,969,807

  • 27 · Net assets without donor restrictions

    beginning of year $40,890,769 · end of year $47,128,964

Mission and programs · 2024

Mission

WE, TRINITY HEALTH GEORGIA AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. GOOD SAMARITAN HOSPITAL IS A MEMBER OF TRINITY HEALTH GEORGIA AND TRINITY HEALTH.

Activities or mission (Part I)

TO PROVIDE HEALTH CARE AND HOSPITAL SERVICES

  • ST. MARY'S GOOD SAMARITAN HOSPITAL (GOOD SAMARITAN HOSPITAL) WAS ESTABLISHED TO SERVE THE HEALTH CARE NEEDS OF THE PEOPLE OF GREENSBORO AND THE GREATER GREENE COUNTY AREAS OF EAST GEORGIA. GOOD SAMARITAN HOSPITAL OPERATES A 25-BED CRITICAL ACCESS HOSPITAL FOR THE COMMUNITY, INCLUDING GENERAL SURGERY, A 24-HOUR EMERGENCY DEPARTMENT AND MOST ANCILLARY SERVICES ASSOCIATED WITH A MODERN HEALTH CARE FACILITY. GOOD SAMARITAN HOSPITAL PROVIDES THESE SERVICES ALONG WITH OTHER WELLNESS AND EDUCATIONAL PROGRAMS TO THE COMMUNITY AT REDUCED COST, OR IN SOME CASES NO CHARGE, BASED ON THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.PLEASE VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION ABOUT PROGRAMS AND SERVICES: WWW.STMARYSHEALTHCARESYSTEM.ORG

    Expenses $30,127,679 · Grants $15,973 · Revenue $40,302,809

As filed on the 2024 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • STONISH PIERCE

    DIRECTOR; PRESIDENT & CEO

    Total calculated
    $994,277
    From this org
    $0
    From related orgs
    $801,650
    Other
    $192,627
    Hours/week
    2 + 53 related

    Schedule J breakdown matched by us

    Base
    $0 + $528,535 related
    Bonus
    $0 + $240,139 related
    Other
    $0 + $32,976 related
    Deferred
    $0 + $156,644 related
    Nontaxable benefits
    $0 + $35,983 related
    Filer's total
    $0 + $994,277 related

  • JOHN FOOS

    DIRECTOR; CHAIR THROUGH 12/24

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • JEAN MEYER

    DIRECTOR; CHAIR AS OF 1/25

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • ROBERT MOORE JR

    DIRECTOR; VICE CHAIR AS OF 1/25

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • JOAN ANTONE

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • DONNIE HARRISON JR

    DIRECTOR THROUGH 12/24

    Total calculated
    $0
    Hours/week
    1

  • KRISTINE HOPKINS

    DIRECTOR THROUGH 12/24

    Total calculated
    $0
    Hours/week
    1

  • MICHAEL KENNEDY

    DIRECTOR AS OF 1/25

    Total calculated
    $0
    Hours/week
    1

  • STACY MCCLENDON

    DIRECTOR AS OF 1/25

    Total calculated
    $0
    Hours/week
    1

  • JAMES PARKS

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • ELIZABETH STRICKLAND THOMAS

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JUNE TOMPKINS

    DIRECTOR THROUGH 12/24

    Total calculated
    $0
    Hours/week
    1

  • GARY USRY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • ELENA BARBERIS

    TREAS AT 1/25;VP, FIN FL/GA AT 10/24

    Total calculated
    $65,282
    From this org
    $0
    From related orgs
    $59,597
    Other
    $5,685
    Hours/week
    2 + 48 related

  • MICHAEL GUSHO

    TREAS THR 12/24; CFO SVC AREA SOUTH

    Total calculated
    $1,079,883
    From this org
    $0
    From related orgs
    $1,027,237
    Other
    $52,646
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $678,393 related
    Bonus
    $0 + $220,404 related
    Other
    $0 + $128,440 related
    Deferred
    $0 + $20,425 related
    Nontaxable benefits
    $0 + $32,221 related
    Filer's total
    $0 + $1,079,883 related

  • ELIZABETH SCHOEN

    SECRETARY; ASSOCIATE COUNSEL

    Total calculated
    $317,377
    From this org
    $0
    From related orgs
    $267,189
    Other
    $50,188
    Hours/week
    2 + 48 related

    Schedule J breakdown matched by us

    Base
    $0 + $233,830 related
    Bonus
    $0 + $31,782 related
    Other
    $0 + $1,577 related
    Deferred
    $0 + $18,200 related
    Nontaxable benefits
    $0 + $31,988 related
    Filer's total
    $0 + $317,377 related

  • JEFFREY BROWN

    SENIOR VICE PRESIDENT, OPERATIONS

    Total calculated
    $384,357
    From this org
    $0
    From related orgs
    $351,372
    Other
    $32,985
    Hours/week
    5 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $276,928 related
    Bonus
    $0 + $70,916 related
    Other
    $0 + $3,528 related
    Deferred
    $0 + $20,425 related
    Nontaxable benefits
    $0 + $12,560 related
    Filer's total
    $0 + $384,357 related

  • MICHAEL BORN MD

    INT CHIEF MEDICAL OFFICER THR 12/24

    Total calculated
    $170,000
    From this org
    $0
    From related orgs
    $170,000
    Other
    $0
    Hours/week
    5 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $170,000 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $170,000 related

  • DONALD SOUTHARD

    NURSING SUPERVISOR

    Total calculated
    $200,734
    From this org
    $178,733
    From related orgs
    $0
    Other
    $22,001
    Hours/week
    45

    Schedule J breakdown matched by us

    Base
    $176,403
    Bonus
    $0
    Other
    $2,330
    Deferred
    $9,945
    Nontaxable benefits
    $12,056
    Filer's total
    $200,734

  • JOSEPH HANCOCK

    PHARMACIST

    Total calculated
    $190,739
    From this org
    $148,470
    From related orgs
    $0
    Other
    $42,269
    Hours/week
    45

    Schedule J breakdown matched by us

    Base
    $147,901
    Bonus
    $0
    Other
    $569
    Deferred
    $10,172
    Nontaxable benefits
    $32,097
    Filer's total
    $190,739

  • LISA BATCHELOR

    SURGICAL NURSE

    Total calculated
    $150,606
    From this org
    $130,872
    From related orgs
    $0
    Other
    $19,734
    Hours/week
    45

    Schedule J breakdown matched by us

    Base
    $130,698
    Bonus
    $0
    Other
    $174
    Deferred
    $7,392
    Nontaxable benefits
    $12,342
    Filer's total
    $150,606

  • CYNTHIA DAVIS

    MANAGER, REHABILITATION

    Total calculated
    $166,960
    From this org
    $127,665
    From related orgs
    $0
    Other
    $39,295
    Hours/week
    45

    Schedule J breakdown matched by us

    Base
    $127,511
    Bonus
    $0
    Other
    $154
    Deferred
    $8,783
    Nontaxable benefits
    $30,512
    Filer's total
    $166,960

  • ANITA BROWN

    UTILIZATION REVIEW PROGRAM MANAGER

    Total calculated
    $142,850
    From this org
    $124,979
    From related orgs
    $0
    Other
    $17,871
    Hours/week
    45

  • TANYA ADCOCK

    FORMER OFFICER

    Total calculated
    $126,325
    From this org
    $0
    From related orgs
    $126,325
    Other
    $0
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $0 + $126,325 related
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $126,325 related

  • D MONTEZ CARTER

    FORMER OFFICER; TH OF NE PRES & CEO

    Total calculated
    $1,659,446
    From this org
    $0
    From related orgs
    $1,378,384
    Other
    $281,062
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $846,241 related
    Bonus
    $0 + $409,155 related
    Other
    $0 + $122,988 related
    Deferred
    $0 + $245,931 related
    Nontaxable benefits
    $0 + $35,131 related
    Filer's total
    $0 + $1,659,446 related

  • JANICE DUNN

    FORMER OFFICER

    Total calculated
    $479,802
    From this org
    $0
    From related orgs
    $411,298
    Other
    $68,504
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $45,789 related
    Bonus
    $0 + $51,555 related
    Other
    $0 + $313,954 related
    Deferred
    $0 + $53,040 related
    Nontaxable benefits
    $0 + $15,464 related
    Filer's total
    $0 + $479,802 related

  • DAVID SPIVEY

    FORMER OFFICER

    Total calculated
    $1,044,731
    From this org
    $0
    From related orgs
    $656,763
    Other
    $387,968
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $99,885 related
    Bonus
    $0
    Other
    $0 + $556,878 related
    Deferred
    $0 + $372,703 related
    Nontaxable benefits
    $0 + $15,265 related
    Filer's total
    $0 + $1,044,731 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)

PART I, LINE 3
GOOD SAMARITAN HOSPITAL IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. GOOD SAMARITAN HOSPITAL'S CEO IS PAID DIRECTLY BY THE SYSTEM'S PARENT ENTITY, TRINITY HEALTH CORPORATION. TRINITY HEALTH CORPORATION USED THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF GOOD SAMARITAN HOSPITAL'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINES 4A-B
THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN CALENDAR 2024. THESE AMOUNTS ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: TANYA ADCOCK - $126,325 JANICE DUNN - $299,934 DAVID SPIVEY - $534,765 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. IN ADDITION, COLUMN C OF SCHEDULE J, PART II INCLUDES THE FOLLOWING SEVERANCE AMOUNTS, WHICH WERE UNPAID AS OF 12/31/24: JANICE DUNN - $46,656 (PAID IN 2025) DAVID SPIVEY - $368,445 (PAID IN 2025) THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2024. THE PLAN PROVIDES RETIREMENT BENEFITS TO CERTAIN TRINITY HEALTH EXECUTIVES SUBJECT TO MEETING SPECIFIED VESTING AND EMPLOYMENT DATE REQUIREMENTS. PARTICIPANTS' VESTED BENEFITS WERE PAID OUT IN 2024, AND THEIR NON-VESTED BENEFITS FOR 2024 WERE ACCRUED. THE FOLLOWING PAYOUTS FOR 2024 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: D. MONTEZ CARTER - $105,121 MICHAEL GUSHO - $106,209 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS. THE FOLLOWING ACCRUALS FOR 2024 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: D. MONTEZ CARTER - $225,506 STONISH PIERCE - $139,969 THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH RESTORATION PLAN. THE RESTORATION PLAN PROVIDES RETIREMENT BENEFITS FOR CERTAIN TRINITY HEALTH SYSTEM OFFICE EXECUTIVES WITH EARNINGS ABOVE THE IRS PAY CAP FOR QUALIFIED PLANS ($345,000 FOR 2024). THE FOLLOWING PAYOUTS FOR 2024 FOR THIS PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: JANICE DUNN - $498 STONISH PIERCE - $19,169 COLUMN F OF SCHEDULE J, PART II INCLUDES THE PORTION OF THESE AMOUNTS THAT WERE REPORTED AS DEFERRED COMPENSATION IN PRIOR YEARS.

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
2024
Filed
4 May 2026
IRS schema version
2024v5.5
Source object
202601249349302960

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