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Nonprofiteer
← GOOD SAMARITAN INSTITUTE FOR RESEARCH AND EDUCATION

Form 990 for tax year 2022

Filed by GOOD SAMARITAN INSTITUTE FOR RESEARCH AND EDUCATION.

Totals

Total revenue
$433,148
Total expenses
$321,216
Contributions and grants received
$426,495
Grants paid
$15,366
Program service revenue
$0
Investment income
$6,653
Other revenue
$0
Total assets, end of year
$665,031
Total liabilities, end of year
$4,648,283
Net assets or fund balances, end of year
-$3,983,252
Program services expenses (Part IX)
$291,206
Management and general expenses
$30,010
Fundraising expenses
$0
Program service expenses (Part III)
$291,206

Program services were 90.7% 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

    $300,100

  • 1f · All other contributions, gifts and grants

    $126,395

  • 3 · Investment income

    total $6,653 · excluded $6,653

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $15,366 · program services $15,366

  • 7 · Other salaries and wages

    total $258,358 · program services $232,522 · management and general $25,836

  • 9 · Other employee benefits

    total $19,724 · program services $17,752 · management and general $1,972

  • 10 · Payroll taxes

    total $20,518 · program services $18,466 · management and general $2,052

  • 11a · Fees: management

    total $1,500 · program services $1,350 · management and general $150

  • 22 · Depreciation, depletion and amortization

    total $5,750 · program services $5,750

Balance sheet

Part X, book values.

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

    $55,750

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

    $21,556

  • 10c · Land, buildings and equipment, net

    beginning of year $39,944 · end of year $34,194

  • 11 · Investments: publicly traded securities

    beginning of year $598,409 · end of year $630,837

  • 25 · Other liabilities

    beginning of year $4,434,878 · end of year $4,648,283

  • 27 · Net assets without donor restrictions

    beginning of year -$3,996,701 · end of year -$4,302,550

  • 28 · Net assets with donor restrictions

    beginning of year $200,176 · end of year $319,298

Mission and programs · 2022

Mission

THE INSTITUTE CARRIES OUT RESEARCH AND EDUCATIONAL ACTIVITY IN CONNECTION WITH THE OPERATION OF PIH HEALTH GOOD SAMARITAN HOSPITAL WITH A FOCUS ON CARDIOLOGY AND CARDIOVASCULAR SERVICES.

Activities or mission (Part I)

RESEARCH AND EDU. REGARDING THE CARE, CURE AND PREVENTION OF CARDIAC AND CARDIOVASCULAR DISEASES.

  • SCIENTIFIC AND MEDICAL RESEARCH AND EDUCATION REGARDING THE CARE, CURE AND PREVENTION OF CARDIAC AND CARDIOVASCULAR DISEASES.

    Expenses $291,206 · Grants $15,366

As filed on the 2022 return.

Listed in Part VII

  • James West

    SYSTEM PRESIDENT & CEO

    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

  • Peggy Chulack

    SYSTEM CAO & ASST 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

  • Vid Shivaraman

    SYSTEM CFO & ASST 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

  • Cecile Mayoralgo

    RESEARCH RN

    Total calculated
    $182,926
    From this org
    $167,678
    From related orgs
    $0
    Other
    $15,248
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $167,678
    Bonus
    $0
    Other
    $0
    Deferred
    $8,429
    Nontaxable benefits
    $6,863
    Filer's total
    $182,970

  • Young Park

    RESEARCH RN

    Total calculated
    $186,586
    From this org
    $159,849
    From related orgs
    $0
    Other
    $26,737
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $159,849
    Bonus
    $0
    Other
    $0
    Deferred
    $9,935
    Nontaxable benefits
    $16,847
    Filer's total
    $186,631

  • Anita Chou

    FORMER CFO & ASST TRASURER

    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, 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, LINES 4A-B
ANITA CHOU RECEIVED A SEVERANCE PAYMENT DURING THE CALENDAR YEAR. THE PAYMENT IS INCLUDED IN PART VII, COLUMN E AND SCHEDULE J, PART II, COLUMN B(III). THE TERMS AND CONDITIONS OF THE CONFIDENTIAL SEVERANCE AGREEMENT ARE AVAILABLE TO THE INTERNAL REVENUE SERVICE UPON REQUEST.
PART I, LINE 3:
COMPENSATION FOR THE CEO WAS ESTABLISHED AND PAID BY PIH HEALTH WHITTIER HOSPITAL (PIHW), A RELATED ORGANIZATION. PIHW USED THE FOLLOWING TO ESTABLISH THE CEO'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) FORM 990 OF OTHER ORGANIZATIONS; (4) COMPENSATION SURVEY OR STUDY; (5) APPROVAL BY THE BOARD.
PART I, LINES 4A-B:
A RELATED ORGANIZATION, PIH HEALTH, INC., PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR CERTAIN EXECUTIVES. THE FOLLOWING INDIVIDUALS PARTICIPATE IN THE PLAN: VID SHIVARAMAN JAMES WEST PEGGY CHULACK
PART II, COLUMN (B)(III):
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 VID SHIVARAMAN $61,131 PEGGY CHULACK $120,897

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 corporations and trusts

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

  • PIH HEALTH INSURANCE COMPANY

    T · CAPTIVE INSURANCE · HI

  • PIH HEALTH CARE SOLUTIONS

    C · HEALTHCARE · CA

  • DRMC PROPERTIES INC

    C · REAL ESTATE · CA

  • PIH HEALTH RE

    T · CAPTIVE INSURANCE · HI

  • HEALTHMED SERVICES INC

    C · HEALTHCARE · CA

  • PIONEER MEDICAL GROUP INC

    C · MEDICAL SERVICES · CA

  • PIONEER PROVIDER NETWORK A MEDICAL GROUP INC

    C · MANAGEMENT SERVICES · CA

Provenance

Return type
form_990
Tax year
2022
Filed
31 July 2024
IRS schema version
2022v5.0
Source object
202422199349301582

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