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Nonprofiteer
← SAMARITAN PACIFIC HEALTH SERVICES INC

Form 990 for tax year 2024

Filed by SAMARITAN PACIFIC HEALTH SERVICES INC.

Totals

Total revenue
$152,600,769
Total expenses
$137,229,048
Contributions and grants received
$453,497
Grants paid
$59,625
Program service revenue
$146,881,632
Investment income
$209,973
Other revenue
$5,055,667
Total assets, end of year
$154,667,552
Total liabilities, end of year
$29,506,380
Net assets or fund balances, end of year
$125,161,172
Program services expenses (Part IX)
$122,528,691
Management and general expenses
$14,698,647
Fundraising expenses
$1,710
Program service expenses (Part III)
$122,528,691

Program services were 89.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • DOUGLAS BOYSEN

    BOARD MEMBER / CEO SHS

    Total calculated
    $1,407,871
    From this org
    $0
    From related orgs
    $1,336,861
    Other
    $71,010
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,082,734 related
    Bonus
    $0 + $199,331 related
    Other
    $0 + $54,796 related
    Deferred
    $0 + $27,756 related
    Nontaxable benefits
    $0 + $43,254 related
    Filer's total
    $0 + $1,407,871 related

  • KELLEY KAISER

    BOARD SECRETARY / CAO SHS

    Total calculated
    $518,553
    From this org
    $0
    From related orgs
    $448,420
    Other
    $70,133
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $398,049 related
    Bonus
    $0 + $27,052 related
    Other
    $0 + $23,319 related
    Deferred
    $0 + $27,756 related
    Nontaxable benefits
    $0 + $42,377 related
    Filer's total
    $0 + $518,553 related

  • JERRY ROBBINS MD

    BOARD MEMBER

    Total calculated
    $12,647
    From this org
    $0
    From related orgs
    $12,400
    Other
    $247
    Hours/week
    1 + 2 related

  • RALPH BREITENSTEIN MD

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • ALEXANDRA GUEVARA

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • STEPHEN BURNS MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • JAYNE ROMERO

    BOARD VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • LYNN BARTON

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • WILLIAM HANSON

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • MATT UPDENKELDER

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • DANIEL SMITH

    SVP / CFO

    Total calculated
    $688,921
    From this org
    $0
    From related orgs
    $622,805
    Other
    $66,116
    Hours/week
    2 + 38 related

    Schedule J breakdown matched by us

    Base
    $0 + $539,235 related
    Bonus
    $0 + $31,558 related
    Other
    $0 + $52,012 related
    Deferred
    $0 + $27,756 related
    Nontaxable benefits
    $0 + $38,360 related
    Filer's total
    $0 + $688,921 related

  • LESLEY OGDEN MD

    CEO / CEO SNLH

    Total calculated
    $525,261
    From this org
    $0
    From related orgs
    $464,515
    Other
    $60,746
    Hours/week
    20 + 20 related

    Schedule J breakdown matched by us

    Base
    $0 + $399,478 related
    Bonus
    $0 + $25,785 related
    Other
    $0 + $39,252 related
    Deferred
    $0 + $27,756 related
    Nontaxable benefits
    $0 + $32,990 related
    Filer's total
    $0 + $525,261 related

  • JANE RUSSELL

    VP COO

    Total calculated
    $331,196
    From this org
    $302,188
    From related orgs
    $0
    Other
    $29,008
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $270,957
    Bonus
    $6,611
    Other
    $24,620
    Deferred
    $23,372
    Nontaxable benefits
    $5,636
    Filer's total
    $331,196

  • SAM JONES

    VP PATIENT CARE SERVICES

    Total calculated
    $281,366
    From this org
    $218,800
    From related orgs
    $0
    Other
    $62,566
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $211,209
    Bonus
    $5,437
    Other
    $2,154
    Deferred
    $16,010
    Nontaxable benefits
    $46,556
    Filer's total
    $281,366

  • JK SHUMATE MD

    PHYSICIAN

    Total calculated
    $596,250
    From this org
    $596,250
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

    Schedule J breakdown matched by us

    Base
    $0
    Bonus
    $0
    Other
    $596,250
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $596,250

  • DAVID LARSEN MD

    PHYSICIAN

    Total calculated
    $552,025
    From this org
    $480,698
    From related orgs
    $0
    Other
    $71,327
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $479,111
    Bonus
    $0
    Other
    $1,587
    Deferred
    $27,756
    Nontaxable benefits
    $43,571
    Filer's total
    $552,025

  • BREWSTER KELLOGG DO

    MEDICAL DIRECTOR

    Total calculated
    $530,181
    From this org
    $455,941
    From related orgs
    $0
    Other
    $74,240
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $427,434
    Bonus
    $0
    Other
    $28,507
    Deferred
    $27,756
    Nontaxable benefits
    $46,484
    Filer's total
    $530,181

  • ERIN GUILIANO LICHY DO

    MEDICAL DIRECTOR

    Total calculated
    $496,245
    From this org
    $434,300
    From related orgs
    $0
    Other
    $61,945
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $410,439
    Bonus
    $2,500
    Other
    $21,361
    Deferred
    $27,756
    Nontaxable benefits
    $34,189
    Filer's total
    $496,245

  • NATHANIEL UECKER MD

    PHYSICIAN

    Total calculated
    $485,792
    From this org
    $414,811
    From related orgs
    $0
    Other
    $70,981
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $372,499
    Bonus
    $14,169
    Other
    $28,143
    Deferred
    $27,756
    Nontaxable benefits
    $43,225
    Filer's total
    $485,792

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
  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 5a · Pay contingent on this organization's revenues

Answered no

  • 4c · Equity-based compensation arrangement
  • 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 ON PART VII USED THE NON-SAMARITAN GYM REIMBURSEMENT 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, TWO KEY EMPLOYEES, TWO OFFICERS, AND ONE HIGHEST PAID EMPLOYEE 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, LINES 4A-B
JK SHUMATE, A HIGHEST PAID EMPLOYEE, RECEIVED A CHANGE OF CONTROL PAYMENT OF 596,250 PURSUANT TO AN AGREEMENT REEACHED WITH THE FILING ORGANIZATION. 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, LINE 5
VARIOUS PHYSICIAN COMPENSATION METHODOLOGIES ARE UTILIZED AND, DEPENDING ON SPECIALTY, RELATIVE VALUE UNITS (RVU'S) MAY BE USED IN DETERMINING A PORTION OF OR ALL OF THEIR COMPENSATION.

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
28 October 2025
IRS schema version
2024v5.2
Source object
202533179349307593

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