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Nonprofiteer
← MEDICAL STAFF OF GOOD SAMARITAN HOSPITAL

Form 990 for tax year 2022

Filed by MEDICAL STAFF OF GOOD SAMARITAN HOSPITAL.

Totals

Total revenue
$177,931
Total expenses
$263,419
Contributions and grants received
$0
Grants paid
$15,000
Program service revenue
$176,100
Investment income
$1,831
Other revenue
$0
Total assets, end of year
$331,681
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$331,681
Program services expenses (Part IX)
$232,323
Management and general expenses
$31,096
Fundraising expenses
$0
Program service expenses (Part III)
$232,323

Program services were 88.2% 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.

  • 2a · Program service revenue: MEMBERSHIP DUES & ASSE

    total $104,000 · related or exempt $104,000

  • 2b · Program service revenue: MEMBERSHIP DUES & ASSE

    total $63,500 · related or exempt $63,500

  • 2c · Program service revenue: MEMBERSHIP DUES & ASSE

    total $8,600 · related or exempt $8,600

  • 3 · Investment income

    total $1,700 · excluded $1,700

  • 7a · Gross sales of assets other than inventory

    securities $30,000

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

    securities $29,869

  • 7c · Gain or loss

    securities $131

  • 7d · Net gain or loss

    total $131 · related or exempt $131

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $15,000 · program services $15,000

  • 5 · Compensation of officers, directors and key employees

    total $155,250 · program services $139,725 · management and general $15,525

  • 11b · Fees: legal

    total $2,255 · management and general $2,255

  • 11c · Fees: accounting

    total $5,550 · management and general $5,550

  • 11g · Fees: other

    total $30,125 · program services $30,125

  • 24a · Other expenses: PPEC EXPENSE

    total $35,100 · program services $35,100

  • 24b · Other expenses: LEADERSHIP EDUCATION

    total $11,500 · program services $11,500

  • 24c · Other expenses: STAFF SOCIAL FUNCTIONS

    total $5,000 · management and general $5,000

  • 24d · Other expenses: OUTSIDE SERVICES

    total $2,400 · management and general $2,400

  • 24e · All other expenses

    total $1,239 · program services $873 · management and general $366

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $310,996 · end of year $223,870

  • 11 · Investments: publicly traded securities

    beginning of year $109,205 · end of year $107,811

  • 29 · Capital stock, trust principal or current funds

    beginning of year $0 · end of year $0

  • 30 · Paid-in or capital surplus, or land, building or equipment fund

    beginning of year $175,901 · end of year $175,901

  • 31 · Retained earnings, endowment or other funds

    beginning of year $244,300 · end of year $155,780

Mission and programs · 2022

Mission

THE ORGANIZATION IS DEDICATED TO THE TASK OF PROMOTING HIGH QUALITY MEDICAL CARE FOR ALL PATIENTS ADMITTED TO OR TREATED IN THE HOSPITAL.

  • ASSURE THAT ALL PATIENTS ADMITTED TO THE HOSPITAL RECEIVE HIGH QUALITY OF CARE. PROVIDE MEDIATION BETWEEN GOOD SAMARITAN HOSPITAL AND MEDICAL STAFF. PROVIDE REGULATIONS FOR SELF-GOVERNANCE OF MEDICAL STAFF. FOSTER ATMOSPHERE OF EDUCATION AND RESEARCH. MAINTAIN HIGH PROFESSIONAL AND ETHICAL STANDARDS.

    Expenses $232,323

As filed on the 2022 return.

Listed in Part VII

  • BALDEV SINGH MD

    CHIEF OF STAFF

    Total calculated
    $71,250
    From this org
    $71,250
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • GOPI AYER MD

    CHIEF OF STAFF-ELECT

    Total calculated
    $27,500
    From this org
    $27,500
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • JANE YIEH MD

    SECRETARY-TREASURER

    Total calculated
    $6,000
    From this org
    $6,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    5

  • ANUP SINGH MD

    PAST CHIEF OF STAFF

    Total calculated
    $11,750
    From this org
    $11,750
    From related orgs
    $0
    Other
    $0
    Hours/week
    20

  • CK PARK MD

    CHAIR/ADVISORY COUNCIL

    Total calculated
    $1,500
    From this org
    $1,500
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • MING-YUN TANG MD

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • GEORGE LEE MD

    CHAIR

    Total calculated
    $1,500
    From this org
    $1,500
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • MOHAMMED QAYYUM MD

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • KENNETH ONG MD

    CHAIR

    Total calculated
    $2,000
    From this org
    $2,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • JUDONG PAN MD

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • DAVID FELDMAN

    CHAIR

    Total calculated
    $2,000
    From this org
    $2,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • MY PHOUNG MITARAI MD

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • JOHN RASHKIS MD

    CHAIR

    Total calculated
    $4,700
    From this org
    $4,700
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • SATYA CHELAMKURI MD

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • DIANA TSAI MD

    CHAIR

    Total calculated
    $4,000
    From this org
    $4,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • ALEXANDER PHAM MD

    VICE CHAIR

    Total calculated
    $3,000
    From this org
    $3,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • FAHD KHAN MD

    CHAIR

    Total calculated
    $1,375
    From this org
    $1,375
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • SONYA PATEL DO

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • NIDHI JACOB MD

    CHAIR

    Total calculated
    $3,675
    From this org
    $3,675
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • MARK FIERRO MD

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • KRIKOR BARSOUMIAN MD

    CHAIR

    Total calculated
    $2,000
    From this org
    $2,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • HOWARD CHEN MD

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • SANDEEP GIDVANI MD

    CHAIR

    Total calculated
    $4,000
    From this org
    $4,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • JOTHI MURALI MD

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • SALMA DABIRI MD

    CHAIR

    Total calculated
    $2,000
    From this org
    $2,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • MONICA ENERIZ WIEMER MD

    CHAIR

    Total calculated
    $4,000
    From this org
    $4,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • PUI LAI MD

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • KIRK CHURUKIAN MD

    CHAIR

    Total calculated
    $3,000
    From this org
    $3,000
    From related orgs
    $0
    Other
    $0
    Hours/week
    1

  • MOHAMMADREZA ROHANINEJAD MD

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1

  • MAHSA ESFAHANI MD

    MEMBER AT LARGE

    Total calculated
    $0
    Hours/week
    1

  • DANAGRA IKOSSI MD

    MEMBER AT LARGE

    Total calculated
    $0
    Hours/week
    1

  • LINDA CHUNG MD

    ADVISORY COUNCIL

    Total calculated
    $0
    Hours/week
    1

  • RAJEEV TANDON MD

    ADVISORY COUNCIL

    Total calculated
    $0
    Hours/week
    1

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.

Grants on this return

Provenance

Return type
form_990
Tax year
2022
Filed
21 June 2023
IRS schema version
2022v5.0
Source object
202312349349300906

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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