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Nonprofiteer
← ST MARYS GOOD SAMARITAN FOUNDATION INC

Form 990 for tax year 2023

Filed by ST MARYS GOOD SAMARITAN FOUNDATION INC.

Totals

Total revenue
$425,100
Total expenses
$108,218
Contributions and grants received
$401,065
Grants paid
$66,715
Program service revenue
$0
Investment income
$43,060
Other revenue
-$19,025
Total assets, end of year
$1,994,596
Total liabilities, end of year
$97,382
Net assets or fund balances, end of year
$1,897,214
Program services expenses (Part IX)
$66,715
Management and general expenses
$10,149
Fundraising expenses
$31,354
Program service expenses (Part III)
$66,715

Program services were 61.6% 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.

  • 1c · Fundraising events

    $32,513

  • 1d · Related organizations

    $2,250

  • 1f · All other contributions, gifts and grants

    $366,302

  • 3 · Investment income

    total $41,930 · excluded $41,930

  • 7a · Gross sales of assets other than inventory

    securities $1,130

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

    securities $0

  • 7c · Gain or loss

    securities $1,130

  • 7d · Net gain or loss

    total $1,130 · excluded $1,130

  • 8a · Fundraising events: gross income

    $18,062

  • 8a · Fundraising events: contributions included on line 1c

    $32,513

  • 8b · Fundraising events: direct expenses

    $37,087

  • 8c · Net income from fundraising events

    total -$19,025 · excluded -$19,025

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $66,715 · program services $66,715

  • 11f · Fees: investment management

    total $10,149 · management and general $10,149

  • 13 · Office expenses

    total $1,262 · fundraising $1,262

  • 24a · Other expenses: OTHER RELATED EXPENSES

    total $30,092 · fundraising $30,092

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $233,294 · end of year $233,294

  • 2 · Savings and temporary cash investments

    beginning of year $704,806 · end of year $1,160,685

  • 3 · Pledges and grants receivable

    beginning of year $3,497 · end of year $3,500

  • 9 · Prepaid expenses and deferred charges

    end of year $20,632

  • 11 · Investments: publicly traded securities

    beginning of year $367,032 · end of year $566,734

  • 15 · Other assets

    beginning of year $110,225 · end of year $9,751

  • 17 · Accounts payable and accrued expenses

    end of year $1,262

  • 25 · Other liabilities

    beginning of year $129,557 · end of year $96,120

  • 27 · Net assets without donor restrictions

    beginning of year $918,767 · end of year $1,387,214

  • 28 · Net assets with donor restrictions

    beginning of year $370,530 · end of year $510,000

Mission and programs · 2023

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. ST. MARY'S GOOD SAMARITAN FOUNDATION IS A MEMBER OF THE TRINITY HEALTH GEORGIA AND TRINITY HEALTH.

Activities or mission (Part I)

TO PROVIDE SUPPORT FOR THE PROGRAMS OF TRINITY HEALTH GEORGIA AND ITS AFFILIATES

  • ST. MARY'S GOOD SAMARITAN FOUNDATION RECEIVES, MAINTAINS, AND DISTRIBUTES FUNDS EXCLUSIVELY FOR THE CHARITABLE, EDUCATIONAL, AND FUNCTIONAL ACTIVITIES OF TRINITY HEALTH GEORGIA AND ITS AFFILIATES.PLEASE VISIT OUR WEBSITE FOR ADDITIONAL INFORMATION: WWW.STMARYSHEALTHCARESYSTEM.ORG/FOUNDATIONS

    Expenses $66,715 · Grants $66,715

As filed on the 2023 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
    $916,778
    From this org
    $0
    From related orgs
    $778,059
    Other
    $138,719
    Hours/week
    1 + 54 related

    Schedule J breakdown matched by us

    Base
    $0 + $473,856 related
    Bonus
    $0 + $223,750 related
    Other
    $0 + $80,453 related
    Deferred
    $0 + $109,787 related
    Nontaxable benefits
    $0 + $28,932 related
    Filer's total
    $0 + $916,778 related

  • REBECCA SMITH

    DIRECTOR; CHAIR

    Total calculated
    $0
    Hours/week
    1

  • PRICE WOODWARD

    DIRECTOR & VICE CHAIR THROUGH 12/23

    Total calculated
    $0
    Hours/week
    1

  • NEENA AMIN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • DEBORAH CORNELIA

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • AVIS DICKEY

    DIRECTOR THROUGH 12/23

    Total calculated
    $0
    Hours/week
    1

  • TINA FISCHLIN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • VICKIE HANEY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • PERRY LEE OD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JENNIFER MERCER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • JAMES PARKS MD

    DIRECTOR THROUGH 12/23

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • JEP POUND

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • LOUIS SEABOLT

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • ARTHUR TORSIGLIERI MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1

  • MICHAEL GUSHO

    TREAS AT 2/24; CFO SVC AREA SOUTH

    Total calculated
    $1,002,197
    From this org
    $0
    From related orgs
    $936,965
    Other
    $65,232
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $650,389 related
    Bonus
    $0 + $166,250 related
    Other
    $0 + $120,326 related
    Deferred
    $0 + $24,750 related
    Nontaxable benefits
    $0 + $40,482 related
    Filer's total
    $0 + $1,002,197 related

  • JANICE DUNN

    TREASURER & CFO THROUGH 2/24

    Total calculated
    $394,670
    From this org
    $0
    From related orgs
    $350,886
    Other
    $43,784
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $340,370 related
    Bonus
    $0
    Other
    $0 + $10,516 related
    Deferred
    $0 + $14,850 related
    Nontaxable benefits
    $0 + $28,934 related
    Filer's total
    $0 + $394,670 related

  • ELIZABETH SCHOEN

    SECRETARY; ASSOCIATE COUNSEL

    Total calculated
    $293,002
    From this org
    $0
    From related orgs
    $250,579
    Other
    $42,423
    Hours/week
    1 + 49 related

    Schedule J breakdown matched by us

    Base
    $0 + $225,447 related
    Bonus
    $0 + $23,633 related
    Other
    $0 + $1,499 related
    Deferred
    $0 + $11,785 related
    Nontaxable benefits
    $0 + $30,638 related
    Filer's total
    $0 + $293,002 related

  • D MONTEZ CARTER

    FORMER OFFICER; TH OF NE PRES & CEO

    Total calculated
    $1,638,045
    From this org
    $0
    From related orgs
    $1,367,293
    Other
    $270,752
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $820,976 related
    Bonus
    $0 + $371,250 related
    Other
    $0 + $175,067 related
    Deferred
    $0 + $233,475 related
    Nontaxable benefits
    $0 + $37,277 related
    Filer's total
    $0 + $1,638,045 related

  • DAVID SPIVEY

    FORMER OFF;PRES SAINT AGNES THR 1/24

    Total calculated
    $965,098
    From this org
    $0
    From related orgs
    $916,565
    Other
    $48,533
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $699,276 related
    Bonus
    $0 + $75,000 related
    Other
    $0 + $142,289 related
    Deferred
    $0 + $24,750 related
    Nontaxable benefits
    $0 + $23,783 related
    Filer's total
    $0 + $965,098 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

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 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
ST. MARY'S GOOD SAMARITAN FOUNDATION IS A SUBSIDIARY IN THE TRINITY HEALTH SYSTEM. ST. MARY'S GOOD SAMARITAN FOUNDATION'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 ST. MARY'S GOOD SAMARITAN FOUNDATION'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, LINE 4B
THE FOLLOWING ARE PARTICIPANTS IN A TRINITY HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2023. 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 2023, AND THEIR NON-VESTED BENEFITS FOR 2023 WERE ACCRUED. THE FOLLOWING PAYOUTS FOR 2023 FOR THE PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: D. MONTEZ CARTER - $73,923 MICHAEL GUSHO - $99,937 DAVID SPIVEY - $137,761 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 2023 ARE INCLUDED IN COLUMN C OF SCHEDULE J, PART II: D. MONTEZ CARTER - $213,675 STONISH PIERCE - $94,937 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 ($330,000 FOR 2023). THE FOLLOWING PAYOUTS FOR 2023 FOR THIS PLAN ARE INCLUDED IN COLUMN B(III) OF SCHEDULE J, PART II: JANICE DUNN - $3,129 STONISH PIERCE - $0

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
2023
Filed
13 May 2025
IRS schema version
2023v6.0
Source object
202521339349302752

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