Skip to content
Nonprofiteer
← GOOD SAMARITAN HOSPITAL PHYSICIAN SERVICES INC

Form 990 for tax year 2022

Filed by GOOD SAMARITAN HOSPITAL PHYSICIAN SERVICES INC.

Totals

Total revenue
$35,860,772
Total expenses
$59,858,281
Contributions and grants received
$1,483,014
Grants paid
$0
Program service revenue
$0
Investment income
$23,722
Other revenue
$34,354,036
Total assets, end of year
$2,533,660
Total liabilities, end of year
$954,769
Net assets or fund balances, end of year
$1,578,891
Program services expenses (Part IX)
$57,196,027
Management and general expenses
$2,662,254
Fundraising expenses
$0
Program service expenses (Part III)
$57,196,027

Program services were 95.6% 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.

  • 1a · Federated campaigns

    $0

  • 1b · Membership dues

    $0

  • 1c · Fundraising events

    $0

  • 1d · Related organizations

    $1,483,014

  • 1e · Government grants (contributions)

    $0

  • 1f · All other contributions, gifts and grants

    $0

  • 1g · Noncash contributions included above

    $0

  • 3 · Investment income

    total $23,722 · related or exempt $23,722 · unrelated business $0 · excluded $0

  • 4 · Income from investment of tax-exempt bond proceeds

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 5 · Royalties

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 6a · Gross rents

    real property $102,014 · personal property $0

  • 6b · Less rental expenses

    real property $0 · personal property $0

  • 6c · Rental income or loss

    real property $102,014 · personal property $0

  • 6d · Net rental income or loss

    total $102,014 · related or exempt $102,014 · unrelated business $0 · excluded $0

  • 7c · Gain or loss

    securities $0 · other assets $0

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

    $0

  • 11a · Other revenue: Physician Offices

    total $34,252,022 · related or exempt $34,252,022 · unrelated business $0 · excluded $0

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $34,252,022

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $4,043,379 · program services $4,043,379

  • 6 · Compensation of disqualified persons

    total $40,795,869 · program services $40,795,869

  • 8 · Pension plan contributions

    total $2,140,232 · program services $2,140,232

  • 9 · Other employee benefits

    total $3,131,977 · program services $3,131,977

  • 10 · Payroll taxes

    total $1,818,801 · program services $1,818,801

  • 11g · Fees: other

    total $1,533,944 · program services $1,533,944

  • 12 · Advertising and promotion

    total -$12,517 · program services -$12,517

  • 13 · Office expenses

    total $2,552,531 · program services $2,552,531

  • 14 · Information technology

    total $203,994 · program services $203,994

  • 16 · Occupancy

    total $637,453 · program services $637,453

  • 17 · Travel

    total $69,127 · program services $69,127

  • 19 · Conferences, conventions and meetings

    total $215,981 · program services $215,981

  • 22 · Depreciation, depletion and amortization

    total $65,256 · program services $65,256

  • 24a · Other expenses: Dues & Subscriptions

    total $56,411 · program services $0 · management and general $56,411 · fundraising $0

  • 24b · Other expenses: Unassigned Claims

    total $240,355 · program services $0 · management and general $240,355 · fundraising $0

  • 24c · Other expenses: Bad Debt Expense

    total $2,345,488 · program services $0 · management and general $2,345,488 · fundraising $0

  • 24d · Other expenses: Physician Loan Writeoff

    total $20,000 · program services $0 · management and general $20,000 · fundraising $0

Balance sheet

Part X, book values.

  • 4 · Accounts receivable

    beginning of year $3,015,196 · end of year $2,533,660

  • 17 · Accounts payable and accrued expenses

    beginning of year $1,057,054 · end of year $954,769

  • 29 · Capital stock, trust principal or current funds

    beginning of year $23,564,775 · end of year $25,576,401

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

    beginning of year $0 · end of year $0

  • 31 · Retained earnings, endowment or other funds

    beginning of year -$21,606,633 · end of year -$23,997,510

Mission and programs · 2022

Mission

Provide excellent healthcare by promoting wellness, education and healing through trusting relationships.

Activities or mission (Part I)

Provide excellent health care by promoting wellness, education and healing through trusting relationships.

  • Provide excellent healthcare by promoting wellness, education and healing through trusting relationships.

    Expenses $57,196,027 · Revenue $34,377,758

  • n/a

  • n/a

As filed on the 2022 return.

Listed in Part VII

  • Vikash Khurana MD

    Cardiologist

    Total calculated
    $1,072,067
    From this org
    $1,072,067
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $694,819 related
    Bonus
    $0 + $282,832 related
    Other
    $0 + $94,416 related
    Deferred
    $0 + $21,934 related
    Nontaxable benefits
    $0 + $50,408 related
    Filer's total
    $0 + $1,144,409 related

  • Philip Bacidore DO

    Cardiologist

    Total calculated
    $931,439
    From this org
    $931,439
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $762,987 related
    Bonus
    $0
    Other
    $0 + $168,452 related
    Deferred
    $0 + $33,014 related
    Nontaxable benefits
    $0 + $36,035 related
    Filer's total
    $0 + $1,000,488 related

  • Oluwagbenga Serrano MD

    Gastroenterologist

    Total calculated
    $698,274
    From this org
    $698,274
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $536,559 related
    Bonus
    $0 + $41,249 related
    Other
    $0 + $120,466 related
    Deferred
    $0 + $63,466 related
    Nontaxable benefits
    $0 + $45,590 related
    Filer's total
    $0 + $807,330 related

  • Brian Gebhardt MD

    Oncologist

    Total calculated
    $681,422
    From this org
    $681,422
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $473,131 related
    Bonus
    $0 + $182,913 related
    Other
    $0 + $25,378 related
    Deferred
    $0 + $53,795 related
    Nontaxable benefits
    $0 + $37,805 related
    Filer's total
    $0 + $773,022 related

  • Elizabeth Ashworth MD

    Cardiologist

    Total calculated
    $660,177
    From this org
    $660,177
    From related orgs
    $0
    Other
    $0
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $487,040 related
    Bonus
    $0 + $8,430 related
    Other
    $0 + $164,707 related
    Deferred
    $0 + $17,560 related
    Nontaxable benefits
    $0 + $28,138 related
    Filer's total
    $0 + $705,875 related

  • Robert McLin

    President of the Board

    Total calculated
    $0
    Hours/week
    0.25

  • Matt Schuckman

    Treasurer of the Board

    Total calculated
    $0
    Hours/week
    0.25

  • Susan Brocksmith

    Chairman of the Board

    Total calculated
    $0
    Hours/week
    0.25

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

None.

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 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

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

No itemized grants to organizations 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.

Provenance

Return type
form_990
Tax year
2022
Filed
27 April 2023
IRS schema version
2022v5.0
Source object
202341179349301919

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

The source document this was parsed from is served over the API, which is where bulk and document access live.