2020-08-13T16:28:52-05:00 2019-09-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2018-10-01 370724112 GOOD SAMARITAN HOME OF QUINCY % SARAH DOLBEARE GOOD 2172238717 2130 HARRISON STREET QUINCY IL 62301 CHARLES NEWTON CEO 2172238717 2020-02-13 true Brian D Todd P00422601 4178658701 167.68.126.162 43032920202265000014 2020-08-13 P 34FEC733D9517700F77F9305E895A80725933709 DC217978BA4E90A39731850ED9CC10A93A8E606F 2018 2020-11-06 18:47:13Z CHARLES NEWTON 2130 HARRISON STREET QUINCY IL 62301 20302514 false X WWW.GSHQ.ORG X 1953 IL SERVING OUR RESIDENTS, THEIR FAMILIES, STAFF AND THE GREATER COMMUNITY THROUGH COMPASSIONATE CARE. 14 14 523 190 0 0 214672 380771 16670514 16196785 775252 527329 15614 54479 17676052 17159364 0 0 0 0 12341481 11680589 0 0 0 7446092 7686263 19787573 19366852 -2111521 -2207488 37702952 35369578 9626465 9637052 28076487 25732526 X SUPERIOR CHRISTIAN SERVICE IN A CHARITABLE COMMUNITY. false false 13291324 12554775 THE GOOD SAMARITAN HOME OF QUINCY OPERATES A SKILLED NURSING FACILITY. THIS FACILITY OFFERS 24 HOUR CARE. THERE IS AN EXTENSIVE ACTIVITY PROGRAM THAT INCLUDES OUTINGS, CRAFTS, COOKING, ENTERTAINMENT AND DAILY CHAPEL SERVICES TO HELP KEEP RESIDENTS ACTIVE. GOOD SAMARITAN PROVIDES CHARITY CARE TO PATIENTS WHO ARE UNABLE TO PAY FOR SERVICES. DURING FY 2019, THE ORGANIZATION SERVED A DAILY AVERAGE OF 152 RESIDENTS THROUGH ITS SKILLED NURSING FACILITY. 969594 2196228 GOOD SAMARITAN HOME OF QUINCY OFFERS 180 COTTAGES FOR INDEPENDENT LIVING. THEY ALL OFFER THE PRIVACY AND INDEPENDENCE OF HAVING YOUR OWN APARTMENT. COTTAGERS ARE WELCOME TO PARTICIPATE IN ACTIVITIES AT THE HOME, SUCH AS AQUATIC EXERCISE CLASSES, OUTINGS, ENTERTAINMENT, AND DAILY CHAPEL SERVICES. DURING FY 2019, THE ORGANIZATION SERVED A DAILY AVERAGE OF 211 RESIDENTS THROUGH ITS INDEPENDENT LIVING PROGRAM. 1000873 1102516 GOOD SAMARITAN HOME OF QUINCY OFFERS AN ASSISTED LIVING FACILITY. THERE ARE SEVERAL ROOM SIZES, INCLUDING APARTMENT STYLE WITH A KITCHENETTE IN EACH ROOM. RESIDENTS ARE ALSO WELCOME TO USE A COMMUNAL FULL KITCHEN. THERE IS ALSO AN EXTENSIVE ACTIVITY PROGRAM THAT INCLUDES OUTINGS, CRAFTS, COOKING, ENTERTAINMENT AND DAILY CHAPEL SERVICES. DURING FY 2019, THE ORGANIZATION SERVED A DAILY AVERAGE OF 35 RESIDENTS THROUGH ITS ASSISTED LIVING FACILITY. 200000 15261791 true true false true false false false false true true true false false false false false true false false false false false false false false false false false false true true false false false false false false false false false false false false false false false false false false false true 11 0 true 523 true false false false false false false false false false false false false X 14 14 false false false false true true true true true false false true true true true true true true true false IL X SARAH DOLBEARE 2172238717 2130 HARRISON ST QUINCY IL 62301 LAURA EHRHART DIRECTOR END 09/19 0.5 0.0 X 0 0 0 RANDY RILEY 1ST VP BEG 11/18 0.5 0.0 X X 0 0 0 JERRY JACKSON PRESIDENT END 10/18 1.0 0.0 X 0 0 0 PAUL KEMNER 2ND VP BEG 11/18 0.5 0.0 X 0 0 0 LARRY SHEPHERD DIRECTOR 0.5 0.0 X 0 0 0 STEVE WAVERING DIRECTOR 0.5 0.0 X 0 0 0 BOB YOUNG DIRECTOR 0.25 0.0 X 0 0 0 ROB OVERHOLSER DIRECTOR 0.5 0.0 X 0 0 0 ALOK PATEL 3RD VP END 09/19 0.5 0.0 X X 0 0 0 SHARON HIGGINS DIRECTOR 0.5 0.0 X 0 0 0 RICHARD BOWMAN DIRECTOR 0.5 0.0 X 0 0 0 JEFF SPEAR SECRETARY/TREASURER 0.5 0.0 X X 0 0 0 GARY BLICKHAN DIRECTOR 0.5 0.0 X 0 0 0 ANDREW CASHMAN PRESIDENT BEG 11/18 0.5 1.0 X X 0 0 0 MIKE OBERDAHLHOFF DIRECTOR 0.5 0.0 X 0 0 0 MICHAEL DUFFY CEO END 09/19 40.0 0.0 X 159699 0 26796 STEPHANIE ERWIN CFO END 06/19 40.0 0.0 X 81714 0 12804 DAVID STIEGLITZ CFO BEG 08/19 40.0 0.0 X 0 0 0 CHARLES NEWTON CEO BEG 09/19 40.0 0.0 X 0 0 0 JUDY GRAHAM INTERIM CFO 06/19-08/19 40.0 0.0 X 0 0 0 241413 0 39600 1 false true false ATI PHYSICAL THERAPY 62718 COLLECTION CENTER DR CHICAGO IL 60693 THERAPY PROVIDER 226899 FIRST CHOICE PHYSICAL THERAPY 5 W STATE 8TH PLAZA QUINCY IL 62301 THERAPY CONTRACT 172501 PETERS HEATING AIR CONDITIONING 4520 BROADWAY QUINCY IL 62305 HVAC MAINTENANCE 126388 BKD LLP 910 E ST LOUIS STREET SPRINGFIELD MO 65801 AUDIT/CONSULTING/TAX 123877 MATRIXCARE PO BOX 1414 MINNEAPOLIS MN 55480 CLINICAL- A/R PORTAL 111132 5 2735 378036 380771 NET PATIENT SERVICE REVENUE 13540422 13540422 RESIDENT SERVICES 2238472 2238472 MANAGEMENT FEE 200000 200000 CAFETERIA 74625 74625 MISCELLANEOUS INCOME 143266 143266 16196785 179582 179582 0 0 0 0 0 3490897 3135602 7548 355295 -7548 347747 347747 0 0 0 0 0 0 0 0 0 MISCELLANEOUS INCOME 54479 54479 54479 17159364 16196785 581808 0 0 0 0 281013 281013 0 8841893 8013231 828662 0 1888983 1700933 188050 668700 584389 84311 0 80630 80630 125316 125316 0 0 55621 55621 521450 316145 205305 32645 32645 1095516 316518 778998 301270 301270 0 787658 448920 338738 12141 6920 5221 0 9094 9094 165905 145806 20099 0 1660428 1509559 150869 586759 586759 FOOD & PROGRAM SUPPLIES 954922 954922 Medical Supplies & Drugs 585147 584632 515 PROVIDER TAX 414150 414150 BAD DEBT 265666 265666 31945 31945 19366852 15261791 4105061 0 3150 3150 1009490 326473 12050 12050 1069572 889188 0 0 0 0 0 0 0 0 71517 26963 50282022 24347898 27108188 25934124 8246604 7874158 0 0 0 0 0 0 182381 303472 37702952 35369578 2162586 2646342 0 0 2292814 2115661 5073478 4721621 97587 153428 0 0 0 0 0 0 0 0 9626465 9637052 X 27976487 25632526 0 0 100000 100000 28076487 25732526 37702952 35369578 -2207488 -136473 X false true X true false X 347956 2048075 2131725 214672 380771 5123199 15393569 16527628 16810671 16670514 16196785 81599167 0 0 0 15741525 18575703 18942396 16885186 16577556 86722366 39255 625000 265450 223725 166008 1319438 781 781 39255 625000 265450 223725 166789 1320219 85402147 30644 369205 199906 196707 179582 976044 0 30644 369205 199906 196707 179582 976044 0 229426 6270 39920 15614 54479 345709 16001595 18951178 19182222 17097507 16811617 88044119 0.96999 0.94840 0.01109 0.03130 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 2274 2274 false SCHEDULE C, PART II-B, LINE 1I OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO LEADING AGE ILLINOIS. THE PORTION OF DUES ATTRIBUTABLE TO LOBBYING IS $2,274. false true X 100000 100000 100000 100000 100000 100000 100000 100000 100000 100000 1.00000 false false 1135037 1135037 36746798 16614575 20132223 9657048 6038270 3618778 2743139 1695053 1048086 25934124 16974818 -136473 -55621 -192094 17166912 -7548 -7548 17159364 19318779 7548 7548 19311231 55621 55621 19366852 SCHEDULE D, PART IV, LINE 2B ESCROW ACCOUNT: THE ORGANIZATION IS THE TRUSTEE OF FUNDS RECEIVED ON BEHALF OF VARIOUS RESIDENTS. THE ORGANIZATION HAS A FIDUCIARY RESPONSIBILITY FOR THE ADMINISTRATION OF THE BANK ACCOUNT AND THE DISTRIBUTION OF THE FUNDS TO RESIDENTS. SCHEDULE D, PART V, LINE 4 PURPOSE OF ENDOWMENT: THE CORPORATION'S ENDOWMENT IS INVESTED TO PROVIDE INVESTMENT RETURNS TO FUND GENERAL OPERATIONS. SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITION: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12: $ (55,621) INVESTMENT MANAGEMENT FEES SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12 BUT NOT ON LINE 1: $ ( 7,548) LOSS ON SALE OF ASSETS SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ 7,548 LOSS ON SALE OF ASSETS SCHEDULE D, PART XII, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 55,621 INVESTMENT MANAGEMENT FEES X X false false false false false false false false false MICHAEL DUFFY CEO END 09/19 159699 0 0 0 0 0 8919 0 17877 0 186495 0 0 0 A CITY OF QUINCY 376000378 2013-07-11 8000000 FINANCE PORTION OF GOOD SAM HOME false false false A 3202473 0 7960000 0 0 0 0 0 0 7960000 0 0 2013 true false true true A false false false false 0 false false false true A false true false false true false 0 false 0 false true A true FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES: GOOD SAMARITAN PROVIDES MANAGEMENT SERVICES UNDER A MANAGEMENT AGREEMENT TO OPERATE AND ASSIST WITH FUNDRAISING NEEDS OF THE FOUNDATION. IN 2019, THE FOUNDATION PAID GOOD SAMARITAN $200,000 FOR THESE SERVICES. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS: THE ORGANIZATION HAS 7 TYPES OF MEMBERS: PATRON MEMBER, SUSTAINING MEMBER, SUPPORTING MEMBER, ASSOCIATE MEMBER, REGULAR MEMBER, AND LIFETIME MEMBER FORM 990, PART VI, SECTION A, LINE 7A & 7B MEMBER RIGHTS: EACH MEMBER OVER 18 YEARS OF AGE OF EACH CLASS SHALL BE ENTITLED TO ONE VOTE ON EACH MATTER SUBMITTED TO A VOTE OF THE MEMBERS. MEMBERS SHALL ATTEND AN ANNUAL MEETING TO ELECT BOARD MEMBERS. TWELVE (12) DIRECTORS OF THE BOARD SHALL BE ELECTED BY THE MEMBERSHIP, EACH SERVING A THREE-YEAR TERM, WHICH TERMS SHALL BE STAGGERED SO FOUR DIRECTORS SHALL BE ELECTED AT EACH ANNUAL MEETING. UP TO SEVEN (7) DIRECTORS OF THE BOARD MAY BE APPOINTED FROM ONE OR MORE OF THE FOLLOWING CORPORATION AFFILIATES AS FOLLOWS: UP TO TWO (2) DIRECTORS MAY BE APPOINTED BY THE IOWA CONFERENCE OF THE UNITED CHURCH OF CHRIST; UP TO THREE (3) DIRECTORS MAY BE APPOINTED BY ILLINOIS CONFERENCE OF THE UNITED CHURCH OF CHRIST; UP TO ONE (1) DIRECTOR MAY BE APPOINTED BY THE AUXILIARY OF THE CORPORATION; AND UP TO ONE (1) DIRECTOR MAY BE APPOINTED BY THE UNCLE SAMS OF THE CORPORATION BOTH OF WHOM (AUXILIARY AND UNCLE SAMS) SHALL ALSO BE A MEMBER OF THE CORPORATION. THE APPOINTED MEMBERS OF THE BOARD SHALL SERVE FOR SUCH A PERIOD OF TIME, WITHOUT LIMITATION, AS IS DETERMINED BY THE APPOINTING BODY. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE FORM 990 IS SENT TO BOARD MEMBERS FOR REVIEW BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY COMPLIANCE: EACH BOARD MEMBER IS REQUIRED TO SIGN A CONFLICT OF INTEREST STATEMENT AND CONFIDENTIALITY AGREEMENT. ANY CONFLICTS ARE ADDRESSED IMMEDIATELY OR BOARD MEMBERS ABSTAIN FROM VOTING IF THERE APPEARS TO BE A CONFLICT ON A CERTAIN ISSUE. FORM 990, PART VI, SECTION B, LINE 15A & 15B COMPENSATION DETERMINATION: THE COMPENSATION OF THE CEO AND CFO IS REVIEWED ANNUALLY. FOR THE CEO THIS REVIEW WAS PERFORMED BY THE EXECUTIVE COMMITTEE. FOR THE CFO THIS REVIEW WAS PERFORMED BY THE CEO AND BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENT AVAILABILITY: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE BY REQUEST.