GOOD SAMARITAN FDN FOR BETTER HEALTH INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
GOOD SAMARITAN FDN FOR BETTER HEALTH INC (EIN 13-3400353)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-05
IRS object ID
201933099349300133
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-05T08:41:35-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15 TIMES SQUAREAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10036ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN133400353EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GOOD SAMARITAN FOUNDATION FOR BETTER HEALTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% MAUREEN BURKEInCareOfNm
Business Name ControlGOODBusinessNameControlTxt
Phone8453685151PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1255 Lafayette AvenueAddressLine1Txt
CitySuffernCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10901ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARY LEAHY MDPersonNm
Person TitleCEO - BSCHSPersonTitleTxt
Phone8453685305PhoneNum
Signature2019-11-04SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLAURA KIELCZEWSKIPreparerPersonNm
PTINP00740769PTIN
Phone2127733000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address164.57.159.254IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id26308520193085000025FederalOriginalSubmissionId
Federal Original Submission Id2019-11-04FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdCE4D3F0B42E73FE2D2DB8750BDCFCB0574B0A649AtSubmissionCreationDeviceId
At Submission Filing Device Id047C777BBD395ADD529156C75D94AFF56594489CAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-01-14 16:20:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARY LEAHY MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1255 Lafayette AvenueAddressLine1Txt
CitySuffernCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10901ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$923,345GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.bschsf.org/goodsamWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1986FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionFundraising for the benefit of Good Samaritan Hospital of Suffern, NY.ActivityOrMissionDesc
Voting Members Governing Body27VotingMembersGoverningBodyCnt
Voting Members Independent25VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers40TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$735,272PYContributionsGrantsAmt
CY Contributions Grants$694,982CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$16,656PYInvestmentIncomeAmt
CY Investment Income$29,847CYInvestmentIncomeAmt
PY Other Revenue-$142,586PYOtherRevenueAmt
CY Other Revenue-$91,565CYOtherRevenueAmt
PY Total Revenue$609,342PYTotalRevenueAmt
CY Total Revenue$633,264CYTotalRevenueAmt
PY Grants And Similar Paid$10,999PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$62,322CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$216,099PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$98,244CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$378,717CYTotalFundraisingExpenseAmt
PY Other Expenses$328,553PYOtherExpensesAmt
CY Other Expenses$455,190CYOtherExpensesAmt
PY Total Expenses$555,651PYTotalExpensesAmt
CY Total Expenses$615,756CYTotalExpensesAmt
PY Revenues Less Expenses$53,691PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$17,508CYRevenuesLessExpensesAmt
Total Assets BOY$3,481,523TotalAssetsBOYAmt
Total Assets EOY$3,842,118TotalAssetsEOYAmt
Total Liabilities BOY$13,270TotalLiabilitiesBOYAmt
Total Liabilities EOY$35,925TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,468,253NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,806,193NetAssetsOrFundBalancesEOYAmt
MissionTHE MISSION IS TO MAKE VISIBLE GOD'S LOVE AND TO BE GOOD HELP TO THOSE IN NEED, ESPECIALLY THOSE WHO ARE POOR, VULNERABLE AND DYING. AS A SYSTEM OF CAREGIVERS, WE COMMIT OURSELVES TO HELP BRING PEOPLE AND COMMUNITIES TO HEALTH AND WHOLENESS AS PART OF THE HEALING MINISTRY OF JESUS CHRIST AND THE CATHOLIC CHURCH.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$181,695ExpenseAmt
Grant$62,322GrantAmt
Revenue$0RevenueAmt
DescThe Good Samaritan Foundation is the voice of philanthropy for Good Samaritan Regional Medical Center. We increase awareness, create good will and raise funds to further the mission of the Bon Secours Charity Health System - to give Good Help to Those in Need. A few of the many ways that we've helped bring state-of-the-art medical care to our community: Facility and infrastructure improvements: -Patients that require emergency medical care receive expert attention in our newly expanded and renovated Emergency Department. Here, clinicians provide care using "ahead-of-the-art" equipment and technology. -Moms, dads and siblings bond with newborns in our new Family Unit. The unit also includes specially designed pediatric areas for children needing in-patient care. -Patients receive same day diagnostic and surgical procedures in the new Ambulatory Surgery Center. The center features state-of-the-art operating suites and advanced medical equipment. New equipment and state-of-the-art technology: -Upgrades to Electrophysiology Lab prevent patients with cardiac rhythm abnormalities from experiencing cardiac crises by mapping, detecting and treating even the most complicated cases. -Our da Vinci advanced surgical robotic system allows physicians to perform minimally invasive procedures. -The 128-slice CT scan allows clinicians to view high-definition images while patients receive low-dose radiation. -New MRI equipment is wider than the standard providing patients greater comfort and less confinement than standard equipment. Programs: The Bobbi Lewis Cancer Program provides personalized, compassionate, state-of-the-art oncology care. Community-wide support makes expanding and upgrading Good Samaritan's cancer services possible. Fundraising: We raise funds so children and adults in our community can count on state-of-the-art care when they come to Good Samaritan. The Foundation receives support from public and private organizations and individuals including board members, vendors, patients, their families, residents and our employees. Throughout the year, we initiate appeals and apply for grants. We also host a variety of events: The Spring Ball, Golf & Tennis Classic and Corks & Forks. Our signature annual events have raised millions of dollars over the years for patients at Good Samaritan. -The Spring Ball has been Rockland County's most prestigious gala for nearly 30 years. It is the one time each year when the entire Good Samaritan community comes together to reaffirm its commitment to advance healthcare in our region. -The Golf & Tennis Classic has been a legacy event for 25 years. Golf enthusiasts play on an elite 18-Hole course while those who prefer tennis volley in a tournament of their own. -Corks & Forks, A Celebration of Food and Wine, is our newest event. Culinary enthusiasts can enjoy five-course signature dishes and wine pairings courtesy of Hudson Valley's award-winning chefs and our wine partner.Desc
Total Program Service Expenses$181,695TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document8IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members27GoverningBodyVotingMembersCnt
Independent Voting Member25IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMAUREEN BURKEPersonNm
Phone8453685448PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1255 LAFAYETTE AVENUEAddressLine1Txt
CitySuffernCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10901ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
Nicholas DeSantis
Board Member1.00.0Yes (X)$0$0$0
Gil Heim
Board Member1.00.0Yes (X)$0$0$0
Gayle Hirsch Esq
Board Member1.039.0Yes (X)$0$155,653$29,535
Jack Holt
Board Member (term 4/18)1.00.0Yes (X)$0$0$0
Geanette Katz
Secretary1.00.0Yes (X)$0$0$0Yes (X)
Kevin Kern
Treasurer1.00.0Yes (X)$0$0$0Yes (X)
Joseph Lagana
Board Member1.00.0Yes (X)$0$0$0
Mary Leahy MD
CEO - BSCHS1.039.0Yes (X)$0$916,194$91,847Yes (X)
Patricia Lefkowitz
Board Member1.00.0Yes (X)$0$0$0
Aurelius Licata
Board Member0.00.0Yes (X)$0$0$0
Kathy Medici
Board Member1.00.0Yes (X)$0$0$0
Glenn Mendoza MD
Board Member1.00.0Yes (X)$0$0$0
Harold Peterson
Chair1.00.0Yes (X)$0$0$0Yes (X)
Amra Sabic-El-Rayess PhD
Board Member1.00.0Yes (X)$0$0$0
Louis Siracusano
Board Member1.00.0Yes (X)$0$0$0
Frank Stillo
Board Member1.00.0Yes (X)$0$0$0
Mark Acker
Board Member1.00.0Yes (X)$0$0$0
Joseph Allen
Board Member1.00.0Yes (X)$0$0$0
Heather Bowie
Board Member1.00.0Yes (X)$0$0$0
Gene Cortes
Board Member1.00.0Yes (X)$0$0$0
Lawrence Garvey
Board Member1.00.0Yes (X)$0$0$0
Angela Clarkin
Board Member1.00.0Yes (X)$0$0$0
Richard Clarkin MD
Board Member1.00.0Yes (X)$0$0$0
John DeCicco
Board Member1.00.0Yes (X)$0$0$0
JAIN JACOB
BOARD MEMBER1.00.0Yes (X)$0$0$0
JOYCE WALGROVE
BOARD MEMBER1.00.0Yes (X)$0$0$0
JOSEPH CASERES
BOARD MEMBER (EFFECT. 1/1/18)1.00.0Yes (X)$0$0$0
SR SUSAN EVELYN RSM
BOARD MEMBER (EFFECT. 1/1/18)1.039.0Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,071,847TotReportableCompRltdOrgAmt
Total Other Compensation$121,382TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

FieldValueIRS element (for citing)
PersonNONEPersonNm
FieldValueIRS element (for citing)
Contractor AddressContractorAddress
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$293,326FundraisingAmt
All Other Contributions$401,656AllOtherContributionsAmt
Total Contributions$694,982TotalContributionsAmt
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$31,763TotalRevenueColumnAmt
Exclusion$31,763ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$26,140SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$28,056SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$1,916SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$1,916TotalRevenueColumnAmt
Exclusion-$1,916ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$170,460FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$293,326ContriRptFundraisingEventAmt
Fundraising Direct Expenses$262,025FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$91,565TotalRevenueColumnAmt
Exclusion-$91,565ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$633,264TotalRevenueColumnAmt
Exclusion-$61,718ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$56,175TotalAmt
Program Services$56,175ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$6,147TotalAmt
Program Services$6,147ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$90,651TotalAmt
Program Services$18,130ProgramServicesAmt
Management And General$9,065ManagementAndGeneralAmt
Fundraising$63,456FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$4,040TotalAmt
Program Services$808ProgramServicesAmt
Management And General$404ManagementAndGeneralAmt
Fundraising$2,828FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total-$2,823TotalAmt
Program Services-$565ProgramServicesAmt
Management And General-$282ManagementAndGeneralAmt
Fundraising-$1,976FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$6,376TotalAmt
Program Services$1,275ProgramServicesAmt
Management And General$638ManagementAndGeneralAmt
Fundraising$4,463FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$7,803TotalAmt
Program Services$7,023ProgramServicesAmt
Management And General$780ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$107,433TotalAmt
Program Services$21,487ProgramServicesAmt
Management And General$10,743ManagementAndGeneralAmt
Fundraising$75,203FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$83,887TotalAmt
Program Services$16,777ProgramServicesAmt
Management And General$8,389ManagementAndGeneralAmt
Fundraising$58,721FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$4,607TotalAmt
Program Services$4,146ProgramServicesAmt
Management And General$461ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,893TotalAmt
Program Services$979ProgramServicesAmt
Management And General$489ManagementAndGeneralAmt
Fundraising$3,425FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$3,426TotalAmt
Program Services$685ProgramServicesAmt
Management And General$343ManagementAndGeneralAmt
Fundraising$2,398FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$52,354TotalAmt
Program Services$10,471ProgramServicesAmt
Management And General$5,235ManagementAndGeneralAmt
Fundraising$36,648FundraisingAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescPURCHASED SERVICESDesc
Total$190,787TotalAmt
Program Services$38,157ProgramServicesAmt
Management And General$19,079ManagementAndGeneralAmt
Fundraising$133,551FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$615,756TotalAmt
Program Services$181,695ProgramServicesAmt
Management And General$55,344ManagementAndGeneralAmt
Fundraising$378,717FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$478,667BOYAmt
EOY$207,180EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$158,824BOYAmt
EOY$117,380EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$3,250EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,224,578BOYAmt
EOY$2,894,854EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$619,454BOYAmt
EOY$619,454EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,481,523BOYAmt
EOY$3,842,118EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$13,270BOYAmt
EOY$35,925EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,270BOYAmt
EOY$35,925EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$688,477BOYAmt
EOY$394,336EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,742,002BOYAmt
EOY$3,331,010EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$37,774BOYAmt
EOY$80,847EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,468,253BOYAmt
EOY$3,806,193EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,481,523BOYAmt
EOY$3,842,118EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$17,508ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$21,738NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$342,170OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$339,632CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,204,731CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$547,127CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$735,272CurrentTaxYearMinus1YearAmt
Current Tax Year$694,982CurrentTaxYearAmt
Total$3,521,744TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$339,632CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,204,731CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$547,127CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$735,272CurrentTaxYearMinus1YearAmt
Current Tax Year$694,982CurrentTaxYearAmt
Total$3,521,744TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$353,759SubstantialContributorsTotAmt
Public Support Total170$3,167,985PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,088CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$22,483CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,194CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,649CurrentTaxYearMinus1YearAmt
Current Tax Year$31,763CurrentTaxYearAmt
Total$84,177TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,344,118CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$176,170CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$99,100CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$155,129CurrentTaxYearMinus1YearAmt
Current Tax Year$170,460CurrentTaxYearAmt
Total$3,944,977TotalAmt
FieldValueIRS element (for citing)
Total Support$7,550,898TotalSupportAmt
Public Support CY1700.41955PublicSupportCY170Pct
Public Support PY1700.46493PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePart II, Line 10FormAndLineReferenceDesc
ExplanationExplanation for Other Income: Special Events Revenue 2014 AMOUNT: $ 33,000 2015 AMOUNT: $ 176,170 2016 AMOUNT: $ 99,100 2017 AMOUNT: $ 155,129 2018 AMOUNT: $ 170,460 Forgiveness of Debt 2014 AMOUNT: $ 3,311,118 SHORT PERIOD RETURN GOOD SAMARITAN FOUNDATION FOR BETTER HEALTH FILED A 2014 FORM 990 SHORT PERIOD RETURN. THE ACTIVITY REPORTED REFLECTED THE ACTIVITY OF THE FILING ORGANIZATION FROM SEPTEMBER 1, 2014 THROUGH DECEMBER 31, 2014. THIS SHORT PERIOD WAS A RESULT OF A CHANGE IN THE ACCOUNTING PERIOD OF THE ORGANIZATION FROM A FISCAL YEAR ENDING AUGUST 31 TO A CALENDAR YEAR ENDING DECEMBER 31. THE CHANGE IN ACCOUNTING PERIOD WAS REPORTED ON THE 2014 FORM 990.ExplanationTxt

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,770,776BeginningYearBalanceAmt
Contributions$831,849ContributionsAmt
Grants Or Scholarships$197,666GrantsOrScholarshipsAmt
End Year Balance$3,404,959EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,489,307BeginningYearBalanceAmt
Contributions$774,238ContributionsAmt
Grants Or Scholarships$483,769GrantsOrScholarshipsAmt
End Year Balance$2,779,776EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,999,405BeginningYearBalanceAmt
Contributions$615,372ContributionsAmt
Grants Or Scholarships$125,470GrantsOrScholarshipsAmt
End Year Balance$2,489,307EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,249,715BeginningYearBalanceAmt
Contributions$656,141ContributionsAmt
Grants Or Scholarships$906,451GrantsOrScholarshipsAmt
End Year Balance$1,999,405EndYearBalanceAmt
FieldValueIRS element (for citing)
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
Prmnnt Endowment Balance EOY0.02370PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.97630TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp
EquipmentEquipmentGrp
Other Land BuildingsOtherLandBuildingsGrp

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
INSURANCE-CASH SURRENDER VALUE$223,080
CASH SURRENDER VALUE$396,374
FieldValueIRS element (for citing)
Total Book Value Other Assets$619,454TotalBookValueOtherAssetsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART V, LINE 4FormAndLineReferenceDesc
ExplanationIntended use of endowment funds: To support the mission of Good Samaritan Hospital of Suffern through program funding and capital acquisitions.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1SPRING BALLEvent1Nm
Gross Receipts Event1$193,379GrossReceiptsEvent1Amt
Charitable Contri Event1$107,379CharitableContriEvent1Amt
Gross Revenue Event1$86,000GrossRevenueEvent1Amt
Rent Facility Costs Event1$87,523RentFacilityCostsEvent1Amt
Entertainment Event1$10,500EntertainmentEvent1Amt
Other Direct Expenses Event1$80,343OtherDirectExpensesEvent1Amt
Event2FALL CLASSICEvent2Nm
Gross Receipts Event2$149,874GrossReceiptsEvent2Amt
Charitable Contri Event2$109,074CharitableContriEvent2Amt
Gross Revenue Event2$40,800GrossRevenueEvent2Amt
Rent Facility Costs Event2$10,000RentFacilityCostsEvent2Amt
Other Direct Expenses Event2$8,494OtherDirectExpensesEvent2Amt
Other Events Total2OtherEventsTotalCnt
Gross Receipts Other Events$120,533GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$76,873CharitableContriOtherEventsAmt
Gross Revenue Other Events$43,660GrossRevenueOtherEventsAmt
Rent Fclty Costs Other Events$52,961RentFcltyCostsOtherEventsAmt
Entertainment Other Events$2,000EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events$10,204OthDirectExpnssOtherEventsAmt
Gross Receipts Total$463,786GrossReceiptsTotalAmt
Charitable Contributions Tot$293,326CharitableContributionsTotAmt
Gross Revenue Total Events$170,460GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$150,484RentFcltyCostsTotalEventsAmt
Entertainment Total Events$12,500EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$99,041OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$262,025DirectExpenseSummaryEventsAmt
Net Income Summary-$91,565NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmt
CENTER FOR SAFETY AND CHANGE
NINE JOHNSONS LANENEW CITYNY10956132989233501(C)(3)$17,800
GOOD SAMARITAN HOSPITAL
255 LAFAYETTE AVESUFFERNNY10901131740104501(C)(3)$37,917
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeEMPLOYEE ASSISTANCEGrantTypeTxt
Recipient11RecipientCnt
Cash Grant$6,147CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I Description of Procedure for Monitoring Use of FundsFormAndLineReferenceDesc
ExplanationThe organization complies with Bon Secours Charity Health System, Inc's system-wide financial and accounting policies. Contributions are generally made as reimbursements for funds spent. In such cases, the donee/grantee organization must provide documentation to the filing organization before funds are approved for disbursement.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Gayle Hirsch Esq
Board Member$0$154,775$0$0$0$878$0$10,570$0$18,965$0$185,188$0$0
Mary Leahy MD
CEO - BSCHS$0$693,405$0$222,789$0$0$0$38,500$0$53,347$0$1,008,041$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J PART I LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION AS DESCRIBED BELOW: THE BOARD OF DIRECTORS PERSONNEL AND COMPENSATION COMMITTEE SETS THE LEVEL OF TOTAL COMPENSATION (BASE SALARY AND INCENTIVE COMPENSATION) AND THE BENEFITS PROVIDED TO THE ORGANIZATION'S SENIOR EXECUTIVES. IN ORDER TO SET BASE SALARY AND INCENTIVE COMPENSATION LEVELS, THE COMMITTEE WORKS WITH A NATIONAL INDEPENDENT COMPENSATION CONSULTING FIRM. THE CONSULTING FIRM ASSISTS THE COMMITTEE WITH ITS DECISION-MAKING PROCESSES TO ENSURE THAT (I) EXECUTIVE COMPENSATION LEVELS ARE REASONABLE AND APPROPRIATE RELATIVE TO THOSE OF OTHER SIMILAR ORGANIZATIONS, AS WELL AS (II) SUCH LEVELS MEET THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" STANDARD COMPENSATION LEVELS ARE DETERMINED BASED ON COMPETITIVE MARKET DATA FOR COMPARABLE POSITIONS IN SIMILAR SIZED AND TYPE OF ORGANIZATIONS AND EACH EXECUTIVE'S SCOPE OF RESPONSIBILITIES. IN ADDITION, INCENTIVE COMPENSATION ARRANGEMENTS ARE BASED ON EACH EXECUTIVE'S ACHIEVEMENT OF SPECIFIC PERFORMANCE GOALS SET FORTH AT THE BEGINNING OF EACH CALENDAR YEAR, THE ACHIEVEMENT OF WHICH IS MEASURED AT THE END OF EACH CALENDAR YEAR BY THE CEO OR THE BOARD OF DIRECTORS DEPENDING ON THE EXECUTIVE.
PART I, LINE 4BTHE FILING ORGANIZATION PARTICIPATES IN A BON SECOURS CHARITY HEALTH SYSTEM, INC. (BSCHS) supplemental executive retirement plan THAT ALLOWS FOR DEPOSITS INTO ADDITIONAL RETIREMENT PLANS AND IS AVAILABLE ONLY TO OFFICERS AND CERTAIN OTHER EMPLOYEES. THE 457(F) PLAN IS A NON-QUALIFIED PLAN AND IS SUBJECT TO A MINIMUM THREE-YEAR SERVICE REQUIREMENT BEFORE VESTING ON DEPOSITS MADE INTO THE PLAN. NO PAYOUTS HAVE BEEN MADE DURING THE YEAR.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, LINE 2business or family relationships: BOARD MEMBERS ANGELA CLARKIN AND RICHARD CLARKIN HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, LINE 6 MEMBERS OR STOCKHOLDERS: BON SECOURS CHARITY HEALTH SYSTEM, INC. (BSCHS) IS THE SOLE MEMBER OF GOOD SAMARITAN FOUNDATION FOR BETTER HEALTH (GSFBH).
FORM 990, PART VI, LINE 7APOWER TO ELECT OR APPOINT MEMBERS: The governing body of GOOD SAMARITAN FOUNDATION FOR BETTER HEALTH is appointed by its member, BON SECOURS CHARITY HEALTH SYSTEM, INC. and subject to approval of WMC Health Network-Rockland, Inc. (WMC-ROCKLAND) AND BON SECOURS HEALTH SYSTEM, INC. (BSHSI), TWO of the three corporate members of Bon Secours Charity Health System (BSCHS) The Sisters of Charity of Saint Elizabeth (SCSE).
FORM 990, PART VI, LINE 7BDECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS: Certain authorities of GOOD SAMARITAN FOUNDATION FOR BETTER HEALTH are reserved to its member, BON SECOURS CHARITY HEALTH SYSTEM, INLC or is jointly reserved to WMC HEALTH NETWORK, ROCKLAND, INC., BON SECOURS HEALTH SYSTEM, INC., the SISTERS OF CHARITY, THE THREE CORPORATE MEMBERS OF BON SECOURS CHARITY HEALTH SYSTEM, INC.
FORM 990, PART VI, LINE 11BPROCESS USED TO REVIEW THE FORM 990: The Form 990 was prepared by the BON SECOURS CHARITY HEALTH SYSTEM, INC.'S finance department with the assistance from various departments throughout the organization. The Form 990 was reviewed by internal leadership AND OUR EXTERNAL TAX ADVISORS. Upon completion of the various reviews, the Form 990 was PROVIDED to the board of the organization for approval prior to filing with the IRS.
FORM 990, PART VI, LINE 12CMONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY: The organization monitors and enforces compliance with the Conflict of Interest policy by means of a survey developed and approved by the Chief Compliance Officer. The survey is sent to all trustees, officers, and key executives for completion. All survey responses are reviewed by the Chief Compliance Officer. Any potential conflicts identified in the responses are discussed with senior management and/or referred to the WMCHealth Conflicts of Interest Committee for discussion. Potential actions to be taken in response to a conflict can be one or more of the following: 1) disclosure of the conflict, 2) individual recusal from decisions for transactions where that individual may have a conflict, 3) request in writing that the individual alleviates the conflict, or 4) removal of the individual from employment.
FORM 990, PART VI, LINE 13 AND 14Written whistleblower and document retention and destruction policies: The Foundation does not have its own written whistleblower and document retention and destruction policies. However, the Foundation does follow the policies approved by the Board of its related organization, BSCHS.
FORM 990, PART VI, LINE 19PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VIIBOARD MEMBER POSITIONS ARE GENERALLY VOLUNTARY IN NATURE. COMPENSATED EMPLOYEES OF THE FILING ORGANIZATION AND OTHER RELATED ORGANIZATIONS WHO ALSO HOLD BOARD POSITIONS ARE COMPENSATED ONLY IN RELATION TO THEIR EMPLOYMENT AND DO NOT RECEIVE ADDITIONAL COMPENSATION FOR THEIR BOARD RESPONSIBILITIES. SISTER SUSAN EVELYN DOES NOT RECEIVE COMPENSATION AS SHE HAS TAKEN A VOW OF POVERTY. Form 990, Part IX, Line 9 Other Employee Benefits Amounts for employee benefits are negative this year due to a credit from an allocation of prior year expenses to related organizations.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS: - PRIOR YEAR PLEDGE ADJUSTMENTS $ (35,693) - TRANSFERS FROM AFFILIATES $ 377,863 ----------- TOTAL $ 342,170

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (18 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
WMC HEALTH NETWORK - ROCKLAND INC
100 WOODS ROADVALHALLANY10595320467873SUPPORTINGNY501(C)(3)12ANAfalse
WMC HEALTH NETWORK - ULSTER INC
100 WOODS ROADVALHALLANY10595320477183SUPPORTINGNY501(C)(3)12AWCHCCfalse
WESTCHESTER COUNTY HEALTH CARE CORP
100 WOODS ROADVALHALLANY10595133964321HEALTHCARENY115N/ANAfalse
WMC NEW YORK INC
100 WOODS ROADVALHALLANY10595134107894FUNDRAISINGNY501(C)(3)12AWCHCCfalse
NORTH ROAD LHCSA INC
241 NORTH ROADPOUGHKEEPSIENY12601465293268HOMECARE SVCSNY501(C)(3)10WCHCCfalse
MID-HUDSON VALLEY EARLY EDUCATION CENTER
100 WOODS RD TAYLOR PAVILIONVALHALLANY10595465534882PRESCHOOLNY501(C)(3)7WCHCCfalse
WESTCHESTER MEDICAL CENTER FOUNDATION I
100 WOODS ROADVALHALLANY10595134095845FUNDRAISINGNY501(C)(3)7WCHCCfalse
HEALTHALLIANCE INC
741 GRANT AVENUELAKE KATRINENY12449261850453SUPPORTINGNY501(C)(3)12AWCHCCfalse
HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS
396 BROADWAYKINGSTONNY12401141349558EXEMPT HOSPNY501(C)(3)3HA INCfalse
HEALTHALLIANCE HOSPITAL MARY'S AVE CAMPU
105 MARYS AVENUEKINGSTONNY12401141338470EXEMPT HOSPNY501(C)(3)3HA INCfalse
MARGARETVILLE MEMORIAL HOSPITAL
42084 STATE ROUTE 28MARGARETVILLENY12455150552726EXEMPT HOSPNY501(C)(3)3HA INCfalse
MARGARETVILLE NURSING HOME INC
42158 STATE HIGHWAY 28MARGARETVILLENY12455223143565NURSING HOMENY501(C)(3)10MMHfalse
MARGARETVILLE HEALTH FOUNDATION
42084 STATE HIGHWAY 28MARGARETVILLENY12455261998454SUPPORT FDNNY501(C)(3)12AMMHfalse
FASC FOUNDATION
741 GRANT AVENUELAKE KATRINENY12449264201295SUPPORT FDNNY501(C)(3)7HAH BWAYfalse
BON SECOURS COMMUNITY HOSPITAL FDN
255 LAFAYETTE AVESUFFERNNY10901810667395SUPPORT FDNNY501(C)(3)7BSCHSfalse
BON SECOURS WARWICK HEALTH FOUNDATION
255 LAFAYETTE AVESUFFERNNY10901141972807SUPPORT FDNNY501(C)(3)7BSCHSfalse
BON SECOURS CHARITY HEALTH SYSTEM INC
255 LAFAYETTE AVESUFFERNNY10901912135195SUPPORTINGNY501(C)(3)12C, III-FIWCHCCfalse
HealthAlliance Foundation Inc
741 GRANT AVENUELAKE KATRINENY12449222511450FUNDRAISINGNY501(C)(3)7HA INCfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINLegal Domicile StateLegalDomicileStateCd
HUDSON RIVER WEST INSURANCE (BARBADOS)
38 PINE ROADBELLEVILLE ST MICHAELBBCAP INSURANCEBBBSCHSC CORPYes (true)
KINGSTON INSURANCE (BARBADOS) LIMITED
38 PINE ROADBELLEVILLE ST MICHAELBBCAP INSURANCEBBHEALTHALLIANCEC CORPYes (true)
NORTHEAST PROVIDER SOLUTIONS INC
MSO & HEARING AIDNAC CORPYes (true)100 WOODS ROADVALHALLANY10595133991673NY
WMC ADVANCED PHYSICIAN SERVICES PC
PHYSICIAN OFFICESNAC CORPYes (true)19 BRADHURST AVENUEHAWTHORNENY10595264709927NY
WESTCHESTER MEDICAL REGIONAL PHYS SVCS
PHYSICIAN OFFICESNAC CORPYes (true)241 NORTH ROADPOUGHKEEPSIENY10532465522536NY
WCHCC (BERMUDA) LIMITED
VICTORIA HALL 11 VICTORIA STREETHAMILTONBDCAP INSURANCEBDNAC CORPYes (true)
KINGSTON REGIONAL HEALTH CARE ENTERPRISE
INVESTMENTHAH BWAYC CORPYes (true)396 BROADWAYKINGSTONNY12401161514994NY
MID HUDSON PHYSICIANS PC
MEDICAL SVCSNAC CORPYes (true)396 BROADWAYKINGSTONNY12401203564769NY
BSCHS MEDICAL GROUP PC
PHYSICIAN OFFICESBSCHSC CORPYes (true)10 FRANKLIN TURNPIKEMAHWAHNJ07430821632215NJ
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Bon Secours Charity Health System Inc
Q$425,362Cost
GOOD SAMARITAN HOSPITAL FOR BETTER HEALTH
B$50,538Cost

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART II, BON SECOURS CHARITY HEALTH SYSTEM, INC. (BSCHS)FormAndLineReferenceDesc
ExplanationGOOD SAMARITAN FOUNDATION FOR BETTER HEALTH has a brother-sister relationship with BSCHSS six subordinates in a group exemption within BSCHS.ExplanationTxt

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