GOOD SAMARITAN FDN FOR BETTER HEALTH INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
GOOD SAMARITAN FDN FOR BETTER HEALTH INC (EIN 13-3400353)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-10-30
IRS object ID
201723039349300217
Schema version
2016v3.1
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)
Return2017-10-30T10:17:08-05:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

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 Begin2016-01-01TaxPeriodBeginDt

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 LeahyPersonNm
Person TitleCEOPersonTitleTxt
Phone8453685305PhoneNum
Signature2017-10-25SignatureDt
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 Id26308520173035000006FederalOriginalSubmissionId
Federal Original Submission Id2017-10-30FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id050F75853A9F423F493495C03CDD05FDA32C01D0AtSubmissionCreationDeviceId
At Submission Filing Device Id050F75853A9F423F493495C03CDD05FDA32C01D0AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMary LeahyPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1255 Lafayette AvenueAddressLine1Txt
CitySuffernCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10901ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$654,421GrossReceiptsAmt
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, NYActivityOrMissionDesc
Voting Members Governing Body34VotingMembersGoverningBodyCnt
Voting Members Independent31VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers30TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,204,831PYContributionsGrantsAmt
CY Contributions Grants$547,127CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$22,483PYInvestmentIncomeAmt
CY Investment Income$8,194CYInvestmentIncomeAmt
PY Other Revenue-$83,770PYOtherRevenueAmt
CY Other Revenue-$73,765CYOtherRevenueAmt
PY Total Revenue$1,143,544PYTotalRevenueAmt
CY Total Revenue$481,556CYTotalRevenueAmt
PY Grants And Similar Paid$1,144,984PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$603CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$307,291PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$316,533CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$430,427CYTotalFundraisingExpenseAmt
PY Other Expenses$276,939PYOtherExpensesAmt
CY Other Expenses$553,678CYOtherExpensesAmt
PY Total Expenses$1,729,214PYTotalExpensesAmt
CY Total Expenses$870,814CYTotalExpensesAmt
PY Revenues Less Expenses-$585,670PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$389,258CYRevenuesLessExpensesAmt
Total Assets BOY$2,560,726TotalAssetsBOYAmt
Total Assets EOY$2,940,805TotalAssetsEOYAmt
Total Liabilities BOY$28,213TotalLiabilitiesBOYAmt
Total Liabilities EOY$40,822TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,532,513NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,899,983NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
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$378,868ExpenseAmt
Grant$0GrantAmt
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 scans allows clinicians to view high-definition images while patients receive low-dose radiation. -New MRI equipment is wider than the standard providing patients greater comfortable (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 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$378,868TotalProgramServiceExpensesAmt
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 OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
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 Document10IRPDocumentCnt
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
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members34GoverningBodyVotingMembersCnt
Independent Voting Member31IndependentVotingMemberCnt
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 (35 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
Suzanne Donaghy
Board Member1.00.0Yes (X)$0$0$0
Tessa Garcia
Board Member1.00.0Yes (X)$0$0$0
Sr Fran Gorsuch CBS
Board Member1.039.0Yes (X)$0$6,943$6,322
Colin Gray
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$147,131$25,291
Jack Holt
Board Member1.00.0Yes (X)$0$0$0
Jeffrey Horowitz
Board Member1.00.0Yes (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$777,821$51,211Yes (X)
Patricia Lefkowitz
Board Member1.00.0Yes (X)$0$0$0
Aurelius Licata
Board Member1.00.0Yes (X)$0$0$0
Jeffrey Marangi
Board Member1.00.0Yes (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
Mona Montal
Board Member1.00.0Yes (X)$0$0$0
Sr Mary-Louise Moran SC
President1.00.0Yes (X)$0$0$0Yes (X)
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
Irene Tsetsekos
Board Member1.00.0Yes (X)$0$0$0
Bryan Newman
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 Member (AS OF 1/1/16)1.00.0Yes (X)$0$0$0
Lawrence Garvey
Board Member (AS OF 1/1/16)1.00.0Yes (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
Christopher Banks
VP of Philanthropy15.025.0$0$229,170$41,548Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,161,065TotReportableCompRltdOrgAmt
Total Other Compensation$124,372TotalOtherCompensationAmt
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$326,350FundraisingAmt
All Other Contributions$220,777AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$547,127TotalContributionsAmt
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,194TotalRevenueColumnAmt
Exclusion$8,194ExclusionAmt

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

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$99,100FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$326,350ContriRptFundraisingEventAmt
Fundraising Direct Expenses$172,865FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$73,765TotalRevenueColumnAmt
Exclusion-$73,765ExclusionAmt
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$481,556TotalRevenueColumnAmt
Exclusion-$65,571ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$603TotalAmt
Program Services$603ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

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$277,899TotalAmt
Program Services$55,580ProgramServicesAmt
Management And General$27,789ManagementAndGeneralAmt
Fundraising$194,530FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$6,651TotalAmt
Program Services$1,331ProgramServicesAmt
Management And General$665ManagementAndGeneralAmt
Fundraising$4,655FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$16,758TotalAmt
Program Services$3,352ProgramServicesAmt
Management And General$1,675ManagementAndGeneralAmt
Fundraising$11,731FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$15,225TotalAmt
Program Services$3,044ProgramServicesAmt
Management And General$1,523ManagementAndGeneralAmt
Fundraising$10,658FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$7,133TotalAmt
Program Services$1,427ProgramServicesAmt
Management And General$713ManagementAndGeneralAmt
Fundraising$4,993FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$47,658TotalAmt
Program Services$9,532ProgramServicesAmt
Management And General$4,765ManagementAndGeneralAmt
Fundraising$33,361FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$316TotalAmt
Program Services$284ProgramServicesAmt
Management And General$32ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$12,422TotalAmt
Program Services$2,484ProgramServicesAmt
Management And General$1,242ManagementAndGeneralAmt
Fundraising$8,696FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,899TotalAmt
Program Services$380ProgramServicesAmt
Management And General$190ManagementAndGeneralAmt
Fundraising$1,329FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$60,141TotalAmt
Program Services$12,028ProgramServicesAmt
Management And General$6,014ManagementAndGeneralAmt
Fundraising$42,099FundraisingAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescPurchased ServicesDesc
Total$424,109TotalAmt
Program Services$288,823ProgramServicesAmt
Management And General$16,911ManagementAndGeneralAmt
Fundraising$118,375FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$870,814TotalAmt
Program Services$378,868ProgramServicesAmt
Management And General$61,519ManagementAndGeneralAmt
Fundraising$430,427FundraisingAmt

Total Joint Costs TotalJointCostsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

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

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$434,833BOYAmt
EOY$235,776EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$354,640BOYAmt
EOY$257,921EOYAmt

Accounts Receivable AccountsReceivableGrp

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

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$1,144,391BOYAmt
EOY$1,820,246EOYAmt

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$626,862BOYAmt
EOY$626,862EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,560,726BOYAmt
EOY$2,940,805EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$28,213BOYAmt
EOY$40,822EOYAmt

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$28,213BOYAmt
EOY$40,822EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$533,108BOYAmt
EOY$410,676EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,961,631BOYAmt
EOY$2,406,360EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$37,774BOYAmt
EOY$82,947EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,532,513BOYAmt
EOY$2,899,983EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,560,726BOYAmt
EOY$2,940,805EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$389,258ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$26,139NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$0PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$730,589OtherChangesInNetAssetsAmt
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$1,380,886CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$987,190CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$339,632CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,204,831CurrentTaxYearMinus1YearAmt
Current Tax Year$547,127CurrentTaxYearAmt
Total$4,459,666TotalAmt

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$1,380,886CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$987,190CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$339,632CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,204,831CurrentTaxYearMinus1YearAmt
Current Tax Year$547,127CurrentTaxYearAmt
Total$4,459,666TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$90,392SubstantialContributorsTotAmt
Public Support Total170$4,369,274PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,225CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,947CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,088CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$22,483CurrentTaxYearMinus1YearAmt
Current Tax Year$8,194CurrentTaxYearAmt
Total$59,937TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$182,105CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$204,485CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,344,118CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$176,170CurrentTaxYearMinus1YearAmt
Current Tax Year$99,100CurrentTaxYearAmt
Total$4,005,978TotalAmt
FieldValueIRS element (for citing)
Total Support$8,525,581TotalSupportAmt
Public Support CY1700.51249PublicSupportCY170Pct
Public Support PY1700.52209PublicSupportPY170Pct
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 2012 AMOUNT: $ 182,105 2013 AMOUNT: $ 204,485 2014 AMOUNT: $ 33,000 2015 AMOUNT: $ 176,170 2016 AMOUNT: $ 99,100 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 END ON AUGUST 31 TO A CALENDAR YEAR ENDING DECEMBER 31. THE 2015 FORM 990 COVERS THE ENTIRE CALENDAR YEAR. THE CHANGE IN ACCOUNTING PERIOD WAS REPORTED ON THE 2014 FORM 990.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

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$1,999,405BeginningYearBalanceAmt
Contributions$615,372ContributionsAmt
Grants Or Scholarships$125,470GrantsOrScholarshipsAmt
End Year Balance$2,489,307EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt FundCYMinus2YrEndwmtFundGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
Prmnnt Endowment Balance EOY0.03300PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.96700TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp
EquipmentEquipmentGrp
Other Land BuildingsOtherLandBuildingsGrp

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
SUPPLEMENTAL SURVIVOR$0
INSURANCE-CASH SURRENDER VALUE$230,489
SURVIVING SPOUSE INSURANCE-$0
CASH SURRENDER VALUE$396,373
FieldValueIRS element (for citing)
Total Book Value Other Assets$626,862TotalBookValueOtherAssetsAmt

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$221,900GrossReceiptsEvent1Amt
Charitable Contri Event1$162,100CharitableContriEvent1Amt
Gross Revenue Event1$59,800GrossRevenueEvent1Amt
Rent Facility Costs Event1$52,500RentFacilityCostsEvent1Amt
Entertainment Event1$11,000EntertainmentEvent1Amt
Other Direct Expenses Event1$860OtherDirectExpensesEvent1Amt
Event2Fall ClassicEvent2Nm
Gross Receipts Event2$108,750GrossReceiptsEvent2Amt
Charitable Contri Event2$99,750CharitableContriEvent2Amt
Gross Revenue Event2$9,000GrossRevenueEvent2Amt
Rent Facility Costs Event2$51,095RentFacilityCostsEvent2Amt
Other Direct Expenses Event2$4,610OtherDirectExpensesEvent2Amt
Other Events Total2OtherEventsTotalCnt
Gross Receipts Other Events$94,800GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$64,500CharitableContriOtherEventsAmt
Gross Revenue Other Events$30,300GrossRevenueOtherEventsAmt
Rent Fclty Costs Other Events$51,800RentFcltyCostsOtherEventsAmt
Entertainment Other Events$1,000EntertainmentOtherEventsAmt
Gross Receipts Total$425,450GrossReceiptsTotalAmt
Charitable Contributions Tot$326,350CharitableContributionsTotAmt
Gross Revenue Total Events$99,100GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$155,395RentFcltyCostsTotalEventsAmt
Entertainment Total Events$12,000EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$5,470OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$172,865DirectExpenseSummaryEventsAmt
Net Income Summary-$73,765NetIncomeSummaryAmt

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 (3 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$146,333$0$0$0$798$0$10,039$0$15,252$0$172,422$0$0
Mary Leahy MD
CEO - BSCHS$0$627,821$0$150,000$0$0$0$15,900$0$35,311$0$829,032$0$0
Christopher Banks
VP of Philanthropy$0$228,657$0$0$0$513$0$17,706$0$23,842$0$270,718$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 4bFormAndLineReferenceDesc
ExplanationThe filing organization participates in a BSCHS sponsored executive retirement program that allows for deposits into additional retirement plans and is available only to officers and key employees. The 457f 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.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, LINE 2RELATED PARTIES BOARD MEMBERS ANGELA CLARKIN AND RICHARD CLARKIN ARE MARRIED. 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 GSFBH is appointed by its member, BSHSI and subject to approval of WMC Health Network-Rockland, Inc. (WMC-ROCKLAND), one of the three corporate members of Bon Secours Charity Health System (BSHS) along with BSHSI, and The Sisters of Charity of Saint Elizabeth (SCSE).
FORM 990, PART VI, LINE 7BDECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS: Certain authorities of GSFBH are reserved to its member or is jointly reserved to BSHSI, the SCSE and WMC-Rockland, the three corporate members of BSCHSI.
FORM 990, PART VI, LINE 11BPROCESS USED TO REVIEW THE FORM 990: The Form 990 was prepared by our tax advisors together with our finance department with the assistance from various departments throughout the organization. The Form 990 was reviewed by internal leadership. Upon completion of the various reviews, the Form 990 was presented to the board of the organization for approval prior to filing with the IRS.
FORM 990, PART VI, LINE 12CThe organization monitors and enforces compliance with the Conflict of Interest policy by means of a survey developed and approved by the WMCHealth 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 the individual alleviate the conflict, or 4) removal of the individual from employment. Form 990, Part VI lines 13 and 14 Written whistleblower and document retention and destruction policies: The Foundation does not have its own written whistblower and document retention and destruction policies; however, the Foundation does follow the policies approved by the Board of its related organization, BSCHSI. FORM 990, PART VI, LINE 15 THE COMPENSATION COMMITTEE OF WMC HEALTH NETWORK-ROCKLAND, INC. (WMC-ROCKLAND) ENGAGES IN A COMPREHENSIVE PROCESS FOR THE OVERSIGHT AND MANAGEMENT OF REMUNERATION FOR EXECUTIVE EMPLOYEES AND DISQUALIFIED PARTIES OF BSCHS. THE COMPENSATION COMMITTEE CONSISTS OF A GROUP OF INDEPENDENT BOARD MEMBERS AND ENGAGES AN INDEPENDENT EXTERNAL COMPENSATION CONSULTANT TO ENSURE THEY RECEIVE APPROPRIATE ANALYSIS OF MARKET AND FOLLOW THE PRACTICES NECESSARY TO OBTAIN FULL COMPLIANCE WITH THE IRS REBUTTABLE PRESUMPTION OF REASONABLENESS. THE COMMITTEE ESTABLISHES AND MAINTAINS A COMPENSATION PHILOSOPHY, REVIEWS PAY PRACTICES AGAINST LOCAL, REGIONAL AND NATIONAL HEALTHCARE ORGANIZATIONS AND APPROVES ALL REMUNERATIVE DECISIONS FOR THIS GROUP OF INDIVIDUALS. THE COMMITTEE REVIEWS AND RECEIVES ASSURANCES THAT ALL LEVELS OF PAY WITHIN THE ORGANIZATION ARE REASONABLE BASED ON PERFORMANCE AND VALIDATES INCENTIVES ARE MET. THESE DECISIONS ARE DOCUMENTED IN THE WMC-ROCKLAND BOARD OF DIRECTORS AND COMPENSATION COMMITTEE MINUTES.
FORM, 990, PART VI, LINE 19Process for making documents available to the public: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENT 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 MARY-LOUISE MORAN DOES NOT RECEIVE COMPENSATION AS SHE HAS TAKEN A VOW OF POVERTY. SISTER FRAN GORSUCH, CBS HAS TAKEN A VOW OF POVERTY AND ONLY RECEIVES IMPUTED INCOME for HOUSING AND GROUP TERM LIFE INSURANCE.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS: - Prior Year Pledge Adjustments $ 2,020 - TRANSFERS FROM AFFILIATES $ 728,569 --------- TOTAL $ 730,589

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
241 NORTH ROADPOUGHKEEPSIENY12601465534882PRESCHOOLNY501(C)(3)10WCHCCfalse
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
HEALTHALLIANCE SENIOR LIVING CORP
396 BROADWAYKINGSTONNY12401300164277RTMNT COMMNY501(C)(3)10HA 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)7BSCHSIfalse
BON SECOURS WARWICK HEALTH FOUNDATION
255 LAFAYETTE AVESUFFERNNY10901141972807SUPPORT FDNNY501(C)(3)7BSCHSIfalse
BON SECOURS CHARITY HEALTH SYSTEM INC
255 LAFAYETTE AVESUFFERNNY10901912135195SUPPORTINGNY501(C)(3)12C, III-FIWCHCCfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINLegal Domicile StateLegalDomicileStateCd
HUDSON RIVER WEST INSURANCE (BARBADOS)
38 PINE ROADBELLEVILLE ST MICHAELBBCAP INSURANCEBBBSCHSIC CORP$474,216$10,940,250Yes (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 SVCSHAH BWAYC CORPYes (true)396 BROADWAYKINGSTONNY12401203564769NY
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
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 OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Bon Secours Charity Health System Inc
q$394,415Cost
Bon Secours Charity Health System Inc
r$79,647Cost

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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