GOOD SAMARITAN FDN FOR BETTER HEALTH INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SAMARITAN FDN FOR BETTER HEALTH INC (EIN 13-3400353)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-10
- IRS object ID
- 201643159349304504
- Schema version
- 2015v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-10T17:26:53-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 TIMES SQUARE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10036 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 133400353 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Good Samaritan Foundation For Better Health | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % PETER KENNIFF | InCareOfNm |
| Business Name Control | GOOD | BusinessNameControlTxt |
| Phone | 8453685151 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 Lafayette Avenue | AddressLine1Txt |
| City | Suffern | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10901 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Christopher Banks | PersonNm |
| Person Title | VP of Philanthropy | PersonTitleTxt |
| Phone | 8453685305 | PhoneNum |
| Signature | 2016-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAURA KIELCZEWSKI | PreparerPersonNm |
| PTIN | P00740769 | PTIN |
| Phone | 2127733000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Christopher Banks | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 Lafayette Avenue | AddressLine1Txt |
| City | Suffern | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,403,484 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.bschsf.org/goodsam | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | Fundraising for the benefit of Good Samaritan Hospital of Suffern, NY | ActivityOrMissionDesc |
| Voting Members Governing Body | 33 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 31 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $339,632 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,204,831 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,088 | PYInvestmentIncomeAmt |
| CY Investment Income | $22,483 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,320,911 | PYOtherRevenueAmt |
| CY Other Revenue | -$83,770 | CYOtherRevenueAmt |
| PY Total Revenue | $3,665,631 | PYTotalRevenueAmt |
| CY Total Revenue | $1,143,544 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $93,780 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,144,984 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $102,132 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $307,291 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $408,955 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $163,689 | PYOtherExpensesAmt |
| CY Other Expenses | $276,939 | CYOtherExpensesAmt |
| PY Total Expenses | $359,601 | PYTotalExpensesAmt |
| CY Total Expenses | $1,729,214 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,306,030 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$585,670 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,169,708 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,560,726 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,367 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $28,213 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,152,341 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,532,513 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission is to bring compassion to health care and to be hood help to those in need, especially those who are poor and dying. As a system of caregivers, we commit ourselves to help bring people and communities to health and wholeness. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,261,837 | ExpenseAmt |
| Grant | $1,144,984 | GrantAmt |
| Desc | The 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 | $1,261,837 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 8 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 33 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 31 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PETER KENNIFF | PersonNm |
| Phone | 8453685305 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 LAFAYETTE AVENUE | AddressLine1Txt |
| City | Suffern | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| Angela Clarkin | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Richard Clarkin MD | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| John DeCicco | |||||||
| Secretary | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Nicholas DeSantis | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Suzanne Donaghy | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Tessa Garcia | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Sr Fran Gorsuch CBS | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Colin Gray | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Gil Heim | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Gayle Hirsch Esq | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $149,495 | $24,900 | |
| Jack Holt | |||||||
| Chairman | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Jeffrey Horowitz | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Geanette Katz | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Kevin Kern | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Joseph Lagana | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Mary Leahy MD | |||||||
| CEO - BSCHS | 1.0 | 39.0 | Yes (X) | $0 | $951,438 | $86,622 | Yes (X) |
| Patricia Lefkowitz | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Aurelius Licata | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Pierson Mapes | |||||||
| Board Member (Jan - Oct) | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Jeffrey Marangi | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Kathy Medici | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Glenn Mendoza MD | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Mona Montal | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Sr Mary-Louise Moran SC | |||||||
| President | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Harold Peterson | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Amra Sabic-El-Rayess PhD | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Louis Siracusano | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Frank Stillo | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Irene Tsetsekos | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Eric Wiggins | |||||||
| Treasurer | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Bryan Newman | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Mark Acker | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Joseph Allen | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Heather Bowie | |||||||
| Board Member | 0.5 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Christopher Banks | |||||||
| VP of Philanthropy | 40.0 | 10.0 | $0 | $244,242 | $27,492 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,345,175 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $139,014 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NONE | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contractor Address | ContractorAddress |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $345,179 | FundraisingAmt |
| Related Organizations | $190,000 | RelatedOrganizationsAmt |
| All Other Contributions | $669,652 | AllOtherContributionsAmt |
| Noncash Contributions | $21,010 | NoncashContributionsAmt |
| Total Contributions | $1,204,831 | TotalContributionsAmt |
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,483 | TotalRevenueColumnAmt |
| Exclusion | $22,483 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $176,170 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $345,179 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $259,940 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$83,770 | TotalRevenueColumnAmt |
| Exclusion | -$83,770 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,143,544 | TotalRevenueColumnAmt |
| Exclusion | -$61,287 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,144,984 | TotalAmt |
| Program Services | $1,144,984 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,074 | TotalAmt |
| Program Services | $54,215 | ProgramServicesAmt |
| Management And General | $27,107 | ManagementAndGeneralAmt |
| Fundraising | $189,752 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,884 | TotalAmt |
| Program Services | $377 | ProgramServicesAmt |
| Management And General | $188 | ManagementAndGeneralAmt |
| Fundraising | $1,319 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,970 | TotalAmt |
| Program Services | $4,194 | ProgramServicesAmt |
| Management And General | $2,097 | ManagementAndGeneralAmt |
| Fundraising | $14,679 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,363 | TotalAmt |
| Program Services | $2,673 | ProgramServicesAmt |
| Management And General | $1,336 | ManagementAndGeneralAmt |
| Fundraising | $9,354 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,671 | TotalAmt |
| Program Services | $534 | ProgramServicesAmt |
| Management And General | $267 | ManagementAndGeneralAmt |
| Fundraising | $1,870 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,510 | TotalAmt |
| Program Services | $11,702 | ProgramServicesAmt |
| Management And General | $5,851 | ManagementAndGeneralAmt |
| Fundraising | $40,957 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9 | TotalAmt |
| Program Services | $8 | ProgramServicesAmt |
| Management And General | $1 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,829 | TotalAmt |
| Program Services | $1,366 | ProgramServicesAmt |
| Management And General | $683 | ManagementAndGeneralAmt |
| Fundraising | $4,780 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,169 | TotalAmt |
| Program Services | $234 | ProgramServicesAmt |
| Management And General | $117 | ManagementAndGeneralAmt |
| Fundraising | $818 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,594 | TotalAmt |
| Program Services | $3,319 | ProgramServicesAmt |
| Management And General | $1,659 | ManagementAndGeneralAmt |
| Fundraising | $11,616 | FundraisingAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Purchased Services | $170,147 | $34,029 | $17,015 | $119,103 |
| Supplies | $21,010 | $4,202 | $2,101 | $14,707 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,729,214 | TotalAmt |
| Program Services | $1,261,837 | ProgramServicesAmt |
| Management And General | $58,422 | ManagementAndGeneralAmt |
| Fundraising | $408,955 | FundraisingAmt |
Total Joint Costs TotalJointCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $271,664 | BOYAmt |
| EOY | $434,833 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $588,959 | BOYAmt |
| EOY | $354,640 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,628,085 | BOYAmt |
| EOY | $1,144,391 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $681,000 | BOYAmt |
| EOY | $626,862 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,169,708 | BOYAmt |
| EOY | $2,560,726 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,060 | BOYAmt |
| EOY | $28,213 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,307 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,367 | BOYAmt |
| EOY | $28,213 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $905,083 | BOYAmt |
| EOY | $533,108 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,209,484 | BOYAmt |
| EOY | $1,961,631 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,774 | BOYAmt |
| EOY | $37,774 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,152,341 | BOYAmt |
| EOY | $2,532,513 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,169,708 | BOYAmt |
| EOY | $2,560,726 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$585,670 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$7,320 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $55,500 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$82,338 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $980,369 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,380,886 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $987,190 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $339,632 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,204,831 | CurrentTaxYearAmt |
| Total | $4,892,908 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $980,369 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,380,886 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $987,190 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $339,632 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,204,831 | CurrentTaxYearAmt |
| Total | $4,892,908 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $156,362 | SubstantialContributorsTotAmt |
| Public Support Total170 | $4,736,546 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $24,687 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,225 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,947 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,088 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $22,483 | CurrentTaxYearAmt |
| Total | $76,430 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $196,132 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $182,105 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $204,485 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,344,118 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $176,170 | CurrentTaxYearAmt |
| Total | $4,103,010 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $9,072,348 | TotalSupportAmt |
| Public Support CY170 | 0.52209 | PublicSupportCY170Pct |
| Public Support PY170 | 0.52290 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II, Line 10 | FormAndLineReferenceDesc |
| Explanation | Explanation for Other Income: Special Events Revenue 2011 AMOUNT: $ 167,493 2012 AMOUNT: $ 182,105 2013 AMOUNT: $ 204,485 2014 AMOUNT: $ 33,000 2015 AMOUNT: $ 176,170 Insurance Reimbursement Income 2011 AMOUNT: $ 28,639 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $0 | BeginningYearBalanceAmt |
| Contributions | $656,141 | ContributionsAmt |
| Grants Or Scholarships | $906,451 | GrantsOrScholarshipsAmt |
| End Year Balance | -$250,310 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Prmnnt Endowment Balance EOY | 0.01890 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.98110 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp | |
| Equipment | EquipmentGrp | |
| Other Land Buildings | OtherLandBuildingsGrp |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INSURANCE-CASH SURRENDER VALUE | $230,489 |
| SURVIVING SPOUSE INSURANCE- | $0 |
| CASH SURRENDER VALUE | $396,373 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $626,862 | TotalBookValueOtherAssetsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4 | FormAndLineReferenceDesc |
| Explanation | Intended 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Fall Classic | Event1Nm |
| Gross Receipts Event1 | $152,700 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $127,919 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $24,781 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $2,450 | CashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $46,575 | RentFacilityCostsEvent1Amt |
| Other Direct Expenses Event1 | $44,365 | OtherDirectExpensesEvent1Amt |
| Event2 | Spring Ball | Event2Nm |
| Gross Receipts Event2 | $257,000 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $204,362 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $52,638 | GrossRevenueEvent2Amt |
| Rent Facility Costs Event2 | $53,220 | RentFacilityCostsEvent2Amt |
| Entertainment Event2 | $6,500 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $25,915 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $111,649 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $12,898 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $98,751 | GrossRevenueOtherEventsAmt |
| Rent Fclty Costs Other Events | $68,708 | RentFcltyCostsOtherEventsAmt |
| Entertainment Other Events | $1,000 | EntertainmentOtherEventsAmt |
| Oth Direct Expnss Other Events | $11,207 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $521,349 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $345,179 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $176,170 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $2,450 | CashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $168,503 | RentFcltyCostsTotalEventsAmt |
| Entertainment Total Events | $7,500 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $81,487 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $259,940 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$83,770 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Good Samaritan Hospital of Suffern | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 Lafayette Avenue | AddressLine1Txt |
| City | Suffern | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 109015620 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 131740104 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $1,140,684 | CashGrantAmt |
| Purpose Of Grant | General Support | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I Description of Procedure for Monitoring Use of Funds | FormAndLineReferenceDesc |
| Explanation | The organization complies with Bon Secours 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Gayle Hirsch Esq | ||||||||||||||
| Board Member | $0 | $145,643 | $0 | $3,060 | $0 | $792 | $0 | $9,945 | $0 | $14,955 | $0 | $174,395 | $0 | $0 |
| Mary Leahy MD | ||||||||||||||
| CEO - BSCHS | $0 | $563,172 | $0 | $336,638 | $0 | $51,628 | $0 | $55,342 | $0 | $31,280 | $0 | $1,038,060 | $0 | $0 |
| Christopher Banks | ||||||||||||||
| VP of Philanthropy | $0 | $223,512 | $0 | $20,235 | $0 | $495 | $0 | $3,109 | $0 | $24,383 | $0 | $271,734 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 3 | FormAndLineReferenceDesc |
| Explanation | Bon Secours Health System, Inc., (BSHSI) a related organization of the filing organization, uses the following to establish the compensation of the organization's CEO/Executive Director: - Compensation Committee - Independent Compensation Consultant - Compensation Survey or Study - Approval by the Board or Compensation Committee Part I, Line 4b: PARTICIPATE IN, OR RECEIVE PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: The filing organization participates in a BSHSI 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. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, line 6 | MEMBERS OR STOCKHOLDERS: BON SECOURS CHARITY HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF GOOD SAMARITAN FOUNDATION FOR BETTER HEALTH. |
| Form 990, Part VI, Line 7a | POWER 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 by Bon Secours Health System, Inc., one of two corporate members of Bon Secours Charity Health System, Inc. along with the Sisters of Charity of Saint Elizabeth. |
| Form 990, Part VI, Line 7b | DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS: Certain authorities of Good Samaritan Foundation for Better Health are reserved to its member or is jointly reserved to Bon Secours Health System, Inc., the Sisters of Charity of Saint Elizabeth and WMC - Rockland, the three corporate members of Bon Secours Charity Health System, Inc. |
| Form 990, Part VI, Line 11b | PROCESS USED TO REVIEW THE FORM 990: The process the organization uses to review the Form 990 consists of a review of the return in draft form by the Board of Directors. All comments and changes are reviewed and discussed with management and incorporated into the return as applicable prior to filing. |
| Form 990, Part VI, Line 12c | MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY: The organization regularly and consistently monitors compliance with the conflict of interest policy. On an annual basis, all persons subject to the policy, including all officers, directors and key employees are required to make certain disclosures. These include disclosures related to certain personal, financial and organizational relationships that may present a conflict, or the appearance of a conflict of interest with the organization. All disclosures go through a three-part review process: (1)disclosures are reviewed first by the corporate responsibility officer (CRO); (2) a governance team comprised of the CEO, board president, board chair, CRO, and the BSHSI CRO participate in a second review of all disclosures during which recommendations are made as to the resolution of any conflicts or potential conflicts. Depending on the facts and circumstances, resolutions may include ongoing disclosure, recusal or removal of the conflict; and (3) all disclosures and recommendations are reviewed by a board committee (audit and compliance committee reviews the disclosures of management and the governance committee reviews the disclosures of the board and board committee members). 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, Bon Secours Charity Health System, Inc. FORM 990, PART VI, LINE 15 THE COMPENSATION COMMITTEE OF THE BOARD OF BON SECOURS HEALTH SYSTEM, INC. (BSHSI) ENGAGES IN A COMPREHENSIVE PROCESS FOR THE OVERSIGHT AND MANAGEMENT OF REMUNERATION FOR EXECUTIVE EMPLOYEES AND DISQUALIFIED PARTIES OF THE BSHSI. 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 BSHSI BOARD OF DIRECTORS AND COMPENSATION COMMITTEE MINUTES. |
| Form 990, Part VI, Line 19 | the organization's governing documents, conflict of interest policy, and financial statements are made available for public inspection upon request. |
| Form 990, Part VII | Board 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 Fran Gorsuch, CBS does not receive compensation as she has taken a vow of poverty. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS: - PV, Writeoffs, Allowances, Pledge Adjustments $ (82,338) |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| WMC Health Network - Rockland Inc | ||||||||||
| 100 Woods Rd | Valhalla | NY | 10595 | 320467873 | Parent Org | NY | 501(c)(3) | 11c, III-FI | Na | false |
| WESTCHESTER COUNTY HEALTH CARE CORP | ||||||||||
| 100 WOODS ROAD | VALHALLA | NY | 10595 | 133964321 | Parent Org | NY | 115 | NA | false | |
| Bon Secours Charity Health System Inc | ||||||||||
| 255 Lafayette Ave | Suffern | NY | 10901 | 912135195 | Local System | NY | 501(c)(3) | 11C, III-FI | WCHCC | false |
| Good Samaritan Hospital of Suffern NY | ||||||||||
| 255 Lafayette Ave | Suffern | NY | 10901 | 131740104 | Healthcare | NY | 501(c)(3) | LINE 3 | BSCHSI | false |
| Bon Secours Community Hospital | ||||||||||
| 160 E Main St | Port Jervis | NY | 12771 | 141347717 | Healthcare | NY | 501(c)(3) | LINE 3 | BSCHSI | false |
| St Francis Center at the Knolls dba Mt | ||||||||||
| 20 Grand St | Warwick | NY | 10990 | 061370576 | Longterm Care | NY | 501(c)(3) | LINE 9 | BSCHSI | false |
| St Anthony's Community Hospital | ||||||||||
| 15-19 Maple Ave | Warwick | NY | 10990 | 141340100 | Healthcare | NY | 501(c)(3) | Line 3 | BSCHSI | false |
| Bon Secours Community Hospital Foundatio | ||||||||||
| 255 Lafayette Ave | Suffern | NY | 10901 | 810667395 | FOUNDATION | NY | 501(c)(3) | Line 7 | BSCHSI | false |
| Bon Secours Warwick Health Foundation - | ||||||||||
| 255 Lafayette Ave | Suffern | NY | 10901 | 141972807 | FOUNDATION | NY | 501(c)(3) | Line 7 | St Anthony | false |
| Villa Francis at the Knolls dba Schervie | ||||||||||
| 20 Grand St | Warwick | NY | 10990 | 061381994 | Nursing svcs | NY | 501(c)(3) | Line 9 | BSCHSI | false |
| Bon Secours Health System Medical Group | ||||||||||
| 255 Lafayette Ave | Suffern | NY | 10901 | 223636986 | Primary Care | NY | 501(c)(3) | Line 9 | BSCHSI | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt |
|---|---|
| Good Samaritan Hospital | |
| b | $2,386,603 |
| Good Samaritan Hospital | |
| c | $424,926 |
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