GOOD SAMARITAN FDN FOR BETTER HEALTH INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SAMARITAN FDN FOR BETTER HEALTH INC (EIN 13-3400353)
- Tax period
- 2013-09-01 to 2014-08-31
- Filed
- 2015-06-12
- IRS object ID
- 201531639349300523
- Schema version
- 2013v4.0
- 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 | 2015-06-12T10:44:52-05:00 | ReturnTs |
| Tax Period End | 2014-08-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-09-01 | 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 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GOOD | BusinessNameControlTxt |
| Phone | 8453685151 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 Lafayette Avenue | AddressLine1 |
| City | Suffern | City |
| State | NY | State |
| ZIP Code | 109015620 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Christopher Banks | PersonNm |
| Person Title | VP of Philantrophy | PersonTitleTxt |
| Phone | 8453685305 | PhoneNum |
| Signature | 2015-06-12 | SignatureDt |
| Discuss With Paid Preparer | 0 | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | 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 | AddressLine1 |
| City | Suffern | City |
| State | NY | State |
| ZIP Code | 109015620 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,207,622 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | 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 | 34 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 32 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,388,386 | PYContributionsGrantsAmt |
| CY Contributions Grants | $987,190 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,225 | PYInvestmentIncomeAmt |
| CY Investment Income | $15,947 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$163,460 | PYOtherRevenueAmt |
| CY Other Revenue | -$199,475 | CYOtherRevenueAmt |
| PY Total Revenue | $1,233,151 | PYTotalRevenueAmt |
| CY Total Revenue | $803,662 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $84,165 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,968,278 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $236,260 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $319,218 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $567,266 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $212,946 | PYOtherExpensesAmt |
| CY Other Expenses | $491,162 | CYOtherExpensesAmt |
| PY Total Expenses | $533,371 | PYTotalExpensesAmt |
| CY Total Expenses | $3,778,658 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $699,780 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,974,996 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,965,998 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,269,640 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,394,813 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,488,951 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,571,185 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$219,311 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission is to bring compassion to health care and to be good 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 | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,130,354 | ExpenseAmt |
| Grant | $2,968,278 | 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 | $3,130,354 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 11 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 34 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 32 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | 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 | Laura Ellison | PersonNm |
| Phone | 4433673835 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8990 Old Annapolis Road | AddressLine1 |
| City | Columbia | City |
| State | MD | State |
| ZIP Code | 21045 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (40 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 | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| Mark Acker | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Joseph Allen | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Kim Bergstol | ||||||||
| Board Member (Sep-Dec) | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Heather Bowie | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Angela Clarkin | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Richard Clarkin MD | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| John DeCicco | ||||||||
| Secretary | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Nicholas DeSantis | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Suzanne Donaghy | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Peter Fernandez | ||||||||
| Board Member (Sep-Dec) | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Tessa Garcia | ||||||||
| Board Member (Jan-Aug) | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sr Fran Gorsuch CBS | ||||||||
| Board Member | 0.50 | 49.50 | Yes (X) | $0 | $0 | $0 | ||
| Colin Gray | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Gil Heim | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Gayle Hirsch Esq | ||||||||
| Board Member | 0.50 | 49.50 | Yes (X) | $0 | $256,751 | $27,538 | ||
| Jack Holt | ||||||||
| Chair | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Jeffrey Horowitz | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Geanette Katz | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Kevin Kern | ||||||||
| Board Member (Jan-Aug) | 0.50 | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| Andrew Kritzer | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Joseph Lagana | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Mary Leahy MD | ||||||||
| CEO - BSCHS (Oct-Aug) | 0.50 | 49.50 | Yes (X) | $0 | $506,375 | $43,233 | Yes (X) | |
| Patricia Lefkowitz | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Aurelius Licata | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Pierson Mapes | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Jeffrey Marangi | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Kathy Medici | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Glenn Mendoza MD | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Mona Montal | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sr Mary-Louise Moran SC | ||||||||
| President | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Harold Peterson | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Amra Sabic-El-Rayess PhD | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Louis Siracusano | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Frank Stillo | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Irene Tsetsekos | ||||||||
| Board Member | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Eric Wiggins | ||||||||
| Treasurer | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Philip Patterson | ||||||||
| CEO - BSCHS (Sep) | 0.50 | 49.50 | Yes (X) | $0 | $604,909 | $72,532 | Yes (X) | |
| Stacey Kirschenbaum | ||||||||
| Executive Director | 15.00 | 10.00 | $0 | $141,445 | $19,208 | Yes (X) | ||
| Melinda Hancock | ||||||||
| Former CFO | 0.00 | 0.00 | $0 | $365,950 | $30,891 | Yes (X) | ||
| David Capone | ||||||||
| Former CFO | 0.00 | 0.00 | $0 | $261,699 | $9,284 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,137,129 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $202,686 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $427,120 | FundraisingAmt |
| Related Organizations | $94,000 | RelatedOrganizationsAmt |
| All Other Contributions | $466,070 | AllOtherContributionsAmt |
| Noncash Contributions | $17,940 | NoncashContributionsAmt |
| Total Contributions | $987,190 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,947 | TotalRevenueColumnAmt |
| Exclusion | $15,947 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $204,485 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $427,120 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $403,960 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$199,475 | TotalRevenueColumnAmt |
| Exclusion | -$199,475 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $803,662 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$183,528 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,968,278 | TotalAmt |
| Program Services | $2,968,278 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $271,626 | TotalAmt |
| Program Services | $54,325 | ProgramServicesAmt |
| Management And General | $27,163 | ManagementAndGeneralAmt |
| Fundraising | $190,138 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,554 | TotalAmt |
| Program Services | $711 | ProgramServicesAmt |
| Management And General | $355 | ManagementAndGeneralAmt |
| Fundraising | $2,488 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,259 | TotalAmt |
| Program Services | $5,052 | ProgramServicesAmt |
| Management And General | $2,526 | ManagementAndGeneralAmt |
| Fundraising | $17,681 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,779 | TotalAmt |
| Program Services | $3,756 | ProgramServicesAmt |
| Management And General | $1,878 | ManagementAndGeneralAmt |
| Fundraising | $13,145 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,646 | TotalAmt |
| Program Services | $6,529 | ProgramServicesAmt |
| Management And General | $3,265 | ManagementAndGeneralAmt |
| Fundraising | $22,852 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,519 | TotalAmt |
| Program Services | $3,104 | ProgramServicesAmt |
| Management And General | $1,552 | ManagementAndGeneralAmt |
| Fundraising | $10,863 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,449 | TotalAmt |
| Program Services | $4,290 | ProgramServicesAmt |
| Management And General | $2,145 | ManagementAndGeneralAmt |
| Fundraising | $15,014 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,244 | TotalAmt |
| Program Services | $249 | ProgramServicesAmt |
| Management And General | $124 | ManagementAndGeneralAmt |
| Fundraising | $871 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $800 | TotalAmt |
| Program Services | $160 | ProgramServicesAmt |
| Management And General | $80 | ManagementAndGeneralAmt |
| Fundraising | $560 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,813 | TotalAmt |
| Program Services | $2,163 | ProgramServicesAmt |
| Management And General | $1,081 | ManagementAndGeneralAmt |
| Fundraising | $7,569 | FundraisingAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Purchased Services | $390,754 | $78,151 | $39,075 | $273,528 |
| Supplies | $17,937 | $3,586 | $1,794 | $12,557 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,778,658 | TotalAmt |
| Program Services | $3,130,354 | ProgramServicesAmt |
| Management And General | $81,038 | ManagementAndGeneralAmt |
| Fundraising | $567,266 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $126,731 | BOYAmt |
| EOY | $236,554 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $499,471 | BOYAmt |
| EOY | $543,277 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,673,780 | BOYAmt |
| EOY | $1,453,067 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $666,016 | BOYAmt |
| EOY | $1,036,742 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,965,998 | BOYAmt |
| EOY | $3,269,640 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,285 | BOYAmt |
| EOY | $10,600 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,388,528 | BOYAmt |
| EOY | $3,478,351 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,394,813 | BOYAmt |
| EOY | $3,488,951 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,590,524 | BOYAmt |
| EOY | -$2,260,050 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,123,935 | BOYAmt |
| EOY | $2,002,965 | 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 | $2,571,185 | BOYAmt |
| EOY | -$219,311 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,965,998 | BOYAmt |
| EOY | $3,269,640 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,974,996 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $32,405 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $75,000 | DonatedServicesAndUseFcltsAmt |
| Other Changes In Net Assets | $77,095 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 | $886,320 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,136,944 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $980,369 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,380,886 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $987,190 | CurrentTaxYearAmt |
| Total | $5,371,709 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $886,320 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,136,944 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $980,369 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,380,886 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $987,190 | CurrentTaxYearAmt |
| Total | $5,371,709 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $239,657 | SubstantialContributorsTotAmt |
| Public Support Total170 | $5,132,052 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $41,008 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $25,935 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $24,687 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,225 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,947 | CurrentTaxYearAmt |
| Total | $115,802 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $179,586 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $259,603 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $196,132 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $182,105 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $204,485 | CurrentTaxYearAmt |
| Total | $1,021,911 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $6,509,422 | TotalSupportAmt |
| Public Support CY170 | 0.78840 | PublicSupportCY170Pct |
| Public Support PY170 | 0.68070 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part IV Form990ScheduleAPartIVGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part II, Line 10, Explanation of Other Income: | FormAndLineReferenceDesc |
| Explanation | Special Event Revenue - 2009 Amount: $ 179,586. 2010 Amount: $ 259,603. 2011 Amount: $ 167,493. 2012 Amount: $ 182,105. 2013 Amount: $ 204,485. Insurance Reimbursement Income - 2011 Amount: $ 28,639. | 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) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Supplemental Survivor Ins - Cash Surrender Value | $561,789 |
| Due from Affiliates | $474,953 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,036,742 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Due to Affiliates | $1,880,789 |
| Due to BSHSI | $1,597,562 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,478,351 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | Schedule D, Part X, Line 2 requires that the organization provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under ASC 740. ASC 740 addresses the accounting for uncertainty in income taxes recognized in an entity's financial statements and prescribes a threshold of more-likely-than-not for recognition and derecognition of tax positions taken or expected to be taken in a tax return. The adoption of ASC 740 by BSHSI on September 1, 2007 did not have a material impact on BSHSI's consolidated financial statements. As the organization does not conduct a separate audit of its financial statements, below is the related statement from the Bon Secours Health System' Inc. consolidated audited financial statements: The System and most of its subsidiaries (including certain joint venture entities) are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code of 1986, as amended. The system accounts for uncertain tax positions in accordance with ASC Topic 740. Income taxes of the System's for-profit subsidiaries are not material to the accompanying consolidated financial statements. The System's taxable subsidiaries have approximately $61,513 and $66,681 of net operating loss carryforwards as of August 31, 2014 and 2013, respectively, which expire in varying periods through 2034 and are available to offset future taxable income. The System's deferred tax assets are fully reserved at August 31, 2014 and 2013. Any changes to the valuation allowance on the deferred tax asset are reflected in the year of the change. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Fall Classic/Golf | NameOfEvent1Amt |
| Gross Receipts Event1 | $198,000 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $120,650 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $77,350 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $2,720 | CashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $77,639 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $20,000 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $4,436 | OtherDirectExpensesEvent1Amt |
| Name Of Event2 | Spring Ball | NameOfEvent2Amt |
| Gross Receipts Event2 | $263,325 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $204,525 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $58,800 | GrossRevenueEvent2Amt |
| Rent Facility Costs Event2 | $101,604 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $6,031 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $1,625 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $104,105 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $170,280 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $101,945 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $68,335 | GrossRevenueOtherEventsAmt |
| Cash Prizes Other Events | $2,080 | CashPrizesOtherEventsAmt |
| Rent Fclty Costs Other Events | $68,708 | RentFcltyCostsOtherEventsAmt |
| Food And Beverage Other Events | $0 | FoodAndBeverageOtherEventsAmt |
| Entertainment Other Events | $0 | EntertainmentOtherEventsAmt |
| Oth Direct Expnss Other Events | $15,012 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $631,605 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $427,120 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $204,485 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $4,800 | CashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $247,951 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $26,031 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $1,625 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $123,553 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $403,960 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$199,475 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Good Samaritan Hospital | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 Lafayette Avenue | AddressLine1 |
| City | Suffern | City |
| State | NY | State |
| ZIP Code | 109015620 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 131740104 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $2,968,278 | CashGrantAmt |
| Purpose Of Grant | General Support | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | 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 | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 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 | $253,050 | $0 | $3,000 | $0 | $701 | $0 | $10,269 | $0 | $17,269 | $0 | $284,289 | $0 | $0 |
| Mary Leahy MD | ||||||||||||||
| CEO - BSCHS (Oct-Aug) | $0 | $300,114 | $0 | $115,252 | $0 | $91,009 | $0 | $21,289 | $0 | $21,944 | $0 | $549,608 | $0 | $0 |
| Philip Patterson | ||||||||||||||
| CEO - BSCHS (Sep) | $0 | $336,904 | $0 | $205,912 | $0 | $62,093 | $0 | $45,612 | $0 | $26,920 | $0 | $677,441 | $0 | $3,750 |
| Stacey Kirschenbaum | ||||||||||||||
| Executive Director | $0 | $119,712 | $0 | $21,481 | $0 | $252 | $0 | $9,291 | $0 | $9,917 | $0 | $160,653 | $0 | $0 |
| Melinda Hancock | ||||||||||||||
| Former CFO | $0 | $270,243 | $0 | $56,597 | $0 | $39,110 | $0 | $5,235 | $0 | $25,656 | $0 | $396,841 | $0 | $0 |
| David Capone | ||||||||||||||
| Former CFO | $0 | $0 | $0 | $0 | $0 | $261,699 | $0 | $0 | $0 | $9,284 | $0 | $270,983 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | Bon Secours Health System, Inc., 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 Written Employment Contract Compensation Survey or Study Approval by the Board or Compensation Committee |
| Part I, Lines 4a-b | Bon Secours Health System, Inc. has system wide severance policies for various levels of executive management. Executive positions throughout the system may include, but are not limited to, CEO/President, CFO, COO, EVP, SVP, VP and Directors. Severance periods vary based on length of service, subsequent employment and violations of the severance policy. Generally, severance periods can be up to 24 months. Benefits may include, but are not limited to, base salary, certain health benefits and payment of unused vacation. The following individual(s) received severance payments during the applicable calendar year: David Capone, $256,154. The filing organization participates in a BSHSI sponsored executive retirement program that allows for deposits into additional retirement plans and 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 this plan. Individuals that received a distribution include: Philip Patterson, $4,902. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 4 | On September 1, 2014, the bylaws of the filing organization were amended to change the year end from August 31st to December 31st. |
| Form 990, Part VI, Section A, line 6 | Bon Secours Health System, Inc. is one of two corporate members of Bon Secours Charity Health System along with the Sisters of Charity of Saint Elizabeth of Convent Station. Bon Secours Charity Health System, Inc. is the sole member of Good Samaritan Foundation for Better Health. |
| Form 990, Part VI, Section A, line 7a | 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 of Convent Station. |
| Form 990, Part VI, Section A, line 7b | Certain authorities of Good Samaritan Foundation for Better Health are reserved to its member or is jointly reserved to Bon Secours Health System, Inc. and the Sisters of Charity of Saint Elizabeth of Convent Station, the two corporate members of Bon Secours Charity Health System, Inc. |
| Form 990, Part VI, Section B, line 11 | The process the organization uses to review the Form 990 consists of a review by the local system's audit and compliance board-committee and providing the form to the local system board of directors to allow for a thorough review by both before the filing date. The local system's audit and compliance committee and board of directors have reviewed the Form 990, scheduled time on meeting agendas, and asked questions regarding the Form 990 before the return is filed. |
| Form 990, Part VI, Section B, line 12c | 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, Section B, 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, Section B, Line 15b - Compensation Process Other Officers/ Key Employees: For those key employees and highest paid employees that are not reviewed by the BSHSI compensation committee, the process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. In the review, the positions of other officers or key employees of the organization were compared to similar position market data in comparably situated organizations taking into consideration geographic location and organization size where appropriate. During the review and approval of the compensation, documentation of the decision was recorded in human resources. |
| Form 990, Part VI, Section C, line 19 | The filing organization provides any documents open to 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: | PV, Writeoffs, Allowances, Pledge Adjustments 77,095. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Bon Secours Health System Inc | ||||||||||
| 1505 Marriottsville Road | Marriottsville | MD | 21104 | 521301088 | Parent Org. - Management Services | MD | 501(c)(3) | Line 11c, III-FI | Bon Secours Inc | 0 |
| Bon Secours Charity Health System Inc | ||||||||||
| 255 Lafayette Avenue | Suffern | NY | 109015620 | 912135195 | Local System Parent Org. | NY | 501(c)(3) | Line 11a, I | Bon Secours Health System Inc | 0 |
| Good Samaritan Hospital of Suffern NY | ||||||||||
| 255 Lafayette Avenue | Suffern | NY | 109015620 | 131740104 | Healthcare | NY | 501(c)(3) | Line 3 | Bon Secours Charity Health System | 0 |
| Bon Secours Community Hospital | ||||||||||
| 160 E Main Street | Port Jervis | NY | 127712253 | 141347717 | Healthcare | NY | 501(c)(3) | Line 3 | Bon Secours Charity Health System | 0 |
| St Francis Center at the Knolls (dba Mount Alverno Center) | ||||||||||
| 20 Grand Street | Warwick | NY | 109901028 | 061370576 | Long-term Care | NY | 501(c)(3) | Line 9 | Bon Secours Charity Health System | 0 |
| St Anthony Community Hospital | ||||||||||
| 15-19 Maple Avenue | Warwick | NY | 109901028 | 141340100 | Healthcare | NY | 501(c)(3) | Line 3 | Bon Secours Charity Health System | 0 |
| Bon Secours Community Hospital Foundation | ||||||||||
| 255 Lafayette Avenue | Suffern | NY | 109015620 | 810667395 | Grant Making Foundation | NY | 501(c)(3) | Line 7 | Bon Secours Charity Health System | 0 |
| Bon Secours Warwick Health Foundation | ||||||||||
| 20 Grand Street | Warwick | NY | 109901028 | 141972807 | Grant Making Foundation | NY | 501(c)(3) | Line 7 | Bon Secours Charity Health System | 0 |
| Villa Francis at the Knolls (dba Schervier Pavilion) | ||||||||||
| 20 Grand Street | Warwick | NY | 109901028 | 061381994 | Skilled Nursing Facility | NY | 501(c)(3) | Line 9 | Bon Secours Charity Health System | 0 |
| Bon Secours Charity Health System Medical Group | ||||||||||
| 255 Lafayette Avenue | Suffern | NY | 109015620 | 223636986 | Primary Care | NY | 501(c)(3) | Line 9 | Bon Secours Charity Health System | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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