PIH HEALTH GOOD SAMARITAN HOSPITAL: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: PIH HEALTH GOOD SAMARITAN HOSPITAL (EIN 95-1656366)
Tax period: 2022-10-01 to 2023-09-30
Filed: 2024-08-06
IRS object ID: 202412199349300831
Schema version: 2022v5.0
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 C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2024-08-06T13:53:39-05:00	ReturnTs
Tax Period End	2023-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	135565207	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	301 MAIN STREET SUITE 2150	AddressLine1Txt
City	BATON ROUGE	CityNm
State Abbreviation	LA	StateAbbreviationCd
ZIP	70801	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	951656366	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PIH HEALTH GOOD SAMARITAN HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	PIHH	BusinessNameControlTxt
Phone	2139772121	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1225 WILSHIRE BLVD	AddressLine1Txt
City	LOS ANGELES	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	900172395	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	VID SHIVARAMAN	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	5626980811	PhoneNum
Signature	2024-07-31	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	0	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	BRITTANY ELLISER	PreparerPersonNm
PTIN	P01284594	PTIN
Phone	2253444000	PhoneNum
Preparation	2024-07-22	PreparationDt

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2024-08-08 14:25:15Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JAMES WEST	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	12401 WASHINGTON BLVD	AddressLine1Txt
City	WHITTIER	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	90602	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$390,117,862	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.PIHHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1885	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	PROVIDE HIGH-QUALITY HEALTHCARE, WITHOUT DISCRIMINATION, AND CONTRIBUTE TO THE HEALTH AND WELL-BEING	ActivityOrMissionDesc
Voting Members Governing Body	17	VotingMembersGoverningBodyCnt
Voting Members Independent	17	VotingMembersIndependentCnt
Total Employee	1976	TotalEmployeeCnt
Total Volunteers	295	TotalVolunteersCnt
Total Gross UBI	$173,402	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$5,256,557	PYContributionsGrantsAmt
CY Contributions Grants	$3,322,305	CYContributionsGrantsAmt
PY Program Service Revenue	$394,173,438	PYProgramServiceRevenueAmt
CY Program Service Revenue	$361,265,554	CYProgramServiceRevenueAmt
PY Investment Income	$30,119,687	PYInvestmentIncomeAmt
CY Investment Income	$8,797,284	CYInvestmentIncomeAmt
PY Other Revenue	$6,371,765	PYOtherRevenueAmt
CY Other Revenue	$5,753,362	CYOtherRevenueAmt
PY Total Revenue	$435,921,447	PYTotalRevenueAmt
CY Total Revenue	$379,138,505	CYTotalRevenueAmt
PY Grants And Similar Paid	$238,180	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$300,100	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$181,281,254	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$171,842,791	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$176,067	CYTotalFundraisingExpenseAmt
PY Other Expenses	$254,205,924	PYOtherExpensesAmt
CY Other Expenses	$239,274,805	CYOtherExpensesAmt
PY Total Expenses	$435,725,358	PYTotalExpensesAmt
CY Total Expenses	$411,417,696	CYTotalExpensesAmt
PY Revenues Less Expenses	$196,089	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$32,279,191	CYRevenuesLessExpensesAmt
Total Assets BOY	$607,219,911	TotalAssetsBOYAmt
Total Assets EOY	$566,649,349	TotalAssetsEOYAmt
Total Liabilities BOY	$171,956,806	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$155,809,140	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$435,263,105	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$410,840,209	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	WE PROVIDE HIGH-QUALITY HEALTHCARE, WITHOUT DISCRIMINATION, AND CONTRIBUTE TO THE HEALTH AND WELL-BEING OF OUR COMMUNITIES IN AN ETHICAL, SAFE AND FISCALLY PRUDENT MANNER, IN RECOGNITION OF OUR CHARITABLE PURPOSE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$212,201,369	ExpenseAmt
Grant	$300,100	GrantAmt
Revenue	$262,968,147	RevenueAmt
Desc	PATIENT CARE: FOUNDED IN 1885, PIH HEALTH GOOD SAMARITAN HOSPITAL BECAME PART OF PIH HEALTH IN DECEMBER 2019. AS A 501(C) (3) NONPROFIT, 408-BED ACUTE CARE HOSPITAL, THE DOWNTOWN LOS ANGELES CAMPUS SERVES THE HEALTHCARE NEEDS OF A GROWING AND DIVERSE COMMUNITY. PATIENT CARE IN FISCAL YEAR 2022-2023EMPLOYEES 1,389VOLUNTEERS 295NUMBER OF EMERGENCY DEPARTMENT (ED) VISITS 47,812NUMBER OF BIRTHS 1,471MEDICAL STAFF 669	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$158,289,209	ExpenseAmt
Revenue	$98,230,080	RevenueAmt
Desc	FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS: FINANCIAL ASSISTANCE, ALSO KNOWN AS CHARITY CARE, IS DEFINED AS FREE OR DISCOUNTED HEALTH SERVICES PROVIDED TO INDIVIDUALS WHO CANNOT AFFORD TO PAY AND WHO MEET THE ELIGIBILITY CRITERIA OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. PIH HEALTH GOOD SAMARITAN HOSPITAL OFFERS A GENEROUS FINANCIAL ASSISTANCE PROGRAM, PROVIDING CHARITY CARE TO THOSE WITH FAMILY INCOME(S) AT OR BELOW 400% OF FEDERAL POVERTY LEVEL GUIDELINES. THE HOSPITAL HAS A POLICY TO TREAT EMERGENCY AND CERTAIN OTHER PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. UNDER THE CHARITY CARE POLICY, CHARITY CARE MAY BE PROVIDED TO PEOPLE WHO ARE UNINSURED OR UNDERINSURED AND CANNOT AFFORD TO PAY FOR THEIR OWN MEDICAL CARE.IN PROVIDING SERVICES TO THOSE PATIENTS PARTICIPATING IN MEANS-TESTED GOVERNMENT HEALTH PROGRAMS, SUCH AS MEDI-CAL, PIH HEALTH GOOD SAMARITAN HOSPITAL REALIZES A COLLECTIVE NET LOSS EACH FISCAL YEAR DUE TO THE SHORTFALL CREATED WHEN THE PAYMENTS RECEIVED FROM THESE PROGRAMS ARE LESS THAN THE COST OF CARING FOR PUBLIC PROGRAM BENEFICIARIES. NUMBER OF PERSONS SERVED BY FINANCIAL ASSISTANCE AND MEANS-TESTED GOVERNMENT PROGRAMS: 37,994	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$9,356,117	ExpenseAmt
Revenue	$67,327	RevenueAmt
Desc	"OTHER COMMUNITY BENEFIT SERVICES: COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED SERVICES, RESEARCH, COMMUNITY BUILDING AND CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT ARE COMPRISED OF THE FOLLOWING: COMMUNITY HEALTH IMPROVEMENT SERVICES: DEFINED AS COMMUNITY HEALTH IMPROVEMENT ACTIVITIES, WHICH EXTEND BEYOND PATIENT CARE ACTIVITIES. THIS CATEGORY INCLUDES COMMUNITY HEALTH EDUCATION, COMMUNITY SOCIAL SERVICE HELPLINE, FLU AND COVID-19 VACCINATION CLINICS, MEDI-CAL ELIGIBILITY WORKERS AND TRANSPORTATION SERVICES.SNAPSHOT OF OUTCOMES: 17,608 COMMUNITY MEMBERS WERE REACHED THROUGH A VARIETY OF COMMUNITY HEALTH IMPROVEMENT ACTIVITIES.HEALTH PROFESSIONS EDUCATION: THIS CATEGORY INCLUDES EDUCATIONAL PROGRAMS FOR PHYSICIANS, NURSES, CHAPLAIN AND OTHER HEALTH PROFESSIONAL STUDENTS WHEN EDUCATION IS NECESSARY OR REQUIRED BY STATE LAW, ACCREDITING BODY OR HEALTH PROFESSION SOCIETY. SNAPSHOT OF OUTCOMES: 68 MEDICAL RESIDENTS AND ANCILLARY PROFESSIONS STUDENTS WERE PROVIDED WITH MENTORSHIP, INTERNSHIP AND TRAINING OPPORTUNITIES.SUBSIDIZED HEALTH SERVICES: SUBSIDIZED SERVICES ARE CLINICAL PROGRAMS, WHICH ARE PROVIDED DESPITE A FINANCIAL LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF FINANCIAL ASSISTANCE, BAD DEBT AND MEDI-CAL SHORTFALLS. NEVERTHELESS, THE SERVICE IS PROVIDED BECAUSE IT MEETS AN IDENTIFIED COMMUNITY NEED AND, IF NO LONGER OFFERED, WOULD EITHER BE UNAVAILABLE IN THE AREA OR FALL TO THE RESPONSIBILITY OF GOVERNMENT OR ANOTHER NONPROFIT ORGANIZATION TO PROVIDE. PIH HEALTH GOOD SAMARITAN HOSPITAL SUBSIDIZED EMERGENCY DEPARTMENT ON-CALL PHYSICIANS AND THE NEONATAL INTENSIVE CARE UNIT (NICU).SNAPSHOT OF OUTCOMES: $843,068 IN EXPENSES WERE INCURRED IN SUBSIDIZED SERVICES IN FISCAL YEAR 2022-2023RESEARCH: RESEARCH THAT MAY BE REPORTED AS COMMUNITY BENEFIT INCLUDES CLINICAL AND COMMUNITY HEALTH RESEARCH AS WELL AS STUDIES ON HEALTHCARE DELIVERY THAT ARE GENERALIZABLE AND SHARED WITH THE PUBLIC. PIH HEALTH GOOD SAMARITAN HOSPITAL HAS BEEN OFFERING CLINICAL TRIALS AND RESEARCH STUDIES AIMED AT IMPROVING HEALTH. SNAPSHOT OF OUTCOMES: OVER $307,016 IN EXPENSES HAVE BEEN INCURRED IN RESEARCH IN FISCAL YEAR 2022-2023CASH & IN-KIND CONTRIBUTIONS: THIS CATEGORY INCLUDES FUNDS AND IN-KIND SERVICES DONATED BY PIH HEALTH GOOD SAMARITAN HOSPITAL TO COMMUNITY ORGANIZATIONS OR TO THE COMMUNITY-AT-LARGE FOR A COMMUNITY BENEFIT PURPOSE. THESE DONATIONS INCLUDE CASH DONATIONS TO COMMUNITY ORGANIZATIONS, IN-KIND HOURS CONTRIBUTED BY STAFF TO THE COMMUNITY WHILE ON PIH HEALTH WORK TIME, THE COST OF OFFICE AND MEETING SPACE PROVIDED TO COMMUNITY GROUPS, AND THE DONATIONS OF EQUIPMENT, MEDICATIONS, SUPPLIES AND SERVICES. SNAPSHOT OF OUTCOMES:4,102 AT-RISK INDIVIDUALS WERE PROVIDED WITH IN-KIND DURABLE MEDICAL EQUIPMENT OR SERVICES, SUCH AS SKILLED NURSING OR MENTAL HEALTHCARE.TOTAL NUMBER OF PERSONS SERVED BY OTHER COMMUNITY BENEFIT SERVICES: 18,036 FOR ADDITIONAL INFORMATION, PLEASE REFER TO PIH HEALTH'S COMMUNITY BENEFIT REPORT AT PIHHEALTH.ORG/CBA ANNUALREPORT	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$379,846,695	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	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
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	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	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
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 With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
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	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	285	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1976	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
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
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	17	GoverningBodyVotingMembersCnt
Independent Voting Member	17	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	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	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	0	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MARK KAWAUCHI	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	5626980811	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	12102 WASHINGTON BLVD	AddressLine1Txt
City	WHITTIER	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	90606	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ALEX ALVAREZ
DIRECTOR & TREASURER	1.50	6.00	Yes (X)	Yes (X)	$0	$0	$0
BLAYNE CUTLER MD PHD
DIRECTOR	1.50	6.00	Yes (X)		$0	$0	$0
CHARLOTTE WEAVER PHD
DIRECTOR & VICE CHAIR	1.50	6.00	Yes (X)	Yes (X)	$0	$0	$0
JANE DICUS
DIRECTOR	1.50	6.00	Yes (X)		$0	$0	$0
JAY BROWN AS OF 3123
DIRECTOR	1.50	6.00	Yes (X)		$0	$0	$0
JEFF HAMAR
DIRECTOR	1.50	6.00	Yes (X)		$0	$0	$0
KENTON WOODS
DIRECTOR	1.50	6.00	Yes (X)		$0	$0	$0
MARISSA GOLDBERG
DIRECTOR	1.50	6.00	Yes (X)		$0	$0	$0
MELANIE BATISTE
DIRECTOR	1.50	6.00	Yes (X)		$0	$0	$0
PATRICK MONROE
DIRECTOR & CHAIR	1.50	6.00	Yes (X)	Yes (X)	$0	$0	$0
PAUL TREINEN
DIRECTOR	1.50	6.00	Yes (X)		$0	$0	$0
PAULA COWAN UNTIL 9222023
DIRECTOR	1.50	6.00	Yes (X)		$0	$0	$0
PETER GREANEY MD
DIRECTOR & SECRETARY	1.50	6.00	Yes (X)	Yes (X)	$0	$0	$0
RICHARD ATWOOD
DIRECTOR	1.50	7.50	Yes (X)		$0	$0	$0
ROBERT MALONEY MD
DIRECTOR	1.50	6.00	Yes (X)		$0	$0	$0
WESLEY HEARTFIELD MD
DIRECTOR	1.50	0.00	Yes (X)		$0	$0	$0
WILLIAM ROTH AS OF 3123
DIRECTOR	1.50	6.00	Yes (X)		$0	$0	$0
JAMES WEST
SYSTEM PRESIDENT & CEO	10.00	42.20		Yes (X)	$0	$2,046,653	$355,723
ROSALIO LOPEZ MD
SYSTEM CSO/CMO	10.00	36.20		Yes (X)	$0	$1,114,134	$46,447
BRIAN SMOLSKIS UNTIL 9282023
SYSTEM COO	10.00	37.70		Yes (X)	$0	$1,034,811	$219,042
PEGGY CHULACK
SYSTEM CAO & ASST SECRETARY	10.00	42.20		Yes (X)	$0	$995,412	$192,712
VID SHIVARAMAN
SYSTEM CFO & ASST TREASURER	10.00	42.20		Yes (X)	$0	$749,812	$150,468
IRENA ZUANIC
CNO & CO-SITE ADMIN	40.00	0.00		Yes (X)	$0	$384,178	$103,157
MOHAMMED GHONIM
REGIONAL VP	15.00	25.00			$0	$365,787	$71,068	Yes (X)
KEVIN BROWN UNTIL 542023
VP, CARDIOLOGY SERVICES	30.00	10.00			$0	$262,193	$44,695	Yes (X)
JING CHEUNG
RN	40.00	0.00			$362,626	$0	$21,766		Yes (X)
IRA MEISELMAN
DIRECTOR MANAGED CARE	40.00	0.00			$335,127	$0	$24,912		Yes (X)
REDENTOR CERVANTES
RN	40.00	0.00			$334,639	$0	$12,083		Yes (X)
DALE MCCREE
SUPERVISOR, SURGERY	40.00	0.00			$295,310	$0	$26,351		Yes (X)
MATILDA HERNANDEZ
RN	40.00	0.00			$288,726	$0	$35,490		Yes (X)
ANITA CHOU
FORMER CFO & ASST. TREASURER	0.00	0.00			$0	$119,014	$14			Yes (X)
JAIME DIAZ MD
FORMER CMO & CO-SITE ADMIN	0.00	0.00			$546,097	$0	$18,255			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,162,525	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$7,071,994	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,322,183	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	590	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
CROSS COUNTRY STAFFING
P O BOX 404674	ATLANTA	GA	30384	NURSING REGISTRY SERVICES	$21,107,964
SODEXO AMERICA LLC
9801 WASHINGTON BLVD	GAITHERSBURG	MD	20878	DIETARY SERVICES	$10,349,533
REHABCARE GROUP OF CALIFORNIA LLC
P O BOX 502096	ST LOUIS	MO	63150	REHABILITATION SERVICES	$4,080,153
MILES & KELLY CONSTRUCTION COMPANY INC
23691 VIA DEL RIO	YORBA LINDA	CA	92887	CONSTRUCTION SERVICES	$2,829,694
AYA HEALTHCARE INC
5930 CORNERSTONE CT W SUITE 300	SAN DIEGO	CA	92121	NURSING REGISTRY SERVICES	$2,769,195

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	65	CntrctRcvdGreaterThan100KCnt
Related Organizations	$169,477	RelatedOrganizationsAmt
Government Grants	$1,552,583	GovernmentGrantsAmt
All Other Contributions	$1,600,245	AllOtherContributionsAmt
Noncash Contributions	$10,575	NoncashContributionsAmt
Total Contributions	$3,322,305	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT REVENUE	622110	$311,865,542	$311,865,542
HOSPITAL FEE PROGRAM	900099	$46,809,431	$46,809,431
LAMBERT RADIOLOGY	622110	$2,466,070	$2,466,070
RENTAL INCOME	532000	$124,511	$124,511

Field	Value	IRS element (for citing)
Total Program Service Revenue	$361,265,554	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,635,379	TotalRevenueColumnAmt
Exclusion	$8,635,379	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$11,127,104	SecuritiesAmt
Other	$14,158	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$10,979,357	SecuritiesAmt
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$147,747	SecuritiesAmt
Other	$14,158	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$161,905	TotalRevenueColumnAmt
Exclusion	$161,905	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
PARKING LOT	812930	$2,476,510	$76,511	$2,399,999
VIVITY EARNINGS DISTRI	900099	$1,071,055		$1,071,055
PHYSICIAN MANAGEMENT S	621110	$52,200	$52,200

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,153,597	TotalRevenueColumnAmt
Unrelated Business Revenue	$44,691	UnrelatedBusinessRevenueAmt
Exclusion	$2,108,906	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$5,753,362	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$379,138,505	TotalRevenueColumnAmt
Related Or Exempt Func Income	$361,265,554	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$173,402	UnrelatedBusinessRevenueAmt
Exclusion	$14,377,244	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$300,100	TotalAmt
Program Services	$300,100	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$420,957	TotalAmt
Program Services	$294,670	ProgramServicesAmt
Management And General	$126,287	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$123,036,659	TotalAmt
Program Services	$117,433,120	ProgramServicesAmt
Management And General	$5,603,539	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$5,358,488	TotalAmt
Program Services	$5,139,317	ProgramServicesAmt
Management And General	$219,171	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$32,735,868	TotalAmt
Program Services	$31,002,288	ProgramServicesAmt
Management And General	$1,733,580	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$10,290,819	TotalAmt
Program Services	$10,189,550	ProgramServicesAmt
Management And General	$101,269	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$66,065	TotalAmt
Management And General	$66,065	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$1,911	TotalAmt
Management And General	$1,911	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$80,229	TotalAmt
Management And General	$80,229	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$202,178	TotalAmt
Management And General	$202,178	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$95,992,186	TotalAmt
Program Services	$88,614,602	ProgramServicesAmt
Management And General	$7,377,584	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$299,659	TotalAmt
Program Services	$2,000	ProgramServicesAmt
Management And General	$297,659	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,748,258	TotalAmt
Program Services	$2,706,346	ProgramServicesAmt
Management And General	$41,912	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$223	TotalAmt
Program Services	$223	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$6,271,567	TotalAmt
Program Services	$5,388,403	ProgramServicesAmt
Management And General	$883,164	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$3,741,230	TotalAmt
Program Services	$433,937	ProgramServicesAmt
Management And General	$3,307,293	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
SUPPLIES	$60,689,423	$60,472,655	$216,768
HOSPITAL FEE PROGRAM	$21,756,365	$21,756,365
BAD DEBT EXPENSE	$21,002,300	$21,002,300
UTILITIES	$6,683,851	$6,668,408	$15,443

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$19,739,360	TotalAmt
Program Services	$8,442,411	ProgramServicesAmt
Management And General	$11,120,882	ManagementAndGeneralAmt
Fundraising	$176,067	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$411,417,696	TotalAmt
Program Services	$379,846,695	ProgramServicesAmt
Management And General	$31,394,934	ManagementAndGeneralAmt
Fundraising	$176,067	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$2,406,617	BOYAmt
EOY	$1,974,969	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,367,000	BOYAmt
EOY	$1,528,905	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$92,194,351	BOYAmt
EOY	$102,437,233	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$5,549,268	BOYAmt
EOY	$5,692,298	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$6,115,499	BOYAmt
EOY	$2,545,308	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$345,749,151	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$31,238,956	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$311,993,507	BOYAmt
EOY	$314,510,195	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$84,859,495	BOYAmt
EOY	$87,141,966	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$102,734,174	BOYAmt
EOY	$50,818,475	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$607,219,911	BOYAmt
EOY	$566,649,349	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$95,666,268	BOYAmt
EOY	$83,892,137	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$76,290,538	BOYAmt
EOY	$71,917,003	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$171,956,806	BOYAmt
EOY	$155,809,140	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$361,127,939	BOYAmt
EOY	$336,324,802	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$74,135,166	BOYAmt
EOY	$74,515,407	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$435,263,105	BOYAmt
EOY	$410,840,209	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$607,219,911	BOYAmt
EOY	$566,649,349	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$32,279,191	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$5,502,272	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$2,354,023	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)
Hospital	Yes (X)	HospitalInd

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 C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$80,229	OtherActivitiesAmt
Total Lobbying Expenditures	$80,229	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	LOBBYING EXPENSES REPRESENT A PORTION OF THE DUES PIH HEALTH GOOD SAMARITAN HOSPITAL PAYS TO THE HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA AND TO AMERICAN HOSPITAL ASSOCIATION. PIH HEALTH GOOD SAMARITAN HOSPITAL DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OF STATEMENTS), ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$69,931,515	BeginningYearBalanceAmt
Contributions	$593	ContributionsAmt
Investment Earnings Or Losses	$3,371,694	InvestmentEarningsOrLossesAmt
Other Expenditures	$2,575,117	OtherExpendituresAmt
Administrative Expenses	$721,634	AdministrativeExpensesAmt
End Year Balance	$70,007,051	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$70,136,970	BeginningYearBalanceAmt
Contributions	$18,931	ContributionsAmt
Investment Earnings Or Losses	$3,493,226	InvestmentEarningsOrLossesAmt
Other Expenditures	$2,963,822	OtherExpendituresAmt
Administrative Expenses	$753,790	AdministrativeExpensesAmt
End Year Balance	$69,931,515	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$68,288,340	BeginningYearBalanceAmt
Contributions	$35,438	ContributionsAmt
Investment Earnings Or Losses	$5,607,660	InvestmentEarningsOrLossesAmt
Other Expenditures	$3,656,122	OtherExpendituresAmt
Administrative Expenses	$138,346	AdministrativeExpensesAmt
End Year Balance	$70,136,970	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$68,269,283	BeginningYearBalanceAmt
Investment Earnings Or Losses	$20,070	InvestmentEarningsOrLossesAmt
Administrative Expenses	$1,013	AdministrativeExpensesAmt
End Year Balance	$68,288,340	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$72,033,292	BeginningYearBalanceAmt
Contributions	$9,678	ContributionsAmt
Investment Earnings Or Losses	-$1,950,120	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,648,396	OtherExpendituresAmt
Administrative Expenses	$175,171	AdministrativeExpensesAmt
End Year Balance	$68,269,283	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.16234	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.77734	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.06032	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$204,149,473	OtherCostOrOtherBasisAmt
Book Value	$204,149,473	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$61,473,866	OtherCostOrOtherBasisAmt
Depreciation	$5,515,856	DepreciationAmt
Book Value	$55,958,010	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$65,346,343	OtherCostOrOtherBasisAmt
Depreciation	$23,339,975	DepreciationAmt
Book Value	$42,006,368	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$14,779,469	OtherCostOrOtherBasisAmt
Depreciation	$2,383,125	DepreciationAmt
Book Value	$12,396,344	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$314,510,195	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
RIGHT-OF-USE ASSETS	$57,513
HOSPITAL FEE PROGRAM RECEIVABLE	$47,166,847
SELF-INSURANCE RECEIVABLE - CURRENT PORTION	$1,568,000
OTHER NOTES AND LOAN RECEIVABLE	$2,026,115

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$50,818,475	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (10 entries)

DescDesc	AmtAmt
ADVANCES FROM THIRD PARTY PAYORS	$7,776,212
CARES ACT PROVIDER RELIEF FUNDS	$3,998,463
OTHER ANNUITY PAYMENT LIABILITY	$1,362,618
HOSPITAL FEE PROGRAM PAYABLE	$26,740,358
OTHER LIABILITIES	$450,413
OTHER LONG TERM RESERVES	$6,869,839
PENSION PLAN	$6,469,235
RESERVE FOR ASSET RETIREMENT OBLIGATION	$13,351,873
RESERVE FOR SELF-INSURED PROGRAMS	$2,195,590
INTERCOMPANY PAYABLE	$2,702,402

Field	Value	IRS element (for citing)
Total Liability	$71,917,003	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART V, LINE 4:

THE ORGANIZATION'S ENDOWMENT CONSISTS OF FUNDS ESTABLISHED FOR HEALTH CARE SERVICES, AS SPECIFIED BY DONORS OR THE ORGANIZATION'S BOARD OF DIRECTORS.

PART X, LINE 2:

THE PRINCIPAL OPERATIONS OF THE COMPANY ARE EXEMPT FROM INCOME TAXES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3) AND THE LAWS OF THE STATES IN WHICH IT OPERATES AND, AS SUCH, IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, THE COMPANY IS SUBJECT TO INCOME TAXES ON NET INCOME DERIVED FROM A TRADE OR BUSINESS REGULARLY CARRIED ON THAT DOES NOT FURTHER THE ORGANIZATION'S EXEMPT PURPOSE. FURTHER, THE COMPANY IS ALSO SUBJECT TO FEDERAL EXCISE TAXES PURSUANT TO THE TAX CUTS AND JOBS ACT. NO SIGNIFICANT INCOME TAX PROVISION HAS BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR NET INCOME DERIVED FROM UNRELATED TRADE OR BUSINESS AND EXCISE TAXES. THE COMPANY MEASURES LIABILITIES FOR UNRECOGNIZED TAX UNCERTAINTIES IN ACCORDANCE WITH ASC 740, INCOME TAXES, WHICH PRESCRIBES A COMPREHENSIVE MODEL FOR HOW A COMPANY SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE IN ITS FINANCIAL STATEMENTS UNCERTAIN TAX POSITIONS THAT A COMPANY HAS TAKEN OR EXPECTS TO TAKE ON A TAX RETURN. THE GUIDANCE IS APPLICABLE TO PROFIT-ORIENTED ENTITIES, PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. MANAGEMENT BELIEVES IT HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS AND, AS SUCH, NO TAX LIABILITY, BENEFITS, INTEREST OR PENALTIES WERE ACCRUED AT SEPTEMBER 30, 2023 OR 2022. THE COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE COMPANY BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2019 FOR FEDERAL PURPOSES AND 2017 FOR CALIFORNIA PURPOSES.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	7327	PersonsServedCnt
Total Community Benefit Expns	$5,133,470	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,133,470	NetCommunityBenefitExpnsAmt
Total Expense	0.01320	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	30667	PersonsServedCnt
Total Community Benefit Expns	$151,606,430	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$98,230,080	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$53,376,350	NetCommunityBenefitExpnsAmt
Total Expense	0.13920	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Persons Served	37994	PersonsServedCnt
Total Community Benefit Expns	$156,739,900	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$98,230,080	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$58,509,820	NetCommunityBenefitExpnsAmt
Total Expense	0.15240	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	11	ActivitiesOrProgramsCnt
Persons Served	17608	PersonsServedCnt
Total Community Benefit Expns	$6,382,307	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$6,382,307	NetCommunityBenefitExpnsAmt
Total Expense	0.01620	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	68	PersonsServedCnt
Total Community Benefit Expns	$1,755,341	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$67,328	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,688,013	NetCommunityBenefitExpnsAmt
Total Expense	0.00430	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	37	PersonsServedCnt
Total Community Benefit Expns	$843,068	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$843,068	NetCommunityBenefitExpnsAmt
Total Expense	0.00210	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	251	PersonsServedCnt
Total Community Benefit Expns	$307,016	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$307,016	NetCommunityBenefitExpnsAmt
Total Expense	0.00080	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	72	PersonsServedCnt
Total Community Benefit Expns	$68,385	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$68,385	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	18	ActivitiesOrProgramsCnt
Persons Served	18036	PersonsServedCnt
Total Community Benefit Expns	$9,356,117	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$67,328	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,288,789	NetCommunityBenefitExpnsAmt
Total Expense	0.02360	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	18	ActivitiesOrProgramsCnt
Persons Served	56030	PersonsServedCnt
Total Community Benefit Expns	$166,096,017	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$98,297,408	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$67,798,609	NetCommunityBenefitExpnsAmt
Total Expense	0.17600	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$430,382	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$87,708,662	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$91,108,973	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$3,400,311	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	0	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PIH HEALTH GOOD SAMARITAN HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1225 WILSHIRE BLVD	AddressLine1Txt
City	LOS ANGELES	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	90017	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.PIHHEALTH.ORG	WebsiteAddressTxt
State License	930000071	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Research Facility	Yes (X)	ResearchFacilityInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	PIH HEALTH GOOD SAMARITAN HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
Other	Yes (X)	OtherInd
CHNA Conducted	22	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	HTTPS://WWW.PIHHEALTH.ORG/ABOUT-US/COMMUNITY-BENEFIT/	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	22	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	HTTPS://WWW.PIHHEALTH.ORG/WELLNESS/COMMUNITY-BENEFIT/	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	HTTPS://WWW.PIHHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTPS://WWW.PIHHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTPS://WWW.PIHHEALTH.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PIH HEALTH GOOD SAMARITAN HOSPITAL	PART V, SECTION B, LINE 3J: THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDES DATA, MAPS AND INFORMATION REGARDING SOCIAL DETERMINANTS OF HEALTH, HEALTH STATUS AND LIFE EXPECTANCY, ACCESS TO HEALTHCARE, MENTAL HEALTH, ALCOHOL, SUBSTANCE AND TOBACCO USE, PHYSICAL ACTIVITY, NUTRITION AND WEIGHT STATUS, REPRODUCTIVE HEALTH, ACUTE AND CHRONIC DISEASE, LEADING CAUSES OF DEATH, COMMUNITY PERSPECTIVES GATHERED FROM FOCUS GROUPS AND INTERVIEWS, AND PROGRESS ON THE IMPLEMENTATION STRATEGY.
PIH HEALTH GOOD SAMARITAN HOSPITAL	PART V, SECTION B, LINE 5: PIH HEALTH GOOD SAMARITAN HOSPITAL CONDUCTED TARGETED INTERVIEWS TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE MEDICAL CENTER.FORTY-THREE (43) TELEPHONE INTERVIEWS WERE CONDUCTED DURING DECEMBER 2021 AND JANUARY 2022. INTERVIEW PARTICIPANTS INCLUDED A BROAD RANGE OF STAKEHOLDERS CONCERNED WITH HEALTH AND WELLBEING IN THE LOS ANGELES SERVICE AREA WHO SPOKE TO ISSUES AND NEEDS IN THE COMMUNITIES SERVED BY THE HOSPITAL. THE IDENTIFIED STAKEHOLDERS WERE INVITED BY EMAIL TO PARTICIPATE IN THE PHONE INTERVIEW. APPOINTMENTS FOR THE INTERVIEWS WERE MADE ON DATES AND TIMES CONVENIENT TO THE STAKEHOLDERS. AT THE BEGINNING OF EACH INTERVIEW, THE PURPOSE OF THE INTERVIEW IN THE CONTEXT OF THE ASSESSMENT WAS EXPLAINED, THE STAKEHOLDERS WERE ASSURED THEIR RESPONSES WOULD REMAIN CONFIDENTIAL, AND CONSENT TO PROCEED WAS GIVEN. INTERVIEW QUESTIONS FOCUSED ON THE FOLLOWING TOPICS: - BIGGEST HEALTH ISSUES IN THE COMMUNITY- GROUPS MOST IMPACTED BY COMMUNITY ISSUES- WHERE PEOPLE ACCESS ROUTINE HEALTHCARE SERVICES- REASONS FOR NOT HAVING HEALTH COVERAGE/INSURANCE- REASONS FOR DELAYING NEEDED HEALTHCARE- COVID-19 PANDEMIC IMPACT AND THE VACCINE- PRIORITY RANKING OF COMMUNITY NEEDS- WHETHER THEY HAVE RECEIVED ANY CANCER SCREENINGS AND REASONS FOR DELAYING- BARRIERS EXPERIENCED WHILE RECEIVING CANCER TREATMENT- ADDITIONAL COMMENTS AND CONCERNS A LIST OF THE STAKEHOLDER INTERVIEW RESPONDENTS, THEIR TITLES AND ORGANIZATIONS CAN BE FOUND IN ATTACHMENT 2.THE FULL COMMUNITY HEALTH NEEDS ASSESSMENT, CAN BE FOUND AT HTTPS://WWW.PIHHEALTH.ORG/APP/FILES/PUBLIC/7FB79B0D-DEB2-42E7-A1B6-DA7400C7F211/COMMUNITY%20HEALTH%20IMPROVEMENT%20PLAN%202022_PHGSH.PDF
PIH HEALTH GOOD SAMARITAN HOSPITAL	PART V, SECTION B, LINE 6A: PIH HEALTH GOOD SAMARITAN HOSPITAL PARTICIPATED IN A COLLABORATIVE PROCESS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT, IN PARTNERSHIP WITH CALIFORNIA HOSPITAL MEDICAL CENTER.
PIH HEALTH GOOD SAMARITAN HOSPITAL	PART V, SECTION B, LINE 11: PIH HEALTH'S COMMUNITY HEALTH IMPLEMENTATION STRATEGY (CHIS) ENSURES ALIGNMENT OF CHNA FINDINGS, OUR COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND PIH HEALTH'S ORGANIZATIONAL STRATEGY. TO VIEW THE 2023-2025 CHIS AND THE INITIATIVES IDENTIFIED TO ADDRESS AREAS OF FOCUS (ACCESS TO HEALTH CARE - PRIMARY CARE, DENTAL CARE AND MENTAL HEALTH, CANCER INCIDENCE/MORTALITY, DIABETES INCIDENCE/MORTALITY, HEART DISEASE/STROKE INCIDENCE/MORTALITY, OVERWEIGHT/OBESITY, SUBSTANCE USE AND MISUSE, PREVENTATIVE SCREENINGS AND IMMUNIZATIONS WITH EMPHASIS ON FLU AND PNEUMONIA VACCINES AND CANCER SCREENINGS, FOOD INSECURITY, HOUSING/HOMELESSNESS), VISIT HTTPS://WWW.PIHHEALTH.ORG/APP/FILES/PUBLIC/7FB79B0D-DEB2-42E7-A1B6-DA7400C7F211/COMMUNITY%20HEALTH%20IMPROVEMENT%20PLAN%202022_PHGSH.PDF.SINCE PIH HEALTH GOOD SAMARITAN HOSPITAL CANNOT DIRECTLY ADDRESS ALL THE HEALTH NEEDS PRESENT IN THE COMMUNITY, WE WILL CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED GIVEN OUR AREAS OF FOCUS AND EXPERTISE. TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, PIH HEALTH GOOD SAMARITAN HOSPITAL WILL NOT DIRECTLY ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA, INCLUDING: BIRTH INDICATORS, COVID-19, ECONOMIC INSECURITY, EDUCATION, AND VIOLENCE AND INJURY PREVENTION. WHILE THE HOSPITAL DOES NOT INTEND TO EMPHASIZE COMMUNITY COVID-19 INTERVENTIONS AT THIS POINT IN THE PANDEMIC, PIH HEALTH GOOD SAMARITAN HOSPITAL WILL CONTINUE TO DELIVER VACCINES, TESTING AND ACUTE MEDICAL CARE TO ADDRESS COVID-19.
PIH HEALTH GOOD SAMARITAN HOSPITAL	PART V, SECTION B, LINE 13B: ASSISTANCE IS PROVIDED FREE OR DISCOUNTED FOR THOSE PATIENTS ELIGIBLE FOR FAP. THE CRITERIA FOR FAP IS IF THE PATIENT IS UNINSURED AND DOES NOT HAVE THE ABILITY TO PAY, HAS RESTRICTED MEDI-CAL BENEFITS, OR IS UNINSURED. THERE ARE ALSO CONSIDERATIONS FOR PATIENTS WHERE THE FPG IS NOT APPLICABLE AND THE PATIENT IS INSURED WITH INADEQUATE COVERAGE OR EXCESSIVE LIABILITY.

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 6A:	PIH HEALTH'S COMMUNITY BENEFIT REPORT, PREPARED ANNUALLY, ACCOUNTS FOR THE ORGANIZATION'S PROGRAMS AND SERVICES THAT PROMOTE THE HEALTH OF THE COMMUNITY. THE REPORT SEPARATES OUT COMMUNITY BENEFIT INVESTMENT FIGURES FOR EACH HOSPITAL. THE REPORT WAS MADE WIDELY AVAILABLE TO THE PUBLIC VIA SOCIAL MEDIA, OUR ORGANIZATION'S WEBSITE AND A COMMUNITY E-NEWSLETTER. IT WILL ALSO BE SHARED WITH CERTAIN INTERNAL AND COMMUNITY STAKEHOLDERS VIA PRESENTATION. TO VIEW THE FULL REPORT, VISIT HTTPS://WWW.PIHHEALTH.ORG/APP/FILES/PUBLIC/2992BE3C-D8DA-4036-A2D3-C2D2AB0DC19E/PIH_HEALTH_GOOD_SAMARITAN_HOSPITAL_FY23_COMMUNITY_BENEFIT_ANNUAL_REPORT_AND_PLAN.PDF
PART I, LINE 7:	PATIENT CARE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2 WAS USED TO CALCULATE THE FINANCIAL ASSISTANCE AND UNREIMBURSED MEDICAID COST. ACTUAL COSTS FROM GENERAL LEDGER OR DEPARTMENTS WERE USED FOR ALL OTHER COSTS.
PART I, LN 7 COL(F):	BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $21,002,300.
PART III, LINE 2:	BAD DEBT EXPENSE IS THE BAD DEBT TRANSFERS NET OF RECOVERIES. THIS EXPENSE WAS NOT INCLUDED IN COMMUNITY BENEFIT EXPENSE.
PART III, LINE 3:	PIH HEALTH GOOD SAMARITAN HOSPITAL ACTIVELY PROVIDES ALL PATIENTS THE OPTION TO APPLY FOR FINANCIAL ASSISTANCE, THEREFORE, NO ESTIMATE IS MADE FOR BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY.
PART III, LINE 4:	FROM THE AUDITED FINANCIAL STATEMENTS OF PIH HEALTH, INC. AND SUBSIDIARIES FOR THE YEAR ENDED SEPTEMBER 30, 2023: "IMPLICIT PRICE CONCESSIONS ARE BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TAKING INTO CONSIDERATION HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT ROUTINELY ASSESSES THE ADEQUACY OF THE IMPLICIT PRICE CONCESSIONS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. IMPLICIT PRICE CONCESSIONS ARE INCLUDED AS A DEDUCTION FROM PATIENT SERVICES REVENUES SINCE THE COMPANY GENERALLY ACCEPTS AND TREATS ALL PATIENTS WITHOUT REGARD TO THE ABILITY TO PAY." THE BAD DEBT EXPENSE ON LINE 2 IS CALCULATED USING TOTAL COST TO CHARGE RATIO APPLYING TO TOTAL BAD DEBT TRANSFERS NET OF RECOVERIES AND NONE OF THE BAD DEBT EXPENSE IS INCLUDED IN COMMUNITY BENEFIT EXPENSE.
PART III, LINE 8:	THE AMOUNTS ON LINES 5 AND 6 ARE FROM THE FY 2023 MEDICARE COST REPORT AND WE BELIEVE DO NOT QUALIFY AS COMMUNITY BENEFIT.
PART VI, LINE 2:	IN ADDITION TO THE HOSPITAL'S CHNA, PIH HEALTH UTILIZES THE FOLLOWING METHODS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES:COMMUNITY BENEFIT OVERSIGHT COMMITTEE- IN 2006, PIH HEALTH'S BOARD OF DIRECTORS ESTABLISHED THE COMMUNITY BENEFIT OVERSIGHT COMMITTEE (CBOC), WHICH IS COMPRISED OF COMMUNITY STAKEHOLDERS AND KEY PUBLIC HEALTH AND LEGISLATIVE REPRESENTATIVES. THIS COMMITTEE MEETS REGULARLY AND ITS MEMBERS SHARE HEALTHCARE-RELATED NEEDS/CONCERNS EXPERIENCED BY THE COMMUNITY MEMBERS THEY REPRESENT AS WELL AS ASSETS OR POTENTIAL PARTNERS FOR THE HOSPITAL TO ENGAGE IN ADDRESSING THE IDENTIFIED NEEDS.FEEDBACK FROM COMMUNITY ORGANIZATIONS / COLLABORATIVE- THROUGH PARTICIPATION IN VARIOUS COMMUNITY COLLABORATIVE AND NETWORKING MEETINGS, PIH HEALTH IS ABLE TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITY AND IDENTIFY PARTNERSHIP OPPORTUNITIES.
PART VI, LINE 3:	UNINSURED PATIENTS ARE SCREENED FOR MEDI-CAL LINKAGE AND IF THEY MEET THE CRITERIA, THE PATIENT IS REFERRED TO RISARC AND COMSPEC TO ASSIST WITH THE APPLICATION AND ELIGIBILITY PROCESS. IF THE PATIENT DOES NOT HAVE MEDI-CAL LINKAGE, THEY ARE SCREENED FOR QUEENS CARE WHICH IS A PROGRAM FOR UNINSURED PATIENTS THAT RESIDE WITHIN SPECIFIC ZIP CODES IN LOS ANGELES COUNTY AND MEET INCOME QUALIFICATION. FINANCIAL ASSISTANCE APPLICATIONS ARE PROVIDED TO ALL PATIENTS WHO ARE UNISURED, UNDERINSURED, FINANCIAL HARDSHIP, HAVE CATASTROPHIC ILLNESS OR HAVE EXCESSIVE MEDICAL EXPENSES. THE FOLLOWING HOSPITAL POLICIES ARE AVAILABLE ON OUR WEBSITE; CHARITY CARE / DISCOUNT POLICY, FINANCIAL ASSISTANCE APPLICATION AND CASH PRICE POLICY. THE STATEMENTS MAILED TO PATIENTS PROVIDES INFORMATION REGARDING FINANCIAL ASSISTANCE, COVERED CALIFORNIA HEALTH BENEFITS, MEDI-CAL AND MEDICARE.
PART VI, LINE 4:	PIH HEALTH GOOD SAMARITAN HOSPITAL (PHGSH) IS LOCATED AT 1225 WILSHIRE BLVD., LOS ANGELES, CALIFORNIA 90017. THE HOSPITAL SERVICE AREA INCLUDES 17 ZIP CODES IN LOS ANGELES. THE SERVICE AREA IS SERVED BY THE LOS ANGELES COUNTY 1ST AND 2ND SUPERVISORIAL DISTRICTS AND FALLS WITHIN THE LOS ANGELES COUNTY SERVICE PLANNING AREAS (SPAS) 4 AND 6.*PIH HEALTH GOOD SAMARITAN HOSPITAL TRACKS ZIP CODES OF ORIGIN FOR PATIENT ADMISSIONS. THE SERVICE AREA WAS DETERMINED FROM THE ZIP CODES THAT REFLECT A MAJORITY (59%) OF PATIENT ADMISSIONS FROM THE LOCAL GEOGRAPHIC AREA.BASED ON THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT, THE POPULATION FOR THE PHGSH SERVICE AREA IS 930,016. CHILDREN AND YOUTH, AGES 0-17, MAKE UP 22.8% OF THE POPULATION, 67.6% ARE 18-64 YEARS OF AGE, AND 9.6% ARE SENIORS, 65 YEARS AND OLDER. IN THE SERVICE AREA, 62.4% OF THE POPULATION ARE HISPANIC/LATINO, 13.3% ARE ASIAN, 13.2% BLACK/AFRICAN AMERICAN, 9.0% ARE WHITE, AND THE REMAINING 2.1% ARE NATIVE AMERICAN RESIDENTS, HAWAIIAN OR PACIFIC ISLANDER. AMONG THE SERVICE AREA POPULATION, AGES FIVE AND OLDER, 58.1% SPEAK SPANISH, 27.9% SPEAK ONLY ENGLISH, 11.6%SPEAK AN ASIAN OR PACIFIC ISLANDER LANGUAGE, 1.7% SPEAK OTHER INDO-EUROPEAN LANGUAGES, AND 0.7% SPEAK OTHER LANGUAGES IN THEIR HOME ENGLISH IS SPOKEN IN THE HOME AMONG 32.8% OF THE SERVICE AREA POPULATION. IN THE SERVICE AREA, 27.1% OF THE POPULATION IS AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL. AMONG SERVICE AREA ADULTS, AGES 25 AND OLDER, 22.3% HAVE LESS THAN A 9TH GRADE EDUCATION. 36.8% OF AREA ADULTS ARE HIGH SCHOOL GRADUATES, AND 27.9% HAVE AN ASSOCIATE, BACHELOR'S, OR GRADUATE/PROFESSIONAL DEGREE. AREA RESIDENTS HAVE LOWER EDUCATIONAL LEVELS THAN ADULTS IN THE COUNTY AND STATE.
PART VI, LINE 5:	COMMUNITY BOARDPIH HEALTH'S COMMUNITY BOARD OF DIRECTORS WORKS TO ADVANCE THE COMMITMENT TO HELPING OUR COMMUNITIES GET WELL AND STAY HEALTHY.OPEN MEDICAL STAFFPIH HEALTH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES.DONATION OF TIMEMANY PIH HEALTH PROVIDERS ARE LIVING OUT THEIR PASSION TO SERVE PEOPLE IN NEED BY DONATING THEIR TIME AND TALENTS BOTH IN OUR COMMUNITY AND OVERSEAS. ENVIRONMENTAL AND RECYCLING PROJECTSPIH HEALTH CONTINUES TO IMPLEMENT "GREEN" INITIATIVES, INCLUDING INCREASED USAGE OF LED LIGHTING TO DECREASE CONSUMPTION OF ELECTRICITY AND DEVELOPING ENERGY MANAGEMENT PROJECTS.VOLUNTEER CONTRIBUTIONS SOME 1,355 PIH HEALTH VOLUNTEERS COLLECTIVELY CONTRIBUTED 112,001 HOURS OF SERVICE, SUPPORTING DEPARTMENTS THROUGHOUT THE ORGANIZATION. THROUGH THE PIH HEALTH MEDICAL CAREERS PROGRAM, WHICH GIVES STUDENT VOLUNTEERS A HEAD START IN DISCOVERING PRODUCTIVE AND MEANINGFUL CAREERS IN HEALTHCARE, 30 INDIVIDUALS SPENT 184 HOURS SHADOWING MEDICAL CAREER PROFESSIONALS AND ATTENDING SIMULATION LABS. SOME 15 VOLUNTEERS AND COMMUNITY MEMBERS ATTENDED A 'MEET THE PROS' EDUCATIONAL CLASS, WHERE A HEALTHCARE PROFESSIONAL GAVE A PRESENTATION ON HIS CAREER PATH.
PART VI, LINE 6:	HOSPITAL AFFILIATES INCLUDE: 1) PIH HEALTH, INC., PIH HEALTH'S PARENT COMPANY; 2) PIH HEALTH DOWNEY HOSPITAL; 3) PIH HEALTH WHITTIER HOSPITAL 4) PIH HEALTH PHYSICIANS, A NONPROFIT MEDICAL FOUNDATION; 5) PIH HEALTH HOME HEALTHCARE AND 6) THE PIH HEALTH FOUNDATION, A NONPROFIT ORGANIZATION THAT EXISTS TO RAISE PHILANTHROPIC FUNDS IN SUPPORT OF PIH HEALTH'S CHARITABLE MISSION 1) PIH HEALTH, INC. PROVIDES TECHNICAL, FACILITY AND SUPPORT SERVICES FOR TAX-EXEMPT AFFILIATES WHOSE CHARITABLE PURPOSE IS TO PROVIDE A BROAD RANGE OF HEALTHCARE SERVICES TO THEIR COMMUNITY BY WAY OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM.2) PIH HEALTH DOWNEY HOSPITAL OFFICIALLY BECAME PART OF PIH HEALTH IN OCTOBER 2013. AS A 501 (C)(3) NONPROFIT, 199-BED HOSPITAL, THE DOWNEY CAMPUS HAS PROVIDED QUALITY CARE IN A WELCOMING ENVIRONMENT FOR MORE THAN 100 YEARS. AS A NONNPROFIT HOSPITAL WITH A CHARITABLE MISSION, PIH HEALTH HOSPITAL DOWNEY IS A DEDICATED COMMUNITY HEALTH AND WELLNESS PARTNER. THIS COMMITMENT AND LEADERSHIP GIVES BACK TO THE COMMUNITY THROUGH CHARITY CARE, HEALTH PROFESSIONS EDUCATION AND MORE.3) PIH HEALTH WHITTIER HOSPITAL OPENED IN 1959. AS A 501 (C)(3) NONPROFIT, 523-BED HOSPITAL, THE WHITTIER CAMPUS HAS DEVELOPED INTO A HEALTH SYSTEM OFFERING A MULTITUDE OF SERVICES. AS A NONPROFIT HOSPITAL WITH A CHARITABLE MISSION, PIH HEALTH HOSPITAL WHITTIER IS A DEDICATED COMMUNITY HEALTH AND WELLNESS PARTNER. THIS COMMITMENT AND LEADERSHIP GIVES BACK TO THE COMMUNITY THROUGH CHARITY CARE, MEDICAL RESEARCH, DONATIONS, HEALTH PROFESSIONS EDUCATION AND MORE.4) PIH HEALTH PHYSICIANS (PHP) A 501(C)(3) NONPROFIT MEDICAL GROUP THAT IS EXCLUSIVELY AFFILIATED WITH PIH HEALTH, THE GROUP IS COMPRISED OF MORE THAN 150 PRIMARY CARE PHYSICIANS AND OVER 250 SPECIALISTS WHO COORDINATE CARE FROM DIAGNOSIS TO RECOVERY. PHP SUPPORTS THE LOCAL COMMUNITY THROUGH ITS FINANCIAL ASSISTANCE PROGRAM, WHITTIER FIRST DAY HEALTH & WELLNESS CENTER FOR THE HOMELESS AND THOSE AT-RISK FOR HOMELESSNESS, HEALTH PROFESSIONS EDUCATION, AND OTHER COMMUNITY HEALTH IMPROVEMENT SERVICES.5) PIH HEALTH HOME HEALTHCARE PROVIDES AROUND-THE-CLOCK, QUALITY CARE FOR PATIENTS IN THEIR OWN HOME. PIH HEALTH HOME HEALTHCARE IS CERTIFIED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES.6) THE PIH HEALTH FOUNDATION IS A 501(C)(3) NONPROFIT ORGANIZATION WITH THE SOLE MISSION TO RAISE FUNDS THROUGH PHILANTHROPHY TO BENEFIT PIH HEALTH AND ITS AFFILIATES. DOLLARS RAISED ARE REINVESTED INTO THE COMMUNITIES WE SERVE THROUGH QUALITY HEALTHCARE, HEALTH-BASED PROGRAMS AND SERVICES OFFERED THROUGH PIH HEALTH.FOR DETAILED INFORMATION REGARDING THESE PIH HEALTH AFFILIATES' ADDITIONAL ACTIVITIES TO SUPPORT AND PROMOTE COMMUNITY HEALTH, PLEASE SEE EACH RESPECTIVE ORGANIZATION'S IRS FORM 990.
PART VI, LINE 7, REPORTS FILED WITH STATES	CA

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 INSTITUTE FOR RESEARCH AND EDUCATION	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1225 WILSHIRE BLVD	AddressLine1Txt
City	LOS ANGELES	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	90017	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	954077161	RecipientEIN
IRC Section	501(C) (3)	IRCSectionDesc
Cash Grant	$300,100	CashGrantAmt
Non Cash Assistance	$0	NonCashAssistanceAmt
Purpose Of Grant	EXPENSES PAID BY THE ORGANIZATION	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, LINE 2:	FormAndLineReferenceDesc
Explanation	PIH HEALTH PROVIDES FINANCIAL ASSISTANCE TO BOTH NOT-FOR-PROFIT ORGANIZATIONS AND INDIVIDUALS. PIH HEALTH PROVIDES FINANCIAL SUPPORT TO NONPROFIT ORGANIZATIONS IN OUR SERVICE AREA CITIES THROUGH ITS COMMUNITY SUPPORT AND SPONSORSHIPS PROGRAM, WITH EMPHASIS ON COMMUNITY HEALTH NEEDS/AREAS OF CONCERN AS IDENTIFIED BY PIH HEALTH'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT FINDINGS. FINANCIAL SUPPORT MAY BE PROVIDED IF THE REQUESTING ORGANIZATION ADDRESSES ONE OR MORE OF THESE AREAS AND IS RESPONSIVE TO THE HEALTH AND WELLNESS NEEDS OF THE COMMUNITIES WE SERVE, ALLOWING PIH HEALTH TO BUILD UPON THE IMPACT OF EXISTING COMMUNITY HEALTH IMPROVEMENT EFFORTS. FOR CONTRIBUTIONS MADE TO CHARITABLE ORGANIZATIONS, PIH HEALTH HAS ADOPTED A POLICY WHICH GUIDES THE PROCESS TO ENSURE GOOD STEWARDSHIP OF PIH HEALTH'S CHARITABLE RESOURCES AS A FEDERALLY REGISTERED NONPROFIT ENTITY. TO ENSURE ACCURATE COMMUNITY BENEFIT REPORTING, THIS POLICY SETS FORTH THAT DIRECT FINANCIAL CONTRIBUTIONS MADE TO COMMUNITY ORGANIZATIONS MUST BE APPROPRIATELY CLASSIFIED AS EITHER A) COMMUNITY BENEFIT OR B) A SPONSORSHIP (A MARKETING COMMUNICATIONS DEPARTMENT EXPENSE NOT REPORTABLE AS COMMUNITY BENEFIT). IN COMPLIANCE WITH THIS POLICY, INFORMATION IS GATHERED FROM THE GRANTEE REGARDING THE INTENDED USE OF FUNDS AND A RESTRICTION LETTER IS SENT, NOTING THE INTENDED USE OF FUNDS. ORGANIZATIONS RECEIVING COMMUNITY SUPPORT FUNDING IN THE AMOUNT OF $2,500 OR MORE ARE REQUIRED TO SUBMIT A SUMMARY REPORT OF PROGRAM OR SERVICE IMPACT, WITHIN 90 DAYS AFTER EVENT OR RECEIPT OF PROGRAM FUNDING, UNLESS AN ALTERNATE DATE IS DESIGNATED. FOR CONTRIBUTIONS MADE TO INDIVIDUALS, PIH HEALTH HAS ESTABLISHED A DEDICATED BUDGET WHICH SUBSIDIZES VITAL ASSISTANCE SUCH AS PURCHASE OF DURABLE MEDICAL EQUIPMENT OR NON-ACUTE CARE NOT COVERED BY INSURANCE UPON HOSPITAL DISCHARGE, INCLUDING PAID PLACEMENT IN SKILLED NURSING OR MENTAL HEALTH FACILITIES. IN THESE INSTANCES, A SPECIFIC SERVICE IS BEING PURCHASED AND RECEIPT OF PROPER SERVICE IS ENSURED THROUGH FOLLOW-UP BY PIH HEALTH DISCHARGE PLANNERS OR SOCIAL WORKERS.	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 (15 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
JAMES WEST
SYSTEM PRESIDENT & CEO	$0	$1,506,821	$0	$0	$0	$539,832	$0	$335,520	$0	$20,325	$0	$2,402,498	$0	$517,243
BRIAN SMOLSKIS UNTIL 9282023
SYSTEM COO	$0	$838,304	$0	$0	$0	$196,507	$0	$196,657	$0	$22,507	$0	$1,253,975	$0	$188,312
PEGGY CHULACK
SYSTEM CAO & ASST SECRETARY	$0	$826,709	$0	$0	$0	$168,703	$0	$178,274	$0	$14,760	$0	$1,188,446	$0	$120,897
ROSALIO LOPEZ MD
SYSTEM CSO/CMO	$0	$907,438	$0	$0	$0	$206,696	$0	$36,700	$0	$9,869	$0	$1,160,703	$0	$0
VID SHIVARAMAN
SYSTEM CFO & ASST TREASURER	$0	$681,460	$0	$0	$0	$68,352	$0	$141,186	$0	$9,404	$0	$900,402	$0	$61,131
JAIME DIAZ MD
FORMER CMO & CO-SITE ADMIN	$546,097	$0	$0	$0	$0	$0	$0	$0	$18,358	$0	$564,455	$0	$0	$0
IRENA ZUANIC
CNO & CO-SITE ADMIN	$0	$376,622	$0	$0	$0	$7,556	$0	$87,395	$0	$15,884	$0	$487,457	$0	$0
MOHAMMED GHONIM
REGIONAL VP	$0	$357,516	$0	$0	$0	$8,271	$0	$69,038	$0	$2,151	$0	$436,976	$0	$0
JING CHEUNG
RN	$350,803	$0	$0	$0	$11,823	$0	$15,250	$0	$6,560	$0	$384,436	$0	$0	$0
IRA MEISELMAN
DIRECTOR MANAGED CARE	$335,127	$0	$0	$0	$0	$0	$9,150	$0	$15,884	$0	$360,161	$0	$0	$0
REDENTOR CERVANTES
RN	$319,318	$0	$0	$0	$15,321	$0	$0	$0	$12,128	$0	$346,767	$0	$0	$0
MATILDA HERNANDEZ
RN	$280,712	$0	$0	$0	$8,014	$0	$20,526	$0	$15,008	$0	$324,260	$0	$0	$0
DALE MCCREE
SUPERVISOR, SURGERY	$295,310	$0	$0	$0	$0	$0	$5,966	$0	$20,429	$0	$321,705	$0	$0	$0
KEVIN BROWN UNTIL 542023
VP, CARDIOLOGY SERVICES	$0	$255,779	$0	$0	$0	$6,414	$0	$36,142	$0	$8,675	$0	$307,010	$0	$0
ANITA CHOU
FORMER CFO & ASST. TREASURER	$0	-$14	$0	$0	$0	$119,028	$0	$0	$0	$14	$0	$119,028	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART I, LINE 3

COMPENSATION FOR THE CEO WAS ESTABLISHED AND PAID BY PIH HEALTH WHITTIER HOSPITAL (PIH), A RELATED ORGANIZATION. PIH USED THE FOLLOWING TO ESTABLISH THE CEO'S COMPENSATION: (1) COMPENSATION COMMITTEE; (2) INDEPENDENT COMPENSATION CONSULTANT; (3) FORM 990 OF OTHER ORGANIZATIONS; (4) COMPENSATION SURVEY OR STUDY; (5) APPROVAL BY THE BOARD.

PART I, LINES 4A-B

ANITA CHOU RECEIVED A SEVERANCE PAYMENT DURING THE CALENDAR YEAR. THE PAYMENT IS INCLUDED IN PART VII, COLUMN D (E) AND SCHEDULE J, PART II, COLUMN B(III). THE TERMS AND CONDITIONS OF THE CONFIDENTIAL SEVERANCE AGREEMENT ARE AVAILABLE TO THE INTERNAL REVENUE SERVICE UPON REQUEST. PIH HEALTH INC. AND ITS AFFILIATES PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR CERTAIN EXECUTIVES. THE FOLLOWING INDIVIDUALS PARTICIPATE IN THE PLAN: JAMES WEST PEGGY CHULACK VID SHIVARAMAN BRIAN SMOLSKIS IRENA ZUANIC MOHAMMED GHONIM KEVIN BROWN THE FOLLOWING AMOUNTS BECAME VESTED OR WERE PAID-OUT IN 2022 AND ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III): JAMES WEST $517,243 PEGGY CHULACK $120,897 VID SHIVARAMAN $61,131 BRIAN SMOLSKIS $188,312

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2	THE ORGANIZATION IS A MEMBER OF AN INTEGRATED HEALTHCARE SYSTEM CONTROLLED BY PIH HEALTH, INC. THE FOLLOWING INDIVIDUALS HAVE A BUSINESS RELATIONSHIP BY VIRTUE OF THEIR POSITIONS AS OFFICERS OR DIRECTORS OF RELATED ENTITIES WITHIN THE SYSTEM: J. RICHARD ATWOOD, JEFFREY HAMAR, PAULA COWAN, ALEX ALVAREZ, BLAYNE CUTLER, JANE DICUS, PATRICK MONROE, CHARLOTTE WEAVER, KENTON WOODS, PETER GREANEY, PAUL TREINEN, JAMES WEST, PEGGY CHULACK, VID SHIVARAMAN, ROSALIO LOPEZ, MARISSA GOLDBERG, MELANIE BATISTE, ROBERT MALONEY, BRIAN SMOLSKIS, JAY BROWN AND WILLIAM ROTH.
FORM 990, PART VI, SECTION A, LINE 6	PIH HEALTH, INC. IS THE SOLE MEMBER OF PIH HEALTH GOOD SAMARITAN HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A	PIH HEALTH, INC. HAS AUTHORITY TO ELECT ALL THE MEMBERS OF THE BOARD OF DIRECTORS OF PIH HEALTH GOOD SAMARITAN HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B	PIH HEALTH, INC. HAS ALL VOTING RIGHTS AND THE POWER TO ELECT THE BOARD OF DIRECTORS OF PIH HEALTH GOOD SAMARITAN HOSPITAL.
FORM 990, PART VI, SECTION B, LINE 11B	THE ORGANIZATION WORKS WITH AN INDEPENDENT ACCOUNTANT, KPMG LLP, TO PREPARE THE FORM 990. ONCE THE RETURN IS PREPARED, THE RETURN IS REVIEWED BY THE CHIEF FINANCIAL OFFICER AND VP OF FINANCE. FORM 990 IS THEN REVIEWED BY THE AUDIT COMMITTEE OF PIH HEALTH, INC., WHICH IS MADE UP OF INDEPENDENT DIRECTORS. KPMG LLP MAKES ALL CHANGES NECESSARY. THE FINAL FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C	EACH YEAR, ALL MANAGEMENT AND BOARD OF DIRECTORS MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. ALL POSITIVE RESPONSES ARE REVIEWED BY THE GENERAL COUNSEL AND CHIEF ADMINISTRATIVE OFFICER OF PIH HEALTH, INC. EACH POSITIVE RESPONSE IS CONSIDERED IN LIGHT OF MAGNITUDE OF OWNERSHIP INTEREST, FINANCIAL TRANSACTION(S), ETC. IF DEEMED NECESSARY, CONFLICTS OF INTEREST COULD BE RESOLVED BY INSISTING THAT THE INCUMBENT EITHER DIVEST THEIR OWNERSHIP INTEREST, THAT THE ORGANIZATION TERMINATE THE BUSINESS RELATIONSHIP, OR EVEN THAT THE DIRECTOR RESIGN. DIRECTORS WITH POTENTIAL CONFLICTS OF INTEREST MAY RECUSE THEMSELVES FROM VOTING ON CERTAIN MATTERS AND/OR MAY EXCUSE THEMSELVES FROM MEETINGS DURING THE DISCUSSION, DELIBERATION, AND VOTING ON OF MATTERS.
FORM 990, PART VI, SECTION C, LINE 19	PIH HEALTH GOOD SAMARITAN HOSPITAL'S ORGANIZING AND GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. THE FINANCIAL INFORMATION FROM THE FINANCIAL STATEMENTS IS INCLUDED IN THE ORGANIZATION'S FORM 990, WHICH IS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 16B:	PIH HEALTH GOOD SAMARITAN HOSPITAL HOLDS A 10.4% INTEREST A JOINT VENTURE ARRANGEMENT THAT EXISTS TO FURTHER THE CHARITABLE AND COMMUNITY-BASED HEALTH CARE PURPOSES, MISSION, VISION, AND VALUES OF ITS CONTROLLING TAX EXEMPT MEMBERS. PIH HEALTH GOOD SAMARITAN HOSPITAL ANNUALLY EVALUATES ITS PARTICIPATION IN JOINT VENTURE ARRANGEMENTS.
FORM 990, PART VII, SECTION A, LINE 1:	ONE OF THE FILING ORGANIZATION'S OFFICERS, ROSALIO LOPEZ, RECEIVES COMPENSATION FOR DIRECTORSHIP FROM PIH HEALTH DOWNEY MEDICAL GROUP, INC. (DMG), WHICH HAS A PROFESSIONAL SERVICE AGREEMENT WITH PIH HEALTH PHYSICIANS, AN AFFILIATE OF THE FILING ORGANIZATION, TO PROVIDE PHYSICIAN SERVICES. THE INDIVIDUALS RECEIVED COMPENSATION FROM DMG, AS FOLLOWS: ROSALIO LOPEZ: REPORTABLE BASE COMPENSATION - $70,464 OTHER COMPENSATION - $0
FORM 990, PART IX, LINE 11G	PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 11,143,515. MANAGEMENT AND GENERAL EXPENSES -13,882. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,129,633. CONSULTING & MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 160,309. MANAGEMENT AND GENERAL EXPENSES 913,592. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,073,901. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 3,976,247. MANAGEMENT AND GENERAL EXPENSES 32,335. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,008,582. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 10,500. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,500. MEDICAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,629,724. MANAGEMENT AND GENERAL EXPENSES 94,800. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,724,524. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 4,812,662. MANAGEMENT AND GENERAL EXPENSES 220,077. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,032,739. SOFTWARE MAINTENANCE: PROGRAM SERVICE EXPENSES 3,140,763. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,140,763. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 26,708,129. MANAGEMENT AND GENERAL EXPENSES 6,107,195. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,815,324. OUTSIDE PROVIDER COST: PROGRAM SERVICE EXPENSES 19,903,743. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,903,743. PURCHASED LABOR: PROGRAM SERVICE EXPENSES 15,139,510. MANAGEMENT AND GENERAL EXPENSES 12,967. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,152,477.
FORM 990, PART XI, LINE 9:	ACCRUED MINIMUM PENSION LIABILITY 2,041,649. NET ASSETS RELEASED FROM RESTRICTIONS - OPERATIONS 12,274. OTHER INTERCOMPANY TRANSFERS (EXPENSES PAID BY GSH) 300,100.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 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	Direct Controlling NADirectControllingNACd
GOOD SAMARITAN INSTITUTE FOR RESEARCH AND EDUCATION
1225 WILSHIRE BLVD	LOS ANGELES	CA	90017	954077161	HEART RESEARCH	CA	501(C) (3)	LINE 4	PIH HEALTH GOOD SAMARITAN HOSPITAL	Yes (1)
ORTHOPEDIC INSTITUTE OF THE GOOD SAMARITAN HOSPITAL
1225 WILSHIRE BLVD	LOS ANGELES	CA	90017	954346048	ORTHOPEDIC RESEARCH	CA	501(C) (3)	LINE 12A, I	PIH HEALTH GOOD SAMARITAN HOSPITAL	Yes (1)
SAMARITAN IMAGING CENTER
1225 WILSHIRE BLVD	LOS ANGELES	CA	90017	954252321	OUTPATIENT IMAGING	CA	501(C) (3)	LINE 10	PIH HEALTH GOOD SAMARITAN HOSPITAL	Yes (1)
GOOD SAMARITAN MEDICAL OFFICE BUILDING INC
1225 WILSHIRE BLVD	LOS ANGELES	CA	90017	953244046	PHYSICIANS MEDICAL OFFICES	CA	501(C) (3)	LINE 12A, I	PIH HEALTH GOOD SAMARITAN HOSPITAL	Yes (1)
KATE VAN NUYS PAGE FOUNDATION
12401 WASHINGTON BLVD	LOS ANGELES	CA	90602	956028032	GRANTS INCOME TO GOOD SAMARITAN HOSPITAL	CA	501(C) (3)	LINE 12A, I	PIH HEALTH GOOD SAMARITAN HOSPITAL	Yes (1)
PIH HEALTH ADULT DAY HEALTHCARE
12401 WASHINGTON BLVD	LOS ANGELES	CA	90602	953643829	SUPPORT OF TAX-EXEMPT AFFILIATES	CA	501(C) (3)	LINE 12B, II	PIH HEALTH INC	Yes (1)
PIH HEALTH FOUNDATION
12401 WASHINGTON BLVD	LOS ANGELES	CA	90602	953761274	FUNDRAISING	CA	501(C) (3)	LINE 7	PIH HEALTH INC	Yes (1)
PIH HEALTH HOME HEALTHCARE
12401 WASHINGTON BLVD	LOS ANGELES	CA	90602	953036281	SUPPORT OF TAX-EXEMPT AFFILIATES	CA	501(C) (3)	LINE 12B, II	PIH HEALTH INC	Yes (1)
PIH HEALTH DOWNEY HOSPITAL
11500 BROOKSHIRE AVE	LOS ANGELES	CA	90017	951903935	HEALTHCARE	CA	501(C) (3)	LINE 3	PIH HEALTH INC	Yes (1)
PIH HEALTH WHITTIER HOSPITAL
12401 WASHINGTON BLVD	LOS ANGELES	CA	90602	951934652	HEALTHCARE	CA	501(C) (3)	LINE 3	PIH HEALTH INC	Yes (1)
PIH HEALTH MANAGEMENT CORP
12401 WASHINGTON BLVD	LOS ANGELES	CA	90602	954016278	SUPPORT OF TAX-EXEMPT AFFILIATES	CA	501(C) (3)	LINE 12B, II	PIH HEALTH INC	Yes (1)
PIH HEALTH PHYSICIANS
6557 GREENLEAF AVE	LOS ANGELES	CA	90601	953942828	HEALTHCARE	CA	501(C) (3)	LINE 10	PIH HEALTH INC	Yes (1)
PIH HEALTH INC
12401 WASHINGTON BLVD	LOS ANGELES	CA	90602	953619388	SUPPORT OF TAX-EXEMPT AFFILIATES	CA	501(C) (3)	LINE 12B, II		0	N/A
AUXILIARY OF THE HOSPITAL OF THE GOOD SAMARITAN
1225 WILSHIRE BLVD	LOS ANGELES	CA	90017	956051253	WELFARE OF THE GOOD SAMARITAN HOSPITAL	CA	501(C) (3)	LINE 12C, III-FI		0	N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
PIH HEALTH INSURANCE COMPANY
733 BISHOP STREET STE 1555	HONOLULU	HI	96813	263760243	CAPTIVE INSURANCE	HI	N/A	T	Yes (1)
PIH HEALTH CARE SOLUTIONS
6557 GREENLEAF AVENUE	WHITTIER	CA	90601	462072342	HEALTHCARE	CA	N/A	C	Yes (1)
DRMC PROPERTIES INC
12401 WASHINGTON BLVD	WHITTIER	CA	90602	954769768	REAL ESTATE	CA	N/A	C	Yes (1)
PIH HEALTH RE
733 BISHOP STREET STE 1555	HONOLULU	HI	96813	472501390	CAPTIVE INSURANCE	HI	N/A	T	Yes (1)
HEALTHMED SERVICES INC
12401 WASHINGTON BLVD	WHITTIER	CA	90602	300831225	HEALTHCARE	CA	N/A	C	Yes (1)
PIONEER MEDICAL GROUP INC
12401 WASHINGTON BLVD	WHITTIER	CA	90602	330927283	MEDICAL SERVICES	CA	N/A	C	Yes (1)
PIONEER PROVIDER NETWORK A MEDICAL GROUP INC
12401 WASHINGTON BLVD	WHITTIER	CA	90602	330922631	MANAGEMENT SERVICES	CA	N/A	C	Yes (1)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (1)	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	0	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	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	0	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
GOOD SAMARITAN HOSPITAL MEDICAL OFFICE BUILDING INC
A	$5,642,809	FMV
GOOD SAMARITAN HOSPITAL MEDICAL OFFICE BUILDING INC
K	$2,711,817	FMV
GOOD SAMARITAN INSTITUTE FOR RESEARCH AND EDUCATION
B	$300,100	FMV
KATE VAN NUYS PAGE FOUNDATION
C	$126,162	FMV