PIH HEALTH GOOD SAMARITAN HOSPITAL: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- PIH HEALTH GOOD SAMARITAN HOSPITAL (EIN 95-1656366)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-07-07
- IRS object ID
- 202321889349301177
- Schema version
- 2021v4.2
- 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 | 2023-07-07T16:47:18-05:00 | ReturnTs |
| Tax Period End | 2022-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RSM US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 30 South Wacker Dr Suite 3300 | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606063392 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | 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 | 2139772121 | PhoneNum |
| Signature | 2023-06-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Vid | PersonFirstNm |
| Person Last | Shivaraman | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Rebekuh Eley | PreparerPersonNm |
| PTIN | P01247672 | PTIN |
| Phone | 3126343400 | PhoneNum |
| Preparation | 2023-06-28 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | 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 | $473,668,615 | 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 of our communities in an ethical, safe and fiscally prudent manner, in recognition of our charitable purpose. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 1977 | TotalEmployeeCnt |
| Total Volunteers | 326 | TotalVolunteersCnt |
| Total Gross UBI | $137,469 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $15,082,179 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,256,557 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $400,932,901 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $394,173,438 | CYProgramServiceRevenueAmt |
| PY Investment Income | $12,384,612 | PYInvestmentIncomeAmt |
| CY Investment Income | $30,119,687 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,637,121 | PYOtherRevenueAmt |
| CY Other Revenue | $6,371,765 | CYOtherRevenueAmt |
| PY Total Revenue | $436,036,813 | PYTotalRevenueAmt |
| CY Total Revenue | $435,921,447 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $53,083 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $238,180 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $185,710,516 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $181,281,254 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $39,053 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $268,873,341 | PYOtherExpensesAmt |
| CY Other Expenses | $254,205,924 | CYOtherExpensesAmt |
| PY Total Expenses | $454,636,940 | PYTotalExpensesAmt |
| CY Total Expenses | $435,725,358 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$18,600,127 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $196,089 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $663,025,397 | TotalAssetsBOYAmt |
| Total Assets EOY | $607,219,911 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $193,503,519 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $171,956,806 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $469,521,878 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $435,263,105 | 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 | $223,608,024 | ExpenseAmt |
| Grant | $238,180 | GrantAmt |
| Revenue | $279,994,580 | 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 2021-2022Employees 1,977Volunteers 326Number of Emergency Department (ED) visits 47,761Number of Births 1,543Medical Staff 691 | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $167,876,289 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $113,430,472 | 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 350% 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: 35,167 | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,180,342 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $748,386 | 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:- 20,935 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:- 75 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:- $440,862 in expenses were incurred in subsidized services in Fiscal Year 2021-2022RESEARCH: 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 $193,559 in expenses have been incurred in research in Fiscal Year 2021-2022CASH & 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:- 3,390 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: 21,253 For additional information, please refer to PIH Health's community benefit report at https://www.pihhealth.org/about-us/community-benefit/ | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $397,664,655 | 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 | 0 | 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 | 309 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1977 | 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 | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | 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 (29 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Patrick Monroe | ||||||||||
| Trustee & Chair | 1.50 | 6.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Charlotte Weaver PhD | ||||||||||
| Trustee & Vice Chair | 1.50 | 6.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Jeffrey Hamar | ||||||||||
| Trustee & Treasurer | 1.50 | 6.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Peter Greaney MD | ||||||||||
| Trustee & Secretary | 1.50 | 6.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Alex Alvarez | ||||||||||
| Trustee | 1.50 | 6.00 | Yes (X) | $0 | $0 | $0 | ||||
| J Richard Atwood | ||||||||||
| Trustee | 1.50 | 7.50 | Yes (X) | $0 | $0 | $0 | ||||
| Melanie Batiste | ||||||||||
| Trustee | 1.50 | 6.00 | Yes (X) | $0 | $0 | $0 | ||||
| Paula Cowan | ||||||||||
| Trustee | 1.50 | 6.00 | Yes (X) | $0 | $0 | $0 | ||||
| Blayne Cutler MD PhD | ||||||||||
| Trustee | 1.50 | 6.00 | Yes (X) | $0 | $0 | $0 | ||||
| Jane Dicus | ||||||||||
| Trustee | 1.50 | 6.00 | Yes (X) | $0 | $0 | $0 | ||||
| Marissa Goldberg | ||||||||||
| Trustee | 1.50 | 6.00 | Yes (X) | $0 | $0 | $0 | ||||
| Wesley Heartfield MD | ||||||||||
| Trustee | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| Robert Maloney MD | ||||||||||
| Trustee | 1.50 | 6.00 | Yes (X) | $0 | $0 | $0 | ||||
| Paul Treinen | ||||||||||
| Trustee | 1.50 | 6.00 | Yes (X) | $0 | $0 | $0 | ||||
| Kenton Woods | ||||||||||
| Trustee | 1.50 | 6.00 | Yes (X) | $0 | $0 | $0 | ||||
| James West | ||||||||||
| System President & CEO | 10.00 | 43.20 | Yes (X) | $0 | $2,763,938 | $340,079 | ||||
| Rosalio Lopez MD | ||||||||||
| Chief Strategy Officer | 10.00 | 36.20 | Yes (X) | $0 | $1,573,688 | $212,248 | ||||
| Peggy Chulack | ||||||||||
| System CAO & Asst. Secretary | 10.00 | 43.20 | Yes (X) | $0 | $1,058,662 | $164,469 | ||||
| Vid Shivaraman | ||||||||||
| System CFO & Assistant Treasurer | 10.00 | 43.20 | Yes (X) | $0 | $702,914 | $118,060 | ||||
| Irena Zuanic | ||||||||||
| CNO & Co-Site Admin. | 40.00 | 0.00 | Yes (X) | $0 | $336,137 | $94,125 | ||||
| Jaime Diaz MD | ||||||||||
| CMO & Co-Site Admin. (Until 9/2022) | 40.00 | 0.00 | Yes (X) | $378,851 | $138,688 | $24,210 | ||||
| Brian Smolskis | ||||||||||
| System COO | 10.00 | 37.70 | Yes (X) | $0 | $1,029,190 | $176,975 | ||||
| Jean Meussner | ||||||||||
| VP Human Resources (Until 9/2021) | 0.00 | 0.00 | $554,338 | $0 | $22,774 | Yes (X) | ||||
| Hilarion Castillo | ||||||||||
| Controller | 40.00 | 0.00 | $293,812 | $0 | $18,678 | Yes (X) | ||||
| Ira Meiselman | ||||||||||
| Director Managed Care | 40.00 | 0.00 | $276,206 | $0 | $27,995 | Yes (X) | ||||
| Noli Perillo | ||||||||||
| Staff RN | 40.00 | 0.00 | $271,079 | $0 | $15,995 | Yes (X) | ||||
| Maria Chacon | ||||||||||
| Staff RN | 40.00 | 0.00 | $269,516 | $0 | $17,090 | Yes (X) | ||||
| Jing Cheung | ||||||||||
| Staff RN | 40.00 | 0.00 | $263,722 | $0 | $14,180 | Yes (X) | ||||
| Anita Chou | ||||||||||
| Former CFO & Asst. Treasurer | 0.00 | 0.00 | $0 | $1,100,156 | $21,568 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,307,524 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,703,373 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,268,446 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 637 | 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 | |||||
| PO Box 404674 | Atlanta | GA | 30384 | Nursing Registry Services | $25,567,992 |
| Morrison Management Specialists | |||||
| 5801 Peachtree Dunwoody Road | Atlanta | GA | 30342 | Dietary Services | $4,659,401 |
| RehabCare Group of California LLC | |||||
| PO Box 502096 | St Louis | MO | 63150 | Rehabilitation Services | $3,639,606 |
| Sodexo America LLC | |||||
| 9801 Washington Blvd | Gaithersburg | MD | 20878 | Dietary Services | $2,929,558 |
| Crothall Healthcare Inc | |||||
| 955 Chesterbrook Blvd Ste 300 | Wayne | PA | 19087 | Environmental Services | $2,870,816 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 74 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $2,225,149 | RelatedOrganizationsAmt |
| Government Grants | $1,319,656 | GovernmentGrantsAmt |
| All Other Contributions | $1,711,752 | AllOtherContributionsAmt |
| Total Contributions | $5,256,557 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Revenue | 621990 | $341,673,275 | $341,673,275 |
| Hospital Fee Program | 900099 | $52,411,344 | $52,411,344 |
| Rental Income | 532000 | $88,819 | $88,819 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $394,173,438 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,129,801 | TotalRevenueColumnAmt |
| Exclusion | $20,129,801 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $47,725,022 | SecuritiesAmt |
| Other | $12,032 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $37,747,168 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $9,977,854 | SecuritiesAmt |
| Other | $12,032 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,989,886 | TotalRevenueColumnAmt |
| Exclusion | $9,989,886 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Parking Lot | 812930 | $2,084,999 | $74,654 | $2,010,345 |
| Physician Mngmt Svcs | 621110 | $39,150 | $39,150 | |
| Child Care Center | 624410 | -$641 | -$212 | -$429 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,248,257 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $23,877 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,224,380 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $6,371,765 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $435,921,447 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $394,173,438 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $137,469 | UnrelatedBusinessRevenueAmt |
| Exclusion | $36,353,983 | 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 | $238,180 | TotalAmt |
| Program Services | $238,180 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $451,833 | TotalAmt |
| Program Services | $316,283 | ProgramServicesAmt |
| Management And General | $135,550 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,986,659 | TotalAmt |
| Program Services | $125,250,380 | ProgramServicesAmt |
| Management And General | $5,736,279 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,773,819 | TotalAmt |
| Program Services | $4,594,146 | ProgramServicesAmt |
| Management And General | $179,673 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,734,729 | TotalAmt |
| Program Services | $32,287,128 | ProgramServicesAmt |
| Management And General | $1,447,601 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,334,214 | TotalAmt |
| Program Services | $10,947,217 | ProgramServicesAmt |
| Management And General | $386,997 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $547,696 | TotalAmt |
| Management And General | $547,696 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$202,227 | TotalAmt |
| Management And General | -$202,227 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,014 | TotalAmt |
| Management And General | $101,014 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $234,523 | TotalAmt |
| Management And General | $234,523 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,633,459 | TotalAmt |
| Program Services | $94,031,345 | ProgramServicesAmt |
| Management And General | $6,686,385 | ManagementAndGeneralAmt |
| Fundraising | -$84,271 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $305,873 | TotalAmt |
| Program Services | $43,899 | ProgramServicesAmt |
| Management And General | $261,974 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,740,480 | TotalAmt |
| Program Services | $2,693,381 | ProgramServicesAmt |
| Management And General | $47,099 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $808 | TotalAmt |
| Program Services | $808 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $957 | TotalAmt |
| Program Services | $957 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,510,813 | TotalAmt |
| Program Services | $5,265,406 | ProgramServicesAmt |
| Management And General | $1,245,407 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,819,796 | TotalAmt |
| Management And General | $1,819,796 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Supplies | $77,280,935 | $77,092,527 | $188,173 | $235 |
| Hospital Fee Program | $29,670,858 | $29,670,858 | ||
| Bad Debt Expense | $15,723,327 | $15,723,327 | ||
| Utilities | $6,242,891 | $6,213,697 | $29,194 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,594,721 | TotalAmt |
| Program Services | $9,018,443 | ProgramServicesAmt |
| Management And General | $3,453,189 | ManagementAndGeneralAmt |
| Fundraising | $123,089 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $435,725,358 | TotalAmt |
| Program Services | $397,664,655 | ProgramServicesAmt |
| Management And General | $38,021,650 | ManagementAndGeneralAmt |
| Fundraising | $39,053 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $976,293 | BOYAmt |
| EOY | $2,406,617 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,200,000 | BOYAmt |
| EOY | $1,367,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,185,535 | BOYAmt |
| EOY | $92,194,351 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,533,573 | BOYAmt |
| EOY | $5,549,268 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,086,698 | BOYAmt |
| EOY | $6,115,499 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $336,960,898 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $24,967,391 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $293,582,346 | BOYAmt |
| EOY | $311,993,507 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,045,419 | BOYAmt |
| EOY | $84,859,495 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $182,415,533 | BOYAmt |
| EOY | $102,734,174 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $663,025,397 | BOYAmt |
| EOY | $607,219,911 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,772,461 | BOYAmt |
| EOY | $95,666,268 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,731,058 | BOYAmt |
| EOY | $76,290,538 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,503,519 | BOYAmt |
| EOY | $171,956,806 | 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 | $400,357,909 | BOYAmt |
| EOY | $361,127,939 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,163,969 | BOYAmt |
| EOY | $74,135,166 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $469,521,878 | BOYAmt |
| EOY | $435,263,105 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $663,025,397 | BOYAmt |
| EOY | $607,219,911 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $196,089 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$35,348,135 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $893,273 | 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 | $101,014 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $101,014 | 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 | $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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| 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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| 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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| 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 |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $73,767,150 | BeginningYearBalanceAmt |
| Contributions | $108,951 | ContributionsAmt |
| Investment Earnings Or Losses | $4,068,889 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,875,119 | OtherExpendituresAmt |
| Administrative Expenses | $36,579 | AdministrativeExpensesAmt |
| End Year Balance | $72,033,292 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.16252 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.79385 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.04363 | 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 | $44,751,537 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,819,246 | DepreciationAmt |
| Book Value | $40,932,291 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $50,354,725 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,765,020 | DepreciationAmt |
| Book Value | $31,589,705 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $37,705,163 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,383,125 | DepreciationAmt |
| Book Value | $35,322,038 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $311,993,507 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Intercompany Receivable | $50,026,824 |
| Right-of-Use Assets | $293,420 |
| Hospital Fee Program Receivable | $45,019,782 |
| Self-Insurance receivable - current portion | $2,545,300 |
| Other notes and loan receivable | $4,848,848 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $102,734,174 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (10 entries)
| DescDesc | AmtAmt |
|---|---|
| Advances from Third Party Payors | $7,030,253 |
| CARES Act Provider Relief Funds | $5,622,435 |
| Other Annuity Payment Liability | $1,578,521 |
| Hospital Fee Payable | $29,166,044 |
| Other Liabilities | $263,044 |
| Other Long Term Reserves | $8,263,787 |
| Pension Plan | $9,069,940 |
| Reserve for Asset Retirement Obligation | $12,521,955 |
| Reserve for Self-Insured Programs | $2,518,671 |
| Right-of-Use Liability | $255,888 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $76,290,538 | 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, 2022 or 2021. 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 2018 for federal purposes and 2016 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 |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| 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 | 7137 | PersonsServedCnt |
| Total Community Benefit Expns | $4,869,318 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,869,318 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01160 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 28030 | PersonsServedCnt |
| Total Community Benefit Expns | $161,093,357 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $113,430,472 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $47,662,885 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11350 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 35167 | PersonsServedCnt |
| Total Community Benefit Expns | $165,962,675 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $113,430,472 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $52,532,203 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12510 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 20935 | PersonsServedCnt |
| Total Community Benefit Expns | $3,075,146 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,124 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,056,022 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00730 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 75 | PersonsServedCnt |
| Total Community Benefit Expns | $2,350,397 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $719,167 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,631,230 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 25 | PersonsServedCnt |
| Total Community Benefit Expns | $474,390 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $474,390 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 209 | PersonsServedCnt |
| Total Community Benefit Expns | $203,654 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,095 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $193,559 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 9 | PersonsServedCnt |
| Total Community Benefit Expns | $76,755 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $76,755 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 16 | ActivitiesOrProgramsCnt |
| Persons Served | 21253 | PersonsServedCnt |
| Total Community Benefit Expns | $6,180,342 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $748,386 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,431,956 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01300 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 16 | ActivitiesOrProgramsCnt |
| Persons Served | 56420 | PersonsServedCnt |
| Total Community Benefit Expns | $172,143,017 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $114,178,858 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $57,964,159 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13810 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $761,793 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $88,992,311 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $102,291,248 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$13,298,937 | 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 | 21 | 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 | See Part V, Page 8 | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Part V, Page 8 | 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 | 350.000000000000 | 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 | See Part V, Page 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Part V, Page 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See Part V, Page 8 | 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 (10 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 athttps://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. |
| Part V, Section B, Line 7, CHNA Policy Website: | https://www.pihhealth.org/about-us/community-benefit/ |
| Part V, Section B, Line 10, Implementation Strategy Website: | https://www.pihhealth.org/wellness/community-benefit/ |
| Part V, Section B, Line 16a, FAP website: | https://www.pihhealth.org/patients-visitors/billing-financial-assistance/financial-assistance/ |
| Part V, Section B, Line 16b, FAP Application website: | https://www.pihhealth.org/patients-visitors/billing-financial-assistance/financial-assistance/ |
| Part V, Section B, Line 16c, FAP Plain Language Summary website: | https://www.pihhealth.org/patients-visitors/billing-financial-assistance/financial-assistance/ |
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/ea2d53fa-d864-4c4f-aacf-39799409ebaf/PIH_Health_Good_Samaritan_Hospital_FY22_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 Medi-Cal cost. Actual costs from general ledger or departments were used for all other Costs. |
| Part I, Line 7, Column (f): | The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 15,723,327. |
| Part III, Line 2: | Bad debt expense is determined by applying cost to charge ratio to 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, 2022: "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 2022 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 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, 67.7% 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 0.2% are Native Hawaiian/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 1,459 PIH Health volunteers collectively contributed 116,429 hours of service, supporting departments throughout the organization. |
| 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 nonnprofit 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 (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| Good Samaritan Institute for Research Education | ||||||||
| 1225 Wilshire Blvd | Los Angeles | CA | 90017 | 954077161 | 501(c)(3) | $196,738 | $0 | Expenses paid by the Organization |
| Rampart Pal | ||||||||
| 8726 S Sepulveda Blvd Suite D132 | Los Angeles | CA | 90045 | 954675764 | 501(c)(3) | $10,392 | $0 | To purchase first aid kits for Rampart Police Substation patrol vehicles |
| Cultivala Inc | ||||||||
| 1723 James M Wood Blvd | Los Angeles | CA | 90015 | 842062123 | 501(c)(3) | $6,700 | $0 | To support the mission of Cultivala Inc |
| Breastfeeding Task Force of Greater Los Angeles | ||||||||
| 2851 W 120th Street Suite E 335 | Hawthorne | CA | 90250 | 954861413 | 501(c)(3) | $6,325 | $0 | To support the mission of Breastfeed LA |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 4 | 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 | 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 (14 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 | $1,403,776 | $0 | $1,129,582 | $0 | $230,580 | $0 | $320,688 | $0 | $19,391 | $0 | $3,104,017 | $0 | $210,464 |
| Rosalio Lopez MD | ||||||||||||||
| Chief Strategy Officer | $0 | $848,206 | $0 | $336,481 | $0 | $389,001 | $0 | $203,006 | $0 | $9,242 | $0 | $1,785,936 | $0 | $381,303 |
| Peggy Chulack | ||||||||||||||
| System CAO & Asst. Secretary | $0 | $701,640 | $0 | $347,513 | $0 | $9,509 | $0 | $150,342 | $0 | $14,127 | $0 | $1,223,131 | $0 | $0 |
| Brian Smolskis | ||||||||||||||
| System COO | $0 | $697,337 | $0 | $323,736 | $0 | $8,117 | $0 | $155,902 | $0 | $21,073 | $0 | $1,206,165 | $0 | $0 |
| Anita Chou | ||||||||||||||
| Former CFO & Asst. Treasurer | $0 | $113,900 | $0 | $142,450 | $0 | $843,806 | $0 | $8,041 | $0 | $13,527 | $0 | $1,121,724 | $0 | $233,343 |
| Vid Shivaraman | ||||||||||||||
| System CFO & Assistant Treasurer | $0 | $516,146 | $0 | $180,469 | $0 | $6,299 | $0 | $111,770 | $0 | $6,290 | $0 | $820,974 | $0 | $0 |
| Jean Meussner | ||||||||||||||
| VP Human Resources (Until 9/2021) | $238,415 | $0 | $0 | $0 | $315,923 | $0 | $9,217 | $0 | $13,557 | $0 | $577,112 | $0 | $0 | $0 |
| Jaime Diaz MD | ||||||||||||||
| CMO & Co-Site Admin. (Until 9/2022) | $378,851 | $138,615 | $0 | $0 | $0 | $73 | $2,808 | $0 | $19,629 | $1,773 | $401,288 | $140,461 | $0 | $0 |
| Irena Zuanic | ||||||||||||||
| CNO & Co-Site Admin. | $0 | $264,750 | $0 | $65,869 | $0 | $5,518 | $0 | $80,394 | $0 | $13,731 | $0 | $430,262 | $0 | $0 |
| Hilarion Castillo | ||||||||||||||
| Controller | $286,294 | $0 | $7,241 | $0 | $277 | $0 | $9,042 | $0 | $9,636 | $0 | $312,490 | $0 | $0 | $0 |
| Ira Meiselman | ||||||||||||||
| Director Managed Care | $271,098 | $0 | $5,108 | $0 | $0 | $0 | $8,898 | $0 | $19,097 | $0 | $304,201 | $0 | $0 | $0 |
| Noli Perillo | ||||||||||||||
| Staff RN | $268,979 | $0 | $2,100 | $0 | $0 | $0 | $9,100 | $0 | $6,895 | $0 | $287,074 | $0 | $0 | $0 |
| Maria Chacon | ||||||||||||||
| Staff RN | $264,716 | $0 | $4,800 | $0 | $0 | $0 | $7,445 | $0 | $9,645 | $0 | $286,606 | $0 | $0 | $0 |
| Jing Cheung | ||||||||||||||
| Staff RN | $261,322 | $0 | $2,400 | $0 | $0 | $0 | $7,875 | $0 | $6,305 | $0 | $277,902 | $0 | $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 | Part I, Line 4A: Anita Chou and Jean Meussner 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. Part I, Line 4B: PIH Health Inc. and its affiliates provides a supplemental executive retirement plan for certain executives. The following individuals participate in the plan: Anita Chou Brian Smolskis James West Peggy Chulack Rosalio Lopez Vid Shivaraman The following amounts became vested or were paid-out in 2021 and are included in Schedule J, Part II, Column (b)(iii): Anita Chou: $233,343 James West $210,464 Rosalio Lopez $381,303 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 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, and Brian Smolskis. |
| 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, RSM US 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. RSM US 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 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 9.8% 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, is an employee of 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 - $72,736 Other Compensation - $0 |
| Form 990, Part IX, line 11g | Physician Fees: Program service expenses 13,961,854. Management and general expenses 0. Fundraising expenses 0. Total expenses 13,961,854. Consulting and Management Fees: Program service expenses 0. Management and general expenses 9,687. Fundraising expenses -90,000. Total expenses -80,313. Other Contracted Services: Program service expenses 3,814,794. Management and general expenses 8,468. Fundraising expenses 0. Total expenses 3,823,262. Other Professional Fees: Program service expenses 17,494. Management and general expenses 16,970. Fundraising expenses 0. Total expenses 34,464. Medical Purchased Services: Program service expenses 4,062,978. Management and general expenses 94,800. Fundraising expenses 0. Total expenses 4,157,778. Repairs and Maintenance: Program service expenses 4,388,384. Management and general expenses 239,808. Fundraising expenses 0. Total expenses 4,628,192. Software Maintenance : Program service expenses 3,676,318. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,676,318. Collection Fees: Program service expenses 0. Management and general expenses 71,020. Fundraising expenses 0. Total expenses 71,020. Other Purchased Services: Program service expenses 22,711,806. Management and general expenses 6,245,632. Fundraising expenses 5,729. Total expenses 28,963,167. Outside Provider Cost : Program service expenses 18,708,276. Management and general expenses 0. Fundraising expenses 0. Total expenses 18,708,276. Purchased Labor: Program service expenses 22,689,441. Management and general expenses 0. Fundraising expenses 0. Total expenses 22,689,441. |
| Form 990, Part X, Column A, Line 7: | The FY21 amount in line 7 of $176,172,569 was moved to line 15 to match the FY22 presentation. The amounts in line 7 were all moved to line 15 as other assets with the detail being shown on Form 990, Schedule D, Part IX. |
| Form 990, Part XI, line 9: | Accrued Minimum Pension Liability 659,617. Intercompany Transfer 185,388. Grant Refund 41,442. Net Assets Released from Restrictions 6,826. |
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 Services | 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 | |||||||||||
| 1225 Wilshire Blvd | Los Angeles | CA | 90017 | 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 Boulevard | Whittier | 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 Boulevard | Whittier | CA | 90602 | 953761274 | Fundraising | CA | 501(c)(3) | Line 7 | PIH Health Inc | Yes (1) | |
| PIH Health Home Healthcare | |||||||||||
| 12401 Washington Boulevard | Whittier | 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 Avenue | Downey | CA | 90241 | 951903935 | Healthcare | CA | 501(c)(3) | Line 3 | PIH Health Inc | Yes (1) | |
| PIH Health Whittier Hospital | |||||||||||
| 12401 Washington Boulevard | Whittier | CA | 90602 | 951934652 | Healthcare | CA | 501(c)(3) | Line 3 | PIH Health Inc | Yes (1) | |
| PIH Health Management Corp | |||||||||||
| 12401 Washington Boulevard | Whittier | 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 | Whittier | CA | 90601 | 953942828 | Healthcare | CA | 501(c)(3) | Line 10 | PIH Health Inc | Yes (1) | |
| PIH Health Inc | |||||||||||
| 12401 Washington Boulevard | Whittier | 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 |
|---|---|---|---|---|---|---|---|---|---|
| DRMC Properties Inc | |||||||||
| 11500 Brookshire Avenue | Downey | CA | 90241 | 954769768 | Real Estate | CA | N/A | C | Yes (1) |
| HealthMed Services Inc | |||||||||
| 12401 Washington Boulevard | Whittier | CA | 90602 | 300831225 | Healthcare | CA | N/A | C | Yes (1) |
| PIH Health Care Solutions | |||||||||
| 6557 Greenleaf Avenue | Whittier | CA | 90601 | 462072342 | Healthcare | CA | N/A | C | Yes (1) |
| PIH Health Insurance Company | |||||||||
| 1003 Bishop Street | Honolulu | HI | 96813 | 263760243 | Captive Insurance | HI | N/A | T | Yes (1) |
| PIH Health RE | |||||||||
| 1003 Bishop Street | Honolulu | HI | 96813 | 472501390 | Captive Insurance | HI | N/A | T | Yes (1) |
| Pioneer Medical Group Inc | |||||||||
| 12401 Washington Boulevard | Whittier | CA | 90602 | 330927283 | Medical Services | CA | N/A | C | Yes (1) |
| Pioneer Provider Network A Medical Group Inc | |||||||||
| 12401 Washington Boulevard | 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 (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Good Samaritan Hospital Medical Office Building Inc | ||
| A | $5,368,676 | FMV |
| Good Samaritan Hospital Medical Office Building Inc | ||
| K | $2,682,517 | FMV |
| Orthopedic Institute of the Good Samaritan Hospital | ||
| C | $1,661,372 | FMV |
| Good Samaritan Institute for Research and Education | ||
| C | $532,428 | FMV |
| Good Samaritan Institute for Research and Education | ||
| B | $196,738 | FMV |