2022-10-24T07:24:08-07:00 2021-12-31 990 2021-01-01 262813100 GOOD SAMARITAN HOSPITAL PHYSICIAN SERVICES INC GOOD 8128853333 520 South 7th Street Vincennes IN 47591 Robert McLin CEO 8128853333 2022-10-24 1 11 0 AAL2 2021 2022-09-23 18:48:47Z Robert McLin 520 South 7th Street Vincennes IN 47591 37072637 0 X www.gshvin.org X 2008 IN Provide excellent health care by promoting wellness, education and healing through trusting relationships. 5 0 344 0 0 0 2851305 2452761 0 0 12156 6247 30675342 34613629 33538803 37072637 0 0 0 0 49217662 50821862 0 0 0 6857401 7857406 56075063 58679268 -22536260 -21606631 2316393 3015196 1386439 1057054 929954 1958142 Provide excellent healthcare by promoting wellness, education and healing through trusting relationships. 0 0 56308472 0 0 Provide excellent healthcare by promoting wellness, education and healing through trusting relationships. 0 0 0 To provide excellent healthcare by promoting wellness and healing through trusting relationships 0 0 0 To provide excellent healthcare by promoting wellness and healing through trusting relationships 0 0 0 56308472 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 344 1 0 0 0 0 0 0 0 0 X 5 0 0 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 IN X Adam Thacker 8128858946 520 South 7th Street Vincennes IN 47591 Vikash Khurana MD Cardiologist 40 X 1018282 0 0 Brian Gebhardt MD Oncologist 40 X 764093 0 0 Philip Bacidore DO Cardiologist 40 X 738565 0 0 Elizabeth Ashworth MD Cardiologist 40 X 681742 0 0 Oluwagbenga Serrano MD Gastroenterologist 40 X 650089 0 0 Robert McLin President of the Board 0.25 X 0 0 0 Matt Schuckman Treasurer Of the Board 0.25 X 0 0 0 James Zeigler Chairman of the Board 0.25 X 0 0 0 3852771 0 0 81 0 1 0 Apogee Medical Management 15059 N Scottsdale Road Scottsdale AZ 85254 Hospitalist Management 3254737 Indiana University-Purdue University PO Box 78000 Detroit MI 482780920 GME Residency Management 1458085 Midwest Emergency Medicine 520 South 7th St Vincennes IN 47591 ER Physicians Management 1254307 CompHealth PO Box 972651 Dallas TX 753972651 Physician 1129065 John Pidgeon 212 South 10th Street Apt 1 Vincennes IN 47591 Physician 420000 12 0 0 0 1553945 898816 0 0 2452761 0 6247 6247 0 0 0 0 0 0 0 0 0 0 83833 0 0 0 83833 0 83833 83833 0 0 0 0 0 Physician Offices 561110 34529796 34529796 0 0 0 0 0 0 34529796 37072637 34619876 0 0 X 3996248 3996248 0 0 38756306 38756306 0 0 0 0 0 0 2223482 2223482 0 0 3918615 3918615 0 0 1927211 1927211 0 0 1657469 1657469 23832 23832 2694340 2694340 177355 177355 489904 489904 22086 22086 204190 204190 217434 217434 Dues & Subscriptions 58553 0 58553 0 Unassigned Claims 582598 0 582598 0 Bad Debt Expense 1729645 0 1729645 0 58679268 56308472 2370796 0 2316393 3015196 0 2316393 3015196 1386439 1057054 1386439 1057054 X 23466215 23564775 0 0 -22536261 -21606633 929954 1958142 2316393 3015196 X -21606631 0 0 0 0 22634819 X 0 1 X 1 0 X X 1 Good Samaritan Hospital 356001532 3 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 Vikash Khurana MD Cardiologist 0 561156 0 431133 0 25993 0 32659 0 50739 0 1101680 0 0 Brian Gebhardt MD Oncologist 0 378558 0 355779 0 29756 0 48891 0 40618 0 853602 0 0 Philip Bacidore DO Cardiologist 0 683838 0 544 0 54183 0 29008 0 31126 0 798699 0 0 Oluwagbenga Serrano MD Gastroenterologist 0 530484 0 57676 0 61929 0 62364 0 45813 0 758266 0 0 Elizabeth Ashworth MD Cardiologist 0 420518 0 10215 0 251009 0 17371 0 28138 0 727251 0 0 Form 990, Part VI, Section A, Line 1a There are no differences in voting rights. Form 990, Part VI, Section A, Line 6 The organization has members which are board members. Form 990, Part VI, Section A, Line 7a The members elect new officers annually. Form 990, Part VI, Section A, Line 7b Any decisions of the governing body are subject to approval by the board. Form 990, Part VI, Section B, Line 11b Form 990 is completed by the Financial Analyst and reviewed/approved by the Director of Accounting. Form 990, Part VI, Section B, Line 12c Directors complete the conflict of interest statements for Good Samaritan on an annual basis. Form 990, Part VI, Section B, Line 15 The process for determining the compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. Form 990, Part VI, Section C, Line 19 They are made available upon written request. Form 990, Part IX, Line 9 Good Samaritan Hospital Physician Services, Inc. and Good Samaritan Hospital have written off inter-company loans between them per independent auditor recommendations. Form 990, Part XI, Line 9 Good Samaritan Hospital Physician Services and Good Samaritan Hospital have written off inter company loans between them per independent auditors. Good Samaritan Hospital 520 South 7th Street Vincennes IN 47591 356001532 Healthcare IN 501(c)(3) N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Due to pandemic and being short staffed a Request for Filing Extension was filed with the IRS. The request was granted by IRS on 5/16/2022.