GOOD SAMARITAN FDN FOR BETTER HEALTH INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SAMARITAN FDN FOR BETTER HEALTH INC (EIN 13-3400353)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-04
- IRS object ID
- 202243089349300109
- 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 D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-04T06:25:47-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1101 NEW YORK AVENUE NW | AddressLine1Txt |
| City | WASHINGTON | CityNm |
| State Abbreviation | DC | StateAbbreviationCd |
| ZIP | 20005 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 133400353 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SAMARITAN FOUNDATION FOR BETTER HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % MAUREEN BURKE | InCareOfNm |
| Business Name Control | GOOD | BusinessNameControlTxt |
| Phone | 8453685151 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 Lafayette Avenue | AddressLine1Txt |
| City | Suffern | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10901 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary Leahy MD | PersonNm |
| Person Title | CEO - BSCHS | PersonTitleTxt |
| Phone | 8453685305 | PhoneNum |
| Signature | 2022-11-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Mary | PersonFirstNm |
| Person Last | Leahy MD | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Justin Lowe | PreparerPersonNm |
| PTIN | P01866796 | PTIN |
| Phone | 2023276000 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Mary Leahy MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 Lafayette Avenue | AddressLine1Txt |
| City | Suffern | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $821,947 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.bschsf.org/goodsam | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | Fundraising for the benefit of Good Samaritan Hospital of Suffern, NY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 33 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 29 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 40 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $562,748 | PYContributionsGrantsAmt |
| CY Contributions Grants | $663,850 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $30,032 | PYInvestmentIncomeAmt |
| CY Investment Income | $33,380 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | -$7,948 | CYOtherRevenueAmt |
| PY Total Revenue | $592,780 | PYTotalRevenueAmt |
| CY Total Revenue | $689,282 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $836,045 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $17,643 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $277,036 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $283,642 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $372,189 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $285,901 | PYOtherExpensesAmt |
| CY Other Expenses | $274,178 | CYOtherExpensesAmt |
| PY Total Expenses | $1,398,982 | PYTotalExpensesAmt |
| CY Total Expenses | $575,463 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$806,202 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $113,819 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,151,594 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,092,782 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $804,531 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $517 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,347,063 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,092,265 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION IS TO MAKE VISIBLE GOD'S LOVE AND TO BE GOOD HELP TO THOSE IN NEED, ESPECIALLY THOSE WHO ARE POOR, VULNERABLE AND DYING. AS A SYSTEM OF CAREGIVERS, WE COMMIT OURSELVES TO HELP BRING PEOPLE AND COMMUNITIES TO HEALTH AND WHOLENESS AS PART OF THE HEALING MINISTRY OF JESUS CHRIST AND THE CATHOLIC CHURCH. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $147,492 | ExpenseAmt |
| Grant | $17,088 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | THE GOOD SAMARITAN FOUNDATION IS THE VOICE OF PHILANTHROPY FOR GOOD SAMARITAN REGIONAL MEDICAL CENTER. WE INCREASE AWARENESS, CREATE GOOD WILL AND RAISE FUNDS TO FURTHER THE MISSION OF THE BON SECOURS CHARITY HEALTH SYSTEM - TO GIVE GOOD HELP TO THOSE IN NEED. A FEW OF THE MANY WAYS THAT WE'VE HELPED BRING STATE-OF-THE-ART MEDICAL CARE TO OUR COMMUNITY: FACILITY AND INFRASTRUCTURE IMPROVEMENTS: -PATIENTS THAT REQUIRE EMERGENCY MEDICAL CARE RECEIVE EXPERT ATTENTION IN OUR NEWLY EXPANDED AND RENOVATED EMERGENCY DEPARTMENT WHICH WAS PARTIALLY SUPPORTED BY THE GOOD SAMARITAN FOUNDATION FOR BETTER HEALTH. HERE, CLINICIANS PROVIDE CARE USING "STATE-OF-THE-ART" EQUIPMENT AND TECHNOLOGY. -MOMS, DADS AND SIBLINGS BOND WITH NEWBORNS IN OUR NEW FAMILY UNIT. THE UNIT ALSO INCLUDES SPECIALLY DESIGNED PEDIATRIC AREAS FOR CHILDREN NEEDING IN-PATIENT CARE. -PATIENTS RECEIVE SAME DAY DIAGNOSTIC AND SURGICAL PROCEDURES IN THE NEW AMBULATORY SURGERY CENTER AT GOOD SAMARITAN HOSPITAL. THE CENTER FEATURES STATE-OF-THE-ART OPERATING SUITES AND ADVANCED MEDICAL EQUIPMENT. NEW EQUIPMENT AND STATE-OF-THE-ART TECHNOLOGY: -UPGRADES TO ELECTROPHYSIOLOGY LAB PREVENT PATIENTS WITH CARDIAC RHYTHM ABNORMALITIES FROM EXPERIENCING CARDIAC CRISES BY MAPPING, DETECTING AND TREATING EVEN THE MOST COMPLICATED CASES. -OUR DA VINCI ADVANCED SURGICAL ROBOTIC SYSTEM ALLOWS PHYSICIANS TO PERFORM MINIMALLY INVASIVE PROCEDURES. -THE 128-SLICE CT SCAN ALLOWS CLINICIANS TO VIEW HIGH-DEFINITION IMAGES WHILE PATIENTS RECEIVE LOW-DOSE RADIATION. -NEW MRI EQUIPMENT IS WIDER THAN THE STANDARD PROVIDING PATIENTS GREATER COMFORT AND LESS CONFINEMENT THAN STANDARD EQUIPMENT. PROGRAMS: THE BOBBI LEWIS CANCER PROGRAM PROVIDES PERSONALIZED, COMPASSIONATE, STATE-OF-THE-ART ONCOLOGY CARE. COMMUNITY-WIDE SUPPORT MAKES EXPANDING AND UPGRADING GOOD SAMARITAN'S CANCER SERVICES POSSIBLE. FUNDRAISING: WE RAISE FUNDS SO CHILDREN AND ADULTS IN OUR COMMUNITY CAN COUNT ON STATE-OF-THE-ART CARE WHEN THEY COME TO GOOD SAMARITAN. THE FOUNDATION RECEIVES SUPPORT FROM PUBLIC AND PRIVATE ORGANIZATIONS AND INDIVIDUALS INCLUDING BOARD MEMBERS, VENDORS, PATIENTS, THEIR FAMILIES, RESIDENTS AND OUR EMPLOYEES. DUE TO THE EFFECTS OF THE COVID-19 PANDEMIC ALL SCHEDULED IN-PERSON FUNDRAISING EVENTS WERE SCALED BACK. OUR SIGNATURE EVENTS (THE SPRING BALL AND CORKS & FORKS WERE CANCELLED AND VIRTUAL GIRLS NIGHT OUT BENEFIT WAS HELD IN THE SPRING OF 2021 TO RAISE FUNDS FOR SURGICAL SERVICES AT GOOD SAMARITAN HOSPITAL. OUR GOLF & TENNIS CLASSIC WAS HELD WITH A SMALLER FIELD OF PARTICIPANTS. | Desc |
| Total Program Service Expenses | $147,492 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 33 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 29 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | false | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MAUREEN BURKE | PersonNm |
| Phone | 8453685305 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 LAFAYETTE AVENUE | AddressLine1Txt |
| City | Suffern | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| Mary Leahy MD | |||||||
| CEO - BSCHS | 1.0 | 39.0 | Yes (X) | Yes (X) | $0 | $1,161,474 | $82,279 |
| MILL ETIENNE | |||||||
| BOARD MEMBER (EFFECT. 1/21) | 1.0 | 39.0 | Yes (X) | $0 | $467,336 | $48,607 | |
| TARA CULLEN | |||||||
| BOARD MEMBER | 1.0 | 39.0 | Yes (X) | $0 | $183,520 | $16,380 | |
| Gayle Hirsch Esq | |||||||
| Board Member | 1.0 | 39.0 | Yes (X) | $0 | $174,241 | $20,665 | |
| Nicholas DeSantis | |||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Gil Heim | |||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Geanette Katz | |||||||
| Secretary | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Kevin Kern | |||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Joseph Lagana | |||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Patricia Lefkowitz | |||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Aurelius Licata | |||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Kathy Medici | |||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Harold Peterson | |||||||
| Chair | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Amra Sabic-El-Rayess PhD | |||||||
| Board Member | 1.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |
| Frank Stillo | |||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Mark Acker | |||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Joseph Allen | |||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Heather Bowie | |||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Gene Cortes | |||||||
| Board Member (thru 6/21) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Lawrence Garvey | |||||||
| Board Member (thru 12/21) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Angela Clarkin | |||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Richard Clarkin MD | |||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Joseph DeCicco | |||||||
| Board Member | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| JAIN JACOB | |||||||
| TREASURER | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JOYCE WALGROVE | |||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| JOSEPH CASERES | |||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| SR SUSAN EVELYN RSM | |||||||
| Board Member | 1.0 | 39.0 | Yes (X) | $0 | $0 | $0 | |
| GEORGE KREIS | |||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| DOUG GRAUBARD | |||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| MITA PANDYA | |||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| SHAWN REILLY | |||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| SHIBU ABRAHAM | |||||||
| BOARD MEMBER (EFFECTIVE 6/21) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| PHYLLIS EIG | |||||||
| BOARD MEMBER (EFFECTIVE 1/21) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| JAMES MACAGNA | |||||||
| BAORD MEMBER (EFFECTIVE 6/21) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| JESSICA MITCHELL | |||||||
| BOARD MEMBER (EFFECTIVE 6/21) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,986,571 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $167,931 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NONE | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contractor Address | ContractorAddress |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $90,685 | FundraisingAmt |
| All Other Contributions | $573,165 | AllOtherContributionsAmt |
| Total Contributions | $663,850 | TotalContributionsAmt |
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,656 | TotalRevenueColumnAmt |
| Exclusion | $20,656 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $95,961 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $83,237 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,724 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,724 | TotalRevenueColumnAmt |
| Exclusion | $12,724 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $41,480 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $90,685 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $49,428 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$7,948 | TotalRevenueColumnAmt |
| Exclusion | -$7,948 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $689,282 | TotalRevenueColumnAmt |
| Exclusion | $25,432 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,088 | TotalAmt |
| Program Services | $17,088 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $555 | TotalAmt |
| Program Services | $555 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $238,111 | TotalAmt |
| Program Services | $47,622 | ProgramServicesAmt |
| Management And General | $23,811 | ManagementAndGeneralAmt |
| Fundraising | $166,678 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,539 | TotalAmt |
| Program Services | $908 | ProgramServicesAmt |
| Management And General | $454 | ManagementAndGeneralAmt |
| Fundraising | $3,177 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,493 | TotalAmt |
| Program Services | $4,899 | ProgramServicesAmt |
| Management And General | $2,449 | ManagementAndGeneralAmt |
| Fundraising | $17,145 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,499 | TotalAmt |
| Program Services | $3,300 | ProgramServicesAmt |
| Management And General | $1,650 | ManagementAndGeneralAmt |
| Fundraising | $11,549 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,381 | TotalAmt |
| Program Services | $2,076 | ProgramServicesAmt |
| Management And General | $1,038 | ManagementAndGeneralAmt |
| Fundraising | $7,267 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,689 | TotalAmt |
| Program Services | $17,538 | ProgramServicesAmt |
| Management And General | $8,769 | ManagementAndGeneralAmt |
| Fundraising | $61,382 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,533 | TotalAmt |
| Program Services | $5,307 | ProgramServicesAmt |
| Management And General | $2,653 | ManagementAndGeneralAmt |
| Fundraising | $18,573 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150 | TotalAmt |
| Program Services | $30 | ProgramServicesAmt |
| Management And General | $15 | ManagementAndGeneralAmt |
| Fundraising | $105 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,021 | TotalAmt |
| Program Services | $404 | ProgramServicesAmt |
| Management And General | $202 | ManagementAndGeneralAmt |
| Fundraising | $1,415 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,120 | TotalAmt |
| Program Services | $23,508 | ProgramServicesAmt |
| Management And General | $2,612 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| PURCHASED SERVICES | $118,515 | $23,703 | $11,852 | $82,960 |
| SUPPLIES | $2,769 | $554 | $277 | $1,938 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $575,463 | TotalAmt |
| Program Services | $147,492 | ProgramServicesAmt |
| Management And General | $55,782 | ManagementAndGeneralAmt |
| Fundraising | $372,189 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,034,947 | BOYAmt |
| EOY | $458,438 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,507 | BOYAmt |
| EOY | $133,329 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,425 | BOYAmt |
| EOY | $11,508 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,385,129 | BOYAmt |
| EOY | $2,780,821 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $705,586 | BOYAmt |
| EOY | $708,686 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,151,594 | BOYAmt |
| EOY | $4,092,782 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $804,531 | BOYAmt |
| EOY | $517 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $804,531 | BOYAmt |
| EOY | $517 | 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 | $539,628 | BOYAmt |
| EOY | $770,233 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,807,435 | BOYAmt |
| EOY | $3,322,032 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,347,063 | BOYAmt |
| EOY | $4,092,265 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,151,594 | BOYAmt |
| EOY | $4,092,782 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $113,819 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $120,470 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $510,913 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $735,272 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $694,982 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $638,758 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $562,748 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $663,850 | CurrentTaxYearAmt |
| Total | $3,295,610 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $735,272 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $694,982 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $638,758 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $562,748 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $663,850 | CurrentTaxYearAmt |
| Total | $3,295,610 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $673,620 | SubstantialContributorsTotAmt |
| Public Support Total170 | $2,621,990 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $16,649 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $31,763 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $59,381 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $30,032 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,656 | CurrentTaxYearAmt |
| Total | $158,481 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $155,129 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $170,460 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $161,285 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $41,480 | CurrentTaxYearAmt |
| Total | $528,354 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $3,982,445 | TotalSupportAmt |
| Public Support CY170 | 0.65839 | PublicSupportCY170Pct |
| Public Support PY170 | 0.64782 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II, Line 10 | FormAndLineReferenceDesc |
| Explanation | Explanation for Other Income: Special Events Revenue 2017 AMOUNT: $ 155,129 2018 AMOUNT: $ 170,460 2019 AMOUNT: $ 161,285 2020 AMOUNT: $ 0 2021 AMOUNT: $ 41,480 | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,800,536 | BeginningYearBalanceAmt |
| Contributions | $705,329 | ContributionsAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $190,732 | OtherExpendituresAmt |
| End Year Balance | $3,315,133 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,251,680 | BeginningYearBalanceAmt |
| Contributions | $562,595 | ContributionsAmt |
| Grants Or Scholarships | $950,575 | GrantsOrScholarshipsAmt |
| Other Expenditures | $63,164 | OtherExpendituresAmt |
| End Year Balance | $2,800,536 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,404,959 | BeginningYearBalanceAmt |
| Contributions | $758,938 | ContributionsAmt |
| Grants Or Scholarships | $912,217 | GrantsOrScholarshipsAmt |
| End Year Balance | $3,251,680 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,770,776 | BeginningYearBalanceAmt |
| Contributions | $831,849 | ContributionsAmt |
| Grants Or Scholarships | $197,666 | GrantsOrScholarshipsAmt |
| End Year Balance | $3,404,959 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,489,307 | BeginningYearBalanceAmt |
| Contributions | $774,238 | ContributionsAmt |
| Grants Or Scholarships | $483,769 | GrantsOrScholarshipsAmt |
| End Year Balance | $2,779,776 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.02430 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.97570 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp | |
| Equipment | EquipmentGrp | |
| Other Land Buildings | OtherLandBuildingsGrp |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INSURANCE-CASH SURRENDER VALUE | $309,212 |
| CASH SURRENDER VALUE | $396,374 |
| OTHER ASSETS | $3,100 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $708,686 | TotalBookValueOtherAssetsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4 | FormAndLineReferenceDesc |
| Explanation | Intended use of endowment funds: To support the mission of Good Samaritan Hospital of Suffern through program funding and capital acquisitions. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF OUTING | Event1Nm |
| Gross Receipts Event1 | $132,165 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $90,685 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $41,480 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $49,428 | RentFacilityCostsEvent1Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $132,165 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $90,685 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $41,480 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $49,428 | RentFcltyCostsTotalEventsAmt |
| Direct Expense Summary Events | $49,428 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$7,948 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BSCHS MEDICAL GROUP PC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 255 Lafayette Avenue | AddressLine1Txt |
| City | Suffern | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 223636986 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $12,909 | CashGrantAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I Description of Procedure for Monitoring Use of Funds | FormAndLineReferenceDesc |
| Explanation | The organization complies with Bon Secours Charity Health System, Inc's system-wide financial and accounting policies. Contributions are generally made as reimbursements for funds spent. In such cases, the donee/grantee organization must provide documentation to the filing organization before funds are approved for disbursement. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Gayle Hirsch Esq | ||||||||||||||
| Board Member | $0 | $172,348 | $0 | $0 | $0 | $1,893 | $0 | $10,778 | $0 | $9,887 | $0 | $194,906 | $0 | $0 |
| Mary Leahy MD | ||||||||||||||
| CEO - BSCHS | $0 | $883,812 | $0 | $277,662 | $0 | $0 | $0 | $40,600 | $0 | $41,679 | $0 | $1,243,753 | $0 | $0 |
| TARA CULLEN | ||||||||||||||
| BOARD MEMBER | $0 | $180,858 | $0 | $2,500 | $0 | $162 | $0 | $10,965 | $0 | $5,415 | $0 | $199,900 | $0 | $0 |
| MILL ETIENNE | ||||||||||||||
| BOARD MEMBER (EFFECT. 1/21) | $0 | $264,381 | $0 | $0 | $0 | $202,955 | $0 | $18,113 | $0 | $30,494 | $0 | $515,943 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J PART I LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION AS DESCRIBED BELOW: THE BOARD OF DIRECTORS PERSONNEL AND COMPENSATION COMMITTEE SETS THE LEVEL OF TOTAL COMPENSATION (BASE SALARY AND INCENTIVE COMPENSATION) AND THE BENEFITS PROVIDED TO THE ORGANIZATION'S SENIOR EXECUTIVES. IN ORDER TO SET BASE SALARY AND INCENTIVE COMPENSATION LEVELS, THE COMMITTEE WORKS WITH A NATIONAL INDEPENDENT COMPENSATION CONSULTING FIRM. THE CONSULTING FIRM ASSISTS THE COMMITTEE WITH ITS DECISION-MAKING PROCESSES TO ENSURE THAT (I) EXECUTIVE COMPENSATION LEVELS ARE REASONABLE AND APPROPRIATE RELATIVE TO THOSE OF OTHER SIMILAR ORGANIZATIONS, AS WELL AS (II) SUCH LEVELS MEET THE "REBUTTABLE PRESUMPTION OF REASONABLENESS." STANDARD COMPENSATION LEVELS ARE DETERMINED BASED ON COMPETITIVE MARKET DATA FOR COMPARABLE POSITIONS IN SIMILAR SIZED AND TYPE OF ORGANIZATIONS AND EACH EXECUTIVE'S SCOPE OF RESPONSIBILITIES. IN ADDITION, INCENTIVE COMPENSATION ARRANGEMENTS ARE BASED ON EACH EXECUTIVE'S ACHIEVEMENT OF SPECIFIC PERFORMANCE GOALS SET FORTH AT THE BEGINNING OF EACH CALENDAR YEAR, THE ACHIEVEMENT OF WHICH IS MEASURED AT THE END OF EACH CALENDAR YEAR BY THE CEO OR THE BOARD OF DIRECTORS DEPENDING ON THE EXECUTIVE. |
| PART I, LINE 4B | PARTICIPATE IN, OR RECEIVE PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: THE FILING ORGANIZATION PARTICIPATES IN A BON SECOURS CHARITY HEALTH SYSTEM, INC. supplemental executive retirement plan that ALLOWS FOR DEPOSITS INTO ADDITIONAL RETIREMENT PLANS AND IS AVAILABLE ONLY TO OFFICERS AND CERTAIN OTHER EMPLOYEES. THE 457(F) PLAN IS A NON-QUALIFIED PLAN AND IS SUBJECT TO A MINIMUM THREE-YEAR SERVICE REQUIREMENT BEFORE VESTING ON DEPOSITS MADE INTO THE PLAN. NO PAYOUTS HAVE BEEN MADE DURING THE YEAR. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, LINE 2 | business or family relationships: BOARD MEMBERS ANGELA CLARKIN AND RICHARD CLARKIN HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, LINE 6 MEMBERS OR STOCKHOLDERS: BON SECOURS CHARITY HEALTH SYSTEM, INC. (BSCHS) IS THE SOLE MEMBER OF GOOD SAMARITAN FOUNDATION FOR BETTER HEALTH (GSFBH). |
| FORM 990, PART VI, LINE 7A | POWER TO ELECT OR APPOINT MEMBERS: The governing body of GOOD SAMARITAN FOUNDATION FOR BETTER HEALTH is appointed by its member, BSCHS and subject to approval of WMC HEALTH NETWORK - ROCKLAND, INC. ONE OF THE THREE CORPORATE MEMBERS OF BSCHS ALONG WITH BON SECOURS MERCY HEALTH, INC. (BSMH), AND THE SISTERS OF CHARITY OF SAINT ELIZABETH (SCSE). |
| FORM 990, PART VI, LINE 7B | DECISIONS RESERVED TO MEMBERS OR STOCKHOLDERS: Certain authorities of GOOD SAMARITAN FOUNDATION FOR BETTER HEALTH are reserved to its member, BSCHS or is jointly reserved to WMC HEALTH NETWORK, ROCKLAND, INC., BSMH AND the SISTERS OF CHARITY, THE THREE CORPORATE MEMBERS OF BSCHS. |
| FORM 990, PART VI, LINE 11B | PROCESS USED TO REVIEW THE FORM 990: The Form 990 was prepared by the finance department with assistance from various departments throughout the organization. The Form 990 was reviewed by internal leadership AND OUR EXTERNAL TAX ADVISORS. Upon completion of the various reviews, the Form 990 was PROVIDED to the board of the organization for approval prior to filing with the IRS. |
| FORM 990, PART VI, LINE 12C | MONITORING AND ENFORCEMENT OF COMPLIANCE WITH CONFLICT OF INTEREST POLICY: The organization monitors and enforces compliance with the Conflict of Interest policy by means of a survey developed and approved by the Chief Compliance Officer. The survey is sent to all trustees, officers, and key executives for completion. All survey responses are reviewed by the Chief Compliance Officer. Any potential conflicts identified in the responses are discussed with senior management and/or referred to the WMC Health Conflicts of Interest Committee for discussion. Potential actions to be taken in response to a conflict can be one or more of the following: 1) disclosure of the conflict, 2) individual recusal from decisions for transactions where that individual may have a conflict, 3) request in writing that the individual alleviates the conflict, or 4) removal of the individual from employment. |
| FORM 990, PART VI, LINES 13 AND 14 | Written whistleblower and document retention and destruction policies: The Foundation does not have its own written whistleblower and document retention and destruction policies. However, the Foundation does follow the policies approved by the Board of its related organization, BSCHS. |
| FORM 990, PART VI, LINE 19 | PROCESS FOR MAKING DOCUMENTS AVAILABLE TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VII | SISTER SUSAN EVELYN DOES NOT RECEIVE COMPENSATION AS SHE HAS TAKEN A VOW OF POVERTY. BOARD MEMBER POSITIONS ARE GENERALLY VOLUNTARY IN NATURE. COMPENSATED EMPLOYEES OF THE FILING ORGANIZATION AND OTHER RELATED ORGANIZATIONS WHO ALSO HOLD BOARD POSITIONS ARE COMPENSATED ONLY IN RELATION TO THEIR EMPLOYMENT AND DO NOT RECEIVE ADDITIONAL COMPENSATION FOR THEIR BOARD RESPONSIBILITIES. |
| FORM 990, PART XI, LINE 9 | FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: - TRANSFERS FROM AFFILIATES $ 510,913 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (17 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| WMC HEALTH NETWORK - ROCKLAND INC | ||||||||||
| 100 WOODS ROAD | VALHALLA | NY | 10595 | 320467873 | SUPPORTING | NY | 501(C)(3) | 12A | NA | false |
| WMC HEALTH NETWORK - ULSTER INC | ||||||||||
| 100 WOODS ROAD | VALHALLA | NY | 10595 | 320477183 | SUPPORTING | NY | 501(C)(3) | 12A | WCHCC | false |
| WESTCHESTER COUNTY HEALTH CARE CORP | ||||||||||
| 100 WOODS ROAD | VALHALLA | NY | 10595 | 133964321 | HEALTHCARE | NY | 115 | N/A | NA | false |
| WMC NEW YORK INC | ||||||||||
| 100 WOODS ROAD | VALHALLA | NY | 10595 | 134107894 | FUNDRAISING | NY | 501(C)(3) | 12A | WCHCC | false |
| NORTH ROAD LHCSA INC | ||||||||||
| 241 NORTH ROAD | POUGHKEEPSIE | NY | 12601 | 465293268 | HOMECARE SVCS | NY | 501(C)(3) | 10 | WCHCC | false |
| MID-HUDSON VALLEY EARLY EDUCATION CENTER | ||||||||||
| 100 WOODS RD TAYLOR PAVILION | VALHALLA | NY | 10595 | 465534882 | PRESCHOOL | NY | 501(C)(3) | 7 | WCHCC | false |
| WESTCHESTER MEDICAL CENTER FOUNDATION I | ||||||||||
| 100 WOODS ROAD | VALHALLA | NY | 10595 | 134095845 | FUNDRAISING | NY | 501(C)(3) | 7 | WCHCC | false |
| HEALTHALLIANCE INC | ||||||||||
| 741 GRANT AVENUE | LAKE KATRINE | NY | 12449 | 261850453 | SUPPORTING | NY | 501(C)(3) | 12A | WCHCC | false |
| HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS | ||||||||||
| 396 BROADWAY | KINGSTON | NY | 12401 | 141349558 | EXEMPT HOSP | NY | 501(C)(3) | 3 | HA INC | false |
| HEALTHALLIANCE HOSPITAL MARY'S AVE CAMPU | ||||||||||
| 105 MARYS AVENUE | KINGSTON | NY | 12401 | 141338470 | EXEMPT HOSP | NY | 501(C)(3) | 3 | HA INC | false |
| MARGARETVILLE MEMORIAL HOSPITAL | ||||||||||
| 42084 STATE ROUTE 28 | MARGARETVILLE | NY | 12455 | 150552726 | EXEMPT HOSP | NY | 501(C)(3) | 3 | HA INC | false |
| MARGARETVILLE NURSING HOME INC | ||||||||||
| 42158 STATE HIGHWAY 28 | MARGARETVILLE | NY | 12455 | 223143565 | NURSING HOME | NY | 501(C)(3) | 10 | MMH | false |
| MARGARETVILLE HEALTH FOUNDATION | ||||||||||
| 42084 STATE HIGHWAY 28 | MARGARETVILLE | NY | 12455 | 261998454 | SUPPORT FDN | NY | 501(C)(3) | 12A | MMH | false |
| BON SECOURS COMMUNITY HOSPITAL FDN | ||||||||||
| 255 LAFAYETTE AVE | SUFFERN | NY | 10901 | 810667395 | SUPPORT FDN | NY | 501(C)(3) | 7 | BSCHS | false |
| BON SECOURS WARWICK HEALTH FOUNDATION | ||||||||||
| 255 LAFAYETTE AVE | SUFFERN | NY | 10901 | 141972807 | SUPPORT FDN | NY | 501(C)(3) | 7 | BSCHS | false |
| BON SECOURS CHARITY HEALTH SYSTEM INC | ||||||||||
| 255 LAFAYETTE AVE | SUFFERN | NY | 10901 | 912135195 | SUPPORTING | NY | 501(C)(3) | 12C, III-FI | WCHCC | false |
| HealthAlliance Foundation Inc | ||||||||||
| 741 GRANT AVENUE | LAKE KATRINE | NY | 12449 | 222511450 | FUNDRAISING | NY | 501(C)(3) | 7 | HA INC | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)
| Address Line1ForeignAddress/AddressLine1Txt | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Legal Domicile StateLegalDomicileStateCd | CityForeignAddress/CityNm |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HUDSON RIVER WEST INSURANCE LIMITED | |||||||||||||||
| 23 LIME TREE BAY AVE PO BOX 1051 | GRAND CAYMAN | CJ | KY1-1102 | CAP INSURANCE | CJ | BSCHS | C CORP | false | |||||||
| HUDSON RIVER NORTH INSURANCE LIMITED | |||||||||||||||
| 23 LIME TREE BAY AVE PO BOX 1051 | GRAND CAYMAN | CJ | KY1-1102 | CAP INSURANCE | CJ | HEALTHALLIANCE | C CORP | false | |||||||
| NORTHEAST PROVIDER SOLUTIONS INC | |||||||||||||||
| MSO & HEARING AID | NA | C CORP | false | 100 WOODS ROAD | VALHALLA | NY | 10595 | 133991673 | NY | ||||||
| WMC ADVANCED PHYSICIAN SERVICES PC | |||||||||||||||
| PHYSICIAN OFFICES | NA | C CORP | false | 19 BRADHURST AVENUE | HAWTHORNE | NY | 10595 | 264709927 | NY | ||||||
| WCHCC (BERMUDA) LIMITED | |||||||||||||||
| VICTORIA HALL 11 VICTORIA STREET | BD | CAP INSURANCE | BD | NA | C CORP | false | HAMILTON | ||||||||
| KINGSTON REGIONAL HEALTH CARE ENTERPRISE | |||||||||||||||
| INVESTMENT | HAH BWAY | C CORP | false | 396 BROADWAY | KINGSTON | NY | 12401 | 161514994 | NY | ||||||
| MID HUDSON PHYSICIANS PC | |||||||||||||||
| MEDICAL SVCS | NA | C CORP | false | 396 BROADWAY | KINGSTON | NY | 12401 | 203564769 | NY | ||||||
| BSCHS MEDICAL GROUP PC | |||||||||||||||
| PHYSICIAN OFFICES | BSCHS | C CORP | false | 10 FRANKLIN TURNPIKE | MAHWAH | NJ | 07430 | 821632215 | NJ | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART II, BON SECOURS CHARITY HEALTH SYSTEM, INC. (BSCHS) | FormAndLineReferenceDesc |
| Explanation | GOOD SAMARITAN FOUNDATION FOR BETTER HEALTH has a brother-sister relationship with BSCHSS six subordinates in a group exemption within BSCHS. | ExplanationTxt |