2022-11-04T06:25:47-05:00 2021-12-31 ERNST & YOUNG US LLP 1101 NEW YORK AVENUE NW WASHINGTON DC 20005 990 2021-01-01 133400353 GOOD SAMARITAN FOUNDATION FOR BETTER HEALTH % MAUREEN BURKE GOOD 8453685151 255 Lafayette Avenue Suffern NY 10901 Mary Leahy MD CEO - BSCHS 8453685305 2022-11-02 true Mary Leahy MD 999009999 Justin Lowe P01866796 2023276000 2 2021 2022-09-23 18:48:47Z Mary Leahy MD 255 Lafayette Avenue Suffern NY 10901 821947 false 0928 X www.bschsf.org/goodsam X 1986 NY Fundraising for the benefit of Good Samaritan Hospital of Suffern, NY. 33 29 0 40 0 0 562748 663850 0 0 30032 33380 0 -7948 592780 689282 836045 17643 0 0 277036 283642 0 0 372189 285901 274178 1398982 575463 -806202 113819 4151594 4092782 804531 517 3347063 4092265 X 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. false false 147492 17088 0 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. 147492 true true false false false false false false false true false false false true false false false true false false false false false false true false false true false true false false false false false false false false false false false false false true false false false true 6 0 true 0 false false false false false false false false false false false false X 33 29 true false false false true true true true false false false true true true true false false false false false NY X MAUREEN BURKE 8453685305 255 LAFAYETTE AVENUE Suffern NY 10901 X Mary Leahy MD CEO - BSCHS 1.0 39.0 X X 0 1161474 82279 MILL ETIENNE BOARD MEMBER (EFFECT. 1/21) 1.0 39.0 X 0 467336 48607 TARA CULLEN BOARD MEMBER 1.0 39.0 X 0 183520 16380 Gayle Hirsch Esq Board Member 1.0 39.0 X 0 174241 20665 Nicholas DeSantis Board Member 1.0 0.0 X 0 0 0 Gil Heim Board Member 1.0 0.0 X 0 0 0 Geanette Katz Secretary 1.0 0.0 X X 0 0 0 Kevin Kern BOARD MEMBER 1.0 0.0 X 0 0 0 Joseph Lagana Board Member 1.0 0.0 X 0 0 0 Patricia Lefkowitz Board Member 1.0 0.0 X 0 0 0 Aurelius Licata Board Member 1.0 0.0 X 0 0 0 Kathy Medici Board Member 1.0 0.0 X 0 0 0 Harold Peterson Chair 1.0 0.0 X X 0 0 0 Amra Sabic-El-Rayess PhD Board Member 1.0 2.0 X 0 0 0 Frank Stillo Board Member 1.0 0.0 X 0 0 0 Mark Acker Board Member 1.0 0.0 X 0 0 0 Joseph Allen Board Member 1.0 0.0 X 0 0 0 Heather Bowie Board Member 1.0 0.0 X 0 0 0 Gene Cortes Board Member (thru 6/21) 1.0 0.0 X 0 0 0 Lawrence Garvey Board Member (thru 12/21) 1.0 0.0 X 0 0 0 Angela Clarkin Board Member 1.0 0.0 X 0 0 0 Richard Clarkin MD Board Member 1.0 0.0 X 0 0 0 Joseph DeCicco Board Member 1.0 0.0 X 0 0 0 JAIN JACOB TREASURER 1.0 0.0 X X 0 0 0 JOYCE WALGROVE BOARD MEMBER 1.0 0.0 X 0 0 0 JOSEPH CASERES BOARD MEMBER 1.0 0.0 X 0 0 0 SR SUSAN EVELYN RSM Board Member 1.0 39.0 X 0 0 0 GEORGE KREIS BOARD MEMBER 1.0 0.0 X 0 0 0 DOUG GRAUBARD BOARD MEMBER 1.0 0.0 X 0 0 0 MITA PANDYA BOARD MEMBER 1.0 0.0 X 0 0 0 SHAWN REILLY BOARD MEMBER 1.0 0.0 X 0 0 0 SHIBU ABRAHAM BOARD MEMBER (EFFECTIVE 6/21) 1.0 0.0 X 0 0 0 PHYLLIS EIG BOARD MEMBER (EFFECTIVE 1/21) 1.0 0.0 X 0 0 0 JAMES MACAGNA BAORD MEMBER (EFFECTIVE 6/21) 1.0 0.0 X 0 0 0 JESSICA MITCHELL BOARD MEMBER (EFFECTIVE 6/21) 1.0 0.0 X 0 0 0 0 1986571 167931 0 false true false NONE 0 90685 573165 663850 0 20656 20656 0 0 0 0 0 95961 83237 12724 12724 12724 41480 90685 49428 -7948 -7948 0 0 0 0 0 0 0 689282 25432 17088 17088 555 555 0 0 0 0 238111 47622 23811 166678 4539 908 454 3177 24493 4899 2449 17145 16499 3300 1650 11549 0 0 0 0 0 10381 2076 1038 7267 0 87689 17538 8769 61382 26533 5307 2653 18573 0 0 150 30 15 105 2021 404 202 1415 0 0 0 0 0 26120 23508 2612 PURCHASED SERVICES 118515 23703 11852 82960 SUPPLIES 2769 554 277 1938 575463 147492 55782 372189 0 0 1034947 458438 11507 133329 14425 11508 0 0 0 0 0 0 0 0 0 0 0 0 2385129 2780821 0 0 0 0 0 0 705586 708686 4151594 4092782 804531 517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 804531 517 X 539628 770233 2807435 3322032 3347063 4092265 4151594 4092782 X 113819 120470 510913 X false true X true false X 735272 694982 638758 562748 663850 3295610 0 0 735272 694982 638758 562748 663850 3295610 673620 2621990 16649 31763 59381 30032 20656 158481 0 155129 170460 161285 0 41480 528354 3982445 0.65839 0.64782 X Part II, Line 10 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 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2800536 705329 0 190732 3315133 3251680 562595 950575 63164 2800536 3404959 758938 912217 3251680 2770776 831849 197666 3404959 2489307 774238 483769 2779776 0.00000 0.02430 0.97570 false false INSURANCE-CASH SURRENDER VALUE 309212 CASH SURRENDER VALUE 396374 OTHER ASSETS 3100 708686 PART V, LINE 4 Intended use of endowment funds: To support the mission of Good Samaritan Hospital of Suffern through program funding and capital acquisitions. GOLF OUTING 132165 90685 41480 49428 0 132165 90685 41480 49428 49428 -7948 true BSCHS MEDICAL GROUP PC 255 Lafayette Avenue Suffern NY 10901 223636986 501(c)(3) 12909 1 Part I Description of Procedure for Monitoring Use of Funds 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. false true false false false false false false false Gayle Hirsch Esq Board Member 0 172348 0 0 0 1893 0 10778 0 9887 0 194906 0 0 Mary Leahy MD CEO - BSCHS 0 883812 0 277662 0 0 0 40600 0 41679 0 1243753 0 0 TARA CULLEN BOARD MEMBER 0 180858 0 2500 0 162 0 10965 0 5415 0 199900 0 0 MILL ETIENNE BOARD MEMBER (EFFECT. 1/21) 0 264381 0 0 0 202955 0 18113 0 30494 0 515943 0 0 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. 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 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 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 100 WOODS ROAD VALHALLA NY 10595 133991673 MSO & HEARING AID NY NA C CORP false WMC ADVANCED PHYSICIAN SERVICES PC 19 BRADHURST AVENUE HAWTHORNE NY 10595 264709927 PHYSICIAN OFFICES NY NA C CORP false WCHCC (BERMUDA) LIMITED VICTORIA HALL 11 VICTORIA STREET HAMILTON BD CAP INSURANCE BD NA C CORP false KINGSTON REGIONAL HEALTH CARE ENTERPRISE 396 BROADWAY KINGSTON NY 12401 161514994 INVESTMENT NY HAH BWAY C CORP false MID HUDSON PHYSICIANS PC 396 BROADWAY KINGSTON NY 12401 203564769 MEDICAL SVCS NY NA C CORP false BSCHS MEDICAL GROUP PC 10 FRANKLIN TURNPIKE MAHWAH NJ 07430 821632215 PHYSICIAN OFFICES NJ BSCHS C CORP false false true false false false false false false false false false false false false false true true false false SCHEDULE R, PART II, BON SECOURS CHARITY HEALTH SYSTEM, INC. (BSCHS) GOOD SAMARITAN FOUNDATION FOR BETTER HEALTH has a brother-sister relationship with BSCHSS six subordinates in a group exemption within BSCHS.