2020-09-25T08:39:47-05:00 2019-12-31 420714325 RSM US LLP 1 S Wacker Dr Ste 800 Chicago IL 606063392 990 2019-01-01 351288674 Samaritan Health & Living Center Inc SAMA 5742623597 311 West High Street Elkhart IN 46516 Randal J Rhoade CEO 5742623597 2020-09-22 1 Rebekuh Eley P01247672 3126343400 2020-09-22 98.226.130.40 2020-09-22 09:41:56 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 49D5A1596642B6DD837368B1E984A310120BB776 2019 2021-01-29 14:40:06Z Randal J Rhoade 311 West High Street Elkhart IN 46516 1017036 0 X www.elkhartsamaritan.org X 1973 IN To be an expression of the love of God through a ministry of helping people under stress. 23 23 15 25 0 0 572281 393209 424151 534505 13893 64962 -28556 -22168 981769 970508 0 0 0 0 497047 611575 0 0 22653 175593 142373 672640 753948 309129 216560 1904431 2148016 0 0 1904431 2148016 The Center is an expression of the love of God through a ministry of helping people under stress. It offers the following services: counseling, educational programs, and consultation for pastors and other professionals. 0 0 660134 0 534505 The Center provides counseling services with fee assistance for those who could not otherwise afford services. Fee assistance is provided on a sliding fee based on household size and income. For 2019 the standard charge was $110 - $135 per clinical hour. With fee assistance the minimum fee paid per standard policy is $20 per clinical hour, although there are exceptions where a lesser amount may be charged due to special circumstances. For the year 2019 a total of $156,414 in fee assistance was applied directly to client accounts for 3,343 clinical hours of services. Approximately 37% of clients receive some level of fee assistance. 660134 1 1 0 0 0 0 0 0 0 1 1 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 0 0 0 0 0 0 0 1 1 0 0 0 1 3 0 1 15 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 23 23 1 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 IN X Randal J Rhoade 5742623597 311 West High Street Elkhart IN 46516 Randal Rhoade CEO 20.00 0.50 X 52500 0 2100 Karen Smith Past President 0.50 0.20 X X 0 0 0 Melissa Ramey President 0.50 0.01 X X 0 0 0 Marc Anderson Vice President 0.50 0.01 X 0 0 0 Brian Housand Treasurer 0.50 0.01 X X 0 0 0 Aimee Bontrager Secretary 0.50 0.01 X X 0 0 0 Ginny Russell Board Member 0.50 0.01 X 0 0 0 Jennifer Collins Board Member 0.25 0.01 X 0 0 0 Jessica Bond Board Member 0.10 0.01 X 0 0 0 Kathleen Bowers Board Member 0.10 0.01 X 0 0 0 Lauree Brown Board Member 0.10 0.01 X 0 0 0 Laura Ezzell Board Member 0.10 0.01 X 0 0 0 Ben Holdread Board Member 0.10 0.01 X 0 0 0 Patty Killoren Board Member 0.10 0.01 X 0 0 0 Dean Leazenby Board Member 0.10 0.01 X 0 0 0 Tim Koch Board Member 0.10 0.01 X 0 0 0 Katie McCormick Board Member 0.10 0.01 X 0 0 0 Jeff Miller Board Member until 6/16/19 0.10 0.01 X 0 0 0 Ann Chris Nilsen Board Member 0.10 0.01 X 0 0 0 Betsy Tavernier Board Member 0.10 0.01 X 0 0 0 Michael Terlep Board Member 0.25 0.01 X 0 0 0 Sheila Terlep Board Member 0.25 0.01 X 0 0 0 Michelle Thomas Board Member 0.10 0.01 X 0 0 0 Joan Vidic Board Member 0.10 0.01 X 0 0 0 Frank Lucchese Board Member 0.10 0.01 X 0 0 0 52500 0 2100 0 0 0 0 0 346395 46814 393209 Professional Fees 621300 534505 534505 534505 64962 64962 24360 346395 46528 -22168 -22168 970508 534505 0 42794 52500 21947 16295 14258 489647 472035 17612 26024 24097 1357 570 43404 39551 2713 1140 21047 17036 522 3489 787 787 11969 8458 2828 683 12657 8859 2025 1773 27121 18039 8677 405 5602 5602 30021 21015 9006 8323 6658 1415 250 Education & Development 11950 11950 Dues & Subscriptions 10111 4254 5772 85 2785 633 2152 753948 660134 71161 22653 495563 60550 457189 800067 86306 690256 713761 451902 508600 266710 407916 1904431 2148016 0 0 X 1505745 1623591 398686 524425 1904431 2148016 1904431 2148016 216560 27025 0 X 0 0 0 X 418086 708787 620174 572281 393209 2712537 286379 331526 402588 424151 534505 1979149 704465 1040313 1022762 996432 927714 4691686 145923 408600 304377 263614 162271 1284785 870 10675 11545 146793 408600 315052 263614 162271 1296330 3395356 8530 18259 24785 13893 64962 130429 8530 18259 24785 13893 64962 130429 712995 1058572 1047547 1010325 992676 4822115 0.70410 0.70730 0.02700 0.01690 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 266710 100251 49699 7810 934 407916 174956 100000 -7573 673 266710 62173 102650 10584 451 174956 36995 22800 2628 251 62173 24263 13250 -451 67 36995 0.00000 1.00000 0.00000 1 0 103725 11220 92505 626827 67319 559508 69515 7767 61748 713761 Funds held at Elkhart County Community Foundation 407916 407916 Part V, Line 4: The Elkhart Community Foundation Inc. (The Foundation) holds a fund named the Samaritan Center Kintner-Ross Fund (The Fund). The purpose of the fund is to further the charitable purposes of the organization. Dancing Competition 354825 330465 24360 1575 21974 22797 Silent Samaritan 15930 15930 182 370755 346395 24360 1575 21974 22979 46528 -22168 Form 990, Part VI, Section A, line 2 Sheila Terlep and Michael Terlep have a familial relationship. Form 990, Part VI, Section A, line 6 Section 1. Classes: Any person, church, or group interested in the Samaritan Health and Living Center, Inc. contributing directly $1.00 or more per year for membership shall hereby become an individual member of this corporation for the year for which the contribution was given and shall be entitled to attend and vote at all membership meetings during that period. Section 2. Rights, Preferences, Limitations, and Restrictions of Classes: There shall be only one class of membership. Section 3. Voting Rights of Classes: Each member shall be entitled to one vote. Form 990, Part VI, Section B, line 11b A copy of the Form 990 is emailed to the Executive Director for distribution to the board prior to filing. Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors and enforces their conflict of interest policy via annual disclosure questionnaires. Board members agree to alert the Board of any potential conflict that may arise subsequent to the completion of the disclosure statement. If such conflict arises, the Board reviews and votes on the transaction while the member with the conflict abstains from voting. Form 990, Part VI, Section B, line 15 The CEO compensation is approved by the board annually with the approval of the next year's annual budget. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and financial statements available to the public upon request for the same period of disclosure as set forth in IRC Section 6104(d). Elkhart County Samaritan Center Foundation Inc 311 West High Street Elkhart IN 46516 311164839 Endowment Fund - Support of the Samaritan Health and Living Center IN 501(c)(3) 509(A)(3), Type I Samaritan Health and Living Center 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Elkhart County Samaritan Center Foundation Inc C 100000 FMV