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SAMARITAN BEHAVIORAL HEALTH INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
SAMARITAN BEHAVIORAL HEALTH INC (EIN 02-0633634)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-12
IRS object ID
201633179349300213
Schema version
2015v2.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2016-11-12T09:41:29-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1800 YARD STREET SUITE 200AddressLine1Txt
CityGRANDVIEW HEIGHTSCityNm
State AbbreviationOHStateAbbreviationCd
ZIP43212ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN020633634EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Samaritan Behavioral Health IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% J MICHAEL SIMSInCareOfNm
Business Name ControlSAMABusinessNameControlTxt
Phone9372768333PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 N Main St 500AddressLine1Txt
CityDaytonCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45402ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTIMOTHY D SNIDERPersonNm
Person TitleOFFICERPersonTitleTxt
Phone9374999942PhoneNum
Signature2016-11-08SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDIANE L BEANPreparerPersonNm
PTINP00104972PTIN
Phone6142245678PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSUE V MCGATHAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1601 S EDWIN C MOSES BLVDAddressLine1Txt
CityDAYTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45408ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$12,489,091GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SBHIHELP.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2002FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionMission: To Provide Mental Health and addiction services that touch, teach, and heal. Vision: Where help for life's challenges is openly sought and compassionately given.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee225TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$3,827,631PYContributionsGrantsAmt
CY Contributions Grants$2,243,457CYContributionsGrantsAmt
PY Program Service Revenue$8,520,100PYProgramServiceRevenueAmt
CY Program Service Revenue$10,110,161CYProgramServiceRevenueAmt
PY Investment Income$22,984PYInvestmentIncomeAmt
CY Investment Income$6,469CYInvestmentIncomeAmt
PY Other Revenue$169,101PYOtherRevenueAmt
CY Other Revenue$129,004CYOtherRevenueAmt
PY Total Revenue$12,539,816PYTotalRevenueAmt
CY Total Revenue$12,489,091CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$9,732,868PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,060,828CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,129,165PYOtherExpensesAmt
CY Other Expenses$2,393,561CYOtherExpensesAmt
PY Total Expenses$11,862,033PYTotalExpensesAmt
CY Total Expenses$12,454,389CYTotalExpensesAmt
PY Revenues Less Expenses$677,783PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$34,702CYRevenuesLessExpensesAmt
Total Assets BOY$4,415,646TotalAssetsBOYAmt
Total Assets EOY$3,720,430TotalAssetsEOYAmt
Total Liabilities BOY$1,565,052TotalLiabilitiesBOYAmt
Total Liabilities EOY$835,134TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,850,594NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,885,296NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE MENTAL HEALTH AND ADDICTION SERVICES THAT TOUCH, TEACH AND HEAL. VISION: WHERE HELP FOR LIFE'S CHALLENGES IS OPENLY SOUGHT AND COMPASSIONATELY GIVEN.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$4,105,323ExpenseAmt
Grant$0GrantAmt
Revenue$4,347,365RevenueAmt
DescMontgomery County Mental Health Services: Samaritan Behavioral Healths Youth and Adult Outpatient Services offer the following to adults, adolescents, and children living in Montgomery County: Behavioral health assessments to determine the nature and extent of mental health problems/concerns, Recommendations regarding services that address presenting problems/symptoms, An individualized service plan with therapeutic goals developed in collaboration with the patient/family, Individual and family counseling, Referral to psychiatric services if it appears that medication may be beneficial, Ongoing psychiatric medication management, Case management (CONTINUED IN SCHEDULE O)Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$2,011,194ExpenseAmt
Grant$0GrantAmt
Revenue$1,342,595RevenueAmt
DescCRISIS-CARE: Samaritan Behavioral Healths CrisisCare Program offers the following services to any adult, adolescent or child regardless of their ability to pay: Hotline 24-hour suicide prevention and crisis counseling telephone line, Warmline 24-hour supportive telephone counseling service, Screening & Triage Evaluation of crisis needs with follow-up recommendations for service, Emergency Walk-Ins Face-to-face crisis intervention, Pre-Hospital Screening Health Officers evaluate whether a person needs to be hospitalized due to life threatening circumstances, Mobile Crisis Services Crisis intervention services provided at residences (CONTINUED IN SCHEDULE O)Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$1,315,247ExpenseAmt
Grant$0GrantAmt
Revenue$1,771,465RevenueAmt
DescSUBSTANCE ABUSE: Samaritan Behavioral Healths Substance Abuse Services offer the following to any adult living in Montgomery County: Medication Assisted Treatment (MAT) for Opioid addiction using buprenorphine/naloxone (Suboxone); neltrexone (Vivitrol); All MAT services require participation in group and individual counseling, Individual, Group, and Family Counseling, and Case Management, Services to treat abuse and addiction to alcohol, cocaine, barbiturates, marijuana, heroin, and other addictive substances, Project Dawn Training in the use and distribution of Naloxone (Narcan) Kits, Combined Substance Abuse and Mental Health Counseling. During 2015, 1,279 patients were served.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$2,894,937TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$2,777,740TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$10,326,701TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document31IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee225EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJ MICHAEL SIMSPersonNm
Phone9374999942PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 N MAIN ST SUITE 500AddressLine1Txt
CityDAYTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45402ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Eloise P Broner
Chair0.539.5Yes (X)Yes (X)$0$686,548$13,990
Sue V McGatha
President & CEO / Vice Chair40.00.0Yes (X)Yes (X)$215,397$0$33,626
Thomas R Curtin
Treasurer (To Aug)0.57.5Yes (X)Yes (X)$0$276,277$37,323
Timothy D Snider
Treasurer (From Aug)0.519.5Yes (X)Yes (X)$0$119,664$17,481
Carol Bauer SC
Trustee0.539.5Yes (X)$0$0$0
Robert E Hickey Jr
Trustee0.50.0Yes (X)$0$0$0
John M Rahe MD
Trustee (To Nov)0.50.0Yes (X)$0$0$0
Frank E Sawyer
Trustee0.539.5Yes (X)$0$226,322$34,501
Evan Steffens
Trustee (From Nov)0.50.0Yes (X)$0$0$0
Teresa Zryd MD
Trustee0.50.0Yes (X)$0$5,440$0
Jenna Downey ESQ
Board Secretary0.50.0Yes (X)$0$0$0
Ellen W Ballerene MD
Psychiatrist40.00.0$174,459$0$23,133Yes (X)
Elizabeth L Schmitt MD
Psychiatrist40.00.0$103,911$0$15,292Yes (X)
Melissa C Whitesell
Nurse Practitioner40.00.0$110,676$0$23,591Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$604,443TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,314,251TotReportableCompRltdOrgAmt
Total Other Compensation$198,937TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K4IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Wright State Physicians
725 University BlvdFAIRBORNOH45324Psychiatric Services$126,930
Cirrus Concept Consulting Inc
1 Elizabeth PlDAYTONOH45417Personnel Consulting$172,456
Qualifacts Systems Inc
200 2nd Avenue SouthNASHVILLETN37201Medical Software$176,274
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Related Organizations$170,818RelatedOrganizationsAmt
Government Grants$1,951,012GovernmentGrantsAmt
All Other Contributions$121,627AllOtherContributionsAmt
Total Contributions$2,243,457TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROGRAM SERVICE REVDesc
Business900099BusinessCd
Total Revenue Column$10,110,161TotalRevenueColumnAmt
Related Or Exempt Func Income$10,110,161RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$10,110,161TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,469TotalRevenueColumnAmt
Exclusion$6,469ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISC REVENUEDesc
Business900099BusinessCd
Total Revenue Column$129,004TotalRevenueColumnAmt
Related Or Exempt Func Income$129,004RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$129,004OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,489,091TotalRevenueColumnAmt
Related Or Exempt Func Income$10,239,165RelatedOrExemptFuncIncomeAmt
Exclusion$6,469ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$249,023TotalAmt
Program Services$225,216ProgramServicesAmt
Management And General$23,807ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,847,472TotalAmt
Program Services$6,871,055ProgramServicesAmt
Management And General$976,417ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$256,911TotalAmt
Program Services$239,897ProgramServicesAmt
Management And General$17,014ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,079,464TotalAmt
Program Services$925,757ProgramServicesAmt
Management And General$153,707ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$627,958TotalAmt
Program Services$516,828ProgramServicesAmt
Management And General$111,130ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$30,049TotalAmt
Program Services$13,535ProgramServicesAmt
Management And General$16,514ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$386TotalAmt
Management And General$386ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$21,313TotalAmt
Management And General$21,313ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$686,744TotalAmt
Program Services$465,151ProgramServicesAmt
Management And General$221,593ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$9,699TotalAmt
Program Services$5,373ProgramServicesAmt
Management And General$4,326ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$276,700TotalAmt
Program Services$141,634ProgramServicesAmt
Management And General$135,066ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$183,254TotalAmt
Program Services$6,703ProgramServicesAmt
Management And General$176,551ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$649,412TotalAmt
Program Services$588,792ProgramServicesAmt
Management And General$60,620ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$65,252TotalAmt
Program Services$57,197ProgramServicesAmt
Management And General$8,055ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$44,004TotalAmt
Program Services$26,215ProgramServicesAmt
Management And General$17,789ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$120,909TotalAmt
Program Services$60,985ProgramServicesAmt
Management And General$59,924ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$73,683TotalAmt
Management And General$73,683ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
CATHOLIC HEALTH FEES$121,355$101,099$20,256
OPERATING SUPPLIES$67,500$66,770$730
REPAIRS AND MAINTENANCE$34,743$12,984$21,759
ALL OTHER EXPENSES$8,558$1,510$7,048

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$12,454,389TotalAmt
Program Services$10,326,701ProgramServicesAmt
Management And General$2,127,688ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,874,210BOYAmt
EOY$2,340,132EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$771,508BOYAmt
EOY$602,229EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$35,154BOYAmt
EOY$63,279EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$634,459LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$480,292LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$177,954BOYAmt
EOY$154,167EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$556,820BOYAmt
EOY$560,623EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,415,646BOYAmt
EOY$3,720,430EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,197,754BOYAmt
EOY$708,995EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$367,298BOYAmt
EOY$126,139EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,565,052BOYAmt
EOY$835,134EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,293,774BOYAmt
EOY$2,324,673EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$165,899BOYAmt
EOY$166,853EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$390,921BOYAmt
EOY$393,770EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,850,594BOYAmt
EOY$2,885,296EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,415,646BOYAmt
EOY$3,720,430EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$34,702ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,050CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,757CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,947,674CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,827,631CurrentTaxYearMinus1YearAmt
Current Tax Year$2,243,457CurrentTaxYearAmt
Total$10,032,569TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,581,281CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,229,707CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,666,530CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,520,100CurrentTaxYearMinus1YearAmt
Current Tax Year$10,110,161CurrentTaxYearAmt
Total$49,107,779TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,585,331CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,239,464CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,614,204CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$12,347,731CurrentTaxYearMinus1YearAmt
Current Tax Year$12,353,618CurrentTaxYearAmt
Total$59,140,348TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$59,140,348PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$48,828CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$43,454CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$22,984CurrentTaxYearMinus1YearAmt
Current Tax Year$6,469CurrentTaxYearAmt
Total$121,735TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$59,262,083TotalSupportAmt
Gross Receipts Rltd Activities$484,107GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99795PublicSupportCY170Pct
Public Support PY1700.99799PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$556,820BeginningYearBalanceAmt
Contributions$5,845ContributionsAmt
Investment Earnings Or Losses-$603InvestmentEarningsOrLossesAmt
Other Expenditures$1,439OtherExpendituresAmt
End Year Balance$560,623EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$543,318BeginningYearBalanceAmt
Contributions$4,141ContributionsAmt
Investment Earnings Or Losses$15,718InvestmentEarningsOrLossesAmt
Other Expenditures$6,357OtherExpendituresAmt
End Year Balance$556,820EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$536,233BeginningYearBalanceAmt
Contributions$4,728ContributionsAmt
Investment Earnings Or Losses$37,682InvestmentEarningsOrLossesAmt
Other Expenditures$35,326OtherExpendituresAmt
End Year Balance$543,317EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$530,903BeginningYearBalanceAmt
Contributions$9,757ContributionsAmt
Investment Earnings Or Losses$43,753InvestmentEarningsOrLossesAmt
Other Expenditures$48,180OtherExpendituresAmt
End Year Balance$536,233EndYearBalanceAmt
FieldValueIRS element (for citing)
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
Prmnnt Endowment Balance EOY0.70000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.30000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd
LandLandGrp
BuildingsBuildingsGrp

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$168,442OtherCostOrOtherBasisAmt
Depreciation$153,814DepreciationAmt
Book Value$14,628BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$466,017OtherCostOrOtherBasisAmt
Depreciation$326,478DepreciationAmt
Book Value$139,539BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$154,167TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescFUNDS HELD BY GOOD SAMARITANDesc
Book Value$560,623BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$560,623TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt
Total Liability$0TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$12,489,093TotalRevEtcAuditedFinclStmtAmt
Recoveries Prior Year Grants$2RecoveriesPriorYearGrantsAmt
Revenue Not Reported$2RevenueNotReportedAmt
Revenue Subtotal$12,489,091RevenueSubtotalAmt
Total Revenue Per Form990$12,489,091TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$12,454,389TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$12,454,389ExpensesSubtotalAmt
Total Expenses Per Form990$12,454,389TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part X, Line 2:FormAndLineReferenceDesc
ExplanationTHE FOLLOWING FOOTNOTE IS FROM THE AUDITED COMBINED FINANCIAL STATEMENTS FOR PREMIER HEALTH AND AFFILIATES. SAMARITAN HEALTH PARTNERS IS THE PARENT ORGANIZATION OF THE SAMARITAN BEHAVIORAL HEALTH, INC. PREMIER HEALTH (PREMIER), MEDAMERICA HEALTH SYSTEMS (MAHS), ATRIUM HEALTH SYSTEM (AHS), AND UVMC have been determined by the Internal Revenue Service to be tax-exempt nonprofit corporations and public charities under Sections 501(c)(3) and 509(a), respectively, of the Internal Revenue Code. SHP is tax-exempt under Section 501(c)(3) and is a public charity by reason of being included in the group ruling issued to the U.S. Catholic Church. As tax-exempt organizations, their income is exempt from federal income tax except to the extent of any unrelated business activities. PREMIER, MAHS, SHP, AHS, AND UVMC ALSO OWN OR CONTROL CERTAIN SUBSIDIARIES, WHICH ARE FOR PROFIT CORPORATIONS SUBJECT TO FEDERAL INCOME TAXES. Taxes payable at December 31, 2015 and 2014, for such unrelated business activities are not significant. Management annually reviews the tax positions and has determined that there are no material uncertain tax positions.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Eloise P Broner
Chair$0$433,215$0$113,857$0$139,476$0$11,050$0$2,940$0$700,538$0$0
Sue V McGatha
President & CEO / Vice Chair$174,314$0$36,620$0$4,463$0$22,759$0$10,867$0$249,023$0$0$0
Thomas R Curtin
Treasurer (To Aug)$0$217,858$0$55,160$0$3,259$0$8,232$0$29,091$0$313,600$0$0
Frank E Sawyer
Trustee$0$192,254$0$33,469$0$599$0$9,640$0$24,861$0$260,823$0$0
Ellen W Ballerene MD
Psychiatrist$174,090$0$200$0$169$0$0$0$23,133$0$197,592$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 4B:FormAndLineReferenceDesc
ExplanationDUE TO RESTRICTIONS IMPOSED BY THE INTERNAL REVENUE CODE, CERTAIN PERSONS ARE LIMITED IN THE AMOUNT OF BENEFIT THAT CAN BE EARNED UNDER A QUALIFIED RETIREMENT PLAN. LIKE MANY EMPLOYERS, SAMARITAN BEHAVIORAL HEALTH, INC. (SBHI) AND ITS AFFILIATED ORGANIZATIONS COMPENSATES FOR THIS LIMITATION AND SUPPLEMENTS THE AFFECTED EXECUTIVES' QUALIFIED PENSION THROUGH CERTAIN NONQUALIFIED PLANS. SBHI SUPPLEMENTS THE AFFECTED EXECUTIVES THROUGH A PENSION RESTORATION PLAN AND A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THE BENEFITS UNDER THESE SUPPLEMENTAL NONQUALIFIED PLANS ARE SUBJECT TO MULTI-YEAR VESTING AND A PARTICIPANT CAN FORFEIT BENEFITS EARNED IF VESTING REQUIREMENTS ARE NOT SATISFIED. UNDER THE TERMS OF THE SUPPLEMENTAL PLANS, AND BECAUSE OF TAX RULES PERTAINING TO TAXATION OF THE EARNED BENEFITS UPON VESTING, A CERTAIN INDIVIDUAL RECEIVED A PAYOUT OF THE CUMULATIVE VESTED BENEFITS UNDER THEIR SUPPLEMENTAL PLAN DURING 2015. THE INDIVIDUAL LISTED BELOW HAS MET THE MULTI-YEAR VESTING REQUIREMENT UNDER THE PENSION RESTORATION PLAN AND RECEIVED THE ASSOCIATED PAYMENT IN 2015: ELOISE BRONER $118,605. BASED ON THE GUIDANCE PROVIDED IN THE INSTRUCTIONS TO THE FORM 990, ANY PAYMENTS TO THE PARTICIPANTS RELATED TO THESE PLANS THAT WERE MADE WITHIN 2-1/2 MONTHS AFTER THE END OF THE ORGANIZATION'S TAX YEAR ARE NOT TREATED AS DEFERRED COMPENSATION FOR PURPOSES OF SCHEDULE J. SUCH AMOUNTS ARE PROPERLY REPORTED AS COMPENSATION FOR FORM 990 PURPOSES WHEN INCLUDED IN THE PARTICIPANTS' FORM W-2 WAGES. ANY PAYMENTS MADE AFTER THE 2-1/2 MONTHS WERE PROPERLY REPORTED ON PRIOR YEARS' FILED IRS FORM 990 RETURNS, DISCLOSING COMPENSATION EARNED BY THESE INDIVIDUALS UNDER THE PLANS FOR EACH SUCH YEAR.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceForm 990 - Part III, Question 4A (CONTINUED):FormAndLineReferenceDesc
Explanation(Community Psychiatric Supportive Treatment) services to further support therapeutic interventions and link patient/family to community resources. During 2015, 3,674 patients were served. Form 990 - Part III, Question 4b (CONTINUED): and/or in the community for those who are at risk of harm to themselves or others, Crisis Counseling Provides counseling up to 4 sessions for acute stabilization and on-going support, Crisis Debriefing Services are available for individuals or groups involved in traumatic events. Crisis-Care served 1,518 patients and provided 8,614 in services for 2015. Form 990, Part III, Question 4d: This number represents the balance of total expenditures of temporarily restricted funds for Samaritan Behavorial Health net of programs described in service accomplishments. Form 990 - Part VI, Section A, Question 3: Premier Health (Premier), as the operator of Samaritan Bevavioral Health, Inc.(SBHI), develops and oversees the implementation of the strategic plan for SBHI, which includes (but is not limited to) such matters as location of clinical and administrative expenses and the consolidation of such services. SBHI shall comply with and implement this plan and shall not take any action that materially departs from this plan without Premier's approval. SBHI shall implement any capital and operating budget so approved and/or revised for it by Premier. SBHI shall implement the business plan approved by Premier. Premier is the sole agent to negotiate all relationships with payors on behalf of SBHI with all third party payors and alternative delivery systems including, but not limited to insurers. SBHI must have approval from Premier to borrow in any fiscal year, guarantee in any year, or incur any lien or other encumbrance on any property in an amount equal to or greater than $1,000,000. SBHI must seek Premier's approval for any acquisitions, sale or transfer of any material asset used in Premier's activities. Form 990 - Part VI, Question 6: samaritan Behavioral Health Inc. (SBHI) has one corporate member, which is Samaritan Health Partners, Inc. (SHP), the parent company of SBHI. Form 990 - Part VI, Section A, Question 7a: Samaritan Health Partners (SHP) has the sole authority to elect the Board of Trustees for Samaritan Behavioral Health, Inc. (SBHI). SHP has the authority to remove trustees at any regular or special meeting or by written consent. Form 990 - Part VI, Section A, Question 7b: SEE THE RESPONSE ABOVE FOR FORM 990, PART VI, SECTION A, QUESTION 3. Form 990 - Part VI, Section B, Question 11B: This 990 tax return and attached schedules (the return) are prepared by a staff member in the Tax Department of Premier Health (Premier), which Samaritan Behavorial health, Inc. is an affiliate. The return is reviewed by the Tax Manager and the Director of Tax Compliance of Premier. The return is concurrently sent to Ernst & Young U.S. LLP for their review. After all changes from the above groups are made, the return is reviewed by the Vice President/Controller of Premier and the Chief Financial Officer of this entity. A final version of the return is sent to Ernst & Young U.S. LLP for a final review and then provided to the Board of Trustees for review. At the Board of Trustees meeting, the Vice President/Controller of Premier (or designee) shares detailed information on compensation and other key areas, as well as address any other questions from the Board of Trustees, pending their review. The 990 tax return is also shared with the Audit Committee of Premier. Form 990 - Part VI, Section B, Question 12c: PREMIER HEALTH (PREMIER), OF WHICH Samaritan Behavioral Health, Inc. IS AN AFFILIATE, REQUIRES ALL BOARD MEMBERS, OFFICERS, EXECUTIVE DIRECTORS, VICE PRESIDENTS, DIRECTORS, PURCHASING DEPARTMENT STAFF, AUTHORIZED PURCHASERS, MEDICAL DIRECTORS, DEPARTMENT AND SECTIONS CHAIRS, AND ALL EMPLOYED PHYSICIANS TO ANNUALLY REVIEW THE PREMIER COMPREHENSIVE CONFLICT OF INTEREST STATEMENT, AN EXPLANATORY MEMORANDUM, THE ANTITRUST COMPLIANCE POLICY, AND COMPLETE AN INDIVIDUAL QUESTIONNAIRE DISCLOSING ANY POTENTIAL CONFLICTS AS DEFINED IN THE CONFLICT OF INTEREST POLICY. THIS IS ACCOMPLISHED EITHER BY WAY OF AN ELECTRONIC COMMUNICATION SENT OUT DIRECTLY BY THE CORPORATE COMPLIANCE DEPARTMENT OR BY WAY OF A MEMO SENT OUT FROM THE CHAIRMAN OF THE BOARD AND CHIEF EXECUTIVE OFFICER OF PREMIER. IT ALSO INCLUDES AN EXPLANATORY MEMORANDUM OF SPECIFIC ACTIVITIES THAT MIGHT GIVE CAUSE TO A CONFLICT AND AN INDIVIDUAL QUESTIONNAIRE TO DISCLOSE ALL SUCH ACTIVITIES. THIS QUESTIONNAIRE MUST BE COMPLETED AND SIGNED BY THE INDIVIDUAL. THIS CORRESPONDENCE INCLUDES A COPY OF THE ANTITRUST COMPLIANCE POLICY THAT MUST BE SIGNED BY THE INDIVIDUAL. ALL OF THESE DOCUMENTS ARE SENT TO THE CORPORATE COMPLIANCE DEPARTMENT. THE CORPORATE COMPLIANCE DEPARTMENT ENSURES ALL FORMS ARE RETURNED AND RETAINS THE DOCUMENTS FOR FIVE YEARS. IN ADDITION, AT EACH MEETING OF THE BOARD OR ANY BOARD COMMITTEE, FOLLOWING APPROVAL OF THE PREVIOUS MEETING'S MINUTES, THE BOARD OR COMMITTEE CHAIR SHALL REQUEST ANY BOARD MEMBER WHO PERCEIVES A POTENTIAL CONFLICT OF INTEREST ON ANY OF THE MEETING'S AGENDA ITEMS TO DISCLOSE THE POTENTIAL CONFLICT. ADDITIONALLY, AT ANY BOARD OR BOARD COMMITTEE MEETING WHERE THE SUBJECT OF CONFLICT OF INTEREST IS DISCUSSED, THE MINUTES SHALL CONTAIN THE NAME OF THE PARTY DISCUSSING A POTENTIAL CONFLICT OF INTEREST, THE NATURE OF THE POTENTIAL CONFLICT OF INTEREST AND WHETHER A CONFLICT OF INTEREST WAS FOUND TO EXIST. IF A CONFLICT OF INTEREST IS DETERMINED BY THE BOARD TO EXIST, THE MEMBER WILL BE EXCUSED FROM PARTICIPATING IN ANY DISCUSSION OR VOTING ON THE PARTICULAR AGENDA ITEM. THE CHIEF COMPLIANCE AND ENTERPRISE RISK OFFICER REPORTS THE RESULTS OF THE PREMIER CONFLICT OF INTEREST QUESTIONNAIRES NO LESS THAN ANNUALLY TO THE BOARD OF TRUSTEES BY WAY OF THE COMPLIANCE AND AUDIT COMMITTEE. THIS REVIEW IS DOCUMENTED IN THE MINUTES OF THE MEETING. PERIODICALLY, THE INTERNAL AUDIT DEPARTMENT WILL REVIEW A SAMPLE OF COMPLETED CONFLICT OF INTEREST QUESTIONNAIRES AND REPORT THE RESULTS TO THE COMPLIANCE AND AUDIT COMMITTEE. THE ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES ARE INDIVIDUALLY SUMMARIZED IN A DOCUMENT AND SENT ELECTRONICALLY TO THE FINANCE DEPARTMENT FOR ANY NECESSARY DISCLOSURES REQUIRED ON THE 990 TAX RETURN. Form 990 - Part VI, Section B, Question 15A and 15B: COMPENSATION TO THE CEO OF SAMARITAN BEHAVIORAL HEALTH, INC. (SBHI) IS REVIEWED AND APPROVED BY PREMIER HEALTH (PREMIER), of which SBHI IS AN AFFILIATE, ON AN ANNUAL BASIS. THE REVIEW PROCESS PERFORMED BY PREMIER FOLLOWS A MARKET BASED COMPENSATION PHILOSOPHY designed to attract and retain the executive talent required to meet the high performance standards of our board and our community. PREMIER ANNUALLY REVIEWS EXECUTIVE COMPENSATION SURVEY DATA FOR A REGIONAL PEER GROUP OF SYSTEMS AND HOSPITALS THAT ARE SIMILAR IN SIZE AND COMPLEXITY TO PREMIER AND ITS AFFILIATES. THE DATA FOR THE SURVEY IS PROVIDED BY A THIRD PARTY CONSULTANT GROUP THAT IS INDEPENDENT OF PREMIER. THIS REPORT INCLUDES COMPARABILITY FOR KEY EXECUTIVES, VICE PRESIDENTS, AND DIRECTOR LEVEL POSITIONS. THE INDEPENDENT COMPARABILITY DATA IS REVIEWED BY THE EXECUTIVE COMPENSATION COMMITTEE ON AN ANNUAL BASIS. THIS COMMITTEE IS COMPRISED OF THREE MEMBERS, ALL OF WHICH ARE INDEPENDENT. THIS COMMITTEE REVIEWS IN DETAIL THE COMPENSATION FOR THE PREMIER CEO, COO, CFO, CHIEF STRATEGY OFFICER, AND THE HOSPITAL CEOS. OTHER POSITIONS ARE REVIEWED AT A HIGH LEVEL FOR REASONABLENESS. ALL THE MEETING MINUTES ARE DOCUMENTED AND KEPT ON FILE ALONG WITH ANY COMPARABILITY DATA AND THE CONSULTANT REPORT. AFTER THE COMPENSATION COMMITTEE REVIEWS AND APPROVES THE COMPENSATION ACTIONS, THE PROCESS IS AUDITED BY THE INTERNAL AUDIT DEPARTMENT. THE EXECUTIVE COMPENSATION COMMITTEE PRESENTS THE COMPENSATION ACTIONS TO THE PREMIER BOARD ANNUALLY. Form 990 - Part VI, Section C Question 19: THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC WHEN REQUIRED BY LAW OR FOR ACCREDITATION PURPOSES. THE CONFLICT OF INTEREST POLICY IS AVAILABLE ON WWW.PREMIERHEALTH.COM.ExplanationTxt

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Samaritan Health Partners (SHP)
110 N MAIN St SUITE 500DaytonOH45402311107411ParentOH501(c)(3)11C III FINAfalse
Good Samaritan Hospital
110 N MAIN ST SUITE 500DAYTONOH45402310536981HOSPITALOH501(c)(3)3SHPYes (true)
Catholic Health Initiatives
198 Inverness Dr W Suite 500EnglewoodCO80112470617373ParentCO501(C)(3)9NAfalse
THE HEART INSTITUTE OF DAYTON
2200 PHILADELPHIA DRDAYTONOH45406300502367EDUCATIONOH501(C)(3)9SHPYes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SAMARITAN NORTH SURGERY CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line19000 N MAIN ST STE 500AddressLine1Txt
CityDAYTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45415ZIPCd
FieldValueIRS element (for citing)
EIN311618587EIN
Primary ActivitiesO/P SURGERYPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1GSHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income$0ShareOfTotalIncomeAmt
Share Of EOY Assets$0ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
UBI Code V$0UBICodeVAmt
General Or Managing PartnerfalseGeneralOrManagingPartnerInd
Ownership0.00000OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SAMARITAN FAMILY CAREBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 N MAIN ST STE 500AddressLine1Txt
CityDAYTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45402ZIPCd
FieldValueIRS element (for citing)
EIN311299450EIN
Primary ActivitiesPHYSICIANSPrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SHPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeC CORPEntityTypeTxt
Share Of Total Income$0ShareOfTotalIncomeAmt
Share Of EOY Assets$0ShareOfEOYAssetsAmt
Ownership0.00000OwnershipPct
Controlled OrganizationYes (true)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Catholic Health Initiatives
C$170,818Cash
Catholic Health Initiatives
P$121,355Cash
Good Samaritan Hospital
P$236,928Cash