STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

SAMARITAN HEALTH & LIVING CENTER INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
SAMARITAN HEALTH & LIVING CENTER INC (EIN 35-1288674)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-09-14
IRS object ID
201232589349300143
Schema version
2011v1.2
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-09-14T14:20:00-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN420714325EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MCGLADREY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 99AddressLine1
CityELKHARTCity
StateINState
ZIP Code465150099ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN351288674EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SAMARITAN HEALTH AND LIVING CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSAMANameControl
Phone5742623597Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1221 EAST CRAWFORD STREETAddressLine1
CityELKHARTCity
StateINState
ZIP Code46514ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameGREGORY HINKLE PH DName
TitleDIRECTORTitle
Phone5742623597Phone
Date Signed2012-09-07DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameSANDRA S SCHNEIDERName
PTINP00214417PTIN
Phone5742963780Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGREGORY HINKLE PH DNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1221 EAST CRAWFORD STREETAddressLine1
CityELKHARTCity
StateINState
ZIP Code46514ZIPCode
FieldValueIRS element (for citing)
Gross Receipts401929GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1973YearFormation
State Legal DomicileINStateLegalDomicile
Activity Or Mission DescriptionWE PROVIDE PSYCHOTHERAPY, PASTORAL COUNSELING, CONSULTATION, AND EDUCATION WITH A "WHOLE PERSON-MIND, BODY AND SPIRIT" EMPHASIS, WITH THE GOAL OF OFFERING HEALING, HOPE AND GROWTH TO ALL IN NEED.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members18NbrIndependentVotingMembers
Total Nbr Employees9TotalNbrEmployees
Total Nbr Volunteers1TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year173741ContributionsGrantsPriorYear
Contributions Grants Current Year158376ContributionsGrantsCurrentYear
Program Service Revenue Prior Year235424ProgramServiceRevenuePriorYear
Program Service Revenue CY242918ProgramServiceRevenueCY
Investment Income Prior Year6InvestmentIncomePriorYear
Investment Income Current Year635InvestmentIncomeCurrentYear
Other Revenue Prior Year-9236OtherRevenuePriorYear
Other Revenue Current Year-7116OtherRevenueCurrentYear
Total Revenue Prior Year399935TotalRevenuePriorYear
Total Revenue Current Year394813TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year169725SalariesEtcPriorYear
Salaries Etc Current Year261559SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year13179TotalFundrsngExpCurrentYear
Other Expense Prior Year182933OtherExpensePriorYear
Other Expenses Current Year76306OtherExpensesCurrentYear
Total Expenses Prior Year352658TotalExpensesPriorYear
Total Expenses Current Year337865TotalExpensesCurrentYear
Revenues Less Expenses Prior Year47277RevenuesLessExpensesPriorYear
Revenues Less Expenses CY56948RevenuesLessExpensesCY
Total Assets BOY99854TotalAssetsBOY
Total Assets EOY156802TotalAssetsEOY
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY99854NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY156802NetAssetsOrFundBalancesEOY
Mission DescriptionWE PROVIDE PSYCHOTHERAPY, PASTORAL COUNSELING, CONSULTATION, AND EDUCATION WITH A "WHOLE PERSON-MIND,BODY, AND SPIRIT" EMPHASIS, WITH THE GOAL OF OFFERING HEALNG, HOPE AND GROWTH TO ALL IN NEED.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense239095Expense
Revenue242918Revenue
DescriptionPSYCHOTHERAPY, PASTORAL COUNSELING AND CONSULTATIONDescription
Total Program Service Expense239095TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10962NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees9NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members18NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledINStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonGREGORY HINKLE PH DNamePerson
Telephone Number5742623597TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line122493 PEPPERWOOD LANEAddressLine1
CityGOSHENCity
StateINState
ZIP Code46528ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
GREGORY HINKLE
DIRECTOR40.00X64657027115
BRADEN MCCORMICK
PAST PRESIDEMT0.00X000
ANN MCCUISTION
TREASURER0.00X000X
JULIE APP BREITLING
BOARD MEMBER0.00X000
RANDALL LIPPS
BOARD MEMBER0.00X000
SUZANNE WYATT
BOARD MEMBER0.00X000
LAIN RUCH DOWNS
VICE PRESIDENT0.00X000X
REV JOSEPH SMITH
BOARD MEMBER0.00X000
JENNIFER HIATT-SCHUMAN
SECRETARY0.00X000X
DEAN E LEAZENBY
BOARD MEMBER0.00X000
DAVID MARKS
BOARD MEMBER0.00X000
SCOTT MERENESS
BOARD MEMBER0.00X000
JENNIFER PITCHER
BOARD MEMBER0.00X000
MARY JO SARTORIUS
BOARD MEMBER0.00X000
CINDY BURNS
BOARD MEMBER0.00X000
GINNY RUSSELL
BOARD MEMBER0.00X000
KIM WELCH
BOARD MEMBER0.00X000
JULI MEYER
PRESIDENT0.00X000X
REV STEPHEN BRADEN
BOARD MEMBER0.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org64657TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation27115TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Fundraising Events93903FundraisingEvents
All Other Contributions64473AllOtherContributions
Total Contributions158376TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPROFESSIONAL FEESDescription
Business Code621300BusinessCode
Total Revenue Column242918TotalRevenueColumn
Related Or Exempt Function Income242918RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue242918TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column635TotalRevenueColumn
Exclusion$635ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events0GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events93903CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses7116FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-7116TotalRevenueColumn
Exclusion-$7,116ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column394813TotalRevenueColumn
Related Or Exempt Function Income242918RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$6,481ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total91772Total
Program Services91772ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total136958Total
Program Services77397ProgramServices
Management And General49240ManagementAndGeneral
Fundraising10321Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4984Total
Management And General4984ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total27845Total
Program Services20595ProgramServices
Management And General5994ManagementAndGeneral
Fundraising1256Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total34774Total
Program Services34774ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total4118Total
Program Services1366ProgramServices
Management And General2441ManagementAndGeneral
Fundraising311Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total6528Total
Program Services3226ProgramServices
Management And General2845ManagementAndGeneral
Fundraising457Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total1024Total
Program Services188ProgramServices
Management And General836ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total3210Total
Management And General3210ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServicesFundraisingFundraising
(A) AGENCY DUES51615161
(B) CLEANING/SECURITY484737941053
(C) MISCELLANEOUS33418391668834
(I) TELEPHONE26976602037

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total10606Total
Program Services5019ProgramServices
Management And General5587ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total337865Total
Program Services239095ProgramServices
Management And General85591ManagementAndGeneral
Fundraising13179Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY99854BOY
EOY156802EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY99854BOY
EOY156802EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY99854BOY
EOY156802EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY99854BOY
EOY156802EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY99854BOY
EOY156802EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses56948ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited0FSAudited
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years337537CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years269563CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years332992CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year173741CurrentTaxYearMinus1Year
Current Tax Year158376CurrentTaxYear
Total1272209Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year235424CurrentTaxYearMinus1Year
Current Tax Year242918CurrentTaxYear
Total478342Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years337537CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years269563CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years332992CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year409165CurrentTaxYearMinus1Year
Current Tax Year401294CurrentTaxYear
Total1750551Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total5091750551PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1962CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years18CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years206CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6CurrentTaxYearMinus1Year
Current Tax Year635CurrentTaxYear
Total2827Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1962CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years18CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years206CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6CurrentTaxYearMinus1Year
Current Tax Year635CurrentTaxYear
Total2827Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years60CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years652CurrentTaxYearMinus2Years
Total712Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years339499CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years269641CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years333850CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year409171CurrentTaxYearMinus1Year
Current Tax Year401929CurrentTaxYear
Total1754090Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99800PublicSupportPercentage509
Prior Year Support Percentage0.99690PriorYearSupportPercentage
Investment Income Percentage0.00160InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00270PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings
Total Revenue394813TotalRevenue
Total Expenses337865TotalExpenses
Excess Or Deficit For Year56948ExcessOrDeficitForYear
Excess Or Deficit Per FS56948ExcessOrDeficitPerFS

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1DANCING COMPETITIONNameOfEvent1
Gross Receipts Event193903GrossReceiptsEvent1
Charitable Contributions Event193903CharitableContributionsEvent1
Other Direct Expenses Event17116OtherDirectExpensesEvent1
Gross Receipts Total93903GrossReceiptsTotal
Charitable Contributions Total93903CharitableContributionsTotal
Other Direct Expenses Total Events7116OtherDirectExpensesTotalEvents
Direct Expense Summary Events7116DirectExpenseSummaryEvents
Net Income Summary-7116NetIncomeSummary

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11A 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 12CTHE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES THEIR CONFLICT OF INTEREST POLICY VIA ANNUAL DISCLOSURE QUESTIONNAIRES.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT PERSONS, DETERMINES COMPENSATION FOR THE EXECUTIVE DIRECTOR AND KEY EMPLOYEES. THE COMPENSATION IS THEN REVIEWED ANNUALLY. MINUTES ARE TAKEN FOR ALL EXECUTIVE COMMITTEE MEETINGS AND COMPARATIVE DATA, INCLUDING THE SAMARITAN INSTITUTE REPORT ON COMPENSATION, ARE USED.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1ELKHART COUNTY SAMARITAN CENTER FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1221 E CRAWFORD STAddressLine1
CityELKHARTCity
StateINState
ZIP Code46514ZIPCode
FieldValueIRS element (for citing)
EIN311164839EIN
Primary ActivitiesENDOWMENT FUND - SUPPORT OF THE SAMARITAN HEALTH AND LIVING CENTERPrimaryActivities
Legal Domicile StateINLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status509(A)(3), TYPE IPublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SAMARITAN HEALTH AND LIVING CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg