Civic Intelligence

Good Samaritan Hospital Foundation Inc

EIN 35-1637684 • 501(c)3 • Vincennes, IN

Profile

Provide excellent health care by promoting wellness, education and healing through trusting relationships.

328 N 2nd Street Suite 201Vincennes, IN 47591

www.gshvin.org/foundation

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

44th percentile

0.04x

Higher debt load relative to assets than 44% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Source year 2024

Liabilities / Revenue

71st percentile

0.26x

Higher debt load relative to revenue than 71% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Source year 2024

Net Margin

72nd percentile

19%

Higher net margin than 72% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Source year 2024

Top Officer Pay

50th percentile

$58,815

Higher top officer pay than 50% of similar nonprofits.

Top officer pay equals 8.4% of source-year revenue.

501(c)3 • $1M-$5M nonprofits • Source year 2024

Asset Growth

60th percentile

7.4%

Faster asset growth than 60% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Annualized from 2023 to 2024

Revenue Growth

12th percentile

-28%

Faster revenue growth than 12% of similar nonprofits.

501(c)3 • $1M-$5M nonprofits • Annualized from 2023 to 2024

Balance Sheet
Liabilities / Assets44th percentile

Assets

Up

$4,945,808

Up $341,695 (+7.4%) from 2023

Liabilities

Up

$182,623

Up $182,508 (+158703%) from 2023

Net Assets

Up

$4,763,185

Up $159,187 (+3.5%) from 2023

Operations
Liabilities / Revenue71st percentileNet Margin72nd percentile

Revenue

Down

$700,248

Down $267,753 (-28%) from 2023

Expenses

Down

$566,740

Down $314,395 (-36%) from 2023

Net Income

Up

$133,508

Up $46,642 (+54%) from 2023

Trend Graphs

Balance Sheet Trend

Asset Growth60th percentile

Grouped bars show assets, liabilities, and net assets across loaded filings.

$6.0M$4.0M$2.0M$0-$2.0MAssets 2020: $4,905,158Liabilities 2020: $5,864Net Assets 2020: $4,899,2942020Assets 2021: $4,610,658Liabilities 2021: -$206,704Net Assets 2021: $4,817,3622021Assets 2022: $4,190,547Liabilities 2022: $229Net Assets 2022: $4,190,3182022Assets 2023: $4,604,113Liabilities 2023: $115Net Assets 2023: $4,603,9982023Assets 2024: $4,945,808Liabilities 2024: $182,623Net Assets 2024: $4,763,1852024

Highlighted filing

2024

Assets$4,945,808
Liabilities$182,623
Net Assets$4,763,185
Open 2024 Filing

Operations Trend

Revenue Growth12th percentile

Revenue, expenses, and net income by year, with the latest filing highlighted.

$3.0M$2.0M$1.0M$0-$1.0MRevenue 2020: $1,147,622Expenses 2020: $1,147,409Net Income 2020: $2132020Revenue 2021: $1,741,371Expenses 2021: $2,031,858Net Income 2021: -$290,4872021Revenue 2022: -$181,576Expenses 2022: $636,449Net Income 2022: -$818,0252022Revenue 2023: $968,001Expenses 2023: $881,135Net Income 2023: $86,8662023Revenue 2024: $700,248Expenses 2024: $566,740Net Income 2024: $133,5082024

Highlighted filing

2024

Revenue$700,248
Expenses$566,740
Net Income$133,508
Open 2024 Filing

Filings

Most recent year

2024 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$4,945,808
Liabilities
$182,623
Net assets
$4,763,185
Revenue
$700,248
Expenses
$566,740
Net income
$133,508
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Detailed filing. Detailed filing data is available for this year.$4.95$0.18$4.76$0.70$0.57$0.13
2023Detailed filing. Detailed filing data is available for this year.$4.60$0.00$4.60$0.97$0.88$0.09
2022Detailed filing. Detailed filing data is available for this year.$4.19$0.00$4.19$0.18$0.64$0.82
2021Detailed filing. Detailed filing data is available for this year.$4.61$0.21$4.82$1.74$2.03$0.29
2020Detailed filing. Detailed filing data is available for this year.$4.91$0.01$4.90$1.15$1.15$0.00
Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Jan 1, 2024 to Dec 31, 2024
Signed
Apr 23, 2025
Return Version
2024v5.0
Gross Receipts
$725,664
Mission and Program Overview

Mission

Provide excellent health care by promoting wellness education and healing through trusting relationships.

The mission of Good Samaritan Hospital Foundation is to raise private philanthropic support for Good Samaritan Hospital, its programs and services and to assure the continuation of the delivery of the highest quality medical and health care services that our community deserves and has come to expect. The services assist with charity care activities to assist the patients and families and provide equipment and educational opportunities for clinical staff.

Balance Sheet Detail
LineBeginningEndChange
Assets
Cap Stk Tr Prin Current Funds$6,022,895$6,048,573▲ $25,678
Investments in Publicly Traded Securities$4,287,505$4,559,941▲ $272,436
Cash and Non-Interest-Bearing Accounts$216,848$210,116▼ $6,732
Savings and Temporary Cash Investments$78,758$156,352▲ $77,594
Land, Buildings, and Equipment, Net$21,002$19,399▼ $1,603
Pd in Cap Srpls Land Bldg Eqp Fund$0$0→ $0
Rtn Earn Endowment Incm Other Fnds$-1,418,897$-1,285,388▲ $133,509
Total Assets$4,604,113$4,945,808▲ $341,695
Liabilities
Accounts Payable and Accrued Expenses$115$182,623▲ $182,508
Total Liabilities$115$182,623▲ $182,508
Net Assets / Fund Balance
Total Net Assets Fund Balance$4,603,998$4,763,185▲ $159,187
Total Liabilities and Net Assets / Fund Balance$4,604,113$4,945,808▲ $341,695

Asset Categories

AssetBook ValueDepreciationBasis
Buildings$0$0$0
Other Land Buildings$0$0$0
Land$0-$0
Equipment$19,399$3,397$0
Leasehold Improvements$0$0$0
Compensation and Service Providers
Top Officer Pay50th percentile

Employees

NameTitleFull / Part TimeBaseTotal
Nicole CoomerDirectorFT$58,815$58,815
Ashley MelvinDonor Relation CoordinatorFT$38,475$38,475

Board Members and Trustees

NameTitle
Lowell StoeltingGrant Committe Chair
Joyce VillwockScholarship Chair
Patricia BuntrockScholarship Chair
Helen SeirpPresident
Regina McCord FithianVice President
Austin Muranaka MDBoard Member
Carson ThackerBoard Member
Cindy MooreBoard Member
Dave MillerBoard Member
Dennis KordesBoard Member
Kendall ViekeBoard Member
Leslie KidwellBoard Member
Patty NiehausBoard Member
Patty SummersBoard Member
Robert McLinBoard Member
Tiffany ConoverBoard Member
Ann HeddeSecretary
Roy IceTreasurer
Revenue and Support

Revenue Composition

Contributions and Grants
$268,531
Program Service Revenue
$0
Investment Income
$361,788
Other Revenue
$69,929
All Other Contributions
$251,742
Change in Net Assets
$133,508
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Grants and Similar Amounts Paid$308,782
Salaries, Compensation, and Employee Benefits$136,309
Other Expenses$121,649
Total Fundraising Expense$103,669
Professional Fundraising Fees$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Grants to Domestic Orgs$266,463--$266,463
Current Officers, Directors, Trustees, and Key Employees$0$42,803$64,204$107,007
Grants to Domestic Individuals$42,319--$42,319
Advertising$0$0$18,662$18,662
Other Employee Benefits$0$6,944$10,417$17,361
Fees for Services Other$0$10,574-$10,574
Payroll Taxes$0$3,264$4,895$8,159
Information Technology$0$1,420$2,418$3,838
Pension Plan Contributions$0$1,513$2,269$3,782
Conferences and Meetings$0$3,452$0$3,452
Depreciation Depletion$0$1,603$0$1,603
Office Expenses$0$632$804$1,436
Other Expenses$0$3$0$3
Total Functional Expenses$308,782$154,289$103,669$566,740
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Good Samaritan HospitalVincennes, IN501 (c)(3)health care$189,733
Fundraising, Events, and Gaming
Fundraising activities
Yes
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Gross Income$95,345
Fundraising Direct Expenses$25,416
Professional Fundraising Fees$0

Fundraising Events

EventGross ReceiptsGross RevenueDirect ExpensesNet Income
Golf Outing$70,345$70,345$0$70,345
Golf Cart Raffle$25,000$25,000$10,671$14,329
Total Events$95,345$95,345$25,416$69,929
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Subject to proxy tax
No
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
Yes
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with 35% controlled entity
No
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
No
Other officer compensation reviewed
No
Conflict-of-interest policy
Yes
Audited financial statements prepared
Yes
Key decisions subject to board approval
Yes
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 6

“The Foundation Members are the Board Members”

Form 990, Part VI, Section A, Line 7A

“The members elect new officers annually”

Form 990, Part VI, Section A, Line 7B

“Any decisions of the governing body are subject to approval by the Board”

Form 990, Part VI, Section B, Line 11B

“Form 990 is reviewed by Director of Foundation and the President of the Board”

Form 990, Part VI, Section B, Line 12C

“Foundation Board members sign a conflict of interest form on an annual basis.”

Form 990, Part VI, Section C, Line 19

“Available upon request”

Filing and Contact Details

Filer

Filer Name
Good Samaritan Hospital Foundation Inc
EIN
35-1637684
Phone
8128853192
Address
328 N 2nd Street Suite 201, Vincennes, IN 47591

Signing Officer

Name
Helen Seirp
Title
President
Phone
8128853273
Signed
2025-04-23

Organization Details

Principal Officer
Helen Seirp
Formed
1995
Legal Domicile
In
Voting Board Members
17
Independent Board Members
0
Employees
2
Volunteers
25
Supplemental Narrative

Additional Explanations

Form 990, Part XI, Line 9

“Elimination of inner corporate loans”

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IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt00
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt10
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt20
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt30
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt40
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt50
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt60
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt70
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt80
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt90
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt100
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt110
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt120
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt130
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt140
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt150
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt160
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt170
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt180
IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt190
IRS990/Form990PartVIISectionAGrp/TitleTxt0Director
IRS990/Form990PartVIISectionAGrp/TitleTxt1Donor Relation Coordinator
IRS990/Form990PartVIISectionAGrp/TitleTxt2Grant Committe Chair
IRS990/Form990PartVIISectionAGrp/TitleTxt3Scholarship Chair
IRS990/Form990PartVIISectionAGrp/TitleTxt4Scholarship Chair
IRS990/Form990PartVIISectionAGrp/TitleTxt5Board Member
IRS990/Form990PartVIISectionAGrp/TitleTxt6Board Member
IRS990/Form990PartVIISectionAGrp/TitleTxt7Board Member
IRS990/Form990PartVIISectionAGrp/TitleTxt8Board Member
IRS990/Form990PartVIISectionAGrp/TitleTxt9Board Member
IRS990/Form990PartVIISectionAGrp/TitleTxt10Board Member
IRS990/Form990PartVIISectionAGrp/TitleTxt11Board Member
IRS990/Form990PartVIISectionAGrp/TitleTxt12Board Member
IRS990/Form990PartVIISectionAGrp/TitleTxt13Board Member
IRS990/Form990PartVIISectionAGrp/TitleTxt14Board Member
IRS990/Form990PartVIISectionAGrp/TitleTxt15Board Member
IRS990/Form990PartVIISectionAGrp/TitleTxt16President
IRS990/Form990PartVIISectionAGrp/TitleTxt17Vice President
IRS990/Form990PartVIISectionAGrp/TitleTxt18Treasurer
IRS990/Form990PartVIISectionAGrp/TitleTxt19Secretary
IRS990/Form990ProvidedToGvrnBodyInd00
IRS990/FormationYr01995
IRS990/FormerOfcrEmployeesListedInd00
IRS990/FSAuditedBasisGrp/ConsolAndSepBasisFinclStmtInd0X
IRS990/FSAuditedInd01
IRS990/FundraisingActivitiesInd01
IRS990/FundraisingAmt00
IRS990/FundraisingDirectExpensesAmt025416
IRS990/FundraisingGrossIncomeAmt095345
IRS990/GainOrLossGrp/OtherAmt00
IRS990/GainOrLossGrp/SecuritiesAmt00
IRS990/GamingActivitiesInd00
IRS990/GoverningBodyVotingMembersCnt017
IRS990/GovernmentGrantsAmt00
IRS990/GrantAmt00
IRS990/GrantsToDomesticIndividualsGrp/ProgramServicesAmt042319
IRS990/GrantsToDomesticIndividualsGrp/TotalAmt042319
IRS990/GrantsToDomesticOrgsGrp/ProgramServicesAmt0266463
IRS990/GrantsToDomesticOrgsGrp/TotalAmt0266463
IRS990/GrantsToIndividualsInd01
IRS990/GrantsToOrganizationsInd01
IRS990/GrantToRelatedPersonInd00
IRS990/GrossReceiptsAmt0725664
IRS990/GroupReturnForAffiliatesInd00
IRS990/IncludeFIN48FootnoteInd00
IRS990/IncmFromInvestBondProceedsGrp/ExclusionAmt00
IRS990/IncmFromInvestBondProceedsGrp/RelatedOrExemptFuncIncomeAmt00
IRS990/IncmFromInvestBondProceedsGrp/TotalRevenueColumnAmt00
IRS990/IncmFromInvestBondProceedsGrp/UnrelatedBusinessRevenueAmt00
IRS990/IndependentAuditFinclStmtInd00
IRS990/IndependentVotingMemberCnt00
IRS990/IndivRcvdGreaterThan100KCnt00
IRS990/IndoorTanningServicesInd00
IRS990/InfoInScheduleOPartVIInd0X
IRS990/InfoInScheduleOPartXIInd0X
IRS990/InformationTechnologyGrp/FundraisingAmt02418
IRS990/InformationTechnologyGrp/ManagementAndGeneralAmt01420
IRS990/InformationTechnologyGrp/ProgramServicesAmt00
IRS990/InformationTechnologyGrp/TotalAmt03838
IRS990/InsuranceGrp/FundraisingAmt00
IRS990/InsuranceGrp/ManagementAndGeneralAmt00
IRS990/InsuranceGrp/ProgramServicesAmt00
IRS990/InsuranceGrp/TotalAmt00
IRS990/InterestGrp/FundraisingAmt00
IRS990/InterestGrp/ManagementAndGeneralAmt00
IRS990/InterestGrp/ProgramServicesAmt00
IRS990/InterestGrp/TotalAmt00
IRS990/InvestmentExpenseAmt00
IRS990/InvestmentIncomeGrp/ExclusionAmt00
IRS990/InvestmentIncomeGrp/RelatedOrExemptFuncIncomeAmt0361788
IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt0361788
IRS990/InvestmentIncomeGrp/UnrelatedBusinessRevenueAmt00
IRS990/InvestmentInJointVentureInd00
IRS990/InvestmentsPubTradedSecGrp/BOYAmt04287505
IRS990/InvestmentsPubTradedSecGrp/EOYAmt04559941
IRS990/IRPDocumentCnt00
IRS990/IRPDocumentW2GCnt00
IRS990/LandBldgEquipAccumDeprecAmt03397
IRS990/LandBldgEquipBasisNetGrp/BOYAmt021002
IRS990/LandBldgEquipBasisNetGrp/EOYAmt019399
IRS990/LandBldgEquipCostOrOtherBssAmt022796
IRS990/LegalDomicileStateCd0IN
IRS990/LoanOutstandingInd00
IRS990/LobbyingActivitiesInd00
IRS990/LocalChaptersInd00
IRS990/MaterialDiversionOrMisuseInd00
IRS990/MembershipDuesAmt00
IRS990/MembersOrStockholdersInd01
IRS990/MethodOfAccountingAccrualInd0X
IRS990/MinutesOfCommitteesInd01
IRS990/MinutesOfGoverningBodyInd01
IRS990/MissionDesc0Provide excellent health care by promoting wellness, education and healing through trusting relationships.
IRS990/MoreThan5000KToIndividualsInd00
IRS990/MoreThan5000KToOrgInd00
IRS990/NetAssetsOrFundBalancesBOYAmt04603998
IRS990/NetAssetsOrFundBalancesEOYAmt04763185
IRS990/NetIncmFromFundraisingEvtGrp/ExclusionAmt069929
IRS990/NetIncmFromFundraisingEvtGrp/TotalRevenueColumnAmt069929
IRS990/NetIncmFromFundraisingEvtGrp/UnrelatedBusinessRevenueAmt00
IRS990/NetUnrelatedBusTxblIncmAmt00
IRS990/NetUnrlzdGainsLossesInvstAmt00
IRS990/NoncashContributionsAmt00
IRS990/NondeductibleContributionsInd00
IRS990/OccupancyGrp/FundraisingAmt00
IRS990/OccupancyGrp/ManagementAndGeneralAmt00
IRS990/OccupancyGrp/ProgramServicesAmt00
IRS990/OccupancyGrp/TotalAmt00
IRS990/OfficeExpensesGrp/FundraisingAmt0804
IRS990/OfficeExpensesGrp/ManagementAndGeneralAmt0632
IRS990/OfficeExpensesGrp/ProgramServicesAmt00
IRS990/OfficeExpensesGrp/TotalAmt01436
IRS990/OfficerMailingAddressInd00
IRS990/OperateHospitalInd00
IRS990/Organization501c3Ind0X
IRS990/OrgDoesNotFollowFASB117Ind0X
IRS990/OtherChangesInNetAssetsAmt025679
IRS990/OtherEmployeeBenefitsGrp/FundraisingAmt010417
IRS990/OtherEmployeeBenefitsGrp/ManagementAndGeneralAmt06944
IRS990/OtherEmployeeBenefitsGrp/ProgramServicesAmt00
IRS990/OtherEmployeeBenefitsGrp/TotalAmt017361
IRS990/OtherExpensesGrp/Desc0Dues
IRS990/OtherExpensesGrp/Desc1General Expense
IRS990/OtherExpensesGrp/Desc2Investment transaction fees
IRS990/OtherExpensesGrp/FundraisingAmt00
IRS990/OtherExpensesGrp/FundraisingAmt10
IRS990/OtherExpensesGrp/FundraisingAmt20
IRS990/OtherExpensesGrp/ManagementAndGeneralAmt01935
IRS990/OtherExpensesGrp/ManagementAndGeneralAmt180146
IRS990/OtherExpensesGrp/ManagementAndGeneralAmt23
IRS990/OtherExpensesGrp/ProgramServicesAmt00
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IRS990/OtherExpensesGrp/ProgramServicesAmt20
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IRS990/OtherExpensesGrp/TotalAmt180146
IRS990/OtherExpensesGrp/TotalAmt23
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IRS990/OtherSalariesAndWagesGrp/FundraisingAmt00
IRS990/OtherSalariesAndWagesGrp/ManagementAndGeneralAmt00
IRS990/OtherSalariesAndWagesGrp/ProgramServicesAmt00
IRS990/OtherSalariesAndWagesGrp/TotalAmt00
IRS990/PartialLiquidationInd00
IRS990/PaymentsToAffiliatesGrp/FundraisingAmt00
IRS990/PaymentsToAffiliatesGrp/ManagementAndGeneralAmt00
IRS990/PaymentsToAffiliatesGrp/ProgramServicesAmt00
IRS990/PaymentsToAffiliatesGrp/TotalAmt00
IRS990/PayrollTaxesGrp/FundraisingAmt04895
IRS990/PayrollTaxesGrp/ManagementAndGeneralAmt03264
IRS990/PayrollTaxesGrp/ProgramServicesAmt00
IRS990/PayrollTaxesGrp/TotalAmt08159
IRS990/PdInCapSrplsLandBldgEqpFundGrp/BOYAmt00

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