Good Samaritan Hospital Foundation Kearney Nebraska

“Pursuant to section 8.6 of the bylaws of good samaritan hospital foundation, the executive committee is composed of the board chair, the board vice chair and up to four voting members appointed by the board of directors. Pursuant to section 8.1 of the corporation's bylaws, committees, such as the executive committee, that are granted the authority to act on behalf of the board of directors may include only directors of the corporation. Further, pursuant to section 8.6 of the corporation's bylaws, the executive committee has and may exercise such powers as may be delegated to it by the board of directors. The executive committee also possesses the power to transact routine business of the corporation in the interim period between regularly scheduled meetings of the board of directors.”

“The organization's sole corporate member is good samaritan hospital, a nebraska nonprofit corporation.”

“In accordance with the organization's bylaws, the sole corporate member, good samaritan hospital, may unilaterally appoint one or more individuals to the organization's board of directors.”

“The organization's corporate member is good samaritan hospital. Pursuant to section 5.4 of the organization's bylaws, good samaritan hospital, chi nebraska, (good samaritan hospital's sole corporate member) and catholic health initiatives (chi nebraska's sole corporate member) ("chi") have reserved powers as outlined in the chi governance matrix. Pursuant to the governance matrix the following rights are held by the board of good samaritan hospital: * approve members of the good samaritan hospital foundation's board. * amend the corporate documents of the good samaritan hospital foundation. * approve removal of a member of the governing body of the good samaritan hospital foundation. * adopt long range and strategic plans for the good samaritan hospital foundation. The following rights are reserved for chi's board directly or through powers delegated to the chi chief executive officer: * substantial change of the mission or philosophy of the good samaritan hospital foundation. * removal of a member of the governing body of the good samaritan hospital foundation. * approval of issuance of debt by good samaritan hospital foundation. * approval of participation of good samaritan hospital foundation in a joint venture. * approval of formation of a new corporation by good samaritan hospital foundation. * approval of a merger involving the good samaritan hospital foundation. * approval of the sale of all or substantially all of the assets of the good samaritan hospital foundation. * requirement of the transfer of assets by the good samaritan hospital foundation to chi to accomplish chi's goals and objectives, and to satisfy chi debts. Pursuant to section 5.5.2 of the organization's bylaws, good samaritan hospital or chi may, in exercise of their approval powers, grant or withhold approval in whole or in part, or may, in its complete discretion, after consultation with the board and its president and the chief executive officer of the organization, recommend such other or different actions as it deems appropriate.”

“The organization's accounting personnel work with the chi tax department to prepare the form 990 and the finance staff consults with executive management regarding the items of interest (i.e. Conflicts, political activities, etc.) of which they would have firsthand knowledge. After completion of the form 990, a draft copy is reviewed by finance and either the director of finance or cfo for any potential errors, omissions, or clarifications needed for proper presentation. After final changes are made to the form 990, the final return is then provided to the board members prior to the board meeting date. At the next board meeting, the form 990 is an agenda item whereby the board has an opportunity to ask questions or obtain clarification of the form 990 information. Subsequent to the return being provided to the board, the tax department files the return with the appropriate federal agencies, making any non-substantive changes necessary to effect e-filing. Any such changes are not re-submitted to the board.”

“Procedures for monitoring and enforcing the coi policy disclosure, review and initial determination: 1) general obligation. Each director must promptly and fully report to the board chair situations that may create a conflict of interest when he or she becomes aware of such situations. In any situation when a director is in doubt, full disclosure should be made so as to permit an impartial and objective determination. A written record of the disclosure will be made. 2) annual disclosure statement. In addition to the ongoing disclosure obligation, the corporation's president and chief executive officer shall annually send to all directors a copy of this policy and the conflict of interest disclosure statement. The director must promptly complete, sign and return the statement to the corporation's president and chief executive officer. The completed statement will be reviewed by the president and chief executive officer and the board chair. 3) review, evaluation and initial determination. The board chair or designee shall make such further investigation of any conflict of interest disclosures as he or she may deem appropriate. If the conflict involves the board chair, the vice chair will assume the chair's role outlined in this policy. Based on review and evaluation of the relevant facts and circumstances, the board chair will make an initial determination as to whether a conflict of interest exists and whether, pursuant to this policy, review and approval or other action by the board of directors is required. A written record of the board chair's determination, including relevant facts and circumstances, will be made. The board chair shall then make an appropriate report to the executive committee of the board concerning such review, evaluation and determination. If a difference of opinion exists between the board chair and another director as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether board of directors review and approval or other action is required within this policy, the matter shall be submitted to the board's executive committee, which shall make a final determination as to the matter presented. Such determination, including relevant facts and circumstances, will be reflected in the committee minutes and will be reported to the board of directors. Board review: 1) transactional conflicts of interest. The board of directors shall carefully scrutinize and must in good faith approve or disapprove any transaction in which the corporation and/or any of its affiliates is a party and in which one or more of the corporation's directors either: * has a material financial interest; or * is a director of the other party (other than the corporation's own affiliates). 2) the board of directors must approve the transaction by a majority of the directors on the board, without counting the vote of any director who has an interest in the transaction. In reviewing such transactions between the corporation and vendors or other contractors who are, or are affiliated with, directors, the board shall act no more or less favorably than it would in reviewing transactions with unrelated third parties. The transaction will not be approved unless the board determines that the transaction is fair to the corporation. 3) other conflicts of interest. The board shall carefully review and scrutinize any non-transactional conflict of interest (e.g. Disclosure of nonpublic information, competition with the corporation, failure to disclose a corporate opportunity, excessive gifts or entertainment, etc.) by a majority vote of the disinterested directors, the board shall take whatever action is deemed appropriate with respect to the director under the circumstances, including possible disciplinary or corrective action, in order to best protect the interests of the corporation. The board should consult with a member of the chi legal resource group when considering disciplinary or corrective action.”

“The organization's top management official's compensation is paid by franciscan health system (fhs), a related organization. Fhs uses an external compensation firm who utilizes actual market data compensation from similar institutions with comparable positions and compensation levels and considering the organization's geographic location. The executive committee of the board annually evaluates and approves the executive compensation arrangement for each executive for fair market value along with other applicable factors relied on by the board's determination. The supporting documentation becomes part of the minutes of the meeting. This process is completed yearly.”

“During the tax year ended 6-30-2014, no officers, directors, or trustees received compensation from the organization. Any executive compensation paid to officers, directors, or trustees by related organizations was set by the related organization's compensation committee utilizing both an independent consultant and comparability studies to determine compensation. Therefore, this question is more appropriately answered as na but has been answered no per irs instructions.”

“The organization's governing documents and conflict of interest policy are available to the public upon request. The organization's financial statements are included in catholic health initiatives' consolidated audited financial statements that are available at www.catholichealthinit.org or at www.dacbond.org.”

“I. Mission - good samaritan hospital foundation supports the health care services, research and education mission of good samaritan hospital. The foundation seeks, receives and administers donations for the benefit of the entire health system. Our fundraising activities and careful stewardship of resources make possible the programs that help further our organizational mission of serving patients, families and our community. Ii. Vision - honoring our catholic heritage, good samaritan health systems is recognized for excellence in regional healthcare through values-based leadership. Iii. Primary tax-exempt purpose - the primary exempt purpose of good samaritan hospital foundation is to support the charitable mission of good samaritan hospital through solicitation and receipt of contributions, gifts, grants, devises or bequests.”

“Qualitative description of community benefit good samaritan hospital, through its foundation and various programs, has taken a leadership role in providing a vehicle for the community at large and employees within the system to donate funds that will serve the needy and a variety of community groups and organizations. Examples of these initiatives include: aircare funds - these are funds designated to support the medical helicopter service in the region. Cancer fund - good samaritan hospital and the area community donate to the cancer fund to support cancer survivor's day, an awareness campaign in the community. The cancer fund is also used to help defray the cost of travel for cancer patients traveling outside the kearney area for treatment. Cancer assistance fund - this fund was started as an annual campaign by kearney high school's tackle cancer drive. The money raised by students has been donated to good samaritan hospital foundation to provide financial assistance to patients and families in the kearney area. Good samaritan fund - this fund provides emergency funds and relief for employees, patients, and families in need. Hiram and suz walker endowed medical scholarship fund - this endowed fund was established in 1997 by dr. And mrs. H.r. Walker. The late dr. Walker was a member of the good samaritan hospital medical staff for 37 years and served as vice president of medical affairs at good samaritan hospital for eight years. The walkers' generous gift will assist in providing medical scholarships in the years to come. Holiday tree - the community donates approximately $20,000 each year through the holiday tree to assist functions of the home care family bereavement program as well as allow patients to receive hospice care who otherwise could not afford it. Margaret mitchell palmer hospice/home health endowment fund - this is a fund established to provide hospice and home health services to those unable to afford such services. Marjorie rogers endowment fund - this fund was established in memory of marjorie rogers to assist hospice patients who are unable to afford such services. Ron and carol cope endowed elder health care fund - this is a fund established to assist elder citizens in gaining access to needed health care services. Several patients and their families were assisted during fiscal year 2014 through the cope fund. Scholarship funds - a variety of scholarship funds and loan assistance programs have been established to provide monetary support for students pursuing careers in health professions. Steinle endowed pediatric fund - the steinle endowed fund was established to assist patients who are under 18 years of age and are not benefited by assistance from medicaid and/or insurance. Bernard haag nursing scholarship fund - this endowed fund was established in memory of bernard haag to benefit individuals pursuing a career in nursing. Wellness/fitness center scholarship fund - this fund was established by a donor in 2003 to provide people with financial need scholarships to the wellness/fitness center at good samaritan hospital. Don and delores williams endowed scholarship fund - the late don williams was a former employee of good samaritan hospital. In 1992, he and his wife, delores, created this endowed scholarship. This fund makes possible an annual scholarship for a student pursuing a health care career. Shirley chavanu nursing scholarship - shirley chavanu was an oncology nurse at good samaritan hospital from 1982 to 1999. Shirley, her family, and friends have made possible this annual scholarship for an individual pursuing a career in nursing. The foundation awarded safe teen driver scholarships to high school students attending driver's education. In summary, during fiscal year 2014 the foundation raised approximately $1.8 million in grants, cash and irrevocable deferred gift agreements.”