Civic Intelligence

Good Samaritan Hospital Foundation Kearney Nebraska

990 • Fiscal year 2018 • EIN 47-0659443

Jul 01, 2017 to Jun 30, 2018 • Filed on May 10, 2019

111 W 31st StreetKearney, NE 68847-2916

(308) 865-7900

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

69th percentile

0.44x

Higher debt load relative to assets than 69% of similar nonprofits.

2018 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2018

Liabilities / Revenue

88th percentile

2.19x

Higher debt load relative to revenue than 88% of similar nonprofits.

2018 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2018

Net Margin

93rd percentile

59%

Higher net margin than 93% of similar nonprofits.

2018 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2018

Top Officer Pay

99th percentile

$2,072,905

Higher top officer pay than 99% of similar nonprofits.

Top officer pay equals 79.2% of source-year revenue.

2018 filings • 501(c)3 • $10M-$25M nonprofits • Source year 2018

Asset Growth

81st percentile

15%

Faster asset growth than 81% of similar nonprofits.

2018 filings • 501(c)3 • $10M-$25M nonprofits • Annualized from 2017 to 2018

Revenue Growth

10th percentile

-25%

Faster revenue growth than 10% of similar nonprofits.

2018 filings • 501(c)3 • $10M-$25M nonprofits • Annualized from 2017 to 2018

Assets

Up

$13,115,267

Up $1,669,712 (+15%) from 2017

Net Assets

Up

$7,394,404

Up $1,615,041 (+28%) from 2017

Liabilities

Up

$5,720,863

Up $54,671 (+1.0%) from 2017

Revenue

Down

$2,617,384

Down $877,094 (-25%) from 2017

Expenses

Down

$1,066,549

Down $1,898,840 (-64%) from 2017

Net Income

Up

$1,550,835

Up $1,021,746 (+193%) from 2017

Historical Trend

Balance Sheet Trend

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$30M$20M$10M$0Assets 2010: $6,203,458Liabilities 2010: $1,767,722Net Assets 2010: $4,435,7362010Assets 2011: $7,907,810Liabilities 2011: $2,032,209Net Assets 2011: $5,875,6012011Assets 2012: $10,295,927Liabilities 2012: $3,691,848Net Assets 2012: $6,604,0792012Assets 2013: $9,818,930Liabilities 2013: $4,466,814Net Assets 2013: $5,352,1162013Assets 2014: $9,848,752Liabilities 2014: $3,915,483Net Assets 2014: $5,933,2692014Assets 2015: $15,007,972Liabilities 2015: $9,072,066Net Assets 2015: $5,935,9062015Assets 2016: $9,581,974Liabilities 2016: $4,460,951Net Assets 2016: $5,121,0232016Assets 2017: $11,445,555Liabilities 2017: $5,666,192Net Assets 2017: $5,779,3632017Assets 2018: $13,115,267Liabilities 2018: $5,720,863Net Assets 2018: $7,394,4042018Assets 2019: $10,248,165Liabilities 2019: $2,715,917Net Assets 2019: $7,532,2482019Assets 2020: $12,478,936Liabilities 2020: $4,755,031Net Assets 2020: $7,723,9052020Assets 2021: $21,057,431Liabilities 2021: $5,287,435Net Assets 2021: $15,769,9962021Assets 2022: $15,174,287Liabilities 2022: $2,405,783Net Assets 2022: $12,768,5042022Assets 2023: $12,854,572Liabilities 2023: $2,405,023Net Assets 2023: $10,449,5492023Assets 2024: $13,286,569Liabilities 2024: $2,370,862Net Assets 2024: $10,915,7072024

Highlighted filing

2018

Assets$13,115,267
Liabilities$5,720,863
Net Assets$7,394,404

Operations Trend

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$10M$5.0M$0-$5.0MExpenses 2010: $1,558,7912010Revenue 2011: $2,642,332Expenses 2011: $1,629,349Net Income 2011: $1,012,9832011Expenses 2012: $2,332,9612012Expenses 2013: $2,652,6732013Revenue 2014: $2,081,264Expenses 2014: $1,962,689Net Income 2014: $118,5752014Revenue 2015: $6,836,977Expenses 2015: $6,048,262Net Income 2015: $788,7152015Revenue 2016: $1,184,752Expenses 2016: $1,936,408Net Income 2016: -$751,6562016Revenue 2017: $3,494,478Expenses 2017: $2,965,389Net Income 2017: $529,0892017Revenue 2018: $2,617,384Expenses 2018: $1,066,549Net Income 2018: $1,550,8352018Revenue 2019: $858,922Expenses 2019: $595,869Net Income 2019: $263,0532019Revenue 2020: $2,790,069Expenses 2020: $585,976Net Income 2020: $2,204,0932020Revenue 2021: $6,868,075Expenses 2021: $3,122,865Net Income 2021: $3,745,2102021Revenue 2022: $1,604,278Expenses 2022: $3,422,197Net Income 2022: -$1,817,9192022Revenue 2023: $1,452,103Expenses 2023: $4,045,544Net Income 2023: -$2,593,4412023Revenue 2024: $520,824Expenses 2024: $711,580Net Income 2024: -$190,7562024

Highlighted filing

2018

Revenue$2,617,384
Expenses$1,066,549
Net Income$1,550,835
Jump To
Filing Snapshot
Filing Period
Jul 1, 2017 to Jun 30, 2018
Signed
May 10, 2019
Return Version
2017v2.2
Gross Receipts
$2,737,059
Mission and Program Overview

Mission

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.

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. The organization was, for the year ended 6/30/18, affiliated with Catholic Health Initiatives ("CHI"). Following the close of the 6/30/2018 tax year, on 2/1/19, in connection with the alignment of the Catholic ministries of CHI and Dignity Health, CHI changed its name to CommonSpirit Health.

Balance Sheet Detail
LineBeginningEndChange
Assets
Investments Other Securities$8,084,444$8,470,098▲ $385,654
Savings and Temporary Cash Investments$1,284,675$2,272,788▲ $988,113
Investments in Publicly Traded Securities$988,534$1,675,269▲ $686,735
Land, Buildings, and Equipment, Net$400,738$400,551▼ $187
Inventories for Sale or Use$82,458$58,400▼ $24,058
Accounts Receivable$386,804$19,610▼ $367,194
Cash and Non-Interest-Bearing Accounts$2,028$2,677▲ $649
Other Notes and Loans Receivable, Net$0$0→ $0
Pledges and Grants Receivable$0$0→ $0
Receivable From Disqualified Prsn-$0-
Receivables From Officers Etc$0$0→ $0
Investments Program Related$0--
Intangible Assets$0$0→ $0
Loans From Officers Directors-$0-
Prepaid Expenses and Deferred Charges$0$0→ $0
Total Assets$11,445,555$13,115,267▲ $1,669,712
Other Assets Total$215,874$215,874→ $0
Liabilities
Other Liabilities$2,426,786$2,917,409▲ $490,623
Accounts Payable and Accrued Expenses$2,866,489$2,670,974▼ $195,515
Deferred Revenue$372,917$132,480▼ $240,437
Grants Payable$0$0→ $0
Mortgage Notes Payable Secured by Investment Property$0$0→ $0
Unsecured Notes Loans Payable$0$0→ $0
Escrow Account Liability$0$0→ $0
Tax Exempt Bond Liabilities$0$0→ $0
Total Liabilities$5,666,192$5,720,863▲ $54,671
Net Assets / Fund Balance
Unrestricted Net Assets$2,674,758$3,521,396▲ $846,638
Temporarily Rstr Net Assets$2,607,925$3,238,292▲ $630,367
Permanently Rstr Net Assets$496,680$634,716▲ $138,036
Total Net Assets Fund Balance$5,779,363$7,394,404▲ $1,615,041
Total Liabilities and Net Assets / Fund Balance$11,445,555$13,115,267▲ $1,669,712

Asset Categories

AssetBook ValueDepreciationBasis
Land$400,551-$400,551
Equipment$0$26,222$26,222
Buildings$0$0$0
Other Land Buildings$0$0$0
Leasehold Improvements$0$0$0
Other Securities$5,328,062--

Endowment Activity

PeriodBeginningContrib.Gain/LossOther UsesEnd
2017$1,757,597$301,538▲ $25,856$32,120$2,052,871
2016$1,752,166$5,586▲ $15,456$15,611$1,757,597
2015$1,707,795$50,000▲ $8,580$14,209$1,752,166
2014$1,671,408-▲ $48,959$12,572$1,707,795
2013$1,471,607-▲ $208,770$8,969$1,671,408
Compensation and Service Providers

Board Members and Trustees

NameTitle
-Chair
-President Gsh
-Vice Chair
-Board Member
-Executive Director
-CEO CHI Health
-CFO, CHI Health
-Secretary
-Treasurer/VP Finance
-VP Philanthropy
Revenue and Support

Revenue Composition

Contributions and Grants
$1,485,338
Program Service Revenue
$0
Investment Income
$1,063,001
Other Revenue
$69,045
All Other Contributions
$1,046,273
Change in Net Assets
$1,550,835
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Grants and Similar Amounts Paid$652,655
Other Expenses$413,894
Total Fundraising Expense$6,059
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Grants to Domestic Orgs$638,855--$638,855
Fees for Services Other$58,647$262,827$5,949$327,423
Interest$32,860--$32,860
Office Expenses-$14,219-$14,219
Grants to Domestic Individuals$13,800--$13,800
Other Expenses-$3,835-$3,835
Travel-$330$110$440
Depreciation Depletion-$187-$187
Total Functional Expenses$744,162$316,328$6,059$1,066,549
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
Good Samaritan HospitalKearney, NE501(c)(3)Hospital Health Funds$622,123
Alegent Creighton HealthOmaha, NE501(c)(3)General Support$12,770
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Fundraising Direct Expenses$0
Fundraising Gross Income$0
Gaming Direct Expenses$0
Gaming Gross Income$0
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Loans from Officers, Directors, Trustees, and Key Employees-$0-
Receivables from Disqualified Persons-$0-
Receivables from Officers, Directors, Trustees, and Key Employees$0$0→ $0
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Intercompany Payable$2,891,174
Accounts Payable Accruals$20,187
Other Liabilities$4,999
Accounts Payable Auxiliary (Gift Shop)$1,049
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
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, Line 15B PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS/KEY EMPLOYEES

During the tax year ended 6/30/2018, 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, these questions are more appropriately answered as N/A.

Form 990, Part VI, Line 15A PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL

The organization's top management official's compensation is paid by Catholic Health Initiatives (CHI), a related organization. CHI has a defined compensation philosophy. Both the executive and non-executive compensation structures and ranges are reviewed annually in comparison to market data. CHI uses The Korn Ferry Hay Group as the independent third party to assess executive compensation programs and to ensure the reasonableness of actual salaries and total compensation packages. Compensation of the senior most executives is reviewed annually. The Korn Ferry Hay Group reviews both cash and total compensation for overall reasonableness, for adherence to CHI's compensation philosophy, and for comparability to the not-for-profit healthcare market. This independent review is delivered by Korn Ferry Hay Group to the HR committee of the CHI Board of Stewardship Trustees annually at their September meeting and minutes are shared with the full board at the December meeting. The last review was September 11, 2017. In addition, Korn Ferry Hay Group completed a comprehensive review of all positions at the level of vice president and above in the fall of 2014 to determine and validate appropriate compensation levels. These levels have been reviewed annually since and revised based on market data, where applicable. FOR MEMBERS OF MANAGEMENT WHO WERE PAID UNDER CHI HEALTH FOR CALENDAR YEAR 2017, CHI HEALTH COMPLETES A COMPENSATION MARKET STUDY TO DETERMINE SALARY.

Form 990, Part VI, Line 12C Conflict of Interest pOlicy

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 the COI 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 the COI Policy, review and approval or other action by the Board 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 Trustee as to whether the facts and circumstances of a given situation constitute a conflict of interest or whether Board review and approval or other action is required within the COI 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 Executive Committee minutes and will be reported to the Board. The Board shall carefully scrutinize and must in good faith approve or disapprove any transaction in which CHI or a CHI Entity is a party and in which the Trustee or Corporate Officer either: * Has a material financial interest; or * Is a Trustee or Corporate Officer of the other party (other than a CHI-affiliated organization). The Board must approve the transaction by a majority of the Trustees on the Board, without counting the vote of any individual who has an interest in the transaction. In reviewing such transactions between CHI or CHI Entities and vendors or other contractors who are, or are affiliated with, Trustees or Corporate Officers, 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 CHI or the CHI Entity. The Board shall carefully review and scrutinize any non-transactional conflict of interest (e.g., disclosure of nonpublic information, competition with CHI or a CHI Entity, failure to disclose a corporate opportunity, excessive gifts or entertainment, etc.). By a majority vote of the disinterested Trustees, the Board shall take whatever action is deemed appropriate with respect to the Trustee or Corporate Officer under the circumstances, including possible disciplinary or corrective action, in order to best protect the interests of CHI or the CHI Entity. The Board should consult with the General Counsel of CHI or his or her designee when considering disciplinary or corrective action. When any conflict of interest is considered by the Board, the Trustee or Corporate Officer, as appropriate, must disclose all of the material facts to the Board. The Trustee shall not vote and the Trustee or Corporate Officer shall not use his or her personal influence on the matter. However, if requested, such Trustee or Corporate Officer is not prevented from briefly stating his or her position in the matter, nor from answering pertinent questions from Trustees, as his or her knowledge may be of significant importance. The Trustee or Corporate Officer shall be excused from the meeting during discussion and vote on the conflict of interest. Minutes of the Board shall reflect the following: the individual making the disclosure, the nature of the disclosure, discussion regarding any proposed transaction, the decision made by the Board, and that the interested Trustee or Corporate Officer was excused during the discussion, and that the interested Trustee abstained from voting. If the Board reasonably believes that a Trustee or Corporate Officer has failed to disclose ei

Form 990, Part VI, Line 1A Delegate broad authority to A committee

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.

Form 990, Part VI, Line 6 Classes of members or stockholders

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

Form 990, Part VI, Line 7A Members or stockholders electing members of governing body

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.

Form 990, Part VI, Line 7B Decisions requiring approval by members or stockholders

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.

Form 990, Part VI, Line 11B Review of form 990 by governing body

Following the preparation of the form 990 by tax analysts of catholic health initiatives, a related organization, the return is reviewed by the chi tax director and the local chief financial officer. Additionally, the board of directors are provided the final form 990 and related schedules to review and are able to ask the chief financial officer and tax director questions prior to filing with the irs. Upon chief financial officer approval and signature, the tax analyst files the final form 990 as presented to the board and finance committee, making any non-substantive changes necessary in order to effect e-filing. Any such changes are not re-submitted to the board.

Form 990, Part VI, Line 12C Conflict of interest policy

Catholic Health Initiatives ("CHI") has a Conflicts of Interest ("COI") policy (the "Policy") in place to maintain the integrity of all of its activities. The Policy applies to CHI Board of Stewardship Trustees and members of its committees; all CHI Entity board and board committee members; all CHI employees; and all CHI research personnel (both employed and non-employed). Disclosure, review and management of perceived, potential or actual conflicts of interest are accomplished through a defined COI disclosure process. Each Person must promptly and fully disclose to his/her direct manager, supervisor, medical staff office, board or board committee chair any situation or circumstance that may create a conflict of interest. The Person must disclose the actual or potential conflict as soon as she/he becomes aware of it. In any situation where the Person may be in doubt, a full disclosure should be made to permit an impartial and objective determination. In addition to the general ongoing obligation, there are initial disclosure obligations. At the time of initial appointment, a copy of the Policy shall be distributed to the board or committee member along with a conflict of interest disclosure. The board or committee member will complete and submit the disclosure. The completed disclosure shall be maintained in confidence and access shall be limited to persons who have a reasonable need to know the contents. At the time of hiring, a copy of the Policy shall be distributed to all Employees. In addition, a conflict of interest disclosure will be provided. The Employee must complete and submit a conflict of interest disclosure. The completed disclosure shall be maintained in confidence and access shall be limited to persons who have a reasonable need to know the contents. In addition to the general ongoing and initial disclosure obligations, there is an annual disclosure obligation. On an annual basis, the following Persons must complete a new conflict of interest disclosure: * Board and board committee members; * Employees at the level of vice president and above; * Researchers * Supply Chain Employees at the level of vice president and above and those employees involved in contracting regardless of employment level; * Other Employees as deemed applicable by CHI Leadership * Employees at the level of manager and above (through 6/21/17) Disclosures of perceived, potential or actual conflicts involving financial interests are forwarded to the Conflicts of Interest Review Committee ("C-CIRC"), National or Regional Legal Services, National, Entity, or Research Corporate Responsibility Program, or the Executive Committee of the Board or Board Chair, for review depending on the position of the person involved. Among the factors that should be considered in determining whether a conflict exists are the nature and magnitude of the opportunity, transaction or arrangement, the degree to which it is related to CHI's business, whether the Person with the conflict is the ultimate decision-maker or holds significant influence over the ultimate decision-maker (i.e., degree of independence of the decision-making process), the unique nature of the opportunity, transaction or arrangement, the existence of other viable alternatives and the quality of those alternatives, and what is customary and reasonable in the health care or research industry. When a Person has, or is considering initiating, a business interest or relationship outside of CHI but is uncertain whether the interest constitutes a conflict of interest requiring disclosure under this Policy, the Person should consult with local Corporate Responsibility Program (CRP) staff or CHI Legal Services Group (LSG) staff, as appropriate. As appropriate, a COI management plan will be developed. With respect to those audiences for which the C-CIRC has review responsibility, the C-CIRC will facilitate development of any such COI management plan in collaboration with local CRP staff or CHI LSG staff,

Form 990, Part VI, Line 19 Required documents available to the public

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.

Filing and Contact Details

Filer

Filer Name
Good Samaritan Hospital Foundation
EIN
47-0659443
Phone
3088657900
Address
111 W 31ST STREET, KEARNEY, NE 68847-2916

Signing Officer

Name
Jeanette Wojtalewicz
Title
CFO, CHI Health
Signed
2019-05-10
Discuss with paid preparer
Yes

Organization Details

Formed
1983
Legal Domicile
Ne
Voting Board Members
13
Independent Board Members
10
Employees
0
Volunteers
10

Preparer

Firm
Catholic Health Initiatives
Address
198 INVERNESS DRIVE WEST, ENGLEWOOD, CO 80112
Preparer
Angela Noel
Phone
3032989100
Supplemental Narrative

Additional Explanations

Form 990, Part IX, Line 11G Other Fees

Purchased Services - Total Expense: 327423, Program Service Expense: 58647, Management and General Expenses: 262827, Fundraising Expenses: 5949;

Financial Statement Notes

Schedule D, Part V, Line 4 Intended uses of endowment funds

The Foundation's endowment funds are used to provide financial support for hospital programs that enhance the health of the Kearney community and surrounding areas.

Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote

Good Samaritan Hospital Foundation's financial information is included in the consolidated audited financial statements of Catholic Health Initiatives (CHI), a related organization. CHI's FIN 48 (ASC 740) footnote for the year ended June 30, 2018, reads as follows: "CHI is a tax-exempt Colorado corporation and has been granted an exemption from federal income tax under Section 501(c)(3) of the Internal Revenue Code. CHI owns certain taxable subsidiaries and engages in certain activities that are unrelated to its exempt purpose and therefore subject to income tax. Management reviews its tax positions annually and has determined that there are no material uncertain tax positions that require recognition in the accompanying consolidated financial statements."

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IRS990/Desc0QUALITATIVE 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 - THE CANCER FUND IS 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 CHI HEALTH GOOD SAMARITAN 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 IN NEED. GOOD SAM ENDOWMENT - THIS WAS ESTABLISHED WITH UNRESTRICTED FUNDS TO ADDRESS AREAS OF GREATEST NEED AT CHI HEALTH GOOD SAMARITAN HOSPITAL. FAMILY ASSISTANCE FUND - THIS FUND PROVIDES EMERGENCY FUNDS AND RELIEF TO PATIENTS IN NEED AND THEIR FAMILIES. 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. TREE OF HOPE CHRISTMAS CAMPAIGN - A MAILER IS SENT TO KEARNEY AND THE SURROUNDING COMMUNITIES TO SOLICIT DONATIONS FOR THE CANCER ASSISTANCE FUND ESTABLISHED IN 2009. THIS CAMPAIGN REPLACED THE FORMER HOLIDAY TREE HOSPICE / HOME HEALTH FUNDRAISER. MARGARET MITCHELL PALMER HOME HEALTH ENDOWMENT FUND - THIS IS A FUND ESTABLISHED TO PROVIDE HOME HEALTH SERVICES TO THOSE 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 2018 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. 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 ENDOWED 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. JIM AND MARCIA ELDER FAMILY ENDOWED RADIOLOGY SCHOLARSHIP - THE LATE JIM ELDER, A FORMER GOOD SAMARITAN RADIOLOGY EMPLOYEE, AND HIS LATE WIFE MARCIA, WERE HONORED BY FRIENDS AND FAMILY WITH THIS SCHOLARSHIP FUND THAT AWARDS A RADIOLOGY STUDENT ATTENDING UNMC-KEARNEY AND COMPLETEING THEIR ROTATION AT GOOD SAMARITAN. HARMS' FAMILY ENDOWED SCHOLARSHIP - GEORGE, FORMER VICE PRESIDENT OF FINANCE AT GOOD SAMARITAN, AND JANA HARMS ESTABLISHED THE HARMS' FAMILY ENDOWED SCHOLARSHIP IN 2008 TO BENEFIT THOSE STUDENTS PURSUING A HEALTHCARE CAREER. PROFESSIONAL DEVELOPMENT COUNCIL SCHOLARSHIP - GOOD SAMARITAN PROFESSIONAL DEVELOPMENT COUNCIL ESTABLISHED A SCHO
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IRS990/OtherExpensesGrp/ManagementAndGeneralAmt23835
IRS990/OtherExpensesGrp/TotalAmt033769
IRS990/OtherExpensesGrp/TotalAmt11161
IRS990/OtherExpensesGrp/TotalAmt23835
IRS990/OtherLiabilitiesGrp/BOYAmt02426786
IRS990/OtherLiabilitiesGrp/EOYAmt02917409
IRS990/OtherRevenueMiscGrp/ExclusionAmt00
IRS990/OtherRevenueMiscGrp/ExclusionAmt10
IRS990/OtherRevenueMiscGrp/ExclusionAmt20
IRS990/OtherRevenueMiscGrp/RelatedOrExemptFuncIncomeAmt00
IRS990/OtherRevenueMiscGrp/RelatedOrExemptFuncIncomeAmt10
IRS990/OtherRevenueMiscGrp/RelatedOrExemptFuncIncomeAmt20
IRS990/OtherRevenueMiscGrp/TotalRevenueColumnAmt00
IRS990/OtherRevenueMiscGrp/TotalRevenueColumnAmt10
IRS990/OtherRevenueMiscGrp/TotalRevenueColumnAmt20
IRS990/OtherRevenueMiscGrp/UnrelatedBusinessRevenueAmt00
IRS990/OtherRevenueMiscGrp/UnrelatedBusinessRevenueAmt10
IRS990/OtherRevenueMiscGrp/UnrelatedBusinessRevenueAmt20
IRS990/OtherRevenueTotalAmt00
IRS990/OthNotesLoansReceivableNetGrp/BOYAmt00
IRS990/OthNotesLoansReceivableNetGrp/EOYAmt00
IRS990/PartialLiquidationInd0false
IRS990/PayPremiumsPrsnlBnftCntrctInd0false
IRS990/PermanentlyRstrNetAssetsGrp/BOYAmt0496680
IRS990/PermanentlyRstrNetAssetsGrp/EOYAmt0634716
IRS990/PledgesAndGrantsReceivableGrp/BOYAmt00
IRS990/PledgesAndGrantsReceivableGrp/EOYAmt00
IRS990/PoliticalCampaignActyInd0false
IRS990/PrepaidExpensesDefrdChargesGrp/BOYAmt00
IRS990/PrepaidExpensesDefrdChargesGrp/EOYAmt00
IRS990/PrincipalOfcrBusinessName/BusinessNameLine1Txt0KATHY BERTOLINI
IRS990/ProfessionalFundraisingInd0false
IRS990/ProgramServiceRevenueGrp/ExclusionAmt00
IRS990/ProgramServiceRevenueGrp/ExclusionAmt10
IRS990/ProgramServiceRevenueGrp/ExclusionAmt20
IRS990/ProgramServiceRevenueGrp/ExclusionAmt30
IRS990/ProgramServiceRevenueGrp/ExclusionAmt40
IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt00
IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt10
IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt20
IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt30

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Filings

Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Detailed filing. Detailed filing data is available for this year.$13.3$2.37$10.9$0.52$0.71$0.19
2023Detailed filing. Detailed filing data is available for this year.$12.9$2.41$10.4$1.45$4.05$2.59
2022Detailed filing. Detailed filing data is available for this year.$15.2$2.41$12.8$1.60$3.42$1.82
2021Detailed filing. Detailed filing data is available for this year.$21.1$5.29$15.8$6.87$3.12$3.75
2020Detailed filing. Detailed filing data is available for this year.$12.5$4.76$7.72$2.79$0.59$2.20
2019Detailed filing. Detailed filing data is available for this year.$10.2$2.72$7.53$0.86$0.60$0.26
2018Detailed filing. Detailed filing data is available for this year.$13.1$5.72$7.39$2.62$1.07$1.55
2017Detailed filing. Detailed filing data is available for this year.$11.4$5.67$5.78$3.49$2.97$0.53
2016Detailed filing. Detailed filing data is available for this year.$9.58$4.46$5.12$1.18$1.94$0.75
2015Detailed filing. Detailed filing data is available for this year.$15.0$9.07$5.94$6.84$6.05$0.79
2014Detailed filing. Detailed filing data is available for this year.$9.85$3.92$5.93$2.08$1.96$0.12
2013Facts available. Structured filing facts are available, but richer extracted sections are limited.$9.82$4.47$5.35$2.65
2012Facts available. Structured filing facts are available, but richer extracted sections are limited.$10.3$3.69$6.60$2.33
2011Summary only. Only limited summary data is available for this year.$7.91$2.03$5.88$2.64$1.63$1.01
2010Facts available. Structured filing facts are available, but richer extracted sections are limited.$6.20$1.77$4.44$1.56