Civic Intelligence

St Marys Good Samaritan Foundation Inc

990 • Fiscal year 2018 • EIN 81-1660088

Jul 01, 2017 to Jun 30, 2018 • Filed on May 14, 2019

1230 Baxter StreetAthens, GA 30606

(706) 389-3938

Siviq Scores

Scores are not available for this record yet.

Balance Sheet

Assets

Flat

$330,643

Flat from 2018

Net Assets

Flat

$330,643

Flat from 2018

Liabilities

Flat

$0

Flat from 2018

Revenue And Expenses

Revenue

Flat

$206,395

Flat from 2018

Expenses

Flat

$42

Flat from 2018

Net Income

Flat

$206,353

Flat from 2018

Historical Trend

Balance Sheet Trend

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

$3.0M$2.0M$1.0M$0Assets 2017: $12,227Liabilities 2017: $0Net Assets 2017: $12,2272017Assets 2018: $330,643Liabilities 2018: $0Net Assets 2018: $330,6432018Assets 2018: $330,643Liabilities 2018: $0Net Assets 2018: $330,6432018Assets 2019: $1,180,981Liabilities 2019: $710,725Net Assets 2019: $470,2562019Assets 2020: $2,199,844Liabilities 2020: $14,413Net Assets 2020: $2,185,4312020Assets 2021: $2,603,515Liabilities 2021: $75,315Net Assets 2021: $2,528,2002021Assets 2022: $2,028,713Liabilities 2022: $77,077Net Assets 2022: $1,951,6362022Assets 2023: $1,418,854Liabilities 2023: $129,557Net Assets 2023: $1,289,2972023Assets 2024: $1,994,596Liabilities 2024: $97,382Net Assets 2024: $1,897,2142024

Highlighted filing

2018

Assets$330,643
Liabilities$0
Net Assets$330,643

Operations Trend

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

$2.0M$1.0M$0-$1.0MRevenue 2017: $12,256Expenses 2017: $29Net Income 2017: $12,2272017Revenue 2018: $206,395Expenses 2018: $42Net Income 2018: $206,3532018Revenue 2018: $206,395Expenses 2018: $42Net Income 2018: $206,3532018Revenue 2019: $91,639Expenses 2019: $0Net Income 2019: $91,6392019Revenue 2020: $1,913,699Expenses 2020: $92,429Net Income 2020: $1,821,2702020Revenue 2021: $1,222,137Expenses 2021: $1,117,700Net Income 2021: $104,4372021Revenue 2022: $356,348Expenses 2022: $956,604Net Income 2022: -$600,2562022Revenue 2023: $1,105,658Expenses 2023: $1,368,450Net Income 2023: -$262,7922023Revenue 2024: $425,100Expenses 2024: $108,218Net Income 2024: $316,8822024

Highlighted filing

2018

Revenue$206,395
Expenses$42
Net Income$206,353
Jump To
Filing Snapshot
Filing Period
Jul 1, 2017 to Jun 30, 2018
Signed
May 14, 2019
Return Version
2017v2.3
Gross Receipts
$206,395
Mission and Program Overview

Mission

We, st. Mary's health care system and trinity health, serve together in the spirit of the gospel as a compassionate and transforming healing presence within our communities. St. Mary's good samaritan foundation is a member of the st. Mary's health care system and trinity health.

To provide support for the programs of st. Mary's health care system and its affiliates

Balance Sheet Detail
LineBeginningEndChange
Assets
Savings and Temporary Cash Investments$9,927$247,312▲ $237,385
Pledges and Grants Receivable-$83,331-
Total Assets$12,227$330,643▲ $318,416
Other Assets Total$2,300$0▼ $2,300
Liabilities
Total Liabilities$0$0→ $0
Net Assets / Fund Balance
Unrestricted Net Assets$-28$247,312▲ $247,340
Temporarily Rstr Net Assets$12,255$83,331▲ $71,076
Total Net Assets Fund Balance$12,227$330,643▲ $318,416
Total Liabilities and Net Assets / Fund Balance$12,227$330,643▲ $318,416
Compensation and Service Providers

Board Members and Trustees

NameTitle
Riezl BakerDIR;V CHAIR THR 12/17; CHAIR AT 1/18
Jack BrownDIRECTOR; CHAIR THROUGH 12/17
Donald MckennaDir, Smhcs President & CEO Thr 12/17
Louis SeaboltDIRECTOR; VICE CHAIR AS OF 1/18
Arthur Torsiglieri MdDirector
Frederica MeindlDirector
Jenny BedellDirector
Linda WeltyDirector
Rebecca SmithDirector
Thomas ClareDirector
Thomas RobertsDirector
WENDY O'TOOLEDirector
Adam ShaiferDirector as of 1/18
Deborah CorneliaDirector as of 1/18
Jep PoundDirector as of 1/18
Joan AntoneDirector as of 1/18
June TompkinsDirector as of 1/18
Patricia WilmotDirector as of 1/18
Perry Lee OdDirector as of 1/18
Avis WilliamsDirector Through 12/17
Bo AkersDirector Through 12/17
Frederick WolfertDirector Through 12/17
John FoosDirector Through 12/17
John PastorelloDirector Through 12/17
Mimi VickersDirector Through 12/17
D Montez CarterSEC; DIR, SMHCS PRES & CEO AT 1/18
Daniel PowellTREASURER AT 11/17; INT CFO AT 10/17
Martin HutsonTreasurer, VP & CFO Thr 9/17
Revenue and Support

Revenue Composition

Contributions and Grants
$205,967
Program Service Revenue
$0
Investment Income
$428
Other Revenue
$0
All Other Contributions
$205,967
Change in Net Assets
$206,353
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$42
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Salaries, Compensation, and Employee Benefits$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Expenses$42--$42
Total Functional Expenses$42$0$0$42
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
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
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, Section A, Line 6

The sole member of st. Mary's good samaritan foundation is st. Mary's health care system. See line 7 for additional information.

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

St. Mary's health care system is the sole member of st. Mary's good samaritan foundation. St. Mary's health care system has the right to appoint all persons to the board of directors of st. Mary's good samaritan foundation.

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

As sole member, st. Mary's health care system must approve certain decisions of the governing body, including the strategic plan, annual capital plan, and annual operating budget. St. Mary's health care system must also approve significant changes such as a merger, dissolution, sale of assets in excess of certain limits, and modifications to governing documents. As the parent of the national trinity health system, certain powers are reserved to trinity health corporation. These include the authority to adopt or modify the organization's governing documents, to approve major changes such as a merger or dissolution, and to approve significant finance matters in excess of certain limits established by trinity health corporation.

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

Prior to filing, the form 990 for st. Mary's good samaritan foundation is reviewed by management. Each member of the board receives a copy of the return in its final form before it is filed with the internal revenue service.

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

St. Mary's good samaritan foundation has adopted trinity health's governance policy no. 1, which sets forth the organization's conflict of interest policy and processes. It applies to all "interested persons" of st. Mary's good samaritan foundation, which includes directors, principal officers, key employees, and members of committees with board-delegated powers. Interested persons are expected to discharge their duties in a manner the person reasonably believes to be in the best interests of st. Mary's good samaritan foundation and to avoid situations involving a conflict of interest. On an annual basis, interested persons are required to complete a conflict of interest disclosure statement and to affirm their receipt of the conflict of interest policy, compliance with its requirements, and agree to notify the organization of changes impacting their annual disclosure in accordance with the policy. The annual disclosures are provided to internal legal counsel and the integrity and compliance officer, from which legal counsel prepares a report for the board chair and ceo. A summary of potential conflicts is reviewed with the board of directors of st. Mary's good samaritan foundation on a yearly basis. Interested persons are required to make full disclosure to st. Mary's good samaritan foundation of any financial or business interests that might result in or have the appearance of a conflict of interest. The board of directors of st. Mary's good samaritan foundation (or a delegated committee of the board) is responsible for the review of transactions to determine whether an actual conflict of interest exists. In the event of an actual conflict, the board will either avoid the conflict or appropriately scrutinize the transaction to ensure it is in the best interests of st. Mary's good samaritan foundation. Interested persons are required to recuse themselves from discussion and voting on matters involving a conflict of interest. The policy further addresses the proper documentation of the proceedings and potential disciplinary and corrective action for violations of the policy. The policy is available to the public upon request.

Form 990, Part VI, Section B, Line 15

Questions 15a and 15b are answered "no" because the compensation for certain officers and key management officials of st. Mary's good samaritan foundation is established by trinity health, a related organization. In establishing ceo and cfo compensation, trinity health follows a process and policy that is intended to mirror the irc section 4958 guidelines for obtaining a "rebuttable presumption of reasonableness" with regard to compensation and benefits. As part of that process, the compensation and benefits of the ceo and cfo of st. Mary's good samaritan foundation are reviewed at least annually by the trinity health board or the trinity health human resources and compensation committee (hrcc) of the board, authorized to act on behalf of the board with respect to certain compensation matters. As part of its review process, the hrcc retains an independent firm experienced in compensation and benefit matters for not-for-profit health care organizations to advise it in the determinations it makes on the reasonableness of proposed compensation and benefits arrangements. The compensation of other officers and key management officials of st. Mary's good samaritan foundation is established by st. Mary's health care system, a related organization. In establishing officer and key management official compensation, st. Mary's health care system follows a process which includes the following: the board has an independent committee review and approve all elements of remuneration for all disqualified persons, as well as officers and other key management officials. The board/committee has an established compensation philosophy which details the objectives of market positioning and pay elements. The committee engages with external consultants to provide market data comparing the organization's roles to similarly sized organizations utilizing both title and job content comparisons. The committee reviews the market analysis, approves any salary adjustments for the executive population, considers both reasonableness and effectiveness of all remunerative programs, and establishes the detailed performance expectations which are incorporated into the incentive plan. All of these discussions and decisions are documented through the provision of meeting minutes.

Form 990, Part VI, Section C, Line 19

St. Mary's good samaritan foundation is a subsidiary organization in the trinity health system. Trinity health makes certain of its key documents available to the public on its website, www.trinity-health.org, in the "about us" section. In this section, the consolidated audited financial statements are publicly available. St. Mary's good samaritan foundation's governing documents and conflict of interest policy are available upon request.

Filing and Contact Details

Filer

Filer Name
ST MARY'S GOOD SAMARITAN FOUNDATION
EIN
81-1660088
Phone
7063893938
Address
1230 BAXTER STREET, ATHENS, GA 30606

Signing Officer

Name
D Montez Carter
Title
President & CEO
Phone
7063893938
Signed
2019-05-14

Organization Details

Principal Officer
D Montez Carter
Formed
2016
Legal Domicile
Ga
Voting Board Members
19
Independent Board Members
18
Employees
0
Volunteers
48
Supplemental Narrative

Additional Explanations

FORM 990, PART XI, LINE 9:

Equity transfers (to) from affliates -4,270. Other transactions 116,333.

FORM 990, PART XII, LINE 2:

St. Mary's good samaritan foundation's financial statements were included in the fy18 consolidated financial statements of trinity health, which were audited by an independent public accounting firm.

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IRS990/Form990PartVIISectionAGrp/TitleTxt0SEC; DIR, SMHCS PRES & CEO AT 1/18
IRS990/Form990PartVIISectionAGrp/TitleTxt1DIR, SMHCS PRESIDENT & CEO THR 12/17
IRS990/Form990PartVIISectionAGrp/TitleTxt2DIR;V CHAIR THR 12/17; CHAIR AT 1/18
IRS990/Form990PartVIISectionAGrp/TitleTxt3DIRECTOR; CHAIR THROUGH 12/17
IRS990/Form990PartVIISectionAGrp/TitleTxt4DIRECTOR; VICE CHAIR AS OF 1/18
IRS990/Form990PartVIISectionAGrp/TitleTxt5DIRECTOR THROUGH 12/17
IRS990/Form990PartVIISectionAGrp/TitleTxt6DIRECTOR AS OF 1/18
IRS990/Form990PartVIISectionAGrp/TitleTxt7DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt8DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt9DIRECTOR AS OF 1/18
IRS990/Form990PartVIISectionAGrp/TitleTxt10DIRECTOR THROUGH 12/17
IRS990/Form990PartVIISectionAGrp/TitleTxt11DIRECTOR AS OF 1/18
IRS990/Form990PartVIISectionAGrp/TitleTxt12DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt13DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt14DIRECTOR THROUGH 12/17
IRS990/Form990PartVIISectionAGrp/TitleTxt15DIRECTOR AS OF 1/18
IRS990/Form990PartVIISectionAGrp/TitleTxt16DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt17DIRECTOR AS OF 1/18
IRS990/Form990PartVIISectionAGrp/TitleTxt18DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt19DIRECTOR AS OF 1/18
IRS990/Form990PartVIISectionAGrp/TitleTxt20DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt21DIRECTOR THROUGH 12/17
IRS990/Form990PartVIISectionAGrp/TitleTxt22DIRECTOR
IRS990/Form990PartVIISectionAGrp/TitleTxt23DIRECTOR THROUGH 12/17
IRS990/Form990PartVIISectionAGrp/TitleTxt24DIRECTOR AS OF 1/18
IRS990/Form990PartVIISectionAGrp/TitleTxt25DIRECTOR THROUGH 12/17
IRS990/Form990PartVIISectionAGrp/TitleTxt26TREASURER AT 11/17; INT CFO AT 10/17
IRS990/Form990PartVIISectionAGrp/TitleTxt27TREASURER, VP & CFO THR 9/17
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IRS990/FormationYr02016
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IRS990/GrantsToOrganizationsInd00
IRS990/GrantToRelatedPersonInd00
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IRS990/MembersOrStockholdersInd01
IRS990/MethodOfAccountingAccrualInd0X
IRS990/MinutesOfCommitteesInd01
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IRS990/MissionDesc0WE, ST. MARY'S HEALTH CARE SYSTEM AND TRINITY HEALTH, SERVE TOGETHER IN THE SPIRIT OF THE GOSPEL AS A COMPASSIONATE AND TRANSFORMING HEALING PRESENCE WITHIN OUR COMMUNITIES. ST. MARY'S GOOD SAMARITAN FOUNDATION IS A MEMBER OF THE ST. MARY'S HEALTH CARE SYSTEM AND TRINITY HEALTH.
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IRS990/OfficerMailingAddressInd00
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IRS990/OtherAssetsTotalGrp/BOYAmt02300
IRS990/OtherAssetsTotalGrp/EOYAmt00
IRS990/OtherChangesInNetAssetsAmt0112063
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IRS990/PrincipalOfficerNm0D MONTEZ CARTER
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IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt0ST. MARY'S GOOD SAMARITAN FOUNDATION'S SUPPORTED ORGANIZATION IS NOT LISTED BY NAME IN THE GOVERNING DOCUMENTS, BUT IS DESIGNATED BY PURPOSE. THE PURPOSE OF ST. MARY'S GOOD SAMARITAN FOUNDATION AS STATED IN ITS GOVERNING DOCUMENTS IS TO ADVANCE, PROMOTE, SUPPORT, AND CARRY OUT THE PURPOSES OF CATHOLIC HEALTH MINISTRIES AND TRINITY HEALTH. ITS SPECIFIC PURPOSES ARE TO ENGAGE IN THE DELIVERY OF AND TO CARRY ON, SPONSOR OR PARTICIPATE, DIRECTLY OR THROUGH ONE OR MORE AFFILIATES, IN ANY ACTIVITIES RELATED TO THE DELIVERY OF HEALTH CARE AND HEALTH CARE RELATED SERVICES AS APPROPRIATE IN CARRYING OUT THE HEALTH CARE MISSION OF CATHOLIC HEALTH MINISTRIES AND TRINITY HEALTH. SUCH ACTIVITIES INCLUDE THE SUPPORT AND ASSISTANCE OF AFFILIATES TO ACCOMPLISH THE FOREGOING PURPOSES. THE SUPPORTED ORGANIZATION LISTED IN PART I, LINE 12 IS AN AFFILIATE OF TRINITY HEALTH AND QUALIFIES AS A SEC. 509(A)(1) PUBLIC CHARITY, AND SHARES THE EXEMPT PURPOSES OF ST. MARY'S GOOD SAMARITAN FOUNDATION AND TRINITY HEALTH.
IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt1ST. MARY'S GOOD SAMARITAN FOUNDATION SUPPORTS ST. MARY'S HEALTH CARE SYSTEM. ST. MARY'S HEALTH CARE SYSTEM DOES NOT HAVE AN IRS DETERMINATION OF STATUS UNDER SECTION 509(A)(1); IT HAS BEEN RECOGNIZED AS EXEMPT UNDER SECTION 501(C)(3) UNDER GROUP EXEMPTION NO. 0928 AND IS LISTED IN THE OFFICIAL CATHOLIC DIRECTORY AS A HOSPITAL. ST. MARY'S HEALTH CARE SYSTEM IS A PUBLIC CHARITY AS DESCRIBED IN SECTION 509(A)(1) BECAUSE IT IS A HOSPITAL AS DESCRIBED UNDER SECTION 170(B)(1)(A)(III).
IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt2ST. MARY'S GOOD SAMARITAN FOUNDATION PROVIDED SUPPORT TO RELATED ORGANIZATIONS THAT ARE PART OF TRINITY HEALTH AND SHARE THE CHARITABLE PURPOSES OF ITS SUPPORTED ORGANIZATION AND TRINITY HEALTH.
IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc0SCHEDULE A, PART IV, SECTION A, LINE 1:
IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc1SCHEDULE A, PART IV, SECTION A, LINE 2:
IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc2SCHEDULE A, PART IV, SECTION B, LINE 2:
IRS990ScheduleA/OtherSupportSumAmt00
IRS990ScheduleA/SupportedOrganizationsCnt01

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