Exempla Good Samaritan Medical Center Foundation

“Dawn anuszkiewicz / steven hankins / janet bonner - business relationship (employer/employee relationship in good samaritan medical center, llc, a related tax-exempt organization).”

“Members or stockholders intermountain front range, inc., is the sole member of good samaritan medical center foundation.”

“Power to elect or appoint members intermountain front range, inc., the sole member of good samaritan medical center foundation, approves members of good samaritan medical center foundation board of directors.”

“Decisions reserved to members or stockholders intermountain front range, inc., has certain reserve powers to approve changes to the articles of incorporation and the bylaws including the appointment or removal of trustees and the president/ceo. Sisters of charity of leavenworth health system, inc. Also has certain reserve powers over any change in ownership of the corporation, change in mission, acquisition of assets, disposal of assets, leasing of assets, incurrence of debt, merger or dissolution, approval of strategic plans and budgets, appointment of auditors and oversight and approval of compensation and benefits for trustees, officers, key employees and physicians.”

“Process used to review the form 990 the form 990 is prepared by the tax department of intermountain health care, inc. And subsidiaries. The draft form 990 is reviewed by certain members of senior management. A copy of the final form 990 is provided to the board of directors prior to the filing with the internal revenue service.”

“Monitoring and enforcement of compliance with conflict of interest policy: each officer, director, trustee and key employee is required to complete a conflict of interest questionnaire at least annually. These individuals have been instructed to update their questionnaire information if they become aware of a new potential conflict, or if any of the previously reported information changes. Additionally, board members are asked at the beginning of each board or committee meeting if they are aware of any conflicts. According to policy, the questionnaires are collected and reviewed by intermountain's chief compliance officer. Potential conflicts of interest are reviewed with appropriate personnel, which may include (but is not limited to) the audit and compliance committee chair, senior management and the legal department. If an individual discloses a situation that poses a conflict of interest, a determination is made whether the situation can be managed (such as by recusal in decision-making settings) or must be eliminated (such as through divestiture of the outside interest). Findings are reported to the audit and compliance committee of intermountain health care, inc.”

“The compensation committee ("compensation committee"), a subset of intermountain health care, inc.'s governing body (a related nonprofit organization), is responsible for the process of annually determining the total compensation packages (including cash and noncash benefits) for the following officers: - executive directors the compensation committee annually retains an independent, external consulting firm to provide an analysis of comparable market data. The consultants review the various types of direct compensation, including base salary, total cash, and annual and long-term incentives. Information from a selected group of comparable nonprofit organizations is used to supplement published survey data. The consultants also conduct an in-depth analysis of the associated benefits and perquisites. Information provided by the external consultants is reviewed by the compensation committee along with the performance data for each officer listed above. Decisions by the compensation committee are contemporaneously documented. The compensation committee presents the collected information and the associated compensation decisions to the entire board of trustees. The philosophy is to pay compensation at market competitive rates. The determination of executive compensation is also designed to meet the "rebuttable presumption of reasonableness" standard as outlined in the treasury regulations.”

“Does not currently allow public inspection of its governing documents or conflict of interest policy. The consolidated financial statements are available to the public on the electronic municipal market access website (https://emma.msrb.org/p11734936-p11333642-p11768080.pdf), a service provided by the municipal securities rulemaking board.”

“The organization's expenses are paid by a related 501(c)(3) tax-exempt organization. The related organization files the required form 1096 and related 1099 tax forms for any expenditure that requires a form 1099 to be filed.”

“Website https://intermountainhealthcare.org/foundation/good-samaritan-foundation”

“Explanation for number reported in box 3 of form 1096: the organization's expenses are paid by a related 501(c)(3) tax-exempt organization. The related organization files the required form 1096 and related 1099 tax forms for any expenditure that requires a form 1099 to be filed.”

“Explanation for number reported on form w-3: the organization leases employees from a related 501(c)(3) tax-exempt organization. The related organization files the required w-3 and related w-2 tax forms for these individuals. According to the form 990 instructions for part ix, we reflect the leased employee's compensation on the form 990, part ix as if the organization compensates these individuals.”

“Prior year pledges receivable written-off in 2024 -39,497.”