Pih Health Good Samaritan Hospital

“PIH Health Good Samaritan Hospital holds a 10.8% interest a joint venture arrangement that exists to further the charitable and community-based health care purposes, mission, vision, and values of its controlling tax exempt members. PIH Health Good Samaritan Hospital annually evaluates its participation in joint venture arrangements.”

“James West - Business relationship, Peggy Chulack - Business relationship, Vid Shivaraman - Business relationship, Rosalio Lopez - Business relationship, Alex Alvarez - Business relationship, Charlotte Weaver - Business relationship, Jeff Hamar - Business relationship, Kenton Woods - Business relationship, Marissa Goldberg - Business relationship, Melanie Batiste - Business relationship, Patrick Monroe - Business relationship, Paul Treinen - Business relationship, Peter Greaney - Business relationship, WIlliam Roth - Business relationship, Richard Atwood - Business relationship, Blayne Cutler - Business relationship, Jane Dicus - Business relationship, Jay Brown - Business relationship, Robert Maloney - Business relationship, THURSO BARENDSE - Business relationship, TRACEA SARALIEV - Business relationship”

“PIH Health, Inc. is the sole member of PIH Health Good Samaritan Hospital.”

“PIH Health, Inc. has authority to elect all the members of the board of directors of PIH Health Good Samaritan Hospital.”

“PIH Health, Inc. has all voting rights and the power to elect the board of directors of PIH Health Good Samaritan Hospital.”

“The Organization works with an independent accountant, KPMG LLP, to prepare the Form 990. Once the return is prepared, the return is reviewed by the Chief Financial Officer and VP of Finance. Form 990 is then reviewed by the Audit Committee of PIH Health, Inc., which is made up of independent directors. KPMG LLP makes all changes necessary. The final Form 990 is provided to the board prior to filing.”

“Each year, all management and board of directors members are required to complete a conflict of interest disclosure form. All positive responses are reviewed by the General Counsel and Chief Administrative Officer of PIH Health, Inc. Each positive response is considered in light of magnitude of ownership interest, financial transaction(s), etc. If deemed necessary, conflicts of interest could be resolved by insisting that the incumbent either divest their ownership interest, that the organization terminate the business relationship, or even that the director resign. Directors with potential conflicts of interest may recuse themselves from voting on certain matters and/or may excuse themselves from meetings during the discussion, deliberation, and voting on of matters.”

“PIH Health Good Samaritan Hospital's organizing and governing documents and the Conflict of Interest Policy are not made available to the public. The financial information from the financial statements is included in the Organization's Form 990, which is available for public inspection upon request.”

“One of the filing organization's officers, Rosalio Lopez, receives compensation for Directorship from PIH Health Downey Medical Group, Inc. (DMG), which has a professional service agreement with PIH Health Physicians, an affiliate of the filing organization, to provide physician services. The individuals received compensation from DMG, as follows: Rosalio Lopez: Reportable Base Compensation - $0 Other Compensation - $5,376”

“ALL OTHER REVENUE - Total Revenue: 2482588, Related or Exempt Function Revenue: , Unrelated Business Revenue: 49261, Revenue Excluded from Tax Under Sections 512, 513, or 514: 2433327;”

“Physician Fees - Total Expense: 12325218, Program Service Expense: 12325218, Management and General Expenses: , Fundraising Expenses: ; Consulting and Management Fees - Total Expense: 39641, Program Service Expense: 103925, Management and General Expenses: -64284, Fundraising Expenses: ; Other Contracted Services - Total Expense: 3723401, Program Service Expense: 3634001, Management and General Expenses: 89400, Fundraising Expenses: ; Other Professional Services - Total Expense: 54758, Program Service Expense: 54758, Management and General Expenses: , Fundraising Expenses: ; Medical Purchased Services - Total Expense: 2113166, Program Service Expense: 2011781, Management and General Expenses: 101385, Fundraising Expenses: ; Repairs and Maintenance - Total Expense: 4988445, Program Service Expense: 4618706, Management and General Expenses: 369739, Fundraising Expenses: ; Software Maintenance - Total Expense: 2637167, Program Service Expense: 2637167, Management and General Expenses: , Fundraising Expenses: ; Other Purchased Services - Total Expense: 30672663, Program Service Expense: 25817699, Management and General Expenses: 4854964, Fundraising Expenses: ; Outside Provider Cost - Total Expense: 13455540, Program Service Expense: 13455540, Management and General Expenses: , Fundraising Expenses: ; Purchased Labor - Total Expense: 14655692, Program Service Expense: 14659192, Management and General Expenses: -3500, Fundraising Expenses: ;”

“Accrued Minimum Pension Liability - 631132; Net Assets released from restrictions - operations - -7497; Other Intercompany transfers (expenses paid by GSH) - 323092;”