2024-08-06T17:08:57-05:00 2023-09-30 135565207 KPMG LLP 301 MAIN STREET SUITE 2150 BATON ROUGE LA 70801 990 2022-10-01 956051253 AUXILIARY OF THE HOSPITAL OF THE GOOD SAMARITAN AUXI 2139772121 1225 WILSHIRE BLVD LOS ANGELES CA 900172395 MAHLON LAWTON PRESIDENT 2139772121 2024-07-28 1 0 BRITTANY ELLISER P01284594 2253444000 2024-07-22 2022 2024-08-08 14:25:15Z MAHLON LAWTON 1225 WILSHIRE BLVD LOS ANGELES CA 900172395 5 0 X N/A X 1972 CA TO PROMOTE AND ADVANCE THE WELFARE OF PIH HEALTH GOOD SAMARITAN HOSPITAL. 15 15 0 15 0 0 940 0 0 0 7 5 5665 0 6612 5 20000 25000 0 0 0 0 0 0 0 981 304 20981 25304 -14369 -25299 64448 39149 0 0 64448 39149 TO PROMOTE AND ADVANCE THE WELFARE OF PIH HEALTH GOOD SAMARITAN HOSPITAL. 0 0 25304 25000 THE ORGANIZATION MAINLY PROVIDES SERVICE TO THE HOSPITAL. 25304 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X JUNE BILGORE 2139772121 1225 WILSHIRE BLVD LOS ANGELES CA 900172395 X MAHLON LAWTON PRESIDENT 1.00 X X 0 0 0 FRANCIE KLEIN TRUSTEE 1.00 X 0 0 0 BEATE MCDERMOTT RECORDING SECRETARY 1.00 X X 0 0 0 ADRIANNE ANDREWS CORRESPONDING SECRETARY 1.00 X X 0 0 0 JUNE BILGORE TREASURER 1.00 X X 0 0 0 BARBARA BUNDY TRUSTEE 1.00 X 0 0 0 SUSAN BLUMENTHAL TRUSTEE 1.00 X 0 0 0 SALLY DAVIES TRUSTEE 1.00 X 0 0 0 GRACE FRITZINGER TRUSTEE 1.00 X 0 0 0 MARILYN KEZIRIAN TRUSTEE 1.00 X 0 0 0 DENIZ OLGAC TRUSTEE 1.00 X 0 0 0 MARYLIN STEPHENS TRUSTEE 1.00 X 0 0 0 LAURIE STONEMAN TRUSTEE 1.00 X 0 0 0 SARANE VAN DYKE TRUSTEE 1.00 X 0 0 0 ELAINE ZIMMERMAN TRUSTEE 1.00 X 0 0 0 0 0 0 0 0 0 0 0 5 5 5 0 0 5 25000 25000 LUNCHEON EXPENSES 304 304 25304 25304 0 0 64448 39149 64448 39149 0 0 X 64448 39149 64448 39149 64448 39149 -25299 0 X 0 0 0 X X X 1 PIH HEALTH GOOD SAMARITAN HOSPITAL 951656366 3 1 25000 0 1 25000 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 X 1 1 PART IV, SECTION E, LINE 2A: THE AUXILIARY HELPED THE HOSPITAL (THE SUPPORTED ORGANIZATION) BY RAISING MONEY TO BE CONTRIBUTED TO THE HOSPITAL FOR USE TO FURTHER ITS MISSION. PART IV, SECTION D, LINE 2: PIH HEALTH GOOD SAMARITAN HOSPITAL HAS THE AUTHORITY TO APPROVE THE POLICIES AND ACTIVITIES OF THE AUXILIARY, WHICH ENSURES A CLOSE AND CONTINUOUS RELATIONSHIP BETWEEN THE SUPPORTING AND SUPPORTED ORGANIZATION. PART IV, SECTION D, LINE 3: THE AUXILIARY'S POLICIES AND ACTIVITIES, INCLUDING ITS INVESTMENT POLICIES AND ITS USE OF INCOME AND ASSETS, ARE SUBJECT TO THE APPROVAL OF THE PIH HEALTH GOOD SAMARITAN HOSPITAL BOARD OF TRUSTEES. PART IV, SECTION E, LINE 2B: THE AUXILIARY HELPED THE HOSPITAL (THE SUPPORTED ORGANIZATION) BY RAISING MONEY TO BE CONTRIBUTED TO THE HOSPITAL FOR USE TO FURTHER ITS MISSION. 1 PIH HEALTH GOOD SAMARITAN HOSPITAL 1225 WILSHIRE BLVD LOS ANGELES CA 90017 951656366 501(C) (3) 25000 0 GRANT MADE TO SUPPORTED ORGANIZATION 1 PART I, LINE 2: DURING TAX YEAR 2022, AUXILIARY OF THE HOSPITAL OF THE GOOD SAMARITAN MADE GRANTS TO ITS SUPPORTED ORGANIZATION, PIH HEALTH GOOD SAMARITAN HOSPITAL. THE ORGANIZATION MAINTAINS A CLOSE RELATIONSHIP WITH THE GRANT RECIPIENT THROUGH ITS EX-OFFICIO BOARD MEMBERS WHO ALSO SERVE AS OFFICERS/DIRECTORS OF PIH HEALTH GOOD SAMARITAN HOSPITAL. THIS RELATIONSHIP ALLOWS AUXILIARY OF THE HOSPITAL OF THE GOOD SAMARITAN TO MONITOR AND ENSURE ITS GRANTS ARE USED FOR PROPER PURPOSES AND AREN'T OTHERWISE DIVERTED FROM THE INTENDED USE. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERSHIP OF THE ORGANIZATION CONSISTS OF THOSE PERSONS WHO ARE INTERESTED IN THE HOSPITAL AND WHO QUALIFY AS ANNUAL MEMBERS OR LIFE MEMBERS. THE ORGANIZATION HAS THREE CLASSES OF MEMBERS: ANNUAL MEMBERS, LIFE MEMBERS, AND HONORARY LIFE MEMBERS. ANY MEMBER (WHETHER AN ANNUAL, A LIFE MEMBER, OR AN HONORARY LIFE MEMBER) IN GOOD STANDING SHALL HAVE THE RIGHT TO VOTE, PARTICIPATE IN MEETINGS, AND BE ELIGIBLE TO HOLD OFFICE IN THE AUXILIARY AND TO BE A MEMBER OF THE BOARD OF DIRECTORS OF THE AUXILIARY. FORM 990, PART VI, SECTION A, LINE 7A THE GOVERNING BODY MEMBERS ARE ELECTED BY THE ORGANIZATION'S MEMBERS AT THE ANNUAL GENERAL MEETING WITH THE EXCEPTION OF 2 EX-OFFICIO MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B THE POLICIES AND ACTIVITIES OF THE AUXILIARY SHALL BE IN HARMONY WITH THE POLICIES OF THE BOARD OF TRUSTEES OF PIH HEALTH GOOD SAMARITAN HOSPITAL AND ARE SUBJECT TO THE APPROVAL OF THE PIH HEALTH GOOD SAMARITAN HOSPITAL BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION WORKS WITH AN INDEPENDENT ACCOUNTANT, KPMG LLP, TO PREPARE THE FORM 990. ONCE THE RETURN IS PREPARED, IT IS REVIEWED BY THE PRESIDENT AND TREASURER. KPMG LLP MAKES ALL CHANGES NECESSARY. THE FINAL FORM 990 IS PROVIDED TO THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT EACH YEAR. THE POLICY REQUIRES EACH GOVERNING BODY MEMBER TO DISCLOSE ANY CONFLICT ON A PARTICULAR MATTER THAT MAY ARISE, AND RECUSE HIM OR HERSELF FROM DELIBERATIONS AND VOTES ON SUCH MATTERS. FORM 990, PART VI, SECTION C, LINE 19 AUXILIARY OF THE HOSPITAL OF THE GOOD SAMARITAN'S ORGANIZING AND GOVERNING DOCUMENTS 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. PIH HEALTH GOOD SAMARITAN HOSPITAL 1225 WILSHIRE BLVD LOS ANGELES CA 90017 951656366 HOSPITAL CA 501(C)(3) LINE 3 PIH HEALTH INC 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0