2026-08-14T19:11:23+00:00 2025-09-30 135565207 KPMG LLP 55 SECOND STREET SUITE 1400 SAN FRANCISCO CA 94105 990 2024-10-01 954346048 ORTHOPEDIC INSTITUTE OF THE GOOD SAMARITAN HOSPITAL ORTH 2139772121 1225 WILSHIRE BLVD LOS ANGELES CA 900172395 VID SHIVARAMAN CFO 2026-08-15 true true ALISON LAKRITZ P01935980 4159635100 2026-08-15 2024 2025-03-06 01:10:19Z JAMES WEST 12401 WASHINGTON BLVD WHITTIER CA 90602 141897 false X X 1992 CA RESEARCH AND EDUCATIONAL ACTIVITY WITH A FOCUS ON ORTHOPEDIC ACTIVITY. 3 0 0 0 0 25000 0 0 4201 141897 0 29201 141897 8371 2939 0 0 0 0 1166 1166 9537 4105 19664 137792 1597281 1932622 0 0 1597281 1932622 THE ORTHOPEDIC INSTITUTE IS A 509(A)(3) SUPPORTING ORGANIZATION OF THE PIH HEALTH GOOD SAMARITAN HOSPITAL. THE GENERAL PURPOSES OF THE INSTITUTE INCLUDE SUPPORT OF RESEARCH AND EDUCATIONAL ACTIVITY IN CONNECTION WITH THE OPERATION OF THE HOSPITAL, WITH A FOCUS ON ORTHOPEDIC ACTIVITIES; PARTICIPATION IN FUND-RAISING AND DEVELOPMENT IN SUPPORT OF SUCH ACTIVITIES; THE ADMINISTRATION OF GIFTS, FUNDS, AND OTHER ASSETS PROVIDED TO THE INSTITUTE BY THE HOSPITAL OR DIRECTLY OBTAINED BY THE INSTITUTE; AND THE DISBURSEMENT OF SUCH FUNDS FOR PURPOSES DESCRIBED HEREIN. false false 4105 2939 THE ORTHOPEDIC INSTITUTE PREVIOUSLY PROVIDED SUPPORT FOR CLINICAL RESEARCH AND EDUCATIONAL ACTIVITIES IN CONNECTION WITH THE OPERATION OF ITS SUPPORTED ORGANIZATION, PIH HEALTH GOOD SAMARITAN HOSPITAL. THE ORGANIZATION IS IN A TRANSITION PHASE AND IS IN THE PROCESS OF EVALUATING PLANS FOR FUTURE ACTIVITIES. 4105 true false false false false false false false false true true false false true false true false true false false false false false false false false false false false true false false false false false false false false false false false false false false false true false false false false true 0 0 0 false false false false false false false false false false false false X 3 0 true false false false true true true true true false false false true true true true true true false false false false CA X MARK KAWAUCHI 5626980811 12401 WASHINGTON BLVD WHITTIER CA 90602 JAMES WEST SYSTEM PRESIDENT & CEO 1.5 50.7 X X 0 1623596 40183 PEGGY CHULACK SYSTEM CAO & ASST SECRETARY 1.5 50.7 X X 0 1481245 33880 VID SHIVARAMAN SYSTEM CFO & ASST TREASURER 1.5 50.7 X X 0 870104 215850 0 3974945 289913 0 false true false 0 0 0 0 0 0 0 141897 141897 0 0 0 0 0 0 0 0 0 141897 0 0 141897 2939 2939 0 0 0 0 1166 1166 0 0 0 0 4105 4105 0 0 0 0 0 0 12600 4666 9101 7934 1364814 1436230 0 0 223366 488458 1597281 1932622 0 0 0 0 0 0 X -1418120 -1419286 3015401 3351908 1597281 1932622 1597281 1932622 137792 197549 0 X false true true false X X 1 PIH HEALTH GOOD SAMARITAN HOSPITAL 951656366 3 true 2939 0 1 2939 0 true false false false false false false false false false false false false false false true false 2990400 339446 2939 3326907 2440694 557977 8271 2990400 2175036 265658 2440694 2596908 -421872 2175036 2539211 57697 2596908 0.0 0.4529 0.5471 false false 12600 4666 7934 7934 INTERCOMPANY RECEIVABLES 488458 488458 0 X 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE D, PART V, LINE 4 INTENDED USES OF ENDOWMENT FUNDS THE ORGANIZATION'S ENDOWMENT CONSISTS OF FUNDS ESTABLISHED FOR HEALTH CARE SERVICES, AS SPECIFIED BY DONORS OR THE ORGANIZATION'S BOARD OF DIRECTORS. SCHEDULE D, PART X, LINE 2 FIN 48 (ASC 740) FOOTNOTE THE PRINCIPAL OPERATIONS OF THE COMPANY ARE EXEMPT FROM INCOME TAXES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3) AND THE LAWS OF THE STATES IN WHICH IT OPERATES AND, AS SUCH, IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, THE COMPANY IS SUBJECT TO INCOME TAXES ON NET INCOME DERIVED FROM A TRADE OR BUSINESS REGULARLY CARRIED ON THAT DOES NOT FURTHER THE ORGANIZATION'S EXEMPT PURPOSE. FURTHER, THE COMPANY IS ALSO SUBJECT TO FEDERAL EXCISE TAXES PURSUANT TO THE TAX CUTS AND JOBS ACT. NO SIGNIFICANT INCOME TAX PROVISION HAS BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR NET INCOME DERIVED FROM UNRELATED TRADE OR BUSINESS AND EXCISE TAXES. THE COMPANY MEASURES LIABILITIES FOR UNRECOGNIZED TAX UNCERTAINTIES IN ACCORDANCE WITH ASC 740, INCOME TAXES, WHICH PRESCRIBES A COMPREHENSIVE MODEL FOR HOW A COMPANY SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE IN ITS FINANCIAL STATEMENTS UNCERTAIN TAX POSITIONS THAT A COMPANY HAS TAKEN OR EXPECTS TO TAKE ON A TAX RETURN. THE GUIDANCE IS APPLICABLE TO PROFIT-ORIENTED ENTITIES, PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. MANAGEMENT BELIEVES IT HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS AND, AS SUCH, NO TAX LIABILITY, BENEFITS, INTEREST OR PENALTIES WERE ACCRUED AT SEPTEMBER 30, 2025 OR 2024. THE COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE COMPANY BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2021 FOR FEDERAL PURPOSES AND 2019 FOR CALIFORNIA PURPOSES. false true false false false false false false false PEGGY CHULACK SYSTEM CAO & ASST SECRETARY 0 872084 0 0 0 609161 0 18300 0 15580 0 1515125 0 600326 VID SHIVARAMAN SYSTEM CFO & ASST TREASURER 0 862548 0 0 0 7556 0 190785 0 25065 0 1085954 0 0 JAMES WEST SYSTEM PRESIDENT & CEO 0 1603998 0 0 0 19598 0 18300 0 21883 0 1663779 0 0 SCHEDULE J, PART I, LINE 3 ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION COMPENSATION FOR THE CEO WAS ESTABLISHED AND PAID BY PIH HEALTH WHITTIER HOSPITAL (PHWH), A RELATED ORGANIZATION. PHWH USED THE FOLLOWING TO ESTABLISH THE CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) FORM 990 OF OTHER ORGANIZATIONS; 4) COMPENSATION SURVEY OR STUDY; 5) APPROVAL BY THE BOARD. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PIH HEALTH INC. AND ITS AFFILIATES PROVIDES A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR CERTAIN EXECUTIVES. THE FOLLOWING INDIVIDUALS PARTICIPATE IN THE PLAN: JAMES WEST PEGGY CHULACK VID SHIVARAMAN THE FOLLOWING AMOUNTS ARE VESTED OR WERE PAID OUT IN 2024 AND ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B) (III) PEGGY CHULACK $600,326 FORM 990, PART VI, LINE 15 DURING THE TAX YEAR ENDED SEPTEMBER 30, 2025, NO OFFICERS, DIRECTORS, OR TRUSTEES RECEIVED COMPENSATION FROM THIS ORGANIZATION. THE COMPENSATION REPORTED IS PAID BY A RELATED ORGANIZATION AND IS DETERMINED BASED ON THE COMPENSATION REVIEW PRACTICES AND POLICIES OF THAT RELATED ORGANIZATION. FORM 990, PART VI, LINE 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS JAMES WEST - BUSINESS RELATIONSHIP, PEGGY CHULACK - BUSINESS RELATIONSHIP, VID SHIVARAMAN - BUSINESS RELATIONSHIP FORM 990, PART VI, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS THE SOLE MEMBER OF THE ORGANIZATION IS PIH HEALTH GOOD SAMARITAN HOSPITAL, A CALIFORNIA NONPROFIT CORPORATION. FORM 990, PART VI, LINE 7A MEMBERS OR STOCKHOLDERS ELECTING MEMBERS OF GOVERNING BODY THE SOLE MEMBER HAS THE POWER TO APPOINT, REPLACE OR REMOVE THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, LINE 7B DECISIONS REQUIRING APPROVAL BY MEMBERS OR STOCKHOLDERS THE ORGANIZATION'S CORPORATE MEMBER IS PIH HEALTH GOOD SAMARITAN HOSPITAL ("PHGSH"). PURSUANT TO SECTION 3.2 OF THE ORGANIZATION'S BYLAWS, THE FOLLOWING DECISIONS REQUIRE APPROVAL BY PHGSH: - AMENDMENT OF THE ARTICLES OF INCORPORATION OR BYLAWS - REMOVAL OF A DIRECTOR FOR CAUSE - SALE OR DISPOSAL OF ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S ASSETS - DISSOLUTION OR WINDING UP OF THE ORGANIZATION - APPROVAL OF A MERGER - CONTRACTS RESULTING IN EXPENDITURES OF THE ORGANIZATION'S ASSETS IN EXCESS OF AN AMOUNT AS SHALL BE DETERMINED, FROM TIME TO TIME, BY RESOLUTION OF THE BOARD OF DIRECTORS OF PHGSH - CONTRACTS FOR THE PURCHASE, SALE, EXCHANGE, OR OTHER DISPOSITION OR GIFT OF ANY REAL ESTATE OWNED OR PARTIALLY OWNED BY THE ORGANIZATION - SHORT-TERM OR LONG-TERM BORROWINGS, MORTGAGES, PLEDGES OF, OR LEASES ENTAILING CUMULATIVE PAYMENTS BY THE ORGANIZATION IN EXCESS OF SUCH AMOUNT(S) RESPECTING SPECIFIC TYPES OF TRANSACTIONS AS SHALL BE DETERMINED FROM TIME TO TIME, BY RESOLUTION OF THE BOARD OF DIRECTORS OF PHGSH - HIRING OR FIRING OF THE ORGANIZATION'S SENIOR EXECUTIVES, AS SUCH TERM SHALL BE DEFINED BY RESOLUTION OF THE BOARD OF DIRECTORS OF PHGSH - FINAL APPROVAL OF THE ANNUAL OPERATING BUDGET OF THE ORGANIZATION - ACCEPTANCE OF A LEGACY OR GIFT IMPOSING A PERMANENT OR CONTINUING OBLIGATION ON THE ORGANIZATION - ESTABLISH AND/OR ACKNOWLEDGEMENT OF ANY AUXILIARY AND/OR AUXILIARY CORPORATION TO BE ASSOCIATION WITH THE ORGANIZATION. FORM 990, PART VI, LINE 11B REVIEW OF FORM 990 BY GOVERNING BODY 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. FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY THE ORGANIZATION IS INCLUDED IN THE CONFLICT OF INTEREST POLICY FOR PIH HEALTH GOOD SAMARITAN HOSPITAL, THE ORGANIZATION'S SOLE MEMBER. ACCORDING TO THE POLICY, ALL BOARD MEMBERS AND OFFICERS 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. THE POLICIES ARE MONITORED AND ENFORCED BY THE AUDIT COMMITTEE CHAIRPERSON. FORM 990, PART VI, LINE 19 REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC ORTHOPEDIC INSTITUTE OF THE 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. PIH HEALTH GOOD SAMARITAN HOSPITAL 1225 WILSHIRE BLVD LOS ANGELES CA 90017 951656366 HOSPITAL CA 501(C)(3) 3 PIH HEALTH INC false GOOD SAMARITAN INSTITUTE FOR RESEARCH AND EDUCATION 1225 WILSHIRE BLVD LOS ANGELES CA 90017 954077161 HEART RESEARCH CA 501(C)(3) 4 PIH HEALTH GOOD SAMARITAN HOSPITAL false SAMARITAN IMAGING CENTER 1225 WILSHIRE BLVD LOS ANGELES CA 90017 954252321 OUTPATIENT IMAGING SERVICES CA 501(C)(3) 10 PIH HEALTH GOOD SAMARITAN HOSPITAL false GOOD SAMARITAN MEDICAL OFFICE BUILDING INC 1225 WILSHIRE BLVD LOS ANGELES CA 90017 953244046 PHYSICIANS MEDICAL OFFICES CA 501(C)(3) TYPE I PIH HEALTH GOOD SAMARITAN HOSPITAL false KATE VAN NUYS PAGE FOUNDATION 12401 WASHINGTON BLVD WHITTIER CA 90602 956028032 GRANTS INCOME TO PIH HEALTH GOOD SAMARITAN HOSPITAL CA 501(C)(3) TYPE I PIH HEALTH GOOD SAMARITAN HOSPITAL false PIH HEALTH ADULT DAY HEALTHCARE 12401 WASHINGTON BLVD WHITTIER CA 90602 953643829 SUPPORT OF TAX-EXEMPT AFFILIATES CA 501(C)(3) TYPE II PIH HEALTH INC false PIH HEALTH FOUNDATION 12401 WASHINGTON BLVD WHITTIER CA 90602 953761274 FUNDRAISING CA 501(C)(3) 7 PIH HEALTH INC false PIH HEALTH HOME HEALTHCARE 12401 WASHINGTON BLVD WHITTIER CA 90602 953036281 SUPPORT OF TAX-EXEMPT AFFILIATES CA 501(C)(3) TYPE II PIH HEALTH INC false PIH HEALTH DOWNEY HOSPITAL 11500 BROOKSHIRE AVE DOWNEY CA 90241 951903935 HEALTHCARE CA 501(C)(3) 3 PIH HEALTH INC false PIH HEALTH WHITTIER HOSPITAL 12401 WASHINGTON BLVD WHITTIER CA 90602 951934652 HEALTHCARE CA 501(C)(3) 3 PIH HEALTH INC false PIH HEALTH MANAGEMENT CORP 12401 WASHINGTON BLVD WHITTIER CA 90602 954016278 SUPPORT OF TAX-EXEMPT AFFILIATES CA 501(C)(3) TYPE II PIH HEALTH INC false PIH HEALTH PHYSICIANS 6557 GREENLEAF AVE WHITTIER CA 90601 953942828 HEALTHCARE CA 501(C)(3) 10 PIH HEALTH INC false PIH HEALTH INC 12401 WASHINGTON BLVD WHITTIER CA 90602 953619388 SUPPORT OF TAX-EXEMPT AFFILIATES CA 501(C)(3) TYPE II NA false DRMC PROPERTIES INC 12401 WASHINGTON BLVD WHITTIER CA 90602 954769768 REAL ESTATE CA NA C CORPORATION false HEALTHMED SERVICES INC 12401 WASHINGTON BLVD WHITTIER CA 90602 300831225 HEALTHCARE CA NA C CORPORATION false PIH HEALTH CARE SOLUTIONS 6557 GREENLEAF AVE WHITTIER CA 90601 462072342 HEALTHCARE CA NA C CORPORATION false PIH INSURANCE CO A RECIPROCAL RISK RETENTION GROUP 733 BISHOP STREET STE 1555 HONOLULU HI 96813 263760243 CAPTIVE INSURANCE HI NA TRUST false PIH HEALTH RE 733 BISHOP STREET STE 1555 HONOLULU HI 96813 472501390 CAPTIVE INSURANCE HI NA TRUST false PIONEER MEDICAL GROUP INC 6557 GREENLEAF AVE WHITTIER CA 90601 330927283 MEDICAL SERVICES CA NA C CORPORATION false TEXASCONNECT INC 3223 S LOOP 289 SUITE 600 6339 LUBBOCK TX 79423 335000461 MANAGEMENT SERVICES TX NA C CORPORATION false false true false false false false false false false false false false false false false false false false false