Good Samaritan Family Health Center
- Assets
- $1.3m
- Revenue
- $4.0m
- Investments
- $0.0
- Employees
- 1
- Location
- Vincennes, IN
- Founding
- 04/2018
- Data as of
- 12/2021
- EIN
- 82-2966384
Organization Overview
Good Samaritan Family Health Center is located in Vincennes, IN. The organization was established in 2018. According to its NTEE Classification (E22) the organization is classified as: General Hospitals, under the broad grouping of Health Care and related organizations. This organization is an independent organization and not affiliated with a larger national or regional group of organizations. Good Samaritan Family Health Center is a 501(c)(3) and as such, is described as a "Charitable or Religous organization or a private foundation" by the IRS.
Form
990
Mission & Program ActivityExcerpts From the 990 Filing
TAX YEAR
2021
Describe the Organization's Mission:
Part 3 - Line 1
GOOD SAMARITAN FAMILY HEALTH CENTER WILL PROMOTE A HEALTHY COMMUNITY BY PROVIDING ACCESSIBLE RESPECTFUL AND COLLABORATIVE PRIMARY HEALTH CARE TO ALL REGARDLESS OF ABILITY TO PAY
Describe the Organization's Program Activity:
Part 3 - Line 4a
PATIENT SERVICES
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Board, Officers & Key Employees
| Name (title) | Role | Hours | Compensation |
|---|---|---|---|
Jennifer L Emmons CEO | Officer | 40 | $192,000 |
John Manning Chairman | Officer | 2 | $0 |
Phil Mangin Secretary | Officer | 2 | $0 |
Libby Gartner Vice Chairman | Officer | 2 | $0 |
Thomas Cook CFO | Officer | 2 | $0 |
Mary Cay Martin Board Member | Trustee | 2 | $0 |
Financial Statements
| Statement of Revenue | |
|---|---|
| Federated campaigns | $0 |
| Membership dues | $0 |
| Fundraising events | $0 |
| Related organizations | $0 |
| Government grants | $1,703,405 |
| All other contributions, gifts, grants, and similar amounts not included above | $9,300 |
| Noncash contributions included in lines 1a–1f | $0 |
| Total Revenue from Contributions, Gifts, Grants & Similar | $1,712,705 |
| Total Program Service Revenue | $2,283,780 |
| Investment income | $0 |
| Tax Exempt Bond Proceeds | $0 |
| Royalties | $0 |
| Net Rental Income | $0 |
| Net Gain/Loss on Asset Sales | $0 |
| Net Income from Fundraising Events | $0 |
| Net Income from Gaming Activities | $0 |
| Net Income from Sales of Inventory | $0 |
| Miscellaneous Revenue | $0 |
| Total Revenue | $3,996,485 |
| Statement of Expenses | |
|---|---|
| Grants and other assistance to domestic organizations and domestic governments. | $0 |
| Grants and other assistance to domestic individuals. | $0 |
| Grants and other assistance to Foreign Orgs/Individuals | $0 |
| Benefits paid to or for members | $0 |
| Compensation of current officers, directors, key employees. | $192,000 |
| Compensation of current officers, directors, key employees. | $192,000 |
| Compensation to disqualified persons | $0 |
| Other salaries and wages | $1,189,919 |
| Pension plan accruals and contributions | $0 |
| Other employee benefits | $4,000 |
| Payroll taxes | $11,638 |
| Fees for services: Management | $0 |
| Fees for services: Legal | $1,185 |
| Fees for services: Accounting | $167,045 |
| Fees for services: Lobbying | $0 |
| Fees for services: Fundraising | $0 |
| Fees for services: Investment Management | $0 |
| Fees for services: Other | $0 |
| Advertising and promotion | $1,873 |
| Office expenses | $549,709 |
| Information technology | $3,571 |
| Royalties | $0 |
| Occupancy | $97,588 |
| Travel | $0 |
| Payments of travel or entertainment expenses for any federal, state, or local public officials | $0 |
| Conferences, conventions, and meetings | $3,252 |
| Interest | $119,662 |
| Payments to affiliates | $0 |
| Depreciation, depletion, and amortization | $2,277 |
| Insurance | $18,386 |
| All other expenses | $0 |
| Total functional expenses | $2,447,014 |
| Balance Sheet | |
|---|---|
| Cash—non-interest-bearing | $881,619 |
| Savings and temporary cash investments | $0 |
| Pledges and grants receivable | $0 |
| Accounts receivable, net | $354,309 |
| Loans from Officers, Directors, or Controlling Persons | $0 |
| Loans from Disqualified Persons | $0 |
| Notes and loans receivable | $0 |
| Inventories for sale or use | $0 |
| Prepaid expenses and deferred charges | $0 |
| Net Land, buildings, and equipment | $0 |
| Investments—publicly traded securities | $0 |
| Investments—other securities | $0 |
| Investments—program-related | $0 |
| Intangible assets | $0 |
| Other assets | $15,937 |
| Total assets | $1,251,865 |
| Accounts payable and accrued expenses | $101,341 |
| Grants payable | $0 |
| Deferred revenue | $0 |
| Tax-exempt bond liabilities | $0 |
| Escrow or custodial account liability | $0 |
| Loans and other payables to any current Officer, Director, or Controlling Person | $0 |
| Secured mortgages and notes payable | $0 |
| Unsecured mortgages and notes payable | $0 |
| Other liabilities | $3,325,734 |
| Total liabilities | $3,427,075 |
| Net assets without donor restrictions | $0 |
| Net assets with donor restrictions | $0 |
| Capital stock or trust principal, or current funds | $0 |
| Paid-in or capital surplus, or land, building, or equipment fund | $0 |
| Retained earnings, endowment, accumulated income, or other funds | -$2,175,210 |
| Total liabilities and net assets/fund balances | $1,251,865 |
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