TY 2017 Form 990 Schedule O

efile Public Visual Render ObjectId: 201833039349301373 - Submission: 2018-10-30 TIN: 46-0422866

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
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Attach to Form 990 or 990-EZ.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2017

Open to Public
Inspection

Name of the organization

THE EVANGELICAL LUTHERAN GOOD SAMARITAN
FOUNDATION

Employer identification number

46-0422866

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 1	THE EXECUTIVE COMMITTEE OF THE BOARD SHALL CONSIST OF THE CHAIRPERSON, VICE CHAIRPERSON, SOCIETY PRESIDENT/CHIEF EXECUTIVE OFFICER, FOUNDATION PRESIDENT, AUDIT COMMITTEE CHAIR, AND THE GOVERNANCE/NOMINATING COMMITTEE CHAIR. NO EMPLOYEE OF THE SOCIETY, EXCEPT THE SOCIETY PRESIDENT/CHIEF EXECUTIVE OFFICER AND THE FOUNDATION PRESIDENT, MAY SERVE ON THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE OF THE BOARD SHALL BE CHAIRED BY THE VICE CHAIRPERSON WHEN THE CHAIRPERSON IS ABSENT FOR ANY REASON. THE POWERS AND DUTIES OF THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS SHALL BE: A. TO HAVE FULL AUTHORITY TO ACT BETWEEN MEETINGS OF THE BOARD UPON MATTERS WHICH, IN THE JUDGMENT OF THE COMMITTEE, ARE OF SUCH A NATURE AS TO REQUIRE ACTION PRIOR TO THE NEXT REGULAR MEETING OF THE BOARD BUT DO NOT REQUIRE CALLING OF A SPECIAL MEETING OF THE BOARD. B. TO DEVELOP ADMINISTRATIVE RULES FOR THE IMPLEMENTATION OF THE ARTICLES OF INCORPORATION AND BYLAWS AS AND WHEN NEEDED. C. TO CREATE AN EXECUTIVE SUB-COMMITTEE TO EVALUATE THE PERFORMANCE OF THE FOUNDATION PRESIDENT. D. ANY ACTION TAKEN BY THE COMMITTEE INVOLVING EXERCISE OF THE POWERS OF THE BOARD SHALL BE REPORTED PROMPTLY TO THE BOARD, AND RATIFIED BY THE BOARD AT THE NEXT MEETING OF THE BOARD FOLLOWING SUCH ACTION.
FORM 990, PART VI, SECTION A, LINE 4	THE ORGANIZATIONS BYLAWS WERE AMENDED AS FOLLOWS IN APRIL 2017: THE PRESIDENT/CEO OF THE SOCIETY SHALL BE EX-OFFICIO MEMBERS. THE CEO OF THE SOCIETY INSTEAD OF THE CHAIRPERSON OF THE SOCIETY'S BOARD SHALL BE ELIGIBLE TO SERVE ON THE FOUNDATION BOARD OF DIRECTORS. THE BOARD SHALL ELECT FROM ITS OWN MEMBERSHIP, A CHAIRPERSON AND A VICE CHAIRPERSON, UNLESS OTHERWISE DETERMINED BY THE MEMBER. NO EMPLOYEE OF THE SOCIETY OR THE CORPORATION MAY SERVE IN THESE POSITIONS. IT IS THE EXPECTATION THAT THE VICE CHAIRPERSON SHALL BE THE NEXT SELECTED PERSON TO SUCCEED THE THEN CURRENT CHAIRPERSON. A BOARD TERM LENGTH OF THREE YEARS WAS ESTABLISHED AND IS LIMITED TO TWO (2) SUCCESSIVE FULL TERMS BUT MAY BE RE-ELECTED AFTER AN ABSENCE OF AT LEAST ONE (1) YEAR. AN EXECUTIVE COMMITTEE OF THE BOARD WAS ESTABLISHED.
FORM 990, PART VI, SECTION A, LINE 6	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY IS THE SOLE MEMBER OF THE FOUNDATION.
FORM 990, PART VI, SECTION A, LINE 7A	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY BOARD OF DIRECTORS APPROVES THE BOARD MEMBER APPOINTMENTS OF THE FOUNDATION.
FORM 990, PART VI, SECTION A, LINE 7B	THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY BOARD OF DIRECTORS APPROVES THE BOARD MEMBER APPOINTMENTS OF THE FOUNDATION AND ANY AMENDMENTS TO THE BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11B	ACCOUNTANTS WITH THE FOUNDATION REVIEWED THE 990 IN DETAIL PRIOR TO IT BEING SUBMITTED. ANY QUESTIONS WERE RESOLVED WITH THE TREASURER AND/OR PRESIDENT OF THE ORGANIZATION PRIOR TO THE 990 BEING FILED. A COPY OF THE 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY PRIOR TO THE 990 BEING FILED FOR THEIR REVIEW AND APPROVAL.
FORM 990, PART VI, SECTION B, LINE 12C	OFFICERS AND DIRECTORS ARE REQUIRED TO ANNUALLY DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. ALL POTENTIAL DIRECTOR CONFLICTS ARE INVESTIGATED BY THE FOUNDATION'S CHIEF LEGAL OFFICER. THE CHIEF LEGAL OFFICER REPORTS HIS FINDINGS TO THE BOARD CHAIR. THE BOARD ULTIMATELY DETERMINES WHETHER OR NOT AN ACTUAL CONFLICT OF INTEREST EXISTS AND THE REMEDIAL STEPS NECESSARY BASED UPON SUCH LEGAL OPINION. THE FOUNDATION HAS A CONFLICT OF INTEREST POLICY THAT COVERS SUBSTANTIALLY ALL EMPLOYEES. ALL EMPLOYEES ARE REQUIRED TO REPORT ANY POTENTIAL CONFLICTS TO THE APPROPRIATE INDIVIDUAL AS INDICATED IN THE POLICY. ALL POTENTIAL CONFLICTS ARE INVESTIGATED TO DETERMINE IF A CONFLICT EXISTS. IF APPROVAL IS GIVEN TO PROCEED WITH THE ACTION, A COPY OF THE APPROVAL IS DOCUMENTED IN THE EMPLOYEE'S PERSONNEL FILE.
FORM 990, PART VI, SECTION C, LINE 19	THE FOUNDATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.

Return Reference

Explanation

FORM 990, PART VI, SECTION A, LINE 1

THE EXECUTIVE COMMITTEE OF THE BOARD SHALL CONSIST OF THE CHAIRPERSON, VICE CHAIRPERSON, SOCIETY PRESIDENT/CHIEF EXECUTIVE OFFICER, FOUNDATION PRESIDENT, AUDIT COMMITTEE CHAIR, AND THE GOVERNANCE/NOMINATING COMMITTEE CHAIR. NO EMPLOYEE OF THE SOCIETY, EXCEPT THE SOCIETY PRESIDENT/CHIEF EXECUTIVE OFFICER AND THE FOUNDATION PRESIDENT, MAY SERVE ON THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE OF THE BOARD SHALL BE CHAIRED BY THE VICE CHAIRPERSON WHEN THE CHAIRPERSON IS ABSENT FOR ANY REASON. THE POWERS AND DUTIES OF THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS SHALL BE: A. TO HAVE FULL AUTHORITY TO ACT BETWEEN MEETINGS OF THE BOARD UPON MATTERS WHICH, IN THE JUDGMENT OF THE COMMITTEE, ARE OF SUCH A NATURE AS TO REQUIRE ACTION PRIOR TO THE NEXT REGULAR MEETING OF THE BOARD BUT DO NOT REQUIRE CALLING OF A SPECIAL MEETING OF THE BOARD. B. TO DEVELOP ADMINISTRATIVE RULES FOR THE IMPLEMENTATION OF THE ARTICLES OF INCORPORATION AND BYLAWS AS AND WHEN NEEDED. C. TO CREATE AN EXECUTIVE SUB-COMMITTEE TO EVALUATE THE PERFORMANCE OF THE FOUNDATION PRESIDENT. D. ANY ACTION TAKEN BY THE COMMITTEE INVOLVING EXERCISE OF THE POWERS OF THE BOARD SHALL BE REPORTED PROMPTLY TO THE BOARD, AND RATIFIED BY THE BOARD AT THE NEXT MEETING OF THE BOARD FOLLOWING SUCH ACTION.

FORM 990, PART VI, SECTION A, LINE 4

THE ORGANIZATIONS BYLAWS WERE AMENDED AS FOLLOWS IN APRIL 2017: THE PRESIDENT/CEO OF THE SOCIETY SHALL BE EX-OFFICIO MEMBERS. THE CEO OF THE SOCIETY INSTEAD OF THE CHAIRPERSON OF THE SOCIETY'S BOARD SHALL BE ELIGIBLE TO SERVE ON THE FOUNDATION BOARD OF DIRECTORS. THE BOARD SHALL ELECT FROM ITS OWN MEMBERSHIP, A CHAIRPERSON AND A VICE CHAIRPERSON, UNLESS OTHERWISE DETERMINED BY THE MEMBER. NO EMPLOYEE OF THE SOCIETY OR THE CORPORATION MAY SERVE IN THESE POSITIONS. IT IS THE EXPECTATION THAT THE VICE CHAIRPERSON SHALL BE THE NEXT SELECTED PERSON TO SUCCEED THE THEN CURRENT CHAIRPERSON. A BOARD TERM LENGTH OF THREE YEARS WAS ESTABLISHED AND IS LIMITED TO TWO (2) SUCCESSIVE FULL TERMS BUT MAY BE RE-ELECTED AFTER AN ABSENCE OF AT LEAST ONE (1) YEAR. AN EXECUTIVE COMMITTEE OF THE BOARD WAS ESTABLISHED.

FORM 990, PART VI, SECTION A, LINE 6

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY IS THE SOLE MEMBER OF THE FOUNDATION.

FORM 990, PART VI, SECTION A, LINE 7A

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY BOARD OF DIRECTORS APPROVES THE BOARD MEMBER APPOINTMENTS OF THE FOUNDATION.

FORM 990, PART VI, SECTION A, LINE 7B

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY BOARD OF DIRECTORS APPROVES THE BOARD MEMBER APPOINTMENTS OF THE FOUNDATION AND ANY AMENDMENTS TO THE BYLAWS.

FORM 990, PART VI, SECTION B, LINE 11B

ACCOUNTANTS WITH THE FOUNDATION REVIEWED THE 990 IN DETAIL PRIOR TO IT BEING SUBMITTED. ANY QUESTIONS WERE RESOLVED WITH THE TREASURER AND/OR PRESIDENT OF THE ORGANIZATION PRIOR TO THE 990 BEING FILED. A COPY OF THE 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY PRIOR TO THE 990 BEING FILED FOR THEIR REVIEW AND APPROVAL.

FORM 990, PART VI, SECTION B, LINE 12C

OFFICERS AND DIRECTORS ARE REQUIRED TO ANNUALLY DISCLOSE INTERESTS THAT COULD GIVE RISE TO CONFLICTS. ALL POTENTIAL DIRECTOR CONFLICTS ARE INVESTIGATED BY THE FOUNDATION'S CHIEF LEGAL OFFICER. THE CHIEF LEGAL OFFICER REPORTS HIS FINDINGS TO THE BOARD CHAIR. THE BOARD ULTIMATELY DETERMINES WHETHER OR NOT AN ACTUAL CONFLICT OF INTEREST EXISTS AND THE REMEDIAL STEPS NECESSARY BASED UPON SUCH LEGAL OPINION. THE FOUNDATION HAS A CONFLICT OF INTEREST POLICY THAT COVERS SUBSTANTIALLY ALL EMPLOYEES. ALL EMPLOYEES ARE REQUIRED TO REPORT ANY POTENTIAL CONFLICTS TO THE APPROPRIATE INDIVIDUAL AS INDICATED IN THE POLICY. ALL POTENTIAL CONFLICTS ARE INVESTIGATED TO DETERMINE IF A CONFLICT EXISTS. IF APPROVAL IS GIVEN TO PROCEED WITH THE ACTION, A COPY OF THE APPROVAL IS DOCUMENTED IN THE EMPLOYEE'S PERSONNEL FILE.

FORM 990, PART VI, SECTION C, LINE 19

THE FOUNDATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2017

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