GOOD SAMARITAN PHYSICIAN SERVICES: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SAMARITAN PHYSICIAN SERVICES (EIN 25-1832359)
- Tax period
- 2024-07-01 to 2025-06-30
- Filed
- 2026-05-08
- IRS object ID
- 202641289349300424
- Schema version
- 2024v5.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2026-05-08T09:36:54-05:00 | ReturnTs |
| Tax Period End | 2025-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 222517863 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLSPAN HEALTH | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2767 | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17405 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251832359 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SAMARITAN PHYSICIAN SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GOOD | BusinessNameControlTxt |
| Phone | 7178513055 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2767 | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 174052767 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LAURA BUCZKOWSKI | PersonNm |
| Person Title | EXECUTIVE VP & CFO | PersonTitleTxt |
| Phone | 7178513055 | PhoneNum |
| Signature | 2026-05-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID P RIZZUTO | PreparerPersonNm |
| PTIN | P01210563 | PTIN |
| Phone | 7178513055 | PhoneNum |
| Preparation | 2026-05-08 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLSPAN MEDICAL SERVICES I | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROXANNA GAPSTUR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2767 | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 174052767 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $72,412,128 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WELLSPAN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE MEDICAL CARE TO PATIENTS WITHOUT REGARD FOR THE PATIENT'S ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,250 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $20,789,333 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $72,403,678 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,800 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $7,200 | CYOtherRevenueAmt |
| PY Total Revenue | $20,792,133 | PYTotalRevenueAmt |
| CY Total Revenue | $72,412,128 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $24,288,521 | PYOtherExpensesAmt |
| CY Other Expenses | $74,840,353 | CYOtherExpensesAmt |
| PY Total Expenses | $24,288,521 | PYTotalExpensesAmt |
| CY Total Expenses | $74,840,353 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,496,388 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,428,225 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,063,984 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,979,023 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,063,984 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,979,023 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | GOOD SAMARITAN PHYSICIAN SERVICES' MISSION IS IMPROVING THE HEALTH OF PATIENTS AND OUR COMMUNITIES AS A MULTI-SPECIALTY GROUP, BUILT ON A FOUNDATION OF PRIMARY CARE AND PREVENTION, AND COORDINATED WITHIN A COMPREHENSIVE SYSTEM OF CARE TO DELIVER EXCEPTIONAL AND AFFORDABLE HEALTH SERVICES. GOOD SAMARITAN PHYSICIAN SERVICES PROVIDES CARE WITHOUT REGARD FOR AN INDIVIDUAL'S HEALTH STATUS OR ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $71,772,778 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $72,403,678 | RevenueAmt |
| Desc | GOOD SAMARITAN PHYSICIAN SERVICES IS A NON-PROFIT GROUP OF PHYSICIAN PRACTICES THAT PROVIDES PREVENTIVE SERVICES, PRIMARY CARE, AS WELL AS SPECIALTY SERVICES TO THE RESIDENTS OF IN SOUTH CENTRAL PENNSYLVANIA AND SURROUNDING COMMUNITIES.SEE WELLSPAN HEALTH - 2025 COMMUNITY BENEFIT REPORT LOCATED AT HTTPS://WWW.WELLSPAN.ORG/ABOUT-WELLSPAN/IMPROVING-HEALTHY-COMMUNITIES/COMMUNITY-BENEFIT. | Desc |
| Total Program Service Expenses | $71,772,778 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID P RIZZUTO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7178513055 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3350 WHITEFORD ROAD | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 174029081 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| ROXANNA GAPSTUR PHD RN | |||||||||
| PRESIDENT & CEO - WELLSPAN HEALTH | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $3,124,465 | $52,133 | ||
| LAURA BUCZKOWSKI | |||||||||
| EXECUTIVE VP & CFO - WELLSPAN HEALTH | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $1,355,384 | $53,169 | ||
| ANTHONY AQUILINA DO | |||||||||
| EXEC. VP & CHIEF PHYSICIAN EXECUTIVE | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $1,242,245 | $52,878 | ||
| TARA ASSI PA-C | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $177,842 | $45,052 | |||
| AMBER BILLET MD | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $379,436 | $48,437 | |||
| ALMIRA CONTRACTOR MD | |||||||||
| CHAIR | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $275,130 | $48,989 | ||
| JULIAN ESTEBAN MD | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $739,343 | $52,059 | |||
| STEPHEN FLACK MD | |||||||||
| VICE CHAIR | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $622,655 | $54,033 | ||
| LESLEY HUGHES MD | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $578,934 | $37,751 | |||
| ROBERT KNIPE DO | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $846,876 | $54,006 | |||
| ROBERT PARGAMENT MD | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $314,316 | $51,353 | |||
| DUANE BRITTON | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LARRY MILLER | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SRIKANTH HOSUR MD | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $658,183 | $37,105 | |||
| VALERIE DORCELUS MD | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $395,282 | $36,945 | |||
| WILLIAM GUNNETT DO | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $960,479 | $54,152 | |||
| JOHN NAWA MD | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $701,297 | $51,451 | |||
| AMY NELSON | |||||||||
| SECRETARY/SR VP & GENERAL COUNSEL | 1.00 | 40.00 | Yes (X) | Yes (X) | $0 | $873,620 | $74,125 | ||
| UZOMA NWAKUCHE | |||||||||
| MEDICAL ONCOLOGIST | 40.00 | 0.00 | $0 | $983,561 | $35,963 | Yes (X) | |||
| IKECHUKWU AKUNYILI | |||||||||
| MEDICAL ONCOLOGIST | 40.00 | 0.00 | $0 | $962,056 | $51,629 | Yes (X) | |||
| ADNAN MALIK | |||||||||
| NON-INVASIVE CARDIOLOGIST | 40.00 | 0.00 | $0 | $726,404 | $42,247 | Yes (X) | |||
| MICHAEL VRANIAN | |||||||||
| NON-INVASIVE CARDIOLOGIST | 40.00 | 0.00 | $0 | $698,155 | $33,955 | Yes (X) | |||
| POOJA SAHNI | |||||||||
| NON-INVASIVE CARDIOLOGIST | 40.00 | 0.00 | $0 | $669,681 | $16,588 | Yes (X) | |||
| FARAAZ YOUSUF | |||||||||
| FORMER EXECUTIVE VP & COO | 0.00 | 0.00 | $0 | $1,056,585 | $37,354 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $18,341,929 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,021,374 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CHG COMPANIES INC | |||||
| PO BOX 972651 | DALLAS | TX | 75397 | STAFFING SERVICES | $315,009 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 976233 | DALLAS | TX | 75397 | TEMPORARY HELP | $103,728 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $1,250 | AllOtherContributionsAmt |
| Total Contributions | $1,250 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HEALTH CARE SERVICES | 621110 | $50,438,052 | $50,438,052 |
| SALARY & SPECIALIST | 621110 | $21,965,626 | $21,965,626 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $72,403,678 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EDUCATION REVENUE | Desc |
| Business | 611430 | BusinessCd |
| Total Revenue Column | $7,200 | TotalRevenueColumnAmt |
| Exclusion | $7,200 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $7,200 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $72,412,128 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $72,403,678 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $7,200 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,218,118 | TotalAmt |
| Program Services | $34,321,088 | ProgramServicesAmt |
| Management And General | $2,897,030 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190 | TotalAmt |
| Program Services | $190 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,551 | TotalAmt |
| Program Services | $40,252 | ProgramServicesAmt |
| Management And General | $1,299 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,979 | TotalAmt |
| Program Services | $33,301 | ProgramServicesAmt |
| Management And General | $10,678 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $968,652 | TotalAmt |
| Program Services | $866,958 | ProgramServicesAmt |
| Management And General | $101,694 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,879 | TotalAmt |
| Program Services | $55,219 | ProgramServicesAmt |
| Management And General | $3,660 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,541 | TotalAmt |
| Program Services | $41,740 | ProgramServicesAmt |
| Management And General | $2,801 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,335 | TotalAmt |
| Program Services | $149,334 | ProgramServicesAmt |
| Management And General | $16,001 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $359,711 | TotalAmt |
| Program Services | $327,980 | ProgramServicesAmt |
| Management And General | $31,731 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $35,483,745 | $35,483,745 | |
| BAD DEBT EXPENSE | $326,354 | $326,354 | |
| LICENSES & FEES | $66,008 | $65,413 | $595 |
| DUES & SUBSCRIPTIONS | $54,615 | $52,799 | $1,816 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,675 | TotalAmt |
| Program Services | $8,405 | ProgramServicesAmt |
| Management And General | $270 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,840,353 | TotalAmt |
| Program Services | $71,772,778 | ProgramServicesAmt |
| Management And General | $3,067,575 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,307,544 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,328,521 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,063,984 | BOYAmt |
| EOY | $2,979,023 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,063,984 | BOYAmt |
| EOY | $2,979,023 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,063,984 | BOYAmt |
| EOY | $2,979,023 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,063,984 | BOYAmt |
| EOY | $2,979,023 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,063,984 | BOYAmt |
| EOY | $2,979,023 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,428,225 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $2,343,264 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $1,250 | CurrentTaxYearAmt |
| Total | $1,250 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $20,789,333 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $72,403,678 | CurrentTaxYearAmt |
| Total | $93,193,011 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $20,789,333 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $72,404,928 | CurrentTaxYearAmt |
| Total | $93,194,261 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $93,194,261 | PublicSupportTotal509Amt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $7,200 | CurrentTaxYearAmt |
| Total | $7,200 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $20,789,333 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $72,412,128 | CurrentTaxYearAmt |
| Total | $93,201,461 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99990 | PublicSupportCY509Pct |
| Public Support PY509 | 1.00000 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | EDUCATION REVENUE - 2024 AMOUNT: $ 7,200. | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,520,652 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,614,804 | DepreciationAmt |
| Book Value | $2,905,848 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $258,401 | OtherCostOrOtherBasisAmt |
| Depreciation | $229,680 | DepreciationAmt |
| Book Value | $28,721 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $518,702 | OtherCostOrOtherBasisAmt |
| Depreciation | $484,037 | DepreciationAmt |
| Book Value | $34,665 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,789 | OtherCostOrOtherBasisAmt |
| Book Value | $9,789 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,979,023 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $74,425,675 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $2,013,547 | OtherRevenueAmt |
| Revenue Not Reported | $2,013,547 | RevenueNotReportedAmt |
| Revenue Subtotal | $72,412,128 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $72,412,128 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $74,510,636 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $74,510,636 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $329,717 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $329,717 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $74,840,353 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE COMPANY AND MOST OF ITS SUBSIDIARIES (INCLUDING CERTAIN JOINT VENTURE ENTITIES) ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. THEIR RELATED INCOME IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A). SOME OF THE SUBSIDIARIES ARE TAXABLE ENTITIES, AND SOME OF THE INCOME OF THE TAX-EXEMPT ENTITIES IS SUBJECT TO TAXATION AS UNRELATED BUSINESS TAXABLE INCOME. THE COMPANY AND ITS SUBSIDIARIES FILE U.S. FEDERAL INCOME TAX RETURNS, AND THEY ALSO FILE IN VARIOUS STATE AND FOREIGN JURISDICTIONS. THE COMPANY ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ASC TOPIC 740, INCOME TAXES. THE COMPANY ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE COMPANY HAS DETERMINED THAT NO SIGNIFICANT UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2025, AND 2024. ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, ASC TOPIC 740-10 PRESCRIBES A COMPREHENSIVE MODEL FOR HOW AN ORGANIZATION SHOULD MEASURE, RECOGNIZE, PRESENT AND DISCLOSE IN ITS FINANCIAL STATEMENTS UNCERTAIN TAX POSITIONS THAT AN ORGANIZATION HAS TAKEN OR EXPECTS TO TAKE ON A TAX RETURN. THE COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. THERE ARE NO CURRENT AUDITS IN PROGRESS. AS OF JUNE 30, 2025, THE COMPANY HAS NO UNCERTAIN TAX POSITIONS. FOR YEARS BEFORE 2022, THE COMPANY IS NO LONGER SUBJECT TO EXAMINATIONS FROM MAJOR TAXING JURISDICTIONS. A SUBSIDIARY OF THE COMPANY IS CLASSIFIED AS A RECIPROCAL RISK RETENTION GROUP (RRRG) FORMED UNDER THE FEDERAL LIABILITY RISK RETENTION ACT OF 1986. RRRG QUALIFIES AS AN INSURANCE COMPANY FOR FEDERAL INCOME TAX PURPOSES. RRRG IS DOMICILED IN VERMONT (VT) AND OPERATES WITHIN THE STATES OF PENNSYLVANIA (PA) AND MARYLAND (MD). VT, PA, AND MD DO NOT IMPOSE A CORPORATE INCOME TAX ON INSURANCE COMPANIES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | TRANSFERS FROM AFFILIATES 2,343,264. BAD DEBTS -320,702. EXPENSES NETTED WITH REVENUE ON FINANCIALS -9,015. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBTS 320,702. EXPENSES NETTED WITH REVENUE ON FINANCIALS 9,015. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (22 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROXANNA GAPSTUR PHD RN | ||||||||||||||
| PRESIDENT & CEO - WELLSPAN HEALTH | $0 | $1,739,595 | $0 | $1,112,453 | $0 | $272,417 | $0 | $11,203 | $0 | $40,930 | $0 | $3,176,598 | $0 | $269,264 |
| LAURA BUCZKOWSKI | ||||||||||||||
| EXECUTIVE VP & CFO - WELLSPAN HEALTH | $0 | $949,313 | $0 | $402,918 | $0 | $3,153 | $0 | $16,601 | $0 | $36,568 | $0 | $1,408,553 | $0 | $0 |
| ANTHONY AQUILINA DO | ||||||||||||||
| EXEC. VP & CHIEF PHYSICIAN EXECUTIVE | $0 | $874,016 | $0 | $365,076 | $0 | $3,153 | $0 | $17,211 | $0 | $35,667 | $0 | $1,295,123 | $0 | $0 |
| FARAAZ YOUSUF | ||||||||||||||
| FORMER EXECUTIVE VP & COO | $0 | $120,553 | $0 | $0 | $0 | $936,032 | $0 | $0 | $0 | $37,354 | $0 | $1,093,939 | $0 | $0 |
| UZOMA NWAKUCHE | ||||||||||||||
| MEDICAL ONCOLOGIST | $0 | $825,574 | $0 | $0 | $0 | $157,987 | $0 | $22,835 | $0 | $13,128 | $0 | $1,019,524 | $0 | $0 |
| WILLIAM GUNNETT DO | ||||||||||||||
| DIRECTOR | $0 | $846,307 | $0 | $5,250 | $0 | $108,922 | $0 | $17,279 | $0 | $36,873 | $0 | $1,014,631 | $0 | $0 |
| IKECHUKWU AKUNYILI | ||||||||||||||
| MEDICAL ONCOLOGIST | $0 | $860,871 | $0 | $0 | $0 | $101,185 | $0 | $22,890 | $0 | $28,739 | $0 | $1,013,685 | $0 | $0 |
| AMY NELSON | ||||||||||||||
| SECRETARY/SR VP & GENERAL COUNSEL | $0 | $641,147 | $0 | $229,320 | $0 | $3,153 | $0 | $40,330 | $0 | $33,795 | $0 | $947,745 | $0 | $0 |
| ROBERT KNIPE DO | ||||||||||||||
| DIRECTOR | $0 | $769,436 | $0 | $981 | $0 | $76,459 | $0 | $17,803 | $0 | $36,203 | $0 | $900,882 | $0 | $0 |
| JULIAN ESTEBAN MD | ||||||||||||||
| DIRECTOR | $0 | $725,597 | $0 | $11,692 | $0 | $2,054 | $0 | $18,014 | $0 | $34,045 | $0 | $791,402 | $0 | $0 |
| ADNAN MALIK | ||||||||||||||
| NON-INVASIVE CARDIOLOGIST | $0 | $707,545 | $0 | $0 | $0 | $18,859 | $0 | $18,307 | $0 | $23,940 | $0 | $768,651 | $0 | $0 |
| JOHN NAWA MD | ||||||||||||||
| DIRECTOR | $0 | $638,651 | $0 | $5,923 | $0 | $56,723 | $0 | $18,518 | $0 | $32,933 | $0 | $752,748 | $0 | $0 |
| MICHAEL VRANIAN | ||||||||||||||
| NON-INVASIVE CARDIOLOGIST | $0 | $679,566 | $0 | $0 | $0 | $18,589 | $0 | $21,022 | $0 | $12,933 | $0 | $732,110 | $0 | $0 |
| SRIKANTH HOSUR MD | ||||||||||||||
| DIRECTOR | $0 | $538,585 | $0 | $117,544 | $0 | $2,054 | $0 | $19,389 | $0 | $17,716 | $0 | $695,288 | $0 | $0 |
| POOJA SAHNI | ||||||||||||||
| NON-INVASIVE CARDIOLOGIST | $0 | $624,297 | $0 | $0 | $0 | $45,384 | $0 | $15,957 | $0 | $631 | $0 | $686,269 | $0 | $0 |
| STEPHEN FLACK MD | ||||||||||||||
| VICE CHAIR | $0 | $573,599 | $0 | $14,267 | $0 | $34,789 | $0 | $18,974 | $0 | $35,059 | $0 | $676,688 | $0 | $0 |
| LESLEY HUGHES MD | ||||||||||||||
| DIRECTOR | $0 | $576,880 | $0 | $0 | $0 | $2,054 | $0 | $19,142 | $0 | $18,609 | $0 | $616,685 | $0 | $0 |
| VALERIE DORCELUS MD | ||||||||||||||
| DIRECTOR | $0 | $348,850 | $0 | $3,115 | $0 | $43,317 | $0 | $20,390 | $0 | $16,555 | $0 | $432,227 | $0 | $0 |
| AMBER BILLET MD | ||||||||||||||
| DIRECTOR | $0 | $378,964 | $0 | $42 | $0 | $430 | $0 | $20,539 | $0 | $27,898 | $0 | $427,873 | $0 | $0 |
| ROBERT PARGAMENT MD | ||||||||||||||
| DIRECTOR | $0 | $308,382 | $0 | $0 | $0 | $5,934 | $0 | $18,847 | $0 | $32,506 | $0 | $365,669 | $0 | $0 |
| ALMIRA CONTRACTOR MD | ||||||||||||||
| CHAIR | $0 | $254,072 | $0 | $288 | $0 | $20,770 | $0 | $16,666 | $0 | $32,323 | $0 | $324,119 | $0 | $0 |
| TARA ASSI PA-C | ||||||||||||||
| DIRECTOR | $0 | $168,181 | $0 | $923 | $0 | $8,738 | $0 | $10,714 | $0 | $34,338 | $0 | $222,894 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4A: | DURING CALENDAR YEAR 2024, THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT: FARAAZ YOUSUF, FORMER EXECUTIVE VP & COO - $928,846 |
| PART I, LINE 4B: | THE WELLSPAN HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS ADOPTED AND MADE EFFECTIVE ON DECEMBER 19TH, 2008. THE OBJECTIVE OF THE EXECUTIVE BENEFITS PROGRAM IS TO PROVIDE AN EXECUTIVE BENEFITS PROGRAM THAT IS COMPETITIVE WITH NATIONAL NORMS IN THE HEALTHCARE INDUSTRY FOR SIMILARLY SIZED ORGANIZATIONS ENABLING WELLSPAN HEALTH TO RECRUIT AND RETAIN TOP EXECUTIVE TALENT. TIER I EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. A DESCRIPTION OF THE TARGETED BENEFIT OF THE PLAN IS AS FOLLOWS: 1) PROVIDE AN EMPLOYER SPONSORED RETIREMENT BENEFIT THAT REPLACES 60% OF AVERAGE PRE-RETIREMENT (5 YEARS) BASE COMPENSATION THROUGH A COMBINED APPROACH UTILIZING WELLSPAN'S RETIREMENT PLAN, 50% OF SOCIAL SECURITY, SPLIT-DOLLAR LIFE INSURANCE BENEFIT, AND SUPPLEMENTAL EXECUTIVE RETIREMENT BENEFIT. 2) PROVIDES A MINIMUM BENEFIT AFTER 10 YEARS OF SERVICE. 3) PROVIDES THE FULL TARGETED BENEFIT AFTER 25 YEARS OF SERVICE. 4) BENEFIT IS VESTED WHEN ELIGIBLE EXECUTIVE REACHES AGE 65. THE BENEFIT IS ALSO VESTED UPON DEATH, DISABILITY, JOB ELIMINATION AND "TERMINATION FOR GOOD REASON". 5) CREDITED SERVICE GRANTED ON A 1:2 BASIS FOR PREVIOUS SERVICE IN AN ELIGIBLE TIER II POSITION. 6) TARGETED BENEFIT IS TO BE CALCULATED USING A 15 YEAR CERTAIN PAYOUT. 7) PAYOUT WILL BE IN A LUMP SUM. 8) PAYOUT WILL BE TAXABLE WHEN VESTED. DURING THE CALENDAR YEAR 2024, THERE WERE NO DISTRIBUTIONS FROM THE SERP. THE WELLSPAN HEALTH DEFINED CONTRIBUTION DEFERRED COMPENSATION PLAN WAS ADOPTED AND MADE EFFECTIVE AS OF JULY 1, 2017. THIS PLAN WILL REPLACE THE SERP. AS PART OF THE TRANSITION, EACH PARTICIPANT IN THE SERP WAS GIVEN A ONE-TIME CHOICE TO BE GRANDFATHERED IN THE SERP OR TRANSFER TO THE NEW WELLSPAN HEALTH DEFINED CONTRIBUTION DEFERRED COMPENSATION PLAN. THE OBJECTIVE OF THE WELLSPAN HEALTH DEFINED CONTRIBUTION DEFERRED COMPENSATION PLAN IS TO ATTRACT AND RETAIN EXECUTIVE AND UPPER-LEVEL MANAGEMENT EMPLOYEES OF OUTSTANDING ABILITY. TIERS I, II, III AND A SELECT GROUP OF TIER IV EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. A DESCRIPTION OF THE TARGETED BENEFIT OF THE PLAN IS AS FOLLOWS: 1)PROVIDE AN UNFUNDED DEFERRED COMPENSATION BENEFIT TO A SELECT GROUP OF MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES. 2)PLAN ACCOUNT CONTRIBUTIONS ARE CREDITED EACH YEAR TO A SUBACCOUNT, BASED UPON VARIOUS TIER LEVELS; TIER I, 22%, TIER II, 17%, TIER III, 12%, AND TIER IV, 8%. 3)PARTICIPANT ACCOUNTS ARE CREDITED INTEREST EACH YEAR BY APPLICATION OF THE 30-YEAR U.S. TREASURY RATE ON JUNE 30 OF THE PLAN YEAR THEN ENDING, PLUS ONE PERCENT (1%). 4)PARTICIPANT VESTING OCCURS ON THE EARLIER OF: A)JUNE 30TH OF THE FOURTH PLAN YEAR: 25% PER YEAR B)PARTICIPANT REACHES AGE 65. C)UPON DEATH, DISABILITY, JOB ELIMINATION AND "TERMINATION FOR GOOD REASON". 5)NON-ELECTIVE EMPLOYER CONTRIBUTIONS ARE ALSO PERMITTED. 6)PLAN DISTRIBUTIONS TO BE ADMINISTERED PER THE PLAN DOCUMENT. DURING THE CALENDAR YEAR 2024, THE FOLLOWING INDIVIDUALS RECEIVED DISTRIBUTIONS FROM THE DEFERRED COMPENSATION PLAN: ROXANNA GAPSTUR - $269,264 ADDITIONALLY, ANY VESTED PORTION OF CONTRIBUTIONS MADE TO THE PLAN WHICH ARE NO LONGER SUBJECT TO THE RISK OF FORFEITURE, ARE REFLECTED IN SCHEDULE J, PART II, COLUMN B(III). |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | GOOD SAMARITAN PHYSICIAN SERVICES AMENDED ITS BY-LAWS TO STATE THAT THE CORPORATION MAY ALSO DO BUSINESS UNDER THE FICITITOUS NAME "WELLSPAN MEDICAL SERVICES I". THE BY-LAWS WERE ALSO UPDATED TO REFLECT THE ORGANIZATION'S NEW SOLE MEMBER, WELLSPAN MEDICAL GROUP. |
| FORM 990, PART VI, SECTION A, LINE 6 | WELLSPAN MEDICAL GROUP, A NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER OF GOOD SAMARITAN PHYSICIAN SERVICES. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE PRIMARY PURPOSE OF THE GOVERNANCE COMMITTEE, AS ASSIGNED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, IS TO DEVELOP AND SUPPORT THE CULTURE OF HIGH-FUNCTIONING GOVERNANCE WITHIN THE WELLSPAN SYSTEM, INCLUDING THROUGH POLICIES, NOMINATIONS, COMPETENCIES OF DIRECTORS, EDUCATION, AND SELF-EVALUATIONS. THE GOVERNANCE COMMITTEE SHALL CONSIST OF NOT LESS THAN FIVE (5) NOR MORE THAN SEVEN (7) MEMBERS. NEITHER THE CHAIR OF THE WELLSPAN HEALTH BOARD OF DIRECTORS NOR PERSONS WHO ARE NOT MEMBERS OF THE WELLSPAN HEALTH BOARD OF DIRECTORS, MAY BE APPOINTED TO THE COMMITTEE. EACH GOVERNANCE COMMITTEE MEMBER SHALL BE NOMINATED BY THE GOVERNANCE COMMITTEE, AND APPOINTED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, FOR A TERM OF ONE (1) YEAR. REAPPOINTMENT OF A GOVERNANCE COMMITTEE MEMBER FOR MORE THAN ONE (1) TERM IS NOT AUTOMATIC OR PRESUMED AND SHALL BE BASED ON AN INDIVIDUAL PERFORMANCE EVALUATION OF THE GOVERNANCE COMMITTEE MEMBER (AS PERFORMED OR OVERSEEN BY THE GOVERNANCE COMMITTEE). |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING RESPONSIBILITIES ARE SET FORTH AS A GUIDE FOR FULFILLING THE GOVERNANCE COMMITTEE'S PURPOSES IN SUCH MANNER AS THE COMMITTEE DETERMINES IS APPROPRIATE: 1. OVERSEE THE PROCESS OF SELECTING AND NOMINATING DIRECTORS AND OFFICERS FOR EACH OF THE GOVERNING BOARDS WITHIN THE WELLSPAN SYSTEM, INCLUDING ENSURING THAT DIRECTOR NOMINEES MEET THE QUALIFICATIONS REQUIRED BY THE RELEVANT BOARD COMPOSITION AND COMPETENCY GRID AND CHARACTERISTICS, BYLAWS, AND BOARD-APPROVED POLICIES AND GUIDELINES, AS APPLICABLE, AND ESTABLISH OTHER CRITERIA THAT ARE DESIRABLE FOR DIRECTORS; 2. IDENTIFY, EVALUATE AND SCREEN DIRECTOR CANDIDATES FOR EACH OF THE GOVERNING BOARDS WITHIN THE WELLSPAN SYSTEM (INCLUDING INCUMBENT DIRECTORS FOR POTENTIAL RE-NOMINATION), AND NOMINATE QUALIFIED INDIVIDUALS TO THE WELLSPAN HEALTH BOARD OF DIRECTORS FOR: (A) APPOINTMENT OR REAPPOINTMENT TO REGULAR TERMS, OR (B) APPOINTMENT TO FILL THE REMAINING TERM OF ANY GOVERNING BOARD VACANCIES; 3. REVIEW ANNUALLY THE SIZE, COMPOSITION AND LEADERSHIP OF EACH OF THE GOVERNING BOARDS WITHIN THE WELLSPAN SYSTEM, INCLUDING THE WELLSPAN HEALTH BOARD OF DIRECTORS AS A WHOLE, ITS COMMITTEES, AND ANY ADVISORY BODIES, MAKE A DETERMINATION OF WHETHER THE BOARD, ITS COMMITTEES AND ANY ADVISORY BODIES REFLECT THE APPROPRIATE BALANCE OF INDEPENDENCE, SOUND JUDGMENT, BUSINESS SPECIALIZATION, TECHNICAL SKILLS, DIVERSITY, FUNDRAISING AND DEVELOPMENT ABILITY, GEOGRAPHIC AND DEMOGRAPHIC REPRESENTATION, AND OTHER DESIRED QUALITIES, AND RECOMMEND ANY APPROPRIATE CHANGES TO THE WELLSPAN HEALTH BOARD OF DIRECTORS; 4. COORDINATE AND OVERSEE A PERIODIC SELF-EVALUATION OF THE ROLE AND PERFORMANCE OF EACH OF THE GOVERNING BOARDS WITHIN THE WELLSPAN SYSTEM, INCLUDING THE WELLSPAN HEALTH BOARD OF DIRECTORS, ITS COMMITTEES, AND ANY ADVISORY BODIES, AND EACH OF THEIR DIRECTORS AND OFFICERS; 5. DEVELOP AND RECOMMEND FOR APPROVAL BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, REVIEW THE EFFECTIVENESS OF, AND RECOMMEND MODIFICATIONS AS APPROPRIATE TO, THE ORGANIZATION'S COMMITTEE STRUCTURE AND ORGANIZATIONAL DOCUMENTS, INCLUDING THE ARTICLES OF INCORPORATION, BYLAWS, BOARD-APPROVED POLICIES AND GUIDELINES, AND COMMITTEE CHARTERS; 6. THE GOVERNANCE COMMITTEE SHALL UNDERTAKE THE RESPONSIBILITY FOR BOARD EDUCATION AND BOARD RETREAT PLANNING. IN ADDITION, THE GOVERNANCE COMMITTEE SHALL COORDINATE WITH MANAGEMENT TO DEVELOP AND IMPLEMENT AN EFFECTIVE ORIENTATION PROGRAM FOR NEW DIRECTORS, INCLUDING ASSIGNMENT OF EXPERIENCED DIRECTORS AS APPROPRIATE MENTORS OF NEW DIRECTORS. 7. REVIEW EMERGING CORPORATE GOVERNANCE ISSUES AND BEST GOVERNANCE PRACTICES AND MAKE APPROPRIATE RECOMMENDATIONS TO THE WELLSPAN HEALTH BOARD OF DIRECTORS; 8. CONDUCT A PERIODIC SELF-EVALUATION OF THE PERFORMANCE OF THE COMMITTEE, INCLUDING ITS EFFECTIVENESS AND COMPLIANCE WITH THIS CHARTER, AND RECOMMEND TO THE WELLSPAN HEALTH BOARD OF DIRECTORS MODIFICATIONS AS APPROPRIATE; 9. THE GOVERNANCE COMMITTEE SHALL MAINTAIN MINUTES OF GOVERNANCE COMMITTEE MEETINGS AND RECORDS OF ITS ACTIVITIES AND SHALL REPORT PROMPTLY TO THE WELLSPAN HEALTH BOARD OF DIRECTORS ANY ACTION TAKEN BY THE GOVERNANCE COMMITTEE, ANY RECOMMENDATIONS OF THE GOVERNANCE COMMITTEE, AND ANY OTHER MATTERS THE GOVERNANCE COMMITTEE DEEMS APPROPRIATE OR THE WELLSPAN HEALTH BOARD OF DIRECTORS REQUESTS. 10. THE GOVERNANCE COMMITTEE SHALL UNDERTAKE SUCH OTHER RESPONSIBILITIES AS THE WELLSPAN HEALTH BOARD OF DIRECTORS MAY DELEGATE OR ASSIGN TO THE GOVERNANCE COMMITTEE FROM TIME TO TIME. THE GOVERNANCE COMMITTEE SHALL BE RESPONSIBLE TO, AND SUBJECT TO THE DIRECTION AND CONTROL OF, THE WELLSPAN HEALTH BOARD OF DIRECTORS. THE WELLSPAN HEALTH BOARD OF DIRECTORS SHALL BE SOLELY RESPONSIBLE FOR DELINEATING THE RESPONSIBILITIES OF THE GOVERNANCE COMMITTEE. THE GOVERNANCE COMMITTEE SHALL PERFORM ONLY SUCH FUNCTIONS AND DUTIES AS SHALL FROM TIME TO TIME BE SPECIFICALLY DELEGATED TO THE GOVERNANCE COMMITTEE BY THE WELLSPAN HEALTH BOARD OF DIRECTORS. THE GOVERNANCE COMMITTEE DOES NOT HAVE DELEGATED AUTHORITY TO TAKE FINAL AND BINDING ACTIONS ON BEHALF OF WELLSPAN HEALTH, AND THEREFORE ANY ACTIONS AND RECOMMENDATIONS OF THE COMMITTEE MUST BE APPROVED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS BEFORE THEY ARE FINAL AND BINDING. IN DISCHARGING ITS ROLE, THE GOVERNANCE COMMITTEE IS EMPOWERED TO INQUIRE INTO ANY MATTER IT CONSIDERS APPROPRIATE TO CARRY OUT ITS RESPONSIBILITIES, WITH ACCESS TO ALL BOOKS, RECORDS, FACILITIES, AND PERSONNEL OF THE WELLSPAN SYSTEM. |
| FORM 990, PART VI, SECTION B, LINE 11B | MANAGEMENT PROVIDED AN ELECTRONIC COPY OF THE FORM 990 TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, PRIOR TO ITS FILING WITH THE IRS. THE ORGANIZATION'S FINANCE MANAGEMENT TEAM PROVIDED A PRESENTATION TO THE AUDIT COMMITTEE ON THE ORGANIZATION'S 990 RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A WELLSPAN HEALTH "CONFLICT OF INTEREST DISCLOSURE STATEMENT" QUESTIONNAIRE ANNUALLY. THE INTERNAL AUDIT DEPARTMENT OF WELLSPAN HEALTH ADMINISTERS THE QUESTIONNAIRES. THERE SHALL BE FULL DISCLOSURE BY A DIRECTOR HAVING A BUSINESS OR PERSONAL INTEREST OR RELATIONSHIP WHICH MAY BE IN CONFLICT WITH THE INTERESTS OF THE CORPORATION. AFTER SUCH DISCLOSURE, THE DIRECTOR SHALL ABIDE BY THE DETERMINATION OF THE BOARD OF DIRECTORS AS TO WHETHER A CONFLICT EXISTS, THE EXTENT TO WHICH, IF AT ALL, THE DIRECTOR WILL BE PERMITTED TO BE PRESENT DURING THE BOARD OF DIRECTORS' DISCUSSION OF THE MATTER IN WHICH THE DIRECTOR MAY BE INTERESTED, AND WHETHER THE DIRECTOR WILL BE PERMITTED TO PARTICIPATE IN SUCH DISCUSSION AND CAST A VOTE IN SUCH MATTER. ADDITIONALLY, ALL BOARD MEMBERS, EMPLOYEES, STUDENTS, AND VOLUNTEERS OF WELLSPAN HEALTH AND ITS RELATED ORGANIZATIONS MUST COMPLETE A "CODE OF CONDUCT" FORM TO ACKNOWLEDGE THAT HE OR SHE UNDERSTANDS THAT WE ALL HAVE AN OBLIGATION TO ACT IN WAYS THAT WILL MERIT THE TRUST, CONFIDENCE, AND RESPECT OF THE COMMUNITY WE SERVE, OTHER HEALTH CARE PROVIDERS, AND ALL OF THOSE WITH WHOM WE INTERACT. |
| FORM 990, PART VI, SECTION B, LINE 15B | THIS ORGANIZATION DOES NOT DIRECTLY COMPENSATE ANY EMPLOYEES. THE FOLLOWING PROCEDURE IS FOLLOWED BY OUR PARENT COMPANY AND AFFILIATES IN SETTING COMPENSATION. THE PRIMARY PURPOSE OF WELLSPAN HEALTH COMPENSATION COMMITTEE, AS ASSIGNED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, IS TO REVIEW COMPENSATION PACKAGES OFFERED AND/OR PAID TO SENIOR SYSTEM EXECUTIVES AND PRACTICING PHYSICIANS EMPLOYED WITHIN THE SYSTEM. THE COMPENSATION COMMITTEE SHALL MONITOR AND EVALUATE THE PERFORMANCE OF THE PRESIDENT AND CEO OF WELLSPAN HEALTH AND SHALL, AT LEAST ANNUALLY, COORDINATE THE IN-PERSON PERFORMANCE REVIEW OF THE PRESIDENT AND CEO BY THE WELLSPAN HEALTH BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE SHALL CONSIST OF 5-10 MEMBERS OF THE WELLSPAN HEALTH BOARD OF DIRECTORS, INCLUDING THE CHAIR AND THE VICE CHAIR. EACH COMPENSATION COMMITTEE MEMBER SHALL BE NOMINATED BY THE GOVERNANCE COMMITTEE, AND APPOINTED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, FOR A TERM OF ONE (1) YEAR. REAPPOINTMENT OF A COMPENSATION COMMITTEE MEMBER FOR MORE THAN ONE (1) TERM IS NOT AUTOMATIC OR PRESUMED AND SHALL BE BASED ON AN INDIVIDUAL PERFORMANCE EVALUATION OF THE COMPENSATION COMMITTEE MEMBER (AS PERFORMED OR OVERSEEN BY THE GOVERNANCE COMMITTEE). THE COMPENSATION COMMITTEE SHALL BE RESPONSIBLE TO, AND SUBJECT TO THE DIRECTION AND CONTROL OF, THE WELLSPAN HEALTH BOARD OF DIRECTORS. THE WELLSPAN HEALTH BOARD OF DIRECTORS SHALL BE SOLELY RESPONSIBLE FOR DELINEATING THE RESPONSIBILITIES OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE SHALL PERFORM ONLY SUCH FUNCTIONS AND DUTIES AS SHALL FROM TIME TO TIME BE SPECIFICALLY DELEGATED TO THE COMPENSATION COMMITTEE BY THE WELLSPAN HEALTH BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE DOES NOT HAVE DELEGATED AUTHORITY, AND THEREFORE ANY ACTIONS AND RECOMMENDATIONS OF THE COMMITTEE MUST BE APPROVED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS BEFORE THEY ARE FINAL AND BINDING. IN DISCHARGING ITS ROLE, THE COMPENSATION COMMITTEE IS EMPOWERED TO INQUIRE INTO ANY MATTER IT CONSIDERS APPROPRIATE TO CARRY OUT ITS RESPONSIBILITIES, WITH ACCESS TO ALL BOOKS, RECORDS, FACILITIES, AND PERSONNEL OF THE WELLSPAN SYSTEM. THE FOLLOWING RESPONSIBILITIES ARE SET FORTH AS A GUIDE FOR FULFILLING THE COMPENSATION COMMITTEE'S PURPOSES IN SUCH MANNER AS THE COMMITTEE DETERMINES IS APPROPRIATE: 1. SET, PERIODICALLY REVIEW AND ENSURE COMPLIANCE WITH THE EXECUTIVE COMPENSATION PHILOSOPHY FOR WELLSPAN, IN AN EFFORT TO ATTRACT AND RETAIN HIGH QUALITY EXECUTIVES, WHILE CONSIDERING COMPENSATION OFFERED TO THOSE IN COMPARABLE POSITIONS IN SIMILAR EMPLOYMENT MARKETS AS WELL AS THE SYSTEM'S NEEDS AND FINANCIAL RESOURCES. 2. RECOMMEND APPROVAL OF EXECUTIVE COMPENSATION PROGRAM ELEMENTS (INCENTIVES, SUPPLEMENTAL BENEFITS, ETC.). 3. IN CONJUNCTION WITH THE WELLSPAN HEALTH BOARD OF DIRECTORS, EVALUATE PERFORMANCE AND ESTABLISH COMPENSATION FOR THE PRESIDENT & CEO OF WELLSPAN HEALTH. 4. EVALUATE EXECUTIVE TEAM PERFORMANCE AND ESTABLISH AWARDS. 5. RECOMMEND APPROVAL OF SENIOR EXECUTIVE BASE SALARY RANGES. 6. ALIGN EXECUTIVE COMPENSATION WITH EXECUTIVE TALENT MANAGEMENT AND SUCCESSION. 7. OVERSEE EMPLOYED PHYSICIAN COMPENSATION PROGRAM. 8. THE COMPENSATION COMMITTEE SHALL MAINTAIN MINUTES OF COMPENSATION COMMITTEE MEETINGS AND RECORDS OF ITS ACTIVITIES, AND SHALL REPORT PROMPTLY TO THE WELLSPAN HEALTH BOARD OF DIRECTORS ANY ACTION TAKEN BY THE COMPENSATION COMMITTEE, ANY RECOMMENDATIONS OF THE COMPENSATION COMMITTEE, AND ANY OTHER MATTERS THE COMPENSATION COMMITTEE DEEMS APPROPRIATE TO THE WELLSPAN HEALTH BOARD OF DIRECTORS REQUESTS. 9. THE COMPENSATION COMMITTEE SHALL UNDERTAKE SUCH OTHER RESPONSIBILITIES AS THE WELLSPAN HEALTH BOARD OF DIRECTORS MAY DELEGATE OR ASSIGN TO THE COMPENSATION COMMITTEE FROM TIME TO TIME. THE COMPENSATION COMMITTEE ALSO UTILIZES THE SERVICES OF SULLIVANCOTTER, AN INDEPENDENT, THIRD-PARTY HEALTH CARE COMPENSATION CONSULTANT, TO ALIGN AND STRUCTURE WORKFORCE COMPENSATION AND BENEFIT STRATEGIES THAT SUPPORT ENTERPRISE-WIDE TRANSFORMATION AND BUSINESS PERFORMANCE. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 7,039,549. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,039,549. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,170. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,170. CONTRACTED WAGES: PROGRAM SERVICE EXPENSES 27,280,369. MANAGEMENT AND GENERAL EXPENSES 2,897,030. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,177,399. |
| FORM 990, PART XI, LINE 9: | TRANSFERS FROM AFFILIATE 2,343,264. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (25 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| APPLE HILL SURGICAL CENTER INC | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 222842253 | SURGICAL CENTER | PA | 501(C)(3) | LINE 10 | WELLSPAN HEALTH CARE SERVICES | 0 | |
| CHAMBERSBURG HOSPITAL | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 230465970 | HEALTH CARE SERVICES | PA | 501(C)(3) | LINE 3 | WELLSPAN SUMMIT HEALTH | 0 | |
| EPHRATA COMMUNITY HEALTH FOUNDATION | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 800940005 | FUNDRAISING FOR EPHRATA HOSPITAL | PA | 501(C)(3) | LINE 12A, I | EPHRATA COMMUNITY HOSPITAL | 0 | |
| EPHRATA COMMUNITY HOSPITAL | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231370484 | HEALTH CARE SERVICES | PA | 501(C)(3) | LINE 3 | WELLSPAN HEALTH | 0 | |
| EVANGELICAL COMMUNITY HOSPITAL FOUNDATION | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 992776957 | FUNDRAISING FOR EVANGELICAL HOSPITAL | PA | 501(C)(3) | LINE 12A, I | EVANGELICAL COMMUNITY HOSPITAL | 0 | |
| EVANGELICAL COMMUNITY HOSPITAL | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 240795411 | HEALTH CARE SERVICES | PA | 501(C)(3) | LINE 3 | WELLSPAN HEALTH | 0 | |
| GETTYSBURG HOSPITAL FOUNDATION | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232251358 | FUNDRAISING FOR GETTYSBURG HOSPITAL | PA | 501(C)(3) | LINE 12A, I | GETTYSBURG HOSPITAL | 0 | |
| GETTYSBURG HOSPITAL | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231352220 | HEALTH CARE SERVICES | PA | 501(C)(3) | LINE 3 | WELLSPAN HEALTH | 0 | |
| GOOD SAMARITAN HEALTH SERVICES FOUNDATION OF LEBANON PA | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232356151 | FUNDRAISING FOR GOOD SAMARITAN | PA | 501(C)(3) | LINE 12A, I | GOOD SAMARITAN HOSPITAL | 0 | |
| HEALTHY COMMUNITY PHARMACY INC | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 200519121 | REDUCED RATE PRESCRIPTION DRUGS TO UNINSURED | PA | 501(C)(3) | LINE 12A, I | WELLSPAN HEALTH CARE SERVICES | 0 | |
| PHILHAVEN | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231548822 | HEALTH CARE SERVICES | PA | 501(C)(3) | LINE 3 | WELLSPAN HEALTH | 0 | |
| SUMMIT HEALTH FOUNDATION | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 831196554 | FUNDRAISING FOR HEALTH CARE SYSTEM | PA | 501(C)(3) | LINE 12B, II | WELLSPAN SUMMIT HEALTH | 0 | |
| SUMMIT PHYSICIAN SERVICES | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251716306 | MEDICAL AND SURGICAL CARE | PA | 501(C)(3) | LINE 10 | WELLSPAN SUMMIT HEALTH | 0 | |
| THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 230794160 | HEALTH CARE SERVICES | PA | 501(C)(3) | LINE 3 | WELLSPAN HEALTH | 0 | |
| THE MILLER CENTER FOR RECREATION AND WELLNESS | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 473104877 | RECREATION AND WELLNESS CENTER | PA | 501(C)(3) | LINE 10 | EVANGELICAL COMMUNITY HOSPITAL | 0 | |
| VNA HOME HEALTH SERVICES | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231352573 | HOME HEALTH AND HOSPICE CARE SERVICES | PA | 501(C)(3) | LINE 10 | WELLSPAN SURGERY & REHABILITATION HOSPITAL | 0 | |
| WAYNESBORO HOSPITAL | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231360854 | HEALTH CARE SERVICES | PA | 501(C)(3) | LINE 3 | WELLSPAN SUMMIT HEALTH | 0 | |
| WELLSPAN HEALTH | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 222517863 | INTEGRATED HEALTH SYSTEM | PA | 501(C)(3) | LINE 12C, III-FI | 0 | N/A | |
| WELLSPAN HEALTH CARE SERVICES | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232400237 | HEALTH CARE SERVICES | PA | 501(C)(3) | LINE 12B, II | WELLSPAN HEALTH | 0 | |
| WELLSPAN MEDICAL GROUP | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232730785 | MEDICAL AND SURGICAL CARE | PA | 501(C)(3) | LINE 10 | WELLSPAN HEALTH | 0 | |
| WELLSPAN PROPERTIES INC | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 222842252 | LEASES FACILITIES TO AFFILIATES | PA | 501(C)(3) | LINE 12B, II | WELLSPAN HEALTH CARE SERVICES | 0 | |
| WELLSPAN SUMMIT HEALTH | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251515371 | INTEGRATED HEALTH SYSTEM | PA | 501(C)(3) | LINE 7 | WELLSPAN HEALTH | 0 | |
| WELLSPAN SURGERY & REHABILITATION HOSPITAL | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232899911 | SURGERY AND REHABILITATION HOSPITAL | PA | 501(C)(3) | LINE 3 | WELLSPAN HEALTH | 0 | |
| YORK HEALTH FOUNDATION | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 233050192 | FUNDRAISING FOR WELLSPAN ENTITIES | PA | 501(C)(3) | LINE 12C, III-FI | WELLSPAN HEALTH | 0 | |
| YORK HOSPITAL | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231352222 | COMMUNITY TEACHING HOSPITAL | PA | 501(C)(3) | LINE 3 | WELLSPAN HEALTH | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|
| APPLE HILL SURGICAL CENTER PARTNERS | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232489452 | SURGICAL CENTER | PA | WELLSPAN HEALTH | 0 | 0 | |
| CHERRY TREE CANCER CENTER LLP | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232915628 | RADIATION | PA | WELLSPAN HEALTH CARE SERVICES | 0 | 0 | |
| CUMBERLAND VALLEY MOBILE SERVICES | ||||||||||
| 5 S MAIN ST | SUGARLOAF | PA | 18249 | 200884014 | MOBILE HEALTH SERVICES | PA | WELLSPAN HEALTH CARE SERVICES | 0 | 0 | |
| LITTLESTOWN HEALTH CARE PARTNERSHIP | ||||||||||
| 300 WEST KING STREET | LITTLESTOWN | PA | 17340 | 232880464 | LEASE FACILITY | PA | WELLSPAN HEALTH CARE SERVICES | 0 | 0 | |
| SUMMIT SURGERY CENTER LP | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251845303 | PHYSICIAN SERVICES | PA | WELLSPAN HEALTH CARE SERVICES | 0 | 0 | |
| SURGERY CENTER ASSOCIATES LLC | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251845304 | PHYSICIAN SERVICES | PA | WELLSPAN HEALTH CARE SERVICES | 0 | 0 | |
| THE REHAB CENTER | ||||||||||
| 855 SPRINGDALE DRIVE SUITE 20 | EXTON | PA | 19341 | 251687903 | PHYSICAL THERAPY REHABILITATION | PA | EPHRATA HOSPITAL | 0 | 0 | |
| WELLSPAN SCA HOLDINGS LLC | ||||||||||
| 569 BROOKWOOD VLG SUITE 901 | BIRMINGHAM | AL | 35209 | 882731487 | INVESTMENTS | MD | WELLSPAN HEALTH CARE SERVICES | 0 | 0 | |
| EVANGELICAL-GEISINGER HEALTH LLC | ||||||||||
| 100 N ACADEMY AVENUE | DANVILLE | PA | 178224031 | 460567687 | HEALTHCARE | PA | 0 | 0 | N/A | |
| WELLSPAN HEALTH NEIGHBORHOOD HOSPITALS LLC | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 933129944 | HEALTHCARE | PA | WELLSPAN HEALTH CARE SERVICES | 0 | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| APPLE HILL CONDOMINIUM ASSOCIATION | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232504543 | CONDOMINIUM ASSOCIATION | PA | WELLSPAN HEALTH CARE SERVICES | C | 0 |
| CUMBERLAND VALLEY HEALTH NETWORK INC | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232775583 | HEALTH NETWORK | PA | WELLSPAN SUMMIT HEALTH | C | 0 |
| EPHRATA HEALTH PAVILION CONDOMINIUM ASSOCIATION | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 475367279 | CONDOMINIUM ASSOCIATION | PA | EPHRATA HOSPITAL | C | 0 |
| EPHRATA MEDICAL OFFICE CONDOMINIUM ASSOCIATION | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232526873 | CONDOMINIUM ASSOCIATION | PA | EPHRATA HOSPITAL | C | 0 |
| EVANGELICAL MEDICAL SERVICE ORGANIZATION | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232809429 | MEDICAL SERVICES | PA | EVANGELICAL COMMUNITY HOSPITAL | C | 0 |
| GOOD SAMARITAN PHYSICIAN HOSPITAL ORGANIZATION OF LEBANON PA | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251769419 | HEALTH CARE SERVICES | PA | THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA | C | 0 |
| GSH REALTY INC | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232446622 | NON-RESIDENTIAL REAL ESTATE | PA | WELLSPAN HEALTH CARE SERVICES | C | 0 |
| QUEST BEHAVIORAL HEALTH | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232910565 | HEALTH CARE NETWORK SERVICE | PA | WELLSPAN HEALTH | C | 0 |
| SPOTLIGHT VENTURES INC | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 934762032 | INNOVATIVE INITATIVES | PA | WELLSPAN HEALTH | C | 0 |
| WELLSPAN HEARING CENTER INC | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231954338 | HEARING AID PRACTICE | PA | WELLSPAN HEALTH CARE SERVICES | C | 0 |
| WELLSPAN PHARMACY INC | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232374072 | DISPENSES RX & PROVIDES IV THERAPY | PA | WELLSPAN HEALTH CARE SERVICES | C | 0 |
| WELLSPAN PROVIDER NETWORK | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232907828 | COORDINATE MANAGED CARE RISK CONTRACTS | PA | WELLSPAN HEALTH | C | 0 |
| WELLSPAN RECIPROCAL RISK RETENTION GROUP | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 200048457 | RISK RETENTION GROUP | VT | WELLSPAN HEALTH | C | 0 |
| YORK HEALTH PLAN | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232664989 | PREFERRED PROVIDER ORGANIZATION | PA | WELLSPAN HEALTH | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (1) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |