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WELLSPAN SURGERY AND REHABILITATION HOSPITAL: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
WELLSPAN SURGERY AND REHABILITATION HOSPITAL (EIN 23-2899911)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-05-12
IRS object ID
202311329349305711
Schema version
2021v4.2
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

FieldValueIRS element (for citing)
Return2023-05-12T13:30:25-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN134008324PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PRICEWATERHOUSECOOPERS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1655 NEW YORK AVENUE NW - SUITE 1100AddressLine1Txt
CityWASHINGTONCityNm
State AbbreviationDCStateAbbreviationCd
ZIP20001ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN232899911EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WELLSPAN SURGERY & REHABILITATIONBusinessNameLine1Txt
Business Name Line2HOSPITALBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlWELLBusinessNameControlTxt
Phone7178513055PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2767AddressLine1Txt
CityYORKCityNm
State AbbreviationPAStateAbbreviationCd
ZIP174052767ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLAURA BUCZKOWSKIPersonNm
Person TitleEXECUTIVE VP & CFOPersonTitleTxt
Phone7178513055PhoneNum
Signature2023-05-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstLAURAPersonFirstNm
Person LastBUCZKOWSKIPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTRAVIS L PATTONPreparerPersonNm
PTINP00369623PTIN
Phone2024141000PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerROXANNA GAPSTURPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2767AddressLine1Txt
CityYORKCityNm
State AbbreviationPAStateAbbreviationCd
ZIP174052767ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$115,411,712GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.WELLSPAN.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionWELLSPAN SURGERY AND REHABILITATION HOSPITAL'S MISSION IS "SUPPORTING THE JOURNEY TO OPTIMAL HEALTH AND INDEPENDENCE BY PROVIDING EXCEPTIONAL ORTHOPEDIC, SPINE AND ACUTE REHABILITATIVE CARE IN A HEALING ENVIRONMENT AND COORDINATED THROUGH A COMPREHENSIVE SYSTEM OF CARE."ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee533TotalEmployeeCnt
Total Volunteers19TotalVolunteersCnt
Total Gross UBI$5,254TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants-$349,237PYContributionsGrantsAmt
CY Contributions Grants$657,969CYContributionsGrantsAmt
PY Program Service Revenue$106,914,897PYProgramServiceRevenueAmt
CY Program Service Revenue$114,028,666CYProgramServiceRevenueAmt
PY Investment Income-$828,303PYInvestmentIncomeAmt
CY Investment Income$47,671CYInvestmentIncomeAmt
PY Other Revenue$510,679PYOtherRevenueAmt
CY Other Revenue$677,406CYOtherRevenueAmt
PY Total Revenue$106,248,036PYTotalRevenueAmt
CY Total Revenue$115,411,712CYTotalRevenueAmt
PY Grants And Similar Paid$100,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$100,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$32,986,272PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$38,417,343CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$62,261,319PYOtherExpensesAmt
CY Other Expenses$72,041,368CYOtherExpensesAmt
PY Total Expenses$95,347,591PYTotalExpensesAmt
CY Total Expenses$110,558,711CYTotalExpensesAmt
PY Revenues Less Expenses$10,900,445PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$4,853,001CYRevenuesLessExpensesAmt
Total Assets BOY$83,482,844TotalAssetsBOYAmt
Total Assets EOY$76,959,143TotalAssetsEOYAmt
Total Liabilities BOY$70,526,953TotalLiabilitiesBOYAmt
Total Liabilities EOY$64,420,833TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$12,955,891NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$12,538,310NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWELLSPAN SURGERY AND REHABILITATION HOSPITAL'S MISSION IS "SUPPORTING THE JOURNEY TO OPTIMAL HEALTH AND INDEPENDENCE BY PROVIDING EXCEPTIONAL ORTHOPEDIC, SPINE AND ACUTE REHABILITATIVE CARE IN A HEALING ENVIRONMENT AND COORDINATED THROUGH A COMPREHENSIVE SYSTEM OF CARE." SERVICES ARE PROVIDED TO PATIENTS WITHOUT REGARD FOR AN INDIVIDUAL'S ABILITY TO PAY.WELLSPAN SURGERY AND REHABILITATION HOSPITAL ALSO PROVIDES HOME HEALTH, AND OTHER HEALTH CARE AND PERSONAL CARE TO RESIDENTS OF YORK COUNTY, PENNSYLVANIA AND THE SURROUNDING REGION THROUGH ITS SUBSIDIARIES, VNA HOME HEALTH SERVICES AND VNA COMMUNITY SERVICES. EACH SUPPORTED ORGANIZATION QUALIFIES FOR EXEMPTION FROM INCOME TAX UNDER SECTION 501(C)(3) PURSUANT TO SECTION 509(A)(1)OR 509(A)(2) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$86,079,361ExpenseAmt
Grant$100,000GrantAmt
Revenue$114,023,427RevenueAmt
DescWELLSPAN SURGERY AND REHABILITATION HOSPITAL (WSRH), A 73-BED HOSPITAL, LOCATED ON THE APPLE HILL HEALTH CAMPUS, OPENED ON APRIL 23, 2012. WSRH PROVIDES A SPECIALIZED TREATMENT ENVIRONMENT FOR PATIENTS REQUIRING ADVANCED ORTHOPEDIC, SPINE, AND NEUROSURGICAL SURGERIES, ACUTE INPATIENT REHABILITATION, AND SPECIALIZED OUTPATIENT REHABILITATION SERVICES. OUR MODERN, PATIENT-CENTERED FACILITY OFFERED ADVANCED ORTHOPEDIC, SPINE AND NEUROSURGICAL TREATMENT, AND INPATIENT REHABILITATION FOR THOSE WHO NEEDED EXTRA ATTENTION BEFORE RETURNING TO THEIR HOMES AND RESUMING THEIR LIVES. SEE WELLSPAN HEALTH - 2022 COMMUNITY BENEFIT REPORT LOCATED AT HTTPS://WWW.WELLSPAN.ORG/ABOUT/WELLSPAN-IN-THE-COMMUNITY/2022-COMMUNITY-BENEFIT-REPORT/Desc
Total Program Service Expenses$86,079,361TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee533EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DAVID RIZZUTOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7178513055PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13350 WHITEFORD ROADAddressLine1Txt
CityYORKCityNm
State AbbreviationPAStateAbbreviationCd
ZIP174029081ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
SUZANNE MCCONKEY
DIRECTOR1.000.00Yes (X)$0$0$0
VICTORIA DIAMOND
SR VP1.0040.00Yes (X)$0$761,262$67,466Yes (X)
PAMELA GUNTER-SMITH
DIRECTOR1.000.00Yes (X)$0$0$0
JEFF LOBACH ESQ
DIRECTOR1.000.00Yes (X)$0$0$0
LEE MADDOX MD
DIRECTOR1.0040.00Yes (X)$0$591,433$67,450
LAURA BUCZKOWSKI
EXECUTIVE VP & CFO - WELLSPAN HEALTH1.0040.00Yes (X)$0$840,750$68,808Yes (X)
ROXANNA GAPSTUR
PRESIDENT & CEO - WELLSPAN HEALTH1.0040.00Yes (X)$0$2,170,321$83,138Yes (X)
MIKE SEIM
SR VP & CHIEF QUALITY OFFICER1.0040.00Yes (X)$0$928,980$68,596Yes (X)
KRISTA DARR
DIRECTOR1.000.00Yes (X)$0$0$0
CHERYL THOMPSON RN
DIRECTOR1.000.00Yes (X)$0$0$0
SANDIE WALKER
DIRECTOR1.000.00Yes (X)$0$0$0
CAROL SMITH
VP & PRESIDENT - WSRH40.000.00Yes (X)$287,308$0$55,801Yes (X)
NEIL SLENKER ESQ
DIRECTOR1.000.00Yes (X)$0$0$0
FARAAZ YOUSUF
EXECUTIVE VP & COO - WELLSPAN HEALTH1.0040.00Yes (X)$0$0$0Yes (X)
ELIZABETH DELLINGER
DIRECTOR1.000.00Yes (X)$0$0$0
BENJAMIN MCGLAUGHLIN
DIRECTOR1.000.00Yes (X)$0$0$0
NATASHA ROMERO
DIRECTOR1.000.00Yes (X)$0$0$0
ROSA HICKEY
SR DIRECTOR - PATIENT CARE SERVICES/CNO40.000.00$206,133$0$54,082Yes (X)
ELIZABETH TRUMBLE
DIRECTOR - INPATIENT REHABILITATION40.000.00$169,285$0$46,381Yes (X)
DARCI WOLF
DIRECTOR - CLINICAL SERVICES40.000.00$159,275$0$51,108Yes (X)
GLYNNIS LOWE
DIRECTOR - CLINICAL SERVICES40.000.00$152,978$0$49,310Yes (X)
MARY KILE
SR DIR - PROJECT OPERATIONS40.000.00$163,683$0$47,419Yes (X)
JANET HOWELLS
MANAGER - REHABILITATION SERVICES40.000.00$147,896$0$34,681Yes (X)
AUDREY SCOTT
DIRECTOR - CLINICAL SERVICES40.000.00$146,726$0$50,723Yes (X)
MICHAEL O'CONNOR
FORMER DIRECTOR0.000.00$0$833,772$27,389Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,433,284TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$6,126,518TotReportableCompRltdOrgAmt
Total Other Compensation$772,352TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K51IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
HEALTHTRUST WORKFORCE SOLUTIONS
6565 N MACARTHUR BLVD STE 325IRVINGTX750392475STAFFING SERVICES$1,278,800
ANESTHESIA ASSOCIATES OF YORK
110 PINE GROVE COMMONSYORKPA17405ANESTHESIA SERVICES$688,262
HCSC LAUNDRY
PO BOX 25092LEHIGH VALLEYPA180025092LAUNDRY SERVICES$203,077
J-MAR LANDSCAPING INC
2057 SEAKS RUN ROADGLEN ROCKPA17327LAWN CARE$144,350
DAVITA INC
2000 16TH STREETDENVERCO80202DIALYSIS SERVICES$125,012
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Related Organizations$69,496RelatedOrganizationsAmt
Government Grants$588,473GovernmentGrantsAmt
Total Contributions$657,969TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICESDesc
Business621500BusinessCd
Total Revenue Column$114,028,666TotalRevenueColumnAmt
Related Or Exempt Func Income$114,023,427RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$5,239UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$114,028,666TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,099TotalRevenueColumnAmt
Exclusion$9,099ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$38,572TotalRevenueColumnAmt
Exclusion$38,572ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
CAFETERIAN SALES722210$470,802$470,802
SHIPPING AND RECEIVING488510$174,488$174,488
GIFT SHOP SALES453220$23,884$23,884

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,232TotalRevenueColumnAmt
Unrelated Business Revenue$15UnrelatedBusinessRevenueAmt
Exclusion$8,217ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$677,406OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$115,411,712TotalRevenueColumnAmt
Related Or Exempt Func Income$114,023,427RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$5,254UnrelatedBusinessRevenueAmt
Exclusion$725,062ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$100,000TotalAmt
Program Services$100,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$818,990TotalAmt
Management And General$818,990ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$26,953,638TotalAmt
Program Services$25,965,863ProgramServicesAmt
Management And General$987,775ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,515,752TotalAmt
Program Services$1,459,009ProgramServicesAmt
Management And General$56,743ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,057,386TotalAmt
Program Services$6,748,677ProgramServicesAmt
Management And General$308,709ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,071,577TotalAmt
Program Services$1,947,769ProgramServicesAmt
Management And General$123,808ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$19,538,878TotalAmt
Management And General$19,538,878ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$21,822TotalAmt
Management And General$21,822ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$657TotalAmt
Management And General$657ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$19,253,944TotalAmt
Program Services$17,880,004ProgramServicesAmt
Management And General$1,373,940ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$7,852TotalAmt
Program Services$5,399ProgramServicesAmt
Management And General$2,453ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$168,872TotalAmt
Program Services$134,854ProgramServicesAmt
Management And General$34,018ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$156,968TotalAmt
Program Services$112,316ProgramServicesAmt
Management And General$44,652ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,156,145TotalAmt
Program Services$435,862ProgramServicesAmt
Management And General$720,283ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$6,262TotalAmt
Program Services$4,794ProgramServicesAmt
Management And General$1,468ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$19,067TotalAmt
Program Services$9,339ProgramServicesAmt
Management And General$9,728ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$790,590TotalAmt
Program Services$790,590ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,722,294TotalAmt
Program Services$3,700,801ProgramServicesAmt
Management And General$21,493ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$734,439TotalAmt
Program Services$734,439ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$20,480,418$20,480,418
BAD DEBT$3,133,613$3,133,613
TAXES & LICENSES$1,540,594$1,497,522$43,072
REPAIRS & MAINTENANCE$1,280,218$920,980$359,238

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$28,735TotalAmt
Program Services$17,112ProgramServicesAmt
Management And General$11,623ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$110,558,711TotalAmt
Program Services$86,079,361ProgramServicesAmt
Management And General$24,479,350ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,480BOYAmt
EOY$1,730EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,175,186BOYAmt
EOY$7,883,159EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$15,065,484BOYAmt
EOY$18,610,815EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$18,383,935BOYAmt
EOY$9,438,756EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,459,235BOYAmt
EOY$1,459,205EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,196,904BOYAmt
EOY$1,169,128EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$78,831,368LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$40,435,018LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$40,956,359BOYAmt
EOY$38,396,350EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$244,261BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$83,482,844BOYAmt
EOY$76,959,143EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,891,307BOYAmt
EOY$6,026,612EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY-$419,665BOYAmt
EOY-$148,862EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$59,710,272BOYAmt
EOY$44,910,561EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,345,039BOYAmt
EOY$13,632,522EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$70,526,953BOYAmt
EOY$64,420,833EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,920,104BOYAmt
EOY$12,438,254EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$35,787BOYAmt
EOY$100,056EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$12,955,891BOYAmt
EOY$12,538,310EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$83,482,844BOYAmt
EOY$76,959,143EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$4,853,001ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$5,270,582OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$657OtherActivitiesAmt
Total Lobbying Expenditures$657TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationA PORTION OF THE DUES PAID TO THE HOSPITAL ASSOCIATION OF PENNSYLVANIA INCLUDE LOBBYING ($657).ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$35,787BeginningYearBalanceAmt
Contributions$66,111ContributionsAmt
Other Expenditures$1,842OtherExpendituresAmt
End Year Balance$100,056EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$25,753BeginningYearBalanceAmt
Contributions$21,794ContributionsAmt
Other Expenditures$11,760OtherExpendituresAmt
End Year Balance$35,787EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,063BeginningYearBalanceAmt
Contributions$9,690ContributionsAmt
End Year Balance$25,753EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Contributions$16,063ContributionsAmt
End Year Balance$16,063EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$142,575BeginningYearBalanceAmt
Contributions-$142,575ContributionsAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$54,695,768OtherCostOrOtherBasisAmt
Depreciation$21,373,546DepreciationAmt
Book Value$33,322,222BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,048,225OtherCostOrOtherBasisAmt
Depreciation$920,339DepreciationAmt
Book Value$1,127,886BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,910,309OtherCostOrOtherBasisAmt
Depreciation$18,141,133DepreciationAmt
Book Value$3,769,176BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$177,066OtherCostOrOtherBasisAmt
Book Value$177,066BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$38,396,350TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
LEASE PAYABLE$481
TAXABLE BOND LIABILITIES$13,632,041
FieldValueIRS element (for citing)
Total Liability$13,632,522TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$110,843,248TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$4,504,195OtherRevenueAmt
Revenue Not Reported-$4,504,195RevenueNotReportedAmt
Revenue Subtotal$115,347,443RevenueSubtotalAmt
Other Revenues Not Included$64,269OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$64,269RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$115,411,712TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$107,325,098TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$107,325,098ExpensesSubtotalAmt
Other Expenses Not Included$3,233,613OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$3,233,613ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$110,558,711TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE FUNDS WERE USED TO IMPROVE THE HEALTH AND WELFARE OF THE RESIDENTS OF YORK AND ADAMS COUNTIES OF PENNSYLVANIA.
PART X, LINE 2:IN JUNE 2006, THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES-AN INTERPRETATION OF FASB STATEMENT NO. 109, ACCOUNTING FOR INCOME TAXES (FIN 48), WHICH CREATES A SINGLE MODEL TO ADDRESS UNCERTAINTY IN TAX POSITIONS AND CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING THE MINIMUM RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. UNDER THE REQUIREMENTS OF FIN 48, TAX-EXEMPT ORGANIZATIONS COULD NOW BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN OR VARIOUS TAX EXPOSURE ITEMS. PRIOR TO FIN 48, THE DETERMINATION OF WHEN TO RECORD A LIABILITY FOR TAX EXPOSURE WAS BASED ON WHETHER A LIABILITY WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE IN ACCORDANCE WITH SFAS NO.5, ACCOUNTING FOR CONTINGENCIES. ON JULY 1, 2007, THE PARENT COMPANY, WELLSPAN HEALTH, ADOPTED FIN 48. WELLSPAN HEALTH DETERMINED THAT IT DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THROUGH JUNE 30, 2022.
PART XI, LINE 2D - OTHER ADJUSTMENTS:GRANTS -100,000. CHANGE IN FV DERIVATIVE -1,109,415. LOSS ON DEBT REFINANCING -161,167. BAD DEBT -3,133,613.
PART XI, LINE 4B - OTHER ADJUSTMENTS:NET ASSET ACTIVITY 64,269.
PART XII, LINE 4B - OTHER ADJUSTMENTS:GRANTS 100,000. BAD DEBT 3,133,613.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$203,161TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$203,161NetCommunityBenefitExpnsAmt
Total Expense0.00190TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served1201PersonsServedCnt
Total Community Benefit Expns$15,391,090TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,760,862DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,630,228NetCommunityBenefitExpnsAmt
Total Expense0.09900TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served1201PersonsServedCnt
Total Community Benefit Expns$15,594,251TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,760,862DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,833,389NetCommunityBenefitExpnsAmt
Total Expense0.10090TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs8ActivitiesOrProgramsCnt
Persons Served628PersonsServedCnt
Total Community Benefit Expns$11,233TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,233NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs8ActivitiesOrProgramsCnt
Persons Served628PersonsServedCnt
Total Community Benefit Expns$11,233TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$11,233NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs9ActivitiesOrProgramsCnt
Persons Served1829PersonsServedCnt
Total Community Benefit Expns$15,605,484TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,760,862DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,844,622NetCommunityBenefitExpnsAmt
Total Expense0.10100TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$100,000TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$100,000NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served59PersonsServedCnt
Total Community Benefit Expns$122,379TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$122,379NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served59PersonsServedCnt
Total Community Benefit Expns$222,379TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$222,379NetCommunityBenefitExpnsAmt
Total Expense0.00200TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$1,361,592BadDebtExpenseAmt
Bad Debt Expense Attributable$21,513BadDebtExpenseAttributableAmt
Reimbursed By Medicare$34,088,085ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$38,470,511CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$4,382,426MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WELLSPAN SURGERY & REHABILITATION HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line155 MONUMENT ROADAddressLine1Txt
CityYORKCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17403ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.WELLSPAN.ORGWebsiteAddressTxt
State License22750101StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
OtherORTHO/NEURO/PLASTIC SURGERY / REHABOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1WELLSPAN SURGERY & REHABILITATION HOSPITBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.WELLSPAN.ORGOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLVARIOUS COALITION WEBSITES - PART VI, LINE 5 EXPLANATIONOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.WELLSPAN.ORGStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care350.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.WELLSPAN.ORGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.WELLSPAN.ORGFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.WELLSPAN.ORGFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care Policy0NondisEmergencyCarePolicyInd
No Emergency CareYes (X)NoEmergencyCareInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
WELLSPAN SURGERY & REHABILITATION HOSPITALPART V, SECTION B, LINE 5: COMMUNITY STAKEHOLDER ENGAGEMENT HAS BEEN VITAL TO THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS SINCE IT BEGAN IN YORK COUNTY IN 1994. COUNTY HEALTH COALITIONS ACROSS THE REGION, INCLUDING HEALTHY ADAMS COUNTY, HEALTHY FRANKLIN COUNTY, HEALTHY YORK, HEALTHY COMMUNITY NETWORK, NORTHERN LANCASTER COUNTY HUB, AND THE COMMUNITY HEALTH COUNCIL OF LEBANON COUNTY HAVE BEEN INSTRUMENTAL IN THE COMPLETION OF WELLSPAN'S COMMUNITY HEALTH NEEDS ASSESSMENT. THE COALITION LEADERS HAVE BEEN ACTIVELY ENGAGED THROUGHOUT THE PROCESS AND HAVE PROVIDED EXPERTISE AND GUIDANCE WHILE ALSO ENSURING THEIR LEADERSHIP AND COMMUNITY PARTNERS ARE HEARD AND ENGAGED IN THE NEEDS ASSESSMENT PROCESS. ADDITIONALLY, A DIVERSE GROUP OF STAKEHOLDERS INCLUDING COMMUNITY NOT-FOR-PROFIT AGENCIES, ELECTED OFFICIALS, FEDERALLY QUALIFIED HEALTH CENTERS, AND PUBLIC HEALTH EXPERTS, WERE ACTIVELY ENGAGED IN THE PROCESS.
WELLSPAN SURGERY & REHABILITATION HOSPITALPART V, SECTION B, LINE 6A: WELLSPAN'S COMMUNITY HEALTH NEEDS ASSESSMENT IS PREPARED BY THE PARENT ORGANIZATION, WELLSPAN HEALTH, AND INCLUDES COLLECTIVE EFFORTS OF ALL ENTITIES UNDER THE PARENT ORGANIZATION. HOSPITALS:1. YORK HOSPITAL2. GETTYSBURG HOSPITAL3. CHAMBERSBURG HOSPITAL4. WAYNESBORO HOSPITAL5. EPHRATA COMMUNITY HOSPITAL6. THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA7. WELLSPAN SURGERY & REHABILITATION HOSPITAL8. PHILHAVENFOUNDATIONS:1. YORK HEALTH FOUNDATION2. SUMMIT HEALTH FOUNDATION3. GETTYSBURG HOSPITAL FOUNDATION4. EPHRATA COMMUNITY HEALTH FOUNDATION5. GOOD SAMARITAN HEALTH SERVICES FOUNDATIONMEDICAL SERVICES:1. APPLE HILL SURGICAL CENTER, INC.2. CHAMBERSBURG HEALTH SERVICES3. SUMMIT PHYSICIAN SERVICES4. VNA HOME HEALTH SERVICES5. WELLSPAN HEALTH CARE SERVICES6. WELLSPAN MEDICAL GROUP7. WELLSPAN SUMMIT HEALTH8. GOOD SAMARITAN PHYSICIAN SERVICES9. HEALTHY COMMUNITY PHARMACY10. VNA COMMUNITY SERVICES
WELLSPAN SURGERY & REHABILITATION HOSPITALPART V, SECTION B, LINE 6B: COUNTY HEALTH COALITIONS ACROSS THE REGION, INCLUDING HEALTHY ADAMS COUNTY, HEALTHY FRANKLIN COUNTY, HEALTHY YORK, THE NORTHERN LANCASTER COUNTY HUB, AND THE COMMUNITY HEALTH COUNCIL OF LEBANON COUNTY HAVE BEEN INSTRUMENTAL IN THE COMPLETION OF WELLSPAN'S COMMUNITY HEALTH NEEDS ASSESSMENT. THE COALITION LEADERS HAVE BEEN ACTIVELY ENGAGED THROUGHOUT THE PROCESS AND HAVE PROVIDED EXPERTISE AND GUIDANCE WHILE ALSO ENSURING THEIR LEADERSHIP AND COMMUNITY PARTNERS ARE HEARD AND ENGAGED IN THE NEEDS ASSESSMENT PROCESS. FEDERALLY QUALIFIED HEALTH CENTERS ACROSS WELLSPAN'S REGION WERE ALSO CONTRIBUTING PARTNERS, INCLUDING FAMILY FIRST HEALTH, KEYSTONE HEALTH, AND UNION COMMUNITY CARE.
WELLSPAN SURGERY & REHABILITATION HOSPITALPART V, SECTION B, LINE 7D: WITH EACH ITERATION OF THE CHNA PROCESS, WELLSPAN AND ITS COMMUNITY PARTNERS CONTINUE TO REFINE AND ENHANCE THE SYSTEM BY WHICH IT OBTAINS DATA, SHARED IT WITH KEY COMMUNITY, HOSPITAL ENTITIES, AND SYSTEM LEADERS, AND INTEGRATED IT INTO THE SYSTEM-WIDE AND ENTITY-LEVEL PLANNING PROCESSES. THE CHNA RESULTS AND RELATED PRIORITIES IDENTIFIED WERE SHARED WITH WELLSPAN HEALTH'S REGIONAL BOARDS OF DIRECTORS AND THE SYSTEM-WIDE LEADERSHIP TEAMS. THIS STAKEHOLDER GROUP IS COMPRISED OF COMMUNITY MEMBERS AND LEADERS THAT REPRESENT EACH OF WELLSPAN'S PRIMARY ENTITIES AND SERVICE AREAS, IN ADDITION TO EXECUTIVE LEADERSHIP. COLLECTIVE INPUT WAS USED TO ESTABLISH SYSTEM-WIDE PRIORITIES. THE ESTABLISHED COMMUNITY-DRIVEN COUNTY HEALTH COALITIONS AND WELLSPAN SPECIFIC PRIORITIES AND ASSOCIATED DATA WERE PRESENTED TO THE WELLSPAN HEALTH BOARD FOR THEIR ADOPTION. EACH COUNTY HEALTH COALITION HOSTED A PUBLIC FORUM IN SUMMER/ FALL 2022 TO COMMUNICATE THE CHNA RESULTS AND IDENTIFY PRIORITIES TO HUNDREDS OF COMMUNITY MEMBERS ACROSS THE REGION. DURING THE FORUMS, COMMUNITY MEMBERS DISCUSSED THE OPPORTUNITIES AND RISKS ASSOCIATED WITH EACH PRIORITY, AS WELL AS HOW THE ORGANIZATION WHICH THEY REPRESENT CAN HAVE AN IMPACT ON EACH PRIORITY. IN ADDITION TO THESE VENUES, CHNA RESULTS ARE AVAILABLE ON EACH COALITION'S WEBSITE, AS WELL AS WELLSPAN HEALTH'S WEBSITE AND MAY ALSO BE OBTAINED UPON REQUEST. THE CORRESPONDING WELLSPAN COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IS ALSO AVAILABLE ON THE WELLSPAN HEALTH WEBSITE.
WELLSPAN SURGERY & REHABILITATION HOSPITALPART V, SECTION B, LINE 11: WELLSPAN'S THREE-YEAR COMMUNITY HEALTH IMPROVEMENT PLAN PROVIDES A FRAMEWORK FOR THE ORGANIZATION'S PROGRAMS AND ACTIVITIES THAT PROMOTE HEALTH AND WELLNESS IN RESPONSE TO THE NEEDS IDENTIFIED IN THE CHNA REPORTS. THESE AREAS OF FOCUS MEET AT LEAST ONE, AND OFTEN SEVERAL, OF THE COMMUNITY BENEFIT GUIDELINES OF A NONPROFIT HEALTH SYSTEM, AS OUTLINED BY THE CATHOLIC HEALTH ASSOCIATION: IMPROVING ACCESS TO HEALTHCARE SERVICES; ENHANCING THE HEALTH OF THE COMMUNITY; ADVANCING MEDICAL OR HEALTHCARE KNOWLEDGE OR RELIEVING OR REDUCING THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. SPECIFIC PRIORITIES ARE THEN INCORPORATED INTO WELLSPAN'S ANNUAL OPERATING PLAN AND BUDGET.WHILE THIS PLAN INCLUDES AN ARRAY OF GOALS AND OBJECTIVES FOR BROAD PRIORITY AREAS, IT DOES NOT ADDRESS ALL HEALTH-RELATED ISSUES IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. WELLSPAN USES THE FOLLOWING CRITERIA TO DETERMINE WHEN NOT TO ADDRESS AN IDENTIFIED NEED IN OUR FORMAL COMMUNITY HEALTH IMPROVEMENT PLAN:1. EFFORTS SPECIFIC TO AN ISSUE ARE ALREADY UNDERWAY AND WILL CONTINUE, THEREFORE A CALL-OUT IN THE COMMUNITY HEALTH IMPROVEMENT PLAN IS UNNECESSARY.2. ISSUE APPEARS TO BE EMERGING AND WARRANTS MONITORING, BUT NOT AFFECTING THE COMMUNITY IN A MANNER THAT REQUIRES IMMEDIATE ACTION.3. A COMMUNITY-WIDE OR PARTNER SPECIFIC APPROACH WOULD BE MORE EFFECTIVE IN ADDRESSING THE NEED.SEE THE WELLSPAN HEALTH COMMUNITY HEALTH IMPROVEMENT PLAN AVAILABLE ONLINE AT: HTTPS://WWW.WELLSPAN.ORG/ABOUT/WELLSPAN-IN-THE-COMMUNITY/.
WELLSPAN SURGERY & REHABILITATION HOSPITALPART V, SECTION B, LINE 13H: WELLSPAN HEALTH IS COMMITTED TO CARING FOR ALL THE MEMBERS OF ITS COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY. IN RECENT YEARS, OVERALL CHARITY CARE HAS DECREASED SLIGHTLY AS MORE PEOPLE HAVE OBTAINED HEALTH INSURANCE COVERAGE THROUGH THE AFFORDABLE CARE ACT AND THE EXPANSION OF PENNSYLVANIA'S MEDICAL ASSISTANCE (MEDICAID) PROGRAM. WELLSPAN IS PROUD TO BE A LEADING PARTNER IN THE HEALTHY COMMUNITY NETWORK, WHICH WORKS TO ADDRESS THE NEEDS OF UNINSURED AND UNDERINSURED INDIVIDUALS IN OUR COMMUNITY. IN ADDITION, THE HEALTH SYSTEM RECENTLY ENHANCED ITS FINANCIAL ASSISTANCE POLICY AND THE DISCOUNTS THAT IT PROVIDES ON SERVICES. FOR MORE INFORMATION ON WELLSPAN'S FINANCIAL ASSISTANCE PROGRAM, VISIT HTTPS://WWW.WELLSPAN.ORG/PATIENTS-VISITORS/PATIENT-GUIDE/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/.
WELLSPAN SURGERY & REHABILITATION HOSPITALPART V, SECTION B, LINE 16J: IN AN EFFORT TO MAKE PATIENTS, FAMILIES AND OTHERS IN OUR COMMUNITIES AWARE OF THE NEWLY EXPANDED FINANCIAL ASSISTANCE POLICY (FAP), WELLSPAN BROADLY PUBLICIZED ITS POLICY VIA PROMOTIONAL SIGNAGE AND THE DISTRIBUTION OF EASY-TO-READ INFORMATIONAL MATERIALS AT REGISTRATION SITES THROUGHOUT OUR COMMUNITIES. WELLSPAN PROVIDED INFORMATION ON THE FAP ON ITS BILLING STATEMENTS AND INCLUDED INFORMATION IN PATIENT DISCHARGE MATERIALS. IN ADDITION, THE MATERIALS AND INFORMATION ARE EASILY ACCESSIBLE VIA WELLSPAN'S WEBSITE AT WWW.WELLSPAN.ORG. THE SITE REFLECTS WELLSPAN'S NEWLY ENHANCED POLICY, AS WELL AS INFORMATIONAL AND APPLICATION MATERIALS. IT WAS ALSO PUBLICIZED VIA WELLSPAN'S ON-HOLD PHONE MESSAGING SYSTEM AND IN ITS DIRECT-TO-CONSUMER COMMUNITY NEWSLETTER/MAGAZINE, WHICH IS DISTRIBUTED BY MAIL, EMAIL AND ON-LINE. IN ADDITION, WELLSPAN PLACED POSTERS AND SIGNAGE AT ITS VARIOUS SITES OF CARE TO PUBLICIZE THE FAP. PRINTED COPIES OF WELLSPAN HEALTH'S POLICY AND THE PLAIN LANGUAGE SUMMARY OF THE POLICY, BOTH OF WHICH ARE AVAILABLE IN ENGLISH AND SPANISH, MAY BE OBTAINED AT NO COST BY VISITING OR CALLING ONE OF THE WELLSPAN PATIENT FINANCIAL SERVICES OFFICES.THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION, AND THE FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ARE ALL AVAILABLE IN ENGLISH AND SPANISH.

Supplemental Information Detail SupplementalInformationDetail (14 entries)

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PART I, LINE 3C:PATIENTS/GUARANTORS WHO COMPLETE AN APPLICATION FOR FINANCIAL ASSISTANCE, WHOSE GROSS INCOME FALLS BETWEEN 351-400% OF THE FEDERAL POVERTY LEVEL (FPL), AND MEET ALL OTHER FINANCIAL ASSISTANCE QUALIFICATIONS, WILL BE ELIGIBLE FOR A 40% DISCOUNT ON SELF-PAY BALANCES. PATIENTS WHO HAVE GROSS INCOME IN EXCESS OF 400% OF FPL DO NOT QUALIFY FOR FINANCIAL ASSISTANCE.
PART I, LINE 6A:COMMUNITY BENEFIT INFORMATION IS INCLUDED IN THE COMMUNITY BENEFIT REPORT FOR WELLSPAN HEALTH LOCATED AT WWW.WELLSPAN.ORG.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,133,613.
PART III, LINE 2:THE NUMBER WAS CALCULATED USING THE COST TO CHARGE RATIO FACTOR APPLIED AGAINST ACTUAL PATIENT BAD DEBT WRITE-OFFS. THESE NUMBERS ARE INCLUDED AFTER ALL EFFORTS HAVE BEEN EXHAUSTED TO DETERMINE IF THE PATIENT MEETS OUR CHARITY CARE WRITE-OFF POLICY BASED ON FEDERAL POVERTY LEVELS.
PART III, LINE 3:THE ESTIMATE OF BAD DEBT ATTRIBUTABLE TO CHARITY CARE POLICY WAS CALCULATED BY DIVIDING THE BAD DEBT AMOUNT THAT WAS ORIGINALLY CODED BAD DEBT BUT LATER FOUND TO QUALIFY AS CHARITY CARE BY THE AMOUNT CODED TO THE CHARITY CARE WRITE-OFF CODES. THIS RATIO IS APPLIED TO THE BAD DEBT COST FACTOR EXPENSE.
PART III, LINE 4:WELLSPAN SURGERY & REHABILITATION HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR ESTIMATED LOSSES RESULTING FROM THE UNWILLINGNESS OR INABILITY OF PATIENTS TO MAKE PAYMENTS FOR SERVICES. THE ALLOWANCE IS DETERMINED BY ANALYZING SPECIFIC AMOUNTS AND HISTORICAL DATA AND TRENDS. PATIENT ACCOUNTS RECEIVABLE ARE CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHEN MANAGEMENT DETERMINES THAT RECOVERY IS UNLIKELY AND THE COMPANY CEASES COLLECTION EFFORTS. LOSSES HAVE BEEN CONSISTENT WITH MANAGEMENT'S EXPECTATIONS IN ALL MATERIAL RESPECTS.
PART III, LINE 8:WELLSPAN SURGERY AND REHABILITATION HOSPITAL (WSRH) MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE AND COMMUNITY SERVICE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE BASED ON ESTABLISHED RATES FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE AND COMMUNITY SERVICE POLICIES AND THE ESTIMATED COST OF THESE SERVICES. PAYMENTS FROM MEDICARE ARE GENERALLY LESS THAN WSRH'S COSTS OF PROVIDING THE SERVICE.
PART III, LINE 9B:GUIDELINES FOR SUGGESTED MINIMUM NUMBER OF PHONE ATTEMPTS AND LETTERS TO BE SENT BEFORE THE ACCOUNT IS TURNED OVER TO AN OUTSIDE COLLECTION AGENCY ARE INCLUDED IN THE PATIENT ADMINISTRATIVE SERVICES POLICY. UPON FINAL PARO (PAYMENT ASSISTANCE RANK ORDERING) SCORING, IF A PATIENT QUALIFIES FOR PRESUMPTIVE CHARITY, THEIR ACCOUNT WOULD NOT BE FORWARDED TO ANY THIRD PARTY COLLECTIONS. IT SHALL BE THE POLICY OF PATIENT ADMINISTRATIVE SERVICES TO RECOMMEND ACCOUNTS TO BAD DEBT ON A TIMELY BASIS. INPATIENT/OUTPATIENT ACCOUNTS WILL GO TO BAD DEBT AUTOMATICALLY AFTER THE ACCOUNT HAS BEEN IN THE FINANCIAL CLASS PENDING BAD DEBT FOR 30 DAYS. ALL ACCOUNTS MUST FOLLOW THE APPROVED LIMITS FOR REFUNDS AND WRITE OFFS, AS ESTABLISHED IN POLICY PF-102, BEFORE BEING TRANSFERRED. THE PRIMARY AGENCIES WILL WORK THE ACCOUNTS FOR 6 MONTHS OR UNTIL THEY FEEL IT IS UNCOLLECTABLE AND RETURN THE ACCOUNT. THE ACCOUNTS ARE FORWARDED TO SECONDARY AGENCIES FROM THE PRIMARY AGENCIES CLOSED AND RETURN REPORTS. THE FINANCIAL CLASS IS CHANGED TO BAD DEBT OTHER AFTER THE CLOSED AND RETURN REPORTS ARE RECEIVED FROM THE SECONDARY AGENCY. THE AGENCIES MUST GET WRITTEN APPROVAL FROM THE MANAGER IN THE RELATIVELY RARE INSTANCE OF LEGAL ACTION BEING TAKEN TO COLLECT THE DEBT.
PART VI, LINE 2:THE 2022 WELLSPAN COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES A REPRESENTATIVE ANALYSIS OF PERTINENT COMMUNITY HEALTH ISSUES IN THE SOUTH CENTRAL PENNSYLVANIA. THE ASSESSMENT INCLUDES THE ENTIRETY OF FRANKLIN, ADAMS, YORK AND LEBANON COUNTIES AS WELL AS SPECIFIC GEOGRAPHIC AREAS WITHIN LANCASTER COUNTY. THIS GEOGRAPHIC FOCUS ENCOMPASSES THE WELLSPAN SERVICE AREA AND THE PATIENTS, COVERED LIVES, AND COMMUNITIES WITHIN THE FIVE-COUNTY REACH OF OUR ORGANIZATION. A LOCAL EMPHASIS PERMITS WELLSPAN'S SEVEN ACUTE CARE HOSPITALS AND ONE BEHAVIORAL HEALTH HOSPITAL TO ACT ON UNIQUE COUNTY ATTRIBUTES WHILE MAINTAINING A REGIONAL PERSPECTIVE OF COMMUNITY HEALTH ISSUES CHALLENGING OUR PATIENTS, NEIGHBORS AND COMMUNITIES. WELLSPAN'S 2022 COMMUNITY HEALTH NEEDS ASSESSMENT LEVERAGED DATA FROM MULTIPLE DATA SOURCES, INCLUDING: 1. WELLSPAN HEALTH PATIENT DATA. 2. WELLSPAN HEALTH'S PROVIDER SURVEY. 3. LOCAL, STATE AND NATIONAL DATA SOURCES. 4. REPRESENTATIVE AND SPECIAL POPULATIONS COMMUNITY SURVEY. 5. SPECIAL POPULATIONS DATA COLLECTION. IN ADDITION TO OUR ROUTINE DATA COLLECTION METHODS, WHICH PROVIDE A COMMUNITY-WIDE PERSPECTIVE OF STRENGTHS AND CHALLENGES, A PLAIN COMMUNITY SURVEY, FOCUS GROUPS AND KEY INFORMANT INTERVIEWS, AND OFF-CYCLE EXPLORATORY DATA COLLECTION HAVE PERMITTED AN OPPORTUNITY TO LEARN ABOUT GROUPS WITHIN OUR COMMUNITY WHO HAVE BEEN MARGINALIZED AND UNDERREPRESENTED IN SIMILAR ASSESSMENTS. MANY COMMUNITY MEMBERS ARE DISPROPORTIONATELY AT RISK OF POOR HEALTH OUTCOMES BECAUSE OF HEALTH INEQUITIES. OUR COMMUNITY HEALTH NEEDS ASSESSMENT STRATEGY ALIGNS WITH WELLSPAN'S ORGANIZATIONAL APPROACHES TO ADDRESS DIVERSITY AND INCLUSION AND HEALTH EQUITY. FOR EXAMPLE, EACH INDICATOR WAS CONSIDERED WITH A GEOGRAPHIC, AGE, RACE, LANGUAGE, GENDER AND INCOME/ POVERTY LENS TO IDENTIFY DISPARITIES AMONG SEGMENTS OF OUR COMMUNITY. THE COMMUNITY HEALTH NEEDS ASSESSMENT ALSO GATHERED DATA ABOUT SUBGROUPS WITHIN OUR COMMUNITY WHO HAVE TRADITIONALLY BEEN UNDERSERVED THROUGH HEALTHCARE INCLUDING (BUT NOT LIMITED TO) HISPANIC/LATINO, BLACK/AFRICAN AMERICAN, PLAIN COMMUNITY, INDIVIDUALS LIVING IN POVERTY, SENIORS, AND CHILDREN. THE DATA COLLECTION METHODS OF THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) BUILT ON FOUNDATIONAL WORK FROM PREVIOUS WELLSPAN COMMUNITY HEALTH NEEDS ASSESSMENT PROCESSES AND WERE EXPANDED TO BE MORE INCLUSIVE AND INNOVATIVE. DATA COLLECTION WAS FACILITATED BY THE CENTER FOR OPINION RESEARCH AT FRANKLIN AND MARSHALL COLLEGE, LED BY BERWOOD YOST, DIRECTOR OF THE CENTER AND PROJECT CONSULTANT FOR THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. A DIVERSE GROUP OF STAKEHOLDERS THROUGHOUT THE REGION WERE ACTIVELY ENGAGED IN THE NEEDS ASSESSMENT PROCESS, INCLUDING LOCAL HEALTH COALITIONS, COMMUNITY NOT-FOR-PROFIT AGENCIES, ELECTED OFFICIALS, FEDERALLY QUALIFIED HEALTH CENTERS, PUBLIC HEALTH EXPERTS, ETC. BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT RESULTS, WELLSPAN'S THREE-YEAR STRATEGIES AND PRIORITIES WITHIN ITS COMMUNITY HEALTH IMPROVEMENT PLAN WILL INCLUDE: - CARE FOR ALL: ENSURE ACCESS AND QUALITY OF CARE FOR PATIENTS BY IDENTIFYING AND REDUCING DISPARITIES AND BARRIERS TO CARE. - MENTAL WELL-BEING: SUPPORT PERSONAL WELL-BEING AND WHOLE PERSON HEALTH BY MAKING IT EASIER FOR PEOPLE TO RECOGNIZE AND GET SUPPORT FOR MENTAL HEALTH AND ADDICTION ISSUES. - SOCIAL DETERMINANTS OF HEALTH: DEVELOP AND IMPLEMENT NEW APPROACHES FOR COLLABORATING WITH COMMUNITY-BASED ORGANIZATIONS TO IMPACT THE MOST PRESSING SOCIAL DETERMINANTS OF HEALTH (SDOH) IMPACTING OUR PATIENTS AND THE COMMUNITY. - HEALTHY COMMUNITIES: CREATE HEALTHY, SAFE COMMUNITIES AND ENSURE OUR YOUNGEST COMMUNITY MEMBERS AND NEXT GENERATION CAN THRIVE AND GROW. WELLSPAN HAS EVOLVED ITS COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS OVER TIME AND REMAINS COMMITTED TO ENSURING DATA INTEGRITY AND A SOUND SCIENTIFIC APPROACH. NEVERTHELESS, THERE ARE LIMITATIONS TO OUR PROCESS. WE HAVE MINIMIZED THE RISK OF INCOMPLETE OR INACCURATE DATA WHENEVER POSSIBLE BUT REMAIN COGNIZANT OF THE FOLLOWING LIMITATIONS: 1. LAGGING DATA: UTILIZING SECONDARY DATA SOURCES MEANS EMBRACING THE LIMITATIONS OF THOSE SOURCES. 2. INTERNAL PATIENT DATA: UTILIZING WELLSPAN PATIENT DATA MAY HAVE AN INHERENT BIAS OF NOT INCLUDING THOSE WHO CANNOT AFFORD CARE AND ARE THEREFORE NOT CAPTURED IN OUR RECORDS. 3. SURVEY SAMPLE SIZES: FOR A VARIETY OF REASONS, WE ARE NOT ABLE TO SURVEY EVERY MEMBER OF OUR COMMUNITY. OUR HEALTH SYSTEM AND COMMUNITY EXPERIENCED GREAT HARDSHIPS OVER THE PAST COUPLE YEARS DUE TO THE PANDEMIC. THE ENORMITY OF THE COVID-19 IMPACT WARRANTS A REALISTIC APPROACH TO ADDRESSING COMMUNITY NEEDS IN AN OUTCOMES-FOCUSED MANNER. THIS IS AN UNPRECEDENTED TIME, AND OUR COMMUNITIES HAVE NOT YET RECOVERED FROM THE INTENSITY OF THE PANDEMIC'S INFLUENCES. THE WELLSPAN BOARD OF DIRECTORS APPROVED THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IS MADE AVAILABLE TO THE PUBLIC ON OUR WEBSITE AT: HTTPS://WWW.WELLSPAN.ORG/ABOUT/WELLSPAN-IN-THE-COMMUNITY/. IN ADDITION TO THE PLACEMENT OF THE CHNA ON THE WEBSITE, THERE WERE COMMUNITY LEVEL FORUMS IN THE COUNTY OF EACH WELLSPAN FACILITY WHICH PUBLICLY RELEASED THE DATA, SUMMARIZED THE FINDINGS, AND ARTICULATED WELLSPAN'S INTENTION TO ADDRESS THE IDENTIFIED NEEDS.
PART VI, LINE 3:IN ACCORDANCE WITH THE WELLSPAN HEALTH FINANCIAL ASSISTANCE POLICY (FAP), PATIENTS/RESPONSIBLE PARTIES WILL BE NOTIFIED OF THE AVAILABLE OPTIONS FOR FINANCIAL ASSISTANCE PER IRS REGULATION 501(R). METHODS OF NOTIFICATION INCLUDE, BUT ARE NOT LIMITED TO: 1. POSTING OF LEGIBLE SIGNAGE2. DEVELOPMENT OF A PLAIN LANGUAGE SUMMARY3. DISTRIBUTING INFORMATIONAL BROCHURES AT HOSPITAL AND OFFICE REGISTRATION AREAS4. DISTRIBUTING INFORMATIONAL BROCHURES THROUGHOUT ITS COMMUNITIES5. A COPY OF THE FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY OFFERED DURING THE REGISTRATION/DISCHARGE PROCESS6. CONSPICUOUS NOTICE REGARDING THE FINANCIAL ASSISTANCE POLICY PRINTED ON ALL ACCOUNT STATEMENTS7. COPY OF THE FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY PROVIDED WITH LAST BILLING STATEMENT THE WELLSPAN FAP CAN BE FOUND ONLINE AT:HTTPS://WWW.WELLSPAN.ORG/MEDIA/2783971/118-WSH-FINANCIAL-ASSISTANCE-POLICY-71322.PDF
PART VI, LINE 4:EVERY THREE YEARS, WE PARTNER WITH LIKE-MINDED COMMUNITY PARTNERS AND LOCAL COALITIONS TO CONDUCT COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) FOR WHICH WE SURVEY COMMUNITY MEMBERS ABOUT THEIR HEALTH, LIFESTYLE BEHAVIORS, FINANCES, ACCESS TO HEALTH SERVICES AND OTHER RELATED TOPICS. WE USE THESE CHNA REPORTS TO IDENTIFY SPECIFIC COMMUNITY NEEDS AND DEVELOP STRATEGIES TO ADDRESS THEM.THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES INSIGHT ON THE HEALTH OF OUR COMMUNITIES, FROM BIRTH THROUGH ADVANCED AGE, ACROSS THE WELLSPAN HEALTH FIVE COUNTY REGION, INCLUDING ADAMS, FRANKLIN, LEBANON, YORK, AS WELL AS GEOGRAPHIC REGIONS WITHIN LANCASTER COUNTY.DIFFERENCES AMONG OUR GEOGRAPHIC COMMUNITIES OFTEN DO NOT DEMONSTRATE AS SIGNIFICANT A DIFFERENCE AS OBSERVED IN ATTRIBUTES SUCH AS RACE/ETHNICITY, GENDER, AGE, INCOME AND THE EXPERIENCE OF DEPRESSION, TRAUMA, OR DISCRIMINATION. IN SOME CIRCUMSTANCES HOWEVER, UNIQUE ATTRIBUTES IDENTIFIED FROM OUR COMMUNITY HEALTH NEEDS ASSESSMENT DATA SPECIFIC TO EACH COUNTY POINT TO OBVIOUS AREAS FOR IMPROVEMENT. THIS INFORMATION IS IMPORTANT AS WELLSPAN ANTICIPATES THE IMPLEMENTATION OF THE 2023-2025 COMMUNITY HEALTH IMPROVEMENT PLAN.A COUNTY-BY-COUNTY DEMOGRAPHIC ASSESSMENT IS CONTAINED WITHIN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT, AVAILABLE ON OUR WEBSITE AT:HTTPS://WWW.WELLSPAN.ORG/ABOUT/WELLSPAN-IN-THE-COMMUNITY/
PART VI, LINE 5:AS A CHARITABLE, COMMUNITY-BASED HEALTHCARE ORGANIZATION, OUR COMMITMENT TO IMPROVING THE LIVES AND WELL-BEING OF ALL PEOPLE AND COMMUNITIES WE SERVE IS EVIDENT IN OUR MISSION STATEMENT: "WORKING AS ONE TO IMPROVE HEALTH THROUGH EXCEPTIONAL CARE FOR ALL, LIFELONG WELLNESS, AND HEALTHIER COMMUNITIES." EMPLOYEES LIVE OUT THIS MISSION STATEMENT EVERY DAY BY ENGAGING IN COMMUNITY BENEFIT ACTIVITIES THAT ADDRESS COMMUNITY NEEDS, ESPECIALLY THE HEALTH PRIORITIES IDENTIFIED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. MANY OF WELLSPAN'S EFFORTS TO ADVANCE COMMUNITY HEALTH PRIORITIES ARE OUTLINED IN OUR COMMUNITY BENEFIT REPORT, PUBLISHED ONLINE AT HTTPS://WWW.WELLSPAN.ORG/ABOUT/WELLSPAN-IN-THE-COMMUNITY/. BELOW ARE SOME EXAMPLES OF OUR EFFORTS ACROSS WELLSPAN'S FIVE-COUNTY SERVICE AREA IN THE LAST YEAR: - THE MOBILE MAMMOGRAPHY COACH, OUR STATE-OF-THE-ART BREAST IMAGING SERVICE MADE POSSIBLE THROUGH OUR COLLABORATIVE PARTNERSHIP WITH CAPITAL BLUE CROSS, CRISSCROSSED OUR SERVICE AREA PROVIDING PRIVATE AND DISCREET ONSITE SCREENINGS AT 70 COMMUNITY EVENTS AT NO COST FOR ALL UNINSURED PATIENTS. OF THE 595 PATIENTS SCREENED, SIX INDIVIDUALS WERE DIAGNOSED WITH CANCER THAT MIGHT OTHERWISE HAVE ESCAPED DETECTION. ADDITIONALLY, OUR MOBILE MAMMOGRAPHY PROGRAM HAS SUCCESSFULLY BUILT PARTNERSHIPS WITH SEVERAL COMMUNITY-BASED ORGANIZATIONS THAT HAVE SIGNIFICANTLY CONTRIBUTED TO OUR ABILITY TO REACH OUR DIVERSE AND UNDERSERVED PATIENTS.- WELLSPAN, IN PARTNERSHIP WITH ORGANIZATIONS INCLUDING THE NATIONAL ASSOCIATION FOR THE ADVANCEMENT OF COLORED PEOPLE (NAACP) YORK CHAPTER, CREATED THE OPPORTUNITY TO LEARN ABOUT THESE BARRIERS DIRECTLY FROM THE MEMBERS OF OUR COMMUNITY BY HOSTING A SERIES OF LISTENING SESSIONS ON COLORECTAL AND BREAST CANCER SCREENINGS. THESE INFORMATIVE AND ENGAGING SESSIONS ALLOWED WELLSPAN AND OUR PARTNERS TO HEAR ABOUT REAL CHALLENGES, BETTER IDENTIFY BARRIERS AND FIND MORE EFFECTIVE WAYS TO REACH OUT TO ALL.WELLSPAN IS AN HONORED COMMUNITY PARTNER WITH THE FOLLOWING HEALTH COALITIONS:- HEALTHY ADAMS COUNTY - WWW.HEALTHYADAMSCOUNTY.ORG- HEALTHY FRANKLIN COUNTY - WWW.HEALTHYFRANKLINCOUNTY.ORG- HEALTHY YORK COALITION - WWW.HEALTHYYORK.ORG- HEALTHY COMMUNITY NETWORK - WWW.HEALTHYCOMMUNITYNETWORK.ORG- NORTHERN LANCASTER COUNTY HUB - WWW.NORTHERNLANCASTERHUB.ORG- COMMUNITY HEALTH COUNCIL OF LEBANON COUNTY - WWW.COMMUNITYHEALTHCOUNCIL.COMTHESE COALITIONS PLAY AN IMPORTANT ROLE IN WELLSPAN'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. THIS YEAR, WELLSPAN COLLABORATED WITH OUR COALITIONS AND OTHER PARTNERS TO COMPLETE THE 2022 CHNA. THIS DATA WAS USED TO DESIGN WELLSPAN'S 2023-2025 COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP).THROUGH OUR COLLABORATION WITH THE COALITIONS AND OTHERS, WE IDENTIFIED CORE THEMES AND AREAS FOR IMPROVEMENT INCLUDING HEALTH EQUITY, SOCIAL DETERMINANTS OF HEALTH AND LIFELONG WELLNESS. EACH COUNTY COALITION HOSTED ITS OWN PUBLIC HEALTH FORUM EVENT, TO REVIEW THE IDENTIFIED NEEDS AND STRATEGIC PRIORITY AREAS FOR THE COMING YEARS AND ENGAGE NEW PARTNERS AND VOLUNTEERS TO HELP ADVANCE THE HEALTHCARE AGENDA FOR OUR COMMUNITIES.- WELLSPAN CONDUCTED MORE THAN 350,000 SCREENINGS TO IDENTIFY MORE THAN 21,000 PATIENTS WITH FOOD INSECURITY. WITHIN THE PAST THREE YEARS, WE INVESTED NEARLY $575,000 TO SUPPORT OUR COMMUNITY PARTNERS IN ADDRESSING HUNGER FOR OUR PATIENTS AND OTHERS WHO NEED HELP. - OUR VITAL LOCAL PARTNERSHIPS WITH FEDERALLY QUALIFIED HEALTH CENTERS CREATE A STRONG SAFETY NET OF HEALTH CARE SERVICES TO HELP MEET THE HEALTH NEEDS OF SO MANY OF OUR UNDERSERVED POPULATIONS. TOGETHER, WE PROVIDED MORE THAN 330,000 MEDICAL AND DENTAL VISITS ACROSS ADAMS, FRANKLIN, LANCASTER, LEBANON, AND YORK COUNTIES.- AS THE LEAD PARTNER IN?HEALTHY COMMUNITY NETWORK,?WELLSPAN HELPS TO PROVIDE THOUSANDS OF UNINSURED AND UNDERINSURED COMMUNITY MEMBERS WITH ACCESS TO CARE. OVER THE PAST YEAR, THE NETWORK ASSISTED 2,517 MEMBERS IN NEED OF CARE ACROSS THE REGION.- THROUGH THE PRESCRIPTION FOR CARING PROGRAM, HEALTHY COMMUNITY NETWORK PROVIDED FINANCIAL ASSISTANCE FOR NEARLY 16,562 PRESCRIPTIONS, SO THAT INDIVIDUALS LACKING SUFFICIENT HEALTH INSURANCE OR FINANCIAL MEANS COULD ACCESS THE MEDICATIONS THEY NEED.- PARTICIPATION BY 75,000 NEIGHBORS IN WELLSPAN HEALTH EDUCATION PROGRAMS IN THE LAST THREE YEARS, WITH MORE THAN 16,000 ENGAGED IN FISCAL YEAR 2022. THIS INCLUDED THE EXPANSION OF THE GET OUTDOORS (GO) PROGRAM TO ALL OF LANCASTER COUNTY AND ADDITION OF CUMBERLAND COUNTY, REACHING THOUSANDS OF FAMILIES IN SIX COUNTIES. PILOTED THE PROGRAM TO ADULTS IN CUMBERLAND AND YORK COUNTIES. - EXPANDED SUPPORT FOR THOSE WITH SUBSTANCE USE DISORDER, AND INTRODUCTION OF OPIOID PAIN MANAGEMENT OPTIONS. EFFORTS INCLUDED EXPANSION OF THE CCBH MODEL TO SUPPORT INCARCERATED INDIVIDUALS AS THEY RETURN TO OUR COMMUNITY; ESTABLISHING WARM LINE CALL CENTER FOR INDIVIDUALS SEEKING ADDICTION RESOURCES AND TREATMENT; AND BUILDING FOUNDATIONS PREGNANCY SUPPORT PROGRAM, WITH 97% ABSTINENCE RATE FOR MORE THAN SIX MONTHS.- THROUGH THE WELLSPAN COMMUNITY HEALTH FUND AND SUMMIT ENDOWMENT, WELLSPAN PARTNERED WITH 57 NONPROFIT COMMUNITY ORGANIZATIONS?AND PROVIDED $1.4 MILLION IN COMMUNITY GRANTS TO DRIVE ACHIEVEMENT OF OUR COMMUNITY HEALTH IMPROVEMENT PLAN BY INCREASING ACCESS TO CARE AND CREATING INNOVATIVE APPROACHES TO IMPACT SOCIAL DETERMINANTS OF HEALTH.
PART VI, LINE 6:WELLSPAN HEALTH IS AN INTEGRATED HEALTH SYSTEM SERVING THE COMMUNITIES OF SOUTHCENTRAL PENNSYLVANIA AND NORTHERN MARYLAND. AS A COMMUNITY-BASED, NOT-FOR-PROFIT ORGANIZATION, WELLSPAN IS DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF THE PEOPLE IT SERVES. WELLSPAN WILL ASSUME A LEADERSHIP ROLE AND DEVELOP PARTNERSHIPS WITH OTHER ORGANIZATIONS TO IMPROVE ACCESS TO COORDINATED, HIGH-QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES, EDUCATE THE HEALTH CARE PROVIDERS OF TOMORROW, PROMOTE HEALTHY LIFESTYLES AND LIFELONG WELLNESS, AND MAKE ITS LOCAL COMMUNITIES HEALTHIER, MORE DESIRABLE PLACES TO LIVE, WORK, AND PLAY. EACH OF OUR HOSPITALS WORK WITH OTHER PARTS OF THE SYSTEM TO PROVIDE A COMPREHENSIVE APPROACH TO MEETING COMMUNITY NEEDS.WELLSPAN HEALTH INCLUDES: HOSPITALS:1. YORK HOSPITAL2. GETTYSBURG HOSPITAL3. CHAMBERSBURG HOSPITAL4. WAYNESBORO HOSPITAL5. EPHRATA COMMUNITY HOSPITAL6. THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA7. WELLSPAN SURGERY & REHABILITATION HOSPITAL8. PHILHAVENFOUNDATIONS:1. YORK HEALTH FOUNDATION2. SUMMIT HEALTH FOUNDATION3. GETTYSBURG HOSPITAL FOUNDATION4. EPHRATA COMMUNITY HEALTH FOUNDATION5. GOOD SAMARITAN HEALTH SERVICES FOUNDATIONMEDICAL SERVICES:1. APPLE HILL SURGICAL CENTER, INC.2. CHAMBERSBURG HEALTH SERVICES3. SUMMIT PHYSICIAN SERVICES4. VNA HOME HEALTH SERVICES5. WELLSPAN HEALTH CARE SERVICES6. WELLSPAN MEDICAL GROUP7. WELLSPAN SUMMIT HEALTH8. GOOD SAMARITAN PHYSICIAN SERVICES9. HEALTHY COMMUNITY PHARMACY10. VNA COMMUNITY SERVICESWELLSPAN'S COMMUNITY BENEFIT REPORT IS PREPARED BY THE PARENT ORGANIZATION, WELLSPAN HEALTH, AND INCLUDES COLLECTIVE EFFORTS OF ALL ENTITIES UNDER THE PARENT ORGANIZATION. SEE WELLSPAN HEALTH'S CURRENT COMMUNITY BENEFIT REPORT, COMMUNITY HEALTH NEEDS ASSESSMENT, AND COMMUNITY HEALTH IMPROVEMENT PLAN AT HTTPS://WWW.WELLSPAN.ORG/ABOUT/WELLSPAN-IN-THE-COMMUNITY/.
PART VI, LINE 7, REPORTS FILED WITH STATESPA

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1DALLASTOWN AREA SCHOOL DISTRICTBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1700 NEW SCHOOL LANEAddressLine1Txt
CityDALLASTOWNCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17313ZIPCd
FieldValueIRS element (for citing)
Recipient EIN231671700RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$100,000CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Purpose Of GrantCOMMUNITY SUPPORTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationALL WELLSPAN ENTITIES FOLLOW WELLSPAN POLICIES AND PROCEDURES REGARDING GRANT PROJECTS (MAP 107) TO ENSURE THAT THE USE OF GRANT FUNDS ARE CONSISTENT WITH WELLSPAN'S MISSION OF WORKING AS ONE TO IMPROVE HEALTH THROUGH EXCEPTIONAL CARE FOR ALL, LIFELONG WELLNESS AND HEALTHY COMMUNITIES. COMMUNITY SUPPORT IS PROVIDED IN THE FORM OF GRANTS, WHICH SERVE HEALTH-RELATED PURPOSES AND ARE IN ALIGNMENT WITH THE WELLSPAN MISSION. ALL GRANTS ARE MADE TO ELIGIBLE 501(C)(3) ORGANIZATIONS AND INCLUDE CHURCHES, PUBLIC SCHOOLS, PUBLIC CHARITIES, PUBLIC CLINICS AND HOSPITALS, LEGAL AID SOCIETIES, VOLUNTEER SERVICES ORGANIZATIONS, AND SOME GOVERNMENTAL AGENCIES. WE MAINTAIN ADEQUATE RECORDS TO SUBSTANTIATE AMOUNTS, ELIGIBILITY, AND SELECTION CRITERIA USED FOR ALL GRANTS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROXANNA GAPSTUR
PRESIDENT & CEO - WELLSPAN HEALTH$0$1,345,021$0$825,300$0$0$0$12,765$0$70,373$0$2,253,459$0$0
MIKE SEIM
SR VP & CHIEF QUALITY OFFICER$0$640,895$0$288,000$0$85$0$14,254$0$54,342$0$997,576$0$0
LAURA BUCZKOWSKI
EXECUTIVE VP & CFO - WELLSPAN HEALTH$0$653,090$0$187,650$0$10$0$15,722$0$53,086$0$909,558$0$0
MICHAEL O'CONNOR
FORMER DIRECTOR$0$94,517$0$400,546$0$338,709$0$3,492$0$23,897$0$861,161$0$256,622
VICTORIA DIAMOND
SR VP$0$515,660$0$235,613$0$9,989$0$15,473$0$51,993$0$828,728$0$0
LEE MADDOX MD
DIRECTOR$0$523,405$0$44,811$0$23,217$0$18,418$0$49,032$0$658,883$0$0
CAROL SMITH
VP & PRESIDENT - WSRH$212,110$0$58,245$0$16,953$0$13,150$0$42,651$0$343,109$0$0$0
ROSA HICKEY
SR DIRECTOR - PATIENT CARE SERVICES/$189,401$0$16,715$0$17$0$13,291$0$40,791$0$260,215$0$0$0
ELIZABETH TRUMBLE
DIRECTOR - INPATIENT REHABILITATION$150,940$0$15,196$0$3,149$0$9,557$0$36,824$0$215,666$0$0$0
MARY KILE
SR DIR - PROJECT OPERATIONS$146,827$0$13,662$0$3,194$0$11,627$0$35,792$0$211,102$0$0$0
DARCI WOLF
DIRECTOR - CLINICAL SERVICES$138,876$0$14,120$0$6,279$0$9,131$0$41,977$0$210,383$0$0$0
GLYNNIS LOWE
DIRECTOR - CLINICAL SERVICES$135,641$0$11,108$0$6,229$0$14,120$0$35,190$0$202,288$0$0$0
AUDREY SCOTT
DIRECTOR - CLINICAL SERVICES$124,675$0$11,752$0$10,299$0$14,410$0$36,313$0$197,449$0$0$0
JANET HOWELLS
MANAGER - REHABILITATION SERVICES$128,144$0$14,553$0$5,199$0$19,500$0$15,181$0$182,577$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4BFormAndLineReferenceDesc
ExplanationTHE 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 2021, 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. 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).ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA
A23298223384129NHL62014-11-10$15,899,939REFUND BONDS & EXPANSION000
GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA
B2329822332018-03-13$5,859,336REFUND 2008A BONDS000
GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA
C2329822332018-09-04$4,924,416REFUND 2008A BONDS000
GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA
D2773341602019-04-03$1,441,833REFUND BONDS & EXPANSION000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$2,971,178$12,666,637$15,938,511$592,014$592,014$38,572$140,504$6,840,817$8,326,6042016Yes (1)Yes (1)Yes (1)Yes (1)
B$2,707,992$5,859,336$17,398$5,841,93820180Yes (1)Yes (1)Yes (1)
C$369,600$4,924,416$14,285$4,910,13120180Yes (1)Yes (1)Yes (1)
D$78,907$1,441,833$2,327$9,631$1,336,669$93,2062019Yes (1)Yes (1)Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00000.000000.000000.0000000Yes (1)
B00000.000000.000000.0000000Yes (1)
C00000.000000.000000.0000000Yes (1)
D00000.000000.000000.0000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A0Yes (1)000000Yes (1)
B00Yes (1)0Yes (1)000Yes (1)
C00Yes (1)0Yes (1)000Yes (1)
D0Yes (1)00Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)
DYes (1)

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE K, PART I, COLUMN (E) - ISSUE PRICEWELLSPAN HEALTH, THE PARENT ORGANIZATION, ALLOCATED PORTIONS OF THE PROCEEDS OF THIS TAX-EXEMPT BOND ISSUE TO MEMBERS OF THE OBLIGATED GROUP. THE AMOUNT ON SCHEDULE K, PART I, COLUMN (E) AND PART II, LINE 3 REPRESENTS THE ENTITY'S ALLOCATED PORTION OF THE TOTAL BOND PROCEEDS, AS SHOWN ON FORM 8038, PART III, LINE 21(B). ALL ITEMS IN PART II HAVE ALSO BEEN ALLOCATED.
SCHEDULE K, PART II, LINE 3THE TOTAL PROCEEDS ARE NOT IDENTICAL TO PART I, COLUMN (E) BECAUSE OF INVESTMENT EARNINGS.
SCHEDULE K, PART III, LINE 4 & 5 - PRIVATE BUSINESS USETHE ENTITY, IN CONJUNCTION WITH BOND COUNSEL, MONITORS ACTIVITIES THAT MAY RESULT IN PRIVATE BUSINESS USE. THERE WERE NONE FOUND.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIABusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN232982233BondIssuerEIN
CUSIP84129NMG1CUSIPNum
Bond Issued2019-04-03BondIssuedDt
Issue Price$35,731,920IssuePriceAmt
PurposeREFUND BONDS ISSUED 11/12/2008PurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$35,731,920TotalProceedsAmt
Issuance Costs From Proceeds$166,320IssuanceCostsFromProceedsAmt
Other Spent Proceeds$35,565,600OtherSpentProceedsAmt
Substantial Completion2019SubstantialCompletionYr
Refunding Tax Exempt BondsYes (1)RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6WELLSPAN HEALTH, A NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7ATHE 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 7BTHE 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 11BMANAGEMENT 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 12COFFICERS, 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 15BTHE 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 18AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GOUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 5,648,643. MANAGEMENT AND GENERAL EXPENSES 1,373,940. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,022,583. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 370,269. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 370,269. SPECIALIST CONTRACT: PROGRAM SERVICE EXPENSES 8,682,628. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,682,628. TEMPORARY PROFESSIONAL STAFF: PROGRAM SERVICE EXPENSES 3,178,464. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,178,464.
FORM 990, PART XI, LINE 9:CHANGE IN FV DERIVATIVE -1,109,415. LOSS ON DEBT REFINANCING -161,167. TRANSFER TO WELLSPAN HEALTH -4,000,000.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (25 entries)

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APPLE HILL SURGICAL CENTER INC
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CHAMBERSBURG HEALTH SERVICES
PO BOX 2767YORKPA174052767251515376HEALTH CARE SERVICESPA501(C)(3)12 TYPE IWELLSPAN SUMMIT HEALTH0
CHAMBERSBURG HOSPITAL
PO BOX 2767YORKPA174052767230465970HEALTH CARE SERVICESPA501(C)(3)LINE_3_HOSPITAL_COOPWELLSPAN SUMMIT HEALTH0
CHAMBERSBURG HOSPITAL WORKERS COMPENSATION TRUST
PO BOX 2767YORKPA174052767256450683WORKERS COMPENSATION BENEFITS FOR WORKERSPA501(C)(4)CHAMBERSBURG HOSPITAL0
EPHRATA COMMUNITY HEALTH FOUNDATION
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GETTYSBURG HOSPITAL
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GOOD SAMARITAN HEALTH SERVICES FOUNDATION OF LEBANON PA
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GOOD SAMARITAN PHYSICIAN SERVICES
PO BOX 2767YORKPA174052767251832359MEDICAL AND SURGICAL CAREPA501(C)(3)LINE_10_ORGANIZATIONGOOD SAM HEALTH SERVICES FOUNDATION0
HEALTHY COMMUNITY PHARMACY INC
PO BOX 2767YORKPA174052767200519121REDUCED RATE PRESCRIPTION DRUGS TO UNINSUREDPA501(C)(3)12 TYPE IWELLSPAN HEALTH CARE SERVICES0
PHILHAVEN
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THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA
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VNA COMMUNITY SERVICES
PO BOX 2767YORKPA174052767232338591HOME PERSONAL CARE SERVICES FOR ELDERLY AND DISABLEDPA501(C)(3)LINE_10_ORGANIZATIONWELLSPAN SURGERY & REHABILITATION HOSPITAL0
VNA HOME HEALTH SERVICES
PO BOX 2767YORKPA174052767231352573HOME HEALTH AND HOSPICE CARE SERVICESPA501(C)(3)LINE_10_ORGANIZATIONWELLSPAN SURGERY & REHABILITATION HOSPITAL0
WAYNESBORO HOSPITAL
PO BOX 2767YORKPA174052767231360854HEALTH CARE SERVICESPA501(C)(3)LINE_3_HOSPITAL_COOPWELLSPAN SUMMIT HEALTH0
WELLSPAN HEALTH
PO BOX 2767YORKPA174052767222517863INTEGRATED HEALTH SYSTEMPA501(C)(3)12 TYPE III0N/A
WELLSPAN HEALTH CARE SERVICES
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WELLSPAN MEDICAL GROUP
PO BOX 2767YORKPA174052767232730785MEDICAL AND SURGICAL CAREPA501(C)(3)LINE_10_ORGANIZATIONWELLSPAN HEALTH0
WELLSPAN PROPERTIES
PO BOX 2767YORKPA174052767222842252LEASES FACILITIES TO AFFILIATESPA501(C)(3)12 TYPE IIWELLSPAN HEALTH CARE SERVICES0
WELLSPAN SUMMIT HEALTH
PO BOX 2767YORKPA174052767251515371INTEGRATED HEALTH SYSTEMPA501(C)(3)LINE_7_ORGANIZATION_WELLSPAN HEALTH0
YORK HEALTH FOUNDATION
PO BOX 2767YORKPA174052767233050192FUNDRAISING FOR WELLSPAN ENTITIESPA501(C)(3)12 TYPE IIIWELLSPAN HEALTH0
YORK HOSPITAL
PO BOX 2767YORKPA174052767231352222COMMUNITY TEACHING HOSPITALPA501(C)(3)LINE_3_HOSPITAL_COOPWELLSPAN HEALTH0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)

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APPLE HILL SURGICAL CENTER PARTNERS
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CHERRY TREE CANCER CENTER LLP
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THE REHAB CENTER
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Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)

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APPLE HILL CONDOMINIUM ASSOCIATION
PO BOX 2767YORKPA174052767232504543CONDOMINIUM ASSOCIATIONPAWELLSPAN HEALTH CARE SERVICESC0
EPHRATA HEALTH PAVILION CONDOMINIUM ASSOCIATION
PO BOX 2767YORKPA174052767475367279CONDOMINIUM ASSOCIATIONPAEPHRATA HOSPITALC0
GOOD SAMARITAN PHYSICIAN HOSPITAL ORGANIZATION OF LEBANON PA
PO BOX 2767YORKPA174052767251769419HEALTH CARE SERVICESPATHE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIAC0
GSH REALTY INC
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QUEST BEHAVIORAL HEALTH
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WELLSPAN HEARING CENTER INC
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WELLSPAN PHARMACY INC
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WELLSPAN PROVIDER NETWORK
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WELLSPAN RECIPROCAL RISK RETENTION GROUP
PO BOX 2767YORKPA174052767200048457RISK RETENTION GROUPPAWELLSPAN HEALTHC0
YORK HEALTH PLAN
PO BOX 2767YORKPA174052767232664989PREFERRED PROVIDER ORGANIZATIONPAWELLSPAN HEALTHC0
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