THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA (EIN 23-0794160)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-12
- IRS object ID
- 202321329349305707
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-12T13:23:53-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 134008324 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRICEWATERHOUSECOOPERS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 655 NEW YORK AVENUE NW - SUITE 1100 | AddressLine1Txt |
| City | WASHINGTON | CityNm |
| State Abbreviation | DC | StateAbbreviationCd |
| ZIP | 20001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 230794160 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE GOOD SAMARITAN HOSPITAL OF LEBANON | BusinessNameLine1Txt |
| Business Name Line2 | PENNSYLVANIA | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GOOD | BusinessNameControlTxt |
| Phone | 7178513055 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2767 | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 174052767 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LAURA BUCZKOWSKI | PersonNm |
| Person Title | EXECUTIVE VP & CFO | PersonTitleTxt |
| Phone | 7178513055 | PhoneNum |
| Signature | 2023-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | LAURA | PersonFirstNm |
| Person Last | BUCZKOWSKI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TRAVIS L PATTON | PreparerPersonNm |
| PTIN | P00369623 | PTIN |
| Phone | 2024141000 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROXANNA GAPSTUR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2767 | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 174052767 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $294,015,658 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WELLSPAN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1891 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | THE GOOD SAMARITAN HOSPITAL IS A TAX-EXEMPT ORGANIZATION DEDICATED TO PROVIDING HIGH-QUALITY, COMPASSIONATE HEALTHCARE THAT IMPROVES THE OVERALL HEALTH OF THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 1292 | TotalEmployeeCnt |
| Total Volunteers | 488 | TotalVolunteersCnt |
| Total Gross UBI | $1,578,885 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $442,057 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $8,961,735 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,764,658 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $236,390,562 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $285,272,554 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,759,732 | PYInvestmentIncomeAmt |
| CY Investment Income | $341,986 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,389,239 | PYOtherRevenueAmt |
| CY Other Revenue | $669,026 | CYOtherRevenueAmt |
| PY Total Revenue | $249,501,268 | PYTotalRevenueAmt |
| CY Total Revenue | $290,048,224 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $7,361,500 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $438,777 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $86,594,686 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $94,587,320 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $156,449,994 | PYOtherExpensesAmt |
| CY Other Expenses | $196,723,727 | CYOtherExpensesAmt |
| PY Total Expenses | $250,406,180 | PYTotalExpensesAmt |
| CY Total Expenses | $291,749,824 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$904,912 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,701,600 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $117,612,049 | TotalAssetsBOYAmt |
| Total Assets EOY | $117,483,758 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $201,252,331 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $209,330,699 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$83,640,282 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$91,846,941 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE GOOD SAMARITAN HOSPITAL IS A TAX-EXEMPT ORGANIZATION DEDICATED TO PROVIDING HIGH-QUALITY, COMPASSIONATE HEALTHCARE THAT IMPROVES THE OVERALL HEALTH OF THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $229,988,336 | ExpenseAmt |
| Grant | $438,777 | GrantAmt |
| Revenue | $283,693,669 | RevenueAmt |
| Desc | THE GOOD SAMARITAN HOSPITAL OF LEBAONON PENNSYLVANIA HAS BEEN PROVIDING POWERFUL MEDICINE AND COMFORTING CARE TO THE RESIDENTS OF LEBANON COUNTY FOR MORE THAN 125 YEARS.AS THE COMMUNITY HOSPITAL OF THE LEBANON VALLEY REGION, THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA OFFERS A WIDE VARIETY OF ACUTE CARE AND OUTPATIENT SERVICES THAT HELP IMPROVE THE HEALTH OF OUR COMMUNITY. THE SECHLER FAMILY CANCER CENTER IS LEBANON COUNTY'S FIRST AND ONLY INTEGRATED CANCER CENTER PROVIDING MEDICAL AND RADIATION ONCOLOGY IN A STATE OF THE ART FACILITY WITH A WARM AND HEALING ENVIRONMENT.THE STATE-OF-THE-ART CARDIAC & VASCULAR CENTER HAS WON NATIONAL AWARDS FROM THE AMERICAN HEART ASSOCIATION. THE CENTER HAS ALSO BEEN DESIGNATED AS A BLUE DISTINCTION CENTER FOR CARDIAC CARE BY HIGHMARK BLUE SHIELD. DIAGNOSTIC AND INTERVENTIONAL CARDIOLOGY IS OFFERED, AS WELL AS ELECTROPHYSIOLOGY AND OPEN HEART SURGERY. THE NEW BEGINNING BIRTH SUITES OFFER A ONE-STOP EXPERIENCE FOR LABOR, DELIVERY AND RECOVERY IN A FAMILY-FRIENDLY SETTING.THE GOOD SAMARITAN CENTER FOR WOUND CARE & HYPERBARIC MEDICINE HAS CREATED NEW HOPE FOR THOSE WITH NON-HEALING WOUNDS. THE HOSPITAL OFFERS A NETWORK OF LABORATORY AND IMAGING CENTERS THROUGHOUT LEBANON COUNTY.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 | $229,988,336 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1292 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID P RIZZUTO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7178513055 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3350 WHITEFORD ROAD | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 174029081 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MONIQUA ACOSTA | ||||||||||
| ACTING CHAIR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| REYNA BRITTON RN | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| THOMAS HARLOW | ||||||||||
| PRESIDENT | 40.00 | 0.00 | Yes (X) | $552,288 | $0 | $45,850 | Yes (X) | |||
| ROXANNA GAPSTUR | ||||||||||
| PRESIDENT & CEO - WELLSPAN HEALTH | 1.00 | 40.00 | Yes (X) | $0 | $2,170,321 | $83,138 | Yes (X) | |||
| CARRIE WILSON | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| CHRISTOPHER GRANT PSY D | ||||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $0 | $0 | ||||
| KIMBERLY KREIDER UMBLE | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| STEPHEN LINDSEY | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| MIKE SEIM | ||||||||||
| SR VP & CHIEF QUALITY OFFICER | 1.00 | 40.00 | Yes (X) | $0 | $928,980 | $68,596 | Yes (X) | |||
| ROBERT FUNK | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| ROBERT HOFFMAN | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| EDWARD TADAJWESKI MD | ||||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $699,561 | $69,546 | ||||
| CARRIE WILLETTS | ||||||||||
| SR VP | 1.00 | 40.00 | Yes (X) | $0 | $651,075 | $65,580 | Yes (X) | |||
| LAURA BUCZKOWSKI | ||||||||||
| EXECUTIVE VP & CFO - WELLSPAN HEALTH | 1.00 | 40.00 | Yes (X) | $0 | $840,750 | $68,808 | Yes (X) | |||
| ROGER ZIMMERMAN | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| AMANDA DAVIS-BUIE | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| VINCENT GARCIA | ||||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||||
| FARAAZ YOUSUF | ||||||||||
| EXECUTIVE VP & COO - WELLSPAN HEALTH | 1.00 | 40.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| ROBERT SHAVER | ||||||||||
| VP - MEDICAL AFFAIRS | 40.00 | 0.00 | $439,880 | $0 | $62,560 | Yes (X) | ||||
| PATRICIA DONLEY | ||||||||||
| VP & PRESIDENT - GSH | 40.00 | 0.00 | $268,812 | $0 | $52,935 | Yes (X) | ||||
| KELLY SMITH | ||||||||||
| VP PATIENT CARE SVCS | 40.00 | 0.00 | $161,286 | $0 | $49,180 | Yes (X) | ||||
| VIRGINIA FOLLETT | ||||||||||
| SR DIRECTOR - ANCIL & SUPPORT SVCS | 40.00 | 0.00 | $199,667 | $0 | $47,663 | Yes (X) | ||||
| DEBRA NEY | ||||||||||
| MANAGER-PHARMACY | 40.00 | 0.00 | $207,930 | $0 | $37,776 | Yes (X) | ||||
| BONNIE PIETRUCH | ||||||||||
| DIRECTOR CLINICAL OPER | 40.00 | 0.00 | $162,328 | $0 | $23,449 | Yes (X) | ||||
| STEPHANIE THOMPSON | ||||||||||
| DIRECTOR CLINICAL OPER | 40.00 | 0.00 | $161,710 | $0 | $50,742 | Yes (X) | ||||
| TIMOTHY PANTELICH | ||||||||||
| TEAM LEADER PHYSICAL THERAPY | 40.00 | 0.00 | $161,457 | $0 | $32,030 | Yes (X) | ||||
| JANE HYDE | ||||||||||
| FORMER DIRECTOR | 0.00 | 40.00 | $0 | $1,210,709 | $56,488 | Yes (X) | ||||
| MICHAEL O'CONNOR | ||||||||||
| FORMER DIRECTOR | 0.00 | 40.00 | $0 | $833,772 | $27,389 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,315,358 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,335,168 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $841,730 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 122 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LEBANON ANESTHESIA ASSOCIATES | |||||
| 110 29TH AVENUE | NASHVILLE | TN | 37203 | ANESTHESIA SERVICES | $4,588,458 |
| HEALTHTRUST WORKFORCE SOLUTIONS | |||||
| 6565 N MACARTHUR BLVD STE 325 | IRIVNG | TX | 75039 | STAFFING SERVICE | $2,207,038 |
| QUEST DIAGNOSTICS | |||||
| PO BOX 912512 | PASADENA | CA | 91110 | LAB SERVICES | $2,117,004 |
| EMERGENCY PHYSICIAN ASSOCIATES | |||||
| PO BOX 634850 | CINCINNATI | OH | 45263 | EMERGENCY MEDICINE SERV. | $2,102,640 |
| NUWEST GROUP HOLDINGS LLC | |||||
| 325 118TH AVE SE 300 | BELLEVUE | WA | 98005 | STAFFING SERVICE | $889,946 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 22 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,797,980 | RelatedOrganizationsAmt |
| Government Grants | $1,825,782 | GovernmentGrantsAmt |
| All Other Contributions | $140,896 | AllOtherContributionsAmt |
| Total Contributions | $3,764,658 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT SERVICES | 621500 | $285,263,986 | $283,685,101 | $1,578,885 |
| FUNDRAISING FEES | 621500 | $8,568 | $8,568 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $285,272,554 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,632 | TotalRevenueColumnAmt |
| Exclusion | $17,632 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $969,489 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,222,074 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$252,585 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$252,585 | TotalRevenueColumnAmt |
| Exclusion | -$252,585 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,069,714 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,647,899 | SecuritiesAmt |
| Other | $97,461 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $421,815 | SecuritiesAmt |
| Other | -$97,461 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $324,354 | TotalRevenueColumnAmt |
| Exclusion | $324,354 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA SALES | 722514 | $592,491 | $592,491 |
| FEDERAL INCOME TAX | 900099 | $181,359 | $181,359 |
| OTHER SERVICES | 900099 | $54,205 | $54,205 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $93,556 | TotalRevenueColumnAmt |
| Exclusion | $93,556 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $921,611 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $290,048,224 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $283,693,669 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,578,885 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,011,012 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $438,777 | TotalAmt |
| Program Services | $438,777 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,632,791 | TotalAmt |
| Management And General | $1,632,791 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,088,458 | TotalAmt |
| Program Services | $64,666,520 | ProgramServicesAmt |
| Management And General | $3,421,938 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,016,568 | TotalAmt |
| Program Services | $3,792,921 | ProgramServicesAmt |
| Management And General | $223,647 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,697,680 | TotalAmt |
| Program Services | $14,743,294 | ProgramServicesAmt |
| Management And General | $954,386 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,151,823 | TotalAmt |
| Program Services | $4,792,792 | ProgramServicesAmt |
| Management And General | $359,031 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,175,086 | TotalAmt |
| Management And General | $43,175,086 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,600 | TotalAmt |
| Management And General | $31,600 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,172 | TotalAmt |
| Management And General | $58,172 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,324 | TotalAmt |
| Management And General | $12,324 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,754,492 | TotalAmt |
| Program Services | $56,387,093 | ProgramServicesAmt |
| Management And General | $1,367,399 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,378 | TotalAmt |
| Program Services | $2,792 | ProgramServicesAmt |
| Management And General | $586 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $778,192 | TotalAmt |
| Program Services | $427,130 | ProgramServicesAmt |
| Management And General | $351,062 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $529,740 | TotalAmt |
| Program Services | $446,450 | ProgramServicesAmt |
| Management And General | $83,290 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,022,271 | TotalAmt |
| Program Services | $1,021,898 | ProgramServicesAmt |
| Management And General | $2,000,373 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,928 | TotalAmt |
| Program Services | $47,743 | ProgramServicesAmt |
| Management And General | $1,185 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,275 | TotalAmt |
| Program Services | $46,883 | ProgramServicesAmt |
| Management And General | $1,392 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,473,832 | TotalAmt |
| Program Services | $5,473,832 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,087,456 | TotalAmt |
| Program Services | $7,087,456 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,896,537 | TotalAmt |
| Program Services | $1,896,537 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $47,094,118 | $47,094,118 | |
| BAD DEBT | $18,451,765 | $18,451,765 | |
| REPAIRS & MAINTENANCE | $5,294,331 | $1,276,144 | $4,018,187 |
| TAXES & LICENSES | $4,171,424 | $161,440 | $4,009,984 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,791,806 | TotalAmt |
| Program Services | $1,732,751 | ProgramServicesAmt |
| Management And General | $59,055 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $291,749,824 | TotalAmt |
| Program Services | $229,988,336 | ProgramServicesAmt |
| Management And General | $61,761,488 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,085 | BOYAmt |
| EOY | $4,586 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$66,250 | BOYAmt |
| EOY | $113,109 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,051,815 | BOYAmt |
| EOY | $717,516 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,811,479 | BOYAmt |
| EOY | $27,070,603 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,434,749 | BOYAmt |
| EOY | $4,329,854 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $331,692 | BOYAmt |
| EOY | $377,112 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $178,441,781 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $115,827,630 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,700,370 | BOYAmt |
| EOY | $62,614,151 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,281,387 | BOYAmt |
| EOY | $12,686,581 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,435,095 | BOYAmt |
| EOY | $1,603,666 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $859,108 | BOYAmt |
| EOY | $3,817,462 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,577,519 | BOYAmt |
| EOY | $4,149,118 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,612,049 | BOYAmt |
| EOY | $117,483,758 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,596,813 | BOYAmt |
| EOY | $22,757,179 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,557,294 | BOYAmt |
| EOY | $3,984,317 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,176,542 | BOYAmt |
| EOY | $2,129,396 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $159,934,607 | BOYAmt |
| EOY | $123,532,774 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $987,075 | BOYAmt |
| EOY | $56,927,033 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $201,252,331 | BOYAmt |
| EOY | $209,330,699 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$89,970,935 | BOYAmt |
| EOY | -$99,433,868 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,330,653 | BOYAmt |
| EOY | $7,586,927 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$83,640,282 | BOYAmt |
| EOY | -$91,846,941 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,612,049 | BOYAmt |
| EOY | $117,483,758 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,701,600 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,316,532 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$4,188,527 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $12,324 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $12,324 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | A PORTION OF THE DUES PAID TO THE HOSPITAL ASSOCIATION OF PENNSYLVANIA AND THE AMERICAN HOSPITAL ASSOCIATION INCLUDE LOBBYING ($1,566 AND $10,758). | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,330,653 | BeginningYearBalanceAmt |
| Contributions | $1,863,355 | ContributionsAmt |
| Investment Earnings Or Losses | -$54,983 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $552,098 | OtherExpendituresAmt |
| End Year Balance | $7,586,927 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,183,834 | BeginningYearBalanceAmt |
| Contributions | $1,853,565 | ContributionsAmt |
| Investment Earnings Or Losses | $281,589 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,988,335 | OtherExpendituresAmt |
| End Year Balance | $6,330,653 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,878,431 | BeginningYearBalanceAmt |
| Contributions | $799,233 | ContributionsAmt |
| Investment Earnings Or Losses | $85,487 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $579,317 | OtherExpendituresAmt |
| End Year Balance | $8,183,834 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,004,069 | BeginningYearBalanceAmt |
| Contributions | $3,985,145 | ContributionsAmt |
| Investment Earnings Or Losses | $58,490 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $169,273 | OtherExpendituresAmt |
| End Year Balance | $7,878,431 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,592,136 | BeginningYearBalanceAmt |
| Contributions | $3,545,261 | ContributionsAmt |
| Investment Earnings Or Losses | $227,655 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $7,360,983 | OtherExpendituresAmt |
| End Year Balance | $4,004,069 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.15330 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.84670 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,468,847 | OtherCostOrOtherBasisAmt |
| Book Value | $1,468,847 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $105,121,777 | OtherCostOrOtherBasisAmt |
| Depreciation | $65,681,537 | DepreciationAmt |
| Book Value | $39,440,240 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,458,180 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,442,223 | DepreciationAmt |
| Book Value | $2,015,957 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $59,878,082 | OtherCostOrOtherBasisAmt |
| Depreciation | $43,703,870 | DepreciationAmt |
| Book Value | $16,174,212 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,514,895 | OtherCostOrOtherBasisAmt |
| Book Value | $3,514,895 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $62,614,151 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| INTERCOMPANY PAYABLE | $53,255,197 |
| LEASE PAYABLE | $3,671,836 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $56,927,033 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $272,895,582 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$2,316,532 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$14,762,890 | OtherRevenueAmt |
| Revenue Not Reported | -$17,079,422 | RevenueNotReportedAmt |
| Revenue Subtotal | $289,975,004 | RevenueSubtotalAmt |
| Other Revenues Not Included | $73,220 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $73,220 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $290,048,224 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $273,631,851 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $1,222,074 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $1,222,074 | ExpensesNotReportedAmt |
| Expenses Subtotal | $272,409,777 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $19,340,047 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $19,340,047 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $291,749,824 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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: | CHANGE IN FV DERIVATIVE -53,490. GAIN ON PENSION PLAN 4,630,647. GRANTS -438,777. MANAGEMENT FEES -403,235. BAD DEBT -18,451,765. ANNUITY -46,270. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSES -1,222,074. NET ASSET ACTIVITY 1,295,294. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 1,222,074. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | GRANTS 438,777. MANAGEMENT FEE 403,235. BAD DEBT 18,451,765. ANNUITY 46,270. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,372,611 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,372,611 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 56886 | PersonsServedCnt |
| Total Community Benefit Expns | $46,158,894 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,454,919 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,703,975 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08310 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 56886 | PersonsServedCnt |
| Total Community Benefit Expns | $47,531,505 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,454,919 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $24,076,586 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08810 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 621 | PersonsServedCnt |
| Total Community Benefit Expns | $670,167 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $65,216 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $604,951 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 1050 | PersonsServedCnt |
| Total Community Benefit Expns | $394,374 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $394,374 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 1671 | PersonsServedCnt |
| Total Community Benefit Expns | $1,064,541 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $65,216 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $999,325 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 58557 | PersonsServedCnt |
| Total Community Benefit Expns | $48,596,046 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,520,135 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,075,911 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09170 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $246,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $246,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $98,779 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $86,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,779 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 47 | PersonsServedCnt |
| Total Community Benefit Expns | $213,688 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $213,688 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 47 | PersonsServedCnt |
| Total Community Benefit Expns | $558,467 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $86,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $472,467 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,305,564 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $83,828 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $107,266,187 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $113,476,763 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$6,210,576 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4TH WALNUT STREET | AddressLine1Txt |
| City | LEBANON | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17042 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.WELLSPAN.ORG | WebsiteAddressTxt |
| State License | 072401 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE GOOD SAMARITAN HOSPITAL OF LEBANON P | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 21 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.WELLSPAN.ORG | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | VARIOUS COALITION WEBSITES - PART VI, LINE 5 EXPLANATION | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 21 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.WELLSPAN.ORG | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.WELLSPAN.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.WELLSPAN.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.WELLSPAN.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| THE GOOD SAMARITAN HOSPITAL OF LEBANON PA | PART 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. |
| THE GOOD SAMARITAN HOSPITAL OF LEBANON PA | PART 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 |
| THE GOOD SAMARITAN HOSPITAL OF LEBANON PA | PART 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. |
| THE GOOD SAMARITAN HOSPITAL OF LEBANON PA | PART 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. |
| THE GOOD SAMARITAN HOSPITAL OF LEBANON PA | PART 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/. |
| THE GOOD SAMARITAN HOSPITAL OF LEBANON PA | PART 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/. |
| THE GOOD SAMARITAN HOSPITAL OF LEBANON PA | PART 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. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 14 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - WELLSPAN SECHLER FAMILY CANCER CENTER | ||||
| 844 TUCK STREET | LEBANON | PA | 170427477 | CANCER CENTER |
| 2 - WELLSPAN IMAGING SERVICES PALMYRA | ||||
| 1400 SOUTH FORGE ROAD | PALMYRA | PA | 170789519 | IMAGINGING SERVICES |
| 3 - WELLSPAN REHAB | ||||
| 1400 SOUTH FORGE ROAD | PALMYRA | PA | 170789519 | REHABILITATION SERVICES |
| 4 - WELLSPAN IMAGING | ||||
| 297 WEST LINCOLN AVENUE | MYERSTOWN | PA | 170672324 | IMAGINGING SERVICES |
| 5 - WELLSPAN WOUND HEALING | ||||
| 840 TUCK STREET | LEBANON | PA | 170427477 | WOUND HEALING SERVICES |
| 6 - WELLSPAN DIXON FOUNDATION HEALTH CENTER | ||||
| 30 NORTH 4TH STREET | LEBANON | PA | 170465606 | REHABILITATION SERVICES |
| 7 - WELLSPAN GOOD SAMARITAN HOSPITAL SLEEP C | ||||
| 206 HATHAWAY PARK | LEBANON | PA | 170426162 | SLEEP CENTER |
| 8 - WELLSPAN REHABILITATION MYERSTOWN | ||||
| 11 EAST LINCOLN AVENUE | MYERSTOWN | PA | 170671108 | REHABILITATION SERVICES |
| 9 - WELLSPAN REHABILITATION QUENTIN CIRCLE | ||||
| 950 ISABEL DRIVE | LEBANON | PA | 170427482 | REHABILITATION SERVICES |
| 10 - WELLSPAN SURGERY CENTER | ||||
| 830 TUCK STREET | LEBANON | PA | 170427477 | OUTPATIENT SURGERY CENTER |
| 11 - WELLSPAN GOOD SAMARITAN HOSPITAL | ||||
| 30 NORTH 4TH STREET | LEBANON | PA | 170465606 | PATIENT SERVICES |
| 12 - WELLSPAN GOOD SAMARITAN HOSPITAL BLOOD D | ||||
| 750 NORMAN DRIVE | LEBANON | PA | 170427495 | BLOOD DONOR CENTER & LAB |
| 13 - WELLSPAN IMAGING | ||||
| 805 HELEN DRIVE | LEBANON | PA | 170427493 | IMAGINGING SERVICES |
| 14 - WELLSPAN CARDIOVASCULAR DIAGNOSTIC CENTE | ||||
| 781 NORMAN DRIVE | LEBANON | PA | 170427497 | CARDIOVASCULAR DIAGNOSTIC CENTER |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. |
| 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 $ 18,451,765. |
| 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: | THE GOOD SAMARITAN HOSPITAL OF LEBANON PA 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: | THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA 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 THOSE SERVICES. PAYMENTS FROM MEDICARE ARE GENERALLY LESS THAN GOOD SAMARITAN HOSPITAL'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 STATES | PA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| FAMILY FIRST HEALTH CORP | ||||||||
| 116 S GEORGE ST STE 301 | YORK | PA | 17401 | 237118262 | 501(C)(3) | $191,808 | $0 | GENERAL SUPPORT |
| LEBANON SCHOOL DISTRICT | ||||||||
| 1000 S 8TH STREET | LEBANON | PA | 17042 | 231646050 | 501(C)(3) | $84,000 | $0 | COMMUNITY SUPPORT |
| CITY OF LEBANON | ||||||||
| 400 8TH ST | LEBANON | PA | 17042 | 236001905 | 501(C)(3) | $95,000 | $0 | COMMUNITY SUPPORT |
| LEBANON VALLEY COLLEGE | ||||||||
| 101 N COLLEGE AVE | ANNVILLE | PA | 17003 | 231352354 | 501(C)(3) | $25,000 | $0 | COMMUNITY SUPPORT |
| CORNWALL LEBANON SCHOOL DISTRICT | ||||||||
| 105 EAST EVERGREEN ROAD | LEBANON | PA | 17042 | 231646050 | 501(C)(3) | $42,000 | $0 | GENERAL SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 5 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ALL 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROXANNA GAPSTUR | ||||||||||||||
| 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 |
| JANE HYDE | ||||||||||||||
| FORMER DIRECTOR | $0 | $391,128 | $0 | $171,738 | $0 | $647,843 | $0 | $15,615 | $0 | $40,873 | $0 | $1,267,197 | $0 | $647,708 |
| 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 |
| EDWARD TADAJWESKI MD | ||||||||||||||
| DIRECTOR | $0 | $546,899 | $0 | $152,662 | $0 | $0 | $0 | $18,916 | $0 | $50,630 | $0 | $769,107 | $0 | $0 |
| CARRIE WILLETTS | ||||||||||||||
| SR VP | $0 | $452,383 | $0 | $198,682 | $0 | $10 | $0 | $15,615 | $0 | $49,965 | $0 | $716,655 | $0 | $0 |
| THOMAS HARLOW | ||||||||||||||
| PRESIDENT | $376,036 | $0 | $167,234 | $0 | $9,018 | $0 | $14,367 | $0 | $31,483 | $0 | $598,138 | $0 | $0 | $0 |
| ROBERT SHAVER | ||||||||||||||
| VP - MEDICAL AFFAIRS | $336,681 | $0 | $88,800 | $0 | $14,399 | $0 | $18,040 | $0 | $44,520 | $0 | $502,440 | $0 | $0 | $0 |
| PATRICIA DONLEY | ||||||||||||||
| VP & PRESIDENT - GSH | $198,651 | $0 | $56,275 | $0 | $13,886 | $0 | $11,850 | $0 | $41,085 | $0 | $321,747 | $0 | $0 | $0 |
| VIRGINIA FOLLETT | ||||||||||||||
| SR DIRECTOR - ANCIL & SUPPORT SVCS | $180,142 | $0 | $12,476 | $0 | $7,049 | $0 | $22,503 | $0 | $25,160 | $0 | $247,330 | $0 | $0 | $0 |
| DEBRA NEY | ||||||||||||||
| MANAGER-PHARMACY | $186,227 | $0 | $14,404 | $0 | $7,299 | $0 | $11,274 | $0 | $26,502 | $0 | $245,706 | $0 | $0 | $0 |
| STEPHANIE THOMPSON | ||||||||||||||
| DIRECTOR CLINICAL OPER | $152,424 | $0 | $9,161 | $0 | $125 | $0 | $45,500 | $0 | $5,242 | $0 | $212,452 | $0 | $0 | $0 |
| KELLY SMITH | ||||||||||||||
| VP PATIENT CARE SVCS | $145,148 | $0 | $9,726 | $0 | $6,412 | $0 | $16,226 | $0 | $32,954 | $0 | $210,466 | $0 | $0 | $0 |
| TIMOTHY PANTELICH | ||||||||||||||
| TEAM LEADER PHYSICAL THERAPY | $151,297 | $0 | $5,173 | $0 | $4,987 | $0 | $6,464 | $0 | $25,566 | $0 | $193,487 | $0 | $0 | $0 |
| BONNIE PIETRUCH | ||||||||||||||
| DIRECTOR CLINICAL OPER | $145,646 | $0 | $10,339 | $0 | $6,343 | $0 | $19,689 | $0 | $3,760 | $0 | $185,777 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | THE WELLSPAN HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS ADOPTED AND MADE EFFECTIVE ON DECEMBER 19TH, 2008. THE OBJECTIVE OF THE EXECUTIVE BENEFITS PROGRAM IS TO PROVIDE AN EXECUTIVE BENEFITS PROGRAM THAT IS COMPETITIVE WITH NATIONAL NORMS IN THE HEALTHCARE INDUSTRY FOR SIMILARLY SIZED ORGANIZATIONS ENABLING WELLSPAN HEALTH TO RECRUIT AND RETAIN TOP EXECUTIVE TALENT. TIER I EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. A DESCRIPTION OF THE TARGETED BENEFIT OF THE PLAN IS AS FOLLOWS: 1) PROVIDE AN EMPLOYER SPONSORED RETIREMENT BENEFIT THAT REPLACES 60% OF AVERAGE PRE-RETIREMENT (5 YEARS) BASE COMPENSATION THROUGH A COMBINED APPROACH UTILIZING WELLSPAN'S RETIREMENT PLAN, 50% OF SOCIAL SECURITY, SPLIT-DOLLAR LIFE INSURANCE BENEFIT, AND SUPPLEMENTAL EXECUTIVE RETIREMENT BENEFIT. 2) PROVIDES A MINIMUM BENEFIT AFTER 10 YEARS OF SERVICE. 3) PROVIDES THE FULL TARGETED BENEFIT AFTER 25 YEARS OF SERVICE. 4) BENEFIT IS VESTED WHEN ELIGIBLE EXECUTIVE REACHES AGE 65. THE BENEFIT IS ALSO VESTED UPON DEATH, DISABILITY, JOB ELIMINATION AND "TERMINATION FOR GOOD REASON". 5) CREDITED SERVICE GRANTED ON A 1:2 BASIS FOR PREVIOUS SERVICE IN AN ELIGIBLE TIER II POSITION. 6) TARGETED BENEFIT IS TO BE CALCULATED USING A 15 YEAR CERTAIN PAYOUT. 7) PAYOUT WILL BE IN A LUMP SUM. 8) PAYOUT WILL BE TAXABLE WHEN VESTED. DURING THE CALENDAR YEAR 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 ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd | CUSIPCUSIPNum |
|---|---|---|---|---|---|---|---|---|
| GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA | ||||||||
| A | 232982233 | 2018-03-13 | $282,504 | REFUND 2008A BONDS | 0 | 0 | 0 | |
| GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA | ||||||||
| B | 232982233 | 2018-09-04 | $237,427 | REFUND 2008A BONDS | 0 | 0 | 0 | |
| GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA | ||||||||
| C | 277334160 | 2019-04-03 | $42,216 | REFUND BONDS & EXPANSION | 0 | 0 | 0 | |
| GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA | ||||||||
| D | 232982233 | 2019-04-03 | $1,722,789 | REFUND BONDS ISSUED 11/12/2008 | 0 | 0 | 0 | 84129NMG1 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Capitalized InterestCapitalizedInterestAmt | Capital ExpendituresCapitalExpendituresAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $130,564 | $282,504 | $839 | $281,665 | 2018 | 0 | Yes (1) | Yes (1) | Yes (1) | ||
| B | $17,820 | $237,427 | $689 | $236,738 | 2018 | 0 | Yes (1) | Yes (1) | Yes (1) | ||
| C | $42,216 | $282 | $2,729 | 2019 | Yes (1) | Yes (1) | Yes (1) | Yes (1) | $68 | $39,137 | |
| D | $1,722,789 | $8,019 | $1,714,770 | 2019 | Yes (1) | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| C | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
| D | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
| C | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
| D | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
| D | Yes (1) |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE K, PART I, COLUMN (E) - ISSUE PRICE | WELLSPAN 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 III, LINE 4 & 5 - PRIVATE BUSINESS USE | THE ENTITY, IN CONJUNCTION WITH BOND COUNSEL, MONITORS ACTIVITIES THAT MAY RESULT IN PRIVATE BUSINESS USE. THERE WERE NONE FOUND. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | WELLSPAN HEALTH, A NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE PRIMARY PURPOSE OF THE GOVERNANCE COMMITTEE, AS ASSIGNED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, IS TO DEVELOP AND SUPPORT THE CULTURE OF HIGH-FUNCTIONING GOVERNANCE WITHIN THE WELLSPAN SYSTEM, INCLUDING THROUGH POLICIES, NOMINATIONS, COMPETENCIES OF DIRECTORS, EDUCATION, AND SELF-EVALUATIONS. THE GOVERNANCE COMMITTEE SHALL CONSIST OF NOT LESS THAN FIVE (5) NOR MORE THAN SEVEN (7) MEMBERS. NEITHER THE CHAIR OF THE WELLSPAN HEALTH BOARD OF DIRECTORS NOR PERSONS WHO ARE NOT MEMBERS OF THE WELLSPAN HEALTH BOARD OF DIRECTORS, MAY BE APPOINTED TO THE COMMITTEE. EACH GOVERNANCE COMMITTEE MEMBER SHALL BE NOMINATED BY THE GOVERNANCE COMMITTEE, AND APPOINTED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, FOR A TERM OF ONE (1) YEAR. REAPPOINTMENT OF A GOVERNANCE COMMITTEE MEMBER FOR MORE THAN ONE (1) TERM IS NOT AUTOMATIC OR PRESUMED AND SHALL BE BASED ON AN INDIVIDUAL PERFORMANCE EVALUATION OF THE GOVERNANCE COMMITTEE MEMBER (AS PERFORMED OR OVERSEEN BY THE GOVERNANCE COMMITTEE). |
| FORM 990, PART VI, SECTION A, LINE 7B | THE FOLLOWING RESPONSIBILITIES ARE SET FORTH AS A GUIDE FOR FULFILLING THE GOVERNANCE COMMITTEE'S PURPOSES IN SUCH MANNER AS THE COMMITTEE DETERMINES IS APPROPRIATE: 1. OVERSEE THE PROCESS OF SELECTING AND NOMINATING DIRECTORS AND OFFICERS FOR EACH OF THE GOVERNING BOARDS WITHIN THE WELLSPAN SYSTEM, INCLUDING ENSURING THAT DIRECTOR NOMINEES MEET THE QUALIFICATIONS REQUIRED BY THE RELEVANT BOARD COMPOSITION AND COMPETENCY GRID AND CHARACTERISTICS, BYLAWS, AND BOARD-APPROVED POLICIES AND GUIDELINES, AS APPLICABLE, AND ESTABLISH OTHER CRITERIA THAT ARE DESIRABLE FOR DIRECTORS; 2. IDENTIFY, EVALUATE AND SCREEN DIRECTOR CANDIDATES FOR EACH OF THE GOVERNING BOARDS WITHIN THE WELLSPAN SYSTEM (INCLUDING INCUMBENT DIRECTORS FOR POTENTIAL RE-NOMINATION), AND NOMINATE QUALIFIED INDIVIDUALS TO THE WELLSPAN HEALTH BOARD OF DIRECTORS FOR: (A) APPOINTMENT OR REAPPOINTMENT TO REGULAR TERMS, OR (B) APPOINTMENT TO FILL THE REMAINING TERM OF ANY GOVERNING BOARD VACANCIES; 3. REVIEW ANNUALLY THE SIZE, COMPOSITION AND LEADERSHIP OF EACH OF THE GOVERNING BOARDS WITHIN THE WELLSPAN SYSTEM, INCLUDING THE WELLSPAN HEALTH BOARD OF DIRECTORS AS A WHOLE, ITS COMMITTEES, AND ANY ADVISORY BODIES, MAKE A DETERMINATION OF WHETHER THE BOARD, ITS COMMITTEES AND ANY ADVISORY BODIES REFLECT THE APPROPRIATE BALANCE OF INDEPENDENCE, SOUND JUDGMENT, BUSINESS SPECIALIZATION, TECHNICAL SKILLS, DIVERSITY, FUNDRAISING AND DEVELOPMENT ABILITY, GEOGRAPHIC AND DEMOGRAPHIC REPRESENTATION, AND OTHER DESIRED QUALITIES, AND RECOMMEND ANY APPROPRIATE CHANGES TO THE WELLSPAN HEALTH BOARD OF DIRECTORS; 4. COORDINATE AND OVERSEE A PERIODIC SELF-EVALUATION OF THE ROLE AND PERFORMANCE OF EACH OF THE GOVERNING BOARDS WITHIN THE WELLSPAN SYSTEM, INCLUDING THE WELLSPAN HEALTH BOARD OF DIRECTORS, ITS COMMITTEES, AND ANY ADVISORY BODIES, AND EACH OF THEIR DIRECTORS AND OFFICERS; 5. DEVELOP AND RECOMMEND FOR APPROVAL BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, REVIEW THE EFFECTIVENESS OF, AND RECOMMEND MODIFICATIONS AS APPROPRIATE TO, THE ORGANIZATION'S COMMITTEE STRUCTURE AND ORGANIZATIONAL DOCUMENTS, INCLUDING THE ARTICLES OF INCORPORATION, BYLAWS, BOARD-APPROVED POLICIES AND GUIDELINES, AND COMMITTEE CHARTERS; 6. THE GOVERNANCE COMMITTEE SHALL UNDERTAKE THE RESPONSIBILITY FOR BOARD EDUCATION AND BOARD RETREAT PLANNING. IN ADDITION, THE GOVERNANCE COMMITTEE SHALL COORDINATE WITH MANAGEMENT TO DEVELOP AND IMPLEMENT AN EFFECTIVE ORIENTATION PROGRAM FOR NEW DIRECTORS, INCLUDING ASSIGNMENT OF EXPERIENCED DIRECTORS AS APPROPRIATE MENTORS OF NEW DIRECTORS. 7. REVIEW EMERGING CORPORATE GOVERNANCE ISSUES AND BEST GOVERNANCE PRACTICES AND MAKE APPROPRIATE RECOMMENDATIONS TO THE WELLSPAN HEALTH BOARD OF DIRECTORS; 8. CONDUCT A PERIODIC SELF-EVALUATION OF THE PERFORMANCE OF THE COMMITTEE, INCLUDING ITS EFFECTIVENESS AND COMPLIANCE WITH THIS CHARTER, AND RECOMMEND TO THE WELLSPAN HEALTH BOARD OF DIRECTORS MODIFICATIONS AS APPROPRIATE; 9. THE GOVERNANCE COMMITTEE SHALL MAINTAIN MINUTES OF GOVERNANCE COMMITTEE MEETINGS AND RECORDS OF ITS ACTIVITIES AND SHALL REPORT PROMPTLY TO THE WELLSPAN HEALTH BOARD OF DIRECTORS ANY ACTION TAKEN BY THE GOVERNANCE COMMITTEE, ANY RECOMMENDATIONS OF THE GOVERNANCE COMMITTEE, AND ANY OTHER MATTERS THE GOVERNANCE COMMITTEE DEEMS APPROPRIATE OR THE WELLSPAN HEALTH BOARD OF DIRECTORS REQUESTS. 10. THE GOVERNANCE COMMITTEE SHALL UNDERTAKE SUCH OTHER RESPONSIBILITIES AS THE WELLSPAN HEALTH BOARD OF DIRECTORS MAY DELEGATE OR ASSIGN TO THE GOVERNANCE COMMITTEE FROM TIME TO TIME. THE GOVERNANCE COMMITTEE SHALL BE RESPONSIBLE TO, AND SUBJECT TO THE DIRECTION AND CONTROL OF, THE WELLSPAN HEALTH BOARD OF DIRECTORS. THE WELLSPAN HEALTH BOARD OF DIRECTORS SHALL BE SOLELY RESPONSIBLE FOR DELINEATING THE RESPONSIBILITIES OF THE GOVERNANCE COMMITTEE. THE GOVERNANCE COMMITTEE SHALL PERFORM ONLY SUCH FUNCTIONS AND DUTIES AS SHALL FROM TIME TO TIME BE SPECIFICALLY DELEGATED TO THE GOVERNANCE COMMITTEE BY THE WELLSPAN HEALTH BOARD OF DIRECTORS. THE GOVERNANCE COMMITTEE DOES NOT HAVE DELEGATED AUTHORITY TO TAKE FINAL AND BINDING ACTIONS ON BEHALF OF WELLSPAN HEALTH, AND THEREFORE ANY ACTIONS AND RECOMMENDATIONS OF THE COMMITTEE MUST BE APPROVED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS BEFORE THEY ARE FINAL AND BINDING. IN DISCHARGING ITS ROLE, THE GOVERNANCE COMMITTEE IS EMPOWERED TO INQUIRE INTO ANY MATTER IT CONSIDERS APPROPRIATE TO CARRY OUT ITS RESPONSIBILITIES, WITH ACCESS TO ALL BOOKS, RECORDS, FACILITIES, AND PERSONNEL OF THE WELLSPAN SYSTEM. |
| FORM 990, PART VI, SECTION B, LINE 11B | MANAGEMENT PROVIDED AN ELECTRONIC COPY OF THE FORM 990 TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, PRIOR TO ITS FILING WITH THE IRS. THE ORGANIZATION'S FINANCE MANAGEMENT TEAM PROVIDED A PRESENTATION TO THE AUDIT COMMITTEE ON THE ORGANIZATION'S 990 RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A WELLSPAN HEALTH "CONFLICT OF INTEREST DISCLOSURE STATEMENT" QUESTIONNAIRE ANNUALLY. THE INTERNAL AUDIT DEPARTMENT OF WELLSPAN HEALTH ADMINISTERS THE QUESTIONNAIRES. THERE SHALL BE FULL DISCLOSURE BY A DIRECTOR HAVING A BUSINESS OR PERSONAL INTEREST OR RELATIONSHIP WHICH MAY BE IN CONFLICT WITH THE INTERESTS OF THE CORPORATION. AFTER SUCH DISCLOSURE, THE DIRECTOR SHALL ABIDE BY THE DETERMINATION OF THE BOARD OF DIRECTORS AS TO WHETHER A CONFLICT EXISTS, THE EXTENT TO WHICH, IF AT ALL, THE DIRECTOR WILL BE PERMITTED TO BE PRESENT DURING THE BOARD OF DIRECTORS' DISCUSSION OF THE MATTER IN WHICH THE DIRECTOR MAY BE INTERESTED, AND WHETHER THE DIRECTOR WILL BE PERMITTED TO PARTICIPATE IN SUCH DISCUSSION AND CAST A VOTE IN SUCH MATTER. ADDITIONALLY, ALL BOARD MEMBERS, EMPLOYEES, STUDENTS, AND VOLUNTEERS OF WELLSPAN HEALTH AND ITS RELATED ORGANIZATIONS MUST COMPLETE A "CODE OF CONDUCT" FORM TO ACKNOWLEDGE THAT HE OR SHE UNDERSTANDS THAT WE ALL HAVE AN OBLIGATION TO ACT IN WAYS THAT WILL MERIT THE TRUST, CONFIDENCE, AND RESPECT OF THE COMMUNITY WE SERVE, OTHER HEALTH CARE PROVIDERS, AND ALL OF THOSE WITH WHOM WE INTERACT. |
| FORM 990, PART VI, SECTION B, LINE 15B | THE PRIMARY PURPOSE OF WELLSPAN HEALTH COMPENSATION COMMITTEE, AS ASSIGNED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, IS TO REVIEW COMPENSATION PACKAGES OFFERED AND/OR PAID TO SENIOR SYSTEM EXECUTIVES AND PRACTICING PHYSICIANS EMPLOYED WITHIN THE SYSTEM. THE COMPENSATION COMMITTEE SHALL MONITOR AND EVALUATE THE PERFORMANCE OF THE PRESIDENT AND CEO OF WELLSPAN HEALTH AND SHALL, AT LEAST ANNUALLY, COORDINATE THE IN-PERSON PERFORMANCE REVIEW OF THE PRESIDENT AND CEO BY THE WELLSPAN HEALTH BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE SHALL CONSIST OF 5-10 MEMBERS OF THE WELLSPAN HEALTH BOARD OF DIRECTORS, INCLUDING THE CHAIR AND THE VICE CHAIR. EACH COMPENSATION COMMITTEE MEMBER SHALL BE NOMINATED BY THE GOVERNANCE COMMITTEE, AND APPOINTED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, FOR A TERM OF ONE (1) YEAR. REAPPOINTMENT OF A COMPENSATION COMMITTEE MEMBER FOR MORE THAN ONE (1) TERM IS NOT AUTOMATIC OR PRESUMED AND SHALL BE BASED ON AN INDIVIDUAL PERFORMANCE EVALUATION OF THE COMPENSATION COMMITTEE MEMBER (AS PERFORMED OR OVERSEEN BY THE GOVERNANCE COMMITTEE). THE COMPENSATION COMMITTEE SHALL BE RESPONSIBLE TO, AND SUBJECT TO THE DIRECTION AND CONTROL OF, THE WELLSPAN HEALTH BOARD OF DIRECTORS. THE WELLSPAN HEALTH BOARD OF DIRECTORS SHALL BE SOLELY RESPONSIBLE FOR DELINEATING THE RESPONSIBILITIES OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE SHALL PERFORM ONLY SUCH FUNCTIONS AND DUTIES AS SHALL FROM TIME TO TIME BE SPECIFICALLY DELEGATED TO THE COMPENSATION COMMITTEE BY THE WELLSPAN HEALTH BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE DOES NOT HAVE DELEGATED AUTHORITY, AND THEREFORE ANY ACTIONS AND RECOMMENDATIONS OF THE COMMITTEE MUST BE APPROVED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS BEFORE THEY ARE FINAL AND BINDING. IN DISCHARGING ITS ROLE, THE COMPENSATION COMMITTEE IS EMPOWERED TO INQUIRE INTO ANY MATTER IT CONSIDERS APPROPRIATE TO CARRY OUT ITS RESPONSIBILITIES, WITH ACCESS TO ALL BOOKS, RECORDS, FACILITIES, AND PERSONNEL OF THE WELLSPAN SYSTEM. THE FOLLOWING RESPONSIBILITIES ARE SET FORTH AS A GUIDE FOR FULFILLING THE COMPENSATION COMMITTEE'S PURPOSES IN SUCH MANNER AS THE COMMITTEE DETERMINES IS APPROPRIATE: 1. SET, PERIODICALLY REVIEW AND ENSURE COMPLIANCE WITH THE EXECUTIVE COMPENSATION PHILOSOPHY FOR WELLSPAN, IN AN EFFORT TO ATTRACT AND RETAIN HIGH QUALITY EXECUTIVES, WHILE CONSIDERING COMPENSATION OFFERED TO THOSE IN COMPARABLE POSITIONS IN SIMILAR EMPLOYMENT MARKETS AS WELL AS THE SYSTEM'S NEEDS AND FINANCIAL RESOURCES. 2. RECOMMEND APPROVAL OF EXECUTIVE COMPENSATION PROGRAM ELEMENTS (INCENTIVES, SUPPLEMENTAL BENEFITS, ETC.). 3. IN CONJUNCTION WITH THE WELLSPAN HEALTH BOARD OF DIRECTORS, EVALUATE PERFORMANCE AND ESTABLISH COMPENSATION FOR THE PRESIDENT & CEO OF WELLSPAN HEALTH. 4. EVALUATE EXECUTIVE TEAM PERFORMANCE AND ESTABLISH AWARDS. 5. RECOMMEND APPROVAL OF SENIOR EXECUTIVE BASE SALARY RANGES. 6. ALIGN EXECUTIVE COMPENSATION WITH EXECUTIVE TALENT MANAGEMENT AND SUCCESSION. 7. OVERSEE EMPLOYED PHYSICIAN COMPENSATION PROGRAM. 8. THE COMPENSATION COMMITTEE SHALL MAINTAIN MINUTES OF COMPENSATION COMMITTEE MEETINGS AND RECORDS OF ITS ACTIVITIES, AND SHALL REPORT PROMPTLY TO THE WELLSPAN HEALTH BOARD OF DIRECTORS ANY ACTION TAKEN BY THE COMPENSATION COMMITTEE, ANY RECOMMENDATIONS OF THE COMPENSATION COMMITTEE, AND ANY OTHER MATTERS THE COMPENSATION COMMITTEE DEEMS APPROPRIATE TO THE WELLSPAN HEALTH BOARD OF DIRECTORS REQUESTS. 9. THE COMPENSATION COMMITTEE SHALL UNDERTAKE SUCH OTHER RESPONSIBILITIES AS THE WELLSPAN HEALTH BOARD OF DIRECTORS MAY DELEGATE OR ASSIGN TO THE COMPENSATION COMMITTEE FROM TIME TO TIME. THE COMPENSATION COMMITTEE ALSO UTILIZES THE SERVICES OF SULLIVANCOTTER, AN INDEPENDENT, THIRD-PARTY HEALTH CARE COMPENSATION CONSULTANT, TO ALIGN AND STRUCTURE WORKFORCE COMPENSATION AND BENEFIT STRATEGIES THAT SUPPORT ENTERPRISE-WIDE TRANSFORMATION AND BUSINESS PERFORMANCE. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 12,093,887. MANAGEMENT AND GENERAL EXPENSES 1,367,399. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,461,286. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 6,252,216. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,252,216. SPECIALIST CONTRACT: PROGRAM SERVICE EXPENSES 32,884,366. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,884,366. TEMPORARY PROFESSIONAL STAFF: PROGRAM SERVICE EXPENSES 5,156,624. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,156,624. |
| FORM 990, PART XI, LINE 9: | CHANGE IN FOUNDATION NET ASSETS 92,443. CHANGE IN FV DERIVATIVE -53,490. CHANGE IN RETIREMENT -11,858,127. GAIN ON PENSION PLAN 4,630,647. TRANSFER FROM WELLSPAN HEALTH 10,000,000. TRANSFER TO WELLSPAN MEDICAL GROUP -7,000,000. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (25 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| APPLE HILL SURGICAL CENTER INC | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 222842253 | SOLE GP IN LP. OPERATING SURGICAL CENTER | PA | 501(C)(3) | LINE_10_ORGANIZATION | WELLSPAN HEALTH CARE SERVICES | 0 | |
| CHAMBERSBURG HEALTH SERVICES | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251515376 | HEALTH CARE SERVICES | PA | 501(C)(3) | 12 TYPE I | WELLSPAN SUMMIT HEALTH | 0 | |
| CHAMBERSBURG HOSPITAL | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 230465970 | HEALTH CARE SERVICES | PA | 501(C)(3) | LINE_3_HOSPITAL_COOP | WELLSPAN SUMMIT HEALTH | 0 | |
| EPHRATA COMMUNITY HEALTH FOUNDATION | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 800940005 | FUNDRAISING FOR EPHRATA HOSPITAL | PA | 501(C)(3) | 12 TYPE I | EPHRATA COMMUNITY HOSPITAL | 0 | |
| EPHRATA COMMUNITY HOSPITAL | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231370484 | HEALTH CARE SERVICES | PA | 501(C)(3) | LINE_3_HOSPITAL_COOP | WELLSPAN HEALTH | 0 | |
| GETTYSBURG HOSPITAL | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231352220 | HEALTH CARE SERVICES | PA | 501(C)(3) | LINE_3_HOSPITAL_COOP | WELLSPAN HEALTH | 0 | |
| GETTYSBURG HOSPITAL FOUNDATION | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232251358 | FUNDRAISING FOR GETTYSBURG HOSPITAL | PA | 501(C)(3) | 12 TYPE I | GETTYSBURG HOSPITAL | 0 | |
| GOOD SAMARITAN HEALTH SERVICES FOUNDATION OF LEBANON PA | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232356151 | FUNDRAISING FOR THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA | PA | 501(C)(3) | 12 TYPE I | GOOD SAMARITAN HOSPITAL | 0 | |
| GOOD SAMARITAN PHYSICIAN SERVICES | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251832359 | MEDICAL AND SURGICAL CARE | PA | 501(C)(3) | LINE_10_ORGANIZATION | GOOD SAM HEALTH SERVICES FOUNDATION | 0 | |
| HEALTHY COMMUNITY PHARMACY INC | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 200519121 | REDUCED RATE PRESCRIPTION DRUGS TO UNINSURED | PA | 501(C)(3) | 12 TYPE I | WELLSPAN HEALTH CARE SERVICES | 0 | |
| PHILHAVEN | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231549922 | HEALTH CARE SERVICES | PA | 501(C)(3) | LINE_3_HOSPITAL_COOP | WELLSPAN HEALTH | 0 | |
| SUMMIT HEALTH FOUNDATION | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 831196554 | FUNDRAISING FOR HEALTH CARE SYSTEM | PA | 501(C)(3) | 12 TYPE II | WELLSPAN SUMMIT HEALTH | 0 | |
| SUMMIT PHYSICIAN SERVICES | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251716306 | MEDICAL AND SURGICAL CARE | PA | 501(C)(3) | LINE_3_HOSPITAL_COOP | WELLSPAN SUMMIT HEALTH | 0 | |
| VNA COMMUNITY SERVICES | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232338591 | HOME PERSONAL CARE SERVICES FOR ELDERLY AND DISABLED | PA | 501(C)(3) | LINE_10_ORGANIZATION | WELLSPAN SURGERY & REHABILITATION HOSPITAL | 0 | |
| VNA HOME HEALTH SERVICES | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231352573 | HOME HEALTH AND HOSPICE CARE SERVICES | PA | 501(C)(3) | LINE_10_ORGANIZATION | WELLSPAN SURGERY & REHABILITATION HOSPITAL | 0 | |
| WAYNESBORO HOSPITAL | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231360854 | HEALTH CARE SERVICES | PA | 501(C)(3) | LINE_3_HOSPITAL_COOP | WELLSPAN SUMMIT HEALTH | 0 | |
| WELLSPAN HEALTH | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 222517863 | INTEGRATED HEALTH SYSTEM | PA | 501(C)(3) | 12 TYPE III | 0 | N/A | |
| WELLSPAN HEALTH CARE SERVICES | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232400237 | HEALTH CARE SERVICES | PA | 501(C)(3) | 12 TYPE II | WELLSPAN HEALTH | 0 | |
| WELLSPAN MEDICAL GROUP | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232730785 | MEDICAL AND SURGICAL CARE | PA | 501(C)(3) | LINE_10_ORGANIZATION | WELLSPAN HEALTH | 0 | |
| WELLSPAN PROPERTIES | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 222842252 | LEASES FACILITIES TO AFFILIATES | PA | 501(C)(3) | 12 TYPE II | WELLSPAN HEALTH CARE SERVICES | 0 | |
| WELLSPAN SUMMIT HEALTH | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251515371 | INTEGRATED HEALTH SYSTEM | PA | 501(C)(3) | LINE_7_ORGANIZATION_ | WELLSPAN HEALTH | 0 | |
| WELLSPAN SURGERY & REHABILITATION HOSPITAL | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232899911 | SURGERY AND REHABILITATION HOSPITAL | PA | 501(C)(3) | LINE_3_HOSPITAL_COOP | WELLSPAN HEALTH | 0 | |
| YORK HOSPITAL | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231352222 | COMMUNITY TEACHING HOSPITAL | PA | 501(C)(3) | LINE_3_HOSPITAL_COOP | WELLSPAN HEALTH | 0 | |
| YORK HEALTH FOUNDATION | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 233050192 | FUNDRAISING FOR WELLSPAN ENTITIES | PA | 501(C)(3) | 12 TYPE III | WELLSPAN HEALTH | 0 | |
| CHAMBERSBURG HOSPITAL WORKERS COMPENSATION TRUST | |||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 256450683 | WORKERS COMPENSATION BENEFITS FOR WORKERS | PA | 501(C)(4) | CHAMBERSBURG HOSPITAL | 0 | ||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| APPLE HILL SURGICAL CENTER PARTNERS | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232489452 | SURGICAL CENTER | PA | WELLSPAN HEALTH | 0 | 0 |
| CHERRY TREE CANCER CENTER LLP | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232915628 | RADIATION | PA | WELLSPAN HEALTH CARE SERVICES | 0 | 0 |
| CUMBERLAND VALLEY MOBILE SERVICES | |||||||||
| 5 S MAIN ST | SUGARLOAF | PA | 18249 | 200884014 | MOBILE HEALTH SERVICES | PA | CHAMBERSBURG HEALTH SERVICES | 0 | 0 |
| LITTLESTOWN HEALTH CARE PARTNERS | |||||||||
| 300 WEST KING STREET | LITTLESTOWN | PA | 17340 | 232880464 | LEASE FACILITY | PA | WELLSPAN HEALTH CARE SERVICES | 0 | 0 |
| SUMMIT SURGERY CENTER | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251845303 | PHYSICIAN SERVICES | PA | CHAMBERSBURG HEALTH SERVICES | 0 | 0 |
| SURGERY CENTER ASSOCIATES LLC | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251845304 | PHYSICIAN SERVICES | PA | CHAMBERSBURG HEALTH SERVICES | 0 | 0 |
| THE REHAB CENTER | |||||||||
| 855 SPRINGDALE DRIVE SUITE 20 | EXTON | PA | 19341 | 251687903 | PHYSICAL THERAPY REHABILITATION | PA | EPHRATA HOSPITAL | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| APPLE HILL CONDOMINIUM ASSOCIATION | ||||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232504543 | CONDOMINIUM ASSOCIATION | PA | WELLSPAN HEALTH CARE SERVICES | C | 0 | |||
| EPHRATA HEALTH PAVILION CONDOMINIUM ASSOCIATION | ||||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 475367279 | CONDOMINIUM ASSOCIATION | PA | EPHRATA HOSPITAL | C | 0 | |||
| GOOD SAMARITAN PHYSICIAN HOSPITAL ORGANIZATION OF LEBANON PA | ||||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251769419 | HEALTH CARE SERVICES | PA | THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA | C | 0 | $50,500 | $823,411 | 0.50000 |
| GSH REALTY INC | ||||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251832359 | NON-RESIDENTIAL REAL ESTATE | PA | WELLSPAN HEALTH CARE SERVICES | C | 0 | |||
| NORTHERN LANCASTER COUNTY PHYSICIAN HOSPITAL ALLIANCE | ||||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232421885 | COORD PHYS & HOSPITAL | PA | EPHRATA HOSPITAL | C | 0 | |||
| QUEST BEHAVIORAL HEALTH | ||||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232446622 | HEALTH CARE NETWORK SERVICE | PA | WELLSPAN HEALTH | C | 0 | |||
| WELLSPAN HEARING CENTER INC | ||||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231954338 | HEARING AID PRACTICE | PA | WELLSPAN HEALTH CARE SERVICES | C | 0 | |||
| WELLSPAN PHARMACY INC | ||||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232374072 | DISPENSES RX & PROVIDES IV THERAPY | PA | WELLSPAN HEALTH CARE SERVICES | C | 0 | |||
| WELLSPAN PROVIDER NETWORK | ||||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232907828 | COORDINATE MANAGED CARE RISK CONTRACTS | PA | WELLSPAN HEALTH | C | 0 | |||
| WELLSPAN RECIPROCAL RISK RETENTION GROUP | ||||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 200048457 | RISK RETENTION GROUP | PA | WELLSPAN HEALTH | C | 0 | |||
| YORK HEALTH PLAN | ||||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232664989 | PREFERRED PROVIDER ORGANIZATION | PA | WELLSPAN HEALTH | C | 0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (1) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SAMARITAN HEALTH SERVICES FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $1,797,980 | InvolvedAmt |
| Method Of Amount Determination | COST | MethodOfAmountDeterminationTxt |