WELLSPAN SURGERY AND REHABILITATION HOSPITAL: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- WELLSPAN SURGERY AND REHABILITATION HOSPITAL (EIN 23-2899911)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-13
- IRS object ID
- 202201339349307305
- Schema version
- 2020v4.0
- 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 D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-13T12:31:56-07:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135381590 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WellSpan Health | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3350 WHITEFORD ROAD | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 232899911 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLSPAN SURGERY & REHABILITATION | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WELL | 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 | 17405 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Laura Buczkowski | PersonNm |
| Person Title | SR VP & CFO | PersonTitleTxt |
| Signature | 2022-05-13 | SignatureDt |
| Discuss With Paid Preparer | false | 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 | See Attached | PreparerPersonNm |
| PTIN | P01871563 | PTIN |
| Phone | 7038930600 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | 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 | $106,268,438 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WELLSPAN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | WellSpan Surgery and Rehabilitation Hospital's mission is "Supporting the journey to optimal health and independence by providing exceptional orthopedic, spine and acute rehabilitative care in a healing environment and coordinated through a comprehensive system of care." | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 493 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $457,070 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,893,770 | PYContributionsGrantsAmt |
| CY Contributions Grants | -$349,237 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $91,166,368 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $106,914,897 | CYProgramServiceRevenueAmt |
| PY Investment Income | $214,784 | PYInvestmentIncomeAmt |
| CY Investment Income | -$828,303 | CYInvestmentIncomeAmt |
| PY Other Revenue | $626,292 | PYOtherRevenueAmt |
| CY Other Revenue | $510,679 | CYOtherRevenueAmt |
| PY Total Revenue | $93,901,214 | PYTotalRevenueAmt |
| CY Total Revenue | $106,248,036 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $8,800,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $100,000 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $30,385,064 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $32,986,272 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $53,946,259 | PYOtherExpensesAmt |
| CY Other Expenses | $62,261,319 | CYOtherExpensesAmt |
| PY Total Expenses | $93,131,323 | PYTotalExpensesAmt |
| CY Total Expenses | $95,347,591 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $769,891 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $10,900,445 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $85,216,385 | TotalAssetsBOYAmt |
| Total Assets EOY | $83,482,844 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $71,670,974 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $70,526,953 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $13,545,411 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,955,891 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WellSpan Surgery and Rehabilitation Hospital's mission is "Supporting the journey to optimal health and independence by providing exceptional orthopedic, spine and acute rehabilitative care in a healing environment and coordinated through a comprehensive system of care." Services are provided to patients without regard for an individual's ability to pay.WellSpan Surgery and Rehabilitation Hospital also provides home health, and other health care and personal care to residents of York County, Pennsylvania and the surrounding region through its subsidiaries, VNA Home Health Services and VNA Community Services. Each supported organization qualifies for exemption from income tax under Section 501(c)(3) pursuant to Section 509(a)(1)or 509(a)(2) of the Internal Revenue Code of 1986, as amended. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $74,393,119 | ExpenseAmt |
| Grant | $100,000 | GrantAmt |
| Revenue | $106,914,897 | RevenueAmt |
| Desc | WellSpan Surgery and Rehabilitation Hospital (WSRH), a 73-bed hospital, located on the Apple Hill Health Campus, opened on April 23, 2012. WSRH provides a specialized treatment environment for patients requiring advanced orthopedic, spine, and neurosurgical surgeries, acute inpatient rehabilitation, and specialized outpatient rehabilitation services. Our modern, patient-centered facility offered advanced orthopedic, spine and neurosurgical treatment, and inpatient rehabilitation for those who needed extra attention before returning to their homes and resuming their lives. See WellSpan Health - 2021 Community Benefit Report located at https://www.wellspan.org/about/wellspan-in-the-community/2021-community-benefit-report/ | Desc |
| Total Program Service Expenses | $74,393,119 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 493 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID RIZZUTO | PersonNm |
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| Michael O'Connor | |||||||
| Former Director | 0.00 | 40.00 | $0 | $3,058,887 | $208,991 | ||
| Roxanna Gapstur | |||||||
| CEO-WSH/Dir. | 1.00 | 40.00 | $0 | $1,531,608 | $72,560 | Yes (X) | Yes (X) |
| Victoria Diamond | |||||||
| Sr VP | 1.00 | 40.00 | $0 | $558,813 | $69,280 | Yes (X) | Yes (X) |
| Mike Seim | |||||||
| Sr VP | 1.00 | 40.00 | $0 | $514,458 | $44,526 | Yes (X) | Yes (X) |
| Lee Maddox MD | |||||||
| Director | 1.00 | 40.00 | $0 | $496,213 | $61,511 | Yes (X) | |
| Barbara Yarrish | |||||||
| Former Director | 0.00 | 40.00 | $0 | $374,055 | $38,441 | ||
| Carol Smith | |||||||
| Vice President | 40.00 | 0.00 | $241,654 | $0 | $48,870 | Yes (X) | Yes (X) |
| Rosa Hickey | |||||||
| Sr. Dir. Pat. Care | 40.00 | 0.00 | $202,861 | $0 | $50,640 | ||
| Darci Wolf | |||||||
| Dir-Clinical | 40.00 | 0.00 | $150,921 | $0 | $48,136 | ||
| Elizabeth Trumble | |||||||
| Dir-I/P Rehab | 40.00 | 0.00 | $153,382 | $0 | $42,721 | ||
| Lorrie Monoski | |||||||
| Dir - Clinical Svc | 40.00 | 0.00 | $136,411 | $0 | $47,210 | ||
| Jennifer Green | |||||||
| Nurse Manager | 40.00 | 0.00 | $126,946 | $0 | $38,930 | ||
| Laura Buczkowski | |||||||
| SR VP & CFO WSH | 1.00 | 40.00 | $0 | $55,289 | $7,796 | Yes (X) | Yes (X) |
| Suzanne McConkey | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Mandy Arnold | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Barry Douglas | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Pamela Gunter-Smith | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Jeff Lobach Esq | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Todd Martellar | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Krista Darr | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Cheryl Thompson RN | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Sandie Walker | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Neil Slenker Esq | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,012,175 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,589,323 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $779,612 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HCSC Laundry | |||||
| PO Box 25092 | Lehigh Valley | PA | 180025092 | Laundry Services | $192,356 |
| Anesthesia Associates of York | |||||
| 110 Pine Grove Commons | York | PA | 17405 | Anesthesia Services | $224,227 |
| Healthtrust Workforce Solutions | |||||
| 6565 N MacArthur Blvd Ste 325 | Irving | TX | 750392475 | Staffing Services | $178,583 |
| DaVita Inc | |||||
| 2000 16th Street | Denver | CO | 80202 | Dialysis Services | $101,038 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $8,067 | RelatedOrganizationsAmt |
| Government Grants | -$376,444 | GovernmentGrantsAmt |
| All Other Contributions | $19,140 | AllOtherContributionsAmt |
| Total Contributions | -$349,237 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Net Patient Revenue | 621500 | $109,865,389 | $109,408,319 | $457,070 |
| W/O Bad Debts | 622150 | -$2,724,951 | -$2,724,951 | |
| W/O Financial Assistance | 622150 | -$225,541 | -$225,541 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $106,914,897 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$829,303 | TotalRevenueColumnAmt |
| Exclusion | -$829,303 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $21,402 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $20,402 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,000 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,000 | TotalRevenueColumnAmt |
| Exclusion | $1,000 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CENT Credential | 611699 | $13,750 | $13,750 |
| Food Service | 722210 | $362,884 | $362,884 |
| Shipping and Receiving | 488510 | $133,136 | $133,136 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $909 | TotalRevenueColumnAmt |
| Exclusion | $909 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $510,679 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $106,248,036 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $106,457,827 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $457,070 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$317,624 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,000 | TotalAmt |
| Program Services | $100,000 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $290,524 | TotalAmt |
| Program Services | $290,524 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,683,504 | TotalAmt |
| Program Services | $18,409,218 | ProgramServicesAmt |
| Management And General | $5,274,286 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,204,242 | TotalAmt |
| Program Services | $939,309 | ProgramServicesAmt |
| Management And General | $264,933 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,935,810 | TotalAmt |
| Program Services | $4,629,932 | ProgramServicesAmt |
| Management And General | $1,305,878 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,872,192 | TotalAmt |
| Program Services | $1,460,310 | ProgramServicesAmt |
| Management And General | $411,882 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,969,784 | TotalAmt |
| Program Services | $14,796,432 | ProgramServicesAmt |
| Management And General | $4,173,352 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,866 | TotalAmt |
| Program Services | $20,175 | ProgramServicesAmt |
| Management And General | $5,691 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,429,880 | TotalAmt |
| Program Services | $1,115,306 | ProgramServicesAmt |
| Management And General | $314,574 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $421 | TotalAmt |
| Program Services | $328 | ProgramServicesAmt |
| Management And General | $93 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $246,196 | TotalAmt |
| Program Services | $192,033 | ProgramServicesAmt |
| Management And General | $54,163 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,066 | TotalAmt |
| Program Services | $10,971 | ProgramServicesAmt |
| Management And General | $3,095 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,536 | TotalAmt |
| Program Services | $1,978 | ProgramServicesAmt |
| Management And General | $558 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,540 | TotalAmt |
| Program Services | $5,101 | ProgramServicesAmt |
| Management And General | $1,439 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,054,532 | TotalAmt |
| Program Services | $1,602,535 | ProgramServicesAmt |
| Management And General | $451,997 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,700,230 | TotalAmt |
| Program Services | $2,886,179 | ProgramServicesAmt |
| Management And General | $814,051 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $803,235 | TotalAmt |
| Program Services | $626,523 | ProgramServicesAmt |
| Management And General | $176,712 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $17,735,676 | $13,833,827 | $3,901,849 |
| Outside Services | $13,771,149 | $10,741,496 | $3,029,653 |
| Licenses/ Fees | $1,369,798 | $1,068,442 | $301,356 |
| Repair & Maintenance | $1,325,300 | $1,033,734 | $291,566 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $806,110 | TotalAmt |
| Program Services | $628,766 | ProgramServicesAmt |
| Management And General | $177,344 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,347,591 | TotalAmt |
| Program Services | $74,393,119 | ProgramServicesAmt |
| Management And General | $20,954,472 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,230 | BOYAmt |
| EOY | $1,480 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,150,941 | BOYAmt |
| EOY | $6,175,186 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,975,893 | BOYAmt |
| EOY | $15,065,484 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,494,437 | BOYAmt |
| EOY | $18,383,935 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,459,235 | BOYAmt |
| EOY | $1,459,235 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,261,700 | BOYAmt |
| EOY | $1,196,904 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $80,900,326 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $39,943,967 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,144,170 | BOYAmt |
| EOY | $40,956,359 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,728,779 | BOYAmt |
| EOY | $244,261 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,216,385 | BOYAmt |
| EOY | $83,482,844 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,739,618 | BOYAmt |
| EOY | $5,891,307 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | -$419,665 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,844,571 | BOYAmt |
| EOY | $59,710,272 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,086,785 | BOYAmt |
| EOY | $5,345,039 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,670,974 | BOYAmt |
| EOY | $70,526,953 | 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 | $13,519,658 | BOYAmt |
| EOY | $12,920,104 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,753 | BOYAmt |
| EOY | $35,787 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,545,411 | BOYAmt |
| EOY | $12,955,891 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,216,385 | BOYAmt |
| EOY | $83,482,844 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $10,900,445 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$11,489,965 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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 D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $25,753 | BeginningYearBalanceAmt |
| Contributions | $21,794 | ContributionsAmt |
| Other Expenditures | $11,760 | OtherExpendituresAmt |
| End Year Balance | $35,787 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $16,063 | BeginningYearBalanceAmt |
| Contributions | $9,690 | ContributionsAmt |
| End Year Balance | $25,753 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | $16,063 | ContributionsAmt |
| End Year Balance | $16,063 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $142,575 | BeginningYearBalanceAmt |
| Contributions | -$142,575 | ContributionsAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $109,752 | BeginningYearBalanceAmt |
| Contributions | $32,823 | ContributionsAmt |
| End Year Balance | $142,575 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | false | RelatedOrgListSchRInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $54,672,948 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,258,266 | DepreciationAmt |
| Book Value | $35,414,682 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,048,225 | OtherCostOrOtherBasisAmt |
| Depreciation | $811,453 | DepreciationAmt |
| Book Value | $1,236,772 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,176,396 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,874,248 | DepreciationAmt |
| Book Value | $4,302,148 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,757 | OtherCostOrOtherBasisAmt |
| Book Value | $2,757 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $40,956,359 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Other Liabilities | $5,345,038 |
| Rounding | $1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,345,039 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $106,248,036 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $106,248,036 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $106,248,036 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $83,847,591 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $83,847,591 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $11,500,000 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $11,500,000 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $95,347,591 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: Intended uses of the endowment fund. | The funds were used to improve the health and welfare of the residents of York and Adams counties of Pennsylvania. |
| Part X : FIN48 Footnote | 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, 2021. |
| Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S | Revenue netted with expenses $0 Grant to WellSpan Health $11500000 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 8 | PersonsServedCnt |
| Total Community Benefit Expns | $90,364 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $90,364 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 986 | PersonsServedCnt |
| Total Community Benefit Expns | $13,504,517 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,900,031 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,604,486 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07980 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 994 | PersonsServedCnt |
| Total Community Benefit Expns | $13,594,881 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,900,031 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,694,850 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08070 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 415 | PersonsServedCnt |
| Total Community Benefit Expns | $14,268 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,268 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $183,854 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $183,854 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 415 | PersonsServedCnt |
| Total Community Benefit Expns | $198,122 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $198,122 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 1409 | PersonsServedCnt |
| Total Community Benefit Expns | $13,793,003 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,900,031 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,892,972 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08270 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $100,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $100,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 30 | PersonsServedCnt |
| Total Community Benefit Expns | $178,693 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $178,693 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 30 | PersonsServedCnt |
| Total Community Benefit Expns | $278,693 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $278,693 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00290 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,091,762 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $17,250 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $30,995,217 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $33,073,801 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,078,584 | 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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | 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 | WS Surgery & Rehab Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 Monument Road | AddressLine1Txt |
| City | York | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17403 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.wellspan.org | WebsiteAddressTxt |
| State License | 22750101 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Other | Ortho/Neuro/Plastic Surgery/Rehab | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WS Surgery & Rehab Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.wellspan.org | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | www.healthyyork.org | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.wellspan.org | StrategyWebsiteURLTxt |
| Strategy Attached | Yes (true) | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.0000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350.0000 | 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 (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | 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 (true) | 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 (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | 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 | false | NondisEmergencyCarePolicyInd |
| No Emergency Care | Yes (X) | NoEmergencyCareInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Facility: WS Surgery & Rehab Hospital - 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. The Healthy York County Coalition (HYCC)- a local health coalition representing the diversity of the community- has led each of the seven CHNAs that have been conducted. For the 2018 CHNA, HYCC partnered with its sister health coalition in Adams County- Healthy Adams County- to form a CHNA Planning Committee comprised of representatives from health and human service agencies, government entities, community-based organizations, higher education institutions, and other interested community members to assist with survey development, data review and analysis, and results distribution. This core committee also assisted with sharing the data and association community health priorities, once identified by Coalition leadership, to community members at a public forum on June 7th, 2018. WellSpan Health and its entities, including WellSpan Surgery and Rehabilitation Hospital, is a funding partner and governance leader within Healthy York County Coalition and served on the CHNA Planning committee. In that regard, WellSpan Surgery & Rehabilitation Hospital partners to conduct the CHNA, disseminate its results both among hospital leadership and in the community, and integrates evidence-based strategies that impact identified community health needs into its annual planning process. Whether in meetings with community stakeholders or system/ hospital leaders or at larger public forum, WellSpan- Surgery & Rehabilitation Hospital is committed to obtaining community input to ensure that the CHNA and its associated implementation strategies appropriately address the identified needs of the entire community. Additional details of how community members were engaged is included in Part V1- Needs Assessment. |
| Facility: WS Surgery & Rehab Hospital - Part V, Section B, Line 6a | WellSpan Ephrata Community Hospital (Lancaster); WellSpan The Good Samaritan Hospital of Lebanon Pennsylvania (Lebanon); WellSpan York Hospital, and WellSpan Gettysburg Hospital (Adams). Outside of WellSpan Health, UPMC Pinnacle Memorial and UPMC Pinnacle Hanover engaged in the CHNA process for York and Adams counties. |
| Facility: WS Surgery & Rehab Hospital - Part V, Section B, Line 7d | With each iteration of the CHNA process, WellSpan Health, its entities (WellSpan Surgery & Rehabilitation Hospital), and its community partners continue to refine and enhance the system by which it obtains data, shared it with key community, hospital and system leaders, and integrated it into the system-wide and entity-level planning processes. In 2018, the CHNA results and related priorities identified by Healthy York County Coalition were shared with the system-wide Planning Committee and WellSpan Health. This committee is comprised of community members and leader that represent each of WellSpans primary entities and service areas, in addition to corporate leadership. Planning Committee members reviewed the CHNA data and designated system-wide priorities as: Care for all, including a focus on access to care and health equity; Behavioral health and lifelong wellness, which would incorporate behavioral health, substance use and addiction and lifelong wellness, and healthy communities and social determinants of health, which provide a deeper dive into community engagement, social determinants of health and violence prevention. These priorities and associated data were subsequently presented to the WellSpan Specialty Services Board, which is the governing body for the WellSpan Surgery & Rehabilitation Hospital, for their adoption. Additionally, the CHNA data was presented to multiple members of WellSpans leadership team. Similarly, Healthy York County Coalition selected adult overweight and obesity, depression, and the social determinants of health as priorities- these priorities built on previously developed strategies that were a result of the 2015 CHNA and also encourage a deeper dive into the WellSpan system-wide, organizational priorities. Healthy York County Coalition communicated the CHNA results and identified priorities to more than 100 community members at a public forum held on June 7, 2018. During that forum, community members discussed the opportunities and risk associated with each priority, as well as how the organization which they represent can have an impact on the priority. In addition to these venues, CHNA results are available on the Healthy York County Coalition wwwhealthyyork.org and WellSpan Health www.wellspan.org websites and may also be obtained upon request. The corresponding WellSpan Community Health Improvement Plan is also available on the WellSpan Health website. |
| Facility: WS Surgery & Rehab Hospital - Part V, Section B, Line 11 | See attached 2019 WellSpan Health Community Health Improvement Plan, also available online at www.wellspan.org in Community Benefits section. |
| Facility: WS Surgery & Rehab Hospital - 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 Pennsylvanias 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 example, if a patients income is less than 300 percent of the federal poverty level, that patient would be eligible for a 100 percent discount on the services provided. Additionally, significant discounts are available for patients whose income is between 300 percent and 350 percent of the federal poverty level. For more information on WellSpans Financial Assistance program, visit www.WellSpan.org/FinancialAssistance. |
| Facility: WS Surgery & Rehab Hospital - 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, 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 Financial Assistance Policy on its billing statements and included information in patient discharge materials. In addition, the materials and information are easily accessible via WellSpans website at www.WellSpan.org/FinancialAssistance. The site reflects WellSpans newly enhanced policy, as well as informational and application materials. It was also publicized via WellSpans on-hold phone messaging system and in its direct-to-consumer community newsletter/magazine, which is distributed by mail, email and Web. In addition, WellSpan placed posters and signage at its various sites of care to publicize its Financial Assistance Policy. Printed copies of WellSpan Healths entire financial assistance 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 Financial Assistance Policy Plain Language Summary are all available in Spanish. |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) | Patients 401% of poverty level and greater do not qualify for financial assistance. Patients/guarantors who complete an application for Financial Assistance whose gross income falls between 351-400% of the FPL level and meet all other Financial Assistance qualifications (MAP 118) will be eligible for a 40% discount of self-pay balances. |
| Part I, Line 6a - Related Organization Community Benefit Report | Community Benefit Information is included in the Community Benefit Report for WellSpan Health located at www.wellspan.org. |
| Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense | 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 - Methodology of Estimated Amount & Rationale for Including in Community Benefit | 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 - Bad Debt Expense | The Company 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 - Explanation Of Shortfall As Community Benefit | WellSpan Surgery and Rehabilitation Hospital (WSRH) maintains records to identify and monitor the level of charity care and community service it provides. These records include the amount of charges forgone based on established rates for services and supplies furnished under its charity care and community service policies and the estimated cost of these services. Payments from Medicare are generally less than WSRH's costs of providing the service. |
| Part III, Line 9b - Provisions On Collection Practices For Qualified Patients | 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 - Needs Assessment | WellSpan Health and its entities have a long history of understanding and responding to the needs of the communities and populations it serves. This commitment was strengthened in 1998 when, in partnership with the Healthy York County Coalition, WellSpan conducted its first Community Health Needs Assessment (CHNA). Six subsequent CHNAs were conducted in 2000, 2005, 2008, 2012, 2015 and 2018. These assessments- one method for collecting diverse information on a community and which involves surveying a representative sample of community members on their demographics, chronic health conditions, lifestyle behaviors, finances, access to health services, and related topics- have been administered before the Affordable Care Act (ACA) requirement. As previously noted, the WellSpan CHNA process, which includes survey development, data collection and analysis, and result dissemination, was led by both county-level health coalitions- Healthy Adams County and the Healthy York County Coalition- for Adams and York Counties. A similar process was utilized for the remaining counties of the WellSpan service area, including northern Lancaster and Lebanon counties. Healthy Adams County, Healthy York County Coalition, and its regional partner the Community Health Council of Lebanon County receive financial support from WellSpan Health and its entities, and other community stakeholders. The CHNA was developed utilizing consulting support and guidance through a contract with the Floyd Institute for Public Policy at Franklin and Marshall College. Dr. Berwood Yost, Institute Director and Project Lead has an extensive background conducting and analyzing community and corporate surveys and has been integral to the prior three CHNAs (2008, 2012 and 2015). The 2018 Adams and York CHNA is a byproduct of a collaboration of community organizations who partnered to provide guidance and support to the effort, including: County of York, Family First Health; Gettysburg College; UPMC Pinnacle Hanover; UPMC Pinnacle Memorial; York County Human Services; South Central Community Action Program (SCCAP); TrueNorth Wellness Services; United Way of York County; York City Health Bureau; York College of Pennsylvania, and York County Community Foundation. This collaboration of community stakeholders determined the survey questions to be asked of the community; discussed data collection methodology, including sample size and method of obtaining data; reviewed the raw data and supporting charts/ graphs; identified potential community health priorities, and developed the process by which the results and priorities were to be shared with the community. The 2018 CHNA planning process engaged a wide range of community organizations serving the diverse interests of all partners. The intent of the CHNA was to collect adequate valuable data and information that would satisfy the needs of all participating organizations, without burdening CHNA respondents with too many questions. Committee members reviewed questions asked in the 2015 CHNA and edited accordingly based on the current health care environment and areas of interest. Survey questions were derived from the Behavioral Risk Factor Surveillance System (BRFSS), a validated survey tool utilized by the Centers for Disease Control and Prevention (CDC), and organized into four categories: healthcare access, behavioral risk, health conditions and prevention behaviors and context. A representative sample of 799 adult residents in York County were interviewed between December 4, 2017, and February 25, 2018. Supplemental secondary data from the Robert Wood Johnson Foundation (RWJF) annual County Health Rankings and from the Pennsylvania Department of Health was compiled and integrated into the 2018 CHNA. Data collected and analyzed by the Floyd Institute for Public Policy included breakdowns by age, gender, geographic area, race/ethnicity, and income level, and enabled the development of charts/ graphs that identified: trends and disparities; quantity of residents affected; health risks and disability-adjusted life years, and social determinants of health impact. This information is included in the 2018 Community Health Needs Assessment Summary Report available at www.wellspan.org. CHNA results and related priorities identified by Healthy York County Coalition were shared with the system-wide Planning Committee at WellSpan Health, a committee comprised of community members and leaders that represent each of WellSpans primary entities and service areas, in addition to corporate leadership. Planning Committee members reviewed the CHNA data, and designated system-wide priorities as: Care for all, including a focus on access to care and health equity; Behavioral health and lifelong wellness, which would incorporate behavioral health, substance use and addiction and lifelong wellness, and; healthy communities and social determinants of health, which provide a deeper dive into community engagement, social determinants of health and violence prevention. The identified priorities and associated data were subsequently presented to the WellSpan Specialty Services Board, the governing body for WellSpan Surgery & Rehabilitation Hospital, for their adoption. Board members discussed the data and identified priorities within the context of existing staffing and financial resources, current and future entity initiatives, and community partnership opportunities to address systemic community change. The final CHNA report, along with the WellSpan Community Health Improvement Plan (CHIP) was presented in June 2019 to the Planning Committee, at which time correlations were observed between the CHNA, CHIP and the WellSpan 2025 Strategic Plan. |
| Part VI, Line 5 - Promotion of Community Health | As a charitable, community-based healthcare organization, our commitment to improving the lives and well-being of the 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 2018 CHNA - access to care and health equity, behavioral health, substance use and addiction, and lifelong wellness, and community engagement, social determinants of health and violence prevention. Below are a few examples of the work accomplished to address each: *Access to healthcare and medications for uninsured community members or those with high out-of-pocket costs is often financially challenging. Healthy Community Network, a collaborative between WellSpan Health, physicians and community partners to support prospective enrollment, the management and support of patients, and coordination of care, serves as a support for those individuals, offering free or discounted resources based on need. In 2021, Healthy Community Network served 2,221 community members in need of care across the region and provided financial assistance for nearly 16,000 prescriptions, allowing individuals who lack sufficient health insurance or financial means to access the medications they need.*WellSpan remains committed to the strong safety net of partnering health care services in our region. Together, we demonstrate strong community impact in health. For example, WellSpans support of both the Family First Health Hannah Penn Center and Katallasso Family Health Center enhanced its ability to provide 4,365 acute and preventive visits for underserved adults and children.*In 2021, WellSpan Health encouraged community members, local employers and employees, and WellSpan staff and patients to engage in the 8th annual 10 Pound Throwdown initiative. The 10 Pound Throwdown is a 10-week community challenge that encourages participants to lose or maintain a healthy weight through healthier eating and increased physical activity. The initiative was created in 2013 to address the growing issue of adult overweight/obesity and utilizes a core website (www.10poundthrowdown.com) to encourage team participation and to offer an online weight tracker, badges to encourage healthier choices, and diverse health education resources. The 10 Pound Throwdown engaged 7,200 community members across four southcentral Pennsylvania counties -Adams, Franklin, Lancaster, Lebanon, and York- participated in the 2021 iteration of the 10 Pound Throwdown program. *Opioid use, as in other communities across the United States, has become a crisis in York County. WellSpan remains a steadfast partner in advancing work in this area. In 2021, we actively supported the York Opioid Collaborative by helping to solicit funds and participating in the Public Health, Safety, and Data teams. WellSpan admitted 667 patients into a Medication Assisted Treatment (MAT) program, which combines the use of medications and behavioral therapy to treat people with substance use disorders. *Historically, WellSpan Health and its entities have taken planned steps to build community capacity that addresses complex health issues, as identified by the Community Health Needs Assessment (CHNA). Through financial and management support of a county health coalition, the Healthy York County Coalition (HYCC), more than 200 York County community members have been engaged in community health improvement initiatives. HYCC consists of three committees -Access and Empowerment; Community Engagement, and Prevention and Wellness, each of which continue to attract new community members, leaders, and professionals. These committees foster partnerships and collaboration between entities to ensure that efforts to address and impact identified community health needs are coordinated and successful. In 2021, the Healthy York County Coalition engaged community members around the advancement of public health infrastructure and a coordinated COVID-19 response. *WellSpan Health maintains its commitment to supporting local non-projects with Community Partnership Grant funds to like-minded nonprofit organizations to address key issues and health priorities. In 2021, WellSpan Community Partnership grants supported the following organizations serving York County: ARC of York County, Crispus Attucks Association, SpiriTrust Lutheran, and Friends and Neighbors of Pennsylvania. In addition, nearly $200,000 was awarded to 19 community-based agencies across the region in response to mitigating COVID-19 spread in the community.*WellSpan Health staff members and leadership from the WellSpan Surgery & Rehabilitation Hospital maintain a commitment to caring for patients and family members whether they are in their care facility or in the community. Support groups for traumatic brain injury patients and families throughout the region are offered regularly, along with spinal cord injury and amputee support groups. The 2021 WellSpan Community Benefit Report shares additional stories and details about the impact that WellSpan Health and its entities continue to have among the populations it serves. Whether by leading community collaboratives, such as Safe Kids York County, to prevent pediatric injuries to the allocation of community partnership grant grants to support local organizations with shared health-related goals to training healthcare providers of the future, WellSpan Surgery & Rehabilitation Hospital is committed to improving the health and well-being of those living or working in York County and the surrounding region.Additional examples of how WellSpan Surgery & Rehabilitation Hospital fulfilled its community mission in the York area may be found in the 2021 WellSpan Community Benefit Report available online at https://www.wellspancommunity.org/2021-community-benefit-report. |
| Part VI, Line 6 - Affilated Health Care System | 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. WellSpan Surgery & Rehabilitation Hospital works with other parts of the system to provide a comprehensive approach to meeting community needs.WellSpan Health includes: WellSpan Gettysburg Hospital, WellSpan York Hospital, WellSpan Surgery and Rehabilitation Hospital, WellSpan Ephrata Community Hospital, WellSpan The Good Samaritan Hospital of Lebanon Pennsylvania, WellSpan Philhaven, Chambersburg Hospital, Waynesboro Hospital, Apple Hill Surgical Center, Summit Surgery Center, WellSpan VNA Home Health, WellSpan Medical Group, Northern Lancaster County Medical Group, Physician Specialists of Northern Lancaster County Medical Group, Good Samaritan Physician Services, Summit Physician Services, Chambersburg Health Services, WellSpan Population Health Services, WellSpan Pharmacy, Gettysburg Hospital Foundation, York Health Foundation, Ephrata Community Health Foundation, Good Samaritan Health Services Foundation, Summit Health Foundation, WellSpan Summit Health, WellSpan Provider Network, GSH Services, and WellSpan Medical Equipment.WellSpan Specialty Services' community benefit report is contained in a report prepared by their parent organization, WellSpan Health. See WellSpan Health - 2021 Community Benefit Report located at www.wellspan.org |
| Part VI, Line 7 - States Filing of Community Benefit Report | PA |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WellSpan Health | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2767 | AddressLine1Txt |
| City | York | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17405 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 222517863 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $11,500,000 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | Community health | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Grantmaker's Description of How Grants are Used | FormAndLineReferenceDesc |
| Explanation | All WellSpan entities follow WellSpan policies and procedures regarding grant projects to ensure that the use of grant funds are consistent with WellSpan's commitment to endeavor to improve the health status of the communities that we serve.The WellSpan foundations are supporting organizations and substantially all of the grants and other assistance they make furthers the exempt purposes of their "supported organizations", each of which are exempt affiliated organizations within the WellSpan Health system. Because the supported organizations identify the projects and exempt activities that will be funded by the foundations' grants and other assistance, and because there is a cross-over between the respective governing bodies and management of the foundations and their supported organizations, the foundations are able to effectively monitor that the grants they make are used for their intended purposes. | 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 | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Barbara Yarrish | |||||||||||||
| Former Director | $1,780 | $372,275 | $219 | $38,222 | $412,496 | ||||||||
| Carol Smith | |||||||||||||
| Vice President | $199,072 | $38,509 | $4,073 | $8,269 | $40,601 | $290,524 | |||||||
| Darci Wolf | |||||||||||||
| Dir-Clinical | $136,382 | $11,824 | $2,715 | $6,037 | $42,099 | $199,057 | |||||||
| Elizabeth Trumble | |||||||||||||
| Dir-I/P Rehab | $138,951 | $14,356 | $75 | $6,013 | $36,708 | $196,103 | |||||||
| Jennifer Green | |||||||||||||
| Nurse Manager | $117,125 | $7,316 | $2,505 | $5,116 | $33,814 | $165,876 | |||||||
| Lee Maddox MD | |||||||||||||
| Director | $483,698 | $12,058 | $49,453 | $557,724 | $12,515 | ||||||||
| Lorrie Monoski | |||||||||||||
| Dir - Clinical Svc | $122,922 | $10,970 | $2,519 | $5,455 | $41,755 | $183,621 | |||||||
| Michael O'Connor | |||||||||||||
| Former Director | $611,969 | $2,042,231 | $123,405 | $85,586 | $3,267,878 | $404,687 | $2,042,158 | ||||||
| Mike Seim | |||||||||||||
| Sr VP | $438,755 | $22,903 | $7,015 | $37,511 | $558,984 | $52,800 | $18,133 | ||||||
| Rosa Hickey | |||||||||||||
| Sr. Dir. Pat. Care | $183,268 | $16,468 | $3,125 | $9,684 | $40,956 | $253,501 | |||||||
| Roxanna Gapstur | |||||||||||||
| CEO-WSH/Dir. | $1,091,608 | $11,619 | $60,941 | $1,604,168 | $440,000 | $242,000 | |||||||
| Victoria Diamond | |||||||||||||
| Sr VP | $431,563 | $11,619 | $57,661 | $628,093 | $127,250 | $41,645 | |||||||
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | See Schedule O | BusinessNameLine1Txt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | Barry Douglas is a director on WellSpan Surgery and Rehabilitation Hospital board. His wife, Wanda Major is a director on the York Health Foundation board. |
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | WellSpan Health is the sole member of WellSpan Surgery & Rehabilitation Hospital. |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | The Board of Directors shall be composed of at least twelve persons, at least seventy-five percent of whom shall not be employed by the Corporation or any entity affiliated with either the Corporation or WellSpan. The appointment of the Directors shall be subject to the ratification by WellSpan. |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | Except as specifically reserved to the member by law, the Articles of Incorporation, or the Bylaws, all rights of member(s) as set forth under the Nonprofit Corporation Law of 1988 are assumed by the Board of Directors. The business and affairs of and the responsibility and authority for governing the Corporation shall be vested in the Board of Directors.Notwithstanding the foregoing paragraph, the authority of the Board of Directors to exercise the following powers is subject to the ratification of the Board of Directors of WellSpan. (a) the adoption of operating, personnel and capital budgets: (b) any voluntary dissolution, merger, or consolidation of the Corporation or the sale or transfer of all or substantially all of the Corporation's assets or the creation or acquisition of any subsidiary or affiliate corporation of the Corporation; (c) the borrowing of any sum which has a stated term greater than one year or which is secured by a security interest in the Corporation's assets or revenues or by a mortgage of all or any part of the Corporation's real property, if any; (d) the adoption of a strategic plan for the Corporation; and (e) the adoption, amendment, revocation of these Bylaws or the Articles of Incorporation. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | 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, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Officers, directors, and key employees fill out a WellSpan Health Conflict of Interest Disclosure Statement questionnaire annually. The questionnaire is administered by the Internal Audit Department of WellSpan Health, the Parent Company.There shall be full disclosure by any 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. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | The Compensation Committee of WellSpan Health is responsible for rewarding and reinforcing key executives for the achievement of annual and long-term performance objectives. The Compensation Committee shall consist of not more than six (6) persons, of whom two (2) shall be the Chairman and Vice Chairman of the Board of the Corporation, and the remaining members shall be such other persons as may be appointed by the Chairman of the Board of the Corporation, with the approval of the Board of Directors; provided, however, that the Compensation Committee shall not include any persons who are employed by the System. The role of the Compensation Committee is to set the Executive Compensation Philosophy for the system and ensure adherence, evaluate performance and establish compensation for the WellSpan President, evaluate team performance of the executive team and establish awards, review and approve senior executive base salary ranges, and oversee employed physician compensation programs. The Committee will approve salary ranges for each executive position and review incumbent salaries annually. The Committee will be responsible for reviewing the President's salary each year, and if warranted, authorizing an adjustment to maintain competitiveness. The President will have the authority to make salary adjustments for subordinate positions. The Committee is responsible for approving and authorizing payment of the performance awards. The Committee will approve and authorize payment of the President's performance awards. Integrated Healthcare Strategies, Inc., based in Minneapolis Minnesota is the external consultant to the committee. This consultant focuses exclusively on executive and physician compensation in the health care industry. In summary, the executive and physician compensation review process consists of the following: 1) Cash compensation reviewed annually 2) Cash compensation reviewed by external consultant biennially 3) external total compensation (cash, incentives, benefits, perquisites) reviewed by external consultant periodically 4) Process is integrated with compensation analysis for other WellSpan positions 5) Committee decisions are documented in minutes maintained in Human Resources. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Governing documents, policies, and financial statements are available upon request. |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Restricted assets released = $10035 |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Transfer to WellSpan Health = -$11500000 |
| Schedule K -Tax-Exempt Bonds | 1.2014 GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA REVENUE REFUNDING BONDS, SERIES A:On November 11, 2014, the General Authority of Southcentral Pennsylvania issued $213,430,000 of Revenue Refunding bonds, Series 2014A for WellSpan Health Obligated Group. The purpose of this bond issue was revenue refund for bonds issued 06/23/1993 and 11/12/2008. WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to York Hospital (23-1352222), Gettysburg Hospital (23-1352220), WellSpan Properties (22-2842252), WellSpan Surgery & Rehabilitation Hospital (23-2899911), and Ephrata Community Hospital (23-1370484). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K. As of 6/30/21, the allocation of the Debt Capital program including issue premium of $47,545,967 was as follows:York Hospital: $27,890,452Gettysburg Hospital: $1,922,543WellSpan Properties: $6,845,852WellSpan Surgery & Rehabilitation Hospital: $3,377,167Ephrata Community Hospital: $7,509,953These amounts are reported on the respective balance sheets for each of these entities.An Arbitrage Rebate and Yield Restriction Liability Calculation was performed for the period of November 10, 2014, to November 10, 2019. No rebate was due._______________________________________________________________________________2.2015 LANCASTER MUNICIPAL AUTHORITY BANK LOAN, SERIES A:On May 22, 2015, the Lancaster Municipal Authority issued $36,572,083 of Revenue Refunding bonds, Series 2015A, to an Obligated Group consisting of York Hospital, Gettysburg Hospital and Ephrata Community Hospital. The purpose of this bond issue was to refund bonds issued on behalf of Ephrata Community Hospital, including the Lancaster Municipal Authority Revenue Notes Series 2009, 2010A, 2012, and 2013. To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K.As of 6/30/21, the $27,600,768 of outstanding liability is reported on the Ephrata Community Hospital return balance sheet._______________________________________________________________________________3.2019 GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA REVENUE REFUNDING BONDS, SERIES A & B:On April 19, 2019, the General Authority of Southcentral Pennsylvania issued $331,502,627 of Revenue Refunding bonds, Series 2019A and 2019B for WellSpan Health Obligated Group. The purpose of this bond issue was revenue refund for bonds issued 11/12/2008. WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to York Hospital (23-1352222), Chambersburg Hospital (23-0465970), WellSpan Properties (22-2842252), Chambersburg Health Services (25-1515376), The Good Samaritan Hospital of Lebanon Pennsylvania (23-1794160), Waynesboro Hospital (23-1360854), Summit Physician Services (25-1716306), Gettysburg Hospital (23-1352220), WellSpan Surgery & Rehabilitation Hospital (23-2899911) and Ephrata Community Hospital (23-1370484). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K. As of 6/30/21, the allocation of the Debt Capital program of $324,770,019 was as follows:York Hospital: $109,820,502Waynesboro Hospital: $455,712Chambersburg Hospital: $110,975,751Chambersburg Health Services: $18,656,026Summit Physician Services: $983,590WellSpan Properties: $66,683,198Gettysburg Hospital: $12,384,727Ephrata Community Hospital: $3,372,694The Good Samaritan Hospital of Lebanon Pennsylvania: $42,216WellSpan Surgery & Rehabilitation Hospital: $1,395,603These amounts are reported on the respective balance sheets for each of these entities._______________________________________________________________________________4.2019 GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA REVENUE REFUNDING BONDS, SERIES C-E:On April 3, 2019, the General Authority of Southcentral Pennsylvania issued $212,690,000 of Revenue Refunding bonds Series 2019C, 2019D and 2019E for WellSpan Health Obligated Group. The purpose of this bond issue was revenue refund for bonds issued 11/12/2008. WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to York Hospital (23-1352222), Gettysburg Hospital (23-1352220), WellSpan Properties (22-2842252), WellSpan Surgery & Rehabilitation Hospital (23-2899911), The Good Samaritan Hospital of Lebanon Pennsylvania (23-1794160) and WellSpan Health (22-2517863). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K. As of 6/30/21, the allocation of the Debt Capital program of $212,690,000 was as follows: York Hospital: $123,530,352Gettysburg Hospital: $19,290,983WellSpan Properties: $22,545,140WellSpan Surgery & Rehabilitation Hospital: $35,731,920The Good Samaritan Hospital of Lebanon Pennsylvania: $1,722,789WellSpan Health: $9,868,816These amounts are reported on the respective balance sheets for each of these entities._______________________________________________________________________________5.2014 FRANKLIN COUNTY INDUSTIAL AUTHORITY REVENUE REFUNDING BONDS, SERIES A & C:On April 30, 2014, the Franklin County Industrial Authority issued $35,795,000 of Healthcare Revenue Refunding bonds, Series 2014A & 2014C for the WellSpan Health Obligated Group. WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to Waynesboro Hospital (23-1360854), Chambersburg Hospital (23-0465970) and Chambersburg Health Services (25-1515376). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K.As of 6/30/21, the allocation of the Debt Capital program of $25,493,770 was as follows: Waynesboro Hospital: $6,390,449Chambersburg Hospital: $18,577,321Chambersburg Health Services: $526,000These amounts are reported on the respective balance sheets for each of these entities.______________________________________________________________________________6.2017 BANK LOANS / REISSUE BONDS ISSUED 11/12/2008:On March 13, 2018, the General Authority of Southcentral Pennsylvania issued $34,877,000 of Revenue bonds, Series 2017A Notes (taxable) for WellSpan Health Obligated Group. Such notes were applied to refund 2008A Bonds. Also, on September 4, 2018, the General Authority of Southcentral Pennsylvania issued $29,312,000 of Revenue Bonds, Series 2017B (tax-exempt bonds) for WellSpan Health Obligated Group.Such notes were applied to refund 2008A Bonds.WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to York Hospital (23-1352222), Gettysburg Hospital (23-1352220), WellSpan Properties (22-2842252), WellSpan Surgery & Rehabilitation Hospital (23-2899911), and The Good Samaritan Hospital of Lebanon Pennsylvania (23-1794160). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K.As of 6/30/21, the allocation of the Debt Capital program of $50,807,000 was as follows: York Hospital: $29,508,705Gettysburg Hospital: $4,608,195WellSpan Properties: $5,385,542WellSpan Surgery & Rehabilitation Hospital: $8,535,576The Good Samaritan Hospital of Lebanon Pennsylvania: $411,536WellSpan Health: $2,357,446These amounts are reported on the respective balance sheets for each of these entities. |
| Signature Box - Paid Preparer Explanation | Paid Preparer ExplanationDue to a software limitation, we wish to clarify that WellSpan Health is the ERO.The paid preparer is:BDO USA, LLP13-53815908401 Greensboro Drive, Suite 800McLean, VA 22102(703) 893-0600The preparers name is Marc Berger, PTIN P01871563 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Apple Hill Surgical Center Inc | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 222842253 | Sole GP in limited ptnrshp. operating surgical center | PA | 501(c)(3) | 10 | WellSpan Health Care Services | false |
| Gettysburg Hospital | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 231352220 | Health Care Services | PA | 501(c)(3) | 3 | WellSpan Health | false |
| Gettysburg Hospital Foundation | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232251358 | Fundraising for Gettysburg Hospital | PA | 501(c)(3) | 12 Type I | Gettysburg Hospital | false |
| Healthy Community Pharmacy | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 200519121 | Reduced rate prescription drugs to uninsured | PA | 501(c)(3) | 12 Type I | WellSpan Health Care Services | false |
| VNA Community Services | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232338591 | Home personal care services for elderly and disabled | PA | 501(c)(3) | 10 | WellSpan Surgery & Rehab Hospital | Yes (true) |
| VNA Home Health Services | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 231352573 | Home health services | PA | 501(c)(3) | 10 | WellSpan Surgery & Rehab Hospital | Yes (true) |
| WellSpan Health | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 222517863 | Integrated Health System | PA | 501(c)(3) | 12 Type III | NA | false |
| WellSpan Health Care Services | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232400237 | Health-related activities in the service area | PA | 501(c)(3) | 12 Type II | WellSpan Health | false |
| WellSpan Medical Group | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232730785 | Medical and surgical care | PA | 501(c)(3) | 10 | WellSpan Health | false |
| York Health Foundation | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 233050192 | Charitable contributions for WellSpan entities | PA | 501(c)(3) | 12 Type III | WellSpan Health | false |
| York Hospital | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 231352222 | Community teaching hospital | PA | 501(c)(3) | 3 | WellSpan Health | false |
| WellSpan Properties | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 222842252 | Leases facilities to affiliates | PA | 501(c)(3) | 12 Type II | WellSpan Health Care Services | false |
| Ephrata Community Hospital | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 231370484 | Health care services | PA | 501(c)(3) | 3 | WellSpan Health | false |
| Ephrata Community Hospital Foundation | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 800940005 | Fundraising for Ephrata Hospital | PA | 501(c)(3) | 12 Type I | Ephrata Community Hospital | false |
| Northern Lancaster County Medical Group | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 203033058 | Medical and surgical care | PA | 501(c)(3) | 12 Type II | Ephrata Community Hospital | false |
| Phys Spec of North Lanc Co Med Gr | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 452537633 | Physician Practices | PA | 501(c)(3) | 12 Type II | Northern Lancaster County Medical Group | false |
| Good Samaritan Hosptial | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 230794160 | Health Care Services | PA | 501(c)(3) | 3 | WellSpan Health | false |
| Philhaven | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 231549922 | Health Care Services | PA | 501(c)(3) | 3 | WellSpan Health | false |
| Good Samaritan Health Service Foundation | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232356151 | Fundraising for Good Samaritan | PA | 501(c)(3) | 12 Type I | Good Samaritan Hospital | false |
| Good Samaritan Phyisican Services | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 251832359 | Medical and Surgical Care | PA | 501(c)(3) | 10 | Good Sam Health Services Foundation | false |
| WellSpan Summit Health | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 251515371 | Integrated health system | PA | 501(c)(3) | 7 | WellSpan Health | false |
| Waynesboro Hospital | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 231360854 | Health care services | PA | 501(c)(3) | 3 | WellSpan Summit Health | false |
| Chambersburg Hospital | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 230465970 | Health care services | PA | 501(c)(3) | 3 | WellSpan Summit Health | false |
| Summit Physician Services | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 251716306 | Medical and surgical care | PA | 501(c)(3) | 3 | WellSpan Summit Health | false |
| 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 | false |
| Chambersburg Health Services | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 251515376 | Health care services | PA | 501(c)(3) | 12 Type I | WellSpan Summit Health | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (8 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 Cn | PA | NA | false | false |
| Central PA Alliance Laboratories LLC | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232910950 | Ref. Lab | PA | NA | false | false |
| Littlestown Health Care Partners | |||||||||
| 300 West King Street | Littlestown | PA | 17340 | 232880464 | Lease facility | PA | NA | false | false |
| Cherry Tree Cancer Center LLP | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232915628 | Radiation | PA | NA | false | false |
| The Rehab Center | |||||||||
| 855 Springdale Drive Suite 20 | Exton | PA | 19341 | 251687903 | Physical Therapy Rehab | PA | NA | false | false |
| Surgery Center Associates | |||||||||
| 785 5th Ave | Chambersburg | PA | 17201 | 251845304 | Physician services | PA | Chambersburg Health | false | false |
| Summit Surgery Center | |||||||||
| 785 5th Ave | Chambersburg | PA | 17201 | 251845303 | Physician services | PA | Chambersburg Health | false | false |
| Cumberland Valley Mobile Services | |||||||||
| 5 S Main St | Sugarloaf | PA | 18249 | 200884014 | Mobile health services | PA | Chambersburg Health | false | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 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 |
|---|---|---|---|---|---|---|---|---|---|
| WellSpan Pharmacy Inc | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232374072 | dispenses Rx & provides IV therapy | PA | NA | C corp | false |
| Wellspan Reciprocal Risk Retention Group | |||||||||
| PO Box 2767 | York | PA | 174052767 | 200048457 | Risk Retention Group | PA | NA | C corp | false |
| York Health Plan | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232664989 | Preferred Provider Organization | PA | NA | C corp | false |
| Wellspan Provider Network | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232907828 | Coord. managed care risk contract. | PA | NA | C corp | false |
| Apple Hill Condominium Association | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232504543 | Condo Mgmt Association | PA | NA | Homeowner Assoc | false |
| North Lanc Co Phys Hosp Alliance | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232421885 | Coord Phys & Hospital | PA | NA | C corp | false |
| GSH Realty Inc | |||||||||
| PO Box 2767 | York | PA | 174052767 | 251832359 | Non-res. real estate | PA | WSH Care Services | C corp | false |
| Ephrata Health Pavilion Condo Assoc | |||||||||
| PO Box 2767 | York | PA | 174052767 | 475367279 | Condo association | PA | Ephrata Hospital | C corp | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| WellSpan Health | ||
| b | $11,500,000 | General Ledger |
| York Health Foundation | ||
| c | $8,067 | General Ledger |