THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA (EIN 23-0794160)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-13
- IRS object ID
- 202221339349306837
- 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 C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-13T12:35:22-07:00 | 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 | 230794160 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE GOOD SAMARITAN HOSPITAL OF LEBANON | BusinessNameLine1Txt |
| Business Name Line2 | PENNSYLVANIA | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GOOD | BusinessNameControlTxt |
| Phone | 7178513055 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2767 | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 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 | $305,796,101 | 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 | 1891 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | The Good Samaritan Hospital is a tax-exempt organization dedicated to providing high-quality, compassionate healthcare that improves the overall health of the community. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 1271 | TotalEmployeeCnt |
| Total Volunteers | 442 | TotalVolunteersCnt |
| Total Gross UBI | $1,065,710 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $92,023 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $10,748,142 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,961,735 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $216,533,942 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $236,390,562 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,407,558 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,759,732 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,121,708 | PYOtherRevenueAmt |
| CY Other Revenue | $1,389,239 | CYOtherRevenueAmt |
| PY Total Revenue | $232,811,350 | PYTotalRevenueAmt |
| CY Total Revenue | $249,501,268 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $8,160,605 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $7,361,500 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $84,518,348 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $86,594,686 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $144,562,957 | PYOtherExpensesAmt |
| CY Other Expenses | $156,449,994 | CYOtherExpensesAmt |
| PY Total Expenses | $237,241,910 | PYTotalExpensesAmt |
| CY Total Expenses | $250,406,180 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$4,430,560 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$904,912 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $114,912,013 | TotalAssetsBOYAmt |
| Total Assets EOY | $117,612,049 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $216,530,180 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $201,252,331 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$101,618,167 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$83,640,282 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The Good Samaritan Hospital is a tax-exempt organization dedicated to providing high-quality, compassionate healthcare that improves the overall health of the community. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $213,949,477 | ExpenseAmt |
| Grant | $7,361,500 | GrantAmt |
| Revenue | $237,044,720 | RevenueAmt |
| Desc | The Good Samaritan Hospital of Lebaonon Pennsylvania has been providing powerful medicine and comforting care to the residents of Lebanon County for more than 125 years.As the community hospital of the Lebanon valley region, The Good Samaritan Hospital of Lebanon, Pennsylvania offers a wide variety of acute care and outpatient services that help improve the health of our community. The Sechler Family Cancer Center is Lebanon County's first and only integrated cancer center providing medical and radiation oncology in a state of the art facility with a warm and healing environment.The state-of-the-art Cardiac & Vascular Center has won national awards from the American Heart Association. The center has also been designated as a Blue Distinction Center for Cardiac Care by Highmark Blue Shield. Diagnostic and interventional cardiology is offered, as well as electrophysiology and open heart surgery. The New Beginning Birth Suites offer a one-stop experience for labor, delivery and recovery in a family-friendly setting.The Good Samaritan Center for Wound Care & Hyperbaric Medicine has created new hope for those with non-healing wounds. The hospital offers a network of laboratory and imaging centers throughout Lebanon county.See WellSpan Health - 2021 Community Benefit Report located at https://www.wellspan.org/about/wellspan-in-the-community/2021-community-benefit-report/ | Desc |
| Total Program Service Expenses | $213,949,477 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | 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 | Yes (true) | BackupWthldComplianceInd |
| Employee | 1271 | 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 | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | 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 | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| 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 P 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 (26 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) |
| Edward Tadajweski MD | |||||||
| Director | 1.00 | 40.00 | $0 | $735,560 | $66,878 | Yes (X) | |
| Tyler Fugate DO | |||||||
| Former Director | 0.00 | 40.00 | $0 | $684,089 | $63,030 | ||
| Carrie Willetts | |||||||
| Sr VP | 1.00 | 40.00 | $0 | $574,522 | $60,510 | Yes (X) | Yes (X) |
| Jane Hyde | |||||||
| Former Director | 0.00 | 40.00 | $0 | $500,900 | $109,473 | ||
| Mike Seim | |||||||
| Vice President | 1.00 | 40.00 | $0 | $514,458 | $44,526 | Yes (X) | Yes (X) |
| Thomas Harlow | |||||||
| President | 40.00 | 0.00 | $495,787 | $0 | $39,407 | Yes (X) | Yes (X) |
| Kristen O'Shea | |||||||
| Former Director | 0.00 | 40.00 | $0 | $469,964 | $62,125 | ||
| Robert Shaver | |||||||
| VP-Medical Affairs | 40.00 | 0.00 | $392,003 | $0 | $56,262 | ||
| Patricia Donley | |||||||
| VP - Patient Care | 40.00 | 0.00 | $228,857 | $0 | $84,147 | ||
| Virginia Follett | |||||||
| Sr. Dir - Support | 40.00 | 0.00 | $193,111 | $0 | $43,778 | ||
| Debra Ney | |||||||
| Manager-Pharmacy | 40.00 | 0.00 | $179,861 | $0 | $35,152 | ||
| Stephanie Andreozzi | |||||||
| VP | 40.00 | 0.00 | $162,008 | $0 | $43,278 | ||
| Laura Buczkowski | |||||||
| SR VP & CFO WSH | 1.00 | 40.00 | $0 | $55,289 | $7,796 | Yes (X) | Yes (X) |
| Christopher Grant PsY D | |||||||
| Director | 1.00 | 40.00 | $0 | $36,788 | $14,774 | Yes (X) | |
| Moniqua Acosta | |||||||
| Chairman | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Reyna Britton RN | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Carrie Wilson | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Kimberly Kreider Umble | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Stephen Lindsey | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Robert Funk | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Robert Hoffman | |||||||
| Vice Chair | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Roger Zimmerman | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Amanda Davis | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Vincent Garcia | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,651,627 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,162,065 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,012,687 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 89 | 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 (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Lebanon Anesthesia Associates | |||||
| 110 29th Avenue | Nashville | TN | 37203 | Anesthesia Services | $4,292,164 |
| Healthtrust Workforce Solutions | |||||
| 6565 N MacArthur Blvd Ste 325 | Irivng | TX | 750392475 | Staffing Service | $751,090 |
| Emergency Physician Associates | |||||
| PO Box 634850 | Cincinnati | OH | 452634850 | Emergency Medicine Serv. | $1,793,269 |
| Womens Health Center of Lebanon | |||||
| 845 Helen Drive | Lebanon | PA | 17042 | Temporary Help | $739,740 |
| Quest Diagnostics | |||||
| PO Box 912512 | Pasadena | CA | 911102512 | Lab Services | $2,299,729 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,567,094 | RelatedOrganizationsAmt |
| Government Grants | $6,771,087 | GovernmentGrantsAmt |
| All Other Contributions | $623,554 | AllOtherContributionsAmt |
| Total Contributions | $8,961,735 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Net Patient Services | 621500 | $258,882,203 | $257,816,493 | $1,065,710 |
| W/O Bad Debts | 621500 | -$19,887,652 | -$19,887,652 | |
| W/O Financial Assistance | 621500 | -$2,603,989 | -$2,603,989 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $236,390,562 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $478 | TotalRevenueColumnAmt |
| Exclusion | $478 | 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 |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $735,081 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $735,081 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $735,081 | TotalRevenueColumnAmt |
| Exclusion | $735,081 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $59,026,179 | SecuritiesAmt |
| Other | $27,908 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $56,268,229 | SecuritiesAmt |
| Other | $26,604 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,757,950 | SecuritiesAmt |
| Other | $1,304 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,759,254 | TotalRevenueColumnAmt |
| Exclusion | $2,759,254 | 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 | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| Cafeteria Atrium Sales | 722210 | $512,311 | $512,311 | |
| Health Promotion | 611710 | $42,730 | $42,730 | |
| Housekeeping Offsite | 561700 | $54,205 | $54,205 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,912 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $36,572 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $8,340 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $654,158 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $249,501,268 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $235,458,359 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,065,710 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,015,464 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,361,500 | TotalAmt |
| Program Services | $7,361,500 | 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 | $535,194 | TotalAmt |
| Program Services | $535,194 | 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 | $63,323,259 | TotalAmt |
| Program Services | $53,744,491 | ProgramServicesAmt |
| Management And General | $9,578,768 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,413,858 | TotalAmt |
| Program Services | $2,901,779 | ProgramServicesAmt |
| Management And General | $512,079 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,437,322 | TotalAmt |
| Program Services | $12,271,724 | ProgramServicesAmt |
| Management And General | $2,165,598 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,885,053 | TotalAmt |
| Program Services | $4,152,295 | ProgramServicesAmt |
| Management And General | $732,758 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,632,459 | TotalAmt |
| Program Services | $33,687,590 | ProgramServicesAmt |
| Management And General | $5,944,869 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,351 | TotalAmt |
| Program Services | $10,498 | ProgramServicesAmt |
| Management And General | $1,853 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,365 | TotalAmt |
| Program Services | $52,160 | ProgramServicesAmt |
| Management And General | $9,205 | 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 | $12,745,618 | TotalAmt |
| Program Services | $10,833,775 | ProgramServicesAmt |
| Management And General | $1,911,843 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,774 | TotalAmt |
| Program Services | $2,358 | ProgramServicesAmt |
| Management And General | $416 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $728,748 | TotalAmt |
| Program Services | $619,436 | ProgramServicesAmt |
| Management And General | $109,312 | 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 | $1,075,628 | TotalAmt |
| Program Services | $914,284 | ProgramServicesAmt |
| Management And General | $161,344 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,035 | TotalAmt |
| Program Services | $41,680 | ProgramServicesAmt |
| Management And General | $7,355 | 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 | $69,479 | TotalAmt |
| Program Services | $59,057 | ProgramServicesAmt |
| Management And General | $10,422 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,944,552 | TotalAmt |
| Program Services | $4,202,869 | ProgramServicesAmt |
| Management And General | $741,683 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,549,342 | TotalAmt |
| Program Services | $6,416,940 | ProgramServicesAmt |
| Management And General | $1,132,402 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,997,748 | TotalAmt |
| Program Services | $1,698,086 | ProgramServicesAmt |
| Management And General | $299,662 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Supplies | $37,422,584 | $31,809,196 | $5,613,388 |
| Outside Services | $35,833,034 | $30,458,079 | $5,374,955 |
| Repairs & Maintenance | $6,165,540 | $5,240,709 | $924,831 |
| Taxes & Licenses | $4,039,702 | $3,433,747 | $605,955 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,120,035 | TotalAmt |
| Program Services | $3,502,030 | ProgramServicesAmt |
| Management And General | $618,005 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,406,180 | TotalAmt |
| Program Services | $213,949,477 | ProgramServicesAmt |
| Management And General | $36,456,703 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $123,563 | BOYAmt |
| EOY | $195,085 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,223 | BOYAmt |
| EOY | -$66,250 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $742,765 | BOYAmt |
| EOY | $1,051,815 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,753,133 | BOYAmt |
| EOY | $23,811,479 | 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) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,331,451 | BOYAmt |
| EOY | $6,434,749 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $255,251 | BOYAmt |
| EOY | $331,692 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $177,741,335 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $113,040,965 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,463,391 | BOYAmt |
| EOY | $64,700,370 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,821,378 | BOYAmt |
| EOY | $13,281,387 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,604 | BOYAmt |
| EOY | $2,435,095 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $963,197 | BOYAmt |
| EOY | $859,108 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,352,057 | BOYAmt |
| EOY | $4,577,519 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,912,013 | BOYAmt |
| EOY | $117,612,049 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,873,021 | BOYAmt |
| EOY | $8,059,779 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,662,521 | BOYAmt |
| EOY | $20,557,294 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,213,525 | BOYAmt |
| EOY | $2,176,542 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,269,195 | BOYAmt |
| EOY | $159,934,607 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,511,918 | BOYAmt |
| EOY | $10,524,109 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $216,530,180 | BOYAmt |
| EOY | $201,252,331 | 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 | -$109,802,001 | BOYAmt |
| EOY | -$89,970,935 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,183,834 | BOYAmt |
| EOY | $6,330,653 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$101,618,167 | BOYAmt |
| EOY | -$83,640,282 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,912,013 | BOYAmt |
| EOY | $117,612,049 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$904,912 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,356,636 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $16,526,161 | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form4720 Filed Section4955 Tax | false | Form4720FiledSection4955TaxInd |
| Correction Made | false | CorrectionMadeInd |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
| Form4720 Filed4912 Tax | false | Form4720Filed4912TaxInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1i - Other Activities Description | FormAndLineReferenceDesc |
| Explanation | The hospital holds membership in the American Hospital Association (AHA) and the Hospital & Healthsystem Association of Pennsylvania (HAP) both of which engage in lobbying as a part of their mission to represent the interests of the hospitals at both the federal and state levels. A portion of the dues paid to the Hospital Association of Pennsylvania and the American Hospital Association include lobbying ($6,219 and $6,117). On occasion, HAP requests the help of member providers to communicate concerns to legislators regarding pending legislation which could impact hospitals. This can involve direct contact with legislators or letter writing. This occurs infrequently and the cost to the hospital is negligible. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,183,834 | BeginningYearBalanceAmt |
| Contributions | $1,853,565 | ContributionsAmt |
| Investment Earnings Or Losses | $281,589 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,988,335 | OtherExpendituresAmt |
| End Year Balance | $6,330,653 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,878,431 | BeginningYearBalanceAmt |
| Contributions | $799,233 | ContributionsAmt |
| Investment Earnings Or Losses | $85,487 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $579,317 | OtherExpendituresAmt |
| End Year Balance | $8,183,834 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,004,069 | BeginningYearBalanceAmt |
| Contributions | $3,985,145 | ContributionsAmt |
| Investment Earnings Or Losses | $58,490 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $169,273 | OtherExpendituresAmt |
| End Year Balance | $7,878,431 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,592,136 | BeginningYearBalanceAmt |
| Contributions | $3,545,261 | ContributionsAmt |
| Investment Earnings Or Losses | $227,655 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $7,360,983 | OtherExpendituresAmt |
| End Year Balance | $4,004,069 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,112,140 | BeginningYearBalanceAmt |
| Contributions | $1,014,123 | ContributionsAmt |
| Investment Earnings Or Losses | -$4,978 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $529,149 | OtherExpendituresAmt |
| End Year Balance | $7,592,136 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.02310 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.97690 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | false | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,468,847 | OtherCostOrOtherBasisAmt |
| Book Value | $1,468,847 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $104,835,564 | OtherCostOrOtherBasisAmt |
| Depreciation | $63,143,890 | DepreciationAmt |
| Book Value | $41,691,674 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,420,102 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,194,047 | DepreciationAmt |
| Book Value | $2,226,055 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $58,988,612 | OtherCostOrOtherBasisAmt |
| Depreciation | $43,703,028 | DepreciationAmt |
| Book Value | $15,285,584 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,028,210 | OtherCostOrOtherBasisAmt |
| Book Value | $4,028,210 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $64,700,370 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Private Equity, Ltd Partners | $603,317 | F |
| Real estate, limited partnerships | $974,542 | F |
| Absolute return, Ltd Ptnrs | $857,236 | F |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| Accrued Payroll | $2,075,880 |
| Accrued Payroll w/h | $312,704 |
| Accrued Pension | $3,198,216 |
| Accrued Sales Tax | $2,933 |
| Accrued Vacation | $3,947,301 |
| Due to Affiliates | $266,509 |
| LTD-Leases | $720,566 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,524,109 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $250,817,956 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $2,356,636 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $2,356,636 | RevenueNotReportedAmt |
| Revenue Subtotal | $248,461,320 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,039,948 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,039,948 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $249,501,268 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $242,339,451 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $242,339,451 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $8,066,729 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $8,066,729 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $250,406,180 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 XI, Line 4b: Other revenue amounts included on 990 but not included in F/S | Restricted Contributions (Net) $-26781 Revenue Netted with Expenses $1066729 |
| Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S | Revenue Netted with Expenses $1066729 Grant to WellSpan Medical Group $7000000 |
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 | 806 | PersonsServedCnt |
| Total Community Benefit Expns | $610,436 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $610,436 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 40337 | PersonsServedCnt |
| Total Community Benefit Expns | $37,053,278 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,918,880 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,134,398 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02050 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 41143 | PersonsServedCnt |
| Total Community Benefit Expns | $37,663,714 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,918,880 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,744,834 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02290 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 280 | PersonsServedCnt |
| Total Community Benefit Expns | $372,912 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $103,180 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $269,732 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $235,055 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $235,055 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 280 | PersonsServedCnt |
| Total Community Benefit Expns | $607,967 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $103,180 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $504,787 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 41423 | PersonsServedCnt |
| Total Community Benefit Expns | $38,271,681 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $32,022,060 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,249,621 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02490 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $294,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $294,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 74 | PersonsServedCnt |
| Total Community Benefit Expns | $304,914 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $304,914 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 74 | PersonsServedCnt |
| Total Community Benefit Expns | $598,914 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $598,914 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,492,358 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $86,779 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $91,119,504 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $100,750,290 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$9,630,786 | 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 | WellSpan Good Samaritan Hospit | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4th Walnut Street | AddressLine1Txt |
| City | Lebanon | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17042 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.wellspan.org | WebsiteAddressTxt |
| State License | 072401 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WellSpan Good Samaritan Hospit | 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 | https://communityhealthcouncil.com/data/ | 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 | 400.0000 | 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 | Yes (true) | NondisEmergencyCarePolicyInd |
| 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: WellSpan Good Samaritan Hospit - Part V, Section B, Line 5 | Prior to its affiliation with WellSpan Health, WellSpan The Good Samaritan Hospital of Lebanon Pennsylvania conducted independent Community Health Needs Assessments (CHNA) of Lebanon County residents through key informant interviews and the collection and analysis of secondary data. Beginning with the 2015 CHNA, WellSpan-Good Samaritan Hospital transitioned to a streamlined approach to regional CHNA processes in an effort to bring consistency to the entire footprint of WellSpan Health. The 2018 CHNA is a compilation of primary and secondary data sources including telephonic interviews, a review of the Robert Wood Johnson Foundation County Health Rankings, and an analysis of access, behavioral risk and health condition indicators from the PA Department of Healths data retrieval system. Information collected through the CHNA was shared with key community stakeholders to gain their input and perspective on the data, to learn about the existing healthcare environment in Lebanon County, and to identify priorities on which three-year implementation strategies should focus. These stakeholders represented the Lebanon Family Health Services, Lebanon Valley Family YMCA, and the United Way of Lebanon County.A subsequent presentation and discussion of the data and identified priorities was held with the Community Health Council of Lebanon County Board, a coalition of diverse individuals and organizations working together to encourage and support a safe, healthy, and substance-free community for every Lebanon County resident. Sectors represented in the Council included, for example: aging population; behavioral health; community-based organizations; social services; education; healthcare; county government; faith-based organizations; drug and alcohol resources, and philanthropy. |
| Facility: WellSpan Good Samaritan Hospit - Part V, Section B, Line 6a | Ephrata Community Hospital (Lancaster), Gettysburg Hospital (Adams), WellSpan Surgery and Rehabilitation Hospital, and York Hospital (York). |
| Facility: WellSpan Good Samaritan Hospit - Part V, Section B, Line 7d | With each iteration of the CHNA process, WellSpan The Good Samaritan Hospital of Lebanon Pennsylvania and its community partners continue to refine and enhance the system by which it obtains data, shares it with key community stakeholders, hospital and system leaders, and integrates with system-wide and entity-level planning processes. In 2018, the CHNA results and related priorities identified by WellSpan Health and the Community Health Council of Lebanon County were shared with the system-wide Planning Committee at WellSpan Health. This committee is 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, 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. Similarly, the Community Health Council of Lebanon County embraced the findings of the report to solidify their operational focus areas and to align with the WellSpan Health strategic directions. The specific priorities and associated data were presented to the hospital Board for their adoption. Collaboratively, the Community Health Council of Lebanon County and WellSpan community health leadership communicated the CHNA results and identified priorities to community members at a public forum held in September 2018. During that forum, CHNA data, CHNA priorities/ opportunities, and WellSpan and coalition recommendations were presented and discussed. In addition to these venues, CHNA results are available on the Community Health Council of Lebanon County (http://communityhealthcouncil.com/data/) and WellSpan Health "http://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: WellSpan Good Samaritan Hospit - 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: WellSpan Good Samaritan Hospit - 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: WellSpan Good Samaritan Hospit - 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 on-line. 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. |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| WELLSPAN DIXON FOUNDATION HEALTH CENTER | ||||
| 40 NORTH 4TH STREET | LEBANON | PA | 17042 | REHABILITATION |
| WS GOOD SAMARITAN OUTPATIENT SURGICAL CENTER | ||||
| 830 TUCK ST | LEBANON | PA | 17042 | OUTPATIENT SURGERY CENTER |
| WS WOUND HEALTH CENTER | ||||
| 840 TUCK ST | LEBANON | PA | 17042 | WOUND CARE & HYPERBARIC CNTR |
| WS GOOD SAMARITAN SLEEP CENTER | ||||
| 206 HATHAWAY PARK | LEBANON | PA | 17042 | SLEEP DISORDERS CENTER |
| WS GOOD SAMARITAN IMAGING- LEBANON | ||||
| 805 HELEN DR | LEBANON | PA | 17042 | OUTPATIENT RADIOLOGY CENTER |
| WS GOOD SAMARITAN BLOOD DONOR CENTER | ||||
| 750 NORMAN DR | LEBANON | PA | 17042 | BLOOD DONOR CNTR & LAB |
| WS AMBULATORY SERVICES CENTER | ||||
| 297 WEST LINCOLN AVE | LEBANON | PA | 17042 | OUTPATIENT DIAGNOSTIC CENTER (MYERSTOWN) |
| WS AMBULATORY SERVICES CENTER - PALMYRA | ||||
| 1400 SOUTH FORGE RD | LEBANON | PA | 17042 | AMBULATORY SERVICES CENTER (PALMYRA) |
| WS AMBULATORY SERVICES CENTER- JONESTOWN | ||||
| 100 QUEEN STREET | LEBANON | PA | 17042 | AMBULATORY SERVICES CENTER (JONESTOWN) |
| WS GOOD SAMARITAN REHABILITATION- LEBANON | ||||
| 950 ISABEL DR | LEBANON | PA | 17042 | OUTPATIENT PHYSICAL THERAPY |
| WS GOOD SAMARITAN CARDIOVASCULAR DIAGNOSTIC | ||||
| 781 NORMAN DR | LEBANON | PA | 17042 | CARDIOVASCULAR DIAGNOSTIC CENTER |
| WS SECHLER FAMILY CANCER CENTER | ||||
| 844 TUCK ST | LEBANON | PA | 17042 | CANCER CENTER |
| MYERSTOWN PHYSICAL THERAPY | ||||
| 11 E LINCOLN AVENUE | MYERSTOWN | PA | 17067 | PHYSICAL THERAPY |
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. |
| 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 | Good Samaritan Hospital maintains records to identify and monitor the level of charity care and community service it provides. These records include the amount of charges forgone based on established rates for services and supplies furnished under its charity care and community service policies and the estimated cost of those services. Payments from Medicare are generally less than Good Samaritan Hospital's costs of providing the service. |
| Part III, Line 9b - 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 | After its affiliation with WellSpan Health, a regional health care system, WellSpan The Good Samaritan Hospital of Lebanon Pennsylvania (WGSHOLPA) engaged in the 2015 iteration of the system-wide CHNA process. This process evolved regionally to include each respective communities previous successes and lessons learned in conducting CHNAs. For example, York and Adams counties had been conducting CHNAs for 20 years and had extensive expertise to share related to primary data collection. The system-wide approach to the CHNA enabled WGSH to collect primary data from Lebanon County residents, share it with key community, hospital, and system leaders, and integrate it into the system-wide and entity-level planning processes. A representative sample of 470 Lebanon County adults were interviewed between March 26 and May 13, 2018, using survey questions 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. Supplemental secondary data from the Robert Wood Johnson Foundation (RWJF) annual County Health Rankings and from the Pennsylvania Department of Health was also integrated into the 2018 CHNA.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. The CHNA was developed utilizing consulting support and guidance through a contract with the Floyd Institute for Public Policy at Franklin and Marshall College. The collaborative efforts of the 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. 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 focused on: quantity of residents affected; health risks and disability-adjusted life years; correlates of obesity and depression (two significant health priorities); health disparities, 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 the Community Health Council of Lebanon County and other pertinent community stakeholder groups 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 WGSHOLPA Board 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. WellSpan The Good Samaritan Hospital of Lebanon Pennsylvania continues to develop its suite of wellness and health education programs designed to address key CHNA findings and to promote healthy lifestyles and disease prevention. These programs include community health screenings; healthy eating initiatives in the community (i.e., healthy cooking demonstrations at the Lebanon Farmer's Market); weight management classes, and physical activity promotion initiatives. Many of these programs are offered for free or at a minimal cost to the participant. WellSpan-Good Samaritan Hospital continues to partner with the Lebanon County Library System to offer the Get Outdoors (GO) Lebanon! summer physical activity program for Lebanon County families. Originating in York County, this summer-long initiative encourages children and their families to be physically active by locating posts "hidden" in parks throughout Lebanon County. In FY21, over 5,200 families across WellSpans service area participated in this outdoor physical activity program.WellSpan The Good Samaritan Hospital of Lebanon Pennsylvania maintains its support of Lebanon Countys safety net of services that enables access to care among vulnerable populations through: enrolling financially-challenged community members in Healthy Community Network, a partnership between WellSpan Health, physicians and community partners to support prospective enrollment, the management and support of patients, and coordination of care; and; the ongoing partnership between Lebanon Family Health Services and WellSpan The Good Samaritan Hospital of Lebanon Pennsylvania to utilize doctors from the hospitals Family Medicine Residency program to provide prenatal care for its low-income clients. Additionally, leadership partners with Family First Health, a federally qualified health center with locations throughout central Pennsylvania, to provide primary care services at the WellSpan Dixon Foundation Health Center. The WellSpan Dixon Foundation Health Center opened in 2020 and has improved access to primary care, behavioral health and other health and social services in Lebanon County. In FY21, Family First Health completed 2,690 medical visits for Lebanon County residents.WellSpan-Good Samaritan Hospital is an integral partner in the Community Health Council of Lebanon County and, as such, supports key Council initiatives such as the Lebanon County Tobacco Coalition, Lebanon County Teen Pregnancy and Support Network, and Lebanon County Suicide Task Force. WellSpan The Good Samaritan Hospital of Lebanon Pennsylvania maintains its support of the full-time, Executive Director position by leveraging Community Partnership Grant funds to cover this expense. Additionally, the Council maintains alignment with the Better Together Coalition in Lebanon County and launched a mobile kitchen to provide hands-on cooking classes to residents, in partnership with The American Heart Association. Additional efforts focused on: an email and social medical platform to connect residents to local health and wellness events and services; educational initiatives that emphasize importance of advanced care planning and end-of-life care, and tackling the issue of homelessness by supporting the Lebanon County Coalition to End Homelessness. Community Health in Lebanon County continues to unfold in the offering of nutrition and food insecurity related efforts like the WellSpan Mondays Market program, which partners to provide a convenient location for families using Farmers Market Nutrition Program and WIC vouchers to shop for healthful foods. WellSpans Market Bucks program addresses food insecurity and increases the consumption of fruits and vegetables. Regionally, this program provided vouchers to 474 WellSpan patients with food insecurity challenges, which contributed $50,000 to local farmers and growers. This program reaches those with an elevated Body Mass Index (BMI) who also experience a comorbidity associated with diet. Market Bucks consistently boasts an astounding 86% redemption rate, in addition to demonstrating increase fruit and vegetable consumption for participants with medical challenges.WellSpan continues to support efforts to encourage healthy behaviors throughout the region, including programs like A Healthy You, Winter STREAK, and Yoga in the Park. WellSpan supported the Lebanon County 50+ Festival by offering health screenings and other educational opportunities to 500 older community members. Each of these Lebanon County programs encourage healthy living and lifelong health.In 2021, WellSpan Health encouraged community members, local employers and employees, and WellSpan staff and patients to engage in the 9th 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. In 2021, the 10 Pound Throwdown engaged 9,500 community members in losing weight across five southcentral Pennsylvania counties -Adams, Franklin, Lancaster, Lebanon, and York. Additional examples of how WellSpan The Good Samaritan Hospital of Lebanon Pennsylvania fulfilled its community mission in Lebanon County may be found in the 2021 WellSpan Community Benefit Report available online at www.wellspan.org. |
| 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 Good Samaritan Community 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.Good Samaritan Hospital's 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 Medical Group | 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 | 232730785 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $7,000,000 | 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 | Additional Supplemental Information | 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 (14 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Carrie Willetts | ||||||||||||||
| Sr VP | $430,948 | $143,574 | $11,619 | $48,891 | $635,032 | $52,199 | ||||||||
| Debra Ney | ||||||||||||||
| Manager-Pharmacy | $166,833 | $9,830 | $3,198 | $7,415 | $27,737 | $215,013 | ||||||||
| Edward Tadajweski MD | ||||||||||||||
| Director | $734,360 | $1,200 | $15,955 | $50,923 | $802,438 | |||||||||
| Jane Hyde | ||||||||||||||
| Former Director | $376,695 | $124,080 | $74,251 | $35,222 | $610,373 | $125 | ||||||||
| Kristen O'Shea | ||||||||||||||
| Former Director | $364,498 | $98,231 | $14,796 | $47,329 | $532,089 | $44,482 | $7,235 | |||||||
| Michael O'Connor | ||||||||||||||
| Former Director | $611,969 | $404,687 | $123,405 | $85,586 | $3,267,878 | $2,042,158 | $2,042,231 | |||||||
| Mike Seim | ||||||||||||||
| Vice President | $438,755 | $52,800 | $7,015 | $37,511 | $558,984 | $18,133 | $22,903 | |||||||
| Patricia Donley | ||||||||||||||
| VP - Patient Care | $185,115 | $39,908 | $3,834 | $8,032 | $76,115 | $313,004 | ||||||||
| Robert Shaver | ||||||||||||||
| VP-Medical Affairs | $317,632 | $68,046 | $6,325 | $12,184 | $44,078 | $448,265 | ||||||||
| Roxanna Gapstur | ||||||||||||||
| CEO-WSH/Dir | $1,091,608 | $440,000 | $11,619 | $60,941 | $1,604,168 | $242,000 | ||||||||
| Stephanie Andreozzi | ||||||||||||||
| VP | $145,741 | $13,266 | $3,001 | $6,415 | $36,863 | $205,286 | ||||||||
| Thomas Harlow | ||||||||||||||
| President | $362,301 | $127,233 | $6,253 | $11,744 | $27,663 | $535,194 | $43,937 | |||||||
| Tyler Fugate DO | ||||||||||||||
| Former Director | $682,889 | $1,200 | $12,853 | $50,177 | $747,119 | |||||||||
| Virginia Follett | ||||||||||||||
| Sr. Dir - Support | $177,268 | $12,291 | $3,552 | $18,767 | $25,011 | $236,889 | ||||||||
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 L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Funk Construction | |||
| Pres - Funk | $1,767,140 | Construction | false |
| Beers Hoffman Architech | |||
| Architect Hoffman | $169,828 | Architectural Serv | false |
| Britton Consulting Group | |||
| Partner Britton | $22,575 | Team retreats Exec Coach | false |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | Reyna Britton is a member of the East Region Board of Directors. Her Husband, Duane Britton, is a member of the WellSpan Health Planning Committee as Vice Chair |
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | WellSpan Health, a not for profit corporation, is the sole member. |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | The Board of Directors shall be elected by the Board of Directors of the Member. The Member shall determine annually the number of Directors which shall in no event be less than ten persons nor more than eighteen persons. In addition, the President of the Organization and the President of the Medical Staff of the Organization shall be Directors, ex officio, without vote.The Directors shall be elected at the annual meeting of the Member. The term of the newly elected Directors shall commence at the close of the Member's annual meeting. All Directors shall be selected for their experience, relevant areas of interest and expertise, and ability and willingness to participate actively and effectively in fulfilling the Board of Directors' responsibilities without conflicting interests. |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | The Board of Directors shall recommend strategic and operating plans that are in conformance with System-approved priorities and plans; monitor accomplishment of such plans; recommend operating and capital budgets that are in conformance with System targets; monitor financial performance against budget; monitor the quality of and satisfaction with clinical services provided; serve as a sounding board for the Organization's President, providing advice and counsel to System and Organization management; nominate and, subject to the prior review and ratification of the Member, appoint the officers of the Organization, except for appointment of the Organizations' President, which requires the concurrence of both the Member and the Organization's Boards of Directors and whose removal by the Member requires prior consultation with the Organization's Board; maintain the licensure and accreditation of the Corporation, including, maintaining compliance with all of the applicable publicness requirements established by the Pennsylvania Department of Health for acute general hospitals, the Medicare Conditions of Participation established by CMS for hospitals, and the accreditation standards established by The Joint Commission for hospitals, including but not limited to requirements regarding medical staff appointments, credentialing, and oversight; recommend changes in the services provided by the Organization; recommend amendments to the Organization's Articles of Incorporation and/or Bylaws; recommend fundamental transactions involving the Organization, including the reorganization, merger, the sale of all or substantially all of the assets of the Organization, or dissolution of the Organization; recommend investment of the Organizations' assets other than in accordance with a WellSpan approved investment policy; recommend the issuance of debt for the Organization; recommend the transfer or sale of the Organizations' assets in excess of limits established by WellSpan policy; recommend capital expenditures by the Organization in excess of approved budget; recommend any capital contribution by the Member to the Corporation; recommend any material change to any permit, approval, or license of the Organization; recommend outside legal counsel for the Corporation's local needs or activities; recommend changes to the Organization's statement of mission and vision; recommend the creation of new (or material changes to existing) lines of business, sites of business, and participation in partnerships or joint ventures by the Organization; recommend changes to managed care and other third party payer contracts for the Organization; and represent the interests of the community or population served by the Organization. |
| 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 | Increase in net assets of Foundation = $333099 |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Increase in permanently restricted net assets = -$322864 |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Net assets released from restriction = $26781 |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Pension adjustment for FAS 158 = $16489145 |
| 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 Block - 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 |
| Part IV, Line 20b | Audited Financial Statements |
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 |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 to support GH | PA | 501(c)(3) | 12 Type I | Gettysburg Hospital | false |
| Healthy Community Pharmacy | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 200519121 | Reduced rate prescription drugs | 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 | PA | 501(c)(3) | 10 | WellSpan Specialty Services | false |
| VNA Home Health Services | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 231352573 | Home health services | PA | 501(c)(3) | 10 | WellSpan Specialty Services | false |
| Wellspan Health | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 222517863 | Intergrated Health System | PA | 501(c)(3) | 12 Type III | NA | false |
| Wellspan Health Care Services | ||||||||||
| PO Box 2767 | York | PA | 174032767 | 232400237 | Health-related activities in the service | PA | 501(c)(3) | 12 Type II | WellSpan Health | false |
| Wellspan Medical Group | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232730785 | Medical and Surgial care | PA | 501(c)(3) | 10 | WellSpan Health | false |
| York Health Foundation | ||||||||||
| PO BOX 2767 | York | PA | 174052767 | 233050192 | Charitable contributions for Wellspan | PW | 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 Surgery & Rehab Hospital | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232899911 | Surgery and Rehabilitation Hospital | PA | 501(c)(3) | 3 | WellSpan Health | false |
| Wellspan Properties Inc | ||||||||||
| 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 | 501(c)(3) | 3 | WellSpan Health | false | |
| Ephrata Community Health Foundation | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 800940005 | Fundraising for Ephrata Hospital | PA | 501(c)(3) | 12 Type I | Ephrata Community Hospital | 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 Northern Lanc Co Med Group | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 452537633 | Physician Practices | PA | 501(c)(3) | 12 Type II | Northern Lancaster County Med Group | false |
| Philhaven | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 231549922 | Health 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 | Yes (true) |
| Good Samaritan Physician Services | ||||||||||
| PO BOx 2767 | York | PA | 174052767 | 251832359 | Medical and Surgical Care | PA | 501(c)(3) | 10 | Good Sam Health Services Foundation | false |
| Apple Hill Surgical Center Inc | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 222842253 | Sole GP in limited ptnrshp operating sur | PA | 501(c)(3) | 10 | WellSpan Health Care Services | 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 | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Apple Hill Surgical Center Partners | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232489452 | Surgical Cn | PA | NA | N/A | false | false |
| Central PA Alliance Laboratories LLC | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232910950 | Ref. Lab | PA | NA | N/A | false | false |
| Littlestown Health Care Partners | ||||||||||
| 300 West King Street | Littlestown | PA | 17340 | 232880464 | Lease Facility | PA | NA | N/A | false | false |
| Cherry Tree Cancer Center LLP | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232915628 | Radiation | PA | NA | N/A | false | false |
| The Rehab Center | ||||||||||
| 855 Springdale Drive Suite 20 | Exton | PA | 19341 | 251687903 | Physical Therapy Rehab | PA | NA | N/A | false | false |
| Surgery Center Associates | ||||||||||
| 785 5th Avenue | Chambersburg | PA | 17201 | 251845304 | Physician Services | PA | Chambersburg Health | N/A | false | false |
| Summit Surgery Center | ||||||||||
| 785 5th Avenue | Chambersburg | PA | 17201 | 251845303 | Physician Services | PA | Chambersburg Health | N/A | false | false |
| Cumberland Valley Mobile Services | ||||||||||
| 5 S Main St | Sugarloaf | PA | 18249 | 200884014 | Mobile health services | PA | Chambersburg Health | N/A | 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 |
|---|---|---|---|---|---|---|---|---|---|
| GSH Realty Inc | |||||||||
| PO Box 2767 | York | PA | 174052767 | 251832359 | Non res. real estate | PA | WSH Care Services | C corp | false |
| Wellspan Pharmacy Inc | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232374072 | Dispense 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 Org | PA | NA | C corp | false |
| Wellspan Provider Network | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232907828 | Coord. managed car risk contracts | PA | NA | C corp | false |
| Apple Hill Condominium Association | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232504543 | Condo Mgmt Association | PA | NA | Homeowner Assoc | false |
| Northern Lan Co Phys Hosp Alliance | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232421885 | Coord. Phys & Hospital | PA | NA | 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 | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (true) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | 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 | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Wellspan Medical Group | ||
| b | $7,000,000 | General Ledger |
| Good Samaritan Health Service Foundation | ||
| c | $1,567,094 | General Ledger |