STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

WAYNESBORO HOSPITAL: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
WAYNESBORO HOSPITAL (EIN 23-1360854)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-13
IRS object ID
202231339349306893
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 ReturnHeader

FieldValueIRS element (for citing)
Return2022-05-13T12:20:00-07:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135381590PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WellSpan HealthBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13350 WHITEFORD ROADAddressLine1Txt
CityYORKCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN231360854EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WAYNESBORO HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlWAYNBusinessNameControlTxt
Phone7178513055PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2767AddressLine1Txt
CityYORKCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17405ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLaura BuczkowskiPersonNm
Person TitleSR VP & CFOPersonTitleTxt
Signature2022-05-13SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstLauraPersonFirstNm
Person LastBuczkowskiPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSee AttachedPreparerPersonNm
PTINP01871563PTIN
Phone7038930600PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
Federated Assurance LevelFAL1FederatedAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRoxanna GapsturPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2767AddressLine1Txt
CityYORKCityNm
State AbbreviationPAStateAbbreviationCd
ZIP174052767ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$112,696,621GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.WELLSPAN.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1922FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionWaynesboro Hospital is a regional nonprofit healthcare organization committed to the improvement of the health and well-being of the people in Southcentral Pennsylvania.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee726TotalEmployeeCnt
Total Volunteers70TotalVolunteersCnt
Total Gross UBI$10,065TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$7,074NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$6,350,729PYContributionsGrantsAmt
CY Contributions Grants$2,310,855CYContributionsGrantsAmt
PY Program Service Revenue$63,463,108PYProgramServiceRevenueAmt
CY Program Service Revenue$76,058,309CYProgramServiceRevenueAmt
PY Investment Income$1,467,893PYInvestmentIncomeAmt
CY Investment Income$2,212,210CYInvestmentIncomeAmt
PY Other Revenue$383,347PYOtherRevenueAmt
CY Other Revenue$335,763CYOtherRevenueAmt
PY Total Revenue$71,665,077PYTotalRevenueAmt
CY Total Revenue$80,917,137CYTotalRevenueAmt
PY Grants And Similar Paid$30,284,637PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$8,040,000CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$38,356,248PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$34,001,641CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$25,289,905PYOtherExpensesAmt
CY Other Expenses$35,705,984CYOtherExpensesAmt
PY Total Expenses$93,930,790PYTotalExpensesAmt
CY Total Expenses$77,747,625CYTotalExpensesAmt
PY Revenues Less Expenses-$22,265,713PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,169,512CYRevenuesLessExpensesAmt
Total Assets BOY$135,116,336TotalAssetsBOYAmt
Total Assets EOY$151,400,285TotalAssetsEOYAmt
Total Liabilities BOY$33,608,600TotalLiabilitiesBOYAmt
Total Liabilities EOY$28,533,728TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$101,507,736NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$122,866,557NetAssetsOrFundBalancesEOYAmt
MissionWaynesboro Hospital is a regional nonprofit healthcare organization committed to the improvement of the health and well-being of the people in Southcentral Pennsylvania.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$66,590,729ExpenseAmt
Grant$8,040,000GrantAmt
Revenue$76,058,249RevenueAmt
DescWaynesboro Hospital, established in 1922 by a group of volunteers in response to the Spanish Influenza, provides needed medical care to the community regardless of any patient's ability to pay. Health care services include inpatient routine, inpatient ancillary and outpatient care. An expert team of dedicated physicians, surgeons and healthcare professionals provide a full range of medical services, award-winning stroke care, comfortable patient rooms, and wound care center.Recent Awards and Recognitions include:2021 Get with the Guidelines - Stroke Gold Plus2021 High Performing Recognition for Pneumonia by U.S. News & World Report2021 Centers for Medicare & Medicaid Services (CMS) 4 Star Overall Hospital Quality Rating2020 Leapfrog Top Teaching Small Hospital2020 American Heart Association/American Stroke Association's Get With The Guidelines-Stroke Gold Plus Quality Achievement Award2019 Leapfrog Top Decile Recognition2019 Advanced Primary Stroke Center2019 American Heart Association/American Stroke Association's Get With The Guidelines-Stroke Silver Plus Quality Achievement Award and recognition on the Target: Stroke Honor RollSee 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$66,590,729TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document38IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee726EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDAVID RIZZUTOPersonNm
Phone7178513055PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13350 WHITEFORD ROADAddressLine1Txt
CityYORKCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17402ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerInd
Michael O'Connor
Former Director0.0040.00$0$3,058,887$208,991
Charles Chondroff MD
Former Director0.0040.00$0$2,987,195$71,789
Roxanna Gapstur
CEO-WSH/Dir.1.0040.00$0$1,531,608$72,560Yes (X)Yes (X)
Patrick O'Donnell
Former Director0.0040.00$0$1,486,416$77,222
Sherri Stahl
SVP1.0040.00$0$629,634$64,127Yes (X)Yes (X)
Edward Mackle MD
Director1.0040.00$0$557,905$80,805Yes (X)
Mike Seim
SVP CQO1.0040.00$0$514,458$44,526Yes (X)Yes (X)
Kevin Lorentsen
Director1.0040.00$0$490,304$46,020Yes (X)
Robert Robertson MD
Former Director0.0040.00$0$461,769$47,424
David Doud DO
Director1.0040.00$0$337,661$57,504Yes (X)
Scott Card
Physician40.000.00$336,163$0$53,971
Melissa Dubrow
President40.000.00$289,132$0$71,924Yes (X)Yes (X)
Jill Keller-Reyka
Regional Director40.000.00$229,227$0$55,763
Clarence Miller
Pathologist40.000.00$227,922$0$47,452
Wanda Crilly
Manager FBS40.000.00$214,368$0$26,601
Kevin Sanders
Physician Assistan40.000.00$184,627$0$39,945
Laura Buczkowski
SR VP & CFO WSH1.0040.00$0$55,289$40,338Yes (X)Yes (X)
Nancy Myers Esq
Chairman1.000.00$0$0$0Yes (X)
Edith Jardine
Director1.000.00$0$0$0Yes (X)
Horace Martin MD
Director1.000.00$0$0$0Yes (X)
Julie Ramsey
Director1.000.00$0$0$0Yes (X)
Steve Holoviak
Director1.000.00$0$0$0Yes (X)
Denis Onieal
Director1.000.00$0$0$0Yes (X)
Cheryl Plummer
Chairman1.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,481,439TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$12,111,126TotReportableCompRltdOrgAmt
Total Other Compensation$1,106,962TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Quest DiagnosticsBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 912512AddressLine1Txt
CityPasadenaCityNm
State AbbreviationCAStateAbbreviationCd
ZIP911102512ZIPCd
FieldValueIRS element (for citing)
ServicesLab ServicesServicesDesc
Compensation$104,711CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Related Organizations$163,467RelatedOrganizationsAmt
Government Grants$2,119,266GovernmentGrantsAmt
All Other Contributions$28,122AllOtherContributionsAmt
Total Contributions$2,310,855TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Policy Adjustments621500-$1,682,781-$1,682,781
Total Patient Revenue621500$85,371,513$85,361,448$10,065
W/O Bad Debts621500-$5,588,027-$5,588,027
W/O Free Service621500-$2,042,396-$2,042,396
FieldValueIRS element (for citing)
Total Program Service Revenue$76,058,309TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$712,149TotalRevenueColumnAmt
Exclusion$712,149ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,305,499RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,174,949RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$130,550RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$130,550TotalRevenueColumnAmt
Exclusion$130,550ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$32,104,596SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$30,604,535SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,500,061SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,500,061TotalRevenueColumnAmt
Exclusion$1,500,061ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
Cafeteria Sales722514$189,402$189,402
Medical Abstracts541700$8,608$8,608
Physician Billing561000$7,890$7,890

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column-$687TotalRevenueColumnAmt
Related Or Exempt Func Income-$60RelatedOrExemptFuncIncomeAmt
Exclusion-$627ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$205,213OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$80,917,137TotalRevenueColumnAmt
Related Or Exempt Func Income$76,048,184RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$10,065UnrelatedBusinessRevenueAmt
Exclusion$2,548,033ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$8,040,000TotalAmt
Program Services$8,040,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$361,056TotalAmt
Program Services$361,056ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$24,729,149TotalAmt
Program Services$20,714,716ProgramServicesAmt
Management And General$4,014,433ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,239,292TotalAmt
Program Services$1,041,005ProgramServicesAmt
Management And General$198,287ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,802,336TotalAmt
Program Services$4,873,962ProgramServicesAmt
Management And General$928,374ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,869,808TotalAmt
Program Services$1,570,639ProgramServicesAmt
Management And General$299,169ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$3,666,237TotalAmt
Program Services$3,079,639ProgramServicesAmt
Management And General$586,598ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$4,376TotalAmt
Management And General$4,376ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$25,727TotalAmt
Program Services$21,611ProgramServicesAmt
Management And General$4,116ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,670,947TotalAmt
Program Services$3,923,595ProgramServicesAmt
Management And General$747,352ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$89,624TotalAmt
Program Services$75,284ProgramServicesAmt
Management And General$14,340ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$163,425TotalAmt
Program Services$137,277ProgramServicesAmt
Management And General$26,148ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$142,434TotalAmt
Program Services$119,645ProgramServicesAmt
Management And General$22,789ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$18,393TotalAmt
Program Services$15,450ProgramServicesAmt
Management And General$2,943ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$9,543TotalAmt
Program Services$8,016ProgramServicesAmt
Management And General$1,527ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$289,067TotalAmt
Program Services$242,816ProgramServicesAmt
Management And General$46,251ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,908,101TotalAmt
Program Services$3,282,805ProgramServicesAmt
Management And General$625,296ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$780,841TotalAmt
Program Services$655,906ProgramServicesAmt
Management And General$124,935ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Outside Services$13,466,300$11,311,692$2,154,608
Direct Supplies$5,814,085$4,883,831$930,254
Taxes & Licenses$1,475,302$1,239,254$236,048
Repair & Maintenance$1,358,552$1,141,184$217,368

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total-$176,970TotalAmt
Program Services-$148,654ProgramServicesAmt
Management And General-$28,316ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$77,747,625TotalAmt
Program Services$66,590,729ProgramServicesAmt
Management And General$11,156,896ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,125BOYAmt
EOY$1,425EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$10,446,998BOYAmt
EOY$6,870,401EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,045BOYAmt
EOY$1,770EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,358,822BOYAmt
EOY$9,166,216EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$2,225BOYAmt
EOY$2,662,154EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$478,939BOYAmt
EOY$579,713EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$767,961BOYAmt
EOY$538,047EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$77,968,010LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$44,649,263LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$36,733,809BOYAmt
EOY$33,318,747EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$22,252,335BOYAmt
EOY$81,970,158EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$54,427,149BOYAmt
EOY$15,028,939EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$93,247BOYAmt
EOY$74,738EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,549,681BOYAmt
EOY$1,187,977EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$135,116,336BOYAmt
EOY$151,400,285EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,751,588BOYAmt
EOY$4,386,616EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,233,517BOYAmt
EOY$6,846,161EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$6,253,792BOYAmt
EOY$4,990,640EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,369,703BOYAmt
EOY$12,310,311EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$33,608,600BOYAmt
EOY$28,533,728EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$101,485,121BOYAmt
EOY$122,828,713EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$22,615BOYAmt
EOY$37,844EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$101,507,736BOYAmt
EOY$122,866,557EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$135,116,336BOYAmt
EOY$151,400,285EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,169,512ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$18,174,075NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$15,234OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$22,615BeginningYearBalanceAmt
Contributions$15,229ContributionsAmt
End Year Balance$37,844EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,782,030BeginningYearBalanceAmt
Contributions$108,272ContributionsAmt
Investment Earnings Or Losses-$101,647InvestmentEarningsOrLossesAmt
Other Expenditures$10,766,040OtherExpendituresAmt
End Year Balance$22,615EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,228,229BeginningYearBalanceAmt
Contributions$128,383ContributionsAmt
Investment Earnings Or Losses$1,024,925InvestmentEarningsOrLossesAmt
Other Expenditures-$593,517OtherExpendituresAmt
Administrative Expenses-$5,990AdministrativeExpensesAmt
End Year Balance$11,981,044EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,507,802BeginningYearBalanceAmt
Contributions$136,108ContributionsAmt
Investment Earnings Or Losses$597,504InvestmentEarningsOrLossesAmt
Other Expenditures-$8,251OtherExpendituresAmt
Administrative Expenses-$4,510AdministrativeExpensesAmt
End Year Balance$10,254,175EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$8,591,208BeginningYearBalanceAmt
Contributions$128,985ContributionsAmt
Investment Earnings Or Losses$800,942InvestmentEarningsOrLossesAmt
Other Expenditures-$8,675OtherExpendituresAmt
Administrative Expenses-$4,658AdministrativeExpensesAmt
End Year Balance$9,534,468EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.46000BoardDesignatedBalanceEOYPct
Term Endowment Balance EOY0.54000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd
Related Org List Sch RfalseRelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,092,477OtherCostOrOtherBasisAmt
Book Value$4,092,477BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$37,397,605OtherCostOrOtherBasisAmt
Depreciation$16,635,435DepreciationAmt
Book Value$20,762,170BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$205,315OtherCostOrOtherBasisAmt
Book Value$205,315BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$35,167,126OtherCostOrOtherBasisAmt
Depreciation$27,075,160DepreciationAmt
Book Value$8,091,966BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,105,487OtherCostOrOtherBasisAmt
Depreciation$938,668DepreciationAmt
Book Value$166,819BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$33,318,747TotalBookValueLandBuildingsAmt
Total Book Value Securities$15,028,939TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Rounding$2
Third Party Advances$12,310,309
FieldValueIRS element (for citing)
Total Liability$12,310,311TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$100,205,757TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$18,174,075NetUnrealizedGainsInvstAmt
Revenue Not Reported$18,174,075RevenueNotReportedAmt
Revenue Subtotal$82,031,682RevenueSubtotalAmt
Other Revenues Not Included-$1,114,545OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$1,114,545RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$80,917,137TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$70,862,170TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$1,174,949OtherExpensesIncludedAmt
Expenses Not Reported$1,174,949ExpensesNotReportedAmt
Expenses Subtotal$69,687,221ExpensesSubtotalAmt
Other Expenses Not Included$8,060,404OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$8,060,404ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$77,747,625TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X : FIN48 FootnoteIn June 2006, the Financial Accounting Standards Board (FASB) issued Interpretation NO. 48, Accounting for Uncertainty in Income Taxes-an interpretation of FASB Statement NO. 109, Accounting for Income Taxes (FIN 48), which creates a single model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing the minimum recognition threshold a tax position is required to meet before being recognized in the financial statements. Under the requirements of FIN 48, tax-exempt organizations could now be required to record an obligation as the result of a tax position they have historically taken or various tax exposure items. Prior to FIN 48, the determination of when to record a liability for tax exposure was based on whether a liability was considered probable and reasonably estimable in accordance with SFAS No.5, Accounting for Contingencies. On July 1, 2007, the parent company, WellSpan Health, adopted FIN 48. WellSpan Health determined that it does not have any uncertain tax positions through June 30, 2021.
Part XII, Line 2d: Other expenses and losses per audited F/SRental expense netted with revenue $1174949
Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/STransfer to WellSpan Health $5000000 Revenue netted with expense $60404 Transfer to WellSpan Medical Group $3000000

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served879PersonsServedCnt
Total Community Benefit Expns$652,765TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$652,765NetCommunityBenefitExpnsAmt
Total Expense0.00840TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served12933PersonsServedCnt
Total Community Benefit Expns$9,916,981TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,386,199DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,530,782NetCommunityBenefitExpnsAmt
Total Expense0.05830TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served13812PersonsServedCnt
Total Community Benefit Expns$10,569,746TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,386,199DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,183,547NetCommunityBenefitExpnsAmt
Total Expense0.06670TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$1,275TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,275NetCommunityBenefitExpnsAmt

Research ResearchGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$20,572TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$20,572NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Total Community Benefit Expns$183,388TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$183,388NetCommunityBenefitExpnsAmt
Total Expense0.00240TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Total Community Benefit Expns$205,235TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$205,235NetCommunityBenefitExpnsAmt
Total Expense0.00270TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs6ActivitiesOrProgramsCnt
Persons Served13812PersonsServedCnt
Total Community Benefit Expns$10,774,981TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,386,199DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,388,782NetCommunityBenefitExpnsAmt
Total Expense0.06940TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$2,445TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,445NetCommunityBenefitExpnsAmt

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$2,284TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,284NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Total Community Benefit Expns$4,729TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,729NetCommunityBenefitExpnsAmt
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$1,785,975BadDebtExpenseAmt
Bad Debt Expense Attributable$28,218BadDebtExpenseAttributableAmt
Reimbursed By Medicare$30,848,087ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$30,991,506CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$143,419MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Waynesboro HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1501 East Main StreetAddressLine1Txt
CityWaynesboroCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17268ZIPCd
FieldValueIRS element (for citing)
Website Addresswww.wellspan.orgWebsiteAddressTxt
State License234301StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

FieldValueIRS element (for citing)
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLwww.healthyfranklincounty.orgOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLwww.wellspan.orgStrategyWebsiteURLTxt
Strategy AttachedYes (true)StrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.0000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care350.0000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLwww.wellspan.orgFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLwww.wellspan.orgFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLwww.wellspan.orgFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Facility: - Part V, Section B, Line 5The Summit Health Management Team, the Summit Health Community Services Team, the Healthy Franklin County Leadership Advisory Committee, and the Center for Opinion Research at Franklin and Marshall College, led by Berwood Yost, contributed to the development of the Community Health Needs Assessment (CHNA) and the Community Health Improvement Plan (CHIP). The Healthy Franklin County Leadership Advisory Committee, and the Center for Opinion Research at Franklin and Marshall College, led by Berwood Yost, contributed to the development of the Community Health Needs Assessment (CHNA) and the Community Health Improvement Plan (CHIP). The Healthy Franklin County Leadership Advisory Committee, composed of a cross-section of stakeholders in Franklin County, brought significant insight and meaningful engagement to the CHNA process. The Community Services team coordinated and/or facilitated a series of seven focus groups with community members in the Summit Health Service area. The goal of these focus groups was to gather information about Franklin County's top community health needs from the perspective of targeted community informants that included schools, low-income, minority and senior populations. Focus groups were held with Franklin County school nurses and Chambersburg and Waynesboro area school counselors, respectively. Additionally, Dr. Jose Ricardo-Osorio, a professor at Shippensburg University and a member of Healthy Franklin County Leadership team, led a focus group of Spanish-speaking Hispanic community members. Dr. Annette Searfoss, the President and CEO of First Start Partnerships for Children and Families (formerly Franklin County Head Start) and a member of Healthy Franklin County Leadership team, also led a focus groups with a group of currently-enrolled First Start families in Chambersburg while Education and Family Services staff led a second group with the same target population in Waynesboro. Last, Dr. Annette Searfoss later facilitated a focus group in Chambersburg with working adults of retirement age who must continue to work because they do not have enough savings or a retirement fund to support themselves. The goal of each of these focus groups was to gather information about Franklin Countys top community health needs from the perspective of targeted community informants.A second tool was a survey of 51 veterans conducted by the Community Services team atSummit Health. This survey was designed to closely mirror the community behavioral risk factor survey and provide more details about the health conditions, risks, and behaviors of this population.In addition to the focus groups and veterans survey, Summit Health hosted a stakeholder forum on April 15, 2019, with members of the Healthy Franklin County Leadership Advisory Group. The three primary goals of the forum were to: (1) explain the CHNA process and the role of community stakeholders; (2) present the analytic framework and preliminary community health data included in the summary; and (3) gather input from these community stakeholders who have public health expertise or serve medically underserved, low income, and minority populations in Franklin County, about community health needs and community resources.
Facility: - Part V, Section B, Line 6aThe Chambersburg Hospital.
Facility: - Part V, Section B, Line 7dA printed copy of the report may be obtained upon request to: WellSpan Summit Health, Ann Spottswood, Director of Community Services, mail to: Aspottswood2@wellspan.org.With each iteration of the CHNA process, WellSpan- Summit and its community partners continue to refine and enhance the system by which it obtains data, share it with key community, hospital and system leaders, and integrate it into the system-wide and entity-level planning processes. The key findings from the CHNA and the selected community health priorities were presented at an open community forum: BUILDING A CULTURE OF HEALTH IN FRANKLIN COUNTY, on June 5, 2019. 120 community members were given an opportunity to discuss the priorities identified and give input about how to address them through a health equity lens.The 2018 CHNA results and related priorities identified by Healthy Franklin County Leadership Advisory Group were then shared with Summit Health Management, Waynesboro Hospital, Chambersburg Hospital, and Summit Health Boards.
Facility: - Part V, Section B, Line 11The Community Health Needs Assessment process encourages communities to reflect on the initiatives that they have undertaken and their successes in addressing the health priorities they have established. Since 2015, Summit Health's Community Services team engaged with the community to establish specific activities targeted to improving community health in seven priority areas. The community priorities, goals, and activities resulting from the 2015 Community Health Needs Assessment process are fully described in Appendix I of the 2018-2019 Summit Health Community Health Needs Assessment.The seven priority areas established in 2015 include access to primary care services, nutrition, physical activity, mental health and substance use and prevention, education and community-based education, early childhood education, and adolescent health. Table 8 of the 2018-2019 Summit Health Community Health Needs Assessment shows the number of initiatives implemented and health indicators related to each. The community, led by Summit Health and the Healthy Franklin County Leadership Group, created many community interventions, with the most effort dedicated to nutrition, followed by mental health and substance use and prevention, physical activity, and access to care. Unfortunately, all of these activities have not yet produced much community-level change. Access to care has remained virtually unchanged with the exception of higher rates of dental visits. Indicators related to nutrition and physical activity have gotten worse. Mental health indicators have also declined. Education and community-based education indicators have remained virtually unchanged. Access to early childhood education has improved as have teen birth rates and teen chlamydia rates. These results are reminders of at least two important truths about improving public health. First, effecting change will require more than three or four years. Most of the public health problems in our communities have emerged over long periods of time and it will require a long-term and sustained investment to produce change. Second, most of the indicators used here are trailing indicators that reflect at least in part social and structural contexts that are likely to move once those underlying conditions begin to change. Put simply, time and social change are necessary conditions for improving the health of a community. The priorities and impacts established by the 2015 Community Health Needs Assessment (CHNA) provide a summary of the work implemented guided by the results of the previous CHNA regarding the seven priority areas indicated above. To access progress towards these goals, community indicators from the 2015 CHNA and 2019 CHNA were compared in the categories of organizational indicators and presented in a table in the CHNA assessment report. Access to care has remained virtually unchanged with the exception of higher rates of dentist visits.Nutrition and physical activity have gotten worse for all indicators, despite the many activities completed at an organizational level to address these issues. Mental health indicators have also declined. Education and community-based education indicators have remained virtually unchanged. Access to early childhood education has improved. Teen birth rate and teen chlamydia rates have gone down, while the chlamydia rate for young adults has increased. These results should be viewed while considering one important point - it takes time to see changes at the community level. Simply because an indicator has not changed or has declined does not mean that the intervention has failed - there may be more reasons why a positive changed has not occurred.See attached 2019 WellSpan Summit Health Community Health Improvement Plan, also available online at www.wellspan.org in Community Benefits section.
Facility: - Part V, Section B, Line 13hWellSpan 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: - Part V, Section B, Line 16jIn 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 (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
WellSpan Rehabilitation
500 E Main StWaynesboroPA17268Rehabilitation
WellSpan Lab Services
6155 Anthony HwyMont AltoPA17237Lab Draw Site
WellSpan Lab Services
24 Antrim Commons DrGreencastlePA17225Lab Draw site

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 ReportCommunity Benefit Information is included in the Community Benefit Report for WellSpan Health.
Part III, Line 2 - Methodology Used To Estimate Bad Debt ExpenseThe 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 BenefitThe 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 ExpenseThe 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 BenefitWaynesboro 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 Waynesboro Hospital's costs of providing the service.
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsGuidelines 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 AssessmentWellSpan Summit Health and its entities have a long history of working to better understand and respond to the health and healthcare needs of our communities and the populations we serve. Throughout the last two decades, Summit Health has made great changes to programs and services based on the findings of the CHNAs conducted in 2008, 2012, 2015 and 2018. The data played a large role in the overall strategic planning process for Summit Health.The Patient Protection and Affordable Care Act of 2010 required non-profit hospitals to conduct community health needs assessments every three years. Summit Health, and its affiliates, Chambersburg Hospital and Waynesboro Hospital, completed a CHNA report and CHIP in 2015. The 2015 CHNA report identified community health priorities of access to care; obesity, nutrition, and physical activity; mental health, substance use, and prevention; educational and community- based engagement; early childhood education; and adolescent health. Based on the data, plans were created to address the identified needs by developing education, screenings, recruitment, partnerships, and needed infrastructure.The programs helped community members gain access to needed prescriptions, primary care providers and specialists. New facilities were constructed to offer the care the community needed. Free screenings, camps and classes were put into motion and awareness was created through advertising, speaking events, health fairs, and social media. Several grants were awarded to community non- profits through Summit Endowment whose projects address key health priorities of Franklin County. While many of the goals were accomplished, others went unmet. It became clear, to be more effective, Summit Health needed to further work with community partners to determine the health needs and key priorities of the community and to work together to develop strategies to address them, a process that is constantly evolving. The 2018 CHNA was developed utilizing consulting support and guidance through a contract with the Floyd Institute for Public Policy at Franklin and Marshall College. Dr. Berwood Yost, Institute Director and Project Lead has an extensive background conducting and analyzing community and corporate surveys and was integral to the prior CHNA conducted in 2015.The Summit Health Community Services team facilitated planning and collaboration with community stakeholders who 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 results and priorities were to be shared with the community. The telephone survey was conducted by staff of the Floyd Institute for Public Policy at Franklin and Marshall College with 506 adult residents throughout Franklin County completing responses.WellSpan Health held a meeting of the Healthy Franklin County leadership team on April 15, 2019. The three primary goals of the forum were to explain the CHNA process and the role of community stakeholders, present the analytic framework and preliminary community health data included in this summary, and gather input from community stakeholders, particularly those with public health expertise and individuals and organizations serving medically underserved, low-income, and minority populations in Franklin County, about community health needs and community resources. After a brief presentation of community health data, including demographics, social determinants such as education and income, health behaviors, and health outcomes, attendees answered three specific questions: what are the most important health needs in our community? How important is addressing this need to our communitys overall health and well-being? How likely is it that our community could implement the changes needed to address this problem?Four working groups then created a final list of 35 distinct health needs, which were ranked. Based on scope, severity, and community perceptions of severity and potential impact, and considering the community initiatives taken since 2015, Franklin Countys most significant needs focus on two social determinants and two behavioral health priorities: Establishing and maintaining the basic conditions that support health, including, access to care, family-sustaining incomes, accessible transportation, reduced stress, and affordable and quality housingEstablishing and maintaining systems that assure that children and families have access to high quality educational opportunities throughout the lifespanSupporting improved mental health including reducing and treating substance useSupporting active living, healthy eating, and less obesityThe identified priorities and associated data were subsequently presented to the WellSpan-Chambersburg and Waynesboro Hospital Boards 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 Summit Community Health Improvement Plan (CHIP) was presented in September 2019 to the Summit Health Board for their review and approval. This information is included in the 2018 Community Health Needs Assessment Summary Report available at www.wellspan.org.
Part VI, Line 5 - Promotion of Community HealthAs a charitable, community-based healthcare organization, our commitment to improving the lives and well-being of the people and communities we serve is carried out every day. Our Community Health Improvement Plan framework is constructed with Healthy People 2020 Leading Health Indicators and objectives. Further, our work at the local level aligns with similar goals and objectives in the 2017 Pennsylvania Department of Healths State Health Improvement Plan. Over the last three years, WellSpan Summit Health provided over $101 million of charity care to the community. Continuing our commitment to supporting the work of high-performing non-profit community organizations, between 2018 --2021, the Summit Endowment awarded more than $1.2 million in the form of 42 grants to address key issues and health priorities as outlined in our Community Health Improvement Plan.Below are a few examples of the work accomplished in the various priority areas in fiscal year 2021: In 2021, WellSpan Health encouraged community members, local employers and employees, and WellSpan staff and patients to engage in the 8th annual 10 Pound Throwdown. The 10 pound Throwdown is a 10-week community challenge that encourages participants to lose or maintain a healthy weight through healthier eating and increased physical activity. The initiative was created in 2013 to address the growing issue of adult overweight/obesity and utilizes a core website (www.10poundthrowdown.com) to encourage team participation and to offer an online weight tracker, badges to encourage healthier choices, and diverse health education resources. The 10 Pound Throwdown engaged 7,200 community members across five southcentral Pennsylvania countiesAdams, Lancaster, Lebanon, York and Franklin.A series of health improvement workshops, titled Winter STREAK were held between January--March 2021. More than 250 individuals participated in virtual sessions that included timely information around Relaxation, Eating Healthy, Trekking, and Physical Activity.In 2021, WellSpan expanded its GO (Get Outdoors) program into Franklin County. 28 individuals participated in this initiative with the aim of helping families increase physical activity by getting outdoors. The program utilized an adaptation of letterboxing, an international hobby where participants use written clues to find items hidden in various places.Offering financial support for youth who wish to pursue careers in healthcare is essential to maintaining quality healthcare services. The Greencastle -Antrim Endowment, a component of Summit Health Endowment, is a funding mechanism which offers scholarships that ultimately impact the CHNA priority of Access to Care. From 2017-2021, $136,000 was awarded via 74 college scholarships to Greencastle-Antrim high school students pursuing a career in healthcare. 16 pre-med students participated in a summer work experience at Summit Health and 12 medical students participated in a resident internship in the Emergency Room at Summit Health. Summit Physician Services established a work group, created a plan and received funding from Summit Endowment to establish a community health worker program in 2017 to serve vulnerable, low-resourced seniors. Funding supports two Community Health Workers, who serve as liaisons between health and social services, and the community, to facilitate access to services. In 2018, the workers focused on targeted populations in the community, specifically residents of the Towers of Falling Spring in Chambersburg and diabetic patients with HgA1C greater than 9 percent. In 2019, the program expanded services to the Cottages, a senior-living apartment complex in Shippensburg. In 2021 one of the Community Health Workers expanded services to better understand and support the needs of the Latino community.Both Keystone Health and Summit Health providers are using health risk assessments to collect data to better understand and act on their patients social determinants of health. Keystone Health adopted and implemented a plan to reach linguistically isolated individuals which is reviewed annually.Summit Community Services supports Healthy Communities Partnership of Greater Franklin County in their coordination of Chambersburg Cares, a community-wide effort to engage community members and aligns resources, to promote healthy youth behaviors and reduce risk factors. Chambersburg Cares uses a data-driven process and the Communities That Care model. The group determines risks and root causes, working together to target the prioritized risks through evidence-based programs in schools and other community organizations. The Healthy Franklin County Leadership committee formed an ad hoc diversity, inclusion, and discrimination committee in the fall of 2017, due to heightened racial tensions occurring nationally which also emerged locally. The ad hoc committee conducted an environmental scan to see how these issues were being addressed in the community and to gain a better understanding of what the committees role could be in addressing them. The research done by the committee uncovered the connection between the Social Determinants of Health (SDOH) and health equity. As a result, the Healthy Franklin County Leadership committee determined that it and its partners should take steps to address the SDOH more intentionally with their work. During the same time, several grass roots groups have emerged in the community to champion the need for more diversity and inclusion training, increase the awareness and acceptance of the LGBTQ+ and the importance of racial reconciliation. Our Community Services team has continued to engage in various activities that raise awareness and honors diversity, including co-hosting MLK Day events in both 2020 and 2021.Community Services team members continue to support the Be The Village collaborative, a school-based Prenatal3rd grade initiative that supports families in their parenting role. Through ongoing efforts to strengthen standardized readiness assessment staff has implemented the KEI, Kindergarten Entry Inventory, to better assess the childs developmental status. In June 2021, 40 school nurses attended a virtual training that included presentations around diversity and inclusion, the culture of trauma informed care, and the health impact of vaping upon youth. 100% of attendees that completed evaluations stated that they have a better understanding of how to define and implement strategies and interventions to support individuals in the school setting.In 2021, The Healthy Franklin County Nutrition, Physical Activity and Weight Status Task force coordinated a virtual Community Garden Workshop where 45 individuals learned about various topics including foraging, herb spirals, honeybees, food scaping and Panel Wrap up. In 2021, more than 350 families received boxes of school supplies, hand sanitizer and masks during the Shippensburg Family Fund Day/Back to School Drive. In addition, 400 families benefited during United Ways Learn and Play Day. 300 bags were distributed in conjunction with a virtual education series aimed to support childrens emotional well-being.An evidenced-based, Center for Disease Control (CDC) Recognized Lifestyle Change Program, Prevent T2 was implemented by Summit Health in 2016 to help those with prediabetes make changes that can cut the risk of developing Type 2 diabetes by more than half. In 2021, three series of this year-long evidence-based model were implemented and served 24 individuals.From 2016-2021, a total of 277 adults across Franklin County in Chambersburg and Waynesboro have participated in Summit Healths Get Fit Now program. This five-week healthy lifestyle program uses a combination of Fit Bit technology and supportive group sessions to help participants learn strategies to improve health by tracking physical activity, developing personal health goals, learning healthier ways to shop for and prepare food, and understanding how stress influences how they eat and move. Additional examples of how WellSpan-Waynesboro Hospital fulfilled its community mission in Franklin County may be found in the 2021 WellSpan Community Benefit Report available online at: https://www.wellspan.org/about/wellspan-in-the-community/2021-community-benefit-report/
Part VI, Line 6 - Affilated Health Care SystemWellSpan 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 Gettysburg 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.Waynesboro Hospital's community benefit report is contained in a report prepared by their parent organization, WellSpan Health. See WellSpan Health - 2021 Community Benefit Report at www.wellspan.org
Part VI, Line 7 - States Filing of Community Benefit ReportPA

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
WellSpan Health
PO Box 2767YorkPA17405222517863501(c)(3)$5,000,000$0Community health
WellSpan Medical Group
PO Box 2767YorkPA17405232730785501(c)(3)$3,000,000$0Community health
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceGrantmaker's Description of How Grants are UsedFormAndLineReferenceDesc
ExplanationAll 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

FieldValueIRS element (for citing)
Discretionary Spending AcctYes (X)DiscretionarySpendingAcctInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
Charles Chondroff MD
Former Director$311,503$605,876$2,069,816$7,037$64,752$3,058,984$1,997,388
Clarence Miller
Pathologist$222,644$1,200$4,078$3,869$43,583$275,374
David Doud DO
Director$336,461$1,200$12,082$45,422$395,165
Edward Mackle MD
Director$556,705$1,200$31,458$49,347$638,710
Jill Keller-Reyka
Regional Director$185,036$28,943$15,248$2,779$52,984$284,990
Kevin Lorentsen
Director$439,604$50,700$8,550$37,470$536,324
Kevin Sanders
Physician Assistan$183,427$1,200$3,378$36,567$224,572
Melissa Dubrow
President$226,764$41,768$20,600$16,688$55,236$361,056
Michael O'Connor
Former Director$611,969$404,687$2,042,231$123,405$85,586$3,267,878$2,042,158
Mike Seim
SVP CQO$438,755$52,800$22,903$7,015$37,511$558,984$18,133
Patrick O'Donnell
Former Director$942,819$57,149$486,448$25,200$52,022$1,563,638
Robert Robertson MD
Former Director$440,119$16,715$4,935$8,550$38,874$509,193
Roxanna Gapstur
CEO-WSH/Dir.$1,091,608$440,000$11,619$60,941$1,604,168$242,000
Scott Card
Physician$329,237$1,200$5,726$5,371$48,600$390,134
Sherri Stahl
SVP$426,019$122,742$80,873$5,700$58,427$693,761
Wanda Crilly
Manager FBS$88,373$1,739$124,256$1,796$24,805$240,969

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 1a: Relevant information in regards to selections on 1a.FormAndLineReferenceDesc
ExplanationThe officers receive an allowance that can be considered a discretionary spending account. The monies are in lieu of an automobile allowance, to purchase additional life insurance, etc. Results Fitness Club membership is available free of charge for any officer and active board member.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1See Schedule OBusinessNameLine1Txt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Dr David Doud DOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionOwnerRelationshipDescriptionTxt
Transaction$98,921TransactionAmt
TransactionProperty LeaseTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderWellSpan Summit Health, a not-for-profit corporation, is the sole member of the Hospital.WellSpan Health, a not-for-profit corporation, is the sole member of WellSpan Summit Health.
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodySubject to any powers reserved to WellSpan Health or the Member (WellSpan Summit Health) by the bylaws, the governance of the Hospital shall be vested in the Board of Directors of the Hospital who shall have authority to manage the business, property and affairs of the Hospital as provided by the Act. In this capacity, the Board shall act as the governing body of the Hospital on all matters not reserved to WellSpan and the Member, including but not limited to, responsibility for the quality of care delivered by the Hospital and its Medical Staff, and for adherence to applicable licensure requirements established by the Pennsylvania Department of Health for acute care general hospitals, the Medicare Conditions of Participation established by CMS for hospitals, and the accreditation standards established by The Joint Commission (or similar accreditation organization), including requirements regarding medical staff appointments, credentialing and oversight. With respect to those powers and responsibilities reserved to WellSpan and the Member, the Board shall serve in an advisory capacity.
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersRights of WellSpan. WellSpan may, with respect to the Hospital, initiate and implement any of the following actions, except as otherwise provided in the Affiliation Agreement, and if any of the following actions are otherwise initiated by the Hospital or the Member, such action shall not become effective unless approved by WellSpan:(a)adoption, amendment, restatement, repeal, termination or any other modification of any governing instrument of the Hospital; (b)any fundamental transactions involving the Hospital, including the reorganization, merger, consolidation, change of control, sale of all or substantially all the assets, conversion, dissolution, assignment for the benefit of creditors, filing of any bankruptcy petition, or similar transaction; provided however, for at least ten (10) years following the Effective Date, WellSpan shall not sell, transfer, convey, lease, exchange, or otherwise dispose of all or substantially all of Hospitals assets, unless otherwise approved by the Member and a majority of the Board;(c)except as otherwise provided in Section 10.4(d) of the Affiliation Agreement. investment of any Hospitals assets other than in accordance with WellSpans investment policy then in effect; provided, that any Hospital assets invested by WellSpan will be invested pro rata in accordance with WellSpans risk allocation strategy applicable to the assets of all other WellSpan entities; (d)incurrence of indebtedness in excess of limits established by WellSpans policy then in effect (which shall in no event be less than One Million Dollars ($1,000,000)) by the Hospital;(e)any sale, transfer, conveyance, lease, exchange, mortgage, encumbrance, pledge or other disposition of the Hospitals assets with fair market value in excess of limits established by WellSpans policy then in effect (which shall in no event be less than One Million Dollars ($1,000,000)), other than in the normal course of business; (f)adopting any annual operating or capital budgets for the Hospital, provided, however, that such operating budget shall include funding for community benefit programs;(g)any capital expenditures by the Hospital in excess of the WellSpan-approved annual capital budgets for the Hospital;(h)except as otherwise provided in the Affiliation Agreement, any material changes to licenses held by the Hospital; (i)selecting, hiring, contracting with, or otherwise entering into agreements with, whether oral or written, any outside financial auditors, legal counsel or investment advisors that may be recommended by the Hospital for its local needs or activities, other than the outside financial auditors, legal counsel or investment advisors selected by WellSpan;(j)review and approval of the Hospitals nominees for the Hospitals corporate officers before such nominees are appointed by the Board; (k)adopting the statement of mission and vision, strategic and operating plans and any amendments thereto for the Hospital; (l)creation of new (or material changes, including closure or cessation, to existing) lines of business, sites of business, subsidiaries, partnerships or joint venture by the Hospital (subject to WellSpans and the Members right to require the decision-making process described in Section 10.3(a)(iv) of the Affiliation Agreement, if applicable); and(m)Any change in the Hospitals tax-exempt status (subject to Section 10.1 of the Affiliation Agreement), charitable mission, or charity care policies and practices (which shall at all times comply with the integrated regional nonprofit health care systems charity care policies and practices in effect from time to time).Section 2.2Rights of the Member. Subject to WellSpans reserved powers in Section 2.1 above and in addition to all matters required by law or these By-Laws to be approved by the Member, the Member shall have the following rights and responsibilities: (a)recommending (for WellSpan approval) operating plans for the Hospital that are in conformance with System-approved priorities and plans;(b)monitoring the Hospitals accomplishment of the Hospitals operating plans;(c)recommending (for WellSpan approval) annual operating and capital budgets for the Hospital that are in conformance with System budget targets;(d)monitoring the Hospitals financial performance against the Hospitals operating and capital budgets;(e)monitoring the quality of and satisfaction with clinical services provided by the Hospital; (f)nominating the Hospitals corporate officers for review and approval by WellSpan before they are appointed by the Board; (g)ensuring that the governing board of the Hospital is effectively monitoring compliance with applicable licensure requirements established by the Pennsylvania Department of Health for acute care general hospitals, the Medicare Conditions of Participation established by The Centers for Medicare and Medicaid Services for hospitals, and the accreditation standards established by The Joint Commission (or similar accreditation organization), including requirements regarding medical staff appointments, credentialing, and oversight; (h)representing the interests of the community or population served by the Hospital;(i)recommending (for WellSpan approval) changes in the services provided by the Hospital (subject to WellSpans and the Members right to require the decision-making process described in Section 10.3(a)(iv) of the Affiliation Agreement, if applicable);(j)recommending (for WellSpan approval) amendments to the Hospitals Articles of Incorporation or By-Laws;(k)recommending (for WellSpan approval) fundamental transactions involving the Hospital, including the reorganization, merger, consolidation, change of control, sale of all or substantially all the assets, conversion, dissolution, assignment for the benefit of creditors, filing of any bankruptcy petition, or similar transaction;(l)except as otherwise provided in Section 10.4(d) of the Affiliation Agreement, recommending (for WellSpan approval) investment of any Hospitals assets other than in accordance with WellSpans investment policy then in effect;(m)recommending (for WellSpan approval) the Hospitals incurrence of indebtedness in excess of limits established by a WellSpan policy then in effect (which shall in no event be less than One Million Dollars ($1,000,000));(n)recommending (for WellSpan approval) the sale, transfer, conveyance, lease, exchange, mortgage, encumbrance, pledge or other disposition of the Hospitals assets with fair market value in excess of limits established by a WellSpan policy then in effect (which shall in no event be less than One Million Dollars ($1,000,000)), other than in the normal course of business;(o)recommending (for WellSpan approval) capital expenditures in excess of the WellSpan-approved annual capital budgets for the Hospital;(p)recommending (for WellSpan approval) material changes to licenses held by the Hospital;(q)recommending (for WellSpan approval) any outside financial auditors, legal counsel or investment advisors for the Hospitals local needs or activities, other than the outside financial auditors, legal counsel or investment advisors selected by the System;(r)recommending (for WellSpan approval) changes to the Hospitals statement of mission and vision, strategic and operating plans; (s)recommending (for WellSpan approval) the creation of new (or material changes, including closure or cessation, to existing) lines of business, sites of business, subsidiaries, partnerships or joint ventures by the Hospital (subject to WellSpans and the Members right to require the decision-making process described in Section 10.3(a)(iv) of the Affiliation Agreement, if applicable); and (t)recommending (for WellSpan approval) any change in any the Hospitals tax-exempt status, charitable mission or charity care policies and practices (which shall at all times comply with the Systems charity care policies and practices in effect from time to time).
Form 990, Part VI, Line 11b: Form 990 Review ProcessManagement 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 ConflictsOfficers, 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 EmployeesThe 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 AvailableGoverning documents, policies, and financial statements are available upon request.
Other Changes In Net Assets Or Fund Balances - Other IncreasesAdjustment = $5
Other Changes In Net Assets Or Fund Balances - Other IncreasesIncrease in permanently restricted net assets = $15229
Other Changes In Net Assets Or Fund Balances - Other IncreasesRental expenses netted with revenue = $0
Schedule K - Tax Exempt Bonds1.2014 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 Line - Paid Preparer ExplanationPaid 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) 893-0600
Part IV, Line 20bAudited Financial Statements

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (25 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Apple Hill Surgical Center Inc
PO Box 2767YorkPA174052767222842253Sole GP in limited ptnrshp operating surPA501(c)(3)10Wellspan Health Care Servicesfalse
Gettysburg Hospital
PO Box 2767YorkPA174052767231352220Health Care ServicesPA501(c)(3)3Wellspan Healthfalse
Gettysburg Hospital Foundation
PO Box 2767YorkPA174052767232251358Fundraising for Gettysburg HospitalPA501(c)(3)12 Type IIGettysburg Hospitalfalse
Healthy Community Pharmacy Inc
PO Box 2767YorkPA174052767200519121Reduced rate prescription drugsPA501(c)(3)12 Type IWellspan Health Care Servicesfalse
VNA Community Services
PO Box 2767YorkPA174052767232338591Home personal care services for elderlyPA501(c)(3)10Wellspan Specialty Servicesfalse
VNA Home Health Services
PO Box 2767YorkPA174052767231352573Home health servicesPA501(c)(3)10Wellspan Specialty Servicesfalse
Wellspan Health
PO Box 2767YorkPA174052767222517863Integrated Health SystemPA501(c)(3)12 Type IIINAfalse
Wellspan Health Care Services
PO Box 2767YorkPA174052767232400237Health-related activities in the servicePA501(c)(3)12 Type IIWellspan Healthfalse
Wellspan Medical Group
PO Box 2767YorkPA174052767232730785Meidcal and surgical carePA501(c)(3)10Wellspan Healthfalse
York Health Foundation
PO Box 2767YorkPA174052767233050192CHaritable contributions for WellspanPA501(c)(3)12 Type IIIWellspan Healthfalse
York Hospital
PO Box 2767YorkPA174052767231352222Community teaching hospitalPA501(c)(3)3Wellspan Healthfalse
Wellspan Surgery & Rehab Hospital
PO Box 2767YorkPA174052767232899911Surgery and Rehabilitation HospitalPA501(c)(3)3Wellspan Healthfalse
Wellspan Properties
PO Box 2767YorkPA174052767222842252Leases facilities to affliatesPA501(c)(3)12 Type IIWellspan Health Care Servicesfalse
Ephrata Community Hospital
PO Box 2767YorkPA174052767231370484Health Care ServicesPA501(c)(3)3Wellspan Healthfalse
Northern Lancaster County Medical Group
PO Box 2767YorkPA174052767203033058Medical and surgical carePA501(c)(3)12 Type IIEphrata Community Hospitalfalse
Phys Spec of North Lanc Co Med Gr
PO Box 2767YorkPA174052767452537633Physician PracticesPA501(c)(3)12 Type IINorthern Lancaster County Medical Groupfalse
Good Samaritan Hospital
PO Box 2767YorkPA174052767230794160Health Care ServicesPA501(c)(3)3Wellspan Healthfalse
Philhaven
PO Box 2767YorkPA174052767231549922Health Care ServicesPA501(c)(3)3Wellspan Healthfalse
Good Samaritan Health Service Foundation
PO Box 2767YorkPA174052767232356151FundraisingPA501(c)(3)12 Type IGood Samaritan Hospitalfalse
Good Samaritan Physician Services
PO Box 2767YorkPA174052767251832359Medical and Surgical CarePA501(c)(3)10Good Sam Health Service Foundationfalse
Wellspan Summit Health
PO Box 2767YorkPA174052767251515371Integrated Health SystemPA501(c)(3)7Wellspan Healthfalse
Wellspan Summit Foundation
PO Box 2767YorkPA174052767831196554Fundraising for health care systemPA501(c)(3)12 Type IIWellspan Summit Healthfalse
Chambersburg Hospital
PO Box 2767YorkPA174052767230465970Health Care ServicesPA501(c)(3)3Wellspan Summit Healthfalse
Summit Physician Services
PO Box 2767YorkPA174052767251716306Medical and surgical carePA501(c)(3)3Wellspan Summit Healthfalse
Chambersburg Health Services
PO Box 2767YorkPA174052767251515376Health care servicesPA501(c)(3)12 Type IWellspan Summit Healthfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
Apple Hill Surgical Center Partners
PO Box 2767YorkPA174052767232489452Surgical CenterPANAfalsefalse
Central PA Alliance Laboratories LLC
PO Box 2767YorkPA174052767232910950Ref. LabPANAfalsefalse
Littlestown Health Care Partners
300 West King StreetLittlestownPA17340232880464Lease facilityPANAfalsefalse
Cherry Tree Cancer Center LLP
PO Box 2767YorkPA174052767232915628RadiationPANAfalsefalse
The Rehab Center
855 Springdale Drive Suite 20ExtonPA19341251687903Physical Therapy RehabPANAfalsefalse
Surgery Center Associates
785 5th AvenueChambersburgPA17201251845304Physician servicesPAChambersburg Healthfalsefalse
Summit Surgery Center
785 5th AvenueChambersburgPA17201251845303Physician ServicesPAChamberburg Healthfalsefalse
Cumberland Valley Mobile Services LLC
5 South Main StreetSugarloafPA18249200884014Mobile medical servicesPAChambersburg Healthfalsefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
Wellspan Pharmacy Inc
PO Box 2767YorkPA174052767232374072Dispense Rx's & provPANAC corpfalse
WellSpan Reciprocal Risk Retention Group
PO Box 2767YorkPA174052767200048457Risk Retention GroupPANAC corpfalse
York Health Plan
PO Box 2767YorkPA174052767232664989Preferred ProviderPANAC corpfalse
Wellspan Provider Network
PO Box 2767YorkPA174052767232907828Coordinated managedPANAC corpfalse
Apple Hill Condominium Association
PO Box 2767YorkPA174052767232504543Condo Mgmt AssociationPANAHomeownersfalse
North Lanc Co Phys Hosp All
PO Box 2767YorkPA174052767232421885Coord Phys & HospitalPANAC corpfalse
GSH Realty Inc
PO Box 2767YorkPA174052767251832359Non-res rentalsPANAC corpfalse
Ephrata Health Pavilion Condo Assoc
PO Box 2767YorkPA174052767475367279Condo associationPAEphrata HospitalC corpfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Wellspan Health
b$5,000,000General Ledger
Wellspan Medical Group
b$3,000,000General Ledger
Wellspan Summit Foundation
c$163,467General Ledger