2022-05-13T12:20:00-07:00 2021-06-30 135381590 WellSpan Health 3350 WHITEFORD ROAD YORK PA 17402 990 2020-07-01 231360854 WAYNESBORO HOSPITAL WAYN 7178513055 PO BOX 2767 YORK PA 17405 Laura Buczkowski SR VP & CFO 2022-05-13 false Laura Buczkowski 999009999 See Attached P01871563 7038930600 2 AAL1 IAL1 FAL1 2020 2022-09-23 18:48:47Z Roxanna Gapstur PO BOX 2767 YORK PA 174052767 112696621 false X WWW.WELLSPAN.ORG X 1922 PA Waynesboro Hospital is a regional nonprofit healthcare organization committed to the improvement of the health and well-being of the people in Southcentral Pennsylvania. 15 7 726 70 10065 7074 6350729 2310855 63463108 76058309 1467893 2212210 383347 335763 71665077 80917137 30284637 8040000 0 38356248 34001641 0 0 25289905 35705984 93930790 77747625 -22265713 3169512 135116336 151400285 33608600 28533728 101507736 122866557 Waynesboro Hospital is a regional nonprofit healthcare organization committed to the improvement of the health and well-being of the people in Southcentral Pennsylvania. false false 66590729 8040000 76058249 Waynesboro 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/ 66590729 true true false false false false false false false true true true false false true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true false false false true 38 0 true 726 true true true false false false false false false 0 false false false false false false false X 15 7 false false false false true true true true true false false true true true true true true false true true true PA X DAVID RIZZUTO 7178513055 3350 WHITEFORD ROAD YORK PA 17402 X Michael O'Connor Former Director 0.00 40.00 0 3058887 208991 Charles Chondroff MD Former Director 0.00 40.00 0 2987195 71789 Roxanna Gapstur CEO-WSH/Dir. 1.00 40.00 X X 0 1531608 72560 Patrick O'Donnell Former Director 0.00 40.00 0 1486416 77222 Sherri Stahl SVP 1.00 40.00 X X 0 629634 64127 Edward Mackle MD Director 1.00 40.00 X 0 557905 80805 Mike Seim SVP CQO 1.00 40.00 X X 0 514458 44526 Kevin Lorentsen Director 1.00 40.00 X 0 490304 46020 Robert Robertson MD Former Director 0.00 40.00 0 461769 47424 David Doud DO Director 1.00 40.00 X 0 337661 57504 Scott Card Physician 40.00 0.00 336163 0 53971 Melissa Dubrow President 40.00 0.00 X X 289132 0 71924 Jill Keller-Reyka Regional Director 40.00 0.00 229227 0 55763 Clarence Miller Pathologist 40.00 0.00 227922 0 47452 Wanda Crilly Manager FBS 40.00 0.00 214368 0 26601 Kevin Sanders Physician Assistan 40.00 0.00 184627 0 39945 Laura Buczkowski SR VP & CFO WSH 1.00 40.00 X X 0 55289 40338 Nancy Myers Esq Chairman 1.00 0.00 X 0 0 0 Edith Jardine Director 1.00 0.00 X 0 0 0 Horace Martin MD Director 1.00 0.00 X 0 0 0 Julie Ramsey Director 1.00 0.00 X 0 0 0 Steve Holoviak Director 1.00 0.00 X 0 0 0 Denis Onieal Director 1.00 0.00 X 0 0 0 Cheryl Plummer Chairman 1.00 0.00 X 0 0 0 1481439 12111126 1106962 6 true true false Quest Diagnostics PO Box 912512 Pasadena CA 911102512 Lab Services 104711 1 163467 2119266 28122 2310855 Policy Adjustments 621500 -1682781 -1682781 Total Patient Revenue 621500 85371513 85361448 10065 W/O Bad Debts 621500 -5588027 -5588027 W/O Free Service 621500 -2042396 -2042396 76058309 712149 712149 0 0 1305499 1174949 130550 130550 130550 32104596 30604535 1500061 1500061 1500061 0 0 0 Cafeteria Sales 722514 189402 189402 Medical Abstracts 541700 8608 8608 Physician Billing 561000 7890 7890 -687 -60 -627 205213 80917137 76048184 10065 2548033 8040000 8040000 0 0 0 361056 361056 0 24729149 20714716 4014433 1239292 1041005 198287 5802336 4873962 928374 1869808 1570639 299169 3666237 3079639 586598 4376 4376 25727 21611 4116 0 0 0 4670947 3923595 747352 89624 75284 14340 163425 137277 26148 0 0 142434 119645 22789 18393 15450 2943 0 9543 8016 1527 289067 242816 46251 0 3908101 3282805 625296 780841 655906 124935 Outside Services 13466300 11311692 2154608 Direct Supplies 5814085 4883831 930254 Taxes & 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Rounding 2 Third Party Advances 12310309 12310311 X 100205757 18174075 18174075 82031682 -1114545 -1114545 80917137 70862170 1174949 1174949 69687221 8060404 8060404 77747625 Part X : FIN48 Footnote In June 2006, the Financial Accounting Standards Board (FASB) issued Interpretation NO. 48, Accounting for Uncertainty in Income Taxes-an interpretation of FASB Statement NO. 109, Accounting for Income Taxes (FIN 48), which creates a single model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing the minimum recognition threshold a tax position is required to meet before being recognized in the financial statements. Under the requirements of FIN 48, tax-exempt organizations could now be required to record an obligation as the result of a tax position they have historically taken or various tax exposure items. Prior to FIN 48, the determination of when to record a liability for tax exposure was based on whether a liability was considered probable and reasonably estimable in accordance with SFAS No.5, Accounting for Contingencies. On July 1, 2007, the parent company, WellSpan Health, adopted FIN 48. WellSpan Health determined that it does not have any uncertain tax positions through June 30, 2021. Part XII, Line 2d: Other expenses and losses per audited F/S Rental expense netted with revenue $1174949 Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S Transfer to WellSpan Health $5000000 Revenue netted with expense $60404 Transfer to WellSpan Medical Group $3000000 true true X true X 300.000000000 true X true true false false true true 1 879 652765 652765 0.00840 1 12933 9916981 5386199 4530782 0.05830 2 13812 10569746 5386199 5183547 0.06670 1 1275 1275 1 20572 20572 0.00030 2 183388 183388 0.00240 4 205235 205235 0.00270 6 13812 10774981 5386199 5388782 0.06940 1 2445 2445 1 2284 2284 2 4729 4729 true 1785975 28218 30848087 30991506 -143419 X true true 1 1 Waynesboro Hospital 501 East Main Street Waynesboro PA 17268 www.wellspan.org 234301 X X X false false true X X X X X X X X X 18 true true true true X www.healthyfranklincounty.org X X true 19 true www.wellspan.org true false true X 300.0000 350.0000 X X X X X X X true true X X X X true X www.wellspan.org X www.wellspan.org X www.wellspan.org X X X X X X X true X false X X X X true X false false Facility: - Part V, Section B, Line 5 The 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 6a The Chambersburg Hospital. Facility: - Part V, Section B, Line 7d A 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 11 The 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 13h WellSpan Health is committed to caring for all the members of its communities, regardless of their ability to pay. In recent years, overall charity care has decreased slightly as more people have obtained health insurance coverage through the Affordable Care Act and the expansion of Pennsylvanias Medical Assistance (Medicaid) program. WellSpan is proud to be a leading partner in the Healthy Community Network, which works to address the needs of uninsured and underinsured individuals in our community. In addition, the health system recently enhanced its financial assistance policy and the discounts that it provides on services. For example, if a patients income is less than 300 percent of the federal poverty level, that patient would be eligible for a 100 percent discount on the services provided. Additionally, significant discounts are available for patients whose income is between 300 percent and 350 percent of the federal poverty level. For more information on WellSpans Financial Assistance program, visit www.WellSpan.org/FinancialAssistance. Facility: - Part V, Section B, Line 16j In an effort to make patients, families and others in our communities aware of the newly expanded Financial Assistance Policy, WellSpan broadly publicized its policy via promotional signage and the distribution of easy-to-read informational materials at registration sites throughout our communities. WellSpan provided information on the Financial Assistance Policy on its billing statements and included information in patient discharge materials. In addition, the materials and information are easily accessible via WellSpans website at www.WellSpan.org/FinancialAssistance. The site reflects WellSpans newly enhanced policy, as well as informational and application materials. It was also publicized via WellSpans on-hold phone messaging system and in its direct-to-consumer community newsletter/magazine, which is distributed by mail, email and on-line. In addition, WellSpan placed posters and signage at its various sites of care to publicize its Financial Assistance Policy. Printed copies of WellSpan Healths entire financial assistance policy and the plain language summary of the policy, both of which are available in English and Spanish, may be obtained at no cost by visiting or calling one of the WellSpan patient financial services offices.The Financial Assistance Policy, Financial Assistance Application and Financial Assistance Policy Plain Language Summary are all available in Spanish. WellSpan Rehabilitation 500 E Main St Waynesboro PA 17268 Rehabilitation WellSpan Lab Services 6155 Anthony Hwy Mont Alto PA 17237 Lab Draw Site WellSpan Lab Services 24 Antrim Commons Dr Greencastle PA 17225 Lab Draw site Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) Patients 401% of poverty level and greater do not qualify for financial assistance. Patients/guarantors who complete an application for Financial Assistance whose gross income falls between 351-400% of the FPL level and meet all other Financial Assistance qualifications (MAP 118) will be eligible for a 40% discount of self-pay balances. Part I, Line 6a - Related Organization Community Benefit Report Community Benefit Information is included in the Community Benefit Report for WellSpan Health. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense The number was calculated using the cost to charge ratio factor applied against actual patient bad debt write-offs. These numbers are included after all efforts have been exhausted to determine if the patient meets our charity care write-off policy based on federal poverty levels. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit The estimate of bad debt attributable to charity care policy was calculated by dividing the bad debt amount that was originally coded bad debt but later found to qualify as charity care by the amount coded to the charity care write-off codes. This ratio is applied to the bad debt cost factor expense. Part III, Line 4 - Bad Debt Expense The Company provides an allowance for doubtful accounts for estimated losses resulting from the unwillingness or inability of patients to make payments for services. The allowance is determined by analyzing specific amounts and historical data and trends. Patient accounts receivable are charged off against the allowance for doubtful accounts when management determines that recovery is unlikely and the Company ceases collection efforts. Losses have been consistent with management's expectations in all material respects. Part III, Line 8 - Explanation Of Shortfall As Community Benefit Waynesboro 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 Patients Guidelines for suggested minimum number of phone attempts and letters to be sent before the account is turned over to an outside collection agency are included in the Patient Administrative Services Policy. Upon final PARO (Payment Assistance Rank Ordering) scoring, if a patient qualifies for presumptive charity, their account would not be forwarded to any third-party collections. It shall be the policy of Patient Administrative Services to recommend accounts to Bad Debt on a timely basis. Inpatient/Outpatient accounts will go to bad debt automatically after the account has been in the financial class Pending Bad Debt for 30 days. All accounts must follow the approved limits for refunds and write offs, as established in Policy PF-102, before being transferred. The primary agencies will work the accounts for 6 months or until they feel it is uncollectable and return the account. The accounts are forwarded to secondary agencies from the primary agencies Closed and Return Reports. The financial class is changed to Bad Debt Other after the Closed and Return Reports are received from the Secondary Agency. The agencies must get written approval from the manager in the relatively rare instance of legal action being taken to collect the debt. Part VI, Line 2 - Needs Assessment WellSpan 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 Health As a charitable, community-based healthcare organization, our commitment to improving the lives and well-being of the people and communities we serve is 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 System WellSpan Health is an integrated health system serving the communities of southcentral Pennsylvania and northern Maryland. As a community-based, not-for-profit organization, WellSpan is dedicated to improving the health and well-being of the people it serves. WellSpan will assume a leadership role and develop partnerships with other organizations to improve access to coordinated, high-quality, cost-effective health care services, educate the health care providers of tomorrow, promote healthy lifestyles and lifelong wellness, and make its local communities healthier, more desirable places to live, work, and play. WellSpan 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 Report PA true WellSpan Health PO Box 2767 York PA 17405 222517863 501(c)(3) 5000000 0 Community health WellSpan Medical Group PO Box 2767 York PA 17405 232730785 501(c)(3) 3000000 0 Community health 2 0 Grantmaker's Description of How Grants are Used All WellSpan entities follow WellSpan policies and procedures regarding grant projects to ensure that the use of grant funds are consistent with WellSpan's commitment to endeavor to improve the health status of the communities that we serve.The WellSpan foundations are supporting organizations and substantially all of the grants and other assistance they make furthers the exempt purposes of their "supported organizations", each of which are exempt affiliated organizations within the WellSpan Health system. Because the supported organizations identify the projects and exempt activities that will be funded by the foundations' grants and other assistance, and because there is a cross-over between the respective governing bodies and management of the foundations and their supported organizations, the foundations are able to effectively monitor that the grants they make are used for their intended purposes. X X true true X X X X true true false false false false false false false Charles Chondroff MD Former Director 311503 605876 2069816 7037 64752 3058984 1997388 Clarence Miller Pathologist 222644 1200 4078 3869 43583 275374 David Doud DO Director 336461 1200 12082 45422 395165 Edward Mackle MD Director 556705 1200 31458 49347 638710 Jill Keller-Reyka Regional Director 185036 28943 15248 2779 52984 284990 Kevin Lorentsen Director 439604 50700 8550 37470 536324 Kevin Sanders Physician Assistan 183427 1200 3378 36567 224572 Melissa Dubrow President 226764 41768 20600 16688 55236 361056 Michael O'Connor Former Director 611969 404687 2042231 123405 85586 3267878 2042158 Mike Seim SVP CQO 438755 52800 22903 7015 37511 558984 18133 Patrick O'Donnell Former Director 942819 57149 486448 25200 52022 1563638 Robert Robertson MD Former Director 440119 16715 4935 8550 38874 509193 Roxanna Gapstur CEO-WSH/Dir. 1091608 440000 11619 60941 1604168 242000 Scott Card Physician 329237 1200 5726 5371 48600 390134 Sherri Stahl SVP 426019 122742 80873 5700 58427 693761 Wanda Crilly Manager FBS 88373 1739 124256 1796 24805 240969 Part I, Line 1a: Relevant information in regards to selections on 1a. The 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. A See Schedule O Dr David Doud DO Owner 98921 Property Lease false Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder WellSpan 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 Body Subject 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 Shareholders Rights 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 Process Management provided an electronic copy of the form 990 to each voting member of the organization's governing body, prior to its filing with the IRS. The organization's finance management team provided a presentation to the Audit Committee on the organization's 990 return. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts Officers, directors, and key employees fill out a WellSpan Health Conflict of Interest Disclosure Statement questionnaire annually. The questionnaire is administered by the Internal Audit Department of WellSpan Health, the Parent Company.There shall be full disclosure by any Director having a business or personal interest or relationship which may be in conflict with the interests of the Corporation. After such disclosure the Director shall abide by the determination of the Board of Directors as to whether a conflict exists, the extent to which, if at all, the Director will be permitted to be present during the Board of Directors' discussion of the matter in which the Director may be interested, and whether the Director will be permitted to participate in such discussion and cast a vote in such matter. Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The Compensation Committee of WellSpan Health is responsible for rewarding and reinforcing key executives for the achievement of annual and long-term performance objectives. The Compensation Committee shall consist of not more than six (6) persons, of whom two (2) shall be the Chairman and Vice Chairman of the Board of the Corporation, and the remaining members shall be such other persons as may be appointed by the Chairman of the Board of the Corporation, with the approval of the Board of Directors; provided, however, that the Compensation Committee shall not include any persons who are employed by the System. The role of the Compensation Committee is to set the Executive Compensation Philosophy for the system and ensure adherence, evaluate performance and establish compensation for the WellSpan President, evaluate team performance of the executive team and establish awards, review and approve senior executive base salary ranges, and oversee employed physician compensation programs. The Committee will approve salary ranges for each executive position and review incumbent salaries annually. The Committee will be responsible for reviewing the President's salary each year, and if warranted, authorizing an adjustment to maintain competitiveness. The President will have the authority to make salary adjustments for subordinate positions. The Committee is responsible for approving and authorizing payment of the performance awards. The Committee will approve and authorize payment of the President's performance awards. Integrated Healthcare Strategies, Inc., based in Minneapolis Minnesota is the external consultant to the committee. This consultant focuses exclusively on executive and physician compensation in the health care industry. In summary, the executive and physician compensation review process consists of the following: 1) Cash compensation reviewed annually 2) Cash compensation reviewed by external consultant biennially 3) external total compensation (cash, incentives, benefits, perquisites) reviewed by external consultant periodically 4) Process is integrated with compensation analysis for other WellSpan positions 5) Committee decisions are documented in minutes maintained in Human Resources. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Governing documents, policies, and financial statements are available upon request. Other Changes In Net Assets Or Fund Balances - Other Increases Adjustment = $5 Other Changes In Net Assets Or Fund Balances - Other Increases Increase in permanently restricted net assets = $15229 Other Changes In Net Assets Or Fund Balances - Other Increases Rental expenses netted with revenue = $0 Schedule K - Tax Exempt Bonds 1.2014 GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA REVENUE REFUNDING BONDS, SERIES A:On November 11, 2014, the General Authority of Southcentral Pennsylvania issued $213,430,000 of Revenue Refunding bonds, Series 2014A for WellSpan Health Obligated Group. The purpose of this bond issue was revenue refund for bonds issued 06/23/1993 and 11/12/2008. WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to York Hospital (23-1352222), Gettysburg Hospital (23-1352220), WellSpan Properties (22-2842252), WellSpan Surgery & Rehabilitation Hospital (23-2899911), and Ephrata Community Hospital (23-1370484). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K. As of 6/30/21, the allocation of the Debt Capital program including issue premium of $47,545,967 was as follows:York Hospital: $27,890,452Gettysburg Hospital: $1,922,543WellSpan Properties: $6,845,852WellSpan Surgery & Rehabilitation Hospital: $3,377,167Ephrata Community Hospital: $7,509,953These amounts are reported on the respective balance sheets for each of these entities.An Arbitrage Rebate and Yield Restriction Liability Calculation was performed for the period of November 10, 2014, to November 10, 2019. No rebate was due._______________________________________________________________________________2.2015 LANCASTER MUNICIPAL AUTHORITY BANK LOAN, SERIES A:On May 22, 2015, the Lancaster Municipal Authority issued $36,572,083 of Revenue Refunding bonds, Series 2015A, to an Obligated Group consisting of York Hospital, Gettysburg Hospital and Ephrata Community Hospital. The purpose of this bond issue was to refund bonds issued on behalf of Ephrata Community Hospital, including the Lancaster Municipal Authority Revenue Notes Series 2009, 2010A, 2012, and 2013. To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K.As of 6/30/21, the $27,600,768 of outstanding liability is reported on the Ephrata Community Hospital return balance sheet._______________________________________________________________________________3.2019 GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA REVENUE REFUNDING BONDS, SERIES A & B:On April 19, 2019, the General Authority of Southcentral Pennsylvania issued $331,502,627 of Revenue Refunding bonds, Series 2019A and 2019B for WellSpan Health Obligated Group. The purpose of this bond issue was revenue refund for bonds issued 11/12/2008. WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to York Hospital (23-1352222), Chambersburg Hospital (23-0465970), WellSpan Properties (22-2842252), Chambersburg Health Services (25-1515376), The Good Samaritan Hospital of Lebanon Pennsylvania (23-1794160), Waynesboro Hospital (23-1360854), Summit Physician Services (25-1716306), Gettysburg Hospital (23-1352220), WellSpan Surgery & Rehabilitation Hospital (23-2899911) and Ephrata Community Hospital (23-1370484). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K. As of 6/30/21, the allocation of the Debt Capital program of $324,770,019 was as follows:York Hospital: $109,820,502Waynesboro Hospital: $455,712Chambersburg Hospital: $110,975,751Chambersburg Health Services: $18,656,026Summit Physician Services: $983,590WellSpan Properties: $66,683,198Gettysburg Hospital: $12,384,727Ephrata Community Hospital: $3,372,694The Good Samaritan Hospital of Lebanon Pennsylvania: $42,216WellSpan Surgery & Rehabilitation Hospital: $1,395,603These amounts are reported on the respective balance sheets for each of these entities._______________________________________________________________________________4.2019 GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA REVENUE REFUNDING BONDS, SERIES C-E:On April 3, 2019, the General Authority of Southcentral Pennsylvania issued $212,690,000 of Revenue Refunding bonds Series 2019C, 2019D and 2019E for WellSpan Health Obligated Group. The purpose of this bond issue was revenue refund for bonds issued 11/12/2008. WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to York Hospital (23-1352222), Gettysburg Hospital (23-1352220), WellSpan Properties (22-2842252), WellSpan Surgery & Rehabilitation Hospital (23-2899911), The Good Samaritan Hospital of Lebanon Pennsylvania (23-1794160) and WellSpan Health (22-2517863). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K. As of 6/30/21, the allocation of the Debt Capital program of $212,690,000 was as follows: York Hospital: $123,530,352Gettysburg Hospital: $19,290,983WellSpan Properties: $22,545,140WellSpan Surgery & Rehabilitation Hospital: $35,731,920The Good Samaritan Hospital of Lebanon Pennsylvania: $1,722,789WellSpan Health: $9,868,816These amounts are reported on the respective balance sheets for each of these entities._______________________________________________________________________________5.2014 FRANKLIN COUNTY INDUSTIAL AUTHORITY REVENUE REFUNDING BONDS, SERIES A & C:On April 30, 2014, the Franklin County Industrial Authority issued $35,795,000 of Healthcare Revenue Refunding bonds, Series 2014A & 2014C for the WellSpan Health Obligated Group. WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to Waynesboro Hospital (23-1360854), Chambersburg Hospital (23-0465970) and Chambersburg Health Services (25-1515376). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K.As of 6/30/21, the allocation of the Debt Capital program of $25,493,770 was as follows: Waynesboro Hospital: $6,390,449Chambersburg Hospital: $18,577,321Chambersburg Health Services: $526,000These amounts are reported on the respective balance sheets for each of these entities.______________________________________________________________________________6.2017 BANK LOANS / REISSUE BONDS ISSUED 11/12/2008:On March 13, 2018, the General Authority of Southcentral Pennsylvania issued $34,877,000 of Revenue bonds, Series 2017A Notes (taxable) for WellSpan Health Obligated Group. Such notes were applied to refund 2008A Bonds. Also, on September 4, 2018, the General Authority of Southcentral Pennsylvania issued $29,312,000 of Revenue Bonds, Series 2017B (tax-exempt bonds) for WellSpan Health Obligated Group.Such notes were applied to refund 2008A Bonds.WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to York Hospital (23-1352222), Gettysburg Hospital (23-1352220), WellSpan Properties (22-2842252), WellSpan Surgery & Rehabilitation Hospital (23-2899911), and The Good Samaritan Hospital of Lebanon Pennsylvania (23-1794160). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K.As of 6/30/21, the allocation of the Debt Capital program of $50,807,000 was as follows: York Hospital: $29,508,705Gettysburg Hospital: $4,608,195WellSpan Properties: $5,385,542WellSpan Surgery & Rehabilitation Hospital: $8,535,576The Good Samaritan Hospital of Lebanon Pennsylvania: $411,536WellSpan Health: $2,357,446These amounts are reported on the respective balance sheets for each of these entities. Signature Line - Paid Preparer Explanation Paid Preparer ExplanationDue to a software limitation, we wish to clarify that WellSpan Health is the ERO.The paid preparer is:BDO USA, LLP13-53815908401 Greensboro Drive, Suite 800McLean, VA 22102(703) 893-0600 Part IV, Line 20b Audited Financial Statements Apple Hill Surgical Center Inc PO Box 2767 York PA 174052767 222842253 Sole GP in limited ptnrshp operating sur PA 501(c)(3) 10 Wellspan Health Care Services false Gettysburg Hospital PO Box 2767 York PA 174052767 231352220 Health Care Services PA 501(c)(3) 3 Wellspan Health false Gettysburg Hospital Foundation PO Box 2767 York PA 174052767 232251358 Fundraising for Gettysburg Hospital PA 501(c)(3) 12 Type II Gettysburg Hospital false Healthy Community Pharmacy Inc PO Box 2767 York PA 174052767 200519121 Reduced rate prescription drugs PA 501(c)(3) 12 Type I Wellspan Health Care Services false VNA Community Services PO Box 2767 York PA 174052767 232338591 Home personal care services for elderly PA 501(c)(3) 10 Wellspan Specialty Services false VNA Home Health Services PO Box 2767 York PA 174052767 231352573 Home health services PA 501(c)(3) 10 Wellspan Specialty Services false Wellspan Health PO Box 2767 York PA 174052767 222517863 Integrated Health System PA 501(c)(3) 12 Type III NA false Wellspan Health Care Services PO Box 2767 York PA 174052767 232400237 Health-related activities in the service PA 501(c)(3) 12 Type II Wellspan Health false Wellspan Medical Group PO Box 2767 York PA 174052767 232730785 Meidcal and surgical care PA 501(c)(3) 10 Wellspan Health false York Health Foundation PO Box 2767 York PA 174052767 233050192 CHaritable contributions for Wellspan PA 501(c)(3) 12 Type III Wellspan Health false York Hospital PO Box 2767 York PA 174052767 231352222 Community teaching hospital PA 501(c)(3) 3 Wellspan Health false Wellspan Surgery & Rehab Hospital PO Box 2767 York PA 174052767 232899911 Surgery and Rehabilitation Hospital PA 501(c)(3) 3 Wellspan Health false Wellspan Properties PO Box 2767 York PA 174052767 222842252 Leases facilities to affliates PA 501(c)(3) 12 Type II Wellspan Health Care Services false Ephrata Community Hospital PO Box 2767 York PA 174052767 231370484 Health Care Services PA 501(c)(3) 3 Wellspan Health false Northern Lancaster County Medical Group PO Box 2767 York PA 174052767 203033058 Medical and surgical care PA 501(c)(3) 12 Type II Ephrata Community Hospital false Phys Spec of North Lanc Co Med Gr PO Box 2767 York PA 174052767 452537633 Physician Practices PA 501(c)(3) 12 Type II Northern Lancaster County Medical Group false Good Samaritan Hospital PO Box 2767 York PA 174052767 230794160 Health Care Services PA 501(c)(3) 3 Wellspan Health false Philhaven PO Box 2767 York PA 174052767 231549922 Health Care Services PA 501(c)(3) 3 Wellspan Health false Good Samaritan Health Service Foundation PO Box 2767 York PA 174052767 232356151 Fundraising PA 501(c)(3) 12 Type I Good Samaritan Hospital false Good Samaritan Physician Services PO Box 2767 York PA 174052767 251832359 Medical and Surgical Care PA 501(c)(3) 10 Good Sam Health Service Foundation false Wellspan Summit Health PO Box 2767 York PA 174052767 251515371 Integrated Health System PA 501(c)(3) 7 Wellspan Health false Wellspan Summit Foundation PO Box 2767 York PA 174052767 831196554 Fundraising for health care system PA 501(c)(3) 12 Type II Wellspan Summit Health false Chambersburg Hospital PO Box 2767 York PA 174052767 230465970 Health Care Services PA 501(c)(3) 3 Wellspan Summit Health false Summit Physician Services PO Box 2767 York PA 174052767 251716306 Medical and surgical care PA 501(c)(3) 3 Wellspan Summit Health false Chambersburg Health Services PO Box 2767 York PA 174052767 251515376 Health care services PA 501(c)(3) 12 Type I Wellspan Summit Health false Apple Hill Surgical Center Partners PO Box 2767 York PA 174052767 232489452 Surgical Center PA NA false false Central PA Alliance Laboratories LLC PO Box 2767 York PA 174052767 232910950 Ref. Lab PA NA false false Littlestown Health Care Partners 300 West King Street Littlestown PA 17340 232880464 Lease facility PA NA false false Cherry Tree Cancer Center LLP PO Box 2767 York PA 174052767 232915628 Radiation PA NA false false The Rehab Center 855 Springdale Drive Suite 20 Exton PA 19341 251687903 Physical Therapy Rehab PA NA false false Surgery Center Associates 785 5th Avenue Chambersburg PA 17201 251845304 Physician services PA Chambersburg Health false false Summit Surgery Center 785 5th Avenue Chambersburg PA 17201 251845303 Physician Services PA Chamberburg Health false false Cumberland Valley Mobile Services LLC 5 South Main Street Sugarloaf PA 18249 200884014 Mobile medical services PA Chambersburg Health false false Wellspan Pharmacy Inc PO Box 2767 York PA 174052767 232374072 Dispense Rx's & prov PA NA C corp false WellSpan Reciprocal Risk Retention Group PO Box 2767 York PA 174052767 200048457 Risk Retention Group PA NA C corp false York Health Plan PO Box 2767 York PA 174052767 232664989 Preferred Provider PA NA C corp false Wellspan Provider Network PO Box 2767 York PA 174052767 232907828 Coordinated managed PA NA C corp false Apple Hill Condominium Association PO Box 2767 York PA 174052767 232504543 Condo Mgmt Association PA NA Homeowners false North Lanc Co Phys Hosp All PO Box 2767 York PA 174052767 232421885 Coord Phys & Hospital PA NA C corp false GSH Realty Inc PO Box 2767 York PA 174052767 251832359 Non-res rentals PA NA C corp false Ephrata Health Pavilion Condo Assoc PO Box 2767 York PA 174052767 475367279 Condo association PA Ephrata Hospital C corp false false true true false false false false false false false false false false false false false false false false Wellspan Health b 5000000 General Ledger Wellspan Medical Group b 3000000 General Ledger Wellspan Summit Foundation c 163467 General Ledger