THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA (EIN 23-0794160)
Tax period: 2019-07-01 to 2020-06-30
Filed: 2021-05-14
IRS object ID: 202111349349300711
Schema version: 2019v5.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-05-14T04:03:56-07:00	ReturnTs
Tax Period End	2020-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	135381590	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	WellSpan Health	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	3350 WHITEFORD ROAD	AddressLine1Txt
City	YORK	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	17402	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2019-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	230794160	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GOOD SAMARITAN HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	GOOD	BusinessNameControlTxt
Phone	7178513055	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 2767	AddressLine1Txt
City	YORK	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	17405	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Laura Buczkowski	PersonNm
Person Title	CFO	PersonTitleTxt
Signature	2021-05-14	SignatureDt
Discuss With Paid Preparer	false	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	See Attached	PreparerPersonNm
PTIN	P01871563	PTIN
Phone	7038930600	PhoneNum

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Roxanna Gapstur	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 2767	AddressLine1Txt
City	York	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	174052767	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$248,533,382	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.WELLSPAN.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1891	FormationYr
Legal Domicile State	PA	LegalDomicileStateCd
Activity Or Mission	The Good Samaritan Hospital is a tax-exempt organization dedicated to providing high-quality, compassionate healthcare that improves the overall health of the community.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	6	VotingMembersIndependentCnt
Total Employee	1316	TotalEmployeeCnt
Total Volunteers	295	TotalVolunteersCnt
Total Gross UBI	$1,975,235	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$685,661	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,126,813	PYContributionsGrantsAmt
CY Contributions Grants	$10,748,142	CYContributionsGrantsAmt
PY Program Service Revenue	$219,175,568	PYProgramServiceRevenueAmt
CY Program Service Revenue	$216,533,942	CYProgramServiceRevenueAmt
PY Investment Income	$325,473	PYInvestmentIncomeAmt
CY Investment Income	$4,407,558	CYInvestmentIncomeAmt
PY Other Revenue	$1,157,543	PYOtherRevenueAmt
CY Other Revenue	$1,121,708	CYOtherRevenueAmt
PY Total Revenue	$221,785,397	PYTotalRevenueAmt
CY Total Revenue	$232,811,350	CYTotalRevenueAmt
PY Grants And Similar Paid	$8,578,701	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$8,160,605	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$81,004,940	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$84,518,348	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$437,274	CYTotalFundraisingExpenseAmt
PY Other Expenses	$143,770,091	PYOtherExpensesAmt
CY Other Expenses	$144,562,957	CYOtherExpensesAmt
PY Total Expenses	$233,353,732	PYTotalExpensesAmt
CY Total Expenses	$237,241,910	CYTotalExpensesAmt
PY Revenues Less Expenses	-$11,568,335	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$4,430,560	CYRevenuesLessExpensesAmt
Total Assets BOY	$113,316,772	TotalAssetsBOYAmt
Total Assets EOY	$114,912,013	TotalAssetsEOYAmt
Total Liabilities BOY	$199,149,393	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$216,530,180	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	-$85,832,621	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	-$101,618,167	NetAssetsOrFundBalancesEOYAmt
Mission	The Good Samaritan Hospital is a tax-exempt organization dedicated to providing high-quality, compassionate healthcare that improves the overall health of the community.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$184,830,439	ExpenseAmt
Grant	$8,160,605	GrantAmt
Revenue	$217,136,954	RevenueAmt
Desc	WellSpan Good Samaritan Hospital has been providing powerful medicine and comforting care to the residents of Lebanon County for more than 125 years.As the community hospital of the Lebanon valley region, WellSpan Good Samaritan Hospital offers a wide variety of acute care and outpatient services that help improve the health of our community. The Sechler Family Cancer Center is Lebanon County's first and only integrated cancer center providing medical and radiation oncology in a state of the art facility with a warm and healing environment. The state-of-the-art Cardiac & Vascular Center has won national awards from the American Heart Association. The center has also been designated as a Blue Distinction Center for Cardiac Care by Highmark Blue Shield. Diagnostic and interventional cardiology is offered as well as electrophysiology and open heart surgery. The New Beginning Birth Suites offer a one-stop experience for labor, delivery and recovery in a family-friendly setting. The Good Samaritan Center for Wound Care & Hyperbaric Medicine has created new hope for those with non-healing wounds. Finally, Good Samaritan Hospital offers a network of laboratory and imaging centers around the county of Lebanon.See WellSpan Health - 2020 Community Benefit Report located at https://www.wellspan.org/about/wellspan-in-the-community/	Desc
Total Program Service Expenses	$184,830,439	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (true)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	false	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1316	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Form8282 Filed	0	Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind	false	Form8899Filedind
Form1098 C Filed	false	Form1098CFiledInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	6	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	PA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	DAVID P RIZZUTO	PersonNm
Phone	7178513055	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3350 WHITEFORD ROAD	AddressLine1Txt
City	YORK	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	174029081	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd
Kevin Mosser
Former CEO-WSH	0.00	0.00	$0	$1,583,936	$1,630,258
Roxanna Gapstur
CEO-WSH/Dir	1.00	40.00	$0	$1,292,495	$177,068	Yes (X)	Yes (X)
Michael O'Connor
CFO-WSH	1.00	40.00	$0	$831,632	$330,778		Yes (X)
Jane Hyde
Former President	0.00	40.00	$0	$671,581	$200,951
Thomas Harlow
President	40.00	0.00	$678,713	$0	$88,583	Yes (X)	Yes (X)
Tyler Fugate DO
Director	1.00	40.00	$0	$652,674	$64,077	Yes (X)
Kristen O'Shea
Dir end. 10/19	1.00	40.00	$0	$437,302	$65,081	Yes (X)
Robert Shaver
VP-Medical Affairs	40.00	0.00	$418,856	$0	$59,856
Patricia Donley
VP - Patient Care	40.00	0.00	$236,248	$0	$75,364
Virginia Follett
Sr. Dir - Support	40.00	0.00	$181,071	$0	$62,364
Debra Ney
Manager-Pharmacy	40.00	0.00	$177,606	$0	$37,513
Michele Rosario-Melendez
Pharmacist	40.00	0.00	$167,300	$0	$32,575
Thomas Clemens MD
Dir beg. 11/19	1.00	0.00	$0	$1,500	$205	Yes (X)
Michael Bechtold
Director	1.00	0.00	$0	$0	$0	Yes (X)
Susan Eberly
Director	1.00	0.00	$0	$0	$0	Yes (X)
Dennis Shalters
Dir end. 10/19	1.00	0.00	$0	$0	$0	Yes (X)
Evelyn Colon
Dir. end 10/19	1.00	0.00	$0	$0	$0	Yes (X)
Paul DiGiacomo MD
Dir end. 10/19	1.00	0.00	$0	$0	$0	Yes (X)
Donald Dreibelbis
Chairman	1.00	0.00	$0	$0	$0	Yes (X)	Yes (X)
Robert Funk
Director	1.00	0.00	$0	$0	$0	Yes (X)
Robert Hoffman
Vice Chair	1.00	0.00	$0	$0	$0	Yes (X)	Yes (X)
Robert Phillips
Secretary	1.00	0.00	$0	$0	$0	Yes (X)
Kristen Watts
Director	1.00	0.00	$0	$0	$0	Yes (X)
Vincent Garcia
Dir beg. 11/19	1.00	0.00	$0	$0	$0	Yes (X)
John Welch MD
Director	1.00	0.00	$0	$0	$0	Yes (X)	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,859,794	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$5,471,120	TotReportableCompRltdOrgAmt
Total Other Compensation	$2,824,673	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	72	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Lebanon Anesthesia Associates
110 29th Avenue	Nashville	TN	37203	Anesthesia Services	$4,403,001
American HealthCare Svcs
10126 Cherry Bend	Traverse City	MI	49684	Staffing Service	$966,358
Emergency Physician Associates
PO Box 634850	Cincinnati	OH	452634850	Emergency Medicine Serv.	$2,302,342
Womens Health Center of Lebanon
845 Helen Drive	Lebanon	PA	17042	Temporary Help	$895,592
Quest Diagnostics
PO Box 912512	Pasadena	CA	911102512	Lab Services	$657,558

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	20	CntrctRcvdGreaterThan100KCnt
Related Organizations	$677,939	RelatedOrganizationsAmt
Government Grants	$9,847,938	GovernmentGrantsAmt
All Other Contributions	$222,265	AllOtherContributionsAmt
Total Contributions	$10,748,142	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
Net Patient Services	621500	$237,261,908	$235,286,673	$1,975,235
W/O- Bad Debt	621500	-$19,170,720	-$19,170,720
W/O Financial Assitance	621500	-$1,557,246	-$1,557,246

Field	Value	IRS element (for citing)
Total Program Service Revenue	$216,533,942	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$12,371	TotalRevenueColumnAmt
Exclusion	$12,371	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$518,696	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$518,696	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$518,696	TotalRevenueColumnAmt
Exclusion	$518,696	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$19,948,179	SecuritiesAmt
Other	$169,040	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$15,722,032	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$4,226,147	SecuritiesAmt
Other	$169,040	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,395,187	TotalRevenueColumnAmt
Exclusion	$4,395,187	ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Cafeteria Sales	722210	$613,011	$613,011
Credentialing	900099	$24,000	$24,000
Health Promotion	611710	$52,350	$52,350

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$86,349	TotalRevenueColumnAmt
Related Or Exempt Func Income	-$86,349	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$603,012	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$232,811,350	TotalRevenueColumnAmt
Related Or Exempt Func Income	$215,161,719	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,975,235	UnrelatedBusinessRevenueAmt
Exclusion	$4,926,254	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$8,160,605	TotalAmt
Program Services	$8,160,605	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$767,296	TotalAmt
Management And General	$767,296	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$61,220,333	TotalAmt
Program Services	$55,521,216	ProgramServicesAmt
Management And General	$5,699,117	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,711,673	TotalAmt
Program Services	$2,322,395	ProgramServicesAmt
Management And General	$389,278	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$15,081,481	TotalAmt
Program Services	$13,508,203	ProgramServicesAmt
Management And General	$1,573,278	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$4,737,565	TotalAmt
Program Services	$4,284,916	ProgramServicesAmt
Management And General	$452,649	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$27,364,426	TotalAmt
Management And General	$27,364,426	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$132,333	TotalAmt
Management And General	$132,333	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$60,029	TotalAmt
Management And General	$60,029	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$20	TotalAmt
Management And General	$20	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$11,623,934	TotalAmt
Program Services	$11,471,148	ProgramServicesAmt
Management And General	$152,786	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$9,527	TotalAmt
Program Services	$9,527	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$866,475	TotalAmt
Program Services	$603,172	ProgramServicesAmt
Management And General	$263,303	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$8,406,066	TotalAmt
Management And General	$8,406,066	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,387,305	TotalAmt
Program Services	$1,380,799	ProgramServicesAmt
Management And General	$6,506	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$105,549	TotalAmt
Program Services	$93,856	ProgramServicesAmt
Management And General	$11,693	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$46,298	TotalAmt
Program Services	$42,761	ProgramServicesAmt
Management And General	$3,537	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$6,389,834	TotalAmt
Program Services	$6,389,834	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,582,884	TotalAmt
Program Services	$7,582,884	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,435,757	TotalAmt
Program Services	$1,435,757	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Supplies	$35,297,920	$35,124,692	$173,228
Purchased Services	$30,830,670	$29,380,388	$1,450,282
Repairs & Maintenance	$4,678,505	$1,716,875	$2,961,630
Taxes & Licenses	$4,321,474	$4,321,474

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,023,951	TotalAmt
Program Services	$1,479,937	ProgramServicesAmt
Management And General	$2,106,740	ManagementAndGeneralAmt
Fundraising	$437,274	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$237,241,910	TotalAmt
Program Services	$184,830,439	ProgramServicesAmt
Management And General	$51,974,197	ManagementAndGeneralAmt
Fundraising	$437,274	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$46,234	BOYAmt
EOY	$123,563	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$38,942	BOYAmt
EOY	$80,223	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,211,567	BOYAmt
EOY	$742,765	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$22,913,871	BOYAmt
EOY	$21,753,133	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,268,399	BOYAmt
EOY	$4,331,451	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$410,241	BOYAmt
EOY	$255,251	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$178,131,370	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$112,667,979	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$64,940,685	BOYAmt
EOY	$65,463,391	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$11,128,289	BOYAmt
EOY	$11,821,378	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$26,228	BOYAmt
EOY	$25,604	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$124,404	BOYAmt
EOY	$963,197	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$10,207,912	BOYAmt
EOY	$9,352,057	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$113,316,772	BOYAmt
EOY	$114,912,013	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$5,131,501	BOYAmt
EOY	$6,873,021	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$2,811,326	BOYAmt
EOY	$24,662,521	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,250,026	BOYAmt
EOY	$2,213,525	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$157,632,195	BOYAmt
EOY	$150,269,195	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$31,324,345	BOYAmt
EOY	$32,511,918	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$199,149,393	BOYAmt
EOY	$216,530,180	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$93,711,052	BOYAmt
EOY	-$109,802,001	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,878,431	BOYAmt
EOY	$8,183,834	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	-$85,832,621	BOYAmt
EOY	-$101,618,167	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$113,316,772	BOYAmt
EOY	$114,912,013	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$4,430,560	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$3,448,831	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$7,906,155	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Form4720 Filed Section4955 Tax	false	Form4720FiledSection4955TaxInd
Correction Made	false	CorrectionMadeInd
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$12,336	OtherActivitiesAmt
Total Lobbying Expenditures	$12,336	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind
Form4720 Filed4912 Tax	false	Form4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part II-B, Line 1i - Other Activities Description	FormAndLineReferenceDesc
Explanation	The hospital holds membership in the American Hospital Association (AHA) and the Hospital & Healthsystem Association of Pennsylvania (HAP) both of which engage in lobbying as a part of their mission to represent the interests of the hospitals at both the federal and state levels. A portion of the dues paid to the Hospital Association of Pennsylvania and the American Hospital Association include lobbying ($6,219 and $6,117). On occasion, HAP requests the help of member providers to communicate concerns to legislators regarding pending legislation which could impact hospitals. This can involve direct contact with legislators or letter writing. This occurs infrequently and the cost to the hospital is negligible.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$7,878,431	BeginningYearBalanceAmt
Contributions	$799,233	ContributionsAmt
Investment Earnings Or Losses	$85,487	InvestmentEarningsOrLossesAmt
Other Expenditures	$579,317	OtherExpendituresAmt
End Year Balance	$8,183,834	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,004,069	BeginningYearBalanceAmt
Contributions	$3,985,145	ContributionsAmt
Investment Earnings Or Losses	$58,490	InvestmentEarningsOrLossesAmt
Other Expenditures	$169,273	OtherExpendituresAmt
End Year Balance	$7,878,431	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$7,592,136	BeginningYearBalanceAmt
Contributions	$3,545,261	ContributionsAmt
Investment Earnings Or Losses	$227,655	InvestmentEarningsOrLossesAmt
Other Expenditures	$7,360,983	OtherExpendituresAmt
End Year Balance	$4,004,069	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$7,112,140	BeginningYearBalanceAmt
Contributions	$1,014,123	ContributionsAmt
Investment Earnings Or Losses	-$4,978	InvestmentEarningsOrLossesAmt
Other Expenditures	$529,149	OtherExpendituresAmt
End Year Balance	$7,592,136	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$6,868,452	BeginningYearBalanceAmt
Contributions	$289,830	ContributionsAmt
Investment Earnings Or Losses	$21,394	InvestmentEarningsOrLossesAmt
Other Expenditures	$67,536	OtherExpendituresAmt
End Year Balance	$7,112,140	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.12940	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.87060	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	false	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,468,847	OtherCostOrOtherBasisAmt
Book Value	$1,468,847	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$104,794,616	OtherCostOrOtherBasisAmt
Depreciation	$61,157,166	DepreciationAmt
Book Value	$43,637,450	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$8,343,723	OtherCostOrOtherBasisAmt
Depreciation	$5,940,755	DepreciationAmt
Book Value	$2,402,968	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$61,997,176	OtherCostOrOtherBasisAmt
Depreciation	$45,570,058	DepreciationAmt
Book Value	$16,427,118	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,527,008	OtherCostOrOtherBasisAmt
Book Value	$1,527,008	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$65,463,391	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (4 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
Private Equity, Ltd Partners	$1,027	F
Real estate, limited partnerships	$1,388	F
Absolute return, Ltd Ptnrs	$2,005	F
Collective mutual funds & inv trusts	$19,989	F

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
Beneficial Interest Trust	$228,667
Due from affiliates	$278,006

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$9,352,057	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
Accrued Payroll	$1,788,449
Accrued Payroll w/h	$310,062
Accrued Pension	$25,485,095
Accrued Sales Tax	$2,429
Accrued Vacation	$4,088,036
Due to Affiliates	$6,248
LTD-Leases	$831,599

Field	Value	IRS element (for citing)
Total Liability	$32,511,918	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$229,334,451	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$3,534,318	NetUnrealizedGainsInvstAmt
Revenue Not Reported	-$3,534,318	RevenueNotReportedAmt
Revenue Subtotal	$232,868,769	RevenueSubtotalAmt
Other Revenues Not Included	-$57,419	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	-$57,419	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$232,811,350	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$229,524,245	TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal	$229,524,245	ExpensesSubtotalAmt
Other Expenses Not Included	$7,717,665	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$7,717,665	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$237,241,910	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Part X : FIN48 Footnote

In June 2006, the Financial Accounting Standards Board (FASB) issued Interpretation NO. 48, Accounting for Uncertainty in Income Taxes-an interpretation of FASB Statement NO. 109, Accounting for Income Taxes (FIN 48), which creates a single model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing the minimum recognition threshold a tax position is required to meet before being recognized in the financial statements. Under the requirements of FIN 48, tax-exempt organizations could now be required to record an obligation as the result of a tax position they have historically taken or various tax exposure items. Prior to FIN 48, the determination of when to record a liability for tax exposure was based on whether a liability was considered probable and reasonably estimable in accordance with SFAS No.5, Accounting for Contingencies. On July 1, 2007, the parent company, WellSpan Health, adopted FIN 48. WellSpan Health determined that it does not have any uncertain tax positions through June 30, 2020.

Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S

Expense netted with Revenue $-282335 Grant To WMG $8000000

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	300.000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	489	PersonsServedCnt
Total Community Benefit Expns	$460,123	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$460,123	NetCommunityBenefitExpnsAmt
Total Expense	0.00190	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	36942	PersonsServedCnt
Total Community Benefit Expns	$38,067,508	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$29,542,917	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,524,591	NetCommunityBenefitExpnsAmt
Total Expense	0.03590	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	37431	PersonsServedCnt
Total Community Benefit Expns	$38,527,631	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$29,542,917	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,984,714	NetCommunityBenefitExpnsAmt
Total Expense	0.03780	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	17	ActivitiesOrProgramsCnt
Persons Served	1971	PersonsServedCnt
Total Community Benefit Expns	$425,003	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$110,322	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$314,681	NetCommunityBenefitExpnsAmt
Total Expense	0.00130	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Persons Served	93	PersonsServedCnt
Total Community Benefit Expns	$153,385	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$153,385	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	21	ActivitiesOrProgramsCnt
Persons Served	2064	PersonsServedCnt
Total Community Benefit Expns	$578,388	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$110,322	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$468,066	NetCommunityBenefitExpnsAmt
Total Expense	0.00190	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	23	ActivitiesOrProgramsCnt
Persons Served	39495	PersonsServedCnt
Total Community Benefit Expns	$39,106,019	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$29,653,239	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,452,780	NetCommunityBenefitExpnsAmt
Total Expense	0.03970	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$84,000	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$84,000	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	10	PersonsServedCnt
Total Community Benefit Expns	$5,428	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,428	NetCommunityBenefitExpnsAmt

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	61	PersonsServedCnt
Total Community Benefit Expns	$203,191	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$203,191	NetCommunityBenefitExpnsAmt
Total Expense	0.00090	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	71	PersonsServedCnt
Total Community Benefit Expns	$292,619	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$292,619	NetCommunityBenefitExpnsAmt
Total Expense	0.00130	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$5,664,414	BadDebtExpenseAmt
Bad Debt Expense Attributable	$56,644	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$80,110,135	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$85,963,994	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$5,853,859	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	WellSpan Good Samaritan Hospit	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4th Walnut Street	AddressLine1Txt
City	Lebanon	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	17042	ZIPCd

Field	Value	IRS element (for citing)
Website Address	http://www.wellspan.org	WebsiteAddressTxt
State License	072401	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Field	Value	IRS element (for citing)
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
CHNA Conducted	18	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	www.wellspan.org	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	https://communityhealthcouncil.com/data/	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	18	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	www.wellspan.org	StrategyWebsiteURLTxt
Strategy Attached	Yes (true)	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	300.0000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.0000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	http://www.wellspan.org	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	http://www.wellspan.org	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	http://www.wellspan.org	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Facility: - Part V, Section B, Line 5	Prior to its affiliation with WellSpan Health, WellSpan-Good Samaritan Hospital conducted independent Community Health Needs Assessments (CHNA) of Lebanon County residents through key informant interviews and the collection and analysis of secondary data. Beginning with the 2015 CHNA, WellSpan-Good Samaritan Hospital transitioned to a streamlined approach to regional CHNA processes in an effort to bring consistency to the entire footprint of WellSpan Health. The 2018 CHNA is a compilation of primary and secondary data sources including telephonic interviews, a review of the Robert Wood Johnson Foundation County Health Rankings, and an analysis of access, behavioral risk and health condition indicators from the PA Department of Healths data retrieval system. Information collected through the CHNA was shared with key community stakeholders to gain their input and perspective on the data, to learn about the existing healthcare environment in Lebanon County, and to identify priorities on which three-year implementation strategies should focus. These stakeholders represented the Lebanon Family Health Services, Lebanon Valley Family YMCA, and the United Way of Lebanon County.A subsequent presentation and discussion of the data and identified priorities was held with the Community Health Council of Lebanon County Board, a coalition of diverse individuals and organizations working together to encourage and support a safe, healthy and substance-free community for every Lebanon County resident. Sectors represented in the Council included, for example: aging population; behavioral health; community-based organizations; social services; education; healthcare; county government; faith-based organizations; drug and alcohol resources, and philanthropy.
Facility: - Part V, Section B, Line 6a	Ephrata Community Hospital (Lancaster); Gettysburg Hospital (Adams), and; WellSpan Surgery and Rehabilitation Hospital and York Hospital (York)
Facility: - Part V, Section B, Line 7d	With each iteration of the CHNA process, WellSpan- Good Samaritan Hospital and its community partners continue to refine and enhance the system by which it obtains data, shares it with key community stakeholders, hospital and system leaders, and integrates with system-wide and entity-level planning processes. In 2018, CHNA results and related priorities identified by WellSpan Health and the Community Health Council of Lebanon County were shared with the system-wide Planning Committee at WellSpan Health. This committee is comprised of community members and leaders that represent each of WellSpans primary entities and service areas, in addition to corporate leadership. Planning Committee members reviewed the CHNA data and designated system-wide priorities as: Care for all, including a focus on access to care and health equity; Behavioral health and lifelong wellness, which would incorporate behavioral health, substance use, addiction and lifelong wellness, and; healthy communities and social determinants of health, which provide a deeper dive into community engagement, social determinants of health and violence prevention. Similarly, the Community Health Council of Lebanon County embraced the findings of the report to solidify their operational focus areas and to align with the WellSpan Health strategic directions. The specific priorities and associated data were presented to the WellSpan- Good Samaritan Hospital Board for their adoption. Collaboratively, the Community Health Council of Lebanon County and WellSpan community health leadership communicated the CHNA results and identified priorities to community members at a public forum held in September 2018. During that forum, CHNA data, CHNA priorities/ opportunities, and WellSpan and coalition recommendations were presented and discussed. In addition to these venues, CHNA results are available on the Community Health Council of Lebanon County (http://communityhealthcouncil.com/data/) and WellSpan Health ( HYPERLINK "http://www.wellspan.org" www.wellspan.org) websites, and may also be obtained upon request. The corresponding WellSpan Community Health Improvement Plan is also available on the WellSpan Health website.
Facility: - Part V, Section B, Line 11	See attached 2019 WellSpan Health Community Health Improvement Plan, also available online at www.wellspan.org in Community Benefits section.
Facility: - 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 Web. In addition, WellSpan placed posters and signage at its various sites of care to publicize its Financial Assistance Policy. Printed copies of WellSpan Healths entire financial assistance policy and the plain language summary of the policy, both of which are available in English and Spanish, may be obtained at no cost by visiting or calling one of the WellSpan patient financial services offices.The Financial Assistance Policy, Financial Assistance Application and Financial Assistance Policy Plain Language Summary are all available in Spanish.

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (13 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
WS SECHLER FAMILY CANCER CENTER
844 TUCK ST	LEBANON	PA	17042	CANCER CENTER
WS GOOD SAMARITAN BLOOD DONOR CENTER
750 NORMAN DR	LEBANON	PA	17042	BLOOD DONOR CNTR & LAB
WS GOOD SAMARITAN OUTPATIENT SURGICAL CENTER
830 TUCK ST	LEBANON	PA	17042	OUTPATIENT SURGERY CENTER
WS GOOD SAMARITAN IMAGING- LEBANON
805 HELEN DR	LEBANON	PA	17042	OUTPATIENT RADIOLOGY CENTER
WS GOOD SAMARITAN CARDIOVASCULAR DIAGNOSTIC
781 NORMAN DR	LEBANON	PA	17042	CARDIOVASCULAR DIAGNOSTIC CENTER
WS AMBULATORY SERVICES CENTER - PALMYRA
1400 SOUTH FORGE RD	LEBANON	PA	17042	AMBULATORY SERVICES CENTER (PALMYRA)
WELLSPAN DIXON FOUNDATION HEALTH CENTER
40 NORTH 4TH STREET	LEBANON	PA	17042	REHABILITATION
WS GOOD SAMARITAN REHABILITATION- LEBANON
950 ISABEL DR	LEBANON	PA	17042	OUTPATIENT PHYSICAL THERAPY
WS GOOD SAMARITAN SLEEP CENTER
206 HATHAWAY PARK	LEBANON	PA	17042	SLEEP DISORDERS CENTER
WS WOUND HEALTH CENTER
840 TUCK ST	LEBANON	PA	17042	WOUND CARE & HYPERBARIC CNTR
MYERSTOWN PHYSICAL THERAPY
11 E LINCOLN AVENUE	MYERSTOWN	PA	17067	PHYSICAL THERAPY
WS AMBULATORY SERVICES CENTER
297 WEST LINCOLN AVE	LEBANON	PA	17042	OUTPATIENT DIAGNOSTIC CENTER (MYERSTOWN)
WS AMBULATORY SERVICES CENTER- JONESTOWN
100 QUEEN STREET	LEBANON	PA	17042	AMBULATORY SERVICES CENTER (JONESTOWN)

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used)	Patients 401% of poverty level and greater do not qualify for financial assistance.Patients/guarantors who complete an application for Financial Assistancewhose gross income falls between 351-400% of the FPL level and meet allother Financial Assistance qualifications (MAP 118) will be eligible for a 40%discount of self-pay balances.
Part I, Line 6a - Related Organization Community Benefit Report	Community Benefit Information is included in the Community Benefit Report for WellSpan Health.
Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense	The number was calculated using the cost to charge ratio factor applied against actual patient bad debt write-offs. These numbers are included after all efforts have been exhausted to determine if the patient meets our charity care write-off policy based on federal poverty levels.
Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit	The estimate of bad debt attributable to charity care policy was calculated by dividing the bad debt amount that was originally coded bad debt but later found to qualify as charity care by the amount coded to the charity care write-off codes. This ratio is applied to the bad debt cost factor expense.
Part III, Line 4 - Bad Debt Expense	The Company provides an allowance for doubtful accounts for estimated losses resulting from the unwillingness or inability of patients to make payments for services. The allowance is determined by analyzing specific amounts and historical data and trends. Patient accounts receivable are charged off against the allowance for doubtful accounts when management determines that recovery is unlikely and the Company ceases collection efforts. Losses have been consistent with management's expectations in all material respects.
Part III, Line 8 - Explanation Of Shortfall As Community Benefit	Good Samaritan Hospital maintains records to identify and monitor the level of charity care and community service it provides. These records include the amount of charges forgone based on established rates for services and supplies furnished under its charity care and community service policies and the estimated cost of those services. Payments from Medicare are generally less than Good Samaritan Hospital's costs of providing the service.
Part III, Line 9b - Provisions On Collection Practices For Qualified Patients	Guidelines for suggested minimum number of phone attempts and letters to be sent before the account is turned over to an outside collection agency are included in the Patient Administrative Services Policy. Upon final PARO (Payment Assistance Rank Ordering) scoring, if a patient qualifies for presumptive charity, their account would not be forwarded to any third party collections. It shall be the policy of Patient Administrative Services to recommend accounts to Bad Debt on a timely basis. Inpatient/Outpatient accounts will go to bad debt automatically after the account has been in the financial class Pending Bad Debt for 30 days. All accounts must follow the approved limits for refunds and write offs, as established in Policy PF-102, before being transferred. The primary agencies will work the accounts for 6 months or until they feel it is uncollectable and return the account. The accounts are forwarded to secondary agencies from the primary agencies Closed and Return Reports. The financial class is changed to Bad Debt Other after the Closed and Return Reports are received from the Secondary Agency. The agencies must get written approval from the manager in the relatively rare instance of legal action being taken to collect the debt.
Part VI, Line 2 - Needs Assessment	After its affiliation with WellSpan Health, a regional health care system, WellSpan-Good Samaritan Hospital (WGSH) engaged in the 2015 iteration of the system-wide CHNA process. This process evolved regionally to include each respective communities previous successes and lessons learned in conducting CHNAs. For example, York and Adams counties had been conducting CHNAs for 20 years and had extensive expertise to share related to primary data collection. The system-wide approach to the CHNA enabled WGSH to collect primary data from Lebanon County residents, share it with key community, hospital and system leaders, and integrate it into the system-wide and entity-level planning processes. A representative sample of 470 Lebanon County adults were interviewed between March 26 and May 13, 2018 using survey questions derived from the Behavioral Risk Factor Surveillance System (BRFSS), a validated survey tool utilized by the Centers for Disease Control and Prevention (CDC), and organized into four categories: healthcare access, behavioral risk, health conditions, and prevention behaviors and context. Supplemental secondary data from the Robert Wood Johnson Foundation (RWJF) annual County Health Rankings and from the Pennsylvania Department of Health was also integrated into the 2018 CHNA.The 2018 CHNA planning process engaged a wide range of community organizations serving the diverse interests of all partners. The intent of the CHNA was to collect adequate valuable data and information that would satisfy the needs of all participating organizations, without burdening CHNA respondents with too many questions. Committee members reviewed questions asked in the 2015 CHNA and edited accordingly based on the current health care environment and areas of interest. The CHNA was developed utilizing consulting support and guidance through a contract with the Floyd Institute for Public Policy at Franklin and Marshall College. The collaborative efforts of the community stakeholders determined the survey questions to be asked of the community; discussed data collection methodology, including sample size and method of obtaining data; reviewed the raw data and supporting charts/ graphs; identified potential community health priorities, and; developed the process by which results and priorities were to be shared with the community. Data collected and analyzed by the Floyd Institute for Public Policy included breakdowns by age, gender, geographic area, race/ethnicity, and income level, and enabled the development of charts/graphs focused on: quantity of residents affected; health risks and disability-adjusted life years; correlates of obesity and depression (two significant health priorities); health disparities, and; social determinants of health impact. This information is included in the 2018 Community Health Needs Assessment Summary Report available at www.wellspan.org.CHNA results and related priorities identified by the Community Health Council of Lebanon County and other pertinent community stakeholder groups were shared with the system-wide Planning Committee at WellSpan Health, a Committee comprised of community members and leaders that represent each of WellSpans primary entities and service areas, in addition to corporate leadership. Planning Committee members reviewed the CHNA data, and designated system-wide priorities as: Care for all, including a focus on access to care and health equity; Behavioral health and lifelong wellness, which would incorporate behavioral health, substance use and addiction and lifelong wellness, and; healthy communities and social determinants of health, which provide a deeper dive into community engagement, social determinants of health and violence prevention. The identified priorities and associated data were subsequently presented to the WellSpan- Good Samaritan Hospital Board for their adoption. Board members discussed the data and identified priorities within the context of existing staffing and financial resources, current and future entity initiatives, and community partnership opportunities to address systemic community change. The final CHNA report, along with the WellSpan Community Health Improvement Plan (CHIP) was presented in June 2019 to the Planning Committee, at which time correlations were observed between the CHNA, CHIP and the WellSpan 2025 Strategic Plan.
Part VI, Line 5 - Promotion of Community Health	As a charitable, community-based healthcare organization, our commitment to improving the lives and well-being of the people and communities we serve is evident in our mission statement: working as one to improve health through exceptional care for all, lifelong wellness, and healthier communities. Employees live out this mission statement every day by engaging in community benefit activities that address community needs, especially the health priorities identified in the 2018 CHNA - access to care and health equity; behavioral health, substance use and addiction, and lifelong wellness, and community engagement, social determinants of health and violence prevention. WellSpan-Good Samaritan Hospital continues to develop its suite of wellness and health education programs designed to address key CHNA findings and to promote healthy lifestyles and disease prevention. These programs include community health screenings; healthy eating initiatives in the community (i.e., healthy cooking demonstrations at the Lebanon Farmer's Market); weight management classes, and; physical activity promotion initiatives. Many of these programs are offered for free or at a minimal cost to the participant. WellSpan-Good Samaritan Hospital continues to partner with the Lebanon County Library System to offer the Get Outdoors (GO) Lebanon! summer physical activity program for Lebanon County families. Originating in York County, this summer-long initiative encourages children and their families to be physically active by locating posts "hidden" in parks throughout Lebanon County. WellSpan-Good Samaritan Hospital maintains its support of Lebanon Countys safety net of services that enables access to care among vulnerable populations through: enrolling financially-challenged community members in Healthy Community Network, a partnership between WellSpan Health, physicians and community partners to support prospective enrollment, the management and support of patients, and coordination of care; supporting the expansion of a diabetes support group offered by Lebanon Valley Volunteers in Medicine to meet the needs of the growing, Spanish-speaking population in Lebanon, and; the ongoing partnership between Lebanon Family Health Services and WellSpan Good Samaritan Hospital to utilize doctors from the hospitals Family Medicine Residency program to provide prenatal care for its low-income clients. Additionally, WellSpan Good Samaritan Hospital leadership selected Family First Health, a federally qualified health center with locations throughout central Pennsylvania, to provide primary care services at the WellSpan Dixon Foundation Health Center. The WellSpan Dixon Foundation Health Center opened in 2020 and has improved access to primary care, behavioral health and other health and social services in Lebanon County. WellSpan-Good Samaritan Hospital is an integral partner in the Community Health Council of Lebanon County and, as such, supports key Council initiatives such as the Lebanon County Tobacco Coalition, Lebanon County Teen Pregnancy and Support Network, and Lebanon County Suicide Task Force. WellSpan- Good Samaritan Hospital maintains its support of the full-time, Executive Director position by leveraging Community Partnership Grant funds to cover this expense. Additionally, the Council maintains alignment with the Better Together Coalition in Lebanon County and launched a mobile kitchen to provide hands-on cooking classes to residents, in partnership with The American Heart Association. Additional efforts focused on: an email and social medical platform to connect residents to local health and wellness events and services; educational initiatives that emphasize importance of advanced care planning and end of life care, and; tackling the issue of homelessness by supporting the Lebanon County Coalition to End Homelessness. Community Health in Lebanon County continues to unfold in the offering of nutrition and food insecurity related efforts like the WellSpan Mondays Market program, which partners to provide a convenient location for families using Farmers Market Nutrition Program and WIC vouchers to shop for healthful foods. WellSpans Market Bucks program addresses food insecurity and increases the consumption of fruits and vegetables. Regionally, this program provided vouchers to 310 WellSpan patients with food insecurity challenges, which contributed $31,620 to local farmers and growers. This program reaches those with an elevated Body Mass Index (BMI) who also experience a comorbidity associated with diet. Market Bucks consistently boasts an astounding 86% redemption rate, in addition to demonstrating increase fruit and vegetable consumption for participants with medical challenges.WellSpan continues to support efforts to reduce overweight and obesity throughout the region, including programs like A Healthy You, Hike to Health, and A Stronger You. Each of these Lebanon County programs encourage healthy living and lifelong health. In 2020, WellSpan Health encouraged community members, local employers and employees, and WellSpan staff and patients to engage in the 8th annual 10 Pound Throwdown initiative. The 10 Pound Throwdown is a 10-week community challenge that encourages participants to lose or maintain a healthy weight through healthier eating and increased physical activity. The initiative was created in 2013 to address the growing issue of adult overweight/obesity and utilizes a core website (www.10poundthrowdown.com) to encourage team participation and to offer an online weight tracker, badges to encourage healthier choices, and diverse health education resources. In 2020, the 10 Pound Throwdown engaged 7200 community members in losing 14,000 pounds across four southcentral Pennsylvania counties -Adams, Lancaster, Lebanon, and York. Additional examples of how WellSpan-Good Samaritan Hospital fulfilled its community mission in Lebanon County may be found in the 2020 WellSpan Community Benefit Report available online at www.wellspan.org.
Part VI, Line 6 - Affilated Health Care System	WellSpan Health is an integrated health system serving the communities of southcentral Pennsylvania and northern Maryland. As a community-based, not-for-profit organization, WellSpan is dedicated to improving the health and well-being of the people it serves. WellSpan will assume a leadership role and develop partnerships with other organizations to: improve access to coordinated, high-quality, cost-effective health care services, educate the health care providers of tomorrow, promote healthy lifestyles and lifelong wellness, and make its local communities healthier, more desirable places to live, work, and play. WellSpan Good Samaritan Community Hospital works with other parts of the system to provide a comprehensive approach to meeting community needs.WellSpan Health includes: WellSpan Gettysburg Hospital, WellSpan York Hospital, WellSpan Surgery and Rehabilitation Hospital, WellSpan Ephrata Community Hospital,WellSpan Good Samaritan Hospital, WellSpan Philhaven, Chambersburg Hospital, Waynesboro Hospital, Apple Hill Surgical Center, Summit Surgery Center, WellSpan VNA Home Health, WellSpan Medical Group, Northern Lancaster County Medical Group, Physician Specialists of Northern Lancaster County Medical Group, Good Samaritan Physician Services, Summit Physician Services, Chambersburg Health Services, WellSpan Population Health Services, WellSpan Pharmacy, Gettysburg Hospital Foundation, York Health Foundation, Ephrata Community Health Foundation, Good Samaritan Health Services Foundation, Summit Health Foundation, WellSpan Summit Health,WellSpan Provider Network, GSH Services,and WellSpan Medical Equipment.Good Samaritan Hospital's community benefit report is contained in a report prepared by their parent organization, WellSpan Health. See WellSpan Health - 2019 Community Benefit Report located at www.wellspan.org
Part VI, Line 7 - States Filing of Community Benefit Report	PA

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt	Purpose Of GrantPurposeOfGrantTxt	IRC SectionIRCSectionDesc
Lebanon School District
1000 S 8th Street	Lebanon	PA	17042	231646050	$84,000	$0	Community Support
Lebanon Valley College
101 N College Ave	Annville	PA	17003	231352354	$75,000	$0	Community Support	501(c)(3)
WellSpan Medical Group
3350 Whiteford Road	York	PA	17402	232730785	$8,000,000	$0	Community Health	501(c)(3)

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Additional Supplemental Information	FormAndLineReferenceDesc
Explanation	All WellSpan entities follow WellSpan policies and procedures regarding grant projects to ensure that the use of grant funds are consistent with WellSpan's commitment to endeavor to improve the health status of the communities that we serve.The WellSpan foundations are supporting organizations and substantially all of the grants and other assistance they make furthers the exempt purposes of their "supported organizations", each of which are exempt affiliated organizations within the WellSpan Health system. Because the supported organizations identify the projects and exempt activities that will be funded by the foundations' grants and other assistance, and because there is a cross-over between the respective governing bodies and management of the foundations and their supported organizations, the foundations are able to effectively monitor that the grants they make are used for their intended purposes.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt
Debra Ney
Manager-Pharmacy	$162,420	$12,665	$2,521	$10,722	$26,791	$215,119
Jane Hyde
Former President							$372,070	$299,436	$75	$168,329	$32,622	$872,532	$143,520
Kevin Mosser
Former CEO-WSH							$212,990	$763,820	$607,126	$1,596,796	$33,462	$3,214,194	$763,820
Kristen O'Shea
Dir end. 10/19							$344,758	$85,290	$7,254	$18,308	$46,773	$502,383
Michael O'Connor
CFO-WSH							$605,042	$226,590		$279,133	$51,645	$1,162,410	$226,590
Michele Rosario-Melendez
Pharmacist	$146,568		$20,732	$9,477	$23,098	$199,875
Patricia Donley
VP - Patient Care	$183,880	$47,971	$4,397	$12,065	$63,299	$311,612
Robert Shaver
VP-Medical Affairs	$330,432	$82,193	$6,231	$17,032	$42,824	$478,712
Roxanna Gapstur
CEO-WSH/Dir							$988,473	$271,790	$32,232	$121,240	$55,828	$1,469,563
Thomas Harlow
President	$364,049	$307,623	$7,041	$58,607	$29,976	$767,296								$153,270
Tyler Fugate DO
Director							$652,674			$16,097	$47,980	$716,751
Virginia Follett
Sr. Dir - Support	$169,012	$11,934	$125	$21,374	$40,990	$243,435

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	See Schedule O	BusinessNameLine1Txt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Funk Construction
Pres - Funk	$2,780,596	Construction	false
Beers Hoffman Architech
Architect Hoffman	$413,868	Architectural Serv	false
WelchWagner Partnership
Partner Welch	$381,871	Lease to WellSpan	false

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Client Note 1	Client Note 1 - Paid Preparer ExplanationDue to a software limitation, we wish to clarify that WellSpan Health is the ERO.The paid preparer is:BDO USA, LLP13-53815908401 Greensboro Drive, Suite 800McLean, VA 22102(703) 893-0600The preparers name is Marc Berger, PTIN P01871563
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder	WellSpan Health, a not for profit corporation, is the sole member.
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body	The Board of Directors shall be elected by the Board of Directors of the Member. The Member shall determine annually the number of Directors which shall in no event be less than ten persons nor more than eighteen persons. In addition, the President of the Organization and the President of the Medical Staff of the Organization shall be Directors, ex officio, without vote.The Directors shall be elected at the annual meeting of the Member. The term of the newly elected Directors shall commence at the close of the Member's annual meeting. All Directors shall be selected for their experience, relevant areas of interest and expertise, and ability and willingness to participate actively and effectively in fulfilling the Board of Directors' responsibilities without conflicting interests.
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders	The Board of Directors shall recommend strategic and operating plans that are in conformance with System-approved priorities and plans; monitor accomplishment of such plans; recommend operating and capital budgets that are in conformance with System targets; monitor financial performance against budget; monitor the quality of and satisfaction with clinical services provided; serve as a sounding board for the Organization's President, providing advice and counsel to System and Organization management; nominate and, subject to the prior review and ratification of the Member, appoint the officers of the Organization, except for appointment of the Organizations' President, which requires the concurrence of both the Member and the Organization's Boards of Directors and whose removal by the Member requires prior consultation with the Organization's Board; maintain the licensure and accreditation of the Corporation, including, maintaining compliance with all of the applicable publicness requirements established by the Pennsylvania Department of Health for acute general hospitals, the Medicare Conditions of Participation established by CMS for hospitals, and the accreditation standards established by The Joint Commission for hospitals, including but not limited to requirements regarding medical staff appointments, credentialing, and oversight; recommend changes in the services provided by the Organization; recommend amendments to the Organization's Articles of Incorporation and/or Bylaws; recommend fundamental transactions involving the Organization, including the reorganization, merger, the sale of all or substantially all of the assets of the Organization, or dissolution of the Organization; recommend investment of the Organizations' assets other than in accordance with a WellSpan approved investment policy; recommend the issuance of debt for the Organization; recommend the transfer or sale of the Organizations' assets in excess of limits established by WellSpan policy; recommend capital expenditures by the Organization in excess of approved budget; recommend any capital contribution by the Member to the Corporation; recommend any material change to any permit, approval, or license of the Organization; recommend outside legal counsel for the Corporation's local needs or activities; recommend changes to the Organization's statement of mission and vision; recommend the creation of new (or material changes to existing) lines of business, sites of business, and participation in partnerships or joint ventures by the Organization; recommend changes to managed care and other third party payer contracts for the Organization; and represent the interests of the community or population served by the Organization.
Form 990, Part VI, Line 11b: Form 990 Review Process	Management provided an electronic copy of the form 990 to each voting member of the organization's governing body, prior to its filing with the IRS. The organization's finance management team provided a presentation to the Audit Committee on the organization's 990 return.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	Officers, directors, and key employees fill out a WellSpan Health Conflict of Interest Disclosure Statement questionnaire annually. The questionnaire is administered by the Internal Audit Department of WellSpan Health, the Parent Company.There shall be full disclosure by any Director having a business or personal interest or relationship which may be in conflict with the interests of the Corporation. After such disclosure the Director shall abide by the determination of the Board of Directors as to whether a conflict exists, the extent to which, if at all, the Director will be permitted to be present during the Board of Directors' discussion of the matter in which the Director may be interested, and whether the Director will be permitted to participate in such discussion and cast a vote in such matter.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees	The Compensation Committee of WellSpan Health is responsible for rewarding and reinforcing key executives for the achievement of annual and long-term performance objectives. The Compensation Committee shall consist of not more than six (6) persons, of whom two (2) shall be the Chairman and Vice Chairman of the Board of the Corporation, and the remaining members shall be such other persons as may be appointed by the Chairman of the Board of the Corporation, with the approval of the Board of Directors; provided, however, that the Compensation Committee shall not include any persons who are employed by the System. The Chairman of the Board of Gettysburg Hospital shall participate. 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 Decreases	Equity Lease Adjustment = -$51866
Other Changes In Net Assets Or Fund Balances - Other Decreases	Pension adjustment for FAS 158 = -$7854289
Schedule K - Tax-Exempt Bonds	$213,430,000 of Revenue bonds for Wellspan Health Obligated Group, Series 2014A were issued November 10, 2014 by General Authority of South Central Pennsylvania. 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 Specialty Services (23-2899911), and Ephrata Community Hospital (23-1370484). In order 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 6/30/20, the allocation of the Debt Capital program including issue premium was as follows: York Hospital $113,006,240, Gettysburg Hospital $7,607,130, WellSpan Properties $27,233,962, WellSpan Specialty Services $13,390,824, and Ephrata Community Hospital $27,945,016. These amounts are reported on the respective balance sheets for each of these entities.Arbitrage Rebate and Yield Restriction Liability Calculation was performed for the period of November 10, 2014 to November 10, 2019. No rebate was due.On May 22, 2015, the Lancaster Municipal Authority issued $36,572,083 of Revenue 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. In order 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 6/30/20, the $29,212,704 of outstanding liability is reported on the Ephrata Community Hospital return balance sheet.$34,877,000 of Revenue bonds for Wellspan Health Obligated Group, Series 2017A were issued March 13, 2018 by General Authority of South Central Pennsylvania to refinance Series 2017A Notes (taxable). 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 Specialty Services (23-2899911), and Good Samaritan Hospital (23-1794160). In order 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 6/30/20, the allocation of the Debt Capital program was as follows: York Hospital $15,775,109, Gettysburg Hospital $2,462,503, WellSpan Properties $2,879,066, WellSpan Specialty Services $4,563,048, Good Samaritan Hospital $220,004, and WellSpan Health $1,260,270. These amounts are reported on the respective balance sheets for each of these entities.$29,312,000 of Revenue Bonds, Series 2017B (tax exempt bonds) for WellSpan Health Obligated Group were issued 9/4/2018 by General Authority of South Central Pennsylvania to refinance Series 2017B Notes (taxable). Such notes were applied to refund 2008A Bonds. In order 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 6/30/20, the allocation of the Debt Capital program was as follows: York Hospital $16,385,530, Gettysburg Hospital $2,558,828, WellSpan Properties $2,990,472, WellSpan Specialty Services $4,739,616, Good Samaritan Hospital $228,517, and WellSpan Health $1,309,037. These amounts are reported on the respective balance sheets for each of these entities.$331,502,627 of Revenue bonds Series 2019A and 2019B for Wellspan Health Obligated Group were issued 4/3/2019 by General Authority of South Central Pennsylvania. 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), Good Samaritan Hospital (23-1794160), Waynesboro Hospital (23-1360854), Summit Physician Services (25-1716306), Gettysburg Hospital (23-1352220), WellSpan Specialty Services (23-2899911) and Ephrata Community Hospital (23-1370484). In order 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 6/30/20, the allocation of the Debt Capital program was as follows: York Hospital $115,696,732, Waynesboro Hospital $461,652, Chambersburg Hospital $110,576,835, Chambersburg Health Services $18,680,280, Summit Physician Services $972,536. WellSpan Properties $66,489,250, Gettysburg Hospital $10,539,595, Ephrata Community Hospital $3,425,157, Good Samaritan Hospital $42,216, and WellSpan Specialty Services $1,419,163. These amounts are reported on the respective balance sheets for each of these entities.$212,690,000 of Revenue bonds Series 2019C, 2019D and 2019E for WellSpan Health Obligated Group were issued 4/3/2019 by General Authority of South Central Pennsylvania. 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 Specialty Services (23-2899911), Good Samaritan Hospital (23-1794160) and WellSpan Health (22-2517863). In order 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 6/30/20, the allocation of the Debt Capital program was as follows: York Hospital $123,530,352, Gettysburg Hospital $19,290,983, WellSpan Properties $22,545,140, WellSpan Specialty Services $35,731,920, Good Samaritan Hospital $1,722,789, and WellSpan Health $9,868,816. These amounts are reported on the respective balance sheets for each of these entities.On April 30, 2014, $35,795,000 of Healthcare Revenue Bonds Series 2014A & 2014C were issued by Franklin County Industrial Authority. In order 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 6/30/20, the allocation of the Debt Capital program was as follows: Waynesboro Hospital (23-1360854) $6,771,865, Chambersburg Hospital (23-0465970) $19,824,238, and Chambersburg Health Services (25-1515376) $513,108. These amounts are reported on the respective balance sheets for each of these entities.
Signature Block - Paid Preparer Explanation	Paid Preparer ExplanationDue to a software limitation, we wish to clarify that WellSpan Health is the ERO.The paid preparer is:BDO USA, LLP13-53815908401 Greensboro Drive, Suite 800McLean, VA 22102(703) 893-0600The preparers name is Marc Berger, PTIN P01871563

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
Gettysburg Hospital
PO Box 2767	York	PA	174052767	231352220	Health Care Services	PA	501(c)(3)	3	WellSpan Health	false
Gettysburg Hospital Foundation
PO Box 2767	York	PA	174052767	232251358	Fundraising to support GH	PA	501(c)(3)	12 Type I	Gettysburg Hospital	false
Healthy Community Pharmacy
PO Box 2767	York	PA	174052767	200519121	Reduced rate prescription drugs	PA	501(c)(3)	12 Type I	WellSpan Health Care Services	false
VNA Community Services
PO Box 2767	York	PA	174052767	232338591	Home Personal care services for elderly	PA	501(c)(3)	10	WellSpan Specialty Services	false
VNA Home Health Services
PO Box 2767	York	PA	174052767	231352573	Home health services	PA	501(c)(3)	10	WellSpan Specialty Services	false
Wellspan Health
PO Box 2767	York	PA	174052767	222517863	Intergrated Health System	PA	501(c)(3)	12 Type III	NA	false
Wellspan Health Care Services
PO Box 2767	York	PA	174032767	232400237	Health-related activities in the service	PA	501(c)(3)	12 Type II	WellSpan Health	false
Wellspan Medical Group
PO Box 2767	York	PA	174052767	232730785	Medical and Surgial care	PA	501(c)(3)	10	WellSpan Health	false
York Health Foundation
PO BOX 2767	York	PA	174052767	233050192	Charitable contributions for Wellspan	PW	501(c)(3)	12 Type III	WellSpan Health	false
York Hospital
PO Box 2767	York	PA	174052767	231352222	Community Teaching Hospital	PA	501(c)(3)	3	WellSpan Health	false
Wellspan Specialty Services
PO Box 2767	York	PA	174052767	232899911	Surgery and Rehabilitation Hospital	PA	501(c)(3)	3	WellSpan Health	false
Wellspan Properties Inc
PO Box 2767	York	PA	174052767	222842252	Leases facilities to affiliates	PA	501(c)(3)	12 Type II	WellSpan Health Care Services	false
Ephrata Community Hospital
PO Box 2767	York	PA	174052767	231370484	Health Care Services		501(c)(3)	3	WellSpan Health	false
Ephrata Community Health Foundation
PO Box 2767	York	PA	174052767	800940005	Fundraising for Ephrata Hospital	PA	501(c)(3)	12 Type I	Ephrata Community Hospital	false
Northern Lancaster County Medical Group
PO Box 2767	York	PA	174052767	203033058	Medical and Surgical Care	PA	501(c)(3)	12 Type II	Ephrata Community Hospital	false
Phys Spec of Northern Lanc Co Med Group
PO Box 2767	York	PA	174052767	452537633	Physician Practices	PA	501(c)(3)	12 Type II	Northern Lancaster County Med Group	false
Philhaven
PO Box 2767	York	PA	174052767	231549922	Health Services	PA	501(c)(3)	3	WellSpan Health	false
Good Samaritan Health Service Foundation
PO Box 2767	York	PA	174052767	232356151	Fundraising for Good Samaritan	PA	501(c)(3)	12 Type I	Good Samaritan Hospital	Yes (true)
Good Samaritan Physician Services
PO BOx 2767	York	PA	174052767	251832359	Medical and Surgical Care	PA	501(c)(3)	10	Good Sam Health Services Foundation	false
Apple Hill Surgical Center Inc
PO Box 2767	York	PA	174052767	222842253	Sole GP in limited ptnrshp operating sur	PA	501(c)(3)	10	WellSpan Health Care Services	false
WellSpan Summit Health
PO Box 2767	York	PA	174052767	251515371	Integrated Health System	PA	501(c)(3)	7	WellSpan Health	false
Waynesboro Hospital
PO Box 2767	York	PA	174052767	231360854	Health Care Services	PA	501(c)(3)	3	WellSpan Summit Health	false
Chambersburg Hospital
PO Box 2767	York	PA	174052767	230465970	Health Care Services	PA	501(c)(3)	3	WellSpan Summit Health	false
Summit Physician Services
PO Box 2767	York	PA	174052767	251716306	Medical and surgical care	PA	501(c)(3)	3	WellSpan Summit Health	false
Summit Health Foundation
PO Box 2767	York	PA	174052767	831196554	Fundraising for Health Care System	PA	501(c)(3)	12 Type II	WellSpan Summit Health	false
Chambersburg Health Services
PO Box 2767	York	PA	174052767	251515376	Health care services	PA	501(c)(3)	12 Type I	WellSpan Summit Health	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd
Apple Hill Surgical Center Partners
PO Box 2767	York	PA	174052767	232489452	Surgical Cn	PA	NA	false	false
Central PA Alliance Laboratories LLC
PO Box 2767	York	PA	174052767	232910950	Ref. Lab	PA	NA	false	false
Littlestown Health Care Partners
300 West King Street	Littlestown	PA	17340	232880464	Lease Facility	PA	NA	false	false
Cherry Tree Cancer Center LLP
PO Box 2767	York	PA	174052767	232915628	Radiation	PA	NA	false	false
The Rehab Center
855 Springdale Drive Suite 20	Exton	PA	19341	251687903	Physical Therapy Rehab	PA	NA	false	false
Surgery Center Associates
785 5th 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	Chambersburg Health	false	false
Cumberland Valley Mobile Services
5 S Main St	Sugarloaf	PA	18249	200884014	Mobile health services	PA	Chambersburg Health	false	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
GSH Realty Inc
PO Box 2767	York	PA	174052767	251832359	Non res. real estate	PA	WSH Care Services	C corp	false
Wellspan Pharmacy Inc
PO Box 2767	York	PA	174052767	232374072	Dispense Rx & provides IV therapy	PA	NA	C corp	false
Wellspan Reciprocal Risk Retention Group
PO Box 2767	York	PA	174052767	200048457	Risk Retention Group	PA	NA	C corp	false
York Health Plan
PO Box 2767	York	PA	174052767	232664989	Preferred Provider Org	PA	NA	C corp	false
Wellspan Provider Network
PO Box 2767	York	PA	174052767	232907828	Coord. managed car risk contracts	PA	NA	C corp	false
Apple Hill Condominium Association
PO Box 2767	York	PA	174052767	232504543	Condo Mgmt Association	PA	NA	Homeowner Assoc	false
Northern Lan Co Phys Hosp Alliance
PO Box 2767	York	PA	174052767	232421885	Coord. Phys & Hospital	PA	NA	C corp	false
Ephrata Health Pavilion Condo Assoc
PO Box 2767	York	PA	174052767	475367279	Condo association	PA	Ephrata Hospital	C corp	false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	Yes (true)	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Good Samaritan Health Service Foundation
c	$677,939	General Ledger
Good Samaritan Health Service Foundation
m	$437,274	General Ledger