2021-05-14T04:03:56-07:00 2020-06-30 135381590 WellSpan Health 3350 WHITEFORD ROAD YORK PA 17402 990 2019-07-01 230794160 GOOD SAMARITAN HOSPITAL GOOD 7178513055 PO BOX 2767 YORK PA 17405 Laura Buczkowski CFO 2021-05-14 false See Attached P01871563 7038930600 2019 2022-09-23 18:48:47Z Roxanna Gapstur PO Box 2767 York PA 174052767 248533382 false X WWW.WELLSPAN.ORG X 1891 PA The Good Samaritan Hospital is a tax-exempt organization dedicated to providing high-quality, compassionate healthcare that improves the overall health of the community. 13 6 1316 295 1975235 685661 1126813 10748142 219175568 216533942 325473 4407558 1157543 1121708 221785397 232811350 8578701 8160605 0 81004940 84518348 0 437274 143770091 144562957 233353732 237241910 -11568335 -4430560 113316772 114912013 199149393 216530180 -85832621 -101618167 The Good Samaritan Hospital is a tax-exempt organization dedicated to providing high-quality, compassionate healthcare that improves the overall health of the community. false false 184830439 8160605 217136954 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/ 184830439 true true false true false false false false false true true false false true true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true true false false false true 0 0 true 1316 true true true false false false false false false 0 false false false false false false false X 13 6 false false false false true true true true true false false true true true true true true true true true true PA X DAVID P RIZZUTO 7178513055 3350 WHITEFORD ROAD YORK PA 174029081 X Kevin Mosser Former CEO-WSH 0.00 0.00 0 1583936 1630258 Roxanna Gapstur CEO-WSH/Dir 1.00 40.00 X X 0 1292495 177068 Michael O'Connor CFO-WSH 1.00 40.00 X 0 831632 330778 Jane Hyde Former President 0.00 40.00 0 671581 200951 Thomas Harlow President 40.00 0.00 X X 678713 0 88583 Tyler Fugate DO Director 1.00 40.00 X 0 652674 64077 Kristen O'Shea Dir end. 10/19 1.00 40.00 X 0 437302 65081 Robert Shaver VP-Medical Affairs 40.00 0.00 418856 0 59856 Patricia Donley VP - Patient Care 40.00 0.00 236248 0 75364 Virginia Follett Sr. Dir - Support 40.00 0.00 181071 0 62364 Debra Ney Manager-Pharmacy 40.00 0.00 177606 0 37513 Michele Rosario-Melendez Pharmacist 40.00 0.00 167300 0 32575 Thomas Clemens MD Dir beg. 11/19 1.00 0.00 X 0 1500 205 Michael Bechtold Director 1.00 0.00 X 0 0 0 Susan Eberly Director 1.00 0.00 X 0 0 0 Dennis Shalters Dir end. 10/19 1.00 0.00 X 0 0 0 Evelyn Colon Dir. end 10/19 1.00 0.00 X 0 0 0 Paul DiGiacomo MD Dir end. 10/19 1.00 0.00 X 0 0 0 Donald Dreibelbis Chairman 1.00 0.00 X X 0 0 0 Robert Funk Director 1.00 0.00 X 0 0 0 Robert Hoffman Vice Chair 1.00 0.00 X X 0 0 0 Robert Phillips Secretary 1.00 0.00 X 0 0 0 Kristen Watts Director 1.00 0.00 X 0 0 0 Vincent Garcia Dir beg. 11/19 1.00 0.00 X 0 0 0 John Welch MD Director 1.00 0.00 X X 0 0 0 1859794 5471120 2824673 72 true true false Lebanon Anesthesia Associates 110 29th Avenue Nashville TN 37203 Anesthesia Services 4403001 American HealthCare Svcs 10126 Cherry Bend Traverse City MI 49684 Staffing Service 966358 Emergency Physician Associates PO Box 634850 Cincinnati OH 452634850 Emergency Medicine Serv. 2302342 Womens Health Center of Lebanon 845 Helen Drive Lebanon PA 17042 Temporary Help 895592 Quest Diagnostics PO Box 912512 Pasadena CA 911102512 Lab Services 657558 20 677939 9847938 222265 10748142 Net Patient Services 621500 237261908 235286673 1975235 W/O- Bad Debt 621500 -19170720 -19170720 W/O Financial Assitance 621500 -1557246 -1557246 216533942 12371 12371 0 0 518696 518696 518696 518696 19948179 169040 15722032 4226147 169040 4395187 4395187 0 0 0 Cafeteria Sales 722210 613011 613011 Credentialing 900099 24000 24000 Health Promotion 611710 52350 52350 -86349 -86349 603012 232811350 215161719 1975235 4926254 8160605 8160605 0 0 0 767296 767296 0 61220333 55521216 5699117 2711673 2322395 389278 15081481 13508203 1573278 4737565 4284916 452649 27364426 27364426 132333 132333 60029 60029 0 0 20 20 11623934 11471148 152786 9527 9527 866475 603172 263303 8406066 8406066 0 1387305 1380799 6506 105549 93856 11693 0 46298 42761 3537 6389834 6389834 0 7582884 7582884 1435757 1435757 Supplies 35297920 35124692 173228 Purchased Services 30830670 29380388 1450282 Repairs & Maintenance 4678505 1716875 2961630 Taxes & Licenses 4321474 4321474 4023951 1479937 2106740 437274 237241910 184830439 51974197 437274 46234 123563 38942 80223 1211567 742765 22913871 21753133 0 0 0 2268399 4331451 410241 255251 178131370 112667979 64940685 65463391 11128289 11821378 26228 25604 0 124404 963197 10207912 9352057 113316772 114912013 5131501 6873021 2811326 24662521 2250026 2213525 157632195 150269195 31324345 32511918 199149393 216530180 X -93711052 -109802001 7878431 8183834 -85832621 -101618167 113316772 114912013 X -4430560 -3448831 -7906155 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 12336 12336 false false Part II-B, Line 1i - Other Activities Description 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. 7878431 799233 85487 579317 8183834 4004069 3985145 58490 169273 7878431 7592136 3545261 227655 7360983 4004069 7112140 1014123 -4978 529149 7592136 6868452 289830 21394 67536 7112140 0.12940 0.87060 false false false 1468847 1468847 104794616 61157166 43637450 8343723 5940755 2402968 61997176 45570058 16427118 1527008 1527008 65463391 Private Equity, Ltd Partners 1027 F Real estate, limited partnerships 1388 F Absolute return, Ltd Ptnrs 2005 F Collective mutual funds & inv trusts 19989 F Beneficial Interest Trust 228667 Due from affiliates 278006 9352057 Accrued Payroll 1788449 Accrued Payroll w/h 310062 Accrued Pension 25485095 Accrued Sales Tax 2429 Accrued Vacation 4088036 Due to Affiliates 6248 LTD-Leases 831599 32511918 X 229334451 -3534318 -3534318 232868769 -57419 -57419 232811350 229524245 229524245 7717665 7717665 237241910 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 true true X true X 300.000000000 true X true true false false true true 1 489 460123 460123 0.00190 1 36942 38067508 29542917 8524591 0.03590 2 37431 38527631 29542917 8984714 0.03780 17 1971 425003 110322 314681 0.00130 4 93 153385 153385 0.00060 21 2064 578388 110322 468066 0.00190 23 39495 39106019 29653239 9452780 0.03970 1 84000 84000 0.00040 1 10 5428 5428 1 61 203191 203191 0.00090 3 71 292619 292619 0.00130 true 5664414 56644 80110135 85963994 -5853859 X true true 1 1 WellSpan Good Samaritan Hospit 4th Walnut Street Lebanon PA 17042 http://www.wellspan.org 072401 X X X X false false true X X X X X X X X 18 true true true true X www.wellspan.org X https://communityhealthcouncil.com/data/ X X true 18 true www.wellspan.org true false true X 300.0000 400.0000 X X X X X X X true true X X X X true X http://www.wellspan.org X http://www.wellspan.org X http://www.wellspan.org X X X X X X X true X false X X X X true X false false Facility: - Part V, Section B, Line 5 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. 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) 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 true Lebanon School District 1000 S 8th Street Lebanon PA 17042 231646050 84000 0 Community Support Lebanon Valley College 101 N College Ave Annville PA 17003 231352354 501(c)(3) 75000 0 Community Support WellSpan Medical Group 3350 Whiteford Road York PA 17402 232730785 501(c)(3) 8000000 0 Community Health 3 0 Additional Supplemental Information All WellSpan entities follow WellSpan policies and procedures regarding grant projects to ensure that the use of grant funds are consistent with WellSpan's commitment to endeavor to improve the health status of the communities that we serve.The WellSpan foundations are supporting organizations and substantially all of the grants and other assistance they make furthers the exempt purposes of their "supported organizations", each of which are exempt affiliated organizations within the WellSpan Health system. Because the supported organizations identify the projects and exempt activities that will be funded by the foundations' grants and other assistance, and because there is a cross-over between the respective governing bodies and management of the foundations and their supported organizations, the foundations are able to effectively monitor that the grants they make are used for their intended purposes. X X X X X true true false false false false false false false Debra Ney Manager-Pharmacy 162420 12665 2521 10722 26791 215119 Jane Hyde Former President 372070 299436 75 168329 32622 872532 143520 Kevin Mosser Former CEO-WSH 212990 763820 607126 1596796 33462 3214194 763820 Kristen O'Shea Dir end. 10/19 344758 85290 7254 18308 46773 502383 Michael O'Connor CFO-WSH 605042 226590 279133 51645 1162410 226590 Michele Rosario-Melendez Pharmacist 146568 20732 9477 23098 199875 Patricia Donley VP - Patient Care 183880 47971 4397 12065 63299 311612 Robert Shaver VP-Medical Affairs 330432 82193 6231 17032 42824 478712 Roxanna Gapstur CEO-WSH/Dir 988473 271790 32232 121240 55828 1469563 Thomas Harlow President 364049 307623 7041 58607 29976 767296 153270 Tyler Fugate DO Director 652674 16097 47980 716751 Virginia Follett Sr. Dir - Support 169012 11934 125 21374 40990 243435 A See Schedule O Funk Construction Pres - Funk 2780596 Construction false Beers Hoffman Architech Architect Hoffman 413868 Architectural Serv false WelchWagner Partnership Partner Welch 381871 Lease to WellSpan false 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 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 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 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 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 false false true true true false false true false true true false true false false true false true false Good Samaritan Health Service Foundation c 677939 General Ledger Good Samaritan Health Service Foundation m 437274 General Ledger