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EPHRATA COMMUNITY HOSPITAL: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
EPHRATA COMMUNITY HOSPITAL (EIN 23-1370484)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-14
IRS object ID
202141349349300209
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 ReturnHeader

FieldValueIRS element (for citing)
Return2021-05-14T03:59:27-07:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135381590PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WellSpan HealthBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13350 WHITEFORD ROADAddressLine1Txt
CityYORKCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN231370484EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1EPHRATA COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlEPHRBusinessNameControlTxt
Phone7178513055PhoneNum

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLaura BuczkowskiPersonNm
Person TitleCFOPersonTitleTxt
Signature2021-05-14SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSee AttachedPreparerPersonNm
PTINP01871563PTIN
Phone7038930600PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRoxanna GapsturPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 2767AddressLine1Txt
CityYorkCityNm
State AbbreviationPAStateAbbreviationCd
ZIP174052767ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$226,536,634GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.WELLSPAN.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1940FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionThe Ephrata Community Hospital is a tax exempt organization dedicated to providing preventive, primary, acute care, diagnostic and rehabilitative services.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee1381TotalEmployeeCnt
Total Volunteers165TotalVolunteersCnt
Total Gross UBI$397,997TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$1,692NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$962,694PYContributionsGrantsAmt
CY Contributions Grants$5,492,886CYContributionsGrantsAmt
PY Program Service Revenue$227,289,219PYProgramServiceRevenueAmt
CY Program Service Revenue$218,144,990CYProgramServiceRevenueAmt
PY Investment Income$1,499,971PYInvestmentIncomeAmt
CY Investment Income$1,409,255CYInvestmentIncomeAmt
PY Other Revenue$376,912PYOtherRevenueAmt
CY Other Revenue$327,921CYOtherRevenueAmt
PY Total Revenue$230,128,796PYTotalRevenueAmt
CY Total Revenue$225,375,052CYTotalRevenueAmt
PY Grants And Similar Paid$14,632,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$15,647,750CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$78,716,811PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$84,792,491CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$361,239CYTotalFundraisingExpenseAmt
PY Other Expenses$135,301,079PYOtherExpensesAmt
CY Other Expenses$141,383,220CYOtherExpensesAmt
PY Total Expenses$228,649,890PYTotalExpensesAmt
CY Total Expenses$241,823,461CYTotalExpensesAmt
PY Revenues Less Expenses$1,478,906PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$16,448,409CYRevenuesLessExpensesAmt
Total Assets BOY$153,388,188TotalAssetsBOYAmt
Total Assets EOY$154,855,390TotalAssetsEOYAmt
Total Liabilities BOY$92,079,198TotalLiabilitiesBOYAmt
Total Liabilities EOY$110,821,578TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$61,308,990NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$44,033,812NetAssetsOrFundBalancesEOYAmt
MissionThe mission of the Ephrata Community Hospital:1)To assure community access to health care services that are high in quality, compassionate and cost-effective.2)To partner with employees, physicians, volunteers, and other health care organizations to meet the health care needs of the communities we serve.3)To combine advanced medical technology with professional, personalized care.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$188,144,106ExpenseAmt
Grant$15,647,750GrantAmt
Revenue$218,334,791RevenueAmt
DescEphrata Community Hospital is an acute care hospital providing care for residents of northern Lancaster County and surrounding communities. For the fiscal year that ended June 30, 2016, program services included 7167 inpatient acute, sub-acute, behavioral health, acute rehab and newborn admissions, for a total of 27,788 patient bed days.Additionally, outpatient services included imaging studies (x-ray, ultrasound, MRI, CT, mammography), lab testing, physical, occupational and speech therapy, non-invasive cardiology procedures including echocardiograms and EKG's, behavioral health counseling, radiation and medical oncology, emergency department visits, prenatal care through our healthy beginnings plus.See WellSpan Health - 2020 Community Benefit Report located at https://www.wellspan.org/about/wellspan-in-the-community/Desc
Total Program Service Expenses$188,144,106TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesYes (true)ForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1381EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDAVID P RIZZUTOPersonNm
Phone7178513055PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13350 WHITEFORD ROADAddressLine1Txt
CityYORKCityNm
State AbbreviationPAStateAbbreviationCd
ZIP174029081ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerInd
Kevin Mosser
Former CEO WSH0.000.00$0$1,583,936$1,630,258
John M Porter Jr
Former President0.0040.00$0$1,314,301$367,603
Roxanna Gapstur
Pres & CEO-WSH1.0040.00$0$1,292,495$177,068Yes (X)Yes (X)
Michael F O'Connor
CFO-WellSpan1.0040.00$0$831,632$330,778Yes (X)
Douglas Arbittier MD
Director1.0040.00$0$958,001$170,129Yes (X)
Carrie Willetts
President40.000.00$702,300$0$112,084Yes (X)
Ill Chon
VP-Med Affairs40.000.00$384,827$0$63,793
Lloyd G Goldfarb MD
Dir. end 10/191.0040.00$0$372,738$57,868Yes (X)
Jeffrey Keyser DO
Director1.0040.00$0$332,806$52,732Yes (X)
Joseph Degenhard MD
Director1.0040.00$0$300,906$60,508Yes (X)
Robert Ortmyer
VP-Operations40.000.00$276,254$0$57,295
Tina Citro
VP-Patient Service40.000.00$248,545$0$52,050
Bashirat Giwa MD
Dir. beg. 11/191.0040.00$0$238,228$57,163Yes (X)
Steven Thomas
Direct.-Pharm Care40.000.00$199,311$0$54,583
Lauren Fund
Manager-Pharm40.000.00$196,293$0$35,468
David Kreider
Treasurer1.0040.00$0$171,026$50,428Yes (X)Yes (X)
R Fred Groff III
Dir. end 10/191.000.00$0$0$0Yes (X)
William C Funk DMD
Chair end 10/191.000.00$0$0$0Yes (X)Yes (X)
Leon Ray Burkholder
Director1.000.00$0$0$0Yes (X)
Carrie Evans
Director1.000.00$0$0$0Yes (X)
P Joshua Gluck
Vice Chair1.000.00$0$0$0Yes (X)Yes (X)
Aaron L Groff Jr
Tres end 10/191.000.00$0$0$0Yes (X)Yes (X)
Jeffrey Musser DO
Director1.000.00$0$0$0Yes (X)
Reyna Britton
Secretary1.000.00$0$0$0Yes (X)Yes (X)
Richard Broadbent
Director1.000.00$0$0$0Yes (X)
Meredith Dahl
Dir.beg 11/191.000.00$0$0$0Yes (X)
Linda H Weaver
Chair beg 11/191.000.00$0$0$0Yes (X)Yes (X)
Patrick Glavce
Dir beg 11/191.000.00$0$0$0Yes (X)
Jeffrey Stauffer
Dir. beg 11/191.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,007,530TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$7,396,069TotReportableCompRltdOrgAmt
Total Other Compensation$3,329,808TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K56IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
American HealthCare Svcs
10126 Cherry BendTraverse CityMI49684Staffing services$967,042
OnSite NeonatalPC
1000 Haddonfield-Berlin RdVoorheesNJ08047NICU Physicians$704,000
Quest Diagnostics
PO Box 912512PasadenaCA911012512Lab Services$525,226
ABM Healthcare
PO Box 74008829ChicagoIL606748829Valet services$486,625
TransTime Express
11820 Parklawn DriveRockvilleMD20852Delivery Services$502,299
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K15CntrctRcvdGreaterThan100KCnt
Related Organizations$503,964RelatedOrganizationsAmt
Government Grants$4,604,221GovernmentGrantsAmt
All Other Contributions$384,701AllOtherContributionsAmt
Total Contributions$5,492,886TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
EHR Incentive Program(MU)621500$271,330$271,330
Patient Services621500$241,112,398$240,729,363$383,035
W/O - Bad Debts621990-$18,238,738-$18,238,738
W/O - Free Service621990-$5,000,000-$5,000,000
FieldValueIRS element (for citing)
Total Program Service Revenue$218,144,990TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,407,772TotalRevenueColumnAmt
Exclusion$1,407,772ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$399,248RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$799,557RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$400,309RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$400,309TotalRevenueColumnAmt
Exclusion-$400,309ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$361,914SecuritiesAmt
Other$1,594OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$362,025SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$111SecuritiesAmt
Other$1,594OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,483TotalRevenueColumnAmt
Exclusion$1,483ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Net Income From Gaming NetIncomeFromGamingGrp

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Cafeteria/Cafe722210$432,821$432,821
Other Revenue900099$108,089$108,089
Work First621300$40,570$40,570

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$146,750TotalRevenueColumnAmt
Related Or Exempt Func Income$41,142RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$14,962UnrelatedBusinessRevenueAmt
Exclusion$90,646ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$728,230OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$225,375,052TotalRevenueColumnAmt
Related Or Exempt Func Income$217,951,756RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$397,997UnrelatedBusinessRevenueAmt
Exclusion$1,532,413ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$15,647,750TotalAmt
Program Services$15,647,750ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$814,384TotalAmt
Program Services$814,384ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$60,297,233TotalAmt
Program Services$53,091,704ProgramServicesAmt
Management And General$7,205,529ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,608,695TotalAmt
Program Services$2,218,876ProgramServicesAmt
Management And General$389,819ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$16,471,932TotalAmt
Program Services$14,489,584ProgramServicesAmt
Management And General$1,982,348ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,600,247TotalAmt
Program Services$4,057,843ProgramServicesAmt
Management And General$542,404ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$27,503,956TotalAmt
Management And General$27,503,956ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$42,935TotalAmt
Program Services$42,935ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$55,578TotalAmt
Program Services$55,578ProgramServicesAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$40,218,757TotalAmt
Program Services$39,230,171ProgramServicesAmt
Management And General$988,586ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$9,314TotalAmt
Program Services$6,814ProgramServicesAmt
Management And General$2,500ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$620,891TotalAmt
Program Services$620,891ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$8,448,928TotalAmt
Management And General$8,448,928ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,912,150TotalAmt
Program Services$1,643,358ProgramServicesAmt
Management And General$268,792ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$147,419TotalAmt
Program Services$112,856ProgramServicesAmt
Management And General$34,563ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$58,562TotalAmt
Program Services$46,864ProgramServicesAmt
Management And General$11,698ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,391,282TotalAmt
Program Services$2,391,282ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$8,937,249TotalAmt
Program Services$8,937,249ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,434,429TotalAmt
Program Services$7,861ProgramServicesAmt
Management And General$1,426,568ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Supplies$35,836,941$35,529,843$307,098
Repair & Maintenance$5,041,180$3,294,826$1,746,354
Taxes & Licenses$4,175,952$3,927,462$248,490
Utilities$2,342,441$644,711$1,697,730

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,205,256TotalAmt
Program Services$1,331,264ProgramServicesAmt
Management And General$512,753ManagementAndGeneralAmt
Fundraising$361,239FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$241,823,461TotalAmt
Program Services$188,144,106ProgramServicesAmt
Management And General$53,318,116ManagementAndGeneralAmt
Fundraising$361,239FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$5,834BOYAmt
EOY$5,972EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,100,556BOYAmt
EOY$5,267,153EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$133,900BOYAmt
EOY$205,650EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$30,062,873BOYAmt
EOY$23,845,733EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$932,583BOYAmt
EOY$793,703EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,133,218BOYAmt
EOY$3,336,203EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$397,137BOYAmt
EOY$164,672EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$227,336,118LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$118,107,789LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$101,793,807BOYAmt
EOY$109,228,329EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$14,874BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$41,151BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$5,103,164EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$11,772,255BOYAmt
EOY$6,904,811EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$153,388,188BOYAmt
EOY$154,855,390EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,747,633BOYAmt
EOY$5,099,748EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$3,589,370BOYAmt
EOY$22,771,374EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$67,103,739BOYAmt
EOY$64,776,423EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$246,660BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,391,796BOYAmt
EOY$18,174,033EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$92,079,198BOYAmt
EOY$110,821,578EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$55,772,179BOYAmt
EOY$38,317,754EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,536,811BOYAmt
EOY$5,716,058EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$61,308,990BOYAmt
EOY$44,033,812EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$153,388,188BOYAmt
EOY$154,855,390EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$16,448,409ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$511,295NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$315,474OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed Section4955 TaxfalseForm4720FiledSection4955TaxInd
Correction MadefalseCorrectionMadeInd
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$12,915OtherActivitiesAmt
Total Lobbying Expenditures$12,915TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind
Form4720 Filed4912 TaxfalseForm4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1i - Other Activities DescriptionFormAndLineReferenceDesc
ExplanationA portion of the dues paid to the Hospital Association of Pennsylvania and the American Hospital Association include lobbying ($6,842 and $6,073).ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,536,811BeginningYearBalanceAmt
Contributions$572,485ContributionsAmt
Investment Earnings Or Losses-$23,658InvestmentEarningsOrLossesAmt
Other Expenditures$369,580OtherExpendituresAmt
End Year Balance$5,716,058EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,279,246BeginningYearBalanceAmt
Contributions$886,687ContributionsAmt
Investment Earnings Or Losses-$8,761InvestmentEarningsOrLossesAmt
Other Expenditures$620,361OtherExpendituresAmt
End Year Balance$5,536,811EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,380,692BeginningYearBalanceAmt
Contributions$774,279ContributionsAmt
Investment Earnings Or Losses$328InvestmentEarningsOrLossesAmt
Other Expenditures$876,053OtherExpendituresAmt
End Year Balance$5,279,246EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,133,170BeginningYearBalanceAmt
Contributions$1,506,873ContributionsAmt
Investment Earnings Or Losses$21,321InvestmentEarningsOrLossesAmt
Other Expenditures$280,672OtherExpendituresAmt
End Year Balance$5,380,692EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,116,977BeginningYearBalanceAmt
Contributions$401,491ContributionsAmt
Investment Earnings Or Losses-$34,125InvestmentEarningsOrLossesAmt
Other Expenditures$351,173OtherExpendituresAmt
End Year Balance$4,133,170EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.11480PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.88520TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,528,030OtherCostOrOtherBasisAmt
Book Value$1,528,030BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$135,518,939OtherCostOrOtherBasisAmt
Depreciation$56,783,132DepreciationAmt
Book Value$78,735,807BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,221,294OtherCostOrOtherBasisAmt
Depreciation$7,469,158DepreciationAmt
Book Value$1,752,136BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$77,132,029OtherCostOrOtherBasisAmt
Depreciation$53,855,499DepreciationAmt
Book Value$23,276,530BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,935,826OtherCostOrOtherBasisAmt
Book Value$3,935,826BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$109,228,329TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
Accrd Payroll W/H$274,600
Accrued Payroll$1,834,628
Accrued Vacation$3,623,562
Capital Lease Obligation$5,051,960
Due to Affiliates$5,974,034
Total Other Noncurrent Liabili$1,415,249
FieldValueIRS element (for citing)
Total Liability$18,174,033TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$225,318,818TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$487,637NetUnrealizedGainsInvstAmt
Revenue Not Reported-$487,637RevenueNotReportedAmt
Revenue Subtotal$225,806,455RevenueSubtotalAmt
Other Revenues Not Included-$431,403OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$431,403RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$225,375,052TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$227,378,778TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$227,378,778ExpensesSubtotalAmt
Other Expenses Not Included$14,444,683OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$14,444,683ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$241,823,461TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4: Intended uses of the endowment fund.The funds are to be used to improve the health and welfare of the patients of Ephrata Community Hospital.
Part X : FIN48 FootnoteIn June 2006, the Financial Accounting Standards Board (FASB) issued Interpretation No. 48, Accounting for Uncertainty in Income Taxes-an interpretation of Fasb Statement No. 109, Accounting for income Taxes (FIN 48), which creates a single model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing the minimum recognition threshold a tax position is required to meet before being recognized in the financial statements. Under the requirements of FIN 48, tax-exempt organizations could now be required to record an obligation as a 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/SRevenue netted against Expense $-1055317 Grant-WellSpan Medical Group $15500000

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

FieldValueIRS element (for citing)
RegionCentral America and CarribbeanRegionTxt
Offices0OfficesCnt
Employee0EmployeeCnt
Type Of Activities ConductedInvestmentTypeOfActivitiesConductedTxt
Region Total Expenditures$315,010RegionTotalExpendituresAmt
FieldValueIRS element (for citing)
Subtotal Spent$315,010SubtotalSpentAmt
Total Spent$315,010TotalSpentAmt
Transfer To Foreign CorpfalseTransferToForeignCorpInd
Interest In Foreign TrustfalseInterestInForeignTrustInd
Foreign Corp OwnershipYes (true)ForeignCorpOwnershipInd
Passive Foreign Investmest CofalsePassiveForeignInvestmestCoInd
Foreign PartnershipfalseForeignPartnershipInd
Boycott CountriesfalseBoycottCountriesInd

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served1298PersonsServedCnt
Total Community Benefit Expns$1,453,201TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,453,201NetCommunityBenefitExpnsAmt
Total Expense0.00600TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served24020PersonsServedCnt
Total Community Benefit Expns$30,128,166TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,679,460DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,448,706NetCommunityBenefitExpnsAmt
Total Expense0.05560TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Persons Served25318PersonsServedCnt
Total Community Benefit Expns$31,581,367TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,679,460DirectOffsettingRevenueAmt
Net Community Benefit Expns$14,901,907NetCommunityBenefitExpnsAmt
Total Expense0.06160TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs12ActivitiesOrProgramsCnt
Persons Served16709PersonsServedCnt
Total Community Benefit Expns$1,275,847TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$165,482DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,110,365NetCommunityBenefitExpnsAmt
Total Expense0.00460TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs5ActivitiesOrProgramsCnt
Persons Served129PersonsServedCnt
Total Community Benefit Expns$213,829TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$213,829NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs17ActivitiesOrProgramsCnt
Persons Served16838PersonsServedCnt
Total Community Benefit Expns$1,489,676TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$165,482DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,324,194NetCommunityBenefitExpnsAmt
Total Expense0.00550TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs19ActivitiesOrProgramsCnt
Persons Served42156PersonsServedCnt
Total Community Benefit Expns$33,071,043TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,844,942DirectOffsettingRevenueAmt
Net Community Benefit Expns$16,226,101NetCommunityBenefitExpnsAmt
Total Expense0.06710TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$128,500TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$128,500NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served4220PersonsServedCnt

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served81PersonsServedCnt
Total Community Benefit Expns$208,792TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$208,792NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served4301PersonsServedCnt
Total Community Benefit Expns$337,292TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$337,292NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$5,300,912BadDebtExpenseAmt
Bad Debt Expense Attributable$71,562BadDebtExpenseAttributableAmt
Reimbursed By Medicare$60,704,083ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$77,229,423CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$16,525,340MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Ephrata Community HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1169 Martin AvenueAddressLine1Txt
CityEphrataCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17522ZIPCd
FieldValueIRS element (for citing)
Website Addresshttp://www.wellspan.orgWebsiteAddressTxt
State License747105StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

FieldValueIRS element (for citing)
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLwww.wellspan.orgOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLhttp://www.wellspan.orgStrategyWebsiteURLTxt
Strategy AttachedYes (true)StrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.0000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care350.0000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttp://www.wellspan.orgFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttp://www.wellspan.orgFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttp://www.wellspan.orgFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Facility: - Part V, Section B, Line 5The healthcare environment in Lancaster County and its associated historical partnerships has resulted in WellSpan-Ephrata Community Hospital participating in two separate Community Health Needs Assessment (CHNA) processes in Lancaster County. First, WellSpan-Ephrata Community Hospital maintained its partnership with Live Well Lancaster and its partner organizations to conduct an ongoing CHNA across the county. Using the Conduent-Healthy Communities Initiative model (HCI), these entities regularly collect available secondary data on diverse topics including: community demographics; health behaviors and conditions; vital statistics, and; community conditions (i.e., air and water quality).Public health experts and various community stakeholders review this data and provide comments and recommendations based on county data and the clients they represent. The individuals consulted with represent diverse sectors of the Lancaster County community including: mental health; city and county government; health care organizations; the state health department; nursing homes; public health entities; homeless facilities; pregnancy services; faith-based; low-income service agencies; the local chamber of commerce; chronic disease and health-related organizations (HIV prevention; cancer prevention; immunization), and; racial/ethnic community-based organizations.In addition, to better understand the health needs of its service market, WellSpan-Ephrata Community Hospital conducted a CHNA with other WellSpan Health entities across its region, with a focus on the primary market served by WellSpan-Ephrata Community Hospital. Information collected through the CHNA was then shared with diverse community stakeholders to educate about current needs, identify areas of focus, and garner collective support for future strategy development and implementation. Community organizations represented included: Ephrata Area School District; the Northern Lancaster County Chamber of Commerce; Ephrata Community Hospital Foundation; Good Samaritan Shelter; WellSpan Philhaven; WellSpan Medical Group; Cocalico School District; the Northern Lancaster County Hub including Ephrata Area Social Services and Real Life Community Services; the Ephrata Public Library and; Welsh Mountain Federally Qualified Health Center (FQHC).
Facility: - Part V, Section B, Line 6aCounty-wide CHNA Lancaster Behavioral Health Hospital, Lancaster General Hospital, Lancaster Rehabilitation Hospital, UPMC Lititz, WellSpan Ephrata Community Hospital. Ephrata market-specific CHNA: Gettysburg Hospital (Adams); Good Samaritan Hospital (Lebanon); WellSpan Surgery and Rehabilitation Hospital; and York Hospital (York).
Facility: - Part V, Section B, Line 11See 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 13hWellSpan Health is committed to caring for all the members of its communities, regardless of their ability to pay. In recent years, overall charity care has decreased slightly as more people have obtained health insurance coverage through the Affordable Care Act and the expansion of Pennsylvanias Medical Assistance (Medicaid) program. WellSpan is proud to be a leading partner in the Healthy Community Network, which works to address the needs of uninsured and underinsured individuals in our community. In addition, the health system recently enhanced its financial assistance policy and the discounts that it provides on services. For example, if a patients income is less than 300 percent of the federal poverty level, that patient would be eligible for a 100 percent discount on the services provided. Additionally, significant discounts are available for patients whose income is between 300 percent and 350 percent of the federal poverty level. For more information on WellSpans Financial Assistance program, visit www.WellSpan.org/FinancialAssistance.
Facility: - Part V, Section B, Line 16jIn an effort to make patients, families and others in our communities aware of the newly expanded Financial Assistance Policy, WellSpan broadly publicized its policy via promotional signage and the distribution of easy-to-read informational materials at registration sites throughout our communities. WellSpan provided information on the Financial Assistance Policy on its billing statements and included information in patient discharge materials. In addition, the materials and information are easily accessible via WellSpans website at www.WellSpan.org/FinancialAssistance. The site reflects WellSpans newly enhanced policy, as well as informational and application materials. It was also publicized via WellSpans on-hold phone messaging system and in its direct-to-consumer community newsletter/magazine, which is distributed by mail, email and 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 (17 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
Ephrata Cancer Center
460 North Reading RoadEphrataPA17522Medical & Radiology Oncology/Pet Scanning
WellSpan Reading Road Health Center
446 North Reading RoadEphrataPA17522Imaging/Lab/Occupational Medicine
WellSpan Garden Spot Health Center
435 South Kinzer AvenueNew HollandPA17557Cardiology/Lab/Imaging/Quick Care/Therapy/Occupational Medicine
Ephrata Health Pavilion
175 Martin AvenueEphrataPA17522Wound care & Hyperbaric/Women's Center
WellSpan Adamstown Health Center
30 West Swartzville RoadReinholdsPA17569Imaging/Lab
WellSpan Crossroads Health Center
4131 Oregon PikeEphrataPA17522Lab/Imaging/Therapy
WellSpan Meadowbrook Health Center
337 West Main StreetLeolaPA17540Lab/Imaging/Therapy
WellSpan Brossman Health Center
136 Lake StreetEphrataPA17522Cardiology/Therapy
Pain Management Center-Ephrata WellSpan Health
4150 Barrett BoulevardEphrataPA17522Pain Management & Radiology
WellSpan Rothsville Health Center
2320 Rothsville RoadLititzPA17543Lab/Pulmonary Rehab
Cornerstone Medical Center
6 West Newport RoadLititzPA17543Imaging/Lab/Therapy
WellSpan Cocalico Health Center
63-71 West Church StreetStevensPA17578Therapy/sleep studies/Wellness/Weight Loss
Medical Office Building
157-181 North Reading RoadEphrataPA17522Cardiology/Health Beginnings Plus
Ephrata Medical Lab-Adamstown
2580 North Reading RoadAdamstownPA19501Lab
Sleep Centers-Lancaster Co - WellSpan Health
217 Granite Run DriveLancasterPA17603Sleep Studies
WellSpan Georgetown Road Health Services
1135 Georgetown RoadChristianaPA17509Imaging and Lab
WellSpan Granite Run Health Center
268 Granite Run DriveLancasterPA17601Lab/Imaging/Therapy

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used)Patients 401% of poverty level and greater do not qualify for financial assistance.Patients/guarantors who complete an application for Financial 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 ReportCommunity Benefit Information is included in the Community Benefit Report for WellSpan Health.
Part III, Line 2 - Methodology Used To Estimate Bad Debt ExpenseThe number was calculated using the cost to charge ratio factor applied against actual patient bad debt write-offs. These numbers are included after all efforts have been exhausted to determine if the patient meets our charity care write-off policy based on federal poverty levels.
Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community BenefitThe estimate of bad debt attributable to charity care policy was calculated by dividing the bad debt amount that was originally coded bad debt but later found to qualify as charity care by the amount coded to the charity care write-off codes. This ratio is applied to the bad debt cost factor expense.
Part III, Line 4 - Bad Debt ExpenseEphrata Community Hospital 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 accounts 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 ECH ceases collection efforts. Losses have been consistent with management's expectations in all material respects.
Part III, Line 8 - Explanation Of Shortfall As Community BenefitEphrata Community 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 these services. Payments from Medicare are generally less than Ephrata Community Hospital's costs of providing the service.
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsGuidelines for suggested minimum number of phone attempts and letters to be sent before the account is turned over to an outside collection agency are included in the Patient Administrative Services Policy. Upon final PARO (Payment Assistance Rank Ordering) scoring, if a patient qualifies for presumptive charity, their account would not be forwarded to any third party collections. It shall be the policy of Patient Administrative Services to recommend accounts to Bad Debt on a timely basis. Inpatient/Outpatient accounts will go to bad debt automatically after the account has been in the financial class Pending Bad Debt for 30 days. All accounts must follow the approved limits for refunds and write offs, as established in Policy PF-102, before being transferred. The primary agencies will work the accounts for 6 months or until they feel it is uncollectable and return the account. The accounts are forwarded to secondary agencies from the primary agencies Closed and Return Reports. The financial class is changed to Bad Debt Other after the Closed and Return Reports are received from the Secondary Agency. The agencies must get written approval from the manager in the relatively rare instance of legal action being taken to collect the debt.
Part VI, Line 2 - Needs AssessmentAs noted, WellSpan-Ephrata Community Hospital participated in the completion of two Community Health Needs Assessments (CHNA) in the 2018 tax year. The first, a county-wide CHNA, was conducted in partnership with Live Well Lancaster and its partner organizations using the Conduent-Healthy Communities Initiative (HCI) model. These entities regularly collect available secondary data on diverse topics including: community demographics; health behaviors and conditions; vital statistics, and; community conditions (i.e., air and water quality), and share it with community members through its organizational websites. The current county-wide CHNA may be found on the WellSpan Health website (www.wellspan.org). In addition, results are annually shared at the Lancaster Health Summit, a partnership between Live Well Lancaster and the Lancaster County Business Group of Health.After its affiliation with WellSpan Health, a regional health care system, WellSpan-Ephrata Community Hospital (WECH) also adopted a second, parallel CHNA process to better understand the health needs of its service market specifically. The CHNA marks the second CHNA conducted in this manner. The methodology, analysis and priority setting processes mirror the other WellSpan Health entities regionally. Information collected through the CHNA was then shared with diverse community stakeholders to educate about current needs, identify areas of focus, and garner collective support for future strategy development and implementation. Community organizations represented included: Ephrata Area School District; the Northern Lancaster County Chamber of Commerce; Ephrata Community Hospital Foundation; Good Samaritan Shelter; WellSpan Philhaven; WellSpan Medical Group; Cocalico School District; the Northern Lancaster County Hub including Ephrata Area Social Services and Real Life Community Services; the Ephrata Public Library and; Welsh Mountain Federally Qualified Health Center (FQHC). Through the consulting support of the Floyd Institute for Public Policy at Franklin and Marshall College. a representative sample of 500 adults residents in the greater Ephrata (Northern Lancaster County) area 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 compiled and integrated into the 2018 CHNA.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 WellSpan- Ephrata Community Hospital and its community partners 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- Ephrata Community 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 HealthAs 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. Through its various locations in the greater Ephrata community, WellSpan-Ephrata Community Hospital provides a range of wellness and health education programs designed to address key CHNA findings and to promote healthy lifestyles and disease prevention. These programs include health screenings; diabetes education; nutrition and weight management counseling; tobacco cessation; CPR and first aid instruction; support groups; community health fair participation, and; health education programs. Many of these programs are offered for free or at a minimal cost to the participant. In addition to the educational and health promoting programs offered by WellSpan- Ephrata Community Hospital, the hospital has an evident commitment to building and strengthening community partnerships, enhancing access to healthcare services for community members, and supporting the lifelong wellness of northern Lancaster County. One of many exemplary community partnerships in the northern Lancaster county region includes WellSpan Ephrata Community Hospitals relationship with the Ephrata Public Library. This partnership continues to grow and expand and is a catalyst for change in the community. One example of a unique community-based partnership between WellSpan-Ephrata Community Hospital and Ephrata Public Library includes the implementation of the GO Lancaster! summer physical activity program. The Ephrata Public Library and its Summer Reading Club, along with WellSpan-Ephrata Community Hospital, annually encourage children and their families to be physically active during the summer months by participating in an adaptation of letterboxing, which engages children and their families in an adaptation of letterboxing, where participants use written clues to find hidden posts in county parks. This program expanded to include the Adamstown Library in 2019.Additionally, WellSpan-Ephrata Community Hospital has been an active participant with the Ephrata Public Library and other community partners to develop the Northern Lancaster County Hub. This hub serves as a resource center for residents desiring connections with community and social service organizations, many of which are located in Lancaster City, approximately 16 miles away. The Hub provides a wide array of services including food assistance, health care, career help, literacy services, counseling, housing support and other services to residents of Ephrata, Denver,and nearby communities. This initiative has been supported financially by WellSpan Health Community Partnership Grant funds. Opioid use, as in other communities across the United States, has become a crisis in the Ephrata area. WellSpan- Ephrata Community Hospital staff participate with a regional Opioid Awareness coalition, a multi-sector collaborative seeking to create coordinated messaging, outreach and management of opioid users in southcentral Pennsylvania. The program aims to reduce opioid use and overdoses. Regionally, WellSpan has also developed and expanded its Medication Assisted Treatment (MAT) program, by serving 520 patients in 2020. The program combines the use of medication and behavioral therapy. Access to high quality healthcare remains a regional focus for WellSpan, as observed in Lancaster County by the organizations support of the Welsh Mountain Medical and Dental Center, an FQHC that met patient needs in Lancaster and Lebanon counties by providing over 17,500 medical visits and over 19,000 dental visits. Regionally, WellSpan also supports thousands of uninsured and underinsured community members with its Healthy Community Network program and provides financial assistance for prescriptions so that those facing financial hardship will not need to avoid medications because of cost. Additionally, WellSpan-Ephrata Community Hospital participated in system-wide initiatives to address the shared community health priorities for the entire WellSpan footprint. These efforts included behavioral health specific efforts, advanced care planning and adult overweight/obesity, for example. WellSpan-Ephrata Community Hospital supported the education of greater Ephrata area residents about end-of-life planning and care, or Horizon Planning as it is termed locally and continues to offer both the Early Bird Walkers and Healthy Moves programs for older adults. WellSpan- Ephrata Community Hospital employees and community members engaged in the 8th annual 10 Pound Throwdown in 2020. 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. Developed in 2013 to address the growing issue of adult overweight/obesity, the initiative utilizes a core website (www.10poundthrowdown.com). In 2020, the 10 Pound Throwdown engaged 7,200 community members to lose 14,000 pounds across four southcentral Pennsylvania counties -Adams, Lancaster, Lebanon, and York. WellSpan- Ephrata Community Hospital primary care practices in northern Lancaster County participated in the Market Bucks program to address food insecurity and increase the consumption of fruits and vegetables. This program reaches those with an elevated Body Mass Index (BMI) who also experience a comorbidity associated with diet. The program provides fruit and vegetable vouchers to be redeemed at local farmers markets and encourages healthy eating. Market Bucks boasts an astounding 86% redemption rate and contributed $31,620 to the regional economy in addition to demonstrating increased fruit and vegetable consumption for the 310 participants in 2020. Additional examples of how WellSpan-Ephrata Community Hospital fulfilled its community mission in the greater Ephrata (Northern Lancaster County) area may be found in the 2019 WellSpan Community Benefit Report- available online at www.wellspan.org. CHNA results were also made available to the public on the WellSpan Health (www.wellspan.org) website, and may also be obtained upon request.
Part VI, Line 6 - Affilated Health Care SystemWellSpan Health is an integrated health system serving the communities of southcentral Pennsylvania and northern Maryland. As a community-based, not-for-profit organization, WellSpan is dedicated to improving the health and well-being of the people it serves. WellSpan will assume a leadership role and develop partnerships with other organizations to: improve access to coordinated, high-quality, cost-effective health care services, educate the health care providers of tomorrow, promote healthy lifestyles and lifelong wellness, and make its local communities healthier, more desirable places to live, work, and play. WellSpan Ephrata 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.Ephrata Community Hospital's community benefit report is contained in a report prepared by their parent organization, WellSpan Health. See Attached Federal Supplemental Information: WellSpan Health - 2019 Community Benefit Report
Part VI, Line 7 - States Filing of Community Benefit ReportPA

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
Lincoln Fire Company
38 S Market StEphrataPA17522236283046501(c)(3)$10,000$0Community Support
Pioneer Steam Fire Engine
135 S State StEphrataPA17522223118533501(c)(3)$10,000$0Community Support
WellSpan Medical Group
45 Monument RoadYorkPA17103232730785501(c)(3)$15,500,000$0Charitable Activities
Welsh Mountain Health Centers
584 Springville RdNew HollandPA17557231909490501(c)(3)$125,000$0Charitable Activities
FieldValueIRS element (for citing)
Total501c3 Org4Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmt
Bashirat Giwa MD
Dir. beg. 11/19$227,673$10,555$14,200$42,963$295,391
Carrie Willetts
President$384,573$317,727$63,176$48,908$814,384$153,270
David Kreider
Treasurer$156,708$3,158$10,226$40,202$221,454$11,160
Douglas Arbittier MD
Director$663,231$13,063$117,722$52,407$1,128,130$281,707
Ill Chon
VP-Med Affairs$358,229$26,598$16,097$47,696$448,620
Jeffrey Keyser DO
Director$332,806$13,495$39,237$385,538
John M Porter Jr
Former President$712,490$328,811$310,499$57,104$1,681,904$273,000$273,000
Joseph Degenhard MD
Director$300,906$16,129$44,379$361,414
Kevin Mosser
Former CEO WSH$212,990$607,126$1,596,796$33,462$3,214,194$763,820$763,820
Lauren Fund
Manager-Pharm$181,235$11,998$10,707$24,761$231,761$3,060
Lloyd G Goldfarb MD
Dir. end 10/19$372,613$125$15,927$41,941$430,606
Michael F O'Connor
CFO-WellSpan$605,042$279,133$51,645$1,162,410$226,590$226,590
Robert Ortmyer
VP-Operations$215,785$56,169$14,814$42,481$333,549$4,300
Roxanna Gapstur
Pres & CEO-WSH$988,473$32,232$121,240$55,828$1,469,563$271,790
Steven Thomas
Direct.-Pharm Care$185,253$10,349$12,209$42,374$253,894$3,709
Tina Citro
VP-Patient Service$197,661$50,884$12,499$39,551$300,595

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1See Schedule OBusinessNameLine1Txt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Anesthesia & Pain AssocBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionPartner MusserRelationshipDescriptionTxt
Transaction$523,258TransactionAmt
TransactionAnesthesia Serv ContrTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Client Note 1Client 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 2: Description of Business or Family Relationship of Officers, Directors, EtReyna Britton serves as a director on the Ephrata Community Hospital Board of Directors. Her husband, Duane Britton serves on the Philhaven Board.
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderEffective 10/1/2013, WellSpan Health, a not for profit corporation, is the sole member.
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyThe Board of Directors of the Corporation shall be elected as provided herein 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 twenty-five persons. Nominations for Directors other than the Designated Directors specified in Specified in Section 5.2 of the Bylaws shall be made by the Board of Directors to the Member's Nominating Committee for Directors.
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersThe Member may, with respect to the Corporation, initiate and implement any of the following actions, and if any of the following actions are otherwise initiated by the Corporation, such action shall not become effective unless approved by the Member:(a)The adoption, amendment, or revocation of the Corporation's Articles of Incorporation or Bylaws (b)The termination, liquidation, reorganization, division, conversion, or dissolution of the Corporation, or the merger, consolidation, or combination of the Corporation with another person; provided however, that in accordance with Section 3.9(b) of the Affiliation Agreement, the Member shall not cause the Corporation to be merged with or into any other entity and it shall maintain the Corporation's status as a separate corporation for a period of at least three years after the effective date of the Affiliation, unless otherwise consented by the Boards of the Member and the Corporation (c) Any change or transfer of the Member's membership interest in the Corporation, or the creation or issuance of any additional membership interests in the Corporation (d) The investment of the Corporation's assets other than in accordance with the Member's current investment policy, any investment other than in the ordinary course of business, which shall consist of federally-insured interest-bearing bank accounts, short-term direct U.S. obligations, short term certificates of deposit of domestic banks, or highly-rated money market funds (e) The incurrence by the Corporation of indebtedness in excess of such amounts as may be reasonably designated by the Member from time to time, except pursuant to a budget approved by the Member. This is not meant to restrict the Corporation's ability to incur indebtedness in the ordinary course of the Corporation's day-to-day business, in amounts less than the amounts designated by the Member, such as routine trade and accounts payable obligations (f) The conveyance, transfer, lease, or sale of any of the Corporation's assets with a fair market value in excess of such aggregate amount as may be designated by the Member from time, except pursuant to a budget approved by the member, or the conveyance, transfer, lease or sale of any of the Corporation's assets to the Member or another System Affiliate; provided, however, that in accordance with Section 3.9(e) of the Affiliation Agreement, the member shall not cause the Corporation to sell all or substantially all of its assets for a period of ten years after the effective date of the Affiliation, unless it has received prior approval by the Board of Directors of the Corporation (g)The making of any capital expenditure or the incurrence of any capital obligations by or on behalf of the Corporation in excess of such annual aggregate amount as may be designated by the Member from time to time, except pursuant to a budget approved by the Member (h)The incurrence of any obligation (whether actual or contingent) by the Corporation to guarantee or be responsible for the debts or obligations of any person in excess of such amounts as may be designated by the Member from time to time, except pursuant to a budget approved by the Member. This is not meant to restrict the Corporation's ability to incur obligations in the ordinary course of the Corporation's day-to-day business, in amount less than the amounts designated by the Member. (i)The approval of the Corporation's operating and capital budgets, or any material changes thereto. (j)The voluntary granting of any lien or encumbrance (including a confession of judgment)with respect of the Corporation's assets, except in the ordinary course of business (k) The surrender of or material change to any permit, approval, or license of the Corporation; provided, however, that in accordance with Section 3.9 of the Affiliation Agreement, the Member shall maintain the Corporation's separate licensure and separate medical staff for a period of at least three after the effective date of the Affiliation (l)The selection of the Corporation's outside financial auditors, general legal counsel, or investment advisors (m)The requirement that the Member make any capital contribution to the Corporation (n)The appointment and reappointment of the individuals to serve on the Corporation's Board of Directors, and their removal as set forth in Section 5.3 of these Bylaws (o)The approval of the Corporation's strategic and operating plans, or any changes thereto. (p) The approval of the Corporation's statements of purpose, vision, or mission, or any changes thereto. (q) The creation by the Corporation of any new lines of business, sites of business, subsidiary corporations, or partnerships or other joint ventures, or any material changes in existing services, or participation in any key strategic relationship outside the System. This is not meant to restrict the Corporation's right to enhance and expand its current lines of business (r) All health care services contracting by the Corporation that could materially impact the System.
Form 990, Part VI, Line 11b: Form 990 Review ProcessManagement provided an electronic copy of the form 990 to each voting member of the organization's governing body, prior to its filing with the IRS. The organization's finance management team provided a presentation to the Audit Committee on the organization's 990 return.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsOfficers, directors, and key employees fill out a WellSpan Health Conflict of Interest Disclosure Statement questionnaire annually. The questionnaire is administered by the Internal Audit Department of WellSpan Health, the Parent Company.There shall be full disclosure by any Director having a business or personal interest or relationship which may be in conflict with the interests of the Corporation. After such disclosure the Director shall abide by the determination of the Board of Directors as to whether a conflict exists, the extent to which, if at all, the Director will be permitted to be present during the Board of Directors' discussion of the matter in which the Director may be interested, and whether the Director will be permitted to participate in such discussion and cast a vote in such matter.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe Compensation Committee of WellSpan Health is responsible for rewarding and reinforcing key executives for the achievement of annual and long-term performance objectives. The Compensation Committee shall consist of not more than six (6) persons, of whom two (2) shall be the Chairman and Vice Chairman of the Board of the Corporation, and the remaining members shall be such other persons as may be appointed by the Chairman of the Board of the Corporation, with the approval of the Board of Directors; provided, however, that the Compensation Committee shall not include any persons who are employed by the System. The 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 AvailableGoverning documents, policies and financial statements are available upon request.
Other Changes In Net Assets Or Fund Balances - Other DecreasesEquity Lease Adjustment = -$315474
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 PresentationPaid 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 P018715633

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Apple Hill Surgical Center Inc
PO Box 2767YorkPA174052767222842253Sole GP in limited ptnrshp. operating suPA501(c)(3)10WellSpan Health Care Servicesfalse
Gettysburg Hospital
PO Box 2767YorkPA174052767231352220Health care servicesPA501(c)(3)3WellSpan Healthfalse
Gettysburg Hospital Foundation
PO Box 2767YorkPA174052767232251358Fundraising for Gettysburg HospitalPA501(c)(3)12 Type IGettysburg Hospitalfalse
Healthy Community Pharmacy Inc
PO Box 2767YorkPA174052767200519121Reduced rate prescription drugs to uninsPA501(c)(3)12 Type IWellSpan Health Care Servicesfalse
VNA Community Services
PO Box 2767YorkPA174052767232338591Home personal care services for elderlyPA501(c)(3)10WellSpan Specialty Servicesfalse
VNA Home Health Services
PO Box 2767YorkPA174052767231352573Home health servicesPA501(c)(3)10WellSpan Specialty Servicesfalse
WellSpan Health
PO Box 2767YorkPA174052767222517863Integrated Health SystemPA501(c)(3)12 Type IIINAfalse
WellSpan Health Care Services
PO Box 2767YorkPA174052767232400237Health-related activities in the servicePA501(c)(3)12 Type IIWellSpan Healthfalse
WellSpan Medical Group
PO Box 2767YorkPA174052767232730785Medical and surgical carePA501(c)(3)10WellSpan Healthfalse
York Health Foundation
PO Box 2767YorkPA174052767233050192Charitable contributions for WellSpan enPA501(c)(3)12 Type IIIWellSpan Healthfalse
York Hospital
PO Box 2767YorkPA174052767231352222Community teaching hospitalPA501(c)(3)3WellSpan Healthfalse
WellSpan Specialty Services
PO Box 2767YorkPA174052767232899911Surgery and Rehabilitation HospitalPA501(c)(3)3WellSpan Healthfalse
WellSpan Properties
PO Box 2767YorkPA174052767222842252Leases facilities to affiliatesPA501(c)(3)12 Type IIWellSpan Health Care Servicesfalse
Ephrata Community Health Foundation
PO Box 2767YorkPA174052767800940005Fundraising for Ephrata HospitalPA501(c)(3)12 Type IEphrata Community Hospitalfalse
Northern Lancaster County Medical Group
PO Box 2767YorkPA174052767203033058Medical and surgical carePA501(c)(3)12 Type IIEphrata Community HospitalYes (true)
Phys Spec of North Lanc Co Med Gr
PO Box 2767YorkPA174052767452537633Physician PracticesPA501(c)(3)12 Type IINorthern Lancaster County Medical GroupYes (true)
Good Samaritan Hosptial
PO Box 2767YorkPA174052767230794160Health Care ServicesPA501(c)(3)3WellSpan Healthfalse
Philhaven
PO Box 2767YorkPA174052767231549922Health Care ServicesPA501(c)(3)3WellSpan Healthfalse
Good Samaritan Health Services
PO Box 2767YorkPA174052767232356151Fundraising for Good SamartianPA501(c)(3)12 Type IGood Samaritan Hospitalfalse
Good Samaritan Physician Services
PO Box 2767YorkPA174052767251832359Medical and Surgical CasesPA501(c)(3)10Good Sam Health Services Foundationfalse
WellSpan Summit Health
PO Box 2767YorkPA174052767251515371Integrated Health SystemPA501(c)(3)7WellSpan Healthfalse
Waynesboro Hospital
PO Box 2767YorkPA174052767231360854Health Care ServicesPA501(c)(3)3WellSpan Summit Healthfalse
Chambersburg Hospital
PO Box 2767YorkPA174052767230465970Health Care ServicesPA501(c)(3)3WellSpan Summit Healthfalse
Summit Physician Services
PO Box 2767YorkPA174052767251716306Medical and surgucal carePA501(c)(3)3WellSpan Summit Healthfalse
Summit Health Foundation
PO Box 2767YorkPA174052767831196554Fundraising for Health Care SystemPA501(c)(3)12 Type IIWellSpan Summit Healthfalse
Chambersburg Health Services
PO Box 2767YorkPA174052767251515376Health Care ServicesPA501(c)(3)12 Type IWellSpan Summit Healthfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPct
Apple Hill Surgical Center Partners
PO Box 2767YorkPA174052767232489452Surgical CenterPANAfalsefalse
Central PA Alliance Laboratories LLC
PO Box 2767YorkPA174052767232910950Ref. LabPANAfalseYes (true)-$156,239-$86,5720.10000
Littlestown Health Care Partners
300 West King StreetLittlestownPA17340232880464Lease facilityPANAfalsefalse
Cherry Tree Cancer Center LLP
PO Box 2767YorkPA174052767232915628RadiationPANAfalsefalse
The Rehab Center
855 Springdale Drive Suite 20ExtonPA19341251687903Physical Therapy RehabPAEphrata HospitalfalseYes (true)0.51000
Surgery Center Associates
785 5th AveChambersburgPA17201251845304Physician servicesPAChambersburg Healthfalsefalse
Summit Surgery Center
785 5th AvenueChambersburgPA17201251845303Physician servicesPAChambersburg Healthfalsefalse
Cumberland Valley Mobile Services
5 South Main StreetSugarloafPA18249200884014Health carePAChambersburg Healthfalsefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndOwnershipOwnershipPct
WellSpan Pharmacy Inc
PO Box 2767YorkPA174052767232374072Dispense Rx's & provPANAC corpfalse
WellSpan Reciprocal Risk Retention Group
PO Box 2767YorkPA174052767200048457Risk Retention GroupPANAC corpfalse
York Health Plan
PO Box 2767YorkPA174052767232664989Preferred Provider OPANAC corpfalse
WellSpan Provider Network
PO Box 2767YorkPA174052767232907828Coordinate managed carePANAC corpfalse
Apple Hill Condominium Association
PO Box 2767YorkPA174052767232504543Condo Mgmt AssociatiPANAHomeowners Assocfalse
North Lanc Co Phys Hosp Alliance
PO Box 2767YorkPA174052767232421885Coordinate Phys & HospitalPANAC Corpfalse0.50000
GSH Realty Inc
PO Box 2767YorkPA174052767251832359Non-res. real estatePAWSH Care ServicesC corpfalse
Ephrata Health Pavilion Condo Assoc
PO Box 2767YorkPA174052767475367279Condo AssocPAEphrata HospitalC Corpfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd