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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>R Fred Groff III</PersonNm>
        <TitleTxt>Dir. end 10/19</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>William C Funk DMD</PersonNm>
        <TitleTxt>Chair end 10/19</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Leon Ray Burkholder</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Carrie Evans</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>P Joshua Gluck</PersonNm>
        <TitleTxt>Vice Chair</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Aaron L Groff Jr</PersonNm>
        <TitleTxt>Tres end 10/19</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jeffrey Musser DO</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Reyna Britton</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Richard Broadbent</PersonNm>
        <TitleTxt>Director</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Meredith Dahl</PersonNm>
        <TitleTxt>Dir.beg 11/19</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Linda H Weaver</PersonNm>
        <TitleTxt>Chair beg 11/19</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Patrick Glavce</PersonNm>
        <TitleTxt>Dir beg 11/19</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jeffrey Stauffer</PersonNm>
        <TitleTxt>Dir. beg 11/19</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>2007530</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>7396069</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>3329808</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>56</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>true</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>true</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>false</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>American HealthCare Svcs</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>10126 Cherry Bend</AddressLine1Txt>
            <CityNm>Traverse City</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>49684</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Staffing services</ServicesDesc>
        <CompensationAmt>967042</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>OnSite NeonatalPC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1000 Haddonfield-Berlin Rd</AddressLine1Txt>
            <CityNm>Voorhees</CityNm>
            <StateAbbreviationCd>NJ</StateAbbreviationCd>
            <ZIPCd>08047</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>NICU Physicians</ServicesDesc>
        <CompensationAmt>704000</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Quest Diagnostics</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 912512</AddressLine1Txt>
            <CityNm>Pasadena</CityNm>
            <StateAbbreviationCd>CA</StateAbbreviationCd>
            <ZIPCd>911012512</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Lab Services</ServicesDesc>
        <CompensationAmt>525226</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>ABM Healthcare</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO Box 74008829</AddressLine1Txt>
            <CityNm>Chicago</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>606748829</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Valet services</ServicesDesc>
        <CompensationAmt>486625</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>TransTime Express</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>11820 Parklawn Drive</AddressLine1Txt>
            <CityNm>Rockville</CityNm>
            <StateAbbreviationCd>MD</StateAbbreviationCd>
            <ZIPCd>20852</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Delivery Services</ServicesDesc>
        <CompensationAmt>502299</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>15</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>503964</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>4604221</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>384701</AllOtherContributionsAmt>
      <TotalContributionsAmt>5492886</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>EHR Incentive Program(MU)</Desc>
        <BusinessCd>621500</BusinessCd>
        <TotalRevenueColumnAmt>271330</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>271330</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Patient Services</Desc>
        <BusinessCd>621500</BusinessCd>
        <TotalRevenueColumnAmt>241112398</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>240729363</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>383035</UnrelatedBusinessRevenueAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>W/O - Bad Debts</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>-18238738</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-18238738</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>W/O - Free Service</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>-5000000</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>-5000000</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>218144990</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1407772</TotalRevenueColumnAmt>
        <ExclusionAmt>1407772</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>399248</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>799557</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>-400309</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>-400309</TotalRevenueColumnAmt>
        <ExclusionAmt>-400309</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>361914</SecuritiesAmt>
        <OtherAmt>1594</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>362025</SecuritiesAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>-111</SecuritiesAmt>
        <OtherAmt>1594</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>1483</TotalRevenueColumnAmt>
        <ExclusionAmt>1483</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <NetIncmFromFundraisingEvtGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncmFromFundraisingEvtGrp>
      <NetIncomeFromGamingGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeFromGamingGrp>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
      </NetIncomeOrLossGrp>
      <OtherRevenueMiscGrp>
        <Desc>Cafeteria/Cafe</Desc>
        <BusinessCd>722210</BusinessCd>
        <TotalRevenueColumnAmt>432821</TotalRevenueColumnAmt>
        <ExclusionAmt>432821</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Other Revenue</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>108089</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>108089</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>Work First</Desc>
        <BusinessCd>621300</BusinessCd>
        <TotalRevenueColumnAmt>40570</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>40570</RelatedOrExemptFuncIncomeAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>146750</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>41142</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>14962</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>90646</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>728230</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>225375052</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>217951756</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>397997</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>1532413</ExclusionAmt>
      </TotalRevenueGrp>
      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>15647750</TotalAmt>
        <ProgramServicesAmt>15647750</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
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      </GrantsToDomesticIndividualsGrp>
      <ForeignGrantsGrp>
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      </ForeignGrantsGrp>
      <BenefitsToMembersGrp>
        <TotalAmt>0</TotalAmt>
      </BenefitsToMembersGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>814384</TotalAmt>
        <ProgramServicesAmt>814384</ProgramServicesAmt>
      </CompCurrentOfcrDirectorsGrp>
      <CompDisqualPersonsGrp>
        <TotalAmt>0</TotalAmt>
      </CompDisqualPersonsGrp>
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        <ProgramServicesAmt>53091704</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7205529</ManagementAndGeneralAmt>
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      <PensionPlanContributionsGrp>
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        <ProgramServicesAmt>2218876</ProgramServicesAmt>
        <ManagementAndGeneralAmt>389819</ManagementAndGeneralAmt>
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      <OtherEmployeeBenefitsGrp>
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        <ProgramServicesAmt>14489584</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1982348</ManagementAndGeneralAmt>
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      <PayrollTaxesGrp>
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        <ProgramServicesAmt>4057843</ProgramServicesAmt>
        <ManagementAndGeneralAmt>542404</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
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        <ManagementAndGeneralAmt>27503956</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
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        <ProgramServicesAmt>42935</ProgramServicesAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>55578</TotalAmt>
        <ProgramServicesAmt>55578</ProgramServicesAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>0</TotalAmt>
      </FeesForServicesProfFundraising>
      <FeesForSrvcInvstMgmntFeesGrp>
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      </FeesForSrvcInvstMgmntFeesGrp>
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        <ProgramServicesAmt>39230171</ProgramServicesAmt>
        <ManagementAndGeneralAmt>988586</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>6814</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2500</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
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        <ProgramServicesAmt>620891</ProgramServicesAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>8448928</TotalAmt>
        <ManagementAndGeneralAmt>8448928</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>1643358</ProgramServicesAmt>
        <ManagementAndGeneralAmt>268792</ManagementAndGeneralAmt>
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      <TravelGrp>
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        <ProgramServicesAmt>112856</ProgramServicesAmt>
        <ManagementAndGeneralAmt>34563</ManagementAndGeneralAmt>
      </TravelGrp>
      <PymtTravelEntrtnmntPubOfclGrp>
        <TotalAmt>0</TotalAmt>
      </PymtTravelEntrtnmntPubOfclGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>58562</TotalAmt>
        <ProgramServicesAmt>46864</ProgramServicesAmt>
        <ManagementAndGeneralAmt>11698</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>2391282</TotalAmt>
        <ProgramServicesAmt>2391282</ProgramServicesAmt>
      </InterestGrp>
      <PaymentsToAffiliatesGrp>
        <TotalAmt>0</TotalAmt>
      </PaymentsToAffiliatesGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>8937249</TotalAmt>
        <ProgramServicesAmt>8937249</ProgramServicesAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>1434429</TotalAmt>
        <ProgramServicesAmt>7861</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1426568</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Supplies</Desc>
        <TotalAmt>35836941</TotalAmt>
        <ProgramServicesAmt>35529843</ProgramServicesAmt>
        <ManagementAndGeneralAmt>307098</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Repair &amp; Maintenance</Desc>
        <TotalAmt>5041180</TotalAmt>
        <ProgramServicesAmt>3294826</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1746354</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Taxes &amp; Licenses</Desc>
        <TotalAmt>4175952</TotalAmt>
        <ProgramServicesAmt>3927462</ProgramServicesAmt>
        <ManagementAndGeneralAmt>248490</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Utilities</Desc>
        <TotalAmt>2342441</TotalAmt>
        <ProgramServicesAmt>644711</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1697730</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>2205256</TotalAmt>
        <ProgramServicesAmt>1331264</ProgramServicesAmt>
        <ManagementAndGeneralAmt>512753</ManagementAndGeneralAmt>
        <FundraisingAmt>361239</FundraisingAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>241823461</TotalAmt>
        <ProgramServicesAmt>188144106</ProgramServicesAmt>
        <ManagementAndGeneralAmt>53318116</ManagementAndGeneralAmt>
        <FundraisingAmt>361239</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>5834</BOYAmt>
        <EOYAmt>5972</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>5100556</BOYAmt>
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        <ImplementationStrategyAdptYr>18</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>true</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>http://www.wellspan.org</StrategyWebsiteURLTxt>
        <StrategyAttachedInd>true</StrategyAttachedInd>
        <OrganizationIncurExciseTaxInd>false</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>true</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>300.0000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>350.0000</FPGFamilyIncmLmtDscntCarePct>
        <IncomeLevelCriteriaInd>X</IncomeLevelCriteriaInd>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ResidencyCriteriaInd>X</ResidencyCriteriaInd>
        <OtherCriteriaInd>X</OtherCriteriaInd>
        <ExplainedBasisInd>true</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>true</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <ProvidedNonprofitContactInd>X</ProvidedNonprofitContactInd>
        <IncludesPublicityMeasuresInd>true</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>http://www.wellspan.org</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>http://www.wellspan.org</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>http://www.wellspan.org</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <OtherPublicityInd>X</OtherPublicityInd>
        <FAPActionsOnNonpaymentInd>true</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>false</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>true</NondisEmergencyCarePolicyInd>
        <LookBackMedicaidMedcrPrvtInd>X</LookBackMedicaidMedcrPrvtInd>
        <AmountsGenerallyBilledInd>false</AmountsGenerallyBilledInd>
        <GrossChargesInd>false</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility: - Part V, Section B, Line 5</FormAndLineReferenceDesc>
        <ExplanationTxt>The 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).</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility: - Part V, Section B, Line 6a</FormAndLineReferenceDesc>
        <ExplanationTxt>County-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).</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility: - Part V, Section B, Line 11</FormAndLineReferenceDesc>
        <ExplanationTxt>See attached 2019 WellSpan Health Community Health Improvement Plan, also available online at www.wellspan.org in Community Benefits section.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility: - Part V, Section B, Line 13h</FormAndLineReferenceDesc>
        <ExplanationTxt>WellSpan Health is committed to caring for all the members of its communities, regardless of their ability to pay. In recent years, overall charity care has decreased slightly as more people have obtained health insurance coverage through the Affordable Care Act and the expansion of Pennsylvanias Medical Assistance (Medicaid) program. WellSpan is proud to be a leading partner in the Healthy Community Network, which works to address the needs of uninsured and underinsured individuals in our community. In addition, the health system recently enhanced its financial assistance policy and the discounts that it provides on services. For example, if a patients income is less than 300 percent of the federal poverty level, that patient would be eligible for a 100 percent discount on the services provided. Additionally, significant discounts are available for patients whose income is between 300 percent and 350 percent of the federal poverty level. For more information on WellSpans Financial Assistance program, visit www.WellSpan.org/FinancialAssistance.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Facility: - Part V, Section B, Line 16j</FormAndLineReferenceDesc>
        <ExplanationTxt>In an effort to make patients, families and others in our communities aware of the newly expanded Financial Assistance Policy, WellSpan broadly publicized its policy via promotional signage and the distribution of easy-to-read informational materials at registration sites throughout our communities. WellSpan provided information on the Financial Assistance Policy on its billing statements and included information in patient discharge materials. In addition, the materials and information are easily accessible via WellSpans website at www.WellSpan.org/FinancialAssistance. The site reflects WellSpans newly enhanced policy, as well as informational and application materials. It was also publicized via WellSpans on-hold phone messaging system and in its direct-to-consumer community newsletter/magazine, which is distributed by mail, email and Web. In addition, WellSpan placed posters and signage at its various sites of care to publicize its Financial Assistance Policy. Printed copies of WellSpan Healths entire financial assistance policy and the plain language summary of the policy, both of which are available in English and Spanish, may be obtained at no cost by visiting or calling one of the WellSpan patient financial services offices.The Financial Assistance Policy, Financial Assistance Application and Financial Assistance Policy Plain Language Summary are all available in Spanish.</ExplanationTxt>
      </SupplementalInformationGrp>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Ephrata Cancer Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>460 North Reading Road</AddressLine1Txt>
            <CityNm>Ephrata</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17522</ZIPCd>
          </USAddress>
          <FacilityTxt>Medical &amp; Radiology Oncology/Pet Scanning</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>WellSpan Reading Road Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>446 North Reading Road</AddressLine1Txt>
            <CityNm>Ephrata</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17522</ZIPCd>
          </USAddress>
          <FacilityTxt>Imaging/Lab/Occupational Medicine</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>WellSpan Garden Spot Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>435 South Kinzer Avenue</AddressLine1Txt>
            <CityNm>New Holland</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17557</ZIPCd>
          </USAddress>
          <FacilityTxt>Cardiology/Lab/Imaging/Quick Care/Therapy/Occupational Medicine</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Ephrata Health Pavilion</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>175 Martin Avenue</AddressLine1Txt>
            <CityNm>Ephrata</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17522</ZIPCd>
          </USAddress>
          <FacilityTxt>Wound care &amp; Hyperbaric/Women's Center</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>WellSpan Adamstown Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>30 West Swartzville Road</AddressLine1Txt>
            <CityNm>Reinholds</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17569</ZIPCd>
          </USAddress>
          <FacilityTxt>Imaging/Lab</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>WellSpan Crossroads Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4131 Oregon Pike</AddressLine1Txt>
            <CityNm>Ephrata</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17522</ZIPCd>
          </USAddress>
          <FacilityTxt>Lab/Imaging/Therapy</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>WellSpan Meadowbrook Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>337 West Main Street</AddressLine1Txt>
            <CityNm>Leola</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17540</ZIPCd>
          </USAddress>
          <FacilityTxt>Lab/Imaging/Therapy</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>WellSpan Brossman Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>136 Lake Street</AddressLine1Txt>
            <CityNm>Ephrata</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17522</ZIPCd>
          </USAddress>
          <FacilityTxt>Cardiology/Therapy</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Pain Management Center-Ephrata WellSpan Health</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4150 Barrett Boulevard</AddressLine1Txt>
            <CityNm>Ephrata</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17522</ZIPCd>
          </USAddress>
          <FacilityTxt>Pain Management &amp; Radiology</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>WellSpan Rothsville Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2320 Rothsville Road</AddressLine1Txt>
            <CityNm>Lititz</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17543</ZIPCd>
          </USAddress>
          <FacilityTxt>Lab/Pulmonary Rehab</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Cornerstone Medical Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>6 West Newport Road</AddressLine1Txt>
            <CityNm>Lititz</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17543</ZIPCd>
          </USAddress>
          <FacilityTxt>Imaging/Lab/Therapy</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>WellSpan Cocalico Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>63-71 West Church Street</AddressLine1Txt>
            <CityNm>Stevens</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17578</ZIPCd>
          </USAddress>
          <FacilityTxt>Therapy/sleep studies/Wellness/Weight Loss</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Medical Office Building</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>157-181 North Reading Road</AddressLine1Txt>
            <CityNm>Ephrata</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17522</ZIPCd>
          </USAddress>
          <FacilityTxt>Cardiology/Health Beginnings Plus</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Ephrata Medical Lab-Adamstown</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>2580 North Reading Road</AddressLine1Txt>
            <CityNm>Adamstown</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>19501</ZIPCd>
          </USAddress>
          <FacilityTxt>Lab</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>Sleep Centers-Lancaster Co - WellSpan Health</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>217 Granite Run Drive</AddressLine1Txt>
            <CityNm>Lancaster</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17603</ZIPCd>
          </USAddress>
          <FacilityTxt>Sleep Studies</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>WellSpan Georgetown Road Health Services</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1135 Georgetown Road</AddressLine1Txt>
            <CityNm>Christiana</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17509</ZIPCd>
          </USAddress>
          <FacilityTxt>Imaging and Lab</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>WellSpan Granite Run Health Center</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>268 Granite Run Drive</AddressLine1Txt>
            <CityNm>Lancaster</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>17601</ZIPCd>
          </USAddress>
          <FacilityTxt>Lab/Imaging/Therapy</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used)</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 6a - Related Organization Community Benefit Report</FormAndLineReferenceDesc>
        <ExplanationTxt>Community Benefit Information is included in the Community Benefit Report for WellSpan Health.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense</FormAndLineReferenceDesc>
        <ExplanationTxt>The number was calculated using the cost to charge ratio factor applied against actual patient bad debt write-offs. These numbers are included after all efforts have been exhausted to determine if the patient meets our charity care write-off policy based on federal poverty levels.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 3 - Methodology of Estimated Amount &amp; Rationale for Including in Community Benefit</FormAndLineReferenceDesc>
        <ExplanationTxt>The estimate of bad debt attributable to charity care policy was calculated by dividing the bad debt amount that was originally coded bad debt but later found to qualify as charity care by the amount coded to the charity care write-off codes. This ratio is applied to the bad debt cost factor expense.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 4 - Bad Debt Expense</FormAndLineReferenceDesc>
        <ExplanationTxt>Ephrata 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 8 - Explanation Of Shortfall As Community Benefit</FormAndLineReferenceDesc>
        <ExplanationTxt>Ephrata 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 9b - Provisions On Collection Practices For Qualified Patients</FormAndLineReferenceDesc>
        <ExplanationTxt>Guidelines for suggested minimum number of phone attempts and letters to be sent before the account is turned over to an outside collection agency are included in the Patient Administrative Services Policy. Upon final PARO (Payment Assistance Rank Ordering) scoring, if a patient qualifies for presumptive charity, their account would not be forwarded to any third party collections. It shall be the policy of Patient Administrative Services to recommend accounts to Bad Debt on a timely basis. Inpatient/Outpatient accounts will go to bad debt automatically after the account has been in the financial class Pending Bad Debt for 30 days. All accounts must follow the approved limits for refunds and write offs, as established in Policy PF-102, before being transferred. The primary agencies will work the accounts for 6 months or until they feel it is uncollectable and return the account. The accounts are forwarded to secondary agencies from the primary agencies Closed and Return Reports. The financial class is changed to Bad Debt Other after the Closed and Return Reports are received from the Secondary Agency. The agencies must get written approval from the manager in the relatively rare instance of legal action being taken to collect the debt.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 2 - Needs Assessment</FormAndLineReferenceDesc>
        <ExplanationTxt>As 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 5 - Promotion of Community Health</FormAndLineReferenceDesc>
        <ExplanationTxt>As a charitable, community-based healthcare organization, our commitment to improving the lives and well-being of the people and communities we serve is evident in our mission statement: working as one to improve health through exceptional care for all, lifelong wellness, and healthier communities. Employees live out this mission statement every day by engaging in community benefit activities that address community needs, especially the health priorities identified in the 2018 CHNA - access to care and health equity; behavioral health, substance use and addiction, and lifelong wellness, and community engagement, social determinants of health and violence prevention. 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.</ExplanationTxt>
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        <ExplanationTxt>WellSpan Health is an integrated health system serving the communities of southcentral Pennsylvania and northern Maryland. As a community-based, not-for-profit organization, WellSpan is dedicated to improving the health and well-being of the people it serves. WellSpan will assume a leadership role and develop partnerships with other organizations to: improve access to coordinated, high-quality, cost-effective health care services, educate the health care providers of tomorrow, promote healthy lifestyles and lifelong wellness, and make its local communities healthier, more desirable places to live, work, and play. WellSpan 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</ExplanationTxt>
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        <ExplanationTxt>The 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.</ExplanationTxt>
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        <FormAndLineReferenceDesc>Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders</FormAndLineReferenceDesc>
        <ExplanationTxt>The 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 11b: Form 990 Review Process</FormAndLineReferenceDesc>
        <ExplanationTxt>Management provided an electronic copy of the form 990 to each voting member of the organization's governing body, prior to its filing with the IRS. The organization's finance management team provided a presentation to the Audit Committee on the organization's 990 return.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</FormAndLineReferenceDesc>
        <ExplanationTxt>Officers, directors, and key employees fill out a WellSpan Health Conflict of Interest Disclosure Statement questionnaire annually. The questionnaire is administered by the Internal Audit Department of WellSpan Health, the Parent Company.There shall be full disclosure by any Director having a business or personal interest or relationship which may be in conflict with the interests of the Corporation. After such disclosure the Director shall abide by the determination of the Board of Directors as to whether a conflict exists, the extent to which, if at all, the Director will be permitted to be present during the Board of Directors' discussion of the matter in which the Director may be interested, and whether the Director will be permitted to participate in such discussion and cast a vote in such matter.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</FormAndLineReferenceDesc>
        <ExplanationTxt>The Compensation Committee of WellSpan Health is responsible for rewarding and reinforcing key executives for the achievement of annual and long-term performance objectives. The Compensation Committee shall consist of not more than six (6) persons, of whom two (2) shall be the Chairman and Vice Chairman of the Board of the Corporation, and the remaining members shall be such other persons as may be appointed by the Chairman of the Board of the Corporation, with the approval of the Board of Directors; provided, however, that the Compensation Committee shall not include any persons who are employed by the System. The Chairman of the Board of Gettysburg Hospital shall participate. The role of the Compensation Committee is to set the Executive Compensation Philosophy for the system and ensure adherence, evaluate performance and establish compensation for the WellSpan President, evaluate team performance of the executive team and establish awards, review and approve senior executive base salary ranges, and oversee employed physician compensation programs. The Committee will approve salary ranges for each executive position and review incumbent salaries annually. The Committee will be responsible for reviewing the President's salary each year, and if warranted, authorizing an adjustment to maintain competitiveness. The President will have the authority to make salary adjustments for subordinate positions. The Committee is responsible for approving and authorizing payment of the performance awards. The Committee will approve and authorize payment of the President's performance awards. Integrated Healthcare Strategies, Inc., based in Minneapolis Minnesota is the external consultant to the committee. This consultant focuses exclusively on executive and physician compensation in the health care industry. In summary, the executive and physician compensation review process consists of the following: 1) Cash compensation reviewed annually 2) Cash compensation reviewed by external consultant biennially 3) external total compensation (cash, incentives, benefits, perquisites) reviewed by external consultant periodically 4) Process is integrated with compensation analysis for other WellSpan positions 5) Committee decisions are documented in minutes maintained in Human Resources.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</FormAndLineReferenceDesc>
        <ExplanationTxt>Governing documents, policies and financial statements are available upon request.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Other Changes In Net Assets Or Fund Balances - Other Decreases</FormAndLineReferenceDesc>
        <ExplanationTxt>Equity Lease Adjustment = -$315474</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule K -Tax-Exempt Bonds</FormAndLineReferenceDesc>
        <ExplanationTxt>$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 &amp; 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Signature Block - Paid Preparer Presentation</FormAndLineReferenceDesc>
        <ExplanationTxt>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 P018715633</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR" softwareId="19009920" softwareVersionNum="2019v5.0">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Apple Hill Surgical Center Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>222842253</EIN>
        <PrimaryActivitiesTxt>Sole GP in limited ptnrshp. operating su</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Health Care Services</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Gettysburg Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>231352220</EIN>
        <PrimaryActivitiesTxt>Health care services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Gettysburg Hospital Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>232251358</EIN>
        <PrimaryActivitiesTxt>Fundraising for Gettysburg Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Gettysburg Hospital</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Healthy Community Pharmacy Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>200519121</EIN>
        <PrimaryActivitiesTxt>Reduced rate prescription drugs to unins</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Health Care Services</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNA Community Services</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>232338591</EIN>
        <PrimaryActivitiesTxt>Home personal care services for elderly</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Specialty Services</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>VNA Home Health Services</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>231352573</EIN>
        <PrimaryActivitiesTxt>Home health services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Specialty Services</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WellSpan Health</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>222517863</EIN>
        <PrimaryActivitiesTxt>Integrated Health System</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type III</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WellSpan Health Care Services</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>232400237</EIN>
        <PrimaryActivitiesTxt>Health-related activities in the service</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WellSpan Medical Group</BusinessNameLine1Txt>
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          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>232730785</EIN>
        <PrimaryActivitiesTxt>Medical and surgical care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
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          <BusinessNameLine1Txt>WellSpan Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>York Health Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
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          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>233050192</EIN>
        <PrimaryActivitiesTxt>Charitable contributions for WellSpan en</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type III</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>York Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>231352222</EIN>
        <PrimaryActivitiesTxt>Community teaching hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WellSpan Specialty Services</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>232899911</EIN>
        <PrimaryActivitiesTxt>Surgery and Rehabilitation Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WellSpan Properties</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>222842252</EIN>
        <PrimaryActivitiesTxt>Leases facilities to affiliates</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Health Care Services</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Ephrata Community Health Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>800940005</EIN>
        <PrimaryActivitiesTxt>Fundraising for Ephrata Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Ephrata Community Hospital</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Northern Lancaster County Medical Group</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>203033058</EIN>
        <PrimaryActivitiesTxt>Medical and surgical care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Ephrata Community Hospital</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Phys Spec of North Lanc Co Med Gr</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>452537633</EIN>
        <PrimaryActivitiesTxt>Physician Practices</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type II</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Northern Lancaster County Medical Group</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>true</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Good Samaritan Hosptial</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>230794160</EIN>
        <PrimaryActivitiesTxt>Health Care Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Philhaven</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>231549922</EIN>
        <PrimaryActivitiesTxt>Health Care Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Good Samaritan Health Services</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>232356151</EIN>
        <PrimaryActivitiesTxt>Fundraising for Good Samartian</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Good Samaritan Hospital</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Good Samaritan Physician Services</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>251832359</EIN>
        <PrimaryActivitiesTxt>Medical and Surgical Cases</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Good Sam Health Services Foundation</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>WellSpan Summit Health</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>251515371</EIN>
        <PrimaryActivitiesTxt>Integrated Health System</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Waynesboro Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>231360854</EIN>
        <PrimaryActivitiesTxt>Health Care Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Summit Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Chambersburg Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>230465970</EIN>
        <PrimaryActivitiesTxt>Health Care Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Summit Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Summit Physician Services</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>251716306</EIN>
        <PrimaryActivitiesTxt>Medical and surgucal care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WellSpan Summit Health</BusinessNameLine1Txt>
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        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Summit Health Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>831196554</EIN>
        <PrimaryActivitiesTxt>Fundraising for Health Care System</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>12 Type II</PublicCharityStatusTxt>
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          <BusinessNameLine1Txt>WellSpan Summit Health</BusinessNameLine1Txt>
        </DirectControllingEntityName>
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      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Chambersburg Health Services</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>251515376</EIN>
        <PrimaryActivitiesTxt>Health Care Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
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        <DirectControllingEntityName>
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      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Apple Hill Surgical Center Partners</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
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        <PrimaryActivitiesTxt>Surgical Center</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Central PA Alliance Laboratories LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
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        <PrimaryActivitiesTxt>Ref. Lab</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ShareOfTotalIncomeAmt>-156239</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>-86572</ShareOfEOYAssetsAmt>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>true</GeneralOrManagingPartnerInd>
        <OwnershipPct>0.10000</OwnershipPct>
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      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
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        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>300 West King Street</AddressLine1Txt>
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          <ZIPCd>17340</ZIPCd>
        </USAddress>
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        <PrimaryActivitiesTxt>Lease facility</PrimaryActivitiesTxt>
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        </DirectControllingEntityName>
        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
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      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Cherry Tree Cancer Center LLP</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
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          <StateAbbreviationCd>PA</StateAbbreviationCd>
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      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>The Rehab Center</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>855 Springdale Drive Suite 20</AddressLine1Txt>
          <CityNm>Exton</CityNm>
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        <PrimaryActivitiesTxt>Physical Therapy Rehab</PrimaryActivitiesTxt>
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        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
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        <USAddress>
          <AddressLine1Txt>785 5th Ave</AddressLine1Txt>
          <CityNm>Chambersburg</CityNm>
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        </USAddress>
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        <PrimaryActivitiesTxt>Physician services</PrimaryActivitiesTxt>
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        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
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      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Summit Surgery Center</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>785 5th Avenue</AddressLine1Txt>
          <CityNm>Chambersburg</CityNm>
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        <PrimaryActivitiesTxt>Physician services</PrimaryActivitiesTxt>
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          <BusinessNameLine1Txt>Chambersburg Health</BusinessNameLine1Txt>
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        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Cumberland Valley Mobile Services</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>5 South Main Street</AddressLine1Txt>
          <CityNm>Sugarloaf</CityNm>
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          <ZIPCd>18249</ZIPCd>
        </USAddress>
        <EIN>200884014</EIN>
        <PrimaryActivitiesTxt>Health care</PrimaryActivitiesTxt>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Chambersburg Health</BusinessNameLine1Txt>
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        <DisproportionateAllocationsInd>false</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>false</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>WellSpan Pharmacy Inc</BusinessNameLine1Txt>
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        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>232374072</EIN>
        <PrimaryActivitiesTxt>Dispense Rx's &amp; prov</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
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          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C corp</EntityTypeTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>WellSpan Reciprocal Risk Retention Group</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>200048457</EIN>
        <PrimaryActivitiesTxt>Risk Retention Group</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C corp</EntityTypeTxt>
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      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>York Health Plan</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>232664989</EIN>
        <PrimaryActivitiesTxt>Preferred Provider O</PrimaryActivitiesTxt>
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        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C corp</EntityTypeTxt>
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      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>WellSpan Provider Network</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>232907828</EIN>
        <PrimaryActivitiesTxt>Coordinate managed care</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
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        <EntityTypeTxt>C corp</EntityTypeTxt>
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      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Apple Hill Condominium Association</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>232504543</EIN>
        <PrimaryActivitiesTxt>Condo Mgmt Associati</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>Homeowners Assoc</EntityTypeTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>North Lanc Co Phys Hosp Alliance</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>232421885</EIN>
        <PrimaryActivitiesTxt>Coordinate Phys &amp; Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NA</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <OwnershipPct>0.50000</OwnershipPct>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>GSH Realty Inc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>251832359</EIN>
        <PrimaryActivitiesTxt>Non-res. real estate</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>WSH Care Services</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C corp</EntityTypeTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>Ephrata Health Pavilion Condo Assoc</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>PO Box 2767</AddressLine1Txt>
          <CityNm>York</CityNm>
          <StateAbbreviationCd>PA</StateAbbreviationCd>
          <ZIPCd>174052767</ZIPCd>
        </USAddress>
        <EIN>475367279</EIN>
        <PrimaryActivitiesTxt>Condo Assoc</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>PA</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Ephrata Hospital</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C Corp</EntityTypeTxt>
        <ControlledOrganizationInd>false</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>false</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>true</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>false</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>false</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>true</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>false</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>false</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>false</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>false</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>true</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>false</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>false</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>true</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>false</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>false</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>true</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>false</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>true</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>true</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>