STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

CHAMBERSBURG HEALTH SERVICES: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
CHAMBERSBURG HEALTH SERVICES (EIN 25-1515376)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-05-20
IRS object ID
202021419349300132
Schema version
2018v3.2
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2020-05-20T14:22:12-05:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN520783935PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SMITH ELLIOTT KEARNS & COMPANY LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line119 BROOKWOOD AVE STE 101AddressLine1Txt
CityCARLISLECityNm
State AbbreviationPAStateAbbreviationCd
ZIP17015ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN251515376EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHAMBERSBURG HEALTH SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCHAMBusinessNameControlTxt
Phone7178513055PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2767AddressLine1Txt
CityYORKCityNm
State AbbreviationPAStateAbbreviationCd
ZIP174052767ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL F O'CONNORPersonNm
Person TitleCFO - WELLSPANPersonTitleTxt
Phone7172673000PhoneNum
Signature2020-05-20SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonGREGORY P HALL CPAPreparerPersonNm
PTINP00156653PTIN
Phone7172439104PhoneNum
Preparation2020-05-20PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address65.144.154.59IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-05-20IPDt
IP Tm14:22:12IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id6B3D5CFE32BBD35C7631821135029589AD16E6BCAtSubmissionCreationDeviceId
At Submission Filing Device Id8C3DE7AC8B2B6548563FFD49837976E3A40C018BAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerROXANNA GAPSTURPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2767AddressLine1Txt
CityYORKCityNm
State AbbreviationPAStateAbbreviationCd
ZIP174052767ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$42,574,180GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SUMMITHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1985FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionOPERATIONS INCLUDE THE SUMMIT CANCER SERVICES RADIATION AND MEDICAL ONCOLOGY; RESULTS THERAPY & FITNESS; 64.45% PARTNER OF ROY HIMELFARB SURGERY CENTER; 51% PARTNER IN CUMBERLAND VALLEY MOBILE SERVICES, LLC, AND LANDLORD/OWNER OF SUMMIT HEALTH CENTER; MERCERSBURG HEALTH CENTER; MONT ALTO CENTER, RESULTS AND KEYSTONE PAVILION FACILITIES.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee76TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$19,345PYContributionsGrantsAmt
CY Contributions Grants$34,938CYContributionsGrantsAmt
PY Program Service Revenue$28,060,879PYProgramServiceRevenueAmt
CY Program Service Revenue$31,499,187CYProgramServiceRevenueAmt
PY Investment Income$3,040,556PYInvestmentIncomeAmt
CY Investment Income$4,106,055CYInvestmentIncomeAmt
PY Other Revenue$2,210,836PYOtherRevenueAmt
CY Other Revenue$2,305,547CYOtherRevenueAmt
PY Total Revenue$33,331,616PYTotalRevenueAmt
CY Total Revenue$37,945,727CYTotalRevenueAmt
CY Grants And Similar Paid$4,108CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,578,025PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,022,904CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$24,740,900PYOtherExpensesAmt
CY Other Expenses$26,937,936CYOtherExpensesAmt
PY Total Expenses$32,318,925PYTotalExpensesAmt
CY Total Expenses$33,964,948CYTotalExpensesAmt
PY Revenues Less Expenses$1,012,691PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,980,779CYRevenuesLessExpensesAmt
Total Assets BOY$94,528,114TotalAssetsBOYAmt
Total Assets EOY$115,311,688TotalAssetsEOYAmt
Total Liabilities BOY$12,659,478TotalLiabilitiesBOYAmt
Total Liabilities EOY$28,592,208TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$81,868,636NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$86,719,480NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionOPERATIONS INCLUDE THE SUMMIT CANCER SERVICES RADIATION AND MEDICAL ONCOLOGY; RESULTS THERAPY & FITNESS; 64.45% PARTNER OF ROY HIMELFARB SURGERY CENTER; 51% PARTNER IN CUMBERLAND VALLEY MOBILE SERVICES, LLC, AND LANDLORD/OWNER OF SUMMIT HEALTH CENTER; MERCERSBURG HEALTH CENTER; MONT ALTO CENTER, RESULTS AND KEYSTONE PAVILION FACILITIES.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$31,603,727ExpenseAmt
Grant$4,108GrantAmt
Revenue$31,499,187RevenueAmt
DescCHAMBERSBURG HEALTH SERVICES PROVIDES CANCER TREATMENT THEARAPY SERVICES TO PATIENTS IN THE COMMUNITY, AS WELL AS INPATIENTS OF THE CHAMBERSBURG HOSPITAL, AN AFFILIATED ORGANIZATION. MEDICAL ONCOLOGY, PHYSICAL THERAPY AND FITNESS SERVICES ARE PROVIDED TO PATIENTS IN THE COMMUNITY.Desc
Total Program Service Expenses$31,603,727TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document22IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee76EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtYes (true)SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldPAStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDAVID P RIZZUTO SENIOR CONTROLLERPersonNm
Phone7178513055PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 2767AddressLine1Txt
CityYORKCityNm
State AbbreviationPAStateAbbreviationCd
ZIP174052767ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
NANCY MYERS
CHAIR0.280.28Yes (X)Yes (X)$0$0$0
R WILLIAM HAPPEL
VICE-CHAIR0.320.67Yes (X)Yes (X)$0$0$0
RODGER SAVAGE
SECRETARY0.280.63Yes (X)Yes (X)$0$0$0
KIMBERLY M RZOMP
TREASURER/VP2.0038.35Yes (X)Yes (X)$28,542$542,313$72,744
PATRICK W O'DONNELL
PRESIDENT/CE2.3239.00Yes (X)Yes (X)$95,694$1,818,184$310,020
ROXANNA GAPSTUR STARTED 112019
CEO WELLSPAN0.1440.14Yes (X)Yes (X)$0$0$0
KEVIN MOSSER ENDED 123118
CFO WELLSPAN40.00Yes (X)Yes (X)$0$4,267,289$111,748
MICHAEL F O'CONNOR
CFO - WELLSP40.00Yes (X)$0$811,162$641,117
J EDWARD BECK
DIRECTOR0.250.25Yes (X)$0$0$0
DEMAREE DEARDORFF
DIRECTOR0.290.29Yes (X)$0$0$0
PHILIP FAGUE
DIRECTOR0.24Yes (X)$0$0$0
DR RICHARD MARKS
DIRECTOR0.320.32Yes (X)$0$0$0
CHERYL PLUMMER
DIRECTOR0.240.41Yes (X)$0$0$0
DR ROGER ROBERTSON
DIRECTOR0.220.22Yes (X)$0$0$0
PAUL SCHEMEL
DIRECTOR0.27Yes (X)$0$0$0
DR JOSEPH THORNTON
DIRECTOR0.280.28Yes (X)$0$0$0
CHARLIE CHODROFF
DIRECTOR0.150.15Yes (X)$0$0$0
MICHELE ZEIGLER
CIO/VP OF IN1.0039.00$8,644$337,131$59,359Yes (X)
LISSA HINCKLE
VP PHYSICIAN8.0032.38$121,449$485,794$27,109Yes (X)
DOUGLAS LENTZ
DIRECTOR OF40.00$129,399$0$32,606Yes (X)
JANET DANIELS
ADM DIR OF O40.00$123,185$0$13,870Yes (X)
MELISSA HELFRICK
RADIATION TH40.00$101,831$0$20,736Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$608,744TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$8,261,873TotReportableCompRltdOrgAmt
Total Other Compensation$1,289,309TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
VARIAN MEDICAL SYSTEMS INC
70140 NETWORK PLACECHICAGOIL60673MAINTENANCE SVC$970,435
FRANKLIN CO RADIATION ONCOLOGISTS
260 NORTH 7TH STREETCHAMBERSBURGPA17201MEDICAL SERVICE$601,637
LEHMAN CONSTRUCTION SVC INC
5800 CUMBERLAND HIGHWAYCHAMBERSBURGPA17201CONSTRUCTION$553,613
R A HILL INC
1364 LINCOLN WAY EASTCHAMBERSBURGPA17202CONSTRUCTION$376,354
ALICIA L HARRIS
260 NORTH 7TH STREETCHAMBERSBURGPA17201MEDICAL SERVICE$244,100
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K12CntrctRcvdGreaterThan100KCnt
All Other Contributions$34,938AllOtherContributionsAmt
Total Contributions$34,938TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE621110$31,374,187$31,374,187
MANAGEMENT SERVICE REVENUE621110$125,000$125,000
FieldValueIRS element (for citing)
Total Program Service Revenue$31,499,187TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,713,963TotalRevenueColumnAmt
Exclusion$2,713,963ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$6,248,698RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$4,587,896RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$1,660,802RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,660,802TotalRevenueColumnAmt
Exclusion$1,660,802ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,432,649SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$40,443SecuritiesAmt
Other$114OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,392,206SecuritiesAmt
Other-$114OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,392,092TotalRevenueColumnAmt
Exclusion$1,392,092ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
INCENTIVES/REBATES621110$528,374$528,374
OTHER OPERATING REVENUE621110$116,371$116,371
FieldValueIRS element (for citing)
Other Revenue Total$644,745OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$37,945,727TotalRevenueColumnAmt
Related Or Exempt Func Income$31,499,187RelatedOrExemptFuncIncomeAmt
Exclusion$6,411,602ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$4,108TotalAmt
Program Services$4,108ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$280,246TotalAmt
Management And General$280,246ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,539,666TotalAmt
Program Services$5,539,666ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$883,066TotalAmt
Program Services$869,608ProgramServicesAmt
Management And General$13,458ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$319,926TotalAmt
Program Services$307,129ProgramServicesAmt
Management And General$12,797ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$156,356TotalAmt
Program Services$84,432ProgramServicesAmt
Management And General$71,924ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$29,781TotalAmt
Program Services$16,082ProgramServicesAmt
Management And General$13,699ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,077,398TotalAmt
Program Services$1,568,617ProgramServicesAmt
Management And General$508,781ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$111,889TotalAmt
Program Services$32,448ProgramServicesAmt
Management And General$79,441ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$568,013TotalAmt
Program Services$164,724ProgramServicesAmt
Management And General$403,289ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$31,585TotalAmt
Program Services$17,056ProgramServicesAmt
Management And General$14,529ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$236,756TotalAmt
Program Services$236,756ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$7,037TotalAmt
Program Services$2,041ProgramServicesAmt
Management And General$4,996ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$23,949TotalAmt
Program Services$6,945ProgramServicesAmt
Management And General$17,004ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$40,129TotalAmt
Program Services$4,013ProgramServicesAmt
Management And General$36,116ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,122,541TotalAmt
Program Services$322,354ProgramServicesAmt
Management And General$800,187ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$49,907TotalAmt
Program Services$14,473ProgramServicesAmt
Management And General$35,434ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES/ RX MEDS$22,384,962$22,384,962
OTHER SUPPLIES$78,807$22,854$55,953
MISCELLANEOUS EXPENSE$9,552$2,770$6,782
DUES$9,274$2,689$6,585

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$33,964,948TotalAmt
Program Services$31,603,727ProgramServicesAmt
Management And General$2,361,221ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$650BOYAmt
EOY$650EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,023,041BOYAmt
EOY$5,579,226EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$15,839BOYAmt
EOY$13,839EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,553,397BOYAmt
EOY$3,064,132EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$527,715BOYAmt
EOY$380,920EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$728,444BOYAmt
EOY$593,424EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$87,406,400LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$34,419,241LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$37,124,856BOYAmt
EOY$52,987,159EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$11,891,724BOYAmt
EOY$28,655,387EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$25,022,966BOYAmt
EOY$9,740,463EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$97,726BOYAmt
EOY$167,988EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$11,541,756BOYAmt
EOY$14,128,500EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$94,528,114BOYAmt
EOY$115,311,688EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,214,103BOYAmt
EOY$3,347,058EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$9,442,502BOYAmt
EOY$25,242,277EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,873BOYAmt
EOY$2,873EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$12,659,478BOYAmt
EOY$28,592,208EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$70,900,551BOYAmt
EOY$75,540,893EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$15,839BOYAmt
EOY$15,839EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$10,952,246BOYAmt
EOY$11,162,748EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$81,868,636BOYAmt
EOY$86,719,480EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$94,528,114BOYAmt
EOY$115,311,688EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,980,779ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$294,116NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$1,164,181OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Supported Organizations2SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (2 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
SUMMIT HEALTH
2515153717Yes (true)$0$0
THE CHAMBERSBURG HOSPITAL
2304659703Yes (true)$0$0
FieldValueIRS element (for citing)
Supported Organizations Total2SupportedOrganizationsTotalCnt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (true)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt OrgfalseOperateBenefitNonSuprtOrgInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,284,402BeginningYearBalanceAmt
Contributions$9,199ContributionsAmt
Investment Earnings Or Losses$346,320InvestmentEarningsOrLossesAmt
Other Expenditures-$87,536OtherExpendituresAmt
Administrative Expenses-$16,250AdministrativeExpensesAmt
End Year Balance$5,536,135EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,908,904BeginningYearBalanceAmt
Investment Earnings Or Losses$468,295InvestmentEarningsOrLossesAmt
Other Expenditures-$77,300OtherExpendituresAmt
Administrative Expenses-$15,497AdministrativeExpensesAmt
End Year Balance$5,284,402EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,428,908BeginningYearBalanceAmt
Investment Earnings Or Losses$567,633InvestmentEarningsOrLossesAmt
Other Expenditures-$73,031OtherExpendituresAmt
Administrative Expenses-$14,606AdministrativeExpensesAmt
End Year Balance$4,908,904EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,603,115BeginningYearBalanceAmt
Contributions$53,836ContributionsAmt
Investment Earnings Or Losses-$147,268InvestmentEarningsOrLossesAmt
Other Expenditures-$67,583OtherExpendituresAmt
Administrative Expenses-$13,191AdministrativeExpensesAmt
End Year Balance$4,428,909EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,348,391BeginningYearBalanceAmt
Contributions$174,177ContributionsAmt
Investment Earnings Or Losses$155,876InvestmentEarningsOrLossesAmt
Other Expenditures-$62,136OtherExpendituresAmt
Administrative Expenses-$13,193AdministrativeExpensesAmt
End Year Balance$4,603,115EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,411,705OtherCostOrOtherBasisAmt
Book Value$7,411,705BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$49,680,256InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$20,412,120OtherCostOrOtherBasisAmt
Depreciation$26,764,108DepreciationAmt
Book Value$43,328,268BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$50,260OtherCostOrOtherBasisAmt
Depreciation$11,437DepreciationAmt
Book Value$38,823BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,852,059OtherCostOrOtherBasisAmt
Depreciation$7,643,696DepreciationAmt
Book Value$2,208,363BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$52,987,159TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (7 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
LIMITED PARTNERSHIPS$3,716,407F
INVESTMENTS - EQUITY METHOD$3,132,623C
COMMODITIES$1,149,321F
FIXED INCOME$957,497F
OTHER INVESTMENTS$500,205C
REAL ASSETS$168,367F
CASH EQUIVALENTS$116,043F
FieldValueIRS element (for citing)
Total Book Value Securities$9,740,463TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
PERPETUAL TRUST HELD BY THIRD PARTY$11,162,748
OTHER RECEIVABLES$2,965,752
FieldValueIRS element (for citing)
Total Book Value Other Assets$14,128,500TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDEFERRED COMPENSATIONDesc
Amt$2,873Amt
FieldValueIRS element (for citing)
Total Liability$2,873TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 2, PART V, LINE 4ENDOWMENT FUNDS ARE TO BE USED FOR THE DEVELOPMENT OR EXPANSION OF COMMUNITY HEALTHCARE INITIATIVES AND PROGRAMS. FUNDS ARE ALSO TO EDUCATE TEH COMMUNITY ABOUT HEALTH CARE ISSUES.
SCHEDULE D, PAGE 3, PART XIN JUNE 2006, THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO 109, ACCOUNTING FOR INCOME TAXES (FIN 48,) WHICH CREATES A SINGLE MODEL TO ADDRESS UNCERTAINTY IN TAX POSITIONS AND CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING THE MINIMUM RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. UNDER THE REQUIREMENTS OF FIN 48, TAX EXEMPT ORGANIZATIONS COULD NOW BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN OR VARIOUS TAX EXPOSURE ITEMS. PRIOR TO FIN 48, THE DETERMINATION OF WHEN TO RECORD A LIABILITY FOR TAX EXPOSURE WAS BASED ON WHETHER A LIABILITY WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE IN ACCORDANCE WITH SFAS NO. 5, ACCOUNTING FOR CONTINGENCIES. ON JULY 1, 2007, THE PARENT COMPANY, WELLSPAN HEALTH, ADOPTED FIN 48. WELLSPAN HEALTH DETERMINED THAT IT DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THROUGH JUNE 30, 2019.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Discretionary Spending AcctYes (X)DiscretionarySpendingAcctInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmt
KIMBERLY M RZOMP
TREASURER/VP & CFO$20,078$381,491$7,065$134,241$1,399$26,581$2,757$52,388$880$16,719$32,179$611,420
PATRICK W O'DONNELL
PRESIDENT/CE0$82,072$1,559,370$11,424$217,061$2,198$41,753$13,232$251,405$2,269$43,114$111,195$2,112,703
KEVIN MOSSER ENDED 123118
CFO WELLSPAN/DIR.$1,023,400$420,420$2,823,469$13,433$98,315$4,379,037
MICHAEL F O'CONNOR
CFO - WELLSPAN$588,737$222,300$125$590,416$50,701$1,452,279
MICHELE ZEIGLER
CIO/VP OF INFO SERV$6,445$251,372$1,454$56,696$745$29,063$1,260$49,145$224$8,730$10,128$395,006
LISSA HINCKLE
VP PHYSICIAN PRACT$98,188$392,750$16,250$64,999$7,011$28,045$1,650$6,600$3,772$15,087$126,871$507,481
DOUGLAS LENTZ
DIRECTOR OF WELLNESS$122,857$6,542$19,289$13,317$162,005

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PAGE 1, PART I, LINE 1ATHE ORGANIZATION REIMBURSES THE COO FOR DUES ASSOCIATED WITH A SOCIAL CLUB. THE OFFICER REVIEWS AN ALLOWANCE THAT CAN BE CONSIDERED A DISCRETIONARY SPENDING ACCOUNT. THE MONIES ARE IN LIEU OF AN AUTOMOBILE ALLOWANCE, TO PURCHASE ADDITIONAL LIFE INSURANCE, ETC. THESE MONIES ARE INCLUDED IN COMPENSATION AS REPORTED IN THE COMPENSATION OF OFFICERS TABLE. A RESULTS FITNESS CLUB MEMBERSHIP IS AVAILABLE FREE OF CHARGE FOR ANY OFFICER AND ACTIVE BOARD MEMBER.
SCHEDULE J, PAGE 1, PART I, LINE 7INCENTIVE COMPENSATION IS BASED ON PRE-DETERMINED, MEASURABLE GOALS APPROVED BY THE BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE. THE MEASURABLE GOALS ARE BASED ON QUALITY, COMMUNITY ACCESS TO CARE, PATIENT SAFETY AND LEADERSHIP.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990 - ORGANIZATION'S MISSIONOPERATIONS INCLUDE THE SUMMIT CANCER SERVICES RADIATION AND MEDICAL ONCOLOGY; RESULTS THERAPY & FITNESS; 64.45% PARTNER OF ROY HIMELFARB SURGERY CENTER; 51% PARTNER IN CUMBERLAND VALLEY MOBILE SERVICES, LLC, AND LANDLORD/OWNER OF SUMMIT HEALTH CENTER; MERCERSBURG HEALTH CENTER; MONT ALTO CENTER, RESULTS AND KEYSTONE PAVILION FACILITIES.
FORM 990, PAGE 6, PART VI, LINE 6SUMMIT HEALTH, A 501(C)(3) ENTITY, IS A MEMBER OF THIS ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 7ASUMMIT HEALTH, A 501(C)(3) ENTITY, ELECTS THE MEMBERS OF THE GOVERNING BODY.
FORM 990, PAGE 6, PART VI, LINE 7BSUMMIT HEALTH, A 501(C)(3) ENTITY, RETAINS CERTAIN RESERVE POWERS OVER THIS ORGANIZATION.
FORM 990, PAGE 6, PART VI, LINE 11BTHE ORGANIZATION'S 990 IS REVIEWED BY THE AUDIT COMMITTEE AND UPON APPROVAL RECOMMENDED TO THE FULL BOARD OF DIRECTORS FOR SUBMISSION TO THE IRS.
FORM 990, PAGE 6, PART VI, LINE 12CMEMBERS ARE ASKED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THEY MAY HAVE.
FORM 990, PAGE 6, PART VI, LINE 15ACOMPENSATION IS DISCUSSED WITH AN INDEPENDENT COMPENSATION COMMITTEE. THIS IS PERFORMED IN CONCERT WITH A COMPENSATION CONSULTANT WHO ASSISTS THIS COMMITTEE IN SETTING THE COMPENSATION FOR THESE INDIVIDUALS.
FORM 990, PAGE 6, PART VI, LINE 15BCOMPENSATION IS DISCUSSED WITH AN INDEPENDENT COMPENSATION COMMITTEE. THIS IS PERFORMED IN CONCERT WITH A COMPENSATION CONSULTANT WHO ASSISTS THIS COMMITTEE IN SETTING THE COMPENSATION FOR THESE INDIVIDUALS.
FORM 990, PAGE 6, PART VI, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS ARE HELD IN THE FINANCE DEPARTMENT OF THE CHAMBERSBURG HOSPITAL.
FORM 990, PART XI, LINE 9TRANSFERS FROM AFFILIATED ENTITIES 1,495,267 CHANGE IN PENSION LIABILITY -331,086 TOTAL 1,164,181

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (25 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
WELLSPAN SUMMIT HEALTH
PO BOX 2767YORKPA174052767251515371HEALTHCAREPA501C37WELLSPAN Sfalse
WAYNESBORO HOSPITAL
PO BOX 2767YORKPA174052767231360854HEALTHCAREPA501C33WELLSPAN Sfalse
THE CHAMBERSBURG HOSPITAL
PO BOX 2767YORKPA174052767230465970HEALTHCAREPA501C33WELLSPAN Sfalse
SUMMIT PHYSICIAN SERVICES
PO BOX 2767YORKPA174052767251716306HEALTHCAREPA501C33WELLSPAN Sfalse
YORK HOSPITAL
PO BOX 2767YORKPA174052767231352222HEALTHCAREPA501C33NAfalse
APPLE HILL SURGICAL CENTER INC
PO BOX 2767YORKPA174052767222842253SOLE GP INPA501C310NAfalse
GETTYSBURG HOSPITAL
PO BOX 2767YORKPA174052767231352220HEALTH CARPA501C33NAfalse
GETTYSBURG HOSPITAL FOUNDATION
PO BOX 2767YORKPA174052767232251358FUNDRAISINPA501C312ANAfalse
HEALTHY COMMUNITY PHARMACY INC
PO BOX 2767YORKPA174052767200519121REDUCED RAPA501C312ANAfalse
VNA COMMUNITY SERVICES
PO BOX 2767YORKPA174052767232338591HORNE PERSPA501C310NAfalse
VNA HOME HEALTH SERVICES
PO BOX 2767YORKPA174052767231352573HORNE HEALPA501C310NAfalse
WELLSPAN HEALTH
PO BOX 2767YORKPA174052767222517863INTEGRATEDPA501C312CNAfalse
WELLSPAN HEALTH CARE SERVICES
PO BOX 2767YORKPA174052767232400237HEALTH-RELPA501C312BNAfalse
WELLSPAN MEDICAL GROUP
PO BOX 2767YORKPA174052767232730785MEDICAL ANPA501C310NAfalse
YORK HEALTH FOUNDATION
PO BOX 2767YORKPA174052767233050192CHARITABLEPA501C312CNAfalse
WELLSPAN SPECIALTY SERVICES
PO BOX 2767YORKPA174052767232899911SURGERY ANPA501C33NAfalse
WELLSPAN PROPERTIES INC
PO BOX 2767YORKPA174052767222842252LEASES FACPA501C312ANAfalse
EPHRATA COMMUNITY HOSPITAL
PO BOX 2767YORKPA174052767231370484HEALTH CARPA501C33NAfalse
EPHRATA COMMUNITY HEALTH FOUNDATION
PO BOX 2767YORKPA174052767800940005FUNDRAISINPA501C312AEPHRATA COfalse
NORTHERN LANCASTER COUNTY MEDICAL G
PO BOX 2767YORKPA174052767203033058MEDICAL ANPA501C312BEPHRATA COfalse
PHYS SPEC OF NORTH LANC CO MED
PO BOX 2767YORKPA174052767452537633PHYSICIANPA501C312BNORTHERN Lfalse
GOOD SAMARITAN HOSPITAL
PO BOX 2767YORKPA174052767230794160HEALTH CARPA501C33NAfalse
PHILHAVEN
PO BOX 2767YORKPA174052767231548822HEALTH CARPA501C33NAfalse
GOOD SAMARITAN HEATH SERVICE FOUNDA
PO BOX 2767YORKPA174052767232356151FUNDRAISINPA501C312ANAfalse
GOOD SAMARITAN PHYSICIAN SERVICES
PO BOX 2767YORKPA174052767251832359MEDICAL ANPA501C310NAfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPct
SUMMIT SURGERY CENTER LP
785 5TH AVENUE SUITE 3CHAMBERSBURGPA17201251845303PHYSICIANPANAfalsefalse0.00650
SURGERY CENTER ASSOCIATES LLC
785 5TH AVENUE SUITE 3CHAMBERSBURGPA17201251845304PHYSICIANPANAfalseYes (true)0.01000
APPLE HILL SURGICAL CENTER PARTNERS
PO BOX 2767YORKPA174052767232489452SURGICAL CPANAfalsefalse
CENTRAL PA ALLIANCE LABORATORIES LL
PO BOX 2767YORKPA174052767232910950REF. LABPANAfalsefalse
LITTLESTOWN HEALTH CARE PARTNERS
300 WEST KING STREETLITTLESTOWNPA17340232880464LEASE FACIPANAfalsefalse
CHERRY TREE CANCER CENTER LLP
PO BOX 2767YORKPA174052767232915628RADIATIONPANAfalsefalse
THE REHAB CENTER
855 SPRINGDALE DRIVE SUITE 20EXTONPA19341251687903PHYSICAL TPANAfalsefalse
CUMBERLAND VALLEY MOBILE SVC LLC
112 NORTH SEVENTH STREETCHAMBERSBURGPA17201200884014MOBILE SVCPANAfalsefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
WELLSPAN PHARMACY INC
PO BOX 2767YORKPA174052767232374072DISPENSESPAN/AC CORPfalse
WELLSPAN RECIPROCAL RISK RETEN
PO BOX 2767YORKPA174052767200048457RISK RETENPAN/AC CORPfalse
YORK HEALTH PLAN
PO BOX 2767YORKPA174052767232664989PREFERREDPAN/AC CORPfalse
WELLSPAN PROVIDER NETWORK
PO BOX 2767YORKPA174052767232907828COORD MNGDPAN/AC CORPfalse
APPLE HILL CONDOMINIUM ASSOCIA
PO BOX 2767YORKPA174052767232504543CONDO MGMTPAN/AC CORPfalse
NORTH LANC CO PHYS HOSP ALLIAN
PO BOX 2767YORKPA174052767232421885COORD PHYSPAN/AC CORPfalse
GSH REALTY INC
PO BOX 2767YORKPA174052767251832359RENTAL NONPAN/AC CORPfalse
EPHRATA HEALTH PAVILION CONDO ASSOC
PO BOX 2767YORKPA174052767475367279CONDO ASSOPAN/AC CORPfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd