2020-05-20T14:22:12-05:00 2019-06-30 520783935 SMITH ELLIOTT KEARNS & COMPANY LLC 19 BROOKWOOD AVE STE 101 CARLISLE PA 17015 990 2018-07-01 251515376 CHAMBERSBURG HEALTH SERVICES CHAM 7178513055 PO BOX 2767 YORK PA 174052767 MICHAEL F O'CONNOR CFO - WELLSPAN 7172673000 2020-05-20 true GREGORY P HALL CPA P00156653 7172439104 2020-05-20 65.144.154.59 2020-05-20 14:22:12 CD P 6B3D5CFE32BBD35C7631821135029589AD16E6BC 8C3DE7AC8B2B6548563FFD49837976E3A40C018B 2018 2021-01-29 14:40:06Z X ROXANNA GAPSTUR PO BOX 2767 YORK PA 174052767 42574180 false X WWW.SUMMITHEALTH.ORG X 1985 PA OPERATIONS 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. 13 11 76 10 0 19345 34938 28060879 31499187 3040556 4106055 2210836 2305547 33331616 37945727 4108 0 7578025 7022904 0 0 24740900 26937936 32318925 33964948 1012691 3980779 94528114 115311688 12659478 28592208 81868636 86719480 X OPERATIONS 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. false false 31603727 4108 31499187 CHAMBERSBURG 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. 31603727 true true false false false false false false false true true true false true true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 22 0 true 76 true false false false false false false false false false false true false X 13 11 false false false false true true true true true false false true true true true true true true true true true PA X X DAVID P RIZZUTO SENIOR CONTROLLER 7178513055 PO BOX 2767 YORK PA 174052767 NANCY MYERS CHAIR 0.28 0.28 X X 0 0 0 R WILLIAM HAPPEL VICE-CHAIR 0.32 0.67 X X 0 0 0 RODGER SAVAGE SECRETARY 0.28 0.63 X X 0 0 0 KIMBERLY M RZOMP TREASURER/VP 2.00 38.35 X X 28542 542313 72744 PATRICK W O'DONNELL PRESIDENT/CE 2.32 39.00 X X 95694 1818184 310020 ROXANNA GAPSTUR STARTED 112019 CEO WELLSPAN 0.14 40.14 X X 0 0 0 KEVIN MOSSER ENDED 123118 CFO WELLSPAN 40.00 X X 0 4267289 111748 MICHAEL F O'CONNOR CFO - WELLSP 40.00 X 0 811162 641117 J EDWARD BECK DIRECTOR 0.25 0.25 X 0 0 0 DEMAREE DEARDORFF DIRECTOR 0.29 0.29 X 0 0 0 PHILIP FAGUE DIRECTOR 0.24 X 0 0 0 DR RICHARD MARKS DIRECTOR 0.32 0.32 X 0 0 0 CHERYL PLUMMER DIRECTOR 0.24 0.41 X 0 0 0 DR ROGER ROBERTSON DIRECTOR 0.22 0.22 X 0 0 0 PAUL SCHEMEL DIRECTOR 0.27 X 0 0 0 DR JOSEPH THORNTON DIRECTOR 0.28 0.28 X 0 0 0 CHARLIE CHODROFF DIRECTOR 0.15 0.15 X 0 0 0 MICHELE ZEIGLER CIO/VP OF IN 1.00 39.00 X 8644 337131 59359 LISSA HINCKLE VP PHYSICIAN 8.00 32.38 X 121449 485794 27109 DOUGLAS LENTZ DIRECTOR OF 40.00 X 129399 0 32606 JANET DANIELS ADM DIR OF O 40.00 X 123185 0 13870 MELISSA HELFRICK RADIATION TH 40.00 X 101831 0 20736 608744 8261873 1289309 3 false true false VARIAN MEDICAL SYSTEMS INC 70140 NETWORK PLACE CHICAGO IL 60673 MAINTENANCE SVC 970435 FRANKLIN CO RADIATION ONCOLOGISTS 260 NORTH 7TH STREET CHAMBERSBURG PA 17201 MEDICAL SERVICE 601637 LEHMAN CONSTRUCTION SVC INC 5800 CUMBERLAND HIGHWAY CHAMBERSBURG PA 17201 CONSTRUCTION 553613 R A HILL INC 1364 LINCOLN WAY EAST CHAMBERSBURG PA 17202 CONSTRUCTION 376354 ALICIA L HARRIS 260 NORTH 7TH STREET CHAMBERSBURG PA 17201 MEDICAL SERVICE 244100 12 34938 34938 PATIENT SERVICE REVENUE 621110 31374187 31374187 MANAGEMENT SERVICE REVENUE 621110 125000 125000 31499187 2713963 2713963 6248698 4587896 1660802 1660802 1660802 1432649 40443 114 1392206 -114 1392092 1392092 INCENTIVES/REBATES 621110 528374 528374 OTHER OPERATING REVENUE 621110 116371 116371 644745 37945727 31499187 6411602 4108 4108 280246 280246 5539666 5539666 883066 869608 13458 319926 307129 12797 156356 84432 71924 29781 16082 13699 2077398 1568617 508781 111889 32448 79441 568013 164724 403289 31585 17056 14529 236756 236756 7037 2041 4996 23949 6945 17004 40129 4013 36116 1122541 322354 800187 49907 14473 35434 MEDICAL SUPPLIES/ RX MEDS 22384962 22384962 OTHER SUPPLIES 78807 22854 55953 MISCELLANEOUS EXPENSE 9552 2770 6782 DUES 9274 2689 6585 33964948 31603727 2361221 0 650 650 4023041 5579226 15839 13839 3553397 3064132 527715 380920 728444 593424 87406400 34419241 37124856 52987159 11891724 28655387 25022966 9740463 97726 167988 11541756 14128500 94528114 115311688 3214103 3347058 9442502 25242277 2873 2873 12659478 28592208 X 70900551 75540893 15839 15839 10952246 11162748 81868636 86719480 94528114 115311688 X 3980779 -294116 1164181 X false true X true false X X X 2 SUMMIT HEALTH 251515371 7 true 0 0 THE CHAMBERSBURG HOSPITAL 230465970 3 true 0 0 2 0 true false false false false false false false false false false false false false false true false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5284402 9199 346320 -87536 -16250 5536135 4908904 468295 -77300 -15497 5284402 4428908 567633 -73031 -14606 4908904 4603115 53836 -147268 -67583 -13191 4428909 4348391 174177 155876 -62136 -13193 4603115 1.00000 false false 7411705 7411705 49680256 20412120 26764108 43328268 50260 11437 38823 9852059 7643696 2208363 52987159 LIMITED PARTNERSHIPS 3716407 F INVESTMENTS - EQUITY METHOD 3132623 C COMMODITIES 1149321 F FIXED INCOME 957497 F OTHER INVESTMENTS 500205 C REAL ASSETS 168367 F CASH EQUIVALENTS 116043 F 9740463 PERPETUAL TRUST HELD BY THIRD PARTY 11162748 OTHER RECEIVABLES 2965752 14128500 DEFERRED COMPENSATION 2873 2873 X SCHEDULE D, PAGE 2, PART V, LINE 4 ENDOWMENT 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 X IN JUNE 2006, THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ISSUED INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO 109, ACCOUNTING FOR INCOME TAXES (FIN 48,) WHICH CREATES A SINGLE MODEL TO ADDRESS UNCERTAINTY IN TAX POSITIONS AND CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING THE MINIMUM RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. UNDER THE REQUIREMENTS OF FIN 48, TAX EXEMPT ORGANIZATIONS COULD NOW BE REQUIRED TO RECORD AN OBLIGATION AS THE RESULT OF A TAX POSITION THEY HAVE HISTORICALLY TAKEN OR VARIOUS TAX EXPOSURE ITEMS. PRIOR TO FIN 48, THE DETERMINATION OF WHEN TO RECORD A LIABILITY FOR TAX EXPOSURE WAS BASED ON WHETHER A LIABILITY WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE IN ACCORDANCE WITH SFAS NO. 5, ACCOUNTING FOR CONTINGENCIES. ON JULY 1, 2007, THE PARENT COMPANY, WELLSPAN HEALTH, ADOPTED FIN 48. WELLSPAN HEALTH DETERMINED THAT IT DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THROUGH JUNE 30, 2019. X X true true X X X X X false false false false false false false true false KIMBERLY M RZOMP TREASURER/VP & CFO 20078 381491 7065 134241 1399 26581 2757 52388 880 16719 32179 611420 PATRICK W O'DONNELL PRESIDENT/CE0 82072 1559370 11424 217061 2198 41753 13232 251405 2269 43114 111195 2112703 KEVIN MOSSER ENDED 123118 CFO WELLSPAN/DIR. 1023400 420420 2823469 13433 98315 4379037 MICHAEL F O'CONNOR CFO - WELLSPAN 588737 222300 125 590416 50701 1452279 MICHELE ZEIGLER CIO/VP OF INFO SERV 6445 251372 1454 56696 745 29063 1260 49145 224 8730 10128 395006 LISSA HINCKLE VP PHYSICIAN PRACT 98188 392750 16250 64999 7011 28045 1650 6600 3772 15087 126871 507481 DOUGLAS LENTZ DIRECTOR OF WELLNESS 122857 6542 19289 13317 162005 SCHEDULE J, PAGE 1, PART I, LINE 1A THE 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 7 INCENTIVE 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. FORM 990 - ORGANIZATION'S MISSION OPERATIONS 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 6 SUMMIT HEALTH, A 501(C)(3) ENTITY, IS A MEMBER OF THIS ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7A SUMMIT HEALTH, A 501(C)(3) ENTITY, ELECTS THE MEMBERS OF THE GOVERNING BODY. FORM 990, PAGE 6, PART VI, LINE 7B SUMMIT HEALTH, A 501(C)(3) ENTITY, RETAINS CERTAIN RESERVE POWERS OVER THIS ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 11B THE 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 12C MEMBERS ARE ASKED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THEY MAY HAVE. FORM 990, PAGE 6, PART VI, LINE 15A COMPENSATION 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 15B COMPENSATION 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 19 GOVERNING 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 9 TRANSFERS FROM AFFILIATED ENTITIES 1,495,267 CHANGE IN PENSION LIABILITY -331,086 TOTAL 1,164,181 WELLSPAN SUMMIT HEALTH PO BOX 2767 YORK PA 174052767 251515371 HEALTHCARE PA 501C3 7 WELLSPAN S false WAYNESBORO HOSPITAL PO BOX 2767 YORK PA 174052767 231360854 HEALTHCARE PA 501C3 3 WELLSPAN S false THE CHAMBERSBURG HOSPITAL PO BOX 2767 YORK PA 174052767 230465970 HEALTHCARE PA 501C3 3 WELLSPAN S false SUMMIT PHYSICIAN SERVICES PO BOX 2767 YORK PA 174052767 251716306 HEALTHCARE PA 501C3 3 WELLSPAN S false YORK HOSPITAL PO BOX 2767 YORK PA 174052767 231352222 HEALTHCARE PA 501C3 3 NA false APPLE HILL SURGICAL CENTER INC PO BOX 2767 YORK PA 174052767 222842253 SOLE GP IN PA 501C3 10 NA false GETTYSBURG HOSPITAL PO BOX 2767 YORK PA 174052767 231352220 HEALTH CAR PA 501C3 3 NA false GETTYSBURG HOSPITAL FOUNDATION PO BOX 2767 YORK PA 174052767 232251358 FUNDRAISIN PA 501C3 12A NA false HEALTHY COMMUNITY PHARMACY INC PO BOX 2767 YORK PA 174052767 200519121 REDUCED RA PA 501C3 12A NA false VNA COMMUNITY SERVICES PO BOX 2767 YORK PA 174052767 232338591 HORNE PERS PA 501C3 10 NA false VNA HOME HEALTH SERVICES PO BOX 2767 YORK PA 174052767 231352573 HORNE HEAL PA 501C3 10 NA false WELLSPAN HEALTH PO BOX 2767 YORK PA 174052767 222517863 INTEGRATED PA 501C3 12C NA false WELLSPAN HEALTH CARE SERVICES PO BOX 2767 YORK PA 174052767 232400237 HEALTH-REL PA 501C3 12B NA false WELLSPAN MEDICAL GROUP PO BOX 2767 YORK PA 174052767 232730785 MEDICAL AN PA 501C3 10 NA false YORK HEALTH FOUNDATION PO BOX 2767 YORK PA 174052767 233050192 CHARITABLE PA 501C3 12C NA false WELLSPAN SPECIALTY SERVICES PO BOX 2767 YORK PA 174052767 232899911 SURGERY AN PA 501C3 3 NA false WELLSPAN PROPERTIES INC PO BOX 2767 YORK PA 174052767 222842252 LEASES FAC PA 501C3 12A NA false EPHRATA COMMUNITY HOSPITAL PO BOX 2767 YORK PA 174052767 231370484 HEALTH CAR PA 501C3 3 NA false EPHRATA COMMUNITY HEALTH FOUNDATION PO BOX 2767 YORK PA 174052767 800940005 FUNDRAISIN PA 501C3 12A EPHRATA CO false NORTHERN LANCASTER COUNTY MEDICAL G PO BOX 2767 YORK PA 174052767 203033058 MEDICAL AN PA 501C3 12B EPHRATA CO false PHYS SPEC OF NORTH LANC CO MED PO BOX 2767 YORK PA 174052767 452537633 PHYSICIAN PA 501C3 12B NORTHERN L false GOOD SAMARITAN HOSPITAL PO BOX 2767 YORK PA 174052767 230794160 HEALTH CAR PA 501C3 3 NA false PHILHAVEN PO BOX 2767 YORK PA 174052767 231548822 HEALTH CAR PA 501C3 3 NA false GOOD SAMARITAN HEATH SERVICE FOUNDA PO BOX 2767 YORK PA 174052767 232356151 FUNDRAISIN PA 501C3 12A NA false GOOD SAMARITAN PHYSICIAN SERVICES PO BOX 2767 YORK PA 174052767 251832359 MEDICAL AN PA 501C3 10 NA false SUMMIT SURGERY CENTER LP 785 5TH AVENUE SUITE 3 CHAMBERSBURG PA 17201 251845303 PHYSICIAN PA NA false false 0.00650 SURGERY CENTER ASSOCIATES LLC 785 5TH AVENUE SUITE 3 CHAMBERSBURG PA 17201 251845304 PHYSICIAN PA NA false true 0.01000 APPLE HILL SURGICAL CENTER PARTNERS PO BOX 2767 YORK PA 174052767 232489452 SURGICAL C PA NA false false CENTRAL PA ALLIANCE LABORATORIES LL PO BOX 2767 YORK PA 174052767 232910950 REF. LAB PA NA false false LITTLESTOWN HEALTH CARE PARTNERS 300 WEST KING STREET LITTLESTOWN PA 17340 232880464 LEASE FACI PA NA false false CHERRY TREE CANCER CENTER LLP PO BOX 2767 YORK PA 174052767 232915628 RADIATION PA NA false false THE REHAB CENTER 855 SPRINGDALE DRIVE SUITE 20 EXTON PA 19341 251687903 PHYSICAL T PA NA false false CUMBERLAND VALLEY MOBILE SVC LLC 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 200884014 MOBILE SVC PA NA false false WELLSPAN PHARMACY INC PO BOX 2767 YORK PA 174052767 232374072 DISPENSES PA N/A C CORP false WELLSPAN RECIPROCAL RISK RETEN PO BOX 2767 YORK PA 174052767 200048457 RISK RETEN PA N/A C CORP false YORK HEALTH PLAN PO BOX 2767 YORK PA 174052767 232664989 PREFERRED PA N/A C CORP false WELLSPAN PROVIDER NETWORK PO BOX 2767 YORK PA 174052767 232907828 COORD MNGD PA N/A C CORP false APPLE HILL CONDOMINIUM ASSOCIA PO BOX 2767 YORK PA 174052767 232504543 CONDO MGMT PA N/A C CORP false NORTH LANC CO PHYS HOSP ALLIAN PO BOX 2767 YORK PA 174052767 232421885 COORD PHYS PA N/A C CORP false GSH REALTY INC PO BOX 2767 YORK PA 174052767 251832359 RENTAL NON PA N/A C CORP false EPHRATA HEALTH PAVILION CONDO ASSOC PO BOX 2767 YORK PA 174052767 475367279 CONDO ASSO PA N/A C CORP false false false true false false false false false false true true false false false true true false true true