2020-06-01T14:16:55-07:00 2019-06-30 135381590 WellSpan Health 3350 WHITEFORD ROAD YORK PA 17402 990 2018-07-01 231352222 YORK HOSPITAL YORK 7178513055 PO BOX 2767 YORK PA 17405 Michael F O'Connor CFO 2020-06-01 false See Attached P01871563 7038930600 2018 2021-01-29 14:40:06Z Roxanna Gapstur PO Box 2767 York PA 174052767 1458377344 false false X WWW.WELLSPAN.ORG X 1880 PA York Hospital is a premier community teaching hospital providing quality, cost-effective health care services strongly supporting excellence in education, and offering essential services without regard for an individual's ability to pay. 13 8 5797 1204 9695841 2799826 6809428 2015270 1051997238 1147674773 54466134 78720346 6841514 6659487 1120114314 1235069876 55779818 111315418 0 358243229 364920053 0 0 600947303 650729844 1014970350 1126965315 105143964 108104561 1705536363 1940147416 498510153 648375435 1207026210 1291771981 York Hospital is a premier community teaching hospital providing quality, cost-effective health care services strongly supporting excellence in education, and offering essential services without regard for an individual's ability to pay. false false 880196054 111315418 1149665050 WellSpan York Hospital is the region's leader in advanced specialty care. What began in 1880 has become a 572-bed community teaching hospital that employs more then 4,800 people and serves a population of more than 520,000 in south central Pennsylvania. WellSpan York Hospital offers services and programs that feature highly skilled clinical staff, life-saving technology and state-of-the-art facilities to address some of the most complex medical, surgical and behavioral conditions.WellSpan York Hospital has been designated as a Bariatric Center for Excellence by the American Society for Metabolic and Bariatric Surgery; recognized as one of the Best Regional Hospitals in its Best Hospitals publication; named a Top 100 Hospital by Thomson Reuters, a leading source of health care information, on seven occasions. In addition WellSpan York Hospital has been designated as a Robotic Epicenter by Intuitive Surgical, accredited as a Level 1 Regional Resource Trauma Center, designated as a Primary Stroke Center by the Joint Commission, and designated as a Magnet Hospital by The American Nurses Credentialing Center. WellSpan York Hospital is a nationally recognized teaching hospital with seven residency programs, five allied health schools and other training programs. More than 690 physicians and other professionals belong to WellSpan York Hospital's medical and dental staff.See Attached Federal Supplemental Information: WellSpan Health - 2019 Community Benefit Report 880196054 true true false true false false false false false true true true false true true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true false false false true 0 0 true 5797 true true true false false false false false false 0 false false false false false false false false false false false false X 13 8 false false false false true true true true true false false true true true true true true true true false PA X DAVID RIZZUTO 7178513055 3350 WHITEFORD ROAD YORK PA 17402 X Todd Marsteller Vice Chairman 1.00 0.00 X X 0 0 0 Mandy Arnold Director 1.00 0.00 X 0 0 0 Pamela Gunter-Smith Director 1.00 0.00 X 0 0 0 Percival Buenaventura MD Director 1.00 40.00 X 0 798411 60564 Lee Maddox MD Dir. beg. 11/18 1.00 40.00 X 0 493845 62777 Gary Stewart Jr Director 1.00 0.00 X 0 0 0 Dave Meckley Secr/Treas 1.00 0.00 X X 0 0 0 Jean Treuthart Director 1.00 0.00 X 0 0 0 Kevin Mosser MD Pres end 12/31 1.00 40.00 X X 0 4267289 111748 Eileen Beck Director 1.00 0.00 X 0 0 0 Roxanna Gapstur Pres 1/1/19 1.00 0.00 X X 0 0 0 William Dannehl Chairman 1.00 0.00 X X 0 0 0 Steven Schirk Dir. beg. 11/18 1.00 40.00 X 0 377656 65455 Sandie Walker Dir. beg. 11/18 1.00 0.00 X 0 0 0 Steve Pandelidis MD Dir. end. 10/18 1.00 0.00 X 0 0 0 Todd Butz MD Dir. end. 10/18 1.00 0.00 X 0 0 0 Michael F O'Connor CFO-WellSpan H. 1.00 40.00 X 0 811162 641117 Keith Noll President 40.00 0.00 X 867950 0 333376 Nelson Aegbuniwe Clinical RN 40.00 0.00 X 269422 0 55303 Allan Birenberg VP-Med Affairs 40.00 0.00 X 532109 0 62127 Astrid Davis Sr.Dir.-Nursing 40.00 0.00 X 295146 0 55390 Shelly Buck VP & Chief RN Off. 40.00 0.00 X 291952 0 44284 Thomas Dondero Dir-Pharm Care 40.00 0.00 X 286755 0 76082 Victoria Diamond Former VP Ancillary Svcs 0.00 40.00 X 0 387674 48953 2543334 7136037 1617176 421 true true false York Laboratory Associates 1001 South George Street York PA 17403 Lab Services 7992759 Anesthesia Associates of York 110 Pine Grove Commons York PA 17405 Physician Services 6065072 American HealthCare Services PO Box 945 Traverse City MI 49685 Temporary help 2192708 Quest Diagnostics PO Box 9125512 Pasadena CA 911102512 Lab Services 2589674 HCSC Laundry PO Box 25092 Lehigh Valley PA 180025092 Laundry Services 1947047 34 959460 393901 661909 2015270 EHR Incentive Program(MU) 621500 8500 8500 Patient Services 621500 1235281660 1226207034 9074626 W/O - Bad Debt 621500 -78094044 -78094044 W/O -Financial Assistance 621500 -9521343 -9521343 1147674773 37625954 37625954 0 0 410729 410729 410729 410729 263422873 978987 223222314 85154 40200559 893833 41094392 41094392 0 0 0 Food Service/Hospitality 722210 596078 109795 486283 Medical Education 611710 1714781 1686981 27800 Snack/Coffee Bar & Cafe 722210 2723281 2723281 1214618 303296 511420 399902 6248758 1235069876 1140590424 9695841 82768341 X 111315418 111315418 0 0 0 1201326 1201326 0 264218030 255639449 8578581 10092631 9720748 371883 69189450 66640026 2549424 20218616 19473621 744995 171018924 171018924 24545 1165 23380 392268 392268 0 0 0 163690578 161589070 2101508 94325 82079 12246 2916645 2916645 47507685 47507685 0 5389263 5389263 640996 589425 51571 0 407213 374139 33074 13135955 13135955 0 28896140 21504495 7391645 15242675 15242675 Supplies 152266695 152266695 Taxes & Licenses 21310930 21197475 113455 Repair & Maintenance 13422345 13422345 Utilities 7880283 5537319 2342964 6492379 4158047 2334332 1126965315 880196054 246769261 0 0 31279832 35675115 1285228 1545206 160302193 166255150 0 0 0 6657949 6662281 1818070 1926948 628323568 390972443 223146763 237351125 224876269 243324174 605854019 734228883 0 0 450316040 513178534 1705536363 1940147416 19087849 21506855 8628841 3485915 384990138 498857946 85803325 124524719 498510153 648375435 X 1186557250 1271147717 12192122 12437258 8276838 8187006 1207026210 1291771981 1705536363 1940147416 X 108104561 -22253303 -1105487 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 55549 55549 false false Part II-B, Line 1i - Other Activities Description A portion of the dues paid to the Hospital Association of Pennsylvania and the American Hospital Association include lobbying ($37,170 and $18,379). 20468960 727949 -35615 537030 20624264 18572636 2478669 439846 1022191 20468960 17074112 1809648 522621 833745 18572636 18895888 1664676 -1231979 2254473 17074112 18188902 1640924 248151 1182089 18895888 0.39700 0.60300 true true true 2008597 2008597 353267223 195587204 157680019 12827221 10773219 2054002 246992015 184612020 62379995 13228512 13228512 237351125 734228883 Due from affiliates 4208841 Intangible Assets 2965856 Notes Receivable 498163361 Total Other noncurrent assets 7085388 513178534 Accrd Payroll W/H 1095820 Accrued Asbestos Removal Exp 1489207 Accrued Payroll 6779614 Accrued Vacation 14106562 AP Intercompany 41230193 Current Portion - LTD 5999750 Insurance Reserve 5768000 Post Retirement Benefit Obligations 21483392 Total Other Noncurrent Liabili 26572181 124524719 X 1208851497 -24815948 -24815948 1233667445 1402431 1402431 1235069876 1015744143 1015744143 111221172 111221172 1126965315 Part V, Line 4: Intended uses of the endowment fund. The funds were used to improve the health and welfare of the residents of York and Adams counties of Pennsylvania. Part X : FIN48 Footnote In June 2006, the Financial Accounting Standards Board (FASB) issued Interpretation NO. 48, Accounting for Uncertainty in Income Taxes-an interpretation of FASB Statement NO. 109, Accounting for Income Taxes (FIN 48), which creates a single model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing the minimum recognition threshold a tax position is required to meet before being recognized in the financial statements. Under the requirements of FIN 48, tax-exempt organizations could now be required to record an obligation as the result of a tax position they have historically taken or various tax exposure items. Prior to FIN 48, the determination of when to record a liability for tax exposure was based on whether a liability was considered probable and reasonably estimable in accordance with SFAS No.5, Accounting for Contingencies. On July 1, 2007, the parent company, WellSpan Health, adopted FIN 48. WellSpan Health determined that it does not have any uncertain tax positions through June 30, 2019. Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S Restricted Contributions(Net) $41813 Restricted Contributions(Net)-YHF $149107 Expenses Netted with Revenue $1121172 Net Assets Released for PPE $90339 Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S Grant-WellSpan Medical Group $52100000 Grant-WellSpan Health $58000000 Expense Netted with Revenue $1121172 true true X true X 300.000000000 true X true true false false true true 1 3425 3408641 3408641 0.00300 1 155885 176522901 104425283 72097618 0.06400 2 159310 179931542 104425283 75506259 0.06700 47 34883 2387904 171222 2216682 0.00200 3 77 508384 508384 0.00050 7 156285 7207231 4151903 3055328 0.00270 1 878561 2175 876386 0.00080 6 1751 411128 411128 0.00040 64 192996 11393208 4325300 7067908 0.00640 66 352306 191324750 108750583 82574167 0.07340 1 660000 660000 0.00060 1 27 782 782 10 11606 47054 16967 30087 2 78 1551 1551 2 161 597918 597918 0.00050 16 11872 1307305 16967 1290338 0.00110 true 26525668 419105 318530811 358135171 -39604360 X true true 1 1 WellSpan York Hospital 1001 S George Street York PA 17405 http://www.wellspan.org 250301 X X X X X X false false true X X X X X X X X 18 true true true true X www.wellspan.org X www.healthyyork.org X X true 18 true www.wellspan.org true false true X 300.0000 400.0000 X X X X X X X true true X X X X true X http://www.wellspan.org X http://www.wellspan.org X http://www.wellspan.org X X X X X X X true X false X X X X true X false false Facility: - Part V, Section B, Line 5 Community stakeholder engagement has been vital to the Community Health Needs Assessment (CHNA) process since it began in York County in 1994. The Healthy York County Coalition (HYCC)- a local health coalition representing the diversity of the community- has led each of the seven CHNAs that have been conducted. For the 2018 CHNA, HYCC partnered with its sister health coalition in Adams County- Healthy Adams County- to form a CHNA Planning Committee comprised of representatives from health and human service agencies, government entities, community-based organizations, higher education institutions, and other interested community members to assist with survey development, data review and analysis, and results distribution. This core committee also assisted with sharing the data and association community health priorities, once identified by Coalition leadership, to community members at a public forum on June 7th, 2018. WellSpan- York Hospital is a funding partner and governance leader within Healthy York County Coalition and served on the CHNA Planning committee. In that regard, WellSpan- York Hospital partners to conduct the CHNA, disseminate its results both among hospital leadership and in the community, and integrates evidence-based strategies that impact identified community health needs into its annual planning process. Whether in meetings with community stakeholders or system/ hospital leaders or at larger public forum, WellSpan- York Hospital is committed to obtaining community input to ensure that the CHNA and its associated implementation strategies appropriately address the identified needs of the entire community. Additional details of how community members were engaged is included in Part V1- Needs Assessment. Facility: - Part V, Section B, Line 6a WellSpan Ephrata Community Hospital (Lancaster); WellSpan Good Samaritan Hospital (Lebanon); WellSpan Surgery and Rehabilitation Hospital, and WellSpan Gettysburg Hospital (Adams). Outside of WellSpan Health, UPMC Pinnacle Memorial and UPMC Pinnacle Hanover engaged in the CHNA process for York and Adams counties. Facility: - Part V, Section B, Line 7d With each iteration of the CHNA process, WellSpan- York Hospital and its community partners continue to refine and enhance the system by which it obtains data, shared it with key community, hospital and system leaders, and integrated it into the system-wide and entity-level planning processes. In 2018, CHNA results and related priorities identified by Healthy York County Coalition were shared with the system-wide Planning Committee and WellSpan Health. This committee is comprised of community members and leader 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. Similarly, Healthy York County Coalition selected adult overweight and obesity, depression, and the social determinants of health as priorities- these priorities built on previously developed strategies that were a result of the 2015 CHNA and also encourage a deeper dive into the WellSpan system-wide, organizational priorities. The established Healthy York County Coalition and WellSpan specific priorities and associated data were presented to the WellSpan- York Hospital Board for their adoption. Additionally, the CHNA data was presented to multiple members of WellSpans leadership team. Healthy York County Coalition communicated the CHNA results and identified priorities to more than 100 community members at a public forum held on June 7, 2018. During that forum, community members discussed the opportunities and risk associated with each priority, as well as how the organization which they represent can have an impact on the priority. In addition to these venues, CHNA results are available on the Healthy York County Coalition (www.healthyyork.org) and WellSpan Health (www.wellspan.org) websites, and may also be obtained upon request. The corresponding WellSpan Community Health Improvement Plan is also available on the WellSpan Health website. Facility: - Part V, Section B, Line 13b Patients 401% of poverty level and greater do not qualify for financial assistance. However, all uninsured patients qualify for a 20% "no insurance" discount, regardless of income. Facility: - Part V, Section B, Line 13h WellSpan Health is committed to caring for all the members of its communities, regardless of their ability to pay. In recent years, overall charity care has decreased slightly as more people have obtained health insurance coverage through the Affordable Care Act and the expansion of Pennsylvanias Medical Assistance (Medicaid) program. WellSpan is proud to be a leading partner in the Healthy Community Network, which works to address the needs of uninsured and underinsured individuals in our community. In addition, the health system recently enhanced its financial assistance policy and the discounts that it provides on services. For example, if a patients income is less than 300 percent of the federal poverty level, that patient would be eligible for a 100 percent discount on the services provided. Additionally, significant discounts are available for patients whose income is between 300 percent and 400 percent of the federal poverty level. For more information on WellSpans Financial Assistance program, visit www.WellSpan.org/FinancialAssistance. Facility: - Part V, Section B, Line 16j In an effort to make patients, families and others in our communities aware of the newly expanded Financial Assistance Policy, WellSpan broadly publicized its policy via promotional signage and the distribution of easy-to-read informational materials at registration sites throughout our communities. WellSpan provided information on the Financial Assistance Policy on its billing statements and included information in patient discharge materials. In addition, the materials and information are easily accessible via WellSpans website at www.WellSpan.org/FinancialAssistance. The site reflects WellSpans newly enhanced policy, as well as informational and application materials. It was also publicized via WellSpans on-hold phone messaging system and in its direct-to-consumer community newsletter/magazine, which is distributed by mail, email and Web. In addition, WellSpan placed posters and signage at its various sites of care to publicize its Financial Assistance Policy. Printed copies of WellSpan Healths entire financial assistance policy and the plain language summary of the policy, both of which are available in English and Spanish, may be obtained at no cost by visiting or calling one of the WellSpan patient financial services offices.The Financial Assistance Policy, Financial Assistance Application and Financial Assistance Policy Plain Language Summary are all available in Spanish. Facility: - Part V, Section B, Line 22d WellSpan Health will provide assistance to all patients whose income falls within 400 percent of the federal poverty guidelines and within the asset limits listed on Attachment A. Those patients qualifying for financial assistance will receive a discount based on the amount generally billed (AGB), which is applicable to the facility at which services were provided. The AGB is calculated by the look-back method, in accordance with IRS Regulation 501(r). This is based on payment received from Medical Assistance and all private payors, in the most recent completed fiscal year. York Cancer Center Apple Hill Medical Center 25 Monume York PA 17403 Cancer Patient Support, Social worker, Financial Counselor, Dietician, Library, Genetic Counseling WellSpan Rehab & Lab -Queensgate Towne Center 2015 Springwood Rd York PA 17403 Physical Therapy, Occupational Therapy, Speech Therapy, Laboratory Collection WellSpan Wound Healing Center 1399 S Queen St York PA 17403 Wound Care, Hyperbaric Oxygen Therapy WellSpan Behavioral Crisis Intervention 1101 S Edgar St Suite C York PA 17403 Mental Health & Substance Abuse Assessments, Crisis Counseling Community Health Center &Hoodner Dental Center 605 S George St York PA 17401 Dental Clinic, Pediatric Care, Women's Health Care,Adult Care, Urgent Care Special Services Wellspan Imaging - East Berlin 105 Fourth St East Berlin PA 17316 Laboratory Collection, General Radiology, Mammogram Screening, EKG WellSpan Lab Services & Imaging 2775 N George St York PA 17402 Laboratory collection, general radiology, mammogram Screening, EKG WellSpan Apple Hill Womens Imaging & Specialty Services 35 Monument Road Suites 201 202 204 York PA 17403 Mammography, MRI/Ultrasound, Bone Density, Breast and Thyroid, Ultrasound, High Risk Pregnancy, Phys WellSpan Lab Services 4222 Lincoln Highway York PA 17406 Laboratory collection, General Radiology, Mammogram Screening, EKG WellSpan Interventional Pain Mgmt 228 St Charles Way York PA 17402 Interventional Pain Mgmt, Radiology Fluroscopy WellSpan Rehabilitation 1575 Bannister St York PA 17404 Physical Therapy, Occupational Therapy, Speech Therapy WellSpan Rehabilitation and Imaging 207 Blooming Grove Road Hanover PA 17331 Post Operative Orthopedic Rehab, Acute Rehab following injury (work/athletic), Cumulative stress inj WellSpan Lab & Imaging 3065 Windsor Road Red Lion PA 17356 Laboratory Collection, General Radiology, Mammogram Screening WellSpan Rehabilitation 235 Rosedale Drive Manchester PA 17345 Physical Therapy, Occupational Therapy WellSpan Lab & Imaging 4020 Carlisle Road Dover PA 17315 Laboratory Collection, General Radiology, Mammogram Screening, EKG, Sleep Disorders WellSpan Lab & Imaging Services 13515 Wolfe Rd Ste D New Freedom PA 17349 Laboratory Collection, General Radiology, Mammogram Screening, EKG WellSpan Imaging 2250 E Market St York PA 17402 general Radiology, Mammogram Screening, EKG, Bone Density, Orthopedic Services WellSpan Lab Services at Valley Green 1790 Old Trail Road Etters PA 17319 Laboratory Collection WellSpan Health Lab Services at Westgate Plaza 1550 Kenneth Rd York PA 17404 Laboratory Collection WellSpan Pulmonary Sleep Medicine & Pulmonary Rehab 2350 Freedom Way Suites 201 207 York PA 17402 Pulmonary Function Testing, Pulmonary Rehab & Asthma Instruction WellSpan Rehabilitation 73 East Forrest Avenue Suite 210 Shrewsbury PA 17361 Physical Therapy, Occupational Therapy, Speech Therapy WellSpan Lab Services & Occupational Health 1150 Carlisle St Hanover PA 17331 Laboratory Collection, Screenings, Physicals, Drug & Alcolhol Screening, Injury Evaluation, Immuniza Apple Hill Infusion Center 25 Monument Road Suite 120 York PA 17403 Infusion Services, Genetic Counseling York Cancer Center-Radiation Therapy Apple Hill Medical Center -25 Monum York PA 17403 Oncology Radiation WellSpan Heart & Vasular & Nuclear Medicine- Apple Hill 25 Monument Road - Suites 190 199 York PA 17403 Cardiac Rehavilitation, Cardiovascular Health Management Clinic, Cardiac stress testing, Echo Cardio WellSpan Heart & Vascular -Bannister St 1575 Bannister Street Suite 7 York PA 17404 Coumadin Clinic, Congestive Heart Failure Clinic, IV Diuretic Clinic, Women's Heart Program WellSpan Rehabilitation - Apple Hill 25 Monument Road Suite 175 York PA 17403 Physical Therapy, Occupational Therapy, Speech Therapy WellSpan Rehabilitation - North Hanover 1000 Carlistle St Suite 1175 Hanover PA 17331 Post Operative Orthopedic Rehab, Acute Rehab following injury (work/athletic), Cumulative stress inj WellSpan Rehabilitation - Cape Horn Square 635 Lombard Road Red Lion PA 173569054 Physical therapy WellSpan Rehabilitation- Manheim 93 Doe Run Road Manheim PA 17545 Physical therapy, Occupational Therapy WellSpan Rehabilitation - Valley Green 1790 Old Trail Road Suite F Etters PA 17319 Physical therapy WellSpan Imaging 37 Monument Road Suite 101 York PA 17403 General Radiology, Fluroscopy, General Ultrasound, Vascular Ultrasound, EKG, Computed Tomography WellSpan Imaging - Apple Hill 25 Monument Road Suite 290 York PA 17403 General Radiology WellSpan Imaging 2775 North George St York PA 17406 Laboratory Collection, General Radiology, mammogram Screening, EKG WellSpan Lab Services 46 West Market St York PA 17401 Laboratory Collection, urine specimen collection, glucose tolerance WellSpan Lab Services- Apple Hill 25 Monument Road - Suite 198 York PA 17403 Laboratory Collection WellSpan Occupational Health 2250 E Market St York PA 17402 Screenings, Physicals, Drug & Alcolhol Screening, Injury Evaluation, Immunizations, Occupational Hea WellSpan Occupational Health - Gettysburg 455 South Washington St Suite 12 Gettysburg PA 17325 Screenings, Physicals, Drug & Alcolhol Screening, Injury Evaluation, Immunizations, Occupational Hea Thomas Hart Family Practice Center 1001 S George St York PA 17403 Primary Care, women's healthcare, pediatric & geriatric care, prenatal care, minor surgical procedur WellSpan OB GYN & Specialty Care Clinic 1101 Edgar St York PA 17403 Women's Health, special procedures - lumbar puncture, PHAS- Surgery Setups thru clinics as as GYN Cl Part I, Line 6a - Related Organization Community Benefit Report Community Benefit Information is included in the Community Benefit Report for WellSpan Health. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense The number was calculated using the cost to charge ratio factor applied against actual patient bad debt write-offs. These numbers are included after all efforts have been exhausted to determine if the patient meets our charity care write-off policy based on federal poverty levels. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit The estimate of bad debt attributable to charity care policy was calculated by dividing the bad debt amount that was originally coded bad debt but later found to qualify as charity care by the amount coded to the charity care write-off codes. This ratio is applied to the bad debt cost factor expense. Part III, Line 4 - Bad Debt Expense York 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 YH ceases collection efforts. Losses have been consistent with management's expectations in all material respects. Part III, Line 8 - Explanation Of Shortfall As Community Benefit York 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 York Hospital's costs of providing the service. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients Guidelines for suggested minimum number of phone attempts and letters to be sent before the account is turned over to an outside collection agency are included in the Patient Administrative Services Policy. Upon final PARO (Payment Assistance Rank Ordering) scoring, if a patient qualifies for presumptive charity, their account would not be forwarded to any third party collections. It shall be the policy of Patient Administrative Services to recommend accounts to Bad Debt on a timely basis. Inpatient/Outpatient accounts will go to bad debt automatically after the account has been in the financial class Pending Bad Debt for 30 days. All accounts must follow the approved limits for refunds and write offs, as established in Policy PF-102, before being transferred. The primary agencies will work the accounts for 6 months or until they feel it is uncollectable and return the account. The accounts are forwarded to secondary agencies from the primary agencies Closed and Return Reports. The financial class is changed to Bad Debt Other after the Closed and Return Reports are received from the Secondary Agency. The agencies must get written approval from the manager in the relatively rare instance of legal action being taken to collect the debt. Part VI, Line 2 - Needs Assessment WellSpan Health and its entities have a long history of understanding and responding to the needs of the communities and populations it serves. This commitment was strengthened in 1998 when, in partnership with the Healthy York County Coalition, WellSpan conducted its first Community Health Needs Assessment (CHNA). Six subsequent CHNAs were conducted in 2000, 2005, 2008, 2012, 2015 and 2018. These assessments- one method for collecting diverse information on a community and which involves surveying a representative sample of community members on their demographics, chronic health conditions, lifestyle behaviors, finances, access to health services, and related topics- have been administered before the Affordable Care Act (ACA) requirement. As previously noted, the WellSpan CHNA process, which includes survey development, data collection and analysis, and result dissemination, was led by both county-level health coalitions- Healthy Adams County and the Healthy York County Coalition- for Adams and York Counties. A similar process was utilized for the remaining counties of the WellSpan service area, including northern Lancaster and Lebanon counties. Healthy Adams County, Healthy York County Coalition, and its regional partner the Community Health Council of Lebanon County receive financial support from WellSpan Health and its entities, and other community stakeholders. The CHNA was developed utilizing consulting support and guidance through a contract with the Floyd Institute for Public Policy at Franklin and Marshall College. Dr. Berwood Yost, Institute Director and Project Lead has an extensive background conducting and analyzing community and corporate surveys and has been integral to the prior three CHNAs (2008, 2012 and 2015). The 2018 Adams and York CHNA is a byproduct of a collaboration of community organizations who partnered to provide guidance and support to the effort, including: County of York, Family First Health; Gettysburg College; UPMC Pinnacle Hanover; UPMC Pinnacle Memorial; York County Human Services; South Central Community Action Program (SCCAP); TrueNorth Wellness Services; United Way of York County; York City Health Bureau; York College of Pennsylvania, and; York County Community Foundation. This collaboration of community stakeholders determined the survey questions to be asked of the community; discussed data collection methodology, including sample size and method of obtaining data; reviewed the raw data and supporting charts/ graphs; identified potential community health priorities, and; developed the process by which results and priorities were to be shared with the community. The 2018 CHNA planning process engaged a wide range of community organizations serving the diverse interests of all partners. The intent of the CHNA was to collect adequate valuable data and information that would satisfy the needs of all participating organizations, without burdening CHNA respondents with too many questions. Committee members reviewed questions asked in the 2015 CHNA and edited accordingly based on the current health care environment and areas of interest. Survey questions were 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. A representative sample of 799 adult residents in York County were interviewed between December 4, 2017 and February 25, 2018. 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 that identified: trends and disparities; quantity of residents affected; health risks and disability-adjusted life years, 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 Healthy York County Coalition 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- York Hospital Board for their adoption. Board members discussed the data and identified priorities within the context of existing staffing and financial resources, current and future entity initiatives, and community partnership opportunities to address systemic community change. The final CHNA report, along with the WellSpan Community Health Improvement Plan (CHIP) was presented in June 2019 to the Planning Committee, at which time correlations were observed between the CHNA, CHIP and the WellSpan 2025 Strategic Plan. Part VI, Line 5 - Promotion of Community Health As a charitable, community-based healthcare organization, our commitment to improving the lives and well-being of the people and communities we serve is evident in our mission statement: working as one to improve health through exceptional care for all, lifelong wellness, and healthier communities." Employees live out this mission statement every day by engaging in community benefit activities that address community needs, especially the health priorities identified in the 2018 CHNA - access to care and health equity; behavioral health, substance use and addiction, and lifelong wellness, and community engagement, social determinants of health and violence prevention. Below are a few examples of the work accomplished to address each: *Access to healthcare and medications for uninsured community members or those with high out-of-pocket costs is often financially challenging. Healthy Community Network, a collaborative between WellSpan Health, physicians and community partners to support prospective enrollment, the management and support of patients, and coordination of care, serves as a support for those individuals, offering free or discounted resources based on need. In 2019, Healthy Community Network served 3,200 community members in need of care across the region and provided financial assistance for 12,000 prescriptions, allowing individuals who lack sufficient health insurance or financial means to access the medications they need.*WellSpan remains committed to the strong safety net of partnering health care services in our region. Together, we demonstrate strong community impact in health. For example, WellSpans support of the Family First Health Hannah Penn Center enhanced its ability to provide 4,241 acute and preventive visits for underserved adults and children. *In 2019, WellSpan Health encouraged community members, local employers and employees, and WellSpan staff and patients to engage in the 7th annual 10 Pound Throwdown initiative. The 10 Pound Throwdown is a 10-week community challenge that encourages participants to lose or maintain a healthy weight through healthier eating and increased physical activity. The initiative was created in 2013 to address the growing issue of adult overweight/obesity and utilizes a core website (www.10poundthrowdown.com) to encourage team participation and to offer an online weight tracker, badges to encourage healthier choices, and diverse health education resources. In 2019, the 10 Pound Throwdown engaged 6,400 community members across four southcentral Pennsylvania counties -Adams, Lancaster, Lebanon, and York- participated in the 2019 iteration of the 10 Pound Throwdown program. *WellSpan Health -York Hospital primary care practices in York County participated in the Market Bucks program to address food insecurity and increase the consumption of fruits and vegetables. Regionally, this program provided fruit and vegetable vouchers to 239 WellSpan patients with food insecurity challenges, which contributed nearly $28,000 to local farmers and growers. This program reaches those with an elevated Body Mass Index (BMI) who also experience a comorbidity associated with diet. Market Bucks consistently boasts an astounding 86% redemption rate, in addition to demonstrating increased fruit and vegetable consumption for participants with medical challenges. *WellSpans commitment to lifelong wellness begins with the support it provides to our youngest residents. WellSpan- York Hospital remains the lead agency for Safe Kids York County, distributed nearly 10,000 books to children through our Reach Out and Read program, engaged more than 400 children and families in child abuse prevention programs, and distributed more than 200 cribs to families without a safe place for their baby to sleep. *Celebrating more than a decade of promoting summertime physical activity, Get Outdoors (GO) York!, a partnership between WellSpan-York Hospital and York County Libraries, more than 9,000 children participated in an adaptation of letterboxing, an international hobby where participants use written clues to find items hidden in various places. *Opioid use, as in other communities across the United States, has become a crisis in York County. WellSpan remains a steadfast partner in advancing work in this area. In 2019, Community Partnership Grant funds supported both the Project Lazarus opioid overdose prevention program, and a drug treatment program called Gaudenzia Inc. in a very desolate region within York County. Additionally, WellSpan admitted 476 patients into a Medication Assisted Treatment (MAT) program, which combines the use of medications and behavioral therapy to treat people with substance use disorders. WellSpan offered support and leadership to the York Opioid Collaborative, which continues to gain traction in the community and welcomed a new executive director in 2019. *WellSpan Health and its community partners have been working to address housing insecurity in central Pennsylvania. Three of the collaborative solutions- the Omega Bed Lease Program, Arches to Wellness and ALPHA Community Initiative- earned the Hospital and Healthsystem Association of Pennsylvania (HAP) 2019 Living the Vision award. *Historically, WellSpan Health and its entities have taken planned steps to build community capacity that addresses complex health issues, as identified by the Community Health Needs Assessment (CHNA). Through financial and management support of a county health coalition, the Healthy York County Coalition (HYCC), more than 200 York County community members have been engaged in community health improvement initiatives. HYCC consists of three committees -Access and Empowerment; Community Engagement, and; Prevention and Wellness, each of which continue to attract new community members, leaders, and professionals. These committees foster partnerships and collaboration between entities to ensure that efforts to address and impact identified community health needs are coordinated and successful. In 2019, the Healthy York County Coalition prepared research on York County residents life expectancy variance by zip code. *WellSpan-York Hospital maintains its commitment to supporting local non-projects with Community Partnership Grant funds to like-minded nonprofit organizations to address key issues and health priorities. In 2019, WellSpan- York Hospital also awarded grants to the York County Food Bank, VisionCorps, the York County Public Library system, and the YWCA Dialogues on Race effort. Additional examples of how WellSpan-York Hospital fulfilled its community mission in York County may be found in the 2019 WellSpan Community Benefit Report available online at www.wellspan.org. Part VI, Line 6 - Affilated Health Care System WellSpan Health is an integrated health system serving the communities of southcentral Pennsylvania and northern Maryland. As a community-based, not-for-profit organization, WellSpan is dedicated to improving the health and well-being of the people it serves. WellSpan will assume a leadership role and develop partnerships with other organizations to: improve access to coordinated, high-quality, cost-effective health care services, educate the health care providers of tomorrow, promote healthy lifestyles and lifelong wellness, and make its local communities healthier, more desirable places to live, work, and play. WellSpan York 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.WellSpan York Hospital's community benefit report is contained in a report prepared by their parent organization, WellSpan Health. See Attached Federal Supplemental Information: WellSpan Health - 2019 Community Benefit Report Part VI, Line 7 - States Filing of Community Benefit Report PA true WellSpan Health PO Box 2767 York PA 17405 222517863 58000000 0 General Support WellSpan Medical Group PO Box 2767 York PA 17405 232730785 52100000 0 General Support 2 0 Grantmaker's Description of How Grants are Used All WellSpan entities follow WellSpan policies and procedures regarding grant projects to ensure that the use of grant funds are consistent with WellSpan's commitment to endeavor to improve the health status of the communities that we serve.The WellSpan foundations are supporting organizations and substantially all of the grants and other assistance they make furthers the exempt purposes of their "supported organizations", each of which are exempt affiliated organizations within the WellSpan Health system. Because the supported organizations identify the projects and exempt activities that will be funded by the foundations' grants and other assistance, and because there is a cross-over between the respective governing bodies and management of the foundations and their supported organizations, the foundations are able to effectively monitor that the grants they make are used for their intended purposes. X X X X X false true false false false false false false false false Allan Birenberg VP-Med Affairs 455017 77092 15654 46473 594236 Astrid Davis Sr.Dir.-Nursing 127913 50463 116770 14010 41380 350536 Keith Noll President 489546 368821 9583 286007 47369 1201326 203580 Kevin Mosser MD Pres end 12/31 1023400 420420 2823469 13433 98315 4379037 420420 Lee Maddox MD Dir. beg. 11/18 462230 31615 16289 46488 556622 Michael F O'Connor CFO-WellSpan H. 588737 222300 125 590416 50701 1452279 222300 Nelson Aegbuniwe Clinical RN 265715 1538 2169 14194 41109 324725 Percival Buenaventura MD Director 795411 3000 16254 44310 858975 Shelly Buck VP & Chief RN Off. 253054 38898 13327 30957 336236 Steven Schirk Dir. beg. 11/18 377656 19734 45721 443111 Thomas Dondero Dir-Pharm Care 264589 17718 4448 35025 41057 362837 Victoria Diamond Former VP Ancillary Svcs 331870 55804 15982 32971 436627 A See Schedule O A true Stewart Properties cos Officer Stewart 488000 construction, rental false Client Note 1 Client Note 1 - Paid Preparer ExplanationDue to a software limitation, we wish to clarify that WellSpan Health is the ERO.The paid preparer is:BDO USA, LLP13-53815908401 Greensboro Drive, Suite 800McLean, VA 22102(703) 893-0600The preparers name is Marc Berger, PTIN P01871563 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder WellSpan Health, a not for profit corporation, is the sole member.The Member of the Corporation shall meet at any place, date, and time designated by the Member, for the transaction of the general business of the Corporation. Action of the Member shall generally be taken by a written consent in lieu of a meeting.Any action which may be taken at a meeting of the Member may be taken without a meeting if a consent or consents in writing, setting forth the action so taken, shall be signed by the Member and filed with the Secretary of the Corporation. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body 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 nor more than fifteen persons. Nominations for the Directors to be elected by the Member shall be made only by the Nominating Committee for Directors, except for vacancies in the Board of Directors occurring by death, resignation, disqualification, removal or otherwise, may, upon the recommendation of the Executive Committee, be filled by appointment by the Member to serve until the next annual meeting of the Member, at which time the Member may elect a Director to fill such vacancy for the remainder of the unexpired term thereof. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The member may, with respect to the Corporation, initiate and implement any of the following actions, and it 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. 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; or, in the absence of a current Member 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 day-to-day business, in amounts less than the amounts designated by the Member, such as routine trade and accounts payable or obligations. f) The conveyance, transfer, lease, or sale of any of the Corporation's assets with fair market value in excess of such aggregate amount as may be designated by the Member from time to 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. 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 amounts 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 to 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. l) The selection of the Corporation's outside auditors, general legal counsel, or investment advisors. m) The requirement that the Member make any capital contribution to the Corporation. n) The ratification of appointments and reappointments to the Corporation's Board of Directors. o) The approval of the Corporation's strategic and operating plans, or any changes thereto. p) The approval of the Corporation's statements of purpose, vision, or mission, or any changes thereto. q) The creation by the Corporation of any new lines of business, sites of business, subsidiary corporations, or partnerships or other joint ventures, or any material changes in existing services, or participation in any key strategic relationship outside the System. This is not meant to restrict the Corporation's right to enhance and expand its current lines of business. r) All health care services contracting by the Corporation that could materially impact the System. Form 990, Part VI, Line 11b: Form 990 Review Process Management provided an electronic copy of the form 990 to each voting member of the organization's governing body, prior to its filing with the IRS. The organization's finance management team provided a presentation to the Audit Committee on the organization's 990 return. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts Officers, directors, and key employees fill out a WellSpan Health Conflict of Interest Disclosure Statement questionnaire annually. The questionnaire is administered by the Internal Audit Department of WellSpan Health, the Parent Company.There shall be full disclosure by any Director having a business or personal interest or relationship which may be in conflict with the interests of the Corporation. After such disclosure the Director shall abide by the determination of the Board of Directors as to whether a conflict exists, the extent to which, if at all, the Director will be permitted to be present during the Board of Directors' discussion of the matter in which the Director may be interested, and whether the Director will be permitted to participate in such discussion and cast a vote in such matter. Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The Compensation Committee of WellSpan Health is responsible for rewarding and reinforcing key executives for the achievement of annual and long-term performance objectives. The Compensation Committee shall consist of not more than six (6) persons, of whom two (2) shall be the Chairman and Vice Chairman of the Board of the Corporation, and the remaining members shall be such other persons as may be appointed by the Chairman of the Board of the Corporation, with the approval of the Board of Directors; provided, however, that the Compensation Committee shall not include any persons who are employed by the System. The Chairman of the Board of Gettysburg Hospital shall participate. The role of the Compensation Committee is to set the Executive Compensation Philosophy for the system and ensure adherence, evaluate performance and establish compensation for the WellSpan President, evaluate team performance of the executive team and establish awards, review and approve senior executive base salary ranges, and oversee employed physician compensation programs. The Committee will approve salary ranges for each executive position and review incumbent salaries annually. The Committee will be responsible for reviewing the President's salary each year, and if warranted, authorizing an adjustment to maintain competitiveness. The President will have the authority to make salary adjustments for subordinate positions. The Committee is responsible for approving and authorizing payment of the performance awards. The Committee will approve and authorize payment of the President's performance awards. Integrated Healthcare Strategies, Inc., based in Minneapolis Minnesota is the external consultant to the committee. This consultant focuses exclusively on executive and physician compensation in the health care industry. In summary, the executive and physician compensation review process consists of the following: 1) Cash compensation reviewed annually 2) Cash compensation reviewed by external consultant biennially 3) external total compensation (cash, incentives, benefits, perquisites) reviewed by external consultant periodically 4) Process is integrated with compensation analysis for other WellSpan positions 5) Committee decisions are documented in minutes maintained in Human Resources. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Governing documents, policies, and financial statements are available upon request. Other Changes In Net Assets Or Fund Balances - Other Decreases Change in Retirement Liability = -$1105487 Part V line 1a Part V line 1a - Most 1099s are issued through WellSpan Health, the parent company. Schedule K -Tax-Exempt Bonds $213,430,000 of Revenue bonds for Wellspan Health Obligated Group, Series 2014A were issued November 11, 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 6/30/19, the allocation of the Debt Capital program including issue premium was as follows: York Hospital $115,717,777, Gettysburg Hospital $7,778,848, WellSpan Properties $27,853,476, WellSpan Specialty Services $13,693,232, and Ephrata Community Hospital $28,452,517. These amounts are reported on the respective balance sheets for each of these entities.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 6/30/19, the $30,762,699 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. 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), 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 6/30/19, the allocation of the Debt Capital program was as follows: York Hospital $18,072,754, Gettysburg Hospital $2,822,312, WellSpan Properties $3,298,402, WellSpan Specialty Services $5,227,656,Good Samaritan Hospital $252,048, and WellSpan Health $1,443,829. These amounts are reported on the respective balance sheets for each of these entities.$29,312,000 of Revenue Bonds, Series 2017B for WellSpan Health Obligated Group were issued 9/4/2018 by General Authority of South Central Pennsylvania. The purpose of the bond issue was refund for bonds issued 11/12/2008. 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 6/30/19, the allocation of the Debt Capital program was as follows: York Hospital $16,704,970, Gettysburg Hospital $2,608,713 WellSpan Properties $3,048,772, WellSpan Specialty Services $4,832,016, Good Samaritan Hospital $232,972, and WellSpan Health $1,334,557. 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) 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 6/30/19, the allocation of the Debt Capital program was as follows: York Hospital $131,706,215, Chambersburg Hospital $110,087,343, WellSpan Properties $65,734,073, Chambersburg Health Services $18,810,564, Good Samaritan Hospital $1,482,627, and Ephrata Community Hospital $3,472,471. 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 6/30/19, the allocation of the Debt Capital program was as follows: York Hospital $123,530,352, Gettysburg Hospital $19,290,983, WellSpan Properties $22,545,140, WellSpan Specialty Services $35,731,920, Good Samaritan Hospital $1,722,789, and WellSpan Health $9,868,816. These amounts are reported on the respective balance sheets for each of these entities.On April 30, 2014, $35,795,000 of Healthcare Revenue Bonds Series 2014A & 2014C were issued by Franklin County Industrial Authority. In order to remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K. As of 6/30/19, the allocation of the Debt Capital program was as follows: Waynesboro Hospital (23-1360854) $7,143,140, Chambersburg Hospital (23-0465970) $21,039,169,and Chambersburg Health Services(25-1515376) $499,518. These amounts are reported on the respective balance sheets for each of these entities. Signature Block - Paid Preparer Explanation Paid Preparer ExplanationDue to a software limitation, we wish to clarify that WellSpan Health is the ERO.The paid preparer is:BDO USA, LLP13-53815908401 Greensboro Drive, Suite 800McLean, VA 22102(703) 893-0600The preparers name is Marc Berger, PTIN P01871563 Apple Hill Surgical Center Inc PO Box 2767 York PA 174052767 222842253 Sole GP in limited ptnrshp. operating surgical center PA 501(c)(3) 10 WellSpan Health Care Services false Gettysburg Hospital PO Box 2767 York PA 174052767 231352220 Health Care Services PA 501(c)(3) 3 WellSpan Health false Gettysburg Hospital Foundation PO Box 2767 York PA 174052767 232251358 Fundraising for Gettysburg Hospital PA 501(c)(3) 12 Type I Gettysburg Hospital false Healthy Community Pharmacy Inc PO Box 2767 York PA 174052767 200519121 Reduced rate prescription drugs to uninsured PA 501(c)(3) 12 Type I WellSpan Health Care Services false VNA Community Services PO Box 2767 York PA 174052767 232338591 Home personal care services for elderly and disabled PA 501(c)(3) 10 WellSpan Specialty Services false VNA Home Health Services PO Box 2767 York PA 174052767 231352573 Home Health services PA 501(c)(3) 10 WellSpan Specialty Services false Wellspan Health PO Box 2767 York PA 174052767 222517863 Integrated Health System PA 501(c)(3) 12 Type III NA false Wellspan Health Care Services PO Box 2767 York PA 174052767 232400237 Health-related activities in the service area PA 501(c)(3) 12 Type II WellSpan Health false Wellspan Medical Group PO Box 2767 York PA 174052767 232730785 Medical and surgical care PA 501(c)(3) 10 WellSpan Health false York Health Foundation PO Box 2767 York PA 174052767 233050192 Charitable contributions for Wellspan entities PA 501(c)(3) 12 Type III WellSpan Health false WellSpan Specialty Services PO Box 2767 York PA 174052767 232899911 Surgery and Rehabilitation Hospital PA 501(c)(3) 3 WellSpan Health false Wellspan Properties Inc PO Box 2767 York PA 174052767 222842252 Leases facilities to affiliates PA 501(c)(3) 12 Type I WellSpan Health Care Services false Ephrata Community Hospital PO Box 2767 York PA 174052767 231370484 Health care services PA 501(c)(3) 3 WellSpan Health false Ephrata Community Health Foundation PO Box 2767 York PA 174052767 800940005 Fundraising for Ephrata Hospital PA 501(c)(3) 12 Type I Ephrata Community Hospital false Northern Lancaster County Medical Group PO Box 2767 York PA 174052767 203033058 Medical and surgical care PA 501(c)(3) 12 Type II Ephrata Community Hospital false Phys Spec of North Lanc Co Med Gr PO Box 2767 York PA 174052767 452537633 Physician Practices PA 501(c)(3) 12 Type II Northern Lancaster County Medical Group false Good Samaritan Hospital PO Box 2767 York PA 174052767 230794160 Health Care Services PA 501(c)(3) 3 WellSpan Health false Philhaven PO Box 2767 York PA 174052767 231549922 Health Care Services PA 501(c)(3) 3 WellSpan Health false Good Samaritan Heath Service Foundation PO Box 2767 York PA 174052767 232356151 Fundraising for Good Samaritan PA 501(c)(3) 12 Type I Good Samaritan Hospital false Good Samaritan Physician Services PO Box 2767 York PA 174052767 251832359 Medical and Surgical Care PA 501(c)(3) 10 Good Sam Health Services Foundation false WellSpan Summit Health PO Box 2767 York PA 174052767 251515371 Integrated health system PA 501(c)(3) 7 WellSpan Health false Waynesboro Hospital PO Box 2767 York PA 174052767 231360854 Health care services PA 501(c)(3) 3 WellSpan Summit false Chambersburg Hospital PO Box 2767 York PA 174052767 230465970 Health care services PA 501(c)(3) 3 WellSpan Summit false Summit Physician Services PO Box 2767 York PA 174052767 251716306 Medical and surgical care PA 501(c)(3) 3 WellSpan Summit false Summit Health Foundation PO Box 2767 York PA 174052767 831196554 Fundraising for health care system PA 501(c)(3) 12 Type II WellSpan Summit false Chambersburg Health Services PO Box 2767 York PA 174052767 251515376 Health care services PA 501(c)(3) 12 Type I WellSpan Summit false Apple Hill Surgical Center Partners PO Box 2767 York PA 174052767 232489452 Surgical Cn PA NA false false Central PA Alliance Laboratories LLC PO Box 2767 York PA 174052767 232910950 Ref. Lab PA NA false false Littlestown Health Care Partners 300 West King Street Littlestown PA 17340 232880464 Lease facility PA NA false false Cherry Tree Cancer Center LLP PO Box 2767 York PA 174052767 232915628 Radiation PA NA false false The Rehab Center 855 Springdale Drive Suite 20 Exton PA 19341 251687903 Physical Therapy Rehab PA NA false false Surgery Center Associates 785 5th Avenue Chambersburg PA 17201 251845304 Physician services PA Chambersburg Health false false Summit Surgery Center 785 5th Avenue Chambersburg PA 17201 251845303 Physcian services PA Chambersburg Health false false Cumberland Valley Mobile Services 5 S Main St Sugarloaf PA 18249 200884014 Mobile health services PA Chambersburg Health false false Wellspan Pharmacy Inc PO Box 2767 York PA 174052767 232374072 Dispenses Rx & provides IV therapy PA NA C corp false Wellspan Reciprocal Risk Retention Group PO Box 2767 York PA 174052767 200048457 Risk Retention Group PA NA C Corp 9472216 20567750 0.66710 false York Health Plan PO Box 2767 York PA 174052767 232664989 Preferred Provider Organization PA NA C corp false WellSpan Provider Network PO Box 2767 York PA 174052767 232907828 Coord mngd care risk contracting PA NA C Corp false Apple Hill Condominium Association PO Box 2767 York PA 174052767 232504543 Condo Mgmt Association PA NA Homeowner Assoc false North Lanc Co Phys Hosp Alliance PO Box 2767 York PA 174052767 232421885 Coord Phys & Hospital PA NA C corp false GSH Realty Inc PO Box 2767 York PA 174052767 251832359 Non-res. real estate PA WSH Care Services C corp false Ephrata Health Pavilion Condo Assoc PO Box 2767 York PA 174052767 475367279 Condo association PA Ephrata Hospital C corp false false true true true true false false true false true true true true false false true false false false