WAYNESBORO HOSPITAL: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- WAYNESBORO HOSPITAL (EIN 23-1360854)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-14
- IRS object ID
- 201901349349306160
- Schema version
- 2017v2.3
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-14T13:40:44-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 520783935 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SMITH ELLIOTT KEARNS & COMPANY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19 BROOKWOOD AVE STE 101 | AddressLine1Txt |
| City | CARLISLE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17015 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 231360854 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNESBORO HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WAYN | BusinessNameControlTxt |
| Phone | 7177654000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 E MAIN ST | AddressLine1Txt |
| City | WAYNESBORO | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17268 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KIMBERLY M RZOMP | PersonNm |
| Person Title | TREASURER/VP & CFO | PersonTitleTxt |
| Phone | 7177654000 | PhoneNum |
| Signature | 2019-05-14 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | GREGORY P HALL CPA | PreparerPersonNm |
| PTIN | P00156653 | PTIN |
| Phone | 7172439104 | PhoneNum |
| Preparation | 2019-05-14 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 50.192.7.141 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-14 | IPDt |
| IP Tm | 13:40:44 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 6CBB79C053B248571C9CF37C921E5AD012119690 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | F292BA449C1BF8BBA7F8F0BF46EB3EDD96736C0F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PATRICK W O'DONNELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 112 N SEVENTH STREET | AddressLine1Txt |
| City | CHAMBERSBURG | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $81,281,046 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SUMMITHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1922 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | THE WAYNESBORO HOSPITAL IS A REGIONAL NONPROFIT HEALTH CARE ORGANIZATION COMMITTED TO THE IMPROVEMENT OF THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTH-CENTRAL PENNSYLVANIA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 623 | TotalEmployeeCnt |
| Total Volunteers | 217 | TotalVolunteersCnt |
| Total Gross UBI | $135,081 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$49,888 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $140,223 | PYContributionsGrantsAmt |
| CY Contributions Grants | $104,254 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $66,620,015 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $73,341,536 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,504,146 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,176,155 | CYInvestmentIncomeAmt |
| PY Other Revenue | $735,259 | PYOtherRevenueAmt |
| CY Other Revenue | $882,195 | CYOtherRevenueAmt |
| PY Total Revenue | $70,999,643 | PYTotalRevenueAmt |
| CY Total Revenue | $77,504,140 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $37,451,511 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $37,915,391 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $22,382,319 | PYOtherExpensesAmt |
| CY Other Expenses | $25,044,410 | CYOtherExpensesAmt |
| PY Total Expenses | $59,833,830 | PYTotalExpensesAmt |
| CY Total Expenses | $62,959,801 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $11,165,813 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $14,544,339 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $139,191,250 | TotalAssetsBOYAmt |
| Total Assets EOY | $144,309,278 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $27,789,720 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $26,237,684 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $111,401,530 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $118,071,594 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE WAYNESBORO HOSPITAL IS A REGIONAL NONPROFIT HEALTH CARE ORGANIZATION COMMITTED TO THE IMPROVEMENT OF THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTH-CENTRAL PENNSYLVANIA. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $46,993,218 | ExpenseAmt |
| Revenue | $73,341,536 | RevenueAmt |
| Desc | THE WAYNESBORO HOSPITAL PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY REGARDLESS OF ANY PATIENT'S ABILITY TO PAY. HEALTH CARE SERVICES INCLUDE INPATIENT ROUTINE, INPATIENT ANCILLARY AND OUTPATIENT CARE. ALL MANAGEMENT AND GENERAL EXPENSES ARE CONSIDERED PROGRAM RELATED. | Desc |
| Total Program Service Expenses | $46,993,218 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 51 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 623 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KIMBERLY M RZOMP VPCFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7172677107 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 112 NORTH SEVENTH STREET | AddressLine1Txt |
| City | CHAMBERSBURG | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17201 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| PAUL SCHEMEL | |||||||||
| CHAIR | 0.14 | 0.45 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DR JOSEPH STEWART | |||||||||
| VICE-CHAIR | 0.07 | 0.27 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| PATRICK W O'DONNELL | |||||||||
| PRESIDENT | 6.12 | 36.58 | Yes (X) | Yes (X) | $129,391 | $733,217 | $271,314 | ||
| KIMBERLY M RZOMP | |||||||||
| TREASURER/VP | 4.00 | 37.04 | Yes (X) | Yes (X) | $48,542 | $436,875 | $71,976 | ||
| DR LISA HIGGINBOTHAM | |||||||||
| DIRECTOR | 0.12 | 40.00 | Yes (X) | $0 | $196,750 | $14,618 | |||
| DR FRANCIS ACHAMPONG | |||||||||
| DIRECTOR | 0.05 | 0.09 | Yes (X) | $0 | $0 | $0 | |||
| JOHN BLUBAUGH | |||||||||
| DIRECTOR | 0.10 | 0.27 | Yes (X) | $0 | $0 | $0 | |||
| FRANK ERVIN | |||||||||
| DIRECTOR | 0.02 | 0.24 | Yes (X) | $0 | $0 | $0 | |||
| STEVE HOLOVIAK | |||||||||
| DIRECTOR | 0.12 | 0.40 | Yes (X) | $0 | $0 | $0 | |||
| GREG DUFFEY | |||||||||
| DIRECTOR | 0.09 | Yes (X) | $0 | $0 | $0 | ||||
| DR ROBERT PYATT | |||||||||
| DIRECTOR | 0.09 | 0.22 | Yes (X) | $0 | $0 | $0 | |||
| JAMES ROCK | |||||||||
| DIRECTOR | 0.14 | 0.03 | Yes (X) | $0 | $0 | $0 | |||
| DENNIS SHOCKEY | |||||||||
| DIRECTOR | 0.14 | 0.19 | Yes (X) | $0 | $0 | $0 | |||
| BONNIE ZEHLER | |||||||||
| DIRECTOR | 0.04 | Yes (X) | $0 | $0 | $0 | ||||
| THOMAS ANDERSON | |||||||||
| VP MEDICAL A | 8.00 | 32.00 | $99,061 | $396,242 | $58,426 | Yes (X) | |||
| BARBARA ROSSINI | |||||||||
| VP COMMUNITY | 4.00 | 36.00 | $27,453 | $247,053 | $49,742 | Yes (X) | |||
| MELISSA DUBROW | |||||||||
| VP & COO | 40.00 | $258,565 | $0 | $40,344 | Yes (X) | ||||
| SHERRI STAHL | |||||||||
| SR VP HOSPIT | 8.00 | 32.00 | $87,506 | $350,024 | $67,190 | Yes (X) | |||
| MICHELE ZEIGLER | |||||||||
| VP INFORMATI | 8.00 | 32.00 | $65,572 | $262,288 | $57,331 | Yes (X) | |||
| JEFF CARTY | |||||||||
| VP OF FINANC | 40.00 | $222,765 | $0 | $42,918 | Yes (X) | ||||
| JILL KELLER | |||||||||
| VP NURSING S | 40.00 | $189,689 | $0 | $35,274 | Yes (X) | ||||
| BRUCE FOSTER | |||||||||
| ED PHYSICIAN | 40.00 | $132,336 | $0 | $24,156 | Yes (X) | ||||
| SCOTT CARD | |||||||||
| ED PHYSICIAN | 40.00 | $312,542 | $0 | $35,577 | Yes (X) | ||||
| KEVIN SANDERS | |||||||||
| ED PHYSICIAN | 40.00 | $166,608 | $0 | $15,425 | Yes (X) | ||||
| CLARENCE MILLER | |||||||||
| PATHOLOGIST | 40.00 | $219,426 | $0 | $29,508 | Yes (X) | ||||
| JARETT LOGSDON | |||||||||
| PHARMACY MAN | 40.00 | $131,978 | $0 | $16,027 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,091,434 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,622,449 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $829,826 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| FRANKLIN COUNTY EMER ASSO LLC | |||||
| 720 ORCHARD CT | CHAMBERSBURG | PA | 17201 | PROF MED SERV | $3,719,533 |
| PYRAMID CONSTRUCTION SVS INC | |||||
| 840 NORTH FRONT STREET | WORMLEYSBURG | PA | 17043 | GENERAL CONTRAC | $2,624,326 |
| GE HEALTHCARE IITS USA CORP | |||||
| 40 IDX DRIVE | SOUTH BURLINGTON | VT | 05403 | COMPUTER SERVIC | $764,241 |
| MUSSER MECHANICAL INC | |||||
| 80 LANDIS DRIVE | MERCERSBURG | PA | 17236 | PROF. SERVICES | $511,740 |
| FASTAFF LLC | |||||
| 5700 S QUEBEC STREET | DENVER | CO | 80111 | MEDICAL STAFFIN | $345,253 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 16 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $84,957 | GovernmentGrantsAmt |
| All Other Contributions | $19,297 | AllOtherContributionsAmt |
| Total Contributions | $104,254 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM SERVICE REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $73,341,536 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $73,341,536 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $73,341,536 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,478,556 | TotalRevenueColumnAmt |
| Exclusion | $2,478,556 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,435,780 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,375,502 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $60,278 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $60,278 | TotalRevenueColumnAmt |
| Exclusion | $60,278 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,099,003 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,385,000 | SecuritiesAmt |
| Other | $16,404 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $714,003 | SecuritiesAmt |
| Other | -$16,404 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $697,599 | TotalRevenueColumnAmt |
| Exclusion | $697,599 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| VHA INCENTIVE BONUS | 621990 | $272,429 | $272,429 | |
| CAFETERIA REVENUE | 621990 | $253,454 | $253,454 | |
| COURIER AND LAB SERVICES | 621500 | $135,081 | $135,081 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $160,953 | TotalRevenueColumnAmt |
| Exclusion | $160,953 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $821,917 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $77,504,140 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $73,341,536 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $135,081 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,923,269 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,368,426 | TotalAmt |
| Management And General | $1,368,426 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,531,231 | TotalAmt |
| Program Services | $22,375,055 | ProgramServicesAmt |
| Management And General | $5,156,176 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $934,119 | TotalAmt |
| Program Services | $813,482 | ProgramServicesAmt |
| Management And General | $120,637 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,063,389 | TotalAmt |
| Program Services | $4,809,457 | ProgramServicesAmt |
| Management And General | $1,253,932 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,018,226 | TotalAmt |
| Program Services | $1,574,115 | ProgramServicesAmt |
| Management And General | $444,111 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,375 | TotalAmt |
| Program Services | $17,743 | ProgramServicesAmt |
| Management And General | $12,632 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,940,357 | TotalAmt |
| Program Services | $2,885,762 | ProgramServicesAmt |
| Management And General | $2,054,595 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,908 | TotalAmt |
| Program Services | $78,218 | ProgramServicesAmt |
| Management And General | $55,690 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,371,249 | TotalAmt |
| Program Services | $800,974 | ProgramServicesAmt |
| Management And General | $570,275 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $629,395 | TotalAmt |
| Program Services | $367,642 | ProgramServicesAmt |
| Management And General | $261,753 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,339 | TotalAmt |
| Program Services | $32,909 | ProgramServicesAmt |
| Management And General | $23,430 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,769 | TotalAmt |
| Program Services | $12,716 | ProgramServicesAmt |
| Management And General | $9,053 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,567,616 | TotalAmt |
| Program Services | $1,945,778 | ProgramServicesAmt |
| Management And General | $1,621,838 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $479,810 | TotalAmt |
| Program Services | $280,267 | ProgramServicesAmt |
| Management And General | $199,543 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHYSICIAN CONTRACTUAL PAY | $7,046,035 | $7,046,035 | |
| SUPPLIES | $6,625,214 | $3,869,920 | $2,755,294 |
| MISCELLANEOUS EXPENSE | $78,429 | $45,812 | $32,617 |
| DUES | $63,914 | $37,333 | $26,581 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,959,801 | TotalAmt |
| Program Services | $46,993,218 | ProgramServicesAmt |
| Management And General | $15,966,583 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,125 | BOYAmt |
| EOY | $1,125 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,350,025 | BOYAmt |
| EOY | $9,344,335 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,671 | BOYAmt |
| EOY | $22,615 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,614,128 | BOYAmt |
| EOY | $6,194,059 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $345,257 | BOYAmt |
| EOY | $359,076 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $253,261 | BOYAmt |
| EOY | $278,827 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $746,746 | BOYAmt |
| EOY | $876,706 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $101,720,964 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $61,122,440 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,401,180 | BOYAmt |
| EOY | $40,598,524 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,195,801 | BOYAmt |
| EOY | $24,539,123 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,054,788 | BOYAmt |
| EOY | $58,325,581 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $162,023 | BOYAmt |
| EOY | $142,962 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,051,245 | BOYAmt |
| EOY | $3,626,345 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $139,191,250 | BOYAmt |
| EOY | $144,309,278 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,033,728 | BOYAmt |
| EOY | $8,096,459 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,612,507 | BOYAmt |
| EOY | $13,039,117 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,143,485 | BOYAmt |
| EOY | $5,102,108 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,789,720 | BOYAmt |
| EOY | $26,237,684 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,118,326 | BOYAmt |
| EOY | $114,732,876 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,471 | BOYAmt |
| EOY | $22,615 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,269,733 | BOYAmt |
| EOY | $3,316,103 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,401,530 | BOYAmt |
| EOY | $118,071,594 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $139,191,250 | BOYAmt |
| EOY | $144,309,278 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $14,544,339 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $526,019 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$8,400,294 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,507,802 | BeginningYearBalanceAmt |
| Contributions | $136,108 | ContributionsAmt |
| Investment Earnings Or Losses | $597,504 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$8,251 | OtherExpendituresAmt |
| Administrative Expenses | -$4,510 | AdministrativeExpensesAmt |
| End Year Balance | $10,228,229 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,591,208 | BeginningYearBalanceAmt |
| Contributions | $128,985 | ContributionsAmt |
| Investment Earnings Or Losses | $800,942 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$8,675 | OtherExpendituresAmt |
| Administrative Expenses | -$4,658 | AdministrativeExpensesAmt |
| End Year Balance | $9,507,802 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,609,595 | BeginningYearBalanceAmt |
| Contributions | $138,437 | ContributionsAmt |
| Investment Earnings Or Losses | -$143,310 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$8,509 | OtherExpendituresAmt |
| Administrative Expenses | -$5,005 | AdministrativeExpensesAmt |
| End Year Balance | $8,591,208 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,355,696 | BeginningYearBalanceAmt |
| Contributions | $191,429 | ContributionsAmt |
| Investment Earnings Or Losses | $73,178 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$6,513 | OtherExpendituresAmt |
| Administrative Expenses | -$4,195 | AdministrativeExpensesAmt |
| End Year Balance | $8,609,595 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,379,981 | BeginningYearBalanceAmt |
| Contributions | $127,977 | ContributionsAmt |
| Investment Earnings Or Losses | $859,000 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$6,878 | OtherExpendituresAmt |
| Administrative Expenses | -$4,388 | AdministrativeExpensesAmt |
| End Year Balance | $8,355,696 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.95450 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.04550 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $3,009,243 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $1,083,234 | OtherCostOrOtherBasisAmt |
| Book Value | $4,092,477 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $17,216,780 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $20,619,448 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,293,684 | DepreciationAmt |
| Book Value | $23,542,544 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,247,779 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $58,544,480 | OtherCostOrOtherBasisAmt |
| Depreciation | $46,828,756 | DepreciationAmt |
| Book Value | $12,963,503 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $40,598,524 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (6 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| FIXED INCOME | $34,188,325 | F |
| REAL ASSETS | $21,059,900 | F |
| CASH AND MONEY FUNDS | $2,288,985 | F |
| PARTNERSHIPS | $670,083 | F |
| FIXED INCOME MUTUAL FUNDS | $118,279 | F |
| OTHER SECURITIES | $9 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $58,325,581 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED PAYABLES TO THIRD PARTY | $4,849,308 |
| ADVANCES FROM THIRD PARTY PAYORS | $252,800 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,102,108 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $78,030,159 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $526,019 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $526,019 | RevenueNotReportedAmt |
| Revenue Subtotal | $77,504,140 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $77,504,140 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $62,959,801 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $62,959,801 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $62,959,801 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 2, PART V, LINE 4 | ENDOWMENT FUNDS ARE TO BE USED FOR THE DEVELOPMENT OR EXPANSIONS OF COMMUNITY HEALTHCARE INITIATIVES AND PROGRAMS. FUNDS ARE ALSO USED TO EDUCATE THE COMMUNITY ABOUT HEALTHCARE ISSUES. |
| SCHEDULE D, PAGE 3, PART X | WHEN TAX RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD BE ULTIMATELY SUSTAINED. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH , BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORITON OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE WOULD BE REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED TAX BENEFITS WOULD BE CLASSIFIED AS EXPENSES AGAINST OTHER OPERATING REVENUE IN THE STATEMENTS OF OPERATIONS. AT JUNE 30, 2018 AND 2017, THERE WAS NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS. |
| SCHEDULE D, PAGE 4, PART XII, LINE 4B | -746,473 BOOK / TAX DEPRECIATION DIFFERENCE 746,473 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | false | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $778,735 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $778,735 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01240 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,948,159 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,100,414 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,847,745 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07700 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,726,894 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,100,414 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,626,480 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08940 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $87,866 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $87,866 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $46,612 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $46,612 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $33,303 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $33,303 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,783 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $18,783 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $87,515 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $87,515 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $274,079 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $274,079 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00430 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,000,973 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,100,414 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,900,559 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09370 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,366,444 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $9,534,536 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $10,530,051 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$995,515 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNESBORO HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 501 EAST MAIN STREET | AddressLine1Txt |
| City | WAYNESBORO | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17268 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WAYNESBORO HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.SUMMITHEALTH.ORG | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | WWW.HEALTHYFRANKLINCOUNTY.ORG | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.SUMMITHEALTH.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.SUMMITHEALTH.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.SUMMITHEALTH.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.SUMMITHEALTH.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, WAYNESBORO HOSPITAL - PART V, LINE 5 | THE ORGANIZATION FORMED AN ADVISORY GROUP WHICH IS COMPOSED OF A CORE GROUP OF AGENCIES AND COMMUNITY LEADERS IN FRANKLIN COUNTY. THE ORGANIZATION ALSO CONTRACTED THE PENN STATE HARRISBURG'S INSTITUTE OF STATE AND REGIONAL AFFAIRS. PENN STATE OBTAINED DATA THROUGH THE USE OF FOCUS GROUPS, A COMMUNITY HEALTH SURVEY, AND RESEARCHING SECONDARY DEMOGRAPHIC AND HEALTH DATA. |
| FACILITY 1, WAYNESBORO HOSPITAL - PART V, LINE 6A | THE CHAMBERSBURG HOSPITAL |
| FACILITY 1, WAYNESBORO HOSPITAL - PART V, LINE 6B | HEALTHY FRANKLIN COUNTY |
| FACILITY 1, WAYNESBORO HOSPITAL - PART V, LINE 7D | ONE JUNE 9, 2016, SUMMIT HEALTH AND HEALTHY FRANKLIN COUNTY FACILITATED A COMMUNITY HEALTH SUMMIT ON THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT. THERE WERE 121 INDIVIDUALS WHO ATTENDED THE HEALTH SUMMIT, REPRESENTING HEALTHCARE ORGANIZATIONS, COMMUNITY ORGANIZATIONS, EDUCATION INSTITUTIONS, LOCAL GOVERNMENT, AND COMMUNITY. |
| FACILITY 1, WAYNESBORO HOSPITAL - PART V, LINE 11 | A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) WAS DEVELOPED. |
| FACILITY 1, WAYNESBORO HOSPITAL - PART V, LINE 16J | INFORMATION AND APPLICATION CAN BE FOUND ON THE BACK OF A PATIENT BILLING STATEMENT. |
| FACILITY 1, WAYNESBORO HOSPITAL - PART V, LINE 20E | FINANCIAL COUNSELORS CALL AND SEND LETTERS TO SELF PAY PATIENTS OR PATIENTS WITH HIGH DEDUCTIBLE PLANS THAT RECEIVE EMERGENCY DEPARTMENT, SURGICAL, OR I/P SERVICES. |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE | IF A FAMILY HAS LIQUID ASSETS AVAILABLE, THEY ARE EXPECTED TO CONTRIBUTE TO THE COST OF THEIR CARE USING THOSE FUNDS. HOWEVER, THEY ARE NOT REQUIRED TO SPEND DOWN ALL OF THEIR LIQUID ASSETS IN ORDER TO BE ELIGIBLE FOR A DISCOUNT. PATIENTS MAY RETAIN SIX MONTHS OF LIVING EXPENSES FROM THEIR LIQUID ASSETS. SIX MONTHS OF LIVING EXPENSES IS ESTIMATED TO BE ONE HALF OF 300% OF FPG. AT THAT POINT, THEY RECEIVE A DISCOUNT ON THEIR MEDICAL BILL. |
| PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION | THE INFORMATION WAS OBTAINED USING THE COST METHODS USED IN PREPARING THE MEDICARE COST REPORTS. |
| PART II - COMMUNITY BUILDING ACTIVITIES | WAYNESBORO HOSPITAL WORKS TO STRENGTHEN OUR COMMUNITY THROUGH HEALTH EDUCATION EFFORTS FOR CHILDREN AND ADULTS, HEALTH FAIRS PROVIDING DIAGNOSTIC TESTING, EDUCATING COMMUNITY GROUPS OF SPECIFIC HEALTH TOPICS, FUNDING LOCAL COMMUNITY ORGANIZATIONS THROUGH THE SUMMIT HEALTH ENDOWNMENT PROGRAM, PROVIDING RESOURCES FOR THE "HEALTHY COMMUNITIES PARTNERSHIP" PROGRAM, PARTICIPATING IN LOCAL CIVIC ORGANIZATIONS, SPONSORING EVENTS HELD BY LOCAL CHARITABLE ORGANIZATIONS, AND SUPPORTING WORKFORCE DEVELOPMENT INITIATIVES THROUGH SUMMIT HEALTH'S SCHOOL LIAISON DEPARTMENT. |
| PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY | FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE COST TO CHARGE RATIO WAS USED TO CALCULATE THE COST OF BAD DEBT EXPENSE. THIS RATIO IS CALCULATED AS FOLLOWS: (NET PATIENT REVENUE DIVIDED BY THE TOTAL OPERATING REVENUE MULTIPLIED BY THE TOTAL OPERATING EXPENSE) DIVIDED BY THE GROSS PATIENT REVENUE. |
| BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS | THE HOSPITAL PROVIDES CREDIT IN THE NORMAL COURSE OF ITS BUSINESS TO PATIENTS. PATIENT RECEIVABLES ARE BASED ON THE OUTSTANDING PATIENT BALANCE AFTER ANY CONTRACTUAL REIMBURSEMENTS ARE APPLIED AND ARE GENERALLY DUE 30 DAYS AFTER BILLED. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD- PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| PART III, LINE 8 - MEDICARE EXPLANATION | THE INFORMATION WAS OBTAINED USING THE COST METHODS USED IN PREPARING THE MEDICARE COST REPORTS. THE SHORTFALL ABOVE RELATES TO OUR MISSION OF PROVIDING SERVICES TO MEMBERS OF OUR COMMUNITY. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | ALL PATIENTS ARE SUBJECT TO THE DEBT COLLECTION POLICY REGARDLESS OF THEIR ABILITY TO PAY. |
| PART VI, LINE 2 - NEEDS ASSESSMENT | HEALTH NEEDS OF FRANKLIN COUNTY RESIDENTS AND SURROUNDING COMMUNITIES ARE ASSESSED THROUGH NUMEROUS RESEARCH METHODS INCLUDING CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENT(TELEPHONE SURVEY FORMAT) IN 2012. THE NEEDS WERE IDENTIFIED BY KEY LEADERS AND NONPROFITS WITHIN THE COMMUNITY. FOUR PRIORITIES WERE DETERMINED: ACCESS TO HEALTHCARE, NUTRITION, EDUCATION AND MENTAL HEALTH. THE COMMUNITY NEEDS ASSESSMENT CAN BE FOUND ON OUR WEBSITE AT WWW.SUMMITHEALTH.ORG/ABOUTUS. |
| PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PATIENTS ARE MADE AWARE OF THE CHARITY PROGRAM AND OTHER BILLING ASSISTANCE SERVICES AT REGISTRATION, DURING EMERGENCY ROOM VISITS, AND NOTICES PLACED IN SERVICE AREAS. BILLING STATEMENTS ARE ALSO INFORM PATIENTS OF CHARITY CARE AND OTHER BILLING ASSISTANCE PROGRAMS. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | WAYNESBORO HOSPITAL PRIMARILY SERVES COMMUNITY MEMBERS FROM FRANKLIN AND FULTON COUNTY, PA, AND NEARBY COMMUNITIES IN WASHINGTON COUNTY, MD. ACCORDING TO U.S. CENSUS DATA, FRANKLIN COUNTY RESIDENTS HAVE A SLIGHTLY LOWER INCOME AND ARE SLIGHTLY OLDER THAN THE STATE AVERAGE. FOR A HEALTH SYSTEM, THIS TYPICALLY RESULTS IN AN INCREASED NEED FOR HEALTHCARE SERVICES. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | WAYNESBORO HOSPITAL SUPPORTS LOCAL NON-PROFIT ORGANIZATIONS WITH FINANCIAL GRANTS FROM THE SUMMIT ENDOWMENT. |
| PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM | THE HOSPITAL IS PART OF SUMMIT HEALTH, A REGIONAL NETWORK OF HOSPITALS AND HEALTHCARE PROVIDERS THAT ARE SERVED BY THE ORGANIZATION'S COMMUNITY HEALTH DEPARTMENT. THIS DEPARTMENT'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITY THROUGH EDUCATION, DETECTION AND PREVENTION PROGRAMS INCLUDING HEALTH FAIRS, SCREENINGS, AND SEMINARS. THIS MISSION IS COMPLETED ON BEHALF OF WAYNESBORO HOSPITAL AND ALL OTHER SUMMIT AFFILIATES. PART OF THIS MISSION IS COMPLETED THROUGH COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS INCLUDING THE PA DEPARTMENT OF HEALTH. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PATRICK W O'DONNELL | ||||||||||||
| PRESIDENT | $93,453 | $529,568 | $29,520 | $167,280 | $6,418 | $36,369 | $33,660 | $190,739 | $7,037 | $39,878 | $170,088 | $963,834 |
| KIMBERLY M RZOMP | ||||||||||||
| TREASURER/VP & CFO | $37,649 | $338,842 | $8,145 | $73,301 | $2,748 | $24,732 | $5,300 | $47,700 | $1,898 | $17,078 | $55,740 | $501,653 |
| DR LISA HIGGINBOTHAM | ||||||||||||
| DIRECTOR | $182,732 | $13,788 | $230 | $5,818 | $8,800 | $211,368 | ||||||
| THOMAS ANDERSON | ||||||||||||
| VP MEDICAL AFFAIRS | $76,424 | $305,696 | $16,146 | $64,583 | $6,491 | $25,963 | $7,839 | $31,357 | $3,846 | $15,384 | $110,746 | $442,983 |
| BARBARA ROSSINI | ||||||||||||
| VP COMMUNITY RELATIO | $20,757 | $186,809 | $4,585 | $41,241 | $2,111 | $19,003 | $2,593 | $23,341 | $2,381 | $21,427 | $32,427 | $291,821 |
| MELISSA DUBROW | ||||||||||||
| VP & COO | $187,949 | $41,011 | $29,605 | $13,787 | $26,557 | $298,909 | ||||||
| SHERRI STAHL | ||||||||||||
| SR VP HOSPITAL SERVI | $67,660 | $270,639 | $14,608 | $58,433 | $5,238 | $20,952 | $9,389 | $37,557 | $4,049 | $16,195 | $100,944 | $403,776 |
| MICHELE ZEIGLER | ||||||||||||
| VP INFORMATION SERVI | $49,322 | $197,287 | $10,493 | $41,973 | $5,757 | $23,028 | $9,554 | $38,218 | $1,912 | $7,647 | $77,038 | $308,153 |
| JEFF CARTY | ||||||||||||
| VP OF FINANCE | $181,981 | $22,645 | $18,139 | $12,917 | $30,001 | $265,683 | ||||||
| JILL KELLER | ||||||||||||
| VP NURSING SERVICES/ | $171,127 | $9,614 | $8,948 | $11,005 | $24,269 | $224,963 | ||||||
| BRUCE FOSTER | ||||||||||||
| ED PHYSICIAN | $127,401 | $4,935 | $8,133 | $16,023 | $156,492 | |||||||
| SCOTT CARD | ||||||||||||
| ED PHYSICIAN | $301,430 | $11,112 | $16,200 | $19,377 | $348,119 | |||||||
| KEVIN SANDERS | ||||||||||||
| ED PHYSICIAN | $166,469 | $139 | $9,996 | $5,429 | $182,033 | |||||||
| CLARENCE MILLER | ||||||||||||
| PATHOLOGIST | $215,399 | $4,027 | $13,419 | $16,089 | $248,934 | |||||||
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 1A | THE ORGANIZATION REIMBURSES THE COO FOR DUES ASSOCIATED WITH A SOCIAL CLUB. THE OFFICER RECEIVES 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 4 | PATRICK W. O'DONNELL 0 2,700 0 KIMBERLY M. RZOMP 0 1,800 0 THOMAS ANDERSON 0 3,600 0 BARBARA ROSSINI 0 1,293 0 MELISSA DUBROW 0 11,551 0 SHERRI STAHL 0 3,600 0 MICHELE ZEIGLER 0 3,012 0 |
| SCHEDULE J, PAGE 1, PART I, LINE 7 | INCENTIVE COMPENSATION IS BASED ON PRE-DETERMINED, MEASURABLE GOALS APPROVED BY THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE. THE MEASUREABLE GOALS ARE BASED ON QUALITY, COMMUNITY ACCESS TO CARE, PATIENT SAFETY, AND LEADERSHIP. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 COMMITEE 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 WAYNESBORO HOSPITAL. HOSPITAL BYLAWS AND ALL POLICIES AND PROCEDURES ARE FOUND ON THE WAYNESBORO HOSPITAL INTRANET. |
| FORM 990, PART XI, LINE 9 | NET TRANSFERS TO AFFILIATES -8,400,294 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SUMMIT PHYSICIAN SERVICES | ||||||||||
| 785 5TH AVENUE SUITE 3 | CHAMBERSBURG | PA | 17201 | 251716306 | HEALTHCARE | PA | 501C3 | 3 | SUMMIT HEA | Yes (true) |
| CHAMBERSBURG HOSPITAL | ||||||||||
| 112 NORTH SEVENTH STREET | CHAMBERSBURG | PA | 17201 | 230465970 | HEALTHCARE | PA | 501C3 | 3 | SUMMIT HEA | Yes (true) |
| CHAMBERSBURG HEALTH SERVICES | ||||||||||
| 785 5TH AVENUE SUITE 5 | CHAMBERSBURG | PA | 17201 | 251515376 | HEALTHCARE | PA | 501C3 | 12A | SUMMIT HEA | Yes (true) |
| SUMMIT HEALTH | ||||||||||
| 112 NORTH SEVENTH STREET | CHAMBERSBURG | PA | 17201 | 251515371 | HEALTHCARE | PA | 501C3 | 7 | SUMMIT HEA | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |