2017-05-10T08:07:47-07:00 2016-06-30 WELLSPAN HEALTH 3350 WHITEFORD ROAD YORK PA 17403 990 2015-07-01 231548822 WELLSPAN PHILHAVEN WELL 7178513055 PO BOX 2767 YORK PA 17405 Michael O'Connor CFO 2017-05-10 false DAVID P RIZZUTO P01210563 7178513095 2015 2021-01-29 14:40:06Z X Kevin Mosser MD PO Box 2767 York PA 174052767 77628577 false false X WWW.WELLSPAN.ORG X 1949 PA WellSpan Philhaven provides behavioral health services to individuals in Central PA 17 15 1321 110 471271 -34290 519455 7700727 62296472 63386911 136382 87353 963250 571408 63915559 71746399 56000 7352853 0 47478263 50493913 60983 0 251906 14154361 14036149 61749607 71882915 2165952 -136516 37680180 42336927 10035243 14834538 27644937 27502389 WellSpan Philhaven promotes hope, healing and wholeness through the provision of behavioral resources. false false 62207218 7352853 63386911 WellSpan Philhaven's inpatient psychiatric program is available to individuals who are in most severe distress and/or danger of harming themselves or others. The inpatient program provides a 24-hour a day therapeutic milieu and interventions that serve to stabilize acute psychiatric symptoms. Services are provided to children and adolescents ages three to eighteen and adults over eighteen years of age. Typical length of stay is approximately eleven days for both adults and children/adolescents. Additionally, Philhaven offers extended acute psychiatric inpatient services for adults that require long-term intensive interventions to stabilize their symptoms. Once behavioral stabilization is achieved, the patient is then prepared for transition to the next appropriate level of care. WellSpan Philhaven's children's and adolescents' Behavioral Health Rehabilitation Services (BHRS) program includes both community based and after school services. The goal of all BHRS services is to enhance the child's or adolescent's ability to function emotionally, socially and behaviorally. Indivualized interventions serve to facilitate youth's behavioral stabilization and emotional growth. Mental health specialists help youth learn skills and coping strategies which enable the youth to prevent deterioration and more restrictive services. Afterschool services are provided Monday through Friday after school for children ages six to twelve years. Community based services are provided in schools and homes by trained therapeutic support staff, mobile therapists and behavioral specialist consultants. The outpatient program provides the least restrictive type of mental health treatment available at WellSpan Philhaven. Staff who are professionally trained in psychiatry, psychology, social work and counseling strive to provide outpatient services to clients in a conscientious and caring manner as they work toward their therapeutic goals. WellSpan Philhaven strives to provide individuals and their families with the skills and resources necessary to live healthy, fulfilled lives within their homes and communities. Specific services offered include evaluations and assessments, psychiatric medication management, psychiatric consultation, individual therapy, family therapy, group therapy and marriage counseling. See Attached Federal Supplemental Information: WellSpan Health - 2016 Community Benefit Report 62207218 true true false true false false false false false true true false false false true true false true false false false false false false true false true true true false true false false false false false false false false false false false false false false false false true false false false false true 122 0 true 1321 true true true false false false false true true false 0 false false false false false false false false false false X 17 15 false false false false true true true true true false false true true true true true true true true true true PA X DAVID P RIZZUTO 7178513055 3350 WHITEFORD ROAD YORK PA 174029081 X Kevin Mosser MD CEO/Director 1.00 40.00 X X 0 1060758 821679 George Stoltzfus President 1.00 0.00 X X 0 0 0 Janet Stauffer Vice President 1.00 0.00 X X 0 0 0 Kenneth Moore Treasurer 1.00 0.00 X X 0 0 0 Moniqua Acosta Secr/Vice Pres. 1.00 0.00 X X 0 0 0 Audrey Groff Secretary 1.00 0.00 X X 0 0 0 Janet Breneman Director 1.00 0.00 X 0 0 0 Duane Britton Director 1.00 0.00 X 0 0 0 Rebecca Burkholder Director 1.00 0.00 X 0 0 0 Robert Fortna Director 1.00 0.00 X 0 0 0 James Herr Director 1.00 0.00 X 0 0 0 Robert Hoffman Director 1.00 0.00 X 0 0 0 Kyle Horst Director 1.00 0.00 X 0 0 0 Karen Jones MD Director 1.00 40.00 X 0 429939 252402 Sam Thomas Director 1.00 0.00 X 0 0 0 David Warren Director 1.00 0.00 X 0 0 0 Aaron Groff Director 1.00 0.00 X 0 0 0 Michael O'Connor CFO-WSH 1.00 40.00 X 0 698953 488337 Philip Hess CEO until 12/15 40.00 0.00 X 214502 0 40776 Matthew Rogers CFO until 12/15 40.00 0.00 X 125521 0 25620 Olaniyi Oluleye Physician 40.00 0.00 X 253438 0 43877 Umar Khayyam Physician 40.00 0.00 X 255347 0 34415 Jeremy Walters Physician 40.00 0.00 X 248320 0 41217 Dele Omije Physician 40.00 0.00 X 282753 0 20566 Jose Montaner Physician 40.00 0.00 X 248227 0 41070 1628108 2189650 1809959 34 false true false Daval Services LLC 275 Cumberland Parkway 245 Mechanicsburg PA 17055 Pharmacy Services 400677 Allcare Family Health PC PO Box 1210 Lebanon PA 17042 Medical Services 335000 Zimmeys Automotive of Schaefferstown PO Box 322 Schaefferstown PA 17088 Vehicle Repair/Renta 284458 Comphealth PO Box 972651 Dallas TX 753972651 Temporary Staffing 205905 McNees Wallace & Nurck PO Box 1166 Harrisburg PA 171081166 Pharmacy Services 171687 9 12445 7260000 428282 7700727 NET PATIENT SERVICE REV 63751126 63751126 W/O BAD DEBTS -192603 -192603 W/O FINANCIAL ASSISTANCE -171612 -171612 63386911 84172 84172 0 0 8906 8906 8906 8906 5862758 13462 5873039 -10281 13462 3181 3181 5139 12445 9139 -4000 -4000 0 0 CAFETERIA SALES 722210 95231 95231 FARM INCOME 471271 471271 566502 71746399 63386911 471271 187490 7352853 7352853 0 0 0 406419 406419 0 42216643 37804364 4273508 138771 389286 340673 47370 1243 4423820 3859788 549606 14426 3057745 2675900 372078 9767 0 32821 32821 102020 102020 65584 65584 0 0 1852846 1158862 657409 36575 51703 4857 46846 0 0 0 935507 935507 517373 461465 50042 5866 0 117139 84233 31966 940 263818 263818 0 2131617 1662488 461329 7800 1023850 1023850 Supplies 2752917 2065830 679411 7676 Repair & Maintenence 1030727 123467 907260 Outside Services 974354 595251 374659 4444 Utilities 968284 912213 55099 972 1215589 881799 310364 23426 71882915 62207218 9423791 251906 23033 918792 5726637 0 1194279 355111 8304917 14358054 0 0 340000 340000 10535 16226 1324182 948695 50825005 32618594 17787281 18206411 1468462 3720043 939861 1787594 0 3096 1946 557897 1684055 37680180 42336927 5848902 4487511 365 365 2820303 2311992 100000 7000000 1265673 1034670 10035243 14834538 X 26482345 26302061 567006 611226 595586 589102 27644937 27502389 37680180 42336927 -136516 -6032 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 65584 65584 false false Part II-B, Line 1i - Other Activities Description The hospital engaged a professional lobbying firm to assist in securing governmental funding for specialized programs ($60,000). In addition, a portion of the dues paid to the Hospital Association of Pennsylvania and the American Hospital Association include lobbying ($3,534 and $2,050). 683218 840118 -6032 316976 1200328 670163 13055 683218 605882 64281 670163 475713 80560 49609 605882 490269 -14556 475713 0.49100 0.50900 true true true 355952 355952 20465681 11907657 8558024 1584738 1275410 309328 28259286 19409626 8849660 159348 25901 133447 18206411 Insurance Reserve 988770 Third Party Advances-Blue Cross-Other 45900 1034670 X 71904373 201742 201742 71702631 43768 43768 71746399 72084657 201742 201742 71882915 71882915 Part V, Line 4: Intended uses of the endowment fund. The purpose of these donor-restricted funds is to provide a stable source of perpetual financial support for the WellSpan Philhaven programs. 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, 2016. Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990 Expenses netted against revenue $201742 Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S Restricted Contributions Net $43768 Part XII, Line 2d: Other expenses and losses per audited F/S Expenses netted against revenue $201742 X X X X X X X true Benevon 4528 Eight Avenue NE Seattle WA 98105 Consult on Fundraising false 79983 20000 59983 79983 20000 59983 Golf Tournament 17584 12445 5139 9139 17584 12445 5139 9139 9139 -4000 true true X true X 300.000000000 true X true true false false true true 607892 343782 264110 0.00370 39288167 38185018 1103149 0.01530 39896059 38528800 1367259 0.01900 1737738 1397942 339796 0.00470 106405 106405 0.00150 1844143 1397942 446201 0.00620 41740202 39926742 1813460 0.02520 4385 4385 0.00010 4385 4385 0.00010 false 204242 2525391 2633338 -107947 X true true 1 1 WellSpan Philhaven 283 South Butler Road Mount Gretna PA 17064 www.wellspan.org 318550 X Behavioral Health Hospital false false true X X X X X X X X 15 true true false true X www.wellspan.org true 15 true www.wellspan.org false false true X 300.0000 400.0000 X X X X X X X true true X X X X true X www.wellspan.org X www.wellspan.org X www.wellspan.org X X X X X true X false X X X X X false X X false false Part V, Line 5 - Account Input from Persons Who Represent the Community Prior to its affiliation with WellSpan Health in 2016, WellSpan-Philhaven conducted an independent Community Health Needs Assessment (CHNA) across its multi-county service area. The most recent CHNA, finalized in May 2013, employed secondary data and input obtained at two community forums to identify the following three priorities: the need for integrated treatment models; a focus on the prevention of behavioral health issues, and; a reduction in emergency department usage by those experiencing mental issues. In 2016, WellSpan-Philhaven affiliated with WellSpan Health and, as such, reviewed and adopted the current WellSpan CHNA, finalized in May 2016. The service areas of both WellSpan Health and WellSpan-Philhaven are nearly identical and system leadership felt that, given the chronological alignment of data collection and analysis, CHNA adoption was appropriate. Therefore, the WellSpan Planning Committee prioritized results from the CHNA and these results were presented to WellSpan-Philhaven leadership for their adoption. In addition, CHNA results were also presented at county-specific community forums for the diverse input of county residents and community stakeholders. Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment WellSpan Ephrata Community Hospital (Lancaster); WellSpan Gettysburg Hospital (Adams), and WellSpan Surgery and Rehabilitation Hospital and York Hospital (York) Part V, Line 13b - Criteria For Providing Discounted Care If Not FPG WellSpan Health's policy is that 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.For the first half of this fiscal year, before becoming affiliated with WellSpan Health, Philhaven used 150% of FPG for free care and 300% for discounted care. Part V, Line 13h - Other Factors Used in Determing Amounts Charged Patients 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. Part V, Line 16i - Other Means Hospital Facility Publicized the Policy 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. Part V, Line 21d - Other Reason Not Having Nondiscriminatory Policy for Emergency Medical Care WellSpan Philhaven does not have a dedicated emergency department as that term is defined under EMTALA and therefore EMTALA does not apply. Part V, Line 22d - Other Billing Determination of Individuals Without Insurance 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. 17 WellSpan Philhaven Prince Street Programs 812 N Prince St Lancaster PA 17604 Behavioral Healthcare Clinic WellSpan Philhaven Dauphin County Programs 2601 Herr St Harrisburg PA 17103 Behavioral Healthcare Clinic Lancaster Child & Adol Day Program 780 Eden Road Bldg 5 Lancaster PA 17601 Behavioral Healthcare Clinic York Child & Adol Day Program 1245A West Princess St York PA 17404 Behavioral Healthcare Clinic Hathaway Park Outpatient Clinic 204 Hathaway Park Lebanon PA 17042 Behavioral Health Clinic Lebanon Outpatient Clinic 962-964 Isabel Drive Lebanon PA 17042 Behavioral Healthcare Clinic Ephrata Outpatient Clinic 354 N Reading Road Ephrata PA 17522 Behavioral Healthcare Clinic CADD Outpatient Clinic 1886 Rohrerstown Road Lancaster PA 17601 Behavioral Healthcare Clinic Lebanon ACT 20 South 8th Street Suite 1 Lebanon PA 17042 Behavioral Healthcare Clinic Lancaster ACT 315 W James Street Lancaster PA 17603 Behavioral Healthcare Clinic Lancaster Outpatient Clinic 1884 Rohrerstown Road Lancaster PA 17601 Behavioral Healthcare Clinic Elizabethtown Outpatient Clinic 422 Cloverleaf Road Elizabethtown PA 17022 Behavioral Healthcare Clinic Lebanon Crisis 229 South 4th Street Lebanon PA 17042 Crisis Intervention Lancaster Diversion Program 101 Euclid Avenue Lancaster PA 17603 Community based residential behavioral health Lancaster Area Psychiatric Services 1120 Francis Ave Lancaster PA 17602 Behavioral Healthcare Clinic Water Street Outpatient Clinic 210 South Prince Street Lancaster PA 17603 Behavioral Healthcare Clinic Paxton Street Outpatient Clinic 2001 Paxton Street Harrisburg PA 17111 Behavioral Healthcare Clinic Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) For the first half of this fiscal year, before becoming affiliated with WellSpan Health, Philhaven used 150% of FPG for free care and 300% for discounted care. 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. 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 - Explanation Of How Organization Furthers Its Exempt Purpose As the largest behavioral health provider in southcentral Pennsylvania, WellSpan-Philhaven is committed to transforming care by integrating behavioral and physical health services in the primary care setting, training hundreds of community members in mental health first aid, and increasing awareness of and prevention opportunities for key behavioral health issues. WellSpan-Philhaven also plays leadership roles on community behavioral health-related task forces including Lets Talk Lancaster!, the Lebanon County Suicide Prevention Task Force, and multiple county-level opioid prevention committees. Care transformation both in the practice setting and the surrounding community is occurring through the recent affiliation between Philhaven and WellSpan Health. Since its integration with WellSpan Health, WellSpan-Philhaven has also participated in system-wide initiatives to address the shared community health priorities of depression (mental health) and adult overweight/obesity. The Feeling Blue depression awareness campaign (www.feeling-blue.com) originated as a resource for York and Adams County adults suffering from mild depression. In 2016, Feeling Blue expanded to Lebanon County and continues to be a valuable resource for its community members. WellSpan-Good Samaritan Hospital also implemented the regional 10Lb. Throwdown initiative, 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 to address the growing issue of adult overweight/obesity, and utilizes a core website (www.10poundthrowdown.com) on which may be found an online weight tracker, physical activity program (Make the Most of the Coast), and tips that promote a healthier lifestyle. More than 1900 community members across three southcentral Pennsylvania counties Adams, Lancaster, Lebanon, and York participated in the 2016 iteration of the 10Lb. Throwdown program. Additional examples of how WellSpan-Philhaven has advanced behavioral health and fulfilled its community mission across southcentral Pennsylvania may be found in the 2016 WellSpan Community Benefit Report available online at www.wellspan.org. Part VI - Affilated Health Care System Roles and Promotion After its affiliation with WellSpan Health, a regional health care system, WellSpan-Philhaven adopted the current CHNA conducted by WellSpan, started in 2014 and finalized in 2015. This CHNA enabled WellSpan-Philhaven to access primary data collected across its multiple county service area, share it with key community, hospital and system leaders, and integrate it into the system-wide and entity-level planning processes. Through the consulting support of the Floyd Institute for Public Policy at Franklin and Marshall College. a representative sample of 3422 adults across the four-county region (769 Adams County, 729 Lancaster, 896 Lebanon, and 1028 York) were interviewed between two time periods October 27-December 12, 2014 and February 23-May 5, 2015 using survey questions derived from the Behavioral Risk Factor Surveillance System (BRFSS), a validated survey tool utilized by the Centers for Disease Control and Prevention (CDC). BRFSS questions were organized into four categories: healthcare access, behavioral risk, health conditions, and prevention behaviors and context. Supplemental secondary data from the Robert Wood Johnson Foundation (RWJF) annual County Health Rankings and from the Pennsylvania Department of Health was compiled and integrated into the 2015 CHNA. Data collected and analyzed by the Floyd Institute for Public Policy included breakdowns by age, gender, geographic area, race/ethnicity, and income level, and enabled the development of charts/graphs focused on: quantity of residents affected; health risks and disability-adjusted life years; correlates of obesity and depression (two significant health priorities); health disparities, and; social determinants of health impact. This information is included in the 2015 Community Health Needs Assessment Summary Report available at www.wellspan.org. In 2015, CHNA results and related priorities identified across the region were shared with the system-wide Planning Committee at WellSpan Health. This Committee is 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 adopted the community priorities of adult overweight/obesity and depression/mental health while also identifying two additional priorities: access related to gaps in care caused by high-deductible insurance plans and the emerging opioid misuse and abuse issue facing the community. These priorities and associated data were subsequently presented to WellSpan-Philhaven leadership for their adoption. CHNA results were made available to the public on the WellSpan Health (www.wellspan.org) website, and may also be obtained upon request. 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 Philhaven 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, Apple Hill Surgical 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, WellSpan Population Health Services, WellSpan Pharmacy, Gettysburg Hospital Foundation, York Health Foundation, Ephrata Community Health Foundation, Good Samaritan Health Services Foundation, WellSpan Provider Network, GSH Services,and WellSpan Medical Equipment.Philhaven's community benefit report is contained in a report prepared by their parent organization, WellSpan Health. See Attached Federal Supplemental Information: WellSpan Health - 2016 Community Benefit Report false LMC Legacy Foundation 2160 Lincoln Highway E 5 Lancaster PA 17602 813742183 501(C)(3) 7260000 0 behavioral healthcare needs Mental Health Asso of Lebanon 4 South 4th Street Unit C Lebanon PA 17042 231647042 501(c)(3) 13000 0 behavioral health care support 2 0 X X X X X false true false false false false false false false false Dele Omije Physician 282253 500 20566 303319 Jeremy Walters Physician 248320 3859 37358 289537 Jose Montaner Physician 248227 3819 37251 289297 Karen Jones MD Director 365889 64050 215787 36615 682341 Kevin Mosser MD CEO/Director 865813 181560 13385 772892 48787 1882437 181560 Matthew Rogers CFO until 12/15 125521 1980 23640 151141 Michael O'Connor CFO-WSH 543913 155040 440496 47841 1187290 155040 Olaniyi Oluleye Physician 253438 3971 39906 297315 Philip Hess CEO until 12/15 214502 2250 38526 255278 Umar Khayyam Physician 255347 1687 32728 289762 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 Jeffrey Schragg, PTIN P00234543 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder WellSpan Health, a not for profit corporation, is the sole member. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body The Board of Directors of the Organization shall be elected by the Board of Directors of the Member. The Member shall determine annually the number of Directors, which shall in no event be less than ten persons, nor more that eighteen persons. Additionally, the President of the Organization and the President of the Medical Staff of the Organization shall be Directors, ex officio.All Directors shall be selected for their experience, relevant areas of interest and expertise, and ability and willingness to participate actively and effectively in fulfilling the Board of Directors' responsibilities without conflicting interests. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The Member may, with respect to the Organization, initiate and implement any of the following actions, and if any of the following actions are otherwise initiated by the Organization, such action shall not become effective unless approved by the Member:(a) Approval of the Organization's articles of incorporation and bylaws and amendments thereto;(b) Approval of all fundamental transactions involving the Organization, including, without limitation, the reorganization, merger, or dissolution of the Organization or the sale or disposition of substantially all of the assets of the Organization;(c) Approval of investment of the Organization's assets;(d) Approval of issuance of the Organization's debt;(e) Approval of the transfer or sale of Organization assets in excess of limits established by a Member-approved asset sale policy;(f) Approval of operating and capital budgets for the Organization;(g) Approval of capital expenditures by the Organization in excess of a Member-approved Organization capital budget;(h) Approval of Member's capital contributions to the Organization;(i) Approval of changes to the Organization's licenses;(j) Selection of outside financial auditors, legal counsel or investment advisors for the entire System, including approval of any outside legal counsel that may be recommended by the Organization for the Organization's particular needs or activities;(k) Nominating (with appropriate input from the governance and administration of the Organization) and appointing the Organization's board members;(l) Prior review and approval of the Organization's officers (except for the Organization's President, whose appointment requires the concurrence of both Member and the Organization's Boards);(m) Removal of board members of the Organization for cause;(n) Approval of the Organization's statement of mission and vision, strategic and operating plans and charity care policy;(o) Approval of the Organization's creation of new or material changes to existing lines of business, sites of business, and participation in partnerships or joint ventures; and(p) Approval of all managed care and other third party contracts for the Organization. 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. 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 Jeffrey Schragg, PTIN P00234543 Part II Signature Block 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 Jeffrey Schragg, PTIN P00234543 Gettysburg Hospital PO Box 2767 York PA 174052767 231352220 Health Care Services PA 501(c)(3) 3 NA false Gettysburg Hospital Foundation PO Box 2767 York PA 174052767 232251358 Fundraising to support GH PA 501(c)(3) 11 Type 1 NA false Healthy Community Pharmacy PO Box 2767 York PA 174052767 200519121 Reduced Rx for uninsured PA 501(c)(3) 11 Type 1 NA false VNA Community Services PO Box 2767 York PA 174052767 232338591 Home personal care services for elderly PA 501(c)(3) 9 NA false VNA Home Health Services PO BOx 2767 York PA 174052767 231352573 Home Health and hospice care services PA 501(c)(3) 9 NA false Wellspan Health PO BOx 2767 York PA 174052767 222517863 Intergrated Health System PA 501(c)(3) 11 Type 1 NA false Wellspan Health Care Services PO Box 2767 York PA 174052767 232400237 Health-related activities in the service PA 501(c)(3) 11 Type 1 NA false Wellspan Medical Group PO Box 2767 York PA 174052767 232730785 Medical and surgical care PA 501(c)(3) 9 NA false York Health Foundation PO Box 2767 York PA 174052767 233050192 Charitable contributions for wellspan PA 501(c)(3) 11 Type 3 NA false York Hospital PO Box 2767 York PA 174052767 231352222 Community Teaching Hospital PA 501(c)(3) 3 NA false Wellspan Specialty Services PO Box 2767 York PA 174052767 232899911 Mgmt. hospice/ home health PA 501(c)(3) 11 Type 1 NA false Wellspan Properties Inc PO Box 2767 York PA 174052767 222842252 Leases facilities to affiliates PA 501(c)(3) 11 Type 1 NA false Ephrata Community Hospital PO Box 2767 York PA 174052767 231370484 Health Care Services PA 501(c)(3) 3 NA false Ephrata Community Health Foundation PO Box 2767 York PA 174052767 880940005 Fundraising for Ephrata Hospital PA 501(c)(3) 11 Type 1 Ephrata Community Hospital false Northern Lancaster County Medical Group PO Box 2767 York PA 174052767 203033058 Medical and surgical care PA 501(c)(3) 11 Type II Ephrata Community Hospital false Phys Spec of Northern Lanc Co Med Group PO BOx 2767 York PA 174052767 452537633 Physician practices PA 501(c)(3) 11 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 NA false Good Samaritan Health Service Foundation PO Box 2767 York PA 174052767 232356151 Fundraising for Good Samaritan PA 501(c)(3) 11 Type 1 NA false Good Samaritan Real Estate PO Box 2767 York PA 174052767 232447262 Leases facilities to affiliates PA 501(c)(2) NA false Good Samaritan Phyisican Services PO BOx 2767 York PA 174052767 251832359 Medical and Surgical Care PA 501(c)(3) 9 NA false Apple Hill Surgical Center Inc PO BOx 2767 York PA 174052767 222842253 Sole GP in limited ptnrshp operating sur PA 501(c)(3) 9 NA false Apple Hill Surgical Center Partners PO Box 2767 York PA 174052767 232489452 Surgical cn PA N/A N/A 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 Ephrata Hospital false false GSH Home Med Care Inc PO BOx 2767 York PA 174052767 233028099 Sales/rent of med equip/supplies PA GSH Services C corp false GSH Services Inc PO Box 2767 York PA 174052767 232353047 Accounting and financial managment PA GS Health Foundation C corp false GSH Realty Inc PO Box 2767 York PA 174052767 251832359 Rental of non res. real estate PA GSH Services C corp false Wellspan Pharmacy Inc PO Box 2767 York PA 174052767 232374072 Dispense Rx & provides IV therapy PA N/A C corp false Wellspan Reciprocal Risk Retention Group PO Box 2767 York PA 174052767 200048457 Risk Retention Group PA NA C corp 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. managed risk contracts PA NA C corp false Apple Hill Condominium Association PO Box 2767 York PA 174052767 232504543 Condo Mgmt Association PA N/A Homeowner Assoc false Northern Lanc Co Phys Hosp Alliance PO Box 2767 York PA 174052767 232421885 Coord Phys & Hospital PA NA C corp false false false false true true false false false false false false false false false false false false false true