THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA (EIN 23-0794160)
Tax period: 2014-07-01 to 2015-06-30
Filed: 2016-05-16
IRS object ID: 201641379349307639
Schema version: 2014v6.0
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-05-16T15:41:35-05:00	ReturnTs
Tax Period End	2015-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	GRANT THORNTON LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	2001 MARKET STREET SUITE 700	AddressLine1Txt
City	PHILADELPHIA	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	19103	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	230794160	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Good Samaritan Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% DAVID RIZZUTO	InCareOfNm
Business Name Control	GOOD	BusinessNameControlTxt
Phone	7172707500	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 1281 4th Walnut Streets	AddressLine1Txt
City	Lebanon	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	170421281	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Michael F O'Connor	PersonNm
Person Title	Chief Financial Officer	PersonTitleTxt
Phone	7178512706	PhoneNum
Signature	2016-05-16	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Russlee Armstrong	PreparerPersonNm
PTIN	P00288383	PTIN
Phone	2155614200	PhoneNum

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-08-17 19:52:53Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	jane hyde	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4th walnut Streets	AddressLine1Txt
City	Lebanon	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	170421281	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$188,426,039	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.gshleb.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1989	FormationYr
Legal Domicile State	PA	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE HIGH-QUALITY, COMPASSIONATE HEALTHCARE THAT IMPROVES THE OVERALL HEALTH OF OUR COMMUNITY.	ActivityOrMissionDesc
Voting Members Governing Body	18	VotingMembersGoverningBodyCnt
Voting Members Independent	17	VotingMembersIndependentCnt
Total Employee	1484	TotalEmployeeCnt
Total Volunteers	285	TotalVolunteersCnt
Total Gross UBI	$4,361,635	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$685,424	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$3,957,723	PYContributionsGrantsAmt
CY Contributions Grants	$2,091,000	CYContributionsGrantsAmt
PY Program Service Revenue	$165,702,225	PYProgramServiceRevenueAmt
CY Program Service Revenue	$181,425,802	CYProgramServiceRevenueAmt
PY Investment Income	$1,767,172	PYInvestmentIncomeAmt
CY Investment Income	$681,500	CYInvestmentIncomeAmt
PY Other Revenue	$6,816,127	PYOtherRevenueAmt
CY Other Revenue	$4,227,737	CYOtherRevenueAmt
PY Total Revenue	$178,243,247	PYTotalRevenueAmt
CY Total Revenue	$188,426,039	CYTotalRevenueAmt
PY Grants And Similar Paid	$7,058,000	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$13,900	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$76,866,688	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$75,332,328	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$100,632,852	PYOtherExpensesAmt
CY Other Expenses	$108,604,723	CYOtherExpensesAmt
PY Total Expenses	$184,557,540	PYTotalExpensesAmt
CY Total Expenses	$183,950,951	CYTotalExpensesAmt
PY Revenues Less Expenses	-$6,314,293	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$4,475,088	CYRevenuesLessExpensesAmt
Total Assets BOY	$146,479,246	TotalAssetsBOYAmt
Total Assets EOY	$137,841,236	TotalAssetsEOYAmt
Total Liabilities BOY	$143,739,768	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$148,071,758	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$2,739,478	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	-$10,230,522	NetAssetsOrFundBalancesEOYAmt
Mission	THE MISSION OF GOOD SAMARITAN HEALTH SYSTEM IS TO PROVIDE HIGH-QUALITY, COMPASSIONATE HEALTHCARE THAT IMPROVES THE OVERALL HEALTH OF OUR COMMUNITY. TO FULFILL THIS MISSION, GOOD SAMARITAN HAS FOCUSED ITS EFFORTS ON MAKING YOUR COMMUNITY HOSPITAL ONE OF THE TOP PERFORMING HOSPITALS IN THE NATION WITH ADVANCED, HIGH-QUALITY CARE THAT ALSO CARES ABOUT THE RESIDENTS OF LEBANON COUNTY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$160,879,186	ExpenseAmt
Grant	$13,900	GrantAmt
Revenue	$181,425,802	RevenueAmt
Desc	Acute care hospital with inpatient and outpatient services. Effective July 1, 2015, Wellspan Health acquired Good Samaritan Hospital.	Desc
Total Program Service Expenses	$160,879,186	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	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	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	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	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
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	Yes (true)	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	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	Yes (true)	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	104	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1484	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	18	GoverningBodyVotingMembersCnt
Independent Voting Member	17	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	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	DAVID RIZZUTO	PersonNm
Phone	7178513055	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3350 WHITEFORD ROAD	AddressLine1Txt
City	YORK	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	17402	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 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
John P Welch MD
Chairman/Trustee	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
Dennis L Shalters
Past Chairman/Trustee	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
Donald H Dreibelbis
First Vice Chairman/Trustee	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
Robert J Funk
Second Vice Chairman/Trustee	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
Frederick S Wolfson
Treasurer/Trustee	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
Evelyn C Colon
Trustee	1.0	1.0	Yes (X)		$0	$0	$0
Paul R DiGiacomo MD
Trustee	1.0	1.0	Yes (X)		$0	$0	$0
Robert P Hoffman
Trustee	1.0	1.0	Yes (X)		$0	$0	$0
Frederick C Laurenzo
Trustee	1.0	1.0	Yes (X)		$0	$0	$0
Robert J Phillips
Trustee	1.0	1.0	Yes (X)		$0	$0	$0
Galen G Weaber
Trustee	1.0	1.0	Yes (X)		$0	$0	$0
Bryan G Pilkington MD
Trustee	1.0	1.0	Yes (X)		$0	$0	$0
Robert J Longo
Pres/Asst Sec&Trea/Trustee/CEO	49.0	1.0	Yes (X)	Yes (X)	$496,971	$0	$27,140
Jane Juppenlatz
Secretary/Trustee	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
Carol Blecker
Trustee	1.0	1.0	Yes (X)		$0	$0	$0
William E Schaeffer
Trustee	1.0	1.0	Yes (X)		$0	$0	$0
Deborah T Weaver
Trustee	1.0	1.0	Yes (X)		$0	$0	$0
Julie Zinsser
Trustee	1.0	1.0	Yes (X)		$0	$0	$0
Kimberly Feeman
Senior VP & COO	35.0	15.0		Yes (X)	$326,451	$0	$20,900
robert j richards
vp finance & cfo	50.0	0.0		Yes (X)	$297,675	$0	$27,362
Jacquelyn M Gould
VP of Nursing	35.0	15.0			$200,357	$0	$14,086	Yes (X)
Robert Shaver
VP Medical Affairs	50.0	0.0			$355,022	$0	$3,438	Yes (X)
William Mulligan
VP Strategic Planning & MKTG	50.0	0.0			$144,825	$0	$19,338	Yes (X)
Victoria Brown
Residency Physician	50.0	0.0			$163,856	$0	$23,000		Yes (X)
Daria Kovarikova
Residency Physician	50.0	0.0			$212,885	$0	$3,146		Yes (X)
John Sheffield
Residency Physician	50.0	0.0			$167,613	$0	$20,939		Yes (X)
aaron lane
Residency Physician	50.0	0.0			$190,179	$0	$190,148		Yes (X)
byard yoder
residency physician	50.0	0.0			$178,173	$0	$16,833		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,734,007	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$366,330	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	47	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
MCKESSON TECHNOLOGIES
PO Box 98347	CHICAGO	IL	606938347	IT Support	$5,035,920
LEBANON ANESTHESIA ASSOC LTD
PO Box 1281	LEBANON	PA	17042	Anesthesiologists	$3,241,185
LEBANON CARDIOLOGY ASSOCIATES
775 Norman Drive	LEBANON	PA	17042	Cardiologists	$2,003,341
Sodexo Operations LLC
PO Box 360170	PITTSBURGH	PA	152516170	Dietary mgmt Service	$1,508,800
ARTHUR FUNK AND SONS INC
1405 BIRTH ROAD	LEBANON	PA	17042	BUILDING CONTRACTOR	$1,891,553

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	49	CntrctRcvdGreaterThan100KCnt
All Other Contributions	$2,091,000	AllOtherContributionsAmt
Total Contributions	$2,091,000	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICE REVENUE/LABORATORY	900099	$181,227,099	$176,865,464	$4,361,635
HEALTH PROGRAMS	900099	$169,343	$169,343
PHARMACY SALES	900099	$29,360	$29,360

Field	Value	IRS element (for citing)
Total Program Service Revenue	$181,425,802	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$641,000	TotalRevenueColumnAmt
Exclusion	$641,000	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$35,500	TotalRevenueColumnAmt
Exclusion	$35,500	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$416,369	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$416,369	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$416,369	TotalRevenueColumnAmt
Exclusion	$416,369	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$5,000	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$5,000	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,000	TotalRevenueColumnAmt
Exclusion	$5,000	ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
MALPRACTICE INSURANCE	524298	$1,908,420	$1,908,420
SNACK BAR/CAFE	722511	$545,072	$545,072
MANAGEMENT SERVICES	900099	$544,451	$544,451

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$813,425	TotalRevenueColumnAmt
Exclusion	$813,425	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$3,811,368	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$188,426,039	TotalRevenueColumnAmt
Related Or Exempt Func Income	$177,064,167	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$4,361,635	UnrelatedBusinessRevenueAmt
Exclusion	$4,909,237	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$13,900	TotalAmt
Program Services	$13,900	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,997,621	TotalAmt
Management And General	$1,997,621	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$57,703,858	TotalAmt
Program Services	$49,538,724	ProgramServicesAmt
Management And General	$8,165,134	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$2,009,266	TotalAmt
Program Services	$1,707,876	ProgramServicesAmt
Management And General	$301,390	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$9,292,282	TotalAmt
Program Services	$7,898,440	ProgramServicesAmt
Management And General	$1,393,842	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$4,329,301	TotalAmt
Program Services	$3,198,983	ProgramServicesAmt
Management And General	$1,130,318	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$732,203	TotalAmt
Management And General	$732,203	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$15,931	TotalAmt
Management And General	$15,931	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$4,223,013	TotalAmt
Program Services	$3,589,561	ProgramServicesAmt
Management And General	$633,452	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,365,399	TotalAmt
Program Services	$2,258	ProgramServicesAmt
Management And General	$1,363,141	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$978,207	TotalAmt
Program Services	$831,476	ProgramServicesAmt
Management And General	$146,731	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,505,389	TotalAmt
Program Services	$2,129,581	ProgramServicesAmt
Management And General	$375,808	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$55,227	TotalAmt
Program Services	$46,943	ProgramServicesAmt
Management And General	$8,284	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$4,102,724	TotalAmt
Program Services	$3,487,315	ProgramServicesAmt
Management And General	$615,409	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,332,322	TotalAmt
Program Services	$6,232,474	ProgramServicesAmt
Management And General	$1,099,848	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,979,929	TotalAmt
Program Services	$1,682,940	ProgramServicesAmt
Management And General	$296,989	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$32,397,839	$32,397,839
BAD DEBT	$13,258,781	$13,258,781
PURCHASED SERVICES	$31,971,092	$27,175,428	$4,795,664
OTHER	$7,686,667	$7,686,667

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$183,950,951	TotalAmt
Program Services	$160,879,186	ProgramServicesAmt
Management And General	$23,071,765	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$5,870	BOYAmt
EOY	$5,926	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$4,425,803	BOYAmt
EOY	$2,016,900	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$4,971,913	BOYAmt
EOY	$5,082,853	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$19,527,175	BOYAmt
EOY	$21,847,380	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$630,974	BOYAmt
EOY	$540,242	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,378,552	BOYAmt
EOY	$1,404,122	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$3,178,058	BOYAmt
EOY	$3,094,902	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$198,609,676	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$140,205,201	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$57,851,996	BOYAmt
EOY	$58,404,475	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$44,266,754	BOYAmt
EOY	$35,226,593	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$10,242,151	BOYAmt
EOY	$10,217,843	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$146,479,246	BOYAmt
EOY	$137,841,236	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$22,457,026	BOYAmt
EOY	$28,482,428	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$61,155,896	BOYAmt
EOY	$60,794,000	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$5,138,118	BOYAmt
EOY	$6,113,784	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$54,988,728	BOYAmt
EOY	$52,681,546	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$143,739,768	BOYAmt
EOY	$148,071,758	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$4,674,000	BOYAmt
EOY	-$17,101,000	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$6,725,000	BOYAmt
EOY	$6,182,000	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$688,478	BOYAmt
EOY	$688,478	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,739,478	BOYAmt
EOY	-$10,230,522	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$146,479,246	BOYAmt
EOY	$137,841,236	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$4,475,088	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$626,000	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$18,071,088	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

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$15,931	OtherActivitiesAmt
Total Lobbying Expenditures	$15,931	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1G	FormAndLineReferenceDesc
Explanation	The Hospital holds membership in the American Hospital Association (AHA) and the Hospital & Healthsystem Association of Pennsylvania both of which engage in lobbying as a part of their mission to represent the interests of the hospitals at both the federal and state levels. For the year end 6/30/15 the amount of dues paid to the HAP totaled $69,267 which 23% - $15,931 was used for lobbying purposes. On occasion, HAP requests the help of member providers to communicate concerns to legislators regarding pending legislation, which could impact hospitals. This can involve direct contact with legislators or letter writing. This occurs infrequently and the cost to the hospital is negligible.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$7,412,227	BeginningYearBalanceAmt
Contributions	$989,598	ContributionsAmt
Investment Earnings Or Losses	$19,671	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,553,044	OtherExpendituresAmt
End Year Balance	$6,868,452	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,073,656	BeginningYearBalanceAmt
Contributions	$3,551,208	ContributionsAmt
Investment Earnings Or Losses	$40,947	InvestmentEarningsOrLossesAmt
Other Expenditures	$253,584	OtherExpendituresAmt
End Year Balance	$7,412,227	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,719,409	BeginningYearBalanceAmt
Contributions	$2,252,267	ContributionsAmt
Investment Earnings Or Losses	$54,351	InvestmentEarningsOrLossesAmt
Other Expenditures	$952,371	OtherExpendituresAmt
End Year Balance	$4,073,656	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,945,233	BeginningYearBalanceAmt
Contributions	$424,618	ContributionsAmt
Investment Earnings Or Losses	$53,135	InvestmentEarningsOrLossesAmt
Other Expenditures	$703,577	OtherExpendituresAmt
End Year Balance	$2,719,409	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$3,005,818	BeginningYearBalanceAmt
Contributions	$834,833	ContributionsAmt
Investment Earnings Or Losses	$26,652	InvestmentEarningsOrLossesAmt
Other Expenditures	$922,070	OtherExpendituresAmt
End Year Balance	$2,945,233	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.10000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.90000	TermEndowmentBalanceEOYPct
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	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$1,468,847	OtherCostOrOtherBasisAmt
Book Value	$1,468,847	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$90,182,799	OtherCostOrOtherBasisAmt
Depreciation	$48,170,116	DepreciationAmt
Book Value	$42,012,683	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$5,525,278	OtherCostOrOtherBasisAmt
Depreciation	$5,130,349	DepreciationAmt
Book Value	$394,929	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$97,452,318	OtherCostOrOtherBasisAmt
Depreciation	$86,904,736	DepreciationAmt
Book Value	$10,547,582	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$3,980,434	OtherCostOrOtherBasisAmt
Book Value	$3,980,434	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$58,404,475	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
ACCRUED RETIREMENT BENEFIT COSTS	$43,016,537
3RD PARTY PAYABLES	$3,591,000
INSURANCE RESERVES	$4,191,000
DUE TO AFFILIATES	$1,078,009
OTHER LIABILITIES	$805,000

Field	Value	IRS element (for citing)
Total Liability	$52,681,546	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule D, Part V, Line 4

The Good Samaritan Hospital maintains temporarily restricted and permanently restricted assets to purchase specific pieces of equipment and provide qualified applicants a scholarship.

Fin 48 (ASC 740) Footnote

Schedule D, Part X, Line 2 GOOD SAMARITAN Hospital is included in the consolidated audited financial statements of Good Samaritan Health services Foundation. GOOD SAMARITAN Hospital FOLLOWS THE ACCOUNTING GUIDANCE FOR UNCERTAINTIES IN INCOME TAX POSITIONS WHICH REQUIRES THAT A TAX POSITION BE RECOGNIZED OR DERECOGNIZED BASED ON A "MORE LIKELY THAN NOT" THRESHOLD. THIS APPLIES TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. GSH DOES NOT BELIEVE ITS CONSOLIDATED FINANCIAL STATEMENTS INCLUDE ANY MATERIAL UNCERTAIN TAX POSITIONS. AT JUNE 30, 2015, GSH'S TAX YEARS ENDED JUNE 30, 2012 THROUGH 2015 FOR THE FEDERAL TAX JURISDICTION REMAIN OPEN.

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	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
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	$2,994,266	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,994,266	NetCommunityBenefitExpnsAmt
Total Expense	0.01490	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,204,147	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,798,687	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,405,460	NetCommunityBenefitExpnsAmt
Total Expense	0.00700	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$15,723,735	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,414,378	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,309,357	NetCommunityBenefitExpnsAmt
Total Expense	0.03640	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,922,148	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,213,065	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,709,083	NetCommunityBenefitExpnsAmt
Total Expense	0.05830	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,690,727	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$764,156	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$926,571	NetCommunityBenefitExpnsAmt
Total Expense	0.00460	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,690,727	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$764,156	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$926,571	NetCommunityBenefitExpnsAmt
Total Expense	0.00460	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$23,612,875	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,977,221	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,635,654	NetCommunityBenefitExpnsAmt
Total Expense	0.06290	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$43,909	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$43,909	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$34,509	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$34,509	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$78,418	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$78,418	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$13,258,781	BadDebtExpenseAmt
Bad Debt Expense Attributable	$10,045,711	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$40,738,345	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$67,652,251	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$26,913,906	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	The Good Samaritan Hospital	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4TH walnut street	AddressLine1Txt
City	lebanon	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	17042	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.gshleb.org	WebsiteAddressTxt
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	The Good Samaritan 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
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
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	12	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	www.gshleb.org	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	12	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	www.gshleb.org	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	www.gshleb.org	FAPAppAvailableOnWebsiteURLTxt
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit Report To Credit Agency	Yes (X)	PermitReportToCreditAgencyInd
Collection Activities	false	CollectionActivitiesInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	Yes (true)	GrossChargesInd

Supplemental Information SupplementalInformationGrp

Field	Value	IRS element (for citing)
Form And Line Reference	Part V, Section B	FormAndLineReferenceDesc
Explanation	Question 11 In the most recent CHNA, The Good Samaritan Hospital documented nine major health need priorities for Lebanon County. For those priorities that correspond to hospital services and mission, The Good Samaritan Hospital has worked to fulfill the needs that were identified. Chronic Disease Management - The hospital has provided free education on heart disease, diabetes, and healthy eating to promote healthy lifestyles. In addition, numerous free health screenings (such as free blood glucose and cholesterol screenings) were provided throughout the year. The hospital partnered with the American Heart Association for the annual Heart Walk, Heart Ball, and Go Red For Women event. Obesity - The hospital has provided free education on healthy eating to promote healthy lifestyles. In addition, numerous free health screenings (such as free blood glucose and cholesterol screenings) were provided throughout the year. The hospital also partnered with the Age Wave Initiative of Lebanon County to promote the "Take Five to Feel Alive" exercise campaign and the Lebanon Valley Family YMCA for a family -oriented 5k and 10k race. Smoking - The hospital offers free tobacco cessation classes and free nicotine patches to participants. Accidents and Injuries - The hospital continues to promote child safety and safe installation of car seats for infants and children. Maternal and Child Health - The hospital offers free birthing classes to moms-to-be and breast-feeding coaching for new moms. A National Committee for Quality Assurance (NCQA) Level 3 rated Patient Centered Medical HomeTM model is used to provide clinical and social service support to families at The Good Samaritan Family Practice Center, which serves many low-income families in the county. In conjunction with community partners, the CHNA also indicated needs for support for Oral Health Services and Mental Health Services. These areas are outside of the scope of services and mission of The Good Samaritan Hospital. Good Samaritan has worked to share this research with communities in the community that work in these areas. Good Samaritan did provide a $15,000 donation to Welsh Mountain Health Centers, which opened the new Lebanon Ridge Oral Health Clinic in the city of Lebanon. Question 13 The Good Samaritan hospital calculates the amount charged to a patient based on catastrophic or physical hardship and the number of individuals living in a household. Question 22 The Good Samaritan Hospital bills individuals without insurance their gross charges associated with the services they received during their visit. GSH offers all self-pay patients a 35% discount if they pay their bill within 30 days of their services. Question 24 The Good Samaritan Hospital charges its self-pay patients their gross charges for the services rendered.	ExplanationTxt

Field	Value	IRS element (for citing)
Facility	11	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (11 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
The Good Samaritan Hospital
fourth Willow Streets	Lebanon	PA	17042	Rehab & Tuc Units
The Good Samaritan Hospital
830 Tuck Street	Lebanon	PA	17042	Outpatient surgical center
The Good Samaritan Hospital
840 Tuck Street	Lebanon	PA	17042	Wound Care & Hyperbaric Cntr
The Good Samaritan Hospital
206 Hathaway Park	Lebanon	PA	17042	Sleep Disorders Center
The Good Samaritan Hospital
805 Helen Drive	Lebanon	PA	17042	Outpatient Radiology Center
The Good Samaritan Hospital
750 Norman Drive	Lebanon	PA	17042	Blood Donor Cntr & Lab
The Good Samaritan Hospital
297 West Lincoln Ave	Lebanon	PA	17042	Outpatient Diagnostics Center
The Good Samaritan Hospital
1400 South Forge Road	Lebanon	PA	17042	Ambulatory Services Center
The Good Samaritan Hospital
100 Queen Street	Lebanon	PA	17042	Satellite Services Center
The Good Samaritan Hospital
950 Isabel Drive	Lebanon	PA	17042	Outpatient Physical Therapy
The Good Samaritan Hospital
781 Norman Drive	Lebanon	PA	17042	Cardiovascular Diagnostic

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 6a	Our annual community benefit report is prepared by our marketing department. The report can be found at our website, www.gshleb.org. We also mail the report out to the members of our community.
Part I, Line 7	The Good Samaritan Hospital used the cost to change ratio cost methodology to calculate the charity unreimbursed medicaid and other government programs. The hospital used direct costs for the other community benefits on Line 7.
Part II	The Good Samaritan Health System is involved in some community building programs which are designed to "improve the overall health of our community" (mission statement). The GSH participates in a disaster preparedness program which provides a plan in the case of a disaster that affects the community. The GSH also provides space for support groups to meet and education classes for the people within the community, like expectant parents. The activities are not included elsewhere on the Schedule H
Part III, Line 4	AFS Footnote: The Hospital establishes an allowance for doubtful accounts to report the net realizable amounts to be received from patients. Increases to this allowance are reflected as a provision for doubtful accounts in the statement of operations. The hospital regularly performs a detailed analysis of the collectability of patient accounts receivable and considers such factors as prior collection experience and the age of the receivables to determine the appropriate allowance level. Bad Debt Methodology: The Good Samaritan Hospital is a tax-exempt non-for-profit hospital that provides quality medical services to patients regardless of their ability to pay. By providing medical services to all community members regardless of their ability to pay, the hospital's bad debt expense qualifies as a community benefit. The bad debt expense calculated on line 2 was calculated using the patient care cost to changes methodolgy. The Good Samaritan Hospital uses an automated system called presumptive to charity care tool to calculate the amount on line 3. All self pay accounts and all the self pay after insurance accounts are imported into the tool, then the tool scores each account based on the government guidelines for poverty levels. For FYE 6/30/15, the tool estimated $10,045,711 of the organization's bad debt expense should be considered charity care.
Part III, Line 8	Medicare allowance costs were calculated using a cost to charge ratio. The Good Samaritan Hospital provides quality medical services to all patients regardless of what insurance they have. Approximately 58% of The Good Samaritan Hospital's revenue is attributable to medicare patients. The Good Samaritan Hospital is relieving the government's burden, because the hospital is providing services to medicare patients which cost more than the medicare reimbursement. Therefore, the $26,913,906 medicare shortfall should be considered a community benefit.
Part III, Line 9b	Collection policies are the same for all patients. If a patient notifies the hospital about their inability to pay, the hospital will send them charity care and financial assistance forms to fill out. Once the forms are completed and returned to the hospital and if the patient qualifies for financial assistance, the patient's account will be removed from collections and the account will be written off.
Part VI, Line 2	The Good Samaritan Hospital (the Hospital) has participated in a variety of community health needs assessments over the past 17 years. The hospital was instrumental in helping to launch the Community Health Council of Lebanon County. In partnership with the council, a community health needs assessment was created 17 years ago and an updated assessment completed 12 years ago. Another assessment was created in 2005, led by efforts of The United Way of Lebanon County. The Hospital's most recent community health needs assessment was completed in conjunction with the Community Health Council of Lebanon County, the United Way and Lebanon Family Health Services. The assessment report was developed by Civic Research Alliance LLC, published in June 2012 and subsequently approved by the Board of Directors of the Hospital on July 24, 2012. Data were collected and analyzed by the Hospital from sources that included the Pennsylvania Department of Health, the Centers for Disease Control and Prevention, the U.S. Census, the American Community Surveys, and interviews of community leaders and healthcare professionals in Lebanon County. over time. Additional data were gathered when a trend identified a high priority need. Priorities were then categorized as a need to be addressed by the community or by the Hospital. The following were identified as the priority health care needs of the communities the Hospital serves and the action plan adopted by the Board of Directors of the Hospital. - Chronic Disease Management Provide programs that educate and assist patients with chronic diseases to self-manage their condition. Continue to offer Medical Home services at Good Samaritan primary care practices to deliver preventive care that reduces need for acute care services. Increase awareness and use of Diabetic Education services in community. Promote tobacco cessation programs. Offer cardiac education at hospital and in community. Participate in healthy lifestyle events, such as Give Thanks for Lebanon 5k/10k event. - Overweight and Obesity Raise community awareness about obesity issues. Provide education about healthy lifestyles to patients and to community groups. - Smoking Promote smoking cessation among hospital employees. Support community smoking cessation programs. Encourage doctors to tell patients to quit and share information about hospital and community-based cessation programs. - Accidents and Injuries Emergency department readiness. Continue to enforce hospital rules for use of child care seats. Raise awareness about accidents for young drivers. Raise awareness and provide education for patients and families about the risks of falling for the population 75 years and older. - Oral Health Services These services are not part of the acute health care mission of the Hospital. - Mental Health Services These services are not part of the acute health care mission of the Hospital. - Maternal and Child Health Prepare for younger maternity patients as demographics shift. Maintain high-quality maternity facilities. Raise awareness for pre- natal health checks. Promote smoking cessation to those in child- bearing years. - Access to Healthcare This issue falls outside the scope of The Hospital because most primary care is provided by independent community physicians. Encourage providers to accept Medicaid and Medicare. Keep access to public insurance at The Good Samaritan Family Practice Center, ELCO Family Practice, and Good Samaritan Pediatrics. - Culturally and linguistically appropriate healthcare Continue to provide diversity education to employees. Conduct additional outreach efforts to non- English speaking populations in community. Additional supplemental information: The hospital also maintains an independent, countywide physician needs assessment to evaluate gaps in healthcare access. A new physician needs assessment was also completed in 2011. In addition to these countywide efforts, the hospital has performed a variety of studies on specific health concerns and community needs. Key studies have included services for cardiovascular, oncology, gastroenterology, wound care, and more. The hospital has also acted to fulfill the needs identified in these studies. The hospital created one of the nation's leading cardiac and vascular centers, which has earned several national awards for quality of care. The hospital introduced a new wound care service to deal with patients suffering from complications of diabetes - a particular problem to Lebanon County - and has already expanded operations to add a third hyperbaric oxygen treatment chamber to the two originally installed in the center. In addition, the hospital has protected the community by recruiting new physicians for key services - general surgery, oncology, and gastroenterology - allowing patients to get access to care in Lebanon County instead of traveling throughout the region.
Part VI, Line 3	The Good Samaritan Hospital Charity Care policy outlines the process of financial, medical and catastrophic categories where a patient could qualify for charity care. the hospital has a self-pay brochure available that provides information and available hours. Financial counselors are on site to meet with patients to discuss their financial obligations, assist them in completing the application for the charity care, and answer their questions. Patients are encouraged to apply for charity care if they are unable to come in for an appointment. There is a note on the statements that is mailed to patients, letting them know that financial assistance is available. The Good Samaritan hospital's website also provides the contact information for those community members who need medical services and financial assistance.
Part VI, Line 4	Lebanon County includes a mix of urban, suburban, and rural areas. The city of Lebanon is centrally located, serving as the county seat. The city is home to more than 24,000 residents and is classified by the commonwealth of Pennsylvania as a third class city. The county includes 25 other municipalities. the rest of the county is made up of suburban and rural areas, with rural farmland providing a dominant character of county life. while most of the population tends to be of white ancestry (91%), the county has a fast-growing Hispanic population (7.8%) that centers in the city of Lebanon (source: U.S. Census Bureau). The U.S. census bureau also reports that 8% of the population speaks a language other than English at home. Employment rates in the county are currently at 6.8% - one of the lowest rates in the state - and average household income is at $50,334 according to the USDA economic research service. The federal government is the county's largest employer, with large work forces at the Lebanon veteran's administration hospital and fort Indiantown gap. The Good Samaritan hospital is the largest non-governmental employer with 1,500 employees. according to the U.S. census bureau American community survey, 8% of the population lives in poverty. The Good Samaritan Hospital is the only hospital in Lebanon county. The hospital has performed thousands of outpatient procedures - from surgeries to imaging to laboratory to physical therapy - every year. The hospital also provides a continuity of care through a skilled nursing unit, rehabilitation services, home healthcare, and hospice care. the hospital is the largest provider of care to Medicaid and Medicare populations. while most Lebanon county residents choose to stay in the county for their care, with more than 60% choosing the Good Samaritan hospital for services. according to the Robert Wood Johnson Foundation community health rankings, Lebanon county is the 13th most healthy of Pennsylvania's 67 counties. the health rankings indicate key areas of improvement, including diabetes, tobacco use, and other health behaviors that are problematic. the hospital has taken steps to address these areas by expanding services and educational opportunities.
Part VI, Line 5	Good Samaritan strives to deliver powerful medicine with comforting care every day. As part of our non-profit mission, The Good Samaritan Hospital and its affiliated organizations deliver healthcare services that improve the quality of life throughout the region. As Lebanon County's only hospital, Good Samaritan is the community's primary - and sometimes only - resource for: -Inpatient hospital care -Emergency care -Surgical services -Digestive health services -Maternity services -Cardiac & vascular services -Radiology and medical imaging services -Laboratory diagnostic services and blood bank -Physical and occupational therapies -Transitional care and rehabilitation services -Home health and hospice services -Wound care and hyperbaric medicine -Diabetic education and nutrition counseling -Audiology and speech therapy -Sleep disorders -Physician services for needed specialties including cardiac, gastroenterology, general surgery, hematology, hospitalists, oncology, pediatrics, primary care (particularly for Medicaid population), thoracic, vascular, and wound care. -Medical residency program to train new physicians -And many more Community Benefit Total $2,371,205 Good Samaritan and its employees donate many hours of time to improve the health of the community. In 2014, key projects included: -Health Fairs - the countywide 50+ Festival and Women's Health Expo as well as individual events hosted by various nursing and retirement facilities, employers and other community groups -Education programs - offered at the hospital or presented to community groups on topics such as smoking cessation, cardiac health, cancer prevention, sleep disorders, diabetic health, breast health and more -Medical clinic - Good Samaritan donated employee time to support a new independent medical clinics for poor and low-income patients -Health screenings - screenings for cholesterol, blood glucose, BMI, skin cancer, blood pressure, varicose veins and other health conditions were provided throughout the year Charitable and Uncompensated Care In reflection of our non-profit mission, Good Samaritan delivered over $21 million dollars in charitable and uncompensated care to the community. Economic Impact In addition to our core healthcare mission, Good Samaritan is Lebanon County's largest non-government employer - and positively impacts the economy by generating more than 1,000 jobs outside of the health system. Service Statistics The Good Samaritan Hospital treated 7,582 patients in 2014. In addition, the health system offers a wide variety of diagnostic and non-acute health services that are needed by the community. Many of these services would not be available to the community if they were not offered by Good Samaritan. Behind the Statistics Many of the 109,852 radiology services we provided in 2014 include those services provided by our Women's Imaging Center, mainly screening mammograms. Breast cancer remains an important women's health issue with thirty-two percent of women in Pennsylvania diagnosed daily with the disease. One in eight women will be diagnosed with invasive breast cancer in their lifetime, including those with no family history of the disease. To help women fight this disease, Good Samaritan provides the latest, comprehensive breast imaging services and follow-up care to improve detection and shorten the time from diagnosis until treatment can begin. Dense breast tissue can make cancer harder to find on a mammogram, which increases the risk of a late-stage cancer diagnosis in many women. Because of this, Pennsylvania now requires all patients with dense breast tissue be notified in their result letter after a mammogram. Good Samaritan goes beyond the required notification for our patients, introducing new software that utilizes several different risk assessment tools to assist in calculating if a woman is high-risk for developing breast cancer in her lifetime. This risk assessment may recommend that breast ultrasound or magnetic resonance imaging (MRI) be utilized in conjunction with screening mammography to assist in detecting breast cancer. In addition to the use of this risk assessment tool in screening, Good Samaritan has focused our efforts on reducing the "door-to-diagnosis" time for women having diagnostic imaging. All diagnostic mammograms and ultrasounds are promptly read by a board-certified radiologist who specializes in breast imaging so the patient receives the results before leaving the Women's Imaging Center. If an abnormality is detected, a certified breast patient navigator in imaging and cancer care works with the patient to help her understand the process and schedule a biopsy. Good Samaritan is now able to perform all minimally-invasive biopsies in the Women's Imaging Center under stereotactic or ultrasound guidance and MRI-guided breast biopsies also available. Reducing the time from imaging to treatment is important both psychologically and physically. In the past women may have had to wait weeks after an abnormality was found for a biopsy and the following surgical consultation if the biopsy was positive. Now many women are having diagnostic imaging, a biopsy and their surgical consult in days rather than weeks. By shortening this process, women are able to either eliminate unnecessary worry more quickly or receive the earliest possible treatment for a cure. Breast cancer remains a focus of Good Samaritan's efforts to provide quality care that changes lives. Supporting Our Community The employees of the Good Samaritan Health System have a spirit of generosity. Each year employees donate their time, goods and money to support worthy causes. -United Way - Good Samaritan employees donate more than $30,000 annually to the United Way of Lebanon County. -Reach Out and Read - a national program to give free books to children of low income families. -Cribs for Kids - brand new cribs provided to low-income families -Bridge of Love - personal care items provided to families in need -Car Seats - new car seats are made available to low-income families -American Heart Association - more than 100 employees participate in the annual Heart Walk, raising thousands of dollars each year -Operation Good Sam - During the Thanksgiving Food Drive, food is collected and delivered to more than 100 families in need. -Good Samaritan Christmas Toy Drive - employees donate toys that are delivered to more than 250 children each year to spread holiday cheer Community Health Council The Good Samaritan Hospital helped to create the independent Community Health Council of Lebanon County. From its humble inception, the Council has grown into a premier county organization. More than 400 volunteers collaborate on programs to increase healthy lifestyles and to eliminate alcohol and drug abuse in the county. The Council sponsors programs that address the special needs of youth, parents and seniors. A Home for Community Groups The Good Samaritan Hospital opens its doors to support a variety of community groups. The hospital provides rent-free classroom space for a variety of support groups such as: -Alcoholics Anonymous -Alanon -Better Breather's Club -I Can Cope (cancer support) -Journey Through Grief Bereavement Support (adult focused Hospice support) -Support and Help in Airing and Resolving Experiences (for grieving parents) -Rainbow Connection (teen focused Hospice support) -Narcotics Anonymous Sharing Our Knowledge At Good Samaritan Health System, caring for our community extends beyond providing medical services. Through our educational services department, we offer classes and support groups that address multiple health related topics, which in turn offer the members of our community an opportunity to improve their health, both physically and emotionally. The educational services department oversees community education classes such as babysitter training and a variety of Heartsaver CPR programs, which range from basic first aid to advanced cardiac life support. These classes provide individuals a chance to obtain skills which can benefit their lives both personally and professionally. Diabetes is prominent in the Lebanon County. To address this growing health concern, Good Samaritan offers Diabetic Education Classes. This program is a series of four classes which addresses topics such as: the importance of managing diabetes; meal planning; use of medication; glucose monitoring; and coping with diabetes. Community members dealing with substance addiction or those who are grieving can receive much needed support through community groups whose meetings are scheduled through the educational services department. These include: Al-Anon; Journey through Grief; and Narcotics Anonymous. Most of these programs are offered on a weekly or bi-weekly basis and all are free of charge. In addition to offering classes to the general public, the educational services department also assists in the coordination of nursing student clinical rotations. Working in conju
Part VI, Line 6	The Good Samaritan Hospital is a part of the Good Samaritan Health System. The system includes a foundation, real estate companies, family practices, specialty health services, and a DME company. In addition to the community benefits provided by the hospital, the health system evaluates the needs the community and the system will participate in community benefit programs, like supporting the volunteers in medicine free clinic which serves the underprivileged members of the community.
Part VI, Line 7	Pennsylvania

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	Various Scholarships	GrantTypeTxt
Cash Grant	$13,900	CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Parts I, Line 2	FormAndLineReferenceDesc
Explanation	The David Broderic employee scholarship program and the Margaret L. Connell scholarship fund are for the sons and daughters of employees. The GSH auxiliary and Caplan nursing scholarships are awarded to Lebanon County residents enrolled in a nursing program. The Good Samaritan hospital distributes a portion of the money allotted to every person who applies for the scholarship. The Good Samaritan Hospital has internal controls with regards to issuing grants to individuals.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
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 (11 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
Robert J Longo
Pres/Asst Sec&Trea/Trustee/CEO	$408,584	$0	$84,263	$0	$4,124	$0	$21,202	$0	$5,938	$0	$524,111	$0
Kimberly Feeman
Senior VP & COO	$274,106	$0	$52,075	$0	$270	$0	$17,461	$0	$3,439	$0	$347,351	$0
Jacquelyn M Gould
VP of Nursing	$170,591	$0	$27,876	$0	$1,890	$0	$10,648	$0	$3,438	$0	$214,443	$0
Robert Shaver
VP Medical Affairs	$304,783	$0	$48,294	$0	$1,945	$0	$0	$0	$3,438	$0	$358,460	$0
William Mulligan
VP Strategic Planning & MKTG	$124,244	$0	$20,468	$0	$113	$0	$15,328	$0	$4,010	$0	$164,163	$0
Victoria Brown
Residency Physician	$163,856	$0	$0	$0	$0	$0	$23,000	$0	$0	$0	$186,856	$0
Daria Kovarikova
Residency Physician	$193,521	$0	$18,638	$0	$726	$0	$0	$0	$3,146	$0	$216,031	$0
John Sheffield
Residency Physician	$167,611	$0	$0	$0	$2	$0	$17,500	$0	$3,439	$0	$188,552	$0
aaron lane
Residency Physician	$143,697	$0	$46,466	$0	$16	$0	$190,148	$0	$0	$0	$380,327	$0
byard yoder
residency physician	$177,099	$0	$0	$0	$1,074	$0	$11,187	$0	$5,646	$0	$195,006	$0
robert j richards
vp finance & cfo	$241,471	$0	$47,542	$0	$8,662	$0	$21,974	$0	$5,388	$0	$325,037	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 3	The compensation committee hires an independent compensation consultant to establish the CEO's compensation amount and compose the contract. the compensation committee presents the information to the board and the board member can ask to review the contract privately.
Part I, Line 4b	Robert Longo is a participant in a 457f retirement plan. he recieved no payment from the plan this year.
Part I, Line 7	Bonuses are based on a number of variables including but not limited to individual goal achievements as well as organization operation achievements. The final determination of the bonus amount is determined and approved by the board as part of the overall copmensation review of the officers.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	Lebanon County Health Facilities Authority	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	232546819	BondIssuerEIN
CUSIP	522455BE3	CUSIPNum
Bond Issued	2004-03-11	BondIssuedDt
Issue Price	$17,255,816	IssuePriceAmt
Purpose	See Part VI	PurposeDesc
Defeased	false	DefeasedInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Pool Financing	false	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$0	RetiredAmt
Bond Defeased	$0	BondDefeasedAmt
Total Proceeds	$17,255,816	TotalProceedsAmt
In Reserve Fund	$0	InReserveFundAmt
Capitalized Interest	$0	CapitalizedInterestAmt
Refunding Escrow	$0	RefundingEscrowAmt
Issuance Costs From Proceeds	$0	IssuanceCostsFromProceedsAmt
Credit Enhancement	$0	CreditEnhancementAmt
Working Capital Expenditures	$0	WorkingCapitalExpendituresAmt
Capital Expenditures	$0	CapitalExpendituresAmt
Other Spent Proceeds	$0	OtherSpentProceedsAmt
Unspent	$0	UnspentAmt
Substantial Completion	2004	SubstantialCompletionYr
Current Refunding	Yes (true)	CurrentRefundingInd
Advance Refunding	false	AdvanceRefundingInd
Final Allocation Made	Yes (true)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (true)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedPropertyInd
Any Lease Arrangements	false	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	false	MgmtContractBondFincdPropInd
Any Research Agreements	false	AnyResearchAgreementsInd
Private Bus Use By Others	0	PrivateBusUseByOthersPct

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiledInd
Exception To Rebate	Yes (true)	ExceptionToRebateInd
Variable Rate Issue	false	VariableRateIssueInd
Hedge Identified In Bks And Rec	false	HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

GIC Provider Name GICProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Gross Proceeds Invested	false	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	false	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	false	ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
John P Welch MD
See Part V	$316,119	Property Rental	false
Frederick C Laurenzo
See Part V	$86,014	Car Sales	false
Frederick S Wolfson
See Part V	$138,334	Attorney Fees	false

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part IV, line 2	John Welch, a trustee of the good samaritan hospital, is a partner in Welch wagner partnership.
Part IV, Line 3	Frederick Laurenzo, a trustee of the good samaritan hospital, is a partner in federick chevrolet, cadillac, and toyota.
Part IV, Line 4	Frederick Wolfson, a trustee of the good samaritan hospital, is a partner in reilly, wolfson, sheffey, schrum & lundberg.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part VI, Section A, Line 1a	There are no material differences in voting rights among the members of the governing body. The executive committee shall consist of the officers of the corporation other than the vice president, the president of the medical staff, the solicitor, the chairman of all standing committees and the most recent past chairman of the board. It shall be the duty of the executive committee to review matters brought to its attention and to make recommendations to the board for board action. It shall have the power to transact emergency business of the corporation during the interval between board meetings, provided such action does not conflict with policies and expressed wishes of the board. It shall report any actions taken to the board at the board's next regular meeting.
Part VI, Section A, Line 6	At June 30, 2015, The Good Samaritan Health Services Foundation, another 501(c)(3) organization, is the sole member of the Good Samaritan Hospital. Effective July 1, 2015, Wellspan Health acquired Good Samaritan Hospital.
Part VI, Section A, Line 7a	The Good Samaritan Health Services Foundation, as the sole member of the Good Samaritan Hospital, may elect one or more trustees of the hospital's governing body.
Part VI, Section A, Line 7b	Certain decisions of the hospital's governing body are subject to approval by the Hospital's sole member, The Good Samaritan Health Services Foundation.
Part VI, Section B, Line 11	Management provides an electronic copy of the form 990 to each voting member of the organization's governing body prior to its filing with the IRS.
Part VI, Section B, Line 12a	The Good Samaritan Hospital has a Compliance Officer who is responsible for monitoring and enforcing the compliance of policies. Board members sign a conflict of interest statement every year which states what organizations or businesses he or she is the owner, officer, member or employee. If an issue is brought to the board members, the board member would remove himself/herself from the discussion and abstain from voting on the issue.
Part VI, Section B, Line 15a	The compensation committee hires an independent compensation consultant to establish the CFO's compensation and compose the contract. The compensation committee presents the information to the board for discussion. The deliberation and compensation decision are documented in the committee and/or Board meetings.
Part VI, Section C, Line 19	The governing documents, conflict of interest policy and audited financial statements are available upon request.
Other Changes in Net Assets or Fund Balance	Change in accrued reitrement benefit costs ($ 9,568,768) Transfer to Affiliates ($ 8,502,320) ------------- total ($18,071,088)

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
Good Samaritan Health Service Foundation
259 South 4th Street	Lebanon	PA	17042	232356151	Parent	PA	501(c)(3)	11 Type I	NA	false
Good Samaritan Physician Services
259 South 4th Street	Lebanon	PA	17042	251832359	Family Med	PA	501(c)(3)	9	GSHS FDN	false
Good Samaritan Real Estate Inc
241 South 4th Street	Lebanon	PA	17042	232447262	HOLDING COMP	PA	501(c)(2)		GSHS FDN	false
GSH Dialysis Inc
440 oak Street	lebanon	PA	17042	232500940	dialysis	PA	501(c)(3)	3	GSHS FDN	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	Lebanon MRI Associates Ltd	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4th Walnut Streets	AddressLine1Txt
City	Lebanon	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	17042	ZIPCd

Field	Value	IRS element (for citing)
EIN	363730905	EIN
Primary Activities	imaging	PrimaryActivitiesTxt
Legal Domicile State	PA	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	GSH Services	BusinessNameLine1Txt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt
GSH Services Inc
241 South 4th Street	Lebanon	PA	17042	232353047	Mgmt/Acct	PA	GSH Fnd	C Corp
GSH Home Med Center Inc
301 Schneider Drive	Lebanon	PA	17042	232028099	Med Equip	PA	GSH FDN	C Corp
GSH Realty Inc
241 South 4th Street	Lebanon	PA	17042	232446622	Title Holding	PA	GSH FDN	C Corp

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	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	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd