2014-04-10T10:14:32-05:00 2013-06-30 520783935 SMITH ELLIOTT KEARNS & COMPANY LLC 804 WAYNE AVENUE CHAMBERSBURG PA 17201 990 2012-07-01 251515376 CHAMBERSBURG HEALTH SERVICES CHAM 7172672668 785 5TH AVENUE NO 5 CHAMBERSBURG PA 17201 KIMBERLY M RZOMP 7172677107 2014-04-04 1 GREGORY P HALL CPA P00156653 7172633910 2012 2015-11-30 17:44:51Z KIMBERLY M RZOMP 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 27833117 0 X WWW.SUMMITHEALTH.ORG X 1985 PA OPERATIONS INCLUDE THE SUMMIT CANCER SERVICES RADIATION AND MEDICAL ONCOLOGY; RESULTS THERAPY & FITNESS; 50% PARTNER IN SHIPPENSBURG FAMILY PRACTICE AND WALK-IN CARE; 87.6% PARTNER OF SUMMIT SURGERY CENTER; 48% PARTNER IN MEDCAREERS LLC; 51% PARTNER IN CUMBERLAND VALLEY MOBILE SERVICES, LLC, AND LANDLORD/OWNER OF SUMMIT HEALTH CENTER; MERCERSBURG HEALTH CENTER; MONT ALTO CENTER, RESULTS AND KEYSTONE PAVILION FACILITIES. 15 13 73 0 0 0 16629 11970 20137070 20555414 2021494 2946017 870801 861945 23045994 24375346 0 0 0 0 6015349 5971111 0 0 0 14145434 15115810 20160783 21086921 2885211 3288425 68911978 74069314 14305786 13823388 54606192 60245926 X OPERATIONS INCLUDE THE SUMMIT CANCER SERVICES RADIATION AND MEDICAL ONCOLOGY; RESULTS THERAPY & FITNESS; 68.45% PARTNER OF SUMMIT SURGERY CENTER; 51% PARTNER IN CUMBERLAND VALLEY MOBILE SERVICES, LLC, AND LANDLORD/OWNER OF SUMMIT HEALTH CENTER; MERCERSBURG HEALTH CENTER; MONT ALTO CENTER, RESULTS AND KEYSTONE PAVILION FACILITIES. 0 0 20070472 20590338 CHAMBERSBURG HEALTH SERVICES PROVIDES CANCER TREATMENT THERAPY SERVICES TO PATIENTS IN THE COMMUNITY, AS WELL AS INPATIENTS OF THE CHAMBERSBURG HOSPITAL, AN AFFILIATED ORGANIZATION. MEDICAL ONCOLOGY, PHYSICAL THERAPY AND FITNESS SERVICES ARE PROVIDED TO PATIENTS IN THE COMMUNITY. 20070472 1 1 0 0 0 0 0 0 0 1 1 1 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 23 0 1 73 1 0 0 0 0 0 0 0 0 0 0 X 15 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 PA X KIMBERLY M RZOMP - VICE PRESIDENT AND CFO 7172673000 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 VALORIE DICK 0.30 X X 0 0 0 JOEL R ZULLINGER 0.20 X X 0 0 0 FRANK S ELLIOTT 0.60 X X 0 0 0 PATRICK O'DONNELL 2.00 38.00 X X 27105 514987 99212 NORMAN EPSTEIN 0.20 X X 0 1677309 101975 J EDWARD BECK 0.50 X 0 0 0 J FRED STENGER 0.50 X 0 0 0 ANGELA STOOPS 0.20 X 0 0 0 PAUL SCHEMEL 0.60 X 0 0 0 R WILLIAM HAPPEL 0.60 X 0 0 0 ROY HIMELFARB DDS 0.50 X 0 0 0 DEMAREE DEARDORFF 0.10 X 0 0 0 RODGER SAVAGE 0.20 X 0 0 0 NANCY MEYERS 0.10 X 0 0 0 DR JOSEPH THORNTON 0.60 X 0 0 0 KIMBERLY M RZOMP 2.00 38.00 X 9209 174957 47209 MICHELE ZEIGLER 1.00 39.00 X 7037 274414 50811 LISSA NIKI SHOWE 8.00 32.00 X 65524 262098 19019 JIANZHONG LI 40.00 X 208678 0 24874 DOUGLAS LENTZ 40.00 X 110163 0 30642 ZHI LIANG 40.00 X 145300 0 19996 573016 2903765 393738 3 0 1 0 AMERISOURCE BERGEN PO BOX 5187 NEW YORK CITY NY 10087 PARAMEDICALS 9112477 FRANKLIN COUNTY RADIATION 260 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 PROFESSIONAL SERVICES 1599788 MCKESSON PLASMA & BIOLOGIC 16578 COLLECTION CENTER DRIVE CHICAGO IL 60693 PHARMACEUTICALS 885765 ELEKTA INC PO BOX 404199 ATLANTA GA 30384 PROFESSIONAL SERVICES 308033 TOMOTHERAPY INC 1240 DEMING WAY MADISON WI 17224 PROFESSIONAL SERVICES 275000 7 11970 11970 PATIENT SERVICE REVENUE 621110 20555414 20555414 20555414 2946017 2946017 4284792 3457771 827021 827021 827021 OTHER REVENUE 621110 34924 34924 34924 24375346 20590338 0 3773038 129159 129159 4776600 4475748 300852 280848 280848 509160 434076 75084 275344 250480 24864 6705 6705 13078 13078 196206 112732 83474 139689 60032 79657 638225 634622 3603 191425 191425 17154 15020 2134 22509 19515 2994 35496 35496 1131332 862572 268760 37945 37945 SUPPLIES 11016135 10994175 21960 PHYSICIAN FEES 1632627 1632627 DUES 20069 19164 905 MISCELLANEOUS EXPENSE 8863 5643 3220 8352 8352 21086921 20070472 1016449 0 650 650 6451059 4813770 1534594 1905545 84775 61350 281677 281677 523455 567735 54242735 25373600 30712419 28869135 4740024 5207935 14072119 22464504 10511206 9897013 68911978 74069314 2506802 2362040 11798984 11461348 14305786 13823388 X 45601871 50640697 9004321 9605229 54606192 60245926 68911978 74069314 X 3288425 810159 1541150 X X 0 1 X 1 0 X X 0 0 0 THE CHAMBERSBURG HOSPITAL 230465970 3 0 0 1 0 SUMMIT HEALTH 251515371 7 0 0 1 0 2 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3453074 432872 71119 10516 3804311 3488674 40933 67134 9399 3453074 2961043 602341 65385 9325 3488674 2689276 344757 64139 8851 2961043 3260620 -483423 74705 13216 2689276 0.99800 0.00200 0 0 2159954 2159954 8197909 3128838 5069071 14770 1980 12790 9304495 7700610 1603885 34452622 112985 14542172 20023435 28869135 INVESTMENTS - EQUITY METHOD 2214428 F CASH EQUIVALENTS 200149 F FIXED INCOME 16698764 F REAL ASSETS 3351163 F 22464504 OTHER RECEIVABLES 239691 PERPETUAL TRUSTS HELD BY THIRD PARTIES 9597590 TRUST INCOME RECEIVABLE 59732 9897013 X 24584597 0 24584597 -209251 -209251 24375346 21086921 0 21086921 0 21086921 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: WHEN TAX RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD BE ULTIMATELY SUSTAINED. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSISTIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITIY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE WOULD BE REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNZIED TAX BENEFITS WOULD BE CLASSIFIED AS EXPENSES AGAINST OTHER OPERATING REVENUE IN THE STATEMENT OF OPERATIONS. AT JUNE 30, 2013 AND 2012, THERE WAS NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS. PART XI, LINE 4B - OTHER ADJUSTMENTS: ADJUSTMENTS TO MARKET -209,251. X X 0 1 X X X X X 0 1 0 0 0 0 0 1 0 PATRICK O'DONNELL 20534 390144 5061 96162 1510 28681 4006 76113 955 18138 32066 609238 0 0 NORMAN EPSTEIN 0 1419090 0 214500 0 43719 0 78105 0 23870 0 1779284 0 0 KIMBERLY M RZOMP 7674 145801 1470 27930 65 1226 1399 26584 961 18265 11569 219806 0 0 MICHELE ZEIGLER 5530 215668 1007 39254 500 19492 858 33449 413 16091 8308 323954 0 0 LISSA NIKI SHOWE 50301 201204 9456 37824 5767 23070 1500 6000 2304 9215 69328 277313 0 0 JIANZHONG LI 206810 0 0 0 1868 0 23554 0 1320 0 233552 0 0 0 ZHI LIANG 145021 0 0 0 279 0 11245 0 8751 0 165296 0 0 0 PART I, LINE 1A THE ORGANIZATION REIMBURSES THE CEO FOR DUES ASSOCIATED WITH A SOCIAL CLUB. THE OFFICERS RECEIVE AN ALLOWANCE THAT CAN BE CONSIDERED A DISCRETIONARY SPENDING ACCOUNT. THE MONIES ARE IN LIEU OF AN AUTOMOBILE ALLOWANCE, TO PURCHASE ADDITIONAL LIFE INSURANCE, ETC. THESE MONIES ARE INCLUDED IN COMPENSATION AS REPORTED IN THE COMPENSATION OF OFFICERS TABLE. RESULTS FITNESS CLUB MEMBERSHIP IS AVAILABLE FREE OF CHARGE FOR ANY OFFICER AND ACTIVE BOARD MEMBER. PART I, LINE 4B NORMAN EPSTEIN - NO PAYMENT PATRICK W. O'DONNELL - NO PAYMENT MICHELE ZEIGLER - NO PAYMENT PART I, LINE 7 INCENTIVE COMPENSATION IS BASED ON PRE-DETERMINED, MEASURABLE GOALS APPROVED BY THE BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE. THE MEASURABLE GOALS ARE BASED ON QUALITY, COMMUNITY ACCESS TO CARE, PATIENT SAFETY AND LEADERSHIP. A FCIDA HEALTHCARE REVENUE BOND SERIES 2009-08-24 30000000 ISSUED TO REFINANCE THE SERIES OF 2000 AND SERIES OF 2004 0 0 0 A 30000000 117184 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 SUMMIT HEALTH, A 501(C)(3) ENTITY, IS A MEMBER OF THIS ORGANIZATION FORM 990, PART VI, SECTION A, LINE 7A SUMMIT HEALTH, A 501(C)(3) ENTITY, ELECTS THE MEMBERS OF THE GOVERNING BODY FORM 990, PART VI, SECTION A, LINE 7B SUMMIT HEALTH, A 501(C)(3) ENTITY, RETAINS CERTAIN RESERVE POWERS OVER THIS ORGANIZATION FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S 990 IS REVIEWED BY THE AUDIT COMMITEE AND UPON APPROVAL RECOMMENDED TO THE FULL BOARD OF DIRECTORS FOR SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS ARE ASKED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THEY MAY HAVE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DISCUSSED WITH AN INDEPENDENT COMPENSATION COMMITTEE. THIS IS PERFORMED IN CONCERT WITH A COMPENSATION CONSULTANT WHO ASSISTS THIS COMMITTEE IN SETTING THE COMPENSATION FOR THESE INDIVIDUALS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. DOCUMENTS ARE HELD IN THE FINANCE DEPARTMENT OF THE CHAMBERSBURG HOSPITAL. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN PENSION LIABILITY 253,592. TRANSFERS FROM AFFILIATES 1,287,558. 990 PART XII LINE 2C THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. SUMMIT HEALTH 112 NORTH 7TH STREET CHAMBERSBURG PA 17201 251515371 MANAGE AND ADMINISTER THE LOCAL & REGIONAL NETWORK OF HEALTHCARE PROVIDERS. PA 501(C)(3) 7 SUMMIT HEALTH 0 WAYNESBORO HOSPITAL 501 EAST MAIN STREET WAYNESBORO PA 17268 231360854 SERVE THE HEALTH CARE NEEDS OF FRANKLIN COUNTY PA AND SURRONDING COMMUN. PA 501(C)(3) 3 SUMMIT HEALTH 0 CHAMBERSBURG HOSPITAL 112 NORTH 7TH STREET CHAMBERSBURG PA 17201 230465970 SERVE THE HEALTH CARE NEEDS OF SOUTH CENTRAL PA AND SURROUNDING COMMUN. PA 501(C)(3) 3 SUMMIT HEALTH 0 SUMMIT PHYSICIAN SERVICES 785 5TH AVENUE SUITE 3 CHAMBERSBURG PA 17201 251716306 TO PROVIDE APPROPRIATE PHYSICIAN MANPOWER TO SERVE THE LOCAL PHYSICIAN PRACT PA 501(C)(3) 11A - TYPE 1 SUMMIT HEALTH 0 MONT ALTO HEALTH CENTER LP 6155 ANTHONY HIGHWAY MONT ALTO PA 17237 251839895 RENTAL REAL ESTATE PA NOT A DISREGARDED ENTITY FOR TAX PURPOSES INVESTMENT 47018 502078 0 0 0.49900 MONT ALTO HEALTH CENTER LLC 6155 ANTHONY HIGHWAY MONT ALTO PA 17237 231843380 PHYSICIAN SERVICES PA NOT A DISREGARDED ENTITY FOR TAX PURPOSES RELATED 94 1277 0 1 0.50000 SURGERY CENTER ASSOCIATES LLC 785 5TH AVENUE SUITE 3 CHAMBERSBURG PA 17201 251845304 PHYSICIAN SERVICES PA NOT A DISREGARDED ENTITY FOR TAX PURPOSES RELATED 8098 10802 0 1 0.64850 SUMMIT SURGERY CENTER LP 785 5TH AVENUE SUITE 3 CHAMBERSBURG PA 17201 251845303 PHYSICIAN SERVICES PA NOT A DISREGARDED ENTITY FOR TAX PURPOSES RELATED 657456 1482799 0 0 0.68450 SHIPPENSBURG FAMILY PRACTICE LTD 46 WALNUT BOTTOM ROAD SHIPPENSBURG PA 17257 232942280 PHYSICIAN SERVICES PA NOT A DISREGARDED ENTITY FOR TAX PURPOSES RELATED 47503 0 0 0.50000 CUMBERLAND VALLEY MOBILE SERVICES LLC 5 SOUTH MAIN STREET SUITE 5 SUGARLOAF PA 18249 200884014 MOBILE X-RAY SERVICES PA NOT A DISREGARDED ENTITY FOR TAX PURPOSES RELATED 361994 61035 0 0 0.51000 0 0 1 0 0 0 0 0 0 1 1 0 1 0 0 0 0 1 1 SUMMIT SURGERY CENTER LP J 675084 FMV