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WAYNESBORO HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
WAYNESBORO HOSPITAL (EIN 23-1360854)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-10
IRS object ID
201311309349302766
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-10T14:08:04-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN520783935EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SMITH ELLIOTT KEARNS & COMPANY LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1804 WAYNE AVENUEAddressLine1
CityCHAMBERSBURGCity
StatePAState
ZIP Code17201ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN231360854EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1WAYNESBORO HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWAYNNameControl
Phone7177653410Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1501 EAST MAIN STREETAddressLine1
CityWAYNESBOROCity
StatePAState
ZIP Code17268ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePATRICK W O'DONNELLName
TitleCHIEF FINANCIAL OFFICERTitle
Phone7172677106Phone
Date Signed2013-05-01DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameGREGORY P HALL CPAName
PTINP00156653PTIN
Phone7172633910Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonPATRICK W O'DONNELLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1501 EAST MAIN STREETAddressLine1
CityWAYNESBOROCity
StatePAState
ZIP Code17268ZIPCode
FieldValueIRS element (for citing)
Gross Receipts67936702GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1922YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionTHE WAYNESBORO HOSPITAL IS A REGIONAL NONPROFIT HEALTH CARE ORGANIZATION COMMITTED TO THE IMPROVEMENT OF THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTH-CENTRAL PENNSYLVANIA.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees590TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI231001TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year263467ContributionsGrantsPriorYear
Contributions Grants Current Year217978ContributionsGrantsCurrentYear
Program Service Revenue Prior Year65074572ProgramServiceRevenuePriorYear
Program Service Revenue CY65258974ProgramServiceRevenueCY
Investment Income Prior Year1744409InvestmentIncomePriorYear
Investment Income Current Year1621023InvestmentIncomeCurrentYear
Other Revenue Prior Year1225716OtherRevenuePriorYear
Other Revenue Current Year761269OtherRevenueCurrentYear
Total Revenue Prior Year68308164TotalRevenuePriorYear
Total Revenue Current Year67859244TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year35818935SalariesEtcPriorYear
Salaries Etc Current Year35970170SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year21294283OtherExpensePriorYear
Other Expenses Current Year21756383OtherExpensesCurrentYear
Total Expenses Prior Year57113218TotalExpensesPriorYear
Total Expenses Current Year57726553TotalExpensesCurrentYear
Revenues Less Expenses Prior Year11194946RevenuesLessExpensesPriorYear
Revenues Less Expenses CY10132691RevenuesLessExpensesCY
Total Assets BOY79456933TotalAssetsBOY
Total Assets EOY85396587TotalAssetsEOY
Total Liabilities BOY8665865TotalLiabilitiesBOY
Total Liabilities EOY10412007TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY70791068NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY74984580NetAssetsOrFundBalancesEOY
Mission DescriptionTHE WAYNESBORO HOSPITAL IS A REGIONAL NON-PROFIT HEALTH CARE ORGANIZATION COMMITTED TO THE IMPROVEMENT OF THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTH CENTRAL PENNSYLVANIA.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense46901400Expense
Revenue65677511Revenue
DescriptionTHE WAYNESBORO HOSPITAL PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY REGARDLESS OF ANY PATIENT'S ABILITY TO PAY. HEALTH CARE SERVICES INCLUDE INPATIENT ROUTINE, INPATIENT ANCILLARY AND OUTPATIENT CARE. ALL MANAGEMENT AND GENERAL EXPENSES ARE CONSIDERED PROGRAM RELATED.Description
Total Program Service Expense46901400TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities1ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109625NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees590NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account1ForeignFinancialAccount
Name Of Foreign CountryCJNameOfForeignCountry
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1PATRICK W O'DONNELL CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7172673000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1112 NORTH SEVENTH STREETAddressLine1
CityCHAMBERSBURGCity
StatePAState
ZIP Code17201ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
RICHARD MARKS
PRESIDENT0.80XX000
PAUL D GUNDER
VICE CHAIR OF BOARD0.70XX000
DENNIS SHOCKEY
SECRETARY0.50XX000
PATRICK O'DONNELL
TREASURER/V.P. OF FINANCE4.00XX4583141248092359
NORMAN B EPSTEIN
PRESIDENT6.00XX14644282984098560
JOHN BLUBAUGH
DIRECTOR0.60X000
FRANK ERVIN
DIRECTOR0.60X000
JEAN LESSARD MD
DIRECTOR0.30X000
KATHRYN REIHARD MD
DIRECTOR0.70X000
JAMES ROCK
DIRECTOR0.60X000
PAUL SCHEMEL
DIRECTOR0.70X000
LISA WARD
DIRECTOR0.60X000
BONNIE ZEHLER
DIRECTOR0.60X000
THOMAS ANDERSON
VP MEDICAL AFFAIRS8.00X7944531778141693
PATRICIA BABAROWICZ
V.P. OF COMMUNITY RELATIONS4.00X1865816792251378
KENNETH L SHUR
VICE PRESIDENT OPERATIONS40.00X225847037404
SHERRI STAHL
V.P. FOR PATIENT SERVICES8.00X4887019547844860
MICHELE ZEIGLER
V.P. OF INFORMATION SERVICES8.00X5197820791055902
JEFF CARTY
VP FINANCE40.00X193631036333
JILL KELLER
VP NURSING SVCS/QUALITY/RISK MANAGEMENT40.00X154030032159
MELISSA DUBROW
VP ALLIED SERVICES40.00X143910029073
SCOTT CARD
PHYSICIAN40.00258696028917X
ELIZABETH COOK
EMERGENCY SERVICES40.00255458030593X
VICKI ELLIS
EMERGENCY SERVICES40.00269911028302X
BRUCE FOSTER
EMERGENCY SERVICES40.00327939029568X
NORBERT MATHAIS
EMERGENCY SERVICES40.00429305029462X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2649951TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2131411TotalReportableCompFrmRltdOrgs
Total Other Compensation666563TotalOtherCompensation
Number Individuals GT100 K18NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
THE CHAMBERSBURG HOSPITAL
112 N SEVENTH STREETCHAMBERSBURGPA17201PHYSICAL THERAPY SERVICES, LABORATORY SE1434867
ROBINWOOD ORTHOPEDIC SERVICES
11110 MEDICAL CAMPUS ROADHAGERSTOWNMD21742SURGERY ON-CALL407503
SUMMIT PHYSICIAN SERVICES
785 FIFTH AVENUECHAMBERSBURGPA17201PHYSICIAN SERVICES334342
ELLSWORTH ELECTRIC
131 SUNSET BLVD WESTCHAMBERSBURGPA17201ELECTRICAL SERVICES246240
QUEST DIAGNOSTICS
12436 COLLECTIONS CENTER DRIVECHICAGOIL60693LAB TESTING SERVICES202446
FieldValueIRS element (for citing)
Number Of Contractors GT100 K9NumberOfContractorsGT100K
Government Grants16589GovernmentGrants
All Other Contributions201389AllOtherContributions
Total Contributions217978TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT REVENUEDescription
Business Code621990BusinessCode
Total Revenue Column65258974TotalRevenueColumn
Related Or Exempt Function Income65258974RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue65258974TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1296576TotalRevenueColumn
Exclusion$1,296,576ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real189189Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real77458Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real111731Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column111731TotalRevenueColumn
Exclusion$111,731ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities247883Securities
Other76564Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities247883Securities
Other76564Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column324447TotalRevenueColumn
Exclusion$324,447ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
CAFETERIA900099238327238327
COURIER AND LAB SERVIC621500231001231001
MISC. OPERATING REVENU9000998425184251

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column95959TotalRevenueColumn
Related Or Exempt Function Income95959RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue649538TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column67859244TotalRevenueColumn
Related Or Exempt Function Income65677511RelatedOrExemptFunctionIncome
Unrelated Business Revenue231001UnrelatedBusinessRevenue
Exclusion$1,732,754ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1324725Total
Management And General1324725ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total25694279Total
Program Services21940003ProgramServices
Management And General3754276ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1233676Total
Program Services1001771ProgramServices
Management And General231905ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5848270Total
Program Services4748919ProgramServices
Management And General1099351ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1869220Total
Program Services1517846ProgramServices
Management And General351374ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total27700Total
Program Services21145ProgramServices
Management And General6555ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2986874Total
Program Services2280041ProgramServices
Management And General706833ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total84623Total
Program Services64597ProgramServices
Management And General20026ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total152056Total
Program Services116072ProgramServices
Management And General35984ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total628448Total
Program Services479728ProgramServices
Management And General148720ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total77803Total
Program Services59391ProgramServices
Management And General18412ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total30723Total
Program Services23453ProgramServices
Management And General7270ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total6876Total
Program Services3929ProgramServices
Management And General2947ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2735022Total
Program Services1444012ProgramServices
Management And General1291010ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total622327Total
Program Services475056ProgramServices
Management And General147271ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE59350435935043
SUPPLIES571315543611571351998
PROFESSIONAL SERVICES13760551376055
EQUIPMENT RENTAL AND RE1101253840645260608

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total278425Total
Program Services212537ProgramServices
Management And General65888ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total57726553Total
Program Services46901400ProgramServices
Management And General10825153ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1420BOY
EOY1420EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3752922BOY
EOY6817106EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY22550BOY
EOY19478EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6035617BOY
EOY6954267EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY335832BOY
EOY315524EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY776335BOY
EOY790118EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis61988145LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec42904547LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY18159722BOY
EOY19083598EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY11199169BOY
EOY13205130EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY36249589BOY
EOY35455590EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2923777BOY
EOY2754356EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY79456933BOY
EOY85396587EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6053109BOY
EOY7472635EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY595000BOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2017756BOY
EOY2939372EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8665865BOY
EOY10412007EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY68271633BOY
EOY72614886EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2519435BOY
EOY2369694EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY70791068BOY
EOY74984580EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY79456933BOY
EOY85396587EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses10132691ReconcilationRevenueExpenses
Reconcilation Other Changes-5939179ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance6174336BeginningOfYearBalance
Contributions109424Contributions
End Of Year Balance6567209EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance6096545BeginningOfYearBalance
Contributions77791Contributions
Investment Earnings Or Losses756758InvestmentEarningsOrLosses
Other Expenditures450000OtherExpenditures
End Of Year Balance7381094EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5498442BeginningOfYearBalance
Contributions98262Contributions
Investment Earnings Or Losses499841InvestmentEarningsOrLosses
End Of Year Balance6096545EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance6290104BeginningOfYearBalance
Contributions80824Contributions
Investment Earnings Or Losses-872486InvestmentEarningsOrLosses
End Of Year Balance5498442EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.96000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.04000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis333802InvestmentCostOrOtherBasis
Other Cost Or Other Basis2184775OtherCostOrOtherBasis
Book Value2518577BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis2483074InvestmentCostOrOtherBasis
Other Cost Or Other Basis15163745OtherCostOrOtherBasis
Depreciation9776803Depreciation
Book Value7870016BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis40431131OtherCostOrOtherBasis
Depreciation32438456Depreciation
Book Value7992675BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1391618OtherCostOrOtherBasis
Depreciation689288Depreciation
Book Value702330BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings19083598TotalOfBookValueLandBuildings

Other Securities OtherSecurities (4 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
CASH AND MONEY FUNDS450829F
FIXED INCOME24857306F
REAL ASSETS10113077F
PENSION TRUST34378F
FieldValueIRS element (for citing)
Total Of Book Value Securities35455590TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
ADVANCES FROM THIRD PARTY PAYORS$252,800
PAYABLE UNDER THIRD PARTY CONTRATUAL AGREEMENT$2,640,218
PENSION PAYROLL DEDUCTION$46,354
FieldValueIRS element (for citing)
Total Of Amounts2939372TotalOfAmounts
Total Revenue67859244TotalRevenue
Total Expenses57726553TotalExpenses
Excess Or Deficit For Year10132691ExcessOrDeficitForYear
Net Unrealized GL On Investments-427802NetUnrealizedGLOnInvestments
Other-$5,511,377OtherAmount
Total Adjustments-5939179TotalAdjustments
Excess Or Deficit Per FS4193512ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt67829124TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal67829124RevenueSubtotal
Other Revenues Not Included30120OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt30120RevenueNotRptdOnFinStmt
Total Revenue Per Form99067859244TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt57726553TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal57726553ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99057726553TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:WHEN TAX RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD BE ULTIMATELY SUSTAINED. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE 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 UNRECOGNIZED TAX BENEFITS WOULD BE CLASSIFIED AS EXPENSES AGAINST OTHER OPERATING REVENUE IN THE STATEMENT OF OPERATIONS. AT JUNE 30, 2012 AND 2011 THERE WAS NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS.
PART XI, LINE 8 - OTHER ADJUSTMENTS:DECREASE IN PERPETUAL TRUSTS HELD BY THIRD PARTIES: -167,997. TRANSFER TO AFFILIATE ORG. - SUMMIT PHYSICIAN SERVICES: -5,343,380. TOTAL TO SCHEDULE D, PART XI, LINE 8: -5,511,377.
PART XII, LINE 4B - OTHER ADJUSTMENTS:RESTRICTED INVESTMENT INCOME 30,120.

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCENTRAL AMERICA AND THE CARIBBEANRegion
Number Of Offices0NumberOfOffices
Number Of Employees0NumberOfEmployees
Type Of Activities ConductedALTERNATIVE INVESTMENT VEHICLE.TypeOfActivitiesConducted
Total Expenditures4818222TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Number Of Offices0SubtotalNumberOfOffices
Subtotal Number Of Employees0SubtotalNumberOfEmployees
Cont Number Of Offices0ContNumberOfOffices
Cont Number Of Employees0ContNumberOfEmployees
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees0TotalNumberOfEmployees
Subtotal Amount Spent4818222SubtotalAmountSpent
Cont Amount Spent0ContAmountSpent
Total Amount Spent4818222TotalAmountSpent
Transfer To Foreign Corp0TransferToForeignCorp
Interest In Foreign Trust0InterestInForeignTrust
Own Foreign Corp1OwnForeignCorp
Passive Foreign Invest Co0PassiveForeignInvestCo
Foreign Partnership0ForeignPartnership
Boycott Countries0BoycottCountries

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage250.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense739120TotalCommunityBenefitExpense
Net Community Benefit Expense739120NetCommunityBenefitExpense
Percent Of Total Expense0.01280PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense7251852TotalCommunityBenefitExpense
Direct Offsetting Revenue3752477DirectOffsettingRevenue
Net Community Benefit Expense3499375NetCommunityBenefitExpense
Percent Of Total Expense0.06060PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense7990972TotalCommunityBenefitExpense
Direct Offsetting Revenue3752477DirectOffsettingRevenue
Net Community Benefit Expense4238495NetCommunityBenefitExpense
Percent Of Total Expense0.07340PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served2256PersonsServed
Total Community Benefit Expense65723TotalCommunityBenefitExpense
Net Community Benefit Expense65723NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served12PersonsServed
Total Community Benefit Expense17447TotalCommunityBenefitExpense
Net Community Benefit Expense17447NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served508PersonsServed
Total Community Benefit Expense17310TotalCommunityBenefitExpense
Net Community Benefit Expense17310NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs13NumberOfActivitiesOrPrograms
Persons Served2776PersonsServed
Total Community Benefit Expense51598TotalCommunityBenefitExpense
Net Community Benefit Expense51598NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs26NumberOfActivitiesOrPrograms
Persons Served5552PersonsServed
Total Community Benefit Expense152078TotalCommunityBenefitExpense
Net Community Benefit Expense152078NetCommunityBenefitExpense
Percent Of Total Expense0.00260PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs26NumberOfActivitiesOrPrograms
Persons Served5552PersonsServed
Total Community Benefit Expense8143050TotalCommunityBenefitExpense
Direct Offsetting Revenue3752477DirectOffsettingRevenue
Net Community Benefit Expense4390573NetCommunityBenefitExpense
Percent Of Total Expense0.07600PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$5,935,043BadDebtExpenseAmount
Amount Reimbursed By Medicare11377582AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare15984693CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-4607111MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1WAYNESBORO HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1501 EAST MAIN STREETAddressLine1
CityWAYNESBOROCity
StatePAState
ZIP Code17268ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1WAYNESBORO HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent125.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent250.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Insurance StatusXInsuranceStatus
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 3C: THE ORGANIZATION USES FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE CHARITY CARE.
PART I, LINE 7: NOTE 1. TO THE FINANCIAL STATEMENTS: PATIENT RECEIVABLESTHE HOSPITAL PROVIDES CREDIT IN THE NORMAL COURSE OF ITS BUSINESS TO PATIENTS. PATIENT RECEIVABLES ARE GENERALLY DUE 60 DAYS AFTER BILLED. AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CARRIED FOR PATIENT ACCOUNTS THAT MAY BECOME UNCOLLECTIBLE IN FUTURE PERIODS. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED ON MANAGEMENT'S JUDGMENT OF UNCOLLECTIBLE ACCOUNTS, HISTORICAL TRENDS AND OTHER INFORMATION. PATIENT RECEIVABLES ARE CHARGED AGAINST THE ALLOWANCE WHEN, IN THE JUDGMENT OF MANAGEMENT, IT IS UNLIKELY THEY WILL BE COLLECTED. BAD DEBT AMOUNTS ARE REPORTED AT GROSS CHARGES.THE SHORTFALL FOR MEDICARE IS NOT INCLUDED IN OUR COMMUNITY BENEFIT REPORTING. A COST TO CHARGE RATIO WAS USED TO CALCULATE THE MEDICARE ALLOWABLE COST. RCC=((NET PATIENT REVENUE/(TOTAL OPERATING REV+(OTHER OPR REV -+ DERIVATIVE GAIN/LOSS))*TOTAL OPERATING EXPENSE)/GROSS PT REVALL PATIENTS ARE SUBJECT TO THE DEBT COLLECTION POLICY REGARDLESS OF THEIR ABILITY TO PAY.
PART II: WAYNESBORO HOSPITAL WORKS TO STRENGTHEN OUR COMMUNITY THROUGH HEALTH EDUCATION EFFORTS FOR CHILDREN AND ADULTS, HEALTH FAIRS PROVIDING DIAGNOSTIC TESTING, EDUCATING COMMUNITY GROUPS ON SPECIFIC HEALTH TOPICS, FUNDING LOCAL COMMUNITY ORGANIZATIONS THROUGH THE SUMMIT ENDOWMENT PROGRAM, PROVIDING RESOURCES FOR THE "HEALTHY COMMUNITIES PARTNERSHIP" PROGRAM, PARTICIPATING IN LOCAL CIVIC ORGANZIATIONS, SPONSORING EVENTS HELD BY LOCAL CHARTIABLE ORGANIZATIONS, AND SUPPORTING WORKFORCE DEVELOPMENT INITIATIVES THROUGH SUMMIT HEALTH'S SCHOOL LIAISON DEPARTMENT.
PART III, LINE 4: THE HOSPITAL PROVIDES CREDIT IN THE NORMAL COURSE OF ITS BUSINESS TO PATIENTS. PATIENT RECEIVABLES ARE GENERALLY DUE 60 DAYS AFTER BILLED. AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CARRIED FOR PATIENT ACCOUNTS THAT MAY BECOME UNCOLLECTIBLE IN FUTURE PERIODS. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED ON MANAGEMENT'S JUDGMENT OF UNCOLLECTIBLE ACCOUNTS, HISTORICAL TRENDS AND OTHER INFORMATION. PATIENT RECEIVABLES ARE CHARGED AGAINST THE ALLOWANCE WHEN, IN THE JUDGMENT OF MANAGEMENT, IT IS UNLIKELY THEY WILL BE COLLECTED.THE COST TO CHARGE RATIO WAS USE TO CALCULATE THE COST OF BAD DEBT EXPENSE. THIS RATIO IS CALCULATED AS FOLLOWS: [NET PATIENT REVENUE DIVIDED BY THE TOTAL OPERATING REVENUE MULTIPLIED BY THE TOTAL OPERATING EXPENSE] DIVIDED BY THE GROSS PATIENT REVENUE.
PART III, LINE 8: THE INFORMATION WAS OBTAINED USING THE COST METHODS USED IN PREPARING THE MEDICARE COST REPORTS. THE SHORTFALL ABOVE RELATES TO OUR MISSION OF PROVIDING SERVICES TO MEMBERS OF OUR COMMUNITY.
PART V, SECTION B, LINE 19D: A SLIDING SCALE IS USED TO DETERMINE THE DISCOUNTED RATE. ANYONE WHO QUALIFIES RECEIVES A MINIMUM OF 25% OFF CHARGES.WAYNESBORO HOSPITAL
PART VI, LINE 2: HEALTH NEEDS OF FRANKLIN COUNTY RESIDENTS AND SURROUNDING COMMUNITIES ARE ASSESSED THROUGH NUMEROUS RESEARCH METHODS INCLUDING CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENT (SURVEY FORMAT) IN SPRING 2009, A REVIEW OF REGIONAL HEALTH DATA AND INTERVIEWS WITH KEY COMMUNITY ORGANIZATIONS INCLUDING SCHOOLS, AREA AGENCY ON AGING, PA DEPARTMENT OF HEALTH, FRANKLIN COUNTY HUMAN SERVICES AND THE HEALTHY COMMUNITIES PARTNERSHIP.
PART VI, LINE 3: PATIENTS ARE MADE AWARE OF THE CHARITY PROGRAM AND OTHER BILLING ASSISTANCE SERVICES AT REGISTRATION, DURING EMERGENCY ROOM VISITS, AND NOTICES PLACED IN SERVICE AREAS. BILLING STATEMENTS ALSO INFORM PATIENTS OF CHARITY CARE AND OTHER BILLING ASSISTANCE PROGRAMS.
PART VI, LINE 4: WAYNESBORO HOSPITAL PRIMARILY SERVES COMMUNITY MEMBERS FROM FRANKLIN AND FULTON COUNTY, PA, AND NEARBY COMMUNITIES IN WASHINGTON COUNTY, MD. ACCORDING TO U.S. CENSUS DATA, FRANKLIN COUNTY RESIDENTS HAVE A SLIGHTLY LOWER INCOME AND ARE SLIGHTLY OLDER THAN THE STATE AVERAGE. FOR A HEALTH SYSTEM, THIS TYPICALLY RESULTS IN AN INCREASED NEED FOR HEALTHCARE SERVICES.
PART VI, LINE 5: WAYNESBORO HOSPITAL SUPPORTS LOCAL NON-PROFIT ORGANIZATIONS WITH FINANCIAL GRANTS FROM THE SUMMIT ENDOWMENT.
PART VI, LINE 6: THE HOSPITAL IS PART OF SUMMIT HEALTH, A REGIONAL NETWORK OF HOSPITALS AND HEALTHCARE PROVIDERS THAT ARE SERVED BY THE ORGANIZATION'S COMMUNITY HEALTH DEPARTMENT. THIS DEPARTMENT'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITY THROUGH EDUCATION, DETECTION AND PREVENTION PROGRAMS INCLUDING HEALTH FAIRS, SCREENINGS, AND SEMINARS. THIS MISSION IS COMPLETED ON BEHALF OF WAYNESBORO HOSPITAL AND ALL OTHER SUMMIT HEATLH AFFILIATES. PART OF THIS MISSION IS COMPLETED THROUGH COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS INCLUDING THE PA DEPARTMENT OF HEALTH.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantFLU VACCINATIONSTypeOfGrant
Number Of Recipients452NumberOfRecipients
Amount Of Non Cash Assistance9227AmountOfNonCashAssistance
Method Of ValuationCOSTMethodOfValuation

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: ALL FUNDING DECISIONS ARE MADE BY THE SUMMIT ENDOWMENT COMMITTEE, A COMMITTEE OF THE SUMMIT HEALTH BOARD. THE ENDOWMENT MANAGER PROCESSES GRANT APPLICATIONS, ASSISTS GRANTEES IN DEVELOPING SOUND PROGRAM EVALUATION METHODOLOGIES, RECEIVES AND SUMMARIZES PERIODIC REPORTS, AND VISITS PROGRAM SITES, REPORTING ALL ACTIVITIES TO THE SUMMIT ENDOWMENT COMMITTEE. AS WELL, ENDOWMENT COMMITTEE MEETING MINUTES ARE SHARED WITH WAYNESBORO HOSPITAL, CHAMBERSBURG HOSPITAL AND SUMMIT HEALTH BOARDS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Discretionary Spending AccountXDiscretionarySpendingAccount
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
PATRICK O'DONNELL
332882995959574861642969267217516676411720154825506749560300
NORMAN B EPSTEIN
11031962514129700168300642336399112796391435051986216122691361600
THOMAS ANDERSON
6316725266911340453604938197525400215982939117568778435113500
PATRICIA BABAROWICZ
1406312656932502925013451210344734025866559822379621416200
KENNETH L SHUR
1745390387450125630127870246170263251000
SHERRI STAHL
385891543567380295182901116046033241322939117565784223136600
MICHELE ZEIGLER
403761615057766310633836153427121284864059162366315825263200
JEFF CARTY
1495670288100152540111970251360229964000
JILL KELLER
1386860800007344091440230150186189000
MELISSA DUBROW
1281160789707897083290207440172983000
SCOTT CARD
2524950600002010133060156110287613000
ELIZABETH COOK
25063400048240147000158930286051000
VICKI ELLIS
26038300095280123590159430298213000
BRUCE FOSTER
32399200039470147000148680357507000
NORBERT MATHAIS
415857000134480147000147620458767000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ATHE ORGANIZATION REIMBURSES THE COO FOR DUES ASSOCIATED WITH A SOCIAL CLUB. THE OFFICER RECEIVES AN ALLOWANCE THAT CAN BE CONSIDERED A DISCRETIONARY SPENDING ACCOUNT. THE MONIES ARE IN LIEU OF AN AUTOMOBILE ALLOWANCE, TO PURCHASE ADDITIONAL LIFE INSURANCE, ETC. THESE MONIES ARE INCLUDED IN COMPENSATION AS REPORTED IN THE COMPENSATION OF OFFICERS TABLE. RESULTS FITNESS CLUB MEMBERSHIP IS AVAILABLE FREE OF CHARGE FOR ANY OFFICER AND ACTIVE BOARD MEMBER.
PART I, LINE 4BNORMAN EPSTEIN - NO PAYMENT PATRICK W. O'DONNELL - NO PAYMENT THOMAS ANDERSON - NO PAYMENT PAT BARBAROWICZ - NO PAYMENT JOHN MCELWEE - NO PAYMENT
PART I, LINE 7INCENTIVE 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.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6SUMMIT HEALTH, A 501(C)(3) ENTITY, IS A MEMBER OF THIS ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7ASUMMIT HEALTH, A 501(C)(3) ENTITY, ELECTS THE GOVERNING BODY OF THIS ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7BSUMMIT HEALTH, A 501(C)(3) ENTITY, HAS CERTAIN RESERVE POWERS OF THIS ORGANIZATION
FORM 990, PART VI, SECTION B, LINE 11THE 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 12CMEMBERS ARE ASKED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THEY MAY HAVE.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION IS DISCUSSED WITH A COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. 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 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THESE DOCUMENTS ARE HELD IN THE FINANCE DEPARTMENT OF THE WAYNESBORO HOSPITAL. HOSPITAL BYLAWS AND ALL POLICIES AND PROCEDURES ARE FOUND ON THE WAYNESBORO HOSPITAL INTRANET.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -427,802. DECREASE IN PERPETUAL TRUSTS HELD BY THIRD PARTIES: -167,997. TRANSFER TO AFFILIATE ORG. - SUMMIT PHYSICIAN SERVICES: -5,343,380. TOTAL TO FORM 990, PART XI, LINE 5: -5,939,179.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CTHE ORGANIZATIONS PROCESS REGARDING THE COMMITTEE THAT OVERSEES THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED SINCE THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
SUMMIT HEALTH
112 NORTH SEVENTH STREETCHAMBERSBURGPA17201251515371MANAGE AND ADMINISTER THE LOCAL AND REGIONAL NETWORK OF HEALTHCARE PROVIDERSPA501(C)(3)LINE 7SUMMIT HEALTH0
THE CHAMBERSBURG HOSPITAL
112 NORTH SEVENTH STREETCHAMBERSBURGPA17201230465970SERVE THE HEALTH CARE NEEDS OF FRANKLIN COUNTY PA AND THE SURROUNDING COMMUNPA501(C)(3)LINE 3SUMMIT HEALTH0
CHAMBERSBURG HEALTH SERVICES
260 NORTH SEVENTH STREETCHAMBERSBURGPA17201251515376SERVE THE HEALTH CARE NEEDS OF FRANKLIN COUNTY PA AND THE SURROUNDING COMMUNPA501(C)(3)LINE 11A, ISUMMIT HEALTH0
SUMMIT PHYSICIAN SERVICES
601 NORLAND AVENUECHAMBERSBURGPA17201251716306PROVIDES APPROPRIATE PHYSICIAN MANPOWER FOR VARIOUS FAMILY PRACTICES SERVINGPA501(C)(3)LINE 11A, ISUMMIT HEALTH0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg