2012-05-14T09:47:49-05:00 2011-06-30 SMITH ELLIOTT KEARNS & COMPANY LLC 804 WAYNE AVENUE CHAMBERSBURG PA 17201 990 2010-07-01 231360854 WAYNESBORO HOSPITAL WAYN 7177654000 501 EAST MAIN STREET WAYNESBORO PA 17268 PATRICK W O'DONNELL 7172677106 2012-05-10 1 GREGORY P HALL CPA 7172633910 2010 2016-02-24 21:20:13Z PATRICK W O'DONNELL 501 EAST MAIN STREET WAYNESBORO PA 17268 68382011 0 X N/A X 1922 PA THE WAYNESBORO HOSPITAL IS A REGIONAL NONPROFIT HEALTH CARE ORGANIZATION COMMITTED TO THE IMPROVEMENT OF THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTH-CENTRAL PENNSYLVANIA. 12 11 597 123 712575 -2735 188242 263467 63676380 65074572 626406 1744409 1244672 1225716 65735700 68308164 0 0 0 0 35636211 35818935 0 0 0 21557712 21294283 57193923 57113218 8541777 11194946 70887279 79456933 8108774 8665865 62778505 70791068 THE WAYNESBORO HOSPITAL IS A REGIONAL NONPROFIT HEALTH CARE ORGANIZATION COMMITTED TO THE IMPROVEMENT OF THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTH-CENTRAL PENNSYLVANIA. 0 0 46692130 65471330 THE WAYNESBORO HOSPITAL PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY REGARDLESS OF ANY PATIENT'S ABILITY TO PAY. HEALTH CARE SERVICES INCLUDE INPATIENT ROUTINE, INPATIENT ANCILLARY AND OUTPATIENT CARE. ALL MANAGEMENT AND GENERAL EXPENSES ARE CONSIDERED PROGRAM RELATED. 46692130 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 0 0 1 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 31 0 1 597 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X X PATRICK W O'DONNELL CFO 7172673000 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 RICHARD MARKS 0.40 X X 0 0 0 PAUL GUNDER 0.40 X X 0 0 0 JOHN BLUBAUGH 0.30 X X 0 0 0 DENNIS SHOCKEY 0.20 X X 0 0 0 NORMAN B EPSTEIN 6.00 X X 143041 810566 94455 FRANK ERVIN 0.30 X 0 0 0 JEAN LESSARD MD 0.20 X 0 0 0 KATHRYN A REIHARD MD 0.20 X 0 0 0 JAMES ROCK 0.20 X 0 0 0 PAUL SCHEMEL 0.20 X 0 0 0 LISA WARD 0.10 X 0 0 0 BONNIE ZEHLER 0.30 X 0 0 0 PATRICK W O'DONNELL 4.00 X 45089 405804 87205 KENNETH L SHUR 40.00 X 226736 0 35489 JEFF CARTY 40.00 X 168707 0 31556 THOMAS E ANDERSON MD 8.00 X 77482 309929 35290 SHERRI STAHL 8.00 X 48143 192572 40055 MICHELE ZEIGLER 8.00 X 49511 198044 44942 PATRICIA BARBAROWICZ 4.00 X 24370 219328 52683 JILL KELLER 40.00 X 154574 0 30078 ELIZABETH COOK 40.00 X 237673 0 28744 VICKI ELLIS 40.00 X 251399 0 28743 BRUCE FOSTER 40.00 X 311169 0 28155 NORBERT MATHAIS 40.00 X 417468 0 28034 MERRILL MCKENZIE 40.00 X 240620 0 21477 2395982 2136243 586906 18 0 1 0 CHAMBERSBURG HOSPITAL 112 N SEVENTH STREET CHAMBERSBURG PA 17201 PHYSICAL THERAPY, X-RAY, SECURITY, LABOR 1006490 ROBINWOOD ORTHOPEDIC SPECIALISTS 11110 MEDICAL CAMPUS ROAD SUITE 20 HAGERSTOWN MD 21742 SURGERY ON CALL 392375 SUMMIT PHYSICIAN SERVICES 785 FIFTH AVENUE SUITE 3 CHAMBERSBURG PA 17201 PHYSICIAN SERVICES 326729 QUEST DIAGNOSTICS 12436 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 LAB TESTING SERVICES 190467 E-PHARMPRO 3605 EDGEMONT AVE BACK BLDG STE BROOKHAVEN PA 19015 PHARMACY SERVICES 150400 5 32398 231069 263467 PATIENT REVENUE 621990 65074572 65074572 65074572 763976 763976 190230 73847 116383 116383 116383 978033 2400 978033 2400 980433 980433 COURIER AND LAB SERVIC 621500 712575 712575 CAFETERIA 900099 241133 241133 VHA INCENTIVE 900099 66817 66817 88808 88808 1109333 68308164 65471330 712575 1860792 1103042 1103042 26047819 22137368 3910451 1128533 983407 145126 5668097 4715552 952545 1871444 1534550 336894 24350 24350 2569051 2077170 491881 64880 51841 13039 171558 137079 34479 740667 591813 148854 69624 55631 13993 27880 22277 5603 21688 11902 9786 2779772 1470960 1308812 583112 465922 117190 SUPPLIES 6306592 5039137 1267455 BAD DEBT EXPENSE 5260181 5260181 PHYSICIAN CONTRACTUAL P 1323022 1057130 265892 EQUIPMENT RENTAL AND RE 1068606 853845 214761 MISCELLANEOUS EXPENSE 102314 81752 20562 180986 144613 36373 57113218 46692130 10421088 0 1420 1420 8851861 3752922 22550 5603530 6035617 362136 335832 672868 776335 58973124 40813402 19268897 18159722 11199169 33496561 36249589 2630006 2923777 70887279 79456933 5169500 6053109 1165000 595000 1774274 2017756 8108774 8665865 X 60613797 68271652 2164708 2519416 62778505 70791068 70887279 79456933 X 11194946 -3182383 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6096545 77791 756758 450000 6481094 5498442 98262 499841 6096545 6290104 80824 -872486 5498442 0.96000 0.04000 0 0 313743 2184775 2498518 2302539 15194458 9343976 8153021 37796113 30876365 6919748 1181496 593061 588435 18159722 CASH AND MONEY FUNDS 7171849 F FIXED INCOME 22090187 F REAL ASSETS 6987553 F 36249589 ADVANCES FROM THIRD PARTY PAYORS 252800 PAYABLE UNDER THIRD PARTY CONTRACTUAL AGREEMENT 1764956 2017756 68308164 57113218 11194946 1187051 -4369434 -3182383 8012563 69810781 1187051 315566 1502617 68308164 0 68308164 57113218 0 57113218 0 57113218 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENT FUNDS ARE TO BE USED FOR THE DEVELOPMENT OR EXPANSION OF COMMUNITY HEALTHCARE INITIATIVES AND PROGRAMS. FUNDS ARE ALSO USED TO EDUCATE THE COMMUNITY ABOUT HEALTH CARE ISSUES. 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, 2011 THERE WAS NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS. PART XI, LINE 8 - OTHER ADJUSTMENTS: INCREASE IN PERPETUAL TRUSTS HELD BY THIRD PARTIES 315,566. TRANSFER TO AFFILIATE ORG. - SUMMIT PHYSICIAN SERVICES -4,685,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: INCREASE IN PERPETUAL TRUSTS HELD BY THIRD PARTIES 315,566. CENTRAL AMERICAN AND CARRIBBEAN 0 0 INVESTMENT IN ALTERNATIVE INVESTMENT VEHICLE 711000 0 0 0 0 0 0 711000 0 711000 0 0 1 0 0 0 1 1 X 1 X 125.000000000000 1 X 1 1 1 0 1 1 970182 970182 0.01700 6514924 3125009 3389915 0.05940 7485106 3125009 4360097 0.07640 7 1726 101252 101252 0.00180 2 269 46275 46275 0.00080 3 290 15072 15072 0.00030 1 51082 51082 0.00090 13 2285 213681 213681 0.00380 13 2285 7698787 3125009 4573778 0.08020 0 2161934 102339 12550761 17675672 -5124911 X 1 1 1 1 WAYNESBORO HOSPITAL

501 EAST MAIN STREET WAYNESBORO PA 17268

X NOT REQUIRED 1 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 BASED ON THE OUTSTANDING PATIENT BALANCE AFTER ANY CONTRACTUAL REIMBURSEMENTS ARE APPLIED AND ARE GENERALLY DUE 30 DAYS AFTER BILLED. AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CARRIED FOR PATIENT ACCOUNTS THAT MAY BECOME UNCOLLECTIBLE IN FUTURE PERIODS BASED ON A SLIDING SCALE OF ESTIMATED UNCOLLECTIBLE PERCENTAGES COMPARED TO VARIOUS AGING SELF-PAY BALANCE CATEGORIES. THE ESTIMATED ALLOCATIONS ARE BASED ON MANAGEMENT'S JUDGMENT OF UNCOLLECTIBLE ACCOUNTS, HISTORICAL TRENDS OF CHARGE-OFFS, AND OTHER INFORMATION. PATIENT RECEIVABLES ARE CHARGED AGAINST THE ALLOWANCE WHEN, IN THE JUDGMENT OF MANAGEMENT, IT IS UNLIKELY THEY WILL BE COLLECTED. 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 BASED ON THE OUTSTANDING PATIENT BALANCE AFTER ANY CONTRACTUAL REIMBURSEMENTS ARE APPLIED AND ARE GENERALLY DUE 30 DAYS AFTER BILLED. AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CARRIED FOR PATIENT ACCOUNTS THAT MAY BECOME UNCOLLECTIBLE IN FUTURE PERIODS BASED ON A SLIDING SCALE OF ESTIMATED UNCOLLECTIBLE PERCENTAGES COMPARED TO VARIOUS AGING SELF-PAY BALANCE CATEGORIES. THE ESTIMATED ALLOCATIONS ARE BASED ON MANAGEMENT'S JUDGMENT OF UNCOLLECTIBLE ACCOUNTS, HISTORICAL TRENDS OF CHARGE-OFFS, 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 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 6: WAYNESBORO HOSPITAL SUPPORTS LOCAL NON-PROFIT ORGANIZATIONS WITH FINANCIAL GRANTS FROM THE SUMMIT ENDOWMENT. PART VI, LINE 7: 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. 1 FLU VACCINATIONS 233 5688 COST PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE 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. X X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 NORMAN B EPSTEIN 107204 607490 29400 166600 6437 36476 10873 61616 3295 18671 157209 890853 0 0 PATRICK W O'DONNELL 32225 290028 9232 83084 3632 32692 7217 64948 1504 13536 53810 484288 0 0 KENNETH L SHUR 169331 0 39452 0 17953 0 12548 0 22941 0 262225 0 0 0 JEFF CARTY 141661 0 13967 0 13079 0 9813 0 21743 0 200263 0 0 0 THOMAS E ANDERSON MD 61264 245057 11280 45120 4938 19752 4494 17970 2565 10261 84541 338160 0 0 SHERRI STAHL 37896 151587 7413 29651 2834 11334 5446 21783 2565 10261 56154 224616 0 0 MICHELE ZEIGLER 39555 158221 6976 27903 2980 11920 6423 25693 2565 10261 58499 233998 0 0 PATRICIA BARBAROWICZ 18998 170981 3758 33821 1614 14526 4587 41290 681 6125 29638 266743 0 0 JILL KELLER 133304 0 7750 0 13520 0 8935 0 21143 0 184652 0 0 0 ELIZABETH COOK 228401 0 0 0 9272 0 14369 0 14375 0 266417 0 0 0 VICKI ELLIS 242125 0 0 0 9274 0 14368 0 14375 0 280142 0 0 0 BRUCE FOSTER 307398 0 0 0 3771 0 14700 0 13455 0 339324 0 0 0 NORBERT MATHAIS 404497 0 0 0 12971 0 14700 0 13334 0 445502 0 0 0 MERRILL MCKENZIE 239706 0 0 0 914 0 14466 0 7011 0 262097 0 0 0 PART I, LINE 1A THE ORGANIZATION REIMBURSES THE COO FOR DUES ASSOCIATED WITH A SOCIAL CLUB. THE OFFICER RECEIVES AN ALLOWANCE THAT CAN BE CONSIDERED A DISCRETIONARY SPENDING ACCOUNT. THE MONIES ARE IN LIEU OF AN AUTOMOBILE ALLOWANCE, TO PURCHASE ADDITIONAL LIFE INSURANCE, ETC. THESE MONIES ARE INCLUDED IN COMPENSATION AS REPORTED IN THE COMPENSATION OF OFFICERS TABLE. 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 THOMAS ANDERSON - NO PAYMENT PAT BARBAROWICZ - NO PAYMENT KENNETH L. SHUR - $ 41,873 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. 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 GOVERNING BODY OF THIS ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B SUMMIT HEALTH, A 501(C)(3) ENTITY, HAS CERTAIN RESERVE POWERS OF 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. 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. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 1,187,051. INCREASE IN PERPETUAL TRUSTS HELD BY THIRD PARTIES: 315,566. TRANSFER TO AFFILIATE ORG. - SUMMIT PHYSICIAN SERVICES: -4,685,000. TOTAL TO FORM 990, PART XI, LINE 5: -3,182,383. SUMMIT HEALTH 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 251515371 MANAGE AND ADMINISTER THE LOCAL AND REGIONAL NETWORK OF HEALTHCARE PROVIDERS PA 501(C)(3) 7 SUMMIT HEALTH 0 THE CHAMBERSBURG HOSPITAL 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 230465970 SERVE THE HEALTH CARE NEEDS OF FRANKLIN COUNTY PA AND THE SURROUNDING COMMUN PA 501(C)(3) 3 SUMMIT HEALTH 0 CHAMBERSBURG HEALTH SERVICES 260 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 251515376 SERVE THE HEALTH CARE NEEDS OF FRANKLIN COUNTY PA AND THE SURROUNDING COMMUN PA 501(C)(3) 11A - TYPE 1 SUMMIT HEALTH 0 SUMMIT PHYSICIAN SERVICES 601 NORLAND AVENUE CHAMBERSBURG PA 17201 251716306 PROVIDES APPROPRIATE PHYSICIAN MANPOWER FOR VARIOUS FAMILY PRACTICES SERVING PA 501(C)(3) 11A - TYPE 1 SUMMIT HEALTH 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 1 0