SUMMIT PHYSICIAN SERVICES: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- SUMMIT PHYSICIAN SERVICES (EIN 25-1716306)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-13
- IRS object ID
- 202241339349305704
- Schema version
- 2020v4.0
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-13T10:39:54-07:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135381590 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WellSpan Health | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3350 WHITEFORD ROAD | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 251716306 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUMMIT PHYSICIAN SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SUMM | BusinessNameControlTxt |
| Phone | 7178513055 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2767 | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17405 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Laura Buczkowski | PersonNm |
| Person Title | SR VP & CFO | PersonTitleTxt |
| Signature | 2022-05-13 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Laura | PersonFirstNm |
| Person Last | Buczkowski | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | See Attached | PreparerPersonNm |
| PTIN | P01871563 | PTIN |
| Phone | 7038930600 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Roxanna Gapstur | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2767 | AddressLine1Txt |
| City | YORK | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 174052767 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $138,048,087 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WELLSPAN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | Summit Physician Services, in coordination with Waynesboro Hospital, Chambersburg Hospital, York Hospital, Gettysburg Hospital, Ephrata Hospital, The Good Samaritan Hospital of Lebanon Pennsylvania, and WellSpan Surgery and Rehabilitation Hospital, provides medical and surgical care to patients in and around Franklin, Lebanon, Lancaster, York and Adams Counties, Pennsylvania without regard to the ability to pay. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 1214 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $56,696,679 | PYContributionsGrantsAmt |
| CY Contributions Grants | $22,986,928 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $88,131,714 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $71,346,767 | CYProgramServiceRevenueAmt |
| PY Investment Income | $42,195 | PYInvestmentIncomeAmt |
| CY Investment Income | -$155,999 | CYInvestmentIncomeAmt |
| PY Other Revenue | $414,767 | PYOtherRevenueAmt |
| CY Other Revenue | $43,677,108 | CYOtherRevenueAmt |
| PY Total Revenue | $145,285,355 | PYTotalRevenueAmt |
| CY Total Revenue | $137,854,804 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,326 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,958 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $119,436,125 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $113,741,444 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $26,936,601 | PYOtherExpensesAmt |
| CY Other Expenses | $24,111,402 | CYOtherExpensesAmt |
| PY Total Expenses | $146,374,052 | PYTotalExpensesAmt |
| CY Total Expenses | $137,854,804 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,088,697 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $0 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $25,123,943 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,991,039 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $21,577,873 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,429,081 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,546,070 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,561,958 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Summit Physician Services, and the associated WellSpan Medical Group, operate on the belief that a large, well-organized group practice, based on primary and preventive care, and working collaboratively as part of an integrated health care delivery system, can deliver a superior standard of care. Its mission is to promote and to provide quality, cost-effective health care services which seek to improve the health status of the community. Summit Physician Services provides care without regard for an individual's health status or ability to pay. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $118,325,040 | ExpenseAmt |
| Grant | $1,958 | GrantAmt |
| Revenue | $115,023,875 | RevenueAmt |
| Desc | Summit Physician Services, which does not contemplate pecuniary gain or profit, incidental or otherwise, was formed for the purposes of furthering the charitable purposes of WellSpan Health, and promoting the provision of health care services in South Central Pennsylvania, including Franklin, Lancaster, Lebanon, York and Adams Counties, by providing clinically effective health care services, including professional health care services, in a cost effective manner in settings appropriate to patient and payor needs under a variety of health care financing arrangements; enhancing the continuity and quality of health care services provided to patients; ensuring the continued local patient access to health care services; enhancing the health status of the communities served by WellSpan Health; effectively responding to changing payor requirements; achieving excellence in clinical innovations, service, quality, cost and outcomes; and achieving operating efficiencies, such as containing and reducing costs and avoiding unnecessary duplication of services and equipment, thereby utilizing resources more effectively.See WellSpan Health - 2021 Community Benefit Report located at https://www.wellspan.org/about/wellspan-in-the-community/2021-community-benefit-report/ | Desc |
| Total Program Service Expenses | $118,325,040 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | 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 |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | 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 | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | 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 With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| 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 | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 48 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1214 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| 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 |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | 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 | false | 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 | false | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| 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 | 174052767 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| Michael O'Connor | |||||||
| Former Director | 0.00 | 40.00 | $0 | $3,058,887 | $208,991 | ||
| Roxanna Gapstur | |||||||
| WSH Pres. & CEO | 1.00 | 40.00 | $0 | $1,531,608 | $72,560 | Yes (X) | Yes (X) |
| Patrick O'Donnell | |||||||
| Former Director | 0.00 | 40.00 | $0 | $1,486,416 | $77,222 | ||
| Joshua Dunklebarger | |||||||
| Physician | 40.00 | 0.00 | $1,011,579 | $0 | $59,643 | ||
| Aylmer Tang | |||||||
| Physician | 40.00 | 0.00 | $984,012 | $0 | $59,435 | ||
| Arshad Safi | |||||||
| Physician | 40.00 | 0.00 | $971,977 | $0 | $61,961 | ||
| Nadeem Quazi | |||||||
| Surgeon | 40.00 | 0.00 | $842,102 | $0 | $46,724 | ||
| Richard Richards II | |||||||
| Physician | 40.00 | 0.00 | $748,717 | $0 | $55,832 | ||
| Robert Knipe DO | |||||||
| Director | 1.00 | 40.00 | $0 | $674,625 | $63,218 | Yes (X) | |
| Mark Smith MD | |||||||
| Director | 1.00 | 40.00 | $0 | $581,515 | $60,205 | Yes (X) | |
| Tony Aquilina DO | |||||||
| CP Executive | 1.00 | 40.00 | $0 | $357,285 | $32,103 | Yes (X) | Yes (X) |
| Robert Pargament MD | |||||||
| Director | 1.00 | 40.00 | $0 | $259,496 | $54,350 | Yes (X) | |
| H Wallace Brubaker | |||||||
| Director | 40.00 | 0.00 | $299,901 | $0 | $0 | Yes (X) | |
| Angie Heiland | |||||||
| Director | 1.00 | 40.00 | $0 | $239,658 | $47,482 | Yes (X) | |
| Almira Contractor MD | |||||||
| Director | 1.00 | 40.00 | $0 | $224,811 | $52,437 | Yes (X) | |
| Rebecca Newcomer | |||||||
| Director | 40.00 | 0.00 | $56,397 | $0 | $31,019 | Yes (X) | |
| Laura Buczkowski | |||||||
| SR VP & CFO WSH | 1.00 | 40.00 | $0 | $55,289 | $7,796 | Yes (X) | Yes (X) |
| Larry Miller | |||||||
| Director | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,914,685 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,469,590 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $990,978 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | 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 |
|---|---|---|---|---|
| ABEO | ||||
| PO Box 680 | Frederick | MD | 21705 | Medical Billing and Codin |
| Doppler Diagnostics I | ||||
| 757 Norland Ave Suite 104 | Chambersburg | PA | 17201 | Lab Services |
| Press Ganey Assoc Inc | ||||
| PO Box 88335 | Milwaukee | WI | 532880335 | Fixed Contract Fees |
| Peerless Credit Services | ||||
| 449 Eisenhower Blvd Suite 120 | Harrisburg | PA | 17111 | Debt Collector |
| City Answering Service | ||||
| PO Box 458 | Chambersburg | PA | 17201 | Answering Service |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $19,945,292 | RelatedOrganizationsAmt |
| Government Grants | $2,916,476 | GovernmentGrantsAmt |
| All Other Contributions | $125,160 | AllOtherContributionsAmt |
| Total Contributions | $22,986,928 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient Revenue | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $71,346,767 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $71,346,767 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $71,346,767 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,284 | TotalRevenueColumnAmt |
| Exclusion | $37,284 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $193,283 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$193,283 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$193,283 | TotalRevenueColumnAmt |
| Exclusion | -$193,283 | 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 | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Other Operating Revenue | 621110 | $1,481,002 | $1,481,002 |
| Specialist Income | 621110 | $42,107,919 | $42,107,919 |
| Work First Occupational Health | 621110 | $87,994 | $87,994 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $193 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $193 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $43,677,108 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $137,854,804 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $115,023,875 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | -$155,999 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,958 | TotalAmt |
| Program Services | $1,958 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
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 | $87,416 | TotalAmt |
| Management And General | $87,416 | 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 | $94,500,699 | TotalAmt |
| Program Services | $94,500,699 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,322,373 | TotalAmt |
| Program Services | $3,322,373 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,007,637 | TotalAmt |
| Program Services | $11,007,637 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,823,319 | TotalAmt |
| Program Services | $4,823,319 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $450,000 | TotalAmt |
| Management And General | $450,000 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,627 | TotalAmt |
| Management And General | $88,627 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,328 | TotalAmt |
| Management And General | $26,328 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
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 | $2,639,655 | TotalAmt |
| Program Services | $2,639,655 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $248,662 | TotalAmt |
| Program Services | $248,662 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $515,466 | TotalAmt |
| Program Services | $515,466 | ProgramServicesAmt |
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 | $5,627,307 | TotalAmt |
| Program Services | $5,627,307 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,192 | TotalAmt |
| Program Services | $44,192 | ProgramServicesAmt |
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 | $399,731 | TotalAmt |
| Program Services | $399,731 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,164 | TotalAmt |
| Program Services | $41,164 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,566,800 | TotalAmt |
| Program Services | $1,566,800 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,353,943 | TotalAmt |
| Program Services | $2,353,943 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Direct Supplies | $6,323,981 | $6,323,981 |
| Outside Services | $2,351,038 | $2,351,038 |
| Repair & Maintenance | $855,713 | $855,713 |
| Utilities | $164,000 | $164,000 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $414,795 | TotalAmt |
| Program Services | -$18,462,598 | ProgramServicesAmt |
| Management And General | $18,877,393 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,854,804 | TotalAmt |
| Program Services | $118,325,040 | ProgramServicesAmt |
| Management And General | $19,529,764 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,312 | BOYAmt |
| EOY | $12,775 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,829,525 | BOYAmt |
| EOY | $503,185 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,328 | BOYAmt |
| EOY | $6,263 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,315,074 | BOYAmt |
| EOY | $10,726,310 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,952,036 | BOYAmt |
| EOY | $1,648,731 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $127,587 | BOYAmt |
| EOY | $61,542 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,397,097 | BOYAmt |
| EOY | $1,381,607 | EOYAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,299,249 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,978 | BOYAmt |
| EOY | $57,978 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $883,554 | BOYAmt |
| EOY | $585,961 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,241,203 | BOYAmt |
| EOY | $6,687 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,123,943 | BOYAmt |
| EOY | $14,991,039 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $482,222 | BOYAmt |
| EOY | $119,526 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,695 | BOYAmt |
| EOY | $15,172 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $963,531 | BOYAmt |
| EOY | $965,596 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,111,425 | BOYAmt |
| EOY | $10,328,787 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,577,873 | BOYAmt |
| EOY | $11,429,081 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,513,385 | BOYAmt |
| EOY | $3,516,224 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,685 | BOYAmt |
| EOY | $45,734 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,546,070 | BOYAmt |
| EOY | $3,561,958 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,123,943 | BOYAmt |
| EOY | $14,991,039 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $0 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $15,888 | 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 | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $30,916 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $50,019 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus1 Year | $56,696,679 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $22,986,928 | CurrentTaxYearAmt |
| Total | $79,764,542 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $72,179,163 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $75,613,366 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $75,298,571 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $88,131,714 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $71,346,767 | CurrentTaxYearAmt |
| Total | $382,569,581 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $72,210,079 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $75,663,385 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $75,298,571 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $144,828,393 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $94,333,695 | CurrentTaxYearAmt |
| Total | $462,334,123 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $462,334,123 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $524,878 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $619,525 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $70,622 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $42,045 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $37,284 | CurrentTaxYearAmt |
| Total | $1,294,354 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $524,878 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $619,525 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $70,622 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $42,045 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $37,284 | CurrentTaxYearAmt |
| Total | $1,294,354 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $17,915,445 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,081,549 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $18,572,660 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,749 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $43,677,108 | CurrentTaxYearAmt |
| Total | $99,257,511 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $90,650,402 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $95,364,459 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $93,941,853 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $144,881,187 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $138,048,087 | CurrentTaxYearAmt |
| Total | $562,885,988 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.82140 | PublicSupportCY509Pct |
| Public Support PY509 | 0.85210 | PublicSupportPY509Pct |
| Investment Income CY | 0.00230 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00340 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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 D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $32,685 | BeginningYearBalanceAmt |
| Contributions | $13,049 | ContributionsAmt |
| End Year Balance | $45,734 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $32,685 | BeginningYearBalanceAmt |
| End Year Balance | $32,685 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $32,685 | BeginningYearBalanceAmt |
| End Year Balance | $32,685 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $32,685 | BeginningYearBalanceAmt |
| End Year Balance | $32,685 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,002 | BeginningYearBalanceAmt |
| End Year Balance | $10,002 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | false | RelatedOrgListSchRInd |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| Accrd Payroll W/H | $130,756 |
| Accrued liablilities | $404,430 |
| Accrued Payroll Incentives | $1,820,051 |
| Accrued Pension | $1,203,719 |
| Current Portion of Long Term Debt | $17,994 |
| Due to Affiliates | $6,165,470 |
| LTD Leases | $586,367 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,328,787 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $137,765,494 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $137,765,494 | RevenueSubtotalAmt |
| Other Revenues Not Included | $89,310 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $89,310 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $137,854,804 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $137,765,494 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $137,765,494 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $89,310 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $89,310 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $137,854,804 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X : FIN48 Footnote | In June 2006, the Financial Accounting Standards Board (FASB) issued Interpretation NO. 48, Accounting for Uncertainty in Income Taxes-an interpretation of FASB Statement NO. 109, Accounting for Income Taxes (FIN 48), which creates a single model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing the minimum recognition threshold a tax position is required to meet before being recognized in the financial statements. Under the requirements of FIN 48, tax-exempt organizations could now be required to record an obligation as the result of a tax position they have historically taken or various tax exposure items. Prior to FIN 48, the determination of when to record a liability for tax exposure was based on whether a liability was considered probable and reasonably estimable in accordance with SFAS No.5, Accounting for Contingencies. On July 1, 2007, the parent company, WellSpan Health, adopted FIN 48. WellSpan Health determined that it does not have any uncertain tax positions through June 30, 2021. |
| Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S | Grant - Waynesboro Hospital $0 Grant - Chambersburg Hospital $0 Revenues netted with expense $89310 |
| Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S | Expenses Netted with Revenue $89310 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Discretionary Spending Acct | Yes (X) | DiscretionarySpendingAcctInd |
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Almira Contractor MD | |||||||||||||
| Director | $223,536 | $1,200 | $75 | $7,609 | $44,828 | $277,248 | |||||||
| Angie Heiland | |||||||||||||
| Director | $238,458 | $1,200 | $9,428 | $38,054 | $287,140 | ||||||||
| Arshad Safi | |||||||||||||
| Physician | $743,854 | $201,200 | $26,923 | $8,550 | $53,411 | $1,033,938 | |||||||
| Aylmer Tang | |||||||||||||
| Physician | $746,821 | $200,000 | $37,191 | $8,550 | $50,885 | $1,043,447 | |||||||
| H Wallace Brubaker | |||||||||||||
| Director | $252,047 | $8,393 | $39,461 | $299,901 | |||||||||
| Joshua Dunklebarger | |||||||||||||
| Physician | $974,514 | $2,450 | $34,615 | $8,550 | $51,093 | $1,071,222 | |||||||
| Mark Smith MD | |||||||||||||
| Director | $554,967 | $26,548 | $11,515 | $48,690 | $641,720 | ||||||||
| Michael O'Connor | |||||||||||||
| Former Director | $611,969 | $404,687 | $2,042,231 | $123,405 | $85,586 | $3,267,878 | $2,042,158 | ||||||
| Nadeem Quazi | |||||||||||||
| Surgeon | $585,849 | $249,965 | $6,288 | $8,550 | $38,174 | $888,826 | |||||||
| Patrick O'Donnell | |||||||||||||
| Former Director | $942,819 | $57,149 | $486,448 | $25,200 | $52,022 | $1,563,638 | |||||||
| Richard Richards II | |||||||||||||
| Physician | $738,671 | $1,200 | $8,846 | $8,550 | $47,282 | $804,549 | |||||||
| Robert Knipe DO | |||||||||||||
| Director | $673,425 | $1,200 | $13,178 | $50,040 | $737,843 | ||||||||
| Robert Pargament MD | |||||||||||||
| Director | $253,258 | $1,200 | $5,038 | $10,330 | $44,020 | $313,846 | |||||||
| Roxanna Gapstur | |||||||||||||
| WSH Pres. & CEO | $1,091,608 | $440,000 | $11,619 | $60,941 | $1,604,168 | $242,000 | |||||||
| Tony Aquilina DO | |||||||||||||
| CP Executive | $348,346 | $8,939 | $3,288 | $28,815 | $389,388 | ||||||||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 1a: Relevant information in regards to selections on 1a. | FormAndLineReferenceDesc |
| Explanation | 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. Results Fitness Club membership is available free of charge for any officer and active board member. | ExplanationTxt |
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 | See Schedule O | BusinessNameLine1Txt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | WellSpan Summit Health, a not for profit corporation, is the sole member. |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | The governance of the Corporation shall be vested in its Board of Directors, who have authority to manage the business, property and affairs of the Corporation. The sole member of the Corporation is Summit Health, a Pennsylvania nonprofit corporation (the Member). The sole member of the Member is WellSpan Health, a Pennsylvania nonprofit corporation (WellSpan), and WellSpan has certain specified reserved powers with respect to the Corporation as described in Section 2.2 of the Bylaws. Section 2.2. Rights of WellSpan. WellSpan may, with respect to the Corporation, initiate and implement any of the following actions, except as otherwise provided in the Affiliation Agreement, and if any of the following actions are otherwise initiated by the Corporation or the Member, such action shall not become effective unless approved by WellSpan: (a) adoption, amendment, restatement, repeal, termination or any other modification of any governing instrument of the Corporation;(b) any fundamental transactions involving the Corporation, including the reorganization, merger, consolidation, change of control, sale of all or substantially all the assets, conversion, dissolution, assignment for the benefit of creditors, filing of any bankruptcy petition, or similar transaction; provided however, for at least ten (10) years following the Effective Date, WellSpan shall not sell, transfer, convey, lease, exchange, or otherwise dispose of all or substantially all of the Corporations assets, unless otherwise approved by the member and a majority of the Board of Directors of the Corporation (the Board or Board of Directors);(c) except as otherwise provided in Section 10.4(d) of the Affiliation Agreement, investment of any of the Corporations assets other than in accordance with WellSpans investment policy then in effect; provided, that any Corporation assets invested by WellSpan will be invested pro rata in accordance with WellSpans risk allocation strategy applicable to the assets of all other WellSpan entities;(d) incurrence of indebtedness in excess of limits established by WellSpans policy then in effect (which shall in no event be less than One Million Dollars ($1,000,000)) by the Corporation;(e) any sale, transfer, conveyance, lease, exchange, mortgage, encumbrance, pledge,or other disposition of the Corporations assets with fair market value in excess of limits established by WellSpans policy then in effect (which shall in no event be less than One Million Dollars ($1,000,000)), other than in the normal course of business;(f) adopting any annual operating or capital budgets for the Corporation, provided,however, that such operating budget shall include funding for community benefit programs;(g) any capital expenditures by the Corporation in excess of the WellSpan-approved annual capital budgets for the Corporation;(h) except as otherwise provided in the affiliation Agreement, any material changes to licenses held by the Corporation;(i) selecting, hiring, contracting with, or otherwise entering into agreements with,whether oral or written, any outside financial auditors, legal counsel or investment advisors that may be recommended by the Corporation for its local needs or activities, other than the outside financial auditors, legal counsel or investment advisors selected by WellSpan;(j) review and approval of the Corporations nominees for the Corporations corporate officers before such nominees are appointed by the Board;(k) adopting the statement of mission and vision, strategic and operating plans and any amendments thereto for the Corporation;(l) creation of new (or material changes, including closure or cessation, to existing) lines of business, sites of business, subsidiaries, partnerships or joint venture by the Corporation(subject to WellSpans and the Members right to require the decision-making process described in Section 10.3(a)(iv) of the Affiliation Agreement, if applicable); and(m) Any change in the Corporations tax-exempt status (subject to Section 10.1 of the Affiliation Agreement), charitable mission, or charity care policies and practices (which shall at all times comply with the integrated regional nonprofit health care systems charity care policies and practices in effect from time to time). Section 2.3. Rights of the Member. Subject to WellSpans reserved powers in Section 2.2 above and in addition to all matters required by law or these By-Laws to be approved by the Member, the Member shall have the following rights and responsibilities:(a) recommending (for WellSpan approval) operating plans for the Corporation that are in conformance with System-approved priorities and plans;(b) monitoring the Corporations accomplishment of the Corporations operatingplans;(c) recommending (for WellSpan approval) annual operating and capital budgets for the Corporation that are in conformance with System budget targets;(d) monitoring the Corporations financial performance against the Corporationsoperating and capital budgets;(e) monitoring the quality of and satisfaction with clinical services provided by the Corporation;(f) nominating the Corporations corporate officers for review and approval by WellSpan before they are appointed by the Board of Directors;(g) representing the interests of the community or population served by the Corporation;(h) recommending (for WellSpan approval) changes in the services provided by the Corporation (subject to WellSpans and the Members right to require the decision-making process described in Section 10.3(a)(iv) of the Affiliation Agreement, if applicable);(i) recommending (for WellSpan approval) amendments to the Corporations Articles of Incorporation or By-Laws;(j) recommending (for WellSpan approval) fundamental transactions involving theCorporation, including the reorganization, merger, consolidation, change of control, sale of all or substantially all the assets, conversion, dissolution, assignment for the benefit of creditors, filing of any bankruptcy petition, or similar transaction;4(k) except as otherwise provided in Section 10.4(d) of the Affiliation Agreement,recommending (for WellSpan approval) investment of the Corporations assets other than in accordance with the WellSpan investment policy then in effect;(l) recommending (for WellSpan approval) the Corporations incurrence of indebtedness in excess of limits established by a WellSpan policy then in effect (which shall inno event be less than One Million Dollars ($1,000,000));(m) recommending (for WellSpan approval) the sale, transfer, conveyance, lease,exchange, mortgage, encumbrance, pledge or other disposition of the Corporations assets withfair market value in excess of limits established by a WellSpan policy then in effect (which shall in no event be less than One Million Dollars ($1,000,000)), other than in the normal course of business;(n) recommending (for WellSpan approval) capital expenditures in excess of the WellSpan-approved annual capital budgets for the Corporation;(o) recommending (for WellSpan approval) material changes to licenses held by the Corporation;(p) recommending (for WellSpan approval) any outside financial auditors, legal counsel or investment advisors for the corporations local needs or activities, other than the outside financial auditors, legal counsel or investment advisors selected by the System;(q) recommending (for WellSpan approval) changes to the Corporations statement of mission and vision, strategic and operating plans;(r) recommending (for WellSpan approval) the creation of new (or material changes,including closure or cessation, to existing) lines of business, sites of business, subsidiaries,partnerships or joint ventures by the Corporation (subject to WellSpans and the Members right to require the decision-making process described in Section 10.3(a)(iv) of the Affiliation Agreement, if applicable); and (s) recommending (for WellSpan approval) any change in any the Corporations tax exempt status, charitable mission, or charity care policies and practices (which shall at all times comply with the Systems charity care policies and practices in effect from time to time). |
| Form 990, Part VI, Line 11b: Form 990 Review Process | Management provided an electronic copy of the form 990 to each voting member of the organization's governing body, prior to its filing with the IRS. The organization's finance management team provided a presentation to the Audit Committee on the organization's 990 return. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Officers, directors, and key employees fill out a WellSpan Health Conflict of Interest Disclosure Statement questionnaire annually. The questionnaire is administered by the Internal Audit Department of WellSpan Health, the Parent Company.There shall be full disclosure by any Director having a business or personal interest or relationship which may be in conflict with the interests of the Corporation. After such disclosure the Director shall abide by the determination of the Board of Directors as to whether a conflict exists, the extent to which, if at all, the Director will be permitted to be present during the Board of Directors' discussion of the matter in which the Director may be interested, and whether the Director will be permitted to participate in such discussion and cast a vote in such matter. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | The Compensation Committee of WellSpan Health is responsible for rewarding and reinforcing key executives for the achievement of annual and long-term performance objectives. The Compensation Committee shall consist of not more than six (6) persons, of whom two (2) shall be the Chairman and Vice Chairman of the Board of the Corporation, and the remaining members shall be such other persons as may be appointed by the Chairman of the Board of the Corporation, with the approval of the Board of Directors; provided, however, that the Compensation Committee shall not include any persons who are employed by the System. The role of the Compensation Committee is to set the Executive Compensation Philosophy for the system and ensure adherence, evaluate performance and establish compensation for the WellSpan President, evaluate team performance of the executive team and establish awards, review and approve senior executive base salary ranges, and oversee employed physician compensation programs. The Committee will approve salary ranges for each executive position and review incumbent salaries annually. The Committee will be responsible for reviewing the President's salary each year, and if warranted, authorizing an adjustment to maintain competitiveness. The President will have the authority to make salary adjustments for subordinate positions. The Committee is responsible for approving and authorizing payment of the performance awards. The Committee will approve and authorize payment of the President's performance awards. Integrated Healthcare Strategies, Inc., based in Minneapolis Minnesota is the external consultant to the committee. This consultant focuses exclusively on executive and physician compensation in the health care industry. In summary, the executive and physician compensation review process consists of the following: 1) Cash compensation reviewed annually 2) Cash compensation reviewed by external consultant biennially 3) external total compensation (cash, incentives, benefits, perquisites) reviewed by external consultant periodically 4) Process is integrated with compensation analysis for other WellSpan positions 5) Committee decisions are documented in minutes maintained in Human Resources. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Governing documents, policies, and financial statements are available upon request. |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Adjustment = $15888 |
| Schedule K- Tax Exempt Bonds | 1.2014 GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA REVENUE REFUNDING BONDS, SERIES A:On November 11, 2014, the General Authority of Southcentral Pennsylvania issued $213,430,000 of Revenue Refunding bonds, Series 2014A for WellSpan Health Obligated Group. The purpose of this bond issue was revenue refund for bonds issued 06/23/1993 and 11/12/2008. WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to York Hospital (23-1352222), Gettysburg Hospital (23-1352220), WellSpan Properties (22-2842252), WellSpan Surgery & Rehabilitation Hospital (23-2899911), and Ephrata Community Hospital (23-1370484). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K. As of 6/30/21, the allocation of the Debt Capital program including issue premium of $47,545,967 was as follows:York Hospital: $27,890,452Gettysburg Hospital: $1,922,543WellSpan Properties: $6,845,852WellSpan Surgery & Rehabilitation Hospital: $3,377,167Ephrata Community Hospital: $7,509,953These amounts are reported on the respective balance sheets for each of these entities.An Arbitrage Rebate and Yield Restriction Liability Calculation was performed for the period of November 10, 2014, to November 10, 2019. No rebate was due._______________________________________________________________________________2.2015 LANCASTER MUNICIPAL AUTHORITY BANK LOAN, SERIES A:On May 22, 2015, the Lancaster Municipal Authority issued $36,572,083 of Revenue Refunding bonds, Series 2015A, to an Obligated Group consisting of York Hospital, Gettysburg Hospital and Ephrata Community Hospital. The purpose of this bond issue was to refund bonds issued on behalf of Ephrata Community Hospital, including the Lancaster Municipal Authority Revenue Notes Series 2009, 2010A, 2012, and 2013. To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K.As of 6/30/21, the $27,600,768 of outstanding liability is reported on the Ephrata Community Hospital return balance sheet._______________________________________________________________________________3.2019 GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA REVENUE REFUNDING BONDS, SERIES A & B:On April 19, 2019, the General Authority of Southcentral Pennsylvania issued $331,502,627 of Revenue Refunding bonds, Series 2019A and 2019B for WellSpan Health Obligated Group. The purpose of this bond issue was revenue refund for bonds issued 11/12/2008. WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to York Hospital (23-1352222), Chambersburg Hospital (23-0465970), WellSpan Properties (22-2842252), Chambersburg Health Services (25-1515376), The Good Samaritan Hospital of Lebanon Pennsylvania (23-1794160), Waynesboro Hospital (23-1360854), Summit Physician Services (25-1716306), Gettysburg Hospital (23-1352220), WellSpan Surgery & Rehabilitation Hospital (23-2899911) and Ephrata Community Hospital (23-1370484). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K. As of 6/30/21, the allocation of the Debt Capital program of $324,770,019 was as follows:York Hospital: $109,820,502Waynesboro Hospital: $455,712Chambersburg Hospital: $110,975,751Chambersburg Health Services: $18,656,026Summit Physician Services: $983,590WellSpan Properties: $66,683,198Gettysburg Hospital: $12,384,727Ephrata Community Hospital: $3,372,694The Good Samaritan Hospital of Lebanon Pennsylvania: $42,216WellSpan Surgery & Rehabilitation Hospital: $1,395,603These amounts are reported on the respective balance sheets for each of these entities._______________________________________________________________________________4.2019 GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA REVENUE REFUNDING BONDS, SERIES C-E:On April 3, 2019, the General Authority of Southcentral Pennsylvania issued $212,690,000 of Revenue Refunding bonds Series 2019C, 2019D and 2019E for WellSpan Health Obligated Group. The purpose of this bond issue was revenue refund for bonds issued 11/12/2008. WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to York Hospital (23-1352222), Gettysburg Hospital (23-1352220), WellSpan Properties (22-2842252), WellSpan Surgery & Rehabilitation Hospital (23-2899911), The Good Samaritan Hospital of Lebanon Pennsylvania (23-1794160) and WellSpan Health (22-2517863). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K. As of 6/30/21, the allocation of the Debt Capital program of $212,690,000 was as follows: York Hospital: $123,530,352Gettysburg Hospital: $19,290,983WellSpan Properties: $22,545,140WellSpan Surgery & Rehabilitation Hospital: $35,731,920The Good Samaritan Hospital of Lebanon Pennsylvania: $1,722,789WellSpan Health: $9,868,816These amounts are reported on the respective balance sheets for each of these entities._______________________________________________________________________________5.2014 FRANKLIN COUNTY INDUSTIAL AUTHORITY REVENUE REFUNDING BONDS, SERIES A & C:On April 30, 2014, the Franklin County Industrial Authority issued $35,795,000 of Healthcare Revenue Refunding bonds, Series 2014A & 2014C for the WellSpan Health Obligated Group. WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to Waynesboro Hospital (23-1360854), Chambersburg Hospital (23-0465970) and Chambersburg Health Services (25-1515376). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K.As of 6/30/21, the allocation of the Debt Capital program of $25,493,770 was as follows: Waynesboro Hospital: $6,390,449Chambersburg Hospital: $18,577,321Chambersburg Health Services: $526,000These amounts are reported on the respective balance sheets for each of these entities.______________________________________________________________________________6.2017 BANK LOANS / REISSUE BONDS ISSUED 11/12/2008:On March 13, 2018, the General Authority of Southcentral Pennsylvania issued $34,877,000 of Revenue bonds, Series 2017A Notes (taxable) for WellSpan Health Obligated Group. Such notes were applied to refund 2008A Bonds. Also, on September 4, 2018, the General Authority of Southcentral Pennsylvania issued $29,312,000 of Revenue Bonds, Series 2017B (tax-exempt bonds) for WellSpan Health Obligated Group.Such notes were applied to refund 2008A Bonds.WellSpan Health, the parent organization, allocated portions of the proceeds of this tax-exempt bond issue to York Hospital (23-1352222), Gettysburg Hospital (23-1352220), WellSpan Properties (22-2842252), WellSpan Surgery & Rehabilitation Hospital (23-2899911), and The Good Samaritan Hospital of Lebanon Pennsylvania (23-1794160). To remain consistent with the reporting on Form 8038, all outstanding liabilities associated with this tax-exempt bond issue is reported on the WellSpan Health (22-2517863) Schedule K.As of 6/30/21, the allocation of the Debt Capital program of $50,807,000 was as follows: York Hospital: $29,508,705Gettysburg Hospital: $4,608,195WellSpan Properties: $5,385,542WellSpan Surgery & Rehabilitation Hospital: $8,535,576The Good Samaritan Hospital of Lebanon Pennsylvania: $411,536WellSpan Health: $2,357,446These amounts are reported on the respective balance sheets for each of these entities. |
| Signature Line - Paid Preparer Explanation | Paid Preparer ExplanationDue to a software limitation, we wish to clarify that WellSpan Health is the ERO.The paid preparer is:BDO USA, LLP13-53815908401 Greensboro Drive, Suite 800McLean, VA 22102(703) 893-0600 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Apple Hill Surgical Center Inc | ||||||||||
| PO Box 2767 | York | PA | 175042767 | 222842253 | Sole GP in limited pntrshp operating sur | PA | 501(c)(3) | 10 | WellSpan Health Care Services | false |
| Gettysburg Hospital | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 231352220 | Health Care Services | PA | 501(c)(3) | 3 | WellSpan Health | false |
| Gettysburg Hospital Foundation | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232251358 | Fundraising for Gettysburg Hospital | PA | 501(c)(3) | 12 Type I | Gettysburg Hospital | false |
| Healthy Community Pharmacy Inc | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 200519121 | Reduced rate prescription drugs | PA | 501(c)(3) | 12 Type I | WellSpan Health Care Services | false |
| VNA Community Services | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232338591 | Home personal care services for elderly | PA | 501(c)(3) | 10 | WellSpan Specialty Services | false |
| VNA Home Health Services | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 231352573 | Home health services | PA | 501(c)(3) | 10 | WellSpan Specialty Services | false |
| Wellspan Health | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 222517863 | Integrated Health System | PA | 501(c)(3) | 12 Type III | NA | false |
| Wellspan Health Care Services | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232400237 | Health-related activities in community | PA | 501(c)(3) | 12 Type II | WellSpan Health | false |
| York Health Foundation | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 233050192 | Charitable contributions for WS entities | PA | 501(c)(3) | 12 Type III | WellSpan Health | false |
| York Hospital | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 231352222 | Community teaching hospital | PA | 501(c)(3) | 3 | WellSpan Health | false |
| WellSpan Surgery & Rehab Hospital | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232899911 | Surgery and Rehabilitation Hospital | PA | 501(c)(3) | 3 | WellSpan Health | false |
| Wellspan Properties Inc | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 222842252 | Leases facilities to affiliates | PA | 501(c)(3) | 12 Type II | WellSpan Health Care Services | false |
| Ephrata Community Hospital | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 231370484 | Health care services | PA | 501(c)(3) | 3 | WellSpan Health | false |
| Ephrata Community Health Foundation | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 800940005 | Fundraising for Ephrata Hospital | PA | 501(c)(3) | 12 Type I | Ephrata Community Hospital | false |
| Northern Lancaster County Medical Group | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 203033058 | Medical and surgical care | PA | 501(c)(3) | 12 Type II | Ephrata Community Hospital | false |
| Phys Spec of North Lanc Co Med Gr | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 452537633 | Physician Properties | PA | 501(c)(3) | 12 Type II | Northern Lancaster County Medical Group | false |
| The Good Samaritan Hospital of Lebanon | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 230794160 | Health Care Services | PA | 501(c)(3) | 3 | WellSpan Health | false |
| Philhaven | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 231549922 | Health Care Services | PA | 501(c)(3) | 3 | WellSpan Health | false |
| Good Samaritan Health Service Foundation | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232356151 | Fundraising for Good Samaritan | PA | 501(c)(3) | 12 Type I | Good Samaritan Hospital | false |
| Good Samaritan Physician Services | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 251832359 | Medical and Surgical Care | PA | 501(c)(3) | 10 | Good Sam Health Services Foundation | false |
| WellSpan Summit Health | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 251515371 | Integrated Health System | PA | 501(c)(3) | 7 | WellSpan Health | false |
| Waynesboro Hospital | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 231360854 | Health Care Services | PA | 501(c)(3) | 3 | WellSpan Summit Health | false |
| Chambersburg Hospital | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 230465970 | Health Care Services | PA | 501(c)(3) | 3 | WellSpan Summit Health | false |
| WellSpan Medical Group | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 232730785 | Medical and surgical care | PA | 501(c)(3) | 10 | WellSpan Health | false |
| Summit Health Foundation | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 831196554 | Fundraising for health care system | PA | 501(c)(3) | 12 Type II | WellSpan Summit Health | false |
| Chambersburg Health Services | ||||||||||
| PO Box 2767 | York | PA | 174052767 | 251515376 | Health care services | PA | 501(c)(3) | 12 Type I | WellSpan Summit Health | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| Apple Hill Surgical Center Partners | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232489452 | Surgical Cn | PA | NA | false | false |
| Central PA Alliance Laboratories LLC | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232910950 | Ref. Lab | PA | NA | false | false |
| Littlestown Health Care Partners | |||||||||
| 300 West King Street | Littlestown | PA | 17340 | 232880464 | Lease facility | PA | NA | false | false |
| Cherry Tree Cancer Center LLP | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232915628 | Radiation | PA | NA | false | false |
| The Rehab Center | |||||||||
| 855 Springdale Drive Suite 20 | Exton | PA | 19341 | 251687903 | Physical Therapy Rehab | PA | NA | false | false |
| Surgery Center Associates | |||||||||
| 785 5th Ave | Chambersburg | PA | 17201 | 251845304 | Physician services | PA | Chambersburg Health | false | false |
| Summit Surgery Center | |||||||||
| 785 5th Ave | Chambersburg | PA | 17201 | 251845303 | Physician services | PA | Chambersburg Health | false | false |
| Cumberland Valley Mobile Services LLC | |||||||||
| 5 S Main St | Sugarloaf | PA | 18249 | 200884014 | Mobile health services | PA | Chambersburg Health | false | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Wellspan Pharmacy Inc | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232374072 | Dispenses Rx & provides IV therapy | PA | NA | C corp | false |
| Wellspan Reciprocal Risk Retention Group | |||||||||
| PO Box 2767 | York | PA | 174052767 | 200048457 | Risk Retention Group | PA | NA | C corp | false |
| GSH Realty Inc | |||||||||
| PO Box 2767 | York | PA | 174052767 | 251832359 | Rent of non res. real estate | PA | WSH Care Services | C corp | false |
| York Health Plan | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232664989 | Preferred Provider Organization | PA | NA | C corp | false |
| Wellspan Provider Network | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232907828 | Coord. managed car risk contracts | PA | NA | C corp | false |
| Apple Hill Condominium Association | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232504543 | Condo Mgmt Association | PA | NA | Homeowner Assoc | false |
| Northern Lanc Co Phys Hosp Alliance | |||||||||
| PO Box 2767 | York | PA | 174052767 | 232421885 | Coord Phys & Hospital | PA | NA | C corp | false |
| Ephrata Health Pavilion Condo Assoc | |||||||||
| PO Box 2767 | York | PA | 174052767 | 475367279 | Condo association | PA | Ephrata Hospital | C corp | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | 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 | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Comments