SUMMIT PHYSICIAN SERVICES: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- SUMMIT PHYSICIAN SERVICES (EIN 25-1716306)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-05-20
- IRS object ID
- 202001419349301655
- Schema version
- 2018v3.2
- 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 | 2020-05-20T14:22:12-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 520783935 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SMITH ELLIOTT KEARNS & COMPANY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19 BROOKWOOD AVE STE 101 | AddressLine1Txt |
| City | CARLISLE | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17015 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | 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 | 174052767 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL F O'CONNOR | PersonNm |
| Person Title | CFO WELLSPAN HEALTH | PersonTitleTxt |
| Phone | 0717267775 | PhoneNum |
| Signature | 2020-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | GREGORY P HALL CPA | PreparerPersonNm |
| PTIN | P00156653 | PTIN |
| Phone | 7172439104 | PhoneNum |
| Preparation | 2020-05-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 65.144.154.59 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-05-20 | IPDt |
| IP Tm | 14:22:12 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 6B3D5CFE32BBD35C7631821135029589AD16E6BC | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 6B3D5CFE32BBD35C7631821135029589AD16E6BC | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| 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 | $94,606,992 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SUMMITHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | PA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE APPROPRIATE PHYSICIAN MANPOWER TO SERVE THE NEEDS OF RESIDENTS IN FRANKLIN COUNTY AND SURROUNDING AREAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 1027 | TotalEmployeeCnt |
| Total Gross UBI | $591,101 | TotalGrossUBIAmt |
| PY Contributions Grants | $50,019 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $75,613,366 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $75,298,571 | CYProgramServiceRevenueAmt |
| PY Investment Income | $619,525 | PYInvestmentIncomeAmt |
| CY Investment Income | $70,640 | CYInvestmentIncomeAmt |
| PY Other Revenue | $19,525,533 | PYOtherRevenueAmt |
| CY Other Revenue | $19,237,781 | CYOtherRevenueAmt |
| PY Total Revenue | $95,808,443 | PYTotalRevenueAmt |
| CY Total Revenue | $94,606,992 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $4,314 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $106,764,699 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $113,825,244 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $29,907,708 | PYOtherExpensesAmt |
| CY Other Expenses | $25,856,841 | CYOtherExpensesAmt |
| PY Total Expenses | $136,672,407 | PYTotalExpensesAmt |
| CY Total Expenses | $139,686,399 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$40,863,964 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$45,079,407 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $22,019,495 | TotalAssetsBOYAmt |
| Total Assets EOY | $21,921,822 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,615,965 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $17,280,474 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,403,530 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,641,348 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE APPROPRIATE PHYSICIAN MANPOWER TO SERVE THE NEEDS OF RESIDENTS IN FRANKLIN COUNTY AND SURROUNDING AREAS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $124,698,758 | ExpenseAmt |
| Grant | $4,314 | GrantAmt |
| Revenue | $75,298,571 | RevenueAmt |
| Desc | SUMMIT PHYSICIAN SERVICES EXEMPT PURPOSE IS TO PROVIDE PRIMARY HEALTH CARE TO PATIENTS IN THE FRANKLIN COUNTY AND SURROUNDING AREAS OF SOUTH CENTRAL PENNSYLVANIA. ALL GENERAL AND ADMINISTRATIVE EXPENSES SUPPORT EFFORTS TO PROVIDE HEALTH CARE TO THE COMMUNITY. | Desc |
| Total Program Service Expenses | $124,698,758 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | 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 |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 65 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1027 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | Yes (true) | 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 | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | PA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID P RIZZUTO SENIOR CONTROLLER | PersonNm |
| 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 | 174052767 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| RODGER SAVAGE | |||||||||
| CHAIR | 0.35 | 0.56 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ADELINA PALADE MD | |||||||||
| VICE CHAIR | 0.38 | Yes (X) | Yes (X) | $242,092 | $0 | $26,194 | |||
| KEVIN J LORENTSON MD | |||||||||
| SECRETARY | 40.38 | 0.30 | Yes (X) | Yes (X) | $485,675 | $0 | $26,422 | ||
| KIMBERLY M RZOMP | |||||||||
| TREASURER/VP | 2.35 | 38.00 | Yes (X) | Yes (X) | $28,542 | $542,313 | $72,744 | ||
| PATRICK W O'DONNELL | |||||||||
| PRESIDENT/CE | 2.38 | 38.94 | Yes (X) | Yes (X) | $95,694 | $1,818,184 | $310,020 | ||
| ROXANNA GAPSTUR STARTED 112019 | |||||||||
| CEO WELLSPAN | Yes (X) | $0 | $0 | $0 | |||||
| KEVIN MOSSER ENDED 123118 | |||||||||
| CEO WELLSPAN | 40.00 | Yes (X) | $0 | $4,267,289 | $111,748 | ||||
| MICHAEL F O'CONNOR | |||||||||
| CFO WELLSPAN | 40.00 | Yes (X) | $0 | $811,162 | $641,117 | ||||
| MARIE BECK | |||||||||
| DIRECTOR | 0.23 | Yes (X) | $0 | $0 | $0 | ||||
| H WALLACE BRUBAKER MD | |||||||||
| DIRECTOR | 40.38 | Yes (X) | $231,939 | $0 | $25,891 | ||||
| VALORIE DICK | |||||||||
| DIRECTOR | 0.35 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| R WILLIAM HAPPEL | |||||||||
| DIRECTOR | 0.35 | 0.64 | Yes (X) | $0 | $0 | $0 | |||
| DR PETER HOLDAWAY | |||||||||
| DIRECTOR | 40.35 | Yes (X) | $313,435 | $0 | $26,884 | ||||
| REBECCA NEWCOMER CRNP | |||||||||
| DIRECTOR | 0.35 | 40.00 | Yes (X) | $558 | $123,565 | $197,845 | |||
| LISSA NIKI HINCKLE | |||||||||
| SR VP OF PHY | 32.38 | 8.00 | $485,794 | $121,449 | $27,109 | Yes (X) | |||
| FRANK S MOZDY MD | |||||||||
| CHIEF MEDICA | 40.00 | 0.00 | $383,864 | $0 | $9,375 | Yes (X) | |||
| MICHELE ZEIGLER | |||||||||
| VP INFO SERV | 1.00 | 39.00 | $8,644 | $337,131 | $59,359 | Yes (X) | |||
| ARSHAD M SAFI | |||||||||
| PHYSICIAN | 40.00 | $1,030,439 | $0 | $83,327 | Yes (X) | ||||
| AYLMER C TANG | |||||||||
| PHYSICIAN | 40.00 | $1,015,936 | $0 | $83,327 | Yes (X) | ||||
| JOSHUA L DUNKLEBARGER | |||||||||
| PHYSICIAN | 40.00 | $949,005 | $0 | $27,354 | Yes (X) | ||||
| JEFFREY S LUTTON JR | |||||||||
| PHYSICIAN | 40.00 | $769,773 | $0 | $26,053 | Yes (X) | ||||
| DAVID A GUTHRIE | |||||||||
| PHYSICIAN | 40.00 | $765,845 | $0 | $23,941 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $6,807,235 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,021,093 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,778,710 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 258 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CHAMBERSBURG HEALTH SVCS INC | |||||
| 601 NORLAND AVENUE SUITE 201 | CHAMBERSBURG | PA | 17201 | PROF MED SVC. | $2,034,191 |
| MEDICUS HOSPITALISTS LLC | |||||
| 22 ROULSTON ROAD | WINDHAM | NH | 03087 | STAFFING SVC. | $654,750 |
| CHAMBERSBURG HOSPITAL | |||||
| 112 NORTH SEVENTH STREET | CHAMBERSBURG | PA | 17201 | MEDICAL SERVICE | $623,844 |
| SPRING MEDICAL LLC | |||||
| 24 BELLA VISTA DRIVE | MECHANICSBURG | PA | 17050 | STAFFING SVC. | $623,602 |
| WAYNESBORO HOSPITAL | |||||
| 501 EAST MAIN STREET | WAYNESBORO | PA | 17268 | HEALTH CARE SVC | $602,440 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 27 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $75,298,571 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $75,298,571 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $75,298,571 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $70,622 | TotalRevenueColumnAmt |
| Exclusion | $70,622 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $26,049 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $26,049 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,049 | TotalRevenueColumnAmt |
| Exclusion | $26,049 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $18 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $18 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18 | TotalRevenueColumnAmt |
| Exclusion | $18 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| MANAGEMENT SERVICE REVENUE | 621110 | $14,828,856 | $14,828,856 | |
| OTHER INCOME | 621110 | $3,743,804 | $3,743,804 | |
| SALE OF SKIN CARE PRODUCTS | 621110 | $528,298 | $528,298 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $110,774 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $47,971 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $62,803 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $19,211,732 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $94,606,992 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $93,919,202 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $591,101 | UnrelatedBusinessRevenueAmt |
| Exclusion | $96,689 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,314 | TotalAmt |
| Program Services | $4,314 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,587,814 | TotalAmt |
| Program Services | $1,508,151 | ProgramServicesAmt |
| Management And General | $1,079,663 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,585,283 | TotalAmt |
| Program Services | $86,884,605 | ProgramServicesAmt |
| Management And General | $7,700,678 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,597,665 | TotalAmt |
| Program Services | $2,254,528 | ProgramServicesAmt |
| Management And General | $343,137 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,274,326 | TotalAmt |
| Program Services | $7,982,328 | ProgramServicesAmt |
| Management And General | $1,291,998 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,780,156 | TotalAmt |
| Program Services | $4,110,934 | ProgramServicesAmt |
| Management And General | $669,222 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $368,770 | TotalAmt |
| Program Services | $346,644 | ProgramServicesAmt |
| Management And General | $22,126 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,696 | TotalAmt |
| Program Services | $119,094 | ProgramServicesAmt |
| Management And General | $7,602 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,197,555 | TotalAmt |
| Program Services | $5,710,573 | ProgramServicesAmt |
| Management And General | $486,982 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $569,462 | TotalAmt |
| Program Services | $432,791 | ProgramServicesAmt |
| Management And General | $136,671 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $996,310 | TotalAmt |
| Program Services | $757,196 | ProgramServicesAmt |
| Management And General | $239,114 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $870,793 | TotalAmt |
| Program Services | $818,545 | ProgramServicesAmt |
| Management And General | $52,248 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,150,068 | TotalAmt |
| Program Services | $3,914,052 | ProgramServicesAmt |
| Management And General | $1,236,016 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $199,784 | TotalAmt |
| Program Services | $151,836 | ProgramServicesAmt |
| Management And General | $47,948 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $796,852 | TotalAmt |
| Program Services | $605,608 | ProgramServicesAmt |
| Management And General | $191,244 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,141,050 | TotalAmt |
| Program Services | $753,093 | ProgramServicesAmt |
| Management And General | $387,957 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,554,819 | TotalAmt |
| Program Services | $1,941,662 | ProgramServicesAmt |
| Management And General | $613,157 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & MEDS | $5,088,898 | $5,038,009 | $50,889 |
| OTHER SUPPLIES | $1,391,399 | $1,057,463 | $333,936 |
| DUES | $284,520 | $216,235 | $68,285 |
| MISCELLANEOUS EXPENSE | $119,865 | $91,097 | $28,768 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,686,399 | TotalAmt |
| Program Services | $124,698,758 | ProgramServicesAmt |
| Management And General | $14,987,641 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,372 | BOYAmt |
| EOY | $12,722 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,250,597 | BOYAmt |
| EOY | $1,463,191 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,685 | BOYAmt |
| EOY | $17,289 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,747,601 | BOYAmt |
| EOY | $7,094,343 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,041,614 | BOYAmt |
| EOY | $5,763,574 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,596 | BOYAmt |
| EOY | $52,413 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,341,371 | BOYAmt |
| EOY | $1,308,475 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,604,548 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $12,215,923 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,873,435 | BOYAmt |
| EOY | $3,388,625 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,274,042 | BOYAmt |
| EOY | $1,293,494 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,978 | BOYAmt |
| EOY | $57,978 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,294,204 | BOYAmt |
| EOY | $1,469,718 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,019,495 | BOYAmt |
| EOY | $21,921,822 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,144,110 | BOYAmt |
| EOY | $13,658,039 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,471,855 | BOYAmt |
| EOY | $3,622,435 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,615,965 | BOYAmt |
| EOY | $17,280,474 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,370,845 | BOYAmt |
| EOY | $4,608,663 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,685 | BOYAmt |
| EOY | $32,685 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,403,530 | BOYAmt |
| EOY | $4,641,348 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,019,495 | BOYAmt |
| EOY | $21,921,822 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$45,079,407 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $45,317,225 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,983,613 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,264 | DepreciationAmt |
| Book Value | $1,970,349 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,620,935 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,202,659 | DepreciationAmt |
| Book Value | $1,418,276 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,388,625 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATES | $1,192,722 |
| MISC AR | $254,381 |
| CONSTRUCTION IN PROGRESS | $11,755 |
| DEPOSITS | $10,860 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,469,718 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED LIABILITY INSURANCE | $1,550,440 |
| DEFERRED COMPENSATION | $1,274,042 |
| ACCRUED HEALTH INSURANCE | $790,927 |
| DEFERRED INCOME | $7,026 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,622,435 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | 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, 2019. | ExplanationTxt |
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 |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ADELINA PALADE MD | ||||||||||||
| VICE CHAIR | $185,326 | $56,394 | $372 | $7,453 | $18,741 | $268,286 | ||||||
| KEVIN J LORENTSON MD | ||||||||||||
| SECRETARY | $425,633 | $58,365 | $1,677 | $8,250 | $18,172 | $512,097 | ||||||
| KIMBERLY M RZOMP | ||||||||||||
| TREASURER/VP & CFO | $20,078 | $7,065 | $1,399 | $2,757 | $880 | $32,179 | $381,491 | $134,241 | $26,581 | $52,388 | $16,719 | $611,420 |
| PATRICK W O'DONNELL | ||||||||||||
| PRESIDENT/CEO | $82,072 | $11,424 | $2,198 | $13,232 | $2,269 | $111,195 | $1,559,370 | $217,061 | $41,753 | $251,405 | $43,114 | $2,112,703 |
| KEVIN MOSSER ENDED 123118 | ||||||||||||
| CEO WELLSPAN HEALTH | $1,023,400 | $420,420 | $2,823,469 | $13,433 | $98,315 | $4,379,037 | ||||||
| MICHAEL F O'CONNOR | ||||||||||||
| CFO WELLSPAN HEALTH | $588,737 | $222,300 | $125 | $590,416 | $50,701 | $1,452,279 | ||||||
| H WALLACE BRUBAKER MD | ||||||||||||
| DIRECTOR | $196,620 | $34,153 | $1,166 | $7,096 | $18,795 | $257,830 | ||||||
| DR PETER HOLDAWAY | ||||||||||||
| DIRECTOR | $231,641 | $75,869 | $5,925 | $8,180 | $18,704 | $340,319 | ||||||
| REBECCA NEWCOMER CRNP | ||||||||||||
| DIRECTOR | $558 | $558 | $118,763 | $4,802 | $179,220 | $18,625 | $321,410 | |||||
| LISSA NIKI HINCKLE | ||||||||||||
| SR VP OF PHYSICIAN | $392,750 | $64,999 | $28,045 | $6,600 | $15,087 | $507,481 | $98,188 | $16,250 | $7,011 | $1,650 | $3,772 | $126,871 |
| FRANK S MOZDY MD | ||||||||||||
| CHIEF MEDICAL OFFICE | $344,996 | $36,641 | $2,227 | $8,250 | $1,125 | $393,239 | ||||||
| MICHELE ZEIGLER | ||||||||||||
| VP INFO SERVICES/CIO | $6,445 | $1,454 | $745 | $1,260 | $224 | $10,128 | $251,372 | $56,696 | $29,063 | $49,145 | $8,730 | $395,006 |
| ARSHAD M SAFI | ||||||||||||
| PHYSICIAN | $802,274 | $200,000 | $28,165 | $64,250 | $19,077 | $1,113,766 | ||||||
| AYLMER C TANG | ||||||||||||
| PHYSICIAN | $807,980 | $200,000 | $7,956 | $64,250 | $19,077 | $1,099,263 | ||||||
| JOSHUA L DUNKLEBARGER | ||||||||||||
| PHYSICIAN | $784,043 | $136,091 | $28,871 | $8,250 | $19,104 | $976,359 | ||||||
| JEFFREY S LUTTON JR | ||||||||||||
| PHYSICIAN | $750,537 | $18,750 | $486 | $8,250 | $17,803 | $795,826 | ||||||
| DAVID A GUTHRIE | ||||||||||||
| PHYSICIAN | $441,652 | $295,781 | $28,412 | $8,250 | $15,691 | $789,786 | ||||||
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 1A | THE OFFICERS RECEIVE AN ALLOWANCE THAT CAN BE CONSIDERED A DISCRETIONARY SPENDING ACCOUNT. THE MONIES ARE IN LIEU OF AN AUTOMOBILE ALLOWANCE, TO PURCHASE ADDITIONAL LIFE INSURANCE, ETC. THESE MONIES ARE INCLUDED IN COMPENSATION AS REPORTED IN THE COMPENSATION OF OFFICERS TABLE. RESULTS FITNESS CLUB MEMBERSHIP IS AVAILABLE FREE OF CHARGE FOR ANY OFFICER AND ACTIVE BOARD MEMBER. |
| SCHEDULE J, PAGE 1, 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. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 6 | SUMMIT HEALTH, A 501(C)(3) ENTITY, IS A MEMBER OF THIS ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 7A | SUMMIT HEALTH, A 501(C)(3) ENTITY, ELECTS THE GOVERNING BODY OF THIS ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 7B | SUMMIT HEALTH, A 501(C)(3) ENTITY, HAS CERTAIN RESERVE POWERS OVER THIS ORGANIZATION. |
| FORM 990, PAGE 6, PART VI, LINE 11B | PRIOR TO FILING, THE FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE AND APPROVED BY THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | MEMBERS ARE ASKED ANNUALLY TO DISCLOSE ANY CONFLICTS OF INTEREST THEY MAY HAVE. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE COMPENSATION IS DISCUSSED WITH AN INDEPENDENT COMPENSATION COMMITTEE. THIS IS PERFORMED IN CONCERT WITH A COMPENSATION CONSULTANT WHO ASSISTS THIS COMMITTEE IN SETTING THE COMPENSATIONS FOR THESE INDIVIDUALS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE COMPENSATION IS DISCUSSED WITH AN INDEPENDENT COMPENSATION COMMITTEE. THIS IS PERFORMED IN CONCERT WITH A COMPENSATION CONSULTANT WHO ASSISTS THIS COMMITTEE IN SETTING THE COMPENSATIONS FOR THESE INDIVIDUALS. |
| FORM 990, PAGE 6, PART VI, 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 CHAMBERSBURG HOSPITAL. |
| FORM 990, PART XI, LINE 9 | TRANSFERS FROM AFFILIATED ORGANIZATIONS 48,729,273 TRANSFERS TO AFFILIATED ORGANIZATIONS -3,412,048 TOTAL 45,317,225 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (25 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| WELLSPAN SUMMIT HEALTH | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251515371 | HEALTHCARE | PA | 501C3 | 7 | WELLSPAN S | false |
| WAYNESBORO HOSPITAL | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231360854 | HEALTHCARE | PA | 501C3 | 3 | WELLSPAN S | false |
| CHAMBERSBURG HEALTH SERVICES | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251515376 | HEALTHCARE | PA | 501C3 | 12A | WELLSPAN S | false |
| THE CHAMBERSBURG HOSPITAL | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 230465970 | HEALTHCARE | PA | 501C3 | 3 | WELLSPAN S | false |
| YORK HOSPITAL | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231352222 | HEALTHCARE | PA | 501C3 | 3 | NA | false |
| APPLE HILL SURGICAL CENTER INC | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 222842253 | SOLE GP IN | PA | 501C3 | 10 | NA | false |
| GETTYSBURG HOSPITAL | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231352220 | HEALTH CAR | PA | 501C3 | 3 | NA | false |
| GETTYSBURG HOSPITAL FOUNDATION | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232251358 | FUNDRAISIN | PA | 501C3 | 12A | NA | false |
| HEALTHY COMMUNITY PHARMACY INC | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 200519121 | REDUCED RA | PA | 501C3 | 12A | NA | false |
| VNA COMMUNITY SERVICES | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232338591 | HORNE PERS | PA | 501C3 | 10 | NA | false |
| VNA HOME HEALTH SERVICES | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231352573 | HORNE HEAL | PA | 501C3 | 10 | NA | false |
| WELLSPAN HEALTH | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 222517863 | INTEGRATED | PA | 501C3 | 12C | NA | false |
| WELLSPAN HEALTH CARE SERVICES | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232400237 | HEALTH-REL | PA | 501C3 | 12B | NA | false |
| WELLSPAN MEDICAL GROUP | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232730785 | MEDICAL AN | PA | 501C3 | 10 | NA | false |
| YORK HEALTH FOUNDATION | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 233050192 | CHARITABLE | PA | 501C3 | 12C | NA | false |
| WELLSPAN SPECIALTY SERVICES | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232899911 | SURGERY AN | PA | 501C3 | 3 | NA | false |
| WELLSPAN PROPERTIES INC | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 222842252 | LEASES FAC | PA | 501C3 | 12A | NA | false |
| EPHRATA COMMUNITY HOSPITAL | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231370484 | HEALTH CAR | PA | 501C3 | 3 | NA | false |
| EPHRATA COMMUNITY HEALTH FOUNDATION | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 800940005 | FUNDRAISIN | PA | 501C3 | 12A | EPHRATA CO | false |
| NORTHERN LANCASTER COUNTY MEDICAL G | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 203033058 | MEDICAL AN | PA | 501C3 | 12B | EPHRATA CO | false |
| PHYS SPEC OF NORTH LANC CO MED | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 452537633 | PHYSICIAN | PA | 501C3 | 12B | NORTHERN L | false |
| GOOD SAMARITAN HOSPITAL | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 230794160 | HEALTH CAR | PA | 501C3 | 3 | NA | false |
| PHILHAVEN | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 231548822 | HEALTH CAR | PA | 501C3 | 3 | NA | false |
| GOOD SAMARITAN HEATH SERVICE FOUNDA | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232356151 | FUNDRAISIN | PA | 501C3 | 12A | NA | false |
| GOOD SAMARITAN PHYSICIAN SERVICES | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251832359 | MEDICAL AN | PA | 501C3 | 10 | NA | 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 | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|
| SUMMIT SURGERY CENTER LP | ||||||||||
| 785 5TH AVENUE SUITE 3 | CHAMBERSBURG | PA | 17201 | 251845303 | PHYSICIAN | PA | NA | false | false | 0.00650 |
| SURGERY CENTER ASSOCIATES LLC | ||||||||||
| 785 5TH AVENUE SUITE 3 | CHAMBERSBURG | PA | 17201 | 251845304 | PHYSICIAN | PA | NA | false | Yes (true) | 0.01000 |
| APPLE HILL SURGICAL CENTER PARTNERS | ||||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232489452 | SURGICAL C | PA | NA | false | false | |
| CENTRAL PA ALLIANCE LABORATORIES LL | ||||||||||
| 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 FACI | 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 T | PA | NA | false | false | |
| CUMBERLAND VALLEY MOBILE SVC LLC | ||||||||||
| 112 NORTH SEVENTH STREET | CHAMBERSBURG | PA | 17201 | 200884014 | MOBILE SVC | PA | NA | 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 | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| WELLSPAN PHARMACY INC | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232374072 | DISPENSES | PA | N/A | C CORP | false |
| WELLSPAN RECIPROCAL RISK RETEN | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 200048457 | RISK RETEN | PA | N/A | C CORP | false |
| YORK HEALTH PLAN | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232664989 | PREFERRED | PA | N/A | C CORP | false |
| WELLSPAN PROVIDER NETWORK | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232907828 | COORD MNGD | PA | N/A | C CORP | false |
| APPLE HILL CONDOMINIUM ASSOCIA | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232504543 | CONDO MGMT | PA | N/A | C CORP | false |
| NORTH LANC CO PHYS HOSP ALLIAN | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 232421885 | COORD PHYS | PA | N/A | C CORP | false |
| GSH REALTY INC | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 251832359 | RENTAL NON | PA | N/A | C CORP | false |
| EPHRATA HEALTH PAVILION CONDO ASSOC | |||||||||
| PO BOX 2767 | YORK | PA | 174052767 | 475367279 | CONDO ASSO | PA | N/A | 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 | Yes (true) | 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 | Yes (true) | 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 | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
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