2020-05-20T14:22:12-05:00 2019-06-30 520783935 SMITH ELLIOTT KEARNS & COMPANY LLC 19 BROOKWOOD AVE STE 101 CARLISLE PA 17015 990 2018-07-01 251716306 SUMMIT PHYSICIAN SERVICES SUMM 7178513055 PO BOX 2767 YORK PA 174052767 MICHAEL F O'CONNOR CFO WELLSPAN HEALTH 0717267775 2020-05-15 true GREGORY P HALL CPA P00156653 7172439104 2020-05-15 65.144.154.59 2020-05-20 14:22:12 CD P 6B3D5CFE32BBD35C7631821135029589AD16E6BC 6B3D5CFE32BBD35C7631821135029589AD16E6BC 2018 2020-09-23 17:36:50Z X ROXANNA GAPSTUR PO BOX 2767 YORK PA 174052767 94606992 false X WWW.SUMMITHEALTH.ORG X 1993 PA TO PROVIDE APPROPRIATE PHYSICIAN MANPOWER TO SERVE THE NEEDS OF RESIDENTS IN FRANKLIN COUNTY AND SURROUNDING AREAS. 11 4 1027 591101 50019 0 75613366 75298571 619525 70640 19525533 19237781 95808443 94606992 4314 0 106764699 113825244 0 0 29907708 25856841 136672407 139686399 -40863964 -45079407 22019495 21921822 17615965 17280474 4403530 4641348 TO PROVIDE APPROPRIATE PHYSICIAN MANPOWER TO SERVE THE NEEDS OF RESIDENTS IN FRANKLIN COUNTY AND SURROUNDING AREAS. false false 124698758 4314 75298571 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. 124698758 true false false false false false false false false false true false false true true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true 65 0 true 1027 true true true false false false false false false false false false true false X 11 4 false false false false true true true true true false false true true true true true true true true false PA X X DAVID P RIZZUTO SENIOR CONTROLLER 7178513055 PO BOX 2767 YORK PA 174052767 RODGER SAVAGE CHAIR 0.35 0.56 X X 0 0 0 ADELINA PALADE MD VICE CHAIR 0.38 X X 242092 0 26194 KEVIN J LORENTSON MD SECRETARY 40.38 0.30 X X 485675 0 26422 KIMBERLY M RZOMP TREASURER/VP 2.35 38.00 X X 28542 542313 72744 PATRICK W O'DONNELL PRESIDENT/CE 2.38 38.94 X X 95694 1818184 310020 ROXANNA GAPSTUR STARTED 112019 CEO WELLSPAN X 0 0 0 KEVIN MOSSER ENDED 123118 CEO WELLSPAN 40.00 X 0 4267289 111748 MICHAEL F O'CONNOR CFO WELLSPAN 40.00 X 0 811162 641117 MARIE BECK DIRECTOR 0.23 X 0 0 0 H WALLACE BRUBAKER MD DIRECTOR 40.38 X 231939 0 25891 VALORIE DICK DIRECTOR 0.35 0.00 X 0 0 0 R WILLIAM HAPPEL DIRECTOR 0.35 0.64 X 0 0 0 DR PETER HOLDAWAY DIRECTOR 40.35 X 313435 0 26884 REBECCA NEWCOMER CRNP DIRECTOR 0.35 40.00 X 558 123565 197845 LISSA NIKI HINCKLE SR VP OF PHY 32.38 8.00 X 485794 121449 27109 FRANK S MOZDY MD CHIEF MEDICA 40.00 0.00 X 383864 0 9375 MICHELE ZEIGLER VP INFO SERV 1.00 39.00 X 8644 337131 59359 ARSHAD M SAFI PHYSICIAN 40.00 X 1030439 0 83327 AYLMER C TANG PHYSICIAN 40.00 X 1015936 0 83327 JOSHUA L DUNKLEBARGER PHYSICIAN 40.00 X 949005 0 27354 JEFFREY S LUTTON JR PHYSICIAN 40.00 X 769773 0 26053 DAVID A GUTHRIE PHYSICIAN 40.00 X 765845 0 23941 6807235 8021093 1778710 258 false true false CHAMBERSBURG HEALTH SVCS INC 601 NORLAND AVENUE SUITE 201 CHAMBERSBURG PA 17201 PROF MED SVC. 2034191 MEDICUS HOSPITALISTS LLC 22 ROULSTON ROAD WINDHAM NH 03087 STAFFING SVC. 654750 CHAMBERSBURG HOSPITAL 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 MEDICAL SERVICE 623844 SPRING MEDICAL LLC 24 BELLA VISTA DRIVE MECHANICSBURG PA 17050 STAFFING SVC. 623602 WAYNESBORO HOSPITAL 501 EAST MAIN STREET WAYNESBORO PA 17268 HEALTH CARE SVC 602440 27 PATIENT SERVICE REVENUE 621110 75298571 75298571 75298571 70622 70622 26049 26049 26049 26049 18 18 18 18 MANAGEMENT SERVICE REVENUE 621110 14828856 14828856 OTHER INCOME 621110 3743804 3743804 SALE OF SKIN CARE PRODUCTS 621110 528298 528298 110774 47971 62803 19211732 94606992 93919202 591101 96689 4314 4314 2587814 1508151 1079663 94585283 86884605 7700678 2597665 2254528 343137 9274326 7982328 1291998 4780156 4110934 669222 368770 346644 22126 126696 119094 7602 6197555 5710573 486982 569462 432791 136671 996310 757196 239114 870793 818545 52248 5150068 3914052 1236016 199784 151836 47948 796852 605608 191244 1141050 753093 387957 2554819 1941662 613157 MEDICAL SUPPLIES & MEDS 5088898 5038009 50889 OTHER SUPPLIES 1391399 1057463 333936 DUES 284520 216235 68285 MISCELLANEOUS EXPENSE 119865 91097 28768 139686399 124698758 14987641 0 12372 12722 2250597 1463191 32685 17289 6747601 7094343 5041614 5763574 93596 52413 1341371 1308475 15604548 12215923 3873435 3388625 1274042 1293494 57978 57978 1294204 1469718 22019495 21921822 14144110 13658039 3471855 3622435 17615965 17280474 X 4370845 4608663 32685 32685 4403530 4641348 22019495 21921822 X -45079407 45317225 X false true X true false X 1983613 13264 1970349 13620935 12202659 1418276 3388625 DUE FROM AFFILIATES 1192722 MISC AR 254381 CONSTRUCTION IN PROGRESS 11755 DEPOSITS 10860 1469718 ACCRUED LIABILITY INSURANCE 1550440 DEFERRED COMPENSATION 1274042 ACCRUED HEALTH INSURANCE 790927 DEFERRED INCOME 7026 3622435 X SCHEDULE D, PAGE 3, PART X 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. X X true true X X X X X false false false false false false false true false ADELINA PALADE MD VICE CHAIR 185326 56394 372 7453 18741 268286 KEVIN J LORENTSON MD SECRETARY 425633 58365 1677 8250 18172 512097 KIMBERLY M RZOMP TREASURER/VP & CFO 20078 381491 7065 134241 1399 26581 2757 52388 880 16719 32179 611420 PATRICK W O'DONNELL PRESIDENT/CEO 82072 1559370 11424 217061 2198 41753 13232 251405 2269 43114 111195 2112703 KEVIN MOSSER ENDED 123118 CEO WELLSPAN HEALTH 1023400 420420 2823469 13433 98315 4379037 MICHAEL F O'CONNOR CFO WELLSPAN HEALTH 588737 222300 125 590416 50701 1452279 H WALLACE BRUBAKER MD DIRECTOR 196620 34153 1166 7096 18795 257830 DR PETER HOLDAWAY DIRECTOR 231641 75869 5925 8180 18704 340319 REBECCA NEWCOMER CRNP DIRECTOR 558 118763 4802 179220 18625 558 321410 LISSA NIKI HINCKLE SR VP OF PHYSICIAN 392750 98188 64999 16250 28045 7011 6600 1650 15087 3772 507481 126871 FRANK S MOZDY MD CHIEF MEDICAL OFFICE 344996 36641 2227 8250 1125 393239 MICHELE ZEIGLER VP INFO SERVICES/CIO 6445 251372 1454 56696 745 29063 1260 49145 224 8730 10128 395006 ARSHAD M SAFI PHYSICIAN 802274 200000 28165 64250 19077 1113766 AYLMER C TANG PHYSICIAN 807980 200000 7956 64250 19077 1099263 JOSHUA L DUNKLEBARGER PHYSICIAN 784043 136091 28871 8250 19104 976359 JEFFREY S LUTTON JR PHYSICIAN 750537 18750 486 8250 17803 795826 DAVID A GUTHRIE PHYSICIAN 441652 295781 28412 8250 15691 789786 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. 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 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 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 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 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 false false true false false false false false false false true false false false true false false true true