2019-05-08T11:39:50-07:00 2018-06-30 135381590 WellSpan Health 3350 WHITEFORD ROAD YORK PA 17402 990 2017-07-01 231370484 EPHRATA COMMUNITY HOSPITAL EPHR 7178513055 PO BOX 2767 YORK PA 17405 Michael F O'Connor CFO 2019-05-08 false See Attached P01871563 7038930600 2017 2019-02-21 02:37:17Z Kevin Mosser MD PO Box 2767 York PA 174052767 218122334 false false X WWW.WELLSPAN.ORG X 1940 PA The Ephrata Community Hospital is a tax exempt organization dedicated to providing preventive, primary, acute care, diagnostic and rehabilitative services. 14 10 1488 273 490986 81108 1680719 1930240 197324190 213385746 1020703 1468149 523102 541079 200548714 217325214 6402100 11652275 0 77799105 76418106 0 311080 120391313 128056552 204592518 216126933 -4043804 1198281 158065476 152112757 100106969 91986189 57958507 60126568 The mission of the Ephrata Community Hospital:1)To assure community access to health care services that are high in quality, compassionate and cost-effective.2)To partner with employees, physicians, volunteers, and other health care organizations to meet the health care needs of the communities we serve.3)To combine advanced medical technology with professional, personalized care. false false 172589887 11652275 213658794 Ephrata Community Hospital is an acute care hospital providing care for residents of northern Lancaster County and surrounding communities. For the fiscal year that ended June 30, 2016, program services included 7167 inpatient acute, sub-acute, behavioral health, acute rehab and newborn admissions, for a total of 27,788 patient bed days.Additionally, outpatient services included imaging studies (x-ray, ultrasound, MRI, CT, mammography), lab testing, physical, occupational and speech therapy, non-invasive cardiology procedures including echocardiograms and EKG's, behavioral health counseling, radiation and medical oncology, emergency department visits, prenatal care through our healthy beginnings plus.See Attached 2018 WellSpan Health Community Benefit Report 172589887 true true false true false false false false false true true false false false true true false true false false true false false false false false true true true false true true false false false false false false false false false false false false false false false true true true false false true 4 0 true 1488 true true true false false false false false false 0 false false false false false false false false false false X 14 10 false false false false true true true true true false false true true true true true true true true true true PA X DAVID P RIZZUTO 7178513055 3350 WHITEFORD ROAD YORK PA 174029081 X R Fred Groff III Director 1.00 0.00 X 0 0 0 William C Funk DMD Chairman 1.00 0.00 X X 0 0 0 Leon Ray Burkholder Director 1.00 0.00 X 0 0 0 Douglas Arbittier MD Director 1.00 40.00 X 0 800328 85912 Carrie Evans Director 1.00 0.00 X 0 0 0 P Joshua Gluck Treasurer 1.00 0.00 X X 0 0 0 Lloyd G Goldfarb MD Director 1.00 40.00 X 0 327279 56284 Aaron L Groff Jr Secretary 1.00 0.00 X X 0 0 0 Jeffrey Musser DO Director 1.00 0.00 X 0 0 0 Kevin Mosser MD Dir/CEO WSH 1.00 40.00 X X 0 1432923 760166 Jeffrey Keyser DO Director 1.00 40.00 X 0 415405 40773 Dean A Stoesz Director 1.00 0.00 X 0 0 0 Linda H Weaver Vice Chair 1.00 0.00 X X 0 0 0 Dale Whitebloom DO Director 1.00 0.00 X 0 0 0 Carrie Willetts President 40.00 0.00 X 438959 0 60773 Michael F O'Connor CFO-WellSpan 1.00 40.00 X 0 790085 474403 David Vega VP-Medical Affairs 40.00 0.00 X 397647 0 66343 Robert Ortmyer VP-Operations 40.00 0.00 X 255441 0 55272 Tina Citro VP-Patient Service 40.00 0.00 X 215659 0 50808 Steven Thomas Direct.-Pharm Care 40.00 0.00 X 189729 0 51755 David Heidelbaugh Pharmacist 40.00 0.00 X 184926 0 32564 John M Porter Jr Former President 0.00 40.00 X 0 948605 539235 1682361 4714625 2274288 47 true true false American HealthCare Svcs 10126 Cherry Bend Traverse City MI 49684 Staffing services 1900047 OnSite NeonatalPC 1000 Haddonfield-Berlin Rd Voorhees NJ 08047 NICU Physicians 650850 Anesthesia and Pain Associates 169 Martin Avenue Ephrata PA 17522 Anesthesia Services 550774 ABM Building Value PO Box 74008829 Chicago IL 606748829 Valet services 508697 Quest Diagnostics PO Box 912512 Pasadena CA 911102512 Lab services 455843 17 1535655 17883 376702 1930240 EHR Incentive Program(MU) 621500 Patient Services 621500 232754936 232278864 476072 W/O - Bad Debts 621990 -9397862 -9397862 W/O - Free Service 621990 -9971328 -9971328 213385746 1012694 1012694 0 0 359065 770154 -411089 -411089 -411089 469014 13407 24303 2663 444711 10744 455455 455455 0 0 0 Cafeteria/Cafe 722210 513050 513050 Gift Shop Sales 453220 87024 87024 Other Revenue 900099 121585 121585 230509 151463 14914 64132 952168 217325214 213182722 490986 1721266 X 11652275 11652275 0 0 0 463990 463990 0 56374238 49734808 6639430 2171610 1917938 253672 13150262 11626059 1524203 4258006 3759385 498621 21202255 21202255 8090 8090 85774 85774 0 0 0 36330240 34935607 1394633 11589 10467 1122 1018571 1018571 7218998 7218998 0 2088686 1709884 378802 142413 95728 46685 0 45982 25608 20374 2440448 2440448 0 8547232 8547232 1965010 1965010 Supplies 33968371 33187767 780604 Repair & Maintenance 4712563 2519317 2193246 Taxes & Licenses 2932818 2676991 255827 Utilities 2617896 2542445 75451 2719616 1760357 648179 311080 216126933 172589887 43225966 311080 5596 5975 3029462 4157616 -500 114750 26213366 30171655 0 0 1120855 1027449 3308565 3391266 353317 191858 208149685 106554686 103988067 101594999 3531519 1247927 10520502 3636327 0 0 5994727 6572935 158065476 152112757 3005408 3706347 205322 -90508 66267301 68986114 6169289 835848 24459649 18548388 100106969 91986189 X 52577815 54847322 4691477 4589581 689215 689665 57958507 60126568 158065476 152112757 X 1198281 969902 -122 X false true X true true true X false false false false false false false false false false true 14258 14258 false false Part II-B, Line 1i - Other Activities Description A portion of the dues paid to the Hospital Association of Pennsylvania and the American Hospital Association include lobbying ($7,572 and $6,686). 5380692 774279 328 876053 5279246 4133170 1506873 21321 280672 5380692 4116977 401491 -34125 351173 4133170 1800465 3175941 -33693 825736 4116977 1854473 1800465 0.13060 0.86940 false true true 1528030 1528030 125409020 48032418 77376602 9283175 6761367 2521808 68302623 51760901 16541722 3626837 3626837 101594999 Private equity, Limited Partnerships 110741 F Real estate, limited partnerships 194679 F Absolute return, Limited partners 217887 F Collective mutual funds & invest. trusts 2917527 F Accrd Payroll W/H 258664 Accrued Payroll 1226203 Accrued Vacation 3418237 Due to Affiliates 12755037 Total Other Noncurrent Liabili 890247 18548388 X 217227956 969454 969454 216258502 1066712 1066712 217325214 204937267 204937267 11189666 11189666 216126933 Part V, Line 4: Intended uses of the endowment fund. The funds are to be used to improve the health and welfare of the patients of Ephrata Community Hospital. 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 a 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, 2018. Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/S Restricted Contributions(Net) $-393629 Revenue netted against expense $-450959 Net assets through Foundation $291855 Grant from PSNLCMG $795704 Net assets released for PPE $823741 Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S Revenue netted against Expense $-450959 Grant-WellSpan Medical Group $10100000 Grant- N Lanc County Med Group $1540625 Grant - Physician Specialists of NLCMG $0 Central America and Carribbean 0 0 Investment 315010 315010 315010 false false true false false false true true X true X 300.000000000 true X true true true false true true 2941542 2941542 0.01360 26155984 14021453 12134531 0.05610 29097526 14021453 15076073 0.06970 20 3573 1258008 190778 1067230 0.00490 1024026 692832 331194 0.00150 4 393 137463 20 137443 0.00060 24 3966 2419497 883630 1535867 0.00700 24 3966 31517023 14905083 16611940 0.07670 1 128500 128500 0.00060 1 1392 3021 3021 1 56 251141 251141 0.00120 3 1448 382662 382662 0.00180 true 2772369 37427 64845093 74659510 -9814417 X true true 1 1 Ephrata Community Hospital 169 Martin Avenue Ephrata PA 17522 http://www.wellspan.org 747105 X X X false false true X X X X X X X X 15 true true true true X http://www.wellspan.org X http://www.wellspan.org X true 15 true http://www.wellspan.org true false true X 300.0000 400.0000 X X X X X X X true true X X X X true X http://www.wellspan.org X http://www.wellspan.org X http://www.wellspan.org X X X X X X X true X false X X X X true X false false Part V, Line 5 - Account Input from Persons Who Represent the Community The healthcare environment in Lancaster County and its associated historical partnerships has resulted in WellSpan-Ephrata Community Hospital participating in two separate Community Health Needs Assessment (CHNA) processes in Lancaster County. First, WellSpan-Ephrata Community Hospital maintained its partnership with the Lancaster Health Improvement Partnership (LHIP) and its partner organizations to conduct an ongoing CHNA across the county. Using the Conduent-Healthy Communities Initiative model, these entities regularly collect available secondary data on diverse topics including: community demographics; health behaviors and conditions; vital statistics, and; community conditions (i.e., air and water quality). Public health experts and various community stakeholders review this data and provide comments and recommendations based on county data and the clients they represent. The individuals consulted with represent diverse sectors of the Lancaster County community including: mental health; city and county government; health care organizations; the state health department; nursing homes; public health entities; homeless facilities; pregnancy services; faith-based, low-income service agencies; the local chamber of commerce; chronic disease and health-related organizations (HIV prevention; cancer prevention; immunization), and; racial/ethnic community-based organizations. In addition, to better understand the health needs of its service market, WellSpan-Ephrata Community Hospital Community conducted a CHNA with other WellSpan Health entities across its region, with a focus on the primary market served by WellSpan-Ephrata Community Hospital. Information collected through the CHNA was then shared with diverse community stakeholders to educate about current needs, identify areas of focus, and garner collective support for future strategy development and implementation. Community organizations represented included: Cocalico Area Senior Center; Ephrata Area School District; Ephrata Area Senior Center; Ephrata Chamber of Commerce; Ephrata Community Hospital Foundation; Good Samaritan Shelter; Philhaven; WellSpan Medical Group, and; Welsh Mountain Federally Qualified Health Center (FQHC). In addition, an individual representing the local Plain Population participated in the process. CHNA data is revisited regularly to guide implementation strategies and progress toward achieving identified Community Health Implementation Plan (CHIP) objectives. Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment County-wide CHNA - Lancaster General Hospital; Lancaster Rehabilitation Hospital; Women & Babies HospitalEphrata market-specific CHNA: Gettysburg Hospital (Adams); Good Samaritan Hospital (Lebanon), and; WellSpan Surgery and Rehabilitation Hospital and York Hospital (York) Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why In reviewing the top twenty indicators detected in the CHNA, many are related to the root causes of chronic diseases that are addressed by our two adopted focus areas. There are other areas that are not addressed by the hospital's action plan. Some indicators go beyond the scope of a community hospital's services, such as workers who drive alone to work, unemployed workers in civilian labor force, and households without a vehicle. In these cases the hospital would lack an effective approach to elicit any meaningful impact. Part V, Line 13b - Criteria For Providing Discounted Care If Not FPG Patients 401% of poverty level and greater do not qualify for financial assistance. However, all uninsured patients qualify for a 20% "no insurance" discount, regardless of income. Part V, Line 13h - Other Factors Used in Determing Amounts Charged Patients WellSpan Health is committed to caring for all the members of its communities, regardless of their ability to pay. In recent years, overall charity care has decreased slightly as more people have obtained health insurance coverage through the Affordable Care Act and the expansion of Pennsylvanias Medical Assistance (Medicaid) program. WellSpan is proud to be a leading partner in the Healthy Community Network, which works to address the needs of uninsured and underinsured individuals in our community. In addition, the health system recently enhanced its financial assistance policy and the discounts that it provides on services. For example, if a patients income is less than 300 percent of the federal poverty level, that patient would be eligible for a 100 percent discount on the services provided. Additionally, significant discounts are available for patients whose income is between 300 percent and 400 percent of the federal poverty level. For more information on WellSpans Financial Assistance program, visit www.WellSpan.org/FinancialAssistance. Part V, Line 16j - Other Means Hospital Facility Publicized the Policy In an effort to make patients, families and others in our communities aware of the newly expanded Financial Assistance Policy, WellSpan broadly publicized its policy via promotional signage and the distribution of easy-to-read informational materials at registration sites throughout our communities. WellSpan provided information on the Financial Assistance Policy on its billing statements and included information in patient discharge materials. In addition, the materials and information are easily accessible via WellSpans website at www.WellSpan.org/FinancialAssistance. The site reflects WellSpans newly enhanced policy, as well as informational and application materials. It was also publicized via WellSpans on-hold phone messaging system and in its direct-to-consumer community newsletter/magazine, which is distributed by mail, email and Web. In addition, WellSpan placed posters and signage at its various sites of care to publicize its Financial Assistance Policy. Printed copies of WellSpan Healths entire financial assistance policy and the plain language summary of the policy, both of which are available in English and Spanish, may be obtained at no cost by visiting or calling one of the WellSpan patient financial services offices.The Financial Assistance Policy, Financial Assistance Application and Financial Assistance Policy Plain Language Summary are all available in Spanish. Part V, Line 22d - Other Billing Determination of Individuals Without Insurance WellSpan Health will provide assistance to all patients whose income falls within 400 percent of the federal poverty guidelines and within the asset limits listed on Attachment A. Those patients qualifying for financial assistance will receive a discount based on the amount generally billed (AGB), which is applicable to the facility at which services were provided. The AGB is calculated by the look-back method, in accordance with IRS Regulation 501(r). This is based on payment received from Medical Assistance and all private payors, in the most recent completed 12 months. Ephrata Cancer Center 460 North Reading Road Ephrata PA 17522 Medical & Radiology Oncology/Pet Scanning WellSpan Reading Road Health Center 446 North Reading Road Ephrata PA 17522 Imaging/Lab/Occupational Medicine WellSpan Garden Spot Health Center 435 South Kinzer Avenue New Holland PA 17557 Cardiology/Lab/Imaging/Quick Care/Therapy/Occupational Medicine Ephrata Health Pavilion 175 Martin Avenue Ephrata PA 17522 Wound care & Hyperbaric/Women's Center Pain Management Center-Ephrata WellSpan Health 4150 Barrett Boulevard Ephrata PA 17522 Pain Management WellSpan Adamstown Health Center 30 West Swartzville Road Reinholds PA 17569 Imaging/Lab WellSpan Crossroads Health Center 4131 Oregon Pike Ephrata PA 17522 Lab/Imaging/Therapy WellSpan Meadowbrook Health Center 337 West Main Street Leola PA 17540 Lab/Imaging/Therapy WellSpan Brossman Health Center 136 Lake Street Ephrata PA 17522 Cardiology/Therapy WellSpan Rothsville Health Center 2320 Rothsville Road Lititz PA 17543 Lab/Pulmonary Rehab Cornerstone Medical Center 6 West Newport Road Lititz PA 17543 Imaging/Lab/Therapy WellSpan Cocalico Health Center 63-71 West Church Street Stevens PA 17578 Therapy/sleep studies/Wellness/Weight Loss Medical Office Building 157-181 North Reading Road Ephrata PA 17522 Cardiology/Health Beginnings Plus Ephrata Medical Lab-Adamstown 2580 North Reading Road Adamstown PA 19501 Lab Sleep Centers-Lancaster Co - WellSpan Health 217 Granite Run Drive Lancaster PA 17603 Sleep Studies WellSpan Georgetown Road Health Services 1135 Georgetown Road Christiana PA 17509 Imaging and Lab WellSpan Granite Run Health Center 268 Granite Run Drive Lancaster PA 17601 Lab/Imaging/Therapy Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) Patients 401% of poverty level and greater do not qualify for financial assistance. However, all uninsured patients qualify for a 20% "no insurance" discount, regardless of income. Part I, Line 6a - Related Organization Community Benefit Report Community Benefit Information is included in the Community Benefit Report for WellSpan Health. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense The number was calculated using the cost to charge ratio factor applied against actual patient bad debt write-offs. These numbers are included after all efforts have been exhausted to determine if the patient meets our charity care write-off policy based on federal poverty levels. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit The estimate of bad debt attributable to charity care policy was calculated by dividing the bad debt amount that was originally coded bad debt but later found to qualify as charity care by the amount coded to the charity care write-off codes. This ratio is applied to the bad debt cost factor expense. Part III, Line 4 - Bad Debt Expense Ephrata Community Hospital provides an allowance for doubtful accounts for estimated losses resulting from the unwillingness or inability of patients to make payments for services. The allowance is determined by analyzing specific accounts and historical data and trends. Patient accounts receivable are charged off against the allowance for doubtful accounts, when management determines that recovery is unlikely, and ECH ceases collection efforts. Losses have been consistent with management's expectations in all material respects. Part III, Line 8 - Explanation Of Shortfall As Community Benefit Ephrata Community Hospital maintains records to identify and monitor the level of charity care and community service it provides. These records include the amount of charges forgone based on established rates for services and supplies furnished under its charity care and community service policies and the estimated cost of these services. Payments from Medicare are generally less than Ephrata Community Hospital's costs of providing the service. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients Guidelines for suggested minimum number of phone attempts and letters to be sent before the account is turned over to an outside collection agency are included in the Patient Administrative Services Policy. Upon final PARO (Payment Assistance Rank Ordering) scoring, if a patient qualifies for presumptive charity, their account would not be forwarded to any third party collections. It shall be the policy of Patient Administrative Services to recommend accounts to Bad Debt on a timely basis. Inpatient/Outpatient accounts will go to bad debt automatically after the account has been in the financial class Pending Bad Debt for 30 days. All accounts must follow the approved limits for refunds and write offs, as established in Policy PF-102, before being transferred. The primary agencies will work the accounts for 6 months or until they feel it is uncollectable and return the account. The accounts are forwarded to secondary agencies from the primary agencies Closed and Return Reports. The financial class is changed to Bad Debt Other after the Closed and Return Reports are received from the Secondary Agency. The agencies must get written approval from the manager in the relatively rare instance of legal action being taken to collect the debt. Part VI, Line 2 - Needs Assessment As noted, WellSpan-Ephrata Community Hospital conducted two Community Health Needs Assessments (CHNA) in the 2015 tax year. The first, a county-wide CHNA, was conducted in partnership with the Lancaster Health Improvement Partnership (LHIP) and its partner organizations using the Conduent-Healthy Communities Initiative model. These entities regularly collect available secondary data on diverse topics including: community demographics; health behaviors and conditions; vital statistics, and; community conditions (i.e., air and water quality), and share it with community members through its organizational websites. The current county-wide CHNA may be found on the WellSpan Health website (www.wellspan.org). In addition, results are annually shared at the Lancaster Health Summit, a partnership between LHIP and the Lancaster County Business Group of Health.After its affiliation with WellSpan Health, a regional health care system, WellSpan-Ephrata Community Hospital (WECH) engaged in the next iteration of the system-wide CHNA process. This process, refined after being conducted in York and Adams counties for 20 years, enabled WECH to obtain data about its primary market, share it with key community, hospital and system leaders, and integrate it into the system-wide and entity-level planning processes. Through the consulting support of the Floyd Institute for Public Policy at Franklin and Marshall College. a representative sample of 729 adults residents in the greater Ephrata (Northern Lancaster County) area were interviewed between February 23 and May 5, 2015 using survey questions derived from the Behavioral Risk Factor Surveillance System (BRFSS), a validated survey tool utilized by the Centers for Disease Control and Prevention (CDC), and organized into four categories: healthcare access, behavioral risk, health conditions, and prevention behaviors and context. Supplemental secondary data from the Robert Wood Johnson Foundation (RWJF) annual County Health Rankings and from the Pennsylvania Department of Health was compiled and integrated into the 2015 CHNA. Data collected and analyzed by the Floyd Institute for Public Policy included breakdowns by age, gender, geographic area, race/ethnicity, and income level, and enabled the development of charts/graphs focused on: quantity of residents affected; health risks and disability-adjusted life years; correlates of obesity and depression (two significant health priorities); health disparities, and; social determinants of health impact. This information is included in the 2015 Community Health Needs Assessment Summary Report available at www.wellspan.org. In 2015, CHNA results and related priorities identified by WellSpan-Ephrata Community Hospital and its community partners were shared with the system-wide Planning Committee at WellSpan Health. This Committee is comprised of community members and leaders that represent each of WellSpans primary entities and service areas, in addition to corporate leadership. Planning Committee members reviewed the CHNA data, adopted WECHs community priorities of adult overweight/obesity, and depression/mental health while also identifying two additional priorities: access related to gaps in care caused by high-deductible insurance plans and the emerging opioid misuse and abuse issue facing the community. These priorities and associated data were subsequently presented to the WellSpan-Ephrata Community Hospital Board for their adoption. CHNA results were made available to the public on the WellSpan Health (www.wellspan.org) website, and may also be obtained upon request. Part VI, Line 5 - Promotion of Community Health Through its various locations in the greater Ephrata community, WellSpan-Ephrata Community Hospital provides a range of wellness and health education programs designed to address key CHNA findings and to promote healthy lifestyles and disease prevention. These programs include: health screenings; diabetes education; nutrition and weight management counseling; tobacco cessation; CPR and first aid instruction; support groups; community health fair participation, and; health education programs. Many of these programs are offered for free or at a minimal cost to the participant.One of many exemplary community partnerships in the northern Lancaster county region includes WellSpan Ephrata Community Hospitals relationship with the Ephrata Public Library. This partnership continues to grow and expand and is a catalyst for change in the community. One example of a unique community-based partnership between WellSpan-Ephrata Community Hospital and Ephrata Public Library includes the implementation of the GO Ephrata! summer physical activity program. The Ephrata Public Library and its Summer Reading Club, along with WellSpan-Ephrata Community Hospital, annually encourage children and their families to be physically active during the summer months by participating in an adaptation of letterboxing, an international hobby where participants use written clues to find items hidden in various places. During fiscal year 2018, 794 children participated in the GO Ephrata! program, and 202 participants (25.4%) submitted their program rubbing sheets and collectively walked a total of 1,360 miles. Additionally, WellSpan-Ephrata Community Hospital has been an active participant with the Ephrata Public Library and other community partners to develop a community hub. This hub serves as a resource center for residents desiring connections with community and social service organizations, many of which are located in Lancaster City, approximately 16 miles away. The Hub will provide a wide array of services including food assistance, health care, career help, literacy services, counseling, housing support and other services to residents of Ephrata, Denver, and nearby communities. This initiative has been supported financially by WellSpan Health Community Partnership Grant funds. The relationship between Ephrata Public Library and Ephrata Community Hospital extends beyond traditional community relationships and consistently expands- in the last year, the library began displaying WellSpans Market Basket of the Month healthy eating materials for community members, and the library received additional Community Partnership funds to implement PlayLab, a sensory friendly learning opportunity for children with autism. Opioid use, as in other communities across the United States, has become a crisis in the Ephrata area. WellSpan Health staff regularly participate in Ephrata Cares, a local initiative developed by the Ephrata Borough Mayor. In addition, staff participate with a regional Opioid Awareness coalition, a multi-sector collaborative seeking to create coordinated messaging, outreach and management of opioid users in southcentral Pennsylvania. This staff commitment compliments a financial commitment to SouthEast Lancaster Health Services to implement Project Lazarus Lancaster, an overdose prevention program that addresses the growing opioid epidemic. Collectively, these programs aim to reduce opioid use and overdoses. Additionally, WellSpan-Ephrata Community Hospital participated in system-wide initiatives to address the shared community health priorities of advanced care planning and adult overweight/obesity while also remaining committed to advancing the skills of current and prospective healthcare professionals. WellSpan-Ephrata Community Hospital supported the education of greater Ephrata area residents about end-of-life planning and care, or Horizon Planning as it is termed locally and continues to offer both the Early Bird Walkers and Healthy Moves programs for older adults. In addition, WellSpan Health celebrated the 6th anniversary of its regional 10 Pound Throwdown initiative, a 10-week community challenge that encourages participants to lose or maintain a healthy weight through healthier eating and increased physical activity. The initiative was created to address the growing issue of adult overweight/obesity and utilizes a core website (www.10poundthrowdown.com) to encourage team participation utilizing an online weight tracker, badges to encourage healthier choices, and diverse health education resources. Nearly 5800 community members across four southcentral Pennsylvania counties -Adams, Lancaster, Lebanon, and York- participated in the 2018 iteration of the 10 Pound Throwdown program.WellSpan- Ephrata Community Hospital primary care practices in northern Lancaster County participated in the Market Bucks program- ten practices engaged over 40 patients- to address food insecurity and increase the consumption of fruits and vegetables. This program reaches those with an elevated Body Mass Index (BMI) who also experience a comorbidity associated with diet. The program provides fruit and vegetable vouchers to be redeemed at local farmers markets and encourages healthy eating. Market Bucks boasts an astounding 86% redemption rate and contributes over $27,000 to the regional economy each year, in addition to demonstrating increased fruit and vegetable consumption for participants. WellSpan-Ephrata Community Hospital served as a resource for students considering a healthcare career as well as those enrolled in healthcare training programs. Job shadowing opportunities and clinical training placements were available within hospital departments. In addition, the Ephrata Community Health Foundation assisted in raising funds to support community health and clinical initiatives of WellSpan-Ephrata Community Hospital, such as the development of a Clinical Simulation Lab to advance the skillset and knowledge of healthcare professionals in the region.Additional examples of how WellSpan-Ephrata Community Hospital fulfilled its community mission in the greater Ephrata (Northern Lancaster County) area may be found in the 2018 WellSpan Community Benefit Report - It's What Neighbors Do - available online at www.wellspan.org. CHNA results were made available to the public on the WellSpan Health (www.wellspan.org) website, and may also be obtained upon request. Part VI, Line 6 - Affilated Health Care System WellSpan Health is an integrated health system serving the communities of southcentral Pennsylvania and northern Maryland. As a community-based, not-for-profit organization, WellSpan is dedicated to improving the health and well-being of the people it serves. WellSpan will assume a leadership role and develop partnerships with other organizations to: improve access to coordinated, high-quality, cost-effective health care services, educate the health care providers of tomorrow, promote healthy lifestyles and lifelong wellness, and make its local communities healthier, more desirable places to live, work, and play. WellSpan Ephrata Community Hospital works with other parts of the system to provide a comprehensive approach to meeting community needs.WellSpan Health includes: WellSpan Gettysburg Hospital, WellSpan York Hospital, WellSpan Surgery and Rehabilitation Hospital, WellSpan Ephrata Community Hospital,WellSpan Good Samaritan Hospital, WellSpan Philhaven, Apple Hill Surgical Center, WellSpan VNA Home Health, WellSpan Medical Group, Northern Lancaster County Medical Group, Physician Specialists of Northern Lancaster County Medical Group, Good Samaritan Physician Services, WellSpan Population Health Services, WellSpan Pharmacy, Gettysburg Hospital Foundation, York Health Foundation, Ephrata Community Health Foundation, Good Samaritan Health Services Foundation, WellSpan Provider Network, GSH Services,and WellSpan Medical Equipment.Ephrata Community Hospital's community benefit report is contained in a report prepared by their parent organization, WellSpan Health. See Attached Federal Supplemental Information: WellSpan Health - 2018 Community Benefit Report Part VI, Line 7 - States Filing of Community Benefit Report PA true Borough of Ephrata 124 South State Street Ephrata PA 17522 236002972 10000 0 Community support Northern Lancaster County Medical Group-169 Martin Ave Ephrata PA 17522 203033058 1540625 0 Charitable Activities WellSpan Medical Group 45 Monument Road York PA 17103 232730785 501(c)(3) 10100000 0 Charitable Activities 3 0 Grantmaker's Description of How Grants are Used All WellSpan entities follow WellSpan policies and procedures regarding grant projects to ensure that the use of grant funds are consistent with WellSpan's commitment to endeavor to improve the health status of the communities that we serve.The WellSpan foundations are supporting organizations and substantially all of the grants and other assistance they make furthers the exempt purposes of their "supported organizations", each of which are exempt affiliated organizations within the WellSpan Health system. Because the supported organizations identify the projects and exempt activities that will be funded by the foundations' grants and other assistance, and because there is a cross-over between the respective governing bodies and management of the foundations and their supported organizations, the foundations are able to effectively monitor that the grants they make are used for their intended purposes. X X X X X false true false false false false false false false false Carrie Willetts President 361568 77391 16823 43950 499732 David Heidelbaugh Pharmacist 162051 22875 10497 22067 217490 David Vega VP-Medical Affairs 329903 54830 12914 23191 43152 463990 Douglas Arbittier MD Director 637727 138210 24391 37473 48439 886240 Jeffrey Keyser DO Director 409532 5873 14382 26391 456178 John M Porter Jr Former President 659345 266000 23260 486595 52640 1487840 266000 Kevin Mosser MD Dir/CEO WSH 985110 409640 38173 703900 56266 2193089 409640 Lloyd G Goldfarb MD Director 320875 6404 16600 39684 383563 Michael F O'Connor CFO-WellSpan 573485 216600 425958 48445 1264488 216600 Robert Ortmyer VP-Operations 188842 45459 21140 13826 41446 310713 Steven Thomas Direct.-Pharm Care 172981 11066 5682 11578 40177 241484 Tina Citro VP-Patient Service 177159 38500 11158 39650 266467 A See Schedule O Client Note 1 Client Note 1 - 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) 893-0600The preparers name is Marc Berger, PTIN P01871563 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Effective 10/1/2013, WellSpan Health, a not for profit corporation, is the sole member. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body The Board of Directors of the Corporation shall be elected as provided herein by the Board of Directors of the Member. The Member shall determine annually the number of Directors, which shall in no event be less than ten persons, nor more than twenty-five persons. Nominations for Directors other than the Designated Directors specified in Specified in Section 5.2 of the Bylaws shall be made by the Board of Directors to the Member's Nominating Committee for Directors. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The Member may, with respect to the Corporation, initiate and implement any of the following actions, and if any of the following actions are otherwise initiated by the Corporation, such action shall not become effective unless approved by the Member:(a)The adoption, amendment, or revocation of the Corporation's Articles of Incorporation or Bylaws (b)The termination, liquidation, reorganization, division, conversion, or dissolution of the Corporation, or the merger, consolidation, or combination of the Corporation with another person; provided however, that in accordance with Section 3.9(b) of the Affiliation Agreement, the Member shall not cause the Corporation to be merged with or into any other entity and it shall maintain the Corporation's status as a separate corporation for a period of at least three years after the effective date of the Affiliation, unless otherwise consented by the Boards of the Member and the Corporation (c) Any change or transfer of the Member's membership interest in the Corporation, or the creation or issuance of any additional membership interests in the Corporation (d) The investment of the Corporation's assets other than in accordance with the Member's current investment policy, any investment other than in the ordinary course of business, which shall consist of federally-insured interest-bearing bank accounts, short-term direct U.S. obligations, short term certificates of deposit of domestic banks, or highly-rated money market funds (e) The incurrence by the Corporation of indebtedness in excess of such amounts as may be reasonably designated by the Member from time to time, except pursuant to a budget approved by the Member. This is not meant to restrict the Corporation's ability to incur indebtedness in the ordinary course of the Corporation's day-to-day business, in amounts less than the amounts designated by the Member, such as routine trade and accounts payable obligations (f) The conveyance, transfer, lease, or sale of any of the Corporation's assets with a fair market value in excess of such aggregate amount as may be designated by the Member from time, except pursuant to a budget approved by the member, or the conveyance, transfer, lease or sale of any of the Corporation's assets to the Member or another System Affiliate; provided, however, that in accordance with Section 3.9(e) of the Affiliation Agreement, the member shall not cause the Corporation to sell all or substantially all of its assets for a period of ten years after the effective date of the Affiliation, unless it has received prior approval by the Board of Directors of the Corporation (g)The making of any capital expenditure or the incurrence of any capital obligations by or on behalf of the Corporation in excess of such annual aggregate amount as may be designated by the Member from time to time, except pursuant to a budget approved by the Member (h)The incurrence of any obligation (whether actual or contingent) by the Corporation to guarantee or be responsible for the debts or obligations of any person in excess of such amounts as may be designated by the Member from time to time, except pursuant to a budget approved by the Member. This is not meant to restrict the Corporation's ability to incur obligations in the ordinary course of the Corporation's day-to-day business, in amount less than the amounts designated by the Member. (i)The approval of the Corporation's operating and capital budgets, or any material changes thereto. (j)The voluntary granting of any lien or encumbrance (including a confession of judgment)with respect of the Corporation's assets, except in the ordinary course of business (k) The surrender of or material change to any permit, approval, or license of the Corporation; provided, however, that in accordance with Section 3.9 of the Affiliation Agreement, the Member shall maintain the Corporation's separate licensure and separate medical staff for a period of at least three after the effective date of the Affiliation (l)The selection of the Corporation's outside financial auditors, general legal counsel, or investment advisors (m)The requirement that the Member make any capital contribution to the Corporation (n)The appointment and reappointment of the individuals to serve on the Corporation's Board of Directors, and their removal as set forth in Section 5.3 of these Bylaws (o)The approval of the Corporation's strategic and operating plans, or any changes thereto. (p) The approval of the Corporation's statements of purpose, vision, or mission, or any changes thereto. (q) The creation by the Corporation of any new lines of business, sites of business, subsidiary corporations, or partnerships or other joint ventures, or any material changes in existing services, or participation in any key strategic relationship outside the System. This is not meant to restrict the Corporation's right to enhance and expand its current lines of business (r) All health care services contracting by the Corporation that could materially impact the System. 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 Chairman of the Board of Gettysburg Hospital shall participate. 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 Decreases Decrease in temporarily restricted net assets = -$122 Schedule K -Tax-Exempt Bonds $412,230,000 of Revenue Bonds for WellSpan Health Obligated Group, Series 2008A, 2008B, 2008C and 2008D were issued 11/12/2008 by General Authority of Southcentral Pennsylvania. The purpose of this bond issue was to refund bonds issued 5/13/2002, 5/17/2005, 6/16/2005, and 6/5/2007. 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 Specialty Services (23-2899911), and Good Samaritan Hospital (23-0794160). In order 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 6/30/18, the allocation of the Debt Capital program was as follows: York Hospital $122,977,217 (58.09%), WellSpan Properties $22,427,073 (10.60%), WellSpan Health $9,834,426 (4.64%), WellSpan Specialty Services $35,562,493 (16.80%), Gettysburg Hospital $19,194,268 (9.07%), and Good Samaritan Hospital $1,704,522 (.81%). These amounts are reported on the respective balance sheets (Part X Line 20)for each of these entities.The 11/12/2008 issue included reissuance of all unspent proceeds from the refunded 2007 bond issue. Total proceeds of issue includes the original 11/12/2008 issue plus investment earnings on transferred proceeds and the short investment of proceeds between date of issue and payoff on 12/1/2008.$213,430,000 of Revenue bonds for Wellspan Health Obligated Group, Series 2014A were issued November 11, 2014 by General Authority of South Central Pennsylvania. 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 Specialty Services (23-2899911), and Ephrata Community Hospital (23-1370484). In order 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 6/30/18, the allocation of the Debt Capital program including issue premium was as follows: York Hospital $131,585,478, Gettysburg Hospital $8,828,846, WellSpan Properties $31,624,065, WellSpan Specialty Services $15,539,494, and Ephrata Community Hospital $32,084,864. These amounts are reported on the respective balance sheets for each of these entities.On May 22, 2015, the Lancaster Municipal Authority issued $36,572,083 of Revenue 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. In order 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 6/30/18, the $32,268,972 of outstanding liability is reported on the Ephrata Community Hospital return balance sheet.$34,877,000 of Revenue bonds for Wellspan Health Obligated Group, Series 2017A were issued March 23, 2018 by General Authority of South Central Pennsylvania. 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 Specialty Services (23-2899911), and Good Samaritan Hospital (23-1794160). In order 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 6/30/18, the allocation of the Debt Capital program was as follows: York Hospital $20,256,562, Gettysburg Hospital $3,163,344, WellSpan Properties $3,696,962, WellSpan Specialty Services $5,859,336, and Good Samaritan Hospital $282,504. These amounts are reported on the respective balance sheets for each of these entities. Signature Block - Paid Preparer Presentation 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) 893-0600The preparers name is Marc Berger, PTIN P018715633 Apple Hill Surgical Center Inc PO Box 2767 York PA 174052767 222842253 Sole GP in limited ptnrshp. operating su PA 501(c)(3) 10 NA false Gettysburg Hospital PO Box 2767 York PA 174052767 231352220 Health care services PA 501(c)(3) 3 NA false Gettysburg Hospital Foundation PO Box 2767 York PA 174052767 232251358 Fundraising for Gettysburg Hospital PA 501(c)(3) 12 Type I NA false Healthy Community Pharmacy Inc PO Box 2767 York PA 174052767 200519121 Reduced rate prescription drugs to unins PA 501(c)(3) 12 Type I NA false VNA Community Services PO Box 2767 York PA 174052767 232338591 Home personal care services for elderly PA 501(c)(3) 10 NA false VNA Home Health Services PO Box 2767 York PA 174052767 231352573 Home health services PA 501(c)(3) 10 NA 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 the service PA 501(c)(3) 12 Type II NA false WellSpan Medical Group PO Box 2767 York PA 174052767 232730785 Medical and surgical care PA 501(c)(3) 10 NA false York Health Foundation PO Box 2767 York PA 174052767 233050192 Charitable contributions for WellSpan en PA 501(c)(3) 12 Type III NA false York Hospital PO Box 2767 York PA 174052767 231352222 Community teaching hospital PA 501(c)(3) 3 NA false WellSpan Specialty Services PO Box 2767 York PA 174052767 232899911 Surgery and Rehabilitation Hospital PA 501(c)(3) 3 NA false WellSpan Properties PO Box 2767 York PA 174052767 222842252 Leases facilities to affiliates PA 501(c)(3) 12 Type II NA 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 true Phys Spec of North Lanc Co Med Gr PO Box 2767 York PA 174052767 452537633 Physician Practices PA 501(c)(3) 12 Type II Northern Lancaster County Medical Group true Good Samaritan Hosptial PO Box 2767 York PA 174052767 230794160 Health Care Services PA 501(c)(3) 3 NA false Philhaven PO Box 2767 York PA 174052767 231549922 Health Care Services PA 501(c)(3) 3 NA false Good Samaritan Health Services PO Box 2767 York PA 174052767 232356151 Fundraising for Good Samartian PA 501(c)(3) 12 Type I NA false Good Samaritan Physician Services PO Box 2767 York PA 174052767 251832359 Medical and Surgical Cases PA 501(c)(3) 10 NA false Apple Hill Surgical Center Partners PO Box 2767 York PA 174052767 232489452 Surgical Center PA NA false false Central PA Alliance Laboratories LLC PO Box 2767 York PA 174052767 232910950 Ref. Lab PA NA 43900 false true 0.10000 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 Ephrata Hospital 824354 971618 false true 0.51000 WellSpan Pharmacy Inc PO Box 2767 York PA 174052767 232374072 Dispense Rx's & prov 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 York Health Plan PO Box 2767 York PA 174052767 232664989 Preferred Provider O PA NA C corp false WellSpan Provider Network PO Box 2767 York PA 174052767 232907828 Coordinate managed care PA NA C corp false Apple Hill Condominium Association PO Box 2767 York PA 174052767 232504543 Condo Mgmt Associati PA NA Homeowners Assoc false North Lanc Co Phys Hosp Alliance PO Box 2767 York PA 174052767 232421885 Coordinate Phys & Hospital PA NA C Corp 0.50000 false GSH Realty Inc PO Box 2767 York PA 174052767 251832359 Rental of non residential real estate PA WSH Care Services C corp false false true true false true false false false false true true false true false false true true false false Ephrata Community Health Foundation c 739951 General Ledger Ephrata Community Health Foundation m 311080 General Ledger Northern Lancaster County Medical Group b 1540625 General Ledger Phys Spec of North Lanc Co Med Gr c 795704 General Ledger