2018-05-02T10:15:42-04:00 2017-06-30 520783935 SMITH ELLIOTT KEARNS & COMPANY LLC 19 BROOKWOOD AVE STE 101 CARLISLE PA 17015 990 2016-07-01 230465970 THE CHAMBERSBURG HOSPITAL CHAM 7172673000 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 KIMBERLY M RZOMP TREASURER/VP & CFO 7172673000 2018-04-23 true GREGORY P HALL CPA P00156653 7172439104 2018-04-23 F292BA449C1BF8BBA7F8F0BF46EB3EDD96736C0F D5D70B8B0EFB409D4D4AE5283BD76078BF919D50 2016 2021-01-29 14:40:06Z KIMBERLY M RZOMP 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 386854101 false X WWW.SUMMITHEALTH.ORG X 1904 PA THE CHAMBERSBURG HOSPITAL IS A REGIONAL NONPROFIT HEALTH CARE ORGANIZATION COMMITTED TO THE IMPROVEMENT OF THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTH-CENTRAL PENNSYLVANIA. 14 8 2232 446 3684365 476752 407913 311879655 340184627 3909999 21499191 5650157 5709276 321916563 367801007 1465051 2392959 0 162259941 170752338 0 0 116832863 128403101 280557855 301548398 41358708 66252609 497598929 513333407 304732353 246915813 192866576 266417594 THE CHAMBERSBURG HOSPITAL IS A REGIONAL NONPROFIT HEALTH CARE ORGANIZATION COMMITTED TO THE IMPROVEMENT OF THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTH-CENTRAL PENNSYLVANIA. false false 223625659 340184627 THE CHAMBERSBURG HOSPITAL PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY REGARDLESS OF ANY PATIENT'S ABILITY TO PAY. HEALTH CARE SERVICES INCLUDE INPATIENT ROUTINE, INPATIENT ANCILLARY AND OUTPATIENT CARE. ALL MANAGEMENT AND GENERAL EXPENSES ARE CONSIDERED PROGRAM RELATED. 2392959 2392959 GRANTS TO VARIOUS NON-PROFIT ORGANIZATIONS IN THE COMMUNITY TO DEVELOP OR EXPAND HEALTH CARE PROGRAMS TO EDUCATE THE COMMUNITY ABOUT HEALTH CARE ISSUES. CHAMBERSBURG HOSPITAL PARTNERS WITH COMMUNITY ORGANIZATIONS TO ENHANCE, PROMOTE, AND OFFER COMMUNITY PROGRAMS FOR THE HEALTH AND WELL BEING OF RESIDENTS IN SOUTH CENTRAL PENNSYLVANIA. 226018618 true true false false false false false false false true true true false true true true true 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 false false false true 163 0 true 2232 true true true false false false false false false false false false X 14 8 false false false false true true true true true false false true true true true true true true true true true PA X X KIMBERLY M RZOMP VPCFO 7172677107 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 CHERYL PLUMMER CHAIR 0.16 0.88 X X 0 0 0 SUZANNE MILLER TRINH VICE-CHAIR 0.16 0.24 X X 0 0 0 DENISE B BARROWS CPA SECRETARY 0.08 0.33 X X 0 0 0 KIMBERLY M RZOMP TREASURER/VP 26.00 15.11 X X 301488 162340 71429 PATRICK O'DONNELL PRESIDENT 24.16 18.45 X X 482631 321754 240408 JOANNE COCHRAN DIRECTOR 0.16 0.00 X 0 0 0 DR JOSHUA DUNKLEBARGER DIRECTOR 0.16 0.17 X 0 0 0 DR W DAVID KENT DIRECTOR 0.16 0.13 X 0 0 0 DR CHRISTINE MOLLOY DIRECTOR 0.32 0.00 X 0 0 0 DR ROBERT PYATT DIRECTOR 0.11 0.56 X 0 0 0 JEFF REEDER DIRECTOR 0.05 0.00 X 0 0 0 L MICHAEL ROSS DIRECTOR 0.38 0.15 X 0 0 0 MICHAEL STARR DIRECTOR 0.11 0.00 X 0 0 0 JOHN VANHORN DIRECTOR 0.14 0.00 X 0 0 0 THOMAS ANDERSON MD VP MED AFFAI 32.00 8.00 X 388272 97068 53937 CATHY PUHL VP HUMAN RES 40.00 0.00 X 228948 0 46126 JOHN MASSIMILLA COO & VP ADM 40.00 0.00 X 337535 0 72786 BARBARA ROSSINI VP COMMUNITY 30.00 10.00 X 199560 66520 43512 SHERRI STAHL SR VP HOSPIT 32.00 8.00 X 338487 84621 65091 MICHELE ZEIGLER VP INFORMATI 28.00 12.00 X 222637 95417 53263 DAVID K GRANT VP OF PATIEN 40.00 0.00 X 206566 0 53905 EVANS T PRIESTON ASST. DIR OF 40.00 0.00 X 172729 0 46347 CAROLYN GEORGE VP CORPORATE 40.00 0.00 X 189182 0 46519 ELYSE FISLER VP OF PATIEN 40.00 0.00 X 195208 0 43771 BRUCE KEHR VP FOR SUPPL 40.00 0.00 X 178878 0 71950 3442121 827720 909044 196 false true false SUMMIT PHYSICIAN SERVICES 601 NORLAND AVENUE SUITE 201 CHAMBERSBURG PA 17201 PROF MED SERVIC 8798989 CUMBERLAND VALLEY EMER ASSOCIATES 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 PROF MED SERVIC 7464856 FASTAFF INC PO BOX 911452 DENVER CO 80291 TEMP EMPL SVCS 2501294 GE HEALTHCARE IITS USA CORP 40 IDX DRIVE SOUTH BURLINGTON VT 05403 SERVICE/LIC FEE 1955007 KEYSTONE RURAL HEALTH CENTER 22 ST PAUL DRIVE SUITE 200 CHAMBERSBURG PA 17201 PROF MED SERVIC 1693576 63 407913 407913 PROGRAM SERVICE REVENUE 621990 340184627 340184627 340184627 4397647 4397647 586559 712550 -125991 -125991 -125991 35425903 16185 18340544 17085359 16185 17101544 17101544 UNRELATED BUSINESS INCOME 621990 1870181 1870181 COURIER AND LAB SERVICES 621500 1571815 1571815 PURCHASE DISCOUNTS/RECYCLING 621990 1000067 1000067 1393204 655908 242369 494927 5835267 367801007 341840602 3684365 21868127 2392959 2392959 3025079 3025079 118588079 90985473 27602606 18736511 14333123 4403388 22052204 16664777 5387427 8350465 6272034 2078431 301806 301806 57972 57972 17670775 7408390 10262385 1104007 433079 670928 6282054 3721134 2560920 4333619 1031867 3301752 248138 37488 210650 152347 42231 110116 6635458 4534008 2101450 15266776 10431789 4834987 2032141 1388562 643579 SUPPLIES 45011535 41423712 3587823 PHYSICIAN CONTRACTUAL PAY 24678806 24678806 MISCELLANEOUS EXPENSE 4331707 181625 4150082 DUES 295960 57561 238399 301548398 226018618 75529780 0 6170 6345 16338404 25190088 27673039 29866843 3260040 3914004 2403820 2796343 4202352 5289629 379978296 245197685 138626669 134780611 44654223 72548027 218516751 206769045 1014793 959319 40902668 31213153 497598929 513333407 33741724 27285967 117477483 115676426 14586237 13935001 138926909 90018419 304732353 246915813 X 183402862 256211926 131468 186255 9332246 10019413 192866576 266417594 497598929 513333407 66252609 -1515043 8813452 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1885357 40038 247551 -41918 -20425 2110603 1875978 16187 -34780 -20110 -18751 1885357 1875978 54280 43996 -14532 -16911 1942811 1564587 125693 218390 -17048 -15644 1875978 1234952 202502 158035 -30902 1564587 0.62860 0.37140 false false 6285655 6285655 11618255 181228240 88119123 104727372 1966737 1432454 534283 178879409 155646108 23233301 134780611 FIXED INCOME SECURITIES 124659106 F REAL ASSETS 64893521 F CASH AND MONEY FUNDS 16282019 F PARTNERSHIPS 856998 F UNCONDITIONAL PROMISES TO GIVE 77000 C OTHER INVESTMENTS 401 F 206769045 RESTRICTED CASH 17490000 THIRD-PARTY TRUSTS 9235579 OTHER RECEIVABLES 4487574 31213153 ACCRUED PENSION OBLIGATION 41703399 INTEREST RATE SWAP AGREEMENTS 26292311 ADVANCES FROM THIRD-PARTY PAYORS 10478424 PAYABLE UNDER THIRD-PARTY AGREEMENTS 6161740 DEFERRED COMPENSATION 3086293 ACCRUED WORKERS' COMP 1227830 ACCRUED LIABILITY INSURANCE 1068422 90018419 X 377271688 -1515043 10985724 9470681 367801007 367801007 303720670 2172272 2172272 301548398 301548398 SCHEDULE D, PAGE 2, PART V, LINE 4 ENDOWMENT FUNDS ARE TO BE USED FOR THE DEVELOPMENT OR EXPANSION OF COMMUNITY HEALTHCARE INITIATIVE AND PROGRAMS. FUNDS ARE ALSO USED TO EDUCATE THE COMMUNITY ABOUT HEALTHCARE ISSUES. SCHEDULE D, PAGE 3, PART X WHEN TAX RETURNS ARE FILED, IT IS HIGHLY CERTAIN SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WUOLD BE ULTIMATELY SUSTAINED. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE WOULD BE REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEETS ALONG WITH ANY ASSOICATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. INTEREST AND PENALTIES ASSOCIATED WITH UNRECOGNIZED TAX BENEFITS WOULD BE CLASSIFIED AS EXPENSES AGAINST OTHER OPERATING REVENUE IN THE STATEMENTS OF OPERATIONS. AT JUNE 30, 2017 AND 2016, THERE WAS NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS. SCHEDULE D, PAGE 4, PART XI, LINE 2D CHANGE IN NET VALUE OF DERIVATIVES 11,223,570 EXPENSES NETTED AGAINST REVENUES -237,846 SCHEDULE D, PAGE 4, PART XII, LINE 2D CHANGES IN PENSION LIABILITY -28,410,597 TRANSFERS TO PARENT, NET 2,046,566 TRANSFERS TO AFFILIATED ORGANIZATIONS, NET 28,774,149 EXPENSES NETTED AGAINST REVENUES -237,846 false CENTRAL AMERICAN AND CARRIBEAN INVESTMENT 22032645 22032645 22032645 false false false false false false SCHEDULE F, PAGE 1, PART I, LINE 3 CENTRAL AMERICAN AND CARRIBEAN 0 22,032,645 true true X true X true X false true true false true true 3374197 3374197 0.01130 16892959 16892959 0.05650 19849 19849 0.00010 20287005 20287005 0.06790 28 15976 215541 15663 199878 0.00070 4 1078 187984 187984 0.00060 2 3677973 3677973 0.01230 1 150263 150263 0.00050 5 2828526 2828526 0.00950 40 17054 7060287 15663 7044624 0.02360 40 17054 27347292 15663 27331629 0.09150 1 4147 4147 1 4147 4147 false 19217254 52314308 84080412 -31766104 X true true 1 1 THE CHAMBERSBURG HOSPITAL 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 X X X THE CHAMBERSBURG HOSPITAL 1 false false true X X X X X X X X X 15 true true true true X WWW.SUMMITHEALTH.ORG X HTTP://WWW.HEALTHYFRANKLINCOUNTY.ORG/C X X true 16 true WWW.SUMMITHEALTH.ORG false false true X 200.000000000000 300.000000000000 X true true X X X X true X WWW.SUMMITHEALTH.ORG X WWW.SUMMITHEALTH.ORG X WWW.SUMMITHEALTH.ORG X X X X X X X true X true X X X X X X true X false false FACILITY 1, THE CHAMBERSBURG HOSPITAL - PART V, LINE 5 THE HEALTHY FRANKLIN COUNTY WEB SITE WAS LUANCHED IN THE FALL OF 2015 TO PROVIDE A RICH PLATFORM FOR DATA AND INFORMATION REGARDING THE HEALTH OF OUR COMMUNITIES. ORIGINALLY POPULATED WITH DATA FROM COUNTY HEALTH RANKINGS, PA DOH, THE CDC DATA WAREHOUSE, AND OTHER STATE AND LCOAL ENTITIES, THIS SITE IS NOW UPDATED ANNUALLY WITH SECONDARY DATA, WHICH IS PARTICULARLY VALUABLE IN YEARS WHEN A CHNA IS NOT CONDUCTED. FACILITY 1, THE CHAMBERSBURG HOSPITAL - PART V, LINE 6A WAYNESBORO HOSPITAL FACILITY 1, THE CHAMBERSBURG HOSPITAL - PART V, LINE 6B HEALTHY FRANKLIN COUNTY FACILITY 1, THE CHAMBERSBURG HOSPITAL - PART V, LINE 7D ON JUNE 9, 2016, SUMMIT HEALTH AND HEALTHY FRANKLIN COUNTY FACILITATED A COMMUNITY HEALTH SUMMIT ON THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT. 121 INDIVIDUALS ATTENDED THE HEALTH SUMMIT, REPRESENTING HEALTHCARE ORGANIZATIONS, COMMUNITY ORGANIZATIONS, EDUCATION INSTITUTIONS, LOCAL GOVERNMENT, AND COMMUNITY REPRESENTATIVES. FACILITY 1, THE CHAMBERSBURG HOSPITAL - PART V, LINE 11 A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) WAS DEVELOPED. FACILITY 1, THE CHAMBERSBURG HOSPITAL - PART V, LINE 16J INFORMATION AND APPLICATION CAN BE FOUND ON THE BACK OF A PATIENT BILLING STATEMENT. FACILITY 1, THE CHAMBERSBURG HOSPITAL - PART V, LINE 19E THE HOSPITAL DOES NOT PURSUE ANY COLLECTION ATTEMPTS OR SELL ANY DEBT BEFORE DETERMINING A PATIENTS ELIGIBILITY FOR THE FAP. FACILITY 1, THE CHAMBERSBURG HOSPITAL - PART V, LINE 20E FINANCIAL COUNSELORS CALL AND SEND LETTERS TO SELF-PAY PATIENTS OR PATIENTS WITH HIGH DEDUCTIBLE PLANS THAT RECEIVE EMERGENCY DEPARTMENT, SURGICAL OR I/P SERVICES. PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE IF A FAMILY HAS LIQUID ASSETS AVAILABLE, THEY ARE EXPECTED TO CONTRIBUTE TO THE COST OF THEIR CARE USING THOSE FUNDS. HOWEVER, THEY ARE NOT REQUIRED TO SPEND DOWN ALL OF THEIR LIQUID ASSETS IN ORDER TO BE ELIGIBLE FOR A DISCOUNT. PATIENTS MAY RETAIN SIX MONTHS OF LIVING EXPENSES FROM THEIR LIQUID ASSETS. SIX MONTHS OF LIVING EXPENSES IS ESTIMATED TO BE ONE HALF OF 300% OF FPG. AT THAT POINT, THEY RECEIVE A DISCOUNT ON THEIR MEDICAL BILL. PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION THE INFORMATION WAS OBTAINED USING THE COST METHODS USED IN PREPARING THE MEDICARE COST REPORTS. PART II - COMMUNITY BUILDING ACTIVITIES CHAMBERSBURG HOSPITAL WORKS TO STRENGTHEN OUR COMMUNITY THROUGH HEALTH EDUCATION EFFORTS FOR CHILDREN AND ADULTS, HEALTH FAIRS PROVIDING HEALTH SCREENINGS, EDUCATING COMMUNITY GROUPS ON SPECIFIC HEALTH TOPICS, FUNDING HEALTH PROGRAMS BY LOCAL NONPROFIT ORGANIZATIONS THROUGH THE SUMMIT ENDOWMENT PROGRAM, PROVIDING CAPACITY-BUILDING WORKSHOPS AND ASSISTANCE THROUGH SUMMIT ENDOWMENT, PARTICIPATING IN MANY LOCAL CIVIC ORGANIZATIONS, SPONSORING EVENTS HELD BY LOCAL CHARITABLE ORGANIZATIONS, AND SUPPORTING WORKFORCE DEVELOPMENT INITIATIVES THROUGH SUMMIT HEALTH'S SCHOOL LIASON PROGRAMS. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE COST TO CHARGE RATIO WAS USED TO CALCULATE THE COST OF BAD DEBT EXPENSE. THIS RATIO IS CALCULATED AS FOLLOWS: (NET PATIENT REVENUE DIVIDED BY THE TOTAL OPERATING REVENUE MULTIPLIED BY THE TOTAL OPERATING EXPENSE) DIVIDED BY THE GROSS PATIENT REVENUE. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS THE HOSPITAL PROVIDES CREDIT IN THE NORMAL COURSE OF ITS BUSINESS TO PATIENTS. PATIENT RECEIVABLES ARE BASED ON THE OUTSTANDING PATIENT BALANCE AFTER ANY CONTRACTUAL REIMBURSEMENTS ARE APPLIED AND ARE GENERALLY DUE 30 DAYS AFTER BILLED. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD- PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT SOME PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 8 - MEDICARE EXPLANATION THE SHORTFALL FOR MEDICARE IS NOT INCLUDED IN THE CHAMBERSBURG HOSPITAL'S COMMUNITY BENEFIT REPORTING. A COST TO CHARGE RATIO WAS USED TO CALCULATE THE MEDICARE ALLOWABLE COST. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION ALL PATIENTS ARE SUBJECT TO THE DEBT COLLECTION POLICY REGARDLESS OF THEIR ABILITY TO PAY. PART VI, LINE 2 - NEEDS ASSESSMENT THE HEALTHY FRANKLIN COUNTY WEB SITE WAS LAUNCHED IN THE FALL OF 2015 TO PROVIDE A RICH PLATFORM FOR DATA AND INFORMATION REGARDING THE HEALTH OF OUR COMMUNITIES. ORIGINALLY POPULATED WITH DATA FROM COUNTY HEALTH RANKING, PA DOH, THE CDC DATA WAREHOUSE, AND OTHER STATE AND LOCAL ENTITIES, THIS SITE IS NOW UPDATED ANNUALLY WITH SECONDARY DATA, WHICH IS PARTICULARLY VALUABLE WHEN A CHNA IS NOT CONDUCTED. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PATIENTS ARE MADE AWARE OF THE CHARITY PROGRAM AND OTHER BILLING ASSISTANCE SERVICES AT REGISTRATION, DURING EMERGENCY ROOM VISITS, AND NOTICES PLACED IN SERVICE AREAS. BILLING STATEMENTS ALSO INFORM PATIENTS OF CHARITY CARE AND OTHER BILLING ASSISTANCE PROGRAMS. AVAILABILITY OF CHARITY PROGRAMS IS ALSO LISTED ON OUR WEBSITE. PART VI, LINE 4 - COMMUNITY INFORMATION THE PRIMARY SERVICE AREA IS FRANKLIN COUNTY, PA AND SURRONDING COMMUNITIES, WHICH INCLUDES 23 MUNICIPALITIES 800 SQUARE MILES, AND A POPULATION OF 170,000 PEOPLE. ABOUT 94% OF FRANKLIN COUNTY'S POPULATION IDENTIFIES AS WHITE. THERE ARE SIGNIFICANT BLACK AND LATINO POPULATIONS IN THE COUNTY, EACH COMPRISING 5% OF THE POPULATION. FOR 93% OF FRANKLIN COUNTY'S POPULATION, ENGLISH IS THE ONLY LANGUAGE SPOKEN AT HOME. FOR THE 7% WHO SPEAK ANOTHER LANGUAGE AT HOME, MOST ALSO REPORT SPEAKING ENGLISH "VERY WELL." PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH THE SUMMIT HEALTH ANNUAL REPORT DOCUMENTS A WIDE RANGE OF COMMUNITY HEALTH PROGRAMS AND INITIATIVES, INFORMATION REGARDING THE GRANTS PROVIDED VIA SUMMIT ENDOWMENT, AND AN OVERVIEW OF HEALTHY FRANKLIN COUNTY. (SEE AT WWW.SUMMITHEALTH.ORG) PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM THE HOSPITAL IS PART OF SUMMIT HEALTH, A REGIONAL NETWORK OF HOSPITALS AND HEALTHCARE PROVIDERS THAT ARE SERVED BY THE ORGANIZATION'S COMMUNITY HEALTH DEPARTMENT. THE DERPARTMENT'S MISSION IS TO IMPROVE THE HEALTH OF THE COMMUNITY THROUGH EDUCATION, DETECTION AND PREVENTION PROGRAMS INCLUDING HEALTH FAIRS, SCREENINGS, AND SEMINARS. THIS MISSION IS COMPLETED ON BEHALF OF CHAMBERSBURG HOSPITAL AND ALL OTEHR SUMMIT AFFILIATES. PART OF THIS MISSION IS COMPLETED THROUGH COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS INCLUDING THE PA DEPARTMENT OF HEALTH. true SOUTH CENTRAL COMMUNITY ACTION PROG 153 N STRATTON STREET GETTYSBURG PA 17235 232020123 3 36037 FOOD DONATIONS WAYNESBORO COMMUNITY & HUMAN SERVIC 123 WALNUT STREET WAYNESBORO PA 17268 251366504 3 75000 NURSE PROGRAM SUMMIT PHYSICIAN SERVICES 112 NORTH 7TH STREET CHAMBERSBURG PA 17201 251716306 3 29846 HOME MONITORING SUMMIT PHYSICIAN SERVICES 112 NORTH 7TH STREET CHAMBERSBURG PA 17201 251716306 3 102960 COMMUNITY OUTREACH NOAH'S HOUSE RECOVERY HOMES 635 S 4TH STREET CHAMBERSBURG PA 17201 812810826 3 8000 RECOVERY AND SUPPORT SHIPPENSBURG COMMUNITY RESOURCE CO 130 S PENN STREET SHIPPENSBURG PA 17257 232046093 3 8000 FOOD DONATIONS 6 SCHEDULE I, PAGE 1, PART I, LINE 2 ALL FUNDING DECISIONS ARE MADE BY THE SUMMIT ENDOWMENT COMMITTEE, A COMMITTEE OF THE SUMMIT HEALTH BOARD. THE ENDOWMENT MANAGER PROCESSES GRANT APPLICATIONS, ASSISTS GRANTEES IN DEVELOPING SOUND PROGRAM EVALUATION METHODOLOGIES, RECEIVES AND SUMMARIZES PERIODIC REPORTS, AND VISITS PROGRAM SITES, REPORTING ALL ACTIVITIES TO THE SUMMIT ENDOWMENT COMMITTEE. AS WELL, ENDWOMENT COMMITTEE MEETING MINUTES ARE SHARED WITH WAYNESBORO HOSPITAL'S, CHAMBERSBURG HOSPITAL'S, AND SUMMIT HEALTH'S BOARD OF DIRECTORS. X X true true X X X X false true false false false false false true false KIMBERLY M RZOMP TREASURER/VP & CFO 230905 124334 52721 28388 17862 9618 33195 17874 13234 7126 347917 187340 PATRICK O'DONNELL PRESIDENT 343433 228955 113526 75684 25672 17115 116718 77812 27527 18351 626876 417917 THOMAS ANDERSON MD VP MED AFFAIRS/CMO 296380 74095 66460 16615 25432 6358 28807 7202 14342 3586 431421 107856 CATHY PUHL VP HUMAN RESOURCES 167141 38763 23044 25557 20569 275074 JOHN MASSIMILLA COO & VP ADMIN. 250244 57218 30073 53580 19206 410321 BARBARA ROSSINI VP COMMUNITY RELATIO 149624 49875 34558 11519 15378 5126 15694 5231 16940 5647 232194 77398 SHERRI STAHL SR VP HOSPITAL SERVI 255304 63826 57094 14273 26089 6522 36709 9177 15364 3841 390560 97639 MICHELE ZEIGLER VP INFORMATION SERVI 165946 71120 37377 16019 19314 8278 31697 13584 5587 2395 259921 111396 DAVID K GRANT VP OF PATIENT SERVIC 201106 5000 460 32909 20996 260471 EVANS T PRIESTON ASST. DIR OF PHARM 163909 5000 3820 27190 19157 219076 CAROLYN GEORGE VP CORPORATE FINANCE 177648 10844 690 25623 20896 235701 ELYSE FISLER VP OF PATIENT SERVIC 183156 11752 300 22835 20936 238979 BRUCE KEHR VP FOR SUPPLY CHAIN 145269 32322 1287 49474 22476 250828 SCHEDULE J, PAGE 1, PART I, LINE 1A THE ORGANIZATION REIMBURSES THE COO FOR DUES ASSOCIATED WITH A SOCIAL CLUB. THE OFFICER RECEIVES AN ALLOWANCE THAT CAN BE CONSIDERED A DISCRETIONARY SPENDING ACCOUNT. THE MONIES ARE IN LIEU OF AN AUTOMOBILE ALLOWANCE, TO PURCHASE ADDITIONAL LIFE INSURANCE, ETC. THESE MONIES ARE INCLUDED IN COMPENSATION AS REPORTED IN THE COMPENSATION OF OFFICERS TABLE. A RESULTS FITNESS CLUB MEMBERSHIP IS AVAILABLE FREE OF CHARGE FOR ANY OFFICER AND ACTIVE BOARD MEMBER. SCHEDULE J, PAGE 1, PART I, LINE 4 KIMBERLY M. RZOMP 0 11,700 0 PATRICK O'DONNELL 0 10,800 0 THOMAS ANDERSON, MD 0 14,400 0 CATHY PUHL 0 10,728 0 JOHN MASSIMILLA 0 15,590 0 BARBARA ROSSINI 0 9,416 0 SHERRI STAHL 0 14,400 0 MICHELE ZEIGLER 0 10,277 0 SCHEDULE J, PAGE 1, PART I, LINE 7 INCENTIVE COMPENSATION IS BASED ON PRE-DETERMINED, MEASURABLE GOALS APPROVED BY THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE. THE MEASURABLE GOALS ARE BASED ON QUALITY, COMMUNITY ACCESS TO CARE, PATIENT SAFETY, AND LEADERSHIP. A FCIDA REVENUE BONDS SERIES 2010 230458500 353273AQ8 2010-07-28 350000 NEW BUILDING AND REFINANCE 1998 BONDS false false false B FCIDA REVENUE BOND SERIES 2010 230458500 353273AZ8 2010-07-28 1255000 NEW BUILDING AND REFINANCE 1998 BONDS false false false C FCIDA REVENUE BONDS SERIES 2010 230458500 353273AR6 2010-07-28 685000 NEW BUILDING AND REFINANCE 1998 BONDS false false false D FCIDA REVENUE BONDS SERIES 2010 230458500 353273BA2 2010-07-28 1000000 NEW BUILDING AND REFINANCE 1998 BONDS false false false A 350000 29796 42236 3049 270886 false true true true B 1255000 106839 151445 10932 971321 false true true true C 685000 58315 82661 5967 530163 false true true true D 1000000 85131 120673 8711 773961 false true true true A false false true true true true false false false B false false true true true true false false false C false false true true true true false false false D false false true true true true false false false A false false false false false false false false false B false false false false false false false false false C false false false false false false false false false D false false false false false false false false false A false B false C false D false 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 PRESENTED TO THE FULL BOARD OF DIRECTORS FOR APPROVAL. FORM 990, PAGE 6, PART VI, LINE 12C MEMBERS ARE ASKED TO ANNUALLY 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 THE COMMITTEE IN SETTING THE COMPENSATION 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 THE COMMITTEE IN SETTING THE COMPENSATION 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. HOSPITAL BYLAWS AND ALL POLICIES AND PROCEDURES ARE FOUND ON THE CHAMBERSBURG HOSPITAL INTRANET. FORM 990, PART XI, LINE 9 PENSION LIABILITY ADJUSTMENT 28,410,597 CHANGE IN VALUE OF DERIVATIVES 11,223,570 TRANSFERS TO AFFILIATES -30,820,715 TOTAL 8,813,452 SUMMIT HEALTH 112 NORTH SEVENTH STREET CHAMBERSBURG PA 17201 251515371 HEALTHCARE PA 501C3 7 SUMMIT HEA false WAYNESBORO HOSPITAL 501 EAST MAIN STREET WAYNESBORO PA 17268 231360854 HEALTHCARE PA 501C3 3 SUMMIT HEA false CHAMBERSBURG HEALTH SERVICES 785 5TH AVENUE SUITE 5 CHAMBERSBURG PA 17201 251515376 HEALTHCARE PA 501C3 12A SUMMIT HEA false SUMMIT PHYSICIAN SERVICES 785 5TH AVENUE SUITE 3 CHAMBERSBURG PA 17201 251716306 HEALTHCARE PA 501C3 3 SUMMIT HEA false SUMMIT SURGERY CENTER LP 785 5TH AVENUE SUITE 3 CHAMBERSBURG PA 17201 251845303 PHYSICIAN PA NA 16953 33872 false false 0.00650 SURGERY CENTER ASSOCIATES LLC 785 5TH AVENUE SUITE 3 CHAMBERSBURG PA 17201 251845304 PHYSICIAN PA NA 339 520 false true 0.01000 false false true false false false false false false true true true true false false true true true true