WAYNESBORO HOSPITAL: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
WAYNESBORO HOSPITAL (EIN 23-1360854)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-11
IRS object ID
201121319349301547
Schema version
2009v1.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-05-11T13:08:03-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SMITH ELLIOTT KEARNS & COMPANY LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line119 Brookwood Avenue Suite 101AddressLine1
CityCarlisleCity
StatePAState
ZIP Code17201ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN231360854EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Waynesboro HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWAYNNameControl
Phone7177654000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1501 East Main StreetAddressLine1
CityWaynesboroCity
StatePAState
ZIP Code17268ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePatrick W O'DonnellName
TitleCHIEF FINANCIAL OFFICERTitle
Phone7172677106Phone
Date Signed2011-05-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameGregory P Hall CPAName
Phone7172633910Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonPATRICK W O'DONNELLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1501 East Main StreetAddressLine1
CityWaynesboroCity
StatePAState
ZIP Code17268ZIPCode
FieldValueIRS element (for citing)
Gross Receipts65811871GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1922YearFormation
State Legal DomicilePAStateLegalDomicile
Activity Or Mission DescriptionThe Waynesboro 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.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees611TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI762487TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year238484ContributionsGrantsPriorYear
Contributions Grants Current Year188242ContributionsGrantsCurrentYear
Program Service Revenue Prior Year63044849ProgramServiceRevenuePriorYear
Program Service Revenue CY63676380ProgramServiceRevenueCY
Investment Income Prior Year125804InvestmentIncomePriorYear
Investment Income Current Year626406InvestmentIncomeCurrentYear
Other Revenue Prior Year1260202OtherRevenuePriorYear
Other Revenue Current Year1244672OtherRevenueCurrentYear
Total Revenue Prior Year64669339TotalRevenuePriorYear
Total Revenue Current Year65735700TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year36465868SalariesEtcPriorYear
Salaries Etc Current Year35636211SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year20566223OtherExpensePriorYear
Other Expenses Current Year21557712OtherExpensesCurrentYear
Total Expenses Prior Year57032091TotalExpensesPriorYear
Total Expenses Current Year57193923TotalExpensesCurrentYear
Revenues Less Expenses Prior Year7637248RevenuesLessExpensesPriorYear
Revenues Less Expenses CY8541777RevenuesLessExpensesCY
Total Assets BOY65839957TotalAssetsBOY
Total Assets EOY70887279TotalAssetsEOY
Total Liabilities BOY8340701TotalLiabilitiesBOY
Total Liabilities EOY8108774TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY57499256NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY62778505NetAssetsOrFundBalancesEOY
Mission DescriptionTHE WAYNESBORO HOSPITAL IS A REGIONAL NON-PROFIT HEALTH CARE ORGANIZATION COMMITTED TO THE IMPROVEMENT OF THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTH CENTRAL PENNSYLVANIA.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense45350548Expense
Revenue64053592Revenue
DescriptionThe Waynesboro 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.Description
Total Program Service Expense45350548TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109636NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees611NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account1ForeignFinancialAccount
Name Of Foreign CountryNTNameOfForeignCountry
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledPAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1PATRICK W O'DONNELL CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7172673000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1112 NORTH SEVENTH STREETAddressLine1
CityCHAMBERSBURGCity
StatePAState
ZIP Code17201ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Rodger W Savage
CHAIR0.40XX000
Norman B Epstein
President9.00XX176780100175190981
Richard Marks
VICE CHAIR0.20XX000
DENNIS SHOCKEY
SECRETARY0.20XX000
MARIE BECK
TREASURER0.80XX000
Lynn Y MacBride
Director0.10X000
JOHN BLUBAUGH
Director0.10X000
fRANK ERVIN
Director0.10X000
ALLISON KOHLER
Director0.60X000
JEAN LESSARD MD
DIREctor0.30X000
KATHRYN A REIHARD MD
Director0.20X000
Patrick O'Donnell
Vice President Finance6.00X4500740506885759
Kenneth L Shur
Vice President Operations50.00X221861032996
JEFF CARTY
V.P. OF FINANCE - WAYNESBORO HOSP.50.00X164087029618
Thomas Anderson
VP MEDICAL AFFAIRS10.007951031804135550X
SHERRI STAHL
V.P. FOR PATIENT SERVICES11.005074020295640837X
PATRICIA BABAROWICZ
V.P. OF COMMUNITY RELATION5.002503022526352828X
MICHELE ZEIGLER
V.P. OF INFORMATION SERVIC12.005124220496845578X
NORBERT P MATHIAS
EMERGENCY SERVCIES40.00407508027104X
DB FOSTER
EMERGENCY SERVCIES40.00309233026855X
VICKI ELLIS
EMERGENCY SERVCIES40.00235673024939X
MERRIL MCKENZIE
EMERGENCY SERVCIES40.00232335020393X
ELIZABETH COOK
EMERGENCY SERVCIES40.00251048027685X
JILL KELLER
V.P. NURSING & QUALITY45.00128817026135X
MELISSA DUBROW
V.P. ALLIED SERVICES45.00126708018473X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2250054TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2358047TotalReportableCompFrmRltdOrgs
Total Other Compensation541123TotalOtherCompensation
Number Individuals GT100 K17NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CHAMBERSBURG HOSPITAL
112 N SEVENTH STREETCHAMBERSBURGPA17201PHYSICAL THERAPY, X-RAY, AND LABORATORY807845
ROBINWOOD ORTHOPEDIC SPECIALISTS
1110 MEDICAL CAMPUS ROAD SUITE 205HAGERSTOWNMD21742SURGERY ON CALL395000
WAYNESBORO CONTRUCTION
215 WEST FIFTH STREETWAYNESBOROPA17268BUILDING CONSTRUCTION389073
SUMMIT PHYSICIAN SERVICES
785 FIFTH AVENUE SUITE 3CHAMBERSBURGPA17201PHYSICIAN SERVICES260620
QUEST DIAGNOSTICS
12436 COLLECTIONS CENTER DRIVECHICAGOIL60693LAB TESTING SERVICES202054
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K
Government Grants40504GovernmentGrants
All Other Contributions147738AllOtherContributions
Total Contributions188242TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT REVENUEDescription
Business Code621990BusinessCode
Total Revenue Column63676380TotalRevenueColumn
Related Or Exempt Function Income63676380RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue63676380TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column568429TotalRevenueColumn
Exclusion$568,429ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real178819Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real73846Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real104973Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column104973TotalRevenueColumn
Exclusion$104,973ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities60302Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other2325Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities60302Securities
Other-2325Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column57977TotalRevenueColumn
Exclusion$57,977ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
COURIER AND LAB SERVIC621500762487762487
CAFETERIA900099244572244572
VHA INCENTIVE9000996559865598

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column67042TotalRevenueColumn
Related Or Exempt Function Income67042RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1139699TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column65735700TotalRevenueColumn
Related Or Exempt Function Income64053592RelatedOrExemptFunctionIncome
Unrelated Business Revenue762487UnrelatedBusinessRevenue
Exclusion$731,379ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total861647Total
Management And General861647ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total26614599Total
Program Services22619995ProgramServices
Management And General3994604ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1192394Total
Program Services1052749ProgramServices
Management And General139645ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5041357Total
Program Services4221578ProgramServices
Management And General819779ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1926214Total
Program Services1593902ProgramServices
Management And General332312ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total38637Total
Management And General38637ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total25425Total
Management And General25425ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2783613Total
Program Services1942297ProgramServices
Management And General841316ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total47741Total
Program Services32213ProgramServices
Management And General15528ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total202041Total
Program Services136327ProgramServices
Management And General65714ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total746957Total
Program Services504007ProgramServices
Management And General242950ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total55813Total
Program Services37660ProgramServices
Management And General18153ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total23308Total
Program Services15727ProgramServices
Management And General7581ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total29128Total
Program Services15198ProgramServices
Management And General13930ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2894991Total
Program Services1455039ProgramServices
Management And General1439952ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total666218Total
Program Services449529ProgramServices
Management And General216689ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES615451741527432001774
BAD DEBT EXPENSE55288825528882
PHYSICIAN CONTRACTUAL P1101851743471358380
EQUIPMENT RENTAL AND RE1026794692826333968
MISCELLANEOUS EXPENSE712064804723159

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total160590Total
Program Services108358ProgramServices
Management And General52232ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total57193923Total
Program Services45350548ProgramServices
Management And General11843375ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1420BOY
EOY1420EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY8457528BOY
EOY8851861EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6523519BOY
EOY5603530EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY377957BOY
EOY362136EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY808022BOY
EOY672868EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis57480054LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec38211157LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY20243721BOY
EOY19268897EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY26908499BOY
EOY33496561EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2519291BOY
EOY2630006EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY65839957BOY
EOY70887279EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5559263BOY
EOY5169500EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1710000BOY
EOY1165000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1071438BOY
EOY1774274EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8340701BOY
EOY8108774EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY55557370BOY
EOY60613797EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1941886BOY
EOY2164708EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY57499256BOY
EOY62778505EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY65839957BOY
EOY70887279EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance5498442BeginningOfYearBalance
Contributions98262Contributions
Investment Earnings Or Losses499841InvestmentEarningsOrLosses
End Of Year Balance6096545EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance6290104BeginningOfYearBalance
Contributions80824Contributions
Investment Earnings Or Losses-872486InvestmentEarningsOrLosses
End Of Year Balance5498442EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.97000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.03000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis313743InvestmentCostOrOtherBasis
Other Cost Or Other Basis2184775OtherCostOrOtherBasis
Book Value2498518BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis2302539InvestmentCostOrOtherBasis
Other Cost Or Other Basis15194458OtherCostOrOtherBasis
Depreciation8863041Depreciation
Book Value8633956BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis36212312OtherCostOrOtherBasis
Depreciation28851898Depreciation
Book Value7360414BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1272227OtherCostOrOtherBasis
Depreciation496218Depreciation
Book Value776009BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings19268897TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionINVESTMENTSDescription
Book Value33496561BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities33496561TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Advances From Third Party Payors$252,800
Payable Under Third Party Contratual Agreement$1,519,474
Pledges Payable$2,000
FieldValueIRS element (for citing)
Total Of Amounts1774274TotalOfAmounts
Total Revenue65735700TotalRevenue
Total Expenses57193923TotalExpenses
Excess Or Deficit For Year8541777ExcessOrDeficitForYear
Other-$3,262,528OtherAmount
Total Adjustments-3262528TotalAdjustments
Excess Or Deficit Per FS5279249ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt65735700TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal65735700RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99065735700TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt57193924TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal57193924ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99057193924TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part X:Description of Uncertain Tax Positions Under FIN 48:When tax returns are filed, it is highly certain that 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 would 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 sheet along with any associated 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 statement of operations. At June 30, 2010 there was no liability for unrecognized tax benefits.
Part XI, Line 8 - Other Adjustments:Current Year Change In Unrealized Investment Gains: 12499. Current Year Change In Unrealized Investment gains: 948870. INCREASE In Perpetual Trusts Held By Third Parties: 209980. TRANSFER TO AFFILIATE ORGANIZATION - SUMMIT PHYSICIAN SERVICES: -4433877.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage125.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense845049TotalCommunityBenefitExpense
Net Community Benefit Expense845067NetCommunityBenefitExpense
Percent Of Total Expense0.01480PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense6321397TotalCommunityBenefitExpense
Direct Offsetting Revenue3026296DirectOffsettingRevenue
Net Community Benefit Expense3295101NetCommunityBenefitExpense
Percent Of Total Expense0.05760PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense76825TotalCommunityBenefitExpense
Net Community Benefit Expense76825NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense7243271TotalCommunityBenefitExpense
Direct Offsetting Revenue3026296DirectOffsettingRevenue
Net Community Benefit Expense4216993NetCommunityBenefitExpense
Percent Of Total Expense0.07370PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served1528PersonsServed
Direct Offsetting Revenue0DirectOffsettingRevenue

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served30PersonsServed
Direct Offsetting Revenue0DirectOffsettingRevenue

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served93PersonsServed
Direct Offsetting Revenue0DirectOffsettingRevenue

Research Research

FieldValueIRS element (for citing)
Direct Offsetting Revenue0DirectOffsettingRevenue

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served504PersonsServed
Direct Offsetting Revenue0DirectOffsettingRevenue

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served2155PersonsServed

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served2155PersonsServed
Total Community Benefit Expense7243271TotalCommunityBenefitExpense
Direct Offsetting Revenue3026296DirectOffsettingRevenue
Net Community Benefit Expense4216993NetCommunityBenefitExpense
Percent Of Total Expense0.07370PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$5,528,882BadDebtExpenseAmount
Amount Reimbursed By Medicare12531497AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare-18245837CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall30777334MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1WAYNESBORO HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1501 EAST MAIN STREETAddressLine1
CityWAYNESBOROCity
StatePAState
ZIP Code17268ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaPart I, Line 3c: THE ORGANIZATION USES FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE CHARITY CARE.IncomeBasedCriteria
Costing Method UsedPart I, Line 7: NOTE 1. TO THE FINANCIAL STATEMENTS: PATIENT RECEIVABLESTHE HOSPITAL PROVIDES CREDIT IN THE NORMAL COURSE OF ITS BUSINESS TO PATIENTS. PATIENT RECEIVABLES ARE GENERALLY DUE 60 DAYS AFTER BILLED. AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CARRIED FOR PATIENT ACCOUNTS THAT MAY BECOME UNCOLLECTIBLE IN FUTURE PERIODS. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED ON MANAGEMENT'S JUDGMENT OF UNCOLLECTIBLE ACCOUNTS, HISTORICAL TRENDS AND OTHER INFORMATION. PATIENT RECEIVABLES ARE CHARGED AGAINST THE ALLOWANCE WHEN, IN THE JUDGMENT OF MANAGEMENT, IT IS UNLIKELY THEY WILL BE COLLECTED. THE SHORTFALL FOR MEDICARE IS NOT INCLUDED IN OUR COMMUNITY BENEFIT REPORTING. A COST TO CHARGE RATIO WAS USED TO CALCULATE THE MEDICARE ALLOWABLE COST. RCC=((Net Patient Revenue/(Total operating rev+(other opr rev -+ derivative gain/loss))*Total Operating Expense)/Gross PT revALL PATIENTS ARE SUBJECT TO THE DEBT COLLECTION POLICY REGARDLESS OF THEIR ABILITY TO PAY.CostingMethodUsed
Bad Debt FootnotePart III, Line 4: The Hospital provides credit in the normal course of its business to patients. Patient receivables are generally due 60 days after billed. An allowance for doubtful accounts is carried for patient accounts that may become uncollectible in future periods. The allowance for doubtful accounts is based on management's judgment of uncollectible accounts, historical trends and other information. Patient receivables are charged against the allowance when, in the judgment of management, it is unlikely they will be collected.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.BadDebtFootnote
Shortfall As Community BenefitPart III, Line 8: THE INFORMATION WAS OBTAINED USING THE COST METHODS USED IN PREPARING THE MEDICARE COST REPORTS. THE SHORTFALL ABOVE RELATES TO OUR MISSION OF PROVIDING SERVICES TO MEMBERS OF OUR COMMUNITY.ShortfallAsCommunityBenefit
Needs AssessmentPart VI, Line 2: HEALTH NEEDS OF FRANKLIN COUNTY RESIDENTS AND SURROUNDING COMMUNITIES ARE ASSESSED THROUGH NUMEROUS RESEARCH METHODS INCLUDING CONDUCTING COMMUNITY HEALTH NEEDS ASSESSMENT (SURVEY FORMAT) IN SPRING 2009, A REVIEW OF REGIONAL HEALTH DATA AND INTERVIEWS WITH KEY COMMUNITY ORGANIZATIONS INCLUDING SCHOOLS, AREA AGENCY ON AGING, PA DEPARTMENT OF HEALTH, FRANKLIN COUNTY HUMAN SERVICES AND THE HEALTHY COMMUNITIES PARTNERSHIP.NeedsAssessment
Patient Education AssistancePart VI, Line 3: 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.PatientEducationAssistance
Community InformationPart VI, Line 4: WAYNESBORO HOSPITAL PRIMARILY SERVES COMMUNITY MEMBERS FROM FRANKLIN AND FULTON COUNTY, PA, AND NEARBY COMMUNITIES IN WASHINGTON COUNTY, MD. ACCORDING TO U.S. CENSUS DATA, FRANKLIN COUNTY RESIDENTS HAVE A SLIGHTLY LOWER INCOME AND ARE SLIGHTLY OLDER THAN THE STATE AVERAGE. FOR A HEALTH SYSTEM, THIS TYPICALLY RESULTS IN AN INCREASED NEED FOR HEALTHCARE SERVICES.CommunityInformation
Community Building ActivitiesPart VI, Line 5: WAYNESBORO HOSPITAL WORKS TO STRENGTHEN OUR COMMUNITY THROUGH HEALTH EDUCATION EFFORTS FOR CHILDREN AND ADULTS, HEALTH FAIRS PROVIDING DIAGNOSTIC TESTING, EDUCATING COMMUNITY GROUPS ON SPECIFIC HEALTH TOPICS, FUNDING LOCAL COMMUNITY ORGANIZATIONS THROUGH THE SUMMIT ENDOWMENT PROGRAM, PROVIDING RESOURCES FOR THE "HEALTHY COMMUNITIES PARTNERSHIP" PROGRAM, PARTICIPATING IN LOCAL CIVIC ORGANZIATIONS, SPONSORING EVENTS HELD BY LOCAL CHARTIABLE ORGANIZATIONS, AND SUPPORTING WORKFORCE DEVELOPMENT INITIATIVES THROUGH SUMMIT HEALTH'S SCHOOL LIAISON DEPARTMENT.CommunityBuildingActivities
Other InformationPart VI, Line 6: WAYNESBORO HOSPITAL SUPPORTS LOCAL NON-PROFIT ORGANIZATIONS WITH FINANCIAL GRANTS FROM THE SUMMIT ENDOWMENT.OtherInformation
Affiliated Health Care SystemPart VI, Line 7: 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. THIS DEPARTMENT'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 WAYNESBORO HOSPITAL AND ALL OTHER SUMMIT HEATLH AFFILIATES. PART OF THIS MISSION IS COMPLETED THROUGH COLLABORATION WITH OTHER COMMUNITY ORGANIZATIONS INCLUDING THE PA DEPARTMENT OF HEALTH.AffiliatedHealthCareSystem

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantFLU VACCINATIONSTypeOfGrant
Number Of Recipients504NumberOfRecipients
Amount Of Non Cash Assistance8495AmountOfNonCashAssistance
Method Of ValuationCOSTMethodOfValuation

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, 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, Endowment Committee Meeting Minutes are shared with Waynesboro Hospital, Chambersburg Hospital and Summit Health Boards.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Discretionary Spending AccountXDiscretionarySpendingAccount
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Norman B Epstein
10184957714230000170000449312546091040958986323818348190427107908500
Patrick O'Donnell
319442874999420847803643327897110639891466131945358348225100
Kenneth L Shur
1664800338540215270119280210680254857000
JEFF CARTY
137457013968012662095510200670193705000
Thomas Anderson
6246424985612000480005046201854606184242504100168662034648100
SHERRI STAHL
403091612357488299502943117715663226542504100165890723562600
PATRICIA BABAROWICZ
1957817620037963416316561490045874128169662643031327280800
MICHELE ZEIGLER
402811611247838313523123124926612264462504100166035824143000
NORBERT P MATHIAS
394724000127840147000124040434612000
DB FOSTER
30748300017500147000121550336088000
VICKI ELLIS
22675700089160121630127760260612000
MERRIL MCKENZIE
231463000872013969064240252728000
ELIZABETH COOK
24199700090510147000129850278733000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 1aThe 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. Results fitness club membership is available free of charge for any officer and active board member.
Part I, Line 4aNORMAN EPSTEIN - $120,099 PATRICK W. O'DONNELL - NO PAYMENT THOMAS ANDERSON - NO PAYMENT PAT BARBAROWICZ - NO PAYMENT JOHN MCELWEE - NO PAYMENT
Part I, Line 7Incentive compensation is based on pre-determined, measurable goals approved by the Board of Directors' Executive Compensation Committee. The measurable goals are based on quality, community access to care, patient safety and leadership.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section A, line 6SUMMIT HEALTH, A 501(C)(3) ENTITY, IS A MEMBER OF THIS ORGANIZATION.
Form 990, Part VI, Section A, line 7aSUMMIT HEALTH, A 501(C)(3) ENTITY, ELECTS THE GOVERNING BODY OF THIS ORGANIZATION.
Form 990, Part VI, Section A, line 7bSUMMIT HEALTH, A 501(C)(3) ENTITY, HAS CERTAIN RESERVE POWERS OF THIS ORGANIZATION.
Form 990, Part VI, Section B, line 11The organization's 990 is reviewed by the audit commitee and upon approval recommended to the full board of directors for submission to the IRS.
Form 990, Part VI, Section B, line 12cMEMBERS ARE ASKED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THEY MAY HAVE.
Form 990, Part VI, Section B, line 15COMPENSATION IS DISCUSSED WITH AN INDEPENDENT COMPENSATION COMMITTEE. THIS IS PERFORMED IN CONCERT WITH A COMPENSATION CONSULTANT WHO ASSISTS THIS COMMITTEE IN SETTING THE COMPENSATION FOR THESE INDIVIDUALS.
Form 990, Part VI, Section C, line 19Governing documents, conflict of interest policy and financial statements are available upon request. These documents are held in the Finance department of the Waynesboro Hospital. Hospital bylaws and all Policies and Procedures are found on the Waynesboro Hospital intranet.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
SUMMIT HEALTH
112 north seventh streetCHAMBERSBURGPA17201251515371MANAGE AND ADMINISTER THE LOCAL AND REGIONAL NETWORK OF HEALTHCARE PROVIDERSPA501(C)(3)7SUMMIT HEALTH
THE CHAMBERSBURG HOSPITAL
112 NORTH SEVENTH STREETCHAMBERSBURGPA17201230465970SERVE THE HEALTH CARE NEEDS OF FRANKLIN COUNTY PA AND THE SURROUNDING COMMUNPA501(C)(3)11A - TYPE 1SUMMIT HEALTH
CHAMBERSBURG HEALTH SERVICES
260 NORTH SEVENTH STREETCHAMBERSBURGPA17201251515376SERVE THE HEALTH CARE NEEDS OF FRANKLIN COUNTY PA AND THE SURROUNDING COMMUNPA501(C)(3)11A - TYPE 1SUMMIT HEALTH
SUMMIT PHYSICIAN SERVICES
601 NORLAND AVENUECHAMBERSBURGPA17201251716306PROVIDES APPROPRIATE PHYSICIAN MANPOWER FOR VARIOUS FAMILY PRACTICES SERVINGPA501(C)(3)3SUMMIT HEALTH

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1CUMBERLAND VALLEY SPECIALTY SERVICESBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1120 NORTH SEVENTH STREETAddressLine1
CityCHAMBERSBURGCity
StatePAState
ZIP Code17201ZIPCode
FieldValueIRS element (for citing)
EIN201408985EIN
Primary ActivityMEDICAL SERVICES PROVIDED TO FRANKLIN COUNTY PENNSYLVANIAPrimaryActivity
Legal Domicile StatePALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SUMMIT HEALTHBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
THE CHAMBERSBURG HOSPITAL
L1651199
SUMMIT PHYSICIAN SERVICES
I67000
summit PHYSICIAN SERVICES
O147667
chambersburg health services
I12600
summit health
B147738

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