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Nonprofiteer
← CHAMBERSBURG HOSPITAL

Form 990 for tax year 2023

Filed by CHAMBERSBURG HOSPITAL.

Totals

Total revenue
$520,023,472
Total expenses
$475,288,066
Contributions and grants received
$2,490,116
Grants paid
$2,233,896
Program service revenue
$496,172,457
Investment income
$19,870,427
Other revenue
$1,490,472
Total assets, end of year
$561,450,038
Total liabilities, end of year
$143,713,532
Net assets or fund balances, end of year
$417,736,506
Program services expenses (Part IX)
$388,841,723
Management and general expenses
$86,446,343
Fundraising expenses
$0
Program service expenses (Part III)
$388,841,723

Program services were 81.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $2,218,848

  • 1e · Government grants (contributions)

    $246,803

  • 1f · All other contributions, gifts and grants

    $24,465

  • 2a · Program service revenue: PATIENT SERVICES

    total $496,172,385 · related or exempt $495,518,812 · unrelated business $653,573

  • 2b · Program service revenue: MEDICAL EDUCATION

    total $72 · related or exempt $72

  • 3 · Investment income

    total $4,033,079 · excluded $4,033,079

  • 6a · Gross rents

    real property $575,934

  • 6b · Less rental expenses

    real property $655,079

  • 6c · Rental income or loss

    real property -$79,145

  • 6d · Net rental income or loss

    total -$79,145 · excluded -$79,145

  • 7a · Gross sales of assets other than inventory

    securities $125,793,924 · other assets $18,180

  • 7b · Less cost or other basis and sales expenses

    securities $109,974,756 · other assets $0

  • 7c · Gain or loss

    securities $15,819,168 · other assets $18,180

  • 7d · Net gain or loss

    total $15,837,348 · excluded $15,837,348

  • 11a · Other revenue: INTERCOMPANY LABS

    total $409,889 · excluded $409,889

  • 11b · Other revenue: SALARY REIMBURSEMENTS

    total $351,490 · excluded $351,490

  • 11c · Other revenue: CAFETERIA SALES

    total $338,358 · excluded $338,358

  • 11d · All other revenue

    total $469,880 · excluded $469,880

  • 11e · Other revenue, total

    $1,569,617

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $2,233,896 · program services $2,233,896

  • 5 · Compensation of officers, directors and key employees

    total $2,343,304 · management and general $2,343,304

  • 7 · Other salaries and wages

    total $127,882,340 · program services $119,133,851 · management and general $8,748,489

  • 8 · Pension plan contributions

    total $1,714,084 · program services $1,688,583 · management and general $25,501

  • 9 · Other employee benefits

    total $31,880,673 · program services $24,148,538 · management and general $7,732,135

  • 10 · Payroll taxes

    total $9,638,119 · program services $8,923,242 · management and general $714,877

  • 11a · Fees: management

    total $64,706,166 · management and general $64,706,166

  • 11b · Fees: legal

    total $255,500 · management and general $255,500

  • 11c · Fees: accounting

    total $69,857 · management and general $69,857

  • 11d · Fees: lobbying

    total $18,571 · management and general $18,571

  • 11f · Fees: investment management

    total $704,213 · management and general $704,213

  • 11g · Fees: other

    total $105,263,686 · program services $104,824,118 · management and general $439,568

  • 12 · Advertising and promotion

    total $84,046 · program services $82,027 · management and general $2,019

  • 13 · Office expenses

    total $799,586 · program services $758,711 · management and general $40,875

  • 14 · Information technology

    total $449,498 · program services $437,010 · management and general $12,488

  • 16 · Occupancy

    total $5,547,399 · program services $5,163,904 · management and general $383,495

  • 17 · Travel

    total $106,191 · program services $73,000 · management and general $33,191

  • 19 · Conferences, conventions and meetings

    total $70,538 · program services $68,156 · management and general $2,382

  • 20 · Interest

    total $5,017,015 · program services $5,017,015

  • 22 · Depreciation, depletion and amortization

    total $11,152,967 · program services $11,152,967

  • 23 · Insurance

    total $3,682,126 · program services $3,682,126

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $62,465,773 · program services $62,465,773

  • 24b · Other expenses: BAD DEBT EXPENSE

    total $26,349,997 · program services $26,349,997

  • 24c · Other expenses: TAXES & LICENSES

    total $8,379,368 · program services $8,379,368

  • 24d · Other expenses: REPAIRS & MAINTENANCE

    total $4,162,373 · program services $4,038,674 · management and general $123,699

  • 24e · All other expenses

    total $310,780 · program services $220,767 · management and general $90,013

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $5,650 · end of year $5,500

  • 2 · Savings and temporary cash investments

    beginning of year $10,897,931 · end of year $18,476,831

  • 3 · Pledges and grants receivable

    end of year $124,623

  • 4 · Accounts receivable

    beginning of year $52,658,320 · end of year $54,572,740

  • 7 · Other notes and loans receivable

    beginning of year $6,462,538 · end of year $6,404,935

  • 8 · Inventories for sale or use

    beginning of year $3,901,551 · end of year $3,541,503

  • 9 · Prepaid expenses and deferred charges

    beginning of year $913,039 · end of year $349,324

  • 10a · Land, buildings and equipment: cost or other basis

    $291,980,311

  • 10b · Land, buildings and equipment: accumulated depreciation

    $191,052,338

  • 10c · Land, buildings and equipment, net

    beginning of year $105,311,608 · end of year $100,927,973

  • 11 · Investments: publicly traded securities

    beginning of year $277,854,380 · end of year $253,964,671

  • 12 · Investments: other securities

    beginning of year $36,219,154 · end of year $35,323,563

  • 13 · Investments: program-related

    beginning of year $14,331,408 · end of year $84,197,991

  • 14 · Intangible assets

    beginning of year $68,983 · end of year $52,212

  • 15 · Other assets

    beginning of year $0 · end of year $3,508,172

  • 17 · Accounts payable and accrued expenses

    beginning of year $39,090,261 · end of year $35,804,020

  • 19 · Deferred revenue

    beginning of year $2,652,453 · end of year $2,512,086

  • 20 · Tax-exempt bond liabilities

    beginning of year $115,493,641 · end of year $102,710,109

  • 23 · Secured mortgages and notes payable

    beginning of year $546,694 · end of year $1,062,830

  • 25 · Other liabilities

    beginning of year $39,166,576 · end of year $1,624,487

  • 27 · Net assets without donor restrictions

    beginning of year $309,698,365 · end of year $343,108,459

  • 28 · Net assets with donor restrictions

    beginning of year $1,976,572 · end of year $74,628,047

Mission and programs · 2023

Mission

THE CHAMBERSBURG HOSPITAL IS A REGIONAL NON-PROFIT HEALTH CARE ORGANIZATION COMMITTED TO THE IMPROVEMENT OF THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTHCENTRAL PENNSYLVANIA.

Activities or mission (Part I)

TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE IN SOUTHCENTRAL PENNSYLVANIA.

  • ESTABLISHED IN 1895, WELLSPAN CHAMBERSBURG HOSPITAL CONTINUES TO GROW TO BETTER SERVE FRANKLIN COUNTY AND SURROUNDING COMMUNITIES.OUR CORE VALUES OF INTEGRITY, COMPASSION, EXCELLENCE AND SERVICE ARE AT THE FOUNDATION OF EVERY DECISION WE MAKE WHILE YOU ARE IN OUR CARE. AN EXPERT TEAM OF DEDICATED PHYSICIANS, SURGEONS AND HEALTHCARE PROFESSIONALS AWAIT TO PROVIDE YOU THE TOP-QUALITY CARE YOU NEED AND DESERVE.AT THE HOSPITAL, WE OFFER A FULL RANGE OF MEDICAL SERVICES, AS WELL AS AWARD-WINNING HEART AND STROKE CARE. OUR FACILITY OFFERS PRIVATE PATIENT ROOMS, CARDIOVASCULAR SUITES, FAMILY BIRTHING UNIT, STATE-OF-THE-ART EQUIPMENT, SURGICAL ROOMS, INPATIENT REHAB UNIT AND WOUND CARE CENTER WITH HYPERBARIC OXYGEN THERAPY.NOW, YOU DON'T HAVE TO LOOK ANY FURTHER FOR GREAT CARE AND CAN REST ASSURE WE'RE HERE WHEN YOU NEED US.SEE WELLSPAN HEALTH - 2024 COMMUNITY BENEFIT REPORT LOCATED AT HTTPS://WWW.WELLSPAN.ORG/ABOUT-WELLSPAN/IMPROVING-HEALTHY-COMMUNITIES/COMMUNITY-BENEFIT.

    Expenses $388,841,723 · Grants $2,233,896 · Revenue $495,518,885

As filed on the 2023 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Roxanna Gapstur PhD RN

    PRESIDENT & CEO - WELLSPAN HEALTH

    Total calculated
    $3,123,984
    From this org
    $0
    From related orgs
    $3,023,715
    Other
    $100,269
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,654,407 related
    Bonus
    $0 + $1,111,800 related
    Other
    $0 + $257,508 related
    Deferred
    $0 + $14,469 related
    Nontaxable benefits
    $0 + $85,800 related
    Filer's total
    $0 + $3,123,984 related
  • Julianne Craig

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • John Massimilla

    VP & PRESIDENT - CHAMBERSBURG

    Total calculated
    $573,520
    From this org
    $493,358
    From related orgs
    $0
    Other
    $80,162
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $346,569
    Bonus
    $89,440
    Other
    $57,349
    Deferred
    $28,939
    Nontaxable benefits
    $51,223
    Filer's total
    $573,520
  • Horace Martin MD

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Julie Ramsey

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Stephen Holoviak

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 6 related
  • Monica Meta Campos

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Cheryl Plummer

    CHAIR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Denis Onieal

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • David Doud Do

    DIRECTOR

    Total calculated
    $505,241
    From this org
    $0
    From related orgs
    $438,335
    Other
    $66,906
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $356,221 related
    Bonus
    $0 + $82,114 related
    Other
    $0
    Deferred
    $0 + $19,800 related
    Nontaxable benefits
    $0 + $47,106 related
    Filer's total
    $0 + $505,241 related
  • Edie Jardine

    DIRECTOR (UNTIL DEC. '23)

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Edward Mackle MD

    DIRECTOR

    Total calculated
    $700,756
    From this org
    $0
    From related orgs
    $606,789
    Other
    $93,967
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $532,814 related
    Bonus
    $0 + $65,372 related
    Other
    $0 + $8,603 related
    Deferred
    $0 + $39,854 related
    Nontaxable benefits
    $0 + $54,113 related
    Filer's total
    $0 + $700,756 related
  • Michael Seim

    SR VP & CHIEF QUALITY OFFICER

    Total calculated
    $1,098,774
    From this org
    $0
    From related orgs
    $1,022,554
    Other
    $76,220
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $685,514 related
    Bonus
    $0 + $293,372 related
    Other
    $0 + $43,668 related
    Deferred
    $0 + $16,754 related
    Nontaxable benefits
    $0 + $59,466 related
    Filer's total
    $0 + $1,098,774 related
  • Sherri Stahl

    SVP, DIRECTOR (UNTIL DEC. '23)

    Total calculated
    $430,676
    From this org
    $0
    From related orgs
    $409,297
    Other
    $21,379
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $0 + $37,044 related
    Bonus
    $0
    Other
    $0 + $372,253 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $21,379 related
    Filer's total
    $0 + $430,676 related
  • Patricia Green-Rodgers

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Laura Buczkowski

    EXECUTIVE VP & CFO - WELLSPAN HEALTH

    Total calculated
    $1,336,194
    From this org
    $0
    From related orgs
    $1,256,714
    Other
    $79,480
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $796,549 related
    Bonus
    $0 + $382,500 related
    Other
    $0 + $77,665 related
    Deferred
    $0 + $18,101 related
    Nontaxable benefits
    $0 + $61,379 related
    Filer's total
    $0 + $1,336,194 related
  • David Lovett

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Amy Nelson

    SECRETARY/SR VP & GENERAL COUNSEL

    Total calculated
    $942,746
    From this org
    $0
    From related orgs
    $846,535
    Other
    $96,211
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $548,624 related
    Bonus
    $0 + $222,525 related
    Other
    $0 + $75,386 related
    Deferred
    $0 + $42,139 related
    Nontaxable benefits
    $0 + $54,072 related
    Filer's total
    $0 + $942,746 related
  • William Happel

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Ed Schuurman Pa

    DIRECTOR

    Total calculated
    $280,943
    From this org
    $0
    From related orgs
    $222,380
    Other
    $58,563
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $162,919 related
    Bonus
    $0 + $57,084 related
    Other
    $0 + $2,377 related
    Deferred
    $0 + $11,445 related
    Nontaxable benefits
    $0 + $47,118 related
    Filer's total
    $0 + $280,943 related
  • Niki Hinckle

    SVP - WEST REGION

    Total calculated
    $808,144
    From this org
    $685,250
    From related orgs
    $48,726
    Other
    $74,168
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $444,399 + $48,726 related
    Bonus
    $154,313
    Other
    $86,538
    Deferred
    $16,754 + $2,285 related
    Nontaxable benefits
    $47,762 + $7,367 related
    Filer's total
    $749,766 + $58,378 related
  • Elyse Fisler

    CHIEF NURSING OFFICER

    Total calculated
    $362,057
    From this org
    $287,677
    From related orgs
    $0
    Other
    $74,380
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $214,603
    Bonus
    $56,627
    Other
    $16,447
    Deferred
    $24,659
    Nontaxable benefits
    $49,721
    Filer's total
    $362,057
  • Gautam Wadhwa

    VP MED. AFFAIRS, CHIEF MED. OFFICER

    Total calculated
    $619,392
    From this org
    $554,756
    From related orgs
    $16,710
    Other
    $47,926
    Hours/week
    20 + 20 related

    Schedule J breakdown matched by us

    Base
    $385,129 + $15,556 related
    Bonus
    $116,133 + $1,154 related
    Other
    $53,494
    Deferred
    $18,431 + $762 related
    Nontaxable benefits
    $27,422 + $1,311 related
    Filer's total
    $600,609 + $18,783 related
  • Ginger Everhart

    SR. DIRECTOR CLINICAL OPERATIONS

    Total calculated
    $266,188
    From this org
    $202,626
    From related orgs
    $0
    Other
    $63,562
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $183,638
    Bonus
    $15,776
    Other
    $3,212
    Deferred
    $18,117
    Nontaxable benefits
    $45,445
    Filer's total
    $266,188
  • Mohammed-Awal Bukari

    PHARMACIST

    Total calculated
    $260,479
    From this org
    $228,965
    From related orgs
    $0
    Other
    $31,514
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $228,965
    Bonus
    $0
    Other
    $0
    Deferred
    $2,711
    Nontaxable benefits
    $28,803
    Filer's total
    $260,479
  • Nikola Kounev

    PHARMACIST

    Total calculated
    $245,257
    From this org
    $214,887
    From related orgs
    $0
    Other
    $30,370
    Hours/week
    5 + 35 related

    Schedule J breakdown matched by us

    Base
    $214,887
    Bonus
    $0
    Other
    $0
    Deferred
    $3,286
    Nontaxable benefits
    $27,084
    Filer's total
    $245,257
  • Nicholas Signorella

    PHARMACIST

    Total calculated
    $242,471
    From this org
    $214,549
    From related orgs
    $0
    Other
    $27,922
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $214,549
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $27,922
    Filer's total
    $242,471
  • Ximena Dickmann

    PHARMACIST

    Total calculated
    $251,318
    From this org
    $204,518
    From related orgs
    $0
    Other
    $46,800
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $204,518
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $46,800
    Filer's total
    $251,318
  • Tanya Rudolph

    ASSISTANT MANAGER - PHARMACY

    Total calculated
    $266,470
    From this org
    $207,610
    From related orgs
    $0
    Other
    $58,860
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $175,632
    Bonus
    $14,673
    Other
    $17,305
    Deferred
    $11,974
    Nontaxable benefits
    $46,886
    Filer's total
    $266,470
  • Faraaz Yousuf

    FORMER EXECUTIVE VP & COO

    Total calculated
    $1,121,629
    From this org
    $0
    From related orgs
    $1,061,597
    Other
    $60,032
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $1,045,354 related
    Bonus
    $0
    Other
    $0 + $16,243 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $60,032 related
    Filer's total
    $0 + $1,121,629 related
  • Jane Hyde

    FORMER SR VP - WESTERN REGION

    Total calculated
    $702,230
    From this org
    $158,138
    From related orgs
    $492,948
    Other
    $51,144
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $76,857 + $35,733 related
    Bonus
    $20,000 + $138,249 related
    Other
    $61,281 + $318,966 related
    Deferred
    $4,569
    Nontaxable benefits
    $15,554 + $31,021 related
    Filer's total
    $178,261 + $523,969 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 1a · Discretionary spending account
  • 1a · Health or social club dues or initiation fees
  • 1b · Written policy on the line-1a expenses
  • 2 · Substantiation required before reimbursing expenses
  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 4A:
DURING CALENDAR YEAR 2023, THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT: JANE HYDE, FORMER SR VICE PRESIDENT - $318,966 SHERRI STAHL, SR VICE PRESIDENT - $372,253
PART I, LINE 4B:
THE WELLSPAN HEALTH SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS ADOPTED AND MADE EFFECTIVE ON DECEMBER 19TH, 2008. THE OBJECTIVE OF THE EXECUTIVE BENEFITS PROGRAM IS TO PROVIDE AN EXECUTIVE BENEFITS PROGRAM THAT IS COMPETITIVE WITH NATIONAL NORMS IN THE HEALTHCARE INDUSTRY FOR SIMILARLY SIZED ORGANIZATIONS ENABLING WELLSPAN HEALTH TO RECRUIT AND RETAIN TOP EXECUTIVE TALENT. TIER I EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. A DESCRIPTION OF THE TARGETED BENEFIT OF THE PLAN IS AS FOLLOWS: 1) PROVIDE AN EMPLOYER SPONSORED RETIREMENT BENEFIT THAT REPLACES 60% OF AVERAGE PRE-RETIREMENT (5 YEARS) BASE COMPENSATION THROUGH A COMBINED APPROACH UTILIZING WELLSPAN'S RETIREMENT PLAN, 50% OF SOCIAL SECURITY, SPLIT-DOLLAR LIFE INSURANCE BENEFIT, AND SUPPLEMENTAL EXECUTIVE RETIREMENT BENEFIT. 2) PROVIDES A MINIMUM BENEFIT AFTER 10 YEARS OF SERVICE. 3) PROVIDES THE FULL TARGETED BENEFIT AFTER 25 YEARS OF SERVICE. 4) BENEFIT IS VESTED WHEN ELIGIBLE EXECUTIVE REACHES AGE 65. THE BENEFIT IS ALSO VESTED UPON DEATH, DISABILITY, JOB ELIMINATION AND "TERMINATION FOR GOOD REASON". 5) CREDITED SERVICE GRANTED ON A 1:2 BASIS FOR PREVIOUS SERVICE IN AN ELIGIBLE TIER II POSITION. 6) TARGETED BENEFIT IS TO BE CALCULATED USING A 15 YEAR CERTAIN PAYOUT. 7) PAYOUT WILL BE IN A LUMP SUM. 8) PAYOUT WILL BE TAXABLE WHEN VESTED. DURING THE CALENDAR YEAR 2023, THERE WERE NO DISTRIBUTIONS FROM THE SERP. THE WELLSPAN HEALTH DEFINED CONTRIBUTION DEFERRED COMPENSATION PLAN WAS ADOPTED AND MADE EFFECTIVE AS OF JULY 1, 2017. THIS PLAN WILL REPLACE THE SERP. AS PART OF THE TRANSITION, EACH PARTICIPANT IN THE SERP WAS GIVEN A ONE-TIME CHOICE TO BE GRANDFATHERED IN THE SERP OR TRANSFER TO THE NEW WELLSPAN HEALTH DEFINED CONTRIBUTION DEFERRED COMPENSATION PLAN. THE OBJECTIVE OF THE WELLSPAN HEALTH DEFINED CONTRIBUTION DEFERRED COMPENSATION PLAN IS TO ATTRACT AND RETAIN EXECUTIVE AND UPPER-LEVEL MANAGEMENT EMPLOYEES OF OUTSTANDING ABILITY. TIERS I, II, III AND A SELECT GROUP OF TIER IV EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE PLAN. A DESCRIPTION OF THE TARGETED BENEFIT OF THE PLAN IS AS FOLLOWS: 1)PROVIDE AN UNFUNDED DEFERRED COMPENSATION BENEFIT TO A SELECT GROUP OF MANAGEMENT AND HIGHLY COMPENSATED EMPLOYEES. 2)PLAN ACCOUNT CONTRIBUTIONS ARE CREDITED EACH YEAR TO A SUBACCOUNT, BASED UPON VARIOUS TIER LEVELS; TIER I, 22%, TIER II, 17%, TIER III, 12%, AND TIER IV, 8%. 3)PARTICIPANT ACCOUNTS ARE CREDITED INTEREST EACH YEAR BY APPLICATION OF THE 30-YEAR U.S. TREASURY RATE ON JUNE 30 OF THE PLAN YEAR THEN ENDING, PLUS ONE PERCENT (1%). 4)PARTICIPANT VESTING OCCURS ON THE EARLIER OF: A)JUNE 30TH OF THE FOURTH PLAN YEAR: 25% PER YEAR B)PARTICIPANT REACHES AGE 65. C)UPON DEATH, DISABILITY, JOB ELIMINATION AND "TERMINATION FOR GOOD REASON". 5)NON-ELECTIVE EMPLOYER CONTRIBUTIONS ARE ALSO PERMITTED. 6)PLAN DISTRIBUTIONS TO BE ADMINISTERED PER THE PLAN DOCUMENT. DURING THE CALENDAR YEAR 2023, THE FOLLOWING INDIVIDUALS RECEIVED DISTRIBUTIONS FROM THE DEFERRED COMPENSATION PLAN: ROXANNA GAPSTUR - $122,031 ADDITIONALLY, ANY VESTED PORTION OF CONTRIBUTIONS MADE TO THE PLAN WHICH ARE NO LONGER SUBJECT TO THE RISK OF FORFEITURE, ARE REFLECTED IN SCHEDULE J, PART II, COLUMN B(III).

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

The 10 largest by cash amount. The API serves every itemized grant.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • APPLE HILL SURGICAL CENTER PARTNERS

    SURGICAL CENTER · PA

    Directly controlled by WELLSPAN HEALTH

  • CHERRY TREE CANCER CENTER LLP

    RADIATION · PA

    Directly controlled by WELLSPAN HEALTH CARE SERVICES

  • CUMBERLAND VALLEY MOBILE SERVICES

    MOBILE HEALTH SERVICES · PA

    Directly controlled by CHAMBERSBURG HEALTH SERVICES

  • LITTLESTOWN HEALTH CARE PARTNERSHIP

    LEASE FACILITY · PA

    Directly controlled by WELLSPAN HEALTH CARE SERVICES

  • SUMMIT SURGERY CENTER LP

    PHYSICIAN SERVICES · PA

    Directly controlled by WELLSPAN HEALTH CARE SERVICES

  • SURGERY CENTER ASSOCIATES LLC

    PHYSICIAN SERVICES · PA

    Directly controlled by WELLSPAN HEALTH CARE SERVICES

  • THE REHAB CENTER

    PHYSICAL THERAPY REHABILITATION · PA

    Directly controlled by EPHRATA HOSPITAL

  • WELLSPAN SCA HOLDINGS LLC

    INVESTMENTS · MD

    Directly controlled by WELLSPAN HEALTH CARE SERVICES

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • APPLE HILL CONDOMINIUM ASSOCIATION

    C · CONDOMINIUM ASSOCIATION · PA

    Directly controlled by WELLSPAN HEALTH CARE SERVICES

  • CUMBERLAND VALLEY HEALTH NETWORK INC

    C · HEALTH NETWORK · PA

    Directly controlled by WELLSPAN SUMMIT HEALTH

  • EPHRATA HEALTH PAVILION CONDOMINIUM ASSOCIATION

    C · CONDOMINIUM ASSOCIATION · PA

    Directly controlled by EPHRATA HOSPITAL

  • EPHRATA MEDICAL OFFICE CONDOMINIUM ASSOCIATION

    C · CONDOMINIUM ASSOCIATION · PA

    Directly controlled by EPHRATA HOSPITAL

  • GOOD SAMARITAN PHYSICIAN HOSPITAL ORGANIZATION OF LEBANON PA

    C · HEALTH CARE SERVICES · PA

    Directly controlled by THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA

  • GSH REALTY INC

    C · NON-RESIDENTIAL REAL ESTATE · PA

    Directly controlled by WELLSPAN HEALTH CARE SERVICES

  • NORTHERN LANCASTER COUNTY PHYSICIAN HOSPITAL ALLIANCE

    C · COORD PHYS & HOSPITAL · PA

    Directly controlled by EPHRATA HOSPITAL

  • QUEST BEHAVIORAL HEALTH

    C · HEALTH CARE NETWORK SERVICE · PA

    Directly controlled by WELLSPAN HEALTH

  • SPOTLIGHT VENTURES INC

    C · INNOVATIVE INITATIVES · PA

    Directly controlled by WELLSPAN HEALTH

  • WELLSPAN HEARING CENTER INC

    C · HEARING AID PRACTICE · PA

    Directly controlled by WELLSPAN HEALTH CARE SERVICES

  • WELLSPAN PHARMACY INC

    C · DISPENSES RX & PROVIDES IV THERAPY · PA

    Directly controlled by WELLSPAN HEALTH CARE SERVICES

  • WELLSPAN PROVIDER NETWORK

    C · COORDINATE MANAGED CARE RISK CONTRACTS · PA

    Directly controlled by WELLSPAN HEALTH

  • WELLSPAN RECIPROCAL RISK RETENTION GROUP

    C · RISK RETENTION GROUP · PA

    Directly controlled by WELLSPAN HEALTH

  • YORK HEALTH PLAN

    C · PREFERRED PROVIDER ORGANIZATION · PA

    Directly controlled by WELLSPAN HEALTH

Provenance

Return type
form_990
Tax year
2023
Filed
8 May 2025
IRS schema version
2023v6.0
Source object
202531289349301893

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