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Nonprofiteer
← THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA

Form 990 for tax year 2023

Filed by THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA.

Totals

Total revenue
$324,702,509
Total expenses
$321,195,177
Contributions and grants received
$2,096,438
Grants paid
$408,180
Program service revenue
$322,572,310
Investment income
$436,935
Other revenue
-$403,174
Total assets, end of year
$116,365,909
Total liabilities, end of year
$113,874,702
Net assets or fund balances, end of year
$2,491,207
Program services expenses (Part IX)
$245,830,769
Management and general expenses
$75,364,408
Fundraising expenses
$0
Program service expenses (Part III)
$245,830,769

Program services were 76.5% 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

    $1,459,942

  • 1e · Government grants (contributions)

    $384,450

  • 1f · All other contributions, gifts and grants

    $252,046

  • 2a · Program service revenue: PATIENT SERVICES

    total $322,563,742 · related or exempt $320,979,434 · unrelated business $1,584,308

  • 2b · Program service revenue: FUNDRAISING FEES

    total $8,568 · related or exempt $8,568

  • 3 · Investment income

    total $12,851 · excluded $12,851

  • 6a · Gross rents

    real property $1,024,399

  • 6b · Less rental expenses

    real property $1,468,994

  • 6c · Rental income or loss

    real property -$444,595

  • 6d · Net rental income or loss

    total -$444,595 · excluded -$444,595

  • 7a · Gross sales of assets other than inventory

    securities $3,333,217 · other assets $4,917

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

    securities $2,914,050 · other assets $0

  • 7c · Gain or loss

    securities $419,167 · other assets $4,917

  • 7d · Net gain or loss

    total $424,084 · excluded $424,084

  • 11a · Other revenue: INTERCOMPANY LABS

    total $38,721 · excluded $38,721

  • 11b · Other revenue: OTHER INCOME

    total $2,088 · excluded $2,088

  • 11c · Other revenue: MEDICAL EDUCATION

    total $612 · excluded $612

  • 11e · Other revenue, total

    $41,421

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $377,504 · program services $377,504

  • 2 · Grants to domestic individuals

    total $30,676 · program services $30,676

  • 5 · Compensation of officers, directors and key employees

    total $1,153,152 · management and general $1,153,152

  • 7 · Other salaries and wages

    total $66,750,577 · program services $66,523,427 · management and general $227,150

  • 8 · Pension plan contributions

    total $3,538,881 · program services $3,393,373 · management and general $145,508

  • 9 · Other employee benefits

    total $13,387,734 · program services $10,785,715 · management and general $2,602,019

  • 10 · Payroll taxes

    total $4,891,320 · program services $4,538,395 · management and general $352,925

  • 11a · Fees: management

    total $69,825,477 · management and general $69,825,477

  • 11c · Fees: accounting

    total $56,344 · management and general $56,344

  • 11d · Fees: lobbying

    total $14,593 · management and general $14,593

  • 11f · Fees: investment management

    total $64,373 · management and general $64,373

  • 11g · Fees: other

    total $68,430,402 · program services $68,334,186 · management and general $96,216

  • 12 · Advertising and promotion

    total $66,465 · program services $66,167 · management and general $298

  • 13 · Office expenses

    total $490,097 · program services $488,624 · management and general $1,473

  • 14 · Information technology

    total $517,066 · program services $455,157 · management and general $61,909

  • 16 · Occupancy

    total $3,532,239 · program services $2,922,033 · management and general $610,206

  • 17 · Travel

    total $107,651 · program services $103,284 · management and general $4,367

  • 19 · Conferences, conventions and meetings

    total $61,026 · program services $48,539 · management and general $12,487

  • 20 · Interest

    total $4,050,145 · program services $4,050,145

  • 22 · Depreciation, depletion and amortization

    total $5,971,613 · program services $5,970,302 · management and general $1,311

  • 23 · Insurance

    total $2,397,169 · program services $2,397,169

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $49,266,622 · program services $49,266,622

  • 24b · Other expenses: BAD DEBT EXPENSE

    total $17,337,542 · program services $17,337,542

  • 24c · Other expenses: TAXES & LICENSES

    total $5,639,760 · program services $5,639,760

  • 24d · Other expenses: EQUIPMENT RENTAL

    total $2,201,697 · program services $2,201,697

  • 24e · All other expenses

    total $1,035,052 · program services $900,452 · management and general $134,600

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $2,867 · end of year $2,867

  • 2 · Savings and temporary cash investments

    beginning of year $10,678 · end of year $0

  • 3 · Pledges and grants receivable

    beginning of year $540,000 · end of year $1,800,000

  • 4 · Accounts receivable

    beginning of year $28,761,215 · end of year $30,482,763

  • 8 · Inventories for sale or use

    beginning of year $4,851,235 · end of year $785,459

  • 9 · Prepaid expenses and deferred charges

    beginning of year $333,367 · end of year $290,598

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

    $179,471,628

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

    $119,328,986

  • 10c · Land, buildings and equipment, net

    beginning of year $60,571,546 · end of year $60,142,642

  • 11 · Investments: publicly traded securities

    beginning of year $13,781,822 · end of year $15,273,764

  • 12 · Investments: other securities

    beginning of year $1,796,502 · end of year $2,124,405

  • 13 · Investments: program-related

    beginning of year $4,273,010 · end of year $4,825,037

  • 14 · Intangible assets

    beginning of year $1,247,731 · end of year $114,955

  • 15 · Other assets

    beginning of year $223,042 · end of year $523,419

  • 17 · Accounts payable and accrued expenses

    beginning of year $20,451,114 · end of year $14,060,961

  • 19 · Deferred revenue

    beginning of year $2,247,119 · end of year $96,939

  • 20 · Tax-exempt bond liabilities

    beginning of year $2,066,817 · end of year $2,011,549

  • 23 · Secured mortgages and notes payable

    end of year $14,152

  • 25 · Other liabilities

    beginning of year $117,898,546 · end of year $97,691,101

  • 27 · Net assets without donor restrictions

    beginning of year -$33,889,394 · end of year -$2,304,096

  • 28 · Net assets with donor restrictions

    beginning of year $7,618,813 · end of year $4,795,303

Mission and programs · 2023

Mission

THE GOOD SAMARITAN HOSPITAL IS A TAX-EXEMPT ORGANIZATION DEDICATED TO PROVIDING HIGH-QUALITY, COMPASSIONATE HEALTHCARE THAT IMPROVES THE OVERALL HEALTH OF THE COMMUNITY.

Activities or mission (Part I)

PROVIDE HIGH-QUALITY, COMPASSIONATE HEALTHCARE TO IMPROVE OVERALL HEALTH OF THE COMMUNITY.

  • THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA HAS BEEN PROVIDING POWERFUL MEDICINE AND COMFORTING CARE TO THE RESIDENTS OF LEBANON COUNTY FOR MORE THAN 125 YEARS.AS THE COMMUNITY HOSPITAL OF THE LEBANON VALLEY REGION, THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA OFFERS A WIDE VARIETY OF ACUTE CARE AND OUTPATIENT SERVICES THAT HELP IMPROVE THE HEALTH OF OUR COMMUNITY. THE SECHLER FAMILY CANCER CENTER IS LEBANON COUNTY'S FIRST AND ONLY INTEGRATED CANCER CENTER PROVIDING MEDICAL AND RADIATION ONCOLOGY IN A STATE OF THE ART FACILITY WITH A WARM AND HEALING ENVIRONMENT.THE STATE-OF-THE-ART CARDIAC & VASCULAR CENTER HAS WON NATIONAL AWARDS FROM THE AMERICAN HEART ASSOCIATION. THE CENTER HAS ALSO BEEN DESIGNATED AS A BLUE DISTINCTION CENTER FOR CARDIAC CARE BY HIGHMARK BLUE SHIELD. DIAGNOSTIC AND INTERVENTIONAL CARDIOLOGY IS OFFERED, AS WELL AS ELECTROPHYSIOLOGY AND OPEN HEART SURGERY. THE NEW BEGINNING BIRTH SUITES OFFER A ONE-STOP EXPERIENCE FOR LABOR, DELIVERY AND RECOVERY IN A FAMILY-FRIENDLY SETTING.THE GOOD SAMARITAN CENTER FOR WOUND CARE & HYPERBARIC MEDICINE HAS CREATED NEW HOPE FOR THOSE WITH NON-HEALING WOUNDS. THE HOSPITAL OFFERS A NETWORK OF LABORATORY AND IMAGING CENTERS THROUGHOUT LEBANON COUNTY.SEE WELLSPAN HEALTH - 2024 COMMUNITY BENEFIT REPORT LOCATED AT HTTPS://WWW.WELLSPAN.ORG/ABOUT-WELLSPAN/IMPROVING-HEALTHY-COMMUNITIES/COMMUNITY-BENEFIT.

    Expenses $245,830,769 · Grants $408,180 · Revenue $320,988,002

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
  • Reyna Britton

    VICE CHAIR (UNTIL DEC. '23)

    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
  • Moniqua Acosta

    CHAIR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Carrie Wilson

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Robert Funk

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Vincent Garcia

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Christopher Grant Psy D

    DIRECTOR

    Total calculated
    $142,568
    From this org
    $0
    From related orgs
    $95,457
    Other
    $47,111
    Hours/week
    1 + 40 related
  • Robert Hoffman

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 4 related
  • Kimberly Kreider Umble

    DIRECTOR

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

    DIRECTOR

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

    DIRECTOR

    Total calculated
    $798,030
    From this org
    $0
    From related orgs
    $723,426
    Other
    $74,604
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $535,767 related
    Bonus
    $0 + $187,659 related
    Other
    $0
    Deferred
    $0 + $19,800 related
    Nontaxable benefits
    $0 + $54,804 related
    Filer's total
    $0 + $798,030 related
  • Roger Zimmerman

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Amanda Davis-Buie

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • James Stuccio

    DIRECTOR/SVP - EAST REGION

    Total calculated
    $647,008
    From this org
    $0
    From related orgs
    $592,743
    Other
    $54,265
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $474,022 related
    Bonus
    $0 + $118,721 related
    Other
    $0
    Deferred
    $0 + $5,077 related
    Nontaxable benefits
    $0 + $49,188 related
    Filer's total
    $0 + $647,008 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
  • Patricia Donley

    VP & PRESIDENT - GOOD SAMARITAN

    Total calculated
    $491,093
    From this org
    $442,250
    From related orgs
    $0
    Other
    $48,843
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $309,764
    Bonus
    $79,560
    Other
    $52,926
    Deferred
    $17,414
    Nontaxable benefits
    $31,429
    Filer's total
    $491,093
  • Kelly Smith

    VP - PATIENT CARE SERVICES

    Total calculated
    $398,040
    From this org
    $337,157
    From related orgs
    $0
    Other
    $60,883
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $248,707
    Bonus
    $54,902
    Other
    $33,548
    Deferred
    $14,753
    Nontaxable benefits
    $46,130
    Filer's total
    $398,040
  • Jilian White MD

    VP MED AFF (AS OF AUG '23)/CMO-WSRH

    Total calculated
    $485,105
    From this org
    $159,664
    From related orgs
    $245,987
    Other
    $79,454
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $145,148 + $245,987 related
    Bonus
    $14,516
    Other
    $0
    Deferred
    $5,289 + $14,142 related
    Nontaxable benefits
    $21,703 + $38,320 related
    Filer's total
    $186,656 + $298,449 related
  • Virginia Sanger

    SR DIR. ANCILLARY & SUPPORT SERVICES

    Total calculated
    $273,247
    From this org
    $220,136
    From related orgs
    $0
    Other
    $53,111
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $202,942
    Bonus
    $17,144
    Other
    $50
    Deferred
    $25,190
    Nontaxable benefits
    $27,921
    Filer's total
    $273,247
  • Debra Ney

    MANAGER - PHARMACY OPERATIONS

    Total calculated
    $247,485
    From this org
    $205,811
    From related orgs
    $0
    Other
    $41,674
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $188,020
    Bonus
    $14,753
    Other
    $3,038
    Deferred
    $12,357
    Nontaxable benefits
    $29,317
    Filer's total
    $247,485
  • Bonnie Pietruch

    DIRECTOR - CLINICAL SERVICES

    Total calculated
    $217,794
    From this org
    $191,376
    From related orgs
    $0
    Other
    $26,418
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $173,892
    Bonus
    $14,526
    Other
    $2,958
    Deferred
    $10,711
    Nontaxable benefits
    $15,707
    Filer's total
    $217,794
  • Donna Palmer

    REGISTERED NURSE

    Total calculated
    $240,111
    From this org
    $188,506
    From related orgs
    $0
    Other
    $51,605
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $168,983
    Bonus
    $19,523
    Other
    $0
    Deferred
    $11,529
    Nontaxable benefits
    $40,076
    Filer's total
    $240,111
  • Stephanie Thompson

    DIRECTOR - CLINICAL SERVICES

    Total calculated
    $242,980
    From this org
    $188,400
    From related orgs
    $0
    Other
    $54,580
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $173,607
    Bonus
    $14,743
    Other
    $50
    Deferred
    $10,576
    Nontaxable benefits
    $44,004
    Filer's total
    $242,980
  • Faraaz Yousuf

    FORMER EXECUTIVE VP & COO

    Total calculated
    $1,061,597
    From this org
    $0
    From related orgs
    $1,061,597
    Other
    $0
    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
    Filer's total
    $0 + $1,061,597 related
  • Robert Shaver

    FORMER VP - MEDICAL AFFAIRS

    Total calculated
    $482,732
    From this org
    $119,719
    From related orgs
    $301,064
    Other
    $61,949
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $119,719
    Bonus
    $0 + $74,039 related
    Other
    $0 + $227,025 related
    Deferred
    $6,854
    Nontaxable benefits
    $20,138 + $34,957 related
    Filer's total
    $146,711 + $336,021 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

  • 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: ROBERT SHAVER, FORMER VP MEDICAL AFFAIRS - $227,025
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

  • GENERAL SUPPORT

  • CITY OF LEBANON

    $100,000

    COMMUNITY SUPPORT

  • LEBANON SCHOOL DISTRICT

    $84,000

    GENERAL SUPPORT

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 · 50% owned · share of income $49,183 · share of assets $802,353

    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 · 6.27% owned · share of income -$406,699 · share of assets $3,347,485

    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
202511289349302321

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