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Nonprofiteer
← THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA

Form 990 for tax year 2024

Filed by THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA.

Totals

Total revenue
$336,729,854
Total expenses
$316,585,354
Contributions and grants received
$1,121,294
Grants paid
$558,185
Program services expenses (Part IX)
$231,526,415
Management and general expenses
$85,058,939
Fundraising expenses
$0
Program service expenses (Part III)
$231,526,415

Program services were 73.1% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • ROXANNA GAPSTUR PHD RN

    PRESIDENT & CEO - WELLSPAN HEALTH

    Total calculated
    $3,176,598
    From this org
    $0
    From related orgs
    $3,124,465
    Other
    $52,133
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,739,595 related
    Bonus
    $0 + $1,112,453 related
    Other
    $0 + $272,417 related
    Deferred
    $0 + $11,203 related
    Nontaxable benefits
    $0 + $40,930 related
    Filer's total
    $0 + $3,176,598 related

  • LAURA BUCZKOWSKI

    EXECUTIVE VP & CFO - WELLSPAN HEALTH

    Total calculated
    $1,408,553
    From this org
    $0
    From related orgs
    $1,355,384
    Other
    $53,169
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $949,313 related
    Bonus
    $0 + $402,918 related
    Other
    $0 + $3,153 related
    Deferred
    $0 + $16,601 related
    Nontaxable benefits
    $0 + $36,568 related
    Filer's total
    $0 + $1,408,553 related

  • MONIQUA ACOSTA

    CHAIR

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • CARRIE WILSON

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • ROBERT FUNK

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • CHRISTOPHER GRANT PSY D

    DIRECTOR

    Total calculated
    $99,529
    From this org
    $0
    From related orgs
    $74,543
    Other
    $24,986
    Hours/week
    1 + 40 related

  • ROBERT HOFFMAN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related

  • KIMBERLY KREIDER UMBLE

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • STEPHEN LINDSEY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • MICHAEL SEIM

    SR VP & CHIEF QUALITY OFFICER

    Total calculated
    $1,042,098
    From this org
    $0
    From related orgs
    $987,854
    Other
    $54,244
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $711,414 related
    Bonus
    $0 + $254,210 related
    Other
    $0 + $22,230 related
    Deferred
    $0 + $18,200 related
    Nontaxable benefits
    $0 + $36,044 related
    Filer's total
    $0 + $1,042,098 related

  • EDWARD TADAJWESKI MD

    DIRECTOR

    Total calculated
    $817,177
    From this org
    $0
    From related orgs
    $763,266
    Other
    $53,911
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $700,388 related
    Bonus
    $0 + $18,519 related
    Other
    $0 + $44,359 related
    Deferred
    $0 + $18,168 related
    Nontaxable benefits
    $0 + $35,743 related
    Filer's total
    $0 + $817,177 related

  • ROGER ZIMMERMAN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 2 related

  • JAMES STUCCIO

    DIRECTOR/SVP - EAST REGION

    Total calculated
    $872,517
    From this org
    $0
    From related orgs
    $823,930
    Other
    $48,587
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $604,681 related
    Bonus
    $0 + $216,096 related
    Other
    $0 + $3,153 related
    Deferred
    $0 + $12,723 related
    Nontaxable benefits
    $0 + $35,864 related
    Filer's total
    $0 + $872,517 related

  • AMY NELSON

    SECRETARY/SR VP & GENERAL COUNSEL

    Total calculated
    $947,745
    From this org
    $0
    From related orgs
    $873,620
    Other
    $74,125
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $641,147 related
    Bonus
    $0 + $229,320 related
    Other
    $0 + $3,153 related
    Deferred
    $0 + $40,330 related
    Nontaxable benefits
    $0 + $33,795 related
    Filer's total
    $0 + $947,745 related

  • PATRICIA DONLEY

    VP & PRES.-GSH (UNTIL 3/25)/CNO

    Total calculated
    $452,593
    From this org
    $415,679
    From related orgs
    $0
    Other
    $36,914
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $331,094
    Bonus
    $71,500
    Other
    $13,085
    Deferred
    $20,700
    Nontaxable benefits
    $16,214
    Filer's total
    $452,593

  • TINA CITRO

    VP&PRES-GSH(EFF. 3/25)/VP&PRES-ECH

    Total calculated
    $463,237
    From this org
    $0
    From related orgs
    $409,858
    Other
    $53,379
    Hours/week
    10 + 30 related

    Schedule J breakdown matched by us

    Base
    $0 + $335,201 related
    Bonus
    $0 + $72,603 related
    Other
    $0 + $2,054 related
    Deferred
    $0 + $20,700 related
    Nontaxable benefits
    $0 + $32,679 related
    Filer's total
    $0 + $463,237 related

  • VALERIE ADAMS

    VP - PATIENT CARE SERVICES AND CNO

    Total calculated
    $300,065
    From this org
    $274,530
    From related orgs
    $0
    Other
    $25,535
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $231,815
    Bonus
    $41,999
    Other
    $716
    Deferred
    $10,420
    Nontaxable benefits
    $15,115
    Filer's total
    $300,065

  • JILIAN WHITE MD

    VP - MEDICAL AFFAIRS

    Total calculated
    $521,252
    From this org
    $470,425
    From related orgs
    $0
    Other
    $50,827
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $398,354
    Bonus
    $71,355
    Other
    $716
    Deferred
    $20,489
    Nontaxable benefits
    $30,338
    Filer's total
    $521,252

  • VIRGINIA SANGER

    SR DIR ANCILLIARY & SUPPORT SERVICES

    Total calculated
    $262,875
    From this org
    $228,100
    From related orgs
    $0
    Other
    $34,775
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $209,939
    Bonus
    $14,958
    Other
    $3,203
    Deferred
    $20,192
    Nontaxable benefits
    $14,583
    Filer's total
    $262,875

  • DEBRA NEY

    MANAGER - PHARMACY OPERATIONS

    Total calculated
    $240,370
    From this org
    $212,243
    From related orgs
    $0
    Other
    $28,127
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $194,953
    Bonus
    $12,863
    Other
    $4,427
    Deferred
    $12,691
    Nontaxable benefits
    $15,436
    Filer's total
    $240,370

  • BONNIE PIETRUCH

    DIRECTOR - CLINICAL SERVICES

    Total calculated
    $213,377
    From this org
    $199,053
    From related orgs
    $0
    Other
    $14,324
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $178,010
    Bonus
    $12,673
    Other
    $8,370
    Deferred
    $11,603
    Nontaxable benefits
    $2,721
    Filer's total
    $213,377

  • LORRAINE CUNNINGHAM

    PHARMACIST

    Total calculated
    $222,837
    From this org
    $186,033
    From related orgs
    $0
    Other
    $36,804
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $185,344
    Bonus
    $0
    Other
    $689
    Deferred
    $11,169
    Nontaxable benefits
    $25,635
    Filer's total
    $222,837

  • STEPHANIE THOMPSON

    DIRECTOR - CLINICAL SERVICES

    Total calculated
    $236,613
    From this org
    $195,713
    From related orgs
    $0
    Other
    $40,900
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $179,905
    Bonus
    $12,863
    Other
    $2,945
    Deferred
    $11,583
    Nontaxable benefits
    $29,317
    Filer's total
    $236,613

  • FARAAZ YOUSUF

    FORMER EXECUTIVE VP & COO

    Total calculated
    $1,093,939
    From this org
    $0
    From related orgs
    $1,056,585
    Other
    $37,354
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $120,553 related
    Bonus
    $0
    Other
    $0 + $936,032 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $37,354 related
    Filer's total
    $0 + $1,093,939 related

  • ROBERT SHAVER

    FORMER VP - MEDICAL AFFAIRS

    Total calculated
    $239,121
    From this org
    $0
    From related orgs
    $226,141
    Other
    $12,980
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $36 related
    Bonus
    $0
    Other
    $0 + $226,105 related
    Deferred
    $0
    Nontaxable benefits
    $0 + $12,980 related
    Filer's total
    $0 + $239,121 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 — 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 2024, THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT: ROBERT SHAVER, FORMER VP MEDICAL AFFAIRS - $40,063 FARAAZ YOUSUF, FORMER EXECUTIVE VP & COO - $928,846
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 2024, 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 2024, THE FOLLOWING INDIVIDUALS RECEIVED DISTRIBUTIONS FROM THE DEFERRED COMPENSATION PLAN: ROXANNA GAPSTUR - $269,264 MICHAEL SEIM - $20,176 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

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.

Provenance

Return type
form_990
Tax year
2024
Filed
8 May 2026
IRS schema version
2024v5.5
Source object
202621289349301857

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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