Form 990 for tax year 2022

Revenue

Part VIII, the statement of revenue.

• 1c · Fundraising events

  $48,400

• 1f · All other contributions, gifts and grants

  $583,911

• 2a · Program service revenue: FUNDRAISING FEES

  total $285,728 · related or exempt $285,728

• 3 · Investment income

  total $224,955 · excluded $224,955

• 7a · Gross sales of assets other than inventory

  securities $2,098,862

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

  securities $2,028,300

• 7c · Gain or loss

  securities $70,562

• 7d · Net gain or loss

  total $70,562 · excluded $70,562

• 8a · Fundraising events: gross income

  $26,900

• 8a · Fundraising events: contributions included on line 1c

  $48,400

• 8b · Fundraising events: direct expenses

  $17,846

• 8c · Net income from fundraising events

  total $9,054 · excluded $9,054

Functional expenses

Part IX, the statement of functional expenses.

• 1 · Grants to domestic organizations and governments

  total $887,321 · program services $887,321

• 11e · Fees: professional fundraising services

  total $34,613 · fundraising $34,613

• 11f · Fees: investment management

  total $42,993 · management and general $42,993

• 11g · Fees: other

  total $224,620 · program services $121,427 · management and general $20,238 · fundraising $82,955

• 12 · Advertising and promotion

  total $3,582 · fundraising $3,582

• 13 · Office expenses

  total $2,719 · program services $2,719

• 14 · Information technology

  total $16,276 · program services $16,276

• 17 · Travel

  total $1,101 · fundraising $1,101

• 19 · Conferences, conventions and meetings

  total $45 · fundraising $45

• 24a · Other expenses: DUES & SUBSCRIPTIONS

  total $1,545 · management and general $1,545

• 24b · Other expenses: REPAIRS & MAINTENANCE

  total $1,226 · management and general $1,226

Balance sheet

Part X, book values.

• 2 · Savings and temporary cash investments

  beginning of year $1,252,200 · end of year $0

• 3 · Pledges and grants receivable

  beginning of year $9 · end of year $0

• 9 · Prepaid expenses and deferred charges

  beginning of year $123,589 · end of year $127,193

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

  $0

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

  $0

• 10c · Land, buildings and equipment, net

  beginning of year $0 · end of year $0

• 11 · Investments: publicly traded securities

  beginning of year $11,041,077 · end of year $12,179,061

• 12 · Investments: other securities

  beginning of year $1,395,664 · end of year $1,587,577

• 15 · Other assets

  beginning of year $7,394,541 · end of year $8,434,420

• 17 · Accounts payable and accrued expenses

  beginning of year $775 · end of year $763

• 19 · Deferred revenue

  beginning of year $46,884 · end of year $48,725

• 27 · Net assets without donor restrictions

  beginning of year $13,085,148 · end of year $14,058,818

• 28 · Net assets with donor restrictions

  beginning of year $8,074,273 · end of year $8,219,945

The filer's explanations (Part III)

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 2022, 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 2022, THERE WERE NO DISTRIBUTIONS FROM THE WELLSPAN HEALTH DEFINED CONTRIBUTION DEFERRED COMPENSATION PLAN. 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).

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 CHAMBERSBURG HEALTH SERVICES

• SURGERY CENTER ASSOCIATES LLC

  PHYSICIAN SERVICES · PA

  Directly controlled by CHAMBERSBURG HEALTH 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

• 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

• 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