Form 990 for tax year 2022
Filed by THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA.
Totals
- Total revenue
- $286,142,172
- Total expenses
- $293,910,564
- Contributions and grants received
- $4,342,774
- Grants paid
- $150,693
- Program service revenue
- $281,247,948
- Investment income
- $254,676
- Other revenue
- $296,774
- Total assets, end of year
- $116,393,015
- Total liabilities, end of year
- $142,663,596
- Net assets or fund balances, end of year
- -$26,270,581
- Program services expenses (Part IX)
- $220,375,676
- Management and general expenses
- $73,534,888
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $220,375,676
Program services were 75.0% 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
$143,806
-
1e · Government grants (contributions)
$3,969,111
-
1f · All other contributions, gifts and grants
$229,857
-
2a · Program service revenue: PATIENT SERVICES
total $281,239,380 · related or exempt $279,625,271 · unrelated business $1,614,109
-
2b · Program service revenue: FUNDRAISING FEES
total $8,568 · related or exempt $8,568
-
3 · Investment income
total $18,568 · excluded $18,568
-
6a · Gross rents
real property $821,901
-
6b · Less rental expenses
real property $1,312,644
-
6c · Rental income or loss
real property -$490,743
-
6d · Net rental income or loss
total -$490,743 · excluded -$490,743
-
7a · Gross sales of assets other than inventory
securities $8,390,177 · other assets $4,037
-
7b · Less cost or other basis and sales expenses
securities $8,108,106 · other assets $50,000
-
7c · Gain or loss
securities $282,071 · other assets -$45,963
-
7d · Net gain or loss
total $236,108 · excluded $236,108
-
11a · Other revenue: CAFETERIA SALES
total $643,400 · excluded $643,400
-
11b · Other revenue: HOUSEKEEPING SERVICES
total $55,831 · excluded $55,831
-
11c · Other revenue: HEALTH PROMOTION
total $46,545 · excluded $46,545
-
11d · All other revenue
total $41,741 · excluded $41,741
-
11e · Other revenue, total
$787,517
Functional expenses
Part IX, the statement of functional expenses.
-
1 · Grants to domestic organizations and governments
total $120,000 · program services $120,000
-
2 · Grants to domestic individuals
total $30,693 · program services $30,693
-
5 · Compensation of officers, directors and key employees
total $1,248,431 · management and general $1,248,431
-
7 · Other salaries and wages
total $65,352,959 · program services $60,783,767 · management and general $4,569,192
-
8 · Pension plan contributions
total $3,698,206 · program services $3,534,722 · management and general $163,484
-
9 · Other employee benefits
total $14,579,760 · program services $11,449,918 · management and general $3,129,842
-
10 · Payroll taxes
total $4,936,583 · program services $4,569,723 · management and general $366,860
-
11a · Fees: management
total $52,192,097 · management and general $52,192,097
-
11b · Fees: legal
total $26,189 · management and general $26,189
-
11c · Fees: accounting
total $86,977 · management and general $86,977
-
11d · Fees: lobbying
total $12,542 · management and general $12,542
-
11f · Fees: investment management
total $58,716 · management and general $58,716
-
11g · Fees: other
total $61,148,420 · program services $59,190,516 · management and general $1,957,904
-
12 · Advertising and promotion
total $9,879 · program services $8,573 · management and general $1,306
-
13 · Office expenses
total $724,708 · program services $480,973 · management and general $243,735
-
14 · Information technology
total $494,668 · program services $425,601 · management and general $69,067
-
16 · Occupancy
total $3,164,012 · program services $1,096,542 · management and general $2,067,470
-
17 · Travel
total $100,352 · program services $95,703 · management and general $4,649
-
19 · Conferences, conventions and meetings
total $65,183 · program services $56,570 · management and general $8,613
-
20 · Interest
total $10,791,391 · program services $10,791,391
-
22 · Depreciation, depletion and amortization
total $6,988,373 · program services $6,980,698 · management and general $7,675
-
23 · Insurance
total $2,078,250 · program services $2,078,250
-
24a · Other expenses: MEDICAL SUPPLIES
total $44,208,645 · program services $44,208,645
-
24b · Other expenses: BAD DEBT
total $11,723,685 · program services $11,723,685
-
24c · Other expenses: REPAIRS & MAINTENANCE
total $4,409,573 · program services $1,171,304 · management and general $3,238,269
-
24d · Other expenses: TAXES & LICENSES
total $4,127,700 · program services $117,639 · management and general $4,010,061
-
24e · All other expenses
total $1,532,572 · program services $1,460,763 · management and general $71,809
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $4,586 · end of year $2,867
-
2 · Savings and temporary cash investments
beginning of year $113,109 · end of year $10,678
-
3 · Pledges and grants receivable
beginning of year $717,516 · end of year $540,000
-
4 · Accounts receivable
beginning of year $27,070,603 · end of year $28,761,215
-
8 · Inventories for sale or use
beginning of year $4,329,854 · end of year $4,851,235
-
9 · Prepaid expenses and deferred charges
beginning of year $377,112 · end of year $333,367
-
10a · Land, buildings and equipment: cost or other basis
$177,838,910
-
10b · Land, buildings and equipment: accumulated depreciation
$117,267,364
-
10c · Land, buildings and equipment, net
beginning of year $62,614,151 · end of year $60,571,546
-
11 · Investments: publicly traded securities
beginning of year $12,686,581 · end of year $13,781,822
-
12 · Investments: other securities
beginning of year $1,603,666 · end of year $1,796,502
-
13 · Investments: program-related
beginning of year $3,870,035 · end of year $4,273,010
-
14 · Intangible assets
beginning of year $3,817,462 · end of year $1,247,731
-
15 · Other assets
beginning of year $279,083 · end of year $223,042
-
17 · Accounts payable and accrued expenses
beginning of year $22,757,179 · end of year $20,451,114
-
19 · Deferred revenue
beginning of year $3,984,317 · end of year $2,247,119
-
20 · Tax-exempt bond liabilities
beginning of year $2,129,396 · end of year $2,066,817
-
23 · Secured mortgages and notes payable
beginning of year $123,532,774 · end of year $0
-
25 · Other liabilities
beginning of year $56,927,033 · end of year $117,898,546
-
27 · Net assets without donor restrictions
beginning of year -$99,433,868 · end of year -$33,889,394
-
28 · Net assets with donor restrictions
beginning of year $7,586,927 · end of year $7,618,813
Mission and programs · 2022
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 - 2023 COMMUNITY BENEFIT REPORT LOCATED AT HTTPS://WWW.WELLSPAN.ORG/ABOUT/WELLSPAN-IN-THE-COMMUNITY/2023-COMMUNITY-BENEFIT-REPORT/.
Expenses $220,375,676 · Grants $150,693 · Revenue $279,633,839
As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.
Listed in Part VII
-
Moniqua AcostaMONIQUA ACOSTA
CHAIR
- Total calculated
- $0
- Hours/week
- 1 + 3 related
-
Reyna Britton RNREYNA BRITTON RN
DIRECTOR, VICE CHAIR (AS OF 1/23)
- Total calculated
- $0
- Hours/week
- 1 + 3 related
-
Roxanna Gapstur PhD RNROXANNA GAPSTUR PHD RN
PRESIDENT & CEO - WELLSPAN HEALTH
- Total calculated
- $2,391,449
- From this org
- $0
- From related orgs
- $2,303,962
- Other
- $87,487
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $1,523,876 related
- Bonus
- $0 + $780,000 related
- Other
- $0 + $86 related
- Deferred
- $0 + $13,477 related
- Nontaxable benefits
- $0 + $74,010 related
- Filer's total
- $0 + $2,391,449 related
-
Carrie WilsonCARRIE WILSON
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 3 related
-
Christopher Grant Psy DCHRISTOPHER GRANT PSY D
DIRECTOR
- Total calculated
- $2,023
- From this org
- $0
- From related orgs
- $1,780
- Other
- $243
- Hours/week
- 1 + 40 related
-
Kimberly Kreider UmbleKIMBERLY KREIDER UMBLE
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 3 related
-
Stephen LindseySTEPHEN LINDSEY
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 3 related
-
Michael SeimMICHAEL SEIM
SR VP & CHIEF QUALITY OFFICER
- Total calculated
- $975,892
- From this org
- $0
- From related orgs
- $904,525
- Other
- $71,367
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $660,561 related
- Bonus
- $0 + $243,904 related
- Other
- $0 + $60 related
- Deferred
- $0 + $15,485 related
- Nontaxable benefits
- $0 + $55,882 related
- Filer's total
- $0 + $975,892 related
-
Robert FunkROBERT FUNK
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 3 related
-
Robert HoffmanROBERT HOFFMAN
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 4 related
-
Edward Tadajweski MDEDWARD TADAJWESKI MD
DIRECTOR
- Total calculated
- $758,007
- From this org
- $0
- From related orgs
- $687,229
- Other
- $70,778
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $518,654 related
- Bonus
- $0 + $168,575 related
- Other
- $0
- Deferred
- $0 + $18,351 related
- Nontaxable benefits
- $0 + $52,427 related
- Filer's total
- $0 + $758,007 related
-
Laura BuczkowskiLAURA BUCZKOWSKI
EXECUTIVE VP & CFO - WELLSPAN HEALTH
- Total calculated
- $1,018,368
- From this org
- $0
- From related orgs
- $944,343
- Other
- $74,025
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $694,583 related
- Bonus
- $0 + $249,750 related
- Other
- $0 + $10 related
- Deferred
- $0 + $16,892 related
- Nontaxable benefits
- $0 + $57,133 related
- Filer's total
- $0 + $1,018,368 related
-
Roger ZimmermanROGER ZIMMERMAN
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 3 related
-
Amanda Davis-BuieAMANDA DAVIS-BUIE
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 3 related
-
Vincent GarciaVINCENT GARCIA
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 3 related
-
Faraaz YousufFARAAZ YOUSUF
EXEC. VP & COO (UNTIL 11/22)
- Total calculated
- $1,032,704
- From this org
- $0
- From related orgs
- $987,746
- Other
- $44,958
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $563,091 related
- Bonus
- $0 + $401,869 related
- Other
- $0 + $22,786 related
- Deferred
- $0 + $3,087 related
- Nontaxable benefits
- $0 + $41,871 related
- Filer's total
- $0 + $1,032,704 related
-
James StuccioJAMES STUCCIO
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 3 related
-
Amy NelsonAMY NELSON
SECRETARY/SR VP & GENERAL COUNSEL
- Total calculated
- $749,817
- From this org
- $0
- From related orgs
- $661,328
- Other
- $88,489
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $477,341 related
- Bonus
- $0 + $173,900 related
- Other
- $0 + $10,087 related
- Deferred
- $0 + $38,242 related
- Nontaxable benefits
- $0 + $50,247 related
- Filer's total
- $0 + $749,817 related
-
Carrie WillettsCARRIE WILLETTS
SR VP - EAST REGION (UNTIL 7/22)
- Total calculated
- $618,509
- From this org
- $0
- From related orgs
- $567,828
- Other
- $50,681
- Hours/week
- 0 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $276,897 related
- Bonus
- $0 + $173,160 related
- Other
- $0 + $117,771 related
- Deferred
- $0 + $12,435 related
- Nontaxable benefits
- $0 + $38,246 related
- Filer's total
- $0 + $618,509 related
-
Patricia DonleyPATRICIA DONLEY
PRESIDENT
- Total calculated
- $407,961
- From this org
- $361,891
- From related orgs
- $0
- Other
- $46,070
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $282,216
- Bonus
- $62,700
- Other
- $16,975
- Deferred
- $15,953
- Nontaxable benefits
- $30,117
- Filer's total
- $407,961
-
Robert ShaverROBERT SHAVER
VP - MEDICAL AFFAIRS (UNTIL 4/23)
- Total calculated
- $490,627
- From this org
- $425,710
- From related orgs
- $0
- Other
- $64,917
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $344,859
- Bonus
- $74,164
- Other
- $6,687
- Deferred
- $18,668
- Nontaxable benefits
- $46,249
- Filer's total
- $490,627
-
Kelly SmithKELLY SMITH
VP PATIENT CARE SERVICES
- Total calculated
- $280,685
- From this org
- $224,695
- From related orgs
- $0
- Other
- $55,990
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $197,349
- Bonus
- $23,210
- Other
- $4,136
- Deferred
- $13,000
- Nontaxable benefits
- $42,990
- Filer's total
- $280,685
-
Jilian White MDJILIAN WHITE MD
VP - MEDICAL AFFAIRS
- Total calculated
- $423,219
- From this org
- $0
- From related orgs
- $378,648
- Other
- $44,571
- Hours/week
- 0 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $353,722 related
- Bonus
- $0 + $24,851 related
- Other
- $0 + $75 related
- Deferred
- $0 + $11,463 related
- Nontaxable benefits
- $0 + $33,108 related
- Filer's total
- $0 + $423,219 related
-
Virginia SangerVIRGINIA SANGER
SR DIR. ANCILLARY & SUPPORT SERVICES
- Total calculated
- $265,949
- From this org
- $214,867
- From related orgs
- $0
- Other
- $51,082
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $197,155
- Bonus
- $13,708
- Other
- $4,004
- Deferred
- $24,555
- Nontaxable benefits
- $26,527
- Filer's total
- $265,949
-
Debra NeyDEBRA NEY
MANAGER-PHARMACY
- Total calculated
- $246,404
- From this org
- $206,917
- From related orgs
- $0
- Other
- $39,487
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $190,504
- Bonus
- $13,018
- Other
- $3,395
- Deferred
- $11,502
- Nontaxable benefits
- $27,985
- Filer's total
- $246,404
-
Bonnie PietruchBONNIE PIETRUCH
DIRECTOR CLINICAL OPERATIONS
- Total calculated
- $204,502
- From this org
- $178,917
- From related orgs
- $0
- Other
- $25,585
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $163,647
- Bonus
- $11,934
- Other
- $3,336
- Deferred
- $10,555
- Nontaxable benefits
- $15,030
- Filer's total
- $204,502
-
Annie DonleyANNIE DONLEY
DIRECTOR CLINICAL PHARMACY SERVICES
- Total calculated
- $229,700
- From this org
- $179,430
- From related orgs
- $0
- Other
- $50,270
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $163,893
- Bonus
- $15,537
- Other
- $0
- Deferred
- $10,852
- Nontaxable benefits
- $39,418
- Filer's total
- $229,700
-
Donna PalmerDONNA PALMER
CLINICAL NURSE
- Total calculated
- $227,465
- From this org
- $178,719
- From related orgs
- $0
- Other
- $48,746
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $132,939
- Bonus
- $45,780
- Other
- $0
- Deferred
- $10,344
- Nontaxable benefits
- $38,402
- Filer's total
- $227,465
-
Thomas HarlowTHOMAS HARLOW
FORMER PRESIDENT
- Total calculated
- $379,857
- From this org
- $356,714
- From related orgs
- $0
- Other
- $23,143
- Hours/week
- 0
Schedule J breakdown matched by us
- Base
- $51,506
- Bonus
- $79,752
- Other
- $225,456
- Deferred
- $3,724
- Nontaxable benefits
- $19,419
- Filer's total
- $379,857
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
- 4b · Supplemental nonqualified retirement plan
Answered no
- 4a · Severance or change-of-control payment
- 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 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, THE FOLLOWING INDIVIDUALS RECEIVED DISTRIBUTIONS FROM THE DEFERRED COMPENSATION PLAN: CARRIE WILLETTS - $50,621 THOMAS HARLOW - $181,583 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
-
CITY OF LEBANON
$100,000
COMMUNITY SUPPORT
-
$20,000
COMMUNITY 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.
-
APPLE HILL SURGICAL CENTER INC
501(C)(3) · SOLE GP IN LP. OPERATING SURGICAL CENTER · PA
Directly controlled by WELLSPAN HEALTH CARE SERVICES
-
501(C)(3) · HEALTH CARE SERVICES · PA
Directly controlled by WELLSPAN SUMMIT HEALTH
-
501(C)(3) · HEALTH CARE SERVICES · PA
Directly controlled by WELLSPAN SUMMIT HEALTH
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CHAMBERSBURG HOSPITAL WORKER'S COMPENSATION TRUST
501(C)(4) · WORKERS COMPENSATION TRUST · PA
Directly controlled by CHAMBERSBURG HOSPITAL
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EPHRATA COMMUNITY HEALTH FOUNDATION
501(C)(3) · FUNDRAISING FOR EPHRATA HOSPITAL · PA
Directly controlled by EPHRATA COMMUNITY HOSPITAL
-
501(C)(3) · HEALTH CARE SERVICES · PA
Directly controlled by WELLSPAN HEALTH
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GETTYSBURG HOSPITAL FOUNDATION
501(C)(3) · FUNDRAISING FOR GETTYSBURG HOSPITAL · PA
Directly controlled by GETTYSBURG HOSPITAL
-
501(C)(3) · HEALTH CARE SERVICES · PA
Directly controlled by WELLSPAN HEALTH
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GOOD SAMARITAN HEALTH SERVICES FOUNDATION OF LEBANON PA
501(C)(3) · FUNDRAISING FOR GOOD SAMARITAN · PA · controlled entity
Directly controlled by GOOD SAMARITAN HOSPITAL
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GOOD SAMARITAN PHYSICIAN SERVICES
501(C)(3) · MEDICAL AND SURGICAL CARE · PA
Directly controlled by GOOD SAM HEALTH SERVICES FOUNDATION
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HEALTHY COMMUNITY PHARMACY INC
501(C)(3) · REDUCED RATE PRESCRIPTION DRUGS TO UNINSURED · PA
Directly controlled by WELLSPAN HEALTH CARE SERVICES
-
501(C)(3) · HEALTH CARE SERVICES · PA
Directly controlled by WELLSPAN HEALTH
-
501(C)(3) · FUNDRAISING FOR HEALTH CARE SYSTEM · PA
Directly controlled by WELLSPAN SUMMIT HEALTH
-
501(C)(3) · MEDICAL AND SURGICAL CARE · PA
Directly controlled by WELLSPAN SUMMIT HEALTH
-
501(C)(3) · HOME PERSONAL CARE SERVICES FOR ELDERLY AND DISABLED · PA
Directly controlled by WELLSPAN SURGERY & REHABILITATION HOSPITAL
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501(C)(3) · HOME HEALTH AND HOSPICE CARE SERVICES · PA
Directly controlled by WELLSPAN SURGERY & REHABILITATION HOSPITAL
-
501(C)(3) · HEALTH CARE SERVICES · PA
Directly controlled by WELLSPAN SUMMIT HEALTH
-
501(C)(3) · INTEGRATED HEALTH SYSTEM · PA
-
501(C)(3) · HEALTH CARE SERVICES · PA
Directly controlled by WELLSPAN HEALTH
-
501(C)(3) · MEDICAL AND SURGICAL CARE · PA
Directly controlled by WELLSPAN HEALTH
-
501(C)(3) · LEASES FACILITIES TO AFFILIATES · PA
Directly controlled by WELLSPAN HEALTH CARE SERVICES
-
501(C)(3) · INTEGRATED HEALTH SYSTEM · PA
Directly controlled by WELLSPAN HEALTH
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WELLSPAN SURGERY & REHABILITATION HOSPITAL
501(C)(3) · SURGERY AND REHABILITATION HOSPITAL · PA
Directly controlled by WELLSPAN HEALTH
-
501(C)(3) · FUNDRAISING FOR WELLSPAN ENTITIES · PA
Directly controlled by WELLSPAN HEALTH
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501(C)(3) · COMMUNITY TEACHING HOSPITAL · PA
Directly controlled by WELLSPAN HEALTH
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
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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
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CUMBERLAND VALLEY HEALTH NETWORK INC
C · HEALTH NETWORK · PA
Directly controlled by WELLSPAN SUMMIT HEALTH
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EPHRATA HEALTH PAVILION CONDOMINIUM ASSOCIATION
C · CONDOMINIUM ASSOCIATION · PA
Directly controlled by EPHRATA HOSPITAL
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EPHRATA MEDICAL OFFICE CONDOMINIUM ASSOCIATION
C · CONDOMINIUM ASSOCIATION · PA
-
GOOD SAMARITAN PHYSICIAN HOSPITAL ORGANIZATION OF LEBANON PA
C · HEALTH CARE SERVICES · PA · 50% owned · share of income $47,770 · share of assets $761,108
Directly controlled by THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA
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GSH REALTY INC
C · NON-RESIDENTIAL REAL ESTATE · PA
Directly controlled by WELLSPAN HEALTH CARE SERVICES
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NORTHERN LANCASTER COUNTY PHYSICIAN HOSPITAL ALLIANCE
C · COORD PHYS & HOSPITAL · PA
Directly controlled by EPHRATA HOSPITAL
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QUEST BEHAVIORAL HEALTH
C · HEALTH CARE NETWORK SERVICE · PA
Directly controlled by WELLSPAN HEALTH
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WELLSPAN HEARING CENTER INC
C · HEARING AID PRACTICE · PA
Directly controlled by WELLSPAN HEALTH CARE SERVICES
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WELLSPAN PHARMACY INC
C · DISPENSES RX & PROVIDES IV THERAPY · PA
Directly controlled by WELLSPAN HEALTH CARE SERVICES
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WELLSPAN PROVIDER NETWORK
C · COORDINATE MANAGED CARE RISK CONTRACTS · PA
Directly controlled by WELLSPAN HEALTH
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WELLSPAN RECIPROCAL RISK RETENTION GROUP
C · RISK RETENTION GROUP · PA
Directly controlled by WELLSPAN HEALTH
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YORK HEALTH PLAN
C · PREFERRED PROVIDER ORGANIZATION · PA
Directly controlled by WELLSPAN HEALTH
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 9 May 2024
- IRS schema version
- 2022v5.0
- Source object
- 202411309349301611
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