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Nonprofiteer
← CHAMBERSBURG HOSPITAL

Form 990 for tax year 2022

Filed by CHAMBERSBURG HOSPITAL.

Totals

Total revenue
$467,354,077
Total expenses
$435,680,436
Contributions and grants received
$8,083,918
Grants paid
$2,141,890
Program service revenue
$457,148,240
Investment income
$1,097,495
Other revenue
$1,024,424
Total assets, end of year
$508,624,562
Total liabilities, end of year
$196,949,625
Net assets or fund balances, end of year
$311,674,937
Program services expenses (Part IX)
$375,629,108
Management and general expenses
$60,051,328
Fundraising expenses
$0
Program service expenses (Part III)
$375,629,108

Program services were 86.2% 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

    $1,101,436

  • 1e · Government grants (contributions)

    $6,430,995

  • 1f · All other contributions, gifts and grants

    $551,487

  • 2a · Program service revenue: PATIENT SERVICES

    total $457,147,770 · related or exempt $456,629,192 · unrelated business $518,578

  • 2b · Program service revenue: MEDICAL EDUCATION

    total $470 · related or exempt $470

  • 3 · Investment income

    total $3,246,071 · excluded $3,246,071

  • 6a · Gross rents

    real property $550,775

  • 6b · Less rental expenses

    real property $477,975

  • 6c · Rental income or loss

    real property $72,800

  • 6d · Net rental income or loss

    total $72,800 · excluded $72,800

  • 7a · Gross sales of assets other than inventory

    securities $61,798,369 · other assets $11,683

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

    securities $63,948,256 · other assets $10,372

  • 7c · Gain or loss

    securities -$2,149,887 · other assets $1,311

  • 7d · Net gain or loss

    total -$2,148,576 · excluded -$2,148,576

  • 11a · Other revenue: CAFETERIA SALES

    total $338,436 · excluded $338,436

  • 11b · Other revenue: OTHER SERVICES

    total $285,978 · excluded $285,978

  • 11c · Other revenue: CLINICAL SERVICES PHARMACY

    total $168,000 · excluded $168,000

  • 11d · All other revenue

    total $159,210 · excluded $159,210

  • 11e · Other revenue, total

    $951,624

Functional expenses

Part IX, the statement of functional expenses.

  • 1 · Grants to domestic organizations and governments

    total $2,141,890 · program services $2,141,890

  • 5 · Compensation of officers, directors and key employees

    total $2,185,590 · management and general $2,185,590

  • 7 · Other salaries and wages

    total $120,347,814 · program services $110,349,954 · management and general $9,997,860

  • 8 · Pension plan contributions

    total $1,137,177 · program services $1,119,814 · management and general $17,363

  • 9 · Other employee benefits

    total $31,180,308 · program services $28,353,978 · management and general $2,826,330

  • 10 · Payroll taxes

    total $9,050,157 · program services $8,171,906 · management and general $878,251

  • 11a · Fees: management

    total $40,706,317 · management and general $40,706,317

  • 11b · Fees: legal

    total $359,675 · management and general $359,675

  • 11c · Fees: accounting

    total $125,012 · management and general $125,012

  • 11d · Fees: lobbying

    total $15,302 · management and general $15,302

  • 11g · Fees: other

    total $107,677,488 · program services $106,803,604 · management and general $873,884

  • 12 · Advertising and promotion

    total $757 · program services $726 · management and general $31

  • 13 · Office expenses

    total $1,138,088 · program services $878,697 · management and general $259,391

  • 14 · Information technology

    total $568,920 · program services $540,903 · management and general $28,017

  • 16 · Occupancy

    total $4,552,800 · program services $3,509,833 · management and general $1,042,967

  • 17 · Travel

    total $94,009 · program services $83,802 · management and general $10,207

  • 19 · Conferences, conventions and meetings

    total $78,311 · program services $68,445 · management and general $9,866

  • 20 · Interest

    total $4,220,377 · program services $4,220,377

  • 22 · Depreciation, depletion and amortization

    total $12,336,307 · program services $12,203,796 · management and general $132,511

  • 23 · Insurance

    total $3,343,766 · program services $3,299,917 · management and general $43,849

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $60,137,994 · program services $60,137,994

  • 24b · Other expenses: BAD DEBT EXPENSE

    total $21,360,873 · program services $21,360,873

  • 24c · Other expenses: TAXES & LICENSES

    total $6,992,193 · program services $6,948,056 · management and general $44,137

  • 24d · Other expenses: REPAIRS & MAINTENANCE

    total $4,916,649 · program services $4,546,452 · management and general $370,197

  • 24e · All other expenses

    total $1,012,662 · program services $888,091 · management and general $124,571

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $5,815 · end of year $5,650

  • 2 · Savings and temporary cash investments

    beginning of year $612,894 · end of year $10,897,931

  • 4 · Accounts receivable

    beginning of year $49,616,687 · end of year $52,658,320

  • 7 · Other notes and loans receivable

    beginning of year $13,925,881 · end of year $6,462,538

  • 8 · Inventories for sale or use

    beginning of year $3,875,858 · end of year $3,901,551

  • 9 · Prepaid expenses and deferred charges

    beginning of year $4,833,980 · end of year $913,039

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

    $292,055,485

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

    $186,743,877

  • 10c · Land, buildings and equipment, net

    beginning of year $109,321,275 · end of year $105,311,608

  • 11 · Investments: publicly traded securities

    beginning of year $259,939,711 · end of year $277,854,380

  • 12 · Investments: other securities

    beginning of year $32,858,060 · end of year $36,219,154

  • 13 · Investments: program-related

    beginning of year $13,271,337 · end of year $14,331,408

  • 14 · Intangible assets

    beginning of year $2,020,412 · end of year $68,983

  • 17 · Accounts payable and accrued expenses

    beginning of year $49,217,502 · end of year $39,090,261

  • 19 · Deferred revenue

    beginning of year $12,146,816 · end of year $2,652,453

  • 20 · Tax-exempt bond liabilities

    beginning of year $118,150,218 · end of year $115,493,641

  • 23 · Secured mortgages and notes payable

    beginning of year $546,694 · end of year $546,694

  • 25 · Other liabilities

    beginning of year $13,676,389 · end of year $39,166,576

  • 27 · Net assets without donor restrictions

    beginning of year $295,355,203 · end of year $309,698,365

  • 28 · Net assets with donor restrictions

    beginning of year $1,189,088 · end of year $1,976,572

Mission and programs · 2022

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.THE CHAMBERSBURG HOSPITAL PROVIDES NEEDED MEDICAL CARE TO THE COMMUNITY REGARDLESS OF ANY PATIENT'S ABILITY TO PAY. HEALTH CARE SERVICES INCLUDE INPATIENT ROUTINE, INPATIENT ANCILLARY AND OUTPATIENT CARE. 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.SEE WELLSPAN HEALTH - 2023 COMMUNITY BENEFIT REPORT LOCATED AT HTTPS://WWW.WELLSPAN.ORG/ABOUT/WELLSPAN-IN-THE-COMMUNITY/2023-COMMUNITY-BENEFIT-REPORT/.

    Expenses $375,629,108 · Grants $2,141,890 · Revenue $456,629,662

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Amy 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
  • Cheryl Plummer

    CHAIR

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

    DIRECTOR - DOCTOR

    Total calculated
    $497,831
    From this org
    $0
    From related orgs
    $430,418
    Other
    $67,413
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $382,825 related
    Bonus
    $0 + $47,593 related
    Other
    $0
    Deferred
    $0 + $18,605 related
    Nontaxable benefits
    $0 + $48,808 related
    Filer's total
    $0 + $497,831 related
  • David Lovett

    DIRECTOR

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

    VICE CHAIR

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

    DIRECTOR

    Total calculated
    $245,337
    From this org
    $0
    From related orgs
    $190,734
    Other
    $54,603
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $146,898 related
    Bonus
    $0 + $41,153 related
    Other
    $0 + $2,683 related
    Deferred
    $0 + $10,258 related
    Nontaxable benefits
    $0 + $44,345 related
    Filer's total
    $0 + $245,337 related
  • Edie Jardine

    DIRECTOR

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

    DIRECTOR - DOCTOR

    Total calculated
    $690,394
    From this org
    $0
    From related orgs
    $601,608
    Other
    $88,786
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $531,688 related
    Bonus
    $0 + $60,361 related
    Other
    $0 + $9,559 related
    Deferred
    $0 + $36,600 related
    Nontaxable benefits
    $0 + $52,186 related
    Filer's total
    $0 + $690,394 related
  • Faraaz 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
  • Horace Martin MD

    DIRECTOR

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

    VP & PRESIDENT - CHAMBERSBURG

    Total calculated
    $486,638
    From this org
    $410,293
    From related orgs
    $0
    Other
    $76,345
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $331,357
    Bonus
    $72,226
    Other
    $6,710
    Deferred
    $27,582
    Nontaxable benefits
    $48,763
    Filer's total
    $486,638
  • Julianne Craig

    DIRECTOR

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

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Kevin Lorentsen MD

    DIRECTOR (RES. 12/22)

    Total calculated
    $741,756
    From this org
    $0
    From related orgs
    $664,608
    Other
    $77,148
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $510,913 related
    Bonus
    $0 + $92,490 related
    Other
    $0 + $61,205 related
    Deferred
    $0 + $16,679 related
    Nontaxable benefits
    $0 + $60,469 related
    Filer's total
    $0 + $741,756 related
  • Laura 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
  • Michael 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
  • Patricia Green-Rodgers

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 3 related
  • Roxanna 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
  • Sherri Stahl

    SVP, DIRECTOR

    Total calculated
    $690,210
    From this org
    $228,261
    From related orgs
    $396,991
    Other
    $64,958
    Hours/week
    40 + 1 related

    Schedule J breakdown matched by us

    Base
    $228,201 + $228,290 related
    Bonus
    $0 + $168,451 related
    Other
    $60 + $250 related
    Deferred
    $10,088 + $10,088 related
    Nontaxable benefits
    $22,391 + $22,391 related
    Filer's total
    $260,740 + $429,470 related
  • Stephen Holoviak

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 6 related
  • William Happel

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 5 related
  • Jane Hyde

    SR VICE PRESIDENT (UNTIL 2/23)

    Total calculated
    $738,257
    From this org
    $503,681
    From related orgs
    $180,940
    Other
    $53,636
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $221,897 + $180,880 related
    Bonus
    $200,443
    Other
    $81,341 + $60 related
    Deferred
    $8,377 + $8,377 related
    Nontaxable benefits
    $18,441 + $18,441 related
    Filer's total
    $530,499 + $207,758 related
  • Anthony Bruno MD

    CHIEF MED. OFFICER (UNTIL 8/22)

    Total calculated
    $407,454
    From this org
    $361,350
    From related orgs
    $0
    Other
    $46,104
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $263,515
    Bonus
    $88,739
    Other
    $9,096
    Deferred
    $12,979
    Nontaxable benefits
    $33,125
    Filer's total
    $407,454
  • Elyse Fisler

    CHIEF NURSING OFFICER

    Total calculated
    $322,805
    From this org
    $254,535
    From related orgs
    $0
    Other
    $68,270
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $208,221
    Bonus
    $46,294
    Other
    $20
    Deferred
    $22,399
    Nontaxable benefits
    $45,871
    Filer's total
    $322,805
  • Gautam Wadhwa

    VP MED. AFFAIRS, CHIEF MED. OFFICER

    Total calculated
    $490,337
    From this org
    $0
    From related orgs
    $455,682
    Other
    $34,655
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $0 + $347,126 related
    Bonus
    $0 + $108,556 related
    Other
    $0
    Deferred
    $0 + $18,145 related
    Nontaxable benefits
    $0 + $16,510 related
    Filer's total
    $0 + $490,337 related
  • Ginger Everhart

    SR DIR CLINICAL OPERATIONS

    Total calculated
    $256,376
    From this org
    $196,262
    From related orgs
    $0
    Other
    $60,114
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $174,686
    Bonus
    $17,932
    Other
    $3,644
    Deferred
    $16,278
    Nontaxable benefits
    $43,836
    Filer's total
    $256,376
  • Beverly Cardinale

    DIRECTOR OF PATIENT SERVICES

    Total calculated
    $243,856
    From this org
    $183,016
    From related orgs
    $0
    Other
    $60,840
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $157,998
    Bonus
    $21,687
    Other
    $3,331
    Deferred
    $16,275
    Nontaxable benefits
    $44,565
    Filer's total
    $243,856
  • James Pryor

    VP PATIENT CARE SVCS, CHIEF NURSING OFFICER

    Total calculated
    $268,714
    From this org
    $212,266
    From related orgs
    $0
    Other
    $56,448
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $170,667
    Bonus
    $38,060
    Other
    $3,539
    Deferred
    $11,410
    Nontaxable benefits
    $45,038
    Filer's total
    $268,714
  • Larry Pentz

    MANAGER - PHARMACY OPERATIONS

    Total calculated
    $269,226
    From this org
    $208,113
    From related orgs
    $0
    Other
    $61,113
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $184,190
    Bonus
    $12,731
    Other
    $11,192
    Deferred
    $8,313
    Nontaxable benefits
    $52,800
    Filer's total
    $269,226
  • Melissa Gross

    REGIONAL MGR - CLINICAL PHARMACY

    Total calculated
    $270,520
    From this org
    $215,506
    From related orgs
    $0
    Other
    $55,014
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $193,476
    Bonus
    $16,224
    Other
    $5,806
    Deferred
    $9,878
    Nontaxable benefits
    $45,136
    Filer's total
    $270,520
  • Tanya Rudolph

    PHARMACIST COORDINATOR

    Total calculated
    $242,932
    From this org
    $186,988
    From related orgs
    $0
    Other
    $55,944
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $172,358
    Bonus
    $11,310
    Other
    $3,320
    Deferred
    $11,282
    Nontaxable benefits
    $44,662
    Filer's total
    $242,932

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:
LARRY PENTZ, MANAGER OF PHARMACY OPERATIONS RECEIVED A SEVERANCE PAYMENT OF $11,192 DURING CALENDAR YEAR 2022.
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, THE FOLLOWING INDIVIDUAL RECEIVED A DISTRIBUTION FROM THE SERP. JANE HYDE - $81,266 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).

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 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

Provenance

Return type
form_990
Tax year
2022
Filed
9 May 2024
IRS schema version
2022v5.0
Source object
202421309349301922

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