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← WELLSPAN SURGERY AND REHABILITATION HOSPITAL

Form 990 for tax year 2023

Filed by WELLSPAN SURGERY AND REHABILITATION HOSPITAL.

Totals

Total revenue
$125,973,265
Total expenses
$113,993,426
Contributions and grants received
$99,517
Grants paid
$115,000
Program services expenses (Part IX)
$80,563,098
Management and general expenses
$33,430,328
Fundraising expenses
$0
Program service expenses (Part III)
$80,563,098

Program services were 70.7% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • SUZANNE MCCONKEY

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 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

  • KRISTA DARR

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • LEE MADDOX MD

    DIRECTOR

    Total calculated
    $665,664
    From this org
    $0
    From related orgs
    $592,397
    Other
    $73,267
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $537,172 related
    Bonus
    $0 + $55,225 related
    Other
    $0
    Deferred
    $0 + $17,555 related
    Nontaxable benefits
    $0 + $55,712 related
    Filer's total
    $0 + $665,664 related

  • VICTORIA DIAMOND

    SR VP - CENTRAL REGION

    Total calculated
    $1,007,714
    From this org
    $0
    From related orgs
    $933,763
    Other
    $73,951
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $603,034 related
    Bonus
    $0 + $257,999 related
    Other
    $0 + $72,730 related
    Deferred
    $0 + $18,531 related
    Nontaxable benefits
    $0 + $55,420 related
    Filer's total
    $0 + $1,007,714 related

  • JEFF LOBACH ESQ

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 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

  • NEIL SLENKER ESQ

    CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • 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

  • CHERYL THOMPSON DPN RN

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • SANDIE WALKER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • ELIZABETH DELLINGER

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • BENJAMIN MCGLAUGHLIN

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • NATASHA ROMERO

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 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

  • THOMAS BURNS

    DIRECTOR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • CAROL SMITH

    VP & PRESIDENT - WSRH

    Total calculated
    $405,958
    From this org
    $342,536
    From related orgs
    $0
    Other
    $63,422
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $255,746
    Bonus
    $65,000
    Other
    $21,790
    Deferred
    $17,024
    Nontaxable benefits
    $46,398
    Filer's total
    $405,958

  • JILIAN WHITE MD

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

    Total calculated
    $485,104
    From this org
    $54,649
    From related orgs
    $351,002
    Other
    $79,453
    Hours/week
    0 + 40 related

    Schedule J breakdown matched by us

    Base
    $54,649 + $336,486 related
    Bonus
    $0 + $14,516 related
    Other
    $0
    Deferred
    $3,143 + $16,288 related
    Nontaxable benefits
    $8,958 + $51,064 related
    Filer's total
    $66,750 + $418,354 related

  • ELIZABETH TRUMBLE

    SR DIR-ACUTE & POST-ACUTE REHAB SVCS

    Total calculated
    $238,799
    From this org
    $186,831
    From related orgs
    $0
    Other
    $51,968
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $172,335
    Bonus
    $14,496
    Other
    $0
    Deferred
    $11,227
    Nontaxable benefits
    $40,741
    Filer's total
    $238,799

  • ROSA HICKEY

    SR DIRECTOR - PATIENT CARE

    Total calculated
    $274,201
    From this org
    $223,756
    From related orgs
    $242
    Other
    $50,203
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $199,867 + $242 related
    Bonus
    $17,876
    Other
    $6,013
    Deferred
    $12,827
    Nontaxable benefits
    $37,356 + $20 related
    Filer's total
    $273,939 + $262 related

  • NICK HSIEH

    SR DIRECTOR - OPERATIONS

    Total calculated
    $244,749
    From this org
    $183,791
    From related orgs
    $0
    Other
    $60,958
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $168,827
    Bonus
    $14,839
    Other
    $125
    Deferred
    $11,335
    Nontaxable benefits
    $49,623
    Filer's total
    $244,749

  • GLYNNIS LOWE

    DIRECTOR - NURSING SERVICES

    Total calculated
    $212,516
    From this org
    $174,525
    From related orgs
    $0
    Other
    $37,991
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $160,842
    Bonus
    $13,633
    Other
    $50
    Deferred
    $9,827
    Nontaxable benefits
    $28,164
    Filer's total
    $212,516

  • DARCI WOLF

    DIRECTOR - CLINICAL SERVICES

    Total calculated
    $230,960
    From this org
    $173,843
    From related orgs
    $0
    Other
    $57,117
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $159,998
    Bonus
    $13,845
    Other
    $0
    Deferred
    $10,614
    Nontaxable benefits
    $46,503
    Filer's total
    $230,960

  • MARK KAHLER II

    DIRECTOR - CLINICAL DEVELOPMENT

    Total calculated
    $231,495
    From this org
    $162,942
    From related orgs
    $10,983
    Other
    $57,570
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $143,940 + $10,750 related
    Bonus
    $13,465
    Other
    $5,537 + $233 related
    Deferred
    $9,795 + $665 related
    Nontaxable benefits
    $43,655 + $3,455 related
    Filer's total
    $216,392 + $15,103 related

  • AUDREY SCOTT

    DIRECTOR - CLINICAL SERVICES

    Total calculated
    $210,678
    From this org
    $161,098
    From related orgs
    $0
    Other
    $49,580
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $143,187
    Bonus
    $12,355
    Other
    $5,556
    Deferred
    $9,549
    Nontaxable benefits
    $40,031
    Filer's total
    $210,678

  • FARAAZ YOUSUF

    FORMER EXECUTIVE VP & COO

    Total calculated
    $1,121,629
    From this org
    $0
    From related orgs
    $1,061,597
    Other
    $60,032
    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 + $60,032 related
    Filer's total
    $0 + $1,121,629 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
  • 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 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 VICTORIA DIAMOND - $30,926 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
2023
Filed
8 May 2025
IRS schema version
2023v6.0
Source object
202531289349300408

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

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