2025-05-08T10:11:55-05:00 2024-06-30 222517863 WELLSPAN HEALTH 3350 WHITEFORD ROAD YORK PA 17402 990 2023-07-01 831196554 SUMMIT HEALTH FOUNDATION SUMM 7172677794 PO BOX 2767 YORK PA 174052767 LAURA BUCZKOWSKI EXECUTIVE VP & CFO 7172677794 2025-05-08 1 1 DAVID P RIZZUTO P01210563 7178513055 2025-03-25 2023 2025-03-06 01:10:19Z ROXANNA GAPSTUR PO BOX 2767 YORK PA 174052767 14375970 0 X WWW.WELLSPAN.ORG X 2018 PA IMPROVE THE HEALTH OF PEOPLE IN FRANKLIN COUNTY, PA BY GENERATING CHARITABLE CONTRIBUTIONS. 12 6 0 8 0 0 1658538 2476547 255410 275536 68596 1805472 0 0 1982544 4557555 1538490 2112311 0 0 0 0 34613 22388 127464 220797 352936 1793900 2487635 188644 2069920 65952362 72355865 14593 17553 65937769 72338312 X SUMMIT HEALTH FOUNDATION IS A COMMUNITY-BASED, NON-PROFIT ORGANIZATION FORMED TO SUPPORT WELLSPAN SUMMIT HEALTH, THE CHAMBERSBURG HOSPITAL, WAYNESBORO HOSPITAL AND SUMMIT PHYSICIAN SERVICES AND THEIR MISSION OF ASSURING ACCESS TO EXCEPTIONAL HEALTH CARE SERVICES THAT ARE HIGH IN QUALITY, COMPASSIONATE AND COST EFFECTIVE. THE FOUNDATION MAKES GRANTS TO THESE ORGANIZATIONS IN ORDER TO SUPPORT THEM AND THEIR RELATED ACTIVITIES. THESE ACTIVITIES INCLUDE, BUT ARE NOT LIMITED TO:1)FURTHERING THE ORGANIZATIONS' ABILITIES TO EXPAND HEALTH SERVICES IN OUR COMMUNITY;2)FUNDING THE PURCHASE OF NEW CLINICAL AND SUPPORT-RELATED TECHNOLOGIES AND THE CONSTRUCTION OF HEALTH CARE FACILITIES;3)EXTENDING CHARITABLE HEALTH CARE TO QUALIFYING INDIVIDUALS; AND4)ADDRESSING HEALTH PRIORITIES, INCLUDING OBESITY AND SMOKING AND TOBACCO USE IN OUR COMMUNITY. 0 0 2267371 2112311 275536 SUMMIT HEALTH FOUNDATION IS A COMMUNITY-BASED, NOT-FOR-PROFIT ORGANIZATION THAT EXISTS TO INSPIRE GIFTS AND GRANTS FROM INDIVIDUALS, FOUNDATIONS, CORPORATIONS, AND OTHER ENTITIES TO SUPPORT THE HEALTH AND WELL-BEING OF PEOPLE IN FRANKLIN COUNTY AND COMMUNITIES IN ADJACENT CUMBERLAND COUNTY. THE ORGANIZATION CONDUCTS FUNDRAISING ACTIVITIES AND SEEKS GRANT FUNDING ON BEHALF OF WELLSPAN SUMMIT HEALTH, WAYNESBORO HOSPITAL, CHAMBERSBURG HOSPITAL, SUMMIT PHYSICIAN SERVICES AND THEIR AFFILIATES. SUMMIT HEALTH FOUNDATION DESIGNATES MONEY RAISED TO THE FOLLOWING FUNDS:WHERE NEEDED MOST - HELP US RESPOND TO EMERGING NEEDS. GIVING TO THIS FUND ENABLES US TO ADDRESS THE AREAS OF GREATEST NEED FOR WELLSPAN HEALTH IN FRANKLIN COUNTY.WELLSPAN FRANKLIN COUNTY PATIENT SUPPORT FUND - HELP PATIENTS WHO HAVE NEEDS THAT AFFECT THEIR TREATMENT OR HEALTH OUTCOMES. THIS FUND ASSISTS AT-RISK PATIENTS WITH FOOD, TRANSPORTATION, TRANSITIONAL HOUSING AND LIFE-SAVING MEDICATIONS.ONCOLOGY BRIDGE FUND - LEND A HAND TO PATIENTS FACING THE FINANCIAL BURDENS THAT OFTEN RESULT FROM DEALING WITH THE IMPACT OF CANCER. THIS FUND HELPS WITH BASIC LIVING EXPENSES, SUCH AS RENT, UTILITIES, GROCERIES AND TRANSPORTATION TO AND FROM MEDICAL APPOINTMENTS. FUNDS ARE AVAILABLE TO PATIENTS WHO MEET SPECIFIC FINANCIAL AID GUIDELINES.KRISTIN RUNYON MEMORIAL SCHOLARSHIP FUND - HELP PROVIDE TUITION ASSISTANCE FOR STUDENTS PURSUING THEIR REGISTERED NURSE DEGREES. MANY OF THESE OUTSTANDING SCHOLARSHIPS RECIPIENTS ARE WORKING WITHIN THE WALLS OF OUR HOSPITALS AND PHYSICIAN PRACTICES, PROVIDING HIGH-QUALITY, COMPASSIONATE CARE TO OUR PATIENTS.WELLSPAN FRANKLIN COUNTY SAFE (SEXUAL ASSAULT FORENSIC EXAMINER) FUND - LEND A HAND IN PROVIDING COMPASSIONATE CARE FOR VICTIMS OF SEXUAL ASSAULT. THIS FUND PROVIDES LOCAL ACCESS TO COMPREHENSIVE AND CARING MEDICAL TREATMENT THROUGH THE SAFE PROGRAM.WELLSPAN FRANKLIN COUNTY FUTURE PHYSICIAN SCHOLARSHIP PROGRAM - HELP PROVIDE FUNDING TO THIS UNIQUE WELLSPAN INITIATIVE TO SPONSOR MEDICAL SCHOOL SCHOLARSHIPS. SCHOLARSHIPS AID YOUNG PEOPLE WITH A CONNECTION TO A LOCAL WELLSPAN COMMUNITY AND REQUIRE THEM TO RETURN TO WORK WITHIN THE WELLSPAN FOOTPRINT FOLLOWING THEIR GRADUATION.SPOTLIGHT ON CHILDREN'S HEALTH - INVEST IN CHILDREN'S EARLY DEVELOPMENT TO ELIMINATE HEALTH AND ACHIEVEMENT INEQUITIES LATER IN LIFE BY PROVIDING LITERACY AND EARLY CHILDHOOD EDUCATION SERVICES AND MEETING SPECIAL HEALTH CARE NEEDS. THIS FUND SUPPORTS THE OPPORTUNITY FOR ALL CHILDREN IN OUR REGIONS OF CARE TO DEVELOP IN SAFE, STABLE, NURTURING RELATIONSHIPS AND ENVIRONMENTS.SEE WELLSPAN HEALTH - 2024 COMMUNITY BENEFIT REPORT LOCATED AT HTTPS://WWW.WELLSPAN.ORG/ABOUT-WELLSPAN/IMPROVING-HEALTHY-COMMUNITIES/COMMUNITY-BENEFIT. 2267371 1 1 0 0 0 0 0 0 0 1 0 1 0 1 0 1 0 1 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 6 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 1 0 PA X DAVID P RIZZUTO 7178513055 3350 WHITEFORD ROAD YORK PA 174029081 KATE CASHDOLLAR VICE CHAIRMAN 1.00 40.00 X X 0 219724 50833 ROXANNA GAPSTUR PHD RN PRESIDENT & CEO - WELLSPAN HEALTH 1.00 40.00 X X 0 3023715 100269 STEPHEN HOLOVIAK SECRETARY / TREASURER 1.00 6.00 X X 0 0 0 PHYLLIS A NYE CHAIRMAN 1.00 0.00 X X 0 0 0 JOEL ZULLINGER CHAIRMAN (RES. DEC. '23) 1.00 0.00 X 0 0 0 DAVID A HOFFMAN MD DIRECTOR 1.00 0.00 X 0 0 0 JORDAN R STATLER DIRECTOR 1.00 0.00 X 0 0 0 CANDICE STUMBAUGH DIRECTOR 1.00 0.00 X 0 0 0 ABEL CASTRO DIRECTOR 1.00 0.00 X 0 0 0 MELISSA DUBROW DIRECTOR 1.00 40.00 X 0 331452 44413 JOHN MASSIMILLA DIRECTOR 1.00 40.00 X 0 493358 80162 LAURA BUCZKOWSKI EXECUTIVE VP & CFO - WELLSPAN HEALTH 1.00 40.00 X X 0 1256714 79480 HARVEY GREEN SR. VP & CHIEF DEVELOPMENT OFFICER 8.00 32.00 X X 0 499533 49080 0 5824496 404237 0 0 1 0 0 2476547 2476547 FUNDRAISING FEES 561000 275536 275536 275536 393155 393155 11230732 9818415 1412317 1412317 1412317 4557555 275536 0 1805472 X 2112311 2112311 22388 22388 66544 66544 250519 138559 23093 88867 8881 8881 924 924 15577 15577 6552 6552 776 776 DUES & SUBSCRIPTIONS 1617 1617 LICENSES & FEES 995 995 REPAIRS & MAINTENANCE 551 551 2487635 2267371 92800 127464 35501211 39229890 4627689 5456426 25823462 27669549 65952362 72355865 14593 17553 14593 17553 X 40458264 44683572 25479505 27654740 65937769 72338312 65952362 72355865 2069920 4330623 0 X 0 1 X 1 0 X X X 7 CHAMBERSBURG HOSPITAL 230465970 3 1 1726763 0 WAYNESBORO HOSPITAL 231360854 3 1 238219 0 SUMMIT PHYSICIAN SERVICES 251716306 10 1 0 0 WELLSPAN SUMMIT HEALTH 251515371 7 1 0 0 CHAMBERSBURG HEALTH SERVICES 251515376 10 1 81848 0 WELLSPAN HEALTH 222517863 7 1 15481 0 WELLSPAN MEDICAL GROUP 232730785 7 1 50000 0 7 2112311 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 25479505 1696332 1597582 1118679 27654740 24772165 367334 405072 65066 25479505 29874436 32387 -5103236 31422 24772165 25100620 55047 4773816 55047 29874436 25085160 15460 25100620 0.00000 0.96810 0.03190 1 1 1 0 PRIVATE EQUITY, LIMITED PARTNERSHIPS 4480916 F REAL ESTATE, LIMITED PARTNERSHIPS 975510 F 5456426 BENEFICIAL INTEREST TRUST 244852 INTERCOMPANY RECEIVABLE 1518151 PERPETUAL TRUSTS 25906546 27669549 X 6708571 4330623 -2179607 2151016 4557555 0 4557555 308028 0 308028 2179607 2179607 2487635 PART V, LINE 4: THE FUNDS WERE USED TO IMPROVE THE HEALTH AND WELFARE OF THE RESIDENTS OF YORK AND ADAMS COUNTIES OF PENNSYLVANIA. PART X, LINE 2: THE COMPANY AND MOST OF ITS SUBSIDIARIES (INCLUDING CERTAIN JOINT VENTURE ENTITIES) ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. THEIR RELATED INCOME IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A). SOME OF THE SUBSIDIARIES ARE TAXABLE ENTITIES, AND SOME OF THE INCOME OF THE TAX EXEMPT ENTITIES IS SUBJECT TO TAXATION AS UNRELATED BUSINESS TAXABLE INCOME. THE COMPANY AND ITS SUBSIDIARIES FILE U.S. FEDERAL INCOME TAX RETURNS, AND THEY ALSO FILE IN VARIOUS STATE AND FOREIGN JURISDICTIONS. THE COMPANY ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ASC TOPIC 740, INCOME TAXES. THE COMPANY ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE COMPANY HAS DETERMINED THAT NO SIGNIFICANT UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2024 AND 2023. ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, ASC TOPIC 740-10 PRESCRIBES A COMPREHENSIVE MODEL FOR HOW AN ORGANIZATION SHOULD MEASURE, RECOGNIZE, PRESENT AND DISCLOSE IN ITS FINANCIAL STATEMENTS UNCERTAIN TAX POSITIONS THAT AN ORGANIZATION HAS TAKEN OR EXPECTS TO TAKE ON A TAX RETURN. THE COMPANY IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS. THERE ARE NO CURRENT AUDITS IN PROGRESS. AS OF JUNE 30, 2024, THE COMPANY HAS NO UNCERTAIN TAX POSITIONS. A SUBSIDIARY OF THE COMPANY IS CLASSIFIED AS A RECIPROCAL RISK RETENTION GROUP (RRRG) FORMED UNDER THE FEDERAL LIABILITY RISK RETENTION ACT OF 1986. RRRG QUALIFIES AS AN INSURANCE COMPANY FOR FEDERAL INCOME TAX PURPOSES. RRRG IS DOMICILED IN VERMONT (VT) AND OPERATES WITHIN THE STATES OF PENNSYLVANIA (PA) AND MARYLAND (MD). VT, PA, AND MD DO NOT IMPOSE A CORPORATE INCOME TAX ON INSURANCE COMPANIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: GRANTS -2,112,311. INVESTMENT MANAGEMENT FEES -66,544. EXPENSES NETTED WITH REVENUE ON FINANCIALS -752. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANTS 2,112,311. INVESTMENT MANAGEMENT FEES 66,544. EXPENSES NETTED WITH REVENUE ON FINANCIALS 752. X X X 1 CCS FUNDRAISING PO BOX 824885 PHILADELPHIA PA 19812 CONSULTING AND STRATEGY PLANNING 0 0 0 15750 15750 PA 1 WELLSPAN HEALTH PO BOX 2767 YORK PA 17405 222517863 501(C)(3) 15481 0 GENERAL SUPPORT WELLSPAN MEDICAL GROUP PO BOX 2767 YORK PA 17405 232730785 501(C)(3) 50000 0 GENERAL SUPPORT WAYNESBORO HOSPITAL PO BOX 2767 YORK PA 17405 231360854 501(C)(3) 238219 0 GENERAL SUPPORT CHAMBERSBURG HOSPITAL PO BOX 2767 YORK PA 17405 230465970 501(C)(3) 1726763 0 GENERAL SUPPORT CHAMBERSBURG HEALTH SERVICES PO BOX 2767 YORK PA 17405 251515376 501(C)(3) 81848 0 GENERAL SUPPORT 5 0 PART I, LINE 2: ALL WELLSPAN ENTITIES FOLLOW WELLSPAN POLICIES AND PROCEDURES REGARDING GRANT PROJECTS TO ENSURE THAT THE USE OF GRANT FUNDS ARE CONSISTENT WITH WELLSPAN'S COMMITMENT TO ENDEAVOR TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES THAT WE SERVE. THE WELLSPAN FOUNDATIONS ARE SUPPORTING ORGANIZATIONS AND SUBSTANTIALLY ALL OF THE GRANTS AND OTHER ASSISTANCE THEY MAKE FURTHERS THE EXEMPT PURPOSES OF THEIR "SUPPORTED ORGANIZATIONS", EACH OF WHICH ARE EXEMPT AFFILIATED ORGANIZATIONS WITHIN THE WELLSPAN HEALTH SYSTEM. BECAUSE THE SUPPORTED ORGANIZATIONS IDENTIFY THE PROJECTS AND EXEMPT ACTIVITIES THAT WILL BE FUNDED BY THE FOUNDATIONS' GRANTS AND OTHER ASSISTANCE, AND BECAUSE THERE IS A CROSS-OVER BETWEEN THE RESPECTIVE GOVERNING BODIES AND MANAGEMENT OF THE FOUNDATIONS AND THEIR SUPPORTED ORGANIZATIONS, THE FOUNDATIONS ARE ABLE TO EFFECTIVELY MONITOR THAT THE GRANTS THEY MAKE ARE USED FOR THEIR INTENDED PURPOSES. X X 1 1 X X X X 0 1 0 0 0 0 0 0 0 ROXANNA GAPSTUR PHD RN PRESIDENT & CEO - WELLSPAN HEALTH 0 1654407 0 1111800 0 257508 0 14469 0 85800 0 3123984 0 122031 LAURA BUCZKOWSKI EXECUTIVE VP & CFO - WELLSPAN HEALTH 0 796549 0 382500 0 77665 0 18101 0 61379 0 1336194 0 0 JOHN MASSIMILLA DIRECTOR 0 346569 0 89440 0 57349 0 28939 0 51223 0 573520 0 0 HARVEY GREEN SR. VP & CHIEF DEVELOPMENT OFFICER 0 397785 0 99760 0 1988 0 1777 0 47303 0 548613 0 0 MELISSA DUBROW DIRECTOR 0 245439 0 63360 0 22653 0 15312 0 29101 0 375865 0 0 KATE CASHDOLLAR VICE CHAIRMAN 0 203526 0 0 0 16198 0 6248 0 44585 0 270557 0 0 PART I, LINE 1A THE OFFICERS RECEIVE AN ALLOWANCE THAT CAN BE CONSIDERED A DISCRETIONARY SPENDING ACCOUNT. THE MONIES ARE IN LIEU OF AN AUTOMOBILE ALLOWANCE, TO PURCHASE ADDITIONAL LIFE INSURANCE, ETC. RESULTS FITNESS CLUB MEMBERSHIP IS AVAILABLE FREE OF CHARGE FOR ANY OFFICER AND ACTIVE BOARD MEMBER. 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 INDIVIDUAL RECEIVED A DISTRIBUTION FROM THE DEFERRED COMPENSATION PLAN: ROXANNA GAPSTUR - $122,031 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). FORM 990, PART VI, SECTION A, LINE 6 WELLSPAN SUMMIT HEALTH, A NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER OF THE SUMMIT HEALTH FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A THE PRIMARY PURPOSE OF THE GOVERNANCE COMMITTEE, AS ASSIGNED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, IS TO DEVELOP AND SUPPORT THE CULTURE OF HIGH-FUNCTIONING GOVERNANCE WITHIN THE WELLSPAN SYSTEM, INCLUDING THROUGH POLICIES, NOMINATIONS, COMPETENCIES OF DIRECTORS, EDUCATION, AND SELF-EVALUATIONS. THE GOVERNANCE COMMITTEE SHALL CONSIST OF NOT LESS THAN FIVE (5) NOR MORE THAN SEVEN (7) MEMBERS. NEITHER THE CHAIR OF THE WELLSPAN HEALTH BOARD OF DIRECTORS NOR PERSONS WHO ARE NOT MEMBERS OF THE WELLSPAN HEALTH BOARD OF DIRECTORS, MAY BE APPOINTED TO THE COMMITTEE. EACH GOVERNANCE COMMITTEE MEMBER SHALL BE NOMINATED BY THE GOVERNANCE COMMITTEE, AND APPOINTED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, FOR A TERM OF ONE (1) YEAR. REAPPOINTMENT OF A GOVERNANCE COMMITTEE MEMBER FOR MORE THAN ONE (1) TERM IS NOT AUTOMATIC OR PRESUMED AND SHALL BE BASED ON AN INDIVIDUAL PERFORMANCE EVALUATION OF THE GOVERNANCE COMMITTEE MEMBER (AS PERFORMED OR OVERSEEN BY THE GOVERNANCE COMMITTEE). FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT PROVIDES AN ELECTRONIC COPY OF THE FORM 990 TO EACH VOTING MEMBER OF THE ORGANIZATION'S GOVERNING BODY, PRIOR TO ITS FILING WITH THE IRS. THE ORGANIZATION'S FINANCE MANAGEMENT TEAM PROVIDES A PRESENTATION TO THE AUDIT COMMITTEE ON THE ORGANIZATION'S 990 RETURN. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A WELLSPAN HEALTH "CONFLICT OF INTEREST DISCLOSURE STATEMENT" QUESTIONNAIRE ANNUALLY. THE INTERNAL AUDIT DEPARTMENT OF WELLSPAN HEALTH ADMINISTERS THE QUESTIONNAIRES. THERE SHALL BE FULL DISCLOSURE BY A DIRECTOR HAVING A BUSINESS OR PERSONAL INTEREST OR RELATIONSHIP WHICH MAY BE IN CONFLICT WITH THE INTERESTS OF THE CORPORATION. AFTER SUCH DISCLOSURE, THE DIRECTOR SHALL ABIDE BY THE DETERMINATION OF THE BOARD OF DIRECTORS AS TO WHETHER A CONFLICT EXISTS, THE EXTENT TO WHICH, IF AT ALL, THE DIRECTOR WILL BE PERMITTED TO BE PRESENT DURING THE BOARD OF DIRECTORS' DISCUSSION OF THE MATTER IN WHICH THE DIRECTOR MAY BE INTERESTED, AND WHETHER THE DIRECTOR WILL BE PERMITTED TO PARTICIPATE IN SUCH DISCUSSION AND CAST A VOTE IN SUCH MATTER. ADDITIONALLY, ALL BOARD MEMBERS, EMPLOYEES, STUDENTS, AND VOLUNTEERS OF WELLSPAN HEALTH AND ITS RELATED ORGANIZATIONS MUST COMPLETE A "CODE OF CONDUCT" FORM TO ACKNOWLEDGE THAT HE OR SHE UNDERSTANDS THAT WE ALL HAVE AN OBLIGATION TO ACT IN WAYS THAT WILL MERIT THE TRUST, CONFIDENCE, AND RESPECT OF THE COMMUNITY WE SERVE, OTHER HEALTH CARE PROVIDERS, AND ALL OF THOSE WITH WHOM WE INTERACT. FORM 990, PART VI, SECTION B, LINE 15B THIS ORGANIZATION DOES NOT DIRECTLY COMPENSATE ANY EMPLOYEES. THE FOLLOWING PROCEDURE IS FOLLOWED BY OUR PARENT COMPANY AND AFFILIATES IN SETTING COMPENSATION. THE PRIMARY PURPOSE OF WELLSPAN HEALTH COMPENSATION COMMITTEE, AS ASSIGNED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, IS TO REVIEW COMPENSATION PACKAGES OFFERED AND/OR PAID TO SENIOR SYSTEM EXECUTIVES AND PRACTICING PHYSICIANS EMPLOYED WITHIN THE SYSTEM. THE COMPENSATION COMMITTEE SHALL MONITOR AND EVALUATE THE PERFORMANCE OF THE PRESIDENT AND CEO OF WELLSPAN HEALTH AND SHALL, AT LEAST ANNUALLY, COORDINATE THE IN-PERSON PERFORMANCE REVIEW OF THE PRESIDENT AND CEO BY THE WELLSPAN HEALTH BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE SHALL CONSIST OF 5-10 MEMBERS OF THE WELLSPAN HEALTH BOARD OF DIRECTORS, INCLUDING THE CHAIR AND THE VICE CHAIR. EACH COMPENSATION COMMITTEE MEMBER SHALL BE NOMINATED BY THE GOVERNANCE COMMITTEE, AND APPOINTED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, FOR A TERM OF ONE (1) YEAR. REAPPOINTMENT OF A COMPENSATION COMMITTEE MEMBER FOR MORE THAN ONE (1) TERM IS NOT AUTOMATIC OR PRESUMED AND SHALL BE BASED ON AN INDIVIDUAL PERFORMANCE EVALUATION OF THE COMPENSATION COMMITTEE MEMBER (AS PERFORMED OR OVERSEEN BY THE GOVERNANCE COMMITTEE). THE COMPENSATION COMMITTEE SHALL BE RESPONSIBLE TO, AND SUBJECT TO THE DIRECTION AND CONTROL OF, THE WELLSPAN HEALTH BOARD OF DIRECTORS. THE WELLSPAN HEALTH BOARD OF DIRECTORS SHALL BE SOLELY RESPONSIBLE FOR DELINEATING THE RESPONSIBILITIES OF THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE SHALL PERFORM ONLY SUCH FUNCTIONS AND DUTIES AS SHALL FROM TIME TO TIME BE SPECIFICALLY DELEGATED TO THE COMPENSATION COMMITTEE BY THE WELLSPAN HEALTH BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE DOES NOT HAVE DELEGATED AUTHORITY, AND THEREFORE ANY ACTIONS AND RECOMMENDATIONS OF THE COMMITTEE MUST BE APPROVED BY THE WELLSPAN HEALTH BOARD OF DIRECTORS BEFORE THEY ARE FINAL AND BINDING. IN DISCHARGING ITS ROLE, THE COMPENSATION COMMITTEE IS EMPOWERED TO INQUIRE INTO ANY MATTER IT CONSIDERS APPROPRIATE TO CARRY OUT ITS RESPONSIBILITIES, WITH ACCESS TO ALL BOOKS, RECORDS, FACILITIES, AND PERSONNEL OF THE WELLSPAN SYSTEM. THE FOLLOWING RESPONSIBILITIES ARE SET FORTH AS A GUIDE FOR FULFILLING THE COMPENSATION COMMITTEE'S PURPOSES IN SUCH MANNER AS THE COMMITTEE DETERMINES IS APPROPRIATE: 1. SET, PERIODICALLY REVIEW AND ENSURE COMPLIANCE WITH THE EXECUTIVE COMPENSATION PHILOSOPHY FOR WELLSPAN, IN AN EFFORT TO ATTRACT AND RETAIN HIGH QUALITY EXECUTIVES, WHILE CONSIDERING COMPENSATION OFFERED TO THOSE IN COMPARABLE POSITIONS IN SIMILAR EMPLOYMENT MARKETS AS WELL AS THE SYSTEM'S NEEDS AND FINANCIAL RESOURCES. 2. RECOMMEND APPROVAL OF EXECUTIVE COMPENSATION PROGRAM ELEMENTS (INCENTIVES, SUPPLEMENTAL BENEFITS, ETC.). 3. IN CONJUNCTION WITH THE WELLSPAN HEALTH BOARD OF DIRECTORS, EVALUATE PERFORMANCE AND ESTABLISH COMPENSATION FOR THE PRESIDENT & CEO OF WELLSPAN HEALTH. 4. EVALUATE EXECUTIVE TEAM PERFORMANCE AND ESTABLISH AWARDS. 5. RECOMMEND APPROVAL OF SENIOR EXECUTIVE BASE SALARY RANGES. 6. ALIGN EXECUTIVE COMPENSATION WITH EXECUTIVE TALENT MANAGEMENT AND SUCCESSION. 7. OVERSEE EMPLOYED PHYSICIAN COMPENSATION PROGRAM. 8. THE COMPENSATION COMMITTEE SHALL MAINTAIN MINUTES OF COMPENSATION COMMITTEE MEETINGS AND RECORDS OF ITS ACTIVITIES, AND SHALL REPORT PROMPTLY TO THE WELLSPAN HEALTH BOARD OF DIRECTORS ANY ACTION TAKEN BY THE COMPENSATION COMMITTEE, ANY RECOMMENDATIONS OF THE COMPENSATION COMMITTEE, AND ANY OTHER MATTERS THE COMPENSATION COMMITTEE DEEMS APPROPRIATE TO THE WELLSPAN HEALTH BOARD OF DIRECTORS REQUESTS. 9. THE COMPENSATION COMMITTEE SHALL UNDERTAKE SUCH OTHER RESPONSIBILITIES AS THE WELLSPAN HEALTH BOARD OF DIRECTORS MAY DELEGATE OR ASSIGN TO THE COMPENSATION COMMITTEE FROM TIME TO TIME. THE COMPENSATION COMMITTEE ALSO UTILIZES THE SERVICES OF SULLIVANCOTTER, AN INDEPENDENT, THIRD-PARTY HEALTH CARE COMPENSATION CONSULTANT, TO ALIGN AND STRUCTURE WORKFORCE COMPENSATION AND BENEFIT STRATEGIES THAT SUPPORT ENTERPRISE-WIDE TRANSFORMATION AND BUSINESS PERFORMANCE. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 19,588. TOTAL EXPENSES 19,588. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 138,559. MANAGEMENT AND GENERAL EXPENSES 23,093. FUNDRAISING EXPENSES 69,279. TOTAL EXPENSES 230,931. APPLE HILL SURGICAL CENTER INC PO BOX 2767 YORK PA 174052767 222842253 SURGICAL CENTER PA 501(C)(3) LINE 10 WELLSPAN HEALTH CARE SERVICES 0 CHAMBERSBURG HEALTH SERVICES PO BOX 2767 YORK PA 174052767 251515376 HEALTH CARE SERVICES PA 501(C)(3) LINE 12A, I WELLSPAN SUMMIT HEALTH 0 CHAMBERSBURG HOSPITAL PO BOX 2767 YORK PA 174052767 230465970 HEALTH CARE SERVICES PA 501(C)(3) LINE 3 WELLSPAN SUMMIT HEALTH 0 CHAMBERSBURG HOSPITAL WORKER'S COMPENSATION TRUST PO BOX 2767 YORK PA 174052767 256450683 WORKERS COMPENSATION TRUST PA 501(C)(4) CHAMBERSBURG HOSPITAL 0 EPHRATA COMMUNITY HEALTH FOUNDATION PO BOX 2767 YORK PA 174052767 800940005 FUNDRAISING FOR EPHRATA HOSPITAL PA 501(C)(3) LINE 12A, I EPHRATA COMMUNITY HOSPITAL 0 EPHRATA COMMUNITY HOSPITAL PO BOX 2767 YORK PA 174052767 231370484 HEALTH CARE SERVICES PA 501(C)(3) LINE 3 WELLSPAN HEALTH 0 GETTYSBURG HOSPITAL FOUNDATION PO BOX 2767 YORK PA 174052767 232251358 FUNDRAISING FOR GETTYSBURG HOSPITAL PA 501(C)(3) LINE 12A, I GETTYSBURG 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