2025-06-11T10:38:57-05:00 2024-07-03 222517863 WELLSPAN HEALTH 3350 WHITEFORD ROAD YORK PA 17402 990EZ 2024-07-01 251716306 SUMMIT PHYSICIAN SERVICES SUMM 7178513055 PO BOX 2767 YORK PA 174052767 LAURA BUCZKOWSKI EXECUTIVE VP & CFO 7178513055 2025-06-11 1 0 DAVID RIZZUTO P01210563 7178513055 2025-06-02 2024 2025-03-06 01:10:19Z X X X WWW.WELLSPAN.ORG X X 0 0 0 0 0 0 0 0 0 0 0 0 0 X SUMMIT PHYSICIAN SERVICES, AND THE ASSOCIATED WELLSPAN MEDICAL GROUP, OPERATE ON THE BELIEF THAT A LARGE, WELL-ORGANIZED GROUP PRACTICE, BASED ON PRIMARY AND PREVENTIVE CARE, AND WORKING COLLABORATIVELY AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM, CAN DELIVER A SUPERIOR STANDARD OF CARE. ITS MISSION IS TO PROMOTE AND TO PROVIDE QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES WHICH SEEK TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY. SUMMIT PHYSICIAN SERVICES PROVIDES CARE WITHOUT REGARD FOR AN INDIVIDUAL'S HEALTH STATUS OR ABILITY TO PAY. SUMMIT PHYSICIAN SERVICES TRANSFERRED ITS OPERATIONS TO A TAX-EXEMPT AFFILIATE AND MERGED WITH WELLSPAN MEDICAL GROUP. FOLLOWING THE MERGER, SUMMIT PHYSICIAN SERVICES OPERATIONS CEASED. 0 0 0 X ROXANNA GAPSTUR PHD RN PRESIDENT & CEO - WELLSPAN HEALTH 1.00 0 0 0 LAURA BUCZKOWSKI EXEC. VP & CFO - WELLSPAN HEALTH 1.00 0 0 0 ANTHONY AQUILINA DO EXEC. VP & CHIEF PHYSICIAN EXEC. 1.00 0 0 0 AMY NELSON SECRETARY/SR VP & GENERAL COUNSEL 1.00 0 0 0 ALMIRA CONTRACTOR MD CHAIR 1.00 0 0 0 STEPHEN FLACK MD VICE CHAIR 1.00 0 0 0 ROBERT PARGAMENT MD DIRECTOR 1.00 0 0 0 ROBERT KNIPE DO DIRECTOR 1.00 0 0 0 LARRY MILLER DIRECTOR 1.00 0 0 0 DUANE BRITTON DIRECTOR 1.00 0 0 0 TARA ASSI PA-C DIRECTOR 1.00 0 0 0 AMBER BILLET MD DIRECTOR 1.00 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 PA DAVID P RIZZUTO 3350 WHITEFORD ROAD YORK PA 174052767 7178513055 0 0 0 0 0 0 0 0 0 0 NONE NONE 1 X 22986928 880722 148852 51560 0 24068062 71346767 154805749 172082304 95278934 0 493513754 94333695 155686471 172231156 95330494 517581816 0 0 0 517581816 37284 53536 54987 4246 0 150053 37284 53536 54987 4246 150053 43677108 808295 317627 279841 45082871 138048087 156548302 172603770 95614581 562814740 0.91960 0.93600 0.00030 0.00030 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2020 AMOUNT: $ 43,677,108. 2021 AMOUNT: $ 530,098. MANAGEMENT SERVICE REVENUE - SALARY INCOME - 2021 AMOUNT: $ 172,362. 2022 AMOUNT: $ 236,262. 2023 AMOUNT: $ 268,159. WORK FIRST OCCUP - 2021 AMOUNT: $ 105,835. 2022 AMOUNT: $ 81,365. 2023 AMOUNT: $ 11,682. 1 0 0 0 1 1 1 1 0 PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: ROXANNA GAPSTUR - PRESIDENT & CEO, LAURA BUCZKOWSKI - EXECUTIVE VP & CFO, ANTHONY AQUILINA - EXECUTIVE VP & CHIEF PHYSICIAN EXECUTIVE, AND AMY NELSON - SECRETARY/SR VP & GENERAL COUNSEL, ALMIRA CONTRACTOR - CHAIR, STEPHEN FLACK - VICE CHAIR, ROBERT PARGAMENT - DIRECTOR, ROBERT KNIPE - DIRECTOR, LARRY MILLER - DIRECTOR, DUANE BRITTON - DIRECTOR, TARA ASSI - DIRECTOR, AMBER BILLET - DIRECTOR, JULIAN ESTEBAN - DIRECTOR, LESLEY HUGHES - DIRECTOR, AND SRIKANTH HOSUR - DIRECTOR; ALL BECAME DIRECTORS AND OFFICERS OF THE TRANSFEREE ORGANIZATION. SCHEDULE N, PART I, LINE 1: AT THE ORGANIZATION'S TERMINIATION DATE OF JULY 3, 2024, SUMMIT PHYSICIAN SERVICES HAD NO ASSETS TO BE DISTRIBUTED TO THE TRANSFEREE ORGANIZATION, WELLSPAN MEDICAL GROUP (EIN: 23-2730785). THIS RETURN IS BEING FILED LATE DUE TO AN ADMINISTRATIVE OVERSIGHT AND NOT AN INTENTIONAL ACT. IT HAS COME TO OUR ATTENTION THAT WE FAILED TO FILE THE PROPER EXTENSION FOR THE FINAL FORM 990-EZ WHICH WAS ALSO A SHORT PERIOD. THE RETURN WAS PREPARED AND FILED AS SOON AS THIS CAME TO OUR ATTENTION. WE ARE RESPECTFULLY REQUESTING ANY PENALTIES AND INTEREST BE WAIVED AS THIS WAS NOT AN INTENTIONAL ACT, AND WE BELIEVE OUR FILING HISTORY WILL SHOW THAT WE HAVE BEEN IN GOOD STANDING WITH REGARDS TO TAX FILINGS.