2026-05-08T08:56:55-05:00 2025-06-30 920460586 PWC US TAX LLP 655 NEW YORK AVENUE NW - SUITE 1100 WASHINGTON DC 20001 990 2024-07-01 230794160 THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA GOOD 7178513055 PO BOX 2767 YORK PA 174052767 LAURA BUCZKOWSKI EXECUTIVE VP & CFO 7178513055 2026-05-08 1 1 TRAVIS L PATTON P00369623 2024141000 2024 2025-03-06 01:10:19Z ROXANNA GAPSTUR PO BOX 2767 YORK PA 174052767 340986192 0 X WWW.WELLSPAN.ORG X 1891 PA PROVIDE HIGH-QUALITY, COMPASSIONATE HEALTHCARE TO IMPROVE OVERALL HEALTH OF THE COMMUNITY. 14 7 1236 87 1561431 237253 2096438 1121294 322572310 335165729 436935 811997 -403174 -369166 324702509 336729854 408180 558185 0 0 89721664 93088475 0 0 0 231065333 222938694 321195177 316585354 3507332 20144500 116365909 125634767 113874702 99053385 2491207 26581382 X THE GOOD SAMARITAN HOSPITAL IS A TAX-EXEMPT ORGANIZATION DEDICATED TO PROVIDING HIGH-QUALITY, COMPASSIONATE HEALTHCARE THAT IMPROVES THE OVERALL HEALTH OF THE COMMUNITY. 0 0 231526415 558185 333612866 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.THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA HAD 8,816 ADMISSIONS, 39,714 PATIENT DAYS, 5,588 SURGICAL CASES, 46,568 EMERGENCY DEPARTMENT VISITS AND 661 BIRTHS DURING FISCAL YEAR 2025.DURING THE FISCAL YEAR THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA HAD THE FOLLOWING ACHIEVEMENTS:- EARNED AN "A" SAFETY GRADE RATING FROM THE LEAPFROG GROUP.- HONORED WITH THE PARTNER FOR CHANGE AWARD AS A PART OF THE 2025 PRACTICE GREENHEALTH ENVIRONMENTAL EXCELLENCE AWARDS. THIS RECOGNITION HIGHLIGHTS WELLSPAN HEALTH'S LONG-TERM COMMITMENT TO CREATING A GREENER ENVIRONMENT FOR OUR PATIENTS AND COMMUNITIES.- RECOGNIZED BY THE HOSPITAL AND HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA (HAP) IN THE OPTIMAL OPERATIONS CATEGORY FOR EFFORTS TO STREAMLINE PROCESSES TO PROVIDE THE BEST POSSIBLE CARE FOR PATIENTS IN LEBANON COUNTY.SEE WELLSPAN HEALTH - 2025 COMMUNITY BENEFIT REPORT LOCATED AT HTTPS://WWW.WELLSPAN.ORG/ABOUT-WELLSPAN/IMPROVING-HEALTHY-COMMUNITIES/COMMUNITY-BENEFIT. 231526415 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1236 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 7 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 1 PA X DAVID P RIZZUTO 7178513055 3350 WHITEFORD ROAD YORK PA 174029081 ROXANNA GAPSTUR PHD RN PRESIDENT & CEO - WELLSPAN HEALTH 1.00 40.00 X X 0 3124465 52133 LAURA BUCZKOWSKI EXECUTIVE VP & CFO - WELLSPAN HEALTH 1.00 40.00 X X 0 1355384 53169 MONIQUA ACOSTA CHAIR 1.00 2.00 X X 0 0 0 CARRIE WILSON VICE CHAIR 1.00 2.00 X X 0 0 0 ROBERT FUNK DIRECTOR 1.00 2.00 X 0 0 0 CHRISTOPHER GRANT PSY D DIRECTOR 1.00 40.00 X 0 74543 24986 ROBERT HOFFMAN DIRECTOR 1.00 3.00 X 0 0 0 KIMBERLY KREIDER UMBLE DIRECTOR 1.00 2.00 X 0 0 0 STEPHEN LINDSEY DIRECTOR 1.00 2.00 X 0 0 0 MICHAEL SEIM SR VP & CHIEF QUALITY OFFICER 1.00 40.00 X X 0 987854 54244 EDWARD TADAJWESKI MD DIRECTOR 1.00 40.00 X 0 763266 53911 ROGER ZIMMERMAN DIRECTOR 1.00 2.00 X 0 0 0 JAMES STUCCIO DIRECTOR/SVP - EAST REGION 1.00 40.00 X X 0 823930 48587 AMY NELSON SECRETARY/SR VP & GENERAL COUNSEL 1.00 40.00 X X 0 873620 74125 PATRICIA DONLEY VP & PRES.-GSH (UNTIL 3/25)/CNO 40.00 0.00 X 415679 0 36914 TINA CITRO VP&PRES-GSH(EFF. 3/25)/VP&PRES-ECH 10.00 30.00 X 0 409858 53379 VALERIE ADAMS VP - PATIENT CARE SERVICES AND CNO 40.00 0.00 X 274530 0 25535 JILIAN WHITE MD VP - MEDICAL AFFAIRS 40.00 0.00 X 470425 0 50827 VIRGINIA SANGER SR DIR ANCILLIARY & SUPPORT SERVICES 40.00 0.00 X 228100 0 34775 DEBRA NEY MANAGER - PHARMACY OPERATIONS 40.00 0.00 X 212243 0 28127 BONNIE PIETRUCH DIRECTOR - CLINICAL SERVICES 40.00 0.00 X 199053 0 14324 LORRAINE CUNNINGHAM PHARMACIST 40.00 0.00 X 186033 0 36804 STEPHANIE THOMPSON DIRECTOR - CLINICAL SERVICES 40.00 0.00 X 195713 0 40900 FARAAZ YOUSUF FORMER EXECUTIVE VP & COO 0.00 0.00 X 0 1056585 37354 ROBERT SHAVER FORMER VP - MEDICAL AFFAIRS 0.00 0.00 X 0 226141 12980 2181776 9695646 733074 157 1 1 0 HEALTHTRUST WORKFORCE SOLUTIONS 6565 N MACARTHUR BLVD STE 325 IRIVNG TX 75039 STAFFING SERVICES 4428818 QUEST DIAGNOSTICS PO BOX 912512 PASADENA CA 91110 LAB SERVICES 771972 PROCIRCA 1020 MADISON AVE SUITE C-700 PITTSBURGH PA 15213 HEALTHCARE SERVICES 747695 FIRST AID AND SAFETY PATROL PO BOX 108 LEBANON PA 17042 TRANSPORT SERVICES 338847 NEW HEALTHWORKS INC 515 OLD SWEDE ROAD DOUGLASSVILLE PA 19518 STAFFING SERVICES 300399 6 322520 663880 134894 1121294 PATIENT SERVICES 621500 335165729 333612866 1552863 335165729 385341 385341 873207 1339807 -466600 -466600 -466600 3321604 21583 2916531 0 405073 21583 426656 426656 SALARY REIMBURSEMENT 900099 55499 55499 REFUNDS 900099 22785 22785 MANGEMENT FEE 561000 8568 8568 10582 10582 97434 336729854 333612866 1561431 434263 X 534892 534892 23293 23293 1373515 1373515 69997643 69838358 159285 3248358 3156569 91789 13545425 11006558 2538867 4923534 4583310 340224 72326398 72326398 56247 56247 15633 15633 72626 72626 63237131 62650843 586288 18355 18355 818652 813726 4926 343703 341794 1909 4959140 4390942 568198 88147 77859 10288 19184 17545 1639 3092785 3092785 6151640 6144290 7350 2947688 2947688 FEDERAL INCOME TAX 30682 30682 MEDICAL SUPPLIES 38459971 38459971 BAD DEBT EXPENSE 20806188 20806188 TAXES & LICENSES 6897213 70415 6826798 2597311 2520352 76959 316585354 231526415 85058939 0 2867 2368 1800000 1080000 30482763 33044734 785459 786760 290598 147755 186227619 120913366 60142642 65314253 15273764 15838582 2124405 3436225 4825037 5322655 114955 114955 523419 546480 116365909 125634767 14060961 13072955 96939 2405500 2011549 1952005 14152 0 97691101 81622925 113874702 99053385 X -2304096 16036178 4795303 10545204 2491207 26581382 116365909 125634767 X 20144500 757795 3187880 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 15633 15633 0 PART II-B, LINE 1: A PORTION OF THE DUES PAID TO THE HOSPITAL ASSOCIATION OF PENNSYLVANIA AND THE AMERICAN HOSPITAL ASSOCIATION INCLUDE LOBBYING ($1,528 AND $14,105). 9524525 886260 483484 349065 10545204 7618813 2614522 866239 1575049 9524525 7586927 317454 446004 731572 7618813 6330653 1863355 -54983 552098 7586927 8183834 1853565 281589 3988335 6330653 0.00000 0.66800 0.33200 0 0 1468847 1468847 113320711 73416695 39904016 8502171 7154985 1347186 56235706 40341686 15894020 6700184 6700184 65314253 INTERCOMPANY PAYABLE 81622925 81622925 X 318188274 757795 191808 -20830990 -19881387 338069661 -1339807 -1339807 336729854 294098099 191808 1339807 1531615 292566484 24018870 24018870 316585354 PART V, LINE 4: THE FUNDS WERE USED TO IMPROVE THE HEALTH AND WELFARE OF THE RESIDENTS OF LEBANON COUNTY 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, 2025, AND 2024. 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, 2025, THE COMPANY HAS NO UNCERTAIN TAX POSITIONS. FOR YEARS BEFORE 2022, THE COMPANY IS NO LONGER SUBJECT TO EXAMINATIONS FROM MAJOR TAXING JURISDICTIONS. 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: GAIN ON PENSION PLAN 190,263. GRANTS -534,892. MANAGEMENT FEES -258,630. BAD DEBT -20,599,776. INVESTMENT FEES -72,626. CHANGE IN FOUNDATION NET ASSETS 497,617. TRANSFER TO AFFILIATES -13,100,000. TRANSFER FROM AFFILIATES 15,600,000. FEDERAL INCOME TAX -30,682. EXPENSES NETTED WITH REVENUE ON FINANCIALS -2,522,264. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -1,339,807. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 1,339,807. PART XII, LINE 4B - OTHER ADJUSTMENTS: GRANTS 534,892. MANAGEMENT FEE 258,630. BAD DEBT 20,599,776. INVESTMENT FEES 72,626. FEDERAL INCOME TAX 30,682. EXPENSES NETTED WITH REVENUE ON FINANCIALS 2,522,264. 1 1 X 1 X 300.000000000000 1 X 1 1 0 1 1 2369489 2369489 0.00800 46672215 20411836 26260379 0.08880 49041704 20411836 28629868 0.09680 20 8980 759092 759092 0.00260 1 15884 15884 0.00010 2 717690 717690 0.00240 4 40 579761 579761 0.00200 27 9020 2072427 2072427 0.00710 27 9020 51114131 20411836 30702295 0.10390 1 250000 250000 0.00080 1 70661 70661 0.00020 1 16500 16500 0.00010 1 81 653451 653451 0.00220 4 81 990612 990612 0.00330 1 5355608 84619 118940077 119192103 -252026 X 1 1 1 1 THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA 4TH WALNUT STREET LEBANON PA 17042 WWW.WELLSPAN.ORG 072401 X X X X THE GOOD SAMARITAN HOSPITAL OF LEBANON P 1 0 0 1 X X X X X X X X X 24 1 1 1 1 X WWW.WELLSPAN.ORG X VARIOUS COALITION WEBSITES - PART VI, LINE 5 EXPLANATION X X 1 24 1 WWW.WELLSPAN.ORG 0 1 X 300.000000000000 350.000000000000 X X X X X X X 1 1 X X X X 1 X WWW.WELLSPAN.ORG X WWW.WELLSPAN.ORG X WWW.WELLSPAN.ORG X X X X X X X 1 X 0 X X X X 1 X 0 0 THE GOOD SAMARITAN HOSPITAL OF LEBANON PA PART V, SECTION B, LINE 5: COMMUNITY STAKEHOLDER ENGAGEMENT HAS BEEN VITAL TO THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS SINCE IT BEGAN IN YORK COUNTY IN 1994. COUNTY HEALTH COALITIONS ACROSS THE REGION, INCLUDING HEALTHY ADAMS COUNTY, HEALTHY FRANKLIN COUNTY, HEALTHY YORK, AND THE COMMUNITY HEALTH COUNCIL OF LEBANON COUNTY HAVE BEEN INSTRUMENTAL IN THE COMPLETION OF WELLSPAN'S COMMUNITY HEALTH NEEDS ASSESSMENT. THE COALITION LEADERS HAVE BEEN ACTIVELY ENGAGED THROUGHOUT THE PROCESS AND HAVE PROVIDED EXPERTISE AND GUIDANCE WHILE ALSO ENSURING THEIR LEADERSHIP AND COMMUNITY PARTNERS ARE HEARD AND ENGAGED IN THE NEEDS ASSESSMENT PROCESS. ADDITIONALLY, A DIVERSE GROUP OF STAKEHOLDERS INCLUDING COMMUNITY NOT-FOR-PROFIT AGENCIES, ELECTED OFFICIALS, FEDERALLY QUALIFIED HEALTH CENTERS, AND PUBLIC HEALTH EXPERTS, WERE ACTIVELY ENGAGED IN THE PROCESS. THE GOOD SAMARITAN HOSPITAL OF LEBANON PA PART V, SECTION B, LINE 6A: WELLSPAN'S COMMUNITY HEALTH NEEDS ASSESSMENT IS PREPARED BY THE PARENT ORGANIZATION, WELLSPAN HEALTH, AND INCLUDES COLLECTIVE EFFORTS OF ALL ENTITIES UNDER THE PARENT ORGANIZATION. HOSPITALS:1. YORK HOSPITAL2. GETTYSBURG HOSPITAL3. CHAMBERSBURG HOSPITAL4. WAYNESBORO HOSPITAL5. EPHRATA COMMUNITY HOSPITAL6. THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA7. WELLSPAN SURGERY & REHABILITATION HOSPITAL8. PHILHAVEN9. EVANGELICAL COMMUNITY HOSPITALFOUNDATIONS:1. YORK HEALTH FOUNDATION2. SUMMIT HEALTH FOUNDATION3. GETTYSBURG HOSPITAL FOUNDATION4. EPHRATA COMMUNITY HEALTH FOUNDATION5. GOOD SAMARITAN HEALTH SERVICES FOUNDATION6. EVANGELICAL COMMUNITY HOSPITAL FOUNDATIONMEDICAL SERVICES:1. APPLE HILL SURGICAL CENTER, INC.2. VNA HOME HEALTH SERVICES3. WELLSPAN HEALTH CARE SERVICES4. WELLSPAN MEDICAL GROUP5. WELLSPAN SUMMIT HEALTH6. GOOD SAMARITAN PHYSICIAN SERVICES7. HEALTHY COMMUNITY PHARMACY THE GOOD SAMARITAN HOSPITAL OF LEBANON PA PART V, SECTION B, LINE 6B: COUNTY HEALTH COALITIONS ACROSS THE REGION, INCLUDING HEALTHY ADAMS COUNTY, HEALTHY FRANKLIN COUNTY, HEALTHY YORK, AND THE COMMUNITY HEALTH COUNCIL OF LEBANON COUNTY HAVE BEEN INSTRUMENTAL IN THE COMPLETION OF WELLSPAN'S COMMUNITY HEALTH NEEDS ASSESSMENT. THE COALITION LEADERS HAVE BEEN ACTIVELY ENGAGED THROUGHOUT THE PROCESS AND HAVE PROVIDED EXPERTISE AND GUIDANCE WHILE ALSO ENSURING THEIR LEADERSHIP AND COMMUNITY PARTNERS ARE HEARD AND ENGAGED IN THE NEEDS ASSESSMENT PROCESS. FEDERALLY QUALIFIED HEALTH CENTERS ACROSS WELLSPAN'S REGION WERE ALSO CONTRIBUTING PARTNERS, INCLUDING FAMILY FIRST HEALTH, KEYSTONE HEALTH, AND UNION COMMUNITY CARE. THE GOOD SAMARITAN HOSPITAL OF LEBANON PA PART V, SECTION B, LINE 7D: WITH EACH ITERATION OF THE CHNA PROCESS, WELLSPAN AND ITS COMMUNITY PARTNERS CONTINUE TO REFINE AND ENHANCE THE SYSTEM BY WHICH IT OBTAINS DATA, SHARED IT WITH KEY COMMUNITY, HOSPITAL ENTITIES, AND SYSTEM LEADERS, AND INTEGRATED IT INTO THE SYSTEM-WIDE AND ENTITY-LEVEL PLANNING PROCESSES. THE CHNA RESULTS AND RELATED PRIORITIES IDENTIFIED WERE SHARED WITH WELLSPAN HEALTH'S REGIONAL BOARDS OF DIRECTORS AND THE SYSTEM-WIDE LEADERSHIP TEAMS. THIS STAKEHOLDER GROUP IS COMPRISED OF COMMUNITY MEMBERS AND LEADERS THAT REPRESENT EACH OF WELLSPAN'S PRIMARY ENTITIES AND SERVICE AREAS, IN ADDITION TO EXECUTIVE LEADERSHIP. COLLECTIVE INPUT WAS USED TO ESTABLISH SYSTEM-WIDE PRIORITIES. THE ESTABLISHED COMMUNITY-DRIVEN COUNTY HEALTH COALITIONS AND WELLSPAN SPECIFIC PRIORITIES AND ASSOCIATED DATA WERE PRESENTED TO THE WELLSPAN HEALTH BOARD FOR THEIR ADOPTION. EACH COUNTY HEALTH COALITION HOSTED A PUBLIC FORUM TO COMMUNICATE THE CHNA RESULTS AND IDENTIFY PRIORITIES TO HUNDREDS OF COMMUNITY MEMBERS ACROSS THE REGION. DURING THE FORUMS, COMMUNITY MEMBERS DISCUSSED THE OPPORTUNITIES AND RISKS ASSOCIATED WITH EACH PRIORITY, AS WELL AS HOW THE ORGANIZATION WHICH THEY REPRESENT CAN HAVE AN IMPACT ON EACH PRIORITY. IN ADDITION TO THESE VENUES, CHNA RESULTS ARE AVAILABLE ON EACH COALITION'S WEBSITE, AS WELL AS WELLSPAN HEALTH'S WEBSITE AND MAY ALSO BE OBTAINED UPON REQUEST. THE CORRESPONDING WELLSPAN COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IS ALSO AVAILABLE ON THE WELLSPAN HEALTH WEBSITE. THE GOOD SAMARITAN HOSPITAL OF LEBANON PA PART V, SECTION B, LINE 11: WELLSPAN'S THREE-YEAR COMMUNITY HEALTH IMPROVEMENT PLAN PROVIDES A FRAMEWORK FOR THE ORGANIZATION'S PROGRAMS AND ACTIVITIES THAT PROMOTE HEALTH AND WELLNESS IN RESPONSE TO THE NEEDS IDENTIFIED IN THE CHNA REPORTS. THESE AREAS OF FOCUS MEET AT LEAST ONE, AND OFTEN SEVERAL, OF THE COMMUNITY BENEFIT GUIDELINES OF A NONPROFIT HEALTH SYSTEM, AS OUTLINED BY THE CATHOLIC HEALTH ASSOCIATION: IMPROVING ACCESS TO HEALTHCARE SERVICES; ENHANCING THE HEALTH OF THE COMMUNITY; ADVANCING MEDICAL OR HEALTHCARE KNOWLEDGE OR RELIEVING OR REDUCING THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. SPECIFIC PRIORITIES ARE THEN INCORPORATED INTO WELLSPAN'S ANNUAL OPERATING PLAN AND BUDGET.WHILE THIS PLAN INCLUDES AN ARRAY OF GOALS AND OBJECTIVES FOR BROAD PRIORITY AREAS, IT DOES NOT ADDRESS ALL HEALTH-RELATED ISSUES IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. WELLSPAN USES THE FOLLOWING CRITERIA TO DETERMINE WHEN NOT TO ADDRESS AN IDENTIFIED NEED IN OUR FORMAL COMMUNITY HEALTH IMPROVEMENT PLAN:1. EFFORTS SPECIFIC TO AN ISSUE ARE ALREADY UNDERWAY AND WILL CONTINUE, THEREFORE A CALL-OUT IN THE COMMUNITY HEALTH IMPROVEMENT PLAN IS UNNECESSARY.2. ISSUE APPEARS TO BE EMERGING AND WARRANTS MONITORING, BUT NOT AFFECTING THE COMMUNITY IN A MANNER THAT REQUIRES IMMEDIATE ACTION.3. A COMMUNITY-WIDE OR PARTNER SPECIFIC APPROACH WOULD BE MORE EFFECTIVE IN ADDRESSING THE NEED.OUR HEALTH SYSTEM AND COMMUNITY CONTINUE TO EXPERIENCE HARDSHIPS AS A RESULT OF WORKFORCE SHORTAGES, CHALLENGING FINANCIAL TIMES AND HEALTH CARE EXPENSES. DESPITE THESE CHALLENGING TIMES, WELLSPAN REMAINS FOCUSED ON OUR MISSION-DRIVEN COMMITMENT TO THE COMMUNITIES WE SERVE. WE WILL CONTINUE IN OUR RELENTLESS GOAL OF BUILDING VIBRANT COMMUNITIES AND WILL ADVANCE EFFORTS THAT PROMOTE HEALTHY LIVING, COLLABORATE WITH PARTNERS TO ADDRESS ISSUES IMPORTANT TO EACH LOCAL COMMUNITY AND MONITOR EMERGING TRENDS THAT MAY WARRANT ACTION IN THE FUTURE.SEE THE WELLSPAN HEALTH COMMUNITY HEALTH IMPROVEMENT PLAN AVAILABLE ONLINE AT: HTTPS://WWW.WELLSPAN.ORG/ABOUT/WELLSPAN-IN-THE-COMMUNITY/. THE GOOD SAMARITAN HOSPITAL OF LEBANON PA PART V, SECTION B, LINE 13H: WELLSPAN HEALTH IS COMMITTED TO CARING FOR ALL THE MEMBERS OF ITS COMMUNITIES, REGARDLESS OF THEIR ABILITY TO PAY. IN RECENT YEARS, OVERALL CHARITY CARE HAS DECREASED SLIGHTLY AS MORE PEOPLE HAVE OBTAINED HEALTH INSURANCE COVERAGE THROUGH THE AFFORDABLE CARE ACT AND THE EXPANSION OF PENNSYLVANIA'S MEDICAL ASSISTANCE (MEDICAID) PROGRAM. WELLSPAN IS PROUD TO BE A LEADING PARTNER IN THE HEALTHY COMMUNITY NETWORK, WHICH WORKS TO ADDRESS THE NEEDS OF UNINSURED AND UNDERINSURED INDIVIDUALS IN OUR COMMUNITY. IN ADDITION, THE HEALTH SYSTEM RECENTLY ENHANCED ITS FINANCIAL ASSISTANCE POLICY AND THE DISCOUNTS THAT IT PROVIDES ON SERVICES. FOR MORE INFORMATION ON WELLSPAN'S FINANCIAL ASSISTANCE PROGRAM, VISIT HTTPS://WWW.WELLSPAN.ORG/PATIENTS-VISITORS/PATIENT-GUIDE/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/. THE GOOD SAMARITAN HOSPITAL OF LEBANON PA PART V, SECTION B, LINE 16J: IN AN EFFORT TO MAKE PATIENTS, FAMILIES AND OTHERS IN OUR COMMUNITIES AWARE OF THE NEWLY EXPANDED FINANCIAL ASSISTANCE POLICY (FAP), WELLSPAN BROADLY PUBLICIZED ITS POLICY VIA PROMOTIONAL SIGNAGE AND THE DISTRIBUTION OF EASY-TO-READ INFORMATIONAL MATERIALS AT REGISTRATION SITES THROUGHOUT OUR COMMUNITIES. WELLSPAN PROVIDED INFORMATION ON THE FAP ON ITS BILLING STATEMENTS AND INCLUDED INFORMATION IN PATIENT DISCHARGE MATERIALS. IN ADDITION, THE MATERIALS AND INFORMATION ARE EASILY ACCESSIBLE VIA WELLSPAN'S WEBSITE AT WWW.WELLSPAN.ORG. THE SITE REFLECTS WELLSPAN'S NEWLY ENHANCED POLICY, AS WELL AS INFORMATIONAL AND APPLICATION MATERIALS. IT WAS ALSO PUBLICIZED VIA WELLSPAN'S ON-HOLD PHONE MESSAGING SYSTEM AND IN ITS DIRECT-TO-CONSUMER COMMUNITY NEWSLETTER/MAGAZINE, WHICH IS DISTRIBUTED BY MAIL, EMAIL AND ON-LINE. IN ADDITION, WELLSPAN PLACED POSTERS AND SIGNAGE AT ITS VARIOUS SITES OF CARE TO PUBLICIZE THE FAP. PRINTED COPIES OF WELLSPAN HEALTH'S POLICY AND THE PLAIN LANGUAGE SUMMARY OF THE POLICY, BOTH OF WHICH ARE AVAILABLE IN ENGLISH AND SPANISH, MAY BE OBTAINED AT NO COST BY VISITING OR CALLING ONE OF THE WELLSPAN PATIENT FINANCIAL SERVICES OFFICES.THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION, AND THE FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY ARE ALL AVAILABLE IN ENGLISH AND SPANISH. 14 1 - WELLSPAN SECHLER FAMILY CANCER CENTER 844 TUCK STREET LEBANON PA 170427477 CANCER CENTER 2 - WELLSPAN IMAGING SERVICES PALMYRA 1400 SOUTH FORGE ROAD PALMYRA PA 170789519 IMAGINGING SERVICES 3 - WELLSPAN REHAB 1400 SOUTH FORGE ROAD PALMYRA PA 170789519 REHABILITATION SERVICES 4 - WELLSPAN IMAGING 297 WEST LINCOLN AVENUE MYERSTOWN PA 170672324 IMAGINGING SERVICES 5 - WELLSPAN WOUND HEALING 840 TUCK STREET LEBANON PA 170427477 WOUND HEALING SERVICES 6 - WELLSPAN DIXON FOUNDATION HEALTH CENTER 30 NORTH 4TH STREET LEBANON PA 170465606 REHABILITATION SERVICES 7 - WELLSPAN GOOD SAMARITAN HOSPITAL SLEEP C 206 HATHAWAY PARK LEBANON PA 170426162 SLEEP CENTER 8 - WELLSPAN REHABILITATION MYERSTOWN 11 EAST LINCOLN AVENUE MYERSTOWN PA 170671108 REHABILITATION SERVICES 9 - WELLSPAN REHABILITATION QUENTIN CIRCLE 950 ISABEL DRIVE LEBANON PA 170427482 REHABILITATION SERVICES 10 - WELLSPAN SURGERY CENTER 830 TUCK STREET LEBANON PA 170427477 OUTPATIENT SURGERY CENTER 11 - WELLSPAN GOOD SAMARITAN HOSPITAL 30 NORTH 4TH STREET LEBANON PA 170465606 PATIENT SERVICES 12 - WELLSPAN GOOD SAMARITAN HOSPITAL BLOOD D 750 NORMAN DRIVE LEBANON PA 170427495 BLOOD DONOR CENTER & LAB 13 - WELLSPAN IMAGING 805 HELEN DRIVE LEBANON PA 170427493 IMAGINGING SERVICES 14 - WELLSPAN CARDIOVASCULAR DIAGNOSTIC CENTE 781 NORMAN DRIVE LEBANON PA 170427497 CARDIOVASCULAR DIAGNOSTIC CENTER PART I, LINE 3C: PATIENTS/GUARANTORS WHO COMPLETE AN APPLICATION FOR FINANCIAL ASSISTANCE, WHOSE GROSS INCOME FALLS BETWEEN 351-400% OF THE FEDERAL POVERTY LEVEL (FPL), AND MEET ALL OTHER FINANCIAL ASSISTANCE QUALIFICATIONS, WILL BE ELIGIBLE FOR A 40% DISCOUNT ON SELF-PAY BALANCES. PATIENTS WHO HAVE GROSS INCOME IN EXCESS OF 400% OF FPL DO NOT QUALIFY FOR FINANCIAL ASSISTANCE. PART I, LINE 6A: COMMUNITY BENEFIT INFORMATION IS INCLUDED IN THE COMMUNITY BENEFIT REPORT FOR WELLSPAN HEALTH. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 20,806,188. PART II, COMMUNITY BUILDING ACTIVITIES: ECONOMIC DEVELOPMENT:WELLSPAN IS A GOOD STEWARD IN THE COMMUNITY AND SERVES AS AN ANCHOR ORGANIZATION. ANNUALLY, WELLSPAN CONTRIBUTES FINANCIALLY TO SUPPORT LOCAL MUNICIPALITIES, SCHOOL DISTRICTS, PUBLIC SERVICE AGENCIES (FIRE AND POLICE DEPARTMENTS, FOR EXAMPLE) AND LOCAL GOVERNMENT. THESE CONTRIBUTIONS SUPPORT THE ECONOMIC DEVELOPMENT OF THE COMMUNITY, ADVANCE PUBLIC HEALTH AND SAFETY EFFORTS, AND SUPPORT NECESSARY IMPROVEMENTS AT AREA SCHOOLS. IN THE PAST 5 YEARS, WELLSPAN HAS CONTRIBUTED A COLLECTIVE $1,074,00 TO THE GEOGRAPHIC REGION WHERE GOOD SAMARITAN HOSPITAL IS LOCATED WITH $250,000 CONTRIBUTED THIS YEAR. ADDITIONALLY, OVER THE PAST 5 YEARS, NEARLY $2.5 MILLION HAS BEEN CONTRIBUTED TO THE GREATER LEBANON AREA, INCLUDING CONTRIBUTIONS TO NEIGHBORING LANCASTER COUNTY. COALITION BUILDING:A CORE PILLAR OF WELLSPAN'S COMMUNITY-DRIVEN APPROACH INCLUDES LEANING INTO OUR ROLE AS A CONVENOR IN THE COMMUNITY. IN THE LEBANON COUNTY COMMUNITY, THIS INCLUDES FINANCIALLY SUPPORTING THE COMMUNITY HEALTH COUNCIL OF LEBANON COUNTY, A COLLABORATIVE GROUP THAT BRINGS TOGETHER STAKEHOLDERS FROM ACROSS THE COMMUNITY TO DISCUSS COMMON HEALTH GOALS AND OPPORTUNITIES. WELLSPAN'S FINANCIAL COMMITMENT INCLUDES SUPPORT FOR THE SALARY AND BENEFIT EXPENSES FOR THE EXECUTIVE DIRECTOR POSITION AS WELL AS EXPENSES ASSOCIATED WITH THE COMMUNITY HEALTH NEEDS ASSESSMENT/ COMMUNITY HEALTH IMPROVEMENT PLAN DISSEMINATION AND GENERAL PROGRAMMING EXPENSES, TOTALING ROUGHLY $71,000 IN FY25. COMMUNITY HEALTH IMPROVEMENT ADVOCACY:WELLSPAN HEALTH IS PROUD TO OPERATE THE LONGEST-RUNNING MEDICAL-LEGAL PARTNERSHIP (MLP) IN SOUTH CENTRAL PENNSYLVANIA, DEMONSTRATING A LONGSTANDING COMMITMENT TO ADDRESSING HEALTH-HARMING LEGAL NEEDS THAT IMPACT PATIENT HEALTH. THIS CRITICAL PROGRAM IS FUNDED THROUGH A STRATEGIC THREE-PRONGED APPROACH - PAYER SUPPORT, PHILANTHROPIC CONTRIBUTIONS, AND OPERATIONAL FUNDS WHICH CURRENTLY SUSTAINS A 1.0 FTE ATTORNEY THROUGH MIDPENN LEGAL SERVICES AND A 0.5 FTE ATTORNEY THROUGH THE PENNSYLVANIA IMMIGRATION RESOURCE CENTER (PIRC). IN RESPONSE TO SYSTEM GROWTH, INCLUDING THE ACQUISITION OF EVANGELICAL COMMUNITY HOSPITAL, AND A REDUCTION IN AVAILABLE COMMUNITY RESOURCES, FUTURE EXPANSION MAY INVOLVE INCREASING MIDPENN LEGAL SUPPORT TO 1.5 FTE ATTORNEYS AND EXPANDING THE PIRC ROLE TO A FULL-TIME 1.0 FTE TO MEET THE GROWING DEMAND FOR IMMIGRATION-RELATED LEGAL ASSISTANCE. THIS STRATEGIC GROWTH WILL STRENGTHEN WELLSPAN'S ABILITY TO ADDRESS SOCIAL DETERMINANTS OF HEALTH AND IMPROVE HEALTH OUTCOMES FOR VULNERABLE POPULATIONS ACROSS THE REGION. TO DATE, THE PROGRAM HAS DELIVERED $16,500 IN DIRECT MONETARY BENEFITS TO THE LOCAL COMMUNITY, AN INVESTMENT THAT CONTINUES TO GROW IN BOTH VALUE AND IMPACT.WORKFORCE DEVELOPMENT:WELLSPAN SUPPORTS A ROBUST UNPAID INTERNSHIP PROGRAM THAT HOSTS AN AVERAGE OF 500 STUDENTS ANNUALLY, CONTRIBUTING AN AVERAGE OF MORE THAN 105,000 HOURS WITH OUR TEAMS ACROSS THE ENTIRETY OF WELLSPAN'S FOOTPRINT- INCLUDING MORE THAN 8,100 HOURS FOR 81 STUDENTS THIS YEAR AT GOOD SAMARITAN HOSPITAL. OUR TEAM MEMBERS CONTRIBUTE THEIR TIME TO ADVANCE STUDENTS' KNOWLEDGE- OFTEN GOING ABOVE AND BEYOND THEIR NORMAL RESPONSIBILITIES. THE COMMUNITY BENEFIT CONTRIBUTION FOR THIS PROGRAM INCLUDES STAFF TIME MENTORING INTERNS THAT EXCEEDS THEIR NORMAL JOB EXPECTATIONS. WELLSPAN BELIEVES STRONGLY IN FOSTERING A LEARNING ENVIRONMENT FOR COLLEGE STUDENTS LOOKING TO EXPLORE CAREERS IN HEALTHCARE. PART III, LINE 2: THE NUMBER WAS CALCULATED USING THE COST TO CHARGE RATIO FACTOR APPLIED AGAINST ACTUAL PATIENT BAD DEBT WRITE-OFFS. THESE NUMBERS ARE INCLUDED AFTER ALL EFFORTS HAVE BEEN EXHAUSTED TO DETERMINE IF THE PATIENT MEETS OUR CHARITY CARE WRITE-OFF POLICY BASED ON FEDERAL POVERTY LEVELS. PART III, LINE 3: THE ESTIMATE OF BAD DEBT ATTRIBUTABLE TO CHARITY CARE POLICY WAS CALCULATED BY DIVIDING THE BAD DEBT AMOUNT THAT WAS ORIGINALLY CODED BAD DEBT BUT LATER FOUND TO QUALIFY AS CHARITY CARE BY THE AMOUNT CODED TO THE CHARITY CARE WRITE-OFF CODES. THIS RATIO IS APPLIED TO THE BAD DEBT COST FACTOR EXPENSE. PART III, LINE 4: THE GOOD SAMARITAN HOSPITAL OF LEBANON PA PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR ESTIMATED LOSSES RESULTING FROM THE UNWILLINGNESS OR INABILITY OF PATIENTS TO MAKE PAYMENTS FOR SERVICES. THE ALLOWANCE IS DETERMINED BY ANALYZING SPECIFIC AMOUNTS AND HISTORICAL DATA AND TRENDS. PATIENT ACCOUNTS RECEIVABLE ARE CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS WHEN MANAGEMENT DETERMINES THAT RECOVERY IS UNLIKELY AND THE COMPANY CEASES COLLECTION EFFORTS. LOSSES HAVE BEEN CONSISTENT WITH MANAGEMENT'S EXPECTATIONS IN ALL MATERIAL RESPECTS. PART III, LINE 8: THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE AND COMMUNITY SERVICE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE BASED ON ESTABLISHED RATES FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE AND COMMUNITY SERVICE POLICIES AND THE ESTIMATED COST OF THOSE SERVICES. PAYMENTS FROM MEDICARE ARE GENERALLY LESS THAN GOOD SAMARITAN HOSPITAL'S COSTS OF PROVIDING THE SERVICE. PART III, LINE 9B: GUIDELINES FOR SUGGESTED MINIMUM NUMBER OF PHONE ATTEMPTS AND LETTERS TO BE SENT BEFORE THE ACCOUNT IS TURNED OVER TO AN OUTSIDE COLLECTION AGENCY ARE INCLUDED IN THE PATIENT ADMINISTRATIVE SERVICES POLICY. UPON FINAL PARO (PAYMENT ASSISTANCE RANK ORDERING) SCORING, IF A PATIENT QUALIFIES FOR PRESUMPTIVE CHARITY, THEIR ACCOUNT WOULD NOT BE FORWARDED TO ANY THIRD PARTY COLLECTIONS. IT SHALL BE THE POLICY OF PATIENT ADMINISTRATIVE SERVICES TO RECOMMEND ACCOUNTS TO BAD DEBT ON A TIMELY BASIS. INPATIENT/OUTPATIENT ACCOUNTS WILL GO TO BAD DEBT AUTOMATICALLY AFTER THE ACCOUNT HAS BEEN IN THE FINANCIAL CLASS PENDING BAD DEBT FOR 30 DAYS. ALL ACCOUNTS MUST FOLLOW THE APPROVED LIMITS FOR REFUNDS AND WRITE OFFS, AS ESTABLISHED IN POLICY PF-102, BEFORE BEING TRANSFERRED. THE PRIMARY AGENCIES WILL WORK THE ACCOUNTS FOR 6 MONTHS OR UNTIL THEY FEEL IT IS UNCOLLECTABLE AND RETURN THE ACCOUNT. THE ACCOUNTS ARE FORWARDED TO SECONDARY AGENCIES FROM THE PRIMARY AGENCIES CLOSED AND RETURN REPORTS. THE FINANCIAL CLASS IS CHANGED TO BAD DEBT OTHER AFTER THE CLOSED AND RETURN REPORTS ARE RECEIVED FROM THE SECONDARY AGENCY. THE AGENCIES MUST GET WRITTEN APPROVAL FROM THE MANAGER IN THE RELATIVELY RARE INSTANCE OF LEGAL ACTION BEING TAKEN TO COLLECT THE DEBT. PART VI, LINE 2: THE 2025 WELLSPAN COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES A REPRESENTATIVE ANALYSIS OF PERTINENT COMMUNITY HEALTH ISSUES IN SOUTH CENTRAL PENNSYLVANIA. THE 2025 WELLSPAN CHNA FOCUSED ON THE HEALTH AND WELL-BEING OF RESIDENTS ACROSS THE WELLSPAN REGION, INCLUDING ADAMS, CUMBERLAND, FRANKLIN, LEBANON AND YORK COUNTIES, AS WELL AS PARTS OF LANCASTER COUNTY AND NORTHERN MARYLAND AND BUILDS THE FOUNDATION FOR WELLSPAN'S COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THIS GEOGRAPHIC FOCUS ENCOMPASSES THE MAJORITY OF THE WELLSPAN SERVICE AREA AND THE PATIENTS, COVERED LIVES, AND COMMUNITIES. THE REMAINDER OF THE WELLSPAN FOOTPRINT, INCLUDING LYCOMING, NORTHUMBERLAND, SNYDER AND UNION COUNTIES WERE INTEGRATED AS A PART OF THE WELLSPAN ACQUISITION IN JULY 2024. THIS REGION, WHICH IS SERVED BY WELLSPAN EVANGELICAL HOSPITAL, COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT IN 2024. WELLSPAN HEALTH UTILIZES BOTH NEEDS ASSESSMENTS AND COMMUNITY HEALTH IMPROVEMENT PLANS TO ADDRESS PERTINENT NEEDS ACROSS OUR REGION. TOGETHER, THE CHNA DATA SUGGESTS OPPORTUNITIES TO ADDRESS IDENTIFIED DIFFERENCES AND PROVIDES A CRITICAL BACKDROP FOR LIFE EXPECTANCY EFFORTS REGIONALLY. WELLSPAN'S EMPHASIS ON LOCAL AND REGIONAL DATA ENABLES ITS SEVEN ACUTE CARE HOSPITALS, TWO SPECIALTY HOSPITALS AND REGIONAL BEHAVIORAL HEALTH ORGANIZATION TO ACT ON UNIQUE COUNTY ATTRIBUTES, WHILE MAINTAINING A REGIONAL PERSPECTIVE ON COMMUNITY HEALTH ISSUES CHALLENGING OUR PATIENTS, NEIGHBORS AND COMMUNITIES.THE AVAILABILITY OF DATA, BOTH PUBLICLY ACCESSIBLE AND COLLECTED THROUGH THE NEEDS ASSESSMENT PROCESS, CONTINUES TO IMPROVE OVER TIME. THE ABUNDANCE OF AVAILABLE DATA TODAY NECESSITATES A THOUGHTFUL APPROACH TO WEAVING TOGETHER FINDINGS IN A WAY THAT TELLS THE STORY OF OUR COMMUNITY. WELLSPAN'S 2025 CHNA LEVERAGED DATA FROM MULTIPLE DATA SOURCES, INCLUDING:1. WELLSPAN HEALTH PATIENT DATA. 2. WELLSPAN HEALTH'S PROVIDER SURVEY. 3. LOCAL, STATE AND NATIONAL DATA SOURCES. 4. REPRESENTATIVE AND SPECIAL POPULATIONS COMMUNITY SURVEY. THE DATA COLLECTION METHODS OF THE 2025 CHNA BUILD ON DECADES OF LEARNINGS FROM PREVIOUS ASSESSMENTS. OUR PROCESSES STRIVE FOR CONSTANT IMPROVEMENT, ENSURING OUR SURVEY SAMPLE IS REPRESENTATIVE OF THE COMMUNITY, AND THAT OUR PROCESSES MINIMIZE BIAS. DATA COLLECTION WAS FACILITATED BY THE CENTER FOR OPINION RESEARCH AT FRANKLIN & MARSHALL COLLEGE, LED BY BERWOOD YOST, DIRECTOR OF THE CENTER AND PROJECT CONSULTANT. DATA COLLECTION STARTED IN THE SPRING OF 2024 WITH AN ANALYSIS OF DEMOGRAPHIC INDICATORS FROM SECONDARY DATA SOURCES. SIMULTANEOUSLY, THE ENGAGEMENT OF KEY STAKEHOLDERS AND SUBJECT MATTER EXPERTS HELPED TO FRAME CORE AREAS OF FOCUS FOR FURTHER EXPLORATION. OUR INTEREST IN CONTINUED LEARNING MEANS THE NEEDS ASSESSMENT PROCESS DOESN'T STOP WITH THE CREATION OF OUR COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. WE CONTINUE TO INVEST IN COMMUNITY-WIDE ASSESSMENTS ON FOCUSED TOPICS LIKE FOOD, HOUSING AND TRANSPORTATION CONDUCTED EXTERNALLY BY COMMUNITY PARTNERS. ONGOING QUALITATIVE FOCUS GROUPS AND KEY INFORMANT INTERVIEWS CONTINUE TO ADD FOCUS AND DIRECTION FOR ACTION. BASED ON THE COMMUNITY HEALTH NEEDS ASSESSMENT RESULTS, WELLSPAN'S THREE-YEAR STRATEGIES AND PRIORITIES WITHIN ITS COMMUNITY HEALTH IMPROVEMENT PLAN WILL INCLUDE: - CARE FOR ALL: DELIVER ON EXCEPTIONAL CARE THAT IS ACCESSIBLE AND AFFORDABLE FOR ALL BY IDENTIFYING AND REDUCING BARRIERS TO CARE. - CHILDREN'S HEALTH: LEAD THE REGION IN ADDRESSING THE PHYSICAL, EMOTIONAL, INTELLECTUAL AND DEVELOPMENTAL NEEDS OF CHILDREN.- NON- MEDICAL FACTORS: COLLABORATE WITH COMMUNITY-BASED ORGANIZATIONS TO IMPACT THE NON-MEDICAL FACTORS THAT INFLUENCE THE HEALTH OF OUR PATIENTS AND COMMUNITY. - PHYSICAL ENVIRONMENT: PROMOTE A HEALTHIER COMMUNITY BY ENHANCING ENVIRONMENTAL SUSTAINABILITY EFFORTS AND BUILDING COMMUNITY INFRASTRUCTURE TO SUPPORT HEALTH.- CHRONIC DISEASE: IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY THROUGH STRATEGIES THAT PROMOTE HEALTH BEHAVIORS, SUPPORT PERSONAL WELL-BEING AND PRIORITIZE THE MANAGEMENT OF CHRONIC DISEASES. OUR CHNA PROCESS IS ALWAYS IMPROVING. WE LOOK FOR OPPORTUNITIES TO ENHANCE THE VALUE OF THE DATA WE EXTRAPOLATE AND APPRECIATE THE INCREASING AVAILABILITY OF DATA. WE ARE COMMITTED TO ENSURING DATA INTEGRITY AND A SOUND SCIENTIFIC APPROACH. NEVERTHELESS, THERE ARE LIMITATIONS TO OUR PROCESS. WE HAVE MINIMIZED THE RISK OF INCOMPLETE OR INACCURATE DATA WHENEVER POSSIBLE BUT REMAIN COGNIZANT OF THE FOLLOWING LIMITATIONS: 1. LAGGING DATA: UTILIZING SECONDARY DATA SOURCES MEANS EMBRACING THE LIMITATIONS OF THOSE SOURCES. FOR EXAMPLE, DATA MAY NOT BE REPORTED WITHIN THE LAST YEAR AND MAY LACK STATISTICAL SIGNIFICANCE FOR SPECIFIC SUBGROUPS OF THE COMMUNITY, LEAVING A GAP. 2. INTERNAL PATIENT DATA: UTILIZING WELLSPAN PATIENT DATA MAY HAVE AN INHERENT BIAS OF NOT INCLUDING THOSE WHO CANNOT AFFORD CARE AND ARE THEREFORE NOT CAPTURED IN OUR RECORDS. 3. SURVEY SAMPLE SIZES: DESPITE OUR EFFORTS TO ENGAGE A LARGE PORTION OF THE COMMUNITY, WE ARE NOT ABLE TO SURVEY EVERY MEMBER OF OUR COMMUNITY. THOUGH WE MAINTAIN A COMMITMENT TO STATISTICALLY SIGNIFICANT SAMPLE SIZES, OUR SAMPLE SIZES MAY LIMIT OUR ABILITY TO DRAW CONCLUSIONS ABOUT CERTAIN SUBSETS OR VERY SPECIFIC GROUPS OF THE COMMUNITY. 4. ACCESS BIAS: THERE IS AN INHERENT BIAS IN SURVEY RESPONSES DUE TO THE TIME AND INTERNET OR PHONE CONNECTIVITY REQUIRED TO COMPLETE THE SURVEY. INDIVIDUALS WHO LACK INTERNET OR PHONE ACCESS ARE MOST LIKELY NOT REPRESENTED. CONTINUED IMPROVEMENT EFFORTS ALLOW US TO BUILD ON EACH NEEDS ASSESSMENT, EACH METHOD UTILIZED AND EACH REPORT GENERATED. WE WILL CONTINUE TO ADVANCE ONGOING EFFORTS THAT PROMOTE HEALTHY LIVING, COLLABORATE WITH PARTNERS TO ADDRESS ISSUES IMPORTANT TO EACH LOCAL COMMUNITY, AND MONITOR EMERGING TRENDS THAT MAY WARRANT ACTION IN THE FUTURE.THE WELLSPAN BOARD OF DIRECTORS APPROVED THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH IS MADE AVAILABLE TO THE PUBLIC ON OUR WEBPAGE- HTTPS://WWW.WELLSPAN.ORG/ABOUT-WELLSPAN/IMPROVING-HEALTHY-COMMUNITIES/COMMUNITY-BENEFIT. IN ADDITION TO THE PLACEMENT OF THE CHNA ON THE WEBPAGE, THERE WERE COMMUNITY LEVEL FORUMS IN THE COUNTY OF EACH WELLSPAN FACILITY WHICH PUBLICLY RELEASED THE DATA, SUMMARIZED THE FINDINGS, AND ARTICULATED WELLSPAN'S INTENTION TO ADDRESS THE IDENTIFIED NEEDS. PART VI, LINE 3: IN ACCORDANCE WITH THE WELLSPAN HEALTH FINANCIAL ASSISTANCE POLICY (FAP), PATIENTS/RESPONSIBLE PARTIES WILL BE NOTIFIED OF THE AVAILABLE OPTIONS FOR FINANCIAL ASSISTANCE PER IRS REGULATION 501(R). METHODS OF NOTIFICATION INCLUDE, BUT ARE NOT LIMITED TO: 1. POSTING OF LEGIBLE SIGNAGE2. DEVELOPMENT OF A PLAIN LANGUAGE SUMMARY3. DISTRIBUTING INFORMATIONAL BROCHURES AT HOSPITAL AND OFFICE REGISTRATION AREAS4. DISTRIBUTING INFORMATIONAL BROCHURES THROUGHOUT ITS COMMUNITIES5. A COPY OF THE FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY OFFERED DURING THE REGISTRATION/DISCHARGE PROCESS6. CONSPICUOUS NOTICE REGARDING THE FINANCIAL ASSISTANCE POLICY PRINTED ON ALL ACCOUNT STATEMENTS7. COPY OF THE FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY PROVIDED WITH LAST BILLING STATEMENT THE WELLSPAN FAP CAN BE FOUND ONLINE AT:HTTPS://WWW.WELLSPAN.ORG/PATIENT-RESOURCES/BILLING-AND-INSURANCE/FINANCIAL-ASSISTANCE PART VI, LINE 4: GOOD SAMARITAN HOSPITAL IS LOCATED WITHIN LEBANON COUNTY, PENNSYLVANIA IN THE COUNTY'S ONLY CITY, LEBANON CITY. DESPITE BEING THE SMALLEST COUNTY IN LAND AREA IN THE WELLSPAN FOOTPRINT, LEBANON COUNTY IS ONE OF THE FASTEST GROWING AT 2.5%, WITH A CURRENT POPULATION OF 143,258. THE HISPANIC/LATINO COMMUNITY CONTINUES TO EXPAND AND NOW REPRESENTS 14.5% OF THE COUNTY'S POPULATION ONE OF THE HIGHEST PROPORTIONS IN THE REGION. LEBANON CITY, THE COUNTY'S URBAN CENTER, IS HOME TO A 45% HISPANIC POPULATION, HIGHLIGHTING THE CITY'S SIGNIFICANT ROLE IN THE COUNTY'S DEMOGRAPHIC DIVERSITY. LEBANON COUNTY HAS THE LOWEST PERCENTAGE OF WORKING-AGE ADULTS (AGES 18-64) IN THE FOOTPRINT AT 55%, FALLING BELOW BOTH THE PENNSYLVANIA AVERAGE (57.8%) AND THE NATIONAL AVERAGE (58.7%). IT ALSO HAS THE SECOND-LOWEST MEDIAN HOUSEHOLD INCOME IN THE REGION AT $72,532 TRAILING BOTH STATE AND NATIONAL LEVELS. ECONOMIC VARIANCES ARE PARTICULARLY EVIDENT WITHIN THE LATINO COMMUNITY, WHERE THE MEDIAN HOUSEHOLD INCOME IS JUST $46,780. ADDITIONALLY, 7.8% OF FAMILIES IN LEBANON COUNTY LIVE BELOW THE FEDERAL POVERTY LEVEL, THE HIGHEST RATE AMONG COUNTIES IN THE WELLSPAN FOOTPRINT. WHILE THERE HAS BEEN A SLIGHT IMPROVEMENT IN THE PERCENTAGE OF CHILDREN UNDER 18 LIVING IN POVERTY (DOWN FROM 16.5% TO 16.2%), THIS REMAINS THE HIGHEST CHILD POVERTY RATE IN THE REGION. LEBANON COUNTY ALSO HAS THE LOWEST MEDIAN HOME VALUE ($211,400) AND AN AVERAGE MEDIAN RENT OF $1,022 MAKING HOUSING COSTS MORE AFFORDABLE THAN IN NEIGHBORING COUNTIES, THOUGH STILL REFLECTIVE OF BROADER AFFORDABILITY CHALLENGES. ENCOURAGINGLY, LEBANON COUNTY HAS IMPROVED IN SEVERAL COUNTY HEALTH RANKINGS METRICS. THE COUNTY'S RANK FOR PHYSICAL ENVIRONMENT IMPROVED FROM 65TH TO 59TH, WHILE OVERALL HEALTH OUTCOMES ROSE FROM 29TH TO 26TH, AND HEALTH FACTORS IMPROVED FROM 19TH TO 17TH. REGARDLESS, POOR AIR QUALITY REMAINS A CONCERN DUE TO THE COUNTY'S GEOGRAPHIC FEATURES, WHICH CONTRIBUTE TO PERSISTENT ENVIRONMENTAL HEALTH CHALLENGES. FINDINGS FROM THE 2025 COMMUNITY SURVEY UNDERSCORE SEVERAL HEALTH CONCERNS. RESIDENTS REPORTED HIGHER RATES OF DEPRESSION, INCREASED FINANCIAL STRESS AND ONGOING POOR HEALTH HABITS. SADLY, 85% OF RESPONDENTS SAID THEY DID NOT GET THE RECOMMENDED AMOUNT OF EXERCISE IN THE PAST WEEK. LEBANON ALSO HAD THE HIGHEST PERCENTAGE (16%) OF SURVEY PARTICIPANTS REPORTING EXPERIENCES OF UNFAIR TREATMENT DUE TO RACE, ETHNICITY OR CULTURAL BACKGROUND. FORTUNATELY, PREVENTIVE CARE AND COVERAGE ARE TRENDING UPWARD. MORE RESIDENTS REPORTED HAVING A REGULAR CHECK UP IN THE PAST 12 MONTHS, AND THE RATE OF ADULTS WITH HEALTH INSURANCE CONTINUES TO IMPROVE ACROSS THE COUNTY. PART VI, LINE 5: AS A CHARITABLE, COMMUNITY-BASED HEALTHCARE ORGANIZATION, OUR COMMITMENT TO IMPROVING THE LIVES AND WELL-BEING OF ALL PEOPLE AND COMMUNITIES WE SERVE IS EVIDENT IN OUR MISSION STATEMENT: "WORKING AS ONE TO IMPROVE HEALTH THROUGH EXCEPTIONAL CARE FOR ALL, LIFELONG WELLNESS, AND HEALTHIER COMMUNITIES." EMPLOYEES LIVE OUT THIS MISSION STATEMENT EVERY DAY BY ENGAGING IN COMMUNITY BENEFIT ACTIVITIES THAT ADDRESS COMMUNITY NEEDS, ESPECIALLY THE HEALTH PRIORITIES IDENTIFIED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. MANY OF WELLSPAN'S EFFORTS TO ADVANCE COMMUNITY HEALTH PRIORITIES ARE OUTLINED IN OUR COMMUNITY BENEFIT REPORT, PUBLISHED ONLINE AT HTTPS://WWW.WELLSPAN.ORG/ABOUT/WELLSPAN-IN-THE-COMMUNITY/. BELOW ARE SOME EXAMPLES OF EFFORTS WITHIN THE GOOD SAMARITAN HOSPITAL SERVICE AREA IN THE LAST YEAR: - WELLSPAN FUNDED THE EXECUTIVE DIRECTOR POSITION FOR THE COMMUNITY HEALTH COUNCIL OF LEBANON COUNTY.- THE COMMUNITY HEALTH COUNCIL SUPPORTED AN ANNUAL YOUTH ONLY FISHING DAY WHICH ENGAGED 450 CHILDREN, THE TOUR DE LEBANON COUNTY BIKE RACE ENGAGING 400 RIDERS, AND THE BETTER TOGETHER HEALTH SUMMIT WHICH RALLIED 140 COMMUNITY LEADERS AROUND PERTINENT HEALTH TOPICS.- THE HEALTH COUNCIL CONTINUES TO SUPPORT AND INVEST IN OUR COUNTYWIDE YOUTH ADVISORY BOARD (YAB), ESTABLISHED IN 2021. ABOUT 30 YOUTH REPRESENTATIVES ARE RECRUITED FROM ALL SIX SCHOOL DISTRICTS ACROSS THE COUNTY. THROUGHOUT THE SCHOOL YEAR, THE YAB MEETS REGULARLY WITH LOCAL ORGANIZATIONS THAT ARE EAGER TO HEAR THEIR PERSPECTIVES AND IDEAS.- WELLSPAN OFFERS A GENEROUS FINANCIAL ASSISTANCE PROGRAM TO EXTEND FINANCIAL SUPPORT TO PATIENTS EARNING UP TO 350% OF THE FEDERAL POVERTY LEVEL. IN TOTAL, $51.2M WAS PROVIDED TO ALMOST 13,000 PATIENTS AT WELLSPAN IN FY25, INCLUDING OVER 1,100 ATTRIBUTED TO PREVENTIVE SCREENINGS THAT WERE COVERED FOR PATIENTS WHO MAY OTHERWISE HAVE DELAYED CARE BECAUSE OF COST.- ENGAGED 211 CHILDREN AND 102 ADULTS IN GET OUTDOORS LEBANON PROGRAM, A PARTNERSHIP WITH THE COUNTY LIBRARY AND PARKS.- AWARDED MORE THAN $198,000 IN COMMUNITY GRANTS TO NON-PROFIT ORGANIZATIONS TO FUEL 8 COMMUNITY-BASED PROJECTS TO ADVANCE ACCESS TO CARE, MENTAL WELL-BEING, CHILDREN'S HEALTH, AND FOOD SECURITY.- MULTIPLE DEPARTMENTS AND SERVICES AT WELLSPAN SUPPORTED THE HEALTHY KIDS DAY WHICH REACHED OVER 450 LOCAL CHILDREN. - SUPPORTED MORE THAN 3,000 INDIVIDUALS IN THEIR HEALTH JOURNEY BY PARTICIPATING IN LOCAL HEALTH EVENTS AND FAIRS. - ENGAGED 196 RESIDENTS IN WELLSPAN'S WINTER STREAK PROGRAM TO PROMOTE HEALTHY LIVING AND PROVIDE EDUCATION DURING THE WINTER MONTHS, INCLUDING THROUGH A WELLNESS GUIDE AND ONLINE WORKSHOPS.WELLSPAN IS AN HONORED COMMUNITY PARTNER WITH THE FOLLOWING HEALTH COALITIONS:- HEALTHY ADAMS COUNTY - WWW.HEALTHYADAMSCOUNTY.ORG- HEALTHY FRANKLIN COUNTY - WWW.HEALTHYFRANKLINCOUNTY.ORG- HEALTHY YORK COALITION - WWW.HEALTHYYORK.ORG- COMMUNITY HEALTH COUNCIL OF LEBANON COUNTY - WWW.COMMUNITYHEALTHCOUNCIL.COMTHESE COALITIONS PLAY AN IMPORTANT ROLE IN WELLSPAN'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. THIS YEAR, WELLSPAN COLLABORATED WITH OUR COALITIONS AND OTHER PARTNERS TO COMPLETE THE 2025 CHNA. THIS DATA WAS USED TO DESIGN WELLSPAN'S 2026-2028 COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP).THROUGH OUR COLLABORATION WITH THE COALITIONS AND OTHERS, WE IDENTIFIED CORE THEMES AND AREAS FOR IMPROVEMENT INCLUDING CHILDREN'S HEALTH, NON-MEDICAL FACTORS AND CHRONIC DISEASE. EACH COUNTY COALITION HOSTED ITS OWN PUBLIC HEALTH FORUM EVENT, TO REVIEW THE IDENTIFIED NEEDS AND STRATEGIC PRIORITY AREAS FOR THE COMING YEARS AND ENGAGE NEW PARTNERS AND VOLUNTEERS TO HELP ADVANCE THE HEALTHCARE AGENDA FOR OUR COMMUNITIES. PART VI, LINE 6: WELLSPAN HEALTH IS AN INTEGRATED HEALTH SYSTEM SERVING THE COMMUNITIES OF SOUTHCENTRAL PENNSYLVANIA AND NORTHERN MARYLAND. AS A COMMUNITY-BASED, NOT-FOR-PROFIT ORGANIZATION, WELLSPAN IS DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF THE PEOPLE IT SERVES. WELLSPAN WILL ASSUME A LEADERSHIP ROLE AND DEVELOP PARTNERSHIPS WITH OTHER ORGANIZATIONS TO IMPROVE ACCESS TO COORDINATED, HIGH-QUALITY, COST-EFFECTIVE HEALTH CARE SERVICES, EDUCATE THE HEALTH CARE PROVIDERS OF TOMORROW, PROMOTE HEALTHY LIFESTYLES AND LIFELONG WELLNESS, AND MAKE ITS LOCAL COMMUNITIES HEALTHIER, MORE DESIRABLE PLACES TO LIVE, WORK, AND PLAY. EACH OF OUR HOSPITALS WORK WITH OTHER PARTS OF THE SYSTEM TO PROVIDE A COMPREHENSIVE APPROACH TO MEETING COMMUNITY NEEDS.WELLSPAN HEALTH INCLUDES: HOSPITALS:1. YORK HOSPITAL2. GETTYSBURG HOSPITAL3. CHAMBERSBURG HOSPITAL4. WAYNESBORO HOSPITAL5. EPHRATA COMMUNITY HOSPITAL6. THE GOOD SAMARITAN HOSPITAL OF LEBANON, PENNSYLVANIA7. WELLSPAN SURGERY & REHABILITATION HOSPITAL8. PHILHAVEN9. EVANGELICAL COMMUNITY HOSPITALFOUNDATIONS:1. YORK HEALTH FOUNDATION2. SUMMIT HEALTH FOUNDATION3. GETTYSBURG HOSPITAL FOUNDATION4. EPHRATA COMMUNITY HEALTH FOUNDATION5. GOOD SAMARITAN HEALTH SERVICES FOUNDATION6. EVANGELICAL COMMUNITY HOSPITAL FOUNDATIONMEDICAL SERVICES:1. APPLE HILL SURGICAL CENTER, INC.2. VNA HOME HEALTH SERVICES3. WELLSPAN HEALTH CARE SERVICES4. WELLSPAN MEDICAL GROUP5. WELLSPAN SUMMIT HEALTH6. GOOD SAMARITAN PHYSICIAN SERVICES7. HEALTHY COMMUNITY PHARMACYWELLSPAN'S COMMUNITY BENEFIT REPORT IS PREPARED BY THE PARENT ORGANIZATION, WELLSPAN HEALTH, AND INCLUDES COLLECTIVE EFFORTS OF ALL ENTITIES UNDER THE PARENT ORGANIZATION. SEE WELLSPAN HEALTH'S CURRENT COMMUNITY BENEFIT REPORT, COMMUNITY HEALTH NEEDS ASSESSMENT, AND COMMUNITY HEALTH IMPROVEMENT PLAN AT HTTPS://WWW.WELLSPAN.ORG/ABOUT/WELLSPAN-IN-THE-COMMUNITY/. PART VI, LINE 7, REPORTS FILED WITH STATES PA 1 CITY OF LEBANON 400 8TH ST LEBANON PA 17042 236001905 COUNTY GOVERNMENT 125000 0 COMMUNITY SUPPORT LEBANON SCHOOL DISTRICT 1000 S 8TH STREET LEBANON PA 17042 231646050 501(C)(3) 84000 0 GENERAL SUPPORT FAMILY FIRST HEALTH CORPORATION 116 S GEORGE ST YORK PA 17401 237118262 501(C)(3) 325892 0 GENERAL SUPPORT 3 0 PRESCRIPTION FOR CARING PROGRAM 127 23293 PART I, LINE 2: ALL WELLSPAN ENTITIES FOLLOW WELLSPAN POLICIES AND PROCEDURES REGARDING GRANT PROJECTS (MAP 1007) TO ENSURE THAT THE USE OF GRANT FUNDS ARE CONSISTENT WITH WELLSPAN'S MISSION OF WORKING AS ONE TO IMPROVE HEALTH THROUGH EXCEPTIONAL CARE FOR ALL, LIFELONG WELLNESS AND HEALTHY COMMUNITIES. COMMUNITY SUPPORT IS PROVIDED IN THE FORM OF GRANTS, WHICH SERVE HEALTH-RELATED PURPOSES AND ARE IN ALIGNMENT WITH THE WELLSPAN MISSION. ALL GRANTS ARE MADE TO ELIGIBLE 501(C)(3) ORGANIZATIONS AND INCLUDE CHURCHES, PUBLIC SCHOOLS, PUBLIC CHARITIES, PUBLIC CLINICS AND HOSPITALS, LEGAL AID SOCIETIES, VOLUNTEER SERVICES ORGANIZATIONS, AND SOME GOVERNMENTAL AGENCIES. WE MAINTAIN ADEQUATE RECORDS TO SUBSTANTIATE AMOUNTS, ELIGIBILITY, AND SELECTION CRITERIA USED FOR ALL GRANTS. X X X X 1 1 0 0 0 0 0 0 0 ROXANNA GAPSTUR PHD RN PRESIDENT & CEO - WELLSPAN HEALTH 0 1739595 0 1112453 0 272417 0 11203 0 40930 0 3176598 0 269264 LAURA BUCZKOWSKI EXECUTIVE VP & CFO - WELLSPAN HEALTH 0 949313 0 402918 0 3153 0 16601 0 36568 0 1408553 0 0 FARAAZ YOUSUF FORMER EXECUTIVE VP & COO 0 120553 0 0 0 936032 0 0 0 37354 0 1093939 0 0 MICHAEL SEIM SR VP & CHIEF QUALITY OFFICER 0 711414 0 254210 0 22230 0 18200 0 36044 0 1042098 0 20176 AMY NELSON SECRETARY/SR VP & GENERAL COUNSEL 0 641147 0 229320 0 3153 0 40330 0 33795 0 947745 0 0 JAMES STUCCIO DIRECTOR/SVP - EAST REGION 0 604681 0 216096 0 3153 0 12723 0 35864 0 872517 0 0 EDWARD TADAJWESKI MD DIRECTOR 0 700388 0 18519 0 44359 0 18168 0 35743 0 817177 0 0 JILIAN WHITE MD VP - MEDICAL AFFAIRS 398354 0 71355 0 716 0 20489 0 30338 0 521252 0 0 0 TINA CITRO VP&PRES-GSH(EFF. 3/25)/VP&PRES-ECH 0 335201 0 72603 0 2054 0 20700 0 32679 0 463237 0 0 PATRICIA DONLEY VP & PRES.-GSH (UNTIL 3/25)/CNO 331094 0 71500 0 13085 0 20700 0 16214 0 452593 0 0 0 VALERIE ADAMS VP - PATIENT CARE SERVICES AND CNO 231815 0 41999 0 716 0 10420 0 15115 0 300065 0 0 0 VIRGINIA SANGER SR DIR ANCILLIARY & SUPPORT SERVICES 209939 0 14958 0 3203 0 20192 0 14583 0 262875 0 0 0 DEBRA NEY MANAGER - PHARMACY OPERATIONS 194953 0 12863 0 4427 0 12691 0 15436 0 240370 0 0 0 ROBERT SHAVER FORMER VP - MEDICAL AFFAIRS 0 36 0 0 0 226105 0 0 0 12980 0 239121 0 0 STEPHANIE THOMPSON DIRECTOR - CLINICAL SERVICES 179905 0 12863 0 2945 0 11583 0 29317 0 236613 0 0 0 LORRAINE CUNNINGHAM PHARMACIST 185344 0 0 0 689 0 11169 0 25635 0 222837 0 0 0 BONNIE PIETRUCH DIRECTOR - CLINICAL SERVICES 178010 0 12673 0 8370 0 11603 0 2721 0 213377 0 0 0 PART I, LINE 4A: DURING CALENDAR YEAR 2024, THE FOLLOWING INDIVIDUALS RECEIVED A SEVERANCE PAYMENT: ROBERT SHAVER, FORMER VP MEDICAL AFFAIRS - $40,063 FARAAZ YOUSUF, FORMER EXECUTIVE VP & COO - $928,846 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 2024, 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 2024, THE FOLLOWING INDIVIDUALS RECEIVED DISTRIBUTIONS FROM THE DEFERRED COMPENSATION PLAN: ROXANNA GAPSTUR - $269,264 MICHAEL SEIM - $20,176 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). A GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA 232982233 2018-03-13 282504 REFUND 2008A BONDS 0 0 0 B GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA 232982233 84129NMG1 2019-04-03 1722789 REFUND BONDS ISSUED 11/12/2008 0 0 0 C GENERAL AUTHORITY OF SOUTHCENTRAL PENNSYLVANIA 232982233 84129NNG0 2023-12-14 1120867 REFUND 2014 BONDS 0 0 0 A 76837 282504 839 281665 2018 0 1 1 1 B 1064138 1722789 8019 1714770 2019 1 0 1 1 C 24535 1120867 8441 1112426 2023 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 0 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 SCHEDULE K, PART I, COLUMN (E) - ISSUE PRICE WELLSPAN HEALTH, THE PARENT ORGANIZATION, ALLOCATED PORTIONS OF THE PROCEEDS OF THIS TAX-EXEMPT BOND ISSUE TO MEMBERS OF THE OBLIGATED GROUP. THE AMOUNT ON SCHEDULE K, PART I, COLUMN (E) AND PART II, LINE 3 REPRESENTS THE ENTITY'S ALLOCATED PORTION OF THE TOTAL BOND PROCEEDS, AS SHOWN ON FORM 8038, PART III, LINE 21(B). ALL ITEMS IN PART II HAVE ALSO BEEN ALLOCATED. SCHEDULE K, PART III, LINE 4 & 5 - PRIVATE BUSINESS USE THE ENTITY, IN CONJUNCTION WITH BOND COUNSEL, MONITORS ACTIVITIES THAT MAY RESULT IN PRIVATE BUSINESS USE. THERE WERE NONE FOUND. FORM 990, PART VI, SECTION A, LINE 4 THE GOOD SAMARITAN HOSPITAL OF LEBANON PENNSYLVANIA AMENDED ITS BY-LAWS TO REMOVE THE REQUIREMENT THAT THE MEMBER'S CHIEF EXECUTIVE OFFICER SERVE AS A DESIGNATED DIRECTOR ON THE BOARD OF DIRECTORS OF THE HOSPITAL, REVISE AND SIMPLIFY THE LANGUAGE REGARDING THE TERM OF SERVICE OF DIRECTORS TO PROVIDE, AND REMOVE THE LANGUAGE STATING THAT "NO PERSON MAY SIMULTANEOUSLY SERVE ON THE BOARD AND THE BOARD OF DIRECTORS OF A SYSTEM AFFILIATE". FORM 990, PART VI, SECTION A, LINE 6 WELLSPAN HEALTH, A NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER. 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 A, LINE 7B THE FOLLOWING RESPONSIBILITIES ARE SET FORTH AS A GUIDE FOR FULFILLING THE GOVERNANCE COMMITTEE'S PURPOSES IN SUCH MANNER AS THE COMMITTEE DETERMINES IS APPROPRIATE: 1. OVERSEE THE PROCESS OF SELECTING AND NOMINATING DIRECTORS AND OFFICERS FOR EACH OF THE GOVERNING BOARDS WITHIN THE WELLSPAN SYSTEM, INCLUDING ENSURING THAT DIRECTOR NOMINEES MEET THE QUALIFICATIONS REQUIRED BY THE RELEVANT BOARD COMPOSITION AND COMPETENCY GRID AND CHARACTERISTICS, BYLAWS, AND BOARD-APPROVED POLICIES AND GUIDELINES, AS APPLICABLE, AND ESTABLISH OTHER CRITERIA THAT ARE DESIRABLE FOR DIRECTORS; 2. IDENTIFY, EVALUATE AND SCREEN DIRECTOR CANDIDATES FOR EACH OF THE GOVERNING BOARDS WITHIN THE WELLSPAN SYSTEM (INCLUDING INCUMBENT DIRECTORS FOR POTENTIAL RE-NOMINATION), AND NOMINATE QUALIFIED INDIVIDUALS TO THE WELLSPAN HEALTH BOARD OF DIRECTORS FOR: (A) APPOINTMENT OR REAPPOINTMENT TO REGULAR TERMS, OR (B) APPOINTMENT TO FILL THE REMAINING TERM OF ANY GOVERNING BOARD VACANCIES; 3. REVIEW ANNUALLY THE SIZE, COMPOSITION AND LEADERSHIP OF EACH OF THE GOVERNING BOARDS WITHIN THE WELLSPAN SYSTEM, INCLUDING THE WELLSPAN HEALTH BOARD OF DIRECTORS AS A WHOLE, ITS COMMITTEES, AND ANY ADVISORY BODIES, MAKE A DETERMINATION OF WHETHER THE BOARD, ITS COMMITTEES AND ANY ADVISORY BODIES REFLECT THE APPROPRIATE BALANCE OF INDEPENDENCE, SOUND JUDGMENT, BUSINESS SPECIALIZATION, TECHNICAL SKILLS, DIVERSITY, FUNDRAISING AND DEVELOPMENT ABILITY, GEOGRAPHIC AND DEMOGRAPHIC REPRESENTATION, AND OTHER DESIRED QUALITIES, AND RECOMMEND ANY APPROPRIATE CHANGES TO THE WELLSPAN HEALTH BOARD OF DIRECTORS; 4. COORDINATE AND OVERSEE A PERIODIC SELF-EVALUATION OF THE ROLE AND PERFORMANCE OF EACH OF THE GOVERNING BOARDS WITHIN THE WELLSPAN SYSTEM, INCLUDING THE WELLSPAN HEALTH BOARD OF DIRECTORS, ITS COMMITTEES, AND ANY ADVISORY BODIES, AND EACH OF THEIR DIRECTORS AND OFFICERS; 5. DEVELOP AND RECOMMEND FOR APPROVAL BY THE WELLSPAN HEALTH BOARD OF DIRECTORS, REVIEW THE EFFECTIVENESS OF, AND RECOMMEND MODIFICATIONS AS APPROPRIATE TO, THE ORGANIZATION'S COMMITTEE STRUCTURE AND ORGANIZATIONAL DOCUMENTS, INCLUDING THE ARTICLES OF INCORPORATION, BYLAWS, BOARD-APPROVED POLICIES AND GUIDELINES, AND COMMITTEE CHARTERS; 6. THE GOVERNANCE COMMITTEE SHALL UNDERTAKE THE RESPONSIBILITY FOR BOARD EDUCATION AND BOARD RETREAT PLANNING. IN ADDITION, THE GOVERNANCE COMMITTEE SHALL COORDINATE WITH MANAGEMENT TO DEVELOP AND IMPLEMENT AN EFFECTIVE ORIENTATION PROGRAM FOR NEW DIRECTORS, INCLUDING ASSIGNMENT OF EXPERIENCED DIRECTORS AS APPROPRIATE MENTORS OF NEW DIRECTORS. 7. REVIEW EMERGING CORPORATE GOVERNANCE ISSUES AND BEST GOVERNANCE PRACTICES AND MAKE APPROPRIATE RECOMMENDATIONS TO THE WELLSPAN HEALTH BOARD OF DIRECTORS; 8. CONDUCT A PERIODIC SELF-EVALUATION OF THE PERFORMANCE OF THE COMMITTEE, INCLUDING ITS EFFECTIVENESS AND COMPLIANCE WITH THIS CHARTER, AND RECOMMEND TO THE WELLSPAN HEALTH BOARD OF DIRECTORS MODIFICATIONS AS APPROPRIATE; 9. THE GOVERNANCE COMMITTEE SHALL MAINTAIN MINUTES OF GOVERNANCE COMMITTEE MEETINGS AND RECORDS OF ITS ACTIVITIES AND SHALL REPORT PROMPTLY TO THE WELLSPAN HEALTH BOARD OF DIRECTORS ANY ACTION TAKEN BY THE GOVERNANCE COMMITTEE, ANY RECOMMENDATIONS OF THE GOVERNANCE COMMITTEE, AND ANY OTHER MATTERS THE GOVERNANCE COMMITTEE DEEMS APPROPRIATE OR THE WELLSPAN HEALTH BOARD OF DIRECTORS REQUESTS. 10. THE GOVERNANCE COMMITTEE SHALL UNDERTAKE SUCH OTHER RESPONSIBILITIES AS THE WELLSPAN HEALTH BOARD OF DIRECTORS MAY DELEGATE OR ASSIGN TO THE GOVERNANCE COMMITTEE FROM TIME TO TIME. THE GOVERNANCE 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 GOVERNANCE COMMITTEE. THE GOVERNANCE COMMITTEE SHALL PERFORM ONLY SUCH FUNCTIONS AND DUTIES AS SHALL FROM TIME TO TIME BE SPECIFICALLY DELEGATED TO THE GOVERNANCE COMMITTEE BY THE WELLSPAN HEALTH BOARD OF DIRECTORS. THE GOVERNANCE COMMITTEE DOES NOT HAVE DELEGATED AUTHORITY TO TAKE FINAL AND BINDING ACTIONS ON BEHALF OF WELLSPAN HEALTH, 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 GOVERNANCE 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. FORM 990, PART VI, SECTION B, LINE 11B MANAGEMENT PROVIDED 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 PROVIDED 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 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 3,891,798. MANAGEMENT AND GENERAL EXPENSES 575,706. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,467,504. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,095,884. MANAGEMENT AND GENERAL EXPENSES 10,582. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,106,466. SPECIALIST CONTRACT: PROGRAM SERVICE EXPENSES 52,707,991. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 52,707,991. TEMPORARY PROFESSIONAL STAFF: PROGRAM SERVICE EXPENSES 4,955,170. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,955,170. FORM 990, PART XI, LINE 9: CHANGE IN FOUNDATION NET ASSETS 497,617. CHANGE IN VALUE OF PENSION PLAN 190,263. TRANSFER FROM AFFILIATES 15,600,000. TRANSFER TO AFFILIATES -13,100,000. 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