SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/form990 for instructions and the latest informtion.
OMB No. 1545-0047
2017
Open to Public Inspection
Name of the organization
YORK HOSPITAL
 
Employer identification number

23-1352222
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		  5,619 5,966,898   5,966,898 0.590 %
b Medicaid (from Worksheet 3, column a) . . . . .   136,001 158,092,451 91,027,294 67,065,157 6.610 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .   141,620 164,059,349 91,027,294 73,032,055 7.200 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 51 26,022 2,589,189 257,083 2,332,106 0.230 %
f Health professions education (from Worksheet 5) . . . 3 3 479,879   479,879 0.050 %
g Subsidized health services (from Worksheet 6) . . . . 2 156,140 6,341,260 1,475,364 4,865,896 0.480 %
h Research (from Worksheet 7) . 1   2,991,830 1,143,461 1,848,369 0.180 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 5 2,094 322,068   322,068 0.030 %
j Total. Other Benefits . . 62 184,259 12,724,226 2,875,908 9,848,318 0.970 %
k Total. Add lines 7d and 7j . 62 325,879 176,783,575 93,903,202 82,880,373 8.170 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2017
Schedule H (Form 990) 2017
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development 1   450,000   450,000 0.040 %
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		 1 14 386   386  
6 Coalition building 10 10,799 41,196 12,666 28,530  
7 Community health improvement advocacy            
8 Workforce development 3 1,966 718,598   718,598 0.070 %
9 Other            
10 Total 15 12,779 1,210,180 12,666 1,197,514 0.110 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
17,566,540
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
277,551
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
313,674,809
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
350,510,236
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-36,835,427
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2017
Schedule H (Form 990) 2017
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 WellSpan York Hospital
1001 S George Street
York,PA17405
http://www.wellspan.org
250301 		X X   X X X X      
Schedule H (Form 990) 2017
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Schedule H (Form 990) 2017
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Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
 
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		 
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): www.wellspan.org
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b Yes  
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2017
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Schedule H (Form 990) 2017
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
 
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
http://www.wellspan.org
b
http://www.wellspan.org
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2017
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Schedule H (Form 990) 2017
Page 6
Part VFacility Information (continued)

Billing and Collections
 
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2017
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Schedule H (Form 990) 2017
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
 
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2017
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Schedule H (Form 990) 2017
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
Part V, Line 5 - Account Input from Persons Who Represent the Community Community stakeholder engagement has been vital to the Community Health Needs Assessment (CHNA) process since it began in York County in 1994. The Healthy York County Coalition (HYCC) a local health coalition representing the diversity of the community has led each of the six CHNAs that have been conducted. For the 2015 CHNA, HYCC partnered with its sister health coalition in Adams County Healthy Adams County to form a CHNA Planning Committee comprised of representatives from health and human service agencies, government entities, community-based organizations, higher education institutions, and other interested community members to assist with survey development, data review and analysis, and results distribution. This core committee also assisted with sharing the data and associated community health priorities, once identified by Coalition leadership, to community members at a public form in June 2016. WellSpan-York Hospital is a funding partner and governance leader within the Healthy York County Coalition and served on the CHNA Planning committee. In that regard, York Hospital partners to conduct the CHNA, disseminate its results both among hospital leadership and in the community, and integrate evidence-based strategies that impact identified community health needs into its annual planning process. Whether in meetings with community stakeholders or system/hospital leaders or at larger public forums, WellSpan-York Hospital is committed to obtaining community input to ensure that the CHNA and its associated implementation strategies appropriately address the identified needs of the entire community. Additional details of how community members were engaged is included in Part VI-Needs Assessment.
Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment Ephrata Community Hospital (Lancaster); Gettysburg Hospital (Adams) Good Samaritan Hospital (Lebanon); Philhaven (multiple counties), and; WellSpan Surgery and Rehabilitation Hospital. Outside of WellSpan Health, Hanover Hospital engaged in the CHNA process for York and Adams counties.
Part V, Line 7d - Description of Making Needs Assessment Widely Available With each iteration of the CHNA process, WellSpan-York Hospital and its community partners continue to refine and enhance the system by which it obtains data, shares it with key community, hospital and system leaders, and integrates it into the system-wide and entity-level planning processes. In 2015, CHNA results and related priorities identified by the Healthy York County Coalition were shared with the system-wide Planning Committee at WellSpan Health. This Committee is comprised of community members and leaders that represent each of WellSpans primary entities and service areas, in addition to corporate leadership. Planning Committee members reviewed the CHNA data, adopted HYCCs priorities of adult overweight/obesity, depression/mental health, and maternal/child health while also identifying two additional priorities: access related to gaps in care caused by high-deductible insurance plans and the emerging opioid misuse and abuse issue facing the community. These five priorities and associated data were subsequently presented to the WellSpan-York Hospital Board for their adoption. The Healthy York County Coalition communicated the CHNA results and identified priorities to approximately 200 community members at a public forum held on June 11, 2016. During that forum, 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 the priority. In addition to these venues, CHNA results are available on the Healthy York County Coalition (www.healthyyork.org) and WellSpan Health (www.wellspan.org) websites, and may also be obtained upon request. The corresponding WellSpan Community Health Improvement Plan is also available on the WellSpan Health website.
Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why Public health research recommends that a root cause approach be utilized to address many chronic disease, diabetes, respiratory ailments, and overweight/obesity. A focus on improving healthy eating and physical activity behaviors and reducing tobacco use has demonstrated efficacy in reducing the impact of various chronic conditions. A few cardiovascular indicators were ranked high by Community Benefit Council members, but not selected as priorities. These include those who have high blood pressure and high cholesterol, and those who have been told that they have heart disease, heart attack, or stroke risk indicators. Council members felt that the root causes of these conditions - unhealthy eating, physical inactivity, and tobacco use - were already part of the selected priorities - adult overweight/obesity and tobacco use.
Part V, Line 13b - Criteria For Providing Discounted Care If Not FPG Patients 401% of poverty level and greater do not qualify for financial assistance. However, all uninsured patients qualify for a 20% "no insurance" discount, regardless of income.
Part V, Line 13h - Other Factors Used in Determing Amounts Charged Patients 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 Pennsylvanias 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 example, if a patients income is less than 300 percent of the federal poverty level, that patient would be eligible for a 100 percent discount on the services provided. Additionally, significant discounts are available for patients whose income is between 300 percent and 400 percent of the federal poverty level. For more information on WellSpans Financial Assistance program, visit www.WellSpan.org/FinancialAssistance.
Part V, Line 16j - Other Means Hospital Facility Publicized the Policy In an effort to make patients, families and others in our communities aware of the newly expanded Financial Assistance Policy, 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 Financial Assistance Policy on its billing statements and included information in patient discharge materials. In addition, the materials and information are easily accessible via WellSpans website at www.WellSpan.org/FinancialAssistance. The site reflects WellSpans newly enhanced policy, as well as informational and application materials. It was also publicized via WellSpans on-hold phone messaging system and in its direct-to-consumer community newsletter/magazine, which is distributed by mail, email and Web. In addition, WellSpan placed posters and signage at its various sites of care to publicize its Financial Assistance Policy. Printed copies of WellSpan Healths entire financial assistance 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 Financial Assistance Policy Plain Language Summary are all available in Spanish.
Part V, Line 22d - Other Billing Determination of Individuals Without Insurance WellSpan Health will provide assistance to all patients whose income falls within 400 percent of the federal poverty guidelines and within the asset limits listed on Attachment A. Those patients qualifying for financial assistance will receive a discount based on the amount generally billed (AGB), which is applicable to the facility at which services were provided. The AGB is calculated by the look-back method, in accordance with IRS Regulation 501(r). This is based on payment received from Medical Assistance and all private payors, in the most recent completed fiscal year.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2017
Page 9
Schedule H (Form 990) 2017
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1 York Cancer Center
Apple Hill Medical Center 25 Monume
York,PA17403 		Cancer Patient Support, Social worker, Financial Counselor, Dietician, Library, Genetic Counseling
2 WellSpan Rehab & Lab -Queensgate Towne Center
2015 Springwood Rd
York,PA17403 		Physical Therapy, Occupational Therapy, Speech Therapy, Laboratory Collection
3 WellSpan Wound Healing Center
1399 S Queen St
York,PA17403 		Wound Care, Hyperbaric Oxygen Therapy
4 WellSpan Behavioral Crisis Intervention
1101 S Edgar St Suite C
York,PA17403 		Mental Health & Substance Abuse Assessments, Crisis Counseling
5 Community Health Center &Hoodner Dental Center
605 S George St
York,PA17401 		Dental Clinic, Pediatric Care, Women's Health Care,Adult Care, Urgent Care Special Services
6 Wellspan Imaging - East Berlin
105 Fourth St
East Berlin,PA17316 		Laboratory Collection, General Radiology, Mammogram Screening, EKG
7 WellSpan Lab Services & Imaging
2775 N George St
York,PA17402 		Laboratory collection, general radiology, mammogram Screening, EKG
8 WellSpan Apple Hill Womens Imaging & Specialty Services
35 Monument Road Suites 201 202 204
York,PA17403 		Mammography, MRI/Ultrasound, Bone Density, Breast and Thyroid, Ultrasound, High Risk Pregnancy, Phys
9 WellSpan Lab Services
4222 Lincoln Highway
York,PA17406 		Laboratory collection, General Radiology, Mammogram Screening, EKG
10 WellSpan Interventional Pain Mgmt
228 St Charles Way
York,PA17402 		Interventional Pain Mgmt, Radiology Fluroscopy
11 WellSpan Rehabilitation
1575 Bannister St
York,PA17404 		Physical Therapy, Occupational Therapy, Speech Therapy
12 WellSpan Rehabilitation and Imaging
207 Blooming Grove Road
Hanover,PA17331 		Post Operative Orthopedic Rehab, Acute Rehab following injury (work/athletic), Cumulative stress inj
13 WellSpan Lab & Imaging
3065 Windsor Road
Red Lion,PA17356 		Laboratory Collection, General Radiology, Mammogram Screening
14 WellSpan Rehabilitation
235 Rosedale Drive
Manchester,PA17345 		Physical Therapy, Occupational Therapy
15 WellSpan Lab & Imaging
4020 Carlisle Road
Dover,PA17315 		Laboratory Collection, General Radiology, Mammogram Screening, EKG, Sleep Disorders
16 WellSpan Lab & Imaging Services
13515 Wolfe Rd Ste D
New Freedom,PA17349 		Laboratory Collection, General Radiology, Mammogram Screening, EKG
17 WellSpan Imaging
2250 E Market St
York,PA17402 		general Radiology, Mammogram Screening, EKG, Bone Density, Orthopedic Services
18 WellSpan Lab Services at Valley Green
1790 Old Trail Road
Etters,PA17319 		Laboratory Collection
19 WellSpan Health Lab Services at Westgate Plaza
1550 Kenneth Rd
York,PA17404 		Laboratory Collection
20 WellSpan Pulmonary Sleep Medicine & Pulmonary Rehab
2350 Freedom Way Suites 201 207
York,PA17402 		Pulmonary Function Testing, Pulmonary Rehab & Asthma Instruction
21 WellSpan Rehabilitation
73 East Forrest Avenue Suite 210
Shrewsbury,PA17361 		Physical Therapy, Occupational Therapy, Speech Therapy
22 WellSpan Lab Services & Occupational Health
1150 Carlisle St
Hanover,PA17331 		Laboratory Collection, Screenings, Physicals, Drug & Alcolhol Screening, Injury Evaluation, Immuniza
23 Apple Hill Infusion Center
25 Monument Road Suite 120
York,PA17403 		Infusion Services, Genetic Counseling
24 York Cancer Center-Radiation Therapy
Apple Hill Medical Center -25 Monum
York,PA17403 		Oncology Radiation
25 WellSpan Heart & Vasular & Nuclear Medicine- Apple Hill
25 Monument Road - Suites 190 199
York,PA17403 		Cardiac Rehavilitation, Cardiovascular Health Management Clinic, Cardiac stress testing, Echo Cardio
26 WellSpan Heart & Vascular -Bannister St
1575 Bannister Street Suite 7
York,PA17404 		Coumadin Clinic, Congestive Heart Failure Clinic, IV Diuretic Clinic, Women's Heart Program
27 WellSpan Rehabilitation - Apple Hill
25 Monument Road Suite 175
York,PA17403 		Physical Therapy, Occupational Therapy, Speech Therapy
28 WellSpan Rehabilitation - North Hanover
1000 Carlistle St Suite 1175
Hanover,PA17331 		Post Operative Orthopedic Rehab, Acute Rehab following injury (work/athletic), Cumulative stress inj
29 WellSpan Rehabilitation - Cape Horn Square
635 Lombard Road
Red Lion,PA173569054 		Physical therapy
30 WellSpan Rehabilitation- Manheim
93 Doe Run Road
Manheim,PA17545 		Physical therapy, Occupational Therapy
31 WellSpan Rehabilitation - Valley Green
1790 Old Trail Road Suite F
Etters,PA17319 		Physical therapy
32 WellSpan Imaging
37 Monument Road Suite 101
York,PA17403 		General Radiology, Fluroscopy, General Ultrasound, Vascular Ultrasound, EKG, Computed Tomography
33 WellSpan Imaging - Apple Hill
25 Monument Road Suite 290
York,PA17403 		General Radiology
34 WellSpan Imaging
2775 North George St
York,PA17406 		Laboratory Collection, General Radiology, mammogram Screening, EKG
35 WellSpan Lab Services
46 West Market St
York,PA17401 		Laboratory Collection, urine specimen collection, glucose tolerance
36 WellSpan Lab Services- Apple Hill
25 Monument Road - Suite 198
York,PA17403 		Laboratory Collection
37 WellSpan Occupational Health
2250 E Market St
York,PA17402 		Screenings, Physicals, Drug & Alcolhol Screening, Injury Evaluation, Immunizations, Occupational Hea
38 WellSpan Occupational Health - Gettysburg
455 South Washington St Suite 12
Gettysburg,PA17325 		Screenings, Physicals, Drug & Alcolhol Screening, Injury Evaluation, Immunizations, Occupational Hea
39 Thomas Hart Family Practice Center
1001 S George St
York,PA17403 		Primary Care, women's healthcare, pediatric & geriatric care, prenatal care, minor surgical procedur
40 WellSpan OB GYN & Specialty Care Clinic
1101 Edgar St
York,PA17403 		Women's Health, special procedures - lumbar puncture, PHAS- Surgery Setups thru clinics as as GYN Cl
Schedule H (Form 990) 2017
Page 10
Schedule H (Form 990) 2017
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
Part I, Line 6a - Related Organization Community Benefit Report Community Benefit Information is included in the Community Benefit Report for WellSpan Health.
Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense 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 - Methodology of Estimated Amount & Rationale for Including in Community Benefit 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 - Bad Debt Expense York Hospital 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 accounts 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 YH ceases collection efforts. Losses have been consistent with management's expectations in all material respects.
Part III, Line 8 - Explanation Of Shortfall As Community Benefit York Hospital 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 these services. Payments from Medicare are generally less than York Hospital's costs of providing the service.
Part III, Line 9b - Provisions On Collection Practices For Qualified Patients 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 - Needs Assessment WellSpan Health and its entities have a long history of understanding and responding to the needs of the communities and populations it serves. This commitment was strengthened in 1998 when, in partnership with the Healthy York County Coalition, WellSpan conducted its first Community Health Needs Assessment (CHNA). Five subsequent CHNAs were conducted in 2000, 2005, 2008, 2012 and 2015. These assessments one method for collecting diverse information on a community and which involves surveying a representative sample of community members on their demographics, chronic health conditions, lifestyle behaviors, finances, access to health services, and related topics have been administered before the Affordable Care Act (ACA) requirement. As previously noted, the WellSpan CHNA process, which includes survey development, data collection and analysis, and result dissemination, was led by both county-level health coalitions Healthy Adams County and the Healthy York County Coalition. These coalitions receive financial support from WellSpan Health and its entities, and other community stakeholders. The following community organizations partnered to provide guidance and support to the 2015 CHNA: County of York; Family First Health; Hanover Hospital; TrueNorth Wellness Services; United Way of York County; York City Health Bureau; York College of Pennsylvania, and; York County Community Foundation. Additional consulting support was provided through a contract with the Floyd Institute for Public Policy at Franklin and Marshall College. Dr. Berwood Yost, Institute Director and Project has an extensive background conducting and analyzing community and corporate surveys, and has been integral to the prior two CHNAs (2008 and 2012). This collaboration of community stakeholders: determined the survey questions to be asked of the community; discussed data collection methodology, including sample size and method of obtaining data; reviewed the raw data and supporting charts/graphs; identified potential community health priorities, and; developed the process by which results and priorities were to be shared with the community.The 2015 CHNA planning process engaged a wide range of community organizations serving the diverse interests of all partners without burdening CHNA respondents with too many questions. Committee members reviewed questions asked in the 2012 CHNA and edited accordingly based on the current health care environment and areas of interest. Survey questions were derived from the Behavioral Risk Factor Surveillance System (BRFSS), a validated survey tool utilized by the Centers for Disease Control and Prevention (CDC), and organized into four categories: healthcare access, behavioral risk, health conditions, and prevention behaviors and context. A representative sample of 1,028 adult residents in York County were interviewed between October 27 and December 12, 2014. Supplemental secondary data from the Robert Wood Johnson Foundation (RWJF) annual County Health Rankings and from the Pennsylvania Department of Health was compiled and integrated into the 2015 CHNA. Data collected and analyzed by the Floyd Institute for Public Policy included breakdowns by age, gender, geographic area, race/ethnicity, and income level, and enabled the development of charts/graphs focused on: quantity of residents affected; health risks and disability-adjusted life years; correlates of obesity and depression (two significant health priorities); health disparities, and; social determinants of health impact. This information is included in the 2015 Community Health Needs Assessment Summary Report available at www.wellspan.org. In 2015, CHNA results and related priorities identified by the Healthy York County Coalition were shared with the system-wide Planning Committee at WellSpan Health. This Committee is comprised of community members and leaders that represent each of WellSpans primary entities and service areas, in addition to corporate leadership. Planning Committee members reviewed the CHNA data, adopted HYCCs priorities of adult overweight/obesity, depression/mental health, and maternal/child health while also identifying two additional priorities pertinent to WellSpan Health: access related to gaps in care caused by high-deductible insurance plans and the emerging opioid misuse and abuse issue facing the community. These five priorities and associated data were subsequently presented to the WellSpan-York Hospital Board for their adoption. Board members discussed the data and identified priorities within the context of existing staffing and financial resources, current and future entity initiatives, and community partnership opportunities to address systemic community change.
Part VI, Line 5 - Promotion of Community Health As a charitable, community-based healthcare organization, our commitment to improving the lives and well-being of the 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 five health priorities identified in the 2015 CHNA - adult overweight/obesity; access related to gaps in care caused by high-deductible insurance plans; depression/mental health; maternal/child health, and opioid misuse and abuse. Below are a few examples of the work accomplished to address each:*Access to healthcare and medications for uninsured community members or those with high out-of-pocket costs is often financially challenging. Healthy Community Network, a collaborative between WellSpan Health, physicians and community partners to support prospective enrollment, the management and support of patients, and coordination of care, serves as a support for those individuals, offering free or discounted resources based on need. In addition, through support of the Family First Health Hannah Penn Center, 2,639 acute and preventative visits were provided to underserved adults and children.*In 2018, WellSpan Health encouraged community members, local employers and employees, and WellSpan staff and patients to engage in the 6th annual 10 Pound Throwdown initiative. The 10 Pound Throwdown is a 10-week community challenge that encourages participants to lose or maintain a healthy weight through healthier eating and increased physical activity. The initiative was created to address the growing issue of adult overweight/obesity, and utilizes a core website (www.10poundthrowdown.com) to encourage team participation and to offer an online weight tracker, badges to encourage healthier choices, and diverse health education resources. Nearly 5800 community members across four southcentral Pennsylvania counties -Adams, Lancaster, Lebanon, and York- participated in the 2018 iteration of the 10 Pound Throwdown program. *Feeling Blue is a depression awareness campaign that engages community members, clients of services, and mental health professionals in efforts to reduce the stigma and enhance the awareness of depression in York County. The Feeling Blue group teamed up with the Jewish Community Center and a locally owned theatre arts group to provide a theatrical event and group discussion of mental health in spring 2018. The event, named Breaking Blue, was sponsored by a WellSpan Community Partnership Grant. The Breaking Blue event also featured a resource fair, highlighting the services available in the region. One of the many resources highlighted was the National Alliance on Mental Illness (NAMI), who also received Community Partnership grant funds. NAMI utilized the funds to implement healthy cooking classes and nutrition education for individuals with mental illness. *Community Partnership Grant funds also assisted with the establishment of safe, comfortable and compassionate end-of-life care in York County. WellSpan Health worked with community partners to support the development of Pappus House, a special home dedicated to offering personalized end-of-life care for individuals and their families, in collaboration with hospice providers. WellSpan worked with Pappus House to identify patients who would benefit from care in the homes unique environment. *Celebrating more than a decade of promoting summertime physical activity, Get Outdoors (GO) York!, a partnership between WellSpan-York Hospital and York County Libraries, 9,000 children participated in an adaptation of letterboxing, an international hobby where participants use written clues to find items hidden in various places. More than 1,143 participants (12.7%) submitted their program rubbing sheets and collectively walked a total of 22,250 miles.*Opioid use, as in other communities across the United States, has become a crisis in York County. A WellSpan Family Physician and faculty member, who also serves as the Medical Director at York City Bureau of Health, leads the York Regional Opiate Collaborative. WellSpan continues to support this position financially along with key community partners committed to this cause. In 2018 alone, faith leaders, business managers, and school nurses attended educational presentations on the topic of opioid use and misuse provided by WellSpan staff.*WellSpan Health -York Hospital primary care practices in York County participated in the Market Bucks program- 15 practices engaged over 130 patients- to address food insecurity and increase the consumption of fruits and vegetables. This program reaches those with an elevated Body Mass Index (BMI) who also experience a comorbidity associated with diet. The program provides fruit and vegetable vouchers to be redeemed at local farmers markets and encourages healthy eating. Market Bucks boasts an astounding 86% redemption rate and contributes over $27,000 to the regional economy each year, in addition to demonstrating increased fruit and vegetable consumption for participants. Historically, WellSpan Health and its entities have taken planned steps to build community capacity that addresses complex health issues, as identified by the Community Health Needs Assessment (CHNA). Through financial and management support of a county health coalition, the Healthy York County Coalition (HYCC), more than 200 York County community members have been engaged in community health improvement initiatives. HYCC consists of three committees -Access and Empowerment; Community Engagement, and; Prevention and Wellness, each of which continue to attract new community members, leaders, and professionals. These committees foster partnerships and collaboration between entities to ensure that efforts to address and impact identified community health needs are coordinated and successful.Additional examples of how WellSpan-York Hospital fulfilled its community mission in York County may be found in the 2018 WellSpan Community Benefit Report - It's What Neighbors Do - available online at www.wellspan.org.
Part VI, Line 6 - Affilated Health Care System 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. WellSpan York Hospital works with other parts of the system to provide a comprehensive approach to meeting community needs.WellSpan Health includes: WellSpan Gettysburg Hospital, WellSpan York Hospital, WellSpan Surgery and Rehabilitation Hospital, WellSpan Ephrata Community Hospital, WellSpan Good Samaritan Hospital, WellSpan Philhaven, Apple Hill Surgical Center, WellSpan VNA Home Health, WellSpan Medical Group, Northern Lancaster County Medical Group, Physician Specialists of Northern Lancaster County Medical Group, Good Samaritan Physician Services, WellSpan Population Health Services, WellSpan Pharmacy, Gettysburg Hospital Foundation, York Health Foundation, Ephrata Community Health Foundation, Good Samaritan Health Services Foundation, WellSpan Provider Network, GSH Services, and WellSpan Medical Equipment.WellSpan York Hospital's community benefit report is contained in a report prepared by their parent organization, WellSpan Health. See Attached Federal Supplemental Information: WellSpan Health - 2018 Community Benefit Report
Part VI, Line 7 - States Filing of Community Benefit Report PA
Schedule H (Form 990) 2017
Additional Data


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