2021-11-15T14:55:12-06:00 2020-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2020-01-01 311480941 GENESIS HEALTHCARE SYSTEM GENE 7404545000 2951 MAPLE AVENUE ZANESVILLE OH 43701 MICHAEL NORMAN CFO 7404545000 2021-11-12 1 MICHAEL NORMAN 999009999 AMY CIMINELLO P00796388 6148493000 2021-11-12 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z MATTHEW PERRY 2951 MAPLE AVENUE ZANESVILLE OH 43701 529584784 0 3727 X WWW.GENESISHCS.ORG X 1997 OH IN 1997, GOOD SAMARITAN MEDICAL CENTER AND BETHESDA HOSPITAL ASSOCIATION, A TAX-EXEMPT COMMUNITY HOSPITAL ALSO LOCATED IN ZANESVILLE, AFFILIATED TO FORM GENESIS HEALTHCARE SYSTEM. GENESIS HAS BEEN GRANTED 501C3 STATUS AS A HOSPITAL. ALL HOSPITAL OPERATIONS AND ASSETS OF GOOD SAMARITAN MEDICAL CENTER WERE TRANSFERRED TO GENESIS WITH THE EXCEPTION OF CERTAIN INVESTMENTS. GOOD SAMARITAN MEDICAL CENTER WILL CONTINUE TO HAVE CONTROL OVER CERTAIN INVESTMENTS WHICH ARE BEING USED BY THE GENESIS HEALTHCARE SYSTEM IN FULFILLING ITS TAX-EXEMPT PURPOSE. 17 13 3566 335 185077 0 669958 36640849 455478706 455530661 4195739 8373276 24415257 26952885 484759660 527497671 343077 322389 0 0 186153313 187475317 0 0 0 241706280 262928052 428202670 450725758 56556990 76771913 607216176 697051307 412395266 481340257 194820910 215711050 X TO PROVIDE COMPASSIONATE, QUALITY HEALTH CARE 0 0 279726633 322389 475560673 GENESIS PROVIDES ACUTE CARE SERVICES INCLUDING MEDICAL, SURGICAL, OBSTETRICAL, PEDIATRIC AND CRITICAL CARE. GENESIS PROVIDES A WIDE RANGE OF DIAGNOSTIC AND SUPPORT SERVICES FOR INPATIENTS AND OUTPATIENTS. THESE SERVICES ARE COMPRISED OF LABORATORY, IMAGING SERVICES, CARDIAC, AND PHARMACY. LABORATORY SERVICES INCLUDE CHEMISTRY, PATHOLOGY, MICROBIOLOGY, HEMATOLOGY, CYTOLOGY, AND PHLEBOTOMY. IMAGING SERVICES INCLUDES RADIOLOGY, NUCLEAR MEDICINE, MRI, ULTRASOUND, CT SCAN, PET SCAN, MAMMOGRAPHY AND BONE DENSITY SCANNING.GENESIS HEART & VASCULAR SERVICES PROVIDE NEEDED HEART CARE FROM PREVENTION TO REHABILITATION. OUR BOARD-CERTIFIED SPECIALISTS INCLUDE CARDIOLOGISTS, CARDIOTHORACIC VASCULAR SURGEONS, ELECTROPHYSIOLOGISTS, INTERVENTIONAL CARDIOLOGISTS, CARDIAC ANESTHESIOLOGISTS AND CARDIAC REHAB SPECIALISTS. THE CARDIOTHORACIC AND VASCULAR SURGICAL TEAMS PERFORM A WIDE VARIETY OF COMPLEX AND HIGH-RISK CARDIAC, THORACIC AND VASCULAR PROCEDURES INCLUDING OPEN HEART SURGERY. OUR CARDIAC TEAM TAKES OUR PATIENTS FROM EVALUATION AND DIAGNOSIS THROUGH LIFESTYLE CHANGES AND TREATMENTS. ALSO INCLUDED IN OUR CARDIAC SERVICES ARE OUR CLINICS AND SPECIALTY PROGRAMS. THESE INCLUDE AN ANTICOAGULATION CLINIC, A CONGESTIVE HEART FAILURE CLINIC, A DEVICE CLINIC, A VEIN CLINIC AND A CARDIAC REHABILITATION PROGRAM. GENESIS IS AN ACCREDITED CHEST PAIN CENTER WITH PCI, AN ACCREDITED ECHOCARDIOGRAPHY FACILITY. RESPIRATORY SERVICES - GENESIS RESPIRATORY & LUNG PROVIDES SERVICES FOR A VARIETY OF LUNG CONDITIONS AND DISEASES INCLUDING LUNG SURGERIES AND RESPIRATORY THERAPY. OUR TEAM, INCLUDING BOARD-CERTIFIED PULMONOLOGISTS, PROVIDE CARE AND TREATMENT FOR PATIENTS WITH PNEUMONIA, LUNG CANCER, BLACK LUNG DISEASE, RESPIRATORY FAILURE, COLLAPSED LUNG, AND OTHER PLEURAL DISEASES. THE GENESIS ORTHOPEDIC TEAM OF BOARD-CERTIFIED SURGEONS, SPECIALLY TRAINED NURSES, AND REHABILITATION THERAPISTS WORK TOGETHER TO DIAGNOSE AND TREAT THE MUSCULOSKELETAL ISSUES OF OUR PATIENTS. SERVICES RANGE FROM ADVANCED IMAGING TESTING THROUGH TO REHABILITATION. SURGICAL SURGERIES INCLUDE NUMEROUS PROCEDURES INCLUDING REPLACEMENT OF THE HIP, KNEE, OR SHOULDER AS WELL AS VARIOUS SURGERIES INVOLVING THE HAND. THE SPECIALIZED REHABILITATION PROGRAM SPEEDS RECOVERY AFTER A SERIOUS INJURY OR SURGERY RELATED TO A BONE, JOINT, LIGAMENT, TENDON OR MUSCLE. IN ADDITION TO PHYSICAL AND OCCUPATIONAL THERAPY, GENESIS ALSO PROVIDES AMPUTEE AND PROSTHETICS THERAPY AND TRAINING. 279726633 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 279 0 1 3566 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 0 X 17 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X MICHAEL NORMAN 7404544773 2951 MAPLE AVENUE ZANESVILLE OH 43701 MATTHEW PERRY PRESIDENT/CEO 48.72 1.28 X 954673 0 29700 SCOTT WEGNER MD CHIEF CLINICAL OFFICER 50.00 0.00 X 703939 0 114636 DANIEL SCHEERER MD CHIEF MEDICAL AFFAIRS OFFICER 50.00 0.00 X 521442 0 91894 EDMUND ROMITO CHIEF INFORMATION OFFICER 50.00 0.00 X 471679 0 140264 DIANNA LEVECK CHIEF HUMAN RESOURCES OFFICER 49.85 0.15 X 494233 0 85928 MICHAEL NORMAN CHIEF FINANCIAL OFFICER 48.97 1.03 X 519826 0 30048 SHARON PARKER CHIEF OPERATION OFFICER 49.85 0.15 X 498357 0 37630 WENDY CEDOZ CHIEF LEGAL OFFICER 49.86 0.14 X 425666 0 65900 KRISTY RITCHIE MD TRUSTEE 50.00 0.00 X 0 441518 36023 CHRISTOPHER SCHOELLES CHIEF OPERATION OFFICER 50.00 0.00 X 396084 0 35593 SHON BENDER CHIEF NURSING OFFICER 49.92 0.08 X 354889 0 8335 ERIN REMSTER DO TRUSTEE 50.00 0.00 X 0 284261 21633 JONATHAN TONGSON MD TRUSTEE 50.00 0.00 X 285916 0 0 WILLIAM SHADE MD TRUSTEE 50.00 0.00 X 0 235300 22564 LINDA SUPPLEE DIRECTOR 50.00 0.00 X 223336 0 3633 GREG MATONAK DIRECTOR 50.00 0.00 X 202863 0 23440 CHARLES ADAMS JR DIRECTOR 50.00 0.00 X 182661 0 28967 LES BOYER DIRECTOR 50.00 0.00 X 175911 0 34856 MARIANNE GRAHAM MANAGER 50.00 0.00 X 179892 0 21517 RANDY COCHRANE EX-OFFICIO 1.67 0.06 X X 0 0 0 TOD KLOTZBACH TREASURER 1.04 0.06 X X 0 0 0 PATRICK NASH CHAIR 1.79 0.14 X X 0 0 0 JAMES MCDONALD VICE CHAIR 1.15 0.14 X X 0 0 0 JIM NICHOLSON SECRETARY 1.21 0.14 X X 0 0 0 JOANN BUTCHER TRUSTEE 1.27 0.20 X 0 0 0 JOHN DITTOE TRUSTEE 1.15 0.00 X 0 0 0 COLBY GRAHAM TRUSTEE 0.98 0.00 X 0 0 0 SUSAN HOLDREN TRUSTEE 1.21 0.06 X 0 0 0 SR MARY ANN NUGENT TRUSTEE 1.15 0.00 X 0 0 0 SHIRLEY VAN WYE TRUSTEE 1.33 0.10 X 0 0 0 SCOTT MCCONNAHA EX-OFFICIO 0.63 0.00 X 0 0 0 LORI LOWE TRUSTEE 1.21 0.00 X 0 0 0 6591367 961079 832561 16 0 1 0 CENTRAL OHIO HOSPITALISTS INC 3525 OLENTANGY RIVER RD SUITE 4330 COLUMBUS OH 43214 MEDICAL SERVICES 6791031 ARUP LABORATORIES 500 CHIPETA WAY SALT LAKE CITY UT 84127 MEDICAL SERVICES 1587805 DVA RENAL HEALTHCARE INC PO BOX 8500-1607 PHILADELPHIA PA 19178 MEDICAL SERVICES 694872 PLANTE & MORAN PLLC 16060 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 PROFESSIONAL SERVICES 680507 ADVIZEX TECHNOLOGIES LLC 6480 ROCKSIDE WOODS BLVD 190 INDEPENDENCE OH 44131 TECHNOLOGY SERVICES 662770 49 5014 36635835 36640849 NET PATIENT SERVICES 621110 455530661 455530661 455530661 8927645 8927645 1068303 1532744 -464441 -464441 -464441 554369 -554369 -554369 -554369 340B DISPENSING 621110 2935054 2935054 CAFETERIA SALES 621110 2543719 2543719 LABORATORY 621110 25500 25500 21913053 17533899 185077 4194077 27417326 527497671 475560673 185077 15111072 X 322389 322389 8099121 235330 7863791 135524052 93490046 42034006 6383431 2346747 4036684 26545666 -108738 26654404 10923047 8741972 2181075 600838 551493 49345 509695 509695 9238533 9238533 165227 165227 47676640 31124159 16552481 721762 64702 657060 6833372 2718946 4114426 9506377 1627861 7878516 484352 254968 229384 2909 -4497 7406 16343783 1716154 14627629 22693635 7929464 14764171 3528935 15263 3513672 MEDICAL SUPPLIES 109862941 103893806 5969135 BAD DEBT EXPENSE 19087956 19087956 DUES/LICENSES/SUBSCRIPT 10363914 1895268 8468646 EMPLOYEE RECOGNITION 3331155 3279008 52147 1976028 544336 1431692 450725758 279726633 170999125 0 3072513 16816468 32735511 116600134 78429953 69139538 9456168 9963877 11591840 11353314 504942786 221008743 296679215 283934043 109634918 121487554 6951820 9114220 4281450 4281450 54382788 54360709 607216176 697051307 73910410 108116570 271933593 267717550 13289290 4365000 53261973 101141137 412395266 481340257 X 194820910 215711050 194820910 215711050 607216176 697051307 X 76771913 3811335 -59693108 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 165227 0 1 10235 175462 0 PART II-B, LINE 1: GENESIS HEALTHCARE SYSTEM PAYS MEMBERSHIP DUES AND A PORTION OF THOSE DUES ARE RELATED TO LOBBYING: OHIO HOSPITAL ASSOCIATION - FSCC SHARE (OHA): 4.60% OF $89,101 ($4,099) CATHOLIC CONFERENCE OF OHIO: 4.30% OF $2,060 ($89) CATHOLIC HEALTH ASSOC (FSCC SHARE): 3.66% OF $37,063 ($1,357) CATHOLIC HEALTH ASSOC (FSCC SHARE): 3.76% OF $36,696 ($1,380) 340B HEALTH 2020: 8.00% OF $10,780 ($862) ACADEMY OF NUTRITION & DIETETICS: 14.00% OF $234 ($33) AMERICAN MEDICAL GROUP ASSOCIATION (AMGA): 10.00% OF $11,250 ($1,125) HEALTHCARE INFORMATION & MGMT SYSTEMS SOCIETY (MIMSS): 1.87% OF $3,375 ($63) TRAUMA CENTER ASSOCIATION OF AMERICA (TCAA): 23.00% OF $2,000 ($460) AMERICAN SOCIETY FOR HEALTH CARE ENGINEERING, AMERICAN (ASHI): 22.73% OF $300 ($68) OHIO HOSPICE AND PALLIATIVE CARE ORGANIZATION DBA MIDWEST CARE ALLIANCE (OHPCO): 2.80% OF 400 ($11) OHIO HOSPICE AND PALLIATIVE CARE ORGANIZATION DBA MIDWEST CARE ALLIANCE (OHPCO): 8.60% OF 8,000 ($688) GENESIS HEALTHCARE SYSTEM PAID SECOND CAPITAL CONSULTING, LLC $165,227 IN 2020 FOR ADVOCACY AND OUTREACH CONSULTING SERVICES. SECOND CAPITAL CONSULTING, LLC HAS PROVIDED ADVOCACY AND OUTREACH CONSULTING SERVICES TO GENESIS HEALTHCARE SYSTEM SINCE 2013. THESE SERVICES ASSIST THE SYSTEM TO ENGAGE, EDUCATE AND COMMUNICATE WITH PUBLIC POLICY MAKERS REGARDING PENDING LEGISLATION OR PROPOSED REGULATIONS, AS WELL AS, ASSIST ELECTED OFFICIALS IN UNDERSTANDING THE IMPACT OF LEGISLATION ON GHCS'S ABILITY TO DELIVER COST EFFECTIVE, QUALITY CARE FOR PATIENTS IN SOUTHEAST OHIO. GENESIS WORKS PRIMARILY THROUGH NATIONAL AND STATE HOSPITAL ASSOCIATIONS, IN WHICH GENESIS HAS MEMBERSHIP, TO UNDERSTAND POTENTIAL POLICIES WHICH COULD NEGATIVELY AFFECT THEIR ABILITY TO WORK WITH THE LOCAL MEDICAL COMMUNITY TO MEET THE HEALTHCARE NEEDS OF THE REGION. SOME ISSUES OF INTEREST INCLUDE THE 340B PROGRAM, MEDICARE & MEDICAID BUDGET DECISIONS AND REGULATIONS, AND INFRASTRUCTURE IMPROVEMENTS AT THE LOCAL LEVEL THAT ENHANCE ACCESS TO THE HOSPITAL. IN FACT, A DIRECT ACCESS LANE OPENED THIS YEAR FOR EMERGENCY VEHICLES, SPEEDING THE TIME CRITICAL TO PATIENTS IN ARRIVING FOR EMERGENCY CARE. 10433728 10433728 230482754 32187781 198294973 5409605 3028046 2381559 245534875 183780844 61754031 13081824 2012072 11069752 283934043 INVESTMENTS IN RELATED AND OTHER HEALTHCARE ORGANIZATIONS 3687016 ASSETS LIMITED AS TO USE 27975988 RIGHT OF USE LEASE ASSETS 22697705 54360709 ACCRUED MINIMUM PENSION LIABILITY 28153032 ACCRUED PROFESSIONAL LIABILITY 5238259 LEASE LIABILITIES - OPERATING 19882598 LEASE LIABILITIES - FINANCING 561332 MEDICARE ACCELERATED AND ADVANCED PAYMENTS 47305916 101141137 X PART X, LINE 2: THE SYSTEM AND ITS SUBSIDIARIES ARE TAX-EXEMPT ORGANIZATIONS, EXCEPT FOR CARELIFE; ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE CONSOLIDATED FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND TO RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER APPLICABLE TAXING AUTHORITIES. 1 1 X 1 X 1 X 1 1 1 0 1 1 2007759 1018761 988998 0.00230 87367526 80289670 7077856 0.01640 89375285 81308431 8066854 0.01870 44 96025 1593947 54736 1539211 0.00360 8 1863 876867 0 876867 0.00200 9 386 8433 8433 0.00000 61 98274 2479247 54736 2424511 0.00560 61 98274 91854532 81363167 10491365 0.02430 0 19087956 0 115322031 112061448 3260583 X 1 1 1 1 GENESIS HOSPITAL 2951 MAPLE AVE ZANESVILLE OH 43701 X X X ACUTE CARE HOSPITAL GENESIS HOSPITAL 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X HTTPS://WWW.GENESISHCS.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT X 1 19 1 WWW.GENESISHCS.ORG/ABOUT-US/COMMUNITY 0 1 X 100.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X 1 X 0 X X X X 1 X 0 0 GENESIS HOSPITAL PART V, SECTION B, LINE 5: A COMMUNITY HEALTH SURVEY WAS CONDUCTED. THE SURVEY GATHERED THE COMMUNITY INPUT ON THEIR PRIORITIES FOR CHRONIC CONDITIONS, RISK FACTORS FOR DISEASE, MOTHERS AND CHILDREN AND ACCESS TO CARE. THE SURVEY WAS COLLECTED ON THE GENESIS WEBSITE IN SEPTEMBER OF 2018 AND USED FACEBOOK, TWITTER, AND THE ZANESVILLE TIMES RECORDER TO PUBLICIZE THE COMMUNITY HEALTH NEEDS SURVEY. 67 COMPLETED SURVEYS WERE COLLECTED FROM THE GENESIS WEBSITE AND FROM INDIVIDUALS WAITING FOR SERVICES AT THE GENESIS HOSPITAL. ALL SIX COUNTIES WERE REPRESENTED IN THE SURVEY. TWO STUDENTS FROM MUSKINGUM UNIVERSITY AND KEY PARTNERS SUCH AS MUSKINGUM VALLEY HEALTH CENTER, THE VETERAN'S CLINIC, SALVATION ARMY, CHRIST'S TABLE, AND UNITED WAY COLLECTED SURVEYS FROM LOCATIONS SERVICING THE UNDERSERVED POPULATION. SIXTY-THREE PERSONS COMPLETED THE SURVEY IN THE UNDERSERVED LOCATIONS. A TOTAL OF 130 SURVEYS WERE COLLECTED.58 KEY INFORMANT SURVEYS WERE COLLECTED IN THE COMMUNITY AND CONTAINED CATEGORIES FOR BEHAVIORAL RISKS, MOMS AND BABIES, MORTALITY RATES AND POVERTY. SPECIAL CARE WAS USED TO IDENTIFY KEY INFORMANTS WITH KNOWLEDGE OF UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS. IN ADDITION, WE HAVE IDENTIFIED THE KEY INFORMANTS SPECIFICALLY AS: (1) PERSONS WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH; (2) REPRESENTATIVES FROM GOVERNMENT OR PUBLIC HEALTH DEPARTMENTS; AND (3) LEADERS, REPRESENTATIVES, OR MEMBERS OF MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE NEEDS. ALL SIX COUNTIES WERE REPRESENTED IN THE KEY INFORMANT SURVEY.IN ADDITION TO USING COUNTY BASED NEEDS ASSESSMENTS, DUE TO THE LARGE COMMUNITY DEFINED IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT, SPECIAL CARE WAS TAKEN TO INCORPORATE THE VIEWS OF KEY INFORMANTS FROM EACH COUNTY. BELOW ARE EXAMPLES OF THE AGENCIES AND GROUPS COMPLETING THE KEY INFORMANT SURVEYS.COSHOCTON:GENESIS HEALTHCARE SYSTEMCOSHOCTON COUNTY HEALTH DEPARTMENTCOSHOCTON JOB AND FAMILY SERVICESCOSHOCTON UNITED WAYMUSKINGUM VALLEY HEALTH CENTERCOSHOCTON BEHAVIORAL HEALTH CHOICESMUSKINGUM:GENESIS HEALTHCARE SYSTEMTHE CARR CENTERQUALITY CARE PARTNERSZANESVILLE-MUSKINGUM COUNTY HEALTH DEPARTMENTHEART BEATSBIG BROTHERS BIG SISTERSMUSKINGUM COUNTY COMMUNITY FOUNDATIONMUSKINGUM RECREATION CENTERMUSKINGUM COUNTY PORT AUTHORITYSALVATION ARMYBETHEL MISSIONFIRST UNITED METHODIST CHURCHMUSKINGUM VALLEY HEALTH CENTERAMERICAN CANCER SOCIETYWICGUERNSEY:GENESIS HEALTHCARE SYSTEMAMERICAN CANCER SOCIETYMUSKINGUM VALLEY HEALTH CENTERMORGAN:GENESIS HEALTHCARE SYSTEMMORGAN LOCAL SCHOOLSMUSKINGUM VALLEY HEALTH CENTERBUCKEYE HILLSSALVATION ARMYNOBLE:GENESIS HEALTHCARE SYSTEMBUCKEYE HILLS-HOCKING VALLEY REGIONAL DEVELOPMENT DISTRICTCARESOURCEAMERICAN CANCER SOCIETYPERRY:GENESIS HEALTHCARE SYSTEMPERRY COUNTY HEALTH DEPARTMENTNORTHERN LOCAL SCHOOLSHELP ME GROWHOPEWELL HEALTH CENTERCROOKSVILLE SCHOOL NURSESALVATION ARMY GENESIS HOSPITAL PART V, SECTION B, LINE 7D: THE CHNA REPORT IS AVAILABLE ON OUR WEBSITE AT HTTP://GENESISHCS.ORG, AT THE BOTTOM OF THE FRONT PAGE. THE REPORT WAS SHARED WITH COMMUNITY PARTNERS AND COPIES ARE AVAILABLE FOR FREE UPON REQUEST. GENESIS HOSPITAL PART V, SECTION B, LINE 11: PLEASE NOTE: THE CHNA WAS COMPLETED IN 2018. A NEW THE 2019-2021 IMPLEMENTATION STRATEGY ON OUR WEBSITE WAS COMPLETED IN MAY OF 2019. THE INFORMATION BELOW IS FOR THE COMMUNITY BENEFIT 2019-2021 IMPLEMENTATION STRATEGY. IT IS THE WRITTEN PLAN THAT EACH OF THE COMMUNITY HEALTH NEEDS FOR 2018.THE COMMUNITY BENEFIT 2019-2021 IMPLEMENTATION STRATEGY IS A WRITTEN PLAN GENESIS HEALTHCARE SYSTEM THAT ADDRESSES EACH OF THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2018 CHNA. THE IMPLEMENTATION STRATEGY HAS BEEN TAILORED TO THE SERVICE LINES OF GENESIS, TAKING INTO ACCOUNT SPECIFIC PROGRAMS, RESOURCES AND PRIORITIES.THE INITIAL PROPOSED OUTCOMES IN THE TABLES WILL BE USED AS A BASELINE FOR PERFORMANCE FOR EACH YEAR AND USED TO GUIDE THE EVALUATION PROCESS AND FUTURE INITIATIVE DEVELOPMENT.THE COMMUNITY BENEFIT 2019-2021 IMPLEMENTATION STRATEGY OUTCOMES ARE TRACKED QUARTERLY AND ANNUALLY THROUGH THE COMMUNITY BENEFIT'S DATA SYSTEM KNOWN AS THE COMMUNITY BENEFIT INVENTORY OF SOCIAL ACCOUNTABILITY (CBISA). THE INITIAL PROPOSED OUTCOMES IN THE TABLES WILL BE USED AS A BASELINE FOR PERFORMANCE FOR EACH YEAR AND USED TO GUIDE THE EVALUATION PROCESS AND FUTURE INITIATIVE DEVELOPMENT.THE DOCUMENT "2020 COMMUNITY BENEFIT PLAN" CONTAINED THE 2019 EVALUATION OF OUTCOMES AND THE 2020 PROPOSED OUTCOMES OF THE 2019-2021 COMMUNITY IMPLEMENTATION STRATEGY WHICH WAS APPROVED BY THE GENESIS QUALITY. PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.GENESISHCS.ORG/SITES/DEFAULT/FILES/2021-08/FINANCIAL%20ASSISTANCE%20POLICY_%20CURRENT%20REVISED%20AUGUST2021%20UPDATE%20OHIO%20REVISED%20CO%20SECTION%20NUMBER.PDF PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://GENESISHCS.NA1.ADOBESIGN.COM/PUBLIC/ESIGNWIDGET?WID=CBFCIBAA3AAABLBLQZHDBPIH48URU3JMCFR7WQBKK7GJU8ZNXDXISNXUI9K9D0SRIFLRKGLQLQIZT3YWWEYA* PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.GENESISHCS.ORG/SITES/DEFAULT/FILES/2021-03/PLAIN-LANGUAGE-SUMMARY.PDF 16 1 - HOSPICE & PALLIATIVE CARE 713 FOREST AVENUE ZANESVILLE OH 43701 HOSPICE & PALLIATIVE CARE CENTER 2 - CTR FOR OUTPATIENT & OCCUPATIONAL REHAB 740 ADAIR AVENUE ZANESVILLE OH 43701 OUTPATIENT REHAB SERVICES 3 - HEALTHPLEX 2800 MAPLE AVENUE ZANESVILLE OH 43701 OUTPATIENT LAB/IMAGING; PEDIATRIC REHAB 4 - GENESIS PHYSICIAN'S PAVILION 945 BETHESDA DRIVE ZANESVILLE OH 43701 OUTPATIENT CARDIAC REHAB SERVICES; WOUND CARE CENTER 5 - GENESIS BEHAVIORAL HEALTH 2991 MAPLE AVENUE ZANESVILLE OH 43701 MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT 6 - GENESIS INTERVENTIONAL PAIN MGT CLINIC 2945 MAPLE AVENUE ZANESVILLE OH 43701 PAIN MEDICINE SPECIALIZATION;IMAGING TECHNIQUES;SOLUTIONS TO PAIN MANAGEMENT 7 - GENESIS SLEEP DISORDERS CENTER 840 BETHESDA DRIVE ZANESVILLE OH 43701 DIAGNOSIS AND TREATMENT OF SLEEP DISORDERS 8 - GENESIS RHEUMATOLOGY CARE CENTER 2525 MAPLE AVENUE ZANESVILLE OH 43701 EDUCATION AND OUTPATIENT RHEUMATOLOGY SERVICES 9 - CAMBRIDGE HEALTH CENTER 61353 SOUTHGATE PARKWAR CAMBRIDGE OH 43725 IMAGING SERVICES/LAB SERVICE/WOUND MANAGEMENT 10 - GENESIS CANCER CENTER 2951 MAPLE AVENUE ZANESVILLE OH 43701 CANCER & PALLATIVE CARE/WOMEN'S BOUTIQUE 11 - GENESIS HEALTHCARE CENTER - NEW CONCORD 1 EAST MAIN STREET NEW CONCORD OH 43762 LAB SERVICES 12 - GENESIS HEALTH CENTER - PERRY COUNTY 301 DR MIKE CLOUSE DRIVE SOMERSET OH 43783 DIAGNOSITC HEALTHCARE SERVICES/PHYSICAL & OCCUPATIONAL THERAPY 13 - GENESIS SURGERY CENTER 2907 MAPLE AVENUE ZANESVILLE OH 43701 OUTPATIENT SURGERY 14 - GENESIS NEW LEXINGTON DRAW CENTER 445 WEST BROADWAY NEW LEXINGTON OH 43764 LAB SERVICES 15 - GENESIS ENDOCRINOLOGY 860 BETHESDA DRIVE BUILDING 2 UNIT 4 ZANESVILLE OH 43701 EDUCATION AND OUTPATIENT ENDOCRINOLOGY SERVICES 16 - GENESIS VAIN CENTER 930 BETHESDA DRIVE BUILDING 4 UNIT 1 ZANESVILLE OH 43701 DIAGNOSIS AND TREATMENT OF OUTPATIENT VEIN DISORDERS PART I, LINE 7: COSTS OF CHARITY CARE AND COMMUNITY BENEFIT ACTIVITIES WERE CALCULATED USING THE HOSPITAL'S COST ACCOUNTING SYSTEM.PART I, LINE 7, COLUMN (F): PERCENTAGE OF TOTAL EXPENSES WAS CALCULATED BASED ON TOTAL EXPENSES LESS BAD DEBT EXPENSE AS REPORTED ON FORM 990, PART IX. 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 $ 19,087,956. PART II, COMMUNITY BUILDING ACTIVITIES: GENESIS HAS AN ACTIVE PRESENCE ON MANY COMMITTEES INVOLVED IN FINDING LOW COST SOLUTIONS TO PHYSICAL AND MENTAL HEALTH ISSUES PREVALENT IN OUR COMMUNITIES, WITH PARTICULAR FOCUS ON SERVING LOW-INCOME, UNINSURED OR OTHERWISE UNDERSERVED. THESE ACTIVITIES ARE CAPTURED IN CBISA AS IN-KIND CONTRIBUTIONS BY THE SERVICE LINES UNDER COMMUNITY HEALTH IMPROVEMENT ACTIVITIES. COMMUNITY BUILDING ACTIVITIES ARE CURRENTLY NOT PART OF THE DOCUMENTATION FOR COMMUNITY BENEFIT. PART III, LINE 2: BAD DEBT IS CALCULATED USING GROSS CHARGES. PART III, LINE 3: NO BAD DEBT IS ESTIMATED TO RELATE TO CHARITY CARE. PART III, LINE 4: THE FINANCIAL STATEMENT FOOTNOTE RELATED TO BAD DEBT IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENT FOOTNOTE 1 "NATURE OF BUSINESS AND SIGNIFICANT ACCOUNTING POLICIES" GROUPED WITH ACCOUNTS RECEIVABLE ON PAGE 8. PART III, LINE 8: CALCULATION WAS BASED ON THE MEDICARE COST TO CHARGE RATIO. PART III, LINE 9B: ALL PATIENTS ARE OFFERED A PLAIN LANGUAGE SUMMARY (PLS) OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY PRIOR TO DISCHARGE FROM THE HOSPITAL. AT LEAST THREE SEPARATE COMMUNICATIONS WILL BE MAILED TO THE LAST KNOWN ADDRESS OF THE RESPONSIBLE PARTY ALSO CONTAINING THE PLS. AT LEAST 60 DAYS WILL LAPSE BETWEEN THE FIRST AND THIRD REQUIRED COMMUNICATION. DETAILED ITEMIZED STATEMENTS WILL BE MADE AVAILABLE UPON REQUEST EXCEPT WHERE PROHIBITED BY STATE OR FEDERAL REGULATIONS. ACCOUNTS WITH ZERO BALANCES WILL NOT RECEIVE THREE SEPARATE COMMUNICATIONS; HOWEVER, THESE ACCOUNT HOLDERS MAY ALSO BE ELIGIBLE TO APPLY FOR FINANCIAL ASSISTANCE. ALL RESPONSIBLE PARTIES WILL RECEIVE WRITTEN NOTIFICATION REGARDING EXTRAORDINARY COLLECTION ACTIONS (ECA) THAT MAY COMMENCE IF ACTION IS NOT TAKEN. THIRTY DAYS WILL LAPSE BETWEEN ISSUANCE OF NOTIFICATION AND COMMENCEMENT OF ECA. ACTION TAKEN BY THE RESPONSIBLE PARTY CONSTITUTES MAKING PAYMENT ARRANGEMENTS FOR THE AMOUNT DUE OR COMPLETING A FINANCIAL ASSISTANCE APPLICATION. ACCOUNTS GO TO FULL COLLECTION AFTER DAY 120 IF NO PRIOR ARRANGEMENTS HAVE BEEN MADE. COLLECTION AGENCIES ARE INSTRUCTED TO MAKE PHONE CALLS AND SEND LETTERS. IF THEY CANNOT RESOLVE THE BALANCE, OR HAVE NOT BEEN ABLE TO MAKE PAYMENT ARRANGEMENTS, THE ACCOUNT IS SENT BACK TO GENESIS AS NON-COLLECTIBLE IN 18 MONTHS. PART VI, LINE 2: GENESIS HEALTHCARE SYSTEM, AS A NOT-FOR-PROFIT HEALTH CARE SYSTEM, IS DEDICATED TO MEETING THE HEALTH NEEDS OF OUR COMMUNITIES, REGARDLESS OF ONE'S ABILITY TO PAY. WE ENCOURAGE AND SUPPORT COLLABORATION WITH OTHER COMMUNITY PARTNERS TO IDENTIFY, RESPOND TO AND STRIVE TO IMPROVE THE HEALTH-RELATED NEEDS OF THE POOR, THE UNDERSERVED, AND THE COMMUNITY AT LARGE. WE PLEDGE ALL AVAILABLE FINANCIAL RESOURCES - AFTER OUR OPERATING EXPENSES ARE MET - TO RESPOND TO THE COMMUNITY'S HEALTH NEEDS WITH SERVICE INITIATIVES, FINANCIAL AND PROFESSIONAL SUPPORT, AND EDUCATION AND WELLNESS PROGRAMS.THE COMMUNITY BENEFIT COMMITTEE COLLABORATES WITH GENESIS ADMINISTRATION AND DEPARTMENTS AND WITH COMMUNITY AGENCIES IN OUR DEFINED GEOGRAPHIC MARKET, INCLUDING BUT NOT LIMITED TO THE PUBLIC HEALTH DEPARTMENTS, MUSKINGUM VALLEY HEALTH CENTERS, AND THE UNITED WAY, TO ASSESS COMMUNITY HEALTH NEEDS AND STRENGTHS; DEVELOP A COMMUNITY BENEFIT PLAN WITH STRATEGIC GOALS AND INTERVENTIONS; MONITOR IMPLEMENTATION OF COMMUNITY BENEFIT ACTIVITIES; EVALUATE COMMUNITY BENEFIT ACTIVITIES; ADVOCATE FOR THE COMMUNITY BENEFIT PROGRAMS; AND ASSIST IN TELLING THE GENESIS HOSPITAL COMMUNITY BENEFIT STORY. PART VI, LINE 3: GENESIS HAS SIGNAGE STRATEGICALLY LOCATED IN THE FACILITY (REGISTRATION AREAS AND CASHIER AREAS) ADVISING OF FREE CARE. BILLING STATEMENTS ALSO CONTAIN THIS INFORMATION ALONG WITH A CHARITY CARE APPLICATION PRINTED ON THE REVERSE SIDE OF THE BILL. THE INFORMATION IS ALSO AVAILABLE ON OUR WEBSITE. WE HAVE REGISTRATION STAFF THAT WORK IN THE EMERGENCY DEPARTMENT TO SCREEN PATIENTS FOR POTENTIAL MEDICAID QUALIFIERS IF THE PATIENT ALLOWS. FOR INPATIENTS, WE HAVE RESOURCE COUNSELING STAFF THAT SCREEN SELF-PAY, UNDERINSURED AND MEDICARE ONLY PATIENTS FOR MEDICAID AND/OR CHARITY. PART VI, LINE 4: OUR GEOGRAPHIC MARKET AREA IS A SIX-COUNTY RURAL REGION OF SOUTHEAST OHIO, INCLUDING MUSKINGUM, MORGAN, PERRY, COSHOCTON, GUERNSEY AND NOBLE COUNTIES. FROM 2015-2019, TOTAL MARKET AREA POPULATION IS APPROXIMATELY 226,453, WITH MUSKINGUM COUNTY (86,131) REPRESENTING THE LARGEST COUNTY. MEDIAN HOUSEHOLD INCOME LEVELS RANGE FROM $42,341 TO $50,150 WHICH IS LOWER THAN THE STATE MEDIAN HOUSEHOLD INCOME OF $56,602 AND EVEN LOWER THAN THE NATIONAL MEDIAN HOUSEHOLD INCOME OF $62,843. PEOPLE LIVING BELOW POVERTY LEVEL RANGE FROM 14% TO 20% IN THE REGION VERSES 13.1% FOR THE STATE AND 11.4% FOR THE NATION. IN 2019, CHILDREN IN POVERTY RANGE FROM 11.4% TO 22% IN OUR REGION COMPARED TO 18% FOR THE STATE OF OHIO. PART VI, LINE 5: ONGOING COMMUNITY HEALTH EDUCATION IS PROVIDED THROUGH REGULARLY SCHEDULED HEALTH AND WELLNESS PROGRAMS PRESENTED BY GENESIS STAFF AND AFFILIATED PHYSICIANS. PREVENTATIVE HEALTH SCREENINGS ARE PROVIDED FOR PULSE OX AND I.M.P.A.C.T (IMMEDIATE POST-CONCUSSION ASSESSMENT AND COGNITIVE TESTING). PROGRAM TOPICS ARE BASED ON COMMUNITY NEED AS DETERMINED BY FEEDBACK FROM PARTICIPANTS, THE COMMUNITY BENEIFIT COMMITTEE AND SERVICE LINE LEADERS. GENESIS ALSO REGULARLY PROVIDES HEALTH AND WELLNESS PROMOTION THROUGH COMMUNITY-BASED HEALTH FAIRS AND EVENTS HELD THROUGHOUT THE COMMUNITY. CLINICAL EXPERIENCES ARE OFFERED FOR HEALTHCARE STUDENTS AS WELL AS TRAINING OPPORTUNITIES FOR HEALTHCARE PROFESSIONALS.IN MARCH 2020, COVID-19 WAS DECLARED A PANDEMIC. EARLY IN 2020, GENESIS HEALTHCARE SYSTEM REPRESENTATIVES BEGAN MEETING DAILY WITH THE JOINT UNIFIED COMMAND GROUP. THE GROUP INCLUDED REPRESENTATIVES FROM THE ZANESVILLE-MUSKINGUM COUNTY HEALTH DEPARTMENT, THE CITY OF ZANESVILLE, GENESIS COMMUNITY AMBULANCE, MUSKINGUM COUNTY COMMISSIONERS, MUSKINGUM COUNTY EMERGENCY MANAGEMENT, MUSKINGUM COUNTY SHERIFF, ZANESVILLE FIRE DEPARTMENT, ZANESVILLE POLICE DEPARTMENT AND OTHERS. THROUGHOUT THE PANDEMIC, GENESIS HEALTHCARE SYSTEM CONTINUED TO OFFER INNOVATIVE CARE. IN NOVEMBER, THE GENESIS HEALTHCARE SYSTEM COVID-19 INFUSION CLINIC BEGAN TREATING HIGH-RISK PATIENTS WITHIN THREE DAYS OF TESTING POSITIVE WITH A SINGLE DOSE OF MONOCLONAL ANTIBODY. GENESIS HEALTHCARE SYSTEM WAS ONE OF THE FEW HEALTHCARE SYSTEMS IN THE AREA PROVIDING MONOCLONAL ANTIBODIES TO HELP HIGH-RISK PATIENTS WITH COVID-19. THE ANTIBODIES ARE GIVEN THROUGH AN INFUSION TO HELP DECREASE THE SYMPTOMS OF COVID-19 AND KEEP PATIENTS FROM BEING HOSPITALIZED. GENES GENESIS HEALTHCARE SYSTEM LAUNCHED AN AWARENESS CAMPAIGN TO HELP STOP THE SPREAD OF COVID-19. THE STOP THE SPREAD CAMPAIGN HIGHLIGHTS GENESIS HEALTHCARE SYSTEM FRONT-LINE NURSES ENCOURAGED THE COMMUNITY TO WEAR MASKS, SOCIAL DISTANCE AND WASH THEIR HANDS. GENESIS HEALTHCARE SYSTEM ALSO TOOK THE FOLLOWING ACTIONS:- VISITATION POLICY CHANGED TO ONLY ONE VISITOR PER PATIENT TO HELP PREVENT THE SPREAD OF COVID-19 - IMPLEMENTED FREE ON-DEMAND COVID-19 VIRTUAL SCREENING TELEMEDICINE CLINIC- PROCESSED ANTIBODY TESTS FOR THE VIRUS THAT CAUSES COVID-19 - TOOK TEMPERATURES AND SCREENED STAFF, PATIENTS AND VISITORS FOR COVID-19 AT ALL FACILITY ENTRANCES- PROVIDED A FREE ON-DEMAND COVID-19 VIRTUAL SCREENING TELEMEDICINE CLINIC FOR THOSE WHO WERE EXPERIENCING SYMPTOMS OF COVID-19 BUT DID NOT HAVE A PHYSICIAN OR THEIR PHYSICIAN WAS UNAVAILABLE- TOOK EXTRA PRECAUTIONS, INCLUDING ADDITIONAL CLEANING PROTOCOLS, USING A GERM-ZAPPING UV LIGHT ROBOT, SOCIAL DISTANCING, MASK REQUIREMENTS AND OTHER PRACTICES, TO ENSURE ALL PATIENTS AND STAFF REMAINED SAFE - ERECTED A CONVENIENT DRIVE-THROUGH TENT AT GENESIS FIRSTCARE-NORTH TO PROTECT PATIENTS AND EMPLOYEES FROM THE WEATHER DURING COVID-19 TESTING- LAUNCHED THE GENESIS HEALTHCARE SYSTEM COVID-19 EMPLOYER ASSISTANCE PROGRAM TO SUPPORT AREA BUSINESSES AND SCHOOLS. THE PROGRAM PROVIDED FREE COVID-19 SPECIFIC EMPLOYEE HEALTH SERVICES AND PROTOCOLS FOR THE WORKPLACE AND SCHOOLS. THE PROGRAM WAS MADE POSSIBLE DUE TO A PARTNERSHIP BETWEEN GENESIS HEALTHCARE SYSTEM, ZANESVILLE-MUSKINGUM COUNTY HEALTH DEPARTMENT, THE ZANESVILLE-MUSKINGUM COUNTY CHAMBER OF COMMERCE AND NORTHSIDE PHARMACIES. MORE THAN 31,056 COMMUNITY MEMBERS WERE ENROLLED.GENESIS HEALTHCARE SYSTEM WAS NAMED ONE OF 10 SITES ACROSS THE STATE AS A COVID-19 VACCINE DISTRIBUTOR. PART VI, LINE 6: GENESIS HOSPITAL AND ITS AFFILIATES ARE REACHING OUT TO IMPROVE THE HEALTH OF THE COMMUNITY THROUGH COMMUNITY INITIATIVES, MANY BASED ON PREVENTION. SOME EXAMPLES INCLUDE:- PROVIDING CLINICAL EXPERIENCES FOR NURSING, MEDICAL, AND OTHER HEALTH PROFESSIONAL STUDENTS - COMMUNITY HEALTH EDUCATION/HEALTH PROMOTION INITIATIVES ON VARIOUS HEALTH TOPICS - PROVIDE HEALTHCARE SUPPORT SERVICES SUCH AS NURSELINE- SUBSIDIZED HEALTH SERVICES SUCH AS THE VACCINATIONS FOR COVID-19 AND MEDICAL CLINICS FOR COVID POSITIVE MEMBERS- SUPPORT GROUPS ARE AVAILABLE FOR VARIOUS HEALTH CONDITIONS 1 UNITED WAY OF MPM COUNTIES 526 PUTNAM AVENUE ZANESVILLE OH 43701 314379456 501(C)(3) 15000 CORPORATE DONATION FOR PLEDGE CAMPAIGN CENTRAL AMERICAN MEDICAL OUTREACH 322 WESTWOOD AVENUE ORVILLE OH 44667 341740695 501(C)(3) 302389 FAIR MARKET VALUE DONATION OF SUPPLIES MUSKINGUM VALLEY HEALTH CENTER 716 ADAIR AVENUE ZANESVILLE OH 43701 208814374 501(C)(3) 5000 0 CORPORATE DONATION FOR PATIENT CARE CHARITABLE FUNDS 3 0 PART I, LINE 2: GENESIS SUPPORTS THE ANNUAL CORPORATE DONATION OF $15,000 IN ADDITION TO THE GENESIS EMPLOYEES ANNUAL DONATIONS. DONATIONS ARE REVIEWED AND MONITORED FOR USAGE. X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 MATTHEW PERRY PRESIDENT/CEO 785472 0 169201 0 0 0 4553 0 25147 0 984373 0 0 0 SCOTT WEGNER MD CHIEF CLINICAL OFFICER 605921 0 98018 0 0 0 3615 0 111021 0 818575 0 0 0 DANIEL SCHEERER MD CHIEF MEDICAL AFFAIRS OFFICER 437473 0 83969 0 0 0 71896 0 19998 0 613336 0 0 0 EDMUND ROMITO CHIEF INFORMATION OFFICER 388231 0 83448 0 0 0 118492 0 21772 0 611943 0 0 0 DIANNA LEVECK CHIEF HUMAN RESOURCES OFFICER 400858 0 93375 0 0 0 52315 0 33613 0 580161 0 0 0 MICHAEL NORMAN CHIEF FINANCIAL OFFICER 426401 0 93425 0 0 0 2372 0 27676 0 549874 0 0 0 SHARON PARKER CHIEF OPERATION OFFICER 410382 0 87975 0 0 0 20132 0 17498 0 535987 0 0 0 WENDY CEDOZ CHIEF LEGAL OFFICER 348039 0 77627 0 0 0 45302 0 20598 0 491566 0 0 0 KRISTY RITCHIE MD TRUSTEE 0 274512 0 167006 0 0 0 5572 0 30451 0 477541 0 0 CHRISTOPHER SCHOELLES CHIEF OPERATION OFFICER 324082 0 72002 0 0 0 4873 0 30720 0 431677 0 0 0 SHON BENDER CHIEF NURSING OFFICER 294991 0 59898 0 0 0 7434 0 901 0 363224 0 0 0 ERIN REMSTER DO TRUSTEE 0 269261 0 15000 0 0 0 4354 0 17279 0 305894 0 0 JONATHAN TONGSON MD TRUSTEE 0 0 0 0 285916 0 0 0 0 0 285916 0 0 0 WILLIAM SHADE MD TRUSTEE 0 235300 0 0 0 0 0 4808 0 17756 0 257864 0 0 LINDA SUPPLEE DIRECTOR 191446 0 31890 0 0 0 1051 0 2582 0 226969 0 0 0 GREG MATONAK DIRECTOR 192410 0 10453 0 0 0 1959 0 21481 0 226303 0 0 0 CHARLES ADAMS JR DIRECTOR 149873 0 32788 0 0 0 4503 0 24464 0 211628 0 0 0 LES BOYER DIRECTOR 166802 0 9109 0 0 0 3462 0 31394 0 210767 0 0 0 MARIANNE GRAHAM MANAGER 170780 0 9112 0 0 0 4226 0 17291 0 201409 0 0 0 PART I, LINE 1A THE ORGANIZATION PAYS COUNTRY CLUB DUES AND RELATED BUSINESS EXPENSES FOR MEMBERS OF SENIOR LEADERSHIP. PERSONAL USAGE IS PAID BY THE INDIVIDUAL AND THE PERCENTAGE OF DUES RELATED TO PERSONAL USAGE ARE ADDED TO THE INDIVIDUALS W-2. PART I, LINE 7 BOARD REVIEWS BONUSES BASED ON PERFORMANCE. PART I, LINE 4B: A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS SET UP TO PROVIDE ADDITIONAL DEFERRED RETIREMENT INCOME TO THE GENESIS HEALTH CARE SYSTEM SENIOR LEADERSHIP TEAM MEMBERS. THIS PLAN IS FUNDED BY GENESIS AND VESTS WITH SERVICE. GENESIS HEALTHCARE SYSTEM MADE CONTRIBUTIONS TO NONQUALIFIED RETIREMENT PLANS FOR THE FOLLOWING INDIVIDUALS: WENDY CEDOZ: $22,426 DIANNA LEVECK: $25,090 EDMUND ROMITO: $36,074 DANIEL SCHEERER, MD: $46,150 A COUNTY OF MUSKINGUM OHIO 316400080 628077CK3 2013-05-09 295000000 ACQUIRING, CONSTRUCTING, RENOVATING, INSTALLING AND EQUIPPING HOSP FAC. 0 0 0 A 8105000 294645952 28217261 2016 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 A 1 FORM 990, PART VI, SECTION A, LINE 6 FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC., AND BETHESDA CARE SYSTEM (OR THEIR RESPECTIVE SUCCESSORS AN ASSIGNS) ARE THE MEMBERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE FILING ORGANIZATION, HAVE THE RIGHT TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY, WHETHER PERIODICALLY, OR AS VACANCIES ARISE, OR OTHERWISE. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS OF THE FILING ORGANIZATION, HAVE THE RIGHT TO APPROVE OR RATIFY DECISIONS OF THE ORGANIZATION'S GOVERNING BODY SUCH AS APPROVAL OF THE GOVERNING'S BODY'S DECISION TO DISSOLVE THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE CFO AND MADE AVAILABLE TO THE BOARD OF DIRECTORS IN ITS ENTIRETY FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY STATES THAT BOARD MEMBERS AND OFFICERS HAVE A DUTY TO GOVERN HONESTLY AND ECONOMICALLY. ALL POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED TO THE BOARD OF DIRECTORS AND THE BOARD WILL DETERMINE IF A CONFLICT EXISTS AND APPROPRIATE PROCEDURES TO MITIGATE THE SITUATION, SUCH AS ALTERNATIVE TRANSACTIONS AND PARTICIPATION AND VOTING RESTRICTIONS. THE COMPLIANCE OFFICER MONITORS AND ENFORCES THESE POLICIES. ALL OFFICERS AND DIRECTORS REVIEW AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE CEO IS MANAGED THROUGH A THIRD PARTY THAT IS A NATIONALLY RECOGNIZED FIRM SPECIALIZING IN COMPENSATION BENCHMARKING AND ANALYSIS. THE FIRM IS RECOGNIZED FOR THEIR EXPERTISE IN EVALUATING TOTAL COMPENSATION AT THE EXECUTIVE LEVEL. THIS FIRM PRESENTS THEIR RECOMMENDATIONS AND ANALYSIS TO THE COMPENSATION COMMITTEE, WHICH IS MADE UP OF INDEPENDENT MEMBERS OF THE GENESIS BOARD OF DIRECTORS. THE COMMITTEE IS RESPONSIBLE FOR MAKING A RECOMMENDATION TO THE BOARD OF DIRECTORS REGARDING THE EXECUTIVE COMPENSATION POLICY AND SPECIFIC COMPONENTS OF THE TOTAL COMPENSATION OF THE CEO. THE CEO IS ACTIVELY INVOLVED IN THE REVIEW, ANALYSIS AND RECOMMENDATION RELATED TO THE TOTAL COMPENSATION FOR THE REMAINING MEMBERS OF THE SENIOR LEADERSHIP TEAM. THE CEO DETERMINES THE COMPENSATION OF THE SENIOR LEADERSHIP TEAM MEMBERS WITHIN THE PARAMETERS ESTABLISHED BY THE COMPENSATION COMMITTEE. THIS COMPENSATION PROCESS WAS LAST COMPLETED IN 2020. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 20,521,894. MANAGEMENT AND GENERAL EXPENSES 5,981,760. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,503,654. MEDICAL AND PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 10,442,586. MANAGEMENT AND GENERAL EXPENSES 1,785,575. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,228,161. LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 56,131. MANAGEMENT AND GENERAL EXPENSES 1,488,008. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,544,139. SECURITY SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 662. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 662. BILLING AND COLLECTION FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,514,025. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,514,025. INPATIENT TRANSPORT: PROGRAM SERVICE EXPENSES 29,728. MANAGEMENT AND GENERAL EXPENSES 881,304. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 911,032. SPONSORSHIP FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,942,161. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,942,161. CONSULTING FEES: PROGRAM SERVICE EXPENSES 73,820. MANAGEMENT AND GENERAL EXPENSES 1,274,525. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,348,345. COURIER SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 684,461. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 684,461. FORM 990, PART XI, LINE 9: GAIN IN FAIR VALUE OF PERPETUAL TRUST -1,491,705. PLEDGE RECEIVABLE FROM RELATED PARTY -54,943,292. CONTRIBUTED CAPITAL 40,000. CHANGE IN FAIR MARKET VALUE INTEREST SWAP -40,000. CHANGE IN PENSION DUE TO SETTLEMENTS -3,106,013. OTHER ADJUSTMENTS -152,098. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND IS INVOLVED IN THE SELECTION OF THE INDEPENDENT ACCOUNTANT WHICH COMPLETES THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PAGE 1, LINE H(D): THIS IS THE PARENT RETURN FOR A GROUP: GENESIS HEALTHCARE SYSTEM GROUP RETURN, EIN: 31-1773259 GENESIS HEALTHCARE FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 311629304 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 GOOD SAMARITAN MEDICAL CENTER FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 310969646 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE FOUNDATION 1 BETHESDA HOSPITAL FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 310885513 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE FOUNDATION 1 FRANCISCAN SISTERS OF CHRISTIAN CHARITY 1415 SOUTH RAPIDS ROAD MANITOWOC WI 542209302 391530622 SPONSOR OF GHS WI 501(C)(3) 7 N/A 0 GOOD SAMARITAN MEDICAL CENTER 2951 MAPLE AVENUE ZANESVILLE OH 43701 314379479 MAINTAINS REAL ESTATE TITLE FOR HOSPITAL OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 BETHESDA CARE SYSTEM 2951 MAPLE AVENUE ZANESVILLE OH 43701 311067174 SPONSOR OF GHS OH 501(C)(3) 9 GENESIS HEALTHCARE SYSTEM 1 BETHESDA HOSPITAL ASSOCIATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 314380038 MAINTAINS REAL ESTATE TITLE FOR HOSPITAL OH 501(C)(3) LINE 12B, II GENESIS HEALTHCARE SYSTEM 1 ALTERNACARE 2951 MAPLE AVENUE ZANESVILLE OH 43701 311487187 STERILIZATIONS OH 501(C)(3) 3 BETHESDA CARE SYSTEM 1 CARESERVE 2951 MAPLE AVENUE ZANESVILLE OH 43701 311099924 FORMERLY OPERATED 2 NURSING HOMES THAT WERE SOLD PRIOR TO 2012 OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 COMMUNITY AMBULANCE SERVICE 2951 MAPLE AVENUE ZANESVILLE OH 43701 341773323 AMBULANCE SERVICE OH 501(C)(3) LINE 11 GENESIS HEALTHCARE SYSTEM 1 GENESIS CAREGIVERS 2951 MAPLE AVENUE ZANESVILLE OH 43701 311282152 HOME CARE SERVICES OH 501(C)(3) 3 CARESERVE 1 BETHESDA HOSPITALITY SHOP 2951 MAPLE AVENUE ZANESVILLE OH 43701 316050713 GIFT SHOP OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 CARELIFE LLC 2951 MAPLE AVENUE ZANESVILLE OH 43701 311128717 PHYSICIAN SERVICES, CHILDCARE SERVICES, PHARMACY, DME OH GENESIS HEALTHCARE SYSTEM C -59945007 49798601 1.00000 1 SOUTHEAST OHIO MEDICAL INSURANCE COMPANY FIRST CARIBBEAN HOUSE GEORGE TOWN CAYMAN ISLANDS CJ 980436356 CAPTIVE INSURANCE COMPANY CJ GENESIS HEALTHCARE SYSTEM C 16966675 1.00000 1 0 0 1 1 0 0 0 0 0 1 1 1 1 0 1 1 1 1 1 GENESIS HEALTHCARE SYSTEM GROUP O 344326 ACCRUAL TRANSACTION CARELIFE LLC S 38561124 ACCRUAL TRANSACTION