2016-05-13T11:29:34-05:00 2015-06-30 990 2014-07-01 231352187 GEISINGER-LEWISTOWN HOSPITAL GEIS 5702716624 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 DAVID J FELICIO ESQUIRE SECRETARY 5702716624 2016-05-06 2014 2016-08-17 19:52:53Z DAVID T FEINBERG MD MBA 100 NORTH ACADEMY AVENUE MC 22-01 DANVILLE PA 17822 106565026 false X WWW.GEISINGER.ORG X 1905 PA TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING ACCESS TO QUALITY POPULATION HEALTH AND HOSPITAL SERVICES THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM....SEE SCHEDULE O. 11 10 948 70 890703 367117 16485 52112 97068938 103242477 1293096 2402917 1237753 679032 99616272 106376538 19909 15206 0 49831779 50392167 0 0 47365035 48569865 97216723 98977238 2399549 7399300 79653058 86074490 61739574 72244717 17913484 13829773 X TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING ACCESS TO QUALITY POPULATION HEALTH AND HOSPITAL SERVICES THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM....SEE SCHEDULE O. false false 94744835 15206 103320181 SEE SCHEDULE O I. MISSION: TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING ACCESS TO QUALITY POPULATION HEALTH AND HOSPITAL SERVICES THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE. II.GENERAL INFORMATION GEISINGER-LEWISTOWN HOSPITAL (GLH), A 501(C)(3) NOT-FOR-PROFIT CORPORATION AND MEMBER OF GEISINGER HEALTH SYSTEM, OWNS AND OPERATES A 123 BED ACUTE CARE HOSPITAL IN LEWISTOWN, PA. GLH IS CONVENIENTLY LOCATED ONLY A FEW MILES FROM SEVERAL CENTRAL PENNSYLVANIA MAJOR HIGHWAYS. THE FACILITY OPENED IN 1905 IN RESPONSE TO A PRESSING NEED FOR HEALTH AND WELLNESS CARE IN THE COMMUNITY. DURING THE FISCAL YEAR ENDED JUNE 30, 2015, GLH PROVIDED 19,067 PATIENT DAYS; 4,700 SAME DAY SURGICAL PROCEDURES; AND 28,938 EMERGENCY ROOM VISITS. GLH PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. THE ORGANIZATION ALSO PROVIDES UNCOMPENSATED CARE TO PATIENTS WHO MET CERTAIN CRITERIA WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. SERVICES OFFERED BY GLH INCLUDE: GENERAL MEDICAL CARE IS PROVIDED BY IN-HOUSE HOSPITALISTS AND SUPPORTED BY CONSULTATIVE SERVICES IN THE AREAS OF CARDIOLOGY, NEUROLOGY, PULMONOLOGY, ORTHOPEDICS, HEMATOLOGY/ONCOLOGY, OTOLARYNGOLOGY, GASTROENTEROLOGY. THE EMERGENCY DEPARTMENT (ED) IS COMMITTED TO PROVIDING HIGH QUALITY, PROMPT EMERGENCY SERVICES. GLH'S ED IS STAFFED 24/7 WITH FULL-TIME PHYSICIANS AND NURSES WHO ARE TRAINED IN ALL SPECIALTIES FROM PEDIATRICS TO CRITICAL CARE. IMMEDIATE ACCESS TO LABORATORY SERVICES, IMAGING SERVICES SUCH AS, CAT SCANS, ULTRASOUND, MRI, AND SURGICAL SERVICES. MOST INSURANCES, INCLUDING MEDICARE AND MEDICAID, ARE ACCEPTED AND NO PATIENT IS REFUSED TREATMENT BECAUSE OF INABILITY TO PAY. OB/GYN FOCUSES ON ALL ASPECTS OF WOMEN'S HEALTH AND EDUCATION, PROVIDING OBSTETRICAL AND GYNECOLOGICAL CARE FOR WOMEN OF ALL AGES. SERVICES INCLUDE BUT ARE NOT LIMITED TO ROUTINE VISITS AND TREATMENTS, PREVENTATIVE HEALTHCARE, BIRTH CONTROL EDUCATION, FAMILY PLANNING, OBSTETRICS, SURGERY & SURGERY CONSULTATIONS, MENOPAUSE COUNSELING, AND MIDWIFERY. MENTAL HEALTH & PSYCHIATRIC PROVIDES ADULT INPATIENT SERVICES DESIGNED TO HELP INDIVIDUALS LIVE AS INDEPENDENTLY AS POSSIBLE. PATIENTS CAN ACCESS QUICK, EFFICIENT ADMISSION 24/7 AND RECEIVE TREATMENT THROUGH A PSYCHIATRIST AVAILABLE ON A DAILY BASIS. ADMISSIONS ARE CONFIDENTIAL AND MAY BE MADE BY PROFESSIONALS AS WELL BY INDIVIDUALS CONCERNED ABOUT THEMSELVES OR OTHERS. DURING HOSPITALIZATION, PATIENT CARE IS PROVIDED THROUGH MULTIPLE PROFESSIONALS WHO COMPRISE THE TREATMENT TEAM. OTHER SERVICES INCLUDE: CARDIAC SERVICES NEUROSURGERY RESPIRATORY SERVICES SLEEP CENTER ORTHOPEDIC GENERAL SURGERY RADIOLOGY OTHER SURGERY SPECIALTIES ICCU UROLOGY PAIN MANAGEMENT LABORATORY SERVICES GYNECOLOGY WOUND MANAGEMENT PHYSICAL THERAPY OTOLARYNGOLOGY WEIGHT MANAGEMENT PEDIATRICS NEWBORN NURSERY GASTROENTEROLOGY NEPHROLOGY OPTHAMOLOGY PATHOLOGY COMMUNITY CANCER TREATMENT/ONCOLOGY III. UNCOMPENSATED CARE GEISINGER-LEWISTOWN HOSPITAL RECOGNIZES ITS MISSION IS TO SERVE ALL MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND EDUCATION. IN THIS REGARD, GLH PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH-RELATED ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A.CHARITY CARE THE PRIMARY CONCERN OF GLH IS THE DELIVERY OF HEALTH CARE TO ALL CITIZENS OF CENTRAL PENNSYLVANIA REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GLH INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. FOR THE FISCAL YEAR ENDED JUNE 30, 2015, THE COST OF THE CHARITY CARE WAS 1.3 MILLION. B.MEDICARE/MEDICAID IN RECOGNIZING ITS MISSION TO THE COMMUNITY, GLH PROVIDES SERVICES TO THE ELDERLY (MEDICARE) AND THE INDIGENT (MEDICAID). GLH PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS TO THE EXTENT THE GOVERNMENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTH CARE. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. THE COST OF PROVIDING HEALTHCARE SERVICES TO MEDICARE AND MEDICAID PATIENTS EXCEEDED REIMBURSEMENT BY APPROXIMATELY 18 MILLION DURING THE FISCAL YEAR ENDED JUNE 30, 2015. C.OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GLH PROVIDES SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2015, WAS 1.7 MILLION. D.OTHER UNINSURED FOR UNINSURED CITIZENS THAT DO NOT QUALIFY FOR CHARITY CARE OR GOVERNMENT OR PRIVATE PROGRAMS GLH OFFERS PAYMENT DISCOUNTS AND TIME PAYMENTS WITHOUT INTEREST OR FEES. IV. VOLUNTEER SERVICES THE VOLUNTEERS OF GEISINGER-LEWISTOWN HOSPITAL ARE AN ACTIVE AND VITAL PART OF THE ACTIVITIES OF THE HOSPITAL. THE HOURS OF VOLUNTEER SERVICES ARE AN IMPORTANT CONTRIBUTION TO THE MISSION OF GLH. THE VOLUNTEERS FROM LOCAL COMMUNITIES CONTRIBUTED 11,340 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTHCARE OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION 269,552 IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND "WELLNESS" PROGRAMS. V. COMMUNITY HEALTH, EDUCATION, AND OUTREACH GLH STRIVES TO BE A VALUABLE RESOURCE FOR THE COMMUNITY AND ITS RESIDENTS. GLH PROVIDES MANY REDUCED-PRICE SERVICES AND FREE PROGRAMS THROUGHOUT THE YEAR THAT SERVE COMMUNITY HEALTH NEEDS. AT A COST OF 41 THOUSAND, THESE SERVICES AND PROGRAMS INCLUDED: SUPPORT GROUPS, COMMUNITY HEALTH EDUCATION, AND OTHER UNIQUE SERVICES. A.GROUPS GLH PROVIDES PROGRAMS FOR ALL DEMOGRAPHICS. CANCER CARE & SHARE SUPPORT GROUP: G-LH FACILITATES A LOCAL CANCER SUPPORT NETWORK THAT WELCOMES ALL CANCER SURVIVORS, FAMILY, AND FRIENDS. THE GROUP MEETS EACH MONTH. BARIATRIC SURGERY SUPPORT GROUP: GEISINGER-FHA CENTER FOR WEIGHT MANAGEMENT AND NUTRITION HOSTS A BARIATRIC SURGERY SUPPORT GROUP EVERY MONTH. SESSIONS ARE MODERATED BY VIRGINIA M. WRAY, DO, CNSP. LIVING WELL CANCER SURVIVORSHIP PROGRAM: CLASSES ARE OFFERED BY LEWISTOWN HOSPITAL TWO TIMES A YEAR. CLASSES ARE FREE AND HELD ONCE A WEEK FOR FOUR WEEKS AT THE COMMUNITY CANCER TREATMENT CENTER. THE PROGRAM ALLOWS CANCER SURVIVORS TO ASK QUESTIONS AND ADDRESS AREAS OF CONCERN. IT ALSO TEACHES PARTICIPANTS HOW TO LIVE A HEALTHY LIFESTYLE AND MAKE NECESSARY LIFESTYLE MODIFICATIONS. THE PROGRAM FOCUSES ON HEALTH AND WELLNESS; TREATMENT AND MANAGEMENT; RESOURCES AND FOLLOW UP CARE; AND INCLUDES A TREATMENT PLAN AND SUMMARY AS WELL AS SUPPORT GROUP INFORMATION. GEISINGER-FAMILY HEALTH ASSOCIATES TIME OF CHANGE WORKSHOPS: GEISINGER- FAMILY HEALTH ASSOCIATES (FHA) OFFERS A WORKSHOP DESIGNED ESPECIALLY FOR MOTHERS AND THEIR ADOLESCENT DAUGHTERS, AGES 9 - 12 YEARS. THE FOCUS OF THE WORKSHOP IS TO ASSIST MOTHERS IN EDUCATING THEIR DAUGHTERS ON CHANGES THAT OCCUR DURING ADOLESCENCE. INFORMATIONAL BOOKLETS FOR MOTHERS AND DAUGHTERS ARE GIVEN TO REINFORCE INFORMATION PRESENTED. PREGNANCY SUPPORT: G-LH OFFERS PREPARED CHILDBIRTH AND BREASTFEEDING CLASSES TO PROMOTE POSITIVE OUTCOMES FOR EXPECTANT MOTHERS AND INFANTS THROUGH REALISTIC INSTRUCTION AND ACHIEVABLE GOALS. CLASSES FOCUS ON PREPARING FOR LABOR, DELIVERY AND POSTPARTUM. B.COMMUNITY HEALTH EDUCATION COMMUNITY HEALTH NEEDS ASSESSMENT DIABETES MANAGEMENT WOMEN'S HEALTH RELATED TOPICS SMOKING CESSATION NUTRITION CLASSES LIVING WILLS PREPARING FOR YOUR DOCTOR'S VISIT MEDICATION SAFETY HEART DISEASE/HEART FAILURE PREVENTION CANCER PREVENTION (SKIN, COLON, BREAST, PROSTATE) VI. COMMUNITY SERVICE SUMMARY AT COST CHARITY CARE 1,330,220 MEDICARE/MEDICAID/OTHER GOVERNMENTAL 17,571,450 UNCOMPENSATED CARE 1,705,153 HEALTH PROFESSIONS EDUCATION 257,493 COMMUNITY HEALTH, EDUCATION, AND OUTREACH 40,945 VOLUNTEER SERVICES (VALUED AT 1/1/2014 269,552 PA STATEWIDE AVERAGE WEEKLY WAGE) TOTAL 21,174,813 VII. STATISTICS GEISINGER-LEWISTOWN HOSPTIAL FISCAL YEAR ENDED JUNE 30, 2015 ADMISSIONS (INCLUDING NEWBORNS) 5,514 ADMISSIONS (EXCLUDING NEWBORNS) 4,944 OUTPATIENT VISITS INCLUDING EMERGENCY DEPARTMENT 148,640 AVERAGE LENGTH OF STAY (EXCLUDING NEWBORNS AND PSYCH) 3.8 PERCENT OF OCCUPANCY (EXCLUDING NEWBORNS) 42.5% PATIENT SERVICE DAYS (EXCLUDING NEWBORNS) 19,067 TOTAL OR CASES 5,554 BEDS (EXCLUDING BASSINETS) (SET UP AND STAFFED) 123 BASSINETS IN NURSERY 12 94744835 true true false true false false false false false true true true false false true false false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true true false true 20 0 true 948 true true true false false false false false false false false false X 11 10 true false false false true true false true true false false true true true true true true true true false PA X KRISTY M HINE AVP FINANCE 7172427650 400 HIGHLAND AVENUE LEWISTOWN PA 17044 DAVID T FEINBERG MD MBA PRES, CHAIR, 40.00 X X 0 0 0 DON A ROSINI DIRECTOR 0.25 5.25 X 0 0 0 E ALLEN DEAVER DIRECTOR 0.25 4.25 X 0 0 0 FRANK M HENRY DIRECTOR 0.25 4.25 X 0 0 0 GLENN D STEELE JR MD PHD PRES, CHAIR, 40.00 X X 0 4288180 472126 RICHARD A GRAFMYRE DIRECTOR 0.25 5.25 X 0 0 0 ROBERT J DIETZ DIRECTOR 0.25 5.00 X 0 0 0 ROBERT E POOLE DIRECTOR 0.25 4.75 X 0 0 0 ROBERT L TAMBUR DIRECTOR, VI 0.25 4.50 X 0 0 0 THOMAS H LEE JR MD DIRECTOR 0.25 5.00 X 0 0 0 WILLIAM R GRUVER DIRECTOR 0.25 4.50 X 0 0 0 WILLIAM H ALEXANDER DIRECTOR 0.25 5.50 X 0 0 0 ALBERT BOTHE JR MD CMO 40.00 X 0 1008208 182440 DAVID J FELICIO ESQUIRE CLO, SECRETA 40.00 X 0 662625 101181 EDWARD J ZYCH ESQUIRE ACLO, ASST S 40.00 X 0 390565 42470 FRANK J TREMBULAK SR VP, TREAS 40.00 X 0 1192394 219582 KEVIN F BRENNAN CPA FHFMA EVP, FINANCE 40.00 X 0 1028344 201791 MICHAEL T HEGSTROM MD CHIEF MEDICA 0.00 40.00 X 0 439654 38612 KAY HAMILTON RN MS CAO 40.00 X 292856 0 35283 CHRISTINE W MATHEWS RN MSN VP, NURSING 40.00 X 171558 0 13924 KIRK E THOMAS FACHE MHA RRT VP, OPERATIO 40.00 X 177659 0 26330 LEWIS D ALLSHOUSE III PHARMACIST 40.00 X 129768 0 27353 NALIN G PATEL MD PSYCHIATRIST 40.00 X 397004 0 21995 PETER A GOYER RAD. PHYSICI 40.00 X 174770 0 7272 RONALD M COWAN AVP, IT 40.00 X 124186 0 16331 RICHARD F STOMACKIN BS RPH DIRECTOR. PH 40.00 X 154808 0 6251 NANCY S REINKE FORMER OFFIC 40.00 X 121583 0 35275 1744192 9009970 1448216 12 true true false CERNER CORPORATION 2800 ROCK CREEK PARKWAY KANSAS CITY MO 641172551 IT SERVICES 1425057 EPA PO BOX 634850 CINCINNATI OH 452634850 ED PHYSICIANS 895066 QUEST DIAGNOSTICS 12436 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 LAB SERVICES 662037 MCKAY CONSULTING 8590 BUSINESS PARK DRIVE SHREVEPORT LA 71105 PROF SERVICES 650921 ALLIANCE HEALTHCARE SERVICES PO BOX 96485 CHICAGO IL 606936485 IMAGING SERVICE 642516 17 X 21438 30674 52112 NET PATIENT REVENUE 621110 101419720 101419720 LAB REVENUE 621500 882758 882758 IC SHARED SERVICE- SCHEDULE O 541900 480252 480252 SCHOOL OF NURSING TUITION 611600 414994 414994 COMMUNITY EDUCATION TRAINING 621400 44753 44753 103242477 889661 889661 1701744 188488 1701744 -188488 1513256 1513256 CAFETERIA SALES 722514 365078 365078 GIFT SHOP SALES 453220 93420 93420 MEDICAL RECORDS TRANSCRIPTION 561000 77704 77704 142830 17537 7945 117348 679032 106376538 102454960 890703 2978763 15206 15206 717583 717583 687438 180650 506788 35423759 34475559 948200 5557730 5229873 327857 5089001 4788795 300206 2916656 2759216 157440 36470 36470 28810 28810 10499 10499 72138 69908 2230 8623522 8450184 173338 121360 15055 106305 3146618 3015004 131614 237142 236429 713 1493104 1429164 63940 170999 149236 21763 673 673 970763 929191 41572 4252910 4076968 175942 580748 578908 1840 MEDICAL SUPPLIES 13344098 13288515 55583 INTERCOMPANY EXPENSE 10158155 9906950 251205 UNCOLLECTIBLE EXPENSE 4962371 4962371 CORPORATE INCOME TAX 140191 140191 219294 186980 32314 98977238 94744835 4232403 0 11771611 10121227 6437973 7308255 5315044 7392193 20106 216763 2351843 2279485 997336 186427 28750564 5842773 21373082 22907791 6031315 4772829 23820639 29816284 1534109 1073236 79653058 86074490 6730512 7474586 19815000 20364067 816365 329404 34377697 44076660 61739574 72244717 X 17108125 13164328 229034 112986 576325 552459 17913484 13829773 79653058 86074490 X 7399300 -2672548 -8810463 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 10499 10499 false SCHEDULE C, PART II-B, LINE 1 THE LOBBYING EXPENSE REPORTED ON SCHEDULE C REPRESENTS THE PORTION OF ANNUAL DUES PAYMENTS TO TRADE ASSOCIATIONS ATTRIBUTABLE TO LOBBYING ACTIVITIES. 179962 907 384 180485 179892 250 1105 1000 285 179962 177960 2103 1341 1000 512 179892 174187 2846 2329 1000 403 177960 80371 91939 3266 1000 389 174187 1.00000 false false 244654 244654 13409391 1922154 11487237 682347 118603 563744 12828452 3705484 9122968 1585720 96532 1489188 22907791 29816284 F 29816284 ACCRUED PENSION LIABILITY 26810127 ESTIMATED 3RD PARTY PAYOR SETTLEMENT 9227555 DUE TO AFFILIATES 6470017 OTHER LONG TERM LIABILITIES 1200000 OTHER LIABILITIES 288329 ESTIMATED MEDICAL MALPRACTICE CLAIMS 80632 44076660 SCHEDULE D, PAGE 4, PART XIII PART V, LINE 4 - INTENDED USES FOR ENDOWMENT FUNDS THE EARNINGS ON THE FRIENDS LEGACY ENDOWMENT FUND WILL BE USED SOLELY FOR THE PURPOSE OF CAPITAL ASND BUILDING EXPENDITURES. NO EXPENDITURES CAN BE MADE UNTIL THE FUND REACHES 1,000,000 AND THEN ONLY THE EARNINGS FROM THE INVESTMENT CAN BE USED FOR THOSE PURPOSES. THE EARNINGS ON THE SCHOOL OF NURSING SCHOLARSHIP FUNDS ARE USED FOR SCHOLARSHIPS FOR GEISINGER-LEWISTOWN HOSPITAL SCHOOL OF NURSING STUDENTS SELECTED BY THE SCHOLARSHIP COMMITTEE BASED ON ESTABLISHED CRITERIA. PART X, LINE 2 - FIN 48 FOOTNOTE EFFECTIVE JULY 1, 2007, GEISINGER HEALTH SYSTEM (1) (GHS) ADOPTED ACCOUNTING STANDARDS CODIFICATION 740 (FIN 48), (FORMERLY KNOWN AS "STATEMENT 109: ACCOUNTING FOR INCOME TAXES- OR "FAS 109"). FIN 48 CLARIFIES THE ACCOUNTING AND REPORTING FOR INCOME TAXES WHERE INTERPRETATION OF THE TAX LAW MAY BE UNCERTAIN. FIN 48 PRESCRIBES A COMPREHENSIVE MODEL FOR THE FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, PRESENTATION AND DISCLOSURE OF INCOME TAX UNCERTAINTIES WITH RESPECT TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN INCOME TAX RETURNS. THE ADOPTION OF FIN 48 HAD NO IMPACT ON UNRESTRICTED NET ASSETS AS OF THE END OF THE FISCAL YEAR OR ANY PREIVIOUS YEARS SINCE ADOPTION. ACCORDINLY, NO FIN 48 FOOTNOTE DISCLOSURE WAS MADE IN THE GHS CONSOLIDATED FINANCIAL STATEMENTS. (1) THROUGHOUT THIS DOCUMENT, THE ACRONYM "GHS- OR THE TERMS "SYSTEM", "GEISINGER", OR "GEISINGER HEALTH SYSTEM" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF THE GEISINGER HEALTH SYSTEM FOUNDATION (THE FOUNDATION) AS PARENT AND ALL SUBSIDIARY CORPORATE ENTITITES COMPRISING THE SYSTEM. true true X true X 3.000000000000 false true true true false true true 1330220 1330220 0.01340 14212851 7117347 7095504 0.07170 350058 296005 54053 0.00050 15893129 7413352 8479777 0.08570 40945 40945 0.00040 676973 419480 257493 0.00260 717918 419480 298438 0.00300 16611047 7832832 8778215 0.08870 true 4962315 1984926 20822929 27518446 -6695517 X true true 1 1 GEISINGER-LEWISTOWN HOSPITAL 400 HIGHLAND AVENUE LEWISTOWN PA 17044 WWW.LEWISTOWNHOSPITAL.ORG 121501 X X X GEISINGER-LEWISTOWN HOSPITAL 1 false false true X X X X X X X X X X 12 true false false true X WWW.LEWISTOWNHOSPITAL.ORG X WWW.GEISINGER.ORG/SITES/CHNA X true 12 true WWW.GEISINGER.ORG/SITES/CHNA-2015/GLH false false true X 300.000000000000 X X X X X true true X X X X true X WWWGEISINGERORG REFER TO SECTION C X WWWGEISINGERORG REFER TO SECTION C X WWWGEISINGERORG REFER TO SECTION C X X X X X X true X true X X X X X true X false false FACILITY 1, GEISINGER-LEWISTOWN HOSPITAL - PART V, LINE 5 PART V, SECTION B, LINE 3: THE NEEDS ASSESSMENT STEERING COMMITTEE AND SEVERAL COMMUNITY PARTNERS MET TO DISCUSS THE KEY ISSUES IDENTIFIED IN THE NEEDS ASSESSMENTS. A TOTAL OF 16 INDIVIDUALS ATTENDED THE STRATEGIC PLANNING SESSION, INCLUDING EXPERTS IN PUBLIC HEALTH, REPRESENTATIVES OF UNDERSERVED POPULATIONS, HEALTH AND SOCIAL SERVICE AGENCIES, AND OTHER COMMUNITY STAKEHOLDERS. -LINDA ALLEN, DIRECTOR, PA DOH - JUNIATA COUNTY STATE HEALTH CENTER -MARIE MULVIHILL, DIRECTOR, UNITED WAY OF MIFFLIN JUNIATA COUNTIES -WALT WHITMER, SR. EXTENSION ASSOCIATE, PENNS STATE COOPERATIVE EXTENSION -CRYSTAL PAIGE, DIRECTOR, THE ABUSE NETWORK -MOLLY KINNEY, DIRECTOR, MIFFLIN COUNTY LIBRARY -PAULA LEACH, HEALTH & NUTRITION COORDINATOR, SUM CHILD DEVELOPMENT -ALETA KAMMERER, EARLY HEAD START COORDINATOR, SUM CHILD DEVELOPMENT -BOB HENRY, MENTAL HEALTH ADULT PROGRAM SPECIALIST, JUNIATA VALLEY BEHAVIORAL & DEVELOPMENT SERVICES -NANCY RECORDS, DIRECTOR COMMUNITIES THAT CARE -JOHN MCCULLOUGH, DIRECTOR, JUNIATA VALLEY YMCA -BETH ZONG, DIRECTOR, MIFFLINC JUNIATA SPECIAL NEEDS CENTER -GAYLE LANDIS, QUALITY ASSURANCE/RISK MANAGEMENT, MIFFLIN JUNIATA REGIONAL SERVICES -RANDY TEWKSBURY, CFO, GEISINGER-LEWISTOWN HOSPITAL -PHYLLIS MITCHELL, VP MARKETING & COMMUNITY AFFAIRS, GEISINGER-LEWISTOWN HOSPITAL -KERIA MEALS, COMMUNICATIONS COORDINATOR, GEISINGER-LEWISTOWN HOSPITAL -CINDY HOUSER, COMMUNICATIONS DIRECTOR, AMERICORPS-GEISINGER LEWISTOWN HOSPITAL FACILITY 1, GEISINGER-LEWISTOWN HOSPITAL - PART V, LINE 11 THREE SIGNIFICANT NEEDS WERE IDENTIFIED BY THE CHNA CONDUCTED FOR GEISINGER-LEWISBURG HOSPITAL (GLH): 1) IMPROVE ACCESS TO HEALTH CARE FOR ALL RESIDENTS IN MIFFLIN AND JUNIATA COUNTIES; 2) IMPROVE THE QUALITY OF HEALTH CARE; AND, 3)PROVIDE ADDITIONAL RESOURCES TO MAKE HEALTH LIFESTYLE CHOICES. IN SUPPORT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, GLH PLANS TO IMPLEMENT THE FOLLOWING STRATEGIES TO IMPACT AND MEASURE COMMUNITY HEALTH IMPROVEMENT: THE HOSPITAL WILL CONTINUE TO TAKE A TWO PRONG APPROACH TO ADDRESSING ACCESS AND QUALITY OF HEALTH CARE. 1) + 2) ACCESS TO QUALITY HEALTHCARE: GLH CONTINUES TO IDENTIFY WAYS THAT RESIDENTS CAN RECEIVE TIMELY, QUALITY CARE WHEN NEEDED. RECENT INITIATIVES TO REDUCE WAITING TIMES IN THE EMERGENCY DEPARTMENT, AS WELL AS WORKING WITH ITS FAMILY HEALTH ASSOCIATES PRACTICES TO IMPROVE SAME DAY SICK VISITS, HAVE BEEN SUCCESSFUL AND WILL CONTINUE. FURTHER, THE HOSPITAL HAS BEEN INTEGRAL IN AN INITIATIVE TO EXPLORE THE FEASIBILITY OF A FEDERALLY-QUALIFIED HEALTH CENTER IN THE REGION. GLH CONTINUE TO PARTNER WITH SOCIAL SERVICE ORGANIZATIONS TO BUILD UPON EXISTING ASSETS TO IMPROVE ACCESS TO CARE FOR RESIDENTS. THE FOLLOWING PROGRAMS ARE REPRESENTATIVE OF GLH'S EFFORTS TO IMPROVE ACCESS TO QUALITY HEALTHCARE: ED WAITING TIM INITIATIVE-THE EMERGENCY DEPARTMENT HAS INITIATED SEVERAL STRATEGIES TO IMPROVE WAITING TIME. CURRENTLY, THE ED HAS A "SPLIT FLOW MODEL- OR QUICK CARE, WHICH ALLOWS OUR LESS CRITICALLY-ILL PATIENTS TO BE SEEN, TREATED, AND DISCHARGED IN A TIMELY FASHION. THE HOSPITAL IS ADDRESSING THE REGISTRATION AND TRIAGE PROCEDURES TO BE MORE EFFICIENT IN ORDER TO GET PATIENTS INTO THE TREATMENT AREA FASTER. IN ADDITION, THE ED IS WORKING ON STRATEGIES WITH THE INPATIENT UNITS TO INCREASE THE SPEED AT WHICH PATIENTS ARE ADMITTED ONCE IT HAS BEEN DECIDED THAT AN INPATIENT STAY IS NECESSARY. SAME DAY APPOINTMENTS AT FAMILY HEALTH ASSOCIATES - THE PHYSICIAN OFFICES HAVE ESTABLISHED A PROCESS TO ENSURE SAME-DAY APPOINTMENTS FOR THEIR PATIENTS WHO ARE SICK. EVERY OFFICE HAS AT LEAST ONE PROVIDER WHO BEGINS THE DAY WITH ENOUGH OPEN APPOINTMENT SLOTS TO ENSURE THEY CAN ACCOMMODATE ANY PATIENTS WHO CALL FOR A SICK APPOINTMENT THAT DAY. HEALTH LITERACY INITIATIVES-THE HOSPITAL PROVIDES ITS PATIENT INFORMATION GUIDE AND SURGICAL CENTER INFORMATION IN SPANISH. THE PHYSICIAN OFFICES ALSO PROVIDES PATIENT INSTRUCTION INFORMATION IN SPANISH, AS NEEDED. IN ADDITION, VARIOUS STAFF TRAINING SESSIONS HAVE BEEN CONDUCTED ON CULTURAL AND GENERATIONAL DIVERSITY. THE HOSPITAL WILL DEVELOP A STRUCTURED EDUCATIONAL PROGRAM FOR ALL MEDICAL AND CLINICAL STAFF ON HOW TO EFFECTIVELY COMMUNICATE WITH PATIENTS. 3) HEALTHY LIFESTYLES. PROVIDE ADDITIONAL RESOURCES TO MAKE HEALTH LIFESTYLE CHOICES. THE CHNA IDENTIFIED A NUMBER OF LIFESTYLE FACTORS SUCH AS DIET, EXERCISE, AND SMOKING THAT PUT RESIDENTS AT RISK FOR CHRONIC DISEASE. GLH PLAYS A LEADERSHIP ROLE IN HELPING RESIDENTS MANAGE CHRONIC HEALTH CONDITIONS AND REDUCE RISK FACTORS FOR DISEASE. GLH WILL SEEK TO REDUCE CHRONIC CONDITIONS BY CONTINUING TO FOCUS ON EDUCATION AND AWARENESS PROGRAMS, AS WELL AS CONTINUING SUCCESSFUL SUPPORT PROGRAMS FOR PATIENTS WITH CHRONIC DISEASE. A REDUCTION IN DISEASE RATES WILL LIKELY NOT BE SEEN IN THE INITIAL THREE-YEAR CYCLE, HOWEVER, GLH EXPECTS THAT SUCCESS IN REDUCING THE PREVALENCE OF RESIDENTS WHO ARE AT RISK FOR CHRONIC CONDITIONS AND BETTER MANAGING CURRENT CHRONIC CONDITIONS WILL IMPACT THE INCIDENCE OF FUTURE CHRONIC DISEASE. THE OBJECTIVES OF THE VARIOUS HOSPITAL PROGRAMS LISTED BELOW ARE TO: PROVIDE EDUCATION AND AWARENESS ABOUT RISK FACTORS FOR CHRONIC DISEASE THROUGH EMPLOYEE WELLNESS PROGRAMS AND PUBLIC EDUCATIONAL FORUMS AND EVENTS; REDUCE PREVALENCE OF SMOKING AMONG ADULT AND YOUTH RESIDENTS; INCREASE THE PROPORTION OF PRIMARY CARE PHYSICIANS WHO REGULARLY ASSESS BODY MASS INDEX IN THEIR PATIENTS (INCLUDES CHILDREN AND ADULTS); INCREASE THE PROPORTION OF PHYSICIAN VISITS MADE BY PATIENTS WHO ARE OBESE THAT INCLUDE COUNSELING OR EDUCATION RELATED TO WEIGHT REDUCTION, NUTRITION, OR PHYSICAL ACTIVITY; IMPROVE CHRONIC DISEASE MANAGEMENT FOR DIAGNOSED PATIENTS THROUGH INTENSIVE CASE MANAGEMENT AND NURSE NAVIGATOR PROGRAMS; PROVIDE EDUCATION AND SUPPORT FOR FAMILIES OF PATIENTS WITH CHRONIC DISEASE THROUGH COMMUNITY BASED PROGRAMS; AND INCREASE THE PROPORTION OF WORKSITES THAT OFFER NUTRITION OR WEIGHT MANAGEMENT CLASSES OR COUNSELING. FHA WEIGHT MANAGEMENT AND NUTRITION PROGRAM-DR. VIRGINIA WRAY, DO, CNSP, DIRECTS THE WEIGHT MANAGEMENT AND NUTRITION PROGRAM FOR OBESE PATIENTS. THE PROGRAM STARTS WITH AN IN-DEPTH REVIEW OF THE PATIENT'S MEDICAL, PSYCHOLOGICAL, AND NUTRITIONAL HISTORY. PATIENTS SET REALISTIC GOALS AND DEVELOP A PLAN FOR SMART EATING AND EXERCISE. THE PATIENT'S MEDICAL CONDITION IS CLOSELY MONITORED AND TRACKED AS THE PLAN IS IMPLEMENTED. TRANSITIONS OF CARE, IN PARTNERSHIP WITH HIGHMARK BLUE SHIELD- THE GOAL OF THE TRANSITIONS OF CARE PROGRAM IS TO REDUCE 30-DAY READMISSIONS TO THE HOSPITAL. THE PROGRAM CONSISTS OF THREE COMPONENTS: MEDICATION LIST MONITORING, INFORMATION PROVIDED TO THE PATIENT AT DISCHARGE, AND DISCHARGE SUMMARY INFORMATION PROVIDED TO THE HEALTHCARE PROVIDER WITHIN 24 HOURS OF DISCHARGE. CONGESTIVE HEART FAILURE CASE MANAGEMENT-THE HOSPITAL EMPLOYS INTENSIVE CASE MANAGEMENT UTILIZING A CHF NURSE NAVIGATOR PROGRAM. CHF PATIENTS ARE MANAGED THROUGH PATIENT EDUCATION REGARDING MEDICATION SCHEDULES, LOW- SODIUM NUTRITION, ACTIVITY LEVEL, WEIGHT AND SYMPTOM MONITORING AS WELL AS KEEPING FOLLOW-UP APPOINTMENTS WITH SPECIALISTS AND FAMILY PHYSICIANS. CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PROGRAM-GLH WILL EXPLORE OPPORTUNITIES TO INITIATE A COMPREHENSIVE PROGRAM TO IMPROVE OUTCOMES FOR PATIENTS WITH COPD. BUPRENORPHINE PROGRAM-FHA PARTICIPATES IN THE BUPRENORPHINE PROGRAM WHICH ASSISTS PATIENTS WITH SUBSTANCE ABUSE PROBLEMS. THE PROGRAM IS A COMMUNITY FOCUSED, COLLABORATIVE, AND COMPREHENSIVE APPROACH TO SUBSTANCE ABUSE THAT INCLUDES MEDICATION TO TREAT OPIOID DEPENDENCE AND EXTENSIVE DRUG COUNSELING. GLH WELLNESS PROGRAM-THE HOSPITAL PARTNERS WITH HIGHMARK BLUE SHIELD TO OFFER AN EMPLOYEE WELLNESS PROGRAM THAT INCLUDES THREE MODULES: WELLNESS PROFILE & EMPLOYEE INTEREST SURVEY, BIOMETRIC HEALTH SCREENINGS, AND WELLNESS INTERVENTIONS. ALL ACTIVITIES ARE TRACKED ON A SCORECARD AND EMPLOYEES CAN EARN A BONUS FOR COMPLETING ALL MODULE ACTIVITIES. SMOKING CESSATION PROGRAM-THE HMJ PATCH PROGRAM (HUNTINGDON, MIFFLIN, AND JUNIATA COUNTIES PROMOTING ADULT/ADOLESCENT TOBACCO CESSATION AND HEALTH) OFFERS A 10-WEEK PROGRAM FOR ADULTS AND TEENS COMBINING EDUCATIONAL MATERIALS, BEHAVIORAL COUNSELING, AND NICOTINE REPLACEMENT THERAPIES TO ASSIST AND SUPPORT INDIVIDUALS IN THEIR EFFORTS TO QUIT USING TOBACCO. HEALTH SCREENINGS-THE HOSPITAL OFFERS HEALTH AND SAFETY SCREENINGS FREE OF CHARGE INCLUDING: BLOOD PRESSURE, BLOOD SUGAR (GLUCOSE), BONE DENSITY, BODY MASS INDEX (BMI), HEALTHY HEART, SPIROMETRIES, AND CHILD SAFETY SEAT INSPECTIONS. BREASTFEEDING INITIATIVE-THE FAMILY PLACE AT GLH OFFERS A BREASTFEEDING BASICS CLASS GEARED TOWARD THE PREGNANT WOMAN AND HER PARTNER. TOPICS COVERED IN THE TWO-HOUR CLASS INCLUDE THE NUTRITIONAL BENEFITS OF BREAST- FEEDING; THE "HOW TO'S" OF GETTING YOU AND YOUR BABY STARTED WITH BREASTFEEDING; AND VARIOUS POSITION ALTERNATIVES. CANCER CARE & SHARE SUPPORT GROUP-GLH'S CANCER SERVICES FACILITATES A LOCAL CANCER SUPPORT NETWORK THAT WELCOMES ALL CANCER SURVIVORS, FAMILY, AND FRIENDS. THE GROUP MEETS EACH MONTH AT GLH. BARIATRIC SURGERY SUPPORT GROUP- FHA CENTER FOR WEIGHT MANAGEMENT AND NUTRITION HOSTS A BARIATRIC SURGERY SUPPORT GROUP EVERY MONTH AT THE HOSPITAL. SESSIONS ARE MODERATED BY VIRGINIA M. WRAY, DO, CNSP. DIABETES EDUCATION CLASSES-THE DIABETES RESOURCE CENTER AT GLH OFFERS EDUCATION CLASSES EACH SPRING AND FALL. CLASSES ARE HELD ONE DAY A WEEK FOR FIVE WEEKS. TOPICS MAY INCLUDE: DIABETES BASIC NUTRITION, CARBOHYDRATE COUNTING, MONITORING, MEDICATIONS, AND AVOIDING COMPLICATIONS. LEWIE B. HEALTHY CHILDREN'S-LEWIE B. HEALTHY IS GLH'S MASCOT. LEWIE MAKES SPECIAL APPEARANCES UPON REQUEST AT CHILD CARE CENTERS, SCHOOLS, AND COMMUNITY EVENTS TO HELP EDUCATE CHILDREN AND ADULTS ON VARIOUS HEALTH TOPICS INCLUDING: BONE HEALTH, FLU PREVENTION, 911 SAFETY, USDA'S MYPLATE, DENTAL HEALTH (IN PARTNERSHIP WITH THE MIFFLIN-JUNIATA DENTAL CLINIC), AND POISON SAFETY. FAMILY HEALTH ASSOCIATES TIME OF CHANGE WORKSHOPS-GLH'S FAMILY HEALTH ASSOCIATES (FHA) OFFERS A WORKSHOP DESIGNED ESPECIALLY FOR MOTHERS AND THEIR ADOLESCENT DAUGHTERS, AGES 9 - 12 YEARS. THE FOCUS OF THE WORKSHOP IS TO ASSIST MOTHERS IN EDUCATING THEIR DAUGHTERS ON CHANGES THAT OCCUR DURING ADOLESCENCE. INFORMATIONAL BOOKLETS FOR MOTHERS AND DAUGHTERS ARE GIVEN TO REINFORCE INFORMATION PRESENTED. KID CONNECTION'S "BEE" HEALTHY AVENUE-LEWISTOWN HOSPITAL, WITH THE HELP OF THEIR MASCOT, LEWIE B. HEALTHY, HOST "BEE" HEALTHY AVENUE ALONG WITH OTHER LOCAL HEALTHCARE AND HEALTH ORIENTED VENDORS WHO TEACH CHILDREN HOW TO FACILITY 1, GEISINGER-LEWISTOWN HOSPITAL - PART V, LINE 13B RECENT WAGE STATEMENTS, UNEMPLOYMENT OR OTHER DOCUMENTATION OF BENEFITS OR COMPENSATION RECEIVED MAY BE CONSIDERED IN DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY. FACILITY 1, GEISINGER-LEWISTOWN HOSPITAL - PART V, LINE 16I THE FAP, FAP APPLICATION, AND A PLAIN LANGUAGE SUMMARY OF THE FAP ARE WIDELY AVAILABLE AT: HTTP://WWW.GEISINGER.ORG/FOR-PATIENTS/RESOURCE- CENTER/PATIENT-BILLING-SERVICES/INDEX.HTML IN ADDITION, REGISTRATION PERSONNEL ALSO REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY. FACILITY 1, GEISINGER-LEWISTOWN HOSPITAL - PART V, LINE 20E UNDER NO CIRCUMSTANCES WILL GLH FREEZE OR ATTACH BANK ACCOUNTS OF A PATIENT, ENFORCE LIENS, ACTIVELY PURSUE ASSETS FROM A PRIOR JUDGMENT OR GARNISH THE WAGES OF A PATIENT AND/OR FAMILY MEMBER BEFORE DETERMINING IF THE PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER GLH'S FINANCIAL ASSISTANCE PROGRAM. FACILITY 1, GEISINGER-LEWISTOWN HOSPITAL - PART V, LINE 22D PATIENTS WHOSE HOUSEHOLD INCOME IS 300% OR LOWER OF THE FEDERAL POVERTY GUIDELINES ARE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FAP. PATIENTS WHO MEET THIS CRITERIA ARE ELIGIBLE FOR 100% DISCOUNT ON CHARGES, RESULTING IN 0 CHARGES FOR MEDICALLY NECESSARY CARE. NO OTHER DISCOUNTS ARE AVAILABLE UNDER GLH'S FAP. FREE CARE OR 0 CHARGE IS BELOW THE HOSPITAL FACILITY'S AMOUNT GENERALLY BILLED. PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE PART I, LINE 3A: DID THE ORGANIZATION USE FPG AS A FACTOR IN DETERMINING FREE CARE? YES, EFFECTIVE 07/01/2014, THE ELIGIBILITY FOR 100% DISCOUNTED FREE CARE UNDER THE GEISINGER-LEWISTOWN HOSPITAL (GLH) FINANCIAL ASSISTANCE POLICY WAS EXPANDED BY INCREASING THE HOUSEHOLD INCOME THRESHOLD FROM 200% TO 300% OF THE FEDERAL POVERTY GUIDELINES. PART I, LINE 3C: FACTORS USED OTHER THAN FPG IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE: SUPPORTING DOCUMENTATION FOR ELIGIBILITY MAY CONSIST OF INCOME AND ASSET INFORMATION, INCLUSIVE BUT NOT LIMITED TO: FEDERAL INCOME TAX FORM 1040 FROM THE PRIOR YEAR, PAY STUB COPIES (FROM FOUR PRIOR PAY PERIODS), WRITTEN VERIFICATION OF ANY OTHER INCOME RECEIVED (I.E. SOCIAL SECURITY, ADC, CHILD SUPPORT, ALIMONY, ETC.), CURRENT CREDIT REPORTS AND ASSET VERIFICATION. GLH MAY ALSO UTILIZE INDUSTRY TESTED EXTERNAL ANALYTICS TOOLS TO QUALIFY PATIENTS FOR UNCOMPENSATED CARE (AKA PRESUMPTIVE CHARITY). PART I, LINE 6A - RELATED ORGANIZATION INFORMATION A SUMMARY OF THE COMMUNITY BENEFIT PROVIDED BY GEISINGER-LEWISTOWN HOSPITAL (GLH) AND ITS RELATED CHARITABLE ORGANIZATIONS IS INCLUDED IN THE ANNUAL REPORT OF THE GEISINGER HEALTH SYSTEM AND IS AVAILABLE AT GEISINGER.ORG AND MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE REPORT CAN BE FOUND AT: HTTP://WWW.GEISINGER.ORG/PAGES/ABOUT-GEISINGER/PAGES/ANNUAL-REPORTS.HTML PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION THERE ARE NO PHYSICIAN CLINICAL SERVICES INCLUDED IN SUBSIDIZED HEALTH SERVICES. PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION A COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE COSTS REPORTED ON LINE 7 AND ADDRESSED PATIENT SEGMENTS BY PAYOR (E.G. MEDICARE, MEDICAID, COMMERCIAL PAYORS, SELF-PAY, ETC.). A COST TO CHARGE RATIO WAS CALCULATED PURSUANT TO WORKSHEET 2 OF THE FORM 990 INSTRUCTIONS WAS USED TO CALCULATE THE COST OF THESE PROGRAMS. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY REFER TO THE RESPONSE FOR PART III, LINE 4. PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE PATIENTS' ACCOUNTS ARE MONITORED THROUGHOUT THE BILLING PROCESS AND ARE RECLASSIFIED TO CHARITY CARE (100% DISCOUNTED CARE) WHENEVER A PATIENT BECOMES ELIGIBLE UNDER GLH'S UNCOMPENSATED OR CHARITY CARE POLICIES. BASED ON EXPERIENCE, GLH ESTIMATES THAT APPROXIMATELY 40% OF THE BAD DEBT ACCOUNTS ARE SUBSEQUENTLY RECLASSIFIED TO UNCOMPENSATED OR CHARITY CARE. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS PART III, LINE 2 AND 4: GEISINGER HEALTH SYSTEM FOUNDATION AND ITS AFFILIATES (THE "SYSTEM"), THAT INCLUDES GEISINGER-LEWISTOWN HOSPITAL, PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM'S ALLOWANCE FOR DOUBTFUL ACCOUNTS (BAD DEBT EXPENSE) METHODOLOGY AND CHARITY CARE POLICIES ARE CONSISTENTLY APPLIED ACROSS ALL CHARITABLE AFFILIATES. THE ORGANIZATIONS WRITE OFF ALL ACCOUNTS THAT HAVE BEEN IDENTIFIED AS UNCOLLECTABLE. AN ALLOWANCE FOR UNCOLLECTABLE ACCOUNTS IS RECORDED FOR ACCOUNTS NOT YET WRITTEN OFF THAT ARE ANTICIPATED TO BECOME UNCOLLECTABLE IN FUTURE PERIODS. FOR THE FOOTNOTES REGARDING ACCOUNTS RECEIVABLE AND ALLOWANCES SEE PAGE 8 OF THE ATTACHED GEISINGER HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTS, JUNE 30, 2015 AND JUNE 30, 2014. FOR THE FOOTNOTE REGARDING BAD DEBT, SEE PAGE 13 OF THE CONSOLIDATED FINANCIAL STATEMENTS. PART III, LINE 8 - MEDICARE EXPLANATION PART III, LINE 3 - BAD DEBT AND LINE 8 - MEDICARE: LINE 6 ONLY INCLUDES THOSE COSTS THAT ARE ALLOWED TO BE REPORTED ON GLH'S MEDICARE COST REPORT THAT ARE REQUIRED TO BE FILED WITH THE FEDERAL GOVERNMENT. SATISFYING THE "COMMUNITY BENEFIT STANDARD," AS ARTICULATED BY THE INTERNAL REVENUE SERVICE (IRS) IN REVENUE RULING 69-545, IS CURRENTLY REQUIRED FOR A HOSPITAL TO BE RECOGNIZED AS A CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE (IRC) 501(C)(3). THIS RULING REMOVED THE PREVIOUS REQUIREMENT OF REVENUE RULING 56-185, KNOWN AS THE "CHARITY CARE STANDARD," THAT IN ORDER TO BE A CHARITABLE ORGANIZATION, A HOSPITAL HAD TO PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS UNABLE TO PAY FOR THEIR CARE. THIS EARLIER RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT MEAN THAT A HOSPITAL WAS NOT CHARITABLE SINCE THAT LEVEL COULD REFLECT THE HOSPITAL'S FINANCIAL ABILITY TO PROVIDE SUCH CARE. REVENUE RULING 56-185 ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE BECAUSE THEY SERVE THE ENTIRE COMMUNITY AND A LOW LEVEL OF CHARITY CARE WOULD NOT IMPACT A HOSPITAL'S CHARITABLE STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. REVENUE RULING 69-545 INVOLVED A HOSPITAL THAT ONLY ADMITTED THOSE WHO COULD PAY FOR THE SERVICES EITHER BY THEMSELVES, THROUGH PRIVATE INSURANCE OR PUBLIC PROGRAMS SUCH AS MEDICARE. IN ADDITION, THE HOSPITAL OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL WAS CHARITABLE BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE "GENERALLY ACCEPTED LEGAL SENSE" OF THE TERM CHARITABLE, AS REQUIRED BY TREASURY REGULATION SECTION 1.501(C)(3)-1(D)(2). THE IRS RULED THAT THE PROMOTION OF HEALTH, LIKE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES OF THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO THOSE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER FACTORS THAT DEMONSTRATED COMMUNITY BENEFIT INCLUDED: SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND FACILITIES AND ADVANCE MEDICAL TRAINING, EDUCATION AND RESEARCH; AND IT WAS CONTROLLED BY A BOARD OF DIRECTORS THAT CONSISTED OF INDEPENDENT CIVIC LEADERS. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") HOLDS THE POSITION THAT MEDICARE UNDERPAYMENTS (SHORTFALLS) AND BAD DEBT SHOULD BE REPORTED AS COMMUNITY BENEFIT ON FORM 990, SCHEDULE H, PART I, LINE 7. IN A LETTER TO THE IRS DATED AUGUST 21, 2007 RESPONDING TO A DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA ARGUES THAT MEDICARE UNDERPAYMENTS (SHORTFALLS) IS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: -PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS REMAINS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. -MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES ONLY 92 CENTS FOR EVERY DOLLAR HOSPITALS SPEND TO CARE FOR MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION IN ITS MARCH 2007 REPORT CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE. -MANY MEDICARE PATIENTS, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46% OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200% OF THE FEDERAL POVERTY LEVEL. MANY ARE ALSO ELIGIBLE FOR MEDICAID, SO CALLED -DUAL ELIGIBLES". PENNSYLVANIA REQUIRES NON-PROFIT HOSPITALS LIKE GLH TO PROVIDE A MINIMUM LEVEL OF COMMUNITY BENEFIT TO RETAIN EXEMPTION FROM STATE AND LOCAL TAXES. ACCORDING TO STATE GUIDANCE AND CASE LAW, THE UNREIMBURSED COST OF MEDICARE AND BAD DEBT IS CONSIDERED TO BE COMMUNITY BENEFIT FOR STATE TAX EXEMPTION PURPOSES. GLH CONSIDERS THE TOTAL MEDICARE UNDERPAYMENTS (SHORTFALL) OF 6,695,517 SHOULD BE REPORTED AS COMMUNITY BENEFIT ON THE FORM 990, SCHEDULE H, PART I, LINE 7. ALONG WITH PROVIDING CARE TO MEDICAID PATIENTS AND PROVIDING FREE OR DISCOUNTED CARE TO OTHER LOW INCOME PATIENTS, THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. FOR MANY OF THE MEDICAL SERVICES PROVIDED BY THE HOSPITAL, MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE TO THESE PATIENTS, FORCING GLH TO USE OTHER FUNDS TO COVER THE SHORTFALL. MEDICARE SHORTFALLS MUST BE ABSORBED BY GLH IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. GLH PROVIDES CARE REGARDLESS OF THE MEDICARE SHORTFALL AND IS THEREBY PROVIDING ACCESS TO MEDICAL SERVICES FOR THE ELDERLY AND RELIEVING THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR PROVIDING CARE TO MEDICARE PATIENTS. ABSENT THE MEDICARE PROGRAM, IT IS LIKELY THAT MEDICARE PATIENTS WOULD BE ELIGIBLE FOR CHARITY CARE OR OTHER NEEDS BASED GOVERNMENT PROGRAMS. THE AMOUNT EXPENDED TO COVER THE SHORTFALL IS MONEY NOT AVAILABLE FOR FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. BOTH GLH AND THE AHA BELIEVE THAT PATIENT BAD DEBT (PART III, LINE 3) BE REPORTED AS A COMMUNITY BENEFIT ON FORM 990, SCHEDULE H, PART I, LINE 7. LIKE MEDICARE UNDERPAYMENTS (SHORTFALLS), BAD DEBT SHOULD BE REPORTED AS COMMUNITY BENEFIT BECAUSE: -A SIGNIFICANT PORTION OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO FOR MANY REASONS DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY UNDER GLH'S CHARITY CARE OR FINANCIAL ASSISTANCE POLICY (FAP). A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO"), "NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFIT", CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." -THE CBO REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF THE BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR CHARITABLE MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THE EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ACCORDING THE CBO REPORT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. (IN FY 2015, APPROXIMATELY 40% OF GLH'S BAD DEBT WAS SUBSEQUENTLY RECLASSIFIED TO CHARITY CARE.) THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE (BAD DEBT AND CHARITY CARE) AS A MEASURE OF COMMUNITY BENEFITS" ASSUMING THE FINDINGS ARE GENERALIZED NATIONALLY. THE EXPERIENCE OF HOSPITALS NATIONWIDE REINFORCE THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHS, DESPITE THE HOSPITAL'S BEST EFFORTS AND DUE DILIGENCE, PATIENT BAD DEBT IS A PART OF THE CHARITABLE MISSION AND CHARITABLE PURPOSES. BAD DEBT REPRESENTS PART OF THE BURDEN HOSPITALS' SHOULDER IN SERVING ALL PATIENTS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. IN ADDITION, THE HOSPITAL INVESTS SIGNIFICANT RESOURCES IN SYSTEMS AND STAFF TRAINING TO ASSIST PATIENTS THAT ARE IN NEED OF FINANCIAL ASSISTANCE. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION GLH IS COMMITTED TO PROVIDING MEDICAL NECESSARY SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND GLH'S COLLECTION ACTIONS ARE CONSISTENTLY APPLIED TO ALL PATIENTS. IT IS GLH POLICY TO PROVIDE FINANCIAL ASSISTANCE AND COUNSELING TO PATIENTS WITH LIMITED FINANCIAL MEANS. A PATIENT MAY BECOME ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING TREATMENT OR DURING THE CONTINUUM OF THE FINANCIAL/BILLING AND COLLECTION PROCESS. IN ANY STAGE OF THE BILLING PROCESS, COLLECTION ACTIONS ARE NOT PURSUED WHENEVER A PATIENT APPLIES AND IS BEING EVALUATED FOR FINANCIAL ASSISTANCE. UNDER NO CIRCUMSTANCE WILL GLH FREEZE OR ATTACH BANK ACCOUNTS OF A PATIENT, ENFORCE LIENS, ACTIVELY PURSUE ASSETS FROM A PRIOR JUDGMENT OR GARNISH THE WAGES OF A PATIENT AND/OR FAMILY MEMBER BEFORE DETERMINING IF THE PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER GLH'S FINANCIAL ASSISTANCE PROGRAM. PART VI, LINE 2 - NEEDS ASSESSMENT GLH ASSESES THE NEEDS OF THE COMMUNITIES SERVED IN THE FOLLOWING MANNER: QUARTERLY ADVISORY GROUPS: THE PATIENT SATISFACTION ADVISORY GROUP PURPOSE IS TO PROVIDE FEEDBACK REGARDING THE HOSPITAL'S PATIENT SATISFACTION EFFORTS. THE COMMITTEE IS COMPOSED OF FORMER AND CURRENT PATIENTS, AS WELL AS COMMUNITY MEMBERS. MEMBERS GIVE INSIGHT INTO WHAT THE COMMUNITY IS SAYING ABOUT THE HOSPITAL AND SUGGESTIONS FOR CHANGES TO MAKE THE HOSPITAL EXPERIENCE MORE PATIENT- FOCUSED. THE MARKETING ADVISORY COMMITTEE'S PURPOSE IS TO PROVIDE GUIDANCE FOR THE HOSPITAL'S MARKETING AND OUTREACH EFFORTS. MEDICAL STAFF SURVEYS: THE PRIMARY OBJECTIVE OF THE MEDICAL STAFF ASSESSMENT PROCESS WAS TO CREATE A MEDICAL STAFF DEVELOPMENT PLAN FOR GLH THAT PROJECTS THE NEEDS FOR PHYSICIANS OVER THE NEXT SEVERAL YEARS, BY SPECIALTY, IN THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS. IN ADDITION, THE SURVEY WAS USED TO CREATE A PHYSICIAN RECRUITMENT STRATEGY FOR THE HOSPITAL AND MEMBERS OF THE MEDICAL STAFF. UTILIZATION STATISTICS AND ANALYSIS: DECISION SUPPORT SOFTWARE WITHIN THE HOSPITAL'S FINANCE DEPARTMENT PROVIDES HISTORICAL AND CURRENT DATA ON THE UTILIZATION OF INPATIENT AND OUTPATIENT SERVICES. STATE HEALTH IMPROVEMENT PLAN PARTNERSHIP (SHIP) DATA: GLH IS A KEY MEMBER OF THE LOCAL SHIP (MIFFLIN-JUNIATA PARTNERS ADVANCING TOMORROW'S HEALTH). THE PURPOSE OF THIS GROUP IS TO SUPPORT THE HEALTH PLANNING INITIATIVES FROM THE PENNSYLVANIA DEPARTMENT OF HEALTH. THIS IS ACCOMPLISHED BY ENGAGING A BROAD SPECTRUM OF LOCAL COMMUNITY INDIVIDUALS AND ORGANIZATIONS WITH INTERESTS AND INFLUENCE ON LOCAL HEALTH STATUS BY WORKING TOGETHER TO PROMOTE EFFECTIVE HEALTH IMPROVEMENT STRATEGIES, INCLUDING PLANNING AND COORDINATION OF LOCAL RESOURCES. MEETINGS ARE HELD BI-MONTHLY. PA DEPARTMENT OF HEALTH STATISTICS: THE PA DEPARTMENT OF HEALTH WEBSITE PROVIDES A WEALTH OF HEALTH STATISTICS AND DATA FOR EACH COUNTY. THIS INCLUDES THE FOLLOWING: RATES FOR BIRTH, DEATH, CANCER, AND OTHER VITAL STATISTICS BEHAVIORAL RISK AND INJURY STATISTICS COMMUNICABLE DISEASES HEALTH FACILITIES SCHOOL HEALTH PA DEPARTMENT OF HEALTH BEHAVIORAL RISK FACTOR SURVEY: THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) IS AN ANNUAL TELEPHONE SURVEY IMPLEMENTED NATIONWIDE UNDER A GRANT FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION. SINCE 1989, THE PENNSYLVANIA DEPARTMENT OF HEALTH HAS RELEASED ANNUAL REPORTS USING BRFSS DATA ON VARIOUS HEALTH RISK BEHAVIORS, SUCH AS SMOKING, DRINKING, SEAT BELT USAGE AND HEALTH STATUS. HOW IS ALL OF THE ABOVE INFORMATION PULLED TOGETHER AND UTILIZED? VARIOUS HOSPITAL STAFF MEMBERS ASSIST WITH THE DATA COLLECTION. PRIMARY AND SECONDARY DATA IS ORGANIZED INTO COMPUTER FILES TO MAKE THE INFORMATION EASIER TO USE AND ANALYZE. ONCE THE HOSPITAL HAS THE PRIMARY AND SECONDARY DATA COLLECTED AND IN HAND, THE SENIOR TEAM SPENDS TIME ANALYZING THE DATA TO DISCERN PATTERNS AND THEMES. ASSESSMENT DATA FINDINGS ARE SHARED WITH A VARIETY OF GROUPS INTERNALLY AND EXTERNALLY (MANAGEMENT STAFF, MEDICAL- DENTAL STAFF, BOARD OF TRUSTEES, COMMUNITY ORGANIZATIONS). SINCE SUFFICIENT RESOURCES ARE NOT AVAILABLE TO ADDRESS ALL THE HEALTH CONCERNS IDENTIFIED IN THE ASSESSMENTS, CHOICES MUST BE MADE ABOUT WHICH ISSUES ARE DESIGNATED AS PRIORITIES FOR ACTION IN THE SHORT TO INTERMEDIATE TERM (ONE TO THREE YEARS). IN GENERAL, THE HOSPITAL ADDRESSES THREE TO FOUR PRIORITIES. THE HOSPITAL COLLABORATES WITH OTHER COMMUNITY STAKEHOLDERS TO GAIN A GREATER COMMITMENT TO ACTION. A CONSENSUS IS REACHED WITH INPUT FROM HOSPITAL STAFF, MEDICAL STAFF, THE BOARD OF TRUSTEES, AND COMMUNITY MEMBERS. CRITERIA THAT ARE USED TO IDENTIFY THE MOST SIGNIFICANT HEALTH ISSUES INCLUDE: THE MAGNITUDE OF THE PROBLEM THE SEVERITY OF THE PROBLEM A HIGH NEED AMONG VULNERABLE POPULATIONS CRITERIA THAT ARE USED TO EVALUATE WHICH HEALTH ISSUES THE HOSPITAL SHOULD PRIORITIZE INCLUDE: THE HOSPITAL'S CAPACITY TO ACT ON THE ISSUE, INCLUDING ECONOMIC,SOCIAL, AND CULTURAL CONSIDERATIONS. THE FEASIBILITY OF HAVING A MEASURABLE IMPACT ON THE ISSUE COMMUNITY RESOURCES ALREADY FOCUSED ON THE ISSUE WHETHER THE ISSUE IS A ROOT CAUSE OF OTHER PROBLEMS (THEREBY POSSIBLY AFFECTING MULTIPLE ISSUES) WHEN THE ISSUES HAVE BEEN PRIORITIZED, THE SENIOR TEAM AND BOARD OF TRUSTEES DISCUSS THE PRIORITIZED LIST AND ASK FOR ADDITIONAL INPUT AND VALIDATION. WHEN A FINAL DECISION IS MADE, A PLAN IS PUT INTO PLACE TO ADDRESS THE PRIORITIES AND IMPROVE COMMUNITY HEALTH. SPECIFIC GOALS HELP FOCUS THE SPECIFIC INTERVENTIONS AND PROVIDE A METHOD FOR VALUING EACH OPTION. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FOR URGENT AND EMERGENT SERVICES, PATIENTS ARE PROVIDED CARE REGARDLESS OF THEIR ABILITY TO PAY. IN THE EVENT A PATIENT HAS AN EMERGENCY MEDICAL CONDITION, TREATMENT IS NOT DELAYED TO PERMIT AN INQUIRY REGARDING A PATIENT'S METHOD OF PAYMENT OR INSURANCE STATUS. FOR OTHER THAN URGENT AND EMERGENT SERVICES, THE HOSPITAL PROVIDES UNCOMPENSATED CARE, FREE OF CHARGE, OR ON A 100% DISCOUNTED BASIS, TO THOSE PATIENTS WHO DEMONSTRATE AN INABILITY TO PAY. DEPENDING UPON FAMILY SIZE AND INCOME, FREE OR 100% DISCOUNTED SERVICES ARE AVAILABLE TO A PATIENT WITH FAMILY INCOME OF 300% OR LESS OF THE FEDERAL POVERTY GUIDELINES. IT IS GEISINGER POLICY TO PROVIDE FINANCIAL ASSISTANCE AND FINANCIAL COUNSELING TO PATIENTS OF LIMITED MEANS. A PATIENT MAY BECOME ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE AT ANY TIME DURING TREATMENT OR DURING THE CONTINUUM OF THE FINANCIAL/BILLING PROCESS. INFORMATION (SIGNS, BROCHURES, ETC.) REGARDING GEISINGER'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES ARE PROVIDED AT THE EMERGENCY ROOM, REGISTRATION AND VARIOUS ACCESS POINTS THROUGHOUT THE HOSPITAL. REGISTRATION PERSONNEL ALSO REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY. NOTICE OF GEISINGER'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES CAN ALSO BE FOUND ON THE GEISINGER WEB SITE AT WWW.GEISINGER.ORG. PATIENTS ARE ALSO PROVIDED INFORMATION ON GEISINGER'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES WITH EACH PATIENT BILL. PART VI, LINE 4 - COMMUNITY INFORMATION THE GLH SERVICE AREA IS COMPRISED OF MIFFLIN COUNTY, JUNIATA COUNTY, AND PARTS OF HUNTINGDON AND SNYDER COUNTIES. THIS RURAL AREA CONTAINS SOME 145,000 PEOPLE SPREAD OVER MORE THAN 2,500 SQUARE MILES OF RUGGED TERRAIN LOCATED IN THE HEART OF THE APPALACHIAN MOUNTAINS IN CENTRAL PENNSYLVANIA. THE AVERAGE POPULATION DENSITY IS APPROXIMATELY 60 PERSONS PER SQUARE MILE. THE JUNIATA RIVER RUNS ALONG THE VERDANT VALLEYS AND SLICES THROUGH NARROW MOUNTAIN PASSES TO CONNECT OUR RESIDENTS TOGETHER, WHICH IS WHY OUR AREA IS CALLED THE JUNIATA VALLEY. TRANSPORTATION BARRIERS PLAY A MAJOR ROLE IN ACCESS TO HEALTH CARE IN OUR REGION. THESE NATURAL BARRIERS INCLUDE NARROW ROADS THAT EITHER MEANDER ALONG STREAMS AND CREEKS OR CROSSOVER THE MOUNTAIN RANGES THAT TRAVERSE OUR APPALACHIAN RIDGE REGION. THESE BARRIERS ARE EVEN MORE DAUNTING GIVEN HAZARDOUS WINTER DRIVING CONDITIONS CAUSED BY SNOW OR ICE COVERED ROADS. LOW-INCOME AND SENIOR CITIZENS ALSO FACE TRANSPORTATION ISSUES, AS THERE IS NO PUBLIC TRANSPORTATION IN OUR SERVICE AREA. SENIOR CITIZENS AND MEDICAID-ELIGIBLE PERSONS CAN USE THE "CARS" VAN SYSTEM FOR TRANSPORTATION TO REGULARLY SCHEDULED APPOINTMENTS WITH A WEEKS' NOTICE BUT NOT FOR URGENT OR EMERGENCY CARE. LOW INCOME CITIZENS HAVE NO ACCESS TO ANY PUBLIC TRANSPORTATION AT ALL IN OUR COMMUNITY. IF A TRIP TO A SPECIALIST IS REQUIRED THE MAJOR SUPPORT HOSPITALS ARE OVER ONE AND HALF HOURS DRIVE. THE POPULATION OF OUR TOTAL SERVICE AREA IS JUST ABOUT 145,000 PERSONS BASED ON 2010 US CENSUS DATA. MIFFLIN COUNTY HAS A RELATIVELY FLAT GROWTH RATE WITH A POPULATION CHANGE OF 0.4% FROM 2000 TO 2010. JUNIATA COUNTY, ON THE OTHER HAND, HAS SEEN SIGNIFICANT GROWTH WITH A 10.6% INCREASE IN POPULATION FROM 2000 TO 2010. IT IS BELIEVED THAT THIS GROWTH IS MOSTLY COMING FROM PEOPLE WHO WORK IN THE NEARBY HARRISBURG AREA WHO ARE LOOKING FOR A LOWER COST OF LIVING. WITH THE RECENT COMPLETION OF A NEW FOUR-LANE HIGHWAY NORTH OF HARRISBURG, THE COMMUTE TO HARRISBURG HAS BECOME MORE CONVENIENT RESULTING IN AN INCREASE IN JUNIATA COUNTY'S POPULATION AS PEOPLE MOVE FURTHER AWAY FROM THE URBAN AREAS TO LIVE IN THE COUNTRY. HIGHER GROWTH IN FULTON COUNTY IS EXPLAINED BY MIGRATION FROM MARYLAND AS PEOPLE TRY TO MOVE AWAY FROM HIGHER HOUSING COSTS IN MARYLAND. HUNTINGDON COUNTY'S GROWTH IS MOSTLY OCCURRING IN THE NORTHERN PORTION OF THE COUNTY THAT IS CLOSE ENOUGH TO STATE COLLEGE TO ALLOW RESIDENTS TO COMMUTE TO PENN STATE UNIVERSITY. THESE GROWTH RATES ARE STILL VERY LOW WHEN COMPARED TO A NATIONAL GROWTH RATE OF OVER 13%. OTHER IMPORTANT DEMOGRAPHIC STATISTICS ARE OUTLINED BELOW. STATISTICS: MIFFLIN COUNTY(MC), JUNIATA COUNTY(JC), PENNSYLVANIA(PA) POPULATION: 46,682(MC), 24,636(JC, 12,702,379(PA) POPULATION LESS THAN 18 YEARS OF AGE: 23.1%(MC), 24%(JC), 22%(PA) AGE 65 AND UP: 18.5%(MC), 16.8%(JC), 15.4%(PA) PERCENTAGE OF POPULATION BELOW THE POVERTY LEVEL (2010): 16.6%(MC), 11.1%(JC), 13.4% (PA) POVERTY RATE FOR CHILDREN UNDER AGE 18 (2010): 28.1%(MC), 18.0%(JC), 18.9%(PA) MEDIAN HOUSEHOLD INCOME: 37,163(MC), 45,810(JC), 49,245(PA) UNINSURED ADULTS (2010): 19.1%(MC), 18.7%(JC), 14.5%(PA) UNEMPLOYMENT RATE (2010): 9.5%(MC), 7.7%(JC), 8.4%(PA) MIFFLIN COUNTY'S 65 AND OVER AGE GROUP IS 18.5 PERCENT (2010), WHILE JUNIATA COUNTY'S IS 16.8%, HUNTINGDON COUNTY'S, 16.2% AND FULTON COUNTY'S 17.1%. THE PENNSYLVANIA AVERAGE FOR THIS STATISTIC IS 15.4%. BOTH MIFFLIN AND JUNIATA COUNTIES HAVE HIGHER PERCENTAGES OF PERSONS LESS THAN 18 YEARS OF AGE, 23.1% AND 24.0% RESPECTIVELY, THAN THE PA AVERAGE OF 22.0%. BOTH OF THESE GROUPS REQUIRE MORE HEALTH CARE RESOURCES THAN OTHER AGE GROUPS IN OUR COMMUNITY. MIFFLIN COUNTY HAS 16.6% OF THE POPULATION WITH INCOME BELOW THE POVERTY LINE AND 28.1% OF CHILDREN UNDER 18 LIVING IN POVERTY. JUNIATA COUNTY HAS 11.1% OF THE POPULATION WITH INCOME BELOW THE POVERTY LINE, WHILE HUNTINGDON AND SNYDER COUNTIES ARE 13% AND 14% RESPECTIVELY. PER CAPITA PERSONAL INCOME (2009) FOR THE FOUR MAIN COUNTIES IN OUR SERVICE AREA ARE AS FOLLOWS: MIFFLIN 28.3K, JUNIATA 30.3K, HUNTINGDON 27.6K, AND SNYDER 30.8K. THE PERCENTAGES OF THE POPULATIONS WHO ARE UNINSURED (IN THE 18-64 AGE RANGE) FOR THOSE COUNTIES ARE AS FOLLOWS: MIFFLIN 19%, JUNIATA 19%, HUNTINGDON 19%, AND SNYDER 16%. AT THE BEGINNING OF FOR FISCAL YEAR 2014, APPROXIMATELY 14.1% OF OUR PATIENT POPULATION WAS MEDICAL ASSISTANCE, WHILE ANOTHER 3.8% WERE SELF PAY. THERE IS ONE OTHER HOSPITAL LOCATED WITHIN THE SERVICE AREA DEBCRIBED ABOVE, JC BLAIR MEMORIAL HOSPITAL IN HUNTINGDON, PA. THERE ARE ALSO SEVERAL OTHER HOSPITALS LOCATED IN AREAS SURROUNDING OUR SERVICE AREA. THESE INCLUDE MT. NITTANY MEDICAL CENTER IN STATE COLLEGE, PA; GEISINGER MEDICAL CENTER IN DANVILLE, PA; HOLY SPIRIT HOSPITAL IN CAMP HILL, PA; THE PENN STATE MILTON S. HERSHEY MEDICAL CENTER IN HERSHEY, PA; AND SEVERAL CAMPUSES OF PINNACLE HEALTH IN THE HARRISBURG, PA AREA. THERE ARE ALSO SEVERAL FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS WITHIN OUR SERVICE AREA. THERE ARE TWO LOCATED IN MIFFLIN COUNTY, ONE IN JUNIATA COUNTY, AND FOUR IN HUNTINGDON COUNTY. THE ADULT BEHAVIORAL HEALTH RISK FACTORS SURVEY (2008-2010) SHOWS THE FOLLOWING STATISTICS FOR THE POPULATION LIVING IN MIFFLIN AND JUNIATA COUNTIES: RISK FACTORS : -PERCENT FAIR OR POOR GENERAL HEALTH: 16% -OBESE: 31% -OVERWEIGHT (INCLUDES OBESE): 66% -DIABETIC: 11% -CURRENTLY HAS ASTHMA: 10% -CURRENT SMOKER:19% FOR MIFFLIN AND JUNIATA COUNTIES, THE HEALTH PROFILE FROM THE PA DEPARTMENT OF HEALTH SHOWS THE MAJOR CAUSES OF DEATH ARE DISEASES OF THE HEART, CANCER, STROKE, AND CHRONIC LOWER RESPIRATORY DISEASES. PROSTATE CANCER RANKS AS NUMBER ONE FOR THE HIGHEST INCIDENCE OF CANCER, FOLLOWED BY FEMALE BREAST CANCER. RANKING THIRD AND FOURTH ON THE LIST ARE LUNG CANCER AND COLON CANCER, RESPECTIVELY. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH SEE THE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS / COMMUNITY BENEFIT REPORTED IN SCHEDULE O. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM GLH IS AN AFFILIATE WITHIN THE GEISINGER HEALTH SYSTEM. GEISINGER HEALTH SYSTEM IS A PHYSICIAN-LED, INTEGRATED HEALTH SERVICES ORGANIZATION THAT HAS AS ITS MAIN COMPONENTS: 1) AN ARRAY OF HEALTH SERVICES PROVIDERS, INCLUDING SIX ACUTE CARE HOSPITALS AND A DRUG AND ALCOHOL TREATMENT FACILITY; 2) A MULTISPECIALTY PHYSICIAN GROUP PRACTICE OF 1,136 PHYSICIANS PRACTICING AT 91 PRIMARY AND SPECIALTY CLINICS; AND 3) ONE OF THE NATION'S LARGEST RURAL HEALTH INSURANCE ORGANIZATIONS WITH 478,501 MEMBERS. GEISINGER OPERATES IN 44 OF PENNSYLVANIA'S 67 COUNTIES, WITH A SIGNIFICANT PRESENCE IN CENTRAL AND NORTHEASTERN PENNSYLVANIA, PRIMARILY OUTSIDE THE MAJOR METROPOLITAN AREAS, GEISINGER AT A GLANCE. -PHYSICIAN PRACTICE GROUP - MULTISPECIALTY GROUP PRACTICE WITH 1,136 EMPLOYED PHYSICIANS PRACTICING AT 91 CLINIC SITES -MANAGED CARE COMPANIES 478,501 MEMBERS -PROVIDER FACILITIES INCLUDES 1,326 LICENSED HOSPITAL BEDS, 344 SKILLED NURSING FACILITY BEDS AND 91 CHEMICAL DEPENDENCY BEDS. MISSION. GEISINGER'S MISSION IS TO ENHANCE THE QUALITY OF LIFE THROUGH AN INTEGRATED HEALTH SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE. THIS MISSION STATEMENT HAS BEEN SUMMARIZED INTO FOUR WORDS - "HEAL. TEACH. DISCOVER. SERVE." HISTORY. GEISINGER HAD ITS BEGINNINGS IN THE SMALL COMMUNITY OF DANVILLE, WHICH IS LOCATED IN CENTRAL PENNSYLVANIA ON THE NORTHERN BRANCH OF THE SUSQUEHANNA RIVER. THERE, IN 1915, ABIGAIL A. GEISINGER FOUNDED THE GEORGE F. GEISINGER MEMORIAL HOSPITAL IN MEMORY OF HER HUSBAND. FROM THE BEGINNING, THE NEW HOSPITAL WAS DESIGNED AS A COMPREHENSIVE HEALTHCARE INSTITUTION THAT WOULD OFFER SPECIALIZED MEDICAL CARE TO PEOPLE IN THE RURAL AREAS OF CENTRAL AND NORTHEASTERN PENNSYLVANIA. UNLIKE MOST HEALTHCARE SYSTEMS, WHICH EVOLVED WITH A HOSPITAL FOCUS, GEISINGER'S HISTORY AND TRADITION IS THAT OF A PHYSICIAN-LED AND PHYSICIAN-DRIVEN HEALTHCARE ORGANIZATION. THIS TRADITION BEGAN WHEN MRS. GEISINGER BROUGHT DR. HAROLD FOSS, A MAYO CLINIC TRAINED PHYSICIAN, TO BE HER HOSPITAL'S FIRST CHIEF OF STAFF. TODAY, GEISINGER IS REGARDED AS A NATIONAL MODEL OF HEALTHCARE DELIVERY CENTERED ON A SOPHISTICATED MULTISPECIALTY GROUP PRACTICE. SINCE THE 1970S, GEISINGER'S STRATEGY OF INTEGRATING PHYSICIANS AND HOSPITALS EXPANDED TO INCLUDE THE MANAGEMENT OF HEALTH AND THE FINANCING OF HEALTHCARE SERVICES THROUGH ITS WHOLLY CONTROLLED HEALTH MAINTENANCE ORGANIZATION, GEISINGER HEALTH PLAN. TWO INDEMNITY HEALTH INSURERS, GEISINGER INDEMNITY INSURANCE COMPANY AND GEISINGER QUALITY OPTIONS, INC., KNOWN COLLECTIVELY WITH GEISINGER HEALTH PLAN AS "GEISINGER HEALTH PLANS- OR "GHPS", HAVE BEEN ADDED IN RECENT YEARS. CORPORATE STRUCTURE. THE ORGANIZATIONAL STRUCTURE OF THE SYSTEM REFLECTS THE STRATEGIC GOAL OF OPERATING AS A FULLY INTEGRATED HEALTHCARE SYSTEM WHOSE CORPORATE COMPONENTS SHARE THE COMMON GOALS OF MANAGING AND IMPROVING THE HEALTHCARE OF ITS PATIENTS AND MEMBERS, WHILE RECOGNIZING AND RESPECTING THE CORPORATE IDENTITY OF EACH ENTITY. THIS INTEGRATION LINKS THE AREAS OF PHYSICIANS, HOSPITALS/CLINICS, AND HEALTHCARE INSURANCE. SEE SCHEDULE R FOR A LIST OF THE AFFILIATED ORGANIZATIONS COMPRISING THE GEISINGER HEALTH SYSTEM. THROUGHOUT THIS DOCUMENT THE TERMS "GEISINGER HEALTH SYSTEM", "GEISINGER- OR "SYSTEM" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH SYSTEM FOUNDATION ("THE FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM. ADDITIONAL INFORMATION FORM 990, SCHEDULE H, PART VI, LINE 7, STATE FILING OF COMMUNITY BENEFIT REPORT: AT THIS TIME, GLH AND ITS AFFILIATES ARE NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE. false ALL OTHER CONTRIBUTIONS COMBINED EACH INDIVIDUALLY 5000 OR LESS DANVILLE PA 17822 15206 12 6 SCHEDULE I, PAGE 4, PART IV GEISINGER-LEWISTOWN HOSPITAL (GLH) DOES NOT AWARD GRANTS BUT PROVIDES ASSISTANCE IN THE FORM OF CHARITABLE CONTRIBUTIONS TO OTHER TAX-EXEMPT ORGANIZATIONS THAT QUALIFY FOR 501 (C)(3)STATUS UNDER THE INTERNAL REVENUE CODE, LIMITED 501(C)(4) ORGANIZATIONS BASED ON EXPLICIT CRITERIA, PUBLIC BENEFIT OR NON-EXEMPT ORGANIZATIONS WHOSE ACTIVITIES FURTHER THE EXEMPT PURPOSE OF GLH. GLH NOTIFIES THE PUBLIC BENEFIT OR NON-EXEMPT ORGANIZATIONS OF THE INTENT AND PURPOSE OF THE CHARITABLE CONTRIBUTION. ORGANIZATIONS SEEKING SUPPORT MUST DEMONSTRATE THAT THEY EFFECTIVELY MEET AN IMPORTANT COMMUNITY NEED. X X X X X X false true false false false false false true false GLENN D STEELE JR MD PHD PRES, CHAIR,DIRECTOR 1091895 1131217 2065068 440136 31990 4760306 1191920 ALBERT BOTHE JR MD CMO 557191 203742 247275 169843 12597 1190648 185129 DAVID J FELICIO ESQUIRE CLO, SECRETARY 390448 164846 107331 76118 25063 763806 61110 EDWARD J ZYCH ESQUIRE ACLO, ASST SECTY 262471 80515 47579 18720 23750 433035 30485 FRANK J TREMBULAK SR VP, TREASURER 628294 313196 250904 208746 10836 1411976 209318 KEVIN F BRENNAN CPA FHFMA EVP, FINANCE, CFO 531656 273329 223359 176933 24858 1230135 185023 MICHAEL T HEGSTROM MD CHIEF MEDICAL OFFICE 339141 73335 27178 18720 19892 478266 KAY HAMILTON RN MS CAO 288832 4024 24409 10874 328139 CHRISTINE W MATHEWS RN MSN VP, NURSING 147989 22901 668 6677 7247 185482 KIRK E THOMAS FACHE MHA RRT VP, OPERATIONS 152905 24483 271 26330 203989 LEWIS D ALLSHOUSE III PHARMACIST 123723 200 5845 13869 13484 157121 NALIN G PATEL MD PSYCHIATRIST 320301 76703 21995 418999 PETER A GOYER RAD. PHYSICIST 172905 1865 7272 182042 RICHARD F STOMACKIN BS RPH DIRECTOR. PHARMACY 148256 6552 6251 161059 NANCY S REINKE FORMER OFFICER 118548 200 2835 8106 27169 156858 SCHEDULE J, PAGE 1, PART I, LINE 4 GLENN D. STEELE JR., MD PHD 0 1,908,021 0 ALBERT BOTHE, JR., MD 0 185,129 0 DAVID J. FELICIO, ESQUIRE 0 61,110 0 EDWARD J. ZYCH, ESQUIRE 0 30,485 0 FRANK J. TREMBULAK 0 209,318 0 KEVIN F. BRENNAN, CPA, FHFMA 0 185,023 0 SCHEDULE J, PAGE 1, PART I, LINE 7 BECAUSE THE PAYMENT OF EARNED PERFORMANCE BASED COMPENSATION IS AT THE DISCRETION OF MANAGEMENT AND THE BOARD OF DIRECTORS, SUCH PAYMENTS MAY BE CONSIDERED NON-FIXED PAYMENTS. PERFORMANCE BASED COMPENSATION IS DETERMINED BY MEETING INDIVIDUALLY MEASURED PERFORMANCE GOALS THAT ARE ALIGNED WITH OVERALL SYSTEM OBJECTIVES, INCLUDING: CLINICAL QUALITY, COMMUNITY MISSION ACHIEVEMENT, AND FINANCIAL STEWARDSHIP. SCHEDULE J, PART III PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN COMPENSATION FOR ELIGIBLE EMPLOYEES MAY BE DEFERRED TO A 457(F) NONQUALIFIED PLAN THAT VESTS WITH COMPLETION OF SERVICE, DEATH AND/OR PERMANENT DISABILITY. __________________________________________________________________________ FOOTNOTE: THROUGHOUT FORM 990, THE TERMS "GEISINGER HEALTH SYSTEM- AND "SYSTEM- OR THE ACRONYM "GHS" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH SYSTEM FOUNDATION ("GHSF") AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM. FORM 990 FORM 990, PART IV, LINE 24A: DID THE ORGANIZATION HAVE A TAX-EXEMPT BOND ISSUE WITH AN OUTSTANDING PRINCIPAL AMOUNT OF MORE THAN 100,000 AS OF THE LAST DAY OF THE YEAR, THAT WAS ISSUED AFTER DECEMBER 31, 2002? GHSF IS CURRENTLY THE SOLE OBLIGOR UNDER A SERIES OF BOND ISSUES WITH A TOTAL OUTSTANDING BALANCE OF 1,230,762,550, INCLUSIVE OF UNAMORTIZED ORIGINAL ISSUE DISCOUNT AS OF JUNE 30, 2015. BECAUSE THE BOND PROCEEDS ARE DISBURSED TO GHSF SUBSIDIARIES, THE BOND LIABILITIES ARE REFLECTED ON THE BALANCE SHEETS OF THE FOLLOWING SUBSIDIARY ORGANIZATIONS: GEISINGER MEDICAL CENTER, EIN: 24-0795959 GEISINGER WYOMING VALLEY MEDICAL CENTER, EIN: 23-1996150 GEISINGER CLINIC, EIN: 23-6291113 MARWORTH, EIN: 23-2171417 GEISINGER SYSTEM SERVICES, EIN: 23-2164794 COMMUNITY MEDICAL CENTER, EIN: 24-0862246 MOUNTAIN VIEW NURSING HOME, INC., EIN: 23-2568288 GEISINGER-BLOOMSBURG HOSPITAL, EIN: 23-2193572 GEISINGER-BLOOMSBURG HEALTH CARE CENTER, EIN: 23-2242854 GEISINGER-LEWISTOWN HOSPITAL, EIN: 23-1352187 HOLY SPIRIT HOSPITAL, EIN: 23-1512747 SCHEDULE K WAS PREPARED ON A CONSOLIDATED BASIS AND IS INCLUDED IN THE FORM 990 FILING OF GEISINGER HEALTH SYSTEM FOUNDATION, EIN: 23-1995911. FORM 990, PAGE 2, PART III, LINE 4A I. MISSION: TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING ACCESS TO QUALITY POPULATION HEALTH AND HOSPITAL SERVICES THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE. II.GENERAL INFORMATION GEISINGER-LEWISTOWN HOSPITAL (GLH), A 501(C)(3) NOT-FOR-PROFIT CORPORATION AND MEMBER OF GEISINGER HEALTH SYSTEM, OWNS AND OPERATES A 123 BED ACUTE CARE HOSPITAL IN LEWISTOWN, PA. GLH IS CONVENIENTLY LOCATED ONLY A FEW MILES FROM SEVERAL CENTRAL PENNSYLVANIA MAJOR HIGHWAYS. THE FACILITY OPENED IN 1905 IN RESPONSE TO A PRESSING NEED FOR HEALTH AND WELLNESS CARE IN THE COMMUNITY. DURING THE FISCAL YEAR ENDED JUNE 30, 2015, GLH PROVIDED 19,067 PATIENT DAYS; 4,700 SAME DAY SURGICAL PROCEDURES; AND 28,938 EMERGENCY ROOM VISITS. GLH PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. THE ORGANIZATION ALSO PROVIDES UNCOMPENSATED CARE TO PATIENTS WHO MET CERTAIN CRITERIA WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. SERVICES OFFERED BY GLH INCLUDE: GENERAL MEDICAL CARE IS PROVIDED BY IN-HOUSE HOSPITALISTS AND SUPPORTED BY CONSULTATIVE SERVICES IN THE AREAS OF CARDIOLOGY, NEUROLOGY, PULMONOLOGY, ORTHOPEDICS, HEMATOLOGY/ONCOLOGY, OTOLARYNGOLOGY, GASTROENTEROLOGY. THE EMERGENCY DEPARTMENT (ED) IS COMMITTED TO PROVIDING HIGH QUALITY, PROMPT EMERGENCY SERVICES. GLH'S ED IS STAFFED 24/7 WITH FULL-TIME PHYSICIANS AND NURSES WHO ARE TRAINED IN ALL SPECIALTIES FROM PEDIATRICS TO CRITICAL CARE. IMMEDIATE ACCESS TO LABORATORY SERVICES, IMAGING SERVICES SUCH AS, CAT SCANS, ULTRASOUND, MRI, AND SURGICAL SERVICES. MOST INSURANCES, INCLUDING MEDICARE AND MEDICAID, ARE ACCEPTED AND NO PATIENT IS REFUSED TREATMENT BECAUSE OF INABILITY TO PAY. OB/GYN FOCUSES ON ALL ASPECTS OF WOMEN'S HEALTH AND EDUCATION, PROVIDING OBSTETRICAL AND GYNECOLOGICAL CARE FOR WOMEN OF ALL AGES. SERVICES INCLUDE BUT ARE NOT LIMITED TO ROUTINE VISITS AND TREATMENTS, PREVENTATIVE HEALTHCARE, BIRTH CONTROL EDUCATION, FAMILY PLANNING, OBSTETRICS, SURGERY & SURGERY CONSULTATIONS, MENOPAUSE COUNSELING, AND MIDWIFERY. MENTAL HEALTH & PSYCHIATRIC PROVIDES ADULT INPATIENT SERVICES DESIGNED TO HELP INDIVIDUALS LIVE AS INDEPENDENTLY AS POSSIBLE. PATIENTS CAN ACCESS QUICK, EFFICIENT ADMISSION 24/7 AND RECEIVE TREATMENT THROUGH A PSYCHIATRIST AVAILABLE ON A DAILY BASIS. ADMISSIONS ARE CONFIDENTIAL AND MAY BE MADE BY PROFESSIONALS AS WELL BY INDIVIDUALS CONCERNED ABOUT THEMSELVES OR OTHERS. DURING HOSPITALIZATION, PATIENT CARE IS PROVIDED THROUGH MULTIPLE PROFESSIONALS WHO COMPRISE THE TREATMENT TEAM. OTHER SERVICES INCLUDE: CARDIAC SERVICES NEUROSURGERY RESPIRATORY SERVICES SLEEP CENTER ORTHOPEDIC GENERAL SURGERY RADIOLOGY OTHER SURGERY SPECIALTIES ICCU UROLOGY PAIN MANAGEMENT LABORATORY SERVICES GYNECOLOGY WOUND MANAGEMENT PHYSICAL THERAPY OTOLARYNGOLOGY WEIGHT MANAGEMENT PEDIATRICS NEWBORN NURSERY GASTROENTEROLOGY NEPHROLOGY OPTHAMOLOGY PATHOLOGY COMMUNITY CANCER TREATMENT/ONCOLOGY III. UNCOMPENSATED CARE GEISINGER-LEWISTOWN HOSPITAL RECOGNIZES ITS MISSION IS TO SERVE ALL MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND EDUCATION. IN THIS REGARD, GLH PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH-RELATED ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A.CHARITY CARE THE PRIMARY CONCERN OF GLH IS THE DELIVERY OF HEALTH CARE TO ALL CITIZENS OF CENTRAL PENNSYLVANIA REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GLH INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. FOR THE FISCAL YEAR ENDED JUNE 30, 2015, THE COST OF THE CHARITY CARE WAS 1.3 MILLION. B.MEDICARE/MEDICAID IN RECOGNIZING ITS MISSION TO THE COMMUNITY, GLH PROVIDES SERVICES TO THE ELDERLY (MEDICARE) AND THE INDIGENT (MEDICAID). GLH PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS TO THE EXTENT THE GOVERNMENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTH CARE. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. THE COST OF PROVIDING HEALTHCARE SERVICES TO MEDICARE AND MEDICAID PATIENTS EXCEEDED REIMBURSEMENT BY APPROXIMATELY 18 MILLION DURING THE FISCAL YEAR ENDED JUNE 30, 2015. C.OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GLH PROVIDES SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2015, WAS 1.7 MILLION. D.OTHER UNINSURED FOR UNINSURED CITIZENS THAT DO NOT QUALIFY FOR CHARITY CARE OR GOVERNMENT OR PRIVATE PROGRAMS GLH OFFERS PAYMENT DISCOUNTS AND TIME PAYMENTS WITHOUT INTEREST OR FEES. IV. VOLUNTEER SERVICES THE VOLUNTEERS OF GEISINGER-LEWISTOWN HOSPITAL ARE AN ACTIVE AND VITAL PART OF THE ACTIVITIES OF THE HOSPITAL. THE HOURS OF VOLUNTEER SERVICES ARE AN IMPORTANT CONTRIBUTION TO THE MISSION OF GLH. THE VOLUNTEERS FROM LOCAL COMMUNITIES CONTRIBUTED 11,340 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTHCARE OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION 269,552 IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND "WELLNESS" PROGRAMS. V. COMMUNITY HEALTH, EDUCATION, AND OUTREACH GLH STRIVES TO BE A VALUABLE RESOURCE FOR THE COMMUNITY AND ITS RESIDENTS. GLH PROVIDES MANY REDUCED-PRICE SERVICES AND FREE PROGRAMS THROUGHOUT THE YEAR THAT SERVE COMMUNITY HEALTH NEEDS. AT A COST OF 41 THOUSAND, THESE SERVICES AND PROGRAMS INCLUDED: SUPPORT GROUPS, COMMUNITY HEALTH EDUCATION, AND OTHER UNIQUE SERVICES. A.GROUPS GLH PROVIDES PROGRAMS FOR ALL DEMOGRAPHICS. CANCER CARE & SHARE SUPPORT GROUP: G-LH FACILITATES A LOCAL CANCER SUPPORT NETWORK THAT WELCOMES ALL CANCER SURVIVORS, FAMILY, AND FRIENDS. THE GROUP MEETS EACH MONTH. BARIATRIC SURGERY SUPPORT GROUP: GEISINGER-FHA CENTER FOR WEIGHT MANAGEMENT AND NUTRITION HOSTS A BARIATRIC SURGERY SUPPORT GROUP EVERY MONTH. SESSIONS ARE MODERATED BY VIRGINIA M. WRAY, DO, CNSP. LIVING WELL CANCER SURVIVORSHIP PROGRAM: CLASSES ARE OFFERED BY LEWISTOWN HOSPITAL TWO TIMES A YEAR. CLASSES ARE FREE AND HELD ONCE A WEEK FOR FOUR WEEKS AT THE COMMUNITY CANCER TREATMENT CENTER. THE PROGRAM ALLOWS CANCER SURVIVORS TO ASK QUESTIONS AND ADDRESS AREAS OF CONCERN. IT ALSO TEACHES PARTICIPANTS HOW TO LIVE A HEALTHY LIFESTYLE AND MAKE NECESSARY LIFESTYLE MODIFICATIONS. THE PROGRAM FOCUSES ON HEALTH AND WELLNESS; TREATMENT AND MANAGEMENT; RESOURCES AND FOLLOW UP CARE; AND INCLUDES A TREATMENT PLAN AND SUMMARY AS WELL AS SUPPORT GROUP INFORMATION. GEISINGER-FAMILY HEALTH ASSOCIATES TIME OF CHANGE WORKSHOPS: GEISINGER- FAMILY HEALTH ASSOCIATES (FHA) OFFERS A WORKSHOP DESIGNED ESPECIALLY FOR MOTHERS AND THEIR ADOLESCENT DAUGHTERS, AGES 9 - 12 YEARS. THE FOCUS OF THE WORKSHOP IS TO ASSIST MOTHERS IN EDUCATING THEIR DAUGHTERS ON CHANGES THAT OCCUR DURING ADOLESCENCE. INFORMATIONAL BOOKLETS FOR MOTHERS AND DAUGHTERS ARE GIVEN TO REINFORCE INFORMATION PRESENTED. PREGNANCY SUPPORT: G-LH OFFERS PREPARED CHILDBIRTH AND BREASTFEEDING CLASSES TO PROMOTE POSITIVE OUTCOMES FOR EXPECTANT MOTHERS AND INFANTS THROUGH REALISTIC INSTRUCTION AND ACHIEVABLE GOALS. CLASSES FOCUS ON PREPARING FOR LABOR, DELIVERY AND POSTPARTUM. B.COMMUNITY HEALTH EDUCATION COMMUNITY HEALTH NEEDS ASSESSMENT DIABETES MANAGEMENT WOMEN'S HEALTH RELATED TOPICS SMOKING CESSATION NUTRITION CLASSES LIVING WILLS PREPARING FOR YOUR DOCTOR'S VISIT MEDICATION SAFETY HEART DISEASE/HEART FAILURE PREVENTION CANCER PREVENTION (SKIN, COLON, BREAST, PROSTATE) VI. COMMUNITY SERVICE SUMMARY AT COST CHARITY CARE 1,330,220 MEDICARE/MEDICAID/OTHER GOVERNMENTAL 17,571,450 UNCOMPENSATED CARE 1,705,153 HEALTH PROFESSIONS EDUCATION 257,493 COMMUNITY HEALTH, EDUCATION, AND OUTREACH 40,945 VOLUNTEER SERVICES (VALUED AT 1/1/2014 269,552 PA STATEWIDE AVERAGE WEEKLY WAGE) TOTAL 21,174,813 VII. STATISTICS GEISINGER-LEWISTOWN HOSPTIAL FISCAL YEAR ENDED JUNE 30, 2015 ADMISSIONS (INCLUDING NEWBORNS) 5,514 ADMISSIONS (EXCLUDING NEWBORNS) 4,944 OUTPATIENT VISITS INCLUDING EMERGENCY DEPARTMENT 148,640 AVERAGE LENGTH OF STAY (EXCLUDING NEWBORNS AND PSYCH) 3.8 PERCENT OF OCCUPANCY (EXCLUDING NEWBORNS) 42.5% PATIENT SERVICE DAYS (EXCLUDING NEWBORNS) 19,067 TOTAL OR CASES 5,554 BEDS (EXCLUDING BASSINETS) (SET UP AND STAFFED) 123 BASSINETS IN NURSERY 12 FORM 990, PART VI FORM 990, PART I, SECTION A, LINE 4: FORM 990, PART VI, SECTION A, LINE 1B: ENTER THE NUMBER OF VOTING MEMBERS THAT ARE INDEPENDENT. BASED ON THE FORM 990 DEFINITION OF "INDEPENDENCE" AS IT RELATES TO VOTING MEMBERS OF THE GOVERNING BODY, ONE VOTING MEMBER IS NOT INDEPENDENT BECAUSE HE IS COMPENSATED AS AN EMPLOYEE OF A RELATED TAX-EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 2: DID ANY OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE HAVE A FAMILY RELATION- SHIP OR BUSINESS RELATIONSHIP WITH ANY OTHER OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE? WILLIAM H. ALEXANDER, ALBERT BOTHE, JR., M.D., E. ALLEN DEAVER, ROBERT J. DIETZ, DAVID T. FEINBERG, M.D., MBA, DAVID J. FELICIO, ESQUIRE, RICHARD A. GRAFMYRE, WILLIAM R. GRUVER, KAY HAMILTON, FRANK M. HENRY, THOMAS H. LEE, JR., M.D., ROBERT E. POOLE, DON A. ROSINI, GLENN D. STEELE, JR., M.D., PH.D., ROBERT L. TAMBUR, FRANK J. TREMBULAK, AND EDWARD J. ZYCH, ESQUIRE, ALL HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER BECAUSE THEY SERVE AS OFFICERS AND/OR DIRECTORS ON ONE OR MORE FOR-PROFIT AFFILIATES OF GEISINGER-LEWISTOWN HOSPITAL. ALL OF THE AFFILIATES ARE PART OF THE GEISINGER HEALTH SYSTEM. FORM 990, PAGE 6, PART VI, LINE 6 THE MEMBERS OF THE CORPORATION HAVE THE POWER AND AUTHORITY TO ELECT AND REMOVE THE DIRECTORS; ELECT AND REMOVE THE PRESIDENT AND FILL ANY VACANCY IN THE OFFICE OF THE PRESIDENT OF THE CORPORATION; AND, MAY APPROVE AMENDMENTS TO THE CORPORATE BYLAWS IN LIEU OF SUCH APPROVAL BY THE BOARD OF DIRECTORS. THE MEMBERS ALSO HAVE THE RESERVE POWERS AS SET FORTH IN THE PENNSYLVANIA NONPROFIT CORPORATION LAW. FORM 990, PAGE 6, PART VI, LINE 7A THE BOARD OF DIRECTORS OF THE CORPORATION SHALL SERVE AS THE GOVERNING BODY OF THE CORPORATION. THE PRESIDENT OF THE CORPORATION SHALL BE A DIRECTOR BY REASON OF HOLDING SUCH OFFICE. THE REMAINING DIRECTORS SHALL BE ELECTED BY THE MEMBERS AT THE ANNUAL MEETING OF THE MEMBERS. THE MEMBERS OF THE CORPORATION MAY SERVE AS DIRECTORS AND DIRECTORS MAY SUCCEED THEMSELVES FROM TERM TO TERM. VACANCIES ON THE BOARD OF DIRECTORS SHALL BE FILLED BY THE MEMBERS AT THEIR DISCRETION AT THE ANNUAL MEETING OF THE MEMBERS OR AT A SPECIAL MEETING CALLED FOR SUCH PURPOSE. FORM 990, PAGE 6, PART VI, LINE 11B ALL OFFICERS AND DIRECTORS WERE ELECTRONICALLY PROVIDED A FINAL COPY OF THE FORM 990 PRIOR TO FILING THE RETURN WITH THE IRS. AN EXECUTIVE SUMMARY OF THE INFORMATION REPORTED ON THE RETURN IS PROVIDED TO ASSIST IN THE REVIEW. IN ACCORDANCE WITH THE GEISINGER HEALTH SYSTEM FOUNDATION BOARD OF DIRECTOR'S FINANCE COMMITTEE CHARTER, STAFF PERIODICALLY REVIEWS THE GHS ORGANIZATIONS' FORM 990 FILINGS. THE FORM 990 IS PREPARED BY THE GEISINGER HEALTH SYSTEM (GHS) TAX AND FINANCIAL REPORTING DEPARTMENTS WITH INFORMATION PROVIDED FROM FINANCE, TAX, HUMAN RESOURCES, LEGAL SERVICES AND OTHER RELEVANT DEPARTMENTS WITHIN THE GEISINGER HEALTH SYSTEM. THE CHIEF FINANCIAL OFFICER (CFO) OF GHS AND THE INDIVIDUAL ORGANIZATIONS SENIOR FINANCIAL MANAGERS REVIEW THEIR RESPECTIVE FORM 990 PRIOR TO MAKING THE FINAL RETURN AVAILABLE TO THE BOARD. IN ADDITION, THE CHIEF LEGAL OFFICER AND CHIEF HUMAN RESOURCE OFFICER OF GHS REVIEW THE INFORMATION DISCLOSED ON THE FORM 990 RELEVANT TO THEIR RESPECTIVE AREAS OF RESPONSIBILITY. FOR PURPOSES OF THEIR ANNUAL AUDIT OF THE GHS CONSOLIDATED FINANCIAL STATEMENTS, INDEPENDENT AUDITORS REVIEW ALL FEDERAL TAX RETURNS FILED BY THE GHS ORGANIZATIONS TO IDENTIFY MATERIAL ITEMS, INCLUDING IF THERE ARE ANY UNCERTAIN TAX POSITIONS THAT MAY BE REQUIRED TO BE RECOGNIZED. THE COMPANY HAD NO UNCERTAIN TAX POSITIONS REQUIRED TO BE REPORTED FOR FISCAL YEAR-ENDED JUNE 30, 2015. FORM 990, PAGE 6, PART VI, LINE 12C THE OFFICERS AND DIRECTORS OF THE ORGANIZATION ARE SUBJECT TO THE GHS CONFLICT OF INTEREST POLICY FOR DIRECTORS, OFFICERS AND SENIOR LEADERS (MAY INCLUDE INDEPENDENT CONTRACTORS). AT LEAST ONCE EACH YEAR DIRECTORS, OFFICERS, KEY EMPLOYEES, SENIOR LEADERS (INCLUDING INDEPENDENT CONTRACTORS) AND OTHERS DESIGNATED BY THE BOARD OF DIRECTORS ARE REQUIRED TO DISCLOSE IN WRITING THE EXISTENCE OF ANY POTENTIAL FINANCIAL INTERESTS THAT MAY GIVE RISE TO A CONFLICT OF INTEREST WITH ANY AFFILIATE WITHIN THE GEISINGER HEALTH SYSTEM. THE DISCLOSURES ARE REVEIWED BY THE OFFICE OF THE CHIEF LEGAL OFFICER AND REPORTED TO THE AUDIT COMMITTEE AND BOARD OF DIRECTORS. AFTER REVIEW OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, INPUT FROM DEPARTMENT OF LEGAL SERVICES AND ANY DISCUSSION WITH THE PERSON DESIRED BY THE BOARD OR COMMITTEE, THE BOARD DECIDES IF A CONFLICT EXISTS AND TAKES APPROPRIATE ACTION. THE INDIVIDUAL DISCLOSING THE FINANCIAL INTEREST IS ABSENT DURING THE BOARD DELIBERATIONS AND DECISIONS ON THE MATTER. FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS TO REVIEW AND APPROVE THE COMPENSATION OF GHS EMPLOYED BOARD DIRECTORS, OFFICERS AND EXECUTIVE MANAGEMENT IS DESIGNED TO SATISFY THE REBUTTABLE PRESUMPTION PROCEDURE AVAILABLE FOR INTERMEDIATE SANCTION PURPOSES. THE PROCESS REQUIRES A REVIEW OF COMPENSATION DETERMINATIONS BY DISINTERESTED PARTIES, USE OF APPROPRIATE COMPARABILITY DATA AND CONTEMPORANEOUS DOCUMENTATION OF THE PROCESS. ON AN ANNUAL BASIS AN INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANT COMPLETES A COMPARATIVE ASSESSMENT OF COMPENSATION FOR THE CEO AND SENIOR MANAGEMENT WITHIN GHS. THE CONSULTANT'S REPORT IS PRESENTED TO THE MANAGEMENT AND COMPENSATION COMMITTEE PRIOR TO ANY COMPENSATION ADJUSTMENT. THE REPORT SUPPORTS THE RIGOROUS REVIEW COMPLETED BY THE MANAGEMENT AND COMPENSATION COMMITTEE TO ENSURE THAT THE PROGRAM IS RESPONSIBLE TO THE GEISINGER CHARITABLE MISSION, REFLECTS REASONABLE COMPENSATION WITHIN THE NONPROFIT MARKET AND IS COMPLIANT WITH THE IRS'S INTERMEDIATE SANCTION REQUIREMENTS. THE SURVEY DATA IN THE COMPARATIVE ANALYSIS IS CAPTURED FOR FUNCTIONALLY COMPARABLE POSITIONS IN MULTIPLE SIMILAR NONPROFIT ORGANIZATIONS AND REFLECTS TOTAL REMUNERATION PROVIDED IN THE MARKET. ALL SURVEYS ARE CONDUCTED BY THIRD PARTY ORGANIZATIONS AND NOT CONDUCTED AT THE SPECIFIC DIRECTION OF GEISINGER. ANY COMPENSATION ADJUSTMENTS ARE APPROVED BY MANAGEMENT AND COMPENSATION COMMITTEE PRIOR TO THE EFFECTIVE DATE OF THE PAYMENT. THE MANAGEMENT AND COMPENSATION COMMITTEE AT ITS SOLE DISCRETION MAY POSITIVELY OR NEGATIVELY ADJUST ANY RECOMMENDED COMPENSATION. FORM 990, PAGE 6, PART VI, LINE 15B SEE SCHEDULE O RESPONSE TO FORM 990, PART VI SECTION B, QUESTION 15A. FORM 990, PAGE 6, PART VI, LINE 19 THE MISSION STATEMENT IS AVAILABLE ON THE GEISINGER HEALTH SYSTEM WEBSITE AT WWW.GEISINGER.ORG. THE ANNUAL REPORT FOR GEISINGER HEALTH SYSTEM, CONTAINING COMMUNITY BENEFIT INFORMATION, CONSOLIDATED FINANCIAL INFORMATION AND OTHER INFORMATION, ARE AVAILABLE ON THE GEISINGER HEALTH SYSTEM WEBSITE. GO TO: WWW.GEISINGER.ORG/PAGES/ABOUT-GEISINGER AND SELECT ANNUAL REPORTS. FINANCIAL STATEMENTS, THE COMPLETE FORM 990 AND FORM 990-T, THE CONFLICTS OF INTEREST POLICY, AND OTHER GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VIII FORM 990, PART VIII, LINE 2C: THE IC SUPPORT SERVICE REVENUE REPRESENTS REVENUE FROM INTERCOMPANY MANAGEMENT, ADMINISTRATIVE, AND CONSULTING SERVICES PROVIDED TO RELATED TAXABLE ORGANIZATIONS. THE ORGANIZATION AND RELATED TAXABLE ORGANIZATIONS ARE ALL CONTROLLED BY GEISINGER HEALTH SYSTEM FOUNDATION. THE SERVICES, PROVIDED AT OR BELOW COST, ARE PERFORMED WITHOUT A PROFIT MOTIVE TO PROMOTE THE EFFICIENT OPERATION OF THE GEISINGER HEALTH SYSTEM IN CARRYING OUT ITS CHARITABLE MISSION. THE SERVICES ARE NOT OFFERED TO UNRELATED ORGANIZATIONS OR TO THE GENERAL PUBLIC. UNDER IRS ADVISORY DATED MARCH 7, 2014, THESE INTERCOMPANY SHARED SERVICES ARE NOT INCLUDED IN THE DEFINITION OF UNRELATED BUSINESS INCOME AND SHOULD NOT TO BE INCLUDED ON FORM 990-T DUE TO THE ABSENCE OF THE FOLLOWING TWO CONDITIONS: (1) THE SERVICES MUST BE ABOVE COST OR AT FAIR MARKET VALUE, AND (2) THERE MUST BE A PROFIT MOTIVE. FORM 990, PART XI, LINE 9 PENSION ADJUSTMENT -4,772,766 TRANSFER TO AFFILIATE, GHS FOUNDATION -4,062,935 OTHER CHANGES IN TEMPORARILY RESTRICTED -18,511 TRANSFER FROM AFFILIATE, HEALTH ENTERPRISES, INC. 43,749 TOTAL OTHER CHANGES IN NET ASSETS -8,810,463 FORM 990, PART XII FORM 990, PART XII, LINE 3A: AS A RESULT OF A FEDERAL AWARD, WAS THE ORGANIZATION REQUIRED TO UNDERGO AN AUDIT OR AUDITS AS SET FORTH IN THE AUDIT ACT OR OMB CIRCULAR A-133? FEDERAL AWARDS ARE AUDITED AS A PART OF THE GEISINGER HEALTH SYSTEM'S CONSOLIDATED REPORT ON FEDERAL AWARDS IN ACCORDANCE WITH OMB CIRCULAR A-133. FOOTNOTE: THROUGHOUT FORM 990, THE TERMS "GEISINGER HEALTH SYSTEM- AND "SYSTEM- OR THE ACRONYM "GHS" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH SYSTEM FOUNDATION ("THE FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM. GEISINGER HEALTH SYSTEM FOUNDATION 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231995911 PHILANTHRO PA 501C3 7 NA true GEISINGER MEDICAL CENTER 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 240795959 HOSPITAL PA 501C3 3 GHSF true GEISINGER CLINIC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 236291113 PHYSICIAN PA 501C3 11A GHSF true GEISINGER WYOMING VALLEY MEDICAL CT 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231996150 HOSPITAL PA 501C3 3 GHSF true MARWORTH 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232171417 D&A REHAB PA 501C3 3 GHSF true GEISINGER HEALTH PLAN 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232311553 HEALTH INS PA 501C4 GHSF true GEISINGER SYSTEM SERVICES 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232164794 SUPPORT SV PA 501C3 11A GHSF true GEISINGER COMMUNITY HEALTH SERVICES 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232967235 HEALTHCARE PA 501C3 9 GSS true GEISINGER INSURANCE CORPORATIONRRG 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 141909894 SELF INS VT 501C3 11A GHSF true COMMUNITY MEDICAL CENTER 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 240862246 HOSPITAL PA 501C3 3 GHSF true COMMUNITY MEDICAL CARE INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232429776 PHYSICIAN PA 501C3 9 GHSF true MOUNTAIN VIEW NURSING HOME INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232568288 LONG TERM PA 501C3 9 GHSF true COMMUNITY MEDICAL CTR HEALTHCARE SY 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232279376 SUPPORT SV PA 501C3 11A GHSF true GEISINGER-BLOOMSBURG HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232193572 HOSPITAL PA 501C3 3 GHSF true GEISINGER-BLOOMSBURG HEALTHCARE CTR 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232242854 SKILLED NU PA 501C3 9 GHSF true LEWISTOWN HEALTH CARE FOUNDATION 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232344363 PHILANTHRO PA 501C3 11A GHSF true LEWISTOWN AMBULATORY CARE CORP 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232344362 RE HOLDIN PA 501C3 11A GHSF true FAM HEALTH ASSOC OF GEISINGER-LEWIS 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 251651582 PHYSICIAN PA 501C3 11A GHSF true KEYSTONE HEALTH INFO EXCHANGE INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 464359893 RHIO PA 501C3 11A GHSF true HEALTH CARE CORP OF NORTHEAST PA 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232337286 SUPPORT SV PA 501C3 11A CMC true SUN HOME HEALTH SERVICES INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231736912 HEALTHCARE PA 501C3 9 GCHS true HOLY SPIRIT HEALTH SYSTEM 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 251865142 PHILANTHRO PA 501C3 11A GHSF true HOLY SPIRIT HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231512747 HOSPITAL PA 501C3 3 HSHS true HOLY SPIRIT CORPORATION 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232214540 REALESTATE PA 501C2 HSHS true SPIRIT PHYSICIAN SERVICES INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 251766971 PHYSICIAN PA 501C3 9 HSHS true WEST SHORE ADVANCED LIFE SUPPORT 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232463002 HEALTHCARE PA 501C3 7 HSHS true KEYSTONE ACCOUNTABLE CARE ORG LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 454475297 ACO PA N/A false false LIFESOURCE GEISINGER BLOOD CTR LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 364718005 BLOOD COLL PA N/A false false MERIDIAN GEISINGER HLTH NETWORKLLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 455484165 ORG DEL SY NJ N/A false false HEALTHSOUTH GHS LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 721398803 PHY THERAP PA N/A false false EVANGELICAL-GEISINGER HEALTH LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 460567687 HEALTHCARE PA N/A false false LEMED II 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232391766 RENTAL PA N/A false false GEISINGER-SCA HOLDINGS LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 461615328 MANAGEMENT DE N/A false false CAMP HILL AMBULATORY SURG CTR LLC 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM AL 35209 521597478 HEALTHCARE PA N/A false false HS ORTHOPEDIC MANAGEMENT CO LLC 503 NORTH 21ST STREET CANP HILL PA 17011 460887384 MANAGEMENT PA N/A false false CAELIAN MEDICAL LLC 880 CENTURY DRIVE MECHANICSBURG PA 17055 208018724 HEALTHCARE PA N/A false false GRANDVIEW SURGERY CENTER LTD 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM AL 35209 521597483 HEALTHCARE PA N/A false false LACKAWANNA PHYS AMB SURG CTRLLC 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM AL 35209 233024998 HEALTHCARE PA N/A false false GEISINGER MEDICAL MANAGEMENT CORP 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232077663 HOTEL/REST PA N/A true GEISINGER INDEMNITY INSURANCE CO 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232815174 HLTH INSUR PA N/A true GEISINGER QUALITY OPTIONS INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 204275139 HLTH INSUR PA N/A true HEALTH ENTERPRISES INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232353212 PHARMACY PA N/A true XG HEALTH SOLUTIONS INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 461657345 CONSULTING DE N/A true GEISINGER ASSURANCE COMPANY LTD 23 LINE TREE BAY AVE PO BOX 1159 GRAND CAYMAN GRAND CAYMAN CJ KY1-1102 981016737 INSURANCE CJ N/A true HOLY SPIRIT VENTURES INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232407709 MED. SERV. PA N/A true false true false false false false false false false true true true true false false true false false true FAM HEALTH ASSOC OF GEISINGER-LEWIS L 197123 GAAP FAM HEALTH ASSOC OF GEISINGER-LEWIS M 2000 GAAP GEISINGER ASSURANCE COMPANY LTD M 281176 GAAP GEISINGER CLINIC J 2025 GAAP GEISINGER CLINIC L 52322 GAAP GEISINGER CLINIC M 1521172 GAAP GEISINGER HEALTH PLAN L 24104737 GAAP GEISINGER HEALTH SYSTEM FOUNDATION L 118281 GAAP GEISINGER HEALTH SYSTEM FOUNDATION B 4000000 GAAP GEISINGER HEALTH SYSTEM FOUNDATION M 23856 GAAP GEISINGER INDEMNITY INSURANCE CO M 250519 GAAP GEISINGER HEALTH SYSTEM FOUNDATION S 52996 GAAP GEISINGER MEDICAL CENTER L 84 GAAP GEISINGER MEDICAL CENTER M 648434 GAAP GEISINGER MEDICAL MGMT CORP M 1636919 GAAP GEISINGER MEDICAL MGMT CORP L 2417 GAAP SUN HOME HEALTH SERVICES INC L 80 GAAP GEISINGER SYSTEM SERVICES M 4635046 GAAP GEISINGER SYSTEM SERVICES L 100 GAAP HEALTH ENTERPRISES INC L 19223 GAAP HEALTH ENTERPRISES INC M 1054092 GAAP HEALTH ENTERPRISES INC C 43749 GAAP KEYSTONE HEALTH INFO EXCHANGE INC M 4320 GAAP LEWISTOWN AMBULATORY CARE CORP L 30857 GAAP LEWISTOWN AMBULATORY CARE CORP K 523665 FMV LEWISTOWN HEALTH CARE FOUNDATION L 15744 GAAP GEISINGER INSURANCE CORPORATIONRRG P 89596 GAAP GEISINGER WYOMING VALLEY MEDICAL CT M 44628 GAAP HOLY SPIRIT HEALTH SYSTEM M 27262 GAAP HEALTHSOUTH GHS LLC M 328322 GAAP SCHEDULE R FORM 990, SCHEDULE R, PART V - TRANSACTIONS WITH RELATED ORGANIZATIONS: AS SHOWN IN THE RESPONSE TO FORM 990, SCHEDULE R, GEISINGER-LEWISTOWN HOSPITAL IS CLOSELY AFFILIATED WITH SEVERAL OTHER ORGANIZATIONS. IN THE NORMAL COURSE OF THE OPERATIONS OF THESE AFFILIATED ORGANIZATIONS THERE ARE NUMEROUS INTERORGANIZATIONAL TRANSACTIONS, WHICH MAY INCLUDE SALES, EXCHANGES AND LEASES OF PROPERTY, EXTENSIONS OF CREDIT, FURNISHING OF GOODS, SERVICES AND FACILITIES, AND TRANSFERS OF ASSETS. THESE INTERORGANIZATION TRANSACTIONS PROMOTE THE EFFICIENT OPERATION OF THE VARIOUS ORGANIZATIONS AND THE ATTAINMENT OF THEIR TAX EXEMPT PURPOSES. THESE TYPES OF INTER ORGANIZATION TRANSACTIONS WERE DESCRIBED TO THE INTERNAL REVENUE SERVICE IN A RULING APPLICATION AND WERE RECOGNIZED BY THE NATIONAL OFFICE OF THE IRS IN A SERIES OF GHS PRIVATE RULINGS AS BEING ENTIRELY CONSISTENT WITH THE ORGANIZATIONS' TAX EXEMPT STATUS.