2016-05-16T07:53:38-05:00 2015-06-30 390859910 BAKER TILLY VIRCHOW KRAUSE LLP 1650 MARKET STREET SUITE 4500 PHILADELPHIA PA 19103 990 2014-07-01 251766971 SPIRIT PHYSICIAN SERVICES INC SPIR 5702716624 100 NORTH ACADEMY AVE MC49-70 DANVILLE PA 17822 DAVID J FELICIO ESQUIRE SECRETARY 5702716624 2016-05-11 1 JULIUS C GREEN CPA JD P00350393 2159720701 2014 2016-08-17 19:52:53Z X DAVID A GATESMAN 100 NORTH ACADEMY AVE MC49-70 DANVILLE PA 17822 81016288 0 X N/A X 1995 PA PROVIDE CHARITY CARE & ACCESS TO AFFORDABLE PRIMARY & SPECIALTY OUTPATIENT MEDICAL SERVICES. 14 10 529 10 0 0 15001572 34841081 42334448 44223920 477 46271 2280227 1905016 59616724 81016288 10000 18333 0 0 46223180 51633170 0 0 0 13532810 15789273 59765990 67440776 -149266 13575512 13136201 23003704 11052539 13637663 2083662 9366041 X SPIRIT PHYSICIAN SERVICES, INC. HEALTHCARE MISSION IS TO PROVIDE CHARITY CARE AND EXPAND ACCESS TO AFFORDABLE PRIMARY AND SPECIALTY OUTPATIENT MEDICAL SERVICES. THE CLINICS OFFER PREVENTATIVE, DIAGNOSTIC, AND THERAPEUTIC MEDICAL SERVICES ON AN OUTPATIENT BASIS. 0 0 58301734 18333 44995556 ALL INDIVIDUAL CLINICS (FAMILY HEALTH CENTERS) OFFER PREVENTATIVE, DIAGNOSTIC, AND THERAPEUTIC MEDICAL SERVICES ON AN OUTPATIENT BASIS. NON-EMERGENCY CARE IS PROVIDED TO ALL INDIVIDUALS ABLE TO PAY FOR SUCH CARE EITHER THEMSELVES, THROUGH PRIVATE HEALTH INSURANCE, OR THROUGH PUBLIC PROGRAMS SUCH AS MEDICARE AND MEDICAL ASSISTANCE. URGENT CARE IS PROVIDED, AS APPROPRIATE, TO ALL INDIVIDUALS REGARDLESS OF ABILITY TO PAY.CONSISTENT WITH HOLY SPIRIT HOSPITAL'S POLICIES CONCERNING INDIGENT CARE, IN ADDITION TO ALL INDIGENT EMERGENCY ROOM PATIENTS BEING ADMITTED TO THE HOSPITAL FOR INPATIENT CARE, SPIRIT PHYSICIAN SERVICES, INC., AS PART OF THE HOSPITAL'S HEALTH CARE SYSTEM, PROVIDES ALL NECESSARY FOLLOW-UP CARE (INCLUDING DIAGNOSTIC SERVICES) TO INDIGENT PATIENTS FREE OR AT DISCOUNTED RATES, BASED ON EACH PATIENT'S ABILITY TO PAY.THE CLINICS PROVIDE AN OUTREACH TO COMMUNITY RESIDENTS WITH MEDICAL CONDITIONS WHICH, IF NOT PROPERLY TREATED IN AN OUTPATIENT SETTING, MIGHT ULTIMATELY REQUIRE MORE EXPENSIVE AND CRITICAL INPATIENT CARE. THUS, THE CLINICS REDUCE HOSPITAL ADMISSIONS, DAYS OF STAY AND SURGICAL RATES.THE CENTER FOR WOMEN'S HEALTH OFFERS FREE INTRODUCTORY SESSIONS TO THE CREIGHTON MODEL FERTILITY CARE SYSTEM AND NAPRO TECHNOLOGY. THIS IS A FULLY INTEGRATED APPROACH TO WOMEN'S HEALTH THAT IS COMPLETELY PRO-LIFE IN ITS OUTLOOK AND THE TECHNIQUES IT EMPLOYS. IT IS PARTICULARLY USEFUL FOR EVALUATING AND TREATING INFERTILITY, RECURRENT PREGNANCY LOSS, ENDOMETRIOSIS, IRREGULAR PERIODS, PMS, OVARION CYSTS, AND POLYCYSTIC OVARY SYNDROME, AS WELL AS FOR FAMILY PLANNING.SPSI MEDICAL OUTREACH SERVICES IS A MEDICAL CLINIC THAT PROVIDES BASIC MEDICAL SERVICES TO THE SEVERELY SOCIAL ECONOMIC DISADVANTAGED IN THE HARRISBURG AREA.CVSI IS A GROUP OF CARDIOVASCULAR HEART SURGEONS. THIS GROUP ALSO USES ROBOTICS DURING SPECIFIC SURGERIES.SPSI HEALTHSHARE IS A MEDICAL SERVICE REFERRAL PROGRAM THAT PROVIDES REFERRAL AND DISCOUNTED MEDICAL SERVICES FOR THOSE WHO DO NOT QUALIFY FOR THE TRADITIONAL PUBLIC ASSISTANCE PROGRAMS.KUNKEL SURGERY IS A GROUP OF GENERAL SURGEONS. THIS GROUP PERFORMS A LARGE ASSORTMENT OF GENERAL SURGERY PROCEDURES.UNCOMPENSATED CARESPIRIT PHYSICIAN SERVICES, INC. (SPSI) RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. SPSI PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD, SPSI PROVIDES FREE CARE OR SUBSIDIZED CARE, TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST, AND PROVIDES VARIOUS HEALTH ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITIES WHERE SPSI PRACTICES.A. CHARITY CARETHE PRIMARY CONCERN OF SPSI IS THE DELIVERY OF HEALTH CARE TO ALL THE CITIZENS IN ALL THE CITIZENS OF THE GREATER HARRISBURG AREA AND SOUTH CENTRAL PENNSYLVANIA, REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST SPSI INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. FOR FISCAL YEAR ENDED JUNE 30, 2015, THE COST OF CHARITY CARE WAS $176,992.B. MEDICARE/MEDICAIDRECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO THE ELDERLY (MEDICARE) AND THE POOR (MEDICAID). SPSI PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS. TO THE EXTENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTHCARE, SPSI IS FURTHERING ITS MISSION TO THE ENTIRE COMMUNITY. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT OF REIMBURSEMENT RECEIVED UNDER THE PROGRAM. FOR FISCAL YEAR ENDED JUNE 30, 2015, THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS $16,108,283. C. OTHER UNCOMPENSATED PATIENT SERVICESIN ADDITION, SPSI PROVIDES OTHER PATIENT 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 $1,368,479.COMMUNITY HEALTH, EDUCATION AND OUTREACH SPIRIT PHYSICIAN SERVICES, INC. STRIVES TO SERVE AS PARTNERS TO THE COMMUNITIES IN WHICH THEY ARE LOCATED. SPSI PROVIDES CARE TO THE COMMUNITY THROUGH REDUCED PRICE SERVICES AND FREE PROGRAMS THROUGHOUT THE YEAR BASED UPON ACTIVITIES AND SERVICES THAT SPSI BELIEVES WILL SERVE A BONAFIDE COMMUNITY HEALTH NEED. THESE SERVICES AND PROGRAMS MAY INCLUDE SUPPORT GROUPS, HEALTH EDUCATION, WELLNESS FAIRS, HEALTH SCREENINGS, OR OTHER HEALTH RELATED PROGRAMS. THE COST OF THESE SERVICES TOTALED $20,611 IN FISCAL YEAR ENDED JUNE 30, 2015. COMMUNITY SERVICE SUMMARYCHARITY CARE $ 176,992 MEDICARE/MEDICAID 16,108,283 OTHER UNCOMPENSATED PATIENT SERVICES 1,368,479 COMMUNITY HEALTH, EDUCATION, OUTREACH 20,611 TOTAL $ 17,674,365 58301734 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 529 1 0 0 0 0 0 0 0 0 0 0 X 14 10 1 0 1 0 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 PA X RANDY B MORRIS CFO 7177632130 100 N ACADEMY AVE MC 86-22 DANVILLE PA 17822 D BRUCE HAGA PRESIDENT 40.00 X X 342885 0 36067 MARGUERITE MACDONALD CHAIRPERSON 0.30 X X 0 0 0 ROBERT KEITH VICE CHAIRPERSON 0.30 X X 0 0 0 WILLIAM KEEN TREASURER 0.30 0.50 X X 0 0 0 SISTER ROMAINE NIEMEYER SCC DIRECTOR (EX-OFFICIO) 1.00 39.00 X 0 0 0 JOSEPH A TORCHIA MD DIRECTOR (EX-OFFICIO) 0.00 40.00 X 0 594277 61286 ROBERT SCAER DIRECTOR 0.30 X 0 0 0 JOSEPH SCHATT DIRECTOR 0.30 X 0 0 0 RYAN BROWN DIRECTOR 0.30 X 0 0 0 MARY KAY DURHAM DIRECTOR 0.30 X 0 0 0 GREG GUNN DIRECTOR 0.30 X 0 0 0 NORA HABIG DIRECTOR 0.30 X 0 0 0 PAUL KUNKEL MD DIRECTOR 40.00 X 362397 0 41597 LORI WALLOWER DO DIRECTOR 40.00 X 168401 0 28468 DAVID A GATESMAN VP, DIRECTOR (EX OFFICIO) 0.00 40.00 X X 0 212244 35295 KEVIN F BRENNAN CPA FHFMA EVP, FINANCE 0.00 40.00 X 0 1028344 201791 MANUEL J EVANS TREASURER 0.00 40.00 X 0 626112 63461 DAVID J FELICIO ESQUIRE SECRETARY 0.00 40.00 X 0 662625 101181 EDWARD J ZYCH EQUIRE ASST SECRETARY 0.00 40.00 X 0 390565 42470 SHUBRA KUMAR BRADLEY MEDICAL DIRECTOR/HOSPITALIST 40.00 X 323119 0 23367 RAJESH M DAVE MD PHYSICIAN 40.00 X 1042904 0 21344 DAVID C MAN MD PHYSICIAN 40.00 X 780201 0 45035 ANDREAS U WALI MD PHYSICIAN 40.00 X 862507 0 39425 SAFWAT A GASSIS MD PHYSICIAN 40.00 X 722569 0 38898 VANKATESH K NADAR MD PHYSICIAN 40.00 X 767449 0 45911 GERALD OSMAN FORMER OFFICER 0.00 40.00 X 0 115000 0 RICHARD LAVANTURE FORMER OFFICER 0.00 40.00 X 0 493185 75978 5372432 4122352 901574 9 1 1 0 COMPHEALTH ASSOCIATES INC PO BOX 972651 DALLAS TX 75397 PHYSICIAN SERVICES 412672 QUALITY SYSTEMS INC PO BOX 809390 CHICAGO IL 60680 IT SERVICES 321707 COMMUNITY MEDICAL ASSOCIATE 3601 NORTH PROGRESS AVE HARRISBURG PA 17110 MEDICAL SERVICES 239041 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 PHYSICIAN SERVICES 185544 KENDALL & DAVIS PO BOX 915241 DALLAS TX 75391 PHYSICIAN RECRUITMENT 158000 5 34841081 34841081 NET PATIENT SERVICE REVENUE 621110 38515900 38515900 HOSPITALIST INCOME 621300 3116047 3116047 CRITICAL CARE SERVICES 621110 1249329 1249329 NEUROLOGY INCOME 621110 713247 713247 STEMMI-CALL REVENUE 621110 494832 494832 134565 134565 44223920 1038 1038 17604 0 17604 17604 17604 45233 0 45233 45233 45233 MEDICARE INCENTIVES 900099 665433 665433 DIRECTORSHIPS 900099 287686 287686 MA MEANINGFUL USE REVENUE 900099 262532 262532 671761 203814 467947 1887412 81016288 44977952 0 1197255 18333 18333 1326301 1326301 42765056 38203641 4561415 1474716 1402852 71864 3695869 3162449 533420 2371228 2115363 255865 46246 28188 18058 128251 128251 6412219 3266799 3145420 54901 54776 125 295569 196669 98900 3601526 3527981 73545 30199 17837 12362 415547 384749 30798 314654 297456 17198 121570 121570 MEDICAL SUPPLIES 1791078 1790796 282 BAD DEBT EXPENSE 1461988 1461988 REPAIRS AND MAINTENANCE 1022168 996014 26154 DUES AND SUBSCRIPTIONS 68003 26063 41940 25354 23479 1875 67440776 58301734 9139042 0 3029 3803 1883638 14520494 3241231 2516837 281734 32294 2608287 153438 1466828 2454849 1221676 194499 5038065 3280928 13136201 23003704 6815000 8444013 4237539 5193650 11052539 13637663 X 2083662 9366041 2083662 9366041 13136201 23003704 X 13575512 -6293133 X X 0 1 X 1 0 X 5571224 16222623 16209048 15001572 34841081 87845548 23636435 33279316 40797732 43856772 44977952 186548207 29207659 49501939 57006780 58858344 79819033 274393755 0 0 0 274393755 5 192 211 477 18642 19527 5 192 211 477 18642 19527 462799 651389 404781 757903 1133380 3410252 29670463 50153520 57411772 59616724 80971055 277823534 0.98770 0.98780 0.00010 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER - 2010 AMOUNT: $ 43,618. 2011 AMOUNT: $ 75,703. 2012 AMOUNT: $ 100,403. 2013 AMOUNT: $ 157,631. 2014 AMOUNT: $ 209,068. BILLING SERVICES - 2010 AMOUNT: $ 217,259. 2011 AMOUNT: $ 272,828. 2012 AMOUNT: $ 257,781. ADMINISTRATIVE SERVICES - 2010 AMOUNT: $ 90,400. 2011 AMOUNT: $ 189,643. 2012 AMOUNT: $ 46,597. 2013 AMOUNT: $ 286,821. 2014 AMOUNT: $ 665,433. OB EMERGENCY ROOM - 2010 AMOUNT: $ 111,522. 2011 AMOUNT: $ 113,215. RESEARCH PAYMENTS - 2013 AMOUNT: $ 313,451. 2014 AMOUNT: $ 258,879. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2848959 -22308 4730 2821921 2563164 285795 2848959 2470802 7245 178061 92727 217 2563164 2540943 9388 70652 8877 2470802 2226656 22983 306634 15330 2540943 0 1 1 212883 2661 210222 525525 41030 484495 814308 109747 704561 1055571 1055571 2454849 DEFERRED COMPENSATION PLAN ASSETS 2700375 DUE FROM AFFILIATE 580553 3280928 DEFERRED COMPENSATION 2700375 ESTIMATED MEDICAL MALPRACTICE CLAIMS 727862 DUE TO AFFILIATE 1083141 ESTIMATED THIRD PARTY LIABILITY 682272 5193650 PART V, LINE 4: INTEREST EARNED IS UNRESTRICTED AND TRANSFERRED TO THE OPERATING FUND. PART X, LINE 2: 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 PREVIOUS YEAR SINCE ADOPTION. ACCORDINGLY, NO FIN 48 FOOTNOTE DISCLOSURE WAS MADE IN THE FISCAL YEAR END GHS CONSOLIDATED FINANCIAL STATEMENTS. 1 EDUCATIONAL GRANT LOAN REPAYMENT 18333 CASH PART I, LINE 2: THE EDUCATIONAL LOAN REPAYMENT PROGRAM IS OFFERED TO QUALIFIED INDIVIDUALS HIRED INTO THE FOLLOWING POSITIONS: REGISTERED NURSE, PHYSICAL THERAPIST, OCCUPATIONAL THERAPIST, CRNA, PHYSICIAN ASSISTANT, NURSE PRACTIONER, OR CLINICAL NURSE SPECIALIST. TO BE ACCEPTED INTO THE PROGRAM, ONE MUST COMPLETE AN EDUCATIONAL LOAN REPAYMENT APPLICATION WHICH IS REVIEWED BY THE ASSOCIATE DIRECTOR OF TALENT ACQUISITION. THE BENEFITS TEAM PROCESSES THE PAYMENT OF GRANT FUNDS AND MONITORS THE EMPLOYEE'S CONTINUED ELIGIBILITY IN THE PROGRAM. 1 1 0 0 0 0 0 0 0 D BRUCE HAGA PRESIDENT 289260 0 50000 0 3625 0 15996 0 20071 0 378952 0 0 0 JOSEPH A TORCHIA MD DIRECTOR (EX-OFFICIO) 0 359903 0 140000 0 94374 0 48850 0 12436 0 655563 0 85642 PAUL KUNKEL MD DIRECTOR 318109 0 43540 0 748 0 18135 0 23462 0 403994 0 0 0 LORI WALLOWER DO DIRECTOR 168073 0 0 0 328 0 8216 0 20252 0 196869 0 0 0 DAVID A GATESMAN VP, DIRECTOR (EX OFFICIO) 0 178187 0 30000 0 4057 0 9328 0 25967 0 247539 0 0 KEVIN F BRENNAN CPA FHFMA EVP, FINANCE 0 531656 0 273329 0 223359 0 176933 0 24858 0 1230135 0 185023 MANUEL J EVANS TREASURER 0 365396 0 150000 0 110716 0 51649 0 11812 0 689573 0 91773 DAVID J FELICIO ESQUIRE SECRETARY 0 390448 0 164846 0 107331 0 76118 0 25063 0 763806 0 61110 EDWARD J ZYCH EQUIRE ASST SECRETARY 0 262471 0 80515 0 47579 0 18720 0 23750 0 433035 0 30485 SHUBRA KUMAR BRADLEY MEDICAL DIRECTOR/HOSPITALIST 292161 0 25000 0 5958 0 2950 0 20417 0 346486 0 0 0 RAJESH M DAVE MD PHYSICIAN 917434 0 106805 0 18665 0 12618 0 8726 0 1064248 0 0 0 DAVID C MAN MD PHYSICIAN 695725 0 42383 0 42093 0 20135 0 24900 0 825236 0 0 0 ANDREAS U WALI MD PHYSICIAN 769555 0 91950 0 1002 0 12884 0 26541 0 901932 0 0 0 SAFWAT A GASSIS MD PHYSICIAN 664183 0 31900 0 26486 0 12596 0 26302 0 761467 0 0 0 VANKATESH K NADAR MD PHYSICIAN 581716 0 161288 0 24445 0 19413 0 26498 0 813360 0 0 0 GERALD OSMAN FORMER OFFICER 0 0 0 0 0 115000 0 0 0 0 0 115000 0 0 RICHARD LAVANTURE FORMER OFFICER 0 313694 0 100000 0 79491 0 53357 0 22621 0 569163 0 68820 PART I, LINE 3 COMPENSATION IS DETERMINED UNDER THE GEISINGER HEALTH SYSTEM PROCESS DESIGNED TO SATISFY THE REBUTTABLE PRESUMPTION PROCEDURE. THE FOLLOWING ARE USED TO ESTABLISH COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACTS, COMPENSATION SURVEY OR STUDIES, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINES 4A-B GERALD OSMAN RECEIVED SEVERANCE OF $115,000. UPON INVOLUNTARY SEPARATION, EMPLOYEES MAY BE ELIGIBLE TO RECEIVE CONTINUATION OF SALARY FOR A TERM THAT IS BASED ON THEIR YEARS OF SERVICE AND POSITION. COMPENSATION FOR ELIGIBLE EMPLOYEES MAY BE DEFERRED TO A 457(F) NONQUALIFIED PLAN THAT VESTS WITH COMPLETION OF SERVICE, DEATH AND/OR PERMANENT DISABILITY. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN: MANUAL EVANS - $101,511 RICHARD LAVANTURE - $76,894 JOSEPH TORCHIA - $91,958 KEVIN BRENNAN - $185,023 DAVE FELICIO - $61,110 EDWARD ZYCH - 30,485 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. FORM 990, PART V, LINE 1C: ALL 1099'S FOR 2014 WERE PROCESSED THROUGH SPSI'S PARENT ORGANIZATION, HOLY SPIRIT HEALTH SYSTEM, AND FILED UNDER THEIR EIN 25-1865142. FORM 990, PART VI, SECTION A, LINE 1 EFFECTIVE, OCTOBER 1, 2014, HOLY SPIRIT HEALTH SYSTEM AND AFFILIATES (HOLY SPIRIT HEALTH SYSTEM, HOLY SPIRIT HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY, WEST SHORE ADVANCED LIFE SUPPORT SERVICES, INC., SPIRIT PHYSICIAN SERVICES, INC., HOLY SPIRIT CORPORATION, AND HOLY SPIRIT VENTURES, INC.) DELEGATED CERTAIN AUTHORITIES TO GEISINGER SYSTEM SERVICES' (GSS, A RELATED TAX-EXEMPT ORGANIZATION) MANAGEMENT AND COMPENSATION COMMITTEE TO REVIEW AND APPROVE MATTERS RELATING TO EMPLOYEE BENEFIT PLANS, EXECUTIVE LEADERSHIP, SENIOR LEADERSHIP AND STAFF PERFORMANCE AND COMPENSATION AND GEISINGER CLINIC'S (GC, A RELATED TAX-EXEMPT ORGANIZATION) MANAGEMENT AND COMPENSATION COMMITTEE TO REVIEW AND APPROVE MATTERS RELATING TO PHYSICIAN COMPENSATION. FORM 990, PART VI, SECTION A, LINE 2 MANUEL J. EVANS, DAVID J. FELICIO, ESQUIRE, SISTER ROMAINE NIEMEYER, SCC 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 SPIRIT PHYSICIAN SERVICES, INC. ALL OF THE AFFILIATES ARE PART OF THE GEISINGER HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 4 ON OCTOBER 1, 2014, HOLY SPIRIT HEALTH SYSTEMS CHANGED ITS RESPECTIVE ARTICLES OF INCORPORATION AND CORPORATE BYLAWS TO REFLECT ITS MERGER AND INTEGRATION WITH GEISINGER HEALTH SYSTEM IN WHICH GEISINGER HEALTH SYSTEM FOUNDATION BECAME THE SOLE CORPORATE MEMBER OF HOLY SPIRIT HEALTH SYSTEM. HOLY SPIRIT HOSPITAL OF THE SISTERS OF CHRISTIAN CHARIY, SPIRIT PHYSICIAN SERVICES, INC., WEST SHORE ADVANCED LIFE SUPPORT SERVICES, INC., HOLY SPIRIT CORPORATION AND HOLY SPIRIT VENTURES CHANGED THEIR RESPECTIVE BYLAWS TO REFLECT GEISINGER HEALTH SYSTEM FOUNDATION'S APPROVAL OF ANY AMENDMENTS TO THE CORPORATE BYLAWS. FORM 990, PART VI, SECTION A, LINE 6 HEALTH SYSTEM FOUNDATION SERVES AS THE SOLE CORPORATE MEMBER OF HOLY SPIRIT HEALTH SYSTEM AND HOLY SPIRIT HEALTH SYSTEM SERVES AS CORPORATE MEMBER FOR HOLY SPIRIT HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY, SPIRIT PHYSICIAN SERVICES, INC., WEST SHORE ADVANCED LIFE SUPPORT SERVICES, INC., HOLY SPIRIT CORPORATION AND SOLE SHAREHOLDER OF HOLY SPIRIT VENTURES, INC. FORM 990, PART VI, SECTION A, 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, PART VI, SECTION B, LINE 11 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, PART VI, SECTION B, 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, PART VI, SECTION B, LINE 15 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 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 DISINTERESTED PARTIES, USE OF APPROPRIATE COMPARABILITY DATA AND 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, PART VI, SECTION C, LINE 19 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. THE ORGANIZATIONS 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 XI, LINE 9: INTERCOMPANY ACTIVITY -6,293,133. FORM 990, PART XII, LINE 2C: EFFECTIVE OCTOBER 1, 2104, HOLY SPIRIT HEALTH SYSTEM WAS INTEGRATED INTO THE GEISINGER HEALTH SYSTEM, AS A RESULT OF THAT INTEGRATION, THE GEISINGER HEALTH SYSTEM FORM 990 REVIEW PROCESS, AS DESCRIBED IN THE SCHEDULE O RESPONSE TO FORM 990, PART VI, LINE 11, WAS IMPLEMENTED. IN ADDITION, THE GEISINGER HEALTH SYSTEM AUDIT COMMITTEE IS NOW RESPONSIBLE FOR THE OVERSIGHT OF THE CONSOLIDATED AUDIT AND SELECTION OF THE INDEPENDENT AUDITORS. FORM 990, PART XII, LINE 3B: 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. GEISINGER HEALTH SYSTEM FOUNDATION 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231995911 PHILANTHROPY PA 501(C)(3) 7 N/A 0 GEISINGER MEDICAL CENTER 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 240795959 HOSPITAL PA 501(C)(3) 3 GHSF 1 GEISINGER CLINIC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 236291113 PHYSICIAN PA 501(C)(3) 11A GHSF 1 GEISINGER WYOMING VALLEY MEDICAL CT 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231996150 HOSPITAL PA 501(C)(3) 3 GHSF 1 MARWORTH 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232171417 D&A REHAB PA 501(C)(3) 3 GHSF 1 GEISINGER HEALTH PLAN 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232311553 HEALTH INS PA 501(C)(4) GHSF 1 GEISINGER SYSTEM SERVICES 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232164794 SUPPORT SVC PA 501(C)(3) 11A GHSF 1 GEISINGER COMMUNITY HEALTH SERVICES 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232967235 HEALTH CARE PA 501(C)(3) 9 GSS 1 GEISINGER INSURANCE CORPORATIONRRG 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 141909894 SELF INS VT 501(C)(3) 11A GHSF 1 COMMUNITY MEDICAL CENTER 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 240862246 HOSPITAL PA 501(C)(3) 3 GHSF 1 COMMUNITY MEDICAL CARE INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232429776 PHYSICIAN PA 501(C)(3) 9 GHSF 1 MOUNTAIN VIEW NURSING HOME INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232568288 LONG TERM PA 501(C)(3) 9 GHSF 1 COMMUNITY MEDICAL CTR HEALTHCARE SY 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232279376 SUPPORT SVC PA 501(C)(3) 11A GHSF 1 GEISINGER-BLOOMSBURG HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232193572 HOSPITAL PA 501(C)(3) 3 GHSF 1 GEISINGER-BLOOMSBURG HEALTHCARE CTR 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232242854 SKILLED NU PA 501(C)(3) 9 GHSF 1 LEWISTOWN HEALTH CARE FOUNDATION 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232344363 PHILANTHROPY PA 501(C)(3) 11A GHSF 1 GEISINGER-LEWISTOWN HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231352187 HOSPITAL PA 501(C)(3) 3 GHSF 1 LEWISTOWN AMBULATORY CARE CORP 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232344362 RE HOLDING PA 501(C)(3) 11A GHSF 1 FAM HEALTH ASSOC OF GEISINGER-LEWISTOWN HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 251651582 PHYSICIAN PA 501(C)(3) 11A GHSF 1 KEYSTONE HEALTH INFORMATION EXCHANGE INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 464359893 RHIO PA 501(C)(3) 11A GHSF 1 HEALTH CARE CORP OF NORTHEAST PA 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232337286 SUPPORT SV PA 501(C)(3) 11A CMC 1 SUN HOME HEALTH SERVICES INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231736912 HEALTH CARE PA 501(C)(3) 9 GCHS 1 HOLY SPIRIT HEALTH SYSTEM 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 251865142 PHILANTHROPY PA 501(C)(3) 11A GHSF 1 HOLY SPIRIT HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231512747 HOSPITAL PA 501(C)(3) 3 HSHS 1 HOLY SPIRIT CORPORATION 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232214540 REAL ESTATE PA 501(C)(2) HSHS 1 WEST SHORE ADVANCED LIFE SUPPORT 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232463002 HEALTH CARE PA 501(C)(3) 7 HSHS 1 SISTERS OF CHRISTIAN CHARITY HEALTH CARE CORPORATION MALLINCKRODT CONVENT MENDHAM NJ 07945 232322926 HEALTH CARE NJ 501(C)(2) 1 N/A 0 KEYSTONE ACCOUNTABLE CARE ORG LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 454475297 ACO PA N/A LIFESOURCE GEISINGER BLOOD CTR LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 364718005 BLOOD COLLECTION PA N/A MERIDIAN GEISINGER HLTH NETWORK LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 455484165 ORG DEL SY NJ N/A HEALTHSOUTH I GHS LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 721398803 PHY THERAEPY PA N/A EVANGELICAL-GEISINGER HEALTH LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 460567687 HEALTH CARE PA N/A LEMED II 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232391766 RENTAL PA N/A GEISINGER - SCA HOLDINGS LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 461615328 MANAGEMENT DE N/A CAMP HILL AMBULATORY SURG CTR LLC 569 BROOKWOOD VILLAG E SUITE 901 BIRMINGHAM AL 35209 521597478 HEALTH CARE PA N/A HS ORTHOPEDIC MANAGEMENT CO LLC 503 NORTH 21ST STREET CAMP HILL PA 17011 460887384 HEALTH CARE PA N/A CAELIAN MEDICAL LLC 880 CENTURY DRIVE MECHANICSBURG PA 17055 208018724 HEALTH CARE RENTAL PA N/A GRANDVIEW SURGERY CENTER LTD 569 BROOKWOOD VILLAG E SUITE 901 BIRMINGHAM AL 35209 521597483 HEALTH CARE PA N/A LACKAWANNA PHYSICIANS AMBULATORY SURGERY CENTER LLC 569 BROOKWOOD VILLAG E SUITE 901 BIRMINGHAM AL 35209 233024998 HEALTH CARE PA N/A GEISINGER MEDICAL MANAGEMENT CORP 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232077663 HOTEL/REST PA N/A C 1 GEISINGER INDEMNITY INSURANCE CO 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232815174 HLTH INSURANCE PA N/A C 1 GEISINGER QUALITY OPTIONS INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 204275139 HLTH INSURANCE PA N/A C 1 HEALTH ENTERPRISES INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232353212 PHARMACY PA N/A C 1 XG HEALTH SOLUTIONS INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 461657345 CONSULTING DE N/A C 1 GEISINGER ASSURANCE COMPANY LTD 23 LINE TREE BAY AVE PO BOX 1159 GRAND CAYMAN CJ KY1-1102 981016737 INSURANCE CJ N/A C 1 HOLY SPIRIT VENTURES INC NORTH 21ST STREET CAMP HILL PA 17011 232407709 MEDICAL SERVICES PA N/A C 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 0 0 1 HOLY SPIRIT HOSPITAL K 232911 GAAP HOLY SPIRIT CORPORATION K 843075 GAAP HOLY SPIRIT VENTURES K 7920 GAAP HOLY SPIRIT HOSPITAL L 4395399 GAAP HOLY SPIRIT HOSPITAL M 300933 GAAP WEST SHORE ALS M 10627 GAAP HOLY SPIRIT VENTURES M 12336 GAAP HOLY SPIRIT HEALTH SYSTEM M 60429 GAAP GEISINGER CLINIC J 17604 FMV GEISINGER CLINIC M 30096 GAAP GEISINGER HEALTH PLAN L 243030 GAAP GEISINGER INSURANCE CORPORATION P 1755295 GAAP GEISINGER SYSTEM SERVICES M 1462319 GAAP HOLY SPIRIT HEALTH SYSTEM S 19823777 GAAP SCHEDULE R, PART V AS SHOWN IN THE RESPONSE TO FORM 990, SCHEDULE R, THE ORGANIZATION IS CLOSELY AFFILIATED WITH SEVERAL OTHER ORGANIZATIONS. IN THE NORMAL COURSE OF THE OPERATIONS OF THESE AFFILIATED ORGANIZATIONS THERE ARE NUMEROUS INTER ORGANIZATIONAL 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.