2015-05-11T14:38:24-05:00 2014-06-30 990 2013-07-01 240862246 COMMUNITY MEDICAL CENTER COMM 5702716624 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 DAVID J FELICIO ESQUIRE SECRETARY 5702716624 2015-05-07 2015-05-11 2013 2016-02-25 16:41:14Z GEISINGER-COMMUNITY MEDICAL CENTER GLENN D STEELE JR MD PHD 100 NORTH ACADEMY AVENUE MC 22-01 DANVILLE PA 17822 201718172 false X WWW.GEISINGER.ORG X 1962 PA TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING ACCESS TO QUALITY POPULATION HEALTH AND HOSPITAL SERVICES ACROSS NORTHEASTERN PENNSYLVANIA THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE. 10 9 1863 200 75875 -108911 18315 2243 177160153 192148607 1977447 2907988 3395215 4988685 182551130 200047523 61381 68300 0 82327133 87012015 0 0 102169657 98453882 184558171 185534197 -2007041 14513326 128547906 149640704 112040764 104635423 16507142 45005281 X TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING ACCESS TO QUALITY POPULATION HEALTH AND HOSPITAL SERVICES ACROSS NORTHEASTERN PENNSYLVANIA THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE. false false 170053909 68300 195792477 SEE SCHEDULE O I. GENERAL INFORMATION COMMUNITY MEDICAL CENTER (CMC), DOING BUSINESS AS GEISINGER-COMMUNITY MEDICAL CENTER (GCMC), IS A TAX-EXEMPT, PENNSYLVANIA NOT-FOR-PROFIT CORPORATION ORGANIZED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. GCMC IS A 297-BED ACUTE CARE HOSPITAL IN SCRANTON, PA. THE HOSPITAL WAS FOUNDED 117 YEARS AGO AT WHICH TIME IT WAS KNOWN AS HAHNEMANN HOSPITAL. THE HOSPITAL WAS SCRANTON'S FIRST AND CURRENTLY ONLY ACUTE CARE HOSPITAL DEDICATED TO SERVING THE COMMUNITY AND THEIR HEALTH NEEDS THROUGH A CHARITABLE PURPOSE. GCMC CONTINUES TO PROVIDE THE COMMUNITY WITH A VARIETY OF SERVICES AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. THIS CONTINUUM OF CARE INCLUDES PREVENTIVE, AMBULATORY, INPATIENT, AND EMERGENCY SERVICES. GCMC IS A NOTED REGIONAL REFERRAL CENTER WITH COMPREHENSIVE ACUTE CARE MEDICAL SERVICES AND HAS DEVELOPED MANY SPECIFIC AREAS OF EXPERTISE. PATIENT ORIGIN AND SERVICE AREA: THE HOSPITAL'S PRIMARY SERVICE AREA IS COMPRISED OF LACKAWANNA COUNTY. THE SECONDARY SERVICE AREAS INCLUDE LUZERNE, MONROE, PIKE, SUSQUEHANNA, WAYNE AND WYOMING COUNTIES. SPECIALIZED / REGIONAL SERVICES, CENTERS OF EXCELLENCE: GCMC IS THE ONLY LEVEL II TRAUMA CENTER IN LACKAWANNA COUNTY. THE NORTHEAST PA TRAUMA CENTER, DESIGNATED BY THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION IN 1988, PROVIDES 24-HOUR COMPREHENSIVE SURGICAL INTERVENTION FOR CRITICALLY INJURED PATIENTS. THE TRAUMA CENTER IS STAFFED CONTINUOUSLY BY AN EMERGENCY PHYSICIAN, TRAUMA SURGEON, AND NURSES CERTIFIED IN CRITICAL CARE, TRAUMA, ORTHOPEDICS, AND THE NEUROSCIENCES. CARDIOLOGY SERVICES AT THE HOSPITAL INCLUDE THE REGION'S FIRST ELECTROPHYSIOLOGY LAB AND AN OPEN HEART SURGERY CENTER. GCMC IS ALSO A CERTIFIED CAROTID STENT FACILITY. GCMC HAS EARNED THE ACTION REGISTRY-GWTG PLATINUM PERFORMANCE ACHIEVEMENT AWARD FOR EIGHT CONSECUTIVE QUARTERS OF QUALITY CARDIOVASCULAR CARE. GCMC ALSO HAS EARNED THE MISSION: LIFELINE BRONZE QUALITY ACHIEVEMENT AWARD FROM THE AMERICAN HEART ASSOCIATION. NEUROLOGICAL SCIENCES AT GCMC SPECIALIZES IN THE CARE OF PEOPLE WITH BRAIN AND SENSE ORGAN DISORDERS. GCMC WAS AWARDED WITH THE AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES BRONZE AWARD. GCMC ALSO EARNED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR CERTIFICATION AS A PRIMARY STROKE CENTER (ONLY ONE OF 54 MEDICAL CENTERS IN PENNSYLVANIA TO OBTAIN THIS). OTHER SPECIALIZED SERVICES INCLUDE: A SAME-DAY SURGERY CENTER, A 24-BED SHORT-TERM PSYCHIATRIC INPATIENT UNIT (THE ONLY ONE IN LACKAWANNA COUNTY), AN ORTHOPEDIC TRAUMA CLINIC, CT SCANNER, MRI IMAGING, ONCOLOGY SERVICES, RENAL DIALYSIS, HYPERBARIC OXYGEN CHAMBER TREATMENTS, THE NEW STEPS JOINT PROGRAM, WOUND CARE, AND STEREOTACTIC SURGERY. GCMC OFFERS EMERGENCY MEDICAL TECHNICIAN AND TRAUMA NURSE TRAINING PROGRAMS. IT HAS AN AFFILIATION WITH THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION. THE WRIGHT CENTER IS AN ACCREDITED PROVIDER OF INTERNAL MEDICINE RESIDENCY EDUCATION BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION. THE WRIGHT CENTER IS ALSO THE REGION'S ONLY PODIATRIC RESIDENCY PROGRAM AND ACCREDITED PROVIDER OF PODIATRIC MEDICINE AND SURGERY EDUCATION BY THE COUNCIL OF PODIATRIC MEDICAL EDUCATION. IN FY 2014, THE UNCOMPENSATED COSTS FOR HEALTH PROFESSIONS EDUCATION TOTALED 1,650,206. GCMC ALSO SPONSORS THE COMMUNITY HEALTH EDUCATION PROGRAM (DETAILED BELOW). THIS PROGRAM IS THE REGION'S FIRST HOSPITAL-BASED AND COMMUNITY-WIDE WELLNESS AND PREVENTION PROGRAM. IN ADDITION, GCMC SPONSORS THE PRIORITY CARE PROGRAM IN WHICH OVER 20,000 SENIOR CITIZENS ARE ENROLLED IN THE REGION'S FIRST HOSPITAL-BASED FREE MEMBERSHIP PLAN FOR PERSONS 55 AND OLDER. PRIORITY CARE PROVIDES SENIOR CITIZENS WITH A WIDE VARIETY OF BENEFITS AND INFORMATION REGARDING HEALTH AND WELLNESS PROGRAMS. PRIORITY CARE OFFERS CONVENIENT ACCESS TO QUALITY SERVICES INCLUDING: -FREE PARKING IN THE GCMC PARKING COMPLEX -COMMUNITY DISCOUNTS -DISCOUNTED MEALS IN THE HOSPITAL'S DINING ROOM -DISCOUNTS IN THE GCMC GIFT SHOP -PHYSICIAN REFERRAL SERVICE AFFILIATIONS: GCMC HAS WORKING RELATIONSHIPS WITH OTHER HEALTH CARE PROVIDERS IN VENTURES SUCH AS THE NORTHEAST SURGERY CENTER AND THE NORTHEASTERN PENNSYLVANIA IMAGING CENTER. GCMC ALSO HAS WORKING RELATIONSHIPS WITH THE CHILDREN'S ADVOCACY CENTER, MATERNAL & FAMILY HEALTH SERVICES, AND THE RONALD MCDONALD HOUSE OF SCRANTON. IN PARTICULAR, GCMC PROVIDES THE CHILDREN'S ADVOCACY CENTER AND MATERNAL & FAMILY HEALTH SERVICES WITH SPACE TO CONDUCT THEIR CHARTABLE PURPOSE FOR FREE. THESE CHARITABLE LEASES WERE VALUED AT 162,406 FOR FY 2014. GCMC ALSO HAS A CONNECTION WITH NUMEROUS AREA INSTITUTIONS, COLLEGES, AND UNIVERSITIES FOR EDUCATIONAL AND CLINICAL PROGRAMS INCLUDING, BUT NOT LIMITED TO, NURSING, MEDICAL TECHNOLOGY, PHYSICAL AND OCCUPATIONAL THERAPY, EMERGENCY MEDICAL TECHNICIANS, PHYSICIAN ASSISTANTS, SOCIAL WORK, AND HEALTHCARE ADMINISTRATION. MEDICAL STAFF: AS OF JUNE 30, 2014, THE MEDICAL STAFF OF GCMC TOTALED 702 PHYSICIANS. UNDER GCMC'S MEDICAL STAFF BY-LAWS, PHYSICIANS MAY HAVE ONE OF SEVERAL TYPES OF PRIVILEGES INCLUDING ACTIVE, COURTESY, CONSULTING, EMERGENCY, AND TEMPORARY. AUXILIARY: THE GCMC AUXILIARY IS COMPRISED OF APPROXIMATELY 60 MEMBERS. FUNCTIONING WITH THE GUIDANCE OF ITS OWN ADVISORY BOARD, THE AUXILIARY IS SPLIT INTO COMMITTEES, EACH OF WHICH HAS THEIR OWN RESPONSIBILITY FOR FUND-RAISING AND SERVICE. THE AUXILIARY ASSISTS IN OPERATING GCMC'S GIFT SHOP ON A DAILY BASIS. ALLOCATIONS OF FUNDS RAISED BY THE AUXILIARY ARE MADE TO GCMC TO ENHANCE PATIENT SERVICES. II. UNCOMPENSATED CARE: GCMC RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND EDUCATION. GCMC PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD GCMC PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A.CHARITY CARE THE PRIMARY CONCERN OF GCMC IS THE DELIVERY OF HEALTH CARE TO ALL THE CITIZENS OF NORTHEASTERN PENNSYLVANIA, REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GCMC INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. THE COST TO GCMC OF PROVIDING THIS CHARITY CARE DURING THE FISCAL YEAR ENDED JUNE 30, 2014 WAS 3,485,380. B.MEDICARE/MEDICAID/OTHER GOVERNMENTAL RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO THE ELDERLY (MEDICARE), THE POOR (MEDICAID), AND OTHER. GCMC PROVIDES CARE BELOW COST TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS. TO THE EXTENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTHCARE, GCMC IS FURTHERING ITS CHARITABLE MISSION. THE UNREIMBURSED VALUE OF MEDICARE, MEDICAID AND OTHER GOVERNMENTAL PAYERS IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. FOR FISCAL YEAR 2014, THE UNREIMBURSED COST OF PROVIDING CARE TO THESE PATIENTS WAS 21,999,409. C.OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GCMC 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, 2014, WAS 642,426. III. COMMUNITY HEALTH, EDUCATION, AND OUTREACH GCMC AND RELATED AFFILIATES PROVIDE A VARIETY OF PROGRAMS TO THE COMMUNITY. THE INTENT OF THESE PROGRAMS IS TO IMPROVE THE HEALTH OF THE COMMUNITY AND PROVIDE FOR COMMUNITY HEALTH NEEDS, E.G. THROUGH ACCIDENT/ILLNESS PREVENTION OR EARLY HEALTH INTERVENTION AS A RESULT OF INCREASED EDUCATION. THE NORTHEAST PA TRAUMA CENTER PROVIDES EMERGENCY PREPAREDNESS ASSISTANCE AND MEDICAL EXPERTISE TO THE AMERICAN RED CROSS LACKAWANNA CHAPTER, LACKAWANNA COUNTY EMERGENCY MANAGEMENT AGENCY, AND THE SCRANTON/WILKES- BARRE INTERNATIONAL AIRPORT. ALSO, FALL AND INJURY PREVENTION FOR THE ELDERLY IS AVAILABLE TO AREA SENIOR CITIZENS AND SENIOR ORGANIZATIONS, AS WELL AS MANY AGE-SPECIFIC PREVENTION PROGRAMS TO VARIOUS ORGANIZATIONS AND SCHOOLS THROUGHOUT THE YEAR. EACH YEAR OVER 500 CHILDREN UNDER THE AGE OF 18 ARE INVOLVED IN EDUCATION'S EXTENSIVE PROGRAMS TARGETING THIS AGE GROUP. TRAUMA PREVENTION PROGRAMS SUCH AS TRAUMA ROOM AND THINK FIRST TEACH KIDS IMPORTANT SAFETY INFORMATION. ASTHMA SKI DAY HELD IN CONJUNCTION WITH MONTAGE MOUNTAIN SKI AREA AND GCMC'S COMMUNITY HEALTH EDUCATION PROGRAM, EMPHASIZING THAT DESPITE ILLNESS, INDIVIDUALS CAN STILL PARTICIPATE IN HEALTHY, EVEN STRENUOUS ACTIVITIES. THIS ACTIVITY WAS PROVIDED AT A COST OF 9,346. MANY OF THESE PROGRAMS ARE THE RESULTS OF EDUCATION'S PARTNERSHIPS WITH OTHER COMMUNITY RESOURCES; E.G., THE AMERICAN LUNG ASSOCIATION, LACKAWANNA COUNTY DRUG AND ALCOHOL COMMISSION, AND ALLIED SERVICES. IN FY 2014, THE TRAUMA CENTER PROVIDED AN ARRAY OF TRAUMA PROGRAMS FOR ABOUT 9,402 OF UNCOMPENSATED COSTS. THE COMMUNITY HEALTH EDUCATION PROGRAM ("LIFECARE") CONDUCTS A WIDE VARIETY OF HEALTHY LIFESTYLE PROGRAMS, FREE OR AT MINIMAL COST, WHICH A 170053909 true false false true false false false false false true true true false true true false false true false false false false false false false false true true true false true false false false false false false false true false false false false false true true true true false true X 2 0 true 1863 true true true false false false false false false false false false X 10 9 true false false false true true false true true false false true true true true true true true true true true PA X EDWARD CHABALOWSKI CFO 5707038837 1822 MULBERRY STREET SCRANTON PA 18510 WILLIAM H ALEXANDER DIRECTOR 0.25 6.00 X 0 0 0 E ALLEN DEAVER DIRECTOR 0.25 4.75 X 0 0 0 DORRANCE R BELIN ESQUIRE DIRECTOR (EM 0.25 4.25 X 0 0 0 RICHARD A GRAFMYRE DIRECTOR 0.25 5.75 X 0 0 0 WILLIAM R GRUVER DIRECTOR 0.25 5.00 X 0 0 0 FRANK M HENRY DIRECTOR 0.25 4.75 X 0 0 0 THOMAS H 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0.00 40.00 X 0 952866 197122 KHALEEL SHAIKH MD PHYSICIAN 0.00 40.00 X 0 412254 29010 SEAN MCANDREW FORMER OFFIC 40.00 0.00 X 158724 0 9065 WENDY K WILSON FORMER OFFIC 40.00 0.00 X 118203 0 20671 2519057 7267797 1684174 51 true true false WRIGHT CENTER FOR MEDICAL GRAD 501 MADISON AVE SCRANTON PA 18510 STAFFING 2124837 SIEMENS HEALTH SERVICES DIVISION 51 VALLEY STREAM PARKWAY MALVERN PA 19355 TECHNOLOGY 1147958 HCSC LAUNDRY PO BOX 25092 LEHIGH VALLEY PA 180025092 LAUNDRY SERVICE 864918 EMERGENCY SERVICES PC 1000 DUNHAM DRIVE DUNMORE PA 18512 PROF STAFFING 628175 DIVERSIFIED CLINICAL SERVICES PO BOX 551187 JACKSONVILLE FL 32255 WOUND CARE 435610 29 X 2243 2243 PATIENT HEALTHCARE 622110 191537711 191537711 IC RENTAL INCOME 531120 511094 511094 HEALTH EDUCATION 622110 77922 77922 IC SUPPORT SERVICE-SCHEDULE O 551112 21880 21880 192148607 1218453 1218453 1667 1667 226409 174316 52093 52093 52093 3089165 95036 1437471 58862 1651694 36174 1687868 1687868 ELECTRONIC HEALTH RECORD 900099 3208197 3208197 DIETARY INCOME 722514 803594 803594 PURCHASE DISCOUNTS 900099 366146 366146 558655 69527 75875 413253 4936592 200047523 195281383 75875 4688022 68300 68300 887285 583289 303996 455914 226382 229532 68013597 63569339 4444258 2321363 2154757 166606 10130041 9403001 727040 5203815 4854456 349359 38050 5600 32450 1533 1533 131545 131545 10885816 8860250 2025566 367979 1166 366813 4843814 4115623 728191 39461 23137 16324 3540011 3244646 295365 189384 142857 46527 51789 50850 939 223531 204880 18651 5594564 5127774 466790 1893527 623364 1270163 MEDICAL SUPPLIES 39274782 39253716 21066 INTER-ENTITY EXPENSES 23623909 19799562 3824347 MA MODERNIZATION 3733092 3733092 UNCOLLECTIBLE EXPENSE 3607312 3607312 413783 400556 13227 185534197 170053909 15480288 0 11879972 7837134 2858026 4766759 13263233 10233672 6060 3208708 3171594 1035455 1359670 84686404 13284874 40155860 71401530 10219227 9449228 25961526 31348678 19965899 10066379 128547906 149640704 6877641 4986541 57295705 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9164983 MEDICAL LEGAL CLAIMS ALLOWANCE 2868508 PATIENT RECEIVABLE CREDIT BALANCES 604115 42353177 SCHEDULE D, PAGE 2, PART V, LINE 4 COMMUNITY MEDICAL CENTER USES ENDOWMENT FUNDS TO SUPPORT PATIENT CARE AND AWARD SCHOLARSHIPS TO EMPLOYEES. SCHEDULE D, PAGE 4, PART XIII PART V LINE 1A - ENDOWMENT FUNDS BEGINNING OF YEAR BALANCE PER THE SCHEDULE D INSTRUCTIONS FOR PART V, "INFORMATION REPORTED IN PART V SHOULD PERTAIN TO THE AGGREGATE OF THE ENDOWMENT ASSETS HELD BY THE ORGANIZATION, ORGANIZATIONS FORMED AND MAINTAINED EXCLUSIVELY TO FURTHER ONE OR MORE EXEMPT PURPOSES OF THE ORGANIZATION, AND ORGANIZATIONS THAT HOLD ENDOWMENT FUNDS FOR THE BENEFIT OF THE ORGANZATION. BEGINNING IN FY2014, GEISINGER HEALTH SYSTEM FOUNDATION ("GHSF") HELD ENDOWMENT FUNDS FOR THE BENEFIT OF GEISINGER-COMMUNITY MEDICAL CENTER. AS SUCH, THE BEGINNING BALANCE INCLUDES ALL GHSF FUNDS AND WILL NOT EQUAL THE PRIOR YEAR END BALANCE. PART X - LIABILITY UNDER 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 NET ASSETS AS OF JUNE 30, 2014 OR ANY PREVIOUS YEARS SINCE ADOPTION. ACCORDINGLY, NO FIN 48 FOOTNOTE DISCLOSURE WAS MADE IN THE JUNE 30, 2014 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 ENTITIES COMPRISING THE SYSTEM. true true X true X true X 3.800000000000 true true true false true true 3485380 3485380 0.01880 23128761 14705451 8423310 0.04540 26614141 14705451 11908690 0.06420 370376 370376 0.00200 2832733 1182527 1650206 0.00890 106653 106653 0.00060 3309762 1182527 2127235 0.01150 29923903 15887978 14035925 0.07570 true 3568959 52668487 61610250 -8941763 X true true 1 1 COMMUNITY MEDICAL CENTER DBA GEISINGER-COMMUNITY MEDICAL CTR 1822 MULBERRY STREET SCRANTON PA 18510 WWW.GEISINGER.ORG 037101 X X X COMMUNITY MEDICAL CENTER 1 true X X X X X X X X X X 11 true true true X WWW.GEISINGER.ORG X WWW.GEISINGER.ORG/SITES/CHNA X X X X X X X X X true false true true 200.000000000000 true 380.000000000000 true X X X X X X true true X X X X X X X true false true X false false FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 3 THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED BY THE INSTITUTE FOR PUBLIC POLICY AND ECONOMIC DEVELOPMENT (THE "INSTITUTE") THROUGH THE HEALTHY NORTHEAST PENNSYLVANIA INITIATIVE (HNPI), A REGIONAL MEMBERSHIP BASED ORGANIZATION WITH EXPERTISE IN COMMUNITY HEALTH AND COMMUNITY EDUCATION PROGRAMS. SURVEYS: THE INSTITUTE CONDUCTED IN DEPTH PRIMARY RESEARCH BY DEPLOYING OVER 12,000 SURVEYS IN GCMC'S PRIMARY AND SECONDARY SERVICE AREAS AND CONDUCTING SEVERAL INTERVIEWS AND FOCUS GROUPS. A HOUSEHOLD SURVEY OF OVER 5% OF THE RESIDENTS WITHIN THE COMMUNITY WAS CONDUCTED TO DETERMINE COMMUNITY NEED. ADDITIONALLY, 200 SPANISH LANGUAGE SURVEYS WERE PREPARED AND DISTRIBUTED TO LOCAL HISPANIC CHURCHES AND FREE MEDICAL CLINICS WITHIN THE COMMUNITY. A LOCAL HOUSING AGENCY ALSO HELPED DISTRIBUTE SPANISH LANGUAGE SURVEYS. OVERALL, 4% OF THE HISPANIC POPULATION RESPONDED. ANOTHER 200 SURVEYS WERE DISTRIBUTED TO AFRICAN AMERICAN AND OTHER MINORITY AND IMMIGRANT POPULATIONS. THESE SURVEYS WERE DISTRIBUTED THROUGH LOCAL YOUTH ORGANIZATIONS AND FREE MEDICAL CLINICS. OVERALL, 3% OF THE AFRICAN AMERICAN POPULATION RESPONDED. THE SURVEYS MET ALL FEDERAL STANDARDS ESTABLISHED FOR THE PROTECTION OF HUMAN SUBJECTS RIGHTS IN RESEARCH. THE WILKES UNIVERSITY INSTITUTIONAL REVIEW BOARD REVIEWED AND APPROVED ALL OF THE PRIMARY RESEARCH INSTRUMENTS AND CONSENTS. THE SURVEY RESPONSES WERE UPLOADED INTO THE STATISTICAL PACKAGES FOR THE SOCIAL SCIENCES WHICH IS AN INTEGRATED SOFTWARE PROGRAM USED FOR ANALYTICAL DATA ANALYSIS. INTERVIEWS: CARE WAS TAKEN TO INTERVIEW STAKEHOLDERS THAT REPRESENTED THE ENTIRE STUDY REGION. INTERVIEWS RANGED FROM 45 MINUTES TO 3 HOURS IN DURATION. EACH INTERVIEWEE HAD THE OPPORTUNITY TO ADD OPEN COMMENTS AT THE SURVEY'S END. SIXTEEN INTERVIEWS WERE CONDUCTED WITH 26 STAKEHOLDERS, INCLUDING THE FOLLOWING: -MAJOR EMPLOYERS -FEDERALLY QUALIFIED HEALTH CENTER -A FREE MEDICAL CLINIC -PENNSYLVANIA DEPARTMENT OF HEALTH -SOCIAL SCIENTISTS AND RESEARCHERS -PHILANTHROPIST AND HEALTH POLICY ADVISOR -DISEASE-BASED ORGANIZATION -SOCIAL SERVICE ORGANIZATION -MENTAL AND BEHAVIORAL HEALTH ORGANIZATION -EPIDEMIOLOGY/ENVIRONMENTAL SPECIALISTS -PRIMARY CARE PHYSICIANS -SURGEONS -MEDICAL TECHNOLOGIST/CLINICAL LABORATORY -HEALTH INSURERS FOCUS GROUPS: VARIOUS SEGMENTS OF THE COMMUNITY WERE CONSULTED IN ORDER TO DETERMINE THE UNIQUE HEALTH CARE NEEDS OF SPECIFIC GROUPS, INCLUDING: HISPANIC/LATINO COMMUNITY -AFRICAN AMERICAN COMMUNITY (2 SEPARATE GROUPS) -IMPOVERISHED -AGING -PHYSICALLY AND MENTALLY CHALLENGED -YOUR -CHRONIC DISEASE/PUBLIC HEALTH ORGANIZATIONS -MAJOR EMPLOYERS -BEHAVIORAL BASED (SUBSTANCE ABUSE) ORGANIZATIONS ADDITIONAL DATA UTILIZED WAS FROM THE PENNSYLVANIA DEPARTMENT OF HEALTH, THE U.S. CENSUS BUREAU, THE CENTER FOR RURAL PENNSYLVANIA, THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, COUNTY HEALTH RANKING PREPARED BY THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE AND THE ROBERT WOOD JOHNSON FOUNDATION. THE DATA INCLUDED DEMOGRAPHIC AND ECONOMIC INDICATORS, HEALTH STATUS, INCIDENCE OF DISEASE, AND INSURANCE STATUS. INFORMATION REGARDING THE HEALTH CARE DELIVERY SYSTEM UTILIZED WAS FROM THE PENNSYLVANIA DEPARTMENT OF HEALTH, PENNSYLVANIA COST CONTAINMENT COUNCIL, PENNSYLVANIA HEALTH CARE ASSOCIATION, THE U.S. DEPARTMENT OF HEALTH AND THE LOCAL PARTICIPATING HOSPITALS. FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 4 GEISINGER-COMMUNITY MEDICAL CENTER AND GEISINGER WYOMING VALLEY MEDICAL CENTER PARTICIPATED IN THE CHNA. FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 14G REGISTRATION PERSONNEL ALSO REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY. PART I, LINE 6A - RELATED ORGANIZATION INFORMATION A SUMMARY OF THE COMMUNITY BENEFIT PROVIDED BY GEISINGER-COMMUNITY MEDICAL CENTER (GCMC) AND ITS RELATED CHARITABLE ORGANIZATIONS IS AVAILABLE AT GEISINGER.ORG AND MADE AVAILABLE TO THE PUBLIC UPON REQUEST. GO TO: HTTP://WWW.GEISINGER.ORG/PAGES/NEWSROOM/INCLUDES/PDF/AR-FINAL-2014.PDF 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 PAYER (E.G. MEDICARE, MEDICAID, COMMERCIAL PAYORS, SELF-PAY, ETC.). A COST TO CHARGE RATIO CALCULATED PURSUANT TO WORKSHEET 2 OF THE FORM 990 INSTRUCTIONS WAS USED TO CALCULATE THE COST OF CHARITY CARE. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY PATIENTS' ACCOUNTS ARE MONITORED THROUGHOUT THE BILLING PROCESS AND RECLASSIFIED TO FREE OR DISCOUNTED CARE WHENEVER THE PATIENT BECOMES ELIGIBLE UNDER GCMC'S UNCOMPENSATED CARE POLICIES. ACCORDINGLY, THE BAD DEBT ACCOUNTS SHOULD NOT INCLUDE AMOUNTS THAT MAY BE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FREE OR DISCOUNTED CARE UNDER GCMC'S UNCOMPENSATED CARE POLICIES. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS GCMC IS A MEMBER OF A GROUP WITH CONSOLIDATED FINANCIAL STATEMENTS. PER THE FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE, THE ORGANIZATIONS WRITE OFF ALL ACCOUNTS THAT HAVE BEEN IDENTIFIED AS UNCOLLECTABLE. AN ALLOWANCE FOR UNCOLLECTABLES IS RECORDED FOR ACCOUNTS NOT YET WRITTEN OFF THAT ARE ANTICIPATED TO BECOME COLLECTABLE IN FUTURE PERIODS. THE FOOTNOTE CAN BE LOCTAED ON PAGE 13 OF THE ATTACHED GEISINGER HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTS, JUNE 30, 2014 AND JUNE 30, 2013. PART III, LINE 8 - MEDICARE EXPLANATION PART III, LINE 6 & LINE 7: MEDICARE SHORTFALL: LINE 6 ONLY INCLUDES THOSE COSTS THAT ARE ALLOWED TO BE REPORTED ON GCMC'S MEDICARE COST REPORT THAT IS REQUIRED TO BE FILED WITH THE FEDERAL GOVERNMENT. PART III, SECTION B, LINE 8, MEDICARE SHORTFALL IS COMMUNITY BENEFIT: GCMC CONSIDERS THAT THE TOTAL MEDICARE SHORTFALL OF 13,576,099 IS REPORTED AS COMMUNITY BENEFIT. 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 GCMC TO USE OTHER FUNDS TO COVER THE SHORTFALL. MEDICARE SHORTFALLS MUST BE ABSORBED BY GCMC IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. GCMC PROVIDES CARE REGARDLESS OF THE MEDICARE SHORTFALL AND THEREBY RELIEVES 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. PENNSYLVANIA REQUIRES NON-PROFIT HOSPITALS LIKE GCMC 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 IS CONSIDERED TO BE COMMUNITY BENEFIT FOR STATE TAX EXEMPTION PURPOSES. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION GCMC IS COMMITTED TO PROVIDING MEDICAL NECESSARY SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND GCMC'S COLLECTION ACTIONS ARE CONSISTENTLY APPLIED TO ALL PATIENTS. IT IS GCMC 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 GCMC 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 GCMC'S FINANCIAL ASSISTANCE PROGRAM. PART VI, LINE 2 - NEEDS ASSESSMENT GEISINGER-COMMUNITY MEDICAL CENTER REGULARLY PARTICIPATES IN COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENTS TO IDENTIFY FAR-REACHING HEALTH NEEDS FACED BY THE POPULATION SERVED BY THE HOSPITAL FOR COMMUNITY BENEFIT PURPOSES. FOR FISCAL YEAR ENDED JUNE 30, 2013, AS A MEMBER OF THE HEALTHY NORTHEAST PENNSYLVANIA INITIATIVE (THE "INITIATIVE"), GCMC PARTICIPATED IN A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED BY THE INSTITUTE FOR PUBLIC POLICY AND ECONOMIC DEVELOPMENT (THE "INSTITUTE"). ASSESSMENT RESULTS ARE EVALUATED OVER TIME AND SERVE AS THE BASIS TO DEVELOP NEW OR EXPANDED PLANS TO ADDRESS SERVICES IN RESPONSE TO NEED. ADDITIONALLY, GCMC DEVELOPS PROGRAMS AND SERVICES TO ADDRESS COMMUNITY HEALTH NEEDS AND MAKES INVESTMENTS IN INITIATIVES THAT ALIGN WITH THE HOSPITAL'S CORE MISSION. BEYOND THAT FOCUS ARE PROGRAMS AND SERVICES THAT BENEFIT EVERY RESIDENT AND SUPPORT THE FAR REACHING GOAL OF A HEALTHIER COMMUNITY. THOSE HEALTHY COMMUNITY GOALS HAVE SERVED AS A CATALYST FOR A COLLABORATIVE COMMUNITY APPROACH GCMC HAS BEEN INSTRUMENTAL IN ESTABLISHING IN ORDER TO ACCESS THE HEALTHCARE NEEDS, HEALTH STATUS, AND QUALITY OF LIFE INDICATORS OF RESIDENTS LIVING IN THE LACKAWANNA COUNTY AND LUZERNE COUNTY COMMUNITIES. THE HOSPITAL IS A CHARTER MEMBER OF HEALTHY NORTHEAST PENNSYLVANIA INITIATIVE (HNPI), AN ALLIANCE AMONG MEMBER REGIONAL HEALTHCARE ORGANIZATIONS AND THE PENNSYLVANIA DEPARTMENT OF HEALTH. THE GOAL OF THE ORGANIZATION IS TO ASSESS AND ADDRESS THE COMMUNITY HEALTH NEEDS, INCREASE REGIONAL HEALTHCARE PROGRAMS AND SERVICES, AND FACILITATE AWARENESS, EDUCATION AND WELLNESS FOR RESIDENTS OF NORTHEAST PENNSYLVANIA. IN ADDITION TO GCMC, OTHER REGIONAL HEALTHCARE PROVIDERS PARTICIPATING IN THE HNPI COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDED, AMONG OTHERS: PENNSYLVANIA DEPARTMENT OF HEALTH, WILKES-BARRE HEALTH DEPARTMENT OF HEALTH, WYOMING VALLEY UNITED WAY, MIGRANT WORKERS PROGRAM IN HAZLETON, MATERNAL AND FAMILY HEALTH, LUZERNE COUNTY TASK FORCE ON DRUG AND ALCOHOL, ALLIED SERVICES, BLUE CROSS OF NEPA, COMMUNITY MEDICAL CENTER, MERCY HEALTH PARTNERS, MOSES TAYLOR HOSPITAL/FOUNDATION, THE COMMONWEALTH MEDICAL COLLEGE, WYOMING VALLEY HEALTHCARE SYSTEM, .ASSESSMENT SURVEYS WERE DONE IN 1997, 2003 AND 2009, WITH THE MOST RECENT SURVEY COMPLETED IN 2012. THE STUDY'S MAIN OBJECTIVE WAS TO COMPLETE A COMPREHENSIVE ASSESSMENT OF THE HEALTHCARE ACCESS NEEDS, HEALTH STATUS, AND QUALITY OF LIFE INDICATORS OF RESIDENTS LIVING IN THE LACKAWANNA COUNTY AND LUZERNE COUNTY COMMUNITIES. MORE SPECIFICALLY, THE PROJECT GOALS WERE: -TO OBTAIN STATISTICALLY VALID INFORMATION ON THE HEALTH STATUS AND SOCIOECONOMIC/ENVIRONMENTAL FACTORS RELATED TO HEALTH OF RESIDENTS OF THE COUNTIES HEALTHY NORTHEAST PENNSYLVANIA INITIATIVE (HNPI) SERVES. - TO SUPPLEMENT THE GENERAL POPULATION SURVEY DATA THAT IS CURRENTLY AVAILABLE TO HNPI AS AN ORGANIZATION. -TO ASSURE THAT COMMUNITY MEMBERS, INCLUDING THOSE OF BROAD RACIAL, ETHNIC, CULTURAL AND LINGUISTIC MINORITY GROUPS, ARE THE PRIMARY PARTICIPANTS IN THE NEEDS ASSESSMENT SURVEY PROCESS. IN ADDITION, EDUCATORS, HEALTH-RELATED PROFESSIONALS, MEDIA REPRESENTATIVES, LOCAL GOVERNMENT, HUMAN SERVICE ORGANIZATIONS, INSTITUTES OF HIGHER LEARNING, RELIGIOUS INSTITUTIONS AND THE PRIVATE SECTOR ARE ALL ENGAGED AT SOME LEVEL OF THE SURVEY PROCESS. -TO DEVELOP ACCURATE COMPARISONS TO THE STATE AND NATIONAL BASELINES OF HEALTH MEASURES, UTILIZING THE MOST CURRENT VALIDATED DATA AVAILABLE. -TO UTILIZE DATA OBTAINED FROM THE ASSESSMENT TO ADDRESS THE IDENTIFIED HEALTH NEEDS OF THE HNPI SERVICE AREA. -TO PROVIDE HNPI WITH APPROPRIATE DATA COMPARISONS, ON LIKE SURVEY QUESTIONS, TO THE 1997-98, 2003-04 AND 2008-2009 COMMUNITY HEALTH NEEDS ASSESSMENTS' HOUSEHOLD SURVEY DATA. THESE DATA COMPARISONS WILL ALLOW HNPI TO DISCOVER BOTH POSITIVE AND NEGATIVE COMMUNITY HEALTH TRENDS. -TO COMPLETE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH NOT ONLY REACHES MINORITY/UNDERSERVED POPULATIONS BUT ALSO ADDRESSES A WIDE VARIETY OF COMMUNITY HEALTH TOPICS INCLUDING, BUT NOT LIMITED TO: ACCESS TO CARE, CHRONIC DISEASE PREVALENCE, PREVENTIVE HEALTH, HEALTH STATUS, ACCESS TO COMMUNITY PROGRAMS AND SERVICES, QUALITY OF LIFE INDICATORS, AND HEALTHY LIFESTYLE BEHAVIORS. THE MAJOR HEALTH NEED THEMES WHICH CONSISTENTLY SURFACED IN THE VARIOUS COMMUNITY HEALTH NEEDS ASSESSMENTS INCLUDED: IMPROVING THE ACCESS TO HEALTHCARE FOR UNDER AND UNINSURED; IMPROVING HEALTHY BEHAVIORS (I.E., OBESITY AND BROADLY, THE RELATED "DISEASE BURDEN/PREVENTION"); AND EXPANDING TREATMENT AND EDUCATION ON DRUG AND ALCOHOL ABUSE. 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 DISCOUNTED BASIS, TO THOSE PATIENTS WHO DEMONSTRATE AN INABILITY TO PAY. DEPENDING UPON FAMILY SIZE AND INCOME, FREE OR DISCOUNTED SERVICES ARE AVAILABLE TO A PATIENT WITH FAMILY INCOME RANGING FROM 200% UP TO 380% OF THE FEDERAL POVERTY GUIDELINES. IT IS GCMC 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 GCMC'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 GCMC'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 GCMC'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES WITH EACH PATIENT BILL. PART VI, LINE 4 - COMMUNITY INFORMATION GEISINGER-CCOMMUNITY MEDICAL CENTER'S SERVICE AREA INCLUDES 9 COUNTIES IN NORTHEASTERN PENNSYLVANIA (BRADFORD, CARBON, LACKAWANNA, LUZERNE, MONROE, PIKE, SUSQUEHANNA, WAYNE, AND WYOMING). THE APPROXIMATE 2013 TOTAL POPULATION WITHIN THIS SERVICE AREA WAS 1,009,439. THIS POPULATION IS EXPECTED TO DECLINE.2% BY 2018, WHILE AN INCREASE IN THE RATE OF GROWTH IS EXPECTED FOR THE STATE AND NATION (1.0% AND 3.3%, RESPECTIVELTY.) IN 2013, THE 65 AND OVER AGE GROUP IS 18.1% OF THE TOTAL POPULATION, WHICH WAS GREATER THAN THE STATE (16.43%) AND NATIONAL (13.9%) PROPORTIONS. ADDITIONALLY, THE 65 AND OVER AGE GROUP IS THE AGE SEGMENT PROJECTED TO EXPERIENCE THE LARGEST FIVE-YEAR POPULATION GROWTH OF 12.5%. THE REGION IS PRIMARILY RURAL, WITH SMALL SUBURBAN AND URBAN POCKETS. AVERAGE HOUSEHOLD INCOME, IN 2013, WAS 60,143, WITH APPROXIMATELY 14.4% OF THE POPULATION FALLING BELOW FEDERAL POVERTY GUIDELINES, IN 2012, WHICH IS GREATER THAN THE STATE PROPORTION OF 13.7%. THE 2012 AVERAGE UNEMPLOYMENT RATE, THE MOST CURRENT FULL YEAR OF COUNTY LEVEL DATA AVAILABLE FROM THE BUREAU OF LABOR STATISITICS, WAS 9.2%, WHICH IS HIGHER THAN BOTH THE COMMONWEALTH RATE OF 7.9%, AND THE NATIONAL RATE OF 8.1%. WITHIN THE 9 COUNTY SERVICE AREA, 14.5% OF GCMC'S INPATIENT DISCHARGES DURING FISCAL YEAR 2013 WERE SELF-PAY OR CHARITY CARE OR WERE MEDICAID RECIPIENTS. THE REGION INCLUDES MULTIPLE MEDICALLY UNDERSERVED AREAS AND POPULATIONS. THE U.S. DEPARTMENT OF HEALTH AND HUMAN RESOURCES HAS DESIGNATED LACKAWANNA COUNTY AS A MEDICALLY UNDERSERVED AREA/POPULATION DUE TO: TOO FEW PRIMARY CARE PROVIDERS, HIGH INFANT MORTALITY, HIGH POVERTY AND/OR HIGH ELDERLY POPULATION. THERE ARE 2 GEISINGER GENERAL MEDICAL/SURGICAL HOSPITALS (GWV AND GCMC), AND 15 GENERAL MEDICAL/SURGICAL NON-GEISINGER HOSPITALS IN THIS MARKET. 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 COMMUNITY MEDICAL CENTER D/B/A GESINGER-COMMUNITY MEDICAL CENTER (GCMC) IS A 501(C)(3) NOT-FOR-PROFIT CORPORATION OWNING AND OPERATING A 297-BED ACUTE CARE HOSPITAL IN SCRANTON, PA. IT IS AN OPEN STAFF HOSPITAL WITH APPROXIMATELY 627 PHYSICIANS HAVING MEDICAL STAFF PRIVILEGES. GCMC OFFERS AN EXPANSIVE RANGE OF SERVICES THROUGH MULTIPLE CLINICAL DEPARTMENTS: MEDICINE, ANESTHESIA, NEUROSCIENCES, GENERAL SURGERY, ORTHOPAEDICS, ADVANCED HEART AND VASCULAR CARE, EMERGENCY MEDICINE, DIAGNOSTIC IMAGING SERVICES, GASTROINTESTINAL LABORATORY, PODIATRY, PEDIATRICS, WOMEN'S SERVICES, PAIN MANAGEMENT, WOUND CARE AND ADDITIONAL OUTPATIENT GENERAL DIAGNOSTIC SERVICES SUCH AS LABORATORY, GENERAL RADIOLOGY AND ULTRASOUND. GCMC IS HOME TO SCRANTON'S ONLY TRAUMA CENTER AND ADULT INPATIENT BEHAVIORAL HEALTH UNIT. IN ADDITION, THE COUNTY'S ONLY CERTIFIED PRIMARY STROKE CARE CENTER IS ALSO LOCATED AT GCMC. MORE THAN 1,400 TRAUMA PATIENTS AND 47,000 EMERGENCY ROOM PATIENTS PASS THROUGH THE GCMC DOORS EACH YEAR. ON JANUARY 1, 2013, GCMC, SURGICAL CARE AFFILIATES, LLC ("SCA") AND NORTH EAST SURGERY CENTER, A PARTNERSHIP INCLUDING 38 LOCAL SURGEONS, FORMED A JOINT VENTURE TO FURTHER SURGICAL CARE FOR PATIENTS IN LACKAWANNA COUNTY AND THE SURROUNDING AREA. SINCE 2001, NORTH EAST SURGERY CENTER HAS OFFERED OUTPATIENT SURGERY AND PAIN MANAGEMENT. LOCATED IN DICKSON CITY NEAR SCRANTON, THE 13,200 SQUARE-FOOT FACILITY HOUSES THREE OPERATING ROOMS AND TWO PROCEDURE ROOMS WITH THE OPTION FOR FUTURE EXPANSION. GCMC IS AN AFFILIATE WITHIN THE GEISINGER HEALTH SYSTEM, WHICH IS ONE OF THE LARGEST RURAL HEALTH CARE SYSTEMS IN THE NATION AND COVERS A 20,000 SQUARE MILE AREA IN NORTHERN AND CENTRAL PENNSYLVANIA. 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 FOUR ACUTE CARE HOSPITALS AND A DRUG AND ALCOHOL TREATMENT FACILITY; 2) A MULTISPECIALTY PHYSICIAN GROUP PRACTICE OF 1,055 PHYSICIANS PRACTICING AT 78 PRIMARY AND SPECIALTY CLINICS; AND 3) ONE OF THE NATION'S LARGEST RURAL HEALTH INSURANCE ORGANIZATIONS WITH 429,135 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. THE SYSTEM 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 WORD: HEAL. TEACH. DISCOVER. SERVE. GEISINGER HEALTH SYSTEM FOUNDATION (FOUNDATION) IS A 501(C)(3) NOT-FOR- PROFIT CORPORATION THAT SERVES AS CORPORATE PARENT WHICH COORDINATES AND SUPERVISES THE ACTIVITIES OF THE SYSTEM'S AFFILIATED ENTITIES. THE FOUNDATION IS NOT A LICENSED HEALTH CARE PROVIDER, NORT DOES IT PROVIDE HEALTH CARE SERVICES TO PATIENTS. IT SERVES TO ENSURE THAT THE SYSTEM AFFILIATED ENTITIES HAVE ADEQUATE FINANCIAL RESOURCES TO FULFILL THEIR CHARITABLE MISSIONS AND TO INITIATE AND ADMINISTER GRANT AND PHILANTHROPIC SUPPORT PROGRAMS FOR ALL GEISINGER ENTITIES. GEISINGER MEDICAL CENTER (GMC)A 501(C)(3) NOT-FOR-PROFIT CORPORATION OPERATING A 505 BED REGIONAL REFERRAL TERTIARY/QUATERNARY CARE MEDICAL CENTER LOCATED IN DANVILLE, PENNSYLVANIA, A SMALL COMMUNITY OF 6,000 PEOPLE. SINCE ITS BEGINNING IN 1915, GHS HAS EMPHASIZED MULTI-SPECIALTY CARE AND HAS MORE THAN 80 MEDICAL SPECIALTIES AND SUB-SPECIALTIES. GMC MAINTAINS AN ACTIVE LEVEL 1 REGIONAL RESOURCE TRAUMA CENTER WITH ADDITIONAL QUALIFICATIONS IN PEDIATRICS (ONE OF ONLY FOUR IN PENNSYLVANIA). LIFE FLIGHT, AN AIR AMBULANCE MEDICAL SERVICE, PROVIDES GEISINGER STAFF TRAINED IN ADVANCED LIFE SUPPORT THAT SUPPLEMENTS THE TRAUMA PROGRAM AND THE NEONATAL INTENSIVE CARE UNIT ("NICU"). GEISINGER'S LIFE FLIGHT OPERATES FIVE BASE LOCATIONS, WHICH ARE THE GMC CAMPUS IN DANVILLE, SCRANTON/WILKES-BARRE, STATE COLLEGE, MINERSVILLE AND WILLIAMSPORT. THE MEDICAL CENTER HAS ALSO BEEN DESIGNATED AS A MAGNET HOSPITAL BY THE AMERICAN NURSES CREDENTIALING CENTER (ANCC). GMC PROVIDES FOR PATIENT SERVICES IN VARIOUS SETTINGS ON OR NEAR THE DANVILLE CAMPUS. THEY INCLUDE THE FOLLOWING: JANET WEIS CHILDREN'S HOSPITAL, A PEDIATRIC TERTIARY HOSPITAL THAT WAS CONSTRUCTED IN 1995 ENTIRELY FROM DONATIONS WHERE MORE THAN 100 SPECIALISTS PROVIDE THEIR EXPERTISE IN OVER 40 MEDICAL FIELDS, INCLUDING ONCOLOGY, NEUROSURGERY, NEONATOLOGY, CARDIOLOGY AND CARDIOVASCULAR SURGERY. GSACH - A 55 BED MEDICAL/SURGICAL ACUTE CARE HOSPITAL SERVING THE PRIMARY AND SECONDARY NEEDS OF NORTHUMBERLAND COUNTY. GSACH IS EQUIPPED WITH A 24-HOUR EMERGENCY DEPARTMENT, RELATED DIAGNOSTIC SERVICES AND OUTPATIENT SURGERIES. ADDITIONALLY, A 15 BED SHORT STAY SKILLED NURSING UNIT IS AVAILABLE FOR POST-ACUTE CARE NEEDS. GEISINGER WOODBINE LANE - LOCATED OFF ROUTE 11 IN DANVILLE, PA, THIS FACILITY HOUSES MANY OUTPATIENT SERVICES, INCLUDING SAME-DAY SURGERY, DERMATOLOGY AND MOHS SKIN CANCER SURGERY, AN INTERVENTIONAL PAIN CENTER, AND REHABILITATION AND SPORTS MEDICINE. GEISINGER-KNAPPER CLINIC - A CENTER WHICH HOUSES GEISINGER'S CANCER INSTITUTE, INCLUDING THE MOST HIGHLY SKILLED AND KNOWLEDGEABLE PHYSICIANS, NURSES AND CANCER SPECIALISTS IN THE REGION, PROVIDING CANCER CARE, RESEARCH, PREVENTION, CLINICAL TRIAL, TREATMENT AND EDUCATION. KNAPPER CLINIC IS ALSO HOME TO FAMILY MEDICINE, GENERAL PEDIATRICS AND SPECIALTY CARE IN ENDOCRINOLOGY AND METABOLISM AND PSYCHOLOGY. ON-SITE SERVICES LIKE X-RAY, LAB, AND PHARMACY MAKE IT ESPECIALLY CONVENIENT FOR PATIENTS. HEALTHSOUTH REHABILITATION HOSPITAL - A 42-BED FACILITY THAT INCLUDES PHYSICAL, OCCUPATIONAL, SPEECH AND OTHER THERAPY PROGRAMS IN INDIVIDUALIZED CARE PLANS. THIS PARTNERSHIP BETWEEN THE SYSTEM AND HEALTHSOUTH CORPORATION IS DESIGNED TO PROVIDE COMPREHENSIVE INPATIENT AND OUTPATIENT CARE. HOUSE OF CARE - A HOME-AWAY-FROM-HOME OFFERING LOW-COST LODGING FOR ADULT CANCER PATIENTS AND THEIR FAMILIES WHILE UNDERGOING TREATMENT AT GMC. GEISINGER WYOMING VALLEY MEDICAL CENTER (GWV) IS A 501(C)(3) NOT-FOR-PROFIT CORPORATION THAT IS A 274 LICENSED-BED ACUTE/TERTIARY HOSPITAL AND REGIONAL REFERRAL CENTER SERVING THE HEALTHCARE NEEDS OF NORTHEASTERN PENNSYLVANIA. IT IS AN OPEN STAFF HOSPITAL WITH 861 PHYSICIANS HAVING MEDICAL STAFF PRIVILEGES. LOCATED IN PLAINS TOWNSHIP, NEAR WILKES-BARRE, PA, IT IS APPROXIMATELY 60 MILES NORTHEAST OF DANVILLE. GWV, INCLUDING ITS SOUTH WILKES-BARRE AMBULATORY CAMPUS ("GSWB"), GCMC AND A SERIES OF REGIONAL CLINICS, FORM THE SYSTEM'S NORTHEASTERN HUB. GWV OFFERS AN EXPANDING RANGE OF SERVICES THROUGH MULTIPLE CLINICAL DEPARTMENTS: MEDICINE, SURGERY, ANESTHESIA, ANATOMIC/CLINICAL PATHOLOGY, EMERGENCY MEDICINE, FAMILY PRACTICE, OBSTETRICS AND GYNECOLOGY, PEDIATRICS, NEUROSCIENCES, ONCOLOGY, TRAUMA SERVICES, ORTHOPAEDICS, TRANSPLANT SERVICES AND DIAGNOSTIC IMAGING SERVICES. GWV OPERATES A FULL-TIME HOSPITALIST PROGRAM. THE HOSPITALISTS WORK IN CONJUNCTION WITH ADMITTING AND REFERRING PHYSICIANS TO CARE FOR PATIENTS ADMITTED TO THE MEDICAL CENTER. THE GWV MAIN CAMPUS IS HOME TO THE HENRY CANCER CENTER. THIS FACILITY DEVELOPS CANCER PREVENTION STRATEGIES, CULTIVATES CANCER RESEARCH, AND PROVIDES ACCESS TO ADVANCED TREATMENT AND CLINICAL TRIALS FOR PEOPLE IN NORTHEASTERN PENNSYLVANIA. THE 55,000 SQUARE-FOOT FACILITY IS DEDICATED TO THE MULTI-DISCIPLINARY DELIVERY OF CANCER CARE THROUGH COMPREHENSIVE CONSULTATION, DIAGNOSIS, AND TREATMENT FOR A FULL RANGE OF CANCER RELATED DIAGNOSES INCLUDING HEMATOLOGY, MEDICAL ONCOLOGY AND RADIATION THERAPY. THE PEARSALL HEART HOSPITAL AT GWV OPENED IN 2001. THE THREE-STORY, 48,000 SQUARE-FOOT FACILITY OFFERS A FULL SPECTRUM OF INPATIENT AND OUTPATIENT CARDIAC SERVICES AND RESEARCH AND IS AN ACCREDITED CHEST PAIN CENTER. TREATMENTS PERFORMED AT THE PEARSALL HEART HOSPITAL INCLUDE DIAGNOSTIC CARDIOLOGY, CORONARY ARTERY BY-PASS SURGERY, ADVANCED VALVE REPAIR AND REPLACEMENT, CARDIAC REHABILITATION, ELECTROPHYSIOLOGY, AND A VARIETY OF INTERVENTIONAL CARDIOLOGY PROCEDURES INCLUDING ANGIOPLASTY, ANGIO-JET, AND CARDIAC STENT PLACEMENT. IN THE CURRENT FISCAL YEAR, THE PEARSALL HEART HOSPITAL BEGAN TO OFFER LEFT VENTRICULAR ASSIST DEVICE ("LVAD") SERVICES. THIS SERVICE PROVIDES PATIENTS WHO ARE AT END STAGE OF HEART FAILURE TWO OPTIONS: ACT AS A BRIDGE TO A HEART TRANSPLANT OR PRO-LONG THE PATIENT'S LIFE. THE JANET WEIS CHILDREN'S HOSPITAL PEDIATRICS UNIT AT GWV OPENED IN 2004 AND PROVIDES CHILDREN AND THEIR PARENTS ACCESS TO A FULL-TIME PEDIATRIC HOSPITALIST PROGRAM AND 45 BOARD-CERTIFIED PEDIATRIC SPECIALISTS IN NINE SUBSPECIALTIES. THE MEDICAL CENTER'S OBSTETRICS AND GYNECOLOGY DEPARTMENT IS HOME TO A LICENSED 15-BED NURSERY, TWO OBSTETRIC-OPERATING SUITES, AND A TEAM OF CHILDBIRTH PRACTITIONERS AND EDUCATORS. ADDITIONALLY, A 12 BED NICU OPENED IN NOVEMBER 2011 AND AN EXPANSION OF THE INPATIENT OBSTETRICS AND GYNECOLOGY INPATIENT FACILITIES WAS ALSO COMPLETED IN 2012. IN 2008, A NEW CRITICAL CARE BUILDING WAS OPENE ADDITIONAL INFORMATION FORM 990, SCHEDULE H, PART V, LINE 21 - DID THE HOSPITAL FACILITY CHARGE ANY OF ITS PATIENTS WHO WERE ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY, AND TO WHOM THE HOSPITAL FACILITY PROVIDED EMERGENCY OR OTHER MEDICALLY NECESSARY SERVICES, MORE THAN THE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAD INSURANCE COVERING SUCH CARE? GCMC POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 70% TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WITH INCOME AT 260% TO 380% OF THE FEDERAL POVERTY GUIDELINES, WHICH RESULTS IN AMOUNTS LESS THAN THE AVERAGE OF THREE BEST NEGOTIATED COMMERCIAL RATES. PATIENTS WHO ARE AT LESS THAN 260% OF THE FEDERAL POVERTY GUIDELINES ARE ELIGIBLE TO RECEIVE UP TO A 100% DISCOUNT. FORM 990, SCHEDULE H, PART VI, LINE 7, STATE FILING OF COMMUNITY BENEFIT REPORT: AT THIS TIME, GCMC AND ITS AFFILIATES ARE NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE. true CHILDREN'S ADVOCACY CENTER OF NEPA 1710 MULBERRY STREET SCRANTON PA 18510 232972024 501C3 7500 CASH UNRESTRICTED CONTRIB SCRANTON HALF LLC C/O SCRANTON RUNNING CO THREE WEST OLIVE STREET SCRANTON PA 18508 462965061 501C3 7500 CASH UNRESTRICTED CONTRIB GREATER SCRANTON CHAMBER OF COMMERC 222 MULBERRY STREET SCRANTON PA 18501 240716460 501C6 7315 CASH UNRESTRICTED CONTRIB AMERICAN HEART ASSOCIATION 5455 NORTH HIGH STREET COLUMBUS OH 43214 135613797 501C3 5500 CASH UNRESTRICTED CONTRIB THE COMMONWEALTH MEDICAL COLLEGE 525 PINE STREET SCRANTON PA 18509 260612968 501C3 5500 CASH UNRESTRICTED CONTRIB ALL OTHER ASSISTANCE COMBINED EACH INDIVIDUALLY 5000 OR LESS DANVILLE PA 17822 34985 CASH UNRESTRICTED CONTRIB 4 1 SCHEDULE I, PAGE 4, PART IV COMMUNITY MEDICAL CENTER (CMC) DOES NOT AWARD GRANTS; CMC PROVIDES ASSISTANCE IN THE FORM OF CHARITABLE CONTRIBUTIONS TO 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 CMC. CMC 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 HEALTH NEED. X true true X X X X X X true true false false false false false true false GLENN D STEELE JR MD PHD PRES, CHAIR, DIR. 1065733 1000000 135283 418415 32864 2652295 ANTHONY D AQUILINA DO CMO 330706 94774 18974 64438 19474 528366 DAVID J FELICIO ESQUIRE CLO, SECRETARY 381608 161063 117228 73936 23587 757422 63492 EDWARD J ZYCH ESQUIRE ACLO, ASST SECTY. 258248 59566 21546 44585 22330 406275 KEVIN F BRENNAN CPA FHFMA EVP, FINANCE, CFO 520243 239635 223487 184190 22908 1190463 185631 ROBERT P STEIGMEYER CAO 428517 73141 78415 116718 16060 712851 FRANK J TREMBULAK SR VP, TREASURER 614182 280856 270632 210979 10303 1386952 205970 BARBARA BOSSI VP ANCILLARY 219620 25906 124811 12588 14527 397452 JOHN DITCHKUS CRNA CRNA 245842 991 13477 14837 275147 MARK R TRENTLY CRNA CRNA 240136 535 13418 14832 268921 MICHELLE T BOYLE CRNA CRNA 297381 217 12411 16386 326395 ROSE A SADOWSKI CRNA CRNA 281831 847 13706 5840 302224 GARY SEBASTIANELLI LEAD CRNA 223114 826 12482 14922 251344 JOSEPH B FISNE FORMER OFFICER 100306 8607 5370 2723 117006 ALBERT BOTHE JR MD FORMER OFFICER 544296 177625 230945 184808 12314 1149988 168915 KHALEEL SHAIKH MD PHYSICIAN 396172 16082 14576 14434 441264 SEAN MCANDREW FORMER OFFICER 132187 25918 619 3190 5875 167789 WENDY K WILSON FORMER OFFICER 95248 22511 444 5541 15130 138874 SCHEDULE J, PAGE 1, PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: FROM TIME TO TIME THE GEISINGER HEALTH SYSTEM BOARD OF DIRECTORS OR GEISINGER HEALTH SYSTEM SENIOR MANAGEMENT APPROVE THE GROSS-UP OF EXPENSES WHICH FURTHER GEISINGER HEALTH SYSTEM BUSINESS. SCHEDULE J, PAGE 1, PART I, LINE 4 DAVID J. FELICIO, ESQUIRE 0 63,492 0 KEVIN F. BRENNAN, CPA, FHFMA 0 185,631 0 ROBERT P. STEIGMEYER 17,308 0 0 FRANK J. TREMBULAK 0 205,970 0 ALBERT BOTHE, JR., M.D. 0 168,915 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 4A - SEVERANCE PAYMENT UPON INVOLUNTARY SEPARATION, EMPLOYEES MAY BE ELIGIBLE TO RECEIVE CONTINUATION OF SALARY FOR A TERM THAT IS BASED ON THEIR YEARS OF GEISINGER HEALTH SYSTEM SERVICE AND POSITION. 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. CEPHEID INC BUSINESS 208784 SUPPLIES false GEISINGER ASSURANCE COMPANY LTD BUSINESS 971352 IC SHARED SRVC EXP false GEISINGER MEDICAL MANAGEMENT CORP BUSINESS 2946392 IC SHARED SRVC EXP false GEISINGER-SCA HOLDINGS LLC BUSINESS 535273 DISTRIBUTIONRECEIVED false GEISINGER-SCA HOLDINGS LLC BUSINESS 21880 IC SHARED SRVC REV false SCHEDULE L, PART V COMMUNITY MEDICAL CENTER (CMC), DBA GEISINGER-COMMUNITY MEDICAL CENTER, IS CLOSELY AFFILIATED WITH SEVERAL OTHER ORGANIZATIONS. IN THE NORMAL COURSE OF 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 TYPES OF INTER-ORGANIZATIONAL TRANSACTIONS WERE DESCRIBED TO THE INTERNAL REVENUE SERVICE (IRS) IN A RULING APPLICATION AND WERE RECOGNIZED BY THE NATIONAL OFFICE OF THE IRS IN A SERIES OF PRIVATE LETTER RULINGS AS BEING ENTIRELY CONSISTENT WITH THE ORGANIZATION'S TAX EXEMPT STATUS. THE FOLLOWING ORGANIZATIONS REPRESENT THE AFFILIATED FOR-PROFIT ORGANIZATIONS WITHIN THE GEISINGER HEALTH SYTEM FOR WHOM BUSINESS TRANSACTIONS MUST BE DISCLOSED FOR PURPOSES OF SCHEDULE L PART IV TRANSACTIONS WITH INTERESTED PERSONS: GEISINGER MEDICAL MANAGEMENT CORPORATION GEISINGER ASSURANCE COMPANY, LTD GEISINGER-SCA HOLDINGS, LLC THE FOLLOWING OFFICERS AND/OR DIRECTORS OF COMMUNITY MEDICAL CENTER ARE OFFICERS AND/OR DIRECTORS OF SOME OR ALL OF THESE ORGANIZATIONS: WILLIAM H. ALEXANDER ANTHONY AQUILINA, M.D. DAVID J. FELICIO, ESQUIRE RICHARD A. GRAFMYRE WILLIAM R. GRUVER ROBERT E. POOLE DON A. ROSINI GLENN D. STEELE, M.D., PH.D. ROBERT STEIGMEYER ROBER L. TAMBUR FRANK J. TREMBULAK EDWARD J. ZYCH, ESQUIRE ALBERT BOTHE, M.D., A FORMER OFFICER OF CMC IS ALSO A DIRECTOR FOR GEISINGER ASSURANCE COMPANY, LTD. GLENN D. STEELE, JR., M.D., PH.D., PRESIDENT, CHAIRMAN OF THE BOARD AND DIRECTOR (EX-OFFICIO) IS A DIRECTOR OF CEPHEID, INC. 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 - ORGANIZATION'S MISSION TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING ACCESS TO QUALITY POPULATION HEALTH AND HOSPITAL SERVICES ACROSS NORTHEASTERN PENNSYLVANIA THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE. 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? GEISINGER HEALTH SYSTEM FOUNDATION, PARENT OF THE ORGANIZATION, IS CURRENTLY THE SOLE OBLIGOR UNDER A SERIES OF BOND ISSUES WITH A TOTAL OUTSTANDING BALANCE OF 1,067,897,566 INCLUSIVE OF UNAMORTIZED ORIGINAL ISSUE DISCOUNT AS OF JUNE 30, 2014. BECAUSE THE BOND PROCEEDS ARE DISBURSED TO GEISINGER HEALTH SYSTEM FOUNDATION 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 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. GENERAL INFORMATION COMMUNITY MEDICAL CENTER (CMC), DOING BUSINESS AS GEISINGER-COMMUNITY MEDICAL CENTER (GCMC), IS A TAX-EXEMPT, PENNSYLVANIA NOT-FOR-PROFIT CORPORATION ORGANIZED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. GCMC IS A 297-BED ACUTE CARE HOSPITAL IN SCRANTON, PA. THE HOSPITAL WAS FOUNDED 117 YEARS AGO AT WHICH TIME IT WAS KNOWN AS HAHNEMANN HOSPITAL. THE HOSPITAL WAS SCRANTON'S FIRST AND CURRENTLY ONLY ACUTE CARE HOSPITAL DEDICATED TO SERVING THE COMMUNITY AND THEIR HEALTH NEEDS THROUGH A CHARITABLE PURPOSE. GCMC CONTINUES TO PROVIDE THE COMMUNITY WITH A VARIETY OF SERVICES AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. THIS CONTINUUM OF CARE INCLUDES PREVENTIVE, AMBULATORY, INPATIENT, AND EMERGENCY SERVICES. GCMC IS A NOTED REGIONAL REFERRAL CENTER WITH COMPREHENSIVE ACUTE CARE MEDICAL SERVICES AND HAS DEVELOPED MANY SPECIFIC AREAS OF EXPERTISE. PATIENT ORIGIN AND SERVICE AREA: THE HOSPITAL'S PRIMARY SERVICE AREA IS COMPRISED OF LACKAWANNA COUNTY. THE SECONDARY SERVICE AREAS INCLUDE LUZERNE, MONROE, PIKE, SUSQUEHANNA, WAYNE AND WYOMING COUNTIES. SPECIALIZED / REGIONAL SERVICES, CENTERS OF EXCELLENCE: GCMC IS THE ONLY LEVEL II TRAUMA CENTER IN LACKAWANNA COUNTY. THE NORTHEAST PA TRAUMA CENTER, DESIGNATED BY THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION IN 1988, PROVIDES 24-HOUR COMPREHENSIVE SURGICAL INTERVENTION FOR CRITICALLY INJURED PATIENTS. THE TRAUMA CENTER IS STAFFED CONTINUOUSLY BY AN EMERGENCY PHYSICIAN, TRAUMA SURGEON, AND NURSES CERTIFIED IN CRITICAL CARE, TRAUMA, ORTHOPEDICS, AND THE NEUROSCIENCES. CARDIOLOGY SERVICES AT THE HOSPITAL INCLUDE THE REGION'S FIRST ELECTROPHYSIOLOGY LAB AND AN OPEN HEART SURGERY CENTER. GCMC IS ALSO A CERTIFIED CAROTID STENT FACILITY. GCMC HAS EARNED THE ACTION REGISTRY-GWTG PLATINUM PERFORMANCE ACHIEVEMENT AWARD FOR EIGHT CONSECUTIVE QUARTERS OF QUALITY CARDIOVASCULAR CARE. GCMC ALSO HAS EARNED THE MISSION: LIFELINE BRONZE QUALITY ACHIEVEMENT AWARD FROM THE AMERICAN HEART ASSOCIATION. NEUROLOGICAL SCIENCES AT GCMC SPECIALIZES IN THE CARE OF PEOPLE WITH BRAIN AND SENSE ORGAN DISORDERS. GCMC WAS AWARDED WITH THE AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES BRONZE AWARD. GCMC ALSO EARNED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR CERTIFICATION AS A PRIMARY STROKE CENTER (ONLY ONE OF 54 MEDICAL CENTERS IN PENNSYLVANIA TO OBTAIN THIS). OTHER SPECIALIZED SERVICES INCLUDE: A SAME-DAY SURGERY CENTER, A 24-BED SHORT-TERM PSYCHIATRIC INPATIENT UNIT (THE ONLY ONE IN LACKAWANNA COUNTY), AN ORTHOPEDIC TRAUMA CLINIC, CT SCANNER, MRI IMAGING, ONCOLOGY SERVICES, RENAL DIALYSIS, HYPERBARIC OXYGEN CHAMBER TREATMENTS, THE NEW STEPS JOINT PROGRAM, WOUND CARE, AND STEREOTACTIC SURGERY. GCMC OFFERS EMERGENCY MEDICAL TECHNICIAN AND TRAUMA NURSE TRAINING PROGRAMS. IT HAS AN AFFILIATION WITH THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION. THE WRIGHT CENTER IS AN ACCREDITED PROVIDER OF INTERNAL MEDICINE RESIDENCY EDUCATION BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION. THE WRIGHT CENTER IS ALSO THE REGION'S ONLY PODIATRIC RESIDENCY PROGRAM AND ACCREDITED PROVIDER OF PODIATRIC MEDICINE AND SURGERY EDUCATION BY THE COUNCIL OF PODIATRIC MEDICAL EDUCATION. IN FY 2014, THE UNCOMPENSATED COSTS FOR HEALTH PROFESSIONS EDUCATION TOTALED 1,650,206. GCMC ALSO SPONSORS THE COMMUNITY HEALTH EDUCATION PROGRAM (DETAILED BELOW). THIS PROGRAM IS THE REGION'S FIRST HOSPITAL-BASED AND COMMUNITY-WIDE WELLNESS AND PREVENTION PROGRAM. IN ADDITION, GCMC SPONSORS THE PRIORITY CARE PROGRAM IN WHICH OVER 20,000 SENIOR CITIZENS ARE ENROLLED IN THE REGION'S FIRST HOSPITAL-BASED FREE MEMBERSHIP PLAN FOR PERSONS 55 AND OLDER. PRIORITY CARE PROVIDES SENIOR CITIZENS WITH A WIDE VARIETY OF BENEFITS AND INFORMATION REGARDING HEALTH AND WELLNESS PROGRAMS. PRIORITY CARE OFFERS CONVENIENT ACCESS TO QUALITY SERVICES INCLUDING: -FREE PARKING IN THE GCMC PARKING COMPLEX -COMMUNITY DISCOUNTS -DISCOUNTED MEALS IN THE HOSPITAL'S DINING ROOM -DISCOUNTS IN THE GCMC GIFT SHOP -PHYSICIAN REFERRAL SERVICE AFFILIATIONS: GCMC HAS WORKING RELATIONSHIPS WITH OTHER HEALTH CARE PROVIDERS IN VENTURES SUCH AS THE NORTHEAST SURGERY CENTER AND THE NORTHEASTERN PENNSYLVANIA IMAGING CENTER. GCMC ALSO HAS WORKING RELATIONSHIPS WITH THE CHILDREN'S ADVOCACY CENTER, MATERNAL & FAMILY HEALTH SERVICES, AND THE RONALD MCDONALD HOUSE OF SCRANTON. IN PARTICULAR, GCMC PROVIDES THE CHILDREN'S ADVOCACY CENTER AND MATERNAL & FAMILY HEALTH SERVICES WITH SPACE TO CONDUCT THEIR CHARTABLE PURPOSE FOR FREE. THESE CHARITABLE LEASES WERE VALUED AT 162,406 FOR FY 2014. GCMC ALSO HAS A CONNECTION WITH NUMEROUS AREA INSTITUTIONS, COLLEGES, AND UNIVERSITIES FOR EDUCATIONAL AND CLINICAL PROGRAMS INCLUDING, BUT NOT LIMITED TO, NURSING, MEDICAL TECHNOLOGY, PHYSICAL AND OCCUPATIONAL THERAPY, EMERGENCY MEDICAL TECHNICIANS, PHYSICIAN ASSISTANTS, SOCIAL WORK, AND HEALTHCARE ADMINISTRATION. MEDICAL STAFF: AS OF JUNE 30, 2014, THE MEDICAL STAFF OF GCMC TOTALED 702 PHYSICIANS. UNDER GCMC'S MEDICAL STAFF BY-LAWS, PHYSICIANS MAY HAVE ONE OF SEVERAL TYPES OF PRIVILEGES INCLUDING ACTIVE, COURTESY, CONSULTING, EMERGENCY, AND TEMPORARY. AUXILIARY: THE GCMC AUXILIARY IS COMPRISED OF APPROXIMATELY 60 MEMBERS. FUNCTIONING WITH THE GUIDANCE OF ITS OWN ADVISORY BOARD, THE AUXILIARY IS SPLIT INTO COMMITTEES, EACH OF WHICH HAS THEIR OWN RESPONSIBILITY FOR FUND-RAISING AND SERVICE. THE AUXILIARY ASSISTS IN OPERATING GCMC'S GIFT SHOP ON A DAILY BASIS. ALLOCATIONS OF FUNDS RAISED BY THE AUXILIARY ARE MADE TO GCMC TO ENHANCE PATIENT SERVICES. II. UNCOMPENSATED CARE: GCMC RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND EDUCATION. GCMC PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD GCMC PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A.CHARITY CARE THE PRIMARY CONCERN OF GCMC IS THE DELIVERY OF HEALTH CARE TO ALL THE CITIZENS OF NORTHEASTERN PENNSYLVANIA, REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GCMC INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. THE COST TO GCMC OF PROVIDING THIS CHARITY CARE DURING THE FISCAL YEAR ENDED JUNE 30, 2014 WAS 3,485,380. B.MEDICARE/MEDICAID/OTHER GOVERNMENTAL RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO THE ELDERLY (MEDICARE), THE POOR (MEDICAID), AND OTHER. GCMC PROVIDES CARE BELOW COST TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS. TO THE EXTENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTHCARE, GCMC IS FURTHERING ITS CHARITABLE MISSION. THE UNREIMBURSED VALUE OF MEDICARE, MEDICAID AND OTHER GOVERNMENTAL PAYERS IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. FOR FISCAL YEAR 2014, THE UNREIMBURSED COST OF PROVIDING CARE TO THESE PATIENTS WAS 21,999,409. C.OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GCMC 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, 2014, WAS 642,426. III. COMMUNITY HEALTH, EDUCATION, AND OUTREACH GCMC AND RELATED AFFILIATES PROVIDE A VARIETY OF PROGRAMS TO THE COMMUNITY. THE INTENT OF THESE PROGRAMS IS TO IMPROVE THE HEALTH OF THE COMMUNITY AND PROVIDE FOR COMMUNITY HEALTH NEEDS, E.G. THROUGH ACCIDENT/ILLNESS PREVENTION OR EARLY HEALTH INTERVENTION AS A RESULT OF INCREASED EDUCATION. THE NORTHEAST PA TRAUMA CENTER PROVIDES EMERGENCY PREPAREDNESS ASSISTANCE AND MEDICAL EXPERTISE TO THE AMERICAN RED CROSS LACKAWANNA CHAPTER, LACKAWANNA COUNTY EMERGENCY MANAGEMENT AGENCY, AND THE SCRANTON/WILKES- BARRE INTERNATIONAL AIRPORT. ALSO, FALL AND INJURY PREVENTION FOR THE ELDERLY IS AVAILABLE TO AREA SENIOR CITIZENS AND SENIOR ORGANIZATIONS, AS WELL AS MANY AGE-SPECIFIC PREVENTION PROGRAMS TO VARIOUS ORGANIZATIONS AND SCHOOLS THROUGHOUT THE YEAR. EACH YEAR OVER 500 CHILDREN UNDER THE AGE OF 18 ARE INVOLVED IN EDUCATION'S EXTENSIVE PROGRAMS TARGETING THIS AGE GROUP. TRAUMA PREVENTION PROGRAMS SUCH AS TRAUMA ROOM AND THINK FIRST TEACH KIDS IMPORTANT SAFETY INFORMATION. ASTHMA SKI DAY HELD IN CONJUNCTION WITH MONTAGE MOUNTAIN SKI AREA AND GCMC'S COMMUNITY HEALTH EDUCATION PROGRAM, EMPHASIZING THAT DESPITE ILLNESS, INDIVIDUALS CAN STILL PARTICIPATE IN HEALTHY, EVEN STRENUOUS ACTIVITIES. THIS ACTIVITY WAS PROVIDED AT A COST OF 9,346. MANY OF THESE PROGRAMS ARE THE RESULTS OF EDUCATION'S PARTNERSHIPS WITH OTHER COMMUNITY RESOURCES; E.G., THE AMERICAN LUNG ASSOCIATION, LACKAWANNA COUNTY DRUG AND ALCOHOL COMMISSION, AND ALLIED SERVICES. IN FY 2014, THE TRAUMA CENTER PROVIDED AN ARRAY OF TRAUMA PROGRAMS FOR ABOUT 9,402 OF UNCOMPENSATED COSTS. THE COMMUNITY HEALTH EDUCATION PROGRAM ("LIFECARE") CONDUCTS A WIDE VARIETY OF HEALTHY LIFESTYLE PROGRAMS, FREE OR AT MINIMAL COST, WHICH ARE DESIGNED TO FORM 990, PART V FORM 990, PART V, LINE 1A: ENTER THE NUMBER REPORTED IN BOX 3 OF FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURNS. GEISINGER SYSTEM SERVICES (GSS), AN AFFILIATE OF THE ORGANIZATION, PROVIDES A CENTRALIZED ACCOUNTS PAYABLE FUNCTION FOR ALL ORGANIZATIONS OF THE GEISINGER HEALTH SYSTEM. AS THE ACCOUNTS PAYABLE PROCESSOR, GSS PREPARES AND FILES FORM 1099 UNDER ITS EIN FOR CERTAIN REPORTABLE PAYMENTS OF THE FILING ORGANIZATION. THE NUMBER OF 1099'S FILED BY GSS FOR THE 2013 REPORTING PERIOD ON BEHALF OF ITSELF AND ITS AFFILIATES WAS 2,147. THE RESPONSE ENTERED ON LINE 1A FOR THE ORGANIZATION INCLUDES ONLY THOSE FORM 1099S FILED UNDER THE ORGANIZATION'S EIN. IT DOES NOT INCLUDE THOSE FILED BY GSS ON ITS BEHALF. 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. INCLUDING THE VOTING MEMBER DESCRIBED ABOVE, A TOTAL OF SEVEN VOTING MEMBERS OF THE GOVERNING BODY ARE ALSO VOTING MEMBERS OF RELATED TAXABLE ORGANIZATIONS FOR WHICH BUSINESS TRANSACTIONS, BETWEEN GCMC AND THE RELATED TAXABLE ORGANIZATION ARE REPORTED ON SCHEDULE L, PART IV. HOWEVER, IF THE RELATED TAXABLE ORGANIZATIONS WERE REQUIRED TO FILE SCHEDULE L, THESE TRANSACTIONS WOULD NOT BE OF A TYPE THAT WOULD BE REPORTABLE ON THEIR SCHEDULE L. IN ADDITION, THESE VOTING MEMBERS ARE NOT COMPENSATED BY THE RELATED TAXABLE ORGANIZATIONS FOR WHICH TRANSACTIONS ARE DISCLOSED IN SCHEDULE L, PART IV, DO NOT HAVE AN OWNERSHIP INTEREST IN OR RECEIVE ANY ECONOMIC BENEFIT FROM THE ACTIVITIES OF THESE RELATED TAXABLE ORGANIZATIONS, RECEIVE NO PRIVATE INUREMENT / PRIVATE BENEFIT FROM THE TRANSACTIONS WITH THE RELATED TAXABLE ORGANIZATIONS AND THE VOTING MEMBERS OF THE GOVERNING BODY ABSTAIN FROM VOTING AND ARE ABSENT FROM BOARD DELIBERATIONS AND DECISIONS ON MATTERS IF A CONFLICT EXISTS. REFER TO THE RESPONSE FOR FORM 990, PART VI, SECTION B, QUESTION 12A, 12B, AND 12C REGARDING THE GEISINGER HEALTH SYSTEM CONFLICTS OF INTEREST POLICY, DISCLOSURE, AND ENFORCEMENT. 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, ANTHONY AQUILINA, D.O., DORRANCE R. BELIN, ESQUIRE, E. ALLEN DEAVER, DAVID J. FELICIO, ESQUIRE, RICHARD A. GRAFMYRE, WILLIAM R. GRUVER, FRANK M. HENRY, THOMAS H. LEE, JR., M.D., ROBERT E. POOLE, DON A. ROSINI, GLENN D. STEELE, JR., M.D., PH.D., ROBERT P. STEIGMEYER, 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-COMMUNITY MEDICAL CENTER. 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 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 THEIR 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, PAYROLL, 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, 2014. FORM 990, PAGE 6, PART VI, LINE 12C THE OFFICERS AND DIRECTORS OF COMMUNITY MEDICAL CENTER 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 REVIEWED 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 2: 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 RECONCILIATION OF DEFINED BENEFIT PLAN 1,081,112 GAIN FROM INVESTMENT IN AFFILIATE GSCA 590,671 EQUITY TRANSFER FROM AFFILIATE MDI 5,049,081 EQUITY TRANSFER GEISINGER HEALTH SYS FND 4,381,843 EQUITY TRANSFER GCMCHS 144,489 ---------------- TOTAL 11,247,196 MEDICAL DIMENSIONS, INC., AN AFFILIATE OF COMMUNITY MEDICAL CENTER, WAS DISOLVED EFFECTIVE JUNE 30, 2014. THE REMAINING ASSETS, LIABILITIES, AND NET ASSETS WERE TRANSFERRED TO COMMUNITY MEDICAL CENTER EFFECTINE JUNE 30, 2014, RESULTING IN AN INCREASE IN NET ASSTES OF 5,049,081. COMMUNITY MEDICAL CENTER PROVIDED EMPLOYEES WITH A DEFINED BENEFIT PENSION PLAN, A NON-CONTRIBUTORY PLAN THAT WAS FROZEN IN 1994. CMC'S LIABILITY IS DETERMINED ANNULLY BY AN ACTUARY BASED ON VESTED EMPLOYEE DEMOGRAPHICS, CURRENT INTEREST RATES, AND THE VALUE OF THE PLAN'S ASSETS. THE RESULT OF THE ACTUARIAL ESTIMATE OF CMC'S LIABILITY RESULTED IN AN INCREASE IN NET ASSTES OF 1,081,112. 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 CARE INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232429776 PHYSICIAN PA 501C3 9 GHSF true MEDICAL DIMENSIONS INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232369788 RE HOLDIN PA 501C2 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 BLOOMSBURG PHYSICIANS SERVICES 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232979856 PHYSICIAN 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 COLUMBIA-MONTOUR HOME HLTH SERVICES 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231704399 HOME HEALT PA 501C3 9 GHSF true LEWISTOWN HEALTHCARE FOUNDATION 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232344363 PHILANTHRO PA 501C3 11A GHSF true GEISINGER-LEWISTOWN HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231352187 HOSPITAL PA 501C3 3 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 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 CMC RELATED 837168 6390155 false true 0.51000 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 true false true false false false false false false false true true true false false true false false true COMMUNITY MEDICAL CARE INC A 29559 FMV COMMUNITY MEDICAL CARE INC L 5742882 GAAP COMMUNITY MEDICAL CTR HEALTHCARE SY C 144489 GAAP GEISINGER ASSURANCE COMPANY LTD M 971352 GAAP GEISINGER CLINIC L 1778901 GAAP GEISINGER CLINIC M 5422930 GAAP GEISINGER CLINIC A 475540 FMV GEISINGER COMMUNITY HEALTH SERVICES L 388371 GAAP GEISINGER HEALTH PLAN L 29558416 GAAP GEISINGER HEALTH PLAN P 3073643 GAAP GEISINGER HEALTH SYSTEM FOUNDATION C 4300000 GAAP GEISINGER HEALTH SYSTEM FOUNDATION L 80004 GAAP GEISINGER HEALTH SYSTEM FOUNDATION L 13712 GAAP GEISINGER HEALTH SYSTEM FOUNDATION C 81843 GAAP GEISINGER INSURANCE CORPORATIONRRG P 19704 GAAP GEISINGER INSURANCE CORPORATIONRRG P 520907 GAAP GEISINGER MEDICAL CENTER L 952 GAAP GEISINGER MEDICAL CENTER M 1277690 GAAP GEISINGER MEDICAL MANAGEMENT CORP M 6645 GAAP GEISINGER MEDICAL MANAGEMENT CORP M 2939747 GAAP GEISINGER SYSTEM SERVICES M 13851525 GAAP GEISINGER SYSTEM SERVICES L 34342 GAAP GEISINGER SYSTEM SERVICES P 10378 GAAP GEISINGER WYOMING VALLEY MED CTR M 703400 GAAP GEISINGER-SCA HOLDINGS LLC L 21880 GAAP GEISINGER-SCA HOLDINGS LLC C 535273 GAAP GESINGER WYOMING VALLEY MED CTR L 79618 GAAP MEDICAL DIMENSIONS INC K 392000 FMV MEDICAL DIMENSIONS INC L 270000 GAAP MEDICAL DIMENSIONS INC S 5049081 GAAP MOUNTAIN VIEW NURSING HOME INC L 1220152 GAAP MOUNTAIN VIEW NURSING HOME INC M 1742 GAAP SCHEDULE R FORM 990, SCHEDULE R, PART V - TRANSACTIONS WITH RELATED ORGANIZATIONS: AS SHOWN IN THE RESPONSE TO FORM 990, SCHEDULE R, COMMUNITY MEDICAL CENTER 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 INTER ORGANIZATION 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. ___________________________________________________________________________