2014-11-13T14:30:13-06:00 2013-12-31 381357951 PLANTE & MORAN PLLC 65 EAST STATE ST STE 600 COLUMBUS OH 43215 990 2013-01-01 311480941 GENESIS HEALTHCARE SYSTEM GENE 7404545000 2951 MAPLE AVENUE ZANESVILLE OH 43701 PAUL MASTERSON CFO 7404545000 2014-11-12 1 BERNIE OSTROWSKI P00366367 6148493000 2013 2015-11-30 17:44:51Z MATTHEW PERRY 2951 MAPLE AVENUE ZANESVILLE OH 43701 360062486 0 3727 X WWW.GENESISHCS.ORG X 1997 OH IN 1997, GOOD SAMARITAN MEDICAL CENTER AND BETHESDA HOSPITAL ASSOCIATION, A TAX-EXEMPT COMMUNITY HOSPITAL ALSO LOCATED IN ZANESVILLE, AFFILIATED TO FORM GENESIS HEALTHCARE SYSTEM. GENESIS HAS BEEN GRANTED 501C3 STATUS AS A HOSPITAL. ALL HOSPITAL OPERATIONS AND ASSETS OF GOOD SAMARITAN MEDICAL CENTER WERE TRANSFERRED TO GENESIS WITH THE EXCEPTION OF CERTAIN INVESTMENTS. GOOD SAMARITAN MEDICAL CENTER WILL CONTINUE TO HAVE CONTROL OVER CERTAIN INVESTMENTS WHICH ARE BEING USED BY THE GENESIS HEALTHCARE SYSTEM IN FULFILLING ITS TAX-EXEMPT PURPOSE. 13 9 3173 404 592310 -300449 369745 370113 336634385 338078219 3570462 6550579 15148859 14167794 355723451 359166705 40000 110000 0 0 154196929 156097798 0 0 0 171023118 183236127 325260047 339443925 30463404 19722780 280222455 542428772 142100697 379542394 138121758 162886378 X TO PROMOTE CHARITABLE SUPPORT FOR GENESIS HEALTHCARE SYSTEM AS WE SHARE ITS MISSION TO PROVIDE COMPASSIONATE, QUALITY HEALTHCARE. 0 0 182338755 110000 139506283 GENESIS PROVIDES ACUTE CARE SERVICES INCLUDING MEDICAL, SURGICAL, OBSTETRICAL, PEDIATRIC AND CRITICAL CARE. THE MEDICAL/SURGICAL UNITS ARE STAFFED AT BOTH CAMPUSES FOR A COMBINED TOTAL OF 237 BEDS. TOTAL PATIENTS DISCHARGED FROM THESE UNITS IN 2013 WERE 13,208. OBSTETRICS STAFFS A TOTAL OF 24 BEDS AT THE BETHESDA CAMPUS AND DISCHARGED 1,461 PATIENTS FOR A TOTAL OF 1,405 BIRTHS. THE PEDIATRIC UNIT IS LOCATED AT THE BETHESDA CAMPUS WITH 10 BEDS AND HAD 272 DISCHARGES IN 2013. THERE ARE 21 CRITICAL CARE BEDS BETWEEN THE TWO CAMPUSES AND DISCHARGED 363 PATIENTS DURING THE YEAR AND 25 CARDIOVASCULAR BEDS IN A UNIT LOCATED ON THE GOOD SAMARITAN CAMPUS WITH 1,519 DISCHARGES IN 2013. THERE IS ALSO A CANCER UNIT ON THE GOOD SAMARITAN CAMPUS WITH 15 BEDS AND 815 DISCHARGES IN 2013 AND AN ORTHOPAEDIC UNIT WITH 6 BEDS AND 611 DISCHARGES IN 2013.GENESIS PROVIDES A WIDE RANGE OF DIAGNOSTIC AND SUPPORT SERVICES ON BOTH CAMPUSES FOR INPATIENTS AND OUTPATIENTS. THESE SERVICES ARE COMPRISED OF LABORATORY, IMAGING SERVICES, CARDIAC, AND PHARMACY. LABORATORY SERVICES INCLUDE CHEMISTRY, PATHOLOGY, MICROBIOLOGY, HEMATOLOGY, AND CYTOLOGY FOR TOTAL VOLUMES IN 2013 OF 1,406,200. IMAGING SERVICES INCLUDES RADIOLOGY, NUCLEAR MEDICINE, MRI, ULTRASOUND, CT SCAN, AND PET SCAN WITH TOTAL VOLUMES OF 157,459. PHARMACY PRESCRIPTIONS TOTALED 6,972,019.GENESIS PROVIDES BEHAVIORAL HEALTH SERVICES FOR PSYCHIATRIC ADULTS ON AN OPEN UNIT AND A PROTECTED UNIT. THERE ARE 8 PSYCHIATRIC INTENSIVE TREATMENT BEDS LOCATED WITHIN THE PROTECTED UNIT. WE HAVE A 14-BED CHILD/ADOLESCENT INPATIENT UNIT, WHICH IS PROTECTED. INPATIENT DETOXIFICATION SERVICES ARE PROVIDED AS WELL AS OUTPATIENT DRUG AND ALCOHOL SERVICES. THERE ARE PARTIAL HOSPITAL PROGRAMS FOR CHILDREN, ADOLESCENTS, ADULTS AND A DUALLY DIAGNOSED PARTIAL PROGRAM FOR ADOLESCENTS. A FULL RANGE OF THERAPEUTIC SERVICES IS OFFERED INCLUDING ART, MUSIC, RECREATION AND OCCUPATIONAL THERAPY. OTHER MISCELLANEOUS PROGRAMS INCLUDE DUI SCHOOL, SHOP LIFTING DIVERSION, UNDERAGECONSUMPTION SCHOOLS AND CLASSES FOR DIVORCING PARENTS AND CHILDREN OF DIVORCE. TOTAL INPATIENTS TREATED IN 2013 WERE 1,721. 40310842 0 112726068 CARDIAC SERVICES - GENESIS PROVIDES CARDIAC SERVICES INCLUDING AN OPEN-HEART SURGERY PROGRAM. THE MOST COMMON OPEN-HEART SURGERY PERFORMED AT GENESIS IS CORONARY ARTERY BYPASS GRAFTING . HOWEVER, OUR BOARD-CERTIFIED SURGEONS PERFORM SEVERAL HEART AND LUNG SURGICAL PROCEDURES. THE TOTAL NUMBER OF CARDIAC CASES TREATED IN 2013 WERE 2,683. 18017875 0 50385556 RESPIRATORY SERVICES - GENESIS TREATS A LARGE VOLUME OF RESPIRATORY CASES ON INPATIENT BASIS. THIS INCLUDES PATIENTS WITH CHRONIC LUNG DISEASE AS WELL AS PNEUMONIA PATIENTS. THE TOTAL NUMBER OF INPATIENT RESPIRATORY CASES TREATED IN 2013 WERE 2,208. 14855133 0 41404875 ORTHOPEDIC SERVICES - GENESIS HAS COMBINED SEVERAL SERVICES INTO A COMPLETE ORTHOPEDIC PROGRAM. GENESIS HAS SPECIALLY EQUIPPED OPERATING ROOMS, A DEDICATED INPATIENT UNIT, AN ORTHOPEDIC REHAB PROGRAM, A SKILLED NURSING FACILITY AND SPORTS MEDICINE SERVICES. BUT THE MOST IMPORTANT ELEMENT IS A COMMITMENT TO EXCELLENCE IN CLINICAL QUALITY, MADE POSSIBLE BY A TEAM OF WELL-TRAINED AND DEDICATED STAFF. THE TOTAL NUMBER OF ORTHOPEDIC INPATIENT CASES TREATED IN 2013 WERE 1,240.GRANTS WERE PAID TO GENESIS HEALTHCARE FOUNDATION TO HELP FURTHER THE RELATED TAX-EXEMPT ORGANIZATION'S PURPOSE. GENESIS PROVIDES BEHAVIORAL HEALTH SERVICES FOR PSYCHIATRIC ADULTS ON AN OPEN UNIT AND A PROTECTED UNIT. THERE ARE 8 PSYCHIATRIC INTENSIVE TREATMENT BEDS LOCATED WITHIN THE PROTECTED UNIT. WE HAVE A 14-BED CHILD/ADOLESCENT INPATIENT UNIT, WHICH IS PROTECTED. INPATIENT DETOXIFICATION SERVICES ARE PROVIDED AS WELL AS OUTPATIENT DRUG AND ALCOHOL SERVICES. THERE ARE PARTIAL HOSPITAL PROGRAMS FOR CHILDREN, ADOLESCENTS, ADULTS AND A DUALLY DIAGNOSED PARTIAL PROGRAM FOR ADOLESCENTS. A FULL RANGE OF THERAPEUTIC SERVICES IS OFFERED INCLUDING ART, MUSIC, RECREATION AND OCCUPATIONAL THERAPY. OTHER MISCELLANEOUS PROGRAMS INCLUDE DUI SCHOOL, SHOP LIFTING DIVERSION, UNDERAGECONSUMPTION SCHOOLS AND CLASSES FOR DIVORCING PARENTS AND CHILDREN OF DIVORCE. TOTAL INPATIENTS TREATED IN 2013 WERE 1,721. 14855133 41404875 255522605 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 352 0 1 3173 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 13 9 0 1 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 OH X MARTI NASH 7404545000 2951 MAPLE AVENUE ZANESVILLE OH 43701 WALTER OFFINGER VICE CHAIR 2.50 0.00 X X 0 0 0 JODY BALLAS CHAIR 3.60 0.00 X X 0 0 0 JERRY NOLDER TREASURER 3.70 0.00 X X 0 0 0 MARK MOYER EX-OFFICIO 2.80 0.00 X 0 0 0 SR LAURA WOLF EX-OFFICIO 2.70 0.20 X 0 0 0 RANDY COCHRANE SECRETARY 2.10 0.40 X X 0 0 0 THOMAS DIEHL MD TRUSTEE 40.00 0.00 X 322513 0 15160 ROBERT KESSLER TRUSTEE 3.30 0.00 X 0 0 0 ERIC NEWSOM MD TRUSTEE 40.00 0.00 X 466127 0 15708 JAMES MCDONALD TRUSTEE 2.70 0.40 X 0 0 0 ERIN WELCH TRUSTEE 1.20 0.00 X 0 0 0 WALTER WIELKIEWICZ MD TRUSTEE 40.00 0.00 X 203790 0 35305 MAX CROWN TRUSTEE 1.20 0.40 X 0 0 0 MATTHEW PERRY CHIEF EXEC OFFICER 36.40 3.60 X 665548 0 93230 PAUL MASTERSON CHIEF FINANCIAL OFFICER 35.60 4.40 X 420736 0 67676 RICHARD HELSPER CHIEF OPER OFFICER 40.00 0.00 X 398157 0 3891 CASSANDRA PALMER CHIEF HR OFFICER (THRU AUGUST) 40.00 0.00 X 315817 0 265517 EDMOND ROMITO CHIEF INFOR OFFICER 40.00 0.00 X 314774 0 22413 ALAN BURNS CHIEF DEVELOPMENT OFFICER 40.00 0.00 X 358724 0 55642 PATRICIA CAMPBELL CHIEF NURSING OFFICER (THRU AUGUST) 39.90 0.10 X 314897 0 241784 REGINA PENNINGTON CHIEF QUALITY OFFICER 39.90 0.10 X 249559 0 85653 DANIEL SCHEERER MD CHIEF MEDICAL AFFAIRS OFFI 40.00 0.00 X 324674 0 16595 ABBY NGUYEN DIRECTOR OF NURSING AND CL 40.00 0.00 X 162898 0 22969 DIANNA LEVECK DIRECTOR OF HUMAN RESOURCE 40.00 0.00 X 178687 0 17110 CHARLES ADAMS JR DIRECTOR OF LEAN SIGMA 40.00 0.00 X 155177 0 13220 RAY RYMAN CLINICAL PHARMACIST 40.00 0.00 X 146785 0 22247 GREGORY PETE HAMILTON DIRECTOR OF PHARMACY SERVI 40.00 0.00 X 143128 0 27866 MICHAEL NORMAN DIRECTOR OF FIN AND REIMB SVCS 40.00 0.00 X 141820 0 10160 SHARON PARKER DIRECTOR OF CANCER SERVICES 40.00 0.00 X 153045 0 19228 5436856 0 1051374 53 0 1 0 ZANESVILLE ANESTHESIA PHYSICIANS INC 37 S SEVENTH ST ZANESVILLE OH 43701 MEDICAL SERVICES 3268816 ACCENTURE LLC 161 CLARK ST CHICAGO IL 60601 CONSULTING 2313901 CARDIAC ANESTHESIA ASSOC 800 FOREST AVE ZANESVILLE OH 43701 MEDICAL SERVICES 1535641 BRICKER & ECKLER LLP 500 CHIPETA WAY SALT LAKE CITY UT 84108 MEDICAL SERVICES 1507984 ADVIZEX TECHNOLOGIES LLC 860 BETHESDA DR ZANESVILLE OH 43701 MEDICAL SERVICES 1180420 50 43250 201692 125171 370113 NET PATIENT SERVICES 621110 337489697 337489697 PASSTHROUGH INCOME 621110 588522 588522 338078219 6192400 6192400 -384080 -384080 937276 895781 41495 41495 41495 742259 0 742259 742259 742259 EHR TECHNOLOGY INCOME 621110 3583370 3583370 CAFETERIA SALES 621110 3542368 99868 3442500 OCCUPATIONAL HEALTH 621110 1388275 1388275 5612286 1254471 492442 3865373 14126299 359166705 344304335 592310 13899947 110000 110000 116809726 81788096 35021630 8080057 5657515 2422542 22772982 15945245 6827737 8435033 5906063 2528970 1302914 818328 484586 2061723 2061723 384097 384097 28691271 13961433 14729838 307685 307685 10745479 4677840 6067639 6365744 1107797 5257947 4531419 3026988 1504431 836777 315762 521015 2193238 2193238 21196590 18967520 2229070 1046632 1032501 14131 MEDICAL SUPPLIES 62722139 62722139 BAD DEBT EXPENSE 27997179 27997179 0 PHYSICIAN RECRUITMENT 3300516 3300516 0 LAB REFERENCE FEES 1338387 1338387 8214337 4348373 3865964 339443925 255522605 83921320 0 1883985 6647860 7327947 5111085 855000 856733 58598927 59913257 5021209 5138075 10919798 10874232 368039099 222314657 104953576 145724442 66651933 78459192 14274732 13443621 1703129 1703129 8032219 214557146 280222455 542428772 31164867 42006589 7702912 6865423 57017747 301754826 46215171 28915556 142100697 379542394 X 138121758 162886378 138121758 162886378 280222455 542428772 X 19722780 5177712 -135872 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 150071 0 1 19882 169953 0 PART II-B, LINE 1: GENESIS HEALTHCARE SYSTEM PAYS MEMBERSHIP DUES TO THE FOLLOWING ORGANIZATIONS. A PORTION OF THE DUES ARE RELATED TO LOBBYING ACTIVITIES. FSCC HEALTHCARE MINISTRY (FOR CHA): 3.31% OF $7,865 ($260) CATHOLIC CONFERENCE OF OHIO: 5.3% OF $858 ($45) OHIO HOSPITAL ASSOCIATION (OHA): 5.3% OF $75,693($4,012) FSCC HEALTHCARE MINISTRY (FOR AHA): 23.65% OF $51,874 ($12,268) AMERICAN ACADEMY OF SLEEP MEDICINE: 7.0% OF $2,200 ($154) HIMSS: 4.01% OF $3,175 ($127) AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES: 1.0% OF $1,125 ($11) AMERICAN COLLEGE OF RADIATION ONCOLOGY: 2.0% OF $255 ($5) AMERICAN HEALTH INFORMATION MANAGEMENT ASSOCIATION: 1.5% OF $1,110 ($17) AMERICAN ORGANIZATION OF NURSE EXECUTIVES: 10.0% OF $220 ($22) ASSOCIATION OF COMMUNITY CANCER CTS (ACCC): 6.0% OF $1,150 ($69) CLINICAL LABORATORY MANAGEMENT ASSOCIATION: 15.0% OF $195 ($29) MEDICAL GROUP MANAGEMENT ASSOCIATION: 15.0% OF $1,095 ($164) NATIONAL QUALITY FORUM: 7.71% OF $5,250 ($405) SOCIETY FOR HUMAN RESOURCE MANAGEMENT: 7.0% OF $345 ($24) SOCIETY OF THORACIC SURGEONS: 17.0% OF $3,200 ($544) TRAUMA CENTER ASSOCIATION OF AMERICA: 29.0% OF $2,000 ($580) ZANESVILLE- MUSKINGUM CO. CHAMBER OF COMMERCE: 10.0% OF $5,000 ($500) OHIO HOSPICE AND PALLIATIVE CARE ORG: 7.0% OF $6,500 ($455) NATIONAL HOSPICE AND PALLIATIVE ORG: 3.03% OF $6,264 ($190) IN ADDITION, GENESIS HEALTHCARE SYSTEM PAID MATTHEW KALLNER, LOBBYIST, $7,000 DURING THE YEAR FOR GENERAL LOBBYING RELATING TO OHIO STATEHOUSE ISSUES. THE FIRM WILLIAMS AND JENSEN WAS PAID $14,499 FOR SERVICES IN RELATION TO BUILDING AND STRENGTHENING RELATIONSHIPS WITH OHIO MEMBERS OF CONGRESS AND OTHER RELEVANT MEMBERS AND THEIR STAFFS. GENESIS HEALTHCARE SYSTEM PAID SECOND CAPITAL CONSULTING, LLC $127,631 PLUS $941 IN REIMBURSED EXPENSES TO MIKE BENNETT, PRINCIPAL. SECOND CAPITAL CONSULTING, LLC PROVIDED GENESIS HEALTHCARE SYSTEM GOVERNMENT RELATIONS SERVICES INCLUDING OUTREACH AND ADVOCACY PRIMARILY AT THE STATE AND LOCAL LEVELS IN 2013. ISSUES AT THE LOCAL LEVEL INCLUDED WORKING WITH CITY OFFICIALS REGARDING THE HOSPITAL CONSOLIDATION PROJECT INVOLVING ZONING CODE VARIANCES FOR PARKING, WATER TAP FEES AND TRANSPORTATION INGRESS AND EGRESS FOR PATIENTS, FAMILIES AND THE PUBLIC RELATED TO A SECOND ENTRANCE TO ITS BETHESDA CAMPUS. STATE ISSUES INCLUDED MEDICAID EXPANSION, TRANSPORTATION FUNDING AND MONITORING OF GENERAL HEALTHCARE RELATED ISSUES. FEDERALLY, THE ORGANIZATION WORKED PRIMARILY THROUGH NATIONAL HEALTHCARE ASSOCIATIONS IN WHICH IT MAINTAINED MEMBERSHIP AND COMMUNICATED WITH LOCAL CONGRESSIONAL DELEGATION REGARDING ISSUES OF PHARMACEUTICAL ACCESS FOR INDIGENT PATIENTS (340B PROGRAM), RAC AUDIT APPEAL DELAYS AND STAGE TWO MEANINGFUL USE CRITERIA FOR ELECTRONIC MEDICAL RECORDS. 7904309 7904309 52717577 40520394 12197183 3765989 1299926 2466063 299854181 177204054 122650127 3797043 3290283 506760 145724442 DEBT SERVICE FUNDS 3860142 UNAMORTIZED BOND ISSUE COSTS 4762317 INVESTMENTS IN RELATED AND OTHER HEALTHCARE ORGANIZATIONS 4410256 ASSETS LIMITED AS TO USE 201524431 214557146 ACCRUED MINIMUM PENSION LIABILITY 27868335 ACCRUED PROFESSIONAL LIABILITY 2224691 COST REPORT SETTLEMENT PAYABLE -1177470 28915556 X PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER APPLICABLE TAX AUTHORITIES. MANAGEMENT HAS ANAYLZED THE TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2013 AND 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER THERE ARE CURRENLTY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES THAT IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO FISCAL YEAR 2010. 1 1 X 1 X 1 X 1 1 0 1 1 10996028 4559347 6436681 0.02070 51830098 41306257 10523841 0.03380 62826126 45865604 16960522 0.05450 20 31586 890795 48358 842437 0.00270 1 121 10496 10496 0.00000 4314448 4015937 298511 0.00100 1 6250 6250 0.00000 22 31707 5221989 4064295 1157694 0.00370 22 31707 68048115 49929899 18118216 0.05820 58 58 0.00000 58 58 0 27997179 749386 93012114 87410295 5601819 X 1 1 2 1 GOOD SAMARITAN HOSPITAL 800 FOREST AVE ZANESVILLE OH 43701 X X X ACUTE CARE HOSPITAL 2 BETHESDA HOSPITAL 2951 MAPLE AVE ZANESVILLE OH 43701 X X X ACUTE CARE HOSPITAL GOOD SAMARITAN HOSPITAL 1 1 X X X X X X X X X 13 1 1 1 X HTTP://WWW.GENESISHCS.ORG X X X X X X X X 0 0 1 1 100.000000000000 1 300.000000000000 1 X X 1 1 X X X X X 1 0 X X 1 X 0 0 BETHESDA HOSPITAL 2 1 X X X X X X X X X 13 1 1 1 X HTTP://WWW.GENESISHCS.ORG X X X X X X X X 0 0 1 1 100.000000000000 1 300.000000000000 1 X X 1 1 X X X 1 0 X X 1 X 0 0 GOOD SAMARITAN HOSPITAL PART V, SECTION B, LINE 7: HTTP://WWW.GENESISHCS.ORG/ABOUT-US/NOT-FOR-PROFIT-STATUS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/IMPLEMENTATION-STRATEGY/ BETHESDA HOSPITAL PART V, SECTION B, LINE 7: HTTP://WWW.GENESISHCS.ORG/ABOUT-US/NOT-FOR-PROFIT-STATUS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/IMPLEMENTATION-STRATEGY/ GOOD SAMARITAN HOSPITAL PART V, SECTION B, LINE 20D: FAP PATIENTS ARE PROVIDED A MINIMUM DISCOUNT OF 40%. THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE ARE THE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE. BETHESDA HOSPITAL PART V, SECTION B, LINE 20D: FAP PATIENTS ARE PROVIDED A MINIMUM DISCOUNT OF 40%. THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE ARE THE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE. 5 HOSPICE & PALLIATIVE CARE 713 FOREST AVENUE ZANESVILLE OH 43701 HOSPICE & PALLIATIVE CARE CENTER RADIATION ONCOLOGY 817 FOREST AVENUE ZANESVILLE OH 43701 OUTPATIENT RADIATION TREATMENT CENTER CTR FOR OUTPATIENT & OCCUPATIONAL REHAB 740 ADAIR AVENUE ZANESVILLE OH 43701 OUTPATIENT REHAB SERVICES HEALTHPLEX 2800 MAPLE AVENUE ZANESVILLE OH 43701 OUTPATIENT LAB, IMAGING, & URGENT CARE SERVICES BETHESDA PHYSICIAN'S PAVILION 945 BETHESDA DRIVE ZANESVILLE OH 43701 OUTPATIENT CARDIAC REHAB SERVICES PART I, LINE 7: COSTS OF CHARITY CARE AND COMMUNITY BENEFIT ACTIVITIES WERE CALCULATED USING THE HOSPITAL'S COST ACCOUNTING SYSTEM.PART I, LINE 7, COLUMN (F): PERCENTAGE OF TOTAL EXPENSES WAS CALCULATED BASED ON TOTAL EXPENSES LESS BAD DEBT EXPENSE AS REPORTED ON FORM 990, PART IX. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 27,997,179. PART II, COMMUNITY BUILDING ACTIVITIES: GENESIS HAS AN ACTIVE PRESENCE ON MANY COMMITTEES INVOLVED IN FINDING LOW COST SOLUTIONS TO PHYSICAL AND MENTAL HEALTH ISSUES PREVALENT IN OUR COMMUNITIES, WITH PARTICULAR FOCUS ON SERVING LOW-INCOME, UNINSURED OR OTHERWISE UNDERSERVED. GENESIS NURSES, THERAPISTS, DIABETES COUNSELORS, ADMINISTRATORS AND OTHER PROFESSIONALS PARTICIPATE IN COMMUNITY COALITIONS AND PREVENTION PROGRAMS, PRIMARILY WITH A FOCUS ON DIABETES, DOMESTIC VIOLENCE, FAMILY SERVICES AND WELLNESS INITIATIVES. PART III, LINE 4: THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO CHARITY CARE WAS ESTIMATED BASED UPON BAD DEBT A/R RECLASSIFIED IN 2013 TO CHARITY WITH SERVICE DATES OF 2012 AND PRIOR. BAD DEBT COST IS CALCULATED USING GROSS CHARGES. THE FINANCIAL STATEMENT FOOTNOTE RELATED TO BAD DEBT IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENT FOOTNOTE 1 "NATURE OF BUSINESS AND SIGNIFICANT ACCOUNTING POLICIES" GROUPED WITH ACCOUNTS RECEIVABLE ON PAGE 8. PART III, LINE 8: CALCULATION WAS BASED ON THE MEDICARE COST TO CHARGE RATIO. PART III, LINE 9B: SELF-PAY ACCOUNTS RECEIVE ONE STATEMENT BEFORE GOING TO PRE-COLLECTION (APPROXIMATELY 30 DAYS). ALL ACCOUNTS ARE ELECTRONICALLY SCREENED FOR FAP ONCE AT PRE-COLLECT STATUS AND ADJUSTMENTS ARE POSTED ELECTRONICALLY BACK IN EPIC. ACCOUNTS STAY IN PRE-COLLECT FOR 60 DAYS UNLESS ACCOUNT HAS BEEN PAID OR REGULAR PAYMENT ARRANGEMENTS ARE ESTABLISHED. ACCOUNTS GO TO FULL COLLECTION AFTER DAY 90 IF NO PRIOR ARRANGEMENTS HAVE BEEN MADE. EACH OF THE COLLECTION AGENCIES IS INSTRUCTED TO MAKE PHONE CALLS AND SEND LETTERS. IF THEY CANNOT RESOLVE THE BALANCE, OR HAVE NOT BEEN ABLE TO MAKE PAYMENT ARRANGEMENTS, IT IS SENT BACK TO GENESIS AS NON-COLLECTIBLE IN 180 DAYS.COLLECTION PRACTICES DO NOT APPLY TO ACCOUNT BALANCES KNOWN TO QUALIFY FOR CHARITY. PART VI, LINE 2: GENESIS HEALTHCARE SYSTEM, AS A NOT-FOR-PROFIT HEALTH CARE SYSTEM, IS DEDICATED TO MEETING THE HEALTH NEEDS OF OUR COMMUNITIES, REGARDLESS OF ONE'S ABILITY TO PAY. WE ENCOURAGE AND SUPPORT COLLABORATION WITH OTHER COMMUNITY PARTNERS TO IDENTIFY, RESPOND TO AND STRIVE TO IMPROVE THE HEALTH-RELATED NEEDS OF THE POOR, THE UNDERSERVED, AND THE COMMUNITY AT LARGE. WE PLEDGE ALL AVAILABLE FINANCIAL RESOURCES - AFTER OUR OPERATING EXPENSES ARE MET - TO RESPOND TO THE COMMUNITY'S HEALTH NEEDS WITH SERVICE INITIATIVES, FINANCIAL AND PROFESSIONAL SUPPORT, AND EDUCATION AND WELLNESS PROGRAMS.THE COMMUNITY BENEFIT COMMITTEE COLLABORATES WITH GENESIS ADMINISTRATION AND DEPARTMENTS AND WITH COMMUNITY AGENCIES IN OUR DEFINED GEOGRAPHIC MARKET, INCLUDING BUT NOT LIMITED TO THE PUBLIC HEALTH DEPARTMENT, MUSKINGUM VALLEY HEALTH CENTERS, AND THE UNITED WAY, TO ASSESS COMMUNITY HEALTH NEEDS AND STRENGTHS; DEVELOP A COMMUNITY BENEFIT PLAN WITH STRATEGIC GOALS AND INTERVENTIONS; MONITOR IMPLEMENTATION OF COMMUNITY BENEFIT ACTIVITIES; EVALUATE COMMUNITY BENEFIT ACTIVITIES; ADVOCATE FOR THE COMMUNITY BENEFIT PROGRAMS; AND ASSIST IN TELLING THE GENESIS COMMUNITY BENEFIT STORY. PART VI, LINE 3: GENESIS HAS SIGNAGE STRATEGICALLY LOCATED IN THE FACILITY (REGISTRATION AREAS AND CASHIER AREAS) ADVISING OF FREE CARE. BILLING STATEMENTS ALSO CONTAIN THIS INFORMATION ALONG WITH A CHARITY CARE APPLICATION PRINTED ON THE REVERSE SIDE OF THE BILL. THE INFORMATION IS ALSO AVAILABLE ON OUR WEBSITE. WE HAVE RESOURCE COUNSELORS THAT WORK IN THE EMERGENCY DEPARTMENT TO SCREEN PATIENTS FOR CHARITY ASSISTANCE AND LOOK FOR POTENTIAL MEDICAID QUALIFIERS. FOR INPATIENTS, WE ALSO HAVE A THIRD PARTY THAT SCREENS SELF-PAYS, UNDERINSURED AND MEDICARE ONLY PATIENTS FOR MEDICAID AND/OR CHARITY. PART VI, LINE 4: OUR GEOGRAPHIC MARKET AREA IS A SIX-COUNTY RURAL REGION OF SOUTHEAST OHIO, INCLUDING MUSKINGUM, MORGAN, PERRY, COSHOCTON, GUERNSEY AND NOBLE COUNTIES. TOTAL MARKET AREA POPULATION IS APPROXIMATELY 227,000, WITH MUSKINGUM COUNTY (85,000) REPRESENTING THE LARGEST COUNTY. MEDIAN HOUSEHOLD INCOME LEVELS RANGE FROM $6,000 TO $11,000 LOWER THAN THE STATE MEDIAN HOUSEHOLD INCOME AND $11,000 TO $16,000 LOWER THAN THE NATIONAL MEDIAN HOUSEHOLD INCOME. PEOPLE LIVING BELOW POVERTY LEVEL RANGES FROM 14.1% TO 18.5% IN THE REGION VERSUS 15.4% FOR STATE AND 14.9% FOR NATION. PART VI, LINE 5: ONGOING COMMUNITY HEALTH EDUCATION IS PROVIDED THROUGH REGULARLY SCHEDULED HEALTH AND WELLNESS PROGRAMS PRESENTED BY GENESIS STAFF AND AFFILIATED PHYSICIANS. PREVENTATIVE HEALTH SCREENINGS ARE ALSO ROUTINELY SCHEDULED. INDIVIDUALS AT RISK ARE ENCOURAGED TO SEE A PHYSICIAN AND PROVIDED ASSISTANCE WITH PHYSICIAN ACCESS AS NEEDED. PROGRAM TOPICS ARE BASED ON COMMUNITY NEED AS DETERMINED BY FEEDBACK FROM PARTICIPANTS, A COMMUNITY ADVISORY GROUP AND INTERNAL CLINICAL GROUP. GENESIS ALSO REGULARLY PROVIDES HEALTH AND WELLNESS EDUCATION THROUGH COMMUNITY-BASED HEALTH FAIRS HELD THROUGHOUT THE COMMUNITY. PART VI, LINE 6: THE GENESIS ORGANIZATION AND IT'S AFFILIATES ARE REACHING OUT TO IMPROVE THE HEALTH OF THE COMMUNITY THROUGH VARIOUS PROGRAMS, MANY BASED ON PREVENTION. THESE FREE PROGRAMS INCLUDE FALL-RISK ASSESSMENTS, THINKFIRST INJURY PREVENTION FOR CHILDREN AND YOUNG ADULTS, AND IMPACT (IMMEDIATE POST-CONCUSSION ASSESSMENT AND COGNITIVE TESTING). AS A PART OF THESE PROGRAMS, GENESIS COMMUNITY AMBULANCE SERVICE (CAS) PARTICIPATES IN PRESENTATIONS THAT SIMULATE DISTRACTED DRIVING ACCIDENTS TO SCHOOLS AND ORGANIZATIONS. CAS ALSO PROMOTES THE WELL-BEING OF THE COMMUNITY THROUGH STANDBYS AT LOCAL EVENTS, PARAMEDIC ASSIST, AMBULANCE TOURS AND EFFORTS TO INCREASE PUBLIC AWARENESS OF EMERGENCY MEDICAL SERVICE AND 9-1-1 BEFORE AN EMERGENCY OCCURS. IN ADDITION, GENESIS PROVIDES NUMEROUS HEALTH SCREENINGS THROUGH OUR AFFILIATED PHARMACIES, PARTICIPATES IN COMMUNITY-BASED HEALTH FAIRS, OFFERS REGULAR EDUCATION PROGRAMS ON A VARIETY OF HEALTH TOPICS, AND COOPERATES WITH OUR IN-HOME CARE AFFILIATES TO GENERATEA BETTER QUALITY OF LIFE FOR AREA RESIDENTS WHO MAY OTHERWISE REQUIRE NURSING HOME CARE.SYSTEM MEMBER ORGANIZATIONS ROUTINELY PARTICIPATE WITH THE HOSPITAL IN PROVIDING HEALTH AND WELLNESS PROGRAMS AND SCREENINGS. SPECIFICALLY, FITNESS CENTER STAFF PROVIDES ADVICE ON EXERCISE AND THE RETAIL PHARMACY OFFERS ONGOING SCREENINGS THROUGH A WELL-ESTABLISHED WELLNESS PROGRAM AND SERVES AS THE HOSPITAL'S SCREENING PARTNER FOR COMMUNITY-BASED INITIATIVES. 1 GENESIS HEALTHCARE FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 311629304 501(C)(3) 55000 GRANTS WERE PAID THE RELATED TAX-EXEMPT ORGANIZATION TO HELP SUPPORT ITS PURPOSE. UNITED WAY- MUSKINGUM COUNTY 526 PUTNAM AVENUE ZANESVILLE OH 43701 314379456 501(C)(3) 55000 GRANTS WERE PAID TO HELP IMPROVE COMMUNITY CONDITIONS THROUGH PARTNERSHIPS IN THE AREAS OF INCOME, EDUCATION AND HEALTH. 2 0 PART I, LINE 2: GRANTS WERE PAID TO GENESIS HEALTHCARE FOUNDATION TO HELP FURTHER THE RELATED TAX-EXEMPT ORGANIZATION'S PURPOSE. THE UNITED WAY DONATION IS MONITORED THROUGH "METRICS AND DATA" REPORTED TO GHCS AND GHCD APPOINTS ONE "AT-LARGE MEMBER" ANNUALLY TO SERVE ON THE COMMUNITY IMPACT BOARD. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 THOMAS DIEHL MD TRUSTEE 231438 0 91075 0 0 0 4036 0 11124 0 337673 0 0 0 ERIC NEWSOM MD TRUSTEE 466127 0 0 0 0 0 0 0 15708 0 481835 0 0 0 WALTER WIELKIEWICZ MD TRUSTEE 189043 0 14747 0 0 0 23000 0 12305 0 239095 0 0 0 MATTHEW PERRY CHIEF EXEC OFFICER 609895 0 55653 0 0 0 76534 0 16696 0 758778 0 0 0 PAUL MASTERSON CHIEF FINANCIAL OFFICER 356975 0 63761 0 0 0 49819 0 17857 0 488412 0 0 0 RICHARD HELSPER CHIEF OPER OFFICER 355641 0 42516 0 0 0 1871 0 2020 0 402048 0 0 0 CASSANDRA PALMER CHIEF HR OFFICER (THRU AUGUST) 268850 0 46967 0 0 0 250691 0 14826 0 581334 0 198081 0 EDMOND ROMITO CHIEF INFOR OFFICER 269224 0 45550 0 0 0 7973 0 14440 0 337187 0 0 0 ALAN BURNS CHIEF DEVELOPMENT OFFICER 309939 0 48785 0 0 0 41831 0 13811 0 414366 0 0 0 PATRICIA CAMPBELL CHIEF NURSING OFFICER (THRU AUGUST) 269373 0 45524 0 0 0 229246 0 12538 0 556681 0 177677 0 REGINA PENNINGTON CHIEF QUALITY OFFICER 210035 0 39524 0 0 0 68222 0 17431 0 335212 0 0 0 DANIEL SCHEERER MD CHIEF MEDICAL AFFAIRS OFFI 275117 0 49557 0 0 0 2550 0 14045 0 341269 0 0 0 ABBY NGUYEN DIRECTOR OF NURSING AND CL 156322 0 6576 0 0 0 4638 0 18331 0 185867 0 0 0 DIANNA LEVECK DIRECTOR OF HUMAN RESOURCE 171677 0 7010 0 0 0 5002 0 12108 0 195797 0 0 0 CHARLES ADAMS JR DIRECTOR OF LEAN SIGMA 123303 0 31874 0 0 0 1250 0 11970 0 168397 0 0 0 RAY RYMAN CLINICAL PHARMACIST 145843 0 942 0 0 0 9546 0 12701 0 169032 0 0 0 GREGORY PETE HAMILTON DIRECTOR OF PHARMACY SERVI 135600 0 7528 0 0 0 11193 0 16673 0 170994 0 0 0 MICHAEL NORMAN DIRECTOR OF FIN AND REIMB SVCS 127704 0 14116 0 0 0 0 0 10160 0 151980 0 0 0 SHARON PARKER DIRECTOR OF CANCER SERVICES 146063 0 6982 0 0 0 3844 0 15384 0 172273 0 0 0 PART I, LINE 1A THE ORGANIZATION PAYS COUNTRY CLUB DUES AND RELATED BUSINESS EXPENSES FOR FIVE MEMBERS OF LEADERSHIP. PERSONAL USAGE IS PAID BY THE INDIVIDUAL AND THE PERCENTAGE OF DUES RELATED TO PERSONAL USAGE ARE ADDED TO THE INDIVIDUALS W-2. PART I, LINE 4B PART I, LINE 4B: A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS SET UP TO PROVIDE ADDITIONAL DEFERRED RETIREMENT INCOME TO THE GENESIS HEALTH CARE SYSTEM SENIOR LEADERSHIP TEAM MEMBERS. THIS PLAN IS FUNDED BY GENESIS AND VESTS WITH SERVICE. GENESIS HEALTHCARE SYSTEM MADE CONTRIBUTIONS TO NONQUALIFIED RETIREMENT PLANS FOR THE FOLLOWING INDIVIDUALS: MATTHEW PERRY, $71,434 PAUL MASTERSON, $23,606 CASSANDRA PALMER, $33,529 PATRICIA CAMPBELL, $32,499 ALAN BURNS, $18,064 REGINA PENNINGTON, $68,222 PART I, LINE 3: A RELATED ORGANIZATION, GENESIS HEALTHCARE SYSTEM, ESTABLISHES COMPENSATION OF THE ORGANIZATION'S CEO THROUGH A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACTS, COMPENSATION SURVEY/STUDY, AND APPROVAL BY THE BOARD AND COMPENSATION COMMITTEE. A MUSKINGUM COUNTY OHIO HOSPITAL FACILITIES REVENUE BONDS 2013-05-09 295000000 0 0 0 A 46879891 295000000 18019125 27255403 5148223 197697358 2016 0 0 0 0 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 0 0 0 0 0 0 0 JOK COMPANY INC BOARD MEMBER, ROBERT KESSLER, IS A PARTNER OF JOK COMPANY, INC. 137004 LEASE PAYMENTS ON OFFICE SPACE 0 FORM 990, PART VI, SECTION A, LINE 3 THE MANAGEMENT OF PHYSICIAN OFFICE SPACE (PROPERTY MANAGEMENT) IS OUTSOURCED AND THE MANAGER REPORTS TO A VP OF THE HOSPITAL. THE MANAGEMENT OF FOOD & NUTRITION AND PLANT OPERATION IS ALSO OUTSOURCED. THE DIRECTORS OF THESE AREAS ALSO REPORT TO A VP OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 6 FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC., AND BETHESDA CARE SYSTEM (OR THEIR RESPECTIVE SUCCESSORS AN ASSIGNS) ARE THE MEMBERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE FILING ORGANIZATION, HAVE THE RIGHT TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY, WHETHER PERIODICALLY, OR AS VACANCIES ARISE, OR OTHERWISE. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS OF THE FILING ORGANIZATION, HAVE THE RIGHT TO APPROVE OR RATIFY DECISIONS OF THE ORGANIZATION'S GOVERNING BODY SUCH AS APPROVAL OF THE GOVERNING'S BODY'S DECISION TO DISSOLVE THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS REVIEWED IN ITS ENTIRETY BY THE CFO. AN OVERVIEW OF THE 990 IS REVIEWED WITH THE EXECUTIVE COMMITTEE AND KEY SCHEDULES ARE REVIEWED WITH THE BOARD OF TRUSTEES PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY STATES THAT BOARD MEMBERS AND OFFICERS HAVE A DUTY TO GOVERN HONESTLY AND ECONOMICALLY. ALL POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED TO THE BOARD OF DIRECTORS AND THE BOARD WILL DETERMINE IF A CONFLICT EXISTS AND APPROPRIATE PROCEDURES TO MITIGATE THE SITUATION, SUCH AS ALTERNATIVE TRANSACTIONS AND PARTICIPATION AND VOTING RESTRICTIONS. THE COMPLIANCE OFFICER MONITORS AND ENFORCES THESE POLICIES. ALL OFFICERS AND DIRECTORS REVIEW AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE CEO IS MANAGED THROUGH A THIRD PARTY THAT IS A NATIONALLY RECOGNIZED FIRM SPECIALIZING IN COMPENSATION BENCHMARKING AND ANALYSIS. THE FIRM IS RECOGNIZED FOR THEIR EXPERTISE IN EVALUATING TOTAL COMPENSATION AT THE EXECUTIVE LEVEL. THIS FIRM PRESENTS THEIR RECOMMENDATIONS AND ANALYSIS TO THE COMPENSATION COMMITTEE, WHICH IS MADE UP OF INDEPENDENT MEMBERS OF THE GENESIS BOARD OF DIRECTORS. THE COMMITTEE IS RESPONSIBLE FOR MAKING A RECOMMENDATION TO THE BOARD OF DIRECTORS REGARDING THE EXECUTIVE COMPENSATION POLICY AND SPECIFIC COMPONENTS OF THE TOTAL COMPENSATION OF THE CEO. THE CEO IS ACTIVELY INVOLVED IN THE REVIEW, ANALYSIS AND RECOMMENDATION RELATED TO THE TOTAL COMPENSATION FOR THE REMAINING MEMBERS OF THE SENIOR LEADERSHIP TEAM. THE CEO DETERMINES THE COMPENSATION OF THE SENIOR LEADERSHIP TEAM MEMBERS WITHIN THE PARAMETERS ESTABLISHED BY THE COMPENSATION COMMITTEE. THIS COMPENSATION PROCESS WAS LAST COMPLETED IN 2013. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: LOSS IN FAIR VALUE OF PERPETUAL TRUST 16,302,602. PLEDGE RECEIVABLE FROM RELATED PARTY -16,499,531. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 61,113. OHIO INTEGRATED CARE PROVIDERS, LLC -56. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND IS INVOLVED IN THE SELECTION OF THE INDEPENDENT ACCOUNTANT WHICH COMPLETES THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PAGE 1, LINE H(D): THIS IS THE PARENT RETURN FOR A GROUP: GENESIS HEALTHCARE SYSTEM GROUP RETURN, EIN: 31-1773259 PART VI, SECTION B, LINE 16B: ALTHOUGH THE ORGANIZATION DOES NOT HAVE A WRITTEN POLICY REGARDING JOINT VENTURES, LEGAL COUNSEL EVALUATES EACH VENTURE IN ADVANCE AND THE BOARD MUST APPROVE. CURRENTLY GENESIS HEALTHCARE SYSTEM IS INVOLVED IN ONE JOINT VENTURE, OF WHICH IT OWNS 50%. ZANESVILLE SURGERY CENTER 2907 BELL STREET ZANESVILLE OH 43701 311620813 SURGICAL CENTER OH 0 0 GENESIS HEALTHCARE SYSTEM OHIO INTEGRATED CARE PROVIDERS LLC 2951 MAPLE AVE ZANSVILLE OH 43701 461795662 OH -56 94 GENESIS HEALTHCARE FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 311629304 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 GOOD SAMARITAN MEDICAL CENTER FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 310969646 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE FOUNDATION 1 BETHESDA HOSPITAL FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 310885513 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE FOUNDATION 1 FRANCISCAN SISTERS OF CHRISTIAN CHARITY 2951 MAPLE AVENUE ZANESVILLE OH 43701 391530622 SPONSOR OF GHS WI 501(C)(3) 7 N/A 1 GOOD SAMARITAN MEDICAL CENTER 2951 MAPLE AVENUE ZANESVILLE OH 43701 314379479 MAINTAINS REAL ESTATE TITLE FOR HOSPITAL OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 BETHESDA CARE SYSTEM 2951 MAPLE AVENUE ZANESVILLE OH 43701 311067174 SPONSOR OF GHS OH 501(C)(3) 9 GENESIS HEALTHCARE SYSTEM 1 BETHESDA HOSPITAL ASSOCIATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 314380038 MAINTAINS REAL ESTATE TITLE FOR HOSPITAL OH 501(C)(3) 11C GENESIS HEALTHCARE SYSTEM 1 ALTERNACARE 2951 MAPLE AVENUE ZANESVILLE OH 43701 311487187 STERILIZATIONS OH 501(C)(3) 3 BETHESDA CARE SYSTEM 1 CARESERVE 2951 MAPLE AVENUE ZANESVILLE OH 43701 311099924 FORMERLY OPERATED 2 NURSING HOMES THAT WERE SOLD PRIOR TO 2012 OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 COMMUNITY AMBULANCE SERVICE 2951 MAPLE AVENUE ZANESVILLE OH 43701 341773323 AMBULANCE SERVICE OH 501(C)(3) 9 GENESIS HEALTHCARE SYSTEM 1 GENESIS CAREGIVERS 2951 MAPLE AVENUE ZANESVILLE OH 43701 311282152 2 NURSING HOMES & HOME CARE SERVICES OH 501(C)(3) 3 CARESERVE 1 BETHESDA HOSPITALITY SHOP 2951 MAPLE AVENUE ZANESVILLE OH 43701 316050713 GIFT SHOP OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 GENESIS PROFESSIONAL CORPORATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 311599754 PHYSICIAN PRACTICES OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 CARELIFE LLC 2951 MAPLE AVENUE ZANESVILLE OH 43701 311128717 FITNESS CENTER, CHILDCARE SVCS, PHARMACY, DME OH GENESIS HEALTHCARE SYSTEM C -24939915 27465520 1.00000 1 SOUTHEAST OHIO MEDICAL INSURANCE COMPANY FIRST CARIBBEAN HOUSE GEORGE TOWN CAYMAN ISLANDS CJ 980436356 CAPTIVE INSURANCE COMPANY CJ GENESIS HEALTHCARE SYSTEM C 17520053 1.00000 1 0 0 1 1 1 0 0 0 0 1 1 1 1 0 1 1 1 1 1 CARELIFE LLC O 3665030 ACCRUAL TRANSACTION CARELIFE LLC S 521316 ACCRUAL TRANSACTION CARELIFE LLC R 421936 ACCRUAL TRANSACTION CARELIFE LLC L 368275 ACCRUAL TRANSACTION CARELIFE LLC M 1172072 ACCRUAL TRANSACTION GENESIS HEALTHCARE SYSTEM GROUP Q 232747 ACCRUAL TRANSACTION COMMUNITY AMBULANCE SERVICE M 1107474 ACCRUAL TRANSACTION GENESIS HEALTHCARE SYSTEM GROUP R 4616420 ACCRUAL TRANSACTION GOOD SAMARITAN MEDICAL CENTER S 840000 ACCRUAL TRANSACTION BETHESDA CARE SYSTEM E 50200 ACCRUAL TRANSACTION BETHESDA HOSPITAL ASSOCIATION D 263150 ACCRUAL TRANSACTION GENESIS HEALTHCARE FOUNDATION B 55000 ACCRUAL TRANSACTION GENESIS HEALTHCARE FOUNDATION S 3118538 ACCRUAL TRANSACTION