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        <NamePerson>LISSA L BRYAN SMITH</NamePerson>
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      <NumberIndividualsGT100K>41</NumberIndividualsGT100K>
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        <NameOfContractor>
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        <NameOfContractor>
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      <ContractorCompensation>
        <NameOfContractor>
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        <Amount>10793642</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>FINANCIAL CONTRACT</Description>
        <Amount>7785462</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>MEDICAL LEGAL CLAIMS ALLOWANCE</Description>
        <Amount>3521302</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>ACCOUNTS RECEIVABLE CREDIT BALANCES</Description>
        <Amount>2016695</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>REBATE PAYABLE</Description>
        <Amount>9503</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>39554972</TotalOfAmounts>
      <Form990ScheduleDPartXIV>
        <Identifier>INTENDED USES FOR ENDOWMENT FUNDS</Identifier>
        <ReturnReference>SCHEDULE D, PAGE 2, PART V, LINE 4</ReturnReference>
        <Explanation>TO SUPPORT RESEARCH, CAPITAL AND PROGRAM EXPENSES AND PATIENT CARE AND PATIENT EDUCATION.</Explanation>
      </Form990ScheduleDPartXIV>
      <Form990ScheduleDPartXIV>
        <Identifier>SUPPLEMENTAL FINANCIAL INFORMATION</Identifier>
        <ReturnReference>SCHEDULE D, PAGE 4, PART XIV</ReturnReference>
        <Explanation>EFFECTIVE JULY 1, 2007, GEISINGER HEALTH SYSTEM ("GHS") ADOPTED FASB INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, AN INTERPRETATION OF FASB STATEMENT NO. 109 ("FIN 48"). FIN 48 CLARIFIES THE ACCOUNTING AND REPORTING FOR INCOME TAXES WHERE INTERPRETATION OF THE TAX LAW MAY BE UNCERTAIN. FIN 48 PRESCRIBES A COMPREHENSIVE MODEL FOR THE FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, PRESENTATION AND DISCLOSURE OF INCOME TAX UNCERTAINTIES WITH RESPECT TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN INCOME TAX RETURNS. THE ADOPTION OF FIN 48 HAD NO IMPACT ON UNRESTRICTED NET ASSETS AS OF JUNE 30, 2011 OR ANY PREVIOUS YEAR SINCE ADOPTION. ACCORDINGLY, NO FIN 48 FOOTNOTE DISCLOSURE WAS MADE IN THE JUNE 30, 2011 GHS CONSOLIDATED FINANCIAL STATEMENTS. 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.</Explanation>
      </Form990ScheduleDPartXIV>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="RetDoc7">
      <CharityCarePolicy>true</CharityCarePolicy>
      <WrittenPolicy>true</WrittenPolicy>
      <PolicyAppliedToAllHospitals>X</PolicyAppliedToAllHospitals>
      <FPGReferenceFreeCare>true</FPGReferenceFreeCare>
      <Pcent200>X</Pcent200>
      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <DiscountedOther>
        <Other>X</Other>
        <DiscountedOtherPercentage>3.80000</DiscountedOtherPercentage>
      </DiscountedOther>
      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>true</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>false</ExpensesExceededBudget>
      <AnnualCommunityBenefitReport>true</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>true</ReportPublicallyAvailable>
      <CharityCareAtCost>
        <TotalCommunityBenefitExpense>4020111</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>4020111</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.01200</PercentOfTotalExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
        <TotalCommunityBenefitExpense>42002607</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>24898280</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>17104327</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.05100</PercentOfTotalExpense>
      </UnreimbursedMedicaid>
      <UnreimbursedCosts>
        <TotalCommunityBenefitExpense>2306461</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>1739376</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>567085</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00170</PercentOfTotalExpense>
      </UnreimbursedCosts>
      <TotalCharityCare>
        <TotalCommunityBenefitExpense>48329179</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>26637656</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>21691523</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.06470</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
        <TotalCommunityBenefitExpense>1003419</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>1003419</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00300</PercentOfTotalExpense>
      </CommunityHealthServices>
      <HealthProfessionsEducation>
        <TotalCommunityBenefitExpense>3134594</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>1534460</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>1600134</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00480</PercentOfTotalExpense>
      </HealthProfessionsEducation>
      <CashAndInKindContributions>
        <TotalCommunityBenefitExpense>3022250</TotalCommunityBenefitExpense>
        <NetCommunityBenefitExpense>3022250</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00900</PercentOfTotalExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
        <TotalCommunityBenefitExpense>7160263</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>1534460</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>5625803</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.01680</PercentOfTotalExpense>
      </TotalOtherBenefits>
      <TotalCommunityBenefits>
        <TotalCommunityBenefitExpense>55489442</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>28172116</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>27317326</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.08150</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <BadDebtExpenseReported>true</BadDebtExpenseReported>
      <BadDebtExpenseAmount>1409578</BadDebtExpenseAmount>
      <AmountReimbursedByMedicare>74170541</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>89845811</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-15675270</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostAccountingSystem>X</CostAccountingSystem>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>true</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>1</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>GEISINGER WYOMING VALLEY MEDICAL</BusinessNameLine1>
          <BusinessNameLine2>CENTER</BusinessNameLine2>
        </Name>
        <Address>
          <AddressLine1>1000 EAST MOUNTAIN DRIVE</AddressLine1>
          <City>WILKESBARRE</City>
          <State>PA</State>
          <ZIPCode>18711</ZIPCode>
        </Address>
        <ChildrensHospital>X</ChildrensHospital>
        <TeachingHospital>X</TeachingHospital>
        <ResearchFacility>X</ResearchFacility>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionB>
        <HospitalFacilityName>
          <BusinessNameLine1>GEISINGER WYOMING VALLEY MEDICAL</BusinessNameLine1>
        </HospitalFacilityName>
        <HospitalFacilityNumber>1</HospitalFacilityNumber>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVI>
        <Identifier>EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE</Identifier>
        <ReturnReference>PART I LINE 7 COLUMN F</ReturnReference>
        <Explanation>THE BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR USED TO CALCULATE THE PERCENT OF COMMUNITY BENEFIT WAS 7618523</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COSTING METHODOLOGY EXPLANATION</Identifier>
        <ReturnReference>PART I LINE 7</ReturnReference>
        <Explanation>A COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE COSTS REPORTED ON LINE 7 AND ADDRESSED PATIENT SEGMENTS BY PAYER EG MEDICARE MEDICAID COMMERCIAL PAYERS SELFPAY ETC</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>NEEDS ASSESSMENT</Identifier>
        <ReturnReference>PART VI</ReturnReference>
        <Explanation>PART VI LINE 2 DESCRIBE HOW THE ORGANIZATION ASSESSES THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES GWV PARTICIPATED AS A MEMBER IN THE HEALTHY NORTHEAST PENNSYLVANIA INITIATIVE THAT ENGAGED MEMBERS IN THE COMMUNITIES TO ASSESS AND ADDRESS COMMUNITY HEALTH NEEDS INCREASE REGIONAL FUNDING FOR PROGRAMS AND SERVICES AND FACILITATE THE AWARENESS EDUCATION AND WELLNESS FOR RESIDENTS OF NORTH EAST PENNSYLVANIA THE HEALTHY NORTHEAST PENNSYLVANIA INITIATIVE THE INITIATIVE IS A COLLABORATION AMONG THE PENNSYLVANIA DEPARTMENT OF HEALTH AND MEMBER HEALTHCARE ORGANIZATIONS OPERATING WITHIN GWVS LACKAWANNA COUNTY AND LUZERNE COUNTY SERVICE AREA PARTICIPANTS IN THE INITIATIVE INCLUDED ALLIED SERVICES BLUE CROSS OF NEPA COMMUNITY MEDICAL CENTER MERCY HEALTH PARTNERS MOSES TAYLOR HOSPITAL AND WYOMING VALLEY HEALTHCARE SYSTEM BASED ON THE DATA GATHERED THROUGH RESEARCH CONDUCTED BY TRIPP UMBACK 5 AREAS OF NEED WERE IDENTIFIED AS PRIORITIES FOR LACKAWANNA AND LUZERNE COUNTIES INCLUDING ACCESS TO CARE CHRONIC DISEASEOBESITY EMPLOYMENT MENTAL HEALTH AND SUBSTANCE ABUSE GEISINGER HEALTH SYSTEM IS ALSO AN ACTIVE PARTICIPANT IN MULTIPLE COMMUNITYBASED ORGANIZATIONS THAT STRIVE TO IMPROVE THE HEALTH AND WELL BEING OF THE COMMUNITY INCLUDING CONDUCTING COMMUNITY NEEDS ASSESSMENTS OF VARYING SCOPE THESE RELATIONSHIPS HAVE ENABLED GEISINGER TO PARTICIPATE AND UNDERSTAND MORE CLEARLY THE UNDERLYING REASONS FOR A SPECIFIC COMMUNITYS HEALTH STATUS AND TO USE THAT INFORMATION IN MAKING FOCUSED DECISIONS ABOUT APPROPRIATE SERVICE MIX AND COMMUNITY OUTREACH SERVICES THERE WERE TWO MAJOR HEALTH NEED THEMES WHICH CONSISTENTLY SURFACED IN THE VARIOUS COMMUNITY HEALTH NEEDS ASSESSMENTS OBESITY AND BROADLY THE RELATED DISEASE BURDENPREVENTION</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE</Identifier>
        <ReturnReference>PART VI</ReturnReference>
        <Explanation>PART VI LINE 3 DESCRIBE HOW THE ORGANIZATION INFORMS PATIENTS OF THE ORGAQNIZATIONS FINANCIAL ASSISTANCE POLICY 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 PATIENTS 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 GEISINGER POLICY TO PROVIDE FINANCIAL ASSISTANCE AND FINANCIAL COUNSELING TO PATIENTS OF LIMITED MEANS A PATIENT MAY BECOME ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE AT ANY TIME DURING TREATMENT OR DURING THE CONTINUUM OF THE FINANCIALBILLING PROCESS INFORMATION SIGNS BROCHURES ETC REGARDING GEISINGERS CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES ARE PROVIDED AT THE EMERGENCY ROOM REGISTRATION AND VARIOUS ACCESS POINTS THROUGHOUT THE HOSPITAL NOTICE OF GEISINGERS CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES CAN ALSO BE FOUND ON THE GEISINGER WEB SITE AT WWWGEISINGERORG PATIENTS ARE ALSO PROVIDED INFORMATION ON GEISINGERS CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES WITH EACH PATIENT BILL</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>COMMUNITY INFORMATION</Identifier>
        <ReturnReference>PART VI</ReturnReference>
        <Explanation>GEISINGER WYOMING VALLEY MEDICAL CENTERS SERVICE AREA INCLUDES 9 COUNTIES IN NORTHEASTERN PENNSYLVANIA BRADFORD CARBON LACKAWANNA LUZERNE MONROE PIKE SUSQUEHANNA WAYNE AND WYOMING THE APPROXIMATE 2011 TOTAL POPULATION WITHIN THIS SERVICE AREA WAS 1000509 THIS POPULATION IS EXPECTED TO GROW 10 BY 2016 SLOWER THAN THE 40 NATIONAL RATE BUT SLIGHTLY HIGHER THAN THE 07 GROWTH RATE IN THE COMMONWEALTH THE 65 AND OVER AGE GROUP IS 175 OF THE TOTAL POPULATION WHICH IS GREATER THAN THE STATE 159 AND NATIONAL 133 PERCENTAGES ADDITIONALLY THE 65 AND OVER AGE GROUP IS THE AGE SEGMENT PROJECTED TO EXPERIENCE THE LARGEST FIVEYEAR POPULATION GROWTH AT 130 THE REGION IS PRIMARILY RURAL WITH SMALL SUBURBAN AND URBAN POCKETS MEDIAN HOUSEHOLD INCOME IS 55392 WITH APPROXIMATELY 136 OF THE POPULATION FALLING BELOW FEDERAL POVERTY GUIDELINES SLIGHTLY HIGHER THAN THE STATE PERCENTAGE OF 134 THE AVERAGE UNEMPLOYMENT RATE WAS 95 WHICH IS HIGHER THAN THE STATE RATE OF 87 AND SLIGHTLY LOWER THAN THE NATIONAL AVERAGE OF 96 211 OF GWVS INPATIENT DISCHARGES DURING CALENDAR YEAR 2010 WERE CHARITY CARE OR MEDICAID RECIPIENTS COMPARATIVELY OF ALL HOSPITAL INPATIENTS FROM THE REGION REGARDLESS OF THEIR SOURCE OF CARE 183 WERE CHARITY CARE OR MEDICAID RECIPIENTS THE REGION INCLUDES MULTIPLE MEDICALLY UNDERSERVED AREAS AND POPULATIONS THERE ARE 17 NONGEISINGER ACUTECARE HOSPITALS IN THIS MARKET</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE</Identifier>
        <ReturnReference>PART VI</ReturnReference>
        <Explanation>SEE THE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTSCOMMUNITY BENEFIT REPORTED IN SCHEDULE O</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>AFFILIATED HEALTH CARE INFORMATION</Identifier>
        <ReturnReference>PART VI</ReturnReference>
        <Explanation>PART VI LINE 6 DESCRIBE ROLES BETWEEN THE ORGANIZATION AND ITS AFFILIATES GEISINGER WYOMING VALLEY MEDICAL CENTER IS AN AFFILIATE WITHIN THE GEISINGER HEALTH SYSTEM WHICH IS ONE OF THE LARGEST RURAL HEALTH CARE SYSTEMS IN THE NATION AND COVERS A 20000 SQUARE MILE AREA IN NORTHERN AND CENTRAL PENNSYLVANIA AS AN INTEGRATED HEALTH CARE SYSTEM IT SERVES MORE THAN TWO MILLION PEOPLE IN 41 OF PENNSYLVANIAS 67 COUNTIES WITH A VARIETY OF CHARITABLE HEALTH CARE PROVIDERS AND A NONPROFIT HMO THE GHS 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 GWV SERVES PATIENTS IN THE GREATER WYOMING VALLEY AND WESTERN POCONO REGION OF THE STATE WITH A COMPREHENSIVE MATERNITY PROGRAM PEDIATRIC SERVICES MEDICAL AND SURGICAL UNITS THE FRANK M AND DOROTHEA HENRY CANCER CENTER A COMPLETE EMERGENCY DEPARTMENT AS WELL AS OFFERING AN EXTENSIVE COMMUNITYHEALTH EDUCATION PROGRAM OPENING IN THE FALL OF 2001 AND CONNECTED DIRECTLY TO GWV WAS THE REGIONS FIRST AND ONLY HEART HOSPITAL THE THREESTORY STRUCTURE OFFERED LIFESAVING HEART PROCEDURES THAT WERE NOT CURRENTLY AVAILABLE IN THE REGION AS WELL AS A RESEARCH PROGRAM NEW THERAPIES AND SPECIAL HEART SERVICES GEISINGER MEDICAL CENTER GMC A 501C3 NOTFORPROFIT HOSPITAL IS LOCATED IN DANVILLE PENNSYLVANIA A SMALL COMMUNITY OF 6000 PEOPLE SINCE ITS BEGINNING IN 1915 GHS HAS EMPHASIZED MULTISPECIALTY CARE AND HAS MORE THAN 80 MEDICAL SPECIALTIES AND SUBSPECIALTIES GMC IS A LEVEL 1 REGIONAL RESOURCE TRAUMA CENTER AND HAS BEEN NAMED TO THE 100 TOP HOSPITALS FOR STROKES LISTS GHS PHYSICIANS WERE LISTED IN THE BEST DOCTORS IN AMERICA AND THE GHS INTEGRATED COSTEFFECTIVE DELIVERY OF MANAGED CARE WAS FEATURED IN A FRONTPAGE NEW YORK TIMES ARTICLE MEDICAL EDUCATION HAS PLAYED A PROMINENT ROLE AT THE GMC WITH MORE THAN 200 RESIDENTS AND FELLOWS RECEIVING POSTDOCTORAL TRAINING AND RESEARCH EXPOSURE THE 437 BED MEDICAL CENTER IS HOME TO THE JANET WEIS WOMENS AND CHILDRENS HOSPITAL THE FIRST RURAL ACUTECARE CHILDRENS HOSPITAL IN THE NATION THE 85 BED CHILDRENS HOSPITAL WAS CONSTRUCTED IN 1995 ENTIRELY FROM DONATIONS AND BOASTS A NEONATAL INTENSIVE CARE UNIT A PEDIATRIC INTENSIVE CARE UNIT AND TWO FLOORS OF MEDICALSURGICAL INPATIENT ROOMS IN JANUARY OF 2000 THE TWOSTORY WOMENS PAVILION OPENED AND STRATEGICALLY ADJOINS THE CHILDRENS HOSPITAL FOSTERING FAMILYCENTERED CARE FOR ALL OBSTETRICAL AND NEWBORN SERVICES THE PAVILION FEATURES 19 LABOR DELIVERY RECOVERY POSTPARTUM ROOMS AND HAS THE STATES FIRST PASSTHROUGH WINDOWS FROM TWO HIGHRISK AND CSECTION DELIVERY ROOMS DIRECTLY INTO THE ADJOINING NEONATAL INTENSIVE CARE UNIT THE ENTIRE HEALTH SYSTEM IS SERVED BY LIFE FLIGHT THE 20 PLUSYEAR OLD AIRMEDICAL TRANSPORT PROGRAM ONE HELICOPTER IS HOUSED ON THE CAMPUS OF GEISINGER MEDICAL CENTER AND ANOTHER IS STATIONED AT THE UNIVERSITY PARK AIRPORT IN STATE COLLEGE GHS PROVIDED THE FIRST FULLSERVICE FULLTIME MEDICAL HELICOPTER STATIONED IN THE WILKESBARRESCRANTON AREA BY ADDING A THIRD HELICOPTER IN THE FLEET IN JULY 2001 A FOURTH HELICOPTER WAS ADDED IN WILLIAMSPORT IN 2005 WITH A FIFTH GOING ONLINE IN POTTSVILLE IN 2006 GEISINGER CLINIC IS A 501C3 NOTFORPROFIT CORPORATION OPERATING A MULTISPECIALTY GROP PRACTICE GEISINGER CLINIC PROVIDES PATIENT STAFF FOR PATIENT CARE EDUCATION AND RESEARCH THERE ARE MORE THAN 800 EMPLOYED PHYSICIANS PRACTICING AT AN ARRAY OF HEALTH CARE DELIVERY PROVIDER FACILITIES AT 61 MEDICAL GROUPS SERVING 31 COUNTIES OPERATED WITHIN THE GEISINGER CLINIC ORGANIZATION THE WEIS CENTER FOR RESEARCH LOCATED ON THE CAMPUS OF GEISINGER MEDICAL CENTER IS HOME TO THE HENRY HOOD RESEARCH PROGRAM THE PREEMINENT FUNCTION OF THE HOOD RESEARCH PROGRAM IS TO CONDUCT ORIGINAL AND INNOVATIVE RESEARCH OF WORLD CLASS QUALITY OUR SCIENTISTS APPLY MODERN MOLECULAR AND CELLULAR APPROACHES TO DIVERSE RESEARCH PROBLEMS IN THE AREAS OF CARDIOVASCULAR FUNCTION CANCER AND DEVELOPMENTAL BIOLOGY BEGUN IN 1972 THE GEISINGER HEALTH PLAN IS A 501C4 NOTFORPROFIT ORGANIZATION THAT HAS GROWN TO BE ONE OF THE LARGEST RURAL HMOS IN THE COUNTRY IT CURRENTLY SERVES APPROXIMATELY 200000 MEMBERS IN A 42COUNTY SERVICE AREA MARWORTH IS A 501C3 NOTFORPROFIT ORGANIZATION AND OPERATES A 77 BED CENTER THAT ALSO OFFERS A BROADBASED OUTPATIENT PROGRAM FOR THE TREATMENT OF ALCOHOL AND CHEMICAL DEPENDENCY MARWORTH IS LOCATED IN WAVERLY PENNSYLVANIA AND IS ANNUALLY RANKED AMONG THE TOP 20 TREATMENT CENTERS IN THE UNITED STATES GEISINGER COMMUNITY HEALTH SERVICES IS A 501C3 NOTFORPROFIT ORGANIZATION DESIGNED TO CONDUCT CHARITABLE SCIENTIFIC AND EDUCATIONAL ACTIVITIES FOR THE CITIZENS OF THE COMMUNITIES SERVED BY GHS</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>ADDITIONAL INFORMATION</Identifier>
        <ReturnReference>PART VI</ReturnReference>
        <Explanation>FORM 990 SCHEDULE H PART I LINE 6A6B A SUMMARY OF THE COMMUNITY BENEFIT PROVIDED BY GEISINGER WYOMING VALLEY MEDICAL CENTER GWVAND ITS RELATED CHARITABLE ORGANIZATIONS IS AVAILABLE AT GEISINGERORG AND MADE AVAILABLE TO THE PUBLIC UPON REQUEST GO TO WWWGEISINGERORGABOUTINDEXHTML FORM 990 SCHEDULE H PART III SECTION A LINE 4 GEISINGER WYOMING VALLEY MEDICAL CENTER IS A MEMBER OF A GROUP WITH CONSOLIDATED FINANCIAL STATEMENTS PER THE FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE THE ORGANIZATIONS OF THE CONSOLIDATED GROUP RECOGNIZE THE ESTIMATED ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON AGING OF ACCOUNTS RECEIVABLE AND HISTORICAL EXPERIENCE GWV REPORTS ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD PARTY PAYERS PATIENTS AND OTHERS AN ALLOWANCE FOR UNCOLLECTABLE ACCOUNTS RECEIVABLES IS PROVIDED BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS THE RATIO OF PATIENT COST TO CHARGES IS APPLIED TO THE GWVS BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD EXPENSE REPORTED ON LINE 2 OF PART III PATIENTS ACCOUNTS ARE MONITORED THROUGHOUT THE BILLING PROCESS AND RECLASSIFIED TO FREE OR DISCOUNTED CARE WHENEVER THE PATIENT BECOMES ELIGIBLE UNDER GWVS 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 GWVS UNCOMPENSATED CARE POLICIES FORM 990 SCHEDULE H PART III SECTION B LINE 8 GWV CONSIDERS THAT THE TOTAL MEDICARE SHORTFALL OF 19188876 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 GWV TO USE OTHER FUNDS TO COVER THE SHORTFALL MEDICARE SHORTFALLS MUST BE ABSORBED BY GWV IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY GWV 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 PENNSYLVANIA REQUIRES NONPROFIT HOSPITALS LIKE GWV TO PROVIDE A MINIMUM LEVEL OF COMMUNITY BENEFIT TO RETAIN EXEMPTION FROM STATE AND LOCAL TAXES ACCORDING TO STATE STATUTE AND CASE LAW THE UNREIMBURSED COST OF MEDICARE IS CONSIDERED TO BE COMMUNITY BENEFIT FOR STATE TAX EXEMPTION PURPOSES FORM 990 SCHEDULE H PART III SECTION C LINE 9B IT IS GWV POLICY TO PROVIDE FINANCIAL ASSISTANCE AND COUNSELING TO PATIENTS WITH LIMITED FINANCIAL MEANS A PATIENT MAY BECOME ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANYTIME DURING TREATMENT OR DURING THE CONTINUUM OF THE FINANCIALBILLING AND COLLECTION PROCESS FORM 990 SCHEDULE H PART VI LINE 7 AT THIS TIME GWV AND ITS AFFILIATES ARE NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="RetDoc8">
      <IdemnificationGrossUpPayments>X</IdemnificationGrossUpPayments>
      <WrittenPolicyReTAndEExpenses>true</WrittenPolicyReTAndEExpenses>
      <SubstantiationRequired>true</SubstantiationRequired>
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
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      <WrittenEmploymentContract>X</WrittenEmploymentContract>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>true</AnyNonFixedPayments>
      <InitialContractException>true</InitialContractException>
      <RebuttablePresumptionProcedure>true</RebuttablePresumptionProcedure>
      <Form990ScheduleJPartII>
        <NamePerson>GLENN D STEELE JR MD PHD</NamePerson>
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        <CompReportPrior990RelatedOrgs>241531</CompReportPrior990RelatedOrgs>
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        <DeferredCompRelatedOrgs>64346</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>16717</NontaxableBenefitsRelatedOrgs>
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        <CompReportPrior990RelatedOrgs>19288</CompReportPrior990RelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>EDWARD J ZYCH ESQUIRE</NamePerson>
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      <Form990ScheduleJPartII>
        <NamePerson>KEVIN F BRENNAN CPA FHFMA</NamePerson>
        <CompBasedOnRelatedOrgs>463447</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>268032</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>77782</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>164879</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>19257</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>993397</TotalCompensationRelatedOrgs>
        <CompReportPrior990RelatedOrgs>41972</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>STEVEN B PIERDON MD</NamePerson>
        <CompBasedOnRelatedOrgs>385301</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>202002</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>37574</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>121779</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>8927</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>755583</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>FRANK J TREMBULAK</NamePerson>
        <CompBasedOnRelatedOrgs>552005</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>285273</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>46559</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>184975</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>9919</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>1078731</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>MARY P GILDEA RN BSN</NamePerson>
        <BaseCompensationFilingOrg>138991</BaseCompensationFilingOrg>
        <BonusFilingOrg>22676</BonusFilingOrg>
        <OtherCompensationFilingOrg>35842</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>11476</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>7409</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>216394</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>MARGARET HENNELLY BERGINRNMSNMBA</NamePerson>
        <BaseCompensationFilingOrg>168358</BaseCompensationFilingOrg>
        <BonusFilingOrg>38154</BonusFilingOrg>
        <OtherCompensationFilingOrg>5117</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>14597</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>14189</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>240415</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>JOHN J BUCKLEY</NamePerson>
        <BaseCompensationFilingOrg>271062</BaseCompensationFilingOrg>
        <BonusFilingOrg>125000</BonusFilingOrg>
        <OtherCompensationFilingOrg>33212</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>45280</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>24638</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>499192</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>CARLA J SCOFIELD MS</NamePerson>
        <BaseCompensationFilingOrg>85192</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>82790</CompBasedOnRelatedOrgs>
        <OtherCompensationFilingOrg>2562</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>1938</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>6820</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>4162</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>5458</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>5454</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>100032</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>94344</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>ERIN PICA</NamePerson>
        <BaseCompensationFilingOrg>85294</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>62242</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>21791</BonusRelatedOrgs>
        <OtherCompensationFilingOrg>1292</OtherCompensationFilingOrg>
        <OtherCompensationRelatedOrgs>981</OtherCompensationRelatedOrgs>
        <DeferredCompFilingOrg>4280</DeferredCompFilingOrg>
        <DeferredCompRelatedOrgs>6735</DeferredCompRelatedOrgs>
        <NontaxableBenefitsFilingOrg>428</NontaxableBenefitsFilingOrg>
        <NontaxableBenefitsRelatedOrgs>311</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationFilingOrg>91294</TotalCompensationFilingOrg>
        <TotalCompensationRelatedOrgs>92060</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>CONRAD W SCHINTZ</NamePerson>
        <BaseCompensationFilingOrg>174220</BaseCompensationFilingOrg>
        <BonusFilingOrg>34572</BonusFilingOrg>
        <OtherCompensationFilingOrg>29300</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>16255</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>12828</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>267175</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>JOHN P WIERCINSKI</NamePerson>
        <BaseCompensationFilingOrg>235816</BaseCompensationFilingOrg>
        <BonusFilingOrg>95144</BonusFilingOrg>
        <OtherCompensationFilingOrg>46192</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>17778</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>16798</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>411728</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>KEVIN J KERESTUS CIA</NamePerson>
        <CompBasedOnRelatedOrgs>159907</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>26114</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>3182</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>12867</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>18150</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>220220</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>BRUCE H HAMORY MD</NamePerson>
        <CompBasedOnRelatedOrgs>456961</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>120250</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>127263</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>133879</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>19779</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>858132</TotalCompensationRelatedOrgs>
        <CompReportPrior990RelatedOrgs>80909</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>RONALD A PAULUS MD</NamePerson>
        <CompBasedOnRelatedOrgs>331500</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>218409</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>33843</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>169124</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>13412</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>766288</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>JOANNE E WADE</NamePerson>
        <CompBasedOnRelatedOrgs>531456</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>268237</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>84354</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>177664</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>8639</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>1070350</TotalCompensationRelatedOrgs>
        <CompReportPrior990RelatedOrgs>47691</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>LISSA L BRYAN SMITH</NamePerson>
        <BaseCompensationFilingOrg>255591</BaseCompensationFilingOrg>
        <BonusFilingOrg>51039</BonusFilingOrg>
        <OtherCompensationFilingOrg>12251</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>17778</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>11638</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>348297</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>FRINGE OR EXPENSE EXPLANATION</Identifier>
        <ReturnReference>SCHEDULE J, PAGE 1, PART I, LINE 1A</ReturnReference>
        <Explanation>TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: FROM TIME TO TIME, THE GHS BOARD OF DIRECTORS OR GHS SENIOR MANAGEMENT APPROVE THE GROSS-UP OF EXPENSES, WHICH FURTHER GHS BUSINESS, FOR TAX OBLIGATIONS.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS</Identifier>
        <ReturnReference>SCHEDULE J, PAGE 1, PART I, LINE 4</ReturnReference>
        <Explanation>GLENN D. STEELE, JR., M.D., PH.D. 0 241,531 0 DAVID J. FELICIO, ESQUIRE 0 19,288 0 KEVIN F. BRENNAN, CPA, FHFMA 0 41,972 0 FRANK J. TREMBULAK 0 3,293 0 BRUCE H. HAMORY, M.D. 0 80,909 0 JOANNE E. WADE 0 47,691 0</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>NON-FIXED PAYMENTS PROVIDED</Identifier>
        <ReturnReference>SCHEDULE J, PAGE 1, PART I, LINE 7</ReturnReference>
        <Explanation>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.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>PURSUANT TO CONTRACT PER REGS. SECTION 53.4958-4(A)(3)</Identifier>
        <ReturnReference>SCHEDULE J, PAGE 1, PART I, LINE 8</ReturnReference>
        <Explanation>THE EMPLOYEES LISTED PARTICIPATE IN A COMPENSATION PROGRAM DESIGNED TO BE MARKET COMPETITIVE. FORM TIME TO TIME, DEPENDING UPON THE AVAILABILITY OF QUALIFIED APPLICANTS, RECRUITMENT LOANS MAY BE MADE AVAILABLE TO QUALIFIED APPLICANTS IN DIFFICULT TO RECRUIT POSITIONS. SUCH LOANS ARE ONLY PROVIDED IF TOTAL COMPENSATION, INCLUDING THE LOAN AMOUNT, IS CONSIDERED REASONABLE COMPENSATION PER INDEPENDENT SALARY SURVEYS.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>OTHER ADDITIONAL INFORMATION</Identifier>
        <ReturnReference>SCHEDULE J, PART III</ReturnReference>
        <Explanation>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 ("THE FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc9">
      <LoanTable>
        <NamePerson>JOHN BUCKLEY</NamePerson>
        <PurposeOfLoan>RECRUITMENT</PurposeOfLoan>
        <LoanFromOrganization>X</LoanFromOrganization>
        <OriginalPrincipalAmount>40000</OriginalPrincipalAmount>
        <BalanceDue>17146</BalanceDue>
        <Default>false</Default>
        <ApprovedByBoard>true</ApprovedByBoard>
        <WrittenAgreement>true</WrittenAgreement>
      </LoanTable>
      <TotalBalanceDue>17146</TotalBalanceDue>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>GEISINGER MEDICAL MANAGEMENT CORP</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>BUSINESS</Relationship>
        <AmountOfTransaction>4360</AmountOfTransaction>
        <DescriptionOfTransaction>IC SHARED SERV REV</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>GEISINGER MEDICAL MANAGEMENT CORP</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>BUSINESS</Relationship>
        <AmountOfTransaction>2866</AmountOfTransaction>
        <DescriptionOfTransaction>IC SHARED SERV EXP</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>GEISINGER QUALITY OPTIONS INC</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>BUSINESS</Relationship>
        <AmountOfTransaction>16491604</AmountOfTransaction>
        <DescriptionOfTransaction>IC SHARED SERV REV</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>INTERNATIONAL SHARED SERVICES INC</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>BUSINESS</Relationship>
        <AmountOfTransaction>6116065</AmountOfTransaction>
        <DescriptionOfTransaction>IC SHARED SERV EXP</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>INTERNATIONAL SHARED SERVICES INC</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>BUSINESS</Relationship>
        <AmountOfTransaction>65759</AmountOfTransaction>
        <DescriptionOfTransaction>LEASE REVENUE</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NameBusiness>
            <BusinessNameLine1>GEISINGER ASSURANCE COMPANY LTD</BusinessNameLine1>
          </NameBusiness>
        </NameOfInterestedPerson>
        <Relationship>BUSINESS</Relationship>
        <AmountOfTransaction>2092152</AmountOfTransaction>
        <DescriptionOfTransaction>IC SHARED SERV EXP</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartV>
        <Identifier>ADDITIONAL INFORMATION</Identifier>
        <ReturnReference>SCHEDULE L PART V</ReturnReference>
        <Explanation>GEISINGER WYOMING VALLEY MEDICAL CENTER GWV IS CLOSELY AFFILIATED WITH SEVERAL OTHER ORGANIZATIONS IN THE NORMAL COURSE OF OPERATIONS OF THESE AFFILIATED ORGANIZATIONS THERE ARE NUMEROUS INTERORGANIZATIONAL TRANSACTIONS WHICH MAY INCLUDE SALES EXCHANGES AND LEASE OF PROPERTY EXTENSIONS OF CREDIT FURNISHING OF GOODS SERVICES AND FACILITIES AND TRANSFERS OF ASSETS THESE TYPES OF INTERORGANIZATIONAL 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 ORGANIZATIONS TAX EXEMPT STATUS THE FOLLOWING ORGANIZATIONS REPRESENT THE AFFILIATED FORPROFIT ORGANIZATIONS WITHIN THE GEISINGER HEALTH SYSTEM FOR WHOM BUSINESS TRANSACTIONS MUST BE DISCLOSED FOR PURPOSES OF SCHEDULE L PART IV TRANSACTIONS WITH INTERESTED PERSONS OFFICERS AND DIRECTORS OF GEISINGER WYOMING VALLEY MEDICAL CENTER ARE OFFICERS AND DIRECTORS OF THESE ORGANIZATIONS AS DESCRIBED BELOW GEISINGER MEDICAL MANAGEMENT CORPORATION GMMC DAVID J FELICIO ESQUIRE IS THE CHIEF LEGAL OFFICER AND SECRETARY OF GWV AND GMMC GLENN D STEELE JR MD PHD IS THE PRESIDENT CHAIRMAN OF THE BOARD AND DIRECTOR EXOFFICIO OF GWV AND THE PRESIDENT CHAIRMAN OF THE BOARD AND DIRECTOR OF GMMC FRANK J TREMBULAK IS THE SENIOR VICE PRESIDENT AND TREASURER OF GWV AND GMMC EDWARD J ZYCH ESQUIRE IS THE ASSISTANCT SECRETARY OF GWV AND GMMC WILLIAM H ALEXANDER IS A DIRECTOR OF GWV AND GMMC WILLIAM R GRUVER IS A DIRECTOR OF GWV AND GMMC ROBERT E POOLE IS A DIRECTOR OF GWV AND GMMC DON A ROSINI IS A DIRECTOR OF GWV AND GMMC GEISINGER QUALITY OPTIONS INC GQO DAVID J FELICIO ESQUIRE IS THE CHIEF LEGAL OFFICER AND SECRETARY OF GWV AND GQO GLENN D STEELE JR MD PHD IS THE PRESIDENT CHAIRMAN OF THE BOARD AND DIRECTOR EXOFFICIO OF GWV AND THE CHAIRMAN OF THE BOARD AND DIRECTOR EXOFFICIO OF GQO FRANK J TREMBULAK IS THE SENIOR VICE PRESIDENT AND TREASURER OF GWV AND SENIOR VICE PRESIDENT TREASURER AND DIRECTOR OF GQO WILLIAM H ALEXANDER IS A DIRECTOR OF GWV AND GQO DON A ROSINI IS A DIRECTOR OF GWV AND GQO THOMAS H LEE JR IS A DIRECTOR OF GWV AND GQO INTERNATIONAL SHARED SERVICES INC ISS DAVID J FELICIO ESQUIRE IS THE CHIEF LEGAL OFFICER AND SECRETARY OF GWV AND ISS GLENN D STEELE JR MD PHD IS THE PRESIDENT CHAIRMAN OF THE BOARD AND DIRECTOR EXOFFICIO OF GWV AND THE CHAIRMAN OF THE BOARD AND DIRECTOR OF ISS FRANK J TREMBULAK IS THE SENIOR VICE PRESIDENT AND TREASURER OF GWV AND THE SENIOR VICE PRESIDENT TREASURER AND DIRECTOR OF ISS EDWARD J ZYCH ESQUIRE IS THE ASSISTANCT SECRETARY OF GWV AND ISS GEISINGER ASSURANCE COMPANY LTD GAC DAVID J FELICIO ESQUIRE IS THE CHIEF LEGAL OFFICER AND SECRETARY OF GWV AND THE SECRETARY AND DIRECTOR OF GAC GLENN D STEELE JR MD PHD IS THE PRESIDENT CHAIRMAN OF THE BOARD AND DIRECTOR EXOFFICIO OF GWV AND THE CHAIRMAN OF THE BOARD AND DIRECTOR OF GAC FRANK J TREMBULAK IS THE SENIOR VICE PRESIDENT AND TREASURER OF GWV AND THE PRESIDENT CHIEF EXECUTIVE OFFICER AND DIRECTOR OF GAC 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</Explanation>
      </Form990ScheduleLPartV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc10">
      <GeneralExplanation>
        <Identifier>ORGANIZATION'S MISSION</Identifier>
        <ReturnReference>FORM 990 - ORGANIZATION'S MISSION</ReturnReference>
        <Explanation>TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING QUALITY HOSPITAL SERVICES AND ACCESS ACROSS NORTHEASTERN PENNSYLVANIA THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE. I. GENERAL INFORMATION GEISINGER WYOMING VALLEY MEDICAL CENTER (GWV), A 501(C)(3) NOT-FOR-PROFIT CORPORATION AND MEMBER OF GEISINGER HEALTH SYSTEM, OWNS AND OPERATES A 242-BED, ACUTE CARE, HOSPITAL WITH ADVANCED TERTIARY SERVICES IN WILKES-BARRE, PA. GWV'S CONVENIENT LOCATION NEAR SEVERAL MAJOR HIGHWAYS MAKES IT ACCESSIBLE FROM ALL AREAS OF NORTHEASTERN PENNSYLVANIA. GWV IS A LEVEL 2 TRAUMA CENTER AND ACCREDITED CHEST PAIN CENTER OFFERING EMERGENCY AND TRAUMA CARE 24 HOURS A DAY. GEISINGER WYOMING VALLEY IS FULLY ACCREDITED BY THE JOINT COMMISSION. THE FACILITY OPENED IN 1981 AS THE NPW MEDICAL CENTER OF N.E. PENNSYLVANIA, INC. GWV PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. SERVICES OFFERED BY GWV INCLUDE: COMPREHENSIVE MATERNITY AND PEDIATRIC SERVICES. A VARIETY OF WOMEN'S SERVICES ARE OFFERED INCLUDING THE SPECIAL DELIVERY PROGRAM IN OBSTETRICS, WHICH FEATURES THE AREA'S ONLY SUB-SPECIALTY, FELLOWSHIP-TRAINED REPRODUCTIVE ENDOCRINOLOGIST/INFERTILITY SPECIALIST. GWV WAS ALSO THE FIRST HOSPITAL IN THE AREA TO OFFER LABOR, DELIVERY, RECOVERY, POST-PARTUM (LRDP) SUITES FOR EXPECTANT PARENTS AND OFFERS TWO DEDICATED C-SECTION SURGICAL SUITES. THE WOMEN'S UNIT WAS EXPANDED IN 2011 TO PROVIDE 15 ADDITIONAL PRIVATE ROOMS EQUIPPED WITH THE MOST ADVANCED TECHNOLOGY FOR POSTPARTUM AND POSTOPERATIVE CARE, AS WELL AS TWO NEW LABOR TRIAGE AREAS FOR ENHANCED LABOR AND DELIVERY CAPABILITIES. IN 2011, THE 12-BED TAMBUR NEONATAL INTENSIVE CARE UNIT (NICU) WAS BUILT. IT IS THE ONLY NICU IN LUZERNE COUNTY PROVIDING CARE FOR PREMATURE INFANTS AND OTHER BABIES IN NEED OF HIGHLY SPECIALIZED MEDICAL CARE. THE JANET WEIS CHILDREN'S HOSPITAL PEDIATRICS UNIT AT GWV PROVIDES NUMEROUS PEDIATRIC SUB-SPECIALTY SERVICES. PEDIATRIC HOSPITALIST PHYSICIANS STAFF THE 7-BED UNIT. IN THE FALL OF 2008, THE CRITICAL CARE BUILDING WAS COMPLETED, WHICH IS A 178,000 SQUARE FOOT FACILITY THAT FEATURES AN EXPANDED 24/7 EMERGENCY DEPARTMENT WITH ROOFTOP HELIPAD AND HIGH-TECH SURGICAL SUITES. AN ORTHOPAEDIC SURGERY DEPARTMENT RECOGNIZED FOR ITS SPECIAL CAPABILITIES IN JOINT REPLACEMENT SURGERY - INCLUDING SERVICES FOR PEOPLE WHO PREVIOUSLY HAD JOINT REPLACEMENTS. OTHER SERVICES INCLUDE A GERIATRIC FRACTURE CARE PROGRAM, ARTHROSCOPIC SURGERY, TREATMENT FOR TRAUMA PATIENTS AND THOSE WITH SPORTS INJURIES. THE LATEST ITERATION OF THE DAVINCI ROBOT TO PERFORM ADVANCED MINIMALLY INVASIVE SURGICAL PROCEDURES. LIFEFLIGHT, GEISINGER'S MEDICAL HELICOPTER SERVICE PROVIDES QUICK AIR MEDICAL RESPONSE FOR TRANSPORTING PATIENTS FOR LIFE-SAVING CARE. THE RICHARD AND MARION PEARSALL HEART HOSPITAL AT GWV OPENED IN OCTOBER 2001. IT IS DEDICATED TO BRINGING THE LATEST TECHNOLOGY USED IN THE TREATMENT OF HEART DISEASE TO THE PEOPLE OF NORTHEAST PENNSYLVANIA. THREE CARDIAC CATHETERIZATION LABORATORIES OFFER ADVANCED TREATMENTS TO PATIENTS WITH HEART DISEASE, INCLUDING A 24 HOUR PER DAY PRIMARY ANGIOPLASTY PROGRAM, ANGIOJET THERAPY, BRACHYTHERAPY, AND THE USE OF A CUTTING BALLOON TO REPAIR BLOCKED VESSELS. THE PEARSALL HEART HOSPITAL OFFERS ANCILLARY CARDIAC TESTING, PHYSICIAN CARE AS WELL AS A NINE BED STEP-DOWN UNIT, CARDIAC REHABILITATION, AND AN EIGHT BED OUTPATIENT UNIT USED FOR PRE AND POST CARDIAC CATH RECOVERY. THE PEARSALL HEART HOSPITAL IS ALSO HOME TO GWV'S CARDIOLOGY, CARDIOTHORACIC SURGERY AND VASCULAR SURGERY DEPARTMENTS AND INCLUDES AN ICAVL-ACCREDITED NONINVASIVE DIAGNOSTIC LABORATORY. THE FRANK AND DOROTHEA HENRY CANCER CENTER PROVIDES MULTIDISCIPLINARY AND COMPREHENSIVE CARE INCLUDING CONSULTATIONS, DIAGNOSIS AND TREATMENT FOR ALL TYPES OF ADULT CANCERS. GWV'S CANCER PROGRAM PROVIDES HEMATOLOGY, AS WELL AS MEDICAL, SURGICAL AND RADIATION ONCOLOGY SERVICES, CLINICAL TRIALS AND CANCER GENETIC COUNSELING. THE PROGRAM HAS EARNED A FULL FOUR-YEAR APPROVAL BY THE COMMISSION ON CANCER OF THE AMERICAN COLLEGE OF SURGEONS. A 32,000 SQUARE FOOT EXPANSION PROJECT AT THE HENRY CANCER CENTER WAS COMPLETED IN SPRING 2009. THE RADIOLOGY DEPARTMENT OFFERS A COMPREHENSIVE IMAGING PROGRAM AND UPGRADED IN 2011 TO OFFER THE LATEST INTERVENTIONAL RADIOLOGY PROCEDURES AS WELL AS ENHANCED PRE-AND POST-PROCEDURE AREAS. NUCLEAR MEDICINE SERVICES INCLUDE P.E.T. SCANS THAT CAN DIAGNOSE AND MANAGE CERTAIN TYPES OF CANCER AS WELL AS CERTAIN OTHER METABOLIC DISEASES OF THE BODY. RADIOLOGY ALSO INCLUDES TWO DEDICATED MRI HIGH FIELD STRENGTH UNITS. THE IMAGING PROGRAM OFFERS GENERAL, OB AND VASCULAR SONOGRAPHY, CAT SCAN AND GENERAL DIAGNOSTIC RADIOLOGY. THE CENTER FOR WOMEN'S IMAGING OFFERS A FULL RANGE OF DIAGNOSTIC SERVICES AT ONE CONVENIENT LOCATION DESIGNED EXCLUSIVELY FOR WOMEN. LOCATED ON THE LOWER LEVEL OF THE VALLEY MEDICAL BUILDING, EXPERIENCED RADIOLOGISTS AND TECHNOLOGISTS PROVIDE HIGH QUALITY PATIENT CARE IN A COMFORTABLE SETTING. SERVICES INCLUDE: DIGITAL MAMMOGRAPHY, ULTRASOUND, DXA SCAN BONE DENSITY TESTING, STEREOTACTIC BREAST BIOPSY AND A COMPREHENSIVE BREAST PROGRAM. THE BREAST PROGRAM OFFERS A MULTI-DISCIPLINARY APPROACH TO DIAGNOSING AND TREATING BREAST DISEASE. A DEDICATED NURSE NAVIGATOR AND A TEAM OF SURGEONS, RADIOLOGISTS, PATHOLOGISTS, AND ONCOLOGISTS COLLABORATE IN ONE CONVENIENT LOCATION TO SPEED TREATMENT AND CARE. RESIDENCY PROGRAM GWV SERVES AS A TEACHING CAMPUS FOR FAMILY MEDICINE AND GENERAL SURGERY RESIDENTS AND OFFERS A SPORTS MEDICINE FELLOWSHIP PROGRAM. RESIDENTS ALSO ROTATE TO GWV FROM GEISINGER MEDICAL CENTER IN SPECIALTIES OF EMERGENCY MEDICINE, OBSTETRICS, ORTHOPAEDICS, DERMATOLOGY, RHEUMATOLOGY, FAMILY PRACTICE, AND GENERAL SURGERY. THE TOTAL COST OF PROVIDING THE RESIDENCY PROGRAM FOR THE FISCAL YEAR ENDED JUNE 30, 2011 WAS 1.5 MILLION. OTHER SERVICES INCLUDE: COLORECTAL SURGERY NEUROLOGY COSMETIC AND RECONSTRUCTIVE SURGERY NEUROSURGERY CRITICAL CARE MEDICINE OPHTHALMOLOGY &amp; EYE SURGERY DERMATOLOGY ORAL AND MAXILLOFACIAL SURGERY EAR, NOSE &amp; THROAT SURGERY PERINATALOGY ELECTROPHYSIOLOGY PODIATRY GASTROENTEROLOGY PULMONARY MEDICINE GENERAL SURGERY RHEUMATOLOGY GYNECOLOGY SPINE SURGERY GYNECOLOGIC ONCOLOGY TRANSPLANT NEONATOLOGY UROLOGY AND UROLOGIC SURGERY II. UNCOMPENSATED CARE GEISINGER WYOMING VALLEY MEDICAL CENTER RECOGNIZES ITS MISSION IS TO SERVE ALL MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND EDUCATION. IN THIS REGARD, GWV PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH-RELATED ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A. CHARITY CARE THE PRIMARY CONCERN OF GWV IS THE DELIVERY OF HEALTH CARE TO ALL CITIZENS OF NORTHEASTERN PENNSYLVANIA REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GWV INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. FOR THE FISCAL YEAR ENDED JUNE 30, 2011, THE COST OF THE CHARITY CARE WAS 4 MILLION. B. MEDICARE/MEDICAID IN RECOGNIZING ITS MISSION TO THE COMMUNITY, GWV PROVIDES SERVICES TO THE ELDERLY (MEDICARE) AND THE INDIGENT (MEDICAID). GWV PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS TO THE EXTENT THE GOVERNMENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTH CARE. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. THE COST OF PROVIDING HEALTHCARE SERVICES TO MEDICARE AND MEDICAID PATIENTS EXCEEDED REIMBURSEMENT BY APPROXIMATELY 36.3 MILLION DURING THE FISCAL YEAR ENDED JUNE 30, 2011. C. OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GWV PROVIDES SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2011, WAS 1.4 MILLION. III. RESEARCH SUPPORT GEISINGER WYOMING VALLEY MEDICAL CENTER CONTRIBUTED 3 MILLION TO GEISINGER CLINIC TO SUPPORT ITS CHARITABLE MISSION THROUGH MEDICAL RESEARCH ACTIVITIES AT TWO FACILITIES ON THE CAMPUS OF THE GEISINGER MEDICAL CENTER: THE SIEGFRIED AND JANET WEIS CENTER FOR RESEARCH (WEIS CENTER) AND THE HENRY HOOD CENTER FOR HEALTH RESEARCH. THE WEIS CENTER PROVIDES A FOCUS FOR LABORATORY RESEARCH AND RESEARCH TRAINING, AND SUPPORTS THE CLINICAL STAFF IN THEIR RESEARCH PROGRAMS. THE PRIMARY MISSION OF THE WEIS CENTER IS TO CONDUCT ORIGINAL AND INNOVATIVE RESEARCH THAT CONTRIBUTES NEW KNOWLEDGE TO BIOMEDICAL SCIENCE. THE CENTER'S SCIENTISTS APPLY MODERN MOLECULAR AND CELLULAR APPROACHES TO DIVERSE RESEARCH PROBLEMS IN THE AREAS OF CARDIOVASCULAR FUNCTION, CANCER AND DEVELOPMENTAL BIOLOGY. THE HENRY HOOD CENTER FOR HEALTH RESEARCH CONDUCTS HEALTH SERVICES, EPIDEMIOLOGIC AND POPULATION GENETICS RESEARCH ON THE BROAD RANGE OF CONDITIONS TYPICALLY SEEN IN PRIMARY AND SPECIALTY CARE SETTINGS. THE CENTER</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ADDITIONAL INFORMATION</Identifier>
        <ReturnReference>FORM 990, PART III</ReturnReference>
        <Explanation>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 GEISINGER WYOMING VALLEY MEDICAL CENTER IS CURRENTLY THE SOLE OBLIGOR UNDER A SERIES OF BOND ISSUES WITH A TOTAL OUTSTANDING BALANCE OF 850,319,214 INCLUSIVE OF UNAMORTIZED ORIGINAL ISSUE DISCOUNT AS OF JUNE 30, 2011. 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 SCHEDULE K WAS PREPARED ON A CONSOLIDATED BASIS AND IS INCLUDED IN THE FORM 990 FILING OF GEISINGER HEALTH SYSTEM FOUNDATION, EIN: 23-1995911.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ADDITIONAL INFORMATION</Identifier>
        <ReturnReference>FORM 990, PART V</ReturnReference>
        <Explanation>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 IT'S EIN FOR CERTAIN REPORTABLE PAYMENTS OF THE FILING ORGANIZATION. THE NUMBER OF FORM 1099'S FILED BY GSS FOR THE 2010 REPORTING PERIOD ON BEHALF OF ITSELF AND IT'S AFFILIATES WAS 1,113. 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 IT'S BEHALF.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ADDITIONAL INFORMATION</Identifier>
        <ReturnReference>FORM 990, PART VI</ReturnReference>
        <Explanation>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 SIX VOTING MEMBERS OF THE GOVERNING BODY ARE ALSO VOTING MEMBERS OF AFFILIATED TAXABLE ORGANIZATIONS FOR WHICH BUSINESS TRANSACTIONS MAY BE DISCLOSED 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 AFFILIATED 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 AFFILIATED 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? GLENN D. STEELE, JR. M.D., PH.D., DAVID J. FELICIO, ESQUIRE, FRANK J. TREMBULAK, EDWARD J. ZYCH, ESQUIRE, WILLIAM H. ALEXANDER, WILLIAM R. GRUVER THOMAS H. LEE, JR., M.D., ROBERT E. POOLE, AND DON A. ROSINI 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 WYOMING VALLEY MEDICAL CENTER. ALL OF THE AFFILIATES ARE PART OF THE GEISINGER HEALTH SYSTEM.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CLASSES OF MEMBERS OR STOCKHOLDERS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 6</ReturnReference>
        <Explanation>THE MEMBERS OF THE CORPORATION HAVE THE POWER AND AUTHORITY TO ELECT AND REMOVE THE DIRECTORS, ELECT AND REMOVE THE PRESIDENT AND FILL ANY VACANCY IN THE OFFICE OF THE PRESIDENT OF THE CORPORATION, AND APPROVE AMENDMENTS TO THE CORPORATE BYLAWS. THE MEMBERS ALSO HAVE THE RESERVE POWERS AS SET FORTH IN THE PENNSYLVANIA NONPROFIT CORPORATION LAW.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ELECTION OF MEMBERS AND THEIR RIGHTS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 7A</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>DECISIONS SUBJECT TO APPROVAL OF MEMBERS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 7B</ReturnReference>
        <Explanation>THE MEMBERS OF THE CORPORATION HAVE THE POWER AND AUTHORITY TO ELECT AND REMOVE THE DIRECTORS; ELECT AND REMOVE THE PRESIDENT AND FILL ANY VACANCY IN THE OFFICE OF THE PRESIDENT OF THE CORPORATION; AND, MAY APPROVE AMENDMENTS TO THE CORPORATE BYLAWS IN LIEU OF SUCH APPROVAL BY THE BOARD OF DIRECTORS. THE MEMBERS ALSO HAVE THE RESERVE POWERS AS SET FORTH IN 15 PA. C.S.A. SUPBCHATER E OF THE PENNSYLVANIA NONPROFIT CORPORATION LAW.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ORGANIZATION'S PROCESS USED TO REVIEW FORM 990</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 11B</ReturnReference>
        <Explanation>ALL OFFICERS AND DIRECTORS WERE ELECTRONICALLY PROVIDED A FINAL COPY OF THE FORM 990 PRIOR TO FILING THE RETURN WITH THE IRS. AN EXECUTIVE SUMMARY OF THE INFORMATION REPORTED ON THE RETURN IS PROVIDED TO ASSIST IN THE REVIEW. IN ACCORDANCE WITH THE GEISINGER HEALTH SYSTEM FOUNDATION BOARD OF DIRECTOR'S FINANCE COMMITTEE CHARTER, STAFF PERIODICALLY REVIEWS THE GHS ORGANIZATIONS' FORM 990 FILINGS. THE FORM 990 IS PREPARED BY THE GEISINGER HEALTH SYSTEM (GHS) TAX AND FINANCIAL REPORTING DEPARTMENTS WITH INFORMATION PROVIDED FROM FINANCE, TAX, HUMAN RESOURCES, 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, 2011.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ENFORCEMENT OF CONFLICTS POLICY</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 12C</ReturnReference>
        <Explanation>THE OFFICERS AND DIRECTORS OF GEISINGER WYOMING 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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>COMPENSATION PROCESS FOR TOP OFFICIAL</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 15A</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>COMPENSATION PROCESS FOR OFFICERS</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 15B</ReturnReference>
        <Explanation>SEE SCHEDULE O RESPONSE TO FORM 990, PART VI, SECTION B, QUESTION 15A.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>GOVERNING DOCUMENTS DISCLOSURE EXPLANATION</Identifier>
        <ReturnReference>FORM 990, PAGE 6, PART VI, LINE 19</ReturnReference>
        <Explanation>THE MISSION STATEMENT IS AVAILABLE ON THE GEISINGER HEALTH SYSTEM WEBSITE AT: WWW.GEISINGER.ORG. THE ANNUAL REPORT FOR THE GEISINGER HEALTH SYSTEM, CONTAINING CONSOLIDATED FINANCIAL STATEMENT INFORMATION, COMMUNITY BENEFIT REPORT AND OTHER INFORMATION, IS AVAILABLE ON THE SYSTEM WEBSITE AT: WWW.GEISINGER.ORG. FINANCIAL STATEMENTS ALONG WITH THE COMPLETE FORM 990 AND 990-T ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GEISINGER HEALTH SYSTEM CONFLICTS OF INTEREST POLICY IS AVAILABLE ON THE SYSTEM WEBSITE AT: WWW.GEISINGER.ORG.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ADDITIONAL INFORMATION</Identifier>
        <ReturnReference>FORM 990, PART VII</ReturnReference>
        <Explanation>FORM 990, PART VII, SECTION A, COLUMN B - AVERAGE HOURS PER WEEK: FOR ALL CURRENT OFFICERS, DIRECTORS, KEY EMPLOYEES, AND FIVE HIGHEST COMPENSATED EMPLOYEES REPORTED IN FORM 990, PART VII, THE AVERAGE HOURS PER WEEK REPRESENTS THE MINIMUM HOURS DEVOTED TO THE ORGANIZATION AND RELATED ORGANIZATIONS OF THE GEISINGER HEALTH SYSTEM, AS APPLICABLE. FORMER OFFICERS, DIRECTORS, KEY EMPLOYEES, AND FIVE HIGHEST COMPENATED EMPLOYEES WORK A MINIMUM OF 40 HOURS PER WEEK FOR RELATED ORGANIZATIONS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER CHANGES IN NET ASSETS EXPLANATION</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 5</ReturnReference>
        <Explanation>OTHER CHANGES IN NET ASSETS OR FUND BALANCES: INCREASES: UNREALIZED GAIN ON INVESTMENT 12,844,473 UNREALIZED GAIN SELF-INSURANCE 17 UNREALIZED GAIN ON DERIVATIVE 1,153,571 CHANGE IN DERIVATIVE VALUE 312,373 TRANSFER FROM AFFILIATE 5,793,793 DECREASES: ENTITY TRANSFER ( 79,500,000) TRANSITIONAL GOODWILL IMPAIRMENT ( 6,616,009) TOTAL (66,011,782)</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ADDITIONAL INFORMATION</Identifier>
        <ReturnReference>FORM 990, PART XII</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
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        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
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          <BusinessNameLine1>INTERNATIONAL SHARED SERVICES INC</BusinessNameLine1>
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        <TransactionType>A</TransactionType>
        <AmountInvolved>65759</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
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      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MARWORTH</BusinessNameLine1>
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        <TransactionType>K</TransactionType>
        <AmountInvolved>189956</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
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      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER HEALTH SYSTEM FOUNDATION</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>B</TransactionType>
        <AmountInvolved>79500000</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER ASSURANCE COMPANY LTD</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>O</TransactionType>
        <AmountInvolved>2092152</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER CLINIC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>L</TransactionType>
        <AmountInvolved>21256358</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISIGNER CLINIC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>J</TransactionType>
        <AmountInvolved>863853</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER CLINIC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>336482</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
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      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER CLINIC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>R</TransactionType>
        <AmountInvolved>15086263</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER CLINIC</BusinessNameLine1>
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        <TransactionType>A</TransactionType>
        <AmountInvolved>196010</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER CLINIC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>L</TransactionType>
        <AmountInvolved>753828</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER COMMUNITY HEALTH SERVICES</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>L</TransactionType>
        <AmountInvolved>128919</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER HEALTH PLAN</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>65044529</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER HEALTH SYSTEM FOUNDATION</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>L</TransactionType>
        <AmountInvolved>1110484</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER HEALTH SYSTEM FOUNDATION</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>C</TransactionType>
        <AmountInvolved>5903870</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER HEALTH SYSTEM FOUNDATION</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>200038</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER INSURANCE CORP RRG</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>O</TransactionType>
        <AmountInvolved>86113</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER INSURANCE CORP RRG</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>O</TransactionType>
        <AmountInvolved>768429</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER MEDICAL CENTER</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>L</TransactionType>
        <AmountInvolved>8518863</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER MEDICAL CENTER</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>199869</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER CLINIC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>Q</TransactionType>
        <AmountInvolved>4419997</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER COMMUNITY HEALTH SERVICES</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>A</TransactionType>
        <AmountInvolved>3600</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER QUALITY OPTIONS INC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>16491604</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER CLINIC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>B</TransactionType>
        <AmountInvolved>2966000</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER SYSTEM SERVICES</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>L</TransactionType>
        <AmountInvolved>64901511</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
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      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER SYSTEM SERVICES</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>O</TransactionType>
        <AmountInvolved>8117092</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
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      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>INTERNATIONAL SHARED SERVICES INC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>L</TransactionType>
        <AmountInvolved>6116065</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>INTERNATIONAL SHARED SERVICES INC</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>A</TransactionType>
        <AmountInvolved>65759</AmountInvolved>
        <MethodOfAmtDetermination>FMV</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>MARWORTH</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>K</TransactionType>
        <AmountInvolved>189956</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>GEISINGER HEALTH SYSTEM FOUNDATION</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>B</TransactionType>
        <AmountInvolved>79500000</AmountInvolved>
        <MethodOfAmtDetermination>GAAP</MethodOfAmtDetermination>
      </TransactionsRelatedOrgsTable>
      <Form990ScheduleRPartVII>
        <Identifier>ADDITIONAL INFORMATION</Identifier>
        <ReturnReference>SCHEDULE R</ReturnReference>
        <Explanation>FORM 990 SCHEDULE R PART V TRANSACTIONS WITH RELATED ORGANIZATIONS AS SHOWN IN THE RESPONSE TO FORM 990 SCHEDULE R GEISINGER WYOMING VALLEY 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</Explanation>
      </Form990ScheduleRPartVII>
    </IRS990ScheduleR>
  </ReturnData>
</Return>