2023-11-14T10:52:07-05:00 2022-12-31 990 2022-01-01 240862246 COMMUNITY MEDICAL CENTER COMM 5702716624 100 N ACADEMY AVE MC 49-70 DANVILLE PA 178229800 KEVIN V ROBERTS MBA CPA EVP, CFO, TREASURER 5702716640 2023-11-07 KEVIN V ROBERTS XXX-XX-XXXX false 2022 2023-04-26 12:10:37Z GEISINGER COMMUNITY MEDICAL CENTER JAEWON RYU MD JD 100 N ACADEMY AVE MC 22-01 DANVILLE PA 178229800 473584325 false X WWW.GEISINGER.ORG X 1962 PA STRIVE TO MAKE BETTER HEALTH EASIER BY PROVIDING ACCESS TO AFFORDABLE, HIGH QUALITY HEALTH SERVICES THROUGH EQUITABLE, INNOVATIVE, AND INCLUSIVE CARE MODELS THAT SUPPORT PATIENT CARE, EDUCATION, RESEARCH, & COMMUNITY SERVICE. 7 3 2552 56 306533 2864682 315000 416265171 464235585 10024838 7152944 2742683 1758487 431897374 473462016 410000 169917 0 136522278 156887345 0 0 263846550 321499671 400778828 478556933 31118546 -5094917 397356239 357519851 200970818 194337178 196385421 163182673 X STRIVE TO MAKE BETTER HEALTH EASIER BY PROVIDING ACCESS TO AFFORDABLE, HIGH QUALITY HEALTH SERVICES THROUGH EQUITABLE, INNOVATIVE, AND INCLUSIVE CARE MODELS THAT SUPPORT PATIENT CARE, EDUCATION, RESEARCH, & COMMUNITY SERVICE. false false 463087808 169917 465170466 I. GENERAL INFORMATION COMMUNITY MEDICAL CENTER (CMC), DOING BUSINESS AS GEISINGER COMMUNITY MEDICAL CENTER (GCMC), IS A TAX-EXEMPT, PENNSYLVANIA NOT-FOR-PROFIT CORPORATION ORGANIZED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. GCMC IS A 293-BED ACUTE CARE HOSPITAL IN SCRANTON, PA. ORIGINALLY CALLED HAHNEMANN HOSPITAL, IT WAS FOUNDED IN 1897 BY A GROUP OF 15 PHILANTHROPIC WOMEN. THE HOSPITAL WAS SCRANTON'S FIRST AND CURRENTLY ONLY ACUTE CARE HOSPITAL DEDICATED TO SERVING THE COMMUNITY AND THEIR HEALTH NEEDS THROUGH A CHARITABLE PURPOSE. GCMC CONTINUES TO PROVIDE THE COMMUNITY WITH A VARIETY OF SERVICES AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. THIS CONTINUUM OF CARE INCLUDES PREVENTIVE, AMBULATORY, INPATIENT, AND EMERGENCY SERVICES. GCMC IS A NOTED REGIONAL REFERRAL CENTER WITH COMPREHENSIVE ACUTE CARE MEDICAL SERVICES AND HAS DEVELOPED MANY SPECIFIC AREAS OF EXPERTISE. PATIENT ORIGIN AND SERVICE AREA: THE HOSPITAL'S PRIMARY SERVICE AREA IS COMPRISED OF LACKAWANNA, LUZERNE, AND WAYNE COUNTIES. SECONDARY SERVICE AREAS INCLUDE MONROE, PIKE, SUSQUEHANNA, AND WYOMING COUNTIES. II. MAJOR PROGRAM SERVICE ACTIVITIES SPECIALIZED / REGIONAL SERVICES, CENTERS OF EXCELLENCE: GCMC IS THE ONLY LEVEL II TRAUMA CENTER IN LACKAWANNA COUNTY. THE NORTHEAST PA TRAUMA CENTER, DESIGNATED BY THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION IN 1988, PROVIDES 24-HOUR COMPREHENSIVE SURGICAL INTERVENTION FOR CRITICALLY INJURED PATIENTS. THE TRAUMA CENTER IS STAFFED CONTINUOUSLY BY AN EMERGENCY PHYSICIAN, TRAUMA SURGEON, AND NURSES CERTIFIED IN CRITICAL CARE, TRAUMA, ORTHOPEDICS, AND THE NEUROSCIENCES. CARDIOLOGY SERVICES AT THE HOSPITAL INCLUDE THE REGION'S FIRST ELECTROPHYSIOLOGY LAB AND AN OPEN-HEART SURGERY CENTER AS WELL AS A CARDIAC REHAB PROGRAM. THE NON-INVASIVE CARDIOVASCULAR DEPARTMENT IS ACCREDITED IN ADULT TRANSTHORACIC ECHOCARDIOGRAPHY BY THE INTERSOCIETAL ACCREDITATION COMMISSION (IAC). GCMC IS ALSO A CERTIFIED CAROTID STENT FACILITY AND CERTIFIED HEART ATTACK RECEIVING CENTER. GCMC CARDIOLOGY HAS EARNED THE AMERICAN HEART ASSOCIATION'S MISSION: LIFELINE HEART ATTACK RECEIVING CENTER AWARD AND HIGHMARK'S BLUE DISTINCTION CENTER+ FOR CARDIAC CARE. IN 2019, GCMC OPENED A 4 MILLION HEART AND VASCULAR CENTER. THIS BRAND NEW 10,000 SQUARE FOOT CLINIC FEATURES 22 EXAM ROOMS AND STREAMLINES CARDIOLOGY, CARDIAC, AND THORACIC SURGERY AT GCMC. IN 2022 GCMC EARNED THE COMPREHENSIVE HEART ATTACK CENTER CERTIFICATION FROM THE JOINT COMMISSION AND THE AMERICAN HEART ASSOCIATION. NEUROSCIENCES AT GCMC SPECIALIZES IN THE CARE OF PEOPLE WITH BRAIN AND SENSE ORGAN DISORDERS. GCMC WAS AWARDED WITH THE AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES GOLD PLUS QUALITY ACHIEVEMENT AWARD WITH TARGET: STROKE HONOR ROLL ELITE AND TYPE 2 DIABETES HONOR ROLL. GCMC ALSO EARNED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR CERTIFICATION AS A PRIMARY STROKE CENTER (ONLY ONE OF 54 MEDICAL CENTERS IN PENNSYLVANIA TO OBTAIN THIS). IN ADDITION, GCMC IS THE ONLY HOSPITAL IN THE REGION TO OFFER A 10-BED ADULT INPATIENT EPILEPSY MONITORING UNIT. OTHER SPECIALIZED SERVICES INCLUDE: INTERVENTIONAL RADIOLOGY THE HOSPITAL'S INTERVENTIONAL RADIOLOGY SUITE OFFERS A STATE-OF-THE-ART SPACE FOR MINIMALLY INVASIVE SURGICAL PROCEDURES THAT TREAT VASCULAR ISSUES, TRAUMA, CANCERS, UTERINE FIBROIDS, KIDNEY STONES AND OTHER CONDITIONS. THE 2.9 MILLION, 2,110-SQUARE-FOOT SPACE BOASTS ADVANCED, HIGH-TECH IMAGING EQUIPMENT FOR MORE PRECISE IMAGING, BETTER DIAGNOSES AND MORE FOCUSED TREATMENT. COMPREHENSIVE BARIATRICS PROGRAM SCRANTON-AREA RESIDENTS COPING WITH SEVERE OBESITY AND OBESITY-RELATED HEALTH DISORDERS DON'T HAVE TO TRAVEL FAR TO FIND HIGH-QUALITY CARE THAT GOES WELL BEYOND TRADITIONAL WEIGHT-LOSS SURGERY WITH GCMC'S PROVENCARE BARIATRIC PROGRAM. THE PROGRAM OFFERS MORE THAN JUST SURGERY - IT'S AN ENTIRE PATHWAY OF CARE THAT STARTS WITH A FULL MEDICAL SCREENING AND EVALUATION BY A NUTRITIONIST. PATIENTS IN THE PROGRAM RECEIVE SEVERAL MONTHS OF CARE, INCLUDING BEHAVIOR MODIFICATION STRATEGIES, NUTRITION AND EXERCISE THERAPY AND GROUP EDUCATION SERVICES BEFORE THEIR SURGERY. GCMC'S PROGRAM IS NATIONALLY ACCREDITED BY THE METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM, THE ONLY ONE IN LACKAWANNA COUNTY. GENERAL SURGERY GCMC'S GENERAL SURGEONS PERFORM LAPAROSCOPIC AND OPEN BARIATRICS, LAPAROSCOPIC BOWEL RESECTIONS, MINIMALLY INVASIVE CARDIAC SURGERY, MINIMALLY INVASIVE SPINAL SURGERY, ROBOTIC -ASSISTED SURGERY, AND MINIMALLY INVASIVE AND ENDOVASCULAR PROCEDURES ON HEART VALVES. SURGEONS IN GCMC'S HYBRID OR ARE PERFORMING RADIOLOGICALLY ASSISTED VASCULAR PROCEDURES, AND GCMC OFFERS THE MOST UP-TO-DATE APPROACH TO HIP ARTHROPLASTY IN THE COUNTRY. IN 2023 GCMC WAS LISTED IN U.S. NEWS & WORLD REPORT BEST HOSPITALS RANKINGS FOR HEART FAILURE, KIDNEY FAILURE, STROKE, COPD, KNEE REPLACEMENT. CANCER CENTER OPENED IN SEPTEMBER 2016, THE HENRY CANCER CENTER SCRANTON CAMPUS IS A 6,500-SQUARE-FOOT CANCER CENTER OFFERS MEDICAL ONCOLOGY SERVICES SUCH AS CHEMOTHERAPY, BLOOD THERAPIES AND INFUSION MEDICATIONS. THE 2.1 MILLION SPACE FEATURES A SOFTLY LIT WAITING AREA, ITS OWN PHARMACY STOCKED FOR THE UNIQUE NEEDS OF CANCER PATIENTS, 7 EXAM ROOMS AND 11 INFUSION BAYS WITH HEATED CHAIRS TO INCREASE PATIENT COMFORT. LABOR AND DELIVERY IN OCTOBER 2019, GCMC BEGAN DELIVERING BABIES AGAIN THE 15 MILLION MATERNITY CENTER OFFERS THE COMBINED EXPERTISE OF OB/GYNS AND CERTIFIED NURSE MIDWIVES (CNMS) TO ALLOWS EXPECTANT MOTHERS TO TAILOR THEIR BIRTH PLAN TO THEIR PREFERENCES AND HAVE THE RESOURCES TO DEVIATE FROM THAT PLAN IF NECESSARY; FEATURES 8 SPACIOUS SUITES DESIGNED FOR LABOR, DELIVERY AND RECOVERY, BIRTHING BALLS, HYDROTHERAPY TUBS AND STATE-OF-THE-ART MONITORING TECHNOLOGY. SINCE IT'S OPENING, THE CHILDBIRTH CENTER AT GCMC HAS BEEN SUCCESSFUL IN KEEPING THE NUMBER OF CESAREAN BIRTHS BELOW THE STATE AVERAGE. GEISINGER VIEWMONT OUTPATIENT ANCILLARY SERVICES UNDER THE NAME OF GEISINGER VIEWMONT, GCMC OFFERS A COMPREHENSIVE SET OF OUTPATIENT LAB, RADIOLOGY, AND PHYSICAL AND OCCUPATIONAL THERAPY SERVICES AT CONVENIENT LOCATIONS THROUGHOUT LACKAWANNA COUNTY. WITH EXPANDED HOURS AND WEEKEND APPOINTMENTS, GCMC PROVIDES THESE CRITICAL TESTING AND THERAPY SERVICES TO PATIENTS FOR TIMELY RESULTS. OTHER SERVICES GCMC ALSO OFFERS A SAME-DAY OUTPATIENT SURGERY CENTER, A 24-BED SHORT-TERM PSYCHIATRIC INPATIENT UNIT (THE ONLY ONE IN LACKAWANNA COUNTY), AN ORTHOPEDIC TRAUMA AND SPORTS MEDICINE CLINIC, A FULL SUITE OF RADIOLOGY AND LABORATORY SERVICES, PULMONOLOGY, WOUND CARE AND HYPERBARIC OXYGEN CHAMBER TREATMENTS, AND PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY. IN OCTOBER 2020, GCMC OPENED THEIR NEW PROGRESSIVE CARE UNIT FEATURING 18 PRIVATE ROOMS AND A NURSING CARE MODEL THAT ALLOWS FOR DIRECT OVERSIGHT OF ALL PATIENTS. THE UNIT IS PART OF A 16M PROJECT THAT BEGINS GCMC'S PROCESS OF SHIFTING TO A PRIVATE-ROOM MODEL. III. PROGRAM SERVICE ACCOMPLISHMENTS UNCOMPENSATED CARE: GCMC RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. GCMC PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, RELIGION, ETHNICITY, SEXUAL ORIENTATION, GENDER IDENTITY, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD, GCMC PROVIDES FREE CARE OR SUBSIDIZED CARE, TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST, AND PROVIDES VARIOUS HEALTH ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITIES WHERE GCMC PRACTICES. A. CHARITY CARE THE PRIMARY CONCERN OF GCMC IS THE DELIVERY OF HEALTH CARE TO ALL THE CITIZENS OF NORTHEASTERN PENNSYLVANIA, REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GCMC INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. THE COST TO GCMC OF PROVIDING THIS CHARITY CARE DURING THE YEAR ENDED DECEMBER 31, 2022 WAS 2,635,569. B. MEDICARE/MEDICAID/OTHER GOVERNMENTAL RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO THE ELDERLY (MEDICARE) AND THE POOR (MEDICAID). GCMC PROVIDES CARE BELOW COST TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS. TO THE EXTENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTHCARE, GCMC IS FURTHERING ITS CHARITABLE MISSION. THE UNREIMBURSED VALUE OF MEDICARE, MEDICAID AND OTHER GOVERNMENTAL PAYERS IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. FOR THE YEAR ENDED DECEMBER 31, 2022, THE UNREIMBURSED COST OF PROVIDING CARE TO THESE PATIENTS WAS 80,392,375. C. OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GCMC PROVIDES OTHER PATIENT SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE YEAR ENDED DECEMBER 31, 2022 WAS 2,608,842. RESIDENCY, FELLOWSHIP, AND ALLIED HEALTH PROGRAMS: GCMC HOSTS THE REGION'S ONLY PODIATRIC RESIDENCY PROGRAM AND IS AN ACCREDITED PROVIDER OF PODIATRIC MEDICINE AND SURGERY EDUCATION BY THE COUNCIL OF PODIATRI 463087808 true true false true false false false false false true true true false false true false false true false false true false false false false false true true true false true false false false true false false true false false false false false true true true true true false true X 1 0 true 2552 true true true false false false false false false false false false false false X 7 3 true false false false true true true true true false false true true true true true true true true true true PA X ERIN FITZGERALD CPA VP AND CAO 5702142299 100 N ACADEMY AVE MC 49-70 DANVILLE PA 178229800 JAEWON RYU MD JD PRESIDENT, D 40.00 X X 0 5545041 1560940 KEVIN V ROBERTS MBA CPA EVP, CFO, TR 40.00 X 0 1735635 374871 MATTHEW WALSH DIRECTOR 40.00 X 0 1371594 307990 STEVEN B BENDER ESQUIRE EVP, CLO, SE 40.00 X 0 885926 215586 GERALD V MALONEY DO DIRECTOR 40.00 X 0 809293 133494 NAVNEET S DANG MD INTERIM CMO 40.00 X 0 563344 59891 MARIA MCGRAW CRNA CRNA, LEAD 40.00 X 417907 0 24654 ROSE A SADOWSKI CRNA CRNA, PASNAP 40.00 X 396961 0 33722 GARY SEBASTIANELLI CRNA CRNA, LEAD 40.00 X 371203 0 48054 LORI R GRAMLEY ESQUIRE ACLO, ASST S 40.00 X 0 347436 45422 MARK ANTONIO CRNA CRNA, PASNAP 40.00 X 335946 0 55782 JOHN DITCHKUS CRNA CRNA, PASNAP 40.00 X 329423 0 53026 JEFFREY A JACOBSON CHAIR, DIREC 0.25 3.25 X 0 0 0 BENJAMIN K CHU MD MPH MACP DIRECTOR 0.25 3.75 X 0 0 0 VIRGINIA MCGREGOR DIRECTOR 0.25 3.50 X 0 0 0 V CHRIS HOLCOMBE PE VICE CHAIR, 0.25 3.25 X 0 0 0 1851440 11258269 2913432 282 false true false MEDEFIS CONSOLIDATED PO BOX 5068 NEW YORK NY 100875068 STAFFING 34799544 WRIGHT CENTER FOR MEDICAL GRAD 501 S WASHINGTON AVE SUITE 1000 SCRANTON PA 18505 PHYS RESIDENTS 3767544 PRIMEMED PC 5 MORGAN HIGHWAY SUITE 6 SCRANTON PA 18508 CONSULT & DEVEL 1313385 FRESENIUS MANAGEMENT SERIVCES 16343 COLLECTION CENTER DRIVE CHICAGO IL 60693 HEMODIALYSIS 1240413 HCSC PO BOX 8016 LANCASTER PA 17604 LAUNDRY 1156494 27 300000 15000 315000 PATIENT HEALTHCARE 622110 463017400 463017400 RENTAL INCOME 531120 692879 692879 PHARMACY 456110 306533 306533 PATIENT CARE REV- PHARMACY 456110 216053 216053 HEALTH EDUCATION 611699 2720 2720 464235585 464030 464030 85 85 6748395 62743 122309 6748395 -59566 6688829 6688829 PURCHASE DISCOUNTS 900099 783832 783832 DIETARY INCOME 722514 709822 709822 REBATES 812930 146707 146707 118126 4342 113784 1758487 473462016 463805574 306533 9034909 X 169917 169917 122392 122392 121568612 117758457 3810155 5584050 5409213 174837 20661761 20014840 646921 8950530 8798786 151744 809686 809686 9405 9405 3605 3605 181078 158416 22662 54498303 51970487 2527816 2553 2553 7750332 7695434 54898 1014779 854971 159808 7317903 7081355 236548 314982 279017 35965 121981 119464 2517 4237156 4100192 136964 17670152 17098973 571179 13702543 12809574 892969 INTER-ENTITY EXPENSES 96555601 90530249 6025352 MEDICAL SUPPLIES 93914408 93910935 3473 UNCOLLECTIBLE EXPENSE 20967960 20967960 INTER-ENTITY TEACH & ADMI 1875528 1875528 551716 540004 11712 478556933 463087808 15469125 0 4591610 10066 11703802 8320100 37269004 39489228 19622 9239 6453146 2757497 8213173 9797577 1568895 1723498 297188110 122838581 154639346 174349529 39052980 116629188 27046537 45351619 45262963 10916834 9700637 397356239 357519851 5713176 7362862 23501993 130141148 121768892 3177423 3081740 38437078 62123684 200970818 194337178 X 188855132 160727230 7530289 2455443 196385421 163182673 397356239 357519851 X -5094917 -23270551 -4837280 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 3605 3605 false SCHEDULE C, PART II-B, LINE 1 LINE 1I: OTHER LOBBYING ACTIVITIES REPORTED ON LINE 1I REPRESENTS THE PORTION OF MEMBERSHIP DUES, PAID BY THE ORGANIZATION TO TRADE OR PROFESSIONAL ASSOCIATIONS, ATTRIBUTABLE TO LOBBYING ACTIVITIES. 385529000 1170000 -20189000 4666000 361844000 372716000 699000 19881000 7767000 385529000 369232000 1328000 20022000 17866000 372716000 373558000 290000 -502000 4114000 369232000 370396000 -2213000 4882000 3933000 373558000 0.77060 0.18390 0.04550 false true true 16402427 16402427 165918369 63268654 102649715 2541671 2459302 82369 105145636 56341493 48804143 7180007 769132 6410875 174349529 27046537 F 27046537 DUE TO AFFILIATES 55785402 THIRD PARTY LIABILITIES 3843426 PATIENT RECEIVABLE CREDIT BALANCES 2454350 SECURITY DEPOSITS 34237 RENT RECEIVABLE ADVANCE 6269 62123684 SCHEDULE D, PAGE 2, PART V, LINE 4 TO SUPPORT RESEARCH, CAPITAL, AND PROGRAM EXPENSES AND PATIENT CARE AND PATIENT AND EMPLOYEE EDUCATION. SCHEDULE D, PAGE 4, PART XIII EFFECTIVE JULY 1, 2007, GEISINGER (1) ADOPTED ACCOUNTING STANDARDS CODIFICATION 740 (FIN 48), (FORMERLY KNOWN AS "STATEMENT 109: ACCOUNTING FOR INCOME TAXES- OR "FAS 109"). FIN 48 CLARIFIES THE ACCOUNTING AND REPORTING FOR INCOME TAXES WHERE INTERPRETATION OF THE TAX LAW MAY BE UNCERTAIN. FIN 48 PRESCRIBES A COMPREHENSIVE MODEL FOR THE FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, PRESENTATION AND DISCLOSURE OF INCOME TAX UNCERTAINTIES WITH RESPECT TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN INCOME TAX RETURN. THE ADOPTION OF FIN 48 HAD NO IMPACT ON UNRESTRICTED NET ASSETS AS OF THE END OF THE FISCAL YEAR OR ANY PREVIOUS YEARS SINCE ADOPTION. ACCORDINGLY, NO FIN 48 FOOTNOTE DISCLOSURE WAS MADE IN THE GEISINGER CONSOLIDATED FINANCIAL STATEMENTS. (1) THROUGHOUT THIS DOCUMENT, THE TERMS "GEISINGER- OR "GEISINGER HEALTH" SHALL REFER TO THE ENTIRE HEALTH CARE SYSTEM COMPRISED OF GEISINGER HEALTH FOUNDATION (THE "FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATE ENTITIES COMPRISING THE HEALTH CARE SYSTEM. IN ADDITION, THROUGHOUT THIS DOCUMENT, THE TERM "SYSTEM" SHALL REFER TO THE ENTIRE HEALTH CARE SYSTEM AS PREVIOUSLY DEFINED PLUS ITS AFFILIATES. CENTRAL AMERICA AND THE CARIBBEAN INVESTMENT 2610971 EAST ASIA AND THE PACIFIC INVESTMENT 165759 EUROPE INVESTMENT 3369933 NORTH AMERICA INVESTMENT 83429 SOUTH AMERICA INVESTMENT 13588 6243680 6243680 false false false false false false SCHEDULE F, PAGE 1, PART I, LINE 3 CENTRAL AMERICA AND THE CARIBBEAN 0 2,610,971 EAST ASIA AND THE PACIFIC 0 165,759 EUROPE 0 3,369,933 NORTH AMERICA 0 83,429 SOUTH AMERICA 0 13,588 true true X true X 3.000000000000 false true true false true true 2635569 2635569 0.00550 92158974 61599266 30559708 0.06390 46421 28211 18210 94840964 61627477 33213487 0.06940 3884409 300000 3584409 0.00750 6506671 1400084 5106587 0.01070 165392 165392 0.00030 10556472 1700084 8856388 0.01850 105397436 63327561 42069875 0.08790 true 20697157 6885263 78855863 101915368 -23059505 X true true 1 1 COMMUNITY MEDICAL CENTER DBA GEISINGER-COMMUNITY MEDICAL CTR 1822 MULBERRY STREET SCRANTON PA 18510 WWW.GEISINGER.ORG 037101 X X X X COMMUNITY MEDICAL CENTER DBA GEISINGER-COMMUNITY MEDICAL CTR 1 false false true X X X X X X X X X X 20 true true false true X WWW.GEISINGER.ORG X X true 21 true REFER TO RESPONSE TO 7D false false true X 300.000000000000 X X X X X true true X X X X true X WWW.GEISINGER.ORG - REFER TO SECTION C X WWW.GEISINGER.ORG - REFER TO SECTION C X WWW.GEISINGER.ORG - REFER TO SECTION C X X X X X X X true X false X X X X X true X false false FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 3E PRIORITIZED COMMUNITY HEALTH NEEDS TO WORK TOWARD HEALTH EQUITY, IT IS IMPERATIVE TO PRIORITIZE RESOURCES AND ACTIVITIES TOWARD THE MOST PRESSING AND CROSS-CUTTING HEALTH NEEDS WITHIN THE COMMUNITY. PRIORITIES WERE JOINTLY DETERMINED BY THE CHNA COLLABORATING HEALTH SYSTEMS USING FEEDBACK FROM COMMUNITY STAKEHOLDERS. THROUGH THIS PROCESS, CHNA PARTNERS AFFIRMED THE FOLLOWING PRIORITY HEALTH NEEDS: ACCESS TO CARE BEHAVIORAL HEALTH CHRONIC DISEASE PREVENTION AND MANAGEMENT THESE PRIORITIES ARE CONSISTENT WITH THOSE DETERMINED IN THE PREVIOUS FY2019 CHNA AND REFLECT COMPLEX NEEDS REQUIRING SUSTAINED COMMITMENT AND RESOURCES. MATERNAL AND CHILD HEALTH NEEDS ARE ALSO PREVALENT ACROSS THE SERVICE AREA. WHILE CHNA PARTNERS DID NOT IDENTIFY MATERNAL AND CHILD HEALTH AS A PRIORITY ISSUE DUE TO THE NEED TO FOCUS AVAILABLE RESOURCES, MANY OF THE HOSPITALS SUPPORT MATERNAL AND CHILD HEALTH STRATEGIES AS PART OF THEIR IMPLEMENTATION PLAN. THESE STRATEGIES INCLUDE FREE OR LOW-COST CLASSES AND SUPPORT GROUPS FOR PREGNANT AND NEW MOTHERS, LACTATION CONSULTATION, TREATMENT AND SUPPORT SERVICES FOR MOTHERS IN RECOVERY, SOCIAL ASSISTANCE, AND POSTPARTUM DEPRESSION SCREENING, AMONG OTHERS. CHNA IMPLEMENTATION PLAN TO DIRECT COMMUNITY BENEFIT AND HEALTH IMPROVEMENT ACTIVITIES, CHNA PARTNERS CREATED INDIVIDUAL HOSPITAL IMPLEMENTATION PLANS TO DETAIL THE RESOURCES AND SERVICES THAT WILL BE USED TO ADDRESS HEALTH PRIORITIES. THE IMPLEMENTATION PLANS BUILD UPON PREVIOUS HEALTH IMPROVEMENT ACTIVITIES AND TAKE INTO CONSIDERATION NEW HEALTH NEEDS AND THE CHANGING HEALTH CARE DELIVERY ENVIRONMENT AS DETAILED IN THE 2021 CHNA. FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 5 SECTION B., COMMUNITY HEALTH NEEDS ASSESSMENT, LINES 3, 5 AND 6A: CHNA COLLABORATING HEALTH SYSTEMS THE 2021 GEISINGER COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED IN PARTNERSHIP WITH GEISINGER, ALLIED SERVICES INTEGRATED HEALTH SYSTEM, AND EVANGELICAL COMMUNITY HOSPITAL. THE STUDY AREA INCLUDED 15 COUNTIES ACROSS CENTRAL AND NORTHEASTERN PENNSYLVANIA, WHICH REPRESENTED THE HEALTH SYSTEMS' COLLECTIVE SERVICE AREAS. COLLABORATION IN THIS WAY CONSERVES VITAL COMMUNITY RESOURCES WHILE FOSTERING A PLATFORM FOR "COLLECTIVE IMPACT" THAT ALIGNS COMMUNITY EFFORTS TOWARD A COMMON GOAL OR ACTION. TO DISTINGUISH UNIQUE SERVICE AREAS AMONG HOSPITALS, REGIONAL RESEARCH AND REPORTING WAS DEVELOPED. CHNA LEADERSHIP THE 2021 CHNA WAS OVERSEEN BY A PLANNING COMMITTEE OF REPRESENTATIVES FROM EACH HEALTH SYSTEM, AS WELL AS A REGIONAL ADVISORY COMMITTEE OF HOSPITAL AND HEALTH SYSTEM REPRESENTATIVES. COMMUNITY HEALTH CONSULTANTS ASSISTED IN ALL PHASES OF THE CHNA, INCLUDING PROJECT MANAGEMENT, DATA COLLECTION AND ANALYSIS, AND REPORT WRITING. CHNA METHODOLOGY THE 2021 CHNA WAS CONDUCTED FROM JULY TO DECEMBER 2020. QUANTITATIVE AND QUALITATIVE METHODS, REPRESENTING BOTH PRIMARY AND SECONDARY RESEARCH, WERE USED TO ILLUSTRATE AND COMPARE HEALTH AND SOCIAL TRENDS AND DISPARITIES ACROSS EACH REGION AND HOSPITAL SERVICE AREA. THE FOLLOWING RESEARCH METHODS WERE USED TO DETERMINE COMMUNITY HEALTH NEEDS: -STATISTICAL ANALYSIS OF HEALTH AND SOCIOECONOMIC DATA INDICATORS; A FULL LISTING OF DATA REFERENCES IS INCLUDED IN THE CHNA -ELECTRONIC SURVEY OF KEY STAKEHOLDERS, INCLUDING EXPERTS IN PUBLIC HEALTH AND INDIVIDUALS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS; A LIST OF KEY INFORMANTS AND THEIR RESPECTIVE ORGANIZATIONS IS INCLUDED IN THE CHNA -DISCUSSION AND PRIORITIZATION OF COMMUNITY HEALTH NEEDS TO DETERMINE THE MOST PRESSING HEALTH ISSUES ON WHICH TO FOCUS COMMUNITY HEALTH IMPROVEMENT EFFORTS COMMUNITY ENGAGEMENT COMMUNITY ENGAGEMENT WAS AN INTEGRAL PART OF THE 2021 CHNA. A VIRTUAL TOWN HALL WAS HELD IN AUGUST 2020 TO ANNOUNCE THE ONSET OF THE CHNA AND ENCOURAGE BROAD STAKEHOLDER PARTICIPATION. A KEY INFORMANT SURVEY WAS SENT TO NEARLY 1,000 COMMUNITY STAKEHOLDERS TO SOLICIT INPUT ON HEALTH DISPARITIES, OPPORTUNITIES FOR COLLABORATION, COVID-19 RESPONSE, COMMUNITY HEALTH PRIORITIES, AMONG OTHER INSIGHTS. CONTINUED COMMUNITY ENGAGEMENT ACTIVITIES ARE PLANNED TO ENSURE ONGOING DIALOGUE AND A FORUM FOR ADDRESSING COMMUNITY HEALTH NEEDS. CHNA IMPLEMENTATION PLAN TO DIRECT COMMUNITY BENEFIT AND HEALTH IMPROVEMENT ACTIVITIES, CHNA PARTNERS CREATED INDIVIDUAL HOSPITAL IMPLEMENTATION PLANS TO DETAIL THE RESOURCES AND SERVICES THAT WILL BE USED TO ADDRESS HEALTH PRIORITIES. THE IMPLEMENTATION PLANS BUILD UPON PREVIOUS HEALTH IMPROVEMENT ACTIVITIES AND TAKE INTO CONSIDERATION NEW HEALTH NEEDS AND THE CHANGING HEALTH CARE DELIVERY ENVIRONMENT AS DETAILED IN THE 2021 CHNA. BOARD APPROVAL THE 2021 CHNA WAS CONDUCTED IN A TIMELINE TO COMPLY WITH IRS TAX CODE 501 (R) REQUIREMENTS TO CONDUCT A CHNA EVERY THREE YEARS AS SET FORTH BY THE AFFORDABLE CARE ACT (ACA). THE RESEARCH FINDINGS WILL BE USED TO GUIDE COMMUNITY BENEFIT INITIATIVES FOR THE HOSPITALS AND ENGAGE LOCAL PARTNERS TO COLLECTIVELY ADDRESS IDENTIFIED HEALTH NEEDS. THE CHNA REPORT WAS PRESENTED TO THE GEISINGER BOARD OF DIRECTORS AND APPROVED IN DECEMBER 2020. GEISINGER IS COMMITTED TO ADVANCING INITIATIVES AND COMMUNITY COLLABORATION TO SUPPORT THE ISSUES IDENTIFIED THROUGH THE CHNA. FOLLOWING THE BOARD'S APPROVAL, ALL CHNA REPORTS WERE MADE AVAILABLE TO THE PUBLIC VIA THE GEISINGER WEBSITE AT HTTPS://WWW.GEISINGER.ORG/ABOUT- GEISINGER/COMMUNITY-ENGAGEMENT/CHNA. THROUGHOUT THIS DOCUMENT, THE TERMS "GEISINGER- OR "GEISINGER HEALTH" SHALL REFER TO THE ENTIRE HEALTH CARE SYSTEM COMPRISED OF GEISINGER HEALTH FOUNDATION (THE "FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATE ENTITIES COMPRISING THE HEALTH CARE SYSTEM. IN ADDITION, THROUGHOUT THIS DOCUMENT, THE TERM "SYSTEM" SHALL REFER TO THE ENTIRE HEALTH CARE SYSTEM AS PREVIOUSLY DEFINED PLUS ITS AFFILIATES. FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 6A ALLIED SERVICES REHABILITATION HOSPITAL, HEINZ REHABILITATION HOSPITAL, EVANGELICAL COMMUNITY HOSPITAL, GEISINGER MEDICAL CENTER (INCLUDES GEISINGER-SHAMOKIN AREA COMMUNITY HOSPITAL), GEISINGER ENCOMPASS HEALTH LIMITED LIABILITY COMPANY (DBA GEISINGER ENCOMPASS HEALTH REHABILITATION HOSPITAL), GEISINGER WYOMING VALLEY MEDICAL CENTER (INCLUDES GEISINGER SOUTH WILKES-BARRE), GEISINGER-BLOOMSBURG HOSPITAL, COMMUNITY MEDICAL CENTER (DBA GEISINGER COMMUNITY MEDICAL CENTER), GEISINGER JERSEY SHORE HOSPITAL, GEISINGER-LEWISTOWN HOSPITAL, AND GEISINGER MEDICAL CENTER MUNCY. FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 7D THE HOSPITAL'S CHNA AND CHNA IMPLEMENTATION STRATEGY ARE POSTED ON THE HOSPITAL'S WEBSITE AT WWW.GEISINGER.ORG/ABOUT-GEISINGER/COMMUNITY- ENGAGEMENT/CHNA. FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 11 GEISINGER, AS PART OF ITS ENDURING DEDICATION TO COMMUNITY WELL-BEING, METICULOUSLY CONDUCTS COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) IN CLOSE COLLABORATION WITH VARIOUS PARTNERS. THESE ASSESSMENTS ENCOMPASS GATHERING VALUABLE FEEDBACK FROM THE POPULATION WE SERVE, INCLUSIVE OF EXPERT INSIGHTS FROM MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY COMMUNITIES. THROUGH A RIGOROUS EXAMINATION OF PREVAILING COMMUNITY HEALTH DEMANDS, AVAILABLE RESOURCES, AND GAPS IN SERVICE DELIVERY, GEISINGER IDENTIFIES AND PRIORITIZES KEY HEALTH IMPERATIVES IN ITS OPERATIONAL FOOTPRINT. THESE PRIORITIES ENCOMPASS ACCESSIBILITY TO HEALTHCARE, BEHAVIORAL HEALTH, AND THE PREVENTION AND MANAGEMENT OF CHRONIC DISEASES. AS A HEALTH SYSTEM, WE REMAIN STEADFAST IN OUR COMMITMENT TO MEETING THE DIVERSE NEEDS OF THE COMMUNITIES WITHIN OUR OPERATIONAL FOOTPRINT. WE STRIVE TO DELIVER HIGHLY LOCALIZED SUPPORT TO THE AREAS SURROUNDING OUR FACILITIES AND LINES OF BUSINESS. ACCESS TO CARE: OUR ASSESSMENTS CONSISTENTLY HIGHLIGHTED THE PRESSING NEED FOR HEALTHCARE ACCESS, PARTICULARLY AMONG VULNERABLE POPULATIONS. THESE GROUPS ENCOMPASSED INDIVIDUALS RESIDING IN RURAL AREAS, FACING A SCARCITY OF HEALTHCARE PROFESSIONALS, PATIENTS LACKING TRANSPORTATION, ELDERLY INDIVIDUALS WITH COMPLEX MEDICAL CONDITIONS, THE HOMEBOUND, THOSE WITH INADEQUATE INSURANCE COVERAGE, AND INDIVIDUALS WHO REFRAINED FROM SEEKING MEDICAL CARE DUE TO CULTURAL REASONS. BEARING THESE CHALLENGES IN MIND, GEISINGER TAILORED ITS ACCESS TO CARE COMMUNITY INITIATIVES TO ENSURE REGULAR AND DEPENDABLE ACCESS TO HEALTH SERVICES, ENABLING EARLY DETECTION, TREATMENT OF ILLNESSES, AND EFFECTIVE DISEASE MANAGEMENT AND PREVENTION FOR OUR DIVERSE PATIENT POPULATION. GEISINGER'S COVID-19 RESPONSE IN RESPONSE TO THE FORMIDABLE CHALLENGE POSED BY THE PANDEMIC, GEISINGER SWIFTLY ADAPTED ITS OPERATIONS TO SUPPORT THE COMMUNITIES WE SERVE, MANIFESTING IN THE FOLLOWING WAYS: - VACCINE DISTRIBUTION: GEISINGER FACILITATED THE DISTRIBUTION OF OVER 320,000 VACCINES TO DATE. WE REPURPOSED VACANT OFFICE SPACES INTO VACCINATION CENTERS, EFFICIENTLY INOCULATING BOTH OUR EMPLOYEES AND THE WIDER COMMUNITY. - OUR WALK-IN CARE LOCATIONS SEAMLESSLY TRANSITIONED INTO TESTING FACILITIES, PROVIDING ESSENTIAL TESTING SERVICES AND ACTING AS A VALUABLE RESOURCE FOR SCHOOLS AND EMPLOYERS SEEKING TESTING AND RETURN TO WORK/SCHOOL DOCUMENTATION. - A COLLABORATIVE EFFORT INVOLVED COORDINATING 2,300 DEPLOYMENTS/INTERVENTIONS WITH SKILLED NURSING FACILITIES ACROSS THE STATE. WE PROVIDED CRUCIAL ASSISTANCE IN RAPID RESPONSE, ENSURING ADEQUATE PPE, CONDUCTING NECESSARY TESTING, IMPLEMENTING INFECTION PREVENTION MEASURES, AND ADMINISTERING VACCINES. - CONTACT TRACING: WHILE TYPICALLY A RESPONSIBILITY OF PUBLIC HEALTH, GEISINGER TOOK PROACTIVE MEASURES TO INTERCEPT THE VIRUS'S SPREAD THROUGH COMPREHENSIVE CONTACT TRACING EFFORTS. WE REDEPLOYED DOZENS OF EMPLOYEES TO BOLSTER OUR CONTACT TRACING INITIATIVES. IN THE SPRING AND SUMMER OF 2020, GEISINGER SUCCESSFULLY COMPLETED OVER 3,000 NOTIFICATIONS AS PART OF OUR EXTENSIVE CONTACT TRACING EFFORTS. - COMMUNITY SUPPORT: GEISINGER ORCHESTRATED A SERIES OF INFORMATIVE WEBINARS, TOWN HALLS, AND DIGITAL RESOURCES AIMED AT KEEPING SCHOOLS, COMMUNITY GROUPS, CHAMBERS, AND EMPLOYERS WELL-INFORMED ABOUT THE EVER- EVOLVING PANDEMIC. OUR FRESH FOOD FARMACY INITIATIVE PLAYED A VITAL ROLE BY PROVIDING AN IMPRESSIVE 42,000 MEALS PER MONTH TO PARTICIPANTS, ADDRESSING A CRUCIAL NEED IN THE COMMUNITY. FURTHER EXTENDING OUR SUPPORT, OUR 65 FORWARD LOCATIONS ORGANIZED OUTDOOR EXERCISE CLASSES AND DISTRIBUTED CARE PACKAGES CONTAINING ESSENTIAL PERSONAL CARE ITEMS TO INDIVIDUALS WHO WERE CONFINED TO THEIR HOMES. ANY PLAN AIMED AT REDUCING BARRIERS TO CARE HAD TO INCORPORATE TELEMEDICINE OPTIONS. THE COVID-19 PANDEMIC SAW A SIGNIFICANT SURGE IN TELEHEALTH UTILIZATION ACROSS THE NATION, AND GEISINGER CAPITALIZED ON THIS OPPORTUNITY, EMERGING AS A LEADING TELEHEALTH NETWORK IN THE US, SURPASSING NATIONAL AVERAGES FOR TELEMEDICINE USE. AS PART OF OUR ROUTINE SCHEDULING PROCESS, WE INQUIRED IF PATIENTS PREFERRED A TELEHEALTH VISIT. IF SO, WE PROMPTLY ARRANGED THE APPOINTMENT AND SENT AN EMAIL WITH A DIRECT LINK TO THEIR PROVIDER OR ANY OF THE 72 SPECIALTIES AVAILABLE FOR VIRTUAL CONSULTATIONS. FOR PATIENTS LACKING INTERNET ACCESS AT HOME, GEISINGER OFFERED TELEHEALTH VISITS AT THEIR NEAREST HEALTH CLINIC. TELEMEDICINE NOT ONLY BENEFITED PATIENTS WITHOUT TRANSPORTATION BUT ALSO CATERED TO THOSE WHO ENDURED LENGTHY DRIVES OR CHALLENGING WEATHER CONDITIONS TO VISIT THEIR DOCTOR, CIRCUMSTANCES THAT MIGHT HAVE LED TO APPOINTMENT CANCELLATIONS. IN MANY CASES, TELEMEDICINE ENABLED WAGE-EARNING PATIENTS TO CONSULT THEIR DOCTOR WITHOUT CLOCKING OUT AND LOSING PAY, AS OUR DOCTORS COULD CONNECT WITH THEM BEFORE WORK OR DURING THEIR LUNCH HOUR. GEISINGER HAD INTEGRATED CLINICAL AND POPULATION HEALTH EXPERTISE TO ADDRESS ACCESS NEEDS FOR TWO DISTINCT PATIENT POPULATIONS: THOSE BURDENED BY THE RISING COSTS OF HEALTHCARE SERVICES AND THE RAPIDLY GROWING SENIOR POPULATION. WE HAD INTEGRATED A RANGE OF HEALTH AND WELLNESS SERVICES CRUCIAL FOR THESE DEMOGRAPHICS, INCORPORATING CARE MODELS SUCH AS TRADITIONAL HOSPITAL SERVICES, 65 FORWARD (SENIOR PRIMARY CARE), CONVENIENT CARE (WALK-IN CLINICS AND URGENT CARE), COMMUNITY CARE CLINICS (URGENT CARE AND PRIMARY CARE), AND VIRTUAL HEALTH INITIATIVES. THIS INTEGRATION ENABLED US TO EFFICIENTLY ADDRESS ACUTE, CHRONIC, AND URGENT CARE NEEDS IN THE MOST COST-EFFECTIVE SETTINGS WHILE ENHANCING ACCESS TO OUTPATIENT CARE FOR DISEASE MANAGEMENT AND PREVENTION. IN 2022, GEISINGER COMMONWEALTH SCHOOL OF MEDICINE (GCSOM) MADE STRIDES TOWARD SOLIDIFYING A PARTNERSHIP TO REOPEN THE LEAHY CLINIC, A PROVIDER OF FREE NON-EMERGENCY HEALTHCARE, AT THE UNIVERSITY OF SCRANTON, TRANSFORMING IT INTO A LONGITUDINAL FREE CLINIC FOR LACKAWANNA COUNTY. IN LINE WITH THIS COMMITMENT, GEISINGER HAD CONTRIBUTED TO "A COMMUNITY CLINIC", WHICH PROVIDED HEALTHCARE FOR THE UNINSURED IN SUNBURY, OFFERING SUPPORT IN MARKETING, REFERRALS, AND PROVIDING LAB AND X-RAY SUPPORT TO THE CLINIC. IN THE PURSUIT OF HEALTH EQUITY, GEISINGER HAD DEVELOPED OUTREACH PROGRAMS IN COLLABORATION WITH COMMUNITY ORGANIZATIONS, NONPROFITS, AND FAITH-BASED GROUPS, AIMED AT EDUCATING, INFORMING, AND GUIDING INDIVIDUALS TOWARDS WELLNESS CARE. ENSURING HEALTHCARE ACCESS HAD NECESSITATED AN ADEQUATE NUMBER OF HEALTHCARE PROFESSIONALS TO SERVE THE PATIENT POPULATION. GEISINGER HAD SUCCESSFULLY RECRUITED AND RETAINED HEALTHCARE PROFESSIONALS WITHIN THE SYSTEM THROUGH A SERIES OF INITIATIVES. OUR SYSTEMWIDE CLINICAL CO-OP PROGRAM ENGAGED HIGH SCHOOL AND TECHNICAL SCHOOL SENIORS INTERESTED IN HEALTHCARE, PROVIDING THEM THE OPPORTUNITY TO WORK AS NURSING ASSISTANTS FOR A YEAR. THEY GAINED EXPOSURE BY SHADOWING OUR NURSES IN PHLEBOTOMY OR SURGICAL TECH. THESE CO-OP PROGRAMS ENCOURAGED MANY TO ENROLL IN NURSING SCHOOL WITH OUR SUPPORT AND SUBSEQUENTLY JOIN GEISINGER UPON GRADUATION. OUR NURSE RESIDENCY PROGRAM HAD TARGETED RECENT NURSING GRADUATES, SUPPORTING THEM THROUGH THEIR INITIAL AND OFTEN CHALLENGING YEAR OF NURSING PRACTICE BY PROVIDING EDUCATION THROUGH RESIDENCY SESSIONS, CLASSES, AND SIMULATIONS CONDUCTED BY OUR STAFF. AS PART OF THIS PROGRAM, WE HAD OFFERED A SIX-MONTH MEDICAL SURGICAL FELLOWSHIP FOR NEW NURSES SEEKING SPECIALIZATION IN CARDIAC, ONCOLOGY, TRAUMA, OR SURGERY. FELLOWSHIP COURSES WERE LED BY OUR EXPERIENCED NURSES, PHYSICIAN ASSISTANTS, AND SURGEONS. THE ABIGAIL GEISINGER SCHOLARS PROGRAM HAD CATERED TO GCSOM STUDENTS WILLING TO WORK AT GEISINGER AS PHYSICIANS IN FAMILY MEDICINE, INTERNAL MEDICINE, MEDICINE/PEDIATRICS, OR PSYCHIATRY. IN EXCHANGE FOR A WORK COMMITMENT OF UP TO FOUR YEARS, SELECTED SCHOLARS HAD RECEIVED TUITION SUPPORT AND A MONTHLY STIPEND. MOREOVER, AN ABIGAIL GEISINGER SCHOLAR PROGRAM WAS OPEN TO ANYONE WORKING IN OUR NURSING DEPARTMENT. WHEN THEY MET THE CRITERIA, WE HAD ASSISTED THEM IN ENROLLING IN NURSING SCHOOL. THESE COMPETITIVE RECRUITMENT PROGRAMS HAD ENSURED A CONSISTENT PIPELINE OF NURSES AND PHYSICIANS TO SERVE OUR COMMUNITIES IN THE FUTURE. GEISINGER COMMONWEALTH SCHOOL OF MEDICINE (GCSOM) HAD RECEIVED A SIGNIFICANT PASMART ADVANCING COMPUTER SCIENCE AND STEM EDUCATION GRANT FROM THE PENNSYLVANIA DEPARTMENT OF EDUCATION. THE GRANT, AMOUNTING TO 494,262, HAD BEEN AIMED AT FOSTERING PARTNERSHIPS WITH VARIOUS SCHOOLS TO PREPARE STUDENTS IN HAZLETON, SCRANTON, WILKES-BARRE, COLUMBIA, AND NORTHUMBERLAND COUNTIES FOR CAREERS IN MEDICINE AND STEM-RELATED FIELDS. THIS INITIATIVE, KNOWN AS THE PA PHYSICIAN READY PROGRAM, HAD NOT ONLY ADDRESSED THE PHYSICIAN SHORTAGE BUT HAD ALSO INCREASED DIVERSITY IN MEDICAL CAREERS AND MET THE HEALTHCARE WORKFORCE DEMANDS IN PENNSYLVANIA. BY TARGETING UNDERREPRESENTED HIGH SCHOOL STUDENTS AND THOSE FACING BARRIERS TO HIGHER EDUCATION, THIS PROGRAM HAD STRIVED TO BRIDGE GAPS AND PAVE THE WAY FOR A DIVERSE AND QUALIFIED HEALTHCARE WORKFORCE. TO ADDRESS THE NEEDS OF MED FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 13B RECENT WAGE STATEMENTS, UNEMPLOYMENT OR OTHER DOCUMENTATION OF BENEFITS OR COMPENSATION RECEIVED MAY BE CONSIDERED IN DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY. FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 16J THE FAP, FAP APPLICATION, AND A PLAIN LANGUAGE SUMMARY OF THE FAP ARE WIDELY AVAILABLE AT HTTPS://WWW.GEISINGER.ORG/PATIENT-CARE/PATIENTS-AND- VISITORS/BILLING-AND-INSURANCE/NEED-HELP. IN ADDITION, REGISTRATION PERSONNEL ALSO REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY. FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 20E REFER TO RESPONSE FOR PART III, LINE 9B SCHEDULE H, PART I, LINE 3C SUPPORTING DOCUMENTATION FOR ELIGIBILITY MAY CONSIST OF INCOME AND ASSET INFORMATION, INCLUSIVE BUT NOT LIMITED TO: FEDERAL INCOME TAX FORM 1040 FROM THE PRIOR YEAR, PAY STUB COPIES, WRITTEN VERIFICATION OF ANY OTHER INCOME RECEIVED (I.E. SOCIAL SECURITY, ADC, CHILD SUPPORT, ALIMONY, ETC.), CURRENT CREDIT REPORTS AND ASSET VERIFICATION. THE HOSPITAL MAY ALSO UTILIZE INDUSTRY TESTED EXTERNAL ANALYTICAL TOOLS TO QUALIFY PATIENTS FOR UNCOMPENSATED CARE (AKA PRESUMPTIVE CHARITY). GEISINGER PROVIDERS, WITHOUT DISCRIMINATION, CARE FOR ALL EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF THEIR FINANCIAL ASSISTANCE ELIGIBILITY OR ABILITY TO PAY. IT IS THE POLICY OF GEISINGER HOSPITAL FACILITIES TO COMPLY WITH THE STANDARDS OF THE FEDERAL EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR TRANSPORT ACT OF 1986 ("EMTLA") AND REGULATIONS IN PROVIDING MEDICAL SCREENING EXAMINATION AND SUCH FURTHER TREATMENT AS MAY BE NECESSARY TO STABILIZE AN EMERGENCY MEDICAL CONDITION FOR ANY INDIVIDUAL PRESENTING TO THE EMERGENCY DEPARTMENT SEEKING TREATMENT. SCHEDULE H, PART I, LINE 6A COMMUNITY BENEFIT REPORT: A COMMUNITY BENEFIT REPORT IS PROVIDED BY THE HOSPITAL AND ITS RELATED CHARITABLE ORGANIZATIONS TO THE GEISINGER HEALTH FINANCE COMMITTEE EACH YEAR. SCHEDULE H, PART I, LINE 7G THERE ARE NO PHYSICIAN CLINICAL SERVICES INCLUDED IN SUBSIDIZED HEALTH SERVICES. SCHEDULE H, PART I, LINE 7 A COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE COSTS REPORTED ON LINE 7 AND ADDRESSED PATIENT SEGMENTS BY PAYOR (E.G. MEDICARE, MEDICAID, COMMERCIAL PAYERS, SELF-PAY, ETC.). A COST TO CHARGE RATIO, CALCULATED PURSUANT TO WORKSHEET 2 OF THE FORM 990 INSTRUCTIONS, WAS USED TO CALCULATE THE COST OF CHARITY CARE. SCHEDULE H, PART III, LINE 2 REFER TO THE RESPONSE FOR PART III, LINE 4. SCHEDULE H, PART III, LINE 3 PATIENTS' ACCOUNTS ARE MONITORED THROUGHOUT THE BILLING PROCESS AND ARE RECLASSIFIED TO CHARITY CARE (100% DISCOUNTED CARE) WHENEVER A PATIENT BECOMES ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE/CHARITY CARE POLICY. DURING CALENDAR 2022, APPROXIMATELY 25% OF THE BAD DEBT ACCOUNTS WERE SUBSEQUENTLY RECLASSIFIED TO UNCOMPENSATED OR CHARITY CARE. SCHEDULE H, PART III, LINE 4 PART III, LINES 2 AND 4: GEISINGER HEALTH AND ITS AFFILIATES ("GEISINGER"), THAT INCLUDES THE HOSPITAL, PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS, ANNUALLY. FOOTNOTE 2, SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES BEGINNING AT PAGE 7 WITHIN THESE FINANCIAL STATEMENTS INCLUDES A DESCRIPTION OF THE ACCOUNTING FOR NET PATIENT SERVICE REVENUE AND ACCOUNTS RECEIVABLE. THIS DISCLOSURE ALSO DESCRIBES THE RELATED EXPLICIT AND IMPLICIT PRICE CONCESSIONS AND BAD DEBTS EXPENSE. CHARITY CARE IS ALSO DESCRIBED IN THE SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES. GEISINGER'S PRICE CONCESSIONS, BAD DEBTS AND CHARITY CARE METHODOLOGIES ARE CONSISTENTLY APPLIED ACROSS ALL CHARITABLE AFFILIATES. SCHEDULE H, PART III, LINE 8 PART III, LINE 3 - BAD DEBT: MEDICARE COSTS WERE DERIVED FROM THE MEDICARE COST REPORT AND THE COST ACCOUNTING SYSTEM. THE ORGANIZATION BELIEVES THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND THE COST OF BAD DEBT ARE COMMUNITY BENEFIT AND SHOULD BE INCLUDED ON FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW, THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON- DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY AND IS CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER THE INTERNAL REVENUE CODE ("IRC") 501(C)(3). SATISFYING THE "COMMUNITY BENEFIT STANDARD," AS ARTICULATED BY THE INTERNAL REVENUE SERVICE (IRS) IN REVENUE RULING 69-545, IS CURRENTLY REQUIRED FOR A HOSPITAL TO BE RECOGNIZED AS A CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE (IRC) 501(C)(3). THIS RULING REMOVED THE PREVIOUS REQUIREMENT OF REVENUE RULING 56-185, KNOWN AS THE "CHARITY CARE STANDARD," THAT IN ORDER TO BE A CHARITABLE ORGANIZATION, A HOSPITAL HAD TO PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS UNABLE TO PAY FOR THEIR CARE. THIS EARLIER RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT MEAN THAT A HOSPITAL WAS CHARITABLE SINCE THAT LEVEL COULD REFLECT THE HOSPITAL'S FINANCIAL ABILITY TO PROVIDE SUCH CARE. REVENUE RULING 56-185 ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE BECAUSE THEY SERVE THE ENTIRE COMMUNITY AND A LOW LEVEL OF CHARITY CARE WOULD NOT IMPACT A HOSPITAL'S CHARITABLE STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. AS DEVELOPED IN REVENUE RULING 69-545, UNDER THE COMMUNITY BENEFIT STANDARD, HOSPITALS WERE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THIS RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED THOSE WHO COULD PAY FOR THE SERVICES EITHER BY THEMSELVES, THROUGH PRIVATE INSURANCE OR PUBLIC PROGRAMS SUCH AS MEDICARE. IN ADDITION, THE HOSPITAL OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL WAS CHARITABLE BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE "GENERALLY ACCEPTED LEGAL SENSE" OF THE TERM CHARITABLE, AS REQUIRED BY TREASURY REGULATION SECTION 1.501 (C)(3)-1(D)(2). THE IRS RULED THAT THE PROMOTION OF HEALTH, LIKE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES OF THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN THOUGH THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO THOSE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER FACTORS THAT DEMONSTRATED COMMUNITY BENEFIT INCLUDED: SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND FACILITIES AND ADVANCE MEDICAL TRAINING, EDUCATION AND RESEARCH; AND IT WAS CONTROLLED BY A BOARD OF DIRECTORS THAT CONSISTED OF INDEPENDENT CIVIC LEADERS. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") BELIEVES THAT MEDICARE UNDERPAYMENTS (SHORTFALLS) AND BAD DEBT SHOULD BE REPORTED AS COMMUNITY BENEFIT ON FORM 990, SCHEDULE H, PART I, LINE 7. THIS ORGANIZATION AGREES WITH THE AHA'S LETTER TO THE IRS DATED AUGUST 21, 2007 RESPONDING TO A DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA ARGUED THAT MEDICARE UNDERPAYMENTS (SHORTFALLS) IS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: -PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS REMAINS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. -MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES ONLY 92 CENTS FOR EVERY DOLLAR HOSPITALS SPEND TO CARE FOR MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION ("MEDPAC") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE, WITH MARGINS REACHING A 10 YEAR LOW AT NEGATIVE 5.4 PERCENT. -MANY MEDICARE PATIENTS, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46% OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200% OF THE FEDERAL POVERTY LEVEL. MANY ARE ALSO ELIGIBLE FOR MEDICAID, SO CALLED -DUAL ELIGIBLES". PENNSYLVANIA REQUIRES NON-PROFIT HOSPITALS TO PROVIDE A MINIMUM LEVEL OF COMMUNITY BENEFIT TO RETAIN EXEMPTION FROM STATE AND LOCAL TAXES. ACCORDING TO STATE GUIDANCE AND CASE LAW, THE UNREIMBURSED COST OF MEDICARE AND BAD DEBT IS CONSIDERED TO BE COMMUNITY BENEFIT FOR STATE TAX EXEMPTION PURPOSES. PART III, LINE 6 ONLY INCLUDES THOSE COSTS THAT ARE PERMITTED TO BE REPORTED IN THE HOSPITAL'S MEDICARE COST REPORT THAT IS REQUIRED TO BE FILED WITH THE FEDERAL GOVERNMENT. THE HOSPITAL CONSIDERS THE TOTAL MEDICARE UNDERPAYMENTS (SHORTFALL) OF 49,814,457 SHOULD BE REPORTED AS COMMUNITY BENEFIT ON THE FORM 990, SCHEDULE H, PART I, LINE 7. ALONG WITH PROVIDING CARE TO MEDICAID PATIENTS AND PROVIDING FREE OR DISCOUNTED CARE TO OTHER LOW INCOME PATIENTS, THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. LIKE MEDICAID, MEDICARE DOES NOT PAY THE FULL COST OF PROVIDING CARE TO THESE PATIENTS, FORCING THE HOSPITAL TO USE OTHER FUNDS TO COVER THE SHORTFALL. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITAL PROVIDES CARE REGARDLESS OF THE MEDICARE SHORTFALL AND IS THEREBY PROVIDING ACCESS TO MEDICAL SERVICES FOR THE ELDERLY AND RELIEVING THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR PROVIDING CARE TO MEDICARE PATIENTS. ABSENT THE MEDICARE PROGRAM, IT IS LIKELY THAT MANY MEDICARE PATIENTS WOULD BE ELIGIBLE FOR CHARITY CARE OR OTHER NEED BASED GOVERNMENT PROGRAMS. THE AMOUNT EXPENDED TO COVER THE SHORTFALL IS MONEY NOT AVAILABLE FOR FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. BOTH THE HOSPITAL AND THE AHA BELIEVE THAT PATIENT BAD DEBT BE REPORTED AS A COMMUNITY BENEFIT ON FORM 990, SCHEDULE H, PART I, LINE 7. LIKE MEDICARE UNDERPAYMENTS (SHORTFALLS), BAD DEBT SHOULD BE REPORTED AS COMMUNITY BENEFIT BECAUSE: -A SIGNIFICANT PORTION OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO FOR MANY REASONS DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY UNDER THE HOSPITAL'S CHARITY CARE OR FINANCIAL ASSISTANCE POLICY (FAP). A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO"), "NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFIT", CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." -THE CBO REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF THE BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR CHARITABLE MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THE EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ACCORDING TO THE CBO REPORT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. (DURING THE CALENDAR YEAR ENDED DECEMBER 31, 2022, APPROXIMATELY 25% OF THE HOSPITAL'S BAD DEBT WAS SUBSEQUENTLY RECLASSIFIED TO CHARITY CARE.) THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE (BAD DEBT AND CHARITY CARE) AS A MEASURE OF COMMUNITY BENEFITS" ASSUMING THE FINDINGS ARE GENERALIZED NATIONALLY. THE EXPERIENCE OF HOSPITALS NATIONWIDE REINFORCE THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE THE HOSPITAL'S BEST EFFORTS AND DUE DILIGENCE, PATIENT BAD DEBT IS A PART OF THE CHARITABLE MISSION AND CHARITABLE PURPOSES. BAD DEBT REPRESENTS PART OF THE BURDEN HOSPITALS' BEAR IN SERVING ALL PATIENTS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. IN ADDITION, THE HOSPITAL INVESTS SIGNIFICANT RESOURCES IN SYSTEMS AND STAFF TRAINING TO ASSIST PATIENTS THAT ARE IN NEED OF FINANCIAL ASSISTA SCHEDULE H, PART III, LINE 9B THE HOSPITAL IS COMMITTED TO PROVIDING MEDICALLY NECESSARY SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND THE HOSPITAL'S COLLECTION ACTIONS ARE CONSISTENTLY APPLIED TO ALL PATIENTS. IT IS THE HOSPITAL'S POLICY TO PROVIDE FINANCIAL ASSISTANCE AND COUNSELING TO PATIENTS WITH LIMITED FINANCIAL MEANS. A PATIENT MAY BECOME ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING TREATMENT OR DURING THE CONTINUUM OF THE FINANCIAL/BILLING AND COLLECTION PROCESS. IN ANY STAGE OF THE BILLING PROCESS, COLLECTION ACTIONS ARE NOT PURSUED WHENEVER A PATIENT APPLIES AND IS BEING EVALUATED FOR FINANCIAL ASSISTANCE. UNDER NO CIRCUMSTANCES WILL THE HOSPITAL FREEZE OR ATTACH BANK ACCOUNTS OF A PATIENT, ENFORCE LIENS, ACTIVELY PURSUE ASSETS FROM A PRIOR JUDGMENT OR GARNISH THE WAGES OF A PATIENT AND/OR FAMILY MEMBER BEFORE DETERMINING IF THE PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. GEISINGER MANAGEMENT HAS DEVELOPED POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES THAT TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR GOVERNMENTAL PROGRAMS OR FINANCIAL ASSISTANCE FROM GEISINGER AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS OR HER PAYMENT AGREEMENTS. BILLING AND COLLECTION POLICY: THE BILLING AND COLLECTION POLICY IS ADMINISTERED IN ACCORDANCE WITH THE MISSION AND VALUES OF THE HOSPITAL AS WELL AS FEDERAL AND STATE LAW. THE POLICY IS DESIGNED TO PROMOTE APPROPRIATE ACCESS TO MEDICAL CARE FOR ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY WHILE MAINTAINING GEISINGER'S FISCAL RESPONSIBILITY TO MAXIMIZE REIMBURSEMENT AND MINIMIZE BAD DEBT. THE ORGANIZATION'S BILLING AND COLLECTION POLICY IS INTENDED TO TAKE INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. THE ORGANIZATION MAKES SURE THAT PATIENTS ARE ASSISTED IN OBTAINING HEALTH INSURANCE COVERAGE FROM PRIVATELY AND PUBLICLY FUNDED SOURCES, WHENEVER POSSIBLE. ALL BUSINESS OFFICE CUSTOMER SERVICE DEPARTMENT REPRESENTATIVES ARE EDUCATED ON ALL ASPECTS OF THE BILLING AND COLLECTION POLICY AND ARE EXPECTED TO ADMINISTER THE POLICY ON A REGULAR AND CONSISTENT BASIS. BUSINESS OFFICE CUSTOMER SERVICE REPRESENTATIVES ARE HELD ACCOUNTABLE TO TREAT ALL PATIENTS WITH COURTESY, RESPECT, CONFIDENTIALITY AND CULTURAL SENSITIVITY. THE BILLING AND COLLECTION POLICY IS ADMINISTERED IN CONJUNCTION WITH THE PROCEDURES OUTLINED IN INTERNAL ADMINISTRATIVE POLICIES. THE GEISINGER EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND VICE PRESIDENT, CHIEF REVENUE OFFICER HAVE OVERALL RESPONSIBILITY FOR THE BILLING AND COLLECTION ACTIVITIES OF THE HOSPITAL. THE BUSINESS OFFICE CUSTOMER SERVICE DEPARTMENT STAFF IS RESPONSIBLE FOR THE DAY-TO-DAY ENFORCEMENT OF APPROVED POLICIES AND PROCEDURES. GEISINGER MAY OFFER EXTENDED PAYMENT PLANS TO PATIENTS WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR HOSPITAL BILLS. EMERGENCY & MEDICALLY NECESSARY SERVICES: GEISINGER DOES NOT ENGAGE IN ANY ACTIONS THAT DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE. THE ORGANIZATION WILL NEVER DEMAND THAT AN EMERGENCY DEPARTMENT PATIENT PAY BEFORE RECEIVING TREATMENT FOR EMERGENCY MEDICAL CONDITIONS. ADDITIONALLY, GEISINGER DOES NOT PERMIT DEBT COLLECTION ACTIVITIES IN THE EMERGENCY DEPARTMENT OR OTHER AREAS WHERE SUCH ACTIVITIES COULD INTERFERE WITH THE PROVISION OF EMERGENCY CARE ON A NONDISCRIMINATORY BASIS. ALL MEDICALLY NECESSARY HOSPITAL SERVICES ARE PROVIDED WITHOUT CONSIDERATION OF ABILITY TO PAY AND ARE NOT DELAYED PENDING APPLICATION OR APPROVAL OF MEDICAL ASSISTANCE OR THE GEISINGER FINANCIAL ASSISTANCE PROGRAM. ADVANCE PAYMENT IS NOT REQUIRED FOR ANY MEDICALLY NECESSARY SERVICES. COMPLIANCE WITH INTERNAL REVENUE CODE SECTION 501(R)(6): GEISINGER DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS ("ECAS") AS DEFINED BY INTERNAL REVENUE CODE SECTION 501(R)(6) PRIOR TO THE EXPIRATION OF THE NOTIFICATION PERIOD. THE NOTIFICATION PERIOD IS DEFINED AS A 120-DAY PERIOD OR GREATER, WHICH BEGINS ON THE DATE OF THE 1ST POST-DISCHARGE BILLING STATEMENT, IN WHICH NO ECAS ARE INITIATED AGAINST THE PATIENT. SUBSEQUENT TO THE NOTIFICATION PERIOD GEISINGER, OR ANY THIRD PARTIES ACTING ON ITS BEHALF, MAY INITIATE THE FOLLOWING ECAS AGAINST A PATIENT FOR AN UNPAID BALANCE IF THE FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION HAS NOT BEEN MADE OR IF AN INDIVIDUAL IS INELIGIBLE FOR FINANCIAL ASSISTANCE. GEISINGER MAY AUTHORIZE THIRD PARTIES TO REPORT ADVERSE INFORMATION ABOUT THE INDIVIDUAL TO CONSUMER CREDIT REPORTING AGENCIES OR CREDIT BUREAUS ON DELINQUENT PATIENT ACCOUNTS AFTER THE NOTIFICATION PERIOD. THE ORGANIZATION ENSURES REASONABLE EFFORTS HAVE BEEN TAKEN TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY AND ENSURES THE FOLLOWING ACTIONS ARE TAKEN AT LEAST 30 DAYS PRIOR TO INITIATING ANY ECA: 1) THE PATIENT IS PROVIDED WITH WRITTEN NOTICE WHICH: INDICATES THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR ELIGIBLE PATIENTS; IDENTIFIES THE ECA(S) THAT GEISINGER INTENDS TO INITIATE TO OBTAIN PAYMENT FOR THE CARE; AND STATES A DEADLINE AFTER WHICH SUCH ECAS MAY BE INITIATED. 2) THE PATIENT IS PROVIDED WITH A COPY OF THE PLAIN LANGUAGE SUMMARY; AND 3) REASONABLE EFFORTS ARE MADE TO ORALLY NOTIFY THE PATIENT ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW THE INDIVIDUAL MAY OBTAIN ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. GEISINGER PROCESSES ALL APPLICATIONS FOR FINANCIAL ASSISTANCE SUBMITTED DURING THE APPLICATION PERIOD. THE APPLICATION PERIOD BEGINS ON THE DATE THE CARE IS PROVIDED AND ENDS ON THE 240TH DAY AFTER THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. SCHEDULE H, PART VI, LINE 2 CHNA COLLABORATING HEALTH SYSTEMS THE 2021 GEISINGER COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED IN PARTNERSHIP WITH GEISINGER, ALLIED SERVICES INTEGRATED HEALTH SYSTEM, AND EVANGELICAL COMMUNITY HOSPITAL. THE STUDY AREA INCLUDED 15 COUNTIES ACROSS CENTRAL AND NORTHEASTERN PENNSYLVANIA, WHICH REPRESENTED THE HEALTH SYSTEMS' COLLECTIVE SERVICE AREAS. COLLABORATION IN THIS WAY CONSERVES VITAL COMMUNITY RESOURCES WHILE FOSTERING A PLATFORM FOR "COLLECTIVE IMPACT" THAT ALIGNS COMMUNITY EFFORTS TOWARD A COMMON GOAL OR ACTION. TO DISTINGUISH UNIQUE SERVICE AREAS AMONG HOSPITALS, REGIONAL RESEARCH AND REPORTING WAS DEVELOPED. 2021 CHNA GEOGRAPHIC REGIONS AND PRIMARY SERVICE COUNTIES 1- CENTRAL REGION INCLUDING THE COUNTIES OF COLUMBIA, MONTOUR, NORTHUMBERLAND, SCHUYLKILL, SNYDER AND UNION REPRESENTED BY GEISINGER- BLOOMSBURG HOSPITAL, GEISINGER MEDICAL CENTER (INCLUDES GEISINGER SHAMOKIN AREA COMMUNITY HOSPITAL), GEISINGER ENCOMPASS HEALTH LIMITED LIABILITY COMPANY (DBA GEISINER ENCOMPASS HEALTH REHABILITATION HOSPITAL) AND EVANGELICAL COMMUNITY HOSPITAL. 2- NORTH CENTRAL REGION INCLUDING THE COUNTIES OF CLINTON AND LYCOMING REPRESENTED BY GEISINGER JERSEY SHORE HOSPITAL AND GEISINGER MEDICAL CENTER MUNCY (LICENSED/OPERATIONAL JANUARY 2022) 3- NORTHEAST REGION INCLUDING THE COUNTIES OF LACKAWANNA, LUZERNE, WAYNE AND WYOMING REPRESENTED BY ALLIED SERVICES REHAB HOSPITAL, COMMUNITY MEDICAL CENTER (DBA GEISINGER COMMUNITY MEDICAL CENTER, GEISINGER WYOMING VALLEY MEDICAL CENTER (INCLUDES GEISINGER SOUTH WILKES-BARRE) AND HEINZ REHAB HOSPITAL. 4- WESTERN REGION INCLUDING THE COUNTIES OF CENTRE, JUNIATA AND MIFFLIN REPRESENTED BY GEISINGER-LEWISTOWN HOSPITAL. GEISINGER SYSTEMWIDE CHNA APPROACH THE 2021 CHNA FOCUSED ON THE PRIMARY SERVICE AREAS OF EACH OF GEISINGER'S NINE HOSPITAL CAMPUSES. UNDERSTANDING OVERLAPPING GEOGRAPHIC BOUNDARIES, SOCIOECONOMICS, AND RELATED COMMUNITY INDICATORS, GEISINGER HOSPITALS WERE GROUPED INTO REGIONS TO ALLOW FOR LOCALIZED DATA COMPARISONS. SYSTEMWIDE PRIORITIES WERE DETERMINED TO ADDRESS COMMON NEEDS ACROSS THE WHOLE SERVICE AREA, WHILE INDIVIDUAL HOSPITAL IMPLEMENTATION PLANS OUTLINED SPECIFIC STRATEGIES TO GUIDE LOCAL EFFORTS AND COLLABORATION WITH COMMUNITY PARTNERS. SEE ALSO THE DISCUSSION RELATED TO THE RESPONSE TO PART V, LINE 5. SCHEDULE H, PART VI, LINE 3 GEISINGER IS COMMITTED TO PROVIDING THE HIGHEST QUALITY HEALTHCARE SERVICES TO OUR COMMUNITY. GEISINGER IS COMMITTED TO A SERVICE EXCELLENCE PHILOSOPHY THAT STRIVES TO MEET OR EXCEED PATIENT EXPECTATIONS. ALL PATIENTS WILL RECEIVE A UNIFORM STANDARD OF CARE THROUGHOUT ALL GEISINGER FACILITIES, REGARDLESS OF SOCIAL, CULTURAL, FINANCIAL, RELIGIOUS, RACIAL, GENDER OR SEXUAL ORIENTATION. GEISINGER STRIVES TO ENSURE THAT ALL PATIENTS RECEIVE ESSENTIAL EMERGENCY AND OTHER MEDICALLY NECESSARY HEALTH SERVICES REGARDLESS OF THEIR ABILITY TO PAY. FOR URGENT AND EMERGENT SERVICES, PATIENTS ARE PROVIDED CARE REGARDLESS OF THEIR ABILITY TO PAY. IN THE EVENT A PATIENT HAS AN EMERGENCY MEDICAL CONDITION; TREATMENT IS NOT DELAYED TO PERMIT AN INQUIRY REGARDING A PATIENT'S METHOD OF PAYMENT OR INSURANCE STATUS. FOR OTHER THAN URGENT AND EMERGENT SERVICES, THE HOSPITAL PROVIDES UNCOMPENSATED CARE, FREE OF CHARGE, OR ON A 100% DISCOUNTED BASIS, TO THOSE PATIENTS WHO DEMONSTRATE AN INABILITY TO PAY. DEPENDING UPON FAMILY SIZE AND INCOME, FREE OR 100% DISCOUNTED SERVICES ARE AVAILABLE TO A PATIENT WITH FAMILY INCOME OF 300% OR LESS OF THE FEDERAL POVERTY GUIDELINES. IT IS THE HOSPITAL'S POLICY TO PROVIDE FINANCIAL ASSISTANCE AND FINANCIAL COUNSELING TO PATIENTS OF LIMITED MEANS. A PATIENT MAY BECOME ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE AT ANY TIME DURING TREATMENT OR DURING THE CONTINUUM OF THE FINANCIAL/BILLING PROCESS. INFORMATION (SIGNS, BROCHURES, ETC.) REGARDING THE HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES ARE PROVIDED AT THE EMERGENCY ROOM, REGISTRATION AND VARIOUS ACCESS POINTS THROUGHOUT THE HOSPITAL. REGISTRATION PERSONNEL ALSO REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY. NOTICE OF THE HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES CAN ALSO BE FOUND ON THE GEISINGER WEB SITE AT WWW.GEISINGER.ORG. PATIENTS ARE ALSO PROVIDED INFORMATION ON THE HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES WITH EACH PATIENT BILL. THE FINANCIAL ASSISTANCE POLICY ("FAP"), THE FAP APPLICATION AND PLAIN LANGUAGE SUMMARY ("PLS") ARE AVAILABLE ON-LINE. PAPER COPIES ARE AVAILABLE UPON REQUEST WITHOUT CHARGE BY MAIL OR ARE AVAILABLE AT REGISTRATION AREAS WHICH INCLUDES EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL-BASED CLINICS AND PATIENT FINANCIAL SERVICES DEPARTMENTS. ALL FAP DOCUMENTS ARE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGE OF POPULATIONS WITH LIMITED ENGLISH PROFICIENCY ("LEP") THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE HOSPITAL'S SERVICE AREA. SIGNS OR DISPLAYS ARE CONSPICUOUSLY POSTED IN PUBLIC HOSPITAL LOCATIONS INCLUDING THE EMERGENCY DEPARTMENT, ADMISSIONS DEPARTMENT AND REGISTRATION DEPARTMENT THAT INFORM PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. ALL PATIENTS ARE OFFERED A COPY OF THE PLS AS PART OF THE INTAKE AND DISCHARGE PROCESSES. ADDITIONALLY, FINANCIAL COUNSELORS AND CUSTOMER SERVICE REPRESENTATIVES ARE AVAILABLE TO ASSIST PATIENTS WITH CONCERNS. SCHEDULE H, PART VI, LINE 4 THE NORTHEAST REGION IS COMPRISED OF FOUR COUNTIES AND IS PRIMARILY SERVED BY THE FOLLOWING HOSPITALS: COMMUNITY MEDICAL CENTER (DBA GEISINGER COMMUNITY MEDICAL CENTER (GCMC)), GEISINGER WYOMING VALLEY MEDICAL CENTER (GWV) (INCLUDES GEISINGER SOUTH WILKES-BARRE (GSWB)), ALLIED SERVICES REHAB HOSPITAL, AND HEINZ REHAB HOSPITAL. GCMC DEFINED ITS PRIMARY SERVICE AREA AS 25 ZIP CODES, PRIMARILY WITHIN THE NORTHEAST REGION. THE PRIMARY SERVICE AREA WAS IDENTIFIED BASED ON THE PATIENT ZIP CODES OF ORIGIN COMPRISING 80% OR MORE OF HOSPITAL DISCHARGES IN FISCAL YEAR 2019. NORTHEAST REGION POPULATION TRENDS THE NORTHEAST REGION IS PREDOMINANTLY RURAL WITH SIGNIFICANT URBAN SETTINGS IN SCRANTON (LACKAWANNA COUNTY), WILKES-BARRE (LUZERNE COUNTY), AND HAZLETON (LUZERNE COUNTY). WITH A POPULATION OF ABOUT 76,200, SCRANTON IS THE LARGEST CITY IN NORTHEASTERN PA, FOLLOWED BY NEIGHBORING WILKES-BARRE WITH ABOUT 42,200 RESIDENTS. HAZLETON (LUZERNE COUNTY) HAS ABOUT 26,700 RESIDENTS. WAYNE COUNTY, WITH A TOTAL POPULATION OF ABOUT 54,000, AND WYOMING COUNTY, WITH ABOUT 28,000, ARE MORE RURAL OVERALL WITH LESS DENSE POPULATION CLUSTERS. DRIVEN BY THE SCRANTON-WILKES-BARRE-HAZLETON METROPOLITAN STATISTICAL AREA, APPROXIMATELY HALF OF ALL NORTHEAST REGION RESIDENTS LIVE IN LUZERNE COUNTY AND ONE-THIRD LIVE IN LACKAWANNA COUNTY. ALL NORTHEAST REGION COUNTIES HAVE A HIGHER PERCENTAGE OF SENIORS AND A HIGHER MEDIAN AGE COMPARED TO THE STATE AND NATION. WAYNE COUNTY HAS THE OLDEST POPULATION: 24% OF RESIDENTS ARE AGE 65 OR OVER AND THE MEDIAN AGE IS 48.6 COMPARED TO 41.6 STATEWIDE. CONSISTENT WITH MUCH OF PA'S RURAL GEOGRAPHY, THE POPULATION OF THE NORTHEAST REGION IS SLIGHTLY DECLINING AND PROJECTED TO DECREASE BY 0.1% BY 2025. THE LARGEST POPULATION DECLINE IS EXPECTED IN WYOMING COUNTY. WAYNE COUNTY HAD THE LARGEST POPULATION GROWTH IN THE NORTHEAST REGION FROM 2017 -2020 AT ABOUT 3%. AS A WHOLE, THE NORTHEAST REGION IS LESS DIVERSE COMPARED TO STATE OR NATIONAL BENCHMARKS, BUT THE CITIES OF SCRANTON, WILKES-BARRE, AND HAZLETON ARE SIGNIFICANTLY MORE DIVERSE THAN SURROUNDING TOWNS. HAZLETON BENEFITS FROM THE GREATEST DIVERSITY AMONG CITIES IN THE REGION. IN HAZLETON, APPROXIMATELY 64% OF RESIDENTS ARE LATINX (OF ANY RACE); 48% ARE WHITE; 6% ARE BLACK; AND 1% ARE ASIAN. IN WILKES-BARRE, 64% OF THE POPULATION IS WHITE; ABOUT 27% ARE LATINX; 16% ARE BLACK; AND 2% ARE ASIAN. IN SCRANTON, ABOUT 75% OF THE POPULATION IS WHITE; 17% ARE LATINX; 8% ARE BLACK; AND 6% ARE ASIAN. THE SCRANTON-WILKES-BARRE AREA IS HOME TO MULTIPLE COLLEGES AND UNIVERSITIES: THE UNIVERSITY OF SCRANTON, GEISINGER COMMONWEALTH SCHOOL OF MEDICINE, JOHNSON COLLEGE, KING'S COLLEGE, LACKAWANNA COLLEGE, MARYWOOD UNIVERSITY, MISERICORDIA UNIVERSITY, AND WILKES UNIVERSITY. SATELLITE CAMPUSES, COMMUNITY COLLEGES, AND VOCATIONAL SCHOOLS INCLUDE FORTIS INSTITUTE, LUZERNE COUNTY COMMUNITY COLLEGE, PENN FOSTER CAREER SCHOOL, PENN STATE SCRANTON, AND PENN STATE WILKES-BARRE. UNIVERSITY AND COLLEGE CAMPUSES OFTEN BRING GREATER COMMUNITY DIVERSITY, PARTICULARLY WITH REGARD TO AGE. DUE TO PARTIAL YEAR RESIDENCY, STUDENT POPULATIONS CAN IMPACT COMMUNITY DEMOGRAPHICS AND NEEDED SERVICES. SOCIOECONOMIC TRENDS THE ECONOMY IN THE NORTHEAST REGION GREW FROM ITS EARLY ROOTS IN IRON AND COAL PRODUCTION, ATTRACTING A DIVERSE LABOR FORCE TO WORK IN THE INDUSTRIAL CENTER. TODAY, THE TOP INDUSTRIES ACROSS THE REGION ARE HEALTH AND HUMAN SERVICES, PROFESSIONAL SERVICES, AND RETAIL. TOURISM IS AN IMPORTANT ECONOMIC ENGINE FOR THE REGION. MAJOR REVITALIZATION PROJECTS HAVE BEEN UNDERWAY IN RECENT YEARS IN SCRANTON, WILKES-BARRE, HAZLETON, CARBONDALE, AND OTHER TOWN CENTERS ACROSS THE REGION TO PRESERVE THE RICH HERITAGE OF THE AREA AND DESIGN FOR THE FUTURE. SCRANTON IS THE GEOGRAPHIC AND CULTURAL CENTER OF THE LACKAWANNA RIVER VALLEY AND NORTHEASTERN PA. LACKAWANNA AND LUZERNE COUNTY RESIDENTS, PARTICULARLY CHILDREN, EXPERIENCE MORE POVERTY AND RELATED CONCERNS THAN WAYNE AND WYOMING COUNTY RESIDENTS. IN LACKAWANNA AND LUZERNE COUNTIES, APPROXIMATELY 15% OF RESIDENTS LIVE IN POVERTY COMPARED TO 13% STATEWIDE. APPROXIMATELY 22% OF LACKAWANNA COUNTY CHILDREN AND 26% OF LUZERNE COUNTY CHILDREN LIVE IN POVERTY COMPARED TO 18% STATEWIDE. NEARLY ONE IN FIVE CHILDREN IN EITHER COUNTY LIVE IN FOOD INSECURE HOUSEHOLDS COMPARED TO 15% STATEWIDE AND NATIONALLY. POVERTY WAS WIDELY SEEN BY KEY INFORMANT SURVEY RESPONDENTS AS A KEY CONTRIBUTOR TO POORER HEALTH OUTCOMES. HEALTHCARE AND SOCIAL SERVICES WERE LISTED AMONG THE COMMUNITY'S STRENGTHS, YET ABOUT ONE-THIRD OF KEY INFORMANTS INDICATED A COMMUNITY NEED FOR MORE SOCIOECONOMIC ASSISTANCE, ESPECIALLY AFFORDABLE HOUSING. HIGHER POVERTY RATES WITHIN LACKAWANNA AND LUZERNE COUNTIES ARE PARTIALLY DRIVEN BY INCOME AND EDUCATION INEQUALITY AMONG RACIAL AND ETHNIC GROUPS. ACROSS BOTH COUNTIES, 35%-45% OF BLACK AND LATINX RESIDENTS LIVE IN POVERTY COMPARED TO 12%-14% OF WHITE RESIDENTS. APPROXIMATELY 8%-12% OF BLACK RESIDENTS AND 10%-13% OF LATINX RESIDENTS HAVE A BACHELOR'S DEGREE COMPARED TO 24%-28% OF WHITE RESIDENTS. IN COMPARISON TO THE STATE AND NATION, RESIDENTS OF WAYNE AND WYOMING COUNTIES ARE MORE LIKELY TO OWN THEIR HOME, WHILE RESIDENTS OF LACKAWANNA AND LUZERNE COUNTIES ARE JUST AS LIKELY TO OWN THEIR HOME. WAYNE COUNTY HAS THE HIGHEST MEDIAN HOME VALUE AND NEWEST HOUSING STOCK IN THE REGION, AND A HIGHER PERCENTAGE OF COST BURDENED HOMEOWNERS (SPENDING 30% OR MORE OF HOUSEHOLD INCOME ON MORTGAGE EXPENSES). HOUSING STOCK IN LACKAWANNA AND LUZERNE COUNTIES IS GENERALLY OLDER THAN IN WAYNE AND WYOMING COUNTIES, AND THE STATE AND NATION. AS A RESULT OF THE COVID-19 PANDEMIC, THE NORTHEAST REGION UNEMPLOYMENT RATE MORE THAN TRIPLED IN LACKAWANNA, LUZERNE, AND WAYNE COUNTIES AND MORE THAN DOUBLED IN WYOMING COUNTY FROM MAY 2019 TO MAY 2020. AS OF MAY 2020, LUZERNE COUNTY HAS THE HIGHEST UNEMPLOYMENT AT 16%, NEARLY 3 PERCENTAGE POINTS HIGHER THAN THE STATE UNEMPLOYMENT. HEALTH TRENDS ACCESS TO HEALTHCARE THE TOTAL UNINSURED POPULATION ACROSS THE NORTHEAST REGION HAS STEADILY DECLINED SINCE 2010, AND ALL COUNTIES HAVE FEWER UNINSURED ADULTS AND CHILDREN COMPARED TO THE STATE AND NATION. UNINSURED RATES AMONG MINORITY RESIDENTS ALSO DECLINED, BUT CONTINUE TO BE DISPROPORTIONATELY HIGHER COMPARED TO WHITES. AVAILABILITY OF PRIMARY CARE PROVIDERS AND DENTISTS IN LACKAWANNA AND LUZERNE COUNTIES IS COMPARABLE TO STATE AND NATIONAL RATES, WHILE THE PROVIDER RATES IN WAYNE AND WYOMING COUNTIES ARE NOTABLY LOWER. WYOMING COUNTY IN PARTICULAR HAS LOWER PROVIDER RATES THAN OTHER COUNTIES, AND A DECLINING DENTAL PROVIDER RATE. ALL COUNTIES ARE DENTAL HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS) FOR LOW-INCOME RESIDENTS. WHILE THE MENTAL HEALTH PROVIDER RATE INCREASED IN THE NORTHEAST REGION, ALL COUNTIES HAVE A LOWER PROVIDER RATE THAN THE STATE AND NATION. WAYNE COUNTY IS A MENTAL HEALTH HPSA. KEY INFORMANT SURVEY RESPONDENTS AFFIRMED THE NEED FOR ADDITIONAL BEHAVIORAL HEALTH SERVICES, PARTICULARLY MENTAL HEALTH SERVICES. CHRONIC DISEASE PREVENTION AND MANAGEMENT OBESITY AMONG ADULTS IN THE NORTHEAST REGION IS ON PAR OR SLIGHTLY HIGHER THAN STATE AND NATIONAL AVERAGES, BUT OBESITY AMONG SCHOOL STUDENTS IS HIGHER FOR EVERY REPORTED AGE GROUP AND IN EVERY COUNTY COMPARED TO THE STATE. OBESITY AMONG STUDENTS IN GRADES 7-12 INCREASED FOR ALL COUNTIES. KEY INFORMANTS SAW HEALTH HABITS AS A TOP CONTRIBUTING FACTOR TO OBESITY AND OTHER REGIONAL HEALTH CONCERNS. IN CONTRAST TO NATIONAL TRENDS, TOBACCO USE IS INCREASING AMONG ADULTS IN PA AND THE NORTHEAST REGION. LACKAWANNA (20.3%) AND LUZERNE (19.3%) COUNTIES EXCEED THE STATE (18.8%) AND NATION (17.1%) FOR THE PERCENTAGE OF ADULTS WHO SMOKE. VAPING AND E-CIGARETTE USE HAS SURPASSED TRADITIONAL CIGARETTE USE AMONG STUDENTS, AND THE PERCENTAGE OF STUDENTS USING VAPING OR E-CIGARETTE PRODUCTS IN THE NORTHEAST REGION IS HIGHER THAN STATEWIDE AVERAGES. LACKAWANNA COUNTY SAW THE GREATEST INCREASE IN ADULT SMOKING, AND HAS A HIGHER, INCREASING RATE OF DEATH DUE TO CHRONIC LOWER RESPIRATORY DISEASE. THE COUNTY ALSO HAS A HIGHER PERCENTAGE OF YOUTH WITH DIAGNOSED ASTHMA. HEALTH RISK FACTORS MAY CONTRIBUTE TO HIGHER DEATH RATES FROM CHRONIC DISEASE. THE NORTHEAST REGION HAS HIGHER DEATH RATES THAN THE STATE AND NATION FOR HEART DISEASE AND DIABETES. CANCER DEATH RATES ARE ALSO HIGHER AND INCREASING IN LACKAWANNA AND WYOMING COUNTIES. OF NOTE, DEATHS DUE TO CHRONIC DISEASE ARE DECREASING IN WAYNE COUNTY. NOTABLE HEALTH DISPARITIES EXIST WITHIN LUZERNE AND WYOMING COUNTIES. BOTH COUNTIES HAVE THE HIGHEST PREVALENCE OF ADULT OBESITY AND DIABETES IN THE REGION, AS WELL AS THE HIGHEST DEATH RATES DUE TO DIABETES. WYOMING COUNTY SAW INCREASES IN BOTH DIABETES PREVALENCE AND DEATH RATES. WYOMING COUNTY ALSO HAS THE HIGHEST RATES OF DEATH DUE TO CANCER AND CLRD IN THE REGION; DEATH RATES INCREASED AND EXCEED STATE AND NATIONAL BENCHMARKS. HIGHER POVERTY RATES, LOWER EDUCATION ATTAINMENT, AND RURAL GEOGRAPHIES CONSISTENT WITH MOST OF THE NORTHEAST REGION CONTRIBU SCHEDULE H, PART VI, LINE 5 SCHEDULE H, PART I IN ADDITION TO THE NET COMMUNITY BENEFIT COSTS INCURRED BY THE ORGANIZATION AS REPORTED IN SCHEDULE H, PART I, LINE 7; PLEASE REFER TO SCHEDULE O OF THIS FORM 990 FOR THE ORGANIZATION'S NARRATIVE COMMUNITY BENEFIT STATEMENT FOR ADDITIONAL INFORMATION ON HOW THE ORGANIZATION PROMOTES HEALTH AND PROVIDES HEALTHCARE SERVICES TO THE COMMUNITY REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY IN FURTHERANCE OF ITS CHARITABLE TAX EXEMPT PURPOSE. SCHEDULE H, PART VI, LINE 6 GEISINGER HEALTH AND ITS SUBSIDIARIES (COLLECTIVELY REFERRED TO AS "GEISINGER") COMPRISE A PHYSICIAN-LED, INTEGRATED HEALTH SERVICES ORGANIZATION THAT HAS AS ITS MAIN COMPONENTS: (I) AN ARRAY OF HEALTH SERVICES PROVIDERS, INCLUDING SIX WHOLLY-CONTROLLED ACUTE-CARE HOSPITALS WITH MULTIPLE CAMPUSES, A JOINT VENTURE HOSPITAL AND A DRUG AND ALCOHOL TREATMENT FACILITY; (II) MULTISPECIALTY PHYSICIAN GROUP PRACTICES; (III) INSURANCE OPERATIONS, INCLUDING A LICENSED HEALTH MAINTENANCE ORGANIZATION; AND (IV) A COMMUNITY-BASED MEDICAL COLLEGE AND DEGREE-GRANTING INSTITUTION. GEISINGER OPERATES IN 46 OF PENNSYLVANIA'S 67 COUNTIES, WITH A SIGNIFICANT PRESENCE IN CENTRAL AND NORTHEASTERN PENNSYLVANIA. THE HOSPITAL IS AN AFFILIATE WITHIN GEISINGER. SEE SCHEDULE R FOR A LIST OF THE AFFILIATED ORGANIZATIONS COMPRISING GEISINGER. CORPORATE STRUCTURE. THE ORGANIZATIONAL STRUCTURE OF GEISINGER REFLECTS THE STRATEGIC GOAL OF OPERATING AS A FULLY INTEGRATED HEALTHCARE SYSTEM WHOSE CORPORATE COMPONENTS SHARE THE COMMON GOALS OF MANAGING AND IMPROVING THE HEALTHCARE OF ITS PATIENTS AND MEMBERS, WHILE RECOGNIZING AND RESPECTING THE CORPORATE IDENTITY OF EACH ENTITY. THIS INTEGRATION LINKS THE AREAS OF PHYSICIANS, HOSPITALS/CLINICS, AND HEALTHCARE INSURANCE. HISTORY. GEISINGER HAD ITS BEGINNINGS IN THE SMALL COMMUNITY OF DANVILLE, LOCATED IN CENTRAL PENNSYLVANIA ON THE NORTHERN BRANCH OF THE SUSQUEHANNA RIVER. THERE, IN 1915, ABIGAIL A. GEISINGER FOUNDED THE GEORGE F. GEISINGER MEMORIAL HOSPITAL IN MEMORY OF HER HUSBAND. FROM THE BEGINNING, THE NEW HOSPITAL WAS DESIGNED AS A COMPREHENSIVE HEALTHCARE INSTITUTION THAT WOULD OFFER SPECIALIZED MEDICAL CARE TO PEOPLE IN THE RURAL AREAS OF CENTRAL AND NORTHEASTERN PENNSYLVANIA. UNLIKE MOST HEALTHCARE SYSTEMS, WHICH EVOLVED WITH A HOSPITAL FOCUS, GEISINGER'S HISTORY AND TRADITION IS THAT OF A PHYSICIAN-LED AND PHYSICIAN-DRIVEN HEALTHCARE ORGANIZATION. THIS TRADITION BEGAN WHEN MRS. GEISINGER BROUGHT DR. HAROLD FOSS, A MAYO CLINIC TRAINED PHYSICIAN, TO BE HER HOSPITAL'S FIRST CHIEF OF STAFF. TODAY, GEISINGER IS REGARDED AS A NATIONAL MODEL OF HEALTHCARE DELIVERY CENTERED ON A SOPHISTICATED MULTISPECIALTY GROUP PRACTICE. SINCE THE 1970S, GEISINGER'S STRATEGY OF INTEGRATING PHYSICIANS AND HOSPITALS EXPANDED TO INCLUDE THE MANAGEMENT OF HEALTH AND THE FINANCING OF HEALTHCARE SERVICES THROUGH ITS WHOLLY CONTROLLED HEALTH MAINTENANCE ORGANIZATION, GEISINGER HEALTH PLAN. TWO INDEMNITY HEALTH INSURERS, GEISINGER INDEMNITY INSURANCE COMPANY AND GEISINGER QUALITY OPTIONS, INC. WERE ALSO ADDED. SEE SCHEDULE R FOR A LIST OF THE AFFILIATED ORGANIZATIONS COMPRISING GEISINGER. SCHEDULE H, PART VI PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT: AT THIS TIME, THE HOSPITAL AND ITS AFFILIATES ARE NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE. true CITY OF SCRANTON 340 N WASHINGTON AVE 2 SCRANTON PA 18503 246000704 GOV 69917 CASH PUBLIC SAFETY SCRANTON MUNICIPAL REC AUTHORITY 340 N WASHINGTON AVE SCRANTON PA 18503 201614730 GOV 100000 CASH PUBLIC SAFETY 2 SCHEDULE I, PAGE 4, PART IV COMMUNITY MEDICAL CENTER (CMC) DOES NOT AWARD GRANTS; CMC PROVIDES ASSISTANCE IN THE FORM OF CHARITABLE CONTRIBUTIONS TO TAX-EXEMPT ORGANIZATIONS THAT QUALIFY FOR 501(C)(3) STATUS UNDER THE INTERNAL REVENUE CODE, LIMITED 501(C)(4) ORGANIZATIONS BASED ON EXPLICIT CRITERIA, PUBLIC BENEFIT OR NON-EXEMPT ORGANIZATIONS WHOSE ACTIVITIES FURTHER THE EXEMPT PURPOSE OF CMC. CMC NOTIFIES THE PUBLIC BENEFIT OR NON-EXEMPT ORGANIZATIONS OF THE INTENT AND PURPOSE OF THE CHARITABLE CONTRIBUTION. ORGANIZATIONS SEEKING SUPPORT MUST DEMONSTRATE THAT THEY EFFECTIVELY MEET AN IMPORTANT COMMUNITY HEALTH NEED. X true true X X X X X X false true false false false false false false false JAEWON RYU MD JD PRESIDENT, DIRECTOR 4189940 1355101 1526570 34370 7105981 1322351 KEVIN V ROBERTS MBA CPA EVP, CFO, TREASURER 1652425 83210 348862 26009 2110506 MATTHEW WALSH DIRECTOR 1219503 152091 271570 36420 1679584 123179 STEVEN B BENDER ESQUIRE EVP, CLO, SECRETARY 846303 39623 181570 34016 1101512 GERALD V MALONEY DO DIRECTOR 679749 129544 91570 41924 942787 70375 NAVNEET S DANG MD INTERIM CMO 409497 153847 21570 38321 623235 MARIA MCGRAW CRNA CRNA, LEAD 386163 31744 21570 3084 442561 ROSE A SADOWSKI CRNA CRNA, PASNAP 373556 12885 10520 21570 12152 430683 GARY SEBASTIANELLI CRNA CRNA, LEAD 359900 11303 21570 26484 419257 LORI R GRAMLEY ESQUIRE ACLO, ASST SECTY 321611 25825 21570 23852 392858 MARK ANTONIO CRNA CRNA, PASNAP 318841 9950 7155 21570 34212 391728 JOHN DITCHKUS CRNA CRNA, PASNAP 319280 3075 7068 21570 31456 382449 SCHEDULE J, PAGE 1, PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - FROM TIME TO TIME, THE GEISINGER BOARD OF DIRECTORS OR GEISINGER SENIOR MANAGEMENT APPROVE THE GROSS-UP OF EXPENSES, WHICH FURTHER GEISINGER BUSINESS, FOR TAX OBLIGATIONS. SCHEDULE J, PAGE 1, PART I, LINE 4 JAEWON RYU, MD, JD 0 1,322,351 0 MATTHEW WALSH 0 123,179 0 GERALD V. MALONEY, DO 0 70,375 0 SCHEDULE J, PART III PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN COMPENSATION FOR ELIGIBLE EMPLOYEES MAY BE DEFERRED TO A 457(F) NONQUALIFIED PLAN THAT VESTS WITH COMPLETION OF SERVICE, DEATH AND/OR PERMANENT DISABILITY. __________________________________________________________________________ FOOTNOTE: THROUGHOUT THIS DOCUMENT, THE TERMS "GEISINGER- OR "GEISINGER HEALTH" SHALL REFER TO THE ENTIRE HEALTH CARE SYSTEM COMPRISED OF GEISINGER HEALTH FOUNDATION (THE "FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATE ENTITIES COMPRISING THE HEALTH CARE SYSTEM. IN ADDITION, THROUGHOUT THIS DOCUMENT, THE TERM "SYSTEM" SHALL REFER TO THE ENTIRE HEALTH CARE SYSTEM AS PREVIOUSLY DEFINED PLUS ITS AFFILIATES. VIRGINIA MCGREGOR RELATIVE OF DIRECTOR RECRUITMENT X 25000 9239 false true true 9239 VIRGINIA MCGREGOR FAMILY 117964 EMPLOYEE COMP/BEN false SCHEDULE L, PART V VIRGINIA MCGREGOR IS A FAMILY MEMBER OF VIRGINIA MCGREGOR, A DIRECTOR OF COMMUNITY MEDICAL CENTER. FORM 990 FORM 990, PART IV, LINE 24A: DID THE ORGANIZATION HAVE A TAX-EXEMPT BOND ISSUE WITH AN OUTSTANDING PRINCIPAL AMOUNT OF MORE THAN 100,000 AS OF THE LAST DAY OF THE YEAR, THAT WAS ISSUED AFTER DECEMBER 31, 2002? GEISINGER HEALTH (GH) IS CURRENTLY THE SOLE OBLIGOR UNDER A SERIES OF BOND ISSUES, INCLUDING TAX-EXEMPT BONDS ISSUED PRIOR TO DECEMBER 31, 2002, WITH A TOTAL OUTSTANDING BALANCE AT DECEMBER 31, 2022 OF 1,656,231,705, INCLUSIVE OF UNAMORTIZED ORIGINAL ISSUE DISCOUNT. BECAUSE THE BOND PROCEEDS ARE DISBURSED TO GH SUBSIDIARIES, THE TAX-EXEMPT BOND LIABILITIES ARE REFLECTED ON THE BALANCE SHEETS OF THE FOLLOWING SUBSIDIARY ORGANIZATIONS: GEISINGER MEDICAL CENTER EIN: 24-0795959 GEISINGER WYOMING VALLEY MEDICAL CENTER EIN: 23-1996150 GEISINGER CLINIC EIN: 23-6291113 MARWORTH EIN: 23-2171417 GEISINGER SYSTEM SERVICES EIN: 23-2164794 COMMUNITY MEDICAL CENTER EIN: 24-0862246 GEISINGER-BLOOMSBURG HOSPITAL EIN: 23-2193572 GEISINGER-LEWISTOWN HOSPITAL EIN: 23-1352187 GEISINGER COMMONWEALTH SCHOOL OF MEDICINE EIN: 26-0812968 GEISINGER JERSEY SHORE HOSPITAL EIN: 24-0792115 SCHEDULE K WAS PREPARED ON A CONSOLIDATED BASIS AND IS INCLUDED IN THE FORM 990 FILING OF GEISINGER HEALTH, EIN: 23-1995911. FORM 990, PAGE 2, PART III, LINE 4A I. GENERAL INFORMATION COMMUNITY MEDICAL CENTER (CMC), DOING BUSINESS AS GEISINGER COMMUNITY MEDICAL CENTER (GCMC), IS A TAX-EXEMPT, PENNSYLVANIA NOT-FOR-PROFIT CORPORATION ORGANIZED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. GCMC IS A 293-BED ACUTE CARE HOSPITAL IN SCRANTON, PA. ORIGINALLY CALLED HAHNEMANN HOSPITAL, IT WAS FOUNDED IN 1897 BY A GROUP OF 15 PHILANTHROPIC WOMEN. THE HOSPITAL WAS SCRANTON'S FIRST AND CURRENTLY ONLY ACUTE CARE HOSPITAL DEDICATED TO SERVING THE COMMUNITY AND THEIR HEALTH NEEDS THROUGH A CHARITABLE PURPOSE. GCMC CONTINUES TO PROVIDE THE COMMUNITY WITH A VARIETY OF SERVICES AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. THIS CONTINUUM OF CARE INCLUDES PREVENTIVE, AMBULATORY, INPATIENT, AND EMERGENCY SERVICES. GCMC IS A NOTED REGIONAL REFERRAL CENTER WITH COMPREHENSIVE ACUTE CARE MEDICAL SERVICES AND HAS DEVELOPED MANY SPECIFIC AREAS OF EXPERTISE. PATIENT ORIGIN AND SERVICE AREA: THE HOSPITAL'S PRIMARY SERVICE AREA IS COMPRISED OF LACKAWANNA, LUZERNE, AND WAYNE COUNTIES. SECONDARY SERVICE AREAS INCLUDE MONROE, PIKE, SUSQUEHANNA, AND WYOMING COUNTIES. II. MAJOR PROGRAM SERVICE ACTIVITIES SPECIALIZED / REGIONAL SERVICES, CENTERS OF EXCELLENCE: GCMC IS THE ONLY LEVEL II TRAUMA CENTER IN LACKAWANNA COUNTY. THE NORTHEAST PA TRAUMA CENTER, DESIGNATED BY THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION IN 1988, PROVIDES 24-HOUR COMPREHENSIVE SURGICAL INTERVENTION FOR CRITICALLY INJURED PATIENTS. THE TRAUMA CENTER IS STAFFED CONTINUOUSLY BY AN EMERGENCY PHYSICIAN, TRAUMA SURGEON, AND NURSES CERTIFIED IN CRITICAL CARE, TRAUMA, ORTHOPEDICS, AND THE NEUROSCIENCES. CARDIOLOGY SERVICES AT THE HOSPITAL INCLUDE THE REGION'S FIRST ELECTROPHYSIOLOGY LAB AND AN OPEN-HEART SURGERY CENTER AS WELL AS A CARDIAC REHAB PROGRAM. THE NON-INVASIVE CARDIOVASCULAR DEPARTMENT IS ACCREDITED IN ADULT TRANSTHORACIC ECHOCARDIOGRAPHY BY THE INTERSOCIETAL ACCREDITATION COMMISSION (IAC). GCMC IS ALSO A CERTIFIED CAROTID STENT FACILITY AND CERTIFIED HEART ATTACK RECEIVING CENTER. GCMC CARDIOLOGY HAS EARNED THE AMERICAN HEART ASSOCIATION'S MISSION: LIFELINE HEART ATTACK RECEIVING CENTER AWARD AND HIGHMARK'S BLUE DISTINCTION CENTER+ FOR CARDIAC CARE. IN 2019, GCMC OPENED A 4 MILLION HEART AND VASCULAR CENTER. THIS BRAND NEW 10,000 SQUARE FOOT CLINIC FEATURES 22 EXAM ROOMS AND STREAMLINES CARDIOLOGY, CARDIAC, AND THORACIC SURGERY AT GCMC. IN 2022 GCMC EARNED THE COMPREHENSIVE HEART ATTACK CENTER CERTIFICATION FROM THE JOINT COMMISSION AND THE AMERICAN HEART ASSOCIATION. NEUROSCIENCES AT GCMC SPECIALIZES IN THE CARE OF PEOPLE WITH BRAIN AND SENSE ORGAN DISORDERS. GCMC WAS AWARDED WITH THE AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES GOLD PLUS QUALITY ACHIEVEMENT AWARD WITH TARGET: STROKE HONOR ROLL ELITE AND TYPE 2 DIABETES HONOR ROLL. GCMC ALSO EARNED THE JOINT COMMISSION'S GOLD SEAL OF APPROVAL FOR CERTIFICATION AS A PRIMARY STROKE CENTER (ONLY ONE OF 54 MEDICAL CENTERS IN PENNSYLVANIA TO OBTAIN THIS). IN ADDITION, GCMC IS THE ONLY HOSPITAL IN THE REGION TO OFFER A 10-BED ADULT INPATIENT EPILEPSY MONITORING UNIT. OTHER SPECIALIZED SERVICES INCLUDE: INTERVENTIONAL RADIOLOGY THE HOSPITAL'S INTERVENTIONAL RADIOLOGY SUITE OFFERS A STATE-OF-THE-ART SPACE FOR MINIMALLY INVASIVE SURGICAL PROCEDURES THAT TREAT VASCULAR ISSUES, TRAUMA, CANCERS, UTERINE FIBROIDS, KIDNEY STONES AND OTHER CONDITIONS. THE 2.9 MILLION, 2,110-SQUARE-FOOT SPACE BOASTS ADVANCED, HIGH-TECH IMAGING EQUIPMENT FOR MORE PRECISE IMAGING, BETTER DIAGNOSES AND MORE FOCUSED TREATMENT. COMPREHENSIVE BARIATRICS PROGRAM SCRANTON-AREA RESIDENTS COPING WITH SEVERE OBESITY AND OBESITY-RELATED HEALTH DISORDERS DON'T HAVE TO TRAVEL FAR TO FIND HIGH-QUALITY CARE THAT GOES WELL BEYOND TRADITIONAL WEIGHT-LOSS SURGERY WITH GCMC'S PROVENCARE BARIATRIC PROGRAM. THE PROGRAM OFFERS MORE THAN JUST SURGERY - IT'S AN ENTIRE PATHWAY OF CARE THAT STARTS WITH A FULL MEDICAL SCREENING AND EVALUATION BY A NUTRITIONIST. PATIENTS IN THE PROGRAM RECEIVE SEVERAL MONTHS OF CARE, INCLUDING BEHAVIOR MODIFICATION STRATEGIES, NUTRITION AND EXERCISE THERAPY AND GROUP EDUCATION SERVICES BEFORE THEIR SURGERY. GCMC'S PROGRAM IS NATIONALLY ACCREDITED BY THE METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM, THE ONLY ONE IN LACKAWANNA COUNTY. GENERAL SURGERY GCMC'S GENERAL SURGEONS PERFORM LAPAROSCOPIC AND OPEN BARIATRICS, LAPAROSCOPIC BOWEL RESECTIONS, MINIMALLY INVASIVE CARDIAC SURGERY, MINIMALLY INVASIVE SPINAL SURGERY, ROBOTIC -ASSISTED SURGERY, AND MINIMALLY INVASIVE AND ENDOVASCULAR PROCEDURES ON HEART VALVES. SURGEONS IN GCMC'S HYBRID OR ARE PERFORMING RADIOLOGICALLY ASSISTED VASCULAR PROCEDURES, AND GCMC OFFERS THE MOST UP-TO-DATE APPROACH TO HIP ARTHROPLASTY IN THE COUNTRY. IN 2023 GCMC WAS LISTED IN U.S. NEWS & WORLD REPORT BEST HOSPITALS RANKINGS FOR HEART FAILURE, KIDNEY FAILURE, STROKE, COPD, KNEE REPLACEMENT. CANCER CENTER OPENED IN SEPTEMBER 2016, THE HENRY CANCER CENTER SCRANTON CAMPUS IS A 6,500-SQUARE-FOOT CANCER CENTER OFFERS MEDICAL ONCOLOGY SERVICES SUCH AS CHEMOTHERAPY, BLOOD THERAPIES AND INFUSION MEDICATIONS. THE 2.1 MILLION SPACE FEATURES A SOFTLY LIT WAITING AREA, ITS OWN PHARMACY STOCKED FOR THE UNIQUE NEEDS OF CANCER PATIENTS, 7 EXAM ROOMS AND 11 INFUSION BAYS WITH HEATED CHAIRS TO INCREASE PATIENT COMFORT. LABOR AND DELIVERY IN OCTOBER 2019, GCMC BEGAN DELIVERING BABIES AGAIN THE 15 MILLION MATERNITY CENTER OFFERS THE COMBINED EXPERTISE OF OB/GYNS AND CERTIFIED NURSE MIDWIVES (CNMS) TO ALLOWS EXPECTANT MOTHERS TO TAILOR THEIR BIRTH PLAN TO THEIR PREFERENCES AND HAVE THE RESOURCES TO DEVIATE FROM THAT PLAN IF NECESSARY; FEATURES 8 SPACIOUS SUITES DESIGNED FOR LABOR, DELIVERY AND RECOVERY, BIRTHING BALLS, HYDROTHERAPY TUBS AND STATE-OF-THE-ART MONITORING TECHNOLOGY. SINCE IT'S OPENING, THE CHILDBIRTH CENTER AT GCMC HAS BEEN SUCCESSFUL IN KEEPING THE NUMBER OF CESAREAN BIRTHS BELOW THE STATE AVERAGE. GEISINGER VIEWMONT OUTPATIENT ANCILLARY SERVICES UNDER THE NAME OF GEISINGER VIEWMONT, GCMC OFFERS A COMPREHENSIVE SET OF OUTPATIENT LAB, RADIOLOGY, AND PHYSICAL AND OCCUPATIONAL THERAPY SERVICES AT CONVENIENT LOCATIONS THROUGHOUT LACKAWANNA COUNTY. WITH EXPANDED HOURS AND WEEKEND APPOINTMENTS, GCMC PROVIDES THESE CRITICAL TESTING AND THERAPY SERVICES TO PATIENTS FOR TIMELY RESULTS. OTHER SERVICES GCMC ALSO OFFERS A SAME-DAY OUTPATIENT SURGERY CENTER, A 24-BED SHORT-TERM PSYCHIATRIC INPATIENT UNIT (THE ONLY ONE IN LACKAWANNA COUNTY), AN ORTHOPEDIC TRAUMA AND SPORTS MEDICINE CLINIC, A FULL SUITE OF RADIOLOGY AND LABORATORY SERVICES, PULMONOLOGY, WOUND CARE AND HYPERBARIC OXYGEN CHAMBER TREATMENTS, AND PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPY. IN OCTOBER 2020, GCMC OPENED THEIR NEW PROGRESSIVE CARE UNIT FEATURING 18 PRIVATE ROOMS AND A NURSING CARE MODEL THAT ALLOWS FOR DIRECT OVERSIGHT OF ALL PATIENTS. THE UNIT IS PART OF A 16M PROJECT THAT BEGINS GCMC'S PROCESS OF SHIFTING TO A PRIVATE-ROOM MODEL. III. PROGRAM SERVICE ACCOMPLISHMENTS UNCOMPENSATED CARE: GCMC RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. GCMC PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, RELIGION, ETHNICITY, SEXUAL ORIENTATION, GENDER IDENTITY, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD, GCMC PROVIDES FREE CARE OR SUBSIDIZED CARE, TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST, AND PROVIDES VARIOUS HEALTH ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITIES WHERE GCMC PRACTICES. A. CHARITY CARE THE PRIMARY CONCERN OF GCMC IS THE DELIVERY OF HEALTH CARE TO ALL THE CITIZENS OF NORTHEASTERN PENNSYLVANIA, REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GCMC INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. THE COST TO GCMC OF PROVIDING THIS CHARITY CARE DURING THE YEAR ENDED DECEMBER 31, 2022 WAS 2,635,569. B. MEDICARE/MEDICAID/OTHER GOVERNMENTAL RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO THE ELDERLY (MEDICARE) AND THE POOR (MEDICAID). GCMC PROVIDES CARE BELOW COST TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS. TO THE EXTENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTHCARE, GCMC IS FURTHERING ITS CHARITABLE MISSION. THE UNREIMBURSED VALUE OF MEDICARE, MEDICAID AND OTHER GOVERNMENTAL PAYERS IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. FOR THE YEAR ENDED DECEMBER 31, 2022, THE UNREIMBURSED COST OF PROVIDING CARE TO THESE PATIENTS WAS 80,392,375. C. OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GCMC PROVIDES OTHER PATIENT SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE YEAR ENDED DECEMBER 31, 2022 WAS 2,608,842. RESIDENCY, FELLOWSHIP, AND ALLIED HEALTH PROGRAMS: GCMC HOSTS THE REGION'S ONLY PODIATRIC RESIDENCY PROGRAM AND IS AN ACCREDITED PROVIDER OF PODIATRIC MEDICINE AND SURGERY EDUCATION BY THE COUNCIL OF PODIATRI FORM 990, PART V FORM 990, PART V, LINE 1A: ENTER THE NUMBER REPORTED IN BOX 3 OF FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURNS. GEISINGER SYSTEM SERVICES (GSS), AN AFFILIATE OF THE ORGANIZATION, PROVIDES A CENTRALIZED ACCOUNTS PAYABLE FUNCTION FOR ALL GEISINGER ORGANIZATIONS. AS THE ACCOUNTS PAYABLE PROCESSOR, GSS PREPARES AND FILES FORM 1099 UNDER ITS EIN FOR CERTAIN REPORTABLE PAYMENTS OF THE FILING ORGANIZATION. THE NUMBER OF FORM 1099'S FILED BY GSS FOR THE 2022 REPORTING PERIOD ON BEHALF OF ITSELF AND ITS AFFILIATES WAS 1,353. THE RESPONSE ENTERED ON LINE 1A FOR THE ORGANIZATION INCLUDES ONLY THOSE FORM 1099S FILED UNDER THE ORGANIZATIONS EIN, IT DOES NOT INCLUDE THOSE FILED BY GSS ON ITS BEHALF. FORM 990, PART VI FORM 990, PART I, SECTION A, LINE 4: FORM 990, PART VI, SECTION A, LINE 1B: ENTER THE NUMBER OF VOTING MEMBERS THAT ARE INDEPENDENT. BASED ON THE FORM 990 DEFINITION OF "INDEPENDENCE" AS IT RELATES TO VOTING MEMBERS OF THE GOVERNING BODY, THREE VOTING MEMBERS ARE NOT INDEPENDENT BECAUSE THEY ARE COMPENSATED AS EMPLOYEES OF THIS OR RELATED TAX-EXEMPT ORGANIZATIONS AND ONE VOTING MEMBER IS NOT INDEPENDENT DUE TO A TRANSACTION REPORTED IN SCHEDULE L, PART IV. 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? BENJAMIN K. CHU, MD, MPH, MACP, GERALD V. MALONEY, DO , JAEWON RYU, MD, JD, JEFFREY A. JACOBSON, KEVIN V. ROBERTS, MBA, CPA, LORI R. GRAMLEY, ESQUIRE, MATTHEW WALSH, STEVEN B. BENDER, ESQUIRE, V. CHRIS HOLCOMBE, PE, AND VIRGINIA MCGREGOR ALL HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER BECAUSE THEY SERVE AS OFFICERS AND/OR DIRECTORS ON ONE OR MORE FOR-PROFIT AFFILIATE OF THE ENTITY. ALL OF THE AFFILIATES ARE PART OF GEISINGER. FORM 990, PAGE 6, PART VI, LINE 1A THERE WAS A DELEGATION OF AUTHORITY TO THE GEISINGER HEALTH EMERGENCY ACTION COMMITTEE, WHICH IS COMPRISED OF THE CHAIR OF THE BOARD, VICE-CHAIR OF THE BOARD, THE PRESIDENT AND CEO (EX-OFFICIO DIRECTOR), CHAIR OF THE FINANCE COMMITTEE AND CHAIR OF THE PATIENT EXPERIENCE, ACADEMIC AFFAIRS AND QUALITY COMMITTEE. UNDER THE NONPROFIT CORPORATION LAW AND UNDER GEISINGER HEALTH'S CORPORATE BYLAWS, THE EMERGENCY ACTION COMMITTEE SHALL EXERCISE THE POWER AND AUTHORITY OF THE BOARD OF DIRECTORS TO ACT ON EMERGENCY MATTERS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS. FORM 990, PAGE 6, PART VI, LINE 6 THE MEMBERS OF THE CORPORATION HAVE THE POWER AND AUTHORITY TO ELECT AND REMOVE THE DIRECTORS; ELECT AND REMOVE THE PRESIDENT AND FILL ANY VACANCY IN THE OFFICE OF THE PRESIDENT OF THE CORPORATION; AND, MAY APPROVE AMENDMENTS TO THE CORPORATE BYLAWS IN LIEU OF SUCH APPROVAL BY THE BOARD OF DIRECTORS. THE MEMBERS ALSO HAVE THE RESERVE POWERS AS SET FORTH IN THE PENNSYLVANIA NONPROFIT CORPORATION LAW. FORM 990, PAGE 6, PART VI, LINE 7A THE BOARD OF DIRECTORS OF THE CORPORATION SHALL SERVE AS THE GOVERNING BODY OF THE CORPORATION. THE PRESIDENT OF THE CORPORATION SHALL BE A DIRECTOR BY REASON OF HOLDING SUCH OFFICE. THE REMAINING DIRECTORS SHALL BE ELECTED BY THE MEMBERS AT THE ANNUAL MEETING OF THE MEMBERS. THE MEMBERS OF THE CORPORATION MAY SERVE AS DIRECTORS AND DIRECTORS MAY SUCCEED THEMSELVES FROM TERM TO TERM. VACANCIES ON THE BOARD OF DIRECTORS SHALL BE FILLED BY THE MEMBERS AT THEIR DISCRETION AT THE ANNUAL MEETING OF THE MEMBERS OR AT A SPECIAL MEETING CALLED FOR SUCH PURPOSE. FORM 990, PAGE 6, PART VI, LINE 7B 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 PENNSYLVANIA NONPROFIT CORPORATION LAW. FORM 990, PAGE 6, PART VI, LINE 11B ALL OFFICERS AND DIRECTORS WERE ELECTRONICALLY PROVIDED A FINAL COPY OF THE FORM 990 PRIOR TO FILING THE RETURN WITH THE IRS. AN EXECUTIVE SUMMARY OF THE INFORMATION REPORTED ON THE RETURN IS PROVIDED TO ASSIST IN THE REVIEW. IN ACCORDANCE WITH THE GEISINGER HEALTH BOARD OF DIRECTOR'S FINANCE COMMITTEE CHARTER, GEISINGER ORGANIZATIONS' FORM 990 FILINGS ARE REVIEWED ANNUALLY. THE FORM 990 IS PREPARED BY GEISINGER TAX AND FINANCE DEPARTMENTS WITH INFORMATION PROVIDED FROM FINANCE, TAX, HUMAN RESOURCES, LEGAL SERVICES AND OTHER RELEVANT DEPARTMENTS WITHIN GEISINGER. THE CHIEF FINANCIAL OFFICER (CFO) OF GEISINGER 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 GEISINGER REVIEW THE INFORMATION DISCLOSED ON THE FORM 990 RELEVANT TO THEIR RESPECTIVE AREAS OF RESPONSIBILITY. FOR PURPOSES OF THEIR ANNUAL AUDIT OF GEISINGER CONSOLIDATED FINANCIAL STATEMENTS, INDEPENDENT AUDITORS REVIEW ALL FEDERAL TAX RETURNS FILED BY GEISINGER 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 REPORTING PERIOD. FORM 990, PAGE 6, PART VI, LINE 12C THE OFFICERS AND DIRECTORS OF THE ORGANIZATION ARE SUBJECT TO THE GEISINGER CONFLICT OF INTEREST POLICY FOR DIRECTORS, OFFICERS AND SENIOR LEADERS. AT LEAST ONCE EACH YEAR DIRECTORS, OFFICERS, KEY EMPLOYEES, SENIOR LEADERS 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 GEISINGER. THE DISCLOSURES ARE REVIEWED BY THE OFFICE OF THE CHIEF COMPLIANCE OFFICER AND REPORTED TO THE AUDIT AND COMPLIANCE COMMITTEE AND/OR 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 COMMITTEE/BOARD DECIDES IF A CONFLICT EXISTS AND TAKES APPROPRIATE ACTION. THE INDIVIDUAL DISCLOSING THE FINANCIAL INTEREST IS ABSENT DURING THE COMMITTEE/BOARD DELIBERATIONS AND DECISIONS ON THE MATTER. FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS TO REVIEW AND APPROVE THE COMPENSATION OF GEISINGER 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 GEISINGER. THE CONSULTANT'S REPORT IS PRESENTED TO THE GEISINGER FAMILY COMMITTEE PRIOR TO ANY COMPENSATION ADJUSTMENT. THE REPORT SUPPORTS THE RIGOROUS REVIEW COMPLETED BY THE GEISINGER FAMILY 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 THE GEISINGER FAMILY COMMITTEE PRIOR TO THE EFFECTIVE DATE OF THE PAYMENT. THE GEISINGER FAMILY COMMITTEE AT ITS SOLE DISCRETION MAY POSITIVELY OR NEGATIVELY ADJUST ANY RECOMMENDED COMPENSATION. FORM 990, PAGE 6, PART VI, LINE 15B SEE SCHEDULE O RESPONSE TO FORM 990, PART VI, SECTION B, QUESTION 15A. FORM 990, PAGE 6, PART VI, LINE 19 FINANCIAL STATEMENTS, FORM 990, FORM 990-T, THE CONFLICTS OF INTEREST POLICY, AND OTHER GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OUTSIDE PURCHASED SERVICES 51,970,487 2,527,816 0 FORM 990, PART XI, LINE 9 GAIN FROM INVESTMENT IN AFFILIATE 664,392 TRANSFER FROM GEISINGER HEALTH 41,115 RECONCILATION OF PENSION LIABILTY -5,542,787 TOTAL -4,837,280 FORM 990, PART XII FORM 990, PART XII, LINE 3A: AS A RESULT OF A FEDERAL AWARD, WAS THE ORGANIZATION REQUIRED TO UNDERGO AN AUDIT OR AUDITS AS SET FORTH IN THE UNIFORM GUIDANCE, 2 C.F.R. PART 200, SUBPART F? FEDERAL AWARDS ARE AUDITED AS A PART OF THE GEISINGER'S CONSOLIDATED REPORT ON FEDERAL AWARDS IN ACCORDANCE WITH UNIFORM GUIDANCE, 2 C.F.R. PART 200, SUBPART F. FOOTNOTE: THROUGHOUT THIS DOCUMENT, THE TERMS "GEISINGER- OR "GEISINGER HEALTH" SHALL REFER TO THE ENTIRE HEALTH CARE SYSTEM COMPRISED OF GEISINGER HEALTH FOUNDATION (THE "FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATE ENTITIES COMPRISING THE HEALTH CARE SYSTEM. IN ADDITION, THROUGHOUT THIS DOCUMENT, THE TERM "SYSTEM" SHALL REFER TO THE ENTIRE HEALTH CARE SYSTEM AS PREVIOUSLY DEFINED PLUS ITS AFFILIATES. GEISINGER-SCA HOLDINGS LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 461615328 HOLD CO DE 635736 7370844 CMC GEISINGER HEALTH 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231995911 PHILANTHRO PA 501C3 7 N/A false GEISINGER MEDICAL CENTER 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 240795959 HOSPITAL PA 501C3 3 GH true GEISINGER CLINIC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 236291113 PHYSN SVCS PA 501C3 3 GH true GEISINGER WYOMING VALLEY MED CTR 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231996150 HOSPITAL PA 501C3 3 GH true MARWORTH 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232171417 D&A REHAB PA 501C3 3 GH true GEISINGER HEALTH PLAN 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232311553 HMO PA 501C4 GH false GEISINGER SYSTEM SERVICES 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232164794 SUPPORT SV PA 501C3 12A GH true GEISINGER COMMUNITY HEALTH SERVICES 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232967235 HEALTHCARE PA 501C3 10 GSS true GEISINGER INSURANCE CORPORATIONRRG 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 141909894 SELF INS VT 501C3 12A GH true GEISINGER-BLOOMSBURG HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232193572 HOSPITAL PA 501C3 3 GH true GEISINGER-LEWISTOWN HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231352187 HOSPITAL PA 501C3 3 GH true LEWISTOWN AMBULATORY CARE CORP 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232344362 HOLDING CO PA 501C3 12A GH true FAMILY HEALTH ASSOCIATES OF GLH 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 251651582 PHYSN SVCS PA 501C3 12A GH true KEYSTONE HEALTH INFORMATION EXCH 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 464359893 RHIO PA 501C3 12A GH false WEST SHORE ADVANCED LIFE SUPP SVCS 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232463002 HEALTHCARE PA 501C3 10 GC true GEISINGER COMMONWEALTH SCH OF MED 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 260812968 EDUCATION PA 501C3 2 GH false GEISINGER JERSEY SHORE HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 240792115 HOSPITAL PA 501C3 3 GH true GEISINGER MEDICAL CENTER MUNCY 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 851226106 HOSPITAL PA 501C3 3 GHM false GNJ PHYSICIANS GROUP PC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 820681884 PHYSN SVCS NJ 501C3 10 GH false GSL HOSPITAL 801 OSTRUM STREET BETHLEHEM PA 18015 824432109 HOSPITAL PA 501C3 3 N/A false GSLPG INC 801 OSTRUM STREET BETHLEHEM PA 18015 825423865 HEALTHCARE PA 501C3 3 GSL HOSP false KEYSTONE ACCOUNTABLE CARE ORG LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 455484165 ACO PA N/A false false GEISINGER ENCOMPASS HEALTH LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 721398803 PHY THERAP PA N/A false false EVANGELICAL-GEISINGER HEALTH LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 460567687 HEALTHCARE PA N/A false false LACKAWANNA PHYS AMB SURG CTRLLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 233024998 HEALTHCARE PA CMC RELATED 5861 1650939 false true 0.83700 GEISINGER-HM JOINT VENTURE LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 831871064 HEALTHCARE PA N/A false false KEYSTONE HEALTHCARE PARTNERSHIPLLC 901 HUGH WALLIS ROAD LAFAYETTE LA 70508 833134941 HOME HLTH PA N/A false false COMMONWEALTH MSO LLC 270 SUSQUEHANNA VALLEY MALL DRIVE SELINSGROVE PA 17870 862178965 HEALTHCARE PA N/A false false PHARMACY INNOVATION ALLIANCE LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 831871064 PURCHASING DE N/A false false KKA VALUE FUND II GMBH & CO GIPSSTRABE 8 BERLIN GERMANY GM 10119 981686914 INVESTMENT GM N/A false false KKA CO-INVEST I GMBH & CO KG GIPSSTRABE 8 BERLIN GERMANY GM 10119 981685919 INVESTMENT GM N/A false false ISS SOLUTIONS INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232077663 CLINIC ENG PA N/A false GEISINGER INDEMNITY INSURANCE CO 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232815174 HLTH INSUR PA N/A false GEISINGER QUALITY OPTIONS INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 204275139 HLTH INSUR PA N/A false GEISINGER ASSURANCE COMPANY LTD 23 LINE TREE BAY AVE PO BOX 1159 GRAND CAYMAN GRAND CAYMAN CJ KY1-1102 981016737 FINANCIAL CJ N/A false CT WAREHOUSE GMBH GIPSSTRABE 8 BERLIN BERLIN GM 10119 HOLDING CO GM N/A false KKA PROJECT 3 HOLDING GMBH GIPSSTRABE 8 BERLIN BERLIN GM 10119 HOLDING CO GM N/A false KKA PROJECT 4 HOLDING GMBH GIPSSTRABE 8 BERLIN BERLIN GM 10119 HOLDING CO GM N/A false RTNX TOP GMBH GIPSSTRABE 8 BERLIN BERLIN GM 10119 HOLDING CO GM N/A false KKA WAREHOUSE GMBH GIPSSTRABE 8 BERLIN BERLIN GM 10119 HOLDING CO GM N/A false KKA PROJECT 2 HOLDING GMBH GIPSSTRABE 8 BERLIN BERLIN GM 10119 HOLDING CO GM N/A false PROJECT 4 WAREHOUSE GMBH GIPSSTRABE 8 BERLIN BERLIN GM 10119 HOLDING CO GM N/A false true false true false false false false false false false true true true false false true false false true GEISINGER CLINIC A 168205 FMV GEISINGER SYSTEM SERVICES A 32617 FMV GEISINGER CLINIC K 74319 FMV GEISINGER CLINIC L 8265566 GAAP GEISINGER COMMUNITY HEALTH SERVICES L 960422 GAAP GEISINGER HEALTH PLAN L 83588396 GAAP GEISINGER INDEMNITY INSURANCE COMP L 7754598 GAAP GEISINGER MEDICAL CENTER L 37497 GAAP GEISINGER QUALITY OPTIONS INC L 6983740 GAAP GEISINGER SYSTEM SERVICES L 136179 GAAP GEISINGER WYOMING VALLEY MED CTR L 21304 GAAP GEISINGER COMMONWEATH SCHOOL OF MED L 97 GAAP GEISINGER LEWISTOWN HOSPITAL M 937 GAAP GEISINGER CLINIC M 28073714 GAAP GEISINGER MEDICAL CENTER M 11138231 GAAP GEISINGER SYSTEM SERVICES M 56505212 GAAP GEISINGER WYOMING VALLEY MED CTR M 4584 GAAP ISS SOLUTIONS INC M 1897413 GAAP GEISINGER HEALTH M 545598 GAAP GEISINGER PHARMACY LLC M 3360387 GAAP GEISINGER INSURANCE CORPORATIONRRG P 1806406 GAAP GEISINGER HEALTH S 54345 FMV GEISINGER ASSURANCE COMPANT LTD M 1551142 GAAP GEISINGER HEALTH C 41115 GAAP GEISINGER HEALTH L 35035 GAAP GEISINGER PHARMACY LLC L 110 GAAP NORTHEAST SURGICAL CENTER L 1062 GAAP SCHEDULE R FORM 990, SCHEDULE R, PART V - TRANSACTIONS WITH RELATED ORGANIZATIONS: AS SHOWN IN FORM 990, SCHEDULE R, COMMUNITY MEDICAL CENTER IS CLOSELY AFFILIATED WITH SEVERAL OTHER ORGANIZATIONS. IN THE NORMAL COURSE OF THE OPERATIONS OF THESE AFFILIATED ORGANIZATIONS THERE ARE NUMEROUS INTER ORGANIZATIONAL TRANSACTIONS, WHICH MAY INCLUDE SALES, EXCHANGES AND LEASES OF PROPERTY, EXTENSIONS OF CREDIT, FURNISHING OF GOODS, SERVICES AND FACILITIES, AND TRANSFERS OF ASSETS. THESE INTER ORGANIZATION TRANSACTIONS PROMOTE THE EFFICIENT OPERATION OF THE VARIOUS ORGANIZATIONS AND THE ATTAINMENT OF THEIR TAX EXEMPT PURPOSES. THESE TYPES OF INTER ORGANIZATION TRANSACTIONS WERE DESCRIBED TO THE INTERNAL REVENUE SERVICE IN A RULING APPLICATION AND WERE RECOGNIZED BY THE NATIONAL OFFICE OF THE IRS IN A SERIES OF GEISINGER PRIVATE RULINGS AS BEING ENTIRELY CONSISTENT WITH THE ORGANIZATIONS' TAX EXEMPT STATUS. ___________________________________________________________________________