2025-11-17T11:49:54-06:00 2024-12-31 PwC US Tax LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2024-01-01 240862246 COMMUNITY MEDICAL CENTER % ERIN FITZGERALD CPA COMM 5702716624 100 N ACADEMY AVE MC 49-70 DANVILLE PA 178229800 ERIN M FITZGERALD CPA INTERIM CO-CFO 5702716624 2025-11-11 true ROBERT W FRIZ P00438748 2673303000 2025-11-10 2024 2025-03-06 01:10:19Z GEISINGER COMMUNITY MEDICAL CENTER TERRY GILLILAND MD JD 100 N ACADEMY AVE MC 22-01 DANVILLE PA 17822 562022346 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 AND COMMUNITY SERVICE. 7 4 2642 147 0 0 14057056 1366090 507070216 553454657 4106474 5302339 2184320 1406011 527418066 561529097 0 23616 0 0 178613311 197508008 0 0 0 297640935 312205360 476254246 509736984 51163820 51792113 350921818 449363606 161398314 227054718 189523504 222308888 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, AND COMMUNITY SERVICE. false false 478869426 23616 553454657 IN APRIL 2025, OUTPATIENT SERVICES IN GENERAL SURGERY, INFECTIOUS DISEASES, NEUROSURGERY, PLASTIC SURGERY, PRE-SURGICAL TESTING, PULMONARY MEDICINE, PULMONARY FUNCTION LAB, RHEUMATOLOGY, SLEEP MEDICINE, AND TRAUMA SURGERY MOVED OUT OF GCMC'S FIRST-FLOOR MULTI-SPECIALTY CLINIC TO GEISINGER'S FACILITY AT 3 W. OLIVE STREET IN SCRANTON. THAT SHIFT ENABLED WORK TO BEGIN ON EXPANDING THE HOSPITAL'S EMERGENCY DEPARTMENT, WHICH TARGETS AN ADDITION OF 26 EMERGENCY MEDICINE TREATMENT AREAS AT GCMC. WORK IS ALSO CURRENTLY UNDERWAY TO ADD 13 NEW POSTPARTUM BEDS TO THE MEDICAL CENTER AND AN ADDITIONAL ENDOSCOPY SUITE. AWARDS AND RECOGNITIONS IN 2024 -GEISINGER HOSPITALS RATED ABOVE THE NATIONAL AVERAGE IN LEAPFROG HOSPITAL SAFETY GRADE GEISINGER HOSPITALS RECOGNIZED FOR MATERNAL HEALTHCARE -THREE GEISINGER HOSPITALS RECOGNIZED AS 'HIGH-PERFORMING' BY U.S. NEWS & WORLD REPORT -GEISINGER HOSPITALS AWARDED GOLD, PLATINUM STATUSES FOR PROMOTING A CULTURE OF HEALTH THROUGH FOOD -GEISINGER HOSPITALS RECEIVE MULTIPLE NATIONAL RECOGNITIONS FOR HEART CARE -GEISINGER COMMUNITY MEDICAL CENTER EARNS EXCELLENCE IN PATIENT SAFETY RECOGNITION 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, 2024 WAS $4,728,051. 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, 2024, THE UNREIMBURSED COST OF PROVIDING CARE TO THESE PATIENTS WAS $69,240,621. 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 PODIATRIC MEDICAL EDUCATION. GCMC ALSO HAS AN AFFILIATION WITH THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION. THE WRIGHT CENTER IS AN ACCREDITED PROVIDER OF INTERNAL MEDICINE AND CARDIOVASCULAR DISEASE FELLOWSHIPS. IT IS ACCREDITED BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION. THE UNCOMPENSATED COSTS FOR GRADUATE MEDICAL EDUCATION TOTALED $3,868,625. COMMUNITY HEALTH EDUCATION AND OUTREACH: GCMC PROVIDES A VARIETY OF HEALTH EDUCATION AND OUTREACH PROGRAMS TO THE COMMUNITY. THE INTENT OF THESE PROGRAMS IS TO IMPROVE THE HEALTH OF THE COMMUNITY AND PROVIDE FOR COMMUNITY HEALTH NEEDS. GCMC'S COST OF THE STOP THE BLEED EDUCATIONAL OUTREACH DURING 2024 WAS $21,391. HEALTH CARE SUPPORT SERVICES: GCMC SUPPORTS THE HEALTHCARE OF THE COMMUNITY BY OFFERING SERVICES, SUCH AS SUPPLIES AND MEDICATION OR SEXUAL ASSAULT VICTIMS. GCMC ALSO ASSISTS DISCHARGED PATIENTS THAT DON'T HAVE AND CAN'T AFFORD TRANSPORTATION HOME BY HIRING A TAXI OR PROVIDING A WHEELCHAIR VAN TO THOSE INDIVIDUALS IN NEED. THE UNCOMPENSATED COST OF THESE HEALTH CARE SUPPORT SERVICES TOTALED $824,080 DURING THE YEAR ENDED DECEMBER 31, 2024. HEALTH PROFESSIONS EDUCATION: IN ADDITION TO SUPPORTING RESIDENCY AND FELLOWSHIP PROGRAMS, GCMC PROVIDED $3,986,405 IN SUPERVISION OF NURSING, PHARMACY AND ADVANCED PRACTITIONERS COMPLETING ROTATIONS AS PART OF THEIR STUDIES DURING THE YEAR ENDED DECEMBER 31, 2024. THIS SUPPORT IS PART OF GCMC'S CONNECTION WITH NUMEROUS AREA INSTITUTIONS, COLLEGES, AND UNIVERSITIES FOR EDUCATIONAL AND CLINICAL PROGRAMS. FINANCIAL DONATIONS FOR THE COMMUNITY: GCMC ALSO HAS A WORKING RELATIONSHIP WITH THE CHILDREN'S ADVOCACY CENTER AND PROVIDES THIS ORGANIZATION WITH SPACE TO CONDUCT ITS CHARITABLE PURPOSE FOR FREE. THIS CHARITABLE DONATION WAS VALUED AT $116,179. VOLUNTEER SERVICES: FROM YEAR TO YEAR, GCMC HAS APPROXIMATELY 100 ACTIVE ADULT AND JUNIOR VOLUNTEERS WHO VOLUNTEER THEIR TIME TO GCMC AND CAN BE FOUND ASSISTING THE STAFF IN A VARIETY OF CAPACITIES IN HOSPITAL DEPARTMENTS SUCH AS: GUEST SERVICES, MAIL ROOM, MEDICAL RECORDS, SURGICAL SERVICES, EMERGENCY DEPARTMENT, AND GIFT SHOP. VOLUNTEERS ALSO ASSIST AT SPECIAL HOSPITAL FUNCTIONS. DURING THE YEAR ENDED DECEMBER 31, 2024, GCMC VOLUNTEERS PROVIDED 6,688 HOURS OF SERVICE TO GCMC. IV. PLANNED FUTURE ACTIVITIES WORK IS UNDERWAY ON A STATE-OF-THE-ART CANCER CENTER IN DICKSON CITY, PENNSYLVANIA TO EXPAND CANCER TREATMENT SERVICES OFFERED IN LACKAWANNA COUNTY. PROJECTED TO OPEN IN LATE 2025, THE 55,000-SQUARE-FOOT FACILITY WILL PROVIDE 22 INFUSION BAYS, 3 MULTIDISCIPLINARY SPACES, A 17-ROOM HEMATOLOGY AND ONCOLOGY CLINIC, RADIATION ONCOLOGY, AND SUPPORT SERVICES. V. DISCONTINUED ACTIVITIES THERE WERE NO DISCONTINUED ACTIVITIES DURING THE YEAR ENDED DECEMBER 31, 2024. VI. COMMUNITY BENEFITS SUMMARY MEDICARE/MEDICAID/OTHER GOVERNMENTAL $69,240,621 RESIDENCY, FELLOWSHIP, & ALLIED HEALTH 3,868,625 CHARITY CARE 4,728,051 COMMUNITY HEALTH, EDUCATION, AND OUTREACH 4,948,055 VOLUNTEER SERVICES (VALUED AT 01/01/2024 221,508 PA STATEWIDE AVERAGE WEEKLY WAGE) TOTAL $83,006,860 VII. STATISTICAL SUMMARY DISCHARGES (EXCL. PSYCH/NURSERY) 16,367 AVERAGE LENGTH OF STAY (EXCL. PSYCH/NURSERY) 5.0 PERCENT OF OCCUPANCY (EXCL. PSYCH/NURSERY) 84.8% PATIENT DAYS 81,325 TOTAL OR SURGERIES 9,565 OUTPATIENT VISITS (INCLUDES OUTPATIENT ER VISITS) 461,647 OUTPATIENT EMERGENCY ROOM VISITS 42,115 LICENSED BEDS (EXCL. NURSERY) 262 478869426 true true false true false false false false false true true true false false true false false true false false false false false false false false true true false true true false false false false false false true false false false false false true true true true true false true X 2 0 true 2642 true true true false false false false false false false false false false false X 7 4 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 5702142299 100 N ACADEMY AVE MC 49-70 DANVILLE PA 178229800 X JAEWON RYU MD JD PRESIDENT, DIRECTOR 0.0 40.0 X X 0 8428472 5867423 TERRY GILLILAND MD PRESIDENT, DIRECTOR 0.0 40.0 X X 0 2349920 867580 KEVIN V ROBERTS MBA CPA EVP, CFO, TREASURER 0.0 40.0 X 0 2685093 66232 STEVEN B BENDER ESQUIRE EVP, CLO, SECRETARY 0.0 40.0 X 0 905815 244367 RONALD BEER MHA FACHE DIRECTOR 0.0 40.0 X 0 876035 116292 GERALD V MALONEY DO DIRECTOR 0.0 40.0 X 0 835370 133826 ROSE A SADOWSKI CRNA CRNA, PASNAP 40.0 0.0 X 718651 0 39394 NAVNEET S DANG MD INTERIM CMO 0.0 40.0 X 0 586124 62192 MARIA MCGRAW CRNA CRNA, LEAD 40.0 0.0 X 494471 0 30045 GARY SEBASTIANELLI CRNA CRNA, LEAD 40.0 0.0 X 464258 0 55285 MARK ANTONIO CRNA CRNA, PASNAP 40.0 0.0 X 432750 0 65511 GEMMA ROSATO CRNA, PASNAP 40.0 0.0 X 420556 0 42541 LORI R GRAMLEY ESQUIRE ACLO, ASSISTANT SECRETARY 0.0 40.0 X 0 367079 52253 RENEE BLAKIEWICZ RN BSN VP, CHIEF NURSING OFFICER 40.0 0.0 X 313234 0 60482 MATTHEW WALSH DIRECTOR 0.0 40.0 X 0 8926 2890 BENJAMIN K CHU MDMPHMACP DIRECTOR 0.25 3.25 X 0 0 0 V CHRIS HOLCOMBE PE VICE CHAIR, DIRECTOR 0.25 2.75 X 0 0 0 JEFFREY A JACOBSON CHAIR, DIRECTOR 0.25 2.75 X 0 0 0 VIRGINIA MCGREGOR DIRECTOR 0.25 3.0 X 0 0 0 2843920 17042834 7706313 316 false true false SORDONI CONSTRUCTION SERVICES 45 OWEN STREET FORTY FORT PA 187044339 CONSTRUCTION SVCS 5662397 WRIGHT CTR FOR GRAD MED EDUCATION 501 S WASHINGTON AVE STE 1000 SCRANTON PA 18505 PHYSICIAN RESIDENTS 2073770 MEDEFIS CONSOLIDATED PO BOX 5068 NEW YORK NY 100875068 STAFFING SERVICES 1863323 QUANDEL CONSTRUCTION GROUP 2601 MARKET PLACE STE 200 HARRISBURG PA 17110 CONSTRUCTION SVCS 1424823 PRIMEMED PC 5 MORGAN HWY STE 6 SCRANTON PA 185082641 CONSULTING & DEVELOP 1420120 36 1357035 9055 1366090 HEALTHCARE 621110 551622211 551622211 RENTAL REVENUE 531120 1831516 1831516 EDUCATION 611310 930 930 553454657 2132687 2132687 0 0 331177 493249 -162072 0 -162072 -162072 3169652 3169652 3169652 3169652 0 0 0 0 0 0 0 0 0 GUEST SERVICES 722514 1010889 1010889 PERIODIC PENSION BENEFIT 900099 365679 365679 PARKING GARAGE REVENUE 812930 112008 112008 79507 79507 1568083 561529097 551623141 0 8539866 0 23616 23616 0 0 358777 358777 109082 109082 145892579 140090589 5801990 6411762 6157471 254291 34201137 32844720 1356417 10534671 10116866 417805 0 1031456 224600 806856 2385 2385 5920 5920 0 278412 4882 273530 22719151 18560631 4158520 6068 6068 9279639 8593532 686107 999833 848563 151270 0 7088240 6701352 386888 375728 345807 29921 0 163413 163413 4271442 4012781 258661 0 15881984 15319113 562871 10881884 9885361 996523 MEDICAL SUPPLIES 117578227 117425573 152654 INTERCOMPANY EXPENSE 112543724 97983630 14560094 MA MODERNIZATION FEE 8230001 8230001 BOOKS, LICENSES, FEES, DUES 574342 573412 930 293511 287201 6310 509736984 478869426 30867558 0 1505 4549 9359519 55639353 0 0 43335613 57807684 0 0 0 0 3327292 2612270 11815044 11840386 1377717 1948451 351559031 148449112 172526143 203109919 27934917 1777576 20888034 53540806 0 0 45174307 45014735 15181727 16067877 350921818 449363606 3735430 29955387 0 0 0 0 121121579 0 0 0 0 0 2722496 2173883 0 0 33818809 194925448 161398314 227054718 X 187151296 220438668 2372208 1870220 189523504 222308888 350921818 449363606 X 51792113 556017 -19562746 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 5920 5920 false 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. 373673000 1177000 13235000 4642000 383443000 361844000 1066000 15229000 4466000 373673000 385529000 1170000 -20189000 4666000 361844000 372716000 699000 19881000 7767000 385529000 369232000 1328000 20022000 17866000 372716000 0.74340 0.18050 0.07610 false true true 19908821 19908821 197592008 81298385 116293623 2492527 2490652 1875 86663857 63604610 23059247 44901818 1055465 43846353 203109919 0 0 DUE TO AFFILIATES 193676165 PATIENT RECEIVABLE CREDIT BALANCES 1230916 SECURITY DEPOSITS 18367 194925448 PART V, LINE 4 - INTENDED USES FOR ENDOWMENT FUNDS TO SUPPORT RESEARCH, CAPITAL, AND PROGRAM EXPENSES AND PATIENT CARE AND PATIENT AND EMPLOYEE EDUCATION. PART XIII - SUPPLEMENTAL FINANCIAL INFORMATION EFFECTIVE JULY 1, 2007, GEISINGER ADOPTED ACCOUNTING STANDARDS CODIFICATION 740 (FIN 48), (FORMERLY KNOWN AS "STATEMENT 109: ACCOUNTING FOR INCOME TAXES"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 CALENDAR YEAR OR ANY PREVIOUS YEARS SINCE ADOPTION. ACCORDINGLY, NO FIN 48 FOOTNOTE DISCLOSURE WAS MADE IN THE GEISINGER CONSOLIDATED FINANCIAL STATEMENTS. true true X true X 300. false true true true false true false 4728051 4728051 0.00930 84742785 78343083 6399702 0.01260 1263541 1142863 120678 0.00020 90734377 79485946 11248431 0.02210 4948055 4948055 0.00970 5591233 1722608 3868625 0.00760 10539288 1722608 8816680 0.01730 101273665 81208554 20065111 0.03940 true 86080482 105623076 -19542594 X true true 1 1 COMMUNITY MEDICAL CENTER 1822 MULBERRY STREET SCRANTON PA 18510 WWW.GEISINGER.ORG 037101 X X X X COMMUNITY MEDICAL CENTER false false true X X X X X X X X X 23 true true false true X WWW.GEISINGER.ORG X X true 24 true REFER TO RESPONSE TO 7D false false true X 300. 0. X X X X X true true X X X X true X WWW.GEISINGER.ORG X WWW.GEISINGER.ORG X WWW.GEISINGER.ORG 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 5 THE 2024 CHNA WAS CONDUCTED FROM JANUARY TO DECEMBER 2023 AND INCLUDED QUANTITATIVE AND QUALITATIVE RESEARCH METHODS TO DETERMINE HEALTH TRENDS AND DISPARITIES IN CENTRAL AND NORTHEAST PENNSYLVANIA. OUR PROCESS WAS IN LINE WITH IRS TAX CODE 501(R) REQUIREMENTS TO CONDUCT A CHNA EVERY THREE YEARS AS SET FORTH BY THE PATIENT PROTECTION AND AFFORDABLE CARE ACT (PPACA). THROUGH A COMPREHENSIVE VIEW OF STATISTICAL HEALTH INDICATORS AND COMMUNITY STAKEHOLDER FEEDBACK, A PROFILE OF PRIORITY AREAS WAS DETERMINED. THE FINDINGS WILL GUIDE HEALTHCARE SERVICES AND HEALTH IMPROVEMENT EFFORTS, AS WELL AS SERVE AS A COMMUNITY RESOURCE FOR GRANTMAKING, ADVOCACY, AND TO SUPPORT THE MANY PROGRAMS PROVIDED BY HEALTH AND SOCIAL SERVICE PARTNERS. SECONDARY DATA ANALYSIS SECONDARY DATA, INCLUDING DEMOGRAPHIC, SOCIOECONOMIC, AND PUBLIC HEALTH INDICATORS, WERE ANALYZED FOR SERVICE AREA COUNTIES TO MEASURE KEY DATA TRENDS AND PRIORITY HEALTH ISSUES AND TO ASSESS EMERGING HEALTH NEEDS. DATA WERE COMPARED TO STATE AND NATIONAL BENCHMARKS AND HEALTHY PEOPLE 2030 (HP2030) GOALS, AS AVAILABLE, TO ASSESS AREAS OF STRENGTH AND OPPORTUNITY. HEALTHY PEOPLE 2030 IS A NATIONAL INITIATIVE ESTABLISHING 10-YEAR GOALS FOR IMPROVING THE HEALTH OF ALL AMERICANS. ALL REPORTED DEMOGRAPHIC AND SOCIOECONOMIC DATA WERE PROVIDED BY THE US CENSUS BUREAU, AMERICAN COMMUNITY SURVEY, UNLESS OTHERWISE NOTED. PUBLIC HEALTH DATA WERE COMPILED FROM A VARIETY OF SOURCES LIKE THE PENNSYLVANIA DEPARTMENT OF HEALTH AND CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), AMONG OTHERS. PRIMARY RESEARCH AND COMMUNITY ENGAGEMENT COMMUNITY ENGAGEMENT WAS AN INTEGRAL PART OF THE 2024 CHNA. INPUT WAS SOLICITED AND RECEIVED FROM INDIVIDUALS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY, AS WELL AS UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. THESE INDIVIDUALS PROVIDED PERSPECTIVES ON HEALTH NEEDS, EXISTING RESOURCES TO MEET THOSE NEEDS, AND SERVICE DELIVERY GAPS THAT CONTRIBUTE TO HEALTH DISPARITIES AND INEQUITIES. PRIMARY RESEARCH AND COMMUNITY ENGAGEMENT STUDY METHODS INCLUDED: -AN ONLINE KEY STAKEHOLDER SURVEY COMPLETED BY 169 INDIVIDUALS SERVING THE NORTHEAST REGION, WHO REPRESENT HEALTHCARE PROVIDERS, SOCIAL SERVICES PROFESSIONALS, EDUCATORS, FAITH-BASED LEADERS, AND COMMUNITY LEADERS, AMONG OTHERS; -REGIONAL COMMUNITY FORUM BRINGING TOGETHER 32 RESIDENTS AND DIVERSE COMMUNITY REPRESENTATIVES TO REVIEW CHNA FINDINGS AND COLLECTIVELY DEFINE CHALLENGES AND CO-DEVELOP MEANINGFUL STRATEGIES FOR HEALTH IMPROVEMENT; AND -CONVERSATIONS WITH HEALTH SYSTEM LEADERS TO ALIGN COMMUNITY HEALTH PLANNING WITH POPULATION HEALTH MANAGEMENT AND COMMUNITY ENGAGEMENT STRATEGIES. FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 6A THE 2024 CHNA WAS CONDUCTED COLLABORATIVELY BY GEISINGER(1), ALLIED SERVICES(2), AND EVANGELICAL COMMUNITY HOSPITAL. THE THREE HEALTH SYSTEMS HAVE PARTNERED SINCE 2012 TO CREATE A COLLECTIVE CHNA FOR THEIR OVERLAPPING SERVICE AREAS SPANNING CENTRAL AND NORTHEAST PENNSYLVANIA. 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. THE CHNA FOCUSED ON THE PRIMARY SERVICE COUNTY(IES) OF EACH PARTICIPATING HOSPITAL TO IDENTIFY HEALTH TRENDS AND UNIQUE DISPARITIES WITHIN THESE COMMUNITIES. HOSPITALS WITH OVERLAPPING SERVICE AREAS WERE GROUPED INTO REGIONS FOR COMPARISONS OF HEALTH AND SOCIOECONOMIC DATA. COMMON PRIORITIES WERE DETERMINED TO ADDRESS WIDESPREAD HEALTH NEEDS. SPECIFIC STRATEGIES WERE OUTLINED IN EACH HOSPITAL'S IMPLEMENTATION PLAN TO GUIDE LOCAL EFFORTS AND COLLABORATION WITH COMMUNITY PARTNERS. (1) GEISINGER INCLUDES: GEISINGER MEDICAL CENTER (INCLUDING 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. (2) ALLIED SERVICES INCLUDES ALLIED SERVICES REHAB HOSPITAL AND HEINZ REHAB HOSPITAL. FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 7D COPIES OF THE FINAL CHNAS ARE SHARED WITH THE COMMUNITY REPRESENTATIVES WHO PARTICIPATED IN THE CHNA PROCESS. ADDITIONALLY, THE HOSPITAL'S CHNA AND CHNA IMPLEMENTATION STRATEGY ("COMMUNITY HOSPITAL IMPROVEMENT PLAN") ARE POSTED ON THE HOSPITAL'S WEBSITE AT: WWW.GEISINGER.ORG/ABOUT-GEISINGER/COMMUNITY-ENGAGEMENT/CHNA HARD COPIES ARE ALSO MAILED, UPON REQUEST. FACILITY 1, COMMUNITY MEDICAL CENTER - PART V, LINE 11 SIGNIFICANT NEEDS IDENTIFIED IN THE MOST RECENTLY CONDUCTED CHNA CONTINUE TO BE: ACCESS TO CARE BEHAVIORAL HEALTH CHRONIC DISEASE MANAGEMENT GEISINGER, LEVERAGES ITS ENTIRE HEALTH CARE SYSTEM TO BETTER IMPACT THE ENTIRE GEOGRAPHIC AREA SERVED AND DEVELOPS SYSTEM-WIDE INITIATIVES AS WELL AS INDIVIDUAL HOSPITAL INITIATIVES TO ADDRESS THE IDENTIFIED COMMUNITY HEALTH NEEDS. THESE INITIATIVES, ADOPTED BY THE BOARD ARE INCLUDED IN THE COMMUNITY HEALTH IMPROVEMENT PLAN, AVAILABLE AT HTTPS://WWW.GEISINGER.ORG/ABOUT-GEISINGER/COMMUNITY-ENGAGEMENT/CHNA. THOSE COMMUNITY NEEDS THAT ARE GENERALLY OUTSIDE THE SCOPE OF A HOSPITAL, SUCH AS HOUSING INSECURITY, CHILDCARE SHORTAGES AND OTHER SOCIAL DETERMINANTS OF HEALTH FACTORS ARE NOT ADDRESSED DIRECTLY BY THE HOSPITAL. ALTHOUGH INDIRECTLY, GEISINGER MAINTAINS POSITIVE SUPPORT AND INFLUENCE THROUGH COALITIONS, REFERRALS AND ADVOCACY WITHIN THE COMMUNITIES IN ITS FOOTPRINT OF EXISTING SOCIAL AGENCIES WHO BETTER ADDRESS THESE COMMUNITY NEEDS. FOLLOWING ARE THE GEISINGER SYSTEM-WIDE AND HOSPITAL SPECIFIC INITIATIVES BASED ON THE MOST RECENT CHNA. PRIORITY AREA: ACCESS TO CARE GOAL: EMPOWER OUR COMMUNITIES TO BE WELL BY REMOVING BARRIERS TO HEALTHCARE. OBJECTIVE: INCREASE THE NUMBER OF RESIDENTS WHO RECEIVE REGULAR PRIMARY CARE SERVICES. SYSTEMWIDE STRATEGIES: . ASSIST WITH ELIGIBILITY DETERMINATION AND ENROLLMENT IN AVAILABLE HEALTH INSURANCE PROGRAMS. . CONDUCT POINT OF CARE PRIMARY CARE SCREENING AND SCHEDULING ASSISTANCE WITHIN THE EMERGENCY DEPARTMENT AND OTHER OUTPATIENT SETTINGS. . EXPAND PRIMARY CARE SERVICES INCLUDING ACCESS TO GEISINGER 65 FORWARD HEALTH CENTERS AND COMMUNITYCARE SLIDING FEE HEALTH SERVICES. . CULTIVATE TRUSTING AND INCLUSIVE CARE ENVIRONMENTS THAT PROMOTE HEALTHCARE ACCESS FOR DIVERSE POPULATIONS. GEISINGER COMMUNITY MEDICAL CENTER TACTICS: . EXPAND THE GEISINGER AT HOME, CARE COORDINATION AND INTEGRATION PROGRAMS TO PROVIDE PRIMARY CARE PROVIDER VISITS VIA MOBILE AND AUDIO- VISUAL TECHNOLOGY TO THE HIGH-RISK AND HOMEBOUND POPULATION. . EXPLORE OPTIONS AND PARTNERS TO PROVIDE HOME-BASED CARE SERVICES (MOBILE INTEGRATED HEALTH, HOME HEALTH AGENCIES, GEISINGER AT HOME, ETC.). OBJECTIVE: INCREASE ACCESS TO PRIMARY AND SPECIALTY CARE SERVICES IN UNDERSERVED COMMUNITIES. SYSTEMWIDE STRATEGIES: . PROVIDE OR SPONSOR SLIDING FEE PROGRAMS FOR INDIVIDUALS WITHOUT HEALTH INSURANCE AND/OR WITH LOW INCOMES. . PROVIDE MOBILE AND HOME- AND COMMUNITY-BASED SERVICES THAT BRING CARE TO RESIDENTS. . SEEK OUT PARTNERSHIPS AND STRATEGIC OPPORTUNITIES TO DEVELOP OR AUGMENT CARE ENVIRONMENTS IN UNDERSERVED COMMUNITIES. . EXPAND ACCESS TO QUALITY TELEHEALTH INCLUDING AGE-INCLUSIVE TELEHEALTH FOR OLDER ADULTS. GEISINGER COMMUNITY MEDICAL CENTER TACTICS: . RECRUIT SPECIALISTS (NOTE: THERE ARE NO PRIMARY CARE PROVIDERS UNDER GCMC; ALL PCPS FALL UNDER GEISINGER CLINIC & COMMUNITY MEDICINE). OBJECTIVE: INCREASE THE AVAILABLE HEALTHCARE WORKFORCE AND ADVANCE DIVERSITY OF TALENT. SYSTEMWIDE STRATEGIES: . PARTNER WITH SCHOOL DISTRICTS, UNIVERSITIES, AND OTHER YOUTH SERVICE PROVIDERS TO FOSTER HEALTHCARE CAREER PATHWAYS. . COLLABORATE WITH SCHOOLS OF MEDICINE, NURSING, AND OTHER HEALTH PROFESSIONALS TO FOSTER CAREERS IN NEEDED HEALTH SERVICES AND RECRUITMENT FOR UNDERSERVED AREAS. . EMBED INCLUSIVE PRACTICES AND PROCESSES INTO HOW WE ATTRACT, RECRUIT, RETAIN, AND ADVANCE A DIVERSITY OF TALENT. GEISINGER COMMUNITY MEDICAL CENTER TACTICS: . PARTNER WITH SCHOOL DISTRICTS, UNIVERSITIES, AND OTHER YOUTH SERVICE PROVIDERS TO FOSTER HEALTHCARE CAREER PATHWAYS. . OFFER COHORT PROGRAMS FOR HIGH SCHOOL STUDENTS TO EXPERIENCE HEALTH CARE IN ALL DISCIPLINES AND SPECIALTIES. OBJECTIVE: REDUCE DISPARITIES IN HEALTHCARE ACCESS. SYSTEMWIDE STRATEGIES: . INCREASE COLLECTION OF REAL, SOGI, ZIP CODE, AND OTHER DEMOGRAPHIC DATA IN ORDER TO BETTER UNDERSTAND AND ADDRESS DISPARITIES. . LEVERAGE LOCAL TRUSTED PEOPLE, PLACES, AND METHODS TO EXPAND HEALTHCARE SERVICES FOR DIVERSE POPULATIONS. . PROVIDE QUALIFIED LANGUAGE SERVICES TO MEET THE DIVERSE AND PREFERRED LANGUAGE NEEDS OF PATIENTS. . SUPPORT NEIGHBORLY ONLINE PLATFORM AND OTHER RESOURCES TO INCREASE AWARENESS OF AVAILABLE SERVICES TO MEET SOCIAL DRIVERS OF HEALTH NEEDS. . SEEK OUT PARTNERSHIPS AND STRATEGIC OPPORTUNITIES WITH COMMUNITY-BASED ORGANIZATIONS TO COORDINATE REFERRALS AND COLLECTIVELY ADDRESS SOCIAL DRIVERS OF HEALTH BARRIERS. . IN PARTNERSHIP WITH GEISINGER HEALTH PLAN, HELP ADDRESS HEALTHCARE TRANSPORTATION BARRIERS. GEISINGER COMMUNITY MEDICAL CENTER TACTICS . PROVIDE EDUCATION TO FRONTLINE CAREGIVERS REGARDING PREFERRED METHODS OF COMMUNICATION. PRIORITY AREA: BEHAVIORAL HEALTH GOAL: IMPROVE BEHAVIORAL HEALTH BY FOSTERING COMMUNITIES AND CARE ENVIRONMENTS THAT PROMOTE WELLNESS, RECOVERY, AND RESILIENCE. OBJECTIVE: REDUCE DISPARITIES IN BEHAVIORAL HEALTH AND WELLBEING. SYSTEMWIDE STRATEGIES: . STRENGTHEN AND SUPPORT COMMUNITY INITIATIVES THAT FOSTER YOUTH RESILIENCE (E.G., MENTORSHIP, CAREER DEVELOPMENT, SOCIAL EMOTIONAL LEARNING OPPORTUNITIES). . PROVIDE TRAUMA SENSITIVE TRAINING, INCLUDING IDENTIFYING AND SUPPORTING INDIVIDUALS WITH ADVERSE CHILDHOOD EXPERIENCES (ACES), IN CLINICAL AND COMMUNITY SETTINGS. . SUPPORT AND PROMOTE EFFORTS TO RAISE COMMUNITY AWARENESS OF BEHAVIORAL HEALTH. . INVEST IN COMMUNITY INITIATIVES AND INFRASTRUCTURE THAT PROMOTE RESIDENT ENGAGEMENT AND SENSE OF COMMUNITY. . INCREASE COLLECTION OF REAL, SOGI, ZIP CODE, AND OTHER DEMOGRAPHIC DATA IN ORDER TO BETTER UNDERSTAND AND ADDRESS DISPARITIES. GEISINGER COMMUNITY MEDICAL CENTER TACTICS: . PROVIDE TRAUMA-INFORMED CARE TRAINING TO FRONTLINE TEAM MEMBERS WHO MANAGE CRISIS PATIENTS. . DEVELOP WORKING RELATIONSHIPS WITH COMMUNITY MENTAL HEALTH LEADERS TO BETTER SUPPORT INITIATIVES IN THE COMMUNITY. OBJECTIVE: INCREASE ACCESS TO AND CAPACITY OF BEHAVIORAL HEALTH SERVICES. SYSTEMWIDE STRATEGIES: . PARTNER WITH COMMUNITY-BASED ORGANIZATIONS TO ASSESS BEHAVIORAL HEALTH NEEDS, FACILITATE SERVICE REFERRALS, AND COORDINATE CARE. . IMPLEMENT UNIVERSAL BEHAVIORAL HEALTH SCREENINGS IN CARE SETTINGS. . PROVIDE COMMUNITY-BASED SUBSTANCE USE PREVENTION AND TREATMENT OPTIONS (E.G., MEDICATION TAKE BACK PROGRAMS, NARCAN DISTRIBUTION, FREE2BMOM). . SEEK OUT PARTNERSHIPS AND STRATEGIC OPPORTUNITIES TO DEVELOP OR AUGMENT CARE ENVIRONMENTS IN UNDERSERVED COMMUNITIES. . IN PARTNERSHIP WITH THE GEISINGER COMMONWEALTH SCHOOL OF MEDICINE'S BEHAVIORAL HEALTH INITIATIVE, INCREASE INTEGRATION OF BEHAVIORAL AND PHYSICAL HEALTHCARE. GEISINGER COMMUNITY MEDICAL CENTER TACTICS: . PROVIDE GEISINGER EMPLOYED AND TRAINED STAFF TO SUPPORT CRISIS PATIENTS IN THE ED AND CONNECT WITH GEISINGER BEHAVIORAL HEALTH NORTHEAST HOSPITAL. . PROVIDE NARCAN KITS FROM THE ED TO PATIENTS AND FAMILIES THROUGH PARTNERSHIP WITH LOCAL DRUG AND ALCOHOL AGENCIES. OBJECTIVE: INCREASE ACCESS TO RECOVERY-ORIENTED CARE AND RECOVERY SUPPORT SYSTEMS. SYSTEMWIDE STRATEGIES: . INCREASE PARTICIPATION OF PEOPLE WITH LIVED EXPERIENCE IN CARE DEVELOPMENT AND DELIVERY. . PARTNER WITH COMMUNITY-BASED ORGANIZATIONS TO ASSESS RECOVERY NEEDS AND STRATEGIC OPPORTUNITIES TO ENHANCE RECOVERY OPTIONS. . SUPPORT AND PROMOTE RECOVERY SUPPORT GROUPS AND OTHER ACTIVITIES. GEISINGER COMMUNITY MEDICAL CENTER TACTICS: . DEVELOP A CERTIFIED RECOVERY SPECIALIST PROGRAM IN GCMC'S EMERGENCY DEPARTMENT TO SUPPORT THE PATIENT AND PROVIDE RECOVERY PATHWAYS. PRIORITY AREA: CHRONIC DISEASE PREVENTION AND MANAGEMENT GOAL: MANAGE TOTAL HEALTH FROM COVERAGE AND PREVENTION TO CARE AND TREATMENT. OBJECTIVE: REDUCE RISK FACTORS FOR CHRONIC DISEASE. SYSTEMWIDE STRATEGIES: . INVEST IN COMMUNITY INITIATIVES AND INFRASTRUCTURE THAT PROMOTE A HEALTHY BUILT ENVIRONMENT. . PROVIDE COMMUNITY-BASED ACCESS TO EARLY SCREENING AND DETECTION SERVICES AND HEALTH PROMOTION PROGRAMMING. . LEVERAGE LOCAL TRUSTED PEOPLE, PLACES, AND METHODS TO EXPAND PREVENTION SERVICES FOR DIVERSE POPULATIONS. . SUPPORT NEIGHBORLY ONLINE PLATFORM AND OTHER RESOURCES TO INCREASE AWARENESS OF AVAILABLE SERVICES TO MEET SOCIAL DRIVERS OF HEALTH NEEDS. . SEEK OUT PARTNERSHIPS AND STRATEGIC OPPORTUNITIES WITH COMMUNITY-BASED ORGANIZATIONS TO COORDINATE REFERRALS AND COLLECTIVELY ADDRESS SOCIAL DRIVERS OF HEALTH BARRIERS. GEISINGER COMMUNITY MEDICAL CENTER TACTICS: . SUPPORT COMMUNITY HEALTH AND WELLNESS PROGRAMS SUCH AS THE SCRANTON MARATHON. . INCREASE AWARENESS OF FRESH FOOD FARMACY. OBJECTIVE: REDUCE DISPARITIES IN CHRONIC DISEASE OUTCOMES. SYSTEMWIDE STRATEGIES: . INCREASE COLLECTION OF REAL, SOGI, ZIP CODE, AND OTHER DEMOGRAPHIC DATA IN ORDER TO BETTER UNDERSTAND AND ADDRESS DISPARITIES. . PROVIDE COORDINATED CARE PROGRAMS FOR INDIVIDUALS WITH COMPLEX MEDICAL CONDITIONS AND/OR AT RISK FOR DISEASE COMPLICATIONS. . PROVIDE SELF-MONITORING AND SELF-MANAGEMENT TOOLS AND PROGRAMS TO EMPOWER INDIVIDUALS TO MANAGE THEIR CONDITION(S). GEISINGER COMMUNITY MEDICAL CENTER TACTICS: . PROVIDE EVIDENCE BASED MEDICAL NUTRITION THERAPY FOR PATIENTS AT GEISINGER'S 65 FORWARD CLINIC LOCATED AT 3 WEST OLIVE STREET. 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-VISTORS/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, SECTION C, LINE 9B PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE 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. PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION THERE ARE NO PHYSICIAN CLINICAL SERVICES INCLUDED IN SUBSIDIZED HEALTH SERVICES. PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION A COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE COSTS REPORTED ON LINE 7 AND ADDRESSED PATIENT SEGMENTS BY 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. PART III, LINE 4 - BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS GEISINGER RECORDS PATIENT SERVICE REVENUE BASED ON STANDARD CHARGES FOR SERVICES PROVIDED, EXPLICIT CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD-PARTY PAYORS AND IMPLICIT PRICE CONCESSIONS PROVIDED TO PATIENTS AS REDUCTIONS FROM ESTABLISHED BILLING RATES. GEISINGER DETERMINES ITS ESTIMATES OF EXPLICIT AND IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL DATA WHICH CONSIDERS EXPERIENCE, MARKET CONDITIONS, AND OTHER FACTORS. EXPLICIT AND IMPLICIT PRICE CONCESSIONS TO PATIENT SERVICE REVENUE ARE RECORDED AT THE TIME THE PERFORMANCE OBLIGATIONS ARE SATISFIED. SUBSTANTIALLY ALL CHANGES TO THESE CONCESSIONS, AS A RESULT OF SUBSEQUENT REASSESSMENT, ARE RECOGNIZED IN THE PERIOD THE CHANGE IS IDENTIFIED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE A RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S OR PAYOR'S ABILITY TO PAY AND ARE MATERIAL ARE RECORDED AS BAD DEBT EXPENSE. NO BAD DEBT EXPENSE WAS RECORDED FOR THE YEARS ENDED DECEMBER 31, 2024 AND 2023 RELATED TO PATIENT SERVICE REVENUE. PART III, LINE 8 - MEDICARE EXPLANATION MEDICARE COSTS WERE DERIVED FROM THE MEDICARE COST REPORT AND THE COST ACCOUNTING SYSTEM. THE ORGANIZATION BELIEVES THE MEDICARE UNDERPAYMENTS (SHORTFALL) 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 THE 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 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 $62,720,241 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. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION 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. PART VI, LINE 2 - NEEDS ASSESSMENT THE 2024 CHNA WAS CONDUCTED COLLABORATIVELY BY GEISINGER, ALLIED SERVICES, AND EVANGELICAL COMMUNITY HOSPITAL. THE THREE HEALTH SYSTEMS HAVE PARTNERED SINCE 2012 TO CREATE A COLLECTIVE CHNA FOR THEIR OVERLAPPING SERVICE AREAS SPANNING CENTRAL AND NORTHEAST PENNSYLVANIA. 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. FROM THIS COLLABORATION, ONGOING RELATIONSHIPS WITH VARIOUS COMMUNITY STAKEHOLDERS HAVE BEEN DEVELOPED. THESE STAKEHOLDER RELATIONSHIPS ARE AN INVALUABLE RESOURCE TO THE HOSPITAL'S IN ITS ONGOING MONITORING OF COMMUNITY HEALTH NEEDS AND OPPORTUNITIES AS TIME PASSES AS WELL AS THOSE IDENTIFIED IN THE TRIENNIAL CHNA. REGIONALLY, GEISINGER CROSS-FUCTIONAL TEAMS ARE ACCOUNTABLE FOR REVIEW OF THE OPERATIONAL HEALTH INITIATIVES IN SUPPORT OF THE COMMUNITY HEALTH IMPROVEMENT PLANS. THESE TEAMS MONITOR AND TRACK PROGRESS IN MEETING THE INITIATIVES AND RESPOND TO ANY NEW OPPORTUNITIES FOR MEETING COMMUNITY HEALTH NEEDS IN FURTHERANCE OF GEISINGER'S CHARITABLE MISSION. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE 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. PART VI, LINE 4 - COMMUNITY INFORMATION THE HOSPITAL IS LOCATED WITHIN THE NORTHEAST REGION OF PENNSYLVANIA. THE NORTHEAST REGION IS COMPRISED OF FIVE PENNSYLVANIA COUNTIES: LACKAWANNA, LUZERNE, SUSQUEHANNA, WAYNE, AND WYOMING. LACKAWANNA AND LUZERNE COUNTIES ARE POPULATION CENTERS FOR THE REGION, AND HOME TO CITIES INCLUDING SCRANTON, WILKES-BARRE, AND HAZLETON. SUSQUEHANNA, WAYNE, AND WYOMING COUNTIES ARE LARGELY RURAL COMMUNITIES WITH TOTAL POPULATIONS OF APPROXIMATELY 25,000 TO 50,000 PEOPLE. POPULATION GROWTH OVER THE PAST DECADE WAS STAGNANT IN LACKAWANNA AND LUZERNE COUNTIES AND DECLINED IN RURAL COUNTIES. SUSQUEHANNA COUNTY SAW THE LARGEST POPULATION DECLINE OF -10.3% FROM 2010 TO 2021. IN CONTRAST, THE REGION SAW SIGNIFICANT GROWTH IN OLDER ADULTS, PARTICULARLY IN RURAL COUNTIES. FROM 2010 TO 2021, SUSQUEHANNA, WAYNE, AND WYOMING COUNTIES SAW 21%-29.5% GROWTH IN ADULTS AGED 65 OR OLDER. OUR COMMUNITY AND RESIDENTS CONSISTENT WITH PENNSYLVANIA OVERALL, THE NORTHEAST REGION IS AGING, WITH A SIGNIFICANT INCREASE IN THE NUMBER OF OLDER ADULTS FROM 2010 TO 2021 IN ALL COUNTIES. OUTSIDE OF LACKAWANNA AND LUZERNE COUNTIES, THE YOUTH POPULATION DECLINED BY APPROXIMATELY 20% FROM 2010 TO 2021. LACKAWANNA AND LUZERNE WERE THE ONLY COUNTIES TO SEE POPULATION GROWTH, ALTHOUGH GROWTH WAS MODEST AT AN ESTIMATED 1-2%. SUSQUEHANNA AND WAYNE ARE AMONG THE OLDEST COUNTIES IN THE REGION; APPROXIMATELY ONE-QUARTER OF RESIDENTS ARE AGED 65 OR OLDER AND MEDIAN AGES ARE NEARLY EIGHT YEARS OLDER THAN THE STATE MEDIAN. IN THE EASTERN PORTION OF WAYNE COUNTY, AS MANY AS 40.5% OF RESIDENTS IN ZIP CODE 18415, DAMASCUS AND 55.3% IN ZIP CODE 18469, TYLER HILL ARE AGED 65 OR OLDER. IT IS WORTH NOTING THAT OUTSIDE OF THE SCRANTON AND WILKES-BARRE METROS, 20% OR MORE OF RESIDENTS OF NEARLY ALL ZIP CODES ARE AGED 65 OR OLDER. NORTHEAST REGION COUNTIES ARE MAJORITY WHITE COMMUNITIES WITH LESS RACIAL DIVERSITY THAN STATE AND NATIONAL BENCHMARKS. LUZERNE COUNTY BENEFITS FROM THE MOST POPULATION DIVERSITY WITH 7% OF RESIDENTS IDENTIFYING WITH A RACE OTHER THAN WHITE AND 14% IDENTIFYING AS LATINX (ANY RACE). CONSISTENT WITH STATE AND NATIONAL TRENDS, POPULATION DIVERSITY IS INCREASING WITHIN THE REGION. IN LACKAWANNA AND LUZERNE COUNTIES, FROM 2010 TO 2021, THE WHITE POPULATION AS A PROPORTION OF THE TOTAL POPULATION DECLINED 6-10 PERCENTAGE POINTS. WHEN ANALYZED BY ZIP CODE, POCKETS OF HIGH POVERTY ARE LARGELY SEEN WITHIN THE HAZLETON, SCRANTON, AND WILKES-BARRE METROS. CHILDREN ARE HISTORICALLY DISPROPORTIONATELY AFFECTED BY POVERTY, AND WITHIN THESE SAME AREAS, APPROXIMATELY ONE-THIRD OF CHILDREN LIVE IN POVERTY. IT IS ALSO WORTH NOTING NEWFOUNDLAND, WHERE 30.3% OF ALL RESIDENTS AND 45.1% OF CHILDREN LIVE IN POVERTY, AND BEACH LAKE, WHERE 13.6% OF ALL RESIDENTS LIVE IN POVERTY BUT 30.8% CHILDREN LIVE IN POVERTY. POVERTY IS NOT EXPERIENCED BY EVERY COMMUNITY EQUALLY AND CONTRIBUTES TO FURTHER INEQUALITIES SUCH AS ACCESS TO SAFE LIVING AND WORKING CONDITIONS, HEALTH SERVICES, AND BASIC NEEDS, AMONG OTHER THINGS. IN LACKAWANNA AND LUZERNE COUNTIES, BLACK AND MULTIRACIAL RESIDENTS MAKE UP 5% OR LESS OF THE POPULATION, EACH, BUT ONE-QUARTER TO ONE-THIRD OF THESE POPULATION GROUPS EXPERIENCE POVERTY, COMPARED WITH ONLY 12% OF THE MAJORITY-WHITE POPULATION. SIMILAR DISPARITIES EXIST FOR INDIVIDUALS IDENTIFYING AS LATINX. WHILE THE REGION HAS FEW RESIDENTS WHO IDENTIFY AS NON-WHITE OR NON-HISPANIC, THEY DO EXIST, AND THEIR LACK OF VISIBILITY MAY CONTRIBUTE TO THESE DISPARATE EXPERIENCES. EDUCATION HIGH SCHOOL GRADUATION IS ONE OF THE STRONGEST PREDICTORS OF LONGEVITY AND ECONOMIC STABILITY. WITHIN NORTHEAST REGION COMMUNITIES, APPROXIMATELY 90% OF ADULTS GRADUATED HIGH SCHOOL, A SIMILAR PROPORTION AS THE STATE OVERALL. ADULTS ARE GENERALLY LESS LIKELY TO PURSUE OR ATTAIN HIGHER EDUCATION, SUCH AS A BACHELOR'S OR GRADUATE DEGREE. OUR HOMES AND WHERE WE LIVE WHERE YOU LIVE IMPACTS THE CHOICES AVAILABLE TO YOU. THESE CHOICES IMPACT YOUR INCOME, WELLNESS, AND ULTIMATELY HOW LONG YOU LIVE. WHEN CONSIDERED WITH LIVED EXPERIENCES SUCH AS ACCESS TO QUALITY SERVICES LIKE EDUCATION AND TRANSPORTATION, PLACE-BASED CHOICES MAY ALSO INFORM PERCEPTION OF OPPORTUNITIES. FOR NEIGHBORHOODS, A HIGHER PROPORTION OF HOMEOWNERSHIP MEANS GREATER NEIGHBORHOOD STABILITY. GREATER NEIGHBORHOOD STABILITY MEANS MORE OPPORTUNITIES FOR INVESTMENT IN INFRASTRUCTURE, SUCH AS SCHOOLS, ROADS, PUBLIC TRANSPORTATION, AND GREEN SPACES, KEY ELEMENTS FOR HEALTHY LIVING. FOR FAMILIES, HOMEOWNERSHIP IS TYPICALLY THEIR LARGEST ASSET. THE SECURITY OF KNOWING ONE HAS A HOME CAN ALSO REDUCE CHRONIC STRESS, A SIGNIFICANT FACTOR IN DEVELOPING CHRONIC DISEASE. IN GENERAL, NORTHEAST REGION RESIDENTS ARE JUST AS LIKELY OR MORE LIKELY TO OWN THEIR HOME WHEN COMPARED TO STATE AND NATIONAL BENCHMARKS. HOMEOWNERSHIP INCREASES IN MORE RURAL COMMUNITIES. HOUSING IS OFTEN THE LARGEST SINGLE MONTHLY EXPENSE FOR HOUSEHOLDS AND SHOULD REPRESENT NO MORE THAN 30% OF A HOUSEHOLD'S MONTHLY INCOME. WHEN HOUSEHOLDS SPEND MORE THAN 30% OF THEIR INCOME ON HOUSING, THEY ARE CONSIDERED HOUSING COST BURDENED AND GENERALLY HAVE FEWER RESOURCES FOR OTHER NECESSITIES LIKE FOOD, TRANSPORTATION, AND CHILDCARE. RENTAL COSTS HAVE BALLOONED ACROSS THE COUNTRY SINCE COVID-19, LEAVING MANY TO STRUGGLE TO CONTINUE TO AFFORD THEIR CURRENT RENT, WHILE ALSO HAVING LESS AND LESS OPPORTUNITY TO SAVE MONEY TO MAKE FUTURE HOMEOWNERSHIP POSSIBLE. THE NORTHEAST REGION IS NO EXCEPTION TO THESE TRENDS. WAYNE AND WYOMING COUNTIES HAVE THE HIGHEST PERCENTAGE OF HOMEOWNERS, BUT WAYNE COUNTY HAS THE MOST COST-BURDENED RESIDENTS, ESTIMATED AT 47%. NEIGHBORHOOD AND BUILT ENVIRONMENT IN ADDITION TO THE RESOURCES AVAILABLE IN COMMUNITIES, THE PHYSICAL ENVIRONMENT AND INFRASTRUCTURE OF NEIGHBORHOODS IMPACTS HEALTH. THE AVAILABILITY OF WELL-MAINTAINED ROADS AND SAFE SIDEWALKS, AND ACCESS TO RECREATION, STORES, BANKS, AND OTHER AMENITIES ARE IMPORTANT COMPONENTS FOR HEALTHY LIVING. FEEDBACK FROM KEY STAKEHOLDER SURVEY PARTICIPANTS CENTERED AROUND THE SCARCITY OF RELIABLE AND AFFORDABLE PUBLIC TRANSPORTATION OPTIONS AVAILABLE TO RESIDENTS. COMBINED WITH A REGION THAT IS, ON THE WHOLE, "BELOW AVERAGE" IN ITS WALKABILITY RATING, AS WELL AS A RAPIDLY AGING POPULATION, IT CAN BE DIFFICULT TO ACCESS OPPORTUNITIES FOR PHYSICAL ACTIVITY. THESE FACTORS MAKE AFTERNOON STROLLS OR REACHING PUBLIC PARKS - ACTIVITIES THAT MIGHT OTHERWISE BE FREE OF COST - CHALLENGING. OTHER OPPORTUNITIES TO BE ACTIVE MAY COST MONEY, CREATING AN ADDITIONAL BARRIER TO PARTICIPATION. DESPITE THESE CONCERNS, RESIDENTS OF THE NORTHEAST REGION HAVE DEMONSTRATED RESILIENCE IN PRIORITIZING PHYSICAL ACTIVITY. SUSQUEHANNA, WAYNE, AND WYOMING COUNTIES ARE FAR BELOW LACKAWANNA AND LUZERNE COUNTIES, AS WELL AS THE STATE AND NATION, IN THE PERCENTAGE OF THE POPULATION WITH ADEQUATE ACCESS TO LOCATIONS FOR PHYSICAL ACTIVITY. YET, IN ALL THREE OF THESE PLACES, THE PERCENTAGE OF ADULTS WHO PARTICIPATE IN LEISURE TIME PHYSICAL ACTIVITY IS ON PAR WITH THEIR COUNTERPARTS, AND FAR OUTPACES WHAT WOULD BE EXPECTED GIVEN THE REPORTED LACK OF ACCESS. FOOD INSECURITY IS DEFINED AS NOT HAVING RELIABLE ACCESS TO A SUFFICIENT AMOUNT OF NUTRITIOUS, AFFORDABLE FOOD. FOOD INSECURITY IS ASSOCIATED WITH BOTH DISPARITIES IN BUILT ENVIRONMENT, SUCH AS FOOD DESERTS, AND SOCIOECONOMIC BARRIERS, SUCH AS LOWER HOUSEHOLD INCOME AND POVERTY. FOOD INSECURITY CAN ULTIMATELY AFFECT OVERALL HEALTH STATUS, CONTRIBUTING TO A HIGHER PREVALENCE OF DISEASE AND POORER DISEASE OUTCOMES. IN 2020, FEEDING AMERICA CONSERVATIVELY PROJECTED A 36% GROWTH IN NATIONAL FOOD INSECURITY RATES AS A RESULT OF THE PANDEMIC. SIMILAR TO POVERTY AND UNEMPLOYMENT TRENDS, FOOD INSECURITY DECLINED POST-PANDEMIC, CONTINUING AN OVERALL DOWNWARD TREND, BUT THE IMPACT OF THIS EXPERIENCE ON LONG-TERM HEALTH OUTCOMES SHOULD CONTINUE TO BE MONITORED. ACROSS THE NORTHEAST REGION IN 2021, APPROXIMATELY 1 IN 10 RESIDENTS WERE ESTIMATED TO BE FOOD INSECURE. IN LACKAWANNA AND LUZERNE COUNTIES, WHERE CHILDREN EXPERIENCE DISPROPORTIONATE POVERTY, NEARLY 1 IN 5 CHILDREN WERE ESTIMATED TO BE FOOD INSECURE. IT IS ALSO WORTH NOTING DISPARITIES AMONG INDIVIDUALS WITH LOW INCOME LIVING IN SUSQUEHANNA COUNTY. SUSQUEHANNA COUNTY OVERALL HAS FEWER RESIDENTS LIVING IN POVERTY AND A SIMILAR PROPORTION OF FOOD INSECURE RESIDENTS AS NEIGHBORING COMMUNITIES, BUT APPROXIMATELY 6% OF RESIDENTS WITH LOW INCOME DO NOT LIVE CLOSE TO A GROCERY STORE, THE HIGHEST PROPORTION IN THE REGION. LOW-INCOME RESIDENTS MAY RELY MORE ON SMALLER NEIGHBORHOOD STORES THAT MAY NOT CARRY HEALTHY FOODS OR MAY OFFER THEM ONLY AT HIGHER PRICES, COMPOUNDING HEALTH AND FINANCIAL HARDSHIPS. PART VI, LINE 4 - COMMUNITY INFORMATION (CONT.) DURING THE COVID PANDEMIC, WE WERE ABLE TO USE TECHNOLOGY TO BRING SERVICES TO PEOPLE IN THEIR HOMES, BUT NOT UNIFORMLY. WE NEED TO BRIDGE THE WIDE DIGITAL DIVIDE WITHIN OUR COMMUNITIES TO EFFECTIVELY REACH ALL RESIDENTS. THE RESIDENTS OF EACH NORTHEAST REGION COUNTY GENERALLY HAVE DIGITAL ACCESS COMPARABLE TO THEIR NEIGHBORS AND STATE AND NATIONAL PERCENTAGES. HOWEVER, THERE ARE SOME SMALLER COMMUNITIES, HIGHLIGHTED ON THE MAP BELOW, WHERE FEWER THAN 65% OF RESIDENTS HAVE RELIABLE INTERNET ACCESS. THESE COMMUNITIES ARE BOTH URBAN, SUCH AS DOWNTOWN WILKES-BARRE, AS WELL AS MORE RURAL. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH 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. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM 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 SEVEN WHOLLY-CONTROLLED ACUTE-CARE HOSPITALS WITH MULTIPLE CAMPUSES, JOINT VENTURE FACILITIES AND A DRUG AND ALCOHOL TREATMENT FACILITY; (II) MULTISPECIALTY PHYSICIAN GROUP PRACTICES; (III) INSURANCE OPERATIONS, INCLUDING A LICENSED HEALTH MAINTENANCE ORGANIZATION AND A NONLICENSED, RISK ASSUMING PREFERRED PROVIDER ORGANIZATION; AND (IV) A COMMUNITY-BASED MEDICAL COLLEGE AND DEGREE-GRANTING INSTITUTION. GEISINGER OPERATES ACROSS PENNSYLVANIA WITH THE MOST CONCENTRATED PRESENCE IN CENTRAL AND NORTHEASTERN PENNSYLVANIA, OUTSIDE THE MAJOR METROPOLITAN AREAS. GEISINGER HEALTH SERVES AS THE CORPORATE PARENT AND EXERCISES CONTROL OVER GEISINGER'S AFFILIATED ENTITIES COMPRISING SUBSTANTIALLY ALL FINANCIAL AND OPERATIONAL ACTIVITY ARE TAX-EXEMPT PURSUANT TO SECTIONS 501(C)(2), 501(C)(3), OR 501(C)(4) OF THE INTERNAL REVENUE CODE. ON MARCH 31, 2024, RISANT HEALTH, INC. BECAME THE SOLE CORPORATE MEMBER OF GEISINGER HEALTH THROUGH A MEMBER SUBSTITUTION PURSUANT TO THE TERMS OF A HEALTH SYSTEM AGREEMENT DATED APRIL 26, 2023 BETWEEN KAISER FOUNDATION HOSPITALS ("KFH"), RISANT HEALTH, INC ("RISANT") AND GEISINGER HEALTH. RISANT IS A NONPROFIT ORGANIZATION, CREATED BY KFH, TO EXPAND AND ACCELERATE THE ADOPTION OF VALUE-BASED CARE IN DIVERSE, MULTI PAYER, MULTI-PROVIDER, AND COMMUNITY-BASED HEALTH SYSTEM ENVIRONMENTS. THE HOSPITAL IS AN AFFILIATE WITHIN GEISINGER. SEE ALSO SCHEDULE R FOR A LIST OF THE AFFILIATED ORGANIZATIONS COMPRISING GEISINGER. 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 NURSING EDUCATION SCHOLARSHIPS 2 16500 CLINICAL EDUCATION SCHOLARSHIPS 2 7116 PART I LINE 2 DESCRIBE PROCESS FOR MONITORING GEISINGER COMMUNITY MEDICAL CENTER (GCMC) PROVIDES A FEW EDUCATION-BASED SCHOLARSHIPS TO ELIGIBLE EMPLOYEES. GCMC CREATED A SCHOLARSHIP COMMITTEE TO REVIEW AND SELECT SCHOLARSHIP RECIPIENTS WHO MEET THE CRITERIA ESTABLISHED THROUGH A COLLABORATIVE PROCESS THAT HONORS DONOR INTENTIONS. THE GEISINGER NURSING EDUCATION DEPARTMENT INTERNALLY ADVERTISES AVAILABLE SCHOLARSHIPS WHICH EMPLOYEES APPLY FOR THROUGH AN ONLINE APPLICATION. AFTER THE APPLICATION PERIOD ENDS, A SCHOLARSHIP COMMITTEE REVIEWS THE APPLICATION AND AWARDS THE SCHOLARSHIPS BASED ON THE DEFINED CRITERIA, EMPLOYEE NEED, AND FUND AVAILABILITY. AWARDS ARE PAID DIRECTLY TO THE EDUCATIONAL INSTITUTION THAT THE EMPLOYEE ATTENDS (THROUGH 12/31/2024). X true true X X X X X X false true false false false false false false false JAEWON RYU MD JD PRESIDENT, DIRECTOR 0 2822318 0 3931000 0 1675154 0 5848696 0 18727 0 14295895 0 1316166 TERRY GILLILAND MD PRESIDENT, DIRECTOR 0 2212113 0 0 0 137807 0 836806 0 30774 0 3217500 0 0 KEVIN V ROBERTS MBA CPA EVP, CFO, TREASURER 0 1749843 0 525000 0 410250 0 24306 0 41926 0 2751325 0 0 STEVEN B BENDER ESQUIRE EVP, CLO, SECRETARY 0 708600 0 0 0 197215 0 209306 0 35061 0 1150182 0 167904 GERALD V MALONEY DO DIRECTOR 0 720238 0 0 0 115132 0 98569 0 35257 0 969196 0 62504 ROSE A SADOWSKI CRNA CRNA, PASNAP 600807 0 97262 0 20582 0 24306 0 15088 0 758045 0 0 0 RONALD BEER MHA FACHE DIRECTOR 0 464048 0 75000 0 336987 0 73699 0 42593 0 992327 0 48140 NAVNEET S DANG MD INTERIM CMO 0 538574 0 0 0 47550 0 24306 0 37886 0 648316 0 0 MARIA MCGRAW CRNA CRNA, LEAD 483231 0 0 0 11240 0 24306 0 5739 0 524516 0 0 0 GARY SEBASTIANELLI CRNA CRNA, LEAD 454763 0 0 0 9495 0 24306 0 30979 0 519543 0 0 0 MARK ANTONIO CRNA CRNA, PASNAP 396374 0 20493 0 15883 0 24306 0 41205 0 498261 0 0 0 GEMMA ROSATO CRNA, PASNAP 382686 0 31760 0 6110 0 24306 0 18235 0 463097 0 0 0 LORI R GRAMLEY ESQUIRE ACLO, ASSISTANT SECRETARY 0 338553 0 0 0 28526 0 24306 0 27947 0 419332 0 0 RENEE BLAKIEWICZ RN BSN VP, CHIEF NURSING OFFICER 297542 0 0 0 15692 0 22009 0 38473 0 373716 0 0 0 PART I, LINE 1A - FRINGE OR EXPENSE EXPLANATION 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. PART I, LINE 4 - SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SEVERANCE NONQUALIFIED EQUITY-BASED JAEWON RYU, MD, JD 0 1,479,829 0 STEVEN B. BENDER, ESQUIRE 0 167,904 0 GERALD V. MALONEY, DO 0 62,504 0 RONALD BEER, MHA, FACHE 0 48,140 0 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. 0 VIRGINIA PADDOCK FAMILY 109082 EMPLOYEE COMP/BENEFITS false SCHEDULE L, PART V - ADDITIONAL INFORMATION VIRGINIA PADDOCK IS A FAMILY MEMBER OF VIRGINIA MCGREGOR, A DIRECTOR OF COMMUNITY MEDICAL CENTER. FORM 990, PART III, LINE 4A - FIRST ACCOMPLISHMENT 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 294-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. THE HOSPITAL'S PRIMARY SERVICE AREA IS COMPRISED OF LACKAWANNA, LUZERNE, WAYNE, AND WYOMING COUNTIES. SECONDARY SERVICE AREAS INCLUDE MONROE, PIKE, AND SUSQUEHANNA 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, JOINING GEISINGER WYOMING VALLEY MEDICAL CENTER AND GEISINGER MEDICAL CENTER AS THE FIRST THREE HOSPITALS IN THE COUNTRY TO BECOME CERTIFIED. 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 2024 GCMC WAS LISTED IN U.S. NEWS & WORLD REPORT BEST HOSPITALS RANKINGS FOR HEART FAILURE, HEART ATTACK, KNEE REPLACEMENT, PNEUMONIA, AND STROKE. 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. IN JUNE 2025, GEISINGER'S CANCER SERVICES IN LACKAWANNA COUNTY WILL MOVE TO THE NEWLY BUILT GEISINGER CANCER CENTER DICKSON CITY, WHICH WILL FEATURE 22 INFUSION BAYS, THREE MULTIDISCIPLINARY SPACES AND A HEMATOLOGY AND ONCOLOGY CLINIC WITH 17 EXAM ROOMS. THE 61,000-SQUARE-FOOT FACILITY, WILL ALSO PROVIDE RADIATION ONCOLOGY CARE - A FIRST FOR GEISINGER IN LACKAWANNA COUNTY. 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, AN ORTHOPEDIC TRAUMA PROGRAM, 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. IN AUGUST 2023, GEISINGER BEHAVIORAL HEALTH CENTER NORTHEAST BEGAN SEEING PATIENTS. THE 96-BED FACILITY PROVIDES CARE FOR ADULT, PEDIATRIC AND ADOLESCENT PATIENTS WHO STRUGGLE WITH ACUTE SYMPTOMS OF BEHAVIORAL HEALTH DISORDERS SUCH AS ANXIETY, DEPRESSION, BIPOLAR DISORDER, PSYCHOSIS AND POSTTRAUMATIC STRESS DISORDER. BEHAVIORAL HEALTH CENTER NORTHEAST WAS BUILT TO HELP ADDRESS THE INCREASED NEED FOR MENTAL HEALTH CARE IN PENNSYLVANIA. ACCORDING TO DATA FROM THE NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI), 1 IN 5 U.S. ADULTS EXPERIENCE MENTAL ILLNESS EACH YEAR. THREE OUT OF 5 PENNSYLVANIA COMMUNITIES DO NOT HAVE ENOUGH MENTAL HEALTH PROVIDERS, AND MORE THAN 1.8 MILLION ADULTS IN PENNSYLVANIA HAVE A MENTAL HEALTH CONDITION. IN SEPTEMBER 2023, GEISINGER ORTHOPAEDICS AND SPORTS MEDICINE SCRANTON OPENED ITS SECOND PHASE IN THE MARKETPLACE AT STEAMTOWN. THE 83,000 SQUARE-FOOT FACILITY IS THE LARGEST BONE, MUSCLE AND JOINT CARE FACILITY IN LACKAWANNA COUNTY. IN ADDITION TO SPORTS MEDICINE AND ORTHOPAEDIC CARE FOR ALL AGES, ORTHOPAEDICS AND SPORTS MEDICINE SCRANTON OFFERS PODIATRY, WOUND CARE AND PHYSICAL AND OCCUPATIONAL THERAPY. IN FEBRUARY 2025, GCMC OPENED A NEWLY RENOVATED INPATIENT UNIT WITH 22 MEDICAL-SURGICAL BEDS, A CAPACITY EXPANSION MADE POSSIBLE BY MOVING BEHAVIORAL HEALTH SERVICES TO GEISINGER BEHAVIORAL HEALTH CENTER NORTHEAST IN MOOSIC. FORM 990, PART V, LINE 1A - ADDITIONAL INFORMATION 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 2024 REPORTING PERIOD ON BEHALF OF ITSELF AND ITS AFFILIATES WAS 1,166. 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, LINE 1A - AUTHORITY DELEGATED TO COMMITTEE EXPLANATION 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, PART VI, LINE 2 - ADDITIONAL INFORMATION 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, NAVNEET S. DANG, MD, RONALD BEER, MHA, FACHE, STEVEN B. BENDER, ESQUIRE, TERRY GILLILAND, MD, 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 AFFILIATES OF THE ENTITY. ALL OF THE AFFILIATES ARE PART OF GEISINGER. FORM 990, PART VI, LINE 6 - CLASSES OF MEMBERS OR STOCKHOLDERS 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, PART VI, LINE 7A - ELECTION OF MEMBERS AND THEIR RIGHTS THE BOARD OF DIRECTORS OF THE CORPORATION SHALL SERVE AS THE GOVERNING BODY OF THE CORPORATION. THE PRESIDENT OF THE CORPORATION SHALL BE A DIRECTOR BY REASON OF HOLDING SUCH OFFICE. THE REMAINING DIRECTORS SHALL BE ELECTED BY THE MEMBERS AT THE ANNUAL MEETING OF THE MEMBERS. THE MEMBERS OF THE CORPORATION MAY SERVE AS DIRECTORS AND DIRECTORS MAY SUCCEED THEMSELVES FROM TERM TO TERM. VACANCIES ON THE BOARD OF DIRECTORS SHALL BE FILLED BY THE MEMBERS AT THEIR DISCRETION AT THE ANNUAL MEETING OF THE MEMBERS OR AT A SPECIAL MEETING CALLED FOR SUCH PURPOSE. FORM 990, PART VI, LINE 7B - DECISIONS SUBJECT TO APPROVAL OF MEMBERS 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, PART VI, LINE 11B - ORGANIZATION'S PROCESS TO REVIEW FORM 990 THE FORM 990 IS PREPARED BY KAISER FOUNDATION HEALTH PLAN, INC.'S TAX PREPARATION AND OVERSIGHT DEPARTMENT WITH INFORMATION PROVIDED FROM GEISINGER FINANCE, HUMAN RESOURCES, LEGAL SERVICES AND OTHER RELEVANT DEPARTMENTS WITHIN GEISINGER. PRIOR TO FINALIZATION, THE RETURN IS REVIEWED BY PWC US TAX, LLP. THE CHIEF FINANCIAL OFFICER OF GEISINGER AND THE INDIVIDUAL ORGANIZATIONS SENIOR FINANCIAL MANAGERS REVIEW THEIR RESPECTIVE FORM 990 PRIOR TO MAKING THE FINAL RETURN AVAILABLE TO THE BOARD. 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. FORM 990, PART VI, LINE 12C - ENFORCEMENT OF CONFLICTS POLICY 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, PART VI, LINE 15A & 15B - COMPENSATION PROCESS FOR TOP OFFICIAL 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, PART VI, LINE 19 - GOVERNING DOCUMENTS DISCLOSURE EXPLANATION 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 XII, LINE 3A - ADDITIONAL INFORMATION 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"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. FORM 990, PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS EXPLANATION TRANSFER TO PARENT, GEISINGER HEALTH $ -35,000,000 GAIN ON EXTINGUISHMENT OF DEBT $ 15,572,054 LOSS FROM SUBSIDIARY $ -182,079 TRANSFER FROM PARENT FOR PPE $ 47,279 TOTAL $ -19,562,746 GEISINGER-SCA HOLDINGS LLC 100 NORTH ACADEMY AVE MC 49-70 DANVILLE PA 17822 461615328 HOLD CO DE 0 0 CMC KAISER FOUNDATION HOSPITALS ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 941105628 HEALTH CARE CA 501(C)(3) 3 NA false KAISER FOUNDATION HEALTH PLAN INC ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 941340523 HEALTH CARE CA 501(C)(3) 10 NA false KAISER FDN HEALTH PLAN OF COLORADO ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 840591617 HEALTH CARE CO 501(C)(3) 10 KFHP INC false KAISER FDN HEALTH PLAN OF GEORGIA INC ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 581592076 HEALTH CARE GA 501(C)(3) 10 KFHP INC false KAISER FOUNDATION HEALTH PLAN OF THE MAS ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 520954463 HEALTH CARE MD 501(C)(3) 10 KFHP INC false KAISER FDN HEALTH PLAN OF THE NORTHWEST ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 930798039 HEALTH CARE OR 501(C)(3) 10 KFHP INC false KAISER FDN HEALTH PLAN OF WASHINGTON ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 910511770 HEALTH CARE WA 501(C)(3) 3 KFHPW HLDGS false KAISER HOSPITAL ASSET MANAGEMENT INC ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 943299125 ASSET MGMT CA 501(C)(3) 12-I KFH false KAISER HEALTH PLAN ASSET MANAGEMENT INC ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 943299124 ASSET MGMT CA 501(C)(3) 12-I KFHP INC false CAMP BOWIE SERVICE CENTER ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 943299123 ADMIN CA 501(C)(3) 12-I KFHP INC false LOKAHI ASSURANCE LTD ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 912171891 WC PLACEMENT HI 501(C)(3) 12-I KFHP INC false 1800 HARRISON FOUNDATION ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 943317484 FINANCING CA 501(C)(3) 12-I KFHP INC false KAISER HOSPITAL ASSISTANCE CORPORATION ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 311779500 FINANCING CA 501(C)(3) 12-I KFH false KAISER HEALTH ALTERNATIVES ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 930954562 HEALTH CARE OR 501(C)(3) 10 KFHP INC false KP BERNARD J TYSON SCHOOL OF MEDICINE ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 814053028 MEDICAL EDUCA CA 501(C)(3) 2 KFH false KFHPW HOLDINGS ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 930480268 HEALTH CARE WA 501(C)(3) 12-I KFHP INC false GROUP HEALTH NORTHWEST ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 911216856 INACTIVE WA 501(C)(3) 12-I KFHP OF WA false KAISER FDN FOR THE ADV OF INTEGRATED HC ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 823819611 ADVOCACY CA 501(C)(4) N/A KFHP INC false KAISER FDN HEALTH PLAN OF NEVADA INC ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 372097870 HEALTH CARE DE 501(C)(4) N/A KFHP INC false KP MEDICAL FOUNDATION ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 920685740 HEALTH CARE DE 501(C)(3) 12-I KFHP INC false KFH HOLDINGS INC ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 884172095 HOLDING CO DE 501(C)(3) 12-I KFH false RISANT HEALTH INC ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 923467590 HEALTH CARE DE 501(C)(3) 12-I RISANT HLTH false GEISINGER HEALTH 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 231995911 PHILANTHROPY PA 501(C)(3) 7 RISANT HLTH false GEISINGER-BLOOMSBURG HOSPITAL 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 232193572 HEALTH CARE PA 501(C)(3) 3 GH false GEISINGER CLINIC 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 236291113 HEALTH CARE PA 501(C)(3) 3 GH false GEISINGER COMMONWEALTH SCH OF MEDICINE 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 260812968 MEDICAL EDU PA 501(C)(3) 2 GH false GEISINGER COMMUNITY HEALTH SERVICES 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 232967235 HEALTH CARE PA 501(C)(3) 10 GSS false GEISINGER HEALTH PLAN 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 232311553 HEALTH CARE PA 501(C)(4) N/A GH false GEISINGER INSURANCE CORPORATION RRG 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 141909894 INSURANCE VT 501(C)(3) 12-I GH false GEISINGER JERSEY SHORE HOSPITAL 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 240792115 HEALTH CARE PA 501(C)(3) 3 GH false GEISINGER-LEWISTOWN HOSPITAL 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 231352187 HEALTH CARE PA 501(C)(3) 3 GH false GEISINGER MEDICAL CENTER 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 240795959 HEALTH CARE PA 501(C)(3) 3 GH false GEISINGER MEDICAL CENTER MUNCY 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 851226106 HEALTH CARE PA 501(C)(3) 3 GHMJV false GEISINGER SYSTEM SERVICES 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 232164794 SUPPORT SVCS PA 501(C)(3) 12-I GH false GSL HOSPITAL 801 OSTRUM STREET BETHLEHEM PA 18015 824432109 HEALTH CARE PA 501(C)(3) 3 GH false GSLPG INC 801 OSTRUM STREET BETHLEHEM PA 18015 825423865 HEALTH CARE PA 501(C)(3) 3 GSL HOSPITAL false GEISINGER WYOMING VALLEY MEDICAL CENTER 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 231996150 HEALTH CARE PA 501(C)(3) 3 GH false KEYSTONE HEALTH INFORMATION EXCHANGEINC 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 464359893 HEALTH CARE PA 501(C)(3) 12-I GH false MARWORTH 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 232171417 HEALTH CARE PA 501(C)(3) 3 GH false WEST SHORE ADVANCED LIFE SUPPORT SVCS 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 232463002 HEALTH CARE PA 501(C)(3) 7 GC false GNJ PHYSICIANS GROUP PC 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 820681884 HEALTH CARE NJ 501(C)(3) 10 GH false THE MOSES H CONE MEMORIAL HOSPITAL 1200 NORTH ELM ST GREENSBORO NC 27401 560532302 HEALTH CARE NC 501(C)(3) 12-II RISANT HLTH false THE MOSES H CONE MEMORIAL HOPS OPER CORP 1200 NORTH ELM ST GREENSBORO NC 27401 581588823 HEALTH CARE NC 501(C)(3) 3 MC HOSPITAL false MOSES CONE AFFILIATED PHYSICIANS INC 1200 NORTH ELM ST GREENSBORO NC 27401 300554775 HEALTH CARE NC 501(C)(3) 3 MC HOSPITAL false MOSES CONE PHYSICIAN SERVICES INC 1200 NORTH ELM ST GREENSBORO NC 27401 800249057 HEALTH CARE NC 501(C)(3) 3 MC HOSPITAL false MOSES CONE MEDICAL SERVICES INC 1200 NORTH ELM ST GREENSBORO NC 27401 561714318 HEALTH CARE NC 501(C)(3) 3 MC HOSPITAL false REIDSVILLE OB & GYN PHYSICIANS INC 1200 NORTH ELM ST GREENSBORO NC 27401 800217430 HEALTH CARE NC 501(C)(3) 3 MC HOSPITAL false ARMC HEALTH CARE 1200 NORTH ELM ST GREENSBORO NC 27401 581681363 HEALTH CARE NC 501(C)(3) 3 MC HOSPITAL false ALAMANCE REGIONAL MEDICAL CENTER INC 1200 NORTH ELM ST GREENSBORO NC 27401 560529994 HEALTH CARE NC 501(C)(3) 3 ARMC HC false CONE HEALTH PHILANTHROPIC FOUNDATION 1200 NORTH ELM ST GREENSBORO NC 27401 581681560 FUNDRAISING NC 501(C)(3) 12-II ALAMANCE MC false ARMC PHYSICIANS CARE INC 1200 NORTH ELM ST GREENSBORO NC 27401 562095382 HEALTH CARE NC 501(C)(3) 3 ARMC HC false THE MOSES CONE - WESLEY LONG HEALTH FDN 1200 NORTH ELM ST GREENSBORO NC 27401 562001399 FUNDING NC 501(C)(3) 12-II MC HOSPITAL false ALAMANCE COMMUNITY & HEALTH FDN INC 1200 NORTH ELM ST GREENSBORO NC 27401 462505818 FUNDING NC 501(C)(3) 12-II ALAMANCE MC false REF CONE INC 20 NORTH BENBOW ROAD GREENSBORO NC 27411 991330813 REAL ESTATE NC 501(C)(3) 12-I MC HOSPITAL false NXT CAP SR LOAN FUND I LLC 191 N WACKER DR STE 1200 CHICAGO IL 60606 371651297 INVESTMENT DE NA N/A 0 0 0.00000 MAUI NUI ASC HOLDCO LLC ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 HOLDING CO HI NA N/A 0 0 0.00000 KEYSTONE ACCOUNTABLE CARE ORGANIZATION 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 455484165 ACCOUNTABLE CARE PA NA N/A 0 0 0.00000 NSC GREENSBORO WEST 3000 RIVERCHASE GALLERIA BIRMINGHAM AL 35244 561963226 HEALTH CARE AL NA N/A 0 0 0.00000 GEISINGER HM JOINT VENTURE LLC 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 831871064 HEALTH CARE PA NA N/A 0 0 0.00000 EVANGELICAL-GEISINGER HEALTH LLC 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 460567687 HEALTH CARE PA NA N/A 0 0 0.00000 GEISINGER ENCOMPASS HEALTH LLC 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 721398803 HEALTH CARE PA NA N/A 0 0 0.00000 KEYSTONE HEALTHCARE PARTNERSHIP LLC 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 833134941 HEALTH CARE PA NA N/A 0 0 0.00000 HTA HOLDINGS LLC 1200 NORTH ELM ST GREENSBORO NC 27401 920615196 HOLDING COMPANY NC NA N/A 0 0 0.00000 CONE HEALTH VENTURES LLC 1200 NORTH ELM ST GREENSBORO NC 27401 920712783 INNOVATION NC NA N/A 0 0 0.00000 LACKAWANNA PHYS AMB SURG CTR LLC 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 233024998 INVESTMENT CMC RELATED -263082 0 true 0.00000 OAK TREE ASSURANCE LTD ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 030329760 INSURANCE VT NA C CORP 0 0 0.00000 false KAISER PERMANENTE INSURANCE COMPANY ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 943203402 INSURANCE CA NA C CORP 0 0 0.00000 false KAISER PERMANENTE INTERNATIONAL ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 943245176 CONSULTING CA NA C CORP 0 0 0.00000 false KFHP OF WASHINGTON OPTIONS INC ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 911467158 INSURANCE WA NA C CORP 0 0 0.00000 false GROUP HEALTH OF WASHINGTON ONE KAISER PLAZA - 26TH FL OAKLAND CA 94612 911314907 INACTIVE WA NA C CORP 0 0 0.00000 false GARFIELD HEALTH SOLUTIONS EAST PVT LTD LEVEL 10 TOWER C PANCHSHIL BUSINESS BALEWADI PUNE IN 411045 ADMIN IN NA C CORP 0 0 0.00000 false GARFIELD HEALTH SOLUTIONS WEST SRL ULTRAPARK II FREE TRADE ZONE BLD 4 LAGUNILLA HEREDIA CS ADMIN CS NA C CORP 0 0 0.00000 false GEISINGER ASSURANCE COMPANY LTD PO BOX 1159 GRAND CAYMAN CJ KY1-1102 981016737 FINANCIAL CJ NA C CORP 0 0 0.00000 false GEISINGER INDEMNITY INSURANCE COMPANY 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 232815174 INSURANCE PA NA C CORP 0 0 0.00000 false GEISINGER QUALITY OPTIONS INC 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 204275139 INSURANCE PA NA C CORP 0 0 0.00000 false ISS SOLUTIONS INC 100 N ACADEMY AVE MC 49-70 DANVILLE PA 17822 232077663 CLIN ENGINEERING PA NA C CORP 0 0 0.00000 false CARE N' CARE INSURANCE CO NORTH CAROLINA 1200 NORTH ELM ST GREENSBORO NC 27401 472847536 INSURANCE NC NA C CORP 0 0 0.00000 false WESLEY LONG COMMUNITY HEALTH SVCS INC 1200 NORTH ELM ST GREENSBORO NC 27401 561441377 HEALTH CARE NC NA C CORP 0 0 0.00000 false INSURANCE CASUALTY AND RISK ENTERPRISE PO BOX 1159 GRAND CAYMAN CJ KY1-1102 981491204 INSURANCE CJ NA C CORP 0 0 0.00000 false PIEDMONT PRACTICE ASSOCIATES INC 1200 NORTH ELM ST GREENSBORO NC 27401 561954739 HEALTH CARE NC NA C CORP 0 0 0.00000 false true true false false false false false false false false true true true false false true false false true GEISINGER ASSURANCE COMPANY LTD P 1704516 GAAP GEISINGER CLINIC A 398626 FMV GEISINGER CLINIC K 74524 FMV GEISINGER CLINIC L 7815664 GAAP GEISINGER CLINIC M 30815994 GAAP GEISINGER COMMUNITY HEALTH SERVICES L 649058 GAAP GEISINGER HEALTH B 35000000 GAAP GEISINGER HEALTH M 545598 GAAP GEISINGER HEALTH PLAN A 82971 FMV GEISINGER HEALTH PLAN L 83773007 GAAP GEISINGER INDEMNITY INSURANCE COMPANY L 17986502 GAAP GEISINGER INSURANCE CORPORATION RRG P 1794901 GAAP GEISINGER MEDICAL CENTER M 12975942 GAAP GEISINGER PHARMACY LLC M 4271426 GAAP GEISINGER QUALITY OPTIONS INC L 6006049 GAAP GEISINGER SYSTEM SERVICES A 87794 FMV GEISINGER SYSTEM SERVICES M 65534341 GAAP GEISINGER WYOMING VALLEY MEDICAL CENTER A 664327 FMV ISS SOLUTIONS INC M 2096565 GAAP KAISER FOUNDATION HEALTH S 464576 GAAP WEST SHORE ADVANCED LIFE SUPPORT SERVICES INC M 443898 GAAP 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.