2025-11-17T17:06:16-06:00 2024-12-31 PwC US Tax LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2024-01-01 232193572 GEISINGER-BLOOMSBURG HOSPITAL % ERIN FITZGERALD CPA GEIS 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 TERRY GILLILAND MD 100 N ACADEMY AVE MC 49-70 DANVILLE PA 178229800 86890311 false X WWW.GEISINGER.ORG X 1982 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 4 521 19 0 0 2022151 1377316 77214965 84839389 205677 202977 443994 470629 79886787 86890311 300 300 0 0 33538808 34015759 0 0 0 41403538 39485087 74942646 73501146 4944141 13389165 50637482 58950033 33935693 36617563 16701789 22332470 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 1 70193640 300 84859039 FORM 990, PART III, LINE 4A - FIRST ACCOMPLISHMENT I.GENERAL INFORMATION GEISINGER-BLOOMSBURG HOSPITAL (GBH), A 501(C)(3) NOT-FOR-PROFIT CORPORATION AND MEMBER OF GEISINGER, OWNS AND OPERATES A 62 BED, ACUTE CARE, HOSPITAL IN BLOOMSBURG, PA. GBH IS CONVENIENTLY LOCATED ONLY A FEW MILES FROM SEVERAL MAJOR HIGHWAYS THROUGHOUT CENTRAL PA. THE FACILITY OPENED IN 1905, ANSWERING A PRESSING NEED FOR HEALTH AND WELLNESS CARE IN THE COMMUNITY. GBH PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. II.MAJOR PROGRAM SERVICES SERVICES OFFERED BY GBH INCLUDE GENERAL MEDICAL CARE PROVIDED BY IN-HOUSE HOSPITALISTS AND SUPPORTED BY CONSULTATIVE SERVICES IN THE AREAS OF CARDIOLOGY, NEUROLOGY, AND PULMONOLOGY. EMERGENCY DEPARTMENT IS COMMITTED TO PROVIDING HIGH QUALITY, PROMPT EMERGENCY SERVICES. GBH'S ED IS STAFFED 24/7 WITH FULL-TIME PHYSICIANS AND NURSES THAT ARE TRAINED IN EMERGENCY MEDICINE AND ARE PREPARED TO TREAT CASES FROM PEDIATRICS TO CRITICAL CARE. IMMEDIATE ACCESS TO LABORATORY SERVICES, X-RAYS, CAT SCANS, 3D-4D ULTRASOUND, MRI, AND SURGICAL SERVICES. MOST INSURANCES, INCLUDING MEDICARE AND MEDICAID, ARE ACCEPTED AND NO PATIENT IS REFUSED TREATMENT BECAUSE OF INABILITY TO PAY. THE WOMAN'S HEALTH UNIT FOCUSES ON ALL ASPECTS OF WOMEN'S HEALTH AND EDUCATION, PROVIDING OBSTETRICAL AND GYNECOLOGICAL CARE FOR WOMEN OF ALL AGES. SERVICES INCLUDE BUT NOT LIMITED TO ROUTINE VISITS AND TREATMENTS, PREVENTATIVE HEALTHCARE, BIRTH CONTROL EDUCATION, FAMILY PLANNING, OBSTETRICS, SURGERY & SURGERY CONSULTATIONS, MENOPAUSE COUNSELING, MIDWIFERY, LACTATION EDUCATION AND SUPPORT. MENTAL HEALTH & PSYCHIATRIC SERVICES IS A DESIGNATED COUNT 302 TRIAGE SITE THAT PROVIDES BOTH INPATIENT AND OUTPATIENT SERVICES DESIGNED TO HELP INDIVIDUALS LIVE AS INDEPENDENTLY AS POSSIBLE. ADULTS TO GERIATRICS CAN ACCESS QUICK, EFFICIENT ADMISSION 24/7 AND RECEIVE TREATMENT THROUGH ONE-ON-ONE PATIENT COUNSELING, TREATMENT MEETINGS AND ACTIVITIES 7 DAYS PER WEEK. A PSYCHIATRIST IS AVAILABLE DAILY. ADMISSIONS ARE CONFIDENTIAL AND MAY BE MADE BY PROFESSIONALS AS WELL BY INDIVIDUALS CONCERNED ABOUT THEMSELVES OR OTHERS. INPATIENT CARE IS PROVIDED THROUGH MULTIPLE PROFESSIONALS WHO COMPRISE THE TREATMENT TEAM. OTHER SERVICES INCLUDE: CARDIAC SERVICES SURGERY SPECIALTIES- RADIOLOGY ORTHOPEDIC UROLOGY LABORATORY SERVICES PHYSICAL THERAPY GYNECOLOGY RESPIRATORY SERVICES GENERAL SURGERY SLEEP SERVICES OUTPATIENT ADDICTION MEDICINE NEUROLOGY ORAL AND MAXILLOFACIAL SURGERY OTOLARYNGOLOGY CONVENIENT CARE PLUS III.PROGRAM SERVICE ACCOMPLISHMENTS UNCOMPENSATED CARE GBH RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. GBH PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, RELIGION, ETHNICITY, SEXUAL ORIENTATION, GENDER IDENTITY, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD, GBH 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 GBH PRACTICES. A. CHARITY CARE THE PRIMARY CONCERN OF GBH IS THE DELIVERY OF HEALTH CARE TO ALL CITIZENS OF CENTRAL PENNSYLVANIA REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GBH INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. THE COST OF PROVIDING CHARITY CARE WAS $1,287,085 DURING THE YEAR ENDED DECEMBER 31, 2024. B. MEDICARE/MEDICAID/OTHER GOVERNMENTAL IN RECOGNIZING ITS MISSION TO THE COMMUNITY, GBH PROVIDES SERVICES TO THE ELDERLY (MEDICARE) AND THE INDIGENT (MEDICAID), AS WELL AS OTHERS. GBH PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS TO THE EXTENT THE GOVERNMENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTH CARE. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. THE COST OF PROVIDING HEALTHCARE SERVICES TO MEDICARE AND MEDICAID PATIENTS EXCEEDED REIMBURSEMENT BY APPROXIMATELY $3,677,040 DURING THE YEAR ENDED DECEMBER 31, 2024. COMMUNITY HEALTH, EDUCATION, AND OUTREACH GBH STRIVES TO BE A VALUABLE RESOURCE FOR THE COMMUNITY AND ITS RESIDENTS. GBH PROVIDES REDUCED-PRICE SERVICES AND FREE PROGRAMS THROUGHOUT THE YEAR THAT SERVE COMMUNITY HEALTH NEEDS. THESE SERVICES AND PROGRAMS INCLUDE COMMUNITY BASED CLINICAL HEALTH SCREENINGS, COMMUNITY HEALTH EDUCATION, AND OTHER UNIQUE SERVICES. A. HEALTH CARE SUPPORT SERVICES GBH PROVIDED TRANSPORTATION FOR INDIGENT PATIENTS AT A COST OF $165,383 AND FREE OR DISCOUNTED PRESCRIPTIONS AND SUPPLIES TO SEXUAL ASSAULT VICTIMS AT A COST OF $21,878 DURING CALENDAR 2024. B. HEALTH PROFESSIONS EDUCATION IN ADDITION TO SUPPORTING RESIDENCY AND FELLOWSHIP PROGRAMS, GBH PROVIDED $660,755 IN SUPERVISION OF NURSING, PHARMACY AND ADVANCED PRACTITIONERS COMPLETING ROTATIONS AS PART OF THEIR STUDIES DURING THE YEAR ENDED DECEMBER 31, 2024. III. RESEARCH SUPPORT GEISINGER-BLOOMSBURG HOSPITAL CONTRIBUTED $305,626 TO GEISINGER CLINIC TO SUPPORT ITS CHARITABLE MISSION THROUGH MEDICAL RESEARCH ACTIVITIES AT TWO FACILITIES ON THE CAMPUS OF GEISINGER MEDICAL CENTER: THE SIEGFRIED AND JANET WEIS CENTER FOR RESEARCH (WEIS CENTER) AND THE HENRY HOOD CENTER FOR HEALTH RESEARCH. THE WEIS CENTER PROVIDES A FOCUS FOR LABORATORY RESEARCH AND RESEARCH TRAINING AND SUPPORTS THE CLINICAL STAFF IN ITS RESEARCH PROGRAMS. THE PRIMARY MISSION OF THE WEIS CENTER IS TO CONDUCT ORIGINAL AND INNOVATIVE RESEARCH THAT CONTRIBUTES NEW KNOWLEDGE TO BIOMEDICAL SCIENCE. THE CENTER'S SCIENTISTS APPLY MODERN MOLECULAR AND CELLULAR APPROACHES TO DIVERSE RESEARCH PROBLEMS IN THE AREAS OF CARDIOVASCULAR FUNCTION, CANCER AND DEVELOPMENTAL BIOLOGY. THE HENRY HOOD CENTER FOR HEALTH RESEARCH CONDUCTS HEALTH SERVICES, EPIDEMIOLOGIC AND POPULATION GENETICS RESEARCH ON THE BROAD RANGE OF CONDITIONS TYPICALLY SEEN IN PRIMARY AND SPECIALTY CARE SETTINGS. THE CENTER ALSO INVESTIGATES EXTRAMURAL SOURCES OF FUNDING FOR CLINICAL RESEARCH. TOGETHER, THE WEIS CENTER AND HENRY HOOD CENTER ARE BUILDING CAPABILITY FOR IMPROVED POPULATION-BASED GENETICS RESEARCH. GEISINGER'S ""MYCODE"" PROJECT IS ONE OF THE LARGEST GENOMIC RESEARCH PROJECTS OF ITS KIND IN THE WORLD, MORE THAN 340,000 ENROLLED PARTICIPANTS. GENERAL PROGRAM SERVICES A. RESIDENCY PROGRAMS: GBH HOSTS FAMILY MEDICINE, NEUROLOGY, OB/GYN, OPHTHALMOLOGY, PATHOLOGY, PHYSICAL MEDICINE AND REHABILITATION AND TRANSITIONAL YEAR RESIDENTS AS A PART OF THEIR EDUCATION REQUIREMENTS UNDER GEISINGER MEDICAL CENTER'S ACCREDITED PROGRAMS. ALL THE PROGRAMS ARE ACCREDITED BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME). THE UNCOMPENSATED COSTS FOR GRADUATE MEDICAL EDUCATION TOTALED $1,980,919 DURING THE YEAR ENDED DECEMBER 31, 2024. B. OTHER CASH CONTRIBUTIONS GEISINGER BLOOMSBURG HOSPITAL PROVIDES FINANCIAL ASSISTANCE TO THE COMMUNITY THROUGH COMMUNITY ASSISTANCE PAYMENTS. THE VALUE OF THE PAYMENTS WAS $5,436. C. VOLUNTEER SERVICES THE VOLUNTEERS OF GEISINGER BLOOMSBURG HOSPITAL ARE AN ACTIVE AND VITAL PART OF THE ACTIVITIES OF THE HOSPITAL. THE HOURS OF VOLUNTEER SERVICES ARE IMPORTANT CONTRIBUTION TO THE MISSION OF GBH. VOLUNTEERS FROM LOCAL COMMUNITIES HAVE CONTRIBUTED 2,130 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTHCARE OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION OF $70,560 IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND "WELLNESS" PROGRAMS. COMMUNITY BENEFITS SUMMARY CHARITY CARE $1,287,085 MEDICARE/MEDICAID/OTHER GOVERNMENTAL $3,677,040 COMMUNITY HEALTH, EDUCATION, OUTREACH AND OTHER $848,016 HEALTH PROFESSIONS EDUCATION $1,980,919 RESEARCH SUPPORT $305,626 COMMUNITY ASSISTANCE PAYMENT $5,436 VOLUNTEER SERVICES (VALUED AT 01/01/2024 PA STATEWIDE AVERAGE WEEKLY WAGE) $70,560 TOTAL $8,174,682 STATISTICS DISCHARGES, EXCLUDING NURSERY, PSYCH, & SNF 2,494 AVERAGE LENGTH OF STAY, EXCLUDING NURSERY, PSYCH, & SNF 2.9 PERCENT OF OCCUPANCY, EXCLUDING NURSERY, PSYCH, & SNF 49.9% TOTAL OR CASES 3,795 OUTPATIENT VISITS, INCLUDING OUTPATIENT ER VISITS 118,534 OUTPATIENT EMERGENCY ROOM VISITS 20,642 LICENSED BEDS, EXCLUDING NURSERY, PSYCH, & SNF 40 BASSINETS IN NURSERY 10 70193640 true true false true false false false false false true true false false false true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true 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12610146 12013895 13888880 11092577 2796303 1918543 616090 1302453 16544894 0 DUE TO AFFILIATES 34114359 PENSION COSTS 450437 PATIENT CREDITS AND REFUNDS 214141 LEASE LIABILITY 5794 34784731 PART V, LINE 4 - INTENDED USES FOR ENDOWMENT FUNDS PERMANENTLY RESTRICTED ENDOWMENT FUNDS ARE HELD AT UNRELATED FINANCIAL INSTITUTIONS RESPONSIBLE FOR MAINTAINING, INVESTING, AND DISTRIBUTING FUNDS IN ACCORDANCE WITH DONOR STIPULATIONS AS DIRECTED IN THE TRUST AGREEMENTS. 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 RETURNS. THE ADOPTION OF FIN 48 HAD NO IMPACT ON UNRESTRICTED NET ASSETS AS OF THE END OF THE CALENDAR YEAR OR ANY PREVIOUS YEAR 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 1287085 1287085 0.01750 14089638 12744511 1345127 0.01830 469102 361851 107251 0.00150 15845825 13106362 2739463 0.03730 848016 848016 0.01150 2798691 817772 1980919 0.02700 311062 311062 0.00420 3957769 817772 3139997 0.04270 19803594 13924134 5879460 0.08000 true 7938563 10163225 -2224662 X true true 1 1 GEISINGER-BLOOMSBURG HOSPITAL 549 FAIR STREET BLOOMSBURG PA 17815 WWW.GEISINGER.ORG 025001 X X X X X TRAUMA SERVICES GEISINGER-BLOOMSBURG HOSPITAL 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, GEISINGER-BLOOMSBURG HOSPITAL - 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 180 INDIVIDUALS SERVING THE CENTRAL REGION, WHO REPRESENT HEALTHCARE PROVIDERS, SOCIAL SERVICES PROFESSIONALS, EDUCATORS, FAITH-BASED LEADERS, AND COMMUNITY LEADERS, AMONG OTHERS; -REGIONAL COMMUNITY FORUM BRINGING TOGETHER 39 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, GEISINGER-BLOOMSBURG HOSPITAL - 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, GEISINGER-BLOOMSBURG HOSPITAL - 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, GEISINGER-BLOOMSBURG HOSPITAL - 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. 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 BLOOMSBURG HOSPITAL TACTICS: . REDUCE THE NUMBER OF RESIDENTS WHO REPORT NOT HAVING A PRIMARY CARE PROVIDER (PCP) OR MEDICAL HOME BY LEVERAGING OPPORTUNITIES WITH POINT OF CARE SCHEDULING. . SCREEN PATIENTS WHO ACCESS SERVICES AT THE EMERGENCY DEPARTMENT (ED) TO DETERMINE IF THEY HAVE A PRIMARY CARE PROVIDER (PCP) AND ASSIST THOSE THAT DO NOT IN FINDING A PCP. 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 BLOOMSBURG HOSPITAL TACTICS: . EXPLORE TELEMEDICINE OPTIONS TO PROVIDE SERVICES AND REDUCE BARRIERS TO CARE RELATED TO TRANSPORTATION. . EXPAND ACCESS TO PRIMARY CARE THROUGH GROWTH IN LEGACY COMMUNITY MEDICINE SITES AND NEW LOCATIONS TO INCLUDE 65 FORWARD, CONVENIENTCARE, CONVENIENTCARE+, AND COMMUNITY CARE. 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 BLOOMSBURG HOSPITAL TACTICS: . CONTINUE TO ENCOURAGE HIGH SCHOOL AND COLLEGE STUDENTS TO ENTER THE HEALTHCARE FIELD BY PROVIDING HIGH SCHOOL STEAM AND CAREER TOURS OF GBH, PARTICIPATE IN COLLEGE ORIENTATIONS AND HEALTH SYMPOSIUMS, AND PROVIDE VOLUNTEERISM OPPORTUNITIES. . OFFER TRAINING AND EDUCATION PROGRAMS WHICH INCLUDE CO-OP PROGRAMS, NURSE RESIDENCY PROGRAM, MED SURG FELLOWSHIP AND ABIGAIL SCHOLARS PROGRAM, WHICH WILL HELP TO INCREASE RECRUITMENT AND RETENTION. 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 BLOOMSBURG HOSPITAL TACTICS: . SPAN REACH OF FRESH FOOD FARMACY. . FURTHER RELATIONSHIPS IN COMMUNITY BY REMAINING ACTIVE IN LOCAL COMMITTEES. . WORK WITH REGIONAL PATIENT ACCESS TO ENCOURAGE HIRING OF BILINGUAL STAFF TO BETTER SERVE PATIENTS WITH PREFERRED LANGUAGE OTHER THAN ENGLISH. . WORK WITH VENDORS TO IMPROVE ACCESS TO FEEDBACK FROM NON-ENGLISH SPEAKING PATIENTS. 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 BLOOMSBURG HOSPITAL TACTICS: . ENDORSE THE USE OF 988 SUICIDE LINE. . DEVELOPMENT AND DEPLOYMENT OF COMMUNITY TRAINING PROGRAMS FOR MENTAL HEALTH. 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 BLOOMSBURG HOSPITAL TACTICS: . COMPLETION OF A BEHAVIORAL HEALTH EDUCATION NEEDS ASSESSMENT WITH THE INSTITUTE PA. . INCREASE COLLABORATION WITH CMSU TO SUPPORT PEDIATRIC PATIENTS. . PARTNER WITH LOCAL EDUCATIONAL INSTITUTIONS TO EDUCATE STUDENTS ON THE IMPORTANCE OF MENTAL HEALTH. . REORGANIZE OUTPATIENT SERVICES TO CREATE ONSITE AND VIRTUAL RESOURCES DEDICATED TO COLUMBIA/MONTOUR COUNTIES. 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 BLOOMSBURG HOSPITAL TACTICS: . HIRING OF CERTIFIED RECOVERY SPECIALISTS AND/OR PEER SUPPORT TO AUGMENT THE PROVIDER TEAMS AND FURTHER ENHANCE THE CARE OF THE TEAMS. FACILITY 1, GEISINGER-BLOOMSBURG HOSPITAL - 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, GEISINGER-BLOOMSBURG HOSPITAL - 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, GEISINGER-BLOOMSBURG HOSPITAL - 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 $2,224,662 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 CENTRAL REGION OF PENNSYLVANIA. THE CENTRAL REGION IS COMPRISED OF SIX RURAL PENNSYLVANIA COUNTIES: COLUMBIA, MONTOUR, NORTHUMBERLAND, SCHUYLKILL, SNYDER, AND UNION. THE CENTER FOR RURAL PENNSYLVANIA DEFINES A COUNTY AS RURAL WHEN POPULATION DENSITY, OR THE NUMBER OF PEOPLE PER SQUARE MILE WITHIN THE COUNTY, IS FEWER THAN 291. NORTHUMBERLAND AND SCHUYLKILL COUNTIES ARE THE MOST POPULATION DENSE (206 AND 190, RESPECTIVELY) COUNTIES. OTHER CENTRAL REGION COUNTIES HAVE SIMILAR POPULATION DENSITY OF 121 TO 142. OUR COMMUNITY AND RESIDENTS CONSISTENT WITH PENNSYLVANIA OVERALL, THE CENTRAL REGION IS AGING, WITH A SIGNIFICANT INCREASE IN THE NUMBER OF OLDER ADULTS FROM 2010 TO 2021 IN ALL COUNTIES. IN CONTRAST, THE YOUTH POPULATION DECLINED ACROSS ALL COUNTIES BY AN AVERAGE OF APPROXIMATELY 7% FROM 2010 TO 2021. MONTOUR AND SNYDER COUNTIES WERE THE ONLY COUNTIES TO SEE POPULATION GROWTH, ALTHOUGH GROWTH WAS MODEST AT AN ESTIMATED <2%. MONTOUR, NORTHUMBERLAND, AND SCHUYLKILL ARE AMONG THE OLDEST COUNTIES IN THE REGION; APPROXIMATELY ONE IN FIVE RESIDENTS ARE AGED 65 OR OLDER AND MEDIAN AGES ARE NEARLY THREE YEARS OLDER THAN THE STATE MEDIAN. IT IS WORTH NOTING THAT THE POPULATION OF RESIDENTS AGED 65 OR OLDER OUTPACES THE NATIONAL ESTIMATE OF 16% IN NEARLY ALL ZIP CODES ACROSS THE REGION. CENTRAL REGION COUNTIES ARE MAJORITY WHITE COMMUNITIES WITH LESS RACIAL DIVERSITY THAN STATE AND NATIONAL BENCHMARKS. UNION COUNTY BENEFITS FROM THE MOST POPULATION DIVERSITY WITH 13% OF RESIDENTS IDENTIFYING WITH A RACE OTHER THAN WHITE AND 6% IDENTIFYING AS LATINX (ANY RACE). UNION COUNTY IS HOME TO THE LEWISBURG PENITENTIARY, A FEDERAL FACILITY WITH AN ESTIMATED INMATE POPULATION OF 1,284. POPULATION DIVERSITY AND SOCIOECONOMIC DISPARITIES BETWEEN RACIAL GROUPS IN UNION COUNTY REFLECT, IN PART, DEEPER INSTITUTIONAL INEQUITIES. AVAILABLE DATA PROVIDED BY THE SENTENCING PROJECT REVEAL THAT BLACK AMERICANS ARE IMPRISONED AT A RATE THAT IS ROUGHLY FIVE TIMES THE RATE OF WHITE AMERICANS. LATINX INDIVIDUALS ARE INCARCERATED IN STATE PRISONS AT A RATE THAT IS 1.3 TIMES THE INCARCERATION RATE OF WHITES. CONSISTENT WITH STATE AND NATIONAL TRENDS, POPULATION DIVERSITY IS INCREASING WITHIN THE REGION, THOUGH ONLY MARGINALLY. MONTOUR COUNTY EXPERIENCED A FOUR-PERCENTAGE POINT DECLINE IN THE WHITE POPULATION FROM 2010 TO 2021, THE LARGEST OF ANY COUNTY IN THE REGION. INCOME AND WORK ALL CENTRAL REGION COUNTIES HAVE LOWER MEDIAN HOUSEHOLD INCOMES THAN STATE AND NATIONAL MEDIANS, ALTHOUGH COUNTY-WIDE POVERTY LEVELS ARE ONLY ELEVATED IN COLUMBIA (15% COMPARED TO 12% AND 13% RESPECTIVELY). COLUMBIA AND SCHUYLKILL COUNTIES HAVE THE HIGHEST PERCENTAGES OF CHILDREN IN POVERTY, OUTPACING THE STATE AND THE NATION, AT 18% AND 19% RESPECTIVELY. OVERALL, DESPITE A DRAMATIC UPTICK IN UNEMPLOYMENT RATES AT THE HEIGHT OF THE COVID-19 PANDEMIC, UNEMPLOYMENT RATES ARE DOWN, LOWER EVEN THAN PRE-PANDEMIC LEVELS IN MOST PLACES. HOWEVER, REPORTS OF FINANCIAL HARDSHIP REMAIN. ALICE AND POVERTY DATA DEMONSTRATE THAT ALTHOUGH PEOPLE ARE WORKING, MANY STILL DO NOT HAVE ENOUGH MONEY TO MEET THEIR BASIC NEEDS, OR TO DO SO WITHOUT THE FEAR OF AN UNEXPECTED EXPENSE. THE PERCENTAGE OF PEOPLE IN THE REGION EXPERIENCING POVERTY CONTINUED A SLOW, DOWNWARD TREND, BUT ALICE HOUSEHOLDS HAVE INCREASED. WHEN ANALYZED BY ZIP CODE, POCKETS OF HIGH POVERTY ARE LARGELY SEEN WITHIN NORTHUMBERLAND AND SCHUYLKILL COUNTIES. CHILDREN ARE HISTORICALLY DISPROPORTIONATELY AFFECTED BY POVERTY, AND WITHIN COMMUNITIES INCLUDING SHAMOKIN, MOUNT CARMEL, MAHANOY CITY, SHENANDOAH, AND GIRARDVILLE, APPROXIMATELY ONE-THIRD TO NEARLY HALF OF 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. UNION COUNTY HAS THE MOST SIGNIFICANT SOCIOECONOMIC DISPARITIES BETWEEN RACIAL GROUPS; ONLY 10% OF WHITE RESIDENTS LIVE IN POVERTY COMPARED TO 42% OF BLACK RESIDENTS AND A STAGGERING 78% OF LATINX RESIDENTS. THIS DISPARITY REFLECTS, IN PART, THE INMATE POPULATION AT THE LEWISBURG PENITENTIARY. EDUCATION HIGH SCHOOL GRADUATION IS ONE OF THE STRONGEST PREDICTORS OF LONGEVITY AND ECONOMIC STABILITY. WITHIN CENTRAL REGION COMMUNITIES, APPROXIMATELY 89% OF ADULTS GRADUATED HIGH SCHOOL, A SLIGHTLY LOWER PROPORTION THAN THE STATE OVERALL. OUTSIDE OF MONTOUR COUNTY, 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, CENTRAL REGION RESIDENTS ARE 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 HOME OWNERSHIP POSSIBLE. THE CENTRAL REGION IS NO EXCEPTION TO THESE TRENDS. SCHUYLKILL AND SNYDER COUNTIES HAVE THE HIGHEST PERCENTAGE OF HOMEOWNERS AND BOAST THE LOWEST PERCENTAGES OF COST-BURDENED HOMEOWNERS, MEANING THAT HOUSING COSTS ARE RELATIVELY AFFORDABLE; HOWEVER, APPROXIMATELY 20% OF HOMEOWNERS AND ONE-THIRD OR MORE OF RENTERS IN THESE COUNTIES STILL MEET THE CRITERIA OF BEING COST-BURDENED. 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 CENTRAL REGION HAVE DEMONSTRATED RESILIENCE IN PRIORITIZING PHYSICAL ACTIVITY. MONTOUR, NORTHUMBERLAND, AND SNYDER COUNTIES ARE FAR BELOW COLUMBIA AND UNION 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 CENTRAL REGION IN 2021, APPROXIMATELY 1 IN 10 RESIDENTS WERE ESTIMATED TO BE FOOD INSECURE. PART VI, LINE 4 - COMMUNITY INFORMATION (CONT.) THE PERCENTAGE OF CHILDREN WHO EXPERIENCE FOOD INSECURITY OUTPACES THAT FOR ADULTS, BUT THE PERCENTAGE OF CHILDREN EXPERIENCING FOOD INSECURITY DECLINED MORE RAPIDLY IN RECENT YEARS THAN THE PERCENTAGE OF ALL RESIDENTS. THIS FINDING OFFERS THE HOPEFUL IMPLICATION THAT CHILDREN ARE BEING REACHED EVEN MORE WITH THE SERVICES THEY NEED. EFFORTS TO REACH RESIDENTS MAY HAVE BEEN HELPED BY THE PANDEMIC EXPERIENCE, WHICH INCREASED RECOGNITION OF PEOPLE'S WIDESPREAD STRUGGLES TO MEET BASIC NEEDS AND INCREASED AVAILABILITY AND AWARENESS OF RESOURCES TO MEET THOSE NEEDS. IT IS WORTH NOTING DISPARITIES AMONG INDIVIDUALS WITH LOW INCOME LIVING IN UNION COUNTY. UNION COUNTY OVERALL HAS A SIMILAR PROPORTION OF RESIDENTS LIVING IN POVERTY AND/OR EXPERIENCING FOOD INSECURITY AS NEIGHBORING COMMUNITIES, BUT APPROXIMATELY 11% OF RESIDENTS WITH LOW INCOME DO NOT LIVE CLOSE TO A GROCERY STORE, THE HIGHEST PROPORTION IN THE REGION. UNION COUNTY'S RURAL STATUS LIKELY CONTRIBUTES TO RESIDENTS' - INCLUDING LOW-INCOME RESIDENTS' - DISTANCE FROM GROCERY STORES, COMPOUNDING HEALTH AND FINANCIAL HARDSHIPS. 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. RESIDENTS OF THE CENTRAL REGION GENERALLY HAVE SLIGHTLY LOWER DIGITAL ACCESS AS COMPARED TO STATE AND NATIONAL BENCHMARKS. HOWEVER, DEEPER ANALYSIS REVEALS THAT IN SOME SMALLER COMMUNITIES, FEWER THAN 65% OF RESIDENTS HAVE RELIABLE INTERNET ACCESS. IN DEWART IN DELAWARE TOWNSHIP, NORTHUMBERLAND COUNTY, ONLY 22% OF RESIDENTS HAVE RELIABLE INTERNET ACCESS. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH 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. 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 RGANIZATION 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. 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 EVP, CFO, TREASURER 0 1749843 0 525000 0 410250 0 24306 0 41926 0 2751325 0 0 STEVEN B BENDER ESQ EVP, CLO, SECRETARY 0 708600 0 0 0 197215 0 209306 0 35061 0 1150182 0 167904 RONALD BEER MHA DIRECTOR 0 464048 0 75000 0 336987 0 73699 0 42593 0 992327 0 48140 GERALD V MALONEY DO DIRECTOR 0 720238 0 0 0 115132 0 98569 0 35257 0 969196 0 62504 MICHAEL FITZPATRICK MD CMO 0 528524 0 0 0 29432 0 24306 0 34953 0 617215 0 0 ROBERT L LOZO MD FORMER 5 HIGHEST 0 402461 0 938 0 31320 0 24306 0 40485 0 499510 0 0 LORI R GRAMLEY ESQ ACLO, ASSISTANT SECRETARY 0 338553 0 0 0 28526 0 24306 0 27947 0 419332 0 0 ROSEMARY LEEMING MD FORMER OFFICER 0 273264 0 1750 0 24857 0 21227 0 29472 0 350570 0 0 SHAOHUA XU MD PHD FORMER 5 HIGHEST 0 253905 0 938 0 13604 0 17492 0 39481 0 325420 0 0 COLLEEN EDDINGER RN INPATIENT RN 160444 0 13407 0 4128 0 9189 0 15197 0 202365 0 0 0 JEREMY R SCOTT PHARMD MANAGER, PHARMACY 138968 0 0 0 4808 0 7575 0 43596 0 194947 0 0 0 NANCY NUSS RN INPATIENT RN 121654 0 4358 0 12849 0 6851 0 41706 0 187418 0 0 0 LORA FITCH RN CLINICAL TEAM COORDINATOR, RN 131465 0 236 0 5368 0 7075 0 40137 0 184281 0 0 0 RAYANNE M ALLEN RN INPATIENT RN CEP 135744 0 7081 0 8386 0 7274 0 13571 0 172056 0 0 0 STEPHEN J PAOLUCCI MD FORMER OFFICER 0 0 0 0 0 169395 0 0 0 0 0 169395 0 41170 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 STEPHEN J. PAOLUCCI, MD 0 169,395 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. 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 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. 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, 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 - 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 15B - COMPENSATION PROCESS FOR OFFICERS SEE SCHEDULE O RESPONSE TO FORM 990, PART VI, SECTION B, QUESTION 15A. 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 XI, LINE 9 - OTHER CHANGES IN NET ASSETS EXPLANATION GAIN ON EXTINGUISHMENT OF DEBT $ 3,489,427 TRANSFER FROM PARENT, GEISINGER HEALTH $ 24,000 TRANSFER TO PARENT, GEISINGER HEALTH $ -12,000,000 ROUNDING $ -4 TOTAL $ -8,486,577 FORM 990, PART XII, LINE 3A 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. 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 - 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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 false true true false false true false false false Geisinger Assurance Company LTD P 845700 GAAP Geisinger Clinic A 777356 FMV Geisinger Clinic L 356812 GAAP Geisinger Clinic M 3043549 GAAP Geisinger Health B 12000000 GAAP Geisinger Health M 83075 GAAP Geisinger Health Plan L 14038484 GAAP Geisinger Indemnity Insurance Company L 2437580 GAAP Geisinger Insurance Corporation RRG P 949068 GAAP Geisinger Medical Center A 96122 FMV Geisinger Medical Center M 2258907 GAAP Geisinger Pharmacy LLC M 86869 GAAP Geisinger Quality Options Inc L 1141327 GAAP Geisinger System Services A 66397 FMV Geisinger System Services M 10652803 GAAP ISS Solutions Inc M 180304 GAAP SCHEDULE R, PART V - TRANSACTIONS WITH RELATED ORGANIZATIONS AS SHOWN IN FORM 990, SCHEDULE R, GEISINGER-BLOOMSBURG HOSPITAL 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 INTERORGANIZATION TRANSACTIONS PROMOTE THE EFFICIENT OPERATION OF THE VARIOUS ORGANIZATIONS AND THE ATTAINMENT OF THEIR TAX-EXEMPT PURPOSES. THESE TYPES OF INTER ORGANIZATIONAL 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 LETTER RULINGS AS BEING ENTIRELY CONSISTENT WITH THE ORGANIZATION'S TAX-EXEMPT STATUS.