2024-11-15T15:56:41-05:00 2023-12-31 920460586 PWC US TAX LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2023-01-01 851226106 GEISINGER MEDICAL CENTER MUNCY GEIS 5702716624 100 N ACADEMY AVE MC 49-70 DANVILLE PA 178229800 SPENCER KOWAL TREASURER, DIRECTOR 5702716624 2024-11-14 false ROBERT W FRIZ P00438748 2673303000 2024-11-15 2023 2024-10-15 13:58:12Z KAREN MURPHY RN PHD 100 N ACADEMY AVE MC 22-01 DANVILLE PA 178229800 60104821 false X WWW.GEISINGER.ORG X 2020 PA GEISINGER MEDICAL CENTER MUNCY STRIVES TO MAKE BETTER HEALTH EASIER IN THE COMMUNITIES IT SERVES BY PROVIDING ACCESS TO AFFORDABLE, QUALITY HEALTH SERVICES THROUGH AN INNOVATIVE MODEL OF CARE AND..........SEE SCHEDULE O 9 0 0 2 0 0 37588211 59348757 227 67 169378 272420 37757816 59621244 0 0 0 0 0 52785128 68293061 52785128 68293061 -15027312 -8671817 108332555 111026726 40051584 51417572 68280971 59609154 X GEISINGER MEDICAL CENTER MUNCY STRIVES TO MAKE BETTER HEALTH EASIER IN THE COMMUNITIES IT SERVES BY PROVIDING ACCESS TO AFFORDABLE, QUALITY HEALTH SERVICES THROUGH AN INNOVATIVE MODEL OF CARE AND COVERAGE BASED ON A BALANCED PROGRAM OF PATIENT AND MEMBER CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE. false false 64443141 59446282 I. GENERAL INFORMATION GEISINGER MEDICAL CENTER MUNCY, (GMCM), A 501(C )(3) NOT-FOR-PROFIT CORPORATION OWNS AND OPERATES A 20 BED ACUTE CARE HOSPITAL IN MUNCY, PA. GMCM BEGAN SEEING PATIENTS JANUARY 10, 2022. GMCM IS MAKING BETTER HEALTH EASIER FOR LYCOMING COUNTY AND THE SURROUNDING AREA. IN ADDITION TO BEING A FULL-SERVICE HOSPITAL, THE NEW FACILITY BRINGS CARE CLOSER TO HOME BY CENTRALIZING SERVICES, LESSENING TRAVEL TIME FOR PATIENTS WHO WENT TO LARGER MEDICAL FACILITIES FOR THEIR CARE. THE 120,000-SQUARE FOOT, THREE-STORY FACILITY IS A 100 MILLION+ INVESTMENT IN MUNCY AND THE SURROUNDING COMMUNITIES AND IS PART OF THE CLINICAL JOINT VENTURE FORMED BY GEISINGER AND HIGHMARK HEALTH IN 2019. FEATURING AN EMERGENCY ROOM, CLINICAL DECISION UNIT, ACUTE CARE UNIT, SURGICAL SUITES AND PRIMARY AND SPECIALTY CARE AREAS, GEISINGER MEDICAL CENTER MUNCY IS DESIGNED TO MEET THE ROUTINE AND ACUTE CARE NEEDS OF THOSE LIVING IN LYCOMING, SULLIVAN, CLINTON AND TIOGA COUNTIES. THE HOSPITAL'S 20 INPATIENT ROOMS ARE OUTFITTED WITH DIGITAL WHITE BOARDS DISPLAYING REAL-TIME HEALTH INFORMATION TO BETTER COORDINATE CARE. THE WHITE BOARDS SERVE AS A CENTRALIZED INFORMATION HUB THAT CAN BE CONNECTED ACROSS SEVERAL DEVICES AND WILL BE ACCESSIBLE TO THE PATIENT, FAMILY AND CARE TEAM. MESSAGING CAPABILITIES STREAMLINE INTERACTIONS WHILE IMPROVING COMMUNICATION ABOUT THE HOSPITAL STAY AND PROVIDING PATIENTS WITH PERSONALIZED HEALTH INFORMATION AND EDUCATIONAL CONTENT. FOR ROUTINE CARE, THE FACILITY INCLUDES A MULTISPECIALTY CLINIC WITH ADULT AND PEDIATRIC PRIMARY CARE, ORTHOPAEDICS, CARDIOLOGY, OPHTHALMOLOGY, PULMONARY SERVICES AND WOMEN'S HEALTH SERVICES. ALSO AVAILABLE ARE IMAGING AND LAB SERVICES, MEDICAL ONCOLOGY SERVICES, CHEMOTHERAPY AND INFUSIONS, GENERAL SURGERY SERVICES. ADULT AND PEDIATRIC PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY SERVICES ARE ALSO PROVIDED. II. MAJOR PROGRAM SERVICES SERVICES OFFERED BY GMCM: -ADULT AND PEDIATRIC PRIMARY CARE -DERMATOLOGY -PHARMACY -IMAGING -INPATIENT UNIT -LAB SERVICES -EMERGENCY ROOM -INFUSIONS -MEDICATION THERAPY MANAGEMENT -PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY -PULMONOLOGY -SPECIALTY CLINICS INCLUDING: CARDIOLOGY EYE CARE HEMATOLOGY AND ONCOLOGY PODIATRY GASTROENTEROLOGY SURGERY ORTHOPAEDICS WOMEN'S HEALTH SERVICES -TELEMEDICINE -UROLOGY III. PROGRAM SERVICE ACCOMPLISHMENTS UNCOMPENSATED CARE GMCM RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. GMCM PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, RELIGION, ETHNICITY, SEXUAL ORIENTATION, GENDER IDENTIY, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD, GMCM 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 GMCM PRACTICES. A. CHARITY CARE THE PRIMARY CONCERN OF GMCM IS THE DELIVERY OF HEALTH CARE TO ALL THE CITIZENS IN ITS PENNSYLVANIA SERVICE AREA, REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GMCM INCURRED BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO COULD NOT AFFORD TO PAY. FOR THE YEAR ENDED DECEMBER 31, 2023, THE COST OF CHARITY CARE WAS 914,189. B. MEDICARE/MEDICAID AND OTHER GOVERNMENTAL PROGRAMS RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO THE ELDERLY (MEDICARE) AND THE POOR (MEDICAID). GMCM PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS. TO THE EXTENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTHCARE, GMCM IS FURTHERING ITS MISSION TO THE ENTIRE COMMUNITY. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT OF REIMBURSEMENT RECEIVED UNDER THE PROGRAM. FOR THE YEAR ENDED DECEMBER 31, 2023, THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 15,797,604. III. COMMUNITY HEALTH, EDUCATION, AND OUTREACH GMCM STRIVES TO BE A VALUABLE RESOURCE FOR THE COMMUNITY AND ITS RESIDENTS. GMCM 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 ACTIVITIES GMCM PROVIDED TRANSPORTATION FOR INDIGENT PATIENTS AT A COST OF 95,692. B.HEALTH PROFESSIONS EDUCATION GMCM PROVIDED 34,081 IN SUPERVISION OF NURSING AND PHARMACY STUDENTS COMPLETING ROTATIONS AS PART OF THEIR STUDIES DURING THE YEAR ENDED DECEMBER 31, 2023. C. VOLUNTEER SERVICES IT IS ANTICIPATED, THE VOLUNTEERS OF GEISINGER MEDICAL CENTER MUNCY WILL BE AN ACTIVE AND VITAL PART OF THE ACTIVITIES OF THE HOSPITAL. THE HOURS OF VOLUNTEER SERVICES ARE AN IMPORTANT CONTRIBUTION TO THE MISSION OF GMCM. DURING ITS START-UP YEAR, VOLUNTEERS FROM LOCAL COMMUNITIES CONTRIBUTED 10 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTHCARE OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION OF 318 IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND "WELLNESS" PROGRAMS. IV. COMMUNITY BENEFITS SUMMARY CHARITY CARE 914,189 MEDICARE/MEDICAID/OTHER GOVERNMENTAL 15,797,604 COMMUNITY HEALTH, EDUCATION, AND OUTREACH 129,773 VOLUNTEER SERVICES (VALUED AT 01/01/2023 PA STATEWIDE AVERAGE WEEKLY WAGE) 318 TOTAL 16,841,884 V. STATISTICAL SUMMARY DISCHARGES 1,284 AVERAGE LENGTH OF STAY 2.9 PERCENT OF OCCUPANCY 50.1% PATIENT DAYS 3,660 TOTAL OR CASES 2,401 OUTPATIENT VISITS (INCLUDES OUTPATIENT ER VISITS) 59,098 OUTPATIENT EMERGENCY ROOM VISITS 15,039 BEDS 20 64443141 true false false true false false false false false false 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 true true true false true X 0 0 true 0 true true false false false false false false false false false false false X 9 0 true false false false true true true true true false false true true true true true true true true false PA X ERIN FITZGERALD CPA VP AND CAO 5702142299 100 N ACADEMY AVE MC 49-70 DANVILLE PA 178229800 JAEWON RYU MD JD DIRECTOR 40.00 X 0 5492112 1571914 MATTHEW WALSH CHAIR, PRES. 40.00 X X 0 1500068 314234 GERALD V MALONEY DO DIRECTOR 40.00 X 0 815329 127061 SPENCER KOWAL TREASURER, D 40.00 X X 0 747984 140684 TRACEY W WOLFE MHA DIRECTOR 40.00 X 0 613738 76731 JEFFREY J ADAMS DIRECTOR 40.00 X 0 481446 98126 JASON SCHAUER MD DIRECTOR 40.00 X 0 461209 57412 MATTHEW VAN LEEUWE DIRECTOR 40.00 X 0 416413 71450 TAMMY ANDERER CRNP PHD SECRETARY, D 40.00 X X 0 300866 37766 JACQUELINE HOLDER DO MBA DIRECTOR 0.25 X 0 0 0 10829165 2495378 false true false WHITE & WILLIAMS LLP 1650 MARKET STREET SUITE 1800 PHILADELPHIA PA 191037395 LEGAL SERVICES 1056613 HCSC PO BOX 8016 LANCASTER PA 17601 LAUNDRY SERVICE 249725 JAFFE RAITT HEUER & WEISS PROF CORP 277777 FRANKLIN RD SUITE 2500 SOUTHFIELD MI 48034 LEGAL SERVICES 164440 QUEST DIAGNOSTICS PO BOX 912512 PASADENA CA 91110 MEDICAL TESTING 156330 ETTINGERS LANDSCAPING 2345 WARRENSVILLE ROAD MONTOURSVILLE PA 17754 LANDSCAPING 126864 6 PATIENT HEALTHCARE 621110 58403346 58403346 RENTAL INCOME 531120 930475 930475 INTERCOMPANY REVENUE 541900 14936 14936 59348757 67 67 483577 483577 CAFE SALES 722514 167880 167880 PURCHASE DISCOUNTS 900099 97525 97525 VENDING COMMISSIONS 900099 6218 6218 797 797 272420 59621244 58515807 1105437 X 2729290 2722540 6750 161 161 17744 4748 12996 22233536 21524587 708949 1560210 1472616 87594 45046 43777 1269 1252850 1142247 110603 50468 45617 4851 8039106 7755561 283545 278623 256044 22579 MEDICAL SUPPLIES 20960483 20959957 526 INTERCOMPANY EXPENSE 10424264 7824892 2599372 MA MODERNIZATION FEES 647537 647537 BOOKS, LICENSES, DUES 53445 43018 10427 298 298 68293061 64443141 3849920 0 X 3218865 2134672 5049929 5104181 2252025 1903262 298190 98560 117004762 16352664 96405339 100652098 1108207 1133953 108332555 111026726 191141 204491 30424 27669 39830019 51185412 40051584 51417572 X 68280971 59609154 68280971 59609154 108332555 111026726 -8671817 X X false true X true false X false false false false false false false false true 161 161 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. 2590132 2590132 35934378 3732073 32202305 70302034 12558178 57743856 8178218 62413 8115805 100652098 DUE TO AFFILIATES 50284379 THIRD PARTY LIABILITIES 737272 ACCOUNTS RECEIVABLE CREDIT BALANCES 163761 51185412 SCHEDULE D, PAGE 4, PART XIII PART X, LINE 2 - LIABILITY FOR UNCERTAIN TAX POSITIONS EFFECTIVE JULY 1, 2007, GEISINGER ADOPTED ACCOUNTING STANDARDS CODIFICATION 740 (FIN 48), (FORMERLY KNOWN AS "STATEMENT 109: ACCOUNTING FOR INCOME TAXES- OR "FAS 109"). FIN 48 CLARIFIES THE ACCOUNTING AND REPORTING FOR INCOME TAXES WHERE INTERPRETATION OF THE TAX LAW MAY BE UNCERTAIN. FIN 48 PRESCRIBES A COMPREHENSIVE MODEL FOR THE FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, PRESENTATION AND DISCLOSURE OF INCOME TAX UNCERTAINTIES WITH RESPECT TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN INCOME TAX 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 3.000000000000 false true true true false true true 914189 914189 0.01340 10494355 4639150 5855205 0.08570 555271 331975 223296 0.00330 11963815 4971125 6992690 0.10240 129773 129773 0.00190 129773 129773 0.00190 12093588 4971125 7122463 0.10430 true 7850278 15468248 -7617970 X true true 1 1 GEISINGER MEDICAL CENTER MUNCY 255 US-220 MUNCY PA 17756 WWW.GEISINGER.ORG 50730101 X X X GEISINGER MEDICAL CENTER MUNCY 1 true true false false true X 300.000000000000 X X X X X true true X X X X true X WWW.GEISINGER.ORG - REFER TO SECTION C X WWW.GEISINGER.ORG - REFER TO SECTION C X WWW.GEISINGER.ORG - REFER TO SECTION C X X X X X X X true X false X X X X X true X false false FACILITY 1, GEISINGER MEDICAL CENTER MUNCY - PART V, LINE 2 GEISINGER MEDICAL CENTER MUNCY WAS FORMED ON JUNE 11, 2020 AND WAS ISSUED AN IRS DETERMINATION LETTER ON JULY 27, 2022 WITH AN EXEMPTION EFFECTIVE DATE OF JUNE 11, 2020. GEISINGER MEDICAL CENTER MUNCY WAS LICENSED AS A HOSPITAL BY THE STATE OF PENNSYLVANIA ON JANUARY 5, 2022. FACILITY 1, GEISINGER MEDICAL CENTER MUNCY - 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 MEDICAL CENTER MUNCY - 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 MEDICAL CENTER MUNCY - PART V, LINE 20E REFER TO RESPONSE FOR PART III, LINE 9B SCHEDULE H, PART I, LINE 3C SUPPORTING DOCUMENTATION FOR ELIGIBILITY MAY CONSIST OF INCOME AND ASSET INFORMATION, INCLUSIVE BUT NOT LIMITED TO: FEDERAL INCOME TAX FORM 1040 FROM THE PRIOR YEAR, PAY STUB COPIES, WRITTEN VERIFICATION OF ANY OTHER INCOME RECEIVED (I.E. SOCIAL SECURITY, ADC, CHILD SUPPORT, ALIMONY, ETC.), CURRENT CREDIT REPORTS AND ASSET VERIFICATION. THE HOSPITAL MAY ALSO UTILIZE INDUSTRY TESTED EXTERNAL ANALYTICAL TOOLS TO QUALIFY PATIENTS FOR UNCOMPENSATED CARE (AKA PRESUMPTIVE CHARITY). GEISINGER PROVIDERS, WITHOUT DISCRIMINATION, CARE FOR ALL EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF THEIR FINANCIAL ASSISTANCE ELIGIBILITY OR ABILITY TO PAY. IT IS THE POLICY OF GEISINGER HOSPITAL FACILITIES TO COMPLY WITH THE STANDARDS OF THE FEDERAL EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR TRANSPORT ACT OF 1986 ("EMTLA") AND REGULATIONS IN PROVIDING MEDICAL SCREENING EXAMINATION AND SUCH FURTHER TREATMENT AS MAY BE NECESSARY TO STABILIZE AN EMERGENCY MEDICAL CONDITION FOR ANY INDIVIDUAL PRESENTING TO THE EMERGENCY DEPARTMENT SEEKING TREATMENT. SCHEDULE H, PART I, LINE 6A COMMUNITY BENEFIT REPORT: A COMMUNITY BENEFIT REPORT IS PROVIDED BY THE HOSPITAL AND ITS RELATED CHARITABLE ORGANIZATIONS TO THE GEISINGER HEALTH FINANCE COMMITTEE EACH YEAR. SCHEDULE H, PART I, LINE 7G THERE ARE NO PHYSICIAN CLINICAL SERVICES INCLUDED IN SUBSIDIZED HEALTH SERVICES. SCHEDULE H, PART I, LINE 7 A COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE COSTS REPORTED ON LINE 7 AND ADDRESSED PATIENT SEGMENTS BY PAYOR (E.G. MEDICARE, MEDICAID, COMMERCIAL PAYERS, SELF-PAY, ETC.). A COST TO CHARGE RATIO, CALCULATED PURSUANT TO WORKSHEET 2 OF THE FORM 990 INSTRUCTIONS, WAS USED TO CALCULATE THE COST OF CHARITY CARE. SCHEDULE H, PART III, LINE 4 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. AMOUNTS RECOGNIZED DUE TO CHANGES IN ESTIMATES OF EXPLICIT AND IMPLICIT PRICE CONCESSIONS FOR THE YEARS ENDED DECEMBER 31, 2023 AND 2022 ARE NOT SIGNIFICANT. 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, 2023 AND 2022 RELATED TO PATIENT SERVICE REVENUE. SCHEDULE H, PART III, LINE 8 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) SHOULD BE REPORTED AS COMMUNITY BENEFIT ON FORM 990, SCHEDULE H, PART I, LINE 7. THIS ORGANIZATION AGREES WITH THE AHA'S LETTER TO THE IRS DATED AUGUST 21, 2007 RESPONDING TO A DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA ARGUED THAT MEDICARE UNDERPAYMENTS (SHORTFALLS) IS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: -PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS REMAINS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. -MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES ONLY 92 CENTS FOR EVERY DOLLAR HOSPITALS SPEND TO CARE FOR MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION ("MEDPAC") IN ITS MARCH 2007 REPORT TO CONGRESS CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE, WITH MARGINS REACHING A 10 YEAR LOW AT NEGATIVE 5.4 PERCENT. -MANY MEDICARE PATIENTS, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46% OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200% OF THE FEDERAL POVERTY LEVEL. MANY ARE ALSO ELIGIBLE FOR MEDICAID, SO CALLED -DUAL ELIGIBLES". PENNSYLVANIA REQUIRES NON-PROFIT HOSPITALS TO PROVIDE A MINIMUM LEVEL OF COMMUNITY BENEFIT TO RETAIN EXEMPTION FROM STATE AND LOCAL TAXES. ACCORDING TO STATE GUIDANCE AND CASE LAW, THE UNREIMBURSED COST OF MEDICARE AND BAD DEBT IS CONSIDERED TO BE COMMUNITY BENEFIT FOR STATE TAX EXEMPTION PURPOSES. PART III, LINE 6 ONLY INCLUDES THOSE COSTS THAT ARE PERMITTED TO BE REPORTED IN THE HOSPITAL'S MEDICARE COST REPORT THAT IS REQUIRED TO BE FILED WITH THE FEDERAL GOVERNMENT. THE HOSPITAL CONSIDERS THE TOTAL MEDICARE UNDERPAYMENTS (SHORTFALL) OF 9,719,103 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. SCHEDULE H, PART III, LINE 9B THE HOSPITAL IS COMMITTED TO PROVIDING MEDICALLY NECESSARY SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND THE HOSPITAL'S COLLECTION ACTIONS ARE CONSISTENTLY APPLIED TO ALL PATIENTS. IT IS THE HOSPITAL'S POLICY TO PROVIDE FINANCIAL ASSISTANCE AND COUNSELING TO PATIENTS WITH LIMITED FINANCIAL MEANS. A PATIENT MAY BECOME ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING TREATMENT OR DURING THE CONTINUUM OF THE FINANCIAL/BILLING AND COLLECTION PROCESS. IN ANY STAGE OF THE BILLING PROCESS, COLLECTION ACTIONS ARE NOT PURSUED WHENEVER A PATIENT APPLIES AND IS BEING EVALUATED FOR FINANCIAL ASSISTANCE. UNDER NO CIRCUMSTANCES WILL THE HOSPITAL FREEZE OR ATTACH BANK ACCOUNTS OF A PATIENT, ENFORCE LIENS, ACTIVELY PURSUE ASSETS FROM A PRIOR JUDGMENT OR GARNISH THE WAGES OF A PATIENT AND/OR FAMILY MEMBER BEFORE DETERMINING IF THE PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. GEISINGER MANAGEMENT HAS DEVELOPED POLICIES AND PROCEDURES FOR INTERNAL AND EXTERNAL COLLECTION PRACTICES THAT TAKE INTO ACCOUNT THE EXTENT TO WHICH THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, A PATIENT'S GOOD FAITH EFFORT TO APPLY FOR GOVERNMENTAL PROGRAMS OR FINANCIAL ASSISTANCE FROM GEISINGER AND A PATIENT'S GOOD FAITH EFFORT TO COMPLY WITH HIS OR HER PAYMENT AGREEMENTS. BILLING AND COLLECTION POLICY: THE BILLING AND COLLECTION POLICY IS ADMINISTERED IN ACCORDANCE WITH THE MISSION AND VALUES OF THE HOSPITAL AS WELL AS FEDERAL AND STATE LAW. THE POLICY IS DESIGNED TO PROMOTE APPROPRIATE ACCESS TO MEDICAL CARE FOR ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY WHILE MAINTAINING GEISINGER'S FISCAL RESPONSIBILITY TO MAXIMIZE REIMBURSEMENT AND MINIMIZE BAD DEBT. THE ORGANIZATION'S BILLING AND COLLECTION POLICY IS INTENDED TO TAKE INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. THE ORGANIZATION MAKES SURE THAT PATIENTS ARE ASSISTED IN OBTAINING HEALTH INSURANCE COVERAGE FROM PRIVATELY AND PUBLICLY FUNDED SOURCES, WHENEVER POSSIBLE. ALL BUSINESS OFFICE CUSTOMER SERVICE DEPARTMENT REPRESENTATIVES ARE EDUCATED ON ALL ASPECTS OF THE BILLING AND COLLECTION POLICY AND ARE EXPECTED TO ADMINISTER THE POLICY ON A REGULAR AND CONSISTENT BASIS. BUSINESS OFFICE CUSTOMER SERVICE REPRESENTATIVES ARE HELD ACCOUNTABLE TO TREAT ALL PATIENTS WITH COURTESY, RESPECT, CONFIDENTIALITY AND CULTURAL SENSITIVITY. THE BILLING AND COLLECTION POLICY IS ADMINISTERED IN CONJUNCTION WITH THE PROCEDURES OUTLINED IN INTERNAL ADMINISTRATIVE POLICIES. THE GEISINGER EXECUTIVE VICE PRESIDENT, CHIEF FINANCIAL OFFICER AND VICE PRESIDENT, CHIEF REVENUE OFFICER HAVE OVERALL RESPONSIBILITY FOR THE BILLING AND COLLECTION ACTIVITIES OF THE HOSPITAL. THE BUSINESS OFFICE CUSTOMER SERVICE DEPARTMENT STAFF IS RESPONSIBLE FOR THE DAY-TO-DAY ENFORCEMENT OF APPROVED POLICIES AND PROCEDURES. GEISINGER MAY OFFER EXTENDED PAYMENT PLANS TO PATIENTS WHO ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR HOSPITAL BILLS. EMERGENCY & MEDICALLY NECESSARY SERVICES: GEISINGER DOES NOT ENGAGE IN ANY ACTIONS THAT DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE. THE ORGANIZATION WILL NEVER DEMAND THAT AN EMERGENCY DEPARTMENT PATIENT PAY BEFORE RECEIVING TREATMENT FOR EMERGENCY MEDICAL CONDITIONS. ADDITIONALLY, GEISINGER DOES NOT PERMIT DEBT COLLECTION ACTIVITIES IN THE EMERGENCY DEPARTMENT OR OTHER AREAS WHERE SUCH ACTIVITIES COULD INTERFERE WITH THE PROVISION OF EMERGENCY CARE ON A NONDISCRIMINATORY BASIS. ALL MEDICALLY NECESSARY HOSPITAL SERVICES ARE PROVIDED WITHOUT CONSIDERATION OF ABILITY TO PAY AND ARE NOT DELAYED PENDING APPLICATION OR APPROVAL OF MEDICAL ASSISTANCE OR THE GEISINGER FINANCIAL ASSISTANCE PROGRAM. ADVANCE PAYMENT IS NOT REQUIRED FOR ANY MEDICALLY NECESSARY SERVICES. COMPLIANCE WITH INTERNAL REVENUE CODE SECTION 501(R)(6): GEISINGER DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS ("ECAS") AS DEFINED BY INTERNAL REVENUE CODE SECTION 501(R)(6) PRIOR TO THE EXPIRATION OF THE NOTIFICATION PERIOD. THE NOTIFICATION PERIOD IS DEFINED AS A 120-DAY PERIOD OR GREATER, WHICH BEGINS ON THE DATE OF THE 1ST POST-DISCHARGE BILLING STATEMENT, IN WHICH NO ECAS ARE INITIATED AGAINST THE PATIENT. SUBSEQUENT TO THE NOTIFICATION PERIOD GEISINGER, OR ANY THIRD PARTIES ACTING ON ITS BEHALF, MAY INITIATE THE FOLLOWING ECAS AGAINST A PATIENT FOR AN UNPAID BALANCE IF THE FINANCIAL ASSISTANCE ELIGIBILITY DETERMINATION HAS NOT BEEN MADE OR IF AN INDIVIDUAL IS INELIGIBLE FOR FINANCIAL ASSISTANCE. GEISINGER MAY AUTHORIZE THIRD PARTIES TO REPORT ADVERSE INFORMATION ABOUT THE INDIVIDUAL TO CONSUMER CREDIT REPORTING AGENCIES OR CREDIT BUREAUS ON DELINQUENT PATIENT ACCOUNTS AFTER THE NOTIFICATION PERIOD. THE ORGANIZATION ENSURES REASONABLE EFFORTS HAVE BEEN TAKEN TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY AND ENSURES THE FOLLOWING ACTIONS ARE TAKEN AT LEAST 30 DAYS PRIOR TO INITIATING ANY ECA: 1) THE PATIENT IS PROVIDED WITH WRITTEN NOTICE WHICH: INDICATES THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR ELIGIBLE PATIENTS; IDENTIFIES THE ECA(S) THAT GEISINGER INTENDS TO INITIATE TO OBTAIN PAYMENT FOR THE CARE; AND STATES A DEADLINE AFTER WHICH SUCH ECAS MAY BE INITIATED. 2) THE PATIENT IS PROVIDED WITH A COPY OF THE PLAIN LANGUAGE SUMMARY; AND 3) REASONABLE EFFORTS ARE MADE TO ORALLY NOTIFY THE PATIENT ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND HOW THE INDIVIDUAL MAY OBTAIN ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. GEISINGER PROCESSES ALL APPLICATIONS FOR FINANCIAL ASSISTANCE SUBMITTED DURING THE APPLICATION PERIOD. THE APPLICATION PERIOD BEGINS ON THE DATE THE CARE IS PROVIDED AND ENDS ON THE 240TH DAY AFTER THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT. SCHEDULE H, PART VI, LINE 2 CHNA COLLABORATING HEALTH SYSTEMS THE 2021 GEISINGER COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED IN PARTNERSHIP WITH GEISINGER, ALLIED SERVICES INTEGRATED HEALTH SYSTEM, AND EVANGELICAL COMMUNITY HOSPITAL. THE STUDY AREA INCLUDED 15 COUNTIES ACROSS CENTRAL AND NORTHEASTERN PENNSYLVANIA, WHICH REPRESENTED THE HEALTH SYSTEMS' COLLECTIVE SERVICE AREAS. COLLABORATION IN THIS WAY CONSERVES VITAL COMMUNITY RESOURCES WHILE FOSTERING A PLATFORM FOR "COLLECTIVE IMPACT" THAT ALIGNS COMMUNITY EFFORTS TOWARD A COMMON GOAL OR ACTION. TO DISTINGUISH UNIQUE SERVICE AREAS AMONG HOSPITALS, REGIONAL RESEARCH AND REPORTING WAS DEVELOPED. 2021 CHNA GEOGRAPHIC REGIONS AND PRIMARY SERVICE COUNTIES 1- CENTRAL REGION INCLUDING THE COUNTIES OF COLUMBIA, MONTOUR, NORTHUMBERLAND, SCHUYLKILL, SNYDER AND UNION REPRESENTED BY GEISINGER- BLOOMSBURG HOSPITAL, GEISINGER MEDICAL CENTER (INCLUDES GEISINGER SHAMOKIN AREA COMMUNITY HOSPITAL), GEISINGER ENCOMPASS HEALTH LIMITED LIABILITY COMPANY (DBA GEISINER ENCOMPASS HEALTH REHABILITATION HOSPITAL) AND EVANGELICAL COMMUNITY HOSPITAL. 2- NORTH CENTRAL REGION INCLUDING THE COUNTIES OF CLINTON AND LYCOMING REPRESENTED BY GEISINGER JERSEY SHORE HOSPITAL AND GEISINGER MEDICAL CENTER MUNCY (LICENSED/OPERATIONAL JANUARY 2022) 3- NORTHEAST REGION INCLUDING THE COUNTIES OF LACKAWANNA, LUZERNE, WAYNE AND WYOMING REPRESENTED BY ALLIED SERVICES REHAB HOSPITAL, COMMUNITY MEDICAL CENTER (DBA GEISINGER COMMUNITY MEDICAL CENTER, GEISINGER WYOMING VALLEY MEDICAL CENTER (INCLUDES GEISINGER SOUTH WILKES-BARRE) AND HEINZ REHAB HOSPITAL. 4- WESTERN REGION INCLUDING THE COUNTIES OF CENTRE, JUNIATA AND MIFFLIN REPRESENTED BY GEISINGER-LEWISTOWN HOSPITAL. GEISINGER SYSTEMWIDE CHNA APPROACH THE 2021 CHNA FOCUSED ON THE PRIMARY SERVICE AREAS OF EACH OF GEISINGER'S NINE HOSPITAL CAMPUSES. UNDERSTANDING OVERLAPPING GEOGRAPHIC BOUNDARIES, SOCIOECONOMICS, AND RELATED COMMUNITY INDICATORS, GEISINGER HOSPITALS WERE GROUPED INTO REGIONS TO ALLOW FOR LOCALIZED DATA COMPARISONS. SYSTEMWIDE PRIORITIES WERE DETERMINED TO ADDRESS COMMON NEEDS ACROSS THE WHOLE SERVICE AREA, WHILE INDIVIDUAL HOSPITAL IMPLEMENTATION PLANS OUTLINED SPECIFIC STRATEGIES TO GUIDE LOCAL EFFORTS AND COLLABORATION WITH COMMUNITY PARTNERS. SCHEDULE H, PART VI, LINE 3 GEISINGER IS COMMITTED TO PROVIDING THE HIGHEST QUALITY HEALTHCARE SERVICES TO OUR COMMUNITY. GEISINGER IS COMMITTED TO A SERVICE EXCELLENCE PHILOSOPHY THAT STRIVES TO MEET OR EXCEED PATIENT EXPECTATIONS. ALL PATIENTS WILL RECEIVE A UNIFORM STANDARD OF CARE THROUGHOUT ALL GEISINGER FACILITIES, REGARDLESS OF SOCIAL, CULTURAL, FINANCIAL, RELIGIOUS, RACIAL, GENDER OR SEXUAL ORIENTATION. GEISINGER STRIVES TO ENSURE THAT ALL PATIENTS RECEIVE ESSENTIAL EMERGENCY AND OTHER MEDICALLY NECESSARY HEALTH SERVICES REGARDLESS OF THEIR ABILITY TO PAY. FOR URGENT AND EMERGENT SERVICES, PATIENTS ARE PROVIDED CARE REGARDLESS OF THEIR ABILITY TO PAY. IN THE EVENT A PATIENT HAS AN EMERGENCY MEDICAL CONDITION; TREATMENT IS NOT DELAYED TO PERMIT AN INQUIRY REGARDING A PATIENT'S METHOD OF PAYMENT OR INSURANCE STATUS. FOR OTHER THAN URGENT AND EMERGENT SERVICES, THE HOSPITAL PROVIDES UNCOMPENSATED CARE, FREE OF CHARGE, OR ON A 100% DISCOUNTED BASIS, TO THOSE PATIENTS WHO DEMONSTRATE AN INABILITY TO PAY. DEPENDING UPON FAMILY SIZE AND INCOME, FREE OR 100% DISCOUNTED SERVICES ARE AVAILABLE TO A PATIENT WITH FAMILY INCOME OF 300% OR LESS OF THE FEDERAL POVERTY GUIDELINES. IT IS THE HOSPITAL'S POLICY TO PROVIDE FINANCIAL ASSISTANCE AND FINANCIAL COUNSELING TO PATIENTS OF LIMITED MEANS. A PATIENT MAY BECOME ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE AT ANY TIME DURING TREATMENT OR DURING THE CONTINUUM OF THE FINANCIAL/BILLING PROCESS. INFORMATION (SIGNS, BROCHURES, ETC.) REGARDING THE HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES ARE PROVIDED AT THE EMERGENCY ROOM, REGISTRATION AND VARIOUS ACCESS POINTS THROUGHOUT THE HOSPITAL. REGISTRATION PERSONNEL ALSO REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY. NOTICE OF THE HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES CAN ALSO BE FOUND ON THE GEISINGER WEB SITE AT WWW.GEISINGER.ORG. PATIENTS ARE ALSO PROVIDED INFORMATION ON THE HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES WITH EACH PATIENT BILL. THE FINANCIAL ASSISTANCE POLICY ("FAP"), THE FAP APPLICATION AND PLAIN LANGUAGE SUMMARY ("PLS") ARE AVAILABLE ON-LINE. PAPER COPIES ARE AVAILABLE UPON REQUEST WITHOUT CHARGE BY MAIL OR ARE AVAILABLE AT REGISTRATION AREAS WHICH INCLUDES EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL-BASED CLINICS AND PATIENT FINANCIAL SERVICES DEPARTMENTS. ALL FAP DOCUMENTS ARE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGE OF POPULATIONS WITH LIMITED ENGLISH PROFICIENCY ("LEP") THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE HOSPITAL'S SERVICE AREA. SIGNS OR DISPLAYS ARE CONSPICUOUSLY POSTED IN PUBLIC HOSPITAL LOCATIONS INCLUDING THE EMERGENCY DEPARTMENT, ADMISSIONS DEPARTMENT AND REGISTRATION DEPARTMENT THAT INFORM PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. ALL PATIENTS ARE OFFERED A COPY OF THE PLS AS PART OF THE INTAKE AND DISCHARGE PROCESSES. ADDITIONALLY, FINANCIAL COUNSELORS AND CUSTOMER SERVICE REPRESENTATIVES ARE AVAILABLE TO ASSIST PATIENTS WITH CONCERNS. SCHEDULE H, PART VI, LINE 4 POPULATION TRENDS THE NORTH CENTRAL REGION IS PREDOMINANTLY RURAL. TOTAL POPULATION OF THE NORTH CENTRAL REGION IS APPROXIMATELY 150,000; 75% OF THE POPULATION IS LOCATED WITHIN LYCOMING COUNTY. WILLIAMSPORT (LYCOMING COUNTY) IS THE LARGEST MUNICIPALITY IN THE REGION WITH APPROXIMATELY 30,000 RESIDENTS. THE WILLIAMSPORT POPULATION IS MORE DIVERSE IN AGE, RACE, AND ETHNICITY THAN THE SURROUNDING MUNICIPALITIES. LYCOMING COLLEGE (1,100 STUDENT BODY) AND PENNSYLVANIA COLLEGE OF TECHNOLOGY, KNOWN AS PENN COLLEGE, (5,000 STUDENT BODY) ARE LOCATED IN WILLIAMSPORT. LOCK HAVEN IS THE LARGEST CITY CENTER IN CLINTON COUNTY WITH APPROXIMATELY 10,000 RESIDENTS. LOCK HAVEN IS THE COUNTY SEAT AND HOME TO LOCK HAVEN UNIVERSITY OF PENNSYLVANIA WITH A STUDENT BODY OF ABOUT 3,400. AS A WHOLE, THE NORTH CENTRAL REGION IS SIGNIFICANTLY LESS DIVERSE AND OLDER AS COMPARED TO STATE AND/OR NATIONAL BENCHMARKS. PENNSYLVANIA AND THE NORTH CENTRAL REGION HAVE A HIGHER MEDIAN AGE THAN THE NATION. APPROXIMATELY 20% OF RESIDENTS ACROSS THE STATE AND REGION ARE AGE 65 OR OVER, AND THAT PERCENTAGE IS PROJECTED TO INCREASE NEARLY 7 PERCENTAGE POINTS BY 2025. THE CLINTON COUNTY POPULATION DECLINED BY 5.1% FROM 2017- 2020, THE LARGEST POPULATION DECLINE IN THE GEISINGER SERVICE AREA. THIS PACE IS PROJECTED TO SLOW BY 2025 AND ALIGN WITH LYCOMING COUNTY AT ABOUT -1.5%. ABOUT 5% OF RESIDENTS IN LYCOMING COUNTY ARE BLACK COMPARED TO 1.6% IN CLINTON COUNTY, AND LESS THAN 3% OF RESIDENTS IN EITHER COUNTY IDENTIFY AS LATINX (OF ANY RACE). GREATER DIVERSITY IN LYCOMING COUNTY IS DRIVEN PRIMARILY BY THE WILLIAMSPORT CITY POPULATION, WHERE 14% OF THE POPULATION IS BLACK AND ABOUT 4% OF THE POPULATION IS LATINX (OF ANY RACE). THE AMISH POPULATION MAKES UP APPROXIMATELY 2.5% OF THE TOTAL NORTH CENTRAL REGION POPULATION. CLINTON COUNTY HAS MORE THAN TWICE AS MANY AMISH (2,527) AS LYCOMING COUNTY (1,194). THE ESTIMATED AMISH POPULATION FOR THE REGION INCREASED NEARLY 11% FROM 3,360 TO 3,721 FROM 2017 TO 2020. DISABILITY-BOTH PHYSICAL AND COGNITIVE-IS MORE PREVALENT AMONG PEOPLE IN THE NORTH CENTRAL REGION THAN IN OTHER PA COUNTIES. WHILE SENIORS COMPRISE THE MAJORITY OF INDIVIDUALS WITH A DISABILITY, WITHIN CLINTON COUNTY, MORE THAN 7% OF YOUTH REPORT A DISABILITY COMPARED TO 5% STATEWIDE. SOCIOECONOMIC TRENDS CLINTON AND LYCOMING COUNTIES BOAST RICH NATURAL RESOURCES AND A LONG HERITAGE IN AGRICULTURE AND MANUFACTURING. MULTIPLE GENERATIONS OF FAMILIES RESIDE WITHIN WELL-ESTABLISHED COMMUNITIES, ANCHORED BY FAITH AND PREDOMINANTLY CONSERVATIVE-LEANING VALUES. THE SOCIOECONOMICS OF CLINTON AND LYCOMING COUNTIES ARE CONSISTENT WITH OTHER RURAL COMMUNITIES ACROSS PA. COMMON FACTORS INCLUDE A PREDOMINANTLY BLUE-COLLAR WORKFORCE; LOWER MEDIAN INCOME LEVELS; INCREASED FOOD INSECURITY; AVERAGE HIGH SCHOOL GRADUATION RATES WITH LESS COLLEGE DEGREES; AND MORE HOME OWNERSHIP WITH LOWER HOUSING COST BURDEN. DESPITE COMMON FACTORS ACROSS THE NORTH CENTRAL REGION, DISTINCT DIFFERENCES EXIST BETWEEN THE TWO COUNTIES. CLINTON COUNTY IS MORE RURAL THAN LYCOMING COUNTY WITH MORE THAN 60% OF THE COUNTY DESIGNATED AS STATE LAND AND OPEN TO THE PUBLIC. THE CITY OF WILLIAMSPORT (LYCOMING COUNTY) BOASTS CULTURAL ATTRACTIONS INCLUDING THE LITTLE LEAGUE WORLD SERIES AND LITTLE LEAGUE HALL OF FAME. THESE RESOURCES LEND TO STRONG TOURISM IN BOTH COUNTIES. FULLTIME CLINTON COUNTY RESIDENTS EXPERIENCE MORE POVERTY AND RELATED CONCERNS THAN LYCOMING COUNTY RESIDENTS. IN CLINTON COUNTY, 17% OF ALL RESIDENTS AND 23% OF CHILDREN LIVE IN POVERTY COMPARED TO 14% OF LYCOMING COUNTY RESIDENTS AND 21% OF CHILDREN AND STATEWIDE PERCENTAGES OF 13% AND 18%, RESPECTIVELY. ONE IN FIVE (20%) OF CHILDREN LIVE IN FOOD INSECURE HOUSEHOLDS COMPARED TO 18% IN LYCOMING COUNTY AND 15% STATEWIDE AND NATIONALLY. THE PERCENTAGE OF RENTERS IS EQUAL IN BOTH COUNTIES, BUT LYCOMING COUNTY RENTERS ARE MORE LIKELY TO BE COST BURDENED THAN CLINTON COUNTY RENTERS. BOTH COUNTIES ARE LESS COST BURDENED THAN THE STATE OR NATIONAL AVERAGES. HOUSING COST BURDEN IS DEFINED AS SPENDING 30% OR MORE OF HOUSEHOLD INCOME ON RENT OR MORTGAGE EXPENSES. HOUSING STOCK IN LYCOMING COUNTY IS GENERALLY OLDER THAN IN CLINTON COUNTY, AND THE STATE AND NATION. FRACKING, OR HYDROFRACKING, HAS BEEN A CONTROVERSIAL INDUSTRY ACROSS PA AND THE NORTH CENTRAL REGION. IT HAS BROUGHT ECONOMIC BENEFIT TO THE NORTH CENTRAL REGION, BUT IT HAS ALSO GENERATED CONCERNS ABOUT HEALTH, INCREASED HOUSING RENTAL COSTS, DECREASED PROPERTY VALUES, AND LONG-TERM ENVIRONMENT IMPACT. CONTINUED MONITORING OF HEALTH, SOCIOECONOMIC, AND ENVIRONMENTAL FACTORS IS ESSENTIAL TO BETTER UNDERSTAND THE FULL IMPACT OF THIS INDUSTRY ON THE NORTH CENTRAL REGION. AS A RESULT OF THE COVID-19 PANDEMIC, THE NORTH CENTRAL REGION UNEMPLOYMENT RATE MORE THAN DOUBLED IN CLINTON COUNTY AND NEARLY TRIPLED IN LYCOMING COUNTY FROM MAY 2019 TO MAY 2020. AS OF MAY 2020, UNEMPLOYMENT RATES IN CLINTON (11%) AND LYCOMING (13%) COUNTIES WERE SIMILAR TO OR LOWER THAN THE STATE AND NATION (13%). HEALTH TRENDS ACCESS TO HEALTHCARE THE PRIMARY CARE PROVIDER RATE, A MEASURE OF PROVIDER AVAILABILITY, INCREASED IN LYCOMING COUNTY AND IS SIMILAR TO THE STATE RATE. THE CLINTON COUNTY PROVIDER RATE DECREASED AND IS NEARLY 30 POINTS LOWER THAN THE STATE. THE NORTH CENTRAL REGION HAS FEWER DENTISTS THAN THE STATE AND NATION; BOTH CLINTON AND LYCOMING COUNTIES ARE DENTAL HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS) FOR LOW-INCOME RESIDENTS. BOTH COUNTIES ARE ALSO MENTAL HEALTH HPSAS. KEY INFORMANT SURVEY RESPONDENTS AFFIRMED THE NEED FOR ADDITIONAL BEHAVIORAL HEALTH SERVICES, PARTICULARLY MENTAL HEALTH SERVICES. MENTAL HEALTH SERVICES WERE THE TOP RANKED MISSING RESOURCE IN THE REGION, IDENTIFIED BY 63% OF RESPONDENTS. SUBSTANCE USE DISORDER SERVICES WERE THE THIRD RANKED MISSING RESOURCE, IDENTIFIED BY 33% OF RESPONDENTS. ACROSS THE NORTH CENTRAL REGION, UNINSURED RATES AMONG ADULTS ARE DECREASING AND GENERALLY IN LINE WITH THE STATE AND BETTER THAN THE NATIONAL AVERAGE. HOWEVER, THE PERCENTAGE OF UNINSURED YOUTH IN CLINTON COUNTY IS MORE THAN DOUBLE STATE AND NATIONAL AVERAGES. MOST UNINSURED RESIDENTS IN CLINTON COUNTY ARE WHITE, WHILE BLACK AND/OR LATINX RESIDENTS EXPERIENCE DISPARITIES IN HEALTH INSURANCE COVERAGE IN LYCOMING COUNTY. CHRONIC DISEASE PREVENTION AND MANAGEMENT ABOUT 59% OF KEY INFORMANT SURVEY RESPONDENTS NAMED OVERWEIGHT/OBESITY AMONG THE TOP THREE HEALTH CONCERNS, RANKING IT AS THE 1 CONCERN FOR THE REGION. OBESITY AMONG ADULTS AND CHILDREN IN THE NORTH CENTRAL REGION CONTINUES TO INCREASE AND EXCEEDS STATE AND NATIONAL BENCHMARKS. AS OF 2017, APPROXIMATELY 40% OF ADULTS IN BOTH COUNTIES WERE OBESE AND NEARLY 30% OF STUDENTS IN GRADES 7-12 WERE OBESE COMPARED TO 19.5% OF THEIR PEERS STATEWIDE. IN CONTRAST TO NATIONAL TRENDS, TOBACCO USE IS INCREASING AMONG ADULTS IN PA AND THE NORTH CENTRAL REGION. LYCOMING COUNTY HAS THE HIGHEST RATE OF ADULT SMOKING, EXCEEDING THE STATE AND NATION, BUT CLINTON COUNTY SAW THE GREATEST INCREASE IN ADULT SMOKING (3 POINTS) FROM 2016 TO 2017. YOUTH VAPING/E-CIGARETTE USE IS ALSO ON THE RISE. FROM 2015 TO 2019, THE PERCENTAGE OF LYCOMING COUNTY YOUTH WHO REPORTED RECENT VAPING OR E- CIGARETTE USE INCREASED FROM 17% TO 23% AND CURRENTLY EXCEEDS THE STATEWIDE AVERAGE OF 19%. THESE RISK FACTORS MAY CONTRIBUTE TO HIGHER DEATH RATES FROM CHRONIC DISEASE. THE NORTH CENTRAL REGION HAS HIGHER DEATH RATES THAN THE STATE AND NATION FOR CANCER, CHRONIC LOWER RESPIRATORY DISEASE, AND DIABETES. CLINTON COUNTY ALSO HAS A HIGHER, INCREASING DEATH RATE DUE TO HEART DISEASE. CONSISTENT WITH STATE AND NATIONAL DATA, CANCER DEATH RATES ARE DECLINING WITHIN THE NORTH CENTRAL REGION. HIGHER POVERTY RATES, LOWER EDUCATIONAL ATTAINMENT, AND RURAL GEOGRAPHIES CONSISTENT WITH MOST OF THE NORTH CENTRAL REGION CONTRIBUTE TO HEALTH DISPARITIES AND REDUCE RESIDENTS' ABILITY TO ACCESS NEEDED HEALTH AND SOCIAL SERVICES. PEOPLE OF COLOR HISTORICALLY AND FREQUENTLY EXPERIENCE A HIGHER INCIDENCE OF POOR HEALTH AND SOCIOECONOMIC STATUS THAN WHITE PEOPLE. WHILE THE NORTH CENTRAL REGION IS SIGNIFICANTLY LESS DIVERSE COMPARED TO THE STATE AND NATION, CITY CENTERS THAT BENEFIT FROM MORE DIVERSITY, LIKE WILLIAMSPORT, MUST BE MONITORED TO APPRECIATE THE NATURE AND EXTENT OF DISPARITIES AMONG RACIAL AND ETHNIC SUBPOPULATIONS. BEHAVIORAL HEALTH BEHAVIORAL HEALTH, PARTICULARLY MENTAL HEALTH, WAS SEEN AS A TOP COMMUNITY HEALTH NEED BY KEY INFORMANT SURVEY RESPONDENTS. NORTH CENTRAL REGION ADULTS AND YOUTH EXPERIENCE MORE MENTAL DISTRESS THAN THEIR PEERS STATEWIDE AND NATIONALLY. THE LYCOMING COUNTY SUICIDE DEATH RATE IS INCREASING AND CURRENTLY EXCEEDS STATE AND NATIONAL BENCHMARKS. CLINTON COUNTY SUICIDE DEATH DATA ARE LIMITED, BUT AVAILABLE DATA INDICATE SIMILAR, HIGH RATES. THESE FINDINGS, COUPLED WITH A MENTAL HEALTH HPSA DESIGNATION, INDICATE THAT NORTH CENTRAL REGION RESIDENTS LIKELY DO NOT RECEIVE THE MENTAL HEALTHCARE THEY NEED. LYCOMING COUNTY YOUTH ARE ALSO MORE LIKELY TO REPORT FEELINGS OF DEPRESSION, ATTE SCHEDULE H, PART VI, LINE 5 SCHEDULE H, PART I IN ADDITION TO THE NET COMMUNITY BENEFIT COSTS INCURRED BY THE ORGANIZATION AS REPORTED IN SCHEDULE H, PART I, LINE 7; PLEASE REFER TO SCHEDULE O OF THIS FORM 990 FOR THE ORGANIZATION'S NARRATIVE COMMUNITY BENEFIT STATEMENT FOR ADDITIONAL INFORMATION ON HOW THE ORGANIZATION PROMOTES HEALTH AND PROVIDES HEALTHCARE SERVICES TO THE COMMUNITY REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY IN FURTHERANCE OF ITS CHARITABLE TAX EXEMPT PURPOSE. SCHEDULE H, PART VI, LINE 6 GEISINGER HEALTH AND ITS SUBSIDIARIES (COLLECTIVELY REFERRED TO AS "GEISINGER") COMPRISE A PHYSICIAN-LED, INTEGRATED HEALTH SERVICES ORGANIZATION THAT HAS AS ITS MAIN COMPONENTS: (I) AN ARRAY OF HEALTH SERVICES PROVIDERS, INCLUDING SIX WHOLLY-CONTROLLED ACUTE-CARE HOSPITALS WITH MULTIPLE CAMPUSES, A JOINT VENTURE HOSPITAL AND A DRUG AND ALCOHOL TREATMENT FACILITY; (II) MULTISPECIALTY PHYSICIAN GROUP PRACTICES; (III) INSURANCE OPERATIONS, INCLUDING A LICENSED HEALTH MAINTENANCE ORGANIZATION; AND (IV) A COMMUNITY-BASED MEDICAL COLLEGE AND DEGREE-GRANTING INSTITUTION. GEISINGER OPERATES IN 46 OF PENNSYLVANIA'S 67 COUNTIES, WITH A SIGNIFICANT PRESENCE IN CENTRAL AND NORTHEASTERN PENNSYLVANIA. THE HOSPITAL IS AN AFFILIATE WITHIN GEISINGER. CORPORATE STRUCTURE. THE ORGANIZATIONAL STRUCTURE OF GEISINGER REFLECTS THE STRATEGIC GOAL OF OPERATING AS A FULLY INTEGRATED HEALTHCARE SYSTEM WHOSE CORPORATE COMPONENTS SHARE THE COMMON GOALS OF MANAGING AND IMPROVING THE HEALTHCARE OF ITS PATIENTS AND MEMBERS, WHILE RECOGNIZING AND RESPECTING THE CORPORATE IDENTITY OF EACH ENTITY. THIS INTEGRATION LINKS THE AREAS OF PHYSICIANS, HOSPITALS/CLINICS, AND HEALTHCARE INSURANCE. HISTORY. GEISINGER HAD ITS BEGINNINGS IN THE SMALL COMMUNITY OF DANVILLE, LOCATED IN CENTRAL PENNSYLVANIA ON THE NORTHERN BRANCH OF THE SUSQUEHANNA RIVER. THERE, IN 1915, ABIGAIL A. GEISINGER FOUNDED THE GEORGE F. GEISINGER MEMORIAL HOSPITAL IN MEMORY OF HER HUSBAND. FROM THE BEGINNING, THE NEW HOSPITAL WAS DESIGNED AS A COMPREHENSIVE HEALTHCARE INSTITUTION THAT WOULD OFFER SPECIALIZED MEDICAL CARE TO PEOPLE IN THE RURAL AREAS OF CENTRAL AND NORTHEASTERN PENNSYLVANIA. UNLIKE MOST HEALTHCARE SYSTEMS, WHICH EVOLVED WITH A HOSPITAL FOCUS, GEISINGER'S HISTORY AND TRADITION IS THAT OF A PHYSICIAN-LED AND PHYSICIAN-DRIVEN HEALTHCARE ORGANIZATION. THIS TRADITION BEGAN WHEN MRS. GEISINGER BROUGHT DR. HAROLD FOSS, A MAYO CLINIC TRAINED PHYSICIAN, TO BE HER HOSPITAL'S FIRST CHIEF OF STAFF. TODAY, GEISINGER IS REGARDED AS A NATIONAL MODEL OF HEALTHCARE DELIVERY CENTERED ON A SOPHISTICATED MULTISPECIALTY GROUP PRACTICE. SINCE THE 1970S, GEISINGER'S STRATEGY OF INTEGRATING PHYSICIANS AND HOSPITALS EXPANDED TO INCLUDE THE MANAGEMENT OF HEALTH AND THE FINANCING OF HEALTHCARE SERVICES THROUGH ITS WHOLLY CONTROLLED HEALTH MAINTENANCE ORGANIZATION, GEISINGER HEALTH PLAN. TWO INDEMNITY HEALTH INSURERS, GEISINGER INDEMNITY INSURANCE COMPANY AND GEISINGER QUALITY OPTIONS, INC. WERE ALSO ADDED. SEE SCHEDULE R FOR A LIST OF THE AFFILIATED ORGANIZATIONS COMPRISING GEISINGER. SCHEDULE H, PART VI PART VI, LINE 7: FORM 990, SCHEDULE H, 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 X X X X X true true false false false false false false false JAEWON RYU MD JD DIRECTOR 4389743 1102369 1528292 43622 7064026 1064507 MATTHEW WALSH CHAIR, PRES., DIR 1248929 251139 273292 40942 1814302 219524 GERALD V MALONEY DO DIRECTOR 699927 115402 95392 31669 942390 64210 SPENCER KOWAL TREASURER, DIRECTOR 690795 57189 94902 45782 888668 TRACEY W WOLFE MHA DIRECTOR 276001 337737 59739 16992 690469 194010 JEFFREY J ADAMS DIRECTOR 397610 83836 61292 36834 579572 11973 JASON SCHAUER MD DIRECTOR 442315 18894 23292 34120 518621 MATTHEW VAN LEEUWE DIRECTOR 373526 42887 60792 10658 487863 TAMMY ANDERER CRNP PHD SECRETARY, DIRECTOR 283578 17288 19910 17856 338632 SCHEDULE J, PAGE 1, PART I, LINE 4 JAEWON RYU, MD, JD 0 1,064,507 0 MATTHEW WALSH 0 219,524 0 GERALD V. MALONEY, DO 0 64,210 0 TRACEY W. WOLFE, MHA 139,160 196,454 0 JEFFREY J. ADAMS 0 78,816 0 SCHEDULE J, PART III PART I, LINE 4A - SEVERANCE PAYMENT UPON INVOLUNTARY SEPARATION, EMPLOYEES MAY BE ELIGIBLE TO RECEIVE CONTINUATION OF SALARY FOR A TERM THAT IS BASED ON THEIR YEARS OF GEISINGER SERVICE AND POSIITON. PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ELIGIBLE EMPLOYEE COMPENSATION MAY BE DEFERRED TO A 457(F)NONQUALIFIED PLAN THAT VESTS WITH COMPLETION OF SERVICE, DEATH AND/OR PERMANENT DISABILITY. FORM 990 - ORGANIZATION'S MISSION GEISINGER MEDICAL CENTER MUNCY STRIVES TO MAKE BETTER HEALTH EASIER IN THE COMMUNITIES IT SERVES BY PROVIDING ACCESS TO AFFORDABLE, QUALITY HEALTH SERVICES THROUGH AN INNOVATIVE MODEL OF CARE AND COVERAGE BASED ON A BALANCED PROGRAM OF PATIENT AND MEMBER CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE. FORM 990, PAGE 2, PART III, LINE 4A I. GENERAL INFORMATION GEISINGER MEDICAL CENTER MUNCY, (GMCM), A 501(C )(3) NOT-FOR-PROFIT CORPORATION OWNS AND OPERATES A 20 BED ACUTE CARE HOSPITAL IN MUNCY, PA. GMCM BEGAN SEEING PATIENTS JANUARY 10, 2022. GMCM IS MAKING BETTER HEALTH EASIER FOR LYCOMING COUNTY AND THE SURROUNDING AREA. IN ADDITION TO BEING A FULL-SERVICE HOSPITAL, THE NEW FACILITY BRINGS CARE CLOSER TO HOME BY CENTRALIZING SERVICES, LESSENING TRAVEL TIME FOR PATIENTS WHO WENT TO LARGER MEDICAL FACILITIES FOR THEIR CARE. THE 120,000-SQUARE FOOT, THREE-STORY FACILITY IS A 100 MILLION+ INVESTMENT IN MUNCY AND THE SURROUNDING COMMUNITIES AND IS PART OF THE CLINICAL JOINT VENTURE FORMED BY GEISINGER AND HIGHMARK HEALTH IN 2019. FEATURING AN EMERGENCY ROOM, CLINICAL DECISION UNIT, ACUTE CARE UNIT, SURGICAL SUITES AND PRIMARY AND SPECIALTY CARE AREAS, GEISINGER MEDICAL CENTER MUNCY IS DESIGNED TO MEET THE ROUTINE AND ACUTE CARE NEEDS OF THOSE LIVING IN LYCOMING, SULLIVAN, CLINTON AND TIOGA COUNTIES. THE HOSPITAL'S 20 INPATIENT ROOMS ARE OUTFITTED WITH DIGITAL WHITE BOARDS DISPLAYING REAL-TIME HEALTH INFORMATION TO BETTER COORDINATE CARE. THE WHITE BOARDS SERVE AS A CENTRALIZED INFORMATION HUB THAT CAN BE CONNECTED ACROSS SEVERAL DEVICES AND WILL BE ACCESSIBLE TO THE PATIENT, FAMILY AND CARE TEAM. MESSAGING CAPABILITIES STREAMLINE INTERACTIONS WHILE IMPROVING COMMUNICATION ABOUT THE HOSPITAL STAY AND PROVIDING PATIENTS WITH PERSONALIZED HEALTH INFORMATION AND EDUCATIONAL CONTENT. FOR ROUTINE CARE, THE FACILITY INCLUDES A MULTISPECIALTY CLINIC WITH ADULT AND PEDIATRIC PRIMARY CARE, ORTHOPAEDICS, CARDIOLOGY, OPHTHALMOLOGY, PULMONARY SERVICES AND WOMEN'S HEALTH SERVICES. ALSO AVAILABLE ARE IMAGING AND LAB SERVICES, MEDICAL ONCOLOGY SERVICES, CHEMOTHERAPY AND INFUSIONS, GENERAL SURGERY SERVICES. ADULT AND PEDIATRIC PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY SERVICES ARE ALSO PROVIDED. II. MAJOR PROGRAM SERVICES SERVICES OFFERED BY GMCM: -ADULT AND PEDIATRIC PRIMARY CARE -DERMATOLOGY -PHARMACY -IMAGING -INPATIENT UNIT -LAB SERVICES -EMERGENCY ROOM -INFUSIONS -MEDICATION THERAPY MANAGEMENT -PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY -PULMONOLOGY -SPECIALTY CLINICS INCLUDING: CARDIOLOGY EYE CARE HEMATOLOGY AND ONCOLOGY PODIATRY GASTROENTEROLOGY SURGERY ORTHOPAEDICS WOMEN'S HEALTH SERVICES -TELEMEDICINE -UROLOGY III. PROGRAM SERVICE ACCOMPLISHMENTS UNCOMPENSATED CARE GMCM RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. GMCM PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, RELIGION, ETHNICITY, SEXUAL ORIENTATION, GENDER IDENTIY, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD, GMCM 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 GMCM PRACTICES. A. CHARITY CARE THE PRIMARY CONCERN OF GMCM IS THE DELIVERY OF HEALTH CARE TO ALL THE CITIZENS IN ITS PENNSYLVANIA SERVICE AREA, REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GMCM INCURRED BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO COULD NOT AFFORD TO PAY. FOR THE YEAR ENDED DECEMBER 31, 2023, THE COST OF CHARITY CARE WAS 914,189. B. MEDICARE/MEDICAID AND OTHER GOVERNMENTAL PROGRAMS RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO THE ELDERLY (MEDICARE) AND THE POOR (MEDICAID). GMCM PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS. TO THE EXTENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTHCARE, GMCM IS FURTHERING ITS MISSION TO THE ENTIRE COMMUNITY. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT OF REIMBURSEMENT RECEIVED UNDER THE PROGRAM. FOR THE YEAR ENDED DECEMBER 31, 2023, THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 15,797,604. III. COMMUNITY HEALTH, EDUCATION, AND OUTREACH GMCM STRIVES TO BE A VALUABLE RESOURCE FOR THE COMMUNITY AND ITS RESIDENTS. GMCM 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 ACTIVITIES GMCM PROVIDED TRANSPORTATION FOR INDIGENT PATIENTS AT A COST OF 95,692. B.HEALTH PROFESSIONS EDUCATION GMCM PROVIDED 34,081 IN SUPERVISION OF NURSING AND PHARMACY STUDENTS COMPLETING ROTATIONS AS PART OF THEIR STUDIES DURING THE YEAR ENDED DECEMBER 31, 2023. C. VOLUNTEER SERVICES IT IS ANTICIPATED, THE VOLUNTEERS OF GEISINGER MEDICAL CENTER MUNCY WILL BE AN ACTIVE AND VITAL PART OF THE ACTIVITIES OF THE HOSPITAL. THE HOURS OF VOLUNTEER SERVICES ARE AN IMPORTANT CONTRIBUTION TO THE MISSION OF GMCM. DURING ITS START-UP YEAR, VOLUNTEERS FROM LOCAL COMMUNITIES CONTRIBUTED 10 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTHCARE OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION OF 318 IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND "WELLNESS" PROGRAMS. IV. COMMUNITY BENEFITS SUMMARY CHARITY CARE 914,189 MEDICARE/MEDICAID/OTHER GOVERNMENTAL 15,797,604 COMMUNITY HEALTH, EDUCATION, AND OUTREACH 129,773 VOLUNTEER SERVICES (VALUED AT 01/01/2023 PA STATEWIDE AVERAGE WEEKLY WAGE) 318 TOTAL 16,841,884 V. STATISTICAL SUMMARY DISCHARGES 1,284 AVERAGE LENGTH OF STAY 2.9 PERCENT OF OCCUPANCY 50.1% PATIENT DAYS 3,660 TOTAL OR CASES 2,401 OUTPATIENT VISITS (INCLUDES OUTPATIENT ER VISITS) 59,098 OUTPATIENT EMERGENCY ROOM VISITS 15,039 BEDS 20 FORM 990, PART V FORM 990, PART V, LINE 1A: ENTER THE NUMBER REPORTED IN BOX 3 OF FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURNS. GEISINGER SYSTEM SERVICES (GSS), AN AFFILIATE OF THE ORGANIZATION, PROVIDES A CENTRALIZED ACCOUNTS PAYABLE FUNCTION FOR ALL GEISINGER ORGANIZATIONS. AS THE ACCOUNTS PAYABLE PROCESSOR, GSS PREPARES AND FILES FORM 1099 UNDER ITS EIN FOR CERTAIN REPORTABLE PAYMENTS OF THE FILING ORGANIZATION. THE NUMBER OF FORM 1099'S FILED BY GSS FOR THE 2023 REPORTING PERIOD ON BEHALF OF ITSELF AND ITS AFFILIATES WAS 1,321. FORM 990, PART VI FORM 990, PART VI, SECTION A, LINE 2: DID ANY OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE HAVE A FAMILY RELATION- SHIP OR BUSINESS RELATIONSHIP WITH ANY OTHER OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE? GERALD V. MALONEY, DO, JACQUELINE HOLDER, DO, MBA, JAEWON RYU, MD, JD, JEFFREY J. ADAMS, MATTHEW VAN LEEUWE, MATTHEW WALSH, SPENCER KOWAL AND TAMMY ANDERER, CRNP, PHD 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 AFFILIATES ARE PART OF GEISINGER. FORM 990, PAGE 6, PART VI, LINE 6 THE MEMBERS OF THE CORPORATION HAVE THE POWER AND AUTHORITY TO ELECT AND REMOVE THE DIRECTORS; ELECT AND REMOVE THE PRESIDENT AND FILL ANY VACANCY IN THE OFFICE OF THE PRESIDENT OF THE CORPORATION; AND, MAY APPROVE AMENDMENTS TO THE CORPORATE BYLAWS IN LIEU OF SUCH APPROVAL BY THE BOARD OF DIRECTORS. THE MEMBERS ALSO HAVE THE RESERVE POWERS AS SET FORTH IN THE PENNSYLVANIA NONPROFIT CORPORATION LAW. FORM 990, PAGE 6, PART VI, LINE 7A THE BOARD OF DIRECTORS OF THE CORPORATION SHALL SERVE AS THE GOVERNING BODY OF THE CORPORATION. THE PRESIDENT OF THE CORPORATION SHALL BE A DIRECTOR BY REASON OF HOLDING SUCH OFFICE. THE REMAINING DIRECTORS SHALL BE ELECTED BY THE MEMBERS AT THE ANNUAL MEETING OF THE MEMBERS. THE MEMBERS OF THE CORPORATION MAY SERVE AS DIRECTORS AND DIRECTORS MAY SUCCEED THEMSELVES FROM TERM TO TERM. VACANCIES ON THE BOARD OF DIRECTORS SHALL BE FILLED BY THE MEMBERS AT THEIR DISCRETION AT THE ANNUAL MEETING OF THE MEMBERS OR AT A SPECIAL MEETING CALLED FOR SUCH PURPOSE. FORM 990, PAGE 6, PART VI, LINE 7B THE MEMBER OF THE CORPORATION SHALL HAVE THE AUTHORITY TO APPOINT AND REMOVE DIRECTORS, APPOINT AND REMOVE THE PRESIDENT, ADOPT, AMEND AND REPEAL THE CORPORATION'S ARTICLES AND BYLAWS, VOTE ON ALL MATTERS PERTAINING TO THE MEMBER AND SUCH OTHER AUTHORITY AS SET FORTH IN THE PENNSYLVANIA NONPROFIT CORPORATION LAW. SPECIFICALLY, THE FOLLOWING SHALL REQUIRE APPROVAL OF THE MEMBER: A)THE CORPORATION'S STRATEGIC APPROACH TO CLINICAL PROGRAMMING, CONTRACTING, CONTRACTING GUIDELINES AND FRAMEWORK; B)CORPORATION PARTNERSHIPS OR STRATEGIC ALLIANCES WITH THIRD PARTIES; C)APPROVAL OF BUSINESS PLANS INCLUDING OPERATING AND CAPITAL BUDGETS, AND ANY UNBUDGETED CAPITAL EXPENDITURE IF, AFTER GIVING EFFECT THERETO, THE AGGREGATE OF ALL UNBUDGETED CAPITAL EXPENDITURES IN ANY GIVEN FISCAL YEAR WOULD BE GREATER THAN 250,000; FURTHERMORE, NOTWITHSTANDING ANY OTHER PROVISION IN THESE BYLAWS TO THE CONTRARY, THE FOLLOWING SHALL REQUIRE APPROVAL BY A SUPERMAJORITY VOTE OF THE BOARD OF MANAGERS OF THE MEMBER: A)APPROVAL OF ANY PLAN OF MERGER OR CONSOLIDATION, ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE CORPORATION, OR REVOCATION OF VOLUNTARY DISSOLUTION PROCEEDINGS; B)TO APPROVE THE CREATION OR ACQUISITION OF ANY SUBSIDIARY OF THE CORPORATION, OR THE CREATION OF ANY OTHER CORPORATION OF WHICH THE CORPORATION IS TO BE A MEMBER, AND TO APPROVE ANY DISSOLUTION OR OTHER CHANGE IN ANY SUCH LEGAL RELATIONSHIP PREVIOUSLY APPROVED BY IT; C)APPOINTMENT AND REMOVAL OF DIRECTORS, APPOINTMENT AND REMOVAL OF THE PRESIDENT, ADOPTION, AMENDMENT AND REPEAL OF THE CORPORATION'S ARTICLES AND BYLAWS, VOTE; AND D)PERMITTING THE CORPORATION TO BORROW MONEY, REFINANCE EXISTING INDEBTEDNESS FOR BORROWED MONEY AND GUARANTEEING OBLIGATIONS OF OTHERS. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS PREPARED BY GEISINGER TAX AND FINANCE DEPARTMENTS WITH INFORMATION PROVIDED FROM FINANCE, TAX, HUMAN RESOURCES, LEGAL SERVICES AND OTHER RELEVANT DEPARTMENTS WITHIN GEISINGER. 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, PAGE 6, PART VI, LINE 12C THE OFFICERS AND DIRECTORS OF THE ORGANIZATION ARE SUBJECT TO THE GEISINGER CONFLICT OF INTEREST POLICY FOR DIRECTORS, OFFICERS AND SENIOR LEADERS. AT LEAST ONCE EACH YEAR DIRECTORS, OFFICERS, KEY EMPLOYEES, SENIOR LEADERS AND OTHERS DESIGNATED BY THE BOARD OF DIRECTORS ARE REQUIRED TO DISCLOSE IN WRITING THE EXISTENCE OF ANY POTENTIAL FINANCIAL INTERESTS THAT MAY GIVE RISE TO A CONFLICT OF INTEREST WITH ANY AFFILIATE WITHIN GEISINGER. THE DISCLOSURES ARE REVIEWED BY THE OFFICE OF THE CHIEF COMPLIANCE OFFICER AND REPORTED TO THE AUDIT AND COMPLIANCE COMMITTEE AND/OR BOARD OF DIRECTORS. AFTER REVIEW OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, INPUT FROM DEPARTMENT OF LEGAL SERVICES AND ANY DISCUSSION WITH THE PERSON DESIRED BY THE BOARD OR COMMITTEE, THE COMMITTEE/BOARD DECIDES IF A CONFLICT EXISTS AND TAKES APPROPRIATE ACTION. THE INDIVIDUAL DISCLOSING THE FINANCIAL INTEREST IS ABSENT DURING THE COMMITTEE/BOARD DELIBERATIONS AND DECISIONS ON THE MATTER. FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS TO REVIEW AND APPROVE THE COMPENSATION OF GEISINGER EMPLOYED BOARD DIRECTORS, OFFICERS, AND EXECUTIVE MANAGEMENT IS DESIGNED TO SATISFY THE REBUTTABLE PRESUMPTION PROCEDURE AVAILABLE FOR INTERMEDIATE SANCTION PURPOSES. THE PROCESS REQUIRES A REVIEW OF COMPENSATION DETERMINATIONS BY DISINTERESTED PARTIES, USE OF APPROPRIATE COMPARABILITY DATA AND CONTEMPORANEOUS DOCUMENTATION OF THE PROCESS. ON AN ANNUAL BASIS AN INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANT COMPLETES A COMPARATIVE ASSESSMENT OF COMPENSATION FOR THE CEO AND SENIOR MANAGEMENT WITHIN GEISINGER. THE CONSULTANT'S REPORT IS PRESENTED TO THE GEISINGER FAMILY COMMITTEE PRIOR TO ANY COMPENSATION ADJUSTMENT. THE REPORT SUPPORTS THE RIGOROUS REVIEW COMPLETED BY THE GEISINGER FAMILY COMMITTEE TO ENSURE THAT THE PROGRAM IS RESPONSIBLE TO THE GEISINGER CHARITABLE MISSION, REFLECTS REASONABLE COMPENSATION WITHIN THE NONPROFIT MARKET AND IS COMPLIANT WITH THE IRS'S INTERMEDIATE SANCTION REQUIREMENTS. THE SURVEY DATA IN THE COMPARATIVE ANALYSIS IS CAPTURED FOR FUNCTIONALLY COMPARABLE POSITIONS IN MULTIPLE SIMILAR NONPROFIT ORGANIZATIONS AND REFLECTS TOTAL REMUNERATION PROVIDED IN THE MARKET. ALL SURVEYS ARE CONDUCTED BY THIRD PARTY ORGANIZATIONS AND NOT CONDUCTED AT THE SPECIFIC DIRECTION OF GEISINGER. ANY COMPENSATION ADJUSTMENTS ARE APPROVED BY THE GEISINGER FAMILY COMMITTEE PRIOR TO THE EFFECTIVE DATE OF THE PAYMENT. THE GEISINGER FAMILY COMMITTEE AT ITS SOLE DISCRETION MAY POSITIVELY OR NEGATIVELY ADJUST ANY RECOMMENDED COMPENSATION. FORM 990, PAGE 6, PART VI, LINE 15B SEE SCHEDULE O RESPONSE TO FORM 990, PART VI SECTION B, QUESTION 15A. FORM 990, PAGE 6, PART VI, LINE 19 FINANCIAL STATEMENTS, FORM 990, FORM 990-T, THE CONFLICTS OF INTEREST POLICY, AND OTHER GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED LABOR SERVICES 20,139,488 250,729 0 OUTSIDE PURCHASED SERVICES 293,501 336,924 0 PATIENT TRANSPORTATION 95,692 0 0 OUTSIDE TESTS PURCHASED 155,474 0 0 EQUIPMENT MAINTENANCE 727,238 112,557 0 REPAIR OF EQUIPMENT 27,098 8,739 0 RECRUITING 314 0 0 OUTSIDE PURCHASED VENDORS 85,782 0 0 TOTAL 21,524,587 708,949 0 FORM 990, PART XII FORM 990, PART XII, LINE 3A: AS A RESULT OF A FEDERAL AWARD, WAS THE ORGANIZATION REQUIRED TO UNDERGO AN AUDIT OR AUDITS AS SET FORTH IN THE UNIFORM GUIDANCE, 2 C.F.R. PART 200, SUBPART F? FEDERAL AWARDS ARE AUDITED AS A PART OF THE GEISINGER'S CONSOLIDATED REPORT ON FEDERAL AWARDS IN ACCORDANCE WITH UNIFORM GUIDANCE, 2 C.F.R. PART 200, SUBPART F. FOOTNOTE: THROUGHOUT THIS DOCUMENT, THE TERMS "GEISINGER- OR "GEISINGER HEALTH" SHALL REFER TO THE ENTIRE HEALTH CARE SYSTEM COMPRISED OF GEISINGER HEALTH FOUNDATION (THE "FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATE ENTITIES COMPRISING THE HEALTH CARE SYSTEM. IN ADDITION, THROUGHOUT THIS DOCUMENT, THE TERM "SYSTEM" SHALL REFER TO THE ENTIRE HEALTH CARE SYSTEM AS PREVIOUSLY DEFINED PLUS ITS AFFILIATES. 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STREET BETHLEHEM PA 18015 824432109 HOSPITAL PA 501C3 3 N/A false GSLPG INC 801 OSTRUM STREET BETHLEHEM PA 18015 825423865 HEALTHCARE PA 501C3 3 GSL HOSP false KEYSTONE ACCOUNTABLE CARE ORG LLC 100 NORTH ACADEMY AVE MC 49-70 DANVILLE PA 17822 455484165 ACO PA N/A false false GEISINGER ENCOMPASS HEALTH LLC 100 NORTH ACADEMY AVE MC 49-70 DANVILLE PA 17822 721398803 PHY THERAP PA N/A false false EVANGELICAL-GEISINGER HEALTH LLC 100 NORTH ACADEMY AVE MC 49-70 DANVILLE PA 17822 460567687 HEALTHCARE PA N/A false false LACKAWANNA PHYS AMB SURG CTRLLC 100 NORTH ACADEMY AVE MC 49-70 DANVILLE PA 17822 233024998 HEALTHCARE PA N/A false false GEISINGER-HM JOINT VENTURE LLC 100 NORTH ACADEMY AVE MC 49-70 DANVILLE PA 17822 831871064 HEALTHCARE PA N/A false false KEYSTONE HEALTHCARE PARTNERSHIPLLC 901 HUGH WALLIS ROAD LAFAYETTE LA 70508 833134941 HOME HLTH PA N/A false false PHARMACY INNOVATION ALLIANCE LLC 100 NORTH ACADEMY AVE MC 49-70 DANVILLE PA 17822 831871064 PURCHASING DE N/A false false KKA VALUE FUND II GMBH & CO GIPSSTRABE 8 BERLIN GERMANY GM 10119 981686914 INVESTMENT GM N/A false false KKA CO-INVEST I GMBH & CO KG GIPSSTRABE 8 BERLIN GERMANY GM 10119 981685919 INVESTMENT GM N/A false false FORMENTERA PARTNERS FUND II-A LP 300 COLORADO ST STE 1900 AUSTIN TX 78701 882933731 INVESTMENT TX N/A false false VOLPI CAPITAL CARBON CO-INVEST SCSP 8 RUE LOU HEMMER SENNINGERBERG LUXENBOURG LU L-1748 981723571 INVESTMENT LU N/A false false ISS SOLUTIONS INC 100 NORTH ACADEMY AVE MC 49-70 DANVILLE PA 17822 232077663 CLINIC ENG PA N/A false GEISINGER INDEMNITY INSURANCE CO 100 NORTH ACADEMY AVE MC 49-70 DANVILLE PA 17822 232815174 HLTH INSUR PA N/A false GEISINGER QUALITY OPTIONS INC 100 NORTH ACADEMY AVE MC 49-70 DANVILLE PA 17822 204275139 HLTH INSUR PA N/A false GEISINGER ASSURANCE COMPANY LTD 23 LINE TREE BAY AVE PO BOX 1159 GRAND CAYMAN GRAND CAYMAN CJ KY1-1102 981016737 INSURANCE CJ N/A false CT WAREHOUSE GMBH GIPSSTRABE 8 BERLIN BERLIN GM 10119 HOLDING CO GM N/A false KKA PROJECT 3 HOLDING GMBH GIPSSTRABE 8 BERLIN BERLIN GM 10119 HOLDING CO GM N/A false KKA PROJECT 4 HOLDING GMBH GIPSSTRABE 8 BERLIN BERLIN GM 10119 HOLDING CO GM N/A false RTNX TOP GMBH GIPSSTRABE 8 BERLIN BERLIN GM 10119 HOLDING CO GM N/A false KKA WAREHOUSE GMBH GIPSSTRABE 8 BERLIN BERLIN GM 10119 HOLDING CO GM N/A false KKA PROJECT 2 HOLDING GMBH GIPSSTRABE 8 BERLIN BERLIN GM 10119 HOLDING CO GM N/A false PROJECT 4 WAREHOUSE GMBH GIPSSTRABE 8 BERLIN BERLIN GM 10119 HOLDING CO GM N/A false SCHRODERS CAPITAL CODA FUND LTD PO BOX 309 UGLAND HOUSE GRAND CAYMAN CAYMAN ISLANDS CJ KY1-1104 INVESTMENT CJ N/A false SCHRODERS CAPITAL CODA MASTER FUND PO BOX 309 UGLAND HOUSE GRAND CAYMAN GRAND CAYMAN CJ KY1-1104 INVESTMENT CJ N/A false true false false false false false false false false false false true true false false true false false false GEISINGER CLINIC A 134654 FMV GEISINGER PHARMACY LLC A 12180 FMV GEISINGER-HM JOINT VENTURE LLC A 1251060 FMV GEISINGER HEALTH PLAN L 9727420 GAAP GEISINGER INDEMNITY INSURANCE CO L 2754806 GAAP GEISINGER QUALITY OPTIONS INC L 1799142 GAAP GEISINGER ASSURANCE CO LTD M 216862 GAAP GEISINGER MEDICAL CENTER M 3712762 GAAP GEISINGER PHARMACY LLC M 190469 GAAP GEISINGER SYSTEM SERVICES M 6630084 GAAP ISS SOLUTIONS INC M 122379 GAAP GEISINGER INSURANCE CORP RRG P 220930 GAAP SCHEDULE R FORM 990, SCHEDULE R, PART V - TRANSACTIONS WITH RELATED ORGANIZATIONS: AS SHOWN IN FORM 990, SCHEDULE R, GEISINGER MEDICAL CENTER MUNCY 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 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.