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      <Desc>I. GENERAL PROGRAM SERVICE INFORMATION SINCE 1915, GEISINGER MEDICAL CENTER (GMC), A 501(C)(3) NOT-FOR-PROFIT CORPORATION, HAS BEEN PROVIDING HIGH-QUALITY HEALTHCARE SERVICES TO MORE THAN TWO MILLION RESIDENTS IN CENTRAL AND NORTHEAST PENNSYLVANIA. GEISINGER IS HOME TO SOME OF THE MOST ADVANCED TECHNOLOGY IN THE COUNTRY, INCLUDING A LEVEL I TRAUMA CENTER, THE REGION'S LONE PEDIATRIC TRAUMA CENTER, THE RENOWNED JANET WEIS CHILDREN'S HOSPITAL, THE STATE-OF-THE-ART HOSPITAL FOR ADVANCED MEDICINE AND CLINICAL RESEARCH FACILITIES. LOCATED IN DANVILLE, PENNSYLVANIA, A PREDOMINANTLY RURAL AREA, GMC OPERATES A 542 BED FACILITY ALONG WITH A 48 BED HOSPITAL LOCATED IN COAL TOWNSHIP, PENNSYLVANIA. PHYSICIANS IN PENNSYLVANIA AND THE SURROUNDING STATES REFER THEIR MOST COMPLEX CASES TO GEISINGER MEDICAL CENTER WHERE THE EXISTENCE OF QUATERNARY HEALTHCARE IN A GENERALLY RURAL AND MEDICALLY UNDERSERVED POPULATION IS UNCOMMON. GMC'S LIFE FLIGHT IS THE LEADER IN MEDICAL AIR TRANSPORTATION IN THE REGION SPECIALIZING IN TRANSPORTING CRITICAL CARE PATIENTS, INCLUDING PREMATURE NEWBORNS, CARDIAC PATIENTS, ORGAN TRANSPLANT PATIENTS AND ACCIDENT VICTIMS. A. SPECIALTIES AND SUBSPECIALTIES GEISINGER CLINIC PHYSICIANS PRACTICING AT GMC PROVIDE SKILLED SERVICES IN NUMEROUS SPECIALTY AND SUBSPECIALTY AREAS. SPECIAL SERVICES AVAILABLE INCLUDE, BUT ARE NOT LIMITED TO: ADULT &amp; PEDIATRIC TRAUMA CENTER MATERNAL FETAL MEDICINE ADULT MEDICAL ONCOLOGY MICROBIOLOGY AERO-MEDICAL SERVICES MINIMALLY INVASIVE SURGERY AIMI (ACUTE INTERVENTION IN MOHS SURGERY MYOCARDIAL INFRACTION) MOLECULAR DIAGNOSTICS ANTICOAGULATION CLINIC MOVEMENT DISORDERS BACLOFEN PUMPS NEUROENDOVASCULAR BAHA (BONE ANCHORED HEARING AID) NEUROMUSCULAR BALANCE CENTER NEUROPSYCH BARIATRIC SURGERY NEUROPATHOLOGY BLOOD BANK NEUROPHYSIOLOGY BLOOD CONSERVATION NEUROSTIMULATORS BODY CONTOURING NEUROTRAUMA BRAIN TUMOR NUCLEAR STRESS TESTING BREAST SURGERY OPEN HEART SURGERY CANCER GENETICS CLINIC OPHTHALMOLOGY (GLAUCOMA, RETINAL, CAPSULE ENDOSCOPY PEDIATRIC, CORNEA, GENERAL, CARDIAC CAT SCAN ANGIOGRAPHY OPHTHALMOPLASTIC SURGERY) CARDIAC MRI TESTING ORTHOPAEDICS (TRAUMA, SPINE, HAND CAROTID STENTING SPORTS MEDICINE, PEDIATRIC, CAT SCAN CARDIAC SCORING JOINT, FOOT/ANKLE, GENERAL) CAT SCAN ORTHOPAEDIC ONCOLOGY CHEMISTRY PEDIATRIC CONGENITAL HEART SURGERY CHEMO-EMBOLIZATION OF LIVER PEDIATRIC GENETICS AND KIDNEY CANCER PEDIATRIC MEDICAL ONCOLOGY CLEFT PALATE CLINIC PEDIATRIC NEURODEVELOPMENT COAGULATION PEDIATRIC OBESITY COCHLEAR IMPLANT PEDIATRIC REHABILITATION COLORECTAL SURGERY PEDIATRIC SURGERY CORNEAL TRANSPLANTS PEDIATRIC UROLOGY CYTOLOGY PEDIATRIC COCHLEAR IMPLANT DEEP BRAIN STIMULATION PEDIATRIC NEUROLOGY/NEUROSURGERY DERMATOPATHOLOGY PET SCANS ECHOCARDIOGRAPHY PODIATRY ELECTROPHYSIOLOGY PRE-SURGERY CENTER EMERGENCY SERVICES PSYCHIATRY (ADOLESCENCE) ENDOVASCULAR PROCEDURES RADIATION ONCOLOGY ENDOVASCULAR GRAFT IMPLANTS EPILEPSY REGIONAL ANESTHESIA PROGRAM EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY RENAL DENERVATION GYNONCOLOGY ROBOTIC SURGERY GYNECOLOGIC &amp; UROPATHOLOGY SKULL BASE SURGERY HEAD AND NECK ONCOLOGY SLEEP DISORDERS LABORATORY HEADACHE SPINAL BIFIDA CLINIC HEART FAILURE SPINAL CORD INJURY HEMATOLOGY SPINE SURGERY HEMATOPATHOLOGY SPINE ASSESSMENT PROGRAM HEPATIC INTRA-ARTERIAL CHEMOTHERAPY STEM CELL TRANSPLANT HIGH DOSE INTERLEUKIN-2 THERAPY STEREOTACTIC RADIOSURGERY HIGH DOSE RATE INTRACAVITARY STRETTA (LASER PROCEDURE) BRACHYTHERAPY STROKE/TELE-STROKE IMMUNOLOGY SURGICAL ONCOLOGY (COLON, LIVER, INFERTILITY PANCREAS, ESOPHAGEAL, &amp; RENAL) INTENSIVE O/P PSYCHIATRIC PROGRAM SURGICAL PATHOLOGY INTERVENTIONAL PAIN MANAGEMENT TRANSCATHETER AORTIC VALVE INTERVENTIONAL RADIOLOGY IMPLEMENTATION INTRA-OPERATIVE HEPATIC ULTRASOUND TISSUE BANKING AND RADIOFREQUENCY ABLATION OF TRAUMATIC BRAIN INJURY LIVER TUMORS TOXICOLOGY KIDNEY, LIVER &amp; PANCREAS TRANSPLANTS TRAUMA SURGERY LASER SURGERY (YAG LASER) UROGYNECOLOGY LVAD (LEFT VENTRICULAR ASSIST DEVICE) VAGAL NERVE STIMULATORS MAGNETIC RESONANCE IMAGING WOUND CARE MEDICATION THERAPY MANAGEMENT PROGRAM B. RESIDENCY, FELLOWSHIP AND ALLIED HEALTH PROGRAMS GMC CONDUCTS 32 GRADUATE MEDICAL EDUCATION RESIDENCY PROGRAMS AND 26 FELLOWSHIP PROGRAMS. THERE WERE 602 GRADUATE PHYSICIANS PARTICIPATING IN THESE PROGRAMS IN THE YEAR ENDED DECEMBER 31, 2023. PROGRAM SPECIALTIES ARE AS FOLLOWS BUT ARE NOT LIMITED TO: RESIDENCY PROGRAMS ANESTHESIOLOGYOBSTETRICS &amp; GYNECOLOGY CHILD NEUROLOGYOPHTHALMOLOGY CLINICAL PSYCHOLOGYORAL &amp; MAXILLOFACIAL SURGERY COLON &amp; RECTAL SURGERYORTHOPAEDIC SURGERY DERMATOLOGYOTOLARYNGOLOGY DIAGNOSTIC RADIOLOGYPATHOLOGY INTERVENTIONAL RADIOLOGY INTEGRATEDPEDIATRIC DENTISTRY EMERGENCY MEDICINEPEDIATRICS FAMILY MEDICINEPHYSICAL MEDICINE &amp; REHABILITATION GENERAL SURGERYPLASTIC SURGERY INTERNAL MEDICINEPODIATRY INTERNAL MEDICINE - PEDIATRICSUROLOGY NEUROLOGYTRANSITIONAL YEAR NEUROSURGERYVASCULAR SURGERY FELLOWSHIP PROGRAMS DERMATOPATHOLOGYHOSPICE &amp; PALLIATIVE MEDICINE MICROGRAPHIC SURGERY &amp; DERMATOLOGIC ONCOLOGYINFECTIOUS DISEASE INTERVENTIONAL RADIOLOGYINTERVENTIONAL CARDIOLOGY SPORTS MEDICINENEPHROLOGY ADDICTION MEDICINEPULMONARY MEDICINE SURGICAL CRITICAL CARERHEUMATOLOGY VASCULAR SURGERYSLEEP MEDICINE CARDIOVASCULAR MEDICINEMEDICAL PHYSICS CLINICAL CARDIAC ELECTROPHYSIOLOGYVASCULAR NEUROLOGY CLINICAL INFORMATICSMATERNAL FETAL MEDICINE CRITICAL CARE MEDICINECYTOPATHOLOGY GASTROENTEROLOGYPEDIATRIC SPORTS MEDICINE HEMATOLOGY AND ONCOLOGY GMC OPERATED TWO SCHOOLS OF ALLIED HEALTH EDUCATION. THESE SCHOOLS ARE OPERATED WITHIN GMC IN CONJUNCTION WITH VARIOUS COLLEGES AND UNIVERSITIES. IN ADDITION TO CLASSROOM TIME, STUDENTS CONTRIBUTE CLINICAL EDUCATION HOURS AS AN INTEGRAL PART OF THEIR CURRICULUM. DURING THE YEAR ENDED DECEMBER 31, 2023, THE CHAPLAIN SCHOOL HAD ONE STUDENT AND THE PHARMACY RESIDENCY PROGRAM HAD NINE STUDENTS. THE TOTAL COST TO GMC OF PROVIDING RESIDENCY, FELLOWSHIP, ALLIED HEALTH, AND RELATED EDUCATION PROGRAMS, NET OF THIRD- PARTY REIMBURSEMENTS WAS 38,819,323. C. TRAUMA CARE IN OCTOBER 1986 GMC WAS DESIGNATED BY THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION AS A REGIONAL RESOURCE TRAUMA CENTER (LEVEL I) BASED ON THE PROVISION OF COMPREHENSIVE TRAUMA CARE 24 HOURS A DAY AND THE CONDUCT OF OUTREACH, EDUCATIONAL AND RESEARCH PROGRAMS IN TRAUMA CARE. IN 1996, THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION ACCREDITED GMC AS ADDITIONAL QUALIFICATIONS IN PEDIATRICS. GMC HAS BEEN ACCREDITED AS A LEVEL II PEDIATRIC TRAUMA CENTER. THE TRAUMA CENTER INCLUDES LIFE FLIGHT, A MULTIPLE AIRCRAFT, REGIONAL HELICOPTER SERVICE. LIFE FLIGHT PROVIDES RAPID RESPONSE TO CRITICALLY ILL PATIENTS WHO NEED ADVANCE LIFE SUPPORT CARE AND TRANSPORTATION TO CRITICAL CARE FACILITIES. GEISINGER LIFE FLIGHT OPERATED NINE AIRCRAFTS AND FOUR GROUND CRITICAL CARE EQUIPPED AMBULANCES FROM SEVEN OPERATIONAL SITES FOR THE YEAR ENDED DECEMBER 31, 2023. NINE STATE-OF-THE-ART MEDICAL HELICOPTERS INCLUDE ONE BK117 AND EIGHT EC145S. THE GROUND UNITS CONTAIN THE SAME EQUIPMENT AS THE AIRCRAFT FOR CRITICAL CARE GROUND TRANSPORTS. THE BASE LOCATIONS FOR THE YEAR ENDING DECEMBER 31, 2023 WERE IN DANVILLE, SELINSGROVE, STATE COLLEGE, AVOCA, WILLIAMSPORT, MINERSVILLE AND LEHIGHTON PA. THE DISPATCHING OF LIFE FLIGHT FOR INTER-HOSPITAL TRANSFERS AND SCENE CALLS IS AUTHORIZED BY A PHYSICIAN OR OTHER QUALIFIED PERSONNEL AND IS DETERMINED ON AN INDIVIDUAL BASIS ACCORDING TO MEDICAL NEED. IN THE YEAR ENDED DECEMBER 31, 2023, LIFE FLIGHT PROVIDED EMERGENCY TRANSPORTATION TO 4,461 PATIENTS AND SERVED MULTIPLE HOSPITALS IN PENNSYLVANIA AND NEIGHBORING STATES. D. JANET WEIS CHILDREN'S HOSPITAL THE JANET WEIS CHILDREN'S HOSPITAL HOUSES ALL INPATIENT PEDIATRIC BEDS INCLUDING 36 MEDICAL AND SURGICAL, 41 NEWBORN INTENSIVE AND SPECIAL CARE AND 14 PEDIATRIC INTENSIVE CARE BEDS. THE FACILITY ALSO PROVIDES SPACE FOR PEDIATRIC REHABILITATION AND HAS ESTABLISHED AN AMBULANCE TRANSPORT SERVICE FOR NEONATAL RETRIEVALS. THE FACILITY IS CONNECTED WITH THE REST OF THE MEDICAL CENTER AT FOUR OF THE FIVE LEVELS TO ALLOW FOR SMOOTH INTEGRATION OF ANCILLARY AND SUPPORT SERVICES. THE FUNDING FOR THE CONSTRUCTION OF THE JANET WEIS CHILDREN'S HOSPITAL WAS PROVIDED BY THE DONATING PUBLIC, INCLUDING FUNDS RAISED BY THE CHILDREN'S MIRACLE NETWORK TELETHON. THIS FACILITY IS VISIBLE EVIDENCE OF GEISINGER'S COMMITMENT TO THE CHILDREN OF PENNSYLVANIA. FOR THE YEAR ENDED DECEMBER 31, 2023, THE JANET WEIS CHILDREN'S HOSPITAL DISCHARGED 3,700 PATIENTS AND PROVIDED 22,274 PATIENT DAYS OF SERVICE. THE FACILITY AFFORDS MORE EFFICIENT CARE WITH AN IMPROVED LENGTH OF STAY. E. WOMEN'S HEALTH PAVILION THE WOMEN'S HEALTH PAVILION, ON THE CAMPUS OF GMC, WAS DEDICATED AS PART OF THE JANET WEIS CHILDREN'S AND WOMEN'S HOSPITAL IN 2000. THE WOMEN'S PAVILION FEATURES FAMILY-ORIENTED BIRTHING SUITES THAT ALLOW EACH WOMAN TO LABOR, DELIVER AND RECOVER IN THE SAME SPACE. IN ADDITION, THERE ARE SEMI-PRIVATE ROOMS, A NURSERY AND TWO CAESAREAN SECTION OPERATING SUITES. THE GEISINGER WOMEN'S PAVILION IS THE ONLY HOSPITAL IN THE AREA THAT OFFERS COVERAGE BY OBS</Desc>
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        <PersonNm>KEVIN V ROBERTS MBA CPA</PersonNm>
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        <PersonNm>STEVEN B BENDER ESQUIRE</PersonNm>
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        <PersonNm>NICHOLAS SEBES MD</PersonNm>
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        <PersonNm>GRANT A CIAVARELLA DO</PersonNm>
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        <PersonNm>MEGAN BROSIOUS</PersonNm>
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      <Form990PartVIISectionAGrp>
        <PersonNm>IAN COOTE MD</PersonNm>
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        <PersonNm>SHEEL MEHTA DO</PersonNm>
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        <PersonNm>MARK MASSAK DO</PersonNm>
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        <PersonNm>CRYSTAL K MUTHLER BSN RN MHA</PersonNm>
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        <PersonNm>LORI R GRAMLEY ESQUIRE</PersonNm>
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        <PersonNm>MISTRAINE DURAND DOUGLAS DO</PersonNm>
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        <PersonNm>HARSH PATEL MD</PersonNm>
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        <PersonNm>TAMMY ANDERER CRNP PHD</PersonNm>
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        <PersonNm>ANDREA WARY MED BSN RN</PersonNm>
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        <PersonNm>THOMAS C WAGNER</PersonNm>
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        <PersonNm>JEFFREY A JACOBSON</PersonNm>
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        <PersonNm>BENJAMIN K CHU MD MPH MACP</PersonNm>
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        <PersonNm>VIRGINIA MCGREGOR</PersonNm>
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        <PersonNm>V CHRIS HOLCOMBE PE</PersonNm>
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          <BusinessName>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>GEISINGER ENCOMPASS HEALTH</BusinessNameLine1Txt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>QUEST DIAGNOSTICS</BusinessNameLine1Txt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>HCSC</BusinessNameLine1Txt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
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        <ServicesDesc>SERVICE AGREE.</ServicesDesc>
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        <Desc>PARTNERSHIP INCOME</Desc>
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      <RelatedOrgListSchRInd>true</RelatedOrgListSchRInd>
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        <BookValueAmt>27358834</BookValueAmt>
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        <DepreciationAmt>203726289</DepreciationAmt>
        <BookValueAmt>137434135</BookValueAmt>
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        <BookValueAmt>1275306</BookValueAmt>
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        <FormAndLineReferenceDesc>SCHEDULE D, PAGE 4, PART XIII</FormAndLineReferenceDesc>
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      </AccountActivitiesOutsideUSGrp>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>EUROPE</RegionTxt>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>GROUP A, FACILITY 1, GEISINGER MEDICAL CENTER - PART V, LINE 3E</FormAndLineReferenceDesc>
        <ExplanationTxt>PRIORITIZED COMMUNITY HEALTH NEEDS TO WORK TOWARD HEALTH EQUITY, IT IS IMPERATIVE TO PRIORITIZE RESOURCES AND ACTIVITIES TOWARD THE MOST PRESSING AND CROSS-CUTTING HEALTH NEEDS WITHIN THE COMMUNITY. PRIORITIES WERE JOINTLY DETERMINED BY THE CHNA COLLABORATING HEALTH SYSTEMS USING FEEDBACK FROM COMMUNITY STAKEHOLDERS. THROUGH THIS PROCESS, CHNA PARTNERS AFFIRMED THE FOLLOWING PRIORITY HEALTH NEEDS: ACCESS TO CARE BEHAVIORAL HEALTH CHRONIC DISEASE PREVENTION AND MANAGEMENT THESE PRIORITIES ARE CONSISTENT WITH THOSE DETERMINED IN THE PREVIOUS FY2019 CHNA AND REFLECT COMPLEX NEEDS REQUIRING SUSTAINED COMMITMENT AND RESOURCES. MATERNAL AND CHILD HEALTH NEEDS ARE ALSO PREVALENT ACROSS THE SERVICE AREA. WHILE CHNA PARTNERS DID NOT IDENTIFY MATERNAL AND CHILD HEALTH AS A PRIORITY ISSUE DUE TO THE NEED TO FOCUS AVAILABLE RESOURCES, MANY OF THE HOSPITALS SUPPORT MATERNAL AND CHILD HEALTH STRATEGIES AS PART OF THEIR IMPLEMENTATION PLAN. THESE STRATEGIES INCLUDE FREE OR LOW-COST CLASSES AND SUPPORT GROUPS FOR PREGNANT AND NEW MOTHERS, LACTATION CONSULTATION, TREATMENT AND SUPPORT SERVICES FOR MOTHERS IN RECOVERY, SOCIAL ASSISTANCE, AND POSTPARTUM DEPRESSION SCREENING, AMONG OTHERS. CHNA IMPLEMENTATION PLAN TO DIRECT COMMUNITY BENEFIT AND HEALTH IMPROVEMENT ACTIVITIES, CHNA PARTNERS CREATED INDIVIDUAL HOSPITAL IMPLEMENTATION PLANS TO DETAIL THE RESOURCES AND SERVICES THAT WILL BE USED TO ADDRESS HEALTH PRIORITIES. THE IMPLEMENTATION PLANS BUILD UPON PREVIOUS HEALTH IMPROVEMENT ACTIVITIES AND TAKE INTO CONSIDERATION NEW HEALTH NEEDS AND THE CHANGING HEALTH CARE DELIVERY ENVIRONMENT AS DETAILED IN THE 2021 CHNA.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>GROUP A, FACILITY 1, GEISINGER MEDICAL CENTER - PART V, LINE 5</FormAndLineReferenceDesc>
        <ExplanationTxt>SECTION B., COMMUNITY HEALTH NEEDS ASSESSMENT, LINES 3, 5 AND 6A: CHNA COLLABORATING HEALTH SYSTEMS THE 2021 GEISINGER COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED IN PARTNERSHIP WITH GEISINGER, ALLIED SERVICES INTEGRATED HEALTH SYSTEM, AND EVANGELICAL COMMUNITY HOSPITAL. THE STUDY AREA INCLUDED 15 COUNTIES ACROSS CENTRAL AND NORTHEASTERN PENNSYLVANIA, WHICH REPRESENTED THE HEALTH SYSTEMS' COLLECTIVE SERVICE AREAS. COLLABORATION IN THIS WAY CONSERVES VITAL COMMUNITY RESOURCES WHILE FOSTERING A PLATFORM FOR "COLLECTIVE IMPACT" THAT ALIGNS COMMUNITY EFFORTS TOWARD A COMMON GOAL OR ACTION. TO DISTINGUISH UNIQUE SERVICE AREAS AMONG HOSPITALS, REGIONAL RESEARCH AND REPORTING WAS DEVELOPED. CHNA LEADERSHIP THE 2021 CHNA WAS OVERSEEN BY A PLANNING COMMITTEE OF REPRESENTATIVES FROM EACH HEALTH SYSTEM, AS WELL AS A REGIONAL ADVISORY COMMITTEE OF HOSPITAL AND HEALTH SYSTEM REPRESENTATIVES. COMMUNITY HEALTH CONSULTANTS ASSISTED IN ALL PHASES OF THE CHNA, INCLUDING PROJECT MANAGEMENT, DATA COLLECTION AND ANALYSIS, AND REPORT WRITING. CHNA METHODOLOGY THE 2021 CHNA WAS CONDUCTED FROM JULY TO DECEMBER 2020. QUANTITATIVE AND QUALITATIVE METHODS, REPRESENTING BOTH PRIMARY AND SECONDARY RESEARCH, WERE USED TO ILLUSTRATE AND COMPARE HEALTH AND SOCIAL TRENDS AND DISPARITIES ACROSS EACH REGION AND HOSPITAL SERVICE AREA. THE FOLLOWING RESEARCH METHODS WERE USED TO DETERMINE COMMUNITY HEALTH NEEDS: -STATISTICAL ANALYSIS OF HEALTH AND SOCIOECONOMIC DATA INDICATORS; A FULL LISTING OF DATA REFERENCES IS INCLUDED IN THE CHNA -ELECTRONIC SURVEY OF KEY STAKEHOLDERS, INCLUDING EXPERTS IN PUBLIC HEALTH AND INDIVIDUALS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS; A LIST OF KEY INFORMANTS AND THEIR RESPECTIVE ORGANIZATIONS IS INCLUDED IN THE CHNA -DISCUSSION AND PRIORITIZATION OF COMMUNITY HEALTH NEEDS TO DETERMINE THE MOST PRESSING HEALTH ISSUES ON WHICH TO FOCUS COMMUNITY HEALTH IMPROVEMENT EFFORTS COMMUNITY ENGAGEMENT COMMUNITY ENGAGEMENT WAS AN INTEGRAL PART OF THE 2021 CHNA. A VIRTUAL TOWN HALL WAS HELD IN AUGUST 2020 TO ANNOUNCE THE ONSET OF THE CHNA AND ENCOURAGE BROAD STAKEHOLDER PARTICIPATION. A KEY INFORMANT SURVEY WAS SENT TO NEARLY 1,000 COMMUNITY STAKEHOLDERS TO SOLICIT INPUT ON HEALTH DISPARITIES, OPPORTUNITIES FOR COLLABORATION, COVID-19 RESPONSE, COMMUNITY HEALTH PRIORITIES, AMONG OTHER INSIGHTS. CONTINUED COMMUNITY ENGAGEMENT ACTIVITIES ARE PLANNED TO ENSURE ONGOING DIALOGUE AND A FORUM FOR ADDRESSING COMMUNITY HEALTH NEEDS. CHNA IMPLEMENTATION PLAN TO DIRECT COMMUNITY BENEFIT AND HEALTH IMPROVEMENT ACTIVITIES, CHNA PARTNERS CREATED INDIVIDUAL HOSPITAL IMPLEMENTATION PLANS TO DETAIL THE RESOURCES AND SERVICES THAT WILL BE USED TO ADDRESS HEALTH PRIORITIES. THE IMPLEMENTATION PLANS BUILD UPON PREVIOUS HEALTH IMPROVEMENT ACTIVITIES AND TAKE INTO CONSIDERATION NEW HEALTH NEEDS AND THE CHANGING HEALTH CARE DELIVERY ENVIRONMENT AS DETAILED IN THE 2021 CHNA. BOARD APPROVAL THE 2021 CHNA WAS CONDUCTED IN A TIMELINE TO COMPLY WITH IRS TAX CODE 501 (R) REQUIREMENTS TO CONDUCT A CHNA EVERY THREE YEARS AS SET FORTH BY THE AFFORDABLE CARE ACT (ACA). THE RESEARCH FINDINGS WILL BE USED TO GUIDE COMMUNITY BENEFIT INITIATIVES FOR THE HOSPITALS AND ENGAGE LOCAL PARTNERS TO COLLECTIVELY ADDRESS IDENTIFIED HEALTH NEEDS. THE CHNA REPORT WAS PRESENTED TO THE GEISINGER BOARD OF DIRECTORS AND APPROVED IN DECEMBER 2020. GEISINGER IS COMMITTED TO ADVANCING INITIATIVES AND COMMUNITY COLLABORATION TO SUPPORT THE ISSUES IDENTIFIED THROUGH THE CHNA. FOLLOWING THE BOARD'S APPROVAL, ALL CHNA REPORTS WERE MADE AVAILABLE TO THE PUBLIC VIA THE GEISINGER WEBSITE AT: HTTPS://WWW.GEISINGER.ORG/ABOUT- GEISINGER/OMMUNITY-ENGAGEMENT/CHNA. THROUGHOUT THIS DOCUMENT, THE TERMS "GEISINGER- OR "GEISINGER HEALTH" SHALL REFER TO THE ENTIRE HEALTH CARE SYSTEM COMPRISED OF GEISINGER HEALTH FOUNDATION (THE "FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATE ENTITIES COMPRISING THE HEALTH CARE SYSTEM. IN ADDITION, THROUGHOUT THIS DOCUMENT, THE TERM "SYSTEM" SHALL REFER TO THE ENTIRE HEALTH CARE SYSTEM AS PREVIOUSLY DEFINED PLUS ITS AFFILIATES.</ExplanationTxt>
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        <FormAndLineReferenceDesc>GROUP A, FACILITY 1, GEISINGER MEDICAL CENTER - PART V, LINE 6A</FormAndLineReferenceDesc>
        <ExplanationTxt>ALLIED SERVICES REHABILITATION HOSPITAL, HEINZ REHABILITATION HOSPITAL, EVANGELICAL COMMUNITY HOSPITAL, GEISINGER MEDICAL CENTER (INCLUDES GEISINGER-SHAMOKIN AREA COMMUNITY HOSPITAL), GEISINGER ENCOMPASS HEALTH LIMITED LIABILITY COMPANY (DBA GEISINGER ENCOMPASS HEALTH REHABILITATION HOSPITAL), GEISINGER WYOMING VALLEY MEDICAL CENTER (INCLUDES GEISINGER SOUTH WILKES-BARRE), GEISINGER-BLOOMSBURG HOSPITAL, COMMUNITY MEDICAL CENTER (DBA GEISINGER COMMUNITY MEDICAL CENTER), GEISINGER JERSEY SHORE HOSPITAL, GEISINGER-LEWISTOWN HOSPITAL, AND GEISINGER MEDICAL CENTER MUNCY.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>GROUP A, FACILITY 1, GEISINGER MEDICAL CENTER - PART V, LINE 7D</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HOSPITAL'S CHNA AND CHNA IMPLEMENTATION STRATEGY ARE POSTED ON THE HOSPITAL'S WEBSITE AT WWW.GEISINGER.ORG/ABOUT-GEISINGER/COMMUNITY- ENGAGEMENT/CHNA.</ExplanationTxt>
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      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>GROUP A, FACILITY 1, GEISINGER MEDICAL CENTER - PART V, LINE 11</FormAndLineReferenceDesc>
        <ExplanationTxt>GEISINGER, AS PART OF ITS ENDURING DEDICATION TO COMMUNITY WELL-BEING, METICULOUSLY CONDUCTS COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNAS) IN CLOSE COLLABORATION WITH VARIOUS PARTNERS. THESE ASSESSMENTS ENCOMPASS GATHERING VALUABLE FEEDBACK FROM THE POPULATION WE SERVE, INCLUSIVE OF EXPERT INSIGHTS FROM MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY COMMUNITIES. THROUGH A RIGOROUS EXAMINATION OF PREVAILING COMMUNITY HEALTH DEMANDS, AVAILABLE RESOURCES, AND GAPS IN SERVICE DELIVERY, GEISINGER IDENTIFIES AND PRIORITIZES KEY HEALTH IMPERATIVES. AS A HEALTH SYSTEM, WE REMAIN STEADFAST IN OUR COMMITMENT TO MEETING THE DIVERSE NEEDS OF THE COMMUNITIES WITHIN OUR OPERATIONAL FOOTPRINT. WE STRIVE TO DELIVER HIGHLY LOCALIZED SUPPORT TO THE AREAS SURROUNDING OUR FACILITIES AND LINES OF BUSINESS. ACCESS TO CARE: OUR ASSESSMENTS CONSISTENTLY HIGHLIGHTED THE PRESSING NEED FOR HEALTHCARE ACCESS, PARTICULARLY AMONG VULNERABLE POPULATIONS. THESE GROUPS ENCOMPASSED INDIVIDUALS RESIDING IN RURAL AREAS, FACING A SCARCITY OF HEALTHCARE PROFESSIONALS, PATIENTS LACKING TRANSPORTATION, ELDERLY INDIVIDUALS WITH COMPLEX MEDICAL CONDITIONS, THE HOMEBOUND, THOSE WITH INADEQUATE INSURANCE COVERAGE, AND INDIVIDUALS WHO REFRAINED FROM SEEKING MEDICAL CARE DUE TO CULTURAL REASONS. BEARING THESE CHALLENGES IN MIND, GEISINGER TAILORED ITS ACCESS TO CARE COMMUNITY INITIATIVES TO ENSURE REGULAR AND DEPENDABLE ACCESS TO HEALTH SERVICES, ENABLING EARLY DETECTION, TREATMENT OF ILLNESSES, AND EFFECTIVE DISEASE MANAGEMENT AND PREVENTION FOR OUR DIVERSE PATIENT POPULATION. GEISINGER'S COVID-19 RESPONSE IN RESPONSE TO THE FORMIDABLE CHALLENGE POSED BY THE PANDEMIC, GEISINGER SWIFTLY ADAPTED ITS OPERATIONS TO SUPPORT THE COMMUNITIES WE SERVE, MANIFESTING IN THE FOLLOWING WAYS: - VACCINE DISTRIBUTION: GEISINGER FACILITATED THE DISTRIBUTION OF OVER 320,000 VACCINES TO DATE. WE REPURPOSED VACANT OFFICE SPACES INTO VACCINATION CENTERS, EFFICIENTLY INOCULATING BOTH OUR EMPLOYEES AND THE WIDER COMMUNITY. - OUR WALK-IN CARE LOCATIONS SEAMLESSLY TRANSITIONED INTO TESTING FACILITIES, PROVIDING ESSENTIAL TESTING SERVICES AND ACTING AS A VALUABLE RESOURCE FOR SCHOOLS AND EMPLOYERS SEEKING TESTING AND RETURN TO WORK/SCHOOL DOCUMENTATION - A COLLABORATIVE EFFORT INVOLVED COORDINATING 2,300 DEPLOYMENTS/INTERVENTIONS WITH SKILLED NURSING FACILITIES ACROSS THE STATE. WE PROVIDED CRUCIAL ASSISTANCE IN RAPID RESPONSE, ENSURING ADEQUATE PPE, CONDUCTING NECESSARY TESTING, IMPLEMENTING INFECTION PREVENTION MEASURES, AND ADMINISTERING VACCINES - CONTACT TRACING: WHILE TYPICALLY A RESPONSIBILITY OF PUBLIC HEALTH, GEISINGER TOOK PROACTIVE MEASURES TO INTERCEPT THE VIRUS'S SPREAD THROUGH COMPREHENSIVE CONTACT TRACING EFFORTS. WE REDEPLOYED DOZENS OF EMPLOYEES TO BOLSTER OUR CONTACT TRACING INITIATIVES. IN THE SPRING AND SUMMER OF 2020, GEISINGER SUCCESSFULLY COMPLETED OVER 3,000 NOTIFICATIONS AS PART OF OUR EXTENSIVE CONTACT TRACING EFFORTS. - COMMUNITY SUPPORT: GEISINGER ORCHESTRATED A SERIES OF INFORMATIVE WEBINARS, TOWN HALLS, AND DIGITAL RESOURCES AIMED AT KEEPING SCHOOLS, COMMUNITY GROUPS, CHAMBERS, AND EMPLOYERS WELL-INFORMED ABOUT THE EVER-EVOLVING PANDEMIC. OUR FRESH FOOD FARMACY INITIATIVE PLAYED A VITAL ROLE BY PROVIDING AN IMPRESSIVE 42,000 MEALS PER MONTH TO PARTICIPANTS, ADDRESSING A CRUCIAL NEED IN THE COMMUNITY. FURTHER EXTENDING OUR SUPPORT, OUR 65 FORWARD LOCATIONS ORGANIZED OUTDOOR EXERCISE CLASSES AND DISTRIBUTED CARE PACKAGES CONTAINING ESSENTIAL PERSONAL CARE ITEMS TO INDIVIDUALS WHO WERE CONFINED TO THEIR HOMES. ANY PLAN AIMED AT REDUCING BARRIERS TO CARE HAD TO INCORPORATE TELEMEDICINE OPTIONS. THE COVID-19 PANDEMIC SAW A SIGNIFICANT SURGE IN TELEHEALTH UTILIZATION ACROSS THE NATION, AND GEISINGER CAPITALIZED ON THIS OPPORTUNITY, EMERGING AS A LEADING TELEHEALTH NETWORK IN THE US, SURPASSING NATIONAL AVERAGES FOR TELEMEDICINE USE. AS PART OF OUR ROUTINE SCHEDULING PROCESS, WE INQUIRED IF PATIENTS PREFERRED A TELEHEALTH VISIT. IF SO, WE PROMPTLY ARRANGED THE APPOINTMENT AND SENT AN EMAIL WITH A DIRECT LINK TO THEIR PROVIDER OR ANY OF THE 72 SPECIALTIES AVAILABLE FOR VIRTUAL CONSULTATIONS. FOR PATIENTS LACKING INTERNET ACCESS AT HOME, GEISINGER OFFERED TELEHEALTH VISITS AT THEIR NEAREST HEALTH CLINIC. TELEMEDICINE NOT ONLY BENEFITED PATIENTS WITHOUT TRANSPORTATION BUT ALSO CATERED TO THOSE WHO ENDURED LENGTHY DRIVES OR CHALLENGING WEATHER CONDITIONS TO VISIT THEIR DOCTOR, CIRCUMSTANCES THAT MIGHT HAVE LED TO APPOINTMENT CANCELLATIONS. IN MANY CASES, TELEMEDICINE ENABLED WAGE-EARNING PATIENTS TO CONSULT THEIR DOCTOR WITHOUT CLOCKING OUT AND LOSING PAY, AS OUR DOCTORS COULD CONNECT WITH THEM BEFORE WORK OR DURING THEIR LUNCH HOUR. GEISINGER HAD INTEGRATED CLINICAL AND POPULATION HEALTH EXPERTISE TO ADDRESS ACCESS NEEDS FOR TWO DISTINCT PATIENT POPULATIONS: THOSE BURDENED BY THE RISING COSTS OF HEALTHCARE SERVICES AND THE RAPIDLY GROWING SENIOR POPULATION. WE HAD INTEGRATED A RANGE OF HEALTH AND WELLNESS SERVICES CRUCIAL FOR THESE DEMOGRAPHICS, INCORPORATING CARE MODELS SUCH AS TRADITIONAL HOSPITAL SERVICES, 65 FORWARD (SENIOR PRIMARY CARE), CONVENIENT CARE (WALK-IN CLINICS AND URGENT CARE), COMMUNITY CARE CLINICS (URGENT CARE AND PRIMARY CARE), AND VIRTUAL HEALTH INITIATIVES. THIS INTEGRATION ENABLED US TO EFFICIENTLY ADDRESS ACUTE, CHRONIC, AND URGENT CARE NEEDS IN THE MOST COST-EFFECTIVE SETTINGS WHILE ENHANCING ACCESS TO OUTPATIENT CARE FOR DISEASE MANAGEMENT AND PREVENTION. IN 2022, GEISINGER COMMONWEALTH SCHOOL OF MEDICINE (GCSOM) MADE STRIDES TOWARD SOLIDIFYING A PARTNERSHIP TO REOPEN THE LEAHY CLINIC, A PROVIDER OF FREE NON-EMERGENCY HEALTHCARE, AT THE UNIVERSITY OF SCRANTON, TRANSFORMING IT INTO A LONGITUDINAL FREE CLINIC FOR LACKAWANNA COUNTY. IN LINE WITH THIS COMMITMENT, GEISINGER HAD CONTRIBUTED TO "A COMMUNITY CLINIC", WHICH PROVIDED HEALTHCARE FOR THE UNINSURED IN SUNBURY, OFFERING SUPPORT IN MARKETING, REFERRALS, AND PROVIDING LAB AND X-RAY SUPPORT TO THE CLINIC. ENSURING HEALTHCARE ACCESS HAD NECESSITATED AN ADEQUATE NUMBER OF HEALTHCARE PROFESSIONALS TO SERVE THE PATIENT POPULATION. GEISINGER HAD SUCCESSFULLY RECRUITED AND RETAINED HEALTHCARE PROFESSIONALS WITHIN THE SYSTEM THROUGH A SERIES OF INITIATIVES. OUR SYSTEMWIDE CLINICAL CO-OP PROGRAM ENGAGED HIGH SCHOOL AND TECHNICAL SCHOOL SENIORS INTERESTED IN HEALTHCARE, PROVIDING THEM THE OPPORTUNITY TO WORK AS NURSING ASSISTANTS FOR A YEAR. THEY GAINED EXPOSURE BY SHADOWING OUR NURSES IN PHLEBOTOMY OR SURGICAL TECH. THESE CO-OP PROGRAMS ENCOURAGED MANY TO ENROLL IN NURSING SCHOOL WITH OUR SUPPORT AND SUBSEQUENTLY JOIN GEISINGER UPON GRADUATION. OUR NURSE RESIDENCY PROGRAM HAD TARGETED RECENT NURSING GRADUATES, SUPPORTING THEM THROUGH THEIR INITIAL AND OFTEN CHALLENGING YEAR OF NURSING PRACTICE BY PROVIDING EDUCATION THROUGH RESIDENCY SESSIONS, CLASSES, AND SIMULATIONS CONDUCTED BY OUR STAFF. AS PART OF THIS PROGRAM, WE HAD OFFERED A SIX-MONTH MEDICAL SURGICAL FELLOWSHIP FOR NEW NURSES SEEKING SPECIALIZATION IN CARDIAC, ONCOLOGY, TRAUMA, OR SURGERY. FELLOWSHIP COURSES WERE LED BY OUR EXPERIENCED NURSES, PHYSICIAN ASSISTANTS, AND SURGEONS. THE ABIGAIL GEISINGER SCHOLARS PROGRAM HAD CATERED TO GCSOM STUDENTS WILLING TO WORK AT GEISINGER AS PHYSICIANS IN FAMILY MEDICINE, INTERNAL MEDICINE, MEDICINE/PEDIATRICS, OR PSYCHIATRY. IN EXCHANGE FOR A WORK COMMITMENT OF UP TO FOUR YEARS, SELECTED SCHOLARS HAD RECEIVED TUITION SUPPORT AND A MONTHLY STIPEND. MOREOVER, AN ABIGAIL GEISINGER SCHOLAR PROGRAM WAS OPEN TO ANYONE WORKING IN OUR NURSING DEPARTMENT. WHEN THEY MET THE CRITERIA, WE HAD ASSISTED THEM IN ENROLLING IN NURSING SCHOOL. THESE COMPETITIVE RECRUITMENT PROGRAMS HAD ENSURED A CONSISTENT PIPELINE OF NURSES AND PHYSICIANS TO SERVE OUR COMMUNITIES IN THE FUTURE. GEISINGER COMMONWEALTH SCHOOL OF MEDICINE (GCSOM) HAD RECEIVED A SIGNIFICANT PASMART ADVANCING COMPUTER SCIENCE AND STEM EDUCATION GRANT FROM THE PENNSYLVANIA DEPARTMENT OF EDUCATION. THE GRANT, AMOUNTING TO 494,262, HAD BEEN AIMED AT FOSTERING PARTNERSHIPS WITH VARIOUS SCHOOLS TO PREPARE STUDENTS IN HAZLETON, SCRANTON, WILKES-BARRE, COLUMBIA, AND NORTHUMBERLAND COUNTIES FOR CAREERS IN MEDICINE AND STEM-RELATED FIELDS. THIS INITIATIVE, KNOWN AS THE PA PHYSICIAN READY PROGRAM, HAD NOT ONLY ADDRESSED THE PHYSICIAN SHORTAGE BUT HAD ALSO INCREASED DIVERSITY IN MEDICAL CAREERS AND MET THE HEALTHCARE WORKFORCE DEMANDS IN PENNSYLVANIA. TO ADDRESS THE NEEDS OF MEDICALLY COMPLEX PATIENTS LACKING TRANSPORTATION MEANS, GEISINGER HAD EXPANDED A FEDERALLY FUNDED GRANT PROGRAM CALLED 4RIDE TRANSPORTATION BY COLLABORATING WITH A MOBILITY SERVICE VENDOR, RABBIT TRANSIT. ELIGIBLE PATIENTS WERE CONNECTED TO PUBLIC TRANSPORTATION, TAXIS, RIDE SERVICE CARRIERS LIKE LYFT, OR OTHER MEDICARE/MEDICAID SERVICES FOR THEIR MEDICAL APPOINTMENTS. NOTABLY, THIS SERVICE HAD EXTENDED TO ESSENTIAL DESTINATIONS SUCH AS FOOD BANKS AND PHARMACIES. FOLLOWING A TRIP, PATIENTS HAD RECEIVED ONGOING FOLLOW-UP TO TACKLE ANY ADDITIONAL SOCIAL OBSTACLES THEY MAY HAVE ENCOUNTERED. SEVERAL GE</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>GROUP A, FACILITY 1, GEISINGER MEDICAL CENTER - PART V, LINE 13B</FormAndLineReferenceDesc>
        <ExplanationTxt>RECENT WAGE STATEMENTS, UNEMPLOYMENT OR OTHER DOCUMENTATION OF BENEFITS OR COMPENSATION RECEIVED MAY BE CONSIDERED IN DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>GROUP A, FACILITY 1, GEISINGER MEDICAL CENTER - PART V, LINE 16J</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>GROUP A, FACILITY 1, GEISINGER MEDICAL CENTER - PART V, LINE 20E</FormAndLineReferenceDesc>
        <ExplanationTxt>REFER TO RESPONSE FOR PART III, LINE 9B</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, LINE 3C</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, LINE 6A</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, LINE 7G</FormAndLineReferenceDesc>
        <ExplanationTxt>THERE ARE NO PHYSICIAN CLINICAL SERVICES INCLUDED IN SUBSIDIZED HEALTH SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, LINE 8</FormAndLineReferenceDesc>
        <ExplanationTxt>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 96,436,309 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART III, LINE 9B</FormAndLineReferenceDesc>
        <ExplanationTxt>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 &amp; 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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>CHNA COLLABORATING HEALTH SYSTEMS THE 2021 GEISINGER COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED IN PARTNERSHIP WITH GEISINGER, ALLIED SERVICES INTEGRATED HEALTH SYSTEM, AND EVANGELICAL COMMUNITY HOSPITAL. THE STUDY AREA INCLUDED 15 COUNTIES ACROSS CENTRAL AND NORTHEASTERN PENNSYLVANIA, WHICH REPRESENTED THE HEALTH SYSTEMS' COLLECTIVE SERVICE AREAS. COLLABORATION IN THIS WAY CONSERVES VITAL COMMUNITY RESOURCES WHILE FOSTERING A PLATFORM FOR "COLLECTIVE IMPACT" THAT ALIGNS COMMUNITY EFFORTS TOWARD A COMMON GOAL OR ACTION. TO DISTINGUISH UNIQUE SERVICE AREAS AMONG HOSPITALS, REGIONAL RESEARCH AND REPORTING WAS DEVELOPED. 2021 CHNA GEOGRAPHIC REGIONS AND PRIMARY SERVICE COUNTIES 1- CENTRAL REGION INCLUDING THE COUNTIES OF COLUMBIA, MONTOUR, NORTHUMBERLAND, SCHUYLKILL, SNYDER AND UNION REPRESENTED BY GEISINGER- BLOOMSBURG HOSPITAL, GEISINGER MEDICAL CENTER (INCLUDES GEISINGER SHAMOKIN AREA COMMUNITY HOSPITAL), GEISINGER ENCOMPASS HEALTH LIMITED LIABILITY COMPANY (DBA GEISINER ENCOMPASS HEALTH REHABILITATION HOSPITAL) AND EVANGELICAL COMMUNITY HOSPITAL. 2- NORTH CENTRAL REGION INCLUDING THE COUNTIES OF CLINTON AND LYCOMING REPRESENTED BY GEISINGER JERSEY SHORE HOSPITAL AND GEISINGER MEDICAL CENTER MUNCY (LICENSED/OPERATIONAL JANUARY 2022) 3- NORTHEAST REGION INCLUDING THE COUNTIES OF LACKAWANNA, LUZERNE, WAYNE AND WYOMING REPRESENTED BY ALLIED SERVICES REHAB HOSPITAL, COMMUNITY MEDICAL CENTER (DBA GEISINGER COMMUNITY MEDICAL CENTER, GEISINGER WYOMING VALLEY MEDICAL CENTER (INCLUDES GEISINGER SOUTH WILKES-BARRE) AND HEINZ REHAB HOSPITAL. 4- WESTERN REGION INCLUDING THE COUNTIES OF CENTRE, JUNIATA AND MIFFLIN REPRESENTED BY GEISINGER-LEWISTOWN HOSPITAL. GEISINGER SYSTEMWIDE CHNA APPROACH THE 2021 CHNA FOCUSED ON THE PRIMARY SERVICE AREAS OF EACH OF GEISINGER'S NINE HOSPITAL CAMPUSES. UNDERSTANDING OVERLAPPING GEOGRAPHIC BOUNDARIES, SOCIOECONOMICS, AND RELATED COMMUNITY INDICATORS, GEISINGER HOSPITALS WERE GROUPED INTO REGIONS TO ALLOW FOR LOCALIZED DATA COMPARISONS. SYSTEMWIDE PRIORITIES WERE DETERMINED TO ADDRESS COMMON NEEDS ACROSS THE WHOLE SERVICE AREA, WHILE INDIVIDUAL HOSPITAL IMPLEMENTATION PLANS OUTLINED SPECIFIC STRATEGIES TO GUIDE LOCAL EFFORTS AND COLLABORATION WITH COMMUNITY PARTNERS. SEE ALSO THE DISCUSSION RELATED TO THE RESPONSE TO PART V, LINE 5.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>GEISINGER MEDICAL CENTER AND GEISINGER SHAMOKIN AREA COMMUNITY HOSPITAL OPERATE UNDER THE SAME LICENSE, AND AS SUCH ARE CONSIDERED A SINGLE ENTITY FOR PURPOSES OF THE CHNA. GEISINGER ENCOMPASS HEALTH REHABILITATION HOSPITAL IS LOCATED ON THE CAMPUS OF GEISINGER MEDICAL CENTER AND IS OPERATED AS A PARTNERSHIP BETWEEN GEISINGER MEDICAL CENTER AND ENCOMPASS HEALTH CORPORATION. COLLECTIVELY, THE THREE FACILITIES PRIMARILY SERVE RESIDENTS IN 81 ZIP CODES SPANNING 15 COUNTIES IN PENNSYLVANIA. THE PRIMARY SERVICE AREA, IDENTIFIED BASED ON THE PATIENT ZIP CODES OF ORIGIN COMPRISING 80% OF HOSPITAL DISCHARGES IN FISCAL YEAR 2019, IS LARGELY WITHIN THE CHNA CENTRAL REGION. CENTRAL REGION POPULATION TRENDS THE CENTRAL REGION IS PREDOMINANTLY RURAL WITH SMALL POPULATION CENTERS SCATTERED ACROSS THE 6-COUNTY GEOGRAPHY. THE LARGEST POPULATION CENTER IS BLOOMSBURG (COLUMBIA COUNTY) WITH 14,290 RESIDENTS, AND HOME TO BLOOMSBURG UNIVERSITY OF PENNSYLVANIA. OTHER POPULATION HUBS ARE CENTERED AROUND THESE CITIES AND BOROUGHS: POTTSVILLE (SCHUYLKILL COUNTY), WITH 13,965 RESIDENTS; BERWICK (COLUMBIA COUNTY) WITH 10,118 RESIDENTS; SUNBURY (NORTHUMBERLAND COUNTY), WITH 9,487 RESIDENTS; SHAMOKIN (NORTHUMBERLAND COUNTY), WITH 7,092 RESIDENTS; TAMAQUA (SCHUYLKILL COUNTY), WITH 6,784 RESIDENTS; SELINSGROVE (SNYDER COUNTY), WITH 5,861 RESIDENTS; LEWISBURG (UNION COUNTY), WITH 5,600 RESIDENTS; AND DANVILLE (MONTOUR COUNTY), WITH 4,656 RESIDENTS. TOTAL POPULATION OF THE CENTRAL REGION IS APPROXIMATELY 400,000 AND IS PROJECTED TO DECLINE AT A RATE OF 1.5% BY 2025. CONSISTENT WITH MUCH OF PA'S RURAL GEOGRAPHY, THE POPULATION OF MOST COUNTIES IN THE CENTRAL REGION IS DECLINING, WITH THE EXCEPTION OF SNYDER COUNTY AND UNION COUNTY, PROJECTED TO GROW 1.8% AND 1.1%, RESPECTIVELY, BY 2025. THE LARGEST POPULATION DECLINE IS EXPECTED IN NORTHUMBERLAND COUNTY (-3%), WHICH ALSO EXPERIENCED A 3% POPULATION DECLINE SINCE 2017. SCHUYLKILL COUNTY IS PROJECTED TO DECLINE AT 2.7%; COLUMBIA COUNTY AT 0.8%; AND MONTOUR COUNTY AT 0.7%. MORE THAN 20% OF RESIDENTS IN COLUMBIA (20.2%), MONTOUR (23%), NORTHUMBERLAND (22.5%), AND SCHUYLKILL (21.8%) COUNTIES ARE AGE 65 OR OLDER COMPARED TO THE STATE (19.3%) AND NATIONAL (16.6%) AVERAGES. MONTOUR (45.6), SCHUYLKILL (45.4), AND NORTHUMBERLAND (45.2) COUNTIES HAVE THE HIGHEST MEDIAN AGES, COMPARED TO THE STATE (41.5) AND NATION (38.5). AS A WHOLE, THE CENTRAL REGION IS SIGNIFICANTLY LESS DIVERSE THAN STATE AND NATIONAL BENCHMARKS. APPROXIMATELY 90% OR MORE OF THE COUNTIES' POPULATIONS ARE WHITE, COMPARED TO STATE (78.5%) AND NATIONAL (69%) AVERAGES. UNION COUNTY IS THE MOST DIVERSE: 6.5% OF THE POPULATION IS BLACK; 6.3% IS LATINX (OF ANY RACE); AND APPROXIMATELY 2% IS ASIAN. FEDERAL PRISONS WITHIN THE CENTRAL REGION SIGNIFICANTLY IMPACT DEMOGRAPHICS IN SCHUYLKILL AND UNION COUNTIES WITH DISPROPORTIONATE INCARCERATION RATES AMONG BLACK AND BROWN MALES THAT ARE REFLECTED IN CENSUS AND SOCIOECONOMIC DATA. SIMULTANEOUSLY, IN LINE WITH STATEWIDE AND NATIONAL TRENDS, MINORITY POPULATIONS ARE GROWING IN ALL COMMUNITIES ACROSS THE CENTRAL REGION. WITH RESPECT TO THESE COINCIDING TRENDS, DEMOGRAPHIC DATA FOR THESE COUNTIES MUST BE CAREFULLY CONSIDERED TO ACKNOWLEDGE THE IMPACT OF INCARCERATED POPULATIONS ON BROADER COMMUNITY DEMOGRAPHICS. UNION COUNTY DATA ARE PARTICULARLY IMPACTED BY PRISON POPULATIONS, WHICH COMPRISE 3% OF THE TOTAL COUNTY POPULATION. THERE ARE FIVE AMISH SETTLEMENTS ACROSS THE CENTRAL REGION TOTALING APPROXIMATELY 2,000 RESIDENTS. THE ESTIMATED AMISH POPULATION FOR THE REGION INCREASED MORE THAN 8% FROM 1,912 TO 2,072 FROM 2017 TO 2020. PENNSYLVANIA RESIDENTS OVERALL ARE SLIGHTLY MORE LIKELY TO REPORT A DISABILITY WHEN COMPARED TO THE NATION. RESIDENTS OF SCHUYLKILL (18%) AND NORTHUMBERLAND (17%) COUNTIES ARE MORE LIKELY TO HAVE A DISABILITY COMPARED TO THE STATE (14%) AND NATIONAL (13%) AVERAGES. SOCIOECONOMIC TRENDS THE CENTRAL REGION HAS A HISTORY OF COAL MINING, AGRICULTURE, AND MANUFACTURING. WHILE THESE INDUSTRIES HAVE PREDOMINANTLY BEEN REPLACED BY HEALTHCARE AND EDUCATION INDUSTRIES AS ECONOMIC DRIVERS, NATURAL GAS MINING HAS BROUGHT NEW INCOME SOURCES, AND NEW CHALLENGES, TO COMMUNITIES IN THE CENTRAL REGION. CONSISTENT WITH OTHER RURAL COMMUNITIES ACROSS PENNSYLVANIA, THE CENTRAL REGION REFLECTS A PREDOMINANTLY BLUE-COLLAR WORKFORCE; LOWER MEDIAN INCOME LEVELS; RURAL POVERTY; INCREASED FOOD INSECURITY; AVERAGE HIGH SCHOOL GRADUATION RATES WITH LESS HIGHER EDUCATION ATTAINMENT; AND MORE HOME OWNERSHIP WITH LOWER HOUSING COST BURDEN. DESPITE COMMON FACTORS ACROSS THE CENTRAL REGION, DISTINCT DIFFERENCES EXIST ACROSS THE COUNTIES. MONTOUR COUNTY IS HOME TO GEISINGER MEDICAL CENTER, WHICH EMPLOYS THOUSANDS OF CLINICAL AND NON-CLINICAL WHITE-COLLAR WORKERS. THIS WORKFORCE TREND IS REFLECTED IN SOCIOECONOMIC INDICATORS. MONTOUR COUNTY HAS ONE OF THE HIGHEST MEDIAN HOUSEHOLD INCOMES AND LOWEST POVERTY RATES, AND IS THE ONLY COUNTY TO HAVE A HIGHER PERCENTAGE OF RESIDENTS ATTAINING A BACHELOR'S DEGREE THAN THE STATE AND NATION. UNION COUNTY, HOME TO EVANGELICAL COMMUNITY HOSPITAL AND BUCKNELL UNIVERSITY, HAS SIMILAR INCOME AND POVERTY INDICATORS AS MONTOUR COUNTY AND THE SECOND HIGHEST PERCENTAGE OF RESIDENTS ATTAINING A BACHELOR'S DEGREE. SNYDER COUNTY ALSO HAS STRONG ECONOMIC INDICATORS, ALTHOUGH THE COUNTY'S TOP EMPLOYERS, WOOD-MODE, RECENTLY FACED ECONOMIC UNCERTAINTY, WHICH MAY IMPACT FUTURE SOCIOECONOMIC STANDING. ABOUT 33% OF KEY INFORMANT SURVEY RESPONDENTS NAMED POVERTY AMONG THE TOP THREE CONTRIBUTING FACTORS TO HEALTH CONCERNS, RANKING IT AS THE 3 CONTRIBUTOR IN THE REGION. RELATED SOCIOECONOMIC FACTORS, INCLUDING ABILITY TO AFFORD HEALTHCARE AND LACK OF TRANSPORTATION, WERE ALSO IDENTIFIED AS TOP CONTRIBUTORS. OVERALL CENTRAL REGION POVERTY RATES ARE GENERALLY CONSISTENT WITH STATE AND NATIONAL AVERAGES, BUT THERE IS A WIDER DISPARITY BETWEEN PEOPLE OF COLOR AND WHITE RESIDENTS, AND MOST COUNTIES EXCEED STATE AND NATIONAL BENCHMARKS ON THIS MEASURE. SCHUYLKILL AND UNION COUNTIES REFLECT THE HIGHEST DISPARITIES AMONG BLACK AND LATINX RESIDENTS, WITH POVERTY RATES UP TO FIVE TIMES MORE THAN WHITES. THIS SIGNIFICANT DIFFERENCE LIKELY REFLECTS THE IMPACT FROM THE FEDERAL PRISON POPULATIONS IN THESE COUNTIES, BUT NOTABLE DISPARITIES IN NEIGHBORING COUNTIES REINFORCE THE GAP IN POVERTY RATES BETWEEN PEOPLE OF COLOR AND THEIR WHITE NEIGHBORS. IN SNYDER COUNTY, 33% OF BLACK RESIDENTS VERSUS 10% OF WHITE RESIDENTS LIVE IN POVERTY. IN NORTHUMBERLAND COUNTY, 44% OF LATINX RESIDENTS LIVE IN POVERTY COMPARED TO 13% OF WHITE RESIDENTS. IN MONTOUR COUNTY, 41% OF BLACKS VERSUS 11% OF WHITES LIVE IN POVERTY. NORTHUMBERLAND COUNTY HAS A HIGHER PERCENTAGE OF CHILDREN LIVING IN POVERTY (19.5%) RELATIVE TO OTHER COUNTIES. THE COUNTY ALSO HAS A HIGHER PERCENTAGE OF FOOD INSECURE CHILDREN (18%). FOOD INSECURITY AMONG CHILDREN DECLINED IN ALL COUNTIES SINCE THE FY2019 CHNA. CENTRAL REGION RESIDENTS ARE MORE LIKELY TO OWN THEIR HOME, AND ARE GENERALLY LESS COST BURDENED COMPARED TO STATEWIDE AND NATIONAL AVERAGES. HOUSING COST BURDEN IS DEFINED AS SPENDING 30% OR MORE OF HOUSEHOLD INCOME ON RENT OR MORTGAGE EXPENSES. RESIDENTS OF SCHUYLKILL, SNYDER, AND UNION COUNTIES HAVE THE HIGHEST HOME OWNERSHIP RATES, EXCEEDING THE STATE AVERAGE. CENTRAL REGION HOUSING STOCK IS OLDER, PARTICULARLY IN NORTHUMBERLAND AND SCHUYLKILL COUNTIES, WHERE 77%-79% OF HOMES WERE BUILT BEFORE 1980. UNION COUNTY HAS THE NEWEST HOUSING STOCK, FOLLOWED BY MONTOUR COUNTY. FRACKING OR HYDROFRACKING HAS BEEN A CONTROVERSIAL INDUSTRY ACROSS PA AND THE CENTRAL REGION. IT HAS BROUGHT ECONOMIC BENEFIT TO THE 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 ARE ESSENTIAL TO BETTER UNDERSTAND THE FULL IMPACT OF THIS INDUSTRY ON THE CENTRAL REGION. AS A RESULT OF THE COVID-19 PANDEMIC, CENTRAL REGION UNEMPLOYMENT RATES MORE THAN DOUBLED IN ALL COUNTIES EXCEPT SNYDER FROM MAY 2019 TO MAY 2020. OF INTEREST, AS OF MAY 2020, CURRENT UNEMPLOYMENT IS LOWER FOR ALL COUNTIES THAN THE STATE AND NATION. HEALTH TRENDS ACCESS TO HEALTHCARE ALL CENTRAL REGION COUNTIES EXCEPT MONTOUR AND UNION HAVE FEWER PRIMARY CARE PROVIDERS THAN THE STATE AND NATION, AND ALL COUNTIES EXCEPT MONTOUR HAVE FEWER DENTISTS AND MENTAL HEALTH PROVIDERS. (NOTE THAT PROVIDER RATES ARE CALCULATED BY THE PRIMARY ADDRESS OF THE OFFICE, AND DO NOT REFLECT SATELLITE LOCATIONS). NORTHUMBERLAND COUNTY HAS THE LOWEST PROVIDER RATES IN THE REGION. ALL COUNTIES EXCEPT UNION ARE DENTAL HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS); WITHIN UNION COUNTY, MIFFLINBURG IS A DENTAL HPSA. 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 67.5% OF RESPONDENTS. SUBSTANCE USE DISORDER SER</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 5</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE H, PART VI</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="RetDoc6">
      <IdemnificationGrossUpPmtsInd>X</IdemnificationGrossUpPmtsInd>
      <WrittenPolicyRefTAndEExpnssInd>true</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>true</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <Form990OfOtherOrganizationsInd>X</Form990OfOtherOrganizationsInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>false</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>true</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>false</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>false</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>false</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>false</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>false</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>false</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>true</InitialContractExceptionInd>
      <RebuttablePresumptionProcInd>true</RebuttablePresumptionProcInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAEWON RYU MD JD</PersonNm>
        <TitleTxt>PRESIDENT, DIRECTOR</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>4389743</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>1102369</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>1528292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>43622</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>7064026</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990RltdOrgsAmt>1064507</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KEVIN V ROBERTS MBA CPA</PersonNm>
        <TitleTxt>EVP, CFO, TREASURER</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>1697460</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>1890806</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>36715</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>3648273</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990RltdOrgsAmt>1488942</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MATTHEW WALSH</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>1248929</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>251139</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>273292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>40942</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>1814302</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990RltdOrgsAmt>219524</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>STEVEN B BENDER ESQUIRE</PersonNm>
        <TitleTxt>EVP, CLO, SECRETARY</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>879843</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>129142</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>203292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>43272</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>1255549</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990RltdOrgsAmt>88396</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GERALD V MALONEY DO</PersonNm>
        <TitleTxt>DIRECTOR</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>699927</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>115402</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>95392</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>31669</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>942390</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990RltdOrgsAmt>64210</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NICHOLAS SEBES MD</PersonNm>
        <TitleTxt>FORMER 5 HIGHEST</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>690355</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>1000</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>38119</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>36200</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>788966</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KYLE D YEBERNETSKY MD</PersonNm>
        <TitleTxt>FORMER 5 HIGHEST</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>371443</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>317518</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>35468</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>747721</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JENNIFER BROOKS MD</PersonNm>
        <TitleTxt>FORMER 5 HIGHEST</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>586550</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>1000</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>72654</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>14626</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>698122</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROBERT J MOYER MD</PersonNm>
        <TitleTxt>FORMER 5 HIGHEST</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>490645</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>145027</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>25220</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>684184</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHAEL FITZPATRICK MD</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>478813</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>130412</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>35294</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>667811</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NATALIE SENTER MD</PersonNm>
        <TitleTxt>FORMER 5 HIGHEST</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>366791</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>258578</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>11762</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>660423</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GRANT A CIAVARELLA DO</PersonNm>
        <TitleTxt>FORMER 5 HIGHEST</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>484772</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>104130</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>36473</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>648667</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ROSEMARY LEEMING MD</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>411302</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>104376</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>81614</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>28102</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>625394</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990RltdOrgsAmt>60261</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NINA AHUJA MD</PersonNm>
        <TitleTxt>FORMER 5 HIGHEST</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>537846</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>4151</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>12772</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>578061</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GINO SARTORI DO</PersonNm>
        <TitleTxt>FORMER 5 HIGHEST</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>465528</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>21086</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>40099</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>550005</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MEGAN BROSIOUS</PersonNm>
        <TitleTxt>CAO, CENTRAL REGION</TitleTxt>
        <BaseCompensationFilingOrgAmt>409491</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>33581</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>66137</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>34308</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>543517</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID DECOSKEY DO</PersonNm>
        <TitleTxt>FORMER 5 HIGHEST</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>452072</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>1000</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>24965</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>34391</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>535720</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>IAN COOTE MD</PersonNm>
        <TitleTxt>FORMER 5 HIGHEST</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>361629</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>1000</BonusRelatedOrganizationsAmt>
        <OtherCompensationRltdOrgsAmt>94515</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>27462</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>507898</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MATTHEW VAN LEEUWE</PersonNm>
        <TitleTxt>CAO, HOSPITAL SVCS</TitleTxt>
        <BaseCompensationFilingOrgAmt>373526</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>42887</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>60792</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>10658</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>487863</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CAROL STOJINSKI MD</PersonNm>
        <TitleTxt>PHYSICIAN, EMERG MED</TitleTxt>
        <BaseCompensationFilingOrgAmt>2438</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>330580</CompensationBasedOnRltdOrgsAmt>
        <BonusRelatedOrganizationsAmt>1000</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>21</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>117027</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23166</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>1089</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>10754</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>3548</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>482527</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>SHEEL MEHTA DO</PersonNm>
        <TitleTxt>FORMER 5 HIGHEST</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>370270</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>49173</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>31876</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>474611</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARK MASSAK DO</PersonNm>
        <TitleTxt>FORMER 5 HIGHEST</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>337072</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>65036</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>30862</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>456262</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CRYSTAL K MUTHLER BSN RN MHA</PersonNm>
        <TitleTxt>VP, CNO</TitleTxt>
        <BaseCompensationFilingOrgAmt>357296</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>9894</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>23292</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>13799</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>404281</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LORI R GRAMLEY ESQUIRE</PersonNm>
        <TitleTxt>ACLO, ASST. SECY.</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>326632</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>27843</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>23292</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>24657</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>402424</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MISTRAINE DURAND DOUGLAS DO</PersonNm>
        <TitleTxt>FORMER 5 HIGHEST</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>182197</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>186088</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>17351</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>15600</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>401236</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990RltdOrgsAmt>80439</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>HARSH PATEL MD</PersonNm>
        <TitleTxt>PHYSICIAN, CRIT CARE</TitleTxt>
        <BaseCompensationFilingOrgAmt>33683</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>212711</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationFilingOrgAmt>18693</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>82661</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>70</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>20468</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>19280</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>169</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>71726</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>316009</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TAMMY ANDERER CRNP PHD</PersonNm>
        <TitleTxt>FORMER KEY EMPLOYEE</TitleTxt>
        <CompensationBasedOnRltdOrgsAmt>283578</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationRltdOrgsAmt>17288</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>19910</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsRltdOrgsAmt>17856</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationRltdOrgsAmt>338632</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ANDREA WARY MED BSN RN</PersonNm>
        <TitleTxt>VP, CANCER, WOMENS</TitleTxt>
        <BaseCompensationFilingOrgAmt>305734</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>3420</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>21148</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>733</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>331035</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JUSTIN HARK DO</PersonNm>
        <TitleTxt>PHYSICIAN, EMERG MED</TitleTxt>
        <BaseCompensationFilingOrgAmt>34590</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>165914</CompensationBasedOnRltdOrgsAmt>
        <OtherCompensationFilingOrgAmt>10824</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>43426</OtherCompensationRltdOrgsAmt>
        <DeferredCompRltdOrgsAmt>12066</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>6293</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>4762</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>51707</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>226168</TotalCompensationRltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>THOMAS C WAGNER</PersonNm>
        <TitleTxt>PROGRAM MANAGER APN</TitleTxt>
        <BaseCompensationFilingOrgAmt>87633</BaseCompensationFilingOrgAmt>
        <OtherCompensationFilingOrgAmt>166032</OtherCompensationFilingOrgAmt>
        <DeferredCompensationFlngOrgAmt>4553</DeferredCompensationFlngOrgAmt>
        <NontaxableBenefitsFilingOrgAmt>17395</NontaxableBenefitsFilingOrgAmt>
        <TotalCompensationFilingOrgAmt>275613</TotalCompensationFilingOrgAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 4</FormAndLineReferenceDesc>
        <ExplanationTxt>JAEWON RYU, MD, JD 0 1,064,507 0 KEVIN V. ROBERTS, MBA, CPA 0 1,488,942 0 MATTHEW WALSH 0 219,524 0 STEVEN B. BENDER, ESQUIRE 0 88,396 0 GERALD V. MALONEY, DO 0 64,210 0 ROSEMARY LEEMING, MD 0 60,261 0 MISTRAINE DURAND DOUGLAS, DO 0 88,018 0</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PAGE 1, PART I, LINE 8</FormAndLineReferenceDesc>
        <ExplanationTxt>THE EMPLOYEES LISTED PARTICIPATE IN A COMPENSATION PROGRAM DESIGNED TO BE MARKET COMPETITIVE. FROM TIME TO TIME, DEPENDING ON THE AVAILABILITY OF QUALIFIED APPLICANTS, RECRUITMENT LOANS MAY BE MADE AVAILABLE TO QUALIFIED APPLICANTS IN DIFFICULT TO RECRUIT POSITIONS. SUCH LOANS ARE ONLY PROVIDED IF TOTAL COMPENSATION, INCLUDING THE LOAN AMOUNT, IS CONSIDERED REASONABLE COMPENSATION PER INDEPENDENT SALARY SURVEYS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART III</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc7">
      <LoansBtwnOrgInterestedPrsnGrp>
        <PersonNm>MATTHEW VAN LEEUWE</PersonNm>
        <RelationshipWithOrgTxt>KEY EMPLOYEE</RelationshipWithOrgTxt>
        <LoanPurposeTxt>RECRUITMENT</LoanPurposeTxt>
        <LoanFromOrganizationInd>X</LoanFromOrganizationInd>
        <OriginalPrincipalAmt>50000</OriginalPrincipalAmt>
        <BalanceDueAmt>16872</BalanceDueAmt>
        <DefaultInd>false</DefaultInd>
        <BoardOrCommitteeApprovalInd>true</BoardOrCommitteeApprovalInd>
        <WrittenAgreementInd>true</WrittenAgreementInd>
      </LoansBtwnOrgInterestedPrsnGrp>
      <TotalBalanceDueAmt>16872</TotalBalanceDueAmt>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc8">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART IV, LINE 24A: DID THE ORGANIZATION HAVE A TAX-EXEMPT BOND ISSUE WITH AN OUTSTANDING PRINCIPAL AMOUNT OF MORE THAN 100,000 AS OF THE LAST DAY OF THE YEAR, THAT WAS ISSUED AFTER DECEMBER 31, 2002? GEISINGER HEALTH (GH) IS CURRENTLY THE SOLE OBLIGOR UNDER A SERIES OF BOND ISSUES, INCLUDING TAX-EXEMPT BONDS ISSUED PRIOR TO DECEMBER 31, 2002, WITH A TOTAL OUTSTANDING BALANCE AT DECEMBER 31, 2023 OF 1,637,871,513, INCLUSIVE OF UNAMORTIZED ORIGINAL ISSUE DISCOUNT. BECAUSE THE BOND PROCEEDS ARE DISBURSED TO GH SUBSIDIARIES, THE TAX-EXEMPT BOND LIABILITIES ARE REFLECTED ON THE BALANCE SHEETS OF THE FOLLOWING SUBSIDIARY ORGANIZATIONS: GEISINGER MEDICAL CENTER EIN: 24-0795959 GEISINGER WYOMING VALLEY MEDICAL CENTER EIN: 23-1996150 GEISINGER CLINIC EIN: 23-6291113 MARWORTH EIN: 23-2171417 GEISINGER SYSTEM SERVICES EIN: 23-2164794 COMMUNITY MEDICAL CENTER EIN: 24-0862246 GEISINGER-BLOOMSBURG HOSPITAL EIN: 23-2193572 GEISINGER-LEWISTOWN HOSPITAL EIN: 23-1352187 GEISINGER COMMONWEALTH SCHOOL OF MEDICINE EIN: 26-0812968 GEISINGER JERSEY SHORE HOSPITAL EIN: 24-0792115 SCHEDULE K WAS PREPARED ON A CONSOLIDATED BASIS AND IS INCLUDED IN THE FORM 990 FILING OF GEISINGER HEALTH, EIN: 23-1995911.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 2, PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>I. GENERAL PROGRAM SERVICE INFORMATION SINCE 1915, GEISINGER MEDICAL CENTER (GMC), A 501(C)(3) NOT-FOR-PROFIT CORPORATION, HAS BEEN PROVIDING HIGH-QUALITY HEALTHCARE SERVICES TO MORE THAN TWO MILLION RESIDENTS IN CENTRAL AND NORTHEAST PENNSYLVANIA. GEISINGER IS HOME TO SOME OF THE MOST ADVANCED TECHNOLOGY IN THE COUNTRY, INCLUDING A LEVEL I TRAUMA CENTER, THE REGION'S LONE PEDIATRIC TRAUMA CENTER, THE RENOWNED JANET WEIS CHILDREN'S HOSPITAL, THE STATE-OF-THE-ART HOSPITAL FOR ADVANCED MEDICINE AND CLINICAL RESEARCH FACILITIES. LOCATED IN DANVILLE, PENNSYLVANIA, A PREDOMINANTLY RURAL AREA, GMC OPERATES A 542 BED FACILITY ALONG WITH A 48 BED HOSPITAL LOCATED IN COAL TOWNSHIP, PENNSYLVANIA. PHYSICIANS IN PENNSYLVANIA AND THE SURROUNDING STATES REFER THEIR MOST COMPLEX CASES TO GEISINGER MEDICAL CENTER WHERE THE EXISTENCE OF QUATERNARY HEALTHCARE IN A GENERALLY RURAL AND MEDICALLY UNDERSERVED POPULATION IS UNCOMMON. GMC'S LIFE FLIGHT IS THE LEADER IN MEDICAL AIR TRANSPORTATION IN THE REGION SPECIALIZING IN TRANSPORTING CRITICAL CARE PATIENTS, INCLUDING PREMATURE NEWBORNS, CARDIAC PATIENTS, ORGAN TRANSPLANT PATIENTS AND ACCIDENT VICTIMS. A. SPECIALTIES AND SUBSPECIALTIES GEISINGER CLINIC PHYSICIANS PRACTICING AT GMC PROVIDE SKILLED SERVICES IN NUMEROUS SPECIALTY AND SUBSPECIALTY AREAS. SPECIAL SERVICES AVAILABLE INCLUDE, BUT ARE NOT LIMITED TO: ADULT &amp; PEDIATRIC TRAUMA CENTER MATERNAL FETAL MEDICINE ADULT MEDICAL ONCOLOGY MICROBIOLOGY AERO-MEDICAL SERVICES MINIMALLY INVASIVE SURGERY AIMI (ACUTE INTERVENTION IN MOHS SURGERY MYOCARDIAL INFRACTION) MOLECULAR DIAGNOSTICS ANTICOAGULATION CLINIC MOVEMENT DISORDERS BACLOFEN PUMPS NEUROENDOVASCULAR BAHA (BONE ANCHORED HEARING AID) NEUROMUSCULAR BALANCE CENTER NEUROPSYCH BARIATRIC SURGERY NEUROPATHOLOGY BLOOD BANK NEUROPHYSIOLOGY BLOOD CONSERVATION NEUROSTIMULATORS BODY CONTOURING NEUROTRAUMA BRAIN TUMOR NUCLEAR STRESS TESTING BREAST SURGERY OPEN HEART SURGERY CANCER GENETICS CLINIC OPHTHALMOLOGY (GLAUCOMA, RETINAL, CAPSULE ENDOSCOPY PEDIATRIC, CORNEA, GENERAL, CARDIAC CAT SCAN ANGIOGRAPHY OPHTHALMOPLASTIC SURGERY) CARDIAC MRI TESTING ORTHOPAEDICS (TRAUMA, SPINE, HAND CAROTID STENTING SPORTS MEDICINE, PEDIATRIC, CAT SCAN CARDIAC SCORING JOINT, FOOT/ANKLE, GENERAL) CAT SCAN ORTHOPAEDIC ONCOLOGY CHEMISTRY PEDIATRIC CONGENITAL HEART SURGERY CHEMO-EMBOLIZATION OF LIVER PEDIATRIC GENETICS AND KIDNEY CANCER PEDIATRIC MEDICAL ONCOLOGY CLEFT PALATE CLINIC PEDIATRIC NEURODEVELOPMENT COAGULATION PEDIATRIC OBESITY COCHLEAR IMPLANT PEDIATRIC REHABILITATION COLORECTAL SURGERY PEDIATRIC SURGERY CORNEAL TRANSPLANTS PEDIATRIC UROLOGY CYTOLOGY PEDIATRIC COCHLEAR IMPLANT DEEP BRAIN STIMULATION PEDIATRIC NEUROLOGY/NEUROSURGERY DERMATOPATHOLOGY PET SCANS ECHOCARDIOGRAPHY PODIATRY ELECTROPHYSIOLOGY PRE-SURGERY CENTER EMERGENCY SERVICES PSYCHIATRY (ADOLESCENCE) ENDOVASCULAR PROCEDURES RADIATION ONCOLOGY ENDOVASCULAR GRAFT IMPLANTS EPILEPSY REGIONAL ANESTHESIA PROGRAM EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY RENAL DENERVATION GYNONCOLOGY ROBOTIC SURGERY GYNECOLOGIC &amp; UROPATHOLOGY SKULL BASE SURGERY HEAD AND NECK ONCOLOGY SLEEP DISORDERS LABORATORY HEADACHE SPINAL BIFIDA CLINIC HEART FAILURE SPINAL CORD INJURY HEMATOLOGY SPINE SURGERY HEMATOPATHOLOGY SPINE ASSESSMENT PROGRAM HEPATIC INTRA-ARTERIAL CHEMOTHERAPY STEM CELL TRANSPLANT HIGH DOSE INTERLEUKIN-2 THERAPY STEREOTACTIC RADIOSURGERY HIGH DOSE RATE INTRACAVITARY STRETTA (LASER PROCEDURE) BRACHYTHERAPY STROKE/TELE-STROKE IMMUNOLOGY SURGICAL ONCOLOGY (COLON, LIVER, INFERTILITY PANCREAS, ESOPHAGEAL, &amp; RENAL) INTENSIVE O/P PSYCHIATRIC PROGRAM SURGICAL PATHOLOGY INTERVENTIONAL PAIN MANAGEMENT TRANSCATHETER AORTIC VALVE INTERVENTIONAL RADIOLOGY IMPLEMENTATION INTRA-OPERATIVE HEPATIC ULTRASOUND TISSUE BANKING AND RADIOFREQUENCY ABLATION OF TRAUMATIC BRAIN INJURY LIVER TUMORS TOXICOLOGY KIDNEY, LIVER &amp; PANCREAS TRANSPLANTS TRAUMA SURGERY LASER SURGERY (YAG LASER) UROGYNECOLOGY LVAD (LEFT VENTRICULAR ASSIST DEVICE) VAGAL NERVE STIMULATORS MAGNETIC RESONANCE IMAGING WOUND CARE MEDICATION THERAPY MANAGEMENT PROGRAM B. RESIDENCY, FELLOWSHIP AND ALLIED HEALTH PROGRAMS GMC CONDUCTS 32 GRADUATE MEDICAL EDUCATION RESIDENCY PROGRAMS AND 26 FELLOWSHIP PROGRAMS. THERE WERE 602 GRADUATE PHYSICIANS PARTICIPATING IN THESE PROGRAMS IN THE YEAR ENDED DECEMBER 31, 2023. PROGRAM SPECIALTIES ARE AS FOLLOWS BUT ARE NOT LIMITED TO: RESIDENCY PROGRAMS ANESTHESIOLOGYOBSTETRICS &amp; GYNECOLOGY CHILD NEUROLOGYOPHTHALMOLOGY CLINICAL PSYCHOLOGYORAL &amp; MAXILLOFACIAL SURGERY COLON &amp; RECTAL SURGERYORTHOPAEDIC SURGERY DERMATOLOGYOTOLARYNGOLOGY DIAGNOSTIC RADIOLOGYPATHOLOGY INTERVENTIONAL RADIOLOGY INTEGRATEDPEDIATRIC DENTISTRY EMERGENCY MEDICINEPEDIATRICS FAMILY MEDICINEPHYSICAL MEDICINE &amp; REHABILITATION GENERAL SURGERYPLASTIC SURGERY INTERNAL MEDICINEPODIATRY INTERNAL MEDICINE - PEDIATRICSUROLOGY NEUROLOGYTRANSITIONAL YEAR NEUROSURGERYVASCULAR SURGERY FELLOWSHIP PROGRAMS DERMATOPATHOLOGYHOSPICE &amp; PALLIATIVE MEDICINE MICROGRAPHIC SURGERY &amp; DERMATOLOGIC ONCOLOGYINFECTIOUS DISEASE INTERVENTIONAL RADIOLOGYINTERVENTIONAL CARDIOLOGY SPORTS MEDICINENEPHROLOGY ADDICTION MEDICINEPULMONARY MEDICINE SURGICAL CRITICAL CARERHEUMATOLOGY VASCULAR SURGERYSLEEP MEDICINE CARDIOVASCULAR MEDICINEMEDICAL PHYSICS CLINICAL CARDIAC ELECTROPHYSIOLOGYVASCULAR NEUROLOGY CLINICAL INFORMATICSMATERNAL FETAL MEDICINE CRITICAL CARE MEDICINECYTOPATHOLOGY GASTROENTEROLOGYPEDIATRIC SPORTS MEDICINE HEMATOLOGY AND ONCOLOGY GMC OPERATED TWO SCHOOLS OF ALLIED HEALTH EDUCATION. THESE SCHOOLS ARE OPERATED WITHIN GMC IN CONJUNCTION WITH VARIOUS COLLEGES AND UNIVERSITIES. IN ADDITION TO CLASSROOM TIME, STUDENTS CONTRIBUTE CLINICAL EDUCATION HOURS AS AN INTEGRAL PART OF THEIR CURRICULUM. DURING THE YEAR ENDED DECEMBER 31, 2023, THE CHAPLAIN SCHOOL HAD ONE STUDENT AND THE PHARMACY RESIDENCY PROGRAM HAD NINE STUDENTS. THE TOTAL COST TO GMC OF PROVIDING RESIDENCY, FELLOWSHIP, ALLIED HEALTH, AND RELATED EDUCATION PROGRAMS, NET OF THIRD- PARTY REIMBURSEMENTS WAS 38,819,323. C. TRAUMA CARE IN OCTOBER 1986 GMC WAS DESIGNATED BY THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION AS A REGIONAL RESOURCE TRAUMA CENTER (LEVEL I) BASED ON THE PROVISION OF COMPREHENSIVE TRAUMA CARE 24 HOURS A DAY AND THE CONDUCT OF OUTREACH, EDUCATIONAL AND RESEARCH PROGRAMS IN TRAUMA CARE. IN 1996, THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION ACCREDITED GMC AS ADDITIONAL QUALIFICATIONS IN PEDIATRICS. GMC HAS BEEN ACCREDITED AS A LEVEL II PEDIATRIC TRAUMA CENTER. THE TRAUMA CENTER INCLUDES LIFE FLIGHT, A MULTIPLE AIRCRAFT, REGIONAL HELICOPTER SERVICE. LIFE FLIGHT PROVIDES RAPID RESPONSE TO CRITICALLY ILL PATIENTS WHO NEED ADVANCE LIFE SUPPORT CARE AND TRANSPORTATION TO CRITICAL CARE FACILITIES. GEISINGER LIFE FLIGHT OPERATED NINE AIRCRAFTS AND FOUR GROUND CRITICAL CARE EQUIPPED AMBULANCES FROM SEVEN OPERATIONAL SITES FOR THE YEAR ENDED DECEMBER 31, 2023. NINE STATE-OF-THE-ART MEDICAL HELICOPTERS INCLUDE ONE BK117 AND EIGHT EC145S. THE GROUND UNITS CONTAIN THE SAME EQUIPMENT AS THE AIRCRAFT FOR CRITICAL CARE GROUND TRANSPORTS. THE BASE LOCATIONS FOR THE YEAR ENDING DECEMBER 31, 2023 WERE IN DANVILLE, SELINSGROVE, STATE COLLEGE, AVOCA, WILLIAMSPORT, MINERSVILLE AND LEHIGHTON PA. THE DISPATCHING OF LIFE FLIGHT FOR INTER-HOSPITAL TRANSFERS AND SCENE CALLS IS AUTHORIZED BY A PHYSICIAN OR OTHER QUALIFIED PERSONNEL AND IS DETERMINED ON AN INDIVIDUAL BASIS ACCORDING TO MEDICAL NEED. IN THE YEAR ENDED DECEMBER 31, 2023, LIFE FLIGHT PROVIDED EMERGENCY TRANSPORTATION TO 4,461 PATIENTS AND SERVED MULTIPLE HOSPITALS IN PENNSYLVANIA AND NEIGHBORING STATES. D. JANET WEIS CHILDREN'S HOSPITAL THE JANET WEIS CHILDREN'S HOSPITAL HOUSES ALL INPATIENT PEDIATRIC BEDS INCLUDING 36 MEDICAL AND SURGICAL, 41 NEWBORN INTENSIVE AND SPECIAL CARE AND 14 PEDIATRIC INTENSIVE CARE BEDS. THE FACILITY ALSO PROVIDES SPACE FOR PEDIATRIC REHABILITATION AND HAS ESTABLISHED AN AMBULANCE TRANSPORT SERVICE FOR NEONATAL RETRIEVALS. THE FACILITY IS CONNECTED WITH THE REST OF THE MEDICAL CENTER AT FOUR OF THE FIVE LEVELS TO ALLOW FOR SMOOTH INTEGRATION OF ANCILLARY AND SUPPORT SERVICES. THE FUNDING FOR THE CONSTRUCTION OF THE JANET WEIS CHILDREN'S HOSPITAL WAS PROVIDED BY THE DONATING PUBLIC, INCLUDING FUNDS RAISED BY THE CHILDREN'S MIRACLE NETWORK TELETHON. THIS FACILITY IS VISIBLE EVIDENCE OF GEISINGER'S COMMITMENT TO THE CHILDREN OF PENNSYLVANIA. FOR THE YEAR ENDED DECEMBER 31, 2023, THE JANET WEIS CHILDREN'S HOSPITAL DISCHARGED 3,700 PATIENTS AND PROVIDED 22,274 PATIENT DAYS OF SERVICE. THE FACILITY AFFORDS MORE EFFICIENT CARE WITH AN IMPROVED LENGTH OF STAY. E. WOMEN'S HEALTH PAVILION THE WOMEN'S HEALTH PAVILION, ON THE CAMPUS OF GMC, WAS DEDICATED AS PART OF THE JANET WEIS CHILDREN'S AND WOMEN'S HOSPITAL IN 2000. THE WOMEN'S PAVILION FEATURES FAMILY-ORIENTED BIRTHING SUITES THAT ALLOW EACH WOMAN TO LABOR, DELIVER AND RECOVER IN THE SAME SPACE. IN ADDITION, THERE ARE SEMI-PRIVATE ROOMS, A NURSERY AND TWO CAESAREAN SECTION OPERATING SUITES. THE GEISINGER WOMEN'S PAVILION IS THE ONLY HOSPITAL IN THE AREA THAT OFFERS COVERAGE BY OBS</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART V</FormAndLineReferenceDesc>
        <ExplanationTxt>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. THE RESPONSE ENTERED ON LINE 1A FOR THE ORGANIZATION INCLUDES ONLY THOSE FORM 1099S FILED UNDER THE ORGANIZATIONS EIN, IT DOES NOT INCLUDE THOSE FILED BY GSS ON ITS BEHALF.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VI, SECTION A, LINE 2: DID ANY OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE HAVE A FAMILY RELATION- SHIP OR BUSINESS RELATIONSHIP WITH ANY OTHER OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE? BENJAMIN K. CHU, MD, MPH, MACP , GERALD V. MALONEY, DO , JAEWON RYU, MD, JD, JEFFREY A. JACOBSON, KEVIN V. ROBERTS, MBA, CPA, LORI R. GRAMLEY, ESQUIRE, MATTHEW VAN LEEUWE, MATTHEW WALSH, MEGAN BROSIOUS, STEVEN B. BENDER, ESQUIRE, V. CHRIS HOLCOMBE, PE, AND VIRGINIA MCGREGOR ALL HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER BECAUSE THEY SERVE AS OFFICERS AND/OR DIRECTORS ON ONE OR MORE FOR-PROFIT AFFILIATES OF THE ENTITY. ALL AFFILIATES ARE PART OF GEISINGER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 1A</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>ALL OFFICERS AND DIRECTORS WERE ELECTRONICALLY PROVIDED A FINAL COPY OF THE FORM 990 PRIOR TO FILING THE RETURN WITH THE IRS. AN EXECUTIVE SUMMARY OF THE INFORMATION REPORTED ON THE RETURN IS PROVIDED TO ASSIST IN THE REVIEW. IN ACCORDANCE WITH THE GEISINGER HEALTH BOARD OF DIRECTOR'S FINANCE COMMITTEE CHARTER, GEISINGER ORGANIZATIONS' FORM 990 FILINGS ARE REVIEWED ANNUALLY. THE FORM 990 IS PREPARED BY GEISINGER TAX AND FINANCE DEPARTMENTS WITH INFORMATION PROVIDED FROM FINANCE, TAX, HUMAN RESOURCES, LEGAL SERVICES AND OTHER RELEVANT DEPARTMENTS WITHIN GEISINGER. THE CHIEF FINANCIAL OFFICER (CFO) OF GEISINGER AND THE INDIVIDUAL ORGANIZATIONS SENIOR FINANCIAL MANAGERS REVIEW THEIR RESPECTIVE FORM 990 PRIOR TO MAKING THE FINAL RETURN AVAILABLE TO THE BOARD. THE CHIEF LEGAL OFFICER AND CHIEF HUMAN RESOURCE OFFICER OF GEISINGER REVIEW THE INFORMATION DISCLOSED ON THE FORM 990 RELEVANT TO THEIR RESPECTIVE AREAS OF RESPONSIBILITY. IN ADDITION, PWC US TAX, LLP., THE REVIEWS EACH GEISINGER FORM 990 PRIOR TO FILING. FOR PURPOSES OF THEIR ANNUAL AUDIT OF GEISINGER CONSOLIDATED FINANCIAL STATEMENTS,INDEPENDENT AUDITORS REVIEW ALL FEDERAL TAX RETURNS FILED BY GEISINGER ORGANIZATIONS TO IDENTIFY MATERIAL ITEMS, INCLUDING IF THERE ARE ANY UNCERTAIN TAX POSITIONS THAT MAY BE REQUIRED TO BE RECOGNIZED. THE COMPANY HAD NO UNCERTAIN TAX POSITIONS REQUIRED TO BE REPORTED FOR REPORTING PERIOD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15A</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 15B</FormAndLineReferenceDesc>
        <ExplanationTxt>SEE SCHEDULE O RESPONSE TO FORM 990, PART VI SECTION B, QUESTION 15A.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PAGE 6, PART VI, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>FINANCIAL STATEMENTS, FORM 990, FORM 990-T, THE CONFLICTS OF INTEREST POLICY, AND OTHER GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VIII</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990, PART VIII, LINE 2F: IC SHARED SERVICE REVENUE OF 4,278 REPRESENTS REVENUE FROM INTERCOMPANY MANAGEMENT, ADMINISTRATIVE, AND CONSULTING SERVICES PROVIDED TO RELATED TAXABLE ORGANIZATIONS. THE ORGANIZATION AND RELATED TAXABLE ORGANIZATIONS ARE ALL CONTROLLED BY GEISINGER HEALTH. THE SERVICES, PROVIDED AT OR BELOW COST, ARE PERFORMED WITHOUT A PROFIT MOTIVE TO PROMOTE THE EFFICIENT OPERATION OF GEISINGER IN CARRYING OUT ITS CHARITABLE MISSION. THE SERVICES ARE NOT OFFERED TO UNRELATED ORGANIZATIONS OR TO THE GENERAL PUBLIC. UNDER IRS ADVISORY DATED MARCH 7, 2014, THESE INTERCOMPANY SHARED SERVICES ARE NOT INCLUDED IN THE DEFINITION OF UNRELATED BUSINESS INCOME AND ARE NOT TO BE INCLUDED ON FORM 990-T DUE TO THE ABSENCE OF THE FOLLOWING TWO CONDITIONS: (1) THE SERVICES MUST BE ABOVE COST OR AT FAIR MARKET VALUE, AND (2) THERE MUST BE A PROFIT MOTIVE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9</FormAndLineReferenceDesc>
        <ExplanationTxt>TRANSFER FROM PARENT, GEISINGER HEALTH 1,231,947 LOSS FROM SUBSIDIARY GEISINGER-HM JV, LLC -20,702,566 TRANSFER TO PARENT, GEISINGER HEALTH -155,000,000 TOTAL -174,470,619</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XII</FormAndLineReferenceDesc>
        <ExplanationTxt>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.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE R</FormAndLineReferenceDesc>
        <ExplanationTxt>INFORMATION REGARDING TRANSFERS TO AND FROM CONTROLLED ORGANIZATIONS: AS SHOWN IN FORM 990, SCHEDULE R, GEISINGER MEDICAL CENTER IS CLOSELY AFFILIATED WITH SEVERAL OTHER ORGANIZATIONS. IN THE NORMAL COURSE OF THE OPERATIONS OF THESE AFFILIATED ORGANIZATIONS THERE ARE NUMEROUS INTER- ORGANIZATIONAL TRANSACTIONS, WHICH MAY INCLUDE SALES, EXCHANGES AND LEASES OF PROPERTY, EXTENSIONS OF CREDIT, FURNISHING OF GOODS, SERVICES, AND FACILITIES, AND TRANSFERS OF ASSETS. THESE INTER-ORGANIZATION TRANSACTIONS PROMOTE THE EFFICIENT OPERATION OF THE VARIOUS ORGANIZATIONS AND THE ATTAINMENT OF THEIR TAX EXEMPT PURPOSES. THESE TYPES OF INTER- 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. __________________________________________________________________________</ExplanationTxt>
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</Return>