2019-11-15T13:50:03-06:00 2018-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2018-01-01 311480941 GENESIS HEALTHCARE SYSTEM GENE 7404545000 2951 MAPLE AVENUE ZANESVILLE OH 43701 MICHAEL NORMAN CFO 7404545000 2019-11-14 1 BERNIE OSTROWSKI P00366367 6148493000 2019-11-14 67.59.56.31 2019-11-14 08:50:39 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 9620C6601C99D82B50252550C6445223DEA5F6EE 2018 2020-03-31 21:24:44Z MATTHEW PERRY 2951 MAPLE AVENUE ZANESVILLE OH 43701 440396766 0 3727 X WWW.GENESISHCS.ORG X 1997 OH IN 1997, GOOD SAMARITAN MEDICAL CENTER AND BETHESDA HOSPITAL ASSOCIATION, A TAX-EXEMPT COMMUNITY HOSPITAL ALSO LOCATED IN ZANESVILLE, AFFILIATED TO FORM GENESIS HEALTHCARE SYSTEM. GENESIS HAS BEEN GRANTED 501C3 STATUS AS A HOSPITAL. ALL HOSPITAL OPERATIONS AND ASSETS OF GOOD SAMARITAN MEDICAL CENTER WERE TRANSFERRED TO GENESIS WITH THE EXCEPTION OF CERTAIN INVESTMENTS. GOOD SAMARITAN MEDICAL CENTER WILL CONTINUE TO HAVE CONTROL OVER CERTAIN INVESTMENTS WHICH ARE BEING USED BY THE GENESIS HEALTHCARE SYSTEM IN FULFILLING ITS TAX-EXEMPT PURPOSE. 18 17 3528 371 471424 0 500784 768619 391615569 414828724 6377923 5340392 17038856 18002684 415533132 438940419 348283 546402 0 0 165219050 171488874 0 0 0 204581451 216610471 370148784 388645747 45384348 50294672 552431211 545108599 378399620 373640996 174031591 171467603 X TO PROVIDE COMPASSIONATE, QUALITY HEALTH CARE 0 0 247272423 546402 427813531 GENESIS PROVIDES ACUTE CARE SERVICES INCLUDING MEDICAL, SURGICAL, OBSTETRICAL, PEDIATRIC AND CRITICAL CARE. TOTAL DISCHARGES FROM MEDICAL/SURGICAL UNITS DURING 2018 WERE 10,470. TOTAL OBSTETRIC DISCHARGES EQUALED 1,558 WITH 1,537 TOTAL BIRTHS AND PEDIATRIC DISCHARGES EQUALED 191. GENESIS PROVIDES A WIDE RANGE OF DIAGNOSTIC AND SUPPORT SERVICES FOR INPATIENTS AND OUTPATIENTS. THESE SERVICES ARE COMPRISED OF LABORATORY, IMAGING SERVICES, CARDIAC, AND PHARMACY. LABORATORY SERVICES INCLUDE CHEMISTRY, PATHOLOGY, MICROBIOLOGY, HEMATOLOGY, CYTOLOGY, AND PHLEBOTOMY. IMAGING SERVICES INCLUDES RADIOLOGY, NUCLEAR MEDICINE, MRI, ULTRASOUND, CT SCAN, PET SCAN, MAMMOGRAPHY AND BONE DENSITY SCANNING.GENESIS HEART & VASCULAR SERVICES PROVIDE NEEDED HEART CARE FROM PREVENTION TO REHABILITATION. OUR BOARD-CERTIFIED SPECIALISTS INCLUDE CARDIOLOGISTS, CARDIOTHORACIC VASCULAR SURGEONS, ELECTROPHYSIOLOGISTS, INTERVENTIONAL CARDIOLOGISTS, CARDIAC ANESTHESIOLOGISTS AND CARDIAC REHAB SPECIALISTS. THE CARDIOTHORACIC AND VASCULAR SURGICAL TEAMS PERFORM A WIDE VARIETY OF COMPLEX AND HIGH-RISK CARDIAC, THORACIC AND VASCULAR PROCEDURES INCLUDING OPEN HEART SURGERY. OUR CARDIAC TEAM TAKES OUR PATIENTS FROM EVALUATION AND DIAGNOSIS THROUGH LIFESTYLE CHANGES AND TREATMENTS. ALSO INCLUDED IN OUR CARDIAC SERVICES ARE OUR CLINICS AND SPECIALTY PROGRAMS. THESE INCLUDE AN ANTICOAGULATION CLINIC, A CONGESTIVE HEART FAILURE CLINIC, A DEVICE CLINIC, A VEIN CLINIC AND A CARDIAC REHABILITATION PROGRAM. GENESIS IS AN ACCREDITED CHEST PAIN CENTER WITH PCI, AN ACCREDITED ECHOCARDIOGRAPHY FACILITY. THE TOTAL NUMBER OF HEART & VASCULAR CASES TREATED IN 2018 WERE 4,304.RESPIRATORY SERVICES - GENESIS RESPIRATORY & LUNG PROVIDES SERVICES FOR A VARIETY OF LUNG CONDITIONS AND DISEASES INCLUDING LUNG SURGERIES AND RESPIRATORY THERAPY. OUR TEAM, INCLUDING BOARD-CERTIFIED PULMONOLOGISTS, PROVIDE CARE AND TREATMENT FOR PATIENTS WITH PNEUMONIA, LUNG CANCER, BLACK LUNG DISEASE, RESPIRATORY FAILURE, COLLAPSED LUNG, AND OTHER PLEURAL DISEASES. THE TOTAL NUMBER OF RESPIRATORY CASES TREATED IN 2018 WERE 1,984.THE GENESIS ORTHOPEDIC TEAM OF BOARD-CERTIFIED SURGEONS, SPECIALLY TRAINED NURSES, AND REHABILITATION THERAPISTS WORK TOGETHER TO DIAGNOSE AND TREAT THE MUSCULOSKELETAL ISSUES OF OUR PATIENTS. SERVICES RANGE FROM ADVANCED IMAGING TESTING THROUGH TO REHABILITATION. SURGICAL SURGERIES INCLUDE NUMEROUS PROCEDURES INCLUDING REPLACEMENT OF THE HIP, KNEE, OR SHOULDER AS WELL AS VARIOUS SURGERIES INVOLVING THE HAND. THE SPECIALIZED REHABILITATION PROGRAM SPEEDS RECOVERY AFTER A SERIOUS INJURY OR SURGERY RELATED TO A BONE, JOINT, LIGAMENT, TENDON OR MUSCLE. IN ADDITION TO PHYSICAL AND OCCUPATIONAL THERAPY, GENESIS ALSO PROVIDES AMPUTEE AND PROSTHETICS THERAPY AND TRAINING. THE TOTAL NUMBER OF ORTHOPEDIC CASES TREATED IN 2018 WERE 701. IN 2014, THE NEW GENESIS BEHAVIORAL HEALTH CENTER OPENED BRINGING TOGETHER ALL GENESIS BEHAVIOR HEALTH SERVICES IN ONE LOCATION. THE PREMIER FACILITY IS THE ONLY COMPREHENSIVE BEHAVIORAL HEALTH CENTER IN SOUTHEASTERN OHIO AND OFFERS INPATIENT AND OUTPATIENT ADULT, ADOLESCENT, AND CHILD PSYCHIATRIC CARE; SUBSTANCE ABUSE SUPPORT AND RECOVERY PROGRAMS; PARTIAL HOSPITALIZATION; AND ANGER MANAGEMENT. INPATIENT & PARTIAL HOSPITALIZATION CARE IS PROVIDED IN THREE DISTINCT AREAS; A PRIVATE, SECURE ADULT UNIT; A CLOSED INTENSIVE PSYCHIATRIC UNIT, AND A PEDIATRIC/ ADOLESCENT UNIT. ALONG WITH PRIVATE ROOMS THE NEW CENTER PROVIDES OPEN, QUIET SPACES WITH NATURAL LIGHTING AND EXERCISE EQUIPMENT. THE GENESIS BEHAVIORAL HEALTH TEAM OF PSYCHIATRISTS, PSYCHOLOGISTS, CERTIFIED COUNSELORS, THERAPISTS, NURSES AND SUPPORT STAFF ARE HIGHLY TRAINED AND WORK CLOSELY WITH OTHER COMMUNITY BASED HEALTH AGENCIES TO COORDINATE SERVICES. MISCELLANEOUS PROGRAMS INCLUDE SUBSTANCE ABUSE, SUICIDE AND DATE VIOLENCE PREVENTION AND GRIEF COUNSELING TO AREA SCHOOLS AND CONDUCTING CLASSES ON DEALING WITH DIVORCE REQUIRED FOR FAMILIES GOING THROUGH THIS PROCESS BY THE MUSKINGUM COUNTY COURT SYSTEM. PEOPLE OF ALL AGES AND FROM 33 COUNTIES COME TO GENESIS FOR BEHAVIORAL HEALTH CARE. TOTAL INPATIENTS TREATED IN 2017 WERE 1,689. 247272423 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 476 0 1 3528 1 1 1 1 CJ 0 0 0 0 0 0 0 0 1 0 X 18 17 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X MICHAEL MEYER 7404545000 2951 MAPLE AVENUE ZANESVILLE OH 43701 RANDY COCHRANE CHAIR 2.62 0.30 X X 0 0 0 TOD KLOTZBACH TREASURER 2.31 0.30 X X 0 0 0 PATRICK NASH VICE CHAIR 2.62 0.30 X X 0 0 0 JAMES MCDONALD SECRETARY 1.15 0.00 X X 0 0 0 WILLIAM SHADE MD TRUSTEE 2.27 0.00 X 86013 0 0 JODY BALLAS EX-OFFICIO 2.62 0.77 X 0 0 0 JOANN BUTCHER EX-OFFICIO 1.62 0.30 X 0 0 0 JOHN DITTOE TRUSTEE 1.15 0.00 X 0 0 0 COLBY GRAHAM TRUSTEE 1.15 0.30 X 0 0 0 SUSAN HOLDREN TRUSTEE 1.15 0.30 X 0 0 0 MARK MOYER TRUSTEE 1.85 0.30 X 0 0 0 SR MARY ANN NUGENT TRUSTEE 1.15 0.00 X 0 0 0 ERIN REMSTER DO TRUSTEE 40.00 0.00 X 0 290050 18319 KRISTY RITCHIE MD TRUSTEE 40.00 0.00 X 0 442704 43988 SHIRLEY VAN WYE TRUSTEE 1.15 0.18 X 0 0 0 SR LAURA WOLF TRUSTEE 0.69 0.00 X 0 0 0 JOHN ZIMMERMAN MD TRUSTEE 39.85 0.15 X 0 504953 26940 SCOTT MCCONNAHA TRUSTEE 1.69 0.00 X 0 0 0 PAUL MASTERSON CHIEF FINANCIAL OFFICER 39.05 0.95 X 395603 0 930295 MATTHEW PERRY PRESIDENT & CEO 39.05 0.95 X 847445 0 182998 SLOAN ALBERT CHIEF PNO: 01/01/17 - 09/1 40.00 0.00 X 271006 0 8401 CHRISTOPHER SCHOELLES COO 40.00 0.00 X 300105 0 28503 SHARON PARKER CHIEF OPERATION OFFICER 39.80 0.20 X 347835 0 32254 WENDY CEDOZ CHIEF LEGAL OFFICER 39.87 0.13 X 396196 0 149211 DIANNA LEVECK CHIEF HUMAN RESOURCES OFFI 39.84 0.16 X 457269 0 143783 ABBY NGUYEN CHIEF NURSING OFFICER 39.89 0.11 X 201325 0 20635 EDMUND ROMITO CHIEF INFORMATION OFFICER 40.00 0.00 X 437331 0 60767 DANIEL SCHEERER MD CHIEF MEDICAL AFFAIRS OFFI 40.00 0.00 X 513863 0 80285 MICHAEL NORMAN VICE PRESIDENT 39.35 0.65 X 340333 0 27590 LES BOYER DIRECTOR 40.00 0.00 X 165350 0 26417 GREGORY HAMILTON DIRECTOR 40.00 0.00 X 164645 0 15682 CHARLES ADAMS JR DIRECTOR 40.00 0.00 X 166275 0 21033 MARIANNE GRAHAM MANAGER 40.00 0.00 X 162883 0 10943 VICKIE SOMERS DIRECTOR 40.00 0.00 X 150037 0 27924 5403514 1237707 1855968 95 0 1 0 NTHRIVE INC PO BOX 733492 DALLAS TX 75373 REVENUE CYCLE CONSULTING 5605728 ZANESVILLE ANESTHESIA PHYSICIANS INC 37 S SEVENTH STREET ZANESVILLE OH 43701 MEDICAL SERVICES 4448829 HOSPITAL MEDICINE ASSOC LLC PO BOX 634850 CINCINNATI OH 45263 PROFESSIONAL FEES 3756032 ARUP LABORATORIES INC 500 CHIPETA WAY SALT LAKE CITY UT 84127 MEDICAL SERVICES 1272744 CARDIAC ANESTHESIA ASSOC OF ZANESVILLE PO BOX 2684 ZANESVILLE OH 43701 MEDICAL SERVICES 1235000 18 163937 604682 768619 NET PATIENT SERVICES 621110 414828724 414828724 414828724 4206185 4206185 1579785 1456347 123438 123438 123438 1134207 0 1134207 1134207 1134207 340B DISPENSING 621110 8630321 8630321 CAFETERIA SALES 621110 3248990 102579 3146411 LABORATORY 621110 320014 93500 226514 5679921 4137548 142331 1400042 17879246 438940419 427813531 471424 9886845 X 546402 546402 127168041 87334734 39833307 35119093 239769 34879324 9201740 7903133 1298607 311952 311752 200 476303 476303 166913 166913 42553373 36132795 6420578 470085 29569 440516 10649951 5663237 4986714 8394527 5687252 2707275 8190890 3326517 4864373 723324 340140 383184 14627404 14627404 21637828 10596628 11041200 2941666 34120 2907546 MEDICAL SUPPLIES 77051593 75454871 1596722 BAD DEBT EXPENSE 13170386 13170386 REFERENCE LAB FEES 1645140 432 1644708 PHYSICIAN RECRUITMENT 127079 127079 13472057 333773 13138284 388645747 247272423 141373324 0 3418982 5170413 17557135 21028936 73325400 67274908 5402928 6572872 6407340 7928656 488228793 190350472 301449225 297878321 98319509 92916100 8272388 6733573 3099034 4301523 35179270 35303297 552431211 545108599 41538816 42173762 3850051 478722 286165829 288621004 9755000 4328569 37089924 38038939 378399620 373640996 X 174031591 171467603 174031591 171467603 552431211 545108599 X 50294672 -10609618 -42249042 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 166913 0 1 29783 196696 0 PART II-B, LINE 1: GENESIS HEALTHCARE SYSTEM PAYS MEMBERSHIP DUES TO THE FOLLOWING ORGANIZATIONS. A PORTION OF THE DUES ARE RELATED TO LOBBYING ACTIVITIES. AMERICAN HOSPITAL ASSOCIATION - FSCC SHARE (AHA): 22.73% OF $58,641 ($13,329) OHIO HOSPITAL ASSOCIATION - FSCC SHARE (OHA): 4.60% OF $84,146 ($3,871) AMERICAN SOCIETY HEALTHCARE ENGINEERING (ASHE/AHA): 22.98% OF $450 ($103) AMERICAN SOCIETY HEALTHCARE HR ADMIN (ASHHRA/AHA): 22.98% OF $160 ($37) AMERICAN SOCIETY HEALTHCARE RISK MGMT (ASHRM/AHA): 22.98% OF $318 ($73) SOC FOR HEALTHCARE STRATEGY & MARKET DEVELOPMENT (SHSMD/AHA): 17.00 OF $235 ($40) CATHOLIC CONFERENCE OF OHIO: 4.6% OF $2,100 ($97) CATHOLIC HEALTH ASSOC (FSCC SHARE): 3.93% OF $39,930 ($1,569) CATHOLIC HEALTH ASSOC (FSCC SHARE): 3.52% OF $36,696 ($1,292) 340B HEALTH 2016: 8.00% OF $5,000 ($400) 340B HEALTH 2017 & 2018: 8.00% OF $15,500 ($1,240) AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS: 17.00% OF $330 OF ($56) AMERICAN ASSOCIATION RESPIRATORY CARE (AARC): 20.0% OF $99 ($20) AMERICAN HEALTH INFORMATION MANAGEMENT ASSOCIATION (AHIMA): 5.0% OF $185 ($9) AMERICAN MEDICAL GROUP ASSOCIATION (AMGA): 20.0% OF $10,250 ($2,050) AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES (ACHE): 1.00% OF $345 ($3) COLLEGE OF HEALTHCARE INFO MGMT EXECUTIVES (CHIME): 8.0% OF $375 ($30) HEALTHCARE INFORMATION & MANAGEMENT SYSTEMS SOCIETY (HIMSS): 1.73% OF $3,375 ($58) MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA): 23.0% OF $5,542 ($1,275) TRAUMA CENTER ASSOCIATION OF AMERICA (TCAA): 23.0% OF $2,000 ($460) ZANESVILLE - MUSKINGUM CO. CHAMBER OF COMMERCE: 10.0% OF $4,590 ($459) OHIO HOSPICE AND PALLIATIVE CARE ORGANIZATION DBA MIDWEST CARE ALLIANCE (OHPCO): 7.3% OF 8,000 ($584) ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI: 22.73% OF $12,000 ($2,728) GENESIS HEALTHCARE SYSTEM PAID SECOND CAPITAL CONSULTING, LLC $166,913 IN 2018 FOR ADVOCACY AND OUTREACH CONSULTING SERVICES. SECOND CAPITAL CONSULTING, LLC HAS PROVIDED ADVOCACY AND OUTREACH CONSULTING SERVICES TO GENESIS HEALTHCARE SYSTEM SINCE 2013. THESE SERVICES ASSIST THE SYSTEM TO ENGAGE, EDUCATE AND COMMUNICATE WITH PUBLIC POLICY MAKERS REGARDING PENDING LEGISLATION OR PROPOSED REGULATIONS, AS WELL AS, ASSIST ELECTED OFFICIALS IN UNDERSTANDING THE IMPACT OF LEGISLATION ON GHCS'S ABILITY TO DELIVER COST EFFECTIVE, QUALITY CARE FOR PATIENTS IN SOUTHEAST OHIO. GENESIS WORKS PRIMARILY THROUGH NATIONAL AND STATE HOSPITAL ASSOCIATIONS, IN WHICH GENESIS HAS MEMBERSHIP, TO UNDERSTAND POTENTIAL POLICIES WHICH COULD NEGATIVELY AFFECT THEIR ABILITY TO WORK WITH THE LOCAL MEDICAL COMMUNITY TO MEET THE HEALTHCARE NEEDS OF THE REGION. SOME ISSUES OF INTEREST INCLUDE THE 340B PROGRAM, MEDICARE & MEDICAID BUDGET DECISIONS AND REGULATIONS, AND INFRASTRUCTURE IMPROVEMENTS AT THE LOCAL LEVEL THAT ENHANCE ACCESS TO THE HOSPITAL. IN FACT, A DIRECT ACCESS LANE OPENED THIS YEAR FOR EMERGENCY VEHICLES, SPEEDING THE TIME CRITICAL TO PATIENTS IN ARRIVING FOR EMERGENCY CARE. 9901714 9901714 231679810 26467916 205211894 4090386 2497097 1593289 229451927 159973002 69478925 13104956 1412457 11692499 297878321 UNAMORTIZED BOND ISSUE COSTS 4084998 INVESTMENTS IN RELATED AND OTHER HEALTHCARE ORGANIZATIONS 3453068 ASSETS LIMITED AS TO USE 27765231 35303297 ACCRUED MINIMUM PENSION LIABILITY 35018739 ACCRUED PROFESSIONAL LIABILITY 3020200 38038939 X PART X, LINE 2: THE SYSTEM AND ITS SUBSIDIARIES ARE TAX-EXEMPT ORGANIZATIONS, EXCEPT FOR CARELIFE; ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE CONSOLIDATED FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND TO RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER APPLICABLE TAXING AUTHORITIES. 1 1 X 1 X 1 X 1 1 0 1 1 3050238 2205501 844737 0.00220 88111722 75527423 12584299 0.03350 91161960 77732924 13429036 0.03570 57 103838 1423535 55136 1368399 0.00360 10 3704 1342465 1342465 0.00360 16 233 56417 56417 0.00020 83 107775 2822417 55136 2767281 0.00740 83 107775 93984377 77788060 16196317 0.04310 0 13170386 0 115553684 114046990 1506694 X 1 1 1 1 GENESIS HOSPITAL 2951 MAPLE AVE ZANESVILLE OH 43701 X X X ACUTE CARE HOSPITAL GENESIS HOSPITAL 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X WWW.GENESISHCS.ORG/ABOUT-US/COMMUNITY X 1 16 1 WWW.GENESISHCS.ORG/ABOUT-US/COMMUNITY 0 1 X 100.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X HTTP://WWW.GENESISHCS.ORG/APP/FILES/PUBLIC/2726/FINANCIAL-ASSISTANCE-SELF-P X HTTP://WWW.GENESISHCS.ORG/APP/FILES/PUBLIC/2660/FIN-ASSIST-FORM-REV.PDF X HTTP://WWW.GENESISHCS.ORG/APP/FILES/PUBLIC/2546/FIN-ASST-SUMMARY.PDF X X X X X 1 X 0 X X X 1 X 0 0 GENESIS HOSPITAL PART V, SECTION B, LINE 5: A COMMUNITY HEALTH SURVEY WAS CONDUCTED. THE SURVEY GATHERED THE COMMUNITY INPUT ON THEIR PRIORITIES FOR CHRONIC CONDITIONS, RISK FACTORS FOR DISEASE, MOTHERS AND CHILDREN AND ACCESS TO CARE. THE SURVEY WAS COLLECTED ON THE GENESIS WEBSITE IN SEPTEMBER OF 2015 AND USED FACEBOOK, TWITTER, AND THE ZANESVILLE TIMES RECORDER TO PUBLICIZE THE COMMUNITY HEALTH NEEDS SURVEY. 67 COMPLETED SURVEYS WERE COLLECTED FROM THE GENESIS WEBSITE AND FROM INDIVIDUALS WAITING FOR SERVICES AT THE GENESIS HOSPITAL. ALL SIX COUNTIES WERE REPRESENTED IN THE SURVEY. TWO STUDENTS FROM MUSKINGUM UNIVERSITY AND KEY PARTNERS SUCH AS MUSKINGUM VALLEY HEALTH CENTER, THE VETERAN'S CLINIC, SALVATION ARMY, CHRIST'S TABLE, AND UNITED WAY COLLECTED SURVEYS FROM LOCATIONS SERVICING THE UNDERSERVED POPULATION. SIXTY-THREE PERSONS COMPLETED THE SURVEY IN THE UNDERSERVED LOCATIONS. A TOTAL OF 130 SURVEYS WERE COLLECTED.58 KEY INFORMANT SURVEYS WERE COLLECTED IN THE COMMUNITY AND CONTAINED CATEGORIES FOR BEHAVIORAL RISKS, MOMS AND BABIES, MORTALITY RATES AND POVERTY. SPECIAL CARE WAS USED TO IDENTIFY KEY INFORMANTS WITH KNOWLEDGE OF UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS. IN ADDITION, WE HAVE IDENTIFIED THE KEY INFORMANTS SPECIFICALLY AS: (1) PERSONS WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH; (2) REPRESENTATIVES FROM GOVERNMENT OR PUBLIC HEALTH DEPARTMENTS; AND (3) LEADERS, REPRESENTATIVES, OR MEMBERS OF MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE NEEDS. ALL SIX COUNTIES WERE REPRESENTED IN THE KEY INFORMANT SURVEY.IN ADDITION TO USING COUNTY BASED NEEDS ASSESSMENTS, DUE TO THE LARGE COMMUNITY DEFINED IN THIS COMMUNITY HEALTH NEEDS ASSESSMENT, SPECIAL CARE WAS TAKEN TO INCORPORATE THE VIEWS OF KEY INFORMANTS FROM EACH COUNTY. BELOW ARE EXAMPLES OF THE AGENCIES AND GROUPS COMPLETING THE KEY INFORMANT SURVEYS.COSHOCTON:GENESIS HEALTHCARE SYSTEMCOSHOCTON COUNTY HEALTH DEPARTMENTCOSHOCTON JOB AND FAMILY SERVICESCOSHOCTON UNITED WAYMUSKINGUM VALLEY HEALTH CENTERCOSHOCTON BEHAVIORAL HEALTH CHOICESMUSKINGUM:GENESIS HEALTHCARE SYSTEMTHE CARR CENTERQUALITY CARE PARTNERSZANESVILLE-MUSKINGUM COUNTY HEALTH DEPARTMENTHEART BEATSBIG BROTHERS BIG SISTERSMUSKINGUM COUNTY COMMUNITY FOUNDATIONMUSKINGUM RECREATION CENTERMUSKINGUM COUNTY PORT AUTHORITYSALVATION ARMYBETHEL MISSIONFIRST UNITED METHODIST CHURCHMUSKINGUM VALLEY HEALTH CENTERAMERICAN CANCER SOCIETYWICGUERNSEY:GENESIS HEALTHCARE SYSTEMAMERICAN CANCER SOCIETYMUSKINGUM VALLEY HEALTH CENTERMORGAN:GENESIS HEALTHCARE SYSTEMMORGAN LOCAL SCHOOLSMUSKINGUM VALLEY HEALTH CENTERBUCKEYE HILLSSALVATION ARMYNOBLE:GENESIS HEALTHCARE SYSTEMBUCKEYE HILLS-HOCKING VALLEY REGIONAL DEVELOPMENT DISTRICTCARESOURCEAMERICAN CANCER SOCIETYPERRY:GENESIS HEALTHCARE SYSTEMPERRY COUNTY HEALTH DEPARTMENTNORTHERN LOCAL SCHOOLSHELP ME GROWHOPEWELL HEALTH CENTERCROOKSVILLE SCHOOL NURSESALVATION ARMY GENESIS HOSPITAL PART V, SECTION B, LINE 7D: THE CHNA REPORT IS AVAILABLE ON OUR WEBSITE AT HTTP://GENESISHCS.ORG, UNDER THE TAB "ABOUT US" AT THE BOTTOM OF THE FRONT PAGE, AND THEN UNDER THE "CARING FOR OUR COMMUNITY" TAB. THE REPORT WAS SHARED WITH COMMUNITY PARTNERS AND COPIES ARE AVAILABLE FOR FREE UPON REQUEST. GENESIS HOSPITAL PART V, SECTION B, LINE 11: PLEASE NOTE: THE NEW CHNA WAS COMPLETED IN 2018. A NEW 2019-2012 IMPLEMENTATION STRATEGY IS NOW ON OUR WEBSITE, BUT WAS NOT COMPLETED UNTIL MAY OF 2019. THE INFORMATION BELOW IS FOR THE COMMUNITY BENEFIT 2016-2018 IMPLEMENTATION STRATEGY. FOR 2018 IT WAS STILL THE WRITTEN PLAN THAT ADDRESSED EACH OF THE COMMUNITY HEALTH NEEDS FOR 2018.THE COMMUNITY BENEFIT 2016-2018 IMPLEMENTATION STRATEGY IS A WRITTEN PLAN THAT ADDRESSES EACH OF THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THE 2015 CHNA. THE PLAN HAS BEEN TAILORED TO THE SERVICE LINES OF GENESIS, TAKING INTO ACCOUNT SPECIFIC PROGRAMS, RESOURCES AND PRIORITIES. THE IMPLEMENTATION STRATEGY PLANNING GROUPS INCLUDED TWO THAT HAD REPRESENTATION ACROSS SERVICE LINES AND INCLUDED COMMUNITY AGENCIES: (1) THE ADDICTION REDUCTION PLANNING GROUP AND (2) THE OBESITY REDUCTION PLANNING GROUP. OTHER GENESIS PLANNING GROUPS INCLUDED: GENESIS BEHAVIORAL HEALTH, CANCER SERVICES, HEART AND VASCULAR SERVICES, TRAUMA SERVICES, NEUROSCIENCE SERVICES, WOMEN'S AND CHILDREN'S SERVICES, POPULATION HEALTH AND WELLNESS, PULMONARY ADMINISTRATION, EDUCATIONAL SERVICES, MEDICAL STAFF SERVICES, GENESIS HOSPICE AND PALLIATIVE CARE/CAREGIVERS, MARKETING AND PUBLIC RELATIONS, MISSION, NURSELINE, SPIRITUAL CARE, PATIENT EDUCATION AND VOLUNTEER SERVICES.GIVEN THE EVER CHANGING LANDSCAPE OF HEALTHCARE, THE INITIATIVES IN THIS IMPLEMENTATION STRATEGY MAY CHANGE AND NEW ONES MAY BE ADDED OR OTHERS ELIMINATED BASED ON THE COMMUNITY NEEDS DURING THE 2016-2018 PERIOD. THESE CHANGES WILL BE NOTED EACH YEAR IN THE ANNUAL EVALUATION REPORT.THE COMMUNITY BENEFIT 2016-2018 IMPLEMENTATION STRATEGY OUTCOMES ARE TRACKED QUARTERLY AND ANNUALLY THROUGH THE COMMUNITY BENEFIT'S DATA SYSTEM KNOWN AS THE COMMUNITY BENEFIT INVENTORY OF SOCIAL ACCOUNTABILITY (CBISA). THE INITIAL PROPOSED OUTCOMES IN THE TABLES BELOW WILL BE USED AS A BASELINE FOR PERFORMANCE FOR EACH YEAR AND USED TO GUIDE THE EVALUATION PROCESS AND FUTURE INITIATIVE DEVELOPMENT. THE INITIATIVES AND ANTICIPATED OUTCOMES INCLUDED IN THIS DOCUMENT WILL BE EVALUATED AGAINST THE DATA COLLECTED FOR THE IDENTIFIED MEASURES THROUGH CBISA. THE FOCUS AREA LEADERS WILL ENSURE THAT THE OUTCOMES FOR EACH INITIATIVE ARE REPORTED IN CBISA THROUGH THE COMMUNITY BENEFIT PROGRAM AND SUMMARY REPORTS WILL BE ASSESSED QUARTERLY BY THE GENESIS COMMUNITY BENEFIT COMMITTEE. THE DOCUMENT "2018 COMMUNITY BENEFIT PLAN" CONTAINS THE 2017 EVALUATION OF OUTCOMES AND THE 2018 PROPOSED OUTCOMES OF THE 2016-2018 COMMUNITY IMPLEMENTATION STRATEGY WHICH WAS APPROVED BY THE GENESIS QUALITY COMMITTEE AND THE BOARD OF DIRECTORS IN APRIL OF 2018. THE CHNA IDENTIFIED TOP PRIORITY CHRONIC CONDITIONS, RELATED RISK FACTORS, ISSUES FOR MOTHERS AND CHILDREN AND ACCESS TO CARE ISSUES. THE COMMUNITY BENEFIT 2016-2018 IMPLEMENTATION STRATEGY FOCUSES ON ALL THE MAJOR AREAS OF NEED EXCEPT ACCESS TO CARE (CHNA PAGES 27-29). ACCESS TO CARE IS A FOCUS OF THE GENESIS STRATEGIC PLAN AND INITIATIVES ARE IMPLEMENTED THROUGH ADMINISTRATION, SERVICE LINE DIRECTORS, FINANCIAL ASSISTANCE, AND TRANSFORMATIONAL CARE DEPARTMENTS. THE TOP HEALTH PRIORITIES FROM THE CHNA, WHICH ARE THE FOCUS OF THE 2016-2018 COMMUNITY BENEFIT IMPLEMENTATION STRATEGY, ARE LISTED BELOW ACCOMPANIED BY THE REFERENCE PAGE WHERE THAT PRIORITY AREA IS LOCATED IN THE CHNA DOCUMENT.THE TOP PRIORITY CHRONIC CONDITIONS IDENTIFIED ARE AS FOLLOWS:1. CANCER (CHNA PAGE 14); PRIORITY RISK FACTOR: TOBACCO USE (CHNA PAGE 15)2. MENTAL HEALTH ISSUES (CHNA PAGE 16); PRIORITY RISK FACTORS: DRUG ADDICTIONS (CHNA PAGE 17) AND ALCOHOL OVERUSE (CHNA PAGE 18)3. DIABETES (CHNA PAGE 18)4. HEART DISEASE (CHNA PAGE 19); PRIORITY RISK FACTORS: OBESITY (CHNA PAGE 20), UNHEALTHY EATING (CHNA PAGE 20), AND PHYSICAL INACTIVITY (CHNA PAGE 21)5. CHRONIC BREATHING PROBLEMS (CHNA PAGE 21)6. JOINT & BACK PAIN (CHNA PAGE 22)7. STROKE (CHNA PAGE 23); PRIORITY RISK FACTOR: HIGH BLOOD PRESSURE (CHNA PAGE 23)THE TOP PRIORITY HEALTH ISSUES FOR MOTHERS AND CHILDREN INCLUDE:1. PREGNANT AND USING TOBACCO (CHNA PAGE 24)2. PREGNANT AND USING ALCOHOL (CHNA PAGE 24)3. PREGNANT AND USING DRUGS (CHNA PAGE 24)4. CHILDREN OVERWEIGHT (CHNA PAGE 25)5. SUPPORT FOR DRUG ADDICTED BABIES (CHNA PAGE 25)6. CHILDREN WITH DISABILITIES (CHNA PAGE 26)GENESIS HAS TWO PLANNING GROUPS THAT INCLUDE COMMUNITY PARTNERS TO COLLABORATIVELY IMPLEMENT INITIATIVES RELATED TO ADDICTIONS AND OBESITY. THE FIRST GROUP, THE "ADDICTIONS REDUCTION GROUP" MEETS QUARTERLY TO COLLABORATE AND ASSESS PROGRESS ON INITIATIVES. THE FOCUS OF THE GROUP INCLUDES ADDICTIONS TO TOBACCO, ALCOHOL, AND DRUGS INCLUDING ADDICTED MOTHERS AND BABIES. THE SECOND GROUP, FORMED ORIGINALLY AS THE "OBESITY REDUCTION GROUP", FOCUSED ON REDUCING BOTH ADULT AND CHILD OBESITY. IN 2017, THIS GROUP MERGED WITH ANOTHER GENESIS COLLABORATION CALLED "MUSKINGUM MOVES". COLLABORATIVE INITIATIVES INCLUDE COMMUNITY INFORMATION DISTRIBUTED THROUGH A FACEBOOK PAGE PROMOTING HEALTHY LIFESTYLES THAT REDUCE OBESITY. ALL GENESIS SERVICE LINE INITIATIVES RELATED TO OBESITY REDUCTION ARE STILL CAPTURED THROUGH CBISA. 14 1 - HOSPICE & PALLIATIVE CARE 713 FOREST AVENUE ZANESVILLE OH 43701 HOSPICE & PALLIATIVE CARE CENTER 2 - CTR FOR OUTPATIENT & OCCUPATIONAL REHAB 740 ADAIR AVENUE ZANESVILLE OH 43701 OUTPATIENT REHAB SERVICES 3 - HEALTHPLEX 2800 MAPLE AVENUE ZANESVILLE OH 43701 OUTPATIENT LAB/IMAGING; PEDIATRIC REHAB 4 - GENESIS PHYSICIAN'S PAVILION 945 BETHESDA DRIVE ZANESVILLE OH 43701 OUTPATIENT CARDIAC REHAB SERVICES; WOUND CARE CENTER 5 - GENESIS BEHAVIORAL HEALTH 2991 MAPLE AVENUE ZANESVILLE OH 43701 MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT 6 - GENESIS INTERVENTIONAL PAIN MGT CLINIC 2945 MAPLE AVENUE ZANESVILLE OH 43701 PAIN MEDICINE SPECIALIZATION;IMAGING TECHNIQUES;SOLUTIONS TO PAIN MANAGEMENT 7 - GENESIS SLEEP DISORDERS CENTER 840 BETHESDA DRIVE ZANESVILLE OH 43701 DIAGNOSIS AND TREATMENT OF SLEEP DISORDERS 8 - GENESIS RHEUMATOLOGY CARE CENTER 2525 MAPLE AVENUE ZANESVILLE OH 43701 EDUCATION AND OUTPATIENT RHEUMATOLOGY SERVICES 9 - CAMBRIDGE HEALTH CENTER 61353 SOUTHGATE PARKWAR CAMBRIDGE OH 43725 IMAGING SERVICES/LAB SERVICE/WOUND MANAGEMENT 10 - GENESIS CANCER CENTER 2951 MAPLE AVENUE ZANESVILLE OH 43701 CANCER & PALLATIVE CARE/WOMEN'S BOUTIQUE 11 - GENESIS HEALTHCARE CENTER - NEW CONCORD 1 EAST MAIN STREET NEW CONCORD OH 43762 LAB SERVICES 12 - GENESIS HEALTH CENTER - PERRY COUNTY 301 DR MIKE CLOUSE DRIVE SOMERSET OH 43783 DIAGNOSITC HEALTHCARE SERVICES/PHYSICAL & OCCUPATIONAL THERAPY 13 - GENESIS SURGERY CENTER 2907 MAPLE AVENUE ZANESVILLE OH 43701 OUTPATIENT SURGERY 14 - GENESIS NEW LEXINGTON DRAW CENTER 445 WEST BROADWAY NEW LEXINGTON OH 43764 LAB SERVICES PART I, LINE 7: COSTS OF CHARITY CARE AND COMMUNITY BENEFIT ACTIVITIES WERE CALCULATED USING THE HOSPITAL'S COST ACCOUNTING SYSTEM.PART I, LINE 7, COLUMN (F): PERCENTAGE OF TOTAL EXPENSES WAS CALCULATED BASED ON TOTAL EXPENSES LESS BAD DEBT EXPENSE AS REPORTED ON FORM 990, PART IX. PART II, COMMUNITY BUILDING ACTIVITIES: GENESIS HAS AN ACTIVE PRESENCE ON MANY COMMITTEES INVOLVED IN FINDING LOW COST SOLUTIONS TO PHYSICAL AND MENTAL HEALTH ISSUES PREVALENT IN OUR COMMUNITIES, WITH PARTICULAR FOCUS ON SERVING LOW-INCOME, UNINSURED OR OTHERWISE UNDERSERVED. GENESIS NURSES, THERAPISTS, DIABETES COUNSELORS, ADMINISTRATORS AND OTHER PROFESSIONALS PARTICIPATE IN COMMUNITY COALITIONS AND PREVENTION PROGRAMS, PRIMARILY WITH A FOCUS ON ACCESS TO CARE, TRANSPORTATION, FOOD INSECURITY, HOMELESSNESS, DOMESTIC VIOLENCE, FAMILY SERVICES, WELLNESS INITIATIVES, COUNTY HEALTH COALITIONS, COMMUNITY RESOURCES, ADDICTION REDUCTION, ACCIDENT PREVENTION, AND MENTAL HEALTH. THESE ACTIVITIES ARE ALL CAPTURED IN CBISA. COMMUNITY BUILDING ACTIVITIES INCLUDE MEMBERSHIP IN COMMUNITY GROUPS AND ATTENDING MEETINGS, CONFERENCES, AND COLLABORATIVE COMMUNITY EVENTS AND PARTICIPATION IN THE HEALTH ASSESSMENTS AND PLANNING EFFORTS OF LOCAL HEALTH DEPARTMENTS. COMMUNITY BENEFIT BUILDING ACTIVITIES ARE CURRENTLY NOT PART OF THE DOCUMENTATION FOR COMMUNITY BENEFIT. PART III, LINE 2: BAD DEBT IS CALCULATED USING GROSS CHARGES. PART III, LINE 3: NO BAD DEBT IS ESTIMATED TO RELATE TO CHARITY CARE. PART III, LINE 4: THE FINANCIAL STATEMENT FOOTNOTE RELATED TO BAD DEBT IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENT FOOTNOTE 1 "NATURE OF BUSINESS AND SIGNIFICANT ACCOUNTING POLICIES" GROUPED WITH ACCOUNTS RECEIVABLE ON PAGE 8. PART III, LINE 8: CALCULATION WAS BASED ON THE MEDICARE COST TO CHARGE RATIO. PART III, LINE 9B: ALL PATIENTS ARE OFFERED A PLAIN LANGUAGE SUMMARY (PLS) OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY PRIOR TO DISCHARGE FROM THE HOSPITAL. AT LEAST THREE SEPARATE COMMUNICATIONS WILL BE MAILED TO THE LAST KNOWN ADDRESS OF THE RESPONSIBLE PARTY ALSO CONTAINING THE PLS. AT LEAST 60 DAYS WILL LAPSE BETWEEN THE FIRST AND THIRD REQUIRED COMMUNICATION. DETAILED ITEMIZED STATEMENTS WILL BE MADE AVAILABLE UPON REQUEST EXCEPT WHERE PROHIBITED BY STATE OR FEDERAL REGULATIONS. ACCOUNTS WITH ZERO BALANCES WILL NOT RECEIVE THREE SEPARATE COMMUNICATIONS; HOWEVER, THESE ACCOUNT HOLDERS MAY ALSO BE ELIGIBLE TO APPLY FOR FINANCIAL ASSISTANCE. ALL RESPONSIBLE PARTIES WILL RECEIVE WRITTEN NOTIFICATION REGARDING EXTRAORDINARY COLLECTION ACTIONS (ECA) THAT MAY COMMENCE IF ACTION IS NOT TAKEN. THIRTY DAYS WILL LAPSE BETWEEN ISSUANCE OF NOTIFICATION AND COMMENCEMENT OF ECA. ACTION TAKEN BY THE RESPONSIBLE PARTY CONSTITUTES MAKING PAYMENT ARRANGEMENTS FOR THE AMOUNT DUE OR COMPLETING A FINANCIAL ASSISTANCE APPLICATION. ACCOUNTS GO TO FULL COLLECTION AFTER DAY 120 IF NO PRIOR ARRANGEMENTS HAVE BEEN MADE. COLLECTION AGENCIES ARE INSTRUCTED TO MAKE PHONE CALLS AND SEND LETTERS. IF THEY CANNOT RESOLVE THE BALANCE, OR HAVE NOT BEEN ABLE TO MAKE PAYMENT ARRANGEMENTS, THE ACCOUNT IS SENT BACK TO GENESIS AS NON-COLLECTIBLE IN 18 MONTHS. PART VI, LINE 2: GENESIS HEALTHCARE SYSTEM, AS A NOT-FOR-PROFIT HEALTH CARE SYSTEM, IS DEDICATED TO MEETING THE HEALTH NEEDS OF OUR COMMUNITIES, REGARDLESS OF ONE'S ABILITY TO PAY. WE ENCOURAGE AND SUPPORT COLLABORATION WITH OTHER COMMUNITY PARTNERS TO IDENTIFY, RESPOND TO AND STRIVE TO IMPROVE THE HEALTH-RELATED NEEDS OF THE POOR, THE UNDERSERVED, AND THE COMMUNITY AT LARGE. WE PLEDGE ALL AVAILABLE FINANCIAL RESOURCES - AFTER OUR OPERATING EXPENSES ARE MET - TO RESPOND TO THE COMMUNITY'S HEALTH NEEDS WITH SERVICE INITIATIVES, FINANCIAL AND PROFESSIONAL SUPPORT, AND EDUCATION AND WELLNESS PROGRAMS.THE COMMUNITY BENEFIT COMMITTEE COLLABORATES WITH GENESIS ADMINISTRATION AND DEPARTMENTS AND WITH COMMUNITY AGENCIES IN OUR DEFINED GEOGRAPHIC MARKET, INCLUDING BUT NOT LIMITED TO THE PUBLIC HEALTH DEPARTMENTS, MUSKINGUM VALLEY HEALTH CENTERS, AND THE UNITED WAY, TO ASSESS COMMUNITY HEALTH NEEDS AND STRENGTHS; DEVELOP A COMMUNITY BENEFIT PLAN WITH STRATEGIC GOALS AND INTERVENTIONS; MONITOR IMPLEMENTATION OF COMMUNITY BENEFIT ACTIVITIES; EVALUATE COMMUNITY BENEFIT ACTIVITIES; ADVOCATE FOR THE COMMUNITY BENEFIT PROGRAMS; AND ASSIST IN TELLING THE GENESIS HOSPITAL COMMUNITY BENEFIT STORY. PART VI, LINE 3: GENESIS HAS SIGNAGE STRATEGICALLY LOCATED IN THE FACILITY (REGISTRATION AREAS AND CASHIER AREAS) ADVISING OF FREE CARE. BILLING STATEMENTS ALSO CONTAIN THIS INFORMATION ALONG WITH A CHARITY CARE APPLICATION PRINTED ON THE REVERSE SIDE OF THE BILL. THE INFORMATION IS ALSO AVAILABLE ON OUR WEBSITE. WE HAVE REGISTRATION STAFF THAT WORK IN THE EMERGENCY DEPARTMENT TO SCREEN PATIENTS FOR POTENTIAL MEDICAID QUALIFIERS IF THE PATIENT ALLOWS. FOR INPATIENTS, WE HAVE RESOURCE COUNSELING STAFF THAT SCREEN SELF-PAY, UNDERINSURED AND MEDICARE ONLY PATIENTS FOR MEDICAID AND/OR CHARITY. PART VI, LINE 4: OUR GEOGRAPHIC MARKET AREA IS A SIX-COUNTY RURAL REGION OF SOUTHEAST OHIO, INCLUDING MUSKINGUM, MORGAN, PERRY, COSHOCTON, GUERNSEY AND NOBLE COUNTIES. TOTAL MARKET AREA POPULATION IS APPROXIMATELY 226,800, WITH MUSKINGUM COUNTY (86,818) REPRESENTING THE LARGEST COUNTY. MEDIAN HOUSEHOLD INCOME LEVELS RANGE FROM $37,067 TO $42,017 WHICH IS LOWER THAN THE STATE MEDIAN HOUSEHOLD INCOME OF $50,074 AND EVEN LOWER THAN THE NATIONAL MEDIAN HOUSEHOLD INCOME OF $53,889. PEOPLE LIVING BELOW POVERTY LEVEL RANGE FROM 15.0% TO 19.0% IN THE REGION VERSES 14.6% FOR THE STATE AND 12.7% FOR THE NATION. CHILDREN IN POVERTY RANGE FROM 18.0% TO 28.0% IN OUR REGION COMPARED TO 20.0% FOR THE STATE OF OHIO. PART VI, LINE 5: ONGOING COMMUNITY HEALTH EDUCATION IS PROVIDED THROUGH REGULARLY SCHEDULED HEALTH AND WELLNESS PROGRAMS PRESENTED BY GENESIS STAFF AND AFFILIATED PHYSICIANS. PREVENTATIVE HEALTH SCREENINGS ARE ALSO ROUTINELY SCHEDULED FOR BLOOD PRESSURE, DIABETES, FALL-RISK ASSESSMENTS, THINK-FIRST INJURY PREVENTION FOR CHILDREN AND YOUNG ADULTS, AND I.M.P.A.C.T (IMMEDIATE POST-CONCUSSION ASSESSMENT AND COGNITIVE TESTING). PROGRAM TOPICS ARE BASED ON COMMUNITY NEED AS DETERMINED BY FEEDBACK FROM PARTICIPANTS, THE COMMUNITY BENEIFIT COMMITTEE AND SERVICE LINE LEADERS. GENESIS ALSO REGULARLY PROVIDES HEALTH AND WELLNESS PROMOTION THROUGH COMMUNITY-BASED HEALTH FAIRS AND EVENTS HELD THROUGHOUT THE COMMUNITY. CLINICAL EXPERIENCES ARE OFFERED FOR HEALTHCARE STUDENTS AS WELL AS TRAINING OPPORTUNITIES FOR HEALTHCARE PROFESSIONALS. PART VI, LINE 6: GENESIS HOSPITAL AND ITS AFFILIATES ARE REACHING OUT TO IMPROVE THE HEALTH OF THE COMMUNITY THROUGH COMMUNITY INITIATIVES, MANY BASED ON PREVENTION. SOME EXAMPLES INCLUDE:- PROVIDING CLINICAL EXPERIENCES WITH AFFILIATED PHYSICIANS FOR MEDICAL STUDENTS- NUMEROUS HEALTH SCREENINGS IN CONJUNCTION WITH AFFILIATED PHARMACY- COMMUNITY PROGRAMS ON VARIOUS HEALTH TOPICES PROVIDED BY AFFILIATED PHYSICIANS- GENESIS COMMUNITY AMBULANCE INITIATIVES INCLUDING PARTICIPATION IN PRESENTATIONS THAT SIMULATE DISTRACTED DRIVING ACCIDENTS AT SCHOOLS AND ORGANIZATIONS, PROMOTING THE WELL-BEING OF THE COMMUNITY THROUGH PARAMEDIC ASSISTS AND STANDBYS AT LOCAL EVENTS AND INCREASING PUBLIC AWARENESS OF EMERGENCY MEDICAL SERVICE THROUGH VARIOUS EFFORTS SUCH AS AMBULANCE TOURS 1 UNITED WAY OF MPM COUNTIES 526 PUTNAM AVENUE ZANESVILLE OH 43701 314379456 501(C)(3) 15000 CORPORATE DONATION FOR PLEDGE CAMPAIGN AMERICAN HEART ASSOCIATION PO BOX 4002907 DES MOINES IA 50340 135613797 501(C)(3) 17000 HEARTCHASE SPONSORSHIP AGREEMENT AMERICAN CANCER SOCIETY 5555 FRANTZ ROAD DUBLIN OH 43017 131788491 501(C)(3) 6000 COUNTY SPONSOR MUSKINGUM VALLEY HEALTH CENTER 716 ADAIR AVENUE ZANESVILLE OH 43701 208814374 501(C)(3) 36337 FAIR MARKET VALUE DONATION OF TRIAGE SERVICES MUSKINGUM VALLEY HEALTH CENTER 716 ADAIR AVENUE ZANESVILLE OH 43701 208814374 501(C)(3) 5000 PATIENT CARE CHARITABLE FUND CENTRAL AMERICAN MEDICAL OUTREACH 322 WESTWOOD AVENUE ORVILLE OH 44667 341740695 501(C)(3) 332065 FAIR MARKET VALUE DONATION OF SUPPLIES GENESIS HEALTHCARE FOUNDATION 1135 MAPLE AVENUE ZANESVILLE OH 43701 311629034 501(C)(3) 135000 DONATION FOR AT RISK COMPENSATION 7 0 PART I, LINE 2: THE ANNUAL COMMUNITY IMPACT DONATION TO THE UNITED WAY, USUALLY MADE IN 4 QUARTERLY INSTALLMENTS, WAS DISCONTINUED AFTER THE JUNE 2017 PAYMENT AS "GENESIS WILL BE RE-DEPLOYING COMMUNITY BENEFIT IMPACT DOLLARS TO COMMUNITY WELLNESS AND HEALTH PROGRAMS THAT GENESIS IS ACTIVELY PROVIDING. GENESIS WILL CONTINUE TO SUPPORT THE ANNUAL CORPORATE DONATION OF $15,000 IN ADDITION TO THE GENESIS EMPLOYEES ANNUAL DONATIONS. THE AMERICAN HEART ASSOCIATION GRANT IS PART OF A 3 YR COMMITMENT FROM 2016-2018 FOR A TOTAL CONTRIBUTION OF $51,000. THIS COMMITMENT WAS AUTHORIZED BY OUR CEO THROUGH A SIGNED AGREEMENT AND IS TO BENEFIT THE LOCAL HEART CHASE PROGRAM OF WHICH GENESIS IS A SPONSOR AND PARTICIPANT. THE AMERICAN CANCER SOCIETY GRANT IS A SPONSORSHIP OF LOCAL ACS EVENTS IN AREA COUNTIES SERVED BY GENESIS. GENESIS ENCOURAGES COMMUNITY AND EMPLOYEE PARTICIPATION IN THESE EVENTS. THE CONTRIBUTION TO THE MUSKINGUM VALLEY HEALTH CENTER PATIENT CARE CHARITABLE FUND IS JUST ONE OF THE MANY WAYS THAT GENESIS WORKS WITH MVHC TO PROVIDE ACCESS TO PRIMARY AND PREVENTIVE CARE SERVICES FOR UNINSURED AND UNDERINSURED RESIDENTS. SEVERAL OF OUR GENESIS PHYSCIANS AND TECHNICAL STAFF MEMBERS WORK CLOSELY WITH MVHC TO HELP MEET THE HEALTH NEEDS OF THE AREA. X 1 1 X X X X X 1 1 0 0 0 0 0 0 0 ERIN REMSTER DO TRUSTEE 0 249608 0 40442 0 0 0 4021 0 14298 0 308369 0 0 KRISTY RITCHIE MD TRUSTEE 0 361130 0 81574 0 0 0 18500 0 25488 0 486692 0 0 JOHN ZIMMERMAN MD TRUSTEE 0 391123 0 113830 0 0 0 8250 0 18690 0 531893 0 0 PAUL MASTERSON CHIEF FINANCIAL OFFICER 294094 0 101509 0 0 0 917625 0 12670 0 1325898 0 0 0 MATTHEW PERRY PRESIDENT & CEO 752982 0 94463 0 0 0 161563 0 21435 0 1030443 0 0 0 SLOAN ALBERT CHIEF PNO: 01/01/17 - 09/1 271006 0 0 0 0 0 8401 0 0 0 279407 0 0 0 CHRISTOPHER SCHOELLES COO 282706 0 17399 0 0 0 11515 0 16988 0 328608 0 0 0 SHARON PARKER CHIEF OPERATION OFFICER 334133 0 13702 0 0 0 15765 0 16489 0 380089 0 0 0 WENDY CEDOZ CHIEF LEGAL OFFICER 320369 0 75827 0 0 0 115763 0 33448 0 545407 0 0 0 DIANNA LEVECK CHIEF HUMAN RESOURCES OFFI 375327 0 81942 0 0 0 127809 0 15974 0 601052 0 0 0 ABBY NGUYEN CHIEF NURSING OFFICER 136457 0 64868 0 0 0 7902 0 12733 0 221960 0 0 0 EDMUND ROMITO CHIEF INFORMATION OFFICER 354168 0 83163 0 0 0 42304 0 18463 0 498098 0 0 0 DANIEL SCHEERER MD CHIEF MEDICAL AFFAIRS OFFI 433144 0 80719 0 0 0 61725 0 18560 0 594148 0 0 0 MICHAEL NORMAN VICE PRESIDENT 322934 0 17399 0 0 0 10011 0 17579 0 367923 0 0 0 LES BOYER DIRECTOR 155970 0 9380 0 0 0 590 0 25827 0 191767 0 0 0 GREGORY HAMILTON DIRECTOR 152724 0 11921 0 0 0 4618 0 11064 0 180327 0 0 0 CHARLES ADAMS JR DIRECTOR 130721 0 35554 0 0 0 2745 0 18288 0 187308 0 0 0 MARIANNE GRAHAM MANAGER 159117 0 3766 0 0 0 3236 0 7707 0 173826 0 0 0 VICKIE SOMERS DIRECTOR 141537 0 8500 0 0 0 4450 0 23474 0 177961 0 0 0 PART I, LINE 1A THE ORGANIZATION PAYS COUNTRY CLUB DUES AND RELATED BUSINESS EXPENSES FOR MEMBERS OF SENIOR LEADERSHIP. PERSONAL USAGE IS PAID BY THE INDIVIDUAL AND THE PERCENTAGE OF DUES RELATED TO PERSONAL USAGE ARE ADDED TO THE INDIVIDUALS W-2. PART I, LINES 4A-B LINE 4A: A SEVERANCE PAYMENT IN THE AMOUNT OF $271,006 WAS REMITTED TO SLOAN ALBERT DURING 2018. LINE 4B: A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS SET UP TO PROVIDE ADDITIONAL DEFERRED RETIREMENT INCOME TO THE GENESIS HEALTH CARE SYSTEM SENIOR LEADERSHIP TEAM MEMBERS. THIS PLAN IS FUNDED BY GENESIS AND VESTS WITH SERVICE. GENESIS HEALTHCARE SYSTEM MADE CONTRIBUTIONS TO NONQUALIFIED RETIREMENT PLANS FOR THE FOLLOWING INDIVIDUALS: PAUL MASTERSON: $900,964 MATTHEW PERRY: $129,720 WENDY CEDOZ: $103,037 DIANNA LEVECK: $110,439 EDMUND ROMITO: $23,075 DANIEL SCHEERER, MD: $42,901 A COUNTY OF PERRY OHIO 316400082 2017-09-19 10000000 SEE PART VI 0 0 0 A 9085660 100500 8985160 2017 1 0 0 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 0 0 0 0 0 A 0 PART II, LINE 6 $46,879,891 WAS SPENT ON THE ISSUE DATE OF THE SERIES 2013 BONDS TO CURRENTLY REFUND A TAXABLE LOAN. THEREFORE, AS OF 12/31/2016, THERE ARE $0 PROCEEDS IN REFUNDING ESCROW. PART I, LINE A(F) (I) CURRENTLY REFUND A TAXABLE LOAN FOR CERTAIN HOSPITAL REVENUE BONDS; AND (II) FINANCE CERTAIN CAPITAL IMPROVEMENT PROJECTS FOR HOSPITAL FACILITIES FORM 990, PART VI, SECTION A, LINE 3 THE HIM DEPARTMENT, INCLUDING A DIRECTOR AND MANAGER, WAS OUTSOURCED IN 2015. DURING 2018, A TOTAL OF $4.65M IN FIXED MONTHLY FEES WAS PAID TO THE MANAGEMENT COMPANY AND INCLUDED ALL PERSONNEL SALARY, WAGE AND BENEFIT COSTS. FEES ARE PART OF AN INITIAL 5 YEAR AGREEMENT AND WERE BASED ON A REVIEW OF ANNUAL VOLUME OF MEDICAL RECORDS PROCESSED. FORM 990, PART VI, SECTION A, LINE 6 FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC., AND BETHESDA CARE SYSTEM (OR THEIR RESPECTIVE SUCCESSORS AN ASSIGNS) ARE THE MEMBERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE FILING ORGANIZATION, HAVE THE RIGHT TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY, WHETHER PERIODICALLY, OR AS VACANCIES ARISE, OR OTHERWISE. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS OF THE FILING ORGANIZATION, HAVE THE RIGHT TO APPROVE OR RATIFY DECISIONS OF THE ORGANIZATION'S GOVERNING BODY SUCH AS APPROVAL OF THE GOVERNING'S BODY'S DECISION TO DISSOLVE THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED IN ITS ENTIRETY BY THE CFO. AN OVERVIEW OF THE 990 IS REVIEWED WITH THE EXECUTIVE COMMITTEE. A COPY OF FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS VIA A WEB PORTAL FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY STATES THAT BOARD MEMBERS AND OFFICERS HAVE A DUTY TO GOVERN HONESTLY AND ECONOMICALLY. ALL POTENTIAL CONFLICTS OF INTEREST MUST BE DISCLOSED TO THE BOARD OF DIRECTORS AND THE BOARD WILL DETERMINE IF A CONFLICT EXISTS AND APPROPRIATE PROCEDURES TO MITIGATE THE SITUATION, SUCH AS ALTERNATIVE TRANSACTIONS AND PARTICIPATION AND VOTING RESTRICTIONS. THE COMPLIANCE OFFICER MONITORS AND ENFORCES THESE POLICIES. ALL OFFICERS AND DIRECTORS REVIEW AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE CEO IS MANAGED THROUGH A THIRD PARTY THAT IS A NATIONALLY RECOGNIZED FIRM SPECIALIZING IN COMPENSATION BENCHMARKING AND ANALYSIS. THE FIRM IS RECOGNIZED FOR THEIR EXPERTISE IN EVALUATING TOTAL COMPENSATION AT THE EXECUTIVE LEVEL. THIS FIRM PRESENTS THEIR RECOMMENDATIONS AND ANALYSIS TO THE COMPENSATION COMMITTEE, WHICH IS MADE UP OF INDEPENDENT MEMBERS OF THE GENESIS BOARD OF DIRECTORS. THE COMMITTEE IS RESPONSIBLE FOR MAKING A RECOMMENDATION TO THE BOARD OF DIRECTORS REGARDING THE EXECUTIVE COMPENSATION POLICY AND SPECIFIC COMPONENTS OF THE TOTAL COMPENSATION OF THE CEO. THE CEO IS ACTIVELY INVOLVED IN THE REVIEW, ANALYSIS AND RECOMMENDATION RELATED TO THE TOTAL COMPENSATION FOR THE REMAINING MEMBERS OF THE SENIOR LEADERSHIP TEAM. THE CEO DETERMINES THE COMPENSATION OF THE SENIOR LEADERSHIP TEAM MEMBERS WITHIN THE PARAMETERS ESTABLISHED BY THE COMPENSATION COMMITTEE. THIS COMPENSATION PROCESS WAS LAST COMPLETED IN 2016. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G BILLING AND COLLECTION FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,774,467. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,774,467. LAUNDRY SERVICE: PROGRAM SERVICE EXPENSES 1,372,057. MANAGEMENT AND GENERAL EXPENSES 34,423. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,406,480. INPATIENT TRANSPORT: PROGRAM SERVICE EXPENSES 329,700. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 329,700. COURIER SERVICE: PROGRAM SERVICE EXPENSES 657,853. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 657,853. MEDICAL AND PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 13,831,862. MANAGEMENT AND GENERAL EXPENSES 455,385. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,287,247. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 16,801,210. MANAGEMENT AND GENERAL EXPENSES 3,535,371. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,336,581. CONSULTING: PROGRAM SERVICE EXPENSES 1,110,488. MANAGEMENT AND GENERAL EXPENSES 607,214. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,717,702. SPONSORSHIP FEES: PROGRAM SERVICE EXPENSES 2,029,625. MANAGEMENT AND GENERAL EXPENSES 13,718. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,043,343. FORM 990, PART XI, LINE 9: LOSS IN FAIR VALUE OF PERPETUAL TRUST -1,128,061. PLEDGE RECEIVABLE FROM RELATED PARTY -41,366,455. RESERVE FOR COSHOCTON COUNTY MEMORIAL 26,360. CONTRIBUTED CAPITAL 40,000. INCOME FROM INVESTMENT IN COMMUNITY AMBULANCE SERVICES 179,114. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND IS INVOLVED IN THE SELECTION OF THE INDEPENDENT ACCOUNTANT WHICH COMPLETES THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PAGE 1, LINE H(D): THIS IS THE PARENT RETURN FOR A GROUP: GENESIS HEALTHCARE SYSTEM GROUP RETURN, EIN: 31-1773259 GENESIS HEALTHCARE FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 311629304 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 GOOD SAMARITAN MEDICAL CENTER FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 310969646 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE FOUNDATION 1 BETHESDA HOSPITAL FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 310885513 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE FOUNDATION 1 FRANCISCAN SISTERS OF CHRISTIAN CHARITY 1415 SOUTH RAPIDS ROAD MANITOWOC WI 542209302 391530622 SPONSOR OF GHS WI 501(C)(3) 7 N/A 0 GOOD SAMARITAN MEDICAL CENTER 2951 MAPLE AVENUE ZANESVILLE OH 43701 314379479 MAINTAINS REAL ESTATE TITLE FOR HOSPITAL OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 BETHESDA CARE SYSTEM 2951 MAPLE AVENUE ZANESVILLE OH 43701 311067174 SPONSOR OF GHS OH 501(C)(3) 9 GENESIS HEALTHCARE SYSTEM 1 BETHESDA HOSPITAL ASSOCIATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 314380038 MAINTAINS REAL ESTATE TITLE FOR HOSPITAL OH 501(C)(3) LINE 12B, II GENESIS HEALTHCARE SYSTEM 1 ALTERNACARE 2951 MAPLE AVENUE ZANESVILLE OH 43701 311487187 STERILIZATIONS OH 501(C)(3) 3 BETHESDA CARE SYSTEM 1 CARESERVE 2951 MAPLE AVENUE ZANESVILLE OH 43701 311099924 FORMERLY OPERATED 2 NURSING HOMES THAT WERE SOLD PRIOR TO 2012 OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 COMMUNITY AMBULANCE SERVICE 2951 MAPLE AVENUE ZANESVILLE OH 43701 341773323 AMBULANCE SERVICE OH 501(C)(3) LINE 11 GENESIS HEALTHCARE SYSTEM 1 GENESIS CAREGIVERS 2951 MAPLE AVENUE ZANESVILLE OH 43701 311282152 HOME CARE SERVICES OH 501(C)(3) 3 CARESERVE 1 BETHESDA HOSPITALITY SHOP 2951 MAPLE AVENUE ZANESVILLE OH 43701 316050713 GIFT SHOP OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 CARELIFE LLC 2951 MAPLE AVENUE ZANESVILLE OH 43701 311128717 PHYSICIAN SERVICES, CHILDCARE SERVICES, PHARMACY, DME OH GENESIS HEALTHCARE SYSTEM C -40194783 36590225 1.00000 1 SOUTHEAST OHIO MEDICAL INSURANCE COMPANY FIRST CARIBBEAN HOUSE GEORGE TOWN CAYMAN ISLANDS CJ 980436356 CAPTIVE INSURANCE COMPANY CJ GENESIS HEALTHCARE SYSTEM C 14770404 1.00000 1 0 0 1 1 0 0 0 0 0 1 1 1 1 0 1 1 1 1 1 GENESIS HEALTHCARE SYSTEM GROUP C 168937 ACCRUAL TRANSACTION GENESIS HEALTHCARE SYSTEM GROUP S 1506632 ACCRUAL TRANSACTION GENESIS HEALTHCARE SYSTEM GROUP O 328365 ACCRUAL TRANSACTION GENESIS HEALTHCARE SYSTEM GROUP Q 261631 ACCRUAL TRANSACTION