2019-05-10T10:12:03-05:00 2018-06-30 990 2017-07-01 231352187 GEISINGER-LEWISTOWN HOSPITAL GEIS 5702716624 100 N ACADEMY AVE MC 49-70 DANVILLE PA 178229800 DAVID J FELICIO ESQUIRE EVP, CLO, SECRETARY 5702716624 2019-04-22 167.68.16.49 2019-05-10 10:12:03 CD P 898C1895B8F201315E3AD013D20E33E4FB790411 768924B3E140BF8261684DD94139B4AA526C5F19 2017 2019-02-21 02:37:17Z JAEWON RYU MD JD 100 N ACADEMY AVE MC 22-01 DANVILLE PA 17822 131066493 false X WWW.GEISINGER.ORG X 1905 PA SEE SCHEDULE O 6 3 1008 91 224866 156140 23178 21631 122454155 129817135 -244795 260775 995281 961442 123227819 131060983 0 0 52910044 51798763 0 0 54455257 63904239 107365301 115703002 15862518 15357981 69475341 66694884 71270813 41722906 -1795472 24971978 X SEE SCHEDULE O false false 107714734 130269736 HEALTHCARE - SEE SCHEDULE O MISSION: TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING ACCESS TO QUALITY POPULATION HEALTH AND HOSPITAL SERVICES THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE. I. GENERAL INFORMATION GEISINGER-LEWISTOWN HOSPITAL (GLH), A 501(C)(3) NOT-FOR-PROFIT CORPORATION AND MEMBER OF GEISINGER, OWNS AND OPERATES A 123-BED ACUTE CARE HOSPITAL IN LEWISTOWN, PA. GLH IS CONVENIENTLY LOCATED ONLY A FEW MILES FROM SEVERAL CENTRAL PENNSYLVANIA MAJOR HIGHWAYS. THE FACILITY OPENED IN 1905 IN RESPONSE TO A PRESSING NEED FOR HEALTH AND WELLNESS CARE IN THE COMMUNITY. DURING THE FISCAL YEAR ENDED JUNE 30, 2018, GLH PROVIDED 20,112 PATIENT DAYS; 4,620 SAME DAY SURGICAL PROCEDURES; AND 29,825 EMERGENCY ROOM VISITS. GLH PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. MOST INSURANCES, INCLUDING MEDICARE AND MEDICAID, ARE ACCEPTED, AND ALL PATIENTS ARE OFFERED TREATMENT REGARDLESS OF THE TYPE OF INSURANCE THEY HAVE. NO PATIENT IS EVER REFUSED TREATMENT BECAUSE OF THE INABILITY TO PAY. THE ORGANIZATION ALSO PROVIDES UNCOMPENSATED CARE TO PATIENTS WHO MEET CERTAIN CRITERIA WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. SERVICES OFFERED BY GLH INCLUDE: GENERAL MEDICAL CARE IS PROVIDED BY IN-HOUSE HOSPITALISTS AND SUPPORTED BY CONSULTATIVE SERVICES IN THE AREAS OF CARDIOLOGY, INFECTIOUS DISEASE, NEUROLOGY, PULMONOLOGY, ORTHOPEDICS, HEMATOLOGY/ONCOLOGY, OTOLARYNGOLOGY, AND GASTROENTEROLOGY. A FULLY-STAFFED SURGICAL SERVICES SUITE OFFERING FIVE OPERATING ROOMS EQUIPPED FOR VARIOUS TYPES OF INPATIENT AND OUTPATIENT GENERAL AND SPECIALTY SURGICAL PROCEDURES. THE EMERGENCY DEPARTMENT(ED) IS COMMITTED TO PROVIDING HIGH QUALITY, PROMPT EMERGENCY SERVICES. GLH'S ED IS STAFFED 24/7 WITH FULL-TIME PHYSICIANS AND NURSES WHO ARE TRAINED IN ALL SPECIALTIES FROM PEDIATRICS TO CRITICAL CARE. IMMEDIATE ACCESS IS AVAILABLE TO LABORATORY SERVICES; IMAGING SERVICES SUCH AS CT SCANS, ULTRASOUND AND MRI; AND SURGICAL SERVICES. OB/GYN FOCUSES ON ALL ASPECTS OF WOMEN'S HEALTH AND EDUCATION, PROVIDING OBSTETRICAL AND GYNECOLOGICAL CARE FOR WOMEN OF ALL AGES. SERVICES INCLUDE BUT ARE NOT LIMITED TO ROUTINE VISITS AND TREATMENTS, PREVENTATIVE HEALTHCARE, BIRTH CONTROL EDUCATION, FAMILY PLANNING, OBSTETRICS, SURGERY & SURGERY CONSULTATIONS, MENOPAUSE COUNSELING, AND MIDWIFERY. MENTAL HEALTH & PSYCHIATRIC SERVICES PROVIDES ADULT INPATIENT SERVICES DESIGNED TO HELP INDIVIDUALS LIVE AS INDEPENDENTLY AS POSSIBLE. PATIENTS CAN ACCESS QUICK, EFFICIENT ADMISSION 24/7 AND RECEIVE TREATMENT THROUGH A PSYCHIATRIST AVAILABLE ON A DAILY BASIS. ADMISSIONS ARE CONFIDENTIAL AND MAY BE MADE BY PROFESSIONALS AS WELL BY INDIVIDUALS CONCERNED ABOUT THEMSELVES OR OTHERS. DURING HOSPITALIZATION, PATIENT CARE IS PROVIDED THROUGH MULTIPLE PROFESSIONALS WHO COMPRISE THE TREATMENT TEAM. OTHER SERVICES INCLUDE: CARDIAC SERVICES OTHER SURGERY SPECIALTIES CLINICAL NUTRITION OTOLARYNGOLOGY GASTROENTEROLOGY PAIN MANAGEMENT GENERAL SURGERY PATHOLOGY GYNECOLOGY PEDIATRICS ICCU PHYSICAL THERAPY LABORATORY SERVICES PODIATRY NEPHROLOGY PULMONARY/VASCULAR NEUROSURGERY RADIOLOGY NEWBORN NURSERY RESPIRATORY SERVICES ONCOLOGY/COMMUNITY CANCER SLEEP CENTER TREATMENT OPHTHALMOLOGY UROLOGY ORTHOPEDIC WOUND MANAGEMENT INFUSION CENTER GEISINGER LEWISTOWN HOSPITAL ALSO OPERATES A DIPLOMA NURSING PROGRAM AS A DEPARTMENT WITHIN ITS ORGANIZATION. OPENED IN 2008 AND ACCREDITED BY THE NATIONAL LEAGUE OF NURSING IN 2010, THE PROGRAM IS A 2-YEAR, SIX SEMESTER PROGRAM THAT ALSO OFFERS AN LPN TO RN TRACK. THE GEISINGER LEWISTOWN HOSPITAL SCHOOL OF NURSING (GLHSON) EXISTS TO PROVIDE QUALITY NURSING EDUCATION AND SEEKS TO ENGAGE A DIVERSE GROUP OF STUDENTS IN A MANNER THAT ENABLES ITS GRADUATES TO BECOME LEADERS IN PROVIDING COMPETENT AND SAFE BEDSIDE NURSING CARE ACROSS THE CONTINUUM AND THROUGHOUT THE SURROUNDING COMMUNITY. THE GLHSON HAS AN AVERAGE PASS RATE OF 99% FOR THE NCLEX/RN EXAM, WHICH IS A COMPETENCY AND LICENSURE EXAM USED BY ALL STATE NURSING BOARDS IN THE US. THIS HIGH EXAM PASS RATE ALONG WITH THE PROGRAM'S HIGH ADMISSION STANDARDS ARE TWO REASONS THAT THE PROGRAM HAS BEEN NAMED ONE OF THE TOP RANKED RN PROGRAMS IN PA BY REGISTERED NURSING.ORG, A NATIONAL RANKING ORGANIZATION, FOR THE LAST THREE YEARS. IN FY18, GLH COMPLETED PREPARATIONS FOR A FAMILY PRACTICE RESIDENCY PROGRAM, WHICH INCLUDED CONTRACTING WITH A CONSULTING FIRM, HIRING APPROPRIATE STAFF AND COMPLETING A SITE SURVEY. IN MAY 2018, GLH HIRED THE FIRST 4 FAMILY PRACTICE RESIDENTS INTO THE PROGRAM WHICH WILL OPERATE ON A 3-YEAR ROTATION, SO THAT BY THE THIRD YEAR OF THE PROGRAM, THERE COULD BE 12 FAMILY PRACTICE RESIDENTS ON SITE. II. UNCOMPENSATED CARE GEISINGER-LEWISTOWN HOSPITAL RECOGNIZES ITS MISSION IS TO SERVE ALL MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND EDUCATION. IN THIS REGARD, GLH PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH-RELATED ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A.CHARITY CARE THE PRIMARY CONCERN OF GLH IS THE DELIVERY OF HEALTH CARE TO ALL CITIZENS OF CENTRAL PENNSYLVANIA REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GLH INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. FOR THE FISCAL YEAR ENDED JUNE 30, 2018, THE TOTAL COST OF THE CHARITY CARE WAS 1.7 MILLION. B. MEDICARE/MEDICAID IN RECOGNIZING ITS MISSION TO THE COMMUNITY, GLH PROVIDES SERVICES TO THE ELDERLY (MEDICARE) AND THE INDIGENT (MEDICAID). GLH PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS TO THE EXTENT THE GOVERNMENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTH CARE. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. THE COST OF PROVIDING HEALTHCARE SERVICES TO MEDICARE AND MEDICAID PATIENTS EXCEEDED REIMBURSEMENT BY APPROXIMATELY 20.2 MILLION DURING THE FISCAL YEAR ENDED JUNE 30, 2018. C.OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GLH PROVIDES SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2018, WAS 840 THOUSAND. D. OTHER UNINSURED FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE OR GOVERNMENT OR PRIVATE PROGRAMS GLH OFFERS PAYMENT DISCOUNTS AND TIME PAYMENTS WITHOUT INTEREST OR FEES. III. VOLUNTEER SERVICES THE VOLUNTEERS OF GEISINGER-LEWISTOWN HOSPITAL ARE AN ACTIVE AND VITAL PART OF THE ACTIVITIES OF THE HOSPITAL. THE HOURS OF VOLUNTEER SERVICES ARE AN IMPORTANT CONTRIBUTION TO THE MISSION OF GLH. IN FY18, THE VOLUNTEERS FROM LOCAL COMMUNITIES CONTRIBUTED 9,587 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTHCARE OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION, 246 THOUSAND, IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND "WELLNESS" PROGRAMS. IV. COMMUNITY HEALTH, EDUCATION, AND OUTREACH GLH STRIVES TO BE A VALUABLE RESOURCE FOR THE COMMUNITY AND ITS RESIDENTS. GLH PROVIDES MANY REDUCED-PRICE SERVICES AND FREE PROGRAMS THROUGHOUT THE YEAR THAT SERVE COMMUNITY HEALTH NEEDS. AT A COST OF 121 THOUSAND, THESE SERVICES AND PROGRAMS INCLUDED: SUPPORT GROUPS, COMMUNITY HEALTH EDUCATION, HEALTH SCREENINGS AND OTHER UNIQUE SERVICES. GLH PROVIDES PROGRAMS FOR ALL DEMOGRAPHICS. A. SUPPORT GROUPS PREGNANCY SUPPORT: G-LH OFFERS LOW-COST PREPARED CHILDBIRTH AND BREASTFEEDING CLASSES TO PROMOTE POSITIVE OUTCOMES FOR EXPECTANT MOTHERS AND INFANTS THROUGH REALISTIC INSTRUCTION AND ACHIEVABLE GOALS. CLASSES FOCUS ON PREPARING FOR LABOR, DELIVERY AND POSTPARTUM. B. COMMUNITY HEALTH EDUCATION COMMUNITY HEALTH NEEDS ASSESSMENT OTHER CHRONIC DISEASE MANAGEMENT DIABETES MANAGEMENT DRUG & ALCOHOL COUNSELING WOMEN'S HEALTH RELATED TOPICS SMOKING CESSATION NUTRITION CLASSES LIVING WILLS PREPARING FOR YOUR DOCTOR'S VISIT MEDICATION SAFETY HEART DISEASE/FAILURE PREVENTION CANCER PREVENTION(SKIN, COLON, INFECTION CONTROL BREAST, PROSTATE) SENIOR CITIZEN EDUCATION & OUTREACH LIFE SAFETY/CPR CLASSES C. HEALTH SCREENINGS BLOOD PRESSURE BLOOD SUGAR LEVELS LUNG FUNCTION SCREENINGS BONE DENSITY HEAL SCANS DEPRESSION SCREENINGS SKIN CANCER SCREENING STROKE RISK ASSESSMENT D. OTHER SERVICES JUNIOR VOLUNTEER PROGRAM SILVER CIRCLES PROGRAM HEALTH FAIRS LOCAL ROTARY CLUB COALITION BUILDING AMISH COMMUNITY VISITS EDUCATION IN HEALTHCARE CAREERS COLLABORATE WITH LOCAL FACILITY TOURS FOR LOCAL SCHOOLS COMMUNITY HEALTH ADVOCACY GROUP V. PLANNED FUTURE ACTIVITIES IN KEEPING WITH ITS MISSION, GLH IS WORKING TO FULFILL THE HEALTH NEEDS OF ITS SURROUNDING COMMUNITIES BY PLANNING FOR THE FOLLOWING SERVICES OR ACTIVITIES IN THE UPCOMING FISCAL YEARS: IN THE FALL OF 2018, GLH ENTERED INTO A LEASE AGREEMENT FOR SPACE FOR A LABORATORY DRAW STATION IN A NEARBY, NEWLY CO 107714734 true true false true false false false false false true true true false false true false false true false false false false false false false false true true false false true false false false false false false true false false false false false false true true true true false true X 62 0 true 1008 true true true false false false false false false false false false X 6 3 true false false false true true false true true false false true true true true true true true true false PA X KRISTY M HINE AVP FINANCE 7172427650 400 HIGHLAND AVENUE LEWISTOWN PA 17044 EARL FOURA VICE CHAIR, 0.25 3.75 X 0 0 0 EDELYN L MILLER DIRECTOR 40.00 X 0 1565659 256399 JAEWON RYU MD JD DIRECTOR 40.00 X 0 1596610 218215 ROBERT J DIETZ CHAIR, DIREC 0.25 4.50 X 0 0 0 V CHRIS HOLCOMBE PE VICE CHAIR, 0.25 3.75 X 0 0 0 VIRGINIA MCGREGOR DIRECTOR 0.25 4.00 X 0 0 0 DAVID T FEINBERG MD MBA PRESIDENT, D 40.00 X X 0 3943153 1025348 DANIEL E LOHR ESQUIRE ACLO, ASST S 40.00 X 0 441235 43464 DAVID J FELICIO ESQUIRE EVP, CLO, SE 40.00 X 0 1142940 258756 KEVIN F BRENNAN CPA FHFMA EVP, CFO, TR 40.00 X 0 2133432 36848 MICHAEL T HEGSTROM MD CMO 40.00 X 0 476484 42603 KIRK E THOMAS FACHE MHA RRT CAO, WESTERN 40.00 X 298204 0 25659 CHRISTINE W MATHEWS RN MSN VP, NURSING 40.00 X 227878 0 4019 KRISTY M HINE AVP, FINANCE 40.00 X 188762 0 26475 NANCY S REINKE DIRECTOR, HU 40.00 X 163319 0 28982 PETER A GOYER RAD. PHYSICI 40.00 X 196743 0 5738 RICHARD F STOMACKIN RPH DIRECTOR, PH 40.00 X 191953 0 23843 KAY HAMILTON RN MS CAO 40.00 X 339983 0 5650 ALBERT BOTHE JR MD FORMER OFFIC 40.00 X 0 3097868 4032 RONALD M COWAN FORMER OFFIC 40.00 X 0 280534 19399 1606842 14677915 2025430 26 true true false MEDEFIS CONSOLIDATED PO BOX 5068 NEW YORK NY 100875068 1476602 HEALTHSOUTH NITTANY VALLEY 550 WEST COLLEGE AVENUE STATE COLLEGE PA 16823 REHAB SERVICES 702002 ALLIANCE HEALTHCARE SERVICES PO BOX 96485 CHICAGO IL 606936485 IMAGING SERVICE 686409 EPA PO BOX 634850 CINCINNATI OH 452634850 ED PHYSICIANS 521652 ENLIGHTEN PSYCHIATRIC SERVICES 300 CORNFIELD CIRCLE LEWISTOWN PA 17044 PSYCH LOCUMS 474700 12 21631 21631 NET PATIENT REVENUE 621110 128824898 128824898 SCHOOL OF NURSING TUITION 611600 533913 533913 LAB REVENUE 621500 222965 222965 INTERCOMPANY REVENUE 541900 196415 196415 COMMUNITY EDUCATION TRAINING 621400 38944 38944 129817135 38549 38549 227736 5510 222226 222226 222226 PURCHASE DISCOUNTS 561000 451291 451291 CAFETERIA SALES 722514 397170 397170 GIFT SHOP SALES 453220 89905 89905 23076 1310 1901 19865 961442 131060983 130046771 224866 767715 X 370885 370885 523665 218620 305045 39953664 38791065 1162599 434854 419230 15624 7528762 7258260 270502 2986933 2916173 70760 67406 67406 14114 14114 4887 4887 108298 8600 99698 7088279 6360983 727296 87282 12223 75059 3228602 2865949 362653 25920 21298 4622 2037282 1896679 140603 207277 196918 10359 346 346 992821 924301 68520 4492874 4182799 310075 887350 804626 82724 INTERCOMPANY EXPENSE 20477552 16392673 4084879 MEDICAL SUPPLIES 20349945 20349945 UNCOLLECTIBLE EXPENSE 3206941 3206941 IC TEACHING & ADMIN 387248 387248 239815 128972 110843 115703002 107714734 7988268 0 8006119 8189165 126295 156465 5928370 8085900 167412 345486 2093504 2204576 1163067 1432607 53598835 17081121 36100833 36517714 2408771 1116551 13452125 5812143 28845 2834277 69475341 66694884 1845076 1157814 30255906 28998387 39169831 11566705 71270813 41722906 X -2361146 24397613 85437 86175 480237 488190 -1795472 24971978 69475341 66694884 15357981 884570 10524899 X X false true X true true true X false false false false false false true 1269 false true 4887 6156 false SCHEDULE C, PART II-B, LINE 1 LINE 1G: AMOUNT REPORTED ON LINE 1G REPRESENTS THE WAGES AND BENEFITS OF EMPLOYEES WHO ASSIST THE GOVERNMENT RELATIONS DEPARTMENT OF THE ORGANIZATION'S AFFILIATE, GEISINGER SYSTEM SERVICES. THE PRIMARY PURPOSE OF THE GOVERNMENT RELATIONS DEPARTMENT IS TO MAINTAIN CONTACT WITH FEDERAL, STATE, AND LOCAL GOVERNMENT OFFICIALS. THE DEPARTMENT PROMOTES LEGISLATIVE ACTIONS WITH RESPECT TO HEALTHCARE RELATED ISSUES THAT COULD IMPACT THE ORGANIZATION AND ITS AFFILIATES. LINE 1I: OTHER LOBBYING ACTIVITIES REPORTED ON LINE 1I REPRESENTS THE PORTION OF MEMBERSHIP DUES, PAID BY THE ORGANIZATION TO TRADE OR PROFESSIONAL ASSOCIATIONS, ATTRIBUTABLE TO LOBBYING ACTIVITIES. 364718004 954000 8483375 -3653000 370502380 104496155 253645542 10396613 -3820306 364718004 180485 1101 1000 -431 180155 179962 907 -384 180485 179892 250 1105 1000 -285 179962 0.74930 0.20890 0.04180 false true true 638236 638236 18939775 6115523 12824252 179262 73999 105263 31324441 10661042 20663399 2517121 230557 2286564 36517714 5812143 F 5812143 DUE TO AFFILIATES 8278963 ESTIMATED 3RD PARTY PAYOR SETTLEMENT 2534310 OTHER LIABILITIES 753432 11566705 SCHEDULE D, PAGE 2, PART V, LINE 4 THE EARNINGS ON THE FRIENDS LEGACY ENDOWMENT FUND WILL BE USED SOLELY FOR THE PURPOSE OF CAPITAL AND BUILDING EXPENDITURES. NO EXPENDITURES CAN BE MADE UNTIL THE FUND REACHES 1,000,000 AND THEN ONLY THE EARNINGS FROM THE INVESTMENT CAN BE USED FOR THOSE PURPOSES. THE EARNINGS ON THE SCHOOL OF NURSING SCHOLARSHIP FUNDS ARE USED FOR SCHOLARSHIPS FOR GEISINGER- LEWISTOWN HOSPITAL SCHOOL OF NURSING STUDENTS SELECTED BY THE SCHOLARSHIP COMMITTEE BASED ON ESTABLISHED CRITERIA. SCHEDULE D, PAGE 4, PART XIII EFFECTIVE JULY 1, 2007, GEISINGER(1) ADOPTED ACCOUNTING STANDARDS CODIFICATION 740 (FIN 48), (FORMERLY KNOWN AS "STATEMENT 109: ACCOUNTING FOR INCOME TAXES- OR "FAS 109"). FIN 48 CLARIFIES THE ACCOUNTING AND REPORTING FOR INCOME TAXES WHERE INTERPRETATION OF THE TAX LAW MAY BE UNCERTAIN. FIN 48 PRESCRIBES A COMPREHENSIVE MODEL FOR THE FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, PRESENTATION AND DISCLOSURE OF INCOME TAX UNCERTAINTIES WITH RESPECT TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN INCOME TAX RETURNS. THE ADOPTION OF FIN 48 HAD NO IMPACT ON UNRESTRICTED NET ASSETS AS OF THE END OF THE FISCAL YEAR OR ANY PREVIOUS YEARS SINCE ADOPTION. ACCORDINGLY, NO FIN 48 FOOTNOTE DISCLOSURE WAS MADE IN THE GEISINGER CONSOLIDATED FINANCIAL STATEMENTS. (1) THROUGHOUT THIS DOCUMENT, THE TERMS "SYSTEM- OR "GEISINGER", SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH "GH" AS PARENT AND ALL SUBSIDIARY ENTITIES COMPRISING THE SYSTEM. true true X true X 3.000000000000 false true true false true true 1720767 1720767 0.01490 18807375 10515849 8291526 0.07170 20528142 10515849 10012293 0.08650 120600 120600 0.00100 1646128 672903 973225 0.00840 1766728 672903 1093825 0.00950 22294870 11188752 11106118 0.09600 true 3206941 1763818 22855850 32669694 -9813844 X true true 1 1 GEISINGER-LEWISTOWN HOSPITAL 400 HIGHLAND AVENUE LEWISTOWN PA 17044 WWW.GEISINGER.ORG 121501 X X X GEISINGER-LEWISTOWN HOSPITAL 1 false false true X X X X X X X X 15 true true false true X WWW.GEISINGER.ORG X WWW.GEISINGER.ORG X true 16 true WWW.GEISINGER.ORG false true X 300.000000000000 X X X X X true true X X X X true X WWW.GEISINGER.ORG - REFER TO SECTION C X WWW.GEISINGER.ORG - REFER TO SECTION C X WWW.GEISINGER.ORG - REFER TO SECTION C X X X X X X X true X false X X X X X true X false false FACILITY 1, GEISINGER-LEWISTOWN HOSPITAL - PART V, LINE 5 SECTION B., COMMUNITY HEALTH NEEDS ASSESSMENT, LINES 3, 5 AND 6A: GEISINGER-LEWISTOWN HOSPITAL ("GLH- OR THE "HOSPITAL"), A 123 BED COMMUNITY MEDICAL CENTER LOCATED IN LEWISTOWN, PA, CONTRACTED WITH TRIPP UMBACH TO FACILITATE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BETWEEN OCTOBER 2014 AND MARCH 2015 THAT IDENTIFIES THE NEEDS OF THE RESIDENTS SERVED BY GLH. AS A PARTNERING HOSPITAL OF A REGIONAL COLLABORATIVE EFFORT TO ASSESS COMMUNITY HEALTH NEEDS; GLH COLLABORATED WITH HOSPITALS AND OUTSIDE ORGANIZATIONS IN THE SURROUNDING REGION (INCLUDING JUNIATA AND MIFFLIN COUNTIES) DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. THE FOLLOWING IS A LIST OF ORGANIZATIONS THAT PARTICIPATED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IN SOME WAY: AREA AGENCY ON AGING, JUNIATA BEHAVIORAL & DEVELOPMENTAL SERVICES, JUNIATA COUNTY COMMISSIONERS, JV TRI-COUNTY DRUG & ALCOHOL, MIFFLIN COUNTY COMMISSIONERS, MIFFLIN COUNTY INDUSTRIAL DEVELOPMENT CORPORATION, MIFFLIN-JUNIATA SPECIAL NEEDS CENTER, PA OFFICE OF RURAL HEALTH, SACRED HEART CATHOLIC SCHOOL, STATE HEALTH CENTER, AND UNITED WAY OF MIFFLIN-JUNIATA. TRIPP UMBACH, HEADQUARTERED IN PITTSBURGH, PA, IS A RECOGNIZED NATIONAL LEADER IN CONDUCTING CHNAS, HAVING CONDUCTED MORE THAN 250 CHNAS OVER THE PAST 20 YEARS, WITH MORE THAN 50 HAVING BEEN COMPLETED WITHIN THE LAST 2 YEARS. TODAY, MORE THAN 1 IN 5 AMERICANS LIVE IN A COMMUNITY WHERE TRIPP UMBACH HAS COMPLETED A CHNA. PAUL UMBACH, FOUNDER AND PRESIDENT OF TRIPP UMBACH, IS AMONG THE MOST EXPERIENCED COMMUNITY HEALTH PLANNERS IN THE NATION, HAVING DIRECTED PROJECTS IN EVERY STATE AND INTERNATIONALLY. TRIPP UMBACH HAS WRITTEN TWO NATIONAL GUIDE BOOKS ON THE TOPIC OF COMMUNITY HEALTH AND HAS PRESENTED AT MORE THAN 50 STATE AND NATIONAL HEALTH CONFERENCES. THE ADDITIONAL TRIPP UMBACH TEAM BROUGHT MORE THAN 30 YEARS OF COMBINED EXPERIENCE TO THE PROJECT. KEY DATA SOURCES IN THE CHNA INCLUDED: CHNA PLANNING: A SERIES OF PLANNING MEETINGS WAS FACILITATED BY TRIPP UMBACH AND THE CHNA OVERSIGHT COMMITTEE, CONSISTING OF REPRESENTATIVES FROM GLH AND OTHER PARTICIPATING HOSPITALS AND ORGANIZATIONS (I.E., GEISINGER MEDICAL CENTER, GEISINGER HEALTHSOUTH REHABILITATION HOSPITAL, GEISINGER WYOMING VALLEY MEDICAL CENTER, GEISINGER COMMUNITY MEDICAL CENTER, GEISINGER-LEWISTOWN HOSPITAL AND GEISINGER-BLOOMSBURG HOSPITAL.) SECONDARY DATA: THE HEALTH OF A COMMUNITY IS LARGELY RELATED TO THE CHARACTERISTICS OF ITS RESIDENTS. AN INDIVIDUAL'S AGE, RACE, GENDER, EDUCATION AND ETHNICITY OFTEN DIRECTLY OR INDIRECTLY IMPACT HEALTH STATUS AND ACCESS TO CARE. TRIPP UMBACH COMPLETED COMPREHENSIVE ANALYSIS OF HEALTH STATUS AND SOCIO-ECONOMIC ENVIRONMENTAL FACTORS RELATED TO THE HEALTH OF RESIDENTS OF THE GLH COMMUNITY FROM EXISTING DATA SOURCES SUCH AS STATE AND COUNTY PUBLIC HEALTH AGENCIES, THE CENTERS FOR DISEASE CONTROL AND PREVENTION, COUNTY HEALTH RANKINGS, THOMPSON REUTERS, CNI, HEALTHY PEOPLE 2020, AND OTHER DATA SOURCES. TRENDING FROM 2012 CHNA: IN 2012, GLH COMPLETED A CHNA FOR THE SAME COUNTIES INCLUDED IN THE SERVICE AREA (JUNIATA AND MIFFLIN COUNTIES). TRIPP UMBACH DID NOT COMPLETE THE 2012 CHNA. AS A RESULT, THE DATA SOURCES USED WERE NOT THE SAME DATA SOURCES FROM THE 2012 CHNA. HOWEVER, TRIPP UMBACH PROVIDED DATA FOR THE SAME YEARS WHICH MADE IT POSSIBLE TO REVIEW TRENDS AND CHANGES ACROSS THE HOSPITAL SERVICE AREA. WHEN POSSIBLE, FINDINGS FROM THE PREVIOUS CHNA HAVE BEEN INCLUDED IN THE EXECUTIVE SUMMARY "KEY COMMUNITY HEALTH PRIORITIES". THERE WERE SEVERAL DATA SOURCES WITH CHANGES IN THE DEFINITION OF SPECIFIC INDICATORS, WHICH RESTRICTED THE USE OF TRENDING IN SEVERAL CASES. THE FACTORS THAT COULD NOT BE TRENDED ARE CLEARLY DEFINED IN THE SECONDARY DATA. INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS: TRIPP UMBACH WORKED CLOSELY WITH THE COLLABORATING ORGANIZATIONS TO IDENTIFY LEADERS FROM ORGANIZATIONS THAT 1) HAD PUBLIC HEALTH EXPERTISE; 2) WERE PROFESSIONALS WITH ACCESS TO COMMUNITY HEALTH RELATED DATA; AND 3) WERE REPRESENTATIVES OF UNDERSERVED POPULATIONS (I.E., SENIORS, LOW-INCOME RESIDENTS, LATINO(A) RESIDENTS, AND RESIDENTS THAT ARE UNINSURED). SUCH PERSONS WERE INTERVIEWED AS PART OF THE NEEDS ASSESSMENT PLANNING PROCESS. A SERIES OF 20 INTERVIEWS WERE COMPLETED WITH KEY STAKEHOLDERS IN THE GLH COMMUNITY, INCLUDING: AREA AGENCY ON AGING, JUNIATA BEHAVIORAL & DEVELOPMENTAL SERVICES, JUNIATA COUNTY COMMISSIONERS, JV TRI-COUNTY DRUG & ALCOHOL, MIFFLIN COUNTY COMMISSIONERS, MIFFLIN COUNTY INDUSTRIAL DEVELOPMENT CORPORATION, MIFFLIN-JUNIATA SPECIAL NEEDS CENTER, PA OFFICE OF RURAL HEALTH, SACRED HEART CATHOLIC SCHOOL, STATE HEALTH CENTER, AND UNITED WAY OF MIFFLIN-JUNIATA. SURVEY OF VULNERABLE POPULATIONS: VULNERABLE POPULATIONS WERE IDENTIFIED BY THE CHNA OVERSIGHT COMMITTEE AND THROUGH STAKEHOLDER INTERVIEWS. VULNERABLE POPULATIONS TARGETED BY THE SURVEYS WERE SENIORS, LOW-INCOME RESIDENTS (INCLUDING FAMILIES), AND RESIDENTS WITH SPECIAL NEEDS. A TOTAL OF 154 SURVEYS WERE COLLECTED IN THE GLH SERVICE AREA. TRIPP UMBACH WORKED WITH THE OVERSIGHT COMMITTEE TO DESIGN A 33 QUESTION HEALTH STATUS SURVEY. THE SURVEY WAS ADMINISTERED BY COMMUNITY BASED ORGANIZATIONS (I.E., MIFFLIN-JUNIATA SPECIAL NEEDS CENTER AND AREA AGENCY ON AGING) PROVIDING SERVICES TO VULNERABLE POPULATIONS IN THE HOSPITAL SERVICE AREA. COMMUNITY BASED ORGANIZATIONS WERE TRAINED TO ADMINISTER THE SURVEY USING HAND-DISTRIBUTION. SURVEYS WERE ADMINISTERED ONSITE AND SECURELY MAILED TO TRIPP UMBACH FOR TABULATION AND ANALYSIS. IDENTIFICATION OF TOP COMMUNITY HEALTH NEEDS: TOP COMMUNITY HEALTH NEEDS WERE IDENTIFIED AND PRIORITIZED BY COMMUNITY LEADERS DURING A REGIONAL COMMUNITY HEALTH NEEDS IDENTIFICATION FORUM HELD ON MARCH 12, 2015. CONSULTANTS PRESENTED TO COMMUNITY LEADERS THE CHNA FINDINGS FROM ANALYZING SECONDARY DATA, KEY STAKEHOLDER INTERVIEWS, AND SURVEYS. COMMUNITY LEADERS DISCUSSED THE DATA PRESENTED, SHARED THEIR VISIONS AND PLANS FOR COMMUNITY HEALTH IMPROVEMENT IN THEIR COMMUNITIES, AND IDENTIFIED AND PRIORITIZED THE TOP COMMUNITY HEALTH NEEDS IN THE GLH COMMUNITY. PUBLIC COMMENT REGARDING THE 2012 CHNA AND IMPLEMENTATION PLAN: TRIPP UMBACH SOLICITED PUBLIC COMMENTARY FROM COMMUNITY LEADERS AND RESIDENTS. COMMENTERS WERE ASKED TO REVIEW THE CHNA AND ACTION PLAN ADOPTED BY GLH IN 2013 AND WERE PROVIDED ACCESS TO EACH DOCUMENT FOR REVIEW. COMMENTERS WERE THEN ASKED TO RESPOND TO A QUESTIONNAIRE WHICH PROVIDED OPEN AND CLOSED RESPONSE QUESTIONS. THE PRIOR CHNA AND IMPLEMENTATION PLAN AND A QUESTIONNAIRE WERE OFFERED IN HARD COPY AT TWO LOCATIONS INSIDE THE HOSPITAL AND WERE ALSO PROVIDED ELECTRONICALLY USING A WEB-BASED PLATFORM. THERE WERE NO RESTRICTIONS OR QUALIFICATIONS REQUIRED OF PUBLIC COMMENTERS. FLYERS WERE CIRCULATED AND ELECTRONIC REQUESTS WERE MADE FOR PUBLIC COMMENT THROUGHOUT THE COLLECTION PERIOD. THROUGHOUT THIS DOCUMENT THE TERMS "SYSTEM- OR "GEISINGER" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH ("GH") AS PARENT AND ALL SUBSIDIARY ENTITIES COMPRISING THE SYSTEM. FACILITY 1, GEISINGER-LEWISTOWN HOSPITAL - PART V, LINE 6A SEE EXPLANATION TO PART V, LINES 3 AND 5. FACILITY 1, GEISINGER-LEWISTOWN HOSPITAL - PART V, LINE 11 BELOW ARE SYSTEM-WIDE PROGRAMS OFFERED BY GEISINGER TO FULFILL COMMUNITY NEEDS THAT WERE IDENTIFIED IN GLH'S 2015 CHNA. SOME PROGRAMS ARE COMPLETELY OPERATED OR FUNDED BY GEISINGER AND SOME ARE OFFERED IN COOPERATION WITH LOCAL HEALTH AND HUMAN SERVICE AGENCIES. FOR MORE SPECIFIC NEEDS FOUND IN OUR LOCAL COMMUNITIES, WE OFFER PROGRAMS TO SERVE PATIENTS CLOSE TO HOME. THE TOP THREE NEEDS IDENTIFIED IN THE MOST RECENT AND/OR PAST CHNA SURVEYS FALL INTO ONE OF THREE COMMUNITY NEED CATEGORIES: 1)IMPROVING ACCESS TO HEALTHCARE: THE MOST SIGNIFICANT NEED IDENTIFIED WAS FOR BETTER, FASTER, MORE CONVENIENT AND LESS COSTLY ACCESS TO HEALTHCARE SERVICES. GEISINGER IS TAKING INNOVATIVE STEPS TO ADDRESS BARRIERS TO HEALTHCARE AND HELP PROVIDE PHYSICAL, MENTAL, DENTAL, REHABILITATIVE AND PREVENTIVE SERVICES TO PATIENTS, REGARDLESS OF THEIR HEALTH INSURANCE STATUS. THE TOPICS ADDRESSED INCLUDE: HOW TO FIND THE RIGHT DOCTOR, PROVIDER OR FACILITY; SPECIAL SERVICES PROVIDED TO PATIENTS WITH SPECIFIC NEEDS (SUCH AS THE ELDERLY, UNDERINSURED OR UNINSURED); TRAUMA PREVENTION AND TREATMENT; AND MANY OTHERS. 2)ADDRESSING BEHAVIORAL HEALTH AND SUBSTANCE ABUSE: GEISINGER HAS A WIDE RANGE OF PROGRAMS TO HELP PATIENTS FIND HEALTHCARE SERVICES WHEN THEY ARE FACING BEHAVIORAL HEALTH CHALLENGES OR STRUGGLING WITH ADDICTION. ALZHEIMER'S DISEASE AND OTHER AGING BRAIN ISSUES AS WELL AS ALCOHOLISM AND OPIOID ABUSE ARE ADDRESSED IN A LARGE AND GROWING NUMBER OF PROGRAMS SPECIFICALLY AIMED AT EXPANDING SERVICES. 3)IMPROVING HEALTHY BEHAVIORS: GEISINGER HAS NUMEROUS EDUCATIONAL PROGRAMS TO HELP PATIENTS LIVE WELL. EFFORTS INCLUDE COMMUNITY AND OUTREACH PROGRAMS THAT BRING HEALTHCARE PROFESSIONALS, EDUCATION, NUTRITION AND MEDICATION TO THE PEOPLE. OUR GOAL IS TO ASSIST PATIENTS WITH THEIR HEALTH BEFORE A SERIOUS PROBLEM ARISES SENDING THEM TO THE HOSPITAL. IMPROVING ACCESS TO HEALTHCARE COMPLEX CARE, CLOSER TO HOME: CARE FOR COMPLEX CONDITIONS SUCH AS HEART, LUNG AND KIDNEY DISEASE ARE USUALLY FOUND AT LARGE HEALTH FACILITIES. LONG DRIVES TO A HOSPITAL, LACK OF TRANSPORTATION OPTIONS AND OF SPECIALISTS IN THE AREA MAKES ACCESS TO CARE DIFFICULT. OUR SPECIALISTS TRAVEL SO PATIENTS ARE PROVIDED WITH NEEDED, CONVENIENT SPECIALTY CARE, WITHOUT LONG DRIVES OR THE CHALLENGES OF SEEKING CARE ONLY AT A HOSPITAL. INSTEAD OUR SPECIALISTS TRAVEL ACROSS THE REGION TO CLINICS THAT PROVIDE ADVANCED CARE, WITH THE BENEFIT OF BETTER TRACKING OF PATIENTS WITH CHRONIC CONDITIONS. CLINICS ARE STAFFED WITH DOCTORS, NURSES AND OTHER HEALTHCARE PROFESSIONALS AND DIAGNOSTIC LAB AND IMAGING SERVICES. MANY LOCATIONS ALSO OFFER SPECIALTY PEDIATRIC AND WOMEN'S HEALTH SERVICES. OUR SPECIALISTS, INCLUDING CARDIOLOGY, DERMATOLOGY, COMPLEX ORTHOPAEDIC AND THORACIC SURGERY AND NEUROSURGERY ARE AVAILABLE IN MORE THAN 30 COMMUNITIES ACROSS NORTHEAST AND CENTRAL PA. GEISINGER HEALTH PLAN (GHP): COMPREHENSIVE COVERAGE FOR THE UNINSURED AND SENIORS: GHP, A NONPROFIT HMO, OFFERS AFFORDABLE HEALTH PLANS THAT SERVES THE MOST VULNERABLE IN OUR COMMUNITIES: UNINSURED ADULTS, CHILDREN AND SENIORS. GHP FAMILY IS A MEDICAL-ASSISTANCE, MANAGED-CARE PLAN THAT OFFERS COMPREHENSIVE COVERAGE TO UNINSURED AND UNDERINSURED RESIDENTS OF 22 COUNTIES IN PA. MANY SERVICES ARE PROVIDED AT NO COST, INCLUDING DOCTOR'S OFFICE VISITS, EMERGENCY CARE, PREVENTIVE SERVICES (INCLUDING IMMUNIZATIONS AND SCREENINGS), DIABETES CARE, MATERNITY CARE, DENTAL AND VISION SERVICES AND PRESCRIPTION DRUGS. THERE IS ALSO 24-HOUR ACCESS TO E-NURSES AND HEALTH COACHES. GHP KIDS OFFERS HEALTH COVERAGE TO UNINSURED CHILDREN UNDER 20 YEARS OF AGE IN 40 COUNTIES THROUGH PA'S CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP). FOR MOST CHIP IS FREE AND INCLUDES ROUTINE CHECKUPS AND IMMUNIZATIONS, PRESCRIPTION DRUGS, VISION AND DENTAL SERVICES AND EMERGENCY CARE. FOR SENIORS, NAVIGATING THE COMPLEXITIES OF HEALTHCARE COVERAGE CAN BE OVERWHELMING. GHP OFFERS A DUAL ELIGIBILITY PLAN FOR SENIORS WHO QUALIFY FOR MEDICARE PARTS A AND B COVERAGE AS WELL AS MEDICAID. GEISINGER GOLD SECURE RX IS DESIGNED TO MAKE MEDICAL EXPENSES MORE PREDICTABLE, ALLOW BETTER COORDINATION AMONG PROVIDERS AND LOWER OUT-OF-POCKET EXPENSES FOR SENIORS. THIS PLAN OFFERS CONVENIENT BENEFITS WITH LOW OR NO PREMIUMS, A SINGLE ID CARD, PRESCRIPTION DRUG COVERAGE, DENTAL AND VISION SERVICES, FITNESS PROGRAMS AND CARE MANAGEMENT NURSES. PROVENHEALTH NAVIGATOR: IS A TEAM-ORIENTED MEDICAL HOME. A MEDICAL "HOME" IS A PATIENT-CENTERED MODEL OF CARE LED BY THE PATIENT'S PRIMARY DOCTOR AND A TEAM OF HEALTHCARE PROFESSIONALS WORKING TOGETHER TO ENSURE THE PROPER CARE. THE TEAM OF SPECIALISTS, CARE MANAGERS, PHARMACISTS, SOCIAL WORKERS AND COMMUNITY HEALTH ASSISTANTS WORK WITH THE PATIENT, FAMILY AND CAREGIVERS TO PLAN CARE THAT WILL PREVENT URGENT/EMERGENT CARE VISITS AND HOSPITALIZATIONS. RESEARCH HAS SHOWN THAT PATIENTS UNDER THE MEDICAL HOME MODEL ARE HEALTHIER AND SPEND LESS TIME HOSPITALIZED. MEDICAL HOME CARE FOCUSES ON FREQUENT DOCTOR VISITS AND CONSISTENT FOLLOW-UP BY THE TEAM, WHICH HAS SHOWN TO BENEFIT THOSE WITH CHRONIC ILLNESSES (DIABETES, HEART DISEASE, ETC.) MEDICAL HOME PATIENTS ALSO HAVE ACCESS TO DOCTORS AND PHN CARE MANAGERS 24/7. CARE MANAGERS HELP PATIENTS NAVIGATE THE COMPLEX HEALTHCARE SYSTEM, COORDINATING CARE AND COMMUNICATING WITH THE TEAM OF PROVIDERS. CARE MANAGERS, SOCIAL WORKERS AND COMMUNITY HEALTH ASSISTANTS ARE ALSO AVAILABLE TO HELP OUR PATIENTS ADDRESS DIFFICULT CHALLENGES, SUCH AS COPING WITH MENTAL ILLNESS, ADDICTION, ABUSE AND LOSS AND MANAGING DISABILITIES. THE TEAM ALSO COORDINATES COMMUNITY RESOURCES THAT ARE AVAILABLE AND ASSISTS THE PATIENT WITH THEIR NEEDS. BY EXPANDING OUR SUCCESSFUL MEDICAL HOME INITIATIVE, WE'RE ENSURING THAT OUR PATIENTS HAVE ACCESS TO THE MOST EFFECTIVE MODELS OF CARE. GEISINGER TELEMEDICINE BRINGS HEALTHCARE CLOSER TO HOME: IN OUR 31COUNTY SERVICE AREA, NEARLY HALF OF OUR PATIENT POPULATION RESIDES IN RURAL AREAS, AND MORE THAN 60 PERCENT OF PATIENTS HAVE CHRONIC HEALTH CONDITIONS. OUR TELEMEDICINE PROGRAM ALLOWS PATIENTS TO STILL RECEIVE SPECIALIZED CARE LOCALLY. OUR PROGRAM USES HIGH-DEFINITION AUDIO/VIDEO TECHNOLOGY AND TOOLS SUCH AS DIGITAL STETHOSCOPES TO CONNECT REMOTE PATIENTS TO OUR HOSPITALS AND PRIMARY CARE CLINICS, AS WELL AS TO NON-GEISINGER FACILITIES. INPATIENTS ARE DIAGNOSED EARLIER, BEGIN TREATMENT SOONER AND AVOID HOSPITAL TRANSFERS, SINCE THEIR PHYSICIANS CAN CONSULT OUR SPECIALISTS ANYWHERE WITHIN OUR SYSTEM. OUR SPECIALISTS HAVE ACCESS TO PATIENTS AT CLINICS ACROSS THE STATE WITHOUT THE PATIENT TRAVELING TO A HOSPITAL TO SEE THE SPECIALIST. THIS SAVES TIME AND REDUCES TRAVEL COSTS AND ALLOWS THE SUPPORT OF LOVED ONES AT HOME. EARLIER DIAGNOSIS REDUCES COSTS FOR EVERYONE. THIS PROGRAM ALLOWS PATIENTS TO CONNECT WITH THE RIGHT SPECIALIST WHEN NEEDED. BY CONNECTING PATIENTS TO OUR SPECIALISTS, ACCESS TO HEALTHCARE IS AVAILABLE TO EVERY PATIENT IN OUR COMMUNITIES. SUPPORT FOR SENIORS AT HOME: LIFE GEISINGER (LIVING INDEPENDENTLY FOR ELDERS) HELPS SENIORS STAY AT HOME, STAY INDEPENDENT AND STAY HEALTHY. THE LIFE GEISINGER TEAM IS ON CALL 24/7, PROVIDING SUPPORT FOR SENIORS AND THEIR LOVED ONES. A PROVIDER TEAM ASSESSES PATIENTS' NEEDS, DEVELOPS CARE PLANS AND DELIVERS THE SERVICES SENIORS AND FAMILIES NEED. TRANSPORTATION SERVICES MAKE HOME DELIVERIES OF SUPPLIES AND/OR MEDICATIONS, CARRY SENIORS TO MEDICAL AND OTHER APPOINTMENTS AND DELIVER LIFE PARTICIPANTS TO AND FROM OUR ADULT DAY CENTERS FOR SCHEDULED VISITS. SENIOR DAY CENTERS OFFER SENIORS COMPREHENSIVE MEDICAL AND SOCIAL SERVICES AND OPPORTUNITIES TO SOCIALIZE AND EXERCISE. OUR ADULT DAY CENTERS ARE OPEN TO ALL SENIORS, REGARDLESS OF WHETHER THEY PARTICIPATE IN LIFE GEISINGER. HIGH-QUALITY, NON-EMERGENCY CARE: FOR PATIENTS EXPERIENCING A NON-EMERGENT INJURY OR ILLNESS, GEISINGER CAREWORKS CLINICS OFFER HIGH-QUALITY MEDICAL SERVICES AT CONVENIENT LOCATIONS THROUGHOUT PA. THESE URGENT CARE CLINICS PROVIDE ECONOMICAL AND CONVENIENT HEALTHCARE FROM HIGHLY TRAINED CERTIFIED NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS. CAREWORKS ATTENDS TO THE MEDICAL NEEDS OF ADULTS AND CHILDREN 12 MONTHS OR OLDER, AND NO APPOINTMENT IS NECESSARY. THE OFFICES COMMUNICATE WITH THE PRIMARY CARE PHYSICIAN ABOUT THE PATIENT'S VISIT. CAREWORKS KEEPS FAMILIES WELL BY INCREASING ACCESS TO OUR PROVIDERS, PROFESSIONALS AND SERVICES IN CONVENIENT COMMUNITY LOCATIONS. BRIDGING THE COMMUNICATIONS GAP: AT GEISINGER, WE SEE PATIENTS WHO HAVE DIFFERENT LEVELS OF HEARING ABILITY AND LITERACY. THEY SPEAK HUNDREDS OF LANGUAGES. TO GIVE OUR PATIENTS THE BEST EXPERIENCE POSSIBLE, WE USE ADVANCED TECHNOLOGY AND CONTINUOUS TRAINING. OUR GOAL IS TO HELP PATIENTS CLEARLY UNDERSTAND HOW BEST TO MANAGE THEIR CONDITION. STRATUS IS A VIDEO-INTERPRETING DEVICE USED FOR PATIENTS WHO ARE HEARING-IMPAIRED OR WHO HAVE LIMITED ENGLISH SKILLS. THERE ARE NOW OVER 250 STRATUS DEVICES ACROSS THE SYSTEM. AVAILABLE 24 HRS/DAY IN MORE THAN 200 LANGUAGES, INCLUDING AMERICAN SIGN LANGUAGE, STRATUS IS OPERATED BY TRAINED I FACILITY 1, GEISINGER-LEWISTOWN HOSPITAL - PART V, LINE 13B RECENT WAGE STATEMENTS, UNEMPLOYMENT OR OTHER DOCUMENTATION OF BENEFITS OR COMPENSATION RECEIVED MAY BE CONSIDERED IN DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY. FACILITY 1, GEISINGER-LEWISTOWN HOSPITAL - PART V, LINE 16J THE FAP, FAP APPLICATION, AND A PLAIN LANGUAGE SUMMARY OF THE FAP ARE WIDELY AVAILABLE AT HTTPS://WWW.GEISINGER.ORG/PATIENT-CARE/PATIENTS-AND- VISITORS/BILLING-AND-INSURANCE/NEED-HELP. IN ADDITION, REGISTRATION PERSONNEL ALSO REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY. FACILITY 1, GEISINGER-LEWISTOWN HOSPITAL - PART V, LINE 20E UNDER NO CIRCUMSTANCE 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. FACILITY 1, GEISINGER-LEWISTOWN HOSPITAL - PART V, LINE 22: PATIENTS WHOSE HOUSEHOLD INCOME IS 300% OR LOWER OF THE FEDERAL POVERTY GUIDELINES ARE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FAP. PATIENTS WHO MEET THIS CRITERIA ARE ELIGIBLE FOR 100% DISCOUNT ON CHARGES, RESULTING IN 0 CHARGES FOR MEDICALLY NECESSARY CARE. NO OTHER DISCOUNTS ARE AVAILABLE UNDER THE HOSPITAL'S FAP. FREE CARE OR 0 CHARGE IS BELOW THE HOSPITAL FACILITY'S AMOUNT GENERALLY BILLED, AS WELL AS, MEDICARE'S OR MEDICAID'S PROSPECTIVE BILLING AMOUNT. FACILITY 1, GEISINGER-LEWISTOWN HOSPITAL - PART V, LINES 23 AND 24: PATIENTS ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY ARE PROVIDED 100% DISCOUNT AND CHARGED 0. SEE ALSO EXPLANATION OF PART V, LINE 22. PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE SUPPORTING DOCUMENTATION FOR ELIGIBILITY MAY CONSIST OF INCOME AND ASSET INFORMATION, INCLUSIVE BUT NOT LIMITED TO: FEDERAL INCOME TAX FORM 1040 FROM THE PRIOR YEAR, PAY STUB COPIES (FROM FOUR PRIOR PAY PERIODS), 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 TREATEMENT AND ACTIVE LABOR TRANSPORT ACT NOF 1986 ("EMTLA") AND REGULATIONS IN PROVIDING MEDICAL SCREENING EXAMINATION AND SUCH FURTHER TREATMENT AS MAY BE NECESSARY TO STABILIZE AN EMERGENCY MEDICAL CONDITION FOR ANY INDIVIDUAL PRESENTING TO THE EMERGENCY DEPARTMENT SEEKING TREATMENT. PART I, LINE 6A - RELATED ORGANIZATION INFORMATION COMMUNITY BENEFIT REPORT: A SUMMARY OF THE COMMUNITY BENEFIT PROVIDED BY THE HOSPITAL AND ITS RELATED CHARITABLE ORGANIZATIONS IS INCLUDED IN GEISINGER'S ANNUAL REPORT AND IS AVAILABLE AT GEISINGER.ORG AND MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE REPORT CAN BE FOUND AT: HTTPS://WWW.GEISINGER.ORG/ABOUT- GEISINGER/NEWS-AND-MEDIA/FOR-MEDIA/ANNUAL-REPORTS PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION THERE ARE NO PHYSICIAN CLINICAL SERVICES INCLUDED IN SUBSIDIZED HEALTH SERVICES. PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION A COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE COSTS REPORTED ON LINE 7 AND ADDRESSED PATIENT SEGMENTS BY PAYOR (E.G. MEDICARE, MEDICAID, COMMERCIAL PAYERS, SELF-PAY, ETC.). A COST TO CHARGE RATIO, CALCULATED PURSUANT TO WORKSHEET 2 OF THE FORM 990 INSTRUCTIONS, WAS USED TO CALCULATE THE COST OF CHARITY CARE. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY REFER TO THE RESPONSE FOR PART III, LINE 4. PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE PATIENTS' ACCOUNTS ARE MONITORED THROUGHOUT THE BILLING PROCESS AND ARE RECLASSIFIED TO CHARITY CARE (100% DISCOUNTED CARE) WHENEVER A PATIENT BECOMES ELIGIBLE UNDER THE HOSPITAL'S UNCOMPENSATED OR CHARITY CARE POLICIES. THE HOSPITAL ESTIMATES THAT APPROXIMATELY 55% OF THE BAD DEBT ACCOUNTS ARE SUBSEQUENTLY RECLASSIFIED TO UNCOMPENSATED OR CHARITY CARE. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS PART III, LINES 2 AND 4: GEISINGER HEALTH AND ITS AFFILIATES ("GEISINGER"), THAT INCLUDES THE HOSPITAL, PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. GEISINGER'S ALLOWANCE FOR DOUBTFUL ACCOUNTS (BAD DEBT EXPENSE) METHODOLOGY AND CHARITY CARE POLICIES ARE CONSISTENTLY APPLIED ACROSS ALL CHARITABLE AFFILIATES. THE ORGANIZATIONS WRITE OFF ALL ACCOUNTS THAT HAVE BEEN IDENTIFIED AS UNCOLLECTABLE. AN ALLOWANCE FOR UNCOLLECTABLE ACCOUNTS IS RECORDED FOR ACCOUNTS NOT YET WRITTEN OFF THAT ARE ANTICIPATED TO BECOME UNCOLLECTABLE IN FUTURE PERIODS. FOR THE FOOTNOTES REGARDING ACCOUNTS RECEIVABLE, ALLOWANCES, AND BAD DEBT SEE PAGE 9 OF THE ATTACHED GEISINGER CONSOLIDATED FINANCIAL STATEMENTS, JUNE 30, 2018 AND JUNE 30, 2017. PART III, LINE 8 - MEDICARE EXPLANATION PART III, LINE 3 - BAD DEBT: LINE 6 ONLY INCLUDES THOSE COSTS THAT ARE ALLOWED TO BE REPORTED IN THE HOSPITAL'S MEDICARE COST REPORT THAT IS REQUIRED TO BE FILED WITH THE FEDERAL GOVERNMENT. THE ORGANIZATION BELIEVES THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND THE COST OF BAD DEBT 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 THAT MEDICARE UNDERPAYMENTS (SHORTFALLS) AND BAD DEBT SHOULD BE REPORTED AS COMMUNITY BENEFIT ON FORM 990, SCHEDULE H, PART I, LINE 7. THIS ORGANIZATION AGREES WITH THE AHA'S LETTER TO THE IRS DATED AUGUST 21, 2007 RESPONDING TO A DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA ARGUED THAT MEDICARE UNDERPAYMENTS (SHORTFALLS) IS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: -PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS REMAINS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. -MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES ONLY 92 CENTS FOR EVERY DOLLAR HOSPITALS SPEND TO CARE FOR MEDICARE PATIENTS. -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 11,912,765 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. BOTH THE HOSPITAL AND THE AHA BELIEVE THAT PATIENT BAD DEBT BE REPORTED AS A COMMUNITY BENEFIT ON FORM 990, SCHEDULE H, PART I, LINE 7. LIKE MEDICARE UNDERPAYMENTS (SHORTFALLS), BAD DEBT SHOULD BE REPORTED AS COMMUNITY BENEFIT BECAUSE: -A SIGNIFICANT PORTION OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO FOR MANY REASONS DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY UNDER THE HOSPITAL'S CHARITY CARE OR FINANCIAL ASSISTANCE POLICY (FAP). A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO"), "NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFIT", CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." -THE CBO REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF THE BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR CHARITABLE MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THE EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ACCORDING TO THE CBO REPORT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. (IN FY 2018, APPROXIMATELY 55% OF THE HOSPITAL'S BAD DEBT WAS SUBSEQUENTLY RECLASSIFIED TO CHARITY CARE.) THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE (BAD DEBT AND CHARITY CARE) AS A MEASURE OF COMMUNITY BENEFITS" ASSUMING THE FINDINGS ARE GENERALIZED NATIONALLY. THE EXPERIENCE OF HOSPITALS NATIONWIDE REINFORCE THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE THE HOSPITAL'S BEST EFFORTS AND DUE DILIGENCE, PATIENT BAD DEBT IS A PART OF THE CHARITABLE MISSION AND CHARITABLE PURPOSES. BAD DEBT REPRESENTS PART OF THE BURDEN HOSPITALS' BEAR IN SERVING ALL PATIENTS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. IN ADDITION, THE HOSPITAL INVESTS SIGNIFICANT RESOURCES IN SYSTEMS AND STAFF TRAINING TO ASSIST PATIENTS THAT ARE IN NEED OF FINANCIAL ASSISTANCE. FOR FISCAL YEAR ENDED 6/30/2018, THE HOSPITAL'S COST OF PROVIDING PATIENT CARE FOR SERVICES ACCOUNTED FOR AS BAD DEBT WAS 840,251. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION THE HOSPITAL IS COMMITTED TO PROVIDING MEDICALLY NECESSARY SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND THE HOSPITAL'S COLLECTION ACTIONS ARE CONSISTENTLY APPLIED TO ALL PATIENTS. IT IS THE HOSPITAL'S POLICY TO PROVIDE FINANCIAL ASSISTANCE AND COUNSELING TO PATIENTS WITH LIMITED FINANCIAL MEANS. A PATIENT MAY BECOME ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING TREATMENT OR DURING THE CONTINUUM OF THE FINANCIAL/BILLING AND COLLECTION PROCESS. IN ANY STAGE OF THE BILLING PROCESS, COLLECTION ACTIONS ARE NOT PURSUED WHENEVER A PATIENT APPLIES AND IS BEING EVALUATED FOR FINANCIAL ASSISTANCE. UNDER NO CIRCUMSTANCES WILL THE HOSPITAL FREEZE OR ATTACH BANK ACCOUNTS OF A PATIENT, ENFORCE LIENS, ACTIVELY PURSUE ASSETS FROM A PRIOR JUDGMENT OR GARNISH THE WAGES OF A PATIENT AND/OR FAMILY MEMBER BEFORE DETERMINING IF THE PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS ("ECAS") 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. THE HOSPITAL ENSURES REASONABLE EFFORTS HAVE BEEN TAKEN TO DETERMINE IF A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER ITS FINANCIAL ASSISTANCE POLICY ("FAP") AND ENSURES THAT THE FOLLOWING ACTIONS ARE TAKEN AT LEAST 30 DAYS PRIOR TO INITIATING AN ECA: 1) THE PATIENT IS PROVIDED WITH WRITTEN NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR ELIGIBLE PATIENTS; IDENTIFIES THE ECAS THAT THE HOSPITAL INTENDS TO TAKE TO OBTAIN PAYMENT FOR CARE; AND STATES A DEADLINE AFTER WHICH ECAS MAY BEGIN. 2) THE PATIENT IS PROVIDED WITH A PLAIN LANGUAGE SUMMARY OF THE FAP; AND 3) REASONABLE EFFORTS ARE MADE TO ORALLY NOTIFY THE PATIENT ABOUT THE FAP AND HOW THE PATIENT MAY OBTAIN ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. THE HOSPITAL PROCESSES APPLICATIONS FOR FINANCIAL ASSISTANCE DURING THE APPLICATION PERIOD. THE APPLICATION BEGINS ON THE DATE CARE IS PROVIDED AND ENDS ON THE 240TH DAY AFTER THE DATE OF THE 1ST POST-DISCHARGE BILLING STATEMENT. PART VI, LINE 2 - NEEDS ASSESSMENT GLH, A 123-BED COMMUNITY MEDICAL CENTER LOCATED IN LEWISTOWN, PA, IN RESPONSE TO ITS COMMUNITY COMMITMENT, CONTRACTED WITH TRIPP UMBACH TO FACILITATE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BETWEEN OCTOBER 2014 AND MARCH 2015 THAT IDENTIFIED THE NEEDS OF THE RESIDENTS SERVED BY GLH. AS A PARTNERING HOSPITAL OF A REGIONAL COLLABORATIVE EFFORT TO ASSESS COMMUNITY HEALTH NEEDS; GLH COLLABORATED WITH HOSPITALS AND OUTSIDE ORGANIZATIONS IN THE SURROUNDING REGION (INCLUDING JUNIATA AND MIFFLIN COUNTIES) DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. SEE ALSO THE DISCUSSION RELATED TO THE RESPONSE TO PART V, LINE 5. PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FOR URGENT AND EMERGENT SERVICES, PATIENTS ARE PROVIDED CARE REGARDLESS OF THEIR ABILITY TO PAY. IN THE EVENT A PATIENT HAS AN EMERGENCY MEDICAL CONDITION; TREATMENT IS NOT DELAYED TO PERMIT AN INQUIRY REGARDING A PATIENT'S METHOD OF PAYMENT OR INSURANCE STATUS. FOR OTHER THAN URGENT AND EMERGENT SERVICES, THE HOSPITAL PROVIDES UNCOMPENSATED CARE, FREE OF CHARGE, OR ON A 100% DISCOUNTED BASIS, TO THOSE PATIENTS WHO DEMONSTRATE AN INABILITY TO PAY. DEPENDING UPON FAMILY SIZE AND INCOME, FREE OR 100% DISCOUNTED SERVICES ARE AVAILABLE TO A PATIENT WITH FAMILY INCOME OF 300% OR LESS OF THE FEDERAL POVERTY GUIDELINES. IT IS THE HOSPITAL'S POLICY TO PROVIDE FINANCIAL ASSISTANCE AND FINANCIAL COUNSELING TO PATIENTS OF LIMITED MEANS. A PATIENT MAY BECOME ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE AT ANY TIME DURING TREATMENT OR DURING THE CONTINUUM OF THE FINANCIAL/BILLING PROCESS. INFORMATION (SIGNS, BROCHURES, ETC.) REGARDING THE HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES ARE PROVIDED AT THE EMERGENCY ROOM, REGISTRATION AND VARIOUS ACCESS POINTS THROUGHOUT THE HOSPITAL. REGISTRATION PERSONNEL ALSO REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY. NOTICE OF THE HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES CAN ALSO BE FOUND ON THE GEISINGER WEB SITE AT WWW.GEISINGER.ORG. PATIENTS ARE ALSO PROVIDED INFORMATION ON THE HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES WITH EACH PATIENT BILL. THE FINANCIAL ASSISTANCE POLICY ("FAP"), THE FAP APPLICATION AND PLAIN LANGUAGE SUMMARY ("PLS") ARE AVAILABLE ON-LINE. PAPER COPIES ARE AVAILABLE UPON REQUEST WITHOUT CHARGE BY MAIL OR ARE AVAILABLE AT REGISTRATION AREAS WHICH INCLUDES EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL-BASED CLINICS AND PATIENT FINANCIAL SERVICES DEPARTMENTS. ALL FAP DOCUMENTS ARE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGE OF POPULATIONS WITH LIMITED ENGLISH PROFICIENCY ("LEP") THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE HOSPITAL'S SERVICE AREA. SIGNS OR DISPLAYS ARE CONSPICUOUSLY POSTED IN PUBLIC HOSPITAL LOCATIONS INCLUDING THE EMERGENCY DEPARTMENT, ADMISSIONS DEPARTMENT AND REGISTRATION DEPARTMENT THAT INFORM PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. ALL PATIENTS ARE OFFERED A COPY OF THE PLS AS PART OF THE INTAKE AND DISCHARGE PROCESSES. ADDITIONALLY, FINANCIAL COUNSELORS AND CUSTOMER SERVICE REPRESENTATIVES ARE AVAILABLE TO ASSIST PATIENTS WITH CONCERNS. PART VI, LINE 4 - COMMUNITY INFORMATION THE GLH SERVICE AREA IS COMPRISED OF MIFFLIN COUNTY, JUNIATA COUNTY, AND PARTS OF HUNTINGDON AND SNYDER COUNTIES. THIS RURAL AREA CONTAINS SOME 145,000 PEOPLE SPREAD OVER MORE THAN 2,500 SQUARE MILES OF RUGGED TERRAIN LOCATED IN THE HEART OF THE APPALACHIAN MOUNTAINS IN CENTRAL PENNSYLVANIA. THE AVERAGE POPULATION DENSITY IS APPROXIMATELY 60 PERSONS PER SQUARE MILE. THE JUNIATA RIVER RUNS ALONG THE VERDANT VALLEYS AND SLICES THROUGH NARROW MOUNTAIN PASSES TO CONNECT OUR RESIDENTS TOGETHER, WHICH IS WHY OUR AREA IS CALLED THE JUNIATA VALLEY. TRANSPORTATION BARRIERS PLAY A MAJOR ROLE IN ACCESS TO HEALTHCARE IN OUR REGION. THESE NATURAL BARRIERS INCLUDE NARROW ROADS THAT EITHER MEANDER ALONG STREAMS AND CREEKS OR CROSSOVER THE MOUNTAIN RANGES THAT TRAVERSE OUR APPALACHIAN RIDGE REGION. THESE BARRIERS ARE EVEN MORE DAUNTING GIVEN HAZARDOUS WINTER DRIVING CONDITIONS CAUSED BY SNOW OR ICE COVERED ROADS. LOW-INCOME AND SENIOR CITIZENS ALSO FACE TRANSPORTATION ISSUES, AS THERE IS NO PUBLIC TRANSPORTATION IN OUR SERVICE AREA. SENIOR CITIZENS AND MEDICAID-ELIGIBLE PERSONS CAN USE THE "CARS" VAN SYSTEM FOR TRANSPORTATION TO REGULARLY SCHEDULED APPOINTMENTS WITH A WEEKS' NOTICE BUT NOT FOR URGENT OR EMERGENCY CARE. LOW INCOME CITIZENS HAVE NO ACCESS TO ANY PUBLIC TRANSPORTATION AT ALL IN OUR COMMUNITY. IF A TRIP TO A SPECIALIST IS REQUIRED THE MAJOR SUPPORT HOSPITALS ARE AT LEAST A ONE AND HALF HOUR DRIVE AWAY. THE POPULATION OF OUR TOTAL SERVICE AREA IS JUST ABOUT 145,000 PERSONS BASED ON 2010 US CENSUS DATA. MIFFLIN COUNTY HAS A RELATIVELY FLAT GROWTH RATE WITH A POPULATION CHANGE OF 0.4% FROM 2000 TO 2010. JUNIATA COUNTY, ON THE OTHER HAND, HAS SEEN SIGNIFICANT GROWTH WITH A 10.6% INCREASE IN POPULATION FROM 2000 TO 2010. IT IS BELIEVED THAT THIS GROWTH IS MOSTLY COMING FROM PEOPLE WHO WORK IN THE NEARBY HARRISBURG AREA WHO ARE LOOKING FOR A LOWER COST OF LIVING. WITH THE RECENT COMPLETION OF A NEW FOUR-LANE HIGHWAY NORTH OF HARRISBURG, THE COMMUTE TO HARRISBURG HAS BECOME MORE CONVENIENT RESULTING IN AN INCREASE IN JUNIATA COUNTY'S POPULATION AS PEOPLE MOVE FURTHER AWAY FROM THE URBAN AREAS TO LIVE IN THE COUNTRY. HIGHER GROWTH IN FULTON COUNTY IS EXPLAINED BY MIGRATION FROM MARYLAND AS PEOPLE TRY TO MOVE AWAY FROM HIGHER HOUSING COSTS IN MARYLAND. HUNTINGDON COUNTY'S GROWTH IS MOSTLY OCCURRING IN THE NORTHERN PORTION OF THE COUNTY THAT IS CLOSE ENOUGH TO STATE COLLEGE TO ALLOW RESIDENTS TO COMMUTE TO PENN STATE UNIVERSITY. THESE GROWTH RATES ARE STILL VERY LOW WHEN COMPARED TO A NATIONAL GROWTH RATE OF OVER 13%. OTHER IMPORTANT DEMOGRAPHIC STATISTICS ARE OUTLINED BELOW. STATISTICS: MIFFLIN COUNTY(MC), JUNIATA COUNTY(JC), PENNSYLVANIA(PA) POPULATION: 46,682(MC), 24,636(JC, 12,702,379(PA) POPULATION LESS THAN 18 YEARS OF AGE: 23.1%(MC), 24%(JC), 22%(PA) AGE 65 AND UP: 18.5%(MC), 16.8%(JC), 15.4%(PA) PERCENTAGE OF POPULATION BELOW THE POVERTY LEVEL (2010): 16.6%(MC), 11.1%(JC), 13.4% (PA) POVERTY RATE FOR CHILDREN UNDER AGE 18 (2010): 28.1%(MC), 18.0%(JC), 18.9%(PA) MEDIAN HOUSEHOLD INCOME: 37,163(MC), 45,810(JC), 49,245(PA) UNINSURED ADULTS (2010): 19.1%(MC), 18.7%(JC), 14.5%(PA) UNEMPLOYMENT RATE (2010): 9.5%(MC), 7.7%(JC), 8.4%(PA) MIFFLIN COUNTY'S 65 AND OVER AGE GROUP IS 18.5 PERCENT (2010), WHILE JUNIATA COUNTY'S IS 16.8%, HUNTINGDON COUNTY'S, 16.2% AND FULTON COUNTY'S 17.1%. THE PENNSYLVANIA AVERAGE FOR THIS STATISTIC IS 15.4%. BOTH MIFFLIN AND JUNIATA COUNTIES HAVE HIGHER PERCENTAGES OF PERSONS LESS THAN 18 YEARS OF AGE, 23.1% AND 24.0% RESPECTIVELY, THAN THE PA AVERAGE OF 22.0%. BOTH OF THESE GROUPS REQUIRE MORE HEALTH CARE RESOURCES THAN OTHER AGE GROUPS IN OUR COMMUNITY. MIFFLIN COUNTY HAS 16.6% OF THE POPULATION WITH INCOME BELOW THE POVERTY LINE AND 28.1% OF CHILDREN UNDER 18 LIVING IN POVERTY. JUNIATA COUNTY HAS 11.1% OF THE POPULATION WITH INCOME BELOW THE POVERTY LINE, WHILE HUNTINGDON AND SNYDER COUNTIES ARE 13% AND 14% RESPECTIVELY. PER CAPITA PERSONAL INCOME (2009) FOR THE FOUR MAIN COUNTIES IN OUR SERVICE AREA ARE AS FOLLOWS: MIFFLIN 28.3K, JUNIATA 30.3K, HUNTINGDON 27.6K, AND SNYDER 30.8K. THE PERCENTAGES OF THE POPULATIONS WHO ARE UNINSURED (IN THE 18-64 AGE RANGE) FOR THOSE COUNTIES ARE AS FOLLOWS: MIFFLIN 19%, JUNIATA 19%, HUNTINGDON 19%, AND SNYDER 16%. AT THE BEGINNING OF FOR FISCAL YEAR 2014, APPROXIMATELY 14.1% OF OUR PATIENT POPULATION WAS MEDICAL ASSISTANCE, WHILE ANOTHER 3.8% WERE SELF- PAY. THERE IS ONE OTHER HOSPITAL LOCATED WITHIN THE SERVICE AREA DESCRIBED ABOVE, JC BLAIR MEMORIAL HOSPITAL IN HUNTINGDON, PA. THERE ARE ALSO SEVERAL OTHER HOSPITALS LOCATED IN AREAS SURROUNDING OUR SERVICE AREA. THESE INCLUDE MT. NITTANY MEDICAL CENTER IN STATE COLLEGE, PA; GEISINGER MEDICAL CENTER IN DANVILLE, PA; HOLY SPIRIT HOSPITAL IN CAMP HILL, PA; THE PENN STATE MILTON S. HERSHEY MEDICAL CENTER IN HERSHEY, PA; AND SEVERAL CAMPUSES OF PINNACLE HEALTH IN THE HARRISBURG, PA AREA. THERE ARE ALSO SEVERAL FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS WITHIN OUR SERVICE AREA. THERE ARE TWO LOCATED IN MIFFLIN COUNTY, ONE IN JUNIATA COUNTY, AND FOUR IN HUNTINGDON COUNTY. THE ADULT BEHAVIORAL HEALTH RISK FACTORS SURVEY (2008-2010) SHOWS THE FOLLOWING STATISTICS FOR THE POPULATION LIVING IN MIFFLIN AND JUNIATA COUNTIES: RISK FACTORS : -PERCENT FAIR OR POOR GENERAL HEALTH: 16% -OBESE: 31% -OVERWEIGHT (INCLUDES OBESE): 66% -DIABETIC: 11% -CURRENTLY HAS ASTHMA: 10% -CURRENT SMOKER:19% FOR MIFFLIN AND JUNIATA COUNTIES, THE HEALTH PROFILE FROM THE PA DEPARTMENT OF HEALTH SHOWS THE MAJOR CAUSES OF DEATH ARE DISEASES OF THE HEART, CANCER, STROKE, AND CHRONIC LOWER RESPIRATORY DISEASES. PROSTATE CANCER RANKS AS NUMBER ONE FOR THE HIGHEST INCIDENCE OF CANCER, FOLLOWED BY FEMALE BREAST CANCER. RANKING THIRD AND FOURTH ON THE LIST ARE LUNG CANCER AND COLON CANCER, RESPECTIVELY. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART I IN ADDITION TO THE NET COMMUNITY BENEFIT COSTS INCURRED BY THE ORGANIZATION AS REPORTED IN SCHEDULE H, PART I, LINE 7; PLEASE REFER TO SCHEDULE O OF THIS FORM 990 FOR THE ORGANIZATION'S NARRATIVE COMMUNITY BENEFIT STATEMENT FOR ADDITIONAL INFORMATION ON HOW THE ORGANIZATION PROMOTES HEALTH AND PROVIDES HEALTHCARE SERVICES TO THE COMMUNITY REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY IN FURTHERANCE OF ITS CHARITABLE TAX EXEMPT PURPOSE. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM THE HOSPITAL IS AN AFFILIATE WITHIN GEISINGER. AS ONE OF THE NATION'S LARGEST HEALTH SERVICE ORGANIZATIONS, GEISINGER SERVES MORE THAN 3 MILLION RESIDENTS THROUGHOUT 45 COUNTIES IN CENTRAL, SOUTH-CENTRAL AND NORTHEAST PENNSYLVANIA, AND IN SOUTHERN NEW JERSEY AT ATLANTICARE. IN 2017, THE GEISINGER COMMONWEALTH SCHOOL OF MEDICINE AND GEISINGER JERSEY SHORE HOSPITAL BECAME THE NEWEST MEMBERS OF THE GEISINGER FAMILY. THE PHYSICIAN- LED SYSTEM IS COMPRISED OF APPROXIMATELY 30,000 EMPLOYEES, INCLUDING NEARLY 1,600 EMPLOYED PHYSICIANS, 13 HOSPITAL CAMPUSES, TWO RESEARCH CENTERS, AND A 583,000-MEMBER HEALTH PLAN, ALL OF WHICH LEVERAGE AN ESTIMATED 12.7 BILLION POSITIVE IMPACT ON THE PENNSYLVANIA AND NEW JERSEY ECONOMIES. HISTORY. GEISINGER HAD ITS BEGINNINGS IN THE SMALL COMMUNITY OF DANVILLE, WHICH IS 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. HAVE BEEN ADDED IN RECENT YEARS. CORPORATE STRUCTURE. THE ORGANIZATIONAL STRUCTURE OF THE SYSTEM 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. SEE SCHEDULE R FOR A LIST OF THE AFFILIATED ORGANIZATIONS COMPRISING GEISINGER. ADDITIONAL INFORMATION PART VI, LINE 7: FORM 990, SCHEDULE H, PART VI, LINE 7, STATE FILING OF COMMUNITY BENEFIT REPORT: AT THIS TIME, THE HOSPITAL AND ITS AFFILIATES ARE NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE. X X X X X X true true false false false false false true false EDELYN L MILLER DIRECTOR 885853 358117 321689 234397 22002 1822058 181433 JAEWON RYU MD JD DIRECTOR 961804 471004 163802 179214 39001 1814825 DAVID T FEINBERG MD MBA PRESIDENT, DIRECTOR 2399174 1339735 204244 996710 28638 4968501 DANIEL E LOHR ESQUIRE ACLO, ASST SECTY 311659 82777 46799 19212 24252 484699 DAVID J FELICIO ESQUIRE EVP, CLO, SECRETARY 668203 273175 201562 234351 24405 1401696 70559 KEVIN F BRENNAN CPA FHFMA EVP, CFO, TREASURER 941959 427380 764093 19212 17636 2170280 MICHAEL T HEGSTROM MD CMO 462587 13897 19212 23391 519087 KIRK E THOMAS FACHE MHA RRT CAO, WESTERN REGION 222520 52036 23648 4167 21492 323863 CHRISTINE W MATHEWS RN MSN VP, NURSING 79400 148478 3800 219 231897 KRISTY M HINE AVP, FINANCE 142463 21730 24569 3067 23408 215237 NANCY S REINKE DIRECTOR, HUMAN RESO 138890 13515 10914 3002 25980 192301 PETER A GOYER RAD. PHYSICIST 190594 100 6049 3824 1914 202481 RICHARD F STOMACKIN RPH DIRECTOR, PHARMACY 163703 15936 12314 3679 20164 215796 KAY HAMILTON RN MS CAO 339983 5300 350 345633 ALBERT BOTHE JR MD FORMER OFFICER 49395 3048473 2567 1465 3101900 RONALD M COWAN FORMER OFFICER 197695 41998 40841 18154 1245 299933 SCHEDULE J, PAGE 1, PART I, LINE 4 EDELYN L. MILLER 0 181,433 0 DAVID J. FELICIO, ESQUIRE 0 70,559 0 KEVIN F. BRENNAN, CPA, FHFMA 0 589,978 0 CHRISTINE W. MATHEWS, RN, MSN 110,525 0 0 KAY HAMILTON, RN, MS 296,400 0 0 ALBERT BOTHE, JR., MD 2,933,320 0 0 SCHEDULE J, PAGE 1, PART I, LINE 7 BECAUSE THE PAYMENT OF EARNED PERFORMANCE BASED COMPENSATION IS AT THE DISCRETION OF MANAGEMENT AND THE BOARD OF DIRECTORS, SUCH PAYMENTS MAY BE CONSIDERED NON-FIXED PAYMENTS. PERFORMANCE BASED COMPENSATION IS DETERMINED BY MEETING INDIVIDUALLY MEASURED PERFORMANCE GOALS THAT ARE ALIGNED WITH OVERALL GEISINGER OBJECTIVES, INCLUDING: CLINICAL QUALITY, COMMUNITY MISSION ACHIEVEMENT, AND FINANCIAL STEWARDSHIP. SCHEDULE J, PART III PART I, LINE 4A - SEVERANCE PAYMENT UPON INVOLUNTARY SEPARATION, EMPLOYEES MAY BE ELIGIBLE TO RECEIVE CONTINUATION OF SALARY FOR A TERM THAT IS BASED ON THEIR YEARS OF GEISINGER SERVICE AND POSITION. 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. __________________________________________________________________________ FOOTNOTE: THROUGHOUT FORM 990, THE TERMS "GEISINGER- AND "SYSTEM" REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH "GH" AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM. GAYLE H COWAN FAMILY 124543 EMPLOYEE COMP/BEN false SCHEDULE L, PART V GAYLE H. COWAN IS A FAMILY MEMBER OF RONALD M. COWAN A FORMER OFFICER OF GEISINGER-LEWISTOWN HOSPITAL. FORM 990 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 WITH A TOTAL OUTSTANDING BALANCE OF 1,745,563,379, INCLUSIVE OF UNAMORTIZED ORIGINAL ISSUE DISCOUNT AS OF JUNE 30, 2018. BECAUSE THE BOND PROCEEDS ARE DISBURSED TO GH SUBSIDIARIES, THE 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 HOLY SPIRIT HOSPITAL EIN: 23-1512747 GEISINGER COMMONWEALTH SCHOOL OF MEDICINE EIN: 26-0812968 ATLANTICARE REGIONAL MEDICAL CENTER EIN: 21-0634549 SCHEDULE K WAS PREPARED ON A CONSOLIDATED BASIS AND IS INCLUDED IN THE FORM 990 FILING OF GEISINGER HEALTH, EIN: 23-1995911. FORM 990, PART IX STATEMENT OF FUNCTIONAL EXPENSES, LINE 24E: INCLUDED ON LINE 24E IS UNRELATED BUSINESS INCOME TAX EXPENSE OF 14,156. FORM 990, PAGE 2, PART III, LINE 4A MISSION: TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING ACCESS TO QUALITY POPULATION HEALTH AND HOSPITAL SERVICES THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE. I. GENERAL INFORMATION GEISINGER-LEWISTOWN HOSPITAL (GLH), A 501(C)(3) NOT-FOR-PROFIT CORPORATION AND MEMBER OF GEISINGER, OWNS AND OPERATES A 123-BED ACUTE CARE HOSPITAL IN LEWISTOWN, PA. GLH IS CONVENIENTLY LOCATED ONLY A FEW MILES FROM SEVERAL CENTRAL PENNSYLVANIA MAJOR HIGHWAYS. THE FACILITY OPENED IN 1905 IN RESPONSE TO A PRESSING NEED FOR HEALTH AND WELLNESS CARE IN THE COMMUNITY. DURING THE FISCAL YEAR ENDED JUNE 30, 2018, GLH PROVIDED 20,112 PATIENT DAYS; 4,620 SAME DAY SURGICAL PROCEDURES; AND 29,825 EMERGENCY ROOM VISITS. GLH PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. MOST INSURANCES, INCLUDING MEDICARE AND MEDICAID, ARE ACCEPTED, AND ALL PATIENTS ARE OFFERED TREATMENT REGARDLESS OF THE TYPE OF INSURANCE THEY HAVE. NO PATIENT IS EVER REFUSED TREATMENT BECAUSE OF THE INABILITY TO PAY. THE ORGANIZATION ALSO PROVIDES UNCOMPENSATED CARE TO PATIENTS WHO MEET CERTAIN CRITERIA WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. SERVICES OFFERED BY GLH INCLUDE: GENERAL MEDICAL CARE IS PROVIDED BY IN-HOUSE HOSPITALISTS AND SUPPORTED BY CONSULTATIVE SERVICES IN THE AREAS OF CARDIOLOGY, INFECTIOUS DISEASE, NEUROLOGY, PULMONOLOGY, ORTHOPEDICS, HEMATOLOGY/ONCOLOGY, OTOLARYNGOLOGY, AND GASTROENTEROLOGY. A FULLY-STAFFED SURGICAL SERVICES SUITE OFFERING FIVE OPERATING ROOMS EQUIPPED FOR VARIOUS TYPES OF INPATIENT AND OUTPATIENT GENERAL AND SPECIALTY SURGICAL PROCEDURES. THE EMERGENCY DEPARTMENT(ED) IS COMMITTED TO PROVIDING HIGH QUALITY, PROMPT EMERGENCY SERVICES. GLH'S ED IS STAFFED 24/7 WITH FULL-TIME PHYSICIANS AND NURSES WHO ARE TRAINED IN ALL SPECIALTIES FROM PEDIATRICS TO CRITICAL CARE. IMMEDIATE ACCESS IS AVAILABLE TO LABORATORY SERVICES; IMAGING SERVICES SUCH AS CT SCANS, ULTRASOUND AND MRI; AND SURGICAL SERVICES. OB/GYN FOCUSES ON ALL ASPECTS OF WOMEN'S HEALTH AND EDUCATION, PROVIDING OBSTETRICAL AND GYNECOLOGICAL CARE FOR WOMEN OF ALL AGES. SERVICES INCLUDE BUT ARE NOT LIMITED TO ROUTINE VISITS AND TREATMENTS, PREVENTATIVE HEALTHCARE, BIRTH CONTROL EDUCATION, FAMILY PLANNING, OBSTETRICS, SURGERY & SURGERY CONSULTATIONS, MENOPAUSE COUNSELING, AND MIDWIFERY. MENTAL HEALTH & PSYCHIATRIC SERVICES PROVIDES ADULT INPATIENT SERVICES DESIGNED TO HELP INDIVIDUALS LIVE AS INDEPENDENTLY AS POSSIBLE. PATIENTS CAN ACCESS QUICK, EFFICIENT ADMISSION 24/7 AND RECEIVE TREATMENT THROUGH A PSYCHIATRIST AVAILABLE ON A DAILY BASIS. ADMISSIONS ARE CONFIDENTIAL AND MAY BE MADE BY PROFESSIONALS AS WELL BY INDIVIDUALS CONCERNED ABOUT THEMSELVES OR OTHERS. DURING HOSPITALIZATION, PATIENT CARE IS PROVIDED THROUGH MULTIPLE PROFESSIONALS WHO COMPRISE THE TREATMENT TEAM. OTHER SERVICES INCLUDE: CARDIAC SERVICES OTHER SURGERY SPECIALTIES CLINICAL NUTRITION OTOLARYNGOLOGY GASTROENTEROLOGY PAIN MANAGEMENT GENERAL SURGERY PATHOLOGY GYNECOLOGY PEDIATRICS ICCU PHYSICAL THERAPY LABORATORY SERVICES PODIATRY NEPHROLOGY PULMONARY/VASCULAR NEUROSURGERY RADIOLOGY NEWBORN NURSERY RESPIRATORY SERVICES ONCOLOGY/COMMUNITY CANCER SLEEP CENTER TREATMENT OPHTHALMOLOGY UROLOGY ORTHOPEDIC WOUND MANAGEMENT INFUSION CENTER GEISINGER LEWISTOWN HOSPITAL ALSO OPERATES A DIPLOMA NURSING PROGRAM AS A DEPARTMENT WITHIN ITS ORGANIZATION. OPENED IN 2008 AND ACCREDITED BY THE NATIONAL LEAGUE OF NURSING IN 2010, THE PROGRAM IS A 2-YEAR, SIX SEMESTER PROGRAM THAT ALSO OFFERS AN LPN TO RN TRACK. THE GEISINGER LEWISTOWN HOSPITAL SCHOOL OF NURSING (GLHSON) EXISTS TO PROVIDE QUALITY NURSING EDUCATION AND SEEKS TO ENGAGE A DIVERSE GROUP OF STUDENTS IN A MANNER THAT ENABLES ITS GRADUATES TO BECOME LEADERS IN PROVIDING COMPETENT AND SAFE BEDSIDE NURSING CARE ACROSS THE CONTINUUM AND THROUGHOUT THE SURROUNDING COMMUNITY. THE GLHSON HAS AN AVERAGE PASS RATE OF 99% FOR THE NCLEX/RN EXAM, WHICH IS A COMPETENCY AND LICENSURE EXAM USED BY ALL STATE NURSING BOARDS IN THE US. THIS HIGH EXAM PASS RATE ALONG WITH THE PROGRAM'S HIGH ADMISSION STANDARDS ARE TWO REASONS THAT THE PROGRAM HAS BEEN NAMED ONE OF THE TOP RANKED RN PROGRAMS IN PA BY REGISTERED NURSING.ORG, A NATIONAL RANKING ORGANIZATION, FOR THE LAST THREE YEARS. IN FY18, GLH COMPLETED PREPARATIONS FOR A FAMILY PRACTICE RESIDENCY PROGRAM, WHICH INCLUDED CONTRACTING WITH A CONSULTING FIRM, HIRING APPROPRIATE STAFF AND COMPLETING A SITE SURVEY. IN MAY 2018, GLH HIRED THE FIRST 4 FAMILY PRACTICE RESIDENTS INTO THE PROGRAM WHICH WILL OPERATE ON A 3-YEAR ROTATION, SO THAT BY THE THIRD YEAR OF THE PROGRAM, THERE COULD BE 12 FAMILY PRACTICE RESIDENTS ON SITE. II. UNCOMPENSATED CARE GEISINGER-LEWISTOWN HOSPITAL RECOGNIZES ITS MISSION IS TO SERVE ALL MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND EDUCATION. IN THIS REGARD, GLH PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH-RELATED ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A.CHARITY CARE THE PRIMARY CONCERN OF GLH IS THE DELIVERY OF HEALTH CARE TO ALL CITIZENS OF CENTRAL PENNSYLVANIA REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GLH INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. FOR THE FISCAL YEAR ENDED JUNE 30, 2018, THE TOTAL COST OF THE CHARITY CARE WAS 1.7 MILLION. B. MEDICARE/MEDICAID IN RECOGNIZING ITS MISSION TO THE COMMUNITY, GLH PROVIDES SERVICES TO THE ELDERLY (MEDICARE) AND THE INDIGENT (MEDICAID). GLH PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS TO THE EXTENT THE GOVERNMENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTH CARE. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. THE COST OF PROVIDING HEALTHCARE SERVICES TO MEDICARE AND MEDICAID PATIENTS EXCEEDED REIMBURSEMENT BY APPROXIMATELY 20.2 MILLION DURING THE FISCAL YEAR ENDED JUNE 30, 2018. C.OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GLH PROVIDES SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2018, WAS 840 THOUSAND. D. OTHER UNINSURED FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE OR GOVERNMENT OR PRIVATE PROGRAMS GLH OFFERS PAYMENT DISCOUNTS AND TIME PAYMENTS WITHOUT INTEREST OR FEES. III. VOLUNTEER SERVICES THE VOLUNTEERS OF GEISINGER-LEWISTOWN HOSPITAL ARE AN ACTIVE AND VITAL PART OF THE ACTIVITIES OF THE HOSPITAL. THE HOURS OF VOLUNTEER SERVICES ARE AN IMPORTANT CONTRIBUTION TO THE MISSION OF GLH. IN FY18, THE VOLUNTEERS FROM LOCAL COMMUNITIES CONTRIBUTED 9,587 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTHCARE OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION, 246 THOUSAND, IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND "WELLNESS" PROGRAMS. IV. COMMUNITY HEALTH, EDUCATION, AND OUTREACH GLH STRIVES TO BE A VALUABLE RESOURCE FOR THE COMMUNITY AND ITS RESIDENTS. GLH PROVIDES MANY REDUCED-PRICE SERVICES AND FREE PROGRAMS THROUGHOUT THE YEAR THAT SERVE COMMUNITY HEALTH NEEDS. AT A COST OF 121 THOUSAND, THESE SERVICES AND PROGRAMS INCLUDED: SUPPORT GROUPS, COMMUNITY HEALTH EDUCATION, HEALTH SCREENINGS AND OTHER UNIQUE SERVICES. GLH PROVIDES PROGRAMS FOR ALL DEMOGRAPHICS. A. SUPPORT GROUPS PREGNANCY SUPPORT: G-LH OFFERS LOW-COST PREPARED CHILDBIRTH AND BREASTFEEDING CLASSES TO PROMOTE POSITIVE OUTCOMES FOR EXPECTANT MOTHERS AND INFANTS THROUGH REALISTIC INSTRUCTION AND ACHIEVABLE GOALS. CLASSES FOCUS ON PREPARING FOR LABOR, DELIVERY AND POSTPARTUM. B. COMMUNITY HEALTH EDUCATION COMMUNITY HEALTH NEEDS ASSESSMENT OTHER CHRONIC DISEASE MANAGEMENT DIABETES MANAGEMENT DRUG & ALCOHOL COUNSELING WOMEN'S HEALTH RELATED TOPICS SMOKING CESSATION NUTRITION CLASSES LIVING WILLS PREPARING FOR YOUR DOCTOR'S VISIT MEDICATION SAFETY HEART DISEASE/FAILURE PREVENTION CANCER PREVENTION(SKIN, COLON, INFECTION CONTROL BREAST, PROSTATE) SENIOR CITIZEN EDUCATION & OUTREACH LIFE SAFETY/CPR CLASSES C. HEALTH SCREENINGS BLOOD PRESSURE BLOOD SUGAR LEVELS LUNG FUNCTION SCREENINGS BONE DENSITY HEAL SCANS DEPRESSION SCREENINGS SKIN CANCER SCREENING STROKE RISK ASSESSMENT D. OTHER SERVICES JUNIOR VOLUNTEER PROGRAM SILVER CIRCLES PROGRAM HEALTH FAIRS LOCAL ROTARY CLUB COALITION BUILDING AMISH COMMUNITY VISITS EDUCATION IN HEALTHCARE CAREERS COLLABORATE WITH LOCAL FACILITY TOURS FOR LOCAL SCHOOLS COMMUNITY HEALTH ADVOCACY GROUP V. PLANNED FUTURE ACTIVITIES IN KEEPING WITH ITS MISSION, GLH IS WORKING TO FULFILL THE HEALTH NEEDS OF ITS SURROUNDING COMMUNITIES BY PLANNING FOR THE FOLLOWING SERVICES OR ACTIVITIES IN THE UPCOMING FISCAL YEARS: IN THE FALL OF 2018, GLH ENTERED INTO A LEASE AGREEMENT FOR SPACE FOR A LABORATORY DRAW STATION IN A NEARBY, NEWLY CONSTRUCTED MEDICAL OFFICE BUI FORM 990, PART V FORM 990, PART V, LINE 1A: ENTER THE NUMBER REPORTED IN BOX 3 OF FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURNS. GEISINGER SYSTEM SERVICES (GSS), AN AFFILIATE OF THE ORGANIZATION, PROVIDES A CENTRALIZED ACCOUNTS PAYABLE FUNCTION FOR ALL GEISINGER ORGANIZATIONS. AS THE ACCOUNTS PAYABLE PROCESSOR, GSS PREPARES AND FILES FORM 1099 UNDER ITS EIN FOR CERTAIN REPORTABLE PAYMENTS OF THE FILING ORGANIZATION. THE NUMBER OF 1099'S FILED BY GSS FOR THE 2017 REPORTING PERIOD ON BEHALF OF ITSELF AND ITS AFFILIATES WAS 1,739. THE RESPONSE ENTERED ON LINE 1A FOR THE ORGANIZATION INCLUDES ONLY THOSE FORM 1099S FILED UNDER THE ORGANIZATIONS EIN. IT DOES NOT INCLUDE THOSE FILED BY GSS ON ITS BEHALF. FORM 990, PART VI FORM 990, PART I, SECTION A, LINE 4: FORM 990, PART VI, SECTION A, LINE 1B: ENTER THE NUMBER OF VOTING MEMBERS THAT ARE INDEPENDENT. BASED ON THE FORM 990 DEFINITION OF "INDEPENDENCE" AS IT RELATES TO VOTING MEMBERS OF THE GOVERNING BODY, THREE VOTING MEMBERS ARE NOT INDEPENDENT BECAUSE THEY ARE COMPENSATED AS EMPLOYEES OF RELATED TAX-EXEMPT ORGANIZATIONS. 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? DANIEL E. LOHR, ESQUIRE, DAVID J. FELICIO, ESQUIRE, DAVID T. FEINBERG, MD, MBA, EARL FOURA, EDELYN L. MILLER, JAEWON RYU, MD, JD, KEVIN F. BRENNAN, CPA, FHFMA, ROBERT J. DIETZ, 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 AFFILIATE OF THE ENTITY. ALL OF THE AFFILIATES ARE PART OF GEISINGER. FORM 990, PAGE 6, PART VI, LINE 6 THE MEMBERS OF THE CORPORATION HAVE THE POWER AND AUTHORITY TO ELECT AND REMOVE THE DIRECTORS; ELECT AND REMOVE THE PRESIDENT AND FILL ANY VACANCY IN THE OFFICE OF THE PRESIDENT OF THE CORPORATION; AND, MAY APPROVE AMENDMENTS TO THE CORPORATE BYLAWS IN LIEU OF SUCH APPROVAL BY THE BOARD OF DIRECTORS. THE MEMBERS ALSO HAVE THE RESERVE POWERS AS SET FORTH IN THE PENNSYLVANIA NONPROFIT CORPORATION LAW. FORM 990, PAGE 6, PART VI, LINE 7A THE BOARD OF DIRECTORS OF THE CORPORATION SHALL SERVE AS THE GOVERNING BODY OF THE CORPORATION. THE PRESIDENT OF THE CORPORATION SHALL BE A DIRECTOR BY REASON OF HOLDING SUCH OFFICE. THE REMAINING DIRECTORS SHALL BE ELECTED BY THE MEMBERS AT THE ANNUAL MEETING OF THE MEMBERS. THE MEMBERS OF THE CORPORATION MAY SERVE AS DIRECTORS AND DIRECTORS MAY SUCCEED THEMSELVES FROM TERM TO TERM. VACANCIES ON THE BOARD OF DIRECTORS SHALL BE FILLED BY THE MEMBERS AT THEIR DISCRETION AT THE ANNUAL MEETING OF THE MEMBERS OR AT A SPECIAL MEETING CALLED FOR SUCH PURPOSE. FORM 990, PAGE 6, PART VI, LINE 11B 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 FINANCIAL REPORTING 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. IN ADDITION, 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. 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. FORM 990, PAGE 6, PART VI, LINE 12C THE OFFICERS AND DIRECTORS OF THE ORGANIZATION ARE SUBJECT TO THE GEISINGER CONFLICT OF INTEREST POLICY FOR DIRECTORS, OFFICERS AND SENIOR LEADERS. AT LEAST ONCE EACH YEAR DIRECTORS, OFFICERS, KEY EMPLOYEES, SENIOR LEADERS AND OTHERS DESIGNATED BY THE BOARD OF DIRECTORS ARE REQUIRED TO DISCLOSE IN WRITING THE EXISTENCE OF ANY POTENTIAL FINANCIAL INTERESTS THAT MAY GIVE RISE TO A CONFLICT OF INTEREST WITH ANY AFFILIATE WITHIN GEISINGER. THE DISCLOSURES ARE REVIEWED BY THE OFFICE OF THE CHIEF LEGAL OFFICER AND REPORTED TO THE AUDIT AND COMPLIANCE COMMITTEES AND 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 BOARD DECIDES IF A CONFLICT EXISTS AND TAKES APPROPRIATE ACTION. THE INDIVIDUAL DISCLOSING THE FINANCIAL INTEREST IS ABSENT DURING THE BOARD DELIBERATIONS AND DECISIONS ON THE MATTER. FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS TO REVIEW AND APPROVE THE COMPENSATION OF GEISINGER EMPLOYED BOARD DIRECTORS, OFFICERS, AND EXECUTIVE MANAGEMENT IS DESIGNED TO SATISFY THE REBUTTABLE PRESUMPTION PROCEDURE AVAILABLE FOR INTERMEDIATE SANCTION PURPOSES. THE PROCESS REQUIRES A REVIEW OF COMPENSATION DETERMINATIONS BY DISINTERESTED PARTIES, USE OF APPROPRIATE COMPARABILITY DATA AND CONTEMPORANEOUS DOCUMENTATION OF THE PROCESS. ON AN ANNUAL BASIS AN INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANT COMPLETES A COMPARATIVE ASSESSMENT OF COMPENSATION FOR THE CEO AND SENIOR MANAGEMENT WITHIN GEISINGER. THE CONSULTANT'S REPORT IS PRESENTED TO THE GEISINGER FAMILY COMMITTEE PRIOR TO ANY COMPENSATION ADJUSTMENT. THE REPORT SUPPORTS THE RIGOROUS REVIEW COMPLETED BY THE GEISINGER FAMILY COMMITTEE TO ENSURE THAT THE PROGRAM IS RESPONSIBLE TO THE GEISINGER CHARITABLE MISSION, REFLECTS REASONABLE COMPENSATION WITHIN THE NONPROFIT MARKET AND IS COMPLIANT WITH THE IRS'S INTERMEDIATE SANCTION REQUIREMENTS. THE SURVEY DATA IN THE COMPARATIVE ANALYSIS IS CAPTURED FOR FUNCTIONALLY COMPARABLE POSITIONS IN MULTIPLE SIMILAR NONPROFIT ORGANIZATIONS AND REFLECTS TOTAL REMUNERATION PROVIDED IN THE MARKET. ALL SURVEYS ARE CONDUCTED BY THIRD PARTY ORGANIZATIONS AND NOT CONDUCTED AT THE SPECIFIC DIRECTION OF GEISINGER. ANY COMPENSATION ADJUSTMENTS ARE APPROVED BY THE GEISINGER FAMILY COMMITTEE PRIOR TO THE EFFECTIVE DATE OF THE PAYMENT. THE GEISINGER FAMILY COMMITTEE AT ITS SOLE DISCRETION MAY POSITIVELY OR NEGATIVELY ADJUST ANY RECOMMENDED COMPENSATION. FORM 990, PAGE 6, PART VI, LINE 15B SEE SCHEDULE O RESPONSE TO FORM 990, PART VI SECTION B, QUESTION 15A. FORM 990, PAGE 6, PART VI, LINE 19 THE ANNUAL REPORT FOR GEISINGER, CONTAINING COMMUNITY BENEFIT INFORMATION, CONSOLIDATED FINANCIAL INFORMATION AND OTHER INFORMATION, IS AVAILABLE ON THE GEISINGER WEBSITE. GO TO: HTTPS://WWW.GEISINGER.ORG/ABOUT- GEISINGER/NEWS-AND-MEDIA/FOR-MEDIA/ANNUAL-REPORTS. FINANCIAL STATEMENTS, FORM 990, FORM 990-T, THE CONFLICTS OF INTEREST POLICY, AND OTHER GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 PENSION ADJUSTMENT 10,461,633 TRANSFER FROM PARENT, GEISINGER HEALTH FOR PPE 62,528 OTHER CHANGES IN TEMPORARILY RESTRICTED 738 TOTAL 10,524,899 FORM 990, PART XII FORM 990, PART XII, LINE 3A: AS A RESULT OF A FEDERAL AWARD, WAS THE ORGANIZATION REQUIRED TO UNDERGO AN AUDIT OR AUDITS AS SET FORTH IN THE AUDIT ACT OR OMB CIRCULAR A-133? FEDERAL AWARDS ARE AUDITED AS A PART OF THE GEISINGER'S CONSOLIDATED REPORT ON FEDERAL AWARDS IN ACCORDANCE WITH OMB CIRCULAR A-133. FOOTNOTE: THROUGHOUT FORM 990, THE TERMS "GEISINGER- AND "SYSTEM" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM. GEISINGER HEALTH 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231995911 PHILANTHRO PA 501C3 7 N/A true GEISINGER MEDICAL CENTER 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 240795959 HOSPITAL PA 501C3 3 GH true GEISINGER CLINIC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 236291113 PHYSICIAN PA 501C3 12A GH true GEISINGER WYOMING VALLEY MED CTR 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231996150 HOSPITAL PA 501C3 3 GH true MARWORTH 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232171417 D&A REHAB PA 501C3 3 GH true GEISINGER HEALTH PLAN 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232311553 HEALTH INS PA 501C4 GH true GEISINGER SYSTEM SERVICES 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232164794 SUPPORT SV PA 501C3 12A GH true GEISINGER COMMUNITY HEALTH SERVICES 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232967235 HEALTHCARE PA 501C3 10 GSS true GEISINGER INSURANCE CORPORATIONRRG 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 141909894 SELF INS VT 501C3 12A GH true COMMUNITY MEDICAL CENTER 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 240862246 HOSPITAL PA 501C3 3 GH true MOUNTAIN VIEW NURSING HOME INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232568288 LONG TERM PA 501C3 10 GH true GEISINGER-BLOOMSBURG HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232193572 HOSPITAL PA 501C3 3 GH true GEISINGER-BLOOMSBURG HEALTHCARE CTR 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232242854 SKILLED NU PA 501C3 10 GH true LEWISTOWN AMBULATORY CARE CORP 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232344362 HOLDING CO PA 501C3 12A GH true FAMILY HEALTH ASSOCIATES OF GLH 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 251651582 PHYSICIAN PA 501C3 12A GH true KEYSTONE HEALTH INFORMATION EXCH 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 464359893 RHIO PA 501C3 12A GH true HEALTH CARE CORP OF NORTHEAST PA 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232337286 SUPPORT SV PA 501C3 12A CMC true HOLY SPIRIT HEALTH SYSTEM 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 251865142 PHILANTHRO PA 501C3 12A GH true HOLY SPIRIT HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 231512747 HOSPITAL PA 501C3 3 HSHS true HOLY SPIRIT CORPORATION 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232214540 HOLDING CO PA 501C2 HSHS true SPIRIT PHYSICIAN SERVICES INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 251766971 PHYSICIAN PA 501C3 10 HSHS true WEST SHORE ADVANCED LIFE SUPP SVCS 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232463002 HEALTHCARE PA 501C3 7 HSHS true GEISINGER COMMONWEALTH SCH OF MED 525 PINE STREET SCRANTON PA 18509 260812968 EDUCATION PA 501C3 2 GH true GEISINGER JERSEY SHORE HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 240792115 HOSPITAL PA 501C3 3 GH true GEISINGER JERSEY SHORE HOSPITAL FND 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232480603 HEALTHCARE PA 501C3 3 GH true ATLANTICARE BEHAVORIAL HEALTH INC 2511 FIRE ROAD EGG HARBOR TOWNSHIP NJ 08234 210721208 HEALTHCARE NJ 501C3 7 ARHS true ATLANTICARE FOUNDATION 6725 DELILAH ROAD EGG HARBOR TOWNSHIP NJ 08234 222148992 SUPPORT AR NJ 501C3 7 AH SYSTEM true ATLANTICARE HEALTH ENGAGEMENT INC 2500 ENGLISH CREEK AVENUE EGG HARBOR TOWNSHIP NJ 08234 611608389 HEALTHCARE NJ 501C3 12A AH SYSTEM true ATLANTICARE HEALTH SERVICES INC 2500 ENGLISH CREEK AVENUE EGG HARBOR TOWNSHIP NJ 08234 223265214 HEALTHCARE NJ 501C3 10 ARHS true ATLANTICARE HEALTH SYSTEM INC 2500 ENGLISH CREEK AVENUE EGG HARBOR TOWNSHIP NJ 08234 223265213 SUPPORT AR NJ 501C3 12A GH true ATLANTICARE REGIONAL MEDICAL CENTER 1925 PACIFIC AVENUE ATLANTIC CITY NJ 08401 210634549 HOSPITAL NJ 501C3 3 ARHS true ATLANTICARE PHYSICIAN GROUP PA 2500 ENGLISH CREEK AVENUE EGG HARBOR TOWNSHIP NJ 08234 020701782 HEALTHCARE NJ 501C3 10 AH SYSTEM true ATLANTICARE REGIONAL HEALTH SERVICE 2500 ENGLISH CREEK AVENUE EGG HARBOR TOWNSHIP NJ 08234 800834222 HOLDING CO NJ 501C3 12A AH SYSTEM true GNJ PHYSICIANS GROUP PC 2500 ENGLISH CREEK AVENUE EGG HARBOR TOWNSHIP NJ 08234 820681884 HEALTHCARE NJ 501C3 10 GH true KEYSTONE ACCOUNTABLE CARE ORG LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 454475297 ACO PA N/A false false LIFESOURCE GEISINGER BLOOD CTR LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 364718005 BLOOD COLL PA N/A false false MERIDIAN GEISINGER HLTH NETWORKLLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 455484165 ORG DEL SY NJ N/A false false HEALTHSOUTH GHS LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 721398803 PHY THERAP PA N/A false false EVANGELICAL-GEISINGER HEALTH LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 460567687 HEALTHCARE PA N/A false false LEMED II 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232391766 RENTAL PA N/A false false GEISINGER-SCA HOLDINGS LLC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 461615328 HEALTHCARE DE N/A false false CAMP HILL AMBULATORY SURG CTR LLC 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM AL 35209 521597478 HEALTHCARE PA N/A false false GRANDVIEW SURGERY CENTER LTD 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM AL 35209 521597483 HEALTHCARE PA N/A false false LACKAWANNA PHYS AMB SURG CTRLLC 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM AL 35209 233024998 HEALTHCARE PA N/A false false SOUTHERN JERSEY ONCOLOGY PROPERTIES 2500 ENGLISH CREEK AVENUE EGG HARBOR TOWNSHIP NJ 08234 943463625 HEALTHCARE NJ N/A false false ATLANTICARE SURGERY CENTER LLC 2500 ENGLISH CREEK AVENUE EGG HARBOR TOWNSHIP NJ 08234 223491867 HEALTHCARE NJ N/A false false COOPERATIVE HEALTH SRVS OF S JERSEY 1301 ATLANTIC AVENUE ATLANTIC CITY NJ 08401 223619231 PURCHASING NJ N/A false false ISS SOLUTIONS INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232077663 HOTEL/REST PA N/A true GEISINGER INDEMNITY INSURANCE CO 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232815174 HLTH INSUR PA N/A true GEISINGER QUALITY OPTIONS INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 204275139 HLTH INSUR PA N/A true XG HEALTH SOLUTIONS INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 461657345 CONSULTING DE N/A true GEISINGER ASSURANCE COMPANY LTD 878 WEST BAY ROAD PO BOX 1159 GRAND CAYMAN GRAND CAYMAN CJ KY1-1102 981016737 INSURANCE CJ N/A true HOLY SPIRIT VENTURES INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE PA 17822 232407709 MED. SERV. PA N/A true ENGLISH CREEK ASSURANCE LTD 44 CHURCH STREET HM12 HAMILTON BERMUDA BERMUDA BD 980656394 FINANCIAL BD N/A true ATLANTICARE HEALTH SOLUTIONS INC 2500 ENGLISH CREEK AVENUE BLDG 500 EGG HARBOR TOWNSHIP NJ 08234 383856295 ACO/HEALTH NJ N/A true ATLANTICARE ASSURANCE ALLIANCE INC 2500 ENGLISH CREEK AVENUE BLDG 500 EGG HARBOR TOWNSHIP NJ 08234 463730123 HEALTHCARE NJ N/A true true false true false false false false false false false true true true false false true false false false COMMUNITY MEDICAL CENTER L 374 GAAP GEISINGER ASSURANCE COMPANY M 335061 GAAP GEISINGER CLINIC L 462749 GAAP GEISINGER CLINIC M 4792043 GAAP GEISINGER CLINIC K 4608 GAAP GEISINGER CLINIC A 225 GAAP GEISINGER HEALTH L 1814 GAAP GEISINGER HEALTH C 115756 GAAP GEISINGER HEALTH PLAN L 36043860 GAAP GEISINGER INSURANCE CORPORATIONRRG P 12543 GAAP GEISINGER MEDICAL CENTER L 14078 GAAP GEISINGER MEDICAL CENTER M 2903538 GAAP GEISINGER SYSTEM SERVICES M 11527599 GAAP GEISINGER SYSTEM SERVICES L 1940 GAAP GEISINGER SYSTEM SERVICES A 23820 GAAP GEISINGER WYOMING VALLEY MEDICAL CT M 28613 GAAP GEISINGER WYOMING VALLEY MEDICAL CT L 7125 GAAP HOLY SPIRIT HOSPITAL L 810 GAAP HOLY SPIRIT HOSPITAL M 6829 GAAP ISS SOLUTIONS INC M 2269977 GAAP LEWISTOWN AMBULATORY CARE CORP L 31200 GAAP LEWISTOWN AMBULATORY CARE CORP K 522684 FMV SPIRIT PHYSICIAN SERVICES INC L 390 GAAP GEISINGER COMMUNITY HEALTH SERVICES L 559 GAAP GEISINGER COMMUNITY HEALTH SERVIES M 14094 GAAP GEISINGER JERSEY SHORE HOSPITAL L 3500 GAAP GEISINGER BLOOMSBURG HOSPITAL L 65 GAAP SCHEDULE R FORM 990, SCHEDULE R, PART V - TRANSACTIONS WITH RELATED ORGANIZATIONS: AS SHOWN IN FORM 990, SCHEDULE R, GEISINGER-LEWISTOWN HOSPITAL IS CLOSELY AFFILIATED WITH SEVERAL OTHER ORGANIZATIONS. IN THE NORMAL COURSE OF THE OPERATIONS OF THESE AFFILIATED ORGANIZATIONS THERE ARE NUMEROUS INTER ORGANIZATIONAL TRANSACTIONS, WHICH MAY INCLUDE SALES, EXCHANGES AND LEASES OF PROPERTY, EXTENSIONS OF CREDIT, FURNISHING OF GOODS, SERVICES AND FACILITIES, AND TRANSFERS OF ASSETS. THESE INTERORGANIZATION TRANSACTIONS PROMOTE THE EFFICIENT OPERATION OF THE VARIOUS ORGANIZATIONS AND THE ATTAINMENT OF THEIR TAX EXEMPT PURPOSES. THESE TYPES OF INTER ORGANIZATION TRANSACTIONS WERE DESCRIBED TO THE INTERNAL REVENUE SERVICE IN A RULING APPLICATION AND WERE RECOGNIZED BY THE NATIONAL OFFICE OF THE IRS IN A SERIES OF GEISINGER PRIVATE RULINGS AS BEING ENTIRELY CONSISTENT WITH THE ORGANIZATIONS' TAX EXEMPT STATUS.