GEISINGER JERSEY SHORE HOSPITAL: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: GEISINGER JERSEY SHORE HOSPITAL (EIN 24-0792115)
Tax period: 2016-07-01 to 2017-06-30
Filed: 2018-05-14
IRS object ID: 201801349349308890
Schema version: 2016v3.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-05-14T16:41:46-04:00	ReturnTs
Tax Period End	2017-06-30	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	240792115	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GEISINGER JERSEY SHORE HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	GEIS	BusinessNameControlTxt
Phone	5702716624	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 N ACADEMY AVE MC 49-70	AddressLine1Txt
City	DANVILLE	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	178229800	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DAVID J FELICIO ESQUIRE	PersonNm
Person Title	SECRETARY	PersonTitleTxt
Phone	5702716624	PhoneNum
Signature	2018-05-02	SignatureDt

Filing Security Information FilingSecurityInformation

Field	Value	IRS element (for citing)
At Submission Creation Device Id	3370824862A80DCC39EED29CD8CF989E4E5ED423	AtSubmissionCreationDeviceId
At Submission Filing Device Id	0D6111DE887E7AF52DE09838A5A5DE7E32FE3032	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Address Change	Yes (X)	AddressChangeInd
Principal Officer	DAVID T FEINBERG MD MBA	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 N ACADEMY AVE MC 22-01	AddressLine1Txt
City	DANVILLE	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	178229800	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$23,830,118	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.GEISINGER.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1922	FormationYr
Legal Domicile State	PA	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF THE JERSEY SHORE AREA.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	302	TotalEmployeeCnt
Total Gross UBI	$666,605	TotalGrossUBIAmt
PY Contributions Grants	$75,845	PYContributionsGrantsAmt
CY Contributions Grants	$34,877	CYContributionsGrantsAmt
PY Program Service Revenue	$24,963,411	PYProgramServiceRevenueAmt
CY Program Service Revenue	$23,342,875	CYProgramServiceRevenueAmt
PY Investment Income	$39,058	PYInvestmentIncomeAmt
CY Investment Income	-$864	CYInvestmentIncomeAmt
PY Other Revenue	$902,285	PYOtherRevenueAmt
CY Other Revenue	$433,106	CYOtherRevenueAmt
PY Total Revenue	$25,980,599	PYTotalRevenueAmt
CY Total Revenue	$23,809,994	CYTotalRevenueAmt
CY Grants And Similar Paid	$2,800	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$12,583,473	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$12,721,807	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$13,873,531	PYOtherExpensesAmt
CY Other Expenses	$13,320,926	CYOtherExpensesAmt
PY Total Expenses	$26,457,004	PYTotalExpensesAmt
CY Total Expenses	$26,045,533	CYTotalExpensesAmt
PY Revenues Less Expenses	-$476,405	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$2,235,539	CYRevenuesLessExpensesAmt
Total Assets BOY	$20,821,259	TotalAssetsBOYAmt
Total Assets EOY	$19,994,287	TotalAssetsEOYAmt
Total Liabilities BOY	$23,326,144	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$23,988,570	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	-$2,504,885	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	-$3,994,283	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	TO BE THE CMMUNITIES FOUNDATION FOR INNOVATIVE PATIENT-CENTERED CARE.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$22,411,838	ExpenseAmt
Grant	$2,800	GrantAmt
Revenue	$23,669,494	RevenueAmt
Desc	HEALTHCARE - SEE SCHEDULE O AS A RURAL HEALTHCARE FACILITY AND DEDICATED COMMUNITY HOSPITAL WITH A COMMITMENT TO PROVIDING A HIGH QUALITY CIRCLE OF CARE, GEISINGER JERSEY SHORE HOSPITAL (GJSH) DEVELOPED DELIVERY SYSTEMS THAT PROVIDE AN EFFICIENT BALANCE OF OUTPATIENT CARE, ACUTE AND SUB-ACUTE INPATIENT CARE, PRIMARY CARE, AND OUTREACH SERVICES. THE HOSPITAL MAXIMIZES THE EFFECTIVENESS OF ITS PROGRAMS FOR QUALITY, EFFICIENCY, AND ACCESSIBILITY BY INTEGRATING WITH OTHER PROVIDERS AND ALTERNATIVE CARE ORGANIZATIONS IN THE SERVICE AREA TO ASSURE COMMUNITY ACCESS TO A BROAD ARRAY OF SERVICE OPTIONS. THE HOSPITAL PROVIDES AN ENVIRONMENT OF CARE THAT IS COMPASSIONATE, HIGHLY-PERSONALIZED, ANO FOCUSED ON THE PHYSICAL, PSYCHO-SOCIAL, AND SPIRITUAL NEEDS OF ITS PATIENTS THROUGH THE USE OF SKILLED NURSES, PHYSICIANS, TECHNICAL AND SUPPORT STAFF, MANAGEMENT, AND COMMUNITY LEADERS. THE HOSPITAL ALSO PROVIDES HEALTH EDUCATION, PROGRAMS IN PREVENTION, AND RELATED SUPPORT SERVICES TO THE COMMUNITY WITH THE GOAL OF IMPROVING THE OVERALL WELLNESS OF ITS RESIDENTS. THE HOSPITAL ENSURES THAT THE NECESSARY RESOURCES ARE AVAILABLE TO PROVIDE THE MOST COST EFFECTIVE MANNER WHILE MAINTAINING A SAFE, PLEASANT, AND MEANINGFUL WORK AND PATIENT CARE ENVIRONMENT. UNCOMPENSATED CARE GEISINGER JERSEY SHORE HOSPITAL RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. GJSH PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD, GJSH PROVIDES FREE CARE OR SUBSIDIZED CARE, TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST, AND PROVIDES VARIOUS HEALTH ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITIES WHERE GJSH PRACTICES. A. CHARITY CARE THE PRIMARY CONCERN OF GJSH IS THE DELIVERY OF HEALTH CARE TO ALL THE CITIZENS IN ITS PENNSYLVANIA SERVICE AREA, REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GJSH INCURRED BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO COULD NOT AFFORD TO PAY. FOR FISCAL YEAR ENDED JUNE 30, 2017, THE COST OF CHARITY CARE WAS 101,913. B. MEDICARE/MEDICAID RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO THE ELDERLY (MEDICARE) AND THE POOR (MEDICAID). GJSH PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS. TO THE EXTENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTHCARE, GJSH IS FURTHERING ITS MISSION TO THE ENTIRE COMMUNITY. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT OF REIMBURSEMENT RECEIVED UNDER THE PROGRAM. FOR FISCAL YEAR ENDED JUNE 30, 2017, THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 3,588,279. C. OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GJSH PROVIDES OTHER PATIENT SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2017, WAS 627,406. COMMUNITY BENEFITS SUMMARY MEDICARE/MEDICAID/OTHER GOVERNMENTAL 3,588,279 CHARITY CARE 101,913 OTHER UNCOMPENSATED CARE 627,406 TOTAL 4,317,598 STATISTICAL SUMMARY FISCAL YEAR ENDED JUNE 30, 2017 DISCHARGES 603 OUTPATIENT VISITS (INCLUDING ER VISITS) 75,881 URGENT CARE VISITS 15,613 PATIENT DAYS 2,248 TOTAL OR PROCEDURES 948 AVAILABLE BEDS 25	Desc
Total Program Service Expenses	$22,411,838	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	false	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	39	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	302	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (true)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (true)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (true)	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	PA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	KEVIN LANCIOTTI VP FINANCECFO	PersonNm
Phone	5702146181	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 N ACADEMY AVENUE MC 01-50	AddressLine1Txt
City	DANVILLE	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	17822	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DAVID A SHANNON
PRESIDENT AN	39.00	1.00	Yes (X)	Yes (X)	$0	$0	$0
SEAN SIMCOX
CHAIRPERSON	1.00	1.00	Yes (X)	Yes (X)	$0	$0	$0
JAMES ELY
VICE CHAIRPE	1.00	1.00	Yes (X)	Yes (X)	$0	$0	$0
RICHARD BEATTY DMD
MEMBER	1.00	1.00	Yes (X)		$0	$0	$0
LEROY H KEILER III
SECRETARY	1.00	1.00	Yes (X)	Yes (X)	$0	$0	$0
WILLIAM R CAMMERER III
TREASURER	1.00	1.00	Yes (X)	Yes (X)	$0	$0	$0
STEPHEN GOYKOVICH DO
MEDICAL STAF	1.00	39.00	Yes (X)		$6,000	$200,050	$12,863
WALTER EISENHAUER
MEMBER	1.00	0.00	Yes (X)		$0	$0	$0
CRAIG HARRIS
MEMBER	1.00	0.00	Yes (X)		$0	$0	$0
STEPHEN P NEUN PHD
MEMBER	1.00	0.00	Yes (X)		$0	$0	$0
CARMEN SPINNEY MD
MEMBER	1.00	0.00	Yes (X)		$0	$0	$0
RICHARD DELANEY
MEMBER	1.00	0.00	Yes (X)		$0	$0	$0
BETH CROSSLEY RN
MEMBER	1.00	0.00	Yes (X)		$0	$0	$0
BARBARA KOZLOWSKI RN
MEMBER	1.00	1.00	Yes (X)		$0	$0	$0
MARK RICE CFO
CFO	39.00	1.00		Yes (X)	$99,579	$0	$26,449
PAULETTE NISH
CHIEF NURSIN	40.00	0.00			$150,391	$0	$2,077	Yes (X)
THEORDORE FEDEROFF DO
PHYSICIAN	40.00	0.00			$293,573	$0	$27,590		Yes (X)
ARLEEN KESSLER
DIRECTOR OF	40.00	0.00			$112,705	$0	$20,416		Yes (X)
KAREN HORNE
PHYSICAL THE	40.00	0.00			$102,280	$0	$3,320		Yes (X)
CHRISTINE HAAS
CIO	40.00	0.00			$134,029	$0	$16,382		Yes (X)
KAREN JOHNSON
PHYSICAL THE	40.00	0.00			$100,364	$0	$1,281		Yes (X)
RONALD N EISTER MD
FORMER 5 HIG	0.00	40.00			$0	$148,968	$20,266			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$998,921	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$349,018	TotReportableCompRltdOrgAmt
Total Other Compensation	$130,644	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	6	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
EMERGENCY PHYSICIAN ASSOCIATES INC
PO BOX 634850	CINCINNATI	OH	452634850	PHYSICIAN SRVCS	$949,001
JERSEY SHORE RADIOLOGY
302 N THIRD STREET	LEWISBURG	PA	17837	RADIOLOGY	$800,000
QUORUM HEALTH RESOURCES
15 CONTINENTAL BLVD	BRENTWOOD	TN	370271018	MANAGEMENT FEES	$612,796
GULFSTREAM ANESTHESIA CONSULTANTS
11440 OKEECHOBEE BLVD	ROYAL PALM BEACH	FL	33411	ANESTHESIOLOGY	$441,614
SHARED IMAGING
801 PHOENIX LAKE AVENUE	STREAMWOOD	IL	60107	IMAGING	$414,978

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	9	CntrctRcvdGreaterThan100KCnt
Fundraising	$2,200	FundraisingAmt
Government Grants	$23,164	GovernmentGrantsAmt
All Other Contributions	$9,513	AllOtherContributionsAmt
Total Contributions	$34,877	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
PATIENT SERVICE REVENUE	621110	$22,588,403	$22,588,403
LAB REVENUE	621500	$666,605		$666,605
RENTAL REVENUE	531120	$72,194			$72,194
PHARMACY REVENUE	446110	$12,778	$12,778
OUTREACH PROGRAM	621990	$2,895	$2,895

Field	Value	IRS element (for citing)
Total Program Service Revenue	$23,342,875	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$17,472	TotalRevenueColumnAmt
Exclusion	$17,472	ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$18,336	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$18,336	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$18,336	TotalRevenueColumnAmt
Exclusion	-$18,336	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$10,525	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$2,200	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$1,788	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,737	TotalRevenueColumnAmt
Exclusion	$8,737	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
MEANINGFUL USE	621110	$229,673	$229,673
DIETARY REVENUE	722514	$80,897		$80,897
RURAL ACO EXPENSE REIMBURSE	722210	$53,748	$53,748

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$60,051	TotalRevenueColumnAmt
Related Or Exempt Func Income	$43,198	RelatedOrExemptFuncIncomeAmt
Exclusion	$16,853	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$424,369	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$23,809,994	TotalRevenueColumnAmt
Related Or Exempt Func Income	$22,930,695	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$666,605	UnrelatedBusinessRevenueAmt
Exclusion	$177,817	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$2,800	TotalAmt
Program Services	$2,800	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$278,334	TotalAmt
Program Services	$154,337	ProgramServicesAmt
Management And General	$123,997	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$37,519	TotalAmt
Program Services	$37,519	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$9,655,965	TotalAmt
Program Services	$8,473,946	ProgramServicesAmt
Management And General	$1,182,019	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$457,054	TotalAmt
Program Services	$397,193	ProgramServicesAmt
Management And General	$59,861	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,557,982	TotalAmt
Program Services	$1,353,932	ProgramServicesAmt
Management And General	$204,050	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$734,953	TotalAmt
Program Services	$638,696	ProgramServicesAmt
Management And General	$96,257	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$69,304	TotalAmt
Management And General	$69,304	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$3,011	TotalAmt
Management And General	$3,011	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$56,218	TotalAmt
Management And General	$56,218	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$4,702,323	TotalAmt
Program Services	$3,666,990	ProgramServicesAmt
Management And General	$1,035,333	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$76,876	TotalAmt
Program Services	$75	ProgramServicesAmt
Management And General	$76,801	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,260,649	TotalAmt
Program Services	$1,175,087	ProgramServicesAmt
Management And General	$85,562	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$641,862	TotalAmt
Program Services	$578,345	ProgramServicesAmt
Management And General	$63,517	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$591,543	TotalAmt
Program Services	$509,015	ProgramServicesAmt
Management And General	$82,528	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$65,240	TotalAmt
Program Services	$55,454	ProgramServicesAmt
Management And General	$9,786	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$796,096	TotalAmt
Program Services	$685,030	ProgramServicesAmt
Management And General	$111,066	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,754,637	TotalAmt
Program Services	$1,509,842	ProgramServicesAmt
Management And General	$244,795	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$323,378	TotalAmt
Program Services	$309,763	ProgramServicesAmt
Management And General	$13,615	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
UNCOLLECTIBLE EXPENSE	$1,553,601	$1,553,601
MEDICAL SUPPLIES	$1,277,933	$1,277,933
BOOKS, LICENSES, DUES	$144,769	$29,164	$115,605
MISCELANEOUS	$3,394	$3,061	$333

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$92	TotalAmt
Program Services	$55	ProgramServicesAmt
Management And General	$37	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$26,045,533	TotalAmt
Program Services	$22,411,838	ProgramServicesAmt
Management And General	$3,633,695	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,420	BOYAmt
EOY	$1,470	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,594,442	BOYAmt
EOY	$1,445,247	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$2,229,325	BOYAmt
EOY	$2,030,239	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$252,192	BOYAmt
EOY	$297,429	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$152,857	BOYAmt
EOY	$245,299	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$37,857,667	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$27,352,387	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$12,288,427	BOYAmt
EOY	$10,505,280	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$4,302,596	BOYAmt
EOY	$5,469,323	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$20,821,259	BOYAmt
EOY	$19,994,287	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$4,334,478	BOYAmt
EOY	$5,658,374	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
EOY	$152,292	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$13,682,329	BOYAmt
EOY	$13,908,806	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$5,309,337	BOYAmt
EOY	$4,269,098	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$23,326,144	BOYAmt
EOY	$23,988,570	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$2,564,809	BOYAmt
EOY	-$4,011,402	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$59,924	BOYAmt
EOY	$17,119	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	-$2,504,885	BOYAmt
EOY	-$3,994,283	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$20,821,259	BOYAmt
EOY	$19,994,287	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$2,235,539	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$746,141	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	false	FSAuditedInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$3,011	OtherActivitiesAmt
Total Lobbying Expenditures	$3,011	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$154,956	OtherCostOrOtherBasisAmt
Book Value	$154,956	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$18,106,028	OtherCostOrOtherBasisAmt
Depreciation	$9,267,726	DepreciationAmt
Book Value	$8,838,302	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$96,900	OtherCostOrOtherBasisAmt
Depreciation	$70,114	DepreciationAmt
Book Value	$26,786	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$18,824,245	OtherCostOrOtherBasisAmt
Depreciation	$17,643,926	DepreciationAmt
Book Value	$1,180,319	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$675,538	OtherCostOrOtherBasisAmt
Depreciation	$370,621	DepreciationAmt
Book Value	$304,917	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$10,505,280	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
DUE TO AFFILIATES	$5,281,749
OTHER RECEIVABLES	$102,158
INVESTMENT CHART	$85,416

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$5,469,323	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
ACCRUED PENSION COST	$3,843,273
THIRD PARTY SETTLEMENTS	$425,825

Field	Value	IRS element (for citing)
Total Liability	$4,269,098	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE D, PAGE 4, PART XIII	FormAndLineReferenceDesc
Explanation	SCHEDULE D, PART X, LINE 2 - THE ORGANIZATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2016 AND 2015. THE ORGANIZATION'S FORM 990 RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX AND FORM 990T EXEMPT ORGANIZATION BUSINESS TAX RETURN FOR THE YEARS ENDED PRIOR TO JUNE 30, 2015 ARE NO LONGER SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent250	Yes (X)	Percent250Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	false	FinancialAssistanceBudgetInd
Annual Community Bnft Report	false	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$101,913	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$101,913	NetCommunityBenefitExpnsAmt
Total Expense	0.00390	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,970,380	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,229,530	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,740,850	NetCommunityBenefitExpnsAmt
Total Expense	0.06680	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,072,293	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,229,530	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,842,763	NetCommunityBenefitExpnsAmt
Total Expense	0.07080	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,072,293	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,229,530	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,842,763	NetCommunityBenefitExpnsAmt
Total Expense	0.07080	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,553,601	BadDebtExpenseAmt
Reimbursed By Medicare	$3,780,952	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$5,628,381	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,847,429	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GEISINGER JERSEY SHORE HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1020 THOMPSON STREET	AddressLine1Txt
City	JERSEY SHORE	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	17740	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.JSH.ORG	WebsiteAddressTxt
State License	101401	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	GEISINGER JERSEY SHORE HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Other	Yes (X)	OtherInd
CHNA Conducted	16	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.JSH.ORG	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.JSH.ORG	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	250.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	WWW.JSH.ORG/FINANCIALASSISTANCE.PHP	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW.JSH.ORG/FINANCIALASSISTANCE.PHP	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	WWW.JSH.ORG/FINANCIALASSISTANCE.PHP	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FACILITY 1, GEISINGER JERSEY SHORE HOSPITAL - PART V, LINE 3J	THE RESPONSE TO QUESTION 3J INCLUDES DESCRIPTIONS RELATED TO QUESTIONS 3A THROUGH 3H. SCHEDULE H, PART V, SECTION B, LINE 3A-DEFINITION OF COMMUNITY: GEISINGER JERSEY SHORE HOSPITAL (GJSH) IN CONJUNCTION WITH QUORUM DEFINES ITS SERVICE ARE AS CLINTON AND LYCOMING COUNTIES IN PENNSYLVANIA. IN 2014, THE HOSPITAL RECEIVED 85% OF ITS PATIENTS FROM THIS AREA. SCHEDULE H, PART V, SECTION B, LINE 3B-DEMOGRAPHICS OF THE COMMUNITY: 2016 POPULATION WAS 155,153 OF WHICH WHITE, NON-HISPANIC COMPRISED 91.7%, AND BLACK, NON-HISPANIC COMPRISED 3.9%; THE MEDIAN AGE WAS 40.2; THE POPULATION LESS THAN AGE 65 WAS 18.2%; 18.8% OF THE POPULATION WERE WOMEN OF CHILDBEARING AGE. THE MEDIAN HOUSEHOLD INCOME WAS 49,146; THE UNEMPLOYMENT RATE WAS 5.5%. SCHEDULE H, PART V, SECTION B, LINE 3C-FACILITIES AND RESOURCES AVAILABLE TO RESPOND TO THE HEALTH NEEDS OF THE COMMUNITY INCLUDE: SUSQUEHANNA HEALTH, LYCOMING & CLINTON COUNTIES MENTAL HEALTH / INTELLECTUAL DISABILITIES PROGRAM, THE MEADOWS, MOUNT NITTANY HEALTH SYSTEM, GEISINGER, SUSAN G KOMEN FOUNDATION, AMERICAN CANCER SOCIETY, CANCER CARE OF CENTRAL PA, AND CANCER CENTERS OF AMERICAN. SCHEDULE H, PART V, SECTION B, LINE 3D-HOW DATA WAS OBTAINED: MOST DATA USED IN THE ANALYSIS IS AVAILABLE FROM PUBLIC INTERNET SOURCES AND QUORUM PROPRIETARY DATA FROM TRUVEN. ANY CRITICAL DATA NEEDED TO ADDRESS SPECIFIC REGULATIONS OR DEVELOPED BY THE LOCAL EXPERT ADVISOR INDIVIDUALS COOPERATING WITH US IN THE STUDY ARE AS FOLLOWS: - WWW.COUNTYHEALTHRANKINGS.ORG FOR ASSESSMENT OF HEALTH NEEDS OF CLINTON COUNTY AND WESTERN LYCOMING COUNTY COMPARED TO ALL STATE COUNTIES. - WWW.COMMUNITYHEALTH.HHS.GOV FOR ASSESSMENT OF HEALTH NEEDS OF CLINTON COUNTY AND WESTERN LYCOMING COUNTY COMPARED TO ITS NATIONAL SET OF 'PEER COUNTIES'. - TRUVEN MARKET (FORMERLY KNOWN AS THOMPSON) TO ASSESS CHARACTERISTICS OF THE HOSPITAL'S PRIMARY SERVICE AREA, AT A ZIP CODE LEVEL BASED ON CLASSIFYING THE POPULATION INTO VARIOUS SOCIO-ECONOMIC GROUPS, DETERMINING THE HEALTH AND MEDICAL TENDENCIES OF EACH GROUP AND CREATING AN AGGREGATE COMPOSITION OF THE SERVICE AREA ACCORDING TO THE PROPORTION OF EACH GROUP IN THE ENTIRE AREA; AND, TO ACCESS POPULATION SIZE, TRENDS, AND SOCIO-ECONOMIC CHARACTERISTICS. - WWW.CAPC.ORG AND WWW.GETPALLIATIVE.ORG TO IDENTIFY THE AVAILABILITY OF PALLIATIVE CARE PROGRAMS AND SERVICES IN THE AREA. - WWW.CARINGINFO.ORG AND IWEB.NHPCO.ORG TO IDENTIFY THE AVAILABILITY OF HOSPICE PROGRAMS IN THE COUNTY. - WWW.HEALTHMETRICSANDEVALUATION.ORG TO EXAMINE THE PREVALENCE OF DIABETIC CONDITIONS AND CHANGE IN LIFE EXPECTANCY. SCHEDULE H, PART V, SECTION B, LINE 3E-SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY: PRIORITY RANKING OF AREA HEALTH NEEDS BY LOCAL EXPERT ADVISORS WERE USED TO ORGANIZE THE SEARCH FOR LOCALLY AVAILABLE RESOURCES AS WELL AS THE GJSH RESPONSE TO THE NEEDS. A LIST WAS DEVELOPED WHICH IDENTIFIED THE RANK ORDER OF EACH SIGNIFICANT NEED, THE FACTORS CONSIDERED IN DEVELOPING THE RANKING, A PROBLEM STATEMENT TO SPECIFY THE PROBLEM INDICATED BY USE OF THE SIGNIFICANT NEED TERM, GJSH CURRENT EFFORTS RESPONDING TO THE NEED INCLUDING ANY WRITTEN COMMENTS RECEIVED REGARDING PRIOR GJSH IMPLEMENTATION ACTIONS, THE IMPLEMENTATION STRATEGY PROGRAMS AND RESOURCES GJSH WILL DEVOTE TO ATTEMPT TO ACHIEVE IMPROVEMENTS, DOCUMENTS THE LEADING INDICATORS GJSH WILL USE TO MEASURE PROGRESS, PRESENTS THE LAGGING INDICATORS GJSH BELIEVES THE LEADING INDICATORS WILL INFLUENCE IN A POSITIVE FASHION, AND PRESENTS THE LOCALLY AVAILABLE RESOURCES NOTED DURING THE DEVELOPMENT OF THIS REPORT AS BELIEVED TO BE CURRENTLY AVAILABLE TO RESPOND TO THIS NEED. SCHEDULE H, PART V, SECTION B, LINE 3F-PRIMARY AND CHRONIC DISEASE NEEDS AND OTHER HEALTH ISSUES: INFORMATION ANALYSIS AUGMENTED BY LOCAL OPINIONS SHOWED HOW CLINTON COUNTY AND WESTERN LYCOMING COUNTY RELATE TO PEERS IN TERMS OF PRIMARY AND CHRONIC NEEDS AND OTHER ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS AND MINORITY GROUPS, RESPONDENTS COMMENTED ON WHETHER THEY BELIEVE CERTAIN POPULATION GROUPS ("PRIORITY POPULATIONS") NEED HELP TO IMPROVE THEIR CONDITION, AND IF SO, WHO NEEDS TO DO WHAT TO IMPROVE THE CONDITIONS OF THE GROUPS. SCHEDULE H, PART V, SECTION B, LINE 3G-PROCESS OF IDENTIFYING AND PRIORITIZING COMMUNITY HEALTH NEEDS: LOCAL EXPERTS OFFERING SOLICITED WRITTEN COMMENTS ON 2013 PRIORITIES AND IMPLEMENTATION SURVEY. THEY RANKED THE FOLLOWING : PUBLIC HEALTH EXPERTISE, DEPARTMENTS AND AGENCIES WITH RELEVANT DATA/INFORMATION REGARDING HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL, PRIORITY POPULATIONS, REPRESENTATIVE/MEMBER OF CHRONIC DISEASE GROUP OR ORGANIZATION, AND REPRESENTS THE BROAD INTEREST OF THE COMMUNITY SCHEDULE H, PART V, SECTION B, LINE 3H-PROCESS FOR CONSULTING WITH PERSONS REPRESENTING THE COMMUNITY'S INTERESTS: THE FINAL REGULATIONS PROVIDE THAT CHNA (COMMUNITY HEALTH NEEDS ASSESSMENT) REPORT DOES NOT NEED TO NAME OR OTHERWISE IDENTIFY ANY SPECIFIC INDIVIDUAL PROVIDING INPUT ON THE CHNA, WHICH WOULD INCLUDE THAT PROVIDED BY INDIVIDUALS IN THE FORM OF WRITIEN COMMENTS. THE "LOCAL EXPERT" IS AN ADVISORY GROUP OF AT LEAST 15 LOCAL RESIDENTS, INCLUSIVE OF AT LEAST ONE MEMBER SELF-IDENTIFYING WITH EACH OF THE FIVE QUORUM HEALTH RESOURCES WRITTEN COMMENT SOLICITATION CLASSIFICATIONS, WITH WHOM THE HOSPITAL SOLICITED TO PARTICIPATE IN QUORUM HEALTH RESOURCES/HOSPITAL CHNA PROCESS.
FACILITY 1, GEISINGER JERSEY SHORE HOSPITAL - PART V, LINE 5	SCHEDULE H, PART V, SECTION B, LINE 5- HAVING TAKEN THE STEPS TO IDENTIFY POTENTIAL COMMUNITY NEEDS, THE LOCAL EXPERTS THEN PARTICIPATED IN A STRUCTURED COMMUNICATION TECHNIQUE CALLED A "WISDOM OF CROWDS" METHOD. THE PREMISE OF THIS APPROACH RELIES ON A PANEL OF EXPERTS WITH THE ASSUMPTION THAT THE COLLECTIVE WISDOM OF PARTICIPANTS IS SUPERIOR TO THE OPINION OF ANY ONE INDIVIDUAL, REGARDLESS OF THEIR PROFESSIONAL CREDENTIALS. GJSH SOLICITED WRITTEN COMMENTS ABOUT ITS 2012 CHNA 16 INDIVIDUALS RESPONDED TO THE REQUEST FOR COMMENTS.
FACILITY 1, GEISINGER JERSEY SHORE HOSPITAL - PART V, LINE 6A	GEISINGER JERSEY SHORE HOSPITAL PARTNERED WITH QUORUM HEALTH RESOURCES (QHR).
FACILITY 1, GEISINGER JERSEY SHORE HOSPITAL - PART V, LINE 11	SCHEDULE H, PART V, SECTION B, LINE 11-GJSH DEVELOPED AN IMPLEMENTATION STRATEGY FOR CANCER, OBESITY/OVERWEIGHT, HEART DISEASE, AND EDUCATION/ PREVENTION. THE STRATEGIES INCLUDE ACTIVITIES TO CONTINUE/PURSUE, COMMUNITY PARTNERS TO WORK ALONGSIDE, AND LEADING AND LAGGING INDICATORS TO TRACK. GJSH IS NOT PLANNING TO ADDRESS MENTAL HEALTH/SUBSTANCE ABUSE AT THIS TIME DUE TO RESOURCE CONSTRAINTS, RELATIVE LACK OF EXPERIENCE/COMPETENCY TO EFFECTIVELY ADDRESS THE NEED, AND THE AVAILABILITY OF OTHER RESOURCES TO ADDRESS THE NEED, SUCH AS SUSQUEHANNA HEALTH, LYCOMING & CLINTON COUNTIES MHID SERVICES, THE MEADOWS, MOUNT NITTANY HEALTH SYSTEM, AND GEISINGER. IT IS BELIEVED THAT THE COMMUNITY WILL SEE MORE BENEFIT IF TIME AND RESOURCS ARE DEVOTED TO THE FOURS NEEDS BEING ADDRESSED.
FACILITY 1, GEISINGER JERSEY SHORE 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 JERSEY SHORE HOSPITAL - PART V, LINE 16J	SCHEDULE H, PART V, SECTION B, LINE 16J: THE POLICY IS REFERENCED ON INVOICES AND VERBALLY DISCUSSED WITH PATIENTS, AND REGISTRATION PERSONNEL REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY IN ADDITION, THE FAP, FAP APPLICATION, AND A PLAIN LANGUAGE SUMMARY OF THE FAP ARE WIDELY AVAILABLE AT HTTP://WWW.JSH.ORG/FINANCIALASSISTANCE.PHP
FACILITY 1, GEISINGER JERSEY SHORE HOSPITAL - PART V, LINE 20E	UNDER NO CIRCUMSTANCE WILL GJSH 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 GJSH'S FINANCIAL ASSISTANCE PROGRAM.

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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. GEISINGER JERSEY SHORE HOSPITAL (GJSH) MAY ALSO UTILIZE INDUSTRY TESTED EXTERNAL ANALYTICS TOOLS TO QUALIFY PATIENTS FOR UNCOMPENSATED CARE (AKA PRESUMPTIVE CHARITY).
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 TO CHARGE RATIO, CALCULATED PURSUANT TO WORKSHEET 2 OF THE FORM 990 INSTRUCTIONS, WAS USED TO CALCULATE THE COST OF SERVICES REPORTED ON LINE 7.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY	BAD DEBT EXPENSE IS CALCULATED BASED ON ACTUAL WRITE-OFFS THROUGHOUT THE YEAR AND IS ESTIMATED AT COST USING THE RATIO OF PATIENT CARE COST TO CHARGE. PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT NET REALIZABLE VALUE. ACCOUNTS ARE WRITTEN OFF WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE BASED UPON MANAGEMENT'S ASSESSMENT OF INDIVIDUAL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUAL AMOUNTS DUE AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS. THE CORPORATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCES, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE BILLED RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. BAD DEBT EXPENSE IS BASED ON THE NECESSARY ALLOWANCE AT THE END OF EACH MONTH. PATIENT DISCOUNTS ARE NOT INCLUDED IN THE ALLOWANCE FOR BAD DEBT.
PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE	THE HOSPITAL IS DILIGENT IN THE CLASSIFICATION OF AMOUNTS AS CHARITY CARE OR BAD DEBT. WE BELIEVE NONE OF THE AMOUNTS IN BAD DEBT WOULD BE RECLASSIFIED TO CHARITY CARE GIVEN ADDITIONAL INFORMATION.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS	GJSH DID NOT HAVE AN AUDIT OF ITS FY2017 FINANCIAL STATEMENTS.
PART III, LINE 8 - MEDICARE EXPLANATION	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. DEVELOPED IN REVENUE RULING 69-545, UNDER THE COMMUNITY BENEFIT STANDARD, HOSPITALS WERE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF 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") HOLDS THE POSITION THAT MEDICARE UNDERPAYMENTS (SHORTFALLS) AND BAD DEBT SHOULD BE REPORTED AS COMMUNITY BENEFIT ON FORM 990, SCHEDULE H, PART I, LINE 7. IN A 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 LIKE GEISINGER JERSEY SHORE HOSPITAL (GJSH) 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 ALLOWED TO BE REPORTED ON GJSH'S MEDICARE COST REPORT THAT ARE REQUIRED TO BE FILED WITH THE FEDERAL GOVERNMENT. GJSH CONSIDERS THE TOTAL MEDICARE UNDERPAYMENTS (SHORTFALL) OF 2,101,612 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 GJSH TO USE OTHER FUNDS TO COVER THE SHORTFALL. MEDICARE SHORTFALLS MUST BE ABSORBED BY GJSH IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. MEDICARE SHORTFALLS MUST BE ABSORBED BY GJSH IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. GJSH 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 MEDICARE PATIENTS WOULD BE ELIGIBLE FOR CHARITY CARE OR OTHER NEEDS BASED GOVERNMENT PROGRAMS. THE AMOUNT EXPENDED TO COVER THE SHORTFALL IS MONEY NOT AVAILABLE FOR FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. BOTH GJSH 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 GJSH'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 THE CBO REPORT, ROUGHLY 40% OF BAD DEBT IS PENDING 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 AHS, 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' SHOULDER 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.
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION	COLLECTIONS ARE PURSUED UP TO THE POINT THAT A PATIENT COMPLETES AND IS APPROVED FOR CHARITY CARE. ONCE CHARITY CARE IS APPROVED, NO FURTHER COLLECTION EFFORTS ARE MADE. GJSH IS COMMITTED TO PROVIDING MEDICAL NECESSARY SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND GSJH'S COLLECTION ACTIONS ARE CONSISTENTLY APPLIED TO ALL PATIENTS. IT IS GJSH 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 GJSH 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 GJSHBH'S FINANCIAL ASSISTANCE PROGRAM.
PART VI, LINE 2 - NEEDS ASSESSMENT	GEISINGER JERSEY SHORE HOSPITAL PERFORMED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO DETERMINE THE HEALTH NEEDS OF THE LOCAL COMMUNITY, DEVELOP AN IMPLEMENTATION PLAN TO OUTLINE AND ORGANIZE HOW TO MEET THOSE NEEDS AND FULFILL FEDERAL REQUIREMENTS. DATA WAS GATHERED FROM MULTIPLE WELL-RESPECTED SECONDARY SOURCES TO BUILD AN ACCURATE PICTURE OF THE CURRENT COMMUNITY AND HEALTH NEEDS. A SURVEY OF A SELECT GROUP OF LOCAL EXPERTS WAS PERFORMED TO REVIEW THE PRIOR CHNA, PROVIDE FEEDBACK, AND TO ASCERTAIN WHETHER THE PREVIOUSLY IDENTIFIED NEEDS ARE STILL PRIORITY. A SECOND SURVEY WAS DISTRIBUTED TO THE SAME GROUP THAT REVIEWED THE DATA GATHERED FROM THE SECONDARY SOURCES AND DETERMINED THE SIGNIFICANT NEEDS OF THE COMMUNITY. THE SIGNIFICANT HEALTH NEEDS FOR CLINTON COUNTY AND LYCOMING COUNTY WERE MENTAL HEALTH/SUBSTANCE ABUSE, CANCER, OBESITY/OVERWEIGT, HEART DISEASE, EDUCATION/PREVENTION. THE HOSPITAL DEVELOPED IMPLEMENTATION STRATEGIES FOR FOUR OF THE FIVE NEEDS, INCLUDING CANCER, OBESITY/OVER WEIGHT, HEART DISEASE, AND EDUCATION/PREVENTION. THE STRATEGIES INCLUDE ACTIVITIES TO CONTINUE/PURSUE, COMMUNITY PARTNERS TO WORK ALONGSIDE, AND LEADING AND LAGGING INDICATORS TO TRACK. THE HOSPITAL IS NOT PLANNING TO ADDRESS MENTAL HEALTH/SUBSTANCE ABUSE AT THIS TIME DUE TO RESOURCE CONSTRAINTS, RELATIVE LACK OF EXPERTISE/COMPETENCY TO EFFECTIVELY ADDRESS THE NEED, AND THE AVAILABILITY OF OTHER RESOURCES TO ADDRESS THE NEED. IT IS BELIEVED THAT THE COMMUNITY WILL SEE MORE BENEFIT IF TIME AND RESOURCES ARE DEVOTED TO THE OTHER FOUR NEEDS.
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 200% OR LESS OF THE FEDERAL POVERTY GUIDELINES. IT IS GJSH 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 GJSH'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 GJSH'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES CAN ALSO BE FOUND HTTP://WWW.JSH.ORG/FINANCIALASSISTANCE.PHP . PATIENTS ARE ALSO PROVIDED INFORMATION ON GJSH'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES WITH EACH PATIENT BILL.
PART VI, LINE 4 - COMMUNITY INFORMATION	GEISINGER JERSEY SHORE HOSPITAL'S (GJSH) PRIMARY SERVICE AREA(PSA)COVERS EASTERN CLINTON COUNTY, AND WESTERN LYCOMING COUNTY, AN AREA WITH POPULATION OF APPROXIMATELY 42,000. THE PSA FOR GJSH CONSISTS OF FIVE ZIP CODES: 17721-AVIS,17740-JERSEY SHORE, 17745-LOCK HAVEN, 17779-WOOLRICH AND 17151-MILL HALL. GJSH'S SERVICE AREA IS CONSIDERED TO BE A MEDICALLY UNDERSERVED AREA (MUA). JERSEY SHORE AND GEISINGER JERSEY SHORE HOSPITAL ARE LOCATED IN LYCOMING COUNTY, WHICH HAS AN AREA OF 1,244 SQUARE MILES. IT IS THE LARGEST COUNTY IN PENNSYLVANIA AND OCCUPIES A HILLY AND HEAVILY FORESTED PART OF THE STATE. THE WEST BRANCH OF THE SUSQUEHANNA RIVER FLOWS THROUGH THE SOUTHERN PART OF THE COUNTY. JERSEY SHORE IS APPROXIMATELY 45 MILES NORTHEAST OF STATE COLLEGE, PENNSYLVANIA AND APPROXIMATELY 15 MILES WEST OF WILLIAMSPORT, PENNSYLVANIA. ABOUT SIXTEEN PERCENT (16%) OF INPATIENT STAYS IN THE PSA OCCUR AT GEISINGER JERSEY SHORE HOSPITAL. ABOUT FORTY PERCENT(40%) OF OUTPATIENT VISITS IN THE PSA OCCUR AT GEISINGER JERSEY SHORE HOSPITAL. JERSEY SHORE HOSPITAL RELIES UPON A RELATIVELY SMALL GEOGRAPHIC AREA TO SUPPORT THE HOSPITAL. THE SECONDARY SERVICE AREA (SSA) CONSISTS OF 20 ADDITIONAL ZIP CODES WHICH ARE IMPORTANT TO THE HOSPITAL. THESE ZIP CODES ARE PRIMARILY TO THE WEST AND NORTH OF THE PSA. ABOUT TWO PERCENT (2%) OF INPATIENT STAYS IN THE SSA OCCUR AT GEISINGER JERSEY SHORE HOSITPAL. ABOUT ELEVEN (11%) PERCENT OF OUTPATIENT VISITS IN THE SSA OCCUR AT GEISINGER JERSEY SHORE HOSPITAL. WITHIN THE PSA, THE TOTAL POPULATION IS EXPECTED TO INCREASE BY 1% BY 2019. A MAJOR DEMOGRAPHIC ISSUE AFFECTING GEISINGER JERSEY SHORE HOSPITAL IS THE AGING POPULATION. THE NUMBER OF INDIVIDUALS LIVING IN THE PSA OVER THE AGE OF 65 IS EXPECTED TO INCREASE 13.7% BY 2019. THIS AGE GROUP CURRENTLY MAKES UP OVER 16% OF THE POPULATION IN THE PSA COMPARED TO ABOUT 14% FOR THE U.S. THIS GROWING ELDERLY SEGMENT SHOULD GENERATE A FUTURE DEMAND FOR HEALTH CARE SERVICES. SINCE INDIVIDUALS OVER AGE 65 USE HEALTHCARE AND HOSPITAL SERVICES 2.7 TIMES THE RATE OF THE UNDER AGE 65 POPULATION. A DEMOGRAPHIC REALITY IS THE LOW INCOME LEVEL OF AREA HOUSEHOLDS. CURRENTLY, THE MEDIAN HOUSEHOLD INCOME IN THE PSA IS 47,303 COMPARED TO PA, 53,115, AND THE U.S., 53,482. THE MEDIAN HOUSEHOLD INCOME IN THE SSA IS 41,085. THE SERVICE AREA IS NOT RACIALLY DIVERSIFIED TO A SIGNIFICANT DEGREE, WITH 98.6% OF THE POPULATION CONSIDERED WHITE. THE EDUCATIONAL PROFILE OF THE SERVICE AREA DEMONSTRATES THAT 40.8% OF THE POPULATION HAS A HIGH SCHOOL EDUCATION AND 9.4% OF THE POPULATION HAS AN ASSOCIATES DEGREE. THE PERCENTAGE ACHIEVING A BACHELOR OR PROFESSIONAL DEGREE IS 11.6% WHICH IS LESS THAN PENNSYLVANIA OR THE U.S. AS A WHOLE. A HIGHER PERCENTAGE OF THE LABOR FORCE IN THE AREA IS ENGAGED IN MANUFACTURING/CONSTRUCTION WHEN COMPARED TO THE STATE AND U.S. AS A WHOLE. IN TERMS OF PATIENTS SERVED, COMBINED INPATIENT AND OUTPATIENT PAYER MIX IN 2014 REMAINED FAIRLY CONSISTENT. MEDICARE AND MEDICARE ADVANTAGE MAKE UP ABOUT 44% OF OUR PAYERS IN TERMS OF GROSS CHARGES. MEDICAL ASSISTANCE BUSINESS CONTINUED TO HAVE A SIGNIFICANT IMPACT ON JERSEY SHORE HOSPITAL AS A CRITICAL ACCESS HOSPITAL. MEDICAL ASSISTANCE CHARGES ACCOUNT FOR ABOUT 11% OF OUR PAYERS. SELF-PAY CHARGES ACCOUNTED FOR ABOUT 4% OF OUR PAYORS.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	ALL OF THE PERSONS SERVING ON OUR BOARD LIVE IN THE PRIMARY COMMUNITIES BEING SERVED BY THE HOSPITAL. THE BOARD CONSISTS OF SOME PHYSICIANS WHO ARE EMPLOYEES OF A RELATED ENTITY, A FEW CONTRACTORS, AND SEVERAL OTHER COMMUNITY MEMBERS. THE HOSPITAL EXTENDS STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE AREA. AS APPLICABLE, THE HOSPITAL APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE THROUGH NEW AND UPDATED EQUIPMENT, MAJOR FACILITY IMPROVEMENTS, AND COMMUNITY HEALTH PROGRAMS. THE HOSPITAL PARTICIPATES IN MEDICARE, MEDICAID, CHAMPUS, AND TRICARE. SEE THE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS/COMMUNITY BENEFIT REPORTED IN SCHEDULE O.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM	THE HOSPITAL IS PART OF GEISINGER JERSEY SHORE HOSPITAL FOUNDATION, INC. THIS AFFILIATION INCLUDES A NON-PROFIT PHYSICIAN PRACTICE WITH FAMILY PRACTICE PHYSICIANS AND SURGEONS, AS WELL AS AN URGENT CARE CENTER.
ADDITIONAL INFORMATION	PART VI, LINE 7: FORM 990, SCHEDULE H, PART VI, LINE 7, STATE FILING OF COMMUNITY BENEFIT REPORT: AT THIS TIME, GEISINGER JERSEY SHORE HOSPITAL AND ITS AFFILIATES ARE NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt
STEPHEN GOYKOVICH DO
MEDICAL STAFF PRES.	$6,000	$170,900	$28,952	$198	$5,034	$7,829	$6,000	$212,913
PAULETTE NISH
CHIEF NURSING OFFICE	$150,010						$152,468		$381	$2,077
THEORDORE FEDEROFF DO
PHYSICIAN	$293,528						$321,163		$45	$3,702	$23,888
CHRISTINE HAAS
CIO	$133,960						$150,411		$69	$4,124	$12,258
RONALD N EISTER MD
FORMER 5 HIGHEST		$148,770		$198	$4,597	$15,669		$169,234

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	MARY HOLLICK	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	FAMILY MEMBER	RelationshipDescriptionTxt
Transaction	$37,519	TransactionAmt
Transaction	EMPLOYEE COMPENSAT.	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE L, PART V	FormAndLineReferenceDesc
Explanation	MARY HOLLICK IS A FAMILY MEMBER OF JAMES ELY, AN OFFICER AND DIRECTOR OF GEISINGER JERSEY SHORE HOSPITAL.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PAGE 2, PART III, LINE 4A	AS A RURAL HEALTHCARE FACILITY AND DEDICATED COMMUNITY HOSPITAL WITH A COMMITMENT TO PROVIDING A HIGH QUALITY CIRCLE OF CARE, GEISINGER JERSEY SHORE HOSPITAL (GJSH) DEVELOPED DELIVERY SYSTEMS THAT PROVIDE AN EFFICIENT BALANCE OF OUTPATIENT CARE, ACUTE AND SUB-ACUTE INPATIENT CARE, PRIMARY CARE, AND OUTREACH SERVICES. THE HOSPITAL MAXIMIZES THE EFFECTIVENESS OF ITS PROGRAMS FOR QUALITY, EFFICIENCY, AND ACCESSIBILITY BY INTEGRATING WITH OTHER PROVIDERS AND ALTERNATIVE CARE ORGANIZATIONS IN THE SERVICE AREA TO ASSURE COMMUNITY ACCESS TO A BROAD ARRAY OF SERVICE OPTIONS. THE HOSPITAL PROVIDES AN ENVIRONMENT OF CARE THAT IS COMPASSIONATE, HIGHLY-PERSONALIZED, ANO FOCUSED ON THE PHYSICAL, PSYCHO-SOCIAL, AND SPIRITUAL NEEDS OF ITS PATIENTS THROUGH THE USE OF SKILLED NURSES, PHYSICIANS, TECHNICAL AND SUPPORT STAFF, MANAGEMENT, AND COMMUNITY LEADERS. THE HOSPITAL ALSO PROVIDES HEALTH EDUCATION, PROGRAMS IN PREVENTION, AND RELATED SUPPORT SERVICES TO THE COMMUNITY WITH THE GOAL OF IMPROVING THE OVERALL WELLNESS OF ITS RESIDENTS. THE HOSPITAL ENSURES THAT THE NECESSARY RESOURCES ARE AVAILABLE TO PROVIDE THE MOST COST EFFECTIVE MANNER WHILE MAINTAINING A SAFE, PLEASANT, AND MEANINGFUL WORK AND PATIENT CARE ENVIRONMENT. UNCOMPENSATED CARE GEISINGER JERSEY SHORE HOSPITAL RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. GJSH PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD, GJSH PROVIDES FREE CARE OR SUBSIDIZED CARE, TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST, AND PROVIDES VARIOUS HEALTH ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITIES WHERE GJSH PRACTICES. A. CHARITY CARE THE PRIMARY CONCERN OF GJSH IS THE DELIVERY OF HEALTH CARE TO ALL THE CITIZENS IN ITS PENNSYLVANIA SERVICE AREA, REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GJSH INCURRED BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO COULD NOT AFFORD TO PAY. FOR FISCAL YEAR ENDED JUNE 30, 2017, THE COST OF CHARITY CARE WAS 101,913. B. MEDICARE/MEDICAID RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO THE ELDERLY (MEDICARE) AND THE POOR (MEDICAID). GJSH PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS. TO THE EXTENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTHCARE, GJSH IS FURTHERING ITS MISSION TO THE ENTIRE COMMUNITY. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT OF REIMBURSEMENT RECEIVED UNDER THE PROGRAM. FOR FISCAL YEAR ENDED JUNE 30, 2017, THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 3,588,279. C. OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GJSH PROVIDES OTHER PATIENT SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2017, WAS 627,406. COMMUNITY BENEFITS SUMMARY MEDICARE/MEDICAID/OTHER GOVERNMENTAL 3,588,279 CHARITY CARE 101,913 OTHER UNCOMPENSATED CARE 627,406 TOTAL 4,317,598 STATISTICAL SUMMARY FISCAL YEAR ENDED JUNE 30, 2017 DISCHARGES 603 OUTPATIENT VISITS (INCLUDING ER VISITS) 75,881 URGENT CARE VISITS 15,613 PATIENT DAYS 2,248 TOTAL OR PROCEDURES 948 AVAILABLE BEDS 25
FORM 990, PART VI	THE PRESIDENT/CEO, DAVID SHANNON, IS AN EMPLOYEE OF QUORUM HEALTH RESOURCES (QUORUM), A MANAGEMENT COMPANY. GEISINGER JERSEY SHORE HOSPITAL PAYS QUORUM FOR THE PRESIDENT/CEO'S SALARY. THE COMPENSATION PAID FOR CALENDAR YEAR 2016 WAS 311,279.
FORM 990, PAGE 6, PART VI, LINE 3	THE GEISINGER JERSEY SHORE HOSPITAL UTILIZED THE MANAGEMENT SERVICES OF QUORUM HEALTH RESOURCES DURING THE FISCAL YEAR ENDED JUNE 30, 2017. THE ORGANIZATION'S PRESIDENT, AND CHIEF EXECUTIVE OFFICER, DAVID A. SHANNON WAS COMPENSATED BY QUORUM HEALTH RESOURCES. GEISINGER JERSEY SHORE HOSPITAL PAID QUORUM HEALTH RESOURCES 311,279 DURING CALENDAR YEAR 2016 FOR THE PRESIDENT AND CHIEF EXECUTIVE OFFICER'S SERVICES.
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 GEISINGER JERSEY SHORE HOSPITAL 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.
FORM 990, PAGE 6, PART VI, LINE 12C	ALL BOARD MEMBERS AND EMPLOYEES OF GEISINGER JERSEY SHORE HOSPITAL (GJSH) ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST STATEMENT. THE OFFICE OF THE CEO MONITORS THE PROCESS AND COMPLETION OF THE STATEMENTS. THE COMPLETED STATEMENTS ARE REVIEWED BY MANAGEMENT. BOARD MEMBERS ARE REQUIRED TO RECUSE THEMSELVES FROM VOTING ON MATTERS THAT ARE RELATED TO ANY POTENTIAL CONFLICTS. GJSH HAS NEVER HAD AN ISSUE INVOLVING CONFLICTS OF INTEREST. EFFECTIVE JULY 1, 2017, GJSH WAS ACQUIRED GEISINGER AND BEGAN FOLLOWING GEISINGER'S CONFLICTS OF INTEREST PROCESS. THE GJSH OFFICERS AND DIRECTORS ARE SUBJECT TO THE GEISINGER CONFLICT OF INTEREST POLICY FOR DIRECTORS, OFFICERS AND SENIOR LEADERS (MAY INCLUDE INDEPENDENT CONTRACTORS). AT LEAST ONCE EACH YEAR DIRECTORS, OFFICERS, KEY EMPLOYEES, SENIOR LEADERS (INCLUDING INDEPENDENT CONTRACTORS) 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 COMMITTEE 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	ON AN ANNUAL BASIS, THE PERSONNEL SALARY COMMITTEE AND QUORUM HEALTH RESOURCES (MANAGEMENT COMPANY)REVIEWS AN EXECUTIVE COMPENSATION STUDY PERFORMED BY YAFFE, AN INDEPENDENT THIRD PARTY WHO IS EMPLOYED BY THE HOSPITAL ASSOCIATION OF PENNSYLVANIA TO CONDUCT A COMPENSATION STUDY. HUMAN RESOURCES PROVIDES A COMPENSATION STUDY FROM ACRS, BASED IN THE APPALACHIAN REGION. THESE TWO STUDIES ARE USED TO DETERMINE FAIR MARKET VALUE. THE RECOMMENDATIONS FOR COMPENSATION LEVELS ARE PROVIDED TO THE BOARD FOR APPROVAL. BOARD APPROVAL IS DOCUMENTED IN THE BOARD MINUTES. THE ACTUAL COMPENSATION AMOUNTS ARE NOT INCLUDED IN THE MINUTES TO PROTECT EMPLOYEE PRIVACY. EFFECTIVE JULY 1, 2017 GJSH IS SUBJECT TO THE GEISINGER COMPENSATION REVIEW PROCESS. 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 IX, LINE 11G	OUTSIDE TESTS PURCHASED 186,029 0 0 CONTRACTED PHYSICIAN SERVICES 1,828,892 0 0 CONTRACTED MEDICAL SERVICES 113,700 0 0 CONSULTNG FEES 96,400 1,155 0 COLLECTION AGENCY FEES 0 35,039 0 EQUIPMNET MAINTENANCE CONT. 517,088 116,974 0 OUTSIDE PURCHASED SERVICES 289,336 470,848 0 TEMPORARY AGENCY SERVICES 605,284 347,591 0 EQUIPMENT REPAIR 18,221 13,589 0 RECRUITMENT 12,040 50,137 0 TOTAL 3,666,990 1,035,333 0
FORM 990, PART XI, LINE 9	PENSION ADJUSTMENT 744,966 ASSETS RELEASED FROM RESTRICTION 1,175 TOTAL 746,141

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	GEISINGER JERSEY SHORE HOSP FOUND	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1020 THOMPSON STREET	AddressLine1Txt
City	JERSEY SHORE	CityNm
State Abbreviation	PA	StateAbbreviationCd
ZIP	17740	ZIPCd

Field	Value	IRS element (for citing)
EIN	232480603	EIN
Primary Activities	HEALTHCARE	PrimaryActivitiesTxt
Legal Domicile State	PA	LegalDomicileStateCd
Exempt Code Section	501C3	ExemptCodeSectionTxt
Public Charity Status	3	PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Controlled Organization	Yes (true)	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (9 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
GEISINGER JERSEY SHORE HOSPITAL FND
D	$5,281,749	CASH
GEISINGER JERSEY SHORE HOSPITAL FND
M	$72,000	CASH
GEISINGER JERSEY SHORE HOSPITAL FND
R	$116,466	FMV
GEISINGER JERSEY SHORE HOSPITAL FND
Q	$11,647	CASH
GEISINGER JERSEY SHORE HOSPITAL FND
J	$28,924	CASH
GEISINGER JERSEY SHORE HOSPITAL FND
R	$29,605	CASH
GEISINGER JERSEY SHORE HOSPITAL FND
R	$825,588	CASH
GEISINGER JERSEY SHORE HOSPITAL FND
S	$50,000	CASH
GEISINGER JERSEY SHORE HOSPITAL FND
R	$1,400	CASH