Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 07-01-2011 and ending 06-30-2012
BCheck if applicable:
CName of organization
COMMUNITY MEDICAL CENTER
 
Doing Business As
GEISINGER-COMMUNITY MEDICAL CENTER
 
Number and street (or P.O. box if mail is not delivered to street address)
100 NORTH ACADEMY AVENUE MC 49-70
 
Room/suite
City or town, state or country, and ZIP + 4
DANVILLE, PA17822
D Employer identification number

24-0862246
E Telephone number

G Gross receipts $ 159,917,949
F Name and address of principal officer:
GLENN D STEELE JR MD PHD
100 NORTH ACADEMY AVENUE MC 22-01
DANVILLE,PA17822
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CMCCARE.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1962
M State of legal domicile: PA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING QUALITY HOSPITAL SERVICES AND ACCESS ACROSS NORTHEASTERN PENNSYLVANIA THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 9
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 8
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 1,720
6 Total number of volunteers (estimate if necessary) .... 6 274
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 25,407
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b -26,501
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 2,042,638 618,746
9 Program service revenue (Part VIII, line 2g) ......... 166,373,151 157,682,384
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 862,345 518,851
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 2,912,353 948,884
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 172,190,487 159,768,865
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 90,902 125,178
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 74,864,514 74,126,365
16a Professional fundraising fees (Part IX, column (A), line 11e).....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet150,394    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 94,385,671 87,225,129
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 169,341,087 161,476,672
19 Revenue less expenses. Subtract line 18 from line 12....... 2,849,400 -1,707,807
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 110,672,775 114,404,869
21 Total liabilities (Part X, line 26)............. 72,135,151 101,342,419
22 Net assets or fund balances. Subtract line 21 from line 20..... 38,537,624 13,062,450
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III .........
1
Briefly describe the organization’s mission: TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING QUALITY HOSPITAL SERVICES AND ACCESS ACROSS NORTHEASTERN PENNSYLVANIA THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 149,962,754 including grants of $ 125,178 ) (Revenue $ 156,445,983 )
SEE SCHEDULE O GCOMMUNITY MEDICAL CENTER, DOING BUSINESS AS GEISINGER-COMMUNITY MEDICAL CENTER (G-CMC), OPENED IN 1897 AS THE HAHNEMANN HOSPITAL AND SCHOOL OF NURSING, THE HOSPITAL WAS SCRANTON'S FIRST HOSPITAL DEDICATED TO COMMUNITY SERVICE. G-CMC CONTINUES TO PROVIDE THE COMMUNITY WITH A VARIETY OF SERVICES AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. THIS CONTINUUM OF CARE INCLUDES PREVENTATIVE, AMBULATORY, INPATIENT, AND EMERGENCY SERVICES. G-CMC IS A NOTED REGIONAL REFERRAL CENTER WITH COMPREHENSIVE ACUTE CARE MEDICAL SERVICES AND HAS DEVELOPED SPECIFIC AREAS OF EXPERTISE. SPECIALIZED / REGIONAL SERVICES, CENTER OF EXCELLENCE: G-CMC IS AN ACUTE CARE HOSPITAL LICENSED FOR 297 BEDS AND THE ONLY LEVEL II TRAUMA CENTER IN LACKAWANNA COUNTY. THE NORTHEAST PA TRAUMA CENTER, DESIGNATED BY THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION IN 1988, PROVIDES 24-HOUR COMPREHENSIVE SURGICAL INTERVENTION FOR CRITICALLY INJURED PATIENTS. THE TRAUMA CENTER IS STAFFED CONTINUOUSLY BY AN EMERGENCY PHYSICIAN, TRAUMA SURGEON AND NURSES CERTIFIED IN CRITICAL CARE, TRAUMA, ORTHOPAEDICS, AND THE NEUROSCIENCES. THE UNREIMBURSED COSTS OF PROVIDING TRAUMA SERVICES TO THE COMMUNITY IN FY 2012 TOTALED 1,281,642. CARDIOLOGY SERVICES AT THE HOSPITAL INCLUDE THE REGION'S FIRST ELECTROPHYSIOLOGY LAB AND AN OPEN HEART SURGERY CENTER. G-CMC IS ALSO A CERTIFIED CAROTID STENT FACILITY. NEUROLOGICAL SCIENCES AT THE HOSPITAL SPECIALIZES IN THE CARE OF PEOPLE WITH BRAIN AND SENSE ORGAN DISORDERS. OTHER SPECIALIZED SERVICES INCLUDE: A SAME-DAY SURGERY CENTER, A 24 LICENSED BED SHORT TERM PSYCHIATRIC INPATIENT UNIT, AN ORTHOPAEDIC TRAUMA CLINIC, CT SCANNER, MRI IMAGING, ONCOLOGY SERVICES, RENAL DIALYSIS, HYPERBARIC OXYGEN CHAMBER TREATMENTS, THE NEW STEPS JOINT PROGRAM, WOUND CARE, AND STEREOTACTIC SURGERY. G-CMC OFFERS EMERGENCY MEDICAL TECHNICIAN AND TRAUMA NURSE TRAINING PROGRAMS. IT HAS AN AFFILIATION WITH THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION, AN ACCREDITED PROVIDER OF INTERNAL MEDICINE RESIDENCY EDUCATION, BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION, AND THE REGION'S ONLY PODIATRIC RESIDENCY PROGRAM, AND ACCREDITED PROVIDER OF PODIATRIC MEDICINE AND SURGERY EDUCATION, BY THE COUNCIL OF PODIATRIC MEDICAL EDUCATION. UNCOMPENSATED COSTS FOR HEALTH PROFESSIONS EDUCATION TOTALED 1,186,186. G-CMC ALSO SPONSORS THE COMMUNITY HEALTH EDUCATION PROGRAM, THE REGION'S FIRST HOSPITAL-BASED AND COMMUNITY-WIDE WELLNESS AND PREVENTION PROGRAM. IN ADDITION, G-CMC SPONSORS THE PRIORITY CARE PROGRAM IN WHICH OVER 20,000 SENIOR CITIZENS ARE ENROLLED IN THE REGION'S FIRST HOSPITAL-BASED FREE MEMBERSHIP PLAN FOR PERSONS OVER 55 AND OLDER. PRIORITY CARE PROVIDES SENIOR CITIZENS WITH A WIDE VARIETY OF BENEFITS AND INFORMATION REGARDING HEALTH AND WELLNESS PROGRAMS. PRIORITY CARE OFFERS CONVENIENT ACCESS TO QUALITY SERVICES INCLUDING: FREE PARKING IN THE G-CMC PARKING COMPLEX COMMUNITY DISCOUNTS DISCOUNTED MEALS IN THE HOSPITAL'S DINING ROOM DISCOUNTS AT THE G-CMC GIFT SHOP PHYSICIAN REFERRAL SERVICE AFFILIATIONS: G-CMC HAS WORKING RELATIONSHIPS WITH OTHER HEALTH CARE PROVIDERS IN VENTURES SUCH AS THE NORTHEASTERN PENNSYLVANIA IMAGING CENTER, THE CHILDREN'S ADVOCACY CENTER, MATERNAL & FAMILY HEALTH SERVICES, AND THE RONALD MCDONALD HOUSE OF SCRANTON. G-CMC ALSO HAS A CONNECTION WITH NUMEROUS AREA INSTITUTIONS, COLLEGES, AND UNIVERSITIES FOR EDUCATIONAL AND CLINICAL PROGRAMS, INCLUDING, BUT NOT LIMITED TO, NURSING, MEDICAL TECHNOLOGY, PHYSICAL AND OCCUPATIONAL THERAPY, EMERGENCY MEDICAL TECHNICIANS, PHYSICIAN ASSISTANTS, SOCIAL WORK AND HEALTHCARE ADMINISTRATION. MEDICAL STAFF: AS OF JUNE 30, 2012, THE MEDICAL STAFF AT G-CMC TOTALED OVER 350 PHYSICIANS. UNDER G-CMC'S MEDICAL STAFF BY-LAWS, PHYSICIANS MAY HAVE ONE OF SEVERAL TYPES OF PRIVILEGES INCLUDING ACTIVE, COURTESY, CONSULTING, EMERGENCY, AND TEMPORARY. AUXILIARY: THE G-CMC AUXILIARY IS COMPRISED OF APPROXIMATELY 65 MEMBERS. FUNCTIONING WITH THE GUIDANCE OF ITS OWN ADVISORY BOARD, THE AUXILIARY HAS COMMITTEES, EACH WITH ITS OWN RESPONSIBILITY FOR FUND-RAISING, AND SERVICE. THE AUXILIARY ASSISTS IN OPERATING G-CMC'S GIFT SHOP SEVEN DAYS A WEEK. ALLOCATIONS OF FUNDS RAISED BY THE AUXILIARY ARE MADE TO G-CMC TO ENHANCE PATIENT SERVICES. VOLUNTEER SERVICES: FROM YEAR TO YEAR, G-CMC HAS APPROXIMATELY 250-300 ACTIVE ADULT AND JUNIOR VOLUNTEERS WHO VOLUNTEER THEIR TIME TO G-CMC AND CAN BE FOUND ASSISTING THE STAFF IN A VARIETY OF CAPACITIES IN HOSPITAL DEPARTMENTS SUCH AS: MAIL ROOM, MEDICAL RECORDS, SURGICAL SERVICES, EMERGENCY DEPARTMENT, AND GIFT SHOP. VOLUNTEERS ALSO ASSIST AT SPECIAL HOSPITAL FUNCTIONS. IN 2012, G- CMC VOLUNTEERS PROVIDED OVER 11,500 HOURS OF SERVICE TO G-CMC. THROUGH G-CMC'S VOLUNTEER DEPARTMENT, HUNDREDS OF SCHOOL AND COLLEGE STUDENTS ARE PROVIDED INFORMATION ABOUT HEALTHCARE TO ASSIST IN CAREER CHOICE THROUGH TOURS AND SHADOWING OPPORTUNITIES AT THE FACILITY. PATIENT ORIGIN AND SERVICE AREA: THE HOSPITAL'S PRIMARY SERVICE AREA IS COMPRISED OF LACKAWANNA COUNTY. THE SECONDARY SERVICE AREA INCLUDES LUZERNE, MONROE, PIKE, SUSQUEHANNA, WAYNE AND WYOMING COUNTIES. SUPPORT TO THE COMMUNITY: G-CMC AND RELATED AFFILIATES PROVIDE A VARIETY OF PROGRAMS TO THE COMMUNITY INCLUDING THE EDUCATION PROGRAM WHICH PROVIDES NUMEROUS COMMUNITY SERVICES SOME OF WHICH ARE LISTED BELOW. THE INTENT OF THESE PROGRAMS AND PARTNERSHIPS IS THE IMPROVED HEALTH OF THE COMMUNITY; I.E., ACCIDENT/ ILLNESS PREVENTION OR EARLY INTERVENTION AS A RESULT OF INCREASED EDUCATION. THE NORTHEAST PA TRAUMA CENTER PROVIDES EMERGENCY PREPAREDNESS ASSISTANCE AND MEDICAL EXPERTISE TO THE AMERICAN RED CROSS LACKAWANNA CHAPTER, LACKAWANNA COUNTY EMERGENCY MANAGEMENT AGENCY, AND THE SCRANTON/WILKES- BARRE INTERNATIONAL AIRPORT. ALSO, FALL AND INJURY PREVENTION FOR THE ELDERLY IS AVAILABLE TO AREA SENIOR CITIZENS AND SENIOR ORGANIZATIONS, AS WELL AS MANY AGE-SPECIFIC PREVENTION PROGRAMS TO VARIOUS ORGANIZATIONS AND SCHOOLS THROUGHOUT THE YEAR. EACH YEAR OVER 500 CHILDREN UNDER THE AGE OF 18 ARE INVOLVED IN EDUCATION'S EXTENSIVE PROGRAMS TARGETING THIS AGE GROUP. TRAUMA PREVENTION PROGRAMS SUCH AS TRAUMA ROOM AND THINK FIRST TEACH KIDS IMPORTANT SAFETY INFORMATION. ASTHMA SKI DAY HELD IN CONJUNCTION WITH SNO MOUNTAIN SKI AREA AND G-CMC'S COMMUNITY HEALTH EDUCATION PROGRAM, EMPHASIZE THAT DESPITE ILLNESS, INDIVIDUALS CAN STILL PARTICIPATE IN HEALTHY, EVEN STRENUOUS ACTIVITIES. IN ADDITION, A POISON PREVENTION PROGRAM IS AVAILABLE ALONG WITH OTHER SUCH PROGRAMS AS REQUESTED. MANY OF THESE PROGRAMS ARE THE RESULTS OF EDUCATION'S PARTNERSHIPS WITH OTHER COMMUNITY RESOURCES; E.G., THE AMERICAN LUNG ASSOCIATION, LACKAWANNA COUNTY DRUG AND ALCOHOL COMMISSION, AND ALLIED SERVICES. THE COMMUNITY HEALTH EDUCATION PROGRAM CONDUCTS A WIDE VARIETY OF HEALTH LIFESTYLE PROGRAMS, FREE OR AT MINIMAL COST, WHICH ARE DESIGNED TO 'PRACTICALLY' ASSIST AN INDIVIDUAL IN THEIR QUEST TO LEAD A HEALTHY AND PRODUCTIVE LIFE. SOME OF THE AREAS OF CONCENTRATION INCLUDE: SMOKING CESSATION, FIRST AID, CPR, AND WEIGHT WATCHERS SESSIONS THAT ARE OPEN TO THE PUBLIC AS WELL AS EMPLOYEES AND FAMILY. PUBLIC / COMMUNITY HEALTH LECTURES: LAST YEAR APPROXIMATELY 400 PEOPLE ATTENDED THESE SESSIONS WHICH ARE FREE TO THE PUBLIC. A SAMPLING OF THE TOPICS INCLUDED THE FOLLOWING: ALZHEIMER'S PROGRAM FOR CAREGIVERS, MENTAL HEALTH ISSUES, END OF LIFE ISSUES, BREAST CANCER AWARENESS, AND COLON CANCER AWARENESS. HEALTH FAIRS / SCREENING PROGRAMS: EDUCATION IN PARTNERSHIP WITH OTHER COMMUNITY RESOURCES PROVIDES HEALTH FAIRS AND SCREENINGS TO THE COMMUNITY AND LOCAL BUSINESS/INDUSTRY FREE OR AT A MINIMAL COST. PROGRAMS INCLUDED: CARBON MONOXIDE SCREENINGS, CHOLESTEROL/BLOOD PRESSURE SCREENINGS, AND DIABETIC SCREENINGS. THE UNREIMBURSED COST OF PROVIDING SUCH SCREENINGS IN FY 2012 TOTALED 24,081. THE SYSTEM PROVIDES MONTHLY MEETING PLACES FREE OF CHARGE TO MANY COMMUNITY SELF-HELP GROUPS WHICH INCLUDE: DIABETES SUPPORT GROUP, CROHNS & COLITIS SUPPORT GROUP, BETTER BREATHER'S CLUB, AND NAMI SUPPORT GROUP MEETINGS. G-CMC'S FACILITIES ARE MADE AVAILABLE TO OTHER COMMUNITY GROUPS UPON REQUEST AND AVAILABILITY; E.G., THE HILL NEIGHBORHOOD ASSOCIATION, AND THE EAST SCRANTON BUSINESS ASSOCIATION. UNCOMPENSATED CARE G-CMC RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND EDUCATION. G-CMC PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD G-CMC PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A. CHARITY CARE THE PRIMARY CONCERN OF G-CMC IS THE DELIVERY OF HEALTH CARE TO ALL THE CITIZENS OF NORTHEASTERN PENNSYLVANIA, REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST G-CMC INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. THE COST TO GMC OF PROVIDING THIS CHARITY CARE DURING THE FISCAL Y
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 149,962,754
Form 990 (2011)
Form 990 (2011)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part IIIClick to see attachment........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment....................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part IClick to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II.......... Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements. Click to see attachment
20b
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
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? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II......................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II....................... Click to see attachment
32
Yes
 
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V .........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
188
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
1,720
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2011)
Form 990 (2011)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI .........
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
9
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
8
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
PA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
EDWARD CHABALOWSKI CFO
1822 MULBERRY STREET
SCRANTON,PA18510
(570) 969-8837
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) WILLIAM H ALEXANDER
DIRECTOR
 2.00 X           0 0 0
(2) WILLIAM AUBREY
DIRECTOR
 2.00 X           0 0 0
(3) MICHAEL KONDASH DO
DIRECTOR
 2.00 X           0 0 0
(4) E ALLEN DEAVER
DIRECTOR
 2.00 X           0 0 0
(5) DEBRA PELLEGRINO EDD
DIRECTOR, SE
 2.00 X   X       0 0 0
(6) FRANK EPIFANO
DIRECTOR
 2.00 X           0 0 0
(7) DORRANCE R BELIN ESQUIRE
DIRECTOR
 2.00 X           0 0 0
(8) MELINDA C GHILARDI ESQUIRE
SECRETARY,VI
 2.00 X   X       0 0 0
(9) RICHARD FINE ESQUIRE
DIRECTOR
 2.00 X           0 0 0
(10) DAVID LOHIN DO FACC
DIRECTOR
 2.00 X           0 0 0
(11) GEORGE GINADER
DIRECTOR, TR
 2.00 X   X       0 0 0
(12) RICHARD A GRAFMYRE
DIRECTOR
 2.00 X           0 0 0
(13) ROLAND GRECO
DIRECTOR
 2.00 X           0 0 0
(14) WILLIAM R GRUVER
DIRECTOR
 2.00 X           0 0 0
(15) FRANK M HENRY
DIRECTOR
 2.00 X           0 0 0
(16) JEFF JACOBSON
DIRECTOR, CH
 2.00 X   X       0 0 0
(17) BRIAN D MOTT MD
PRES. MEDICA
 40.00 X           0 81,330 3,978
Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) LOUIS DENAPLES MD
DIRECTOR
 2.00 X           0 0 0
(19) THOMAS H LEE JR MD
DIRECTOR
 2.00 X           0 0 0
(20) TIMOTHY FARRELL MD
DIRECTOR
 2.00 X           0 0 0
(21) VIRGINIA MCGREGOR
DIR,CHAIR,VI
 2.00 X   X       0 0 0
(22) GLENN D STEELE JR MD PHD
DIRECTOR,PRE
 40.00 X   X       0 5,048,679 390,571
(23) ROBERT E POOLE
DIRECTOR
 2.00 X           0 0 0
(24) DON A ROSINI
DIRECTOR
 2.00 X           0 0 0
(25) ROBERT P STEIGMEYER
DIR.,CAO,PRE
 40.00 X   X       605,284 0 20,502
(26) THOMAS TULANEY
TREASURER
 2.00 X   X       0 0 0
(27) BARBARA BOSSI
VP NURSING
 40.00     X       268,588 0 20,703
(28) ANTHONY AQUILINA DO
CMO
 40.00     X       0 366,104 34,623
(29) DAVID J FELICIO ESQUIRE
CLO,SECRETAR
 40.00     X       0 475,750 133,442
(30) EDWARD J ZYCH ESQUIRE
ASSISTANT SE
 40.00     X       0 336,473 63,965
(31) KEVIN F BRENNAN CPA FHFMA
EVP, FINANCE
 40.00     X       0 970,130 192,289
(32) JAMES J JESIKIEWICZ
ASSISTANT TR
 40.00     X       68,870 0 15,170
(33) ALBERT BOTHE MD
CMO
 40.00     X       0 881,942 181,727
(34) SEAN MCANDREW
VP INFORM. S
 40.00     X       150,356 0 7,584
(35) JOHN SKURKA
INTERIM CFO
 40.00     X       554,986 0 0
(36) FRANK J TREMBULAK
SR VP, TREAS
 40.00     X       0 934,746 206,030
(37) WENDY K WILSON
VP PUBLIC RE
 40.00     X       96,769 0 10,503
(38) MICHELLE T BOYLE
CRNA
 40.00         X   296,800 0 25,932
(39) JOHN DITCHKUS
CRNA
 40.00         X   244,968 0 25,655
(40) ROSE A SADOWSKI
CRNA
 40.00         X   242,944 0 19,530
(41) KHALEEL SHAIKH
PHYSICIAN
 40.00         X   236,705 249,964 24,973
(42) MARK R TRENTLY
CRNA
 40.00         X   241,665 0 25,219
(43) BRIAN E KLOCK MD FACS
FORMER 5 HIG
 40.00           X 0 399,634 35,370
(44) FREDERICK K TOY MD FACS
FORMER 5 HIG
 40.00           X 0 465,548 33,570
(45) JOHN D KIZER MD
FORMER 5 HIG
 40.00           X 0 365,600 34,770
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 3,007,935 10,575,900 1,506,106
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet45
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
ARAMARK
1101 MARKET STREET 29TH FLOOR
PHILADELPHIA,PA19107 		DIETARY, HOUSEK 1,351,215
MEDICAL STAFFING NETWORK
PO BOX 203000
DALLAS,TX753203000 		STAFFING 1,062,053
SIEMENS
HEALTH SERVICES DIVISION
51 VALLEY STREAM PARKWAY
MALVERN,PA19355 		TECHNOLOGY 1,048,343
DUBRAWSKI & ASSOCIATES
11622 EL CAMINO REAL SUITE 100
SAN DIEGO,CA92130 		INSURANCE CONS 1,032,251
ECG MANAGEMENT CONSULTANTS
1111 THIRD AVENUE SUITE 2700
SEATTLE,WA98101 		MANAGEMENT 808,950
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet45
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 45,365
d Related organizations...1d 78,926
e Government grants (contributions)1e 446,338
f All other contributions, gifts, grants, and
similar amounts not included above1f 		48,117
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 618,746
Program Service Revenue Business Code
2a NET PATIENT SERVICE REVENUE 622,110 156,232,846 156,232,846    
b INTERCOMPANY REVENUE 541,900 1,449,538 1,449,538    
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 157,682,384
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 541,152     541,152
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross rents 210,461  
b Less: rental expenses 73,690  
c Rental income or (loss) 136,771  
d Net rental income or (loss).......MediumBullet 136,771     136,771
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   3,458
b Less: cost or other basis and sales expenses   25,759
c Gain or (loss)   -22,301
d Net gain or (loss)..........MediumBullet -22,301     -22,301
8a Gross income from fundraising events (not including
$ 45,365
of contributions reported on line 1c). See Part IV, line 18 ...
a 49,635
b Less: direct expenses ...b 49,635
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a DIETARY INCOME 722,210 309,782     309,782
b OTHER REVENUES 900,099 150,229 150,229    
c PURCHASE DISCOUNTS 900,099 139,264     139,264
d All other revenue .... 212,838 85,209 25,407 102,222
e Total. Add lines 11a–11d ......MediumBullet 812,113
12 Total revenue. See Instructions....MediumBullet 159,768,865 157,917,822 25,407 1,206,890
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 125,178 125,178
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 1,944,320 286,174 1,658,146  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 59,356,020 57,306,221 1,940,760 109,039
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 3,215,199 3,070,790 138,573 5,836
9 Other employee benefits ....... 4,473,336 4,441,925 23,886 7,525
10 Payroll taxes ........... 5,137,490 4,886,590 241,647 9,253
11 Fees for services (non-employees):        
a Management ...... 383,092   383,092  
b Legal ......... 969,902   969,902  
c Accounting ........... 131,870   131,870  
d Lobbying ........... 1,438 1,438    
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ...... 306,171   306,171  
g Other .......... 22,901,412 22,285,645 610,913 4,854
12 Advertising and promotion .... 474,968 15,812 448,971 10,185
13 Office expenses ....... 2,675,787 1,916,473 758,349 965
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 3,156,880 2,501,698 655,182  
17 Travel ............ 231,350 197,997 33,353  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 855,076   855,076  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 6,387,462 6,325,442 61,556 464
23 Insurance .............. 1,529,448 1,169,637 359,811  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a MEDICAL SUPPLIES 39,169,852 39,086,096 81,483 2,273
b INTER-ENTITY EXPENSES 4,910,225 3,298,366 1,611,859  
c MA MODERNIZATION 2,993,737 2,993,737    
d DUES 90,260 24,038 66,222  
e
f All other expenses 56,199 29,497 26,702  
25 Total functional expenses. Add lines 1 through 24f 161,476,672 149,962,754 11,363,524 150,394
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 144,639 1 23,010,308
2 Savings and temporary cash investments ....... 1,198,524 2 2,576,176
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 16,704,295 4 15,668,341
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net ............. 2,209,505 7 1,124,049
8 Inventories for sale or use .............. 3,326,607 8 3,231,348
9 Prepaid expenses and deferred charges ............ 1,546,721 9 1,637,029
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 36,628,868
b Less: accumulated depreciation. ..... 10b 2,632,544 38,339,481 10c 33,996,324
11 Investments—publicly traded securities .......... 6,821,559 11 7,277,044
12 Investments—other securities. See Part IV, line 11 ...... 29,057,839 12 21,371,643
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 11,323,605 15 4,512,607
16 Total assets. Add lines 1 through 15 (must equal line 34)... 110,672,775 16 114,404,869
Liabilities 17 Accounts payable and accrued expenses . 16,859,367 17 7,943,559
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities .......... 38,278,090 20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24 33,891,772
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 16,997,694 25 59,507,088
26 Total liabilities. Add lines 17 through 25..... 72,135,151 26 101,342,419
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 33,943,615 27 9,915,708
28 Temporarily restricted net assets ..... 2,557,573 28 2,130,571
29 Permanently restricted net assets ..... 2,036,436 29 1,016,171
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 38,537,624 33 13,062,450
34 Total liabilities and net assets/fund balances ..... 110,672,775 34 114,404,869
Form 990 (2011)
Form 990 (2011)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI .........
1
Total revenue (must equal Part VIII, column (A), line 12) ...
1
159,768,865
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
161,476,672
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
-1,707,807
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
38,537,624
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-23,767,367
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
13,062,450
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2011)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2011
Name of organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2, of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
COMMUNITY MEDICAL CENTER
  		Employer identification number

24-0862246
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
COMMUNITY MEDICAL CENTER
  		Employer identification number

24-0862246
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions). 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
COMMUNITY MEDICAL CENTER
  		Employer identification number

24-0862246
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
Use duplicate copies of Part III if additional space is needed
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2011

Schedule C (Form 990 or 990-EZ) 2011
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check expenses, and share of excess lobbying expenditures).
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ....... 1,438 640,652
c Total lobbying expenditures (add lines 1a and 1b) ................... 1,438 640,652
d Other exempt purpose expenditures ........................ 161,475,234 2,670,639,189
e Total exempt purpose expenditures (add lines 1c and 1d) ............... 161,476,672 2,671,279,841
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		 1,000,000 1,000,000
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) ................. 250,000 250,000
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) Total
             
2a Lobbying non-taxable amount 1,000,000 1,000,000 1,000,000 1,000,000 4,000,000
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		        6,000,000
             
c Total lobbying expenditures   11,426 1,554 640,652 653,632
             
d Grassroots nontaxable amount 250,000 250,000 250,000 250,000 1,000,000
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		         1,500,000
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2011


Schedule C (Form 990 or 990-EZ) 2011
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
No
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
No
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
No
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
No
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
Schedule C (Form 990 or 990EZ) 2011

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 2,036,436 1,717,248 1,700,302 2,108,817
b Contributions ........        
c Net investment earnings, gains, and losses ... 5,152 402,937 16,946 -408,515
d Grants or scholarships .....   -29,451    
e Other expenditures for facilities
and programs ........ 		-1,024,501 -40,761    
f Administrative expenses ....   -13,537    
g End of year balance ...... 1,017,087 2,036,436 1,717,248 1,700,302
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
No
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   1,034,837 1,034,837
b Buildings ................   15,988,866 561,876 15,426,990
c Leasehold improvements ............   237,677 22,035 215,642
d Equipment ................   19,325,876 2,048,633 17,277,243
e Other .................   41,612   41,612
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 33,996,324
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) NON PUBLICLY TRADED SECURITIES 		21,371,643 F








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 21,371,643
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes  
ACCRUED PENSION 19,769,165
ESTIMATED 3RD PARTY PAYER SETTLEMENT 14,929,091
INSURANCE SELF-INSURANCE 12,316,740
ACCRUED EXPENSES 9,055,791
INTERCOMPANY PAYABLES 2,525,690
ADVANCES FROM 3RD PARTIES 910,611



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 59,507,088
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8  
9 Total adjustments (net). Add lines 4 through 8 ......................... 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
INTENDED USES FOR ENDOWMENT FUNDS SCHEDULE D, PAGE 2, PART V, LINE 4 COMMUNITY MEDICAL CENTER USES ENDOWMENT FUNDS TO SUPPORT PATIENT CARE AND AWARD SCHOLARSHIPS TO EMPLOYEES.
SUPPLEMENTAL FINANCIAL INFORMATION SCHEDULE D, PAGE 4, PART XIV EFFECTIVE JULY 1, 2007, GEISINGER HEALTH SYSTEM(1) ("GHS") ADOPTED FASB INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, AN INTERPRETATION OF FASB STATEMENT NO. 109 ("FIN 48"). FIN 48 CLARIFIES THE ACCOUNTING AND REPORTING FOR INCOME TAXES WHERE THE INTERPRETATION OF THE TAX LAW MAY BE UNCERTAIN. FIN 48 PRESCRIBES A COMPREHENSIVE MODEL FOR THE FINANCIAL STATEMENT RECOGNITION, MANAGEMENT, 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 JUNE 30, 2012 OR ANY PREVIOUS YEAR SINCE ADOPTION. ACCORDINGLY, NO FIN 48 FOOTNOTE DISCLOSURE WAS MADE IN THE JUNE 30, 2012 GHS CONSOLIDATED FINANCIAL STATEMENTS. (1) THROUGHOUT THIS DOCUMENT, THE ACRONYM "GHS" OR THE TERMS "SYSTEM", "GEISINGER", OR "GEISINGER HEALTH SYSTEM" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF THE GEISINGER HEALTH SYSTEM FOUNDATION ("THE FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATE ENTITIES COMPRISING THE SYSTEM.
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,or if the organization entered more than $15,000 on Form 990-EZ, line 6a.right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2011
Schedule G (Form 990 or 990-EZ) 2011
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

ANNUAL GOLF TOU
(event type) 		(b) Event #2

 
(event type) 		(c) Other Events

  
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 95,000     95,000
2 Less: Charitable
contributions . . . 		45,365     45,365
3 Gross income (line 1
minus line 2) . . . 		49,635     49,635
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . . 29,200     29,200
6 Rent/facility costs . . 7,280     7,280
7 Food and beverages . . 11,894     11,894
8 Entertainment . . .        
9 Other direct expenses . 1,261     1,261
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 49,635
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow  
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
Schedule G (Form 990 or 990-EZ) 2011
Schedule G (Form 990 or 990-EZ) 2011
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2011
Additional Data


Software ID:  
Software Version:  
SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the
following was the family income limit for eligibility for discounted care: ............
3b
Yes
 
c
If the organization did not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year?...........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ...............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance
and Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    1,917,465   1,917,465 1.190 %
b Medicaid (from Worksheet 3, column a) .....     23,554,967 12,250,664 11,304,303 7.000 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .            
dTotal Financial Assistance and
Means-Tested Government Programs ..... 		    25,472,432 12,250,664 13,221,768 8.190 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    1,315,585 9,862 1,305,723 0.810 %
f Health professions education
(from Worksheet 5) .. 		    2,864,725 1,678,539 1,186,186 0.730 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....            
jTotal Other Benefits ...     4,180,310 1,688,401 2,491,909 1.540 %
kTotal. Add lines 7d and 7j. ..     29,652,742 13,939,065 15,713,677 9.730 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense........
2
12,780,660
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....
3
 
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
46,114,116
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
64,839,636
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-18,725,520
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures
(see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 COMMUNITY MEDICAL CENTER
DBA GEISINGER COMMUNITY MEDICAL CTR
1822 MULBERRY STREET
SCRANTON,PA18510 		X X         X    
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
COMMUNITY MEDICAL CENTER
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.0%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 380.0%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
RELATED ORGANIZATION INFORMATION PART I LINE 6A A SUMMARY OF THE COMMUNITY BENEFIT PROVIDED BY GEISINGERCOMMUNITY MEDICAL CENTER GCMC AND ITS RELATED CHARITABLE ORGANIZATIONS IS AVAILABLE AT GEISINGERORG AND MADE AVAILABLE TO THE PUBLIC UPON REQUEST GO TO WWWGEISINGERORGABOUTMISSIONHTML
EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE PART I LINE 7 COLUMN F THE BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR USED TO CALCULATE THE PERCENT OF COMMUNITY BENEFIT WAS 12780660
COSTING METHODOLOGY EXPLANATION PART I LINE 7 A COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE COSTS REPORTED ON LINE 7 AND ADDRESSED PATIENT SEGMENTS BY PAYER EG MEDICARE MEDICAID COMMERCIAL PAYERS SELFPAY ETC
BAD DEBT EXPENSE EXPLANATION PART III LINE 4 PART III SECTION A LINE 2 AND LINE 4 GCMC IS A MEMBER OF A GROUP WITH CONSOLIDATED FINANCIAL STATEMENTS PER THE FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE THE ORGANIZATIONS WRITE OFF ALL ACCOUNTS THAT HAVE BEEN IDENTIFIED AS UNCOLLECTABLE AN ALLOWANCE FOR UNCOLLECTABLES IS RECORDED FOR ACCOUNTS NOT YET WRITTEN OFF THAT ARE ANTICIPATED TO BECOME COLLECTABLE IN FUTURE PERIODS PATIENTS ACCOUNTS ARE MONITORED THROUGHOUT THE BILLING PROCESS AND RECLASSIFIED TO FREE OR DISCOUNTED CARE WHENEVER THE PATIENT BECOMES ELIGIBLE UNDER GCMCS UNCOMPENSATED CARE POLICIES ACCORDINGLY THE BAD DEBT ACCOUNTS SHOULD NOT INCLUDE AMOUNTS THAT MAY BE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FREE OR DISCOUNTED CARE UNDER GCMCS UNCOMPENSATED CARE POLICIES
MEDICARE EXPLANATION PART III LINE 8 PART III LINE 6 LINE 7 MEDICARE SHORTFALL LINE 6 ONLY INCLUDES THOSE COSTS THAT ARE ALLOWED TO BE REPORTED ON GCMCS MEDICARE COST REPORT THAT IS REQUIRED TO BE FILED WITH THE FEDERAL GOVERNMENT PART III SECTION B LINE 8 MEDICARE SHORTFALL IS COMMUNITY BENEFIT GCMC CONSIDERS THAT THE TOTAL MEDICARE SHORTFALL OF 18725520 IS REPORTED AS COMMUNITY BENEFIT 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 FOR MANY OF THE MEDICAL SERVICES PROVIDED BY THE HOSPITAL MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE TO THESE PATIENTS FORCING GCMC TO USE OTHER FUNDS TO COVER THE SHORTFALL MEDICARE SHORTFALLS MUST BE ABSORBED BY GCMC IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY GCMC PROVIDES CARE REGARDLESS OF THE MEDICARE SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR PROVIDING CARE TO MEDICARE PATIENTS PENNSYLVANIA REQUIRES NONPROFIT HOSPITALS LIKE GCMC 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 IS CONSIDERED TO BE COMMUNITY BENEFIT FOR STATE TAX EXEMPTION PURPOSES
COLLECTION PRACTICES EXPLANATION PART III LINE 9B GCMC IS COMMITTED TO PROVIDING MEDICAL NECESSARY SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND GCMCS COLLECTION ACTIONS ARE CONSISTENTLY APPLIED TO ALL PATIENTS IT IS GCMC 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 FINANCIALBILLING 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
NEEDS ASSESSMENT PART VI GEISINGERCOMMUNITY MEDICAL CENTER REGULARLY PARTICIPATES IN COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENTS TO IDENTIFY FARREACHING HEALTH NEEDS FACED BY THE POPULATION SERVED BY THE HOSPITAL FOR COMMUNITY BENEFIT PURPOSES ASSESSMENT RESULTS ARE EVALUATED OVER TIME AND SERVE AS THE BASIS TO DEVELOP NEW OR EXPANDED PLANS TO ADDRESS SERVICES IN RESPONSE TO NEED ADDITIONALLY GCMC DEVELOPS PROGRAMS AND SERVICES TO ADDRESS COMMUNITY HEALTH NEEDS AND MAKES INVESTMENTS IN INITIATIVES THAT ALIGN WITH THE HOSPITALS CORE MISSION BEYOND THAT FOCUS ARE PROGRAMS AND SERVICES THAT BENEFIT EVERY RESIDENT AND SUPPORT THE FAR REACHING GOAL OF A HEALTHIER COMMUNITY THOSE HEALTHY COMMUNITY GOALS HAVE SERVED AS A CATALYST FOR A COLLABORATIVE COMMUNITY APPROACH GCMC HAS BEEN INSTRUMENTAL IN ESTABLISHING IN ORDER TO ACCESS THE HEALTHCARE NEEDS HEALTH STATUS AND QUALITY OF LIFE INDICATORS OF RESIDENTS LIVING IN THE LACKAWANNA COUNTY AND LUZERNE COUNTY COMMUNITIES THE HOSPITAL IS A CHARTER MEMBER OF HEALTHY NORTHEAST PENNSYLVANIA INITIATIVE HNPI AN ALLIANCE AMONG MEMBER REGIONAL HEALTHCARE ORGANIZATIONS AND THE PENNSYLVANIA DEPARTMENT OF HEALTH THE GOAL OF THE ORGANIZATION IS TO ASSESS AND ADDRESS THE COMMUNITY HEALTH NEEDS INCREASE REGIONAL HEALTHCARE PROGRAMS AND SERVICES AND FACILITATE AWARENESS EDUCATION AND WELLNESS FOR RESIDENTS OF NORTHEAST PENNSYLVANIA IN ADDITION TO GCMC OTHER REGIONAL HEALTHCARE PROVIDERS IN THE CONSORTIUM INCLUDE ALLIED SERVICES BLUE CROSS OF NEPA MERCY HEALTH PARTNERS MOSES TAYLOR HOSPITAL AND WYOMING VALLEY HEALTHCARE SYSTEM ASSESSMENT SURVEYS WERE DONE IN 1997 AND 2003 WITH THE MOST RECENT SURVEY COMPLETED IN 2009 IN COORDINATION WITH TRIPP UMBACH A NATIONAL MARKETING RESEARCH AND CONSULTING FIRM THE STUDYS MAIN OBJECTIVE WAS TO COMPLETE A COMPREHENSIVE ASSESSMENT OF THE HEALTHCARE ACCESS NEEDS HEALTH STATUS AND QUALITY OF LIFE INDICATORS OF RESIDENTS LIVING IN THE LACKAWANNA COUNTY AND LUZERNE COUNTY COMMUNITIES MORE SPECIFICALLY THE PROJECT GOALS WERE TO OBTAIN STATISTICALLY VALID INFORMATION ON THE HEALTH STATUS AND SOCIOECONOMICENVIRONMENTAL FACTORS RELATED TO HEALTH OF RESIDENTS OF THE COUNTIES HEALTHY NORTHEAST PENNSYLVANIA INITIATIVE HNPI SERVES TO SUPPLEMENT THE GENERAL POPULATION SURVEY DATA THAT IS CURRENTLY AVAILABLE TO HNPI AS AN ORGANIZATION TO ASSURE THAT COMMUNITY MEMBERS INCLUDING THOSE OF BROAD RACIAL ETHNIC CULTURAL AND LINGUISTIC MINORITY GROUPS ARE THE PRIMARY PARTICIPANTS IN THE NEEDS ASSESSMENT SURVEY PROCESS IN ADDITION EDUCATORS HEALTHRELATED PROFESSIONALS MEDIA REPRESENTATIVES LOCAL GOVERNMENT HUMAN SERVICE ORGANIZATIONS INSTITUTES OF HIGHER LEARNING RELIGIOUS INSTITUTIONS AND THE PRIVATE SECTOR ARE ALL ENGAGED AT SOME LEVEL OF THE SURVEY PROCESS TO DEVELOP ACCURATE COMPARISONS TO THE STATE AND NATIONAL BASELINES OF HEALTH MEASURES UTILIZING THE MOST CURRENT VALIDATED DATA AVAILABLE TO UTILIZE DATA OBTAINED FROM THE ASSESSMENT TO ADDRESS THE IDENTIFIED HEALTH NEEDS OF THE HNPI SERVICE AREA TO PROVIDE HNPI WITH APPROPRIATE DATA COMPARISONS ON LIKE SURVEY QUESTIONS TO THE 199798 AND 200304 COMMUNITY HEALTH NEEDS ASSESSMENTS HOUSEHOLD SURVEY DATA THESE DATA COMPARISONS WILL ALLOW HNPI TO DISCOVER BOTH POSITIVE AND NEGATIVE COMMUNITY HEALTH TRENDS TO COMPLETE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH NOT ONLY REACHES MINORITYUNDERSERVED POPULATIONS BUT ALSO ADDRESSES A WIDE VARIETY OF COMMUNITY HEALTH TOPICS INCLUDING BUT NOT LIMITED TO ACCESS TO CARE CHRONIC DISEASE PREVALENCE PREVENTIVE HEALTH HEALTH STATUS ACCESS TO COMMUNITY PROGRAMS AND SERVICES QUALITY OF LIFE INDICATORS AND HEALTHY LIFESTYLE BEHAVIORS RESEARCH STEPS INCLUDED COMMUNITY LEADER INTERVIEWS SOCIOECONOMIC PROFILES SECONDARY DATA IE SOCIOECONOMIC DATA AND DEMOGRAPHIC PROJECTIONS FROM NIELSEN CLARITAS AND THE US CENSUS BUREAU AND HEALTH PREVALENCE DATA FROM THE BRFSS CDC AND HRSA FOCUS GROUPS AND HOUSEHOLD SURVEYS BASED UPON THE DATA GATHERED THROUGH THIS RESEARCH METHODOLOGY TRIPP UMBACH IDENTIFIED FIVE COMMUNITY HEALTH AREAS OF NEED THAT ARE CONSIDERED PRIORITIES FOR LACKAWANNA AND LUZERNE COUNTIES LISTED IN ALPHABETICAL ORDER THE TOP FIVE PRIORITY AREAS ARE ACCESS TO CARE CHRONIC DISEASEOBESITY EMPLOYMENT MENTAL HEALTH SUBSTANCE ABUSE ONCE THIS LATEST NEEDS ASSESSMENT WAS COMPLETED ITS FINDINGS WERE FORMALLY PRESENTED TO THE GCMC BOARD OF DIRECTORS AND TO GCMCS CEO AND PRESIDENT BASED ON WHAT WAS IDENTIFIED AS PRIORITIES THROUGH THE ASSESSMENTS FINDINGS GCMCS CEO AND ITS BOARD OF DIRECTORS THEN COMMITTED HOSPITAL RESOURCES IN ORDER TO PROVIDE THESE MUCHNEEDED SERVICES TO THE COMMUNITY BASED ON THE SUBMITTED PRIORITY OF NEEDS FOR EXAMPLE HOSPITAL ADMINISTRATORS DETERMINED THAT IN ORDER TO BETTER SERVE THE HEALTH NEEDS OF THE COMMUNITY BY BATTLING OBESITY AND CHRONIC DISEASE A PREVENTIVE MEDICINE AND NUTRITION CLINIC WAS ESTABLISHED AT THE HOSPITAL ALSO THE HIGH INCIDENCE OF DIABETES IN THE REGION LED TO A DIABETES EDUCATOR POSITION AT THE HOSPITAL AND AN A RN POSITION THAT IS DEVOTED TO COMMUNITY HEALTH SCREENINGS EDUCATIONAL OUTREACH EFFORTS AND A VARIETY OF SUPPORT GROUPS SUCH AS SMOKING CESSATION AND WEIGHT LOSS
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI 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 PATIENTS METHOD OF PAYMENT OR INSURANCE STATUS FOR OTHER THAN URGENT AND EMERGENT SERVICES THE HOSPITAL PROVIDES UNCOMPENSATED CARE FREE OF CHARGE OR ON A DISCOUNTED BASIS TO THOSE PATIENTS WHO DEMONSTRATE AN INABILITY TO PAY DEPENDING UPON FAMILY SIZE AND INCOME FREE OR DISCOUNTED SERVICES ARE AVAILABLE TO A PATIENT WITH FAMILY INCOME RANGING FROM 200 UP TO 380 OF THE FEDERAL POVERTY GUIDELINES IT IS GCMC 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 FINANCIALBILLING PROCESS INFORMATION SIGNS BROCHURES ETC REGARDING GCMCS CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES ARE PROVIDED AT THE EMERGENCY ROOM REGISTRATION AND VARIOUS ACCESS POINTS THROUGHOUT THE HOSPITAL NOTICE OF GCMCS CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES CAN ALSO BE FOUND ON THE GEISINGER WEB SITE AT WWWGEISINGERORG PATIENTS ARE ALSO PROVIDED INFORMATION ON GCMCS CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES WITH EACH PATIENT BILL
COMMUNITY INFORMATION PART VI LIKE GEISINGER WYOMING VALLEY MEDICAL CENTER GEISINGERCMCS SERVICE AREA INCLUDES 9 COUNTIES IN NORTHEASTERN PENNSYLVANIA BRADFORD CARBON LACKAWANNA LUZERNE MONROE PIKE SUSQUEHANNA WAYNE AND WYOMING THE APPROXIMATE 2012 TOTAL POPULATION WITHIN THIS SERVICE AREA WAS 1020857 THIS POPULATION IS EXPECTED TO GROW 26 BY 2017 SLOWER THAN THE NATIONAL RATE 39 BUT SLIGHTLY HIGHER THAN THE GROWTH RATE IN THE COMMONWEALTH 19 THE 65 AND OVER AGE GROUP IS 168 OF THE TOTAL POPULATION WHICH IS GREATER THAN THE STATE 153 AND NATIONAL 129 PERCENTAGES ADDITIONALLY THE 65 AND OVER AGE GROUP IS THE AGE SEGMENT PROJECTED TO EXPERIENCE THE LARGEST FIVEYEAR POPULATION GROWTH AT 147 THE REGION IS PRIMARILY RURAL WITH SMALL SUBURBAN AND URBAN POCKETS AVERAGE HOUSEHOLD INCOME IS 55381 WITH APPROXIMATELY 132 OF THE POPULATION FALLING BELOW FEDERAL POVERTY GUIDELINES LOWER THAN THE STATE PERCENTAGE OF 137 THE 2012 AVERAGE UNEMPLOYMENT RATE WAS 91 WHICH IS HIGHER THAN BOTH THE COMMONWEALTH RATE OF 79 AND THE NATIONAL RATE OF 79 WITHIN THE 9 COUNTY SERVICE AREA 141 OF GCMCS INPATIENT DISCHARGES DURING FISCAL YEAR 2012 WERE SELFPAY OR CHARITY CARE OR WERE MEDICAID RECIPIENTS THERE ARE 2 GEISINGER GENERAL MEDICALSURGICAL HOSPITALS GWV AND GCMC AND 15 GENERAL MEDICALSURGICAL NONGEISINGER HOSPITALS IN THIS MARKET GCMC OFFERS A COMPLETE CONTINUUM OF EDUCATIONAL DIAGNOSTIC THERAPEUTIC AND REHABILITATIVE SERVICES AND PROGRAMS INCLUDING A LEVEL II TRAUMA CENTER AND INPATIENT BEHAVIORAL UNIT THERE ARE TWO OTHER HOSPITALS LOCATED IN SCRANTON AND SERVING LACKAWANNA COUNTY MERCY HOSPITAL A CATHOLIC NONPROFIT AND MOSES TAYLOR HOSPITAL ACCORDING TO THE 2010 CLARITAS CENSUS THE OFFICIAL POPULATION COUNT FOR LACKAWANNA COUNTY WAS 214437 THE CITY OF SCRANTON WHICH SERVES AS LACKAWANNA COUNTYS SEAT AND HAS DESIGNATED DISTRESSED CITY STATUS SINCE 1992 HAD A TOTAL POPULATION OF 76089 IN 2010 ACCORDING TO THE UNITED STATES CENSUS BUREAU SCRANTON IS THE LARGEST PRINCIPAL CITY IN THE SCRANTONWILKESBARRE METROPOLITAN AREA MAKING IT PENNSYLVANIAS SIXTHMOST POPULOUS CITY AFTER PHILADELPHIA PITTSBURGH ALLENTOWN ERIE AND READING THE US DEPARTMENT OF HEALTH AND HUMAN RESOURCES HAS DESIGNATED LACKAWANNA COUNTY AS A MEDICALLY UNDERSERVED AREAPOPULATION DUE TO TOO FEW PRIMARY CARE PROVIDERS HIGH INFANT MORTALITY HIGH POVERTY ANDOR HIGH ELDERLY POPULATION NEARLY ONE OF SIX SCRANTON RESIDENTS IS LIVING BELOW THE POVERTY LEVEL ACCORDING TO THE AMERICAN COMMUNITY SURVEY A BRANCH OF THE US CENSUS COMPARED TO PENNSYLVANIAS MEDIAN HOUSEHOLD INCOME OF 47913 THE AVERAGE EARNINGS FOR LACKAWANNA COUNTY RESIDENTS 41594 IS SIGNIFICANTLY LESS THAN THE STATE AVERAGE AND WELL BELOW THE NATIONAL MEDIAN HOUSEHOLD INCOME OF 50007 ACCORDING TO THE AMERICAN COMMUNITY SURVEY COMPOUNDING THE ECONOMIC CHALLENGES OF LOWER SALARIES LACKAWANNA COUNTY RESIDENTS ARE TWICE AS LIKELY TO NOT HAVE HEALTH INSURANCE AS LUZERNE COUNTY RESIDENTS THE INSTITUTE FOR PUBLIC POLICY ECONOMIC DEVELOPMENT INDICATORS REPORT FOR 2009 SHOWS A TWO TO ONE RATIO FOR THIS STATISTIC REPORTING THAT 106 OF THE RESIDENTS IN LACKAWANNA COUNTY AND 52 OF RESIDENTS IN LUZERNE COUNTY ARE WITHOUT HEALTH INSURANCE EDUCATION IS ALSO LACKING IN THE REGION ONLY 195 OF RESIDENTS AGE 25 AND OLDER WITHIN LACKAWANNA COUNTY HOLDS A BACHELORS DEGREE OR HIGHER BY COMPARISON 256 OF THE PENNSYLVANIA POPULATION AGE 25 AND OLDER HAS A BACHELORS DEGREE OR HIGHER AND 27 OF THIS AGE GROUP IN THE US HAS A BACHELORS DEGREE OR HIGHER AND WHILE THE REGION IS PRIMARILY WHITE THE REGION IS EXPERIENCING AN INFLUX OF MINORITIES CLARITAS CENSUS ESTIMATES FOR 2009 SHOW THE STUDY AREA POPULATION IS PREDOMINATELY SELFDEFINED AS WHITECAUCASIAN IN LACKAWANNA COUNTY 945 HOWEVER THE REGIONS HISPANIC POPULATION INCREASED FROM 1999 TO 7531 THE ASIAN POPULATION GREW FROM 823 TO 2269 AND THE BLACK POPULATION GREW FROM 2304 TO 4150 ACCORDING TO THE MOBILIZING ACTION TOWARD COMMUNITY HEALTH MATCH PROJECT LACKAWANNA COUNTY RANKS 51ST OUT OF THE 67 PENNSYLVANIA COUNTIES IN OVERALL HEALTH STATUS MATCH IS COLLABORATION BETWEEN THE ROBERT WOOD JOHNSON FOUNDATION AND THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE ACCORDING TO THE HEALTH RANKINGS DEVELOPED BY MATCH LACKAWANNA AND LUZERNE COUNTIES DO NOT COMPARE WELL TO STATE AND NATIONAL AVERAGES FOR MANY OF THE KEY COMMUNITY HEALTH INDICATORS EVALUATED THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM REPORTS THAT THE TOP FIVE MOST PREVALENT CHRONIC DISEASES IN LACKAWANNA AND LUZERNE COUNTIES ARE BLOOD PRESSURE PROBLEMS CHOLESTEROL PROBLEMS ARTHRITIS HEART PROBLEMS AND RESPIRATORY PROBLEMS SUCH AS ASTHMA CHRONIC LUNG DISEASE EMPHYSEMA AND CHRONIC BRONCHITIS WITH THE REGION SCORING HIGHER THAN THE NATIONAL AVERAGE FOR ALL THOSE LISTED ACCORDING TO CENTER FOR DISEASE CONTROL DATA FROM 2010 THE REGIONS INCIDENCE OF DIABETES IS ALSO GETTING WORSE A RECENT FEDERAL STUDY PLACED PENNSYLVANIA IN A 15STATE DIABETES BELT WITH ALMOST 27 PERCENT OF PEOPLE 65 AND OLDER DIAGNOSED WITH DIABETES IN THE REGION BLOOD PRESSURE PROBLEMS REPORTED WITHIN THE STUDY REGION ARE HIGHER THAN BOTH THE STATE AND NATIONAL AVERAGES WITH 362 PERCENT FOR LACKAWANNA COUNTY VERSUS 281 FOR THE STATE OF PENNSYLVANIA AND 275 FOR THE UNITED STATES CONCURRENTLY COMPARED TO 2008 BRFSS STATE 213 AND NATIONAL 183 AVERAGES A HIGHER PERCENTAGE OF SURVEY RESPONDENTS SMOKE CIGARETTES IN LACKAWANNA AND LUZERNE COUNTIES 230 THE INSTITUTE FOR PUBLIC POLICY ECONOMIC DEVELOPMENT INDICATORS REPORT FOR 2009 SHOWS INCREASING DRUG POSSESSION AND DRUG SALEMANUFACTURING OFFENSES WITHIN THE REGION AND THE PERCENTAGE OF BINGE DRINKERS IS ALSO HIGHER THAN THE NATIONAL AVERAGE 155 FOR THE US VERSUS 176 FOR LACKAWANNA COUNTY BETWEEN 2000 AND 2008 THE NUMBER OF DUI OFFENSES WITHIN LACKAWANNA AND LUZERNE COUNTIES ALSO INCREASED BY 441 SINCE 1997 THE PERCENTAGE OF HOUSEHOLD SURVEY RESPONDENTS REPORTING EMOTIONAL AND MENTAL HEALTH CONCERNS HAS ALSO INCREASED SIGNIFICANTLY IN THE REGION ANOTHER INDICATOR OF EMOTIONAL AND MENTAL HEALTH CONCERNS IS THE SUICIDE RATE BOTH LACKAWANNA AND LUZERNE COUNTIES HAVE HIGHER PREVALENCE RATES FOR SUICIDE THAN PENNSYLVANIA STATE AVERAGES ACCORDING TO THE INSTITUTE FOR PUBLIC POLICY ECONOMIC DEVELOPMENT INDICATORS REPORT FOR 2009
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI SEE THE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTSCOMMUNITY BENEFIT REPORTED IN SCHEDULE O
AFFILIATED HEALTH CARE INFORMATION PART VI GCMC IS AN AFFILIATE WITHIN THE GEISINGER HEALTH SYSTEM WHICH IS ONE OF THE LARGEST RURAL HEALTH CARE SYSTEMS IN THE NATION AND COVERS A 20000 SQUARE MILE AREA IN NORTHERN AND CENTRAL PENNSYLVANIA AS AN INTEGRATED HEALTH CARE SYSTEM IT SERVES MORE THAN TWO MILLION PEOPLE IN 41 OF PENNSYLVANIAS 67 COUNTIES WITH A VARIETY OF CHARITABLE HEALTH CARE PROVIDERS AND A NONPROFIT HMO THE GHS MISSION IS TO ENHANCE THE QUALITY OF LIFE THROUGH AN INTEGRATED HEALTH SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE EDUCATION RESEARCH AND COMMUNITY SERVICE GMC A 404 BED TERTIARY AND QUATERNARY MEDICAL CENTER IS LOCATED IN DANVILLE PENNSYLVANIA A SMALL COMMUNITY OF 6000 PEOPLE SINCE ITS BEGINNING IN 1915 GHS HAS EMPHASIZED MULTISPECIALTY CARE AND HAS MORE THAN 80 MEDICAL SPECIALTIES AND SUBSPECIALTIES GMC IS A LEVEL 1 REGIONAL RESOURCE TRAUMA CENTER AND HAS RECENTLY BEEN NAMED TO THE TOP 100 HOSPITALS IN THE COUNTRY THE MEDICAL CENTER HAS ALSO BEEN DESIGNATED AS A MAGNET HOSPITAL BY THE AMERICAN NURSES CREDENTIALING CENTER ANCC GHS PHYSICIANS WERE LISTED IN THE BEST DOCTORS IN AMERICA AND THE GHS INTEGRATED COST EFFECTIVE DELIVERY OF MANAGED CARE WAS FEATURED IN A FRONTPAGE NEW YORK TIMES ARTICLE MEDICAL EDUCATION HAS PLAYED A PROMINENT ROLE AT THE GMC WITH MORE THAN 200 RESIDENTS AND FELLOWS RECEIVING POSTDOCTORAL TRAINING AND RESEARCH EXPOSURE GMC IS ALSO HOME TO THE JANET WEIS WOMENS AND CHILDRENS HOSPITAL THE FIRST RURAL ACUTECARE CHILDRENS HOSPITAL IN THE NATION THE 85 BED CHILDRENS HOSPITAL WAS CONSTRUCTED IN 1995 ENTIRELY FROM DONATIONS AND BOASTS A NEONATAL INTENSIVE CARE UNIT A PEDIATRIC INTENSIVE CARE UNIT AND TWO FLOORS OF MEDICALSURGICAL INPATIENT ROOMS IN JANUARY OF 2000 THE TWOSTORY WOMENS PAVILION OPENED AND STRATEGICALLY ADJOINS THE CHILDRENS HOSPITAL FOSTERING FAMILYCENTERED CARE FOR ALL OBSTETRICAL AND NEWBORN SERVICES THE PAVILION FEATURES 19 LABOR DELIVERY RECOVERY POSTPARTUM ROOMS AND HAS THE STATES FIRST PASSTHROUGH WINDOWS FROM TWO HIGHRISK AND CSECTION DELIVERY ROOMS DIRECTLY INTO THE ADJOINING NEONATAL INTENSIVE CARE UNIT GEISINGER WYOMING VALLEY MEDICAL CENTER GWV SERVES PATIENTS IN THE GREATER WYOMING VALLEY AND WESTERN POCONO REGION OF THE STATE WITH A COMPREHENSIVE MATERNITY PROGRAM PEDIATRIC SERVICES MEDICAL AND SURGICAL UNITS THE FRANK M AND DOROTHEA HENRY CANCER CENTER A COMPLETE EMERGENCY DEPARTMENT AS WELL AS OFFERING AN EXTENSIVE COMMUNITYHEALTH EDUCATION PROGRAM OPENING IN THE FALL OF 2001 AND CONNECTED DIRECTLY TO GWV WAS THE REGIONS FIRST AND ONLY HEART HOSPITAL THE THREESTORY STRUCTURE OFFERED LIFESAVING HEART PROCEDURES THAT WERE NOT CURRENTLY AVAILABLE IN THE REGION AS WELL AS A RESEARCH PROGRAM NEW THERAPIES AND SPECIAL HEART SERVICES THE ENTIRE HEALTH SYSTEM IS SERVED BY LIFE FLIGHT THE 20 PLUSYEAR OLD AIRMEDICAL TRANSPORT PROGRAM ONE HELICOPTER IS HOUSED ON THE CAMPUS OF GEISINGER MEDICAL CENTER AND ANOTHER IS STATIONED AT THE UNIVERSITY PARK AIRPORT IN STATE COLLEGE GHS PROVIDED THE FIRST FULLSERVICE FULLTIME MEDICAL HELICOPTER STATIONED IN THE WILKESBARRESCRANTON AREA BY ADDING A THIRD HELICOPTER IN THE FLEET IN JULY 2001 A FOURTH HELICOPTER WAS ADDED IN WILLIAMSPORT IN 2005 WITH A FIFTH GOING ONLINE IN POTTSVILLE IN 2006 GEISINGER CLINIC IS A 501C3 NOTFORPROFIT CORPORATION OPERATING A MULTISPECIALTY GROUP PRACTICE GEISINGER CLINIC PROVIDES PATIENT STAFF FOR PATIENT CARE EDUCATION AND RESEARCH THERE ARE MORE THAN 750 EMPLOYED PHYSICIANS PRACTICING AT AN ARRAY OF HEALTH CARE DELIVERY PROVIDER FACILITIES AT 61 MEDICAL GROUPS SERVING 31 COUNTIES OPERATED WITHIN THE GEISINGER CLINIC ORGANIZATION THE WEIS CENTER FOR RESEARCH LOCATED ON THE CAMPUS OF GEISINGER MEDICAL CENTER IS HOME TO THE HENRY HOOD RESEARCH PROGRAM THE PREEMINENT FUNCTION OF THE HOOD RESEARCH PROGRAM IS TO CONDUCT ORIGINAL AND INNOVATIVE RESEARCH OF WORLD CLASS QUALITY OUR SCIENTISTS APPLY MODERN MOLECULAR AND CELLULAR APPROACHES TO DIVERSE RESEARCH PROBLEMS IN THE AREAS OF CARDIOVASCULAR FUNCTION CANCER AND DEVELOPMENTAL BIOLOGY BEGUN IN 1972 THE GEISINGER HEALTH PLAN IS A 501C4 NOTFORPROFIT ORGANIZATION THAT HAS GROWN TO BE ONE OF THE LARGEST RURAL HMOS IN THE COUNTRY IT CURRENTLY SERVES APPROXIMATELY 200000 MEMBERS IN A 42COUNTY SERVICE AREA MARWORTH IS A 501C 3 NOTFORPROFIT ORGANIZATION AND OPERATES A 77 BED CENTER THAT ALSO OFFERS A BROADBASED OUTPATIENT PROGRAM FOR THE TREATMENT OF ALCOHOL AND CHEMICAL DEPENDENCY MARWORTH IS LOCATED IN WAVERLY PENNSYLVANIA AND IS ANNUALLY RANKED AMONG THE TOP 20 TREATMENT CENTERS IN THE UNITED STATES GEISINGER COMMUNITY HEALTH SERVICES IS A 501C3 NOTFORPROFIT ORGANIZATION DESIGNED TO CONDUCT CHARITABLE SCIENTIFIC AND EDUCATIONAL ACTIVITIES FOR THE CITIZENS OF THE COMMUNITIES SERVED BY GHS MOUNTAIN VIEW CARE CENTER IS A MODERN 180BED HOMELIKE CENTER PROVIDING SHORT TERM REHABILITATION SKILLED NURSING AND LONG TERM CARE THE FACILITY FEATURES A SPECIALIZED 24BED UNIT DEDICATED TO THE SPECIAL NEEDS AND CARE OF PEOPLE WITH ALZHEIMERS OR MEMORYRELATED ILLNESSES THESE PATIENTS NEED A SAFE AND SECURE PLACE TO LIVE MOUNTAIN VIEW HAS DEVELOPED A SEPARATE UNIT DEDICATED TO THE SPECIAL NEEDS OF PEOPLE WITH ALZHEIMERS MOUNTAIN VIEW ALSO PROVIDES HOSPICE CARE SPECIFICALLY DEVOTED TO THE SPECIAL NEEDS OF SERIOUSLY ILL RESIDENTS THE HOSPICE TEAM PROVIDES COMPASSIONATE CARE WITH DIGNITY FOR FISCAL YEAR 2011 MOUNTAIN VIEW CARE CENTER REALIZED 27 MILLION IN UNREIMBURSED COSTS RELATED TO 39695 MEDICAL ASSISTANCE MEDICAID OR MEDICARE PATIENT CARE DAYS
ADDITIONAL INFORMATION PART VI FORM 990 SCHEDULE H PART V BILLING AND COLLECTIONS UNDER NO CIRCUMSTANCE WILL GCMC FREEZE OR ATTACH BANK ACCOUNTS OF A PATIENTENFORCE LIENS ACTIVELY PURSUE ASSETS FROM A PRIOR JUDGEMENT OR GARNISH THE WAGES OF A PATIENT ANDOR FAMILY MEMBER FORM 990 SCHEDULE H PART V LINE 20 DID THE HOSPITAL FACILITY CHARGE ANY OF ITS PATIENTS WHO WERE ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL FACILITYS FINANCIAL ASSISTANCE POLICY AND TO WHOM THE HOSPITAL FACILITY PROVIDED EMERGENCY OR OTHER MEDICALLY NECESSARY SERVICES MORE THAN THE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAD INSURANCE COVERING SUCH CARE GCMC POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 70 TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WITH INCOME AT 260 TO 380 OF THE FEDERAL POVERTY GUIDELINES WHICH RESULTS IN AMOUNTS LESS THAN THE AVERAGE OF THREE BEST NEGOTIATED COMMERCIAL RATES PATIENTS WHO ARE AT LESS THAN 260 OF THE FEDERAL POVERTY GUIDELINES ARE ELIGIBLE TO RECEIVE UP TO A 100 DISCOUNT FORM 990 SCHEDULE H PART VI LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT AT THIS TIME GCMC AND ITS AFFILIATES ARE NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE
Schedule H (Form 990) 2011
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number
24-0862246
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) THE COMMONWEALTH MEDICAL COLLEGE525 PINE STREET
SCRANTON,PA185093240 		26-0612968 501 43,500   CASH   UNRESTRICTED CONTRIB
(2) AMERICAN HEART ASSOCIATION5455 NORTH HIGH STREET
COLUMBUS,OH432141127 		13-5613797 501 10,600   CASH   UNRESTRICTED CONTRIB
(3) CHILDREN'S ADVOCACY CENTER1710 MULBERRY STREET
SCRANTON,PA185102336 		23-2972024 501 6,767   CASH   UNRESTRICTED CONTRIB
(4) AMERICAN RED CROSS2025 E STREET NW
WASHINGTON,DC200065009 		53-0196605 501 6,264   CASH   UNRESTRICTED CONTRIB
(5) GREATER SCRANTON CHAMBER222 MULBERRY STREET
SCRANTON,PA18501 		24-0716460 501 5,200   CASH   UNRESTRICTED CONTRIB
(6) ALL OTHER ASSISTANCE COMBINEDEACH INDIVIDUALLY 5000 OR LESS
DANVILLE,PA178229800 		  52,847   CASH   UNRESTRICTED CONTRIB












2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
5
3
Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2011

Schedule I (Form 990) 2011
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
ADDITIONAL INFORMATION SCHEDULE I, PAGE 4, PART IV COMMUNITY MEDICAL CENTER (CMC) DOES NOT AWARD GRANTS; CMC PROVIDES ASSISTANCE IN THE FORM OF CHARITABLE CONTRIBUTIONS TO TAX-EXEMPT ORGANIZATIONS THAT QUALIFY FOR 501(C)(3) STATUS UNDER THE INTERNAL REVENUE CODE, LIMITED 501(C)(4) ORGANIZATIONS BASED ON EXPLICIT CRITERIA, PUBLIC BENEFIT OR NON-EXEMPT ORGANIZATIONS WHOSE ACTIVITIES FURTHER THE EXEMPT PURPOSE OF CMC. CMC NOTIFIES THE PUBLIC BENEFIT OR NON-EXEMPT ORGANIZATIONS OF THE INTENT AND PURPOSE OF THE CHARITABLE CONTRIBUTION. ORGANIZATIONS SEEKING SUPPORT MUST DEMONSTRATE THAT THEY EFFECTIVELY MEET AN IMPORTANT COMMUNITY NEED.
Schedule I (Form 990) 2011


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) GLENN D STEELE JR MD PHD (i)
(ii)		  
978,712 		 
825,000 		 
3,244,967 		 
359,130 		 
31,441 		 
5,439,250 		 
2,824,875
(2) ROBERT P STEIGMEYER (i)
(ii)		 446,846
  		135,000
  		23,438
  		7,356
  		13,146
  		625,786
  		 
 
(3) BARBARA BOSSI (i)
(ii)		 226,932
  		34,954
  		6,702
  		11,385
  		9,318
  		289,291
  		 
 
(4) ANTHONY AQUILINA DO (i)
(ii)		  
251,531 		 
98,379 		 
16,194 		 
17,778 		 
16,845 		 
400,727 		 
 
(5) DAVID J FELICIO ESQUIRE (i)
(ii)		  
293,852 		 
144,222 		 
37,676 		 
115,877 		 
17,565 		 
609,192 		 
 
(6) EDWARD J ZYCH ESQUIRE (i)
(ii)		  
244,966 		 
72,505 		 
19,002 		 
42,780 		 
21,185 		 
400,438 		 
 
(7) KEVIN F BRENNAN CPA FHFMA (i)
(ii)		  
481,220 		 
297,816 		 
191,094 		 
170,858 		 
21,431 		 
1,162,419 		 
155,504
(8) ALBERT BOTHE MD (i)
(ii)		  
510,811 		 
253,186 		 
117,945 		 
171,969 		 
9,758 		 
1,063,669 		 
66,050
(9) SEAN MCANDREW (i)
(ii)		 129,119
  		20,847
  		390
  		2,606
  		4,978
  		157,940
  		 
 
(10) JOHN SKURKA (i)
(ii)		 554,986
  		 
  		 
  		 
  		 
  		554,986
  		 
 
(11) FRANK J TREMBULAK (i)
(ii)		  
574,658 		 
303,886 		 
56,202 		 
195,777 		 
10,253 		 
1,140,776 		 
 
(12) MICHELLE T BOYLE (i)
(ii)		 295,857
  		750
  		193
  		13,342
  		12,590
  		322,732
  		 
 
(13) JOHN DITCHKUS (i)
(ii)		 243,695
  		741
  		532
  		13,574
  		12,081
  		270,623
  		 
 
(14) ROSE A SADOWSKI (i)
(ii)		 241,353
  		750
  		841
  		13,380
  		6,150
  		262,474
  		 
 
(15) KHALEEL SHAIKH (i)
(ii)		 198,423
198,423 		36,450
49,867 		1,832
1,674 		11,009
1,241 		6,439
6,284 		254,153
257,489 		 
 
(16) MARK R TRENTLY (i)
(ii)		 238,504
  		750
  		2,411
  		13,145
  		12,074
  		266,884
  		 
 
(17) BRIAN E KLOCK MD FACS (i)
(ii)		  
311,801 		 
62,641 		 
25,192 		 
17,778 		 
17,592 		 
435,004 		 
 
(18) FREDERICK K TOY MD FACS (i)
(ii)		  
365,699 		 
77,256 		 
22,593 		 
17,778 		 
15,792 		 
499,118 		 
 
(19) JOHN D KIZER MD (i)
(ii)		  
298,007 		 
41,628 		 
25,965 		 
17,778 		 
16,992 		 
400,370 		 
 
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
FRINGE OR EXPENSE EXPLANATION SCHEDULE J, PAGE 1, PART I, LINE 1A HOUSING ALLOWANE OR RESIDENCE FOR PERSONAL USE - A HOUSING ALLOWANCE IS PAID DIRECTLY TO ECG MANAGEMENT CONSULTANTS, INC. ON BEHALF OF COMMMUNITY MEDICAL CENTER'S INTERIM CFO. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES - THE COMMUNITY MEDICAL CENTER BOARD OF DIRECTORS APPROVED REIMBURSEMENT OF ATHLETIC AND/OR SOCIAL CLUB DUES UP TO 2,500 FOR THE CHIEF EXECUTIVE OFFICER OF COMMUNITY MEDICAL CENTER.
SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 GLENN D. STEELE JR., M.D., PH.D. 0 3,128,364 0 KEVIN F. BRENNAN, CPA, FHFMA 0 155,504 0 ALBERT BOTHE, M.D. 0 66,050 0 FRANK J. TREMBULAK 0 3,662 0
OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III 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 HEALTH SYSTEM" AND "SYSTEM" OR THE ACRONYM "GHS" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH SYSTEM FOUNDATION ("THE FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM.
Schedule J (Form 990) 2011

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2011
Schedule L (Form 990 or 990-EZ) 2011
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) GEISINGER QUALITY OPTIONS INC
  		BUSINESS 1,851,902 IC SHARED SRVC REV   No
(2) GEISINGER INDEMNITY INSURANCE CO
  		BUSINESS 248,813 IC SHARED SRVC REV   No
(3) INTERNATIONAL SHARED SERVICES INC
  		BUSINESS 484,961 IC SHARED SRVC EXP   No
(4) GEISINGER ASSURANCE COMPANY LTD
  		BUSINESS 856,013 IC SHARED SRVC EXP   No
(5) EMERGENCY SERVICES PC
  		BUSINESS 248,802 EMERGENCY ROOM SVCS   No
(6) GENERAL BILLING ASSOCIATES INC
  		BUSINESS 113,028 BILLING, CODING SVCS   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
ADDITIONAL INFORMATION SCHEDULE L PART V COMMUNITY MEDICAL CENTER DBA GEISINGERCOMMUNITY MEDICAL CENTER GCMC IS CLOSELY AFFILIATED WITH SEVERAL OTHER ORGANIZATIONS IN THE NORMAL COURSE OF OPERATIONS OF THESE AFFILIATED ORGANIZATIONS THERE ARE NUMEROUS INTER ORGANIZATIONAL TRANSACTIONS WHICH MAY INCLUDE SALES EXCHANGES AND LEASE OF PROPERTY EXTENSIONS OF CREDIT FURNISHING OF GOODS SERVICES AND FACILITIES AND TRANSFERS OF ASSETS THESE TYPES OF INTERORGANIZATIONAL TRANSACTIONS WERE DESCRIBED TO THE INTERNAL REVENUE SERVICE IRS IN A RULING APPLICATION AND WERE RECOGNIZED BY THE NATIONAL OFFICE OF THE IRS IN A SERIES OF PRIVATE LETTER RULINGS AS BEING ENTIRELY CONSISTENT WITH THE ORGANIZATIONS TAX EXEMPT STATUS THE FOLLOWING ORGANIZATIONS REPRESENT THE AFFILIATED FORPROFIT ORGANIZATIONS WITHIN THE GEISINGER HEALTH SYSTEM FOR WHOM BUSINESS TRANSACTIONS MUST BE DISCLOSED FOR PURPOSES OF SCHEDULE L PART IV TRANSACTIONS WITH INTERESTED PERSONS OFFICERS AND DIRECTORS OF GCMC ARE OFFICERS AND DIRECTORS OF THESE ORGANIZATIONS AS DESCRIBED BELOW GEISINGER QUALITY OPTIONS INC GQO GLENN D STEELE JR MD PHD IS THE PRESIDENT CHAIRMAN OF THE BOARD AND DIRECTOR OF GCMC AND THE CHAIRMAN OF THE BOARD AND DIRECTOR EX OFFICIO OF GQO DAVID J FELICIO ESQUIRE IS THE CHIEF LEGAL OFFICER AND SECRETARY OF GCMC AND GQO FRANK J TREMBULAK IS THE SENIOR VICE PRESIDENT AND TREASURER OF GCMC AND SENIOR VICE PRESIDENT TREASURER AND DIRECTOR OF GQO WILLIAM H ALEXANDER IS A DIRECTOR OF GCMC AND GQO RICHARD GRAFMYRE IS A DIRECTOR OF GCMC AND GQO DON A ROSINI IS A DIRECTOR OF GCMC AND GQO THOMAS H LEE JR IS A DIRECTOR OF GCMC AND GQO INTERNATIONAL SHARED SERVICES INC ISS GLENN D STEELE JR MD PHD IS THE PRESIDENT CHAIRMAN OF THE BOARD AND DIRECTOR OF GCMC AND THE CHAIRMAN OF THE BOARD AND DIRECTOR OF ISS FRANK J TREMBULAK IS THE SENIOR VICE PRESIDENT AND TREASURER OF GCMC AND THE SENIOR VICE PRESIDENT TREASURER AND DIRECTOR OF ISS DAVID J FELICIO ESQUIRE IS THE CHIEF LEGAL OFFICER AND SECRETARY OF GCMC AND ISS EDWARD J ZYCH ESQUIRE IS THE ASSISTANT SECRETARY OF GCMC AND ISS GEISINGER INDEMNITY INSURANCE COMPANY GIIC GLENN D STEELE JR MD PHD IS THE PRESIDENT CHAIRMAN OF THE BOARD AND DIRECTOR OF GCMC AND THE CHAIRMAN OF THE BOARD AND DIRECTOR EX OFFICIO OF GIIC DAVID J FELICIO ESQUIRE IS THE CHIEF LEGAL OFFICER AND SECRETARY OF GCMC AND GIIC FRANK J TREMBULAK IS THE SENIOR VICE PRESIDENT AND TREASURER OF GCMC AND SENIOR VICE PRESIDENT TREASURER AND DIRECTOR OF GIIC WILLIAM H ALEXANDER IS A DIRECTOR OF GCMC AND GIIC RICHARD GRAFMYRE IS A DIRECTOR OF GCMC AND GIIC DON A ROSINI IS A DIRECTOR OF GCMC AND GIIC THOMAS H LEE JR IS A DIRECTOR OF GCMC AND GIIC GEISINGER ASSURANCE COMPANY LTD GAC GLENN D STEELE JR MD PHD IS THE PRESIDENT CHAIRMAN OF THE BOARD AND DIRECTOR OF GCMC AND THE CHAIRMAN OF THE BOARD AND DIRECTOR OF GAC FRANK J TREMBULAK IS THE SENIOR VICE PRESIDENT AND TREASURER OF GCMC AND THE PRESIDENT CHIEF EXECUTIVE OFFICER AND DIRECTOR OF GAC DAVID J FELICIO ESQUIRE IS THE CHIEF LEGAL OFFICER AND SECRETARY OF GCMC AND THE SECRETARY AND DIRECTOR OF GAC EDWARD J ZYCH ESQUIRE IS THE ASSISTANT SECRETARY OF GCMC AND GAC DR DENAPLES COMPANY EMERGENCY SERVICES PC PROVIDES MEDICAL AND EMERGENCY ROOM SERVICES TO COMMUNITY MEDICAL CENTER COMMUNITY MEDICAL CENTER ALSO PAYS A STIPEND TO EMERGENCY SERVICES PC FOR THE SERVICES PROVIDED BY DR DENAPLES AS A MEDICAL DIRECTOR IN THE HOSPITAL DR DENAPLES COMPANY GENERAL BILLING ASSOCIATES INC PROVIDES PROVIDES BILLING AND CODING SERVICES TO COMMUNITY MEDICAL CENTER FOOTNOTE THROUGHOUT FORM 990 THE TERMS GEISINGER HEALTH SYSTEM AND SYSTEM OR THE ACRONYM GHS SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH SYSTEM FOUNDATION THE FOUNDATION AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM
Schedule L (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE N
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Liquidation, Termination, Dissolution or Significant Disposition of Assets
bullet Complete if the organization answered "Yes" to Form 990, Part IV, lines 31 or 32 or Form 990-EZ, line 36.
bullet Attach certified copies of any articles of dissolution, resolutions or plans.
bullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number
24-0862246
Part I
Liquidation, Termination or Dissolution. Complete if the organization answered "Yes" to Form 990, Part IV, line 31, or Form 990-EZ, line
36. Use Part III if additional space is needed.
1(a)Description of asset(s)
distributed or transaction
expenses paid		 (b)Date of
distribution		 (c)Fair market value of
asset(s) distributed or
amount of transaction
expenses		 (d)Method of
determining FMV for
asset(s) distributed or
transaction expenses		 (e)EIN of recipient (f)Name and address of recipient (g)IRC section
of recipient(s) (if
tax-exempt) or type
of entity
























Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2a
 
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? . . . . . . . . . . . . . . . .
2b
 
 
c
Become a direct or indirect owner of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . .
2c
 
 
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization's liquidation, termination, or dissolution? . . . . .
2d
 
 
e
If the organization answered "Yes" to any of the questions in this line, provide the name of the person involved and explain in Part III. bullet
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.
Cat. No. 50087Z
Schedule N (Form 990 or 990-EZ) 2011

Schedule N (Form 990 or 990-EZ) 2011
Page 2
Part I
Liquidation, Termination or Dissolution (continued)
Note. If the organization distributed all of its assets during the tax year, then Form 990, Part X, column (B), line 16 (Total assets), and line 26 (Total liabilities), should equal -0-.
Yes
No
3
Did the organization distribute its assets in accordance with its governing instrument(s)? If “No,” describe in Part III . . . . . . . . . . .
3
 
 
4a
Is the organization required to notify the attorney general or other appropriate state official of its intent to dissolve, liquidate, or terminate? . . . . . .
4a
 
 
b
If “Yes,” did the organization provide such notice? . . . . . . . . . . . . . . . . . . . . . . . . . .
4b
 
 
5
Did the organization discharge or pay all of its liabilities in accordance with state laws? . . . . . . . . . . . . . . . . .
5
 
 
6a
Did the organization have any tax-exempt bonds outstanding during the year? . . . . . . . . . . . . . . . . . . . .
6a
 
 
b
Did the organization discharge or defease all of its tax-exempt bond liabilities during the tax year in accordance with the Internal Revenue Code and state laws? .
6b
 
 
c
If ‘Yes’ to line 6b, describe in Part III how the organization defeased or otherwise settled these liabilities. If “No,” explain in Part III.

Part II
Sale, Exchange, Disposition or Other Transfer of More Than 25% of the Organization's Assets. Complete if the organization answered "Yes" to Form 990, Part IV, line 32, or Form 990-EZ, line 36. Use Part III if additional space is needed.
1(a)Description of asset(s)
distributed or transaction
expenses paid		 (b)Date of
distribution		 (c)Fair market value of
asset(s) distributed or
amount of transaction
expenses		 (d)Method of
determining FMV for
asset(s) distributed or
transaction expenses		 (e)EIN of recipient (f)Name and address of recipient (g)IRC section
of recipient(s) (if
tax-exempt) or type
of entity
CASH AND INVESTMENTS 02-01-2012 32,647,879 MARKET 23-1995911 GEISINGER HEALTH SYSTEM FOUNDATION
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822 		501(C)(3)
ACCOUNTS RECEIVABLE 02-01-2012 17,146,264 BOOK VALUE 23-1995911 GEISINGER HEALTH SYSTEM FOUNDATION
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822 		501(C)(3)
INVENTORY 02-01-2012 3,379,149 BOOK VALUE 23-1995911 GEISINGER HEALTH SYSTEM FOUNDATION
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822 		501(C)(3)
OTHER RECEIVABLES 02-01-2012 3,238,965 BOOK VALUE 23-1995911 GEISINGER HEALTH SYSTEM FOUNDATION
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822 		501(C)(3)
PREPAID EXPENSES 02-01-2012 1,407,078 BOOK VALUE 23-1995911 GEISINGER HEALTH SYSTEM FOUNDATION
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822 		501(C)(3)
PROPERTY AND EQUIP,NET 02-01-2012 36,064,702 BOOK VALUE 23-1995911 GEISINGER HEALTH SYSTEM FOUNDATION
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822 		501(C)(3)
NOTE RECEIVABLE 02-01-2012 2,079,219 BOOK VALUE 23-1995911 GEISINGER HEALTH SYSTEM FOUNDATION
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822 		501(C)(3)
OTHER 02-01-2012 1,231,973 BOOK VALUE 23-1995911 GEISINGER HEALTH SYSTEM FOUNDATION
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822 		501(C)(3)




Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2a
 
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? . . . . . . . . . . . . . . . .
2b
 
 
c
Become a direct or indirect owner of a successor or transferee organization? . . . . . . . . . . . . . . . . . . . . .
2c
 
 
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization’s significant disposition of assets? . . . . . . .
2d
 
 
e
If the organization answered "Yes" to any of the questions in this line, provide the name of the person involved and explain in Part III.
Schedule N(Form 990 or 990-EZ) 2011

Schedule N (Form 990 or 990-EZ) 2011
Page 3
Part III
Supplemental Information. Complete to provide the information required by Parts I and II,
and any additional information.
Identifier Return Reference Explanation
ADDITIONAL INFORMATION SCHEDULE N ROBERT P STEIGMEYER PRESIDENT AND CEO OF COMMUNITY MEDICAL CENTER BARBARA BOSSI VICE PRESIDENT NURSING JAMES JESIKIEWICZ ASSISTANT TREASURER SEAN MCANDREW VICE PRESIDENT INFORMATION SERVICES AND WENDY K WILSON VICE PRESIDENT PUBLIC RELATIONS WILL CONTINUE TO BE COMPENSATED AS EMPLOYEES OF GEISINGERCOMMUNITY MEDICAL CENTER SUBSEQUENT TO THE ACQUISITION DATE OF 02012012 TIMOTHY FARRELL MD WILL BE AN INDEPENDENT CONTRACTOR OF GEISINGER COMMUNITY MEDICAL CENTER
Schedule N (Form 990 or 990-EZ) 2011


Additional Data


Software ID:  
Software Version:  


SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Identifier Return Reference Explanation
ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING QUALITY HOSPITAL SERVICES AND ACCESS ACROSS NORTHEASTERN PENNSYLVANIA THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE.
FIRST ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4A GCOMMUNITY MEDICAL CENTER, DOING BUSINESS AS GEISINGER-COMMUNITY MEDICAL CENTER (G-CMC), OPENED IN 1897 AS THE HAHNEMANN HOSPITAL AND SCHOOL OF NURSING, THE HOSPITAL WAS SCRANTON'S FIRST HOSPITAL DEDICATED TO COMMUNITY SERVICE. G-CMC CONTINUES TO PROVIDE THE COMMUNITY WITH A VARIETY OF SERVICES AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. THIS CONTINUUM OF CARE INCLUDES PREVENTATIVE, AMBULATORY, INPATIENT, AND EMERGENCY SERVICES. G-CMC IS A NOTED REGIONAL REFERRAL CENTER WITH COMPREHENSIVE ACUTE CARE MEDICAL SERVICES AND HAS DEVELOPED SPECIFIC AREAS OF EXPERTISE. SPECIALIZED / REGIONAL SERVICES, CENTER OF EXCELLENCE: G-CMC IS AN ACUTE CARE HOSPITAL LICENSED FOR 297 BEDS AND THE ONLY LEVEL II TRAUMA CENTER IN LACKAWANNA COUNTY. THE NORTHEAST PA TRAUMA CENTER, DESIGNATED BY THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION IN 1988, PROVIDES 24-HOUR COMPREHENSIVE SURGICAL INTERVENTION FOR CRITICALLY INJURED PATIENTS. THE TRAUMA CENTER IS STAFFED CONTINUOUSLY BY AN EMERGENCY PHYSICIAN, TRAUMA SURGEON AND NURSES CERTIFIED IN CRITICAL CARE, TRAUMA, ORTHOPAEDICS, AND THE NEUROSCIENCES. THE UNREIMBURSED COSTS OF PROVIDING TRAUMA SERVICES TO THE COMMUNITY IN FY 2012 TOTALED 1,281,642. CARDIOLOGY SERVICES AT THE HOSPITAL INCLUDE THE REGION'S FIRST ELECTROPHYSIOLOGY LAB AND AN OPEN HEART SURGERY CENTER. G-CMC IS ALSO A CERTIFIED CAROTID STENT FACILITY. NEUROLOGICAL SCIENCES AT THE HOSPITAL SPECIALIZES IN THE CARE OF PEOPLE WITH BRAIN AND SENSE ORGAN DISORDERS. OTHER SPECIALIZED SERVICES INCLUDE: A SAME-DAY SURGERY CENTER, A 24 LICENSED BED SHORT TERM PSYCHIATRIC INPATIENT UNIT, AN ORTHOPAEDIC TRAUMA CLINIC, CT SCANNER, MRI IMAGING, ONCOLOGY SERVICES, RENAL DIALYSIS, HYPERBARIC OXYGEN CHAMBER TREATMENTS, THE NEW STEPS JOINT PROGRAM, WOUND CARE, AND STEREOTACTIC SURGERY. G-CMC OFFERS EMERGENCY MEDICAL TECHNICIAN AND TRAUMA NURSE TRAINING PROGRAMS. IT HAS AN AFFILIATION WITH THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION, AN ACCREDITED PROVIDER OF INTERNAL MEDICINE RESIDENCY EDUCATION, BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION, AND THE REGION'S ONLY PODIATRIC RESIDENCY PROGRAM, AND ACCREDITED PROVIDER OF PODIATRIC MEDICINE AND SURGERY EDUCATION, BY THE COUNCIL OF PODIATRIC MEDICAL EDUCATION. UNCOMPENSATED COSTS FOR HEALTH PROFESSIONS EDUCATION TOTALED 1,186,186. G-CMC ALSO SPONSORS THE COMMUNITY HEALTH EDUCATION PROGRAM, THE REGION'S FIRST HOSPITAL-BASED AND COMMUNITY-WIDE WELLNESS AND PREVENTION PROGRAM. IN ADDITION, G-CMC SPONSORS THE PRIORITY CARE PROGRAM IN WHICH OVER 20,000 SENIOR CITIZENS ARE ENROLLED IN THE REGION'S FIRST HOSPITAL-BASED FREE MEMBERSHIP PLAN FOR PERSONS OVER 55 AND OLDER. PRIORITY CARE PROVIDES SENIOR CITIZENS WITH A WIDE VARIETY OF BENEFITS AND INFORMATION REGARDING HEALTH AND WELLNESS PROGRAMS. PRIORITY CARE OFFERS CONVENIENT ACCESS TO QUALITY SERVICES INCLUDING: FREE PARKING IN THE G-CMC PARKING COMPLEX COMMUNITY DISCOUNTS DISCOUNTED MEALS IN THE HOSPITAL'S DINING ROOM DISCOUNTS AT THE G-CMC GIFT SHOP PHYSICIAN REFERRAL SERVICE AFFILIATIONS: G-CMC HAS WORKING RELATIONSHIPS WITH OTHER HEALTH CARE PROVIDERS IN VENTURES SUCH AS THE NORTHEASTERN PENNSYLVANIA IMAGING CENTER, THE CHILDREN'S ADVOCACY CENTER, MATERNAL & FAMILY HEALTH SERVICES, AND THE RONALD MCDONALD HOUSE OF SCRANTON. G-CMC ALSO HAS A CONNECTION WITH NUMEROUS AREA INSTITUTIONS, COLLEGES, AND UNIVERSITIES FOR EDUCATIONAL AND CLINICAL PROGRAMS, INCLUDING, BUT NOT LIMITED TO, NURSING, MEDICAL TECHNOLOGY, PHYSICAL AND OCCUPATIONAL THERAPY, EMERGENCY MEDICAL TECHNICIANS, PHYSICIAN ASSISTANTS, SOCIAL WORK AND HEALTHCARE ADMINISTRATION. MEDICAL STAFF: AS OF JUNE 30, 2012, THE MEDICAL STAFF AT G-CMC TOTALED OVER 350 PHYSICIANS. UNDER G-CMC'S MEDICAL STAFF BY-LAWS, PHYSICIANS MAY HAVE ONE OF SEVERAL TYPES OF PRIVILEGES INCLUDING ACTIVE, COURTESY, CONSULTING, EMERGENCY, AND TEMPORARY. AUXILIARY: THE G-CMC AUXILIARY IS COMPRISED OF APPROXIMATELY 65 MEMBERS. FUNCTIONING WITH THE GUIDANCE OF ITS OWN ADVISORY BOARD, THE AUXILIARY HAS COMMITTEES, EACH WITH ITS OWN RESPONSIBILITY FOR FUND-RAISING, AND SERVICE. THE AUXILIARY ASSISTS IN OPERATING G-CMC'S GIFT SHOP SEVEN DAYS A WEEK. ALLOCATIONS OF FUNDS RAISED BY THE AUXILIARY ARE MADE TO G-CMC TO ENHANCE PATIENT SERVICES. VOLUNTEER SERVICES: FROM YEAR TO YEAR, G-CMC HAS APPROXIMATELY 250-300 ACTIVE ADULT AND JUNIOR VOLUNTEERS WHO VOLUNTEER THEIR TIME TO G-CMC AND CAN BE FOUND ASSISTING THE STAFF IN A VARIETY OF CAPACITIES IN HOSPITAL DEPARTMENTS SUCH AS: MAIL ROOM, MEDICAL RECORDS, SURGICAL SERVICES, EMERGENCY DEPARTMENT, AND GIFT SHOP. VOLUNTEERS ALSO ASSIST AT SPECIAL HOSPITAL FUNCTIONS. IN 2012, G- CMC VOLUNTEERS PROVIDED OVER 11,500 HOURS OF SERVICE TO G-CMC. THROUGH G-CMC'S VOLUNTEER DEPARTMENT, HUNDREDS OF SCHOOL AND COLLEGE STUDENTS ARE PROVIDED INFORMATION ABOUT HEALTHCARE TO ASSIST IN CAREER CHOICE THROUGH TOURS AND SHADOWING OPPORTUNITIES AT THE FACILITY. PATIENT ORIGIN AND SERVICE AREA: THE HOSPITAL'S PRIMARY SERVICE AREA IS COMPRISED OF LACKAWANNA COUNTY. THE SECONDARY SERVICE AREA INCLUDES LUZERNE, MONROE, PIKE, SUSQUEHANNA, WAYNE AND WYOMING COUNTIES. SUPPORT TO THE COMMUNITY: G-CMC AND RELATED AFFILIATES PROVIDE A VARIETY OF PROGRAMS TO THE COMMUNITY INCLUDING THE EDUCATION PROGRAM WHICH PROVIDES NUMEROUS COMMUNITY SERVICES SOME OF WHICH ARE LISTED BELOW. THE INTENT OF THESE PROGRAMS AND PARTNERSHIPS IS THE IMPROVED HEALTH OF THE COMMUNITY; I.E., ACCIDENT/ ILLNESS PREVENTION OR EARLY INTERVENTION AS A RESULT OF INCREASED EDUCATION. THE NORTHEAST PA TRAUMA CENTER PROVIDES EMERGENCY PREPAREDNESS ASSISTANCE AND MEDICAL EXPERTISE TO THE AMERICAN RED CROSS LACKAWANNA CHAPTER, LACKAWANNA COUNTY EMERGENCY MANAGEMENT AGENCY, AND THE SCRANTON/WILKES- BARRE INTERNATIONAL AIRPORT. ALSO, FALL AND INJURY PREVENTION FOR THE ELDERLY IS AVAILABLE TO AREA SENIOR CITIZENS AND SENIOR ORGANIZATIONS, AS WELL AS MANY AGE-SPECIFIC PREVENTION PROGRAMS TO VARIOUS ORGANIZATIONS AND SCHOOLS THROUGHOUT THE YEAR. EACH YEAR OVER 500 CHILDREN UNDER THE AGE OF 18 ARE INVOLVED IN EDUCATION'S EXTENSIVE PROGRAMS TARGETING THIS AGE GROUP. TRAUMA PREVENTION PROGRAMS SUCH AS TRAUMA ROOM AND THINK FIRST TEACH KIDS IMPORTANT SAFETY INFORMATION. ASTHMA SKI DAY HELD IN CONJUNCTION WITH SNO MOUNTAIN SKI AREA AND G-CMC'S COMMUNITY HEALTH EDUCATION PROGRAM, EMPHASIZE THAT DESPITE ILLNESS, INDIVIDUALS CAN STILL PARTICIPATE IN HEALTHY, EVEN STRENUOUS ACTIVITIES. IN ADDITION, A POISON PREVENTION PROGRAM IS AVAILABLE ALONG WITH OTHER SUCH PROGRAMS AS REQUESTED. MANY OF THESE PROGRAMS ARE THE RESULTS OF EDUCATION'S PARTNERSHIPS WITH OTHER COMMUNITY RESOURCES; E.G., THE AMERICAN LUNG ASSOCIATION, LACKAWANNA COUNTY DRUG AND ALCOHOL COMMISSION, AND ALLIED SERVICES. THE COMMUNITY HEALTH EDUCATION PROGRAM CONDUCTS A WIDE VARIETY OF HEALTH LIFESTYLE PROGRAMS, FREE OR AT MINIMAL COST, WHICH ARE DESIGNED TO 'PRACTICALLY' ASSIST AN INDIVIDUAL IN THEIR QUEST TO LEAD A HEALTHY AND PRODUCTIVE LIFE. SOME OF THE AREAS OF CONCENTRATION INCLUDE: SMOKING CESSATION, FIRST AID, CPR, AND WEIGHT WATCHERS SESSIONS THAT ARE OPEN TO THE PUBLIC AS WELL AS EMPLOYEES AND FAMILY. PUBLIC / COMMUNITY HEALTH LECTURES: LAST YEAR APPROXIMATELY 400 PEOPLE ATTENDED THESE SESSIONS WHICH ARE FREE TO THE PUBLIC. A SAMPLING OF THE TOPICS INCLUDED THE FOLLOWING: ALZHEIMER'S PROGRAM FOR CAREGIVERS, MENTAL HEALTH ISSUES, END OF LIFE ISSUES, BREAST CANCER AWARENESS, AND COLON CANCER AWARENESS. HEALTH FAIRS / SCREENING PROGRAMS: EDUCATION IN PARTNERSHIP WITH OTHER COMMUNITY RESOURCES PROVIDES HEALTH FAIRS AND SCREENINGS TO THE COMMUNITY AND LOCAL BUSINESS/INDUSTRY FREE OR AT A MINIMAL COST. PROGRAMS INCLUDED: CARBON MONOXIDE SCREENINGS, CHOLESTEROL/BLOOD PRESSURE SCREENINGS, AND DIABETIC SCREENINGS. THE UNREIMBURSED COST OF PROVIDING SUCH SCREENINGS IN FY 2012 TOTALED 24,081. THE SYSTEM PROVIDES MONTHLY MEETING PLACES FREE OF CHARGE TO MANY COMMUNITY SELF-HELP GROUPS WHICH INCLUDE: DIABETES SUPPORT GROUP, CROHNS & COLITIS SUPPORT GROUP, BETTER BREATHER'S CLUB, AND NAMI SUPPORT GROUP MEETINGS. G-CMC'S FACILITIES ARE MADE AVAILABLE TO OTHER COMMUNITY GROUPS UPON REQUEST AND AVAILABILITY; E.G., THE HILL NEIGHBORHOOD ASSOCIATION, AND THE EAST SCRANTON BUSINESS ASSOCIATION. UNCOMPENSATED CARE G-CMC RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND EDUCATION. G-CMC PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD G-CMC PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A. CHARITY CARE THE PRIMARY CONCERN OF G-CMC IS THE DELIVERY OF HEALTH CARE TO ALL THE CITIZENS OF NORTHEASTERN PENNSYLVANIA, REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST G-CMC INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. THE COST TO GMC OF PROVIDING THIS CHARITY CARE DURING THE FISCAL YEAR ENDED JUNE
ADDITIONAL INFORMATION 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, ONE VOTING MEMBER IS NOT INDEPENDENT BECAUSE HE IS COMPENSATED AS AN EMPLOYEE OF A RELATED TAX-EXEMPT ORGANIZATION. INCLUDING THE VOTING MEMBER DESCRIBED ABOVE, A TOTAL OF SIX VOTING MEMBERS OF THE GOVERNING BODY ARE ALSO VOTING MEMBERS OF AFFILIATED TAXABLE ORGANIZATIONS FOR WHICH BUSINESS TRANSACTIONS MAY BE DISCLOSED ON SCHEDULE L, PART IV. HOWEVER, IF THE RELATED TAXABLE ORGANIZATIONS WERE REQUIRED TO FILE SCHEDULE L, THESE TRANSACTIONS WOULD NOT BE OF A TYPE THAT WOULD BE REPORTABLE ON THEIR SCHEDULE L. IN ADDITION, THESE VOTING MEMBERS ARE NOT COMPENSATED BY THE AFFILIATED TAXABLE ORGANIZATIONS FOR WHICH TRANSACTIONS ARE DISCLOSED IN SCHEDULE L, PART IV, DO NOT HAVE AN OWNERSHIP INTEREST IN OR RECEIVE ANY ECONOMIC BENEFIT FROM THE ACTIVITIES OF THESE AFFILIATED TAXABLE ORGANIZATIONS, RECEIVE NO PRIVATE INUREMENT / PRIVATE BENEFIT FROM THE TRANSACTIONS WITH THE RELATED TAXABLE ORGANIZATIONS AND THE VOTING MEMBERS OF THE GOVERNING BODY ABSTAIN FROM VOTING AND ARE ABSENT FROM BOARD DELIBERATIONS AND DECISIONS ON MATTERS IF A CONFLICT EXISTS. REFER TO THE RESPONSE FOR FORM 990, PART VI, SECTION B, QUESTION 12A, 12B, AND 12C REGARDING THE GEISINGER HEALTH SYSTEM CONFLICTS OF INTEREST POLICY, DISCLOSURE, AND ENFORCEMENT. 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? GLENN D. STEELE, JR MD, PHD, ALBERT BOTHE, MD, DAVID J. FELICIO, ESQUIRE, FRANK J. TREMBULAK, EDWARD J. ZYCH, ESQUIRE, WILLIAM H. ALEXANDER, WILLIAM R. GRUVER, RICHARD GRAFMYRE, THOMAS H. LEE, JR., M.D., ROBERT E. POOLE, DON A. ROSINI ALL HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER BECAUSE THEY SERVE AS OFFICERS AND/OR DIRECTORS ON ONE OR MORE FOR-PROFIT AFFILIATES OF GEISINGER-COMMUNITY MEDICAL CENTER. ALL OF THE AFFILIATES ARE PART OF THE GEISINGER HEALTH SYSTEM. FORM 990, PART VI, SECTION B, LINE 13: DID THE ORGANIZATION HAVE A WRITTEN WHISTLEBLOWER POLICY? AND LINE 14: DID THE ORGANIZATION HAVE A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY? THE GEISINGER HEALTH SYSTEM WHISTLEBLOWER POLICY AND DOCUMENT RETENTION AND DESTRUCTION POLICY HAVE BEEN IN EFFECT AND ENFORCED FOR MANY YEARS. IN ADDITION TO THE POLICIES BEING A BEST PRACTICE, GEISINGER HEALTH SYSTEM RECOGNIZES THEIR VALUE AS A GUIDE TO THE GOVERNING BODY OF THE ORGANIZATION , EMPLOYEES, AND OTHERS. THE BOARD OF DIRECTORS OF GEISINGER HEALTH SYSTEM FORMALLY APPROVED THE POLICIES IN THE SPRING OF 2013.
AUTHORITY DELEGATED TO COMMITTEE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 1A OTHER THAN THE COMMITTEES' LISTED IN THE IRS INSTRUCTIONS AND THE MEDICAL AFFAIRS COMMITTEE WHOSE AUTHORITY IS LIMITED IN SCOPE, THERE WAS A DELEGATION OF AUTHORITY TO THE GEISINGER HEALTH SYSTEM FOUNDATION (GHSF) EXECUTIVE COMMITTEE WHICH IS COMPRISED OF THOSE INDIVIDUALS WHO SERVE AS GHSF BOARD MEMBERS. UNDER THE NONPROFIT CORPORATION LAW AND UNDER GHSF'S CORPORATE BYLAWS, THE EXECUTIVE COMMITTEE HAS THE FULL AUTHORITY TO ACT ON BEHALF OF THE FULL BOARD OF DIRECTORS WHEN IT IS NOT IN SESSION.
MANAGEMENT DELEGATED FORM 990, PAGE 6, PART VI, LINE 3 PRIOR TO THE AFFILIATION WITH GEISINGER HEALTH SYSTEM ON FEBRUARY 1, 2012, THE ORGANIZATION DELEGATED CHIEF FINANCIAL OFFICER RESPONSIBILITIES TO AN OUTSIDE MANAGEMENT COMPANY, ECG MANAGEMENT CONSULTANTS. THE ORGANIZATION DELINEATED THE RESPONSIBILITIES IN THE MANAGEMENT AGREEMENT AND REPORTED TO THE BOARD OF DIRECTORS COMPLIANCE WITH THE DELEGATED DUTIES.
SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS FORM 990, PAGE 6, PART VI, LINE 4 COMMUNITY MEDICAL CENTER REVISED ITS ARTICLES OF INCORPORATION AND CORPORATE BYLAWS TO REFLECT GEISINGER HEALTH SYSTEM FOUNDATION HAS THE AUTHORITY TO APPOINT THE CORPORATE MEMBERS AND TO REFLECT NEW GOVERNING BODY AND COMMITTEE STRUCTURE.
CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 THE MEMBERS OF THE CORPORATION HAVE THE POWER AND AUTHORITY TO ELECT AND REMOVE DIRECTORS, ELECT AND REMOVE THE PRESIDENT AND FILL ANY VACANCY IN THE OFFICE OF THE PRESIDENT OF THE CORPORATION AND APPROVE AMENDMENTS TO THE CORPORATE BYLAWS. THE MEMBERS ALSO HAVE THE RESERVE POWERS AS SET FORTH IN THE PENNSYLVANIA NONPROFIT CORPORATION LAW.
ELECTION OF MEMBERS AND THEIR RIGHTS 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.
DECISIONS SUBJECT TO APPROVAL OF MEMBERS FORM 990, PAGE 6, PART VI, LINE 7B 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.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 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 SYSTEM FOUNDATION BOARD OF DIRECTOR'S FINANCE COMMITTEE CHARTER, STAFF PERIODICALLY REVIEWS THE GHS ORGANIZATIONS' FORM 990 FILINGS. THE FORM 990 IS PREPARED BY THE GEISINGER HEALTH SYSTEM (GHS) TAX AND FINANCIAL REPORTING DEPARTMENTS WITH INFORMATION PROVIDED FROM FINANCE, TAX, HUMAN RESOURCES, PAYROLL, LEGAL SERVICES AND OTHER RELEVANT DEPARTMENTS WITHIN THE GEISINGER HEALTH SYSTEM. THE CHIEF FINANCIAL OFFICER (CFO) OF GHS 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 GHS REVIEW THE INFORMATION DISCLOSED ON THE FORM 990 RELEVANT TO THEIR RESPECTIVE AREAS OF RESPONSIBILITY. FOR PURPOSES OF THEIR ANNUAL AUDIT OF THE GHS CONSOLIDATED FINANCIAL STATEMENTS, INDEPENDENT AUDITORS REVIEW ALL FEDERAL TAX RETURNS FILED BY THE GHS 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 FISCAL YEAR-ENDED JUNE 30, 2012.
ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C THE OFFICERS AND DIRECTORS OF COMMUNITY MEDICAL CENTER ARE SUBJECT TO THE GHS 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 THE GEISINGER HEALTH SYSTEM. THE DISCLOSURES ARE REVIEWED BY THE OFFICE OF THE CHIEF LEGAL OFFICER AND REPORTED TO THE AUDIT 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.
COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS TO REVIEW AND APPROVE THE COMPENSATION OF GHS 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 GHS. THE CONSULTANT'S REPORT IS PRESENTED TO THE MANAGEMENT AND COMPENSATION COMMITTEE PRIOR TO ANY COMPENSATION ADJUSTMENT. THE REPORT SUPPORTS THE RIGOROUS REVIEW COMPLETED BY THE MANAGEMENT AND COMPENSATION 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 MANAGEMENT AND COMPENSATION COMMITTEE PRIOR TO THE EFFECTIVE DATE OF THE PAYMENT. THE MANAGEMENT AND COMPENSATION COMMITTEE AT ITS SOLE DISCRETION MAY POSITIVELY OR NEGATIVELY ADJUST ANY RECOMMENDED COMPENSATION.
COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B SEE SCHEDULE O RESPONSE TO FORM 990, PART VI, SECTION B, QUESTION 15A.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE MISSION STATEMENT IS AVAILABLE ON THE GEISINGER HEALTH SYSTEM WEBSITE AT: WWW.GEISINGER.ORG. THE ANNUAL REPORT FOR THE GEISINGER HEALTH SYSTEM, CONTAINING CONSOLIDATED FINANCIAL STATEMENT INFORMATION, COMMUNITY BENEFIT REPORT AND OTHER INFORMATION, IS AVAILABLE ON THE SYSTEM WEBSITE AT: WWW.GEISINGER.ORG/ABOUT/2011_AR_FINAL.PDF FINANCIAL STATEMENTS ALONG WITH THE COMPLETE FORM 990 AND 990-T ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GEISINGER HEALTH SYSTEM CONFLICTS OF INTEREST POLICY IS AVAILABLE ON THE SYSTEM WEBSITE AT: WWW.GEISINGER.ORG.
ADDITIONAL INFORMATION FORM 990, PART VII FORM 990, PART VII, SECTION A, COLUMN B - AVERAGE HOURS PER WEEK: FOR ALL CURRENT OFFICERS, DIRECTORS, KEY EMPLOYEES, AND FIVE HIGHEST COMPENSATED EMPLOYEES REPORTED IN FORM 990, PART VII, THE AVERAGE HOURS PER WEEK REPRESENTS THE MINIMUM HOURS DEVOTED TO THE ORGANIZATION AND RELATED ORGANIZATIONS OF THE GEISINGER HEALTH SYSTEM, AS APPLICABLE. FORMER OFFICERS, DIRECTORS, KEY EMPLOYEES, AND FIVE HIGHEST COMPENSATED EMPLOYEES WORK A MINIMUM OF 40 HOURS PER WEEK FOR RELATED ORGANIZATIONS.
OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 INCREASES IN NET ASSETS: TRANSFER FROM AFFILIATE 20,000,000 DECREASES IN NET ASSETS: UNREALIZED LOSS - 2,000,245 FAIR VALUATION OF ASSETS AND LIABILITIES -41,767,122 NET DECREASE IN NET ASSETS -23,767,367 EFFECTIVE FEBRUARY 1, 2012, COMMUNITY MEDICAL CENTER (CMC) WAS ACQUIRED BY GEISINGER HEALTH SYSTEM (GHS). AS PART OF THAT ACQUISITION, CMC EVALUATED ALL ASSETS AND LIABILITIES AND ADJUSTED TO FAIR MARKET VALUES.
ADDITIONAL INFORMATION 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 HEALTH SYSTEM'S CONSOLIDATED REPORT ON FEDERAL AWARDS IN ACCORDANCE WITH OMB CIRCULAR A-133. FOOTNOTE: THROUGHOUT FORM 990, THE TERMS "GEISINGER HEALTH SYSTEM" AND "SYSTEM" OR THE ACRONYM "GHS" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH SYSTEM FOUNDATION ("THE FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) GEISINGER HEALTH SYSTEM FOUNDATION

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-1995911 		PHILANTHRO PA 501C3 7 NA
 
Yes
 
(2) GEISINGER MEDICAL CENTER

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
24-0795959 		HOSPITAL PA 501C3 3 GHSF
 
Yes
 
(3) GEISINGER CLINIC

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-6291113 		PHYSICIAN PA 501C3 11A GHSF
 
Yes
 
(4) GEISINGER WYOMING VALLEY MED CTR

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-1996150 		HOSPITAL PA 501C3 3 GHSF
 
Yes
 
(5) MARWORTH

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2171417 		D&A REHAB PA 501C3 3 GHSF
 
Yes
 
(6) GEISINGER HEALTH PLAN

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2311553 		HEALTH INS PA 501C4   GHSF
 
Yes
 
(7) HERSHEY MEDICAL CENTER

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2891807 		HOSPITAL PA 501C3 3 GHSF
 
Yes
 
(8) GEISINGER SYSTEM SERVICES

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2164794 		SUPPORT SV PA 501C3 11A GHSF
 
Yes
 
(9) GEISINGER COMMUNITY HEALTH SERVICES

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2967235 		HEALTHCARE PA 501C3 9 GSS
 
Yes
 
(10) GEISINGER INSURANCE CORPORATIONRRG

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
14-1909894 		SELF INS VT 501C3 11A GHSF
 
Yes
 
(11) GEISINGER MED CTR PROF LIAB TRUST

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
25-6220019 		SELF INS PA 501C3 11A GMC
 
Yes
 
(12) GEISINGER EXCESS COV PROF LIAB TR

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-6852932 		SELF INS PA 501C3 11A GMC
 
Yes
 
(13) COMMUNITY MEDICAL CARE INC

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2429776 		PHYSICIAN PA 501C3 9 GHSF
 
Yes
 
(14) MEDICAL DIMENSIONS INC

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2369788 		RE HOLDIN PA 501C2   GHSF
 
Yes
 
(15) CMC HEALTHCARE SYS MED PROF LIAB TR

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
04-6990600 		SELF INS PA 501C3 11A GHSF
 
Yes
 
(16) MOUNTAIN VIEW NURSING HOME INC

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2568288 		LONG TERM PA 501C3 9 GHSF
 
Yes
 
(17) COMMUNITY MEDICAL CTR HEALTHCARE SY

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2279376 		SUPPORT SV PA 501C3 11A GHSF
 
Yes
 
(18) NORTHEAST CANCER CENTER INC

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
20-1687320 		HEALTHCARE PA 501C3 3 NA
 
Yes
 
(19) HEALTH CARE CORP OF NORTHEAST PA

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2337286 		SUPPORT SV PA 501C3 11A NA
 
Yes
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) KEYSTONE ACCOUNTABLE CARE ORG LLC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
45-4475297 		ACO PA N/A
         No     No  
(2) LIFESOURCE GEISINGER BLOOD CTR LLC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
36-4718005 		BLOOD COLL PA N/A
         No     No  
(3) MERIDIAN GEISINGER HLTH NTWRK LLC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
45-5484165 		ORG DL SYS NJ N/A
         No     No  
(4) HEALTHSOUTH GHS LLC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
72-1398803 		PHY THERAP PA N/A
         No     No  
(5) KEYSTONE ACCOUNTABLE CARE ORG LLC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
45-4475297 		ACO PA N/A
         No     No  
(6) LIFESOURCE GEISINGER BLOOD CTR LLC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
36-4718005 		BLOOD COLL PA N/A
         No     No  
(7) MERIDIAN GEISINGER HLTH NTWRK LLC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
45-5484165 		ORG DL SYS NJ N/A
         No     No  
(8) HEALTHSOUTH GHS LLC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
72-1398803 		PHY THERAP PA N/A
         No     No  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) GEISINGER MEDICAL MANAGEMENT CORP
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2077663 		HOTEL/REST PA N/A
        
(2) INTERNATIONAL SHARED SERVICES INC
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2159597 		COMPUTER PA N/A
        
(3) GEISINGER INDEMNITY INSURANCE COMP
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2815174 		HLTH INSUR PA N/A
        
(4) GEISINGER QUALITY OPTIONS INC
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
20-4275139 		HLTH INSUR PA N/A
        
(5) GEISINGER ASSURANCE COMPANY LTD
PO BOX 2196GT
  GRAND CAYMAN  
CJ
98-1016737 		INSURANCE CJ N/A
        
(6) GEISINGER MEDICAL MANAGEMENT CORP
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2077663 		HOTEL/REST PA N/A
        
(7) INTERNATIONAL SHARED SERVICES INC
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2159597 		COMPUTER PA N/A
        
(8) GEISINGER INDEMNITY INSURANCE COMP
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2815174 		HLTH INSUR PA N/A
        
(9) GEISINGER QUALITY OPTIONS INC
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
20-4275139 		HLTH INSUR PA N/A
        
(10) GEISINGER ASSURANCE COMPANY LTD
PO BOX 2196GT
  GRAND CAYMAN  
CJ
98-1016737 		INSURANCE CJ N/A
        
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) GEISINGER HEALTH SYSTEM FOUNDATION

 B 23,187,557 GAAP
(2) GEISINGER HEALTH PLAN

 K 6,499,328 GAAP
(3) GEISINGER HEALTH PLAN

 L 1,904,169 GAAP
(4) MEDICAL DIMENSIONS INC

 J 392,001 FMV
(5) GEISINGER CLINIC

 L 208,509 GAAP
(6) COMMUNITY MEDICAL CARE INC

 A 4,932 FMV
(7) GEISINGER INSURANCE CORPORATIONRRG

 O 189,777 GAAP
(8) GEISINGER SYSTEM SERVICES

 L 2,716,901 GAAP
(9) COMMUNITY MEDICAL CENTER HLTH SYS

 A 80,741 GAAP
(10) COMMUNITY MEDICAL CENTER HLTH SYS

 C 78,926 GAAP
(11) INTERNATIONAL SHARED SERVICES

 L 484,961 GAAP
(12) CMC HEALTHCARE SYS MED PROF LIAB TR

 L 1,247,072 GAAP
(13) MOUNTAIN VIEW NURSING HOME INC

 K 1,051,658 GAAP
(14) COMMUNITY MEDICAL CARE INC

 K 347,058 GAAP
(15) GEISINGER INDEMNITY INSURANCE CO

 K 248,813 GAAP
(16) GEISINGER QUALITY OPTIONS INC

 K 1,851,902 GAAP
(17) GEISINGER ASSURANCE COMPANY LTD

 L 856,013 GAAP
(18) GEISINGER HEALTH SYSTEM FOUNDATION

 B 23,187,557 GAAP
(19) GEISINGER HEALTH PLAN

 K 6,499,328 GAAP
(20) GEISINGER HEALTH PLAN

 L 1,904,169 GAAP
(21) MEDICAL DIMENSIONS INC

 J 392,001 FMV
(22) GEISINGER CLINIC

 L 208,509 GAAP
(23) COMMUNITY MEDICAL CARE INC

 A 4,932 FMV
(24) GEISINGER INSURANCE CORPORATIONRRG

 O 189,777 GAAP
(25) GEISINGER SYSTEM SERVICES

 L 2,716,901 GAAP
(26) COMMUNITY MEDICAL CENTER HLTH SYS

 A 80,741 GAAP
(27) COMMUNITY MEDICAL CENTER HLTH SYS

 C 78,926 GAAP
(28) INTERNATIONAL SHARED SERVICES

 L 484,961 GAAP
(29) CMC HEALTHCARE SYS MED PROF LIAB TR

 L 1,247,072 GAAP
(30) MOUNTAIN VIEW NURSING HOME INC

 K 1,051,658 GAAP
(31) COMMUNITY MEDICAL CARE INC

 K 347,058 GAAP
(32) GEISINGER INDEMNITY INSURANCE CO

 K 248,813 GAAP
(33) GEISINGER QUALITY OPTIONS INC

 K 1,851,902 GAAP
(34) GEISINGER ASSURANCE COMPANY LTD

 L 856,013 GAAP
(35) GEISINGER HEALTH SYSTEM FOUNDATION

 B 23,187,557 GAAP
(36) GEISINGER HEALTH PLAN

 K 6,499,328 GAAP
(37) GEISINGER HEALTH PLAN

 L 1,904,169 GAAP
(38) MEDICAL DIMENSIONS INC

 J 392,001 FMV
(39) GEISINGER CLINIC

 L 208,509 GAAP
(40) COMMUNITY MEDICAL CARE INC

 A 4,932 FMV
(41) GEISINGER INSURANCE CORPORATIONRRG

 O 189,777 GAAP
(42) GEISINGER SYSTEM SERVICES

 L 2,716,901 GAAP
(43) COMMUNITY MEDICAL CENTER HLTH SYS

 A 80,741 GAAP
(44) COMMUNITY MEDICAL CENTER HLTH SYS

 C 78,926 GAAP
(45) INTERNATIONAL SHARED SERVICES

 L 484,961 GAAP
(46) CMC HEALTHCARE SYS MED PROF LIAB TR

 L 1,247,072 GAAP
(47) MOUNTAIN VIEW NURSING HOME INC

 K 1,051,658 GAAP
(48) COMMUNITY MEDICAL CARE INC

 K 347,058 GAAP
(49) GEISINGER INDEMNITY INSURANCE CO

 K 248,813 GAAP
(50) GEISINGER QUALITY OPTIONS INC

 K 1,851,902 GAAP
(51) GEISINGER ASSURANCE COMPANY LTD

 L 856,013 GAAP
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(e)
Are all
partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
ADDITIONAL INFORMATION SCHEDULE R FORM 990 SCHEDULE R PART V TRANSACTIONS WITH RELATED ORGANIZATIONS AS SHOWN IN THE RESPONSE TO FORM 990 SCHEDULE R COMMUNITY MEDICAL CENTER IS CLOSELY AFFILIATED WITH SEVERAL OTHER ORGANIZATIONS IN THE NORMAL COURSE OF THE OPERATIONS OF THESE AFFILIATED ORGANIZATIONS THERE ARE NUMEROUS INTER ORGANIZATIONAL TRANSACTIONS WHICH MAY INCLUDE SALES EXCHANGES AND LEASES OF PROPERTY EXTENSIONS OF CREDIT FURNISHING OF GOODS SERVICES AND FACILITIES AND TRANSFERS OF ASSETS THESE INTER ORGANIZATION TRANSACTIONS PROMOTE THE EFFICIENT OPERATION OF THE VARIOUS ORGANIZATIONS AND THE ATTAINMENT OF THEIR TAX EXEMPT PURPOSES THESE TYPES OF INTER 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 GHS PRIVATE RULINGS AS BEING ENTIRELY CONSISTENT WITH THE ORGANIZATIONS TAX EXEMPT STATUS
Additional Data


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