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
GEISINGER HEALTH SYSTEM FOUNDATION
 
Doing Business As
 
 
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

23-1995911
E Telephone number

G Gross receipts $ 71,825,967
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.GEISINGER.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: 1975
M State of legal domicile: PA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE THE CORPORATE ENTITIES OF GEISINGER HEALTH SYSTEM WITH PHILANTHROPIC SUPPORT TO ASSIST IN MEETING THE CAPITAL AND PROGRAM PRIORITIES OF THE SYSTEM'S PLANNING PROCESS.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 17
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 14
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 50
6 Total number of volunteers (estimate if necessary) .... 6 524
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 4,653
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b  
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 8,153,888 16,387,728
9 Program service revenue (Part VIII, line 2g) ......... 5,326,335 7,855,694
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 20,137,259 47,261,224
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 8,173 40,139
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 33,625,655 71,544,785
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 12,859,766 12,119,968
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) 1,883,142 4,153,720
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 181,578 228,955
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet1,851,492    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 5,756,760 7,551,778
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 20,681,246 24,054,421
19 Revenue less expenses. Subtract line 18 from line 12....... 12,944,409 47,490,364
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,141,552,061 1,380,327,522
21 Total liabilities (Part X, line 26)............. 22,545,834 22,320,922
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,119,006,227 1,358,006,600
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 PROVIDE THE CORPORATE ENTITIES OF GEISINGER HEALTH SYSTEM WITH PHILANTHROPIC SUPPORT TO ASSIST IN MEETING THE CAPITAL AND PROGRAM PRIORITIES OF THE SYSTEM'S PLANNING PROCESS.
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 $ 21,929,434 including grants of $ 12,119,968 ) (Revenue $   )
AS THE PARENT ORGANIZATION OF GEISINGER HEALTH SYSTEM FOUNDATION (GHSF) IS COMMITTED TO THE SYSTEM'S MISSION, VISION, AND VALUES. MISSION: TO PROVIDE THE CORPORATE ENTITIES OF GEISINGER HEALTH SYSTEM WITH PHILANTHROPIC SUPPORT TO ASSIST IN MEETING THE CAPITAL AND PROGRAM PRIORITIES OF THE SYSTEM'S PLANNING PROCESS. VISION: TO BE THE HEALTH SYSTEM OF CHOICE, ADVANCING CARE THROUGH EDUCATION AND RESEARCH. VALUES: -EXCELLENCE - WE STRIVE FOR THE BEST, CONTINUOUSLY IMPROVING QUALITY IN ALL OUR ACTIVITIES. -SERVICE ORGANIZATION - OUR PHYSICIANS AND STAFF USE THEIR SKILLS, CREATIVITY, ENERGY AND LOYALTY AS RESOURCES FOR EFFECTIVE AND QUALITY SERVICES IN EVERY COMMUNITY AND EACH SETTING WE SERVE. -INDIVIDUAL DIGNITY - WE PROVIDE HUMANE, COMPASSIONATE AND EXPERT CARE, ALWAYS EMPHASIZING THE DIGNITY OF THE INDIVIDUAL. -TEAMWORK - WE TAKE PRIDE IN RECOGNIZING AND EMPOWERING GOOD PEOPLE WHO DEMONSTRATE THE IMPORTANCE AND VALUE OF TEAMWORK. -PHYSICIAN LEADERSHIP - WE ARE PHYSICIAN LED ACROSS OUR ENTIRE ORGANIZATION AND THE MANY COMMUNITIES WE SERVE. -DIVERSITY - DIVERSITY AMONG PHYSICIANS, STAFF, STUDENTS AND VOLUNTEERS PROMOTES AN ENVIRONMENT OF MUTUAL SUPPORT AND RESPECT. -EDUCATION - WE BELIEVE IN THE INTELLECTUAL AND PROFESSIONAL PURSUIT OF NEW KNOWLEDGE AND ITS DISSEMINATION TO COLLEAGUES, STUDENTS, AND THE PUBLIC AS AN INSTRUMENT OF OUR HEALTH SYSTEM THAT ADDS VALUE TO ALL OF OUR CUSTOMERS. -RESEARCH - WE BELIEVE THAT BASIC SCIENCE, CLINICAL COMMUNITY HEALTH AND HEALTH SERVICES RESEARCH ADVANCES THE OVERALL HEALTH AND WELL BEING OF OUR PATIENTS AND THEIR COMMUNITIES. -FISCAL RESPONSIBILITY - WE EXERCISE PRUDENT USE OF ALL RESOURCES AS PART OF OUR STEWARDSHIP RESPONSIBILITY FOR FISCAL AND ORGANIZATIONAL SUCCESS. -TRADITION - WE TAKE PRIDE IN OUR HISTORY FOR IT IS THE FOUNDATION OF OUR FUTURE AND OUR LONG-STANDING COMMITMENT TO THE HEALTH OF OUR COMMUNITY. I.GENERAL INFORMATION GHSF, A 501(C)(3) NOT FOR PROFIT CORPORATION, IS THE PARENT ORGANIZATION OF THE VARIOUS GEISINGER ENTITIES. ITS GOVERNING BOARD OVERSEES THE COLLECTIVE EFFORTS OF THE TWENTY-ONE GEISINGER AFFILIATED ENTITIES (FIFTEEN NOT FOR PROFIT ENTITIES, FIVE FOR PROFIT ENTITIES AND ONE FOREIGN CORPORATION)AND THEIR ACTIVITIES IN HEALTH CARE AND RELATED BUSINESSES. GHSF IS INVOLVED WITH INITIATING AND ADMINISTERING GRANT AND PHILANTHROPIC SUPPORT PROGRAMS FOR ALL THE GEISINGER HEALTH SYSTEM NOT-FOR-PROFIT ENTITIES. THE TWENTY-ONE AFFILIATED ENTITIES OF GHSF ARE: GEISINGER MEDICAL CENTER (GMC) IS A REGIONAL REFERRAL TERTIARY HEALTHCARE CENTER LOCATED IN DANVILLE, PENNSYLVANIA, A PREDOMINATELY RURAL AREA OF NORTHEASTERN AND CENTRAL PENNSYLVANIA. GMC OPERATES A LEVEL 1 REGIONAL RESOURCE TRAUMA CENTER INCLUDING LIFE FLIGHT, A RAPID RESPONSE HELICOPTER RETRIEVAL PROGRAM. ALSO PART OF GMC ARE THE HOSPITAL FOR ADVANCED MEDICINE, JANET WEIS CHILDREN'S HOSPITAL AND THE WOMEN'S HEALTH PAVILION, IN ADDITION TO TREATMENT CENTERS FOR CANCER, KIDNEY TRANSPLANTS, HEART AND NEUROLOGICAL DISEASE AND INFERTILITY. GEISINGER CLINIC (THE CLINIC) CONSISTS OF MULTI-SPECIALTY PHYSICIAN GROUP PRACTICES EMPLOYING OVER 900 PHYSICIANS PRACTICING AT 71 SITES IN 50 COMMUNITIES THROUGHOUT NORTHEASTERN AND CENTRAL PENNSYLVANIA. SOME SITES ARE DOCTOR'S OFFICES LOCATED IN THE SMALL TOWNS OF THE REGION; OTHERS ARE CLINICS WITH DIAGNOSTIC CAPABILITIES AND PHARMACIES ON THE PREMISES. THE CLINIC IS DEDICATED TO IMPROVING THE HEALTH OF THE PEOPLE OF PENNSYLVANIA THROUGH AN INTEGRATED SYSTEM OF HEALTH SERVICES BASED UPON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, AND RESEARCH. GEISINGER SYSTEM SERVICES IS A COST-EFFECTIVE CENTRALIZED PROVIDER OF MANAGEMENT AND CONSULTATIVE SERVICES TO OTHER ENTITIES WITHIN THE GEISINGER HEALTH SYSTEM. SERVICES PROVIDED INCLUDE: COMMUNICATION AND PUBLIC RELATIONS, FACILITIES PLANNING AND MANAGEMENT, FINANCIAL SERVICES, HUMAN RESOURCES, INFORMATION SYSTEMS, INTERNAL AUDITS, LEGAL SERVICES, MARKET PLANNING, SUPPLY CHAIN, EMPLOYEE BENEFIT ADMINISTRATION, MAIL SERVICES, REPROGRAPHICS, RISK MANAGEMENT, CAFETERIA, LAUNDRY, AND TELECOMMUNICATIONS. GEISINGER WYOMING VALLEY MEDICAL CENTER (GWV) IS AN ACUTE CARE OPEN STAFF COMMUNITY HOSPITAL AND REFERRAL MEDICAL CENTER IN WILKES-BARRE, PENNSYLVANIA. GWV OFFERS 24-HOUR COMPREHENSIVE EMERGENCY SERVICE, MEDICAL AND SURGICAL UNITS, MATERNITY PROGRAMS, PEDIATRIC CARE AND COMPLETE CANCER TREATMENT AT THE FRANK M. AND DORTHEA HENRY CANCER CENTER. THE HEART HOSPITAL AT GWV IS DEDICATED TO BRINGING THE LATEST TECHNOLOGY USED IN THE TREATMENT OF HEART DISEASE TO THE PEOPLE OF THE WYOMING VALLEY. THERE IS ALSO A SOUTH WILKES-BARRE CAMPUS THAT PROVIDES ADULT AND PEDIATRIC URGENT CARE, INPATIENT REHABILITATION, PAIN MANAGEMENT AND SLEEP CENTER SERVICES AND HOUSES AN AMBULATORY SURGERY CENTER. GEISINGER ASSURANCE COMPANY, LTD. (GAC) IS A WHOLLY OWNED SUBSIDIARY OF THE FOUNDATION LICENSED IN GRAND CAYMAN, BRITISH WEST INDIES. THE PRINCIPAL ACTIVITY OF GAC IS THE REINSURANCE, ON A CLAIMS MADE BASIS, OF A RETROSPECTIVELY RATED PROFESSIONAL LIABILITY INSURANCE POLICY ISSUED BY AN UNRELATED INSURANCE COMPANY BASED IN THE UNITED STATES OF AMERICA TO GAC'S SHAREHOLDER AND CERTAIN AFFILIATES. GEISINGER INSURANCE CORPORATION, RISK RETENTION GROUP - REGISTERED BY THE PA INSURANCE DEPT. TO PROVIDE PRIMARY PROFESSIONAL LIABILITY COVERAGE FOR SEVERAL ENTITIES OF GHS. GEISINGER MEDICAL MANAGEMENT CORPORATION (GMMC) PROVIDES CONTRACT MANAGEMENT, HOSPITALITY AND CONSULTING SERVICES THROUGH CONTRACT RELATIONSHIPS WITH OTHER HEALTHCARE PROVIDERS OR RELATED GEISINGER ENTITIES. SUREHEALTH, A SINGLE MEMBER LIMITED LIABILITY COMPANY OF GMMC, LOCATED IN DANVILLE, PENNSYLVANIA, FORMERLY OPERATED SEVERAL RETAIL PHARMACIES AND A SPECIALTY PHARMACY BUSINESS. GEISINGER COMMUNITY HEALTH SERVICES (GCHS) PROVIDES COMMUNITY HEALTH SERVICES THROUGHOUT NORTHEASTERN AND CENTRAL PENNSYLVANIA. GCHS OFFERS SKILLED NURSING, HOME HEALTH AIDES, MSW, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, HOME INFUSION THERAPY AND RESPIRATORY THERAPY. IN ADDITION, GCHS MANAGES THE UTILIZATION AND CLINICAL PROGRAM DEVELOPMENT RELATING TO THE PROVISION OF HOME CARE THROUGHOUT THE ENTIRE AREA SERVICED BY GHP. MARWORTH PROVIDES NATIONALLY RECOGNIZED ALCOHOL AND CHEMICAL DETOXIFICATION AND REHABILITATION TREATMENT PROGRAMS IN WAVERLY, PENNSYLVANIA. MARWORTH IS LICENSED BY THE PENNSYLVANIA DEPARTMENT OF HEALTH, BUREAU OF DRUG AND ALCOHOL PROGRAMS, AND IS ACCREDITED, WITH COMMENDATION, BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS. MARWORTH OFFERS INDIVIDUALIZED 12-STEP TREATMENT PROGRAMS IN ADDITION TO A SPECIAL DUAL DIAGNOSIS TREATMENT PROGRAM AND SPECIAL PROGRAMS FOR LAW ENFORCEMENT PROFESSIONALS AND HEALTHCARE PROFESSIONALS. GEISINGER HEALTH PLAN (GHP) IS THE LARGEST RURAL HEALTH MAINTENANCE ORGANIZATION (HMO) IN THE NATION. GHP HAS APPROXIMATELY 290,000 MEMBERS FROM PENNSYLVANIA AND WEST VIRGINIA, FROM INDIVIDUALS AND FAMILIES ENROLLED IN THE BASIC HEALTH-MAINTENANCE PROGRAM, INCLUDING A MEDICARE ALTERNATIVE, TO BUSINESS SUBSCRIBERS WHO CAN CHOOSE A CUSTOM-DESIGNED POINT-OF-SERVICE PLAN OR SMALL BUSINESS INSURANCE PLAN. GHP'S MANAGED CARE PATIENTS BENEFIT FROM THEIR FOCUS ON EDUCATION, DISEASE PREVENTION AND WELLNESS. GEISINGER INDEMNITY INSURANCE COMPANY AND GEISINGER QUALITY OPTIONS ARE PENNSYLVANIA BUSINESS CORPORATIONS THAT ARE WHOLLY OWNED SUBSIDIARIES OF THE FOUNDATION AND OFFER INDEMNITY HEALTH INSURANCE. INTERNATIONAL SHARED SERVICES, INC. (ISS), A WHOLLY OWNED SUBSIDIARY OF GMMC, IS ONE OF THE LARGEST INDEPENDENT MEDICAL EQUIPMENT MAINTENANCE, INSTALLATION, PLANNING AND CONSULTING SERVICES GROUPS HEADQUARTERED IN THE MID-ATLANTIC REGION. ISS IS DEDICATED TO THE COST-EFFECTIVE IMPROVEMENT OF PATIENT CARE, SAFETY AND HOSPITAL OPERATIONS THROUGH CONSULTING SERVICES, TRAINING OF MEDICAL MAINTENANCE ENGINEERS AND PLANNING, DESIGN AND EXECUTION OF MEDICAL EQUIPMENT MAINTENANCE PROGRAMS. COMMUNITY MEDICAL CENTER, DBA GEISINGER-COMMUNITY MEDICAL CENTER(GCMC) IS A LEADING PROVIDER OF QUALITY HEALTHCARE SERVICES IN NORTHEASTERN PENNSYLVANIA. A NOT-FOR-PROFIT CHARITABLE HOSPITAL LOCATED IN SCRANTON, GCMC IS HOME TO SCRANTON'S ONLY LEVEL II TRAUMA CENTER AND ADULT INPATIENT BEHAVIORAL HEALTH UNIT. OTHER PROGRAMS INCLUDE: A COMPREHENSIVE CARDIAC SERVICE LINE-INCLUDING OPEN HEART SURGERY; ORTHOPAEDIC SERVICES INCLUDING THE NEWSTEPS JOINT REPLACEMENT CENTER; AND A BROAD RANGE OF OTHER SPECIALIZED SURGICAL AND RADIOLOGICAL SERVICES. COMMUNITY MEDICAL CARE, INC., LOCATED IN SCRANTON, PENNSYLVANIA IS A TAX- EXEMPT ENTITY PROVIDING PHYSICIAN AND OTHER HEALTHCARE PROFESSIONAL SERVICES. COMMUNITY MEDICAL CENTER HEALTHCARE SYSTEM, LOCATED IN SCRANTON, PENNSYLVANIA, IS A TAX-EXEMPT ENTITY THAT PREVIOUSLY SERVED AS THE CORPORATE PARENT OF CMC AND AFFILIATED ENTITIES. COMMUNITY MEDICAL CENTER HEALTHCARE SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF-INSURANCE TRUST, LOCATED IN SCRANTON, PENNSYLVANIA, IS A TAX-EXEMPT ENTITY PROVIDING MEDICAL PROFESSIONAL AND GENERAL LIABILITY COVERAGE. MEDICAL
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$ 21,929,434
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......... Click to see attachment
14b
Yes
 
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.. Click to see attachment
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.. Click to see attachment
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
Yes
 
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
Yes
 
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
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.
20b
 
 
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................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
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
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
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
Yes
 
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
Yes
 
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 MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
Yes
 
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
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.......................
32
 
No
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
34
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
50
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
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ
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
17
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
14
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
 
No
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
 
No
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
 
No
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
 
No
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
Yes
 
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
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
PA , NY , NJ , MA , FL , KY , MN
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
SUSAN HEINTZELMAN DIRECTOR
100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
(570) 214-2299
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
BOARD CHAIR,
 2.00 X   X       0 0 0
(2) E ALLEN DEAVER
DIRECTOR
 2.00 X           0 0 0
(3) ARTHUR M PETERS ESQUIRE
DIRECTOR
 2.00 X           0 0 0
(4) DORRANCE R BELIN ESQUIRE
VICE CHAIR,D
 2.00 X           0 0 0
(5) WILLIAM J FLOOD
DIRECTOR
 2.00 X           0 0 0
(6) RICHARD A GRAFMYRE
DIRECTOR
 2.00 X           0 0 0
(7) WILLIAM R GRUVER
DIRECTOR
 2.00 X           0 0 0
(8) FRANK M HENRY
BOARD CHAIR,
 2.00 X   X       0 0 0
(9) JEFF JACOBSON
DIRECTOR
 2.00 X           0 0 0
(10) JOHN D MORAN JR
DIRECTOR
 2.00 X           0 0 0
(11) RICHARD A ROSE JR
DIRECTOR
 2.00 X           0 0 0
(12) THOMAS H LEE JR MD
DIRECTOR
 2.00 X           0 0 0
(13) VIRGINIA MCGREGOR
DIRECTOR
 40.00 X           0 0 0
(14) GAIL R WILENSKY PHD
DIRECTOR
 2.00 X           0 0 0
(15) GARY A SOJKA PHD
DIRECTOR (EM
 2.00 X           0 0 0
(16) GLENN D STEELE JR MD PHD
PRES, CEO, D
 40.00 X   X       0 5,048,679 390,571
(17) JOEL MINDEL MD PHD
DIRECTOR (EM
 2.00 X           0 0 0
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) KAREN E DAVIS PHD
DIRECTOR
 2.00 X           0 0 0
(19) ROBERT E POOLE
DIRECTOR
 2.00 X           0 0 0
(20) DON A ROSINI
DIRECTOR
 2.00 X           0 0 0
(21) ROBERT L TAMBUR
DIRECTOR
 2.00 X           0 0 0
(22) ANDREW M DEUBLER
EVP, DEVELOP
 40.00     X       0 539,988 115,221
(23) DAVID J FELICIO ESQUIRE
CLO, SECRETA
 40.00     X       0 475,750 133,442
(24) EDWARD J ZYCH ESQUIRE
ASSISTANT SE
 40.00     X       0 336,473 63,965
(25) DAVID H LEDBETTER PHD FACMG
EVP,CHIEF SC
 40.00     X       0 845,580 150,180
(26) KEVIN F BRENNAN CPA FHFMA
EVP,FINANCE,
 40.00     X       0 970,130 192,289
(27) JEAN HAYNES
EVP, INSURAN
 40.00     X       0 830,176 194,983
(28) ALBERT BOTHE JR MD
EVP, CMO
 40.00     X       0 881,942 181,727
(29) DUANE E DAVIS MD
EVP, INSURAN
 40.00     X       0 748,782 58,408
(30) SUSAN M HALLICK MHABSNRNNEA-BC
EVP, CNO
 40.00     X       0 535,692 129,457
(31) EARL P STEINBERG MD MPP
EVP, INNOVAT
 40.00     X       0 242,997 15,845
(32) EDELYN L MILLER
EVP, CLINICA
 40.00     X       0 713,020 136,125
(33) FRANK J TREMBULAK
EVP, COO
 40.00     X       0 934,746 206,030
(34) JOANNE E WADE
EVP STRAT. P
 40.00     X       0 1,043,337 193,326
(35) JAMES H BRUCKER PHD
VP,CHIEF ADV
 40.00       X     287,508 0 51,430
(36) LYN BOOCOCK-TAYLOR
VP,GRANTS
 40.00         X   221,714 0 19,976
(37) KEVIN J KERESTUS CIA
FORMER KEY E
 40.00           X 0 223,720 34,839
(38) BRUCE H HAMORY MD
FORMER OFFIC
 40.00           X 0 667,941 158,947
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 509,222 15,038,953 2,426,761
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet2
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
AFRC INC
208 PASSAIC AVENUE
FAIRFIELD,NJ07004 		PROF FUNDRAISER 146,678
SMART PARTNER LLC
150 E 9TH ST STE 1
BLOOMSBURG,PA17815 		PRINTING 100,239
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet2
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a 4,524
b Membership dues....1b  
c Fundraising events....1c 727,110
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		15,656,094
g Noncash contributions included in lines 1a-1f:$ 9,515,875
h Total. Add lines 1a-1f.......MediumBullet 16,387,728
Program Service Revenue Business Code
2a INTERCOMPANY REVENUE 541,900 7,851,041 7,851,041    
b INTERCOMPANY REVENUE 541,900 4,653   4,653  
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 7,855,694
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 21,721,675     21,721,675
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 25,539,549  
b Less: cost or other basis and sales expenses    
c Gain or (loss) 25,539,549  
d Net gain or (loss)..........MediumBullet 25,539,549     25,539,549
8a Gross income from fundraising events (not including
$ 727,110
of contributions reported on line 1c). See Part IV, line 18 ...
a 447,049
b Less: direct expenses ...b 486,025
c Net income or (loss) from fundraising events..MediumBullet -38,976   -38,976
9a Gross income from gaming activities.
See Part IV, line 19 ...
a 78,197
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 78,197     78,197
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 ESCHEAT REVENUE 900,099 918     918
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 918
12 Total revenue. See Instructions....MediumBullet 71,544,785 7,851,041 4,653 47,301,363
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 12,119,968 12,119,968
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 .... 311,723 288,817 3,750 19,156
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 73,884 68,455 889 4,540
7 Other salaries and wages 3,022,928 2,800,796 36,363 185,769
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 153,531 142,249 1,847 9,435
9 Other employee benefits ....... 374,208 346,711 4,501 22,996
10 Payroll taxes ........... 217,446 201,467 2,616 13,363
11 Fees for services (non-employees):        
a Management ......        
b Legal .........        
c Accounting ........... 20,849   20,849  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17.. 228,955 228,955
f Investment management fees ...... 1,953,116 1,953,116    
g Other .......... 812,802 438,693   374,109
12 Advertising and promotion .... 21,724     21,724
13 Office expenses ....... 510,746 106,889   403,857
14 Information technology ...... 11,805 4,347 948 6,510
15 Royalties ..        
16 Occupancy ........... 70,780 65,579 851 4,350
17 Travel ............ 274,446 193,478   80,968
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 86,670 63,782   22,888
20 Interest ........... 864,066 864,066    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 6,524 6,045 78 401
23 Insurance .............. 95,026   95,026  
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 INTERCOMPANY EXPENSES 2,763,244 2,221,785 103,807 437,652
b BOOKS,LICENSES,FEES,DUES 59,956 43,191 1,970 14,795
c MISCELLANEOUS 24     24
d
e
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 24,054,421 21,929,434 273,495 1,851,492
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 .......... 1,910,813 1 1,453,112
2 Savings and temporary cash investments ....... 125,993,896 2 75,814,701
3 Pledges and grants receivable, net ......... 4,998,083 3 4,834,796
4 Accounts receivable, net .........   4  
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5 22,544
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 ............. 33,035 7 4,075
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges ............   9  
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 68,194
b Less: accumulated depreciation. ..... 10b 41,051 14,779 10c 27,143
11 Investments—publicly traded securities .......... 216,130,433 11 221,754,479
12 Investments—other securities. See Part IV, line 11 ...... 791,192,191 12 1,076,416,672
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 1,278,831 15  
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,141,552,061 16 1,380,327,522
Liabilities 17 Accounts payable and accrued expenses . 429,424 17 523,410
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities ..........   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 .. 17,816,469 23 16,984,100
24 Unsecured notes and loans payable to unrelated third parties ....   24  
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..... 4,299,941 25 4,813,412
26 Total liabilities. Add lines 17 through 25..... 22,545,834 26 22,320,922
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 ..... 1,029,518,989 27 1,271,407,200
28 Temporarily restricted net assets ..... 29,504,898 28 22,922,744
29 Permanently restricted net assets ..... 59,982,340 29 63,676,656
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 ..... 1,119,006,227 33 1,358,006,600
34 Total liabilities and net assets/fund balances ..... 1,141,552,061 34 1,380,327,522
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
71,544,785
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
24,054,421
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
47,490,364
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
1,119,006,227
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
191,510,009
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
1,358,006,600
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
GEISINGER HEALTH SYSTEM FOUNDATION
 
Employer identification number

23-1995911
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.") .... 8,782,291 3,362,359 7,331,406 8,153,888 16,386,810 44,016,754
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.. 8,782,291 3,362,359 7,331,406 8,153,888 16,386,810 44,016,754
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)..           1,364,745
6 Public Support. Subtract line 5 from line 4.           42,652,009
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.. 8,782,291 3,362,359 7,331,406 8,153,888 16,386,810 44,016,754
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 8,020,674 9,457,924 11,563,638 14,441,106 21,721,675 65,205,017
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.. 5,996 14,028 19,979 106 918 41,027
11 Total support (Add lines 7 through 10).           109,262,798
12
12
7,851,041
13
Section C. Computation of Public Support Percentage
14
14
39.040 %
15
15
32.040 %
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
GEISINGER HEALTH SYSTEM FOUNDATION
 
Employer identification number

23-1995911
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
GEISINGER HEALTH SYSTEM FOUNDATION
  		Employer identification number

23-1995911
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
GEISINGER HEALTH SYSTEM FOUNDATION
  		Employer identification number

23-1995911
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
GEISINGER HEALTH SYSTEM FOUNDATION
  		Employer identification number

23-1995911
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
GEISINGER HEALTH SYSTEM FOUNDATION
 
Employer identification number

23-1995911
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) .......   640,652
c Total lobbying expenditures (add lines 1a and 1b) ...................   640,652
d Other exempt purpose expenditures ........................   2,670,639,189
e Total exempt purpose expenditures (add lines 1c and 1d) ...............   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 402,712 574,174 611,545 640,652 2,229,083
             
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
GEISINGER HEALTH SYSTEM FOUNDATION
 
Employer identification number

23-1995911
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 .... 77,598,000 75,302,000 71,078,000 88,270,000
b Contributions ........ 5,172,000 627,000 1,148,000 1,005,000
c Net investment earnings, gains, and losses ... -9,000 13,943,000 8,379,000 -13,762,000
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........ 		-2,675,000 -12,274,000 -5,303,000 -4,435,000
f Administrative expenses ....        
g End of year balance ...... 80,086,000 77,598,000 75,302,000 71,078,000
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet27.000 %
b
Permanent endowment SchDMd Bullet65.000 %
c
Temporarily restricted endowment SchDMd Bullet8.000 %
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 .................      
b Buildings ................        
c Leasehold improvements ............        
d Equipment ................   68,194 41,051 27,143
e Other .................        
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 27,143
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 1,076,416,672 F
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 1,076,416,672
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  
ANNUITIES PAYABLE 4,813,412








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 4,813,412
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 ENDOWMENT FUNDS ARE USED BY THE GEISINGER HEALTH SYSTEM (1) ("GHS") TO SUPPORT PATIENT CARE, RESEARCH, EDUCATION, AND CAPITAL AND PROGRAM EXPENSES.
SUPPLEMENTAL FINANCIAL INFORMATION SCHEDULE D, PAGE 4, PART XIV EFFECTIVE JULY 1, 2007, GEISINGER HEALTH SYSTEM(1) ADOPTED FASB INTERPRETATON 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 INTERPRETATON OF THE TAX LAW MY BE UNCERTAIN. FIN 48 PRESCRIBES A COMPREHENSIVE MODEL FOR THE FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, PRESENTATION AND DISCLOSURE OF INCOME TAX UNCERTAINTIES WITH RESPECT TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN INCOME TAX RETURNS. THE ADOPTION OF FIN 48 HAD NO IMPACT ON UNRESTRICTED NET ASSETS AS OF JUNE 30, 2012 OR ANY PREVIOUS YEARS SINCE ADOPTION. ACCORDINGLY, NO FIN 48 FOOTNOTE DISCLOSURE WAS MADE IN THE JUNE 30, 2012 GHS CONSOLIDATED FINANCIAL STATEMENTS. THOUGHOUT (1) THROUGHOUT FORM 990, THE TERMS "GEISINGER HEALTH SYSTEM" AND "SYSTEM" OR THE ACRONYM "GHS" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF ALL GEISINGER HEALTH SYSTEM FOUNDATION (GHSF)AS PARENT AND ALL SUBSIDIARY CORPORATION COMPRISING THE SYSTEM.
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
GEISINGER HEALTH SYSTEM FOUNDATION
 
Employer identification number

23-1995911
Part I
General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants
and other assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? ..............................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other
assistance outside the United States.
3
Activites per Region. (Use Part V if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees or agents in region or independent contractors (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total
expenditures for region/investments
in region
CENTRAL AMERICA AND THE CARIBBEAN     INVESTMENTS    
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     124,764,093
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     124,764,093
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,
Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet
Use Part V if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .....MediumBullet
 
3
Enter total number of other organizations or entities ........................MediumBullet
 
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Use Part V if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................
2 Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 5
Part V
Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
Identifier ReturnReference Explanation
    CENTRAL AMERICA AND THE CARIBBEAN 0 124,764,093
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2011
Additional Data


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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
GEISINGER HEALTH SYSTEM FOUNDATION
 
Employer identification number

23-1995911
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.
FL, KY, MA, NJ, NY, PA, VA, MN
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

GNE GALA
(event type) 		(b) Event #2

GMC GALA
(event type) 		(c) Other Events

17
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 336,186 222,373 604,688 1,163,247
2 Less: Charitable
contributions . . . 		259,443 169,385 290,579 719,407
3 Gross income (line 1
minus line 2) . . . 		76,743 52,988 314,109 443,840
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . . 47,576 10,145   57,721
6 Rent/facility costs . . 13,757 37,618   51,375
7 Food and beverages . . 35,333 30,059   65,392
8 Entertainment . . . 1,500 2,300   3,800
9 Other direct expenses . 12,822 78,647 193,827 285,296
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 463,584
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow -19,744
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 . . . . 15,155   63,042 78,197
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: PA
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
80.000 %
b
An outside facility ........................
13b
20.000 %
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
VANESSA KLINGENSMITH
Address right arrow
100 NORTH ACADEMY AVENUE MC 24-20
DANVILLE,PA17822
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
JAMES H BRUCKER
Gaming manager compensation right arrow $  
Description of services provided right arrow
CHIEF ADVANCEMENT OFFICER
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
    THE GAMING MANAGER IS NOT COMPENSATED SPECIFICALLY FOR GAMING ACITIVITES THESE ACTIVITIES ARE ONLY A SMALL PERCENTAGE OF HIS RESPONSIBLITIES AND HIS TOTAL COMPENSATION IS REPORTED IN SCHEDULE J
Schedule G (Form 990 or 990-EZ) 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
GEISINGER HEALTH SYSTEM FOUNDATION
 
Employer identification number
23-1995911
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) GEISINGER WYOMING VALLEY MED CENTER1000 EAST MOUNTAIN DRIVE
WILKES BARRE,PA187110027 		23-1996150 3 4,096,497       CAPITAL/PROG SERVICE
(2) GEISINGER MEDICAL CENTER100 NORTH ACADEMY AVENUE
DANVILLE,PA178229800 		24-0795959 3 3,950,961       CAPITAL/PROG SERVICE
(3) GEISINGER CLINIC100 NORTH ACADEMY AVENUE
DANVILLE,PA178229800 		23-6291113 3 2,694,211       CAPITAL/PROG SERVICE
(4) GEISINGER SYSTEM SERVICES100 NORTH ACADEMY AVENUE
DANVILLE,PA178229800 		23-2164794 3 546,941       CAPITAL/PROG SERVICE
(5) DANVILLE AREA UNITED WAY116 MILL ST
DANVILLE,PA17821 		24-6023856 3 208,100       CONTRIBUTION SUPPORT
(6) MARWORTHPO BOX 36
WAVERLY,PA184717736 		23-2171417 3 148,573       CAPITAL/PROG SERVICE
(7) GEISINGER HEALTH PLANPO BOX 8200
DANVILLE,PA178218200 		23-2311553 4 110,307       CAPITAL/PROG SERVICE
(8) DANVILLE BUSINESS ALLIANCEPO BOX 441
DANVILLE,PA17821 		23-3076617 3 105,500       CONTRIBUTION SUPPORT
(9) ACTION HEALTH113 MILL ST
DANVILLE,PA17821 		23-3061897 3 32,000       CONTRIBUTION SUPPORT
(10) ROAD RADIO USA INC601 SOUTH MAIN STREET
MUNCY,PA177561708 		23-2767215 3 25,000       CMN SPONSORSHIP
(11) PA STATE NURSES ASSOCIATION2578 INTERSTATE DRIVE STE 101
HARRISBURG,PA17110 		23-0961200 3 25,000       CONTRIBUTION SUPPORT
(12) CAMP VICTORYPO BOX 810
MILLVILLE,PA17846 		23-2979076 3 18,500       CONTRIBUTION SUPPORT
(13) RONALD MCDONALD HOUSE1019 WEST 9TH AVENUE
KING OF PRUSSIA,PA194061215 		23-2767215 3 12,800       CONTRIBUTION SUPPORT
(14) EAST END FIRE CO1344 BLOOM RD
DANVILLE,PA178211984 		24-0795947 3 12,800       CONTRIBUTION SUPPORT
(15) COUNTRYSIDE CONSERVANCYPO BOX 55
LAPLUME,PA18440 		23-2787790 3 11,000       CONTRIBUTION SUPPORT
(16) GEISINGER MEDICAL MANAGEMENT CORP109 WOODBINE LANE
DANVILLE,PA178219118 		23-2077663   10,490       CAPITAL/PROG SERVICE
(17) CAMP SPIFIDA196 ROSE LANE
PORTTREVERTON,PA17864 		23-2807759 3 8,000       CONTRIBUTION SUPPORT
(18) GEISINGER COMMUNITY HEALTH SERVICES109 WOODBINE LANE
DANVILLE,PA178219118 		23-2967235 3 5,961       CAPITAL/PROG SERVICE
(19) ALL OTHER ASSISTANCE COMBINEDEACH INDIVIDUALLY 5000 OR LESS
DANVILLE,PA178229800 		3 97,327       CONTRIBUTION SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
23
3
Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image
2
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
PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES SCHEDULE I, PAGE 1, PART I, LINE 2 GHSF DOES NOT AWARD GRANTS; GHSF 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 GHSF. GHSF 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


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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
GEISINGER HEALTH SYSTEM FOUNDATION
 
Employer identification number

23-1995911
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
 
 
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
 
 
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
Yes
 
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
Yes
 
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
Yes
 
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) ANDREW M DEUBLER (i)
(ii)		  
312,737 		 
131,180 		 
96,071 		 
83,781 		 
31,440 		 
655,209 		 
 
(3) DAVID J FELICIO ESQUIRE (i)
(ii)		  
293,852 		 
144,222 		 
37,676 		 
115,877 		 
17,565 		 
609,192 		 
 
(4) EDWARD J ZYCH ESQUIRE (i)
(ii)		  
244,966 		 
72,505 		 
19,002 		 
42,780 		 
21,185 		 
400,438 		 
 
(5) DAVID H LEDBETTER PHD FACMG (i)
(ii)		  
521,182 		 
228,381 		 
96,017 		 
122,781 		 
27,399 		 
995,760 		 
 
(6) KEVIN F BRENNAN CPA FHFMA (i)
(ii)		  
481,220 		 
297,816 		 
191,094 		 
170,858 		 
21,431 		 
1,162,419 		 
155,504
(7) JEAN HAYNES (i)
(ii)		  
488,365 		 
276,989 		 
64,822 		 
171,586 		 
23,397 		 
1,025,159 		 
 
(8) ALBERT BOTHE JR MD (i)
(ii)		  
510,811 		 
253,186 		 
117,945 		 
171,969 		 
9,758 		 
1,063,669 		 
66,050
(9) DUANE E DAVIS MD (i)
(ii)		  
338,428 		 
157,460 		 
252,894 		 
45,418 		 
12,990 		 
807,190 		 
184,069
(10) SUSAN M HALLICK MHABSNRNNEA-BC (i)
(ii)		  
304,384 		 
159,610 		 
71,698 		 
110,542 		 
18,915 		 
665,149 		 
39,584
(11) EARL P STEINBERG MD MPP (i)
(ii)		  
205,020 		 
  		 
37,977 		 
15,665 		 
180 		 
258,842 		 
 
(12) EDELYN L MILLER (i)
(ii)		  
407,160 		 
228,002 		 
77,858 		 
124,280 		 
11,845 		 
849,145 		 
33,169
(13) FRANK J TREMBULAK (i)
(ii)		  
574,658 		 
303,886 		 
56,202 		 
195,777 		 
10,253 		 
1,140,776 		 
 
(14) JOANNE E WADE (i)
(ii)		  
553,391 		 
281,613 		 
208,333 		 
184,461 		 
8,865 		 
1,236,663 		 
173,267
(15) JAMES H BRUCKER PHD (i)
(ii)		 218,671
  		37,502
  		31,335
  		17,778
  		33,652
  		338,938
  		 
 
(16) LYN BOOCOCK-TAYLOR (i)
(ii)		 188,762
  		20,000
  		12,952
  		14,595
  		5,381
  		241,690
  		 
 
(17) KEVIN J KERESTUS CIA (i)
(ii)		  
172,254 		 
48,065 		 
3,401 		 
15,962 		 
18,877 		 
258,559 		 
 
(18) BRUCE H HAMORY MD (i)
(ii)		  
459,607 		 
107,734 		 
100,600 		 
137,828 		 
21,119 		 
826,888 		 
54,819
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
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, JR., M.D. 0 66,050 0 DUANE E. DAVIS, M.D. 0 208,068 0 SUSAN M. HALLICK, MHA,BSN,RN,NEA-BC 0 39,584 0 EDELYN L . MILLER 0 33,169 0 FRANK J. TREMBULAK 0 3,662 0 JOANNE E. WADE 0 173,267 0 BRUCE H. HAMORY, M.D. 0 54,819 0
NON-FIXED PAYMENTS PROVIDED SCHEDULE J, PAGE 1, PART I, LINE 7 BECAUSE THE PAYMENT OF EARNED PERFORMANCE BASED COMPENSATION IS AT THE DISCRETION OF MANAGEMENT AND THE BOARD OF DIRECTORS, SUCH PAYMENTS MAY BE CONSIDERED NON-FIXED PAYMENTS. PERFORMANCE BASED COMPENSATION IS DETERMINED BY MEETING INDIVIDUALLY MEASURED PERFORMANCE GOALS THAT ARE ALIGNED WITH OVERALL SYSTEM OBJECTIVES, INCLUDING: CLINICAL QUALITY, COMMUNITY MISSION ACHIEVEMENT, AND FINANCIAL STEWARDSHIP.
PURSUANT TO CONTRACT PER REGS. SECTION 53.4958-4(A)(3) SCHEDULE J, PAGE 1, PART I, LINE 8 THE EMPLOYEES LISTED PARTICIPATE IN A COMPENSATION PROGRAM DESIGNED TO BE MARKET COMPETITIVE. FROM TIME TO TIME, DEPENDING ON THE AVAILABILITY OF QUALIFIED APPLICANTS, RECRUITMENT LOANS MAY BE MADE AVAILABLE TO QUALIFIED APPLICANTS IN DIFFICULT TO RECRUIT POSITIONS. SUCH LOANS ARE ONLY PROVIDED IF TOTAL COMPENSATION, INCLUDING THE LOAN AMOUNT, IS CONSIDERED REASONABLE COMPENSATION PER INDEPENDENT SALARY SURVEYS.
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.
Schedule J (Form 990) 2011

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
GEISINGER HEALTH SYSTEM FOUNDATION
 
Employer identification number
23-1995911
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A GEISINGER AUTHORITY SERIES 2011A
  		23-2471439 368467GN7 06-09-2011 140,181,194 LOANED TO 501(C)(3) AFFILIATES;REFUND 8/11/98 BONDS   X   X X  
B GEISINGER AUTHORITY SERIES 2011 BC
  		23-2471439 368497GY3 06-09-2011 100,000,000 LOANED TO 501(C)(3) AFFILIATES TO FUND HOSPITAL IMPROVEMENTS   X   X X  
C GEISINGER AUTHORITY SERIES 2009 BC
  		23-2471439 368497FT5 06-04-2009 115,000,000 LOANED TO 501(C)(3) AFFILIATES TO FUND HOSPITAL IMPROVEMENTS   X   X X  
D GEISINGER AUTHORITY SERIES 2009A
  		23-2471439 368497FR9 06-04-2009 155,702,940 LOANED TO 501(C)(3) AFFILIATES;REFUND 5/10/2007 BONDS   X   X X  
GEISINGER AUTHORITY SERIES 2011A
  		23-2471439 368467GN7 06-09-2011 140,181,194 LOANED TO 501(C)(3) AFFILIATES;REFUND 8/11/98 BONDS   X   X X  
GEISINGER AUTHORITY SERIES 2011 BC
  		23-2471439 368497GY3 06-09-2011 100,000,000 LOANED TO 501(C)(3) AFFILIATES TO FUND HOSPITAL IMPROVEMENTS   X   X X  
GEISINGER AUTHORITY SERIES 2009 BC
  		23-2471439 368497FT5 06-04-2009 115,000,000 LOANED TO 501(C)(3) AFFILIATES TO FUND HOSPITAL IMPROVEMENTS   X   X X  
GEISINGER AUTHORITY SERIES 2009A
  		23-2471439 368497FR9 06-04-2009 155,702,940 LOANED TO 501(C)(3) AFFILIATES;REFUND 5/10/2007 BONDS   X   X X  
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . .        
2 Amount of bonds legally defeased . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . 140,188,681 100,004,420 115,000,000 155,704,195
4 Gross proceeds in reserve funds . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . .        
8 Credit enhancement from proceeds . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . 84,702,907 65,912,385 115,000,000 144,098,940
11 Other spent proceeds . . . . . . . . . . . 7,487 4,420   11,605,254
12 Other unspent proceeds . . . . . . . . . . . 55,478,287 34,087,615   4,517,887
13 Year of substantial completion . . . . . . . . . . . 2010 2010 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . X     X X   X  
15 Were the bonds issued as part of an advance refunding issue? . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . .   X   X X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2011
Schedule K (Form 990) 2011
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . .   X   X   X   X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . X   X   X   X  
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? . X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet   %   %   %   %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet   %   %   %   %
6 Total of lines 4 and 5 . . .. . . . . . . . .   %   %   %   %
7 Does the bond issue meet the private security or payment test? . . . X   X   X   X  
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue?   X X   X     X
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . .  
  		 
  		 
  		 
 
c Term of hedge . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was a hedge terminated? . . . . .                
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .   X   X   X   X
b Name of provider . . . . . .  
  		 
  		 
  		 
 
c Term of GIC . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . .                
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .   X   X   X   X
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2011

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
GEISINGER HEALTH SYSTEM FOUNDATION
 
Employer identification number
23-1995911
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A GEISINGER AUTHORITY SERIES 2011A
  		23-2471439 368467GN7 06-09-2011 140,181,194 LOANED TO 501(C)(3) AFFILIATES;REFUND 8/11/98 BONDS   X   X X  
B GEISINGER AUTHORITY SERIES 2011 BC
  		23-2471439 368497GY3 06-09-2011 100,000,000 LOANED TO 501(C)(3) AFFILIATES TO FUND HOSPITAL IMPROVEMENTS   X   X X  
C GEISINGER AUTHORITY SERIES 2009 BC
  		23-2471439 368497FT5 06-04-2009 115,000,000 LOANED TO 501(C)(3) AFFILIATES TO FUND HOSPITAL IMPROVEMENTS   X   X X  
D GEISINGER AUTHORITY SERIES 2009A
  		23-2471439 368497FR9 06-04-2009 155,702,940 LOANED TO 501(C)(3) AFFILIATES;REFUND 5/10/2007 BONDS   X   X X  
GEISINGER AUTHORITY SERIES 2011A
  		23-2471439 368467GN7 06-09-2011 140,181,194 LOANED TO 501(C)(3) AFFILIATES;REFUND 8/11/98 BONDS   X   X X  
GEISINGER AUTHORITY SERIES 2011 BC
  		23-2471439 368497GY3 06-09-2011 100,000,000 LOANED TO 501(C)(3) AFFILIATES TO FUND HOSPITAL IMPROVEMENTS   X   X X  
GEISINGER AUTHORITY SERIES 2009 BC
  		23-2471439 368497FT5 06-04-2009 115,000,000 LOANED TO 501(C)(3) AFFILIATES TO FUND HOSPITAL IMPROVEMENTS   X   X X  
GEISINGER AUTHORITY SERIES 2009A
  		23-2471439 368497FR9 06-04-2009 155,702,940 LOANED TO 501(C)(3) AFFILIATES;REFUND 5/10/2007 BONDS   X   X X  
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . .        
2 Amount of bonds legally defeased . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . 140,188,681 100,004,420 115,000,000 155,704,195
4 Gross proceeds in reserve funds . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . .        
8 Credit enhancement from proceeds . . . . . . . . . .        
9 Working capital expenditures from proceeds . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . 84,702,907 65,912,385 115,000,000 144,098,940
11 Other spent proceeds . . . . . . . . . . . 7,487 4,420   11,605,254
12 Other unspent proceeds . . . . . . . . . . . 55,478,287 34,087,615   4,517,887
13 Year of substantial completion . . . . . . . . . . . 2010 2010 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . X     X X   X  
15 Were the bonds issued as part of an advance refunding issue? . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . .   X   X X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2011
Schedule K (Form 990) 2011
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . .   X   X   X   X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . X   X   X   X  
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? . X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet   %   %   %   %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet   %   %   %   %
6 Total of lines 4 and 5 . . .. . . . . . . . .   %   %   %   %
7 Does the bond issue meet the private security or payment test? . . . X   X   X   X  
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X   X   X   X
2 Is the bond issue a variable rate issue?   X X   X     X
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . .  
  		 
  		 
  		 
 
c Term of hedge . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was a hedge terminated? . . . . .                
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .   X   X   X   X
b Name of provider . . . . . .  
  		 
  		 
  		 
 
c Term of GIC . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . .                
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .   X   X   X   X
6 Did the bond issue qualify for an exception to rebate? .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .   X   X   X   X
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (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
GEISINGER HEALTH SYSTEM FOUNDATION
 
Employer identification number

23-1995911
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
(1) LYN BOOCOCK-TAYLOR
  		  X 33,000 22,544   No Yes   Yes  
Total ...............Small Bullet $ 22,544
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) DONNA GRAFMYRE FAMILY 65,835 EMPLOYEE COMPENSAT.   No
(2) HIRTLE CALLAGHAN BUSINESS 884,128 INVESTMENT MGMT FEES   No
(3) GEISINGER MEDICAL MANAGEMENT CORP BUSINESS 4,553 IC SHARED SERV. REV.   No
(4) GEISINGER MEDICAL MANAGEMENT CORP BUSINESS 1,000,000 CAPITAL CONTR. REV.   No
(5) GEISINGER MEDICAL MANAGEMENT CORP BUSINESS 87,607 IC SHARED SERV. EXP.   No
(6) GEISINGER ASSURANCE COMPANY LTD BUSINESS 20,000,000 CAPITAL CONTR. REV.   No
(7) GEISINGER INDEMNITY INSURANCE COMP BUSINESS 14,700,000 CAPITAL CONTR. REV.   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 DONNA M GRAFMYRE IS A FAMILY MEMBER OF RICHARD A GRAFMYRE A DIRECTOR OF GHSF WILLIAM R GRUVER A DIRECTOR OF GHSF IS A DIRECTOR OF HIRTLE CALLAGHAN GHSF IS CLOSELY AFFILIATED WITH SEVERAL OTHER ORGANIZATIONS IN THE NORMAL COURSE OF OPERATIONS OF THESE AFFILIATED ORGANIZATIONS THERE ARE NUMEROUS INTERORGANIZATIONAL TRANSACTIONS WHICH MAY INCLUDE SALES EXCHANGES AND LEASE OF PROPERTYEXTENSIONS 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 SYSTEM FOR WHOM BUSINESS TRANSACTIONS MUST BE DISCLOSED FOR PURPOSES OF SCHEDULE L PART IV TRANSACTIONS WITH INTERESTED PERSONS OFFICERS AND DIRECTORS OF GHSF ARE OFFICERS AND DIRECTORS OF THESE ORGANIZATIONS AS DESCRIBED BELOW GEISINGER MEDICAL MANAGEMENT CORPORATION GMMC DAVID J FELICIO ESQUIRE IS THE CHIEF LEGAL OFFICER AND SECRETARY OF GHSF AND GMMC GLENN D STEELE JR MD PHD IS THE PRESIDENT CHIEF EXECUTIVE OFFICER AND DIRECTOR EXOFFICIO OF GHSF AND THE PRESIDENT CHAIRMAN OF THE BOARD AND DIRECTOR OF GMMC FRANK J TREMBULAK IS THE EXECUTIVE VICE PRESIDENT AND CHIEF OPERATING OFFICER OF GHSF AND THE SENIOR VICE PRESIDENT AND TREASURER OF GMMC EDWARD J ZYCH ESQUIRE IS THE ASSISTANT SECRETARY OF GHSF AND GMMC WILLIAM H ALEXANDER IS THE CHAIRMAN OF THE BOARD AND A DIRECTOR OF GHSF AND A DIRECTOR OF GMMC RICHARD A GRAFMYRE IS A DIRECTOR OF GHSF AND GMMC WILLIAM R GRUVER IS A DIRECTOR OF GHSF AND GMMC JOHN D MORAN JR IS A DIRECTOR OF GHSF AND GMMC ROBERT E POOLE IS A DIRECTOR OF GHSF AND GMMC RICHARD A ROSE IS A DIRECTOR OF GHSF AND GMMC DON A ROSINI IS A DIRECTOR OF GHSF AND GMMC ROBERT L TAMBUR IS A DIRECTOR OF GHSF AND GMMC GEISINGER ASSURANCE COMPANY LTD GAC DAVID J FELICIO ESQUIRE IS THE CHIEF LEGAL OFFICER AND SECRETARY OF GHSF AND A SECRETRAY AND DIRECTOR OF GAC GLENN D STEELE JR MD PHD IS THE PRESIDENT CHIEF EXECUTIVE OFFICER AND DIRECTOR EXOFFICIO OF GHSF AND THE CHAIRMAN OF THE BOARD AND DIRECTOR OF GAC FRANK J TREMBULAK IS THE EXECUTIVE VICE PRESIDENT AND CHIEF OPERATING OFFICER OF GHSF AND PRESIDENT CHIEF EXECUTIVE OFFICER AND DIRECTOR OF GAC KEVIN F BRENNAN CPA IS THE EXECUTIVE VICE PRESIDENT FINANCE AND TREASURER OF GHSF AND DIRECTOR OF GAC ALBERT BOTHE JR MD IS AN EXECUTIVE VICE PRESIDENT AND CHIEF MEDICAL OFFICER OF GHSF AND WAS A DIRECTOR OF GAC EDWARD J ZYCH ESQUIRE IS THE ASSISTANT SECRETARY OF GHSF AND GAC GEISINGER INDEMNITY INSURANCE COMPANY GIIC DUANE DAVIS MD IS EXECUTIVE VICE PRESIDENT INSURANCE OPERATIONS OF GHSF AND THE PRESIDENT CHIEF EXECUTIVE OFFICER AND DIRECTOR OF GIIC DAVID J FELICIO ESQUIRE IS THE CHIEF LEGAL OFFICER AND SECRETARY OF GHSF AND GIIC JEAN HAYNES WAS EXECUTIVE VICE PRESIDENT INSURANCE OPERATIONS OF GHSF AND THE PRESIDENT CHIEF EXECUTIVE OFFICER AND DIRECTOR OF GIIC GLENN D STEELE JR MD PHD IS THE PRESIDENT CHIEF EXECUTIVE OFFICER AND DIRECTOR EXOFFICIO OF GHSF AND THE CHAIRMAN OF THE BOARD AND DIRECTOR EXOFFICIO OF GIIC FRANK J TREMBULAK IS THE EXECUTIVE VICE PRESIDENT AND CHIEF OPERATING OFFICER OF GHSF AND SENIOR VICE PRESIDENT TREASURER AND DIRECTOR OF GIIC WILLIAM H ALEXANDER IS A CHAIRMAN OF THE BOARD AND DIRECTOR OF GHSF AND A DIRECTOR OF GIIC RICHARD GRAFMYRE IS A DIRECTOR OF GHSF AND GIIC DON A ROSINI IS A DIRECTOR OF GHSF AND GIIC THOMAS H LEE JR IS A DIRECTOR OF GHSF AND GIIC JOHN D MORAN JR IS A DIRECTOR OF GHSF AND GIIC
Schedule L (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
GEISINGER HEALTH SYSTEM FOUNDATION
 
Employer identification number

23-1995911
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art .... X 6 5,474 SELLING PRICE OF PROPERTY
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		X 18,869 SELLING PRICE OF PROPERTY
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 7 139,147 PROCEEDS FROM SALE
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies . X 3 23,910 SELLING PRICE OF PROPERTY
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( GIFT CERTIFICAT ) X 39 4,585 FACE VALUE
26 Other Right pointing arrow large image ( JEWELRY ) X 22 8,444 SELLING PRICE OF PROPERTY
27 Other Right pointing arrow large image ( MISCELLANEOUS ) X 94 39,042 VARIOUS
28 Other Right pointing arrow large image ( ACQ. NET ASSETS ) X 2 9,276,404 FMV/NET REALIZABLE VALUE
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
 
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2011
Schedule M (Form 990) 2011
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33 and whether the organization is reporting in Part I, column (b) the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule M (Form 990) 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
GEISINGER HEALTH SYSTEM FOUNDATION
 
Employer identification number

23-1995911
Identifier Return Reference Explanation
FIRST ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4A AS THE PARENT ORGANIZATION OF GEISINGER HEALTH SYSTEM FOUNDATION (GHSF) IS COMMITTED TO THE SYSTEM'S MISSION, VISION, AND VALUES. MISSION: TO PROVIDE THE CORPORATE ENTITIES OF GEISINGER HEALTH SYSTEM WITH PHILANTHROPIC SUPPORT TO ASSIST IN MEETING THE CAPITAL AND PROGRAM PRIORITIES OF THE SYSTEM'S PLANNING PROCESS. VISION: TO BE THE HEALTH SYSTEM OF CHOICE, ADVANCING CARE THROUGH EDUCATION AND RESEARCH. VALUES: -EXCELLENCE - WE STRIVE FOR THE BEST, CONTINUOUSLY IMPROVING QUALITY IN ALL OUR ACTIVITIES. -SERVICE ORGANIZATION - OUR PHYSICIANS AND STAFF USE THEIR SKILLS, CREATIVITY, ENERGY AND LOYALTY AS RESOURCES FOR EFFECTIVE AND QUALITY SERVICES IN EVERY COMMUNITY AND EACH SETTING WE SERVE. -INDIVIDUAL DIGNITY - WE PROVIDE HUMANE, COMPASSIONATE AND EXPERT CARE, ALWAYS EMPHASIZING THE DIGNITY OF THE INDIVIDUAL. -TEAMWORK - WE TAKE PRIDE IN RECOGNIZING AND EMPOWERING GOOD PEOPLE WHO DEMONSTRATE THE IMPORTANCE AND VALUE OF TEAMWORK. -PHYSICIAN LEADERSHIP - WE ARE PHYSICIAN LED ACROSS OUR ENTIRE ORGANIZATION AND THE MANY COMMUNITIES WE SERVE. -DIVERSITY - DIVERSITY AMONG PHYSICIANS, STAFF, STUDENTS AND VOLUNTEERS PROMOTES AN ENVIRONMENT OF MUTUAL SUPPORT AND RESPECT. -EDUCATION - WE BELIEVE IN THE INTELLECTUAL AND PROFESSIONAL PURSUIT OF NEW KNOWLEDGE AND ITS DISSEMINATION TO COLLEAGUES, STUDENTS, AND THE PUBLIC AS AN INSTRUMENT OF OUR HEALTH SYSTEM THAT ADDS VALUE TO ALL OF OUR CUSTOMERS. -RESEARCH - WE BELIEVE THAT BASIC SCIENCE, CLINICAL COMMUNITY HEALTH AND HEALTH SERVICES RESEARCH ADVANCES THE OVERALL HEALTH AND WELL BEING OF OUR PATIENTS AND THEIR COMMUNITIES. -FISCAL RESPONSIBILITY - WE EXERCISE PRUDENT USE OF ALL RESOURCES AS PART OF OUR STEWARDSHIP RESPONSIBILITY FOR FISCAL AND ORGANIZATIONAL SUCCESS. -TRADITION - WE TAKE PRIDE IN OUR HISTORY FOR IT IS THE FOUNDATION OF OUR FUTURE AND OUR LONG-STANDING COMMITMENT TO THE HEALTH OF OUR COMMUNITY. I.GENERAL INFORMATION GHSF, A 501(C)(3) NOT FOR PROFIT CORPORATION, IS THE PARENT ORGANIZATION OF THE VARIOUS GEISINGER ENTITIES. ITS GOVERNING BOARD OVERSEES THE COLLECTIVE EFFORTS OF THE TWENTY-ONE GEISINGER AFFILIATED ENTITIES (FIFTEEN NOT FOR PROFIT ENTITIES, FIVE FOR PROFIT ENTITIES AND ONE FOREIGN CORPORATION)AND THEIR ACTIVITIES IN HEALTH CARE AND RELATED BUSINESSES. GHSF IS INVOLVED WITH INITIATING AND ADMINISTERING GRANT AND PHILANTHROPIC SUPPORT PROGRAMS FOR ALL THE GEISINGER HEALTH SYSTEM NOT-FOR-PROFIT ENTITIES. THE TWENTY-ONE AFFILIATED ENTITIES OF GHSF ARE: GEISINGER MEDICAL CENTER (GMC) IS A REGIONAL REFERRAL TERTIARY HEALTHCARE CENTER LOCATED IN DANVILLE, PENNSYLVANIA, A PREDOMINATELY RURAL AREA OF NORTHEASTERN AND CENTRAL PENNSYLVANIA. GMC OPERATES A LEVEL 1 REGIONAL RESOURCE TRAUMA CENTER INCLUDING LIFE FLIGHT, A RAPID RESPONSE HELICOPTER RETRIEVAL PROGRAM. ALSO PART OF GMC ARE THE HOSPITAL FOR ADVANCED MEDICINE, JANET WEIS CHILDREN'S HOSPITAL AND THE WOMEN'S HEALTH PAVILION, IN ADDITION TO TREATMENT CENTERS FOR CANCER, KIDNEY TRANSPLANTS, HEART AND NEUROLOGICAL DISEASE AND INFERTILITY. GEISINGER CLINIC (THE CLINIC) CONSISTS OF MULTI-SPECIALTY PHYSICIAN GROUP PRACTICES EMPLOYING OVER 900 PHYSICIANS PRACTICING AT 71 SITES IN 50 COMMUNITIES THROUGHOUT NORTHEASTERN AND CENTRAL PENNSYLVANIA. SOME SITES ARE DOCTOR'S OFFICES LOCATED IN THE SMALL TOWNS OF THE REGION; OTHERS ARE CLINICS WITH DIAGNOSTIC CAPABILITIES AND PHARMACIES ON THE PREMISES. THE CLINIC IS DEDICATED TO IMPROVING THE HEALTH OF THE PEOPLE OF PENNSYLVANIA THROUGH AN INTEGRATED SYSTEM OF HEALTH SERVICES BASED UPON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, AND RESEARCH. GEISINGER SYSTEM SERVICES IS A COST-EFFECTIVE CENTRALIZED PROVIDER OF MANAGEMENT AND CONSULTATIVE SERVICES TO OTHER ENTITIES WITHIN THE GEISINGER HEALTH SYSTEM. SERVICES PROVIDED INCLUDE: COMMUNICATION AND PUBLIC RELATIONS, FACILITIES PLANNING AND MANAGEMENT, FINANCIAL SERVICES, HUMAN RESOURCES, INFORMATION SYSTEMS, INTERNAL AUDITS, LEGAL SERVICES, MARKET PLANNING, SUPPLY CHAIN, EMPLOYEE BENEFIT ADMINISTRATION, MAIL SERVICES, REPROGRAPHICS, RISK MANAGEMENT, CAFETERIA, LAUNDRY, AND TELECOMMUNICATIONS. GEISINGER WYOMING VALLEY MEDICAL CENTER (GWV) IS AN ACUTE CARE OPEN STAFF COMMUNITY HOSPITAL AND REFERRAL MEDICAL CENTER IN WILKES-BARRE, PENNSYLVANIA. GWV OFFERS 24-HOUR COMPREHENSIVE EMERGENCY SERVICE, MEDICAL AND SURGICAL UNITS, MATERNITY PROGRAMS, PEDIATRIC CARE AND COMPLETE CANCER TREATMENT AT THE FRANK M. AND DORTHEA HENRY CANCER CENTER. THE HEART HOSPITAL AT GWV IS DEDICATED TO BRINGING THE LATEST TECHNOLOGY USED IN THE TREATMENT OF HEART DISEASE TO THE PEOPLE OF THE WYOMING VALLEY. THERE IS ALSO A SOUTH WILKES-BARRE CAMPUS THAT PROVIDES ADULT AND PEDIATRIC URGENT CARE, INPATIENT REHABILITATION, PAIN MANAGEMENT AND SLEEP CENTER SERVICES AND HOUSES AN AMBULATORY SURGERY CENTER. GEISINGER ASSURANCE COMPANY, LTD. (GAC) IS A WHOLLY OWNED SUBSIDIARY OF THE FOUNDATION LICENSED IN GRAND CAYMAN, BRITISH WEST INDIES. THE PRINCIPAL ACTIVITY OF GAC IS THE REINSURANCE, ON A CLAIMS MADE BASIS, OF A RETROSPECTIVELY RATED PROFESSIONAL LIABILITY INSURANCE POLICY ISSUED BY AN UNRELATED INSURANCE COMPANY BASED IN THE UNITED STATES OF AMERICA TO GAC'S SHAREHOLDER AND CERTAIN AFFILIATES. GEISINGER INSURANCE CORPORATION, RISK RETENTION GROUP - REGISTERED BY THE PA INSURANCE DEPT. TO PROVIDE PRIMARY PROFESSIONAL LIABILITY COVERAGE FOR SEVERAL ENTITIES OF GHS. GEISINGER MEDICAL MANAGEMENT CORPORATION (GMMC) PROVIDES CONTRACT MANAGEMENT, HOSPITALITY AND CONSULTING SERVICES THROUGH CONTRACT RELATIONSHIPS WITH OTHER HEALTHCARE PROVIDERS OR RELATED GEISINGER ENTITIES. SUREHEALTH, A SINGLE MEMBER LIMITED LIABILITY COMPANY OF GMMC, LOCATED IN DANVILLE, PENNSYLVANIA, FORMERLY OPERATED SEVERAL RETAIL PHARMACIES AND A SPECIALTY PHARMACY BUSINESS. GEISINGER COMMUNITY HEALTH SERVICES (GCHS) PROVIDES COMMUNITY HEALTH SERVICES THROUGHOUT NORTHEASTERN AND CENTRAL PENNSYLVANIA. GCHS OFFERS SKILLED NURSING, HOME HEALTH AIDES, MSW, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, HOME INFUSION THERAPY AND RESPIRATORY THERAPY. IN ADDITION, GCHS MANAGES THE UTILIZATION AND CLINICAL PROGRAM DEVELOPMENT RELATING TO THE PROVISION OF HOME CARE THROUGHOUT THE ENTIRE AREA SERVICED BY GHP. MARWORTH PROVIDES NATIONALLY RECOGNIZED ALCOHOL AND CHEMICAL DETOXIFICATION AND REHABILITATION TREATMENT PROGRAMS IN WAVERLY, PENNSYLVANIA. MARWORTH IS LICENSED BY THE PENNSYLVANIA DEPARTMENT OF HEALTH, BUREAU OF DRUG AND ALCOHOL PROGRAMS, AND IS ACCREDITED, WITH COMMENDATION, BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS. MARWORTH OFFERS INDIVIDUALIZED 12-STEP TREATMENT PROGRAMS IN ADDITION TO A SPECIAL DUAL DIAGNOSIS TREATMENT PROGRAM AND SPECIAL PROGRAMS FOR LAW ENFORCEMENT PROFESSIONALS AND HEALTHCARE PROFESSIONALS. GEISINGER HEALTH PLAN (GHP) IS THE LARGEST RURAL HEALTH MAINTENANCE ORGANIZATION (HMO) IN THE NATION. GHP HAS APPROXIMATELY 290,000 MEMBERS FROM PENNSYLVANIA AND WEST VIRGINIA, FROM INDIVIDUALS AND FAMILIES ENROLLED IN THE BASIC HEALTH-MAINTENANCE PROGRAM, INCLUDING A MEDICARE ALTERNATIVE, TO BUSINESS SUBSCRIBERS WHO CAN CHOOSE A CUSTOM-DESIGNED POINT-OF-SERVICE PLAN OR SMALL BUSINESS INSURANCE PLAN. GHP'S MANAGED CARE PATIENTS BENEFIT FROM THEIR FOCUS ON EDUCATION, DISEASE PREVENTION AND WELLNESS. GEISINGER INDEMNITY INSURANCE COMPANY AND GEISINGER QUALITY OPTIONS ARE PENNSYLVANIA BUSINESS CORPORATIONS THAT ARE WHOLLY OWNED SUBSIDIARIES OF THE FOUNDATION AND OFFER INDEMNITY HEALTH INSURANCE. INTERNATIONAL SHARED SERVICES, INC. (ISS), A WHOLLY OWNED SUBSIDIARY OF GMMC, IS ONE OF THE LARGEST INDEPENDENT MEDICAL EQUIPMENT MAINTENANCE, INSTALLATION, PLANNING AND CONSULTING SERVICES GROUPS HEADQUARTERED IN THE MID-ATLANTIC REGION. ISS IS DEDICATED TO THE COST-EFFECTIVE IMPROVEMENT OF PATIENT CARE, SAFETY AND HOSPITAL OPERATIONS THROUGH CONSULTING SERVICES, TRAINING OF MEDICAL MAINTENANCE ENGINEERS AND PLANNING, DESIGN AND EXECUTION OF MEDICAL EQUIPMENT MAINTENANCE PROGRAMS. COMMUNITY MEDICAL CENTER, DBA GEISINGER-COMMUNITY MEDICAL CENTER(GCMC) IS A LEADING PROVIDER OF QUALITY HEALTHCARE SERVICES IN NORTHEASTERN PENNSYLVANIA. A NOT-FOR-PROFIT CHARITABLE HOSPITAL LOCATED IN SCRANTON, GCMC IS HOME TO SCRANTON'S ONLY LEVEL II TRAUMA CENTER AND ADULT INPATIENT BEHAVIORAL HEALTH UNIT. OTHER PROGRAMS INCLUDE: A COMPREHENSIVE CARDIAC SERVICE LINE-INCLUDING OPEN HEART SURGERY; ORTHOPAEDIC SERVICES INCLUDING THE NEWSTEPS JOINT REPLACEMENT CENTER; AND A BROAD RANGE OF OTHER SPECIALIZED SURGICAL AND RADIOLOGICAL SERVICES. COMMUNITY MEDICAL CARE, INC., LOCATED IN SCRANTON, PENNSYLVANIA IS A TAX- EXEMPT ENTITY PROVIDING PHYSICIAN AND OTHER HEALTHCARE PROFESSIONAL SERVICES. COMMUNITY MEDICAL CENTER HEALTHCARE SYSTEM, LOCATED IN SCRANTON, PENNSYLVANIA, IS A TAX-EXEMPT ENTITY THAT PREVIOUSLY SERVED AS THE CORPORATE PARENT OF CMC AND AFFILIATED ENTITIES. COMMUNITY MEDICAL CENTER HEALTHCARE SYSTEM MEDICAL PROFESSIONAL LIABILITY SELF-INSURANCE TRUST, LOCATED IN SCRANTON, PENNSYLVANIA, IS A TAX-EXEMPT ENTITY PROVIDING MEDICAL PROFESSIONAL AND GENERAL LIABILITY COVERAGE. MEDICAL
ADDITIONAL INFORMATION FORM 990, PART V FORM 990, PART IV, LINE 24A: DID THE ORGANIZATION HAVE A TAX-EXEMPT BOND ISSUE WITH AN OUTSTANDING PRINCIPAL AMOUNT OF MORE THAN 100,000 AS OF THE LAST DAY OF THE YEAR, THAT WAS ISSUED AFTER DECEMBER 31, 2002? GHSF, IS CURRENTLY THE SOLE OBLIGOR UNDER A SERIES OF BOND ISSUES WITH A TOTAL OUTSTANDING BALANCE OF 845,252,950 INCLUSIVE OF UNAMORTIZED ORIGINAL ISSUE DISCOUNT AS OF JUNE 30, 2012. BECAUSE THE BOND PROCEEDS ARE DISBURSED TO GHSF SUBSIDIARIES, THE BOND LIABILITIES ARE REFLECTED ON THE BALANCE BALANCE SHEETS OF THE FOLLOWING SUBSIDIARY ORGANIZATIONS: GEISINGER MEDICAL CENTER, EIN: 24-0795959 GEISINGER WYOMING VALLEY MEDICAL CENTER, EIN: 23-1996150 GEISINGER CLINIC, EIN: 23-6291113 MARWORTH, EIN: 23-2171417 GEISINGER SYSTEM SERVICES, EIN: 23-2164794 SCHEDULE K WAS PREPARED ON A CONSOLIDATED BASIS AND IS INCLUDED IN THE FORM 990 FILING OF GEISINGER HEALTH SYSTEM FOUNDATION, EIN: 23-1995911. FORM 990, PART V, LINE 1A: ENTER THE NUMBER REPORTED IN BOX 3 OF FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURNS. GEISINGER SYSTEM SERVICES (GSS), AN AFFILIATE OF THE ORGANIZATION, PROVIDES A CENTRALIZED ACCOUNTS PAYABLE FUNCTION FOR ALL ORGANIZATIONS OF THE GEISINGER HEALTH SYSTEM. AS THE ACCOUNTS PAYABLE PROCESSOR, GSS PREPARES AND FILES FORM 1099 UNDER ITS EIN FOR CERTAIN REPORTABLE PAYMENTS OF THE FILING ORGANIZATION. THE NUMBER OF FORM 1099'S FILED BY GSS FOR THE 2011 REPORTING PERIOD ON BEHALF OF ITSELF AND ITS AFFILIATES WAS 1,212. THE RESPONSE ENTERED ON LINE 1A FOR THE ORGANIZATION INCLUDES ONLY THOSE FORM 1099S FILED UNDER THE ORGANIZATION'S EIN, IT DOES NOT INCLUDE THOSE FILED BY GSS ON ITS BEHALF.
FINANCIAL ACCOUNTS IN FOREIGN COUNTRIES FORM 990, PART V, LINE 4B CAYMAN ISLANDS
ADDITIONAL INFORMATION FORM 990, PART VI 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, AND TWO VOTING MEMBERS ARE NOT INDEPENDENT DUE TO TRANSACTIONS REPORTED ON SCHEDULE L, PART IV. INCLUDING THE VOTINGS MEMBER DESCRIBED ABOVE, A TOTAL OF NINE 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 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. M.D., PH.D., DAVID J. FELICIO, ESQUIRE, FRANK J. TREMBULAK, EDWARD J. ZYCH, ESQUIRE, WILLIAM H. ALEXANDER, RICHARD GRAFMYRE, WILLIAM R. GRUVER, JEAN HAYNES, THOMAS H. LEE, JR., M.D., EDELYN L. MILLER, JOHN D. MORAN, JR., ROBERT E. POOLE, RICHARD A. ROSE, ALBERT BOTHE, M.D., KEVIN BRENNAN, DON A. ROSINI, ROBERT TAMBUR, AND JOANNE E. WADE, ALL HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER BECAUSE THEY SERVE AS OFFICERS AND/OR DIRECTORS ON ONE OR MORE FOR-PROFIT SUBSIDIARIES OF GHSF. FORM 990, PART VI, SECTION B, LINE 13: DID THE ORGANIZATION HAVE A WRITTEN WHISTLEBLOWER POLICY?; LINE 14: DID THE ORGANIZATION HAVE A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY?; LINE 16B: DID THE ORGANIZATION HAVE A WRITTEN JOINT VENTURE POLICY? THE GEISINGER WHISTLEBLOWER POLICY, DOCUMENT RETENTION AND DESTRUCTION POLICY, AND JOINT VENTURE POLICY HAVE BEEN IN EFFECT AND ENFORCED FOR MANY YEARS. IN ADDITION TO THE POLICIES BEING A BEST PRACTICE, SYSTEM RECOGNIZES THEIR VALUE AS A GUIDE TO THE GOVERNING BODY OF THE ORGANIZATION, EMPLOYEES, AND OTHERS. THE BOARD OF DIRECTORS OF GHSF FORMALLY ADOPTED 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 GHSF EXECUTIVE COMMITTEE WHICH IS COMPRISED OF THOSE INDIVIDUALS WHO SERVE AS GHSF'S 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.
SIGNIFICANT CHANGES TO ORGANIZATIONAL DOCUMENTS FORM 990, PAGE 6, PART VI, LINE 4 GHSF REVISED IT'S CORPORATE BYLAWS TO INCLUDE MEMBERSHIP BY TWO FORMER COMMUNITY MEDICAL CENTER HEALTH CARE SYSTEM BOARD MEMBERS AND TO ESTABLISH A TRANSACTION COMPLIANCE COMMITTEE.
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 WAS PROVIDED TO ASSIST IN THE REVIEW. IN ACCORDANCE WITH THE GHSF BOARD OF DIRECTOR'S FINANCE COMMITTEE CHARTER, STAFF PERIODICALLY REVIEWS THE GHS ORGANIZATIONS' FORM 990 FILINGS. THE FORM 990 IS PREPARED BY THE SYSTEM TAX AND FINANCIAL REPORTING DEPARTMENTS WITH INFORMATION PROVIDED FROM FINANCE, TAX, HUMAN RESOURCES, LEGAL SERVICES AND OTHER RELEVANT DEPARTMENTS WITHIN THE 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 GHSF 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 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 THE 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 SYSTEM WEBSITE AT WWW.GEISINGER.ORG. THE COMMUNITY BENEFIT REPORT AND ANNUAL REPORT FOR GEISINGER, CONTAINING CONSOLIDATED FINANCIAL INFORMATION AND OTHER INFORMATION, ARE AVAILABLE ON THE GEISINGER WEBSITE AT: WWW.GEISINGER.ORG/ABOUT/2011_AR_FINAL.PDF FINANCIAL STATEMENTS, THE COMPLETE FORM 990 AND FORM 990-T, THE CONFLICTS OF INTEREST POLICY, AND OTHER GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
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 COMPENATED EMPLOYEES WORK A MINIMUM OF 40 HOURS PER WEEK FOR RELATED ORGANIZATIONS.
OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 5 INCREASE IN NETS ASSETS: ENTITY CONTRIBUTIONS 207,123,594 GAINS ON SUBSIDIARIES 24,771,896 DECREASE IN NET ASSETS: UNRESTRICTED UNREALIZED LOSSES -37,733,228 RESTRICTED UNREALIZED LOSSES - 2,623,792 OTHER - 28,461 NET INCREASE IN NET ASSETS: 191,510,009
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 GESINGER 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
GEISINGER HEALTH SYSTEM FOUNDATION
 
Employer identification number

23-1995911
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 MEDICAL CENTER

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-6852932 		SELF INS PA 501C3 11A GMC
 
Yes
 
(12) COMMUNITY MEDICAL CENTER

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
24-0862246 		HOSPITAL PA 501C3 3 GHSF
 
Yes
 
(13) COMMUNITY MEDICAL CARE INC

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2369788 		HOLDING CO 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 GMMC
  		C CORP 39,377,546 14,747,288 100.000 %
(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 GMMC
  		C CORP 39,377,546 14,747,288 100.000 %
(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
 
No
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
 
No
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 ASSURANCE COMPANY LTD

 C 20,000,000 GAAP
(2) GEISINGER CLINIC

 B 2,694,211 GAAP
(3) GEISINGER CLINIC

 L 187,675 GAAP
(4) GEISINGER CLINIC

 K 2,341,600 GAAP
(5) GEISINGER CLINIC

 C 73,000,000 GAAP
(6) GEISINGER CLINIC

 L 45,118 GAAP
(7) COMMUNITY MEDICAL CENTER

 C 23,187,557 GAAP
(8) GEISINGER HEALTH PLAN

 C 37,000,000 GAAP
(9) GEISINGER HEALTH PLAN

 B 110,307 GAAP
(10) GEISINGER INDEMNITY INSURANCE COMP

 C 14,700,000 GAAP
(11) GEISINGER MEDICAL CENTER

 B 3,954,313 GAAP
(12) GEISINGER MEDICAL CENTER

 L 209,464 GAAP
(13) GEISINGER MEDICAL CENTER

 C 90,700,000 GAAP
(14) GEISINGER MEDICAL CENTER

 K 3,758,653 GAAP
(15) GEISINGER MEDICAL MANAGEMENT CORP

 L 75,690 GAAP
(16) GEISINGER MEDICAL MANAGEMENT CORP

 C 1,000,000 GAAP
(17) GEISINGER SYSTEM SERVICES

 B 546,941 GAAP
(18) GEISINGER SYSTEM SERVICES

 L 2,514,076 GAAP
(19) GEISINGER SYSTEM SERVICES

 O 270,967 GAAP
(20) GEISINGER WYOMING VALLEY MED CTR

 B 4,096,497 GAAP
(21) GEISINGER WYOMING VALLEY MED CTR

 L 188,349 GAAP
(22) GEISINGER WYOMING VALLEY MED CTR

 C 44,300,000 GAAP
(23) GEISINGER WYOMING VALLEY MED CTR

 K 1,692,008 GAAP
(24) MARWORTH

 B 148,573 GAAP
(25) MARWORTH

 K 54,880 GAAP
(26) COMMUNITY MEDICAL CARE INC

 B 8,600,000 GAAP
(27) GEISINGER ASSURANCE COMPANY LTD

 C 20,000,000 GAAP
(28) GEISINGER CLINIC

 B 2,694,211 GAAP
(29) GEISINGER CLINIC

 L 187,675 GAAP
(30) GEISINGER CLINIC

 K 2,341,600 GAAP
(31) GEISINGER CLINIC

 C 73,000,000 GAAP
(32) GEISINGER CLINIC

 L 45,118 GAAP
(33) COMMUNITY MEDICAL CENTER

 C 23,187,557 GAAP
(34) GEISINGER HEALTH PLAN

 C 37,000,000 GAAP
(35) GEISINGER HEALTH PLAN

 B 110,307 GAAP
(36) GEISINGER INDEMNITY INSURANCE COMP

 C 14,700,000 GAAP
(37) GEISINGER MEDICAL CENTER

 B 3,954,313 GAAP
(38) GEISINGER MEDICAL CENTER

 L 209,464 GAAP
(39) GEISINGER MEDICAL CENTER

 C 90,700,000 GAAP
(40) GEISINGER MEDICAL CENTER

 K 3,758,653 GAAP
(41) GEISINGER MEDICAL MANAGEMENT CORP

 L 75,690 GAAP
(42) GEISINGER MEDICAL MANAGEMENT CORP

 C 1,000,000 GAAP
(43) GEISINGER SYSTEM SERVICES

 B 546,941 GAAP
(44) GEISINGER SYSTEM SERVICES

 L 2,514,076 GAAP
(45) GEISINGER SYSTEM SERVICES

 O 270,967 GAAP
(46) GEISINGER WYOMING VALLEY MED CTR

 B 4,096,497 GAAP
(47) GEISINGER WYOMING VALLEY MED CTR

 L 188,349 GAAP
(48) GEISINGER WYOMING VALLEY MED CTR

 C 44,300,000 GAAP
(49) GEISINGER WYOMING VALLEY MED CTR

 K 1,692,008 GAAP
(50) MARWORTH

 B 148,573 GAAP
(51) MARWORTH

 K 54,880 GAAP
(52) COMMUNITY MEDICAL CARE INC

 B 8,600,000 GAAP
(53) GEISINGER ASSURANCE COMPANY LTD

 C 20,000,000 GAAP
(54) GEISINGER CLINIC

 B 2,694,211 GAAP
(55) GEISINGER CLINIC

 L 187,675 GAAP
(56) GEISINGER CLINIC

 K 2,341,600 GAAP
(57) GEISINGER CLINIC

 C 73,000,000 GAAP
(58) GEISINGER CLINIC

 L 45,118 GAAP
(59) COMMUNITY MEDICAL CENTER

 C 23,187,557 GAAP
(60) GEISINGER HEALTH PLAN

 C 37,000,000 GAAP
(61) GEISINGER HEALTH PLAN

 B 110,307 GAAP
(62) GEISINGER INDEMNITY INSURANCE COMP

 C 14,700,000 GAAP
(63) GEISINGER MEDICAL CENTER

 B 3,954,313 GAAP
(64) GEISINGER MEDICAL CENTER

 L 209,464 GAAP
(65) GEISINGER MEDICAL CENTER

 C 90,700,000 GAAP
(66) GEISINGER MEDICAL CENTER

 K 3,758,653 GAAP
(67) GEISINGER MEDICAL MANAGEMENT CORP

 L 75,690 GAAP
(68) GEISINGER MEDICAL MANAGEMENT CORP

 C 1,000,000 GAAP
(69) GEISINGER SYSTEM SERVICES

 B 546,941 GAAP
(70) GEISINGER SYSTEM SERVICES

 L 2,514,076 GAAP
(71) GEISINGER SYSTEM SERVICES

 O 270,967 GAAP
(72) GEISINGER WYOMING VALLEY MED CTR

 B 4,096,497 GAAP
(73) GEISINGER WYOMING VALLEY MED CTR

 L 188,349 GAAP
(74) GEISINGER WYOMING VALLEY MED CTR

 C 44,300,000 GAAP
(75) GEISINGER WYOMING VALLEY MED CTR

 K 1,692,008 GAAP
(76) MARWORTH

 B 148,573 GAAP
(77) MARWORTH

 K 54,880 GAAP
(78) COMMUNITY MEDICAL CARE INC

 B 8,600,000 GAAP
(79) GEISINGER ASSURANCE COMPANY LTD

 C 20,000,000 GAAP
(80) GEISINGER CLINIC

 B 2,694,211 GAAP
(81) GEISINGER CLINIC

 L 187,675 GAAP
(82) GEISINGER CLINIC

 K 2,341,600 GAAP
(83) GEISINGER CLINIC

 C 73,000,000 GAAP
(84) GEISINGER CLINIC

 L 45,118 GAAP
(85) COMMUNITY MEDICAL CENTER

 C 23,187,557 GAAP
(86) GEISINGER HEALTH PLAN

 C 37,000,000 GAAP
(87) GEISINGER HEALTH PLAN

 B 110,307 GAAP
(88) GEISINGER INDEMNITY INSURANCE COMP

 C 14,700,000 GAAP
(89) GEISINGER MEDICAL CENTER

 B 3,954,313 GAAP
(90) GEISINGER MEDICAL CENTER

 L 209,464 GAAP
(91) GEISINGER MEDICAL CENTER

 C 90,700,000 GAAP
(92) GEISINGER MEDICAL CENTER

 K 3,758,653 GAAP
(93) GEISINGER MEDICAL MANAGEMENT CORP

 L 75,690 GAAP
(94) GEISINGER MEDICAL MANAGEMENT CORP

 C 1,000,000 GAAP
(95) GEISINGER SYSTEM SERVICES

 B 546,941 GAAP
(96) GEISINGER SYSTEM SERVICES

 L 2,514,076 GAAP
(97) GEISINGER SYSTEM SERVICES

 O 270,967 GAAP
(98) GEISINGER WYOMING VALLEY MED CTR

 B 4,096,497 GAAP
(99) GEISINGER WYOMING VALLEY MED CTR

 L 188,349 GAAP
(100) GEISINGER WYOMING VALLEY MED CTR

 C 44,300,000 GAAP
(101) GEISINGER WYOMING VALLEY MED CTR

 K 1,692,008 GAAP
(102) MARWORTH

 B 148,573 GAAP
(103) MARWORTH

 K 54,880 GAAP
(104) COMMUNITY MEDICAL CARE INC

 B 8,600,000 GAAP
(105) GEISINGER ASSURANCE COMPANY LTD

 C 20,000,000 GAAP
(106) GEISINGER CLINIC

 B 2,694,211 GAAP
(107) GEISINGER CLINIC

 L 187,675 GAAP
(108) GEISINGER CLINIC

 K 2,341,600 GAAP
(109) GEISINGER CLINIC

 C 73,000,000 GAAP
(110) GEISINGER CLINIC

 L 45,118 GAAP
(111) COMMUNITY MEDICAL CENTER

 C 23,187,557 GAAP
(112) GEISINGER HEALTH PLAN

 C 37,000,000 GAAP
(113) GEISINGER HEALTH PLAN

 B 110,307 GAAP
(114) GEISINGER INDEMNITY INSURANCE COMP

 C 14,700,000 GAAP
(115) GEISINGER MEDICAL CENTER

 B 3,954,313 GAAP
(116) GEISINGER MEDICAL CENTER

 L 209,464 GAAP
(117) GEISINGER MEDICAL CENTER

 C 90,700,000 GAAP
(118) GEISINGER MEDICAL CENTER

 K 3,758,653 GAAP
(119) GEISINGER MEDICAL MANAGEMENT CORP

 L 75,690 GAAP
(120) GEISINGER MEDICAL MANAGEMENT CORP

 C 1,000,000 GAAP
(121) GEISINGER SYSTEM SERVICES

 B 546,941 GAAP
(122) GEISINGER SYSTEM SERVICES

 L 2,514,076 GAAP
(123) GEISINGER SYSTEM SERVICES

 O 270,967 GAAP
(124) GEISINGER WYOMING VALLEY MED CTR

 B 4,096,497 GAAP
(125) GEISINGER WYOMING VALLEY MED CTR

 L 188,349 GAAP
(126) GEISINGER WYOMING VALLEY MED CTR

 C 44,300,000 GAAP
(127) GEISINGER WYOMING VALLEY MED CTR

 K 1,692,008 GAAP
(128) MARWORTH

 B 148,573 GAAP
(129) MARWORTH

 K 54,880 GAAP
(130) COMMUNITY MEDICAL CARE INC

 B 8,600,000 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 GEISINGER HEALTH SYSTEM FOUNDATION 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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