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
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 07-01-2012 , 2012, and ending 06-30-2013
BCheck if applicable:
CName of organization
COMMUNITY MEDICAL CENTER
 
Doing Business As
GEISINGER-COMMUNITY MEDICAL CENTER
 
Number and street (or P.O. box if mail is not delivered to street address)
100 NORTH ACADEMY AVENUE MC 49-70
 
Room/suite
City or town, state or country, and ZIP + 4
DANVILLE, PA17822
D Employer identification number

24-0862246
E Telephone number

G Gross receipts $ 184,730,118
F Name and address of principal officer:
GLENN D STEELE JR MD PHD
100 NORTH ACADEMY AVENUE MC 22-01
DANVILLE,PA17822
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CMCCARE.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1962
M State of legal domicile: PA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING QUALITY HOSPITAL SERVICES AND ACCESS ACROSS NORTHEASTERN PENNSYLVANIA THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 10
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 9
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 2,188
6 Total number of volunteers (estimate if necessary) ............. 6 181
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 97,426
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -72,956
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 618,746 18,315
9 Program service revenue (Part VIII, line 2g) ......... 157,682,384 177,160,153
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 518,851 1,977,447
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 948,884 3,395,215
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 159,768,865 182,551,130
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 125,178 61,381
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 74,126,365 82,327,133
16a Professional fundraising fees (Part IX, column (A), line 11e).....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 87,225,129 102,169,657
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 161,476,672 184,558,171
19 Revenue less expenses. Subtract line 18 from line 12....... -1,707,807 -2,007,041
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 114,404,869 128,547,906
21 Total liabilities (Part X, line 26)............. 101,342,419 112,040,764
22 Net assets or fund balances. Subtract line 21 from line 20..... 13,062,450 16,507,142
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 MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III ...............
1
Briefly describe the organization’s mission: TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING QUALITY HOSPITAL SERVICES AND ACCESS ACROSS NORTHEASTERN PENNSYLVANIA THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations 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 $ 167,502,068 including grants of $ 61,381 ) (Revenue $ 178,956,397 )
SEE SCHEDULE O I. GENERAL INFORMATION COMMUNITY MEDICAL CENTER (CMC), DOING BUSINESS AS GEISINGER-COMMUNITY MEDICAL CENTER (GCMC), IS A TAX-EXEMPT, PENNSYLVANIA NOT-FOR-PROFIT CORPORATIONORGANIZED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. GCMC IS A 297-BED ACUTE CARE HOSPITAL IN SCRANTON, PA. THE HOSPITAL WAS FOUNDED 116 YEARS AGO AT WHICH TIME IT WAS KNOWN AS HAHNEMANN HOSPITAL. THE HOSPITAL WAS SCRANTON'S FIRST AND CURRENTLY ONLY ACUTE CARE HOSPITAL DEDICATED TO SERVING THE COMMUNITY AND THEIR HEALTH NEEDS THROUGH A CHARITABLE PURPOSE. GCMC CONTINUES TO PROVIDE THE COMMUNITY WITH A VARIETY OF SERVICES AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. THIS CONTINUUM OF CARE INCLUDES PREVENTIVE, AMBULATORY, INPATIENT, AND EMERGENCY SERVICES. GCMC IS A NOTED REGIONAL REFERRAL CENTER WITH COMPREHENSIVE ACUTE CARE MEDICAL SERVICES AND HAS DEVELOPED MANY SPECIFIC AREAS OF EXPERTISE. PATIENT ORIGIN AND SERVICE AREA: THE HOSPITAL'S PRIMARY SERVICE AREA IS COMPRISED OF LACKAWANNA COUNTY. THE SECONDARY SERVICE AREAS INCLUDE LUZERNE, MONROE, PIKE, SUSQUEHANNA, WAYNE AND WYOMING COUNTIES. SPECIALIZED / REGIONAL SERVICES, CENTERS OF EXCELLENCE: GCMC IS THE ONLY LEVEL II TRAUMA CENTER IN LACKAWANNA COUNTY. THE NORTHEAST PA TRAUMA CENTER, DESIGNATED BY THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION IN 1988, PROVIDES 24-HOUR COMPREHENSIVE SURGICAL INTERVENTION FOR CRITICALLY INJURED PATIENTS. THE TRAUMA CENTER IS STAFFED CONTINUOUSLY BY AN EMERGENCY PHYSICIAN, TRAUMA SURGEON, AND NURSES CERTIFIED IN CRITICAL CARE, TRAUMA, ORTHOPEDICS, AND THE NEUROSCIENCES. CARDIOLOGY SERVICES AT THE HOSPITAL INCLUDE THE REGION'S FIRST ELECTROPHYSIOLOGY LAB AND AN OPEN HEART SURGERY CENTER. GCMC IS ALSO A CERTIFIED CAROTID STENT FACILITY. GCMC HAS EARNED THE ACTION REGISTRY- GWTG PLATINUM PERFORMANCE ACHIEVEMENT AWARD FOR EIGHT CONSECUTIVE QUARTERS OF QUALITY CARDIOVASCULAR CARE. NEUROLOGICAL SCIENCES AT GCMC SPECIALIZES IN THE CARE OF PEOPLE WITH BRAIN AND SENSE ORGAN DISORDERS. GCMC HAS EARNED THE AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES BRONZE AWARD. OTHER SPECIALIZED SERVICES INCLUDE: A SAME-DAY SURGERY CENTER, A 24-BED SHORT-TERM PSYCHIATRIC INPATIENT UNIT (THE ONLY ONE IN LACKAWANNA COUNTY), AN ORTHOPEDIC TRAUMA CLINIC, CT SCANNER, MRI IMAGING, ONCOLOGY SERVICES, RENAL DIALYSIS, HYPERBARIC OXYGEN CHAMBER TREATMENTS, THE NEW STEPS JOINT PROGRAM, WOUND CARE, AND STEREOTACTIC SURGERY. GCMC OFFERS EMERGENCY MEDICAL TECHNICIAN AND TRAUMA NURSE TRAINING PROGRAMS. IT HAS AN AFFILIATION WITH THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION. THE WRIGHT CENTER IS AN ACCREDITED PROVIDER OF INTERNAL MEDICINE RESIDENCY EDUCATION BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION. THE WRIGHT CENTER IS ALSO THE REGION'S ONLY PODIATRIC RESIDENCY PROGRAM AND ACCREDITED PROVIDER OF PODIATRIC MEDICINE AND SURGERY EDUCATION BY THE COUNCIL OF PODIATRIC MEDICAL EDUCATION. IN FY 2013, THE UNCOMPENSATED COSTS FOR HEALTH PROFESSIONS EDUCATION TOTALED 1,206,528. GCMC ALSO SPONSORS THE COMMUNITY HEALTH EDUCATION PROGRAM (DETAILED BELOW). THIS PROGRAM IS THE REGION'S FIRST HOSPITAL-BASED AND COMMUNITY- WIDE WELLNESS AND PREVENTION PROGRAM. IN ADDITION, GCMC SPONSORS THE PRIORITY CARE PROGRAM IN WHICH OVER 20,000 SENIOR CITIZENS ARE ENROLLED IN THE REGION'S FIRST HOSPITAL-BASED FREE MEMBERSHIP PLAN FOR PERSONS 55 AND OLDER. PRIORITY CARE PROVIDES SENIOR CITIZENS WITH A WIDE VARIETY OF BENEFITS AND INFORMATION REGARDING HEALTH AND WELLNESS PROGRAMS. PRIORITY CARE OFFERS CONVENIENT ACCESS TO QUALITY SERVICES INCLUDING: O FREE PARKING IN THE GCMC PARKING COMPLEX O COMMUNITY DISCOUNTS O DISCOUNTED MEALS IN THE HOSPITAL'S DINING ROOM O DISCOUNTS IN THE GCMC GIFT SHOP O PHYSICIAN REFERRAL SERVICE AFFILIATIONS: GCMC HAS WORKING RELATIONSHIPS WITH OTHER HEALTH CARE PROVIDERS IN VENTURES SUCH AS THE NORTHEAST SURGERY CENTER AND THE NORTHEASTERN PENNSYLVANIA IMAGING CENTER. GCMC ALSO HAS WORKING RELATIONSHIPS WITH THE CHILDREN'S ADVOCACY CENTER, MATERNAL & FAMILY HEALTH SERVICES, AND THE RONALD MCDONALD HOUSE OF SCRANTON. IN PARTICULAR, GCMC PROVIDES THE CHILDREN'S ADVOCACY CENTER AND MATERNAL & FAMILY HEALTH SERVICES WITH SPACE TO CONDUCT THEIR CHARTABLE PURPOSE FOR FREE. THESE CHARITABLE LEASES WERE VALUED AT 123,200 FOR FY 2013. GCMC ALSO HAS A CONNECTION WITH NUMEROUS AREA INSTITUTIONS, COLLEGES, AND UNIVERSITIES FOR EDUCATIONAL AND CLINICAL PROGRAMS INCLUDING, BUT NOT LIMITED TO, NURSING, MEDICAL TECHNOLOGY, PHYSICAL AND OCCUPATIONAL THERAPY, EMERGENCY MEDICAL TECHNICIANS, PHYSICIAN ASSISTANTS, SOCIAL WORK, AND HEALTHCARE ADMINISTRATION. MEDICAL STAFF: AS OF JUNE 30, 2013, THE MEDICAL STAFF OF GCMC TOTALED 568 PHYSICIANS. UNDER GCMC'S MEDICAL STAFF BY-LAWS, PHYSICIANS MAY HAVE ONE OF SEVERAL TYPES OF PRIVILEGES INCLUDING ACTIVE, COURTESY, CONSULTING, EMERGENCY, AND TEMPORARY. AUXILIARY: THE GCMC AUXILIARY IS COMPRISED OF APPROXIMATELY 60 MEMBERS. FUNCTIONING WITH THE GUIDANCE OF ITS OWN ADVISORY BOARD, THE AUXILIARY IS SPLIT INTO COMMITTEES, EACH OF WHICH HAS THEIR OWN RESPONSIBILITY FOR FUND-RAISING AND SERVICE. THE AUXILIARY ASSISTS IN OPERATING GCMC'S GIFT SHOP ON A DAILY BASIS. ALLOCATIONS OF FUNDS RAISED BY THE AUXILIARY ARE MADE TO GCMC TO ENHANCE PATIENT SERVICES. II. UNCOMPENSATED CARE: GCMC RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND EDUCATION. GCMC PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD GCMC PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A.CHARITY CARE THE PRIMARY CONCERN OF GCMC IS THE DELIVERY OF HEALTH CARE TO ALL THE CITIZENS OF NORTHEASTERN PENNSYLVANIA, REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GCMC INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. THE COST TO GCMC OF PROVIDING THIS CHARITY CARE DURING THE FISCAL YEAR ENDED JUNE 30, 2013 WAS 2,015,856. B.MEDICARE/MEDICAID/OTHER GOVERNMENTAL RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO THE ELDERLY (MEDICARE), THE POOR (MEDICAID), AND OTHER. GCMC PROVIDES CARE BELOW COST TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS. TO THE EXTENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTHCARE, GCMC IS FURTHERING ITS CHARITABLE MISSION. THE UNREIMBURSED VALUE OF MEDICARE, MEDICAID AND OTHER GOVERNMENTAL PAYERS IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. FOR FISCAL YEAR 2013, THE UNREIMBURSED COST OF PROVIDING CARE TO THESE PATIENTS WAS 23,906,040. C.OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GCMC PROVIDES OTHER PATIENT SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2013, WAS 2,371,082. III. COMMUNITY HEALTH, EDUCATION, AND OUTREACH GCMC AND RELATED AFFILIATES PROVIDE A VARIETY OF PROGRAMS TO THE COMMUNITY. THE INTENT OF THESE PROGRAMS IS TO IMPROVE THE HEALTH OF THE COMMUNITY AND PROVIDE FOR COMMUNITY HEALTH NEEDS, E.G. THROUGH ACCIDENT/ ILLNESS PREVENTION OR EARLY HEALTH INTERVENTION AS A RESULT OF INCREASED EDUCATION. THE NORTHEAST PA TRAUMA CENTER PROVIDES EMERGENCY PREPAREDNESS ASSISTANCE AND MEDICAL EXPERTISE TO THE AMERICAN RED CROSS LACKAWANNA CHAPTER, LACKAWANNA COUNTY EMERGENCY MANAGEMENT AGENCY, AND THE SCRANTON/WILKES- BARRE INTERNATIONAL AIRPORT. ALSO, FALL AND INJURY PREVENTION FOR THE ELDERLY IS AVAILABLE TO AREA SENIOR CITIZENS AND SENIOR ORGANIZATIONS, AS WELL AS MANY AGE-SPECIFIC PREVENTION PROGRAMS TO VARIOUS ORGANIZATIONS AND SCHOOLS THROUGHOUT THE YEAR. EACH YEAR OVER 500 CHILDREN UNDER THE AGE OF 18 ARE INVOLVED IN EDUCATION'S EXTENSIVE PROGRAMS TARGETING THIS AGE GROUP. TRAUMA PREVENTION PROGRAMS SUCH AS TRAUMA ROOM AND THINK FIRST TEACH KIDS IMPORTANT SAFETY INFORMATION. ASTHMA SKI DAY HELD IN CONJUNCTION WITH MONTAGE MOUNTAIN SKI AREA AND GCMC'S COMMUNITY HEALTH EDUCATION PROGRAM, EMPHASIZING THAT DESPITE ILLNESS, INDIVIDUALS CAN STILL PARTICIPATE IN HEALTHY, EVEN STRENUOUS ACTIVITIES. IN ADDITION, A POISON PREVENTION PROGRAM IS AVAILABLE ALONG WITH OTHER SUCH PROGRAMS AS REQUESTED. MANY OF THESE PROGRAMS ARE THE RESULTS OF EDUCATION'S PARTNERSHIPS WITH OTHER COMMUNITY RESOURCES; E.G., THE AMERICAN LUNG ASSOCIATION, LACKAWANNA COUNTY DRUG AND ALCOHOL COMMISSION, AND ALLIED SERVICES. IN FY 2013, THE TRAUMA CENTER PROVIDED 20 TRAUMA PROGRAMS FOR ABOUT 6,000 OF UNCOMPENSATED COSTS. THE COMMUNITY HEALTH EDUCATION PROGRAM ("LIFECARE") CONDUCTS A WIDE VARIETY OF HEALTHLY LIFESTYLE PROGRAMS, FREE OR AT MINIMAL COST, WHICH ARE DESIGNED TO 'PRACTICALLY' ASSIST AN INDIVIDUAL IN THEIR QUEST TO LEAD A HEALTHY AND PRODUCTIVE LIFE. SOME OF THE AREAS OF CONCENTRATION INCLUDE: SMOKING CESSATION, FIRST AID, CPR, AND WEIGHT WATCHERS SESSIONS THAT ARE OPEN TO THE PUBLI
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 expensesMediumBullet167,502,068
Form 990 (2012)
Form 990 (2012)
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 (see instructions)? 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, or have a section 501(h) election in effect during the tax year? 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 III
Click 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 for escrow or custodial account liability; 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, line 10?
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 VIIClick 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 VIIIClick 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 IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part XClick 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 XClick 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 and XII 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 and XII 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, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the United States? If “Yes,” complete Schedule F, Parts II and IV
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 United States? If “Yes,” complete Schedule F, Parts III and IV...
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 I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............
18
 
No
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...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H.... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2012)
Form 990 (2012)
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, line 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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II
.......................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV
..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I
...........................
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, Part II, III, or IV, and Part 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 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V ...............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
188
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
2,188
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, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes,” to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
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.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the 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 amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
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 .....................
1a
10
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
9
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
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
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 this 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
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:
MediumBulletEDWARD CHABALOWSKI CFO1822 MULBERRY STREETSCRANTONPA18510 (570) 703-8837
Form 990 (2012)
Form 990 (2012)
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. 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 organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) WILLIAM H ALEXANDER........................................................................
DIRECTOR
.25
.......................5.25
X           0 0 0
(2) E ALLEN DEAVER........................................................................
DIRECTOR
.25
.......................4.25
X           0 0 0
(3) DORRANCE R BELIN ESQUIRE........................................................................
DIRECTOR
.25
.......................4.25
X           0 0 0
(4) RICHARD A GRAFMYRE........................................................................
DIRECTOR
.25
.......................5.25
X           0 0 0
(5) WILLIAM R GRUVER........................................................................
DIRECTOR
.25
.......................4.50
X           0 0 0
(6) FRANK M HENRY........................................................................
DIRECTOR
1.00
.......................3.50
X           0 0 0
(7) THOMAS H LEE JR MD........................................................................
DIRECTOR
.25
.......................5.00
X           0 0 0
(8) GLENN D STEELE JR MD PHD........................................................................
PRES,CHAIR,
0.00
.......................40.00
X   X       0 2,062,556 418,454
(9) ROBERT E POOLE........................................................................
DIRECTOR
.25
.......................4.50
X           0 0 0
(10) DON A ROSINI........................................................................
DIRECTOR
.25
.......................5.25
X           0 0 0
(11) ANTHONY D AQUILINA DO........................................................................
CMO
0.00
.......................40.00
    X       0 455,740 76,773
(12) DAVID J FELICIO ESQUIRE........................................................................
CLO, SECRETA
0.00
.......................40.00
    X       0 512,681 140,659
(13) EDWARD J ZYCH ESQUIRE........................................................................
ACLO, ASST S
0.00
.......................40.00
    X       0 344,575 65,798
(14) KEVIN F BRENNAN CPA FHFMA........................................................................
EVP, FINANCE
0.00
.......................40.00
    X       0 1,079,326 202,187
(15) ROBERT P STEIGMEYER........................................................................
CAO
40.00
.......................0.00
    X       912,648 0 29,089
(16) FRANK J TREMBULAK........................................................................
SR VP, TREAS
0.00
.......................40.00
    X       0 1,245,352 216,867
(17) BARBARA BOSSI........................................................................
ASSOCIATE CA
40.00
.......................0.00
      X     309,233 0 24,068
Form 990 (2012)
Form 990 (2012)
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 (list any hours for related organizations below dotted line)
(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) JOHN DITCHKUS CRNA........................................................................
CRNA
40.00
.......................0.00
        X   248,448 0 26,198
(19) MARK R TRENTLY CRNA........................................................................
CRNA
40.00
.......................0.00
        X   239,978 0 25,600
(20) ROSE A SADOWSKI CRNA........................................................................
CRNA
40.00
.......................0.00
        X   258,063 0 19,560
(21) MICHELLE T BOYLE MSN CRNA CRNP........................................................................
CRNA
40.00
.......................0.00
        X   292,234 0 27,634
(22) GARY SEBASTIANELLI........................................................................
LEAD CRNA
40.00
.......................0.00
        X   227,985 0 27,529
(23) ALBERT BOTHE JR MD........................................................................
FORMER OFFIC
0.00
.......................40.00
          X 0 1,071,539 189,516
(24) JOHN D KIZER MD........................................................................
FORMER 5 HIG
40.00
.......................0.00
          X 0 426,889 37,430
(25) KHALEEL SHAIKH MD........................................................................
FORMER 5 HIG
40.00
.......................0.00
          X 0 440,127 27,313
(26) SEAN MCANDREW........................................................................
FORMER OFFIC
0.00
.......................40.00
          X 174,397 0 7,904
(27) WENDY K WILSON........................................................................
FORMER OFFIC
0.00
.......................40.00
          X 127,979 0 16,426






1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 2,790,965 7,638,785 1,579,005
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet44
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
ARAMARK1101 MARKET STREET 29TH FLOORPHILADELPHIAPA19107 DIETARY, HSKPNG 3,141,406
WRIGHT CENTER FOR MEDICAL GRAD501 MADISON AVESCRANTONPA18510 STAFFING 1,898,894
SIEMENSHEALTH SERVICES DIVISION51 VALLEY STREAM PARKWAYMALVERNPA19355 TECHNOLOGY 1,316,319
HCSC LAUNDRYPO BOX 25092LEHIGH VALLEYPA180025092 LAUNDRY SERVICE 862,777
MEDICAL STAFFING NETWORKPO BOX 203000DALLASTX753203000 STAFFING 805,990
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet86
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e 16,915
f All other contributions, gifts, grants, and
similar amounts not included above
1f
1,400
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet 18,315
 Program Service Revenue Business Code
2a PATIENT HEALTHCARE 622110 177,043,300 177,043,300    
b RENTAL INCOME 531120 81,060     81,060
c EDUCATION 622110 35,793 35,793    
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 177,160,153
 Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 933,190     933,190
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 219,893  
b Less: rental expenses 146,680  
c Rental income or (loss) 73,213  
d Net rental income or (loss).......MediumBullet 73,213     73,213
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 3,075,854 711
b Less: cost or other basis and sales expenses 1,940,779 91,529
c Gain or (loss) 1,135,075 -90,818
d Net gain or (loss)..........MediumBullet 1,044,257     1,044,257
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a ELECTRONIC HEALTH RECORD INCE 900099 1,877,304 1,877,304    
b DIETARY INCOME 722514 705,457     705,457
c PARKING GARAGE REVENUE 900099 240,585     240,585
d All other revenue .... 498,656 234,484 97,426 166,746
e Total. Add lines 11a–11d ...... MediumBullet 3,322,002
12 Total revenue. See Instructions......MediumBullet 182,551,130 179,190,881 97,426 3,244,508
Form 990 (2012)
Form 990 (2012)
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).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 61,381 61,381
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 1,267,414   1,267,414  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 67,192,341 61,595,054 5,597,287  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 1,556,352 1,400,291 156,061  
9 Other employee benefits ....... 7,479,437 6,729,447 749,990  
10 Payroll taxes ........... 4,831,589 4,433,862 397,727  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 100,947   100,947  
c Accounting ........... 64,644   64,644  
d Lobbying ........... 2,518   2,518  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 102,557   102,557  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 15,072,382 12,849,488 2,222,894  
12 Advertising and promotion .... 36,511   36,511  
13 Office expenses ....... 4,513,263 3,318,117 1,195,146  
14 Information technology ...... 86,008 80,414 5,594  
15 Royalties ..        
16 Occupancy ........... 3,850,216 3,494,826 355,390  
17 Travel ............ 226,533 151,142 75,391  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 87,576 33,968 53,608  
20 Interest ........... 158,201 143,598 14,603  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 5,851,562 5,311,401 540,161  
23 Insurance .............. 2,089,054 1,912,431 176,623  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 39,117,349 38,984,806 132,543  
b INTER-ENTITY EXPENSES 15,881,875 12,287,454 3,594,421  
c UNCOLLECTIBLE EXPENSE 10,724,163 10,724,163    
d MA MODERNIZATION 3,414,873 3,414,873    
e All other expenses 789,425 575,352 214,073  
25 Total functional expenses. Add lines 1 through 24e 184,558,171 167,502,068 17,056,103 0
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 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 23,010,308 1 11,879,972
2 Savings and temporary cash investments ......... 2,576,176 2 2,858,026
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 15,668,341 4 13,263,233
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net ............. 1,124,049 7  
8 Inventories for sale or use .............. 3,231,348 8 3,208,708
9 Prepaid expenses and deferred charges .......... 1,637,029 9 1,035,455
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 48,299,193
b Less: accumulated depreciation ..... 10b 8,143,333 33,996,324 10c 40,155,860
11 Investments—publicly traded securities .......... 7,277,044 11 10,219,227
12 Investments—other securities. See Part IV, line 11 ..... 21,371,643 12 25,961,526
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 4,512,607 15 19,965,899
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 114,404,869 16 128,547,906
Liabilities 17 Accounts payable and accrued expenses ......... 7,943,559 17 6,877,641
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 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties .... 33,891,772 24 29,262,558
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.................... 59,507,088 25 75,900,565
26 Total liabilities. Add lines 17 through 25......... 101,342,419 26 112,040,764
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 9,915,708 27 13,278,569
28 Temporarily restricted net assets ........... 2,130,571 28 1,944,094
29 Permanently restricted net assets ........... 1,016,171 29 1,284,479
Organizations that do not follow SFAS 117 (ASC 958), 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 ........... 13,062,450 33 16,507,142
34 Total liabilities and net assets/fund balances ........ 114,404,869 34 128,547,906
Form 990 (2012)
Form 990 (2012)
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
182,551,130
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
184,558,171
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-2,007,041
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
13,062,450
5
Net unrealized gains (losses) on investments ...............
5
1,413,333
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
-2,539,718
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
6,578,118
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
16,507,142
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
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 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?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
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
Yes
 
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
Yes
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
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
2012
Open to Public
Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the 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
Provide the following information about the supported organization(s).
(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 monetary support
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

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
2012
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

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





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 2
Name of organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

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

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED


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

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 3
Name of organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 4
Name of organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  

Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

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
2012
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, Part V, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

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

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

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

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

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










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2012

Schedule C (Form 990 or 990-EZ) 2012
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 SchCMd Bulletexpenses, and share of excess lobbying expenditures).Click to see attachment
B Check SchCMd Bullet
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) ......   1,437
b Total lobbying expenditures to influence a legislative body (direct lobbying) ....... 2,518 648,738
c Total lobbying expenditures (add lines 1a and 1b) ................... 2,518 650,175
d Other exempt purpose expenditures ........................ 184,555,653 2,932,675,696
e Total exempt purpose expenditures (add lines 1c and 1d) ............... 184,558,171 2,933,325,871
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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) Total
             
2a Lobbying nontaxable amount 1,000,000 1,000,000 1,000,000 1,000,000 4,000,000
             
b Lobbying ceiling amount
(150% of line 2a, column(e))
        6,000,000
             
c Total lobbying expenditures 11,426 1,554 640,652 650,175 1,303,807
             
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       1,437 1,437
Schedule C (Form 990 or 990-EZ) 2012


Schedule C (Form 990 or 990-EZ) 2012
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)
No
Yes
(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? .........................................
 
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
 
c
Media advertisements? ....................................
 
 
 
d
Mailings to members, legislators, or the public? .........................
 
 
 
e
Publications, or published or broadcast statements? .......................
 
 
 
f
Grants to other organizations for lobbying purposes? .......................
 
 
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
 
 
i
Other activities? ..........................
 
 
 
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)? .....
 
 
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? .......
 
 
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
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
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, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Identifier Return Reference Explanation
Schedule C (Form 990 or 990EZ) 2012

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
2012
Open to Public Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, 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 XIII, 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 Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, 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 XIII.
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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 1,017,087 2,036,436 1,717,248 1,700,302 2,108,817
b Contributions ........          
c Net investment earnings, gains, and losses 267,392 5,152 402,937 16,946 -408,515
d Grants or scholarships .....     -29,451    
e Other expenditures for facilities
and programs ........
  -1,024,501 -40,761    
f Administrative expenses ....     -13,537    
g End of year balance ...... 1,284,479 1,017,087 2,036,436 1,717,248 1,700,302
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   1,109,837 1,109,837
b Buildings ................   26,277,198 3,339,962 22,937,236
c Leasehold improvements ............   875,045 98,708 776,337
d Equipment ................   15,295,133 4,645,427 10,649,706
e Other .................   4,741,980 59,236 4,682,744
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 40,155,860
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
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 25,961,526 F
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 25,961,526
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
(1) DUE FROM AFFILIATES 19,318,530
(2) INSURANCE POLICY CASH SURRENDER VALU 522,906
(3) OTHER RECEIVABLES 120,578
(4) SECURITY DEPOSITS 3,015
(5) SUSPENSE 870
(6) BENEFICIAL INTEREST IN PERP TRUST  
(7) DUE FROM SCRANTON COUNSELING CENTER  
(8) DUE FROM CMCHS  
(9) ESTIMATED THIRD PARTY PAYER SETTLEME  
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 19,965,899
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
DUE TO AFFILIATES 39,788,514
ESTIMATED 3RD PARTY PAYER SETTLEMENT 13,388,868
ACCRUED PENSION LIABILITY 11,381,374
MEDICAL LEGAL CLAIMS ALLOWANCE 11,341,809
ADVANCES FROM 3RD PARTIES  
ACCRUED EXPENSES  



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 75,900,565
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 4
Part XI 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 XIII.) ............ 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 XIII.) ........... 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 XII 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 XIII.) ............ 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 XIII.) ............ 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 XIII
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
INTENDED USES FOR ENDOWMENT FUNDS SCHEDULE D, PAGE 2, PART V, LINE 4 COMMUNITY MEDICAL CENTER USES ENDOWMENT FUNDS TO SUPPORT PATIENT CARE AND AWARD SCHOLARSHIPS TO EMPLOYEES.
SUPPLEMENTAL FINANCIAL INFORMATION SCHEDULE D, PAGE 4, PART XIII EFFECTIVE JULY 1, 2007, GEISINGER HEALTH SYSTEM (1) (GHS) ADOPTED FABS INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, AN INTERPRETATION OF FASB NO. 109 ("FIN 48"). FIN 48 CLARIFIES THE ACCOUNTING AND REPORTING FOR INCOME TAXES WHERE THE INTERPRETATION OF THE TAX LAW MAY BE UNCERTAIN. FIN 48 PRESCRIBES A COMPREHENSIVE MOLED FOR THE FINANCIAL STATEMENT RECOGNITION, MANAGEMENT, PRESENTATION AND DISCLOSURE OF INCOME TAX UNCERTAINTIES WITH RESPECT TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN INOCME TAX RETURNS. THE ADOPTION OF FIN 48 HAD NO IMPACT ON UNRESTRICTED NET ASSETS AS OF JUNE 30, 2013 OR ANY PREVIOUS YEAR SINCE ADOPTION. ACCORDINGLY, NO FIN 48 FOOTNOTE DISCLOSURE WAS MADE IN THE JUNE 30, 2013 GHS CONSOLIDATED FINANCIAL STATEMENTS. (1) THROUGHOUT THIS DOCUMENT, THE ACRONYM "GHS" OR THE TERMS "SYSTEM", "GEISINGER", OR "GEISINGER HEALTH SYSTEM" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF THE GEISINGER HEALTH SYSTEM FOUNDATION ("THE FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATE ENTITIES COMPRISING THE SYSTEM.
Schedule D (Form 990) 2012

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) ..
    2,015,856   2,015,856 1.090 %
b Medicaid (from Worksheet 3,
column a) ....
    19,372,201 11,186,095 8,186,106 4.440 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
           
d Total Financial Assistance
and Means-Tested
Government Programs .
    21,388,057 11,186,095 10,201,962 5.530 %
Other Benefits
    141,561   141,561 0.080 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
    2,951,913 1,745,385 1,206,528 0.650 %
g Subsidized health services
(from Worksheet 6) ..
           
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
    61,381   61,381 0.030 %
j Total. Other Benefits ..     3,154,855 1,745,385 1,409,470 0.760 %
k Total. Add lines 7d and 7j .     24,542,912 12,931,480 11,611,432 6.290 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
10,724,163
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
49,648,711
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
59,802,915
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-10,154,204
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, and primary website address
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 COMMUNITY MEDICAL CENTER
DBA GEISINGER-COMMUNITY MEDICAL CTR
1822 MULBERRY STREET
SCRANTON,PA18510
X X         X      
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
COMMUNITY MEDICAL CENTER
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A) 1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 11
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7 Yes  
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.0%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 380.0%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 17   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
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Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
8 Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
Identifier ReturnReference Explanation
RELATED ORGANIZATION INFORMATION PART I LINE 6A A SUMMARY OF THE COMMUNITY BENEFIT PROVIDED BY GEISINGERCOMMUNITY MEDICAL CENTER GCMC AND ITS RELATED CHARITABLE ORGANIZATIONS IS AVAILABLE AT GEISINGERORG AND MADE AVAILABLE TO THE PUBLIC UPON REQUEST GO TO WWWGEISINGERORGABOUTMISSIONHTML AND CLICK ON 2013 ANNUAL REPORT
COSTING METHODOLOGY EXPLANATION PART I LINE 7 A COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE COSTS REPORTED ON LINE 7 AND ADDRESSED PATIENT SEGMENTS BY PAYER EG MEDICARE MEDICAID COMMERCIAL PAYORS SELFPAY ETC
BAD DEBT EXPENSE EXPLANATION PART III LINE 4 PART III SECTION A LINE 2 AND LINE 4 GCMC IS A MEMBER OF A GROUP WITH CONSOLIDATED FINANCIAL STATEMENTS PER THE FOOTNOTE RELATED TO ACCOUNTS RECEIVABLE THE ORGANIZATIONS WRITE OFF ALL ACCOUNTS THAT HAVE BEEN IDENTIFIED AS UNCOLLECTABLE AN ALLOWANCE FOR UNCOLLECTABLES IS RECORDED FOR ACCOUNTS NOT YET WRITTEN OFF THAT ARE ANTICIPATED TO BECOME COLLECTABLE IN FUTURE PERIODSSEE PAGE 13 OF THE ATTACHED GEISINGER HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTS JUNE 30 2013 AND JUNE 30 2012 PATIENTS ACCOUNTS ARE MONITORED THROUGHOUT THE BILLING PROCESS AND RECLASSIFIED TO FREE OR DISCOUNTED CARE WHENEVER THE PATIENT BECOMES ELIGIBLE UNDER GCMCS UNCOMPENSATED CARE POLICIES ACCORDINGLY THE BAD DEBT ACCOUNTS SHOULD NOT INCLUDE AMOUNTS THAT MAY BE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FREE OR DISCOUNTED CARE UNDER GCMCS UNCOMPENSATED CARE POLICIES
MEDICARE EXPLANATION PART III LINE 8 PART III LINE 6 LINE 7 MEDICARE SHORTFALL LINE 6 ONLY INCLUDES THOSE COSTS THAT ARE ALLOWED TO BE REPORTED ON GCMCS MEDICARE COST REPORT THAT IS REQUIRED TO BE FILED WITH THE FEDERAL GOVERNMENT PART III SECTION B LINE 8 MEDICARE SHORTFALL IS COMMUNITY BENEFIT GCMC CONSIDERS THAT THE TOTAL MEDICARE SHORTFALL OF 15719934 IS REPORTED AS COMMUNITY BENEFIT ALONG WITH PROVIDING CARE TO MEDICAID PATIENTS AND PROVIDING FREE OR DISCOUNTED CARE TO OTHER LOW INCOME PATIENTS THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS FOR MANY OF THE MEDICAL SERVICES PROVIDED BY THE HOSPITAL MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE TO THESE PATIENTS FORCING GCMC TO USE OTHER FUNDS TO COVER THE SHORTFALL MEDICARE SHORTFALLS MUST BE ABSORBED BY GCMC IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY GCMC PROVIDES CARE REGARDLESS OF THE MEDICARE SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR PROVIDING CARE TO MEDICARE PATIENTS ABSENT THE MEDICARE PROGRAM IT IS LIKELY THAT MEDICARE PATIENTS WOULD BE ELIGIBLE FOR CHARITY CARE OR OTHER NEEDS BASED GOVERNMENT PROGRAMS THE AMOUNT EXPENDED TO COVER THE SHORTFALL IS MONEY NOT AVAILABLE FOR FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS PENNSYLVANIA REQUIRES NONPROFIT HOSPITALS LIKE GCMC TO PROVIDE A MINIMUM LEVEL OF COMMUNITY BENEFIT TO RETAIN EXEMPTION FROM STATE AND LOCAL TAXES ACCORDING TO STATE GUIDANCE AND CASE LAW THE UNREIMBURSED COST OF MEDICARE IS CONSIDERED TO BE COMMUNITY BENEFIT FOR STATE TAX EXEMPTION PURPOSES
COLLECTION PRACTICES EXPLANATION PART III LINE 9B GCMC IS COMMITTED TO PROVIDING MEDICAL NECESSARY SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND GCMCS COLLECTION ACTIONS ARE CONSISTENTLY APPLIED TO ALL PATIENTS IT IS GCMC POLICY TO PROVIDE FINANCIAL ASSISTANCE AND COUNSELING TO PATIENTS WITH LIMITED FINANCIAL MEANS A PATIENT MAY BECOME ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING TREATMENT OR DURING THE CONTINUUM OF THE FINANCIALBILLING AND COLLECTION PROCESS IN ANY STAGE OF THE BILLING PROCESS COLLECTION ACTIONS ARE NOT PURSUED WHENEVER A PATIENT APPLIES AND IS BEING EVALUATED FOR FINANCIAL ASSISTANCE UNDER NO CIRCUMSTANCE WILL GCMC FREEZE OR ATTACH BANK ACCOUNTS OF A PATIENT ENFORCE LIENS ACTIVELY PURSUE ASSETS FROM A PRIOR JUDGMENT OR GARNISH THE WAGES OF A PATIENT ANDOR FAMILY MEMBER BEFORE DETERMINING IF THE PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER GCMCS FINANCIAL ASSISTANCE PROGRAM
NEEDS ASSESSMENT PART VI GEISINGERCOMMUNITY MEDICAL CENTER REGULARLY PARTICIPATES IN COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENTS TO IDENTIFY FARREACHING HEALTH NEEDS FACED BY THE POPULATION SERVED BY THE HOSPITAL FOR COMMUNITY BENEFIT PURPOSES FOR FISCAL YEAR ENDED JUNE 30 2013 AS A MEMBER OF THE HEALTHY NORTHEAST PENNSYLVANIA INITIATIVE THE INITIATIVE GCMC PARTICIPATED IN A COMMUNITY HEALTH NEEDS ASSESSMENT CHNA CONDUCTED BY THE INSTITUTE FOR PUBLIC POLICY AND ECONOMIC DEVELOPMENT THE INSTITUTE ASSESSMENT RESULTS ARE EVALUATED OVER TIME AND SERVE AS THE BASIS TO DEVELOP NEW OR EXPANDED PLANS TO ADDRESS SERVICES IN RESPONSE TO NEED ADDITIONALLY GCMC DEVELOPS PROGRAMS AND SERVICES TO ADDRESS COMMUNITY HEALTH NEEDS AND MAKES INVESTMENTS IN INITIATIVES THAT ALIGN WITH THE HOSPITALS CORE MISSION BEYOND THAT FOCUS ARE PROGRAMS AND SERVICES THAT BENEFIT EVERY RESIDENT AND SUPPORT THE FAR REACHING GOAL OF A HEALTHIER COMMUNITY THOSE HEALTHY COMMUNITY GOALS HAVE SERVED AS A CATALYST FOR A COLLABORATIVE COMMUNITY APPROACH GCMC HAS BEEN INSTRUMENTAL IN ESTABLISHING IN ORDER TO ACCESS THE HEALTHCARE NEEDS HEALTH STATUS AND QUALITY OF LIFE INDICATORS OF RESIDENTS LIVING IN THE LACKAWANNA COUNTY AND LUZERNE COUNTY COMMUNITIES THE HOSPITAL IS A CHARTER MEMBER OF HEALTHY NORTHEAST PENNSYLVANIA INITIATIVE HNPI AN ALLIANCE AMONG MEMBER REGIONAL HEALTHCARE ORGANIZATIONS AND THE PENNSYLVANIA DEPARTMENT OF HEALTH THE GOAL OF THE ORGANIZATION IS TO ASSESS AND ADDRESS THE COMMUNITY HEALTH NEEDS INCREASE REGIONAL HEALTHCARE PROGRAMS AND SERVICES AND FACILITATE AWARENESS EDUCATION AND WELLNESS FOR RESIDENTS OF NORTHEAST PENNSYLVANIA IN ADDITION TO GCMC OTHER REGIONAL HEALTHCARE PROVIDERS PARTICIPATING IN THE HNPI COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDED AMONG OTHERS PENNSYLVANIA DEPARTMENT OF HEALTH WILKESBARRE HEALTH DEPARTMENT OF HEALTH WYOMING VALLEY UNITED WAY MIGRANT WORKERS PROGRAM IN HAZLETON MATERNAL AND FAMILY HEALTH LUZERNE COUNTY TASK FORCE ON DRUG AND ALCOHOL ALLIED SERVICES BLUE CROSS OF NEPA COMMUNITY MEDICAL CENTER MERCY HEALTH PARTNERS MOSES TAYLOR HOSPITALFOUNDATION THE COMMONWEALTH MEDICAL COLLEGE WYOMING VALLEY HEALTHCARE SYSTEM ASSESSMENT SURVEYS WERE DONE IN 1997 2003 AND 2009 WITH THE MOST RECENT SURVEY COMPLETED IN 2012 THE STUDYS MAIN OBJECTIVE WAS TO COMPLETE A COMPREHENSIVE ASSESSMENT OF THE HEALTHCARE ACCESS NEEDS HEALTH STATUS AND QUALITY OF LIFE INDICATORS OF RESIDENTS LIVING IN THE LACKAWANNA COUNTY AND LUZERNE COUNTY COMMUNITIES MORE SPECIFICALLY THE PROJECT GOALS WERE TO OBTAIN STATISTICALLY VALID INFORMATION ON THE HEALTH STATUS AND SOCIOECONOMICENVIRONMENTAL FACTORS RELATED TO HEALTH OF RESIDENTS OF THE COUNTIES HEALTHY NORTHEAST PENNSYLVANIA INITIATIVE HNPI SERVES TO SUPPLEMENT THE GENERAL POPULATION SURVEY DATA THAT IS CURRENTLY AVAILABLE TO HNPI AS AN ORGANIZATION TO ASSURE THAT COMMUNITY MEMBERS INCLUDING THOSE OF BROAD RACIAL ETHNIC CULTURAL AND LINGUISTIC MINORITY GROUPS ARE THE PRIMARY PARTICIPANTS IN THE NEEDS ASSESSMENT SURVEY PROCESS IN ADDITION EDUCATORS HEALTHRELATED PROFESSIONALS MEDIA REPRESENTATIVES LOCAL GOVERNMENT HUMAN SERVICE ORGANIZATIONS INSTITUTES OF HIGHER LEARNING RELIGIOUS INSTITUTIONS AND THE PRIVATE SECTOR ARE ALL ENGAGED AT SOME LEVEL OF THE SURVEY PROCESS TO DEVELOP ACCURATE COMPARISONS TO THE STATE AND NATIONAL BASELINES OF HEALTH MEASURES UTILIZING THE MOST CURRENT VALIDATED DATA AVAILABLE TO UTILIZE DATA OBTAINED FROM THE ASSESSMENT TO ADDRESS THE IDENTIFIED HEALTH NEEDS OF THE HNPI SERVICE AREA TO PROVIDE HNPI WITH APPROPRIATE DATA COMPARISONS ON LIKE SURVEY QUESTIONS TO THE 199798 200304 AND 20082009 COMMUNITY HEALTH NEEDS ASSESSMENTS HOUSEHOLD SURVEY DATA THESE DATA COMPARISONS WILL ALLOW HNPI TO DISCOVER BOTH POSITIVE AND NEGATIVE COMMUNITY HEALTH TRENDS TO COMPLETE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH NOT ONLY REACHES MINORITYUNDERSERVED POPULATIONS BUT ALSO ADDRESSES A WIDE VARIETY OF COMMUNITY HEALTH TOPICS INCLUDING BUT NOT LIMITED TO ACCESS TO CARE CHRONIC DISEASE PREVALENCE PREVENTIVE HEALTH HEALTH STATUS ACCESS TO COMMUNITY PROGRAMS AND SERVICES QUALITY OF LIFE INDICATORS AND HEALTHY LIFESTYLE BEHAVIORS THE MAJOR HEALTH NEED THEMES WHICH CONSISTENTLY SURFACED IN THE VARIOUS COMMUNITY HEALTH NEEDS ASSESSMENTS INCLUDED IMPROVING THE ACCESS TO HEALTHCARE FOR UNDER AND UNINSURED IMPROVING HEALTHY BEHAVIORS IE OBESITY AND BROADLY THE RELATED DISEASE BURDENPREVENTION AND EXPANDING TREATMENT AND EDUCATION ON DRUG AND ALCOHOL ABUSE
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI FOR URGENT AND EMERGENT SERVICES PATIENTS ARE PROVIDED CARE REGARDLESS OF THEIR ABILITY TO PAY IN THE EVENT A PATIENT HAS AN EMERGENCY MEDICAL CONDITION TREATMENT IS NOT DELAYED TO PERMIT AN INQUIRY REGARDING A PATIENTS METHOD OF PAYMENT OR INSURANCE STATUS FOR OTHER THAN URGENT AND EMERGENT SERVICES THE HOSPITAL PROVIDES UNCOMPENSATED CARE FREE OF CHARGE OR ON A DISCOUNTED BASIS TO THOSE PATIENTS WHO DEMONSTRATE AN INABILITY TO PAY DEPENDING UPON FAMILY SIZE AND INCOME FREE OR DISCOUNTED SERVICES ARE AVAILABLE TO A PATIENT WITH FAMILY INCOME RANGING FROM 200 UP TO 380 OF THE FEDERAL POVERTY GUIDELINES IT IS GCMC POLICY TO PROVIDE FINANCIAL ASSISTANCE AND FINANCIAL COUNSELING TO PATIENTS OF LIMITED MEANS A PATIENT MAY BECOME ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE AT ANY TIME DURING TREATMENT OR DURING THE CONTINUUM OF THE FINANCIALBILLING PROCESS INFORMATION SIGNS BROCHURES ETC REGARDING GCMCS CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES ARE PROVIDED AT THE EMERGENCY ROOM REGISTRATION AND VARIOUS ACCESS POINTS THROUGHOUT THE HOSPITAL REGISTRATION PERSONNEL ALSO REFER UNINSURED ANDOR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY NOTICE OF GCMCS CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES CAN ALSO BE FOUND ON THE GEISINGER WEB SITE AT WWWGEISINGERORG PATIENTS ARE ALSO PROVIDED INFORMATION ON GCMCS CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES WITH EACH PATIENT BILL
COMMUNITY INFORMATION PART VI GEISINGERCCOMMUNITY MEDICAL CENTERS SERVICE AREA INCLUDES 9 COUNTIES IN NORTHEASTERN PENNSYLVANIA BRADFORD CARBON LACKAWANNA LUZERNE MONROE PIKE SUSQUEHANNA WAYNE AND WYOMING THE APPROXIMATE 2013 TOTAL POPULATION WITHIN THIS SERVICE AREA WAS 1009439 THIS POPULATION IS EXPECTED TO DECLINE2 BY 2018 WHILE AN INCREASE IN THE RATE OF GROWTH IS EXPECTED FOR THE STATE AND NATION 10 AND 33 RESPECTIVELTY IN 2013 THE 65 AND OVER AGE GROUP IS 181 OF THE TOTAL POPULATION WHICH WAS GREATER THAN THE STATE 1643 AND NATIONAL 139 PROPORTIONS ADDITIONALLY THE 65 AND OVER AGE GROUP IS THE AGE SEGMENT PROJECTED TO EXPERIENCE THE LARGEST FIVEYEAR POPULATION GROWTH OF 125 THE REGION IS PRIMARILY RURAL WITH SMALL SUBURBAN AND URBAN POCKETS AVERAGE HOUSEHOLD INCOME IN 2013 WAS 60143 WITH APPROXIMATELY 144 OF THE POPULATION FALLING BELOW FEDERAL POVERTY GUIDELINES IN 2012 WHICH IS GREATER THAN THE STATE PROPORTION OF 137 THE 2012 AVERAGE UNEMPLOYMENT RATE THE MOST CURRENT FULL YEAR OF COUNTY LEVEL DATA AVAILABLE FROM THE BUREAU OF LABOR STATISITICS WAS 92 WHICH IS HIGHER THAN BOTH THE COMMONWEALTH RATE OF 79 AND THE NATIONAL RATE OF 81 WITHIN THE 9 COUNTY SERVICE AREA 145 OF GCMCS INPATIENT DISCHARGES DURING FISCAL YEAR 2013 WERE SELFPAY OR CHARITY CARE OR WERE MEDICAID RECIPIENTS THE REGION INCLUDES MULTIPLE MEDICALLY UNDERSERVED AREAS AND POPULATIONS THE US DEPARTMENT OF HEALTH AND HUMAN RESOURCES HAS DESIGNATED LACKAWANNA COUNTY AS A MEDICALLY UNDERSERVED AREAPOPULATION DUE TO TOO FEW PRIMARY CARE PROVIDERS HIGH INFANT MORTALITY HIGH POVERTY ANDOR HIGH ELDERLY POPULATION THERE ARE 2 GEISINGER GENERAL MEDICALSURGICAL HOSPITALS GWV AND GCMC AND 15 GENERAL MEDICALSURGICAL NONGEISINGER HOSPITALS IN THIS MARKET
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI SEE THE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTSCOMMUNITY BENEFIT REPORTED IN SCHEDULE O
AFFILIATED HEALTH CARE INFORMATION PART VI GCMC IS AN AFFILIATE WITHIN THE GEISINGER HEALTH SYSTEM WHICH IS ONE OF THE LARGEST RURAL HEALTH CARE SYSTEMS IN THE NATION AND COVERS A 20000 SQUARE MILE AREA IN NORTHERN AND CENTRAL PENNSYLVANIA AS AN INTEGRATED HEALTH CARE SYSTEM IT SERVES MORE THAN TWO MILLION PEOPLE IN 41 OF PENNSYLVANIAS 67 COUNTIES WITH A VARIETY OF CHARITABLE HEALTH CARE PROVIDERS AND A NONPROFIT HMO THE GHS MISSION IS TO ENHANCE THE QUALITY OF LIFE THROUGH AN INTEGRATED HEALTH SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE EDUCATION RESEARCH AND COMMUNITY SERVICE GMC A 404 BED TERTIARY AND QUATERNARY MEDICAL CENTER IS LOCATED IN DANVILLE PENNSYLVANIA A SMALL COMMUNITY OF 6000 PEOPLE SINCE ITS BEGINNING IN 1915 GHS HAS EMPHASIZED MULTISPECIALTY CARE AND HAS MORE THAN 80 MEDICAL SPECIALTIES AND SUBSPECIALTIES GMC IS A LEVEL 1 REGIONAL RESOURCE TRAUMA CENTER AND HAS RECENTLY BEEN NAMED TO THE TOP 100 HOSPITALS IN THE COUNTRY THE MEDICAL CENTER HAS ALSO BEEN DESIGNATED AS A MAGNET HOSPITAL BY THE AMERICAN NURSES CREDENTIALING CENTER ANCC GHS PHYSICIANS WERE LISTED IN THE BEST DOCTORS IN AMERICA AND THE GHS INTEGRATED COST EFFECTIVE DELIVERY OF MANAGED CARE WAS FEATURED IN A FRONTPAGE NEW YORK TIMES ARTICLE MEDICAL EDUCATION HAS PLAYED A PROMINENT ROLE AT THE GMC WITH MORE THAN 200 RESIDENTS AND FELLOWS RECEIVING POSTDOCTORAL TRAINING AND RESEARCH EXPOSURE GMC IS ALSO HOME TO THE JANET WEIS WOMENS AND CHILDRENS HOSPITAL THE FIRST RURAL ACUTECARE CHILDRENS HOSPITAL IN THE NATION THE 85 BED CHILDRENS HOSPITAL WAS CONSTRUCTED IN 1995 ENTIRELY FROM DONATIONS AND BOASTS A NEONATAL INTENSIVE CARE UNIT A PEDIATRIC INTENSIVE CARE UNIT AND TWO FLOORS OF MEDICALSURGICAL INPATIENT ROOMS IN JANUARY OF 2000 THE TWOSTORY WOMENS PAVILION OPENED AND STRATEGICALLY ADJOINS THE CHILDRENS HOSPITAL FOSTERING FAMILYCENTERED CARE FOR ALL OBSTETRICAL AND NEWBORN SERVICES THE PAVILION FEATURES 19 LABOR DELIVERY RECOVERY POSTPARTUM ROOMS AND HAS THE STATES FIRST PASSTHROUGH WINDOWS FROM TWO HIGHRISK AND CSECTION DELIVERY ROOMS DIRECTLY INTO THE ADJOINING NEONATAL INTENSIVE CARE UNIT GEISINGER WYOMING VALLEY MEDICAL CENTER GWV SERVES PATIENTS IN THE GREATER WYOMING VALLEY AND WESTERN POCONO REGION OF THE STATE WITH A COMPREHENSIVE MATERNITY PROGRAM PEDIATRIC SERVICES MEDICAL AND SURGICAL UNITS THE FRANK M AND DOROTHEA HENRY CANCER CENTER A COMPLETE EMERGENCY DEPARTMENT AS WELL AS OFFERING AN EXTENSIVE COMMUNITYHEALTH EDUCATION PROGRAM OPENING IN THE FALL OF 2001 AND CONNECTED DIRECTLY TO GWV WAS THE REGIONS FIRST AND ONLY HEART HOSPITAL THE THREESTORY STRUCTURE OFFERED LIFESAVING HEART PROCEDURES THAT WERE NOT CURRENTLY AVAILABLE IN THE REGION AS WELL AS A RESEARCH PROGRAM NEW THERAPIES AND SPECIAL HEART SERVICES THE ENTIRE HEALTH SYSTEM IS SERVED BY LIFE FLIGHT THE 20 PLUSYEAR OLD AIRMEDICAL TRANSPORT PROGRAM ONE HELICOPTER IS HOUSED ON THE CAMPUS OF GEISINGER MEDICAL CENTER AND ANOTHER IS STATIONED AT THE UNIVERSITY PARK AIRPORT IN STATE COLLEGE GHS PROVIDED THE FIRST FULLSERVICE FULLTIME MEDICAL HELICOPTER STATIONED IN THE WILKESBARRESCRANTON AREA BY ADDING A THIRD HELICOPTER IN THE FLEET IN JULY 2001 A FOURTH HELICOPTER WAS ADDED IN WILLIAMSPORT IN 2005 WITH A FIFTH GOING ONLINE IN POTTSVILLE IN 2006 GEISINGER CLINIC IS A 501C3 NOTFORPROFIT CORPORATION OPERATING A MULTISPECIALTY GROUP PRACTICE GEISINGER CLINIC PROVIDES PATIENT STAFF FOR PATIENT CARE EDUCATION AND RESEARCH THERE ARE MORE THAN 750 EMPLOYED PHYSICIANS PRACTICING AT AN ARRAY OF HEALTH CARE DELIVERY PROVIDER FACILITIES AT 61 MEDICAL GROUPS SERVING 31 COUNTIES OPERATED WITHIN THE GEISINGER CLINIC ORGANIZATION THE WEIS CENTER FOR RESEARCH LOCATED ON THE CAMPUS OF GEISINGER MEDICAL CENTER IS HOME TO THE HENRY HOOD RESEARCH PROGRAM THE PREEMINENT FUNCTION OF THE HOOD RESEARCH PROGRAM IS TO CONDUCT ORIGINAL AND INNOVATIVE RESEARCH OF WORLD CLASS QUALITY OUR SCIENTISTS APPLY MODERN MOLECULAR AND CELLULAR APPROACHES TO DIVERSE RESEARCH PROBLEMS IN THE AREAS OF CARDIOVASCULAR FUNCTION CANCER AND DEVELOPMENTAL BIOLOGY BEGUN IN 1972 THE GEISINGER HEALTH PLAN IS A 501C4 NOTFORPROFIT ORGANIZATION THAT HAS GROWN TO BE ONE OF THE LARGEST RURAL HMOS IN THE COUNTRY IT CURRENTLY SERVES APPROXIMATELY 200000 MEMBERS IN A 42COUNTY SERVICE AREA MARWORTH IS A 501C 3 NOTFORPROFIT ORGANIZATION AND OPERATES A 77 BED CENTER THAT ALSO OFFERS A BROADBASED OUTPATIENT PROGRAM FOR THE TREATMENT OF ALCOHOL AND CHEMICAL DEPENDENCY MARWORTH IS LOCATED IN WAVERLY PENNSYLVANIA AND IS ANNUALLY RANKED AMONG THE TOP 20 TREATMENT CENTERS IN THE UNITED STATES GEISINGER COMMUNITY HEALTH SERVICES IS A 501C3 NOTFORPROFIT ORGANIZATION DESIGNED TO CONDUCT CHARITABLE SCIENTIFIC AND EDUCATIONAL ACTIVITIES FOR THE CITIZENS OF THE COMMUNITIES SERVED BY GHS MOUNTAIN VIEW CARE CENTER IS A MODERN 180BED HOMELIKE CENTER PROVIDING SHORT TERM REHABILITATION SKILLED NURSING AND LONG TERM CARE THE FACILITY FEATURES A SPECIALIZED 24BED UNIT DEDICATED TO THE SPECIAL NEEDS AND CARE OF PEOPLE WITH ALZHEIMERS OR MEMORYRELATED ILLNESSES THESE PATIENTS NEED A SAFE AND SECURE PLACE TO LIVE MOUNTAIN VIEW HAS DEVELOPED A SEPARATE UNIT DEDICATED TO THE SPECIAL NEEDS OF PEOPLE WITH ALZHEIMERS MOUNTAIN VIEW ALSO PROVIDES HOSPICE CARE SPECIFICALLY DEVOTED TO THE SPECIAL NEEDS OF SERIOUSLY ILL RESIDENTS THE HOSPICE TEAM PROVIDES COMPASSIONATE CARE WITH DIGNITY FOR FISCAL YEAR 2011 MOUNTAIN VIEW CARE CENTER REALIZED 27 MILLION IN UNREIMBURSED COSTS RELATED TO 39695 MEDICAL ASSISTANCE MEDICAID OR MEDICARE PATIENT CARE DAYS
ADDITIONAL INFORMATION PART VI FORM 990 SCHEDULE H PART V LINE 21 DID THE HOSPITAL FACILITY CHARGE ANY OF ITS PATIENTS WHO WERE ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL FACILITYS FINANCIAL ASSISTANCE POLICY AND TO WHOM THE HOSPITAL FACILITY PROVIDED EMERGENCY OR OTHER MEDICALLY NECESSARY SERVICES MORE THAN THE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAD INSURANCE COVERING SUCH CARE GCMC POLICY ALLOWS FOR A MINIMUM DISCOUNT OF 65 TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WITH INCOME AT 260 TO 380 OF THE FEDERAL POVERTY GUIDELINES WHICH RESULTS IN AMOUNTS LESS THAN THE AVERAGE OF THREE BEST NEGOTIATED COMMERCIAL RATES PATIENTS WHO ARE AT LESS THAN 260 OF THE FEDERAL POVERTY GUIDELINES ARE ELIGIBLE TO RECEIVE UP TO A 100 DISCOUNT FORM 990 SCHEDULE H PART VI LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT AT THIS TIME GCMC AND ITS AFFILIATES ARE NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE
COMMUNITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 3 PART V LINE 3 THE COMMUNITY HEALTH NEEDS ASSESSMENT CHNA WAS CONDUCTED BY THE INSTITUTE FOR PUBLIC POLICY AND ECONOMIC DEVELOPMENT THE INSTITUTE THROUGH THE HEALTHY NORTHEAST PENNSYLVANIA INITIATIVE HNPI A REGIONAL MEMBERSHIP BASED ORGANIZATION WITH EXPERTISE IN COMMUNITY HEALTH AND COMMUNITY EDUCATION PROGRAMS SURVEYS THE INSTITUTE CONDUCTED IN DEPTH PRIMARY RESEARCH BY DEPLOYING OVER 12000 SURVEYS IN GCMCS PRIMARY AND SECONDARY SERVICE AREAS AND CONDUCTING SEVERAL INTERVIEWS AND FOCUS GROUPS A HOUSEHOLD SURVEY OF OVER 5 OF THE RESIDENTS WITHIN THE COMMUNITY WAS CONDUCTED TO DETERMINE COMMUNITY NEED ADDITIONALLY 200 SPANISH LANGUAGE SURVEYS WERE PREPARED AND DISTRIBUTED TO LOCAL HISPANIC CHURCHES AND FREE MEDICAL CLINICS WITHIN THE COMMUNITY A LOCAL HOUSING AGENCY ALSO HELPED DISTRIBUTE SPANISH LANGUAGE SURVEYS OVERALL 4 OF THE HISPANIC POPULATION RESPONDED ANOTHER 200 SURVEYS WERE DISTRIBUTED TO AFRICAN AMERICAN AND OTHER MINORITY AND IMMIGRANT POPULATIONS THESE SURVEYS WERE DISTRIBUTED THROUGH LOCAL YOUTH ORGANIZATIONS AND FREE MEDICAL CLINICS OVERALL 3 OF THE AFRICAN AMERICAN POPULATION RESPONDED THE SURVEYS MET ALL FEDERAL STANDARDS ESTABLISHED FOR THE PROTECTION OF HUMAN SUBJECTS RIGHTS IN RESEARCH THE WILKES UNIVERSITY INSTITUTIONAL REVIEW BOARD REVIEWED AND APPROVED ALL OF THE PRIMARY RESEARCH INSTRUMENTS AND CONSENTS THE SURVEY RESPONSES WERE UPLOADED INTO THE STATISTICAL PACKAGES FOR THE SOCIAL SCIENCES WHICH IS AN INTEGRATED SOFTWARE PROGRAM USED FOR ANALYTICAL DATA ANALYSIS INTERVIEWS CARE WAS TAKEN TO INTERVIEW STAKEHOLDERS THAT REPRESENTED THE ENTIRE STUDY REGION INTERVIEWS RANGED FROM 45 MINUTES TO 3 HOURS IN DURATION EACH INTERVIEWEE HAD THE OPPORTUNITY TO ADD OPEN COMMENTS AT THE SURVEYS END SIXTEEN INTERVIEWS WERE CONDUCTED WITH 26 STAKEHOLDERS INCLUDING THE FOLLOWING MAJOR EMPLOYERS FEDERALLY QUALIFIED HEALTH CENTER A FREE MEDICAL CLINIC PENNSYLVANIA DEPARTMENT OF HEALTH SOCIAL SCIENTISTS AND RESEARCHERS PHILANTHROPIST AND HEALTH POLICY ADVISOR DISEASEBASED ORGANIZATION SOCIAL SERVICE ORGANIZATION MENTAL AND BEHAVIORAL HEALTH ORGANIZATION EPIDEMIOLOGYENVIRONMENTAL SPECIALISTS PRIMARY CARE PHYSICIANS SURGEONS MEDICAL TECHNOLOGISTCLINICAL LABORATORY HEALTH INSURERS FOCUS GROUPS VARIOUS SEGMENTS OF THE COMMUNITY WERE CONSULTED IN ORDER TO DETERMINE THE UNIQUE HEALTH CARE NEEDS OF SPECIFIC GROUPS INCLUDING HISPANICLATINO COMMUNITY AFRICAN AMERICAN COMMUNITY 2 SEPARATE GROUPS IMPOVERISHED AGING PHYSICALLY AND MENTALLY CHALLENGED YOUR CHRONIC DISEASEPUBLIC HEALTH ORGANIZATIONS MAJOR EMPLOYERS BEHAVIORAL BASED SUBSTANCE ABUSE ORGANIZATIONS ADDITIONAL DATA UTILIZED WAS FROM THE PENNSYLVANIA DEPARTMENT OF HEALTH THE US CENSUS BUREAU THE CENTER FOR RURAL PENNSYLVANIA THE BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM COUNTY HEALTH RANKING PREPARED BY THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE AND THE ROBERT WOOD JOHNSON FOUNDATION THE DATA INCLUDED DEMOGRAPHIC AND ECONOMIC INDICATORS HEALTH STATUS INCIDENCE OF DISEASE AND INSURANCE STATUS INFORMATION REGARDING THE HEALTH CARE DELIVERY SYSTEM UTILIZED WAS FROM THE PENNSYLVANIA DEPARTMENT OF HEALTH PENNSYLVANIA COST CONTAINMENT COUNCIL PENNSYLVANIA HEALTH CARE ASSOCIATION THE US DEPARTMENT OF HEALTH AND THE LOCAL PARTICIPATING HOSPITALS
COMMUNITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 4 PART V LINE 4 GEISINGERCOMMUNITY MEDICAL CENTER AND GEISINGER WYOMING VALLEY MEDICAL CENTER PARTICIPATED IN THE CHNA
COMMUNITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 5C PART V LINE 5C THE COMMUNITY HEALTH NEEDS ASSESSMENT AND RELATED IMPLEMENTATION STRATEGIES ARE LOCATED AT WWWGEISINGERORGCHNA
COMMUNITY MEDICAL CENTER LINE NUMBER 1 PART V LINE 14G PART V LINE 14G REGISTRATION PERSONNEL ALSO REFER UNINSURED ANDOR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY
Schedule H (Form 990) 2012
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
2012
Open to Public
Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number
24-0862246
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC Code section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) THE COMMONWEALTH MEDICAL COLLEGE
525 PINE STREET
SCRANTON,PA185093240
26-0612968 501C3 27,200   CASH   UNRESTRICTED CONTRIB
(2) HEALTHY NEPA INITIATIVE
100 ABINGTON EXECUTIVE PARK
CLARKS SUMMIT,PA18411
33-1030272 501C3 10,000   CASH   UNRESTRICTED CONTRIB
(3) ALL OTHER ASSISTANCE COMBINED
EACH INDIVIDUALLY 5000 OR LESS
DANVILLE,PA178229800
  19,181   CASH   UNRESTRICTED CONTRIB


















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
2
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2012

Schedule I (Form 990) 2012
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.
Part III can be duplicated 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, Part III, column (b), and any other additional information.
Identifier Return Reference Explanation
ADDITIONAL INFORMATION SCHEDULE I, PAGE 4, PART IV COMMUNITY MEDICAL CENTER (CMC) DOES NOT AWARD GRANTS; CMC PROVIDES ASSISTANCE IN THE FORM OF CHARITABLE CONTRIBUTIONS TO TAX-EXEMPT ORGANIZATIONS THAT QUALIFY FOR 501(C)(3) STATUS UNDER THE INTERNAL REVENUE CODE, LIMITED 501(C)(4) ORGANIZATIONS BASED ON EXPLICIT CRITERIA, PUBLIC BENEFIT OR NON-EXEMPT ORGANIZATIONS WHOSE ACTIVITIES FURTHER THE EXEMPT PURPOSE OF CMC. CMC NOTIFIES THE PUBLIC BENEFIT OR NON-EXEMPT ORGANIZATIONS OF THE INTENT AND PURPOSE OF THE CHARITABLE CONTRIBUTION. ORGANIZATIONS SEEKING SUPPORT MUST DEMONSTRATE THAT THEY EFFECTIVELY MEET AN IMPORTANT COMMUNITY HEALTH NEED.
Schedule I (Form 990) 2012


Additional Data


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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
2012
Open to Public Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all officers,
directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? .......
2
Yes
 
3
Indicate which, if any, of the following the filing organization used 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
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
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 (E) amounts for that individual.
(A) Name and Title (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 PHDPRESCHAIR DIRECTOR (i)
(ii)
 
1,021,563
 
920,000
 
120,993
 
388,588
 
29,866
 
2,481,010
 
 
(2)ANTHONY D AQUILINA DOCMO (i)
(ii)
 
312,160
 
129,532
 
14,048
 
59,439
 
17,334
 
532,513
 
 
(3)DAVID J FELICIO ESQUIRECLO SECRETARY (i)
(ii)
 
313,540
 
152,506
 
46,635
 
120,520
 
20,139
 
653,340
 
 
(4)EDWARD J ZYCH ESQUIREACLO ASST SECRETARY (i)
(ii)
 
250,888
 
74,435
 
19,252
 
43,763
 
22,035
 
410,373
 
 
(5)KEVIN F BRENNAN CPA FHFMAEVP FINANCE CFO (i)
(ii)
 
501,671
 
290,967
 
286,688
 
181,114
 
21,073
 
1,281,513
 
247,768
(6)ROBERT P STEIGMEYERCAO (i)
(ii)
446,114
 
455,881
 
10,653
 
11,250
 
17,839
 
941,737
 
 
 
(7)FRANK J TREMBULAKSR VP TREASURER (i)
(ii)
 
592,806
 
305,296
 
347,250
 
203,077
 
13,790
 
1,462,219
 
274,280
(8)BARBARA BOSSIASSOCIATE CAO (i)
(ii)
215,818
 
73,790
 
19,625
 
11,537
 
12,531
 
333,301
 
 
 
(9)JOHN DITCHKUS CRNACRNA (i)
(ii)
247,907
 
 
 
541
 
13,197
 
13,001
 
274,646
 
 
 
(10)MARK R TRENTLY CRNACRNA (i)
(ii)
237,974
 
 
 
2,004
 
12,605
 
12,995
 
265,578
 
 
 
(11)ROSE A SADOWSKI CRNACRNA (i)
(ii)
257,216
 
 
 
847
 
13,216
 
6,344
 
277,623
 
 
 
(12)MICHELLE T BOYLE MSN CRNA CRNPCRNA (i)
(ii)
292,037
 
 
 
197
 
11,893
 
15,741
 
319,868
 
 
 
(13)GARY SEBASTIANELLILEAD CRNA (i)
(ii)
226,962
 
 
 
1,023
 
12,760
 
14,769
 
255,514
 
 
 
(14)ALBERT BOTHE JR MDFORMER OFFICER (i)
(ii)
 
528,879
 
268,143
 
274,517
 
178,224
 
11,292
 
1,261,055
 
221,209
(15)JOHN D KIZER MDFORMER 5 HIGHEST (i)
(ii)
 
320,141
 
79,668
 
27,080
 
18,096
 
19,334
 
464,319
 
 
(16)KHALEEL SHAIKH MDFORMER 5 HIGHEST (i)
(ii)
 
396,635
 
39,908
 
3,584
 
13,750
 
13,563
 
467,440
 
 
(17)SEAN MCANDREWFORMER OFFICER (i)
(ii)
129,647
 
44,341
 
409
 
2,618
 
5,286
 
182,301
 
 
 
(18)WENDY K WILSONFORMER OFFICER (i)
(ii)
93,216
 
34,481
 
282
 
3,999
 
12,427
 
144,405
 
 
 
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Identifier Return Reference Explanation
FRINGE OR EXPENSE EXPLANATION SCHEDULE J, PAGE 1, PART I, LINE 1A TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: FROM TIME TO TIME THE GEISINGER HEALTH SYSTEM BOARD OF DIRECTORS OR GEISINGER HEALTH SYSTEM SENIOR MANAGEMENT APPROVE THE GROSS-UP OF EXPENSES WHICH FURTHER GEISINGER HEALTH SYSTEM BUSINESS.
SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS SCHEDULE J, PAGE 1, PART I, LINE 4 KEVIN F. BRENNAN, CPA, FHFMA 0 247,768 0 FRANK J. TREMBULAK 0 276,507 0 ALBERT BOTHE, JR., M.D. 0 221,209 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.
OTHER ADDITIONAL INFORMATION SCHEDULE J, PART III PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN COMPENSATION FOR ELIGIBLE EMPLOYEES MAY BE DEFERRED TO A 457(F) NONQUALIFIED PLAN THAT VESTS WITH COMPLETION OF SERVICE, DEATH AND/OR PERMANENT DISABILITY. __________________________________________________________________________ FOOTNOTE: THROUGHOUT FORM 990, THE TERMS "GEISINGER HEALTH SYSTEM" AND "SYSTEM" OR THE ACRONYM "GHS" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH SYSTEM FOUNDATION ("THE FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM.
Schedule J (Form 990) 2012

Additional Data


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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, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

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





2
Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2012
Schedule L (Form 990 or 990-EZ) 2012
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) GEISINGER QUALITY OPTIONS INC
 
BUSINESS 3,083,167 IC SHARED SRVC REV   No
(2) GEISINGER INDEMNITY INSURANCE CO
 
BUSINESS 461,928 IC SHARED SRVC REV   No
(3) INTERNATIONAL SHARED SERVICES INC
 
BUSINESS 983,971 IC SHARED SRVC EXP   No
(4) GEISINGER MEDICAL MANAGEMENT CORP
 
BUSINESS 1,438,997 IC SHARED SRVC EXP   No
(5) GEISINGER ASSURANCE COMPANY LTD
 
BUSINESS 958,829 IC SHARED SRVC EXP   No
(6) GEISINGER-SCA HOLDINGS LLC
 
BUSINESS 4,702,828 CAPITAL CONTRIBTION   No
(7) GEISINGER-SCA HOLDINGS LLC
 
BUSINESS 70,259 DISTRIBUTIONRECEIVED   No
(8) LACKAWANNA PHYSICIANS AMB SURG CTR
 
BUSINESS 4,168 REVENUE FOR SERVICES   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
ADDITIONAL INFORMATION SCHEDULE L PART V COMMUNITY MEDICAL CENTER CMC DBA GEISINGERCOMMUNITY MEDICAL CENTER IS CLOSELY AFFILIATED WITH SEVERAL OTHER ORGANIZATIONS IN THE NORMAL COURSE OF OPERATIONS OF THESE AFFILIATED ORGANIZATIONS THERE ARE NUMEROUS INTER ORGANIZATIONAL TRANSACTIONS WHICH MAY INCLUDE SALES EXCHANGES AND LEASE OF PROPERTY EXTENSIONS OF CREDIT FURNISHING OF GOODS SERVICES AND FACILITIES AND TRANSFERS OF ASSETS THESE TYPES OF INTERORGANIZATIONAL TRANSACTIONS WERE DESCRIBED TO THE INTERNAL REVENUE SERVICE IRS IN A RULING APPLICATION AND WERE RECOGNIZED BY THE NATIONAL OFFICE OF THE IRS IN A SERIES OF PRIVATE LETTER RULINGS AS BEING ENTIRELY CONSISTENT WITH THE ORGANIZATIONS TAX EXEMPT STATUS THE FOLLOWING ORGANIZATIONS REPRESENT THE AFFILIATED FORPROFIT ORGANIZATIONS WITHIN THE COMMUNITY MEDICAL CENTER FOR WHOM BUSINESS TRANSACTIONS MUST BE DISCLOSED FOR PURPOSES OF SCHEDULE L PART IV TRANSACTIONS WITH INTERESTED PERSONS GEISINGER MEDICAL MANAGEMENT CORPORATION INTERNATIONAL SHARED SERVICES INC GEISINGER INDEMNITY INSURANCE COMPANY GEISINGER QUALITY OPTIONS INC GEISINGER ASSURANCE COMPANY LTD GEISINGERSCA HOLDINGS LLC LACKAWANNA PHYSICIANS AMBULATORY SURGERY CENTER LLC THE FOLLOWING OFFICERS ANDOR DIRECTORS OF COMMUNITY MEDICAL CENTER ARE OFFICERS ANDOR DIRECTORS OF SOME OR ALL OF THESE ORGANIZATIONS WILLIAM H ALEXANDER ANTHONY AQUILINA MD DAVID J FELICIO ESQUIRE RICHARD A GRAFMYRE WILLIAM R GRUVER THOMAS H LEE JR MD ROBERT E POOLE DON A ROSINI GLENN D STEELE MD PHD ROBERT STEIGMEYER FRANK J TREMBULAK EDWARD J ZYCH ESQUIRE FOOTNOTE THROUGHOUT FORM 990 THE TERMS GEISINGER HEALTH SYSTEM AND SYSTEM OR THE ACRONYM GHS SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH SYSTEM FOUNDATION THE FOUNDATION AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM
Schedule L (Form 990 or 990-EZ) 2012

Additional Data


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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
2012
Open to Public
Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Identifier Return Reference Explanation
ORGANIZATION'S MISSION FORM 990 - ORGANIZATION'S MISSION TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING QUALITY HOSPITAL SERVICES AND ACCESS ACROSS NORTHEASTERN PENNSYLVANIA THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE.
FIRST ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4A I. GENERAL INFORMATION COMMUNITY MEDICAL CENTER (CMC), DOING BUSINESS AS GEISINGER-COMMUNITY MEDICAL CENTER (GCMC), IS A TAX-EXEMPT, PENNSYLVANIA NOT-FOR-PROFIT CORPORATIONORGANIZED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. GCMC IS A 297-BED ACUTE CARE HOSPITAL IN SCRANTON, PA. THE HOSPITAL WAS FOUNDED 116 YEARS AGO AT WHICH TIME IT WAS KNOWN AS HAHNEMANN HOSPITAL. THE HOSPITAL WAS SCRANTON'S FIRST AND CURRENTLY ONLY ACUTE CARE HOSPITAL DEDICATED TO SERVING THE COMMUNITY AND THEIR HEALTH NEEDS THROUGH A CHARITABLE PURPOSE. GCMC CONTINUES TO PROVIDE THE COMMUNITY WITH A VARIETY OF SERVICES AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. THIS CONTINUUM OF CARE INCLUDES PREVENTIVE, AMBULATORY, INPATIENT, AND EMERGENCY SERVICES. GCMC IS A NOTED REGIONAL REFERRAL CENTER WITH COMPREHENSIVE ACUTE CARE MEDICAL SERVICES AND HAS DEVELOPED MANY SPECIFIC AREAS OF EXPERTISE. PATIENT ORIGIN AND SERVICE AREA: THE HOSPITAL'S PRIMARY SERVICE AREA IS COMPRISED OF LACKAWANNA COUNTY. THE SECONDARY SERVICE AREAS INCLUDE LUZERNE, MONROE, PIKE, SUSQUEHANNA, WAYNE AND WYOMING COUNTIES. SPECIALIZED / REGIONAL SERVICES, CENTERS OF EXCELLENCE: GCMC IS THE ONLY LEVEL II TRAUMA CENTER IN LACKAWANNA COUNTY. THE NORTHEAST PA TRAUMA CENTER, DESIGNATED BY THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION IN 1988, PROVIDES 24-HOUR COMPREHENSIVE SURGICAL INTERVENTION FOR CRITICALLY INJURED PATIENTS. THE TRAUMA CENTER IS STAFFED CONTINUOUSLY BY AN EMERGENCY PHYSICIAN, TRAUMA SURGEON, AND NURSES CERTIFIED IN CRITICAL CARE, TRAUMA, ORTHOPEDICS, AND THE NEUROSCIENCES. CARDIOLOGY SERVICES AT THE HOSPITAL INCLUDE THE REGION'S FIRST ELECTROPHYSIOLOGY LAB AND AN OPEN HEART SURGERY CENTER. GCMC IS ALSO A CERTIFIED CAROTID STENT FACILITY. GCMC HAS EARNED THE ACTION REGISTRY- GWTG PLATINUM PERFORMANCE ACHIEVEMENT AWARD FOR EIGHT CONSECUTIVE QUARTERS OF QUALITY CARDIOVASCULAR CARE. NEUROLOGICAL SCIENCES AT GCMC SPECIALIZES IN THE CARE OF PEOPLE WITH BRAIN AND SENSE ORGAN DISORDERS. GCMC HAS EARNED THE AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES BRONZE AWARD. OTHER SPECIALIZED SERVICES INCLUDE: A SAME-DAY SURGERY CENTER, A 24-BED SHORT-TERM PSYCHIATRIC INPATIENT UNIT (THE ONLY ONE IN LACKAWANNA COUNTY), AN ORTHOPEDIC TRAUMA CLINIC, CT SCANNER, MRI IMAGING, ONCOLOGY SERVICES, RENAL DIALYSIS, HYPERBARIC OXYGEN CHAMBER TREATMENTS, THE NEW STEPS JOINT PROGRAM, WOUND CARE, AND STEREOTACTIC SURGERY. GCMC OFFERS EMERGENCY MEDICAL TECHNICIAN AND TRAUMA NURSE TRAINING PROGRAMS. IT HAS AN AFFILIATION WITH THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION. THE WRIGHT CENTER IS AN ACCREDITED PROVIDER OF INTERNAL MEDICINE RESIDENCY EDUCATION BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION. THE WRIGHT CENTER IS ALSO THE REGION'S ONLY PODIATRIC RESIDENCY PROGRAM AND ACCREDITED PROVIDER OF PODIATRIC MEDICINE AND SURGERY EDUCATION BY THE COUNCIL OF PODIATRIC MEDICAL EDUCATION. IN FY 2013, THE UNCOMPENSATED COSTS FOR HEALTH PROFESSIONS EDUCATION TOTALED 1,206,528. GCMC ALSO SPONSORS THE COMMUNITY HEALTH EDUCATION PROGRAM (DETAILED BELOW). THIS PROGRAM IS THE REGION'S FIRST HOSPITAL-BASED AND COMMUNITY- WIDE WELLNESS AND PREVENTION PROGRAM. IN ADDITION, GCMC SPONSORS THE PRIORITY CARE PROGRAM IN WHICH OVER 20,000 SENIOR CITIZENS ARE ENROLLED IN THE REGION'S FIRST HOSPITAL-BASED FREE MEMBERSHIP PLAN FOR PERSONS 55 AND OLDER. PRIORITY CARE PROVIDES SENIOR CITIZENS WITH A WIDE VARIETY OF BENEFITS AND INFORMATION REGARDING HEALTH AND WELLNESS PROGRAMS. PRIORITY CARE OFFERS CONVENIENT ACCESS TO QUALITY SERVICES INCLUDING: O FREE PARKING IN THE GCMC PARKING COMPLEX O COMMUNITY DISCOUNTS O DISCOUNTED MEALS IN THE HOSPITAL'S DINING ROOM O DISCOUNTS IN THE GCMC GIFT SHOP O PHYSICIAN REFERRAL SERVICE AFFILIATIONS: GCMC HAS WORKING RELATIONSHIPS WITH OTHER HEALTH CARE PROVIDERS IN VENTURES SUCH AS THE NORTHEAST SURGERY CENTER AND THE NORTHEASTERN PENNSYLVANIA IMAGING CENTER. GCMC ALSO HAS WORKING RELATIONSHIPS WITH THE CHILDREN'S ADVOCACY CENTER, MATERNAL & FAMILY HEALTH SERVICES, AND THE RONALD MCDONALD HOUSE OF SCRANTON. IN PARTICULAR, GCMC PROVIDES THE CHILDREN'S ADVOCACY CENTER AND MATERNAL & FAMILY HEALTH SERVICES WITH SPACE TO CONDUCT THEIR CHARTABLE PURPOSE FOR FREE. THESE CHARITABLE LEASES WERE VALUED AT 123,200 FOR FY 2013. GCMC ALSO HAS A CONNECTION WITH NUMEROUS AREA INSTITUTIONS, COLLEGES, AND UNIVERSITIES FOR EDUCATIONAL AND CLINICAL PROGRAMS INCLUDING, BUT NOT LIMITED TO, NURSING, MEDICAL TECHNOLOGY, PHYSICAL AND OCCUPATIONAL THERAPY, EMERGENCY MEDICAL TECHNICIANS, PHYSICIAN ASSISTANTS, SOCIAL WORK, AND HEALTHCARE ADMINISTRATION. MEDICAL STAFF: AS OF JUNE 30, 2013, THE MEDICAL STAFF OF GCMC TOTALED 568 PHYSICIANS. UNDER GCMC'S MEDICAL STAFF BY-LAWS, PHYSICIANS MAY HAVE ONE OF SEVERAL TYPES OF PRIVILEGES INCLUDING ACTIVE, COURTESY, CONSULTING, EMERGENCY, AND TEMPORARY. AUXILIARY: THE GCMC AUXILIARY IS COMPRISED OF APPROXIMATELY 60 MEMBERS. FUNCTIONING WITH THE GUIDANCE OF ITS OWN ADVISORY BOARD, THE AUXILIARY IS SPLIT INTO COMMITTEES, EACH OF WHICH HAS THEIR OWN RESPONSIBILITY FOR FUND-RAISING AND SERVICE. THE AUXILIARY ASSISTS IN OPERATING GCMC'S GIFT SHOP ON A DAILY BASIS. ALLOCATIONS OF FUNDS RAISED BY THE AUXILIARY ARE MADE TO GCMC TO ENHANCE PATIENT SERVICES. II. UNCOMPENSATED CARE: GCMC RECOGNIZES THAT ITS MISSION IS TO SERVE ALL THE MEMBERS OF THE COMMUNITY WITH RESPECT TO THE PROVISION OF HEALTHCARE SERVICES AND EDUCATION. GCMC PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. IN THIS REGARD GCMC PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A.CHARITY CARE THE PRIMARY CONCERN OF GCMC IS THE DELIVERY OF HEALTH CARE TO ALL THE CITIZENS OF NORTHEASTERN PENNSYLVANIA, REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GCMC INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. THE COST TO GCMC OF PROVIDING THIS CHARITY CARE DURING THE FISCAL YEAR ENDED JUNE 30, 2013 WAS 2,015,856. B.MEDICARE/MEDICAID/OTHER GOVERNMENTAL RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO THE ELDERLY (MEDICARE), THE POOR (MEDICAID), AND OTHER. GCMC PROVIDES CARE BELOW COST TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS. TO THE EXTENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTHCARE, GCMC IS FURTHERING ITS CHARITABLE MISSION. THE UNREIMBURSED VALUE OF MEDICARE, MEDICAID AND OTHER GOVERNMENTAL PAYERS IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. FOR FISCAL YEAR 2013, THE UNREIMBURSED COST OF PROVIDING CARE TO THESE PATIENTS WAS 23,906,040. C.OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GCMC PROVIDES OTHER PATIENT SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2013, WAS 2,371,082. III. COMMUNITY HEALTH, EDUCATION, AND OUTREACH GCMC AND RELATED AFFILIATES PROVIDE A VARIETY OF PROGRAMS TO THE COMMUNITY. THE INTENT OF THESE PROGRAMS IS TO IMPROVE THE HEALTH OF THE COMMUNITY AND PROVIDE FOR COMMUNITY HEALTH NEEDS, E.G. THROUGH ACCIDENT/ ILLNESS PREVENTION OR EARLY HEALTH INTERVENTION AS A RESULT OF INCREASED EDUCATION. THE NORTHEAST PA TRAUMA CENTER PROVIDES EMERGENCY PREPAREDNESS ASSISTANCE AND MEDICAL EXPERTISE TO THE AMERICAN RED CROSS LACKAWANNA CHAPTER, LACKAWANNA COUNTY EMERGENCY MANAGEMENT AGENCY, AND THE SCRANTON/WILKES- BARRE INTERNATIONAL AIRPORT. ALSO, FALL AND INJURY PREVENTION FOR THE ELDERLY IS AVAILABLE TO AREA SENIOR CITIZENS AND SENIOR ORGANIZATIONS, AS WELL AS MANY AGE-SPECIFIC PREVENTION PROGRAMS TO VARIOUS ORGANIZATIONS AND SCHOOLS THROUGHOUT THE YEAR. EACH YEAR OVER 500 CHILDREN UNDER THE AGE OF 18 ARE INVOLVED IN EDUCATION'S EXTENSIVE PROGRAMS TARGETING THIS AGE GROUP. TRAUMA PREVENTION PROGRAMS SUCH AS TRAUMA ROOM AND THINK FIRST TEACH KIDS IMPORTANT SAFETY INFORMATION. ASTHMA SKI DAY HELD IN CONJUNCTION WITH MONTAGE MOUNTAIN SKI AREA AND GCMC'S COMMUNITY HEALTH EDUCATION PROGRAM, EMPHASIZING THAT DESPITE ILLNESS, INDIVIDUALS CAN STILL PARTICIPATE IN HEALTHY, EVEN STRENUOUS ACTIVITIES. IN ADDITION, A POISON PREVENTION PROGRAM IS AVAILABLE ALONG WITH OTHER SUCH PROGRAMS AS REQUESTED. MANY OF THESE PROGRAMS ARE THE RESULTS OF EDUCATION'S PARTNERSHIPS WITH OTHER COMMUNITY RESOURCES; E.G., THE AMERICAN LUNG ASSOCIATION, LACKAWANNA COUNTY DRUG AND ALCOHOL COMMISSION, AND ALLIED SERVICES. IN FY 2013, THE TRAUMA CENTER PROVIDED 20 TRAUMA PROGRAMS FOR ABOUT 6,000 OF UNCOMPENSATED COSTS. THE COMMUNITY HEALTH EDUCATION PROGRAM ("LIFECARE") CONDUCTS A WIDE VARIETY OF HEALTHLY LIFESTYLE PROGRAMS, FREE OR AT MINIMAL COST, WHICH ARE DESIGNED TO 'PRACTICALLY' ASSIST AN INDIVIDUAL IN THEIR QUEST TO LEAD A HEALTHY AND PRODUCTIVE LIFE. SOME OF THE AREAS OF CONCENTRATION INCLUDE: SMOKING CESSATION, FIRST AID, CPR, AND WEIGHT WATCHERS SESSIONS THAT ARE OPEN TO THE PUBLIC AS WELL AS EM
ADDITIONAL INFORMATION FORM 990, PART VI FORM 990, PART I, SECTION A, LINE 4: FORM 990, PART VI, SECTION A, LINE 1B: ENTER THE NUMBER OF VOTING MEMBERS THAT ARE INDEPENDENT. BASED ON THE FORM 990 DEFINITION OF "INDEPENDENCE" AS IT RELATES TO VOTING MEMBERS OF THE GOVERNING BODY, ONE VOTING MEMBER IS NOT INDEPENDENT BECAUSE HE IS COMPENSATED AS AN EMPLOYEE OF A RELATED TAX-EXEMPT ORGANIZATION. INCLUDING THE VOTING MEMBER DESCRIBED ABOVE, A TOTAL OF SEVEN VOTING MEMBERS OF THE GOVERNING BODY ARE ALSO VOTING MEMBERS OF RELATED TAXABLE ORGANIZATIONS FOR WHICH BUSINESS TRANSACTIONS, BETWEEN GCMC AND THE RELATED TAXABLE ORGANIZATION ARE REPORTED 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 RELATED 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 RELATED TAXABLE ORGANIZATIONS, RECEIVE NO PRIVATE INUREMENT / PRIVATE BENEFIT FROM THE TRANSACTIONS WITH THE RELATED TAXABLE ORGANIZATIONS AND THE VOTING MEMBERS OF THE GOVERNING BODY ABSTAIN FROM VOTING AND ARE ABSENT FROM BOARD DELIBERATIONS AND DECISIONS ON MATTERS IF A CONFLICT EXISTS. REFER TO THE RESPONSE FOR FORM 990, PART VI, SECTION B, QUESTION 12A, 12B, AND 12C REGARDING THE GEISINGER HEALTH SYSTEM CONFLICTS OF INTEREST POLICY, DISCLOSURE, AND ENFORCEMENT. FORM 990, PART VI, SECTION A, LINE 2: DID ANY OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE HAVE A FAMILY RELATION- SHIP OR BUSINESS RELATIONSHIP WITH ANY OTHER OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE? GLENN D. STEELE, JR MD, PHD, DAVID J. FELICIO, ESQUIRE, ROBERT STEIGMEYER, FRANK J. TREMBULAK, EDWARD J. ZYCH, ESQUIRE, WILLIAM H. ALEXANDER, WILLIAM R. GRUVER, RICHARD GRAFMYRE, THOMAS H. LEE, JR., M.D., ANTHONY AQUILINA, M.D., ROBERT E. POOLE, DON A. ROSINI ALL HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER BECAUSE THEY SERVE AS OFFICERS AND/OR DIRECTORS ON ONE OR MORE FOR-PROFIT AFFILIATES OF GEISINGER-COMMUNITY MEDICAL CENTER. ALL OF THE AFFILIATES ARE PART OF THE GEISINGER HEALTH SYSTEM.
CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PAGE 6, PART VI, LINE 6 THE MEMBERS OF THE CORPORATION HAVE THE POWER AND AUTHORITY TO ELECT AND REMOVE DIRECTORS, ELECT AND REMOVE THE PRESIDENT AND FILL ANY VACANCY IN THE OFFICE OF THE PRESIDENT OF THE CORPORATION AND APPROVE AMENDMENTS TO THE CORPORATE BYLAWS. THE MEMBERS ALSO HAVE THE RESERVE POWERS AS SET FORTH IN THE PENNSYLVANIA NONPROFIT CORPORATION LAW.
ELECTION OF MEMBERS AND THEIR RIGHTS FORM 990, PAGE 6, PART VI, LINE 7A THE BOARD OF DIRECTORS OF THE CORPORATION SHALL SERVE AS THE GOVERNING BODY OF THE CORPORATION. THE PRESIDENT OF THE CORPORATION SHALL BE A DIRECTOR BY REASON OF HOLDING SUCH OFFICE. THE REMAINING DIRECTORS SHALL BE ELECTED BY THE MEMBERS AT THE ANNUAL MEETING OF THE MEMBERS. THE MEMBERS OF THE CORPORATION MAY SERVE AS DIRECTORS AND DIRECTORS MAY SUCCEED THEMSELVES FROM TERM TO TERM. VACANCIES ON THE BOARD OF DIRECTORS SHALL BE FILLED BY THE MEMBERS AT THEIR DISCRETION AT THE ANNUAL MEETING OF THE MEMBERS OR AT A SPECIAL MEETING CALLED FOR SUCH PURPOSE.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B ALL OFFICERS AND DIRECTORS WERE ELECTRONICALLY PROVIDED A FINAL COPY OF THE FORM 990 PRIOR TO FILING THE RETURN WITH THE IRS. AN EXECUTIVE SUMMARY OF THE INFORMATION REPORTED ON THE RETURN IS PROVIDED TO ASSIST IN THEIR REVIEW. IN ACCORDANCE WITH THE GEISINGER HEALTH SYSTEM FOUNDATION BOARD OF DIRECTOR'S FINANCE COMMITTEE CHARTER, STAFF PERIODICALLY REVIEWS THE GHS ORGANIZATIONS' FORM 990 FILINGS. THE FORM 990 IS PREPARED BY THE GEISINGER HEALTH SYSTEM (GHS) TAX AND FINANCIAL REPORTING DEPARTMENTS WITH INFORMATION PROVIDED FROM FINANCE, TAX, HUMAN RESOURCES, PAYROLL, LEGAL SERVICES AND OTHER RELEVANT DEPARTMENTS WITHIN THE GEISINGER HEALTH SYSTEM. THE CHIEF FINANCIAL OFFICER (CFO) OF GHS AND THE INDIVIDUAL ORGANIZATIONS SENIOR FINANCIAL MANAGERS REVIEW THEIR RESPECTIVE FORM 990 PRIOR TO MAKING THE FINAL RETURN AVAILABLE TO THE BOARD. IN ADDITION, THE CHIEF LEGAL OFFICER AND CHIEF HUMAN RESOURCE OFFICER OF GHS REVIEW THE INFORMATION DISCLOSED ON THE FORM 990 RELEVANT TO THEIR RESPECTIVE AREAS OF RESPONSIBILITY. FOR PURPOSES OF THEIR ANNUAL AUDIT OF THE GHS CONSOLIDATED FINANCIAL STATEMENTS, INDEPENDENT AUDITORS REVIEW ALL FEDERAL TAX RETURNS FILED BY THE GHS ORGANIZATIONS TO IDENTIFY MATERIAL ITEMS, INCLUDING IF THERE ARE ANY UNCERTAIN TAX POSITIONS THAT MAY BE REQUIRED TO BE RECOGNIZED. THE COMPANY HAD NO UNCERTAIN TAX POSITIONS REQUIRED TO BE REPORTED FOR FISCAL YEAR-ENDED JUNE 30, 2013.
ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C THE OFFICERS AND DIRECTORS OF COMMUNITY MEDICAL CENTER ARE SUBJECT TO THE GHS CONFLICT OF INTEREST POLICY FOR DIRECTORS, OFFICERS AND SENIOR LEADERS (MAY INCLUDE INDEPENDENT CONTRACTORS). AT LEAST ONCE EACH YEAR DIRECTORS, OFFICERS, KEY EMPLOYEES, SENIOR LEADERS (INCLUDING INDEPENDENT CONTRACTORS) AND OTHERS DESIGNATED BY THE BOARD OF DIRECTORS ARE REQUIRED TO DISCLOSE IN WRITING THE EXISTENCE OF ANY POTENTIAL FINANCIAL INTERESTS THAT MAY GIVE RISE TO A CONFLICT OF INTEREST WITH ANY AFFILIATE WITHIN THE GEISINGER HEALTH SYSTEM. THE DISCLOSURES ARE REVIEWED BY THE OFFICE OF THE CHIEF LEGAL OFFICER AND REPORTED TO THE AUDIT COMMITTEE AND BOARD OF DIRECTORS. AFTER REVIEW OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, INPUT FROM DEPARTMENT OF LEGAL SERVICES AND ANY DISCUSSION WITH THE PERSON DESIRED BY THE BOARD OR COMMITTEE, THE BOARD DECIDES IF A CONFLICT EXISTS AND TAKES APPROPRIATE ACTION. THE INDIVIDUAL DISCLOSING THE FINANCIAL INTEREST IS ABSENT DURING THE BOARD DELIBERATIONS AND DECISIONS ON THE MATTER.
COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS TO REVIEW AND APPROVE THE COMPENSATION OF GHS EMPLOYED BOARD DIRECTORS, OFFICERS AND EXECUTIVE MANAGEMENT IS DESIGNED TO SATISFY THE REBUTTABLE PRESUMPTION PROCEDURE AVAILABLE FOR INTERMEDIATE SANCTION PURPOSES. THE PROCESS REQUIRES A REVIEW OF COMPENSATION DETERMINATIONS BY DISINTERESTED PARTIES, USE OF APPROPRIATE COMPARABILITY DATA AND CONTEMPORANEOUS DOCUMENTATION OF THE PROCESS. ON AN ANNUAL BASIS AN INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANT COMPLETES A COMPARATIVE ASSESSMENT OF COMPENSATION FOR THE CEO AND SENIOR MANAGEMENT WITHIN GHS. THE CONSULTANT'S REPORT IS PRESENTED TO THE MANAGEMENT AND COMPENSATION COMMITTEE PRIOR TO ANY COMPENSATION ADJUSTMENT. THE REPORT SUPPORTS THE RIGOROUS REVIEW COMPLETED BY THE MANAGEMENT AND COMPENSATION COMMITTEE TO ENSURE THAT THE PROGRAM IS RESPONSIBLE TO THE GEISINGER CHARITABLE MISSION, REFLECTS REASONABLE COMPENSATION WITHIN THE NONPROFIT MARKET AND IS COMPLIANT WITH THE IRS'S INTERMEDIATE SANCTION REQUIREMENTS. THE SURVEY DATA IN THE COMPARATIVE ANALYSIS IS CAPTURED FOR FUNCTIONALLY COMPARABLE POSITIONS IN MULTIPLE SIMILAR NONPROFIT ORGANIZATIONS AND REFLECTS TOTAL REMUNERATION PROVIDED IN THE MARKET. ALL SURVEYS ARE CONDUCTED BY THIRD PARTY ORGANIZATIONS AND NOT CONDUCTED AT THE SPECIFIC DIRECTION OF GEISINGER. ANY COMPENSATION ADJUSTMENTS ARE APPROVED BY MANAGEMENT AND COMPENSATION COMMITTEE PRIOR TO THE EFFECTIVE DATE OF THE PAYMENT. THE MANAGEMENT AND COMPENSATION COMMITTEE AT ITS SOLE DISCRETION MAY POSITIVELY OR NEGATIVELY ADJUST ANY RECOMMENDED COMPENSATION.
COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B SEE SCHEDULE O RESPONSE TO FORM 990, PART VI, SECTION B, QUESTION 15A.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 THE MISSION STATEMENT IS AVAILABLE ON THE GEISINGER HEALTH SYSTEM WEBSITE AT WWW.GEISINGER.ORG. THE ANNUAL REPORT FOR GEISINGER HEALTH SYSTEM, CONTAINING COMMUNITY BENEFIT INFORMATION, CONSOLIDATED FINANCIAL INFORMATION AND OTHER INFORMATION, ARE AVAILABLE ON THE GEISINGER HEALTH SYSTEM WEBSITE. GO TO: WWW.GEISINGER.ORG/ABOUT/MISSION.HTML AND SELECT 2013 ANNUAL REPORT. 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 XI FORM 990,PART XI, LINE 8: AS PART OF ITS AQUISITION OF GEISINGER-COMMUNITY MEDICAL CENTER, GEISINGER HEALTH SYSTEM RECORDED THE ASSETS AND LIABILITIES OF GEISINGER-COMMUNITY MEDICAL CENTER AT THEIR ESTIMATED FAIR VALUES. DURING 2012, AS MORE INFORMATION BECAME AVAILABLE, SEVERAL OF THE VALUATIONS WERE REVISED. THIS REVISION RESULTED IN A DECREASE IN NET ASSETS OF 2,539,718.
OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 9 PENSION ADJUSTMENT 5,920,365 CONTRIBUTIONS FROM AFFILIATE 658,753 EQUITY TRANSFER TO AFFILIATE -1,000 NET INCREASE IN NET ASSETS 6,578,118
ADDITIONAL INFORMATION FORM 990, PART XII FORM 990, PART XII, LINE 3A: AS A RESULT OF A FEDERAL AWARD, WAS THE ORGANIZATION REQUIRED TO UNDERGO AN AUDIT OR AUDITS AS SET FORTH IN THE AUDIT ACT OR OMB CIRCULAR A-133? FEDERAL AWARDS ARE AUDITED AS A PART OF THE GEISINGER HEALTH SYSTEM'S CONSOLIDATED REPORT ON FEDERAL AWARDS IN ACCORDANCE WITH OMB CIRCULAR A-133. FOOTNOTE: THROUGHOUT FORM 990, THE TERMS "GEISINGER HEALTH SYSTEM" AND "SYSTEM" OR THE ACRONYM "GHS" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH SYSTEM FOUNDATION ("THE FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

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
2012
Open to Public Inspection
Name of the organization
COMMUNITY MEDICAL CENTER
 
Employer identification number

24-0862246
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) 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" to 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 entity?
Yes No
(1) GEISINGER HEALTH SYSTEM FOUNDATION

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2337286
SUPPORT SV PA 501C3 11A NA
 
Yes
 
(20) GEISINGER-BLOOMSBURG HOSPITAL

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2193572
HOSPITAL PA 501C3 3 GHSF
 
Yes
 
(21) BLOOMSBURG PHYSICIANS SERVICES

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2979856
PHYS SVCS PA 501C3 3 GHSF
 
Yes
 
(22) GEISINGER-BLOOMSBURG HEALTHCARE CTR

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2242854
SKLD NURSE PA 501C3 9 GHSF
 
Yes
 
(23) COLUMBIA-MONTOUR HOME HEALTH SVC

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-1704399
HOME HLTH PA 501C3 9 GHSF
 
Yes
 
(24) BLOOMSBURG HOSP MED PROF LIAB TRUST

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
14-6222837
SELF INS PA 501C3 11B GHSF
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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) EVANGELICAL-GEISINGER HEALTH LLC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
46-0567687
HEALTHCARE PA N/A
        No     No  
(6) GEISINGER-SCA HOLDINGS LLC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
46-1615328
HOLDING CO DE N/A
RELATED   4,702,828   No   Yes   51.000 %
(7) LACKAWANNA PHYSICIANS AMB SURG CTR

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-3024998
HEALTHCARE PA N/A
        No     No  
(8) KEYSTONE ACCOUNTABLE CARE ORG LLC

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

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

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

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
72-1398803
PHY THERAP PA N/A
        No     No  
(12) EVANGELICAL-GEISINGER HEALTH LLC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
46-0567687
HEALTHCARE PA N/A
        No     No  
(13) GEISINGER-SCA HOLDINGS LLC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
46-1615328
HOLDING CO DE N/A
RELATED   4,702,828   No   Yes   51.000 %
(14) LACKAWANNA PHYSICIANS AMB SURG CTR

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-3024998
HEALTHCARE PA N/A
        No     No  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" to 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
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) GEISINGER MEDICAL MANAGEMENT CORP

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2077663
HOTEL/REST PA N/A
        Yes  
(2) INTERNATIONAL SHARED SERVICES INC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2159597
COMPUTER PA N/A
        Yes  
(3) GEISINGER INDEMNITY INSURANCE COMP

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2815174
HLTH INSUR PA N/A
        Yes  
(4) GEISINGER QUALITY OPTIONS INC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
20-4275139
HLTH INSUR PA N/A
        Yes  
(5) GEISINGER ASSURANCE COMPANY LTD

PO BOX 2196GT
  GRAND CAYMAN  
CJ
98-1016737
INSURANCE CJ N/A
        Yes  
(6) XG HEALTH SOLUTIONS INC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
46-1657345
CONSULTING DE N/A
        Yes  
(7) GEISINGER MEDICAL MANAGEMENT CORP

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2077663
HOTEL/REST PA N/A
        Yes  
(8) INTERNATIONAL SHARED SERVICES INC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2159597
COMPUTER PA N/A
        Yes  
(9) GEISINGER INDEMNITY INSURANCE COMP

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2815174
HLTH INSUR PA N/A
        Yes  
(10) GEISINGER QUALITY OPTIONS INC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
20-4275139
HLTH INSUR PA N/A
        Yes  
(11) GEISINGER ASSURANCE COMPANY LTD

PO BOX 2196GT
  GRAND CAYMAN  
CJ
98-1016737
INSURANCE CJ N/A
        Yes  
(12) XG HEALTH SOLUTIONS INC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
46-1657345
CONSULTING DE N/A
        Yes  
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
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-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) COMMUNITY MEDICAL CARE INC

A 81,060 FMV
(2) COMMUNITY MEDICAL CARE INC

M 72,952 GAAP
(3) COMMUNITY MEDICAL CARE INC

L 3,863,345 GAAP
(4) COMMUNITY MEDICAL CTR HEALTHCARE SY

C 658,753 GAAP
(5) GEISINGER ASSURANCE COMPANY LTD

M 958,829 GAAP
(6) GEISINGER CLINIC

L 65,340 GAAP
(7) GEISINGER CLINIC

M 1,390,128 GAAP
(8) GEISINGER COMMUNITY HEALTH SERVICES

L 269,182 GAAP
(9) GEISINGER HEALTH PLAN

L 19,298,545 GAAP
(10) GEISINGER HEALTH PLAN

M 5,488,053 GAAP
(11) GEISINGER HEALTH SYSTEM FOUNDATION

C 109,141 GAAP
(12) GEISINGER HEALTH SYSTEM FOUNDATION

B 4,555,863 GAAP
(13) GEISINGER INDEMNITY INSURANCE CORP

L 461,928 GAAP
(14) GEISINGER INSURANCE CORPORATIONRRG

M 520,390 GAAP
(15) GEISINGER INSURANCE CORPORATIONRRG

M 1,000 GAAP
(16) GEISINGER MEDICAL CENTER

M 292,484 GAAP
(17) GEISINGER QUALITY OPTIONS INC

L 3,083,167 GAAP
(18) GEISINGER SYSTEM SERVICES

M 11,089,063 GAAP
(19) GEISINGER SYSTEM SERVICES

L 40 GAAP
(20) GEISINGER WYOMING VALLEY MED CTR

M 598,098 GAAP
(21) INTERNATIONAL SHARED SERVICES INC

M 983,971 GAAP
(22) MEDICAL DIMENSIONS INC

K 392,001 FMV
(23) MEDICAL DIMENSIONS INC

L 268,250 GAAP
(24) MOUNTAIN VIEW NURSING HOME INC

L 1,140,940 GAAP
(25) CMC HEALTHCARE SYS MED PROF LIAB TR

S 2,181,870 GAAP
(26) CMC HEALTHCARE SYS MED PROF LIAB TR

M 1,279,441 GAAP
(27) GEISINGER MEDICAL MANAGEMENT CORP

M 1,438,997 GAAP
(28) GEISINGER-SCA HOLDINGS LLC

B 4,702,828 GAAP
(29) GEISINGER-SCA HOLDINGS LLC

C 70,259 GAAP
(30) LACKAWANNA PHYSICIANS AMB SURG CTR

L 4,168 GAAP
(31) COMMUNITY MEDICAL CARE INC

A 81,060 FMV
(32) COMMUNITY MEDICAL CARE INC

M 72,952 GAAP
(33) COMMUNITY MEDICAL CARE INC

L 3,863,345 GAAP
(34) COMMUNITY MEDICAL CTR HEALTHCARE SY

C 658,753 GAAP
(35) GEISINGER ASSURANCE COMPANY LTD

M 958,829 GAAP
(36) GEISINGER CLINIC

L 65,340 GAAP
(37) GEISINGER CLINIC

M 1,390,128 GAAP
(38) GEISINGER COMMUNITY HEALTH SERVICES

L 269,182 GAAP
(39) GEISINGER HEALTH PLAN

L 19,298,545 GAAP
(40) GEISINGER HEALTH PLAN

M 5,488,053 GAAP
(41) GEISINGER HEALTH SYSTEM FOUNDATION

C 109,141 GAAP
(42) GEISINGER HEALTH SYSTEM FOUNDATION

B 4,555,863 GAAP
(43) GEISINGER INDEMNITY INSURANCE CORP

L 461,928 GAAP
(44) GEISINGER INSURANCE CORPORATIONRRG

M 520,390 GAAP
(45) GEISINGER INSURANCE CORPORATIONRRG

M 1,000 GAAP
(46) GEISINGER MEDICAL CENTER

M 292,484 GAAP
(47) GEISINGER QUALITY OPTIONS INC

L 3,083,167 GAAP
(48) GEISINGER SYSTEM SERVICES

M 11,089,063 GAAP
(49) GEISINGER SYSTEM SERVICES

L 40 GAAP
(50) GEISINGER WYOMING VALLEY MED CTR

M 598,098 GAAP
(51) INTERNATIONAL SHARED SERVICES INC

M 983,971 GAAP
(52) MEDICAL DIMENSIONS INC

K 392,001 FMV
(53) MEDICAL DIMENSIONS INC

L 268,250 GAAP
(54) MOUNTAIN VIEW NURSING HOME INC

L 1,140,940 GAAP
(55) CMC HEALTHCARE SYS MED PROF LIAB TR

S 2,181,870 GAAP
(56) CMC HEALTHCARE SYS MED PROF LIAB TR

M 1,279,441 GAAP
(57) GEISINGER MEDICAL MANAGEMENT CORP

M 1,438,997 GAAP
(58) GEISINGER-SCA HOLDINGS LLC

B 4,702,828 GAAP
(59) GEISINGER-SCA HOLDINGS LLC

C 70,259 GAAP
(60) LACKAWANNA PHYSICIANS AMB SURG CTR

L 4,168 GAAP
(61) COMMUNITY MEDICAL CARE INC

A 81,060 FMV
(62) COMMUNITY MEDICAL CARE INC

M 72,952 GAAP
(63) COMMUNITY MEDICAL CARE INC

L 3,863,345 GAAP
(64) COMMUNITY MEDICAL CTR HEALTHCARE SY

C 658,753 GAAP
(65) GEISINGER ASSURANCE COMPANY LTD

M 958,829 GAAP
(66) GEISINGER CLINIC

L 65,340 GAAP
(67) GEISINGER CLINIC

M 1,390,128 GAAP
(68) GEISINGER COMMUNITY HEALTH SERVICES

L 269,182 GAAP
(69) GEISINGER HEALTH PLAN

L 19,298,545 GAAP
(70) GEISINGER HEALTH PLAN

M 5,488,053 GAAP
(71) GEISINGER HEALTH SYSTEM FOUNDATION

C 109,141 GAAP
(72) GEISINGER HEALTH SYSTEM FOUNDATION

B 4,555,863 GAAP
(73) GEISINGER INDEMNITY INSURANCE CORP

L 461,928 GAAP
(74) GEISINGER INSURANCE CORPORATIONRRG

M 520,390 GAAP
(75) GEISINGER INSURANCE CORPORATIONRRG

M 1,000 GAAP
(76) GEISINGER MEDICAL CENTER

M 292,484 GAAP
(77) GEISINGER QUALITY OPTIONS INC

L 3,083,167 GAAP
(78) GEISINGER SYSTEM SERVICES

M 11,089,063 GAAP
(79) GEISINGER SYSTEM SERVICES

L 40 GAAP
(80) GEISINGER WYOMING VALLEY MED CTR

M 598,098 GAAP
(81) INTERNATIONAL SHARED SERVICES INC

M 983,971 GAAP
(82) MEDICAL DIMENSIONS INC

K 392,001 FMV
(83) MEDICAL DIMENSIONS INC

L 268,250 GAAP
(84) MOUNTAIN VIEW NURSING HOME INC

L 1,140,940 GAAP
(85) CMC HEALTHCARE SYS MED PROF LIAB TR

S 2,181,870 GAAP
(86) CMC HEALTHCARE SYS MED PROF LIAB TR

M 1,279,441 GAAP
(87) GEISINGER MEDICAL MANAGEMENT CORP

M 1,438,997 GAAP
(88) GEISINGER-SCA HOLDINGS LLC

B 4,702,828 GAAP
(89) GEISINGER-SCA HOLDINGS LLC

C 70,259 GAAP
(90) LACKAWANNA PHYSICIANS AMB SURG CTR

L 4,168 GAAP
(91) COMMUNITY MEDICAL CARE INC

A 81,060 FMV
(92) COMMUNITY MEDICAL CARE INC

M 72,952 GAAP
(93) COMMUNITY MEDICAL CARE INC

L 3,863,345 GAAP
(94) COMMUNITY MEDICAL CTR HEALTHCARE SY

C 658,753 GAAP
(95) GEISINGER ASSURANCE COMPANY LTD

M 958,829 GAAP
(96) GEISINGER CLINIC

L 65,340 GAAP
(97) GEISINGER CLINIC

M 1,390,128 GAAP
(98) GEISINGER COMMUNITY HEALTH SERVICES

L 269,182 GAAP
(99) GEISINGER HEALTH PLAN

L 19,298,545 GAAP
(100) GEISINGER HEALTH PLAN

M 5,488,053 GAAP
(101) GEISINGER HEALTH SYSTEM FOUNDATION

C 109,141 GAAP
(102) GEISINGER HEALTH SYSTEM FOUNDATION

B 4,555,863 GAAP
(103) GEISINGER INDEMNITY INSURANCE CORP

L 461,928 GAAP
(104) GEISINGER INSURANCE CORPORATIONRRG

M 520,390 GAAP
(105) GEISINGER INSURANCE CORPORATIONRRG

M 1,000 GAAP
(106) GEISINGER MEDICAL CENTER

M 292,484 GAAP
(107) GEISINGER QUALITY OPTIONS INC

L 3,083,167 GAAP
(108) GEISINGER SYSTEM SERVICES

M 11,089,063 GAAP
(109) GEISINGER SYSTEM SERVICES

L 40 GAAP
(110) GEISINGER WYOMING VALLEY MED CTR

M 598,098 GAAP
(111) INTERNATIONAL SHARED SERVICES INC

M 983,971 GAAP
(112) MEDICAL DIMENSIONS INC

K 392,001 FMV
(113) MEDICAL DIMENSIONS INC

L 268,250 GAAP
(114) MOUNTAIN VIEW NURSING HOME INC

L 1,140,940 GAAP
(115) CMC HEALTHCARE SYS MED PROF LIAB TR

S 2,181,870 GAAP
(116) CMC HEALTHCARE SYS MED PROF LIAB TR

M 1,279,441 GAAP
(117) GEISINGER MEDICAL MANAGEMENT CORP

M 1,438,997 GAAP
(118) GEISINGER-SCA HOLDINGS LLC

B 4,702,828 GAAP
(119) GEISINGER-SCA HOLDINGS LLC

C 70,259 GAAP
(120) LACKAWANNA PHYSICIANS AMB SURG CTR

L 4,168 GAAP
(121) COMMUNITY MEDICAL CARE INC

A 81,060 FMV
(122) COMMUNITY MEDICAL CARE INC

M 72,952 GAAP
(123) COMMUNITY MEDICAL CARE INC

L 3,863,345 GAAP
(124) COMMUNITY MEDICAL CTR HEALTHCARE SY

C 658,753 GAAP
(125) GEISINGER ASSURANCE COMPANY LTD

M 958,829 GAAP
(126) GEISINGER CLINIC

L 65,340 GAAP
(127) GEISINGER CLINIC

M 1,390,128 GAAP
(128) GEISINGER COMMUNITY HEALTH SERVICES

L 269,182 GAAP
(129) GEISINGER HEALTH PLAN

L 19,298,545 GAAP
(130) GEISINGER HEALTH PLAN

M 5,488,053 GAAP
(131) GEISINGER HEALTH SYSTEM FOUNDATION

C 109,141 GAAP
(132) GEISINGER HEALTH SYSTEM FOUNDATION

B 4,555,863 GAAP
(133) GEISINGER INDEMNITY INSURANCE CORP

L 461,928 GAAP
(134) GEISINGER INSURANCE CORPORATIONRRG

M 520,390 GAAP
(135) GEISINGER INSURANCE CORPORATIONRRG

M 1,000 GAAP
(136) GEISINGER MEDICAL CENTER

M 292,484 GAAP
(137) GEISINGER QUALITY OPTIONS INC

L 3,083,167 GAAP
(138) GEISINGER SYSTEM SERVICES

M 11,089,063 GAAP
(139) GEISINGER SYSTEM SERVICES

L 40 GAAP
(140) GEISINGER WYOMING VALLEY MED CTR

M 598,098 GAAP
(141) INTERNATIONAL SHARED SERVICES INC

M 983,971 GAAP
(142) MEDICAL DIMENSIONS INC

K 392,001 FMV
(143) MEDICAL DIMENSIONS INC

L 268,250 GAAP
(144) MOUNTAIN VIEW NURSING HOME INC

L 1,140,940 GAAP
(145) CMC HEALTHCARE SYS MED PROF LIAB TR

S 2,181,870 GAAP
(146) CMC HEALTHCARE SYS MED PROF LIAB TR

M 1,279,441 GAAP
(147) GEISINGER MEDICAL MANAGEMENT CORP

M 1,438,997 GAAP
(148) GEISINGER-SCA HOLDINGS LLC

B 4,702,828 GAAP
(149) GEISINGER-SCA HOLDINGS LLC

C 70,259 GAAP
(150) LACKAWANNA PHYSICIANS AMB SURG CTR

L 4,168 GAAP
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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 section 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) 2012
Schedule R (Form 990) 2012
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
ADDITIONAL INFORMATION SCHEDULE R FORM 990 SCHEDULE R PART V TRANSACTIONS WITH RELATED ORGANIZATIONS AS SHOWN IN THE RESPONSE TO FORM 990 SCHEDULE R COMMUNITY MEDICAL CENTER IS CLOSELY AFFILIATED WITH SEVERAL OTHER ORGANIZATIONS IN THE NORMAL COURSE OF THE OPERATIONS OF THESE AFFILIATED ORGANIZATIONS THERE ARE NUMEROUS INTER ORGANIZATIONAL TRANSACTIONS WHICH MAY INCLUDE SALES EXCHANGES AND LEASES OF PROPERTY EXTENSIONS OF CREDIT FURNISHING OF GOODS SERVICES AND FACILITIES AND TRANSFERS OF ASSETS THESE INTER ORGANIZATION TRANSACTIONS PROMOTE THE EFFICIENT OPERATION OF THE VARIOUS ORGANIZATIONS AND THE ATTAINMENT OF THEIR TAX EXEMPT PURPOSES THESE TYPES OF INTER ORGANIZATION TRANSACTIONS WERE DESCRIBED TO THE INTERNAL REVENUE SERVICE IN A RULING APPLICATION AND WERE RECOGNIZED BY THE NATIONAL OFFICE OF THE IRS IN A SERIES OF GHS PRIVATE RULINGS AS BEING ENTIRELY CONSISTENT WITH THE ORGANIZATIONS TAX EXEMPT STATUS

Additional Data


Software ID:  
Software Version:  






TY 2012 AffiliatedGroupSchedule
Name:
COMMUNITY MEDICAL CENTER
EIN: 24-0862246
Affiliated Group Business Name:
GEISINGER HEALTH SYSTEM FOUNDATION
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-1995911
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
0
Total Exempt Purpose Expenditures:
0
Lobbying Nontaxable Amount:
0
Grassroots Nontaxable Amount:
0
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
GEISINGER MEDICAL CENTER
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
24-0795959
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
29,290
Total Lobbying Expenditures:
29,290
Other Exempt Purpose Expenditures:
909,722,334
Total Exempt Purpose Expenditures:
909,751,624
Lobbying Nontaxable Amount:
310,143
Grassroots Nontaxable Amount:
77,536
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
GEISINGER CLINIC
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-6291113
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
37,359
Total Lobbying Expenditures:
37,359
Other Exempt Purpose Expenditures:
777,143,985
Total Exempt Purpose Expenditures:
777,181,344
Lobbying Nontaxable Amount:
264,949
Grassroots Nontaxable Amount:
66,237
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
GEISINGER SYSTEM SERVICES
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-2164794
Electing Organization Checkbox:
Total Grassroots Lobbying:
1,437
Total Direct Lobbying:
560,350
Total Lobbying Expenditures:
561,787
Other Exempt Purpose Expenditures:
512,135,793
Total Exempt Purpose Expenditures:
512,697,580
Lobbying Nontaxable Amount:
174,784
Grassroots Nontaxable Amount:
43,696
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
GEISINGER WYOMING VALLEY MEDICAL CTR
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-1996150
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
7,636
Total Lobbying Expenditures:
7,636
Other Exempt Purpose Expenditures:
413,534,594
Total Exempt Purpose Expenditures:
413,542,230
Lobbying Nontaxable Amount:
140,981
Grassroots Nontaxable Amount:
35,245
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
MARWORTH
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-2171417
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
5,667
Total Lobbying Expenditures:
5,667
Other Exempt Purpose Expenditures:
12,161,456
Total Exempt Purpose Expenditures:
12,167,123
Lobbying Nontaxable Amount:
4,148
Grassroots Nontaxable Amount:
1,037
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
HERSHEY MEDICAL CENTER
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-2891807
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
0
Total Exempt Purpose Expenditures:
0
Lobbying Nontaxable Amount:
0
Grassroots Nontaxable Amount:
0
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
GEISINGER COMMUNITY HEALTH SERVICES
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-2967235
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
4,568
Total Lobbying Expenditures:
4,568
Other Exempt Purpose Expenditures:
40,789,275
Total Exempt Purpose Expenditures:
40,793,843
Lobbying Nontaxable Amount:
13,907
Grassroots Nontaxable Amount:
3,477
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
GEISINGER INSURANCE CORP RRG
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
14-1909894
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
986,617
Total Exempt Purpose Expenditures:
986,617
Lobbying Nontaxable Amount:
336
Grassroots Nontaxable Amount:
84
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
GEISINGER MED CTR PROF LIAB TRUST
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
25-6220019
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
5,147
Total Exempt Purpose Expenditures:
5,147
Lobbying Nontaxable Amount:
2
Grassroots Nontaxable Amount:
0
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
GEISINGER EXCESS COV PROF LIAB TRUST
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-6852932
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
0
Total Exempt Purpose Expenditures:
0
Lobbying Nontaxable Amount:
0
Grassroots Nontaxable Amount:
0
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
COMMUNITY MEDICAL CENTER
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
24-0862246
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
2,518
Total Lobbying Expenditures:
2,518
Other Exempt Purpose Expenditures:
184,555,653
Total Exempt Purpose Expenditures:
184,558,171
Lobbying Nontaxable Amount:
62,918
Grassroots Nontaxable Amount:
15,729
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
COMMUNITY MED CTR HEALTHCARE SYSTEM
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-2279376
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
15,061
Total Exempt Purpose Expenditures:
15,061
Lobbying Nontaxable Amount:
5
Grassroots Nontaxable Amount:
1
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
COMMUNITY MED CTR HLTHCARE SYS TRUST
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
04-6990600
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
1,279,441
Total Exempt Purpose Expenditures:
1,279,441
Lobbying Nontaxable Amount:
436
Grassroots Nontaxable Amount:
109
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
COMMUNITY MEDICAL CARE INC
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-2429776
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
1,029
Total Lobbying Expenditures:
1,029
Other Exempt Purpose Expenditures:
10,186,478
Total Exempt Purpose Expenditures:
10,187,507
Lobbying Nontaxable Amount:
3,473
Grassroots Nontaxable Amount:
868
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
MOUNTAIN VIEW NURSING HOME INC
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-2568288
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
16,731,974
Total Exempt Purpose Expenditures:
16,731,974
Lobbying Nontaxable Amount:
5,704
Grassroots Nontaxable Amount:
1,426
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
GEISINGER-BLOOMSBURG HOSPITAL
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-2193572
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
209
Total Lobbying Expenditures:
209
Other Exempt Purpose Expenditures:
36,430,143
Total Exempt Purpose Expenditures:
36,430,352
Lobbying Nontaxable Amount:
12,419
Grassroots Nontaxable Amount:
3,105
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
BLOOMSBURG PHYSICIAN SERVICES
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-2979856
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
2,231,806
Total Exempt Purpose Expenditures:
2,231,806
Lobbying Nontaxable Amount:
761
Grassroots Nontaxable Amount:
190
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
GEISINGER-BLOOMSBURG HEALTH CARE CTR
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-2242854
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
9,965,074
Total Exempt Purpose Expenditures:
9,965,074
Lobbying Nontaxable Amount:
3,397
Grassroots Nontaxable Amount:
849
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
COLUMBIA-MONTOUR HOME HEALTH SVCS
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
23-1704399
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
112
Total Lobbying Expenditures:
112
Other Exempt Purpose Expenditures:
4,748,651
Total Exempt Purpose Expenditures:
4,748,763
Lobbying Nontaxable Amount:
1,619
Grassroots Nontaxable Amount:
405
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0
Affiliated Group Business Name:
BLOOMSBURG HOSPITAL MED PROFL SIT
 
Address. Either US or Foreign Type:
100 NORTH ACADEMY AVENUE
DANVILLE, PA17822    
EIN:
14-6222837
Electing Organization Checkbox:
Total Grassroots Lobbying:
0
Total Direct Lobbying:
0
Total Lobbying Expenditures:
0
Other Exempt Purpose Expenditures:
52,214
Total Exempt Purpose Expenditures:
52,214
Lobbying Nontaxable Amount:
18
Grassroots Nontaxable Amount:
4
Tot Lobbying Grassroot Minus Non Tx:
0
Tot Lobby Expend Mns Lobbying Non Tx:
0
Share Of Excess Lobbying:
0