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 private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 07-01-2013 , 2013, and ending 06-30-2014
BCheck if applicable:
CName of organization
GEISINGER-BLOOMSBURG HOSPITAL
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
100 NORTH ACADEMY AVENUE MC 49-70
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
DANVILLE, PA17822
D Employer identification number

23-2193572
E Telephone number

G Gross receipts $ 34,893,086
F Name and address of principal officer:
GLENN D STEELE MD PHD
100 NORTH ACADEMY AVENUE MC 22-01
DANVILLE,PA17822
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.GEISINGER.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1982
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 ACCESS TO QUALITY POPULATION HEALTH AND HOSPITAL SERVICES THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE.
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 2013 (Part V, line 2a) ...... 5 514
6 Total number of volunteers (estimate if necessary) ............. 6 80
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 42,504 22,761
9 Program service revenue (Part VIII, line 2g) ......... 32,121,758 32,301,566
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 145,251 258,790
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 358,827 2,230,830
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 32,668,340 34,813,947
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 300 300
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) 19,825,007 19,045,488
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).... 16,605,045 23,697,067
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 36,430,352 42,742,855
19 Revenue less expenses. Subtract line 18 from line 12....... -3,762,012 -7,928,908
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 27,824,618 31,379,895
21 Total liabilities (Part X, line 26)............. 37,693,887 42,104,701
22 Net assets or fund balances. Subtract line 21 from line 20..... -9,869,269 -10,724,806
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 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING ACCESS TO QUALITY POPULATION HEALTH AND HOSPITAL SERVICES THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE.
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 $ 38,842,713 including grants of $ 300 ) (Revenue $ 34,103,989 )
TO OPERATE A 72 BED GENERAL MEDICAL AND SURGICAL HOSPITAL WHICH PROVIDED 5,294 PATIENT DAYS; 3,507 BEHAVIOR HEALTH SERVICES PATIENT DAYS; 530 NURSERY PATIENT DAYS; 2,255 SAME DAY SURGICAL PROCEDURES; 15,778 EMERGENCY ROOM VISITS DURING THE YEAR ENDED JUNE 30, 2014. THE ORGANIZATION ALSO PROVIDED CHARTIY CARE TO PATIENTS WHO MET CERTAIN CRITERIA WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. SEE SCHEDULE O I.GENERAL INFORMATION GEISINGER-BLOOMSBURG HOSPITAL (GBH), A 501(C)(3) NOT-FOR-PROFIT CORPORATION AND MEMBER OF GEISINGER HEALTH SYSTEM, OWNS AND OPERATES A 72 BED, ACUTE CARE, HOSPITAL IN BLOOMSBURG, PA. GBH IS CONVENIENTLY LOCATED ONLY A FEW MILES FROM SEVERAL MAJOR HIGHWAYS THROUGHOUT CENTRAL PA. THE FACILITY OPENED IN 1905, ANSWERING A PRESSING NEED FOR HEALTH AND WELLNESS CARE IN THE COMMUNITY. GBH PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. SERVICES OFFERED BY GBH INCLUDE: GENERAL MEDICAL CARE PROVIDED BY IN-HOUSE HOSPITALIST AND SUPPORTED BY CONSULTATIVE SERVICES IN THE AREAS OF CARDIOLOGY, NEUROLOGY AND PULMONOLOGY. EMERGENCY DEPARTMENT IS COMMITTED TO PROVIDING HIGH QUALITY, PROMPT EMERGENCY SERVICES. GBH'S ED IS STAFFED 24/7 WITH FULL-TIME PHYSICIANS AND NURSES THAT ARE TRAINED IN EMERGENCY MEDICINE AND ARE PREPARED TO TREAT CASES FROM PEDIATRICS TO CRITICAL CARE. IMMEDIATE ACCESS TO LABORATORY SERVICES, X-RAYS, CAT SCANS, 3D-4D ULTRASOUND, MRI AND SURGICAL SERVICES. MOST INSURANCES, INCLUDING MEDICARE AND MEDICAID, ARE ACCEPTED AND NO PATIENT IS REFUSED TREATMENT BECAUSE OF INABILITY TO PAY. THE WOMAN'S HEALTH UNIT FOCUSES ON ALL ASPECTS OF WOMEN'S HEALTH AND EDUCATION, PROVIDING OBSTETRICAL AND GYNECOLOGICAL CARE FOR WOMEN OF ALL AGES. SERVICES INCLUDE BUT NOT LIMITED TO ROUTINE VISITS AND TREATMENTS, PREVENTATIVE HEALTHCARE, BIRTH CONTROL EDUCATION, FAMILY PLANNING, OBSTETRICS, SURGERY & SURGERY CONSULTATIONS, MENOPAUSE COUNSELING, MIDWIFERY, LACTATION EDUCATION AND SUPPORT. MENTAL HEALTH & PSYCHIATRIC SERVICES IS A DESIGNATED COUNT 302 TRIAGE SITE THAT PROVIDES BOTH INPATIENT AND OUTPATIENT SERVICES DESIGNED TO HELP INDIVIDUALS LIVE AS INDEPENDENTLY AS POSSIBLE. ADULTS TO GERIATRICS CAN ACCESS QUICK, EFFICIENT ADMISSION 24/7 AND RECEIVE TREATMENT THROUGH ONE- ON-ONE PATIENT COUNSELING, TREATMENT MEETINGS AND ACTIVITIES 7 DAYS PER WEEK. A PSYCHIATRIST IS AVAILABLE ON A DAILY BASIS. ADMISSIONS ARE CONFIDENTIAL AND MAY BE MADE BY PROFESSIONALS AS WELL BY INDIVIDUALS CONCERNED ABOUT THEMSELVES OR OTHERS. INPATIENT CARE IS PROVIDED THROUGH MULTIPLE PROFESSIONALS WHO COMPRISE THE TREATMENT TEAM. OTHER SERVICES INCLUDE: CARDIAC SERVICES SURGERY SPECIALTIES- RADIOLOGY ORTHOPEDIC ICCU UROLOGY LABORATORY SERVICES PHYSICAL THERAPY OTOLARYNGOLOGY GYNECOLOGY RESPIRATORY SERVICES GENERAL SURGERY II. UNCOMPENSATED CARE GEISINGER-BLOOMSBURG HOSPITAL RECOGNIZES ITS MISSION IN THIS REGARD; GBH PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH- RELATED ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A.CHARITY CARE THE PRIMARY CONCERN OF GBH IS THE DELIVERY OF HEALTH CARE TO ALL CITIZENS OF CENTRAL PENNSYLVANIA REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GBH INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. THE COST OF PROVIDING CHARITY CARE WAS APPROXIMATELY 937,734 DURING THE FISCAL YEAR ENDED JUNE 30, 2014. B.MEDICARE/MEDICAID/OTHER GOVERNMENTAL IN RECOGNIZING ITS MISSION TO THE COMMUNITY, GBH PROVIDES SERVICES TO THE ELDERLY (MEDICARE) AND THE INDIGENT (MEDICAID), AS WELL AS OTHERS. GBH PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS TO THE EXTENT THE GOVERNMENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTH CARE. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. THE COST OF PROVIDING HEALTHCARE SERVICES TO MEDICARE AND MEDICAID PATIENTS EXCEEDED REIMBURSEMENT BY APPROXIMATELY 10,630,156 DURING THE FISCAL YEAR ENDED JUNE 30, 2014. C.OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GBH PROVIDES SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2014, WAS 414,745. III.COMMUNITY HEALTH, EDUCATION, AND OUTREACH GBH STRIVES TO BE A VALUABLE RESOURCE FOR THE COMMUNITY AND ITS RESIDENTS. GBH PROVIDES MANY REDUCED-PRICE SERVICES AND FREE PROGRAMS THROUGHOUT THE YEAR THAT SERVE COMMUNITY HEALTH NEEDS. THESE SERVICES AND PROGRAMS INCLUDE SUPPORT GROUPS, COMMUNITY HEALTH EDUCATION, AND OTHER UNIQUE SERVICES. A. SUPPORT GROUPS THE COST TO GBH OF PROVIDING SERVICES AND/OR FACILITIES FOR SUPPORT GROUP MEETINGS WAS 3,608 DURING THE FISCAL YEAR WITH NUMEROUS ATTENDEES. GBH CONTINUES TO MAKE INROADS WITH THE NEIGHBORING BLOOMSBURG UNIVERSITY WITH INVOLVEMENT BETWEEN LEADERSHIP AND STUDENTS WHO ARE INTEREST IN COMMUNITY HEALTH CARE. THE SUPPORT GROUPS INCLUDED: BLOOMSBURG RACIAL & GENDER EQUITY COMMUNITY SUPPORT PROGRAM TASK FORCE COMMUNITY MEMBER MYASTHENIA GRAVIS SUPPORT GROUPS B. HEALTH SCREENING IN FISCAL YEAR 2014, GBH PROVIDED FREE MENTAL HEALTH SCREENING AT A COST OF 271 WITH 30 PEOPLE SCREENED. C. HEALTH EDUCATION GBH SPONSORS REGULAR COMMUNITY EDUCATION PROGRAMS. THE APPROXIMATE COST IS 12,833 WITH MORE THAN 25,000 ATTENDEES ON TOPICS SUCH AS: COMMUNITY NUTRITION PRESENTATIONS EDUCATIONAL SCHOOL PROGRAMS DENTAL EDUCATION HEALTH FAIRS D. COOPERATIVE COMMUNITY VENTURES IN CONJUNCTION WITH CHARITABLE COMMUNITY ORGANIZATIONS AND/OR BUSINESS, GBH PARTICIPATED IN ACTIVITIES AT A COST TO GBH OF 16,105. SOME OF THESE ACTIVITIES INCLUDE: UNITED WAY VETERAN'S DINNER IV. VOLUNTEER SERVICES THE VOLUNTEERS OF GEISINGER BLOOMSBURG HOSPITAL ARE AN ACTIVE AND VITAL PART OF THE ACTIVITIES OF THE HOSPITAL. THE HOURS OF VOLUNTEER SERVICES ARE IMPORTANT CONTRIBUTION TO THE MISSION OF GBH. VOLUNTEERS FROM LOCAL COMMUNITIES HAVE CONTRIBUTED 10,068 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTHCARE OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND "WELLNESS" PROGRAMS. V.COMMUNITY BENEFITS SUMMARY CHARITY CARE 937,734 MEDICARE/MEDICAID/OTHER GOVERNMENTAL 10,630,156 OTHER UNCOMPENSATED PATIENT SERVICES 414,745 COMMUNITY HEALTH, EDUCATION, OUTREACH AND OTHER 32,817 VOLUNTEER SERVICES (VALUED AT 1/1/2014 PA STATEWIDE AVERAGE WEEKLY WAGE) 234,584 TOTAL 12,250,036 VI. STATISTICS GEISINGER-BLOOMSBURG HOSPTIAL FISCAL YEAR ENDED JUNE 30, 2014 ADMISSIONS (INCLUDING NEWBORNS) 2,270 ADMISSIONS (EXCLUDING NEWBORNS) 2,042 OUTPATIENT VISITS INCLUDING EMERGENCY DEPARTMENT 33,254 AVERAGE LENGTH OF STAY 4.2 PERCENT OF OCCUPANCY (EXCLUDING NEWBORNS) 33.50% PATIENT SERVICE DAYS (EXCLUDING NEWBORNS) 8,801 TOTAL OR CASES 2,650 LICENSED BEDS (EXCLUDING BASSINETS) 72 BASSINETS IN NURSERY 10
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 expensesMediumBullet38,842,713
Form 990 (2013)
Form 990 (2013)
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)? ...
2
 
No
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 IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 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
 
No
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 other assistance to or for any foreign organization? 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 other assistance to or for foreign individuals? 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 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II...
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
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 25a................
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
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, 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
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
 
No
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 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
22
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
514
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
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
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
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
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 (2013)
Form 990 (2013)
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 or note to any line 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
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
PA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletKEVIN LANCIOTTIVP FINANCE CFO100 NORTH ACADEMY AVE MC 01-50DANVILLEPA17822 (570) 214-6181
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) WILLIAM H ALEXANDER........................................................................
DIRECTOR
 .25
.......................6.00 		X           0 0 0
(2) E ALLEN DEAVER........................................................................
DIRECTOR
 .25
.......................4.75 		X           0 0 0
(3) DORRANCE R BELIN ESQUIRE........................................................................
VICE CHAIR,
 .25
.......................4.25 		X           0 0 0
(4) RICHARD A GRAFMYRE........................................................................
DIRECTOR
 .25
.......................5.75 		X           0 0 0
(5) WILLIAM R GRUVER........................................................................
DIRECTOR
 .25
.......................5.00 		X           0 0 0
(6) FRANK M HENRY........................................................................
DIRECTOR
 .25
.......................4.75 		X           0 0 0
(7) THOMAS H LEE JR MD........................................................................
DIRECTOR
 .25
.......................5.50 		X           0 0 0
(8) GLENN D STEELE JR MD PHD........................................................................
PRES, CHAIR,
  
.......................40.00 		X   X       0 2,201,016 451,279
(9) ROBERT E POOLE........................................................................
DIRECTOR
 .25
.......................5.00 		X           0 0 0
(10) DON A ROSINI........................................................................
DIRECTOR
 .25
.......................6.00 		X           0 0 0
(11) ROBERT L TAMBUR........................................................................
DIR., VICE C
 .25
.......................4.75 		X           0 0 0
(12) DAVID J FELICIO ESQUIRE........................................................................
CLO, SECRETA
  
.......................40.00 		    X       0 659,899 97,523
(13) EDWARD J ZYCH ESQUIRE........................................................................
ACLO, ASST.
  
.......................40.00 		    X       0 339,360 66,915
(14) KEVIN F BRENNAN CPA FHFMA........................................................................
EVP, FINANCE
  
.......................40.00 		    X       0 983,365 207,098
(15) STEPHEN PAOLUCCI MD........................................................................
CMO
  
.......................40.00 		    X       0 463,689 41,092
(16) LISSA L BRYAN SMITH........................................................................
CAO
  
.......................40.00 		    X       0 341,533 32,608
(17) FRANK J TREMBULAK........................................................................
SR VP, TREAS
  
.......................40.00 		    X       0 1,165,670 221,282
Form 990 (2013)
Form 990 (2013)
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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) JEAN R THOMAS CRNA........................................................................
CRNA
 40.00
.......................   		        X   216,890 0 7,642
(19) JOSEPH P RUDA CRNA........................................................................
CRNA
 40.00
.......................   		        X   252,854 75 15,879
(20) THOMAS G SMITH CRNA........................................................................
CRNA
 40.00
.......................   		        X   6,489 345,161 38,521
(21) REGIS CABONOR........................................................................
CEO
 40.00
.......................   		        X   273,389 0 0
(22) JOSEPH M DEVITO........................................................................
CFO
 40.00
.......................   		        X   241,562 0 0
(23) PATRICK J ERWIN MD........................................................................
FORMER OFFIC
  
.......................40.00 		          X 0 373,251 44,178














1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 991,184 6,873,019 1,224,017
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet17
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
LABORATORY CORPORATION OF AMERICA, PO BOX 12140BURLINGTONNC272162140 LAB SERVICES 825,158
PYRAMID CONSTRUCTION SERV, 840 N FRONT STREETWORMLEYSBURGPA17043 CONSTRUCTION 236,423
MRO CORPORATION, PO BOX 61507KING OF PRUSSIAPA19406 ABSTRACTING SVC 170,085
HCSC LAUNDRY, 2171 28TH ST SWALLENTOWNPA18103 LINEN SERVICES 152,143
CPSI, PO BOX 850309MOBILEAL366850309 COMPUTER SERV 139,239
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet6
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		22,761
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 22,761
Program Service RevenueAmt Business Code
2a PATIENT SERVICE REVENUE 621110 30,580,477 30,580,477    
b IC NON PROFIT SHARED SERVICES 531120 926,831 926,831    
c RENTAL INCOME 541900 794,258     794,258
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 32,301,566
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 278,069     278,069
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 213,196  
b Less: rental expenses 59,360  
c Rental income or (loss) 153,836  
d Net rental income or (loss).......MediumBullet 153,836     153,836
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   500
b Less: cost or other basis and sales expenses   19,779
c Gain or (loss)   -19,279
d Net gain or (loss)..........MediumBullet -19,279     -19,279
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 REVENUE EHR 900099 1,802,425 1,802,425    
b CAFETERIA SALES 900099 176,535     176,535
c GIFT SHOP SALES 900099 41,192     41,192
d All other revenue .... 56,842     56,842
e Total. Add lines 11a–11d ...... MediumBullet 2,076,994
12 Total revenue. See Instructions......MediumBullet 34,813,947 33,309,733   1,481,453
Form 990 (2013)
Form 990 (2013)
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 or note to any line 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    
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 300 300
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 ....        
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 14,544,624 13,210,302 1,334,322  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 477,398 433,602 43,796  
9 Other employee benefits ....... 2,886,988 2,622,136 264,852  
10 Payroll taxes ........... 1,136,478 1,032,218 104,260  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 5,162 5,000 162  
c Accounting ........... 25,484 3,700 21,784  
d Lobbying ........... 196   196  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 18,417 8,297 10,120  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 2,147,148 1,605,010 542,138  
12 Advertising and promotion .... 6,303 5,000 1,303  
13 Office expenses ....... 1,325,146 1,133,067 192,079  
14 Information technology ...... 96,595 89,598 6,997  
15 Royalties ..        
16 Occupancy ........... 1,131,030 998,007 133,023  
17 Travel ............ 22,236 14,599 7,637  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 4,822 4,822    
20 Interest ........... 139,066 122,710 16,356  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 2,312,262 2,057,097 255,165  
23 Insurance .............. 509,625 356,738 152,887  
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 INTER-ENTITY SERVICES 9,658,044 8,886,497 771,547  
b MEDICAL SUPPLIES 4,613,378 4,596,174 17,204  
c UNCOLLECTIBLE EXPENSE 1,582,269 1,582,269    
d BOOK, LICENSE, FEE, DUE 97,561 75,564 21,997  
e All other expenses 2,323 6 2,317  
25 Total functional expenses. Add lines 1 through 24e 42,742,855 38,842,713 3,900,142 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 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 1,169,981 1 165,319
2 Savings and temporary cash investments ......... 1,655,838 2 2,510,813
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 2,171,207 4 1,712,432
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 .............   7  
8 Inventories for sale or use .............. 393,258 8 132,758
9 Prepaid expenses and deferred charges .......... 146,886 9 158,261
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 19,759,403
b Less: accumulated depreciation ..... 10b 4,356,602 12,687,751 10c 15,402,801
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..... 143,125 13 167,675
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 9,456,572 15 11,129,836
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 27,824,618 16 31,379,895
Liabilities 17 Accounts payable and accrued expenses ......... 2,477,761 17 1,741,267
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities .............   20 22,927,320
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 .... 17,448,058 24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 17,768,068 25 17,436,114
26 Total liabilities. Add lines 17 through 25......... 37,693,887 26 42,104,701
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 .............. -18,238,545 27 -19,890,232
28 Temporarily restricted net assets ........... 81,799 28 -43,088
29 Permanently restricted net assets ........... 8,287,477 29 9,208,514
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 ........... -9,869,269 33 -10,724,806
34 Total liabilities and net assets/fund balances ........ 27,824,618 34 31,379,895
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
34,813,947
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
42,742,855
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-7,928,908
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
-9,869,269
5
Net unrealized gains (losses) on investments ...............
5
839,238
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
6,234,135
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
-10,724,806
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line 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 (2013)
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.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
GEISINGER-BLOOMSBURG HOSPITAL
 
Employer identification number

23-2193572
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. 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) 2013

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.SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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
GEISINGER-BLOOMSBURG HOSPITAL
 
Employer identification number

23-2193572
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) 2013

Schedule C (Form 990 or 990-EZ) 2013
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).
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) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
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) .................    
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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2013


Schedule C (Form 990 or 990-EZ) 2013
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? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
196
j
Total. Add lines 1c through 1i ...............................
196
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
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
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.
Return Reference Explanation
SCHEDULE C, PART II-B, LINE 1 THE LOBBYING EXPENSE REPORTED ON SCHEDULE C REPRESENTS THE PORTION OF ANNUAL DUES PAYMENTS TO TRADE ASSOCIATIONS ATRIBUTABLE TO LOBBYING ACTIVITIES.
Schedule C (Form 990 or 990EZ) 2013

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. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
GEISINGER-BLOOMSBURG HOSPITAL
 
Employer identification number

23-2193572
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) 2013

Schedule D (Form 990) 2013
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 .... 8,369,276 7,917,508 4,333,417 4,128,199 3,972,720
b Contributions ........ 23,102 51,067 4,656,499 282,178 357,290
c Net investment earnings, gains, and losses 174   -250,365 270,432 175,353
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		20,160 34,087 822,043 347,392 377,164
f Administrative expenses ....          
g End of year balance ...... 9,165,426 8,369,275 7,917,508 4,333,417 4,128,199
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 Bullet99.000 %
c
Temporarily restricted endowment SchDMd Bullet1.000 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. 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 .................   422,883 422,883
b Buildings ................   8,785,542 1,582,960 7,202,582
c Leasehold improvements ............        
d Equipment ................   8,647,738 2,664,480 5,983,258
e Other .................   1,573,228 109,162 1,464,066
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 15,072,789
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) BENE. INTEREST, PERPETUAL TRUST 9,126,715
(2) DEFERRED COMPENSATION 834,436
(3) DUE FROM AFFILIATES 483,979
(4) 2013 CAP POOL SERIES D 355,000
(5) 2013 CAP POOL SERIES A 200,000
(6) TRUST & ENDOWMENT AND RESTRICTED 121,881
(7) ACCRUED RENT AND OTHER RECEIVABLES 4,836
(8) ACCRUED INTEREST 2,989

Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 11,129,836
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
PENSION COSTS 7,200,959
DUE TO AFFILIATES 4,300,400
EST. 3RD PARTY PAYOR SETTLEMENTS 3,242,294
MEDICAL MALPRACTICE CLAIMS 2,274,898
PT CREDIT BAL AND PT REFUNDS 222,682
MEDICAL STAFF AND OTHER LIABILITY 162,699
DEFERRED RENTS/SECURITY DEPOSITS 32,182


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 17,436,114
2. Liability for uncertain tax positions 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) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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
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.
Return Reference Explanation
SCHEDULE D, PAGE 2, PART V, LINE 4 PART V LINE 4 - PERMANENTLY RESTRICTED ENDOWMENT FUNDS ARE HELD AT UNRELATED FINANCIAL INSTITUTIONS WHO ARE RESPONSIBLE FOR MAINTAINING AND INVESTING THE PRINCIPLE AND THE DISTRIBUTION OF THE FUNDS IN ACCORDANCE WITH THE DONOR STIPULATIONS. DISTRIBUTIONS FROM THE FUNDS ARE MADE BY THE RESPECTIVE FINANCIAL INSTITIONS TO GEISINGER BLOOMSBURG HOSPITAL WHO USES THE FUNDS AS DIRECTED IN THE TRUST AGREEMENTS.
SCHEDULE D, PAGE 4, PART XIII PART X - LIABILITY UNDER FIN 48 FOOTNOTE EFFECTIVE JULY 1, 2007, GEISINGER HEALTH SYSTEM(1) (GHS) ADOPTED ACCOUNTING STANDARDS CODIFICATION 740 (FIN 48),(FORMERLY KNOWN AS "STATEMENT 109: ACCOUNTING FOR INCOME TAXES" OR "FAS 109"). FIN 48 CLARIFIES THE ACCOUNTING AND REPORTING FOR INCOME TAXES WHERE INTERPRETATION OF THE TAX LAW MAY BE UNCERTAIN. FIN 48 PRESCRIBES A COMPREHENSIVE MODEL FOR THE FINANCIAL STATEMENT RECOGNITION, MEASUREMENT, PRESENTATION AND DISCLOSURE OF INCOME TAX UNCERTAINTIES WITH RESPECT TO POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN INCOME TAX RETURNS. THE ADOPTION OF FIN 48 HAD NO IMPACT ON UNRESTRICTED NET NET ASSETS AS OF JUNE 30, 2014 OR ANY PREVIOUS YEARS SINCE ADOPTION. ACCORDINGLY, NO FIN 48 FOOTNOTE DISCLOSURE WAS MADE IN THE JUNE 30, 2014 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) 2013

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.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
GEISINGER-BLOOMSBURG HOSPITAL
 
Employer identification number

23-2193572
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) .. 		    937,734   937,734 2.190 %
b Medicaid (from Worksheet 3,
column a) .... 		    6,426,253 2,376,888 4,049,365 9.470 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		    160,101 86,209 73,892 0.170 %
d Total Financial Assistance
and Means-Tested
Government Programs . 		    7,524,088 2,463,097 5,060,991 11.840 %
Other Benefits
     32,817   32,817 0.080 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		           
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		           
j Total. Other Benefits ..     32,817   32,817 0.080 %
k Total. Add lines 7d and 7j .     7,556,905 2,463,097 5,093,808 11.920 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
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
1,582,269
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
6,045,275
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
10,166,479
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-4,121,204
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) 2013
Schedule H (Form 990) 2013
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, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 GEISINGER-BLOOMSBURG HOSPITAL
549 FAIR STREET
BLOOMSBURG,PA17815
WWW.GEISINGER.ORG
025001 		X X         X      
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
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)
GEISINGER-BLOOMSBURG HOSPITAL
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility 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 persons who represent the broad interests 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
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
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) 2013
Schedule H (Form 990) 2013
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: 200.000000000000%
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: 380.000000000000%
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
i
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 individual’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 individual’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) 2013
Schedule H (Form 990) 2013
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 individual 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 individual 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) 2013
Schedule H (Form 990) 2013
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference Explanation
FACILITY 1, GEISINGER-BLOOMSBURG HOSPITAL - PART V, LINE 3 ACTION HEALTH, A COLLABORATIVE PARTNERSHIP IN THE CENTRAL SUSQUEHANNA VALLEY THAT INCLUDES GEISINGER MEDICAL CENTER, GEISINGER HEALTH SOUTH REHABILITATION HOSPITAL, GEISINGER SHAMOKIN AREA COMMUNITY HOSPITAL, EVANGELICAL COMMUNITY HOSPITAL, BLOOMSBURG HOSPITAL AND BLOOMSBURG UNIVERSITY CONTRACTED WITH TRIPP UMBACH TO FACILITATE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). (NOTE: THE CHNA WAS CONDUCTED PRIOR TO BLOOMSBURG HOSPITAL'S AFFILIATION WITH THE GEISINGER HEALTH SYSTEM EFFECTIVE JULY 1, 2012. ON THAT DATE, BLOOMSBURG HOPSITAL CHANGED ITS NAME TO GEISINGER-BLOOMSBURG HOSPITAL (G-BH).) THE CHNA WAS CONDUCTED BETWEEN NOVEMBER 2011 AND APRIL 2012 AND RESULTED IN FIVE SEPARATE CHNA REPORTS: FOUR THAT ASSESSED THE HEALTH NEEDS OF THE COMMUNITIES WITHIN EACH HOSPITAL SERVICE AREA AS WELL AS AN ASSESSMENT OF THE REGIONAL NEEDS WITHIN THE FIVE-COUNTY SERVICE AREA (COLUMBIA, MONTOUR, NORTHUMBERLAND, SNYDER AND UNION COUNTY). TRIPP UMBACH IS A RECOGNIZED NATIONAL LEADER IN CONDUCTING CHNA, HAVING CONDUCTED MORE THAN 200 CHNA OVER THE PAST 20 YEARS. PAUL UMBACH, FOUNDER AND PRESIDENT OF TRIPP UMBACH IS AMONG THE MOST EXPERIENCED COMMUNITY HEALTH PLANNERS IN THE NATION, HAVING DIRECTED PROJECTS IN EVERY STATE AND INTERNATIONALLY. TRIPP UMBACH HAS WRITTEN TWO NATIONAL GUIDE BOOKS ON THE TOPIC OF COMMUNITY HEALTH AND HAS PRESENTED AT MORE THAN 50 STATE AND NATIONAL HEALTH CONFERENCES. THE CHNA PROCESS INCLUDED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY GEISINGER-BLOOMSBURG HOSPITAL, INCLUDING THOSE WITH SPECIAL KNOWLEDGE AND EXPERTISE IN PUBLIC HEALTH ISSUES. COMMUNITY HEALTH ASSESSMENT PLANNING: A SERIES OF MEETINGS WERE CONDUCTED CONSISTING OF LEADERSHIP FROM GBH AND THE OTHER PARTICIPATING HOSPITALS AND ORGANIZATIONS: GEISINGER SHAMOKIN AREA COMMUNITY HOSPITAL, EVANGELICAL COMMUNITY HOSPITAL, GEISINGER MEDICAL CENTER AND BLOOMSBURG UNIVERSITY. SECONDARY DATA: THE HEALTH OF THE COMMUNITY IS LARGELY RELATED TO THE CHARACTERISTICS OF ITS RESIDENTS. TRIPP UMBACH COMPLETED COMPREHENSIVE ANALYSIS OF HEALTH STATUS AND SOCIO-ECONOMIC FACTORS RELATED TO THE HEALTH OF RESIDENTS WITHIN THE COMMUNITY FROM EXISTING DATA SOURCES SUCH AS STATE AND COUNTY PUBLIC HEALTH AGENCIES, THE CENTERS FOR DISEASE CONTROL AND PREVENTION, COUNTY HEALTH RANKINGS, THOMSON REUTERS, COMMUNITY NEED INDEX, PREVENTION QUALITY INDICATORS INDEX, THE CENTER OF RURAL PA, PENNDOT AND OTHER DATA SOURCES. INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS: WORKING CLOSELY WITH ACTION HEALTH, TRIPP UMBACH IDENTIFIED LEADERS FROM ORGANIZATIONS THAT HAVE SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH AND A SERIES OF 18 INTERVIEWS WERE CONDUCTED WITH THESE KEY STAKEHOLDERS (I.E., GEISINGER MEDICAL CENTER, PENNSYLVANIA OFFICE OF RURAL HEALTH CARE, MONTOUR COUNTY ASSISTANCE OFFICE, AMONG OTHERS). FOCUS GROUPS WITH COMMUNITY RESIDENTS: TO ASSURE THAT COMMUNITY MEMBERS, INCLUDING UNDER-REPRESENTED RESIDENTS, WERE INCLUDED IN THE NEEDS ASSESSMENT, THREE FOCUS GROUPS WERE CONDUCTED BY TRIPP UMBACH. SECONDARY DATA WAS USED TO IDENTIFY HEALTH NEEDS AND DEFICITS IN TARGETED POPULATIONS. FOCUS GROUP AUDIENCES INCLUDED NURSES EMPLOYED BY A PUBLIC SCHOOL, SMALL BUSINESS OWNERS, FARMERS AND WORKING PROFESSIONALS WITH YOUNG CHILDREN. IDENTIFICATION OF TOP COMMUNITY HEALTH NEEDS: NEEDS WERE PRIORITIZED BY COMMUNITY LEADERS DURING A REGIONAL COMMUNITY HEALTH NEEDS IDENTIFICATION FORUM HELD APRIL 5, 2012. THE FINDINGS PRESENTED WERE FROM ANALYZING DATA, KEY STAKEHOLDERS INTERVIEWS AND FOCUS GROUP INPUTS. COMMUNITY LEADERS DISCUSSED THE DATA PRESENTED, SHARED THEIR VISIONS AND PLANS FOR COMMUNITY HEALTH IMPROVEMENT IN THEIR COMMUNITIES, AND IDENTIFIED THE TOP HEALTH NEEDS IN THE GBH COMMUNITY.
FACILITY 1, GEISINGER-BLOOMSBURG HOSPITAL - PART V, LINE 4 GEISINGER MEDICAL CENTER, GEISINGER HEALTH SOUTH REHABILITATION HOSPITAL, GEISINGER SHAMOKIN AREA COMMUNITY HOSPITAL, EVANGELICAL COMMUNITY HOSPITAL, AND GEISINGER-BLOOMSBURG HOSPITAL PARTICIPATED IN THE CHNA.
FACILITY 1, GEISINGER-BLOOMSBURG HOSPITAL - PART V, LINE 14G REGISTRATION PERSONNEL ALSO REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
FACILITY 1, GEISINGER-BLOOMSBURG HOSPITAL - PART V, LINE 3 ACTION HEALTH, A COLLABORATIVE PARTNERSHIP IN THE CENTRAL SUSQUEHANNA VALLEY THAT INCLUDES GEISINGER MEDICAL CENTER, GEISINGER HEALTH SOUTH REHABILITATION HOSPITAL, GEISINGER SHAMOKIN AREA COMMUNITY HOSPITAL, EVANGELICAL COMMUNITY HOSPITAL, BLOOMSBURG HOSPITAL AND BLOOMSBURG UNIVERSITY CONTRACTED WITH TRIPP UMBACH TO FACILITATE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). (NOTE: THE CHNA WAS CONDUCTED PRIOR TO BLOOMSBURG HOSPITAL'S AFFILIATION WITH THE GEISINGER HEALTH SYSTEM EFFECTIVE JULY 1, 2012. ON THAT DATE, BLOOMSBURG HOPSITAL CHANGED ITS NAME TO GEISINGER-BLOOMSBURG HOSPITAL (G-BH).) THE CHNA WAS CONDUCTED BETWEEN NOVEMBER 2011 AND APRIL 2012 AND RESULTED IN FIVE SEPARATE CHNA REPORTS: FOUR THAT ASSESSED THE HEALTH NEEDS OF THE COMMUNITIES WITHIN EACH HOSPITAL SERVICE AREA AS WELL AS AN ASSESSMENT OF THE REGIONAL NEEDS WITHIN THE FIVE-COUNTY SERVICE AREA (COLUMBIA, MONTOUR, NORTHUMBERLAND, SNYDER AND UNION COUNTY). TRIPP UMBACH IS A RECOGNIZED NATIONAL LEADER IN CONDUCTING CHNA, HAVING CONDUCTED MORE THAN 200 CHNA OVER THE PAST 20 YEARS. PAUL UMBACH, FOUNDER AND PRESIDENT OF TRIPP UMBACH IS AMONG THE MOST EXPERIENCED COMMUNITY HEALTH PLANNERS IN THE NATION, HAVING DIRECTED PROJECTS IN EVERY STATE AND INTERNATIONALLY. TRIPP UMBACH HAS WRITTEN TWO NATIONAL GUIDE BOOKS ON THE TOPIC OF COMMUNITY HEALTH AND HAS PRESENTED AT MORE THAN 50 STATE AND NATIONAL HEALTH CONFERENCES. THE CHNA PROCESS INCLUDED INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY GEISINGER-BLOOMSBURG HOSPITAL, INCLUDING THOSE WITH SPECIAL KNOWLEDGE AND EXPERTISE IN PUBLIC HEALTH ISSUES. COMMUNITY HEALTH ASSESSMENT PLANNING: A SERIES OF MEETINGS WERE CONDUCTED CONSISTING OF LEADERSHIP FROM GBH AND THE OTHER PARTICIPATING HOSPITALS AND ORGANIZATIONS: GEISINGER SHAMOKIN AREA COMMUNITY HOSPITAL, EVANGELICAL COMMUNITY HOSPITAL, GEISINGER MEDICAL CENTER AND BLOOMSBURG UNIVERSITY. SECONDARY DATA: THE HEALTH OF THE COMMUNITY IS LARGELY RELATED TO THE CHARACTERISTICS OF ITS RESIDENTS. TRIPP UMBACH COMPLETED COMPREHENSIVE ANALYSIS OF HEALTH STATUS AND SOCIO-ECONOMIC FACTORS RELATED TO THE HEALTH OF RESIDENTS WITHIN THE COMMUNITY FROM EXISTING DATA SOURCES SUCH AS STATE AND COUNTY PUBLIC HEALTH AGENCIES, THE CENTERS FOR DISEASE CONTROL AND PREVENTION, COUNTY HEALTH RANKINGS, THOMSON REUTERS, COMMUNITY NEED INDEX, PREVENTION QUALITY INDICATORS INDEX, THE CENTER OF RURAL PA, PENNDOT AND OTHER DATA SOURCES. INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS: WORKING CLOSELY WITH ACTION HEALTH, TRIPP UMBACH IDENTIFIED LEADERS FROM ORGANIZATIONS THAT HAVE SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH AND A SERIES OF 18 INTERVIEWS WERE CONDUCTED WITH THESE KEY STAKEHOLDERS (I.E., GEISINGER MEDICAL CENTER, PENNSYLVANIA OFFICE OF RURAL HEALTH CARE, MONTOUR COUNTY ASSISTANCE OFFICE, AMONG OTHERS). FOCUS GROUPS WITH COMMUNITY RESIDENTS: TO ASSURE THAT COMMUNITY MEMBERS, INCLUDING UNDER-REPRESENTED RESIDENTS, WERE INCLUDED IN THE NEEDS ASSESSMENT, THREE FOCUS GROUPS WERE CONDUCTED BY TRIPP UMBACH. SECONDARY DATA WAS USED TO IDENTIFY HEALTH NEEDS AND DEFICITS IN TARGETED POPULATIONS. FOCUS GROUP AUDIENCES INCLUDED NURSES EMPLOYED BY A PUBLIC SCHOOL, SMALL BUSINESS OWNERS, FARMERS AND WORKING PROFESSIONALS WITH YOUNG CHILDREN. IDENTIFICATION OF TOP COMMUNITY HEALTH NEEDS: NEEDS WERE PRIORITIZED BY COMMUNITY LEADERS DURING A REGIONAL COMMUNITY HEALTH NEEDS IDENTIFICATION FORUM HELD APRIL 5, 2012. THE FINDINGS PRESENTED WERE FROM ANALYZING DATA, KEY STAKEHOLDERS INTERVIEWS AND FOCUS GROUP INPUTS. COMMUNITY LEADERS DISCUSSED THE DATA PRESENTED, SHARED THEIR VISIONS AND PLANS FOR COMMUNITY HEALTH IMPROVEMENT IN THEIR COMMUNITIES, AND IDENTIFIED THE TOP HEALTH NEEDS IN THE GBH COMMUNITY.
FACILITY 1, GEISINGER-BLOOMSBURG HOSPITAL - PART V, LINE 4 GEISINGER MEDICAL CENTER, GEISINGER HEALTH SOUTH REHABILITATION HOSPITAL, GEISINGER SHAMOKIN AREA COMMUNITY HOSPITAL, EVANGELICAL COMMUNITY HOSPITAL, AND GEISINGER-BLOOMSBURG HOSPITAL PARTICIPATED IN THE CHNA.
FACILITY 1, GEISINGER-BLOOMSBURG HOSPITAL - PART V, LINE 14G REGISTRATION PERSONNEL ALSO REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY.
Schedule H (Form 990) 2013
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
GEISINGER-BLOOMSBURG HOSPITAL
 
Employer identification number

23-2193572
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
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
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
Yes
 
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) 2013

Schedule J (Form 990) 2013
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 PHDPRES, CHAIR, DIR. (i)
(ii)		  
1,065,733 		 
1,000,000 		 
135,283 		 
418,415 		 
32,864 		 
2,652,295 		 
 
(2)DAVID J FELICIO ESQUIRECLO, SECRETARY (i)
(ii)		  
381,608 		 
161,063 		 
117,228 		 
73,936 		 
23,587 		 
757,422 		 
63,492
(3)EDWARD J ZYCH ESQUIREACLO, ASST. SECTY. (i)
(ii)		  
258,248 		 
59,566 		 
21,546 		 
44,585 		 
22,330 		 
406,275 		 
 
(4)KEVIN F BRENNAN CPA FHFMAEVP, FINANCE, CFO (i)
(ii)		  
520,243 		 
239,635 		 
223,487 		 
184,190 		 
22,908 		 
1,190,463 		 
185,631
(5)STEPHEN PAOLUCCI MDCMO (i)
(ii)		  
336,305 		 
90,019 		 
37,365 		 
18,402 		 
22,690 		 
504,781 		 
 
(6)LISSA L BRYAN SMITHCAO (i)
(ii)		  
261,116 		 
57,498 		 
22,919 		 
18,402 		 
14,206 		 
374,141 		 
 
(7)FRANK J TREMBULAKSR VP, TREASURER (i)
(ii)		  
614,182 		 
280,856 		 
270,632 		 
210,979 		 
10,303 		 
1,386,952 		 
205,970
(8)JEAN R THOMAS CRNACRNA (i)
(ii)		 199,965
  		14,750
  		2,175
  		 
  		7,642
  		224,532
  		 
 
(9)JOSEPH P RUDA CRNACRNA (i)
(ii)		 225,250
75 		22,800
  		4,804
  		 
4 		15,875
  		268,729
79 		 
 
(10)THOMAS G SMITH CRNACRNA (i)
(ii)		 6,489
336,531 		 
  		 
8,630 		 
18,402 		 
20,119 		6,489
383,682 		 
 
(11)REGIS CABONORCEO (i)
(ii)		  
  		 
  		273,389
  		 
  		 
  		273,389
  		 
 
(12)JOSEPH M DEVITOCFO (i)
(ii)		  
  		 
  		241,562
  		 
  		 
  		241,562
  		 
 
(13)PATRICK J ERWIN MDFORMER OFFICER (i)
(ii)		  
305,295 		 
36,422 		 
31,534 		 
18,402 		 
25,776 		 
417,429 		 
 
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
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.
Return Reference Explanation
SCHEDULE J, PAGE 1, PART I, LINE 4 DAVID J. FELICIO, ESQUIRE 0 63,492 0 KEVIN F. BRENNAN, CPA, FHFMA 0 185,631 0 FRANK J. TREMBULAK 0 205,970 0 REGIS CABONOR 273,389 0 0 JOSEPH M. DEVITO 241,562 0 0
SCHEDULE J, PAGE 1, PART I, LINE 7 BECAUSE THE PAYMENT OF EARNED PERFORMANCE BASED COMPENSATION IS AT THE DISCRETION OF MANAGEMENT AND THE BOARD OF DIRECTORS, SUCH PAYMENTS MAY BE CONSIDERED NON-FIXED PAYMENTS. PERFORMANCE BASED COMPENSATION IS DETERMINED BY MEETING INDIVIDUALLY MEASURED PERFORMANCE GOALS THAT ARE ALIGNED WITH OVERALL SYSTEM OBJECTIVES, INCLUDING: CLINICAL QUALITY, COMMUNITY MISSION ACHIEVEMENT, AND FINANCIAL STEWARDSHIP.
SCHEDULE J, PART III PART I, LINE 4A - SEVERANCE PAYMENT: UPON INVOLUNTARY SEPARATION, EMPLOYEES MAY BE ELIGIBLE TO RECEIVE CONTINUATION OF SALARY FOR A TERM THAT IS BASED ON THEIR YEARS OF GEISINGER HEALTH SYSTEM SERVICE AND POSITION. PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN COMPENSATION FOR ELIGIBLE EMPLOYEES MAY BE DEFERRED TO A 457(F) NONQUALIFIED PLAN THAT VESTS WITH COMPLETION OF SERVICE, DEATH AND/OR PERMANENT DISABILITY. __________________________________________________________________________ FOOTNOTE: THROUGHOUT FORM 990, THE TERMS "GEISINGER HEALTH SYSTEM" AND "SYSTEM" OR THE ACRONYM "GHS" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH SYSTEM FOUNDATION ("GHSF") AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM.
Schedule J (Form 990) 2013

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
GEISINGER-BLOOMSBURG HOSPITAL
 
Employer identification number

23-2193572
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) 2013
Schedule L (Form 990 or 990-EZ) 2013
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 INDEMNITY INSURANCE CO
  		BUSINESS 341,938 IC SHARED SRVC. REV.   No
(2) GEISINGER QUALITY OPTIONS INC
  		BUSINESS 997,198 IC SHARED SRVC. REV.   No
(3) GEISINGER MEDICAL MANAGEMENT CORP
  		BUSINESS 901,661 IC SHARED SRVC. EXP.   No
(4) GEISINGER ASSURANCE COMPANY LTD
  		BUSINESS 325,080 IC SHARED SRVC. EXP.   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
SCHEDULE L, PART V GEISINGER-BLOOMSBURG HOSPITAL (GBH) 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 LEASES OF PROPERTY, EXTENSIONS OF CREDIT, FURNISHING OF GOODS, SERVICES, AND FACILITIES, AND TRANSFERS OF ASSETS. THESE TYPES OF INTER-ORGANIZATIONAL 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 ORGANIZATION'S TAX EXEMPT STATUS. THE FOLLOWING ORGANIZATIONS REPRESENT THE AFFILIATED FOR-PROFIT ORGANIZATIONS WITHIN THE GEISINGER HEALTH SYSTEM FOR WHOM BUSINESS TRANSACTIONS MUST BE DISCLOSED FOR PURPOSES OF SCHEDULE L PART IV TRANSACTIONS WITH INTERESTED PERSONS: GEISINGER MEDICAL MANAGEMENT CORPORATION GEISINGER QUALITY OPTIONS, INC. GEISINGER INDEMNITY INSURANCE COMPANY GEISINGER ASSURANCE COMPANY, LTD THE FOLLOWING OFFICERS AND/OR DIRECTORS OF GEISINGER-BLOOMSBURG HOSPITAL ARE OFFICERS AND/OR DIRECTORS OF SOME OR ALL OF THESE ORGANIZATIONS: WILLIAM H. ALEXANDER DAVID J. FELICIO, ESQUIRE RICHARD A. GRAFMYRE WILLIAM R. GRUVER THOMAS H. LEE, JR., M.D. ROBERT E. POOLE DON A. ROSINI GLENN D. STEELE, M.D., PH.D. ROBERT L. TAMBUR 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) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

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

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
GEISINGER-BLOOMSBURG HOSPITAL
 
Employer identification number

23-2193572
Return Reference Explanation
FORM 990 - ORGANIZATION'S MISSION TO ENHANCE THE QUALITY OF LIFE OF THE POPULATION SERVED BY PROVIDING ACCESS TO QUALITY POPULATION HEALTH AND HOSPITAL SERVICES THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE.
FORM 990 FORM 990, PART IV, LINE 24A: DID THE ORGANIZATION HAVE A TAX-EXEMPT BOND ISSUE WITH AN OUTSTANDING PRINCIPAL AMOUNT OF MORE THAN 100,000 AS OF THE LAST DAY OF THE YEAR, THAT WAS ISSUED AFTER DECEMBER 31, 2002? GEISINGER HEALTH SYSTEM FOUNDATION, PARENT OF THE ORGANIZATION, IS CURRENTLY THE SOLE OBLIGOR UNDER A SERIES OF BOND ISSUES WITH A TOTAL OUTSTANDING BALANCE OF 1,067,897,566 INCLUSIVE OF UNAMORTIZED ORIGINAL ISSUE DISCOUNT AS OF JUNE 30, 2014. BECAUSE THE BOND PROCEEDS ARE DISBURSED TO GEISINGER HEALTH SYSTEM FOUNDATION SUBSIDIARIES, THE BOND LIABILITIES ARE REFLECTED ON THE BALANCE SHEETS OF THE FOLLOWING SUBSIDIARY ORGANIZATIONS: GEISINGER MEDICAL CENTER, EIN: 24-0795959 GEISINGER WYOMING VALLEY MEDICAL CENTER, EIN: 23-1996150 GEISINGER CLINIC, EIN: 23-6291113 MARWORTH, EIN: 23-2171417 GEISINGER SYSTEM SERVICES, EIN: 23-2164794 COMMUNITY MEDICAL CENTER, EIN: 24-0862246 MOUNTAIN VIEW NURSING HOME, INC., EIN: 23-2568288 GEISINGER-BLOOMSBURG HOSPITAL, EIN: 23-2193572 GEISINGER-BLOOMSBURG HEALTH CARE CENTER, EIN: 23-2242854 GEISINGER-LEWISTOWN HOSPITAL, EIN: 23-1352187 SCHEDULE K WAS PREPARED ON A CONSOLIDATED BASIS AND IS INCLUDED IN THE FORM 990 FILING OF GEISINGER HEALTH SYSTEM FOUNDATION, EIN: 23-1995911.
FORM 990, PAGE 2, PART III, LINE 4A I.GENERAL INFORMATION GEISINGER-BLOOMSBURG HOSPITAL (GBH), A 501(C)(3) NOT-FOR-PROFIT CORPORATION AND MEMBER OF GEISINGER HEALTH SYSTEM, OWNS AND OPERATES A 72 BED, ACUTE CARE, HOSPITAL IN BLOOMSBURG, PA. GBH IS CONVENIENTLY LOCATED ONLY A FEW MILES FROM SEVERAL MAJOR HIGHWAYS THROUGHOUT CENTRAL PA. THE FACILITY OPENED IN 1905, ANSWERING A PRESSING NEED FOR HEALTH AND WELLNESS CARE IN THE COMMUNITY. GBH PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. SERVICES OFFERED BY GBH INCLUDE: GENERAL MEDICAL CARE PROVIDED BY IN-HOUSE HOSPITALIST AND SUPPORTED BY CONSULTATIVE SERVICES IN THE AREAS OF CARDIOLOGY, NEUROLOGY AND PULMONOLOGY. EMERGENCY DEPARTMENT IS COMMITTED TO PROVIDING HIGH QUALITY, PROMPT EMERGENCY SERVICES. GBH'S ED IS STAFFED 24/7 WITH FULL-TIME PHYSICIANS AND NURSES THAT ARE TRAINED IN EMERGENCY MEDICINE AND ARE PREPARED TO TREAT CASES FROM PEDIATRICS TO CRITICAL CARE. IMMEDIATE ACCESS TO LABORATORY SERVICES, X-RAYS, CAT SCANS, 3D-4D ULTRASOUND, MRI AND SURGICAL SERVICES. MOST INSURANCES, INCLUDING MEDICARE AND MEDICAID, ARE ACCEPTED AND NO PATIENT IS REFUSED TREATMENT BECAUSE OF INABILITY TO PAY. THE WOMAN'S HEALTH UNIT FOCUSES ON ALL ASPECTS OF WOMEN'S HEALTH AND EDUCATION, PROVIDING OBSTETRICAL AND GYNECOLOGICAL CARE FOR WOMEN OF ALL AGES. SERVICES INCLUDE BUT NOT LIMITED TO ROUTINE VISITS AND TREATMENTS, PREVENTATIVE HEALTHCARE, BIRTH CONTROL EDUCATION, FAMILY PLANNING, OBSTETRICS, SURGERY & SURGERY CONSULTATIONS, MENOPAUSE COUNSELING, MIDWIFERY, LACTATION EDUCATION AND SUPPORT. MENTAL HEALTH & PSYCHIATRIC SERVICES IS A DESIGNATED COUNT 302 TRIAGE SITE THAT PROVIDES BOTH INPATIENT AND OUTPATIENT SERVICES DESIGNED TO HELP INDIVIDUALS LIVE AS INDEPENDENTLY AS POSSIBLE. ADULTS TO GERIATRICS CAN ACCESS QUICK, EFFICIENT ADMISSION 24/7 AND RECEIVE TREATMENT THROUGH ONE- ON-ONE PATIENT COUNSELING, TREATMENT MEETINGS AND ACTIVITIES 7 DAYS PER WEEK. A PSYCHIATRIST IS AVAILABLE ON A DAILY BASIS. ADMISSIONS ARE CONFIDENTIAL AND MAY BE MADE BY PROFESSIONALS AS WELL BY INDIVIDUALS CONCERNED ABOUT THEMSELVES OR OTHERS. INPATIENT CARE IS PROVIDED THROUGH MULTIPLE PROFESSIONALS WHO COMPRISE THE TREATMENT TEAM. OTHER SERVICES INCLUDE: CARDIAC SERVICES SURGERY SPECIALTIES- RADIOLOGY ORTHOPEDIC ICCU UROLOGY LABORATORY SERVICES PHYSICAL THERAPY OTOLARYNGOLOGY GYNECOLOGY RESPIRATORY SERVICES GENERAL SURGERY II. UNCOMPENSATED CARE GEISINGER-BLOOMSBURG HOSPITAL RECOGNIZES ITS MISSION IN THIS REGARD; GBH PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH- RELATED ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A.CHARITY CARE THE PRIMARY CONCERN OF GBH IS THE DELIVERY OF HEALTH CARE TO ALL CITIZENS OF CENTRAL PENNSYLVANIA REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GBH INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. THE COST OF PROVIDING CHARITY CARE WAS APPROXIMATELY 937,734 DURING THE FISCAL YEAR ENDED JUNE 30, 2014. B.MEDICARE/MEDICAID/OTHER GOVERNMENTAL IN RECOGNIZING ITS MISSION TO THE COMMUNITY, GBH PROVIDES SERVICES TO THE ELDERLY (MEDICARE) AND THE INDIGENT (MEDICAID), AS WELL AS OTHERS. GBH PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS TO THE EXTENT THE GOVERNMENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTH CARE. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. THE COST OF PROVIDING HEALTHCARE SERVICES TO MEDICARE AND MEDICAID PATIENTS EXCEEDED REIMBURSEMENT BY APPROXIMATELY 10,630,156 DURING THE FISCAL YEAR ENDED JUNE 30, 2014. C.OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GBH PROVIDES SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2014, WAS 414,745. III.COMMUNITY HEALTH, EDUCATION, AND OUTREACH GBH STRIVES TO BE A VALUABLE RESOURCE FOR THE COMMUNITY AND ITS RESIDENTS. GBH PROVIDES MANY REDUCED-PRICE SERVICES AND FREE PROGRAMS THROUGHOUT THE YEAR THAT SERVE COMMUNITY HEALTH NEEDS. THESE SERVICES AND PROGRAMS INCLUDE SUPPORT GROUPS, COMMUNITY HEALTH EDUCATION, AND OTHER UNIQUE SERVICES. A. SUPPORT GROUPS THE COST TO GBH OF PROVIDING SERVICES AND/OR FACILITIES FOR SUPPORT GROUP MEETINGS WAS 3,608 DURING THE FISCAL YEAR WITH NUMEROUS ATTENDEES. GBH CONTINUES TO MAKE INROADS WITH THE NEIGHBORING BLOOMSBURG UNIVERSITY WITH INVOLVEMENT BETWEEN LEADERSHIP AND STUDENTS WHO ARE INTEREST IN COMMUNITY HEALTH CARE. THE SUPPORT GROUPS INCLUDED: BLOOMSBURG RACIAL & GENDER EQUITY COMMUNITY SUPPORT PROGRAM TASK FORCE COMMUNITY MEMBER MYASTHENIA GRAVIS SUPPORT GROUPS B. HEALTH SCREENING IN FISCAL YEAR 2014, GBH PROVIDED FREE MENTAL HEALTH SCREENING AT A COST OF 271 WITH 30 PEOPLE SCREENED. C. HEALTH EDUCATION GBH SPONSORS REGULAR COMMUNITY EDUCATION PROGRAMS. THE APPROXIMATE COST IS 12,833 WITH MORE THAN 25,000 ATTENDEES ON TOPICS SUCH AS: COMMUNITY NUTRITION PRESENTATIONS EDUCATIONAL SCHOOL PROGRAMS DENTAL EDUCATION HEALTH FAIRS D. COOPERATIVE COMMUNITY VENTURES IN CONJUNCTION WITH CHARITABLE COMMUNITY ORGANIZATIONS AND/OR BUSINESS, GBH PARTICIPATED IN ACTIVITIES AT A COST TO GBH OF 16,105. SOME OF THESE ACTIVITIES INCLUDE: UNITED WAY VETERAN'S DINNER IV. VOLUNTEER SERVICES THE VOLUNTEERS OF GEISINGER BLOOMSBURG HOSPITAL ARE AN ACTIVE AND VITAL PART OF THE ACTIVITIES OF THE HOSPITAL. THE HOURS OF VOLUNTEER SERVICES ARE IMPORTANT CONTRIBUTION TO THE MISSION OF GBH. VOLUNTEERS FROM LOCAL COMMUNITIES HAVE CONTRIBUTED 10,068 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTHCARE OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND "WELLNESS" PROGRAMS. V.COMMUNITY BENEFITS SUMMARY CHARITY CARE 937,734 MEDICARE/MEDICAID/OTHER GOVERNMENTAL 10,630,156 OTHER UNCOMPENSATED PATIENT SERVICES 414,745 COMMUNITY HEALTH, EDUCATION, OUTREACH AND OTHER 32,817 VOLUNTEER SERVICES (VALUED AT 1/1/2014 PA STATEWIDE AVERAGE WEEKLY WAGE) 234,584 TOTAL 12,250,036 VI. STATISTICS GEISINGER-BLOOMSBURG HOSPTIAL FISCAL YEAR ENDED JUNE 30, 2014 ADMISSIONS (INCLUDING NEWBORNS) 2,270 ADMISSIONS (EXCLUDING NEWBORNS) 2,042 OUTPATIENT VISITS INCLUDING EMERGENCY DEPARTMENT 33,254 AVERAGE LENGTH OF STAY 4.2 PERCENT OF OCCUPANCY (EXCLUDING NEWBORNS) 33.50% PATIENT SERVICE DAYS (EXCLUDING NEWBORNS) 8,801 TOTAL OR CASES 2,650 LICENSED BEDS (EXCLUDING BASSINETS) 72 BASSINETS IN NURSERY 10
FORM 990, PART V FORM 990, PART V ADDITIONAL INFORMATION FORM 990, PART V, LINE 1A: ENTER THE NUMBER REPORTED IN BOX 3 OF FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURNS. GEISINGER SYSTEM SERVICES (GSS), AN AFFILIATE OF THE ORGANIZATION, PROVIDES A CENTRALIZED ACCOUNTS PAYABLE FUNCTION FOR ALL ORGANIZATIONS OF THE GEISINGER HEALTH SYSTEM. AS THE ACCOUNTS PAYABLE PROCESSOR, GSS PREPARES AND FILES FORM 1099 UNDER ITS EIN FOR CERTAIN REPORTABLE PAYMENTS OF THE FILING ORGANIZATION. THE NUMBER OF FORM 1099'S FILED BY GSS FOR THE 2013 REPORTING PERIOD ON BEHALF OF ITSELF AND ITS AFFILIATES WAS 2,147. THE RESPONSE ENTERED ON LINE 1A FOR THE ORGANIZATION INCLUDES ONLY THOSE FORM 1099S FILED UNDER THE ORGANIZATION'S EIN, IT DOES NOT INCLUDE THOSE FILED BY GSS ON ITS BEHALF
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 MEMBERS DESCRIBED ABOVE, A TOTAL OF EIGHT VOTING MEMBERS OF THE GOVERNING BODY ARE ALSO VOTING MEMBERS OF RELATED TAXABLE ORGANIZATIONS FOR WHICH BUSINESS TRANSACTIONS, BETWEEN GBH AND THE RELATED TAXABLE ORGANIZATION ARE REPORTED IN 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? WILLIAM H. ALEXANDER, DORRANCE R. BELIN, ESQUIRE, E. ALLEN DEAVER, DAVID J. FELICIO, ESQUIRE, RICHARD A. GRAFMYRE, WILLIAM R. GRUVER, FRANK M. HENRY, THOMAS H. LEE, JR., M.D., ROBERT E. POOLE, DON A ROSINI, GLENN D. STEELE, JR., M.D., PH.D., ROBERT L. TAMBUR, FRANK J. TREMBULAK AND EDWARD J. ZYCH, ESQUIRE 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-BLOOMSBURG HOSPITAL. ALL OF THE AFFILIATES ARE PART OF THE GEISINGER HEALTH SYSTEM.
FORM 990, PAGE 6, PART VI, LINE 6 THE MEMBERS OF THE CORPORATION HAVE THE POWER AND AUTHORITY TO ELECT AND REMOVE THE DIRECTORS; ELECT AND REMOVE THE PRESIDENT AND FILL ANY VACANCY IN THE OFFICE OF THE PRESIDENT OF THE CORPORATION; AND, MAY APPROVE AMENDMENTS TO THE CORPORATE BYLAWS IN LIEU OF SUCH APPROVAL BY THE BOARD OF DIRECTORS. THE MEMBERS ALSO HAVE THE RESERVE POWERS AS SET FORTH IN THE PENNSYLVANIA NONPROFIT CORPORATION LAW.
FORM 990, PAGE 6, PART VI, LINE 7A THE BOARD OF DIRECTORS OF THE CORPORATION SHALL SERVE AS THE GOVERNING BODY OF THE CORPORATION. THE PRESIDENT OF THE CORPORATION SHALL BE A DIRECTOR BY REASON OF HOLDING SUCH OFFICE. THE REMAINING DIRECTORS SHALL BE ELECTED BY THE MEMBERS AT THE ANNUAL MEETING OF THE MEMBERS. THE MEMBERS OF THE CORPORATION MAY SERVE AS DIRECTORS AND DIRECTORS MAY SUCCEED THEMSELVES FROM TERM TO TERM. VACANCIES ON THE BOARD OF DIRECTORS SHALL BE FILLED BY THE MEMBERS AT THEIR DISCRETION AT THE ANNUAL MEETING OF THE MEMBERS OR AT A SPECIAL MEETING CALLED FOR SUCH PURPOSE.
FORM 990, PAGE 6, PART VI, LINE 11B ALL OFFICERS AND DIRECTORS WERE ELECTRONICALLY PROVIDED A FINAL COPY OF THE FORM 990 PRIOR TO FILING THE RETURN WITH THE IRS. AN EXECUTIVE SUMMARY OF THE INFORMATION REPORTED ON THE RETURN IS PROVIDED TO ASSIST IN THE REVIEW. IN ACCORDANCE WITH THE GEISINGER HEALTH 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, 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, 2014.
FORM 990, PAGE 6, PART VI, LINE 12C THE OFFICERS AND DIRECTORS OF THE ORGANIZATION 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.
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.
FORM 990, PAGE 6, PART VI, LINE 15B SEE SCHEDULE O RESPONSE TO FORM 990, PART VI, SECTION B, QUESTION 15A.
FORM 990, PAGE 6, PART VI, LINE 19 THE 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/PAGES/ABOUT-GEISINGER AND SELECT ANNUAL REPORTS. 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.
FORM 990, PART XI, LINE 9 PENSION LIABILITY DECREASE 267,223 TRANSFER FROM GHSF 6,000,000 TRANSFER FROM AFFILIATE 10,000 TEMP REST NON GF -43,088 ---------------- TOTAL 6,234,135
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 THE 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) 2013

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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
GEISINGER-BLOOMSBURG HOSPITAL
 
Employer identification number

23-2193572
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on 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" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled 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 MEDICAL CT

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) GEISINGER SYSTEM SERVICES

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
14-1909894 		SELF INS VT 501C3 11A GHSF
 
Yes
 
(10) COMMUNITY MEDICAL CENTER

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2369788 		RE HOLDIN PA 501C2   GHSF
 
Yes
 
(13) MOUNTAIN VIEW NURSING HOME INC

100 NORTH ACADEMY AVENUE MC 49-70

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

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2279376 		SUPPORT SV PA 501C3 11A GHSF
 
Yes
 
(15) BLOOMSBURG PHYSICIANS SERVICES

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2979856 		PHYSICIAN PA 501C3 3 GHSF
 
Yes
 
(16) GEISINGER-BLOOMSBURG HEALTHCARE CTR

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2242854 		SKILLED NU PA 501C3 9 GHSF
 
Yes
 
(17) COLUMBIA-MONTOUR HOME HLTH SERVICES

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-1704399 		HOME HEALT PA 501C3 9 GHSF
 
Yes
 
(18) LEWISTOWN HEALTHCARE FOUNDATION

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2344363 		PHILANTHRO PA 501C3 11A GHSF
 
Yes
 
(19) GEISINGER-LEWISTOWN HOSPITAL

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-1352187 		HOSPITAL PA 501C3 3 GHSF
 
Yes
 
(20) LEWISTOWN AMBULATORY CARE CORP

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2344362 		RE HOLDIN PA 501C3 11A GHSF
 
Yes
 
(21) FAM HEALTH ASSOC OF GEISINGER-LEWIS

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
25-1651582 		PHYSICIAN PA 501C3 11A GHSF
 
Yes
 
(22) KEYSTONE HEALTH INFO EXCHANGE INC

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
46-4359893 		RHIO PA 501C3 11A GHSF
 
Yes
 
(23) HEALTH CARE CORP OF NORTHEAST PA

100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2337286 		SUPPORT SV PA 501C3 11A CMC
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



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

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

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

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
45-5484165 		ORG DEL SY 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) LEMED II

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2391766 		RENTAL PA N/A
         No     No  
(7) GEISINGER-SCA HOLDINGS LLC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
46-1615328 		MANAGEMENT DE N/A
         No     No  
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(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) GEISINGER INDEMNITY INSURANCE CO

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

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
20-4275139 		HLTH INSUR PA N/A
         Yes  
(4) HEALTH ENTERPRISES INC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2353212 		PHARMACY PA N/A
         Yes  
(5) XG HEALTH SOLUTIONS INC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
46-1657345 		CONSULTING DE N/A
         Yes  
(6) GEISINGER ASSURANCE COMPANY LTD

23 LINE TREE BAY AVE PO BOX 1159
GRAND CAYMAN,GRAND CAYMANKY1-1102
CJ
98-1016737 		INSURANCE CJ N/A
         Yes  


Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on 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
 
No
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
 
No
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
Yes
 
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 related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) COLUMBIA MONTOUR HOME HEALTH SVCS

 A 159,833 FMV
(2) COLUMBIA MONTOUR HOME HEALTH SVCS

 L 639 GAAP
(3) GEISINGER CLINIC

 A 591,960 FMV
(4) GEISINGER CLINIC

 L 774,525 GAAP
(5) GEISINGER CLINIC

 M 2,132,338 GAAP
(6) GEISINGER COMMUNITY HEALTH SERVICES

 L 13,892 GAAP
(7) GEISINGER HEALTH PLAN

 L 7,839,898 GAAP
(8) GEISINGER HEALTH PLAN

 P 10,380 GAAP
(9) GEISINGER HEALTH SYSTEM FOUNDATION

 C 10,000 GAAP
(10) GEISINGER HEALTH SYSTEM FOUNDATION

 L 43,885 GAAP
(11) GEISINGER HEALTH SYSTEM FOUNDATION

 L 2,731 GAAP
(12) GEISINGER INDEMNITY INSURANCE CO

 L 341,938 GAAP
(13) GEISINGER INSURANCE CORPORATION RRG

 P 330,519 GAAP
(14) GEISINGER MEDICAL CENTER

 L 9,207 GAAP
(15) GEISINGER MEDICAL CENTER

 M 527,707 GAAP
(16) GEISINGER MEDICAL MANAGEMENT CORP

 M 901,661 GAAP
(17) GEISINGER QUALITY OPTIONS INC

 L 997,168 GAAP
(18) GEISINGER SYSTEM SERVICES

 P 1,128,602 GAAP
(19) GEISINGER SYSTEM SERVICES

 L 136 GAAP
(20) GEISINGER SYSTEM SERVICES

 M 6,066,118 GAAP
(21) GEISINGER WYOMING VALLEY MED CTR

 M 237,238 GAAP
(22) GEISINGER-BLOOMSBURG HEALTHCARE CTR

 L 68,618 GAAP
(23) HEALTHSOUTHGHS LLC

 A 42,465 FMV
(24) HEALTHSOUTHGHS LLC

 M 201,234 GAAP
(25) GEISINGER HEALTH SYSTEM FOUNDATION

 C 6,000,000 GAAP
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




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






























Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
SCHEDULE R INFORMATION REGARDING TRANSFERS TO AND FROM CONTROLLED ORGANIZATIONS: GEISINGER-BLOOMSBURG HOSPITAL IS CLOSELY AFFILIATED WITH SEVERAL OTHER ORGANIZATIONS. IN THE NORMAL COURSE OF THE OPERATIONS OF THESE AFFILIATED ORGANIZATIONS THERE ARE NUMEROUS INTER-ORGANIZATIONAL TRANSACTIONS, WHICH MAY INCLUDE SALES, EXCHANGES AND LEASES OF PROPERTY, EXTENSIONS OF CREDIT, FURNISHING OF GOODS, SERVICES, AND FACILITIES, AND TRANSFERS OF ASSETS. THESE TYPES OF INTER-ORGANIZATIONAL 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 PRIVATE LETTER RULINGS AS BEING ENTIRELY CONSISTENT WITH THE ORGANIZATION'S TAX EXEMPT STATUS. __________________________________________________________________________
Schedule R (Form 990) 2013
Additional Data


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