Form990
Click to see attachment
Department of the TreasuryInternal 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.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 07-01-2015 , and ending 06-30-2016
BCheck if applicable:
CName of organization
HOLY SPIRIT HOSPITAL OF THE SISTERS
OF CHRISTIAN CHARITY
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
100 N ACADEMY AVE MC 49-70
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
DANVILLE, PA178229800
D Employer identification number

23-1512747
E Telephone number

G Gross receipts $ 294,663,241
F Name and address of principal officer:
KYLE C SNYDER MHA
100 NORTH ACADEMY AVENUE MC 22-01
DANVILLE,PA17822
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.HSH.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: 1963
M State of legal domicile: PA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: TO PROVIDE RESOURCES FOR THE RESTORATION AND MAINTENANCE OF HEALTH AND THE PREVENTION OF DISEASE.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 17
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 15
5 Total number of individuals employed in calendar year 2015 (Part V, line 2a) ...... 5 2,303
6 Total number of volunteers (estimate if necessary) ............. 6 190
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,813,766
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 406,982
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 2,134,571 2,156,722
9 Program service revenue (Part VIII, line 2g) ......... 292,096,880 285,299,314
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 15,183,043 4,295,914
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 7,336,769 2,911,291
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 316,751,263 294,663,241
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 37,421,002 0
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) 133,769,614 131,956,007
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).... 158,137,999 156,729,841
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 329,328,615 288,685,848
19 Revenue less expenses. Subtract line 18 from line 12....... -12,577,352 5,977,393
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 224,773,221 206,226,257
21 Total liabilities (Part X, line 26)............. 166,592,756 147,921,316
22 Net assets or fund balances. Subtract line 21 from line 20..... 58,180,465 58,304,941
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 (2015)
Form 990 (2015)
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: HOLY SPIRIT HOSPITAL IS A COMMUNITY CATHOLIC HOSPITAL SPONSORED BY THE SISTERS OF CHRISTIAN CHARITY TO CARRY OUT THE HEALING MINISTRY OF JESUS CHRIST TO ALL IN NEED. WE PROVIDE HIGH QUALITY, COST-EFFECTIVE HEALTH SERVICES TO DEVELOP HEALTHY COMMUNITIES IN THE GREATER PATIENT CARE SERVICES.
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 $ 250,835,508 including grants of $   ) (Revenue $ 286,196,279 )
PATIENT CARE SERVICES: PATIENT CARE SERVICES IS DRIVEN BY THE HOSPITAL'S MISSION, VISION AND VALUES. THE PROVISION OF HIGHLY SKILLED, COMPETENT AND COMPASSIONATE NURSING CARE IS ESSENTIAL TO FULFILL OUR COMMITMENT TO EXCELLENCE IN CLINICAL PRACTICE, EDUCATION AND NURSING RESEARCH. INPATIENT NURSING UNIT EXPENSES IN FY2015 WERE 20,464,112; SURGICAL NURSING SERVICE EXPENSES WERE 30,366,479; AND ALL OTHER NURSING EXPENSES TOTALED 13,265,277. THOSE EXPENSES TOTALED OVER 64 MILLION. IN MAY 2013, HOLY SPIRIT HOSPITAL NURSES ACHIEVED MAGNET STATUS FROM THE AMERICAN NURSES CREDENTIALING CENTER'S MAGNET RECOGNITION PROGRAM. ACHIEVING MAGNET IS THE GOLD STANDARD FOR NURSING EXCELLENCE AND REQUIRES UNDERGOING A VOLUNTARY, RIGOROUS AND LENGTHY REVIEW PROCESS THAT EXAMINES A BROAD RANGE OF BENCHMARKS FROM INNOVATIONS IN NURSING PRACTICE, PROFESSIONAL EDUCATION, AND PATIENT OUTCOMES TO QUALITY MEASURES AND PATIENT SATISFACTION. ONLY A SMALL PERCENTAGE OF HOSPITALS NATIONWIDE HAVE RECEIVED MAGNET CREDENTIALING TO DATE. U.S. NEWS & WORLD REPORTS USES MAGNET STATUS AS ONE FACTOR IN DETERMINING ITS ANNUAL RANKING OF HOSPITALS NATIONWIDE. HOLY SPIRIT HOSPITAL WAS RECOGNIZED AS ONE OF THE BEST REGIONAL HOSPITALS, RANKING 13TH IN PENNSYLVANIA IN 2014-2015. IN ADDITION, HOLY SPIRIT HOSPITAL WAS HONORED AS A HIGH-PERFORMER IN SOUTH CENTRAL PENNSYLVANIA IN TEN SPECIALTIES, INCLUDING CANCER, DIABETES AND ENDOCRINOLOGY, GASTROENTEROLOGY AND GI SURGERY, GERIATRICS, GYNECOLOGY, NEPHROLOGY, NEUROLOGY AND NEUROSURGERY, ORTHOPEDICS, PULMONARY, AND UROLOGY. HOLY SPIRIT HOSPITAL EARNED THE HEALTHSTREAM "EXCELLENCE THROUGH INNOVATION" AWARD FOR LEADING INNOVATION IN PATIENT EXPERIENCE. THE HOSPITAL SAFETY SCORE RATES HOW WELL HOSPITALS PROTECT PATIENTS FROM ACCIDENT, ERRORS, INJURIES, AND INFECTIONS. HOLY SPIRIT IS THE ONLY HOSPITAL IN THE HARRISBURG REGION TO CONSISTENTLY SCORE AN "A" RATING. IN NOVEMBER 2014, THE JOINT COMMISSION RECOGNIZED HOLY SPIRIT HOSPITAL AS A 2013 TOP PERFORMER ON KEY QUALITY MEASURES FOR ATTAINING AND SUSTAINING EXCELLENCE IN ACCOUNTABILITY MEASURE PERFORMANCE FOR HEART ATTACK, HEART FAILURE, PNEUMONIA, AND SURGICAL CARE. HOLY SPIRIT ISONE OF 1,224 HOSPITALS IN THE UNITED STATES TO ACHIEVE THIS DISTINCTION AND ONE OF ONLY 314 HOSPITALS TO ACHIEVE THE TOP PERFORMER DISTINCTION FOR THE PAST THREE CONSECUTIVE YEARS. HOLY SPIRIT HOSPITAL EARNED THE 2015 GET WITH THE GUIDELINES STROKE GOLD PLUS AWARD, AS WELL AS THE 2015 GET WITH THE GUIDELINES A-FIB PARTICIPATING ACHIEVEMENT AWARD FROM THE AMERICAN HEART ASSOCIATION AND THE AMERICAN STROKE ASSOCIATION. THE HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA AWARDED HOLY SPIRIT WITH THE "SAFETY ACROSS THE BOARD" EXCELLENCE AWARD FOR THE HOSPITAL'S WORK ACROSS MULTIPLE TEAMS. HOLY SPIRIT ALSO EARNED THE READMISSIONS PROJECT EXCELLENCE AWARD FOR WORK ON THE PENNSYLVANIA HOSPITAL ENGAGEMENT NETWORK (PA-HEN) READMISSIONS PROJECT. REGISTERED NURSES IN PATIENT CARE SERVICES AND CLINICAL EDUCATION PROVIDED PRESENTATIONS (PODIUM AND POSTER) IN HOUSE, AT PROFESSIONAL CONFERENCES, AND IN VARIOUS OTHER VENUES. THE PRESENTATIONS INCLUDED: - AUGUST 13, 2014: PATIENT TEACHING STRATEGIES - LEA DAILEY, RN, CCRN, MSN, ED - SEPTEMBER 16, 2014:BLDG., A HEALTHSTREAM COMPANY, NEW ORLEANS, LA. - SPIRIT SERVICE EXCELLENCE - A SUSTAINABLE CULTURE TO OPTIMIZE SERVICE AND PERFORMANCE - SISTER ROMAINE NIEMEYER, SCC, CHIEF ADMINISTRATIVE OFFICER, RICK LAVANTURE, SENIOR VICE PRESIDENT/CHIEF STRATEGIC OFFICER, LISA LEWIS, MSN, RN, NEA-BC, VICE PRESIDENT OF PATIENT CARE SERVICES/CHIEF NURSING OFFICER - SEPTEMBER 16, 2014:LEADING CHANGE AND INNOVATION TO TRANSFORM HEALTHCARE, HARRISBURG, PA. HOW TO MAKE CHANGE DESIRABLE - KATHY SHEA, BSN, RN-BC - OCTOBER 7, 2014: ANCC RESEARCH SYMPOSIUM, DALLAS, TX. - SEPSIS: A TEAM APPROACH TO CHANGING OUTCOMES - SARAH COLEMAN, RN, CCRN - OCTOBER 8, 2014 - INFECTION PREVENTION 101: "IT'S THE ONES YOU CAN'T SEE" - JOANN ADKINS, RN, BSN, CIC - OCTOBER 24, 2014: EVIDENCE BASED PRACTICE: TRANSLATING RESEARCH INTO PRACTICE, GEISINGER MEDICAL CENTER, DANVILLE, PA. THE ART AND SCIENCE OF NURSING - SARAH COLEMAN, RN, CCRN, CINDY SWARTZ, MS, RN, ACNS-BC - NOVEMBER 11, 2014 - SUCCESSION PLANNING - JOANN ANN ADKINS, RN, BSN,CIC, RHETT BENNIE, RN, BSN, MSHA, CPI CERTIFIED TRAINER, PATRICIA A. CARNES, MHA, BSN, RN, NE -BC, SUSAN SWAILS, MED, BSN, RN-BC, DEBORAH THORNBERG, BSN, RN-BC - NOVEMBER 12, 2014 - GLYCEMIC CONTROL AND HEALTH OUTCOMES IN THE DIABETIC PATIENT - MARGARITA GARDNER, BSN, RN, CCRN - NOVEMBER 13, 2014:DICKINSON WELLNESS PROGRAM, DICKINSON COLLEGE, CARLISLE, PA. LIVING WELL WITH DIABETES - KATIE FLICKINGER, BSN, RN, CCP, CDE - NOVEMBER 14, 2014:SOUTH CENTRAL MAGNET CONSORTIUM, MAGNET CHAMPION CONFERENCE, HERSHEY MEDICAL CENTER, HERSHEY, PA. SEPSIS: A TEAM APPROACH TO CHANGING OUTCOMES - SARAH COLEMAN, RN, CCRN - JANUARY 30, 2015 RESEARCH DAY - PRESENTATIONS BY HOLY SPIRIT NURSES IN PARTNERSHIP WITH MESSIAH SENIOR NURSING STUDENTS - TO QUIT OR NOT TO QUIT, THAT IS THE QUESTION: CHALLENGES FACED IN THE DEVELOPMENT AND IMPLEMENTATION OF A SMOKING CESSATION PROGRAM - DEBORAH AUDETTE, MS, RN, ACNS-BC, CCRN-CSC, KATHY THUMMA BSN, RN, NE-RC - ARE WE DOING ENOUGH? EFFECTS OF EDUCATION ON NURSING ATTITUDES TOWARDS CHRONIC PAIN - JENNIFER KANE, BSN, RN, PCCN - EVIDENCE-BASED DISTRACTION TECHNIQUES TO DECREASE CHRONIC PAIN IN PEDIATRIC PATIENTS - ALISON NATTRESS, RN - EXERCISE INTERVENTIONS TO IMPROVE OUTCOMES IN HEART FAILURE PATIENTS - PEGGY TRAHAN, RN, PCCN - CARDIAC PRESCREENING IN YOUNG ADULT ATHLETES DECREASES RISK FOR SUDDEN CARDIAC EVENT - DEB THORNBERG, BSN, RN-BC - SHHLET THEM REST - KENDRA WILSON, BSN, RN-BC - CNS IN STROKE: PARTNERSHIP IN BUILDING EXCELLENCE - CYNTHIA SWARTZ, MS, RN, ACNS-BC, MARYANN BROGDEN, ND, MSN, RN, APN-C, CCNS, SCRN - IMPLEMENTATION OF HOURLY ROUNDING TO IMPROVE CLINICAL OUTCOMES" - JENNIFER HIXENBAUGH, BSN, RN - IV ACCESS - TINA SWARTZ CRNA, STEVE TODD BS, RN, JAMES KEVIN TRACEY, JR., RN, BSN, CNOR, ALLISON M. POLINSKI, RN, BSN, CPAN - EARLY IMPLEMENTATION OF PALLIATIVE CARE TO BETTER PATIENT OUTCOMES IN CONGESTIVE HEART FAILURE PATIENTS - PATRICIA A. CARNES, MHA, BSN, RN, NE-BC - KBMA NO SCANNER LEFT BEHIND - JODY HARCLERODE, RN-BC, MS, CPHQ - TRANSITIONING BETWEEN CARE SETTINGS - JUDITH HIMES, BSN, RN, CWON - PCEA:PATIENT CONTROLLED EPIDURAL ANALGESIA FOR INTRAPARTUM PATIENTS - ENID KREINER, MSN, RNC-MNN, C-EFM - PAIN MANAGEMENT CARE MODEL - RHETT BENNIE, MSHA, BSN, RN - NURSING CERTIFICATION: LEADING THE WAY - MICHELLE DEFABIO, MS, RN, ACNS- BC - BEATING SEPSIS - IT'S A SPRINT, NOT A JOG - SARAH COLEMAN, AD, RN - THINK "INSIDE" THE BOX TAKING AN IDEA FROM INCEPTION TO IMPLEMENTATION - JOANN ADKINS, RN, BSN, CIC, EDIE ASBURY, MLS, AHIP - CONNECTING THE DOTS: HOW DO WE PUT IT ALL TOGETHER? - JOANN ADKINS, RN, BSN, CIC, EDIE ASBURY, MLS, AHIP - MARCH 12, 2015 - ADVANCE DIRECTIVES: WHO, WHAT, WHEN, WHY, AND WHERE - MAUREEN ASPER, MS, RN, ACNS-BC - MARCH 20, 2015 - 2015 ADVANCED PRACTICE REGISTERED NURSE PANEL - PAMELA HARRIS-HAMAN, MSN, CRNP, NPP-BC, MICHELLE DEFABIO, MS, RN, ACNS-BC, CCRN, ROBIN CROWLEY CRNA, MS - APRIL 30, 2015: HEALTHSTREAM SUMMIT, NASHVILLE, TN. "STANDARDS OF PERFORMANCE: BRINGING YOUR VALUES TO LIFE" - LISA LEWIS, MSN, RN, NEA- BC, AMI ZUMKHAWALA-COOK - MAY 21, 2015:CAREER DAY AT FINK ELEMENTARY SCHOOL, MIDDLETOWN, PA. "CAREERS IN NURSING" - MARTHA LEE, BSN, RNC-NIC, ENID KREINER, MSN, RNC- MNN/OBC-EFM - JUNE 16, 2015 - OUR JOURNEY TO PATIENT AND FAMILY CENTERED CARE: CREATING A PATIENT AND FAMILY ADVISORY COUNCIL - CYNTHIA SWARTZ, MS, RN, ACNS-BC, SUSAN MCQUADE, RN, CPHQ, CNOR, BSN, MHA, ANN HENDRICKSON, MS, RN,ACNS-BC NURSES ALSO PARTICIPATED IN HOLY SPIRIT COMMUNITY EDUCATION PROGRAMS AND SCREENINGS. - SEPTEMBER 11, 2014: PROJECT HOMELESS CONNECT, FARM SHOW COMPLEX, HARRISBURG, PA. 61 FREE FLU VACCINES PROVIDED BY CHERYL SOLA, COMMUNITY HEALTH AND WELLNESS, LISA LEWIS, CNO, DIANA DAVIDSON, OR, MELISSA NATIVIDAD, OR, RENA EFENDIVA, OR, AND VANESSA GARCIA, MEDICAL OUTREACH - OCTOBER 3, 2014: ST. JOSEPH SCHOOL, MECHANICSBURG, PA. "WHAT TO EXPECT IN THE OR" - LORI BAURER, OR AND NATILIE HATTING, OR - OCTOBER 3, 2014: GIRLS' NIGHT OUT, HARRISBURG, PA. CARDIOVASCULAR RISK ASSESSMENTS AND BLOOD PRESSURE SCREENINGS PROVIDED BY JUDY HIMES, WOUND CARE, PEGGY TRAHAN, 8 MAIN, AND LEONA MLYNEK, WOUND CARE - FEBRUARY 7, 2015: HEARTCARING SYMPOSIUM, HOLY SPIRIT HOSPITAL. VARIOUS SCREENINGS TO DETERMINE CARDIOVASCULAR DISEASE RISK PROVIDED BY BRYNN STRINE, CVICU, AMANDA DONNANGELO, ED, REBECCA MILLER, CVU, MEGAN REEVES, CVU, JENNIFER HIXENBAUGH, CARDIAC DIAGNOSTICS, AMBER THOMAS, ED, WENDY SHOOK, CARDIAC REHAB, BARBARA MUMMERT, CARDIAC REHAB, VIRGINIA BAZAR, INVASIVE CARDIOLOGY, AND SHERRI HEFFNER, INVASIVE CARDIOLOGY - MAY 8, 2015: GIRLS' NIGHT OUT, HARRISBURG, PA. BLOOD PRESSURE SCREENINGS AND CARDIOVASCULAR RISK ASSESSMENTS PROVIDED BY JUDY HIMES, WOUND CARE, LESLY MILLER-JACOBS, MEDICAL INFUSION, JOHN LYONS, OR, PEGGY TRAHAN, 8 MAIN, LEONA MLYNEK,
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 expensesMediumBullet250,835,508
Form 990 (2015)
Form 990 (2015)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment..............
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part 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
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
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 (2015)
Form 990 (2015)
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 domestic 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 or for domestic individuals 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), 501(c)(4), and 501(c)(29) 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 "Yes," complete Schedule L, Part II ................Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV
........................Click to see attachment
28a
Yes
 
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
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II ...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I ........Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
Yes
 
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2015)
Form 990 (2015)
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
0
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
2,303
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
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.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring 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 (2015)
Form 990 (2015)
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
17
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
15
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
Yes
 
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
PA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletRANDY B MORRIS VP FINANCE HSHS100 N ACADEMY AVE MC 86-22   DANVILLE,PA17822 (717) 763-2130
Form 990 (2015)
Form 990 (2015)
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) DAVID PETERS DO......................................................................
DIRECTOR
0.25
.................
 
X           0 0 0
(2) DEBORAH KEYS......................................................................
DIRECTOR
0.25
.................
 
X           0 0 0
(3) GREG GUNN......................................................................
DIRECTOR
0.25
.................
0.25
X           0 0 0
(4) LAURIE SALTZGIVER ESQUIRE......................................................................
DIRECTOR
0.25
.................
 
X           0 0 0
(5) NORA HABIG......................................................................
DIRECTOR
0.25
.................
0.25
X           0 0 0
(6) PATRICIA HUSIC......................................................................
DIRECTOR
0.25
.................
0.25
X           0 0 0
(7) RANNY L SINGISER EDD......................................................................
DIRECTOR
0.25
.................
0.25
X           0 0 0
(8) REVEREND ROBERT F SHARMAN......................................................................
DIRECTOR
0.25
.................
 
X           0 0 0
(9) RICHARD SZELES......................................................................
VICE CHAIR,
0.25
.................
0.25
X   X       0 0 0
(10) RON DRNEVICH......................................................................
DIRECTOR
0.25
.................
 
X           0 0 0
(11) ROBERT SCAER......................................................................
DIRECTOR
0.25
.................
0.25
X           0 0 0
(12) SAMUEL COOPER III......................................................................
DIRECTOR
0.25
.................
 
X           0 0 0
(13) SISTER ROMAINE NIEMEYER SCC......................................................................
PRESIDENT, D
0.25
.................
1.00
X   X       0 0 0
(14) SISTER JOAN DANIEL HEALY SCC......................................................................
DIRECTOR
0.25
.................
 
X           0 0 0
(15) SISTER JOANN MARIE AUMAND SCC......................................................................
DIRECTOR
0.25
.................
 
X           0 0 0
(16) SISTER MARIE PAULINE DEMEK SCC......................................................................
DIRECTOR
0.25
.................
 
X           0 0 0
(17) SISTER MARY IRENE SORBER SCC......................................................................
DIRECTOR
0.25
.................
 
X           0 0 0
Form 990 (2015)
Form 990 (2015)
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) SISTER MARY JOSEPH SHULTZ SCC........................................................................
DIRECTOR
0.25
.......................  
X           0 0 0
(19) CHARLES KINGSLEY MD........................................................................
DIRECTOR
0.25
.......................0.00
X           0 0 0
(20) THOMAS KACHEL MD........................................................................
DIRECTOR
0.25
.......................  
X           0 0 0
(21) SISTER MARY MARK SMITH SCC........................................................................
DIRECTOR
0.25
.......................0.00
X           0 0 0
(22) MICHAEL SERLUCO........................................................................
CHAIR, DIREC
0.25
.......................0.25
X   X       0 0 0
(23) HENRY STRAUB........................................................................
DIRECTOR
0.25
.......................  
X           0 0 0
(24) DANIEL E LOHR ESQUIRE........................................................................
ASST. SECRET
 
.......................40.00
    X       0 329,289 40,678
(25) DAVID J FELICIO ESQUIRE........................................................................
SECRETARY
 
.......................40.00
    X       0 766,266 102,890
(26) KEVIN F BRENNAN CPA FHFMA........................................................................
EVP, FINANCE
 
.......................40.00
    X       0 1,083,348 211,615
(27) MANUEL J EVANS........................................................................
TREASURER
40.00
.......................  
    X       474,426 0 22,041
(28) RANDY B MORRIS........................................................................
TREASURER
40.00
.......................  
    X       172,170 60,991 22,035
(29) DAVID A GATESMAN........................................................................
VP PRO SERVI
40.00
.......................  
      X     163,014 58,045 41,064
(30) JOSEPH A TORCHIA MD........................................................................
SVP MEDICAL
40.00
.......................  
      X     444,566 0 26,227
(31) LISA F TORCHIA........................................................................
VP PATIENT C
40.00
.......................  
      X     295,142 0 35,682
(32) BARBARA SUMBATIAN MD........................................................................
PHYSICIAN
40.00
.......................  
        X   236,482 0 33,512
(33) MARIA E PRUDENCIO MD........................................................................
PHYSICIAN
40.00
.......................  
        X   265,124 0 23,368
(34) MICHAEL J PASZEK MD........................................................................
REGIONAL MED
40.00
.......................  
        X   314,185 0 44,305
(35) PAUL D BRETTSCHNEIDER MD........................................................................
PHYSICIAN
40.00
.......................  
        X   246,331 0 39,182
(36) WILLIAM P SHARTLE........................................................................
SVP, HR
40.00
.......................  
        X   296,141 0 13,438
(37) EDWARD J ZYCH ESQUIRE........................................................................
FORMER OFFIC
 
.......................40.00
          X 0 326,218 16,680
(38) GERALD R NEWHOUSE........................................................................
FORMER KEY E
40.00
.......................  
          X 195,623 0 39,837
(39) RICHARD LAVANTURE........................................................................
FORMER KEY E
40.00
.......................  
          X 377,107 0 49,552
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 3,480,311 2,624,157 762,106
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet124
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
SODEXO INC

9801 WASHINGTONIAN BLVD
GAITHERSBURG,MD20878
DIETARY ETC 7,688,567
RESTORIX HEALTH

445 HAMILTON AVE
SUITE 800
WHITE PLAINS,NY10601
WOUND CARE 2,044,799
PAVONE

1006 MARKET ST
HARRISBURG,PA17101
AD AGENCY 1,910,432
QUANTUM IMAGING THERAPEUTIC

629D LOWTHER RD
LEWISBERRY,PA17339
IMAGING SERVICE 1,514,479
WEST SHORE ANESTHESIA

503 N 21ST STREE
CAMP HILL,PA17011
ANESTHESIA 1,284,524
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet41
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e 1,883,649
f All other contributions, gifts, grants, and similar amounts not included above1f 273,073
g Noncash contributions included in lines 1a-1f:$  
h Total.Add lines 1a-1f.......MediumBullet 2,156,722
 Program Service RevenueAmt Business Code
2a PATIENT SERVICE REVENUE 622110 283,296,973 283,296,973    
b NON-PATIENT LAB 621500 1,063,945   1,063,945  
c RENTAL INCOME 531120 516,021     516,021
d INTER ENTITY REVENUE 622110 399,671     399,671
e REGISTRATION INCOME 611710 22,704     22,704
f All other program service revenue.        
g Total.Add lines 2a–2f.....MediumBullet 285,299,314
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet 4,270,025     4,270,025
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   36,652
b Less: rental expenses    
c Rental income or (loss)   36,652
d Net rental income or (loss)......MediumBullet 36,652     36,652
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   25,889
b Less: cost or other basis and sales expenses    
c Gain or (loss)   25,889
d Net gain or (loss).....MediumBullet 25,889     25,889
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        
Business Code Miscellaneous Revenue
11a GUEST SERVICE REVENUE 532000 1,197,521     1,197,521
b OTHER OPERATING REV LTACH 900099 744,233   744,233  
c OTHER OPERATING REV GENERAL 900099 647,837 647,837    
d All other revenue .... 285,048 249,128 5,588 30,332
e Total. Add lines 11a–11d ...... MediumBullet 2,874,639
12 Total revenue. See Instructions......MediumBullet 294,663,241 284,193,938 1,813,766 6,498,815
Form 990 (2015)
Form 990 (2015)
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 domestic organizations and domestic governments. See Part IV, line 21    
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 1,133,820 762,894 370,926  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 1,266,783 800,082 466,701  
7 Other salaries and wages 104,976,215 99,112,726 5,863,489  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 3,743,005 3,743,005    
9 Other employee benefits ....... 13,218,907 72,283 13,146,624  
10 Payroll taxes ........... 7,617,277 333,419 7,283,858  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 3,086 128 2,958  
c Accounting ........... 57,511 3,750 53,761  
d Lobbying ........... 74,179   74,179  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 290,772 172,435 118,337  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 27,685,349 26,106,766 1,578,583  
12 Advertising and promotion .... 1,978,737 1,976,555 2,182  
13 Office expenses ....... 8,355,526 8,205,035 150,491  
14 Information technology ...... 6,913,230 6,639,255 273,975  
15 Royalties ..        
16 Occupancy ........... 7,575,073 6,931,019 644,054  
17 Travel ............ 637,441 544,869 92,572  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 231,870 205,491 26,379  
20 Interest ........... 4,499,907 4,497,772 2,135  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 13,577,575 9,186,961 4,390,614  
23 Insurance ... 2,018,986 13,850 2,005,136  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 51,303,759 51,303,759    
b IC EXPENSE 21,193,964 20,286,643 907,321  
c UNCOLLECTIBLE EXPENSE 9,578,478 9,578,478    
d BOOKS, LICENSES, FEES 431,219 289,310 141,909  
e All other expenses 323,179 69,023 254,156  
25 Total functional expenses. Add lines 1 through 24e 288,685,848 250,835,508 37,850,340 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 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 5,720 1 3,000,417
2 Savings and temporary cash investments ......... 20,736,434 2 3,110,033
3 Pledges and grants receivable, net ...... 2,699,424 3 1,699,424
4 Accounts receivable, net ............. 30,679,462 4 21,964,806
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 11,231
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 .... 19,104 7 19,999
8 Inventories for sale or use ........ 723,397 8 4,391,349
9 Prepaid expenses and deferred charges ...... 1,518,074 9 2,120,631
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 138,508,828
b Less: accumulated depreciation 10b 22,971,759 111,980,151 10c 115,537,069
11 Investments—publicly traded securities . 53,456,022 11 6,860,641
12 Investments—other securities. See Part IV, line 11 .....   12 44,955,124
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 2,955,433 15 2,555,533
16 Total assets. Add lines 1 through 15 (must equal line 34)... 224,773,221 16 206,226,257
Liabilities 17 Accounts payable and accrued expenses ..... 32,340,623 17 8,124,699
18 Grants payable ...   18  
19 Deferred revenue .........   19 50,960
20 Tax-exempt bond liabilities ......... 91,801,321 20 88,071,758
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.. 948,086 22 911,636
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D 41,502,726 25 50,762,263
26 Total liabilities. Add lines 17 through 25.. 166,592,756 26 147,921,316
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 51,586,810 27 51,856,287
28 Temporarily restricted net assets ........... 3,771,734 28 3,856,338
29 Permanently restricted net assets 2,821,921 29 2,592,316
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 ........... 58,180,465 33 58,304,941
34 Total liabilities and net assets/fund balances ........ 224,773,221 34 206,226,257
Form 990 (2015)
Form 990 (2015)
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
294,663,241
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
288,685,848
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
5,977,393
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
58,180,465
5
Net unrealized gains (losses) on investments ...............
5
-5,080,254
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
-772,663
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
58,304,941
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 (2015)
Form 990 (2015)
Additional Data


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

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
HOLY SPIRIT HOSPITAL OF THE SISTERS
OF CHRISTIAN CHARITY
Employer identification number

23-1512747
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
6
7
8
9
10
11
a
b
c
d
e
f
Enter the number of supported organizations ..............  

g
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 (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total      

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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 VI.)..            
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 section 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) 2015

Schedule A (Form 990 or 990-EZ) 2015
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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (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 VI.) ..            
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) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
 
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions
 
9 Distributable amount for 2015 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2015
(iii)
Distributable
Amount for 2015
1 Distributable amount for 2015 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2015
(reasonable cause required--see instructions)
 
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......  
e From 2014.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2015 distributable amount  
i Carryover from 2010 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2015 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2015 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2015, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)
 
6 Remaining underdistributions for 2015. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)
 
7 Excess distributions carryover to 2016. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a
b
c Excess from 2013.......  
d From 2014.......  
e From 2015.......  
Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2015


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Name of the organization
HOLY SPIRIT HOSPITAL OF THE SISTERS
OF CHRISTIAN CHARITY
Employer identification number

23-1512747
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
Name of organization
HOLY SPIRIT HOSPITAL OF THE SISTERS
OF CHRISTIAN CHARITY
Employer identification number
23-1512747
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$ RESTRICTED


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 3
Name of organization
HOLY SPIRIT HOSPITAL OF THE SISTERS
OF CHRISTIAN CHARITY
Employer identification number

23-1512747
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 4
Name of organization
HOLY SPIRIT HOSPITAL OF THE SISTERS
OF CHRISTIAN CHARITY
Employer identification number

23-1512747
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

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 BulletInformation about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
HOLY SPIRIT HOSPITAL OF THE SISTERS
OF CHRISTIAN CHARITY
Employer identification number

23-1512747
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-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2015

Schedule C (Form 990 or 990-EZ) 2015
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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2012 (b) 2013 (c) 2014 (d) 2015 (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) 2015


Schedule C (Form 990 or 990-EZ) 2015
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 on 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? .......................
Yes
 
3,112
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
74,179
j
Total. Add lines 1c through 1i ....................................................................................................
77,291
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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
SCHEDULE C, PART II-B, LINE 1 LINE 1G AMOUNT REPORTED ON LINE 1G REPRESENTS THE WAGES AND BENEFITS OF EMPLOYEES WHO ASSIST THE GOVERNMENT RELATIONS DEPARTMENT OF THE ORGANIZATION'S AFFILIATE, GEISINGER SYSTEM SERVICES. THE PRIMARY PURPOSE OF THE GOVERNMENT RELATIONS DEPARTMENT IS TO MAINTAIN CONTACT WITH FEDERAL, STATE, AND LOCAL GOVERNMENT OFFICIALS. THE DEPARTMENT PROMOTES LEGISLATIVE ACTIONS WITH RESPECT TO HEALTHCARE RELATED ISSUES THAT COULD IMPACT THE ORGANIZATION AND ITS AFFILIATES. LINE 1I OTHER LOBBYING ACTIVITIES REPORTED ON LINE 1I REPRESENTS THE PORTION OF MEMBERSHIP DUES, PAID BY THE ORGANIZATION TO TRADE OR PROFESSIONAL ASSOCIATIONS, ATTRIBUTABLE TO LOBBYING ACTIVITIES.
Schedule C (Form 990 or 990EZ) 2015


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," on 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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
HOLY SPIRIT HOSPITAL OF THE SISTERS
OF CHRISTIAN CHARITY
Employer identification number

23-1512747
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year ....    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of 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" on 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, 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" on 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)
Revenue included on 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
Revenue included on 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) 2015

Schedule D (Form 990) 2015
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" on 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, for escrow or custodial account liability?
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" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 2,821,921 2,848,959 2,563,164 2,470,802 2,540,943
b Contributions ... 109,799,000     7,245  
c Net investment earnings, gains, and losses -2,060,358 -22,308 285,795 178,061 9,388
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
-3,474,000     92,727 70,652
f Administrative expenses .... 1,752 4,730   217 8,877
g End of year balance ...... 107,084,811 2,821,921 2,848,959 2,563,164 2,470,802
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet23.000 %
b
Permanent endowment SchDMd Bullet69.000 %
c
Temporarily restricted endowment SchDMd Bullet8.000 %
The percentages on 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)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
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' on 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 ...      
b Buildings   42,973,945 4,742,887 38,231,058
c Leasehold improvements   13,750,348 1,461,046 12,289,302
d Equipment ...   64,643,695 16,689,417 47,954,278
e Other ...   17,140,840 78,409 17,062,431
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 115,537,069
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' on 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 44,955,124 F
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 44,955,124
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on 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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
DUE TO AFFILIATES 28,831,271
ESTIMATED 3RD PARTY PAYOR SETTLEMENT 13,938,782
OBLIGATION UNDER CAPITAL LEASE 4,702,164
SECURED 3RD PARTY NOTES 1,662,457
PATIENT CREDIT BALANCE 1,029,921
DEFENSE MED LEGAL CLAIMS ALLOW 597,668
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 50,762,263
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) 2015

Schedule D (Form 990) 2015
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on 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 (losses) 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' on 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 INTEREST EARNED IS UNRESTRICTED AND TRANSFERRED TO THE OPERATING FUND. PART V, LINE 1B - CONTRIBUTIONS 106,445,000 OF THE 109,799,000 REPORTED ON LINE 1B REPRESENTS THE TOTAL ENDOWMENTS HELD BY GEISINGER HEALTH ON BEHALF OF ALL ITS AFFILIATED ORGANIZATIONS. THE 2014 REPORTING PERIOD WAS THE FIRST REPORTING PERIOD DURING WHICH GEISINGER HEALTH HELD ENDOWMENTS ON BEHALF OF HOLY SPIRIT HOSPITAL.
SCHEDULE D, PAGE 4, PART XIII PART V, ENDOWMENT FUNDS THE AMOUNT REPORTED ON LINE 1B CONTRIBUTIONS INCLUDES 106,772,000 FROM GEISINGER HEALTH, EIN 23-1995911. THE AMOUNT REPRESENTS THE BEGINNING BALANCE OF THE AGGREGATE ENDOWMENTS HELD BY GEISINGER HEALTH FOR ALL OF ITS AFFILIATED ORGANIZATIONS, INCLUDING HOLY SPIRIT HOSPITAL. THIS WAS THE FIRST YEAR THAT GEISINGER HEALTH HELD ENDOWMENTS ON BEHALF OF HOLY SPIRIT HOSPITAL. PART X, LINE 2-LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48(ASC 740): EFFECTIVE JULY 1, 2007, GEISINGER(1) 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 ASSETS AS OF THE END OF THE FISCAL YEAR OR ANY PREVIOUS YEARS SINCE ADOPTION. ACCORDINGLY, NO FIN 48 FOOTNOTE DISCLOSURE WAS MADE IN THE GEISINGER CONSOLIDATED FINANCIAL STATEMENTS. (1) THROUGHOUT THIS DOCUMENT, THE TERMS "SYSTEM- OR "GEISINGER", SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH "GH" AS PARENT AND ALL SUBSIDIARY ENTITIES COMPRISING THE SYSTEM.
Schedule D (Form 990) 2015


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" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
HOLY SPIRIT HOSPITAL OF THE SISTERS
OF CHRISTIAN CHARITY
Employer identification number

23-1512747
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
 
No
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    2,164,182   2,164,182 0.750 %
b Medicaid (from Worksheet 3, column a) . . . . .     28,195,029 7,292,035 20,902,994 7.240 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     30,359,211 7,292,035 23,067,176 7.990 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     256,126   256,126 0.090 %
f Health professions education (from Worksheet 5) . . .     507,523 104,413 403,110 0.140 %
g Subsidized health services (from Worksheet 6) . . . .     753,171 690,450 62,721 0.020 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .            
j Total. Other Benefits . .     1,516,820 794,863 721,957 0.250 %
k Total. Add lines 7d and 7j .     31,876,031 8,086,898 23,789,133 8.240 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
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
9,578,478
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
2,356,306
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
49,654,979
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
68,138,818
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-18,483,839
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 %
1HS ORTHO MGMT CO LLC
 
PARTNERSIP AGREEMENT WITH ORTHO PHYS. 40.000 %   60.000 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
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 (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 HOLY SPIRIT HOSPITAL
OF THE SISTERS OF CHRISTIAN CHARITY
503 NORTH 21ST STREET
CANP HILL,PA17011
WWW.HSH.ORG
340801
X X         X      
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
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)
HOLY SPIRIT HOSPITAL
Name of hospital facility or letter of facility reporting group OF THE SISTERS OF CHRISTIAN CHARITY
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 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 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTP://WWW.HSH.ORG/CHNA
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
HOLY SPIRIT HOSPITAL
Name of hospital facility or letter of facility reporting group OF THE SISTERS OF CHRISTIAN CHARITY
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
HTTPHSHORG REFER TO SECTION C
b
HTTPHSHORG REFER TO SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

HOLY SPIRIT HOSPITAL
Name of hospital facility or letter of facility reporting group OF THE SISTERS OF CHRISTIAN CHARITY
Yes No
19 Did the hospital facility or other authorized 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?............ 19 Yes  
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 7
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
FACILITY 1, HOLY SPIRIT HOSPITAL - PART V, LINE 5 SECTION B., COMMUNITY HEALTH NEEDS ASSESSMENT, LINES 3 AND 5 HOLY SPIRIT HOSPITAL ENGAGED IN A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS THAT INVOLVED QUALITATIVE AND QUANTITATIVE DATA COLLECTION FROM A WIDE RANGE OF POPULATIONS, INCLUDING DIFFERENT AGES, INCOMES, HEALTH STATUS (INCLUDING RISK FACTORS, UTILIZATION, AND ACCESS), AND GEOGRAPHIC AREAS (INCLUDING URBAN, SUBURBAN, AND RURAL). AFTER DESIGNING SURVEY QUESTIONS AND INSTRUMENTS TO COLLECT PERTINENT INFORMATION FROM DIFFERENT AUDIENCES, THE CHNA TEAM EMPLOYED A VARIETY OF DATA COLLECTION TECHNIQUES. (1) COMMUNITY LEADERS WERE INTERVIEWED, INCLUDING PUBLIC HEALTH EXPERTS, MEDICAL PROFESSIONALS, SCHOOL SUPERINTENDENTS, EDUCATORS, CITIZEN ADVOCATES, AND ELECTED REPRESENTATIVES FROM LOCAL, COUNTY, AND STATE GOVERNMENTS AND AGENCIES. (2) DATA WAS COLLECTED ON HAND-DISTRIBUTED SURVEYS THAT WERE BROADLY DISTRIBUTED TO RESIDENTS ACROSS THE REGION, INCLUDING AT COMMUNITY CENTERS, HOMELESS SHELTERS, PUBLIC HEALTH CENTERS, FOOD BANKS, FREE CLINICS, SOCIAL SERVICES ORGANIZATIONS, SCHOOLS, CHURCHES, FAITH-BASED ORGANIZATIONS, CAREER AND JOB CENTERS, AND OTHER SETTINGS THAT SERVE POPULATIONS IN NEED. THIS SURVEY WAS AVAILABLE IN BOTH ENGLISH AND SPANISH. (3) HEALTH PROVIDERS WERE SURVEYED TO COLLECT THEIR THOUGHTS AND OPINIONS RELATED TO THE CARE AND SERVICES THEY PROVIDE, AS WELL AS THE TOP HEALTH PROBLEMS IN THE COMMUNITY. (4) A PUBLIC COMMENTARY SURVEY WAS DEVELOPED TO GATHER INPUT FROM THE PUBLIC REGARDING THE PREVIOUS CHNA REPORT AND ADOPTED IMPLEMENTATION PLAN. THIS SURVEY WAS AVAILABLE AT VARIOUS LOCATIONS WITHIN THE HOSPITAL. (5) A COMMUNITY FORUM WAS HELD TO GATHER INPUT FROM COMMUNITY ORGANIZATION LEADERS, RELIGIOUS LEADERS, GOVERNMENT STAKEHOLDERS, AND OTHER KEY CONSTITUENTS. THE CHNA FINDINGS, VARIOUS SURVEY RESULTS, AND SUPPORTING DATA WERE PRESENTED TO OBTAIN FEEDBACK REGARDING THE NEEDS AND CONCERNS OF THE COMMUNITY OVERALL. (6) SECONDARY DATA FROM SEVERAL RELIABLE SOURCES, INCLUDING COMMUNITY NEEDS INDEX (CNI), PENNSYLVANIA COUNTY HEALTH RANKINGS, HEALTHY PEOPLE 2020, KIDS COUNT, AND PENNSYLVANIA DEPARTMENT OF RURAL HEALTH, WAS USED TO PREPARE QUANTITATIVE DATA. EVERY EFFORT WAS UNDERTAKEN TO GATHER AND REPORT DATA CONSISTENT WITH THE CHNA GUIDELINES AND HOLY SPIRIT'S MISSION TO SERVE THOSE IN NEED. INFORMATION FROM THE FINAL SUMMARY REPORT WAS DELIVERED BACK TO THE COMMUNITY IN A VARIETY OF WAYS TO ASSURE BROAD DISTRIBUTION.
FACILITY 1, HOLY SPIRIT HOSPITAL - PART V, LINE 6A CARLISLE REGIONAL MEDICAL CENTER, PENN STATE MILTON S. HERSHEY MEDICAL CENTER, AND PINNACLEHEALTH SYSTEM PARTICIPATED IN THE CHNA.
FACILITY 1, HOLY SPIRIT HOSPITAL - PART V, LINE 6B HAMILTON HEALTH CENTER AND PENNSYLVANIA PSYCHIATRIC INSTITUTE PARTICIPATED IN THE CHNA.
FACILITY 1, HOLY SPIRIT HOSPITAL - PART V, LINE 7D THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED DURING FISCAL YEAR ENDED JUNE 30, 2016 (2015 TAX YEAR). THE REPORT IS CURRENTLY AVAILABLE ON THE HOSPITAL'S WEBSITE (HTTP://WWW.HSH.ORG/CHNA) AND UPON REQUEST. THE HOSPITAL HAS ALSO MADE THE CHNA REPORT AVAILABLE AT A VARIETY OF COMMUNITY BASED INFORMATIONAL SESSIONS THAT THE HOSPITAL HOSTED BOTH AT THE HOSPITAL AND IN VARIOUS LOCATIONS THROUGHOUT THE HOSPITAL'S GEOGRAPHIC FOOTPRINT.
FACILITY 1, HOLY SPIRIT HOSPITAL - PART V, LINE 11 DURING TAX YEAR 2015, HSH, IN ACCORDANCE WITH IRS REGULATIONS REGARDING A COMMUNITY HEALTH NEEDS ASSESSMENT, AS STIPULATED IN THE AFFORDABLE CARE ACT PASSED BY THE U.S. CONGRESS, PARTNERED WITH CARLISLE REGIONAL MEDICAL CENTER, PENN STATE MILTON S. HERSHEY MEDICAL CENTER, PINNACLEHEALTH SYSTEM, HAMILTON HEALTH CENTER, AND PENNSYLVANIA PSYCHIATRIC INSTITUTE TO SELECT THE TRIPP-UMBACH FIRM TO FACILITATE HOLY SPIRIT HOSPITAL (AND THREE OTHER HOSPITAL/HEALTH SYSTEMS AND TWO OTHER HEALTH CARE ORGANIZATIONS) IN THE DEVELOPMENT OF THE SURVEY DESIGN, PROCESS, AND TIMETABLE FOR ITS CHNA. AS PART OF ITS CLINICAL PROGRAM PLANNING AND ENVIRONMENTAL ASSESSMENT PROCESS, HOLY SPIRIT HOSPITAL ADDRESSED THE HEALTH CARE NEEDS OF ITS GEOGRAPHIC FOOTPRINT COMMUNITY. HEART, CANCER, AND STROKE HAVE BEEN IDENTIFIED AS THE LEADING CAUSES OF DEATH. HOLY SPIRIT HAS COMMITTED RESOURCES TO THESE SERVICE LINES TO ADDRESS THE HEALTH NEEDS OF ITS COMMUNITY, AMONG OTHER ITEMS DRIVEN BY DEMOGRAPHICS AND EPIDEMIOLOGY. THE CEO/PRESIDENT AND EXECUTIVE LEADERSHIP OF HOLY SPIRIT HOSPITAL APPOINTED A TEAM OF DIRECTORS TO WORK WITH TRIPP-UMBACH TO PLAN AND CONDUCT THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR HOLY SPIRIT HOSPITAL. THE HOLY SPIRIT HOSPITAL CEO/PRESIDENT, EXECUTIVE LEADERSHIP, AND STRATEGIC PLANNING DEPARTMENT, ALONG WITH THE APPOINTED HOLY SPIRIT COMMUNITY HEALTH NEEDS/ COMMUNITY BENEFIT COMMITTEE MEMBERSHIP, REVIEWED ALL FINDINGS OF THE CHNA AND PREPARED A REPORT WITH RECOMMENDATIONS TO ADDRESS THE THREE PRIORITY HEALTH NEEDS IDENTIFIED THROUGH THE CHNA. THE PRIORITY HEALTH NEEDS ARE: 1.ACCESS TO HEALTH SERVICES - PRIMARY CARE, SPECIALTY CARE, AND DENTAL CARE 2.BEHAVIORAL HEALTH SERVICES - MENTAL HEALTH AND SUBSTANCE ABUSE 3.HEALTHY LIFESTYLES - LACK OF PHYSICAL ACTIVITY, INADEQUATE NUTRITION/OBESITY, AND SMOKING CESSATION AND PREVENTION AN IMPLEMENTATION PLAN, OR ACTION PLAN, WAS DEVELOPED WITH INPUT FROM A VARIETY OF STAKEHOLDERS, INTERNAL AND EXTERNAL, AND PRESENTED FOR REVIEW AND APPROVAL BY OUR CEO/PRESIDENT AND EXECUTIVE LEADERSHIP. THE CHNA ACTION PLAN WAS THEN REVIEWED AND APPROVED BY HOLY SPIRIT PLATFORM LEADERSHIP, HOLY SPIRIT HOSPITAL BOARD OF DIRECTORS, HOLY SPIRIT HEALTH SYSTEM BOARD OF DIRECTORS, AND GEISINGER HEALTH SYSTEM FOUNDATION BOARD OF DIRECTORS. THE CHNA REPORT IS POSTED ON THE HOLY SPIRIT HOSPITAL WEBSITE AND HAS BEEN SHARED PROACTIVELY BY HOLY SPIRIT HOSPITAL WITH VARIOUS COMMUNITY STAKEHOLDERS AND PARTICIPANTS IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. THE CHNA ACTION PLAN AND ACCOMPANYING BROCHURE THAT DESCRIBES OUR RESPONSE TO THE IDENTIFIED COMMUNITY NEEDS ARE ALSO POSTED ON HOLY SPIRIT'S WEBSITE.
FACILITY 1, HOLY SPIRIT HOSPITAL - PART V, LINE 13B RECENT WAGE STATEMENTS, UNEMPLOYMENT OR OTHER DOCUMENTATION OF BENEFITS OR COMPENSATION RECEIVED MAY BE CONSIDERED IN DETERMINING FINANCIAL ASSISTANCE ELIGIBILITY.
FACILITY 1, HOLY SPIRIT HOSPITAL - PART V, LINE 16I THE FAP, FAP APPLICATION AND A PLAIN LANGUAGE SUMMARY OF THE FAP ARE WIDELY AVAILABLE AT: HSH.ORG/PATIENTS-AND-VISITORS/BILLING-INSURANCE/FINANCIAL ASSISTANCE IN ADDITION, PATIENT REGISTRATION PERSONNEL ALSO REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY.
FACILITY 1, HOLY SPIRIT HOSPITAL - PART V, LINE 20E UNDER NO CIRCUMSTANCE WILL HSH FREEZE OR ATTACH BANK ACCOUNTS OF A PATIENT, ENFORCE LIENS, ACTIVELY PURSUE ASSETS FROM A PRIOR JUDGMENT OR GARNISH THE WAGES OF A PATIENT AND/OR FAMILY MEMBER BEFORE DETERMINING IF THE PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER HSH'S FINANCIAL ASSISTANCE PROGRAM.
FACILITY 1, HOLY SPIRIT HOSPITAL - PART V, LINE 22D PATIENTS WHOSE HOUSEHOLD INCOME IS 300% OR LOWER OF THE FEDERAL POVERTY GUIDELINES ARE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S FAP. PATIENTS WHO MEET THIS CRITERIA ARE ELIGIBLE FOR 100% DISCOUNT ON CHARGES, RESULTING IN 0 CHARGES FOR MEDICALLY NECESSARY CARE. NO OTHER DISCOUNTS ARE AVAILABLE UNDER HSH'S FAP. FREE CARE OR 0 CHARGE IS BELOW THE HOSPITAL FACILITY'S AMOUNT GENERALLY BILLED, AS WELL AS, MEDICARE'S PROSPECTIVE BILLING AMOUNT.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 8
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) 2015
Schedule H (Form 990) 2015
Page 9
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
PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE SUPPORTING DOCUMENTATION FOR ELIGIBILITY MAY CONSIST OF INCOME AND ASSET INFORMATION, INCLUSIVE BUT NOT LIMITED TO: FEDERAL INCOME TAX FORM 1040 FROM THE PRIOR YEAR, PAY STUB COPIES (FROM FOUR PRIOR PAY PERIODS), WRITTEN VERIFICATION OF ANY OTHER INCOME RECEIVED (I.E. SOCIAL SECURITY, ADC, CHILD SUPPORT, ALIMONY, ETC.), CURRENT CREDIT REPORTS AND ASSET VERIFICATION. HSH MAY ALSO UTILIZE INDUSTRY TESTED EXTERNAL ANALYTICS TOOLS TO QUALIFY PATIENTS FOR UNCOMPENSATED CARE (AKA PRESUMPTIVE CHARITY).
PART I, LINE 6A - RELATED ORGANIZATION INFORMATION COMMUNITY BENEFIT REPORT: A SUMMARY OF THE COMMUNITY BENEFIT PROVIDED BY HOLY SPIRIT HOSPITAL (HSH) AND ITS RELATED CHARITABLE ORGANIZATIONS IS AVAILABLE AT WWW.HSH.ORG AND MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE REPORT CAN BE FOUND AT: HTTPS://WWW.GEISINGER.ORG/ABOUT-GEISINGER/NEWS-AND-MEDIA/FOR-MEDIA/ANNUAL- REPORTS
PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES EXPLANATION THERE ARE NO PHYSICIAN CLINICAL SERVICES INCLUDED IN SUBSIDIZED HEALTH SERVICES.
PART I, LINE 7 - COSTING METHODOLOGY EXPLANATION A COST ACCOUNTING SYSTEM WAS USED TO DETERMINE THE COSTS REPORTED ON LINE 7 THAT ADDRESSES PATIENT SEGMENTS BY PAYOR (E.G. MEDICARE, MEDICAID, COMMERCIAL PAYERS, SELF-PAY, ETC.). A COST TO CHARGE RATIO, CALCULATED PURSUANT TO WORKSHEET 2 OF THE FORM 990 INSTRUCTIONS, WAS USED TO CALCULATE THE COST OF CHARITY CARE.
PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY REFER TO THE RESPONSE FOR PART III, LINE 4.
PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE PATIENTS' ACCOUNTS ARE MONITORED THROUGHOUT THE BILLING PROCESS AND ARE RECLASSIFIED TO CHARITY CARE (100% DISCOUNTED CARE) WHENEVER A PATIENT BECOMES ELIGIBLE UNDER HSH'S UNCOMPENSATED OR CHARITY CARE POLICIES. HSH ESTIMATES THAT APPROXIMATELY 24.6% OF THE BAD DEBT ACCOUNTS ARE SUBSEQUENTLY RECLASSIFIED TO UNCOMPENSATED OR CHARITY CARE. THIS IS PART OF THE HOSPITAL'S MISSION AND SHOULD BE CONSIDERED COMMUNITY BENEFIT.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS PART III, LINE 2 AND LINE 4 GEISINGER HEALTH AND ITS AFFILIATES (THE "SYSTEM"), THAT INCLUDES HOLY SPIRIT HOSPITAL (HSH), PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM'S ALLOWANCE FOR DOUBTFUL ACCOUNTS (BAD DEBT EXPENSE) METHODOLOGY AND CHARITY CARE POLICIES ARE CONSISTENTLY APPLIED ACROSS ALL CHARITABLE AFFILIATES. THE ORGANIZATIONS WRITE OFF ALL ACCOUNTS THAT HAVE BEEN IDENTIFIED AS UNCOLLECTABLE. AN ALLOWANCE FOR UNCOLLECTABLE ACCOUNTS IS RECORDED FOR ACCOUNTS NOT YET WRITTEN OFF THAT ARE ANTICIPATED TO BECOME UNCOLLECTABLE IN FUTURE PERIODS. FOR THE FOOTNOTES REGARDING ACCOUNTS RECEIVABLE AND ALLOWANCES SEE PAGE 8 OF THE ATTACHED GEISINGER HEALTH SYSTEM CONSOLIDATED FINANCIAL STATEMENTS, JUNE 30, 2016 AND JUNE 30, 2015. FOR THE FOOTNOTE REGARDING BAD DEBT, SEE PAGE 13 OF THE CONSOLIDATED FINANCIAL STATEMENTS.
PART III, LINE 8 - MEDICARE EXPLANATION PART III, LINE 3-BAD DEBT: THE ORGANIZATION BELIEVES THAT MEDICARE UNDERPAYMENTS (SHORTFALL) AND THE COST OF BAD DEBT ARE COMMUNITY BENEFIT AND SHOULD BE INCLUDED ON FORM 990, SCHEDULE H, PART I. AS OUTLINED MORE FULLY BELOW, THE ORGANIZATION BELIEVES THAT THESE SERVICES AND RELATED COSTS PROMOTE THE HEALTH OF THE COMMUNITY AS A WHOLE AND ARE RENDERED IN CONJUNCTION WITH THE ORGANIZATION'S CHARITABLE TAX-EXEMPT PURPOSES AND MISSION IN PROVIDING MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON- DISCRIMINATORY MANNER WITHOUT REGARD TO RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY AND IS CONSISTENT WITH THE COMMUNITY BENEFIT STANDARD PROMULGATED BY THE IRS. SATISFYING THE "COMMUNITY BENEFIT STANDARD," AS ARTICULATED BY THE INTERNAL REVENUE SERVICE (IRS) IN REVENUE RULING 69-545, IS CURRENTLY REQUIRED FOR A HOSPITAL TO BE RECOGNIZED AS A CHARITABLE ORGANIZATION UNDER INTERNAL REVENUE CODE (IRC) 501(C)(3). THIS RULING REMOVED THE PREVIOUS REQUIREMENT OF REVENUE RULING 56-185, KNOWN AS THE "CHARITY CARE STANDARD," THAT IN ORDER TO BE A CHARITABLE ORGANIZATION, A HOSPITAL HAD TO PROVIDE, TO THE EXTENT OF ITS FINANCIAL ABILITY, FREE OR REDUCED-COST CARE TO PATIENTS UNABLE TO PAY FOR THEIR CARE. THIS EARLIER RULING EMPHASIZED THAT A LOW LEVEL OF CHARITY CARE DID NOT MEAN THAT A HOSPITAL WAS NOT CHARITABLE SINCE THAT LEVEL COULD REFLECT THE HOSPITAL'S FINANCIAL ABILITY TO PROVIDE SUCH CARE. REVENUE RULING 56-185 ALSO NOTED THAT PUBLICLY SUPPORTED COMMUNITY HOSPITALS WOULD NORMALLY QUALIFY AS CHARITABLE BECAUSE THEY SERVE THE ENTIRE COMMUNITY AND A LOW LEVEL OF CHARITY CARE WOULD NOT IMPACT A HOSPITAL'S CHARITABLE STATUS IF IT WAS DUE TO THE SURROUNDING COMMUNITY'S LACK OF CHARITABLE DEMANDS. UNDER THE COMMUNITY BENEFIT STANDARD DEVELOPED IN REVENUE RULING 69-545, HOSPITALS WERE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF BROAD CLASS OF INDIVIDUALS IN THE COMMUNITY. THIS RULING INVOLVED A HOSPITAL THAT ONLY ADMITTED THOSE WHO COULD PAY FOR THE SERVICES EITHER BY THEMSELVES, THROUGH PRIVATE INSURANCE OR PUBLIC PROGRAMS SUCH AS MEDICARE. IN ADDITION, THE HOSPITAL OPERATED A FULL-TIME EMERGENCY ROOM THAT WAS OPEN TO EVERYONE. THE IRS RULED THAT THE HOSPITAL WAS CHARITABLE BECAUSE IT PROMOTED THE HEALTH OF PEOPLE IN ITS COMMUNITY. THE IRS REASONED THAT BECAUSE THE PROMOTION OF HEALTH WAS A CHARITABLE PURPOSE ACCORDING TO THE GENERAL LAW OF CHARITY, IT FELL WITHIN THE "GENERALLY ACCEPTED LEGAL SENSE" OF THE TERM CHARITABLE, AS REQUIRED BY TREASURY REGULATION SECTION 1.501(C)(3)-1(D)(2). THE IRS RULED THAT THE PROMOTION OF HEALTH, LIKE RELIEF OF POVERTY AND THE ADVANCEMENT OF EDUCATION AND RELIGION, IS ONE OF THE PURPOSES OF THE GENERAL LAW OF CHARITY THAT IS DEEMED BENEFICIAL TO THE COMMUNITY AS A WHOLE EVEN WHEN THE CLASS OF BENEFICIARIES ELIGIBLE TO RECEIVE A DIRECT BENEFIT FROM ITS ACTIVITIES DOES NOT INCLUDE ALL MEMBERS OF THE COMMUNITY, SUCH AS INDIGENT MEMBERS OF THE COMMUNITY, PROVIDED THAT THE CLASS IS NOT SO SMALL THAT ITS RELIEF IS NOT OF BENEFIT TO THE COMMUNITY. THE IRS CONCLUDED THAT THE HOSPITAL WAS "PROMOTING THE HEALTH OF A CLASS OF PERSONS THAT IS BROAD ENOUGH TO BENEFIT THE COMMUNITY" BECAUSE ITS EMERGENCY ROOM WAS OPEN TO ALL AND IT PROVIDED CARE TO THOSE WHO COULD PAY, WHETHER DIRECTLY OR THROUGH THIRD-PARTY REIMBURSEMENT. OTHER FACTORS THAT DEMONSTRATED COMMUNITY BENEFIT INCLUDED: SURPLUS FUNDS WERE USED TO IMPROVE PATIENT CARE, EXPAND FACILITIES AND ADVANCE MEDICAL TRAINING, EDUCATION AND RESEARCH; AND IT WAS CONTROLLED BY A BOARD OF DIRECTORS THAT CONSISTED OF INDEPENDENT CIVIC LEADERS. THE AMERICAN HOSPITAL ASSOCIATION ("AHA") HOLDS THE POSITION THAT MEDICARE UNDERPAYMENTS (SHORTFALLS) AND BAD DEBT SHOULD BE REPORTED AS COMMUNITY BENEFIT ON FORM 990, SCHEDULE H, PART I, LINE 7. IN A LETTER TO THE IRS DATED AUGUST 21, 2007 RESPONDING TO A DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA ARGUES THAT MEDICARE UNDERPAYMENTS (SHORTFALLS) IS COMMUNITY BENEFIT FOR THE FOLLOWING REASONS: -PROVIDING CARE FOR THE ELDERLY AND SERVING MEDICARE PATIENTS REMAINS AN ESSENTIAL PART OF THE COMMUNITY BENEFIT STANDARD. -MEDICARE, LIKE MEDICAID, DOES NOT PAY THE FULL COST OF CARE. RECENTLY, MEDICARE REIMBURSES ONLY 92 CENTS FOR EVERY DOLLAR HOSPITALS SPEND TO CARE FOR MEDICARE PATIENTS. THE MEDICARE PAYMENT ADVISORY COMMISSION IN ITS MARCH 2007 REPORT CAUTIONED THAT UNDERPAYMENT WILL GET EVEN WORSE. -MANY MEDICARE PATIENTS, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR. MORE THAN 46% OF MEDICARE SPENDING IS FOR BENEFICIARIES WHOSE INCOME IS BELOW 200% OF THE FEDERAL POVERTY LEVEL. MANY ARE ALSO ELIGIBLE FOR MEDICAID, SO CALLED -DUAL ELIGIBLES". PENNSYLVANIA REQUIRES NON-PROFIT HOSPITALS LIKE HSH TO PROVIDE A MINIMUM LEVEL OF COMMUNITY BENEFIT TO RETAIN EXEMPTION FROM STATE AND LOCAL TAXES. ACCORDING TO STATE GUIDANCE AND CASE LAW, THE UNREIMBURSED COST OF MEDICARE AND BAD DEBT IS CONSIDERED TO BE COMMUNITY BENEFIT FOR STATE TAX EXEMPTION PURPOSES. PART III, LINE 6 ONLY INCLUDES THOSE COSTS THAT ARE ALLOWED TO BE REPORTED ON GLH'S MEDICARE COST REPORT THAT ARE REQUIRED TO BE FILED WITH THE FEDERAL GOVERNMENT. GLH CONSIDERS THE TOTAL MEDICARE UNDERPAYMENTS (SHORTFALL) OF 28,684,303 SHOULD BE REPORTED AS COMMUNITY BENEFIT ON THE FORM 990, SCHEDULE H, PART I, LINE 7. ALONG WITH PROVIDING CARE TO MEDICAID PATIENTS AND PROVIDING FREE OR DISCOUNTED CARE TO OTHER LOW INCOME PATIENTS, THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. LIKE MEDICAID, MEDICARE DOES NOT PAY THE FULL COST OF PROVIDING CARE TO THESE PATIENTS, FORCING HSH TO USE OTHER FUNDS TO COVER THE SHORTFALL. MEDICARE SHORTFALLS MUST BE ABSORBED BY HSH IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. HSH PROVIDES CARE REGARDLESS OF THE MEDICARE SHORTFALL AND IS THEREBY PROVIDING ACCESS TO MEDICAL SERVICES FOR THE ELDERLY AND RELIEVING THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR PROVIDING CARE TO MEDICARE PATIENTS. ABSENT THE MEDICARE PROGRAM, IT IS LIKELY THAT MANY MEDICARE PATIENTS WOULD BE ELIGIBLE FOR CHARITY CARE OR OTHER NEEDS BASED GOVERNMENT PROGRAMS. THE AMOUNT EXPENDED TO COVER THE SHORTFALL IS MONEY NOT AVAILABLE FOR FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. BOTH HSH AND THE AHA BELIEVE THAT PATIENT BAD DEBT BE REPORTED AS A COMMUNITY BENEFIT ON FORM 990, SCHEDULE H, PART I, LINE 7. LIKE MEDICARE UNDERPAYMENTS (SHORTFALLS), BAD DEBT SHOULD BE REPORTED AS COMMUNITY BENEFIT BECAUSE: -A SIGNIFICANT PORTION OF BAD DEBT IS ATTRIBUTABLE TO LOW-INCOME PATIENTS, WHO FOR MANY REASONS DECLINE TO COMPLETE THE FORMS REQUIRED TO ESTABLISH ELIGIBILITY UNDER HSH'S CHARITY CARE OR FINANCIAL ASSISTANCE POLICY (FAP). A 2006 CONGRESSIONAL BUDGET OFFICE ("CBO"), "NONPROFIT HOSPITALS AND THE PROVISION OF COMMUNITY BENEFIT", CITED TWO STUDIES INDICATING THAT "THE GREAT MAJORITY OF BAD DEBT WAS ATTRIBUTABLE TO PATIENTS WITH INCOMES BELOW 200% OF THE FEDERAL POVERTY LINE." -THE CBO REPORT ALSO NOTED THAT A SUBSTANTIAL PORTION OF THE BAD DEBT IS PENDING CHARITY CARE. UNLIKE BAD DEBT IN OTHER INDUSTRIES, HOSPITAL BAD DEBT IS COMPLICATED BY THE FACT THAT HOSPITALS FOLLOW THEIR CHARITABLE MISSION TO THE COMMUNITY AND TREAT EVERY PATIENT THAT COMES THROUGH THE EMERGENCY DEPARTMENT, REGARDLESS OF ABILITY TO PAY. PATIENTS WHO HAVE OUTSTANDING BILLS ARE NOT TURNED AWAY, UNLIKE OTHER INDUSTRIES. BAD DEBT IS FURTHER COMPLICATED BY THE AUDITING INDUSTRY'S STANDARDS ON REPORTING CHARITY CARE. MANY PATIENTS CANNOT OR DO NOT PROVIDE THE NECESSARY DOCUMENTATION REQUIRED TO BE DEEMED CHARITY CARE BY AUDITORS. AS A RESULT, ACCORDING THE CBO REPORT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. (IN FY 2016, APPROXIMATELY 24.6% OF HSH'S BAD DEBT WAS SUBSEQUENTLY RECLASSIFIED TO CHARITY CARE.) THE CBO CONCLUDED THAT ITS FINDINGS "SUPPORT THE VALIDITY OF THE USE OF UNCOMPENSATED CARE (BAD DEBT AND CHARITY CARE) AS A MEASURE OF COMMUNITY BENEFITS" ASSUMING THE FINDINGS ARE GENERALIZED NATIONALLY. THE EXPERIENCE OF HOSPITALS NATIONWIDE REINFORCE THAT THEY ARE GENERALIZABLE. AS OUTLINED BY THE AHA, DESPITE THE HOSPITAL'S BEST EFFORTS AND DUE DILIGENCE, PATIENT BAD DEBT IS A PART OF THE CHARITABLE MISSION AND CHARITABLE PURPOSES. BAD DEBT REPRESENTS PART OF THE BURDEN HOSPITALS' SHOULDER IN SERVING ALL PATIENTS REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. IN ADDITION, THE HOSPITAL INVESTS SIGNIFICANT RESOURCES IN SYSTEMS AND STAFF TRAINING TO ASSIST PATIENTS THAT ARE IN NEED OF FINANCIAL ASSISTANCE. FOR FISCAL YEAR ENDED 6/30/2016, HSH'S COST OF PROVIDING PATIENT CARE FOR SERVICES ACCOUNTED FOR AS BAD DEBT WAS 2,823,470.
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION HSH IS COMMITTED TO PROVIDING MEDICAL NECESSARY SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND HSH'S COLLECTION ACTIONS ARE CONSISTENTLY APPLIED TO ALL PATIENTS. IT IS HSH POLICY TO PROVIDE FINANCIAL ASSISTANCE AND COUNSELING TO PATIENTS WITH LIMITED FINANCIAL MEANS. A PATIENT MAY BECOME ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY TIME DURING TREATMENT OR DURING THE CONTINUUM OF THE FINANCIAL/BILLING AND COLLECTION PROCESS. IN ANY STAGE OF THE BILLING PROCESS, COLLECTION ACTIONS ARE NOT PURSUED WHENEVER A PATIENT APPLIES AND IS BEING EVALUATED FOR FINANCIAL ASSISTANCE. UNDER NO CIRCUMSTANCES WILL HSH FREEZE OR ATTACH BANK ACCOUNTS OF A PATIENT, ENFORCE LIENS, ACTIVELY PURSUE ASSETS FROM A PRIOR JUDGMENT OR GARNISH THE WAGES OF A PATIENT AND/OR FAMILY MEMBER BEFORE DETERMINING IF THE PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER HSH'S FINANCIAL ASSISTANCE PROGRAM.
PART VI, LINE 2 - NEEDS ASSESSMENT AS PART OF ITS CLINICAL PROGRAM PLANNING AND ENVIRONMENTAL ANALYSIS, HSH ASSESSES THE HEALTH CARE NEEDS OF ITS COMMUNITY. HEART, CANCER, AND STROKE HAVE BEEN IDENTIFIED AS THE LEADING CAUSES OF DEATH. HOLY SPIRIT HAS COMMITTED RESOURCES TO THESE SERVICE LINES TO ADDRESS THE HEALTH NEEDS OF ITS COMMUNITY, AMONG OTHER ITEMS DRIVEN BY DEMOGRAPHICS AND EPIDEMIOLOGY. HOLY SPIRIT HOSPITAL HAS REGULARLY CONDUCTED PHYSICIAN NEEDS ASSESSMENTS TO IDENTIFY MEDICAL AND SURGICAL SPECIALTIES THAT ARE IN SHORT SUPPLY WITHIN ITS PRIMARY SERVICE AREA. STRONG PHYSICIAN RECRUITMENT INITIATIVES HAVE BEEN DEVELOPED TO ASSURE THAT THE COMMUNITY HAS ACCESS TO THESE PHYSICIANS. HOLY SPIRIT HOSPITAL PARTICIPATED IN A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT WITH THREE OTHER LOCAL HOSPITAL/HEALTH SYSTEMS AND TWO OTHER HEALTH CARE ORGANIZATIONS IN KEEPING WITH IRS GUIDANCE. A THIRD-PARTY CONSULTANT WAS ENGAGED TO OUTLINE THE PROCESS, CONDUCT RESEARCH, AND ENGAGE COMMUNITY STAKEHOLDERS. THIS INFORMATION WAS USED AS THE BASIS FOR A FORMAL, REGIONAL HEALTH ASSESSMENT DOCUMENT. SEE PART V OF SCHEDULE H.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FOR URGENT AND EMERGENT SERVICES, PATIENTS ARE PROVIDED CARE REGARDLESS OF THEIR ABILITY TO PAY. IN THE EVENT A PATIENT HAS AN EMERGENCY MEDICAL CONDITION, TREATMENT IS NOT DELAYED TO PERMIT AN INQUIRY REGARDING A PATIENT'S METHOD OF PAYMENT OR INSURANCE STATUS. FOR OTHER THAN URGENT AND EMERGENT SERVICES, THE HOSPITAL PROVIDES UNCOMPENSATED CARE, FREE OF CHARGE, OR ON A 100% DISCOUNTED BASIS, TO THOSE PATIENTS WHO DEMONSTRATE AN INABILITY TO PAY. DEPENDING UPON FAMILY SIZE AND INCOME, FREE OR 100% DISCOUNTED SERVICES ARE AVAILABLE TO A PATIENT WITH FAMILY INCOME OF 300% OR LESS OF THE FEDERAL POVERTY GUIDELINES. IT IS GEISINGER POLICY TO PROVIDE FINANCIAL ASSISTANCE AND FINANCIAL COUNSELING TO PATIENTS OF LIMITED MEANS. A PATIENT MAY BECOME ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE AT ANY TIME DURING TREATMENT OR DURING THE CONTINUUM OF THE FINANCIAL/BILLING PROCESS. INFORMATION (SIGNS, BROCHURES, ETC.) REGARDING GEISINGER'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES ARE PROVIDED AT THE EMERGENCY ROOM, REGISTRATION AND VARIOUS ACCESS POINTS THROUGHOUT THE HOSPITAL. REGISTRATION PERSONNEL ALSO REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY. NOTICE OF HSH'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES CAN ALSO BE FOUND ON THE WEB SITE AT HSH.ORG/PATIENTS-AND-VISITORS/BILLING- INSURANCE/FINANCIAL ASSISTANCE. PATIENTS ARE ALSO PROVIDED INFORMATION ON GEISINGER'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES WITH EACH PATIENT BILL.
PART VI, LINE 4 - COMMUNITY INFORMATION HOLY SPIRIT HOSPITAL IS A COMMUNITY CATHOLIC HOSPITAL SPONSORED AND MANAGED BY THE SISTERS OF CHRISTIAN CHARITY TO CARRY OUT THE HEALING MINISTRY OF JESUS CHRIST TO ALL IN NEED. HOLY SPIRIT PROVIDES HIGH-QUALITY, COST-EFFECTIVE HEALTH SERVICES TO DEVELOP HEALTHY COMMUNITIES IN THE GREATER HARRISBURG AREA AND SOUTH CENTRAL PENNSYLVANIA. HOLY SPIRIT HOSPITAL IS LOCATED IN CAMP HILL, WHICH IS IN SUBURBAN CUMBERLAND COUNTY, AND IS PART OF THE GREATER HARRISBURG- MECHANICSBURG-CARLISLE METROPOLITAN AREA. HOLY SPIRIT HOSPITAL'S PRIMARY SERVICE AREA COVERS PARTS OF THE FOUR COUNTIES OF CUMBERLAND, DAUPHIN, PERRY, AND NORTHERN YORK WITH A POPULATION OF APPROXIMATELY 500,000, INCLUDING STARKLY DIFFERENT AREAS OF URBAN, SUBURBAN, SEMI-RURAL, AND RURAL POPULATIONS. THIS SAME SERVICE AREA IS SERVED BY FOUR COMPETING HEALTH SYSTEMS: HOLY SPIRIT HOSPITAL, PINNACLEHEALTH SYSTEM, PENN STATE MILTON S. HERSHEY MEDICAL CENTER, AND CARLISLE REGIONAL MEDICAL CENTER. THE POPULATION IN THE HOSPITAL'S PRIMARY SERVICE AREA IS RAPIDLY AGING, AND THE OVER 65 POPULATION IS EXPECTED TO GROW TO ALMOST 20% OF THE TOTAL POPULATION IN THE NEXT FIVE YEARS. THE AVERAGE HOUSEHOLD INCOME IN THE PRIMARY SERVICE IS 80,522, COMPARED TO THE NATIONAL AVERAGE INCOME OF 77,153 (2016 TRUVEN HEALTH ANALYTICS, INC.).
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH CURRENTLY, HOLY SPIRIT HOSPITAL HAS A TOTAL OF 311 PATIENT BEDS AND 15 BASSINETS. THERE ARE NEARLY 540 PHYSICIANS ON STAFF AND ALMOST 1,800 EMPLOYEES, INCLUDING NURSES, NURSING ASSISTANTS AND NURSING SUPPORT STAFF; LAB AND RADIOLOGY TECHNICIANS; PHYSICAL, RESPIRATORY, OCCUPATIONAL AND SPEECH THERAPISTS; PHLEBOTOMISTS AND A BROAD RANGE OF TECHNICAL AND ADMINISTRATIVE PERSONNEL. EACH IS HIGHLY TRAINED TO DELIVER QUALITY AND SAFE CARE TO INPATIENTS AND OUTPATIENTS OR SUPPORT THOSE WHO DO. THE HOSPITAL HAS: 1) AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREAS; 2) A BOARD OF DIRECTORS WHO GOVERN THE ORGANIZATION. THE BOARD IS COMPRISED OF COMMUNITY, BUSINESS, AND RELIGIOUS LEADERS AND PHYSICIANS REPRESENTING THE GEOGRAPHIC AREA OF OUR REGION; AND 3) AN EMERGENCY DEPARTMENT THAT IS OPEN TO ALL PERSONS IN NEED REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. HOLY SPIRIT HOSPITAL OFFERS A COMPREHENSIVE ARRAY OF INPATIENT AND OUTPATIENT SERVICES WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY. HOLY SPIRIT STAFF ARE DEDICATED TO THE VALUES OF DIGNITY, WHOLISM, SERVICE, STEWARDSHIP, QUALITY, AND INTEGRITY. HOLY SPIRIT ALSO HAS A STRONG MISSION-DRIVEN TRADITION OF SUPPORTING THE REGIONAL COMMUNITY THROUGH A BROAD RANGE OF CHARITABLE SERVICES AND COMMUNITY BENEFIT PROGRAMS, WHICH ARE DETAILED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (AVAILABLE ON THE WEBSITE AT WWW.HSH.ORG/CHNA). FREE AND LOW-COST SERVICES AND COMMUNITY BENEFIT PROGRAMS ARE PROVIDED THROUGHOUT THE SERVICE AREA. HOLY SPIRIT CONDUCTS AN ANNUAL APPEAL INVITING EMPLOYEES AND VOLUNTEERS TO SUPPORT INTERNAL COMMUNITY BENEFIT PROGRAMS, WHICH IN TURN HELPS TO PROVIDE FREE AND LOW-COST PROGRAMS. ANY DONATIONS OR GRANTS GENERATED ARE REFLECTED AS REVENUE WITHIN PROGRAMS AND CREDITED AGAINST OPERATING LOSSES. IN ADDITION, HOLY SPIRIT EMPLOYEES SERVE IN A MULTITUDE OF VOLUNTEER ROLES, INCLUDING, BUT NOT LIMITED TO, FIREFIGHTERS, EMERGENCY MANAGEMENT TECHNICIANS, CHAPLAINS, PARISH NURSES, GROUP LEADERS, MENTORS, EDUCATORS, AND DIRECTORS AND VOLUNTEERS FOR REGIONAL NONPROFITS. ALSO SEE THE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS/COMMUNITY BENEFIT REPORTED IN SCHEDULE O.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM HOLY SPIRIT HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY (HSH) IS AN AFFILIATE WITHIN THE GEISINGER HEALTH SYSTEM. GEISINGER HEALTH SYSTEM IS A PHYSICIAN-LED, INTEGRATED HEALTH SERVICES ORGANIZATION THAT HAS AS ITS MAIN COMPONENTS: 1) AN ARRAY OF HEALTH SERVICES PROVIDERS, INCLUDING SIX ACUTE CARE HOSPITALS AND A DRUG AND ALCOHOL TREATMENT FACILITY; 2) A MULTISPECIALTY PHYSICIAN GROUP PRACTICE OF 1,136 PHYSICIANS PRACTICING AT 91 PRIMARY AND SPECIALTY CLINICS; AND 3) ONE OF THE NATION'S LARGEST RURAL HEALTH INSURANCE ORGANIZATIONS WITH OVER 340,000 MEMBERS. GEISINGER OPERATES IN 44 OF PENNSYLVANIA'S 67 COUNTIES, WITH A SIGNIFICANT PRESENCE IN CENTRAL AND NORTHEASTERN PENNSYLVANIA, PRIMARILY OUTSIDE THE MAJOR METROPOLITAN AREAS. GEISINGER AT A GLANCE. -PHYSICIAN PRACTICE GROUP - MULTISPECIALTY GROUP PRACTICE WITH 1,136 EMPLOYED PHYSICIANS PRACTICING AT 91 CLINIC SITES -MANAGED CARE COMPANIES 340,217 MEMBERS -PROVIDER FACILITIES INCLUDES 1,326 LICENSED HOSPITAL BEDS, 344 SKILLED NURSING FACILITY BEDS AND 91 CHEMICAL DEPENDENCY BEDS. MISSION. GEISINGER'S MISSION IS TO ENHANCE THE QUALITY OF LIFE THROUGH AN INTEGRATED HEALTH SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE. THIS MISSION STATEMENT HAS BEEN SUMMARIZED INTO FOUR WORDS - "HEAL. TEACH. DISCOVER. SERVE." HISTORY. GEISINGER HAD ITS BEGINNINGS IN THE SMALL COMMUNITY OF DANVILLE, WHICH IS LOCATED IN CENTRAL PENNSYLVANIA ON THE NORTHERN BRANCH OF THE SUSQUEHANNA RIVER. THERE, IN 1915, ABIGAIL A. GEISINGER FOUNDED THE GEORGE F. GEISINGER MEMORIAL HOSPITAL IN MEMORY OF HER HUSBAND. FROM THE BEGINNING, THE NEW HOSPITAL WAS DESIGNED AS A COMPREHENSIVE HEALTHCARE INSTITUTION THAT WOULD OFFER SPECIALIZED MEDICAL CARE TO PEOPLE IN THE RURAL AREAS OF CENTRAL AND NORTHEASTERN PENNSYLVANIA. UNLIKE MOST HEALTHCARE SYSTEMS, WHICH EVOLVED WITH A HOSPITAL FOCUS, GEISINGER'S HISTORY AND TRADITION IS THAT OF A PHYSICIAN-LED AND PHYSICIAN-DRIVEN HEALTHCARE ORGANIZATION. THIS TRADITION BEGAN WHEN MRS. GEISINGER BROUGHT DR. HAROLD FOSS, A MAYO CLINIC TRAINED PHYSICIAN, TO BE HER HOSPITAL'S FIRST CHIEF OF STAFF. TODAY, GEISINGER IS REGARDED AS A NATIONAL MODEL OF HEALTHCARE DELIVERY CENTERED ON A SOPHISTICATED MULTISPECIALTY GROUP PRACTICE. SINCE THE 1970S, GEISINGER'S STRATEGY OF INTEGRATING PHYSICIANS AND HOSPITALS EXPANDED TO INCLUDE THE MANAGEMENT OF HEALTH AND THE FINANCING OF HEALTHCARE SERVICES THROUGH ITS WHOLLY CONTROLLED HEALTH MAINTENANCE ORGANIZATION, GEISINGER HEALTH PLAN. TWO INDEMNITY HEALTH INSURERS, GEISINGER INDEMNITY INSURANCE COMPANY AND GEISINGER QUALITY OPTIONS, INC., KNOWN COLLECTIVELY WITH GEISINGER HEALTH PLAN AS "GEISINGER HEALTH PLANS- OR "GHPS", HAVE BEEN ADDED IN RECENT YEARS. CORPORATE STRUCTURE. THE ORGANIZATIONAL STRUCTURE OF THE SYSTEM REFLECTS THE STRATEGIC GOAL OF OPERATING AS A FULLY INTEGRATED HEALTHCARE SYSTEM WHOSE CORPORATE COMPONENTS SHARE THE COMMON GOALS OF MANAGING AND IMPROVING THE HEALTHCARE OF ITS PATIENTS AND MEMBERS, WHILE RECOGNIZING AND RESPECTING THE CORPORATE IDENTITY OF EACH ENTITY. THIS INTEGRATION LINKS THE AREAS OF PHYSICIANS, HOSPITALS/CLINICS, AND HEALTHCARE INSURANCE. HOLY SPIRIT HEALTH SYSTEM (HSHS) IS THE CORPORATE ENTITY OVER THE CORPORATIONS LISTED BELOW. EACH CORPORATION SERVES VARIOUS ROLES WITHIN THE HSHS NETWORK. IN PREPARATION FOR ANTICIPATED CHANGES RELATED TO HEALTH CARE REFORM, THE HSHS BOARD OF DIRECTORS ENGAGED IN RESEARCH AND PRELIMINARY DISCUSSIONS ON BEHALF OF THE NETWORK TO ASSESS THE VIABILITY OF AFFILIATING OR MERGING WITH ANOTHER HEALTH SYSTEM. HOLY SPIRIT BECAME AN AFFILIATE OF GEISINGER HEALTH SYSTEM IN OCTOBER 2014. HOLY SPIRIT HOSPITAL (THE "HOSPITAL") IS A COMMUNITY CATHOLIC HOSPITAL, PROVIDING HIGH-QUALITY, COST-EFFECTIVE HEALTH SERVICES TO PATIENTS IN THE GREATER HARRISBURG AREA AND SOUTH CENTRAL PENNSYLVANIA. THE HOSPITAL IS LICENSED FOR 311 ACUTE CARE BEDS AND OPERATES OUTPATIENT CENTERS IN CAMP HILL, CARLISLE, DILLSBURG, DUNCANNON, HARRISBURG, AND MECHANICSBURG. AFFILIATED SERVICES INCLUDE GENERAL AND SPECIALTY SURGERY. OTHER SERVICES INCLUDE CANCER TREATMENT (GAMMA KNIFE AND LINEAR ACCELERATOR) AT THE HOLY SPIRIT CANCER CENTER IN MECHANICSBURG, MULTIPLE CARDIAC REHABILITATION PROGRAMS, AND HOLY SPIRIT SLEEP CENTERS LOCATED IN LEMOYNE AND HARRISBURG. HOLY SPIRIT HOME HEALTH CARE, A DEPARTMENT OF THE HOSPITAL, OFFERS MEDICAL SERVICES UNDER THE DIRECTION OF A PATIENT'S PHYSICIAN IN THE COMFORT AND PRIVACY OF THE PATIENT'S OWN HOME. HOME HEALTH CARE CLINICIANS PROVIDE A VARIETY OF SERVICES, INCLUDING SKILLED NURSING CARE, PHYSICAL AND OCCUPATIONAL THERAPY, SOCIAL SERVICES, AND PERSONAL CARE. PROFESSIONALS ALSO PROVIDE SPECIALTY PROGRAMS IN WOUND AND OSTOMY CARE, INTRAVENOUS THERAPY, MENTAL HEALTH, AND TELEHEALTH. THE HOSPITAL HAS (1) AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREAS AND (2) AN EMERGENCY DEPARTMENT THAT IS OPEN TO ALL PERSONS IN NEED REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. A BOARD OF DIRECTORS COMPRISED OF COMMUNITY, BUSINESS, AND RELIGIOUS LEADERS AND PHYSICIANS GOVERNS THE ORGANIZATION. HOLY SPIRIT PHYSICIAN SERVICES, INC. ("SPSI") IS A NETWORK OF OVER 100 PHYSICIANS AND OTHER HEALTH CARE PROVIDERS DELIVERING PRIMARY AND SPECIALTY CARE SERVICES TO ITS SURROUNDING COMMUNITY. THE PHYSICIAN NETWORK IS OWNED BY HOLY SPIRIT HEALTH SYSTEM, A COMMUNITY CATHOLIC HEALTH SYSTEM. OUR SPECIALTIES INCLUDE FAMILY MEDICINE, OBSTETRICS AND GYNECOLOGY, INTERNAL MEDICINE, PEDIATRICS, GENERAL SURGERY, BREAST CARE, CARDIOTHORACIC SURGERY, CARDIOLOGY, ENDOCRINOLOGY, NEUROLOGY, NEUROSURGERY, ORTHOPAEDICS, PLASTIC SURGERY, PSYCHIATRY (ADULT AND PEDIATRIC), PULMONARY, VASCULAR SURGERY, RADIATION ONCOLOGY, URGENT CARE, AND HOSPITALISTS GROUPS. HOLY SPIRIT CORPORATION ("HSC") IS A REAL ESTATE HOLDING CORPORATION WITH PROPERTIES IN CAMP HILL, DILLSBURG, AND MECHANICSBURG, INCLUDING THE MEDICAL ARTS BUILDING, AMERICAN OFFICE CENTER, AND KINDER CARE CENTER. HOLY SPIRIT VENTURES, INC. ("HSV") IS THE CORPORATE ORGANIZATION THROUGH WHICH HSHS PARTICIPATES IN THE OWNERSHIP AND MANAGEMENT OF HEALTH CARE FACILITIES JOINTLY WITH THE OTHER HEALTH CARE PROVIDERS. IN ADDITION, HSV OWNS A RETAIL PHARMACY AND THE SENATE HOUSE, A COMBINED COMMERCIAL OFFICE/RESIDENTIAL APARTMENT BUILDING. WEST SHORE ADVANCED LIFE SUPPORT SERVICES, INC. ("WSALS") PROVIDES AMBULANCE AND MEDICAL TRANSPORT SERVICES ACROSS CENTRAL PENNSYLVANIA. SERVICES INCLUDE BASIC AND ADVANCED LIFE SUPPORT, AS WELL AS AUTOMATED EXTERNAL DEFIBRILLATION FOR QUICK RESPONSE TO HEART ATTACK AND OTHER CARDIAC EMERGENCIES. FOR NON-EMERGENCY NEEDS, WSALS PROVIDES WHEELCHAIR VANS AND COACH SERVICES TO TRANSPORT INVALID AND BED-BOUND PATIENTS. WSALS ALSO IS INVOLVED IN VARIOUS ADMINISTRATIVE AND CONSULTING SERVICES FOR OTHER AMBULANCE COMPANIES. SEE SCHEDULE R FOR A LIST OF THE AFFILIATED ORGANIZATIONS COMPRISING GEISINGER. THROUGHOUT THIS DOCUMENT THE TERMS "SYSTEM- OR "GEISINGER" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH ("GH") AS PARENT AND ALL SUBSIDIARY ENTITIES COMPRISING THE SYSTEM.
ADDITIONAL INFORMATION PART VI, LINE 7, STATE FILING OF COMMUNITY BENEFIT REPORT: AT THIS TIME, HSH AND ITS AFFILIATES ARE NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE.
Schedule H (Form 990) 2015
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" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
HOLY SPIRIT HOSPITAL OF THE SISTERS
OF CHRISTIAN CHARITY
Employer identification number

23-1512747
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 on 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 on 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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on 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," on line 5a or 5b, describe in Part III.
6
For persons listed on 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," on line 6a or 6b, describe in Part III.
7
For persons listed on 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 on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
Yes
 
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
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 on 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 in column(B) reported as deferred on prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1DANIEL E LOHR ESQUIREASST. SECRETARY (i)

(ii)
 
-------------
231,485
 
-------------
76,502
 
-------------
21,302
 
-------------
19,110
 
-------------
21,568
 
-------------
369,967
 
-------------
 
2DAVID J FELICIO ESQUIRESECRETARY (i)

(ii)
 
-------------
402,686
 
-------------
156,692
 
-------------
206,888
 
-------------
77,507
 
-------------
25,383
 
-------------
869,156
 
-------------
152,495
3KEVIN F BRENNAN CPA FHFMAEVP, FINANCE, CFO (i)

(ii)
 
-------------
541,622
 
-------------
299,769
 
-------------
241,957
 
-------------
185,717
 
-------------
25,898
 
-------------
1,294,963
 
-------------
202,451
4MANUEL J EVANSTREASURER (i)

(ii)
258,674
-------------
 
 
-------------
 
215,752
-------------
 
11,093
-------------
 
10,948
-------------
 
496,467
-------------
 
 
-------------
 
5RANDY B MORRISTREASURER (i)

(ii)
125,023
-------------
59,478
41,539
-------------
 
5,608
-------------
1,513
8,090
-------------
3,035
7,154
-------------
3,756
187,414
-------------
67,782
 
-------------
 
6DAVID A GATESMANVP PRO SERVICES (i)

(ii)
131,495
-------------
57,759
28,800
-------------
 
2,719
-------------
286
9,955
-------------
1,639
20,543
-------------
8,927
193,512
-------------
68,611
 
-------------
 
7JOSEPH A TORCHIA MDSVP MEDICAL AFFAIRS (i)

(ii)
366,344
-------------
 
55,589
-------------
 
22,633
-------------
 
14,015
-------------
 
12,212
-------------
 
470,793
-------------
 
 
-------------
 
8LISA F TORCHIAVP PATIENT CARE SVCS (i)

(ii)
237,600
-------------
 
37,532
-------------
 
20,010
-------------
 
10,627
-------------
 
25,055
-------------
 
330,824
-------------
 
 
-------------
 
9BARBARA SUMBATIAN MDPHYSICIAN (i)

(ii)
221,179
-------------
 
 
-------------
 
15,303
-------------
 
7,245
-------------
 
26,267
-------------
 
269,994
-------------
 
 
-------------
 
10MARIA E PRUDENCIO MDPHYSICIAN (i)

(ii)
262,011
-------------
 
 
-------------
 
3,113
-------------
 
20,829
-------------
 
2,539
-------------
 
288,492
-------------
 
 
-------------
 
11MICHAEL J PASZEK MDREGIONAL MED DIR (i)

(ii)
306,851
-------------
 
 
-------------
 
7,334
-------------
 
16,154
-------------
 
28,151
-------------
 
358,490
-------------
 
 
-------------
 
12PAUL D BRETTSCHNEIDER MDPHYSICIAN (i)

(ii)
233,576
-------------
 
 
-------------
 
12,755
-------------
 
12,191
-------------
 
26,991
-------------
 
285,513
-------------
 
 
-------------
 
13WILLIAM P SHARTLESVP, HR (i)

(ii)
71,653
-------------
 
 
-------------
 
224,488
-------------
 
5,391
-------------
 
8,047
-------------
 
309,579
-------------
 
 
-------------
 
14EDWARD J ZYCH ESQUIREFORMER OFFICER (i)

(ii)
 
-------------
108,861
 
-------------
 
 
-------------
217,357
 
-------------
5,645
 
-------------
11,035
 
-------------
342,898
 
-------------
32,454
15GERALD R NEWHOUSEFORMER KEY EMPLOYEE (i)

(ii)
193,027
-------------
 
 
-------------
 
2,596
-------------
 
17,438
-------------
 
22,399
-------------
 
235,460
-------------
 
 
-------------
 
16RICHARD LAVANTUREFORMER KEY EMPLOYEE (i)

(ii)
306,576
-------------
 
48,445
-------------
 
22,086
-------------
 
17,257
-------------
 
32,295
-------------
 
426,659
-------------
 
 
-------------
 
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
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 0 152,495 0 KEVIN F. BRENNAN, CPA, FHFMA 0 202,451 0 MANUEL J. EVANS 110,179 0 0 WILLIAM P. SHARTLE 178,038 0 0 EDWARD J. ZYCH, ESQUIRE 0 32,454 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 GEISINGER OBJECTIVES, INCLUDING: CLINICAL QUALITY, COMMUNITY MISSION ACHIEVEMENT, AND FINANCIAL STEWARDSHIP.
SCHEDULE J, PAGE 1, PART I, LINE 8 THE EMPLOYEES LISTED PARTICIPATE IN A COMPENSATION PROGRAM DESIGNED TO BE MARKET COMPETITIVE. FROM TIME TO TIME, DEPENDING ON THE AVAILABILITY OF QUALIFIED APPLICANTS, RECRUITMENT LOANS MAY BE MADE AVAILABLE TO QUALIFIED APPLICANTS IN DIFFICULT TO RECRUIT POSITIONS. SUCH LOANS ARE ONLY PROVIDED IF TOTAL COMPENSATION, INCLUDING THE LOAN AMOUNT, IS CONSIDERED REASONABLE COMPENSATION PER INDEPENDENT SALARY SURVEYS.
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 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- AND "SYSTEM" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH "GH" AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM.
Schedule J (Form 990) 2015
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.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
HOLY SPIRIT HOSPITAL OF THE SISTERS
OF CHRISTIAN CHARITY
Employer identification number

23-1512747
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) 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
(1) MICHAEL SERLUCO BOARD DIRECTOR MORTGAGE ON SPACE FOR PATIENT CARE X   1,200,000 911,636   No Yes   Yes  
(2) RANDY B MORRIS OFFICER RECRUITMENT   X 20,000 11,231   No Yes   Yes  
Total ...............Small Bullet $ 922,867
Part III
Grants or Assistance Benefiting 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) 2015
Schedule L (Form 990 or 990-EZ) 2015
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) SZELES REAL ESTATE DEVELOPMENT CO
 
BUSINESS 237,676 RENTAL/LEASE EXPENSE   No
(2) SZELES CAPITAL DEVELOPMENT CO LP
 
BUSINESS 60,273 RENTAL/LEASE EXPENSE   No
(3) ALEX R SZELES INC
 
BUSINESS 6,243 WATER REMEDIATON SVC   No
(4) KATHERINE LAVANTURE FAMILY 20,525 EMPLOYEE COMP/BEN   No
(5) MONICA R JONES FAMILY 65,843 EMPLOYEE COMP/BEN   No
(6) SHANNON M GATESMAN FAMILY 65,928 EMPLOYEE COMP/BEN   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
SCHEDULE L, PART V RICHARD A. SZELES IS AN OFFICER AND DIRECTOR OF HOLY SPIRIT HOSPITAL AND AN OWNER AND MANAGING PARTNER OF: SZELES REAL ESTATE DEVELOPMENT CO., SZELES CAPTIAL DEVELOPMENT CO, LP AND ALEX R. SZELES, INC. KATHERINE LAVANTURE IS A FAMILY MEMBER OF RICHARD E. LAVANTURE, A FORMER KEY EMPLOYEE OF HOLY SPIRIT HOSPITAL. MONICA R. JONES IS A FAMILY MEMBER OF RICHARD A. SZELES, AN OFFICER AND DIRECTOR OF HOLY SPIRIT HOSPITAL. SHANNON A. GATESMAN IS A FAMILY MEMBER OF DAVID A. GATESMAN, A KEY EMPLOYEE OF HOLY SPIRIT HOSPITAL.
Schedule L (Form 990 or 990-EZ) 2015


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 990-EZ 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
2015
Open to Public
Inspection
Name of the organization
HOLY SPIRIT HOSPITAL OF THE SISTERS
OF CHRISTIAN CHARITY
Employer identification number

23-1512747
Return Reference Explanation
FORM 990 - ORGANIZATION'S MISSION HOLY SPIRIT HOSPITAL IS A COMMUNITY CATHOLIC HOSPITAL SPONSORED BY THE SISTERS OF CHRISTIAN CHARITY TO CARRY OUT THE HEALING MINISTRY OF JESUS CHRIST TO ALL IN NEED. WE PROVIDE HIGH QUALITY, COST-EFFECTIVE HEALTH SERVICES TO DEVELOP HEALTHY COMMUNITIES IN THE GREATER PATIENT CARE SERVICES.
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 (GH) IS CURRENTLY THE SOLE OBLIGOR UNDER A SERIES OF BOND ISSUES WITH A TOTAL OUTSTANDING BALANCE OF 1,447,263,694, INCLUSIVE OF UNAMORTIZED ORIGINAL ISSUE DISCOUNT AS OF JUNE 30, 2016. BECAUSE THE BOND PROCEEDS ARE DISBURSED TO GH 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 HOLY SPIRIT HOSPITAL, EIN: 23-1512747 ATLANTICARE REGIONAL MEDICAL CENTER, EIN 21-0634549 SCHEDULE K WAS PREPARED ON A CONSOLIDATED BASIS AND IS INCLUDED IN THE FORM 990 FILING OF GEISINGER HEALTH, EIN: 23-1995911.
FORM 990, PAGE 2, PART III, LINE 4A IN MAY 2013, HOLY SPIRIT HOSPITAL NURSES ACHIEVED MAGNET STATUS FROM THE AMERICAN NURSES CREDENTIALING CENTER'S MAGNET RECOGNITION PROGRAM. ACHIEVING MAGNET IS THE GOLD STANDARD FOR NURSING EXCELLENCE AND REQUIRES UNDERGOING A VOLUNTARY, RIGOROUS AND LENGTHY REVIEW PROCESS THAT EXAMINES A BROAD RANGE OF BENCHMARKS FROM INNOVATIONS IN NURSING PRACTICE, PROFESSIONAL EDUCATION, AND PATIENT OUTCOMES TO QUALITY MEASURES AND PATIENT SATISFACTION. ONLY A SMALL PERCENTAGE OF HOSPITALS NATIONWIDE HAVE RECEIVED MAGNET CREDENTIALING TO DATE. U.S. NEWS & WORLD REPORTS USES MAGNET STATUS AS ONE FACTOR IN DETERMINING ITS ANNUAL RANKING OF HOSPITALS NATIONWIDE. HOLY SPIRIT HOSPITAL WAS RECOGNIZED AS ONE OF THE BEST REGIONAL HOSPITALS, RANKING 13TH IN PENNSYLVANIA IN 2014-2015. IN ADDITION, HOLY SPIRIT HOSPITAL WAS HONORED AS A HIGH-PERFORMER IN SOUTH CENTRAL PENNSYLVANIA IN TEN SPECIALTIES, INCLUDING CANCER, DIABETES AND ENDOCRINOLOGY, GASTROENTEROLOGY AND GI SURGERY, GERIATRICS, GYNECOLOGY, NEPHROLOGY, NEUROLOGY AND NEUROSURGERY, ORTHOPEDICS, PULMONARY, AND UROLOGY. HOLY SPIRIT HOSPITAL EARNED THE HEALTHSTREAM "EXCELLENCE THROUGH INNOVATION" AWARD FOR LEADING INNOVATION IN PATIENT EXPERIENCE. THE HOSPITAL SAFETY SCORE RATES HOW WELL HOSPITALS PROTECT PATIENTS FROM ACCIDENT, ERRORS, INJURIES, AND INFECTIONS. HOLY SPIRIT IS THE ONLY HOSPITAL IN THE HARRISBURG REGION TO CONSISTENTLY SCORE AN "A" RATING. IN NOVEMBER 2014, THE JOINT COMMISSION RECOGNIZED HOLY SPIRIT HOSPITAL AS A 2013 TOP PERFORMER ON KEY QUALITY MEASURES FOR ATTAINING AND SUSTAINING EXCELLENCE IN ACCOUNTABILITY MEASURE PERFORMANCE FOR HEART ATTACK, HEART FAILURE, PNEUMONIA, AND SURGICAL CARE. HOLY SPIRIT ISONE OF 1,224 HOSPITALS IN THE UNITED STATES TO ACHIEVE THIS DISTINCTION AND ONE OF ONLY 314 HOSPITALS TO ACHIEVE THE TOP PERFORMER DISTINCTION FOR THE PAST THREE CONSECUTIVE YEARS. HOLY SPIRIT HOSPITAL EARNED THE 2015 GET WITH THE GUIDELINES STROKE GOLD PLUS AWARD, AS WELL AS THE 2015 GET WITH THE GUIDELINES A-FIB PARTICIPATING ACHIEVEMENT AWARD FROM THE AMERICAN HEART ASSOCIATION AND THE AMERICAN STROKE ASSOCIATION. THE HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA AWARDED HOLY SPIRIT WITH THE "SAFETY ACROSS THE BOARD" EXCELLENCE AWARD FOR THE HOSPITAL'S WORK ACROSS MULTIPLE TEAMS. HOLY SPIRIT ALSO EARNED THE READMISSIONS PROJECT EXCELLENCE AWARD FOR WORK ON THE PENNSYLVANIA HOSPITAL ENGAGEMENT NETWORK (PA-HEN) READMISSIONS PROJECT. REGISTERED NURSES IN PATIENT CARE SERVICES AND CLINICAL EDUCATION PROVIDED PRESENTATIONS (PODIUM AND POSTER) IN HOUSE, AT PROFESSIONAL CONFERENCES, AND IN VARIOUS OTHER VENUES. THE PRESENTATIONS INCLUDED: - AUGUST 13, 2014: PATIENT TEACHING STRATEGIES - LEA DAILEY, RN, CCRN, MSN, ED - SEPTEMBER 16, 2014:BLDG., A HEALTHSTREAM COMPANY, NEW ORLEANS, LA. - SPIRIT SERVICE EXCELLENCE - A SUSTAINABLE CULTURE TO OPTIMIZE SERVICE AND PERFORMANCE - SISTER ROMAINE NIEMEYER, SCC, CHIEF ADMINISTRATIVE OFFICER, RICK LAVANTURE, SENIOR VICE PRESIDENT/CHIEF STRATEGIC OFFICER, LISA LEWIS, MSN, RN, NEA-BC, VICE PRESIDENT OF PATIENT CARE SERVICES/CHIEF NURSING OFFICER - SEPTEMBER 16, 2014:LEADING CHANGE AND INNOVATION TO TRANSFORM HEALTHCARE, HARRISBURG, PA. HOW TO MAKE CHANGE DESIRABLE - KATHY SHEA, BSN, RN-BC - OCTOBER 7, 2014: ANCC RESEARCH SYMPOSIUM, DALLAS, TX. - SEPSIS: A TEAM APPROACH TO CHANGING OUTCOMES - SARAH COLEMAN, RN, CCRN - OCTOBER 8, 2014 - INFECTION PREVENTION 101: "IT'S THE ONES YOU CAN'T SEE" - JOANN ADKINS, RN, BSN, CIC - OCTOBER 24, 2014: EVIDENCE BASED PRACTICE: TRANSLATING RESEARCH INTO PRACTICE, GEISINGER MEDICAL CENTER, DANVILLE, PA. THE ART AND SCIENCE OF NURSING - SARAH COLEMAN, RN, CCRN, CINDY SWARTZ, MS, RN, ACNS-BC - NOVEMBER 11, 2014 - SUCCESSION PLANNING - JOANN ANN ADKINS, RN, BSN,CIC, RHETT BENNIE, RN, BSN, MSHA, CPI CERTIFIED TRAINER, PATRICIA A. CARNES, MHA, BSN, RN, NE -BC, SUSAN SWAILS, MED, BSN, RN-BC, DEBORAH THORNBERG, BSN, RN-BC - NOVEMBER 12, 2014 - GLYCEMIC CONTROL AND HEALTH OUTCOMES IN THE DIABETIC PATIENT - MARGARITA GARDNER, BSN, RN, CCRN - NOVEMBER 13, 2014:DICKINSON WELLNESS PROGRAM, DICKINSON COLLEGE, CARLISLE, PA. LIVING WELL WITH DIABETES - KATIE FLICKINGER, BSN, RN, CCP, CDE - NOVEMBER 14, 2014:SOUTH CENTRAL MAGNET CONSORTIUM, MAGNET CHAMPION CONFERENCE, HERSHEY MEDICAL CENTER, HERSHEY, PA. SEPSIS: A TEAM APPROACH TO CHANGING OUTCOMES - SARAH COLEMAN, RN, CCRN - JANUARY 30, 2015 RESEARCH DAY - PRESENTATIONS BY HOLY SPIRIT NURSES IN PARTNERSHIP WITH MESSIAH SENIOR NURSING STUDENTS - TO QUIT OR NOT TO QUIT, THAT IS THE QUESTION: CHALLENGES FACED IN THE DEVELOPMENT AND IMPLEMENTATION OF A SMOKING CESSATION PROGRAM - DEBORAH AUDETTE, MS, RN, ACNS-BC, CCRN-CSC, KATHY THUMMA BSN, RN, NE-RC - ARE WE DOING ENOUGH? EFFECTS OF EDUCATION ON NURSING ATTITUDES TOWARDS CHRONIC PAIN - JENNIFER KANE, BSN, RN, PCCN - EVIDENCE-BASED DISTRACTION TECHNIQUES TO DECREASE CHRONIC PAIN IN PEDIATRIC PATIENTS - ALISON NATTRESS, RN - EXERCISE INTERVENTIONS TO IMPROVE OUTCOMES IN HEART FAILURE PATIENTS - PEGGY TRAHAN, RN, PCCN - CARDIAC PRESCREENING IN YOUNG ADULT ATHLETES DECREASES RISK FOR SUDDEN CARDIAC EVENT - DEB THORNBERG, BSN, RN-BC - SHHLET THEM REST - KENDRA WILSON, BSN, RN-BC - CNS IN STROKE: PARTNERSHIP IN BUILDING EXCELLENCE - CYNTHIA SWARTZ, MS, RN, ACNS-BC, MARYANN BROGDEN, ND, MSN, RN, APN-C, CCNS, SCRN - IMPLEMENTATION OF HOURLY ROUNDING TO IMPROVE CLINICAL OUTCOMES" - JENNIFER HIXENBAUGH, BSN, RN - IV ACCESS - TINA SWARTZ CRNA, STEVE TODD BS, RN, JAMES KEVIN TRACEY, JR., RN, BSN, CNOR, ALLISON M. POLINSKI, RN, BSN, CPAN - EARLY IMPLEMENTATION OF PALLIATIVE CARE TO BETTER PATIENT OUTCOMES IN CONGESTIVE HEART FAILURE PATIENTS - PATRICIA A. CARNES, MHA, BSN, RN, NE-BC - KBMA NO SCANNER LEFT BEHIND - JODY HARCLERODE, RN-BC, MS, CPHQ - TRANSITIONING BETWEEN CARE SETTINGS - JUDITH HIMES, BSN, RN, CWON - PCEA:PATIENT CONTROLLED EPIDURAL ANALGESIA FOR INTRAPARTUM PATIENTS - ENID KREINER, MSN, RNC-MNN, C-EFM - PAIN MANAGEMENT CARE MODEL - RHETT BENNIE, MSHA, BSN, RN - NURSING CERTIFICATION: LEADING THE WAY - MICHELLE DEFABIO, MS, RN, ACNS- BC - BEATING SEPSIS - IT'S A SPRINT, NOT A JOG - SARAH COLEMAN, AD, RN - THINK "INSIDE" THE BOX TAKING AN IDEA FROM INCEPTION TO IMPLEMENTATION - JOANN ADKINS, RN, BSN, CIC, EDIE ASBURY, MLS, AHIP - CONNECTING THE DOTS: HOW DO WE PUT IT ALL TOGETHER? - JOANN ADKINS, RN, BSN, CIC, EDIE ASBURY, MLS, AHIP - MARCH 12, 2015 - ADVANCE DIRECTIVES: WHO, WHAT, WHEN, WHY, AND WHERE - MAUREEN ASPER, MS, RN, ACNS-BC - MARCH 20, 2015 - 2015 ADVANCED PRACTICE REGISTERED NURSE PANEL - PAMELA HARRIS-HAMAN, MSN, CRNP, NPP-BC, MICHELLE DEFABIO, MS, RN, ACNS-BC, CCRN, ROBIN CROWLEY CRNA, MS - APRIL 30, 2015: HEALTHSTREAM SUMMIT, NASHVILLE, TN. "STANDARDS OF PERFORMANCE: BRINGING YOUR VALUES TO LIFE" - LISA LEWIS, MSN, RN, NEA- BC, AMI ZUMKHAWALA-COOK - MAY 21, 2015:CAREER DAY AT FINK ELEMENTARY SCHOOL, MIDDLETOWN, PA. "CAREERS IN NURSING" - MARTHA LEE, BSN, RNC-NIC, ENID KREINER, MSN, RNC- MNN/OBC-EFM - JUNE 16, 2015 - OUR JOURNEY TO PATIENT AND FAMILY CENTERED CARE: CREATING A PATIENT AND FAMILY ADVISORY COUNCIL - CYNTHIA SWARTZ, MS, RN, ACNS-BC, SUSAN MCQUADE, RN, CPHQ, CNOR, BSN, MHA, ANN HENDRICKSON, MS, RN,ACNS-BC NURSES ALSO PARTICIPATED IN HOLY SPIRIT COMMUNITY EDUCATION PROGRAMS AND SCREENINGS. - SEPTEMBER 11, 2014: PROJECT HOMELESS CONNECT, FARM SHOW COMPLEX, HARRISBURG, PA. 61 FREE FLU VACCINES PROVIDED BY CHERYL SOLA, COMMUNITY HEALTH AND WELLNESS, LISA LEWIS, CNO, DIANA DAVIDSON, OR, MELISSA NATIVIDAD, OR, RENA EFENDIVA, OR, AND VANESSA GARCIA, MEDICAL OUTREACH - OCTOBER 3, 2014: ST. JOSEPH SCHOOL, MECHANICSBURG, PA. "WHAT TO EXPECT IN THE OR" - LORI BAURER, OR AND NATILIE HATTING, OR - OCTOBER 3, 2014: GIRLS' NIGHT OUT, HARRISBURG, PA. CARDIOVASCULAR RISK ASSESSMENTS AND BLOOD PRESSURE SCREENINGS PROVIDED BY JUDY HIMES, WOUND CARE, PEGGY TRAHAN, 8 MAIN, AND LEONA MLYNEK, WOUND CARE - FEBRUARY 7, 2015: HEARTCARING SYMPOSIUM, HOLY SPIRIT HOSPITAL. VARIOUS SCREENINGS TO DETERMINE CARDIOVASCULAR DISEASE RISK PROVIDED BY BRYNN STRINE, CVICU, AMANDA DONNANGELO, ED, REBECCA MILLER, CVU, MEGAN REEVES, CVU, JENNIFER HIXENBAUGH, CARDIAC DIAGNOSTICS, AMBER THOMAS, ED, WENDY SHOOK, CARDIAC REHAB, BARBARA MUMMERT, CARDIAC REHAB, VIRGINIA BAZAR, INVASIVE CARDIOLOGY, AND SHERRI HEFFNER, INVASIVE CARDIOLOGY - MAY 8, 2015: GIRLS' NIGHT OUT, HARRISBURG, PA. BLOOD PRESSURE SCREENINGS AND CARDIOVASCULAR RISK ASSESSMENTS PROVIDED BY JUDY HIMES, WOUND CARE, LESLY MILLER-JACOBS, MEDICAL INFUSION, JOHN LYONS, OR, PEGGY TRAHAN, 8 MAIN, LEONA MLYNEK, WOUND CARE, JENNIFER KANE, NURSING RESOURCES, AND MICHELLE YEAGER, 6 MAIN - MAY 20, 2015:VIERA LIFE, MECHANICSBURG, PA. BODY MASS INDEX SCREENING. INDEX PROVIDED BY KATE BAKOWICZ, NURSING RESOURCES - JUNE 1, 2015:COLONIAL PARK MALL WALKING LOOP, HARRISBURG, PA. BLOOD PRESSURE SCREENINGS PROVIDED BY AMBER CUNNINGHAM, MSICU - JUNE 6, 2015:MOUNT VICTORY UNITED METHODIST CHURCH. BLOOD PRESSURE SCREENINGS PROVIDED BY MICHELLE YEAGER NURSING GRAND ROUNDS - AUGUST 13, 2014: PATIENT TE
FORM 990, PART V ENTER THE NUMBER REPORTED IN BOX 3 OF FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURNS. HOLY SPIRIT HEALTH SYSTEM (HSHS), PARENT OF THE ORGANIZATION, PREPARED AND FILED FORM 1099 UNDER ITS EIN FOR ALL REPORTABLE PAYMENTS OF THE FILING ORGANIZATION AND ITS AFFILIATES. THE NUMBER OF 1099'S FILED BY HSHS FOR THE 2015 REPORTING PERIOD ON BEHALF OF ITSELF AND ITS AFFILIATES WAS 170. 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 HSHS ON ITS BEHALF.
FORM 990, PART VI FORM 990, PART VI, SECTION A, LINE 1B: ENTER THE NUMBER OF VOTING MEMBERS THAT ARE INDEPENDENT. BASED ON THE FORM 990 DEFINITION OF "INDEPENDENCE" AS IT RELATES TO VOTING MEMBERS OF THE GOVERNING BODY, ONE VOTING MEMBER IS NOT INDEPENDENT DUE TO A TRANSACTION REPORTED ON SCHEDULE L, PART II AND ANOTHER VOTING MEMEBER IS NOT INDEPENDENT DUE TO TRANSACTIONS REPORTED ON SCHEDULE L, PART IV. 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? DANIEL E. LOHR, ESQUIRE, SISTER ROMAINE NIEMEYER, SCC, RANDY B. MORRIS, MANUEL J. EVANS, KEVIN F. BRENNAN, CPA, FHFMA, AND DAVID J. FELICIO, 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 HOLY SPIRIT HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY. ALL OF THE AFFILIATES ARE PART OF GEISINGER.
FORM 990, PAGE 6, PART VI, LINE 1A EFFECTIVE OCTOBER 1, 2014, HOLY SPIRIT HEALTH SYSTEM AND AFFILIATES (HOLY SPIRIT HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY, WEST SHORE ADVANCED LIFE SUPPORT SERVICES, INC., SPIRIT PHYSICIAN SERVICES, INC., HOLY SPIRIT CORPORATION, AND HOLY SPIRIT VENTURES, INC.) DELEGATED CERTAIN AUTHORITIES TO GEISINGER SYSTEM SERVICES' GEISINGER FAMILY COMMITTEE TO REVIEW AND APPROVE MATTERS RELATING TO EMPLOYEE BENEFIT PLANS, EXECUTIVE LEADERSHIP, SENIOR LEADERSHIP AND STAFF PERFORMANCE AND COMPENSATION. HOLY SPIRIT HEALTH SYSTEM AND AFFILIATES ALSO DELEGATED TO GEISINGER CLINIC'S GEISINGER FAMILY COMMITTEE THE REVIEW AND APPROVAL OF MATTERS RELATING TO PHYSICIAN COMPENSATION. GEISINGER SYSTEM SERVICES AND GEISINGER CLINIC ARE 501(C)(3) TAX-EXEMPT AFFILIATES OF GEISINGER.
FORM 990, PAGE 6, PART VI, LINE 6 GEISINGER HEALTH SERVES AS THE SOLE CORPORATE MEMBER OF HOLY SPIRIT HEALTH SYSTEM AND HOLY SPIRIT HEALTH SYSTEM SERVES AS CORPORATE MEMBER FOR HOLY SPIRIT HOSPITAL OF THE SISTERS OF CHRISTIAN CHARITY, SPIRIT PHYSICIAN SERVICES, INC., WEST SHORE ADVANCED LIFE SUPPORT SERVICES, INC., HOLY SPIRIT CORPORATION AND SOLE SHAREHOLDER OF HOLY SPIRIT VENTURES INC. 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 9 BARBARA SUMBATIAN, MD
FORM 990, PAGE 6, PART VI, LINE 11B ALL OFFICERS AND DIRECTORS WERE ELECTRONICALLY PROVIDED A FINAL COPY OF THE FORM 990 PRIOR TO FILING THE RETURN WITH THE IRS. AN EXECUTIVE SUMMARY OF THE INFORMATION REPORTED ON THE RETURN IS PROVIDED TO ASSIST IN THE REVIEW. IN ACCORDANCE WITH THE GEISINGER HEALTH BOARD OF DIRECTOR'S FINANCE COMMITTEE CHARTER, GEISINGER ORGANIZATIONS' FORM 990 FILINGS ARE REVIEWED ANNUALLY. THE FORM 990 IS PREPARED BY GEISINGER TAX AND FINANCIAL REPORTING DEPARTMENTS WITH INFORMATION PROVIDED FROM FINANCE, TAX, HUMAN RESOURCES, LEGAL SERVICES AND OTHER RELEVANT DEPARTMENTS WITHIN GEISINGER. THE CHIEF FINANCIAL OFFICER (CFO) OF GEISINGER AND THE INDIVIDUAL ORGANIZATIONS SENIOR FINANCIAL MANAGERS REVIEW THEIR RESPECTIVE FORM 990 PRIOR TO MAKING THE FINAL RETURN AVAILABLE TO THE BOARD. IN ADDITION, THE CHIEF LEGAL OFFICER AND CHIEF HUMAN RESOURCE OFFICER OF GEISINGER REVIEW THE INFORMATION DISCLOSED ON THE FORM 990 RELEVANT TO THEIR RESPECTIVE AREAS OF RESPONSIBILITY. FOR PURPOSES OF THEIR ANNUAL AUDIT OF GEISINGER CONSOLIDATED FINANCIAL STATEMENTS, INDEPENDENT AUDITORS REVIEW ALL FEDERAL TAX RETURNS FILED BY GEISINGER 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 REPORTING PERIOD.
FORM 990, PAGE 6, PART VI, LINE 12C THE OFFICERS AND DIRECTORS OF THE ORGANIZATION ARE SUBJECT TO THE GEISINGER CONFLICT OF INTEREST POLICY FOR DIRECTORS, OFFICERS AND SENIOR LEADERS (MAY INCLUDE INDEPENDENT CONTRACTORS). AT LEAST ONCE EACH YEAR DIRECTORS, OFFICERS, KEY EMPLOYEES, SENIOR LEADERS (INCLUDING INDEPENDENT CONTRACTORS) AND OTHERS DESIGNATED BY THE BOARD OF DIRECTORS ARE REQUIRED TO DISCLOSE IN WRITING THE EXISTENCE OF ANY POTENTIAL FINANCIAL INTERESTS THAT MAY GIVE RISE TO A CONFLICT OF INTEREST WITH ANY AFFILIATE WITHIN GEISINGER. THE DISCLOSURES ARE REVIEWED BY THE OFFICE OF THE CHIEF LEGAL OFFICER AND REPORTED TO THE AUDIT AND COMPLIANCE COMMITTEE AND BOARD OF DIRECTORS. AFTER REVIEW OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, INPUT FROM DEPARTMENT OF LEGAL SERVICES AND ANY DISCUSSION WITH THE PERSON DESIRED BY THE BOARD OR COMMITTEE, THE BOARD DECIDES IF A CONFLICT EXISTS AND TAKES APPROPRIATE ACTION. THE INDIVIDUAL DISCLOSING THE FINANCIAL INTEREST IS ABSENT DURING THE BOARD DELIBERATIONS AND DECISIONS ON THE MATTER.
FORM 990, PAGE 6, PART VI, LINE 15A THE PROCESS TO REVIEW AND APPROVE THE COMPENSATION OF GEISINGER EMPLOYED BOARD DIRECTORS, OFFICERS, AND EXECUTIVE MANAGEMENT IS DESIGNED TO SATISFY THE REBUTTABLE PRESUMPTION PROCEDURE AVAILABLE FOR INTERMEDIATE SANCTION PURPOSES. THE PROCESS REQUIRES A REVIEW OF COMPENSATION DETERMINATIONS BY DISINTERESTED PARTIES, USE OF APPROPRIATE COMPARABILITY DATA AND CONTEMPORANEOUS DOCUMENTATION OF THE PROCESS. ON AN ANNUAL BASIS AN INDEPENDENT, NATIONALLY RECOGNIZED COMPENSATION CONSULTANT COMPLETES A COMPARATIVE ASSESSMENT OF COMPENSATION FOR THE CEO AND SENIOR MANAGEMENT WITHIN GEISINGER. THE CONSULTANT'S REPORT IS PRESENTED TO THE GEISINGER FAMILY COMMITTEE PRIOR TO ANY COMPENSATION ADJUSTMENT. THE REPORT SUPPORTS THE RIGOROUS REVIEW COMPLETED BY THE GEISINGER FAMILY COMMITTEE TO ENSURE THAT THE PROGRAM IS RESPONSIBLE TO THE GEISINGER CHARITABLE MISSION, REFLECTS REASONABLE COMPENSATION WITHIN THE NONPROFIT MARKET AND IS COMPLIANT WITH THE IRS'S INTERMEDIATE SANCTION REQUIREMENTS. THE SURVEY DATA IN THE COMPARATIVE ANALYSIS IS CAPTURED FOR FUNCTIONALLY COMPARABLE POSITIONS IN MULTIPLE SIMILAR NONPROFIT ORGANIZATIONS AND REFLECTS TOTAL REMUNERATION PROVIDED IN THE MARKET. ALL SURVEYS ARE CONDUCTED BY THIRD PARTY ORGANIZATIONS AND NOT CONDUCTED AT THE SPECIFIC DIRECTION OF GEISINGER. ANY COMPENSATION ADJUSTMENTS ARE APPROVED BY THE GEISINGER FAMILY COMMITTEE PRIOR TO THE EFFECTIVE DATE OF THE PAYMENT. THE GEISINGER FAMILY COMMITTEE AT ITS SOLE DISCRETION MAY POSITIVELY OR NEGATIVELY ADJUST ANY RECOMMENDED COMPENSATION.
FORM 990, PAGE 6, PART VI, LINE 15B SEE SCHEDULE O RESPONSE TO FORM 990, PART VI SECTION B, QUESTION 15A.
FORM 990, PAGE 6, PART VI, LINE 19 THE ANNUAL REPORT FOR GEISINGER, CONTAINING COMMUNITY BENEFIT INFORMATION, CONSOLIDATED FINANCIAL INFORMATION AND OTHER INFORMATION, IS AVAILABLE ON THE GEISINGER WEBSITE. GO TO: WWW.GEISINGER.ORG/PAGES/ABOUT-GEISINGER AND SELECT ANNUAL REPORTS. FINANCIAL STATEMENTS, FORM 990, FORM 990-T, THE CONFLICTS OF INTEREST POLICY, AND OTHER GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VIII FORM 990, PART VIII, LINE 2F: THE IC SUPPORT SERVICE REVENUE REPRESENTS REVENUE FROM INTERCOMPANY MANAGEMENT, ADMINISTRATIVE, AND CONSULTING SERVICES PROVIDED TO RELATED TAXABLE ORGANIZATIONS. THE ORGANIZATION AND RELATED TAXABLE ORGANIZATIONS ARE ALL CONTROLLED BY GEISINGER HEALTH. THE SERVICES, PROVIDED AT OR BELOW COST, ARE PERFORMED WITHOUT A PROFIT MOTIVE TO PROMOTE THE EFFICIENT OPERATION OF GEISINGER IN CARRYING OUT ITS CHARITABLE MISSION. THE SERVICES ARE NOT OFFERED TO UNRELATED ORGANIZATIONS OR TO THE GENERAL PUBLIC. UNDER IRS ADVISORY DATED MARCH 7, 2014, THESE INTERCOMPANY SHARED SERVICES ARE NOT INCLUDED IN THE DEFINITION OF UNRELATED BUSINESS INCOME AND SHOULD NOT TO BE INCLUDED ON FORM 990-T DUE TO THE ABSENCE OF THE FOLLOWING TWO CONDITIONS: (1) THE SERVICES MUST BE ABOVE COST OR AT FAIR MARKET VALUE, AND (2) THERE MUST BE A PROFIT MOTIVE.
FORM 990, PART XI, LINE 9 DONATION AND ENDOWMENT ADJUSTMENT 24,857 TRANSFER TO AFFILIATE -797,520 TOTAL -772,663
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'S CONSOLIDATED REPORT ON FEDERAL AWARDS IN ACCORDANCE WITH OMB CIRCULAR A-133. FOOTNOTE: THROUGHOUT FORM 990, THE TERMS "GEISINGER- AND "SYSTEM" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH 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) 2015


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
Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
HOLY SPIRIT HOSPITAL OF THE SISTERS
OF CHRISTIAN CHARITY
Employer identification number

23-1512747
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
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-1995911
PHILANTHRO PA 501C3 7 N/A
Yes
 
(2)GEISINGER MEDICAL CENTER
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
24-0795959
HOSPITAL PA 501C3 3 GH
 
Yes
 
(3)GEISINGER CLINIC
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-6291113
PHYSICIAN PA 501C3 11A GH
 
Yes
 
(4)GEISINGER WYOMING VALLEY MEDICAL CE
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-1996150
HOSPITAL PA 501C3 3 GH
 
Yes
 
(5)MARWORTH
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2171417
D&A REHAB PA 501C3 3 GH
 
Yes
 
(6)GEISINGER HEALTH PLAN
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2311553
HEALTH INS PA 501C4   GH
 
Yes
 
(7)GEISINGER SYSTEM SERVICES
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2164794
SUPPORT SV PA 501C3 11A GH
 
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 CORPORATION RR
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
14-1909894
SELF INS VT 501C3 11A GH
 
Yes
 
(10)COMMUNITY MEDICAL CENTER
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
24-0862246
HOSPITAL PA 501C3 3 GH
 
Yes
 
(11)MOUNTAIN VIEW NURSING HOME INC
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2568288
LONG TERM PA 501C3 9 GH
 
Yes
 
(12)COMMUNITY MEDICAL CENTER HEALTHCARE
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2279376
SUPPORT SV PA 501C3 11A GH
 
Yes
 
(13)GEISINGER-BLOOMSBURG HOSPITAL
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2193572
HOSPITAL PA 501C3 3 GH
 
Yes
 
(14)GEISINGER-BLOOMSBURG HEALTHCARE CEN
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2242854
SKILLED NU PA 501C3 9 GH
 
Yes
 
(15)LEWISTOWN HEALTH CARE FOUNDATION
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2344363
PHILANTHRO PA 501C3 11A GH
 
Yes
 
(16)GEISINGER-LEWISTOWN HOSPITAL
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-1352187
HOSPITAL PA 501C3 3 GH
 
Yes
 
(17)LEWISTOWN AMBULATORY CARE CORPORATI
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2344362
HOLDING CO PA 501C3 11A GH
 
Yes
 
(18)FAMILY HEALTH ASSOCIATES OF GEISING
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
25-1651582
PHYSICIAN PA 501C3 11A GH
 
Yes
 
(19)KEYSTONE HEALTH INFORMATION EXCHANG
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
46-4359893
RHIO PA 501C3 11A GH
 
Yes
 
(20)HEALTH CARE CORP OF NORTHEAST PA
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2337286
SUPPORT SV PA 501C3 11A CMC
 
Yes
 
(21)SUN HOME HEALTH SERVICES INC
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-1736912
HEALTHCARE PA 501C3 9 GCHS
 
Yes
 
(22)HOLY SPIRIT HEALTH SYSTEM
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
25-1865142
PHILANTHRO PA 501C3 11A GH
 
Yes
 
(23)HOLY SPIRIT CORPORATION
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2214540
HOLDING CO PA 501C2   HSHS
 
Yes
 
(24)SPIRIT PHYSICIAN SERVICES INC
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
25-1766971
PHYSICIAN PA 501C3 9 HSHS
 
Yes
 
(25)WEST SHORE ADVANCED LIFE SUPPORT SE
100 NORTH ACADEMY AVENUE MC 49-70

DANVILLE,PA17822
23-2463002
HEALTHCARE PA 501C3 7 HSHS
 
Yes
 
(26)ATLANTICARE BEHAVORIAL HEALTH INC
2511 FIRE ROAD

EGG HARBOR TOWNSHIP,NJ08234
21-0721208
HEALTHCARE NJ 501C3 7 ARHS
 
Yes
 
(27)ATLANTICARE FOUNDATION
6725 DELILAH ROAD

EGG HARBOR TOWNSHIP,NJ08234
22-2148992
SUPPORT AR NJ 501C3 7 AH SYSTEM
 
Yes
 
(28)ATLANTICARE HEALTH ENGAGEMENT INC
2500 ENGLISH CREEK AVENUE

EGG HARBOR TOWNSHIP,NJ08234
61-1608389
HEALTHCARE NJ 501C3 11A AH SYSTEM
 
Yes
 
(29)ATLANTICARE HEALTH SERVICES INC
2500 ENGLISH CREEK AVENUE

EGG HARBOR TOWNSHIP,NJ08234
22-3265214
HEALTHCARE NJ 501C3 9 ARHS
 
Yes
 
(30)ATLANTICARE HEALTH SYSTEM INC
2500 ENGLISH CREEK AVENUE

EGG HARBOR TOWNSHIP,NJ08234
22-3265213
SUPPORT AR NJ 501C3 11A GH
 
Yes
 
(31)ATLANTICARE REGIONAL MEDICAL CENTER
1925 PACIFIC AVENUE

ATLANTIC CITY,NJ08401
21-0634549
HOSPITAL NJ 501C3 3 ARHS
 
Yes
 
(32)ATLANTICARE PHYSICIAN GROUP PA
2500 ENGLISH CREEK AVENUE

EGG HARBOR TOWNSHIP,NJ08234
02-0701782
HEALTHCARE NJ 501C3 9 AH SYSTEM
 
Yes
 
(33)INFOSHARE INC
2500 ENGLISH CREEK AVENUE

EGG HARBOR TOWNSHIP,NJ08234
22-3337816
INFO SERVI NJ 501C3 11A AH SYSTEM
 
Yes
 
(34)ATLANTICARE REGIONAL HEALTH SERVICE
2500 ENGLISH CREEK AVENUE

EGG HARBOR TOWNSHIP,NJ08234
80-0834222
HOLDING CO NJ 501C3 11A AH SYSTEM
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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
HEALTHCARE DE N/A
        No     No  
(8) CAMP HILL AMBULATORY SURG CTR LLC

569 BROOKWOOD VILLAGE SUITE 901
BIRMINGHAM,AL35209
52-1597478
HEALTHCARE PA N/A
        No     No  
(9) HS ORTHOPEDIC MANAGEMENT CO LLC

503 NORTH 21ST STREET
CANP HILL,PA17011
46-0887384
HEALTHCARE PA HSH
 
RELATED 17,744 174,666   No   Yes   40.000 %
(10) CAELIAN MEDICAL LLC

880 CENTURY DRIVE
MECHANICSBURG,PA17055
20-8018724
HEALTHCARE PA HSH
 
RELATED 64,100     No   Yes    
(11) GRANDVIEW SURGERY CENTER LTD

569 BROOKWOOD VILLAGE SUITE 901
BIRMINGHAM,AL35209
52-1597483
HEALTHCARE PA N/A
        No     No  
(12) LACKAWANNA PHYS AMB SURG CTRLLC

569 BROOKWOOD VILLAGE SUITE 901
BIRMINGHAM,AL35209
23-3024998
HEALTHCARE PA N/A
        No     No  
(13) SOUTHERN JERSEY ONCOLOGY PROPERTIES

2500 ENGLISH CREEK AVENUE
EGG HARBOR TOWNSHIP,NJ08234
94-3463625
HEALTHCARE NJ N/A
        No     No  
(14) ATLANTICARE SURGERY CENTER LLC

2500 ENGLISH CREEK AVENUE
EGG HARBOR TOWNSHIP,NJ08234
22-3491867
HEALTHCARE NJ N/A
        No     No  
(15) COOPERATIVE HEALTH SRVS OF S JERSEY

1301 ATLANTIC AVENUE
ATLANTIC CITY,NJ08401
22-3619231
PURCHASING NJ 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) XG HEALTH SOLUTIONS INC

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

878 WEST BAY ROAD PO BOX 1159
GRAND CAYMAN,GRAND CAYMANKY1-1102
CJ
98-1016737
INSURANCE CJ N/A
        Yes  
(6) HOLY SPIRIT VENTURES INC

100 NORTH ACADEMY AVENUE MC 49-70
DANVILLE,PA17822
23-2407709
MED. SERV. PA N/A
        Yes  
(7) ATLANTICARE HEALTH PLANS INC

1001 SOUTH GRAND ST PO BOX 941
HAMMONTON,NJ08037
22-3265212
INACTIVE NJ N/A
        Yes  
(8) ENGLISH CREEK ASSURANCE LTD

44 CHURCH STREET HM12 HAMILTON
BERMUDA,BERMUDA  
BD
98-0656394
FINANCIAL BD N/A
        Yes  
(9) ATLANTICARE HEALTH SOLUTIONS INC

2500 ENGLISH CREEK AVENUE BLDG 500
EGG HARBOR TOWNSHIP,NJ08234
38-3856295
ACO/HEALTH NJ N/A
        Yes  
(10) ATLANTICARE ASSURANCE ALLIANCE INC

2500 ENGLISH CREEK AVENUE BLDG 500
EGG HARBOR TOWNSHIP,NJ08234
46-3730123
HEALTHCARE NJ N/A
        Yes  
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
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
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) GEISINGER MEDICAL CENTER

P 199,179 GAAP
(2) GEISINGER INDEMNITY INSURANCE COMPA

P 938,576 GAAP
(3) GEISINGER SYSTEM SERVICES

L 94,483 GAAP
(4) GEISINGER COMMUNITY HEALTH SERVICES

L 50 GAAP
(5) GEISINGER HEALTH PLAN

L 13,937,000 GAAP
(6) GEISINGER CLINIC

B 245 GAAP
(7) GEISINGER CLINIC

M 416,484 GAAP
(8) GEISINGER SYSTEM SERVICES

M 5,682,544 GAAP
(9) GEISINGER COMMUNITY HEALTH SERVICES

M 149,111 GAAP
(10) SUN HOME HEALTH SERVICES

M 1,742 GAAP
(11) SPIRIT PHYSICIAN SERVICES INC

K 7,504,469 GAAP
(12) WEST SHORE ADVANCED LIFE SUPPORT

K 33,243 GAAP
(13) HOLY SPIRIT CORPORATION

K 1,153,733 GAAP
(14) HOLY SPIRIT VENTURES

K 562,498 GAAP
(15) GEISINGER LEWISTOWN HOSPITAL

P 150 GAAP
(16) SPIRIT PHYSICIAN SERVICES INC

L 801,160 GAAP
(17) WEST SHORE ADVANCED LIFE SUPPORT

L 221,002 GAAP
(18) HOLY SPIRIT VENTURES INC

L 6,241 GAAP
(19) HOLY SPIRIT HEALTH SYSTEM

L 762,896 GAAP
(20) KEYSTONE HEALTH INFO EXCHANGE

M 218,750 GAAP
(21) SPIRIT PHYSICIAN SERVICES INC

M 230,268 GAAP
(22) HOLY SPIRIT VENTURES INC

M 4,389 GAAP
(23) GEISINGER LEWISTOWN HOSPITAL

A 69,656 GAAP
(24) SPIRIT PHYSICIAN SERVICES INC

A 381,732 GAAP
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
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) 2015
Schedule R (Form 990) 2015
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
SCHEDULE R FORM 990, SCHEDULE R, PART V - TRANSACTIONS WITH RELATED ORGANIZATIONS: AS SHOWN IN THE RESPONSE TO FORM 990, SCHEDULE R, THE ORGANIZATION 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 INTERORGANIZATION TRANSACTIONS PROMOTE THE EFFICIENT OPERATION OF THE VARIOUS ORGANIZATIONS AND THE ATTAINMENT OF THEIR TAX EXEMPT PURPOSES. THESE TYPES OF INTER ORGANIZATION TRANSACTIONS WERE DESCRIBED TO THE INTERNAL REVENUE SERVICE IN A RULING APPLICATION AND WERE RECOGNIZED BY THE NATIONAL OFFICE OF THE IRS IN A SERIES OF GHS PRIVATE RULINGS AS BEING ENTIRELY CONSISTENT WITH THE ORGANIZATIONS' TAX EXEMPT STATUS. _
Schedule R (Form 990) 2015

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