Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (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 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(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. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(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.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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 | ||||
| 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) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software Version: |
| Return Reference | Explanation |
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| SCHEDULE E, PART I, LINE 3 | THE FOLLOWING STATEMENT IS INCLUDED ON ALL BROCHURES AND MAILINGS. "GEISINGER COMMONWEALTH SCHOOL OF MEDICINE IS COMMITTED TO NON-DISCRIMINATION IN ALL OF ITS EMPLOYMENT AND EDUCATIONAL OPPORTUNITIES." IN ADDITION, THE COLLEGE ADVERTISED ITS NONDISCRIMINATORY POLICY. |
| SCHEDULE E, PART I, LINE 6 | IN FY 2016 GEISINGER COMMONWEALTH SCHOOL OF MEDICINE RECOGNIZED GRANT REVENUE FROM FEDERAL AND STATE GOVERNMENTS IN THE AMOUNT OF $831,634. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 1: | STUDENTS ENGAGE IN A COMMUNITY PUBLIC HEALTH PROJECT, EMPHASIZING GCSM'S COMMITMENT TO IMPROVING THE QUALITY OF HEALTH CARE IN OUR REGION. IN ADDITION, EACH STUDENT MUST COMPLETE 100 HOURS OF COMMUNITY SERVICE IN NORTHEAST OR NORTH CENTRAL PENNSYLVANIA. GCSM FACULTY HAVE BEEN RECOGNIZED NATIONALLY AND INTERNATIONALLY FOR THEIR SCHOLARLY WORK, PUBLISHING HUNDREDS OF SCHOLARLY PAPERS, AND PRESENTING AT CONFERENCES, AND TO DATE HAVE BEEN AWARDED OVER $5.3 MILLION IN RESEARCH GRANTS, $5.8 MILLION IN TRAINING AND EDUCATION GRANTS AND $2.8 MILLION IN EQUIPMENT/OTHER GRANTS. THE COLLEGE FOCUSES ON CREATING A UNIQUE MEDICAL EDUCATION EXPERIENCE THAT FOSTERS COLLABORATION AMONG INTERDISCIPLINARY TEAM MEMBERS, PATIENT-CENTERED CARE, AND IMPROVING THE HEALTH OF THE LOCAL POPULATION. THE COLLEGE BEGAN OFFERING ACADEMIC PROGRAMS AND AWARD DEGREES IN A PROGRAM IN MEDICINE LEADING TO THE DEGREE OF DOCTOR OF MEDICINE (MD) AND IN A PROGRAM OF BIOMEDICAL SCIENCES LEADING TO THE DEGREE OF MASTER OF BIOMEDICAL SCIENCES (MBS). GCSM ALSO PARTNERS WITH EAST STROUDSBURG UNIVERSITY TO OFFER A JOINT MD / MASTER OF PUBLIC HEALTH (MPH) DEGREE. THE COLLEGE CONTINUED ITS PROGRAMS TO SUPPORT THE BASIC AND CLINICAL SCIENCES THROUGH BIOMEDICAL, BEHAVIORAL, EPIDEMIOLOGICAL, EDUCATIONAL AND HEALTH SCIENCES RESEARCH. IN MAY OF 2010, GCSM'S FIRST CLASS OF MBS STUDENTS GRADUATED AND IN MAY 2016 OUR SEVENTH CLASS GRADUATED. GCSM GRADUATED ITS CHARTER DOCTOR OF MEDICINE CLASS IN MAY 2013 AND A FOURTH CLASS IN MAY 2016. |
| FORM 990, PART VI, SECTION A, LINE 1 | THE PRESIDENT & DEAN ARE EX-OFFICIO MEMBERS AND CAN APPOINT A FACULTY MEMBER IF THE PRESIDENT & DEAN ARE THE SAME PERSON. NEITHER OF THESE POSITIONS ARE VOTING MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 2 | TRUSTEES LOUIS DENAPLES, JOHN MOSES, AND JOHN MENAPACE HAVE A BUSINESS RELATIONSHIP. MR. DENAPLES, ATTORNEY MOSES, AND MR MENAPACE ARE BOARD MEMBERS OF BLUE CROSS OF NORTHEASTERN PENNSYLVANIA, AN ORGANIZATION THAT TRANSACTS BUSINESS WITH GEISINGER COMMONWEALTH SCHOOL OF MEDICINE. |
| FORM 990, PART VI, SECTION A, LINE 7A | SPONSORSHIP TRUSTEES - DURING THE TERM OF A CERTAIN SPONSORSHIP AGREEMENT BY AND BETWEEN BLUE CROSS OF NORTHEASTERN PENNSYLVANIA (BCNEPA), WHICH COMMENCED ON OCT 23, 2007 AND WILL CONCLUDE ON OCT 22, 2020, AND THE CORPORATION, BCNEPA SHALL BE ENTITLED TO APPOINT THAT NUMBER OF INDIVIDUALS AS IS SUFFICIENT TO CONSTITUTE AT LEAST TWENTY-FIVE PERCENT (25%) OF THE TOTAL NUMBER OF VOTING MEMBERS OF THE BOARD. TRUSTEES SO APPOINTED SHALL SERVE FOR TERMS ENDING ON OCT 22, 2020 OR UPON EARLIER TERMINATION, FOR ANY REASON, OF THE SPONSORSHIP AGREEMENT. SUCH TRUSTEES SHALL BE REMOVED FROM THE BOARD ONLY "FOR CAUSE" PURSUANT TO SECTION 6 OF THIS ARTICLE. IN THE EVENT ANY SPONSORSHIP TRUSTEE IS REMOVED FOR CAUSE, OR CEASES TO SERVE BY REASON OF DEATH, RESIGNATION OR OTHERWISE, BCNEPA SHALL APPOINT ANOTHER INDIVIDUAL TO FILL SUCH VACANCY FOR THE REMAINDER OF THE TERM. UNDER AN ASSIGNMENT AND ASSUMPTION AGREEMENT BETWEEN BCNEPA AND ALLONE FOUNDATION DATED JUNE 1, 2015, BCNEPA ASSIGNED ALL OF ITS RIGHTS AND INTERESTS UNDER ITS SPONSORSHIP AGREEMENT WITH GCSM TO THE ALLONE FOUNDATION, A 501(C)(3) ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THESE ARTICLES OF INCORPORATION MAY BE AMENDED OR RESTATED BY A SUPER MAJORITY VOTE (AS HEREINAFTER DEFINED) OF THE BOARD OF DIRECTORS OF THE CORPORATION OR BY UNANIMOUS WRITTEN CONSENT OF ALL MEMBERS OF THE BOARD OF DIRECTORS OF THE CORPORATION. THIS PROVISION IS PURSUANT TO PROCEDURES SET FORTH IN THE BYLAWS, PROVIDED THAT NO AMENDMENT OF ARTICLE X OR OF ARTICLE XII OF THESE ARTICLES SHALL BE EFFECTIVE AND NO AMENDMENT OF ANY OTHER PROVISION OF THESE ARTICLES THAT IS CONSISTENT WITH ARTICLE X OR ARTICLE XII SHALL BECOME EFFECTIVE, UNLESS APPROVED IN WRITING BY BLUE CROSS OF NORTHEASTERN PENNSYLVANIA, NOW THE ALLONE FOUNDATION. FOR PURPOSES HEREOF, A "SUPER MAJORITY VOTE" MEANS THE AFFIRMATIVE VOTE OF AT LEAST SEVENTY-SIX PERCENT (76%) OF THE VOTING MEMBERS OF THE BOARD OF DIRECTORS IN OFFICE OR THE UNANIMOUS WRITTEN CONSENT OF ALL VOTING MEMBERS OF THE BOARD OF DIRECTORS. THE AFFIRMATIVE VOTE OF AT LEAST SEVENTY-SIX PERCENT (76%) OF THE VOTING TRUSTEES IN OFFICE SHALL BE REQUIRED FOR BOARD APPROVAL OF THE FOLLOWING ACTIONS OF THE CORPORATION OR FOR THE CORPORATION'S INCURRING ANY OBLIGATION OR MAKING ANY COMMITMENT IN RESPECT OF SUCH ACTIONS - I ELECTION OR APPOINTMENT OF A CHAIRMAN OF THE BOARD, II APPROVAL OF ANY FUNDAMENTAL TRANSACTION (AS DEFINED BELOW), III APPROVAL OF THE CORPORATION'S ANNUAL OPERATING BUDGET AND CAPITAL BUDGETS AND ANY MATERIAL VARIATIONS THEREFROM, IV APPROVAL OF STRATEGIC BUSINESS PLANS AND MATERIAL VARIATIONS THEREFROM, V THE FILLING OF VACANCIES WITHIN THE BOARD, VI APPROVAL OF ANY INCREASE OR REDUCTION IN THE SIZE OF THE BOARD, VII APPROVAL OF ANY NEW INDEBTEDNESS FOR BORROWED MONEY OR ANY OBLIGATION SECURED BY ANY ASSET OF THE CORPORATION, VIII APPROVAL OF ANY AMENDMENT OF THE TERMS OF THE CORPORATION'S INDEBTEDNESS FOR BORROWED MONEY OR SECURED INDEBTEDNESS OR OF ANY RESTRUCTURING OR REFINANCING OF ANY SUCH INDEBTEDNESS, AND IX APPROVAL OF ANY AMENDMENT OF THE CORPORATION'S BYLAWS OR ARTICLES OF INCORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE COLLEGE'S FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM IN CONJUNCTION WITH THE COLLEGE'S ACCOUNTING DEPARTMENT. A COPY OF THE FORM 990 WAS CIRCULATED TO THE BOARD OF TRUSTEES BY THE VICE PRESIDENT OF FINANCE AND BY THE ADMINISTRATION FOR DISCUSSION AND COMMENT. EACH TRUSTEE WAS PROVIDED AMPLE OPPORTUNITY TO COMMENT ON THE INFORMATION CONTAINED IN THE 990 PRIOR TO ITS ELECTRONIC FILING WITH THE INTERNAL REVENUE SERVICE. THE TRUSTEES HAVE REVIEWED THE "AS FILED" COPY OF THE 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH OFFICER, DIRECTOR, TRUSTEE, KEY EMPLOYEE, FINANCE AND ACCOUNTING STAFF AND ALL FINANCIAL MANAGERS OF THE COLLEGE ARE REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THAT ARISE BY VIRTUE OF THEIR EMPLOYMENT, BOARD SERVICE OR THEIR POSITION WITH THE COLLEGE. THE COLLEGE MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL QUESTIONNAIRE/DISCLOSURE STATEMENT THAT IS DISTRIBUTED TO THESE INDIVIDUALS. POTENTIAL CONFLICTS OF INTEREST ARE REQUIRED TO BE DISCLOSED. THE EXECUTIVE OFFICE ASSISTANT MONITORS THE POLICY AND REVIEWS ANY POTENTIAL CONFLICTS AND DISCLOSURE FORMS WITH THE VICE PRESIDENT/CFO. ANY SUCH CONFLICTS WOULD REQUIRE THAT INDIVIDUAL TO REFRAIN FROM VOTING. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COLLEGE UNDERTAKES A THOROUGH PROCESS TO ENSURE THAT THE EXECUTIVE COMPENSATION IT PAYS ITS TOP MANAGEMENT OFFICIAL AND ALL OF THE OFFICERS AND KEY EMPLOYEES IS REASONABLE GIVEN THE MARKET IN WHICH THE COLLEGE COMPETES AND OPERATES. IN RELEVANT PART, THE BOARD OF DIRECTORS HAS ESTABLISHED A COMPENSATION COMMITTEE OF INDEPENDENT PERSONS WHO HAVE NO PERSONAL INTEREST IN THE PROPOSED COMPENSATION AGREEMENT. THE COMPENSATION COMMITTEE CONTRACTS WITH A COMPENSATION CONSULTANT EVERY TWO YEARS TO COMPLETE A MARKET ASSESSMENT AND COMPETITIVE ANALYSIS FOR THE COLLEGE'S TOP EXECUTIVES. THE COMPENSATION CONSULTANT UTILIZES COMPARABILITY AND BENCHMARKING DATA TO ENSURE THAT THE COLLEGE COMPENSATES ITS EXECUTIVES COMMENSURATE WITH THE MARKET. THE COMPENSATION COMMITTEE WILL THEN SET THE COMPENSATION FOR THE PRESIDENT AND DEAN AND DOCUMENT THE DECISION IN BOARD MINUTES. OTHER POSITIONS ARE SET BY THE PRESIDENT AND DEAN GIVEN MARKET ASSESSMENTS AND COMPETITIVE POSITIONS, AS WELL AS INFORMATION FROM THE EXECUTIVE COMPENSATION REVIEW. THESE DETERMINATIONS ARE DOCUMENTED BY THE CONSULTANT, REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE AND APPROVED BY THE FULL BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE COLLEGE MAKES ITS 990 AVAILABLE TO THE PUBLIC BY RETAINING A COPY AT ITS PLACE OF BUSINESS. THE FORM 990 IS LIKEWISE PUBLISHED ON THE INTERNET AT WWW.GUIDESTAR.ORG. THE ORGANIZATIONS'S FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE NOT ORDINARILY MADE AVAILABLE TO THE PUBLIC, BUT IF REQUESTED, WILL BE PROVIDED AT MANAGEMENT'S DISCRETION. |
| FORM 990, PART XI, LINE 9: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS -2,081,758. |
| Software ID: | |
| Software Version: |