TY 2017 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) EARL FOURA...................................................................... VICE CHAIR,	0.25 ................. 3.75	X				0	0	0
(2) EDELYN L MILLER...................................................................... DIRECTOR	................. 40.00	X				0	1,565,659	256,399
(3) JAEWON RYU MD JD...................................................................... DIRECTOR	................. 40.00	X				0	1,596,610	218,215
(4) ROBERT J DIETZ...................................................................... CHAIR, DIREC	0.25 ................. 4.50	X				0	0	0
(5) V CHRIS HOLCOMBE PE...................................................................... VICE CHAIR,	0.25 ................. 3.75	X				0	0	0
(6) VIRGINIA MCGREGOR...................................................................... DIRECTOR	0.25 ................. 4.00	X				0	0	0
(7) DAVID T FEINBERG MD MBA...................................................................... PRESIDENT, D	................. 40.00	X	X			0	3,943,153	1,025,348
(8) DANIEL E LOHR ESQUIRE...................................................................... ACLO, ASST S	................. 40.00		X			0	441,235	43,464
(9) DAVID J FELICIO ESQUIRE...................................................................... EVP, CLO, SE	................. 40.00		X			0	1,142,940	258,756
(10) KEVIN F BRENNAN CPA FHFMA...................................................................... EVP, CFO, TR	................. 40.00		X			0	2,133,432	36,848
(11) LISSA L BRYAN SMITH...................................................................... VP OPS, GBH	................. 40.00		X			0	404,018	37,477
(12) STEPHEN J PAOLUCCI MD...................................................................... CMO	................. 40.00		X			0	696,513	44,093
(13) BONNIE L HESS RN...................................................................... VP, NURSING	40.00 .................			X		233,454	0	33,068
(14) BEVERLY J TROY...................................................................... RNFA	40.00 .................				X	100,379	0	24,396
(15) BRENDA ALBERTSON...................................................................... IP NURSING O	40.00 .................				X	120,765	0	33,653
(16) CAROL A WALTERS...................................................................... IP NURSING O	40.00 .................				X	102,724	0	31,131
(17) JEREMY R SCOTT...................................................................... MANAGER, PHA	40.00 .................				X	109,480	0	33,792

(A) Name and business address	(B) Description of services	(C) Compensation
MEDEFIS CONSOLIDATED, PO BOX 5068 NEW YORK,NY100875068	TEMPORARY HELP	531,635
OLYMPUS AMERICA INC, PO BOX 200194 PITTSBURGH,PA152510194	MAINT SERVICE	205,223
HCSC, 2171 28TH ST SW ALLENTOWN,PA18103	LAUNDRY SERVICE	187,945
HEALTHSOUTH GHS LLC, 2 REHAB LANE DANVILLE,PA17821	MEDICAL SERVICE	168,641
SCRIBEAMERICA LLC, PO BOX 417756 BOSTON,MA022417756	CHARTING SERV	167,945
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 26

- TIN:

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

GEISINGER-BLOOMSBURG HOSPITAL

Employer identification number

23-2193572

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


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) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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

Gross receipts from related activities, etc. (see instructions) ..................

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

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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.)..

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

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

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.

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.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

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.

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

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).

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.

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.

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.

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

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) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

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

A family member of a person described in (a) above?

11b

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

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

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.

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.

Parent of Supported Organizations. Answer (a) and (b) below.

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.

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.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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

GEISINGER-BLOOMSBURG HOSPITAL

Employer identification number

23-2193572

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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) 2019

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ...................................................................................................................	Yes No

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) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

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)

Yes|No

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

2,767

Total. Add lines 1c through 1i ....................................................................................................

2,767

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

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	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) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

GEISINGER-BLOOMSBURG HOSPITAL

Employer identification number

23-2193572

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" 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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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 ....	9,330,663	8,734,417	9,063,100	9,165,426	8,369,276
b	Contributions ...	441,212	12,000	11,073	32,985	23,102
c	Net investment earnings, gains, and losses	1,554,190		134	166	174
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...					20,160
f	Administrative expenses ....
g	End of year balance ......	11,326,065	9,330,663	8,734,417	9,063,101	9,165,426

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

99.000 %

Term endowment SchDMd Bullet

1.000 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

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 .....	432,243		432,243
b	Buildings ....	10,784,556	4,491,841	6,292,715
c	Leasehold improvements
d	Equipment ....	16,582,174	7,582,320	8,999,854
e	Other .....	1,691,266	402,569	1,288,697
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				17,013,509

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther 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........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram 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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

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)BENEFICIAL INTEREST PERPETUAL TRUSTS				10,525,139
(2)DUE FROM AFFILIATES				868,171
(3)DEFERRED PENSION COMPENSATION				390,653
(4)OTHER RECEIVABLES-ALS				586
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				11,784,549

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
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	8,704,727
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) 2019

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

PERMANENTLY RESTRICTED ENDOWMENT FUNDS ARE HELD AT UNRELATED FUNANCIAL INSTITUTIONS WHO ARE RESPONSBILE FOR MAINTAINING AND INVESTING THE PRINCIPLE AND THE DISTRIBUTION OF THE FUND IN ACCORDANCE WITH THE DONOR STIPULATIONS. DISTRIBUTIONS FROM THE FUNDS ARE MADE BY THE RESPECTIVE FINANCIAL INSTITUTONS TO GEISINGER BLOOMSBURG HOSPITAL WHO USES THE FUNDS AS DIRECTED IN THE TRUST AGREEMENTS.

SCHEDULE D, PAGE 4, PART XIII

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) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

GEISINGER-BLOOMSBURG HOSPITAL

Employer identification number

23-2193572

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other 300.0000000000 %

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: . . . . . . . .

200% 250% 300% 350% 400% Other %

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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	624,057		624,057	1.190 %
b	Medicaid (from Worksheet 3, column a) . . . . .	9,085,495	4,925,631	4,159,864	7.930 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	301,358	210,875	90,483	0.170 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	10,010,910	5,136,506	4,874,404	9.290 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	337,065		337,065	0.640 %
f	Health professions education (from Worksheet 5) . . .	752,850	85,006	667,844	1.270 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	4,447		4,447	0.010 %
j	Total. Other Benefits . .	1,094,362	85,006	1,009,356	1.920 %
k	Total. Add lines 7d and 7j .	11,105,272	5,221,512	5,883,760	11.220 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

1,648,350

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. ......

412,088

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

Enter total revenue received from Medicare (including DSH and IME).....

6,397,700

Enter Medicare allowable costs of care relating to payments on line 5.....

9,946,594

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-3,548,894

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

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?1Name, 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)						Other (describe)
1	GEISINGER-BLOOMSBURG HOSPITAL 549 FAIR STREET BLOOMSBURG,PA17815 WWW.GEISINGER.ORG 025001	X	X	X	X	TRAUMA SERVICES

Schedule H (Form 990) 2019

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)

	GEISINGER-BLOOMSBURG HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

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 .................

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..................................

Yes

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. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.GEISINGER.ORG

Other website (list url): WWW.GEISINGER.ORG

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): WWW.GEISINGER.ORG

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	GEISINGER-BLOOMSBURG HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 300.000000000000%
and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.GEISINGER.ORG - REFER TO SECTION C

The FAP application form was widely available on a website (list url):

WWW.GEISINGER.ORG - REFER TO SECTION C

A plain language summary of the FAP was widely available on a website (list url):
WWW.GEISINGER.ORG - REFER TO SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	GEISINGER-BLOOMSBURG HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	GEISINGER-BLOOMSBURG HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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, GEISINGER-BLOOMSBURG HOSPITAL - PART V, LINE 5	SECTION B., COMMUNITY HEALTH NEEDS ASSESSMENT, LINES 3, 5 AND 6A: GEISINGER-BLOOMSBURG HOSPITAL (GBH), A 72-BED COMMUNITY HOSPITAL LOCATED IN BLOOMSBURG, PA, IN RESPONSE TO ITS COMMUNITY COMMITMENT, CONTRACTED WITH TRIPP UMBACH TO FACILITATE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BETWEEN OCTOBER 2014 AND MARCH 2015. AS A PARTNERING HOSPITAL OF A REGIONAL COLLABORATIVE EFFORT TO ASSESS COMMUNITY HEALTH NEEDS; GBH COLLABORATED WITH HOSPITALS AND OUTSIDE ORGANIZATIONS IN THE SURROUNDING REGION (INCLUDING COLUMBIA, LUZERNE AND MONTOUR COUNTIES) DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. THE FOLLOWING IS A LIST OF ORGANIZATIONS THAT PARTICIPATED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IN SOME WAY: AGAPE, BLOOMSBURG AREA SCHOOL DISTRICT, BLOOMSBURG UNIVERSITY, CARING COMMUNITIES FOR AIDS, CENTRAL SUSQUEHANNA COMMUNITY FOUNDATION, CENTRAL SUSQUEHANNA OPPORTUNITIES CMSU, COLUMBIA COUNTY, COLUMBIA COUNTY VOLUNTEERS IN MEDICINE, COLUMBIA MONTOUR AGENCY ON AGING, COLUMBIA MONTOUR CHAMBER OF COMMERCE, COLUMBIA MONTOUR FAMILY HEALTH, COLUMBIA-SULLIVAN HEAD START, DENTAL HEALTH CLINIC, PA DEPARTMENT OF HEALTH, MONTOUR COUNTY HEAD START, NORTHERN COLUMBIA COMMUNITY & CULTURAL CENTER, NURSE FAMILY PARTNERSHIP, TAPESTRY OF HEALTH AND UNITED WAY OF WYOMING VALLEY WOMEN'S CENTER. TRIPP UMBACH, HEADQUARTERED IN PITTSBURGH, PA, IS A RECOGNIZED NATIONAL LEADER IN CONDUCTING CHNAS, HAVING CONDUCTED MORE THAN 250 CHNAS OVER THE PAST 20 YEARS. TODAY, MORE THAN 1 IN 5 AMERICANS LIVE IN A COMMUNITY WHERE TRIPP UMBACH HAS COMPLETED A CHNA. PAUL UMBACH, FOUNDER AND PRESIDENT OF TRIPP UMBACH, IS AMONG THE MOST EXPERIENCED COMMUNITY HEALTH PLANNERS IN THE NATION, HAVING DIRECTED PROJECTS IN EVERY STATE AND INTERNATIONALLY. TRIPP UMBACH HAS WRITTEN TWO NATIONAL GUIDE BOOKS ON THE TOPIC OF COMMUNITY HEALTH AND HAS PRESENTED AT MORE THAN 50 STATE AND NATIONAL HEALTH CONFERENCES. THE ADDITIONAL TRIPP UMBACH TEAM BROUGHT MORE THAN 30 YEARS OF COMBINED EXPERIENCE TO THE PROJECT. KEY DATA SOURCES IN THE CHNA INCLUDED: CHNA PLANNING: A SERIES OF MEETINGS WAS FACILITATED BY TRIPP UMBACH AND THE CHNA OVERSIGHT COMMITTEE CONSISTING OF LEADERSHIP FROM GBH AND OTHER PARTICIPATING HOSPITALS AND ORGANIZATIONS (I.E., GEISINGER MEDICAL CENTER, GEISINGER ENCOMPASS HEALTH LIMITED LIABILITY COMPANY FORMERLY GEISINGER HEALTHSOUTH REHABILITATION HOSPITAL; GEISINGER WYOMING VALLEY MEDICAL CENTER; GEISINGER SOUTH WILKES-BARRE; GEISINGER COMMUNITY MEDICAL CENTER; GEISINGER LEWISTOWN HOSPITAL; AND EVANGELICAL COMMUNITY HOSPITAL). SECONDARY DATA: THE HEALTH OF A COMMUNITY IS LARGELY RELATED TO THE CHARACTERISTICS OF ITS RESIDENTS. AN INDIVIDUAL'S AGE, RACE, GENDER, EDUCATION AND ETHNICITY OFTEN DIRECTLY OR INDIRECTLY IMPACT HEALTH STATUS AND ACCESS TO CARE. TRIPP UMBACH COMPLETED COMPREHENSIVE ANALYSES OF HEALTH STATUS AND SOCIO-ECONOMIC ENVIRONMENTAL FACTORS RELATED TO THE HEALTH OF RESIDENTS OF THE GEISINGER-BLOOMSBURG HOSPITAL COMMUNITY FROM EXISTING DATA SOURCES SUCH AS STATE AND COUNTY PUBLIC HEALTH AGENCIES, THE CENTERS FOR DISEASE CONTROL AND PREVENTION, COUNTY HEALTH RANKINGS, THOMPSON REUTERS, CNI, HEALTHY PEOPLE 2020, AND OTHER ADDITIONAL DATA SOURCES. TRENDING FROM 2012 CHNA: IN 2012, GBH CONTRACTED WITH TRIPP UMBACH TO COMPLETE A CHNA FOR THE SAME COUNTIES INCLUDED IN THE SERVICE AREA (COLUMBIA, LUZERNE, AND MONTOUR COUNTIES). THE DATA SOURCES USED WERE THE SAME DATA SOURCES FROM THE 2012 CHNA, WHICH MADE IT POSSIBLE TO REVIEW TRENDS AND CHANGES ACROSS THE HOSPITAL SERVICE AREA. DATA AND FINDINGS FROM THE PREVIOUS CHNA WERE CONSIDERED AND CARRIED OVER TO THIS CHNA WHEN APPLICABLE. THERE WERE SEVERAL DATA SOURCES WITH CHANGES IN THE DEFINITION OF SPECIFIC INDICATORS, WHICH RESTRICTED THE USE OF TRENDING IN SEVERAL CASES. THE FACTORS THAT COULD NOT BE TRENDED ARE CLEARLY DEFINED IN THE SECONDARY DATA. INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS: TRIPP UMBACH WORKED CLOSELY WITH THE CHNA OVERSIGHT COMMITTEE TO IDENTIFY LEADERS FROM ORGANIZATIONS THAT INCLUDED 1) PUBLIC HEALTH EXPERTISE; 2) PROFESSIONALS WITH ACCESS TO COMMUNITY HEALTH RELATED DATA; AND 3) REPRESENTATIVES OF UNDERSERVED POPULATIONS (I.E., SENIORS, LOW-INCOME RESIDENTS, AND RESIDENTS THAT ARE UNINSURED). SUCH PERSONS WERE INTERVIEWED AS PART OF THE NEEDS ASSESSMENT PLANNING PROCESS. A SERIES OF 12 INTERVIEWS WAS COMPLETED WITH KEY STAKEHOLDERS IN THE GBH COMMUNITY, INCLUDING: AGAPE, BLOOMSBURG AREA SCHOOL DISTRICT, BLOOMSBURG UNIVERSITY, CARING COMMUNITIES FOR AIDS, CENTRAL SUSQUEHANNA COMMUNITY FOUNDATION, COLUMBIA COUNTY, COLUMBIA COUNTY VOLUNTEERS IN MEDICINE, COLUMBIA MONTOUR AGENCY ON AGING, COLUMBIA MONTOUR CHAMBER OF COMMERCE, COLUMBIA MONTOUR FAMILY HEALTH, COLUMBIA-SULLIVAN HEAD START, DENTAL HEALTH CLINIC, PA DEPARTMENT OF HEALTH, NORTHERN COLUMBIA COMMUNITY & CULTURAL CENTER, TAPESTRY OF HEALTH AND WOMEN'S CENTER. SURVEY OF VULNERABLE POPULATIONS: VULNERABLE POPULATIONS WERE IDENTIFIED BY THE CHNA OVERSIGHT COMMITTEE TO ASSURE THAT COMMUNITY MEMBERS, INCLUDING UNDERREPRESENTED RESIDENTS, WERE INCLUDED IN THE NEEDS ASSESSMENT THROUGH A SURVEY PROCESS. A TOTAL OF 267 SURVEYS WERE COLLECTED IN THE GBH SERVICE AREA. TRIPP UMBACH WORKED WITH THE OVERSIGHT COMMITTEE TO DESIGN A 33- QUESTION HEALTH STATUS SURVEY THAT WAS ADMINISTERED BY COMMUNITY BASED ORGANIZATIONS PROVIDING SERVICES TO VULNERABLE POPULATIONS IN THE HOSPITAL SERVICE AREA. (I.E., CENTRAL SUSQUEHANNA OPPORTUNITIES, CMSU, NURSE FAMILY PARTNERSHIP, MONTOUR COUNTY HEAD START, COLUMBIA-SULLIVAN HEAD START, AGAPE, NORTHERN COLUMBIA COMMUNITY & CULTURAL CENTER, THE DENTAL HEALTH CLINIC, AND THE UNITED WAY OF WYOMING VALLEY). COMMUNITY BASED ORGANIZATIONS WERE TRAINED TO ADMINISTER THE SURVEY USING HAND- DISTRIBUTION. SURVEYS WERE ADMINISTERED ONSITE AND SECURELY MAILED TO TRIPP UMBACH FOR TABULATION AND ANALYSIS. VULNERABLE POPULATIONS WERE IDENTIFIED BY THE CHNA OVERSIGHT COMMITTEE AND THROUGH STAKEHOLDER INTERVIEWS. VULNERABLE POPULATIONS TARGETED BY THE SURVEYS WERE SENIORS, LOW-INCOME RESIDENTS (INCLUDING FAMILIES), RESIDENTS WITH BEHAVIORAL HEALTH NEEDS AND RESIDENTS THAT ARE UNINSURED. PRIORITIZATION OF TOP COMMUNITY HEALTH NEEDS: TOP COMMUNITY HEALTH NEEDS WERE IDENTIFIED AND PRIORITIZED BY COMMUNITY LEADERS DURING A REGIONAL COMMUNITY HEALTH NEEDS IDENTIFICATION FORUM HELD ON MARCH 10, 2015. CONSULTANTS PRESENTED TO COMMUNITY LEADERS THE CHNA FINDINGS FROM ANALYZING SECONDARY DATA, KEY STAKEHOLDER INTERVIEWS AND SURVEYS. COMMUNITY LEADERS DISCUSSED THE DATA PRESENTED, SHARED THEIR VISIONS AND PLANS FOR COMMUNITY HEALTH IMPROVEMENT IN THEIR COMMUNITIES, AND IDENTIFIED AND PRIORITIZED THE TOP COMMUNITY HEALTH NEEDS IN THE GBH COMMUNITY. PUBLIC COMMENT REGARDING THE 2012 CHNA AND IMPLEMENTATION PLAN: TRIPP UMBACH SOLICITED PUBLIC COMMENTARY FROM COMMUNITY LEADERS AND RESIDENTS. COMMENTERS WERE ASKED TO REVIEW THE CHNA AND ACTION PLAN ADOPTED BY GBH IN 2013 AND WERE PROVIDED ACCESS TO EACH DOCUMENT FOR REVIEW. COMMENTERS WERE THEN ASKED TO RESPOND TO A QUESTIONNAIRE WHICH PROVIDED OPEN AND CLOSED RESPONSE QUESTIONS. THE QUESTIONNAIRE WAS OFFERED IN HARD COPY AT TWO LOCATIONS INSIDE THE HOSPITAL AS WELL AS ELECTRONICALLY USING A WEB-BASED PLATFORM. THE CHNA AND ACTION PLAN WERE PROVIDED TO COMMENTERS FOR REVIEW IN THE SAME MANNER (I.E., HARD COPY AT THE HOSPITAL AND ELECTRONICALLY). THERE WERE NO RESTRICTIONS OR QUALIFICATIONS REQUIRED OF PUBLIC COMMENTERS. FLYERS WERE CIRCULATED AND ELECTRONIC REQUESTS WERE MADE FOR PUBLIC COMMENT THROUGHOUT THE COLLECTION PERIOD. 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.
FACILITY 1, GEISINGER-BLOOMSBURG HOSPITAL - PART V, LINE 6A	GEISINGER MEDICAL CENTER, GEISINGER ENCOMPASS HEALTH LIMITED LIABILITY COMPANY FORMERLY GEISINGER HEALTH SOUTH REHABILITATION HOSPITAL, GEISINGER SHAMOKIN AREA COMMUNITY HOSPITAL, EVANGELICAL COMMUNITY HOSPITAL, AND GEISINGER-BLOOMSBURG HOSPITAL PARTICIPATED IN THE CHNA.
FACILITY 1, GEISINGER-BLOOMSBURG HOSPITAL - PART V, LINE 11	BELOW ARE SYSTEM-WIDE PROGRAMS OFFERED BY GEISINGER TO FULFILL COMMUNITY NEEDS THAT WERE IDENTIFIED IN THE HOSPITAL'S 2015 CHNA. SOME PROGRAMS ARE COMPLETELY OPERATED OR FUNDED BY GEISINGER AND SOME ARE OFFERED IN COOPERATION WITH LOCAL HEALTH AND HUMAN SERVICE AGENCIES. FOR MORE SPECIFIC NEEDS FOUND IN OUR LOCAL COMMUNITIES, WE OFFER PROGRAMS TO SERVE PATIENTS CLOSE TO HOME. THE TOP THREE NEEDS IDENTIFIED IN THE MOST RECENT AND/OR PAST CHNA SURVEYS FALL INTO ONE OF THREE COMMUNITY NEED CATEGORIES: 1)IMPROVING ACCESS TO HEALTHCARE: THE MOST SIGNIFICANT NEED IDENTIFIED WAS FOR BETTER, FASTER, MORE CONVENIENT AND LESS COSTLY ACCESS TO HEALTHCARE SERVICES. GEISINGER IS TAKING INNOVATIVE STEPS TO ADDRESS BARRIERS TO HEALTHCARE AND HELP PROVIDE PHYSICAL, MENTAL, REHABILITATIVE AND PREVENTIVE SERVICES TO PATIENTS, REGARDLESS OF THEIR HEALTH INSURANCE STATUS. THE TOPICS ADDRESSED INCLUDE: HOW TO FIND THE RIGHT DOCTOR, PROVIDER OR FACILITY; SPECIAL SERVICES PROVIDED TO PATIENTS WITH SPECIFIC NEEDS (SUCH AS THE ELDERLY, UNDERINSURED OR UNINSURED); TRAUMA PREVENTION AND TREATMENT; AND MANY OTHERS. 2) ADDRESSING BEHAVIORAL HEALTH AND SUBSTANCE ABUSE: GEISINGER HAS A WIDE RANGE OF PROGRAMS TO HELP PATIENTS FIND HEALTHCARE SERVICES WHEN THEY ARE FACING BEHAVIORAL HEALTH CHALLENGES OR STRUGGLING WITH ADDICTION. ALZHEIMER'S DISEASE AND OTHER AGING BRAIN ISSUES AS WELL AS ALCOHOLISM AND OPIOID ABUSE ARE ADDRESSED IN A LARGE AND GROWING NUMBER OF PROGRAMS SPECIFICALLY AIMED AT EXPANDING SERVICES. 3)IMPROVING HEALTHY BEHAVIORS: GEISINGER HAS NUMEROUS EDUCATIONAL PROGRAMS TO HELP PATIENTS LIVE WELL. EFFORTS INCLUDE COMMUNITY AND OUTREACH PROGRAMS THAT BRING HEALTHCARE PROFESSIONALS, EDUCATION, NUTRITION AND MEDICATION TO THE PEOPLE. OUR GOAL IS TO ASSIST PATIENTS WITH THEIR HEALTH BEFORE A SERIOUS PROBLEM ARISES SENDING THEM TO THE HOSPITAL IMPROVING ACCESS TO HEALTHCARE COMPLEX CARE, CLOSER TO HOME: CARE FOR COMPLEX CONDITIONS SUCH AS HEART, LUNG AND KIDNEY DISEASE ARE USUALLY FOUND AT LARGE HEALTH FACILITIES. LONG DRIVES TO A HOSPITAL, LACK OF TRANSPORTATION OPTIONS AND OF SPECIALISTS IN THE AREA MAKES ACCESS TO CARE DIFFICULT. OUR SPECIALISTS TRAVEL SO PATIENTS ARE PROVIDED WITH NEEDED, CONVENIENT SPECIALTY CARE, WITHOUT LONG DRIVES OR THE CHALLENGES OF SEEKING CARE ONLY AT A HOSPITAL. INSTEAD OUR SPECIALISTS TRAVEL ACROSS THE REGION TO CLINICS THAT PROVIDE ADVANCED CARE, WITH THE BENEFIT OF BETTER TRACKING OF PATIENTS WITH CHRONIC CONDITIONS. CLINICS ARE STAFFED WITH DOCTORS, NURSES AND OTHER HEALTHCARE PROFESSIONALS AND DIAGNOSTIC LAB AND IMAGING SERVICES. MANY LOCATIONS ALSO OFFER SPECIALTY PEDIATRIC AND WOMEN'S HEALTH SERVICES. OUR SPECIALISTS, INCLUDING CARDIOLOGY, DERMATOLOGY, COMPLEX ORTHOPAEDIC AND THORACIC SURGERY AND NEUROSURGERY ARE AVAILABLE IN MORE THAN 30 COMMUNITIES ACROSS NORTHEAST AND CENTRAL PA. GEISINGER HEALTH PLAN (GHP): COMPREHENSIVE COVERAGE FOR THE UNINSURED AND SENIORS: GHP, A NONPROFIT HMO, OFFERS AFFORDABLE HEALTH PLANS THAT SERVES THE MOST VULNERABLE IN OUR COMMUNITIES: UNINSURED ADULTS, CHILDREN AND SENIORS. GHP FAMILY IS A MEDICAL-ASSISTANCE, MANAGED-CARE PLAN THAT OFFERS COMPREHENSIVE COVERAGE TO UNINSURED AND UNDERINSURED RESIDENTS OF 22 COUNTIES IN PA. MANY SERVICES ARE PROVIDED AT NO COST, INCLUDING DOCTOR'S OFFICE VISITS, EMERGENCY CARE, PREVENTIVE SERVICES (INCLUDING IMMUNIZATIONS AND SCREENINGS), DIABETES CARE, MATERNITY CARE, DENTAL AND VISION SERVICES AND PRESCRIPTION DRUGS. THERE IS ALSO 24-HOUR ACCESS TO E-NURSES AND HEALTH COACHES. GHP KIDS OFFERS HEALTH COVERAGE TO UNINSURED CHILDREN UNDER 20 YEARS OF AGE IN 40 COUNTIES THROUGH PA'S CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP). FOR MOST CHIP IS FREE AND INCLUDES ROUTINE CHECKUPS AND IMMUNIZATIONS, PRESCRIPTION DRUGS, VISION AND DENTAL SERVICES AND EMERGENCY CARE. FOR SENIORS, NAVIGATING THE COMPLEXITIES OF HEALTHCARE COVERAGE CAN BE OVERWHELMING. GHP OFFERS A DUAL ELIGIBILITY PLAN FOR SENIORS WHO QUALIFY FOR MEDICARE PARTS A AND B COVERAGE AS WELL AS MEDICAID. GEISINGER GOLD SECURE RX IS DESIGNED TO MAKE MEDICAL EXPENSES MORE PREDICTABLE, ALLOW BETTER COORDINATION AMONG PROVIDERS AND LOWER OUT-OF-POCKET EXPENSES FOR SENIORS. THIS PLAN OFFERS CONVENIENT BENEFITS WITH LOW OR NO PREMIUMS, A SINGLE ID CARD, PRESCRIPTION DRUG COVERAGE, DENTAL AND VISION SERVICES, FITNESS PROGRAMS AND CARE MANAGEMENT NURSES. PROVENHEALTH NAVIGATOR: IS A TEAM-ORIENTED MEDICAL HOME. A MEDICAL "HOME" IS A PATIENT-CENTERED MODEL OF CARE LED BY THE PATIENT'S PRIMARY DOCTOR AND A TEAM OF HEALTHCARE PROFESSIONALS WORKING TOGETHER TO ENSURE THE PROPER CARE. THE TEAM OF SPECIALISTS, CARE MANAGERS, PHARMACISTS, SOCIAL WORKERS AND COMMUNITY HEALTH ASSISTANTS WORK WITH THE PATIENT, FAMILY AND CAREGIVERS TO PLAN CARE THAT WILL PREVENT URGENT/EMERGENT CARE VISITS AND HOSPITALIZATIONS. RESEARCH HAS SHOWN THAT PATIENTS UNDER THE MEDICAL HOME MODEL ARE HEALTHIER AND SPEND LESS TIME HOSPITALIZED. MEDICAL HOME CARE FOCUSES ON FREQUENT DOCTOR VISITS AND CONSISTENT FOLLOW-UP BY THE TEAM, WHICH HAS SHOWN TO BENEFIT THOSE WITH CHRONIC ILLNESSES (DIABETES, HEART DISEASE, ETC.) MEDICAL HOME PATIENTS ALSO HAVE ACCESS TO DOCTORS AND PHN CARE MANAGERS 24/7. CARE MANAGERS HELP PATIENTS NAVIGATE THE COMPLEX HEALTHCARE SYSTEM, COORDINATING CARE AND COMMUNICATING WITH THE TEAM OF PROVIDERS. CARE MANAGERS, SOCIAL WORKERS AND COMMUNITY HEALTH ASSISTANTS ARE ALSO AVAILABLE TO HELP OUR PATIENTS ADDRESS DIFFICULT CHALLENGES, SUCH AS COPING WITH MENTAL ILLNESS, ADDICTION, ABUSE AND LOSS AND MANAGING DISABILITIES. THE TEAM ALSO COORDINATES COMMUNITY RESOURCES THAT ARE AVAILABLE AND ASSISTS THE PATIENT WITH THEIR NEEDS. BY EXPANDING OUR SUCCESSFUL MEDICAL HOME INITIATIVE, WE'RE ENSURING THAT OUR PATIENTS HAVE ACCESS TO THE MOST EFFECTIVE MODELS OF CARE. GEISINGER TELEMEDICINE BRINGS HEALTHCARE CLOSER TO HOME: IN OUR 45 COUNTY SERVICE AREA, NEARLY HALF OF OUR PATIENT POPULATION RESIDES IN RURAL AREAS, AND MORE THAN 60 PERCENT OF PATIENTS HAVE CHRONIC HEALTH CONDITIONS. OUR TELEMEDICINE PROGRAM ALLOWS PATIENTS TO STILL RECEIVE SPECIALIZED CARE LOCALLY. OUR PROGRAM USES HIGH-DEFINITION AUDIO/VIDEO TECHNOLOGY AND TOOLS SUCH AS DIGITAL STETHOSCOPES TO CONNECT REMOTE PATIENTS TO OUR HOSPITALS AND PRIMARY CARE CLINICS, AS WELL AS TO NON-GEISINGER FACILITIES. INPATIENTS ARE DIAGNOSED EARLIER, BEGIN TREATMENT SOONER AND AVOID HOSPITAL TRANSFERS, SINCE THEIR PHYSICIANS CAN CONSULT OUR SPECIALISTS ANYWHERE WITHIN OUR SYSTEM. OUR SPECIALISTS HAVE ACCESS TO PATIENTS AT CLINICS ACROSS THE STATE WITHOUT THE PATIENT TRAVELING TO A HOSPITAL TO SEE THE SPECIALIST. THIS SAVES TIME AND REDUCES TRAVEL COSTS AND ALLOWS THE SUPPORT OF LOVED ONES AT HOME. EARLIER DIAGNOSIS REDUCES COSTS FOR EVERYONE. THIS PROGRAM ALLOWS PATIENTS TO CONNECT WITH THE RIGHT SPECIALIST WHEN NEEDED. BY CONNECTING PATIENTS TO OUR SPECIALISTS, ACCESS TO HEALTHCARE IS AVAILABLE TO EVERY PATIENT IN OUR COMMUNITIES. SUPPORT FOR SENIORS AT HOME: LIFE GEISINGER (LIVING INDEPENDENTLY FOR ELDERS) HELPS SENIORS STAY AT HOME, STAY INDEPENDENT AND STAY HEALTHY. THE LIFE GEISINGER TEAM IS ON CALL 24/7, PROVIDING SUPPORT FOR SENIORS AND THEIR LOVED ONES. A PROVIDER TEAM ASSESSES PATIENTS' NEEDS, DEVELOPS CARE PLANS AND DELIVERS THE SERVICES SENIORS AND FAMILIES NEED. TRANSPORTATION SERVICES MAKE HOME DELIVERIES OF SUPPLIES AND/OR MEDICATIONS, CARRY SENIORS TO MEDICAL AND OTHER APPOINTMENTS AND DELIVER LIFE PARTICIPANTS TO AND FROM OUR ADULT DAY CENTERS FOR SCHEDULED VISITS. SENIOR DAY CENTERS OFFER SENIORS COMPREHENSIVE MEDICAL AND SOCIAL SERVICES AND OPPORTUNITIES TO SOCIALIZE AND EXERCISE. OUR ADULT DAY CENTERS ARE OPEN TO ALL SENIORS, REGARDLESS OF WHETHER THEY PARTICIPATE IN LIFE GEISINGER. HIGH-QUALITY, NON-EMERGENCY CARE: FOR PATIENTS EXPERIENCING A NON-EMERGENT INJURY OR ILLNESS, GEISINGER CAREWORKS CLINICS OFFER HIGH-QUALITY MEDICAL SERVICES AT CONVENIENT LOCATIONS THROUGHOUT PA. THESE URGENT CARE CLINICS PROVIDE ECONOMICAL AND CONVENIENT HEALTHCARE FROM HIGHLY TRAINED CERTIFIED NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS. CAREWORKS ATTENDS TO THE MEDICAL NEEDS OF ADULTS AND CHILDREN 12 MONTHS OR OLDER, AND NO APPOINTMENT IS NECESSARY. THE OFFICES COMMUNICATE WITH THE PRIMARY CARE PHYSICIAN ABOUT THE PATIENT'S VISIT. CAREWORKS KEEPS FAMILIES WELL BY INCREASING ACCESS TO OUR PROVIDERS, PROFESSIONALS AND SERVICES IN CONVENIENT COMMUNITY LOCATIONS. BRIDGING THE COMMUNICATIONS GAP: AT GEISINGER, WE SEE PATIENTS WHO HAVE DIFFERENT LEVELS OF HEARING ABILITY AND LITERACY. THEY SPEAK HUNDREDS OF LANGUAGES. TO GIVE OUR PATIENTS THE BEST EXPERIENCE POSSIBLE, WE USE ADVANCED TECHNOLOGY AND CONTINUOUS TRAINING. OUR GOAL IS TO HELP PATIENTS CLEARLY UNDERSTAND HOW BEST TO MANAGE THEIR CONDITION. STRATUS IS A VIDEO-INTERPRETING DEVICE USED FOR PATIENTS WHO ARE HEARING-IMPAIRED OR WHO HAVE LIMITED ENGLISH SKILLS. THERE ARE NOW OVER 250 STRATUS DEVICES ACROSS THE SYSTEM. AVAILABLE 24 HRS/DAY IN MORE THAN 200 LANGUAGES, INCLUDING AMERICAN SIGN LANGUAGE, STRATUS IS OPERATED BY TRAINED
FACILITY 1, GEISINGER-BLOOMSBURG 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, GEISINGER-BLOOMSBURG HOSPITAL - PART V, LINE 16J	THE FAP, FAP APPLICATION, AND A PLAIN LANGUAGE SUMMARY OF THE FAP ARE WIDELY AVAILABLE AT HTTPS://WWW.GEISINGER.ORG/PATIENT-CARE/PATIENTS-AND- VISITORS/BILLING-AND-INSURANCE/NEED-HELP. IN ADDITION, REGISTRATION PERSONNEL ALSO REFER UNINSURED AND/OR LOW INCOME PATIENTS TO FINANCIAL COUNSELORS TO DISCUSS THE FINANCIAL ASSISTANCE POLICY.
FACILITY 1, GEISINGER-BLOOMSBURG HOSPITAL - PART V, LINE 20E	UNDER NO CIRCUMSTANCE WILL THE HOSPITAL 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 THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. FACILITY 1, GEISINGER-BLOOMSBURG HOSPITAL - PART V, LINE 22: 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 THE HOSPITAL'S FAP. FREE CARE OR 0 CHARGE IS BELOW THE HOSPITAL FACILITY'S AMOUNT GENERALLY BILLED, AS WELL AS, MEDICARE'S OR MEDICAID'S PROSPECTIVE BILLING AMOUNT. FACILITY 1, GEISINGER-BLOOMSBURG HOSPITAL - PART V, LINES 23 AND 24: PATIENTS ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY ARE PROVIDED 100% DISCOUNT AND CHARGED 0. SEE ALSO EXPLANATION OF PART V, LINE 22.

Schedule H (Form 990) 2019

Page 9

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) 2019

Page 10

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. THE HOSPITAL MAY ALSO UTILIZE INDUSTRY TESTED EXTERNAL ANALYTICAL TOOLS TO QUALIFY PATIENTS FOR UNCOMPENSATED CARE (AKA PRESUMPTIVE CHARITY). GEISINGER PROVIDERS, WITHOUT DISCRIMINATION, CARE FOR ALL EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF THEIR FINANCIAL ASSISTANCE ELIGIBILITY OR ABILITY TO PAY. IT IS THE POLICY OF GEISINGER HOSPITAL FACILITIES TO COMPLY WITH THE STANDARDS OF THE FEDERAL EMERGENCY MEDICAL TREATEMENT AND ACTIVE LABOR TRANSPORT ACT NOF 1986 ("EMTLA") AND REGULATIONS IN PROVIDING MEDICAL SCREENING EXAMINATION AND SUCH FURTHER TREATMENT AS MAY BE NECESSARY TO STABILIZE AN EMERGENCY MEDICAL CONDITION FOR ANY INDIVIDUAL PRESENTING TO THE EMERGENCY DEPARTMENT SEEKING TREATMENT.
PART I, LINE 6A - RELATED ORGANIZATION INFORMATION	COMMUNITY BENEFIT REPORT: A SUMMARY OF THE COMMUNITY BENEFIT PROVIDED BY THE HOSPITAL AND ITS RELATED CHARITABLE ORGANIZATIONS IS INCLUDED IN GEISINGER'S ANNUAL REPORT AND IS AVAILABLE AT GEISINGER.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 AND ADDRESSED 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 THE HOSPITAL'S UNCOMPENSATED OR CHARITY CARE POLICIES. THE HOSPITAL ESTIMATES THAT APPROXIMATELY 25% OF THE BAD DEBT ACCOUNTS ARE SUBSEQUENTLY RECLASSIFIED TO UNCOMPENSATED OR CHARITY CARE.
BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS	PART III, LINES 2 AND 4: GEISINGER HEALTH AND ITS AFFILIATES ("GEISINGER"), THAT INCLUDES THE HOSPITAL, PREPARE AND ISSUE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. GEISINGER'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, ALLOWANCES, AND BAD DEBT SEE PAGE 9 OF THE ATTACHED GEISINGER CONSOLIDATED FINANCIAL STATEMENTS, JUNE 30, 2018 AND JUNE 30, 2017.
PART III, LINE 8 - MEDICARE EXPLANATION	PART III, LINE 3 - BAD DEBT: LINE 6 ONLY INCLUDES THOSE COSTS THAT ARE ALLOWED TO BE REPORTED IN THE HOSPITAL'S MEDICARE COST REPORT THAT IS REQUIRED TO BE FILED WITH THE FEDERAL GOVERNMENT. 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. THE COMMUNITY BENEFIT STANDARD IS THE CURRENT STANDARD FOR A TAX-EXEMPT AND CHARITABLE ORGANIZATION UNDER THE INTERNAL REVENUE CODE ("IRC") 501(C)(3). 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 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. AS DEVELOPED IN REVENUE RULING 69-545, UNDER THE COMMUNITY BENEFIT STANDARD, HOSPITALS WERE JUDGED ON WHETHER THEY PROMOTE THE HEALTH OF A 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 THOUGH 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") BELIEVES THAT MEDICARE UNDERPAYMENTS (SHORTFALLS) AND BAD DEBT SHOULD BE REPORTED AS COMMUNITY BENEFIT ON FORM 990, SCHEDULE H, PART I, LINE 7. THIS ORGANIZATION AGREES WITH THE AHA'S LETTER TO THE IRS DATED AUGUST 21, 2007 RESPONDING TO A DRAFT OF THE NEW FORM 990 AND SCHEDULE H, THE AHA ARGUED 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. -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 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 PERMITTED TO BE REPORTED IN THE HOSPITAL'S MEDICARE COST REPORT THAT IS REQUIRED TO BE FILED WITH THE FEDERAL GOVERNMENT. THE HOSPITAL CONSIDERS THE TOTAL MEDICARE UNDERPAYMENTS (SHORTFALL) OF 4,708,215 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 THE HOSPITAL TO USE OTHER FUNDS TO COVER THE SHORTFALL. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITAL 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 NEED-BASED GOVERNMENT PROGRAMS. THE AMOUNT EXPENDED TO COVER THE SHORTFALL IS MONEY NOT AVAILABLE FOR FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. BOTH THE HOSPITAL 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 THE HOSPITAL'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 TO THE CBO REPORT, ROUGHLY 40% OF BAD DEBT IS PENDING CHARITY CARE. (IN FY 2018, APPROXIMATELY 25% OF THE HOSPITAL'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' BURDEN 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 6/30/2018, THE HOSPITAL'S COST OF PROVIDING PATIENT CARE FOR SERVICES ACCOUNTED FOR AS BAD DEBT WAS 314,608.
PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION	THE HOSPITAL IS COMMITTED TO PROVIDING MEDICALLY NECESSARY SERVICES TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND THE HOSPITAL'S COLLECTION ACTIONS ARE CONSISTENTLY APPLIED TO ALL PATIENTS. IT IS THE HOSPITAL'S 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 THE HOSPITAL 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 THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS ("ECAS") PRIOR TO THE EXPIRATION OF THE NOTIFICATION PERIOD. THE NOTIFICATION PERIOD IS DEFINED AS A 120-DAY PERIOD OR GREATER, WHICH BEGINS ON THE DATE OF THE 1ST POST-DISCHARGE BILLING STATEMENT, IN WHICH NO ECAS ARE INITIATED AGAINST THE PATIENT. THE HOSPITAL ENSURES REASONABLE EFFORTS HAVE BEEN TAKEN TO DETERMINE IF A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER ITS FINANCIAL ASSISTANCE POLICY ("FAP") AND ENSURES THAT THE FOLLOWING ACTIONS ARE TAKEN AT LEAST 30 DAYS PRIOR TO INITIATING AN ECA: 1) THE PATIENT IS PROVIDED WITH WRITTEN NOTICE THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR ELIGIBLE PATIENTS; IDENTIFIES THE ECAS THAT THE HOSPITAL INTENDS TO TAKE TO OBTAIN PAYMENT FOR CARE; AND STATES A DEADLINE AFTER WHICH ECAS MAY BEGIN. 2) THE PATIENT IS PROVIDED WITH A PLAIN LANGUAGE SUMMARY OF THE FAP; AND 3) REASONABLE EFFORTS ARE MADE TO ORALLY NOTIFY THE PATIENT ABOUT THE FAP AND HOW THE PATIENT MAY OBTAIN ASSISTANCE WITH THE FINANCIAL ASSISTANCE APPLICATION PROCESS. THE HOSPITAL PROCESSES APPLICATIONS FOR FINANCIAL ASSISTANCE DURING THE APPLICATION PERIOD. THE APPLICATION BEGINS ON THE DATE CARE IS PROVIDED AND ENDS ON THE 240TH DAY AFTER THE DATE OF THE 1ST POST-DISCHARGE BILLING STATEMENT.
PART VI, LINE 2 - NEEDS ASSESSMENT	GBH, A 72-BED COMMUNITY HOSPITAL LOCATED IN BLOOMSBURG, PA, IN RESPONSE TO ITS COMMUNITY COMMITMENT, CONTRACTED WITH TRIPP UMBACH TO FACILITATE A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BETWEEN OCTOBER 2014 AND MARCH 2015 THAT IDENTIFIED THE NEEDS OF THE RESIDENTS SERVED BY BOTH FACILITIES. AS A PARTNERING HOSPITAL OF A REGIONAL COLLABORATIVE EFFORT TO ASSESS COMMUNITY HEALTH NEEDS; GBH COLLABORATED WITH HOSPITALS AND OUTSIDE ORGANIZATIONS IN THE SURROUNDING REGION (INCLUDING COLUMBIA, LUZERNE AND MONTOUR COUNTIES) DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS. SEE ALSO THE DISCUSSION RELATED TO THE RESPONSE TO PART V, LINE 5.
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 THE HOSPITAL'S 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 THE HOSPITAL'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 THE HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES CAN ALSO BE FOUND ON THE GEISINGER WEB SITE AT WWW.GEISINGER.ORG. PATIENTS ARE ALSO PROVIDED INFORMATION ON THE HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICIES WITH EACH PATIENT BILL. THE FINANCIAL ASSISTANCE POLICY ("FAP"), THE FAP APPLICATION AND PLAIN LANGUAGE SUMMARY ("PLS") ARE AVAILABLE ON-LINE. PAPER COPIES ARE AVAILABLE UPON REQUEST WITHOUT CHARGE BY MAIL OR ARE AVAILABLE AT REGISTRATION AREAS WHICH INCLUDES EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL-BASED CLINICS AND PATIENT FINANCIAL SERVICES DEPARTMENTS. ALL FAP DOCUMENTS ARE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGE OF POPULATIONS WITH LIMITED ENGLISH PROFICIENCY ("LEP") THAT CONSTITUTE THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE HOSPITAL'S SERVICE AREA. SIGNS OR DISPLAYS ARE CONSPICUOUSLY POSTED IN PUBLIC HOSPITAL LOCATIONS INCLUDING THE EMERGENCY DEPARTMENT, ADMISSIONS DEPARTMENT AND REGISTRATION DEPARTMENT THAT INFORM PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. ALL PATIENTS ARE OFFERED A COPY OF THE PLS AS PART OF THE INTAKE AND DISCHARGE PROCESSES. ADDITIONALLY, FINANCIAL COUNSELORS AND CUSTOMER SERVICE REPRESENTATIVES ARE AVAILABLE TO ASSIST PATIENTS WITH CONCERNS.
PART VI, LINE 4 - COMMUNITY INFORMATION	GBH'S SERVICE AREA INCLUDES ONE COUNTY IN CENTRAL PENNSYLVANIA (COLUMBIA). THE APPROXIMATE 2013 TOTAL POPULATION WITHIN THIS SERVICE AREA WAS 71,369. THIS POPULATION IS EXPECTED TO INCREASE BY 0.8% BY 2018, WHICH IS LESS THAN RATE OF POPULATION GROWTH EXPECTED IN THE STATE (1.0%) AND THE NATION (3.3%). THE 65 AND OVER AGE GROUP WAS 17.6% OF THE TOTAL POPULATION, WHICH IS GREATER THAN THE STATE (16.4%) AND NATIONAL (13.9%) PROPORTIONS. ADDITIONALLY, THE 65 AND OVER AGE GROUP IS PROJECTED TO EXPERIENCE THE SECOND LARGEST FIVE-YEAR POPULATION GROWTH AT 12.8%. THE LARGEST GROWTH IN POPULATION IS WITHIN THE 25-34 AGE GROUP, WHICH IS PROJECTED TO SEE A 24.1% INCREASE. THE REGION, WHICH INCLUDES COLUMBIA COUNTY, IS PRIMARILY RURAL. AVERAGE HOUSEHOLD INCOME IN 2013, WAS 53,121, WITH APPROXIMATELY 13.9% OF THE POPULATION FALLING BELOW FEDERAL POVERTY GUIDELINES IN 2012, WHICH IS A GREATER PROPORTION THAN THE STATE AND SMALLER PROPORTION THAN THE NATION (13.7% AND 15.9, RESPECTIVELY). THE 2012 AVERAGE ANNUAL UNEMPLOYMENT RATE, THE MOST CURRENT FULL YEAR OF COUNTY LEVEL DATA AVAILABLE FROM THE BUREAU OF LABOR STATISTICS, WAS 8.1%, WHICH IS HIGHER THAN THE STATE RATE OF 7.9%, BUT COMPARABLE TO THE NATIONAL RATE OF 8.1%. THE REGION, WHICH INCLUDES COLUMBIA COUNTY, INCLUDES MULTIPLE MEDICALLY UNDERSERVED AREAS AND POPULATIONS. DURING THE ASSOCIATED TIME PERIOD, THERE WAS ONE GENERAL MEDICAL/SURGICAL GEISINGER HOSPITAL, GBH, AND ONE GENERAL MEDICAL/SURGICAL NON-GEISINGER HOSPITAL IN COLUMBIA COUNTY.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	SCHEDULE H, PART I IN ADDITION TO THE NET COMMUNITY BENEFIT COSTS INCURRED BY THE ORGANIZATION AS REPORTED IN SCHEDULE H, PART I, LINE 7; PLEASE REFER TO SCHEDULE O OF THIS FORM 990 FOR THE ORGANIZATION'S NARRATIVE COMMUNITY BENEFIT STATEMENT FOR ADDITIONAL INFORMATION ON HOW THE ORGANIZATION PROMOTES HEALTH AND PROVIDES HEALTHCARE SERVICES TO THE COMMUNITY REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY IN FURTHERANCE OF ITS CHARITABLE TAX EXEMPT PURPOSE.
PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM	THE HOSPITAL IS AN AFFILIATE WITHIN GEISINGER. AS ONE OF THE NATION'S LARGEST HEALTH SERVICE ORGANIZATIONS, GEISINGER SERVES MORE THAN 3 MILLION RESIDENTS THROUGHOUT 45 COUNTIES IN CENTRAL, SOUTH-CENTRAL AND NORTHEAST PENNSYLVANIA, AND IN SOUTHERN NEW JERSEY AT ATLANTICARE. IN 2017, THE GEISINGER COMMONWEALTH SCHOOL OF MEDICINE AND GEISINGER JERSEY SHORE HOSPITAL BECAME THE NEWEST MEMBERS OF THE GEISINGER FAMILY. THE PHYSICIAN- LED SYSTEM IS COMPRISED OF APPROXIMATELY 30,000 EMPLOYEES, INCLUDING NEARLY 1,600 EMPLOYED PHYSICIANS, 13 HOSPITAL CAMPUSES, TWO RESEARCH CENTERS, AND A 583,000-MEMBER HEALTH PLAN, ALL OF WHICH LEVERAGE AN ESTIMATED 12.7 BILLION POSITIVE IMPACT ON THE PENNSYLVANIA AND NEW JERSEY ECONOMIES. 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. 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. SEE SCHEDULE R FOR A LIST OF THE AFFILIATED ORGANIZATIONS COMPRISING GEISINGER.
ADDITIONAL INFORMATION	PART VI, LINE 7: FORM 990, SCHEDULE H, PART VI, LINE 7, STATE FILING OF COMMUNITY BENEFIT EPORT: AT THIS TIME, THE HOSPITAL AND ITS AFFILIATES ARE NOT REQUIRED TO FILE A COMMUNITY BENEFIT REPORT WITH ANY STATE.

Schedule H (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

GEISINGER-BLOOMSBURG HOSPITAL

Employer identification number

23-2193572

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on 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 .........

Yes

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 on Line 1a? ..

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

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:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2019

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1EDELYN L MILLER DIRECTOR	(i) (ii)	------------- 885,853	------------- 358,117	------------- 321,689	------------- 234,397	------------- 22,002	------------- 1,822,058	------------- 181,433
2JAEWON RYU MD JD DIRECTOR	(i) (ii)	------------- 961,804	------------- 471,004	------------- 163,802	------------- 179,214	------------- 39,001	------------- 1,814,825	-------------
3DAVID T FEINBERG MD MBA PRESIDENT, DIRECTOR	(i) (ii)	------------- 2,399,174	------------- 1,339,735	------------- 204,244	------------- 996,710	------------- 28,638	------------- 4,968,501	-------------
4DANIEL E LOHR ESQUIRE ACLO, ASST SECTY	(i) (ii)	------------- 311,659	------------- 82,777	------------- 46,799	------------- 19,212	------------- 24,252	------------- 484,699	-------------
5DAVID J FELICIO ESQUIRE EVP, CLO, SECRETARY	(i) (ii)	------------- 668,203	------------- 273,175	------------- 201,562	------------- 234,351	------------- 24,405	------------- 1,401,696	------------- 70,559
6KEVIN F BRENNAN CPA FHFMA EVP, CFO, TREASURER	(i) (ii)	------------- 941,959	------------- 427,380	------------- 764,093	------------- 19,212	------------- 17,636	------------- 2,170,280	-------------
7LISSA L BRYAN SMITH VP OPS, GBH WOODBINE	(i) (ii)	------------- 260,138	------------- 85,426	------------- 58,454	------------- 19,212	------------- 18,265	------------- 441,495	-------------
8STEPHEN J PAOLUCCI MD CMO	(i) (ii)	------------- 474,059	------------- 142,034	------------- 80,420	------------- 19,212	------------- 24,881	------------- 740,606	-------------
9BONNIE L HESS RN VP, NURSING	(i) (ii)	166,377 -------------	30,388 -------------	36,689 -------------	13,218 -------------	19,850 -------------	266,522 -------------	-------------
10BRENDA ALBERTSON IP NURSING OPS MGR	(i) (ii)	111,693 -------------	7,898 -------------	1,174 -------------	6,187 -------------	27,466 -------------	154,418 -------------	-------------
11JOSEPH J SEMBORSKI RPH CLINICAL PHARMACIST	(i) (ii)	123,692 -------------	-------------	3,478 -------------	6,329 -------------	23,430 -------------	156,929 -------------	-------------
12ALBERT BOTHE JR MD FORMER OFFICER	(i) (ii)	------------- 49,395	-------------	------------- 3,048,473	------------- 2,567	------------- 1,465	------------- 3,101,900	-------------
13ERIN M FITZGERALD CPA FHFMA FORMER 5 HIGHEST	(i) (ii)	------------- 220,180	------------- 56,685	------------- 57,623	------------- 19,212	------------- 3,439	------------- 357,139	-------------
14PENNY E YENCHICK CRNA FORMER 5 HIGHEST	(i) (ii)	------------- 198,590	------------- 800	------------- 2,596	------------- 13,271	------------- 18,402	------------- 233,659	-------------
15THOMAS G SMITH CRNA FORMER 5 HIGHEST	(i) (ii)	------------- 378,344	------------- 29,400	------------- 19,675	------------- 19,212	------------- 21,496	------------- 468,127	-------------
16TIMOTHY J GUSCHEL PHARMD FORMER 5 HIGHEST	(i) (ii)	------------- 137,649	-------------	------------- 10,903	------------- 7,765	------------- 20,120	------------- 176,437	-------------
17JOSEPH P RUDA CRNA FORMER 5 HIGHEST	(i) (ii)	------------- 241,229	------------- 100	------------- 13,396	------------- 16,871	------------- 17,770	------------- 289,366	-------------
18LINDA D PANIKKAR CRNA FORMER 5 HIGHEST	(i) (ii)	------------- 236,265	------------- 250	------------- 9,794	------------- 16,583	------------- 8,545	------------- 271,437	-------------

Schedule J (Form 990) 2019

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 1A	TAX INDEMNIFICATION AND GROSS-UP PAYMENTS - FROM TIME TO TIME, THE GEISINGER BOARD OF DIRECTORS OR GEISINGER SENIOR MANAGEMENT APPROVE THE GROSS-UP OF EXPENSES, WHICH FURTHER GEISINGER BUSINESS, FOR TAX OBLIGATIONS.
SCHEDULE J, PAGE 1, PART I, LINE 4	EDELYN L. MILLER 0 181,433 0 DAVID J. FELICIO, ESQUIRE 0 70,559 0 KEVIN F. BRENNAN, CPA, FHFMA 0 589,978 0 LISSA L. BRYAN SMITH 32,856 0 0 ALBERT BOTHE, JR., MD 2,933,320 0 0
SCHEDULE J, PAGE 1, PART I, LINE 7	BECAUSE THE PAYMENT OF EARNED PERFORMANCE BASED COMPENSATION IS AT THE DISCRETION OF MANAGEMENT AND THE BOARD OF DIRECTORS, SUCH PAYMENTS MAY BE CONSIDERED NON-FIXED PAYMENTS. PERFORMANCE BASED COMPENSATION IS DETERMINED BY MEETING INDIVIDUALLY MEASURED PERFORMANCE GOALS THAT ARE ALIGNED WITH OVERALL GEISINGER OBJECTIVES, INCLUDING: CLINICAL QUALITY, COMMUNITY MISSION ACHIEVEMENT, AND FINANCIAL STEWARDSHIP.
SCHEDULE J, PART III	PART I, LINE 4A - SEVERANCE PAYMENT: UPON INVOLUNTARY SEPARATION, EMPLOYEES MAY BE ELIGIBLE TO RECEIVE CONTINUATION OF SALARY FOR A TERM THAT IS BASED ON THEIR YEARS OF GEISINGER 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" REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH "GH" AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM.

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

GEISINGER-BLOOMSBURG HOSPITAL

Employer identification number

23-2193572

Return Reference	Explanation
FORM 990 - ORGANIZATION'S MISSION	GEISINGER BLOOMSBURG HOSPITAL SERVES TO ENSURE THE QUALITY OF LIFE OF THE POPULATION IT SERVES BY PROVIDING ACCESS TO QUALITY POPULATION HEALTH AND HOSPITAL SERVICES THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM OF PATIENT CARE, EDUCATION, RESEARCH, AND COMMUNITY SERVICE.
FORM 990	FORM 990, PART IV, LINE 24A: DID THE ORGANIZATION HAVE A TAX-EXEMPT BOND ISSUE WITH AN OUTSTANDING PRINCIPAL AMOUNT OF MORE THAN 100,000 AS OF THE LAST DAY OF THE YEAR, THAT WAS ISSUED AFTER DECEMBER 31, 2002? GEISINGER HEALTH (GH) IS CURRENTLY THE SOLE OBLIGOR UNDER A SERIES OF BOND ISSUES WITH A TOTAL OUTSTANDING BALANCE OF 1,745,563,379, INCLUSIVE OF UNAMORTIZED ORIGINAL ISSUE DISCOUNT AS OF JUNE 30, 2018. 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 GEISINGER-BLOOMSBURG HOSPITAL EIN: 23-2193572 GEISINGER-LEWISTOWN HOSPITAL EIN: 23-1352187 HOLY SPIRIT HOSPITAL OF THE SISTERS EIN: 23-1512747 GEISINGER COMMONWEALTH SCHOOL OF MEDICINE EIN: 26-0812968 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	I.GENERAL INFORMATION GEISINGER-BLOOMSBURG HOSPITAL (GBH), A 501(C)(3) NOT-FOR-PROFIT CORPORATION AND MEMBER OF GEISINGER, OWNS AND OPERATES A 76 BED, ACUTE CARE, HOSPITAL IN BLOOMSBURG, PA. GBH IS CONVENIENTLY LOCATED ONLY A FEW MILES FROM SEVERAL MAJOR HIGHWAYS THROUGHOUT CENTRAL PA. THE FACILITY OPENED IN 1905, ANSWERING A PRESSING NEED FOR HEALTH AND WELLNESS CARE IN THE COMMUNITY. GBH PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. II. MAJOR PROGRAM SERVICES SERVICES OFFERED BY GBH INCLUDE: GENERAL MEDICAL CARE PROVIDED BY IN-HOUSE HOSPITALIST AND SUPPORTED BY CONSULTATIVE SERVICES IN THE AREAS OF CARDIOLOGY, NEUROLOGY AND PULMONOLOGY. EMERGENCY DEPARTMENT IS COMMITTED TO PROVIDING HIGH QUALITY, PROMPT EMERGENCY SERVICES. GBH'S ED IS STAFFED 24/7 WITH FULL-TIME PHYSICIANS AND NURSES THAT ARE TRAINED IN EMERGENCY MEDICINE AND ARE PREPARED TO TREAT CASES FROM PEDIATRICS TO CRITICAL CARE. IMMEDIATE ACCESS TO LABORATORY SERVICES, X-RAYS, CAT SCANS, 3D-4D ULTRASOUND, MRI AND SURGICAL SERVICES. MOST INSURANCES, INCLUDING MEDICARE AND MEDICAID, ARE ACCEPTED AND NO PATIENT IS REFUSED TREATMENT BECAUSE OF INABILITY TO PAY. THE WOMAN'S HEALTH UNIT FOCUSES ON ALL ASPECTS OF WOMEN'S HEALTH AND EDUCATION, PROVIDING OBSTETRICAL AND GYNECOLOGICAL CARE FOR WOMEN OF ALL AGES. SERVICES INCLUDE BUT NOT LIMITED TO ROUTINE VISITS AND TREATMENTS, PREVENTATIVE HEALTHCARE, BIRTH CONTROL EDUCATION, FAMILY PLANNING, OBSTETRICS, SURGERY & SURGERY CONSULTATIONS, MENOPAUSE COUNSELING, MIDWIFERY, LACTATION EDUCATION AND SUPPORT. MENTAL HEALTH & PSYCHIATRIC SERVICES IS A DESIGNATED COUNT 302 TRIAGE SITE THAT PROVIDES BOTH INPATIENT AND OUTPATIENT SERVICES DESIGNED TO HELP INDIVIDUALS LIVE AS INDEPENDENTLY AS POSSIBLE. ADULTS TO GERIATRICS CAN ACCESS QUICK, EFFICIENT ADMISSION 24/7 AND RECEIVE TREATMENT THROUGH ONE- ON-ONE PATIENT COUNSELING, TREATMENT MEETINGS AND ACTIVITIES 7 DAYS PER WEEK. A PSYCHIATRIST IS AVAILABLE ON A DAILY BASIS. ADMISSIONS ARE CONFIDENTIAL AND MAY BE MADE BY PROFESSIONALS AS WELL BY INDIVIDUALS CONCERNED ABOUT THEMSELVES OR OTHERS. INPATIENT CARE IS PROVIDED THROUGH MULTIPLE PROFESSIONALS WHO COMPRISE THE TREATMENT TEAM. OTHER SERVICES INCLUDE: CARDIAC SERVICES SURGERY SPECIALTIES- RADIOLOGY ORTHOPEDIC ICCU UROLOGY LABORATORY SERVICES OTOLARYNGOLOGY PHYSICAL THERAPY GYNECOLOGY RESPIRATORY SERVICES GENERAL SURGERY SLEEP SERVICES III. PROGRAM SERVICE ACCOMPLISHMENTS UNCOMPENSATED CARE GEISINGER-BLOOMSBURG HOSPITAL RECOGNIZES ITS MISSION IN THIS REGARD; GBH PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH- RELATED ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A. CHARITY CARE THE PRIMARY CONCERN OF GBH IS THE DELIVERY OF HEALTH CARE TO ALL CITIZENS OF CENTRAL PENNSYLVANIA REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GBH INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. FOR THE FISCAL YEAR ENDED JUNE 30, 2018, THE COST OF PROVIDING CHARITY CARE WAS 624,057. B. MEDICARE/MEDICAID/OTHER GOVERNMENTAL IN RECOGNIZING ITS MISSION TO THE COMMUNITY, GBH PROVIDES SERVICES TO THE ELDERLY (MEDICARE) AND THE INDIGENT (MEDICAID), AS WELL AS OTHERS. GBH PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS TO THE EXTENT THE GOVERNMENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTH CARE. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. THE COST OF PROVIDING HEALTHCARE SERVICES TO MEDICARE AND MEDICAID PATIENTS EXCEEDED REIMBURSEMENT BY APPROXIMATELY 8,958,562 DURING THE FISCAL YEAR ENDED JUNE 30, 2018. C. OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GBH PROVIDES SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2018, WAS 314,608. COMMUNITY HEALTH, EDUCATION, AND OUTREACH GBH STRIVES TO BE A VALUABLE RESOURCE FOR THE COMMUNITY AND ITS RESIDENTS. GBH PROVIDES MANY REDUCED-PRICE SERVICES AND FREE PROGRAMS THROUGHOUT THE YEAR THAT SERVE COMMUNITY HEALTH NEEDS. THESE SERVICES AND PROGRAMS INCLUDE SUPPORT GROUPS, COMMUNITY HEALTH EDUCATION, AND OTHER UNIQUE SERVICES. A. CLINICAL SERVICES THE COST TO GBH OF PROVIDING NUTRITIONAL SERVICES FOR THE ALS CLINIC DURING THE FISCAL YEAR WITH 70 ATTENDEES AND A COST OF 497. B. HEALTH EDUCATION GBH SPONSORS REGULAR COMMUNITY EDUCATION PROGRAMS. THE APPROXIMATE COST IS 10,210 WITH 5,866 ATTENDEES ON TOPICS SUCH AS: COMMUNITY NUTRITION PRESENTATIONS HEALTH FAIRS SENIOR EDUCATION STUDENT HEALTH EDUCATION C. COMMUNITY BUILDING ACTIVITIES GBH IS DEVELOPING NEW PROGRAMS TO IMPROVE THE SURROUNDING COMMUNITY WHILE WORKING TOGETHER WITH THE FOLLOWING OUTSIDE ORGANIZATIONS TO DETERMINE THE NEEDS SUCH AS: BLOOMSBURG UNIVERSITY ADVISORY COLUMBIA COUNTY UNITED WAY COLUMBIA MONTOUR CHAMBER COLUMBIA COUNTY HUMAN SERVICES COALITION GENERAL MEETINGS COLUMBIA CHILD DEVELOPMENT PROGRAM MEETINGS KIWANIS CLUB STREET AND PEDESTRIAN SAFETY VOLUNTEER AUXILIARY MEMBERS THE COST OF THESE ACTIVITIES DURING THE FISCAL YEAR WAS 208,493. D. HEALTH CARE SUPPORT SERVICES - MEALS/NUTRITION SERVICES IN CONJUNCTION WITH CHARITABLE COMMUNITY ORGANIZATIONS AND/OR BUSINESS, GBH PARTICIPATED IN ACTIVITIES AT A COST TO GBH OF 9,486. ACTIVITIES INCLUDED A VETERAN'S DINNER, CLOTHING FOR PSYCH PATIENTS, BUS AND CAB FARE FOR INDIGENT PATIENTS. E. CASH FINANCIAL COMMUNITY DONATIONS GBH OFFERS A 300 SCHOLARSHIP TO A BLOOMSBURG HIGH SCHOOL SENIOR WHO WANTS TO PURSUE A DEGREE IN NURSING. F. GITS IN-KIND FINANCIAL DONATIONS FOR THE COMMUNITY AT A COST OF 6,717, LINEN CLEANING EXCHANGE PROGRAM FOR AMBULANCES, HEAD START READING PROGRAM, FIRST AID STATION CLEANING, AND SUPPLIES FOR THE WOMEN'S CENTER. G. COMMUNITY BENEFIT OPERATIONS THE COST OF DEDICATED STAFF PARTICIPATING ON THE CHNA TEAM 1,780. H. COMMUNITY HEALTH EDUCATION AND SUPPORT GROUPS THE COST OF 4,839, BETTER BREATHERS SUPPORT GROUP. I. HEALTH PROFESSIONS EDUCATION THE COST OF 93,425, STUDENT VOLUNTEER, NURSE EXTERN AND INTERNS SUPERVISION. J. SOCIAL AND ENVIRONMENTAL IMPROVEMENT THE COST OF 1,318, MEDICATION TAKE BACK PROGRAM. GENERAL PROGRAM SERVICES A. RESIDENCY PROGRAMS: GBH HOSTS EMERGENCY MEDICINE, GENERAL SURGERY, INTERNAL MEDICINE, NEUROLOGY, PEDIATRIC AND PSYCHIATRIC RESIDENTS AS A PART OF THEIR EDUCATION REQUIREMENTS UNDER GEISINGER MEDICAL CENTER'S ACCREDITED PROGRAMS. ALL THE PROGRAMS ARE ACCREDITED BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME), OR THE AMERICAN OSTEOPATHIC ASSOCIATION (AOA). IN FY 2018, THE UNCOMPENSATED COSTS FOR GRADUATE MEDICAL EDUCATION TOTALED 667,844. B. COMMUNITY ASSISTANCE PAYMENT GEISINGER BLOOMSBURG HOSPITAL PROVIDED FINANCIAL ASSISTANCE TO THE COMMUNITY THROUGH A COMMUNITY ASSISTANCE PAYMENT. THE VALUE OF THE PAYMENT IS 4,447. THIS AMOUNT IS PAID TO COLUMBIA COUNTY, THE TOWN OF BLOOMSBURG, AND BLOOMSBURG AREA SCHOOL DISTRICT IN LIEU OF REAL ESTATE TAXES BEING ASSESSED ON THEIR PROPERTY. THE PAYMENTS SUPPORT LOCAL GOVERNMENT PROVIDED SERVICES SUCH AS POLICE AND FIRE PROTECTION. C. VOLUNTEER SERVICES THE VOLUNTEERS OF GEISINGER BLOOMSBURG HOSPITAL ARE AN ACTIVE AND VITAL PART OF THE ACTIVITIES OF THE HOSPITAL. THE HOURS OF VOLUNTEER SERVICES ARE IMPORTANT CONTRIBUTION TO THE MISSION OF GBH. VOLUNTEERS FROM LOCAL COMMUNITIES HAVE CONTRIBUTED 8,255 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTHCARE OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION OF 211,576 IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND "WELLNESS" PROGRAMS. COMMUNITY BENEFITS SUMMARY CHARITY CARE 624,057 MEDICARE/MEDICAID/OTHER GOVERNMENTAL 8,958,562 OTHER UNCOMPENSATED PATIENT SERVICES 314,608 COMMUNITY HEALTH, EDUCATION, OUTREACH AND OTHER 337,065 HEALTH PROFESSIONS EDUCATION 667,844 COMMUNITY ASSISTANCE PAYMENT 4,447 VOLUNTEER SERVICES (VALUED AT 06/30/18 PA STATEWIDE AVERAGE WEEKLY WAGE) 211,576 TOTAL 11,118,159 STATISTICS FISCAL YEAR ENDED JUNE 30, 2018 ADMISSIONS (INCLUDING NEWBORNS) 2,892 ADMISSIONS (EXCLUDING NEWBORNS) 2,457 OUTPATIENT VISITS INCLUDING EMERGENCY DEPARTMENT 33,210 DISCHARGES (EXCLUDING NEWBORNS) 2,459 AVERAGE LENGTH OF STAY 2.5 PERCENT OF OCCUPANCY (EXCLUDING NEWBORNS) 25.1% PATIENT SERVICE DAYS (EXCLUDING NEWBORNS) 9,708 TOTAL OR CASES 3,506 LICENSED BEDS (EXCLUDING BASSINETS) 76 BASSINETS IN NURSERY 10
FORM 990, PART V	FORM 990, PART V, LINE 1A: ENTER THE NUMBER REPORTED IN BOX 3 OF FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURNS. GEISINGER SYSTEM SERVICES (GSS), AN AFFILIATE OF THE ORGANIZATION, PROVIDES A CENTRALIZED ACCOUNTS PAYABLE FUNCTION FOR ALL GEISINGER ORGANIZATIONS. AS THE ACCOUNTS PAYABLE PROCESSOR, GSS PREPARES AND FILES FORM 1099 UNDER ITS EIN FOR CERTAIN REPORTABLE PAYMENTS OF THE FILING ORGANIZATION. THE NUMBER OF FORM 1099'S FILED BY GSS FOR THE 2017 REPORTING PERIOD ON BEHALF OF ITSELF AND ITS AFFILIATES WAS 1,739.
FORM 990, PART VI	FORM 990, PART I, SECTION A, LINE 4: FORM 990, PART VI, SECTION A, LINE 1B: ENTER THE NUMBER OF VOTING MEMBERS THAT ARE INDEPENDENT. BASED ON THE FORM 990 DEFINITION OF "INDEPENDENCE" AS IT RELATES TO VOTING MEMBERS OF THE GOVERNING BODY, THREE VOTING MEMBERS ARE NOT INDEPENDENT BECAUSE THEY ARE COMPENSATED AS EMPLOYEES OF A RELATED TAX-EXEMPT ORGANIZATIONS. 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, DAVID J. FELICIO, ESQUIRE, DAVID T. FEINBERG, MD, MBA, EARL FOURA, EDELYN L. MILLER, JAEWON RYU, MD, JD, KEVIN F. BRENNAN, CPA, FHFMA, ROBERT J. DIETZ, V. CHRIS HOLCOMBE, PE, AND VIRGINIA MCGREGOR ALL HAVE A BUSINESS RELATIONSHIP WITH ONE ANOTHER BECAUSE THEY SERVE AS OFFICERS AND/OR DIRECTORS ON ONE OR MORE FOR-PROFIT AFFILIATE OF THE ENTITY. ALL OF THE AFFILIATES ARE PART OF GEISINGER.
FORM 990, PAGE 6, PART VI, LINE 6	THE MEMBERS OF THE CORPORATION HAVE THE POWER AND AUTHORITY TO ELECT AND REMOVE THE DIRECTORS; ELECT AND REMOVE THE PRESIDENT AND FILL ANY VACANCY IN THE OFFICE OF THE PRESIDENT OF THE CORPORATION; AND, MAY APPROVE AMENDMENTS TO THE CORPORATE BYLAWS IN LIEU OF SUCH APPROVAL BY THE BOARD OF DIRECTORS. THE MEMBERS ALSO HAVE THE RESERVE POWERS AS SET FORTH IN THE PENNSYLVANIA NONPROFIT CORPORATION LAW.
FORM 990, PAGE 6, PART VI, LINE 7A	THE BOARD OF DIRECTORS OF THE CORPORATION SHALL SERVE AS THE GOVERNING BODY OF THE CORPORATION. THE PRESIDENT OF THE CORPORATION SHALL BE A DIRECTOR BY REASON OF HOLDING SUCH OFFICE. THE REMAINING DIRECTORS SHALL BE ELECTED BY THE MEMBERS AT THE ANNUAL MEETING OF THE MEMBERS. THE MEMBERS OF THE CORPORATION MAY SERVE AS DIRECTORS AND DIRECTORS MAY SUCCEED THEMSELVES FROM TERM TO TERM. VACANCIES ON THE BOARD OF DIRECTORS SHALL BE FILLED BY THE MEMBERS AT THEIR DISCRETION AT THE ANNUAL MEETING OF THE MEMBERS OR AT A SPECIAL MEETING CALLED FOR SUCH PURPOSE.
FORM 990, PAGE 6, PART VI, LINE 11B	ALL OFFICERS AND DIRECTORS WERE ELECTRONICALLY PROVIDED A FINAL COPY OF THE FORM 990 PRIOR TO FILING THE RETURN WITH THE IRS. AN EXECUTIVE SUMMARY OF THE INFORMATION REPORTED ON THE RETURN IS PROVIDED TO ASSIST IN THE REVIEW. IN ACCORDANCE WITH THE GEISINGER HEALTH 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. AT LEAST ONCE EACH YEAR DIRECTORS, OFFICERS, KEY EMPLOYEES, SENIOR LEADERS 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 COMMITTEES 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: HTTPS://WWW.GEISINGER.ORG/ABOUT- GEISINGER/NEWS-AND-MEDIA/FOR-MEDIA/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 XI, LINE 9	CHANGE IN PENSION LIABILITY 1,577,254 TRANSFER FROM GEISINGER HEALTH 12,152,399 TOTAL 13,729,653
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) 2019

Additional Data

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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

GEISINGER-BLOOMSBURG HOSPITAL

Employer identification number

23-2193572

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(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	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	12A	GH	Yes
(4)GEISINGER WYOMING VALLEY MED CTR 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	12A	GH	Yes
(8)GEISINGER COMMUNITY HEALTH SERVICES 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 23-2967235	HEALTHCARE	PA	501C3	10	GSS	Yes
(9)GEISINGER INSURANCE CORPORATIONRRG 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 14-1909894	SELF INS	VT	501C3	12A	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	10	GH	Yes
(12)GEISINGER-BLOOMSBURG HEALTHCARE CTR 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 23-2242854	SKILLED NU	PA	501C3	10	GH	Yes
(13)GEISINGER-LEWISTOWN HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 23-1352187	HOSPITAL	PA	501C3	3	GH	Yes
(14)LEWISTOWN AMBULATORY CARE CORP 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 23-2344362	HOLDING CO	PA	501C3	12A	GH	Yes
(15)FAMILY HEALTH ASSOCIATES OF GLH 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 25-1651582	PHYSICIAN	PA	501C3	12A	GH	Yes
(16)KEYSTONE HEALTH INFORMATION EXCH 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 46-4359893	RHIO	PA	501C3	12A	GH	Yes
(17)HEALTH CARE CORP OF NORTHEAST PA 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 23-2337286	SUPPORT SV	PA	501C3	12A	CMC	Yes
(18)HOLY SPIRIT HEALTH SYSTEM 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 25-1865142	PHILANTHRO	PA	501C3	12A	GH	Yes
(19)HOLY SPIRIT HOSPITAL OF THE SISTERS 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 23-1512747	HOSPITAL	PA	501C3	3	HSHS	Yes
(20)HOLY SPIRIT CORPORATION 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 23-2214540	HOLDING CO	PA	501C2		HSHS	Yes
(21)SPIRIT PHYSICIAN SERVICES INC 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 25-1766971	PHYSICIAN	PA	501C3	10	HSHS	Yes
(22)WEST SHORE ADVANCED LIFE SUPP SVCS 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 23-2463002	HEALTHCARE	PA	501C3	7	HSHS	Yes
(23)GEISINGER COMMONWEALTH SCH OF MED 525 PINE STREET SCRANTON,PA18509 26-0812968	EDUCATION	PA	501C3	2	GH	Yes
(24)GEISINGER JERSEY SHORE HOSPITAL 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 24-0792115	HOSPITAL	PA	501C3	3	GH	Yes
(25)GEISINGER JERSEY SHORE HOSPITAL FND 100 NORTH ACADEMY AVENUE MC 49-70 DANVILLE,PA17822 23-2480603	HEALTHCARE	PA	501C3	3	GH	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	12A	AH SYSTEM	Yes
(29)ATLANTICARE HEALTH SERVICES INC 2500 ENGLISH CREEK AVENUE EGG HARBOR TOWNSHIP,NJ08234 22-3265214	HEALTHCARE	NJ	501C3	10	ARHS	Yes
(30)ATLANTICARE HEALTH SYSTEM INC 2500 ENGLISH CREEK AVENUE EGG HARBOR TOWNSHIP,NJ08234 22-3265213	SUPPORT AR	NJ	501C3	12A	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	10	AH SYSTEM	Yes
(33)ATLANTICARE REGIONAL HEALTH SERVICE 2500 ENGLISH CREEK AVENUE EGG HARBOR TOWNSHIP,NJ08234 80-0834222	HOLDING CO	NJ	501C3	12A	AH SYSTEM	Yes
(34)GNJ PHYSICIANS GROUP PC 2500 ENGLISH CREEK AVENUE EGG HARBOR TOWNSHIP,NJ08234 82-0681884	HEALTHCARE	NJ	501C3	10	GH	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

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	(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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	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) GRANDVIEW SURGERY CENTER LTD 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM,AL35209 52-1597483	HEALTHCARE	PA	N/A				No			No
(10) LACKAWANNA PHYS AMB SURG CTRLLC 569 BROOKWOOD VILLAGE SUITE 901 BIRMINGHAM,AL35209 23-3024998	HEALTHCARE	PA	N/A				No			No
(11) SOUTHERN JERSEY ONCOLOGY PROPERTIES 2500 ENGLISH CREEK AVENUE EGG HARBOR TOWNSHIP,NJ08234 94-3463625	HEALTHCARE	NJ	N/A				No			No
(12) ATLANTICARE SURGERY CENTER LLC 2500 ENGLISH CREEK AVENUE EGG HARBOR TOWNSHIP,NJ08234 22-3491867	HEALTHCARE	NJ	N/A				No			No
(13) 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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) ISS SOLUTIONS INC 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) ENGLISH CREEK ASSURANCE LTD 44 CHURCH STREET HM12 HAMILTON BERMUDA,BERMUDA BD 98-0656394	FINANCIAL	BD	N/A				Yes
(8) ATLANTICARE HEALTH SOLUTIONS INC 2500 ENGLISH CREEK AVENUE BLDG 500 EGG HARBOR TOWNSHIP,NJ08234 38-3856295	ACO/HEALTH	NJ	N/A				Yes
(9) 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) 2019

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

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 .....................

Yes

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

Yes

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 CLINIC	A	677,175	FMV
(2) GEISINGER CLINIC	L	20,582	GAAP
(3) GEISINGER CLINIC	M	3,091,773	GAAP
(4) GEISINGER COMMUNITY HEALTH SERVICES	A	71,232	FMV
(5) GEISINGER COMMUNITY HEALTH SERVICES	L	35,951	GAAP
(6) GEISINGER HEALTH PLAN	L	10,357,303	GAAP
(7) GEISINGER HEALTH	C	12,112,041	GAAP
(8) GEISINGER HEALTH	L	1,136	GAAP
(9) GEISINGER INDEMNITY INSURANCE CO	L	162,659	GAAP
(10) GEISINGER RISK RETENTION GROUP	P	412,539	GAAP
(11) GEISINGER ASSURANCE CO LTD	P	211,526	GAAP
(12) GEISINGER MEDICAL CENTER	A	79,080	FMV
(13) GEISINGER MEDICAL CENTER	L	22,580	GAAP
(14) GEISINGER MEDICAL CENTER	M	2,269,379	GAAP
(15) ISS SOLUTIONS INC	M	851,734	GAAP
(16) GEISINGER QUALITY OPTIONS INC	L	940,647	GAAP
(17) GEISINGER SYSTEM SERVICES	A	18,851	FMV
(18) GEISINGER SYSTEM SERVICES	L	21,306	GAAP
(19) GEISINGER SYSTEM SERVICES	M	8,383,321	GAAP
(20) GEISINGER WYOMING VALLEY MED CTR	M	8,847	GAAP
(21) GEISINGER-BLOOMSBURG HEALTHCARE CTR	L	16,626	GAAP
(22) ENCOMPASS HEALTH CORP	A	212,969	FMV
(23) ENCOMPASS HEALTH CORP	M	191,155	GAAP
(24) GEISINGER LEWISTOWN HOSPITAL	M	65	GAAP

Schedule R (Form 990) 2019

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference

Explanation

SCHEDULE R

INFORMATION REGARDING TRANSFERS TO AND FROM CONTROLLED ORGANIZATIONS: AS SHOWN IN FORM 990, SCHEDULE R, GEISINGER-BLOOMSBURG HOSPITAL IS CLOSELY AFFILIATED WITH SEVERAL OTHER ORGANIZATIONS. IN THE NORMAL COURSE OF THE OPERATIONS OF THESE AFFILIATED ORGANIZATIONS THERE ARE NUMEROUS INTER ORGANIZATIONAL TRANSACTIONS, WHICH MAY INCLUDE SALES, EXCHANGES AND LEASES OF PROPERTY, EXTENSIONS OF CREDIT, FURNISHING OF GOODS, SERVICES, AND FACILITIES, AND TRANSFERS OF ASSETS. THESE INTERORGANIZATION TRANSACTIONS PROMOTE THE EFFICIENT OPERATION OF THE VARIOUS ORGANIZATIONS AND THE ATTAINMENT OF THEIR TAX EXEMPT PURPOSES. THESE TYPES OF INTER ORGANIZATIONAL TRANSACTIONS WERE DESCRIBED TO THE INTERNAL REVENUE SERVICE IN A RULING APPLICATION AND WERE RECOGNIZED BY THE NATIONAL OFFICE OF THE IRS IN A SERIES OF GEISINGER PRIVATE LETTER RULINGS AS BEING ENTIRELY CONSISTENT WITH THE ORGANIZATION'S TAX EXEMPT STATUS. __________________________________________________________________________

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO ENSURE THE QUALITY OF LIFE OF THE POPULATION IT SERVES BY PROVIDING ACCESS TO QUALITY POPULATION HEALTH AND HOSPITAL SERVICES THROUGH AN INTEGRATED SERVICE ORGANIZATION BASED ON A BALANCED PROGRAM..SEE SCHEDULE O
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	6
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	3
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	446
6	Total number of volunteers (estimate if necessary) .............	6	111
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	65,372
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	-15,615

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........		0
9	Program service revenue (Part VIII, line 2g) .........	44,091,896	47,420,269
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	243,817	-2,900
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	660,716	603,793
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	44,996,429	48,021,162
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	300	300
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	21,269,742	22,399,180
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	27,342,764	30,057,143
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	48,612,806	52,456,623
19	Revenue less expenses. Subtract line 18 from line 12.......	-3,616,377	-4,435,461
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	35,387,455	38,693,248
21	Total liabilities (Part X, line 26).............	41,465,187	34,254,637
22	Net assets or fund balances. Subtract line 21 from line 20.....	-6,077,732	4,438,611

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 49,293,848 including grants of $ 300 ) (Revenue $ 47,582,430 )
	HEALTHCARE - SEE SCHEDULE O GEISINGER-BLOOMSBURG HOSPITAL OPERATES A 76 BED GENERAL MEDICAL AND SURGICAL HOSPITAL WHICH PROVIDED 5,122 PATIENT DAYS; 4,586 BEHAVIOR HEALTH SERVICES PATIENT DAYS; 863 NURSERY PATIENT DAYS; 3,025 SAME DAY SURGICAL CASES; 19,875 EMERGENCY DEPARTMENT VISITS DURING THE YEAR ENDED JUNE 30, 2018. THE ORGANIZATION ALSO PROVIDES CHARITY CARE TO PATIENTS WHO MET CERTAIN CRITERIA WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. I.GENERAL INFORMATION GEISINGER-BLOOMSBURG HOSPITAL (GBH), A 501(C)(3) NOT-FOR-PROFIT CORPORATION AND MEMBER OF GEISINGER, OWNS AND OPERATES A 76 BED, ACUTE CARE, HOSPITAL IN BLOOMSBURG, PA. GBH IS CONVENIENTLY LOCATED ONLY A FEW MILES FROM SEVERAL MAJOR HIGHWAYS THROUGHOUT CENTRAL PA. THE FACILITY OPENED IN 1905, ANSWERING A PRESSING NEED FOR HEALTH AND WELLNESS CARE IN THE COMMUNITY. GBH PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. II. MAJOR PROGRAM SERVICES SERVICES OFFERED BY GBH INCLUDE: GENERAL MEDICAL CARE PROVIDED BY IN-HOUSE HOSPITALIST AND SUPPORTED BY CONSULTATIVE SERVICES IN THE AREAS OF CARDIOLOGY, NEUROLOGY AND PULMONOLOGY. EMERGENCY DEPARTMENT IS COMMITTED TO PROVIDING HIGH QUALITY, PROMPT EMERGENCY SERVICES. GBH'S ED IS STAFFED 24/7 WITH FULL-TIME PHYSICIANS AND NURSES THAT ARE TRAINED IN EMERGENCY MEDICINE AND ARE PREPARED TO TREAT CASES FROM PEDIATRICS TO CRITICAL CARE. IMMEDIATE ACCESS TO LABORATORY SERVICES, X-RAYS, CAT SCANS, 3D-4D ULTRASOUND, MRI AND SURGICAL SERVICES. MOST INSURANCES, INCLUDING MEDICARE AND MEDICAID, ARE ACCEPTED AND NO PATIENT IS REFUSED TREATMENT BECAUSE OF INABILITY TO PAY. THE WOMAN'S HEALTH UNIT FOCUSES ON ALL ASPECTS OF WOMEN'S HEALTH AND EDUCATION, PROVIDING OBSTETRICAL AND GYNECOLOGICAL CARE FOR WOMEN OF ALL AGES. SERVICES INCLUDE BUT NOT LIMITED TO ROUTINE VISITS AND TREATMENTS, PREVENTATIVE HEALTHCARE, BIRTH CONTROL EDUCATION, FAMILY PLANNING, OBSTETRICS, SURGERY & SURGERY CONSULTATIONS, MENOPAUSE COUNSELING, MIDWIFERY, LACTATION EDUCATION AND SUPPORT. MENTAL HEALTH & PSYCHIATRIC SERVICES IS A DESIGNATED COUNT 302 TRIAGE SITE THAT PROVIDES BOTH INPATIENT AND OUTPATIENT SERVICES DESIGNED TO HELP INDIVIDUALS LIVE AS INDEPENDENTLY AS POSSIBLE. ADULTS TO GERIATRICS CAN ACCESS QUICK, EFFICIENT ADMISSION 24/7 AND RECEIVE TREATMENT THROUGH ONE- ON-ONE PATIENT COUNSELING, TREATMENT MEETINGS AND ACTIVITIES 7 DAYS PER WEEK. A PSYCHIATRIST IS AVAILABLE ON A DAILY BASIS. ADMISSIONS ARE CONFIDENTIAL AND MAY BE MADE BY PROFESSIONALS AS WELL BY INDIVIDUALS CONCERNED ABOUT THEMSELVES OR OTHERS. INPATIENT CARE IS PROVIDED THROUGH MULTIPLE PROFESSIONALS WHO COMPRISE THE TREATMENT TEAM. OTHER SERVICES INCLUDE: CARDIAC SERVICES SURGERY SPECIALTIES- RADIOLOGY ORTHOPEDIC ICCU UROLOGY LABORATORY SERVICES OTOLARYNGOLOGY PHYSICAL THERAPY GYNECOLOGY RESPIRATORY SERVICES GENERAL SURGERY SLEEP SERVICES III. PROGRAM SERVICE ACCOMPLISHMENTS UNCOMPENSATED CARE GEISINGER-BLOOMSBURG HOSPITAL RECOGNIZES ITS MISSION IN THIS REGARD; GBH PROVIDES FREE OR SUBSIDIZED CARE BELOW COST AND SUPPORTS VARIOUS HEALTH- RELATED ACTIVITIES AND PROGRAMS IN SUPPORT OF THE COMMUNITY. A. CHARITY CARE THE PRIMARY CONCERN OF GBH IS THE DELIVERY OF HEALTH CARE TO ALL CITIZENS OF CENTRAL PENNSYLVANIA REGARDLESS OF THEIR ABILITY TO PAY. THE UNREIMBURSED COST OF CHARITY CARE REPRESENTS THE COST GBH INCURS BY PROVIDING FREE OR DISCOUNTED SERVICES TO THOSE WHO CANNOT AFFORD TO PAY. FOR THE FISCAL YEAR ENDED JUNE 30, 2018, THE COST OF PROVIDING CHARITY CARE WAS 624,057. B. MEDICARE/MEDICAID/OTHER GOVERNMENTAL IN RECOGNIZING ITS MISSION TO THE COMMUNITY, GBH PROVIDES SERVICES TO THE ELDERLY (MEDICARE) AND THE INDIGENT (MEDICAID), AS WELL AS OTHERS. GBH PROVIDES CARE, BELOW COST, TO PERSONS COVERED BY THESE GOVERNMENTAL PROGRAMS TO THE EXTENT THE GOVERNMENT REIMBURSEMENT IS BELOW THE COST OF PROVIDING HEALTH CARE. THE UNREIMBURSED VALUE OF MEDICARE AND/OR MEDICAID IS EQUAL TO THE COST OF PROVIDING SERVICES LESS THE AMOUNT RECEIVED AS REIMBURSEMENT UNDER THE PROGRAM. THE COST OF PROVIDING HEALTHCARE SERVICES TO MEDICARE AND MEDICAID PATIENTS EXCEEDED REIMBURSEMENT BY APPROXIMATELY 8,958,562 DURING THE FISCAL YEAR ENDED JUNE 30, 2018. C. OTHER UNCOMPENSATED PATIENT SERVICES IN ADDITION, GBH PROVIDES SERVICES FOR WHICH FULL PAYMENT IS NOT RECEIVED. THE UNCOMPENSATED COST OF PROVIDING SUCH PATIENT SERVICES DURING THE FISCAL YEAR ENDED JUNE 30, 2018, WAS 314,608. COMMUNITY HEALTH, EDUCATION, AND OUTREACH GBH STRIVES TO BE A VALUABLE RESOURCE FOR THE COMMUNITY AND ITS RESIDENTS. GBH PROVIDES MANY REDUCED-PRICE SERVICES AND FREE PROGRAMS THROUGHOUT THE YEAR THAT SERVE COMMUNITY HEALTH NEEDS. THESE SERVICES AND PROGRAMS INCLUDE SUPPORT GROUPS, COMMUNITY HEALTH EDUCATION, AND OTHER UNIQUE SERVICES. A. CLINICAL SERVICES THE COST TO GBH OF PROVIDING NUTRITIONAL SERVICES FOR THE ALS CLINIC DURING THE FISCAL YEAR WITH 70 ATTENDEES AND A COST OF 497. B. HEALTH EDUCATION GBH SPONSORS REGULAR COMMUNITY EDUCATION PROGRAMS. THE APPROXIMATE COST IS 10,210 WITH 5,866 ATTENDEES ON TOPICS SUCH AS: COMMUNITY NUTRITION PRESENTATIONS HEALTH FAIRS SENIOR EDUCATION STUDENT HEALTH EDUCATION C. COMMUNITY BUILDING ACTIVITIES GBH IS DEVELOPING NEW PROGRAMS TO IMPROVE THE SURROUNDING COMMUNITY WHILE WORKING TOGETHER WITH THE FOLLOWING OUTSIDE ORGANIZATIONS TO DETERMINE THE NEEDS SUCH AS: BLOOMSBURG UNIVERSITY ADVISORY COLUMBIA COUNTY UNITED WAY COLUMBIA MONTOUR CHAMBER COLUMBIA COUNTY HUMAN SERVICES COALITION GENERAL MEETINGS COLUMBIA CHILD DEVELOPMENT PROGRAM MEETINGS KIWANIS CLUB STREET AND PEDESTRIAN SAFETY VOLUNTEER AUXILIARY MEMBERS THE COST OF THESE ACTIVITIES DURING THE FISCAL YEAR WAS 208,493. D. HEALTH CARE SUPPORT SERVICES - MEALS/NUTRITION SERVICES IN CONJUNCTION WITH CHARITABLE COMMUNITY ORGANIZATIONS AND/OR BUSINESS, GBH PARTICIPATED IN ACTIVITIES AT A COST TO GBH OF 9,486. ACTIVITIES INCLUDED A VETERAN'S DINNER, CLOTHING FOR PSYCH PATIENTS, BUS AND CAB FARE FOR INDIGENT PATIENTS. E. CASH FINANCIAL COMMUNITY DONATIONS GBH OFFERS A 300 SCHOLARSHIP TO A BLOOMSBURG HIGH SCHOOL SENIOR WHO WANTS TO PURSUE A DEGREE IN NURSING. F. GITS IN-KIND FINANCIAL DONATIONS FOR THE COMMUNITY AT A COST OF 6,717, LINEN CLEANING EXCHANGE PROGRAM FOR AMBULANCES, HEAD START READING PROGRAM, FIRST AID STATION CLEANING, AND SUPPLIES FOR THE WOMEN'S CENTER. G. COMMUNITY BENEFIT OPERATIONS THE COST OF DEDICATED STAFF PARTICIPATING ON THE CHNA TEAM 1,780. H. COMMUNITY HEALTH EDUCATION AND SUPPORT GROUPS THE COST OF 4,839, BETTER BREATHERS SUPPORT GROUP. I. HEALTH PROFESSIONS EDUCATION THE COST OF 93,425, STUDENT VOLUNTEER, NURSE EXTERN AND INTERNS SUPERVISION. J. SOCIAL AND ENVIRONMENTAL IMPROVEMENT THE COST OF 1,318, MEDICATION TAKE BACK PROGRAM. GENERAL PROGRAM SERVICES A. RESIDENCY PROGRAMS: GBH HOSTS EMERGENCY MEDICINE, GENERAL SURGERY, INTERNAL MEDICINE, NEUROLOGY, PEDIATRIC AND PSYCHIATRIC RESIDENTS AS A PART OF THEIR EDUCATION REQUIREMENTS UNDER GEISINGER MEDICAL CENTER'S ACCREDITED PROGRAMS. ALL THE PROGRAMS ARE ACCREDITED BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION (ACGME), OR THE AMERICAN OSTEOPATHIC ASSOCIATION (AOA). IN FY 2018, THE UNCOMPENSATED COSTS FOR GRADUATE MEDICAL EDUCATION TOTALED 667,844. B. COMMUNITY ASSISTANCE PAYMENT GEISINGER BLOOMSBURG HOSPITAL PROVIDED FINANCIAL ASSISTANCE TO THE COMMUNITY THROUGH A COMMUNITY ASSISTANCE PAYMENT. THE VALUE OF THE PAYMENT IS 4,447. THIS AMOUNT IS PAID TO COLUMBIA COUNTY, THE TOWN OF BLOOMSBURG, AND BLOOMSBURG AREA SCHOOL DISTRICT IN LIEU OF REAL ESTATE TAXES BEING ASSESSED ON THEIR PROPERTY. THE PAYMENTS SUPPORT LOCAL GOVERNMENT PROVIDED SERVICES SUCH AS POLICE AND FIRE PROTECTION. C. VOLUNTEER SERVICES THE VOLUNTEERS OF GEISINGER BLOOMSBURG HOSPITAL ARE AN ACTIVE AND VITAL PART OF THE ACTIVITIES OF THE HOSPITAL. THE HOURS OF VOLUNTEER SERVICES ARE IMPORTANT CONTRIBUTION TO THE MISSION OF GBH. VOLUNTEERS FROM LOCAL COMMUNITIES HAVE CONTRIBUTED 8,255 HOURS TOWARD THE COMMON PURPOSE OF SERVICING THE HEALTHCARE OF THE COMMUNITY. THE VALUE OF THIS CONTRIBUTION OF 211,576 IS GIVEN BACK TO THE COMMUNITY THROUGH LOWER COSTS IN BOTH PATIENT SERVICES AND "WELLNESS" PROGRAMS. COMMUNITY BENEFITS SUMMARY CHARITY CARE 624,057 MEDICARE/MEDICAID/OTHER GOVERNMENTAL 8,958,562 OTHER UNCOMPENSATED PATIENT SERVICES 314,608 COMMUNITY HEALTH, EDUCATION, OUTREACH AND OTHER 337,065 HEALTH PROFESSIONS EDUCATION 667,844 COMMUNITY ASSISTANCE PAYMENT 4,447 VOLUNTEER SERVICES (VALUED AT 06/30/18 PA STATEWIDE AVERAGE WEEKLY WAGE) 211,576 TOTAL 11,118,159 STATISTICS FISCAL YEAR ENDED JUNE 30, 2018 ADMISSIONS (INCLUDING NEWBORNS) 2,892 ADMISSIONS (EXCLUDING NEWBORNS) 2,457 OUTPATIENT VISITS INCLUDING EMERGENCY DEPARTMENT 33,210 DISCHARGES (EXCLUDING NEWBORNS) 2,459 AVERAGE LENGTH OF STAY 2.5 PERCENT OF OCCUPANCY (EXCLUDING NEWBORNS) 25.1% PATIENT SERVICE DAYS (EXCLUDING NEWBORNS) 9,708 TOTAL OR CASES 3,506 LICENSED BEDS (EXCLUDING BASSINETS) 76 BASSINETS IN NURSERY 10

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses49,293,848

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)			(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
(A) Name and title
(18) JOSEPH J SEMBORSKI RPH........................................................................ CLINICAL PHA	40.00 .......................	X		127,170	0	29,759
(19) ALBERT BOTHE JR MD........................................................................ FORMER OFFIC	.......................40.00		X	0	3,097,868	4,032
(20) ERIN M FITZGERALD CPA FHFMA........................................................................ FORMER 5 HIG	.......................40.00		X	0	334,488	22,651
(21) PENNY E YENCHICK CRNA........................................................................ FORMER 5 HIG	.......................40.00		X	0	201,986	31,673
(22) THOMAS G SMITH CRNA........................................................................ FORMER 5 HIG	.......................40.00		X	0	427,419	40,708
(23) TIMOTHY J GUSCHEL PHARMD........................................................................ FORMER 5 HIG	.......................40.00		X	0	148,552	27,885
(24) JOSEPH P RUDA CRNA........................................................................ FORMER 5 HIG	.......................40.00		X	0	254,725	34,641
(25) LINDA D PANIKKAR CRNA........................................................................ FORMER 5 HIG	.......................40.00		X	0	246,309	25,128

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	793,972	16,634,907	2,293,117

1a	Federated campaigns..	1a
b	Membership dues..	1b
c	Fundraising events..	1c
d	Related organizations	1d
e	Government grants (contributions)	1e

f	All other contributions, gifts, grants, and similar amounts not included above	1f

g	Noncash contributions included in lines 1a - 1f:$	1g

h Total. Add lines 1a-1f.......

		Business Code
2a	PATIENT SERVICE REVENUE	622110	46,108,274	46,108,274
b	RENTAL INCOME	531120	890,269			890,269
c	IC NON PROFIT SHARED SERVICES	541900	355,971	355,971
d	LABORATORY SERVICES	621500	65,372		65,372
e	INTEREST INCOME FROM PAYORS	524298	383	383
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		47,420,269

3 Investment income (including dividends, interest, and othersimilar amounts) ......			18,301			18,301
4 Income from investment of tax-exempt bond proceeds			364			364
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		169,038	6a
b	Less: rental expenses		25,595	6b
c	Rental income or (loss)		143,443	6c
d	Net rental income or (loss).......			143,443			143,443
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses	21,565		7b
c	Gain or (loss)	-21,565		7c
d	Net gain or (loss).........			-21,565			-21,565
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA SALES		722514	216,782			216,782
b	PURCHASE DISCOUNTS		900099	162,161	162,161
c	GIFT SHOP SALES		453220	49,372			49,372
d	All other revenue ....			32,035			32,035
e	Total. Add lines 11a–11d ......			460,350
12	Total revenue. See instructions.....			48,021,162	46,626,789	65,372	1,329,001

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	300	300
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	273,485	273,485
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	17,079,895	16,546,354	533,541
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	479,118	464,387	14,731
9	Other employee benefits .......	3,259,106	3,158,903	100,203
10	Payroll taxes ...........	1,307,576	1,267,374	40,202
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	255,000		255,000
c	Accounting ...........	23,459	18,230	5,229
d	Lobbying ...........	2,767		2,767
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	20,275	3,668	16,607
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	2,038,910	1,580,466	458,444
12	Advertising and promotion ....	12,246	2,257	9,989
13	Office expenses .......	1,385,364	1,198,165	187,199
14	Information technology ......	17,897	17,360	537
15	Royalties ..
16	Occupancy ...........	1,290,115	1,212,825	77,290
17	Travel ............	43,376	26,322	17,054
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	86	86
20	Interest ...........	903,964	849,808	54,156
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	2,347,528	2,217,145	130,383
23	Insurance ...	647,526	453,268	194,258
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	INTER-ENTITY SERVICES	13,700,551	12,705,940	994,611
b	MEDICAL SUPPLIES	5,120,827	5,089,237	31,590
c	UNCOLLECTIBLE EXPENSE	1,648,356	1,648,350	6
d	IC TEACHING & ADMIN REV	529,109	529,109
e	All other expenses	69,787	30,809	38,978
25	Total functional expenses. Add lines 1 through 24e	52,456,623	49,293,848	3,162,775	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			5,910,055	1	6,415,463
2	Savings and temporary cash investments .........			6,318	2	25,039
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			1,315,013	4	1,766,046
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7	105,057
8	Inventories for sale or use ............			324,992	8	419,302
9	Prepaid expenses and deferred charges ......			135,750	9	162,554
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	29,490,239
b	Less: accumulated depreciation	10b	12,476,730	16,095,600	10c	17,013,509
11	Investments—publicly traded securities .			116,536	11	111,960
12	Investments—other securities. See Part IV, line 11 .....			694,018	12	692,660
13	Investments—program-related. See Part IV, line 11 ..			185,380	13	197,109
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			10,603,793	15	11,784,549
16	Total assets. Add lines 1 through 15 (must equal line 33)...			35,387,455	16	38,693,248

17	Accounts payable and accrued expenses .....	837,675	17	671,137
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	25,086,165	20	24,878,773
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
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	15,541,347	25	8,704,727
26	Total liabilities. Add lines 17 through 25..	41,465,187	26	34,254,637

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	-6,077,732	32	4,438,611
33	Total liabilities and net assets/fund balances ........	35,387,455	33	38,693,248