Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
GEISINGER MEDICAL CENTER |
240795959 | 3 | No | 0 | 0 | |
| (B)
GEISINGER WYOMING VALLEY MEDICAL CENTER |
231996150 | 3 | No | 0 | 0 | |
| (C)
MARWORTH |
232171417 | 3 | No | 0 | 0 | |
| (D)
GEISINGER HEALTH |
231995911 | 7 | Yes | 0 | 0 | |
| (E)
GEISINGER COMMUNITY HEALTH SERVICES |
232967235 | 10 | No | 0 | 0 | |
| (F)
COMMUNITY MEDICAL CENTER |
240862246 | 3 | No | 0 | 0 | |
| (G)
MOUNTAIN VIEW NURSING HOME INC |
232568288 | 10 | No | 0 | 0 | |
| (H)
GEISINGER BLOOMSBURG HOSPITAL |
232193572 | 3 | No | 0 | 0 | |
| (I)
GEISINGER BLOOMSBURG HEALTHCARE CENTER |
232242854 | 10 | No | 0 | 0 | |
| (J)
GEISINGER LEWISTOWN HOSPITAL |
231352187 | 3 | No | 0 | 0 | |
| (K)
HOLY SPIRIT HOSPITAL OF THE SISTERS OF CHRISTIAN CHARIT |
231512747 | 3 | No | 0 | 0 | |
| (L)
SPIRIT PHYSICIANS SERVICES INC |
251766971 | 10 | No | 0 | 0 | |
| (M)
WEST SHORE ADVANCED LIFE SUPPORT SERVICES INC |
232463002 | 7 | No | 0 | 0 | |
| (N)
GEISINGER HEALTH PLAN |
232311553 | 10 | No | 0 | 0 | |
| (O)
HOLY SPIRIT HEALTH SYSTEM |
251865142 | 7 | No | 0 | 0 | |
| (P)
HOLY SPIRIT CORPORATION |
232214540 | 10 | No | 0 | 0 | |
| (Q)
ATLANTICARE REGIONAL MEDICAL CENTER |
210634549 | 3 | No | 0 | 0 | |
| (R)
ATLANTICARE BEHAVORIAL HEALTH INC |
210721208 | 7 | No | 0 | 0 | |
| (S)
ATLANTICARE FOUNDATION |
222148992 | 7 | No | 0 | 0 | |
| (T)
ATLANTICARE HEALTH SERVICES INC |
223265214 | 10 | No | 0 | 0 | |
| (U)
GEISINGER JERSEY SHORE HOSPITAL |
240792115 | 3 | No | 0 | 0 | |
|
Total 21
|
0 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (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. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 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 0.015 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 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2020 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2020 |
(iii) Distributable Amount for 2020 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2020 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 2020: | ||||
| a From 2015....... | ||||
| b From 2016....... | ||||
| c From 2017....... | ||||
| d From 2018....... | ||||
| e From 2019....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2020 distributable amount | ||||
|
i
Carryover from 2015 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2020 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2020 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2020, 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 2020. 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 2021. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2016..... | ||||
| b Excess from 2017..... | ||||
| c Excess from 2018..... | ||||
| d Excess from 2019..... | ||||
| e Excess from 2020..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART I, LINE 11H | COMMUNITY MEDICAL CENTER 24-0862246 3 0 0 MOUNTAIN VIEW NURSING HOME, INC. 23-2568288 10 0 0 GEISINGER BLOOMSBURG HOSPITAL 23-2193572 3 0 0 GEISINGER BLOOMSBURG HEALTHCARE CENTER 23-2242854 10 0 0 GEISINGER LEWISTOWN HOSPITAL 23-1352187 3 0 0 HOLY SPIRIT HOSPITAL OF THE SISTERS OF CHRISTIAN CHARIT 23-1512747 3 0 0 SPIRIT PHYSICIANS SERVICES, INC 25-1766971 10 0 0 WEST SHORE ADVANCED LIFE SUPPORT SERVICES, INC 23-2463002 7 0 0 GEISINGER HEALTH PLAN 23-2311553 10 0 0 HOLY SPIRIT HEALTH SYSTEM 25-1865142 7 0 0 HOLY SPIRIT CORPORATION 23-2214540 10 0 0 ATLANTICARE REGIONAL MEDICAL CENTER 21-0634549 3 0 0 ATLANTICARE BEHAVORIAL HEALTH, INC. 21-0721208 7 0 0 ATLANTICARE FOUNDATION 22-2148992 7 0 0 ATLANTICARE HEALTH SERVICES, INC. 22-3265214 10 0 0 GEISINGER JERSEY SHORE HOSPITAL 24-0792115 3 0 0 |
| PART IV, SECTION A, LINE 1 | GEISINGER SYSTEM SERVICES SUPPORTED ORGANIZATIONS ARE DESIGNATED BY CLASS AND PURPOSE. PER GSS'S ARTICLES OF INCORPORATION, THE CORPORATION IS INCORPORATED UNDER THE NONPROFIT CORPORATION LAW OF 1972 OF THE COMMONWEALTH OF PENNSYLVANIA, AS AMENDED, FOR THE PURPOSE OF CONDUCTING EXCLUSIVELY CHARITABLE, SCIENTIFIC AND EDUCATIONAL ACTIVITIES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1954, AS AMENDED (OR THE CORRESPONDING PROVISION OF ANY SUCCESSOR UNITED STATES INTERNAL REVENUE LAW) (THE "INTERNAL REVENUE CODE"), INCLUDING THE PROVISION OF ADMINISTRATIVE, MANAGEMENT AND OTHER SUPPORT SERVICES FOR THE GEISINGER HEALTH SYSTEM FOUNDATION, ORGANIZATIONS AFFILIATED WITH SUCH FOUNDATION AND OTHER ORGANIZATIONS AND MAKING DONATIONS AND OTHER TRANSFERS TO THE GEISINGER HEALTH SYSTEM FOUNDATION AND TO ORGANIZATIONS CONTROLLED BY SUCH FOUNDATION AND DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, CONSISTENT WITH AND IN FURTHERANCE OF THESE PURPOSES. THE CORPORATION SHALL ENGAGE IN ALL ACTIVITIES PROPERLY RELATED TO THE FOREGOING, INCLUDING THE SOLICITATION OF FUNDS FROM INDIVIDUALS, CORPORATIONS AND OTHER EXEMPT ORGANIZATIONS FOR FINANCING THE SERVICES TO BE PROVIDED. GEISINGER HEALTH SYSTEM FOUNDATION IS NOW GEISINGER HEALTH. |
| PART IV, SECTION A, LINE 3B | THE 501(C)(4) ORGANIZATION SUPPORTED BY GEISINGER SYSTEM SERVICES RECEIVED AN IRS DETERMINATION LETTER CONFIRMING ITS STATUS AS A 501(C)(4) ORGANIZATION ON AUGUST 1, 1990. ALSO, REFER TO RESPONSE TO LINE 3C. |
| PART IV, SECTION A, LINE 3C | TO ENSURE THAT ALL SUPPORT IS USED EXCLUSIVELY FROM SECTION 170(C)(2)(B) PURPOSES, THE FOLLOWING CONTROLS ARE IN PLACE: (1) GEISINGER SYSTEM SERVICES RECEIVED A PRIVATE LETTER RULING FROM THE IRS ON AUGUST 1, 1990. THE RULING INDICATES THAT THE PROVISION OF MANAGEMENT AND SUPPORT SERVICES TO THE 501(C)(4) ORGANIZATION CONTRIBUTES IMPORTANTLY TO THE ACCOMPLISHMENT OF GEISINGER SYSTEM SERVICES EXEMPT PURPOSE, THE PROMOTION OF HEALTH. THE PROVISION OF SERVICES TO THE 501(C)(4) ORGANIZATION WAS DEEMED RELATED AND NOT SUBJECT TO THE UNRELATED BUSINESS INCOME TAX. IN ADDITION, GEISINGER SYSTEM SERVICES DOES NOT PROVIDE MONETARY SUPPORT TO THE 501(C)(4) ORGANIZATION. (2) THE ARTICLES OF INCORPORATION OF THE 501(C)(4) ORGANIZATION STATE THAT UPON THE DISSOLUTION OF THE CORPORATION, THE BOARD OF DIRECTORS SHALL, AFTER PAYING OR MAKING PROVISION FOR THE PAYMENT OF ALL OF THE LIABILITIES AND OBLIGATIONS OF THE CORPORATION, PAY OVER AND TRANSFER, SUBJECT TO THE PRIOR APPROVAL OF THE TRUSTEE OF THE ABIGAIL GEISINGER TRUST, OR ITS SUCCESSOR, ALL OF THE ASSETS OF THE CORPORATION TO AN ORGANIZATION OR ORGANIZATIONS ORGANIZED AND OPERATED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL OR SCIENTIFIC PURPOSES, PROVIDED THAT AT SUCH TIME THE RECIPIENT QUALIFIES AS AN ORGANIZATION EXEMPT FROM TAX UNDER THE INTERNAL REVENUE CODE. NO PORTION OF THE ASSETS SHALL INURE TO THE BENEFIT OF ANY DIRECTOR, OFFICER OR MEMBER OF THE CORPORATION OR ANY ENTERPRISE ORGANIZED FOR PROFIT. (3) THE ARTICLES OF INCORPORATION OF THE 501(C)(4) CORPORATION CANNOT BE AMENDED WITHOUT THE PRIOR APPROVAL OF THE GEISINGER HEALTH SYSTEM FOUNDATION, NOW GEISINGER HEALTH, THE 501(C)(3) PARENT ORGANIZATION. |
| PART IV, SECTION B, LINE 2 | GEISINGER IS A PHYSICIAN-LED, INTEGRATED HEALTH SERVICES ORGANIZATION THAT HAS AS ITS MAIN COMPONENTS: 1. AN ARRAY OF HEALTH SERVICES PROVIDERS, INCLUDING SEVEN ACUTE CARE HOSPITALS AND A DRUG AND ALCOHOL TREATMENT FACILITY; 2. A MULTISPECIALTY PHYSICIAN GROUP PRACTICE OF 1,720 PHYSICIANS PRACTICING AT 120 PRIMARY AND SPECIALTY CLINICS; AND 3. ONE OF THE NATION'S LARGEST RURAL HEALTH INSURANCE ORGANIZATIONS WITH 544,600 MEMBERS. GEISINGER HEALTH, PARENT ORGANIZATION OF GEISINGER AND THE ORGANIZATION WHICH HAS THE POWER TO REGULARLY APPOINT AT LEAST A MAJORITY OF GEISINGER SYSTEM SERVICES'S DIRECTORS, IS INCORPORATED FOR THE CHARITABLE PURPOSE OF CONDUCTING EXCLUSIVELY CHARITABLE, SCIENTIFIC AND EDUCATIONAL ACTIVITIES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED (OR THE CORRESPONDING PROVISION OF ANY SUCCESSOR UNITED STATES INTERNAL REVENUE LAW) (THE "INTERNAL REVENUE CODE"), INCLUDING, DIRECTLY OR INDIRECTLY, SUPPORTING THE PURPOSES OF, GEISINGER MEDICAL CENTER OR ANY OTHER ORGANIZATION AFFILIATED WITH THE CORPORATION WHICH QUALIFIES AS AN EXEMPT ORGANIZATION UNDER SECTION 501(C)(3)OF THE INTERNAL REVENUE CODE. GEISINGER HEALTH ENGAGES IN ALL ACTIVITIES PROPERLY RELATED TO THE FOREGOING, INCLUDING THE SOLICITATION OF FUNDS FROM INDIVIDUALS, CORPORATIONS AND OTHER ORGANIZATIONS FOR FINANCING THE SERVICES TO BE PROVIDED. THEREFORE, GEISINGER SYSTEM SERVICES'S SUPPORT OF OTHER 501(C)(3) ORGANIZATIONS WITHIN GEISINGER, AND AFFILIATED WITH GEISINGER MEDICAL CENTER AND GEISINGER HEALTH, SERVES TO SUPPORT THE CHARITABLE PURPOSES OF GEISINGER HEALTH. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| 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, INCLUDING TAX-EXEMPT BONDS ISSUED PRIOR TO DECEMBER 31, 2002, WITH A TOTAL OUTSTANDING BALANCE AT DECEMBER 31, 2020 OF 1,762,906,662, INCLUSIVE OF UNAMORTIZED ORIGINAL ISSUE DISCOUNT. BECAUSE THE BOND PROCEEDS ARE DISBURSED TO GH SUBSIDIARIES, THE TAX-EXEMPT 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 GEISINGER COMMONWEALTH SCHOOL OF MEDICINE EIN: 26-0812968 GEISINGER JERSEY SHORE HOSPITAL EIN: 24-0792115 SCHEDULE K WAS PREPARED ON A CONSOLIDATED BASIS AND IS INCLUDED IN THE FORM 990 FILING OF GEISINGER HEALTH, EIN: 23-1995911. FORM 990, PART IX, LINE 24 OTHER EXPENSES: INCLUDED IN THE 593,024 OF OTHER / EXCISE TAXES ON LINE 24C IS FEDERAL UNRELATED BUSINESS INCOME TAX OF 21,752 AND STATE UNRELATED BUSINESS INCOME TAXES OF 18,086. |
| FORM 990, PAGE 2, PART III, LINE 4A | I. GENERAL PROGRAM SERVICE INFORMATION GEISINGER SYSTEM SERVICES (GSS), A 501(C)(3) NON-PROFIT CORPORATION, PROVIDES MANAGEMENT AND CONSULTATIVE SERVICES, AT COST, TO OTHER ENTITIES WITHIN GEISINGER. GSS PREPARES, IMPLEMENTS, AND AUDITS POLICIES AND PROCEDURES OF SYSTEM WIDE RELEVANCE AND IMPLEMENTS UNIFORM STANDARDS AND METHODS OF MANAGEMENT THROUGHOUT THE SYSTEM. SERVICES HISTORICALLY PROVIDED BY GSS TO OTHER ENTITIES WITHIN GEISINGER INCLUDE: APPOINTMENT SERVICES INTERNAL AUDIT AUTOMOTIVE SERVICES LEGAL SERVICES BUSINESS OFFICE MAIL SERVICES CARE SUPPORT SERVICES MARKETING COURIER SERVICES MEDICAL LIBRARY CUSTOMER ACCESS MEDICAL RECORDS CUSTOMER SERVICE CALL CENTER PATIENT EXPERIENCE ELEVATOR OPERATIONS PATIENT PLACEMENT SERVICES EMPLOYEE BENEFIT ADMINISTRATION PLANT ENGINEERING FACILITIES PLANNING AND MANAGEMENT POWER PLANT FINANCIAL SERVICES QUALITY AND SAFETY GENERAL MAINTENANCE REPROGRAPHICS GROUNDS RISK MANAGEMENT HUMAN RESOURCES TRANSCRIPTION SERVICES INFORMATION SYSTEMS INCLUDES THE OPERATION AND MAINTENANCE OF THE ELECTRONIC HEALTH RECORDS FOR ALL PATIENTS OF THE VARIOUS GEISINGER PROVIDERS. II. COMMUNITY HEALTH, EDUCATION, AND OUTREACH GEISINGER SYSTEM SERVICES PROVIDES REDUCED PRICE SERVICES AND FREE PROGRAMS THROUGHOUT THE YEAR TO VARIOUS ORGANIZATIONS. THE PROVISION OF THESE SERVICES AND PROGRAMS IS BASED UPON THE ACTIVITIES AND SERVICES THAT THE ORGANIZATIONS PROVIDE FOR THE COMMUNITY AND WHICH GEISINGER SYSTEM SERVICES BELIEVES WILL SERVE A BONA FIDE COMMUNITY NEED. THESE COMMUNITY SERVICES AND ORGANIZATIONS RECEIVED CASH DONATIONS OR IN-KIND SERVICES DESCRIBED BELOW. A. HEALTH RELATED PROGRAMS GSS PROVIDED 5,504 OF IN-KIND SUPPORT AT LOCAL BLOOD DRIVES. B. OTHER IN-KIND SERVICES AND CONTRIBUTIONS ADDITIONALLY, THE FOLLOWING ORGANIZATIONS, AND OTHERS NOT LISTED BELOW, RECEIVED CASH CONTRIBUTIONS OR IN-KIND SERVICES INCLUDING, BUT NOT LIMITED TO, MAINTENANCE, INFORMATION TECHNOLOGY, AND MEDICAL HEALTH PHYSICS TEACHING VALUED AT 306,837: AMISH/MENNONITE - PATIENT DISCOUNT GUIDELINES COMMUNITY CARE HEALTH CENTER - PARTICIPATION IN BOARD MEETINGS LOCAL COMMUNITIES - COMMUNITY NEEDS ASSESSMENTS LOCAL FIRE DEPARTMENTS - PREVENTION AND INCIDENT TRAINING LUZERNE COUNTY EMERGENCY MGMT AGENCY - CALIBRATING RADIATION DETECTION EQUIPMENT MEDICAL STUDENTS - RADIATION SCIENCE & BIOLOGY CLASSES RONALD MCDONALD HOUSE - MAINTENANCE AND PRINT SHOP/POSTAGE SERVICES PROVIDED TRUSTED ADVISOR TRAINING (MARKET PLACE INSURANCE GUIDANCE FOR COMMUNITY) VETERANS - VETERANS DAY MEAL III. COMMUNITY SERVICE SUMMARY COMMUNITY HEALTH, EDUCATION AND OUTREACH 312,341 |
| 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) 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 ALL REPORTABLE PAYMENTS OF ITSELF AND CERTAIN AFFILIATES, AND CERTAIN REPORTABLE PAYMENTS OF SOME OF ITS AFFILIATES. THEREFORE, THE NUMBER OF FORM 1099'S FILED BY GSS FOR THE REPORTING PERIOD AS REPORTED ON LINE 1A INCLUDES THE NUMBER OF FORM 1099S FILED ON BEHALF OF ITSELF AND ITS AFFILIATES. |
| 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 THIS OR RELATED TAX-EXEMPT ORGANIZATIONS AND ONE VOTING MEMBER IS NOT INDEPENDENT DUE TO A TRANSACTION REPORTED IN SCHEDULE L, PART IV. FORM 990, PART VI, SECTION A, LINE 2: DID ANY OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE HAVE A FAMILY RELATION- SHIP OR BUSINESS RELATIONSHIP WITH ANY OTHER OFFICER, DIRECTOR, TRUSTEE, OR KEY EMPLOYEE? EDELYN L. MILLER, GERALD V. MALONEY, DO , JAEWON RYU, MD, JD, JANET F. TOMCAVAGE, RN, MSN, JEFFREY A. JACOBSON, KAREN MURPHY, NR, PHD, KEVIN V. ROBERTS, MBA, CPA, LORI R. GRAMLEY, ESQUIRE, MATTHEW WALSH, ROBERT J. DIETZ, STEVEN B. BENDER, ESQUIRE, 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 4 | THE ORGANIZATION, A SUBSIDIARY OF GEISINGER HEALTH, AMENDED THE OFFICERS SECTION OF THE CORPORATE BYLAWS TO REQUIRE THAT THE CHAIR OF EACH BOARD BE, AT ALL TIMES, A GEISINGER HEALTH DIRECTOR AND THAT THE CHAIR OF THE BOARD MAY BE REMOVED BY THE GEISINGER HEALTH BOARD OF DIRECTORS AT ANY TIME WITH OR WITHOUT CAUSE. THE ORGANIZATION ALSO AMENDED THE STANDING COMMITTEE SECTION OF THE CORPORATE BYLAWS TO REQUIRE THAT ALL STANDING COMMITTEE CHAIRS BE, AT ALL TIMES, A GEISINGER HEALTH DIRECTOR AND THAT THE STANDING COMMITTEE CHAIRS BE NOMINATED FROM AMONG THOSE DIRECTORS CURRENTLY SERVING AS MEMBERS OF THE GEISINGER HEALTH BOARD OF DIRECTORS. STANDING COMMITTEE CHAIRS AND VICE-CHAIRS MAY BE REMOVED BY THE GEISINGER HEALTH BOARD OF DIRECTORS AT ANY TIME WITH OR WITHOUT CAUSE. SUCCESSOR CHAIRS AND VICE-CHAIRS SHALL BE APPOINTED CONSISTENT WITH THE APPLICABLE PROVISIONS OF THE BYLAWS. |
| 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 7B | 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 15 PA. C.S.A. SUPBCHATER E OF THE PENNSYLVANIA NONPROFIT CORPORATION LAW. |
| 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 COMPLIANCE OFFICER AND REPORTED TO THE AUDIT AND COMPLIANCE COMMITTEE AND/OR 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 COMMITTEE/BOARD DECIDES IF A CONFLICT EXISTS AND TAKES APPROPRIATE ACTION. THE INDIVIDUAL DISCLOSING THE FINANCIAL INTEREST IS ABSENT DURING THE COMMITTEE/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 | FINANCIAL STATEMENTS, FORM 990, FORM 990-T, THE CONFLICTS OF INTEREST POLICY, AND OTHER GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VIII | FORM 990, PART VIII, LINE 2B: THE IC SUPPORT SERVICE REVENUE REPRESENTS REVENUE FROM INTERCOMPANY MANAGEMENT, ADMINISTRATIVE, AND CONSULTING SERVICES PROVIDED TO RELATED TAXABLE ORGANIZATIONS. THE ORGANIZATION AND RELATED TAXABLE ORGANIZATIONS ARE ALL CONTROLLED BY GEISINGER HEALTH. THE SERVICES, PROVIDED AT OR BELOW COST, ARE PERFORMED WITHOUT A PROFIT MOTIVE TO PROMOTE THE EFFICIENT OPERATION OF GEISINGER IN CARRYING OUT ITS CHARITABLE MISSION. THE SERVICES ARE NOT OFFERED TO UNRELATED ORGANIZATIONS OR TO THE GENERAL PUBLIC. UNDER IRS ADVISORY DATED MARCH 7, 2014, THESE INTERCOMPANY SHARED SERVICES ARE NOT INCLUDED IN THE DEFINITION OF UNRELATED BUSINESS INCOME AND SHOULD NOT BE INCLUDED ON FORM 990-T DUE TO THE ABSENCE OF THE FOLLOWING TWO CONDITIONS: (1) THE SERVICES MUST BE ABOVE COST OR AT FAIR MARKET VALUE, AND (2) THERE MUST BE A PROFIT MOTIVE. |
| FORM 990, PART IX, LINE 11G | CLEANING SERVICES 251,531 14,555 0 CONSULTING FEES 12,752,730 737,940 0 COLLECTION AGENCY FEES 1,044,893 60,463 0 EQUIP MAINT SVC CONTRACTS 2,063,302 119,393 0 OUTSIDE PURCHASED SERVICE 26,052,745 1,507,548 0 REPAIR OF EQUIPMENT 34,854 2,017 0 RECRUIT NONPROVIDER 1,799,618 104,135 0 OUT AGENCY NONCLIN TEMP 288,254 16,680 0 RECRUIT & ADS EXECUTIVE 316,581 18,319 0 OUTSIDE AGENCY CLINICAL 12,402 718 0 MICROFILM FICHE PROCESSING 4,249 246 0 CONTRACTED MEDICAL SERVICES 59,081 3,419 0 TOTAL 44,680,240 2,585,433 0 |
| 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 SINGLE AUDIT ACT AND 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. |
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