TY 2020 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)
(1) C DANA WATERMAN III VICE CHAIR	2.5 ................. 2.0	X	X	0	0
(2) DOUGLAS P CROPPER PRESIDENT/CEO GHS	50.0 ................. 11.5	X	X	948,732	53,480
(3) GREGORY J BUSH TREASURER	2.0 ................. 2.0	X	X	0	0
(4) PETER J BENSON SECRETARY	2.0 ................. 2.0	X	X	0	0
(5) STEVEN C BAHLS CHAIR	4.0 ................. 4.0	X	X	0	0
(6) CHRISTOPHER J COX DIRECTOR	2.0 ................. 2.0	X		0	0
(7) DALE D ZUDE DIRECTOR	2.0 ................. 2.0	X		0	0
(8) DAVID C LARSON DIRECTOR	2.0 ................. 2.0	X		0	0
(9) DAVID HELLER DIRECTOR	2.0 ................. 2.0	X		0	0
(10) EDMUND P COYNE JR Director	2.0 ................. 2.0	X		0	0
(11) EDWIN V MOTTO MD DIRECTOR	5.0 ................. 5.0	X		0	0
(12) G CHRISTOPHER WAHLIG DIRECTOR	2.0 ................. 2.0	X		0	0
(13) GEORGE J KONTOS JR Former Director	40.0 ................. 2.0	X		502,136	47,432
(14) KAREN FITZSIMMONS DIRECTOR	40.0 ................. 2.0	X		362,427	52,823
(15) LASHONDA POLITE DIRECTOR	2.0 ................. 2.0	X		0	0
(16) MARK C KILMER DIRECTOR	2.0 ................. 2.0	X		0	0
(17) MARK D BAWDEN DIRECTOR	2.0 ................. 3.5	X		0	0

(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
(18) MELISSA PEPPER DIRECTOR	2.0 .......................2.0	X					0	0
(19) PATRICIA S GROVES DIRECTOR	2.0 .......................2.0	X					0	0
(20) ROBIN PETERSEN DIRECTOR	2.0 .......................2.0	X					0	0
(21) ROGER J HILL FORMER BOARD MEMBER	2.0 .......................2.0	X					0	0
(22) JOSEPH MALAS VP FINANCE, INTERIM CFO	30.0 .......................10.0		X				115,210	7,060
(23) PAUL BOLLINGER V.P. LEGAL AFFAIRS/Asst. Secretary	30.0 .......................10.0		X				351,487	48,528
(24) JORDAN VOIGT HOSPITAL PRESIDENT GMC DAVENPORT	40.0 .......................0			X			626,282	48,158
(25) KURT A ANDERSEN VP Physician Operations/Chief Medical Officer	32.0 .......................8.0			X			668,780	48,117
(26) ANDREW ANDRESEN VP MEDICAL STAFF AFFAIRS	40.0 .......................0				X		507,607	22,568
(27) GAUTAM KUKREJA PHYSICIAN	40.0 .......................0				X		499,572	49,025
(28) IURIE CARAMAN PHYSICIAN	40.0 .......................0				X		572,378	26,836
(29) NAMRATA MALLIK PHYSICIAN	40.0 .......................0				X		530,636	8,233
(30) TODD GRAY PHYSICIAN ADVISOR	40.0 .......................0				X		517,552	19,791
(31) CHRISTOPHER CROME FORMER PHYSICIAN/DIVISION CHAIR	40.0 .......................0					X	481,907	22,233
(32) HAROLD WAGHER FORMER CHIEF COMPLIANCE RISK OFFICER	40.0 .......................0					X	259,512	24,996
(33) MARK G ROGERS V.P. FINANCE/CFO/ASST TREASURER	30.0 .......................10.0					X	804,440	47,313
(34) NIDAL HARB FORMER CHIEF MEDICAL OFFICER	32.0 .......................8.0					X	659,050	26,586

(A) Name and business address	(B) Description of services	(C) Compensation
Cerner Corporation PO Box 959156 St Louis,MO931959156	Information Technology Services	17,781,559
Crothall Healthcare Inc 1500 Liberty Ridge Drive Wayne,PA19087	Maintenance/Enviromental Services	6,218,198
H R Accounts Inc PO Box 672 5320 22nd Avenue Moline,IL612660672	Collection Services	3,026,208
Renovo Solutions LLC 4 Executive Circle Suite 185 Irvine,CA92614	Maintenance Management Services for Medical Equipment	2,382,253
Morrison Healthcare PO Box 102289 Atlanta,GA30368	Food Management Services	2,197,646
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 90

- 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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

Genesis Health System

Employer identification number

42-1418847

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) 2020

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) 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.

Section B. Total Support

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

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

First 5 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 2020 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2019 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2020. 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—2019. 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—2020. 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—2019. 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) 2020

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) 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.)

Section B. Total Support

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.)..

First 5 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 2020 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2019 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2020 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2019 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2020. 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—2019. 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) 2020

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) 2020

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 lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described in 11a above?

11b

A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2020

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 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

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) 2020

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	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.....

Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020

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) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

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

OMB No. 1545-0047

2020

Name of the organization

Genesis Health System

Employer identification number

42-1418847

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2

Name of organization Genesis Health System

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 3

Name of organization Genesis Health System		Employer identification number 42-1418847

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 4


Name of organization Genesis Health System			Employer identification number 42-1418847
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- 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

2020

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

Genesis Health System

Employer identification number

42-1418847

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) 2020

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) 2017	(b) 2018	(c) 2019	(d) 2020	(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) 2020

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)? ........

Yes

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

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

Yes

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

Yes

5,119

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

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

Yes

79,404

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

84,523

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 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	Part II-B, Line 1b. PAID STAFF OR MANAGEMENT: GENESIS HEALTH SYSTEM (GHS Iowa) HAD ONE STAFF MEMBER INVOLVED IN LOBBYING ACTIVITIES ON A PART TIME BASIS. THEIR LOBBYING ACTIVITIES WERE FOCUSED ON SENDING LETTERS OR PUBLICATIONS TO GOVERNMENT OFFICIALS OR LEGISLATORS AND MEETING WITH OR CALLING GOVERNMENT OFFICIALS OR LEGISLATORS ON HEALTHCARE RELATED MATTERS. Part II-B, Line 1d. MAILINGS TO MEMBERS, LEGISLATURES, OR THE PUBLIC: EMPLOYEES OF GENESIS HEALTH SYSTEM ( GHS IOWA) ARE ENCOURAGED TO PARTICIPATE IN THE IOWA HOSPITAL ASSOCIATION'S "IHA ACTION ALERTS." THE EMPLOYEES PARTICIPATE BY RESPONDING TO E-MAIL ALERTS WHICH ALLOWS THEM TO VOICE THEIR OPINIONS TO THEIR STATE REPRESENTATIVES ON HEALTHCARE RELATED MATTERS (NOT CANDIDATE-SPECIFIC). THERE IS NO DIRECT COST TO GENESIS HEALTH SYSTEM (GHS IOWA) REGARDING THIS ACTIVITY. Part II-B, Line 1g. DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, GOVERNMENT OFFICIALS, OR A LEGISLATIVE BODY: GENESIS HEALTH SYSTEM (GHS IOWA) HAD ONESTAFF MEMBER INVOLVED IN LOBBYING ACTIVITIES ON A PART TIME BASIS. THEIR LOBBYING ACTIVITIES WERE FOCUSED ON SENDING LETTERS OR PUBLICATIONS TO GOVERNMENT OFFICIALS OR LEGISLATORS AND MEETING WITH OR CALLING GOVERNMENT OFFICIALS OR LEGISLATORS ON HEALTHCARE RELATED MATTERS. THE DIRECT COSTS RELATED TO THEIR LOBBYING ACTIVITIES INCLUDED: SALARIES- $5,119. Part II-B, Line 1i. OTHER LOBBYING ACTIVITIES: IN FISCAL YEAR 2021, GENESIS HEALTH SYSTEM (GHS IOWA) RECEIVED PROFESSIONAL LOBBYING AND GOVERNMENTAL RELATIONS CONSULTING SERVICES FROM EIDE & HEISINGER, LLC AT A COST OF $12,500. LOBBYING EXPENDITURES RELATED TO MEMBERSHIP DUES INCLUDED; 17.80% OF MEMBERSHIP DUES TO THE IOWA HOSPITAL ASSOCIATION, OR $22,659, 25.56% OF MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION, OR $15,497, 60% OF MEMBERSHIP DUES TO THE AMERICAN MEDICAL ASSOCIATION, OR $7,490, AND VARIOUS OTHER ASSOCIATIONS- $21,258.

Return Reference

Explanation

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

Part II-B, Line 1b. PAID STAFF OR MANAGEMENT: GENESIS HEALTH SYSTEM (GHS Iowa) HAD ONE STAFF MEMBER INVOLVED IN LOBBYING ACTIVITIES ON A PART TIME BASIS. THEIR LOBBYING ACTIVITIES WERE FOCUSED ON SENDING LETTERS OR PUBLICATIONS TO GOVERNMENT OFFICIALS OR LEGISLATORS AND MEETING WITH OR CALLING GOVERNMENT OFFICIALS OR LEGISLATORS ON HEALTHCARE RELATED MATTERS. Part II-B, Line 1d. MAILINGS TO MEMBERS, LEGISLATURES, OR THE PUBLIC: EMPLOYEES OF GENESIS HEALTH SYSTEM ( GHS IOWA) ARE ENCOURAGED TO PARTICIPATE IN THE IOWA HOSPITAL ASSOCIATION'S "IHA ACTION ALERTS." THE EMPLOYEES PARTICIPATE BY RESPONDING TO E-MAIL ALERTS WHICH ALLOWS THEM TO VOICE THEIR OPINIONS TO THEIR STATE REPRESENTATIVES ON HEALTHCARE RELATED MATTERS (NOT CANDIDATE-SPECIFIC). THERE IS NO DIRECT COST TO GENESIS HEALTH SYSTEM (GHS IOWA) REGARDING THIS ACTIVITY. Part II-B, Line 1g. DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, GOVERNMENT OFFICIALS, OR A LEGISLATIVE BODY: GENESIS HEALTH SYSTEM (GHS IOWA) HAD ONESTAFF MEMBER INVOLVED IN LOBBYING ACTIVITIES ON A PART TIME BASIS. THEIR LOBBYING ACTIVITIES WERE FOCUSED ON SENDING LETTERS OR PUBLICATIONS TO GOVERNMENT OFFICIALS OR LEGISLATORS AND MEETING WITH OR CALLING GOVERNMENT OFFICIALS OR LEGISLATORS ON HEALTHCARE RELATED MATTERS. THE DIRECT COSTS RELATED TO THEIR LOBBYING ACTIVITIES INCLUDED: SALARIES- $5,119. Part II-B, Line 1i. OTHER LOBBYING ACTIVITIES: IN FISCAL YEAR 2021, GENESIS HEALTH SYSTEM (GHS IOWA) RECEIVED PROFESSIONAL LOBBYING AND GOVERNMENTAL RELATIONS CONSULTING SERVICES FROM EIDE & HEISINGER, LLC AT A COST OF $12,500. LOBBYING EXPENDITURES RELATED TO MEMBERSHIP DUES INCLUDED; 17.80% OF MEMBERSHIP DUES TO THE IOWA HOSPITAL ASSOCIATION, OR $22,659, 25.56% OF MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION, OR $15,497, 60% OF MEMBERSHIP DUES TO THE AMERICAN MEDICAL ASSOCIATION, OR $7,490, AND VARIOUS OTHER ASSOCIATIONS- $21,258.

Schedule C (Form 990 or 990EZ) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- 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

2020

Open to Public Inspection

Name of the organization

Genesis Health System

Employer identification number

42-1418847

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) 2020

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 ....	16,641,933	15,498,706	14,081,104	13,249,656	12,080,730
b	Contributions ...	455,141	528,855	937,158	166,432	191,448
c	Net investment earnings, gains, and losses	3,878,888	708,244	562,187	739,721	1,042,683
d	Grants or scholarships ...	5,000	5,000	5,000	5,000	5,000
e	Other expenditures for facilities and programs ...	684,952
f	Administrative expenses ....	134,109	88,872	76,743	69,705	60,205
g	End of year balance ......	20,151,901	16,641,933	15,498,706	14,081,104	13,249,656

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

Board designated or quasi-endowment SchDMd Bullet

30.7 %

Permanent endowment SchDMd Bullet

69.3 %

Term endowment SchDMd Bullet

0 %

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)

Yes

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

Yes

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 .....	12,989,630		12,989,630
b	Buildings ....	398,826,959	213,427,732	185,399,227
c	Leasehold improvements	30,457,371	22,919,163	7,538,208
d	Equipment ....	419,935,943	368,858,221	51,077,722
e	Other .....	29,057,273	8,765,876	20,291,397
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				277,296,184

Schedule D (Form 990) 2020

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) INVESTMENT IN GENVENTURES, INC	27,926,652	C
(B) INVESTMENT IN MISERICORDIA ASSURANCE, LTD.	120,000	C
(C) INVESTMENT IN HEI COOP	8,406,998	C
(D) INVESTMENT IN SPRING PARK SURGERY CENTER, LLC	3,279,237	C
(E) INVESTMENT IN GENGASTRO, LLC	27,922,162	C
(F) INVESTMENT IN GENORTHO, LLC	2,619,873	C
(G) INVESTMENT IN GENRAD IMAGING, LLC	2,943,082	C
(H) OTHER INVESTMENTS - GMC	28,655	C
(I) INVESTMENT IN UNIVERSITY OF IOWA HEALTH ALLIANCE, LLC
(J) INVESTMENT IN DAVITA DIALYSIS, LLC	2,572,298	C
(K) INVESTMENT IN WELLMARK	901,046	C
(L) Investment in Wellspire, LLC	3,218,835	C
(M) Investment in Premier Healthcare	668,527	C
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	80,607,365

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(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)Interest in Net Assets of Foundation				18,373,904
(2)Deferred Compensation Annuity				28,205,014
(3)Cash surrender Value of Life Insurance				8,932,388
(4)Goodwill & Covenant Not to Compete				820,444
(5)Sercurity Escrow and Other Assets				425,449
(6)Interest Receivable				277,076
(7)Lease Right of Use Assets				22,638,415
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				79,672,690

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.)	116,970,999
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) 2020

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, Part V, Line 4 Intended uses of endowment funds

GENESIS HEALTH SERVICES FOUNDATION, A RELATED ORGANIZATION, HOLDS THE ENDOWMENT FUNDS. THE INTENDED USE OF THE FOUNDATION'S ENDOWMENT FUNDS ARE AS FOLLOWS: SCHOLARSHIPS FOR EDUCATION IN THE MEDICAL FIELD, CHARITY CARE FOR THE INDIGENT, EMPLOYEE EMERGENCY ASSITANCE, VISITING NURSE, HOSPICE HOUSE, DIABETIC CARE, PEDIATRIC HOSPICE, DIALYSIS CARE, AND BREAST HEALTH SERVICES.

Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote

Uncertainty in income taxes: GHS Iowa, GHS Illinois, GSL - Aledo, GMC - Aledo, the Genesis Foundation, Genesis Philanthropy and the Workers' Compensation Trust each files a Form 990 (Return of Organization Exempt from Income Tax) annually. When these returns are filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. Examples of tax positions common to health systems include such matters as the following: the tax exempt status of each entity, the nature, characterization and taxability of joint venture income and various positions relative to potential sources of unrelated business taxable income. Unrelated business taxable income is reported on Form 990T, as appropriate. The benefit of a tax position is recognized in the financial statements in the period during which, based on all available evidence, management believes that it is more likely than not that the position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more likely than not" recognition threshold are measured as the largest amount of tax benefit that is more than 50% likely to be realized on settlement with the applicable taxing authority. The portion of the benefits associated with tax positions taken that exceeds the amount measured as described above is reflected as a liability for uncertain tax benefits in the accompanying consolidated balance sheets along with any associated interest and penalties that would be payable to the taxing authorities upon examination. Forms 990 and 990T filed by GHS Iowa, GHS Illinois, GSL - Aledo, GMC - Aledo, the Genesis Foundation, Genesis Philanthropy and the Workers' Compensation Trust are subject to examination by the IRS up to three years from the extended due date of each return. GenVentures is a taxable organization and currently files income tax returns in the U.S. federal jurisdiction and various state jurisdictions. There were no uncertain tax positions as of June 30, 2021 and 2020.

Schedule D (Form 990) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization
Genesis Health System

Employer identification number

42-1418847

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in the region
	Central America and the Caribbean	0	0	Investments	0
















3a	Sub-total ....	0	0		0
b	Total from continuation sheets to Part I ...	0	0		0
c	Totals (add lines 3a and 3b)	0	0		0

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2020

Schedule F (Form 990) 2020

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of noncash assistance	(h) Description of noncash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2020

Schedule F (Form 990) 2020Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of noncash assistance	(g) Description of noncash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2020

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2020

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation

Schedule F (Form 990) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- 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

2020

Open to Public Inspection

Name of the organization

Genesis Health System

Employer identification number

42-1418847

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 %

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: . . . . . . . .

Yes

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		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			3,085,925	0	3,085,925	0.58 %
b	Medicaid (from Worksheet 3, column a) . . . . .			81,005,425	60,829,877	20,175,548	3.80 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	84,091,350	60,829,877	23,261,473	4.39 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			919,154	0	919,154	0.17 %
f	Health professions education (from Worksheet 5) . . .			3,117,874	1,908,660	1,209,214	0.23 %
g	Subsidized health services (from Worksheet 6) . . . .			3,287,297	1,746,779	1,540,518	0.29 %
h	Research (from Worksheet 7) .					0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			302,110	0	302,110	0.06 %
j	Total. Other Benefits . .	0	0	7,626,435	3,655,439	3,970,996	0.75 %
k	Total. Add lines 7d and 7j .	0	0	91,717,785	64,485,316	27,232,469	5.13 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020

Schedule H (Form 990) 2020

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
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	0	0	0	0

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. ......

12,243,326

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. ......

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).....

115,425,540

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

117,124,439

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

-1,698,899

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 %
1GENGASTRO LLC	AMBULATORY SURGERY CENTER	90 %	0 %	10 %
2GENORTHO LLC	ORTHOPAEDIC SURGERY CENTER	40 %	0 %	60 %
3SPRING PARK SURGERY CENTER LLC	OUTPATIENT SURGICAL CENTER	40 %	0 %	60 %
4GENRAD IMAGING LLC	DIAGNOSTIC IMAGING CENTER	50 %	0 %	50 %
5DAVITA DIALYSIS LLC	OUTPATIENT DIALYSIS CENTER	20 %	0 %	80 %
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2020

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?2Name, 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)
2	GENESIS MEDICAL CENTER - DAVENPORT 1227 E RUSHOLME STREET DAVENPORT,IA52803 820011H WWW.GENESISHEALTH.COM	X	X		X
1	GENESIS MEDICAL CENTER - DEWITT 1118 11TH STREET DEWITT,IA52742 WWW.GENESISHEALTH.COM 230149H	X	X	X	X

Schedule H (Form 990) 2020

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)

	GENESIS MEDICAL CENTER - DAVENPORT
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 18

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

Yes

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.GENESISHEALTH.COM/COMMUNITY

Other website (list url):

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 18

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

Yes

If "Yes" (list url): WWW.GENESISHEALTH.COM/COMMUNITY

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) 2020

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	GENESIS MEDICAL CENTER - DAVENPORT
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 200.0%
and FPG family income limit for eligibility for discounted care of 200.0%

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.GENESISHEALTH.COM

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

WWW.GENESISHEALTH.COM

A plain language summary of the FAP was widely available on a website (list url):
WWW.GENESISHEALTH.COM

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) 2020

Page 6

Part VFacility Information (continued)

Billing and Collections

	GENESIS MEDICAL CENTER - DAVENPORT
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) 2020

Page 7

Part VFacility Information (continued)

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

	GENESIS MEDICAL CENTER - DAVENPORT
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) 2020

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)

	GENESIS MEDICAL CENTER - DEWITT
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?........................

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 20

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

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.GENESISHEALTH.COM/COMMUNITY

Other website (list url):

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 20

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

Yes

If "Yes" (list url): WWW.GENESISHEALTH.COM/COMMUNITY

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

10b

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) 2020

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	GENESIS MEDICAL CENTER - DEWITT
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 200.0%
and FPG family income limit for eligibility for discounted care of 200.0%

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

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.GENESISHEALTH.COM

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

WWW.GENESISHEALTH.COM

A plain language summary of the FAP was widely available on a website (list url):
WWW.GENESISHEALTH.COM

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)

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) 2020

Page 6

Part VFacility Information (continued)

Billing and Collections

	GENESIS MEDICAL CENTER - DEWITT
Name of hospital facility or letter of facility reporting group

Yes

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

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

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) 2020

Page 7

Part VFacility Information (continued)

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

	GENESIS MEDICAL CENTER - DEWITT
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 prospective Medicare or Medicaid method

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) 2020

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
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - GENESIS MEDICAL CENTER - DAVENPORT. The sponsors of this study, Community Health Care, Inc., Genesis Health System, Muscatine County Board of Health, Quad City Health Initiative, Rock Island County Health Department, Scott County Health Department and UnityPoint Health-Trinity, collaborate on improving health status and quality of life in the Quad Cities region. This work together is rooted in periodic, comprehensive community health assessments that meet the information and reporting needs of all partners. Understanding our community's health status is the foundation for developing community education, resources and programs that will advance our community's health. The assessment informs the creation of community health improvement plans for the study sponsors. In addition, the study sponsors encourage other organizations to use this information to inform strategic planning, grant writing and project development. For the 2018 Community Health Assessment, our coordinated approach included primary data collection, secondary data analysis, and qualitative data gathering from community leaders and members in our bi-state area. The study sponsors engaged Professional Research Consultants, Inc. (PRC) to collect secondary data and implement a community health survey. In addition, using the Mobilizing for Action through Planning and Partnerships (MAPP) framework, the partners completed local qualitative assessments addressing Community Themes & Strengths, Forces of Change and the Local Public Health System. Select operations data from the two health systems were also summarized. The following document provides PRC's bi-state findings in detail as well as information obtained through local data collection methods. This study was sponsored by a collaboration of local organizations, including: Community Health Care, Inc.; Genesis Health System; Muscatine County Board of Health; Quad City Health Initiative; Rock Island County Health Department; Scott County Health Department; and UnityPoint Health - Trinity. The portion of the study conducted by PRC was funded by Genesis Health System and UnityPoint Health - Trinity. This assessment incorporates data from both quantitative and qualitative sources. Quantitative data input includes primary research (the PRC Community Health Survey) and secondary research (vital statistics and other existing health-related data); these quantitative components allow for trending and comparison to benchmark data at the state and national levels. Qualitative data input includes primary research gathered through Community Stakeholder meetings. Community stakeholder committees including member from community businesses as follows: United way of the QC, Community Plan Iowa, Palmer College of Chiropractic, MetroLink, Rock Island County Sheriff's Office, Medic EMS, QC Chamber of Commerce, Churches United of the QC Area, City of Davenport, Black Hawk College, Bi-State Regional Commission, The Project of the QC, River Bend Foodbank, Community Foundation of the Great River Bend, Scott County Sheriff's Department, World Relief, Pleasant Valley School District, True Lifestyles Medicine Clinic, Alternatives for the Older Adult, and Vera French Community Mental Health Center.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - GENESIS MEDICAL CENTER - DAVENPORT. UNITY POINT HEALTH-TRINITY
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - GENESIS MEDICAL CENTER - DAVENPORT. COMMUNITY HEALTH CARE, QUAD CITY HEALTH INITIATIVE, ROCK ISLAND COUNTY HEALTH DEPARTMENT, Muscatine County Board of Health, AND THE SCOTT COUNTY HEALTH DEPARTMENT
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - GMC Davenport. With following the Genesis Health System's mission along with coordinating with the Quad City Health Initiative Implementation plan, Genesis Medical Center Silvis will be focusing and delivering on the following programs and resources to address the needs of the community: Access to Care: - Care Team concept continued deployment allowing providers to care for more patients. - "Population Health" model of ACO with care coordination - Expanding care into the Community through: - Convenient Care offerings - Healthplexes, and -Eldridge Clinic to expand with adding more providers and extended hours to serve growing community - Partnerships with Community Health Care to address low-income access - OB access at CHC Edgerton Woman's Clinic - Genesis ACO participant - 421-DOCS - phone line for physician appointments - Support "Family Connects" in home education re health - Jane Folwell Heart of Mercy Fund - transportation and non-medical health needs - Community Health Education (incl. available resources) - Genesis Forum - town halls - Column in QC Times re health topics Mental Health & Substance Abuse - participation in the QCHI behavioral health coalition initiatives which included zero suicide prevention program - Continue deployment of "medical home" model - Health coaches, navigators, case management - Genesis Psychology Associates - Partnership with Robert Young Center for inpatient behavioral health unit - Promote Scott County Mental Health Court - Support of Live Lead Free QC (to prevent long term mental health issues related to lead exposure) - Support Family Connects - moms with post-partum depression - Support for LISW in Heart Center for anxiety, depression + Support for Rhonda's House - peer respite - Support for "MST" Multisystemic therapy for teens in collaboration with Vera French - PA Fellowship in Behavioral Health - Promote "ACT" - Assertive Community Treatment - Pain management alternatives to opioids at The Spine & Joint Health Center and Physical Therapy - Advocacy in support of mental health reform Nutrition, Physical Activity, & Weight - "Naturally Slim" program scholarships offered to Community - Support of Be Healthy QC to create a "culture of wellness" that supports healthy eating and active living - Healthy Lifestyle sponsorships, such as Genesis Firecracker Run and the Bix 7 - Children's Nutritional Partnership with Hy-Vee stores - Membership discounts to area fitness centers for employees and their families - "Rock Steady Boxing" for Parkinson's patients - Promote/facilitate Community Gardens for healthy food - Advocacy in support of healthy lifestyles
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - Genesis Medical Center Dewitt. Part V, Section B, Line 5: To complete the community health needs assessment, existing health -related data were collected via the online community commons community health needs assessment report tool at HTTP://www.communitycommons.org/maps-data. This site allows for identification of 87 distinct health and social indicators at the county level , along with comparisons to state and national data, and health people 2020 targets, where available. Once an indicators report was generated, relevant indicators were reviewed to determine how Clinton County compared to available state/national data (see the "detailed health indicators" section of this document. Data was also collected by Genesis Health system Business Intelligence and Communications departments. Information gaps: Because this CHNA relies on existing datasets, it is limited in scope to those indicators currently available through database collection. It does not include a primary research component and many important issues are unaddressed (e.g. access to healthcare). Another limitation is that most measures included in this assessment represent data that are several years old. Community Stakeholder Input: Genesis Medical Center DeWitt got input from public health officials and other community stakeholders through a series of meetings. The organizations involved include: * Westwing Senior Living * Clinton County Public Health Department * GMC DeWitt * Patient Health Services Jack County Board of Health * GMC DeWitt Social Services * GMC DeWitt Community Health Liaison Genesis Medical Center Dewitt also conducts a community survey to local organizations for input on CHNA and implementation strategy.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - GENESIS MEDICAL CENTER - DEWITT:. Genesis Health System, in collaboration with Clinton County Health Department, continues to address the significant needs identified in the most recent CHNA through our ongoing programs and resources. These programs include: Healthy Behaviors: Integrated health, wellness activities, smoking cessation, physical activity and weight status: * Switch program completed for DeWitt area families by extension office * School nurse was provided extension office 5210 healthy eating habits posters for education at DeWitt Schools * Diabetes CCM program * Implementation of Food Pharmacy * Continue Genesis support for primary and specialty care services * Expansion of Genesis emergency and convenient care services in areas of growing population/need * Expansion on telehealth services * Concussion management built into the school's initial assessment for baseline of any student athlete * Coverage for treatment at athletic events (Northeast, DeWitt, and Calamus/Wheatland schools) Decrease Youth Risky Behaviors: Teenage pregnancy, marijuana use: * DeWitt/Camanche coalition attendance provided by Wanda Haack and/or Ann Bixby * Scott Drug provides drop box for unused medication disposal * DeWitt/Camanche Coalition provided education at local schools Mental Health Awareness and Services: Suicide prevention and awareness, medication disposal, education on adverse childhood experience (ACE): * Connections Matter * CNO and RN became educated trainers; provided education to Med/Surg and ED units at GMC-DeWitt and DeWitt Lion's Club * Education provided to VNA staff and hosted at GMC-DeWitt * Respite House support provided through DeWitt and GHS Foundations. House provided through lease agreement with GMC-DeWitt * Continued contract with Eastern Iowa Grant providing telepsyche services within the ED and RN Care Coordination for mental health services from ED to community RN Care Coordinator * Continue efforts to support community mental health programs * Participate in Zero Suicide program * Advocate for improved funding for mental health services

Schedule H (Form 990) 2020

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?42
Name and address		Type of Facility (describe)
1	CENTRAL PARK MEDICAL PAVILIONS 1 & 2 1351 W CENTRAL PARK AVENUE DAVENPORT,IA52804	O/P CANCER, INFUSION, WOUND, & PHYSICIAN CLINIC
2	BETTENDORF HEALTH PLEX 2140 53RD AVENUE BETTENDORF,IA52722	OUTPATIENT PHYSICIAN CLINIC AND IMAGING SERVICES
3	GENESIS MEDICAL PLAZA 2535 MAPLECREST ROAD BETTENDORF,IA52722	O/P REHAB, PAIN, PHYS THERAPY, DIABETES, HOME HEALTH, SPINE CTR & PHSY CLINIC
4	GENESIS IMAGING CENTER 53RD STREET 1970 E 53RD STREET DAVENPORT,IA52807	OUTPATIENT RADIOLOGY SERVICES
5	Davenport HealthPlex 3200 West Kimberly Rd Davenport,IA52806	Outpatient Physician Clinic/Physical Therapy
6	ILLINI LARSON CENTER 855 ILLINI DRIVE SILVIS,IL61282	OUTPATIENT LAB & PHYSICIAN CLINIC
7	GENESIS HEALTH GROUP 865 LINCOLN ROAD BETTENDORF,IA52722	OUTPATIENT PHYSICIAN CLINIC
8	MEDICAL OFFICE BUILDING #1 and #2 1228 E RUSHOLME STREET DAVENPORT,IA52803	O/P MAMMOGRAPHY & DIALYSIS SERVICES
9	VISITING NURSE ASSOC & HOSPICE HOUSE 2546 TECH DRIVE BETTENDORF,IA52722	HOME HEALTH & HOSPICE
10	ELDRIDGE FAMILY PRACTICE 301 N 4TH AVENUE ELDRIDGE,IA52748	OUTPATIENT PHYSICIAN CLINIC
11	GHG-Valley View Moline 615 valley Vew Dr Suite 305 Moline,IL61265	Outpatient Physician Clinic
12	GENESIS CONVENIENT CARE - ILLINOIS 2350 41ST STREET MOLINE,IL61265	OUTPATIENT URGENT CARE CLINIC
13	GENESIS PHYSICAL REHAB - VALLEY FAIR 2300 53RD STREET BETTENDORF,IA52722	O/P PHYSICAL THERAPY CLINIC
14	Genesis PT &Sports Medicaine-Bettendorf 2300 53rs Ave STE LL02 Bettendorf,IA52722	Outpatient Physical Therapy Clinic
15	FAMILY PRACTICE AT WEST CAMPUS 1345 W CENTRAL PARK AVENUE DAVENPORT,IA52804	OUTPATIENT PHYSICIAN CLINIC
16	Woodlands Family Practice 4321 53rd Ave Bettendorf,IA52722	Outpatient Physician Clinic
17	GENESIS PSYCHOLOGY ASSOCIATES 4455 E 56TH STREET DAVENPORT,IA52804	OUTPATIENT COUNSELING CLINIC
18	Dewitt Family Practice 1008 11th St Dewitt,IA52742	Outpatient Physician Clinic
19	GENGASTRO LLC 2222 53RD AVENUE BETTENDORF,IA52722	AMBULATORY SURGERY CENTER
20	NORTH FAMILY PRACTICE 210 W 53RD STREET DAVENPORT,IA52806	OUTPATIENT PHYSICIAN CLINIC
21	ELDRIDGE PHYSICAL THERAPY 170 S 4TH AVENUE ELDRIDGE,IA52748	OUTPATIENT PHYSICAL THERAPY CLINIC
22	GENORTHO LLC 2300 53RD STREET BETTENDORF,IA52722	ORTHOPEDIC SURGERY CENTER
23	GENESIS OCCUPATIONAL HEALTH 2350 41ST STREET MOLINE,IL61265	OUTPATIENT OCCUPATIONAL HEALTH
24	PHYSICAL THERAPY & SPORTS MEDICINE 1702 E 53RD STREET DAVENPORT,IA52807	O/P PHYSICAL THERAPY & SPORTS PERF CLINIC
25	MOLINE HEALTHPLEX 3900 28TH AVENUE MOLINE,IL61265	OUTPATIENT PHYSICIAN CLINIC
26	Genesis Physcial Therapy Davenport 1820 West 3rd St Davenport,IA52801	Outpatient Physical Therapy Clinic and Physician Clinic
27	GENRAD IMAGING LLC 1970 E 53RD STREET DAVENPORT,IA52807	DIAGNOSTIC IMAGING CENTER
28	GHS - AUGUSTANA PT CLINIC 639 38TH STREET ROCK ISLAND,IL61201	OUTPATIENT PHYSICAL THERAPY CLINIC
29	DEWITT AMBULANCE 1220 11TH STREET DEWITT,IA52742	AMBULANCE SERVICES
30	GHS OCCUPATIONAL HEALTH - DAVENPORT 3319 SPRING STREET DAVENPORT,IA52807	OUTPATIENT OCCUPATIONAL HEALTH
31	Genesis Physical Therapy at LeClaire 1003 Canal Shore Drive LeClaire,IA52753	Outpatient Physical Therapy Clinic
32	Durant FAMILY PRACTICE 619 5th Durant,IA52747	OUTPATIENT PHYSICIAN CLINIC
33	LECLAIRE FAMILY PRACTICE - RIVERVIEW 200 S CODY ROAD LECLAIRE,IA52751	OUTPATIENT PHYSICIAN CLINIC
34	Genesis Physical Therapy Clinton 1647 Lincoln Way Clinton,IA52732	Outpatient Physical Therapy Clinic
35	IA CITY PEDIATRIC PT CLINIC 2451 CORAL CT CORALVILLE,IA52241	OUTPATIENT PHYSICAL THERAPY CLINIC
36	BLUE GRASS FAMILY MEDICAL 413 S MISSISSIPPI BLUE GRASS,IA52726	OUTPATIENT PHYSICIAN CLINIC
37	VISITING NURSE ASSOC & HOSPICE HOUSE 611 NORTH 2ND AVE CLINTON,IA52732	HOME HEALTH & HOSPICE
38	SPRING PARK SURGERY CENTER LLC 3319 SPRING STREET STE 202A DAVENPORT,IA52807	OUTPATIENT SURGICAL CENTER
39	ERIE FAMILY PRACTICE 530 12TH STREET ERIE,IL61205	OUTPATIENT PHYSICIAN CLINIC
40	GENESIS HEART INSTITUTE 1236 E RUSHOLME STREET DAVENPORT,IA52803	O/P CARDIAC DIAGNOSTIC & REHAB CARE
41	Conveniet Care Now W Locust 2351 West locust Street Davenport,IA52804	Outpatient Urgent Care Clinic
42	CONVENIENT CARE NOW E KIMBERLY 1823 E KIMBERLY RD DAVENPORT,IA52807	Outpatient Urgent Care clinic

Schedule H (Form 990) 2020

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
Schedule H, Part I, Line 6a Community benefit report prepared by related organization	GENESIS HEALTH SYSTEM (GHS ILLINOIS) AND GENESIS MEDICAL CENTER, ALEDO (GMC, ALEDO)
Schedule H, Part I, Line 7g Subsidized Health Services	No costs associated with a physician clinic were reported in subsidized health services.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	Genesis Health System (GHS Iowa) utilized Worksheet 2 to calculate its cost-to-charge ratio. The calculated cost-to-charge ratio was used to calculate the cost of Charity Care and Unreimbursed Medicaid. Costs of the "Other Benefits" reported in 7e -7i were compiled throughout the year in the community benefit database (i.e., CBISA) that Genesis Health System utilizes.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	In accordance with Healthcare Financial Management Association Statement No. 15, Bad Debt is reported at the full-established charge from the most recent audited financial report. Payments received after an account had been written off to bad debt were credited to a bad debt recovery account. Discounts on patient accounts provided by third-party payers were written off to a contractual allowance account.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	Genesis Health System uses Avadyne Health to process aging patient accounts. Avadyne Health's collection process utilizes publicly available information to ensure all aging patient accounts receive financial assistance in accordance to Genesis Health System policy before being deemed bad debt. Genesis Health System reported zero dollars for the estimated amount of the organization's bad debt attributable to patients eligible under the organization's financial assistance policy.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	The System determines the transaction price based on standard charges for goods and services provided to patients, reduced by explicit price concessions consisting of contractual adjustments provided to third-party payors, discounts provided to uninsured patients in accordance with the System's policy, and/or implicit price concessions provided to uninsured patients based on historical collection experience. The implicit price concessions included in estimating the transaction price represent the difference between amounts billed to patients and the amounts expected to be collected based on the System's collection history with similar classes of patients. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to patient service revenue in the period of the change. Subsequent changes that are determined to be the result of an adverse change in the patient's ability to pay are recorded as bad debt expense. Bad debt expense for the years ended June 30, 2021 and 2020, was not material.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	No Medicare shortfalls were included in community benefit. The Medicare cost report shortfall represents the difference between the total revenue received from Medicare based on Medicare cost report reimbursement rates and the costs incurred by GHS Iowa in providing healthcare services to the elderly. The total Medicare shortfall, which includes fee screen services, was $1,698,899. In 2018, the percent of persons 65 years and over in Rock Island and Scott Counties was 15.8%. In accordance with GHS Iowa's mission statement, "To Provide Compassionate, Quality Health Services to All Those in Need," the elderly were served despite the total Medicare loss of $1,698,899. GHS Iowa has a clear mission to serve all those in need and to improve the health of the community including the elderly. Furthermore, there are no for-profit hospitals in the community, and therefore GHS Iowa is one of two tax-exempt healthcare organizations in the community who provide access to healthcare for Medicare patients. Accordingly, it is GHS Iowa's position for the reasons stated above that the total Medicare shortfall of $1,698,899 represents a Community Benefit. Pursuant to the instructions to the Form 990, Schedule H, the Medicare shortfall is not included in Part I, line 7. If the total Medicare shortfall was included in Part I, line 7, then Part I, line 7k, Column f would be 5.46%.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	Every effort is made to determine a patient's eligibility for financial assistance. If eligible, payment plans are made available based on their resources and income. All balances owing after financial assistance allowances have been taken are payable in monthly payments in accordance with the organization's financial assistance policy.
Schedule H, Part V, Section B, Line 16a FAP website	- GENESIS MEDICAL CENTER - DEWITT: Line 16a URL: WWW.GENESISHEALTH.COM; - GENESIS MEDICAL CENTER - DAVENPORT: Line 16a URL: WWW.GENESISHEALTH.COM;
Schedule H, Part V, Section B, Line 16b FAP Application website	- GENESIS MEDICAL CENTER - DEWITT: Line 16b URL: WWW.GENESISHEALTH.COM; - GENESIS MEDICAL CENTER - DAVENPORT: Line 16b URL: WWW.GENESISHEALTH.COM;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- GENESIS MEDICAL CENTER - DEWITT: Line 16c URL: WWW.GENESISHEALTH.COM; - GENESIS MEDICAL CENTER - DAVENPORT: Line 16c URL: WWW.GENESISHEALTH.COM;
Schedule H, Part VI, Line 2 Needs assessment	Genesis Health System (GHS Illinois) utilizes the community health needs assessment (CHNA) conducted by professional research consultants, Inc. (PRC) in 2018. The CHNA was funded by GHS Illinois and Unity Point Health-Trinity and sponsored by Community Health Care, GHS Illinois, Muscatine County Board of Health, Quad City Health Initiative (QCHI), Rock Island County Health Department, Scott County Health Department, and Unity Point Health - Trinity. QCHI was formed by Genesis Health System (GHS Iowa) and GHS Illinois, which has Headquarters in both Scott County, Iowa, and Rock Island County, Illinois, and Trinity Health System, which is headquartered in Rock Island County, Illinois. QCHI is now a community partnership of over 300 community members and leaders pursuing initiatives to create a healthier community, serving as a catalyst for improving the health and overall quality of life within the Quad Cities. Genesis Medical Center Dewitt utilizes the community health needs assessment (CHNA) conducted by Genesis Health System Business Intelligence and communications department as well partnering with Clinton County Health Department in 2020.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	Information on the availability of financial assistance is posted in visible locations in the admission departments of the hospitals. In addition, the hospital registration staff make available informative brochures for patients in the Emergency Room registration area explaining their eligibility for assistance. Genesis Health System (GHS Iowa) provides patient financial counselors on each hospital campus to discuss options with the patients. Patient Financial Services prepares and provides a letter to each patient, explaining their current balance and advising them of their options. A phone number is provided with the letter encouraging the patient to call if needed.
Schedule H, Part VI, Line 4 Community information	Genesis Health System's (GHS Iowa) mission is to provide quality, compassionate care for all those in need. GHS Illinois lives its mission each day by serving a 10-County region of Eastern Iowa and Western Illinois, including both urban and rural areas. The region served by GHS Illinois (Davenport-Moline-Rock Island, IA - IL. Metropolitan statistical area - Henry County, IL, Mercer County, IL, Muscatine County IA, Rock Island, IL., and Scott County, IA.) has a population of 360,601. According to the US Census Bureau American Community Survey Five Year Estimates (2009-2013), Whites made up 85.0% of the MSA population with 7.8% Black or African-American and 7.2% Hispanic or other origin. In the Quad Cities area, 23.5% of the population are infants, children, or adolescents (age 0-17); another 60.7% are 18-64, while 15.8% are age 65 and older. According to estimates from the US Census Bureau American Community Survey, 13.3% of Quad Cities area residents (Scott and Rock Island Counties) live below the Federal poverty. In 2018, 3.2% of Quad Cities are adults reported that there was a time the past two years when they were living on the street, in a car, or in a temporary shelter. The average unemployment rate in 2018 was 4.0% for the Quad Cities. Lack of health insurance among adults age 18 to 64 is reported by 6.3% of Scott County, IA residents and 7.7% of Rock Island County, IL residents. The Quad Cities area percentage of adults who smoked in 2018 was 19.8%. The percentage of adults who were obese in 2018 was 38.3% in Rock Island County, Illinois and 36.5% in Scott County, Iowa. Obesity rates in both Scott County, IA and Rock Island County, IL are higher than national benchmarks. GMC DeWitt serves the residents of Clinton County, primarily those residing in Dewitt and the surrounding towns. With a population of 47,218, made of age groups of 0-17 (22.82%), 18-44 (30.03%), 45-64 (28.09%), and 65+ (19.06%). Population living areas were 67.77% in urban and 32.23% in rural. Other statistic was population made up of white (93.77%), black or African American (2.67%), Asian (.73%), and other (2.83%). Statistic percentages are according to the U.S. Census Bureau American Community Survey 2014-18 5 year estimates.
Schedule H, Part VI, Line 5 Promotion of community health	Genesis Health System's Board of directors is a diverse representation of persons who reside in the primary service area that Genesis Health System serves. Genesis Health System executives and employees serve on dozens of volunteer boards throughout the region on important projects and initiatives, such as homeless shelters, mental health, downtown redevelopment and events and festivals. Genesis Health System employees serve the communities where they live by serving in elected offices in city and county government. Genesis Health System extends medical staff privileges to all qualified physicians in its communities. Genesis Health System has endeavored to improve access to health care for the communities it serves by participating in appropriate joint ventures that offer needed health care services to under-served areas. Genesis Health System schedules dozens of health screenings and immunizations throughout the year at a reduced cost. These include screenings for diabetes, stroke and heart disease and public flu immunization clinics. Genesis Health System providers translation services based on a percentage of the diversity of the population. Each year, Genesis Health System provides the community with dozens of classes and events promoting health and health education. Hundreds of residents in the region served by Genesis Health System learn CPR, First Aid, parenting skills, and newborn care by enrolling in classes. Genesis Health System supplies medical supplies and equipment to Globus, which is a third party company that helps companies share and transfer research data. Genesis Health System maintains an active effort to advocate for access to health care in Iowa and Illinois State government and in Washington D.C. Genesis Health System employees also participate in a voter voice initiative to advocate on important health issues with City, County, State, and National elected officials. Surplus funds resulting from efficient operations and cost-containment measure are re-invested in the healthcare operations of Genesis Health System to improve the healthcare services that Genesis Health System provides. Advances in medical equipment and technology, staff education, and new medical services are examples of operation investments that ultimately improve the health of the communities that Genesis Health System serves. As part of Genesis Health System, GMC DeWitt is committed to the promotion of community health. The hospital participates in programs such as housing for persons with mental illness.
Schedule H, Part VI, Line 6 Affiliated health care system	Genesis Health System, (GHS Iowa), an Iowa nonprofit corporation, and Genesis Health System,(GHS Illinois), an Illinois not-for-profit corporation, have identical governing boards, management and bylaws and can act jointly. GHS Iowa is also the sole member of Genesis Philanthropy, Genesis Health Services Foundation, Genesis Accountable Care Organization LLC, and Genesis Health System Workers' Compensation Plan and Trust, the sole stockholder of GenVentures, Inc., a member of Misericordia Assurance Company, Ltd. and a partner in GenGastro, LLC. Genesis Health System, EIN 36-3616314 is the sole member of Genesis Medical Center, Aledo and Genesis Senior Living, Aledo, and is a partner in The Larson Center Partnership. GHS Iowa, GHS Illinois, GMC Aledo, and GSL Aledo collectivity represent the obligated group on certain components of the obligated group's long-term debt. Genesis Health System provides administrative, management, information technology and other support services to its affiliates. Genesis Clinical Services operates physician medical practices, convenient care practices and an occupational medicine clinic and provides behavioral health services to the residents of eastern Iowa and western Illinois. Genesis Medical Center - Davenport (GMC - Davenport) is licensed as a 502-bed acute care hospital which provides services from two hospital facilities located in Davenport, Iowa. Genesis Family Medical Center (GFMC) is a family practice residency training program that operates clinics in Davenport and Blue Grass, Iowa to provide a clinical setting for the residents to treat patients. Genesis Medical Center - DeWitt (GMC - DeWitt) is certified as a critical access hospital, which has 13-acute care and swing beds, and has a 77-bed long-term care facility, which provides services from its facility in DeWitt, Iowa. In June 2019, GMC Dewitt entered into a lease agreement where GMC Dewitt will lease the assets to a new joint venture, Wellspire, LLC. Genesis Visiting Nurse Association and Hospice (VNA) provide home health care, community nursing services and hospice services to patients in eastern Iowa and western Illinois. Genesis Medical Center - Silvis is licensed as a 145-bed acute care hospital, which provides services from its facility in Silvis, Illinois. Illini Hospital Nursing Home (INH) operates Illini Restorative Care Center and Crosstown Square. Illini Restorative Care Center is a 120-bed licensed nursing facility, consisting of 92 skilled care beds and 28 sheltered care beds. All 92 beds are dually licenses for Medicare/Medicaid services. The sheltered care unit provides rehabilitative and personal care in a family-oriented setting. Crosstown Square is an independent living facility containing 64 rentable apartments and three guest rooms that offers services designed to meet the needs of senior adults. In June 2019, certain assets of INH were contributed to a new joint venture, Wellspire, LLC. GHS Iowa and GHS Illinois have a controlling ownership interest or membership in the following organizations: Genesis Medical Center Aledo (GMC Aledo) is certified as a critical access hospital, which has 22-acute care and swing beads, as well as a physician clinic, which provides services from its facility in Aledo, Illinois. Genesis Senior Living Aledo (GSL Aledo) is certified as a nursing facility, which has a 92 bed long-term care facility, which provides services from its facility in Aledo, Illinois. On May 31, 2019, the System sold its 100% ownership interest in GSL-Aledo to an unrelated third party. Genesis Health Services Foundation (Genesis Foundation) is an organization whose mission is to develop, manage and grant charitable support to meet the health-related needs of the communities served by Genesis Health System. GenGastro, LLC (d/b/a the Center for Digestive Health) is a limited liability company, which operates a single-specialty gastroenterology ambulatory surgery center located in Bettendorf, Iowa. Genesis Health System Maintains a 75 percent ownership interest in GenGastro, LLC. The Larson Center Partnership (LCP) is a for-profit real estate partnership which owns a medical office building adjacent to GMC - Illini and leases space for clinics, laboratory, pharmacy and offices to GMC - Illini and other third-party organizations. GHS Illinois is a general partner and owns approximately 79.8% of LCP. GenVentures, Inc. (GenVentures) is a wholly-owned for-profit corporation which operates the following divisions, primarily in the Quad Cities: Genesis at Home, Continuing Care sells and leases home medical equipment; provides intravenous therapy services, including sales of related solutions and supplies to patients; and provides retail pharmaceutical and over-the-counter products to patients and employees of the System. GenProperties owns, leases and/or manages office space in 14 medical office buildings located in Bettendorf, Clinton, Davenport, Eldridge, Le Claire and Muscatine, Iowa. Crescent Laundry provides commercial laundry services to health care facilities in eastern Iowa and in north-central Illinois. Genesis Accountable Care Organization, LLC (Genesis ACO) is an Iowa limited liability company formed in December 2011. Its purpose is to engage in any lawful business and any business related to creation and organization of a "physician-driven" network to act as, and/or participate in, an Accountable Care Organization within the meaning of the federal Patient Protection and Affordable Care Act. The company is also organized to develop a clinically integrated network of providers including physicians, health professionals, hospitals and ancillary providers working together to promote high quality, coordinated and efficient care to patients including members of various managed care payors and the community at large. Genesis Health System Workers' Compensation Plan and Trust (Workers' Compensation Trust) provides a fund, which can be used to pay workers' compensation claims and costs for the benefit of Genesis Health System. Misericordia Assurance Company, Ltd. (Misericordia) is a wholly-owned Cayman based captive insurance company which underwrites the general and professional liability risks of Genesis Health System and affiliates. Genesis Philanthropy is a wholly-owned tax-exempt entity formed in 2013, which will partner with other hospital foundations to form a regional network to attract donors to help fund specific health-related causes and promote wellness in the region.
Schedule H, Part VI, Line 7 State filing of community benefit report	IL, IA

Schedule H (Form 990) 2020

Additional Data

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Software Version:	2020v4.0

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
Genesis Health System

Employer identification number
42-1418847

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) GENESIS HEALTH SYSTEM WORKER'S COMPENSATION & TRUST 1227 E RUSHOLME ST DAVENPORT,IA52803	39-1905171	501 ( C ) (3)	1,336,038	CLAIM PAYMENTS
(2) GENESIS HEALTH SERVICES FOUNDATION 1227 E RUSHOLME ST DAVENPORT,IA52803	42-1421670	501 ( C ) (3)	53,136	CME PROGRAM
(3) NAMI Greater Mississippi Valley 1035 W Kimberly Rd Suite 4 DAVENPORT,IA52806	42-1188963	501 (C)(3)	10,000	NAMI Walks Event Donation
(4) Quad Cities Community Foundation 852 Middle Road BETTENDORF,IA52722	42-6122716	501 (C)(3)	10,000	Memorial Scholarship in remembrance of Dr. Pinc
(5) Quad City Symphony 327 bRADY sT DAVENPORT,IA52801	46-6017663	501 ( C ) (3)	10,000	Sponsorships-Seasonal concerts

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2020

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance
(1) MEDICAL SUPPLIES TO INDIVIDUALS/MEDICAL MISSION	500	5,726	FMV	MEDICAL AND PHARMACEUTICAL SUPPLIES DONATED TO PATIENTS AND MERCY MISSION Genesis Health System 42-1418847 67 5/
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	THE GENESIS HEALTH SYSTEM (GHS IOWA) STAFF REQUIRES RECEIPTS AND OTHER DOCUMENTATION PRIOR TO RELEASING FUNDS FOR PROJECTS AND SERVICES WITHIN THE SCOPE OF THE ORGANIZATION'S MISSION. PROPER AUTHORIZATION OF GRANT REQUESTS IS ALSO REQUIRED. STAFF FOLLOWS THE ORGANIZATION'S FUNDING ADMINISTRATIVE POLICY TO ENSURE THAT GRANTS ARE BEING APPROVED AND UTILIZED CORRECTLY.

Schedule I (Form 990) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- 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
Graphic Arrow

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow

Attach to Form 990.
Graphic Arrow

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

Genesis Health System

Employer identification number

42-1418847

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 .....

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? ....

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

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) 2020

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)
1DOUGLAS P CROPPER PRESIDENT/CEO GHS	(i) (ii)	942,542 ------------- 0	0 ------------- 0	6,190 ------------- 0	25,991 ------------- 0	27,489 ------------- 0	1,002,212 ------------- 0	0 ------------- 0
2GEORGE J KONTOS JR Former Director	(i) (ii)	495,183 ------------- 0	0 ------------- 0	6,953 ------------- 0	25,510 ------------- 0	21,922 ------------- 0	549,568 ------------- 0	0 ------------- 0
3KAREN FITZSIMMONS DIRECTOR	(i) (ii)	360,284 ------------- 0	0 ------------- 0	2,143 ------------- 0	25,917 ------------- 0	26,906 ------------- 0	415,250 ------------- 0	0 ------------- 0
4MARK G ROGERS V.P. FINANCE/CFO/ASST TREASURER	(i) (ii)	470,874 ------------- 0	0 ------------- 0	333,566 ------------- 0	24,144 ------------- 0	23,169 ------------- 0	851,753 ------------- 0	0 ------------- 0
5HAROLD WAGHER FORMER CHIEF COMPLIANCE RISK OFFICER	(i) (ii)	226,483 ------------- 0	0 ------------- 0	33,029 ------------- 0	5,301 ------------- 0	19,695 ------------- 0	284,508 ------------- 0	0 ------------- 0
6PAUL BOLLINGER V.P. LEGAL AFFAIRS/Asst. Secretary	(i) (ii)	291,756 ------------- 0	0 ------------- 0	59,731 ------------- 0	24,315 ------------- 0	24,213 ------------- 0	400,015 ------------- 0	0 ------------- 0
7JOSEPH MALAS VP FINANCE, INTERIM CFO	(i) (ii)	101,632 ------------- 0	0 ------------- 0	13,578 ------------- 0	1,794 ------------- 0	5,266 ------------- 0	122,270 ------------- 0	0 ------------- 0
8NIDAL HARB FORMER CHIEF MEDICAL OFFICER	(i) (ii)	387,395 ------------- 0	0 ------------- 0	271,655 ------------- 0	22,992 ------------- 0	3,594 ------------- 0	685,636 ------------- 0	0 ------------- 0
9CHRISTOPHER CROME FORMER PHYSICIAN/DIVISION CHAIR	(i) (ii)	480,930 ------------- 0	0 ------------- 0	977 ------------- 0	4,673 ------------- 0	17,560 ------------- 0	504,140 ------------- 0	0 ------------- 0
10KURT A ANDERSEN VP Physician Operations/Chief Medical Officer	(i) (ii)	513,463 ------------- 0	0 ------------- 0	155,317 ------------- 0	25,987 ------------- 0	22,130 ------------- 0	716,897 ------------- 0	0 ------------- 0
11JORDAN VOIGT HOSPITAL PRESIDENT GMC DAVENPORT	(i) (ii)	407,958 ------------- 0	0 ------------- 0	218,324 ------------- 0	24,375 ------------- 0	23,783 ------------- 0	674,440 ------------- 0	0 ------------- 0
12ANDREW ANDRESEN VP MEDICAL STAFF AFFAIRS	(i) (ii)	428,607 ------------- 0	0 ------------- 0	79,000 ------------- 0	5,500 ------------- 0	17,068 ------------- 0	530,175 ------------- 0	0 ------------- 0
13IURIE CARAMAN PHYSICIAN	(i) (ii)	561,258 ------------- 0	0 ------------- 0	11,120 ------------- 0	4,875 ------------- 0	21,961 ------------- 0	599,214 ------------- 0	0 ------------- 0
14TODD GRAY PHYSICIAN ADVISOR	(i) (ii)	515,616 ------------- 0	0 ------------- 0	1,936 ------------- 0	11,457 ------------- 0	8,334 ------------- 0	537,343 ------------- 0	0 ------------- 0
15GAUTAM KUKREJA PHYSICIAN	(i) (ii)	498,911 ------------- 0	0 ------------- 0	661 ------------- 0	24,375 ------------- 0	24,650 ------------- 0	548,597 ------------- 0	0 ------------- 0
16NAMRATA MALLIK PHYSICIAN	(i) (ii)	530,146 ------------- 0	0 ------------- 0	490 ------------- 0	4,875 ------------- 0	3,358 ------------- 0	538,869 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2020

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, Part II	Based on section 4960 publication, the effective date is for the first taxable year beginning after 12/31/17 in which Genesis first taxable year is 07/01/18-06/30/19; 2018 tax year. For tax year 2019, reportable compensation to report would be between date range 7/1/2020-06/30/2021, Doug Cropper's reportable compensation was under one million.
Schedule J, Part I, Line 4a Severance or change-of-control payment	The following individual received severance pay from Genesis Health System (GHS Iowa) during the calendar year 2020: Nidal Harb, $253,935. This information is included in reportable compensation on form 990, Part VII and Schedule J, Part II, if applicable.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	The following individuals participated in a supplemental ROTH indexed universal life(IUL) plan in 2020 sponsored by Genesis health System (GHS IA): Kurt A. Andersen- $78,757, Paul Bollinger- $40,882, Jordan Voigt-$85,381, Andrew Andresen-$49,460, and Nidal Harb-$87,136. The dollar amount represents the current year contribution made by GHS IA on behalf of the individuals to the plan in 2020. This information is included in reportable compensation on the form 990, Part VII and Schedule J, Part II. The following individual participated in a supplemental executive retirement savings benefit plan in 2020 sponsored by Genesis health System (GHS IA): Mark G. Rogers- $148,668. The dollar amount represents the current year contribution made by GHS IA on behalf of the individual to the plan in 2020. This information is included in reportable compensation on the form 990, Part VII and Schedule J, Part II. Split-dollar life insurance participants are Douglas P. Cropper-established in 2016 and sponsored by Genesis Health System(GHS IA). GHS IA deposited funds into life insurance policies on the participant's life. During life, and subject to the policies generating sufficient values, the participant can borrow from one of the policies. The borrowing is monitored and limited so the policies do not lapse. At the participant's death, the organization recovers premiums plus interest plus additional key-person insurance proceeds. There were no loans or contributions in 2020.

Schedule J (Form 990) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
Genesis Health System

Employer identification number
42-1418847

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	IOWA FINANCE AUTHORITY	52-1699886	46246PLP4	06-24-2010	90,995,000	REFUND 12-23-97 AND 08-02-00 BOND ISSUE; RENOVATE AND EQUIP FACILITY	X			X		X
B	IOWA FINANCE AUTHORITY	52-1699886	46246PMG3	11-26-2013	121,000,000	CONSTRUCT AND EQUIP EAST CAMPUS TOWER		X		X		X
C	Iowa Finance Authority	52-1699886			27,500,000	Partially defease 6-24-10 Bonds		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	86,825,000		2,600,000		6,810,000
2 Amount of bonds legally defeased ..............	0
3 Total proceeds of issue ..................	95,545,195		125,205,892		27,500,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............			21,131,117
6 Proceeds in refunding escrows ...............	0
7 Issuance costs from proceeds ...............	1,478,186		1,267,563
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	23,700,000		123,844,399		27,500,000
11 Other spent proceeds .............	70,367,009
12 Other unspent proceeds .............
13 Year of substantial completion .............	2010		2013		2017
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2019, a current refunding issue)? ........	X			X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2019, an advance refunding issue)? ........		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2020

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X		X		X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0.91 %		0.91 %		0.91 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0.91 %		0.91 %		0.91 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X
b Exception to rebate? ........	X		X		X
c No rebate due? .........		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X			X

Schedule K (Form 990) 2020

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Schedule K, Part II, Line 3	Part II, Line 3, Column A - Investment earnings are the source of the difference between the issue price and the total proceeds of the issue. Part II, Line 3, Column B - Investment earnings are the source of the difference between the issue price and the total proceeds of the issue.
Schedule K, Part V Different Procedures to Undertake Corrective Action	Issuer name: IOWA FINANCE AUTHORITY A PREMIUM OF $4,550,195 WAS PAID TO THE ISSUER BY THE BONDHOLDERS AT THE DATE OF SALE.
Schedule K, Part V Different Procedures to Undertake Corrective Action	Issuer name: IOWA FINANCE AUTHORITY A PREMIUM OF $3,950,091 WAS PAID TO THE ISSUER BY THE BONDHOLDERS AT THE DATE OF SALE. FURTHERMORE, $953,406 WAS EARNED BY INVESTING THE RESERVE FUNDS.

Schedule K (Form 990) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

Genesis Health System

Employer identification number

42-1418847

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2020

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) GENVENTURES INC	DOUGLAS P. CROPPER, ROGER HILL, AND JAMES KOEHLER WERE OFFICERS OF GENVENTURES, INC.	38,249,861	GENVENTURES, INC. PAID GENESIS HEALTH SYSTEM (GHS IOWA) AS A COMMON PAYMASTER AND REIMBURSEMENT OF INTEREST.		No
(2) GENVENTURES INC	DOUGLAS P. CROPPER, ROGER HILL, AND JAMES KOEHLER WERE OFFICERS OF GENVENTURES, INC.	14,295,845	GENESIS HEALTH SYSTEM (GHS IOWA) PAID GENVENTURES, INC. FOR FACILITY LEASE PAYMENTS, MEDICAL SUPPLIES, LAUNDRY SERVICES, AND A LOAN ADVANCE.		No
(3) CARDIOVASCULAR MEDICINE PC	EDMUND P. COYNE, JR., M.D. IS A DIRECTOR OF CARDIOVASCULAR MEDICINE, PC.	1,020,833	HEALTHCARE PROFESSIONAL SERVICES		No
(4) QUAD CITY BANK & TRUST COMPANY	PETER BENSON IS AN OFFICER AND MARK KILMER IS THE CHAIRMAN OF THE BOARD OF QUAD CITY BANK & TRUST	253,927	INTEREST EXPENSE, DEPOSIT ACCOUNT, CREDIT CARD SERVICE, LOCK BOX FEES, AND INTEREST INCOME		No
(5) CLAIRE MOTTO	CLAIRE MOTTO IS THE DAUGHER OF EDWIN V. MOTTO, DIRECTOR OF GHS IA	14,567	REPORTABLE COMPENSATION AS AN EMPLOYEE		No
(6) KRISTI SOUTHERLAND	KRISTI SOUTHERLAND IS THE SISTER OF KURT A. ANDERSEN, A KEY EMPLOYEE OF GHS IA	27,610	REPORTABLE COMPENSATION AS AN EMPLOYEE		No
(7) Dewitt Bank and Trust	Roger J. Hill is a Sr.VP/Trust Officer for Dewitt Bank & Trust	134,450	interest expense, deposit account, lock box fees, and interest income.		No
(8) Main Street AmusementsQC River Bandits	David Heller was president/CEO of Main Street Amusements and Co-owner of the QC River Bandits	113,995	Sponsorship and ticket purchase expenses		No
(9) AUGUSTANA COLLEGE	STEVEN C. BAHLS IS AN OFFICER AND C. DANA WATERMAN III IS A BOARD MEMBER OF AUGUSTANA COLLEGE	704,479	AUGUSTANA PAID GHS IA FOR EMPLOYEE ASSITANCE PROGRAM, HEALTH CLINIC, AND COVID-19 TESTING SERVICES.		No
(10) AUGUSTANA COLLEGE	STEVEN C. BAHLS IS AN OFFICER AND C. DANA WATERMAN III IS A BOARD MEMBER OF AUGUSTANA COLLEGE	90,000	GHS IA PAID AUGUSTANA COLLEGE FOR RENT SPACE AND PROGRAM UNDERWRITING RADIO SERVICES.		No
(11) COURTESY CAR CITY AND KIMBERLY CAR CITY	DALE D. ZUDE IS OWNER OF COURTEST AND KIMBERLY CAR CITY	170,144	PURCHASE OF VEHICLES		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

Genesis Health System

Employer identification number

42-1418847

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Miscellaneous )	X	35	27,053	Market value
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2020)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
Schedule M, Part I Explanations of reporting method for number of contributions	Other - Miscellaneous PART I, COLUMN B IS REPORTED USING A COMBINATION OF NUMBER OF CONTRIBUTIONS AND ITEMS CONTRIBUTED.

Schedule M (Form 990) (2020)

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

- 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

2020

Open to Public
Inspection

Name of the organization

Genesis Health System

Employer identification number

42-1418847

Return Reference	Explanation
Form 990, Part III, Line 4d Description of other program services	(Expenses $ 4,682,843 including grants of $ 0)(Revenue $ 7,951,006) Genesis Accountable Care Organization, LLC (Genesis ACO) is an Iowa limited liability company formed in December 2011. Its purpose is to engage in lawful business related to the creation and organization of a "physician-driven" network to act as, and/or participate in, an Accountable Care Organization within the meaning of the federal Patient Protection and Affordable Care Act. The company is also organized to develop a clinically integrated network of providers including physicians, health professionals, hospitals and ancillary providers working together to promote high quality, coordinated and efficient care to patients including members of various managed care payors and the community at large.
Form 990, Part V, Line 15	Line 15 was purposely marked no based on section 4960 publication, the effective date is for the first taxable year beginning after 12/31/17 in which Genesis first taxable year is 07/01/18-06/30/19; 2018 tax year. For the calendar year 2019,dates to report wages is between 07/01/19 through 06/30/2020; with reportable compensation for Douglas P. Cropper being under $1 million.
Form 990, Part VI, Line 11b Review of form 990 by governing body	Prior to submitting the form 990 to the IRS, it is reviewed at the organization's finance committee meeting, and then it is e-mailed to the organization's board of directors' one week in advance of a scheduled meeting. At the board of directors meeting, internal management reviews the form 990 with the board of directors. Suggested changes from all of the reviews are considered for inclusion in the final form 990 submitted to the IRS. Internal management review is also completed of the compiled information and is provided to the vice president, finance/CFO; vice president, legal affairs; vice president, human resources; and chief compliance risk officer of the organization's corporate member.
Form 990, Part VI, Line 12c Conflict of interest policy	ANY COVERED PERSON, DEFINED AS ANY DIRECTOR, OFFICER, OR MEMBER OF A BOARD OR BOARD COMMITTEE OF GENESIS HEALTH SYSTEM (GHS IOWA) OR AN AFFILIATE, SHOULD DISCLOSE AN INTEREST OR POTENTIAL INTEREST AS SOON AS THEY BECOME AWARE OF A POTENTIAL TRANSACTION THAT WILL BE CONSIDERED BY MANAGEMENT, THE BOARD, OR A COMMITTEE OF THE BOARD. COVERED PERSONS ARE REQUIRED ANNUALLY TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILY, OR BUSINESS RELATIONSHIPS THAT REASONABLY COULD GIVE RISE TO AN INTEREST OR CONFLICT INVOLVING GHS IOWA, OR AN AFFILIATE, OR WITH RESPECT TO DESIGNATED FACILITIES AND ACTIVITIES, AND ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS FAMILIAR WITH AND IS IN COMPLIANCE WITH THE LETTER AND SPIRIT OF THIS POLICY. ANY COVERED PERSON FOUND TO HAVE A CONFLICT OF INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING TO PRESENT INFORMATION AND ADDRESS ANY QUESTIONS RAISED BY OTHER DIRECTORS OR COMMITTEE MEMBERS. SAID PERSON SHALL NOT BE ALLOWED TO ACTIVELY AND AGGRESSIVELY ADVOCATE IN HIS OR HER OWN BEHALF NOR SHALL SUCH PERSON ADVOCATE HIS OR HER POSITION INFORMALLY THROUGH PRIVATE CONTACT, COMMUNICATION AND DISCUSSION WITH ANOTHER DIRECTOR. AFTER SUCH PRESENTATION, THE PERSON SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE APPLICABLE TRANSACTION OR ARRANGEMENT.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	Each executive position is evaluated using a formal evaluation plan that is established by an outside consultant. At the present time, the consultant uses a point system for job evaluation. The point values are based on "know how", "problem solving", "accountability", and other job attribute specific to the position. Once the point value is set for a position, market comparisons for jobs with the same organizational impact can be compared for salary purposes and establish pay ranges. The design of the pay ranges for executives is based on market data. The midpoint of each pay range is established at the 50th percentile of the market comparisons. A minimum and maximum are established off of the midpoint. Specific pay rates for executives are subject to CEO and compensation committee and the Genesis Health System (GHS Iowa) board of directors' approval. Pay ranges are reviewed each year to determine the need for revision. When market conditions suggest an adjustment to pay ranges, data will be presented to the compensation committee for its review. The specific pay ranges are subjected to CEO, compensation committee, and GHS Iowa board of director approval. The president and CEO have the authority and responsibility to establish and adjust, within the range approved by the compensation committee and GHS Iowa board of directors, the base compensation of each executive employed by GHS Iowa, at appropriate times. The GHS Iowa board of directors shall establish and adjust, within the range approved by the compensation committee, the base compensation for the CEO of GHS Iowa, at appropriate times, The Last time this process was formally undertaken was November 2020.
Form 990, Part VI, Line 19 Required documents available to the public	THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC.
Form 990, Part VII, Section A, Line 1a	GENESIS HEALTH SYSTEM (GHS ILLINOIS), GENESIS MEDICAL CENTER, ALEDO, GENESIS SENIOR LIVING, ALEDO, GENESIS HEALTH SERVICES FOUNDATION, GENESIS PHILANTHROPY AND GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST ARE RELATED ORGANIZATIONS OF GENESIS HEALTH SYSTEM (GHS IOWA). THE AMOUNTS REPORTED AS REPORTABLE COMPENSATION FOR THE OFFICERS, KEY EMPLOYEES, AND HIGHLY COMPENSATED EMPLOYEES, UNLESS OTHERWISE NOTED ELSEWHERE IN PART VII, ARE FOR SERVICES RENDERED ON BEHALF OF ALL ORGANIZATIONS. IT WOULD BE ADMINISTRATIVELY IMPRACTICABLE FOR MEMBERS OF THE GOVERNING BOARD AND THE EXECUTIVE TEAM TO BREAKOUT THEIR HOURS DEVOTED AS WELL AS THEIR REPORTABLE COMPENSATION AMONG EACH ORGANIZATION. ALL REPORTABLE COMPENSATION, UNLESS OTHERWISE NOTED IN PART VII, IS PAID BY GHS IOWA.
Form 990, Part VIII, Line 2f Other Program Service Revenue	Contractuals/Charity Care/Bad Debts - Total Revenue: -XXX-XX-XXXX, Related or Exempt Function Revenue: -XXX-XX-XXXX, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Misc Non-operating - Total Revenue: 656182, Related or Exempt Function Revenue: 656182, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees	ANESTHESIA SERVICES - Total Expense: 392587, Program Service Expense: 392587, Management and General Expenses: , Fundraising Expenses: ; BLOOD BANK SERVICES - Total Expense: 1499247, Program Service Expense: 1499247, Management and General Expenses: , Fundraising Expenses: ; COLLECTION SERVICES - Total Expense: 5757355, Program Service Expense: 2279428, Management and General Expenses: 3477927, Fundraising Expenses: ; Signage SERVICES - Total Expense: 2042, Program Service Expense: , Management and General Expenses: 2042, Fundraising Expenses: ; ENVIRONMENTAL SERVICES - Total Expense: 386824, Program Service Expense: 326040, Management and General Expenses: 60784, Fundraising Expenses: ; HEALTH CARE PROFESSIONAL SERVICES - Total Expense: 2585834, Program Service Expense: 2585834, Management and General Expenses: , Fundraising Expenses: ; HEALTH-RELATED IMAGING SERVICES - Total Expense: 12284565, Program Service Expense: 12284565, Management and General Expenses: , Fundraising Expenses: ; HEALTHCARE DATA SYSTEM/STRATEGIC PLANNING: - Total Expense: 4634775, Program Service Expense: 737490, Management and General Expenses: 3897285, Fundraising Expenses: ; IT OUTREACH SERVICES - Total Expense: 14789425, Program Service Expense: , Management and General Expenses: 14789425, Fundraising Expenses: ; LAB SERVICES - Total Expense: 6036871, Program Service Expense: 6036871, Management and General Expenses: , Fundraising Expenses: ; LAUNDRY SERVICES: - Total Expense: 26335, Program Service Expense: 26335, Management and General Expenses: , Fundraising Expenses: ; MAINTENANCE SERVICES - Total Expense: 12050694, Program Service Expense: 11849328, Management and General Expenses: 201366, Fundraising Expenses: ; NUTRITIONAL SERVICES - Total Expense: 2321726, Program Service Expense: 2321726, Management and General Expenses: , Fundraising Expenses: ; OUTSIDE HEALTHCARE-RELATED SERVICES - Total Expense: 1146372, Program Service Expense: 1146372, Management and General Expenses: , Fundraising Expenses: ; PATIENT TRANSPORT SERVICES - Total Expense: 416065, Program Service Expense: 416065, Management and General Expenses: , Fundraising Expenses: ; PHYSICAL THERAPY SERVICES - Total Expense: 2233681, Program Service Expense: 2233681, Management and General Expenses: , Fundraising Expenses: ; ROOM AND BOARD SERVICES - Total Expense: 618963, Program Service Expense: 618963, Management and General Expenses: , Fundraising Expenses: ; TRANSCRIPTIONS SERVICES - Total Expense: 142512, Program Service Expense: , Management and General Expenses: 142512, Fundraising Expenses: ; VISITING NURSE OUTSIDE SERVICES - Total Expense: 462668, Program Service Expense: 462668, Management and General Expenses: , Fundraising Expenses: ; TRANSLATIONS SERVICES - Total Expense: 335965, Program Service Expense: 86, Management and General Expenses: 335879, Fundraising Expenses: ; EMERGENCY ROOM SERVICES - Total Expense: 2535589, Program Service Expense: 2535589, Management and General Expenses: , Fundraising Expenses: ; DIALYSIS SERVICES - Total Expense: 671234, Program Service Expense: 671234, Management and General Expenses: , Fundraising Expenses: ; OUTSIDE PHAMRACY SERVICES - Total Expense: 199944, Program Service Expense: 199944, Management and General Expenses: , Fundraising Expenses: ; COMMUNICATION SERVICES - Total Expense: 212076, Program Service Expense: , Management and General Expenses: 212076, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Equity Transfer to GHS Illinois - -1131034; CHANGE IN NET ASSETS OF GENESIS HEALTH SERVICES FOUNDATION - 3938897; NON-CASH CONTRIBUTIONS NOT REPORTED ON BOOKS - -27053; Equity Transfer from Genesis Senior Living Aledo - 182040; Equity Transfer from Genesis Medical Center Aledo - 383210; Equity Transfer to GHS Foundation - -50000; Balance Sheet Adjust of FY20 GSLA closeout - 10952247;
Form 990, Part XII, Line 2c	THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR TAX YEAR.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2020

Additional Data

Software ID:	20011424
Software Version:	2020v4.0

1	Briefly describe the organization’s mission or most significant activities: GENESIS HEALTH SYSTEM (GHS IOWA) EXISTS TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES TO ALL THOSE IN NEED.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	19
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2020 (Part V, line 2a) ......	5	4,518
6	Total number of volunteers (estimate if necessary) .............	6	96
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,557,925
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	715,154

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	15,247,216	20,199,597
9	Program service revenue (Part VIII, line 2g) .........	487,154,036	514,503,461
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	31,985,953	19,737,711
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	432,825	2,478,783
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	534,820,030	556,919,552
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,426,026	1,438,037
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)	265,390,518	248,307,255
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)....	258,974,729	280,609,596
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	526,791,273	530,354,888
19	Revenue less expenses. Subtract line 18 from line 12.......	8,028,757	26,564,664
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	929,416,357	1,001,993,046
21	Total liabilities (Part X, line 26).............	353,037,374	343,934,036
22	Net assets or fund balances. Subtract line 21 from line 20.....	576,378,983	658,059,010

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 274,060,784 including grants of $ 1,438,037 ) (Revenue $ 410,379,160 )
	GENESIS HEALTH SYSTEM (GHS IOWA) IS A HEALTH SYSTEM LOCATED IN EASTERN IOWA CONSISTING OF THREE HOSPITAL FACILITIES, TWO IN DAVENPORT AND ONE IN DEWITT, IOWA. GENESIS MEDICAL CENTER - DAVENPORT, CONTAINING 502 LICENSED ACUTE CARE BEDS. STATISTICS INCLUDE 71,003 PATIENT DAYS AND 218,584 OUTPATIENT VISITS; GENESIS MEDICAL CENTER - DEWITT, CONTAINING 13 LICENSED ACUTE CARE AND SWING BEDS. STATISTICS INCLUDE 1,384 PATIENT DAYS AND 24,318 OUTPATIENT VISITS. GHS IOWA ALSO INCLUDES A FAMILY MEDICINE RESIDENCY PROGRAM THAT CONTINUES TO EDUCATE RESIDENTS IN THE HOSPITAL SETTING.

4b	(Code: ) (Expenses $ 100,340,703 including grants of $ 0 ) (Revenue $ 69,231,083 )
	GENESIS HEALTH GROUP, A PHYSICIAN GROUP WITHIN GENESIS HEALTH SYSTEM (GHS IOWA) ENCOMPASSES A WIDE VARIETY OF SPECIALTIES AND FAMILY PRACTICE GROUPS SERVING IOWA, ILLINOIS AND SURROUNDING COMMUNITIES IN EASTERN IOWA AND WESTERN ILLINOIS.

4c	(Code: ) (Expenses $ 23,425,519 including grants of $ 0 ) (Revenue $ 26,942,212 )
	GENESIS AT HOME VNA & HOSPICE, A VISITING NURSE AND HOSPICE CARE PROGRAM WITHIN GENESIS HEALTH SYSTEM (GHS IOWA) ENCOMPASSES HOME HEALTH SERVICES (INCLUDING PHYSICAL THERAPY, OCCUPATIONAL/SPEECH THERAPY, SKILLED NURSING, MEDICAL SOCIAL WORKER VISITS), COMMUNITY HOSPICE SERVICES, AND THE CLARISSA C. COOK HOSPICE HOUSE LOCATED IN BETTENDORF, IOWA. STATISTICS INCLUDE 110,535 HOME HEALTH SERVICE UNITS AND 53,317 HOSPICE/HOSPICE HOUSE DAYS.

	(Code: ) (Expenses $ 4,682,843 including grants of $ 0 ) (Revenue $ 7,951,006 )
	Genesis Accountable Care Organization, LLC (Genesis ACO) is an Iowa limited liability company formed in December 2011. Its purpose is to engage in lawful business related to the creation and organization of a "physician-driven" network to act as, and/or participate in, an Accountable Care Organization within the meaning of the federal Patient Protection and Affordable Care Act. The company is also organized to develop a clinically integrated network of providers including physicians, health professionals, hospitals and ancillary providers working together to promote high quality, coordinated and efficient care to patients including members of various managed care payors and the community at large.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 4,682,843 including grants of $ ) (Revenue $ 7,951,006 )
4e	Total program service expenses402,509,849

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	8,407,708	0	553,179

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	1,014,226
e	Government grants (contributions)		1e	16,797,775

f	All other contributions, gifts, grants, and similar amounts not included above		1f	2,387,596

g	Noncash contributions included in lines 1a - 1f:$		1g	27,053

h Total. Add lines 1a-1f.......		20,199,597

		Business Code
2a	OUTPATIENT REVENUE	621400	761,521,103	761,521,103
b	INPATIENT REVENUE	900099	534,809,574	534,809,574
c	CLINIC/NURSING REVENUE	621400	135,909,569	135,909,569
d	HOME HEALTH SERVICES	621400	30,365,726	30,365,726
e	PROFESSIONAL HEALTH SERVICES	621400	16,191,070	14,633,145	1,557,925
f	All other program service revenue.		-964,293,581	-964,293,581	0	0
g	Total. Add lines 2a–2f .....		514,503,461

3 Investment income (including dividends, interest, and othersimilar amounts) ......			8,961,025			8,961,025
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	0	6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	479,092,813		7a
b	Less: cost or other basis and sales expenses	468,316,127		7b
c	Gain or (loss)	10,776,686	0	7c
d	Net gain or (loss).........			10,776,686			10,776,686
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	2,112,941
b	Less: cost of goods sold ..		10b	908,174
c	Net income or (loss) from sales of inventory..			1,204,767			1,204,767
Business Code			Miscellaneous Revenue
11a	VENDOR REBATES		900099	490,414	490,414
b	NUTRITIONAL SERVICES		900099	68,933	68,933
c	AMBULANCE		900099	58,487	58,487
d	All other revenue ....			656,182	656,182	0	0
e	Total. Add lines 11a–11d ......			1,274,016
12	Total revenue. See instructions.....			556,919,552	514,219,552	1,557,925	20,942,478

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,430,674	1,430,674
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	7,363	7,363
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 ...........	2,656,644	415,250	2,241,394	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	41,329	41,329
7	Other salaries and wages........	214,327,490	178,010,737	36,316,753
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,907,815	1,490,237	417,578
9	Other employee benefits .......	15,031,699	11,371,493	3,660,206
10	Payroll taxes ...........	14,342,278	11,724,006	2,618,272
11	Fees for services (non-employees):
a	Management ......	2,058,318	720,886	1,337,432
b	Legal .........	576,194		576,194
c	Accounting ...........	288,996		288,996
d	Lobbying ...........	84,523		84,523
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	1,031,841		1,031,841
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	71,743,349	48,624,053	23,119,296	0
12	Advertising and promotion ....	770,004	114,817	655,187
13	Office expenses .......	7,867,111	4,073,349	3,793,762
14	Information technology ......	2,601,619		2,601,619
15	Royalties ..
16	Occupancy ...........	20,801,333	16,496,823	4,304,510
17	Travel ............	1,039,917	777,515	262,402
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	375,073	295,556	79,517
20	Interest ...........	6,772,948	6,772,948
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	37,548,726	23,176,726	14,372,000
23	Insurance ...	1,810,104	294,902	1,515,202
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	FEDERAL AND STATE INCOME TAX	114,186	114,186
b	MEDICAL AND PHARMACEUTICAL	52,412,071	52,295,600	116,471
c	PATIENT SUPPLY COST OF	46,947,988	46,947,988
d	PHYSICIAN PRACTIVE OVERHEAD	17,112,975		17,112,975
e	All other expenses	8,652,320	1,970,332	6,681,988	0
25	Total functional expenses. Add lines 1 through 24e	530,354,888	407,166,770	123,188,118	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 ........			21,478,246	1	19,449,361
2	Savings and temporary cash investments .........			66,881,971	2	77,014,637
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			86,436,500	4	95,752,065
5	Loans and other receivables from 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 .......
				0	5	0
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) ...
				0	6	0
7	Notes and loans receivable, net ...........			10,502,217	7	13,003,744
8	Inventories for sale or use ............			14,799,634	8	13,539,062
9	Prepaid expenses and deferred charges ......			7,461,008	9	8,786,434
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	891,267,176
b	Less: accumulated depreciation	10b	613,970,992	297,699,425	10c	277,296,184
11	Investments—publicly traded securities .			282,459,886	11	336,365,156
12	Investments—other securities. See Part IV, line 11 .....			68,796,987	12	80,607,365
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............			506,348	14	506,348
15	Other assets. See Part IV, line 11 ...........			72,394,135	15	79,672,690
16	Total assets. Add lines 1 through 15 (must equal line 33)...			929,416,357	16	1,001,993,046

17	Accounts payable and accrued expenses .....	80,797,513	17	81,348,206
18	Grants payable ...		18
19	Deferred revenue .........	2,360,794	19	76,003
20	Tax-exempt bond liabilities .........	154,170,709	20	145,538,828
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 .........
		0	22	0
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	115,708,358	25	116,970,999
26	Total liabilities. Add lines 17 through 25..	353,037,374	26	343,934,036

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	560,274,455	27	638,015,585
28	Net assets with donor restrictions ...........	16,104,528	28	20,043,425
	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 ...........	576,378,983	32	658,059,010
33	Total liabilities and net assets/fund balances ........	929,416,357	33	1,001,993,046

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No

(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
(1) GENESIS ACCOUNTABLE CARE ORGANIZATION LLC 1227 E RUSHOLME STREET DAVENPORT,IA52803 45-4168932	ACCOUNTABLE CARE SERVICES	IA	3,268,162	8,275,482	GENESIS HEALTH SYSTEM (GHS IOWA)
(2) SPIN ECHO LLC 1227 E RUSHOLME STREET DAVENPORT,IA52803 42-1491373	PROPERTY MANAGEMENT	IA	190,639	1,535,578	GENVENTURES INC

(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)GENESIS HEALTH SYSTEM (GHS ILLINOIS) 801 ILLINI DRIVE silvis,IL61282 36-3616314	HEALTHCARE	IL	501(c)(3)	3	GENESIS HEALTH SYSTEM (GHS IOWA)	Yes
(2)GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN & TRUST 1227 E RUSHOLME STREET DAVENPORT,IA52803 39-1905171	EMPLOYEE/BENEFIT/TRUST	IA	501(c)(3)	Type I	GENESIS HEALTH SYSTEM (GHS IOWA)	Yes
(3)DAVENPORT HOSPITAL AMBULANCE CORPORATION 1204 E HIGH STREET DAVENPORT,IA52803 42-1186903	AMBULANCE TRANSFERS	IA	501(c)(3)	Type I	GENESIS HEALTH SYSTEM (GHS IOWA)	Yes
(4)GENESIS SENIOR LIVING ALEDO 309 NW NINTH AVENUE ALEDO,IL61231 45-4475803	SENIOR LIVING SERVICES	IL	501(c)(3)	3	GENESIS HEALTH SYSTEM (GHS ILLINOIS)	Yes
(5)GENESIS HEALTH SERVICES FOUNDATION 1227 E RUSHOLME STREET DAVENPORT,IA52803 42-1421670	CHARITY	IA	501(c)(3)	7	GENESIS HEALTH SYSTEM (GHS IOWA)	Yes
(6)GENESIS PHILANTHROPY 1227 E RUSHOLME STREET DAVENPORT,IA52803 46-2452851	CHARITY	IA	501(c)(3)	10	GENESIS HEALTH SYSTEM (GHS IOWA)	Yes
(7)GENESIS MEDICAL CENTER ALEDO 309 NW NINTH AVENUE ALEDO,IL61231 45-4475683	HEALTHCARE	IL	501(c)(3)	3	GENESIS HEALTH SYSTEM (GHS ILLINOIS)	Yes

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(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	(k) Percentage ownership
(1) GENGASTRO LLC 2222 53RD AVENUE BETTENDORF,IA52722 56-2315623	AMBULATORY SURGERY CENTER	IA	GENESIS HEALTH SYSTEM (GHS IOWA)	Related	3,604,294	401,474		No			No	82 %
(2) SPRING PARK SURGERY CENTER LLC 3319 SPRING STREET STE 202A DAVENPORT,IA52807 42-1483989	OUTPATIENT SURGICAL CENTER	IA	GENESIS HEALTH SYSTEM (GHS IOWA)	Related	616,178	2,998,272		No			No	40 %
(3) LARSON CENTER PARTNERSHIP LLC 801 ILLINI DRIVE SILVIS,IL61282 36-3738454	PROPERTY MANAGEMENT	IL	NA	N/A
(4) GENORTHO LLC 2300 53RD AVENUE BETTENDORF,IA52722 20-3406994	ORTHOPAEDIC SURGERY CENTER	IA	GENESIS HEALTH SYSTEM (GHS IOWA)	Related	2,913,368	1,924,140		No			No	52 %
(5) GENRAD IMAGING LLC 1970 E 53RD STREET DAVENPORT,IA52807 45-3571628	DIAGNOSTIC IMAGING CENTER	IA	GENESIS HEALTH SYSTEM (GHS IOWA)	Related	1,960,197	2,138,135		No			No	50 %
(6) GENRAD IMAGING ILLINOIS LLC 1970 E 53RD STREET DAVENPORT,IA52807 46-2452851	DIAGNOSTIC IMAGING CENTER	IL	NA	N/A

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) GenVentures Inc	A	196,571	FMV
(2) Genesis Health Services Foundation	B	53,136	FMV
(3) Genesis Health Services Foundation	C	968,414	FMV
(4) Gen Gastro LLC	H	3,526,801	FMV
(5) Spring Park Surgery Center	H	567,600	FMV
(6) GenOrthro LLC	H	2,714,384	FMV
(7) GenVentures Inc	K	6,210,446	FMV
(8) Larson Center Partnership	K	498,188	FMV
(9) Genesis health System Illinois	K	151,023	FMV
(10) Larson Center Partnership	J	436,940	FMV
(11) Genesis Health System Workers' Compensation and Trust	B	1,336,038	FMV
(12) Genesis Health System Workers' Compensation and Trust	L	1,265,795	FMV
(13) Davenport Hosptial Ambulance	M	156,098	FMV
(14) Genesis Medical Center Aledo	P	16,891,094	FMV
(15) Genesis Health System Illinois	P	62,289,643	FMV
(16) Davenport Hospital Ambulance	P	74,288	FMV
(17) GenVentures Inc	P	1,613,120	FMV
(18) Genesis Health System Illinois	Q	107,876,959	FMV
(19) Genesis Health System Foundation	Q	2,626,349	FMV
(20) Genesis Medical Center Aledo	Q	20,975,993	FMV
(21) Genventures Inc	Q	38,053,290	FMV
(22) Genesis Philanthropy	Q	439,958	FMV
(23) GenVentures Inc	R	6,472,279	FMV
(24) GenRad LLC	H	1,916,000	FMV
(25) GENESIS HEALTH SERVICES FOUNDATION	R	342,923	FMV
(26) GENESIS PHILANTHROPY	R	51,668	FMV
(27) GENESIS HEALTH SYSTEM IL	R	80,425	FMV
(28) GENESIS SENIOR LIVING ALEDO	R	182,040	FMV
(29) MISERICORDIA ASSURANCE COMPANY	M	1,795,892	FMV
(30) Genesis Philanthropy	C	45,812	FMV

(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?		(k) Percentage ownership
(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	(k) Percentage ownership