SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
GEISINGER SYSTEM SERVICES
 
Employer identification number

23-2164794
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4


5
6
7
8
9
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
No
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
No
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
No

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

(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
(A) GEISINGER MEDICAL CENTER
 
240795959 3 Yes     No Yes   0
(B) GEISINGER WYOMING VALLEY MEDICAL CENTER
 
231996150 3 Yes     No Yes   0
(C) MARWORTH
 
232171417 3 Yes     No Yes   0
(D) GEISINGER HEALTH SYSTEM FOUNDATION
 
231995911 7 Yes     No Yes   0
(E) GEISINGER COMMUNITY HEALTH SERVICES
 
232967235 9 Yes     No Yes   0
(F) COMMUNITY MEDICAL CENTER
 
240862246 3 Yes     No Yes   0
(G) COMMUNITY MEDICAL CARE INC
 
232429776 9 Yes     No Yes   0
(H) MOUNTAIN VIEW NURSING HOME INC
 
232568288 9 Yes     No Yes   0
(I) GEISINGER BLOOMSBURG HOSPITAL
 
232193572 3 Yes     No Yes   0
(J) BLOOMSBURG PHYSICIANS SERVICES
 
232979856 9 Yes     No Yes   0
(K) GEISINGER BLOOMSBURG HEALTHCARE CENTER
 
232242854 9 Yes     No Yes   0
(L) COLUMBIA MONTOUR HOME HEALTH SERVICES VISITING NURSES A
 
231704399 9 Yes     No Yes   0
(M) GEISINGER LEWISTOWN HOSPITAL
 
231352187 3 Yes     No Yes   0
Total 13  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Page 2

Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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 IV.)..            
11 Total support (Add lines 7 through 10).  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here.................................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a

b

17a

b

18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2013
Page 3

Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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 IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
Page 4

Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
PART I, LINE 11H COMMUNITY MEDICAL CENTER 24-0862246 3 X X 0 COMMUNITY MEDICAL CARE, INC. 23-2429776 9 X X 0 MOUNTAIN VIEW NURSING HOME, INC. 23-2568288 9 X X 0 GEISINGER BLOOMSBURG HOSPITAL 23-2193572 3 X X 0 BLOOMSBURG PHYSICIANS SERVICES 23-2979856 9 X X 0 GEISINGER BLOOMSBURG HEALTHCARE CENTER 23-2242854 9 X X 0 COLUMBIA MONTOUR HOME HEALTH SERVICES VISITING NURSES A 23-1704399 9 X X 0 GEISINGER LEWISTOWN HOSPITAL 23-1352187 3 X X 0
SUPPLEMENTAL INFORMATION GEISINGER SYSTEM SERVICES (GSS), A 501(C)(3)NOT-FOR-PROFIT CORPORATION, SUPPORTS ALL OF ITS AFFILIATED ORGANIZATIONS IN THE GEISINGER HEALTH SYSTEM BY PROVIDING MANAGEMENT AND CONSULTATIVE SERVICES, AT COST. GSS PREPARES, IMPLEMENTS AND AUDITS POLICIES AND PROCEDURES OF SYSTEM WIDE RELEVANCE AND IMPLEMENTS UNIFORM STANDARDS AND METHODS OF MANAGEMENT THROUGHOUT THE SYSTEM. SERVICES HISTORICALLY PROVIDED BY GSS TO OTHER ENTITIES WITHIN THE GEISINGER HEALTH SYSTEM INCLUDE: APPOINTMENT SERVICES HUMAN RESOURCES AUTOMOTIVE SERVICES INFORMATION SYSTEMS BUSINESS OFFICE INTERNAL AUDIT CARE SUPPORT SERVICES LAUNDRY CLINICAL CONTENT MANAGEMENT LEGAL SERVICES CLINICAL EFFECTIVENESS MAIL SERVICES CLINICAL INNOVATION MARKET PLANNING COMMUNICATION AND PUBLIC RELATIONS MEDICAL LIBRARY CUSTOMER ACCESS MEDICAL PHOTOGRAPHY CUSTOMER SERVICE CALL CENTER PATIENT TRANSPORT ELEVATOR OPERATIONS PLANT ENGINEERING EMPLOYEE BENEFIT ADMINISTRATION POWER PLANT FACILITIES PLANNING AND MANAGEMENT QUALITY AND SAFETY FINANCIAL SERVICES REPROGRAPHICS FOOD SERVICES RISK MANAGEMENT GENERAL MAINTENANCE SECURITY GROUNDS TELECOMMUNICATIONS HOUSEKEEPING TRANSCRIPTION SERVICES INCLUDES THE OPERATION AND MAINTENANCE OF THE ELECTRONIC HEALTH RECORDS FOR ALL PATIENTS OF GEISINGER HEALTH SYSTEM PROVIDERS. THESE INTER-ORGANIZATION TRANSACTIONS PROMOTE THE EFFICIENT OPERATION OF THE VARIOUS AFFILIATED ORGANIZATIONS AND THE ATTAINMENT OF THEIR TAX EXEMPT PURPOSES. THESE TYPES OF INTER-ORGANIZATION TRANSACTIONS WERE DESCRIBED TO THE INTERNAL REVENUE SERVICE IN A RULING APPLICATION AND WERE RECOGNIZED BY THE NATIONAL OFFICE OF THE IRS IN A SERIES OF GHS PRIVATE RULINGS AS BEING ENTIRELY CONSISTENT WITH THE ORGANIZATIONS' TAX EXEMPT STATUS. FOOTNOTE: THROUGHOUT FORM 990, THE TERMS "GEISINGER HEALTH SYSTEM" AND "SYSTEM" OR THE ACRONYM "GHS" SHALL REFER TO THE ENTIRE HEALTHCARE SYSTEM COMPRISED OF GEISINGER HEALTH SYSTEM FOUNDATION ("THE FOUNDATION") AS PARENT AND ALL SUBSIDIARY CORPORATIONS COMPRISING THE SYSTEM.
Schedule A (Form 990 or 990-EZ) 2013


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