2025-11-17T10:37:25-06:00 2024-12-31 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2024-01-01 311480941 GENESIS HEALTHCARE SYSTEM GENE 7404545000 2951 MAPLE AVENUE ZANESVILLE OH 43701 ADAM HOPPER CFO 7404545000 2025-11-14 1 0 AMY CIMINELLO P00796388 6148493000 2025-11-14 2024 2025-03-06 01:10:19Z MATTHEW PERRY 2951 MAPLE AVENUE ZANESVILLE OH 43701 761724849 0 3727 X WWW.GENESISHCS.ORG X 1997 OH IN 1997, GOOD SAMARITAN MEDICAL CENTER AND BETHESDA HOSPITAL ASSOCIATION, A TAX-EXEMPT COMMUNITY HOSPITAL ALSO LOCATED IN ZANESVILLE, AFFILIATED TO FORM GENESIS HEALTHCARE SYSTEM. GENESIS HAS BEEN GRANTED 501C3 STATUS AS A HOSPITAL. ALL HOSPITAL OPERATIONS AND ASSETS OF GOOD SAMARITAN MEDICAL CENTER WERE TRANSFERRED TO GENESIS WITH THE EXCEPTION OF CERTAIN INVESTMENTS. GOOD SAMARITAN MEDICAL CENTER WILL CONTINUE TO HAVE CONTROL OVER CERTAIN INVESTMENTS WHICH ARE BEING USED BY THE GENESIS HEALTHCARE SYSTEM IN FULFILLING ITS TAX-EXEMPT PURPOSE. 19 16 4004 422 228370 0 18641321 1772542 586584271 657399061 -1156020 11563560 65286643 89173421 669356215 759908584 718365 572423 0 0 237791185 248265468 0 0 0 364370333 413983822 602879883 662821713 66476332 97086871 626849932 728114752 370672998 467221552 256176934 260893200 X WE SERVE OUR COMMUNITY BY HELPING EACH PERSON ACHIEVE THEIR OPTIMAL HEALTH AND WELL-BEING BY PROVIDING COMPASSIONATE, EXCEPTIONAL, AND AFFORDABLE HEALTHCARE SERVICES. 0 0 520594877 572423 744765373 GENESIS PROVIDES ACUTE CARE SERVICES INCLUDING MEDICAL, SURGICAL, OBSTETRICAL, PEDIATRIC AND CRITICAL CARE. GENESIS PROVIDES A WIDE RANGE OF DIAGNOSTIC AND SUPPORT SERVICES FOR INPATIENTS AND OUTPATIENTS. THESE SERVICES ARE COMPRISED OF LABORATORY, IMAGING SERVICES, CARDIAC, AND PHARMACY. LABORATORY SERVICES INCLUDE CHEMISTRY, PATHOLOGY, MICROBIOLOGY, HEMATOLOGY, CYTOLOGY, AND PHLEBOTOMY. IMAGING SERVICES INCLUDES RADIOLOGY, NUCLEAR MEDICINE, MRI, ULTRASOUND, CT SCAN, PET SCAN, MAMMOGRAPHY AND BONE DENSITY SCANNING.GENESIS HEART & VASCULAR SERVICES PROVIDE NEEDED HEART CARE FROM PREVENTION TO REHABILITATION. OUR BOARD-CERTIFIED SPECIALISTS INCLUDE CARDIOLOGISTS, CARDIOTHORACIC VASCULAR SURGEONS, ELECTROPHYSIOLOGISTS, INTERVENTIONAL CARDIOLOGISTS, CARDIAC ANESTHESIOLOGISTS AND CARDIAC REHAB SPECIALISTS. THE CARDIOTHORACIC AND VASCULAR SURGICAL TEAMS PERFORM A WIDE VARIETY OF COMPLEX AND HIGH-RISK CARDIAC, THORACIC AND VASCULAR PROCEDURES INCLUDING OPEN HEART SURGERY. OUR CARDIAC TEAM TAKES OUR PATIENTS FROM EVALUATION AND DIAGNOSIS THROUGH LIFESTYLE CHANGES AND TREATMENTS. ALSO INCLUDED IN OUR CARDIAC SERVICES ARE OUR CLINICS AND SPECIALTY PROGRAMS. THESE INCLUDE AN ANTICOAGULATION CLINIC, A CONGESTIVE HEART FAILURE CLINIC, A DEVICE CLINIC, A VEIN CLINIC AND A CARDIAC REHABILITATION PROGRAM. GENESIS IS AN ACCREDITED CHEST PAIN CENTER WITH PCI, AN ACCREDITED ECHOCARDIOGRAPHY FACILITY. RESPIRATORY SERVICES - GENESIS RESPIRATORY & LUNG PROVIDES SERVICES FOR A VARIETY OF LUNG CONDITIONS AND DISEASES INCLUDING LUNG SURGERIES AND RESPIRATORY THERAPY. OUR TEAM, INCLUDING BOARD-CERTIFIED PULMONOLOGISTS, PROVIDE CARE AND TREATMENT FOR PATIENTS WITH PNEUMONIA, LUNG CANCER, BLACK LUNG DISEASE, RESPIRATORY FAILURE, COLLAPSED LUNG, AND OTHER PLEURAL DISEASES. THE GENESIS ORTHOPEDIC TEAM OF BOARD-CERTIFIED SURGEONS, SPECIALLY TRAINED NURSES, AND REHABILITATION THERAPISTS WORK TOGETHER TO DIAGNOSE AND TREAT THE MUSCULOSKELETAL ISSUES OF OUR PATIENTS. SERVICES RANGE FROM ADVANCED IMAGING TESTING THROUGH TO REHABILITATION. SURGICAL SURGERIES INCLUDE NUMEROUS PROCEDURES INCLUDING REPLACEMENT OF THE HIP, KNEE, OR SHOULDER AS WELL AS VARIOUS SURGERIES INVOLVING THE HAND. THE SPECIALIZED REHABILITATION PROGRAM SPEEDS RECOVERY AFTER A SERIOUS INJURY OR SURGERY RELATED TO A BONE, JOINT, LIGAMENT, TENDON OR MUSCLE. IN ADDITION TO PHYSICAL AND OCCUPATIONAL THERAPY, GENESIS ALSO PROVIDES AMPUTEE AND PROSTHETICS THERAPY AND TRAINING. IN 2023, GENESIS COSHOCTON MEDICAL CENTER OPENED. THIS IS A NEWLY CONSTRUCTED ACUTE CARE HOSPITAL FACILITY. COSHOCTION PROVIDES A WIDE RANGE OF SERVICES INCLUDING A 24/7 EMERGENCY DEPARTMENT, AN OUTPATIENT SURGERY CENTER, AN OVERNIGHT OBSERVATION UNIT, A LABORATORY, CARDIAC DIAGNOSTICS, RESPIRATORY THERAPY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, PHYSICIAN SPECIALISTS, AND AN IMAGING DEPARTMENT THAT OFFERS MRI, CT, X-RAY, 3D MAMMOGRAPHY, AND ULTRASOUND SERVICES.GENESIS HAS INCREASED IN VISISBILITY IN HOSPICE AND PALLITATIVE CARE IN THE COMMUNITY. GENESIS HOSPICE AND PALLIATIVE CARE PROVIDES SPECIAL CARE FOR PEOPLE WHO ARE TERMINALLY ILL. THIS INVOLVES A TEAM-ORIENTED APPROACH THAT ADDRESSES THE MEDICAL, PHYSICAL, SOCIAL, EMOTIONAL, AND SPIRITUAL NEEDS OF THE PATIENT. HOSPICE ALSO PROVIDES SUPPORT TO THE PATIENT'S FAMILY OR CAREGIVER. 520594877 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 306 0 1 4004 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 0 X 19 16 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X ADAM HOPPER 7404545333 2951 MAPLE AVENUE ZANESVILLE OH 43701 X KRISTY RITCHIE MD TRUSTEE 50.00 0.00 X 655571 0 42630 BRANDICE ALEXANDER DO PRESIDENT OF MEDICAL STAFF 50.00 0.00 X 656805 0 28913 ERIN REMSTER DO TRUSTEE 50.00 0.00 X 377489 0 28777 RANDY COCHRANE TRUSTEE 1.35 0.00 X 0 0 0 TOD KLOTZBACH VICE CHAIR 1.32 0.20 X X 0 0 0 JAMES MCDONALD CHAIR 1.32 0.52 X X 0 0 0 JIM NICHOLSON TREASURER 1.29 0.46 X X 0 0 0 MATT ABBOTT ASST. SECRETARY 1.17 0.00 X X 0 0 0 SCOTT MCCONNAHA EX-OFFICIO 1.29 0.00 X 0 0 0 SR MAUREEN ANNE SHEPARD TRUSTEE 1.35 0.80 X 0 0 0 PATRICK NASH TRUSTEE 1.35 0.20 X 0 0 0 DANA MATZ TRUSTEE 1.29 0.00 X 0 0 0 JOANN BUTCHER TRUSTEE 1.32 0.49 X 0 0 0 HANNAH NISSEN TRUSTEE 1.26 0.00 X 0 0 0 SUSAN HOLDREN TRUSTEE 1.32 0.00 X 0 0 0 WILLIAM NOLL TRUSTEE 1.35 0.00 X 0 0 0 LORI LOWE TRUSTEE 1.23 0.00 X 0 0 0 SUSAN HASSELER PHD TRUSTEE 1.26 0.00 X 0 0 0 MATTHEW PERRY PRESIDENT/CEO 49.83 0.17 X 1042506 0 35670 ADAM HOPPER CHIEF FINANCIAL OFFICER 50.00 0.00 X 130955 0 7542 DIANNA LEVECK CHIEF HUMAN RESOURCES OFFI 49.00 1.00 X 873193 0 34795 MICHAEL NORMAN CHIEF FINANCIAL OFFICER 48.92 1.08 X 628779 0 42020 EDMUND ROMITO CHIEF INFORMATION OFFICER 50.00 0.00 X 633577 0 30083 SCOTT WEGNER MD CHIEF CLINICAL OFFICER 50.00 0.00 X 584948 0 45865 SHARON PARKER CHIEF OPERATION OFFICER 49.00 1.00 X 599352 0 30843 WENDY CEDOZ CHIEF LEGAL OFFICER 48.79 1.21 X 586741 0 32553 CHRISTOPHER SCHOELLES CHIEF OPERATION OFFICER 50.00 0.00 X 552015 0 41089 LINDA SUPPLEE DIRECTOR/CPHO 50.00 0.00 X 540465 0 7071 SHON BENDER CHIEF NURSING OFFICER 48.96 0.04 X 501021 0 17608 LES BOYER DIRECTOR 50.00 0.00 X 293018 0 25103 GREG MATONAK DIRECTOR 50.00 0.00 X 276045 0 27851 MARIANNE GRAHAM DIRECTOR 50.00 0.00 X 246246 0 30199 TISHA BABCOCK DIRECTOR 50.00 0.00 X 211345 0 33495 CHARLES ADAMS LEAN SIX SIGMA, DIRECTOR 50.00 0.00 X 247413 0 24194 9637484 0 566301 304 0 1 0 MED ONE HOSPITAL PHYSICIANS 3525 OLENTAGY RIVER RD STE 330 COLUMBUS OH 43214 MEDICAL SERVICES 10859551 LABORATORY CORPORATION OF AMERICA HOLDIN PO BOX 12140 BURLINGTON NC 27216 LABORATORY SERVICES 3003167 ADVIZEX TECHNOLOGIES LLC PO BOX 72130 CLEVELAND OH 44192 MEDICAL SERVICES 2323894 GUIDEHOUSE 4511 PAYSPHERE CIRCLE CHICAGO IL 60674 PROFESSIONAL SERVICES 2276901 BDC ADVISORS LLC 151 N HOP HILL RD STE 465 PLANTATION FL 33324 PROFESSIONAL SERVICES 1534795 80 366238 1398718 7586 1772542 NET PATIENT SERVICES 621110 657399061 657399061 657399061 4429911 4429911 1500560 1816265 -315705 -315705 -315705 7133049 600 0 0 7133049 600 7133649 7133649 PHARMACY 621110 85393302 85393302 CAFETERIA SALES 621110 1578739 1578739 LABORATORY: UBI 900099 138606 138606 2378479 2288715 89764 89489126 759908584 744765373 228370 13142299 X 572423 572423 8447411 8447411 190761414 151570007 39191407 3411693 2688319 723374 30376178 23424436 6951742 15268772 11643966 3624806 627998 27771 600227 634934 634934 245621 245621 86500 86500 71822988 61198764 10624224 998859 183191 815668 6195210 725889 5469321 11650 5868 5782 15326248 2748721 12577527 373439 68796 304643 34460 6320 28140 14638990 14638990 23254571 7585641 15668930 7324109 1343242 5980867 MEDICAL SUPPLIES 201848666 201848666 BAD DEBT EXPENSE 33902558 33902558 DUES/LICENSES/SUBSCRIPT 18502882 3393433 15109449 HFF ASSESSMENT 13447215 13447215 4706924 4209651 497273 662821713 520594877 142226836 0 20358542 24469548 2023993 14626000 72890760 114930944 13026077 13423915 11010667 17810134 615326142 308021873 316975067 307304269 110522782 121680322 18163086 24066504 4281450 4860644 57597508 84942472 626849932 728114752 59501562 78513085 0 1899198 272913078 272612041 5112456 5376154 33145902 108821074 370672998 467221552 X 256176934 260893200 256176934 260893200 626849932 728114752 X 97086871 7535362 -99905967 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 86500 0 1 32061 118561 0 PART II-B, LINE 1: GENESIS HEALTHCARE SYSTEM PAYS MEMBERSHIP DUES AND A PORTION OF THOSE DUES ARE RELATED TO LOBBYING: OHIO HOSPITAL ASSOCIATION - FSCC SHARE (OHA): 6.20% OF $115,960 ($7,190) 340B HEALTH 2020: 6.00% OF $17,505 ($1,050) AMERICAN HEALTH INFORMATION MANAGEMENT ASSOCIATION (AHIMA): 5.00% OF $1,489 ($74) COLLEGE OF HEALTHCARE INFO MGMT EXECUTIVES (CHIME): 15.19% OF $870 ($132) MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA): 5.00% OF $23,000 ($1,150) SOC FOR HEALTHCARE STRATEGY & MARKET DEVELOPMENT (ASHE/AHA): 22.98% OF $150 ($34) TRAUMA CENTER ASSOC OF AMERICA (TCAA): 15.00% OF $2,000 ($300) AMERCIAN COLLEGE OF CARDIOLOGY NATIONAL (ACC): 13.16% OF $39,620 ($5,214) AMERICAN COLLEGE OF CARDIOLOGY STATE (ACC): 2.80% OF $39,620 ($1,109) AMERICAN COLLEGE OF OSTEOPATHIC FAMILY PHYSICIANS (ACOFP): 14.00% OF $445 ($62) AMERICAN COLLEGE OF RADIOLOGY (ACR): 9.40% OF $10,500 ($987) AMERICAN COLLEGE OF SURGEONS (ACS): 4.00% OF $61,913 ($2,477) AMERICAN SOCIETY FOR HEALTH CARE ENGINEERING, AMERICAN (ASHI): 22.73% OF $150 ($34) AMERICAN SOCIETY FOR ANESTESIOLOGIST NATIONAL (ASA): 9.00% OF $28,680 ($2,582) AMERICAN SOCIETY FOR ANESTESIOLOGIST STATE (ASA): 21.00% OF $28,680 ($6,022) ASSOCIATION OF COMMUNITY CANCER CENTERS (ACCC): 1.00% OF $630 ($6) OHIO CHAMBER OF COMMERCE: 30.00% OF $1,654 ($497) FINANCIAL HEALTHCARE MANAGEMENT ASSOCIATION (HFMA): 1.90% OF $399 ($8) AMERICAN MEDICAL ASSOCIATION (AMA): 75.00% OF $420 ($315) OHIO ASSOCIATION OF MEDICAL EQUIPMENT SUPPLIES (OAMES): 25.00% OF $995 ($249) VGM GROUP INC: 5.00% OF $3,060 ($153) AMERICAN AMBULANCE ASSOCIATION (AAA): 50.00% OF $4,833 ($2,416) GENESIS HEALTHCARE SYSTEM PAID SECOND CAPITAL CONSULTING, LLC $86,500 IN 2024 FOR ADVOCACY AND OUTREACH CONSULTING SERVICES. SECOND CAPITAL CONSULTING, LLC HAS PROVIDED ADVOCACY AND OUTREACH CONSULTING SERVICES TO GENESIS HEALTHCARE SYSTEM SINCE 2013. THESE SERVICES ASSIST THE SYSTEM TO ENGAGE, EDUCATE AND COMMUNICATE WITH PUBLIC POLICY MAKERS REGARDING PENDING LEGISLATION OR PROPOSED REGULATIONS, AS WELL AS ASSIST ELECTED OFFICIALS IN UNDERSTANDING THE IMPACT OF LEGISLATION ON GHCS'S ABILITY TO DELIVER COST EFFECTIVE, QUALITY CARE FOR PATIENTS IN SOUTHEAST OHIO. GENESIS WORKS PRIMARILY THROUGH NATIONAL AND STATE HOSPITAL ASSOCIATIONS, IN WHICH GENESIS HAS MEMBERSHIP, TO UNDERSTAND POTENTIAL POLICIES WHICH COULD NEGATIVELY AFFECT THEIR ABILITY TO WORK WITH THE LOCAL MEDICAL COMMUNITY TO MEET THE HEALTHCARE NEEDS OF THE REGION. SOME ISSUES OF INTEREST INCLUDE THE 340B PROGRAM, MEDICARE & MEDICAID BUDGET DECISIONS AND REGULATIONS, AND INFRASTRUCTURE IMPROVEMENTS AT THE LOCAL LEVEL THAT ENHANCE ACCESS TO THE HOSPITAL. IN FACT, A DIRECT ACCESS LANE OPENED THIS YEAR FOR EMERGENCY VEHICLES, SPEEDING THE TIME CRITICAL TO PATIENTS IN ARRIVING FOR EMERGENCY CARE. 10745900 10745900 286589286 58633674 227955612 8119071 4823432 3295639 285773915 236918014 48855901 24097970 7646753 16451217 307304269 INVESTMENTS IN RELATED AND OTHER HEALTHCARE ORGANIZATIONS 3687016 ASSETS LIMITED AS TO USE 31425644 RIGHT OF USE LEASE ASSETS 41457227 CONSTRUCTION IN PROGRESS 2163774 COST REPORT SETTLEMENT RECEIVABLE 315037 CAPITAL LEASES 5893774 84942472 ACCRUED MINIMUM PENSION LIABILITY 1533728 ACCRUED PROFESSIONAL LIABILITY 5058610 LEASE LIABILITIES - OPERATING 37262057 LEASE LIABILITIES - FINANCING 4434675 INTERCOMPANY PAYABLES 60532004 108821074 X PART X, LINE 2: THE SYSTEM AND ITS SUBSIDIARIES ARE TAX-EXEMPT ORGANIZATIONS, EXCEPT FOR CARELIFE; ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE CONSOLIDATED FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND TO RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE OR OTHER APPLICABLE TAXING AUTHORITIES. 1 1 X 1 X 1 X 1 1 1 0 1 1 10017 1638795 0 1638795 0.00260 118497 93847446 66222318 27625128 0.04390 128514 95486241 66222318 29263923 0.04650 50 112536 1162639 61719 1100920 0.00180 7 2630 3032619 3032619 0.00480 12 6116 306827 750 306077 0.00050 69 121282 4502085 62469 4439616 0.00710 69 249796 99988326 66284787 33703539 0.05360 0 33902558 112770742 110686030 2084712 X 1 1 1 1 GENESIS HOSPITAL 2951 MAPLE AVE ZANESVILLE OH 43701 X X X ACUTE CARE HOSPITAL GENESIS HOSPITAL 1 0 0 1 X X X X X X X X X X 24 1 0 1 1 X HTTPS://WWW.GENESISHCS.ORG/SITES/DEFAULT/FILES/2025-01/GENESIS%20HEALTHCARE X 1 22 1 HTTPS://WWW.GENESISHCS.ORG/SITES/DEFAULT/FILES/2023-01/CCB-2022-2024-IMPLEM 0 1 X 100.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X HTTPS://WWW.GENESISHCS.ORG/PATIENTS/FINANCIAL-ASSISTANCE X HTTPS://WWW.GENESISHCS.ORG/PATIENTS/FINANCIAL-ASSISTANCE X HTTPS://WWW.GENESISHCS.ORG/PATIENTS/FINANCIAL-ASSISTANCE X X X X X 1 X 0 X X X X 1 X 0 0 GENESIS HOSPITAL PART V, SECTION B, LINE 5: HEALTH NEEDS WERE ASSESSED THROUGH A REVIEW OF THE SECONDARY (EXISTING) HEALTH DATA COLLECTED AND ANALYZED PRIOR TO CONDUCTING THE INTERVIEWS, FOCUS GROUPS AND SURVEY (PRIMARY DATA COLLECTION). THE INFORMATION AND DATA FROM BOTH THE SECONDARY AND PRIMARY DATA COLLECTION INFORMS THIS CHNA REPORT AND THE DECISIONS ON HEALTH NEEDS THAT THE SOUTHEASTERN OHIO HEALTH COLLABORATIVE (SOHIC) WILL ADDRESS IN ITS IMPLEMENTATION STRATEGY/IMPROVEMENT PLAN (CHIP). KEY INFORMANT INTERVIEWS WERE USED TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY. WE SPOKE WITH EXPERTS FROM VARIOUS ORGANIZATIONS SERVING THE GENESIS SERVICE AREA (GSA) COMMUNITY, INCLUDING LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS, AND LEADERS FROM LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES. FOCUS GROUPS WERE USED TO GATHER INFORMATION AND OPINIONS FROM SPECIFIC SUB-POPULATIONS IN THE COMMUNITY WHO ARE MOST AFFECTED BY HEALTH NEEDS. FOCUS GROUPS INCLUDED LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY POPULATIONS, AND LEADERS FROM LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES. GENESIS HOSPITAL PART V, SECTION B, LINE 6B: THE SOUTHEASTERN OHIO HEALTH IMPROVEMENT COLLABORATIVE (SOHIC) INCLUDES GENESIS HEALTHCARE SYSTEM (GHS), MORGAN COUNTY HEALTH DEPARTMENT (MCHD), NOBLE COUNTY HEALTH DEPARTMENT (NCHD), PERRY COUNTY HEALTH DEPARTMENT (PCHD), AND ZANESVILLE-MUSKINGUM COUNTY HEALTH DEPARTMENT (ZMCHD). GENESIS HOSPITAL PART V, SECTION B, LINE 7D: WIDELY AVAILABLE BY POSTING ON THE HOSPITAL WEBSITE (REPORT WILL BE MADE AVAILABLE IN OTHER FORMATS SUCH AS PAPER UPON REQUEST). GENESIS HOSPITAL PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY/IMPROVEMENT PLAN (CHIP) IDENTIFY AND ADDRESS SIGNIFICANT COMMUNITY HEALTH NEEDS AND HELP GUIDE COMMUNITY BENEFIT ACTIVITIES. THIS IMPLEMENTATION STRATEGY/CHIP EXPLAINS HOW THE SOUTHEASTERN OHIO HEALTH IMPROVEMENT COLLABORATIVE (SOHIC) PLANS TO ADDRESS THE SELECTED PRIORITY HEALTH NEEDS IDENTIFIED BY THE CHNA. SOHIC IS COMMITTED TO MONITORING KEY INDICATORS TO ASSESS IMPACT. OUR REPORTING PROCESS INCLUDES THE COLLECTION AND DOCUMENTATION OF TRACKING MEASURES, SUCH AS THE NUMBER OF PEOPLE REACHED/SERVED AND COLLABORATIVE EFFORTS TO ADDRESS HEALTH NEEDS. A REVIEW OF THE IMPACT OF SOHIC'S ACTIONS TO ADDRESS THESE SIGNIFICANT HEALTH NEEDS WILL BE REPORTED IN THE NEXT SCHEDULED CHNA. SINCE SOHIC CANNOT DIRECTLY ADDRESS ALL THE HEALTH NEEDS PRESENT IN THE COMMUNITY, WE WILL CONCENTRATE OUR RESOURCES ON THOSE HEALTH NEEDS WHERE WE CAN EFFECTIVELY IMPACT OUR REGION GIVEN OUR AREAS OF FOCUS AND EXPERTISE. TAKING EXISTING ORGANIZATION AND COMMUNITY RESOURCES INTO CONSIDERATION, SOHIC WILL NOT DIRECTLY ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA, INCLUDING BUT NOT LIMITED TO CRIME AND VIOLENCE, ACCESS TO CHILDCARE, ENVIRONMENTAL CONDITIONS, INTERNET ACCESS, INJURIES, AND HIV/AIDS AND STIS. WE WILL CONTINUE TO LOOK FOR OPPORTUNITIES TO ADDRESS COMMUNITY NEEDS WHERE WE CAN MAKE A MEANINGFUL CONTRIBUTION. COMMUNITY PARTNERSHIPS MAY SUPPORT OTHER INITIATIVES THAT SOHIC CANNOT INDEPENDENTLY LEAD TO ADDRESS THE OTHER HEALTH NEEDS IDENTIFIED IN THE CHNA. THE IMPLEMENTATION STRATEGY SUPPORTING THE 2024 CHNA WAS ADOPTED IN 2025 AND THAT DATE WILL BE UPDATED ON THE FYE2025 FORM 990. SCHEDULE H, PART V, LINE 5 CON'T: MULTIPLE SETS OF WEIGHTINGS WERE CREATED AND USED IN THE STATISTICAL SOFTWARE PACKAGE (SPSS 26.0) WHEN CALCULATING FREQUENCIES. FOR ANALYSES DONE FOR THE ENTIRE SAMPLE AND ANALYSES DONE BASED ON SUBGROUPS OTHER THAN AGE, RACE, SEX, OR INCOME THE WEIGHTINGS THAT WERE CALCULATED BASED ON THE PRODUCT OF THE FOUR WEIGHTING VARIABLES (AGE, RACE, SEX, INCOME) FOR EACH INDIVIDUAL. WHEN ANALYSES WERE DONE COMPARING GROUPS WITHIN ONE OF THE FOUR WEIGHTING VARIABLES (E.G., SMOKING STATUS BY RACE/ETHNICITY), THAT SPECIFIC VARIABLE WAS NOT USED IN THE WEIGHTING SCORE THAT WAS APPLIED IN THE SOFTWARE PACKAGE. IN THE EXAMPLE SMOKING STATUS BY RACE, THE WEIGHTING SCORE THAT WAS APPLIED DURING ANALYSIS INCLUDED ONLY AGE, SEX, AND INCOME. THUS, A TOTAL OF EIGHT WEIGHTING SCORES FOR EACH INDIVIDUAL WERE CREATED AND APPLIED DEPENDING ON THE ANALYSIS CONDUCTED. 23 1 - HEALTHPLEX 2800 MAPLE AVENUE ZANESVILLE OH 43701 OUTPATIENT LAB/ IMAGING, PEDIATRIC REHAB 2 - MEDICAL ARTS BUILDING (MAB) II 751 FOREST AVENUE ZANESVILLE OH 43701 OUTPATINT DIAGNOSTIC 3 - MOB II 955 BETHESDA DR ZANESVILLE OH 43701 OUTPATIENT DIAGNOSTIC & EDUCATION 4 - GENESIS PHYISCIAN'S PAVILION 945 BETHESDA DR ZANESVILLE OH 43701 OUTPAIENT CARDOAC REHAB SERVICES; WOUND CARE CENTER 5 - GENESIS BEHAVIORAL HEALTH 2991 MAPLE AVE ZANESVILLE OH 43701 MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT 6 - SARAP CANCER CENTER 2951 MAPLE AVE ZANESVILLE OH 43701 CANCER & PALLATIVE CARE/ WOMEN'S BOUTIQUE 7 - GENESIS SURGERY CENTER 2907 MAPLE AVE ZANESVILLE OH 43701 OUTPATIENT SURGERY 8 - GENESIS ORTHOPEDIC CENTER 2904 BELL STREET ZANESVILLE OH 43701 OUTPATIENT ORTHODIC AND SPORTMEDICINE DIAGNOTICS 9 - GENESIS OUTPATIENT REHAB 3297 NAOKE AVE ZANESVILLE OH 43701 OUTPATIENT REHAB AND IMAGING 10 - GENESIS VEIN CENTER 930 BETHESDA DR ZANESVILLE OH 43701 DIAGNOSTIC AND TREATMENT OF OUTPATIENT VEIN DISORDERS 11 - GENESIS INTERVENTIONAL PAIN MGMT CLINIC 2945 MAPLE AVE ZANESVILLE OH 43701 PAIN MEDICINE SPECIALIZATION; IMAGING TECHNIQUES; SOLUTIONS TO PAIN 12 - CAMBRIDGE HEALTH CENTER 61353 SOUTHGATE PARKWAY CAMBRIDGE OH 43725 IMAGING SERVICES/ LAB SERVICE/ WOUND MANAGEMENT 13 - GENESIS SLEEP DISORDERS CENTER 840 BETHESDA DR ZANESVILLE OH 43701 DIAGNOSTICS AND TREATMENT OF SLEEP DISORDERS 14 - GENESIS HEALTH CENTER - PERRY COUNTY 301 DR MIKE CLOUSE DR SOMERSET OH 43783 DIAGNOSITIC HEALTHCARE SERVICES/ PHYSICAL & OCCUPATIONAL THERAPY 15 - GENEIS ENDOCRINOLOGY 860 BETHESDA DR ZANESVILLE OH 43701 EDUCATION AND OUTPATIENT ENDOCRINOLOGY SERVICES 16 - GENESIS HEALTHCARE CENTER - NEW CONCORD 1 EAST MAIN STREET NEW CONCORD OH 43762 LAB SERVICES 17 - HOSPICE & PALLIATIVE CARE 713 FOREST AVE ZANESVILLE OH 43701 HOSPICE & PALLIATIVE CARE CENTER 18 - GENESIS NEW LEXINGTON DRAW CENTER 401 LINCOLN PARK DR NEW LEXINGTON OH 43764 LAB SERVICES 19 - GENEIS RHEUMAOLOGY CARE CENTER 2525 MAPLE AVE ZANESVILLE OH 43701 EDUCATION AND OUTPATIENT RHEUMATOLOGY SERVICE 20 - GENESIS SPECIALY CENTER 1452 CLARK ST CAMBRIDGE OH 43725 LAB SERVICES 21 - IMAGING MVHC PUTNAM 915 PUTNAM AVE ZANESVILLE OH 43701 LAB SERVICES 22 - IMAGING MVHC MALTA 859 S MAIN ST STE 146 MALTA OH 43758 LAB SERVICES 23 - GENESIS COSHOCTON MEDICAL CENTER 48439 GENESIS DRIVE COSHOCTON OH 43812 MEDICAL CENTER PART I, LINE 7: COSTS OF CHARITY CARE AND COMMUNITY BENEFIT ACTIVITIES WERE CALCULATED USING THE HOSPITAL'S COST ACCOUNTING SYSTEM.PART I, LINE 7, COLUMN (F): PERCENTAGE OF TOTAL EXPENSES WAS CALCULATED BASED ON TOTAL EXPENSES LESS BAD DEBT EXPENSE AS REPORTED ON FORM 990, PART IX.PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $33,902,558. PART II, COMMUNITY BUILDING ACTIVITIES: GENESIS HAS AN ACTIVE PRESENCE ON MANY COMMITTEES INVOLVED IN FINDING LOW-COST SOLUTIONS TO PHYSICAL AND MENTAL HEALTH ISSUES PREVALENT IN OUR COMMUNITIES, WITH PARTICULAR FOCUS ON SERVING LOW-INCOME, UNINSURED OR OTHERWISE UNDERSERVED. FOR EXAMPLE, GENESIS FACILITATES BOTH A SOCIAL DETERMINANTS OF HEALTH COLLABORATIVE AND A COMMUNITY HEALTH NEEDS COLLABORATIVE WITH LOCAL HEALTH DEPARTMENTS AND HEALTH PARTNERS AS WELL, TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH AND COMMONLY IDENTIFIED COMMUNITY HEALTH NEEDS INTENTIONALLY AND COLLABORATIVELY. THESE ACTIVITIES ARE CAPTURED IN PART I, LINE 7I AS IN-KIND CONTRIBUTIONS BY THE SERVICE LINES UNDER COMMUNITY HEALTH IMPROVEMENT ACTIVITIES. COMMUNITY BUILDING ACTIVITIES ARE CURRENTLY NOT PART OF THE DOCUMENTATION FOR COMMUNITY BENEFIT, BUT MAY BE DEVELOPED IN THE FUTURE. PART III, LINE 2: BAD DEBT IS CALCULATED USING GROSS CHARGES. PART III, LINE 3: NO BAD DEBT IS ESTIMATED TO RELATE TO CHARITY CARE. PART III, LINE 4: THE FINANCIAL STATEMENT FOOTNOTE RELATED TO BAD DEBT IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENT FOOTNOTE 1 "NATURE OF BUSINESS AND SIGNIFICANT ACCOUNTING POLICIES" GROUPED WITH ACCOUNTS RECEIVABLE ON PAGE 9. PART III, LINE 8: THE SYSTEM TREATS MEDICARE SHORTFALL AS COMMUNITY BENEFIT. THE REASONS FOR THIS TREATMENT INCLUDES (1) NON-NEGOTIABLE MEDICARE RATES ARE SOMETIMES NOT ALIGNED WITH THE TRUE COSTS OF TREATING MEDICARE PATIENTS; (2) THE SYSTEM IS ALLEVIATING THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES; AND (3) IRS REV. RUL. 69-545 NOTES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THIS ACTION INDICATES THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. PART III, LINE 9B: ALL PATIENTS ARE OFFERED A PLAIN LANGUAGE SUMMARY (PLS) OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY PRIOR TO DISCHARGE FROM THE HOSPITAL. AT LEAST THREE SEPARATE COMMUNICATIONS WILL BE MAILED TO THE LAST KNOWN ADDRESS OF THE RESPONSIBLE PARTY ALSO CONTAINING THE PLS. AT LEAST 60 DAYS WILL LAPSE BETWEEN THE FIRST AND THIRD REQUIRED COMMUNICATION. DETAILED ITEMIZED STATEMENTS WILL BE MADE AVAILABLE UPON REQUEST EXCEPT WHERE PROHIBITED BY STATE OR FEDERAL REGULATIONS. ACCOUNTS WITH ZERO BALANCES WILL NOT RECEIVE THREE SEPARATE COMMUNICATIONS; HOWEVER, THESE ACCOUNT HOLDERS MAY ALSO BE ELIGIBLE TO APPLY FOR FINANCIAL ASSISTANCE. ALL RESPONSIBLE PARTIES WILL RECEIVE WRITTEN NOTIFICATION REGARDING EXTRAORDINARY COLLECTION ACTIONS (ECA) THAT MAY COMMENCE IF ACTION IS NOT TAKEN. THIRTY DAYS WILL LAPSE BETWEEN ISSUANCE OF NOTIFICATION AND COMMENCEMENT OF ECA. ACTION TAKEN BY THE RESPONSIBLE PARTY CONSTITUTES MAKING PAYMENT ARRANGEMENTS FOR THE AMOUNT DUE OR COMPLETING A FINANCIAL ASSISTANCE APPLICATION. ACCOUNTS GO TO FULL COLLECTION AFTER DAY 120 IF NO PRIOR ARRANGEMENTS HAVE BEEN MADE. COLLECTION AGENCIES ARE INSTRUCTED TO MAKE PHONE CALLS AND SEND LETTERS. IF THEY CANNOT RESOLVE THE BALANCE, OR HAVE NOT BEEN ABLE TO MAKE PAYMENT ARRANGEMENTS, THE ACCOUNT IS SENT BACK TO GENESIS AS NON-COLLECTIBLE IN 24 MONTHS. PART VI, LINE 2: A COMMUNITY BENEFIT STEERING COMMITTEE COLLABORATES WITH GENESIS ADMINISTRATION, DEPARTMENTS, AND WITH COMMUNITY AGENCIES IN OUR DEFINED GEOGRAPHIC MARKET, INCLUDING BUT NOT LIMITED TO THE PUBLIC HEALTH DEPARTMENTS, MUSKINGUM VALLEY HEALTH CENTERS, AND THE UNITED WAY, TO ASSESS COMMUNITY HEALTH NEEDS AND STRENGTHS; DEVELOP A COMMUNITY BENEFIT PLAN WITH STRATEGIC GOALS AND INTERVENTIONS; MONITOR IMPLEMENTATION OF COMMUNITY BENEFIT ACTIVITIES; EVALUATE COMMUNITY BENEFIT ACTIVITIES; ADVOCATE FOR THE COMMUNITY BENEFIT PROGRAMS; AND ASSIST IN TELLING THE GENESIS HOSPITAL COMMUNITY BENEFIT STORY.GENESIS PARTNERS WITH OUR ENTIRE LOCAL POST-ACUTE COMMUNITY, WHICH ENCOMPASSES SKILLED NURSING FACILITATES, LONG-TERM CARE, AND HOME HEALTH AGENCIES, WITH THE INTENT OF BETTERING THE TRANSITIONS OF CARE OF PATIENTS RECEIVE ONCE THEY LEAVE OUR HOSPITAL AND UNDERSTANDING THE NEEDS THAT ARISE WITHIN THESE FACILITIES IN OUR COMMUNITY. ON A BI-MONTHLY BASIS DATA IS REVIEWED AND REMEDIATION PLANS ARE FORMULATED AROUND ANY UNDERPERFORMING AREAS. WE ALSO PROVIDE ON-SITE, DISEASE-SPECIFIC EDUCATION FOR THOSE AGENCIES THAT DEMONSTRATE A NEED TO FURTHER DEVELOP THEIR STAFF IN THIS REGARD.GENESIS ACTIVELY PARTICIPATES IN MANY COMMUNITY COHORTS FOCUSED ON THE COMMUNITY'S HEALTH NEEDS INCLUDING THE HOMELESS AND HOUSING COMMITTEE, OHIO HEALTH IMPROVEMENT ZONES, COMMUNITY HEALTH WORKER PILOT PROGRAM THROUGH OHIO UNIVERSITY -ZANESVILLE, AND THE HEALTHIER MUSKINGUM COUNTY NETWORK. GENESIS HOSTS A QUARTERLY SOCIAL DETERMINANTS OF HEALTH (SDOH) WORKGROUP WHICH INCLUDES SEVERAL COMMUNITY AGENCIES. THE GOAL BEHIND THIS GROUP IS TO USE GENESIS-PROVIDED SDOH DATA TO IDENTIFY AT-RISK POPULATIONS, AND CREATE ACTION PLANS WITH THE RESOURCES AVAILABLE.GENESIS ALSO LEADS A COMMUNITY HEALTH NEEDS COLLABORATIVE MADE UP OF 5 COUNTY HEALTH DEPARTMENTS FROM THE GENESIS SERVICE AREA, AND GENESIS TEAM MEMBERS. THIS COLLABORATIVE SUPPORTS A COMBINED HEALTH NEEDS ASSESSMENT AND PLANNING PROCESS EVERY THREE YEARS, FOLLOWED BY CONTINUED DISCUSSIONS AND SUPPORT IN MEETING IDENTIFIED NEEDS. THIS GROUP ALSO PROVIDES OPPORTUNITY TO DISCUSS EMERGING NEEDS SEEN IN COMMUNITIES BETWEEN EACH NEEDS ASSESSMENT. FREQUENT MEETINGS ARE CONDUCTED OVER THE YEAR TO PROVIDE UPDATES ON CURRENT PROGRAMS AND THEIR EFFECTIVENESS. ANNUAL RESULTS ARE THEN PUBLISHED ANNUALLY: HTTPS://WWW.GENESISHCS.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-AND-IMPLEMENTATION-STRATEGY PART VI, LINE 3: GENESIS HAS SIGNAGE STRATEGICALLY LOCATED IN THE FACILITY (REGISTRATION AREAS AND CASHIER AREAS) ADVISING OF FREE CARE. BILLING STATEMENTS ALSO CONTAIN THIS INFORMATION ALONG WITH A CHARITY CARE APPLICATION PRINTED ON THE REVERSE SIDE OF THE BILL. THE INFORMATION IS ALSO AVAILABLE ON OUR WEBSITE. WE HAVE REGISTRATION STAFF THAT WORK IN THE EMERGENCY DEPARTMENT TO SCREEN PATIENTS FOR POTENTIAL MEDICAID QUALIFIERS IF THE PATIENT ALLOWS. FOR INPATIENTS, WE HAVE RESOURCE COUNSELING STAFF THAT SCREEN SELF-PAY, UNDERINSURED AND MEDICARE ONLY PATIENTS FOR MEDICAID AND/OR CHARITY. PART VI, LINE 4: GENESIS HEALTHCARE SYSTEM DEFINES THEIR PRIMARY SERVICE AREA (GSA) AS BEING MADE UP OF COSHOCTON, GUERNSEY, MORGAN, MUSKINGUM, NOBLE, AND PERRY COUNTIES, OHIO. THESE COUNTIES ARE IN THE SOUTHEASTERN CORNER OF OHIO. ALL COUNTIES WE SERVE ARE FEDERALLY DESIGNATED AS APPALACHIAN COUNTIES. COSHOCTON, GUERNSEY, MORGAN, AND PERRY HAVE A DESIGNATED ECONOMIC STATUS OF "AT-RISK" BY THE APPALACHIAN REGIONAL COMMISSION. NOBLE IS DESIGNATED AS "DISTRESSED", AND MUSKINGUM IS DESIGNATED AS "TRANSITIONAL." SIMILARLY, ALL COUNTIES ARE DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS, AND DENTAL AND MENTAL HEALTH PROFESSIONAL SHORTAGE AREAS. THE GSA'S POPULATION IS 224,771. THE POPULATIONS OF BOTH THE GSA AND OHIO REMAINED RELATIVELY THE SAME IN THE PAST 3 YEARS. ON AVERAGE, GSA COUNTIES ARE RANKED 63RD OF 88 RANKED COUNTIES IN OHIO, ACCORDING TO SOCIAL, ECONOMIC, AND HEALTH FACTORS (WITH 1 BEING THE BEST), PLACING IT IN THE BOTTOM THIRD OF THE STATE'S COUNTIES. THE % OF MALES AND FEMALES IS APPROXIMATELY EQUAL. YOUTH AGES 0-19 AND SENIORS 65+ MAKE UP 43% OF THE POPULATION. 6% OF GSA RESIDENTS ARE VETERANS, SLIGHTLY HIGHER THAN THE STATE RATE. IN THE GSA, NEARLY 1 IN 5 RESIDENTS ARE AGE 65+. 96% OF THE POPULATION IN THE GSA SPEAKS ONLY ENGLISH. 1% ARE FOREIGN-BORN. THE MAJORITY (94%) OF THE POPULATION IN THE GSA IDENTIFIES AS WHITE AS THEIR ONLY RACE. THE LIFE EXPECTANCY IN THE GSA OF 74.4 YEARS IS 1.2 YEARS SHORTER THAN IT IS FOR THE STATE OF OHIO. 1 IN 195 GSA RESIDENTS WILL DIE PREMATURELY, WHICH IS APPROXIMATELY THE SAME AS THE OHIO STATE RATE. PART VI, LINE 5: 1. OPEN MEDICAL STAFF MODELGENESIS OPERATES WITH AN OPEN MEDICAL STAFF MODEL, ALLOWING INDEPENDENT PHYSICIANS TO APPLY FOR PRIVILEGES AND PRACTICE WITHIN THE SYSTEM. 2. COMMUNITY-BASED GOVERNANCEGENESIS HEALTHCARE SYSTEM OPERATES UNDER A COMMUNITY-BASED GOVERNANCE MODEL AND IS JOINTLY SPONSORED BY TWO BOARDS: THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY, A CATHOLIC SPONSOR, AND THE BETHESDA BOARD. THIS DUAL SPONSORSHIP REFLECTS THE SYSTEM'S HISTORICAL ROOTS, FORMED THROUGH THE 1997 AFFILIATION OF GOOD SAMARITAN MEDICAL CENTER AND BETHESDA CARE SYSTEMTWO ORGANIZATIONS THAT HAD SERVED THE COMMUNITY FOR OVER A CENTURY. 3. REINVESTMENT OF SURPLUS FUNDSAS A NOT-FOR-PROFIT HEALTH SYSTEM, GENESIS REINVESTS ANY SURPLUS FUNDS DIRECTLY INTO IMPROVING PATIENT CARE, EXPANDING SERVICES, UPGRADING FACILITIES, AND SUPPORTING COMMUNITY BENEFIT PROGRAMS. THESE REINVESTMENTS HELP SUSTAIN LONG-TERM ACCESS TO QUALITY HEALTHCARE FOR ALL RESIDENTS, REGARDLESS OF THEIR ABILITY TO PAY 4. CHARITY CARE AND FINANCIAL ASSISTANCEGENESIS PROVIDES MILLIONS OF DOLLARS ANNUALLY IN CHARITY CARE AND ABSORBS SIGNIFICANT LOSSES FROM UNDER-REIMBURSED GOVERNMENT PROGRAMS LIKE MEDICARE AND MEDICAID. THIS FINANCIAL COMMITMENT ENSURES THAT VULNERABLE POPULATIONS CONTINUE TO RECEIVE ESSENTIAL HEALTHCARE SERVICES 5. 340B DRUG PRICING PROGRAM PARTICIPATIONTHROUGH PARTICIPATION IN THE FEDERAL 340B PROGRAM, GENESIS IS ABLE TO OFFER DISCOUNTED OUTPATIENT MEDICATIONS TO LOW-INCOME, UNINSURED, AND MEDICAID PATIENTS, FURTHER REDUCING BARRIERS TO CARE 6. EMPLOYEE VOLUNTEERISM AND COMMUNITY ENGAGEMENTGENESIS ENCOURAGES STAFF TO ENGAGE IN COMMUNITY SERVICE THROUGH A FORMAL EMPLOYEE VOLUNTEER PROGRAM. THIS INITIATIVE STRENGTHENS TIES BETWEEN THE HEALTH SYSTEM AND THE COMMUNITY WHILE PROMOTING A CULTURE OF SERVICE AMONG HEALTHCARE PROFESSIONALS. PART VI, LINE 6: GENESIS HEALTHCARE SYSTEM PARTNERS WITH A NETWORK OF AFFILIATED ORGANIZATIONS TO EXTEND ITS MISSION OF IMPROVING THE HEALTH OF THE COMMUNITIES IT SERVES. KEY AFFILIATES INCLUDE: GENESIS CHILDREN'S CENTER, WHICH PROVIDES HIGH-QUALITY EARLY CHILDHOOD EDUCATION AND CARE, INCLUDING TODDLER AND PRESCHOOL PROGRAMS, FULL-DAY AND DROP-IN CARE, LATCHKEY SERVICES, AND SUMMER PROGRAMS FOR SCHOOL-AGE CHILDREN. GENESIS OXYGEN & SLEEP THERAPY, OFFERING RESPIRATORY AND SLEEP-RELATED MEDICAL EQUIPMENT AND SUPPORT TO PATIENTS MANAGING CHRONIC CONDITIONS AT HOME. GENESIS PHARMACIES, WHICH PROVIDE PRESCRIPTION SERVICES, HOME MEDICAL EQUIPMENT, AND PHARMACY SUPPORT FOR LONG-TERM CARE FACILITIES, WITH ADDED CONVENIENCES SUCH AS FREE LOCAL DELIVERY AND DRIVE-UP WINDOWS. GENESIS COMMUNITY AMBULANCE SERVICE, LAUNCHED IN 2021 TO PROVIDE FREE TRANSPORTATION HOME FOR PATIENTS WHO HAD TESTED POSITIVE FOR OR WERE EXPOSED TO COVID-19 AND WERE UNABLE TO SECURE RIDES THROUGH TRADITIONAL MEANS. IN 2022, GENESIS BEGAN REIMBURSING THE COST OF THESE RIDES AND EXPANDED THE SERVICE TO INCLUDE PATIENTS WITH NO OTHER MEANS OF TRANSPORTATION. ACCESS TO RELIABLE TRANSPORTATION REMAINS A SIGNIFICANT NEED IN THE GENESIS SERVICE AREA. GENESIS IMAGING, OFFERING A FULL SPECTRUM OF ADVANCED DIAGNOSTIC IMAGING SERVICESINCLUDING MRI, CT, ULTRASOUND, DIGITAL MAMMOGRAPHY, AND NUCLEAR MEDICINE. GENESIS ANESTHESIA PROVIDERS (GAP), A DEDICATED TEAM OF ANESTHESIA PROFESSIONALS SUPPORTING SURGICAL AND PROCEDURAL CARE ACROSS GENESIS FACILITIES. GENESIS MEDICAL GROUP (GMG), A NETWORK OF SPECIALTY PROVIDERS COMMITTED TO DELIVERING COORDINATED, PATIENT-CENTERED CARE THROUGHOUT THE REGION. GENESIS PRIMARY CARE PHYSICIANS (GPCP), A GROUP OF DEDICATED FAMILY MEDICINE AND INTERNAL MEDICINE PROVIDERS FOCUSED ON PREVENTIVE CARE, CHRONIC DISEASE MANAGEMENT, AND LONG-TERM PATIENT RELATIONSHIPS TO SUPPORT OVERALL HEALTH AND WELLNESS. GENESIS EMERGENCY PHYSICIANS (GEP), A TEAM OF BOARD-CERTIFIED EMERGENCY MEDICINE PHYSICIANS AND ADVANCED PROVIDERS PROVIDING 24/7 CARE IN GENESIS EMERGENCY DEPARTMENTS. GENESIS INTEGRATED HEALTH NETWORK, A CLINICALLY INTEGRATED NETWORK THAT BRINGS TOGETHER PHYSICIANS, HOSPITALS, AND OTHER PROVIDERS TO IMPROVE QUALITY, ENHANCE PATIENT OUTCOMES, AND REDUCE HEALTHCARE COSTS. HEALTHYPATH, A COMMUNITY-BASED HEALTH PLAN OFFERED IN PARTNERSHIP WITH GENESIS HEALTHCARE SYSTEM, QUALITY CARE PARTNERS, AND LOCAL BENEFIT ADVISORS. DESIGNED FOR EMPLOYER-SPONSORED HEALTH PLANS WITH FIVE OR MORE ENROLLED EMPLOYEES, HEALTHYPATH COMBINES THE PREDICTABILITY OF A FULLY INSURED PLAN WITH THE COST SAVINGS OF A SELF-INSURED MODEL. IT FEATURES CONCIERGE NETWORK MANAGEMENT, LOW-COST PHARMACY BENEFITS, AND REINSURANCE, WHILE OFFERING MEMBERS $0 DEDUCTIBLES AND $0 COPAYS FOR MOST SERVICES WHEN USING LOCAL HEALTHCARE PARTNERS GENESIS HEALTHCARE FOUNDATION, A NOT-FOR-PROFIT ORGANIZATION THAT SUPPORTS THE MISSION OF GENESIS THROUGH PHILANTHROPIC EFFORTS. THE FOUNDATION RAISES FUNDS TO ENHANCE PATIENT CARE, EXPAND COMMUNITY HEALTH INITIATIVES, AND SUPPORT CAPITAL IMPROVEMENTS AND ADVANCED TECHNOLOGY. THROUGH GENEROUS DONATIONS FROM INDIVIDUALS, BUSINESSES, AND COMMUNITY PARTNERS, THE FOUNDATION HELPS ENSURE THAT HIGH-QUALITY, COMPASSIONATE CARE REMAINS ACCESSIBLE TO ALL. PART VI, LINE 7, REPORTS FILED WITH STATES OH 1 UNITED WAY OF COSHOCTON COUNTY 402 MAIN ST COSHOCTON OH 43812 311020238 501(C)(3) 5016 0 CORPORATE DONATION FOR PLEDGE CAMPAIGN GENESIS HEALTHCARE FOUNDATION 1135 MAPLE AVENUE ZANESVILLE OH 43701 311629034 501(C)(3) 63919 0 DONATION FOR AT RISK COMPENSATION GENESIS HEALTHCARE NURSES LINE 1135 MAPLE AVENUE ZANESVILLE OH 43701 311629034 501(C)(3) 53392 0 COMMUNITY NURSES LINE BUCKEYE VALLEY FAMILY YMCA 1425 NEWARK RD ZANESVILLE OH 43701 316053101 501(C)(3) 55000 0 CORPORATE DONATION FOR PLEDGE CAMPAIGN UNITED WAY OF MPM COUNTIES 526 PUTNAM AVENUE ZANESVILLE OH 43701 314379456 501(C)(3) 20000 0 CORPORATE DONATION FOR PLEDGE CAMPAIGN CENTRAL AMERICAN MEDICAL OUTREACH 322 WESTWOOD AVENUE ORVILLE OH 44667 341740695 501(C)(3) 0 260626 FMV DONATION OF SUPPLIES MUSKINGUM VALLEY HEALTH CENTER 716 ADAIR AVENUE ZANESVILLE OH 43701 208814374 501(C)(3) 55000 0 CORPORATE DONATION FOR PATIENT CARE CHARITABLE FUNDS MUSKINGUM COUNTY COMMUNITY FOUNDATION 534 PUTMAN AVENUE ZANESVILLE OH 43701 311147022 501(C)(3) 10000 0 GROUNDHOG DAY CELEBRATION & HALF MARATHON RACE OUR TOWN COSHOCTON PO BOX 1633 COSHOCTON OH 43812 455063130 501(C)(3) 20000 0 CORPORATE SPONSORSHOP FOR OUR TOWN COSHOCTON JUNIOR ACHIEVEMENT OF CENTRAL OHIO 68 E 2ND ST AVE COLUMBUS OH 43201 314385042 501(C)(3) 7500 0 "INSPIRE" SPONSORSHIP 10 0 PART I, LINE 2: DONATIONS ARE GRANTED TO 501(C)(3) OR RELATED GENESIS HEALTHCARE SYSTEM ORGANIZATIONS. RECIPIENTS ARE REVIEWED AND GRANTS ARE MONITORED WHEN AWARDED FOR PROPER USAGE. X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 MATTHEW PERRY PRESIDENT/CEO 980642 0 61864 0 0 0 10350 0 25320 0 1078176 0 0 0 DIANNA LEVECK CHIEF HUMAN RESOURCES OFFI 555463 0 68335 0 249395 0 9352 0 25443 0 907988 0 0 0 KRISTY RITCHIE MD TRUSTEE 379906 0 275665 0 0 0 9866 0 32764 0 698201 0 0 0 BRANDICE ALEXANDER DO PRESIDENT OF MEDICAL STAFF 612177 0 44628 0 0 0 10350 0 18563 0 685718 0 0 0 MICHAEL NORMAN CHIEF FINANCIAL OFFICER 523156 0 73124 0 32499 0 10350 0 31670 0 670799 0 0 0 EDMUND ROMITO CHIEF INFORMATION OFFICER 514790 0 62887 0 55900 0 10350 0 19733 0 663660 0 0 0 SCOTT WEGNER MD CHIEF CLINICAL OFFICER 414845 0 126552 0 43551 0 10350 0 35515 0 630813 0 0 0 SHARON PARKER CHIEF OPERATION OFFICER 475653 0 65758 0 57941 0 10350 0 20493 0 630195 0 0 0 WENDY CEDOZ CHIEF LEGAL OFFICER 487322 0 59672 0 39747 0 10350 0 22203 0 619294 0 0 0 CHRISTOPHER SCHOELLES CHIEF OPERATION OFFICER 466906 0 59711 0 25398 0 6139 0 34950 0 593104 0 0 0 LINDA SUPPLEE DIRECTOR/CPHO 443702 0 51263 0 45500 0 6071 0 1000 0 547536 0 0 0 SHON BENDER CHIEF NURSING OFFICER 426726 0 52769 0 21526 0 10350 0 7258 0 518629 0 0 0 ERIN REMSTER DO TRUSTEE 343043 0 34446 0 0 0 9714 0 19063 0 406266 0 0 0 LES BOYER DIRECTOR 258703 0 34315 0 0 0 5210 0 19893 0 318121 0 0 0 GREG MATONAK DIRECTOR 243144 0 32901 0 0 0 4187 0 23664 0 303896 0 0 0 MARIANNE GRAHAM DIRECTOR 215209 0 31037 0 0 0 6395 0 23804 0 276445 0 0 0 CHARLES ADAMS LEAN SIX SIGMA, DIRECTOR 188329 0 50178 0 8906 0 5069 0 19125 0 271607 0 0 0 TISHA BABCOCK DIRECTOR 179421 0 31924 0 0 0 1253 0 32242 0 244840 0 0 0 PART I, LINE 1A THE ORGANIZATION PAYS COUNTRY CLUB DUES AND RELATED BUSINESS EXPENSES FOR MEMBERS OF SENIOR LEADERSHIP. PERSONAL USAGE IS PAID BY THE INDIVIDUAL AND THE PERCENTAGE OF DUES RELATED TO PERSONAL USAGE ARE ADDED TO THE INDIVIDUALS W-2. PART I, LINE 7 BOARD REVIEWS BONUSES BASED ON PERFORMANCE. PART I, LINE 4B: A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS SET UP TO PROVIDE ADDITIONAL DEFERRED RETIREMENT INCOME TO THE GENESIS HEALTH CARE SYSTEM SENIOR LEADERSHIP TEAM MEMBERS. THIS PLAN IS FUNDED BY GENESIS AND VESTS WITH SERVICE. GENESIS HEALTHCARE SYSTEM MADE CONTRIBUTIONS TO NONQUALIFIED RETIREMENT PLANS FOR THE FOLLOWING INDIVIDUALS: WENDY CEDOZ: $39,747 DIANNA LEVECK: $249,395 EDMUND ROMITO: $55,900 SHARON PARKER: $57,941 SHON BENDER: $21,526 MICHAEL NORMAN: $32,499 CHRISTOPHER SCHOELLES: $25,398 LINDA SUPPLEE: $45,500 SCOTT WEGNER: $43,551 CHARLES ADAMS: $8,906 A COUNTY OF MUSKINGUM OHIO 316400080 628077CK3 2013-05-09 294645952 ACQUIRING, CONSTRUCTING, RENOVATING, INSTALLING AND EQUIPPING HOSP FAC. 0 0 0 B COUNTY OF COSHOCTON OHIO 316400064 000000000 2024-02-01 25000000 ACQUIRING, CONSTRUCTING, RENOVATING, INSTALLING AND EQUIPPING MEDICAL CENTER 0 0 0 A 37610000 294645952 18019125 27255403 4794175 197697357 46879891 2016 0 1 0 1 B 25000000 880245 493610 4383943 19242203 2024 0 1 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 0 B 0 0 0 0 1 0 0 0 0 A 1 B 1 SCHEDULE K: ENTITY A: PART IV: LINE 2C DATES OF REBATE COMPUTATIONS: 05/25/2018 05/04/2023 FORM 990, PART VI, SECTION A, LINE 6 FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC., AND BETHESDA CARE SYSTEM ARE THE MEMBERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE FILING ORGANIZATION, HAVE THE RIGHT TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY, WHETHER PERIODICALLY, OR AS VACANCIES ARISE, OR OTHERWISE. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS OF THE FILING ORGANIZATION, HAVE THE RIGHT TO APPROVE OR RATIFY DECISIONS OF THE ORGANIZATION'S GOVERNING BODY SUCH AS APPROVAL OF THE GOVERNING'S BODY'S DECISION TO DISSOLVE THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS REVIEWED BY THE CFO AND MADE AVAILABLE TO THE BOARD OF DIRECTORS IN ITS ENTIRETY FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ALL POTENTIAL CONFLICTS OF INTEREST OF BOARD MEMBERS AND OFFICERS MUST BE DISCLOSED TO THE BOARD OF DIRECTORS AND THE BOARD WILL DETERMINE IF A CONFLICT EXISTS AND APPROPRIATE PROCEDURES TO MITIGATE THE SITUATION, SUCH AS ALTERNATIVE TRANSACTIONS AND PARTICIPATION AND VOTING RESTRICTIONS. THE COMPLIANCE OFFICER MONITORS AND ENFORCES THESE POLICIES. ALL OFFICERS AND DIRECTORS REVIEW AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE CEO IS MANAGED THROUGH A THIRD PARTY THAT IS A NATIONALLY RECOGNIZED FIRM SPECIALIZING IN COMPENSATION BENCHMARKING AND ANALYSIS. THE FIRM IS RECOGNIZED FOR THEIR EXPERTISE IN EVALUATING TOTAL COMPENSATION AT THE EXECUTIVE LEVEL. THIS FIRM PRESENTS THEIR RECOMMENDATIONS AND ANALYSIS TO THE COMPENSATION COMMITTEE, WHICH IS MADE UP OF INDEPENDENT MEMBERS OF THE GENESIS BOARD OF DIRECTORS. THE COMMITTEE IS RESPONSIBLE FOR MAKING A RECOMMENDATION TO THE BOARD OF DIRECTORS REGARDING THE EXECUTIVE COMPENSATION POLICY AND SPECIFIC COMPONENTS OF THE TOTAL COMPENSATION OF THE CEO. THE CEO IS ACTIVELY INVOLVED IN THE REVIEW, ANALYSIS AND RECOMMENDATION RELATED TO THE TOTAL COMPENSATION FOR THE REMAINING MEMBERS OF THE SENIOR LEADERSHIP TEAM. THE CEO DETERMINES THE COMPENSATION OF THE SENIOR LEADERSHIP TEAM MEMBERS WITHIN THE PARAMETERS ESTABLISHED BY THE COMPENSATION COMMITTEE. THIS COMPENSATION PROCESS WAS LAST COMPLETED IN 2024. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII, SECTION A: RANDY COCHRANE, TRUSTEE, IS ALSO AN INDEPENDENT CONTRACTOR OF THE ORGANIZATION AND IS PAID SOLELY FOR THE SERVICES HE PROVIDES UNDER THE CONTRACT, NOT FOR HOURS SPENT AS A TRUSTEE. FORM 990, PART IX, LINE 11G BILLING: PROGRAM SERVICE EXPENSES 1,112,483. MANAGEMENT AND GENERAL EXPENSES 1,096,140. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,208,623. CLEANING: PROGRAM SERVICE EXPENSES 347,307. MANAGEMENT AND GENERAL EXPENSES 342,205. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 689,512. CONSULTING: PROGRAM SERVICE EXPENSES 1,790,541. MANAGEMENT AND GENERAL EXPENSES 1,764,235. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,554,776. COURIER: PROGRAM SERVICE EXPENSES 513,774. MANAGEMENT AND GENERAL EXPENSES 506,226. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,020,000. FOOD & NUTRITION SERVICES: PROGRAM SERVICE EXPENSES 2,822,050. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,822,050. INFECTIOUS WASTE REMOVAL: PROGRAM SERVICE EXPENSES 129,299. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 129,299. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 3,218,890. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,218,890. LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 1,744,984. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,744,984. MAINTENANCE CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 5,151,246. MANAGEMENT AND GENERAL EXPENSES 5,075,567. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,226,813. MEDICAL SERVICES FEES: PROGRAM SERVICE EXPENSES 42,185,525. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,185,525. PATIENT SERVICES: PROGRAM SERVICE EXPENSES 39,457. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 39,457. PHARMACEUTICAL FEES: PROGRAM SERVICE EXPENSES 275,923. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 275,923. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 36,916. MANAGEMENT AND GENERAL EXPENSES 36,373. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,289. SPONSORSHIP FEES: PROGRAM SERVICE EXPENSES 46,943. MANAGEMENT AND GENERAL EXPENSES 46,253. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 93,196. TRANSPORATION SERVICES: PROGRAM SERVICE EXPENSES 1,783,426. MANAGEMENT AND GENERAL EXPENSES 1,757,225. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,540,651. FORM 990, PART XI, LINE 9: PLEDGE RECEIVABLE FROM RELATED ORG -99,397,000. ASSETS RELEASED FROM RESTRICTION 2,098,235. TRANSFER TO/FROM AFFILIATES -2,607,202. FORM 990, PART XII, LINE 2C: THE FINANCE COMMITTEE OVERSEES THE AUDIT OF THE FINANCIAL STATEMENTS AND IS INVOLVED IN THE SELECTION OF THE INDEPENDENT ACCOUNTANT WHICH COMPLETES THE AUDIT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PAGE 1, LINE H(D): THIS IS THE PARENT RETURN FOR A GROUP: GENESIS HEALTHCARE SYSTEM GROUP RETURN, EIN: 31-1773259 GENESIS INTEGRATED HEALTH NETWORK LLC 2951 MAPLE AVENUE ZANESVILLE OH 43701 881341428 COORDINATE CARE OH 0 0 GENESIS HEALTHCARE SYSTEM GCMC PROPERTIES 2951 MAPLE AVENUE ZANESVILLE OH 43701 934718706 REAL ESTATE HOLDING OH 0 0 GENESIS HEALTHCARE SYSTEM HEALTHYPATH LLC 2951 MAPLE AVENUE ZANESVILLE OH 43701 994041848 INSURANCE OH -1800 0 GENESIS HEALTHCARE SYSTEM GENESIS HEALTHCARE FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 311629304 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 GOOD SAMARITAN MEDICAL CENTER FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 310969646 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE FOUNDATION 1 BETHESDA HOSPITAL FOUNDATION 2951 MAPLE AVENUE ZANESVILLE OH 43701 310885513 FUNDRAISING FOR GHS OH 501(C)(3) 3 GENESIS HEALTHCARE FOUNDATION 1 GOOD SAMARITAN MEDICAL CENTER 2951 MAPLE AVENUE ZANESVILLE OH 43701 314379479 MAINTAINS REAL ESTATE TITLE FOR HOSPITAL OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 CARESERVE 2951 MAPLE AVENUE ZANESVILLE OH 43701 311099924 FORMERLY OPERATED 2 NURSING HOMES THAT WERE SOLD PRIOR TO 2012 OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 COMMUNITY AMBULANCE SERVICE 2951 MAPLE AVENUE ZANESVILLE OH 43701 341773323 AMBULANCE SERVICE OH 501(C)(3) LINE 11 GENESIS HEALTHCARE SYSTEM 1 GENESIS CAREGIVERS 2951 MAPLE AVENUE ZANESVILLE OH 43701 311282152 HOME CARE SERVICES OH 501(C)(3) 3 CARESERVE 1 BETHESDA HOSPITALITY SHOP 2951 MAPLE AVENUE ZANESVILLE OH 43701 316050713 GIFT SHOP OH 501(C)(3) 3 GENESIS HEALTHCARE SYSTEM 1 CARELIFE LLC 2951 MAPLE AVENUE ZANESVILLE OH 43701 311128717 PHYSICIAN SERVICES, CHILDCARE SERVICES, PHARMACY, DME OH GENESIS HEALTHCARE SYSTEM C -87363653 62576875 1.00000 1 SOUTHEAST OHIO MEDICAL INSURANCE COMPANY FIRST CARIBBEAN HOUSE GEORGE TOWN CAYMAN ISLANDS CJ 980436356 CAPTIVE INSURANCE COMPANY CJ GENESIS HEALTHCARE SYSTEM C 19865393 1.00000 1 0 1 1 1 0 0 0 0 0 1 1 1 1 1 1 1 1 1 1 CARELIFE LLC S 99397000 ACCRUAL TRANSACTION