2020-11-10T20:51:21-06:00 2019-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2019-01-01 160978184 PARK RIDGE NURSING HOME INC DBA PARK RIDGE LIVING CENTER PARK 5859221595 1555 LONG POND RD ROCHESTER NY 14626 THOMAS R CRILLY CFO 5859221595 2020-11-08 1 ANGELA M FRANCO P00589741 3154463600 2020-11-08 45.47.35.56 2020-11-08 10:15:35 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 285E53E6E6CFC2A705EC861480093698646C7815 2019 2021-01-29 14:40:06Z ERIC BIEBER MD 100 KINGS HIGHWAY S ROCHESTER NY 14617 27407280 0 X WWW.ROCHESTERREGIONAL.ORG X 1969 NY AS AN AFFILIATE OF THE SYSTEM AND THE CENTER OF AGING AND CONTINUING CARE SERVICES, PARK RIDGE NURSING HOME (DBA PARK RIDGE LIVING CENTER) IS DEDICATED TO PROVIDING QUALITY CARE, INDEPENDENCE AND A POSITIVE LIVING EXPERIENCE FOR THE PATIENTS AND RESIDENTS IN OUR FACILITY. THE MISSION IS ACHIEVED THROUGH THE CORE VALUES OF THE SYSTEM WHICH INCLUDE PEOPLE, EXCELLENCE, LEARNING AND RESULTS. 14 10 425 75 0 0 72090 771181 28876836 26552572 12288 375 65757 83152 29026971 27407280 0 0 0 0 19321469 17739571 0 0 0 9445186 9388328 28766655 27127899 260316 279381 27789120 26195654 25640322 25749117 2148798 446537 X AS AN AFFILIATE OF THE SYSTEM AND THE CENTER OF AGING AND CONTINUING CARE SERVICES, PARK RIDGE NURSING HOME (DBA PARK RIDGE LIVING CENTER) IS DEDICATED TO PROVIDING QUALITY CARE, INDEPENDENCE AND A POSITIVE LIVING EXPERIENCE FOR THE PATIENTS AND RESIDENTS IN OUR FACILITY. THE MISSION IS ACHIEVED THROUGH THE CORE VALUES OF THE SYSTEM WHICH INCLUDE PEOPLE, EXCELLENCE, LEARNING AND RESULTS. 0 0 15389451 18824477 120-BED NURSING FACILITY PROVIDING 42,614 PATIENT CARE DAYS. PARK RIDGE NURSING HOME PROVIDES A MODEL OF CARE FOR RESIDENTS WHERE THEY ARE ENCOURAGED TO MAKE THEIR OWN CHOICES AND PROVIDES A HOME ENVIRONMENT IN WHICH THEY WILL LIVE AND SHARE LIFE'S JOURNEY. 4599072 5625615 CERTIFIED HOME HEALTH AGENCY PROVIDING 2,677 EPISODES OF CARE. THE PROGRAM PROVIDES SHORT-TERM, AT-HOME SERVICES AFTER A HOSPITAL STAY, SURGERY OR A NEW HEALTH DIAGNOSIS. SERVICES ARE CUSTOMIZED FOR EACH INDIVIDUAL AND RANGE FROM SKILLED MEDICAL CARE TO ASSISTANCE WITH HOUSEHOLD TASKS. 1786806 2185632 THREE SOCIAL DAYCARES CENTERS PROVIDING 17,709 CLIENT CARE DAYS. AN ADULT DAY SERVICES PROGRAM WHICH PROVIDES A CARING, SUPPORTIVE AND THERAPEUTIC ENVIRONMENT FOR PEOPLE WHO NEED CARE OR SUPERVISION DURING DAY-TIME HOURS. AN EMERGENCY RESPONSE SYSTEM PROVIDING 6,988 CUSTOMERS. A MULTIPLE SCLEROSIS ACHIEVEMENT CENTER PROVIDING 4,755 CLIENT CARE DAYS. THIS PROGRAM SERVES MID-TO-LATE STAGE M.S. PATIENTS AS WELL AS INDIVIDUALS WITH OTHER NEUROLOGICAL DIAGNOSES. 21775329 1 1 0 0 0 0 0 0 1 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 33 0 1 425 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 10 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X HOWARD GLASTONBURY 5859221595 100 KINGS HIGHWAY ROCHESTER NY 14617 KAREN M GALLINA CHAIR OF THE BOARD 1.00 1.00 X X 0 0 0 DIANNE COONEY MINER VICE CHAIR 1.00 1.00 X X 0 0 0 JEFFREY C MAPSTONE TREASURER 1.00 1.00 X X 0 0 0 JULIA TEDESCO SECRETARY 1.00 1.00 X X 0 0 0 ERIC BIEBER MD CEO 2.00 53.00 X X 88106 2334817 1217086 KARAN SINGH ALAG MD DIRECTOR 1.00 40.00 X 0 348879 110953 LINDA BECKER DIRECTOR 1.00 1.00 X 0 0 0 RALPH DESTEPHANO DIRECTOR 1.00 1.00 X 0 0 0 DANIEL MEYERS DIRECTOR 1.00 1.00 X 0 0 0 ELIZABETH PATTON PHD DIRECTOR 1.00 1.00 X 0 0 0 THOMAS RILEY DIRECTOR 1.00 1.00 X 0 0 0 LEON T SAWYKO DIRECTOR 1.00 1.00 X 0 0 0 DAWN RIEDY MD DIRECTOR 1.00 40.00 X 0 442081 329826 MARCY C MULCONRY MD DIRECTOR 1.00 40.00 X 0 359377 55382 THOMAS CRILLY CFO 2.00 53.00 X 29968 794132 535741 ROBERT NESSELBUSH COO 1.00 54.00 X 36026 1945393 1301293 HUGH THOMAS CAO 2.00 53.00 X 37639 997444 611973 MARK KLYCZEK VP, LONG TERM CARE 10.00 45.00 X 65299 293841 180084 AMANDA D BROWN ADMINISTRATOR 40.00 0.00 X 145971 0 20067 ELIZABETH F LANDER COMMUNITY HEALTH NURSE 40.00 0.00 X 115767 0 24586 CAMILLA J MINER DIRECTOR CLINICAL SERVICES 40.00 0.00 X 115699 0 57897 CONCETTA BOICE COTTAGE RESOURCE NURSE 40.00 0.00 X 113363 0 50734 WARREN HERN FORMER CEO 0.00 0.00 X 0 250000 0 747838 7765964 4495622 4 1 1 0 CORNERSTONE CENTRE LLC 460 WHITE SPRUCE BLVD ROCHESTER NY 14623 RENTAL 111159 1 712951 58230 771181 PATIENT/RESIDENT SERVICE REVENUE 623000 26552572 26552572 26552572 375 375 83152 83152 83152 27407280 26635724 0 375 399432 339634 59798 13945897 12348809 1597088 1374991 1216180 158811 878225 776790 101435 1141026 1009237 131789 6000 3974 2026 2099584 1346502 753082 71 71 290478 186289 104189 675872 519564 156308 169682 130440 39242 13649 12374 1275 521204 18150 503054 1020215 112864 907351 15815 12157 3658 MEDICAL AND FOOD SUPPLI 1471433 1131136 340297 ALLOWANCE FOR DOUBTFUL 1354744 1354744 NYS REVENUE & RECEIPTS 898849 814917 83932 SHARED SERVICES ALLOCAT 637827 326207 311620 212905 115290 97615 27127899 21775329 5352570 0 5651938 6577191 32360 57040 2859855 1932609 8047 11261 38285 24330 26644219 10459298 16733386 16184921 2465249 1408302 27789120 26195654 1906400 2108282 15501510 15121158 28843 52495 8203569 8467182 25640322 25749117 X 1880825 97040 267973 349497 2148798 446537 27789120 26195654 X 279381 -1981642 X X 0 1 X 1 1 1 X 3162031 1556048 1081575 72090 771181 6642925 23045596 25363391 27559400 28876836 26552572 131397795 26207627 26919439 28640975 28948926 27323753 138040720 0 0 0 138040720 2269 4441 6136 12288 375 25509 2269 4441 6136 12288 375 25509 11892 13622 41865 65757 83152 216288 26221788 26937502 28688976 29026971 27407280 138282517 0.99830 0.99880 0.00020 0.00020 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 28843 114647 90995 52495 1 267973 88380 6099 12955 349497 55299 214530 -321 1535 267973 26129 29170 55299 130417 9201 443 113932 26129 123358 34198 2126 29265 130417 0.04280 0.95720 0 1 1 4736 4736 21915366 7138429 14776937 4286428 3301213 985215 437689 19656 418033 16184921 LEASE- RIGHT TO USE ASSETS 39457 OTHER RECEIVABLES 106157 BENEFICIAL INTEREST IN FOUNDATION 349497 THIRD PART RECEIVABLES 913191 1408302 ACCRUED PENSION 6553798 THIRD PARTY PAYABLE 1397243 LEASE RIGHT TO USE LIABILITIES 46058 INTEREST RATE SWAP LIABILITY 470083 8467182 PART V, LINE 4: ENDOWMENT FUNDS HELD FOR INTENDED USE BY PARK RIDGE NURSING HOME, INC. ARE IN THE POSSESSION OF THE ROCHESTER REGIONAL HEALTH FOUNDATION. WHEN THE TERMS OF THE ENDOWMENT ARE MET, THE FOUNDATION GRANTS THE FUNDS OVER TO PARK RIDGE NURSING HOME, INC. 1 1 0 0 0 0 0 0 0 ERIC BIEBER MD CEO 43824 1161342 40453 1071994 3829 101481 43821 1161265 436 11564 132363 3507646 38653 1024317 KARAN SINGH ALAG MD DIRECTOR 0 146623 0 202256 0 0 0 98590 0 12363 0 459832 0 0 DAWN RIEDY MD DIRECTOR 0 352381 0 89700 0 0 0 318398 0 11428 0 771907 0 0 MARCY C MULCONRY MD DIRECTOR 0 96952 0 262425 0 0 0 44382 0 11000 0 414759 0 0 THOMAS CRILLY CFO 17767 470817 12201 323315 0 0 19045 504696 436 11564 49449 1310392 9988 264686 ROBERT NESSELBUSH COO 4431 239284 10903 588740 20692 1117369 23545 1271431 115 6202 59686 3223026 9906 534912 HUGH THOMAS CAO 21926 581041 15713 416403 0 0 21824 578324 430 11395 59893 1587163 14580 386366 MARK KLYCZEK VP, LONG TERM CARE 47283 212771 18016 81070 0 0 30599 137693 2144 9648 98042 441182 10399 46794 AMANDA D BROWN ADMINISTRATOR 124351 0 21620 0 0 0 20067 0 0 0 166038 0 0 0 CAMILLA J MINER DIRECTOR CLINICAL SERVICES 104348 0 11351 0 0 0 54793 0 3104 0 173596 0 0 0 CONCETTA BOICE COTTAGE RESOURCE NURSE 113363 0 0 0 0 0 50734 0 0 0 164097 0 0 0 WARREN HERN FORMER CEO 0 0 0 0 0 250000 0 0 0 0 0 250000 0 250000 PART I, LINE 3 COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS IS ESTABLISHED USING THE FOLLOWING: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - COMPENSATION SURVEYS AND STUDIES - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE ON AN ANNUAL BASIS, THE ORGANIZATION USES AN INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE SALARIES FOR ALL EXECUTIVES TO ENSURE SUCH SALARIES ARE CONSISTENT WITH MARKET SALARIES PAID TO SIMILARLY SITUATED EXECUTIVES. IN ADDITION, A COMPENSATION COMMITTEE REVIEWS THIS INFORMATION ANNUALLY AND IT IS THEN APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. FINALLY, EXECUTIVES RECEIVE A WRITTEN LETTER OUTLINING THE SPECIFICS OF THE COMPENSATION AGREEMENT AND THEIR EXPECTED PERFORMANCE. PART I, LINES 4A-B SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS PROVIDE BENEFITS TO CERTAIN KEY EXECUTIVE EMPLOYEES OF ROCHESTER REGIONAL HEALTH. THE ORGANIZATION MAINTAINS A SECTION 457(F) PLAN WHICH WOULD BE CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THERE WERE NO DISTRIBUTIONS PAID FROM THIS PLAN IN 2019. COMPENSATION TO THE CHIEF OPERATING OFFICER INCLUDES PAYMENTS AGREED TO UNDER A SEPARATION AGREEMENT EXECUTED IN APRIL 2019. THIS AGREEMENT CALLS FOR PAYMENTS TO BE MADE THROUGH EARLY 2021. THESE PAYMENTS HAVE BEEN ACCRUED AND REPORTED AS OTHER DEFERRED COMPENSATION. THE TOTAL COMPENSATION PAID TO THE FORMER CEO REPRESENTED A DISTRIBUTION OF DEFERRED COMPENSATION FROM A 457(B) PLAN. THIS DISTRIBUTION TO THE FORMER CEO SHOWN IN THE 2019 TAX RETURN REPRESENTS COMPENSATION WHICH WAS RECOGNIZED IN PREVIOUS TAX YEARS. THERE WAS NO INCREMENTAL EXPENSE RECOGNIZED BY THE ORGANIZATION IN 2019 FOR PAYMENTS MADE TO THE FORMER CEO. A VILLAGE OF EAST ROCHESTER HOUSING AUTHORITY 161497561 274722DX2 2008-12-11 18750000 SEE PART VI 0 0 0 A 3075000 19177030 19177030 2010 0 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 1 1 1 MORGAN STANLEY CA 10.000000000000 0 0 0 0 1 A 1 SCHEDULE K, PART IV, ARBITRAGE, LINE 2C: DATE THE REBATE COMPUTATION WAS PERFORMED: 12/01/2010 NOTE REGARDING THE REBATE COMPUTATION: SINCE THE BOND PROCEEDS HAVE BEEN SPENT, AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS. NO FURTHER REBATE CALCULATIONS ARE NECESSARY. PART II, LINE 3 - THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN DUE TO INVESTMENT EARNINGS, INC PART IV, LINE 4B - MORGAN STANLEY CAPITAL SERVICES, INC. SCHEDULE K, PART I, LINE A(F), DESCRIPTION OF PURPOSE CONSTRUCTING AND EQUIPPING 23,280 SQUARE FOOT SINGLE STORY BUILDING HOUSING 40 SHORT-STAY SKILLED NUSING FACILITY BEDS PROVIDING RESTORATIVE REHABILITION AND POST ACCUTE CARE AND RELATED DINNING, ACTIVITY AND LIVING AREAS AND FOUR 11,000 SQUARE FOOT (APPROXIMATELY) SINGLE STORY RANCH-STYLE HOUSING 80 HEALTHCARE BEDS AND LIVING AREAS LOCATED ON APPROXIMATELY 5.5 ACRES OF LAND. PART II, LINE 3 THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN DUE TO INVESTMENT EARNINGS, INC. PART IV, LINE 4B MORGAN STANLEY CAPITAL SERVICES, INC. SCHEDULE K, PART I, LINE A(F), DESCRIPTION OF PURPOSE CONSTRUCTING AND EQUIPPING 23,280 SQUARE FOOT SINGLE STORY BUILDING HOUSING 40 SHORT-STAY SKILLED NUSING FACILITY BEDS PROVIDING RESTORATIVE REHABILITION AND POST ACCUTE CARE AND RELATED DINNING, ACTIVITY AND LIVING AREAS AND FOUR 11,000 SQUARE FOOT (APPROXIMATELY) SINGLE STORY RANCH-STYLE HOUSING 80 HEALTHCARE BEDS AND LIVING AREAS LOCATED ON APPROXIMATELY 5.5 ACRES OF LAND. FORM 990, PART VI, SECTION A, LINE 1 EACH BOARD HAS AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD PLUS THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION AND SUCH OTHER DIRECTORS AS THE CHAIR MAY NOMINATE FROM TIME TO TIME FOR APPOINTMENT BY A MAJORITY VOTE OF THE ENTIRE BOARD. BETWEEN MEETINGS OF THE BOARD, AND TO THE EXTENT PERMITTED BY LAW, THE EXECUTIVE COMMITTEE SHALL POSSESS THE POWERS OF THE BOARD WITH RESPECT TO MANAGING AND CONDUCTING THE AFFAIRS OF THE CORPORATION, EXCEPT AS OTHERWISE PROVIDED BY LAW OR WITHIN CERTAIN BY-LAWS. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A MEMBERSHIP (NOT A STOCK) CORPORATION UNDER NEW YORK STATE LAW. THE ORGANIZATION'S SOLE CORPORATE MEMBER IS ROCHESTER REGIONAL HEALTH, A RELATED NOT-FOR-PROFIT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B ROCHESTER REGIONAL HEALTH, AS THE SOLE CORPORATE MEMBER, ALSO HAS THE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY, INCLUDING AMENDMENT OF BYLAWS AND CHARTERS, REMOVAL OF MEMBERS OF THE GOVERNING BODY, AND THE DECISION TO DISSOLVE THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, A COPY OF THE FORM 990 IS PROVIDED TO, AND REVIEWED WITH, ALL MEMBERS OF THE AUDIT AND COMPLIANCE COMMITTEE. THIS REVIEW IS PERFORMED IN CONSULTATION WITH THE ORGANIZATION'S TAX ADVISORS, AND IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS AND OTHER RELEVANT INFORMATION FOR THE APPROPRIATE TIME PERIOD. FORM 990, PART VI, SECTION B, LINE 12C UPON EMPLOYMENT, ALL EMPLOYEES RECEIVE THE ETHICAL STANDARD OF CONDUCT BOOKLET FOR WHICH THEY SIGN A RECEIPT OF ACKNOWLEDGEMENT. CONFLICT OF INTEREST EDUCATION IS CONDUCTED ANNUALLY FOR ALL EMPLOYEES. CONFLICT OF INTEREST IS DEFINED, AS IS MANAGEMENT OF A CONFLICT OF INTEREST. EMPLOYEES ARE REQUIRED TO DISCLOSE AND SEEK RESOLUTION TO ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST BEFORE TAKING A POTENTIALLY IMPROPER ACTION. ANNUALLY, EACH KEY PERSON, DIRECTOR AND OFFICER OF THE ORGANIZATION IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM, PROVIDING MANAGEMENT WITH SUFFICIENT INFORMATION ABOUT HIS/HER PERSONAL INTERESTS AND RELATIONSHIPS SO THAT MANAGEMENT CAN: (1) DETERMINE WHETHER ANY ACTUAL OR PERCEIVED CONFLICT OF INTEREST EXISTS, AND (2) MONITOR WORK ASSIGNMENTS TO AVOID PLACING THE KEY EMPLOYEE OR OFFICER IN A POSITION WHERE THERE MAY BE A QUESTION AS TO HIS/HER OBJECTIVITY AS WELL AS TO AVOID ANY APPEARANCE OF IMPROPRIETY. THROUGHOUT THE YEAR, KEY EMPLOYEES, OFFICERS AND DIRECTORS OF THE ORGANIZATION ARE ALSO REQUIRED TO NOTIFY MANAGEMENT PROMPTLY IF ANY CHANGE TO THEIR DISCLOSURES OCCURS. IN ADDITION, EACH MEMBER OF THE BOARD OF DIRECTORS MUST ALSO COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE FORM, WHICH MUST BE SUBMITTED TO THE GENERAL COUNSEL. BOARD MEMBERS LEAVE THE ROOM DURING DISCUSSIONS AND ABSTAIN FROM VOTING WHEN THEY HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S OFFICER AND KEY EMPLOYEE COMPENSATION ARRANGEMENTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE. INFORMATION REVIEWED FOR THE OFFICER/KEY EMPLOYEE INCLUDES COMPARABLE DATA FROM SIMILAR SIZE TAX EXEMPT ORGANIZATIONS AS WELL AS COMPENSATION FOR THESE POSITIONS (AS DISCLOSED ON FORM 990) WITH OTHER ORGANIZATIONS IN THE HEALTH CARE INDUSTRY THAT ARE OF SIMILAR SIZE. REVIEW AND APPROVAL OF THE COMPENSATION ARRANGEMENT BY THE COMPENSATION COMMITTEE IS DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ADMINISTRATIVE OFFICES OF THE AFFILIATED HEALTH SYSTEM AT 100 KINGS HIGHWAY SOUTH, ROCHESTER, NY 14617. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED. FORM 990, PART XI, LINE 9: PENSION ACTUARIAL VALUATION -1,296,176. FMV ADJUSTMENT ON DERIVATIVE INSTRUMENT -470,948. BENEFICIAL INTEREST IN FOUNDATION 81,524. CHANGE IN ACCOUNTING ESTIMATE -296,042. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 5471 FILED ON BEHALF STATEMENT STATEMENT PURSUANT TO TREAS REG SEC 1 6038-2(J)(3) THE FOLLOWING INFORMATION IS SUBMITTED WITH RESPECT TO PARK RIDGE NURSING HOME, INC. DBA PARK RIDGE LIVING CENTER'S FORM 5471 (INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS) FILING REQUIREMENT FOR THE ENTITY BELOW: NAME OF FOREIGN CORPORATION: HEALTH CARE CASUALTY INSURANCE LIMITED, BEGINNING TAX YEAR OF FOREIGN CORPORATION: JANUARY 1, 2019, ENDING TAX YEAR OF FOREIGN CORPORATION: DECEMBER 31, 2019, THE FORM 5471 FILING REQUIREMENT FOR THIS FOREIGN CORPORATION FOR CATEGORIES 4 AND 5 HAVE BEEN SATISFIED BY INCLUSION IN THE FOLLOWING US FILER'S TAX RETURN: NAME OF US FILER: UNITY HEALTH SYSTEM, INC., ADDRESS OF US FILER: 1555 LONG POND ROAD ROCHESTER, NY 14626, EIN OR SSN: 22-2572873, ENDING TAX YEAR OF US FILER: DECEMBER 31, 2019, TYPE OF RETURN FILED: 990, IRS CENTER WHERE RETURN FILED: OGDEN, UTAH 84201-0027. THE ROCHESTER GENERAL HOSPITAL 1425 PORTLAND AVENUE ROCHESTER NY 14621 160743134 HOSPITAL NY 501(C)(3) LINE 3 ROCHESTER REGIONAL HEALTH 1 GRHS FOUNDATION 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 223378111 R/E INV MGMT NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH 1 ROCHESTER REGIONAL HEALTH FOUNDATION 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 222229425 FUNDRAISING NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH 1 NEWARK WAYNE COMMUNITY HOSPITAL FOUNDATION DRIVING PARK AVENUE NEWARK NY 14513 222963015 FUNDRAISING NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH 1 NEWARK WAYNE COMMUNITY HOSPITAL DRIVING PARK AVENUE NEWARK NY 14513 150584188 HOSPITAL NY 501(C)(3) LINE 3 ROCHESTER REGIONAL HEALTH 1 RGHS WORKERS' COMPENSATION TRUST 1425 PORTLAND AVENUE ROCHESTER NY 14621 166429300 SEE PART VII NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH 1 CONTINUING CARE NETWORK INC (CCN) 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 222963016 SUPPORT RGH NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH 1 ROCHESTER GENERAL HUDSON HOUSING 2066 HUDSON AVENUE ROCHESTER NY 14621 223210351 LOW INC HOUSING NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 VIA HEALTH HOME CARE I 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 161504370 HOME HEALTH NY 501(C)(3) LINE 10 CCN 1 VIA HEALTH HOMECARE II 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 161538727 HOME HEALTH NY 501(C)(3) LINE 10 CCN 1 INDEPENDENT LIVING FOR SENIORS 2066 HUDSON AVENUE ROCHESTER NY 14617 161491059 ADULT DAY HC NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 ROCHESTER GENERAL LONG TERM CARE 1550 EMPIRE BLVD WEBSTER NY 14580 223187140 NH & REHAB NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 WESTERN NEW YORK MEDICAL PRACTICE PC 1425 PORTLAND AVENUE ROCHESTER NY 14621 611654232 PHYS PRAC NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 THE UNITY HOSPITAL OF ROCHESTER 1555 LONG POND RD ROCHESTER NY 14626 237221763 HOSPITAL NY 501(C)(3) LINE 3 ROCHESTER REGIONAL HEALTH 1 NORTH PARK NURSING HOME INC 1555 LONG POND RD ROCHESTER NY 14626 223159644 LONG TERM CARE FACILITY NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 PARK RIDGE CHILD CARE CENTER INC 1555 LONG POND RD ROCHESTER NY 14626 222918126 CHILD DAY CARE SERVICES NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 PARK RIDGE HOUSING DEVELOPMENT FUND 1555 LONG POND RD ROCHESTER NY 14626 222608311 LOW INCOME HOUSING PROJECT FOR ELDERLY NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 PARK RIDGE HOUSING INC 1555 LONG POND RD ROCHESTER NY 14626 222570457 SENIOR APARTMENT COMPLEX NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 PARKWAY COMMONS HOUSING DEVELOPMENT 1555 LONG POND RD ROCHESTER NY 14626 223130818 LOW INCOME HOUSING FOR ELDERLY/HANDICAPPED NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 UNITY AGING SERVICES INC 1555 LONG POND RD ROCHESTER NY 14626 841684195 MANAGEMENT AND DEVELOPMENT CO NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 UNITY HOUSING DEVELOPMENT FUND CORP 1555 LONG POND RD ROCHESTER NY 14626 300068596 RECEIPT AND DISBURSEMENTS OF SUBSIDIES NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 WOODLAND VILLAGE INC 1555 LONG POND RD ROCHESTER NY 14626 161588242 SENIOR APARTMENT COMPLEX NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 UNITY AMBULATORY SURGERY CENTER INC 1555 LONG POND RD ROCHESTER NY 14626 383871383 OUTPATIENT SURGERY NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 UNITY HEALTH SYSTEM INC 1555 LONG POND ROAD ROCHESTER NY 14626 222572873 SYSTEM SUPPORT NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH 1 ROCHESTER REGIONAL HEALTH 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 471234999 SYSTEM PARENT NY 501(C)(3) LINE 12B, II N/A 1 UNITED MEMORIAL MEDICAL CENTER 127 NORTH STREET BATAVIA NY 14020 160743029 HOSPITAL NY 501(C)(3) LINE 3 ROCHESTER REGIONAL HEALTH 1 CLIFTON SPRINGS HOSPITAL AND CLINIC 2 COULTER ROAD CLIFTON SPRINGS NY 14432 160743966 HOSPITAL NY 501(C)(3) LINE 3 ROCHESTER REGIONAL HEALTH 1 BEHAVIORAL HEALTH NETWORK INC 490 EAST RIDGE ROAD ROCHESTER NY 14621 166069131 MENTAL HEALTH NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 PRCD INC 1555 LONG POND RD ROCHESTER NY 14626 161311581 SUBSTANCE ABUSE TREATMENT & REHAB. NY 501(C)(3) LINE 7 ROCHESTER REGIONAL HEALTH 1 ROCHESTER GENERAL HEALTH SYSTEM 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 222551509 SYSTEM SUPPORT NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH 1 UNITED MEMORIAL MEDICAL CENTER FOUNDATION 127 NORTH STREET BATAVIA NY 14020 222611543 FUNDRAISING NY 501(C)(3) LINE 12B, II UNITY MEMORIAL MEDICAL CENTER 1 CLIFTON SPRINGS HOSPITAL & CLINIC FOUNDATION 2 COULTER ROAD CLIFTON SPRINGS NY 14432 161560033 FUNDRAISING NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH 1 GENESEE REGION HOME CARE ASSOCIATION INC 100 KINGS HIGHWAY ROCHESTER NY 14617 160844109 HOME HEALTH NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 GENESEE REGION HOME CARE ASSOCIATION OF ONTARIO COUNTY INC 100 KINGS HIGHWAY ROCHESTER NY 14617 223257719 HOME HEALTH NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH 1 NW ASSOCIATES LP PO BOX 111 DRIVING PARK AVENUE NEWARK NY 14513 141674119 R/E LEASING NY NWCH RELATED 0 0 0.73610 PARMA SENIOR HOUSING 1555 LONG POND RD ROCHESTER NY 14626 432082116 HILTON PROJ NY N/A 0 0 UNITY SENIOR HOUSING 1555 LONG POND RD ROCHESTER NY 14626 061709927 MOORE PK NY N/A 0 0 GREATER ROCHESTER ASSURANCE COMPANY LTD GEORGE TOWN GRAND CAYMAN CJ INSURANCE CJ N/A C 1.00000 0 GRACO RISK RETENTION GROUP INC 1425 PORTLAND AVENUE ROCHESTER NY 14621 710933967 INSURANCE SC RGH C 1.00000 0 NWA INC DRIVING PARK AVENUE NEWARK NY 14513 141667339 R/E LEASING NY NWCH C 1.00000 0 GREATER ROCHESTER INDEPENDENT PRACTICE ASSOCIATION INC 100 KINGS HWY S SUITE 2500 ROCHESTER NY 14617 161507171 INDEPENDENT PRACTICE ASSOCIATION NY N/A C 0.50000 0 ROCHESTER GENERAL HEALTH SYSTEM DIALYSIS INC 1425 PORTLAND AVENUE ROCHESTER NY 14621 383912199 DIALYSIS NY RGHS C 1.00000 0 ACM MEDICAL LABORATORY INC 160 ELMGROVE PARK ROCHESTER NY 14624 161059691 CLINICAL LAB NY PRH INC C 0 PRH INC 1555 LONG POND ROAD ROCHESTER NY 14626 161329632 MEDICAL LAB NY ROCHESTER REGIONAL HEALTH C 0 GREATER ROCHESTER IMMEDIATE MEDICAL CARE PLLC DBA ROCHESTER IMMEDIATE CARE 265 BROOKVIEW CENTRE WAY SUITE 400 KNOXVILLE TN 37919 271453784 URGENT CARE CENTERS TN WESTERN NEW YORK MEDICAL PC C 0 ROCHESTER MEDICINE PLLC 265 BROOKVIEW CENTRE WAY SUITE 400 KNOXVILLE TN 37919 812625325 OCCUPATIONAL MEDICINE TN WESTERN NEW YORK MEDICAL PC C 0 PARMA SENIOR HOUSING LLC 1555 LONG POND ROAD ROCHESTER NY 14626 810671687 SENIOR HOUSING NY ROCHESTER REGIONAL HEALTH C 0 UNITY SENIOR HOUSING CORP 1555 LONG POND ROAD ROCHESTER NY 14624 061709925 SENIOR HOUSING NY ROCHESTER REGIONAL HEALTH C 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 ROCHESTER REGIONAL HEALTH P 864387 FMV ROCHESTER GENERAL HOSPITAL P 1207422 FMV THE UNITY HOSPITAL OF ROCHESTER L 699996 FMV THE UNITY HOSPITAL OF ROCHESTER P 3338153 FMV SCHEDULE R, PART II, COLUMN (B): RELATED TAX-EXEMPT ORGANIZATION - PRIMARY ACTIVITY: RGHS WORKERS' COMPENSATION TRUST SUPPORTS THE ROCHESTER GENERAL HOSPITAL, NEWARK WAYNE COMMUNITY HOSPITAL, ROCHESTER GENERAL LONG TERM CARE, INDEPENDENT LIVING FOR SENIORS, VIAHEALTH HOMECARE I, VIAHEALTH HOMECARE II, BEHAVIORAL HEALTH NETWORK, INC, CLIFTON SPRINGS HOSPITAL & CLINIC, UNITY HOSPITAL OF ROCHESTER AND UNITED MEMORIAL MEDICAL CENTER.