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NORTH PARK NURSING HOME INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
NORTH PARK NURSING HOME INC (EIN 22-3159644)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-13
IRS object ID
201903179349308220
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-13T16:19:43-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN161226221PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FUST CHARLES CHAMBERS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15784 WIDEWATERS PARKWAYAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13214ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN223159644EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTH PARK NURSING HOME INCBusinessNameLine1Txt
Business Name Line2DBA EDNA TINA WILSON LIVING CENTERBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlNORTBusinessNameControlTxt
Phone5859921221PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11555 LONG POND RDAddressLine1Txt
CityROCHESTERCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14626ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTHOMAS R CRILLYPersonNm
Person TitleCFOPersonTitleTxt
Phone5859921221PhoneNum
Signature2019-11-11SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonANGELA M FRANCOPreparerPersonNm
PTINP00589741PTIN
Phone3154463600PhoneNum
Preparation2019-11-07PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address24.39.85.114IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-11-11IPDt
IP Tm14:53:38IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdFD62137317EE26C9F26E40FD83CAC65FE1294EC8AtSubmissionCreationDeviceId
At Submission Filing Device Id95BF4D66B926A32327CE7D91ADC759B9DBEEFFE9AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerERIC BIEBER MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 KINGS HIGHWAY SAddressLine1Txt
CityROCHESTERCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14617ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$15,612,723GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ROCHESTERREGIONAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1991FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionAS AN AFFILIATE OF THE SYSTEM AND THE CENTER OF AGING AND CONTINUING CARE SERVICES, NORTH PARK NURSING HOME, INC. (D.B.A EDNA TINA WILSON LIVING CENTER) IS DEDICATED TO PROVIDING QUALITY CARE, INDEPENDENCE AND A POSITIVE LIVING EXPERIENCE FOR PATIENTS AND RESIDENTS IN OUR FACILITY. THE MISSION IS ACHIEVED THROUGH THE CORE VALUES OF THE SYSTEM WHICH INCLUDE PEOPLE, EXCELLENCE, LEARNING AND RESULTS.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee280TotalEmployeeCnt
Total Volunteers56TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$21,122PYContributionsGrantsAmt
CY Contributions Grants$13,680CYContributionsGrantsAmt
PY Program Service Revenue$15,659,212PYProgramServiceRevenueAmt
CY Program Service Revenue$15,434,812CYProgramServiceRevenueAmt
PY Investment Income$1,334PYInvestmentIncomeAmt
CY Investment Income$1,424CYInvestmentIncomeAmt
PY Other Revenue$79,984PYOtherRevenueAmt
CY Other Revenue$162,807CYOtherRevenueAmt
PY Total Revenue$15,761,652PYTotalRevenueAmt
CY Total Revenue$15,612,723CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,095,976PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,645,751CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,672,498PYOtherExpensesAmt
CY Other Expenses$5,470,344CYOtherExpensesAmt
PY Total Expenses$15,768,474PYTotalExpensesAmt
CY Total Expenses$15,116,095CYTotalExpensesAmt
PY Revenues Less Expenses-$6,822PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$496,628CYRevenuesLessExpensesAmt
Total Assets BOY$11,635,082TotalAssetsBOYAmt
Total Assets EOY$11,836,629TotalAssetsEOYAmt
Total Liabilities BOY$7,698,804TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,962,754TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,936,278NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,873,875NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAS AN AFFILIATE OF THE SYSTEM AND THE CENTER OF AGING AND CONTINUING CARE SERVICES, NORTH PARK NURSING HOME, INC. (D.B.A EDNA TINA WILSON LIVING CENTER) IS DEDICATED TO PROVIDING QUALITY CARE, INDEPENDENCE AND A POSITIVE LIVING EXPERIENCE FOR PATIENTS AND RESIDENTS IN OUR FACILITY. THE MISSION IS ACHIEVED THROUGH THE CORE VALUES OF THE SYSTEM WHICH INCLUDE PEOPLE, EXCELLENCE, LEARNING AND RESULTS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$10,889,278ExpenseAmt
Revenue$13,044,893RevenueAmt
Desc120-BED SKILLED NURSING FACILITY PROVIDING 42,550 PATIENT CARE DAYS. THE EDNA TINA WILSON LIVING CENTER USES AN INNOVATIVE NEIGHBORHOOD DESIGN, WITH RESIDENT ROOMS CLUSTERED AROUND THE ACTIVITY CENTER AND THE LIVING AND DINING AREAS, TO PROMOTE MORE SOCIAL AND INTERACTIVE LIVING.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,588,545ExpenseAmt
Revenue$1,903,010RevenueAmt
DescA LICENSED HOME CARE SERVICE AGENCY PROVIDING 57,067 HOURS OF SERVICES. THIS PROGRAM ALLOWS SENIORS TO CONTINUE LIVING SAFELY AND INDEPENDENTLY IN THEIR OWN HOMES. SERVICES ARE CUSTOMIZED FOR EACH INDIVIDUAL AND RANGE FROM MEAL DELIVERY AND ASSISTANCE WITH HOUSEHOLD TASKS TO MEDICAL CARE.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$522,919ExpenseAmt
Revenue$626,435RevenueAmt
DescAN ADULT DAYCARE CENTER PROVIDING 5,997 CLIENT DAYS. ADULT DAY SERVICES PROVIDE A CARING, SUPPORTIVE, AND THERAPEUTIC ENVIRONMENT FOR PEOPLE WHO NEED CARE OR SUPERVISION DURING DAYTIME HOURS.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$19,435ExpenseAmt
Revenue$23,281RevenueAmt
DescUNITY CARE AT HOME PROVIDES ASSISTANCE WITH UNDERSTANDING COMMUNITY RESOURCES AND OPTIONS FOR CARE. ADDITIONAL SERVICES INCLUDE DEVELOPING AND COORDINATING A SERVICE PLAN, OBTAINING INSURANCE COVERAGE, AND HELPING TO FIND THE RIGHT ASSISTED LIVING OR NURSING HOME. ALSO, THEY PROVIDE SERVICES INCLUDING HOUSEKEEPING, LAUNDRY, GROCERY SHOPPING, RUNNING ERRANDS, COMPANION CARE, ACCOMPANYING TO DOCTOR'S APPOINTMENTS, AND OTHER HELPFUL DUTIES AROUND THE HOUSE.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$19,435TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$23,281TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$13,020,177TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document26IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee280EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HUGH CHISHOLMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5859221221PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 KINGS HIGHWAY SOUTHAddressLine1Txt
CityROCHESTERCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14617ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
LINDA BECKER
DIRECTOR1.001.00Yes (X)$0$0$0
ERIC BIEBER MD
CEO1.0054.00Yes (X)$39,761$2,147,073$1,074,267Yes (X)
DANIEL MEYERS
DIRECTOR1.001.00Yes (X)$0$0$0Yes (X)
RALPH DESTEPHANO
DIRECTOR1.001.00Yes (X)$0$0$0
ELIZABETH PATTON PHD
DIRECTOR1.001.00Yes (X)$0$0$0
THOMAS RILEY
DIRECTOR1.001.00Yes (X)$0$0$0
LEON T SAWYKO
DIRECTOR1.001.00Yes (X)$0$0$0
KAREN M GALLINA
VICE CHAIR1.001.00Yes (X)$0$0$0Yes (X)
JEFFREY C MAPSTONE
TREASURER/SECRETARY1.001.00Yes (X)$0$0$0Yes (X)
DIANNE COONEY MINER
DIRECTOR1.001.00Yes (X)$0$0$0
JULIA TEDESCO
DIRECTOR1.001.00Yes (X)$0$0$0
THOMAS R CRILLY
CFO1.0054.00$15,141$817,630$285,970Yes (X)
ROBERT NESSELBUSH
COO1.0054.00$25,439$1,373,703$555,080Yes (X)
HUGH THOMAS
CAO1.0054.00$18,035$973,891$412,117Yes (X)
MARK KLYCZEK
VICE PRESIDENT, LTC10.0045.00$56,780$255,512$68,100Yes (X)
MEGAN RIVERA
RN NURSE MANAGER40.000.00$111,249$0$2,588Yes (X)
SEVINA INCE
DIRECTOR NURSING, LTC40.000.00$106,821$0$7,114Yes (X)
WARREN HERN
FORMER CEO0.000.00$0$250,000$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$373,226TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,817,809TotReportableCompRltdOrgAmt
Total Other Compensation$2,405,236TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
NURSEFINDER
PO BOX 910738DALLASTX75391TEMPORARY STAFF SERVICES$2,919,495
MEDICAL STAFFING NETWORK
6551 PARK OF COMMERCE BLVDBOCA RATONFL33487TEMPORARY STAFF SERVICES$879,591
SUPPLEMENTAL HEALTH CARE
1640 W REDSTONE CENTER DRIVE SUITPARK CITYUT84098TEMPORARY STAFF SERVICES$172,691
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Government Grants$13,680GovernmentGrantsAmt
Total Contributions$13,680TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Business623000BusinessCd
Total Revenue Column$15,434,812TotalRevenueColumnAmt
Related Or Exempt Func Income$15,434,812RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$15,434,812TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,424TotalRevenueColumnAmt
Exclusion$1,424ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$162,807TotalRevenueColumnAmt
Related Or Exempt Func Income$162,807RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$162,807OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,612,723TotalRevenueColumnAmt
Related Or Exempt Func Income$15,597,619RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,424ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$209,855TotalAmt
Program Services$179,976ProgramServicesAmt
Management And General$29,879ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,497,575TotalAmt
Program Services$6,450,721ProgramServicesAmt
Management And General$1,046,854ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$542,730TotalAmt
Program Services$466,911ProgramServicesAmt
Management And General$75,819ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$911,010TotalAmt
Program Services$783,742ProgramServicesAmt
Management And General$127,268ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$484,581TotalAmt
Program Services$416,885ProgramServicesAmt
Management And General$67,696ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$19,927TotalAmt
Program Services$14,457ProgramServicesAmt
Management And General$5,470ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,660,540TotalAmt
Program Services$1,156,234ProgramServicesAmt
Management And General$504,306ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$22,028TotalAmt
Program Services$19,217ProgramServicesAmt
Management And General$2,811ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$36,903TotalAmt
Program Services$32,193ProgramServicesAmt
Management And General$4,710ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$264,244TotalAmt
Program Services$230,519ProgramServicesAmt
Management And General$33,725ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$86,423TotalAmt
Program Services$85,323ProgramServicesAmt
Management And General$1,100ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$4,701TotalAmt
Program Services$4,101ProgramServicesAmt
Management And General$600ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$125,113TotalAmt
Program Services$119,873ProgramServicesAmt
Management And General$5,240ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$822,377TotalAmt
Program Services$789,953ProgramServicesAmt
Management And General$32,424ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$11,344TotalAmt
Program Services$9,896ProgramServicesAmt
Management And General$1,448ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL AND FOOD SUPPLE$908,894$793,155$115,739
NYS REVENUE AND RECEIPT$796,801$796,801
BAD DEBT EXPENSE$353,747$353,747
SHARED SVCS EXPENSE ALL$115,711$91,314$24,397

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$241,591TotalAmt
Program Services$225,159ProgramServicesAmt
Management And General$16,432ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$15,116,095TotalAmt
Program Services$13,020,177ProgramServicesAmt
Management And General$2,095,918ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$749,766BOYAmt
EOY$1,840,384EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$36,649BOYAmt
EOY$38,717EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,461,030BOYAmt
EOY$1,141,063EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$11,652BOYAmt
EOY$11,652EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$761EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$22,073,310LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$13,386,584LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$9,338,857BOYAmt
EOY$8,686,726EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$37,128BOYAmt
EOY$117,326EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$11,635,082BOYAmt
EOY$11,836,629EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,205,499BOYAmt
EOY$1,275,891EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$36,486BOYAmt
EOY$32,182EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,004,231BOYAmt
EOY$3,391,859EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,452,588BOYAmt
EOY$2,262,822EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,698,804BOYAmt
EOY$6,962,754EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,936,278BOYAmt
EOY$4,834,589EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$39,286EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,936,278BOYAmt
EOY$4,873,875EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,635,082BOYAmt
EOY$11,836,629EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$496,628ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$440,969OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$421,170CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$348,672CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$24,405CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21,122CurrentTaxYearMinus1YearAmt
Current Tax Year$13,680CurrentTaxYearAmt
Total$829,049TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,427,715CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,973,462CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,102,242CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,659,212CurrentTaxYearMinus1YearAmt
Current Tax Year$15,434,812CurrentTaxYearAmt
Total$78,597,443TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,848,885CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,322,134CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,126,647CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,680,334CurrentTaxYearMinus1YearAmt
Current Tax Year$15,448,492CurrentTaxYearAmt
Total$79,426,492TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$79,426,492PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,974CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$909CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,722CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,334CurrentTaxYearMinus1YearAmt
Current Tax Year$1,424CurrentTaxYearAmt
Total$28,363TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$22,974CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$909CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,722CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,334CurrentTaxYearMinus1YearAmt
Current Tax Year$1,424CurrentTaxYearAmt
Total$28,363TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$119,547CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$35,904CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$132,279CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$79,983CurrentTaxYearMinus1YearAmt
Current Tax Year$162,807CurrentTaxYearAmt
Total$530,520TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,991,406CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,358,947CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,260,648CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$15,761,651CurrentTaxYearMinus1YearAmt
Current Tax Year$15,612,723CurrentTaxYearAmt
Total$79,985,375TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99300PublicSupportCY509Pct
Public Support PY5090.99250PublicSupportPY509Pct
Investment Income CY0.00040InvestmentIncomeCYPct
Investment Income PY0.00090InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART III, LINE 12:FormAndLineReferenceDesc
Explanation2017: ALL OTHER REVENUE $79,983 2018: ALL OTHER REVENUE $162,807ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Beginning Balance$36,486BeginningBalanceAmt
Additions During Year$60,107AdditionsDuringYearAmt
Distributions During Year$64,411DistributionsDuringYearAmt
Ending Balance$32,182EndingBalanceAmt
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$37,128BeginningYearBalanceAmt
Contributions$2,158ContributionsAmt
End Year Balance$39,286EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$47,827BeginningYearBalanceAmt
Contributions-$10,699ContributionsAmt
End Year Balance$37,128EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$41,502BeginningYearBalanceAmt
Contributions$215,221ContributionsAmt
Grants Or Scholarships$208,896GrantsOrScholarshipsAmt
End Year Balance$47,827EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$41,502BeginningYearBalanceAmt
End Year Balance$41,502EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$46,511BeginningYearBalanceAmt
Contributions$410,369ContributionsAmt
Grants Or Scholarships$415,378GrantsOrScholarshipsAmt
End Year Balance$41,502EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$485,000OtherCostOrOtherBasisAmt
Book Value$485,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$17,193,179OtherCostOrOtherBasisAmt
Depreciation$10,226,491DepreciationAmt
Book Value$6,966,688BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$133,026OtherCostOrOtherBasisAmt
Depreciation$88,780DepreciationAmt
Book Value$44,246BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,104,275OtherCostOrOtherBasisAmt
Depreciation$3,071,313DepreciationAmt
Book Value$1,032,962BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$157,830OtherCostOrOtherBasisAmt
Book Value$157,830BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$8,686,726TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
ACCRUED PENSION LIABILITY$1,768,893
DUE TO THIRD PARTY$469,708
SELF INSURANCE LIABILITY$24,221
FieldValueIRS element (for citing)
Total Liability$2,262,822TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:RESIDENTS HAVE AUTHORIZED NORTH PARK NURSING HOME TO MANAGE THEIR PERSONAL FINANCES. THE FACILITY HOLDS, SAFEGUARDS, MANAGES, AND ACCOUNTS FOR PERSONAL FUNDS OF THE RESIDENTS DEPOSITED WITH THE FACILITY. INDIVIDUAL RESIDENT FUNDS ARE DEPOSITED IN AN INTEREST-BEARING ACCOUNT AND EACH RESIDENT HAS AN INTERNAL ACCOUNTING OF THE BALANCE OF THEIR FUND. EACH RESIDENT IS PROVIDED ON A MONTHLY BASIS AN ACCOUNTING OF THEIR FUND BALANCE.
PART V, LINE 4:ENDOWMENT FUNDS HELD FOR INTENDED USE BY NORTH PARK 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 NORTH PARK NURSING HOME, INC.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ERIC BIEBER MD
CEO$19,900$1,074,614$17,946$969,063$1,915$103,396$19,327$1,043,644$205$11,091$59,293$3,201,808$19,209$1,037,291
THOMAS R CRILLY
CFO$8,858$478,324$5,854$316,136$429$23,170$4,994$269,680$205$11,091$20,340$1,098,401$8,299$448,170
ROBERT NESSELBUSH
COO$15,234$822,626$10,205$551,077$0$0$9,906$534,912$187$10,075$35,532$1,918,690$0$746,618
HUGH THOMAS
CAO$10,756$580,804$7,279$393,087$0$0$7,290$393,656$203$10,968$25,528$1,378,515$9,700$523,788
MARK KLYCZEK
VICE PRESIDENT, LTC$46,483$209,175$10,297$46,337$0$0$10,399$46,794$1,983$8,924$69,162$311,230$13,759$137,587
WARREN HERN
FORMER CEO$0$0$0$0$0$250,000$0$0$0$0$0$250,000$0$250,000

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3COMPENSATION 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, LINE 4BSUPPLEMENTAL 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 2018. 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 2018 TAX RETURN REPRESENTS COMPENSATION WHICH WAS RECOGNIZED IN PREVIOUS TAX YEARS. THERE WAS NO INCREMENTAL EXPENSE RECOGNIZED BY THE ORGANIZATION IN 2018 FOR PAYMENTS MADE TO THE FORMER CEO.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1EACH 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 6THE 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 7BROCHESTER 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 11BPRIOR 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 12CUPON 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 15THE 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 19THE 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 IX, LINE 11GOTHER: PROGRAM SERVICE EXPENSES 32,346. MANAGEMENT AND GENERAL EXPENSES 14,108. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 46,454. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 116,611. MANAGEMENT AND GENERAL EXPENSES 50,861. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 167,472. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 482,310. MANAGEMENT AND GENERAL EXPENSES 210,367. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 692,677. SHARED SERVICES: PROGRAM SERVICE EXPENSES 261,339. MANAGEMENT AND GENERAL EXPENSES 113,985. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 375,324. TEMPORARY STAFF SERVICES: PROGRAM SERVICE EXPENSES 263,628. MANAGEMENT AND GENERAL EXPENSES 114,985. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 378,613.
FORM 990, PART XI, LINE 9:FMV ADJUSTMENT ON DERIVATIVE INSTRUMENTS 19,104. PENSION ACTUARIAL VALUATION 419,708. CHANGE IN BENEFICIAL INTEREST IN FOUNDATION 1,050. OTHER 1,107.
FORM 990, PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR.
FORM 5471 FILED ON BEHALF STATEMENTSTATEMENT PURSUANT TO TREAS REG SEC 1 6038-2(J)(3) THE FOLLOWING INFORMATION IS SUBMITTED WITH RESPECT TO NORTH PARK NURSING HOME, INC. DBA EDNA TINA WILSON 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, 2018 ENDING TAX YEAR OF FOREIGN CORPORATION DECEMBER 31, 2018 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, 2018 TYPE OF RETURN FILED 990 IRS CENTER WHERE RETURN FILED OGDEN, UTAH 84201-0027.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (32 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
THE ROCHESTER GENERAL HOSPITAL
1425 PORTLAND AVENUEROCHESTERNY14621160743134HOSPITALNY501(C)(3)LINE 3ROCHESTER REGIONAL HEALTHYes (1)
GRHS FOUNDATION
100 KINGS HIGHWAY SOUTHROCHESTERNY14617223378111R/E INV MGMTNY501(C)(3)LINE 12B, IIROCHESTER REGIONAL HEALTHYes (1)
ROCHESTER REGIONAL HEALTH FOUNDATION
100 KINGS HIGHWAY SOUTHROCHESTERNY14617222229425FUNDRAISINGNY501(C)(3)LINE 12B, IIROCHESTER REGIONAL HEALTHYes (1)
NEWARK WAYNE COMMUNITY HOSPITAL FOUNDATION
DRIVING PARK AVENUENEWARKNY14513222963015FUNDRAISINGNY501(C)(3)LINE 12B, IIROCHESTER REGIONAL HEALTHYes (1)
NEWARK WAYNE COMMUNITY HOSPITAL
DRIVING PARK AVENUENEWARKNY14513150584188HOSPITALNY501(C)(3)LINE 3ROCHESTER REGIONAL HEALTHYes (1)
RGHS WORKERS' COMPENSATION TRUST
1425 PORTLAND AVENUEROCHESTERNY14621166429300SEE PART VIINY501(C)(3)LINE 12B, IIROCHESTER REGIONAL HEALTHYes (1)
CONTINUING CARE NETWORK INC (CCN)
100 KINGS HIGHWAY SOUTHROCHESTERNY14617222963016SUPPORT RGHNY501(C)(3)LINE 12B, IIROCHESTER REGIONAL HEALTHYes (1)
ROCHESTER GENERAL HUDSON HOUSING
2066 HUDSON AVENUEROCHESTERNY14621223210351LOW INC HOUSINGNY501(C)(3)LINE 10ROCHESTER REGIONAL HEALTHYes (1)
VIA HEALTH HOME CARE I
100 KINGS HIGHWAY SOUTHROCHESTERNY14617161504370HOME HEALTHNY501(C)(3)LINE 10CCNYes (1)
VIA HEALTH HOMECARE II
100 KINGS HIGHWAY SOUTHROCHESTERNY14617161538727HOME HEALTHNY501(C)(3)LINE 10CCNYes (1)
INDEPENDENT LIVING FOR SENIORS
2066 HUDSON AVENUEROCHESTERNY14617161491059ADULT DAY HCNY501(C)(3)LINE 10ROCHESTER REGIONAL HEALTHYes (1)
ROCHESTER GENERAL LONG TERM CARE
1550 EMPIRE BLVDWEBSTERNY14580223187140NH & REHABNY501(C)(3)LINE 10ROCHESTER REGIONAL HEALTHYes (1)
WESTERN NEW YORK MEDICAL PRACTICE PC
1425 PORTLAND AVENUEROCHESTERNY14621611654232PHYS PRACNY501(C)(3)LINE 10ROCHESTER REGIONAL HEALTHYes (1)
THE UNITY HOSPITAL OF ROCHESTER
1555 LONG POND RDROCHESTERNY14626237221763HOSPITALNY501(C)(3)LINE 3ROCHESTER REGIONAL HEALTHYes (1)
PARK RIDGE NURSING HOME INC
1555 LONG POND RDROCHESTERNY14626160978184LONG TERM CARE FACILITYNY501(C)(3)LINE 10ROCHESTER REGIONAL HEALTHYes (1)
PARK RIDGE CHILD CARE CENTER INC
1555 LONG POND RDROCHESTERNY14626222918126CHILD DAY CARE SERVICESNY501(C)(3)LINE 10ROCHESTER REGIONAL HEALTHYes (1)
PARK RIDGE HOUSING DEVELOPMENT FUND
1555 LONG POND RDROCHESTERNY14626222608311LOW INCOME HOUSING PROJECT FOR ELDERLYNY501(C)(3)LINE 10ROCHESTER REGIONAL HEALTHYes (1)
PARK RIDGE HOUSING INC
1555 LONG POND RDROCHESTERNY14626222570457SENIOR APARTMENT COMPLEXNY501(C)(3)LINE 10ROCHESTER REGIONAL HEALTHYes (1)
PARKWAY COMMONS HOUSING DEVELOPMENT
1555 LONG POND RDROCHESTERNY14626223130818LOW INCOME HOUSING FOR ELDERLY/HANDICAPPEDNY501(C)(3)LINE 10ROCHESTER REGIONAL HEALTHYes (1)
UNITY AGING SERVICES INC
1555 LONG POND RDROCHESTERNY14626841684195MANAGEMENT AND DEVELOPMENT CONY501(C)(3)LINE 10ROCHESTER REGIONAL HEALTHYes (1)
UNITY HOUSING DEVELOPMENT FUND CORP
1555 LONG POND RDROCHESTERNY14626300068596RECEIPT AND DISBURSEMENTS OF SUBSIDIESNY501(C)(3)LINE 10ROCHESTER REGIONAL HEALTHYes (1)
WOODLAND VILLAGE INC
1555 LONG POND RDROCHESTERNY14626161588242SENIOR APARTMENT COMPLEXNY501(C)(3)LINE 10ROCHESTER REGIONAL HEALTHYes (1)
UNITY AMBULATORY SURGERY CENTER INC
1555 LONG POND RDROCHESTERNY14626383871383OUTPATIENT SURGERYNY501(C)(3)LINE 10ROCHESTER REGIONAL HEALTHYes (1)
UNITY HEALTH SYSTEM INC
1555 LONG POND ROADROCHESTERNY14626222572873SYSTEM SUPPORTNY501(C)(3)LINE 12B, IIROCHESTER REGIONAL HEALTHYes (1)
ROCHESTER REGIONAL HEALTH
100 KINGS HIGHWAY SOUTHROCHESTERNY14617471234999SYSTEM PARENTNY501(C)(3)LINE 12B, IIYes (1)N/A
UNITED MEMORIAL MEDICAL CENTER
127 NORTH STREETBATAVIANY14020160743029HOSPITALNY501(C)(3)LINE 3ROCHESTER REGIONAL HEALTHYes (1)
CLIFTON SPRINGS HOSPITAL AND CLINIC
2 COULTER ROADCLIFTON SPRINGSNY14432160743966HOSPITALNY501(C)(3)LINE 3ROCHESTER REGIONAL HEALTHYes (1)
BEHAVIORAL HEALTH NETWORK INC
490 EAST RIDGE ROADROCHESTERNY14621166069131MENTAL HEALTHNY501(C)(3)LINE 10ROCHESTER REGIONAL HEALTHYes (1)
PRCD INC
1555 LONG POND RDROCHESTERNY14626161311581SUBSTANCE ABUSE TREATMENT & REHAB.NY501(C)(3)LINE 7ROCHESTER REGIONAL HEALTHYes (1)
ROCHESTER GENERAL HEALTH SYSTEM
100 KINGS HIGHWAY SOUTHROCHESTERNY14617222551509SYSTEM SUPPORTNY501(C)(3)LINE 12B, IIROCHESTER REGIONAL HEALTHYes (1)
UNITED MEMORIAL MEDICAL CENTER FOUNDATION
127 NORTH STREETBATAVIANY14020222611543FUNDRAISINGNY501(C)(3)LINE 12B, IIUNITED MEMORIAL MEDICAL CENTERYes (1)
CLIFTON SPRINGS HOSPITAL & CLINIC FOUNDATION
2 COULTER ROADCLIFTON SPRINGSNY14432161560033FUNDRAISINGNY501(C)(3)LINE 12B, IIROCHESTER REGIONAL HEALTHYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPctDirect Controlling NADirectControllingNACd
NW ASSOCIATES LP
PO BOX 111 DRIVING PARK AVENUENEWARKNY14513141674119R/E LEASINGNYNWCHRELATED000.75100
PARMA SENIOR HOUSING
1555 LONG POND RDROCHESTERNY14626432082116HILTON PROJNY00N/A
UNITY SENIOR HOUSING ASSOCIATES LP
1555 LONG POND RDROCHESTERNY14626061709927MOORE PKNY00N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtOwnershipOwnershipPctControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
GREATER ROCHESTER ASSURANCE COMPANY LTD
GEORGE TOWNGRAND CAYMANCJINSURANCECJN/AC1.000000
GRACO RISK RETENTION GROUP INC
INSURANCEC1.0000001425 PORTLAND AVENUEROCHESTERNY14621710933967SCRGH
NWA INC
R/E LEASINGC1.000000DRIVING PARK AVENUENEWARKNY14513141667339NYNWCH
GREATER ROCHESTER INDEPENDENT PRACTICE ASSOCIATION INC
INDEPENDENT PRACTICE ASSOCIATIONN/AC0.500000100 KINGS HWY S SUITE 2500ROCHESTERNY14617161507171NY
ROCHESTER GENERAL HEALTH SYSTEM DIALYSIS INC
DIALYSISC1.0000001425 PORTLAND AVENUEROCHESTERNY14621383912199NYRGHS
ACM MEDICAL LABORATORY INC
CLINICAL LABC0160 ELMGROVE PARKROCHESTERNY14624161059691NYPRH INC
PRH INC
MEDICAL LABC01555 LONG POND ROADROCHESTERNY14626161329632NYROCHESTER REGIONAL HEALTH
GREATER ROCHESTER IMMEDIATE MEDICAL CARE PLLC DBA ROCHESTER IMMEDIATE CARE
URGENT CARE CENTERSC0265 BROOKVIEW CENTRE WAY SUITE 400KNOXVILLETN37919271453784TNWESTERN NEW YORK MEDICAL PC
ROCHESTER MEDICINE PLLC
OCCUPATIONAL MEDICINEC0265 BROOKVIEW CENTRE WAY SUITE 400KNOXVILLETN37919812625325TNWESTERN NEW YORK MEDICAL PC
PARMA SENIOR HOUSING LLC
SENIOR HOUSINGC01555 LONG POND ROADROCHESTERNY14626810671687NYROCHESTER REGIONAL HEALTH
UNITY SENIOR HOUSING CORP
SENIOR HOUSINGC01555 LONG POND ROADROCHESTERNY14624061709925NYROCHESTER REGIONAL HEALTH
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
ROCHESTER REGIONAL HEALTH SYSTEM
P$417,419FMV
ROCHESTER GENERAL HOSPITAL
P$998,174FMV
INDEPENDENT LIVING FOR SENIORS
L$722,586FMV
THE UNITY HOSPITAL OF ROCHESTER
P$1,756,319FMV

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART II, COLUMN (B):FormAndLineReferenceDesc
ExplanationRGHS 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 AND UNITED MEMORIAL MEDICAL CENTER.ExplanationTxt