2018-09-26T17:41:37-07:00 2017-12-31 990 2017-01-01 161005419 GENESEE VALLEY GROUP HEALTH ASSOCIATION GENE 5852384579 165 Court Street Rochester NY 14647 James Haefner Sr Vice President & Asst Treasurer 5853276505 2018-09-28 2017 2022-09-23 18:48:47Z Lifetime Health Medical Group Paul Eisenstat 165 Court Street Rochester NY 14647 55614386 0 X www.lifetimehealth.org X 1972 NY Genesee Valley Group Health Association, Inc. provides primary health care for patients in Buffalo and Rochester. A variety of services are offered at each health center and most sites to include pharmacy, laboratory, radiology, internal medicine, pediatrics, family practice and specialty care. X 3 0 533 0 0 0 0 0 32726981 30508935 1091039 4916450 2727182 2771235 36545202 38196620 0 0 0 0 37219939 41343128 0 0 0 12904042 12812368 50123981 54155496 -13578779 -15958876 13307046 12270189 34446302 49436327 -21139256 -37166138 Lifetime Health Medical Group exists to support our patients' pursuit of healthier lives by providing exceptional, high quality and affordable services in a caring environment. We will be the provider of choice in our community by delivering patient-focused, innovation and valued health care. 0 0 40135627 30508935 Health Care Delivery: Health Services (212,810 visits) 0 0 0 40135627 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 1 0 0 1 56 0 1 533 1 0 0 0 0 0 0 0 0 0 0 X 3 0 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X James C Haefner 5853276505 165 Court Street Rochester NY 14647 X Christopher C Booth Director 0.4 40 X 0 2349453 536214 Dorothy Coleman CFO and Treasurer 0.4 40 X X 0 1181196 140735 Stephen Sloan Secretary 0.4 40 X X 0 922299 216509 Paul Eisenstat CEO 2 40 X 0 631510 61811 Stephen LaSalle COO 40 0 X 0 376515 62770 Margaret Cassady Assistant Secretary 1.8 40 X 0 290384 44293 James Haefner Assistant Treasurer 0.4 40 X 0 312483 77207 Stephen Cohen President 20 20 X 0 433884 75779 Mark Perry Chief Medical Officer 40 0 X 0 442154 27483 Robert Cole Medical Director 40 0 X 377175 0 37332 Douglas Golding Medical Director 40 0 X 0 327944 47420 Deborah Carlascio VP Patient Clinicial Services 40 0 X 0 247340 58051 Karen Feigel Marketing & Communications Director 40 0 X 142121 0 30438 Darren Houpt Medical Director 40 0 X 243467 0 34232 Michael Jordan Physician 40 0 X 450122 0 37807 Valerie Newman Physician 40 0 X 445171 0 32574 Stephanie Fretz Physician 0 0 X 343113 0 35124 Josephine Ellis Physician 40 0 X 332695 0 21994 Zhong Guo Physician 40 0 X 335016 0 33515 David H Klein Former CEO 0 0 X 0 1617659 12339 Theo Turque Former Medical Director 0 0 X 191624 0 30755 Eugene Ver Former Physician 0 0 X 254763 0 18227 Richard Vienne Former VP & CMO 0 0 X 10180 311224 62354 Matthew Bartels Former Physician 0 0 X 0 170064 27594 Maritza Baez Former Physician 0 0 X 285149 0 16423 3410596 9614109 1778980 67 1 1 0 LeChase Construction Services 205 Indigo Creek Drive Rochester NY 14626 Construction Mgmt Services 812467 Ciminelli Real Estate Corp 50 Fountain Plaza Buffalo NY 14202 Property Mgmt Services 494164 Quality Systems Inc PO Box 809390 Chicago IL 60680 Software Maintenance 419519 Windsong Radiology Group 55 Spindrift Drive Williamsville NY 14221 Radiology Services 311670 Iron Mountain Inc Dept 785 PO Box 60709 Los Angeles CA 90060 Records Mgmt Services 171232 6 0 Fee For Service Revenue 621110 29142181 29142181 0 0 Capitation Revenue 621110 1366754 1366754 0 0 0 0 0 0 30508935 1218730 1218730 0 0 0 0 0 0 0 0 0 0 57068 0 0 0 57068 0 57068 0 0 57068 0 7537797 0 3840077 0 3697720 3697720 0 0 3697720 16291856 13577689 2714167 0 0 2714167 0 38196620 31727665 0 6468955 0 0 0 0 0 0 0 0 2747124 0 2747124 0 0 0 0 0 31741915 25356620 6385295 0 759159 606444 152715 0 4206679 2767039 1439640 0 1888251 1619936 268315 0 0 0 0 0 276721 0 276721 0 138105 0 138105 0 0 0 0 0 0 0 0 0 0 0 2895443 2765676 129767 0 131077 57921 73156 0 1405818 911058 494760 0 816718 172581 644137 0 0 0 0 0 2951768 2943938 7830 0 86474 29168 57306 0 0 0 0 0 19130 11616 7514 0 80005 0 80005 0 0 0 0 0 1014309 510935 503374 0 618325 4220 614105 0 Other Exp - Medical Supplies 2353226 2353226 0 0 Other Exp - Miscellaneous 25249 25249 0 0 54155496 40135627 14019869 0 11186 0 2929929 7204349 1936391 40041 530639 31154 2207176 1780568 3910445 426608 3988456 4568037 13307046 12270189 3511525 6579553 30934777 42856774 34446302 49436327 X -21139256 -37166138 0 0 0 0 -21139256 -37166138 13307046 12270189 X -15958876 0 0 0 0 -68006 X 0 1 X 1 0 X Schedule A, Part I, Line 3 Genesee Valley Group Health Association is exempt as a hospital under Internal Revenue Code Section 170(b)(1)(A)(iii); however it is not a hospital as defined by the Form 990, Section H instructions: "a hospital is a facility that is, or is required to be licensed, registered, or similarly recognized by a state as a hospital." Genesee Valley Group Health Association does not meet any of these requirements. Genesee Valley Group Health Association is licensed under Article 28 of the New York State Public Health Law to operate diagnostic and treatment centers. 0 289674 289674 0 1604901 1548079 56822 0 164840 122483 42357 0 147761 110006 37755 0 0 0 0 426608 0 0 Investment in Limited Liability Company 4568037 F 4568037 Due to Affiliates 39751892 Post Retirement Benefit Obligation 2040474 Long Term Debt and Capital Leases 1064408 42856774 X 48076589 0 0 0 13577689 13577689 34498900 0 3697720 3697720 38196620 67733185 0 0 0 13577689 13577689 54155496 0 0 0 54155496 Schedule D, Part X, Line 2 Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 740, Income Taxes, provides that a tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. Income tax positions must meet a more likely than not recognition threshold to be recognized. This Topic also provides guidance on measurement, derecognition, classification, interest and penalties, accounting in interim periods, disclosure and transition. The Company recognizes any interest and penalties related to unrecognized tax benefits within the other expenses line in the accompanying statements of activities and changes in accumulated deficit. Accrued interest and penalties are included within accounts payable and accrued expenses in the accompanying statements of financial position. There were no interest and penalties recognized for 2017 or 2016. The Company does not anticipate any uncertain tax positions within the next twelve months. As of December 31, 2017, the Company's tax years for 2014 through 2017 are subject to examination by tax authorities. Schedule D, Part XI, Line 2d Pharmacy Cost of Goods Sold Removed from Pharmacy Revenue: $<13,577,689> Schedule D, Part XI, Line 4b Gain on Disposal of Property, Equipment and Other Assets (Net): $3,697,720 Schedule D, Part XII, Line 2d Pharmacy Cost of Goods Sold: $<13,577,689> 0 1 0 0 0 0 0 0 0 Christopher C Booth Director 0 983230 0 1356757 0 9466 0 508731 0 27483 0 2885667 0 0 Dorothy Coleman CFO and Treasurer 0 579621 0 589746 0 11829 0 110038 0 30697 0 1321931 0 0 Stephen Sloan Secretary 0 491958 0 420997 0 9344 0 196102 0 20408 0 1138809 0 0 Paul Eisenstat CEO 0 386973 0 241995 0 2543 0 38119 0 23692 0 693322 0 0 Stephen LaSalle COO 0 224505 0 95861 0 56150 0 40295 0 22475 0 439286 0 0 Margaret Cassady Assistant Secretary 0 242672 0 44909 0 2803 0 34175 0 10118 0 334677 0 0 James Haefner Assistant Treasurer 0 224696 0 83945 0 3842 0 49742 0 27465 0 389690 0 0 Stephen Cohen President 0 306446 0 122302 0 5136 0 53231 0 22548 0 509663 0 0 Mark Perry Chief Medical Officer 0 277138 0 63071 0 101944 0 11379 0 16104 0 469636 0 0 Robert Cole Medical Director 303794 0 72552 0 830 0 8100 0 29232 0 414508 0 0 0 Douglas Golding Medical Director 0 246557 0 40746 0 40640 0 20139 0 27281 0 375363 0 0 Theo Turque Former Medical Director 190533 0 0 0 1091 0 5460 0 25295 0 222379 0 0 0 Deborah Carlascio VP Patient Clinicial Services 0 188855 0 55811 0 2674 0 40487 0 17563 0 305390 0 0 Michael Jordan Physician 137891 0 310840 0 1391 0 8100 0 29707 0 487929 0 0 0 Valerie Newman Physician 236891 0 205854 0 2426 0 5965 0 26609 0 477745 0 0 0 Stephanie Fretz Physician 120317 0 220601 0 2195 0 5700 0 29424 0 378237 0 0 0 Eugene Ver Former Physician 251120 0 0 0 3643 0 6767 0 11460 0 272990 0 0 0 Richard Vienne Former VP & CMO 10180 260422 0 48269 0 2533 190 34088 12 28065 10382 373377 0 0 David H Klein Former CEO 0 0 0 0 0 1617659 0 0 0 12339 0 1629998 0 1610815 Matthew Bartels Former Physician 0 124119 0 45332 0 612 0 14917 0 12678 0 197658 0 0 Maritza Baez Former Physician 160340 0 123758 0 1052 0 6806 0 9617 0 301573 0 0 0 Karen Feigel Marketing & Communications Director 122767 0 17538 0 1816 0 4491 0 25946 0 172558 0 0 0 Darren Houpt Medical Director 242816 0 0 0 652 0 7014 0 27218 0 277700 0 0 0 Zhong Guo Physician 171616 0 162053 0 1347 0 8100 0 25415 0 368531 0 0 0 Josephine Ellis Physician 163481 0 168081 0 1134 0 0 0 21994 0 354690 0 0 0 Schedule J, Part I, Line 3 Schedule J, Part I, Line 3- The CEO of the filing organization is compensated by a related organization. His compensation is determined in accordance with the Board of Directors approved Executive Compensation Philosophy. The executive process includes an evaluation of market comparable organizations. The Secretary, CFO, and Treasurer of the filing organization are also the Secretary, CFO, and Treasurer of the related organization. The process to determine their compensation includes the use of an external consultant and approval of the Board of Directors of the related organization. Schedule J, Part I, Line 4 Schedule J, Part I, Line 4 - Line 4b - The following persons from Part VII, Section A, Line 1a participated in a supplemental nonqualified retirement plan of a related organization: D. Klein, D. Coleman, C. Booth, S. Sloan, P. Eisenstat, J. Haefner, M. Cassady, M. Perry, D. Golding, S. LaSalle, S. Cohen, M. Bartels, and R. Vienne. Schedule J, Part II Schedule J, Part II - Schedule J Part II, Column (B)(iii) - The amount of Other Reportable Compensation for David Klein of $1,617,659 consists primarily of payments of $1,610,815 from a Supplemental Excess Retirement Plan (SERP) maintained by a related party. The SERP payment was reported on a prior 990 and therefore is recorded in column (F.) Excellus Health Plan Parent 12870274 Revenue from Parent 0 Excellus Health Plan Parent 6334122 Mgmt Fees & Purchased Services 0 Excellus Health Plan Parent 1577410 Rental of Space 0 Schedule L, Part IV The filing organization has various business transactions with Excellus Health Plan Inc whose CEO, CFO/Treasurer, Secretary, Assistant Secretary and Assistant Treasurer are also officers of the filing organization. Pharmacy Business and Inventory 2017-10-05 2313941 Third Party Appraisal 231940649 Rite Aid of New York PO Box 3165 Harrisburg PA 17105 Corporation Medical Practices, Equipment and Pharmacy Inventory 2017-12-31 2111540 Third Party Appraisal 160743134 Rochester General Hospital 100 Kings Highway South Rochester NY 14617 501(c)(3) Medical Building and Land 2017-12-31 1912315 Third Party Appraisal 223378111 GRHS Foundation 100 Kings Highway South Rochester NY 14617 501(c)(3) Medical Practices, Equipment and Pharmacy Inventory 2017-12-31 1200000 Third Party Appraisal 160743209 University of Rochester 601 Elmwood Avenue Rochester NY 14622 501(c)(3) Legal Expenses Related to Dissolution 2017-12-31 18686 Hourly Rate Hinman Straub PC 21 State Street Albany NY 12207 PC 0 1 0 1 Schedule N, Part II, Line 2 During 2017 the process of liquidating and dissolving the reporting entity began with an expected completion date of 9/30/18. Assets, including medical buildings, equipment, pharmacy inventories and medical practices were sold in 2017 to other 501(c)(3) tax exempt organizations. Other pharmacy scripts and inventories were sold to Rite Aid of New York. Third party appraisals were obtained for assets sold. The agreed upon sales prices were presented to and approved by the New York State Attorney General. Certain employees of the reporting entity were offered positions with the purchaser. Of these, Robert Cole MD a key employee of the reporting entity accepted a position with the purchaser in 2018. The following employees were offered severances and or retention packages expected to be paid subsequent to the reporting period ended 12/31/17: Officer: Stephen LaSalle (COO); Key Employees: Mark Perry (CMO), Robert Cole (Medical Director), Douglas Golding (Medical Director), Deborah Carlascio (VP Patient Clinical Services), Karen Feigel (Communications Director); Key Employees: Michael Jordan (Physician), Stephanie Fretz (Physician) and Zhong Guo (Physician). Form 990, Part VI, Section A, Line 2 GVGHA officers Stephen Cohen and Stephen LaSalle and GVGHA key employees Mark Perry, Douglas Golding and Deb Carlascio are employees of Excellus Health Plan, Inc (a related organization). Such employees have a business relationship with GVGHA officers Christopher Booth, Dorothy Coleman, Stephen Sloan, James Haefner and Margaret Cassady who are also officers of Excellus Health Plan, Inc. Form 990, Part VI, Section A, Line 6 The organization's sole member is Excellus Health Plan, Inc. Form 990, Part VI, Section A, Line 7a Pursuant to a resolution of the Board of Directors of Excellus Health Plan, Inc. (the sole member of the organization) the Chief Executive Officer of Excellus Health Plan, Inc. is empowered to act on behalf of Excellus Health Plan, Inc. to elect or reelect the organization's directors. This occurs at a joint annual meeting of the sole member and Board of Directors of the organization, which is held during the first six months of the year pursuant to the Bylaws of the organization. Form 990, Part VI, Section A, Line 7b Bylaw amendments must be approved by the sole member. Certain governance actions (such as the sale of all or substantially all of the assets of the organization) require approval of the member under the New York Not-for-Profit Corporation Law. Form 990, Part VI, Section B, Line 11b The completed IRS Form 990 was provided to the organization's Board of Directors prior to filing allowing the opportunity for review. Responses were provided to questions raised by the governing body and any comments were analyzed and incorporated as applicable. Form 990, Part VI, Section B, Line 12c The organization's Conflict of Interest Policy is regularly and consistently enforced via a robust annual process. Annually, all employees who hold a position at the director level or above complete the Conflict of Interest Questionnaire. New or newly promoted employees at the director level or above complete the questionnaire at the time of employment or promotion. The Corporate Director of Ethical Compliance is responsible for the annual distribution, tracking, review and reporting of the Conflict of Interest or potential Conflict of Interest Questionnaires for employees of the corporation. Corporate legal counsel reviews all Conflicts of Interest or potential Conflicts of Interest and makes recommendations. Form 990, Part VI, Section B, Line 15 The CEO, other officers and key employee compensation is established in conjunction with the Board of Directors by having Human Resources engage independent compensation consultants that provide compensation surveys and information of comparable organizations, as well as market standards and best practices, to make informed compensation decisions on a prospective basis. Form 990, Part VI, Section C, Line 18 The organization's Form 990 is available online via GuideStar.org. Form 990, Part VI, Section C, Line 19 Governing documents, conflict of interest policy and financial statements are available to the public upon request. Form 990, Part VII, Section A, Line 1a Column B - Some of the trustees and officers that devote time to the filing organization do so on an allocated basis as supported by a management fee arrangement with a related organization. Such trustees and officers receive their compensation from a related organization. In some cases, these trustees and officers devote all of their time to the filing organization and in others, the related organization is where the majority of their time is devoted. Form 990, Part XI, Line 9 Pension-Related Changes Other Than Net Periodic Pension Cost Genesee Region Home Care Assoc Inc 165 Court Street Rochester NY 14647 160844109 Home Health Services NY 501(c)(3) 509(a)(2) Excellus Health Plan 1 Genesee Region Home Care of Ontario County Inc 165 Court Street Rochester NY 14647 223257719 Home Health Services NY 501(c)(3) 509(a)(2) Excellus Health Plan 1 Lifetime Healthcare Inc 165 Court Street Rochester NY 14647 161514675 Holding Co NY N/A C 0 Excellus Health Plan Inc 165 Court Street Rochester NY 14647 150329043 Health Insurer NY N/A C Beacon Network Services Inc 165 Court Street Rochester NY 14647 141830065 Inactive NY N/A C Excellus Acquisition Inc 165 Court Street Rochester NY 14647 141830065 Holding Co NY N/A C MedAmerica Inc 165 Court Street Rochester NY 14647 161581817 Holding Co NY N/A C Excellus Ventures Inc 165 Court Street Rochester NY 14647 161550984 Holding Co NY N/A C MedAmerica Insurance Company of NY 165 Court Street Rochester NY 14647 161310986 Long Term Care Ins NY N/A C MedAmerica Insurance Company 165 Court Street Rochester NY 14647 340977231 Long Term Care Ins PA N/A C MedAmerica Insurance Company of FL 165 Court Street Rochester NY 14647 141993330 Long Term Care Ins FL N/A C Lifetime Benefit Solutions Inc 165 Court Street Rochester NY 14647 161171765 Third Party Administrator NY N/A C MedAmerica Reinsurance Company f/k/a MIG Assurance Ltd 165 Court Street Rochester NY 14647 980210843 Long Term Care Insurance CJ N/A C Lifetime Healthcare Companies Workers' Compensation Trust 165 Court Street Rochester NY 14647 161483185 Grantor Trust NY N/A T 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 0 Excellus Health Plan Inc l 12870274 Fair Market Value Excellus Health Plan Inc m 6334122 Fair Market Value Excellus Health Plan Inc k 1577410 Fair Market Value