2015-11-13T14:57:54-06:00 2014-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2014-01-01 160978184 PARK RIDGE NURSING HOME INC DBA PARK RIDGE LIVING CENTER PARK 5853686290 1555 LONG POND RD ROCHESTER NY 14626 THOMAS R CRILLY CFO 5853686290 2015-11-11 1 ANGELA M FRANCO P00589741 3154463600 2014 2016-03-07 17:11:31Z ERIC BIEBER MD 1555 LONG POND RD ROCHESTER NY 14626 26018454 0 X WWW.UNITYHEALTH.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. 25 24 397 0 0 0 1999549 2647132 22079143 23367663 2262 2265 1890 1394 24082844 26018454 0 0 0 0 15306447 17024573 0 0 0 8862261 8949646 24168708 25974219 -85864 44235 28918606 28844832 24255261 27305154 4663345 1539678 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 1 15555237 15780607 120-BED NURSING FACILITY PROVIDING 43,046 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. 3227528 3901371 CERTIFIED HOME HEALTH AGENCY PROVIDING 1,750 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. 1843678 2326137 THREE SOCIAL DAYCARES CENTERS PROVIDING 19,812 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 870 CUSTOMERS. A MULTIPLE SCLEROSIS ACHIEVEMENT CENTER PROVIDING 6,655 CLIENT CARE DAYS. THIS PROGRAM SERVES MID-TO-LATE STAGE M.S. PATIENTS AS WELL AS INDIVIDUALS WITH OTHER NEUROLOGICAL DIAGNOSES. 1504066 1360246 LONG-TERM HOME HEALTHCARE PROGRAM PROVIDING 4,491 PROFESSIONAL VISITS AND 22,062 AIDE HOURS. 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. 1504066 1360246 22130509 1 0 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 0 0 397 1 0 0 0 0 0 0 0 0 0 0 X 25 24 0 0 1 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X CHRIS PETERSON 5859220089 100 KINGS HIGHWAY ROCHESTER NY 14617 LINDA BECKER DIRECTOR 1.00 1.00 X 0 0 0 ERIC BIEBER MD CEO 1.00 54.00 X X 1014 100366 189013 ROBERT DOBIES CHAIRMAN OF THE BOARD 1.00 1.00 X 0 0 0 MICHAEL NUCCITELLI VICE CHAIRMAN 1.00 1.00 X 0 0 0 FAHEEM MASOOD SECRETARY 1.00 1.00 X 0 0 0 DANIEL MEYERS DIRECTOR 1.00 1.00 X 0 0 0 THOMAS PENN MD DIRECTOR 1.00 1.00 X 0 0 0 JOHN RIEDMAN DIRECTOR 1.00 1.00 X 0 0 0 RACHAEL ADONIS DIRECTOR 1.00 1.00 X 0 0 0 ROBERT S SANDS TREASURER 1.00 1.00 X 0 0 0 RALPH DESTEPHANO DIRECTOR 1.00 1.00 X 0 0 0 ROBERT HAVRILLA DIRECTOR 1.00 1.00 X 0 0 0 JAGAT MEHTA MD 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 NANCY FERRIS PHD DIRECTOR 1.00 1.00 X 0 0 0 JOHN GENIER MD DIRECTOR 1.00 1.00 X 0 0 0 TARUN KOTHARI MD DIRECTOR 1.00 1.00 X 0 0 0 ANNA LYNCH DIRECTOR 1.00 1.00 X 0 0 0 LEONARD OLIVIERI DIRECTOR 1.00 1.00 X 0 0 0 EFRAIN RIVERA DIRECTOR 1.00 1.00 X 0 0 0 LEON T SAWYKO DIRECTOR 1.00 1.00 X 0 0 0 JUSTIN SMITH DIRECTOR 1.00 1.00 X 0 0 0 KAREN M GALLINA DIRECTOR 1.00 1.00 X 0 0 0 JEFFREY C MAPSTONE DIRECTOR 1.00 1.00 X 0 0 0 THOMAS R CRILLY CFO 2.00 53.00 X X 25704 616881 60281 MARK CLEMENT CEO (UNTIL 11/30/14) 0.00 55.00 X 0 3233272 2090584 WARREN HERN CEO (UNTIL 11/30/14) 0.00 55.00 X 64201 1005797 6420216 ROBERT NESSELBUSH COO 1.00 54.00 X 15111 1495963 86315 HUGH THOMAS CAO 1.00 54.00 X 12680 1255320 70527 PATRICIA RUBIEN ADMINISTRATOR 40.00 X 187189 20799 9809 BARBARA GRAY VP, HOMECARE 40.00 X 185274 0 5893 PATTI MURPHY SR. DIRECTOR, NURSING & RESIDENT SERVICES 40.00 X 100191 0 4988 591364 7728398 8937626 3 0 1 0 GENESEE TRANSPORTATION 355 PORTLAND AVE ROCHESTER NY 14605 TRANSPORTATION 107105 1 2398034 249098 2647132 MEDICAID 623000 10809518 10809518 PRIVATE PAY 623000 4685324 4685324 MEDICARE / HMO 623000 4119759 4119759 MEDICARE 623000 2631489 2631489 BLUE CROSS 623000 239725 239725 881848 881848 23367663 2265 2265 INTEREST-DELING ACCTS 623000 696 696 698 698 1394 26018454 23368361 0 2961 250224 196289 53935 13496847 11351253 2145594 531295 446288 85007 1734508 1456986 277522 1011699 849827 161872 15061 12651 2410 24762 20800 3962 1597482 1341885 255597 2292 1925 367 202577 170165 32412 156698 131626 25072 599020 503177 95843 169864 142686 27178 906123 761143 144980 957450 804258 153192 137094 115159 21935 ALLOWANCE FOR DOUBTFUL 1216904 1216904 MEDICAL AND FOOD SUPPLI 1177321 988950 188371 NYS REVENUE & RECEIPTS 734118 734118 SERVICE CONTRACTS 410585 344891 65694 642295 539528 102767 25974219 22130509 3843710 0 2090 4942 44980 21601 25743 49748 4076053 4432926 7340 6358 33650 40370 25608167 5421511 20772994 20186656 1512753 1515019 2443003 2587212 28918606 28844832 1106802 980181 273788 286079 17835000 17515000 47347 23740 4992324 8500154 24255261 27305154 X 4663345 1539678 4663345 1539678 28918606 28844832 X 44235 -76 -3167826 X X 0 1 X 1 0 X 1187357 1916333 2210432 1999549 2647132 9960803 22722626 22633285 21166079 22079143 23367663 111968796 23909983 24549618 23376511 24078692 26014795 121929599 0 0 0 121929599 13032 3688 2277 2262 2265 23524 13032 3688 2277 2262 2265 23524 1368 2818 1371 1890 1394 8841 23924383 24556124 23380159 24082844 26018454 121961964 0.99970 0.99880 0.00020 0.00110 X 0 24924 76587 77771 23740 1 165880 16345 356 59223 123358 216788 30201 268 81377 165880 440300 24652 276 248440 216788 740649 311017 230 611596 440300 1313857 95021 136 668365 740649 0.05530 0.94470 0 1 1 4736 4736 21832931 3380053 18452878 43391 7416 35975 505535 171750 333785 3221574 1862292 1359282 20186656 DEFERRED FINANCING COSTS 506349 THIRD PARTY SETTLEMENTS 2080863 2587212 ACCRUED PENSION 5735151 DUE TO AFFILIATES 2232664 LIBOR INTEREST RATE SWAP VALUATION 532339 8500154 26018454 0 26018454 0 26018454 25974219 0 25974219 0 25974219 PART V, LINE 4: ENDOWMENT FUNDS HELD FOR INTENDED USE BY PARK RIDGE NURING HOME, INC. ARE IN THE POSSESSION OF THE UNITY HEALTH SYSTEM 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 1014 100366 0 0 0 0 1886 186677 5 445 2905 287488 0 0 THOMAS R CRILLY CFO 15837 380082 3674 88165 6193 148634 2120 50880 291 6990 28115 674751 0 0 MARK CLEMENT CEO (UNTIL 11/30/14) 0 750257 0 714173 0 1768842 0 2086033 0 4551 0 5323856 0 882997 WARREN HERN CEO (UNTIL 11/30/14) 45960 720034 14429 226049 3812 59714 384852 6029348 361 5655 449414 7040800 7360 115313 ROBERT NESSELBUSH COO 5944 588412 3556 352082 5611 555469 791 78334 72 7118 15974 1581415 3408 337343 HUGH THOMAS CAO 4704 465698 2920 289088 5056 500534 629 62246 77 7575 13386 1325141 2881 285229 PATRICIA RUBIEN ADMINISTRATOR 140801 15645 46388 5154 0 0 0 0 8828 981 196017 21780 0 0 BARBARA GRAY VP, HOMECARE 157252 0 28022 0 0 0 0 0 5893 0 191167 0 0 0 PART I, LINE 3 COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS INCLUDING: -ERIC BIEBER, M.D. (PRESIDENT & CEO) -THOMAS CRILLY (CFO) -MARK CLEMENT (CEO UNTIL 11/30/14) -WARREN HERN (CEO UNTIL 11/30/14) -HUGH THOMAS (CAO) -ROBERT NESSELBUSH (COO) USED THE FOLLOWING TO ESTABLISH THEIR COMPENSATION AND BENEFITS: - 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. IN 2014, DUE TO UNIQUE CIRCUMSTANCES RESULTING FROM THE COMBINATION OF RGHS & UHS TO FORM RU SYSTEM INC., D/B/A ROCHESTER REGIONAL HEALTH, AND ON BASIS OF INPUT FROM AN INDEPENDENT COMPENSATION CONSULTANT, THE LEGACY EXECUTIVE COMPENSATION COMMITTEES DETERMINED IT WAS PRUDENT TO TERMINATE, AND PAY OUT, A VARIETY OF ANNUAL AND MULTI-YEAR INCENTIVE PLANS OPERATED UNDER THE LEGACY ENTITIES. THE EXTERNAL COMPENSATION CONSULTANTS CONCLUDED THAT SUCH PAYMENTS, UNDER THE CIRCUMSTANCES, WERE REASONABLE AND CONSISTENT WITH MARKET, AND THE EARLY TERMINATION AND PAYOUT OF SUCH PLANS IN SIMILAR SITUATIONS WAS STANDARD PRACTICE. PART I, LINES 4A-B SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS PROVIDE BENEFITS TO CERTAIN KEY EXECUTIVE EMPLOYEES OF PARK RIDGE NURSING HOME, INC. D/B/A PARK RIDGE LIVING CENTER. THE ORGANIZATION MAINTAINS A SECTION 457(F) PLAN WHICH WOULD BE CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. DURING 2014, NO DISTRIBUTIONS WERE PAID OUT. OFFICERS ARE PROVIDED ACCESS TO CONTRIBUTE TO THE PLAN. THESE OFFICERS ALSO RECEIVED NON-TAXABLE CONTRIBUTION TO THEIR INDIVIDUAL ACCOUNTS BY THE ORGANIZATION. THE AMOUNTS CONTRIBUTED ARE AS FOLLOWS: - WARREN HERN - $17,500 - STEWART PUTNAM - $17,500 OFFICERS CAN SELECT ADDITIONAL BENEFITS PURSUANT TO A NON-QUALIFIED 457(F) PLAN. THIS BENEFIT IS A CAPITAL ACCUMULATION FUND AND IS OFFERED TO VICE PRESIDENTS THROUGH AN EXTERNAL INVESTMENT COMPANY. EACH VP IS GIVEN A CONTRIBUTION AMOUNTING TO 5% OF THEIR SALARY AND THEY CAN INVEST THE FUNDS IN 3 DIFFERENT OPTIONS. THE OPTIONS ARE LIFE INSURANCE FOR SELF, LIFE INSURANCE FOR SPOUSE OR CAPITAL ACCUMULATION. A VILLAGE OF EAST ROCHESTER 161497561 274722DX2 2008-12-11 18750000 CONSTRUCTING AND EQUIPPING 23, 0 0 0 A 1235000 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 CHEDULE K, PART IV, ARBITRAGE, LINE 2C: SCHEDULE K, PART IV, ARBITRAGE, LINE 2C: (A) ISSUER NAME: VILLAGE OF EAST ROCHESTER HOUSING AUTHORITY 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 (E) DUE TO INVESTMENT EARNINGS. PART IV, LINE 4B - MORGAN STANLEY CAPITAL SERVICES, INC. FORM 990, PART III, LINE 3 ROCHESTER REGIONAL HEALTH WAS FORMED THROUGH A CORPORATE RESTRUCTURING, WHICH BROUGHT TOGETHER ROCHESTER GENERAL HEALTH SYSTEM AND ITS AFFILIATES AND UNITY HEALTH SYSTEM AND ITS AFFILIATES, ON JULY 1, 2014. ROCHESTER REGIONAL HEALTH SEEKS TO BE THE PROVIDER OF CHOICE, WHILE ADRESSING BOTH THE AFFORDABILITY AND QUALITY OF HEALTHCARE SERVICES THAT IT PROVIDES IN UPSTATE/WESTERN NEW YORK. 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 4 RU SYSTEM, INC. D/B/A ROCHESTER REGIONAL HEALTH, IS A NEW YORK NOT-FOR-PROFIT CORPORATION THAT COORDINATES AND MANAGES THE DELIVERY OF HOUSING AND HEALTH CARE-RELATED SERVICES AND EDUCATION BY ITS AFFILIATES (AFFILIATES). ROCHESTER REGIONAL HEALTH WAS FORMED THROUGH A CORPORATE RESTRUCTURING, EFFECTIVE AS OF JULY 1, 2014, WHICH BROUGHT TOGETHER ROCHESTER GENERAL HEALTH SYSTEM AND ITS AFFILIATES AND UNITY HEALTH SYSTEM AND ITS AFFILIATES. AS A RESULT OF THIS CORPORATE REORGANIZATION, ROCHESTER REGIONAL HEALTH SERVES AS THE SOLE CORPORATE MEMBER OF THE ENTITIES LISTED BELOW (THE "EXEMPT AFFILIATES"). IRS FORM 1023 (APPLICATION FOR TAX-EXEMPT STATUS) HAS BEEN FILED FOR ROCHESTER REGIONAL HEALTH, SEEKING EXEMPT STATUS UNDER SECTION 501(C) OF THE INTERNAL REVENUE CODE. THE CORPORATE RESTRUCTURING WHICH CREATED ROCHESTER REGIONAL HEALTH WAS ACCOMPLISHED VIA CHANGES TO THE GOVERNING DOCUMENTS OF THE EXEMPT AFFILIATES, AS FOLLOWS: (A)ROCHESTER REGIONAL HEALTH WAS NAMED AS THE EXEMPT AFFILIATES' SOLE CORPORATE MEMBER; (B)ROCHESTER REGIONAL HEALTH WAS GRANTED THE AUTHORITY TO APPOINT AND REMOVE THE GOVERNING BOARD OF THE EXEMPT AFFILIATES; AND (C)CERTAIN ACTIONS OF THE EXEMPT AFFILIATE AND/OR ITS GOVERNING BOARD WERE MADE SUBJECT TO THE APPROVAL OF THE GOVERNING BOARD OF ROCHESTER REGIONAL HEALTH. IN ADDITION, THE GOVERNING DOCUMENTS OF SOME (BUT NOT ALL) OF THE EXEMPT AFFILIATES WERE CHANGED AS FOLLOWS: (A)THE INDIVIDUALS SERVING ON THE GOVERNING BOARD OF CERTAIN EXEMPT AFFILIATES INCLUDE, IN WHOLE OR IN PART, THE INDIVIDUALS WHO SERVE ON THE GOVERNING BOARD OF ROCHESTER REGIONAL HEALTH; AND (B)THE CHIEF EXECUTIVE OFFICER OF ROCHESTER REGIONAL HEALTH SERVES AS THE CHIEF EXECUTIVE OFFICER OF CERTAIN EXEMPT AFFILIATES. FINALLY, THE GOVERNING DOCUMENTS, SPECIFICALLY THE BYLAWS, OF THE EXEMPT AFFILIATES, WHICH ARE EACH NOT-FOR-PROFIT COMPANIES PURSUANT TO NEW YORK LAW, WERE REVISED TO IMPLEMENT THE REQUIREMENTS OF THE NON-PROFIT REVITALIZATION ACT ("NPRA"); A NEW YORK LAW WHICH WENT INTO EFFECT ON JULY 1. 2015. THE NPRA REQUIRED ALL NEW YORK NOT-FOR-PROFIT CHARITABLE ENTITIES TO ADDRESS CERTAIN ISSUES IN THEIR GOVERNING DOCUMENTS, INCLUDING (BUT NOT LIMITED TO) CONFLICTS OF INTEREST, INDEPENDENT DIRECTORS, FINANCIAL AUDITS AND WHISTLEBLOWER PROTECTIONS. THE EXEMPT AFFILIATES OF ROCHESTER REGIONAL HEALTH (FOR WHICH ROCHESTER REGIONAL HEALTH SERVES AS THE SOLE CORPORATE MEMBER) BEHAVIORAL HEALTH NETWORK, INC. GRHS FOUNDATION, INC. NEWARK-WAYNE COMMUNITY HOSPITAL NORTH PARK NURSING HOME, INC. PARK RIDGE CHILD CARE CENTER, INC. PARK RIDGE HOUSING DEVELOPMENT FUND COMPANY, INC. PARK RIDGE HOUSING, INC. PARK RIDGE NURSING HOME, INC. PARK WAY COMMONS HOUSING DEVELOPMENT FUND COMPANY, INC. PARMA HOUSING DEVELOPMENT FUND CORP. PRCD, INC. ROCHESTER GENERAL HEALTH SYSTEM DIALYSIS, INC. ROCHESTER GENERAL HEALTH SYSTEM ROCHESTER GENERAL HOSPITAL FOUNDATION, INC. ROCHESTER GENERAL HUDSON HOUSING, INC. ROCHESTER GENERAL LONG TERM CARE, INC. ST. BERNARD'S HOUSING DEVELOPMENT FUND COMPANY, INC. ST. BERNARD'S II, INC. THE CLIFTON SPRINGS SANITARIUM COMPANY D/B/A CLIFTON SPRINGS HOSPITAL & CLINIC THE ROCHESTER GENERAL HOSPITAL THE UNITY HOSPITAL OF ROCHESTER UNITED MEMORIAL MEDICAL CENTER UNITY AGING SERVICES, INC. UNITY AMBULATORY SURGERY CENTER, INC. UNITY HEALTH SYSTEM UNITY HEALTH SYSTEM FOUNDATION UNITY HOUSING DEVELOPMENT FUND CORPORATION WOODLAND VILLAGE, INC. 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 RU SYSTEM, INC. D/B/A ROCHESTER REGIONAL HEALTH, A RELATED NOT-FOR-PROFIT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B RU SYSTEM, INC. D/B/A 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 11 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 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 AND THEREAFTER, ANNUALLY, EACH KEY EMPLOYEE AND OFFICER OF THE ORGANIZATION IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST 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 AND OFFICERS OF THE ORGANIZATION ARE ALSO REQUIRED TO NOTIFY MANAGEMENT PROMPTLY IF ANY CHANGE TO THEIR DISCLOSURES OCCURS. BOARD MEMBERS LEAVE THE ROOM DURING DISCUSSIONS AND ABSTAIN FROM VOTING WHEN THEY HAVE A CONFLICT OF INTEREST. 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. 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 OF ROCHESTER REGIONAL HEALTH, A RELATED NOT-FOR-PROFIT ORGANIZATION. INFORMATION REVIEWED FOR THE OFFICER/KEY EMPLOYEE INCLUDES COMPARABLE DATA FROM SIMILAR SIZE TAX EXEMPT ORGANIZATIONS IN THE WESTERN/CENTRAL NY COMMUNITY 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, DEMOGRAPHICS AND GEOGRAPHY. 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 AND ADMINISTRATIVE OFFICES OF THE FILING ORGANIZATION. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED. FORM 990, PART XI, LINE 9: PENSION ACTUARIAL VALUATION -3,168,112. FMV ADJUSTMENT ON DERIVATIVE INSTRUMENT 286. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. THE ROCHESTER GENERAL HOSPITAL 1425 PORTLAND AVENUE ROCHESTER NY 14621 160743134 HOSPITAL NY 501(C)(3) LINE 3 N/A 1 ROCHESTER MENTAL HEALTH CENTER 490 EAST RIDGE ROAD ROCHESTER NY 14621 166069131 MENTAL HEALTH NY 501(C)(3) LINE 9 RU SYSTEM INC 1 GRHS FOUNDATION 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 223378111 R/E INV MGMT NY 501(C)(3) LINE 11B, II RU SYSTEM INC 1 THE ROCHESTER GENERAL HOSPITAL FOUNDATION 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 222229425 FUNDRAISING NY 501(C)(3) LINE 11B, II RU SYSTEM INC 1 NEWARK WAYNE COMMUNITY HOSPITAL FOUNDATION DRIVING PARK AVENUE NEWARK NY 14513 222963015 FUNDRAISING NY 501(C)(3) LINE 11B, II NWCH 1 NEWARK WAYNE COMMUNITY HOSPITAL DRIVING PARK AVENUE NEWARK NY 14513 150584188 HOSPITAL NY 501(C)(3) LINE 3 RU SYSTEM INC 1 RGHS WORKERS' COMPENSATION TRUST 1425 PORTLAND AVENUE ROCHESTER NY 14621 166429300 SEE PART VII NY 501(C)(3) LINE 11B, II RU SYSTEM INC 1 CONTINUING CARE NETWORK INC (CCN) 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 222963016 SUPPORT RGH NY 501(C)(3) LINE 11B, II RU SYSTEM INC 1 ROCHESTER GENERAL HUDSON HOUSING 2066 HUDSON AVENUE ROCHESTER NY 14621 223210351 LOW INC HOUSING NY 501(C)(3) LINE 9 RU SYSTEM INC 1 VIA HEALTH HOME CARE I 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 161504370 HOME HEALTH NY 501(C)(3) LINE 9 CCN 1 VIA HEALTH HOMECARE II 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 161538727 HOME HEALTH NY 501(C)(3) LINE 9 CCN 1 INDEPENDENT LIVING FOR SENIORS 2066 HUDSON AVENUE ROCHESTER NY 14617 161491059 ADULT DAY HC NY 501(C)(3) LINE 9 RU SYSTEM INC 1 ROCHESTER GENERAL LONG TERM CARE 1550 EMPIRE BLVD WEBSTER NY 14580 223187140 NH & REHAB NY 501(C)(3) LINE 9 RU SYSTEM INC 1 WESTERN NEW YORK MEDICAL PRACTICE PC 1425 PORTLAND AVENUE ROCHESTER NY 14621 611654232 PHYS PRAC NY 501(C)(3) LINE 9 RU SYSTEM INC 1 THE UNITY HOSPITAL OF ROCHESTER 1555 LONG POND RD ROCHESTER NY 14626 237221763 HOSPITAL NY 501(C)(3) LINE 3 RU SYSTEM INC 1 NORTH PARK NURSING HOME INC 1555 LONG POND RD ROCHESTER NY 14626 223159644 LONG TERM CARE FACILITY NY 501(C)(3) LINE 9 RU SYSTEM INC 1 UNITY HEALTH SYSTEM INC 1555 LONG POND RD ROCHESTER NY 14626 222572873 SYSTEM SUPPORT NY 501(C)(3) LINE 11B, II RU SYSTEM INC 1 UNITY HEALTH SYSTEM FOUNDATION 1555 LONG POND RD ROCHESTER NY 14626 119627400 FOUNDATION NY 501(C)(3) LINE 7 RU SYSTEM INC 1 PRCD INC 1555 LONG POND RD ROCHESTER NY 14626 161311581 SUBSTANCE ABUSE TREATMENT & REHAB. NY 501(C)(3) LINE 7 RU SYSTEM INC 1 PARK RIDGE CHILD CARE CENTER INC 1555 LONG POND RD ROCHESTER NY 14626 222918126 CHILD DAY CARE SERVICES NY 501(C)(3) LINE 9 RU SYSTEM INC 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 9 RU SYSTEM INC 1 PARK RIDGE HOUSING INC 1555 LONG POND RD ROCHESTER NY 14626 222570457 SENIOR APARTMENT COMPLEX NY 501(C)(3) LINE 9 RU SYSTEM INC 1 PARKWAY COMMONS HOUSING DEVELOPMENT 1555 LONG POND RD ROCHESTER NY 14626 223130818 LOW INCOME HOUSING FOR ELDERLY/HANDICAPPED NY 501(C)(3) LINE 9 RU SYSTEM INC 1 STBERNARD'S HOUSING DEVELOPMENT FU 1555 LONG POND RD ROCHESTER NY 14626 161492955 LOW INCOME HOUSING PROJECT NY 501(C)(3) LINE 9 RU SYSTEM INC 1 UNITY AGING SERVICES INC 1555 LONG POND RD ROCHESTER NY 14626 841684195 MANAGEMENT AND DEVELOPMENT CO NY 501(C)(3) LINE 9 RU SYSTEM INC 1 UNITY HOUSING DEVELOPMENT FUND CORP 1555 LONG POND RD ROCHESTER NY 14626 300068596 RECEIPT AND DISBURSEMENTS OF SUBSIDIES NY 501(C)(3) LINE 9 RU SYSTEM INC 1 WOODLAND VILLAGE INC 1555 LONG POND RD ROCHESTER NY 14626 161588242 SENIOR APARTMENT COMPLEX NY 501(C)(3) LINE 9 RU SYSTEM INC 1 UNITY ABULATORY SURGERY CENTER INC 1555 LONG POND RD ROCHESTER NY 14626 383871383 OUTPATIENT SURGERY NY 501(C)(3) LINE 9 RU SYSTEM INC 1 RU SYSTEM INC DBA ROCHESTER REGIONAL HEALTH SYSTEM 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 471234999 SYSTEM PARENT NY 501(C)(3) LINE 11B, II N/A 1 ROCHESTER GENERAL HEALTH SYSTEM 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 222551509 SYSTEM SUPPORT NY 501(C)(3) LINE 11B, II RU SYSTEM INC 1 NW ASSOCIATES LP PO BOX 111 DRIVING PARK AVENUE NEWARK NY 14513 141674119 R/E LEASING NY NWCH RELATED 0 0 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 0 GRACO RISK RETENTION GROUP INC 1425 PORTLAND AVENUE ROCHESTER NY 14621 710933967 INSURANCE SC RGH C 0 NWA INC DRIVING PARK AVENUE NEWARK NY 14513 141667339 R/E LEASING NY NWCH C 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 ROCHESTER GENERAL HEALTH SYSTEM DIALYSIS INC 1425 PORTLAND AVENUE ROCHESTER NY 14621 383912199 DIALYSIS NY RGHS C 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 RU SYSTEM INC C 0 PARMA SENIOR HOUSING LLC 1555 LONG POND ROAD ROCHESTER NY 14626 810671687 SENIOR HOUSING NY RU SYSTEM INC C 0 UNITY SENIOR HOUSING CORP 1555 LONG POND ROAD ROCHESTER NY 14624 061709925 SENIOR HOUSING NY RU SYSTEM INC C 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 THE UNITY HOSPITAL OF ROCHESTER P 834896 FMV THE UNITY HOSPITAL OF ROCHESTER L 2100000 FMV THE UNITY HOSPITAL OF ROCHESTER R 90496 FMV UNITY HEALTH SYSTEM P 152792 FMV THE UNITY HOSPITAL OF ROCHESTER P 3455256 FMV