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GENESEE REGION HOME CARE OF ONTARIO COUNTY: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
GENESEE REGION HOME CARE OF ONTARIO COUNTY (EIN 22-3257719)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-13
IRS object ID
201333199349304418
Schema version
2012v2.0
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)
Timestamp2013-11-13T09:21:57-07:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN223257719EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GENESEE REGION HOME CARE OF ONTARIO COUNTYBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGENENameControl
Phone5852141000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1165 Court StreetAddressLine1
CityRochesterCity
StateNYState
ZIP Code14647ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTerrence TehanName
TitleCFO/COOTitle
Phone5852384366Phone
Date Signed2013-11-15DateSigned
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Home Care PlusBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonPatricia HeffernanNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13111 S Winton RoadAddressLine1
CityRochesterCity
StateNYState
ZIP Code14647ZIPCode
FieldValueIRS element (for citing)
Gross Receipts10455778GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.lifetimecare.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1994YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTo deliver compassionate, personalized care to adults and children who are ill or injured.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees580TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year10550096ProgramServiceRevenuePriorYear
Program Service Revenue CY10455778ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year10550096TotalRevenuePriorYear
Total Revenue Current Year10455778TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year10083581SalariesEtcPriorYear
Salaries Etc Current Year9972380SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1282665OtherExpensePriorYear
Other Expenses Current Year1343304OtherExpensesCurrentYear
Total Expenses Prior Year11366246TotalExpensesPriorYear
Total Expenses Current Year11315684TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-816150RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-859906RevenuesLessExpensesCY
Total Assets BOY939292TotalAssetsBOY
Total Assets EOY939292TotalAssetsEOY
Total Liabilities BOY8746964TotalLiabilitiesBOY
Total Liabilities EOY9606870TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-7807672NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-8667578NetAssetsOrFundBalancesEOY
Mission DescriptionTo deliver compassionate, personalized care to adults and children who are ill or injured.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense525056Expense
Grants0Grants
Revenue533286Revenue
DescriptionHome Health Care: Licensed Services - Provides services in the home for persons who require nursing care. (14,596 Hours)Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense9812608Expense
Grants0Grants
Revenue9922492Revenue
DescriptionHome Health Care: Home Health Aides - Provides services in the homes to persons who require trained medical services. (426,669 Hours)Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense10337664TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees580NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonTerrence TehanNamePerson
Telephone Number5852141033TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1165 Court StreetAddressLine1
CityRochesterCity
StateNYState
ZIP Code14647ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerFormerFormerKey EmployeeKeyEmployee
John Biemiller
Director00X000
Jordon Brown
Director - Treasurer00X000X
David Klein
CEO040X02070629123729X
William A Johnson Jr
Director00X000
Mordecai Kolko
Director00X000
Jay Mahoney
Director00X000
David Reh
Director00X000
Joseph Kurnath MD
Director-Chairman00X0457110X
Hank Stuart
Director-Vice Chairman00X0275350X
Sy Zivan
Director00X000
Jagat Mehta MD
Director00X000
Manuel Matos MD
Director00X000
Marilyn Dollinger
Director00X000
Hilda Rosario-Escher
Director00X000
Suzanne Brown
Former Secretary040X010619829613X
Patricia Heffernan
President040034280460156X
Margaret Cassady
Secretary040028993235390X
Terrence Tehan
CFO/COO040029228455532X
Casper Sedgwick
Former Director000684420X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs21879197TotalReportableCompFrmRltdOrgs
Total Other Compensation204420TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Sibley Staffing SolutionsBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11100 University Avenue STE 140AddressLine1
CityRochesterCity
StateNYState
ZIP Code14607ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesNrsg and Home Hlth AidesDescriptionOfServices
Compensation133981Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionHome Health Care ServicesDescription
Business Code621610BusinessCode
Total Revenue Column10455778TotalRevenueColumn
Related Or Exempt Function Income10455778RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue10455778TotalProgramServiceRevenue

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other0Other
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column10455778TotalRevenueColumn
Related Or Exempt Function Income10455778RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8313632Total
Program Services7821088ProgramServices
Management And General492544ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total54722Total
Program Services51480ProgramServices
Management And General3242ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total978012Total
Program Services920069ProgramServices
Management And General57943ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total626014Total
Program Services588926ProgramServices
Management And General37088ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total9341Total
Management And General9341ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total19927Total
Management And General19927ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total328677Total
Program Services229966ProgramServices
Management And General98711ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total23567Total
Management And General23567ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total166913Total
Program Services101407ProgramServices
Management And General65506ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total30889Total
Management And General30889ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total199312Total
Program Services134893ProgramServices
Management And General64419ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total406302Total
Program Services397996ProgramServices
Management And General8306ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total6342Total
Program Services4265ProgramServices
Management And General2077ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total321Total
Management And General321ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Other Expenses10608664289417970
Bad Debt Expense232852328500
Employee Referrals223420223420

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total11315684Total
Program Services10337664ProgramServices
Management And General978020ManagementAndGeneral
Fundraising0Fundraising

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY939292BOY
EOY939292EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY939292BOY
EOY939292EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY8746964BOY
EOY9606870EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8746964BOY
EOY9606870EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-7807672BOY
EOY-8667578EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-7807672BOY
EOY-8667578EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY939292BOY
EOY939292EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-859906ReconcilationRevenueExpenses
Reconciliation Unrealized Invest0ReconciliationUnrealizedInvest
Reconcilation Donated Services0ReconcilationDonatedServices
Reconcilation Invest Expenses0ReconcilationInvestExpenses
Reconcilation Prior Adjustment0ReconcilationPriorAdjustment
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12610623CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11670908CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10768329CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10550096CurrentTaxYearMinus1Year
Current Tax Year10455778CurrentTaxYear
Total56055734Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12610623CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11670908CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10768329CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10550096CurrentTaxYearMinus1Year
Current Tax Year10455778CurrentTaxYear
Total56055734Total
FieldValueIRS element (for citing)
Public Support Total50956055734PublicSupportTotal509

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12610623CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11670908CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10768329CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10550096CurrentTaxYearMinus1Year
Current Tax Year10455778CurrentTaxYear
Total56055734Total
FieldValueIRS element (for citing)
Public Support Percentage5091PublicSupportPercentage509
Prior Year Support Percentage1PriorYearSupportPercentage
Investment Income Percentage0InvestmentIncomePercentage
Prior Yr Invest Income Percentage0PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDue to Genesee Region Home Care Association, Inc.Description
Amount$9,606,870Amount
FieldValueIRS element (for citing)
Total Of Amounts9606870TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierSchD_P10_S00_L02Identifier
Return ReferenceSchedule D, Part X, Line 2ReturnReference
ExplanationFASB 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 recogintion threshold at the effective date to be recognized upon the adoption of this interpretation and in subsequent periods. 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 income tax expense line in the accompanying statement of activities and changes in net assets. Accrued interest and penalties are included within the related tax liability line in the consolidated balance sheet. There were no interest and penalties recognized for 2012 or 2011. The Company does not anticipate significant increases or decreases in its uncertain tax positions within the next twelve months.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement1EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
David Klein
CEO01068774020924800175450370141690956002073002000
Patricia Heffernan
President025548107257901474404767101248504029600
Terrence Tehan
CFO/COO02212420673200372203763601789603478160
Margaret Cassady
Secretary0239208049001017230258120957803253220
Suzanne Brown
Medicare Project Manager089309013892029970998801962501358110
Casper Sedgwick
Former Director01442804581008204000006844200

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchJ_P01_S00_L04Schedule J, Part I, Line 4The CEO, President and CFO/COO participated in a supplemental non-qualified retirement plan of a related entity. No payments were made under the plan in the year. Additionally, David Klein participated in an equity-based compensation arrangement of a related organization. Payments of 336,460 were made under this arrangement in 2012.
SchJ_P02_S00_L00Schedule J, Part IILine 1(ii), column B(iii) - The amount of $17,545,037 reported for David Klein includes a total of $16,918,124 of imputed income which was not actually received by Mr. Klein in 2012. The imputed income for Mr. Klein includes the entire amount of the present value of the non-qualified retirement plan benefits that will be paid to Mr. Klein over his lifetime as an annuity. This benefit was earned by Mr. Klein based upon his length of service and compensation according to provisions of the retirement plan. Mr. Klein did not actually receive any portion of this benefit in 2012. As required by IRC Section 3121 regulations, the entire value of the lifetime benefit is recognized in 2012 and applicable FICA and FUTA taxeas are paid.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0A_L02Form 990, Part VI, Section A, Line 2Hank Stuart and Joseph Kurnath MD were board members of a related for-profit entity.
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bA copy of the Form 990 was provided to the Board of Directors prior to filing allowing the opportunity for review.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cAll employees review the Code of Conduct at an annual mandatory training. Directors and above also complete an annual questionnaire to identify potential conflicts of interest. Any potential policy violations are investigated by compliance personnel and corrective measures are taken as appropriate.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15a) Key employee compensation is established in conjunction with the Board of Directors by having Human Resources engage independent compensation 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. b) Key employee compensation is established in conjunction with the Board of Directors by having Human Resources engage independent compensation 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.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19Governing documents, conflicts of interest policies, and financial statements are available to the public upon request.
F990_P07_S0A_L01bForm 990, Part VII, Section A, Line 1bDavid Klein is an Officer of several entities, some of which are listed in Schedule R.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Genesee Region Home Care Association Inc
165 Court StreetRochesterNY14647160844109Provide Home Health ServicesNY501 (c)(3)509(a)(2)North Star Home Health Management Inc1
Genesee Valley Group Health Association Inc
165 Court StreetRochesterNY14647161005419Provide Health ServicesNY501(c)(3)170(b)(1)(A)(iii)Excellus Health Plan Inc1
Univera Community Health Inc
165 Court StreetRochesterNY14647161500379Health InsurerNY501(c)(3)509(a)(2)Excellus Health Plan Inc1

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Univera IPA LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1165 Court StreetAddressLine1
CityRochesterCity
StateNYState
ZIP Code14647ZIPCode
FieldValueIRS element (for citing)
EIN454058523EIN
Primary ActivityIndependent Practice AssociationPrimaryActivity
Legal Domicile StateNYLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part IV Form990ScheduleRPartIV (21 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrgLegal Domicile Foreign CountryLegalDomicileForeignCountry
Excellus Health Plan Inc
165 Court StreetRochesterNY14647150329043Health InsurerNYN/AC1
North Star Home Health Management Inc
165 Court StreetRochesterNY14647161548051Holding CompanyNYN/AC1
Lifetime Healthcare Inc
165 Court StreetRochesterNY14647161514675Holding CompanyNYN/AC1
Excellus Acquisition Inc
165 Court StreetRochesterNY14647061680689Holding CompanyNYN/AC1
MedAmerica Inc
165 Court StreetRochesterNY14647161581817Holding CompanyNYN/AC1
Excellus Ventures Inc
165 Court StreetRochesterNY14647161550984Holding CompanyNYN/AC1
Upstate Professional Liability Corporation
165 Court StreetRochesterNY14647141783968InactiveNYN/AC1
Sibley Nursing Personnel Service Inc
165 Court StreetRochesterNY14647161447472Provide Home Health ServicesNYN/AC1
Beacon Network Services Inc
165 Court StreetRochesterNY14647141830065InactiveNYN/AC1
EBS-RMSCO Inc
165 Court StreetRochesterNY14647161171765Third Party AdministratorNYN/AC1
344 South Warren Street Corporation
165 Court StreetRochesterNY14647010718849Real Estate Holding CompanyNYN/AC1
MedAmerica Insurance Company of New York
165 Court StreetRochesterNY14647161310986Long Term Care InsuranceNYN/AC1
MedAmerica Insurance Company
165 Court StreetRochesterNY14647340977231Long Term Care InsurancePAN/AC1
MedAmerica Insurance Company of Florida
165 Court StreetRochesterNY14647141993330Long Term Care InsuranceFLN/AC1
Support Services Alliance Incorporated
165 Court StreetRochesterNY14647133033862Benefit Plan AdministrationNYN/AC1
Excellus Insurance Agency Inc
165 Court StreetRochesterNY14647161588653Insurance AgancyNYN/AC1
MIG Assurance
165 Court StreetRochesterNY14647980210843Long Term Care InsurerN/AC1CJ
EBS-RMSCO Insurance Agency Inc
165 Court StreetRochesterNY14647161611043InactiveNYN/AC1
Charles A Walker Corporation
165 Court StreetRochesterNY14647150483335BrokerNYN/AC1
Human Care Consortium I Inc
165 Court StreetRochesterNY14647454039701InactiveNYN/AC1
Human Care Consortium II Inc
165 Court StreetRochesterNY14647454039630InactiveNYN/AC1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Genesee Region Home Care Association IncBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypelTransactionType
Amount Involved5776359AmountInvolved
Method Of Amt DeterminationArm's LengthMethodOfAmtDetermination