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NEWARK WAYNE COMMUNITY HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
NEWARK WAYNE COMMUNITY HOSPITAL (EIN 15-0584188)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-12
IRS object ID
201343169349303449
Schema version
2012v2.1
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)
Timestamp2013-11-12T11:13:10-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN161226221EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1FUST CHARLES CHAMBERS LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line15784 WIDEWATERS PARKWAYAddressLine1
CitySYRACUSECity
StateNYState
ZIP Code13214ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN150584188EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NEWARK-WAYNE COMMUNITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNEWANameControl
Phone3153322456Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11200 DRIVING PARK AVENUEAddressLine1
CityNEWARKCity
StateNYState
ZIP Code14513ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePAULA TINCHName
TitleSVP FINANCE & CFOTitle
Phone3153322456Phone
Date Signed2013-11-06DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameANGELA M FRANCOName
PTINP00589741PTIN
Phone3154463600Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARK C CLEMENTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1100 KINGS HIGHWAY SOUTHAddressLine1
CityROCHESTERCity
StateNYState
ZIP Code14617ZIPCode
FieldValueIRS element (for citing)
Gross Receipts85983954GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.ROCHESTERGENERAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1952YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTO OPERATE AN INPATIENT AND OUTPATIENT HOSPITAL, CLINICS AND TREATMENT CENTERS FOR THE DELIVERY OF ACUTE MEDICAL, SURGICAL AND PREVENTATIVE HEALTH CARE SERVICES.ActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees1008TotalNbrEmployees
Total Nbr Volunteers242TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1041133ContributionsGrantsPriorYear
Contributions Grants Current Year2045342ContributionsGrantsCurrentYear
Program Service Revenue Prior Year80383790ProgramServiceRevenuePriorYear
Program Service Revenue CY83065440ProgramServiceRevenueCY
Investment Income Prior Year157178InvestmentIncomePriorYear
Investment Income Current Year197860InvestmentIncomeCurrentYear
Other Revenue Prior Year713093OtherRevenuePriorYear
Other Revenue Current Year675312OtherRevenueCurrentYear
Total Revenue Prior Year82295194TotalRevenuePriorYear
Total Revenue Current Year85983954TotalRevenueCurrentYear
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 Year45885283SalariesEtcPriorYear
Salaries Etc Current Year47381552SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year32076092OtherExpensePriorYear
Other Expenses Current Year34733332OtherExpensesCurrentYear
Total Expenses Prior Year77961375TotalExpensesPriorYear
Total Expenses Current Year82114884TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4333819RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3869070RevenuesLessExpensesCY
Total Assets BOY84218966TotalAssetsBOY
Total Assets EOY95691623TotalAssetsEOY
Total Liabilities BOY56140024TotalLiabilitiesBOY
Total Liabilities EOY61923372TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY28078942NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY33768251NetAssetsOrFundBalancesEOY
Mission DescriptionSEE SCHEDULE OMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense67130481Expense
Revenue83352743Revenue
DescriptionTHE ORGANIZATION HAS 2 COMPONENTS; 1) A TAX EXEMPT HOSPITAL THAT PROVIDES INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO ROCHESTER AND THE SURROUNDING COMMUNITY AND 2) THE DEMAY NURSING HOME WHICH IS A 180 SKILLED NURSING FACILITY OFFERING 24 HOUR NURSING CARE, VENTILATOR DEPENDENT CARE AND SPECIALIZED CARE FOR INDIVIDUALS IN THE EARLY AND MID STAGES OF ALZHEIMER'S AND OTHER COGNITIVE DISORDERS OF AGING. SEE SCHEDULE H FOR CHARITY CARE DETAIL.DURING 2012, THE HOSPITAL PROVIDED 550,331 OUTPATIENT VISITS, 19,643 INPATIENT DAYS AND HAD 397 BIRTHS. THE DEMAY NURSING HOME PROVIDED 9,927 ADULT DAY CARE DAYS AND 62,621 PATIENT DAYS.Description
Total Program Service Expense67130481TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
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 Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109680NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1008NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
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 Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1HUGH CHISHOLMBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5859221221TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 KINGS HIGHWAY SOUTHAddressLine1
CityROCHESTERCity
StateNYState
ZIP Code14617ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
ROBERT F HAVRILLA
CHAIR1.00X000
NORM BRUST
VICE CHAIR1.00X000
GAIL F BEDELL
TREASURER1.00X000
MARY SUE NAPOLEON MD
SECRETARY1.00X000
MARK CLEMENT
PRESIDENT & CEO5.00X126917125825771257250.00X
JOSEPH A DESANTO
DIRECTOR1.00X000
HARVEY E FOWLER
DIRECTOR1.00X000
SCOTT HEALY
DIRECTOR1.00X000
JAMES HOFFMAN
DIRECTOR1.00X000
ROBERT W HUTTEMAN
DIRECTOR1.00X000
MICHAEL P JANKOWSKI
DIRECTOR1.00X000
PAUL E JOHNSON
DIRECTOR1.00X000
DANIEL M MYERS
DIRECTOR1.00X000
JOHN F MURPHY
DIRECTOR1.00X000
MARGARET CHURCHILL
DIRECTOR1.00X000
JAMES E PRAINO DDS
DIRECTOR1.00X000
STEVE TAYLOR
DIRECTOR1.00X000
PAULA TINCH
SVP FINANCE & INTERIM CFO5.00239292372285714050.00X
RICHARD GANGEMI
SVP ACADEMIC & MEDICAL AFFAIRS5.005525552180312945550.00X
MARK KLYCZEK
PRESIDENT - NWH55.001821250217380.00X
HUGH THOMAS
SVP & CORPORATE COUNSEL5.005329952541017071050.00X
JAMES SYRETT
PHYSICIAN40.00314358024867X
EVE WILLIAMS
PHYSICIAN40.00306052058331X
CYNTHIA MARTINEZ-CAPOLINO
PHYSICIAN40.00350133021710X
MICHAEL CUNNINGHAM
PHYSICIAN40.00323470051658X
PETER FENTON
PHYSICIAN40.00298131024088X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2033669TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2542698TotalReportableCompFrmRltdOrgs
Total Other Compensation1272269TotalOtherCompensation
Number Individuals GT100 K7NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ALLIANCE HEALTHCARE SERVICES
PO BOX 6600NEWPORT BEACHCA92658HEALTHCARE SERVICES846141
ANESTHESIA ASSOCIATES OF ROCHESTER
130 ALLENS CREEK ROADROCHESTERNY14618PHYSICIAN SERVICES775190
FINGER LAKES BONE AND JOINT
875 PRE-EMPTION ROADGENEVANY14456HEALTHCARE SERVICES415561
NURSEFINDERS
PO BOX 710738DALLASTX75391AGENCY SERVICES388950
BROWN MD CHRISTOPHER
3766 DEET MEADOW RUNMACEDONNY14502PHYSICIAN SERVICES324167
FieldValueIRS element (for citing)
Number Of Contractors GT100 K9NumberOfContractorsGT100K
Government Grants2043733GovernmentGrants
All Other Contributions1609AllOtherContributions
Total Contributions2045342TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT REVENUEDescription
Business Code621110BusinessCode
Total Revenue Column83065440TotalRevenueColumn
Related Or Exempt Function Income83065440RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue83065440TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column197860TotalRevenueColumn
Exclusion$197,860ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real226163Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real226163Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column226163TotalRevenueColumn
Exclusion$226,163ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
ALL OTHER REVENUE900099287303287303
CAFETERIA SALES722310161846$161,846
FieldValueIRS element (for citing)
Total Other Revenue449149TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column85983954TotalRevenueColumn
Related Or Exempt Function Income83352743RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$585,869ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total561823Total
Program Services476810ProgramServices
Management And General85013ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total38112625Total
Program Services30479406ProgramServices
Management And General7633219ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1884963Total
Program Services1507970ProgramServices
Management And General376993ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4300510Total
Program Services3358389ProgramServices
Management And General942121ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2521631Total
Program Services1969212ProgramServices
Management And General552419ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total121956Total
Management And General121956ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total3329Total
Management And General3329ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total9900Total
Management And General9900ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total8287117Total
Program Services6471642ProgramServices
Management And General1815475ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total74745Total
Program Services58370ProgramServices
Management And General16375ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4674562Total
Program Services3650496ProgramServices
Management And General1024066ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total172669Total
Program Services134842ProgramServices
Management And General37827ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1104662Total
Program Services862662ProgramServices
Management And General242000ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total127479Total
Program Services99552ProgramServices
Management And General27927ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total253481Total
Program Services197950ProgramServices
Management And General55531ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total860427Total
Management And General860427ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3034740Total
Program Services2369913ProgramServices
Management And General664827ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total450539Total
Management And General450539ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES99549779954977
BAD DEBT EXPENSE41499224149922
LICENSES AND TAXES13883681388368
DUES AND SUBSCRIPTIONS6445964459

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total82114884Total
Program Services67130481ProgramServices
Management And General14984403ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY20471627BOY
EOY21011940EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5164039BOY
EOY7815082EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7814511BOY
EOY9876262EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY896423BOY
EOY1271656EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1091773BOY
EOY1528237EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis85087261LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec55973523LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY21767440BOY
EOY29113738EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY9733948BOY
EOY477519EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY17279205BOY
EOY24597189EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY84218966BOY
EOY95691623EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6653305BOY
EOY6998449EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY19775000BOY
EOY18310000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY29711719BOY
EOY36614923EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY56140024BOY
EOY61923372EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY26262781BOY
EOY31341859EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1414162BOY
EOY2024393EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY401999BOY
EOY401999EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY28078942BOY
EOY33768251EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY84218966BOY
EOY95691623EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3869070ReconcilationRevenueExpenses
Reconciliation Unrealized Invest17380ReconciliationUnrealizedInvest
Reconcilation Other Changes1802859ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers1Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$9,900GrantsOtherOrganizationsAmount
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB9900TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationTHE AMOUNT REFLECTED ON PART II-B, LINE 1F REPRESENTS THE PORTION OF DUES PAID TO HEALTH CARE ASSOCIATION OF NYS AND THE AMERICAN HOSPITAL ASSOCIATION THAT ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance401999BeginningOfYearBalance
End Of Year Balance401999EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance401999BeginningOfYearBalance
End Of Year Balance401999EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance400249BeginningOfYearBalance
Contributions1750Contributions
End Of Year Balance401999EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance400249BeginningOfYearBalance
End Of Year Balance400249EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1014307OtherCostOrOtherBasis
Book Value1014307BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis46707189OtherCostOrOtherBasis
Depreciation41138771Depreciation
Book Value5568418BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis28504037OtherCostOrOtherBasis
Depreciation14834752Depreciation
Book Value13669285BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis8861728OtherCostOrOtherBasis
Book Value8861728BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings29113738TotalOfBookValueLandBuildings

Other Assets OtherAssets (7 entries)

DescriptionDescriptionBook ValueBookValue
CUSTODIAL ACCOUNT82952
ESTIMATED 3RD PARTY RECEIVABLE970302
DUE FROM AFFILIATES195146
INTEREST IN ASSETS OF FOUNDATIONS6778831
OTHER INVESTMENTS2120777
INSURANCE RECOVERIES RECEIV.13643580
UNAMORTIZED MORTGAGE COSTS805601
FieldValueIRS element (for citing)
Total Book Value Other Assets24597189TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
CUSTODIAL ACCOUNTS$82,952
ACCRUED INTEREST PAYABLE$35,961
ESTIMATED 3RD PARTY PAYABLES$13,189,181
DUE TO AFFILIATES$5,577,874
ACCRUED SELF-INSURED LIABILITIES$17,728,955
FieldValueIRS element (for citing)
Total Of Amounts36614923TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt84983954TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal84983954RevenueSubtotal
Other Revenues Not Included1000000OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1000000RevenueNotRptdOnFinStmt
Total Revenue Per Form99085983954TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt82114884TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal82114884ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99082114884TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS INCLUDE: 1) CAPITAL EXPANSION 2) THE ADVANCEMENT OF MEDICAL EDUCATION AND RESEARCH AND HEALTH CARE SERVICES
PART XI, LINE 4B - OTHER ADJUSTMENTS:GRANT FOR CAPITAL ACQUISITIONS 1,000,000.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2335274TotalCommunityBenefitExpense
Direct Offsetting Revenue2317398DirectOffsettingRevenue
Net Community Benefit Expense17876NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense17924847TotalCommunityBenefitExpense
Direct Offsetting Revenue17843682DirectOffsettingRevenue
Net Community Benefit Expense81165NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense3026811TotalCommunityBenefitExpense
Direct Offsetting Revenue3313343DirectOffsettingRevenue
Net Community Benefit Expense-286532NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense23286932TotalCommunityBenefitExpense
Direct Offsetting Revenue23474423DirectOffsettingRevenue
Net Community Benefit Expense-187491NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense74926TotalCommunityBenefitExpense
Direct Offsetting Revenue59616DirectOffsettingRevenue
Net Community Benefit Expense15310NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense41450TotalCommunityBenefitExpense
Direct Offsetting Revenue19000DirectOffsettingRevenue
Net Community Benefit Expense22450NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense23698035TotalCommunityBenefitExpense
Direct Offsetting Revenue16999779DirectOffsettingRevenue
Net Community Benefit Expense6698256NetCommunityBenefitExpense
Percent Of Total Expense0.08590PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense1295TotalCommunityBenefitExpense
Net Community Benefit Expense1295NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense23815706TotalCommunityBenefitExpense
Direct Offsetting Revenue17078395DirectOffsettingRevenue
Net Community Benefit Expense6737311NetCommunityBenefitExpense
Percent Of Total Expense0.08640PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense47102638TotalCommunityBenefitExpense
Direct Offsetting Revenue40552818DirectOffsettingRevenue
Net Community Benefit Expense6549820NetCommunityBenefitExpense
Percent Of Total Expense0.08760PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$4,149,922BadDebtExpenseAmount
Amount Attributable To1895756AmountAttributableTo
Amount Reimbursed By Medicare14394586AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare15031298CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-636712MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line11 NW ASSOCIATES LPBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityLEASINGDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.52570OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership0.07430OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership0.40000PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1NEWARK-WAYNE COMMUNITY HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11200 DRIVING PARK AVENUEAddressLine1
CityNEWARKCity
StateNYState
ZIP Code14513ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Research FacilityXResearchFacility
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NEWARK-WAYNE COMMUNITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities4NumberOfOtherFacilities

Other Facilities OtherFacilities (4 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
DEMAY LIVING CENTER
100 SUNSET DRIVENEWARKNY14513SKILLED NURSING FACILITY
MYERS LAB
6692 MIDDLE ROAD SUITE 1100SODUSNY14551LABORATORY
NEWARK HOSPITAL LAB
1200 DRIVING PARK AVENUENEWARKNY14513LABORATORY
WILLIAMSON LAB
4425 OLD RIDGE ROADWILLIAMSONNY14589LABORATORY

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 7: THE COSTING METHODOLOGY USED WAS FROM THE HOSPITAL'S ICR UTILIZING BOTH EXHIBIT 46 AND THE COST TO CHARGE RATIO ON EXHIBIT 49. THE HOSPITALS MEDICARE COST REPORT WAS USED FOR LINE 7F, WHICH UTILIZES WORKSHEET B, PART I.
PART I, LINE 7G: N/A - NO PHYSICIAN CLINIC COSTS WERE INCLUDED IN LINE 7G AMOUNTS.
PART I, L7 COL(F): TOTAL EXPENSE ON FORM 990, PART IX, LINE 25, COLUMN (A) IS $77,964,962.THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS $4,149,922. AFTER BAD DEBT WAS DEDUCTED FROM TOTAL EXPENSES THE AMOUNT OF TOTAL EXPENSES USED TO CALCULATE THE PERCENT IN LINE 7, COLUMN (F) WAS $73,815,040.
NEWARK WAYNE COMMUNITY HOSPITAL SPRING FESTSPRING FEST OFFERED COMMUNITY MEMBERS MANY HEALTH AND SAFETY RELATED SERVICES INCLUDING: FREE FITTING OF BIKE HELMETS TO OVER 400 CHILDREN; CHILDREN'S CAR SEAT SAFETY CHECKS; A BIKE RODEO TO TEACH CHILDREN ABOUT BIKE SAFETY; BLOOD PRESSURE AND GLUCOSE SCREENS; AND INFORMATION ON MANY HEALTH-RELATED TOPICS FROM NWCH AND PARTNER HEALTH AGENCIES FROM AROUND WAYNE COUNTY.DIABETES HEALTH FAIRDIABETES IS A MAJOR HEALTH PROBLEM FOR WAYNE COUNTY RESIDENTS, WITH OVER 7,000 DIAGNOSED DIABETICS OUT OF A POPULATION OF 93,436 (8.6%). FOR THIS REASON, NEWARK-WAYNE PARTICIPATES IN THE WAYNE COUNTY RURAL HEALTH NETWORK'S (WCRHN) DIABETES HEALTH FAIR ANNUALLY. THIS INITIATIVE IS SPONSORED BY WAYNE COUNTY PUBLIC HEALTH, NEWARK-WAYNE COMMUNITY HOSPITAL AND OTHER COMMUNITY PARTNERS. IN 2012, THE DIABETES HEALTH FAIR ATTRACTED AROUND 150 RESIDENTS AND FOCUSED ON LIFESTYLE CHANGES THAT CAN POSITIVELY HAVE IMPACT ON DIABETICS/PRE-DIABETICS INCLUDING EXERCISE, NUTRITIONAL COUNSELING, THE PROPER USE OF MEDICATIONS, AND MORE.ADDITIONAL WAYNE COUNTY COMMUNITY EVENTS:ST. MICHAEL'S/LYONS CENTRAL SCHOOL HEALTH FAIRNEWARK SCHOOL CAREER DAYSORTHO SEMINAR AT BLUE HERON HILLS GOLF CLUBGREEN ANGELS HEALTH FAIRHEALTH FAIR - CHILDREN'S AT CLYDE, MARION, AND HOLIDAY HEALTH FAIRHEALTH FAIR - DIABETES/CHRONIC DISEASEDENTAL HYGIENE AND EDUCATION FOR SCHOOL CHILDRENSUBSIDIZED DENTAL SERVICES AT WC PUBLIC HEALTH DENTAL CENTEREMS - SUPPORT FOR EMS REFERENCE POCKET GUIDESFLCC SCHOLARSHIP SUPPORT FOR RN PROGRAMADS FOR FACILITATED ENROLLMENT - HEALTH CARE ACCESSMARION KID'S FAIRSPRING FEST HEALTH FAIRCOPD EDUCATION (3 SESSIONS)DIABETES HEALTH FAIRWAYNE COUNTY FAIR HEALTH BOOTHUROLOGY SEMINAR IN CANANDAIGUACOLON RECTAL EDUCATION EVENTCARDIAC REHAB EDUCATIONDR. MEDEIROS EVENTCOMMUNITY BENEFIT ACTVITIES:PART I, LINE 7E:
PART III, LINE 4: IN 2012, THE ORGANIZATION CONTINUED ITS ENHANCED PROCESS FOR OBTAINING ADDITIONAL FINANCIAL INFORMATION FOR UNINSURED AND UNDER-INSURED PATIENTS WHO HAVE NOT SUPPLIED THE REQUISITE INFORMATION TO DETERMINE IF THEY QUALIFY FOR CHARITY CARE. THE ADDITIONAL INFORMATION OBTAINED WAS USED BY THE ORGANIZATION TO DETERMINE WHETHER TO QUALIFY PATIENTS FOR CHARITY CARE IN ACCORDANCE WITH THE ORGANIZATION'S POLICY. THE APPLICATION OF THIS ADDITIONAL INFORMATION IN 2012 RESULTED IN ADDITIONAL PATIENTS QUALIFYING FOR CHARITY CARE AND THUS RE-CLASSIFYING THIS AMOUNT FROM BAD DEBT EXPENSE. BAD DEBT EXPENSE ON PART III, LINE 2 REPRESENTS ESTIMATED UNCOLLECTIBLE CHARGES FOR THOSE PATIENTS UNWILLING, NOT UNABLE, TO PAY.BAD DEBT COSTING METHODOLOGY:BAD DEBT EXPENSE IS RECORDED USING THE VALUATION METHOD AS OUTLINED IN HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT 15, WHICH REQUIRES BAD DEBT EXPENSE TO BE RECORDED AT THE AMOUNT THAT THE PAYER IS EXPECTED TO PAY. THE PROVISION FOR BAD DEBTS REPRESENTS ESTIMATED UNCOLLECTIBLE CHARGES OF PATIENTS UNWILLING TO PAY. IN 2012, THE ORGANIZATION CONTINUED ITS ENHANCED PROCESS FOR OBTAINING ADDITIONAL FINANCIAL INFORMATION FOR UNINSURED AND UNDERINSURED PATIENTS WHO HAVE NOT SUPPLIED THE REQUISITE INFORMATION TO DETERMINE IF THEY QUALIFY FOR CHARITY CARE. THE APPLICATION OF THIS ADDITIONAL INFORMATION IN 2012 RESULTED IN ADDITIONAL PATIENTS QUALIFYING FOR CHARITY CARE AND A REDUCTION TO BAD DEBT EXPENSE.TEXT OF THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE:THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HOSPITAL FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE HOSPITAL. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE HOSPITAL'S POLICIES.
PART III, LINE 8: THE ORGANIZATION USED THE FILED 2012 CMS COST REPORT TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENTS RECEIVED FROM MEDICARE. MEDICARE SHORTFALLS, WHICH ARE COSTS INCURRED BY THE HOSPITAL TO PROVIDE QUALITY CARE AND TREATMENT TO ITS PATIENTS, SHOULD BE TREATED AS A COMMUNITY BENEFIT. TO NOT INCUR THESE COSTS WOULD POTENTIALLY LIMIT OR EVEN COMPROMISE THE QUALITY OF SERVICE PROVIDED.
PART III, LINE 9B: AT SUCH TIME THAT A PATIENT EXPRESSES A FINANCIAL CONCERN, THE PATIENT WILL BE OFFERED THE OPPORTUNITY TO APPLY FOR CHARITY CARE. ONCE THE PATIENT SUBMITS THE COMPLETED CHARITY CARE APPLICATION, THE ACCOUNT IS PLACED ON HOLD AND ALL COLLECTION ACTIVITIES ARE SUSPENDED UNTIL AN ELIGIBILITY DETERMINATION IS MADE. IF THE PATIENT IS ELIGIBLE FOR CHARITY CARE, THEN THE PATIENT IS NOTIFIED OF THE LEVEL OF CHARITY CARE AWARDED. IF 100% CHARITY CARE IS AWARDED, THAN NO BILL IS SENT TO THE PATIENT. IF LESS THAN 100% CHARITY CARE IS AWARDED, THAN THE PATIENT WILL RECEIVE A BILL PURSUANT TO THE PRIVATE PAY COLLECTION POLICY. ONLY AFTER PATIENT'S LIABILITY HAS BEEN DETERMINED FOLLOWING PROCESSING OF APPLICATIONS FOR GOVERNMENT ASSISTANCE, CHARITY CARE, AND/OR INSURANCE CARRIER REMITTANCE WILL THE PATIENT STATEMENT BE MAILED FOR PAYMENT RECOVERY. THE HOSPITAL'S COLLECTION PRACTICES SET FORTH IN ITS WRITTEN DEBT COLLECTION POLICY APPLY TO ALL PATIENT TYPES OF THE HOSPITAL.
PART V, SECTION B, LINE 14G: ALSO LOCATED IN OUTPATIENT SETTINGS AND LAB DEPOTS.NEWARK-WAYNE COMMUNITY HOSPITAL
PART V, SECTION B, LINE 20D: WE BILL ACTUAL CHARGES, LESS 30% DISCOUNT, PLUS 9.63% NYS SURCHARGENEWARK-WAYNE COMMUNITY HOSPITAL
PART VI, LINE 2: IN THE SPRING OF 2009, WAYNE COUNTY PUBLIC HEALTH (WCPH) CARRIED OUT A COMPREHENSIVE COMMUNITY HEALTH ASSESSMENT OF SERVICES, PERCEPTIONS, AND HEALTH CARE NEEDS IN WAYNE COUNTY. THE WAYNE COUNTY RURAL HEALTH NETWORK(WCRHN) PARTNERED WITH THE WCPH TO DISSEMINATE THE SURVEY AND TO ENCOURAGE PARTICIPATION. IN JUNE 2009, NEWARK-WAYNE COMMUNITY HOSPITAL (NWCH), WCRHN, AND WCPH MET IN THREE SEPARATE MEETINGS WITH COMMUNITY AND COUNTY LEADERS, INCLUDING NOT-FOR-PROFIT SERVICE AGENCIES, TO REVIEW THE PRIORITIES IDENTIFIED IN THE NEEDS ASSESSMENT AND TO DISCUSS WCPH'S PRIORITIES FOR ITS PLANS TO ADDRESS COUNTY-WIDE NEEDS. THE MEETINGS WERE ALSO OPPORTUNITIES FOR NWCH, WCRHN, WCPH AND PROVIDERS AND HEALTH AND HUMAN SERVICE AGENCIES TO DISCUSS HOW TO LEVERAGE AVAILABLE FUNDS TO EXTEND AND COMPLEMENT THE WORK AND PROGRAMS THAT ARE ON-GOING, AND, TO AGREE ON FUTURE PROGRAM DEVELOPMENT OPPORTUNITIES. THE WCRHN BOARD MEETS BI-MONTHLY TO DISCUSS ACTION PLAN ITEMS AND TO PROVIDE INPUT AND SUGGESTIONS FOR CHANGES AND/OR ADDITIONS. AS A RESULT OF THOSE MEETINGS, NWCH, IN CONCERT WITH WCRHN AND KEY MEDICAL AND HOSPITAL STAFF, THEN IDENTIFIED THREE PRIORITY AREAS FOR ITS COMMUNITY SERVICE ACTIVITIES AND FUTURE PROGRAM DEVELOPMENT OPPORTUNITIES. THOSE THREE PRIORITY AREAS ARE:1.) ACCESS TO HEALTH CARE2.) CHRONIC DISEASE3.) HEALTHY MOTHERS/HEALTHY BABIES/HEALTHY CHILDRENTO DATE, THE PLAN HAS MOVED AHEAD AND NO BARRIERS HAVE BEEN ENCOUNTERED. THE ACTIVITIES THAT REMAIN OPEN ARE STILL ON TRACK AND TARGETED FOR COMPLETION. ONE AMENDMENT TO THE ORIGINAL PLAN FOR ACCESS TO HEALTH CARE IS THE INCLUSION OF THE WAYNE RX DISCOUNT CARD PROGRAM THAT WCRHN ADMINISTERS AND WHICH GIVES GREATER ACCESS TO NEEDED MEDICATIONS FOR WAYNE COUNTY RESIDENTS. IT WAS AN OVERSIGHT THAT THE DISCOUNT CARD PROGRAM WAS NOT INCLUDED IN THE ORIGINAL PLAN, AN UNFORTUNATE OMISSION FOR SUCH A HIGH VALUE INITIATIVE. A LARGER JOINT MEETING WAS HELD ON JUNE 9, 2011 IN THE DEMAY CLASSROOM. THREE LOCAL AGENCIES, WCPH, NWCH, AND WCRHN REVIEWED SURVEY INFORMATION AND DISCUSSED PRIORITIES. FROM THERE THE HOSPITAL CHOSE PRIORITIES TO INITIATE PROGRAMS IN ITS COMMUNITY SERVICE PLAN. PUBLIC HEALTH ALSO DEVELOPED ITS PLAN, AND WCRHN DEVELOPED ITS WORK PLAN. THESE ACTIONS ARE ALL IN LINE WITH THE PREVENTION AGENDA OF NEW YORK STATE DEPARTMENT OF HEALTH (NYSDOH) AND THE DIRECTIVES FROM THE NYSDOH TO HOSPITALS, PUBLIC HEALTH DEPARTMENTS, AND RURAL HEALTH NETWORKS.
PART VI, LINE 3: ROCHESTER GENERAL HEALTH SYSTEM (RGHS) INFORMS INDIVIDUALS OF AVAILABLE FREE OR REDUCED PRICE SERVICES AT THE TIME OF REGISTRATION INTO THE INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENT, AND LONG-TERM CARE FACILITY. POSTERS INFORMING THE PATIENT/FAMILY OF ASSISTANCE ARE AVAILABLE THROUGHOUT THE RGHS LOCATIONS. BROCHURES AND PAMPHLETS INFORMING THE COMMUNITY ARE WIDELY DISTRIBUTED IN THE COMMUNITY AT HEALTH FAIRS, CHURCHES, SCHOOLS AND OTHER PUBLIC LOCATIONS. INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IS ALSO AVAILABLE THROUGH RGHS'S WEBSITE AND PATIENTS WITH A SELF-PAY BALANCE ARE NOTIFIED OF OUR FINANCIAL ASSISTANCE PROGRAM VIA THE PATIENT'S STATEMENT. RGHS OFFERS SEVERAL INITIATIVES TO HELP INDIVIDUALS IN OUR COMMUNITY ACCESS AFFORDABLE HEALTH CARE, INCLUDING:FACILITATED ENROLLMENT: TO ASSIST ELIGIBLE INDIVIDUALS WITH HEALTH INSURANCE ENROLLMENT BY OFFERING EDUCATION AND APPLICATION ASSISTANCE FOR MEDICAID, CHILD HEALTH PLUS, FAMILY HEALTH PLUS, PRENATAL CARE ASSISTANCE PROGRAM, AND STATE AID FOR CHILDREN WITH SPECIAL NEEDS. A DEDICATED TELEPHONE NUMBER IS AVAILABLE AND INFORMATION IS PUBLISHED IN PAMPHLETS AT RGHS SITES AND AT VARIOUS LOCATIONS THROUGHOUT THE COMMUNITY. FINANCIAL ASSISTANCE PROGRAM: THE RGHS FINANCIAL ASSISTANCE PROGRAM OFFERS FREE OR REDUCED-PRICES FOR PATIENTS TREATED AT RGHS HOSPITALS, OUTPATIENT, EMERGENCY ROOM, OR LONG-TERM CARE FACILITIES. DISCOUNTS ARE AWARDED BASED UPON INCOME AND ASSET VERIFICATION. INDIVIDUALS WHO DO NOT QUALIFY FOR MEDICAID, CHILD HEALTH PLUS, FAMILY HEALTH PLUS, PRENATAL CARE ASSISTANCE PROGRAM, AND/OR STATE AID FOR CHILDREN WITH SPECIAL NEEDS ARE CONSIDERED FOR FINANCIAL ASSISTANCE (CHARITY CARE).
PART VI, LINE 4: THE ORGANIZATION IS THE ONLY HOSPITAL IN WAYNE COUNTY. THE NEAREST MAJOR CITY TO NEWARK IS ROCHESTER (WHICH IS 45 MINUTES AWAY IN MONROE COUNTY). THE PRIMARY AREA SERVED BY THE ORGANIZATION INCLUDES VILLAGES AND TOWNS WITHIN WAYNE COUNTY INCLUDING: THE TOWNS OF ARCADIA, ONTARIO, WALWORTH, MACEDON, WILLIAMSON, MARION, PALMYRA, SODUS, SODUS POINT, LYONS, HURON, ROSE, GALEN, SAVANNAH, BUTLER, AND WOLCOTT IN WAYNE COUNTY, AND AREAS OF ONTARIO COUNTY INCLUDING MANCHESTER AND PHELPS. THE MAJORITY OF WAYNE COUNTY IS A SUBSTANTIALLY RURAL LANDSCAPE WITH A LARGE AGRICULTURAL PRESENCE. MANY OF THE ZIP CODES (14589, 14551, 14413, 14433, 14449, 14489, 14516, 14542, 13143, 13146, 13154, AND 14590) IN WAYNE COUNTY ARE DESIGNATED RURAL BY FEDERAL GUIDELINES. ACCORDING TO THE US CENSUS BUREAU, WAYNE COUNTY, WHERE NEWARK-WAYNE IS LOCATED, IS HOME TO OVER 93,000 RESIDENTS, 11.1% OF WHO LIVE BELOW THE POVERTY LINE, AND 13.3% OF WHO HAVE LESS THAN A HIGH SCHOOL DIPLOMA. THE REGION IS ALSO HOME TO THE LARGEST SEASONAL POPULATION OF MIGRANT AND SEASONAL FARM WORKERS IN NEW YORK STATE, DUE TO THE FACT THAT WAYNE COUNTY IS THE SECOND LARGEST APPLE-PRODUCING COUNTY IN THE NATION. DURING THE MIGRANT FARM SEASON THE POPULATION OF MIGRANT FARM WORKERS PRIMARILY LATINO AND HAITIAN - SWELLS BY MORE THAN 7,000 ADDITIONAL RESIDENTS. THE WAYNE COUNTY PUBLIC HEALTH DEPARTMENT ESTIMATES THAT APPROXIMATELY 10% OF THE COUNTY'S ENTIRE POPULATION IS UNINSURED. MANY OF THESE MIGRANT FARM WORKERS (93% OF WHOM ARE UNINSURED), ARE INDIVIDUALS IN TRANSITION FROM WELFARE TO WORK, THOSE EMPLOYED PART-TIME IN FOOD PROCESSING PLANTS, AND THOSE TRANSITIONING FROM JAIL TO THE COMMUNITY. HEALTHCARE DELIVERY IN THE COMMUNITY IS ALSO COMPLICATED BY TRANSPORTATION ISSUES, AN AGING POPULATION BASE, AND RURAL ECONOMIC DECLINE.
PART VI, LINE 5: MEDICAL STAFFTHE NEWARK-WAYNE COMMUNITY HOSPITAL MEDICAL STAFF HAS 324 STAFF MEMBERS WITH 66 CURRENTLY ON ACTIVE STAFF. THESE PHYSICIANS REPRESENT A BROAD SPECTRUM OF PRIMARY CARE AND SPECIALTY SERVICES. AS AN AFFILIATE OF ROCHESTER GENERAL HEALTH SYSTEM, OUR PATIENTS HAVE SEAMLESS ACCESS TO ADDITIONAL SPECIALISTS INCLUDING THE WORLD-CLASS PROVIDERS AT THE ROCHESTER HEART INSTITUTE AND THE LIPSON CANCER CENTER BOTH IN PENFIELD AND ROCHESTER.VOLUNTEERS/AUXILIANSMEMBERS OF COMMUNITIES FROM ACROSS WAYNE AND SURROUNDING COUNTIES HAVE ALWAYS PLAYED AN IMPORTANT ROLE IN ADVOCATING FOR, AND OFFERING ASSISTANCE AT NEWARK-WAYNE COMMUNITY HOSPITAL AND DEMAY LIVING CENTER. IN 2012, 242 VOLUNTEERS PROVIDED MORE THAN 23,827 HOURS OF SERVICE AT NEWARK-WAYNE COMMUNITY HOSPITAL/DEMAY LIVING CENTER. ADDITIONALLY, A FACILITIES ADVISORY COUNCIL AND A COMMUNITY ADVISORY COUNCIL WERE FORMED TO GARNER COMMUNITY FEEDBACK ON SIGNIFICANT CAMPUS CHANGES AND PROGRAMS BEING OFFERED IN THE COMMUNITY.BOARD OF DIRECTORS AND COMMUNITY GUIDANCENEWARK WAYNE COMMUNITY HOSPITAL MAINTAINS COMMUNITY CONTROL OVER THE CORPORATION THROUGH ITS BOARD OF DIRECTORS, COMPRISED OF COMMUNITY AND FAITH LEADERS, AND LEADERS IN BUSINESS AND INDUSTRY, HEALTHCARE, AND PHYSICIANS REPRESENTING THE MEDICAL STAFF OF THE ORGANIZATION. THE MAJORITY OF THE DIRECTORS RESIDE IN THE WAYNE COUNTY AREA AND EACH DIRECTOR SERVES A THREE-YEAR TERM.USE OF SURPLUS FUNDSSURPLUS FUNDS ARE USED TO FURTHER THE MISSION AND OPERATIONS OF THE ORGANIZATION, SUCH AS REINVESTING IN COMMUNITY BENEFIT PROGRAMS, AND MAKING IMPROVEMENTS IN FACILITIES, PATIENT CARE, MEDICAL, NURSING AND ALLIED HEALTH TRAINING, EDUCATION AND RESEARCH IN SUPPORT OF THE HEALTH NEEDS OF THE COMMUNITY.
PART VI, LINE 6: ROCHESTER GENERAL HEALTH SYSTEMS (RGHS) (I.E. THE PARENT ORGANIZATION AND ITS RELATED AFFILIATES) HAS PROVIDED HIGH QUALITY HEALTHCARE SERVICES TO THE GREATER ROCHESTER NY AREA AND SURROUNDING REGIONS FOR MORE THAN 150 YEARS. RGHS HAS A NATIONALLY RECOGNIZED HEART PROGRAM AND A NATIONALLY ACCREDITED CANCER CENTER. RGHS OFFER PATIENTS MANY OF THE SAME LEADING EDGE TREATMENT OPTIONS FOUND AT THE COUNTRY'S FINEST MEDICAL CENTERS. FROM SURGERY TO ORTHOPEDICS, WOMEN'S HEALTH TO EMERGENCY CARE, PEOPLE ALL ACROSS WESTERN NY TURN TO RGHS FOR THEIR EXPERIENCE, COMPASSION AND EXPERTISE IN HELPING THEM GET BACK TO LIVING THEIR LIVES. POVERTY TRENDS, COMMUNITY HEALTH RESEARCH AND NEEDS ASSESSMENTS ARE REVIEWED ON A REGULAR BASIS WHILE PLANNING COMMUNITY HEALTH PROGRAMS. RGHS REPRESENTATIVES ARE ACTIVELY ENGAGED IN VARIOUS COMMUNITY HEALTH COLLABORATIVES WITH THE LOCAL HEALTH DEPARTMENTS, STATE HEALTH DEPARTMENT, AND LOCAL NOT-FOR-PROFIT HEALTH AND HUMAN SERVICE AGENCIES. RGHS IS RESPONSIVE TO COMMUNITY PRIORITIES AND DEVELOP PROGRAMS AND SERVICES THAT FILL A GAP OR SUPPLEMENT AN EXISTING PROGRAM. MOST RGHS COMMUNITY HEALTH OUTREACH PROGRAMS ARE OFFERED IN PARTNERSHIP WITH OTHER COMMUNITY ORGANIZATIONS OR GOVERNMENTAL AGENCIES, IN ORDER TO LEVERAGE RESOURCES TO MEET COMMUNITY NEEDS. INFORMATION REGARDING THE AVAILABILITY OF COMMUNITY HEALTH PROGRAMS, ASSISTANCE WITH HEALTH INSURANCE ENROLLMENT AND FINANCIAL ASSISTANCE FOR MEDICAL CARE RECEIVED AT RGHS HOSPITALS, EMERGENCY DEPARTMENTS, OUTPATIENT DEPARTMENTS OR LONG-TERM CARE FACILITIES ARE DISSEMINATED TO THE PUBLIC IN ELECTRONIC (WEBSITE) FORM.ROCHESTER GENERAL HOSPITAL, THE FLAGSHIP OF THE ROCHESTER GENERAL HEALTH SYSTEM, IS A REGIONAL LEADER IN HEALTH CARE. THIS 528-BED ACUTE CARE, TEACHING HOSPITAL SERVES THE GREATER ROCHESTER, NY REGION AND BEYOND.ROCHESTER GENERAL HOSPITAL IS THE FOURTH LARGEST EMPLOYER IN ROCHESTER AND AN INTEGRAL PART OF THE COMMUNITY. ROCHESTER GENERAL HOSPITAL'S NATIONALLY RECOGNIZED PROGRAMS HAVE CONSISTENTLY DEMONSTRATED QUALITY OUTCOMES THAT POSITIVELY IMPACT PATIENTS, THEIR FAMILIES AND THE ENTIRE COMMUNITY. ROCHESTER GENERAL PROVIDES CARE TO MORE MONROE COUNTY RESIDENTS THAN ANY OTHER HOSPITAL IN THE REGION AND, AS A TERTIARY CARE FACILITY, HAS STRONG REFERRAL RELATIONSHIPS WITH SEVERAL REGIONAL HOSPITALS. IN 2012, RGH CARED FOR MORE THAN 100,000 PATIENTS IN THE EMERGENCY DEPARTMENT, DISCHARGED OVER 32,000 INPATIENTS, AND PERFORMED MORE THAN 26,400 SURGICAL PROCEDURES AND OVER 1,180,000 OUTPATIENT ENCOUNTERS. ROCHESTER GENERAL OFFERS A FULL ARRAY OF SERVICES TO MEET THE MEDICAL NEEDS OF UPSTATE NEW YORK, INCLUDING NATIONALLY RECOGNIZED PROGRAMS IN CARDIAC, CANCER, ORTHOPEDIC, VASCULAR, SURGICAL AND DIABETES CARE. DISTINCTIONS FOR QUALITY INCLUDE DESIGNATION AS A SOLUCIENT/THOMPSON TOP 100 CARDIAC HOSPITAL EIGHT TIMES AND DESIGNATION BY NEW YORK STATE AND THE JCAHO AS AN ACCREDITED STROKE CENTER. HIGH QUALITY CLINICAL CARE PROVIDED AT ROCHESTER GENERAL IS AMPLIFIED BY RELATIONSHIPS AND AFFILIATIONS WITH NATIONALLY RENOWNED INSTITUTIONS SUCH AS THE CLEVELAND CLINIC (FOR CARDIAC CARE) AND ROSWELL PARK CANCER INSTITUTE.NEWARK-WAYNE COMMUNITY HOSPITAL (NWCH) HAS SERVED GENERATIONS OF WAYNE COUNTY RESIDENTS SINCE 1957, AND MANY HAVE BECOME MEMBERS OF OUR GROWING HEALTHCARE FAMILY. WITH NEW, LEADING-EDGE MEDICAL TECHNOLOGY, A DIRECT PARTNERSHIP WITH ROCHESTER GENERAL HOSPITAL, AND HIGHLY TRAINED STAFF DRIVEN BY OUR EXCELLENCE EVERY DAY PROGRAM, NWCH CONTINUES TO GROW IN EVERY ASPECT OF ITS HEALTHCARE DELIVERY. THE HOSPITAL IS LICENSED TO OPERATE 120 ACUTE CARE BEDS, WHICH INCLUDES: 82 MEDICAL/SURGICAL BEDS, 16 ADULT MENTAL HEALTH BEDS, 8 ICU BEDS AND 14 OBSTETRICAL BEDS. NWCH ALSO OFFERS A FULL ARRAY OF OUTPATIENT SERVICES INCLUDING AN EMERGENCY DEPARTMENT, CARDIAC REHABILITATION, LAB SERVICES, DIAGNOSTIC IMAGING, REHABILITATION SERVICES, AS WELL AS LAB DRAW STATIONS AND PATIENT IMAGING UNITS IN OTHER PARTS OF WAYNE COUNTY. IN RESPONSE TO COMMUNITY NEED, NWCH OPENED THE DEMAY LIVING CENTER IN 1994, A 180-BED SKILLED NURSING FACILITY. DEMAY LIVING CENTER OFFERS SKILLED NURSING CARE, A DEMENTIA UNIT, A NEUROBEHAVIORAL UNIT, A REHABILITATION DEPARTMENT AND ADULT DAY CARE. IN 1997, NWCH ESTABLISHED THE WAYNE COUNTY RURAL HEALTH NETWORK (WCRHN) TO ENCOURAGE GREATER COLLABORATION AMONG HEALTH AND SOCIAL SERVICE AGENCIES WITHIN WAYNE COUNTY IN ORDER TO PROVIDE GREATER ACCESS TO NEEDED SERVICES AND TO DEVELOP INNOVATIVE PROGRAMS TO BETTER MEET IDENTIFIED NEEDS. WCRHN IS ONE OF 35 SUCH NETWORKS IN NYS.ROCHESTER MENTAL HEALTH CENTER (RMHC) HAS NINE LOCATIONS ACROSS THE COMMUNITY, INCLUDING TWO OF THE AREA'S BEST MENTAL HEALTH CENTERS,GENESEE MENTAL HEALTH CENTER AND ROCHESTER MENTAL HEALTH CENTER, AND OVER40 YEARS OF EXPERIENCE AND TRADITION. RMHC HAS COMPREHENSIVE SERVICES AND DEDICATED MENTAL HEALTH AND SUBSTANCE ABUSE PROFESSIONALS, WORKING TO HELP PATIENTS ACHIEVE THEIR FULL POTENTIAL TO LIVE AND WORK AS PRODUCTIVE MEMBERS OF THE COMMUNITY. THEY OFFER:-A COMPREHENSIVE SYSTEM OF CLINICAL MENTAL HEALTH SERVICES-READILY-ACCESSIBLE, CULTURALLY-SENSITIVE SERVICES UNIQUELY MATCHED TO THE INDIVIDUAL NEEDS OF EACH PATIENT AND THEIR FAMILY-CONVENIENT ACCESS TO MENTAL HEALTH OUTPATIENT SERVICES WITH LOCATIONS THROUGHOUT THE GREATER ROCHESTER AREA-AN UNWAVERING COMMITMENT TO SERVE THOSE IN THE COMMUNITY WHO HAVE EMOTIONAL NEEDS.INDEPENDENT LIVING FOR SENIORS (ILS) OFFERS A PROGRAM THAT GIVES THE FRAIL ELDERLY AN ALTERNATIVE TO NURSING HOME PLACEMENT. IT IS DESIGNED TO ENABLE SENIORS TO LIVE IN THEIR OWN HOME SERVED BY A NETWORK OF SUPPORTIVE SERVICES. THE ILS PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE), HAS PROVEN THAT INTEGRATING HEALTH CARE SERVICES CAN HAVE A POWERFUL AND BENEFICIAL IMPACT ON INDIVIDUAL HEALTH AND WELL-BEING. SENIORS NOW HAVE A CHOICE TO LIVE OUT THEIR LIVES IN THEIR COMMUNITY - ENJOYING FAMILY, MANAGING THEIR HEALTH, MAKING NEW FRIENDS SIMPLIFYING HOW THEY CHOOSE AND PAY FOR NEEDED LONG-TERM CARE. ILS OFFERS ALL OF THE HEALTH, MEDICAL AND SOCIAL SERVICES NEEDED TO HELP AN AGING LOVED ONE MAINTAIN THEIR INDEPENDENCE, DIGNITY AND QUALITY OF LIFE. A RANGE OF SERVICES ARE AVAILABLE TO AN ILS PARTICIPANT, INCLUDING: ADULT DAY CARE; PRIMARY CARE; LABORATORY; X-RAY AND AMBULANCE SERVICES; REHABILITATIVE AND SUPPORT SERVICES; MEDICAL SPECIALTY SERVICES; SKILLED NURSING CARE; ACUTE HOSPITAL CARE; IN-HOME SERVICES; INTERDISCIPLINARY CONSULTATION; AND NURSING HOME CARE SHOULD THE NEED ARISE.ROCHESTER GENERAL LONG TERM CARE (HILL HAVEN) PROVIDES 24-HOUR SKILLED NURSING CARE TO THOSE IN NEED OF:-REHABILITATION-LONG-TERM CARE-TRANSITIONAL CARE-HOSPICE CARE-CARE FOR ALZHEIMER'S-TYPE DEMENTIATHE GOAL IS TO HELP RESIDENTS REACH THEIR GREATEST LEVEL OF PHYSICAL FUNCTIONING AND EMOTIONAL WELL-BEING. THE FACILITY IS A PARK-LIKE SETTING IN WEBSTER, NEW YORK WITH 355 BEDS, DEDICATED ROOMS FOR MINGLING AND RECREATION, AND BEAUTIFULLY LANDSCAPED GROUNDS. RESIDENTS HAVE ACCESS TO IN-HOUSE MEDICAL CARE PROVIDED BY PHYSICIANS, NURSE PRACTITIONERS AND A RANGE OF MEDICAL AND REHABILITATION SPECIALISTS. HILL HAVEN IS COMMITTED TO HELPING SENIORS STAY AS CONNECTED TO THE COMMUNITY AS POSSIBLE WITH SPECIAL PROGRAMS AND AN OPEN DOOR FOR FAMILY AND FRIENDS. ROCHESTER GENERAL HOSPITAL FOUNDATION AND NEWARK WAYNE COMMUNITY HOSPITALFOUNDATION: THE VITAL SERVICES THAT RGHS PROVIDES TO THE COMMUNITY WOULD NOT BE POSSIBLE WITHOUT THE FOUNDATION SUPPORT. IN THE NONPROFIT ORGANIZATIONAL STRUCTURE THE FOUNDATIONS ARE CRITICAL TO THE ABILITY TO MAKE ONGOING INVESTMENTS IN STATE-OF-THE-ART MEDICAL TECHNOLOGY, CLINICAL PROGRAMS, FACILITIES, RESEARCH AND EDUCATION THAT BENEFIT THE COMMUNITY AS A WHOLE. THE IMPACTS OF THE FOUNDATIONS' EFFORTS ARE VISIBLE THROUGHOUT THE HOSPITAL, AND IN THEIR DISTINGUISHED CENTERS OF EXCELLENCE. THE FOUNDATIONS' FUNDRAISING PROGRAMS DIRECTLY BENEFIT THE ONGOING NEEDS OF THE COMMUNITY THROUGH IMPROVED AND EXPANDED PATIENT CARE PROGRAMS, SERVICES, AND FACILITIES AND HELP PURCHASE EQUIPMENT. THIS ENHANCES THE HIGH-TOUCH AND COMPASSIONATE CARE AVAILABLE TO ALL WHO ARE SERVED IN THE COMMUNITY.
NYREPORTS FILED WITH STATESPART VI, LINE 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
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 (10 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
MARK CLEMENT
PRESIDENT & CEO6462464068758072575727422141843648396428164504467192206190554036421361079
PAULA TINCH
SVP FINANCE & INTERIM CFO1744417294439563921625292506848274785840840472916428913300
RICHARD GANGEMI
SVP ACADEMIC & MEDICAL AFFAIRS31798300284199301882093527333101198611318841038716765163886211841111819
MARK KLYCZEK
PRESIDENT - NWH1342590306560172100152880645002038630180000
HUGH THOMAS
SVP & CORPORATE COUNSEL300742951601809017934151355090915008148785634628368941680478922091407
JAMES SYRETT
PHYSICIAN248554048804017000022954019130339225000
EVE WILLIAMS
PHYSICIAN2662660228220169640454200129110364383000
CYNTHIA MARTINEZ-CAPOLINO
PHYSICIAN277679046372026082018310034000371843000
MICHAEL CUNNINGHAM
PHYSICIAN291234021772010464045677059810375128000
PETER FENTON
PHYSICIAN1008170169850027464017636064520322219000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 3THE FILING ORGANIZATION'S RELATED NON-PROFIT ORGANIZATION, ROCHESTER GENERAL HEALTH SYSTEM, UTILIZES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4BRGHS MAINTAINS A SECTION 457(F) PLAN WHICH WOULD BE CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. DURING 2012, NO DISTRIBUTIONS WERE PAID OUT. THE FOLLOWING OFFICERS AND KEY EMPLOYEES LISTED ON FORM 990, PART VII, SECTION A WOULD BE ELIGIBLE PARTICIPANTS IN THE PLAN SINCE THEY WOULD BE ENTITLED TO A DISTRIBUTION UPON SEPARATION FROM SERVICE: HUGH THOMAS RICHARD GANGEMI, MD MARK CLEMENT

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1WAYNE COUNTY CIVIC FACILITY DEVELOPMENT CORPBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN320345910IssuerEIN
Date Issued2011-11-17DateIssued
Issue Price19775000IssuePrice
Description Of PurposeTO DEFEASE OUTSTANDING 1993 BONDS & FINANCE HOSPITAL RENOVATIONS/EXPANSIONDescriptionOfPurpose
Defeased1Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Bond Defeased8564845AmountBondDefeased
Total Proceeds19775000TotalProceeds
Refunding Escrow6164943RefundingEscrow
Issuance Costs From Proceeds395500IssuanceCostsFromProceeds
Capital Expenditures13214557CapitalExpenditures
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made0FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs1NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet0RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due0NoRebateDue
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs0WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action0ProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSCHEDULE K, PART VIdentifier
ExplanationWRITTEN PROCEDURES ARE IN THE PROCESS OF BEING WRITTENExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990, PART III, LINE 1:THE PURPOSES FOR WHICH THE CORPORATION IS FORMED ARE: (A) TO PLAN, DEVELOP, ESTABLISH, ORGANIZE, CONSTRUCT, ERECT, BUILD, ACQUIRE, ALTER, RECONSTRUCT, REHABILITATE, OWN, OPERATE, MAINTAIN, AND MANAGE ALL TYPES OF INPATIENT AND OUTPATIENT HOSPITALS, HOSPITAL FACILITIES, CLINICS, TREATMENT CENTERS, SERVICES, AND PROGRAMS FOR THE DELIVERY OF ACUTE MEDICAL, SURGICAL AND PREVENTIVE HEALTH CARE SERVICES, IN ACCORDANCE WITH THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK; (B) TO PLAN, DEVELOP, ESTABLISH, ORGANIZE, CONSTRUCT, ERECT, BUILD, ACQUIRE, ALTER, RECONSTRUCT, REHABILITATE, OWN, OPERATE, MAINTAIN AND MANAGE NURSING HOMES AND ALL TYPES OF LONG TERM INPATIENT, OUTPATIENT AND RESIDENTIAL HEALTH CARE FACILITIES, SERVICES, AND PROGRAMS FOR ELDERLY, SICK, INVALID, INFIRM, DISABLED AND CONVALESCENT PERSONS, IN ACCORDANCE WITH THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK; (C) TO PLAN, DEVELOP, ESTABLISH, ORGANIZE, CONSTRUCT, ERECT, BUILD, ACQUIRE, ALTER, RECONSTRUCT, REHABILITATE, OWN OPERATE MAINTAIN, AND MANAGE ALL TYPES OF FAMILY PLANNING FACILITIES, CLINICS, TREATMENT CENTER SERVICES, AND PROGRAMS FOR THE DELIVERY OF ACUTE MEDICAL, SURGICAL AND PREVENTIVE HEALTH CARE SERVICES FOR INDIVIDUALS AND FAMILIES, IN ACCORDANCE WITH THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK; (D) TO PARTICIPATE IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH AND WELFARE OF THE COMMUNITY IN WHICH THE CORPORATION IS LOCATED; (E) TO SOLICIT, ACCEPT, HOLD, INVEST, REINVEST AND ADMINISTER GIFTS, GRANTS, BEQUESTS, CONTRIBUTIONS, DEVISES, BENEFITS OF TRUSTS, ENDOWMENTS AND PROPERTY OF ANY KIND, WITHOUT LIMITATION AS TO AMOUNT OR VALUE, FROM PRIVATE TO PUBLIC SOURCES, IN FURTHERANCE OF ITS CORPORATE PURPOSES; AND (F) TO DO ANY ACT OR THING INCIDENTAL TO OR CONNECT WITH THE FOREGOING PURPOSES OR IN ADVANCEMENT THEREOF, BUT NOT FOR THE PECUNIARY PROFIT OR FINANCIAL GAIN OF ITS MEMBERS, DIRECTORS, OFFICERS OR ANY PRIVATE PERSON.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION IS A MEMBERSHIP (NOT A STOCK) CORPORATION UNDER THE NEW YORK STATE LAW. THE ORGANIZATION'S SOLE CORPORATE MEMBER IS ROCHESTER GENERAL HEALTH SYSTEM (RGHS), A RELATED NOT-FOR-PROFIT ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7AIN ACCORDANCE WITH THE TERMS AND REQUIREMENTS OF ITS GOVERNING DOCUMENTS (I.E. BYLAWS), THE ORGANIZATION'S DIRECTORS ARE DIVIDED INTO THREE CLASSES, AND THE CLASSES SERVE FOR STAGGERED THREE-YEAR TERMS. AT EACH ANNUAL MEETING, DIRECTORS IN A CLASS ARE ELECTED BY A MAJORITY VOTE OF THE DIRECTORS THEN IN OFFICE. DIRECTORS ARE ELECTED FROM AMONG NOMINEES CHOSEN BY THE GOVERNANCE AND NOMINATING COMMITTEE OF THE FILING ORGANIZATION'S SOLE CORPORATE MEMBER, ROCHESTER GENERAL HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7BROCHESTER GENERAL HEALTH SYSTEM, AS THE SOLE CORPORATE MEMBER, ALSO HAS THE RIGHT TO APPROVE OR RATIFY SIGNFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY INCLUDING THE 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 11PRIOR TO FILING, A COPY OF THE FORM 990 IS PROVIDED TO, AND REVIEWED WITH, ALL MEMBERS OF THE EXECUTIVE COMPENSATION 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 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 AND 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 AND OFFICERS 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. IN ADDITION TO THE BOARD OF DIRECTORS, THE ORGANIZATION'S MANAGERS AND DIRECTORS WHO OVERSEE ITS OPERATIONS COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY AS WELL.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION'S OFFICER AND KEY EMPLOYEE COMPENSATION ARRANGEMENTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF ROCHESTER GENERAL HEALTH SYSTEM, 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 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 LOCATED AT 100 KINGS HIGHWAY SOUTH, ROCHESTER, NY 14617. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED.
CHANGES IN NET ASSETS OR FUND BALANCES:FORM 990, PART XI, LINE 9:CHANGE IN INTEREST IN NEWARK WAYNE COMMUNITY HOSPITAL FOUNDATION 1,695,446. CHANGE IN INTEREST IN FINGER LAKES VISITING NURSE SERVICE 107,413.
FORM 990, PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (12 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
THE ROCHESTER GENERAL HOSPITAL
1425 PORTLAND AVENUEROCHESTERNY14621160743134HOSPITALNY501(C)(3)LINE 3RGHS0
ROCHESTER MENTAL HEALTH CENTER
490 EAST RIDGE ROADROCHESTERNY14621166069131MENTAL HEALTHNY501(C)(3)LINE 9RGHS0
GRHS FOUNDATION
100 KINGS HIGHWAY SOUTHROCHESTERNY14617222963015R/E INV MGMTNY501(C)(3)LINE 11B, IIRGHS0
THE ROCHESTER GENERAL HOSPITAL FOUNDATION
100 KINGS HIGHWAY SOUTHROCHESTERNY14617222229425FUNDRAISINGNY501(C)(3)LINE 11B, IIRGHS0
NEWARK WAYNE COMMUNITY HOSPITAL FOUNDATION
DRIVING PARK AVENUENEWARKNY14513222963344FUNDRAISINGNY501(C)(3)LINE 11B, IINWCH1
RGHS WORKERS' COMPENSATION TRUST
1425 PORTLAND AVENUEROCHESTERNY14621169429300SEE PART VIINY501(C)(3)LINE 11B, IIRGHS0
CONTINUING CARE NETWORK INC (CCN)
100 KINGS HIGHWAY SOUTHROCHESTERNY14617222963016SUPPORT RGHNY501(C)(3)LINE 11B, IIRGHS0
ROCHESTER GENERAL HUDSON HOUSING
2066 HUDSON AVENUEROCHESTERNY14617223210351LOW INC HOUSINGNY501(C)(3)LINE 9RGHS0
INDEPENDENT LIVING FOR SENIORS
2066 HUDSON AVENUEROCHESTERNY14617161491059ADULT DAY HCNY501(C)(3)LINE 9RGHS0
ROCHESTER GENERAL LONG TERM CARE
1550 EMPIRE BLVDWEBSTERNY14580223187140NH & REHABNY501(C)(3)LINE 9RGHS0
WESTERN NEW YORK MEDICAL PRACTICE PC
1425 PORTLAND AVENUEROCHESTERNY14621611654232PHYS PRACNY501(C)(3)LINE 9RGHS0
ROCHESTER GENERAL HEALTH SYSTEM
100 KINGS HIGHWAY SOUTHROCHESTERNY14617222551509SYSTEM PARENTNY501(C)(3)LINE 11B, II0N/A

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1NW ASSOCIATESBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 111AddressLine1
CityNEWARKCity
StateNYState
ZIP Code14513ZIPCode
FieldValueIRS element (for citing)
EIN141674119EIN
Primary ActivityLEASINGPrimaryActivity
Legal Domicile StateNYLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NEWARK WAYNE COMMUNITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeEXCLUDEDPredominantIncomeType
Share Of Total Income153578ShareOfTotalIncome
Share Of EOY Assets654465ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner
Percentage Ownership0.52570PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryPrimary ActivityPrimaryActivityLegal Domicile Foreign CountryLegalDomicileForeignCountryDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityPercentage OwnershipPercentageOwnershipControlled OrgControlledOrgAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Share Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssets
GREATER ROCHESTER ASSURANCE COMPANY LTD
GEORGE TOWNGRAND CAYMANCJINSURANCECJN/AC1.000000
NWA INC
REAL EST LEASC1.000000DRIVING PARK AVENUENEWARKNY14513141667339NYNWCH4679811398318
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 Org1GiftGrantOrCapContrFrOtherOrg
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 Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
ROCHESTER GENERAL HOSPITAL
O4289000FMV
GREATER ROCHESTER ASSUANCE COMPANY LTD
O358665FMV
WORKERS COMPENSATION TRUST
O725354FMV
ROCHESTER GENERAL HEALTH SYSTEM (CORPORATE)
O842964FMV

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierRELATED TAX-EXEMPT ORGANIZATION - PRIMARY ACTIVITYIdentifier
Return ReferenceSCHEDULE R, PART II, COLUMN B:ReturnReference
ExplanationRGHS WORKERS' COMPENSATION TRUST SUPPORTS THE GENESEE HOSPITAL, ROCHESTER GENERAL HOSPITAL, ROCHESTER GENERAL HOSPITAL FOUNDATION, NEWARK WAYNE COMMUNITY HOSPITAL, NEWARK COMMUNITY HOSPITAL FOUNDATION, INDEPENDENT LIVING FOR SENIORS, ROCHESTER GENERAL LONG TERM CARE, ROCHESTER GENERAL HUDSON HOUSING, GRHS FOUNDATION, BEHAVIORAL HEALTH NETWORK, AND ROCHESTER GENERAL HEALTH SYSTEMS.Explanation