ROME MEMORIAL HOSPITAL INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: ROME MEMORIAL HOSPITAL INC (EIN 16-1471634)
Tax period: 2010-01-01 to 2010-12-31
Filed: 2011-11-14
IRS object ID: 201133189349306268
Schema version: 2010v3.4
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-11-14T18:09:05-06:00	Timestamp
Tax Period End Date	2010-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	FUST CHARLES CHAMBERS LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	5784 WIDEWATERS PARKWAY	AddressLine1
City	SYRACUSE	City
State	NY	State
ZIP Code	13214	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	161471634	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ROME MEMORIAL HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	ROME	NameControl

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1500 NORTH JAMES STREET	AddressLine1
City	ROME	City
State	NY	State
ZIP Code	13440	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	NICHOLAS MAYHEW	Name
Title	CFO	Title
Phone	3153387000	Phone
Date Signed	2011-10-24	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Phone	3154463600	Phone

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	BASIL ARIGLIO	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1500 NORTH JAMES ST	AddressLine1
City	ROME	City
State	NY	State
ZIP Code	13440	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	87854574	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	ROMEHOSPITAL.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1995	YearFormation
State Legal Domicile	NY	StateLegalDomicile
Activity Or Mission Description	PROVIDE QUALITY, COMPASSIONATE CARE IN A SAFE ENVIRONMENT TO SERVE THE HEALTHCARE NEEDS OF THE PEOPLE OF ROME AND THE SURROUNDING COMMUNITIES.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	10	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	1204	TotalNbrEmployees
Total Nbr Volunteers	125	TotalNbrVolunteers
Total Gross UBI	253882	TotalGrossUBI
Net Unrelated Business Txbl Income	-214	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	246449	ContributionsGrantsPriorYear
Contributions Grants Current Year	432566	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	80631908	ProgramServiceRevenuePriorYear
Program Service Revenue CY	84821455	ProgramServiceRevenueCY
Investment Income Prior Year	-341034	InvestmentIncomePriorYear
Investment Income Current Year	142569	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1003883	OtherRevenuePriorYear
Other Revenue Current Year	1034217	OtherRevenueCurrentYear
Total Revenue Prior Year	81541206	TotalRevenuePriorYear
Total Revenue Current Year	86430807	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	44982418	SalariesEtcPriorYear
Salaries Etc Current Year	48494172	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	37190412	OtherExpensePriorYear
Other Expenses Current Year	37880995	OtherExpensesCurrentYear
Total Expenses Prior Year	82172830	TotalExpensesPriorYear
Total Expenses Current Year	86375167	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-631624	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	55640	RevenuesLessExpensesCY
Total Assets BOY	56991481	TotalAssetsBOY
Total Assets EOY	61433977	TotalAssetsEOY
Total Liabilities BOY	32947164	TotalLiabilitiesBOY
Total Liabilities EOY	37037193	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	24044317	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	24396784	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	ABOUT ROME MEMORIAL HOSPITAL: OVERALL, ROME MEMORIAL HOSPITAL PROVIDES INPATIENT, OUTPATIENT, SKILLED NURSING, AND EMERGENCY CARE SERVICES PRIMARILY FOR THE RESIDENTS OF ROME AND THE SURROUNDING AREAS.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	1	SignificantChange
Expense	37196573	Expense
Revenue	32236495	Revenue
Description	INPATIENT CARE SERVICES, INPATIENT NURSING UNITS CONSIST OF THE FOLLOWING:ACUTE PHYSICAL REHABILITATION-4TH FLOOR,INTENSIVE CARE-2ND FLOOR, MATERNITY-4TH FLOOR, 2 EAST MEDICAL/SURGICAL-2ND FLOOR, 2 NORTH MEDICAL/SURGICAL WITH CARDIAC MONITORING-2ND FLOOR, PEDIATRICS-2ND FLOOR, AND SENIOR BEHAVIORIAL HEALTH- 2ND FLOOR.2010 INPATIENT DISCHARGES: 5,4672010 BIRTHS: 6182010 PATIENT DAYS: 25,556	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	6066487	Expense
Revenue	6785205	Revenue
Description	RESIDENTIAL HEALTHCARE FACILITY (RHCF)BECAUSE OF OUR COMMITTMENT TO SERVE THE UNIQUE NEEDS OF SENIORS, WE HAVE AN 80-BED RESIDENTIAL HEALTH CARE FACILITY AND TWO SPECIALITY INPATIENT UNITS FOR ACUTE-PHYSICAL MEDICINE & REHABILITATION AND SENIOR BEHAVIORIAL HEALTH CARE. OUR RESIDENTIAL HEALTHCARE FACILITY CONSISTS OF THE FOLLOWING: LONG-TERM NURSING HOMECARE, SHORT-TERM SUB-ACUTE REHABILITATION, AND RESPITE CARE- ALL LOCATED ON THE 3RD FLOOR.2010 PATIENT DAYS = 26,0332010 OCCUPANCY PERCENTAGE = 89%	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	9476614	Expense
Grants	0	Grants
Revenue	9904064	Revenue
Description	EMERGENCY DEPARTMENT (ED)ROME MEMORIAL HOSPITAL EMERGENCY DEPARTMENT IS A SAFETY NET FOR THE MOST VULNERABLE POPULATIONS IN THE COMMUNITY. IN 2010, MORE THAN HALF OF THE PATIENTS LISTED NO PRIMARY CARE PHYSICIAN AND 45% WERE UNINSURED OR UNDER INSURED.2010 ED ADMISSIONS: 3,2732010 ED VISITS: 25,396	Description

Activity Other ActivityOther

Field	Value	IRS element (for citing)
Expense	21555610	Expense
Revenue	29184708	Revenue
Description	ALL OTHER ACHIEVEMENTS PROVIDE QUALITY, COMPASSIONATE CARE IN A SAFE ENVIRONMENT TO SERVE THE HEALTHCARE NEEDS OF THE PEOPLE OF ROME AND THE SURROUNDING COMMUNITIES.	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	21555610	TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev	29184708	TotalOfOtherProgramServiceRev
Total Program Service Expense	74295284	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	0	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	0	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	1	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	46	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	1204	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	10	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	NY	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	NICHOLAS MAYHEW CFO ROME MEMORIAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	3153387024	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1500 NORTH JAMES STREET	AddressLine1
City	ROME	City
State	NY	State
ZIP Code	13440	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
CHESTER PATRICK MD
CHAIRMAN	2.00	X	X	0	0	0
DAVID NOLAN
VICE CHAIRMAN/TREASURER	2.00	X	X	0	0	0
LYNN REESE
SECRETARY	2.00	X	X	0	0	0
MARY DAVIS
DIRECTOR	2.00	X		0	0	0
W ROBERT HERMANN
DIRECTOR	2.00	X		0	0	0
MICHAEL KRAMER
DIRECTOR	2.00	X		0	0	0
KIM COOK
DIRECTOR	2.00	X		0	0	0
RONALD CANTOR
DIRECTOR	2.00	X		0	0	0
DR ANKUR DESAI
DIRECTOR	2.00	X		0	0	0
SALLY HINMAN
DIRECTOR	2.00	X		0	0	0
DARLENE BURNS
CEO	55.00		X	319787	0	9513
WALEED ALBERT MD
CMO	55.00			258673	0	14874	X
BASIL ARIGLIO
COO	55.00			248376	0	14874	X
NICHOLAS MAYHEW
CFO	55.00			204052	0	14803	X
RAYMOND CARNEVALE
VP	55.00			165054	0	5871		X
BRUCE PETERSON
AVP/CIO	55.00			148182	0	14712		X
SCOTT BURNS
PHARMACY DIRECTOR	55.00			129443	0	11226		X
MARK SNYDERMAN
VP	55.00			127719	0	11223		X
DEBRA WURZ
VP SENIOR SERVICES	55.00			120552	0	11196		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1721838	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	108292	TotalOtherCompensation
Number Individuals GT100 K	22	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
CENTREX LABS
28 CAMPION RD	NEW HARTFORD	NY	13413	LAB SERVICES	4152631
CARDINAL HEALTH
6012 EAST MOLLOY ROAD	SYRACUSE	NY	13211	PHARMECEUTICALS	2194251
ROME EMERGENCY SERVICES
484 TEMPLE HILL ROAD	NEW WINDSOR	NY	12553	ER SERVICES	424583
HUEBER BREUER
PO BOX 515	SYRACUSE	NY	13205	ARCHITECT	362073
CHUL JO YANG MD
115 GENESEE STREET	NEW HARTFORD	NY	13413	PSYCHIATRY SERVICES	112667

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	5	NumberOfContractorsGT100K
Government Grants	43500	GovernmentGrants
All Other Contributions	389066	AllOtherContributions
Noncash Contributions	133724	NoncashContributions
Total Contributions	432566	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	HOSPITAL	Description
Business Code	621990	BusinessCode
Total Revenue Column	84821455	TotalRevenueColumn
Related Or Exempt Function Income	84821455	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	84821455	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	35251	TotalRevenueColumn
Exclusion	$35,251	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	111033	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	135647	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	-24614	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-24614	TotalRevenueColumn
Exclusion	-$24,614	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	1330598	Securities
Other	64840	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	1267797	Securities
Other	20323	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	62801	Securities
Other	44517	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	107318	TotalRevenueColumn
Exclusion	$107,318	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Unrelated Business RevenueUnrelatedBusinessRevenue	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA SALES	722210	290037	$290,037
ACCOUNTING & CONSULTIN	541200	180000		180000
GAIN/LOSS CHANGE ANGEL	900099	664	$664		0

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	588130	TotalRevenueColumn
Unrelated Business Revenue	73882	UnrelatedBusinessRevenue
Exclusion	$514,248	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	1058831	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	86430807	TotalRevenueColumn
Related Or Exempt Function Income	84821455	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	253882	UnrelatedBusinessRevenue
Exclusion	$922,904	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	1084971	Total
Management And General	1084971	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	37364917	Total
Program Services	32527641	ProgramServices
Management And General	4837276	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	1523167	Total
Program Services	1343311	ProgramServices
Management And General	179856	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	5705139	Total
Program Services	5705129	ProgramServices
Management And General	10	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	2815978	Total
Program Services	2458269	ProgramServices
Management And General	357709	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	120286	Total
Management And General	120286	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	80316	Total
Management And General	80316	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	11238	Total
Management And General	11238	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	491448	Total
Program Services	201798	ProgramServices
Management And General	289650	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	798994	Total
Program Services	101197	ProgramServices
Management And General	697797	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	892877	Total
Program Services	840172	ProgramServices
Management And General	52705	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	104220	Total
Program Services	52847	ProgramServices
Management And General	51373	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	66991	Total
Program Services	43466	ProgramServices
Management And General	23525	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	626370	Total
Program Services	586975	ProgramServices
Management And General	39395	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	4198041	Total
Program Services	3696369	ProgramServices
Management And General	501672	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	1259288	Total
Program Services	58791	ProgramServices
Management And General	1200497	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
PURCHASE SERVICES	6820414	6367825	452589
SUPPLIES	6180701	6157102	23599
BAD DEBT EXPENSE	6147555	6147555	0
PHARMACY	2621499	2614773	6726
OTHER	2472998	796473	1676525

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	4987759	Total
Program Services	4595591	ProgramServices
Management And General	392168	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	86375167	Total
Program Services	74295284	ProgramServices
Management And General	12079883	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	24396	BOY
EOY	3031569	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	2456924	BOY
EOY	2274926	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	11270550	BOY
EOY	11374729	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	2509492	BOY
EOY	1388348	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	1592849	BOY
EOY	1959094	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	738790	BOY
EOY	806060	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	80041751	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	41082506	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	37096532	BOY
EOY	38959245	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1301948	BOY
EOY	1640006	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	56991481	BOY
EOY	61433977	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	10769280	BOY
EOY	11529039	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	13625864	BOY
EOY	13736568	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	5712593	BOY
EOY	6575000	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	2839427	BOY
EOY	5196586	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	32947164	BOY
EOY	37037193	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	23585306	BOY
EOY	23772243	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	12024	BOY
EOY	40494	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	446987	BOY
EOY	584051	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	24044317	BOY
EOY	24396784	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	56991481	BOY
EOY	61433977	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	55640	ReconcilationRevenueExpenses
Reconcilation Other Changes	296827	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	1	DirectContactLegislators
Direct Contact Legislators	$20,844	DirectContactLegislatorsAmount
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	0	OtherActivities
Total Lobbying Expenditures IIB	20844	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF OTHER LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1I:	ReturnReference
Explanation	$20,844 REPRESENTS THE PORTION OF THE 2010 MEMBERSHIP DUES OF HANYS, AHA, AND IROQUOIS HEALTHCARE ALLIANCE, THAT RMH IS A MEMBER OF, THAT HAS BEEN DEEMED TO BE RELATED TO LOBBYING EXPENSES. THESE EXPENDITURES ARE DEFINED AS DIRECT COMMUNICATIONS WITH CERTAIN MEMBERS OF FEDERAL, STATE, OR LOCAL GOVERNMENTS TO INFLUENCE LEGISLATION.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	591605	BeginningOfYearBalance
Contributions	4471	Contributions
Investment Earnings Or Losses	28465	InvestmentEarningsOrLosses
End Of Year Balance	624541	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	338312	BeginningOfYearBalance
Contributions	120609	Contributions
Investment Earnings Or Losses	132684	InvestmentEarningsOrLosses
End Of Year Balance	591605	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	33374	BeginningOfYearBalance
Contributions	304938	Contributions
End Of Year Balance	338312	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.06000	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.94000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	41294593	OtherCostOrOtherBasis
Depreciation	15588624	Depreciation
Book Value	25705969	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2197063	OtherCostOrOtherBasis
Depreciation	2051405	Depreciation
Book Value	145658	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	30467079	OtherCostOrOtherBasis
Depreciation	21584470	Depreciation
Book Value	8882609	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	6083016	OtherCostOrOtherBasis
Depreciation	1858007	Depreciation
Book Value	4225009	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	38959245	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
LINE OF CREDIT	$4,000,000
ASSET RETIREMENT	$556,928
ADVANCE FROM THIRD PARTIES	$441,000
THIRD PARTY PAYABLES	$198,658

Field	Value	IRS element (for citing)
Total Of Amounts	5196586	TotalOfAmounts
Total Revenue	86430807	TotalRevenue
Total Expenses	86375167	TotalExpenses
Excess Or Deficit For Year	55640	ExcessOrDeficitForYear
Net Unrealized GL On Investments	231197	NetUnrealizedGLOnInvestments
Other	$65,630	OtherAmount
Total Adjustments	296827	TotalAdjustments
Excess Or Deficit Per FS	352467	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	95986569	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	231197	NetUnrealizedGainsInvestments
Other Revenues	9335803	OtherRevenues
Revenue Not Rptd F990	9567000	RevenueNotRptdF990
Revenue Subtotal	86419569	RevenueSubtotal
Other Revenues Not Included	11238	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	11238	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	86430807	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	95880402	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	9516473	OtherExpensesIncluded
Expenses Not Rptd F990	9516473	ExpensesNotRptdF990
Expenses Subtotal	86363929	ExpensesSubtotal
Other Expenses Not Included	11238	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	11238	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	86375167	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	INTENDED USE OF ENDOWMENT FUND IS THAT THE PRINCIPLE CAN BE INVESTED, WHILE KEPT IN TACT IN PERPETUITY; ONLY THE INCOME GENERATED CAN BE USED BY THE ORGANIZATION.
		PART X - LIABILITY UNDER FIN 48 FOOTNOTE RMH IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501 (C) (3) OF THE INTERNAL REVENUE CODE, AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501 (A) OF THE INTERNAL REVENUE CODE. THE STANDARDS FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ESTABLISH A RECOGNITION THRESHOLD AND MEASUREMENT FOR INCOME TAX POSITIONS RECOGNIZED IN THE HOSPITAL'S CONSOLIDATED FINANCIAL STATEMENTS. THESE STANDARDS HAD NO IMPACT ON THE ACCOMPANYING FINANCIAL STATEMENTS. AS OF DECEMBER 31, 2010, THE HOSPITAL DID NOT HAVE ANY UNRECOGINIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2007 THROUGH 2010. PART XI, LINE 8 - RECONCILIATION OF CHANGES - OTHER AFFILIATE INCOME-CONSOLIDATED FINANCIAL STATEMENTS $ 9,555,768 AFFILIATE EXPENSES-CONSOLIDATED FINANCIAL STATEMENTS $-9,505,233 BOOK TO TAX DEPRECIATION DIFFERENCE $-4,198,041 BOOK/TAX DEPRECIATION DIFFERENCE $ 4,198,041 PART XII, LINE 2D - REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER AFFILIATE INCOME - CONSOLIDATED FINANCIAL STATEMENTS $9,555,768 PART XIII, LINE 2D - EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER AFFILIATE EXPENSES-CONSOLIDATED FINANCIAL STATEMENTS $ 9,505,233 PART XIII, LINE 4B - EXPENSE AMOUNTS INCLUDED ON RETURN - OTHER BOOK TO TAX DEPRECIATION DIFFERENBCE $-4,198,041 BOOK /TAX DEPRECIATION DIFFERENCE $ 4,198,041

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent100	X	Pcent100
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	0	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	0	AmountsBudgetedForCharityCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	736642	TotalCommunityBenefitExpense
Direct Offsetting Revenue	297188	DirectOffsettingRevenue
Net Community Benefit Expense	439454	NetCommunityBenefitExpense
Percent Of Total Expense	0.00550	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	18353138	TotalCommunityBenefitExpense
Direct Offsetting Revenue	14685209	DirectOffsettingRevenue
Net Community Benefit Expense	3667929	NetCommunityBenefitExpense
Percent Of Total Expense	0.04570	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	562273	TotalCommunityBenefitExpense
Direct Offsetting Revenue	384532	DirectOffsettingRevenue
Net Community Benefit Expense	177741	NetCommunityBenefitExpense
Percent Of Total Expense	0.00220	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	19652053	TotalCommunityBenefitExpense
Direct Offsetting Revenue	15366929	DirectOffsettingRevenue
Net Community Benefit Expense	4285124	NetCommunityBenefitExpense
Percent Of Total Expense	0.05340	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	76946	TotalCommunityBenefitExpense
Direct Offsetting Revenue	31591	DirectOffsettingRevenue
Net Community Benefit Expense	45355	NetCommunityBenefitExpense
Percent Of Total Expense	0.00060	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	30920	TotalCommunityBenefitExpense
Direct Offsetting Revenue	29302	DirectOffsettingRevenue
Net Community Benefit Expense	1618	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	107866	TotalCommunityBenefitExpense
Direct Offsetting Revenue	60893	DirectOffsettingRevenue
Net Community Benefit Expense	46973	NetCommunityBenefitExpense
Percent Of Total Expense	0.00060	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	19759919	TotalCommunityBenefitExpense
Direct Offsetting Revenue	15427822	DirectOffsettingRevenue
Net Community Benefit Expense	4332097	NetCommunityBenefitExpense
Percent Of Total Expense	0.05400	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Total Community Building Expense	789	TotalCommunityBuildingExpense
Direct Offsetting Revenue	494	DirectOffsettingRevenue
Net Community Building Expense	295	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Total Community Building Expense	1979	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	1979	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	75305	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	75305	NetCommunityBuildingExpense
Percent Of Total Expense	0.00090	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	78073	TotalCommunityBuildingExpense
Direct Offsetting Revenue	494	DirectOffsettingRevenue
Net Community Building Expense	77579	NetCommunityBuildingExpense
Percent Of Total Expense	0.00090	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$2,095,202	BadDebtExpenseAmount
Amount Attributable To	166065	AmountAttributableTo
Amount Reimbursed By Medicare	23850824	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	27906493	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-4055669	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	0	ProvisionForCharityCare
Number Of Hospital Facilities	12	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (12 entries)

Facility NumberFacilityNumber	Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Licensed HospitalLicensedHospital	General Medical And SurgicalGeneralMedicalAndSurgical	Er24 HoursEr24Hours	OtherOther
ROME MEMORIAL HOSPITAL
1	1500 NORTH JAMES STREET	ROME	NY	13440	X	X	X
COMMUNITY RECOVERY CENTER
2	264 W DOMINICK STREET	ROME	NY	13440				SUBSTANCE ABUSE COUNSELING
MOHAWK VALLEY RADIATION MEDICINE
3	107 E CHESTNUT STREET	ROME	NY	13440				RADIATION ONCOLOGY
PHYSICAL THERAPY
4	107 E CHESTNUT STREET	ROME	NY	13440				OFFSITE PHYSICAL THERAPY SERVICES
BOONVILLE FAMILY CARE
5	13407 ROUTE 12	BOONVILE	NY	13309				PRIMARY CARE SERVICES
LABORATORY COLLECTION SITE
7	1801 BLACK RIVER BLVD	ROME	NY	13440				OFFSITE LAB COLLECTION SITE
LABORATORY COLLECTION SITE
8	1617 N JAMES STREET	ROME	NY	13440				OFFSITE LAB COLLECTION SITE
LABORATORY COLLECTION SITE
9	13407 STATE ROUTE 12	BOONVILE	NY	13309				OFFSITE LAB COLLECTION SITE
LABORATORY COLLECTION SITE
10	BEECHES OFFICE COMPLEX-TURIN RD	ROME	NY	13440				OFFSITE LAB COLLECTION SITE
MEDICAL IMAGING
11	1819 BLACK RIVER BLVD	ROME	NY	13440				OFFSITE RADIOLOGY SERVICES
MEDICAL IMAGING
12	1617 N JAMES STREET	ROME	NY	13440				OFFSITE RADIOLOGY SERVICES
MEDICAL IMAGING
13	1801 BLACK RIVER BLVD	ROME	NY	13440				OFFSITE RADIOLOGY SERVICES

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ROME MEMORIAL HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	0	EligibilityCriteriaExplained
Uses FPG Free	0	UsesFPGFree
Uses FPG Discounted	0	UsesFPGDiscounted
Explains Basis	0	ExplainsBasis
Explains Application Method	0	ExplainsApplicationMethod
Includes Publicity Measures	0	IncludesPublicityMeasures
Actions On Nonpayment	0	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Nondiscrim Emergency Care Policy	0	NondiscrimEmergencyCarePolicy
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 6A: ROME MEMORIAL HOSPITAL PREPARED A COMMUNITY SERVICE PLAN WHICH WAS UPDATED ON 9/15/2010. THIS IS MADE AVAILABLE TO THE PUBLIC THROUGH THE HOSPITAL'S WEBSITE.
PART I, LINE 7: CHARITY CARE AT COST (7A) AND UNREIMBURSED COSTS - OTHER MEANS TESTED GOVERNMENT PROGRAMS (7C) WERE CALCULATED BY USING A COST TO CHARGE RATIO. THIS COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, SUPPLIED BY THE IRS.UNREIMBURSED MEDICAID (7B) WAS CALCULATED BY USING ACTUAL COSTS.OTHER BENEFITS (7E & 7F) WERE CLACULATED BY DETERMINING ACTUAL COSTS AND ACTUAL REVENUE PER EVENT.THE MAIN SOURCE OR GUIDE OF HOW CALCULATIONS WERE DETERMINED WAS BY UTILIZING THE WORKSHEETS PROVIDED BY THE IRS AND THEN ADJUSTING ACCORDING TO ROME HOSPITAL SPECIFICS (IE. USING ACTUAL COSTS VS. COST TO CHARGE RATIO AS MENTIONED ABOVE).
PART I, L7 COL(F): PERCENT OF TOTAL EXPENSE IS CALCULATED BY USING THE DENOMINATOR OF THE TOTAL FUNCTIONAL EXPENSES LESS BAD DEBT EXPENSE OF $6,147,555 (PER AUDITED FINANCIAL STATEMENTS).
PART II: ROME MEMORIAL HOSPITAL HAS MAINTAINED A LONG-STANDING COMMITMENT TO WELLNESS AND PREVENTION THROUGH AN ACTIVE EDUCATION DEPARTMENT THAT PROVIDES ONGOING HEALTH EDUCATION LECTURES AND FREE SCREENINGS. IN ADDITION, THE HOSPITAL ASSURES ACCESS TO SERVICES BY CONTINUING TO PROVIDE CRITICAL SERVICES TO THE COMMUNITY, EVEN THOUGH THEY ARE OPERATED AT A LOSS TO THE HOSPITAL. THESE ARE SOME OF THE HOSPITAL'S PROGRAMS THAT SUPPORT THE STATE'S PREVENTION AGENDA AND PROMOTE HEALTHY IN OUR COMMUNITY: HEALTHY MOTHERS, HEALTHY BABIES, HEALTHY CHILDREN THE MATERNITY DEPARTMENT'S WEIGH STATION PROVIDES MOTHERS WHO ARE BREASTFEEDING ADDED SUPPORT AND ENSURE THAT BABIES ARE GAINING WEIGHT AT A HEALTHY LEVEL. BABYCARE BASICS AND BREASTFEEDING EDUCATION PROGRAMS FOR NEW PARENTS HELP THEM ACQUIRE THE NECESSARY SKILLS FOR TAKING CARE OF A NEWBORN.CHRONIC DISEASE EDUCATION HEALTH NIGHT, SENIOR LIVE & LEARN, SPEAKER'S BUREAU LECTURES, AND OUTREACH AT HEALTH FAIRS PROVIDE COMMUNITY MEMBERS WITH THE LATEST INFORMATION AVAILABLE TO HELP THEM MODIFY THEIR LIFESTYLES TO PREVENT THE ONSET OF CHRONIC DISEASE OR BETTER MANAGE THEIR CHRONIC CONDITIONS. SMOKING CESSATION CLASSES FOR THE COMMUNITY AND HOSPITAL EMPLOYEES, ALONG WITH SMOKING PREVENTION PROGRAMS FOR AREA SCHOOLS PROVIDES ESSENTIAL OUTREACH TO ERADICATE THE LEADING CAUSE OF PREMATURE DEATH. SPONSORSHIP SUPPORT OF THE AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION, AMERICAN DIABETES ASSOCIATION AND OTHER HEALTH-RELATED ORGANIZATIONS TO PROVIDE FINANCIAL RESOURCES FOR EDUCATION AND RESEARCH.ACCESS TO QUALITY HEALTHCARE FREE ROUTINE SCREENINGS, INCLUDING BLOOD PRESSURE, PSAS, COLORECTAL CANCER AND DIABETES SCREENING, ARE OFFERED TO THE COMMUNITY TO PROMOTE EARLY DETECTION OF DISEASE. FACILITATED ENROLLMENT EFFORTS HELP LINK THE UNINSURED TO AVAILABLE INSURANCE OPTIONS TO ENABLE THEM TO ESTABLISH A RELATIONSHIP WITH A PRIMARY CARE PROVIDER. IMMUNIZATION CLINICS ARE OFFERED IN THE COMMUNITY TO PROTECT RESIDENTS FROM THE FLU. EFFORTS TO RECRUIT ADDITIONAL PHYSICIANS TO THE COMMUNITY ADDRESS THE FACT THAT THE MOHAWK VALLEY REGION HAS THE WORST PHYSICIAN TO POPULATION RATIO IN ALL OF NEW YORK STATE. THE NEWLY CONSTRUCTED DIAGNOSTIC CENTER INCLUDED INVESTMENTS IN THE LATEST TECHNOLOGY INCLUDING DIGITAL MAMMOGRAPHY AND A NEW MRI TO ENHANCE THE HOSPITAL'S DIAGNOSTIC CAPABILITIES. THE HOSPITAL ADDED A NURSE NAVIGATOR TO HELP COORDINATE CARE FOR PATIENTS WITH A POTENTIAL CANCER DIAGNOSIS.PHYSICAL FITNESS AND NUTRITION AN INDOOR WALKING PROGRAM HELPS AREA RESIDENTS INCORPORATE PHYSICAL FITNESS INTO THEIR LIVES TO PREVENT CHRONIC DISEASE AND ENHANCE THEIR MENTAL HEALTH.
PART III, LINE 4: "SIGNIFICANT ESTIMATES MADE BY THE HOSPITAL INCLUDE, BUT ARE NOT LIMITED TO, THE RESERVE FOR UNCOLLECTIBLE ACCOUNTS, RESERVES FOR THIRD-PARTY CONTRACTUAL ADJUSTMENTS AND SETTLEMENTS AND INSURANCE RESERVES. THE CURRENT ECONOMIC ENVIRONMENT HAS INCREASED THE DEGREE OF UNCERTAINITY INHERENT IN THOSE ESTIMATES AND ASSUMPTIONS.""AN ALLOWANCE FOR DOUBTFUL ACCOUNTS RECEIVABLE IS ESTIMATED BY MANAGEMENT BASED ON PERIODIC REVIEWS OF THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE CONSIDERING HISTORICAL EXPERIENCE AND PREVAILING ECONOMIC CONDITIONS."FROM THE AGED ACCOUNTS RECEIVABLE TRIAL BALANCE, THE PAYOR CLASSES ARE SUMMARIZED INTO FOUR CATEGORIES: COLLECTION, SELF PAY, TIME PLAN AND OTHERS (ALL OTHER INSURANCE BALANCES) BY AGING BUCKET. IN ADDITION:THE ACCOUNTS THAT ARE "COLLECTION" ARE ALL PATIENT ACCOUNTS THAT HAVE BEEN SENT TO A COLLECTION AGENCY. FOR ALL ACCOUNTS THAT ARE CONSIDERED COLLECTION THESE ACCOUNTS ARE RESERVED AT:UNBILLED 150 DAYS - 98.63% LESS THE SURCHARGE PORTION OF THE SELF PAY OF 9.63%.151+ DAYS - 99.73% LESS THE SURCHARGE PORTION OF THE SELF PAY OF 9.63%.FOR SELF PAY ACCOUNTS THE FOLLOWING PERCENTAGES ARE USED:UNBILLED - 30%0-30 DAYS - 45%31-60 DAYS - 60%61-90 DAYS - 70%91-120 DAYS - 75%121-150 DAYS - 85%151+ DAYS - 90%FOR TIME PLAN ACCOUNTS THE FOLLOWING PERCENTAGES ARE USED:UNBILLED - 62.38%0-30 DAYS - 62.38%31-60 DAYS - 62.38%61-90 DAYS - 62.38%91-120 DAYS - 62.38%121-150 DAYS - 62.38%151+ DAYS - 62.38%FOR OTHER ACCOUNTS THE FOLLOWING PERCENTAGES ARE USED:UNBILLED - 5%0-30 DAYS - 5%31-60 DAYS - 0%61-90 DAYS - 0%91-120 DAYS - 0%121-150 DAYS - 0%151+ DAYS - 0%THE BAD DEBT RESERVE THAT IS CALCULATED MONTHLY USING THIS ANALYSIS IS COMPARED TO ACTUAL RESERVE AT MONTH END. IF NECESSARY AN ADJUSTMENT WILL BE RECORDED.COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 & 3:RATIO OF PATIENT CARE COST TO CHARGES
PART III, LINE 8: THE EXTENT TO WHICH THE SHORTFALL IN QUESTION 7 SHOULD BE TREATED AS A COMMUNITY BENEFIT IS BEST DESCRIBED BY INFORMATION AVAILABLE IN ROME MEMORIAL HOSPITAL'S COMMUNITY SERVICE PLAN AND ANNUAL UPDATES:FINANCIAL AID PROGRAM A. SUCCESSES AND CHALLENGES WITH TOUGH ECONOMIC TIMES BATTERING THE COUNTRY, MANY PEOPLE HAVE LOST THEIR HEALTH INSURANCE. MANY CANNOT AFFORD RISING PREMIUMS, WHILE OTHERS HAVE LOST THEIR JOBS COMPLETELY. SOME PEOPLE HAVE INSURANCE, BUT THEIR OUT-OF-POCKET COSTS ARE HIGH BECAUSE EMPLOYERS HAVE RAISED THEIR DEDUCTIBLES OR CO-PAYMENTS, OR REDUCED WHAT THEIR PLANS COVER. AS A RESULT, THE AMOUNT OF UNCOMPENSATED CARE PROVIDED BY RMH CONTINUES TO GROW.TO HELP THOSE WHO ARE UNINSURED LEARN MORE ABOUT POSSIBLE OPTIONS, THE HOSPITAL'S PATIENT REGISTRATION DEPARTMENT PROVIDES INFORMATION FROM INSURERS WHICH OFFER FREE OR LOW-COST HEALTH INSURANCE THROUGH NEW YORK STATE'S CHILD HEALTH PLUS AND FAMILY HEALTH PLUS, ALONG WITH SPACE FOR REPRESENTATIVES TO ANSWER QUESTIONS AND ENROLL ELIGIBLE RESIDENTS.IN ADDITION, THE HOSPITAL HAS PARTNERED WITH THE MOHAWK VALLEY PERINATAL NETWORK, WHOSE FACILITATED ENROLLER CAN ASSIST INDIVIDUALS IN APPLYING FOR COVERAGE FROM CHILD HEALTH PLUS, FAMILY HEALTH PLUS, AND MEDICAID. THE ENROLLER IS LOCATED DOWNTOWN IN THE HOSPITAL'S BUSINESS OFFICE, 155 W. DOMINICK ST. IN ADDITION TO HELPING PEOPLE OBTAIN INSURANCE COVERAGE, THE HOSPITAL ALSO PROVIDES A FINANCIAL ASSISTANCE PROGRAM AND WORKS WITH PATIENTS TO SET UP AFFORDABLE PAYMENT PLANS.FINANCIAL ASSISTANCE BROCHURES ARE LOCATED IN THE HOSPITAL'S WAITING AREAS AND APPLICATIONS ARE AVAILABLE ON THE WEBSITE. RMH DISCOUNTS PATIENT ACCOUNTS UP TO 100% DEPENDING UPON FAMILY INCOME IN COMPARISON TO THE FEDERAL POVERTY LEVEL. DISCOUNTS ARE BASED UPON THE BLUE CROSS RATE. ROME MEMORIAL HOSPITAL OFFERS DISCOUNTS TO THE UNINSURED/UNDERINSURED WHOSE INCOME IS UP TO 300% OF THE FEDERAL POVERTY LEVEL.BECAUSE LACK OF AWARENESS IS ONE OF THE BIGGEST BARRIERS, RMH PROVIDES INFORMATION ABOUT AVAILABLE PROGRAMS AT HEALTH FAIRS AND OTHER OUTREACH ACTIVITIES.CHANGES (ACTUAL OR POTENTIAL) IMPACTING COMMUNITY HEALTH, PROVISION OF CHARITY CARE, AND ACCESS TO SERVICES: REIMBURSEMENTS THAT FAIL TO KEEP PACE WITH RISING EXPENSES AND THE CONTINUED GROWTH IN UNCOMPENSATED CARE ARE SIGNIFICANT CHALLENGES THAT NEW YORK'S HOSPITALS FACE, INCLUDING RMH. OTHER CHALLENGES INCLUDE THE ESCALATION OF COSTS FOR DRUGS DUE TO INFLATION AND HAVING TO FIND ALTERNATE SUPPLIERS BECAUSE OF MANUFACTURER PRODUCTION SHORTAGES, SERVICES AND BAD DEBT, AND INVESTMENTS REQUIRED TO COMPLY WITH MANDATES. HERE ARE JUST A FEW EXAMPLES OF OUR CHALLENGES:UNCOMPENSATED CARE: THE COST OF FREE SERVICES PROVIDED TO OUR COMMUNITY CONTINUES TO RISE AS RESIDENTS LOSE THEIR JOBS OR THEIR ABILITY TO AFFORD THEIR INSURANCE PREMIUMS. IN 2010, ROME MEMORIAL HOSPITAL'S BAD DEBT AND CHARITY CARE TOTALED $7.8 MILLION, COMPARED TO $7.4 MILLION IN 2009. PHYSICIAN SHORTAGES: ROME MEMORIAL HOSPITAL HAS BEEN SUCCESSFUL IN RECRUITING SEVERAL NEW PHYSICIANS TO THE COMMUNITY, BUT AT A GREAT COST. TODAY'S PHYSICIAN WANTS TO BE EMPLOYED SO THEY DON'T HAVE TO BEAR THE RISK OF OPENING A NEW PRACTICE OR MANAGE THE ADMINISTRATIVE ASPECTS OF MEDICINE. ALTHOUGH THEY PROVIDE CRITICAL ACCESS TO CARE, THESE PRACTICES WILL STRUGGLE TO BREAK EVEN. LACK OF PRIMARY CARE: PATIENTS WHO DON'T HAVE INSURANCE OR WHO ARE COVERED BY MEDICAID OFTEN DON'T HAVE A REGULAR PHYSICIAN FOR PREVENTATIVE CARE OR TO MANAGE CHRONIC CONDITIONS. AS A RESULT, THEY USE THE EMERGENCY DEPARTMENT AS THEIR PRIMARY CARE OR DELAY CARE UNTIL THEIR CONDITION IS MORE CRITICAL AND MORE EXPENSIVE TO TREAT. SINCE ROME MEMORIAL HOSPITAL'S NEW EMERGENCY DEPARTMENT OPENED, THE NUMBER OF PATIENT VISITS HAS STEADILY INCREASED BY 19,000 IN 2006 TO 25,400 IN 2010. MANY PHYSICIANS DON'T ACCEPT MEDICAID PATIENTS BECAUSE OF LOW REIMBURSEMENT RATES. IN ADDITION, SENIORS MAY SOON FACE THE SAME ACCESS PROBLEMS. PHARMACEUTICALS: THE HOSPITAL CONTINUES TO SEE SIGNIFICANT INCREASE IN DRUG COSTS DUE TO INFLATION AND MANUFACTURER PRODUCTION SHORTAGES. IN MANY CASES, THESE SHORTAGES FORCE US TO TURN TO ALTERNATE SUPPLIERS, WHO CHARGE A PREMIUM PRICE. INTERPRETER SERVICES: AS OUR POPULATION BECOMES MORE DIVERSE WITH BURMESE AND BOSNIAN REFUGEES AND SPANISH SPEAKING RESIDENTS, THERE IS A GREATER DEMAND FOR INTERPRETER SERVICES. DDSO POPULATION - THE HIGH CONCENTRATION OF DDSO CLIENTS IN ONEIDA COUNTY AND ROME PLACES A UNIQUE BURDEN ON ROME MEMORIAL HOSPITAL. ONEIDA COUNTY IS HOME TO 54.6% OF THE DDSO BEDS IN THE CENTRAL NEW YORK REGION. OF THOSE BEDS, 47.7% (MORE THAN 500 DDSO CLIENTS) ARE LOCATED IN ROME. WHEN DDSO CLIENTS REQUIRE HOSPITALIZATION, THEIR CASES ARE OFTEN VERY COMPLEX AND THEIR LENGTH OF STAY IS NEARLY TWICE AS LONG AS THE AVERAGE PATIENT. AS A RESULT, THE HOSPITAL IS ONCE AGAIN FACED WITH ABSORBING THE FINANCIAL LOSS OF CARING FOR THESE PATIENTS. PROGRAM VIABILITY: AS A RESULT OF THESE SIGNIFICANT FINANCIAL CHALLANGES, RMH IS EVALUATING THE VIABILITY OF SOME OF ITS SERVICES. AS A PART OF THE EVALUATION, RMH WILL ASSESS THE NUMBER OF PEOPLE SERVED AND AVAILABILITY OF OTHER SERVICES TO ADDRESS THE COMMUNITY NEED, IN ADDITION TO THE FINANCIAL BURDEN ON THE HOSPITAL. IN DECEMBER 2010, AFTER CONSIDERABLE EVALUATION, RMH DECIDED TO CLOSE THE ACUTE PHYSICAL REHABILITATION DEPARTMENT DUE TO FINANCIAL REASONS. WHILE ELIMINATING A SERVICE IS ALWAYS DIFFICULT, IT ASSURES THAT RESOURCES CAN BE REDIRECTED TO MEET A GREATER NEED AND PROTECT THE OVERALL VIABILITY OF THE HOSPITAL.COSTING METHODOLOGY AND SOURCE FOR LINE 6:2010 ICR EXHIBIT 46 AND TENTATIVE MEDICARE SETTLEMENT RATES
ROME MEMORIAL HOSPITAL FILES A COMMUNITY SERVICE PLAN WITH THE NEW YORK STATE DEPARTMENT OF HEALTH.
PART VI, LINE 2: #2 NEEDS ASSESSMENT:ROME MEMORIAL HOSPITAL PARTICIPATES IN THE ASSESSMENT PROCESS LED BY THE ONEIDA COUNTY HEALTH DEPARTMENT, WHICH USES THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) FRAMEWORK TO CONDUCT THE MAJORITY OF ITS COMMUNITY HEALTH ASSESSMENT (CHA) ACTIVITIES. A COMMUNITY HEALTH ASSESSMENT PLANNING TEAM OF APPROXIMATELY 25-30 INDIVIDUALS WAS CONVENED IN JANUARY 2008 THAT CONSISTED OF THE STEERING COMMITTEE MEMBERS OF AN EXISTING COMMUNITY HEALTH PARTNERSHIP, THE ONEIDA COUNTY HEALTH COALITION, AND ADDITIONAL KEY COMMUNITY STAKEHOLDERS. THIS GROUP IS THE MAPP ADVISORY TEAM (MAT). SEVERAL SUB-COMMITTEES WERE CREATED TO ACCOMPLISH THE ASSESSMENT.THE COLLABORATING AGENCIES CONDUCTED PUBLIC VISIONING SESSIONS, HEALTHY CONVERSATION, FOCUS GROUPS, AND COMMUNITY SURVEYS TO COLLECT THE PERCEPTIONS OF THOSE WHO ARE UNABLE TO ATTEND ONE OF THE FACE TO FACE SESSIONS. THE FEEDBACK FROM SURVEYS AND PUBLIC OUTREACH SESSIONS PROVIDE THE QUALITATIVE INFORMATION TO ENRICH THE STATISTICAL FINDINGS OF THE NEEDS ASSESSMENT TO ADDRESS THE PRIORITY HEALTH NEEDS OF THE COMMUNITY.BASED UPON THIS PROCESS, THE FOLLOWING FIVE ITEMS FROM NEW YORK STATE'S PREVENTION AGENDA WERE IDENTIFIED AS PRIORITIES FOR THE COUNTY:HEALTHY MOTHERS, HEALTHY BABIES, HEALTHY CHILDRENMENTAL HEALTH AND SUBSTANCE ABUSECHRONIC DISEASEACCESS TO QUALITY HEALTHCAREPHYSICAL FITNESS AND NUTRITIONTHE FULL 2010-2013 ONEIDA COUNTY COMMUNITY HEALTH ASSESSMENT, ALONG WITH ITS DETAILED DATA BOOK CAN BE FOUND ONLINE AT WWW.OCGOV.NET/HEALTH/COMMUNITY-HEALTH-ASSESSMENT.ROME MEMORIAL HOSPITAL ALSO PARTICIPATES AND COLLABORATES WITH NUMEROUS COMMUNITY AND PROFESSIONAL ORGANIZATIONS. WITHIN THIS FRAMEWORK, IT IS POSSIBLE TO GAIN A BETTER UNDERSTANDING OF DIFFERENT NEED PERSPECTIVES AND ALSO EVALUATE COMMUNITY RESOURCES. THE ONGOING ANALYSIS OF QUANTITATIVE AND QUALITATIVE DATA IS UTILIZED TO CREATE ROME MEMORIAL HOSPITAL'S STRATEGIC PLAN, WHICH SERVES AS A BLUEPRINT FOR ADAPTING OUR AVAILABLE RESOURCES TO RESPOND TO THE CHANGING NEEDS OF THE COMMUNITY. ALTHOUGH THE 2009 COMMUNITY SERVICE PLAN AND UPDATES THEREAFTER (9/15/2010) WERE DESIGNED TO SPECIFICALLY ADDRESS THE STATE'S PREVENTION AGENDA, IT IS IMPORTANT TO NOTE THAT RMH'S STRATEGIC PLAN INCLUDES MANY ADDITIONAL INITIATIVES TO ADDRESS OUR COMMUNITY'S NEEDS AND ENSURE THE HOSPITAL'S CONTINUED FINANCIAL VIABILITY.RMH'S STRATEGIC PLAN PROVIDES A FRAMEWORK THAT GUIDES OUR DECISIONS AND BRINGS US FOCUS. THE SIX MAJOR OBJECTIVES ARE STRAIGHT-FORWARD, YET THE TACTICS TO ACHIEVE THEM ARE MULTI-FACETED IN SCOPE.QUALITY - WITH A COMMITMENT TO CONTINUOUS QUALITY IMPROVEMENT, PROVIDE THE NECESSARY LEADERSHIP AND RESOURCES TO DELIVER EVIDENCE-BASED, PATIENT-CENTERED HEALTHCARE SERVICES IN SUPPORT OF OUR MISSION. FOR EXAMPLE, AMONG ONEIDA COUNTY HOSPITALS, ROME MEMORIAL HOSPITAL EARNED THE HIGHEST OVERALL MARKS FOR ENSURING THAT PAITENTS RECEIVE THE RECOMMENDED TREATMENTS FOR PNEUMONIA, HEART FAILURE, AND SURGICAL INFECTION PREVENTION FOR PATIENTS DISCHARGED JULY 1, 2009 TO JUNE 30, 2010, ACCORDING TO THE NYS DEPARTMENT OF HEALTH (FIGURES LAST UPDATED 7/15/2011)RECRUITMENT & RETENTION - CONTINUE TO RECRUIT AND RETAIN OUR MOST VALUABLE RESOURCES, OUR PHYSICIANS AND EMPLOYEES, WHO CONSISTENTLY DEMONSTRATE OUR ORGANIZATIONAL MISSION AND VISION. DURING 2010 RMH WELCOMED 15 NEW DOCTORS AND ALLIED HEALTH PROFESSIONALS ON STAFF. PHYSICAL PLANT - UTILIZE THE FACILITY MASTER PLAN TO PROVIDE SERVICES IN ENVIRONMENTS THAT ARE SAFE, EFFICIENT AND SUPPORT OUR ORGANIZATIONAL MISSION AND VISION. IN 2010, ROME MEMORIAL HOSPITAL UPDATED ITS FACILITY MASTER PLAN TO ESTABLISH A FRAMEWORK TO GUIDE ORDERLY GROWTH AND DEVELOPMENT OF THE HOSPITAL CAMPUS.INFORMATION TECHNOLOGY - TO EXTEND THE SCOPE AND APPLICATION OF INFORMATION TECHNOLOGY (IT) ACROSS THE CONTINUUM OF CARE, TO ENHANCE PATIENT SAFETY, EFFICIENCY AND AVAILABILITY OF INFORMATION. DURING 2010, THE FOCUS WAS ON PREPARING FOR THE IMPLEMENTATION OF THE NEW HOSPITAL INFORMATION SYSTEM, NEW RADIOLOGY INFORMATION SYSTEM, AND PICTURE ARCHIVING AND CONTROL SYSTEM FOR MEDICAL IMAGING. BY THE END OF 2010 THE HOSPITAL HAD INVESTED MORE THAN $2.9 MILLION INOT WORK IN PROCESS REGARDING THE IT IMPLEMENTATION PROJECT. ROME HOSPITAL IS SCHEDULED TO "GO LIVE" WITH THE NEW SYSTEMS IN 2011. MARKET PENETRATION - INCREASE THE UTILIZATION OF OUR HEALTHCARE SERVICES BY MAXIMIZING OPPORTUNITIES THAT MEET THE NEEDS OF OUR CUSTOMERS. IN 2010, ROME MEMORIAL HOSPITAL JOINED ITS THREE OPHTALMOLOGISTS TO BREAK GROUND ON A NEW EYE CENTER THAT WILL OPEN IN 2011. THE PROJECT ALIGNS WITH THE HOSPITAL'S NEED TO PROVIDE MORE AVAILABLE OPERATING ROOM TIME FOR NEWLY RECRUITED GENERAL SURGEONS. FINANCE - ENGAGE IN PRUDENT, ETHICAL BUSINESS PRACTICES TO OPTIMIZE PROFITABILITY THAT ALLOW US TO MEET THE PRIORITY HEALTHCARE NEEDS OF OUR COMMUNITY. THE STRATEGIES THAT ROME MEMORIAL HOSPITAL IMPLEMENTED IN 2010 TO DELIVER COST EFFECTIVE QUALITY CARE GENERATED A POSITIVE BOTTOM LINE FOR THE HOSPITAL TO REINVEST IN TECHNOLOGY AND SERVICES.
PART VI, LINE 3: #3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:TO ENSURE THAT THE COMMUNITY IS AWARE OF THE HOSPITAL'S COMMITMENT TO PROVIDE HEALTHCARE SERVICESTO THOSE WHO ARE UNABLE TO PAY, THE HOSPITAL POSTS INFORMATION ABOUT ITS FINANCIAL ASSISTANCEPOLICY ON ITS WEBSITE. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY CONFORMS WITH THE GUIDELINES ESTABLISHED BY THE HEALTHCARE ASSOCIATION OF NEW YORK STATE. THIS POLICY INCLUDES DETAILED INFORMATION REGARDING ELIGIBILITY, THE APPLICATION PROCESS, FINANCIAL GUIDELINES, TYPES OF FINANCIAL ASSISTANCE AVAILABLE, AND THE APPEAL PROCESS. RMH'S WEBSITE ALSO LISTS CONTACT INFORMATION IF YOU NEED HELP DETERMINING IF YOU QUALIFY FOR A DISCOUNT OR HAVE QUESTIONS REGARDING THE PROCESS. FREE, CONFIDENTIAL ASSISTANCE IS AVAILABLE BY CONTACTING THE ROME MEMORIAL HOSPITAL BUSINESS OFFICE. IF YOU DO NOT SPEAK ENGLSH, SOMEONE WILL HELP IN YOUR OWN LANGUAGE. ALSO, ROME MEMORIAL HOSPITAL HOSTS ENROLLMENT REPRESENTATIVES WHO CAN HELP ENROLL IN FREE OR LOW-COST INSURANCE PROGRAMS, SUCH AS MEDICAID, CHILD HEALTH PLUS AND FAMILY HEALTH PLUS.
PART VI, LINE 4: #4 COMMUNITY INFORMATION:ROME MEMORIAL HOSPITAL SERVES THE RESIDENTS OF ROME, A CITY OF 34,220 PEOPLE, AS WELL AS THE SURROUNDING RURAL TOWNS AND VILLAGES IN ONEIDA COUNTY. THE POPULATION OF THE PRIMARY MARKET IS APPROXIMATELY 100,000 PEOPLE. FOR SELECTED SPECIALTIES, SUCH AS SENIOR BEHAVIORAL HEALTH CARE, RMH'S SERVICE AREA EXTENDS INTO THE SURROUNDING COUNTIES OF MADISON, HERKIMER, LEWIS AND ONONDAGA COUNTIES.ACCORDING TO THE MOST RECENT CENSUS ESTIMATES AVAILABLE, OVERALL POPULATION GROWTH HAS DECLINED APPROXIMATELY 3.78% IN THE CITY OF ROME AND ONEIDA COUNTY SINCE 2000. RESEARCH SHOWS THAT SOCIOECONOMIC CHARACTERISTICS HAVE AN IMPACT ON COMMUNITY HEALTH AND ARE AS IMPORTANT TO HEALTH STATUS AS OUR GENES, OUR BEHAVIORS AND EVEN ACCESS TO MEDICAL CARE. WHEN COMPARED AGAINST STATE FIGURES, THE POPULATION IN ROME AND ONEIDA COUNTY IS OLDER, LESS EDUCATED AND EARNS LESS THAN THE AVERAGE NEW YORKER, WHICH PUTS THEM AT HIGHER RISK FOR HEALTH PROBLEMS. IN ONEIDA COUNTY, OVER 15% OF ADULTS OF ALL INCOMES AGED 18-64 ARE UNINSURED; THIS RATE IS HIGHER THAN NEW YORK STATE (EXCLUDING NEW YORK CITY) AT 13.6%. IN ADDITION, APPROXIMATELY 6% OF CHILDREN AGED 18 AND YOUNGER LACK INSURANCE. IN ADDITION, ACCORDING TO THE MOST RECENT ONEIDA COUNTY COMMUNITY HEALTH ASSESSMENT 2010 - 2013, THE NUMBER OF MEDICAID ELIGIBLE CHILDREN AGED 12-17 INCREASED FROM 3,970 IN 2000 TO 5,954 IN 2005. CHILD HEALTH PLUS ENROLLMENT FOR ONEIDA COUNTY WAS 5,454 AS OF JULY 2009. THE NUMBER OF MEDICAID ELIGIBLE ADULTS IN ONEIDA COUNTY AGED 18 AND OLDER INCREASED 18% FROM 22,398 IN 2000 TO 26,346 IN 2005.THE CHALLENGE IS COMPOUNDED BY THE FACT THAT ONEIDA COUNTY IS A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. IN ADDITION, THE CITY OF ROME AND TOWNS OF AVA, BOONVILLE, FORESTPORT, FLOYD, LEE, VERONA, WESTERN, ANNSVILLE, CAMDEN, FLORENCE AND VIENNA ARE FEDERALLY-DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREAS, WITH AN INADEQUATE NUMBER OF PRIMARY MEDICAL CARE PROVIDERS TO SERVE THE COMMUNITY.THE FOLLOWING TABLE HIGHLIGHTS AVAILABLE DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS OF OUR COMMUNITY.SOCIO-ECONOMIC PROFILE ONEIDA COUNTY NEW YORKPOPULATION, 2010 ESTIMATE 234,878 19,378,102POPULATION, PERCENT CHANGE, 2000 TO 2010 -.3% 2.1%POPULATION ESTIMATES BASE (APRIL 1) 2000 235,461 18,976,811PERSONS UNDER 5 YEARS OLD, PERCENT, 2009 5.6% 6.3%PERSONS UNDER 18 YEARS OLD, PERCENT, 2009 21.5% 22.6%PERSONS 65 YEARS OLD AND OVER, PERCENT, 2009 16.3% 13.4%FEMALE PERSONS, PERCENT, 2009 50.0% 51.4% ONEIDA COUNTY NEW YORKWHITE PERSONS, PERCENT, 2010 (A) 87.1% 65.7%BLACK PERSONS, PERCENT, 2010 (A) 6.3% 15.9%AMERICAN INDIAN/ALASKA NATIVE PERSONS,%,2010(A) 0.3% 0.6%ASIAN PERSONS, %, 2010 (A) 2.8% 7.3%NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER, %,2010(A) Z 0.0%PERSONS REPORTING TWO OR MORE RACES, %, 2010 2.1% 3.0%PERSONS OF HISPANIC OR LATINO ORIGIN, %, 2010(B) 4.6% 17.6%WHITE PERSONS NOT HISPANIC, PERCENT, 2010 84.8% 58.3% ONEIDA COUNTY NEW YORK FOREIGN BORN PERSONS, PERCENT, 2005-2009 6.0% 21.3%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME, PCT AGE 5+, 2005-2009 10.1% 28.5%HIGH SCHOOL GRADUATES, PERCENT OF PERSONS AGE 25+, 2005-2009 85.6% 84.2%BACHELOR'S DEGREE OR HIGHER, PCT OF PERSONS AGE 25+, 2005-2009 20.9% 31.8%VETERNS, 2005-2009 21,701 1,064,754 ONEIDA COUNTY NEW YORK HOUSING UNITS, 2009 103,876 8,017,881HOMEOWNERSHIP RATE, 2005-2009 68.2% 55.7%HOUSING UNITS IN MULTI-UNIT STRUCTURES, %,2005-2009 30.7% 50.5%MEDIAN VALUE OF OWNER-OCCUPIED HOUSING UNITS, 2000 $97,000 $300,600 ONEIDA COUNTY NEW YORKHOUSEHOLDS, 2005-2009 92,544 7,137,013PERSONS PER HOUSEHOLD, 2005-2009 2.33 2.64MEDIAN HOUSEHOLD INCOME, 2009 $45,663 $54,554PER CAPITA MONEY INCOME, 2005-2009 $23,224 $30,634PERSONS BELOW POVERTY LEVEL, PERCENT, 2009 14.4% 14.2% ROME NEW YORKPOPULATION, 2006 ESTIMATE 34,220 19,306,183POPULATION, % CHANGE, 4/1/2000 TO 7/1/2006 -2.1% 1.7%POPULATION, 2000 34,950 18,976,457PERSONS UNDER 5 YEARS OLD, PERCENT, 2000 5.9% 6.5%PERSONS UNDER 18 YEARS OLD, PERCENT, 2000 22.1% 24.7%PERSONS 65 YEARS OLD AND OVER, PERCENT, 2000 17.2% 12.9%FEMALE PERSONS, PERCENT, 2000 48.8% 51.8% ROME NEW YORKWHITE PERSONS, PERCENT, 2000 (A) 87.9% 67.9%BLACK PERSONS, PERCENT, 2000 (A) 7.6% 15.9%AMERICAN INDIAN & ALASKA NATIVE PERSONS, %, 2000 (A) 0.3% 0.4%ASIAN PERSONS, PERCENT, 2000 (A) 0.9% 5.5%NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER,%, 2000 (A) Z ZPERSONS REPORTING TWO OR MORE RACES, PERCENT, 2000 2.0% 3.1%PERSONS OF HISPANIC OR LATINO ORIGIN, %, 2000 (B) 4.7% 15.1% ROME NEW YORK LIVING IN SAME HOUSE IN 1995 & 2000, PCT 5 YRS/OVER 60.9% 61.8%FOREIGN BORN PERSONS, PERCENT, 2000 3.8% 20.4%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME, PCT AGE 5+,2000 7.2% 28.0%HIGH SCHOOL GRADUATES, PCT OF PERSONS AGE 25+,2000 74.0% 79.1%BACHELOR'S DEGREE OR HIGHER, PCT OF PERSONS AGE 25+,2000 15.7% 27.4% ROME NEW YORKHOUSING UNITS, 2000 16,272 7,679,307HOMEOWNERSHIP RATE, 2000 57.1% 53.0%MEDIAN VALUE OF OWNER-OCCUPIED HOUSING UNITS,2000 $66,200 $148,700 ROME NEW YORK HOUSEHOLDS, 2000 13,653 7,056,860PERSONS PER HOUSEHOLD, 2000 2.3 2.61MEDIAN HOUSEHOLD INCOME, 1999 $33,643 $43,393PER CAPITA MONEY INCOME, 1999 $18,604 $23,389PERSONS BELOW POVERTY, PERCENT, 1999 15.0% 14.6% SOURCE: US CENSUS BUREAU STATE & COUNTY QUICKFACTS
PART VI, LINE 6: #5 PROMOTION OF COMMUNITY HEALTH:1.ROME MEMORIAL HOSPITAL PROVIDES EMERGENCY SERVICES TO EVERYONE REGARDLESS OF ABILITY TO PAY.2.THE HOSPITAL'S INDEPENDENT GOVERNING BODY IS COMPRISED OF INDIVIDUALS WHO RESIDE OR WORK IN THE PRIMARY SERVICE AREA TO REPRESENT THE INTERESTS OF THE COMMUNITY.3.THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY.4.THE HOSPITAL USES ANY SURPLUS FUNDS TO IMPROVE CARE, EXPAND FACILITIES, RECRUIT STAFF AND ADVANCE MEDICAL TRAINING AND COMMUNITY EDUCATION.
PART VI, LINE 7: #6 AFFILIATED HEALTH CARE SYSTEM:ROME MEMORIAL HOSPITAL, INC. (THE "HOSPITAL") IS A NEW YORK STATE NOT-FOR-PROFIT CORPORATION AND TAX EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC"), AND IS PART OF THE FOLLOWING CORPORATE STRUCTURE: GREATER ROME AFFILIATES, INC. ("GRA"), A NEW YORK STATE NOT-FOR-PROFIT CORPORATION, TAX EXEMPT UNDER SECTION 501(C)(3) OF THE IRC, IS THE SOLE CORPORATE MEMBER, AND THEREFORE, THE "PARENT" OF THE HOSPITAL, AS WELL AS ROME MEMORIAL PROPERTIES, INC., A NEW YORK STATE NOT-FOR-PROFIT CORPORATION, TAX EXEMPT UNDER SECTION 501(C)(3) OF THE IRC. GRA IS ALSO THE SOLE SHAREHOLDER OF RMH SERVICES, INC., A NEW YORK STATE BUSINESS CORPORATION, WHICH WAS ESTABLISHED TO UNDERTAKE CERTAIN FOR-PROFIT BUSINESS ACTIVITIES AND WHICH HAS AN EQUITY OWNERSHIP INTEREST IN, AND IS A MEMBER OF, THREE NEW YORK STATE LIMITED LIABILITY COMPANIES: 1819 BLACK RIVER ASSOCIATES, LLC; CHESTNUT COMMONS, LLC; AND RMH RETAIL PHARMACY, LLC. MEMBERS OF THE HOSPITAL'S BOARD OF TRUSTEES AND ADMINISTRATIVE STAFF HAVE OVERLAPPING RESPONSIBILITIES ON THE BOARDS OF THE AFFILIATED CORPORATIONS TO ENSURE THAT THE HOSPITAL'S BEST INTERESTS ARE BEING SERVED. ROME MEMORIAL HOSPITAL FOUNDATION, INC., A NEW YORK STATE NOT-FOR-PROFIT CORPORATION, TAX EXEMPT UNDER SECTION 501(C)(3) OF THE IRC, IS A SEPARATE CORPORATION ESTABLISHED FOR THE SOLE PURPOSE OF CONDUCTING FUND RAISING ACTIVITIES ON BEHALF OF THE HOSPITAL, INCLUDING THE RECEIPT OF GIFTS AND BEQUESTS ON BEHALF OF THE HOSPITAL, INVESTING SUCH ASSETS, AND TRANSFERRING THEM TO THE HOSPITAL IN SUPPORT OF ITS MISSION. IT IS GOVERNED BY A SEPARATE BOARD OF DIRECTORS, WHICH HAS AMONG ITS MEMBERS HOSPITAL TRUSTEES AND MEMBERS OF THE HOSPITAL'S MEDICAL STAFF.THE SYSTEM ALSO INCLUDES TWO CAPTIVE PROFESSIONAL CORPORATIONS, INCLUDING ROME MEDICAL GROUP, P.C., A MULTI-PHYSICIAN PRIMARY CARE PRACTICE, AND ROME MEDICAL PRACTICE, P.C., A MULTI-PHYSICIAN, SPECIALTY GROUP. THE PCS ARE THE VEHICLES THROUGH WHICH PHYSICIANS ARE EMPLOYED TO SERVE THE COMMUNITY. IN TODAY'S ENVIRONMENT, MANY PHYSICIANS PREFER TO BE EMPLOYED VS. GOING OUT IN PRIVATE PRACTICE.
NY	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DARLENE BURNS
280298	0	39489	0	0	0	0	0	9513	0	329300	0	0	0
WALEED ALBERT MD
236426	0	22247	0	0	0	0	0	14874	0	273547	0	0	0
BASIL ARIGLIO
187484	0	18382	0	42510	0	0	0	14874	0	263250	0	0	0
NICHOLAS MAYHEW
165522	0	15917	0	22613	0	0	0	14803	0	218855	0	0	0
RAYMOND CARNEVALE
145082	0	12578	0	7394	0	0	0	5871	0	170925	0	0	0
BRUCE PETERSON
138081	0	10101	0	0	0	0	0	14712	0	162894	0	0	0

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
ONEIDA COUNTY INDUSTRIAL DEVELOPMENT AGENCY
166158201	6824621LE	2005-06-16	11900000	FINANCE CONSTRUCTION	0	1	0
ONEIDA COUNTY LOCAL DEVELOPMENT CORPORATION
273190422		2010-12-30	6900000	FINANCE MRI CONSTRUCTION	0	1	0

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceeds	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
11900000	509090	2006	0	0	1	1
6900000	222845	2009	0	0	1	1

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Bond Counsel Routinely EngagedBondCounselRoutinelyEngaged	Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
0	0	1	0	1	1
0	0	0	0	1	1

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiled	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Business Name Line2NameOfHedgeProvider/BusinessNameLine2	Term Of HedgeTermOfHedge	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Exception To RebateExceptionToRebate
MANUFACTURERS AND
0	1	1	TRUST	5.000000000000	0	1	0	0	0
(no name)
0	1	0					0	0	0

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
MARY ANN JONES
SISTER OF KEY EMPLOYEE	24023	COMPENSATION	0
SCOTT BURNS
CHILD OF OFFICER	130435	COMPENSATION	0

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable (4 entries)

Non Cash CheckboxNonCashCheckbox	DescriptionDescription	Number Of ContributionsNumberOfContributions	Noncash Contribs Rptd F990NoncashContribsRptdF990	Method Of Determining RevenuesMethodOfDeterminingRevenues
X	MEDICAL EQUIPMENT	5	36174	ACTUAL INVOICE COST
X	INFORMATION SYSTEMS	1	63760	ACTUAL INVOICE COST
X	EMERGENCY ROOM PROJECT		17882	ACTUAL INVOICE COST
X	MRI PROJECT		15908	ACTUAL INVOICE COST

Field	Value	IRS element (for citing)
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts	1	ReviewProcessUnusualNCGifts
Third Parties Used	0	ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
CHANGES IN PROGRAM SERVICES	FORM 990, PART III, LINE 3	ROME MEMORIAL HOSPITAL CLOSED THE ACUTE PHYSICAL REHABILITATION DEPARTMENT IN DECEMBER 2010 DUE TO FINANCIAL REASONS.
FORM 990, PART VI, SECTION A, LINE 6		GREATER ROME AFFILIATES IS THE SOLE MEMBER OF ROME MEMORIAL HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A		PER THE HOSPITAL BY-LAWS "THE SOLE CORPORATE MEMBER OF THE CORPORATION SHALL BE GREATER ROME AFFILIATES, INC. WHICH SHALL ACT HEREUNDER AS SUCH MEMBER BY DULY AUTHORIZED RESOLUTION OF ITS BOARD OF DIRECTORS AND WHICH SHALL COMMUNICATE ITS ACTIONS TO THIS BOARD THROUGH ITS PRESIDENT OR OTHER DULY AUTHORIZED OFFICER." GREATER ROME AFFILIATES APPOINTS THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11		THE COMPLETED 2010 990 WAS PRESENTED TO THE BOARD BY THE CFO OF THE HOSPITAL AT ITS SEPTEMBER 2011 BOARD MEETING.
	FORM 990, PART VI, SECTION B, LINE 12C	CONSISTENT WITH ROME HOSPITAL'S GIFTS, GRATUITIES AND CONFLICT OF INTEREST POLICY, THE COMPLIANCE MANAGER OF RMH HAS A CONFLICT OF INTEREST DISCLOSURE FORM COMPLETED ON AN ANNUAL BASIS BY ALL OFFICERS, DIRECTORS AND MANAGEMENT PERSONNEL. THE CEO COLLECTS AND REVIEWS THE BOARD OF TRUSTEES INTEREST DISCLOSURE FORMS ON AN ANNUAL BASIS. THE INFORMATION GATHERED ON THE DISCLOSURE IS REVIEWED AND ANY CONFLICTS ARE COMMUNICATED TO PRESIDENT/CEO AND BOARD OF TRUSTEES TO ENSURE ALL HOSPITAL TRANSACTIONS ARE COMPLETED FREE FROM OUTSIDE INFLUENCE. POTENTIAL CONFLICTS THAT MAY ARISE THROUGHOUT THE YEAR ARE BROUGHT TO THE ATTENTION OF THE COMPLIANCE OFFICER AND PRESIDENT/CEO FOR REVIEW.
	FORM 990, PART VI, SECTION B, LINE 15	USE OF IROQUOIS DATA, ASSOCIATION FOR HEALTHCARE PHILANTHROPY SALARY DATA, AND THE ROME HOSPITAL HUMAN RESOURCE DEPARTMENT ARE UTILIZED TO DETERMINE COMPENSATION FOR THE ORGANIZATION'S EMPLOYEES.
	FORM 990, PART VI, SECTION C, LINE 18	FORMS ARE AVAILABLE UPON REQUEST.
	FORM 990, PART VI, SECTION C, LINE 19	FORMS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST OR THROUGH WWW.GUIDESTAR.ORG- A WEBSITE THAT PROVIDES NON-PROFIT INFORMATION TO THE PUBLIC. RMH MAKES ITS GOVERNING DOCUMENTS (BY - LAWS) AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC THROUGH RMH WEBSITE - WWW.ROMEHOSPITAL.ORG. ALSO, FINANCIAL FACTS AND FIGURES AND ECONOMIC IMPACT REPORTS CAN BE FOUND ON THIS WEBSITE.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	NET UNREALIZED GAINS ON INVESTMENTS: 231,197. TOTAL CHANGE IN INTEREST IN FOUNDATION 32,272. CHANGE IN UNRESTRICTED INT IN FOUND 33,358. TOTAL TO FORM 990, PART XI, LINE 5: 296,827.
	FORM 990, PART XI, LINE 2C	THE FINANCE/AUDIT COMMITTEE CONSISTES OF LESS THAN 3 AND NOT MORE THAN 7 MEMBERS. THIS COMMITTEE IS RESPONSIBLE FOR GENERAL OVERSIGHT OF THE FINANCIAL AFFAIRS OF THE HOSPITAL. THE COMMITTEE REVIEWS, ADVISES, AND REPORTS TO THE BOARD OF TRUSTEES ON THE INVESTMENT AND MANAGEMENT OF THE FINANCIAL RESOURCES OF THE CORPORATION AND SHALL REVIEW THE ANNUAL BUDGET AND CAPITAL PLANS, FUND MANAGEMENT PROCEDURES, AND INTERNAL CONTROLS RELATING TO THE SAFEGUARD OF FINANCIAL ASSETS. THE COMMITTEE ACTS AS FINANCIAL ADVISOR, REVIEWS PROPOSED SCOPE OF ANNUAL AUDITS PERFORMED BY INDEPENDENT AUDITORS, REVIEWS INDEPENDENT AUDITORS MANAGEMENT LETTERS, REVIEWS THE ADEQUACY OF ACCOUNTING POLICIES AND INTERNAL CONTROL STRUCTURES, RECOMMMENDS THE APPOINTMENT OF INDEPENDENT AUDITORS TO THE BOARD OF TRUSTEES, AND REVIEWS PERIODICALLY THE CONFLICTS OF INTEREST POLICIES, AS WELL AS OVERSEES COMPLIANCE THEREWITH.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Controlled OrgControlledOrg	Business Name Line1DirectControllingEntityName/BusinessNameLine1
GREATER ROME AFFILIATES
1500 N JAMES STREET	ROME	NY	13440	161508597	PARENT CORPORATION	NY	501C3	LINE 11A, I	0
ROME MEMORIAL PROPERTIES
1500 N JAMES STREET	ROME	NY	13440	161492003	SUPPORT HOSPITAL ACTIVITIES	NY	501C3	3	0	GRA

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Percentage OwnershipPercentageOwnership
RMH SERVICES INC
1500 N JAMES STREET	ROME	NY	13440	161490045	FOR PROFIT	NY	GREATER ROME AFFILIATES	C	1.00000
ROME MEDICAL GROUP
1801 BLACK RIVER BLVD	ROME	NY	13440	161464822	CAPTIVE P.C.	NY	ROME MEMORIAL HOSPITAL	C
ROME MEDICAL PRACTICE
1500 N JAMES STREET	ROME	NY	13440	203827393	CAPTIVE P.C.	NY	ROME MEMORIAL HOSPITAL	C

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	1	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg