rom 990 een the Tasy ifort EXTENDED TO NOVEMBER 16, 2015 Return of Orgai > donot ation Exempt From income Tax Una secon 601s, 827, € 404(0K 1) ofthe Internal Ratenue Code (except private foundation] cat umber on hsm sy Bee | 2014 nepal ‘A For the 2016 ealondor yar, or tx year beginning ‘nd ending guy, [Name ofoanzaton Employer identication number see | one Ros GEN) SPITAL 2pnes. | “pong business as 16-0743134 TEU [Number and stroet (or P.0. box t mail snot delivered to stest adress) Roonvéute | Telephone number Crp | 1425 PORTLAND AVENUE. $85-922-40 ES ‘City or town, state or provinoe, country, and ZIP or foreign postal code: Q. Gross recente $ 878,251,742. Coze| H(a) I this group return (COjgee> Tr Name ane addass of pineal offcer ERIC J. BIEBER, MD for subordinates? Ives EX]No a HESTER H(b) seat steers vcvewrl ves L_]No 7 [Assocation [Tomer ‘Summary: ‘roty describe the organization's mission or most slgnifcant actvtls: SEE SCHEDULE O ‘Ghock ine box D> L_]ifthe organization dleoontinued Ne operations or deposed of more than 2596 of ks nat assis, ‘Number of voting members of the governing body Part Vine 1a), "Number of independent voting members ofthe governing body (Part VI ne 18) Total numberof incviduals employed in ealondar yoar 2014 Part V ne 2a); ‘otal numberof volunteers (estimate necessary) a Total unrelated business revenus from Pat Vil, column (0), ne 12 bb Net unoiated tusinese taxable income from Form 990, Ne 34 cs 2 25 [al 24 5 7549 ¢ 598 na ‘624,410. 7 Oe 8 9 Program service revenue (Par Vil ne 29) 0 11. hee revenue (Part Vil column (lines 6,66, 8, 9, 10, anc 11) “otal revenvo add ine 8 through 11 (rust equal Part Vil eotumn (9), 12) ‘Contributions end grants Pat Vil ne 1h) Investment income (Part Vil, column (nes 3, 4, and 7) [Prior Year __| Current Voor. 4,646,595.) 4,875,918. 798,841,,041.| 845,099,777 12,096,678.| 13,722,046. 439.| 12,753, B47. $30,523, 753.| 676,451,588. (i Expenses 2 18. Grants and sir amounts paid (Part IX, column (A, nes 18) a “ 16. Salaio, other compensator {6a Professional fundraising feos (Part 1X, column (ine 110. ‘Benefits ald o or for members (Par X, column (A), ine 4) smployee bones (Part X, column (nes 5-10), 'b Total fundralsing expenses (Part, column (), ne 25) 1047870,| 140,000, 0. fof 440,617, 976.| 459,091,157. 0. oe Cher expenses (Part X, column (4), nee HaTId, 111240). Total expenses. Add tnos 13-17 (must oqual Part, column (A), ne 26). 349,050, 760.| 384 546. 40, 384 40,750,147.| 36,066,685. 7 ® 19 Revenue less expenses. Subiract ne 18 from ine 12, 0 Tota assots Part Xn 16) Total abiltios (Part X, tne 26). [SeanningetCurentYesr | __endot Veer _—__ 795 ,666,612.| 633,553,487. 85 .| 434,721,696. (422.158.985,1 373,507,627, 398, 831,791. of son ot babs Subnet nl IT [Signature Bl ‘Unicepenaies of perry, dele that ave amine is eur nding aosompanyng schedules and soments, edt he bast of iy knowiedpe and bel tis ru ager tp tn bat onal oman of ih pee a og. Siow |) Saamararaner “Tal THOMAS R._CRILLY, CFO ‘ype or pit nae a le Prnvype preparers name Preparers sgnatre oa [oe CI] Pe ELA M. FRANCO ELA M. FRANCO foams BOOS89741. fFim'sane_jp FUST CHARLES CHAMBERS LLP FAisEN, 16-1226221 Fim'ss6oessy 5784 WIDEWATERS PARKWAY SYRACUSE, NY 13214 Phone r0.315~446-3600 nw shown above? seo lastuct 4920p 1107-14 LHA For Paperwork Reduction Act Notice, see the separate Instructions. Form 990 (2014)For 990 (201 HE_ROCHESTER RAL HOS [ Statement of Program Service Accomplishments ‘Check if SohoduleO contains a response or note to any Ing inthis Part I a 1 Bioty describe the organization's mission: BE SCHEDULE O 2 Did the organization undertake any significant program sorvcos during the year which were not listed on the prior Form 980 oF 980EZ? isu E : "Yes," describe these new services on Schedule 0. ‘3 Did the organization cease conducting, oF maka significant changos in how t conducts, eny program sorVl008?,..isne C]¥ee CINo tos," describe these changes on Schedule 0. ‘4 Describe the organization's program service accomplishments for each of its thee largest program services, as measured by expens ‘Seton 501(c)3) and 501(c)4) organizations are required to report the amount of grants and allocations to others, the total expenses, and «avenue; any, for euch program service reported. Ces Cx]no 40 (Come Vexponeet. 674,811,389. rarsnaomeats 140,000.) tommos 852,967,548. } SEE SCHEDULE © ome Vieomes ‘ravang ner 7 wa Y “Ao (cose) (eee Treg pane 7 Gea _ “4e_Other program services (Dsecibe in Schedule 0) frome eludng gat 2 toners 1 49_Total program service expenses D> 674,811,389. Form 980 G18) SR SEE SCHEDULE 0 FOR CONTINUATION(S) 2 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_211 Is the organization doseibed in section 501(¢@) or 4947{a) (ther than a private foundation)? 1s, complete Schedule A... . 2 isthe organization equted to conpiea Scheie B, Schad of Contributor? {8 Didthe organization engege in ect or indrec pital campaign actives on behalf fo in opposition to candidate for public oti? I "Yes," complete Schedule C, Part, 44 Section 601(0¥a) organizations. Oi the organization engage in obbying actives, or have secon 5010) election nafock during the tax year? if "Yes," complete Schedule O, Part ...sms {5 the organization a ction SOK, 501198), o 0118) egerizaton tal ecole membership des assessmants ‘iar amounta as defined in Revenue Procedure 98197 I "Ye," complete Schedule C, Part il {6 Did he organization mahtain any doer advised funds or any simarfunds or acoounts for which donors have the ight to provide advice on te datrbution or investment of arounts in euch funds or accounts? I "Yes," compiote Schedie D, Part / 77d the organization receive or hold a consorvation easemont, including easements to preserve open space, the environment, histori land areas, or historic structures? i "Vos," complete SohaduleD, Prt {8 Did tho organization maintain collections of works of et, historical treasures, or other amar aaeots? I "Ves," compote ‘Schedule D, Part i. : {9 Did tho organization repert en amount in Par X, ne 21, for escrow or custdtlaozount ably; serv a a custodian for ‘amounts not sted in Part X; or provide credit counseling, debt management, credit repar, or debt negotiation services? "Yes," complete Schedule D, Part IV. sen se 10 Cid the organization, drcty or through a elated organization hold assets in temporary restciod endowments, permanent ‘endowments, or quasiendowments? If*¥e5," complete Schedule D, PAM V nu 11 ifthe organization's anewor to ny ofthe folowing quetions i *Ye," then complateSchodlaD, Parts VV, il, or as appleable. ‘Did the organization report an amount for land, bulings, and equipment in Prt X, ne 107 if "Yes," complete Schedule D, Pat vi en 1b Did the organization report an amount or investments - other secures in Part ino 12 that is 6% or mors of total assets reported in Part X,lIne 182 if "Yes," complate Schedule D, Part VI, «© Di the organization reprt an amount for Investments - program relatod in Pat, ie 1 that 9% or moro ot otal assets reported in Part X lne 187 I "Yes," complete Schedule D, Part VI os 4 ithe organization report an amount fo other asso in Part X, ne 16 that a6 oF more oft total assets reporiod in art X,bno 167 I "Ys," compete Schedule D, Part i ten ie «i th organization port an amount for ator abit in Part no 257 Yo," compote SchedulD, Pat X {Did the organization's separate or consolidated financial statements forthe tax year include a footnote that addresses ‘the organization's abit for uncertain tax postions under IN 48 (ASC 740V? I "Ys," complete Schedule D, PRX en ‘2a Did tho organization obtain soparate, Independent aulted hancil statements for the tax year? If "Yee," comploto ‘Schedule O, Parts and XI... 'b Was the orgenizaton included in consoled, independent auld nancial statements for he tax year? 1*¥es," and the organization answored "No" to line 12a, then completing Schedule D, Parts XI and Xi is eptona 149 Iethe organteation a school descrbed in section 170R 1)? if Yes," complete Schedule E ‘eid the organization maintain an office, employees, or agents ouside ofthe United States? ,, 'b Did the organization have aggregate revenues or expenses of mere than $10,000 fom grantmaking, fundraang, businos or aggrogate foreign investments valued at $100,000 oc more? 1 "Yes," completa Schedule F, Parts and IV : 16 Did the organization report an Part x, column (A, ne 3, mar than $8,000 of grants orator assistance fo oto any foreign organization? if "Yes," complete Schedule F Pats Iland IV 418 Did the organization report on Part, column A, ine 8, more than $6, for foreign incivicual? if Yes," complete SchaduleF, Prt il and I, {17 Did the organization repota total of more than $15,000 of expenses for professional fundraising sorices on Part, ‘column (A, ines 6 and 116? if "es," complete Schedule G, PA rm 18 ki tho organization report more than $15,000 total of fundraising event gross income and contibutlons on Pat Vil, ines ‘te and 8a? if “Yes, complete Schedule @, Pat, 19 Did the organization repat more than $15,000 of ae ‘complete Schedule, PA I a... Be 4 roan pate nee ore tie i Yes completo Schedule atx 5. x | x z x 8 x 2 x 3 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI sia sb x ssa] X tte | X a x [12s smo} X 13 x fue |x. 40 x 6. x 16 x ee 8 x x x x Form 890 2014) 200972121 Did the organization report moro than 85,000 of grants or other ‘domestic government on Part 1X column (A), ne 17 "Yes," complete Schedule, Parts fend... 122 Did the organization report more than $5,000 of grants o other assistance to or for domestic individuals on Part IX column (A) ine 2 fos," complete Schedule J, Parts and i. £23 Old the opanization answer "Yes" to Part Vil, Section A ne 3, 4, oF about compensation of the organization's current and former offeare,dveotors, rutees, key employees, and highast compensated employees? i “Yes,” completo Schedule J ‘24a_Did the organization havea tacoxempt Bond issue wih an outstanding principal amount of mor than $100,000 es ofthe last day ofthe year, that wa isaue after December 1, 20027 If "Yes,"answer ines 24b through 24d and completo ‘Schedule Kf No", go tone 250, . 'b Did the organization Invest any proceeds of taxexempt bonds beyond a tamporry potiod exception? {Did ie organization maintain an escrow account othe than a refunding escrow at any time during the yea Yo dofeas any taxoxomot bonds? <4. Did the organization act as an “on behalf of issuer fr bonds oustanding at any te dung th year? 252 Section 601(cK}, 5O1(eN4), and 801(c)(29) organizations. Did the organization engage n an excess bent ‘transaction with a dloqualfed parson during the year? If "Yes," complete Schedule L, PAT... Is the organization aware that engaged In an oxcoes bone transaction witha daqualfed person ina prior year, and ‘that the transaction has not been reported on any ofthe organizations prior Forms 990 or 980E2? i "Yee," compto Schedule L, Part snsisneitinms : su £28 id te organization report any amour on ar Ine 86, 22 for eccabl from or payable Yo ay cunt or former offer, director, trustee, key emloyeus, highest compensated employees, or disquatfiod persons? IT"Yes," complete Sohedie Ly PRIM ae 127 Did te organization provid a grantor ther asitanon to an afer, decir, rusteo, Key amployee, eubetanil Contibutor or employ9o thoraot, @ rant selection committse member, or to a 35% contralled entity or family member of any of these persons? IF "Yes," complete Schedule L, Pat Il ee eee 28 Was the organization a party tos business transaction wlth one ofthe folowing paris (ee Schedule L, Part IV Inatrctons for applicable fing thresholds, conltons, and exception) ‘2 Acurent or former ofier, decor, trustee, okey employes? if Yes," complote Schedule L, Part V ‘A family ember ofa current or former officer, crectr, trust, or kxy employee? "Yes," complete Sched, Part V ‘© Anentty of which a curont or former officer, crctor, trustee, or kay employoe (ora family member thereo?) was an officer, dlrctor,trusteo, or director inact owner? if *Ys," complete Schedule L, Par M..... _ 229 id the organization receive more than $25,000 in non-cash conto? "Yes, complete Schedule {80 Did the organization receive contibuons of at, staical treasure, or ather similar essea, or qualified conservation ‘contibutions? I "Yes," complete Schedule M ‘91 Did the organization quidate terminate, or aisolve and cease oparations? 1 "Yes," complto Schedule N, Part] {82 Did to organization sel, exchange, dispose of, or transfer more than 25% of ts net assets? "es," completo ‘Schedule N, Pati ws 39 Die he organization ain 109 ofan ently dargarded as sopaat om the eganzatian under Regulations ‘sectors 301.7701-2 and 301.7701-3? If "Yes," complete Schedule Pi, Part ‘94 Was the organization relate to ay taxexempt or taxable ent? I "Yes," compa Schedule , Par I il r 1, and Part Vine 4 ‘368 ic the organization have a convalled entity within the moaning of section S126NT3)? It Yee" tone 36a dl the organization rece any payment rom or engago nan transscion with a conwaled ently within the mesning of section 612(2)(12)? If "Yes," complote Schedul Part V, ne 2... ‘86 Section 601()) organizations. Dd the organization make any transfers to an exompt non chaitabie 1 "Yes," complete Schedule Pat V ne 2 z {27 ic te organization conduct mere than 8% of te acise through an ently tht fs not areal evgaization ‘and thts treated a8 a partnership for federal income tax purposes? if Yes," complete Schedule Part VI = ‘38 Did the organization completo Schodule O and provide explanations in Schedule O forPart Vi, nes 11b and 197 Notte: Fi 800 ters are reguired to complete Schweiule 0. x |» x Les | x 24a X fas [| x asa] | X 2so| | x x 2. x a x 4 . [2 | ss | x. 4 |X ssa | X x x Ea x 98. Fox 890 (2014) 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_217 R ri R ‘Statements Regarding Other IRS Filings and Tax Compl Checki Schedule © contains a espense or note to sn nein this Part V ‘ta Enter tho numborroportd in Box of Form 1098. Ener-0-itnot applicable, 'bEntor the numberof Forms W2G included in ne ta. Entor©-itnot applicable. tb ‘ic the organization comply wih backup withholding rue for reportable payment to vendors and reportable arring (Gambing) winnings to prize winnOr8? ee 2 Enter the numberof ployee reported an Form WS, Transmit of Wage and Tax Statements, {lad fr the calendar year ending with or within the yaar covered by this return 2a 'b Iatloast one is reported on kine 2a, did the oxgarization fea requed federal employment tax retuns? [Noto I the sum of tines 1a and 2a greater han 250, you may be required to ef (600 Instructions) ‘38 Did the organization have unrelated businss gross income of $1,000 or more during tho YOR? If *Yes," hast fled a Form 980°T for this yoar? If °No,* to he:9, provde an explanation in Schedule O 4a Atany tine dung the calendar yer, id the organization have an interest in ora signature o thor authority over, a ‘inanolal account ina foelgn country euch as a bank account, secures account, or other financtl account? IF °Ye8," enter the name ofthe orsign country: > ‘S00 instructions fr fing requirements for FinGEN Form 114, Repor of Foreign Bank and Financial Accounts (BAR). ‘5a Was the organization a party toa prohibited tax shelter transaction at anytime during the tax year? 'b Did any taxabe paty not the organization that twas ors apart to a prohibited tax st 6 11°68," to ne Sa or 8b, cid the organization fle Form 8886-77 ‘Does the organization have annual gross receipts that ae normaly greater than $100,000, and dé the organization sot ‘any contributions that were not tax deductible es chartable contbutions? ' bt °¥es, dhe organzation nude wih evry sotation an express statment thal such conrbutons or git wore not tax deduotble? 7 i 7 Organizations that may receive deductle contrbutlone under section 170(0 ‘Dd the organization receive a payment in excess of $75 made party a a contution and party for goods an services provided to the payor? Ife cid the organization not the doner ofthe value ofthe good or services provided?” : oor © Di the organzation st, exchange, o thane pose of tangible personal property for which it was rogues 1 fle Form 82827 n - 4 If °¥es,Iaeato tho numberof Forms 8262 fled during the Year ‘Ui the cxganizationraceve any funds, ccectly or naractly, o pay premiums on a personal benef contract? {Did the organization, during th year, pay premiums, crectl or incrcty, on a personal benefit contract? ° h the oxganizaton received a contibution of qualifed inteetual property, dd the organization fle For 8880 as required? the organization received a contibution of car, boat {8 Sponsoring organizations maintaining donor advised fund. Dida donor advised fund maintained by the ‘poneeving ocanization have exceas business holdings at anytime during the your? Sponsoring organizations maintaining donor acvised fund {Did tho sponsoring organlatlon make any taxable dstfbutions under section 49887 se id the sponsoring organization make a detabution te a donor, donor advisor, or eated person? 10 Section 501(c\7) organizations, Enter: relanes, or other vehicles, ci the organization fo a Form 1088-7 ao [x fa x [Tx ee leo} |x . Lo x Te ze| |x z| |x jm} | x | 2a Es 8 os & 2. Initio fos and capital contributions included on Part Vil ine 12. vo [00 'b Gross recepts, included on Form 880, Part Vl tne 12, for public use of club facto 305 ‘14 Section 601(0\12) organizations. Enter {2 Gross income from members or sharcholdors st susie [M8 b Gross income ftom other sources (Do net net amounts ce oF paid Yo other sources against 41 ‘mounts duo oF received from thar) 428 Seotion 4967(a\1) non-exempt charitable trusts ls the organization fing Form 990 in fou of Form 10817 'b "Yes," enor tho amount of axexempt intros reoived er accrued ding he 88 mre: L120 18 Section 601(0),28) qualified nonprofit health Ingurance Issuers. ‘2 stho organization lcansed to Issue qualified heath plans in more than one state? ne Note, See the inetiutions fractional ivormation the organization must report on Scheduio bb Enter the amount of rso-vas tho rgarization is required to maintain bythe states in which the 138 ‘iganization i icansed to issue qualified healt plans. 180. © Entorthe amount of ra8erv@8 of BAM oss yunsanmerrernoosuonnn “a_i the organization receive any payments fr indoor tanning services during th tax your? x — bien, hant toda Fo 720 to opr theta payments? No eid on expnatn Schade O 5 4b Form 990 (214) 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21aperment, and DISCIDSUTe Fe eah "esaspnte oles Urea Toba, odor No nponse {ono a, 8b, or 10 bal, desobe the creumstances, processes, or changes in Schedule O, See Instuctions. 0 contains a response or note to ay thn tle Part Ol Section A. Governing Body and Management Yes We 1a. Enter he numberof voting members ofthe governing body atthe end of the tax yoar 2! there are materia ferences in voting rights among monbers of th governing boy, ofthe governing body delagntod broad authay ton enoutve commits or sinar commie, explain x Schedule 0. i 1b Entorthe number of voting members included inne ts, above, who are independent 2 Did any effioer, director, tuste, or kay employoe have ately relationship ora business relationship with anyother ‘oticer, dactor, trustee, or key employee? : {304d th organization dlegeto contol ovr management doe customary performed by or under the dct supenson of oicere, dectors, or rustoos, oF kay employees to a management company or other person? : 4 Did the organization make any significant changes tit governing documents sine the prior Form 660 was fled? {5 Did the organization become avare during the year ofa signfcantcvorson of tho organization's assets? {6 Did the organization have mombers or stockholders? ee ‘Ta Did te organization have members, stocktoldere, or other persons who had the power to elect or appoint one or more mambore ofthe goverIng BOS)? nny ae 'b Are any governance decisions of the organization resorved to (or eubjot to spprovel by) member, tockoldors, or prsons other than the governing body? 8 Did the organization contemporaneous docuant ‘8 The governing bod? ..... b Each comiitte wth auhortyto ect on behalf of tho governing body? © Is there any ofcer, crete, ruste,orkey employes lated in Par Vl Section A, who cannot bo reached at the *Yes,* provide tho i edt 2 x 9 hel or wre cans undrakon daring ta yr bythe flowing: : Section B. Policies 7s Sacton 8 requests infomation shout polis ot requd bythe Intel Revenue Code (oa ‘0a Did the organization have local chapters, branchos, oF afte? oa] x > II"¥an" di the organization have ton pokes and procedures govering he att of euch chairs, eases, snd branches to eraur ther operations are conalstant wth the ergantzation's exempt purposes? 100 “1a the organization provided a combate copy of this Fam 980 toll members ofits governing body before ting the tem? ata |X > Doscibe ia Sched Oth proces, any, used bythe organization to reviw this Form S60. ‘2a Did tho organization havea wrt confit of interest pacy? "No, go tin 19 sal X ‘Wore fica, dtr, ruses, and ty employees requte to dose annual eres al [sap x © id the orgeization rusty and consetenty manor and anforce eompllance with the ploy? If Yes," describe fn Schecue Ohow tis was dono [eel x 43. Old the organization nave a writen whitsbiowerpoioy? ae 13 |X 14 Did the organization have a wrton document retention and destruction poy? ooo ee 416 Did te prooees for determining compensation ofthe efowing persons Include a ovow and approvalby independent pareone, comparabity dat, and contamporaneous substantiation ofthe dolboration and decison? I ‘2 The oganization’s GEO, Executive Dracter or top managamont offical room [sal x | 1 Other otfours ore amployees fhe orrlzAON inns x {We tone 16a o 15, descr the process in Schedule O (00 etustions). 16a. ic the organization investi, contribute assots to o patcpat in a joint venture or similar arrangement with & taxable entity during the year? bb It*¥es" ald the organization ft on licy or procedure requing the organization to evaluat partipaion [ Injointvonture arangomonts under spplcable federal tax law, and take steps to safeguard the organization’ 9 with respect to such arrangements? 160] X Seotion C. Disclosure. — “17 List te statas with which a oopy ofthis Form 690 la required to be fied PNY. 48 Section 6104 requires an organization to make its Forms 1023 (or 1024 if applicable), 990, and 880 Section 601(e}a}e nf) avaliable {or publ inspection. Indicate how you made these avaiable. Check al that app. [Jown website —[—]Anotherswebeits [XJ Upon request [1] Other (expan in Schedule O) 49 Describe in Schedule © whether (and 8, how the organization made ts governing documents, confc of interest policy, and nancial statemantsavallabl to the puble during tho tax yoar 20 Stato th name, address, and tlaphone numberof the person who possesses he organization's books and records: HUGH CHISHOLM - 585 221 100 &: cIGHWAY Form 990 (2074) 6 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21, Trustees, Key THER ‘Compensation of Officers, Directors, Employees, and Independent Contractors Check Schedule O conta a reepengo or nto to ny le In ths Pat VE oo Seaton A_Otcere, Directors, Trustees K ond Highest Compensa ‘a Complete this taba for al persone roquled to belted, Report compensation forth calendar yaar ending wih or within the orgerieation’s tax year, © List al ofthe organization's eurent ffs, rectors, trustees (wthor individuals or organizations), regardless of amount of compensation. Enter in cours (Band (9 fe compensation was paid. 2 a ofthe organization's current Key employeos, any. Soe instructions for defintion of “kay employes." List the organization's fe errent highest compensated employes (other than an officer, decor, ustee, or key employee) who reosived report. ompensation (Box 8 of Form V2 and/or Box 7 of Form 1096 MISC) of more than $100,000 ftom to organization and any rated organizations. © Uist al ofthe organization's former afticor, key omployeas, and highest compensated employees who received more than $100,000 of reportable companion from the organization and any elated organization. * Ut al of tho organizations former directors or trustees that recelved, n the capacky asa former crector or trustee ofthe organization, ‘more than $10,000 of reportable compensation from th organization and any related organization. LUst pereons inthe folowing order individual trustees or directors; Institutional mustes; officer; key employees; highest compensated employees; lier er Tloneck this box t nether the ofgantvation nor any rlated organization compensated ary curent offer, director, or trustee. “a © (cy (0) e Name and Tila roe | onaketecimme| Foote Reporaie | Estat ome |ewmttrctnaee| Demmnt, | aamonnn | St amp |Grseasins| meni | creme | a (ist any i ‘the: organizations compensation ee |i cece | eroeseue | aver woes | aE wearroaMiso) cranization jorganizations| a i Che mae ee oo [ELE EWNa (1) LIMDA BECKER 1.00 ‘BERECTOR. 1.00/x) 0. 0. 0. (2) BRIC BIEBER, M.D. 18.00 ‘CRO 37.00|X| xX 56,773.| 44,607.| 189,013. (3) ROBERT DOBIES 1.00 ‘SHATRNAN OF HE BOARD 1.00|x 0. 0 0. (4) MICHABL NUCCITELLI 1.00 ‘VICE cHATmIAN. 1.00% 0. 0.4 ae (5) PAHEEM MASOOD. 1.00 TREASURER. 1.00|x 0, 0.) oO. (6) DANTEL MEYERS 1.00. ‘DIRECTOR 1.00/x 0.| 0.) Ow oe ip ‘DIRBCTOR 1.00/xX 0. 0.) oO. (8) JOHN RIEDMAN 1.00 DIRECTOR _ 7 1.00/x. 0. 0. O. (9) RACHABL ADONTS: 1.00 ‘BIBECTOR 1.00|x: 0. oO Ow (10) ROBERT S SANDS 1.00 ‘SECRETARY. 1.00|x 0.| 0. 0. (11) RALPH DESTEPHANO 1.00 ‘PIRECTOR _ 1.00|x 0. 0.) Oo. (12) ROBERT HAVRILLA 1.00 ‘PIRECTOR 1.00|x 0.| 0.) oO (13) JAGAT MEHTA, M.D. 1.00 ‘PIRECTOR. 1.00 0. 0; 0. (14) BLIZABETH PATTON, PH.D. 1.00 ‘REIRECTOR, 1.00 0. 0.| oO. (15) THOMAS RILEY 1.00 ERECTOR. 1.00)x aaaeeeees 0. O. (16) WANCY FERRIS, PH.D, 1.00 DARBOTOR, 1.00 0. 0. oO. (17) JOHN GENTER, M.D, 1.00 DESKCTOR 1.001% i 0. Oe 432007 19-07-14 Form 990 (2014) 7 14411104 781828 20097.3010 -2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21joes, Key Employees, and Highest Compensated Employees (coined) 0 ©) iC) O) © a ‘Name and tile (Aver¢ | cemactecimcrtenem | Reportable eportablo | Estimated hours per ecentec’s| componsatn | compensation | amovot of vwook ‘rom ‘tom relatod other (atary Ty the ‘xganizations | compensation trours tor | B 5 organization | (W2r090MI50) | — fromthe rooted [31a] | [| | wanosomso) cnganizaton Jesanzaton| i A and ated below ; organizations wo [ELELSLS ULE (8) ARCH KOTHART, HD. 1.00 pxagcron 1.00|x o. 0. Oe (19) anak Lac 1.00 EARGION 1.001, 0. 0. 0. (20) LEONARD OLIVIER 1.00 DxawonOR. 1.00/x| o. 0. Oe (21) BERATN RIVERA 1.00 banncron. 1.00|x 0. o 0 (22) ueoN #, exo 2.00 pIRsoroR 1.001x 0. on 0. (23) gusEEN Sure 2.00 Dxnwcron 1:00|x 0 0 On (26) FAREN H, GNLLINA 1.00 DIRECTOR. 1.001x o. 0. O. (25) JBEYREY C, MAPSTONE DIRECTOR 1.00]x . 0. Os (26) DEREK TERHDOPEN, ND. 1.00 MsbEcht gxnre_PRISIDENT- 9.00)x Oe 0. Oe a a vn 56,773.| 44, 607.| 169,013. © Total from continuation sheets to Part Vil, Soction A “op [79,630,359.| 2,612,043.] 8815540. Tote feddlines 4) and 1) sss wt» ["97687,132.1 2,656,650.] 9004553. "2 Total number of individuals Gnctading but not Ite to those feted above) who received mor than $100,000 of reportable compensation from the organization D> 2 You No {Did the organization litany former offer, ractor or trustee, key employee, ohighest compensated employee on ne 127 "es," compote Schedule J for such indica ‘ : a| |x 4 Forany inva iat on ne t,he um of repoaba compensation ana ater componcaton rom the organization | ‘and elated organizations groator than $150,000? If "Yes," complete Sched J for suc IndMAAA, Lote {5 Did any person lated on tne 1a rote or acerue compensation frm any unrelated organization or individ ox services ——1ntdore to the eigantzaton? "es," compote Schedule fer suc person s Section , Independent Contractors “1 Complete this table for your ve highest compensated Independent contractor thet received more than 6100,000 of compensation fom tho organization, Répert eomipsnation forthe calinder yea nding with or within the bfgentztion’s tax year a © @ Namo and buses adress Desert oseniees Compensation ROCHESTER RADIOLOGY ASSOCIATES, 1255 PORTLAND AVE, 2ND FLOOR, ROCHESTER, NY HYSICIAN SERVICES | 14,710,901. UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AVENUE, BOX 706 pHYSICrAN ggrvices | 4,554,880. DGA BUILDERS, LLC, 1170 PITTSFORD VICTOR PITTSFORD, NY 14534 {coNsTRUCTION 4,374,240. LECHASE CONSTRUCTION SERVICES i 300 TROLLEY BLVD, ROCHESTER, NY 14606 ONSTRUCTION 3,480,986. ROCHESTER CARDIOPULMONARY GROUP PC 30 HAGEN DR, SUITE 100, ROCHESTER, NY 14625PHYSICIAN SERVICES | 1,831,006. ‘2 Total number of indeperdent contractors Vncuding but not limited to those listed above) who reclved more than 000 of a cm SEE PART VII, SECTION A CONTINUATION SHEETS Form 990 e074) 8 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21____-___THE_ROCHESTER GENERAL HOSPITAL __16-0743134 _ [Part VT szciosA os, Decor Tins Kx Ele, sad Maes erred Enns ane “ © © ©) © © Name andthe ‘Average Postion Reportable Reportable | Estimated hrours | (checkalthat appt) | compensation | compensation | amount of er ‘rom ‘rom reatod othr vwook | £ the crpanizations | compensation fstory |B z coxganization | cw2/i09eMisc) | tom the housfor | & A| | owartoastso) corpaization roses 13/8) | IE andreltes loraanizetons| #/ 2) | 815 organizations eiow g imo [EUELEUELELE (27) ware commen 55.00 . oor a1vs0/aay 0.00 x 942,277.| _ 290,995.| 209058 (28) towns R, cary 677 TDF 15.00 | ‘oro. Z x 179,924.| 462,661.| 60,281. { (29) WARREN HER sobo_ununnh 24/30/24) x 0.| 1,069,997.| 6420216. (30) ROBERT NESSELBUSH 00 x 1,103,084,| _407,990.| 86,315. (G1) HUGH Haas Ea x 887,600.| _380,400.|_ 70,528, (32) VINCENT cAI eatarezay x| | 1,263,062.) _ o.| 6,243 (33) PaNarex ROO ‘RAKE x|_| 1,053,719. o.| 4,744. (G4) sEPTREY REODES seaysyeralt x 655, 436.| 0. 943. © (35) PADYOREM PHATAR sic eee eee | x 644,672. o.| 6,333. (36) ROBERE WaXO (SHIM MROTOAL, onPremR x 900,585 os] 64,353. “Total Part Wy, Section Ane 1 9,630,359.| 2,612, 0438815, 540. 9 14411104 781828 20097.3010 _2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21jit of Revenue Check it Schedule O contains a fespanse or note toiling n this Patt WM 1 chal Ocont pene if ei frail zed ‘otatevenve | Felted or "rome ue exempt tuncton | business ie FB] 10 Federated compaigne — fal 3] wambornip ues as — © Fundraising events ” fhe §)] 5 roms orpzatons 1a ann a7 | £5] © coverment rats conto) 45079404), @) ator conebuton, it, gans end ee sina amounts otncuded above. Lat «004 }. i | 9. toca ett nn | ' | Bl te sina i u siness sed 20 mneamuvr nmin __[ exaaio | _e2s.238.s00 026,210, jo ‘> gIWEAL naveus enon suzamep anaz [531320 uiaaa[ a 24.40 - 4 Income from Investment of tax-exempt bond proceeds D> §)] 4 soon. o wasn aeade)as8.34 © | + Aratrprogam see oven 2.806 3 Total, Add lines a2 45 099,11. 7 irtnt heme cg es Fa, cresmtrimomiis ne sna sana ‘© Renta income or oss) d ‘Not rental income or oss) | 7 a Gros amount trom salen ot | (9 Secures |G) ner | bb Loss: cost or othor basis and #808 OHPEMEEE a © Gainor toss) assots other than inventory |” 6,905,405,| 2.733.424.) 6,305 05,| 66.730, i Not gin o os Inctuding $ of contibuttons reported on ine te). See Part, ne 18 bb Lees crect expens Other Revenue © @ Gross income from gaming activites. Soe Pat V0 19 bb Less: direct exper 40 8 Gross sles of inventory, oss rturns and allowaneos b Lose: cost of goods sold, _¢ Not ineome‘o toss) rom sal of inventor 8 Grose income trom fundraising ovents (net «© Notincome or (oss) rom fundraising events > Netcom or Go) om gaming ats. ata 6,938, 615. >| Misoalaneous Revenue, siness Cod 1 © GAPREERIA/CAPE & CATERING [aazaio 1,825,728, 1028,728. bb PARKING 312930 12235, 680, Z| 32151650, | asaa20_ 385.311, 95.302. 4 Allother revenue Tota. Add tines 113110. +2 _ ola yowtue: Se nsucon 12,753, 84 76451 sual 052.967, 548 Logos | a ezzase,[ 2 asz.a02 a4 20 > > 14411104 781828 20097.3010 [az sea.ma. Form 890 (2014) 10 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21‘Do not include amounts reparted on tines 6b, A. 18) ic) P 70.00, oh and 100 OfPu Ve Toa ee emcee | Meare | ee 71 Gani an ter este to deat rao and domestic governments. See Part IV, line 21, 140,000.) 140,000. i 2 Grants and other assistance to domestic i ‘nha See Pat, 022 | s 3. Grants and other assistance to foreign Cr erpezatons, ign goverment, and fb sy a Inds, So Pat, no 18 ard 18 |. ih 4 Benefits paid to or for members: E &Companaton of unent oftows econ tre, and ay erp 7,307,195.|_5,825,376.| 1,481,819. Congestion at nua hve, dia pers deed undead ‘persons described in section 4958(c)(3)(B) 7 Othor salaries and wage 65,045, 042.291,758,532.| 73,286,510. {Penson pn coualsand coitus (eca ‘suction 401(k) and 403(0) employer contributions) | 23,257, 282.| 18,587,220.| 4,670,062. 9 Other employee benefits 7,.694.| 25,093,037.| 6,304,657. 10 32,083,944.| 25,641, 488.] 6,442,456. i i" b Legal 1,317,526.| 1,052,967. 264,559. € Accounting .. 72,800.) 58,182. 14,618 d Lobbying. 40,929. 40,929. €Proleonal nai srns Se Pan 7 { tyocnent manager oe 6 ier ie Higamourtexsds icine column (A) amount, ist ne 119 expenses on Sch 0.) | 7: 17,656. 60,353,711.| 15,163, 945.| 42 Advertising and promotion ccm 2,160,147. 1,726,389. 433,758.) 13. Office expenses, wonum, (LOL, 381,358 f152,951, 981.| 38,429,377. 14 Information technology ....... 13,333,043.| 10,655,768.| 2,677,275. 15 Royalties... 16 Occupancy a 16,972, 288.| 13,564,253.| 3,408,035. 47 Travel 2,206,457.| 1,763,400. 443,057. oe 48. Payrenis otal of ontahrert eponase foran federal stat, oral pub file 40. Confrenes convention, and meetings QO IterORt a. niiseornrnntornrscnei 5,351,199.| 4,276,678.| 1,074,521. 21. Payers toate 22 Depreciation, ‘depletion, and amortization 40,265,714.| 32,180,359.| 8,085,355. 9,196,002.| 7,349, 445.| 1,846,557. resi ee | rout Stopes owns). a BAD DEBT EXPENSE 15,635,477.| 15,635,477. b OTHER EXPENSES 5,668,763.| 4,530,475.| 1,138,288.) c DUES AND SUBSCRIPTIONS 2,034,187.| 1,625,722. 408,465. ‘ «Mina aparocs 26, Toslsionl eget vin vari B40, 384, 703 674,814, 389. .65,573, 316, o. ‘25 int co, Cite se one rac] ‘ata coun (estar a ans sre wen Fam B50 G01 14411104 781828 20097.3010 12 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21at (Check f Schedule O contains a response or note to Any ine in thie PartX i - a) e Beginning of year End of year ee ee 34,942, 859.| 1 | 62,540,554. 2. Savings and temporary cash investments... : WT [46 457, 080. 4 04: 3. Pledges and grants receivable, net 4 Accounts receivabl, net ‘5 Loans and other receivables from current and former offieor, directors, ‘nusto0s, key omployoes, and highest compensated employees. Complete Part hot Sched Ln {6 Loans and other rceWabies rom other asad persons (aa dofned under ‘section 4958(7(1), persons described in section 4956(0X9)), and contbuting I ‘employer and sponsoring organizations of section 601(0K9) voluntary ! ‘employees’ benefcary organizations (09 inet). Complete Par tof Sch L. 7. Notes and loans recelvablo, net , {8 _Invontoves fo slo or use 47,089,499. «| 46,194,110. Assets 6 z 3,612,800.['s | 3,313,371. 10,892,781. 9 | 9,134,905. 8 Prepaid expenses and defored chargoo an 100 Lend, bidngs, nd equipment costo othr Woh bonis. ConpiatoPat VofSoneduleO .... {400} 895,623,342.|" he MPS b Loss: accumudated depreciation aes.inicin. LQ| 318,173, 284.| 267,371, 222:1 100, 7, 45 * | -95,191,335.[ 1 | 95,877,443. 99,364, 462.| 2 | 108,680,854. +1. Inostments- publicly traded secuios 12 vostments- other secure, Gee Pat 1, 11 18 Investments rogram road. Se Pact Vino 11 14 Intangible aesats 16 Other assets, See Part nw 14 46 Tolal assets, Ads ins 1 rough 15 fmt equal ine 3 17 Accounts payable and accrued expenses sieved - 72,726 ,431.| 18 Giants payable : : 19 Dotered verve 20. Taxxompt bond labs 21 Escrow o custodial account abit. Compite Pat v of Schedule 122 Loane and othr payable to curent and former oor, doctors, trustees, ay omployoa,highost compensated employees, and squalid persons, ‘Comiste Part of Schedule. 23 Secured mortgages and notes payabia to uneated third pares. 24 Unsecured notes and loans payable to unelated thd partis 25 Other fables (neticing federal income tax, payables to rlated third partes, and other labile not included on ine 1724), Compete Pant X of Schedule D 28 Total abilities. Aad Organizations tht follow SFAS 117 (ASG S56), check here Lik] end ‘complete lines 27 through 29, and ines 33.and 34, 27 Unrsticted not asets 28 Temporary ostited nol assis 29 Permanently reticted net azote a Organizations that do not follow SFAS 117 (ASC 068), check here be L—1 and complete tines 20 trough 94, {90 Capital tock or ts prncipal,orcuent fund . ‘31 Paldin or capital supe, olan, bung or aqupment fund ‘82 Raid eaminge, endowment, accumulates income, or oho 83 Total net assets orfund balances : 373,507, 627.| 398,831,791. 34 Tota labios and not agsotstund balances 795,666,612 833,553,487 Form 980 2014) 190,824,581. 16 | 185,885,150. so. | 833,553,487. z| 79,893,564. iaT078, 817] 20 | 132,169,481. 7,004, 316. Lsbittes 2,992, 832.| 205,360,905.| 25 | 220,654,335. 422,158,985.| 291 434,721,696. 341,917,524.| 27 | 365,152,763. 23,482, 541.| 25,571,317. 8,107,562. 9| 8,107,711. Net Assets or Fund Balances klgieleis | 12 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21‘Check Schedule © contains a responds or note to ny ine inthis Pant Xt ae 876,451,588, 1) Totalrovenue (rust aqua Part Vi ole (A, 812) ann 1 2 Total expenses (must equal Part IX, column (A), line 25) |. So [2 | 840,384,703. 3. Revenue oss expenses, Subtact ne 2 tome 1, Eee eeneonces [agi mena OSG 7 ABs 4 Not assets or fund balances at Dbaginning of year must oqual Part X. ine 33, ‘column {4 | 373,507,627. 5 Not unrealized gains (losses) on investments, 5 =6,819, 939. 6 Donated services and use of facilities pst 7 trvoximent expences, z 8 Porpaed acjutments 8 8 Other changos in net assets or fund balances (expiinin Sc ~~ [eo [37922782 410 Net asset orfund balances stand of yes. Combine Enes 3 through 9 (must equal Part re 53, 1mm) . a so| 398,831,791. Financial Statements and Reporting “Check if Schedule O contains a ruis0n186 or note to any in ln this Part XA seine syon_ GEL Yes] No 41 Accounting method usedto prepare the Form 900: [—]cash LX] Acoual (J otner toy Ifthe organization changed its method of accounting from a prior year or checked “Other,* explain in Schedule O. 2 2 Were the ocanzatin's rancia sttoments comple or reviewed by an Independent SCECUNIAN? oun wal |x 11°08" check a box blow to indcatowhaher the thancia ttemants fr the year wor comple orviwed on a separate basi, coneolsts basi, or bth Cl separate basic] Consotdated basis] Both consolidated and separate basis 'b Wore the orgenization'sfoancia statements aulted by an independent accountant? | x 11"¥e" heck a box blow to indleate water he fancil tatement fr tho year war audod on ; consolidated basis, or both: i Cl soparate basis [—] Consolidated basis [3K] Both consolidated and separate basis , © If "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibilty for oversight of the 4 ‘evew, or omplaton os franca statements and election of an independent accourtant? zo| X Ifthe organization changed aor ts oversight processor election proces dung tho tax year, expan in Schedule O. ‘2 As ares of federal avard, was the organization equed 1 undergo an ator aus as set oth nthe Sg At ‘et and OMB Goer AAS8 uepcnnnni ae al x by 11°08," oid the organzaton undergo the require aud x sual? fe erganitin id not undergo tho oqued aud dl O and desing akan to un sul x. Form 990 (2014) 13 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21SCHEDULE A co 00 Public Charity Status and Public Support Ferm 00 20-62) Complete the ergantzatien is a seton S019) organo ection 2014 Sata noneromt chaise rt. rere Pentanto Fern 600 or Form 900.2. ‘opento Pune iismaovnse ers” | py information shout Schedule A thar 000 or 690-E2) ond te nsbuctons i at wy sigoVifornaaO. Tame a te orpaneaon Enpojer iteaton wb | 16-0743134 (Al organizations must complete this part) See instructions. “he organization nota private foundation bocause ls: (For ines 1 through 11, heck only one box) 1 [] Achureh, convention of churches, or association of churches described in section 170(BK1)(AN)- 2 [2] Aschoot doscrbadin section #70(K HANI. tech Schade E) 2 [EE] Anospita ora cooperative host service organization described in 4 J) Armoatsi esearch organization operated In conjunction witha hospital described in city, and state 5 (1 Anoiganizatin operated forthe benef ofa calege or univralty owned or operated by a governmental unl descbed in seotlon 170}0X ANIM (Complete Part I) 6 [—) Atederai, state, of local government or governmental unt described in section 170(6K1HANV 7 [1 Ancrgarizaton that normaly recelves a ubetanti arto its suppor trom a governmental uit orm te genera publ deserbed in section 17O(HK AID (Complete Part) 8 J Acommunty trust described in section 47O() 1HAKW). (Completa Pat) © J Anorpenzation that normaly recelvee: (1) more than 29 1% of suppor tom contbutlons, mamborship fees, and gross recaps fom acts related to ts exempt funettons- subject to cartan exception, and) no more than 331% of ts suppor am gross vestment Income and unrelated business taxablo incom (es eection 611 tax fom bushasses acquitedby the organization ate 20,1975, ‘Seo section 500()2).(Complate Pat il) 10 [1 Anocganization organized and cperated excusvel to test for publ satety. See ection E090. 11] ‘Anorpanzatin organized and operated axel fr the Benet of, to paform the function of, oro cary out the purposes of one or ‘more publcly supported organizations deerbed i ection 600(a(t) or section 600(aK2). So section SOR). Check the boxin tings a through 1 that dasarbos the (ype of suoparing organization and complet ines 1,11, and 149. 4 11 Type. A supporting organization operated, supervised, or contrled by ts supported erganzations), typically by ghing ‘he supported orgarization() the power to regulary appoint or elect amo of te dretosor trustees of the supporting ‘organization. You must completo Part IV, Sections A and B, tb [71 type Acupporting organization superled or controled In connection wth supported organizations, by having control or management of he suppertingorgaizaton vested nthe same persons tat control or manage the supported organization(s). You must complete Part IV, Sections A and C. © J Typertsunetionaly integrated. A supporting organization operatd in connection with, and functional integrated with, ite supported organization(s) 08 instructions). You must complete Part W, Sections A, D, and E, 4 [21 Typett non-tunctionaly integrated A supporting organization opertedn connection with ts supported organizations) thats rot unotonaly integrated. The organization ganealy must satis a dtrbutonrequrment and an attentiveness requirement (99 istructions. You must complete Part IV, Seotions A and D, and Part. © [7 check tis boxittho organization received a wrttn determination fom th IFS that ks 2 Type, Typ, Type functionally intersted, o¢ Type Il nonfunctional integrated supporting ogantzation, {Enter tho number of supported organizations wo . : cc s4_Provde te folowing infomation sbout the surat organizations. ction 170K0N HAN tion 70(0) A), tor tho hospital's nam, {Name af upporoa WEN Tn ype of organ WITTE cara] Wout of mansion” | — WATER ganization (Curios 19" | led] soporte cer supp (00 ‘hove or IRC section Iretetons) Instructions) (eeonetuctona), | Yes [No Total |LHA For Paperwork Reduction Act Notice, eee the Instructions for Form 000 oF 990-E2. 42005 omt7-44 ‘Schedule A (Form 060 or 990-EZ) 2014 14 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21[Part Il] Support Sched rganizati (Complete ony i you checkaa the box on tne 8,7, or 8 of Part Iori the orgarizaton fled to qualify under Part Il. the ergaization fat to quail undor the tess fated below plese complete Pati) Seelion A. Public Support Calendar your (orien year begining np >|) 2010 [ween | aoa | ans | c@aoa [into 1 Git, grat, contbutens, and rmomberhip 008 ecohe. (Do include ary "unusual grants”) 2 Taxreveruts levied orth og talons bent and ether pad to or expended on ts bohal 8. Tho vaio of srvces o tacos {urished by a governmental unk 12 the oganizaton wihout charge, 4 Total Ad thes 1 though {5 The potion ofttal contbutons by each porson (other han I ‘governmental unit oF publcly | ‘supported organization) inckided | con ino 1 that exceeds 2% of ho mount shown onthe 11, li ‘column () i ._ Palle ouppor. acting Sonn Wee Section B. Total Support Calendar yar (rfissl year beginning n)P>| (0) 2010 mzon yaqzoia | 2018 e214 ia Total 7. Amounts MNO 4 sa 8 Grose incom from ntoest, dividends, payments recsived on secures oan, ont, royatios ‘and Income fom similar sources. ‘9 Not income tom unrelated bushoss ctv, whether or not the business is reguary cared on 10 Otherincoms. Do not include gain lose trom the sale of capital assets (Explain in Part VI) 14 Total support. Add ne 7 hrovgh 10 412. Grose receipts rom related activites, oto. (ae Instructions) 49. First five year. he Form 9908 forthe organization's est, second, tid, fourth, oF oo son SONS) lg, dace i xa ation €. Computation of Public Support Percentage “fab upper percaiap for 2014 Greco Gide yin 7, cake 48 ule upper percatag Yom 2079 Semel A Pat 4 on to 39 1% support tet 2014 tne cgaieaton dd not check baron na 1 an in 4 91 ome, choke box ard top her. Te ergeizaten qual as a pubic) supported xpazton 301% support tot 201 Ie egeriation dl ot check a oxo na 18.1 and ina 1839 nn tnd stop tere, Tne exrizaton quate as pic sported ereiaton 17a 10% tcl anecvouretanoes teat -20% te cganzaton dine checks box on th 1,8 o 18 andi 18 108 ot, thd organization mets te "esivangceunetanct” fet, check ox and step here xn Part Vi ow he rgarzaton moot th “etsandlaetanos teste oganzaton gute asa ple supported orate, 0% tact-ond-eteumstances est 2018 he rprcton dnt check ox one 12 16,1, or 7a, angie Sis 1% mmr, and te opal mets the acoanderoutanes" shook ie boc an atop hee. pain Part Vow te publicly supported organization > ou ion ia chuck ax oni 3.1 17, choos his box and east Sched A For 90 or 90-62) 2046 ‘hock ths box > 15 14411104 781828 20097.3010 _-2014.04030 THE ROCHESTER GENERAL HOSPI 20097_2114411104 781828 20097. 3020 le for Organtzations Desorb (Compete only if you checked the box online 9 of Part orf he organization fale to qually under Part I. the organization als to | un toa jot Pat ‘Seaton Pubic Support Saeco} weil Calendar year (or izal year begining in)P>]_—_(a) 2010 won| (02 (2018 11 Gite, grants, contributions, and ‘momiberthip feos received. (Do not Include any unusual grants.") 2 Gross receipts fom admissions, smorohandls ‘any activity thats olated to tho ‘organtzation’s tax exemot purpose 8 Gross receipts trom actives th aro not an uncoated trade or bus Ine und escton 513 4 Texrevenues levied forthe organ- zation’ beneft and eithr paid to ‘oraxpondad on its behalt 5 Tho vali of services or fcitios {umished by a governmental unt to tha orpanlzation without charge © Total. Add thes 1 through 5 77a Amounts inolded on tines 1,2, nd 3 recohved trom dlaqualiied pereons ‘Ad lines 7a and 75 Section B. Total Support ‘alendar year (rea year bepinoingn)D> | ta) 2010 mao ean (aa ral 19 AMOUNIS HOM BOE & onsen 108 Gres nse tom nee ‘securities loans, ents, royalties ‘and income fom similar cources bb Unrelated business table income (ess section 511 taxes) om businesses equa atter Je $0, 1975 2Add Ins 108 and 10b ‘11 Net income from unrelated business ‘actus not included in ine 0b, ‘whether or nat the businees le ‘eguary eariad on +2 Other Inoome. Oo not inci gain or loas from the sale of capt assets (Explain in Pat Vi). 49: Totaleupport.astnas, 15 5, aa 1) “14 First five years, I the Form 990i for he oranization’s fet, second, itd, fourth, or fifth fax year asa section 801()@) organization, check thie box and stop her. = ‘Section C. Computation of Public Support Percentage. nis ASD 15 Publ suppor percentage fr 2014 (ine 8, column (cided by ne 13, column ).. 16. Pubte-suppon percentage tin 2018 Scheduo-A, Part Iino 15 18 Section D. Computation of investment income Percentage rd "77 Investment income percentage for 2044 fine 100, column () eivded by ine 18, column), 16 Investment income percentage from 2018 Schedule A, Part ine 17 18 label hehe ‘more than 33 1/9%, check this box and stop here. The organization quails as a pubicly supported organization 'b98 128% support toets- 20, I the organization didnot check a box on ine 14 rlne 198, and ine 16 fs moro than 331/96, and = > 16 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21 |(Form 990 ‘Supporting Organizations: (Compote only you checked a box on ino 11 of Part If you checked 11a of Par |, complste Sections A ‘and 8 you checked 11b of Part complete Sections A and C. you checked 11c of Pat |, completa ‘Sections A, O, and E I you checkad 11d of Part | complete Sections A and 0, and complete Pat V) Section A. All ting Organizations ves | No. 1. Areal ofthe organization's supported organizations listed by namin the organization's governing documents? if °No* escribe In Part V how the supported organizations are designated. designated by lass or purpose, describe the designation If historic and continuing relationship, exp. 2 Old the organization have any supported organization that does nt have an IRS dotermination of status under section 509(a\() or (2)? as," expla in Par I how the organization cstermined thatthe supported cergantation wes described in soction 509() o 2. 2 ‘8a Did the organization have a supported orgarizaton described in ection 501(0), (6, o (6? IF "Yes," answer [ () and ()botow. 90 'b Di the organization confi that each supported organization qualified under section SOWc}), (5), oF) anc aan ‘atefad the pubic support test und section 5092/1 "Yes," describe in Part VI when and how the ft &. cxgantation made the determination © Did te organization ensure tat all suppart to such organizations was usod oxcushvely for section 170(}2) F 7 (©) purposes? 1 "Yes," explain n Part VI what controis the organization put in place fo ensure such use 44a. Was any supperted organtzation not organizd inthe United States (“orlgn supported organization")? if hi "Yes" and if you checked 11a or 11b In Part, answer () ard (2) below. 'b Old the organization have ultimate control and dlscrtion in deciding whether to make grants to the foreign i ‘upported organization? if "Ys," desorbe in Part Vi how the organization had such control and alscrtion iespte being controled or supervised by orn connection wit its supported organizations. © Did the organization support any foreign supported organization that doss not have an IRS determination under sections 501(¢{8) and S00) or 2 i *Yes,"axplain i Part VI what controls the organization used ff {0 onsure theta support tothe foreign supported organization was used exclushaly fr section 170(eN2N) purposes. 658 Oid the organization add, substitute, or remove any supperted organizations during tho tax year? if "Yes ‘answor (3) and (below (it epplcabl). Also, provide dtal ih Part Vi, including () the names and EIN 5 numbers of the supported organizations added, substituted, or removed, (9 the reasons fr each such action, rele (i the authority under te organtzation’s organizing document authorzing such action, and how the action i was accomplished (such as by amondant to the orgsning document bb Type ot Type only. Was any added or substituted supported organization part ofa class already designate in the organization's organizing document? ‘© Substituttone only Was the substitution the result of an ovent beyond the organization's contol? {6 Did the organization provide euppot (whether in the form of grants or the provision of services or faites) to anyone other than (ts supported organizations; (individuals that are pat ofthe chartabio class I benetited by one or more ofits eupported organizations; orc) other suppesting organizations that also ho ‘support or benefit one or more of the fling xganization’s supported organizations? I *Yes," provide dtl n i Petv. 77 Did the organization provide a grant, loan, compensation, or othr similar payment toa substantial contributor (dfind in IRC 4958(¢9)(0), a family member of a substantial contibutor, ora 3S-percent controlled entity wih regard to @ substantial contributor? I "Yes," completa Part | of Schade L. (Frm 990). 8 Did the organization make alan toa dlequalilad porson (as dofined In aaction 4958) not desorived in ine 7? 11," complete Part | of Sched. (Form 990). ‘90. Was the organizatlon contraled dirty or indacty at any time during the tax yearby one of more all Compite ithe organization is described below. D> Attach to Form 900 or Form 990-EZ. i Siete” |p internation abot Schedule C (Form 880 or 850-2) ands nstuotos iat wun govifomse0. omer ifthe organization answered "Yeo," to Form 990, Part W, line 8, or Form 000-EZ, Part V, ine 46 (Pltical Campaign Activities), then '# Section 501(() organizations: Compete Parts FA and B. Do not complat Part I. © Section 501() other than section 601(cN,) organizations: Complote Parts 'A and C below. Oo not camplete Pat FB. ‘Section 527 organizations: Complete Part FA only. {tthe organization answered "Yes," to Form 980, Part I, line 4, or Form 960-2, Part VI, line 47 (Lobbying Aothities), then ‘* Soction 501(0}3) organizations that have fled Form 8768 (lection under section 80" (fh: Complete Part It, Do not complete Part «# Section 601(63) organizations that have NOT fled Form 8768 election under section 801(t): Complete Part IB. Do not completo Part IA Itthe organization answered "Yes," to Form 900, Part WV, line & (Proxy Tax) (S00 separate instructions) or Form 990-E2, Part V, line 350 (Proxy Tax) (200 seperate instruction, then Employer dentication number +1 Provide a doserition ofthe oxganzaion’s direct and Indrec potiel campagn activites in Part IV, 2 Poltloal expanaitures 8 Voluntoor hours [Part5B]_Complete if the organization is exempt under section 501(6)(3)- 1 Enter the amount of any exci tax incured by the organization under s8ction 4955 ann 22 Entar the amount of ay excise tax ncutod by organization managers under section 4958 {3 Hfthe organization incured a secton 4955 tax, dt le Form 4720 for this year? Was a correction made? Ieee dgate nar { Sctnplts W the oraanteaton ie examapt undo section BOT), axcopt aeolian BOTS: 1 Enir the aroun dea eoende byte fing ryan fost 52 rept uretin ache 2 Enter theareuntf te Ming organizations ands enti totiwreranzatons fr econ 27 comet uncon ethos 2 Total xemet tuncton exp he 17 nn 4 id he ing cxarzaton i Form 1120-OL fort oa? 6. Entrthe ras, adreeses and onployer etifeaton umber (al soon 827 poclergrzaone to ih te fng xganiaon made payment, For each ogarzaton feted, ente the amour pald oh ng egaizaton's und, Ao one the auto pola! Centro csves ta were romp and ret dere oa sopra pot eget, sch as aeeparat srgrogste in or Feticalecton conten PAC) Wa loel pace ended, pve tomato Pat Adios ‘ehEN | (apAnount pal tam | (Amount of pata Yeo No a) Name ‘ing organizaon’e | contrbullone received and {tunes itnone, enter-0.| promplly and directly delvored to asoparato ‘poltical orgarization. inane, enter 0. For Paperwork Reduction Act Notice, s0e the Inetructions for Form 800 or @80-EZ, “Schedule © (Form 990 or 990-E2) 2014 ‘Beh 27 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_211 Checke [1 ifthe fing organization balonge to an afiated group (and stn Pan WV each afiatad group mombors name, address, EN, ‘expenses, and share of excoss lobbying expenditures). B_Check. b> [—] tthe fing organization checked box A and “limited contro!" provisions apply. Limits on Lobbying Expenditures {The term “expencitures* means amounts paid or incurred) (ey Aifiated group totals “fa Totalobbying expenditures fo influence puble opinion (grass oats fobbying) bb Total lobbying expenditures to nflunce a lagislative body (dct lobbying) © Total lobbying exponeitues (add lines ta and 18), 1d Othor exempt purpose expenditures ee f¢ Total exempt purpose expenditures (add ines foand cd) {Lobbying nonteabarount, Enter the amount fom the fotowing table in both cours amounton line te, column (a) or() is: _| The lobbying nontaxable amountis: | Not over $500,000 2006 ofthe amount on tno te. [over $500,000 but net aver $7,000,000 | $100,000 plus 15% of tho oxcoss over $500,000. [Over $1,000,000 but not over $1,500,000 | — $175,000 plus 10% ofthe excess ovr $000,000] ‘Gver $1,500,000 but not over $17,000,000 | $225,000 plus 5% ofthe excess over $1,500,000, ‘Over $17,000,000 $1,000,000, {9 Grassroots nontaxable amount enter 25% of 81) an hh Subtract ine 1g from tne ta. zero or less, enter > i ‘Subtract line 1f from tine te, H20r0or oss, enter. ifthere is an amount other than zero on ether ino Thorne 1, did tho organization fe Frm 4720 reporting section 4811 taxtor his year? (yes 1. “4-Year Averaging Period Under setion 601) (Some organizations that made a section 601(h) election donot have to complete al ofthe five columns below, ‘See the saparats Instructions for lines 2a through 21) Lobbying Expenditures During Year Averaging Period (orteclyonrbogerig fy (2011 waote (2018 (azo. (oraa _—2a_Lobbyng nontaxabe amount 'b Lobbying coling amount [ 1 | (150% of na 2, column) © Total lobbying expendiwes 1 Grassroots nontaxable amount Grassroots cellng amount {150% of ine 2a, coun) & 0 ob “Sohedule G Form 990 or 000-2) 2014 | 28 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21(election under section 501(h). For each *Yes," response to lines 1a through 1/ below, provide in Part IV a detailed description (a) fo) of te oying act. yes | no | Amount 7 Daring th yor dha ing cipanzlon llompt to vnce fragrant or Jocal legislation, Inckding any attempt to influence publi opinion on a legislative matter | correerendum, through the ute of } 2 Vola en 7 sc x | 5 Pal sao waragoort Gnade omporston in anpanesfopored ones Ye aug x * ¢ Media advertisements? x 4 Maga to member, nln, tthe pst x ¢ Publeatons, or publahd o broadens talent x 1 Grants oterrgniatons or ioboyng purpones? : x 4 rect contac vith ght, the stats, govern aicas, oleae bogy? x 1 Rafe, dmenataone, somes, convontoa, speeches tues o ary ela es x 1 Otner actos? _ x 40,929, I 3 40,929. 2a Did the activities in line 1 cause the. ‘oparizaton to be not described in section 601(c)(3)? x fh aad tho ting organization Inuinos For 720.6 wie vi [ Part lil-Al Complete ifthe organization is exempt under section S01(c}@, section GOT(e)@), or Section. 504(6) is Yeo [Wo 41 Were substantiaty a (60% or more) duos recsved nondeducte by members? ssi zt 2 heaton ato neu nije eps of 2:00 rhe 2 i Ls tion fa exempt under section G04(o)@), section 80i{ol(a), or section " OR (b) Part Ill-A, line 3, is 501(6N6) and if either (a) BOTH Part I-A, lines 1 and 2, are answered "Ni answered "Yes." 1 Buds, escossments and similar amouna from members 2 Section 182() nondeducte lobbying and poitical expantures (do not include amounts of paltal expenses fr which the section 827(9 tax was pad). Current yar ' Caryovertrom ast year Total : 3 Aggregate amaunt reported n action C083, notices of nondeductibie section 162%) dues — ‘4 tfnotices wore sent and the amount on ine 2c exceeds the amount online 3, what portion ofthe excoss does the erpanizaton agroe to caryover to the reasonable estimate of nondeductible lobbying and pot ‘expenditure next year? es . c lures P ‘Supplemental Information Provide the dscptone requted Pate 7 Pat 8 ine & Par FO oe & Pak WA alto Ga al Part FA, os and Instructions); and Pat 8, ine 1, Also, complete this part for any adtiona information, PART II-B, LINE 1, LOBBYING ACTIVITIES: THE AMOUNT REFLECTED ON PART II-B, LINE 11 REPRESENTS THE PORTION OF MEMBERSHIP DUES PAID TO HEALTH CARE ASSOCIATION OF NYS (HANYS) AND. AMERICAN HOSPITAL ASSOCIATION (AHA) ATTRIBUTABLE TO LOBBYING : ACTIVITIES. 1 2a a 20 3 ‘eco ‘Scheclule G (Form 090 or 000-EZ) 2014 29 14411104 781828 20097.3010 — 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21Supplemental Financial Statements > Complete it ation anewered "Yes" to Form Part W, line 6 7, 8, Ba it Fs fi, He, 1 12m SCHEDULE D (Form 900) Speier lzaton answered "Yes" to Form 990, Part. tine 6. (ei benor adveod unde {hy Funds and ctr accounts 41 Totalnumber at ond of year, 2 Aggregate value of contibutons to (uring yeu) 8 Aggregate value of grants from (ring year) 4 6 ‘Agaregate vali at end of year ‘id the organization inftorm all donors and donor advisors in wing that th aboot ld in donor advised funds ‘are the organization's property, subject tothe organization's exctsive lgal control? {804d the organization informal grantees, donors, and donor advisors in wing that grant funds can be used only {or chartable purpeses and not forthe benef of the donar or donor advisor, or for any other purpose confering Clves [Ino ri ‘Conservation Easements. Complete ithe orgarizaion answored "Yes" to Form $90, Part NY ne 7. 41 Purpose) of conservation easements held by the organization (check all that appl) Preservation of land for public use (0.9. recreation or education) [__] Preservation af a historically important land area Protection of natural habitat | Preservation of a certified historic structure [J Preservation of open spac 2 Complete tines 2a through 2d Ith organization held qualified conservation contibution inthe form of conservation easemant onthe lat day ofthe tax yoo, Held atthe End ofthe Tax Yar ‘8 Total numberof conservation easements ...arenenun bb Total aoroage restricted by conservation : ‘9 Number of conservation easements ona certiledhistorestiucture included inf) ‘d_ Numbor of conservation easements included in) aoqured after 8/17/08, and not on ahistore structure stein the National Register Sone ‘3. Number of conservation easements modified, transferred, released, extingulshed,ortrminated by te organization dung the tax year 4) Numibor of states where property subject to conservation easements located D> {5 Does the organization havea wien policy regarding the periodic monitring,inpection, handling ot me [ze | 20 ‘violations, and enforcement of the conservation easements it holds? Loves Cine 6 Stat and volter hours devoted to montrng,nepecting, and onforcg conservation easements Gung the year 17 Amount of expenses incurred In monkering,Inpecting, end erforing conservation easements during tho year $; {8 Does each conservation exsemnont reported on tne (4) above sats tho raqurements of section 1700 4K} Loves [ino and soction 170PHA)BII? 2 {© InPar Xi, describe how the ergnization reports conservation easemonts in ‘expense sialoment, and balance sheet, and Include, fappable, the txt ofthe footnote tothe organlation’s financial statoments that describes the organizations accounting for _consewvation easements, Part Ill] Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets. Complete ithe organization nswored “os” to Form 990, Pat 1, ne 8 “a fihe organization elected, as permitted under SFAS 116 (ASC 956), not to repor in its revenuo statement and balance sheet works of art, tistorcal treasures, or athereimlar assets held for public exhibition, education, or research in furtherance of publ service, provide, in Pat Xl, the tox of the footnote tot fnanclalstatoments that describes these items. ‘Ifthe organization elected, es permitted under SFAS 118 ASC 956), to repartin ts revenue statement and balance sheet works of wt historical treasures, or other similar aseets held for pubic exhibition, education, or research in furtherance of pubic service, provide the folowing amounts relating to these items (Revenue Inokided in Form 960, Part Vil ine + (i) Assote included In Form 990, Part. 12 the organization reculved or held work ofr historical treasures, the folowing amounta required tobe reported under SFAS 116 (ASC 856) relating to thee Items: ‘8 Revenue incided in Form 960, Part Vil, ine 1 bb Assots Included In Form $90, PARK. ainmmarnn ps. ue S$. ms ms "200 the instructions for Form 990. ‘Schedule D (Form 990) 2014 30 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21 LHA For Paperwork Reduction Act Not39 ofits coleaton items ‘2 Using the organization's acquisition, accession, and other records, check any ofthe folowing that ar significant (check all that apply 2 [J Pubic extibition dC )toan er exchange programs » [2] schotany research e [_Jother, [_] Preservation for future generations. 4 Provo a description of the organizations collections and explain how thoy furthor the organization's exempt purpose in Part Xl ‘5 During tho year, id the organization soot orrecolve donations of ar, historical reasures, or other smiar assets funds a Jottings: r on’ eon [Part IV] Escrow and Custodial Arrangements. compote ithe organization anawored "Yes" to Form 960, Part V, Ine 9, or ‘ported an emount on Form 990, Part X, ine 21. 12 le the organization an agent, trustes,custocan or other intermediary Tor contibulone oF other assete not included ‘on Form 990, Part X? bb 11 *Yes," explain the arangerer sul ¥es No | ‘mount art tl ane Gompit the folowing table © Bohning balance {Addon sing tho yar ‘© Distibutions dung te year {Ending balance aes ceeeeeeeed a Os erin bis an ae on om Fat in 23 fo esrow ot cto aor bit? vag on P ; Endowment Funds. Compl te ogriatonanewores to Form 690, Part ine 0. {9)Current year | (b) Prior yoar fo) Two years back_[() Tivos years back | (o) Fur years back ‘1a. Beginning of year balance 8,107, 563 -8,107,437,| 8,206,144, 6043,0 360, 635, ‘> Contrioutions 149, 125, LL 62,281 23,207, © Netinvtment earings, ga, and ossea Grants or scholarships | (© Other expenditures for facilites. | and programs... | 1 Administrative expenses ‘@ End of yar balance... 8,207,723. 2,107,361 6107 437, 9,043,862, 2 Provide the estimated porcentage ofthe current yearend balance ine 1g, column a) held as ‘a Board designated or quastendowment D> % b Permanent endowment > 100.00 9% © Tomporay restictad ondowment P> ‘Tho percentages in nes 28,2, and 2e should equal 100%, ‘80 Are there endowment funds notin the possession ofthe organization tht re eld and adminatored forth organization oy ‘Yes | No. (unrelated organizations vs ws vs monet ~ |X (i) ated organizations ae — x bb "Yes" to Safi re the elated organization sad as requed on Sched A? : bo in Pat Xl she tandod uses ofthe organization's endowevent funds. PatW | Land, Buildings, and Equipment. | ‘Complato tho eranation anewored “Yoo” to Form 990, Part Vine 11, Seo Form 880, Part Xe 1. DDeseription of property ‘a)Costorattor | (B)Costorother | (@)Accumlated | (@)Bo0k vaio basis (rvestment)_| bass (thor ‘opreciation §,625, 974, 8,625,974 96,462, 189.1124,514,475.f171,947, 714. "a Land b Bullings ne : © Leasehold improvements... : «4 Equlpment wi 57,342, 312.193, 658, 809.| 63,683,503. a. oiner 33,192, 867. 33,192, 867 ‘Schedule D (Form 990) 2016 31 14411104 781828 20097-3010 -2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21jents - Other Sect ‘Compe the ganization answered 40 Form 990, Part WV, ne 1b. See Form 990, Part. {) Descron of security of elegy putronanectexcxinn | —_ (B) BOOK value {6) Matiod of valiaon: Cost of ond ofyoar mart value (@) Financia derivatives... 2) Closelynold equity interest (8) Other 44 COMMON: ILLECTIVE TRUSTS 11,201,04 ‘END-OF-YEAR MARKET VALUE. {®) HEDGE FUNDS 97,479,811.| END-OF-YEAR MARKET VALUE {e) o @ 2) ‘o m1 : agua Form 60, i Investments - Program Related. off tho orgaization answered "Yes" to Form: 108,680,854 tie 116: $20 F (¢) Description of investment (8) Book value ftIX] Other Assets. ‘Complete the organization answered "Vos" to Form 980, Part IV, fe 14d. See Form 960, Part Xe 15. e fne'13. ~ (@) Mathod of valuation: Cost or nd ofyear market value () Description (Book va () DUE FROM. AFFILIATES 66,477,760. @ BENEFICIAL INT IN RGHF ASSETS 35,420,783. @ OTHER ASSETS 68,784,679 ) ESTIMATED THIRD PARTY REC 15,201,920. 8. ‘6. = om ‘ — o must = ae 165, 685,150 Part X | Other Liabilities. Complate if tha organization answored "Vos" to Form 990, Part v 1 110 or 11 9 Fox 990, Part X, fw 25. t {(@) Description of ably (8) 800k vai Federal income faves —lt}_ Federal incometaxes_____ (| DEFERRED COMPENSATION \CRUED 8} _@ ACCRUED SELF INSURANCE ___— | @ ESTIMATED 3RD PARTY PAYABLE | 2,050,727.) 85,626, 500.| 2 | 125,678,375.| (@ UNAMORTIZED_ PREMIUM 6,632,949 (DUE TO AFFILIATES eee 665,784. ; eae] ee @) o “Tota. {Gotu 2) moat equal Form 890, Part X col. (no 5) | 220, 654, 335. 2. Lab for uncertain tax pestions n Par XI, provid the txt ofthe fotnae tothe ogerizatin’ hac tatoments that rapot the 32 ‘Schodule D (Form 850) 2014 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21aconcliaiion of Revenue per Audited ‘Statomonts With Revenge por Return. “Compete ithe organization answered "Yes" to Form 990, Prt Vino 12a 11 Totalrevenue, gains, and other support per audited tinancil ststements 2 Amounts incided on ine t but not]on Form 990, Pat Vil io 12: ‘Net unrealized gain (osses) on investments bb Donated services and use of acts © Rocoverios of prior yaar grants 1d Other (Daseribs in Part XI) © Add ines 2a through 2a. 9 Subtract ne 2e rom line 1 ‘4 Amounts included on Form 980, Pat Vii ine 12, but not one ‘Investment expenses not Included on Form 960, Par Vil ne 75 bb Other (Desorbe in Par MH)... “ Ad aa sn = 56,929,616. 11,237,980. 75,691,636 759,952. 76,451,588. rn. “Complolo it th orgarizition answered "Yes" to Form 990, Pat Vino 12a. “Total expenses and losses per aucited financial statements 2 Amounts included on tne 1 but nat on Form 860, Part I, tn ‘9 Donated services and 60 of 8 nm bb Prior year adjustments © Other los608 a 3 (53,849,842. eee Other (Docent in Part XI) ‘Add tines 2a through 24 a 8 Subtiact ine 2e from Ine 1 ene 4 Amounts included on Form 960, Part 1% ire 2, but not online ‘2. Investment expenses not included on Form 960, Part Vil, Iné 7... bb Other (Describe in Part XI) i © Add nas 4a and 4 ge | 14,225,091. 3 639,624,751. 759,952. 30 [Part Xill| Supplemental information. Provide the descriptions required for Part lines 8,8, and 6; Pat il, ines ta and 4; Pat IV nes 1b and 2b; Part V, fine 4 Part te lings 2d and 4b; and Part Xl, nes 26 and 4b. Also complete this part to provide any additonal information PART V, LINE 4: _ THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS INCLUDE: 1) CAPITAL EXPANSION AND IMPROVEMENT, AND ADVANCEMENT OF MEDICAL EDUCATION AND RESEARCH AND HEAL! .E_ SERVICE! PART XI, LINE 2D ~ OTHER ADJUSTMENTS: WESTERN NEW YORK REVENUE 11,237,980. PART XI, LINE 4B ~ OTHER ADJUSTMENTS: RECLASSED FROM EXPENSE - _759,.952 Pi LINE 2D ~ OTHER ADJU! : ear ‘Schedule D (Form 980) 2014 33 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21WESTERN NEW YORK EXPENSES 14,225,091 PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASSED_ TO REVENUES _ 159, —_ ‘Schedule D (Form 600) 2014 34 14411104 781828 20097.3010 2014,04030 THE ROCHESTER GENERAL HOSPI 20097_21‘SCHEDULE H i meen aren Hospitals 2014 > complet tthe organization answered Yes" o Form 99, Part V, question 20. byenatt ansy D> Attach to Form 900. Pie Gesraeteeet” | ivarmaton sbout schedule Horm out ons mnvuctnsie atone gowomoeo . | _Mmpneie ‘Namo ofthe organization ‘Employer identiication number tn to ogiaton hv frac nanan lye teye Nao son. apparent ; eames applied unilormly to al hoeptal cites J Aposed uritormy to most hospital tacts eon ec ep | Soe ae ee ener 1» Soeecncaiocs asa Pry Gace Fes seh coain sey par Foca ive nace organ Fete cons aby eer 100% = LJ 150% 200% [other % » cxieregtuatonse te tate natoreg ageing deco atte eg wae wry home tn bree crete oe Cl200%, CJ250% (Js00% 350% (XK) 400% « fee acto nt ese eran rh om sity, eb Po te ate log seat schon oe nec caer, ta tamrrsonmnch cbs wosttesutelcrs Pa paneer nn menr enianart ee 1 "¥e9, did the organtzaton’ thancll aseetance expenses exceed the budgeted amount? «I1°¥ee" tone Sb, asa result of budget considerations, was the organization unable to prove ee or dacountod ‘care toa pation who was elpbe for free or dlscourted caro? {60 Did the organization prepare community bent roport during tho tax oar? bb t*Yo6," aid th organization make i avaable to the public? Sc a ng ie nt toda tet cio Orta Ho alae be Sa Financial Assistance and Gertan Olher Community Benes at Cost nancial Assistance and Tazeac | Orme [Elgemrny | Moxigenne | Caceamny | Crear IMeens-Tested Government Programe | #eranetoiwan | coon smn ‘ Financlal Assistance at cost (om Worksheot 1) 2 8044767.[11776655.| 626811; +768 bb Medicaid (tom Worcsheet 3, column a) 25704162153627300341432.| 1.258 (© Costs of ether moans tasieg {government programs (rom ‘Workshoat 3, column b) 19786772.129501652.| 285,120.| _.038 Total Franc ate nd Mas — 17353570105664103716894664.| 2.048 Other Benefits 1 Community neath Improvement services and ‘community benefit operations tom Worksheet 4)... 1 Heattn professions education {rom Worksheet 8) a 26807782. 9001368.17806414.| 2.16% 19 Subsldized heath services {om Worksheet 6) ls3002537.73647573.| 9354964.|_ 1.13% bh Research (rom Works . 830,190.| 830,190. | Gah and inkind contributions for community ben (rem WorSN69t 8) sonansinime 207,270, 0] 207,270.] 03% j Total. Other on: 7 77963479131.7368648.| 3.328 Ak Total, Add inos 7d and 7 84383) 120168) 56368 “eaoes w-%¢LHA For Paperwork Reduction Act Notice, see the Instructions for Form 980, ‘Schedule H (Farm 960) 2014 35 14411104 781828 20097.3010 —_2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21Se tes aoe tte oti conOie ay ConTnky Bong wan tha taxyoar, and deserve in Pat Vihow ts community buling activites promoted the health of the communities it serves. Grimerat | {OT Poses (Ores Tore ele | Wwe atitkecrmesums | svosepiony | cerssay | ofestngronam | conmmniy | iergueae ‘cet sulengaee olangorton i ~3__Soinmuniy supped ‘4 Environmental Improvemenis {6 Leadership development and ‘talnog for community nambors 7 Community health improvement advocacy '_Worderee development ‘other teat [Part i | Bad Debt, Medicare, & Collection Practices ‘Section A. Bad Debt Expense Yoo [ No. +1 Did the organization repert bad dbt expense in accordance with Healthcare Financll Management Association rene FALE Statoment NO. 15? on = 2 Extorth amount of the erganizalion’s bad debt expense, Explain Part Vi tho ‘methodology used by the organization to estate tis amount : 2 | 15,635,477. 8 Entorthe estimated amount ofthe organization's bad debt expanesatoutabe to I, patents eligible under the organization’ nancial assistance policy. Expiah in Part ithe j ‘methodology used by the organization to estimate tis amount and the rationale any, | {or including this portion of bad debt eo community one. 9 | 11,332,473. | 44 Provide in Part ithe tot of the footnote tothe organization's anc statements that doscibes bad debt 4 ‘expense or the page number on which this footnote fs contained inthe attached nancial statements. H Section B. Mectosre | '5 Eno total venue received from Medicare (acuding OSH and INE) it 5 | 97,732,831, Enter Medicare allowable costs of care relating to payments on fine 7,281,472, 77 Subjract ine fom fine 5. This i tha Surplus (Fshortl) 19,448,641. {8 Deserbein Part ithe axon o which any shatal reported inne 7 should ba woatod as communty bene ‘Also describe in Par VI the costing methodology er source used to determine the amount reported on ne 6 ! ‘Check tho box that desorbes the method used: cost accounting system — [X] Costto charge ratio © Ll other i ‘Section C. Collection Practices ‘9 Di he organization have a wtan deb clecton policy during the tax yea? dh organization's clleton poly that applied othe argest ube ofits pits Ging ox yar onan provions on the esc in Pat oo | x Lo» | x inn ey eopoeen mapas natn) (0) Nama of ety (2) Deron of pemary {c}Orgenzaton's |e) Ooo direct] (0) Pryiians’ acto nity rome or atck | os tutes, or | prota or onmeronpss | fjemioyes, | tock ‘ownership % onmership % i _LATTIMORE SERVICES ORGANIZATION, LLC AGEMENT SERVICES 28.00% 72.00% Soe Form 000) 2048 36 14411104 781828 20097-3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21iS arkV | Facility ation, Section A. Hospital Faciities {ist n order of so, rom largest to smallest) How many hospital facilis did the organization operate during the tax year? a Name, address, primary website address, and state teense number {ead fa group retum, the nam and EIN of the subordinate hospital ‘organization that operates the hospital fect) T ROCHESTER Gi PIT: 25 POR’ ‘AVENUE, ITER, NY 1462: deal & eral on eae ‘Schedule H (Form 000) 2014 37 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_.21Facility information conve ‘Section B. Facility Policies and Practices (Complete a separate Section B foreach of the hospital faces or facity reporting groups liste in Part V, Section A) Name of hospital faciity or letter of facility reporting group ROCHESTER GENERAL HOSPITAL. Une number of hospital fact, or ine numbers of hospital facilities ina facity reporting group (rom Part V, Section AY: ‘Community Health Needs Assessment 11 Was the hospital Tacity fst loeneed, registered, or inlay recognized by a State asa hospital facity nthe current tax year othe immediately preceding tax yoar? os ao 2. Was the hospital feclty aquired or placed into service aa a tax-exempt hospital i the cument tx year oF tho immadiatly preceding tax year? If "Yo," provide deals ofthe acquistion in Section C., ‘8 During the tax year or ether ofthe two immediately preceding taxyears, cathe hospital facity conduct & ‘community heslth needs assessment (CHINA)? If ‘No skip tino 12... ‘€"¥¢s, Indicate what the CHNA report describes (check al that apply: 2 2X Adotniton ofthe community served by the hospital faclty tb [30] Demographics of te community cc [3] existing healthcare facies and reeouraee within the community that are avaliable to respond tothe health neods ofthe community How data was obtained ‘The signioant heath needs ofthe community Primary and chronic disease needs and other health Issues of uninsured persons, lowincome person sroups ‘Tha procase for Kdontiying and prioritizing community haath needs and sores to meet the community health needs ‘Tho procoss for consulting with persons representing the community's interests Information gaps that lit the hospital facitysablity to assess the community's heath needs (thor (describe in Section) 4 Incite the tax year the hospital fact last conducted a CHNA: 20_13, §5 In conducting its mos recent CHNA, dd the hospital facity take Into account int fom persons who represent th broad Interests of the commun served by the hospital facity, including thove with epectal knowiedge of or expertise In publo health? i *¥es,* describe in Section Chow the hospital facltytookinto account input rom persons who represent the ‘community, and identify the persona the hospital faiity consuted ‘6a. Was the hospital faolity’s CHNA conducted with one or more other hogptl faci? It hospital facies in Section ©. bb Was the hospital faity’s CHNA conducted It the other organizations in Section © os 7. Did the hoeptalfacity make its CHNA roport widely evalabo to to publ? It Yoo," indicate how the CHINA report was made widely avalabo (chook al that apply: 2 EX) Hospital facity’s website fist ut): WWW, ROCHESTERGENERAL . ORG b LJ other website (ist ut: c [XC] Mado.a paper copy available for public nepaction without charge atthe hospital facility 4 [1 other (describe in Section ©) 8 Dic the hospital factty adopt an implementation strategy to meet the signlcant community heath needs dontiod through is most recently conducted CHNA? "No," skp tno 11 © indicate the tax year the hospita fait last adopted an implementation strategy: 20.14 40 Is the hoeptal faciy's most recently adopted implamentaton strategy posted ona vebsto? en aif*¥e5,*(istul: ._ WWW. ROCHESTERREGIONAL . ORG ‘bf "No", athe hospital aoty’s most recently adopted implementation strategy attached to his retu? 114 Describe in Section C how the hospital faclity fs addressing the significant needs identified ints most recontly conducted CHINA and any such needs that are not being addressed topethor withthe reasons why such needs are not being addressed, +128 Did the organization incur an excise tax under section 4959 forthe hospital faci’ flue to conduct a (CHNA as requicd by section BO1CIE)? ‘bit "Yes" tone 12a, di the organization fle Form cif Yes" totne 12, what the total amount of section 4850 excise taxthe organization reported on Form 4720 or alot is hospital action?” $ nd minor ORR HER BER; bee be be 400 128 ‘Schedule H (Form 880) 2014 38 14411104 781828 20097.3010 —_2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21oc Part Faclity Intormation entnued) Financial Assistance Policy FAP) Name of hospital facility orltter of aciityreporting group ROCHESTER GENERAL HOSPITAL Did the hospital city have in place during the tax year a wren tiancial assistanco policy that: 18. Siplained ality crtoriafr franc assistance, and whethor such asitance included fe or ciscounted care? 11-0," ingleato tho oli ctoria explained in the FAP: a [C} Federal poverty guidelines (FPG), with FPG family income int for aigibity fr free cere of _200 _% ‘and FPG family income iit for eiiity for discounted care of_ 400% {1 income ievel other than FPG (describe in Section C) ‘Assotiovel Modal inigency insurance status (1 underinsurance status [3 Residency [} other Gescribe in Section C) 114 Explained the basis for ealelating amounts chargod to patients? 46 Explained tho mothod for ppg for hancal assistance? .vmmneomevore 1F"Yes- Indicate how the hospital facy's FAP or FAP appication fom (nouing accompanying instuctons) ‘explanod the method for apphyng for fnanal assistance (oheck al that app LX] Described the information the hospital taciity may require an individual to provide as part of his or her application » (XC) Described the supporting documentation the hospital faciity may require an individual to submit a8 part of his orherappbcation © (3C) Provides the contact information of hospital facity staff who can provide an individual with information bout the FAP and FAP appicton procoss 4 CX) Provided the contact information of nonprofit organizations or government agencies that may be sources of aesstance with FAP appcations @ (1 oitor doscibe in Section ©} 46 Included measures to pubtcize th pokey within the commun served by the hospital faci? 1¥2¥e9,* incest how the hoapalfacaty publized the polly (check al that apy “The FAP waa widely avalabo on awobsit (st Ul: Rl, ROCHEOTERREGIONAL ORS “Tho FAP apploaton form was widely avaiable on a wobsit (st ur: wins, ROCHESTERREGEOHAT. O86. ‘Aplain language summary of the FAP was widely avaiable on a websito (st uf: HV, ROCHROTERARGTONAG,ORG ‘The FAP was avaiable upon request and without charge (public locations in tho hospital fact and by mal) ‘The FAP apptcaton form was avatabo upon request and without charge pubic cations inthe hospital facity and by mal) ‘Aplain anguage summary of ho FAP was avaeble upon request and without charge (h pub acatlons in the hospital fecity and by mai) Notice of avadabty of the FAP was coneplovousydaplayad throughout the hospital fay oti members ofthe community who are oa kayo roqutofhancil assistance abou avalabity of tho FAP ‘ther describe in Section ©) BUI ae Yes a 36 |X ‘Bilingand Collections: 117_ Did the hospital facity have in piace during the tax yaar a soparate bling and collections policy, ora vitten financial assistance policy (FAP) that exolaned all of tho actions the hospital faciityor other authorized party may take upon ‘non-payment? . ve 18 Chock al ofthe folowing alone against an naval that wore permitted under the hospital fects pales durin the fax ‘year bofore making reasonable efforts to determine the indviua’selgibity under the facity's FAP: 2 [J Roponting to credit agency'ies) » ‘Soling an individual's debt to another party cc [J Actions that require a legal o judicial process. a (Other sitar actions (describe in Section C) [EF None of these actions or other similar actions wore permitted ‘Schedule H (Form 880) 2016 39 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21oc lon (continua) Name of hospital faciity or letter of facility reporting group ROCHESTER GENERAL HOSPITAL. es 19 id th hosp tector ther authored party perform any ofthe folowing sctions dna the txyoar before making reasonable efforts to determine the individual's eligibility under the facility's FAP? 49 x 1 Yee" check a actions which th opt cy ora rd party engaged: 1 epertng to cred agencies) [J Soting an indicus det another party © Ey Aatone that equi a egal radia process 4) other simi actions (describe in Section C) 20. Inca whch flor he roepta tc or other authorised party mace befor tang ay of he actos lated (whether o rot check} nw 7 crac al hat SPP «+ J niet indicus of te fnncialaestnce poy on admis » ED noted intial ofthe franca eta ploy porto charge © [J nite indus of te financial asistance poy in comrnnicatons withthe nds regacing the nv! DAS d [_) Documented its determination of whether individuals were eligible for financial assistance under the hospital facility's fare aeatance poly «1 otter ener in Section o) + 2] non ot meas eon wore mage ‘Policy Rolating to Emmorgency Medical Care: 21 Oi th sol ay haven lac dung tho lax year a wen olay alain emerpenay modal care that requted he host tcy to prove without Geant, efor emergency mada oto to individuals regardless of their eligibility under the hospital facility's financial assistance policy? 211k FN nao why et a J Thehowpel acy alt not prove care fo any emergency maces conions © I Thehoepitt ec poy was natin wing i [J ‘te hoapital eit ied wh wns ait recov care for emergency medica condone esrb in SactonC) i 1 otperieeaiben Section Gh 0 Una tha ible india indeato how the hosptal fect Getomined rng the ox ony, the maximum amounts tha canbe charged to FAR ote | Individuals for emergency or other medically necessary care. 1 2 [21 The hospt acy uod it owetnogoiated comarca insurance rato when clog the maxim mounts : that canbe charged | 1» [5 Thohoept fact sod the average oft se ones nogotated comarca insurance rates when caleiting te main aunts that canbe charged | ¢ [J The hospital facity used the Medicare rates when calculating the maximum amounts that can be charged [32 other (dente in Section C) | 23. During the tax year, did the hospital factity charge any FAP-sligible individual to whom the hospital facility provided mergncy or other odialy necessary erces mare tan te amounts generaly bed ond who Rak ireuranee ovat ach cae? coon [291 Le ¥en explain Section C. 24 During tho taxjuar dd tho hoop fact charge ay FAP alge ndvual an amount equ othe gross charge for any ‘service provided to that individual? sie 24 x iY, eiplain in Section Schodte H Form 960) 2046 40 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21V || Facility information fesntinod) ‘Section G, Supplemental information for Part V, Section B.Provid descriptions requked for Pat, Section 8 ins 296 Fan rer Ee S20 Paps, joie copa devcrghons x enh hosp ici alegre fc repaint han oat ie nant fom Pa Socton AAA A528 ome ot heap ROCHESTER GENERAL HOSPITAL: PART V, SECTION B IDENTIFIED WITHIN REPORT ROCHESTER GENERAL HOSPITAL: PART V, SECTION B, LINE 6A: UNITY HOSPITAL, STRONG MEMORIAL HOSPI' HIGHLAND HOSPITAL. ROCHESTER GENERAL HOSPITAL: PART V, SECTION B, LINE 6B: LAKESIDE HOSPITAL, ROCHESTER GENERAL HOSP: AL, HIGHLAND HOS! STRONG MEMORIAL HOSPITAL. ROCHESTER GENERAL HOSPITAL: PART V, SECTION B, LINE 16T: ALSO LOCATED IN OUTPATIENT SETTINGS AND LAB DEPOTS. ROCHESTER GENERAL HOSPITAL: PART V, SECTION B, LINE 22D: ACTUAL CHARGES ARE BILLED, LESS 30% DISCOUNT, PLUS 9.63% NYS SURCHARGE. “er wea “Schedule H Form 900) 2016 41 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21f 20 fran [rea lity Information (contivodp ‘Section D. Othor Health Gare Facilites That Are Not Licented, Registored, or Similarly Recognized as a Hospital Facility (ist inorder of siz, ttm largost to smallest) How many nor-hoapitl health care fcities ds the organization operate during the tx yoar?, Name and address 11_RGMG PHYSICAL MEDICINE & REHABILITATI 1425 PORTLAND AVENUE. ROCHESTER, NY 14621 12 _RGMG VASCULAR SURGERY ASSOCIATES. 1445 PORTLAND AVENUE, SUITE 108 ROCHESTER, NY 14621 13_RGMG VEIN CENTER 20 HAGEN DRIVE, SUITE 210 ROCHESTER, NY 14625) —____-}. 14 RGMG BAY CREEK MEDICAL GROUP 2000 EMPIRE BLVD, SUITE 120 = ss WEBSTER, NY 14580 15 RGMG CLINTON FAMILY HEALTH CENTER: ——293_UPPER FALLS BLVD ROCHESTER, NY_14605 Te_R BNE: TE-RGMG GENESEE INTERAD MEDICINE 222 ALEXANDER PARK, STE 5000 ROCHESTER, NY 14607 17 RGMG RIDGEWAY FAMILY MEDICINE 2350 RIDGEWAY AVENUE, SUITE A ROCHESTER, NY 14626 L GENESEE INTE} ‘MEDICINE 1299 PORTLAND AVENUE, SUITE 17 Typo of Favimy (describe) FAMILY MED PRACTICE. D PRACTICE FAMILY MED PRACTICE FAMILY MED, PRACTICE EAMILY MED. PRACTIOR FAMILY ICE FAMILY MED PRACTICE FAMILY MED PRACTICE ROCHESTER, NY 14621 TS RGMG LINDEN MEDICAL GROUP. —_30_HAGEN DRIVE, SUITE 300 ROCHESTER, NY 14625 FAMILY MED PRACTICE 20 RC POND INTERNAL MEDICINE 2350 RIDGEWAY AVENUE, SUITE B ROCHESTER, NY 14626 43 14411104 781828 20097.3010 2014.04030 THE FAMILY MED PRACTICE ‘Schedule H Form 080) 2014 ROCHESTER GENERAL HOSPI 20097_21Facility Information ¢onthwo ‘Section 0. Other Health Core Facile That Are Not Licensed, Registered, or Similrly Recogniaod as a Hospital Facility {Ustin ordr of sia, rom largost to smalst) How many non hospital health cae fades dil th organization operate ducing te tax year? 63 Namo and addons ype Fc (ocr) i JER( ¥ & RHEU 222 ER ST, MO! tT ROCHESTER, NY 14607 —__| FAMT! D_PRACT: Z_RGMG_ASTHMA/ALLERGY INMUNOLOGY € RHEU | 10 HAGEN DRIVE, SUITE 20 FAMILY MED PRACTICE ROCHESTER, NY 14625. 3 _RGuG As’ ALLERGY LOGY _& RHE 5TH FLOOR = TER, 14626 G_RGMG RHEUMATOLOGY _INFUS 10 TE by 1 ROCHESTER, NY 14625 | FAMILY MED PRACTICE __ S_RGMG CENTER POR DERMATOLOGY __| ERMATOLOGY. 20 HAGEN DRIVE, SUITE 2200 Ny 14625 FAMILY MED PRACTICE | FAMILY MED PRACTICE __ FAMILY MED PRACTICE 8 GERIATRI! TATIVE SERVICE 1415 PORT! AVENUE, SUT! 200 ROCHESTER, NY 14621 FAMILY MED PRACTICE 3 __RGNG ORTHOPEDICS Pe NY_14621 FAMILY MED PRACTICE 10 RGMG PHYSICAL MEDICINE REHABILITATI 10 HAGEN DRIVE, SUITE 330 TROGHESTER, NY 14625 —__—— | FAMILY MED PRACTICE ___ ‘Shed W Farm 600) 2098 42 14411104 781828 20097.3010 —-2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21acl information coniund ‘Section D, Other HealthCare Facies That Are Not Licensed elated o i {lot n order of sz, trom largest to smal!) How many nomhospital heath care faces did the organization operate during the tax year? Name and address 2: THR: ICAL GROUP 1338 E. RIDGE ROAD, SUITE 101 3 ROCHE NY 14621 TE PI GRO 371 IDGE ROAD, STE —RocHESTER, NY 14621 [3_RGMG_R¢ ITER _G! MEDICAL ASSOCT 1425 PORTLAND AVENUE HES" _NY_ 14621 24 RGMG ROCHESTER GI iD ASS 4 AVE! — ROCHESTER, N¥_14621__ | 25 RGMG GANANDA FAMILY PRACTICE 1200 FAIRWAY SEVEN a MACEDON, NY 14502 26 RGMG LYONS HEALTH CENTER 12 LEACH RoMD LYONS, NY 14489 2T-RGMG NEWARK INTERNAL MEDICINE | FING Pi NEWARK, NY 14513 28 RGMG SODUS INTERNAL MEDICINE. 6692 MIDDLE ROAD NY 14551. =_-SODUS. 29 RGMG WILLIAMSON FAMILY PRACTICE 4425 OLD RIDGE ROAD a WILLIAMSON, NY 14589 30_RGMG WOLCOTT INTERNAL MEDICINE —| 6254 LAWVILLE RO) —WoLcorr, NY 14590 44 imilarly Recognized as 2 Hospital Facility ‘Type of Facity (desc) FAMILY MED PRACTICE FAMILY MED PRACTICE FAMILY MED PRACTICE | FAMILY MED PRACTICH FAMILY MED PRACTICE FAMILY MED. PRACTICE FAMILY MED PRACTICE FAMILY MED PRACTICE FAMILY MED: PRACTICE ‘Schedule H (Form 060) 2016 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21Facllity Information (a ‘Section D, Other Health Care Faciities That Are Not Liceneed, Registered, or Similarly Recognized ae a Hospital Faclty (stn ordr of size, fom largest to smallost) How many nor hospital health cae facts dd the orgarzation operate during the tax year? Name and adcross 7 7 1415 AVE, SUITE 400/490 ROCHESTER, NY 14621 222 ALEXANDER ST, SUITE 1100 ROCHESTER, NY 14607 33_RGI "§ CENTER 309 UPPER FALLS BLVD _ 5 ROCHESTER,_NY_14605 3a RGMG THE WOMEN'S CENTER 1250 DRIVING PARK AVENUE. NEWARK, NY 14513 35. ¥ PEDIATRIC GROUP. ‘2000 EMPIRE BLVD, SUITE 150 ROCHESTER, NY. ot ESTER, 24581 36 GENESEE PEDIATRI 222 Al RST, SUITE 410 ICI i dt 37_RGMG ROCHESTER GEN PEDIATRIC ASSOC: 1425 PORTLAND AVENUE “ype of Fecity see) FAMILY. MED PRACTICE FAMILY MED CENTER FAMILY MED PRACTICE AMELY MED PRACTICE | WAMILY MED PRACTICE | FAMILY MED PRACTICH WAMILY MED PRACTICE ROCHESTER, NY 14621 36 RGNG PENN FAIR PEDIATRICS 2067 FAIRPORT NINE MILE POINT RD STH Pi D 5 | FAMILY MED PRACTICE 39_RGMG NEWARK PEDIATRICS 1200 DRIVING PARK AVENUE. NEWARK, NY 14513. 40 RGMG SODUS PEDIATRICS 6692 MIDDLE ROAD. SODUS, NY 14551. 45 14411104 781828 20097.3010 —-2014.04030 THE FAMILY MED PRACTICE FAMILY MED PRACTICE ‘Schedule H (Form 680) 2014 ROCHESTER GENERAL HOSPI 20097_21‘Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as @ Hospital Facility {Gstin order of szo, rom fargost to smabst) How mary non hospital health care facttes did the organization operate during tho tax yea? ame and adress Typo ot Facy oworb) ‘41 _RGNG WILLIAMSON PEDIATRICS 4425 OLD RIDGE ROAD WILLIAMSON, NY 14589. @2-RGMG WOLCOTT PEDIATRICS 6254 LAWVILLE ROAD WOLCOTT, NY 14590 a "ASTHMA /ALL! TMMONOLOGY & fi ITE, ROCHESTER, NY 14626 44 BRANDON FAMILY MEDICINE RGHS FAMILY MED PRACTICE zi FAMILY MED PRACTICE FAMILY MED PRACTICE 550 ‘PENFIELD, NY_14526 FAMILY MED PRACTICE @5_LIND) FAMILY MEDICINE 30 HAGEN DRIVE, SUITE 320 FAMILY MED PRACTICE ROCHESTER, NY 14625 6 ONCOL 3G cynscotocié oNcoLocY - ALEXANDER PARK 222 ALEXANDER ST, SUITE 1100 ROCHESTER, NY 14607 FAMILY MED PRACTICE AT EX (ALLERGY IMMUNOLOGY & RHI 12 LEACH ROAD ___ LYONS, NY 14489 FAMILY MED PRACTICE NEWARK, NY_14513 ‘49_ENDOCRINE-DIABETES CARE. & RESOURCE CE 12 LEACH ROAD 46 FAMILY MED PRACTICE FAMILY MED PRACTICE FAMILY MED PRACTICE ‘Schedule H (Form 990) 2014 14411104 781828 20097.3010 _2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21Facil Infortaation baainoee ‘Section D, Other Health Care Facilles That Are Not Licensed, Registered, or Si (lat in order of siz, fom largest to satis) How many non-hospital haath care facies di the organization operate during the tax year? Namo and addroas 51 DEMAY LIVING CENTER 100_SUNSET DRIVE NEWARK, NY 14513 00 2 52 ELDER ONS 2066 HUDSON AVENUE ROCHESTER, NY 14637 53 AIR ROCHESTER, NY 14607 ri i 222 “STREET, STE 5000 ROCHESTER, NY 14607 ‘55_GHS REFUGEE FAMILY MEDICINE 222 ALEXANDER, STE 4000 ROCHESTER, NY 14607 _ | TE 300 i 56 NORTHEAST HEALTH SERVICE OPD 1425 PORTLAND. AVENUE. ROCHESTER, NY 14621 S7_NORTHEAST HEALTH SERVICE TWIG STTE 1425 PORTLAND AVENUE ROCHESTER, NY 14621 58 NORTHEAST HEALTH SEi we ——1415 PORT ROCHESTER, NY 14621 59 NORTHEAST HEALTH SERVICE WOMENS CENTE 1415. PORTLAND AVE ROCHESTER, NY 14621 G0 NORTHEAST HEALTH SERVICE WOMEN'S CENT 1415 PORTLAND AVENUE, SUITE 220. ENT. ——ROGHESTER, NY 14621 Sia ” 14411104 781828 20097.3010 —-2014.04030 THE imilarly Recognized as @ Hospital Facility ‘Typo of city doserbi RII GERIATRIC ALLERGY IMMUNOLOGY & RHKUMATOLOGY INTERNAL MEDICINE FAMILY MEDICINE | INTERNAL MEDICINE INTERNAL MEDICINE | OBSTETRICS AND GYNECOLOGY ___ OBSTETRICS AND GYNECOLOGY __ osx “Sehedule H Form 080) 2014 ROCHESTER GENERAL HOSPI 20097_21Facility Information continuod) ‘Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as @ Hospital Faciity (istin ordr of size, trom largest to smatst) How many nomhosptal health cae facies did the organization operate during th tax year? PENFIELD, NY 14526 LY MEDICINE 360 LINDEN OAKS DRIVE, St PHYSICAL MEDICINE & OCHESTER, NY 141 EHABILITATI 1250 DRIVING PARK Al 3. STETR} “Schedule H (Form 000) 2014 48 14411104 781828 20097.3010 2014-04030 THE ROCHESTER GENERAL HOSPI 20097_21‘Supplemental Information Provide tho folowing information, 1. Required descriptions Provide the descriptions requied for Part | Ines 8c, 8 9%, 2. Needs aasesement. Describe how the organization assesses the healthcare needs ofthe communities it serves in adition to any (CHNAS reported in Part V, Section B. 8 Patient education of eligibility for assistance, Describe how the organization Informs and educates patlnts and persons who may be biled ‘or patont care about thelr efgibilty for assistance under federal, stale, or local government programs or under the organization’ hancial astistance potey. ‘4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constiuents it serves, |5 Promotion of community heath, Provide ay other Information Important to describing how the organization's hospital facies or other health ‘care fects further te exempt purpose by promoting the heath of the community (4. open madical staf, community board, us of SurpL funds, eto). 6 Afiated health care system, the organization Is part ofan afilted heath care systom, desc the respecte roles of the organization ‘and ite atfilates in promoting the heslth of the communitias served. 7. State fling of community benefit report. it applicable, klentiy all states with which the organization, ora related organization, fs @ community benefit report PART I, LINE 6A: ROCHESTER GENERAL 'S COMMUNITY BENEFIT REPORT IS INCLUDED IN COMMUNITY BENEFIT REPORT FOR ROCHESTER REGI HEALTH ‘ED _ NOT-FOR-PROFIT AS_PART OF THE JOINT COMMUNITY EIT REPORT DISTRIBUTED BY MONROE COUNTY, NY. 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 HEET_B. PART I. _ PART I, LINE 7G: N/A ~ NO PHYSICIAN CLINIC COSTS WERE INCLUDED ON LINE 76. PART I, LN 7 COL(F): = TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) ARE $840,384,703. Q D DEBT E INCLUDED IN THIS AMOUNT Is 635,477. AFTER BAD “es Bae Schedule Hfrorm GOO}SDIE 49 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21 14411104 781828 20097.3010HE ROCHESTER ‘Supplemental Information (Continuation) DEBT WAS DEDUCTED PROM TOTAL EXPENSES, THE AMOUNT OF TOTAL EXPENSES USED TO CALCULATE THE PERCENT IN LINE 7, COLUMN (F) WAS $824,749,226. PART I, LINE 7E: DURING 2014 THE FILING ORG 0 PONSORED THE. ING ACTIVITIES TO PROMOTE COMMUNITY HEALTH IMPR THAT MEET THE DEFINITION FOR DISCLOSURE ON SCHEDULE H, PART I, LINE 7) Ty HEALTH ERVICES AND Ct ITY BENEFIT OPERATIONS). VER, COMMUNITY BENEFIT EXPENSE AND DIRECT OFFSETTING REVENUE WERE NOT SEPARATELY TRACKED IN THE ORGANIZATION'S ACCOUNTING RECORDS. AS A RESULT, NO AMOUNTS HAVE BEEN INCLUDED ON SCHEDULE H, PART I, LINE 7E. SPRING INTO SAFETY _ THIS EVENT PROVIDES SAFETY EDUCATION INFORMAT: THE RESIDENTS OF ROCHESTER WITH DISTRIBUTION OF 1,200 BICYCLE HELMETS TO CHILDREN AGE 3-12 (BACH HELMET 18 FITTED DIRECTLY T0 THE CHILD). THE EVENT ALSO FEATURES A BIKE SAFETY RODEO; CHILD PASSENGER RESTRAINT SEAT INSPECTION AND REPLACE! sD); CHILD FINGERPRINTING ID AND OTHER TY INFORMATION FROM LOCAL COMMUNITY AGENCIES. MORE THAN 1,000 PEOPLE BENEFITED FROM SERV: FERED AT THIS EVENT. CAMP BRONCHO POWER THIS EVENT PROVIDES OVER 60 CHILDREN WITH MODERATE TO SEVERE ASTHMA THE OPPORTUNITY TO PARTICIPATE IN A THREE DAY, TWO NIGHT OVERNIGHT CAMP EXPERIENCE. THE PARTICIPANTS RECEIVE EDUCATION WITH RESPECT TO MANAG ‘THE SYMPTOMS OF THEIR DISEASE ALONG WITH TRADITIONAL CAMP ACTIVITIES. THIS EVENT GIVES MEDICAL STAFF AN OPPORTUNITY TO SEE THEIR PATIENT IN THER SETTING WHILE WORKI = : se ‘Schedule H (Form 900) 50 14411104 781828 20097.3010 | 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21CHILDREN'S COMMUNITY HEALTH FAIR THIS EVENT IS HELD WITH A LOCAL SCHOOL AND PARTNERS WITH LOCAL AGENCIES 10 PROVIDE CHILDREN WITH EDUCATIONAL SAFETY MATERTAL. MORE THAN 300 CHILDREN BENEFITED FROM THE IN} ED AT. . CANCER SERVICES WOMAN'S DAY OF SCREENING (AUGUST) a ‘9 DAY OF SCREENING TO PROVIDE 1} ERVICES TO OLDER WHO ARE UNI D. THE APP’ rs. INCLUDED A CLINICAL BREAST EXAM AND A SCREENING MAMMOGRAM. HEALTH ‘PATION ASSEMBLYMAN MORELLI HEALTHFATR (AUGUST) AMILY HEALTH AND F: 0 BER, CALL TO WOI TAL FRING (AUGUST, =PROVIDED BROCHURES, COMPACT MIRRORS, AND NAIL FIUI PARTICIPANTS EARTH DAY CELEBRATION 2013 THE PUBLIC WAS INVITED TO ATTEND THIS ANNUAL EVENT WHICH HIGHLIGHTS THE POSITIVE HEALTH BENEFITS OF A GREENER PLANET. HEALTH’ KING DEMONSTRATIONS WERE PRESENTED AND THERE WERE OPPORTUNITIES TO LEARN ABOUT RECYCLING BENEFITS. HOLIDAY EVENTS RGH HOSTED HALLOWEEN AND CHRISTMAS PARTIES FOR UNDERSERVED CHILDREN AT RGH IN THE PUBLIC ATRIUM. RGH HELD A HOLIDAY TOY DRIVE IN PARTNERSHIP ‘Schedule H (Form 880) 51 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21PEDIATRIC POPULATION. SPONSORSHIPS = BRH / LIPSON CANCER CENTER WA (OR AND PARTNER OF GILDA‘ LUB_AND THE AMERICAN CANCER SOCIETY, TO PROVIDE SUPPORT 1 ER PATIENTS AND THEIR FAMILIES, LOCALLY AS WELL AS SUPPORT CANCER SEARCH. RRH_ SPO) AND SUPPORTS THE AMERIt IABETES ASSOCIATION, INCLUDING THE TOUR DE CURE EVENT. RRH WORKS WI ADA AS WELL AS THE ER ITY COLLABORATIVE 9B EDUCATION AND SUPPORT FOR Pi MANAGEMENT OF CHRONIC PARTICULAR DIABETES, IN THE COMMUNITY. THE SANDS- CONS! TT TUTY SPONSOR. PARTNER OF THE AMERICAN HEART ASSOCIATION. OTHER ‘THERE WERE VARIOUS OTHER ACTIVITIES THAT STAFF PARTICIPATED IN. THROUGHOUT THE BENEFIT THE ITY, WHICH INCLUDE (BUT ARI ‘NOT_LIMITED 70): RONALD MCDONALD HOUSE AND INTERNAL FUNDRAISERS | (HURRICANE RELIEF, SCHOOL SUPPLIES, OPEN DOOR MISSION, ETC. )_ PART IIT, LINE 4: IN 2014, 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. STHE ORGANIZATION TO DETERMINE WHETHER TO QUALIFY PATIENTS FOR CHARITY CARE ACCORD: TH THE IZATION'S POLICY. PPLICATI! see ‘Schedule H (Form 800) 52 14411104 781828 20097.3010 2014.04030 THR ROCHESTER GENERAL HOSPI 20097_21ADDITIONAL INFORMATION IN 2014 RESULTED IN ADDITIONAL PATIENTS QUALIFYING FOR Tr = i ES_AMOT BT EXPENSE. BAD DEBT EXPENSE ON PART II, LINE 2 REPRESENTS ESTIMATED UNCOLLECTIBLE CHARGES FOR THOSE PATIENTS UNWILLING, NOT PAY. BAD DEBT COSTING METHODOLOGY: iE PI 1 R DEBTS_IS BASED UPON MANAGEMENT'S ASSESSMENT OF ISTORICAL AND EXPECTED LLECTIONS CONSIDERING HIS' \L_BUSINI AND_Et me TRI IN HEALTH CARE Ci THER COLLECTION INDICATORS. PERIODICALLY. jOUT THE YEAR, EMENT. ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-( ERIENCE BY PAYO! "EGORY. THE RESULTS OF THIS RE THEN USED TO MAKE ANY MODIFICAT: THE PROVISION FOR BAD DEBTS TO # 181 PROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. 71 \TISFACTION OF. _FROM INSURANCE, THE HOSPITAL FOLLOWS ESTABLISHED GUIDELIN} LACING CERTAIN PAST DUE BALANCES WITH _ COLLECTION AGENCIES, SUBJECT T0 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. BAD DEBT EXPENSE IS RECORDED USING THE VALUATION METHOD AS OUTLINED IN ICARE FINANCIAL MANAG! SOCIATION (HFMA) STATEMENT 15, WHICH H REQUIRES BAD DEBT EXPENSE TO BE RECORDED AT THE AMOUNT THAT THE PAYER IS. ;CTED TO PAY. THE PROVISIO! EPRESENTS ESTIMATED UNCOLLECTIBLE CHARGES OF PATIENTS WNWILLING TO PAY. IN 2014, THE ‘even ‘Schedule H (Form 880) 53 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21Fu \TTON_FOR UNINSURED BRIN: PATI HAVE NOT SUPPL: ISITE INFORMA‘ ETERMINE IF THEY QUALIFY FOR CHARITY CARE. THE APPLICATION OF THIS ADDITIONAL INFORMATION IN 2014 RESULTED IN ADDITIONAL PATIENTS QUALIFYING FOR CHARITY CARE AND A REDUCTION TO BAD DEBT EXPENSE. PART III, LINE 8: MEDICARE COSTING METHODOLOGY: THE ORGANIZATION USED THE FILED 2014 CMS COST REPORT TO DETERMINE THE MEDICARE ALL‘ E COSTS OF CARE RELATING TO PAYMENTS RECEIVED FROM MEDI MEDICARE SHORTFALLS, WHI B_COST INCURRED BY HOSPITAL TO PROVIDE ITY 19 PAT: SH TREATED COMMUNITY TO NOT 1 Hl costs WOULD IALLY LIMIT OR EVEN COMPROMISE THE QUALITY OF SERV: _ PROVIDED. PART ITI, LINE 9B: a AT SUCH TIME THAT A PATIENT EXPRESSES A FINANCIAL CONCERN, THE PATIENT WILL _BE OFFERED THE OPPORTUNITY TO APPLY FOR TY CARE. ONCE THE PATIENT SUBMITS THE COMPLETED CHARITY CARE APPLICATION, THE ACCOUNT 18 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. IE 1008 CHARITY IS AWARDED, THEN NO BILL IS TO IF LESS THAN 100% CHARITY CARE IS AWARDED, THAN THE PATIENT WILL RECEIVE A BILL PURSUANT 10 THE PRIVATE PAY COLLECTION POLICY. ONLY APTER PATIENT'S LIABILITY HAS BEEN DETERMINED FOLLOWING PROCESSING OF APPLICATIONS FOR GOVERNMENT ASSISTANCE, CHARITY Ci AND/OR INSURANCE CARRII ITTANCE 54 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21rs * FPR Sbeomarmranenion Comnaroy F THR HOSPITAL. TION POLICIES API Pi oO PART VI, LINE 2: THROUGH A TWELVE YEAR COLLABORATIVE EFFORT WITH OB COUNTY DEPI Ir. OF PUBLIC HEALTH, AND THE FOLLOWING OTHER HO; F MONROE Ci ARE PARTNERS IN HELPING TO IDENTIFY UNMET AND EMERGING HEALTH CARE NEEDS IN THE TY: L)_UNITY HOSPITAL A) STRONG MEMORIAL HOSPITAG 3) HIGHLAND HOSPITAL PUBLIC PARTICIPATION AND ASSESSMENT OF PUBLIC HEALTH PRIORITIES AND NEEDS OF MONROE COUNTY ARE ACCOMPLISHED USING A PROCESS KNOWN AS HEALTH ACTION. CTION IS A CO} oI Rt INTTIA’ COORDINATED BY THE MONROE COUNTY DEPARTMENT OF PUBLIC HEALTH. THE VISION OR HEALTH ACTION IS Ct .E IMPROVEMENT IN HI STATUS IN MONROE COUNTY. THIS IS IMPLEMENTED BY SELECTING PRIORITIES FOR ACTION FROM HEALTH GOALS IDENTIFIED IN COMMUNITY HEALTH REPORT CARDS IN EACH OF THE FOLLOWING FOCUS AREAS: = = MATERNAL AND CHILD HEALTH = ADOLESCENT HEALTH = ADULT/OLDER ADULT HEALTH ~ ENVIRONMENTAL HEALTH ‘THE PROCESS USED BY HEALTH ACTION FOR EACH FOCUS AREA ABOVE IS: _ - ASSESS HEALTH STATUS = CHOOSE PRIORITY GOALS = DEFINE LEADERSHIP = DEVELOP IMPROVEMENT PLANS PERFORM INTERVENTION: ‘Schedule H (Form 990) 55 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21eae - MEASURE THE IMPACT THE RO ER G smontal Information (Continuation) TO ACCOMPLISH A COMMUNITY ENGAGED HEALTH STATUS ASSESSMENT, THE STEERING COMMITTEE OF HEA TION ESTABLISHED FI SOMMI'TTEES TO DEVELOP THE TIAL COMMUNITY HEALTH REPORT ‘CARDS: MATERNAL/CHILD Hl LE HEALTH, ADULT HEALTH, OLDER J HEALTH AND ENVIRONMENTAL HEALTH. THESE IITTEES WERE CHARGED WI .ING_AND_ANAL TA TO IDENTIFY URES OF HEALTH STATUS F )F THE REPO! DS, IDI FIVE 70 PREPARING REPO! FOR_ PI AND_MAKING REC TIONS ABOUT PRIORITIES FOR ACTION. PUBLICATION DATES OF THE MOST RECENT REPORT CARDS ARE AS FOLLOWS: = HEALTH REPORT CARD - 21 ~_ADOLESCENT HEALTH REPORT CARD - 2006 = ADULT, Jf HEALTH REPORT = 2008 = ADULT TH ASSESSMENT - 2012 AFTER THE PUBLICATION OF EACH REPORT THE REPORT CARD COMMITTEE HOSTS A SERIES OF COMMUNITY FORUMS WITH HEALTH PROFESSIONALS. COMMUNITY ORGANIZATIONS AND MONROE COUNTY RESIDENTS IN ORDER TO OBTAIN INPUT ON WHICH HEALTH GOALS SHOULD BE PRIORITIES FOR ACTION. DURING THE FORUMS BRIEF PRESENTATION OF THE GOALS AND MEASURES C NED (IN THE REPORT CARD. FORUM PARTICIPANTS ARE THEN ASKED TO RANK THE GOALS BASED ON THE FOLLOWING CRITERIA: =IMPORTANCE ; SENSITIVITY TO INTERVENTION; =CONTROL; AND TIMELINESS: N_ADDI' MICIPANTS ARE ASKED WHICH GOAL THEY THINK SHOULD BE A “com ‘Schedule H (Form 990) 56 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21D 22 ITH 284 PARTICIPANTS INCLUDING YOUTH, PARENT! D ROFESSIONALS THAT WORK WITH YOUTH. BASED ON THE FEI RECEIVED NG ‘THE FORUMS, THE BOARD OF HEALTH, IN 2007 RCTED i OWING GOALS AS _ PRIORITIES FOR ACTION: ~ INCREASE PHYSICAL ACTIVITY AND IMPROVE IN = BUILD YOUTH ASSETS | IN 2008, THE ADULT/OLDER ADULT HEALTH REPORT TEE CONI 2: HEALTH FORUMS AND OBTAINED FEEDBACK ABOUT HEALTH PRIORITIES FROM 450 ADULTS, OLDER ADULTS, PROFESSIONALS REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS THAT WORK WITH THIS POPULATION. BASED ON THE FEEDBACK OBTAINED DURING THE FORUMS, THE BOARD OF HEALTH, IN 2009 THE FOLLOWING GOALS AS PRIORITIES FOR ACTION. LT LDER ADULT HEALTH: =_INCREASE PHYSICAL ACTIVITY AND IMPROVE NUTRITION =_IMPROVE PREVENTION AND MANAGEMENT 0) NIC DIS} =_IMPROVE Mi TH (REDUCE VI ADULTS AND ELDER ABUS! AMONG OLDER ADULTS) . IN 2010, THE THREE YEAR PLAN OF ACTION FOR THE COMMUNITY COLLABORATIVE FOCUSED ON TWO PREVENTION AGENDA PRIORITIES: = INCREASE PHYSICAL ACTIVITY AND IMPROVE NUTRITION a | = IMPROVE PREVENTION AND MANAGEMENT OF CHRONIC DISEASE. ALL_OF THE PARTICIPATING HEALTHCARE AGENCIES, INCLUDING RGHS, COMMITTED TO DEVELOP AND ENHANCE THEIR PHYSICAL ACTIVITY AND NUTRITION INITIATIVES WITHIN THEIR OWN ORGANIZATION TO POSITIVELY AFFECT THEIR EMPLOYEE AND PATIENT POPULAT: INCLUDING FREE NUTRITION CLASSES 18, FOOD PRICING STRATEGIES TO ENCOURAGE HEALTHY FOODS AND FOCUS ON CREATION. OR ENHANCED ACCESS TO PLACES THAT ENCOURAGE PHYSICAL ACTIVITY. AS THE THIRD ST _EMPLOVER IN THE C( THER INTTIAT: PI ‘Schedule H (Form 900) 57 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21WALKING TRAILS, WALK | COLLABORATIVE WITH THE OTHER Ci HOSPITALS AND INSURANCE COVERAGE FOR PROGRAMS IN NUTRITION & WEIGHT MANAGEMENT SERVICES TO MANAGE OBESITY. THE INITIATIVES TO IMPROVE REVENT I! MANAGEMENT OF Ci ISEASE ARE: ~=_IMPROVE ASTHMA CARE OF CHILDREN TABL: HE BREATH OF HOPE ASTHMA PROGRAM. = IMPROVE DIABETES CARE IN PRIMARY CARE OFFICES BY CONTINUING TO_IN( ER OF P' PHYSICIANS WHO ~CERTIFIED IN DIABETE: CARE USING THE REGIONAL QUALITY IMPROVEMENT MODEL IMPLEMENTED INITIALLY IN 2009. ANEW ADULT HEALTH SURVEY ADMINISTERED INS! AND_SUMME! 2012 COLLECTING 1800 RES! F WHICH HALF WE! ITY ZIP CODES. THE CITY CODES WERE OVERSAMPLED TO ENSURE DATA WAS COLLECTED FROM A BROAD CROSS SECTION OF RESIDENTS TO ENSURE IT INCLUDED LIMITED INCOME, AFRICAN AMERICAN AND LATINO RESIDENTS. THOSE RESULTS WT LYZED IN 2013 AND ALONG WITH OTHER NYS AND LOCAL DATA INCLUDING MORTALITY, HOSPITALIZATION AND DISEASE AND COND! ECIFIC DATA. THE NEXT JUTION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND PLAN WILL INTEGRATE THE LOCAL FINDINGS AND CONSIDER THE NEW YORK STATE PREVENTION AGENDA, WHICH CONTINUES TO FOCUS ON PRIORITY AREAS OF PREVENTING CHRONIC DISEASE, PROMOTING HEALTHY AND SAFE ENVIRONMENTS, HEALTHY WOMEN, INFANTS AND CHILDREN, PROMOTING MENTAL HEALTH AND PREVENTING SUBSTANCE ABUSE AND 2 TD, VAC PREVENTABLE Di E_AND. HEALTHCARE ASSOCIATED XINFECTIONS. FOLLOWING THE ASSESSMENT, THE COMMITTEE CONDUCTED A PRIORITIZATION PROCESS ir IL! FOUR MAIN HEALTH “soars ‘Schedule H (Form 690) 58 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21COMMUNITY : 1. OBESITY RATES SMOKII 7 PECIALLY CITY RESII 3. BLOOD PRESSURE CONTROL FOR THOSE DIAGNOSED WITH D_PRESSURE. 4. CHRONIC DISEASE MANAG! THE THREE YEAR PLAN OF ACTION 2014-2016 DEVELOPED TO IMPi iE -HEALT! PRIORITIES POR THE AREA WERE: PRIORITY 1: ITE WELLNESS - HOSPITAL WILL MAKE THREE SIGNIFI *TTONS TO E THE WELLNESS OF THEIR EI EES IN THREE YEi ROCHESTER GENERAL HAS OPENED A_FREI EMPLOYERS F. ENTER WITH CLASSES INT, AND WELLNESS SUPPORT. THE ORGANIZATIONS WILL ALSO REACH OUT TO SUPPORT SMALL AND MEDIUM ESSES TO MODEL Wi SS INITIATIVES. PRIORITY 2: SMOKING CESSATION - EACH HOSPITAL WILL PUT A. POLICY IN PLACE ‘TO PROACTIVELY ENROLL PATIENTS IN THE NYS OPT TO QUIT) PROGRAM PRIORITY 3: IIC_DISEASE MAN) ~_IN PARTICULAR, THERE IS COMMUNITY WIDE BLOOD PRESSURE COLLABORATIVE TO WITH PARTICULAR FOCUS ON OUTREACH TO THE AT RISK URBAN POPULATIOI PART VI, LINE 3: ROCHESTER REGIONAL INFORMS INDIVIDUALS OF AVAILABLE FREE OR REDUCED PRICE SERVICES AT THE TIME OF REGISTRATION PATIE! PATIENT, EMERGEN( ‘DEPARTMENT, AND LONG-TERM CARE FACILITIES. POSTERS INFORMING THE em, ‘Schedule H (Form 680) : 59 14411104 781828 20097.3010 2014,04030 THE ROCHESTER GENERAL HOSPI 20097_21{om 901 ‘THE ROCHESTER GENERAL HOSPITAL ___16-0743134 Paws, ed [Part Vi Supplemental Information (Continuation) _ SHURES WIDELY DISTRIBUTED IN THE ITY AT HEALTH F: iS, AND OTHER PUBLIC LOCATIONS. INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE TS ALSO AVAILABLE THROUGH ROCHESTER REGIONAL'S WEBSITE AND PATIENTS WITH A SELF-P, FX IE: )UR_FINANC: ASSIST) PROGRAM VIA THE PATIENT'S 8° ". ROCHESTER REGIONAL OFFE: EVERAL INITIATIVES TO HELP INDIVIDUALS IN OUR Ci TTY ACC! FC LE. HEALTH CARE, INCLUDING: : = FA TE = 0 ASSIST ELIGIBLE INDI 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 SPECL DS. _A DEDICATED ‘TELEPHONE NUMBER IS AVAILABLE AND INFORMATION I$ PUBLISHED IN PAMPHLETS AT GHS SITES AND AT VARIOUS LOCATI( TY. ~ FINANCIAL ASSISTANCE PROGRAM - THE ROCHESTER REGIONAL FINANCIAL = ASSISTANCE PROGRAM OFFERS FREE OR REDUCED-PRICES FOR PATIENTS TREATED AT A_ ROCHESTER REGIONAL HOSPITAL, OUTPATIENT, EMERGENCY R( OR LONG-TEI E ACILITY. DISCOUNTS ARE AWARDED BASED UPON INC AND_ASSET VERIFICATION. INDIVIDUALS WHO DO NOT QUALIFY FOR MEDICAID, CHILD HEALTH PLUS, FAMILY ‘TH PLUS, PRENATAL SISTANCE PROGRAM, TATE AID FOR CHILDREN WITH SPECIAL NEEDS ARE CONSIDERED FOR FINANCIAL ASSISTANCE (CHARITY CARE). PART VI, LINE 4: ROCHESTER GENERAL HOSPITAL SERVES MORE THAN ONE MILLION PEOPLE EACH YEAR, PRIMARILY FROM THE CITY OF ROCHESTER AND SURROUNDING AREAS OF MONROE. COUNTY. LAST YEAR 94,000 PATIENTS VISITED THE EMERGENCY DEPARTMENT, AND gam ‘Schedule H (Ferm 980) 60 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21Part Vi ‘Supplemental Taformation BN + IN MONROE UR_PRI IRVICE AREA, THE POPULATION IS 76% WHITE, 14% AFRICAN AMERICAN, AND 6% HISPANIC (AMERICAN COMMUNITY SURVEY 2005-2009). FROM AMERICAN COMMUNITY SURVEY 2005-2009 INFORMATION, APPROXIMATELY 14% 01 IN COUNTY ARE LIVING \T_OR BELOW THE POVER‘ EL. IN THE CITY OF ROCHESTER ITSELF, HOWEVER, THE POPULATION IS MUCH MORE DIVERSE: 428 ARE WHITE, 38% ARE AFRICAN AMERICAN AND 13% ARE HISPANIC OR LATINO. THE CITY OF ROCHESTER HAS A TY RATE IS DOUBLE 7 F THE ENTIRE COUNTY AT 29.18. Ri TER 1 ALSO ONE OF ONLY FOURTEEN CITIES NATIONWIDE (AND ONE OF TWO IN NEW YORK. TATE) THAT IS DESIGNATED BY TI OFFICE OF REFUGEE RESETTLEMEN’ FOR THE UNACCOMPANIED REFUGEE MINORS PROGRAM, AND BECAUSE OF THIS AND OTHER SIGNIFICANT PROGRAMS F‘ RESETTL WE HAVE AN UNUSUALLY. GE ER_OF INDIVIDUALS ARE FOREIGN-BORN AND SPEAK A. 1B OTHER Ti LISH. IN ADDITI ROVIDING HIGH-QUALITY SERVICES TO INDIVIDUALS FROM THROUGHOUT TH ECAUSE ROCHESTER GENERAL HOSPITAL u F THE POOREST AREAS WITHIN ITY, WE PROVIDE A HEALTH CARE "SAFETY NET" FOR A SUBSTANTIAL AND DIVERSE POPULATION OF LOW IE AND UN- OR UNDERINSURED INDIVIDUALS IN. ROCHESTER AREA. PART VI, LINE 5: MEDICAL STAFF RGH MEDICAL STAFF HAS 758 CURRENTLY ACTIVE STAFF MEMBERS. THESE PHYSICIANS REPRESENT A BROAD SPECTRUM OF PRIMARY CARE AND SPECIALTY SERVICES. AS AN AFFILIATE OF ROCHESTER REGIONAL HEALTH, OUR PATIENTS HAVE SEAMLESS ACCESS 0 ADDITIONAL SPECIALISTS INCLUDING ‘THE WORLD-CLASS PROVIDERS AT THE ROCHESTER HEART INSTITUTE AND THE DI CER ER BOTH IN PENFIELD AND EST! a SonedleH Form 060) ; 61 14411104 781828 20097-3010 _2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21VOLUNTEERS /AUXILIANS_____ MEMBERS OF COMMUNITIES FROM ACROSS MONROE AND SURROUNDING COUNTIES HAVE ___ ALWAYS PLAYED AN IMPORTANT ROLE TN ADVOCATING FOR. AND OFFERING ASSISTANCE. AT_RGH. IN 2014, 598 VOLUNTEERS PROVIDED MORE THAN. 60,000 HOURS OF SERVICE. AT_RGH. BOARD OF DIRECTORS AND COMMUNITY GUIDANCE = RGH_ENSURES COMMUNITY CONTROL OVER THE CORPORATION THROUGH 27S BOARD OF DIRECTORS, COMPRISED OF COMMUNITY AND FAITH LEADERS, AND LEADERS IN BUSINESS AND INDUSTRY, HEALTHCARE, AND PHYSICIANS REPRESENTING TH MEDIC: STAFF OF THE ORGANIZATION. THE MAJORITY OF THE DIRECTORS RESIDE IN ROCHESTER AREA AND BACH DIRECTOR SERVES A THREE-YEAR TERM. USE_OF SURPLUS FUNDS SURPLUS FUNDS ARE USED 10 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 AS WELL AS USED FOR CHARITY CARE. = PART VI, LINE 7, LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: NY ~ PART VI, LINE 6: ROCHESTER REGIONAL HEALTH (ROCHESTER REGIONAL) (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 0. ESTE WAL IS THE ‘eon ‘Schedule H (Form 800), 62 44411104 781828 20097.3010 -2014.04030 THE ROCHESTER GENERAL HOSPT 20097_21& THE GENERAL HOSPT7) 16-07431. [Pari StppienontaTivonnetes eee _ _ zi LARGEST EMPLOYER IN ROCHESTER AND AN INTEGRAL PART OF THE COMMUNITY. ~ ROCHESTER REGIONAL HAS A NATIONALLY RECOGNIZED HEART PROGRAM AND A = MANY OF THE SAME LEADING EDGE TREATMENT OPTIONS FOUND AT THE COUNTRY'S FINEST MEDICAL CENTERS. FROM SURGERY TO ORTHOPEDICS, iEN' S H_TO EMERGENCY CARE, PEOPLE ALL ACROSS WESTERN NY TURN T0 ROCHESTER REGIONAL HOR 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. ROCHESTER REGIONAL REPRESENTATIVES ARE ACTIVELY ENGAGED IN VARIOUS COMMUNITY HEALTH COLLABORATIVE WITH THE LOCAL HEALTH DEPARTMENTS, STATE HEALTH DEPARTMENT, AND LOCAL 1OT-FOR-PROPIT HEALTH AND HU! ERVICE AGENCIES. ROCHESTER REGIONAL 1. RESPONSIVE TO COMMUNITY PRIORITIES AND DEVELOPS PROGRAMS AND SERVICES THAT FILL A GAP OR SUPPLEMENT AN EXISTING PROGRAM. MOST ROCHESTER _ REGIONAL COMMUNITY HEALTH OUTREACH PROGRAMS ARE OFFERED IN PARTNERSHIP ‘WITH OTHER COMMUNITY ORGANIZATIONS OR GOVERNMENTAL AGENCTES, IN ORDER ‘TO LEVERAGE RESOURCES TO MEET COMMUNITY NEEDS. INFORMATION REGARDING _ ‘THE AVAILABILITY OF COMMUNITY HEALTH PROGRAMS, ASSISTANCE WITH HEALTH 7H INSURANCE ENROLLMENT AND FINANCIAL ASSISTANCE FOR MEDICAL CARE RECEIVED AT_ROCHESTER REGIONAL HOSPITALS, EMERGENCY DEPARTMENTS, OUTPATIENT. DEPARTMENTS OR LONG-TERM CARE FACILITIES ARE DISSEMINATED 70 THE PUBLIC IN_ELECTRONIC (WEBSITE) FORM. ROCHESTER GENERAL HOSPITAL (RGH), THE FLAGSHIP OF THE ROCHESTER REGIONAL HEALTH, IS A REGIONAL LEADER IN HEALTH CARE. THIS 528-BED - ACUTE CARE, TEACHING HOSPITAL SERVES THE GREATER ROCHESTER, NY REGION LY RECOGNIZED PROGRAMS ‘Schedule H (Form 990), 63 411104 781828 20097.3010 —_2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21HAVE CONSISTENTLY DEMONSTRA‘ ALITY OUT‘ THAT POSITIVELY IMPACT PATIENTS, THET! LIES HE ENTIRE Ci ITY. ROCHESTER GENERAL. PROVIDES Ci MONROE TY_RESIDI THAN IER_HOSPIT) IN THE REGION AND, AS A TERTIARY CARE FACILITY, HAS STRONG REFERRAL RELATIONSHIPS WITH REGIONAL HOSPITAL! RAL OFFE! A_FULL ARRAY OF SERVICES TO MERT THE MEDICAL NEEDS OF UPSTATE NEW YORK, INCLUDING NATI Y RE ‘ZED PROG! IN CARDIAC, CAN! R! si AND_DI: {TINCTIONS FOR QUALITY INCLUDE DESIGNATION AS A SOLUCIENT/THOMPSON TOP 100 CARDIAC HOSPITAL AND DESIGNATI( YORK STATE AND THE JCAHO AS ACCREDITED STROKE "ER. ITY CLINICAL CARE PROVIDED AT ROCHESTER GE Ig AMPLIFIED BY RELATIONSHIPS AND AFFILIATIONS WITH NATIONALLY RENOWNED INSTITUTIONS SUCH AS THE CLEVELAND CLINIC (FOR CARDIAC CARE) AND ROSWELL PARK CANCER INSTITUTE. ITY HOSPITAL IS LOCATED iB UNITY Pi DGE HEALTH pUS IN THE TOWN OF GREECE AND IS PART OF UNITY 4TH SYSTEM. KEY PI INCLUDE UNITY HOSPITAL'S JOINT REPLACEMENT CENTER, FAMILY BIRTH PLACE SPINE CENTER ES, CENTER, STROKE CENTER, EMERGENCY CENTER CHEMICAL DEPENDENCY, AND BRAIN INJURY & REHABILITATION. IN_AN EFFORT TO PROVIDE THE BEST POSSIBLE PATIENT CARE, UNITY HOSPITAL COMPLETED A FOUR-YEAR $158 MILLION MODERNIZATION AND EXPANSION PROJECT ‘THAT RE-ENGINEERED THE HOSPITAL CAMPUS TO MEET THE NEEDS OF THE COMMUNITY. TODAY, THE 154-ACRE UNITY HOSPITAL CAMPUS IS A 268-BED HOSPITAL THAT D 10 gen, ‘Sohedule H (Form 890) 64 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21THE ROCHESTER G Fora 990) [|| Supplemental Information (Continuation) NEWARK-WAYNE COMMUNITY HOSPITAL (NWCH) SERVED GENERATIONS OF 1B 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 REGIONAL HEALTH, AND HIGHLY TRAINED STAFF, NWCH CONTINUES TO GROW IN EVERY ASPECT OF ITS HEALTHCARE . THE HOSP: IS LICENSED TO OPERATE 120 ACUTE BEDS. wi: INCLUDES: 82 MEDICAL/SURGICAL BEDS, 16 ‘AL HI EDS, = 8 ICU BEDS AND 14 OBSTETRICAL BEDS. NWCH ALSO OFFERS A FULL ARRAY OF OUTPATIENT SERVICES i EMERGENCY DEPAR’ i REHABILITATION, LAB SERVICES, DIAGNOSTIC IMAGING, REHABILITATION ERVI AS WELL AS LAB DRAW STATIONS AND PATIENT IMAGING OTHER PARTS OF WAYNE COUNTY. IN RESPONSE TO COMMUNITY NEED, NWCH OPENED THE DEMAY LIVING CENTER IN 1994, A 180-BED SKILLED NURSING FACILITY. \Y_LIVING CENTER OFFERS SKILU IRSING CARE, A DEMENTIA UNIT NEI HAVIORAL UNIT, BILITATION DEP: IL! DAY CARE. INL! H ESTABLISHED THE WAYNE COUNTY RURAL HEALTH NE! REN, TO ENCOURAGE GREATER COLLABORATION AMONG HEALTH AND SOCIAL SERVICE GI THIN WA’ OUNTY IN ORDER TO PROVIDE GREATER ACCESS NEEDED SERVICES AND T0 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 OVER 40 YEARS OF EXPERIENCE AND TRADITION. RMHC HAS COMPREHENSIVE RVICES. AND DEDICATED MEI HEALTH. wy ABUSE PROFESSIONALS ‘Schedule H (Form 980) 65 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21AS_PRODUCTIVE MEMBERS OF THE COMMUNITY. THEY OFFER: oA REHENSIVE SYSTEM OF CLINICAL HEALTH SERVICES ~READILY-ACCESSIBLE LY-SENSITIVE SERVICES UNIQUELY MATCHED TO ‘THE INDIVIDUAL NEEDS OF EACH PATIENT AND THEIR FAMILY CONVENIENT ACCESS TO MENTAL PATI ERVICES WITH LOCATIONS THROUGHOUT THE GREATER ROCHESTER AREA AN _UNWAVERING COMMITMENT TO SERVE THOSE IN THE COMMUNITY WHO HAVE EMOTIONAL NEEDS. PRCD, INC. OFFERS TWO COMMUNITY RESIDENCES THAT ARE UNIQUE TO UPSTATE YORK, ONE FOR AD‘ MALES, E_OTHER FO) . THESE ID) PROVIDE A STABLE HOUSING ENT. CHEMTCAL. DEPENDENCY TREATMENT, INDEPENDENT LIVING FOR SENIORS (ILS) OFFERS A PROGRAM THAT GIVES THE IL ELDERLY AN ALTERNATIVE TO NURSING HOME PI IT 1 }IGNED 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 a ‘Schedule H (Form 880) 66 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21PECIALTY SERI NURSIN ; ACUTE HOSPI' “ARE; IN-HOME SER) i ESCIPLINARY CONSULTATION; AND NURS: CARE SH THE NEED ARISE. EDNA TINA WILSON LIVING ER IS A_120-BED LITY THE EDNA TINA WILSON LIVING 3ES_AN INNOVATIVE NETGHB WITH RESIDENT ROOMS CLUSTERED AROUND THE ACTIVITY CENT! THE LD AND DINING AREAS MOTE MORE SOCI: TERACTIVE LIVING. EDNA TINA WILSON LIVING CENTER CARES FOR THE PHYSICAL AND MEDICAL NEEDS F_RESIDENT: 18_A NATIONAL CARE FOR THE SPECIAL NEEDS OF THOS ALZHEIMER'S DISEASE AND R_MEMORY IMP! . THE LIVING CENTER ALSO SPECIALIZES IN PAL EMENT, RESPT ‘THERAPY, IV. THERAPY, PERITONEAL DIALYSIS SERVICES, RESPITE CARE, AND HOSPICE CARE. FOR ITS RESIDENTS. PARK RIDGE LIVING CENTER PARK RIDGE LIVING CENTER IS A 120-BED SKILLED NURSING FACILITY THAT INCLUDES THE FAMILY COTTAGES THE 40-BED TIMOTHY R. MCCORMICK ‘TRANSITIONAL CARE CENTER. ‘THE WEGMAN FAMILY COTTAGES ARE DESIGNED AROUND THE SMALL HOME CONCEPT. EACH OF THE FOUR RANCH- COTTAGE HOMES HAS 20 PRIVATE ROOMS, EAC} WITH A PRIVATE BATH. THE CENTRAL DINING AREA IS EASILY ACCESSIBLE WITH ADJACENT KITCHEN AND LIVING ROOM AREAS. THE KITCHEN IS DESIGNED TO ENCOURAGE PARTICIPATION OF THE ELDERS IN MEAL PLANNING AND PREPARATION. sper ‘Schedule H Form 000) 67 04030 THE ROCHESTER GENERAL HOSPI 20097_21 14411104 781828 20097.3010 201.THE WEGMAN FAMILY COTTAGES EMBRACE A NEW MODEL OF CARE FOR LIVING ELDI WHERE THEY ARE_EN( GED TO MAKE THEIR CHOICES, AND ENVIRO! IN WHICH THEY WILL LI" EB LIFE JOURNEY. OFTEN REFERRED TO AS TEE CUL: WE MODEL, THIS IS A NEW APPROACH | TRADITIONAL SKILLED ING CAR} INING A CARING PI SOPHY, | ORGANIZATIONAL ICTURE, AND INVITH \CHITECT! THIS APPR HAS CAREFULLY Ri ‘INSTITUTIONALI! FROM THE LONG-TERM CARE MODEL. PART VI, LINE 6 (CON''?): ECIALIZED SERVICES INCLUDE PHYSICAL CCUPAT: ‘THERAPIE: SPEECH-LANGUAGE PATHOLOGY, MEDICAL CARE, SPECIALIZED DIETARY SERVICES SOCIAL WORK SERVICES, AND PHARMACY SERVICES. IN ADDITION, SEVERAL | SPECIALTY SERVICES ARI ED, _ INCL PSYCHIATRY, ISTRY, AND. PODIATRY. ROCHESTER GENERAL 1 "BRM 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 DEMENTIA THE GOAL I$ TO HELP RESIDENTS REACH THEIR GREATEST sL_OF PHYST WELL-BEING. THE =I ‘Schedule H (Form 880) 68 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21INGLII RECREATION, AND BEAUTIFULLY ED GI . RESIDENT! HAVE ACCESS 10 IN-HOUSE MEDICAL CARE PROVID} PHYSICIANS, NURSE PRACTITIONERS AND A RANGE OF MEDICAL AND REHABILITATION SPECIALISTS. HILL HAVEN IS COMMITTED 10 HELPING SENIORS STAY AS CONNECTED TO THE COMMUNITY AS POSSIBLE WITH TAL PROGRAMS OR FOR FAMILY AND_FRIENDS. | ITY'S 0 P_OFFERS 539 IJ LIVING, ASSISTED LIVING. MEMORY CARE, AFFORDABLE AND SUBSIDIZED APARTMENTS IN FIVE LOCATIONS. VILLAGE AT UNITY WAS ONE OF THE FU EPENDENT LTV) COMMUNITIES IN THE AREA AND IS ONE OF THE LARGEST AND WELL RESPECTED COMMUNITIES AND CATERS TO SENTORS LOOKING FOR SUPERIOR HOSPITALITY ERVICES. IN 2013, A $22 MILLION EXPANSION PROJECT WAS COMPLETED, | ADDING 20 NEW MEMORY CARE APARTMENTS, A NEW ASSISTED LIVING COMMUNITY, COMMUNITY CENTER AND MORE DINING OPTIONS. PARK RIDGE CHILD CARE CENTER IS THE FIRST ONLY CHILD YER I ‘MONROE COUNTY TO BE AWARDED THE PRESTIGIOUS PATHWAYS NATIONAL | ACCREDITATION, AND CARES FOR NEARLY 150 CHILDREN OF UNITY EMPLOYEES AND. ‘THE COMMUNITY PER DAY. ACM MEDICAL LABORATORY IS A FULL SERVICE CLINICAL AND PATHOLOGY LABORATORY CONDUCTING MORE THAN 15 MILLION TESTS EVERY YEAR FOR NURSING HOMES, DOCTORS, COLLEGES, PRISONS AND COMMUNITY HOSPITALS ACROSS THE UNITED STATES. ACM IS ONE OF THE WORLD'S LARGEST PROVIDERS OF CLINICAL TRIALS TESTING, WITH WHOLLY OWNED LABS IN THE U.S. AND U.K., AND ‘Schedule H (Form 880) 69 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21Eom 990) SHE ROCHESTER GENERAL HOSPITAL 16-0743134 rams Part Vi] ‘Supplenontal formation (Continuation INI PATHOLOGY AND MOLECULAR TESTING. ACM IS THE LARGEST PATIENT LAB IN ROCHESTER. ae OCHESTER GENERAL HOSPITAL FOUNDATION, UNITY HEALTH SYSTEM FOUNDATION AND NEWARK WAYNE Ci PITAL Bi PIONS: THE VITAL SERVICES THAT ROCHESTER REGIONAL PROVIDES TO 'tHE COMMUNITY WOULD NOT BE POSSIBLE WITHOUT THE FOUNDATION SUPPORT. IN THE NONPROFIT ORGANIZATIONAL, {TRUCTURE THE Ft TIONS MPICAL T0 THE ABILITY TO MAKE ING. IN_STATE-OF-THE-ART MEDICAL TECHNOLOGY, IICAL_PI 8. FACILITIES, RESEARCH AND EDUCATION THAT BENEFIT THE COMMUNITY AS A WHOLE. THE IMPACTS OF THE FOUNDATIONS’ EFFORTS ARE VISIBLE THROUGHOUT THE HOSPITALS, AND IN THEIR DISTINGUISHED CENTERS 01 ELLENCE. THE UNDATIONS '_F' ISING PROC pq ¥ 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 ARB SERVED IN ‘THE COMMUNITY. ez ‘Sahedile H (Form 680) 70 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21‘oe wuod ny swononana on 98 none iy vononpey youioded edn TSE FEEFEOSROS, wai eceang (0 ont A] venospe a pa sourite 0 si enn feo see SoUaeo 0 mB no WOU eg MENIeeee rewrn errand ee tm esoa + ‘Souniiey PUP Ue vo woRPUOI eueD | TARE PETERLO-ST 22 qunu uoReoyRap sako}dur "WLIGSOW TWEaNaD ESiSaHOOd AHL weasadeuy ‘nang owed EL0e "22.0 12 24 'AL Hed 6 wt Oh 004, posonsuE uoREZUEED aH EEC SO}EIS PawU ot UI s[eNPINIpUl pur ‘sjUaUULEACD ‘SUOREZIUBBIQ 0} SOUENSISSY JNO PUE SINEAD VoEUEBIO ay Jo aN(0x6 wo) rompoues eh TEE TTS TGF TCS ATIC TERUORN EROT T XeTOMIDEL 4O EINSTISNT WEISHNOOU (orno esmeidde “AW 909) | souRmsse sounissee 10 Jeoumsrsse yreouou| —Nogemen vyscousy | yues6 yseo | ayqeondde wuuen08 10 voeauEB:0 web yo oroding (W) wovondicseg (6) | sopomenG) | jownouy(e) | jounouy(p) | uomesoue) | Nee ee) Tir vec TORS Wibal| OMONER) SOV POU Sia WI SUPER UTED pus SUEUUBNGD oy SSUBISSSY JRO PUN GUE 10 WORENUAIO [VEG WILdSOH TWEENS USISHHOON GL —WssunTToNETES+ ioe) 066 we) ompaueS, “SHOTIVZINYOWO (E)(O)TOS GHHLO OL SNOLLMETHENOO SHXWA KINO HOW “INEWAWE JO SONWISSI OL WOTWd SONNE JO GSH NW NOTIVZTEOHIAY HIVIUdOuddY OE CHMAIAGN GUY SHHCUO SSVADMNE ONY ISHNOET HORA Te SNTT "Tavs (ego yoaade 7 counsse yseouou jo uoackosea wy _| Ubabereaye pau) sousianee Wee ssw yo wunouy (| cor sounouy 0) ‘aundoar sesequnn (a) eourstsse 20 wes Jo echt (0) {220 N ved ‘068 wg 1 ,80,, poreNsvE UONEZURELO aka yecUOD “sENPINIpUT RESORT er TWHSNG! ‘epee 5 ede uM peveyd oa => 1 vee srecumersy ono pursed [Tse | SAL Wie Gas wor aR WHLSTEOOR14411104 781828 20097.3010 SCHEDULE J Compensation Information (Form 990) For certain Officers, Directors, Trustees, Key Employees, and Highest ‘Gonpetanted Ebjees > Complete if the organization answered "Yes" on Form 990, Part IV, line 23. paste ney De atach 0 Frm 200. 2014 ‘Name of the opanizaion Erplyerleeitetion numba? |_46-0743134 _ [Part | Questions Regarding Compensation +8. Chook the appropiate boxes) the organization provided any of the fllowing to or fora person iste in Form 990, Part Vil Section A, ne ta, Complete Part Il to provide any relavant information regarding these tems. [) Fest-ciass or charter travel 1 Housing siowance or residence for personal use [1 travel for companions [1 Payments tor business use of personal residence ‘Taxindemnitlation and grossup payments Heath or social chub dues or Initiation fees Discretionary spending account Persona sevioes (6, mad, chauffeur, chet b Ifany of the boxes on in ta are checks, did the organization flow a written poy regarding payment or reimbursement or proviion of al ofthe expenses described above? If "No," complete Part Ito explain 2 Did the organization require substantiation prior to rlmbursing ralowing expenses incurred by al rectors, trustess, and officers, Inoluding the CEO/Executive Director, regarding the items checked in tn Ya? 8 Indleste which, eny, ofthe folowing the fig orgniztion used to estabih the compeneation ofthe organization's ‘CEO/Executive Drector, Check alltht apply. Do not check any boxes for methods used by arelated organization to ‘ostabish componsation ofthe CEO/Executive Diector, but explain Pat {J compensation commnittoo (2) waten employment contract a Independent compensation consultant {) compensation survey or study Form 990 of other organizations [approval by the board or compensation committon 4 During the year, did any person fated in Form 050, Part Vil, Section A, tne 1a, with respect tothe fing ‘organization oa related organization: 1a Receive a severance payment or changet-contal paymant? ' Partipate in, or receive payment rom, a supplemental nanquaifi retramont plan? Participate in, or eosive payment from, an squlty based compeneation arrangement... t1¥est to any of nes 48, it the persons and provide the appfcable amounts fr each tem in Pat i. ‘Only soction 601(6Ka), 601(eKA), and 801(c}20) organizations must complete fines 6-0. ‘5 Farpetsons lated in Frm 990, Part VI, Section A, ne ta, did the organization pay or accrue any compensation contingent on the revenues of: a Thoorganization? bb Any elated organization? Ife" to ti Sa or 5, desorbe In Part {6 For persons fsted in Form $90, Pat Vl, Section A, tne 1s, dd the organization pay r accrue any compensation Contingent onthe net eamings of: ‘8 Tho organization? ee b Any related ganization? —= "Yee" tone Ga or 6, describe in Parti. 7 Forpersons lated in Form 990, Pat Vl, Section A, Eno 1, id the organization provide any nonfved payments not described in ines 5 and 6? "Yas," describ in Pat I {8 Wore any emounts reported in Form 690, Part Vl, paid or acrued paravant to a contract tat was subj othe Initial contrat exception described in Regulations section 58.4858-4()(3) I Yes," describe in Part il. 8 If*Ye8"to tne 8, cid the organization alo follow the rebuttable presumption procedure described in ele bebe ele babe Figulations eoctlon €3,4056-56i? . ‘Schedule J (Form 860) 2014 [TF For Paperwork Reduction Aet Notice, soe the Instructions for Form 990. 14 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_211702 (086 w84)p oinpeuos ro ro I WS TaI TST ATES Pose" Ls ress ete | ORR THEEOE (TT) Fo Fo at "0 ro ‘xvawed WHROKGYE (OT) "0 ro THRTOTSRNT ele T99 ro 0 GONE AEMAGEC (6) "Oo 0 o ‘BNIDISAEG Fesy 850° T | ro ro s00Te WOTMIVE (8) 0 r 0 Fo RESTS soe "eset | Fo FO SID IDNA (4) regs" TOF Fese7et as re Peto" oe SWORE HOOR (9) * Pv9e "Te [c6y TST OS [-TSL"LS "885607 Foor pty 'S |Ses7eo Kg Fo F Fost’ee |scr"trt_|° Forest |rese*ew Fevc"28T |"S6test |" o6e786a"T [999609 Tr la 3 S| EI |e] ‘orn ‘wagura oraz (1) vogesuaduoa ‘geod voyesueduco | SeRUcaS! en. pur owen tv) uz auowaneu (9) | owesueduoo Osin S601 20/PUE Z-m Jo unopEara (B) Tero e492 sunour pu (a) uryoo qeoNdde "ein Y LORDS ‘A Ud "056 UO Jo sunoure feo: oY Ibe ISM ENPWIPA pes ae 20} a) SULT 3 we BL SION,0% 66 we) p omnpoUeS GHINNEIS ATAVTINIS Of Civd SHiaVIVS IHMUWN HIN INELSISNOD Guy SaTEVIVS HOOS SM0SNH OL SHATIOOGKA TI’ WO SHLEVIVS SHE MALAY Of ENWIIMSNOD NOLIVSNHGHOD INSCNHGHONT NY SaSO NOTLVZINWOWO SEL “SISVE TWONNY NV NO “SRLLINHOD NOILWSNEANO WO CaWOU AHL Ad TwAOwday = TSHTaniS ONY SAHAWNS NOTLWSNEENOO = INOLIVZINYOWO WHHIO 30 066 HOE = TNVDIMSNOD NOTIWSNHANO) INTONTGHONT = ‘SELLINWOD NOTIWSNHGNOD = TSiIaaNaG ONY NOTLVSNSdWOD WISHL HSTTAWISE OL ONIMOTION HL GHSH OOS) HSN TASSEN IaaaOU- TOW) SYROHE HOOH- TT/0E7TT TEND O85) NEGH NEWTWH (VT/0E7TT TINT O80) INSNATS Sawn (Odo) TITS SYHORE- TONIGOTONT STWIOTHdO INGASSUNWA dOL S| NOTLWZINWSYO SH JO NOLIWSNEGHOS Te SNIT “T auwa “webu euonippe Aue 05 Wed Sy aeySw0O ORY ed JO} DUE ‘s PUR Z "99°29 ‘AS "eS op ‘ah ep ‘EGE =U Wed 10} paunbes suondLoSSP 10 ‘UONEUERES “UORDUMOSA Ot9 tno WORST eoRTTRNS ea ¢ er VETEPLO-ST WETESOH TWUENED UGLSaHOOe AHL TES aTT‘702 (056 wo.) p aInpeuDS iOaS V SNTW NOTIVZINVDUO GEL “TWLTASOH TWHENED WGISHHOOW BHI JO SHMAOTANE SATION BL WHGNO CHIWGRdO SNVIG SATINGONT EVHA-LOION ONY TWONNY JO ATaTWWA WOO Ata GAY “GINNIWUAL OL GNSGHYd SYM LT CHNINUGIEd SEHLITANOO NOTIVSNaaWOD SIsva NO UNV "HIIVEH TWNOIOHY WALSHHOOW W/G/C "ONT WHISAS OY WHOT Ob SHOT SHOW dO NOTIWNIGNOO Sit WOWE ONTI rauwOd SEE 40 SHLLINNOD NOLIWSNHGHOD SATLAOGKH SEL KA OHAOWAAY NEHL SILT ONY ATIVONNY NOLIWAMOANI STHL SMAIATY SALLINNOD NOTIVSNREROD ‘voqyeuuoyu euoRIPPe Aue Jo} ye sup oycce OBy Hed 20} PUR 'g PUE 7 G9 "29 a "29 0p ‘ar ‘eh 'Esoz (06s we) f onpeNES INERT TS EWR HSOeTHSSaN LUTGOR SYAORL HBOH= TUOTAWAS WOUE NOTIVEWaaS NOAN NOTMOGIMISIO W Of GHTLTINE TIA Gavd "066 WuOd NI GHISTT SHMAOTENY AGW ONY SUHOIAIO ONIMOTION SEL "TAO ivd GaN SNOTLOSTELSIO ON “PTOt ONIHNd “NWid INSNSWLIGY GalaTIvo0-NON ‘wommuuoj UORPPE fue 0, Hed se etdWOD AtY Ed 20} PUE'g PLE‘2 ‘a9 "ED ‘GS "eS ‘oP ‘ap "EP GL. "eL SoUN Yee Jo} paunbes suondio6e 0 0 "omni venBwOH POS6L___ss.tos0)svoyonasu ou 208 canon toy wonanpey omodeg od ViT "3: ¥ ¥ ——— RTT POOR RIOT pene cows aren feu ma smniam enn in onan 3 x ¥ oN = oN = oN =r oN ) x = ¥ x x x x oN oe es oH = x ET0e recs oo oy F699 COL LOS "252" LP = ¥ ¥ NOG" LOSESIZLY | ET/L2/70 PARLSLOTICSSSS1O-1q NOLLWNOTUOD LNENAOTHARC S S00z_aswadad FIXIELSOGNI_ALNNOD FOUNON tJ ¥ ¥ ‘WWAONSE “TWLIESOH"EVOSSITS | ET/ZC/CO BORLSLOTICSSSOTO- 19 NOILWHOAHOD INANAOTHARC ¥ NIVUWID SONYNTA MLSOGNI ALNQOD SOuNOW BA [ERL OW TER] ON LSE Buu | ares atooa (yaa uo ssodind jouondiosea Wi) | soudenssi(e) | penesisieate) | eaisno(e) | Neasenest (a) ue snes) (2) ‘SNOT: (ay RADIOD HOA TA Lave ss sons] pubg Ted _ 7 Tate ope i uotape fue i ounmun saad ‘suopcsosep opioid ere ‘A 84006 tse uo 0, posse UoReeNEEI 218 3 1100 ‘Spuog idle} Xe] uo uoHeuoqu jeywousoracing wainaskosPho7 (066 wu9d) 4 npe4os T ej ¥ Dogrenb on pesewe sense yuinoO a 0 uonEeHIO ASEH ¥ x iy THR SRST Eo ETAT —E a at Sen uonducoeinge oi TEP eu A Ye SONOS 22 OFA x x = x x x = [x OH 3 or RT =i N x e o t ¥ ¥ % % % % ¥ ¥ x x % * % % % % % % % % % % ¥ = sho mx 1 osno2 ping bee HPO} VORERUEIO OP B.A. @ x x TST PEBTEU BU jo BT SBT ow =r ow 3K Om 3a BK ‘rend uy sas Kew wig eRUOD BOWES Jo weUABELMEL Aue OWN ALY ee PRET RTA TT~ 02 (056 wH8) > mpoyos NOISNVGXE ONY SNOTIVAONSY TWiTasOn NIWiUao AONWNIA Tasoduid JO NOILdTasad (a) ‘exgeouede Jopun o(geyene OU | LoRBPUeLyNS 9 wesBard woUSaIBe BUSOD ‘Arewuyon 18 YBnons payaiion puR ReUAUERY ABU a= swewieRbo XE FIepO} 10 Suge} exp sunsve oy samnpeceud usr PouRIaEIs® UoKEAUEEO oR aH oR Br ON =| aw = oH _ San SEI STRUNG] SESE AE x x oN 2ir| 3K PORTER NT VETEPLO-9T IWLIGSOH TWEEN UAISHHOOU GHa rlozmssloT WonPeRS; ws 5507 SCHEDULE O Supplemental Information to Form 990 or 990-EZ Pome es |e ea ete dr art estar armne aes 2014 orm 860 or 990-E2 oo prone any adonel information. i SeputnrtctPeasey 'b Attech to Form 600 o 900-Ez (peep ‘Name ofthe organization Employer Mentiieation number —____________THE_ ROCHESTER GENERAL HOSPITAL, ___|_16- FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION ft OF MONROE, NY FOR MEDICAL TO OPERATE THE IRGICAL AID. 1B AND TREATMENT OF PERSONS IN NEED. 990, PART IIT, LINE 1, DESCRIPTI ANIZATION MISSION: TQ ESTABLISH, ERECT AND MAINTAIN A GENERAL HO: DISPENSARY I THE COUNTY OF MONROE, NY FOR MEDICAL AND SURGI: ID. B_AND. TREATMENT OF PERSONS IN NEED THEREOF; TO CARRY ON AND CONDUCT A TRAL L_FOR Es PROMOTE AND CARRY ON SCIENTFIC RESEARCH _ RELATED TO THE CARE OF THE SICK AND INJURED; TO PARTICIPATE IN ANY ACTIVITIES DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY; AND TO ACQUIRE BY PURCHASE, LEASE OR GIFT, OR IN ANY OTHER FASHION, ANY ALL _REAL AND PERSONAL PROPERTY NECESSARY OR ADVISABLE FOR CARRYING OUT F_THE FORBG PURPOSE! 7 FORM 990 WP ITT, LINE 3, CHANGES IN PROGRAM ROCHESTER REGIONAL HEALTH WAS FORMED THROUGH A CORPORATE RESTRUCTURING WHICH BROUGHT TOGETHER ROCHESTER GENERAL HEALTH SYSTEM AND ITS AFFILIATES AND UNITY HEALTH SYSTEM AND ITS AFFILIATES ON JULY 1, 2014. ROCHESTER REGIONAL HEALTH SEEKS TO BE THE PROVIDER OF CHOICE, WHILE ADDRESSING BOTH THE ABILITY ALITY OF HEALTHCARE SERVICES THAT IT PROVID: |ESTERN NEW YORK. = FORM 990, PART IIT, LINE 4A, PR JERVICE ACCOMPLISHMENTS CHESTER REGIONAL HEALTH (RRH) COMPRISES SEVI LLHA For Paperwork Reduction Act Notice, 800 the instructions for Form 990 or 90-2. 82 14411104 781828 20097.3010 — 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21 ‘Schedule 0 (Form 680 or 990-EZ) (2014)Pad _Sehadule 0 (Form 960.5 9907) 2014) "Namo ofthe oxgantzation Employer identification number THE ROCHESTER GENERAL. HOSPITAL 16-0743134 ORGANIZATIONS THAT HAVE BEEN PROVIDING A CONTINUUM OF HIGH QUALITY HEALTH EI RESIDENTS OF GREATER ROCHESTER ROUNDING REGIONS. RRH SERVES AS THE PARENT OF THE SYSTEM. THE HEALTH CARE AEFILIATES OF RRH INCLUDE: 1) ROCHESTER GENERAL HOSPITAL (RGH) - THE FILING ORGANIZATION AND FLAGSHIP OF RRH AND INCU OCHESTER MEDICAL GROUP, A NETWORK OF 41 PRIMARY AND SPECIALIZED PHYSICIAN PRACT I! \TED_ THROUGHOUT MONROE AND WAYNE COUNTIES, 2) NEWARK WAYNE COMMUNITY HOSPITAL (INCLUDING DEMAY LIVING ER), 3) ROCHESTER ~ HEALTH CENTER - A RK_OF, \L_HEALTH AND SUBST: E PROG! 4) ROCHESTER GENERAL LONG-TERM = DBA HU VEN A. KILL 5) INDEPENDENT LIVING FOR SENIORS 6 UNITY HOsPITy 7)_PRCD, INC., (8)EDNA TINA WILSON LI! ENTER, (9 PARK RIDGE LIVING CENTER, ITY HOUSING GROUP, AND (11) ACM MEDICAL LABRATORY. _ 7 RGH IS A 528 BED TERTIARY CARE FACILITY SERVING THE UNY COMMUNITY FOR. MORE THAN 150 YEARS WITH NATIONALLY RECOGNIZED PROGRAMS IN CARDIAC, CANCER, ORTHOPEDIC, VASCULAR, CAL AND DIABETES RGH IS HOME TO THE ROCHESTER HEART INSTITUTE (RHI_INDEPENDENTLY SOGNIZED EIGHT TIMES A‘ OF THE NATION'S 100 CARDIAC CENTERS. I_ALSO IS AFFILIATED WITH THE CLEVELAND CLINIC, WIDELY RECOGNIZED ‘THE TOP CARDIAC HOSPITAL IN THE UNITED STATES, AND HAS ACCESS TO LEADING EDGE TRAINING, TECHNOLOGY AND RESEARCH. RRH RECENTLY ENTERED. INTO A STRATEGIC ALLIANCE WITH ROCHESTER INSTITUTE OF TECHNOLOGY. ALLOWING FOR MEANINGFUL AND PRODUCTIVE COLLABORATION ON BIOMEDICAL RESEARCH EDUCATION. THE COMMITMENT OF THE RRH'S PHYSICIANS AND STAFF IS ae : - ; ‘Schedule O (Farm 060 or 800-£2) (2014) 83 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21$choduls 0 Yoim 990 or 990.7) (2012) Poga2: Employer Mentication number Name ofthe organization THE ROCHESTER P: 16-0743134 AND THEIR FAMILIES. RGH_ TREATS EMERGENCY ROOM PATIENTS AND PROVIDES OTHER OUTPATIENT CARE HE FORM OF AMBUI ERVICES AND OI CLINIC VISITS. RGH PROVIDES CHARITY AND TO THE AREA Ct . SEE SCHEDULE H FOR ADDITIONAL INFORMATION WITH RESPECT TO THE NUMBER OF PATIENTS TREATED, CHARITY CARI -IDED_AND SERVICE ACTIVITIES CONDUCTED BY RGH. — FORM 990, PART VI, SECTION A, LINE 1: EACH BOARD HAS AN EXECUTIVE COMMITTEE, THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD PLUS THI CUTIVE OFFICER OF THE RPORATION AND SUCH OTHER DIRECTORS ‘THE CHAIR MA’ NATE FROM TIME TO NIMENT BY A MAJORITY Vi THE ENTIRE BOARD. INGS 01 BOARD, AND 10 THE EXTENT PERMITTED BY THE I: ‘TTEE POSSESS THE POWERS OF WITH RESPECT TO MANAGING __ AND CONDUCTING THE AFFAIRS OF THE CORPORATION, EXCEP' [ERWISE PROVIDED BY LAW OR WITHIN CERTAIN BY-LAWS. FORM 990, PART VI, SECTION A, LINE 4: RU SYSTEM, INC. D/B/A ROCHESTER REGIONAL HEALTH, IS A NEW YORK — NOT-FOR-PROFIT CORPORATION THAT COORDINATES AND MANAGES THE DELIVERY OF HOUSING AND HEALTH CARE-RELATED SERVICE: TL AFFILIATES (AFFILIATES). ROCHESTER REGIONAL HEALTH WAS FORMED THROUGH A CORPORATE ESTRUCTURING, EFFECTIVE AS OF JULY 1, 2014, WHICH BROUGHT TOGETHER TER GENERAL HEALTH SYSTEM AND ITS AFFILIATES AND UNITY HEALTH Sv! LZATION. AND ITS AFFILIATES. AS A RESULT OF THIS CORPORATE REO! ota ‘Schedule O (Form 990 or 990-EZ) (2014) 84 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21Page 2 Sohadule OfForm 890 or 60-67) (2014) ‘Name of the organization oer Ketan mir ENTITIES LISTED BEL iE “EXEMPT AFFILIATES"). IRS FORM 1023 {APPLICATION FOR TAX-EXEMPT STATUS) HAS BEEN FILED FOR ROCHESTER REGIONAL. HEALTH, SEEKING EXEMPT STATUS UNDER SECTION 501(C) OF THE INTERNAL REVENUE CODE. = ACCOMPLISHED VIA CHANGES TO THE GOVE! ENTS 0} EXEMPT AFFILIATES, AS FOLLOWS: A)ROCHESTER RI (AL HEALTH WAS Ni THE EXEMPT AFFILIATES’ SOLE CORPORATE MEMBER; B)ROCHESTER REG! HEALTH WAS GRANTEI AUTHOI 0 APPOINT AND REMOVE THE GOVERNING BOARD OF THE EXEMPT AFFILIATES; AND C)CERTAIN ACTIONS OF THE EXEMPT AFFILIATE AND/OR ITS GOVERNING BOARD WERE MADE SUBJECT TO THE APPROVAL OF THE GOVERNING BOARD OF ROCHESTER REGIONAL HEALTH. ADDITION, THE DOCUMENTS OF SOME (BUT NOT ALL) OF THE EXEMPT AFFILIATES WERE CHANGED AS FOLLOWS: A) THE INDIVIDUALS SERVING ON THE GOVERNING BOARD OF CERTAIN EXEMPT AEFILIATES INCLUDE, IN WHOLE OR IN PART, THE INDIVIDUALS WHO SERVE ON THE. VERNING BOARD OF ROCHE: TONAL HEALTH; AND B)THE CHIEF EXBCUTT FICER OF ROCHESTER REGIONAL HEALTH SERVES. THE CHIEF EXECUTIVE OFFICER OF CERTAIN EXEMPT AFFILIATES. FINALLY, THE GOVERNING DOCUMENTS, SPECIFICALLY THE BYLAWS, OF THE T 70 YORK PLL! H_ARE EACH NOT-FOR-1 rh ‘Schedule O (Form 900 or 80-EZ) (2014) a5 14411104 781828 20097-3010 2014,04030 THE ROCHESTER GENERAL HOSPI 20097_21Schodule 0 form 880 or 89087) 2014) Pag Employer Kentifcation number Name ofthe organization THE ROCHESTER GENERAL HOSPITAL 16-0743134 LAW, WERE REVISED T0 IMPLEMENT THE REQUIREMENTS OF THE NON-PROFIT REVITALIZATION ACT ("NPRA"); A NEW YORK LAW WHICH WENT INTO EFFECT ON JULY 1. 2015. JTRED ALL NEW YORK NOT-FOR-PROFIT CHARITABLE ENTITIES TO ADDRESS CERTAIN ISSUES IN THEIR GOVERNING DOCUMENTS, INCLUDING (BUT NOT LIMITED TO) CONFLICTS OF INTEREST, INDEPENDENT D: FINANCIAL AUDITS AND WHISTLEBLOWER PROTECTIONS. — THE EXEMP’ ILIATES OF ROCHESTER 0 (POR WHICH ROCHESTER REGIONAL HEALTH SERVES AS THE SOLE CORPORATE MEMBER, BEHAVIORAL HEALTH NETWORK, INC. GRHS_EOUNDATION, INC. NEWARK-WAYNE COMMUNITY HOSPITAL TH INC. se PARK RIDGE CHILD CARE CENTER, INC. PARK RIDGE HOUSING DEVELOPMENT FUND COMPANY, INC. PARK RIDGE HOUSING, INC. _ RIDGE INC. PARK WAX HOUSING DEVELOPMENT. PANY, INC. PARMA HOUSING DEVELOPMENT FUND CORP. PRcD, INC. ROCHESTER GENERAL HEALTH SYSTEM DIALYSIS, INC. ROCHESTER GENERAL HEALTH SYSTEM ROCHESTER GENERAL HOSPITAL FOUNDATION, INC. ROCHESTER GENERAL HUDSON HOUSING, INC. ROCHESTER GENERAL LONG TERM CARE, INC. ‘ST. BERNARD'S HOUSING DEVELOPMENT COMPANY, INC. ST. BERNARD'S ZI, INC. aR a ‘Shei O (Form 600 or EZ) 014) 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21Pao 2 ‘Schule 0 (Fon 890 or 9902) taO14) ‘Employer identiication number Nam ofa oganaten _______THE ROCHESTER GENERAL HosPrmaL __| _16-0743134 THE CLI RINGS _SANTTARTUM COMP: A CLL PRINGS HOSPITAL & CLINIC THE ROCHESTER GENERAL HOSPITAL THE UNITY HOSPITAL OF ROCHESTER. UNITED MEMORIAL MEDICAL. CENTER ooo UNITY AGING SERVICES, INC. UNITY AMBULATORY SURGERY CENTER, INC, 0 UNITY HEALTH SYSTEM = UNITY HEALTH SYSTEM FOUNDATION UNITY HOUSING DEVELOPMENT FUND CORPORATION MOODLAND VILLAGE, INC. e FORM 990, PART VI, SECTION A, LINE 6: ‘THE ORGANIZATION IS A MEMBERSHIP (NOT A STOCK) CORPORATION UNDER NEW YORK STATE LAW. THE ORGANIZATION'S SOLE CORPORATE MEMBER IS RU SYSTEM, INC. D/B/A ROCHESTER REGI HEALTH ED_NOT-FOR-PROFIT ORGANIZATION. __ FORM 990, PART VI, SECTION A, LINE 7B: RU SYSTEM, INC. D/B/A ROCHESTER REGIONAL HEALTH, AS THE SOLE CORPORATE MEMBER, ALSO HAS THE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS OF THE ORG: \TTON' $ GOVERNING BODY, INCLUDING AMENDMENT OF BYLAWS AND CHARTERS, REMOVAL OF MEMBERS OF THE GOVERNING BODY, AND THE DECISION TO DISSOLVE THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11: RIOR TO FILING OPY OF THE FORM 990 OVIDED TO, REVIEWED WITH, ALL MEMBERS OF THE AUDIT AND COMPLIANCE COMMITTEE. THIS REVIEW IS PERFORMED IN_CONSULTAT: rr TAX AND_Ii ED. E wa ‘Schediule 0 (Form 990 or @80-EZ) (2014) 87 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21‘Schwiduto 0 ish 990 er 000-62) 12014) Panoz "Name of the organization Employer identification number re HOSPITAL 16-0743134 7 L 1TS_AND OTHER RELEVANT INFORMATI FOR THE APPROPRIATE TIME PERIOD. 0, PART VI, SECTION B, LINI A UPON EMPLOYMENT, ALL EMPLOYERS RECEIVE THE ETHICAL STANDARD OF CONDUCT BOOKLET FOR WHICH THEY SIGN A RECEIPT OF ACKNOWLEDGEMENT. CONFLICT OF INTERES’ FINED, AS IS MANAGEMENT OF A CONFLICT OF INTEREST. EMPLOYEES. ARE REQUIRED TO DISCLOSE SEEK RESOLUTION TO ANY. R POTENTIAL _ ELICT OF INTEREST BEFORE TAKING A POTENTIALLY IMP! ACTION AND os THEREAFT) JALLY, EACH EMPLOYEE AND OFFICER OF THE ORGANIZATION. REQUIRED TO COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE FORM, PROVIDING _ AGEMENT WITH SUFI iT MATION 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 iE A QUESTION AS TO HIS/HER OBJECTIVITY AS WELL AS TO AVOID ANY APPEARANCE OF IMPROPRIETY. THROUGHOUT THE YEAR, KEY EMPLOYERS AND OFFICERS OF THE XZATION ARE ALSO i NOTIFY MANAGEMENT PI F. CHANGE TO THEIR DISCLOSURES OCCURS. 101 BER OF THE 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 WELD. ea ‘Schedule O (Form 980 or 880-EZ) (2014) 88 14411104 781828 20097.3010 2014. 04030 THE ROCHESTER GENERAL HOSPI 20097_21‘Schedule om 900 or p0EN Boia) Pasio Employer identiioation number Name ofthe organization R_GENI PITAL 43134 ORM 990, PART VI, SECTION B 4 ‘THE ORGANIZATION'S OFFICER EMPLOYEE COMPENSATION AR! S REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF ROCHESTER REGIONAL HEALTH, A RELATED NOT-FOR-PROFIT IZATION. INFORMATION REVII Fe THE OFFICER/KEY EMPLOYEE INCLUDES COMP B_DATA FRO! ILAR SIZE TAK EXEMPT ORGANIZATIONS IN THE WESTERN / CENTRAL NY Ct WELL AS OMPENS: R_THESE POSITIONS (AS DISCLOSED ON FORM 990 HI ORGANIZATIONS TH INDUSTRY THA’ F SIMILAR SIZE, DEMOGRAPHICS AND GEOGRAPHY. REVIEW AND APPROVAL OF THE COMPENSATION ARRANGEMENT BY THE COMPENSATION COMMITTEE IS DOCUMENTED. FORM 990, PART VI nT THE ORGANIZATION VERNING IFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AV: ETO THE PUBLIC UPON REQUEST ATT! ADMINISTRATIVE OFFICES OF THE AFFILIATED HEALTH SYSTEM AT 100 KINGS HIGHWAY ‘SOUTH, ROCHESTER, NY 14617. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED. FORM 990, PART XI, LINE 9, CHANGES IN NET ASSETS: CHANGE IN INTEREST IN NET ASSETS OF ROCHESTER GENERAL HOSPITAL FOUNDATION 2,517,634. CAPITALIZATION OF ROCHESTER GENERAL LONG TERM CARE 6,440,416. TOTAL TO FORM 990, PART XI, LINE 9 3,922,782 FORM 990, PART XIT, LINE 2c HE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. boas “Schedule © (Form 000 or 060-E2) (2014) 89 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21ven Hei a “056 uu 29 suononaeu 008 2oRON oY woHRNpeY YoModed 204 ¥ x ¥ ¥ == Gov i mosena | om ogeua6 poe 19 imei] Savina [Gwe | wtiona | ecmmaemmnie | fms remo = _ ® ® @ on “Boke a Bp SUCRE A ye, eux pore 1010 bo pe ene209 Ye BU‘ Me 085 uO UO ,£04, pasoNsUR UpgERUEO a SCD SHOES saa a | 7 ° aa a ee om : ‘aye popstos 0 yonico sang | swesemesionia} aucowmes | somes) nn WO soe Ka (erscne sp emi Ue ® ° ° a a ms = Ey eolane "066 03 ob HORRY blo “48 20 96 “aoe ‘ve ‘be ou ‘AL Ue ‘096 tO UO .90A, PasomsuE LoReZ|uEELO oYp 1 EIEIO °° Rare sdiysiouped payejoiun pue suoneZIUeBIO perejeySHY WALES SE SE fod a ar per ae catego | SUED PONG ‘amos p00 ydwexa | 10 oye) opamp eB ‘ungae Kraus epee, VETEVLO-ST- ¥ ¥ ¥ ¥ ¥ ¥ ¥ ¥ ¥ x ¥ a] came ue |vogoes ) sms] —_uonaes (Gaunco wo) sopeabi0 pores jo ear g| Suaomuco ia | Aummorana | opeo ruses | 20 sims) orowop ete ‘argo Kean pu ‘sve ou ‘ef 0 © ® © @ © suopezuetio dung 30] paeiey Jo uonsouRNp| Jo Uonsnunton [ATF] “VETEVLO-ST WWITESOH TWHENED WLISHHOOW GAL Oem TERRES-, BRE ~“HETEVLO-ST ay AN aE in = a x or oi ¥ a0 7 ir eS 7 Sone WIRE = ae spose (enn. 4 Pee: [guscuno| atone | oucm | -acfS'4So.)} uo | Gisas [eiteoey “osets” | mean | “Amuso edd’ | oupontbsioang {ost ey “es [w © o o ® o se0K xe oun Buunp Yona 2 uoREIodioo& se paywon suonaueEIO Pate! evo 0 ¢u0 peu es7=004 FE SU ‘A ed ‘065 Od UO ,80,, PasoMsve LORE ety 1 e1KHUOD NAY 20 UOREIOMND # Se IFEXEL SUORERUESIO pareieu jo woneouauepy AIHA are 7H YN 7 7 CErEY “ET m q a od Ei et Se ee Eee = seme) ESSER] A | caony PERE oe | SS werntn oem af te [em] ERE” | Th [AEE | ellan | SE | cyaeecmay | SHEENA, oe fel” jw | "e o o ole |e © ~mal x oun Bout Ghjouyed © se payan oper ote sro 0 e40 peu 3 9878094 98 UI AI Yee ‘086 oy UO ,S9A, pavemsuE LoREAUEBIO ous ayxdUIOD dNEIOURLEG © 2e EXEL swOReTIUCEND perteu jo uses MEd WEUSEHOOW SHE v107¥ o ay EEE ¥ o Bo er aH SS FORT POETS TH 7 as sar EN TRE Ge = seese eng20 Gummo| maton | cuoy |atttitoa| tue | es sez pom ‘ae Paes “PuES” | mitoses | “Ais eedD| emt [ute poe ma NG Boo Sop SUE “o © o © ° ° ‘a © I re Pe‘7102 (066 w0s) w ompoHeS ress Shs TSE HOTINSEANOOSUESNON SHE "MGLESOH ALINGNNOD NAW WOVMGN SI TINGNDOS WELSES HIIWAN WHISHHOON WELW a o o DNI “SHOINES WOL SHIATT INAGNEAaNI a a Gil’ ANVENOD SONVELSSW WRLSHHOOW WALEED WHOMEN HVIVEH TeuOTAWHaE 0 iL ‘vogezuetio pore: yo owe @ @ PUD FRI SUT OBS SBA, 6 OO THEO ETE STA 8 |octog| aloe] —rnfae nf ne] ven enn =. T= RRTUELIG PE WO ARTO IS ISTO = x ao (S)uonequetio paisa: 0; Kyodaid 0 use Jo 9}8UR 2249 4 xr ‘sesuedeo Jo ()uogERUEDLO paiea Aa ped weursunguet, x, e > ‘sesuod Jo} @howEAUeEN peyes! oI pred wewEnquIeY (2uoyezve6.0 pews qm soeKoidue ped 0 Buueus © (uoneauetio poy: aye swesse Jeyi0 10 ss Sugeu‘yuewdnbe "somOR| 30 BLES jeoueauetio psames fq SuoREYOqOS Burszpuny 0 GycloquouN 30 See o aoURUOe (S)ueneue610 poy so} suoneyoaes BusppUny 10 dyReqUL 20 SEO)UeS Jo COUEULOHIR 1 (Gtuoneque6io persia! way siee58 049010 "UoUIENb “SonReEY Jo OSCE 3om Tea we wa wr Ter eT os a or wr er ar PT00"Sthe o Od TWOIGaN aN NERISaA Fpre"ZORT 3D NOE TES walk aay ooP Oee"E o (WaTED) “ONT “DOSS BOLLOWGd INEONTAZONI WaLSHHOON waLvaYD ‘AWA OOLT80°T 0 | -—_—sSERD WEG ONOT TWUENED HaLSaHDONe— -6L0 She ET a WEISAS HIT TWEENS WaiSaHoOWD = a | SR = Ge'n ved (ose wos) u anpeuce) euoneueSio permeH ui sueRDeSUELL Jo UoREnURCD [ATA] VETEVLO-9T WWELGSOW TWHANED WALSHHOON SAL CSOT THES702 (066 uu0.) w ampeyos "squsioued Wuaisenu Uei80 16) VON Buspiebas SUDRGTUROU OGG “LORRATEDO PETE TGISER TOR _{#ntanas ss0t5 0 sieeve 01 fa ponswout) sone 4 J0 eared Any UEKL @.0W pelonpuCD UoREAURELO au Yo UB GUSIOUMed Be pees Aue Yeo 1) UONELUO; Busoyey oth opal VeeRS“FETEVLO-9T £8 2U1'N1 We ‘056 lO, UO ,99,, persue UOREZUBBIO cin 1 siadiNoD ceuSIBUUEY w se ogee, SUOREZUEEIO PSION AEErH [Part Vl | Supplemental information Provide additional intrmation fr respon 10 questions on Schedul (099 inetuctions). 14411104 781828 99 20097.3010 2014,04030 THE “Schedule (Form 680) 2014 ROCHESTER GENERAL HOSPI 20097_21Form 8965 (fev. 12014) * Tr you ar fllng for an Addtional (Not Automatic) 3-Month Extenion, complete only Part and check tis box Note. Onl complete Pati you have aay been grated an automatic ¢month extension ona prea led Form 868. Enter fers dentving number, se instructions Type or | Name of exempt eganzation or the fier, oo nsiuatons. Employer ideniication number (IN) oF print futye [HE ROCHESTER GENERAL HOSPITAL 16-0743134 ‘gaat Number, soot, and room or suit no. aP.0. box, 00 Instructions. Social secunly number (SSN) msm [L425 PORTLAND AVENUE i ‘easton. ity, town or post ofice, state, and ZIP code, Fora foreign address, see instructions CHESTER, NY 14621 . | Enlor the Retum code forthe return that this appcation le for (lo a separate applloton foreach return). ‘Application Return [ Application Return IsFor code |i For Sot ‘Form 990 or Form 990-E2, ot eae te een | Form 600.5, (02 [Form 1041 08 Form 4720 tnaivua) (03 | orm 4720 (other than naval, 09, | Form Be0PE 4 7 10. orm 090-1 (ee, 40 (aj or 408%) wet) (05 _| Form 6068 m1 08. ‘HUGH CHISHOLM ‘© Thebooks arein the careof > 100 KINGS HIGHWAY SOUTH - ROCHESTER, NY 14617 ‘Telephone No.» 585-922-1221 Fax No. b 585-922-4290 = > ‘© tthe organization does not have an office o place of Business inthe Unted States, check tis box, ‘© Ifthia Is fora Group Retum, enter the organization’ four ait Group Exemption Number (GEN) itis forthe whole group, check this box p> [] tits for part of the group, Sesh tatosB Lol and attach ait wih tho names and ENs of all members the extension i fr. ‘4 Irequest an additional Smonth extension of time unt NOVEMBER 16, 2015 6 Forcelendar year 2014 , or other tax year beginning + and ending, : i 6 she tax year enter in ne 5 i forloss than 12 months, check reason. [_— Jina etum (CT Final return | [J change in accounting period 7 Stato in dotail why you need the extension ADDITIONAL TIME IS NEEDED TO AQCUIRE THE INFORMATION NECESSARY TO FILE A COMPLETE AND ACCURATE TAX RETURN. “Ba I/this application I for Forms 990-BL, B90F, 8007, 4720, or 6069, enter the tontatve tx oss any | onturabe crcl: Soo istvctions, |e} s. 'b Iv this appication is for Fos 980-PF, 9907, 4720, or 6069, enter any refundable credits and estimated | ‘tax payments mado. Include any prior year overpaymontalowod as a credit and any amount paid presiouly with Form 8888. ols Os © Balance due. Subtract line Bb from ine Ba. inolude your payment with this form, Krequred, by using EFTPS (Bottle Federal Tax Payment Syston}. See instructions. sols 0. Signature and Verification must be completed for Part I only. ‘Unde anaes of peri, declare nat nav examined tis for, Ineudng accompanying sheds and statements, nd tothe best of my knowledge nd eb, itis, cree and comple, and that lar auihorze to prepae tis fo Shae It» SVP_ FINANCE Dats > orm 6868 fev. 12014) 111 14411104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21rem 990-T Exempt Organization Business Income Tax Return {and proxy tax under section 6033(¢)) | own sescnar 2014 Plntoimaton a Name of ogaiation (LT unshan tame tanad and see nstetons) rei ett ene fan B_Exempt under section | Print | THE. -HESTER PITAL 16-0743134 Tq]o011C13 | 42 | Nun, set andro a sil ne a0 bos see isons. etic ey ee Jaco) [22010 1425 PORTLAND AVENUE. (Chaosa (ss0¢0} city or town state oF provinge, country, and ZIP o foreign postal code 14621 21500 > orton —TTsoiqyrut TJ aoa)ust [Totter nt itis rainy ove bases ay, De LAB. - | During the tox yer, was th carperation a sbsitiny nan tiated grup oa parent ssi controled group? ...,,.,.,,P> Ul ves [Two Yas enter the name and ientying numberof he parent corporation» _SEE STATEMENT 1. ‘Telnhons eumber BBB5- 922-1221 Tha a Part! | Unrelated Trade or Business income Bylicone (8) Expenses fe} Gros ech or sales 1,968,225. » Less elums andafowances 1,343,815 .| | 624,410. 2 Gast of goods sold (Schedule ine 7) 107,032. 1 uo tether or hw J Capital gn net income (attach Schedule D) | 547.3 78a ee ee Lt 107,032. rn r ‘1 tan os erm 0, eut a lh a a © Capa loss deduction or tuts. Income (as) rom prneshps and corporations (tah tate) emt income (Schedule ©) 4s 5 6 1 é o intrest anna, roti, and rents rom contae rgatatons (SF 5 8 1 Unread cebttinanoas io 8 8 Invasiment income ofa sation 5017) (8), oF (17 oroniation (Schedule 10 Expo exempt activity income (Schedule) 11. Advertsing income (Sohedule J) r 12 Ober ineome (Se instructions, 18_Tota. Combin tines 3 trough 12 | 107,03 107,032. Part It] Deductions Not Taken Elsewhere (Sse instructions for imitations on deductions) (Except for contributions, deductions must be drectly connected with the unlated business incomo) ee 16 Sars and wages. 18 Repais and maintenancs 17 Baddebis 18 inorst atch hod 19 Taxenand loenses : sahnindie 20 Chartablecontbutons (ee isrucons forint rues) 24 Depreciation attach For 4882) — 22 Less dspreciaton caimed on Scheie And sseuhare on retun 28 epeton : 24 Contbutons to deterred compensa 25 Employer benol pO9T@MS cn 26 cess exempt expenses (Sched 27 cess readership costs (Schedule J)... 28 ier deductions (attach schedule) 29. Total deduetions. Add ras 14 hough 28 30 Unrelated business taxabs income befor et operating loss deduction. Subtract ie 29 rom tne 13, 81 Net operating loss deduction (limited to ths amount on fn $0) ....., SRR. aan 2. ‘82 Unrelated busines taxable income before specie deduction Subtract ne 3 rom ine 0 38 Spec deduction (Gneraly $1,000, but ein 3 Instructions for exceptions) 94 Unrelated business taxable income. Subtract ine 93 fom ine 92 Ine 33 gee Taste FETs LHA For Paperwork Reduetion Aet Note 100 o 107,032. at | 107,032. 32 Oe 28 7,000 Form 000-7 (2014) 08521104 781828 20097.3010 —-2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21Fonteortew DHE ROCHESTER GENERAL HOSPITAL __16-0743134 __rw? Part ii] Tax Computation ‘25 Otganallon Taxable Corporations Sr suc fr wxconpuaon. Coad aroxp members (secon 1561 an 1588) check ere > CX See isreons an + eo tn BN 205 ar $2 00 bl ae ci nt ty & 80,000.) qi 25,000) is ig 9,825,000.] Ener orgenatns share of (1 Ana > (at mre than $1,750) {2} Alona 3% (nt mare than $10,00) € lncome ox 1 he amount on 84... 28, Trusts Tnale at Tryst Rates, Se incite orto compulsion. non tx oth a T1toxrate sctaque or [—] Schesule 0 Form 104%), 87 Prony tx See instructions 38 Atcatieminiruraox msn coins : 9 $8, who oes : tT Tax and Payments 40a Frio x red crpratons ash Fam 178 wustsaach Form 178), 2 Ot ces ce nsuctons) «Gower uses re Alach Frm 3600" 4 Grrr yar mine tx (tach Form 801 8527) Toa eres. Ad nese tough 4 44 Sutractine 40 tom na 32 42 Ober tes Chek tom | se | rm 0b 400 404 Ton 4255 CT Ferme6ii (I Foxm 6687 CT Form Tote eta a 2 8 4B Total tox AUG INHS 41312 nen . a ria 44a Payment: A2013 overpayment ede 02014 eens iy 4ae | 1 2014 estimate taxpayments ab i 6 Tox deposed wit Form 866 innate Me 4 Forign organs ax a or wild at source(s intucons) ad ! «Baclup winhoaing (8 instutons) van [AM | {Cad fo smal empath nuance premiums (Ach Form 6941) snes [A 1 Other credits and payments: dram 2439 Form 4196, otter 46 Total payers. A Ties MA THOUDH AAD yop 4“ 1,448. 48 Estimated taxpenaly (Se instrucions).heikitForm 2220s atached b> LT. +46} 4 Teco ne 4 oss than th tlt ines 48 ana 46, ater amount ned a Overpayment. $i rg tn el oti and 8, strc ad pet 2.446. on 5 acute, of otter) ina foregn county? It YES, he organizaton may have to Form FaCEN orm 14, Report of Forlgn Bank and Financial ‘1 Atany time during the 2014 cloner yar cd the eroriaton have an ines nor gnatue rather utory ova ral aovount (bank, [Yew | Wo x x ed. Enter method of ventory vation pe N17 {Inventory t Benning of year Oe] & Invent at ond otyear Te] 0. 2 Purchases act in 8 costo abo — {tom 5, Entree andi Pat, ne 2 2] 517,378. 448 Aina tin oan con any [AB 1 Dotherules of secon 2698 wt respect to. Yes | Ho 1 Oter costs (tach chad)... [42 | 5.17,378.] propor produce or acqited forresse apply to 517,378 | _ theoanzaton? x “Under princes il have ied et elgnoenpry arn ae Sign | selena Ratestane coat te —— Here >. 1 cro nepuouw orn i Ta oi he " vs [1 Pipe roars ae Preparer soe Tae Gece T=) # Jr a sal anpeyed Preparer ANGELA M. FRANCO IGELA M. FRANCO. 7 P00589741 Use Only [Einsnana > FUST CHARTERS CHAMBERS LLP fmsen > _16-1226227, 5784 WIDEWATERS PARKWAY fm’ aass = Tern ovew Form 990-T 2014) 101 08521104 781828 20097.3010 —-2014.04030 THE ROCHESTER GENERAL HOSPI 20097_214. ecient pety a. — re ‘o- 4 ie epee Oraigeereane seen eeceieerraeee ae Sfe)ona iy cons win naecono ls “tao tons etm seca i 2 ) al ow {Teal incom Add tas of columns 2(e) and 2). Enter Tt datum. ‘aro and on pape 1, Prt ne’, calurn (A > Os [rotting Tesonn be 0. ‘Schedule E - Unrelated Debt-Financed Income (see natauctons) 2 ows cae om 8 Sn eas an) 1. rsp of eb reno popety Simod erp Taga ee een Opies 6. Gang aan tren reaumnd) bs | pe Patt eres Pettey, ae 1. nanectemataonetin 2, ae vowels [Sebsirereauate] ‘Seton teat seorgiratoen | ceuemrricens, | iimstitasa’ — [otinitepsceote] "wena a “2. o ‘ iNonoxaript Oontted Oana 7, Tee 8. Wigaraasigsar to] 6, Tawdapaaranims | 0, feicetumgmatmpocne] 17- gence ay ene ‘Sot mn panna’) 1 artes tana a (2. ——as 2 mo) — wnmecauen | maeaurees eine 0. 0 “e erm a6 2014) 08521104 781828 20097.3010 102 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21Fox sot (2614 74313. 4 ‘Schedule G - investment Income of a Section 501(c)(7), (9), or (17) Organization 7 | —— move | SS | ee, | eee - osm f sate | oan, | SESS a = (2) 2) — — a larmeanan nmemnne Totals » 0. 9 ‘Schedule | - Exploited Exempt Activity Income, Other Than Advertising Income rare tomaues — | oadd@ioe | CEES [ERE | gememe | tone | Mee lesen cums | “leet | Retesoamy: | toesahume | acmabte | sheetnns. Ene | ess" | ets | Ce = a 2 o # Towle. > Ds sh henge os nan [Parti |Income From Perlodicals Reported on a Consolidated Basis 2 gon cncreennee eescrei ceeormrernt tpt Soe. | dicer. Lge.) Seam | Same | GREER Shs eer am i 2 { ao 3 4) tule Leary ating (6) Oe [Part it] income Fro parioalals Raper Fieported on a Goparate Basle (ror each paodicalfstedin Parti fin cane 2 eongt? onetenyaerean) Tomes ae {rtp Son | or (SER) Som | meee | ote ‘rcome ‘cala 8 ough 7. "than cote 4) a z = a 2) @ a Totals from Part) ss PI 0.| 0.| et, Becta, park neat le, Pat nes 4:5) > Ow 0.) o. iul pensation of Officers, Directors, and Trustees (see instructions) F cenpepaaten eae 1, mane 2, mm ow. Form 80-1 (2014) el, En ir nd On page 1 Pal Uo 14 103 08521104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_214626 Alternative Minimum Tax - Corporations ca Datasheet ro _ > woman bos om 68 i spn 2014 [Ee een comoor 16-0743134 ___THE_ROCHESTER GENERAL HOSPITAL ote See the instructions to find cut ihe corporation 2 sma eorporalon exempt com te ternative minimum tx (AMT) unde setton55() 11 Tanabe income o (oss) bears net operating loss dodution 2 Adjustments and preferences: 1 Deprcition of post-1988 pO96RY ..s.assneu re Amortization of ertied poiuon contro eis ¢Amortzton of mining exploration and development costs 4 Arizaton of culation expedite (esoal oling companies on) AMWSHE GOOF 1085 pn f Long-tim contacs ‘9 Merchant marina capil constuction funds... 1 Seton 829(0) duction (Be Cross, Bue Si, and sm ype organizations ony) ' i k ' ‘Taxshal farm acts (personal serie corporation ony) Passive atts (asl bald corporations and personel servis corporations ony) LOH HBAONE sen Depletion : Tax-exempt intrest come fom specied private actvty bonds. Ietangieditlg cos (ter adutments and preterancas 1” Preadusinentateratie mri eircom i) Cnn ines ough 20 4 Adjusted eurnt earings (ACE) adustment ‘ACE rom in 10 of the ACE worksheet in the istrctons sone [A 111,330)", 1 106,032. 106,032. ‘Subtract ne rom ne 4, Ine exceeds ine da, enter he derence as @ 5,298.| ‘agate amount (se instructions) oe ty Mutipi Ine 40 by 75% (75) Enter th asl a postive amount Ent tha exces, any, of the corporations ttl increase in ANTI rom pir var ACE adusmens vets oll reductions in AMT ftom prior year ACE ‘adsiments (ee Instructions). Noe; You must nar an arnout on Une 4¢ (eventine 4 is postive). ‘ACE adjustment. © ‘lve as 270 or ore, ena th amount rom ine 4e {© ‘tne 4 sess thane, enter the amar of ira 4 olin as 2 negative amount '5 Combine es 3 and o,1zr0 os, stop hee; the corporation dos not owe ay AMT ‘Murat taxnat operating oss deduction (98st UHONS) oun 7 Alternative minimum table Income, Sutras ne 6 tom ine 6. the corporation hela Intrastin a REMEG, soe nstrctons {8 exemption phase-out ne 7s $310,000 or mor, ship es Ba and band eater-0- on ne Bo. «Subtract $150,00 from ne 7 completing tis ne or amember ofa controled (oup, see instructions). eo or less, enter -0- [4] 3, 974.) Mutpy ne 8 by 25% (25) : tramp, suact nb tom 34,00 (ampli sw fre member a conoled roup, se Instuclions). zr rks, enter 0 8 Subtactine 8 om in 7. Haar oles, eto 10 Mutipiy ine by 20% (20) 41 Atonatveminknum tox orsign tax ort (ANTFTO) 42 Tantaive minimum tax. Sub in 11 rom ine 10 7 18 Regular tax bit botore applying all cad excep the foreign tax creat . ‘14 Auernatve miimum tax, Subrat in 13 rom ine 12. zero oles, eter hre and on ingtutons) 40,000. On On a. u 0. Fon 1120 Sebel Jr 9, othe epororate Ue of he porporavons neon txt ‘WA For Paperwork Reduction Ast tee, rat Intact 104 08521104 781828 20097.3010 2014.04030 THE ROCHESTER Fen 4626 (2016) GENERAL HOSPI 20097_21THE ROC ‘Adjusted Current Earnings (ACE) Worksheet D> Sex ACE Workshost instructions, 1 Pre-adlustment AMTI. Enter the amount from line 3 of Form 4626, ws 1 106,032. 2 ACE dprecaton ustmeat 18 AMT depreciation ms 2a 5,298.) 1 ACE eapretatn: A) Post-1993 property foot | (2) Pos 1909, e199 propery 2 (9) Pre-1990MACRS property sens [2B (4) Pr-1000 ccna CRS propery. [RBA (8) Property described in sections =H 168(1)(1) trough (4) sevens (2OU6 |! (©) Ober propery, 8) (Toa ACE aepresaion a ins 2¢ trough 250) 6 ACE deprecation ausinant Subtract ne 247) mine 2a on 2 5,298. {nul n ACE offers inden earings and profits E4P 1 Tocovempt inset izome ao : | 0 Death berets rom auras eonbaca ‘¢ Allother distributions frorn lite insurance contracts (including surrende 3) 4 isa bul of uncut income init suranc contacts. 4 Other Rams (see Regulations seotions 1.56(g)-1(o)(6)(al) through (Ix) fora para it) xe 1 Totalinreae to AGE rom nision Wn ACE of tans ded EGP a 8 9817000039, st 4 Dsatlenee ces not deduce am E4P: * Catan dnd echod “a ' Ovidends pal on cara rte soko publ uti tat are deuce ner etn 247 a ¢ Dhided pido an ESOP iat re cine onder Scion S04) | 4 Nonpionagecvidend tht re pal and deduct under secon 198200) “4 | ¢ Oe te outs ects #5) aN} and fora | satis svenaanne LM 1 Total nreade to AGE bores of daonance tims ot edt rom ERP dos fa though 4 4 ‘tar astents based on us for ptng ERP: + bangle itr os, . te » creulton expences”, Eo € Organizational xpenares te FO ventory astrnts 4 ¢ Isainent as ...., a 4 Total other EP aasmars amine ies fa trough 86... {Disallowance oftoss on xchange of tt pcos... — 7 Aequstin expenses fl insuranc companies for ualfes fort cotats 8 Daplon : {Baie adhustmenisin dining gal ors am sao xchange ore 1894 property _ 40 Adjusted cuentenraiage, Combine nest 2, 3 and through. Eta terest ie and on ef of Form 4626. us ws se 10 111,330. 105 08521104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21‘THE ROCHESTER GENERAL HOSPITAL 16-0743134 FORM 990-T | PARENT CORPORATION'S NAME AND IDENTIFYING NUMBER STATEMENT 1 CORPORATION'S NAME IDENTIFYING NO RU SYSTEM, INC. D/B/A ROCHESTER REGIONAL HEALTH SYSTEM 47-1234999 FORM 990-T NET OPERATING LOSS DEDUCTION STATEMENT 2 LOss 5 PREVIOUSLY Loss AVAILABLE TAX YEAR ‘LOSS. SUSTAINED APPLIED REMAINING ‘THIS YEAR 12/31/98 35,388. 35,388. 0. oO. 12/31/98 106,745. 106,745. 0. 0. 12/31/99 305,998. 305,998. 0. oO. 12/31/99 191,268. 191,268. oO. . 12/31/00 351,614. 351,614. 0. oO. 12/31/02 155,016. 155,016. oO. oO. 12/31/03 1,455,268. 1,455,268. O. 0. 12/31/04 2,340,135. 907,489. 1,432,646. 1,432,646. 12/31/05 3,164,270. O. 3,164,270. 3,164,270. 12/31/06 1,185,380. 0. 1,185,380. 1,185,380. 12/31/07 515,011. 0. 515,011. 515,011. 12/31/08 277,481. oO. 277,481. 277,481. NOL CARRYOVER AVAILABLE THIS YEAR 6,574,788. 6,574,788. FORM 990-T COST OF GOODS SOLD - OTHER COSTS STATEMENT 3 DESCRIPTION AMOUNT DIRECT SALARY COSTS 183,262. PHYSICIAN SALARY COSTS 1,323. MIDLEVEL 2. PHYSICIAN FEE 426. BENEFITS 46,019. MEDICAL SUPPLIES 102,814. SURGICAL SUPPLIES 786. PHARMACEUTICALS 72. CONTRACTED SERVICES 50,279. OTHER SUPPLIES 3,584. UTILITIES 27,956. BAD DEBTS 23. INDIRECT LAB COSTS 95,534. DEPRECIATION 5,298. TOTAL TO FORM 990-T, SCHEDULE A, LINE 4B 517,378. 106 STATEMENT(S) 1, 2, 3 08521104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21” 16-0743134 ’ ' THE ROCHESTER GENERAL HOSPITAL FORM 4626 ALTERNATIVE MINIMUM TAX NOL DEDUCTION STATEMENT 4 LOSS PREVIOUSLY Loss TAX YEAR LOSS. SUSTAINED APPLIED REMAINING 12/34/03 1,455,268. 1,455,268. oO. 12/31/04 2,340,135. 175,247. 1,564,888. : 12/31/05 3,164,270. o. 3,164,270. | 12/31/06 1,185,380. oO. 1,185,380. | 12/31/07 515,011. o. 515,011. 12/31/08 277,481. oO. 277,481. AMT NOL CARRYOVER AVAILABLE THIS YEAR 6,707,030. 107 STATEMENT(S) 4 08521104 781828 20097.3010 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_21Depreciation and Amortization (ncluding Information on Listed Property) COGS > attach to your tax return. 2014 sb, Seite 170 aera [6-0743134_ fore ou complete Pat. 11 Maximum amount (see instructions) 4 500,000. 2 Total cost of socton 178 property paced in sarc (ec Instructions) | 2 ‘8. Throshold cost of section 179 property before reduction in imtaton 2,000,000. 4 Reduction in imtatin, Steet ne 3 om te 2. Har ols, eter - 4 8. Siw ons tc in oe te ice te na iii, co ea s 6 {vn ery Dj buen dnc ‘oecnaecst 7 Usted propery Enter ho amount fom tne 29 8 Total lected cost of section 179 propery. Ade amounts Incline 6 and 7. 8 Tentative dadution, Entre smaller of 5 CF B98 .nesnaemnon 40 Carryover of caalowed deduction frm in 13 of your 2013 Form 8662 11 Business income mation, Entr the smabor of business income (rt les than 2a) eS 412 Section 179 expense deduction. Add ines 9 and 10, but do not enter more than Ene 11 12 49 Carovert dsstowad deduction to 2015, Add nes 9 and 4 pfs ee Note: Do not use Pat I or Pat il below fr Ited property. Instead, use Pat V. [Part] special Depreciation Allowance and Other Depreciation (De not nciude sted propery) ‘4 Special deprecation allowance for qualified property (other than sted property) placed i service ung thotaxyear - : 18 Proporyaubjeo 0 section 1680) ection . oe 2 ACHS) aril wc beprsiton Be tie fed popry es tuciony Section A {77 MACAS deductions for assets placed In sence in tax years beginning before 2014 Ed Bs 18. yest gue ant ged sa aes ne et ga en ea - ‘Section B- Assets Placed in Sorvce During 2014 Tax Year Using the General Depreciation System uenet | gaskieaweoria, | canes [comin] gions | owrecnton odin cahaeeimee samen | escmceein | emer |acmn| meen] {ea _Syearpropaty b Sven propery — 27a proven Ta 10year property o_15yyeat ptoperty 1 20year property 7 propery 25 ot 7 275. aw | Residential ental property z 275 wm [ st Z says, | mw sa | 1 Nonresidents eal property ni ww Le ‘Bootion G- Assets Plaoad ia Service During 2044 Tax Vout Using the Aterativ Depreciation Sytrm oa Gass We en. bt year ye. Sh eADyear Z ‘oye | wm] St Part IV] Summary (Ses instructions) 2 Usted propery. Entor amount from tne 28 en ai 22 Tota. Add amounts om ine 12 nes 14 tough 77, nee 19 and 20 in clung), anne 2. Enfor here and onthe appropriate nes of your retum, Partnerships and S corporations 60 a 5.298 £28 For assets shou above and placed in erica ding the ourant yer, ota the _qpPotion oth baie alttiutablo to ection 29 coate 2 Form 4662 2014) FERe LAA For Paperwork Reduction Act Notice, see aoparate Instructions. Sas 08521104 781828 20097.3010 108 2014.04030 THE ROCHESTER GENERAL HOSPI 20097_2162 ENERAL_HO! 07 Part V_] Listed Property (rode avfomobies, certain other vetices,coran caf, curtain computer, and property used fr entertainment, Feereation, or amusement) Note: Far any voice for whic 1 te stander mileage rate or deducting ease expense, completeonly 249, 24b, columns (@) Iino tlof Seeson & ao Sector and Section Si Se eee ee aca aim a mera ‘B4a_DoyOU have evidence to Support the business/inwestment use claimed? ‘No | 24 "Yes," is the evidence written? |_] yes L_JNo. wfecy | fs, | sth | cite JemeScmaleclr! ue | amitler | cos gredliggy, | ote | stead | oie, [eau emer] ting, | ae | as | (25 Special depreciation allowance for qualified listed property placed in service during the tax year and | _used more than 50% in a qualified business use, — co | 25 | je iieeate st noncton nae os aerate iss ged inn 2B. Shi iy ‘28 Adel amounts n column (Snes 26 through 27. Enterhore and online 21, pago ‘29 Add amounts in column (ne 26, Ent here and online 7,896 1 ‘Soction & - Information on Use of Vehicles Complete this section for vehicles used by 2 sole proprietor, partner, or other “more than 5% owner,” or lated pereon If you provided vehicles {o-your employees, frst answer the questions n Section C to soe If you meet an exception to complting tis section forthose vehices. @ © @ @ @ @ 20 Totalbusessfmestmant nes ten ing he virice | _verin | vere | _veritn _|_venioo _| vente Year (do nat lus commuting its) Total commuting mies den cing he year “otal othr porsona noncommuting mies aiven,, acti Total ies civ ving he yout. ‘Ad ines 30 through 32 Was the vtil avalabl for pereonal use during oft duty hours? Was tho vehicio weed prima by aimore than 8% onmer rested person? tn snother vile aval or prsona! 80? Ue es es ‘Section © - Questions for Employers Who Provide Vehicles for Uso by Their Employees Angwer these question to determine you meet an axcoption to completing Section B fo vehicles used by employees who are not more than ‘owners or relates pertons. ‘87 Do you maintain a written polcy statement that probit ll personal use of vehicles, hiding commuting by your comployees? ve ‘88 Do you maintain a wationpoicy eater that prohibits personal use of veils, except commuting, by Your ‘employees? See the instruction for vehiles used by corporate officers, doctors, o 1% or more owners, ‘89 Do you treat alluse of vehicles by employeas as porsonal use? 440 Do you provide more than fv vehicles to your employees, obtain information trom your employees about ‘tho uso of the vehicles, and retain the information received? 696 ©), @, @, wtp tents mage ed ‘3a Revarzation of coats that bagins daring your 2014 tax oar, ‘43 Amortization of costs that began before your 2014 tax year a | 4 Total, Adc amounts in col {Seo te nstictions tor where te taba 44 Form 4562 2014) 109 08521104 781828 20097.3010 2014,04030 THE ROCHESTER GENERAL HOSPI 20097_21