﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2017v2.3">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2019-03-21T15:30:39-05:00</ReturnTs>
    <TaxPeriodEndDt>2017-12-31</TaxPeriodEndDt>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2017-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>160743032</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>Geneva General Hospital</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>GENE</BusinessNameControlTxt>
      <PhoneNum>3157874030</PhoneNum>
      <USAddress>
        <AddressLine1Txt>196 North Street</AddressLine1Txt>
        <CityNm>Geneva</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>14456</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>William King</PersonNm>
      <PersonTitleTxt>Treasurer &amp; CFO</PersonTitleTxt>
      <PhoneNum>3157874088</PhoneNum>
      <SignatureDt>2018-11-15</SignatureDt>
    </BusinessOfficerGrp>
    <FilingSecurityInformation>
      <IPAddress>
        <IPv4AddressTxt>204.138.179.237</IPv4AddressTxt>
      </IPAddress>
      <IPDt>2019-03-18</IPDt>
      <IPTm>14:16:24</IPTm>
      <IPTimezoneCd>ED</IPTimezoneCd>
      <FilingLicenseTypeCd>P</FilingLicenseTypeCd>
      <AtSubmissionCreationDeviceId>D63ACBA687D4B43F1175C19E1E27FA773887382A</AtSubmissionCreationDeviceId>
      <AtSubmissionFilingDeviceId>D3AFBB5864F2111DDFDD393852EB1F03B510E128</AtSubmissionFilingDeviceId>
    </FilingSecurityInformation>
    <TaxYr>2017</TaxYr>
    <BuildTS>2019-02-21 02:37:17Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="10">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>Jose Acevedo MD MBA</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>196 North Street</AddressLine1Txt>
        <CityNm>Geneva</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>14456</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>100358117</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>www.flhealth.org</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1898</FormationYr>
      <LegalDomicileStateCd>NY</LegalDomicileStateCd>
      <ActivityOrMissionDesc>Geneva General Hospital is a community based, not-for-profit hospital dedicated to maintaining and improving the health of all people in the central Finger Lakes region. We are committed to safe, high quality, compassionate services that are convenient, accessible and at reasonable cost, through the efforts of our employees, medical staff and volunteers. We are a center for health education that lives its leadership commitments through participation in and sponsorship of professional, allied health and community health education programs.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>20</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>15</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <TotalVolunteersCnt>0</TotalVolunteersCnt>
      <TotalGrossUBIAmt>720036</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>4108359</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>719810</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>82625226</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>88680865</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>992908</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>10237406</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>674478</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>720036</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>88400971</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>100358117</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>59057122</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>59794788</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>33206582</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>34371668</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>92263704</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>94166456</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>-3862733</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>6191661</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>210047784</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>214325015</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>54266276</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>49757798</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>155781508</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>164567217</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>Geneva General Hospital is a community based, not-for-profit hospital dedicated to maintaining and improving the health of all people in the central Finger Lakes region. We are committed to safe, high quality, compassionate services that are convenient, accessible and at reasonable cost, through the efforts of our employees, medical staff and volunteers. We are a center for health education that lives its leadership commitments through participation in and sponsorship of professional, allied health and community health education programs.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>33711502</ExpenseAmt>
      <RevenueAmt>37491280</RevenueAmt>
      <Desc>Patient Service Program:InpatientGeneva General Hospital is a 132-bed acute care hospital providing both primary care and a full range of secondary level services. We operate a 10-bed intensive care unit, and a 12-bed telemetry unit as well as six pediatric beds. The hospital also operates a regional Acute Physical Rehabilitation Center, including an in-patient, 15-bed unit.Inpatient services provided 17,731 patient days of care in 2016 (Medicine, Surgery, Intensive Care &amp; Acute Rehabilitation).</Desc>
      <ProgSrvcAccomActy2Grp>
        <ExpenseAmt>44811997</ExpenseAmt>
        <RevenueAmt>46333091</RevenueAmt>
        <Desc>Patient Service Program:OutpatientA full range of diagnostic and treatment services are available at Geneva General Hospital. We are dedicated to providing a comprehensive array of healthcare services to people in the Finger Lakes region.Outpatient services provided the following in 2016: 463,347 procedures (Laboratory, Imaging, Cardiology, Respiratory Therapy, Physical Therapy, Occupational Therapy, Renal Dialysis &amp; Women's Diagnostic Services), 12,612; Family Health Clinic visits, 7,273 Surgery/Endoscopy Procedures and 20,851 Emergency Services visits.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <ExpenseAmt>1517988</ExpenseAmt>
        <RevenueAmt>1461781</RevenueAmt>
        <Desc>Education Program:Education plays an important role at Geneva General Hospital. Our Education Department, which includes higher education programs for licensed practical nurses (LPN) and registered nurses (RN), is a diversified team of professionals who provide learning opportunities to the members of our organization and residents of surrounding communities.In 2016 our Education Program enrolled the following students: Finger Lakes College of Nursing - 150 students enrolled, 74 graduates; Marion S. Whelan LPN Program - 31 students enrolled, 20 graduates.</Desc>
      </ProgSrvcAccomActy3Grp>
      <ProgSrvcAccomActyOtherGrp>
        <RevenueAmt>3394713</RevenueAmt>
        <Desc>Other Operating Revenue:Expenses associated with Other Operating Revenue are included in other Program Services; they are integral to the operations of those services.</Desc>
      </ProgSrvcAccomActyOtherGrp>
      <TotalOtherProgSrvcRevenueAmt>3394713</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>80041487</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc1039700001">0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd referenceDocumentId="RetDoc1039700001">1</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc1039700001">0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <TempOrPermanentEndowmentsInd referenceDocumentId="RetDoc1040000001">1</TempOrPermanentEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">1</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd referenceDocumentId="RetDoc1041500001">1</OperateHospitalInd>
      <AuditedFinancialStmtAttInd referenceDocumentId="RetDoc2317200001">1</AuditedFinancialStmtAttInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd referenceDocumentId="RetDoc1042800001">0</PYExcessBenefitTransInd>
      <LoanOutstandingInd referenceDocumentId="RetDoc1042800001">1</LoanOutstandingInd>
      <GrantToRelatedPersonInd referenceDocumentId="RetDoc1042800001">0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd referenceDocumentId="RetDoc1042800001">1</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd referenceDocumentId="RetDoc1042800001">1</BusinessRlnWithFamMemInd>
      <BusinessRlnWithOfficerEntInd referenceDocumentId="RetDoc1042800001">0</BusinessRlnWithOfficerEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>1</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc1043400001">1</TransactionWithControlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>0</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <EmployeeCnt>0</EmployeeCnt>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>20</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>15</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>0</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>NY</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>Bill King</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>3157874088</PhoneNum>
        <USAddress>
          <AddressLine1Txt>196 North Street</AddressLine1Txt>
          <CityNm>Geneva</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14456</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Kylene Abraham</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Donald Gentilcore Jr</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Rev James Adams</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>David Bunnell</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Tom Thompson</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Stephen DeRaddo</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Cheveanne DeVaney</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Amy Hoffman</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>James Long</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Donald Wertman</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Robert Stivers</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Rodolfo Queiroz</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Robert Anderson MD</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>39.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>205850</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>James Cheney</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>John Sheppard</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jose Acevedo MD MBA</PersonNm>
        <TitleTxt>President &amp; CEO</TitleTxt>
        <AverageHoursPerWeekRt>17.90</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>22.10</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>976071</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>77455</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Fred Vitello</PersonNm>
        <TitleTxt>Treas &amp; CFO</TitleTxt>
        <AverageHoursPerWeekRt>18.80</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>21.20</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>54437</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>1388</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Phil Beckley</PersonNm>
        <TitleTxt>Trustee through 4/30/17</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Menzo Case</PersonNm>
        <TitleTxt>Trustee through 4/30/17</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dominic Fonte</PersonNm>
        <TitleTxt>Trustee through 4/30/17</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Dr Ketul Patel</PersonNm>
        <TitleTxt>Trustee through 4/30/17</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>427231</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24209</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Ann McMullen</PersonNm>
        <TitleTxt>Chair</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Lance Ward</PersonNm>
        <TitleTxt>Vice Chair</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Laura Pedersen</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Frank Korich</PersonNm>
        <TitleTxt>Sr VP Operations</TitleTxt>
        <AverageHoursPerWeekRt>32.20</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>7.80</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>227434</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26947</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Eileen Gage</PersonNm>
        <TitleTxt>VP, Nursing</TitleTxt>
        <AverageHoursPerWeekRt>31.60</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>8.40</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>231350</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>24502</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jason Feinberg MD</PersonNm>
        <TitleTxt>Chief Medical Officer</TitleTxt>
        <AverageHoursPerWeekRt>33.40</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>6.70</AverageHoursPerWeekRltdOrgRt>
        <KeyEmployeeInd>X</KeyEmployeeInd>
        <ReportableCompFromOrgAmt>389881</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26503</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Patrick Boyle</PersonNm>
        <TitleTxt>VP, Human Resources</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>229530</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28072</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Joseph Gomez MD</PersonNm>
        <TitleTxt>Physician (Cardiology)</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>581958</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Matthew Talbott</PersonNm>
        <TitleTxt>Physician Ed</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>496645</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18955</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Amanda Carpenter</PersonNm>
        <TitleTxt>Physician (Dermatology)</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>488703</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>1311</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Emily Lambert</PersonNm>
        <TitleTxt>Physician (Dermatology)</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>1138971</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CT Harrison</PersonNm>
        <TitleTxt>Anesthesiologist</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>428243</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>9851</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>5670454</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>205850</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>239193</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>11</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Clarus Linen Systems</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>60 GRIDER STREET</AddressLine1Txt>
            <CityNm>Buffalo</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>14215</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Linen Supplier</ServicesDesc>
        <CompensationAmt>745925</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Champion Energy Services LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>4723 Solutions Center</AddressLine1Txt>
            <CityNm>Chicago</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>16067</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Utilities</ServicesDesc>
        <CompensationAmt>516709</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Medical Solutions</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1010 N 102nd Street Ste 300</AddressLine1Txt>
            <CityNm>Omaha</CityNm>
            <StateAbbreviationCd>NE</StateAbbreviationCd>
            <ZIPCd>68114</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Temp Help-Nursing</ServicesDesc>
        <CompensationAmt>478434</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>Acusis LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>223 Fourth Ave</AddressLine1Txt>
            <CityNm>Pittsburgh</CityNm>
            <StateAbbreviationCd>PA</StateAbbreviationCd>
            <ZIPCd>15222</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Transcription Services</ServicesDesc>
        <CompensationAmt>404073</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>William Dean MD Pathology Svcs</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>252 Billsboro Road</AddressLine1Txt>
            <CityNm>Geneva</CityNm>
            <StateAbbreviationCd>NY</StateAbbreviationCd>
            <ZIPCd>14456</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>Pathology Services</ServicesDesc>
        <CompensationAmt>398000</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>5</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>550249</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>160601</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>8960</AllOtherContributionsAmt>
      <TotalContributionsAmt>719810</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>Patient Svc Rev</Desc>
        <BusinessCd>621990</BusinessCd>
        <TotalRevenueColumnAmt>83824371</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>83824371</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>Tuition &amp; Related Fees</Desc>
        <BusinessCd>611600</BusinessCd>
        <TotalRevenueColumnAmt>1461781</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>1461781</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalOthProgramServiceRevGrp>
        <TotalRevenueColumnAmt>3394713</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3394713</RelatedOrExemptFuncIncomeAmt>
      </TotalOthProgramServiceRevGrp>
      <TotalProgramServiceRevenueAmt>88680865</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>10236460</TotalRevenueColumnAmt>
        <ExclusionAmt>10236460</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>946</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>0</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>946</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>946</TotalRevenueColumnAmt>
        <ExclusionAmt>946</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>Child Day Care</Desc>
        <BusinessCd>624410</BusinessCd>
        <TotalRevenueColumnAmt>720036</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>720036</UnrelatedBusinessRevenueAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>720036</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>100358117</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>88680865</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>720036</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>10237406</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>2562529</TotalAmt>
        <ManagementAndGeneralAmt>2562529</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>47893352</TotalAmt>
        <ProgramServicesAmt>42887499</ProgramServicesAmt>
        <ManagementAndGeneralAmt>5005853</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>529754</TotalAmt>
        <ProgramServicesAmt>450291</ProgramServicesAmt>
        <ManagementAndGeneralAmt>79463</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>5696580</TotalAmt>
        <ProgramServicesAmt>4842093</ProgramServicesAmt>
        <ManagementAndGeneralAmt>854487</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>3112573</TotalAmt>
        <ProgramServicesAmt>2645687</ProgramServicesAmt>
        <ManagementAndGeneralAmt>466886</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>1180891</TotalAmt>
        <ProgramServicesAmt>1003757</ProgramServicesAmt>
        <ManagementAndGeneralAmt>177134</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>157382</TotalAmt>
        <ProgramServicesAmt>133775</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23607</ManagementAndGeneralAmt>
      </FeesForServicesLegalGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>203821</TotalAmt>
        <ProgramServicesAmt>173248</ProgramServicesAmt>
        <ManagementAndGeneralAmt>30573</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>58758</TotalAmt>
        <ProgramServicesAmt>49944</ProgramServicesAmt>
        <ManagementAndGeneralAmt>8814</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>159138</TotalAmt>
        <ProgramServicesAmt>135267</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23871</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>137637</TotalAmt>
        <ProgramServicesAmt>116991</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20646</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>1221908</TotalAmt>
        <ProgramServicesAmt>1038622</ProgramServicesAmt>
        <ManagementAndGeneralAmt>183286</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>1489184</TotalAmt>
        <ProgramServicesAmt>1265806</ProgramServicesAmt>
        <ManagementAndGeneralAmt>223378</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>31717</TotalAmt>
        <ProgramServicesAmt>26959</ProgramServicesAmt>
        <ManagementAndGeneralAmt>4758</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>183476</TotalAmt>
        <ProgramServicesAmt>155955</ProgramServicesAmt>
        <ManagementAndGeneralAmt>27521</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>155282</TotalAmt>
        <ProgramServicesAmt>131990</ProgramServicesAmt>
        <ManagementAndGeneralAmt>23292</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>7585075</TotalAmt>
        <ProgramServicesAmt>6447314</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1137761</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>737177</TotalAmt>
        <ProgramServicesAmt>626600</ProgramServicesAmt>
        <ManagementAndGeneralAmt>110577</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>Supplies</Desc>
        <TotalAmt>17670494</TotalAmt>
        <ProgramServicesAmt>15019920</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2650574</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>Purchased Services &amp; Le</Desc>
        <TotalAmt>2626322</TotalAmt>
        <ProgramServicesAmt>2232374</ProgramServicesAmt>
        <ManagementAndGeneralAmt>393948</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>NYS Assessment</Desc>
        <TotalAmt>299455</TotalAmt>
        <ProgramServicesAmt>254537</ProgramServicesAmt>
        <ManagementAndGeneralAmt>44918</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>473951</TotalAmt>
        <ProgramServicesAmt>402858</ProgramServicesAmt>
        <ManagementAndGeneralAmt>71093</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>94166456</TotalAmt>
        <ProgramServicesAmt>80041487</ProgramServicesAmt>
        <ManagementAndGeneralAmt>14124969</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>280701</BOYAmt>
        <EOYAmt>232623</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>6635159</BOYAmt>
        <EOYAmt>5710197</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>12228186</BOYAmt>
        <EOYAmt>12894984</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>12857</BOYAmt>
        <EOYAmt>12857</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>654823</BOYAmt>
        <EOYAmt>590537</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>1440078</BOYAmt>
        <EOYAmt>1619166</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>1216083</BOYAmt>
        <EOYAmt>1164994</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>216568374</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>134422305</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>86060639</BOYAmt>
        <EOYAmt>82146069</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>69723873</BOYAmt>
        <EOYAmt>78403736</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>60000</BOYAmt>
        <EOYAmt>60000</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>31735385</BOYAmt>
        <EOYAmt>31489852</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>210047784</BOYAmt>
        <EOYAmt>214325015</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>19304514</BOYAmt>
        <EOYAmt>20038589</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>9204941</BOYAmt>
        <EOYAmt>9430799</EOYAmt>
      </DeferredRevenueGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>7699933</BOYAmt>
        <EOYAmt>5849411</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>18056888</BOYAmt>
        <EOYAmt>14438999</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>54266276</BOYAmt>
        <EOYAmt>49757798</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsSFAS117Ind>X</OrganizationFollowsSFAS117Ind>
      <UnrestrictedNetAssetsGrp>
        <BOYAmt>132027508</BOYAmt>
        <EOYAmt>137648217</EOYAmt>
      </UnrestrictedNetAssetsGrp>
      <TemporarilyRstrNetAssetsGrp>
        <BOYAmt>20506000</BOYAmt>
        <EOYAmt>23671000</EOYAmt>
      </TemporarilyRstrNetAssetsGrp>
      <PermanentlyRstrNetAssetsGrp>
        <BOYAmt>3248000</BOYAmt>
        <EOYAmt>3248000</EOYAmt>
      </PermanentlyRstrNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>155781508</BOYAmt>
        <EOYAmt>164567217</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>210047784</BOYAmt>
        <EOYAmt>214325015</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>6191661</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>132972</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>2461076</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>1</FederalGrantAuditRequiredInd>
      <FederalGrantAuditPerformedInd>1</FederalGrantAuditPerformedInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <HospitalInd>X</HospitalInd>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="RetDoc1234500001" />
    <IRS990ScheduleC documentId="RetDoc1039700001">
      <VolunteersInd>0</VolunteersInd>
      <PaidStaffOrManagementInd>0</PaidStaffOrManagementInd>
      <MediaAdvertisementsInd>0</MediaAdvertisementsInd>
      <MailingsMembersInd>0</MailingsMembersInd>
      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
      <GrantsOtherOrganizationsInd>0</GrantsOtherOrganizationsInd>
      <DirectContactLegislatorsInd>0</DirectContactLegislatorsInd>
      <RalliesDemonstrationsInd>0</RalliesDemonstrationsInd>
      <OtherActivitiesInd>1</OtherActivitiesInd>
      <OtherActivitiesAmt>17740</OtherActivitiesAmt>
      <TotalLobbyingExpendituresAmt>17740</TotalLobbyingExpendituresAmt>
      <NotDescribedSection501c3Ind>0</NotDescribedSection501c3Ind>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part II-B, Line 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>Portion of association dues attributed to lobbying expenses.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <AgentTrusteeEtcInd>0</AgentTrusteeEtcInd>
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>22555000</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>4006000</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>26561000</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>20655000</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>1900000</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>22555000</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>20728000</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>-73000</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>20655000</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>19128000</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>1600000</InvestmentEarningsOrLossesAmt>
        <EndYearBalanceAmt>20728000</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>17428000</BeginningYearBalanceAmt>
        <InvestmentEarningsOrLossesAmt>3639000</InvestmentEarningsOrLossesAmt>
        <OtherExpendituresAmt>1939000</OtherExpendituresAmt>
        <EndYearBalanceAmt>19128000</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <EndowmentsHeldUnrelatedOrgInd>0</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>0</EndowmentsHeldRelatedOrgInd>
      <LandGrp>
        <OtherCostOrOtherBasisAmt>740369</OtherCostOrOtherBasisAmt>
        <BookValueAmt>740369</BookValueAmt>
      </LandGrp>
      <BuildingsGrp>
        <OtherCostOrOtherBasisAmt>130226892</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>64301985</DepreciationAmt>
        <BookValueAmt>65924907</BookValueAmt>
      </BuildingsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>81804357</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>66985662</DepreciationAmt>
        <BookValueAmt>14818695</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>3796756</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>3134658</DepreciationAmt>
        <BookValueAmt>662098</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>82146069</TotalBookValueLandBuildingsAmt>
      <OtherAssetsOrgGrp>
        <Desc>Workers Compensation Insurance Deposit</Desc>
        <BookValueAmt>599505</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Due from and Investments in Affiliates</Desc>
        <BookValueAmt>25420244</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Guardian Split</Desc>
        <BookValueAmt>565302</BookValueAmt>
      </OtherAssetsOrgGrp>
      <OtherAssetsOrgGrp>
        <Desc>Deferred Compensation Asset</Desc>
        <BookValueAmt>4904801</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>31489852</TotalBookValueOtherAssetsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Pension Liability, Net</Desc>
        <Amt>9534198</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Deferred Compensation Liability</Desc>
        <Amt>4904801</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>14438999</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part V, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>The Endowment Funds consist of donor-restricted funds established for a variety of purposes and are included in the balance sheet in assets that are limited as to use. Net assets associated with endowment funds are classified and reported based on the existence or absence of of donor-imposed restrictions. Amounts included in Schedule D, Part V include Geneva General Hospital and Finger Lakes Health Foundation (EIN 15-0549310) endowments rounded to the nearest thousand.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part X, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Geneva General Hospital (GGH)is a not-for-profit corporation and is exempt from income taxes as an organization qualified under Section 501(c)(3) of the Internal Revenue Code. GGH has also been classified by the Internal Revenue Service as an entity that is not a private foundation. As of December 31, 2017, GGH does not have any uncertain tax positions. GGH files informational returns in the U.S. federal jurisdiction and New York State.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleH documentId="RetDoc1041500001">
      <FinancialAssistancePolicyInd>1</FinancialAssistancePolicyInd>
      <WrittenPolicyInd>1</WrittenPolicyInd>
      <AllHospitalsPolicyInd>X</AllHospitalsPolicyInd>
      <FPGReferenceFreeCareInd>1</FPGReferenceFreeCareInd>
      <Percent100Ind>X</Percent100Ind>
      <FPGReferenceDiscountedCareInd>1</FPGReferenceDiscountedCareInd>
      <Percent300Ind>X</Percent300Ind>
      <FreeCareMedicallyIndigentInd>1</FreeCareMedicallyIndigentInd>
      <FinancialAssistanceBudgetInd>1</FinancialAssistanceBudgetInd>
      <ExpensesExceedBudgetInd>0</ExpensesExceedBudgetInd>
      <AnnualCommunityBnftReportInd>1</AnnualCommunityBnftReportInd>
      <ReportPublicallyAvailableInd>1</ReportPublicallyAvailableInd>
      <FinancialAssistanceAtCostTyp>
        <TotalCommunityBenefitExpnsAmt>1295001</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>781412</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>513590</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00550</TotalExpensePct>
      </FinancialAssistanceAtCostTyp>
      <UnreimbursedMedicaidGrp>
        <TotalCommunityBenefitExpnsAmt>12893044</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>7048447</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>5844597</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.06210</TotalExpensePct>
      </UnreimbursedMedicaidGrp>
      <TotalFinancialAssistanceTyp>
        <TotalCommunityBenefitExpnsAmt>14188045</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>7829859</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>6358187</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.06760</TotalExpensePct>
      </TotalFinancialAssistanceTyp>
      <CommunityHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>262459</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>0</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>262459</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00280</TotalExpensePct>
      </CommunityHealthServicesGrp>
      <HealthProfessionsEducationGrp>
        <TotalCommunityBenefitExpnsAmt>1447805</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>1485781</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>0</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00000</TotalExpensePct>
      </HealthProfessionsEducationGrp>
      <SubsidizedHealthServicesGrp>
        <TotalCommunityBenefitExpnsAmt>2026925</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>1585413</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>441512</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00470</TotalExpensePct>
      </SubsidizedHealthServicesGrp>
      <TotalOtherBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>3737189</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>3071194</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>703971</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00750</TotalExpensePct>
      </TotalOtherBenefitsGrp>
      <TotalCommunityBenefitsGrp>
        <TotalCommunityBenefitExpnsAmt>17925234</TotalCommunityBenefitExpnsAmt>
        <DirectOffsettingRevenueAmt>10901053</DirectOffsettingRevenueAmt>
        <NetCommunityBenefitExpnsAmt>7062158</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.07510</TotalExpensePct>
      </TotalCommunityBenefitsGrp>
      <PhysicalImprvAndHousingGrp>
        <TotalCommunityBenefitExpnsAmt>0</TotalCommunityBenefitExpnsAmt>
      </PhysicalImprvAndHousingGrp>
      <EconomicDevelopmentGrp>
        <TotalCommunityBenefitExpnsAmt>877</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>877</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00000</TotalExpensePct>
      </EconomicDevelopmentGrp>
      <CommunitySupportGrp>
        <TotalCommunityBenefitExpnsAmt>10534</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>10534</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00010</TotalExpensePct>
      </CommunitySupportGrp>
      <EnvironmentalImprovementsGrp>
        <TotalCommunityBenefitExpnsAmt>125</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>125</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00000</TotalExpensePct>
      </EnvironmentalImprovementsGrp>
      <CoalitionBuildingGrp>
        <TotalCommunityBenefitExpnsAmt>68528</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>68528</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00070</TotalExpensePct>
      </CoalitionBuildingGrp>
      <HealthImprovementAdvocacyGrp>
        <TotalCommunityBenefitExpnsAmt>44163</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>44163</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00050</TotalExpensePct>
      </HealthImprovementAdvocacyGrp>
      <WorkforceDevelopmentGrp>
        <TotalCommunityBenefitExpnsAmt>744166</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>744166</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00790</TotalExpensePct>
      </WorkforceDevelopmentGrp>
      <OtherCommuntityBuildingActyGrp>
        <TotalCommunityBenefitExpnsAmt>97355</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>97355</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.00100</TotalExpensePct>
      </OtherCommuntityBuildingActyGrp>
      <TotalCommuntityBuildingActyGrp>
        <TotalCommunityBenefitExpnsAmt>965748</TotalCommunityBenefitExpnsAmt>
        <NetCommunityBenefitExpnsAmt>965748</NetCommunityBenefitExpnsAmt>
        <TotalExpensePct>0.01020</TotalExpensePct>
      </TotalCommuntityBuildingActyGrp>
      <BadDebtExpenseReportedInd>1</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>2973067</BadDebtExpenseAmt>
      <ReimbursedByMedicareAmt>20243469</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>22319873</CostOfCareReimbursedByMedcrAmt>
      <MedicareSurplusOrShortfallAmt>-2076404</MedicareSurplusOrShortfallAmt>
      <CostingMethodologyUsedGrp>
        <CostToChargeRatioInd>X</CostToChargeRatioInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>1</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>1</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>Geneva General Hospital</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>196 North Street</AddressLine1Txt>
          <CityNm>Geneva</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14456</ZIPCd>
        </USAddress>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>Geneva General Hospital</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FacilityNum>1</FacilityNum>
        <FirstLicensedCYOrPYInd>0</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>0</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>1</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <CHNAConductedYr>16</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>1</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>0</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>1</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>0</CHNAReportWidelyAvailableInd>
        <ImplementationStrategyAdoptInd>1</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>16</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>0</StrategyPostedWebsiteInd>
        <StrategyAttachedInd>0</StrategyAttachedInd>
        <OrganizationIncurExciseTaxInd>0</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>1</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>100.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>300.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <IncomeLevelCriteriaInd>X</IncomeLevelCriteriaInd>
        <AssetLevelCriteriaInd>X</AssetLevelCriteriaInd>
        <MedicalIndigencyCriteriaInd>X</MedicalIndigencyCriteriaInd>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <UnderinsuranceStatCriteriaInd>X</UnderinsuranceStatCriteriaInd>
        <ExplainedBasisInd>1</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>1</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <ProvidedNonprofitContactInd>X</ProvidedNonprofitContactInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>www.Flhealth.org</FAPAvailableOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <FAPActionsOnNonpaymentInd>1</FAPActionsOnNonpaymentInd>
        <PermitReportToCreditAgencyInd>X</PermitReportToCreditAgencyInd>
        <PermitLegalJudicialProcessInd>X</PermitLegalJudicialProcessInd>
        <CollectionActivitiesInd>0</CollectionActivitiesInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>1</NondisEmergencyCarePolicyInd>
        <AmountsGenerallyBilledInd>1</AmountsGenerallyBilledInd>
        <GrossChargesInd>0</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Geneva General Hospital</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 5: The Ontario, Seneca and Yates County Public Health Departments, in collaboration with Finger Lakes Health, other hospitals, the S2AY Rural Health Network, and the community based agencies conducted surveys of residents in the three counties through the community health needs assessment process. Surveys were disseminated through many different methods including e-mail, web pages, mailing of paper copies, dissemination of paper copies in local stores, health care facilities, public health and community facilities, and direct assistance within county buildings/agencies. Finger Lakes Health invited public participation in the needs assessment through the Spring 2016 edition of Thrive, our community health magazine. Thrive is mailed to more than 90,000 households in the health system's service area. Readers were invited to log-in to the online survey or to contact Finger Lakes Health for a paper version of the survey. Further input from the public was collected through a number of focus group sessions that were held throughout the counties.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Geneva General Hospital</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 6b: Finger Lakes Health collaborates with public health departments in our service area, as well as other human services providers, to use the framework of the NYS Health Commissioner's "Prevention Agenda" as a basis for our community health planning. We worked together to conduct a Community Health Needs Assessment (CHNA) in 2016 and establish health priorities for 2017-2020. By drawing upon the state's prevention agenda, studying data collected through primary and secondary research, and partnering with local health departments in Ontario, Seneca and Yates counties, we identified health priorities and subsequent community outreach initiatives to align with those priorities.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>Geneva General Hospital</FormAndLineReferenceDesc>
        <ExplanationTxt>Part V, Section B, Line 23: Amounts generally billed:The amounts generally billed are based upon the negotiated commercial insurance rates for the carrier with the greatest volume.</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>Reserve for Doubtful Accounts Footnote:The Hospitals, the P. C., Living Centers and the Homestead estimate the amount to be recognized in the consolidated financial statements for doubtful accounts by analyzing specific patient and resident accounts for collectability and also by applying historically established percentages for self-pay and various third-party payers to the aging categories in the accounts receivable aging for each operation. Accounts for which no payments have been received for a significant amount of time are considered delinquent and the accounts are written-off when customary collection efforts are exhausted. There were no significant changes in the calculation of the allowance for doubtful accounts in 2017.Part III, Section A, 3Costing Methodology:HFMA P&amp;P Board Statement 15, IX. Valuation and Disclosure of Bad Debts, 9.1 has been applied to the amount reported on line 2. The bad debt amount is recorded at the amount that the payer is expected to pay. The amount reported on line 3 is valued at patient care cost, i. e. the expected payment amount included in line 2 has been multiplied by the ratio of patient care cost to charges (34.5%). Based upon an analysis of income levels for accounts included in bad debts we estimated that 27% were eligible under the financial assistance program.Rationale for including a portion of bad debt amount as community benefit:It is not always possible to obtain sufficient information to make a determination of eligibility for financial assistance or reclassify bad debts as charity care. When income levels are learned we identify individuals unable to pay for services. Having provided services to those individuals we believe represents a community benefit.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>Rationale for including shortfall as community benefit:Medicare payment rates reflect constraints on federal government expenditures. In spite of the significant losses caused by these low rates we provide access to health services for a large segment of our community. We believe this enhancement of population health represents a community benefit.Source of Medicare allowable costs:Cost information is taken from the Medicare cost report.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part III, Line 9b:</FormAndLineReferenceDesc>
        <ExplanationTxt>Collection practices for patients who are known to qualify for financial assistance:After the Customer Service Representative's initial determination or the determination rendered after an appeal review, the patient's hospital account is adjusted to reflect the amount of any financial assistance deduction to be applied to it. The patient is billed for any remaining amount due, and is offered the telephone number of an individual within Patient Accounts who is available to assist the person in creating a self-payment plan that outlines patient re-payment steps over a specified period of time should the patient require such assistance. Individuals with valid requests for financial assistance are exempt from referrals to a collection agency.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>Finger Lakes Health believes that healthcare consumers taking active responsibility for their own health is the single most vital aspect to improving the quality of healthcare and to having healthier individuals and healthier communities.Finger Lakes Health's goal, as a healthcare provider, is to be a vital partner with healthcare consumers (our patients) to encourage awareness and dialogue about modifiable risk factors, outline the path and provide necessary support to achieve good health outcomes, and positively impact the health of the communities we serve. We are developing initiatives, and designing our facilities with patient-centered, evidence-based, outcome driven goals in mind. Our team has been working to achieve the best quality care outcomes to keep patients healthy and to develop prevention-oriented programs aimed at creating and sustaining healthy communities. We base programming on areas of health and wellness that matter most in our communities. That is determined by conducting health needs assessments in our communities.Finger Lakes Health collaborates with public health departments in our service area, as well as the S2AY Rural Health Network, Finger Lakes Health Systems Agency (now Common Ground Health), and other human services providers in our service area, to use the framework of the NYS Health Commissioner's "Prevention Agenda" as a basis for our community health planning. We worked together to conduct a Community Health Needs Assessment (CHNA) in 2016 and establish health priorities for 2016-2018. By drawing upon the state's prevention agenda, studying data collected through primary and secondary research, and partnering with local health departments in Ontario, Seneca and Yates counties, we identified health priorities and subsequent community outreach initiatives to align with those priorities.Tools used to conduct the CHNA, included:" Disease prevalence data" Socio-economic factors in the region" A survey in our Thrive community health magazine, circulated to 90,000 households in our service area, seeking comments on the most critical health care needs in the community" Focus groups done in cooperation with our county partners targeting specific populations, included:o In Ontario County -- first responders, Tools for Social Change community coalition, senior citizen group, Canandaigua Rotary Club, senior meal site, county leaders, and a probation groupo In Seneca County -- Seneca Towns Engaging People for Solutions, senior citizen volunteer group, Criminal Justice Advisory Board, Office for the Aging Nutrition Site, Seneca Health Solutions, Seneca Health Advisory Committee, and Ovid Rotary Clubo In Yates County -- Yates Chamber of Commerce Long Range Planning Committee, Workforce Development Job Club, FLPSS Finger Lakes NOCN, Tier II, Penn Yan Baby Caf , Bone Builders Class, Penn Yan Lions ClubAs a result of this data and comment analysis, the most highly ranked health priorities were identified for each county, as noted below:For Ontario County:" Hypertension " Substance Abuse " ObesityFor Seneca County:" Hypertension" Obesity" Substance AbuseFor Yates County:" Cerebrovascular Disease (Hypertension)" Behavioral Health (Substance Abuse and Mental Health)" ObesityWe then developed Community Service Plans (CSP)/Community Health Improvement Plans (CHIPs) for each county outlining action steps to address and target the priorities. As part of our Community Service Plan to target the priorities, Finger Lakes Health: Has all of its primary care physician practices participating in the Regional Blood Pressure Registry being overseen by Common Ground Health in an effort to increase the percentage of patients with hypertension who have controlled their blood pressure. Offers a Diabetes Prevention Program through its Diabetes Care Center that focuses on weight loss to help pre-diabetes and community members concerned about diabetes, as well as diabetics, combat the risk factors for the disease. The Diabetes Care Center has dedicated Certified Diabetes Educators who do one-on-one counseling with diabetics, conduct educational classes for diabetics and their support person and provide continuous glucose monitoring services for diabetics, as well as the prevention program. Provides the "Food, Fun and Fitness" program with teenage mentors from local high schools and colleges trained to present the six-part curriculum that emphasizes the importance of healthy eating and exercise, to elementary age students at local schools and other venues. Offers addictions counseling its employees and their family members, as well as students who are on our campuses through various educational partnerships, that includes training on the use of Narcan. Staff members and families who have at risk family members also have been given free Narcan kits. Conducts a Cardiac PRE-hab program, designed similarly to Cardiac Rehabilitation programs, to educate community members on the risks of cardiac disease, including hypertension and obesity, in an effort to prevent cardiac disease in the community. Provides educational health information on topics such as stroke symptoms, diabetes prevention, hypertension, and others, in its community health magazine Thrive, which is mailed to more than 90,000 homes in our service area twice each year. Offers "Finger Lakes Health Matters", an educational radio show that airs 26 times each year on the regional Finger Lakes Radio Network featuring Finger Lakes Health professionals speaking to a wide range of health topics, including stroke, diabetes, weight loss, and others. Sponsors the Dine &amp; Discuss Lecture Series featuring educational lectures presented by health system physicians and other healthcare professionals on varied topics, including stroke, hypertension and diabetes. Conducts free Support Groups to help individuals and their families/caregivers cope with chronic diseases - including Diabetes &amp; Stroke. Geneva General Hospital is a Joint Commission accredited and New York State-designated Stroke Center. Providers conduct Stroke Education, in addition to the Support Group, on a regular schedule for Emergency Medical Services providers in our service area, as well as for general community members. The education covers signs and symptoms, as well as risk factors and prevention information. Blood Pressure screenings are offered by the Acute Rehab Unit at Geneva General, and by health system staff at the Community Lunch program in Geneva, as well as at work places or special events, as requested by community organizations.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>A1- Community Health Education1. Website Educational Content on Finger Lakes Health websiteA. Adam &amp; Healthday2. Thrive community health magazine, distributed to more than 90,000 households in our service area - health advice, including, but not limited to:A. Partners in PreventionB. Prevention ScreeningsC. Community Health Needs Assessment &amp; Priority Setting - Community Service Plan CommitmentsD. Chat &amp; Snack - educational programs at the Geneva YMCAE. Dine &amp; Discuss - educational programs on varied topics offered to the communityF. Rehab for Older Community Dwelling AdultsG. Cardiac Health - Prevention is the Best MedicineH. Physician Referral Directory of primary care &amp; specialty physicians3. Report to the Community - Caring for you every season of your life - offers annual report distributed to businesses, community organizations, human service providers, etc. in the community. Reports on community outreach and programming to the community, including:A. Financial aid programB. New York State DOH Prevention Agenda commitmentsC. Community outreach activities and programs4. Constant Contact Newsletter - distributed quarterly to our business/fraternal/charitable partners in the community. Newsletter includes health education articles/features/tips.A. Free screenings - Shriners Screening for childrenB. Vein Screening for adultsC. Diabetes Prevention ProgramD. Cardiac PRE-hab programE. Health programs - Afib, GI Cancers, Dermatology Concerns5. CHAT (Choose Health Action Teen) program trained Geneva High School students, through the Cornell Cooperative Extension childhood obesity program curriculum (paid for by Finger Lakes Health) to become mentors to younger students and teach them how to choose healthy foods and stay active. FLH staff then scheduled the mentors at various community programs (after-school, Saturday mornings, day cares, etc.) to present the program. 6. Diabetes Prevention Program offered free educational sessions to community members with risk factors for diabetes and those who are pre-diabetic. Included nutrition, exercise and other tips to prevent diabetes and lose weight.7. Finger Lakes Health Matters - an educational radio show aired 22 times during the year on the regional Finger Lakes Radio Network featuring health system professionals speaking to a wide range of health topics, including heart health/heart disease prevention, stroke prevention, annual health screenings, immunizations &amp; more.8. Dine &amp; Discuss Lecture Series - educational lectures presented by health system physicians and other healthcare professionals on varied health topics, including: GI Cancers, What's on My Skin - dermatology discussion, Role of PT in Women's Pelvic Health, Hip &amp; Knee Replacement, Afib - New Approaches to Stroke Prevention, and others.9. Chat &amp; Snack at the Y - FLH professionals presented health and wellness talks at the YMCA for members and non-members. Topics included: Vein Insufficiency &amp; Treatments, Fall Prevention, Stroke Symptoms &amp; Prevention, Osteoporosis Risk Factors &amp; Prevention.10. Support GroupsA. Stroke Support Group facilitated monthly by Acute Rehab Unit staffA3-Health Care Support Services1. Blood Pressure Screenings - nurses provide free blood pressures at various locations in the community:a. Our Lady of Peace Parishb. Stroke Support Groupc. Community Lunch programB2-Nurses/Nursing Students1. The clinical education and mentoring of nursing students from programs of study, including the Marion W. Whelan School of Practical Nursing and the Finger Lakes Health College of Nursing &amp; Health Sciences.B3 - Other Health Professional Education1. Clinical Education provided to students from various colleges/programs of study for academic credit, including the following programs of study:a. Nurse Practitionerb. Physician Assistantc. Pharmacyd. Occupational Therapiste. Physical Therapistf. Lab2. GGH hosted Finger Lakes Regional EMS program students from FLCC and mentored them in clinical rotations in several areas including: ED, OR, RT.C5 - Negative Margin Services1. Geneva General Child Care Center provides needed services to the community, but incurs a loss.C6- Subsidized Health Services1. Geneva General Renal Dialysis Service provides needed services in our service area, but incurs a loss.E3 - In-Kind Donations1. GGH employees donating time to community agencies on behalf of GGH and Finger Lakes Health - broken out by clinical activities/staff and non-clinical activities/staff including, but not limited to:Non-Clinical:a. United Wayb. Choose Health Ontarioc. Seneca County Health Advisory Councild. Rotary Clubse. Salvation Armyf. House of Concerng. Local Development Councilh. Geneva Chamber of Commercei. Geneva Readsj. Geneva 20/20 Literacy CommitteeClinical:A. ARCs of Ontario, Monroe, SenecaB. Central/Western NY Stroke CoordinatorsC. NY Nurse ExecutivesD. American Red Cross2. Not-for-profit organization event sponsorships/support for community organizations, including:A. Boys &amp; Girls ClubB. Geneva NAACPC. Geneva Chamber of CommerceD. Geneva Rotary Service Above SelfE. ARC of Ontario Cruisin' for a CauseF. United Way of Ontario County Day of Caring3. Free use of facility space provided to community health-related organizations, including: Weight Watchers, Stroke Coordinators, Red Cross, TOPS, Finger Lakes Visiting Nurse, ARC of Ontario, FL Community College, FoodlinkF2 - Economic Development1. Dues paid to Geneva Chamber of Commerce to support economic development initiativesF3 - Community Support1. Disaster Readiness - Dollars spent and space allocated for disaster/emergency preparedness activities - stockpiling supplies to use for those purposesF4 - Environmental Improvements1. Sharps Disposal program - needles are collected from community members who properly secure them, to be disposed of properly, free of charge by the hospitalF6 - Coalition Building1. Health System Administrative Team members participate on various community agency boards and build partnerships with many community organizations to improve the health of our communities, including, but not limited to:A. ARC of OntarioB. Rochester Regional Health AssociationC. Happiness HouseD. Finger Lakes Health Systems AgencyE. City of Geneva Development CommitteeF. Ontario County Choose Health CommitteeG. Lakeview Mental HealthH. Geneva Boys &amp; Girls ClubI. Geneva 2020F7 - Community Health Improvement Advocacy1. City of Geneva Payment - Geneva General Hospital makes a donation to the City of Geneva for civic and community purposes.F8 - Workforce Development1. Partnerships with Colleges &amp; UniversitiesA. Hobart-William Smith Educational Partnership program hosts HWS students in a health services program, who are planning on post-graduate education in health careers to observe/intern in areas of interest to gain experience and participate in career exploration before graduation.B. Observation/Internships/Shadowing - Students from colleges and high schools explore healthcare careers by observing healthcare professionals at work.C. Hobart-William Smith Death &amp; Dying Class - Living Centers at Geneva staff mentor HWS students while the students spend time with residents living at the facilities as part of the students' class related to geriatrics and death and dying topics.2. School-Based Programs on Health CareersA. Exploring Careers in Healthcare - two events for middle school and high school students to explore healthcare careers. Professionals in multiple clinical areas spent time with students outlining careers, educational requirements, etc. and offering many hands-on activities.B. New Vision Medical Career program - extensive, academic year-long medical exploration program for high school seniors planning to pursue healthcare careers. Students spent 150 hours each rotating through departments.C. Healthcare Alliance Event - Shared information on opportunities for students to learn about health careers; gave Surgical Services hands on demo to show students a job and learn about positions and training in the Surg Tech fieldD. Career Exploration Day - health professionals went to the event at a local community center to provide information on health careers to 250 students.3. Workforce InvestmentA. Project Search program - partnership with ARC of Ontario to equip clients with job skills through on-the-job training programs.B. Ontario County Workforce Development placed students during summer to learn job skills from GGH staff. 4. Physician Recruitment - Expenses incurred to recruit physicians to meet an unmet need for access to care in the community.G1 - Community Event Coordination- Dedicated Staff 1. Staff time devoted to Community Event Coordination to meet the needs</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part VI, Line 7, Reports Filed With States</FormAndLineReferenceDesc>
        <ExplanationTxt>NY</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleH>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Robert Anderson MD</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>187418</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>18432</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>205850</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jose Acevedo MD MBA</PersonNm>
        <TitleTxt>President &amp; CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>491150</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>99970</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>384951</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>50000</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>27455</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>1053526</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>334951</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Dr Ketul Patel</PersonNm>
        <TitleTxt>Trustee through 4/30/17</TitleTxt>
        <BaseCompensationFilingOrgAmt>353653</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>30216</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>43362</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24209</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>451440</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Frank Korich</PersonNm>
        <TitleTxt>Sr VP Operations</TitleTxt>
        <BaseCompensationFilingOrgAmt>155368</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>28224</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>43842</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>26947</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>254381</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Eileen Gage</PersonNm>
        <TitleTxt>VP, Nursing</TitleTxt>
        <BaseCompensationFilingOrgAmt>150836</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>20018</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>60496</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>24502</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>255852</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Jason Feinberg MD</PersonNm>
        <TitleTxt>Chief Medical Officer</TitleTxt>
        <BaseCompensationFilingOrgAmt>317699</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>35768</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>36414</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>26503</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>416384</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Patrick Boyle</PersonNm>
        <TitleTxt>VP, Human Resources</TitleTxt>
        <BaseCompensationFilingOrgAmt>189669</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>24149</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>15712</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>28072</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>257602</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Joseph Gomez MD</PersonNm>
        <TitleTxt>Physician (Cardiology)</TitleTxt>
        <BaseCompensationFilingOrgAmt>557958</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>24000</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>581958</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Matthew Talbott</PersonNm>
        <TitleTxt>Physician Ed</TitleTxt>
        <BaseCompensationFilingOrgAmt>467536</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>29109</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18955</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>515600</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Amanda Carpenter</PersonNm>
        <TitleTxt>Physician (Dermatology)</TitleTxt>
        <BaseCompensationFilingOrgAmt>407273</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>63091</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>18339</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>1311</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>490014</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>Emily Lambert</PersonNm>
        <TitleTxt>Physician (Dermatology)</TitleTxt>
        <BaseCompensationFilingOrgAmt>428042</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>674929</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>36000</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>1138971</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CT Harrison</PersonNm>
        <TitleTxt>Anesthesiologist</TitleTxt>
        <BaseCompensationFilingOrgAmt>376898</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>29945</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>21400</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>9851</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>438094</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part I, Line 4b</FormAndLineReferenceDesc>
        <ExplanationTxt>Geneva General Hospital deposited $50,000 into a 457(f) plan in 2017 for Dr. Jose Acevedo, MD, MBA, President &amp; CEO. Dr. Jose Acevedo, MD, MBA, President and &amp; CEO also recieved a distribution of 457 (f) plan in 2017 in the amount of $358,466.93.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="RetDoc1042800001">
      <LoansBtwnOrgInterestedPrsnGrp>
        <PersonNm>Joseph GomezMD</PersonNm>
        <RelationshipWithOrgTxt>Physician (Cardiology), Highest Compensated Employee</RelationshipWithOrgTxt>
        <LoanPurposeTxt>Contract Signing</LoanPurposeTxt>
        <LoanFromOrganizationInd>X</LoanFromOrganizationInd>
        <OriginalPrincipalAmt>25000</OriginalPrincipalAmt>
        <BalanceDueAmt>12857</BalanceDueAmt>
        <DefaultInd>0</DefaultInd>
        <BoardOrCommitteeApprovalInd>0</BoardOrCommitteeApprovalInd>
        <WrittenAgreementInd>1</WrittenAgreementInd>
      </LoansBtwnOrgInterestedPrsnGrp>
      <TotalBalanceDueAmt>12857</TotalBalanceDueAmt>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Jason Feinberg MD</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>VP Med Aff &amp; CMO, Former Trustee</RelationshipDescriptionTxt>
        <TransactionAmt>389881</TransactionAmt>
        <TransactionDesc>Compensation as employee, VP Med Aff &amp; CMO</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
      <BusTrInvolveInterestedPrsnGrp>
        <NameOfInterested>
          <PersonNm>Marjorie Adams</PersonNm>
        </NameOfInterested>
        <RelationshipDescriptionTxt>Daughter of Board Member, Reverend James Adams</RelationshipDescriptionTxt>
        <TransactionAmt>64755</TransactionAmt>
        <TransactionDesc>Ms. Adams is employed by Geneva General Hospital.</TransactionDesc>
        <SharingOfRevenuesInd>0</SharingOfRevenuesInd>
      </BusTrInvolveInterestedPrsnGrp>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>The Form 990 is reviewed by the Administrative Committee of the Board prior to being filed. Any Committee findings are reviewed and implemented as appropriate by management. Changes in IRS requirements and organization practices from the prior year are highlighted for the Committee by management. The Committee reports on this discussion to the full Board.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>Geneva General Hospital maintains a conflict of interest policy which board members are required to sign prior to taking office. Statements are reviewed annually by an Administrative Committee. The process for handling any conflicts of interest which may arise are detailed in the corporate bylaws.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, line 15</FormAndLineReferenceDesc>
        <ExplanationTxt>Compensation is reviewed by a compensation committee, and comparability data is part of the decision.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>Geneva General Hospital makes its governing documents, conflict of interest policy, and financial statements available to the public where required by law and upon request. The organization's Form 990 is provided to any individual who provides a request in person or who submits a written request. There is no charge other than a reasonable fee for copying and postage. Copies are available at the Finance Office. An electronic version may be found at www.guidestar.org.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part XI, line 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>Change in Funded Status of Pension Plan 2,461,076.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Part IV, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>Association dues included in $17,740 of lobbying expense.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Finger Lakes Regional Health System Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>196 North Street</AddressLine1Txt>
          <CityNm>Geneva</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14456</ZIPCd>
        </USAddress>
        <EIN>223193606</EIN>
        <PrimaryActivitiesTxt>Sole Member of GGH, LCS, HLC, LCN, SSMH, FLHSC and FLHF</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>7</PublicCharityStatusTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Living Center at Geneva South</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>196 North Street</AddressLine1Txt>
          <CityNm>Geneva</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14456</ZIPCd>
        </USAddress>
        <EIN>160957268</EIN>
        <PrimaryActivitiesTxt>Skilled Nursing Facility</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Finger Lakes Regional Health System Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Huntington Living Center</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>369 East Main Street</AddressLine1Txt>
          <CityNm>Waterloo</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13165</ZIPCd>
        </USAddress>
        <EIN>510169552</EIN>
        <PrimaryActivitiesTxt>Skilled Nursing Facility</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Finger Lakes Regional Health System Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Geneva General Hospital Housing Development Co</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>260 North Street</AddressLine1Txt>
          <CityNm>Geneva</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14456</ZIPCd>
        </USAddress>
        <EIN>222816883</EIN>
        <PrimaryActivitiesTxt>Operate Low Income Housing for elderly &amp; handicapped</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>9</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Finger Lakes Regional Health System Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Taylor Brown Memorial Hospital Housing Development Co</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>371 East Main Street</AddressLine1Txt>
          <CityNm>Waterloo</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>13165</ZIPCd>
        </USAddress>
        <EIN>222807734</EIN>
        <PrimaryActivitiesTxt>Operate Low Income Housing for elderly &amp; handicapped</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>9</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Finger Lakes Regional Health System Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Living Center at Geneva North</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>196 North Street</AddressLine1Txt>
          <CityNm>Geneva</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14456</ZIPCd>
        </USAddress>
        <EIN>161449543</EIN>
        <PrimaryActivitiesTxt>Skilled Nursing Facility</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Finger Lakes Regional Health System Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Soldiers &amp; Sailors Memorial Hospital</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>418 N Main Street</AddressLine1Txt>
          <CityNm>Penn Yan</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14527</ZIPCd>
        </USAddress>
        <EIN>160743192</EIN>
        <PrimaryActivitiesTxt>Provider of Healthcare Services</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Finger Lakes Regional Health System Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>FLH Senior Communities Inc</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>196 North Street</AddressLine1Txt>
          <CityNm>Geneva</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14456</ZIPCd>
        </USAddress>
        <EIN>205604917</EIN>
        <PrimaryActivitiesTxt>Develop a Senior Citizen Housing Complex</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>9</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Finger Lakes Regional Health System Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Finger Lakes Health Foundation</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>196 North Street</AddressLine1Txt>
          <CityNm>Geneva</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14456</ZIPCd>
        </USAddress>
        <EIN>150549310</EIN>
        <PrimaryActivitiesTxt>Coordinate Fundraising Activities</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>11c</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Finger Lakes Regional Health System Inc</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>FLH Medical PC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>196 North Street</AddressLine1Txt>
          <CityNm>Geneva</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14456</ZIPCd>
        </USAddress>
        <EIN>263765332</EIN>
        <PrimaryActivitiesTxt>Medical Practices</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501 (C) (3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>11a</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>Geneva General Hospital</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>1</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>1</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Finger Lakes Health Foundation</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>3150205</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Direct Transaction(s)</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Finger Lakes Health Foundation</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>5395861</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Direct Transaction(s)</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Soldiers &amp; Sailors Memorial Hospital of Yates County</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>2477253</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Direct Transaction(s)</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Huntington Living Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>870143</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Direct Transaction(s)</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Living Center at Geneva South</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>487730</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Direct Transaction(s)</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Living Center at Geneva North</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>2427069</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Direct Transaction(s)</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>FLH Medical PC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>5097818</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Direct Transaction(s)</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Soldiers Ventures</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>2250</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Direct Transaction(s)</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Soldiers &amp; Sailors Memorial Hospital of Yates County</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>1654211</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Direct Transaction(s)</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Living Center at Geneva South</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>592351</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Direct Transaction(s)</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>FLH Medical PC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>E</TransactionTypeTxt>
        <InvolvedAmt>9853521</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Direct Transaction(s)</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Huntington Living Center</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>E</TransactionTypeTxt>
        <InvolvedAmt>1019119</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Direct Transaction(s)</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Soldiers Ventures</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>E</TransactionTypeTxt>
        <InvolvedAmt>2250</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Direct Transaction(s)</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Living Center at Geneva North</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>D</TransactionTypeTxt>
        <InvolvedAmt>557058</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Direct Transaction(s)</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>