ROME MEMORIAL HOSPITAL INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: ROME MEMORIAL HOSPITAL INC (EIN 16-1471634)
Tax period: 2017-01-01 to 2017-12-31
Filed: 2018-11-09
IRS object ID: 201833139349303413
Schema version: 2017v2.3
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-11-09T14:56:04-06:00	ReturnTs
Tax Period End	2017-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	161226221	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	FUST CHARLES CHAMBERS LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	5784 WIDEWATERS PARKWAY	AddressLine1Txt
City	SYRACUSE	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13214	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2017-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	161471634	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ROME MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	ROME	BusinessNameControlTxt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1500 NORTH JAMES STREET	AddressLine1Txt
City	ROME	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13440	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DEWEY ROWLANDS	PersonNm
Person Title	CFO/VP FINANCE	PersonTitleTxt
Phone	3153387000	PhoneNum
Signature	2018-10-13	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	ANGELA M FRANCO	PreparerPersonNm
PTIN	P00589741	PTIN
Phone	3154463600	PhoneNum
Preparation	2018-10-12	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	24.39.85.114	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2018-10-13	IPDt
IP Tm	13:22:43	IPTm
IP Timezone	ED	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	1810175FCAB42B8EBF7D2FB267B59522BE28B9D6	AtSubmissionCreationDeviceId
At Submission Filing Device Id	FD62137317EE26C9F26E40FD83CAC65FE1294EC8	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2017	TaxYr
Build TS	2019-02-21 02:37:17Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DAVID LUNDQUIST	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1500 NORTH JAMES STREET	AddressLine1Txt
City	ROME	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13440	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$85,964,847	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	ROMEHOSPITAL.ORG	WebsiteAddressTxt
Type Of Organization Assoc	Yes (X)	TypeOfOrganizationAssocInd
Formation	1995	FormationYr
Legal Domicile State	NY	LegalDomicileStateCd
Activity Or Mission	PROVIDE QUALITY HEALTHCARE WITH COMPASSION.	ActivityOrMissionDesc
Voting Members Governing Body	14	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	1220	TotalEmployeeCnt
Total Volunteers	202	TotalVolunteersCnt
Total Gross UBI	$629,658	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$97,679	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$19,064,968	PYContributionsGrantsAmt
CY Contributions Grants	$2,317,919	CYContributionsGrantsAmt
PY Program Service Revenue	$79,995,161	PYProgramServiceRevenueAmt
CY Program Service Revenue	$81,815,112	CYProgramServiceRevenueAmt
PY Investment Income	$145,849	PYInvestmentIncomeAmt
CY Investment Income	$153,507	CYInvestmentIncomeAmt
PY Other Revenue	$1,079,829	PYOtherRevenueAmt
CY Other Revenue	$1,438,124	CYOtherRevenueAmt
PY Total Revenue	$100,285,807	PYTotalRevenueAmt
CY Total Revenue	$85,724,662	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$45,702,829	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$47,764,681	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$39,785,087	PYOtherExpensesAmt
CY Other Expenses	$41,106,535	CYOtherExpensesAmt
PY Total Expenses	$85,487,916	PYTotalExpensesAmt
CY Total Expenses	$88,871,216	CYTotalExpensesAmt
PY Revenues Less Expenses	$14,797,891	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$3,146,554	CYRevenuesLessExpensesAmt
Total Assets BOY	$55,648,804	TotalAssetsBOYAmt
Total Assets EOY	$55,501,103	TotalAssetsEOYAmt
Total Liabilities BOY	$25,230,438	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$27,876,413	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$30,418,366	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$27,624,690	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	ABOUT ROME MEMORIAL HOSPITAL: OVERALL, ROME MEMORIAL HOSPITAL PROVIDES INPATIENT, OUTPATIENT, SKILLED NURSING, AND EMERGENCY CARE SERVICES PRIMARILY FOR THE RESIDENTS OF ROME AND THE SURROUNDING AREAS.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$29,636,027	ExpenseAmt
Revenue	$25,904,263	RevenueAmt
Desc	INPATIENT CARE SERVICES, INPATIENT NURSING UNITS CONSIST OF THE FOLLOWING:INTENSIVE CARE-2ND FLOOR, MATERNITY-4TH FLOOR, 2 EAST MEDICAL/SURGICAL-2ND FLOOR, 2 NORTH MEDICAL/SURGICAL WITH CARDIAC MONITORING-2ND FLOOR, PEDIATRICS-2ND FLOOR, AND SENIOR BEHAVIORIAL HEALTH- 2ND FLOOR.2017 INPATIENT DISCHARGES: 3,8242017 BIRTHS: 5542017 PATIENT DAYS: 16,475	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$8,268,898	ExpenseAmt
Revenue	$7,257,679	RevenueAmt
Desc	RESIDENTIAL HEALTHCARE FACILITY (RHCF)BECAUSE OF OUR COMMITTMENT TO SERVE THE UNIQUE NEEDS OF SENIORS, WE HAVE AN 80-BED RESIDENTIAL HEALTH CARE FACILITY AND INPATIENT UNIT FOR SENIOR BEHAVIORIAL HEALTH CARE. OUR RESIDENTIAL HEALTHCARE FACILITY CONSISTS OF THE FOLLOWING: LONG-TERM NURSING HOME CARE, SHORT-TERM SUB-ACUTE REHABILITATION, AND RESPITE CARE- ALL LOCATED ON THE 3RD FLOOR.2017 PATIENT DAYS = 27,3632017 OCCUPANCY PERCENTAGE = 93.71%	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$8,361,206	ExpenseAmt
Revenue	$11,400,203	RevenueAmt
Desc	EMERGENCY DEPARTMENT (ED)ROME MEMORIAL HOSPITAL EMERGENCY DEPARTMENT IS A SAFETY NET FOR THE MOST VULNERABLE POPULATIONS IN THE COMMUNITY. IN 2017, APPROXIMATELY 46% OF THE PATIENTS TREATED WERE LISTED AS UNINSURED OR UNDER INSURED. FOR LOWER LEVEL EMERGENCY DEPARTMENT VISITS, THIS POPULATION REPRESENTED 59% OF THE VISITS BECAUSE MANY PRIMARY CARE PHYSICIANS DO NOT ACCEPT MEDICAID.2017 ED ADMISSIONS: 3,4162017 ED VISITS: 31,042	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$26,935,394	ExpenseAmt
Revenue	$37,252,967	RevenueAmt
Desc	ALL OTHER ACHIEVEMENTS PROVIDE QUALITY, COMPASSIONATE CARE IN A SAFE ENVIRONMENT TO SERVE THE HEALTHCARE NEEDS OF THE PEOPLE OF ROME AND THE SURROUNDING COMMUNITIES.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$26,935,394	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue	$37,252,967	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$73,201,525	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	40	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1220	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	14	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	NY	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	DEWEY ROWLANDS - ROME MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	3153387024	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1500 NORTH JAMES STREET	AddressLine1Txt
City	ROME	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13440	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
CHESTER PATRICK MD
CHAIRMAN	2.00	Yes (X)	Yes (X)	$0	$0	$0
LYNN REESE
VICE CHAIRMAN	2.00	Yes (X)	Yes (X)	$0	$0	$0
DARLENE BURNS
SECRETARY	2.00	Yes (X)	Yes (X)	$0	$0	$0
JULIE GROW-DENTON
TREASURER	2.00	Yes (X)	Yes (X)	$0	$0	$0
ANKUR DESAI MD
DIRECTOR	2.00	Yes (X)		$7,063	$0	$0
DAVID NOLAN
DIRECTOR	2.00	Yes (X)		$0	$0	$0
DENNIS SURACE
DIRECTOR	2.00	Yes (X)		$0	$0	$0
DONALD HANSON
DIRECTOR	2.00	Yes (X)		$0	$0	$0
JOHN RESTIVO MD
DIRECTOR	2.00	Yes (X)		$0	$0	$0
KIM COOK
DIRECTOR	2.00	Yes (X)		$0	$0	$0
KRISTIN GRUNDER
DIRECTOR	2.00	Yes (X)		$0	$0	$0
LORI KAPLAN FELICE
DIRECTOR	2.00	Yes (X)		$0	$0	$0
RYAN O'SHAUGNESSY
DIRECTOR	2.00	Yes (X)		$0	$0	$0
W ROBERT HERRMANN
DIRECTOR	2.00	Yes (X)		$0	$0	$0
KRISTIN MUCITELLI-HEATH
ST. JOSEPH'S HOSPITAL HEALTH LIASON	2.00	Yes (X)		$0	$0	$0
DAVID LUNDQUIST
CEO	45.00		Yes (X)	$289,067	$67,806	$578	10.00
DEWEY ROWLANDS
CFO	48.00		Yes (X)	$192,413	$28,751	$13,195	7.00
DURINDA DURR
VP CLINICAL SERVICES	55.00			$145,117	$0	$5,269		Yes (X)
SCOTT BURNS
DIRECTOR OF PHARMACY	55.00			$142,696	$0	$13,320		Yes (X)
ROSEMEL ATKINSON
VP PHYSICIAN PRACTICES	11.00			$28,262	$113,047	$229	44.00	Yes (X)
LINDA SMITH
REGISTERED NURSE	55.00			$130,453	$0	$10,674		Yes (X)
LAURA LONERGAN
PHARMACIST	55.00			$128,255	$0	$5,242		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,063,326	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$209,604	TotReportableCompRltdOrgAmt
Total Other Compensation	$48,507	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	40	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
LABCORP
PO BOX 12140	BURLINGTON	NC	27216	LAB SERVICES	$4,750,179
STAT STAFF PROFESSIONALS
18 DIVISION STREET	SARATOGA SPRINGS	NY	12866	NURSE STAFFING	$1,261,780
MCKESSON
PO BOX 98347	CHICAGO	IL	606938347	HEALTHCARE INFORMATION TECHNOLOGY	$798,803
EAGLE HOSPITAL PHYSICIANS LLC
16000 N DALLAS PARKWAY SUITE 450	DALLAS	TX	75248	HOSPITALIST SERVICES	$536,175
HEALOGIC
28525 NETWORK PLACE	CHICAGO	IL	60673	HYPERBARIC MANAGEMENT SERVICES	$506,835

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	29	CntrctRcvdGreaterThan100KCnt
Related Organizations	$128,242	RelatedOrganizationsAmt
Government Grants	$2,116,693	GovernmentGrantsAmt
All Other Contributions	$72,984	AllOtherContributionsAmt
Total Contributions	$2,317,919	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
INPATIENT SERVICES	622110	$25,904,263	$25,904,263
EMERGENCY DEPARTMENT	621990	$11,400,203	$11,400,203
RESIDENTIAL HEALTHCARE FACILITY	623990	$7,257,679	$7,257,679

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$37,252,967	TotalRevenueColumnAmt
Related Or Exempt Func Income	$37,252,967	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$81,815,112	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$89,015	TotalRevenueColumnAmt
Exclusion	$89,015	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$30,101	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$9,531	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$20,570	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$20,570	TotalRevenueColumnAmt
Exclusion	$20,570	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$267,682	SecuritiesAmt
Other	$27,464	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$219,832	SecuritiesAmt
Other	$10,822	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$47,850	SecuritiesAmt
Other	$16,642	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$64,492	TotalRevenueColumnAmt
Exclusion	$64,492	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
ACCOUNTING & CONSULTING	541200	$338,810	$338,810
CAFETERIA SALES	722514	$277,471		$277,471
GRIFFISS EYE SURGERY CENTER	621493	$202,054	$202,054

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$599,219	TotalRevenueColumnAmt
Unrelated Business Revenue	$88,794	UnrelatedBusinessRevenueAmt
Exclusion	$510,425	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,417,554	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$85,724,662	TotalRevenueColumnAmt
Related Or Exempt Func Income	$81,815,112	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$629,658	UnrelatedBusinessRevenueAmt
Exclusion	$961,973	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$500,490	TotalAmt
Management And General	$500,490	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$39,766,970	TotalAmt
Program Services	$35,035,314	ProgramServicesAmt
Management And General	$4,731,656	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$370,575	TotalAmt
Program Services	$322,809	ProgramServicesAmt
Management And General	$47,766	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,111,014	TotalAmt
Program Services	$4,081,537	ProgramServicesAmt
Management And General	$29,477	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,015,632	TotalAmt
Program Services	$2,624,064	ProgramServicesAmt
Management And General	$391,568	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$290,583	TotalAmt
Management And General	$290,583	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$59,825	TotalAmt
Management And General	$59,825	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$20,600	TotalAmt
Management And General	$20,600	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$12,000,596	TotalAmt
Program Services	$11,444,616	ProgramServicesAmt
Management And General	$555,980	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$153,687	TotalAmt
Program Services	$86,636	ProgramServicesAmt
Management And General	$67,051	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$347,347	TotalAmt
Program Services	$171,523	ProgramServicesAmt
Management And General	$175,824	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,833,192	TotalAmt
Program Services	$252,444	ProgramServicesAmt
Management And General	$1,580,748	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,076,037	TotalAmt
Program Services	$891,412	ProgramServicesAmt
Management And General	$184,625	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$90,785	TotalAmt
Program Services	$68,459	ProgramServicesAmt
Management And General	$22,326	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$98,414	TotalAmt
Program Services	$65,528	ProgramServicesAmt
Management And General	$32,886	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$154,776	TotalAmt
Management And General	$154,776	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$3,147,563	TotalAmt
Program Services	$2,113,253	ProgramServicesAmt
Management And General	$1,034,310	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$692,776	TotalAmt
Management And General	$692,776	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
SUPPLIES	$5,363,005	$5,228,857	$134,148
BAD DEBT EXPENSE	$5,049,192	$5,049,192
PHARMACY	$2,678,743	$2,678,743
PURCHASE SERVICES	$2,246,534	$1,920,096	$326,438

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,802,880	TotalAmt
Program Services	$1,167,042	ProgramServicesAmt
Management And General	$4,635,838	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$88,871,216	TotalAmt
Program Services	$73,201,525	ProgramServicesAmt
Management And General	$15,669,691	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$6,007,556	BOYAmt
EOY	$4,990,221	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$6,641,852	BOYAmt
EOY	$6,625,111	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$1,136,883	BOYAmt
EOY	$1,683,589	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,718,359	BOYAmt
EOY	$1,752,619	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$3,666,603	BOYAmt
EOY	$2,993,405	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$83,940,108	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$55,628,035	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$28,291,342	BOYAmt
EOY	$28,312,073	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$1,660,002	BOYAmt
EOY	$1,855,133	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$6,526,207	BOYAmt
EOY	$7,288,952	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$55,648,804	BOYAmt
EOY	$55,501,103	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$11,137,768	BOYAmt
EOY	$12,900,950	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$14,092,670	BOYAmt
EOY	$14,975,463	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$25,230,438	BOYAmt
EOY	$27,876,413	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$29,714,081	BOYAmt
EOY	$26,910,105	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$118,344	BOYAmt
EOY	$128,644	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$585,941	BOYAmt
EOY	$585,941	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$30,418,366	BOYAmt
EOY	$27,624,690	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$55,648,804	BOYAmt
EOY	$55,501,103	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$3,146,554	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$122,197	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$230,681	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (1)	DirectContactLegislatorsInd
Direct Contact Legislators	$17,027	DirectContactLegislatorsAmt
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	0	OtherActivitiesInd
Total Lobbying Expenditures	$17,027	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	$17,027 REPRESENTS THE PORTION OF THE 2017 MEMBERSHIP DUES OF HANYS, AHA, AND IROQUOIS HEALTHCARE ALLIANCE, THAT RMH IS A MEMBER OF, THAT HAS BEEN DEEMED TO BE RELATED TO LOBBYING EXPENSES. THESE EXPENDITURES ARE DEFINED AS DIRECT COMMUNICATIONS WITH CERTAIN MEMBERS OF FEDERAL, STATE, OR LOCAL GOVERNMENTS TO INFLUENCE LEGISLATION.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$704,285	BeginningYearBalanceAmt
Investment Earnings Or Losses	$40,484	InvestmentEarningsOrLossesAmt
Other Expenditures	$30,184	OtherExpendituresAmt
End Year Balance	$714,585	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$751,555	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$12,601	InvestmentEarningsOrLossesAmt
Other Expenditures	$34,669	OtherExpendituresAmt
End Year Balance	$704,285	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$747,775	BeginningYearBalanceAmt
Investment Earnings Or Losses	$102,327	InvestmentEarningsOrLossesAmt
Other Expenditures	$98,547	OtherExpendituresAmt
End Year Balance	$751,555	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$925,258	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$151,437	InvestmentEarningsOrLossesAmt
Other Expenditures	$26,045	OtherExpendituresAmt
End Year Balance	$747,775	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$953,476	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$2,031	InvestmentEarningsOrLossesAmt
Other Expenditures	$26,187	OtherExpendituresAmt
End Year Balance	$925,258	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.82000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.18000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$43,685,935	OtherCostOrOtherBasisAmt
Depreciation	$23,220,413	DepreciationAmt
Book Value	$20,465,522	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,475,341	OtherCostOrOtherBasisAmt
Depreciation	$2,335,059	DepreciationAmt
Book Value	$140,282	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$34,873,690	OtherCostOrOtherBasisAmt
Depreciation	$27,802,326	DepreciationAmt
Book Value	$7,071,364	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,905,142	OtherCostOrOtherBasisAmt
Depreciation	$2,270,237	DepreciationAmt
Book Value	$634,905	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$28,312,073	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
NET ASSETS OF FOUNDATION	$1,021,219
OTHER LONG-TERM RECEIVABLES	$6,166,771
INVESTMENTS - GRIFFISS EYE CENTER	$100,962

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$7,288,952	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
OTHER LONG-TERM LIABILITIES	$8,043,038
THIRD-PARTY PAYABLE, NET	$4,867,679
DUE TO RELATED ENTITIES	$2,064,746

Field	Value	IRS element (for citing)
Total Liability	$14,975,463	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART V, LINE 4:

INTENDED USE OF ENDOWMENT FUND IS THAT THE PRINCIPLE CAN BE INVESTED, WHILE KEPT INTACT IN PERPETUITY; ONLY THE INCOME GENERATED CAN BE USED BY THE ORGANIZATION.

PART X, LINE 2:

THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAXES ON UNRELATED BUSINESS INCOME UNDER SECTION 511 OF THE INTERNAL REVENUE CODE. ROME MEDICAL GROUP AND ROME MEDICAL PRACTICE ARE FOR-PROFIT ENTITIES SUBJECT TO FEDERAL AND STATE INCOME TAXES. AS OF DECEMBER 31, 2017 AND 2016, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2014 THROUGH 2017. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent100	Yes (X)	Percent100Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$763,758	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$487,041	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$276,717	NetCommunityBenefitExpnsAmt
Total Expense	0.00330	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$20,114,907	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,479,961	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,634,946	NetCommunityBenefitExpnsAmt
Total Expense	0.04340	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$20,878,665	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,967,002	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,911,663	NetCommunityBenefitExpnsAmt
Total Expense	0.04670	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$122,152	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,744	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$115,408	NetCommunityBenefitExpnsAmt
Total Expense	0.00140	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$28,847	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$25,465	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,382	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$150,999	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$32,209	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$118,790	NetCommunityBenefitExpnsAmt
Total Expense	0.00140	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,029,664	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,999,211	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,030,453	NetCommunityBenefitExpnsAmt
Total Expense	0.04810	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$115,836	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$115,836	NetCommunityBenefitExpnsAmt
Total Expense	0.00140	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$115,836	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$115,836	NetCommunityBenefitExpnsAmt
Total Expense	0.00140	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReportedInd
Bad Debt Expense	$1,428,420	BadDebtExpenseAmt
Bad Debt Expense Attributable	$240,634	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$20,437,262	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$23,443,111	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$3,005,849	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	0	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	1 GRIFFIS EYE CENTER LLC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	SEE SCHEDULE R PART VII	PrimaryActivitiesTxt
Org Profit Or Ownership	0.29100	OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership	0.00000	OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership	0.70900	PhysiciansProfitOrOwnershipPct

Field	Value	IRS element (for citing)
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ROME MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1500 NORTH JAMES STREET	AddressLine1Txt
City	ROME	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13440	ZIPCd

Field	Value	IRS element (for citing)
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ROME MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	16	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE LINE 7D DESCRIPTION FOR FULL URL	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	SEE LINE 7D DESCRIPTION FOR FULL URL	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE LINE 7D DESCRIPTION FOR FULL URL	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	100.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	HTTP://WWW.ROMEHOSPITAL.ORG/FINANCIALASSISTANCE/	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTP://WWW.ROMEHOSPITAL.ORG/FINANCIALASSISTANCE/	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTP://WWW.ROMEHOSPITAL.ORG/FINANCIALASSISTANCE/	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare	Yes (X)	LookBackMedicareInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
ROME MEMORIAL HOSPITAL	PART V, SECTION B, LINE 5: THE 2016-2018 ONEIDA COUNTY COMMUNITY HEALTH ASSESSMENT (CHA)/COMMUNITY SERVICE PLAN (CSP) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IS AN APPENDIX AND UPDATE TO THE COMPREHENSIVE 2013-2017 ONEIDA COUNTY CHA/CSP AND CHIP. THE REPORT SUMMARIZES THE HEALTH STATUS OF THE COMMUNITY AND PUBLIC HEALTH AND HOSPITAL PREVENTION AGENDA HEALTH IMPROVEMENT GOALS FOR THE RESIDENTS OF THE COUNTY OF ONEIDA.THE PLANNING TEAM, COMPRISED OF THE ONEIDA COUNTY HEALTH DEPARTMENT, ROME MEMORIAL HOSPITAL (RMH), ST. ELIZABETH MEDICAL CENTER (SEMC) AND FAXTON-ST. LUKE'S HOSPITAL (FSL) RECONVENED IN 2017 TO UPDATE THE CHA AND CHIP. THE PROCESS INCLUDED REVIEWING HEALTH DATA FROM VARIOUS LOCAL, REGIONAL AND STATE SOURCES, SOLICITING FEEDBACK FROM THE COMMUNITY AND STAKEHOLDERS, AND REVIEWING, REAFFIRMING, AND ADJUSTING GOALS AND STRATEGIES FOR PRIORITIES SELECTED IN THE PREVIOUS ASSESSMENT. THE REPORT SUMMARIZES THE HEALTH STATUS OF THE COMMUNITY AND THE SELECTED PUBLIC HEALTH AND HOSPITAL PREVENTION AGENDA HEALTH IMPROVEMENT GOALS FROM THE NYS PREVENTION AGENDA FOCUS AREAS, SPECIFICALLY, PREVENT CHRONIC DISEASES WITH A FOCUS ON TOBACCO CESSATION AND PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN, WITH A FOCUS ON BREASTFEEDING PROMOTION.A VARIETY OF DATA SOURCES WERE USED TO IDENTIFY AND CONFIRM PRIORITIES INCLUDING: THE NYS PREVENTION AGENDA DASHBOARD, HEALTHECONNECTIONS, NEW YORK STATE QUITLINE PARTNERS REPORTS, ONEIDA COUNTY TEEN ASSESSMENT PROJECT (TAP), AND THE PEDIATRIC NUTRITION SURVEILLANCE SYSTEM (PEDNSS) REPORTS. THE PLANNING TEAM ALSO REVIEWED DATA FROM THE JOHN SNOW, INC. COMMUNITY HEALTH ASSESSMENT FOR THE CENTRAL NEW YORK CARE COLLABORATIVE (CNYCC), THE COUNTY HEALTH RANKINGS, AND BRIDGES COMMUNITY SURVEY. PARTNERS INCLUDE THE ONEIDA COUNTY HEALTH COALITION STEERING COMMITTEE AND THE TWO PREVENTION AGENDA PRIORITY AREA WORK GROUPS THAT FOCUS ON TOBACCO USE CESSATION AND BREASTFEEDING. THE COALITION CONSISTS OF COMMUNITY PARTNERS INCLUDING HOSPITALS, OCHD AND COMMUNITY ORGANIZATIONS. THE STEERING COMMITTEE ASSISTED BY REAFFIRMING OUR PRIORITY AREAS AND WILL SERVE AS AN ONGOING RESOURCE FOR IMPLEMENTATION EFFORTS. OUR PRIORITY AREA WORK GROUPS INCLUDE MEMBERS FROM ONEIDA COUNTY HOSPITALS, OCHD AND COMMUNITY ORGANIZATION STAFF MEMBERS WHO HAVE A FOCUS ON THE PRIORITY AREA. BOTH GROUPS HELP WITH PLANNING, IMPLEMENTATION AND ONGOING MONITORING OF THE IMPROVEMENT PLANS.THE ONEIDA COUNTY COMMUNITY HEALTH ASSESSMENT/COMMUNITY SERVICE PLAN & COMMUNITY HEALTH IMPROVEMENT PLAN (CHA/CSP/CHIP) PLANNING TEAM REAFFIRMED THE FOLLOWING AS ITS TOP TWO PREVENTION AGENDA PRIORITIES FOR THE 2016-2018 UPDATE: PREVENT CHRONIC DISEASES PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN THE PRIORITY AREAS HAVE REMAINED THE SAME SINCE 2013, HOWEVER THERE ARE SOME ADDITIONAL AREAS IDENTIFIED. THE PRIORITY TO PREVENT CHRONIC DISEASES IS BEING ADDRESSED THROUGH A FOCUS ON TOBACCO CESSATION. WE CONTINUE TO ADDRESS POLICIES PROMOTING USE OF THE NYS QUITLINE WITH PROVIDERS AND HAVE EXPANDED OUR INITIATIVE TO ALIGN WITH THE CENTRAL NEW YORK CARE COLLABORATIVE DSRIP CARDIOVASCULAR DISEASE MANAGEMENT (CVD) INITIATIVE REFERENCING THE TOBACCO STANDARDS OF CARE. WITHIN ITS LARGER GOAL OF PROMOTING TOBACCO USE CESSATION AMONG ADULTS, WE HAVE EXPANDED TO PREVENTING INITIATION OF TOBACCO USE BY YOUTH AND YOUNG ADULTS. EMERGING ISSUES INCLUDE THE USE OF E-CIGARETTES AS A METHOD TO QUIT, THE TREND OF YOUTH STARTING WITH E-CIGARETTES, AND WE HAVE FOUND AN INCREASE IN COMMUNITY INTEREST IN CESSATION CLASSES THAT WE HAVE NOT SEEN IN THE PAST. ROME MEMORIAL HOSPITAL'S EFFORTS TO IMPROVE COMMUNITY HEALTH EXTEND BEYOND THE TWO PRIORITIES IDENTIFIED THROUGH THE CHA/CSP/CHIP PROCESS. SOME OF THE HOSPITAL'S ADDITIONAL INITIATIVES INCLUDE:-OFFERING FREE HEALTH SCREENINGS AT AREA HEALTH FAIRS TO DETECT HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, DEPRESSION AND OBESITY.-CONDUCTING COLORECTAL HEALTH SCREENINGS EACH MARCH TO PROMOTE EARLY DETECTION OF CANCER.-CONDUCTING PSA SCREENINGS FOR THE EARLY DETECTION OF PROSTATE CANCER.-OFFERING FREE BLOOD PRESSURE SCREENINGS MONTHLY AT AREA PHARMACIES AND SENIOR CENTERS TO PROVIDE ONGOING MONITORING FOR PATIENTS THAT SUFFER FROM HIGH BLOOD PRESSURE AND EARLY DETECTION FOR THOSE WHO ARE AT RISK.-OFFERING FREE TYPE 2 DIABETES EDUCATION CLASSES EVERY MONTH FOR DIABETICS AND THEIR FAMILIES. THE NURSE EDUCATOR COVERS EXERCISE, DIET AND MEDICATION MANAGEMENT TO HELP NEWLY DIAGNOSED DIABETICS UNDERSTAND HOW TO MANAGE CONTROLLABLE RISK FACTORS AND PREVENT FUTURE COMPLICATIONS.-SPONSORING HEALTH LECTURES AT THE HOSPITAL AND PROVIDING SPEAKERS AND DISPLAYS FOR LOCAL ORGANIZATIONS AND BUSINESSES TO PROMOTE EARLY DETECTION, TREATMENT AND MANAGEMENT OF CHRONIC DISEASE.-PARTICIPATING WITH THE CANCER SERVICES PROGRAM TO PROVIDE FREE MAMMOGRAPHY SCREENING FOR THE UNINSURED AND UNDERINSURED TO PROMOTE EARLY DETECTION. THE NURSE NAVIGATOR FROM THE HOSPITAL'S BREAST CENTER WORKS CLOSELY WITH THE CSP TO HELP SECURE ADDITIONAL RESOURCES FOR UNDERSERVED WOMEN DIAGNOSED WITH BREAST CANCER.-OFFERING SUPPORT GROUPS FOR PATIENTS WITH CHRONIC RESPIRATORY DISEASE TO IMPROVE THEIR QUALITY OF LIFE AND REDUCE UNNECESSARY HOSPIAL UTILIZATION.-OFFERING SUPPORT GROUPS FOR FAMILIES WHO ARE STRUGGLING WITH ISSUES OF ADDICTION.-INVESTING SIGNIFICANT RESOURCES TO RECRUIT ADDITIONAL PROVIDERS TO THE ROME AREA TO SOLVE THE PHYSICIAN SHORTAGE CONCERNS.-INVESTING PLANNING RESOURCES TO EXPAND ACCESS TO ESSENTIAL HEALTH CARE SERVICES IN THE COMMUNITY.-PARTICIPATING WITH THE CENTRAL NEW YORK CARE COLLABORATIVE IN SUPPORT OF THE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT PROGRAM (DSRIP), AN INITIATIVE TO TRANSFORM THE HEALTH SYSTEM OF NEW YORK STATE, WITH THE GOALS OF REDUCING AVOIDABLE HOSPITAL USE AND IMPROVING HEALTH AND PUBLIC HEALTH MEASURES. -ACHIEVING PATIENT CENTERED MEDICAL HOME CERTIFICATION TO ENHANCE CARE COORDINATION IN THE HOSPITAL'S PRIMARY CARE PRACTICES.-IMPLEMENTING STRATEGIES TO REDUCE HEALTH ACQUIRED INFECTIONS.-PROVIDING SMOKING CESSATION EDUCATION TO REDUCE THE MORTALITY AND MORBIDITY ASSOCIATED WITH SMOKING.-PROVIDING HEALTH INFORMATION THROUGH QUARTERLY NEWSLETTERS TO SENIORS.-ESTABLISHING A CARE TRANSITIONS COALITION TO STRENGTHEN RELATIONSHIPS BETWEEN THE HOSPITAL AND OTHER COMMUNITY PROVIDERS TO BETTER COORDINATE CARE FOR PATIENTS TO PREVENT UNNECESSARY HOSPITAL UTILIZATION.THE 2016-2018 CHNA OUTLINING THE PRIORITIES AND THE IMPACT OF PREVIOUS IMPLEMENTATION STRATEGIES IS AVAILABLE ONLINE AT WWW.ROMEHOSPITAL.ORG.IN SOLICITING FEEDBACK FROM COMMUNITY MEMBERS ABOUT IDENTIFIED SERVICE GAPS IN CARE, ACCESS TO SPECIALTY, PRIMARY, URGENT CARE AND BEHAVIORAL HEALTH SERVICES WERE THE MAIN COMMUNITY NEEDS IDENTIFIED. IN 2017, THE HOSPITAL:-RESTORED THE COMMUNITY'S ACCESS TO URGENT CARE THROUGH ITS ROME MEDICAL GROUP, CAPTIVE P.C., IN COLLABORATION WITH AN INDEPENDENT PHYSICIAN GROUP.-EXPANDED ACCESS TO SUBSTANCE ABUSE SERVICES AT THE COMMUNITY RECOVERY CENTER WITH THE ADDITION OF MEDICATION-ASSISTED TREATMENT TO TREAT OPIOID ADDICTION AND ALCOHOL DEPENDENCE. -EXPANDED ACCESS TO UROLOGY SERVICES WITH THE ADDITION OF THREE SPECIALISTS AT THE HOSPITAL'S CAPTIVE P.C., ROME MEDICAL PRACTICE. THE SPECIALISTS PERFORM SURGICAL PROCEDURES AT THE HOSPITAL AND PROVIDE 24-HOUR COVERAGE IN THE EMERGENCY DEPARTMENT. -PRESERVED ACCESS TO PULMONOLOGY AND SLEEP SERVICES WITH THE ADDITION OF A BOARD CERTIFIED PULMONOLOGIST AND FAMILY NURSE PRACTITIONER AT THE HOSPITAL'S CAPTIVE P.C., ROME MEDICAL PRACTICE TO PROVIDE CARE FOR PATIENTS WITH LUNG DISORDERS AND DISEASES, AND SLEEP DISORDERS. -PRESERVED ACCESS TO PRIMARY CARE IN BOONVILLE WITH THE ADDITION OF TWO FAMILY NURSE PRACTITIONERS.
ROME MEMORIAL HOSPITAL	PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED IN COLLABORATION WITH THE MOHAWK VALLEY HEALTH SYSTEM (FAXTON-ST. LUKE'S HOSPITAL AND ST. ELIZABETH'S MEDICAL CENTER).
ROME MEMORIAL HOSPITAL	PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN CONJUNCTION WITH ONEIDA COUNTY HEALTH DEPARTMENT AND COMMUNITY ORGANIZATIONS THAT REPRESENTED THE BROAD INTERESTS OF THE POPULATIONS SERVED BY THE COUNTY'S HOSPITALS.
ROME MEMORIAL HOSPITAL	PART V, SECTION B, LINE 7D: THE CHNA (INCLUDING AN IMPLEMENTATION PLAN) IS AVAILABLE AT THE HOSPITAL'S WEBSITE USING THE FOLLOWING URL: HTTP://WWW.ROMEHOSPITAL.ORG/ABOUTUS/COMMUNITY_HEALTH_ASSESSMENT/COMMUNITY_HEALTH_ASSESSMENT/THE CHNA IS ALSO AVAILABLE AT ONEIDA COUNTY'S WEBSITE USING THE FOLLOWING URL: HTTP://WWW.OCGOV.NET/HEALTH/COMMUNITY-HEALTH-ASSESSMENT
ROME MEMORIAL HOSPITAL	PART V, SECTION B, LINE 11: ROME MEMORIAL HOSPITAL ADDRESSES THE SIGNIFICANT HEALTHCARE NEEDS OF THE COMMUNITY THROUGH ITS CONTINUUM OF HEALTHCARE SERVICES/PROGRAMS AND RELATIONSHIPS WITH COMMUNITY PARTNERS. THE COMMUNITY HOSPITAL HAS 130 LICENSED ACUTE CARE BEDS, AN 80-BED SKILLED NURSING FACILITY, A BROAD ARRAY OF OUTPATIENT SERVICES AND THREE ARTICLE 28 PRIMARY CARE PRACTICES. IN ADDITION, THE HOSPITAL PROVIDES ESSENTIAL ACCESS TO PRIMARY CARE, URGENT CARE AND SPECIALTY PHYSICIAN SERVICES THROUGH TWO AFFILIATED CAPTIVE PCS.THE DATA FROM THE CHA GUIDES THE HOSPITAL IN THE DEVELOPMENT OF TACTICS IN SUPPORT OF ITS STRATEGIC PLAN, WHICH IS ORGANIZED UNDER THE FOLLOWING PILLARS: FOSTER A CULTURE OF QUALITY AND PATIENT SAFETY. FOSTER A CULTURE OF EXCEPTIONAL SERVICE. OPTIMIZE FINANCIAL PERFORMANCE. RECRUIT, DEVELOP AND RETAIN EXCEPTIONAL PEOPLE. IDENTIFY GROWTH OPPORTUNITIES CONSISTENT WITH THE HOSPITAL'S MISSION.UNMET COMMUNITY NEEDS ARE DUE TO A SHORTAGE OF PROVIDERS AND LIMITED FINANCIAL RESOURCES.

Field	Value	IRS element (for citing)
Facility	13	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (13 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - COMMUNITY RECOVERY CENTER
264 W DOMINICK STREET	ROME	NY	13440	SUBSTANCE ABUSE COUNSELING
2 - MOHAWK VALLEY RADIATION MEDICINE
107 E CHESTNUT STREET	ROME	NY	13440	RADIATION ONCOLOGY
3 - PHYSICAL THERAPY
107 E CHESTNUT STREET	ROME	NY	13440	OFFSITE PHYSICAL THERAPY SERVICES
4 - BOONVILLE FAMILY CARE
13407 STATE ROUTE 12	BOONVILLE	NY	13309	PRIMARY CARE SERVICES
5 - LABORATORY COLLECTION SITE
1801 BLACK RIVER BLVD	ROME	NY	13440	OFFSITE LAB COLLECTION SITE
6 - LABORATORY COLLECTION SITE
1617 N JAMES STREET	ROME	NY	13440	OFFSITE LAB COLLECTION SITE
7 - LABORATORY COLLECTION SITE
13407 STATE ROUTE 12	BOONVILLE	NY	13309	OFFSITE LAB COLLECTION SITE
8 - MEDICAL IMAGING
1801 BLACK RIVER BLVD	ROME	NY	13440	OFFSITE RADIOLOGY SERVICES
9 - MEDICAL IMAGING
107 E CHESTNUT STREET	ROME	NY	13440	OFFSITE RADIOLOGY SERVICES
10 - PRENATAL CARE CENTER
155 WEST DOMINICK STREET	ROME	NY	13440	OFFSITE PRENATAL CARE SERVICES
11 - DELTA MEDICAL CENTER
1819 BLACK RIVER BLVD	ROME	NY	13440	PRIMARY CARE SERVICES
12 - REGIONAL WOUND CARE CENTER
267 HILL ROAD	ROME	NY	13441	ADVANCED WOUND CARE AND HYPERBARIC OXYGEN TREATMENT
13 - CAMDEN FAMILY CARE
5 MASONIC AVENUE	CAMDEN	NY	13316	PRIMARY CARE SERVICES

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 6A:	THE COMBINED ONEIDA COUNTY COMMUNITY HEALTH ASSESSMENT (CHA)/COMMUNITY SERVICE PLAN (CSP) AND COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IS POSTED ON ROME MEMORIAL HOSPITAL'S WEBSITE AT WWW.ROMEHOSPITAL.ORG.
PART I, LINE 7:	FINANCIAL ASSISTANCE AT COST (7A) AND UNREIMBURSED MEDICAID (7B) WERE CALCULATED BY USING A COST TO CHARGE RATIO. THIS COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, SUPPLIED BY THE IRS. OTHER BENEFITS (7E & 7F) WERE CALCULATED BY DETERMINING ACTUAL COSTS AND ACTUAL REVENUE PER EVENT.THE MAIN SOURCE OR GUIDE OF HOW CALCULATIONS WERE DETERMINED WAS BY UTILIZING THE WORKSHEETS PROVIDED BY THE IRS AND THEN ADJUSTING ACCORDING TO ROME HOSPITAL SPECIFICS (IE. USING ACTUAL COSTS VS. COST TO CHARGE RATIO AS MENTIONED ABOVE).
PART I, LN 7 COL(F):	PERCENT OF TOTAL EXPENSE IS CALCULATED BY USING THE DENOMINATOR OF THE TOTAL FUNCTIONAL EXPENSES LESS BAD DEBT EXPENSE OF $5,049,192(PER AUDITED FINANCIAL STATEMENTS).
PART II, COMMUNITY BUILDING ACTIVITIES:	ROME MEMORIAL HOSPITAL PARTICIPATES IN NUMEROUS COMMUNITY COMMITTEES INVOLVED IN ENHANCING HEALTHCARE OUTCOMES THROUGH PREVENTION, EARLY DETECTION AND INTERVENTION AS WELL AS EMERGENCY PREPAREDNESS ACTIVITIES TO ENSURE A COORDINATED RESPONSE IN AN EVENT OF A DISASTER. HOSPITAL EXPERTS ARE CALLED UPON TO PARTICIPATE IN MULTIPLE INITIATIVES TO ADDRESS ISSUES, SUCH AS DOMESTIC VIOLENCE, TEENAGE PREGNANCY, AND SUBSTANCE ABUSE.ROME MEMORIAL HOSPITAL IS ALSO ONE OF 11 HOSPITALS THAT ARE MEMBERS OF THE CENTRAL NEW YORK CARE COLLABORATIVE (CNYCC), WHICH HAS IDENTIFIED 11 DSRIP PROJECTS TO ADDRESS GAPS IN CARE AND IMPROVE OUTCOMES INCLUDING: EXPANDING CAPACITY, ESPECIALLY FOR PRIMARY AND BEHAVIORAL HEALTH SERVICES, AND IMPLEMENTING CARE MANAGEMENT, CARE COORDINATION AND POPULATION HEALTH INITIATIVES. ROME MEMORIAL HOSPITAL IS A PARTNER IN 5 OF THE 11 PROJECTS.RECRUITING PHYSICIANS AND OTHER HEALTH PROFESSIONALS TO ENHANCE ACCESS TO CARE IS ONE OF THE HOSPITAL'S MOST SIGNIFICANT INVESTMENTS IN COMMUNITY BUILDING ACTIVITIES. WITH EXISTING PROVIDER SHORTAGES, MANY PRACTICES ARE NOT ACCEPTING NEW PATIENTS AND SEVERAL PRIMARY CARE PHYSICIANS WITH LARGE PATIENT PANELS ARE NEARING RETIREMENT, WHICH WILL ONLY EXACERBATE THE PROBLEM.IN 2017, ROME MEMORIAL HOSPITAL AFFILIATED WITH ST. JOESEPH'S HEALTH TO EXPAND PATIENT ACCESS TO NEEDED SERVICES IN THE COMMUNITY. BY COORDINATING RESOURCES, ROME MEMORIAL HOSPITAL AND ST. JOESEPH'S HEALTH WILL STRIVE TO IMPROVE THE PATIENT EXPERIENCE OF CARE, IMPROVE THE HEALTH OF COMMUNITY MEMBERS, AND REDUCE THE PER CAPITA COST OF HEALTH CARE.BUILDING ON ITS TRADITION OF SERVING AS A CLINICAL SITE FOR ALLIED HEALTH PROFESSIONALS, ROME MEMORIAL HOSPITAL ENTERED INTO AN AGREEMENT WITH NEW YORK MEDICAL COLLEGE AND ANTICIPATES WELCOMING MEDICAL STUDENTS IN THE FALL OF 2018.
PART III, LINE 2:	BAD DEBT EXPENSE IS CALCULATED BASED ON THE TOTAL BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS. FOR 2017, TOTAL BAD DEBT IS $5,049,192 (PER AUDITED FINANCIAL STATEMENTS). THE RATIO OF PATIENT CARE COST TO CHARGES FROM THE INSTITUTIONAL COST REPORT IS THEN APPLIED TO THE TOTAL BAD DEBT. FOR 2017, THAT PERCENTAGE IS 28.29. THE CALCULATED AMOUNT IS THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS.
PART III, LINE 3:	TO DETERMINE THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, THE TOTAL PERCENTAGE OF FINANCIAL ASSISTANCE PROVIDED TO PATIENTS IS APPLIED TO THE CALCULATED BAD DEBT EXPENSE. FOR 2017, THE TOTAL PERCENTAGE OF FINANCIAL AID PROVIDED IS 16.85%. APPLYING THAT PERCENTAGE AGAINST THE CALCULATED BAD DEBT EXPENSE IN PART III LINE 2 RESULTS IN THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE ATTRIBUTED TO FINANCIAL AID ELIGIBLE PATIENTS.
PART III, LINE 4:	SEE AUDITED FINANCIAL STATEMENTS PAGES 11 THROUGH 13 FOR CURRENT FOOTNOTE LANGUAGE THAT DESCRIBES BAD DEBT. PART III, LINE 6; COSTING METHODOLOGY AND SOURCE:2017 ICR EXHIBIT 46 AND TENTATIVE MEDICARE SETTLEMENT RATES
PART III, LINE 8:	FINANCIAL AID PROGRAM THE SHORTFALL IN QUESTION 7 SHOULD BE TREATED AS COMMUNITY BENEFIT AS MEDICARE REIMBURSEMENTS FAIL TO COVER THE COSTS OF PROVIDING CARE TO MEDICARE BENEFICIARIES. DESPITE EFFORTS TO IMPROVE EFFICIENCY, EXPENSES FOR TECHNOLOGY, PHARMACEUTICAL, AND SALARY AND BENEFITS CONTINUE TO ESCALATE. THE HOSPITALS BAD DEBT EXPENSES IS IMPACTED BY THE SOCIOECONOMICS OF THE COMMUNITY. THE MEDIAN HOUSEHOLD INCOME FOR ONEIDA COUNTY IS LOWER THAN THE STATE AVERAGE AND OVER 16% OF THE POPULATION LIVES BELOW THE POVERTY LINE. ALTHOUGH PEOPLE MAY HAVE INSURANCE, THEIR OUT-OF-POCKET COSTS ARE HIGH BECAUSE EMPLOYERS HAVE RAISED THEIR DEDUCTIBLES OR CO-PAYMENTS, OR REDUCED WHAT THEIR PLANS COVER.TO HELP THOSE WHO ARE UNINSURED LEARN MORE ABOUT POSSIBLE OPTIONS, THE HOSPITAL'S PATIENT REGISTRATION DEPARTMENT PROVIDES INFORMATION FROM INSURERS WHICH OFFER FREE OR LOW-COST HEALTH INSURANCE THROUGH NEW YORK STATE'S CHILD HEALTH PLUS AND FAMILY HEALTH PLUS, ALONG WITH SPACE FOR REPRESENTATIVES TO ANSWER QUESTIONS AND ENROLL ELIGIBLE RESIDENTS.IN ADDITION, THE HOSPITAL HAS PARTNERED WITH THE MOHAWK VALLEY PERINATAL NETWORK, WHOSE FACILITATED ENROLLER CAN ASSIST INDIVIDUALS IN APPLYING FOR COVERAGE FROM CHILD HEALTH PLUS, FAMILY HEALTH PLUS, AND MEDICAID. IN ADDITION TO HELPING PEOPLE OBTAIN INSURANCE COVERAGE, THE HOSPITAL ALSO PROVIDES A FINANCIAL ASSISTANCE PROGRAM AND WORKS WITH PATIENTS TO SET UP AFFORDABLE PAYMENT PLANS.FINANCIAL ASSISTANCE BROCHURES ARE LOCATED IN THE HOSPITAL'S WAITING AREAS AND APPLICATIONS ARE AVAILABLE ON THE WEBSITE. RMH DISCOUNTS PATIENT ACCOUNTS UP TO 100% DEPENDING UPON FAMILY INCOME IN COMPARISON TO THE FEDERAL POVERTY LEVEL. DISCOUNTS ARE BASED UPON THE BLUE CROSS RATE, OUR HIGHEST VOLUME PAYER. ROME MEMORIAL HOSPITAL OFFERS DISCOUNTS TO THE UNINSURED/UNDERINSURED WHOSE INCOME IS UP TO 300% OF THE FEDERAL POVERTY LEVEL.BECAUSE LACK OF AWARENESS IS ONE OF THE BIGGEST BARRIERS, RMH PROVIDES INFORMATION ABOUT AVAILABLE PROGRAMS AT HEALTH FAIRS AND OTHER OUTREACH ACTIVITIES.CHANGES (ACTUAL OR POTENTIAL) IMPACTING COMMUNITY HEALTH, PROVISION OF CHARITY CARE, AND ACCESS TO SERVICES: REIMBURSEMENTS THAT FAIL TO KEEP PACE WITH RISING EXPENSES AND THE CONTINUED GROWTH IN UNCOMPENSATED CARE ARE SIGNIFICANT CHALLENGES THAT NEW YORK'S HOSPITALS FACE, INCLUDING RMH. OTHER CHALLENGES INCLUDE THE ESCALATION OF COSTS FOR DRUGS DUE TO INFLATION AND HAVING TO FIND ALTERNATE SUPPLIERS BECAUSE OF MANUFACTURER PRODUCTION SHORTAGES, SERVICES AND BAD DEBT, AND INVESTMENTS REQUIRED TO COMPLY WITH MANDATES. HERE ARE JUST A FEW EXAMPLES OF OUR CHALLENGES:UNCOMPENSATED CARE: THE COST OF FREE SERVICES PROVIDED TO OUR COMMUNITY REMAINS HIGH WITH THE RISE IN HIGH-DEDUCTIBLE PLANS AND THE APPROXIMATELY 7% OF RESIDENTS WHO ARE UNINSURED. IN 2017, ROME MEMORIAL HOSPITAL'S BAD DEBT AND CHARITY CARE TOTALED $6.6 MILLION. PHYSICIAN SHORTAGES: ROME MEMORIAL HOSPITAL HAS BEEN SUCCESSFUL IN RECRUITING SEVERAL NEW PHYSICIANS TO THE COMMUNITY, BUT AT A GREAT COST. TODAY'S PHYSICIAN WANTS TO BE EMPLOYED SO THEY DON'T HAVE TO BEAR THE RISK OF OPENING A NEW PRACTICE OR MANAGE THE ADMINISTRATIVE ASPECTS OF MEDICINE. ALTHOUGH THEY PROVIDE CRITICAL ACCESS TO CARE, THESE PRACTICES STRUGGLE TO BREAK EVEN. LACK OF PRIMARY CARE: PATIENTS WHO DON'T HAVE INSURANCE OR WHO ARE COVERED BY MEDICAID OFTEN DON'T HAVE A REGULAR PHYSICIAN FOR PREVENTATIVE CARE OR TO MANAGE CHRONIC CONDITIONS. AS A RESULT, THEY USE THE EMERGENCY DEPARTMENT AS THEIR PRIMARY CARE OR DELAY CARE UNTIL THEIR CONDITION IS MORE CRITICAL AND MORE EXPENSIVE TO TREAT. SINCE ROME MEMORIAL HOSPITAL'S NEW EMERGENCY DEPARTMENT OPENED, THE NUMBER OF PATIENT VISITS HAS STEADILY INCREASED FROM 19,000 IN 2006 TO 31,042 IN 2017. MANY PHYSICIANS DON'T ACCEPT MEDICAID PATIENTS BECAUSE OF LOW REIMBURSEMENT RATES. IN ADDITION, SENIORS MAY SOON FACE THE SAME ACCESS PROBLEMS IF CUTS TO PHYSICIAN MEDICARE RATES ARE IMPLEMENTED. PHARMACEUTICALS: THE HOSPITAL CONTINUES TO SEE SIGNIFICANT INCREASE IN DRUG COSTS DUE TO INFLATION AND MANUFACTURER PRODUCTION SHORTAGES. IN MANY CASES, THESE SHORTAGES FORCE US TO TURN TO ALTERNATE SUPPLIERS, WHO CHARGE A PREMIUM PRICE. INTERPRETER SERVICES: AS OUR POPULATION BECOMES MORE DIVERSE WITH BURMESE AND BOSNIAN REFUGEES AND SPANISH SPEAKING RESIDENTS, THERE IS A GREATER DEMAND FOR INTERPRETER SERVICES. DDSO POPULATION: THE HIGH CONCENTRATION OF DDSO CLIENTS IN ONEIDA COUNTY AND ROME PLACES A UNIQUE BURDEN ON ROME MEMORIAL HOSPITAL. WHEN DDSO CLIENTS REQUIRE HOSPITALIZATION, THEIR CASES ARE OFTEN VERY COMPLEX AND THEIR LENGTH OF STAY IS NEARLY TWICE AS LONG AS THE AVERAGE PATIENT. AS A RESULT, THE HOSPITAL IS ONCE AGAIN FACED WITH ABSORBING THE FINANCIAL LOSS OF CARING FOR THESE PATIENTS. PROGRAM VIABILITY: AS A RESULT OF THESE SIGNIFICANT FINANCIAL CHALLENGES, RMH CONTINUALLY EVALUATES THE VIABILITY OF SOME OF ITS SERVICES. AS A PART OF THE EVALUATION, RMH ASSESSES THE NUMBER OF PEOPLE SERVED AND AVAILABILITY OF OTHER SERVICES TO ADDRESS THE COMMUNITY NEED, IN ADDITION TO THE FINANCIAL BURDEN ON THE HOSPITAL.TRANSITION TO VALUE BASED PAYMENTS: TO PREPARE FOR NEW PAYMENT MODELS THAT REWARD QUALITY AND EFFICIENCY, PROVIDERS NEED TO MAKE INVESTMENTS IN SOPHISTICATED ANALYTICS TO MANAGE RISK AND CARE MANAGERS TO BETTER COORDINATE CARE.
PART VI, LINE 2:	LINE 2 - ALWAYS ASSESSING NEEDS:IN ADDITION TO THE FORMAL CHNA REPORTED IN PART V, SECTION B, ROME MEMORIAL HOSPITAL CONTINUALLY ASSESSES THE COMMUNITY'S NEEDS THROUGH ONGOING OBSERVATION AND PARTICIPATION IN COMMUNITY COMMITTEES AND ORGANIZATIONS THAT REPRESENT A BROAD SEGMENT OF THE POPULATION. IN ADDITION, THE HOSPITAL ENCOURAGES COMMUNITY INPUT THROUGH ITS WEBSITE AND PATIENT ENGAGEMENT SURVEYS. INSIGHTS ARE ALSO GATHERED FROM MONITORING SOCIAL MEDIA.
PART VI, LINE 3:	LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:TO ENSURE THAT PATIENTS ARE AWARE OF THE FINANCIAL ASSISTANCE PROGRAM, PATIENTS ARE NOTIFIED THE FOLLOWING WAYS:-THE PATIENT GUIDE, WHICH IS GIVEN TO ALL INPATIENTS AND OBSERVATION PATIENTS, INCLUDES THE PLAIN LANGUAGE SUMMARY OF THE POLICY.-A PAPER COPY OF THE PLAIN LANGUAGE SUMMARY IS OFFERED TO ALL OUTPATIENTS.-SIGNAGE IS LOCATED AT ALL INTAKE AREAS INCLUDING OFF-SITE CLINICS/LOCATIONS AND WITHIN THE BUSINESS OFFICE. THESE AREAS HAVE PAPER COPIES AVAILABLE TO THE PUBLIC IN PERSON AND BY MAIL.-ALL BILLING STATEMENTS AND COLLECTION LETTERS NOTIFY PATIENTS ON HOW TO OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE VIA PHONE OR INTERNET.-BROCHURES/PLAIN LANGUAGE SUMMARIES ARE PROVIDED TO LOCAL COMMUNITY ORGANIZATIONS THAT SERVE INDIVIDUALS MOST LIKELY TO NEED FINANCIAL ASSISTANCE.-INFORMATION IS AVAILABLE ON THE HOSPITAL'S WEBSITE WITH THE LINK TO "FINANCIAL ASSISTANCE" ACCESSIBLE FROM MULTIPLE PAGES.
PART VI, LINE 4:	LINE 4 - COMMUNITY INFORMATION:ROME MEMORIAL HOSPITAL PROVIDES HEALTHCARE SERVICES TO APPROXIMATELY 81,000 RESIDENTS IN ROME AND THE SURROUNDING RURAL COMMUNITIES IN ONEIDA COUNTY. FOR SELECTED SPECIALTIES, SUCH AS SENIOR BEHAVIORAL HEALTH CARE, ROME MEMORIAL HOSPITAL'S SERVICE AREA EXTENDS INTO THE SURROUNDING COUNTIES OF MADISON, HERKIMER LEWIS AND ONONDAGA.ROME MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA INCLUDES: ROME, CAMDEN, BOONVILLE, BLOSSVALE, REMSEN, TABERG, HOLLAND PATENT, ORISKANY, LEE CENTER, FORESTPORT, AVA, WESTMORELAND, SYLVAN BEACH, WESTERNVILLE, WEST LEYDEN, STITTVILLE, NORTH BAY, WOODGATE, PROSPECT, AND WESTDALE.RESIDENTS FROM ROME'S 13440 ZIP CODE WITH A POPULATION OF APPROXIMATELY 42,000 COMPRISE MORE THAN 61% OF RMH'S INPATIENT DISCHARGES. THE SURROUNDING COMMUNITIES ARE MOSTLY RURAL, WITH CAMDEN (POPULATION OF 6,950) AND BOONVILLE (POPULATION OF 6,276) AS THE TWO LARGEST TOWNS LOCATED IN THE PRIMARY SERVICES AREA.ROME MEMORIAL HOSPITAL AND ITS AFFILIATES SERVE AS A SAFETY NET FOR A REGION THAT IS SOCIOECONOMICALLY CHALLENGED AND AGING.KEY DEMOGRAPHICS FROM THE CLARITAS 2017 DEMOGRAPHIC SNAPSHOT:APPROXIMATELY 18.4% OF RESIDENTS IN THE SERVICE AREA ARE 65 OR OLDER. THAT PERCENTAGE IS PROJECTED TO GROW TO 20.7% BY 2022 WITH THE AGING OF THE BABY BOOMERS.LESS THAN 20% OF THE POPULATION HAS A BACHELOR'S DEGREE OR GREATER, COMPARED TO NEARLY 30% NATIONALLY.AVERAGE HOUSEHOLD INCOME FOR THE SERVICE AREA IS 17% LESS THAN THE NATIONAL AVERAGE.THE POPULATION IS 89.9% WHITE NON-HISPANIC, 3.4% BLACK NON-HISPANIC AND 3.6% HISPANIC.ROME MEMORIAL HOSPITAL IS THE ONLY HOSPITAL IN THE CITY OF ROME. THERE ARE TWO HOSPITALS IN SOUTHERN ONEIDA COUNTY (ST. ELIZABETH MEDICAL CENTER AND FAXTON-ST. LUKE'S HEALTHCARE.LACK OF ACCESS TO CARE IS LARGELY DUE TO PROVIDER SHORTAGES IN THE HEALTH PROFESSIONAL SHORTAGE AREA (HPSA). MEDICAID ELIGIBLE - ONEIDA COUNTY MENTAL HEALTH PROFESSIONAL SHORTAGE AREA (ID#736999360I) AND THE MEDICAID-ELIGIBLE-ROME PRIMARY CARE SERVICE AREA HPSA (ID#136999363J), THE MEDICAID-ELIGIBLE-BOONVILLE PRIMARY CARE SERVICE AREA HPSA (ID# 13699936N1), AND THE CAMDEN SERVICE AREA HPSA (ID#13699936J1).
PART VI, LINE 5:	LINE 5 - PROMOTION OF COMMUNITY HEALTH:ADDITIONAL WAYS THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE:1. ROME MEMORIAL HOSPITAL PROVIDES EMERGENCY SERVICES TO EVERYONE REGARDLESS OF ABILITY TO PAY.2. THE HOSPITAL'S INDEPENDENT GOVERNING BODY IS COMPRISED OF INDIVIDUALS WHO RESIDE OR WORK IN THE PRIMARY SERVICE AREA TO REPRESENT THE INTERESTS OF THE COMMUNITY.3. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY.4. THE HOSPITAL USES ANY SURPLUS FUNDS TO IMPROVE CARE, EXPAND FACILITIES, RECRUIT STAFF AND ADVANCE MEDICAL TRAINING AND COMMUNITY EDUCATION.
PART VI, LINE 6:	LINE 6 - AFFILIATED HEALTH CARE SYSTEM:ROME MEMORIAL HOSPITAL, INC. (THE "HOSPITAL") IS A NEW YORK STATE NOT-FOR-PROFIT CORPORATION AND TAX EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC"), AND IS PART OF THE FOLLOWING CORPORATE STRUCTURE: GREATER ROME AFFILIATES, INC. ("GRA"), A NEW YORK STATE NOT-FOR-PROFIT CORPORATION, TAX EXEMPT UNDER SECTION 501(C)(3) OF THE IRC, IS THE SOLE CORPORATE MEMBER, AND THEREFORE, THE "PARENT" OF THE HOSPITAL, AS WELL AS ROME MEMORIAL PROPERTIES, INC., A NEW YORK STATE NOT-FOR-PROFIT CORPORATION, TAX EXEMPT UNDER SECTION 501(C)(3) OF THE IRC. GRA IS ALSO THE SOLE SHAREHOLDER OF RMH SERVICES, INC., A NEW YORK STATE BUSINESS CORPORATION, WHICH WAS ESTABLISHED TO UNDERTAKE CERTAIN FOR-PROFIT BUSINESS ACTIVITIES AND WHICH HAS AN EQUITY OWNERSHIP INTEREST IN, AND IS A MEMBER OF, THREE NEW YORK STATE LIMITED LIABILITY COMPANIES: 1819 BLACK RIVER ASSOCIATES, LLC; CHESTNUT COMMONS, LLC; AND RMH RETAIL PHARMACY, LLC. MEMBERS OF THE HOSPITAL'S BOARD OF TRUSTEES AND ADMINISTRATIVE STAFF HAVE OVERLAPPING RESPONSIBILITIES ON THE BOARDS OF THE AFFILIATED CORPORATIONS TO ENSURE THAT THE HOSPITAL'S BEST INTERESTS ARE BEING SERVED. ROME MEMORIAL HOSPITAL FOUNDATION, INC., A NEW YORK STATE NOT-FOR-PROFIT CORPORATION, TAX EXEMPT UNDER SECTION 501(C)(3) OF THE IRC, IS A SEPARATE CORPORATION ESTABLISHED FOR THE SOLE PURPOSE OF CONDUCTING FUND RAISING ACTIVITIES ON BEHALF OF THE HOSPITAL, INCLUDING THE RECEIPT OF GIFTS AND BEQUESTS ON BEHALF OF THE HOSPITAL, INVESTING SUCH ASSETS, AND TRANSFERRING THEM TO THE HOSPITAL IN SUPPORT OF ITS MISSION. IT IS GOVERNED BY A SEPARATE BOARD OF DIRECTORS, WHICH HAS AMONG ITS MEMBERS HOSPITAL TRUSTEES AND MEMBERS OF THE HOSPITAL'S MEDICAL STAFF.THE SYSTEM ALSO INCLUDES TWO CAPTIVE PROFESSIONAL CORPORATIONS, INCLUDING ROME MEDICAL GROUP, P.C., A MULTI-PHYSICIAN PRIMARY CARE PRACTICE, AND ROME MEDICAL PRACTICE, P.C., A MULTI-PHYSICIAN, SPECIALTY GROUP. THE PCS ARE THE VEHICLES THROUGH WHICH PHYSICIANS ARE EMPLOYED TO SERVE THE COMMUNITY. IN TODAY'S ENVIRONMENT, MANY PHYSICIANS PREFER TO BE EMPLOYED VS. GOING OUT IN PRIVATE PRACTICE.
PART VI, LINE 7, REPORTS FILED WITH STATES	NY

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DAVID LUNDQUIST
CEO	$289,067	$67,806	$0	$0	$0	$0	$0	$0	$468	$110	$289,535	$67,916	$0	$0
DEWEY ROWLANDS
CFO	$192,413	$28,751	$0	$0	$0	$0	$0	$0	$11,480	$1,715	$203,893	$30,466	$0	$0
DURINDA DURR
VP CLINICAL SERVICES	$145,117	$0	$0	$0	$0	$0	$0	$0	$5,269	$0	$150,386	$0	$0	$0
SCOTT BURNS
DIRECTOR OF PHARMACY	$142,696	$0	$0	$0	$0	$0	$0	$0	$13,320	$0	$156,016	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 1A	FormAndLineReferenceDesc
Explanation	TYPE OF BENEFIT: PAYMENT OF 2017 MEMBERSHIP DUES AND GENERAL MAINTENANCE FEE FOR SOCIAL CLUB, AS AGREED UPON IN EMPLOYMENT CONTRACT. PERSON WHO RECEIVED BENEFIT: DAVID LUNDQUIST, CEO THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION IN 2017 FOR PERSON LISTED ABOVE.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
SCOTT BURNS
SON OF BOARD DIRECTOR	$150,603	COMPENSATION	0
SCOTT A GWILT
SON IN LAW OF BOARD DIRECTOR	$41,429	COMPENSATION	0
MEGAN LUNDQUIST
DAUGHTER OF CEO	$22,822	COMPENSATION	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6	GREATER ROME AFFILIATES IS THE SOLE MEMBER OF ROME MEMORIAL HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A	PER THE HOSPITAL BY-LAWS "THE SOLE CORPORATE MEMBER OF THE CORPORATION SHALL BE GREATER ROME AFFILIATES, INC. WHICH SHALL ACT HEREUNDER AS SUCH MEMBER BY DULY AUTHORIZED RESOLUTION OF ITS BOARD OF DIRECTORS AND WHICH SHALL COMMUNICATE ITS ACTIONS TO THIS BOARD THROUGH ITS PRESIDENT OR OTHER DULY AUTHORIZED OFFICER." GREATER ROME AFFILIATES APPOINTS THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11B	THE COMPLETED 2017 990 WAS PRESENTED TO THE BOARD BY THE CFO OF THE HOSPITAL AT ITS SEPTEMBER 2018 BOARD MEETING.
FORM 990, PART VI, SECTION B, LINE 12C	CONSISTENT WITH ROME HOSPITAL'S GIFTS, GRATUITIES AND CONFLICT OF INTEREST POLICY, THE COMPLIANCE OFFICER OF RMH HAS A CONFLICT OF INTEREST DISCLOSURE FORM COMPLETED ON AN ANNUAL BASIS BY ALL OFFICERS, DIRECTORS AND MANAGEMENT PERSONNEL. THE COMPLIANCE OFFICER COLLECTS AND REVIEWS THE BOARD OF TRUSTEES/FOUNDATION BOARD INTEREST DISCLOSURE FORMS ON AN ANNUAL BASIS. THE INFORMATION GATHERED ON THE DISCLOSURE IS REVIEWED AND ANY CONFLICTS ARE COMMUNICATED TO THE PRESIDENT/CEO, COMPLIANCE BOARD, AND BOARD OF TRUSTEES TO ENSURE ALL HOSPITAL TRANSACTION/BUSINESS ACTIVITIES ARE CONDUCTED IN A MANNER THAT IS FREE FROM UNLAWFUL OR OTHERWISE INAPPROPRIATE OFFERS OR SOLICITATIONS OF IMPROPER INDUCEMENTS IN EXCHANGE FOR INFLUENCE OR ASSISTANCE IN A TRANSACTION. POTENTIAL CONFLICTS THAT MAY ARISE THROUGHOUT THE YEAR ARE BROUGHT TO THE ATTENTION OF THE COMPLIANCE OFFICER AND PRESIDENT/CEO FOR REVIEW. ANY IDENTIFIED CONFLICTS ARE THEN REVIEWED AT THE CORPORATE COMPLIANCE COMMITTEE AND BY THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 15	USE OF IROQUOIS DATA, ASSOCIATION FOR HEALTHCARE PHILANTHROPY SALARY DATA, AND THE ROME HOSPITAL HUMAN RESOURCE DEPARTMENT ARE UTILIZED TO DETERMINE COMPENSATION FOR THE ORGANIZATION'S EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 18	FORMS ARE AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19	FORMS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST OR THROUGH WWW.GUIDESTAR.ORG- A WEBSITE THAT PROVIDES NON-PROFIT INFORMATION TO THE PUBLIC. RMH MAKES ITS GOVERNING DOCUMENTS (BY - LAWS) AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC THROUGH RMH WEBSITE - WWW.ROMEHOSPITAL.ORG. ALSO, FINANCIAL FACTS AND FIGURES AND ECONOMIC IMPACT REPORTS CAN BE FOUND ON THIS WEBSITE.
FORM 990, PART IX, LINE 11G	LAB SERVICES: PROGRAM SERVICE EXPENSES 4,760,916. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,760,916. PHYSICIANS: PROGRAM SERVICE EXPENSES 3,742,689. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,742,689. NURSE STAFFING: PROGRAM SERVICE EXPENSES 1,172,131. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,172,131. SERVICE CONTRACT: PROGRAM SERVICE EXPENSES 615,022. MANAGEMENT AND GENERAL EXPENSES 184,194. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 799,216. CONSULTING: PROGRAM SERVICE EXPENSES 735,962. MANAGEMENT AND GENERAL EXPENSES 371,786. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,107,748. LAUNDRY SERVICE: PROGRAM SERVICE EXPENSES 417,896. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 417,896.
FORM 990, PART XI, LINE 9:	CHANGE IN UNRESTRICTED INTEREST IN FOUNDATION 100,376. BOOK/TAX DIFFERENCE OF GRIFFIS EYE CENTER 114,533. CHANGE IN TEMPORARY INTEREST IN FOUNDATION 15,772.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
GREATER ROME AFFILIATES
1500 N JAMES STREET	ROME	NY	13440	161508597	PARENT CORPORATION	NY	501C3	LINE 12C, III-FI	0
ROME MEMORIAL PROPERTIES
1500 N JAMES STREET	ROME	NY	13440	161492003	SUPPORT HOSPITAL ACTIVITIES	NY	501C3	LINE 12A, I	0	GRA

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd
RMH SERVICES INC
1500 N JAMES STREET	ROME	NY	13440	161490045	FOR PROFIT	NY	GREATER ROME AFFILIATES	C	$112,708	$2,378,667	1.00000	0
ROME MEDICAL GROUP
1801 BLACK RIVER BLVD	ROME	NY	13440	161464822	CAPTIVE P.C.	NY	ROME MEMORIAL HOSPITAL	C				0
ROME MEDICAL PRACTICE
1500 N JAMES STREET	ROME	NY	13440	203827393	CAPTIVE P.C.	NY	ROME MEMORIAL HOSPITAL	C				0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (1)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd