UNITY HEALTH SYSTEM FOUNDATION: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- UNITY HEALTH SYSTEM FOUNDATION (EIN 11-9627400)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-14
- IRS object ID
- 201703189349308210
- Schema version
- 2016v3.0
- 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 D
- Schedule G
- Schedule I
- Schedule J
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-14T15:11:19-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | 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 | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 119627400 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNITY HEALTH SYSTEM FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIT | BusinessNameControlTxt |
| Phone | 5859224800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1555 LONG POND RD | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14626 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THOMAS R CRILLY | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5859224800 | PhoneNum |
| Signature | 2017-11-13 | 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 | 2017-11-13 | 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 | 2017-11-13 | IPDt |
| IP Tm | 18:49:53 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 517AEBE328CBAAA90E396C2FD1060AA56161F780 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 517AEBE328CBAAA90E396C2FD1060AA56161F780 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Final Return | Yes (X) | FinalReturnInd |
| Principal Officer | ERIC BIEBER MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1555 LONG POND RD | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14626 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,323,090 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ROCHESTERREGIONAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1976 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | THE UNITY HEALTH FOUNDATION CONDUCTS ANNUAL FUND-RAISING EVENTS AND CULTIVATES AND SOLICITS CAPITAL GIFTS IN SUPPORT OF THE SYSTEM AS WELL AS THE COMMUNITY. THE UNITY HOSPITAL OF ROCHESTER, A MAJOR ENTITY OF THE SYSTEM, IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL WHICH PROVIDES QUALITY GENERAL AND ACUTE INPATIENT AND OUTPATIENT HOSPITAL CARE TO THE RESIDENTS OF ROCHESTER, NY AND THE SURROUNDING COMMUNITY REGARDLESS OF ABILITY TO PAY. | ActivityOrMissionDesc |
| Contract Termination | Yes (X) | ContractTerminationInd |
| Voting Members Governing Body | 30 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 27 | VotingMembersIndependentCnt |
| Total Employee | 7 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,273,440 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,700,262 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,107,925 | PYInvestmentIncomeAmt |
| CY Investment Income | $377,055 | CYInvestmentIncomeAmt |
| PY Other Revenue | $194,767 | PYOtherRevenueAmt |
| CY Other Revenue | $205,496 | CYOtherRevenueAmt |
| PY Total Revenue | $2,576,132 | PYTotalRevenueAmt |
| CY Total Revenue | $2,282,813 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,273,959 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,210,547 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $766,939 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $971,501 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $514,481 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $680,175 | PYOtherExpensesAmt |
| CY Other Expenses | $422,419 | CYOtherExpensesAmt |
| PY Total Expenses | $2,721,073 | PYTotalExpensesAmt |
| CY Total Expenses | $2,604,467 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$144,941 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$321,654 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,504,055 | TotalAssetsBOYAmt |
| Total Assets EOY | $0 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $927,785 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $14,576,270 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE UNITY HEALTH FOUNDATION CONDUCTS ANNUAL FUND-RAISING EVENTS AND CULTIVATES AND SOLICITS CAPITAL GIFTS IN SUPPORT OF THE SYSTEM AS WELL AS THE COMMUNITY. THE UNITY HOSPITAL OF ROCHESTER, A MAJOR ENTITY OF THE SYSTEM, IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL WHICH PROVIDES QUALITY GENERAL AND ACUTE INPATIENT AND OUTPATIENT HOSPITAL CARE TO THE RESIDENTS OF ROCHESTER, NY AND THE SURROUNDING COMMUNITY REGARDLESS OF ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $1,210,547 | ExpenseAmt |
| Grant | $1,210,547 | GrantAmt |
| Desc | THE UNITY HEALTH FOUNDATION CONDUCTS ANNUAL FUND-RAISING EVENTS AND CULTIVATIVE AND SOLICITS CAPITAL GIFTS IN SUPPORT OF ROCHESTER REGIONAL HEALTH (THE SYSTEM) AS WELL AS THE COMMUNITY. THE UNITY HOSPITAL OF ROCHESTER, A MAJOR ENTITY OF THE SYSTEM, IS A NOT-FOR-PROFIT COMMUNITY HOSPITAL WHICH PROVIDES QUALITY GENERAL AND ACUTE INPATIENT AND OUTPATIENT HOSPITAL CARE TO THE RESIDENTS OF ROCHESTER, NY AND THE SURROUNDING COMMUNITY REGARDLESS OF ABILITY TO PAY. | Desc |
| Total Program Service Expenses | $1,210,547 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | Yes (1) | 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 | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | 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 | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | Yes (1) | 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 | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 7 | EmployeeCnt |
| Employment Tax Returns Filed | 0 | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | Yes (1) | NondeductibleContributionsInd |
| Nondeductible Contri Discl | Yes (1) | NondeductibleContriDisclInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 30 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 27 | 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 | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | 0 | InvestmentInJointVentureInd |
| 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 | TAMMY CLAFLIN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5859221745 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 KINGS HIGHWAY SOUTH | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14617 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (34 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| ELIZABETH PATTON PHD | ||||||||
| CO-TREASURER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| THOMAS RILEY | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TARUN KOTHARI MD | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LEON T SAWYKO | ||||||||
| CO-CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK MEYER | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TERESA M ROBACH | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES VAZZANA | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ERIC BIEBER MD | ||||||||
| CEO | 1.00 | 54.00 | Yes (X) | $0 | $3,516,820 | $1,064,908 | Yes (X) | |
| CARL LUGER | ||||||||
| CO-TREASURER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CYNTHIA CHRISTY MD | ||||||||
| MEDICAL LIAISON | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSEPHINE BRAITMAN | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID N BROADBENT MD | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DONALD CAMERON | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LOUISE W EPSTEIN | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID M GERMANO | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LOIS F IRWIN | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RAHUL KOHLI | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KATHERINE SCHUMACHER | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TIM SHANAHAN | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GWEN STERNS MD | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $80,533 | $2,361 | ||
| DON TWEITMEYER | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERTA VAN WINKLE | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES WHELEHAN | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN G WHITE JR | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT W GEORGE MD | ||||||||
| CO-CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $57,697 | $7,752 | ||
| NANCY S FERRIS PHD | ||||||||
| SECRETARY | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAN AUGUST | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GREGORY P KAUSCH | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LEONARD OLIVIERI | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN OVERTON | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| THOMAS R CRILLY | ||||||||
| CFO | 0.00 | 55.00 | $0 | $1,012,616 | $427,250 | Yes (X) | ||
| ROBERT NESSELBUSH | ||||||||
| COO | 1.00 | 55.00 | $0 | $1,608,627 | $676,261 | Yes (X) | ||
| HUGH THOMAS | ||||||||
| CAO | 1.00 | 55.00 | $0 | $1,230,940 | $512,645 | Yes (X) | ||
| MARK CLEMENT | ||||||||
| FORMER CEO | 0.00 | $0 | $1,373,284 | $30,715 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,880,517 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,721,892 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $22,248 | FederatedCampaignsAmt |
| Fundraising | $54,285 | FundraisingAmt |
| Related Organizations | $5,000 | RelatedOrganizationsAmt |
| All Other Contributions | $1,618,729 | AllOtherContributionsAmt |
| Noncash Contributions | $9,498 | NoncashContributionsAmt |
| Total Contributions | $1,700,262 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $292,089 | TotalRevenueColumnAmt |
| Exclusion | $292,089 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $84,966 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $84,966 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $84,966 | TotalRevenueColumnAmt |
| Exclusion | $84,966 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $27,380 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $54,285 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $40,277 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$12,897 | TotalRevenueColumnAmt |
| Exclusion | -$12,897 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RENTAL REIMBURSEMENT | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $218,393 | TotalRevenueColumnAmt |
| Exclusion | $218,393 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $218,393 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,282,813 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $582,551 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,168,596 | TotalAmt |
| Program Services | $1,168,596 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,951 | TotalAmt |
| Program Services | $41,951 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $771,000 | TotalAmt |
| Management And General | $385,500 | ManagementAndGeneralAmt |
| Fundraising | $385,500 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200,501 | TotalAmt |
| Management And General | $100,251 | ManagementAndGeneralAmt |
| Fundraising | $100,250 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,887 | TotalAmt |
| Management And General | $26,248 | ManagementAndGeneralAmt |
| Fundraising | $6,639 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,634 | TotalAmt |
| Fundraising | $10,634 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,634 | TotalAmt |
| Management And General | $16,634 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,769 | TotalAmt |
| Management And General | $15,769 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,277 | TotalAmt |
| Management And General | $35,277 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $870 | TotalAmt |
| Management And General | $870 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,206 | TotalAmt |
| Management And General | $23,206 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|
| BAD DEBTS | $275,684 | $275,684 | |
| DONOR RECOGNITION | $11,458 | $11,458 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,604,467 | TotalAmt |
| Program Services | $1,210,547 | ProgramServicesAmt |
| Management And General | $879,439 | ManagementAndGeneralAmt |
| Fundraising | $514,481 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,549 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $318,124 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,165,787 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $399,217 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,734 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $772,684 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,466,102 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,906 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,324,952 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,504,055 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,306 | BOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,223 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $803,256 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $927,785 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,888,252 | BOYAmt |
| EOY | $0 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,851,280 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,836,738 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,576,270 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,504,055 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$321,654 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $218,781 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$14,473,397 | 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,670,427 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,354,888 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,707,275 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,260,235 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,700,262 | CurrentTaxYearAmt |
| Total | $13,693,087 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,670,427 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,354,888 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,707,275 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,260,235 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,700,262 | CurrentTaxYearAmt |
| Total | $13,693,087 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $10,275,182 | SubstantialContributorsTotAmt |
| Public Support Total170 | $3,417,905 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $312,210 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $232,529 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $302,724 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $350,942 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $292,089 | CurrentTaxYearAmt |
| Total | $1,490,494 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $15,183,581 | TotalSupportAmt |
| Public Support CY170 | 0.22510 | PublicSupportCY170Pct |
| Public Support PY170 | 0.36000 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests PY170 | Yes (X) | ThirtyThrPctSuprtTestsPY170Ind |
| Facts And Circumstances Test | ALTHOUGH THE AMOUNT ON PART II, SECTION C, LINE 14 DID NOT MEET THE 33 1/3% TEST, IT DOES MEET THE 10% SUPPORT LIMITATION TEST. DURING 2016, THE FOUNDATION MERGED WITH ROCHESTER GENERAL HOSPITAL FOUNDATION (EIN: 22-2229425), THIS CAUSED A SHIFT OF ACTIVITIES FROM THE FILING ORGANIZATION TO THE SURVIVING ORGANIZATION, RESULTING IN A LOWER PUBLIC SUPPORT PERCENTAGE FOR 2016. | FactsAndCircumstancesTestTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Funds And Other Accounts Held | 0 | FundsAndOtherAccountsHeldCnt |
| Funds And Other Accounts Contri | $214,799 | FundsAndOtherAccountsContriAmt |
| Funds And Other Accounts Grants | $35,542 | FundsAndOtherAccountsGrantsAmt |
| Funds And Other Accounts Vl EOY | $0 | FundsAndOtherAccountsVlEOYAmt |
| Disclosed Org Leg Ctrl | Yes (1) | DisclosedOrgLegCtrlInd |
| Disclosed For Charitable Prps | Yes (1) | DisclosedForCharitablePrpsInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,688,018 | BeginningYearBalanceAmt |
| Contributions | $1,274,996 | ContributionsAmt |
| Investment Earnings Or Losses | $454,763 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,123,224 | GrantsOrScholarshipsAmt |
| Other Expenditures | $13,294,553 | OtherExpendituresAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $13,810,966 | BeginningYearBalanceAmt |
| Contributions | $635,797 | ContributionsAmt |
| Investment Earnings Or Losses | -$627,136 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,131,609 | GrantsOrScholarshipsAmt |
| End Year Balance | $12,688,018 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $15,915,793 | BeginningYearBalanceAmt |
| Contributions | $1,805,382 | ContributionsAmt |
| Investment Earnings Or Losses | $77,081 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $3,987,290 | GrantsOrScholarshipsAmt |
| End Year Balance | $13,810,966 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $15,326,920 | BeginningYearBalanceAmt |
| Contributions | $2,422,245 | ContributionsAmt |
| Investment Earnings Or Losses | $290,017 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $2,123,389 | GrantsOrScholarshipsAmt |
| End Year Balance | $15,915,793 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $15,069,477 | BeginningYearBalanceAmt |
| Contributions | $3,905,446 | ContributionsAmt |
| Investment Earnings Or Losses | $691,026 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $4,339,029 | GrantsOrScholarshipsAmt |
| End Year Balance | $15,326,920 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $2,323,090 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $40,277 | OtherRevenueAmt |
| Revenue Not Reported | $40,277 | RevenueNotReportedAmt |
| Revenue Subtotal | $2,282,813 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $2,282,813 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,632,134 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $40,277 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $40,277 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,591,857 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,012,610 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,012,610 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $2,604,467 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | PERMANENTLY RESTRICTED ENDOWMENTS ARE HELD IN PERPETUITY, THEIR INCOME IS AVAILABLE FOR USE BASED ON DONOR STIPULATIONS. EARNINGS ON THE ENDOWMENT ARE EARMARKED FOR EITHER UNRESTRICTED OPERATIONS OR SPECIFIC PURPOSE BASED ON DESIGNATION OF THE ENDOWMENT. TEMPORARILY RESTRICTED ENDOWMENT FUNDS ARE RELEASED FROM RESTRICTION FOR PROGRAM PURPOSES IN ACCORDANCE WITH DONOR REQUIREMENTS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSE 40,277. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSE 40,277. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROJECT FUNDING 1,012,610. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF | Event1Nm |
| Gross Receipts Event1 | $81,665 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $54,285 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $27,380 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $40,277 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $81,665 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $54,285 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $27,380 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $40,277 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $40,277 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$12,897 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|
| NORTH PARK NURSING HOME INC | ||||||
| 700 ISLAND COTTAGE ROAD | ROCHESTER | NY | 14626 | 223159644 | $9,119 | FACILITY RENOVATION, STAFF RECOGNITION & GENERAL PURPOSES FOR RESIDENTS |
| PARK RIDGE NURSING HOME INC | ||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 160978184 | $28,026 | FACILITY CONSTRUCTION, MEDICAL & OTHER EQUIPMENT, SUPPLIES & GENERAL PURPOSES |
| THE UNITY HOSPITAL OF ROCHESTER | ||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 237221763 | $959,869 | FACILITY EXPANSION & RENOVATION, MEDICAL & OTHER EQUIPMENT, STAFF TRAINING, SUPPLIES & GEN'L PURPOSES |
| WOODLAND VILLAGE INC | ||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 161588242 | $55,460 | FACILITY CONSTRUCTION AND GENERAL PURPOSES FOR RESIDENTS |
| PARK RIDGE CHILD CARE CENTER | ||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 222918126 | $6,749 | SECURITY EQUIPMENT & CLASSROOM SUPPLIES |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (5 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| FORGIVABLE EMPLOYEE LOAN FOR LOW-INCOME HOME OWNERSHIP | 4 | $12,000 |
| COPAY ASSISTANCE | 27 | $5,660 |
| MEDICATIONS FOR UNDERINSURED | 17 | $891 |
| NURSING TUITION SCHOLARSHIP | 14 | $21,500 |
| SECURITY DEPOSIT ASSISTANCE FOR CLIENTS | 4 | $1,900 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE FOUNDATION'S FINANCIAL COORDINATOR CONDUCTS MONTHLY RECONCILIATION AND MAINTAINS SUBSTANTIATED DOCUMENTATION OF ALL PAYMENTS FOR FULFILLMENT OF EVERY GRANT AWARDED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ERIC BIEBER MD | ||||||||||||||
| CEO | $0 | $1,116,015 | $0 | $2,400,805 | $0 | $0 | $0 | $1,011,846 | $0 | $53,062 | $0 | $4,581,728 | $0 | $1,070,317 |
| THOMAS R CRILLY | ||||||||||||||
| CFO | $0 | $435,307 | $0 | $577,309 | $0 | $0 | $0 | $375,536 | $0 | $51,714 | $0 | $1,439,866 | $0 | $372,767 |
| ROBERT NESSELBUSH | ||||||||||||||
| COO | $0 | $747,958 | $0 | $860,669 | $0 | $0 | $0 | $624,284 | $0 | $51,977 | $0 | $2,284,888 | $0 | $556,513 |
| HUGH THOMAS | ||||||||||||||
| CAO | $0 | $547,274 | $0 | $683,666 | $0 | $0 | $0 | $466,348 | $0 | $46,297 | $0 | $1,743,585 | $0 | $442,221 |
| MARK CLEMENT | ||||||||||||||
| FORMER CEO | $0 | $0 | $0 | $0 | $0 | $1,373,284 | $0 | $26,618 | $0 | $4,097 | $0 | $1,403,999 | $0 | $1,373,284 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS INCLUDING: - ERIC BIEBER, M.D. (PRESIDENT & CEO) - THOMAS CRILLY (CFO) - MARK CLEMENT (CEO UNTIL 11/30/14) - HUGH THOMAS (CAO) - ROBERT NESSELBUSH (COO) USED THE FOLLOWING TO ESTABLISH THEIR COMPENSATION AND BENEFITS: - COMPENSATION COMMITTEE, - INDEPENDENT COMPENSATION CONSULTANT, - FORM 990 OF OTHER ORGANIZATIONS, - COMPENSATION SURVEYS AND STUDIES; - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. ON AN ANNUAL BASIS, THE ORGANIZATION USES AN INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE SALARIES FOR ALL EXECUTIVES TO ENSURE SUCH SALARIES ARE CONSISTENT WITH MARKET SALARIES PAID TO SIMILARLY SITUATED EXECUTIVES. IN ADDITION, A COMPENSATION COMMITTEE REVIEWS THIS INFORMATION ANNUALLY AND IT IS THEN APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. FINALLY, EXECUTIVES RECEIVE A WRITTEN LETTER OUTLINING THE SPECIFICS OF THE COMPENSATION AGREEMENT AND THEIR EXPECTED PERFORMANCE. |
| PART I, LINES 4A-B | SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS PROVIDE BENEFITS TO CERTAIN KEY EXECUTIVE EMPLOYEES OF UNITY HEALTH SYSTEM FOUNDATION. THE ORGANIZATION MAINTAINS A SECTION 457(F) PLAN WHICH WOULD BE CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THERE WERE NO DISTRIBUTIONS PAID IN 2016. IN 2014 AND PRIOR YEARS, THE TOTAL COMPENSATION OF THE FORMER CEO'S WAS DISCLOSED AS A COMBINATION OF CASH PAID BY THE ORGANIZATION AND DEFERRED COMPENSATION. THE CASH PAYMENTS TO THE FORMER CEO'S SHOWN ON THE 2016 TAX RETURNS REPRESENTS PAYMENTS OF COMPENSATION WHICH WAS RECOGNIZED IN PREVIOUS TAX RETURNS. THERE WAS NO INCREMENTAL EXPENSE RECOGNIZED BY THE ORGANIZATION IN 2016 FOR PAYMENTS MADE TO THE FORMER CEO'S. |
Schedule N IRS990ScheduleN
Liquidation Of Assets Table LiquidationOfAssetsTableGrp
Liquidation Of Assets Detail LiquidationOfAssetsDetail (14 entries)
| Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDesc | DistributionDistributionDt | Fair Market Value Of AssetFairMarketValueOfAssetAmt | Method Of FMV DeterminationMethodOfFMVDeterminationTxt | EINEIN | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionTxt |
|---|---|---|---|---|---|---|---|---|---|
| ROCHESTER GENERAL HOSPITAL FOUNDATION INC | |||||||||
| CASH AND CASH EQUIVALENTS | 2016-12-31 | $460,533 | BOOK VALUE | 222229425 | 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 501(C)(3) |
| ROCHESTER GENERAL HOSPITAL FOUNDATION INC | |||||||||
| PLEDGES AND GRANTS RECEIVABLE | 2016-12-31 | $3,272,439 | BOOK VALUE | 222229425 | 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 501(C)(3) |
| ROCHESTER GENERAL HOSPITAL FOUNDATION INC | |||||||||
| NOTES AND LOANS RECEIVABLE | 2016-12-31 | $13,286 | BOOK VALUE | 222229425 | 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 501(C)(3) |
| ROCHESTER GENERAL HOSPITAL FOUNDATION INC | |||||||||
| PREPAID EXPENSES AND DEFERRED CHARGES | 2016-12-31 | $12,723 | BOOK VALUE | 222229425 | 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 501(C)(3) |
| ROCHESTER GENERAL HOSPITAL FOUNDATION INC | |||||||||
| PROPERTY, PLANT, EQUIPMENT, NET | 2016-12-31 | $749,478 | BOOK VALUE | 222229425 | 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 501(C)(3) |
| ROCHESTER GENERAL HOSPITAL FOUNDATION INC | |||||||||
| INVESTMENTS, PUBLICLY TRADED SECURITIES | 2016-12-31 | $2,997,290 | BOOK VALUE | 222229425 | 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 501(C)(3) |
| ROCHESTER GENERAL HOSPITAL FOUNDATION INC | |||||||||
| INVESTMENTS, OTHER SECURITIES | 2016-12-31 | $6,052,697 | BOOK VALUE | 222229425 | 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 501(C)(3) |
| ROCHESTER GENERAL HOSPITAL FOUNDATION INC | |||||||||
| CASH SURRENDER VALUE LIFE INSURANCE POLICIES | 2016-12-31 | $184,393 | BOOK VALUE | 222229425 | 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 501(C)(3) |
| ROCHESTER GENERAL HOSPITAL FOUNDATION INC | |||||||||
| CHARITABLE GIFT ANNUITY RESERVE | 2016-12-31 | $682,847 | BOOK VALUE | 222229425 | 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 501(C)(3) |
| ROCHESTER GENERAL HOSPITAL FOUNDATION INC | |||||||||
| CHARITABLE REMAINDER TRUSTS | 2016-12-31 | $478,474 | BOOK VALUE | 222229425 | 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 501(C)(3) |
| ROCHESTER GENERAL HOSPITAL FOUNDATION INC | |||||||||
| DUE FROM AFFILIATES | 2016-12-31 | $216,778 | BOOK VALUE | 222229425 | 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 501(C)(3) |
| ROCHESTER GENERAL HOSPITAL FOUNDATION INC | |||||||||
| UNRESTRICTED NET ASSETS | 2016-12-31 | $1,177,389 | BOOK VALUE | 222229425 | 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 501(C)(3) |
| ROCHESTER GENERAL HOSPITAL FOUNDATION INC | |||||||||
| TEMPORARILY RESTRICTED NET ASSETS | 2016-12-31 | $7,112,650 | BOOK VALUE | 222229425 | 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 501(C)(3) |
| ROCHESTER GENERAL HOSPITAL FOUNDATION INC | |||||||||
| PERMANENTLY RESTRICTED NET ASSETS | 2016-12-31 | $6,181,903 | BOOK VALUE | 222229425 | 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 501(C)(3) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor | Yes (1) | DirectorOfSuccessorInd |
| Employee Of Successor | 0 | EmployeeOfSuccessorInd |
| Owner Of Successor | 0 | OwnerOfSuccessorInd |
| Receive Compensation | 0 | ReceiveCompensationInd |
| Assets Distributed | Yes (1) | AssetsDistributedInd |
| Required To Notify AG | Yes (1) | RequiredToNotifyAGInd |
| Attorney General Notified | Yes (1) | AttorneyGeneralNotifiedInd |
| Liabilities Paid | 0 | LiabilitiesPaidInd |
| Bonds Outstanding | 0 | BondsOutstandingInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2E: | FormAndLineReferenceDesc |
| Explanation | PERSON(S) INVOLVED: THE BOARD OF DIRECTORS FOR THE FILING ORGANIZATION IS THE SAME BOARD OF DIRECTORS FOR ROCHESTER GENERAL HOSPITAL FOUNDATION, THE SURVIVING ORGANIZATION AFTER MERGER. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 3 | ON DECEMBER 31, 2016 UNITY HEALTH SYSTEM FOUNDATION (THE FILING ORGANIZATION) MERGED WITH ROCHESTER GENERAL HOSPITAL FOUNDATION (EIN: 22-2229425), THE SURVIVING CORPORATION. ALL PROGRAM SERVICE ACTIVITIES WERE TRANSFERRED TO THE SURVIVING CORPORATION AND THE FILING ORGANIZATION CEASED PROGRAM ACTIVITIES. |
| FORM 990, PART VI, SECTION A, LINE 1 | EACH BOARD HAS AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD PLUS THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION AND SUCH OTHER DIRECTORS AS THE CHAIR MAY NOMINATE FROM TIME TO TIME FOR APPOINTMENT BY A MAJORITY VOTE OF THE ENTIRE BOARD. BETWEEN MEETINGS OF THE BOARD, AND TO THE EXTENT PERMITTED BY LAW, THE EXECUTIVE COMMITTEE SHALL POSSESS THE POWERS OF THE BOARD WITH RESPECT TO MANAGING AND CONDUCTING THE AFFAIRS OF THE CORPORATION, EXCEPT AS OTHERWISE PROVIDED BY LAW OR WITHIN CERTAIN BY-LAWS. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION IS A MEMBERSHIP (NOT A STOCK) CORPORATION UNDER NEW YORK STATE LAW. THE ORGANIZATION'S SOLE CORPORATE MEMBER IS ROCHESTER REGIONAL HEALTH, A RELATED NOT-FOR-PROFIT ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7B | ROCHESTER REGIONAL HEALTH, AS THE SOLE CORPORATE MEMBER, ALSO HAS THE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY, INCLUDING AMENDMENT OF BYLAWS AND CHARTERS, REMOVAL OF MEMBERS OF THE GOVERNING BODY, AND THE DECISION TO DISSOLVE THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | PRIOR TO FILING, A COPY OF THE FORM 990 IS PROVIDED TO, AND REVIEWED WITH, ALL MEMBERS OF THE AUDIT AND COMPLIANCE COMMITTEE. THIS REVIEW IS PERFORMED IN CONSULTATION WITH THE ORGANIZATION'S TAX ADVISORS, AND IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS AND OTHER RELEVANT INFORMATION FOR THE APPROPRIATE TIME PERIOD. |
| FORM 990, PART VI, SECTION B, LINE 12C | UPON EMPLOYMENT, ALL EMPLOYEES RECEIVE THE ETHICAL STANDARD OF CONDUCT BOOKLET FOR WHICH THEY SIGN A RECEIPT OF ACKNOWLEDGEMENT. CONFLICT OF INTEREST IS DEFINED, AS IS MANAGEMENT OF A CONFLICT OF INTEREST. EMPLOYEES ARE REQUIRED TO DISCLOSE AND SEEK RESOLUTION TO ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST BEFORE TAKING A POTENTIALLY IMPROPER ACTION AND THEREAFTER, ANNUALLY, EACH KEY EMPLOYEE AND OFFICER OF THE ORGANIZATION IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM, PROVIDING MANAGEMENT WITH SUFFICIENT INFORMATION ABOUT HIS/HER PERSONAL INTERESTS AND RELATIONSHIPS SO THAT MANAGEMENT CAN (1) DETERMINE WHETHER ANY ACTUAL OR PERCEIVED CONFLICT OF INTEREST EXISTS, AND (2) MONITOR WORK ASSIGNMENTS TO AVOID PLACING THE KEY EMPLOYEE OR OFFICER IN A POSITION WHERE THERE MAY BE A QUESTION AS TO HIS/HER OBJECTIVITY AS WELL AS TO AVOID ANY APPEARANCE OF IMPROPRIETY. THROUGHOUT THE YEAR, KEY EMPLOYEES AND OFFICERS OF THE ORGANIZATION ARE ALSO REQUIRED TO NOTIFY MANAGEMENT PROMPTLY IF ANY CHANGE TO THEIR DISCLOSURES OCCURS. BOARD MEMBERS LEAVE THE ROOM DURING DISCUSSIONS AND ABSTAIN FROM VOTING WHEN THEY HAVE A CONFLICT OF INTEREST. IN ADDITION, EACH MEMBER OF THE BOARD OF DIRECTORS MUST ALSO COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE FORM, WHICH MUST BE SUBMITTED TO THE GENERAL COUNSEL. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S OFFICER AND KEY EMPLOYEE COMPENSATION ARRANGEMENTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF ROCHESTER REGIONAL HEALTH, A RELATED NOT-FOR-PROFIT ORGANIZATION. INFORMATION REVIEWED FOR THE OFFICER/KEY EMPLOYEE INCLUDES COMPARABLE DATA FROM SIMILAR SIZE TAX EXEMPT ORGANIZATIONS IN THE WESTERN/CENTRAL NY COMMUNITY AS WELL AS COMPENSATION FOR THESE POSITIONS (AS DISCLOSED ON FORM 990) WITH OTHER ORGANIZATIONS IN THE HEALTH CARE INDUSTRY THAT ARE OF SIMILAR SIZE, DEMOGRAPHICS AND GEOGRAPHY. REVIEW AND APPROVAL OF THE COMPENSATION ARRANGEMENT BY THE COMPENSATION COMMITTEE IS DOCUMENTED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ADMINISTRATIVE OFFICES OF THE AFFILIATED HEALTH SYSTEM AT 100 KINGS HIGHWAY SOUTH, ROCHESTER, NY 14617 AND ADMINISTRATIVE OFFICES OF THE FILING ORGANIZATION. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED. |
| FORM 990, PART XI, LINE 9: | CHANGE-ANNUAL PENSION VALUATION OTHER COMPREHENSIVE INCOME -5,380. CHANGES IN MARKET VALUE OF CHARITABLE REMAINDCER TRUSTS -29,578. CHANGES IN VALUE OF CHARITABLE GIFT ANNUITIES 33,503. TRANSFER OF NET ASSETS TO RGHF -14,471,942. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
| FORM 5471 FILED ON BEHALF STATEMENT | STATEMENT PURSUANT TO TREAS REG SEC 1 6038-2(J)(3) THE FOLLOWING INFORMATION IS SUBMITTED WITH RESPECT TO UNITY HEALTH SYSTEM FOUNDATION FORM 5471 (INFORMATION RETURN OF U S PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS) FILING REQUIREMENT FOR THE ENTITY BELOW NAME OF FOREIGN CORPORATION HEALTH CARE CASUALTY INSURANCE LIMITED BEGINNING TAX YEAR OF FOREIGN CORPORATION JANUARY 1, 2016 ENDING TAX YEAR OF FOREIGN CORPORATION DECEMBER 31, 2016 THE FORM 5471 FILING REQUIREMENT FOR THIS FOREIGN CORPORATION FOR CATEGORIES 4 AND 5 HAVE BEEN SATISFIED BY INCLUSION IN THE FOLLOWING US FILER'S TAX RETURN NAME OF US FILER UNITY HEALTH SYSTEM, INC. ADDRESS OF US FILER 1555 LONG POND ROAD ROCHESTER, NY 14626 EIN OR SSN 22-2572873 ENDING TAX YEAR OF US FILER DECEMBER 31, 2016 TYPE OF RETURN FILED 990 IRS CENTER WHERE RETURN FILED OGDEN, UTAH 84201-0027. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (34 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| THE ROCHESTER GENERAL HOSPITAL | |||||||||||
| 1425 PORTLAND AVENUE | ROCHESTER | NY | 14621 | 160743134 | HOSPITAL | NY | 501(C)(3) | LINE 3 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| GRHS FOUNDATION | |||||||||||
| 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 223378111 | R/E INV MGMT | NY | 501(C)(3) | LINE 12A, I | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| THE ROCHESTER GENERAL HOSPITAL FOUNDATION | |||||||||||
| 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 222229425 | FUNDRAISING | NY | 501(C)(3) | LINE 12A, I | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| NEWARK WAYNE COMMUNITY HOSPITAL FOUNDATION | |||||||||||
| DRIVING PARK AVENUE | NEWARK | NY | 14513 | 222963015 | FUNDRAISING | NY | 501(C)(3) | LINE 12A, I | NWCH | Yes (1) | |
| NEWARK WAYNE COMMUNITY HOSPITAL | |||||||||||
| DRIVING PARK AVENUE | NEWARK | NY | 14513 | 150584188 | HOSPITAL | NY | 501(C)(3) | LINE 3 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| RGHS WORKERS' COMPENSATION TRUST | |||||||||||
| 1425 PORTLAND AVENUE | ROCHESTER | NY | 14621 | 166429300 | SEE PART VII | NY | 501(C)(3) | LINE 12A, I | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| CONTINUING CARE NETWORK INC (CCN) | |||||||||||
| 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 222963016 | SUPPORT RGH | NY | 501(C)(3) | LINE 12A, I | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| ROCHESTER GENERAL HUDSON HOUSING | |||||||||||
| 2066 HUDSON AVENUE | ROCHESTER | NY | 14621 | 223210351 | LOW INC HOUSING | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| VIA HEALTH HOME CARE I | |||||||||||
| 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 161504370 | HOME HEALTH | NY | 501(C)(3) | LINE 10 | CCN | Yes (1) | |
| VIA HEALTH HOMECARE II | |||||||||||
| 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 161538727 | HOME HEALTH | NY | 501(C)(3) | LINE 10 | CCN | Yes (1) | |
| INDEPENDENT LIVING FOR SENIORS | |||||||||||
| 2066 HUDSON AVENUE | ROCHESTER | NY | 14617 | 161491059 | ADULT DAY HC | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| ROCHESTER GENERAL LONG TERM CARE | |||||||||||
| 1550 EMPIRE BLVD | WEBSTER | NY | 14580 | 223187140 | NH & REHAB | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| WESTERN NEW YORK MEDICAL PRACTICE PC | |||||||||||
| 1425 PORTLAND AVENUE | ROCHESTER | NY | 14621 | 611654232 | PHYS PRAC | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| THE UNITY HOSPITAL OF ROCHESTER | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 237221763 | HOSPITAL | NY | 501(C)(3) | LINE 3 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| NORTH PARK NURSING HOME INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 223159644 | LONG TERM CARE FACILITY | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| PARK RIDGE NURSING HOME INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 160978184 | LONG TERM CARE FACILITY | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| ROCHESTER GENERAL HEALTH SYSTEM | |||||||||||
| 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 222551509 | SYSTEM SUPPORT | NY | 501(C)(3) | LINE 12A, I | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| PARK RIDGE CHILD CARE CENTER INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 222918126 | CHILD DAY CARE SERVICES | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| PARK RIDGE HOUSING DEVELOPMENT FUND | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 222608311 | LOW INCOME HOUSING PROJECT FOR ELDERLY | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| PARK RIDGE HOUSING INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 222570457 | SENIOR APARTMENT COMPLEX | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| PARKWAY COMMONS HOUSING DEVELOPMENT | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 223130818 | LOW INCOME HOUSING FOR ELDERLY/HANDICAPPED | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| STBERNARD'S HOUSING DEVELOPMENT FU | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 161492955 | LOW INCOME HOUSING PROJECT | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| UNITY AGING SERVICES INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 841684195 | MANAGEMENT AND DEVELOPMENT CO | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| UNITY HOUSING DEVELOPMENT FUND CORP | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 300068596 | RECEIPT AND DISBURSEMENTS OF SUBSIDIES | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| WOODLAND VILLAGE INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 161588242 | SENIOR APARTMENT COMPLEX | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| UNITY AMBULATORY SURGERY CENTER INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 383871383 | OUTPATIENT SURGERY | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| UNITY HEALTH SYSTEM INC | |||||||||||
| 1555 LONG POND ROAD | ROCHESTER | NY | 14626 | 222572873 | SYSTEM SUPPORT | NY | 501(C)(3) | LINE 12A, I | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| ROCHESTER REGIONAL HEALTH | |||||||||||
| 100 KINGS HIGHWAY SOUTH | ROCHESTER | NY | 14617 | 471234999 | SYSTEM PARENT | NY | 501(C)(3) | LINE 12A, I | Yes (1) | N/A | |
| UNITED MEMORIAL MEDICAL CENTER | |||||||||||
| 127 NORTH STREET | BOTAVIA | NY | 14020 | 160743029 | HOSPITAL | NY | 501(C)(3) | LINE 3 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| HENRY FOSTER ASSOCIATES DBA CORPORATE CARE OF FINGER LAKES | |||||||||||
| 4 COULTER ROAD | CLIFTON SPRINGS | NY | 14432 | 161282294 | EMPLOYEE ASSISTANCE PROGRAMS | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| CLIFTON SPRINGS HOSPITAL AND CLINIC | |||||||||||
| 2 COULTER ROAD | CLIFTON SPRINGS | NY | 14432 | 160743966 | HOSPITAL | NY | 501(C)(3) | LINE 3 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| BEHAVIORAL HEALTH NETWORK INC | |||||||||||
| 490 EAST RIDGE ROAD | ROCHESTER | NY | 14621 | 166069131 | MENTAL HEALTH | NY | 501(C)(3) | LINE 10 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| PRCD INC | |||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 161311581 | SUBSTANCE ABUSE TREATMENT & REHAB. | NY | 501(C)(3) | LINE 7 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
| CLIFTON SPRINGS HOSPITAL & CLINIC FOUNDATION | |||||||||||
| 2 COULTER ROAD | CLIFTON SPRINGS | NY | 14432 | 161560033 | FUNDRAISING | NY | 501(C)(3) | LINE 11 | ROCHESTER REGIONAL HEALTH | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NW ASSOCIATES LP | ||||||||||||
| PO BOX 111 DRIVING PARK AVENUE | NEWARK | NY | 14513 | 141674119 | R/E LEASING | NY | NWCH | RELATED | 0 | 0 | 0.52570 | |
| PARMA SENIOR HOUSING | ||||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 432082116 | HILTON PROJ | NY | 0 | 0 | N/A | |||
| UNITY SENIOR HOUSING | ||||||||||||
| 1555 LONG POND RD | ROCHESTER | NY | 14626 | 061709927 | MOORE PK | NY | 0 | 0 | N/A | |||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GREATER ROCHESTER ASSURANCE COMPANY LTD | |||||||||||||||
| GEORGE TOWN | GRAND CAYMAN | CJ | INSURANCE | CJ | N/A | C | 1.00000 | 0 | |||||||
| GRACO RISK RETENTION GROUP INC | |||||||||||||||
| INSURANCE | C | 1.00000 | 0 | 1425 PORTLAND AVENUE | ROCHESTER | NY | 14621 | 710933967 | SC | RGH | |||||
| NWA INC | |||||||||||||||
| R/E LEASING | C | 1.00000 | 0 | DRIVING PARK AVENUE | NEWARK | NY | 14513 | 141667339 | NY | NWCH | |||||
| GREATER ROCHESTER INDEPENDENT PRACTICE ASSOCIATION INC | |||||||||||||||
| INDEPENDENT PRACTICE ASSOCIATION | N/A | C | 0.50000 | 0 | 100 KINGS HWY S SUITE 2500 | ROCHESTER | NY | 14617 | 161507171 | NY | |||||
| ROCHESTER GENERAL HEALTH SYSTEM DIALYSIS INC | |||||||||||||||
| DIALYSIS | C | 1.00000 | 0 | 1425 PORTLAND AVENUE | ROCHESTER | NY | 14621 | 383912199 | NY | RGHS | |||||
| ACM MEDICAL LABORATORY INC | |||||||||||||||
| CLINICAL LAB | C | 0 | 160 ELMGROVE PARK | ROCHESTER | NY | 14624 | 161059691 | NY | PRH INC | ||||||
| PRH INC | |||||||||||||||
| MEDICAL LAB | C | 0 | 1555 LONG POND ROAD | ROCHESTER | NY | 14626 | 161329632 | NY | ROCHESTER REGIONAL HEALTH | ||||||
| GREATER ROCHESTER IMMEDIATE MEDICAL CARE PLLC DBA ROCHESTER IMMEDIATE CARE | |||||||||||||||
| URGENT CARE CENTERS | C | 1.00000 | 0 | 265 BROOKVIEW CENTRE WAY SUITE 400 | KNOXVILLE | TN | 37919 | 271453784 | TN | WESTERN NEW YORK MEDICAL PC | |||||
| ROCHESTER MEDICINE PLLC | |||||||||||||||
| OCCUPATIONAL MEDICINE | C | 1.00000 | 0 | 265 BROOKVIEW CENTRE WAY SUITE 400 | KNOXVILLE | TN | 37919 | 812625325 | TN | WESTERN NEW YORK MEDICAL PC | |||||
| PARMA SENIOR HOUSING LLC | |||||||||||||||
| SENIOR HOUSING | C | 0 | 1555 LONG POND ROAD | ROCHESTER | NY | 14626 | 810671687 | NY | ROCHESTER REGIONAL HEALTH | ||||||
| UNITY SENIOR HOUSING CORP | |||||||||||||||
| SENIOR HOUSING | C | 0 | 1555 LONG POND ROAD | ROCHESTER | NY | 14624 | 061709925 | NY | ROCHESTER REGIONAL HEALTH | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | 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 |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| UNITY HOSPITAL OF ROCHESTER | ||
| P | $72,233 | FMV |
| PRCD INC | ||
| Q | $136,004 | FMV |
| UNITY HOSPITAL OF ROCHESTER | ||
| B | $922,882 | FMV |
| WOODLAND VILLAGE INC | ||
| B | $55,000 | FMV |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART II, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | RELATED TAX-EXEMPT ORGANIZATION - PRIMARY ACTIVITY: RGHS WORKERS' COMPENSATION TRUST SUPPORTS THE ROCHESTER GENERAL HOSPITAL, NEWARK WAYNE COMMUNITY HOSPITAL, ROCHESTER GENERAL LONG TERM CARE, INDEPENDENT LIVING FOR SENIORS, VIAHEALTH HOMECARE I, VIAHEALTH HOMECARE II, BEHAVIORAL HEALTH NETWORK, INC, CLIFTON SPRINGS HOSPITAL & CLINIC AND UNITED MEMORIAL MEDICAL CENTER. | ExplanationTxt |
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