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Rochester Integrated Health Network Inc: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
Rochester Integrated Health Network Inc (EIN 90-0726696)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-08-04
IRS object ID
201702169349300905
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-08-04T12:33:11-05:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN271895149PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Heveron & Company CPAs PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1260 Plymouth Avenue SouthAddressLine1Txt
CityRochesterCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14608ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN900726696EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Rochester Integrated Health Network IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlROCHBusinessNameControlTxt
Phone5857377522PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 Canal View Blvd No 202AddressLine1Txt
CityRochesterCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14623ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDeborah PeartreePersonNm
Person TitleExecutive DirectorPersonTitleTxt
Phone5857377522PhoneNum
Signature2017-05-26SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonStephanie AnnunziataPreparerPersonNm
PTINP00195472PTIN
Phone5852322956PhoneNum
Preparation2017-05-26PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address24.213.221.209IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-05-26IPDt
IP Tm11:14:43IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id1F8605C01C138A6221EB72FF3FCADABA94ED0000AtSubmissionCreationDeviceId
At Submission Filing Device IdEEA45F81699E10CFF9098B513D476AEA53E0731EAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDeborah PeartreePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 Canal View Blvd No 202AddressLine1Txt
CityRochesterCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14623ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$8,907,171GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.therihn.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2011FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionPromoting the integration and coordination of quality, accessible and affordable health care.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent6VotingMembersIndependentCnt
Total Employee9TotalEmployeeCnt
Total Volunteers13TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$911,908PYContributionsGrantsAmt
CY Contributions Grants$1,243,221CYContributionsGrantsAmt
PY Program Service Revenue$4,311,028PYProgramServiceRevenueAmt
CY Program Service Revenue$7,663,950CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$5,222,936PYTotalRevenueAmt
CY Total Revenue$8,907,171CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$173,305PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$442,032CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$4,828,155PYOtherExpensesAmt
CY Other Expenses$8,531,039CYOtherExpensesAmt
PY Total Expenses$5,001,460PYTotalExpensesAmt
CY Total Expenses$8,973,071CYTotalExpensesAmt
PY Revenues Less Expenses$221,476PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$65,900CYRevenuesLessExpensesAmt
Total Assets BOY$5,162,364TotalAssetsBOYAmt
Total Assets EOY$6,613,049TotalAssetsEOYAmt
Total Liabilities BOY$4,406,755TotalLiabilitiesBOYAmt
Total Liabilities EOY$5,923,340TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$755,609NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$689,709NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionRochester Integrated Health Network is operated exclusively for the charitable purposes of: (a) promoting the integration and coordination of quality, accessible and affordable medical and behavioral health care services for low income, (continued on Schedule O) uninsured and underinsured children and adults in the Greater Rochester, New York region through the distribution of information and through collaborative improvement projects among its member organizations and community partners; and (b) coordinating the care of a population of people in the Greater Rochester, New York region, including without limitation case management and linkages to community-based social support services.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$2,576ExpenseAmt
DescRochester Integrated Health Network has established a provider subcommittee on refugee care; established provider subcommittee on behavioral health access; partnered with a major insurer and local hospitals in a primary care loan assistance program; and hosted a primary care week presentation to support the need for primary care and future challenges. This program is supported by contributions.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$8,172,004ExpenseAmt
Revenue$7,663,950RevenueAmt
DescGreater Rochester Health Home Network is one of two approved Health Homes in Monroe County. Funding was used to develop the legal structure, support meeting time and materials used in the development of partnerships with care management organizations, community based organizations, Monroe County Office of Mental Health, medical, mental health and substance abuse providers, program, policy and procedure development, IT and communication linkages; and many other aspects necessary for implementation of an effective Health Home. This program is also supported by contributions.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$8,174,580TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document10IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee9EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member6IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of Committees0MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1The OrganizationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5857377522PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 Canal View Blvd No 202AddressLine1Txt
CityRochesterCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14623ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Bridgette Wiefling
Chair0.90Yes (X)Yes (X)$0$0$0
Michael Leary
Vice Chair0.70Yes (X)Yes (X)$0$0$0
Thomas Campbell
Vice Chair0.70Yes (X)Yes (X)$0$0$0
Michael Nazar
Treasurer/Secretary0.70Yes (X)Yes (X)$0$0$0
Janice Harbin
Director0.70Yes (X)$0$0$0
Kathy Parrinello
Director0.10Yes (X)$0$0$0
Deborah Peartree
Executive Director65.00Yes (X)$115,000$0$17,824
FieldValueIRS element (for citing)
Total Reportable Comp From Org$115,000TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$17,824TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
BTQ Financial
80 Broad StNew YorkNY10004Financial Management$346,708
Harris Beach PLLC
99 Garnsey RoadPittsfordNY14534Law Practice$126,680
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Membership Dues$25,002MembershipDuesAmt
Government Grants$1,218,219GovernmentGrantsAmt
Total Contributions$1,243,221TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescFees for ServiceDesc
Business900099BusinessCd
Total Revenue Column$7,663,950TotalRevenueColumnAmt
Related Or Exempt Func Income$7,663,950RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$7,663,950TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,907,171TotalRevenueColumnAmt
Related Or Exempt Func Income$7,663,950RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$132,824TotalAmt
Program Services$132,824ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$256,927TotalAmt
Program Services$249,488ProgramServicesAmt
Management And General$7,439ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$4,166TotalAmt
Program Services$4,014ProgramServicesAmt
Management And General$152ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$19,250TotalAmt
Program Services$18,577ProgramServicesAmt
Management And General$673ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$28,865TotalAmt
Program Services$28,288ProgramServicesAmt
Management And General$577ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$408,271TotalAmt
Program Services$7,182ProgramServicesAmt
Management And General$401,089ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$116,121TotalAmt
Management And General$116,121ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$35,974TotalAmt
Management And General$35,974ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,598,055TotalAmt
Program Services$7,598,055ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$74,422TotalAmt
Program Services$74,422ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$41,710TotalAmt
Program Services$41,710ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$6,094TotalAmt
Management And General$6,094ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$998TotalAmt
Management And General$998ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,889TotalAmt
Program Services$4,889ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$11,019TotalAmt
Program Services$9,421ProgramServicesAmt
Management And General$1,598ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
Bad Debt$225,871$225,871
Membership Dues$3,516$3,516
Training$2,194$2,194

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,905TotalAmt
Management And General$1,905ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,973,071TotalAmt
Program Services$8,174,580ProgramServicesAmt
Management And General$798,491ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,860,621BOYAmt
EOY$3,508,994EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,290,317BOYAmt
EOY$3,063,556EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,969BOYAmt
EOY$13,703EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$34,717LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,921LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$9,457BOYAmt
EOY$26,796EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,162,364BOYAmt
EOY$6,613,049EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,383,380BOYAmt
EOY$3,214,734EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$3,023,375BOYAmt
EOY$2,708,606EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,406,755BOYAmt
EOY$5,923,340EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$546,451BOYAmt
EOY$568,801EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$209,158BOYAmt
EOY$120,908EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$755,609BOYAmt
EOY$689,709EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,162,364BOYAmt
EOY$6,613,049EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$65,900ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$50,427CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$558,619CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$476,765CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$911,908CurrentTaxYearMinus1YearAmt
Current Tax Year$1,243,221CurrentTaxYearAmt
Total$3,240,940TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$50,427CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$558,619CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$476,765CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$911,908CurrentTaxYearMinus1YearAmt
Current Tax Year$1,243,221CurrentTaxYearAmt
Total$3,240,940TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$3,240,940PublicSupportTotal170Amt
Total Support$3,240,940TotalSupportAmt
Gross Receipts Rltd Activities$13,431,571GrossReceiptsRltdActivitiesAmt
Public Support CY1701.00000PublicSupportCY170Pct
Public Support PY1701.00000PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$34,717OtherCostOrOtherBasisAmt
Depreciation$7,921DepreciationAmt
Book Value$26,796BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$26,796TotalBookValueLandBuildingsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 6The organization has member organizations.
Form 990, Part VI, Section A, line 7aMember organizations each appoint board members.
Form 990, Part VI, Section A, line 8bThere are no other committees with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11bA complete copy of the 990 is provided to the whole board prior to filing.
Form 990, Part VI, Section B, line 12cThe organization provides each officer and director with the conflict of interest policy when they are elected or appointed. The policy is also reviewed annually. If a potential conflict with any officer or director arises, the organization follows the conflict of interest policy and documents that in meeting minutes.
Form 990, Part VI, Section B, line 15aThe Board of Directors approves the salary for the Executive Director. There are no other paid officers or key employees.
Form 990, Part VI, Section C, line 19The organization does not make its governing documents, conflict of interest policy or financial statements available to the public.
Form 990, Part IX, line 11gHealth Home Providers: Program service expenses 6,821,699. Management and general expenses 0. Fundraising expenses 0. Total expenses 6,821,699. Other Professional Services: Program service expenses 120,815. Management and general expenses 0. Fundraising expenses 0. Total expenses 120,815. Meaningful Use: Program service expenses 655,541. Management and general expenses 0. Fundraising expenses 0. Total expenses 655,541.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Greater Rochester Health Home Network
200 Canal View Blvd Suite 202RochesterNY14623Provide care management services to Medicaid enrollees throughNY$8,882,169$6,554,926Rochester Integrated Health Network
(continued)
partnerships with care management providersNY

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