2015-11-04T11:55:40-07:00 2014-12-31 990 2014-01-01 161005419 GENESEE VALLEY GROUP HEALTH ASSOCIATION GENE 5852384579 165 Court Street Rochester NY 14647 James Haefner Sr Vice President & Asst Treasurer 5853276505 2015-11-02 2014 2016-03-07 17:11:31Z Lifetime Health Medical Group Paul Eisenstat 165 Court Street Rochester NY 14647 76214039 0 X www.lifetimehealth.org X 1972 NY Genesee Valley Group Health Association, Inc. provides primary health care for patients in Buffalo and Rochester. A variety of services are offered at each health center and most sites to include pharmacy, laboratory, radiology, internal medicine, pediatrics, family practice and specialty care. 3 0 649 0 0 0 0 106650355 50180440 1563383 1380513 4280650 4206222 112494388 55767175 0 0 54284810 0 42989342 42401616 0 0 0 15020762 13265473 112294914 55667089 199474 100086 15774712 15841613 14375634 14709985 1399078 1131628 Lifetime Health Medical Group exists to guide and support you with your health needs, to work with you to improve your health, and to care for you during illness. We will do this by: being a responsive and respectful partner in your care and addressing your health needs from your perspective, developing effective relationships with other providers to assure coordination of your care, and seeking innovative solutions to continuously improve your access to quality, evidence-based health care. 0 0 55667089 0 50180440 Health Care Delivery: Health Services (272,728 Visits) 0 0 0 55667089 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 58 0 1 649 1 0 0 0 0 0 0 0 0 0 0 X 3 0 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X Jim Haefner 5853276505 165 Court Street Rochester NY 14647 X Christopher C Booth Director 0.4 40 X 0 1842285 180963 Dorothy Coleman CFO, Treasurer and CEO 1.2 40 X X 0 846043 87562 Stephen Sloan Secretary 0.4 40 X X 0 774560 105219 Anne Ruflin President 40 0 X 0 615253 54675 Paul Eisenstat CEO 1.2 40 X 0 601216 45857 James Haefner Assistant Treasurer 0.4 40 X 0 392583 77470 Mark Perry Interim President 40 0 X 0 346992 40257 Margaret Cassady Assistant Secretary 0.4 40 X 0 299582 36608 Stephen LaSalle COO 40 0 X 0 253882 56674 Robert Cole Medical Director 40 0 X 293053 0 14543 Douglas Golding Medical Director 40 0 X 0 273025 43922 Mark Cohen Medical Director LHMG 40 0 X 233952 0 10037 Theo Turque Medical Director LHMG 40 0 X 199794 0 23922 Richard Dudrak Medical Director LHMG 40 0 X 194919 0 14692 Deborah Carlascio Vice President of Operations 40 0 X 0 193168 57308 Jason Smith Director Pharmacy Services 40 0 X 159540 0 22485 Michael Jordan Physician 40 0 X 352815 0 31853 Valerie Newman Physician 40 0 X 331119 0 24411 Richard Vienne Physician 4 40 X 10465 286370 43896 Matthew Bartels Physician 10 30 X 115055 176215 32723 Pramila Penta Physician 40 0 X 274644 0 12378 David H Klein Former CEO 0 0 X 0 6389763 159593 Emil D Duda Former Treasurer 0 0 X 0 915801 162550 2165356 14206738 1339598 64 1 1 0 LeChase Construction Services LLC 300 Trolley Blvd Rochester NY 14606 Construction Mgmt/General Contractor 1760991 Quality Systems Inc 18111 Von Karman Avenue Suite 700 Irvine CA 92612 Software Maintenance 626759 Eastern Niagara Radiology Associates 222 Genesee Street Buffalo NY 14203 Radiology Services 435000 Windsong Radiology Group 55 Spindrift Drive Williamsville NY 14221 Radiology Services 229365 Mason Marketing Communications LLC 400 Whitney Rd Penfield NY 14526 Advertising 189314 11 0 Fee For Service Revenue 621110 48085694 48085694 0 0 Capitation Revenue 621110 2094746 2094746 0 0 0 0 0 0 50180440 1380513 1380513 0 0 0 0 0 0 0 0 0 0 197858 0 0 0 197858 0 197858 0 0 197858 0 0 24455228 20446864 4008364 0 0 4008364 0 55767175 51560953 0 4206222 1788879 1788879 0 32930944 32930944 750108 750108 4576276 4576276 2355409 2355409 131313 131313 104829 104829 2055090 2055090 278540 278540 1885803 1885803 1011736 1011736 2840003 2840003 167310 167310 12164 12164 224653 224653 990203 990203 545821 545821 Other Exp - Medical Supplies 3018008 3018008 0 0 0 55667089 55667089 0 0 479279 279635 3291044 3214713 2561964 2618983 555098 661450 14879234 10134826 4433201 4744408 1890290 2621336 2563836 1701088 15774712 15841613 9702067 3492653 4673567 11217332 14375634 14709985 X 1399078 1131628 0 0 0 0 1399078 1131628 15774712 15841613 X 100086 0 0 0 0 -367536 X 0 1 X 1 0 X Schedule A, Part I, Line 3 Genesee Valley Group Health Association, Inc. is exempt as a hospital under Internal Revenue Code Section 170(b)(1)(A)(iii); however it is not a hospital as defined by the Form 990, Section H instructions : "a hospital is a facility that is, or is required to be licensed, registered, or similarly recognized by a state as a hospital." Genesee Valley Group Health Association does not meet any of these requirements. Genesee Valley Group Health Association is licensed under Article 28 of the New York State Public Health Law to operate diagnostic and treatment centers. 0 488386 488386 0 4201056 3963549 237507 0 2935720 1069610 1866110 0 7254072 5101667 2152405 0 0 0 0 4744408 0 Investment in Limited Liability Company 2621336 F 2621336 Reg 164 Trust 1701088 1701088 0 Due to Affiliates 8571264 Post Retirement Benefits 1824579 Long Term Debt 782934 Current Debt 38555 11217332 X 76214039 0 0 0 20446864 20446864 55767175 0 0 0 55767175 76113953 0 0 0 20446864 20446864 55667089 0 0 0 55667089 Schedule D, Part X, Line 2 Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) Topic 740, Income Taxes provides that a tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. Income tax positions must meet a more likely than not recognition threshold to be recognized. This Topic also provides guidance on measurement, derecognition, classification, interest and penalties, accounting in interim periods, disclosure and transition. The Company recognizes any interest and penalties related to unrecognized tax benefits within the other expenses line in the accompanying statements of activities and changes in net assets. Accrued interest and penalties are included within accounts payable and accrued expenses in the accompanying statements of financial position. There were no interest and penalties recognized for 2014 or 2013. The Company does not anticipate any uncertain tax positions within the next twelve months. Schedule D, Part XI, Line 2d Pharmacy Cost of Goods Sold $<20,446,864> Schedule D, Part XII, Line 2d Pharmacy Cost of Goods Sold $<20,446,864> 0 1 1 0 1 0 0 0 0 Christopher C Booth Director 0 854238 0 982864 0 5183 0 159626 0 21337 0 2023248 0 0 Dorothy Coleman CFO, Treasurer and CEO 0 527651 0 308020 0 10372 0 65002 0 22560 0 933605 0 0 Stephen Sloan Secretary 0 446057 0 322905 0 5598 0 83004 0 22215 0 879779 0 0 Anne Ruflin President 0 150738 0 91584 0 372931 0 47412 0 7263 0 669928 0 0 Paul Eisenstat CEO 0 357829 0 242182 0 1205 0 28248 0 17609 0 647073 0 0 James Haefner Assistant Treasurer 0 211627 0 75705 0 105251 0 55899 0 21571 0 470053 0 0 Mark Perry Interim President 0 266705 0 79654 0 633 0 20386 0 19871 0 387249 0 0 Margaret Cassady Assistant Secretary 0 253144 0 43532 0 2906 0 27050 0 9558 0 336190 0 0 Stephen LaSalle COO 0 199975 0 52372 0 1535 0 34690 0 21984 0 310556 0 0 Robert Cole Medical Director 258743 0 33433 0 877 0 7800 0 6743 0 307596 0 0 0 Douglas Golding Medical Director 0 237121 0 34630 0 1274 0 24305 0 19617 0 316947 0 0 Mark Cohen Medical Director LHMG 231842 0 0 0 2110 0 6603 0 3434 0 243989 0 0 0 Theo Turque Medical Director LHMG 198643 0 0 0 1151 0 5295 0 18627 0 223716 0 0 0 Richard Dudrak Medical Director LHMG 187563 0 6538 0 818 0 1182 0 13510 0 209611 0 0 0 Deborah Carlascio Vice President of Operations 0 165451 0 26186 0 1531 0 36714 0 20594 0 250476 0 0 Jason Smith Director Pharmacy Services 148717 0 9979 0 844 0 4972 0 17513 0 182025 0 0 0 Michael Jordan Physician 143630 0 201612 0 7573 0 7800 0 24053 0 384668 0 0 0 Valerie Newman Physician 233100 0 95800 0 2219 0 5259 0 19152 0 355530 0 0 0 Richard Vienne Physician 10465 241094 0 43532 0 1744 194 23373 15 20314 10674 330057 0 0 Matthew Bartels Physician 67200 146997 47658 28389 197 829 2022 9339 305 21057 117382 206611 0 0 Pramila Penta Physician 196707 0 75100 0 2837 0 5894 0 6484 0 287022 0 0 0 David H Klein Former CEO 0 0 0 0 0 6389763 0 145401 0 14192 0 6549356 0 1525324 Emil D Duda Former Treasurer 0 0 0 0 0 915801 0 149639 0 12911 0 1078351 0 898368 Schedule J, Part I, Line 3 The CEO of the filing organization is compensated by a related (parent) organization. His compensation is determined in accordance with a Board of Directors approved Executive Compensation Philosophy. The executive compensation process includes an evaluation of market comparable organizations. The CFO and Treasurer of the filing organization, who was also CEO during a portion of the year, is also the CFO of a related (parent) organization. The process to determine her compensation additionally included the use of an external consultant and approval by the Board of Directors of the related organization. Schedule J, Part I, Line 4 b) The following persons from Part VII, Section A, Line 1a participated in supplemental nonqualified retirement plans of a related organization: D. Klein, E. Duda, C. Booth, D. Coleman, P. Eisenstat, S. Sloan, J. Haefner, A. Ruflin, M. Perry, S. LaSalle, D. Golding, R. Vienne and M. Cassady. c) D. Klein and E. Duda participated in an equity-based compensation arrangement of a related entity that resulted in a distribution of $164,380 to each of them in 2014. Schedule J, Part I, Line 5 b) Some officers and key employees participate in a company incentive program. Bonuses are established from the Board approved strategic operating plan of the company or related company. Performance against prescribed goals is utilized in determining incentive awards. Schedule J, Part II Schedule J Continuation Sheet - Column (B)(iii) - The amount of Other Reportable Compensation reported for David Klein of $6,389,763 consists primarily of two items: (1) a payment from a deferred compensation plan of $4,841,382 that represents compensation earned by Mr. Klein over his career (previously reported in public filings, including on Schedule G of New York State's annual financial reports for the affiliated health plan) and voluntarily deferred and the earnings on those deferrals and (2) the amount of $1,525,354 which was paid to Mr. Klein pursuant to a Supplemental Excess Retirement Plan maintained by the related (parent) company. This payment was reported on a prior 990 and thus is also reflected in Column (F). The amount of Other Reportable Compensation reported for Emil Duda of $915,801 consists primarily of a payment of $898,368 which was paid to Mr. Duda pursuant to a Supplemental Excess Retirement Plan maintained by the related (parent) company. This payment was reported on a prior 990 and thus is also reflected in column (F). Excellus Health Plan Parent 25933556 Revenue from Parent 0 Excellus Health Plan Parent 6520780 Mgmt Fees & Purchased Services 0 Excellus Health Plan Parent 1530677 Rental of Space 0 Schedule L, Part IV The filing organization has various business transactions with Excellus Health Plan whose CEO, CFO, Secretary, Assistant Secretary and Assistant Treasurer are also officers of the filing organization. Form 990, Part VI, Section A, Line 2 GVGHA officers Anne Ruflin, Mark Perry, Stephen LaSalle and GVGHA key employee Doug Golding are employees of Excellus Health Plan, Inc. (a related organization). Such employees have a business relationship with GVGHA officers Christopher Booth, Dorothy Coleman, Stephen Sloan, James Haefner and Margaret Cassady who are also officers of Excellus Health Plan, Inc. Form 990, Part VI, Section A, Line 6 The organization's sole member is Excellus Health Plan, Inc. Form 990, Part VI, Section A, Line 7a Pursuant to a resolution of the Board of Directors of Excellus Health Plan, Inc., the sole member of the organization, the Chief Executive Officer of Excellus Health Plan, Inc. is empowered to act on behalf of Excellus Health Plan, Inc. to elect or reelect the organization's directors. This occurs at a joint annual meeting of the sole member and Board of Directors of the organization, which is held during the first six months of the year pursuant to the Bylaws of the organization. Form 990, Part VI, Section A, Line 7b Bylaws amendments must be approved by the sole member. Certain governance actions (such as the sale of all or substantially all of the assets of the organization) require approval of the member under the New York Not-for-Profit Corporation Law. Form 990, Part VI, Section B, Line 11b The completed IRS Form 990 was provided to the organization's Board of Directors prior to filing allowing the opportunity for review. Responses were provided to questions raised by the governing body and any comments were analyzed and incorporated as applicable. Form 990, Part VI, Section B, Line 12c The organization's Conflict of Interest Policy is regularly and consistantly enforced via a robust annual process. Annually, all employees who hold a position at the Director level or above complete the Conflict of Interest Questionnaire. New or newly promoted employees at the Director level complete the questionnaire at the time of employment or promotion. The Corporate Director of Ethical Compliance is responsible for the annual distribution, tracking, review and reporting of the Conflict of Interest or potential Conflict of Interest Questionnaires for employees of the Corporation. Corporate legal counsel reviews all Conflict of Interest or potential Conflicts of Interest and makes recommendations. Form 990, Part VI, Section B, Line 15 Line 15 a) and Line 15 b) Key employee compensation is established in conjunction with the Board of Directors by having Human Resources engage independent compensation consultants that provide compensation surveys and information of comparable organizations, as well as market standards and best practices, to make informed compensation decisions on a prospective basis. Form 990, Part VI, Section C, Line 18 Form 990 is available online via Guidestar.org. Form 990, Part VI, Section C, Line 19 Governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part VII, Section A, Line 1a Column B - Some of the trustees and officers that devote time to the filing organization do so on an allocated basis as supported by a management fee arrangement with a related organization. Such trustees and officers receive their compensation from a related organization. In some cases these trustees and officers devote all of their time to the filing organization, and in others the related organization is where the majority of their time is devoted. Form 990, Part XI, Line 9 Amortization of Net Gain/Loss - Defined Benefit Plans Genesee Region Home Care Assoc Inc 165 Court Street Rochester NY 14647 160844109 Home Health Services NY 501(c)(3) 509(a)(2) Excellus Health Plan 1 Genesee Region Home Care of Ontario County Inc 165 Court Street Rochester NY 14647 223257719 Home Health Services NY 501(c)(3) 509(a)(2) Excellus Health Plan 1 Univera IPA LLC 165 Court Street Rochester NY 14647 454058523 Independent Practice Association NY N/A Lifetime Healthcare Inc 165 Court Street Rochester NY 14647 161514675 Holding Co NY N/A C 0 Excellus Health Plan Inc 165 Court Street Rochester NY 14647 150329043 Health Insurer NY N/A C Beacon Network Services Inc 165 Court Street Rochester NY 14647 141830065 Inactive NY N/A C Excellus Acquisition Inc 165 Court Street Rochester NY 14647 141830065 Holding Co NY N/A C MedAmerica Inc 165 Court Street Rochester NY 14647 161581817 Holding Co NY N/A C Excellus Ventures Inc 165 Court Street Rochester NY 14647 161550984 Holding Co NY N/A C Upstate Professional Liability Corp 165 Court Street Rochester NY 14647 141783968 Inactive NY N/A C North Star Home Health Management Inc 165 Court Street Rochester NY 14647 161548051 Holding Co NY N/A C MedAmerica Insurance Company of NY 165 Court Street Rochester NY 14647 161310986 Long Term Care Ins NY N/A C MedAmerica Insurance Company 165 Court Street Rochester NY 14647 340977231 Long Term Care Ins PA N/A C MedAmerica Insurance Company of FL 165 Court Street Rochester NY 14647 141993330 Long Term Care Ins FL N/A C Lifetime Benefit Solutions Inc 165 Court Street Rochester NY 14647 161171765 Third Party Administrator NY N/A C Excellus Insurance Agency Inc 165 Court Street Rochester NY 14647 161588653 Insurancy Agency NY N/A C MIG Assurance Ltd 165 Court Street Rochester NY 14647 980210843 Long Term Care Insurance CJ N/A C Lifetime Healthcare Companies Workers' Compensation Trust 165 Court Street Rochester NY 14647 161483185 Grantor Trust NY N/A T Sibley Nursing Personnel Service Inc 165 Court Street Rochester NY 14647 161447472 Provide Home Health Services NY N/A C 344 South Warren Street Corporation 165 Court Street Rochester NY 14647 010718849 Real Estate Holding Company NY N/A C 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 1 Excellus Health Plan Inc l 25933556 Arms length transaction Excellus Health Plan Inc m 6520780 Arms length transaction Excellus Health Plan Inc k 1530677 Arms length transaction