2014-11-11T13:23:16-06:00 2013-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2013-01-01 222229425 ROCHESTER GENERAL HOSPITAL FOUNDATION INC ROCH 5859224800 100 KINGS HIGHWAY SOUTH NO 2300 ROCHESTER NY 14617 PAULA TINCH SVP FINANCE & CFO 5859224800 2014-11-05 1 ANGELA M FRANCO P00589741 3154463600 2013 2015-11-30 17:44:51Z HUGH THOMAS 100 KINGS HIGHWAY SOUTH NO 2300 ROCHESTER NY 14617 5697330 0 X WWW.ROCHESTERGENERAL.ORG X 1988 NY TO CONDUCT ACTIVITIES THAT RAISE FUNDS AND TO INVEST SUCH FUNDS FOR THE BENEFIT OF THE ROCHESTER GENERAL HOSPITAL AND ITS AFFILIATED ORGANIZATIONS. 28 21 12 28 0 0 4415887 2608251 0 0 1057001 2965588 -421328 -602468 5051560 4971371 2920962 2211259 0 0 1312604 1076044 142105 102273 640295 1221562 2875225 5597233 6264801 -545673 -1293430 36621400 35202659 2813087 2299509 33808313 32903150 X TO PROVIDE FUNDS TO OR FOR THE BENEFIT OF ROCHESTER GENERAL HOSPITAL AND AFFILIATES BY:A) SOLICITING, ACCEPTING, HOLDING, INVESTING, REINVESTING AND ADMINISTERING ANY GIFTS, BEQUESTS, DEVISES, BENEFITS OF TRUSTS AND PROPERY OF ANY SORT, WITHOUT LIMITATION AS TO AMOUNT OR VALUE;B) USING, DISBURSING OR DONATING THE INCOME OR PRINCIPAL THEREOF EXCLUSIVELY FOR THE FOREGOING PURPOSES; ANDC) PERFORMING ANY OTHER ACT OR THING INCIDENTAL TO OR CONNECTED WITH THE FOREGOING PURPOSES OR IN ADVANCEMENT THEREOF. 0 0 2537525 2211259 SEE SCHEDULE OTHE ROCHESTER GENERAL HOSPITAL FOUNDATION CONDUCTS A BROAD RANGE OF FUNDRAISING EFFORTS TO DRIVE ANNUAL GIVING, SPECIAL EVENT SUPPORT, MAJOR GIFTS AND PLANNED GIFTS. EVENTS - IN 2013, THE FOUNDATION CONDUCTED MULTIPLE SPECIAL EVENTS. EACH EVENT WAS DESIGNED WITH THE PURPOSE OF RAISING MONEY, THANKING MAJOR DONORS OR CULTIVATING NEW MAJOR DONORS. SOMETIMES, EVENTS ACCOMPLISHED TWO OR THREE OF THESE OBJECTIVES. THIS SECTION DESCRIBES SOME HIGHLIGHTS OF 2013 ROCHESTER GENERAL HOSPITAL FOUNDATION EVENTS.THE MOST SIGNIFICANT EVENT OF THE YEAR, THE FOUNDERS SOCIETY GALA, WAS HELD IN NOVEMBER 2013. APPROXIMATELY, 1,400 PEOPLE ATTENDED THE EVENT AND RAISED OVER $892,000 - A RECORD AMOUNT - BEFORE EXPENSES. ADDITIONALLY, SIX PEOPLE WERE RECOGNIZED AS PHILANTHROPY AWARD HONOREES. THIS WAS AN OPPORTUNITY TO THANK THEM FOR THEIR SUPPORT OF THE HEALTH SYSTEM. THIS EVENT WAS ALSO AN OPPORTUNITY TO ENGAGE PROSPECTIVE MAJOR DONORS TO MAKE FUTURE GIFTS TO THE CAPITAL CAMPAIGN.LUNCH AND DINNER EVENTS DESIGNED TO THANK, EDUCATE AND INSPIRE FRIENDS OF ROCHESTER GENERAL HEALTH SYSTEMS WERE PEPPERED THROUGHOUT THE YEAR AS WELL. THE FOUNDERS SOCIETY LUNCHEON, THE HANSFORD LEGACY SOCIETY DINNER AND THE BOARD EMERITUS SOCIAL WERE THE MOST NOTABLE EXAMPLES OF THE FOUNDATION THANKING PAST FRIENDS AND DONORS FOR THEIR GENERAL SUPPORT WHILE ALSO ENLIGHTENING THEM ON THE FUTURE NEEDS OF THE SYSTEM AND NEW WAYS TO LEND PHILANTHROPIC SUPPORT IN THE FUTURE.THE FOUNDATION ALSO HELD SEVERAL PRIVATE EVENTS THAT WERE MEANT TO CULTIVATE PROSPECTIVE DONORS TO THE CAMPAIGN. PAST DONORS AND PEOPLE WHO PREVIOUSLY HAD LITTLE CONTACT WITH THE HEALTH SYSTEM WERE INVITED TO "INSIDER EVENTS", WHERE HEALTH SYSTEM LEADERS AND PROMINENT COMMUNITY SUPPORTERS SHARED NEEDS AND ASPIRATIONS FOR THE HEALTH SYSTEM AND THE REGION AT LARGE.AS THE CAMPAIGN CONTINUES TO PROGRESS, MAJOR GIFT OFFICERS WILL TRY TO REACH OUT TO INDIVIDUALS WHO HAVE MADE MULTIPLE GIFTS AND SATISFY OTHER QUALIFYING CRITERIA TO ENCOURAGE EITHER A MAJOR GIFT OR A PLANNED GIFT. 2537525 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 37 0 1 12 1 0 0 0 0 0 1 1 0 0 0 0 0 X 28 21 0 1 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 NY X TAMMY CLAFLIN 5859221745 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 TRENT BRIDGES DIRECTOR 1.00 X 0 0 0 DAVID N BROADBENT MD DIRECTOR 1.00 X 0 0 0 DONALD S CAMERON DIRECTOR 1.00 X 0 0 0 KEVIN T CANNAN DIRECTOR (UNTIL JUNE 2013) 1.00 X 0 0 0 KEVIN J CASEY MD DIRECTOR/EMPLOYED PHYSICIA 1.00 39.00 X 0 409467 11943 CYNTHIA CHRISTY MD DIRECTOR/MEDICAL LIASON 1.00 39.00 X 0 0 0 CHARLES T EAGLE JR DIRECTOR (UNTIL JUNE 2013) 1.00 X 0 0 0 LOUISE W EPSTEIN DIRECTOR 1.00 X 0 0 0 JACK A ERDLE DIRECTOR 1.00 X 0 0 0 ROBERT W GEORGE SR MD VICE CHAIR/EMPLOYED PHYSICIA 1.00 39.00 X 0 60010 5343 GREGORY P KAUSCH DIRECTOR 1.00 X 0 0 0 PETER A KOUIDES MD DIRECTOR (UNTIL JUNE 2013) 1.00 39.00 X 0 436760 20347 JEFFREY LEENHOUTS CFP CHFE CLU SECRETARY 1.00 X 0 0 0 CARL J LUGER TREASURER 1.00 X 0 0 0 JAMES T MAXWELL MD DIRECTOR 1.00 X 0 0 0 WILLIAM B MENDICK DIRECTOR (UNTIL JUNE 2013) 1.00 X 0 0 0 ANGELO MICCICHE DIRECTOR 1.00 X 0 0 0 LEONARD OLIVIERI DIRECTOR 1.00 X 0 0 0 KEVIN OVERTON ESQ DIRECTOR 1.00 X 0 0 0 RALPH P PENNINO MD DIRECTOR/EMPLOYED PHYSICIA 1.00 39.00 X 0 513439 83054 MICHAEL E PICHICHERO MD DIRECTOR/EMPLOYED PHYSICIA 1.00 39.00 X 0 497471 48583 WANDA POLISSENI DIRECTOR (UNTIL JUNE 2013) 1.00 X 0 0 0 JOSEPH R RULISON DIRECTOR 1.00 X 0 0 0 KATHERINE T SCHUMACHER DIRECTOR (UNTIL JUNE 2013) 1.00 X 0 0 0 ANTHONY F SOLAZZO MD DIRECTOR 1.00 X 0 0 0 JOHN R VALVO MD DIRECTOR/EMPLOYED PHYSICIA 1.00 X 0 0 0 ETHAN L WELCH MD CHAIR 1.00 X 0 0 0 JOSEPHINE BRAITMAN DIRECTOR 1.00 X 0 0 0 ROBERTA VANWINKLE DIRECTOR 1.00 X 0 0 0 JOSEPH VASILE MD DIRECTOR/EMPLOYED PHYSICIA 1.00 39.00 X 0 398082 482 CHRIS MAHAN PRESIDENT 1.00 X 0 0 0 JAMES WHELEHAN DIRECTOR 1.00 X 0 0 0 JOHN WHITE JR DIRECTOR 1.00 X 0 0 0 MARK CLEMENT PRESIDENT/CEO 1.00 54.00 X 0 1555798 643169 PAULA TINCH SVP FINANCE & CFO 1.00 54.00 X 0 393805 117631 0 4264832 930552 0 0 1 0 0 888383 17641 1702227 41046 2608251 2965588 2965588 123491 888383 725959 -602468 -602468 4971371 0 0 2363120 2211259 2211259 791636 395818 395818 67160 33580 33580 217248 108624 108624 1458 1458 102273 102273 5703 5703 38721 38721 90192 90192 76488 76488 33234 33234 UNCOLLECTIBLE PLEDGES 1971444 1971444 PROGRAM EXPENSE 326266 326266 CHANGE IN GIFT ANNUITY 128291 128291 203428 203428 6264801 2537525 3086981 640295 1019153 642624 1006100 1081287 8488389 5120734 153458 114000 967059 118612 881681 848447 9580590 10894967 15475514 16481392 16515 19208 36621400 35202659 562567 388952 214502 186251 2036018 1724306 2813087 2299509 X 1943117 1638635 23757759 23156954 8107437 8107561 33808313 32903150 36621400 35202659 -1293430 388267 0 X X 0 1 X 1 1 1 X X X 0 0 0 ROCHESTER GENERAL HOSPITAL 160743134 3 1 1 1 2193618 ROCHESTER GENERAL LONG TERM CARE 223187140 9 1 1 1 1255 ROCHESTER MENTAL HEALTH CENTER 166069131 3 1 1 1 8121 INDEPENDENT LIVING FOR SENIORS 161491059 3 1 1 1 8265 4 2211259 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8107437 124 8107561 8106143 1294 8107437 8043862 62281 8106143 7960615 83247 8043862 7955419 5196 7960615 1.00000 0 0 510000 510000 457059 118612 338447 848447 COMMON COLLECTIVE TRUSTS 2958664 F HEDGE FUNDS 13522728 F 16481392 DUE TO AFFILIATES 617819 CHARITABLE GIFTS ANNUITY LIABILITY 1106487 1724306 5697330 725959 725959 4971371 0 4971371 6990760 725959 725959 6264801 0 6264801 PART V, LINE 4: THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS INCLUDE: 1) CAPITAL EXPANSION AND IMPROVEMENT 2) ADVANCEMENT OF MEDICAL EDUCATION AND RESEARCH AND HEALTH CARE SERVICES. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 725,959. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 725,959. X X X X X X X 1 CHAD GOBEL AND ASSOCIATES 2 STATE STREET SUITE 1150 ROCHESTER NY 14614 CONSULTING 0 0 102273 102273 102273 102273 GALA 892486 779295 113191 647344 RODEO 119388 109088 10300 78615 0 1011874 888383 123491 725959 725959 -602468 1 ROCHESTER GENERAL HOSPITAL 1425 PORTLAND AVENUE ROCHESTER NY 14621 160743134 2193618 PROJECT FUNDING ROCHESTER MENTAL HEALTH CENTER 490 EAST RIDGE ROAD ROCHESTER NY 14621 166069131 8121 PROJECT FUNDING INDEPENDENT LIVING FOR SENIORS 2066 HUDSON AVENUE ROCHESTER NY 14617 161491059 8265 PROJECT FUNDING ROCHESTER GENERAL LONG TERM CARE 1550 EMPIRE BOULEVARD WEBSTER NY 14580 223187140 1255 PROJECT FUNDING 4 PART I, LINE 2: CHECK REQUESTS AND PURCHASE ORDERS ARE REVIEWED FOR APPROPRIATE AUTHORIZATION AND USE OF FUNDS PRIOR TO ISSUANCE OF PAYMENT. SCHEDULE I, PART II: ALL CONTRIBUTIONS ARE GIVEN SOLELY TO RELATED EXEMPT ORGANIZATIONS. X X 1 1 0 1 0 0 0 0 0 0 0 KEVIN J CASEY MD DIRECTOR/EMPLOYED PHYSICIA 0 179995 0 215472 0 14000 0 4090 0 7853 0 421410 0 0 PETER A KOUIDES MD DIRECTOR (UNTIL JUNE 2013) 0 204405 0 209855 0 22500 0 12213 0 8134 0 457107 0 0 RALPH P PENNINO MD DIRECTOR/EMPLOYED PHYSICIA 0 493439 0 20000 0 0 0 75028 0 8026 0 596493 0 0 MICHAEL E PICHICHERO MD DIRECTOR/EMPLOYED PHYSICIA 0 299946 0 180025 0 17500 0 40900 0 7683 0 546054 0 0 JOSEPH VASILE MD DIRECTOR/EMPLOYED PHYSICIA 0 306493 0 73876 0 17713 0 -7217 0 7699 0 398564 0 0 MARK CLEMENT PRESIDENT/CEO 0 740495 0 761348 0 53955 0 637981 0 5188 0 2198967 0 397500 PAULA TINCH SVP FINANCE & CFO 0 262103 0 114024 0 17678 0 113088 0 4543 0 511436 0 0 PART I, LINE 1A CHARTER TRAVEL AND HEALTH & SOCIAL CLUB BENEFITS AS PART OF THEIR COMPENSATION PACKAGE, THE OFFICERS LISTED ON 990, PART VII ARE ELIGIBLE TO UTILIZE SPECIFIC CHARTER TRAVEL ARRANGEMENTS TO CONDUCT BUSINESS OF THE ORGANIZATION. THIS BENEFIT IS UTILIZED TO MAKE THE BEST USE OF THE EXECUTIVE'S TIME WHEN THERE ARE TIME CONSTRAINTS AND/OR LIMITED AVAILABILITY OF NON-STOP FLIGHTS. THESE BENEFITS HAVE BEEN INCLUDED IN THE EMPLOYEES' FORM W-2 AS TAXABLE COMPENSATION AS REQUIRED. PART I, LINE 3 THE FILING ORGANIZATION'S RELATED NON-PROFIT ORGANIZATION, ROCHESTER GENERAL HEALTH SYSTEM, UTILIZES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B RGHS MAINTAINS A SECTION 457(F) PLAN WHICH WOULD BE CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. DURING 2013, NO DISTRIBUTIONS WERE PAID OUT. THE FOLLOWING OFFICERS AND KEY EMPLOYEES LISTED ON FORM 990, PART VII, SECTION A WOULD BE ELIGIBLE PARTICIPANTS IN THE PLAN SINCE THEY WOULD BE ENTITLED TO A DISTRIBUTION UPON SEPARATION FROM SERVICE: MARK CLEMENT X 651 SALE OF COMP PROP X 3 4845 SALE OF COMP PROP X EQUIPMENT 3 17100 SALE OF COMP PROP X PHOTOGRAPHY A 5 13950 SALE OF COMP PROP X PARKING 1 3000 SALE OF COMP SERVICE X LAWN CARE AND 1 1500 SALE OF COMP SERVICE 0 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 CHRIS MAHAN IS ASSIGNED BY GOBEL GROUP, A CONSULTING FIRM, TO SERVE AS THE INTERIM SENIOR VICE PRESIDENT FOR DEVELOPMENT FOR ONE YEAR, BEGINNING AUGUST 1, 2013. ROCHESTER GENERAL HEALTH SYSTEM (RGHS), THE SOLE CORPORATE MEMBER, PAYS GOBEL GROUP FOR CHRIS MAHAN'S SERVICES. THE AMOUNT AGREED UPON IS $300,000, OR $25,000 PER MONTH. FOR THE SERVICES PROVIDED FROM AUGUST 1, 2013 TO DECEMBER 31, 2013, RGHS PAID $125,000. 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 GENERAL HEALTH SYSTEM (RGHS), A RELATED NOT-FOR-PROFIT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A IN ACCORDANCE WITH THE TERMS AND REQUIREMENTS OF ITS GOVERNING DOCUMENTS (I.E. BYLAWS), THE ORGANIZATION'S DIRECTORS ARE DIVIDED INTO THREE CLASSES, AND THE CLASSES SERVE FOR STAGGERED THREE-YEAR TERMS. AT EACH ANNUAL MEETING, DIRECTORS IN A CLASS ARE ELECTED BY A MAJORITY VOTE OF THE DIRECTORS THEN IN OFFICE. DIRECTORS ARE ELECTED FROM AMONG NOMINEES CHOSEN BY THE GOVERNANCE AND NOMINATING COMMITTEE OF THE FILING ORGANIZATION'S SOLE CORPORATE MEMBER, ROCHESTER GENERAL HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7B RGHS, AS THE SOLE CORPORATE MEMBER, ALSO HAS THE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY INCLUDING THE 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 11 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. 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. BOARD MEMBERS LEAVE THE ROOM DURING DISCUSSIONS AND ABSTAIN FROM VOTING WHEN THEY HAVE A CONFLICT OF INTEREST. IN ADDITION TO THE BOARD OF DIRECTORS, THE ORGANIZATION'S MANAGERS AND DIRECTORS WHO OVERSEE ITS OPERATIONS COMPLETE A CONFLICT OF INTEREST FORM ANNUALLY AS WELL. 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 GENERAL HEALTH SYSTEM, 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 XII, LINE 2C: PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 5471 FILED ON BEHALF OF STATEMENT STATEMENT PURSUANT TO TREAS REG SEC 1 60382-2(J)(3): THE FOLLOWING INFORMATION IS SUBMITTED WITH RESPECT TO ROCHESTER GENERAL HOSPITAL FOUNDATION'S FORM 5471 (INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS) FILING REQUIREMENT FOR THE ENTITY BELOW. NAME OF FOREIGN CORPORATION GREATER ROCHESTER ASSURANCE COMPANY, LTD BEGINNING TAX YEAR OF FOREIGN CORPORATION JANUARY 1, 2013 ENDING TAX YEAR OF FOREIGN CORPORATION DECEMBER 31, 2013 THE FORM 5471 FILING REQUIREMENT FOR THIS FOREIGN CORPORATION FOR CATEGORIES 4 AND 5 HAVE BEEN SATISFIED BY INCLUSION IN THE FOLLOWING U.S. FILER'S TAX RETURN NAME OF U.S. FILER ROCHESTER GENERAL HEALTH SYSTEM ADDRESS OF U.S. FILER 100 KINGS HIGHWAY SOUTH ROCHESTER, NY 14617 EIN OR SSN 22-2551509 ENDING TAX YEAR OF U.S. FILER DECEMBER 31, 2013 TYPE OF RETURN FILED 990-T IRS SERVICE CENTER WHERE RETURN FILED OGDEN, UTAH 84201-0027 THE ROCHESTER GENERAL HOSPITAL 1425 PORTLAND AVENUE ROCHESTER NY 14621 160743134 HOSPITAL NY 501(C)(3) LINE 3 RGHS 0 ROCHESTER MENTAL HEALTH CENTER 490 EAST RIDGE ROAD ROCHESTER NY 14621 166069131 MENTAL HEALTH NY 501(C)(3) LINE 9 RGHS 0 GRHS FOUNDATION 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 222963015 R/E INV MGMT NY 501(C)(3) LINE 11B, II RGHS 0 ROCHESTER GENERAL HEALTH SYSTEM 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 222551509 SYSTEM PARENT NY 501(C)(3) LINE 11B, II N/A 0 NEWARK WAYNE COMMUNITY HOSPITAL DRIVING PARK AVENUE NEWARK NY 14513 150584188 HOSPITAL NY 501(C)(3) LINE 3 RGHS 0 RGHS WORKERS' COMPENSATION TRUST 1425 PORTLAND AVENUE ROCHESTER NY 14621 166429300 SEE PART VII NY 501(C)(3) LINE 11B, II RGHS 0 CONTINUING CARE NETWORK INC (CCN) 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 222963016 SUPPORT RGH NY 501(C)(3) LINE 11B, II RGHS 0 ROCHESTER GENERAL HUDSON HOUSING 2066 HUDSON AVENUE ROCHESTER NY 14617 223210351 LOW INC HOUSING NY 501(C)(3) LINE 9 RGHS 0 INDEPENDENT LIVING FOR SENIORS 2066 HUDSON AVENUE ROCHESTER NY 14617 161491059 ADULT DAY HC NY 501(C)(3) LINE 9 RGHS 0 ROCHESTER GENERAL LONG TERM CARE 1550 EMPIRE BLVD WEBSTER NY 14580 223187140 NH & REHAB NY 501(C)(3) LINE 9 RGHS 0 WESTERN NEW YORK MEDICAL PRACTICE PC 1425 PORTLAND AVENUE ROCHESTER NY 14621 611654232 PHYS PRAC NY 501(C)(3) LINE 9 N/A 0 NEWARK WAYNE COMMUNITY HOSPITAL FOUNDATION DRIVING PARK AVENUE NEWARK NY 14513 222963015 FUNDRAISING NY 501(C)(3) LINE 11B, II NWCH 0 VIA HEALTH HOME CARE I 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 161504370 HOME HEALTH NY 501(C)(3) LINE 9 CCN 0 VIA HEALTH HOMECARE II 100 KINGS HIGHWAY SOUTH ROCHESTER NY 14617 161538727 HOME HEALTH NY 501(C)(3) LINE 9 CCN 0 GREATER ROCHESTER ASSURANCE COMPANY LTD GEORGE TOWN GRAND CAYMAN CJ INSURANCE CJ N/A C 0 ROCHESTER GENERAL HEALTH SYSTEM DIALYSIS INC 1425 PORTLAND AVE ROCHESTER NY 14621 383912199 DIALYSIS NY RGHS C 0 GREATER ROCHESTER INDEPENDENT PRACTICE ASSOCIATION INC 100 KINGS HIGHWAY SOUTH STE 2500 ROCHESTER NY 14617 161507171 INDEPENDENT PRACTICE ASSOCIATION NY N/A C 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 ROCHESTER GENERAL HOSPITAL B 2289874 FMV SCHEDULE R, PART II, COLUMN B: RELATED TAX-EXEMPT ORGANIZATION - PRIMARY ACTIVITY: RGHS WORKERS' COMPENSATION TRUST SUPPORTS THE GENESEE HOSPITAL, ROCHESTER GENERAL HOSPITAL, ROCHESTER GENERAL HOSPITAL FOUNDATION, NEWARK WAYNE COMMUNITY HOSPITAL, NEWARK COMMUNITY HOSPITAL FOUNDATION, INDEPENDENT LIVING FOR SENIORS, ROCHESTER GENERAL LONG TERM CARE, ROCHESTER GENERAL HUDSON HOUSING, GRHS FOUNDATION, BEHAVIORAL HEALTH NETWORK, AND ROCHESTER GENERAL HEALTH SYSTEM.