ROME MEMORIAL HOSPITAL INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: ROME MEMORIAL HOSPITAL INC (EIN 16-1471634)
Tax period: 2013-01-01 to 2013-12-31
Filed: 2014-11-10
IRS object ID: 201423149349300742
Schema version: 2013v3.0
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 C
Schedule D
Schedule H
Schedule J
Schedule K
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2014-11-10T09:57:26-06:00	ReturnTs
Tax Period End	2013-12-31	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	BusinessNameLine1

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	5784 WIDEWATERS PARKWAY	AddressLine1
City	SYRACUSE	City
State	NY	State
ZIP Code	13214	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2013-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	161471634	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ROME MEMORIAL HOSPITAL	BusinessNameLine1

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1500 NORTH JAMES STREET	AddressLine1
City	ROME	City
State	NY	State
ZIP Code	13440	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DEWEY ROWLANDS	PersonNm
Person Title	CFO/VP FINANCE	PersonTitleTxt
Phone	3153387000	PhoneNum
Signature	2014-11-06	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

Field	Value	IRS element (for citing)
Tax	2013	TaxYr
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	BASIL ARIGLIO	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1500 NORTH JAMES ST	AddressLine1
City	ROME	City
State	NY	State
ZIP Code	13440	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$83,219,854	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	ROMEHOSPITAL.ORG	WebsiteAddressTxt
Type Of Organization Assoc	Yes (X)	TypeOfOrganizationAssocInd
Formation	1995	FormationYr
Legal Domicile State	NY	LegalDomicileStateCd
Activity Or Mission	PROVIDE QUALITY HEALTHCARE WITH COMPASSION.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	1147	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$247,849	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$2,837,391	PYContributionsGrantsAmt
CY Contributions Grants	$2,073,222	CYContributionsGrantsAmt
PY Program Service Revenue	$88,352,403	PYProgramServiceRevenueAmt
CY Program Service Revenue	$79,290,733	CYProgramServiceRevenueAmt
PY Investment Income	$95,725	PYInvestmentIncomeAmt
CY Investment Income	$155,399	CYInvestmentIncomeAmt
PY Other Revenue	$959,980	PYOtherRevenueAmt
CY Other Revenue	$626,752	CYOtherRevenueAmt
PY Total Revenue	$92,245,499	PYTotalRevenueAmt
CY Total Revenue	$82,146,106	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$51,362,727	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$48,379,471	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$40,253,290	PYOtherExpensesAmt
CY Other Expenses	$39,504,107	CYOtherExpensesAmt
PY Total Expenses	$91,616,017	PYTotalExpensesAmt
CY Total Expenses	$87,883,578	CYTotalExpensesAmt
PY Revenues Less Expenses	$629,482	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$5,737,472	CYRevenuesLessExpensesAmt
Total Assets BOY	$67,911,075	TotalAssetsBOYAmt
Total Assets EOY	$60,933,528	TotalAssetsEOYAmt
Total Liabilities BOY	$43,197,124	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$41,802,880	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$24,713,951	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$19,130,648	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	ABOUT ROME MEMORIAL HOSPITAL: OVERALL, ROME MEMORIAL HOSPITAL PROVIDES INPATIENT, OUTPATIENT, SKILLED NURSING, AND EMERGENCY CARE SERVICES PRIMARILY FOR THE RESIDENTS OF ROME AND THE SURROUNDING AREAS.	MissionDesc
Significant New Program Srvc	Yes (1)	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$34,784,516	ExpenseAmt
Revenue	$27,309,386	RevenueAmt
Desc	INPATIENT CARE SERVICES, INPATIENT NURSING UNITS CONSIST OF THE FOLLOWING:INTENSIVE CARE-2ND FLOOR, MATERNITY-4TH FLOOR, 2 EAST MEDICAL/SURGICAL-2ND FLOOR, 2 NORTH MEDICAL/SURGICAL WITH CARDIAC MONITORING-2ND FLOOR, PEDIATRICS-2ND FLOOR, AND SENIOR BEHAVIORIAL HEALTH- 2ND FLOOR.2013 INPATIENT DISCHARGES: 4,3662013 BIRTHS: 5732013 PATIENT DAYS: 21,216	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$8,798,740	ExpenseAmt
Revenue	$6,969,140	RevenueAmt
Desc	RESIDENTIAL HEALTHCARE FACILITY (RHCF)BECAUSE OF OUR COMMITTMENT TO SERVE THE UNIQUE NEEDS OF SENIORS, WE HAVE AN 80-BED RESIDENTIAL HEALTH CARE FACILITY AND INPATIENT UNIT FOR SENIOR BEHAVIORIAL HEALTH CARE. OUR RESIDENTIAL HEALTHCARE FACILITY CONSISTS OF THE FOLLOWING: LONG-TERM NURSING HOME CARE, SHORT-TERM SUB-ACUTE REHABILITATION, AND RESPITE CARE- ALL LOCATED ON THE 3RD FLOOR.2013 PATIENT DAYS = 27,2712013 OCCUPANCY PERCENTAGE = 93.39%	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$6,498,746	ExpenseAmt
Revenue	$9,577,748	RevenueAmt
Desc	EMERGENCY DEPARTMENT (ED)ROME MEMORIAL HOSPITAL EMERGENCY DEPARTMENT IS A SAFETY NET FOR THE MOST VULNERABLE POPULATIONS IN THE COMMUNITY. IN 2013, APPROXIMATELY 42% OF THE PATIENTS TREATED WERE LISTED AS UNINSURED OR UNDER INSURED. FOR LOWER LEVEL EMERGENCY DEPARTMENT VISITS, THIS POPULATION REPRESENTED MORE THAN 59% OF THE VISITS BECAUSE MANY PRIMARY CARE PHYSICIANS DO NOT ACCEPT MEDICAID.2013 ED ADMISSIONS: 3,6152013 ED VISITS: 27,787	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$21,066,678	ExpenseAmt
Revenue	$35,434,459	RevenueAmt
Desc	ALL OTHER ACHIEVEMENTS PROVIDE QUALITY, COMPASSIONATE CARE IN A SAFE ENVIRONMENT TO SERVE THE HEALTHCARE NEEDS OF THE PEOPLE OF ROME AND THE SURROUNDING COMMUNITIES.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$21,066,678	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue	$35,434,459	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$71,148,680	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
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	Yes (1)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (1)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	40	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1147	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	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	DEWEY ROWLANDS ROME MEMORIAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Phone	3153387024	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1500 NORTH JAMES STREET	AddressLine1
City	ROME	City
State	NY	State
ZIP Code	13440	ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
CHESTER PATRICK MD
CHAIRMAN	2.00	Yes (X)	Yes (X)	$0	$0	$0
DAVID NOLAN
VICE CHAIRMAN	2.00	Yes (X)	Yes (X)	$0	$0	$0
KIM COOK
TREASURER	2.00	Yes (X)	Yes (X)	$0	$0	$0
LYNN REESE
SECRETARY	2.00	Yes (X)	Yes (X)	$0	$0	$0
W ROBERT HERMANN
DIRECTOR	2.00	Yes (X)		$0	$0	$0
MARY DAVIS
DIRECTOR	2.00	Yes (X)		$0	$0	$0
DR ANKUR DESAI
DIRECTOR	2.00	Yes (X)		$0	$0	$0
SALLY HINMAN
DIRECTOR	2.00	Yes (X)		$0	$0	$0
JULIE GROW-DENTON
ASST TREASURER	2.00	Yes (X)	Yes (X)	$0	$0	$0
MICHAEL O'SHAUGHNESSY
DIRECTOR	2.00	Yes (X)		$0	$0	$0
MICHAEL KRAMER
DIRECTOR	2.00	Yes (X)		$0	$0	$0
DENNIS SURACE
DIRECTOR	2.00	Yes (X)		$0	$0	$0
BASIL ARIGLIO
CEO	55.00		Yes (X)	$326,818	$0	$14,305
NICHOLAS MAYHEW
CFO	55.00			$216,128	$0	$16,367	Yes (X)
LEE SALTZGABER MD
CMO	55.00			$264,723	$0	$14,205	Yes (X)
BRUCE PETERSON
AVP/CIO	55.00			$155,212	$0	$14,027		Yes (X)
SCOTT BURNS
DIRECTOR PHARMACY	55.00			$130,351	$0	$13,987		Yes (X)
DURINDA DURR
VP/CNO	55.00			$129,809	$0	$10,650		Yes (X)
MARK ROWAN
DIRECTOR TECHNICAL SERVICES	55.00			$127,693	$0	$8,342		Yes (X)
DAVID LEE
PHARMACIST	55.00			$125,302	$0	$10,643		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,476,036	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$102,526	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	27	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1	CityContractorAddress/USAddress/City	StateContractorAddress/USAddress/State	ZIP CodeContractorAddress/USAddress/ZIPCode	ServicesServicesDesc	CompensationCompensationAmt
CENTREX LABS
28 CAMPION RD	NEW HARTFORD	NY	13413	LAB SERVICES	$4,091,026
MCKESSON
PO BOX 98347	CHICAGO	IL	606938347	HEALTHCARE INFORMATION TECHNOLOGY	$1,672,275
NY ACUTE CARE SPECIALISTS
PO BOX 634850	CINCINNATI	OH	45263	HOSPITALIST SERVICES	$1,294,021
EAGLE HOSPITAL PHYSICIANS LLC
16000 NORTH DALLAS PARKWAY SUITE 4	DALLAS	TX	75248	HOSPITALIST SERVICES	$385,000
ROBISON & SMITH COMPLETE TEXTILE
335 NORTH MAIN STREET	GLOVERSVILLE	NY	12078	LAUNDRY SERVICES	$365,909

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	25	CntrctRcvdGreaterThan100KCnt
Government Grants	$1,810,100	GovernmentGrantsAmt
All Other Contributions	$263,122	AllOtherContributionsAmt
Noncash Contributions	$116,922	NoncashContributionsAmt
Total Contributions	$2,073,222	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	HOSPITAL	Desc
Business	621990	BusinessCd
Total Revenue Column	$79,290,733	TotalRevenueColumnAmt
Related Or Exempt Func Income	$79,290,733	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$79,290,733	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$62,042	TotalRevenueColumnAmt
Exclusion	$62,042	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$114,570	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$147,393	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$32,823	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$32,823	TotalRevenueColumnAmt
Exclusion	-$32,823	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$1,015,998	SecuritiesAmt
Other	$3,714	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$846,055	SecuritiesAmt
Other	$80,300	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$169,943	SecuritiesAmt
Other	-$76,586	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$93,357	TotalRevenueColumnAmt
Exclusion	$93,357	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
CAFETERIA SALES	722210	$253,931	$253,931
ACCOUNTING & CONSULTING	541200	$190,000		$190,000
GAIN LOSS CHANGE ANGEL FUND	900099	$7,196	$7,196

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$208,448	TotalRevenueColumnAmt
Unrelated Business Revenue	$57,849	UnrelatedBusinessRevenueAmt
Exclusion	$150,599	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$659,575	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$82,146,106	TotalRevenueColumnAmt
Related Or Exempt Func Income	$79,290,733	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$247,849	UnrelatedBusinessRevenueAmt
Exclusion	$534,302	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$852,547	TotalAmt
Management And General	$852,547	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$37,597,890	TotalAmt
Program Services	$32,522,982	ProgramServicesAmt
Management And General	$5,074,908	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$659,719	TotalAmt
Program Services	$564,966	ProgramServicesAmt
Management And General	$94,753	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$6,357,785	TotalAmt
Program Services	$6,334,264	ProgramServicesAmt
Management And General	$23,521	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,911,530	TotalAmt
Program Services	$2,465,292	ProgramServicesAmt
Management And General	$446,238	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$28,188	TotalAmt
Management And General	$28,188	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$55,619	TotalAmt
Management And General	$55,619	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$90,000	TotalAmt
Management And General	$90,000	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$250,084	TotalAmt
Program Services	$116,666	ProgramServicesAmt
Management And General	$133,418	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,180,971	TotalAmt
Program Services	$20,206	ProgramServicesAmt
Management And General	$1,160,765	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,033,786	TotalAmt
Program Services	$838,449	ProgramServicesAmt
Management And General	$195,337	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$92,571	TotalAmt
Program Services	$62,259	ProgramServicesAmt
Management And General	$30,312	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$55,966	TotalAmt
Program Services	$9,375	ProgramServicesAmt
Management And General	$46,591	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$563,228	TotalAmt
Management And General	$563,228	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$4,870,061	TotalAmt
Program Services	$2,882,033	ProgramServicesAmt
Management And General	$1,988,028	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$897,359	TotalAmt
Program Services	$101,192	ProgramServicesAmt
Management And General	$796,167	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
PURCHASE SERVICES	$7,765,601	$7,273,834	$491,767
BAD DEBT EXPENSE	$5,929,420	$5,929,420
SUPPLIES	$5,754,634	$5,590,531	$164,103
PHARMACY	$2,477,556	$2,477,393	$163

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$8,459,063	TotalAmt
Program Services	$3,959,818	ProgramServicesAmt
Management And General	$4,499,245	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$87,883,578	TotalAmt
Program Services	$71,148,680	ProgramServicesAmt
Management And General	$16,734,898	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$3,384,532	BOYAmt
EOY	$1,433,942	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$2,874,389	BOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$14,656,436	BOYAmt
EOY	$11,351,689	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$1,706,342	BOYAmt
EOY	$1,750,436	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,954,263	BOYAmt
EOY	$1,698,749	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,421,058	BOYAmt
EOY	$2,179,347	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$82,978,500	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$47,734,450	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$37,647,200	BOYAmt
EOY	$35,244,050	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
EOY	$2,720,708	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$4,266,855	BOYAmt
EOY	$4,554,607	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$67,911,075	BOYAmt
EOY	$60,933,528	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$13,752,691	BOYAmt
EOY	$11,637,910	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$17,015,223	BOYAmt
EOY	$14,951,207	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$5,855,000	BOYAmt
EOY	$5,475,000	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$6,574,210	BOYAmt
EOY	$9,738,763	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$43,197,124	BOYAmt
EOY	$41,802,880	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$23,835,179	BOYAmt
EOY	$18,725,044	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$292,831	BOYAmt
EOY	$269,663	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$24,713,951	BOYAmt
EOY	$19,130,648	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$67,911,075	BOYAmt
EOY	$60,933,528	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$5,737,472	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$151,636	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$2,533	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

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 C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (1)	DirectContactLegislatorsInd
Direct Contact Legislators	$26,508	DirectContactLegislatorsAmt
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	0	OtherActivitiesInd
Total Lobbying Expenditures	$26,508	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	$26,508 REPRESENTS THE PORTION OF THE 2013 MEMBERSHIP DUES OF HANYS, AHA, AND IROQUOIS HEALTHCARE ALLIANCE, THAT RMH IS A MEMBER OF, THAT HAS BEEN DEEMED TO BE RELATED TO LOBBYING EXPENSES. THESE EXPENDITURES ARE DEFINED AS DIRECT COMMUNICATIONS WITH CERTAIN MEMBERS OF FEDERAL, STATE, OR LOCAL GOVERNMENTS TO INFLUENCE LEGISLATION.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$643,953	BeginningYearBalanceAmt
Investment Earnings Or Losses	$314,851	InvestmentEarningsOrLossesAmt
Other Expenditures	$5,328	OtherExpendituresAmt
End Year Balance	$953,476	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$624,541	BeginningYearBalanceAmt
Contributions	$1,890	ContributionsAmt
Investment Earnings Or Losses	$33,673	InvestmentEarningsOrLossesAmt
Other Expenditures	$16,151	OtherExpendituresAmt
End Year Balance	$643,953	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$591,605	BeginningYearBalanceAmt
Contributions	$4,471	ContributionsAmt
Investment Earnings Or Losses	$28,465	InvestmentEarningsOrLossesAmt
End Year Balance	$624,541	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$338,312	BeginningYearBalanceAmt
Contributions	$120,609	ContributionsAmt
Investment Earnings Or Losses	$132,684	InvestmentEarningsOrLossesAmt
End Year Balance	$591,605	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.29000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.63000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.08000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$43,239,849	OtherCostOrOtherBasisAmt
Depreciation	$18,856,482	DepreciationAmt
Book Value	$24,383,367	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,482,556	OtherCostOrOtherBasisAmt
Depreciation	$2,232,709	DepreciationAmt
Book Value	$249,847	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$34,053,753	OtherCostOrOtherBasisAmt
Depreciation	$24,610,812	DepreciationAmt
Book Value	$9,442,941	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,202,342	OtherCostOrOtherBasisAmt
Depreciation	$2,034,447	DepreciationAmt
Book Value	$1,167,895	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$35,244,050	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
NET ASSETS OF FOUNDATION	$994,180
OTHER LONG TERM ASSETS	$3,473,158
BOND AMORTIZATION	$87,269

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$4,554,607	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
LINE OF CREDIT	$2,000,000
ASSET RETIREMENT	$4,559,224
ADVANCE FROM THIRD PARTIES	$3,179,539

Field	Value	IRS element (for citing)
Total Liability	$9,738,763	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART V, LINE 4:

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

PART X, LINE 2:

THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAXES ON UNRELATED BUSINESS INCOME UNDER SECTION 511 OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2013 AND 2012, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2010 THROUGH 2013. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS.

Schedule H IRS990ScheduleH

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$998,231	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$604,169	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$394,062	NetCommunityBenefitExpnsAmt
Total Expense	0.00480	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$22,670,610	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$20,406,184	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,264,426	NetCommunityBenefitExpnsAmt
Total Expense	0.02760	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$365,461	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$235,799	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$129,662	NetCommunityBenefitExpnsAmt
Total Expense	0.00160	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$24,034,302	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$21,246,152	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,788,150	NetCommunityBenefitExpnsAmt
Total Expense	0.03400	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$130,836	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$12,083	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$118,753	NetCommunityBenefitExpnsAmt
Total Expense	0.00140	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$27,116	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$19,396	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,720	NetCommunityBenefitExpnsAmt
Total Expense	0.00090	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$157,952	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$31,479	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$126,473	NetCommunityBenefitExpnsAmt
Total Expense	0.00230	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$24,192,254	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$21,277,631	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,914,623	NetCommunityBenefitExpnsAmt
Total Expense	0.03630	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,921	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$410	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,511	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,895	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,895	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$232,084	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$232,084	NetCommunityBenefitExpnsAmt
Total Expense	0.00260	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$242,900	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$410	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$242,490	NetCommunityBenefitExpnsAmt
Total Expense	0.00280	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReportedInd
Bad Debt Expense	$1,863,400	BadDebtExpenseAmt
Bad Debt Expense Attributable	$183,655	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$18,952,461	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$27,013,441	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$8,060,980	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	1 GRIFFIS EYE CENTER LLC	BusinessNameLine1

Field	Value	IRS element (for citing)
Primary Activities	SEE SCHEDULE R PART VII	PrimaryActivitiesTxt
Org Profit Or Ownership	0.30000	OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership	0.00000	OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership	0.70000	PhysiciansProfitOrOwnershipPct

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

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ROME MEMORIAL HOSPITAL	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1500 NORTH JAMES STREET	AddressLine1
City	ROME	City
State	NY	State
ZIP Code	13440	ZIPCode

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

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ROME MEMORIAL HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
CHNA Conducted	13	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.ROMEHOSPITAL.ORG	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	WWW.OCGOV.NET	OtherWebsiteURLTxt
Rpt Available Upon Request	Yes (X)	RptAvailableUponRequestInd
Adopt Implementation Strategy	Yes (X)	AdoptImplementationStrategyInd
Exec Implementation Strategy	Yes (X)	ExecImplementationStrategyInd
Develop Community Wide Plan	Yes (X)	DevelopCommunityWidePlanInd
Exec Community Wide Plan	Yes (X)	ExecCommunityWidePlanInd
Include Operational Plan	Yes (X)	IncludeOperationalPlanInd
Adopt Budget	Yes (X)	AdoptBudgetInd
Prioritize Health Needs	Yes (X)	PrioritizeHealthNeedsInd
Prioritize Services	Yes (X)	PrioritizeServicesInd
All Needs Addressed	0	AllNeedsAddressedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Used Deter Elig Free Care	Yes (1)	FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care	100.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt Care	Yes (1)	FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Explained Basis	Yes (1)	ExplainedBasisInd
Income Level	Yes (X)	IncomeLevelInd
Insurance Status	Yes (X)	InsuranceStatusInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
Posted On Website	Yes (X)	PostedOnWebsiteInd
Available On Request	Yes (X)	AvailableOnRequestInd
FAP Actions On Nonpayment	0	FAPActionsOnNonpaymentInd
Collection Activities	0	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
ROME MEMORIAL HOSPITAL	PART V, SECTION B, LINE 3: ROME MEMORIAL HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT WAS DERIVED FROM ITS PARTICIPATION IN THE COMPREHENSIVE COUNTYWIDE COMMUNITY NEEDS ASSESSMENT. THE COMMUNITY HEALTH ASSESSMENT (CHA) FOR ONEIDA COUNTY WAS DEVELOPED WITHIN THE FRAMEWORK OF THE NEW YORK STATE PREVENTION AGENDA AND DREW UPON A VARIETY OF DATA SOURCES, BOTH QUALITATIVE AND QUANTITATIVE. FACULTY AND STAFF FROM THE CENTRAL NEW YORK MASTER OF PUBLIC HEALTH PROVIDED TECHNICAL SUPPORT TO A TEAM MADE UP OF REPRESENTATIVES OF THE ONEIDA COUNTY HEALTH DEPARTMENT, LOCAL HOSPITALS AND COMMUNITY AGENCIES.A STEERING COMMITTEE COMPRISED OF A VARIETY OF AGENCIES AND LED BY THE ONEIDA COUNTY HEALTH DEPARTMENT, MET REGULARLY STARTING IN THE FALL OF 2012. THE COMMITTEE'S FOCUS WAS TO OUTLINE THE CHA PROCESS AND, ROLES AND RESPONSIBILITIES FOR THE NEXT SEVERAL MONTHS. A COMMUNITY HEALTH FORUM, HELD ON MAY 20, 2013, MARKED THE FORMAL LAUNCH OF THE CHA PROCESS. OVER 65 PARTICIPANTS FROM A VARIETY OF AGENCIES GATHERED TO PROVIDE INPUTS ON THE STRENGTHS, WEAKNESSES, THREATS, OPPORTUNITIES AND MAJOR HEALTH SYSTEM AND HEALTH STATUS ISSUES FACING THE COUNTY. PARTICIPANTS WORKED IN SMALL GROUPS TO IDENTIFY AND PRIORITIZE KEY HEALTH SYSTEM AND HEALTH STATUS ISSUES. THE COLLABORATIVE PROCESS ENSURED BROAD PARTICIPATION IN THE ANALYSIS OF DATA AND SELECTION OF PRIORITY AREAS.ORGANIZATIONS PARTICIPATING IN THE STEERING COMMITTEE:ONEIDA COUNTY HEALTH DEPARTMENTONEIDA COUNTY DEPARTMENT OF MENTAL HEALTH ROME MEMORIAL HOSPITALFAXTON-ST. LUKE'S HEALTHCAREST. ELIZABETH'S MEDICAL CENTERUTICA COMMUNITY HEALTH CENTER (FQHC)COMMUNITY AGENCIES AND A VARIETY OF PROGRAM REPRESENTATIVESSYRACUSE UNIVERSITYTHE TARGETED GROUPS LISTED BELOW COLLABORATED DURING THE SECOND HALF OF 2013 TO DEVELOP OBJECTIVES AND IMPLEMENTATION STRATEGIES AROUND EACH OF THE FOCUS AREAS.ONEIDA COUNTY HEALTH DEPARTMENT ROME MEMORIAL HOSPITALFAXTON-ST. LUKE'S HEALTHCAREST. ELIZABETH'S MEDICAL CENTERMOHAWK VALLEY PERINATAL NETWORKMOHAWK VALLEY BREASTFEEDING NETWORKONEIDA COUNTY WOMEN, INFANTS AND CHILDREN PROGRAMCOMMUNITY AGENCIESTOBACCO CESSATION CENTERONEIDA COUNTYUTICA COMMUNITY HEALTH CENTER (FQHC)AMERICAN CANCER SOCIETYHEALTHY FAMILIES ONEIDA COUNTY/KIDS ONEIDANEIGHBORHOOD CENTER/MOHAWK VALLEY COMMUNITY ACTION AGENCYFOLLOWING THE PUBLIC PARTICIPATION AND INPUT PERIOD, THE HEALTH PRIORITIES WERE CHOSEN BASED UPON THE FOLLOWING CRITERIA:-THE PRIORITY AREA WAS CONSISTENT WITH THE CURRENT NYS DEPARTMENT OF HEALTH PREVENTION.-AGENDA AREAS.-THE PRIORITY AREA WAS SUPPORTED BY DATA SHOWING HEALTH STATUS INDICATORS OR HEALTH NEEDS WERE BELOW THE NEW YORK STATE AVERAGE FOR THE ENTIRE POPULATION OR FOR A SUBSET OF THE POPULATION WITH A MEASURABLE DISPARITY.-THE PRIORITY AREA WAS IDENTIFIED/RECOMMNDED DURING THE PUBLIC INPUT PROCESS.-AVAILABILITY OF COLLABORATIVE PARTNERS, RESOURCES AND CAPACITY FOR MEANINGFUL IMPACT.THE WORK GROUP THAT MADE THE FINAL SELECTION OF THE PRIORITY AREAS INCLUDED REPRESENTATIVES FROM THE ONEIDA COUNTY DEPARTMENT OF HEALTH AND THE COUNTY'S THREE HOSPITALS, WITH INPUT FROM FACULTY AND STAFF FROM THE CENTRAL NEW YORK MASTER OF PUBLIC HEALTH PROGRAM.THE COUNTYWIDE HEALTH PRIORITIES TO PROMOTE POPULATION HEALTH INCLUDED:-PROMOTE TOBACCO USE CESSATION AMONG ADULTS.-INCREASE THE PROPORTION OF ONEIDA COUNTY BABIES WHO ARE BREASTFED.ROME MEMORIAL HOSPITAL'S EFFORTS TO IMPROVE COMMUNITY HEALTH EXTEND BEYOND THE TWO PRIORITIES IDENTIFIED THROUGH THE CHA AND CSP PROCESS. SOME OF THE HOSPITAL'S ADDITIONAL INITIATIVES INCLUDE:-HOSTING COUCH TO 5K PROGRAMS AND WALKING PROGRAMS TO PROMOTE PHYSICAL ACTIVITY.-OFFERING FREE HEALTH SCREENINGS AT AREA HEALTH FAIRS TO DETECT HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, DIABETES, AND GLAUCOMA.-CONDUCTING COLORECTAL HEALTH SCREENINGS EACH MARCH IN BOONVILLE, ROME AND CAMDEN TO PROMOTE EARLY DETECTION OF CANCER.-CONDUCTING PSA SCREENINGS EACH SEPTEMBER FOR THE EARLY DETECTION OF PROSTRATE CANCER. -OFFERING FREE BLOOD PRESSURE SCREENINGS MONTHLY AT AREA PHARMACIES AND SENIOR CENTERS TO PROVIDE ONGOING MONITORING FOR PATIENTS THAT SUFFER FROM HIGH BLOOD PRESSURE AND EARLY DETECTION FOR THOSE WHO ARE AT RISK.-OFFERING FREE TYPE 2 DIABETES EDUCATION CLASSES EVERY MONTH FOR DIABETICS AND THEIR FAMILIES. THE NURSE EDUCATOR COVERS EXERCISE, DIET AND MEDICATION MANAGEMENT TO HELP NEWLY DIAGNOSED DIABETICS UNDERSTAND HOW TO MANAGE CONTROLLABLE RISK FACTORS AND PREVENT FUTURE COMPLICATIONS. -SPONSORING MONTHLY HEALTH LECTURES AT THE HOSPITAL AND PROVIDING SPEAKERS AND DISPLAYS FOR LOCAL ORGANIZATIONS AND BUSINESSES TO PROMOTE EARLY DETECTION, TREATMENT AND MANAGEMENT OF CHRONIC DISEASE.-PARTICIPATING WITH THE CANCER SERVICES PROGRAM TO PROVIDE FREE MAMMOGRAPHY SCREENING FOR THE UNINSURED AND UNDERINSURED TO PROMOTE EARLY DETECTION. THE NURSE NAVIGATOR FROM THE HOSPITAL'S BREAST CENTER WORKS CLOSELY WITH THE CSP TO HELP SECURE ADDITIONAL RESOURCES FOR UNDERSERVED WOMEN DIAGNOSED WITH BREAST CANCER.-CONDUCTING FLU VACCINATION CLINCS ANNUALLY TO PROTECT RESIDENTS FROM THE FLU AND PREVENT UNNECESSARY HOSPITALIZATIONS. -INVESTING SIGNIFICANT RESOURCES TO RECRUIT ADDITIONAL PROVIDERS TO THE ROME AREAS TO SOLVE THE PHYSICIAN SHORTAGE CONCERNS. -EXPLORING COLLABORATIVE RELATIONSHIPS WITH OTHER ORGANIZATIONS TO IMPROVE THE COORDINATION OF HIGH QUALITY, COST-EFFECTIVE CARE.-INTRODUCING NEW SERVICES INCLUDING LYMPHADEMA, LOW-DOSE CT LUNG CANCER SCREENING AND ADVANCED WOUND CARE TO ADDRESS UNMET NEEDS IN THE COMMUNITY.-PARTNERING WITH THE ALZHEIMER'S ASSOCIATION TO PROVIDE AN EDUCATIONAL SERIES FOR CAREGIVERS.-PARTNERING WITH THE LOCAL YMCA TO ENHANCE WELLNESS PROGRAMS FOR THE HOSPITAL EMPLOYEES AND PATIENTS OF RMH-OWNED PHYSICIAN PRACTICES.-EXPANDING RMH'S WELLNESS INITIATIVES FOR EMPLOYEES, SUCH AS OFFERING YOGA CLASSES AND POSTING NUTRITIONAL INFORMATION FOR FOOD OFFERED IN THE CAFETERIA.-IMPLEMENTING STARTEGIES TO REDUCE HEALTH ACQUIRED INFECTIONS. RMH HASN'T HAD A CENTRAL LINE INFECTION IN THE ICU SINCE 2006. NOVEMBER 2013, ITS MEDICAL/SURGICAL UNIT CELEBRATED THREE YEARS WITHOUT A CATHETER ASSOCIATED URINARY TRACT INFECTION.-PROVIDING SMOKING PREVENTION EDUCATION AT LOCAL SCHOOLS TO DETER CHILDREN FROM BECOMING ADULT SMOKERS.-PROVIDING HEALTH INFORMATION THROUGH QUARTERLY NEWSLETTERS TO SENIORS.
ROME MEMORIAL HOSPITAL	PART V, SECTION B, LINE 4: HOSPITAL CHNA PARTICIPANTS INCLUDE ROME MEMORIAL HOSPITAL, FAXTON-ST. LUKE'S HEALTHCARE AND ST. ELIZABETH'S MEDICAL CENTER.
ROME MEMORIAL HOSPITAL	PART V, SECTION B, LINE 7: THE MAJOR BARRIERS TO ADDRESSING ALL OF THE COMMUNITY'S HEALTHCARE NEEDS INCLUDE:-LIMITED FINANCIAL RESOURCES.-CHALLANGES WITH IMPACTING INDIVIDUAL LIFESTYLE BEHAVIORS.-SHORTAGE OF PRIMARY AND SPECIALITY PROVIDERS.
ROME MEMORIAL HOSPITAL	PART V, SECTION B, LINE 20D: INDIVIDUALS WILL RECEIVE 50% DISCOUNT WITHOUT INSURANCE. IF APPROVED AND FAP-ELIGIBLE THE DISCOUNT WILL BE BASED ON BLUE CROSS RATES.

Field	Value	IRS element (for citing)
Facility	14	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (14 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	FacilityFacilityTxt
COMMUNITY RECOVERY CENTER
264 W DOMINICK STREET	ROME	NY	13440	SUBSTANCE ABUSE COUNSELING
MOHAWK VALLEY RADIATION MEDICINE
107 E CHESTNUT STREET	ROME	NY	13440	RADIATION ONCOLOGY
PHYSICAL THERAPY
107 E CHESTNUT STREET	ROME	NY	13440	OFFSITE PHYSICAL THERAPY SERVICES
BOONVILLE FAMILY CARE
13407 STATE ROUTE 12	BOONVILLE	NY	13309	PRIMARY CARE SERVICES
LABORATORY COLLECTION SITE
1801 BLACK RIVER BLVD	ROME	NY	13440	OFFSITE LAB COLLECTION SITE
LABORATORY COLLECTION SITE
1617 N JAMES STREET	ROME	NY	13440	OFFSITE LAB COLLECTION SITE
LABORATORY COLLECTION SITE
13407 STATE ROUTE 12	BOONVILLE	NY	13309	OFFSITE LAB COLLECTION SITE
LABORATORY COLLECTION SITE
BEECHES OFFICE COMPLEX-TURIN RD	ROME	NY	13440	OFFSITE LAB COLLECTION SITE
MEDICAL IMAGING
1617 N JAMES STREET	ROME	NY	13440	OFFSITE RADIOLOGY SERVICES
MEDICAL IMAGING
1801 BLACK RIVER BLVD	ROME	NY	13440	OFFSITE RADIOLOGY SERVICES
MEDICAL IMAGING
107 E CHESTNUT STREET	ROME	NY	13440	OFFSITE RADIOLOGY SERVICES
PRENATAL CARE CENTER
155 WEST DOMINICK STREET	ROME	NY	13440	OFFSITE PRENATAL CARE SERVICES
DELTA MEDICAL CENTER
1819 BLACK RIVER BLVD	ROME	NY	13440	PRIMARY CARE SERVICES
REGIONAL WOUND CARE CENTER
267 HILL ROAD	ROME	NY	13441	ADVANCED WOUND CARE AND HYPERBARIC OXYGEN TREATMENT

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 6A:	ROME MEMORIAL HOSPITAL'S 2013 COMMUNITY SERVICE PLAN IS POSTED ON ITS WEBSITE AT: WWW.ROMEHOSPITAL.ORG. THE HOSPITAL'S COMMUNITY SERVICE PLAN IS DERIVED FROM ITS PARTICIPATION IN THE COMPREHENSIVE COUNTYWIDE COMMUNITY NEEDS ASSESSMENT. THE COUNTY 2013 COMMUNITY HEALTH ASSESSMENT IS AVAILABLE ONLINE AT: HTTP://WWW.OCGOV.NET/HEALTH/COMMUNITY-HEALTH-ASSESSMENT.
PART I, LINE 7:	CHARITY CARE AT COST (7A) AND UNREIMBURSED COSTS - OTHER MEANS TESTED GOVERNMENT PROGRAMS (7C) WERE CALCULATED BY USING A COST TO CHARGE RATIO. THIS COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES, SUPPLIED BY THE IRS.UNREIMBURSED MEDICAID (7B) WAS CALCULATED BY USING ACTUAL COSTS.OTHER BENEFITS (7E & 7F) WERE CALCULATED BY DETERMINING ACTUAL COSTS AND ACTUAL REVENUE PER EVENT.THE MAIN SOURCE OR GUIDE OF HOW CALCULATIONS WERE DETERMINED WAS BY UTILIZING THE WORKSHEETS PROVIDED BY THE IRS AND THEN ADJUSTING ACCORDING TO ROME HOSPITAL SPECIFICS (IE. USING ACTUAL COSTS VS. COST TO CHARGE RATIO AS MENTIONED ABOVE).
PART I, LN 7 COL(F):	PERCENT OF TOTAL EXPENSE IS CALCULATED BY USING THE DENOMINATOR OF THE TOTAL FUNCTIONAL EXPENSES LESS BAD DEBT EXPENSE OF $5,929,420 (PER AUDITED FINANCIAL STATEMENTS).
PART II, COMMUNITY BUILDING ACTIVITIES:	ROME MEMORIAL HOSPITAL PARTICIPATES IN NUMEROUS COMMUNITY COMMITTEES INVOLVED IN ENHANCING HEALTHCARE OUTCOMES THROUGH PREVENTION, EARLY DETECTION AND INTERVENTION, AS WELL AS EMERGENCY PREPAREDNESS ACTIVITIES TO ENSURE A COORDINATED RESPONSE IN AN EVENT OF A DISASTER. HOSPITAL EXPERTS ARE CALLED UPON TO PARTICIPATE IN INITIATIVES TO ADDRESS DOMESTIC VIOLENCE, TEENAGE PREGNANCY, SUBSTANCE ABUSE AND LITERACY.RECRUITING PHYSICIANS AND OTHER HEALTH PROFESSIONALS TO ENHANCE ACCESS TO CARE IS ONE OF THE HOSPITAL'S MOST SIGNIFICANT INVESTMENTS IN COMMUNITY BUILDING ACTIVITIES. WITH EXISTING PROVIDER SHORTAGES, MANY PRACTICES ARE NOT ACCEPTING NEW PATIENTS AND SEVERAL PRIMARY CARE PHYSICIANS WITH LARGE PATIENT PANELS ARE NEARING RETIREMENT, WHICH WILL ONLY EXACERBATE THE PROBLEM.
PART III, LINE 4:	SEE AUDITED FINANCIAL STATEMENTS PAGES 12 AND 13 FOR CURRENT FOOTNOTE LANGUAGE THAT DESCRIBES BAD DEBT. PART III, LINE 6; COSTING METHODOLOGY AND SOURCE:2013 ICR EXHIBIT 46 AND TENTATIVE MEDICARE SETTLEMENT RATES
PART III, LINE 8:	FINANCIAL AID PROGRAM THE SHORTFALL IN QUESTION 7 SHOULD BE TREATED AS COMMUNITY BENEFIT AS MEDICARE REIMBURSEMENTS FAIL TO COVER THE COSTS OF PROVIDING CARE TO MEDICARE BENEFICIARIES. DESPITE EFFORTS TO IMPROVE EFFICIENCY, EXPENSES FOR TECHNOLOGY, PHARMACEUTICAL, AND SALARY AND BENEFITS CONTINUE TO ESCALATE. THE HOSPITALS BAD DEBT EXPENSES IS IMPACTED BY THE TOUGH ECONOMIC TIMES BATTERING THE COUNTRY, MANY PEOPLE HAVE LOST THEIR HEALTH INSURANCE. MANY CANNOT AFFORD RISING PREMIUMS, WHILE OTHERS HAVE LOST THEIR JOBS COMPLETELY. SOME PEOPLE HAVE INSURANCE, BUT THEIR OUT-OF-POCKET COSTS ARE HIGH BECAUSE EMPLOYERS HAVE RAISED THEIR DEDUCTIBLES OR CO-PAYMENTS, OR REDUCED WHAT THEIR PLANS COVER. AS A RESULT, THE AMOUNT OF UNCOMPENSATED CARE PROVIDED BY RMH CONTINUES TO GROW.TO HELP THOSE WHO ARE UNINSURED LEARN MORE ABOUT POSSIBLE OPTIONS, THE HOSPITAL'S PATIENT REGISTRATION DEPARTMENT PROVIDES INFORMATION FROM INSURERS WHICH OFFER FREE OR LOW-COST HEALTH INSURANCE THROUGH NEW YORK STATE'S CHILD HEALTH PLUS AND FAMILY HEALTH PLUS, ALONG WITH SPACE FOR REPRESENTATIVES TO ANSWER QUESTIONS AND ENROLL ELIGIBLE RESIDENTS.IN ADDITION, THE HOSPITAL HAS PARTNERED WITH THE MOHAWK VALLEY PERINATAL NETWORK, WHOSE FACILITATED ENROLLER CAN ASSIST INDIVIDUALS IN APPLYING FOR COVERAGE FROM CHILD HEALTH PLUS, FAMILY HEALTH PLUS, AND MEDICAID. IN ADDITION TO HELPING PEOPLE OBTAIN INSURANCE COVERAGE, THE HOSPITAL ALSO PROVIDES A FINANCIAL ASSISTANCE PROGRAM AND WORKS WITH PATIENTS TO SET UP AFFORDABLE PAYMENT PLANS.FINANCIAL ASSISTANCE BROCHURES ARE LOCATED IN THE HOSPITAL'S WAITING AREAS AND APPLICATIONS ARE AVAILABLE ON THE WEBSITE. RMH DISCOUNTS PATIENT ACCOUNTS UP TO 100% DEPENDING UPON FAMILY INCOME IN COMPARISON TO THE FEDERAL POVERTY LEVEL. DISCOUNTS ARE BASED UPON THE BLUE CROSS RATE. ROME MEMORIAL HOSPITAL OFFERS DISCOUNTS TO THE UNINSURED/UNDERINSURED WHOSE INCOME IS UP TO 300% OF THE FEDERAL POVERTY LEVEL.BECAUSE LACK OF AWARENESS IS ONE OF THE BIGGEST BARRIERS, RMH PROVIDES INFORMATION ABOUT AVAILABLE PROGRAMS AT HEALTH FAIRS AND OTHER OUTREACH ACTIVITIES.CHANGES (ACTUAL OR POTENTIAL) IMPACTING COMMUNITY HEALTH, PROVISION OF CHARITY CARE, AND ACCESS TO SERVICES: REIMBURSEMENTS THAT FAIL TO KEEP PACE WITH RISING EXPENSES AND THE CONTINUED GROWTH IN UNCOMPENSATED CARE ARE SIGNIFICANT CHALLENGES THAT NEW YORK'S HOSPITALS FACE, INCLUDING RMH. OTHER CHALLENGES INCLUDE THE ESCALATION OF COSTS FOR DRUGS DUE TO INFLATION AND HAVING TO FIND ALTERNATE SUPPLIERS BECAUSE OF MANUFACTURER PRODUCTION SHORTAGES, SERVICES AND BAD DEBT, AND INVESTMENTS REQUIRED TO COMPLY WITH MANDATES. HERE ARE JUST A FEW EXAMPLES OF OUR CHALLENGES:UNCOMPENSATED CARE: THE COST OF FREE SERVICES PROVIDED TO OUR COMMUNITY REMAINS HIGH AS RESIDENTS LOSE THEIR JOBS OR THEIR ABILITY TO AFFORD THEIR INSURANCE PREMIUMS. IN 2013, ROME MEMORIAL HOSPITAL'S BAD DEBT AND CHARITY CARE TOTALED $8.7 MILLION, COMPARED TO 8.9 MILLION IN 2012. PHYSICIAN SHORTAGES: ROME MEMORIAL HOSPITAL HAS BEEN SUCCESSFUL IN RECRUITING SEVERAL NEW PHYSICIANS TO THE COMMUNITY, BUT AT A GREAT COST. TODAY'S PHYSICIAN WANTS TO BE EMPLOYED SO THEY DON'T HAVE TO BEAR THE RISK OF OPENING A NEW PRACTICE OR MANAGE THE ADMINISTRATIVE ASPECTS OF MEDICINE. ALTHOUGH THEY PROVIDE CRITICAL ACCESS TO CARE, THESE PRACTICES STRUGGLE TO BREAK EVEN. LACK OF PRIMARY CARE: PATIENTS WHO DON'T HAVE INSURANCE OR WHO ARE COVERED BY MEDICAID OFTEN DON'T HAVE A REGULAR PHYSICIAN FOR PREVENTATIVE CARE OR TO MANAGE CHRONIC CONDITIONS. AS A RESULT, THEY USE THE EMERGENCY DEPARTMENT AS THEIR PRIMARY CARE OR DELAY CARE UNTIL THEIR CONDITION IS MORE CRITICAL AND MORE EXPENSIVE TO TREAT. SINCE ROME MEMORIAL HOSPITAL'S NEW EMERGENCY DEPARTMENT OPENED, THE NUMBER OF PATIENT VISITS HAS STEADILY INCREASED BY 19,000 IN 2006 TO 27,787 IN 2013. MANY PHYSICIANS DON'T ACCEPT MEDICAID PATIENTS BECAUSE OF LOW REIMBURSEMENT RATES. IN ADDITION, SENIORS MAY SOON FACE THE SAME ACCESS PROBLEMS IF CUTS TO PHYSICIAN MEDICARE RATES ARE IMPLEMENTED. PHARMACEUTICALS: THE HOSPITAL CONTINUES TO SEE SIGNIFICANT INCREASE IN DRUG COSTS DUE TO INFLATION AND MANUFACTURER PRODUCTION SHORTAGES. IN MANY CASES, THESE SHORTAGES FORCE US TO TURN TO ALTERNATE SUPPLIERS, WHO CHARGE A PREMIUM PRICE. INTERPRETER SERVICES: AS OUR POPULATION BECOMES MORE DIVERSE WITH BURMESE AND BOSNIAN REFUGEES AND SPANISH SPEAKING RESIDENTS, THERE IS A GREATER DEMAND FOR INTERPRETER SERVICES. DDSO POPULATION - THE HIGH CONCENTRATION OF DDSO CLIENTS IN ONEIDA COUNTY AND ROME PLACES A UNIQUE BURDEN ON ROME MEMORIAL HOSPITAL. WHEN DDSO CLIENTS REQUIRE HOSPITALIZATION, THEIR CASES ARE OFTEN VERY COMPLEX AND THEIR LENGTH OF STAY IS NEARLY TWICE AS LONG AS THE AVERAGE PATIENT. AS A RESULT, THE HOSPITAL IS ONCE AGAIN FACED WITH ABSORBING THE FINANCIAL LOSS OF CARING FOR THESE PATIENTS. PROGRAM VIABILITY: AS A RESULT OF THESE SIGNIFICANT FINANCIAL CHALLANGES, RMH CONTINUALLY EVALUATES THE VIABILITY OF SOME OF ITS SERVICES. AS A PART OF THE EVALUATION, RMH ASSESSES THE NUMBER OF PEOPLE SERVED AND AVAILABILITY OF OTHER SERVICES TO ADDRESS THE COMMUNITY NEED, IN ADDITION TO THE FINANCIAL BURDEN ON THE HOSPITAL.
PART VI, LINE 2:	LINE 2 - ALWAYS ASSESSING NEEDS:IN ADDITION TO THE FORMAL CHNA REPORTED IN PART V, SECTION B, ROME MEMORIAL HOSPITAL CONTINUALLY ASSESSES THE COMMUNITY'S NEEDS THROUGH ONGOING OBSERVATION AND PARTICIPATION IN COMMUNITY COMMITTEES AND ORGANIZATIONS THAT REPRESENT A BROAD SEGMENT OF THE POPULATION. IN ADDITION, THE HOSPITAL'S STRATEGIC PLANNING PROCESS INCLUDES QUARTERLY UPDATES THAT TAKE INTO CONSIDERATION EMERGING INFORMATION. SURVEYS ARE PROVIDED AT COMMUNITY LECTURES AND FAIRS ASKING RESIDENTS TO IDENTIFY AREAS OF INTEREST FOR FUTURE PROGRAMS. ROME MEMORIAL HOSPITAL CONDUCTED COMMUNITY OUTREACH SESSIONS IN 2012 AND 2013 WITH VARIOUS CONSTITUENCIES TO BETTER UNDERSTAND THE PERCEIVED GAPS IN THE COMMUNITY. PROVIDER SHORTAGE, ESPECIALLY IN PRIMARY CARE, WAS SEEN AS A BARRIER TO IMPROVING THE COMMUNITY'S HEALTH STATUS. A SURVEY OF LOCAL PHYSICIANS CONFIRMED THAT A SIGNIFICANT PERCENTAGE OF PRIMARY CARE PHYSICIANS ARE NOT ACCEPTING NEW PATIENTS BECAUSE THEIR PATIENT PANELS ARE AT CAPACITY. IT'S THIS PROCESS THAT RESULTED IN COMMUNITY EDUCATION TO HIGHLIGHT THE DANGERS OF SYNTHETIC DRUGS AND THE RE-EMERGENCE OF HEROIN AS A DRUG OF CHOICE AND THE REQUEST TO ADD AN ADDITIONAL INPATIENT PSYCHIATRIC BED TO THE HOSPITAL'S LICENSE.
PART VI, LINE 3:	LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:TO ENSURE THAT THE COMMUNITY IS AWARE OF THE HOSPITAL'S COMMITMENT TO PROVIDE HEALTHCARE SERVICES TO THOSE WHO ARE UNABLE TO PAY, THE HOSPITAL POSTS INFORMATION ABOUT ITS FINANCIAL ASSISTANCE POLICY ON ITS WEBSITE. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY CONFORMS WITH THE GUIDELINES ESTABLISHED BY THE HEALTHCARE ASSOCIATION OF NEW YORK STATE. THIS POLICY INCLUDES DETAILED INFORMATION REGARDING ELIGIBILITY, THE APPLICATION PROCESS, FINANCIAL GUIDELINES, TYPES OF FINANCIAL ASSISTANCE AVAILABLE, AND THE APPEAL PROCESS. RMH'S WEBSITE ALSO LISTS CONTACT INFORMATION IF YOU NEED HELP DETERMINING IF YOU QUALIFY FOR A DISCOUNT OR HAVE QUESTIONS REGARDING THE PROCESS. FREE, CONFIDENTIAL ASSISTANCE IS AVAILABLE BY CONTACTING THE ROME MEMORIAL HOSPITAL BUSINESS OFFICE. IF YOU DO NOT SPEAK ENGLSH, SOMEONE WILL HELP IN YOUR OWN LANGUAGE. ALSO, ROME MEMORIAL HOSPITAL HOSTS ENROLLMENT REPRESENTATIVES WHO CAN HELP ENROLL IN FREE OR LOW-COST INSURANCE PROGRAMS, SUCH AS MEDICAID, CHILD HEALTH PLUS AND FAMILY HEALTH PLUS.
PART VI, LINE 4:	LINE 4 - SERVICE AREA AND COMMUNITY DEMOGRAPHICS:THE HOSPITAL'S PRIMARY SERVICE AREA INCLUDES THE CITY OF ROME AND THE SURROUNDING RURAL TOWNS OF CAMDEN, BOONVILLE, ANNSVILLE, FLORENCE, VIENNA, LEE, AVA, WESTERN AND FLOYD. THE POPULATION OF THE PRIMARY MARKET IS APPROXIMATELY 67,000 PEOPLE. FOR SELECTED SPECIALTIES, SUCH AS SENIOR BEHAVIORIAL HEALTH CARE, THE HOSPITAL'S SERVICE ARE EXTENDS INTO THE SURROUNDING COUNTIES OF MADISON, HERKIMER, LEWIS AND ONONDAGA COUNTIES. ZIP CODES POPULATIONAVA (13303) 1,153BLOSSVALE (13308) 3,625BOONVILLE (13309) 5,889CAMDEN (13316) 6,460LEE CENTER (13363) 2,315ROME (13440) 42,986ROME (13441) 51TABERG (13471) 3,540WESTDALE (13483) 256WESTERNVILLE (13486) 815WESTMORELAND (13490) 1,361MOST ZIP CODES IN THE PRIMARY SERVICE AREA ARE LOCATED IN ONEIDA COUNTY. RESIDENTS FROM ROME'S 13440 ZIP CODE WITH A POPULATION OF ALMOST 43,000 COMPRISE APPROXIMATELY TWO-THIRDS OF RMH'S INPATIENT DISCHARGES. THE SURROUNDING COMMUNITIES ARE MOSTLY RURAL, WITH CAMDEN 13316 (POPULATION OF 6,460) AND BOONVILLE 13309 (POPULATION OF 5,889) AS THE TWO LARGEST TOWNS LOCATED IN THE PRIMARY SERVICE AREA.BASED UPON THE 2010 CENSUS, THE POPULATION OF ONEIDA COUNTY IS 234,878, WITH 50.2% FEMALE; 21.4% OF THE POPULATION WAS UNDER THE AGE OF 18; AND 16.8% WERE 65 AND OLDER.THE POPULATION IS 88.7% WHITE, 6.6% AFRICAN AMERICAN AND 3.1% ASIAN; 4.9% IDENTIFY THEMSELVES AS HISPANIC OR LATINO.AT $48,382, THE MEDIAN HOUSEHOLD INCOME IN ONEIDA COUNTY IS LESS THAN NEW YORK STATE'S AT $56,951. THE PERCENT OF POPULATION BELOW THE POVERTY LINE WAS 15.1% BASED ON THE CENSUS BUREAU'S AMERICAN COMMUNITY SURVEY 2007-2011, HIGHER THAN THE RATE OF 14.5% FOR THE STATE. THERE IS AN EDUCATIONAL ATTAINMENT GAP IN ONEIDA COUNTY WITH ONLY 21.9% OF RESIDENTS AGE 25+ EARNING A BACHELOR'S DEGREE OR HIGHER, COMPARED TO 32.5% IN NEW YORK STATE. NEARLY 60% OF ONEIDA COUNTY RESIDENTS AGE 16 AND OLDER ARE PART OF THE LABOR FORCE, THOUGH 4.3% ARE UNEMPLOYED.THE ROME 13440 ZIP CODE DEMOGRAPHICS GENERALLY MIRROR THE COUNTY'S NUMBERS. THE POPULATION OF ROME 13440 IS 42,986, WITH 48.9% FEMALE; 21% OF THE POPULATION IS UNDER AGE 18; AND 16.7% ARE 65 AND OLDER. THE POPULATION IS 89.5% WHITE, 5.7% AFRICAN AMERICAN AND 1% ASIAN; 4.4% INDENTIFYING THEMSELVES AS HISPANIC OR LATINO.AT $49,553, THE MEDIAN HOUSEHOLD INCOME IN ROME IS LESS THAN NEW YORK STATE. THE PERCENT OF POPULATION BELOW THE POVERTY LINE WAS 12.6%. THE EDUCATIONAL ATTAINMENT GAP IS EVEN GREATER FOR THE ROME POPULATION WITH ONLY 18.9% OF RESIDENTS AGE 25+ EARNING A BACHELOR'S DEGREE OR HIGHER. ABOUT 56% OF RESIDENTS AGE 16 AND OLDER ARE PART OF THE LABOR FORCE, WITH 4.7% UNEMPLOYED.ACCORDING TO COUNTYHEALTHRANKINGS.ORG, ONEIDA COUNTY MEASURES UP POORLY IN TERMS OF MORBIDITY (RANK #53 OUT OF 62 NYS COUNTIES), INCLUDING MENTAL HEALTH AND VARIOUS SOCIOECONOMIC FACTORS (#43 OUT OF 62 COUNTIES). AT THE SAME TIME, IT FARES BETTER THAN MOST COUNTIES REGARDING OVERALL CLINICAL CARE (#16), PARTICULARLY WITH RESPECT TO INSURANCE COVERAGE (DESPITE RELATIVELY FEWER PROVIDERS) AND PHYSICAL ENVIRONMENT (#17). RATES OF ADULT SMOKING, ADULT OBSEITY, PHYSICAL INACTIVITY AND TEEN BIRTH RATE ARE ALL HIGHER THAN THE STATE AND THE NATIONAL BENCHMARK. THE OVERALL RANK OF 50 REFLECTS YEARS OF POTENTIAL LIFE LOST (YPLL) BEFORE AGE 75 PER 100,000 POPULATION, A MEASURE OF PREMATURE MORTALITY.THE PERCENTAGE OF ADULTS WITH HEALTH INSURANCE BETWEEN THE AGES OF 18 AND 64 YEARS OLD IN ONEIDA COUNTY IS 87.4, COMPARED TO THE STATE AVERAGE OF 83.1.AT ROME MEMORIAL HOSPITAL, 34.1% OF PATIENTS ARE UNINSURED OR ON A MEDICAID PROGRAM. ROME MEMORIAL HOSPITAL IS THE ONLY HOSPITAL IN THE CITY OF ROME. THERE ARE TWO HOSPITALS IN SOUTHERN ONEIDA COUNTY (ST. ELIZABETH MEDICAL CENTER AND FAXTON-ST. LUKE'S HEALTHCARE).ALTHOUGH ROME MEMORIAL HOSPITAL IS NOT IN A DESIGNATED MEDICALLY UNDERSERVED AREA, IT IS IN A DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA FOR PRIMARY CARE HPSA 136999363J, MEDICAID ELIGIBLE-ROME PRIMARY CARE SERVICE AREA AND MENTAL HEALTH HPSA 736999360I, MEDICAID ELIGIBLE-ONEIDA COUNTY.
PART VI, LINE 5:	LINE 5 - PROMOTION OF COMMUNITY HEALTH:ADDITIONAL WAYS THE HOSPITAL DEMONSTRATES ITS EXEMPT PURPOSE:1.ROME MEMORIAL HOSPITAL PROVIDES EMERGENCY SERVICES TO EVERYONE REGARDLESS OF ABILITY TO PAY.2.THE HOSPITAL'S INDEPENDENT GOVERNING BODY IS COMPRISED OF INDIVIDUALS WHO RESIDE OR WORK IN THE PRIMARY SERVICE AREA TO REPRESENT THE INTERESTS OF THE COMMUNITY.3.THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY.4.THE HOSPITAL USES ANY SURPLUS FUNDS TO IMPROVE CARE, EXPAND FACILITIES, RECRUIT STAFF AND ADVANCE MEDICAL TRAINING AND COMMUNITY EDUCATION.
PART VI, LINE 6:	LINE 6 - AFFILIATED HEALTH CARE SYSTEM:ROME MEMORIAL HOSPITAL, INC. (THE "HOSPITAL") IS A NEW YORK STATE NOT-FOR-PROFIT CORPORATION AND TAX EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE ("IRC"), AND IS PART OF THE FOLLOWING CORPORATE STRUCTURE: GREATER ROME AFFILIATES, INC. ("GRA"), A NEW YORK STATE NOT-FOR-PROFIT CORPORATION, TAX EXEMPT UNDER SECTION 501(C)(3) OF THE IRC, IS THE SOLE CORPORATE MEMBER, AND THEREFORE, THE "PARENT" OF THE HOSPITAL, AS WELL AS ROME MEMORIAL PROPERTIES, INC., A NEW YORK STATE NOT-FOR-PROFIT CORPORATION, TAX EXEMPT UNDER SECTION 501(C)(3) OF THE IRC. GRA IS ALSO THE SOLE SHAREHOLDER OF RMH SERVICES, INC., A NEW YORK STATE BUSINESS CORPORATION, WHICH WAS ESTABLISHED TO UNDERTAKE CERTAIN FOR-PROFIT BUSINESS ACTIVITIES AND WHICH HAS AN EQUITY OWNERSHIP INTEREST IN, AND IS A MEMBER OF, THREE NEW YORK STATE LIMITED LIABILITY COMPANIES: 1819 BLACK RIVER ASSOCIATES, LLC; CHESTNUT COMMONS, LLC; AND RMH RETAIL PHARMACY, LLC. MEMBERS OF THE HOSPITAL'S BOARD OF TRUSTEES AND ADMINISTRATIVE STAFF HAVE OVERLAPPING RESPONSIBILITIES ON THE BOARDS OF THE AFFILIATED CORPORATIONS TO ENSURE THAT THE HOSPITAL'S BEST INTERESTS ARE BEING SERVED. ROME MEMORIAL HOSPITAL FOUNDATION, INC., A NEW YORK STATE NOT-FOR-PROFIT CORPORATION, TAX EXEMPT UNDER SECTION 501(C)(3) OF THE IRC, IS A SEPARATE CORPORATION ESTABLISHED FOR THE SOLE PURPOSE OF CONDUCTING FUND RAISING ACTIVITIES ON BEHALF OF THE HOSPITAL, INCLUDING THE RECEIPT OF GIFTS AND BEQUESTS ON BEHALF OF THE HOSPITAL, INVESTING SUCH ASSETS, AND TRANSFERRING THEM TO THE HOSPITAL IN SUPPORT OF ITS MISSION. IT IS GOVERNED BY A SEPARATE BOARD OF DIRECTORS, WHICH HAS AMONG ITS MEMBERS HOSPITAL TRUSTEES AND MEMBERS OF THE HOSPITAL'S MEDICAL STAFF.THE SYSTEM ALSO INCLUDES TWO CAPTIVE PROFESSIONAL CORPORATIONS, INCLUDING ROME MEDICAL GROUP, P.C., A MULTI-PHYSICIAN PRIMARY CARE PRACTICE, AND ROME MEDICAL PRACTICE, P.C., A MULTI-PHYSICIAN, SPECIALTY GROUP. THE PCS ARE THE VEHICLES THROUGH WHICH PHYSICIANS ARE EMPLOYED TO SERVE THE COMMUNITY. IN TODAY'S ENVIRONMENT, MANY PHYSICIANS PREFER TO BE EMPLOYED VS. GOING OUT IN PRIVATE PRACTICE.
PART VI, LINE 7, REPORTS FILED WITH STATES	NY

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
BASIL ARIGLIO
CEO	$298,047	$0	$27,766	$0	$1,005	$0	$0	$0	$14,305	$0	$341,123	$0	$0	$0
NICHOLAS MAYHEW
CFO	$191,822	$0	$9,075	$0	$15,231	$0	$0	$0	$16,367	$0	$232,495	$0	$0	$0
LEE SALTZGABER MD
CMO	$264,648	$0	$75	$0	$0	$0	$0	$0	$14,205	$0	$278,928	$0	$0	$0
BRUCE PETERSON
AVP/CIO	$147,173	$0	$7,725	$0	$314	$0	$0	$0	$14,027	$0	$169,239	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 1A	FormAndLineReferenceDesc
Explanation	TYPE OF BENEFIT: PAYMENT OF 2013 MEMBERSHIP DUES AND GENERAL MAINTENANCE FEE FOR SOCIAL CLUB, AS AGREED UPON IN EMPLOYMENT CONTRACT. PERSON WHO RECEIVED BENEFIT: CEO THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION IN 2013 FOR PERSON LISTED ABOVE.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
ONEIDA COUNTY INDUSTRIAL DEVELOPMENT AGENCY
A	166158201	6824621LE	2005-06-16	$11,900,000	FINANCE CONSTRUCTION	0	Yes (1)	0
ONEIDA COUNTY LOCAL DEVELOPMENT CORPORATION
B	273190422		2010-12-30	$6,900,000	FINANCE MRI CONSTRUCTION	0	Yes (1)	0
DORMITORY AUTHORITY OF THE STATE OF NEW YORK
C	146000293		2011-10-27	$7,500,000	FINANCE EQUIPMENT THROUGH CAPITAL LEASE AGREEMENT	0	Yes (1)	0
DORMITORY AUTHORITY OF THE STATE OF NEW YORK
D	146000293		2007-09-21	$1,858,108	FINANCE EQUIPMENT THROUGH CAPITAL LEASE AGREEMENT- CAT SCANN	0	Yes (1)	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Substantial CompletionSubstantialCompletionYr	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Capitalized InterestCapitalizedInterestAmt	Capital ExpendituresCapitalExpendituresAmt
A	$11,900,000	$509,090	2006	Yes (1)	Yes (1)
B	$6,900,000	$222,845	2009	Yes (1)	Yes (1)	$44,569	$5,999,546
C	$7,500,000	$58,827	2011	Yes (1)	Yes (1)	$25,490
D	$1,858,108		2007	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd
A	Yes (1)	Yes (1)	Yes (1)
B	0		Yes (1)
C	Yes (1)	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Business Name Line2HedgeProviderName/BusinessNameLine2	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
MANUFACTURERS AND
A	0	0	0	0	Yes (1)	Yes (1)	TRUST	5.000000000000	0	Yes (1)	0	0	0
(no name)
B	0	0	0	0	Yes (1)	0					0	0	0
(no name)
C	0	0	0	0	0	0					0	0	0
(no name)
D	0	0	0	0	0	0					0	0	0

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	0
B	0
C	0
D	0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE K SUPPLENTAL INFORMATION	FormAndLineReferenceDesc
Explanation	THE CAPITAL LEASE AGREEMENTS ARE ALL TELP (TAX EXEMPT LEASE - PURCHASE (FINANCING)) LEASES THROUGH THE COUNTY OR STATE.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	DORMITORY AUTHORITY OF THE STATE OF NEW YORK	BusinessNameLine1

Field	Value	IRS element (for citing)
Bond Issuer EIN	146000293	BondIssuerEIN
Bond Issued	2009-12-01	BondIssuedDt
Issue Price	$1,935,034	IssuePriceAmt
Purpose	FINANCE EQUIPMENT THROUGH CAPITAL LEASE AGREEMENT - MRI EQUIPMENT	PurposeDesc
Defeased	0	DefeasedInd
On Behalf Of Issuer	Yes (1)	OnBehalfOfIssuerInd
Pool Financing	0	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Total Proceeds	$1,935,034	TotalProceedsAmt
Issuance Costs From Proceeds	$15,338	IssuanceCostsFromProceedsAmt
Substantial Completion	2009	SubstantialCompletionYr
Current Refunding	0	CurrentRefundingInd
Advance Refunding	0	AdvanceRefundingInd
Final Allocation Made	Yes (1)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (1)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedPropertyInd
Any Lease Arrangements	0	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	Yes (1)	MgmtContractBondFincdPropInd
Engage Bond Counsel Contracts	Yes (1)	EngageBondCounselContractsInd
Any Research Agreements	0	AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test	Yes (1)	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	0	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiledInd
Rebate Not Due Yet	0	RebateNotDueYetInd
Exception To Rebate	0	ExceptionToRebateInd
No Rebate Due	0	NoRebateDueInd
Variable Rate Issue	0	VariableRateIssueInd
Hedge Identified In Bks And Rec	0	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	0	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	0	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	0	ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
MARY ANN JONES
SISTER OF KEY EMPLOYEE	$26,216	COMPENSATION	0
SCOTT A GWILT
SON IN LAW OF BOARD DIRECTOR	$39,661	COMPENSATION	0

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)

Non Cash CheckboxNonCashCheckboxInd	DescDesc	ContributionContributionCnt	Noncash Contributions Rpt F990NoncashContributionsRptF990Amt	Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)	2 NORTH RENOV	5	$99,989	ACTUAL INVOICE COST
Yes (X)	MEDICAL EQUIP	2	$16,933	ACTUAL INVOICE COST

Field	Value	IRS element (for citing)
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (1)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	0	ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 2	IN 2013 ROME MEMORIAL HOSPITAL ENGAGED IN THE FOLLOWING THREE SIGNIFICANT PROGRAM CHANGES: 1. IN APRIL 2013, ROME MEMORIAL HOSPITAL ESTABLISHED DELTA MEDICAL CENTER TO ENHANCE PRIMARY CARE ACCESS FOR AREA RESIDENTS FOLLOWING THE LOSS OF SEVERAL WELL-RESPECTED PHYSICIANS IN THE COMMUNITY DUE TO DEATH, RETIREMENT OR RELOCATION. DELTA MEDICAL IS LOCATED IN ROME, NEW YORK, WHICH IS IN HPSA 136999363J, MEDICAID ELIGIBLE-ROME PRIMARY CARE SERVICE AREA. ACCORDING TO A 2010 NEW YORK STATE PHYSICIAN WORKFORCE REPORT, THE MOHAWK VALLEY REGION HAS THE LOWEST RATIO OF PHYSICIANS PER 100,000 POPULATION IN ALL OF NEW YORK STATE. 2. IN APRIL 2013, ROME MEMORIAL HOSPITAL ESTABLISHED THE WOUND CARE CENTER TO SERVE THE HIGH-RISK DIABETIC AND LONG-TERM CARE POPULATIONS IN THE COMMUNITY, WHO OFTEN FIND IT DIFFICULT TO TRAVEL OUT OF TOWN FOR TREATMENTS THAT REQUIRE MULTIPLE VISITS. ALTHOUGH THE PREVELANCE OF DIABETES IN ONEIDA COUNTY IS SIMILAR TO THE STATE AVERAGE, DIABETICS IN THE REGION WERE IDENTIFIED AS A POPULATION WITH AN ELEVATED RATE OF PREVENTABLE HOSPITAL ADMISSIONS. THE CENTER PROVIDES COMPREHENSIVE WOUND CARE SERVICES, HYPERBARIC OXYGEN TREATMENT, FOR HARD TO HEAL WOUNDS. 3. IN OCTOBER 2013, ROME MEMORIAL HOSPITAL ESTABLISHED THE LOW-DOSE CT LUNG CANCER SCREENING PROGRAM FOR ELIGIBLE HIGH RISK SMOKERS AND FORMER SMOKERS WHO MEET GUIDELINES AS RECOMMENDED BY THE NATIONAL COMPREHENSIVE CANCER NETWORK (NCCN). APPROXIMATELY 25% OF ONEIDA COUNTY RESIDENTS OVER THE AGE OF 18 USE TOBACCO, WHICH IS THE LEADING CAUSE OF LUNG CANCER. THE FIVE YEAR SURVIVAL RATE FOR LUNG CANCER IS ONLY 15.9% BECAUSE LUNG CANCER IS TYPICALLY DETECTED IN THE LATER STAGES OF THE DISEASE. SCREENING FOR LUNG CANCER BEFORE SYMPTOMS APPEAR INCREASES THE CHANCE OF BEING DIAGNOSED AT EARLY STAGES WHEN CANCER CAN BE MORE SUCCESSFULLY TREATED AND EVEN CURED.
FORM 990, PART VI, SECTION A, LINE 6	GREATER ROME AFFILIATES IS THE SOLE MEMBER OF ROME MEMORIAL HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A	PER THE HOSPITAL BY-LAWS "THE SOLE CORPORATE MEMBER OF THE CORPORATION SHALL BE GREATER ROME AFFILIATES, INC. WHICH SHALL ACT HEREUNDER AS SUCH MEMBER BY DULY AUTHORIZED RESOLUTION OF ITS BOARD OF DIRECTORS AND WHICH SHALL COMMUNICATE ITS ACTIONS TO THIS BOARD THROUGH ITS PRESIDENT OR OTHER DULY AUTHORIZED OFFICER." GREATER ROME AFFILIATES APPOINTS THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11	THE COMPLETED 2013 990 WAS PRESENTED TO THE BOARD BY THE CFO OF THE HOSPITAL AT ITS OCTOBER 2014 BOARD MEETING.
FORM 990, PART VI, SECTION B, LINE 12C	CONSISTENT WITH ROME HOSPITAL'S GIFTS, GRATUITIES AND CONFLICT OF INTEREST POLICY, THE COMPLIANCE OFFICER OF RMH HAS A CONFLICT OF INTEREST DISCLOSURE FORM COMPLETED ON AN ANNUAL BASIS BY ALL OFFICERS, DIRECTORS AND MANAGEMENT PERSONNEL. THE COMPLIANCE OFFICER COLLECTS AND REVIEWS THE BOARD OF TRUSTEES/FOUNDATION BOARD INTEREST DISCLOSURE FORMS ON AN ANNUAL BASIS. THE INFORMATION GATHERED ON THE DISCLOSURE IS REVIEWED AND ANY CONFLICTS ARE COMMUNICATED TO THE PRESIDENT/CEO, COMPLIANCE BOARD, AND BOARD OF TRUSTEES TO ENSURE ALL HOSPITAL TRANSACTION/BUSINESS ACTIVITIES ARE CONDUCTED IN A MANNER THAT IS FREE FROM UNLAWFUL OR OTHERWISE INAPPROPRIATE OFFERS OR SOLICITATIONS OF IMPROPER INDUCEMENTS IN EXCHANGE FOR INFLUENCE OR ASSISTANCE IN A TRANSACTION. POTENTIAL CONFLICTS THAT MAY ARISE THROUGHOUT THE YEAR ARE BROUGHT TO THE ATTENTION OF THE COMPLIANCE OFFICER AND PRESIDENT/CEO FOR REVIEW. ANY IDENTIFIED CONFLICTS ARE THEN REVIEWED AT THE CORPORATE COMPLIANCE COMMITTEE AND BY THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 15	USE OF IROQUOIS DATA, ASSOCIATION FOR HEALTHCARE PHILANTHROPY SALARY DATA, AND THE ROME HOSPITAL HUMAN RESOURCE DEPARTMENT ARE UTILIZED TO DETERMINE COMPENSATION FOR THE ORGANIZATION'S EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 18	FORMS ARE AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19	FORMS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST OR THROUGH WWW.GUIDESTAR.ORG- A WEBSITE THAT PROVIDES NON-PROFIT INFORMATION TO THE PUBLIC. RMH MAKES ITS GOVERNING DOCUMENTS (BY - LAWS) AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC THROUGH RMH WEBSITE - WWW.ROMEHOSPITAL.ORG. ALSO, FINANCIAL FACTS AND FIGURES AND ECONOMIC IMPACT REPORTS CAN BE FOUND ON THIS WEBSITE.
FORM 990, PART XI, LINE 9:	CHANGE IN INTEREST IN FOUNDATION 28,720. CHANGE IN NET ASSETS -26,187.
FORM 990, PART XII, LINE 2C	THE FINANCE/AUDIT COMMITTEE CONSISTS OF NO LESS THAN 3 AND NOT MORE THAN 7 MEMBERS. THIS COMMITTEE IS RESPONSIBLE FOR GENERAL OVERSIGHT OF THE FINANCIAL AFFAIRS OF THE HOSPITAL. THE COMMITTEE REVIEWS, AVISES AND REPORTS TO THE BOARD OF TRUSTEES ON THE INVESTMENT AND MANAGEMENT OF THE FINANCIAL RESOURCES OF THE CORPORATION AND SHALL REVIEW THE ANNUAL BUDGET AND CAPITAL PLANS, FUND MANAGEMENT PROCEDURES AND INTERNAL CONTROLS RELATING TO THE SAFEGUARD OF FINANCIAL ASSETS. THE COMMITTE ACTS AS FINANCIAL ADVISOR, REVIEWS PROPOSED SCOPE OF THE ANNUAL AUDITS PERFORMED BY INDEPENDENT AUDITORS, REVIEWS INDEPENDENT AUDITORS MANAGEMENT LETTERS, REVIEWS THE ADEQUACY OF ACCOUNTING POLICIES AND INTERNAL CONTROL STRUCTURES, RECOMMENDS THE APPOINTMENT OF INDEPENDENT AUDITORS TO THE BOARD OF TRUSTEES AND REVIEWS PERIODICALLY THE CONFLICTS OF INTEREST POLICIES, AS WELL AS OVERSEES COMPLIANCE THEREWITH.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1
GREATER ROME AFFILIATES
1500 N JAMES STREET	ROME	NY	13440	161508597	PARENT CORPORATION	NY	501C3	LINE 11A, I	0
ROME MEMORIAL PROPERTIES
1500 N JAMES STREET	ROME	NY	13440	161492003	SUPPORT HOSPITAL ACTIVITIES	NY	501C3	3	0	GRA

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	GRIFFIS EYE CENTER LLC	BusinessNameLine1

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	105 DART CIRCLE	AddressLine1
City	ROME	City
State	NY	State
ZIP Code	13441	ZIPCode

Field	Value	IRS element (for citing)
EIN	263738675	EIN
Primary Activities	SEE SCHEDULE R, PART VII	PrimaryActivitiesTxt
Legal Domicile State	NY	LegalDomicileStateCd
Predominant Income Type	INVESTMENT	PredominantIncomeTypeTxt
Share Of Total Income	$111,816	ShareOfTotalIncomeAmt
Share Of EOY Assets	$80,528	ShareOfEOYAssetsAmt
Disproportionate Allocations	0	DisproportionateAllocationsInd
General Or Managing Partner	0	GeneralOrManagingPartnerInd
Ownership	0.30000	OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1	CityUSAddress/City	StateUSAddress/State	ZIP CodeUSAddress/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd
RMH SERVICES INC
1500 N JAMES STREET	ROME	NY	13440	161490045	FOR PROFIT	NY	GREATER ROME AFFILIATES	C	$155,240	$2,559,741	1.00000	0
ROME MEDICAL GROUP
1801 BLACK RIVER BLVD	ROME	NY	13440	161464822	CAPTIVE P.C.	NY	ROME MEMORIAL HOSPITAL	C				0
ROME MEDICAL PRACTICE
1500 N JAMES STREET	ROME	NY	13440	203827393	CAPTIVE P.C.	NY	ROME MEMORIAL HOSPITAL	C				0

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

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE R, PART III COLUMN (B)	FormAndLineReferenceDesc
Explanation	GRIFFIS EYE CENTER, LLC. PRIMARY ACTIVITY: SINGLE SPECIALTY AMBULATORY SURGERY CENTER SPECIALIZING IN AND PROVIDING ONLY OPTHAMOLOGY SERVICES.	ExplanationTxt