ROME MEMORIAL HOSPITAL INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: ROME MEMORIAL HOSPITAL INC (EIN 16-1471634)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-14
IRS object ID: 201323189349304427
Schema version: 2012v2.1
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)
Timestamp	2013-11-14T14:15:23-06:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	161226221	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	FUST CHARLES CHAMBERS LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

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	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	161471634	EIN

Name Name

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

Field	Value	IRS element (for citing)
Name Control	ROME	NameControl

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

Officer Officer

Field	Value	IRS element (for citing)
Name	NICHOLAS MAYHEW	Name
Title	CFO	Title
Phone	3153387000	Phone
Date Signed	2013-11-12	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	ANGELA M FRANCO	Name
PTIN	P00589741	PTIN
Phone	3154463600	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	BASIL ARIGLIO	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

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	92580668	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	ROMEHOSPITAL.ORG	WebSite
Type Of Organization Association	X	TypeOfOrganizationAssociation
Year Formation	1995	YearFormation
State Legal Domicile	NY	StateLegalDomicile
Activity Or Mission Description	PROVIDE QUALITY HEALTHCARE WITH COMPASSION.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	11	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	11	NbrIndependentVotingMembers
Total Nbr Employees	1187	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	275607	TotalGrossUBI
Net Unrelated Business Txbl Income	-37183	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	671957	ContributionsGrantsPriorYear
Contributions Grants Current Year	2837391	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	87265361	ProgramServiceRevenuePriorYear
Program Service Revenue CY	88352403	ProgramServiceRevenueCY
Investment Income Prior Year	169516	InvestmentIncomePriorYear
Investment Income Current Year	95725	InvestmentIncomeCurrentYear
Other Revenue Prior Year	853414	OtherRevenuePriorYear
Other Revenue Current Year	959980	OtherRevenueCurrentYear
Total Revenue Prior Year	88960248	TotalRevenuePriorYear
Total Revenue Current Year	92245499	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	50792045	SalariesEtcPriorYear
Salaries Etc Current Year	51362727	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	38547911	OtherExpensePriorYear
Other Expenses Current Year	40253290	OtherExpensesCurrentYear
Total Expenses Prior Year	89339956	TotalExpensesPriorYear
Total Expenses Current Year	91616017	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-379708	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	629482	RevenuesLessExpensesCY
Total Assets BOY	68210140	TotalAssetsBOY
Total Assets EOY	67911075	TotalAssetsEOY
Total Liabilities BOY	44543290	TotalLiabilitiesBOY
Total Liabilities EOY	43197124	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	23666850	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	24713951	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	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.	MissionDescription
Significant New Program Services	1	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	36656711	Expense
Revenue	34413879	Revenue
Description	INPATIENT CARE SERVICES, INPATIENT NURSING UNITS CONSIST OF THE FOLLOWING:ACUTE PHYSICAL REHABILITATION-4TH FLOOR,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.2012 INPATIENT DISCHARGES: 5,0112012 BIRTHS: 5512012 PATIENT DAYS: 22,923	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	9773174	Expense
Revenue	6973283	Revenue
Description	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 HOMECARE, SHORT-TERM SUB-ACUTE REHABILITATION, AND RESPITE CARE- ALL LOCATED ON THE 3RD FLOOR.2012 PATIENT DAYS = 27,1212012 OCCUPANCY PERCENTAGE = 92.63%	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	6174541	Expense
Revenue	9090999	Revenue
Description	EMERGENCY DEPARTMENT (ED)ROME MEMORIAL HOSPITAL EMERGENCY DEPARTMENT IS A SAFETY NET FOR THE MOST VULNERABLE POPULATIONS IN THE COMMUNITY. IN 2011, APPROXIMATELY 45% OF THE PATIENTS TREATED WERE LISTED AS UNINSURED OR UNDER INSURED. FOR LOWER LEVEL EMERGENCY DEPARTMENT VISITS, THIS POPULATION REPRESENTED MORE THAN 61% OF THE VISITS BECAUSE MANY PRIMARY CARE PHYSICIANS DO NOT ACCEPT MEDICAID.2012 ED ADMISSIONS: 3,3052012 ED VISITS: 27,211	Description

Activity Other ActivityOther

Field	Value	IRS element (for citing)
Expense	23776033	Expense
Revenue	37874242	Revenue
Description	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.	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	23776033	TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev	37874242	TotalOfOtherProgramServiceRev
Total Program Service Expense	76380459	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	1	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	1	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	1	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	46	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	1187	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	11	NbrVotingGoverningBodyMembers
Number Independent Voting Members	11	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	NY	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	NICHOLAS MAYHEW CFO ROME MEMORIAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	3153387024	TelephoneNumber

Address US AddressUS

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)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
CHESTER PATRICK MD
CHAIRMAN	2.00	X	X	0	0	0
DAVID NOLAN
VICE CHAIRMAN	2.00	X	X	0	0	0
KIM COOK
TREASURER	2.00	X	X	0	0	0
LYNN REESE
SECRETARY	2.00	X	X	0	0	0
W ROBERT HERMANN
DIRECTOR	2.00	X		0	0	0
MARY DAVIS
DIRECTOR	2.00	X		0	0	0
DR ANKUR DESAI
DIRECTOR	2.00	X		0	0	0
SALLY HINMAN
DIRECTOR	2.00	X		0	0	0
JULIE GROW-DENTON
DIRECTOR	2.00	X		0	0	0
MICHAEL O'SHAUGHNESSY
DIRECTOR	2.00	X		0	0	0
MICHAEL KRAMER
DIRECTOR	2.00	X		0	0	0
BASIL ARIGLIO
CEO	55.00		X	276838	0	14320
NICHOLAS MAYHEW
CFO	55.00			221930	0	14232	X
WALEED ALBERT MD
CMO	55.00			155119	0	8343	X
RAY CARNIVALE
COO	55.00			184213	0	7030	X
MARK SNYDERMAN
VP	55.00			123745	0	10712		X
SCOTT BURNS
PHARMACY DIRECTOR	55.00			138562	0	14096		X
DAVID LEE
PHARMACIST	55.00			125342	0	10715		X
BRUCE PETERSON
AVP/CIO	55.00			166251	0	14141		X
MARK ROWAN
DIRECTOR OF TECH SVCS	55.00			125192	0	14075		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1517192	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	107664	TotalOtherCompensation
Number Individuals GT100 K	26	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
CENTREX LABS
28 CAMPION RD	NEW HARTFORD	NY	13413	LAB SERVICES	1802851
MCKESSON
PO BOX 98347	CHICAGO	IL	60693	HEALTHCARE INFORMATION TECHNOLOGY	1270586
PORT PLLC
PO BOX 505109	ST LOUIS	MO	63150	CONSULTANT SERVICES	410095
NURSE FINDERS
PO BOX 910738	DALLAS	TX	53910	STAFFING SERVICES	392387
RADIOLOGY ASSOC NEW HARTFORD
185 GENESEE STREET STE 600	UTICA	NY	13501	RADIOLOGY SERVICES	302085

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	15	NumberOfContractorsGT100K
Government Grants	2366682	GovernmentGrants
All Other Contributions	470709	AllOtherContributions
Noncash Contributions	144129	NoncashContributions
Total Contributions	2837391	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	HOSPITAL	Description
Business Code	621990	BusinessCode
Total Revenue Column	88352403	TotalRevenueColumn
Related Or Exempt Function Income	88352403	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	88352403	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	45697	TotalRevenueColumn
Exclusion	$45,697	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	153075	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	187978	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	-34903	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-34903	TotalRevenueColumn
Exclusion	-$34,903	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	146018	Securities
Other	51201	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	104886	Securities
Other	42305	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	41132	Securities
Other	8896	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	50028	TotalRevenueColumn
Exclusion	$50,028	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
CAFETERIA SALES	722210	256401	0	$256,401
ACCOUNTING & CONSULTING	541200	180000	180000
GAIN LOSS CHANGE ANGEL FUND	900099	10624		$10,624

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	547858	TotalRevenueColumn
Unrelated Business Revenue	95607	UnrelatedBusinessRevenue
Exclusion	$452,251	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	994883	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	92245499	TotalRevenueColumn
Related Or Exempt Function Income	88352403	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	275607	UnrelatedBusinessRevenue
Exclusion	$780,098	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	882024	Total
Management And General	882024	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	39334766	Total
Program Services	33633405	ProgramServices
Management And General	5701361	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	1626292	Total
Program Services	1365672	ProgramServices
Management And General	260620	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	6558735	Total
Program Services	6547209	ProgramServices
Management And General	11526	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	2960910	Total
Program Services	2476217	ProgramServices
Management And General	484693	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	37565	Total
Management And General	37565	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	213760	Total
Management And General	213760	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	26098	Total
Management And General	26098	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	437868	Total
Program Services	142587	ProgramServices
Management And General	295281	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	982917	Total
Program Services	207183	ProgramServices
Management And General	775734	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	776275	Total
Program Services	641408	ProgramServices
Management And General	134867	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	86613	Total
Program Services	56745	ProgramServices
Management And General	29868	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	71114	Total
Program Services	33694	ProgramServices
Management And General	37420	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	692993	Total
Program Services	684650	ProgramServices
Management And General	8343	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	5117785	Total
Program Services	3563111	ProgramServices
Management And General	1554674	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	849783	Total
Program Services	80815	ProgramServices
Management And General	768968	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
PURCHASE SERVICES	7805633	7265628	540005
BAD DEBT EXPENSE	6381051	6381051
SUPPLIES	6088424	6045967	42457
PHARMACY	3048088	3048088

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	7637323	Total
Program Services	4207029	ProgramServices
Management And General	3430294	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	91616017	Total
Program Services	76380459	ProgramServices
Management And General	15235558	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	2912737	BOY
EOY	3384532	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	3721436	BOY
EOY	2874389	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	14528649	BOY
EOY	14656436	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	1685833	BOY
EOY	1706342	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	2152446	BOY
EOY	1954263	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	959969	BOY
EOY	1421058	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	83575286	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	45928086	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	39514857	BOY
EOY	37647200	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	2734213	BOY
EOY	4266855	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	68210140	BOY
EOY	67911075	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	12560830	BOY
EOY	13752691	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	19697813	BOY
EOY	17015223	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	6215000	BOY
EOY	5855000	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	6069647	BOY
EOY	6574210	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	44543290	BOY
EOY	43197124	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	23078501	BOY
EOY	23835179	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2408	BOY
EOY	292831	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	585941	BOY
EOY	585941	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	23666850	BOY
EOY	24713951	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	68210140	BOY
EOY	67911075	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	629482	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	159253	ReconciliationUnrealizedInvest
Reconcilation Other Changes	258366	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	1	DirectContactLegislators
Direct Contact Legislators	$22,028	DirectContactLegislatorsAmount
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	0	OtherActivities
Total Lobbying Expenditures IIB	22028	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	$22,028 REPRESENTS THE PORTION OF THE 2012 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.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	643953	BeginningOfYearBalance
Investment Earnings Or Losses	314851	InvestmentEarningsOrLosses
Other Expenditures	5328	OtherExpenditures
End Of Year Balance	953476	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	624541	BeginningOfYearBalance
Contributions	1890	Contributions
Investment Earnings Or Losses	33673	InvestmentEarningsOrLosses
Other Expenditures	16151	OtherExpenditures
End Of Year Balance	643953	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	591605	BeginningOfYearBalance
Contributions	4471	Contributions
Investment Earnings Or Losses	28465	InvestmentEarningsOrLosses
End Of Year Balance	624541	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	338312	BeginningOfYearBalance
Contributions	120609	Contributions
Investment Earnings Or Losses	132684	InvestmentEarningsOrLosses
End Of Year Balance	591605	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	33374	BeginningOfYearBalance
Contributions	304938	Contributions
End Of Year Balance	338312	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.33000	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.61000	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.06000	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	43132938	OtherCostOrOtherBasis
Depreciation	17666504	Depreciation
Book Value	25466434	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2213559	OtherCostOrOtherBasis
Depreciation	2168575	Depreciation
Book Value	44984	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	34973229	OtherCostOrOtherBasis
Depreciation	24131589	Depreciation
Book Value	10841640	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	3255560	OtherCostOrOtherBasis
Depreciation	1961418	Depreciation
Book Value	1294142	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	37647200	TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescription	Book ValueBookValue
NET ASSETS OF FOUNDATION	965460
OTHER LONG TERM ASSETS	3214126
BOND AMORTIZATION	87269

Field	Value	IRS element (for citing)
Total Book Value Other Assets	4266855	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescription	AmountAmount
LINE OF CREDIT	$2,000,000
ASSET RETIREMENT	$4,004,210
ADVANCE FROM THIRD PARTIES	$570,000

Field	Value	IRS element (for citing)
Total Of Amounts	6574210	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	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.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	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, 2012 AND 2011, 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 2009 THROUGH 2012. 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)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent100	X	Pcent100
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	0	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	0	AmountsBudgetedForCharityCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1105178	TotalCommunityBenefitExpense
Direct Offsetting Revenue	386223	DirectOffsettingRevenue
Net Community Benefit Expense	718955	NetCommunityBenefitExpense
Percent Of Total Expense	0.00840	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	20627118	TotalCommunityBenefitExpense
Direct Offsetting Revenue	17859927	DirectOffsettingRevenue
Net Community Benefit Expense	2767191	NetCommunityBenefitExpense
Percent Of Total Expense	0.03250	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	529136	TotalCommunityBenefitExpense
Direct Offsetting Revenue	355088	DirectOffsettingRevenue
Net Community Benefit Expense	174048	NetCommunityBenefitExpense
Percent Of Total Expense	0.00200	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	22261432	TotalCommunityBenefitExpense
Direct Offsetting Revenue	18601238	DirectOffsettingRevenue
Net Community Benefit Expense	3660194	NetCommunityBenefitExpense
Percent Of Total Expense	0.04290	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	80914	TotalCommunityBenefitExpense
Direct Offsetting Revenue	11281	DirectOffsettingRevenue
Net Community Benefit Expense	69633	NetCommunityBenefitExpense
Percent Of Total Expense	0.00080	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	30020	TotalCommunityBenefitExpense
Direct Offsetting Revenue	25411	DirectOffsettingRevenue
Net Community Benefit Expense	4609	NetCommunityBenefitExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	110934	TotalCommunityBenefitExpense
Direct Offsetting Revenue	36692	DirectOffsettingRevenue
Net Community Benefit Expense	74242	NetCommunityBenefitExpense
Percent Of Total Expense	0.00090	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	22372366	TotalCommunityBenefitExpense
Direct Offsetting Revenue	18637930	DirectOffsettingRevenue
Net Community Benefit Expense	3734436	NetCommunityBenefitExpense
Percent Of Total Expense	0.04380	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Total Community Building Expense	4579	TotalCommunityBuildingExpense
Direct Offsetting Revenue	360	DirectOffsettingRevenue
Net Community Building Expense	4219	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Total Community Building Expense	4479	TotalCommunityBuildingExpense
Net Community Building Expense	4479	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	331366	TotalCommunityBuildingExpense
Net Community Building Expense	331366	NetCommunityBuildingExpense
Percent Of Total Expense	0.00390	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Total Community Building Expense	20565	TotalCommunityBuildingExpense
Direct Offsetting Revenue	20565	DirectOffsettingRevenue

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	360989	TotalCommunityBuildingExpense
Direct Offsetting Revenue	20925	DirectOffsettingRevenue
Net Community Building Expense	340064	NetCommunityBuildingExpense
Percent Of Total Expense	0.00400	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$2,124,902	BadDebtExpenseAmount
Amount Attributable To	223484	AmountAttributableTo
Amount Reimbursed By Medicare	23495189	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	27362587	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-3867398	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	0	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

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

Field	Value	IRS element (for citing)
Description Ent Primary Activity	SEE SCHEDULE R PART VII	DescriptionEntPrimaryActivity
Organization Profit Or Ownership	0.30000	OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership	0.00000	OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership	0.70000	PhysicansProfitOrOwnership

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

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

Address Address

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	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Other	X	Other
Needs Assessment Conducted	09	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	1	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	0	AllNeedsAddressed
Organization Incur Excise Tax	0	OrganizationIncurExciseTax
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	100.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	300.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Insurance Status	X	InsuranceStatus
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	12	NumberOfOtherFacilities

Other Facilities OtherFacilities (12 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
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

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 6A: ROME MEMORIAL HOSPITAL'S SECOND UPDATE OF ITS 2009-2012 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 2010-2013 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 CLACULATED 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, L7 COL(F): PERCENT OF TOTAL EXPENSE IS CALCULATED BY USING THE DENOMINATOR OF THE TOTAL FUNCTIONAL EXPENSES LESS BAD DEBT EXPENSE OF $6,519,067 (PER AUDITED FINANCIAL STATEMENTS).
PART II: PART I 7E,7F,7J: ROME MEMORIAL HOSPITAL HAS MAINTAINED A LONG-STANDING COMMITMENT TO WELLNESS AND PREVENTION THROUGH AN ACTIVE EDUCATION DEPARTMENT THAT PROVIDES ONGOING HEALTH EDUCATION LECTURES AND FREE SCREENINGS. IN ADDITION, THE HOSPITAL ASSURES ACCESS TO SERVICES BY CONTINUING TO PROVIDE CRITICAL SERVICES TO THE COMMUNITY, EVEN THOUGH THEY ARE OPERATED AT A LOSS TO THE HOSPITAL. THESE ARE SOME OF THE HOSPITAL'S PROGRAMS THAT SUPPORT THE STATE'S PREVENTION AGENDA AND PROMOTE HEALTH IN OUR COMMUNITY: HEALTHY MOTHERS, HEALTHY BABIES, HEALTHY CHILDREN THE MATERNITY DEPARTMENT'S WEIGH STATION PROVIDES MOTHERS WHO ARE BREASTFEEDING ADDED SUPPORT AND ENSURE THAT BABIES ARE GAINING WEIGHT AT A HEALTHY LEVEL. BABYCARE BASICS AND BREASTFEEDING EDUCATION PROGRAMS FOR NEW PARENTS HELP THEM ACQUIRE THE NECESSARY SKILLS FOR TAKING CARE OF A NEWBORN.CHRONIC DISEASE EDUCATION HEALTH NIGHT, SENIOR LIVE & LEARN, SPEAKER'S BUREAU LECTURES, AND OUTREACH AT HEALTH FAIRS PROVIDE COMMUNITY MEMBERS WITH THE LATEST INFORMATION AVAILABLE TO HELP THEM MODIFY THEIR LIFESTYLES TO PREVENT THE ONSET OF CHRONIC DISEASE OR BETTER MANAGE THEIR CHRONIC CONDITIONS. SMOKING CESSATION CLASSES FOR THE COMMUNITY AND HOSPITAL EMPLOYEES, ALONG WITH SMOKING PREVENTION PROGRAMS FOR AREA SCHOOLS PROVIDES ESSENTIAL OUTREACH TO ERADICATE THE LEADING CAUSE OF PREMATURE DEATH. SPONSORSHIP SUPPORT OF THE AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION, AMERICAN DIABETES ASSOCIATION AND OTHER HEALTH-RELATED ORGANIZATIONS TO PROVIDE FINANCIAL RESOURCES FOR EDUCATION AND RESEARCH.ACCESS TO QUALITY HEALTHCARE FREE ROUTINE SCREENINGS, INCLUDING BLOOD PRESSURE, PSAS, COLORECTAL CANCER AND DIABETES SCREENING, ARE OFFERED TO THE COMMUNITY TO PROMOTE EARLY DETECTION OF DISEASE. FACILITATED ENROLLMENT EFFORTS HELP LINK THE UNINSURED TO AVAILABLE INSURANCE OPTIONS TO ENABLE THEM TO ESTABLISH A RELATIONSHIP WITH A PRIMARY CARE PROVIDER. IMMUNIZATION CLINICS ARE OFFERED IN THE COMMUNITY TO PROTECT RESIDENTS FROM THE FLU. EFFORTS TO RECRUIT ADDITIONIAL PHYSICIANS TO THE COMMUNITY ADDRESS THE FACT THAT THE MOHAWK VALLEY REGION HAS THE WORST PHYSICIAN TO POPULATION RATIO IN ALL OF NEW YORK STATE. THE NEWLY CONSTRUCTED DIAGNOSTIC CENTER INCLUDED INVESTMENTS IN THE LATEST TECHNOLOGY INCLUDING DIGITAL MAMMOGRAPHY AND A NEW MRI TO ENHANCE THE HOSPITAL'S DIAGNOSTIC CAPABILITIES. THE HOSPITAL ADDED A NURSE NAVIGATOR TO HELP COORDINATE CARE FOR PATIENTS WITH A POTENTIAL CANCER DIAGNOSIS.PHYSICAL FITNESS AND NUTRITION AN INDOOR WALKING PROGRAM HELPS AREA RESIDENTS INCORPORATE PHYSICAL FITNESS INTO THEIR LIVES TO PREVENT CHRONIC DISEASE AND ENHANCE THEIR MENTAL HEALTH.COMMUNITY SUPPORT AND COALITION BUILDING ROME MEMORIAL HOSPITAL'S LEADERS ALSO PARTICIPATE ON NUMEROUS COMMUNITY COMMITTEES INVOLVED IN ENHANCING HEALTH CARE OUTCOMES THROUGH PREVENTION, EARLY DETECTION AND INTERVENTION, AS WELL AS EMERGENCY PREPAREDNESS ACTIVITIES TO ENSURE A COORDINATED RESPONSE IN AN EVENT OF A DISASTER.
PART III, LINE 4: SEE AUDITED FINANCIAL STATEMENTS PAGES 8 AND 12 FOR CURRENT FOOTNOTE LAUNGAGE THAT DESCRIBES BAD DEBT. PART III, LINE 6; COSTING METHODOLOGY AND SOURCE:2012 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 CONTINUES TO RISE AS RESIDENTS LOSE THEIR JOBS OR THEIR ABILITY TO AFFORD THEIR INSURANCE PREMIUMS. IN 2012, ROME MEMORIAL HOSPITAL'S BAD DEBT AND CHARITY CARE TOTALED $8.9 MILLION, COMPARED TO 8.7 MILLION IN 2011. 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 27,211 IN 2012. 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 V, SECTION B, LINE 1J: THE HOSPITAL PARTICIPATES IN THE COMPREHENSIVE COUNTY WIDE COMMUNITY NEEDS ASSESSMENT. THE COUNTY 2010 - 2013 ASSESSMENT IS AVAILABLE ONLINE AT WWW.OCGOV.NET/HEALTH/COMMUNITY.HEALTH.ASSESSMENT. SEE PART VI, LINE 2, RESPONSE BELOW FOR REQUIRED DESCRIPTIONS FOR PART VI, LINE 1 SUB-SECTIONS.	ROME MEMORIAL HOSPITAL
PART V, SECTION B, LINE 4: THE HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY THE ONEIDA AND HERKIMER COUNTY HEALTH DEPARTMENTS IN COLLABORATION WITH RMH, FAXTON-ST LUKES HEALTHCARE, ST. ELIZABETH MEDICAL CENTER, AND MULTIPLE COMMUNITY AGENCIES.	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.	ROME MEMORIAL HOSPITAL
PART VI, LINE 2: #2 NEEDS ASSESSMENT:ROME MEMORIAL HOSPITAL PARTICIPATES IN THE ASSESSMENT PROCESS LED BY THE ONEIDA COUNTY HEALTH DEPARTMENT, WHICH USES THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) FRAMEWORK TO CONDUCT THE MAJORITY OF ITS COMMUNITY HEALTH ASSESSMENT (CHA) ACTIVITIES. A COMMUNITY HEALTH ASSESSMENT PLANNING TEAM OF APPROXIMATELY 25-30 INDIVIDUALS WAS CONVENED IN JANUARY 2008 THAT CONSISTED OF THE STEERING COMMITTEE MEMBERS OF AN EXISTING COMMUNITY HEALTH PARTNERSHIP, THE ONEIDA COUNTY HEALTH COALITION, AND ADDITIONAL KEY COMMUNITY STAKEHOLDERS. THIS GROUP IS THE MAPP ADVISORY TEAM (MAT). SEVERAL SUB-COMMITTEES WERE CREATED TO ACCOMPLISH THE ASSESSMENT.THE COLLABORATING AGENCIES CONDUCTED PUBLIC VISIONING SESSIONS, HEALTHY CONVERSATION FOCUS GROUPS, AND COMMUNITY SURVEYS TO COLLECT THE PERCEPTIONS OF THOSE WHO ARE UNABLE TO ATTEND ONE OF THE FACE TO FACE SESSIONS. EFFORTS WERE MADE TO INCLUDE INPUT FROM MULTIPLE CONSTINUENCIES, INCLUDING SENIORS, FAMILIES, THE UNDERSERVED, THE BUSINESS COMMUNITY, ETC. THE SURVEY INSTRUMENT AND FOCUS GROUPS WERE PUBLICLY ADVERTISED. THE FEEDBACK FROM SURVEYS AND PUBLIC OUTREACH SESSIONS PROVIDE THE QUALITATIVE INFORMATION TO ENRICH THE STATISTICAL FINDINGS OF THE NEEDS ASSESSMENT TO ADDRESS THE PRIORITY HEALTH NEEDS OF THE COMMUNITY.BASED UPON THIS PROCESS, THE FOLLOWING FIVE ITEMS FROM NEW YORK STATE'S PREVENTION AGENDA WERE IDENTIFIED AS PRIORITIES FOR THE COUNTY:HEALTHY MOTHERS, HEALTHY BABIES, HEALTHY CHILDRENMENTAL HEALTH AND SUBSTANCE ABUSECHRONIC DISEASEACCESS TO QUALITY HEALTHCAREPHYSICAL ACTIVITY AND NUTRITIONTHE FULL 2010-2013 ONEIDA COUNTY COMMUNITY HEALTH ASSESSMENT, ALONG WITH ITS DETAILED DATA BOOK CAN BE FOUND ONLINE AT WWW.OCGOV.NET/HEALTH/COMMUNITY-HEALTH-ASSESSMENT.ROME MEMORIAL HOSPITAL ALSO PARTICIPATES AND COLLABORATES WITH NUMEROUS COMMUNITY AND PROFESSIONAL ORGANIZATIONS. WITHIN THIS FRAMEWORK, IT IS POSSIBLE TO GAIN A BETTER UNDERSTANDING OF DIFFERENT NEED PERSPECTIVES AND ALSO EVALUATE COMMUNITY RESOURCES. THE ONGOING ANALYSIS OF QUANTITATIVE AND QUALITATIVE DATA IS UTILIZED TO CREATE ROME MEMORIAL HOSPITAL'S STRATEGIC PLAN, WHICH SERVES AS A BLUEPRINT FOR ADAPTING OUR AVAILABLE RESOURCES TO RESPOND TO THE CHANGING NEEDS OF THE COMMUNITY. ALTHOUGH THE CURRENT COMMUNITY SERVICE PLAN (EFFECTIVE 9/15/2012) WAS DESIGNED TO SPECIFICALLY ADDRESS THE STATE'S PREVENTION AGENDA, IT IS IMPORTANT TO NOTE THAT RMH'S STRATEGIC PLAN INCLUDES MANY ADDITIONAL INITIATIVES TO ADDRESS OUR COMMUNITY'S NEEDS AND ENSURE THE HOSPITAL'S CONTINUED FINANCIAL VIABILITY.RMH'S STRATEGIC PLAN PROVIDES A FRAMEWORK THAT GUIDES OUR DECISIONS AND BRINGS US FOCUS. THE STRATEGIC PLAN FOR 2011-2013 HAS FOUR MAJOR OBJECTIVES THAT ARE STRAIGHT-FORWARD, YET THE TACTICS TO ACHIEVE THEM ARE MULTI-FACETED IN SCOPE.1. FOSTER A CULTURE OF PATIENT SERVICE AND PATIENT SAFETY - WITH A COMMITMENT TO CONTINUOUS QUALITY IMPROVEMENT, PROVIDE THE NECESSARY LEADERSHIP AND RESOURCES TO DELIVER EVIDENCE-BASED, PATIENT-CENTERED HEALTHCARE SERVICES IN SUPPORT OF OUR MISSION. RMH HAS BEEN VERY SUCCESSFUL IN CREATING A CULTURE OF SAFETY AND SERVICE FOR ITS PATIENTS. AN EXAMPLE OF THIS IS RMH'S STRATEGIES FOR REDUCING THE RISK OF HEALTH ACQUIRED INFECTIONS. BY ADOPTING EVIDENCE BASED PRACTICES, THE HOSPITAL HAS ELIMINATED CENTRAL LINE INFECTIONS IN ITS ICU SINCE DECEMBER 2006. THE HOSPITAL WAS ONE OF ONLY EIGHT HOSPITALS IN THE NATION TO BE RECOGNIZED BY THE U.S. DEPARTMENT OF HEATH AND HUMAN SERVICES WITH AN "OUTSTANDING LEADERSHIP AWARD" FOR PROTECTING PATIENTS FROM LIFE-THREATENING BLOODSTREAM INFECTIONS. THE HOSPITAL CONTINUED ITS COMMITTMENT TO PREVENT HEALTHCARE ACQUIRED INFECTIONS BY IMPLEMENTING NEW TECHNOLOGY THAT USES HYDROGEN PEROXIDE VAPOR TO KILL DRUG- RESISTANT BACTERIA, VIRUSES, AND FUNGI IN HARD-TO-REACH PLACES. THE BIOQUELL SYSTEM WAS PURCHASED THROUGH THE GENEROSITY OF DONORS WHO CONTRIBUTED TO THE ROME HOSPITAL FOUNDATION.THE NURSE NAVIGATOR FOR THE BREAST CENTER AT ROME MEMORIAL HOSPITAL, EARNED HER DESIGNATION OF CERTIFIED BREAST CANCER NAVIGATOR FOR FOR IMAGING AND CANCER THROUGH THE COMPLETION OF THE NATIONAL CONSRTIUM OF BREAST CENTERS' BREAST PATIENT NAVIGATOR CERTIFICATION PROGRAM.THE HOSPITAL EARNED ITS THREE-YEAR ACCREDITATION FROM THE AMERICAN COLLEGE OF RADIOLOGY FOR ITS MAGNETIC RESONANCE IMAGING, DIGITAL MAMMOGRAPHY AND COMPUTED TOMOGRAPHY (CT) SERVICES.THE HEALTHCARE ASSOCIATION OF NEW YORK STATE RECOGNIZED ROME MEMORIAL HOSPITAL FOR DEMOSTRATING COMMITTMENT TO AND EXPERTISE IN APPROVING QUALITY CARE. THE ASSOCIATION ACKNOWLEDGED THE HOSPITALS' ACHIEVEMENT IN ALIGNING MEDICINE WITH EVIDENCE-BASED PRACTICE TO IMPROVE OUTCOMES OF CRITICAL CARE VENTILATOR PATIENTS.THE HOSPITALS' LABORATORY DEPARTMENT PASSED ITS BIENNIAL NEW YORK STATE DEPARTMENT OF HEALTH INSPECTION WITH NO DEFICIENCIES. THE SLEEP DISORDERS CENTER AT ROME MEMORIAL HOSPITAL EARNED A FIVE YEAR ACCREDITATION FROM THE AMERICAN ACADEMY OF SLEEP MEDICINE (AASM).ROME MEMORIAL HOSPITAL EARNED ITS THREE YEAR ACCREDITATION FROM THE HEALTHCARE FACILITIES ACCREDITATION PROGRAM, WHICH IS AUTHORIZED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES TO VALIDATE ITS COMPLIANCE WITH FEDERAL STANDARDS.BECAUSE OF THE STAFFS' COMMITMENT TO CARING FOR THE RESIDENTS OF THE RESIDENTIAL HEALTH CARE FACILITY (RHCF) AS IF THEY WERE FAMILY, THE RHCF ALSO HAD A SUCCESSFUL SURVEY BY THE NEW YORK STATE DEPARTMENT OF HEALTH. THE HOSPITALS' PRENATAL CARE SERVICES CLINIC WAS AWARDED A $50,000 GRANT FROM THE HEALTH FOUNDATION FOR WESTERN AND CENTRAL NEW YORK TO IMPLEMENT A CENTERING PREGNANCY PROGRAM IN 2013 FOR LOW-INCOME MOTHERS-TO-BE.2. RECRUITMENT & RETENTION - CONTINUE TO RECRUIT AND RETAIN OUR MOST VALUABLE RESOURCES, OUR PHYSICIANS AND EMPLOYEES, WHO CONSISTENTLY DEMONSTRATE OUR ORGANIZATIONAL MISSION AND VISION. DURING 2012 RMH WELCOMED 66 NEW DOCTORS AND ALLIED HEALTH PROFESSIONALS ON STAFF.IN ADDITION, RMH WAS RECOGNIZED BY THE AMERICAN HEART ASSOCIATION AS A "FIT-FRIENDLY WORKSITE".3. INFORMATION TECHNOLOGY - TO EXTEND THE SCOPE AND APPLICATION OF INFORMATION TECHNOLOGY (IT) ACROSS THE CONTINUUM OF CARE, TO ENHANCE PATIENT SAFETY, EFFICIENCY AND AVAILABILITY OF INFORMATION. AFTER 18 MONTHS OF ASSESSING, BUILDING, TESTING AND TRAINING, RMH WENT LIVE ON A NEW HEALTH INFORMATION SYSTEM (HIS) JULY 2011 TO BETTER FACILITATE THE PROCESSING AND EXCHANGE OF CLINICAL, STATISTICAL, AND FINANCIAL INFORMATION. THE NEW HIS REPLACES MORE THAN 30 SEPARATE FINANCIAL, CLINICAL, AND ADMINISTRATIVE SYSTEMS - EVERYTHING FROM PATIENT REGISTRATION, BILLING AND PAYROLL TO PATIENT SCHEDULING, NURSING DOCUMENTATION, AND MEDICATION ADMINISTRATION. THE PROJECT INCLUDES SEVERAL NEW APPLICATIONS THAT ADDRESS THE HOSPITAL'S GOALS OF 1)CONVERTING FROM A PAPER-BASED PATIENT MEDICAL RECORD TO A FULLY ELECTRONIC HEALTH RECORD AND 2) PROVIDING ONLINE CLINICAL DECISION SUPPORT TO STANFARDIZE CARE, ADVANCE PATIENT SAFETY, AND ACHIEVE BETTER OUTCOMES.4. OPTIMIZE FINANCIAL PERFORMANCE BY --ENGAGING IN PRUDENT, ETHICAL BUSINESS PRACTICES TO OPTIMIZE PROFITABILITY THAT ALLOW US TO MEET THE PRIORITY HEALTHCARE NEEDS OF OUR COMMUNITY. THE STRATEGIES THAT ROME MEMORIAL HOSPITAL IMPLEMENTED IN 2012 TO DELIVER COST EFFECTIVE QUALITY CARE INCLUDED:EYE CENTER: A NEW EYE CENTER AT GRIFFISS BUSINESS & TECHNOLOGY PARK OPENED MARCH 2012. THE JOINT VEBNTURE BETWEEN THE HOSPITAL AND ITS THREE OPTHALMOLOGISTS PROVIDES PATIENTS WITH A NEW STATE OF THE ART FACILITY THAT SPECIALIZES IN CATERACT, GLAUCOMA, AND EYELID SURGERY PROCEDURES. HOSPITALISTS: IN EARLY 2012 RMH LAUNCHED A NEW 24-HOUR HOSPITALIST PROGRAM TO PROVIDE COVERAGE FOR PATIENTS WHO DO NOT HAVE A PRIMARY CARE PHYSICIAN WHEN THEY ARE ADMITTED TO THE HOSPITAL. IN ADDITION, THE PROGRAM GIVES PHYSICIANS ON THE HOSPITAL'S MEDICAL STAFF THE OPTION OF UTILIZING THE HOSPITALISTS TO ATTEND TO THEIR PATIENTS SO THEY ARE ABLE TO FOCUS ON THEIR OFFICE PRACTICE.STEREOTACTIC BREAST BIOPSY: IN APRIL 2012, RMH INVESTED IN STEREOTACTIC BREAST BIOPSY TECHNOLOGY TO PROVIDE WOMEN WITH THE MOST MINIMALLY INVASIVE PROCEDURE POSSIBLE TO DIAGNOSE BREAST CANCER. THE HOSPITAL SELECTED THE NEW HOLOGIC MULTICARE (TM) PLATINUM PRONE BREAST BIOPSY TABLE FOR ITS DIAGNOSTIC PRECISION ANDPATIENT COMFORT. THE ADVANCED COMFORT PACKAGE INCLUDES ADJUSTABLE PADDING TO POSITION PATIENTS OF ALL SIZES FOR THEIR COMFORT.LYMPHEDEMA: IN JULY 2012, RMH EXPANDED ITS THERAPY SERVICES TO PROVIDE LYMPHEDEMA CARE TO ADDRESS THE TWO TO THREE MONTH WAITING LIST FOR LYMPHEDEMA SERVICES IN THE COMMUNITY. UPON COMPLETION OF THE THERAPY PROGRAM, PATIENTS LEAVE WITH SKILLS NECESSARY TO MANAGE THEIR SYMPTOMS AT HOME.
PART VI, LINE 3: #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: #4 COMMUNITY INFORMATION:ROME MEMORIAL HOSPITAL SERVES THE RESIDENTS OF ROME, A CITY OF 33,660 PEOPLE, AS WELL AS THE SURROUNDING RURAL TOWNS AND VILLAGES IN ONEIDA COUNTY. THE POPULATION OF THE PRIMARY MARKET IS APPROXIMATELY 100,000 PEOPLE. FOR SELECTED SPECIALTIES, SUCH AS SENIOR BEHAVIORAL HEALTH CARE, RMH'S SERVICE AREA EXTENDS INTO THE SURROUNDING COUNTIES OF MADISON, HERKIMER, LEWIS AND ONONDAGA COUNTIES.ACCORDING TO THE MOST RECENT CENSUS ESTIMATES AVAILABLE, OVERALL POPULATION GROWTH HAS DECLINED APPROXIMATELY 2.0% IN THE CITY OF ROME AND ONEIDA COUNTY SINCE 2000. RESEARCH SHOWS THAT SOCIOECONOMIC CHARACTERISTICS HAVE AN IMPACT ON COMMUNITY HEALTH AND ARE AS IMPORTANT TO HEALTH STATUS AS OUR GENES, OUR BEHAVIORS AND EVEN ACCESS TO MEDICAL CARE. WHEN COMPARED AGAINST STATE FIGURES, THE POPULATION IN ROME AND ONEIDA COUNTY IS OLDER, LESS EDUCATED AND EARNS LESS THAN THE AVERAGE NEW YORKER, WHICH PUTS THEM AT HIGHER RISK FOR HEALTH PROBLEMS. IN ONEIDA COUNTY, OVER 15% OF ADULTS OF ALL INCOMES AGED 18-64 ARE UNINSURED; THIS RATE IS HIGHER THAN NEW YORK STATE (EXCLUDING NEW YORK CITY) AT 13.6%. APPROXIMATELY 6% OF CHILDREN AGED 18 AND YOUNGER LACK INSURANCE. IN ADDITION, ACCORDING TO THE MOST RECENT ONEIDA COUNTY COMMUNITY HEALTH ASSESSMENT 2010 - 2013, THE NUMBER OF MEDICAID ELIGIBLE CHILDREN AGED 12-17 INCREASED FROM 3,970 IN 2000 TO 5,954 IN 2005. CHILD HEALTH PLUS ENROLLMENT FOR ONEIDA COUNTY WAS 5,454 AS OF JULY 2009. THE NUMBER OF MEDICAID ELIGIBLE ADULTS IN ONEIDA COUNTY AGED 18 AND OLDER INCREASED 18% FROM 22,398 IN 2000 TO 26,346 IN 2005.THE CHALLENGE IS COMPOUNDED BY THE FACT THAT ONEIDA COUNTY IS A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. IN ADDITION, THE CITY OF ROME AND TOWNS OF AVA, BOONVILLE, FORESTPORT, FLOYD, LEE, VERONA, WESTERN, ANNSVILLE, CAMDEN, FLORENCE AND VIENNA ARE FEDERALLY-DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREAS, WITH AN INADEQUATE NUMBER OF PRIMARY MEDICAL CARE PROVIDERS TO SERVE THE COMMUNITY.THE FOLLOWING TABLE HIGHLIGHTS AVAILABLE DEMOGRAPHIC AND SOCIOECONOMIC CHARACTERISTICS OF OUR COMMUNITY.SOCIO-ECONOMIC PROFILE ONEIDA COUNTY NEW YORKPOPULATION, 2012 ESTIMATE 233,556 19,570,261POPULATION, % CHANGE, APRIL 2010 TO JULY 2012 -.6% 1.0%POPULATION, 2010 234,878 18,378,102PERSONS UNDER 5 YEARS OLD, PERCENT, 2011 5.6% 6.0%PERSONS UNDER 18 YEARS OLD, PERCENT, 2011 21.5% 22.0%PERSONS 65 YEARS OLD AND OVER, PERCENT, 2011 16.5% 13.7%FEMALE PERSONS, PERCENT, 2011 50.2% 51.5% ONEIDA COUNTY NEW YORKWHITE PERSONS, PERCENT, 2011 (A) 88.2% 71.5%BLACK PERSONS, PERCENT, 2011 (A) 6.7% 17.5%AMERICAN INDIAN/ALASKA NATIVE PERSONS,%,2011(A) 0.3% 1.0%ASIAN PERSONS, %, 2011 (A) 2.9% 7.8%NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER, %,2011(A) .1% .1%PERSONS REPORTING TWO OR MORE RACES, %, 2011 1.8% 2.2%PERSONS OF HISPANIC OR LATINO ORIGIN, %, 2011(B) 4.8% 18.0%WHITE PERSONS NOT HISPANIC, PERCENT, 2011 84.6% 58.0% ONEIDA COUNTY NEW YORK FOREIGN BORN PERSONS, PERCENT, 2007-2011 6.9% 21.8%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME, PCT AGE 5+, 2007-2011 11.1% 29.5%HIGH SCHOOL GRADUATES, PERCENT OF PERSONS AGE 25+, 2007-2011 86.4% 84.6%BACHELOR'S DEGREE OR HIGHER, PCT OF PERSONS AGE 25+, 2006-2010 21.9% 32.5%VETERNS, 2007-2011 20,655 986,313 ONEIDA COUNTY NEW YORK HOUSING UNITS, 2011 104,235 8,119,364HOMEOWNERSHIP RATE, 2007-2011 68.0% 54.8%HOUSING UNITS IN MULTI-UNIT STRUCTURES, %,2007-2011 30.9% 50.5%MEDIAN VALUE OF OWNER-OCCUPIED HOUSING UNITS, 2007-2011 $106,200 $301,000 ONEIDA COUNTY NEW YORKHOUSEHOLDS, 2007-2011 91,568 7,215,687PERSONS PER HOUSEHOLD, 2007-2011 2.4 2.59MEDIAN HOUSEHOLD INCOME, 2007-2011 $48,382 $56,951PER CAPITA MONEY INCOME, 2007-2011 $24,459 $31,796PERSONS BELOW POVERTY LEVEL, PERCENT, 2007-2011 15.1% 14.5% ROME NEW YORKPOPULATION, 2011 ESTIMATE 33,660 19,501,616POPULATION, % CHANGE, 4/1/2000 TO 7/1/2006 -2.0% .6%POPULATION, 2010 33,725 19,378,102PERSONS UNDER 5 YEARS OLD, PERCENT, 2010 6.1% 6.0%PERSONS UNDER 18 YEARS OLD, PERCENT, 2010 20.9% 22.3%PERSONS 65 YEARS OLD AND OVER, PERCENT, 2010 16.5% 13.5%FEMALE PERSONS, PERCENT, 2010 48.6% 51.6% ROME NEW YORKWHITE PERSONS, PERCENT, 2010 (A) 87.4% 65.7%BLACK PERSONS, PERCENT, 2010 (A) 7.1% 15.9%AMERICAN INDIAN & ALASKA NATIVE PERSONS, %, 2010 (A) 0.3% 0.6%ASIAN PERSONS, PERCENT, 2010 (A) 1.1% 7.3%NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER,%, 2010 (A) Z 0.0%PERSONS REPORTING TWO OR MORE RACES, PERCENT, 2010 2.7% 3.0%PERSONS OF HISPANIC OR LATINO ORIGIN, %, 2010 (B) 5.3% 17.6% ROME NEW YORK LIVING IN SAME HOUSE 1 YEAR & OVER, 2007-2011 81.7% 88.5%FOREIGN BORN PERSONS, PERCENT, 2007-2011 4.3% 21.8%LANGUAGE OTHER THAN ENGLISH SPOKEN AT HOME, PCT AGE 5+,2007-2011 8.5% 29.5%HIGH SCHOOL GRADUATES, % PERSONS AGE 25+,2007-2011 84.6% 84.6%BACHELOR'S DEGREE OR HIGHER, PCT OF PERSONS AGE 25+,2007-2011 17.4% 32.5% ROME NEW YORKHOUSING UNITS, 2010 14,893 8,108,103HOMEOWNERSHIP RATE, 2007-2011 58.2% 54.8%MEDIAN VALUE OF OWNER-OCCUPIED HOUSING UNITS, 2007-2011 $88,000 $301,000 ROME NEW YORK HOUSEHOLDS, 2007-2011 13,418 7,215,687PERSONS PER HOUSEHOLD, 2007-2011 2.26 2.59MEDIAN HOUSEHOLD INCOME, 2007-2011 $44,209 $56,951PER CAPITA MONEY INCOME, 2007-2011 $22,265 $31,796PERSONS BELOW POVERTY, PERCENT, 2007-2011 15.5% 14.5% SOURCE: US CENSUS BUREAU STATE & COUNTY QUICKFACTS
PART VI, LINE 5: #5 PROMOTION OF COMMUNITY HEALTH: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: #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.
NY	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
BASIL ARIGLIO
CEO	252844	0	23994	0	0	0	0	0	14320	0	291158	0	0	0
NICHOLAS MAYHEW
CFO	191518	0	18544	0	11868	0	0	0	14232	0	236162	0	0	0
WALEED ALBERT MD
CMO	155119	0	0	0	0	0	0	0	8343	0	163462	0	0	0
RAY CARNIVALE
COO	168213	0	16000	0	0	0	0	0	7030	0	191243	0	0	0
SCOTT BURNS
PHARMACY DIRECTOR	130589	0	0	0	7973	0	0	0	14096	0	152658	0	0	0
BRUCE PETERSON
AVP/CIO	147648	0	10000	0	8603	0	0	0	14141	0	180392	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII

Field	Value	IRS element (for citing)
Return Reference	PART I, LINE 1A	ReturnReference
Explanation	TYPE OF BENEFIT: PAYMENT OF 2012 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 2012 FOR PERSON LISTED ABOVE.	Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCd	Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
ONEIDA COUNTY INDUSTRIAL DEVELOPMENT AGENCY
A	166158201	6824621LE	2005-06-16	11900000	FINANCE CONSTRUCTION	0	1	0
ONEIDA COUNTY LOCAL DEVELOPMENT CORPORATION
B	273190422		2010-12-30	6900000	FINANCE MRI CONSTRUCTION	0	1	0
DORMITORY AUTHORITY OF THE STATE OF NEW YORK
C	146000293		2011-10-27	7500000	FINANCE EQUIPMENT THROUGH CAPITAL LEASE AGREEMENT	0	1	0
DORMITORY AUTHORITY OF THE STATE OF NEW YORK
D	146000293		2007-09-21	1858108	FINANCE EQUIPMENT THROUGH CAPITAL LEASE AGREEMENT- CAT SCANN	0	1	0

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCd	Total ProceedsTotalProceeds	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Year Of Subst CompletionYearOfSubstCompletion	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind	Capitalized InterestCapitalizedInterest	Capital ExpendituresCapitalExpenditures	Refunding EscrowRefundingEscrow
A	11900000	509090	2006	1	1
B	6900000	222845	2009	1	1	29713	5999546
C	7500000	58827	2011	1	1	13726		565429
D	1858108		2007	1	1

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCd	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Engage Bond Counsel ContractsEngageBondCounselContracts	Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest
A	1	1	1
B	0		1
C	1	1	1
D	1	1	1

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiled	Rebate Not Due YetRebateNotDueYet	Exception To RebateExceptionToRebate	No Rebate DueNoRebateDue	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Business Name Line2NameOfHedgeProvider/BusinessNameLine2	Term Of HedgeTermOfHedge	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Written Proc To Monitor ReqsWrittenProcToMonitorReqs
MANUFACTURERS AND
A	0	0	0	0	1	1	TRUST	5.000000000000	0	1	0	0	0
(no name)
B	0	0	0	0	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

Form990 Schedule K Part VI Form990ScheduleKPartVI

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

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

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)
Issuer EIN	146000293	IssuerEIN
Date Issued	2009-12-01	DateIssued
Issue Price	1935034	IssuePrice
Description Of Purpose	FINANCE EQUIPMENT THROUGH CAPITAL LEASE AGREEMENT - MRI EQUIPMENT	DescriptionOfPurpose
Defeased	0	Defeased
On Behalf Of Issuer	1	OnBehalfOfIssuer
Pool Financing	0	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Total Proceeds	1935034	TotalProceeds
Issuance Costs From Proceeds	15338	IssuanceCostsFromProceeds
Year Of Subst Completion	2009	YearOfSubstCompletion
Current Refunding	0	CurrentRefunding
Advance Refunding	0	AdvanceRefunding
Final Allocation Made	1	FinalAllocationMade
Adequate Books And Recds Maintaind	1	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedProperty
Any Lease Arrangements	0	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	1	MngmentCntrctBondFinancdPrprty
Engage Bond Counsel Contracts	1	EngageBondCounselContracts
Any Research Agreements	0	AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test	1	BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs	0	NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiled
Rebate Not Due Yet	0	RebateNotDueYet
Exception To Rebate	0	ExceptionToRebate
No Rebate Due	0	NoRebateDue
Variable Rate Issue	0	VariableRateIssue
Hedge Identified In Books And Recds	0	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGIC
Gross Proceeds Invested	0	GrossProceedsInvested
Written Proc To Monitor Reqs	0	WrittenProcToMonitorReqs

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
MARY ANN JONES
SISTER OF KEY EMPLOYEE	25987	COMPENSATION	0
SCOTT A GWILT
SON IN LAW OF BOARD DIRECTOR	38977	COMPENSATIONCOMPENSATION	0

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable (2 entries)

Non Cash CheckboxNonCashCheckbox	DescriptionDescription	Number Of ContributionsNumberOfContributions	Noncash Contribs Rptd F990NoncashContribsRptdF990	Method Of Determining RevenuesMethodOfDeterminingRevenues
X	MEDICAL EQUIPMENT	5	78681	ACTUAL INVOICE COST
X	2 NORTH RENOV/WOMENS HEALTH SVCS PROJECT	2	65448	ACTUAL INVOICE COST

Field	Value	IRS element (for citing)
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts	1	ReviewProcessUnusualNCGifts
Third Parties Used	0	ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
NEW PROGRAM SERVICES	FORM 990, PART III, LINE 2	IN 2012 ROME MEMORIAL HOSPITAL ENGAGED IN THE FOLLOWING THREE SIGNIFICANT PROGRAM CHANGES: 1. A NEW EYE CENTER AT GRIFFIS BUSINESS & TECHNOLOGY PARK OPENED IN MARCH 2012 IN COLLABORATION WITH AREA OPHTHALMOLOGISTS. 2. IN APRIL 2012, ROME MEMORIAL HOSPITAL INVESTED IN STEREOTACTIC BREAST BIOPSY TECHNOLOGY TO PROVIDE WOMEN WITH THE MOST MINIMALLY INVASIVE PROCEDURE POSSIBLE TO DIAGNOSE BREAST CANCER. 3. IN JULY 2012, ROME MEMORIAL HOSPITAL EXPANDED ITS THERAPY SERVICES TO PROVIDE LYMPHEDEMA CARE TO ADDRESS THE TWO TO THREE MONTH WAITING LIST FOR LYMPHEDEMA SERVICES IN THE COMMUNITY.
	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 2012 990 WAS PRESENTED TO THE BOARD BY THE CFO OF THE HOSPITAL AT ITS OCTOBER 2013 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.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 9:	TOTAL CHANGE IN INTEREST IN FOUNDATION 258,366.
	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 COMMITTEE 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

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Controlled OrgControlledOrg	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

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

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

Address US AddressUS

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 Activity	SEE SCHEDULE R, PART VII	PrimaryActivity
Legal Domicile State	NY	LegalDomicileState
Predominant Income Type	INVESTMENT	PredominantIncomeType
Share Of Total Income	-75885	ShareOfTotalIncome
Share Of EOY Assets	-31288	ShareOfEOYAssets
Disproportionate Allocations	0	DisproportionateAllocations
General Or Managing Partner	0	GeneralOrManagingPartner
Percentage Ownership	0.30000	PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership	Controlled OrgControlledOrg
RMH SERVICES INC
1500 N JAMES STREET	ROME	NY	13440	161490045	FOR PROFIT	NY	GREATER ROME AFFILIATES	C	-9566	2676163	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 Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

Field	Value	IRS element (for citing)
Identifier	GRIFFIS EYE CENTER, LLC. PRIMARY ACTIVITY:	Identifier
Return Reference	SCHEDULE R, PART III, COLUMN (B)	ReturnReference
Explanation	SINGLE SPECIALTY AMBULATORY SURGERY CENTER SPECIALIZING IN AND PROVIDING ONLY OPHTHALMOLOGY SERVICES.	Explanation