2013-11-13T09:26:33-07:00 2012-12-31 990 2012-01-01 160844109 GENESEE REGION HOME CARE ASSOCIATION INC GENE 5852141000 165 Court Street Rochester NY 14647 Terrence Tehan 5852384366 2013-11-15 2012 2016-03-07 17:11:31Z Lifetime Care Patricia Heffernan 3111 Winton Road South Rochester NY 14623 94874680 0 X www.lifetimecare.org X 1960 NY To deliver compassionate, personalized care to adults and children who are ill, injured, dying, or grieving. 14 13 1083 379 32206 31206 376385 335846 83718775 92054047 157578 402312 101771 88084 84354509 92880289 0 0 0 0 48487715 53831246 0 0 22346 35277724 37413860 83765439 91245106 589070 1635183 45732477 47235462 23232955 23187427 22499522 24048035 To deliver compassionate, personalized care to adults and children who are ill, injured, dying, or grieving. 0 0 27012906 0 29471190 Home Health Care: Home Health Skilled Nursing and Related Services - Provides a coordinated program of nursing care to patients in their homes under the supervision of their private physicians. (192,635 Visits) 14471418 0 20108063 Hospice Care: Hospice Skilled Nursing Facility Services - Provides an organized program of Hospice Care to patients in nursing homes. (82,047 Days of Care) 905016 0 905016 Health Care Equipment & Supplies Provision: Equipment, Material/Management - Provides patients with necessary medical related equipment for homecare. (365 Days per year) 4648769 0 8621989 Home Health Care: Home Health Aides - Provides services in the home to persons who require trained medical services. (104,339 Visits) 12320108 14130735 Home Health Care: Certified Home Health Services - Provides for services in the home to persons requiring occupational, physical, and speech therapy, infusion drugs, ambulance service, neurorehab services, drugs and medical social work. (99,266 Visits) 3639418 5186593 Hospice Care: Hospice Home Care Services - Provides an organized program of Hospice care to patients in their homes under the supervision of their private physicians. (36,623 Days) 3563222 3617820 Hospice Care: Hospice Inpatient Services - Provides an organized program of Hospice care to patients who are receiving inpatient care. (3,148 Days of Care) 2490451 2490451 Patient & Family Support Programs, General/Other: Compassionet - Provides services to terminally ill children to pay for costs not covered by insurance. (456 Families Served) 6290035 7522190 Pharmacy: Provide drugs and pharmacy supplies to patients in their homes. 32952003 0 41569778 75341343 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 1 259 0 1 1083 1 1 1 0 0 0 0 0 X 14 13 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 NY X Terrence Tehan 5852141033 165 Court Street Rochester NY 14647 X David Klein 0.4 40.00 X X 0 20706291 23729 Manuel Matos MD 0 0 X 0 0 0 Hank Stuart 0 0 X X 0 27535 0 Sy Zivan 0 0 X 0 0 0 Hilda Rosario-Escher 0 0 X 0 0 0 John Biemiller 0 0 X 0 0 0 Jordon Brown 0 0 X X 0 0 0 Marilyn Dollinger 0 0 X 0 0 0 Jagat Mehta MD 0 0 X 0 0 0 Joseph Kurnath MD 0 0 X X 0 45711 0 William A Johnson Jr 0 0 X 0 0 0 Mordecai Kolko 0 0 X 0 0 0 Jay Mahoney 0 0 X 0 0 0 David Reh 0 0 X 0 0 0 Suzanne Brown 0 40 X X 0 106198 29613 Patricia Heffernan 0.00 40.00 X 0 342804 60156 Margaret Cassady 0.00 40.00 X 0 289932 35390 Terrence Tehan 0.00 40.00 X 0 292284 55532 James Wood 40 0 X 183533 0 1934 David Wastowicz 40 0 X 141794 0 26327 Jeanne Chirico 40 0 X 140198 0 7513 Barbara Giehl 40 0 X 137093 0 8216 Nancy Horn 40 0 X 135118 0 15878 Casper Sedgwick 0 0 X 0 68442 0 737736 21879197 264288 10 1 1 0 Sibley Nursing Personnel SVC 3111 Winton Road South Rochester NY 14623 Nrsg and Home Hlth Aides 736646 Interim Healthcare of New York 347 East Avenue Rochester NY 14604 Home Health Aides 334805 Lechase Construction 300 Trolley Boulevard Rochester NY 14606 Building Maintenance 333071 Misys Healthcare 8529 Six Forks Road Raleigh NC 27615 Computer Sytem Support 188223 Rural Metro Medical 177 University Avenue Rochester NY 14605 Home Health Aides 144323 8 0 0 48660 0 26378 260808 0 335846 Home Health Care Services 621610 92054047 92054047 0 0 0 0 0 0 92054047 106326 0 0 106326 0 0 0 0 0 0 0 0 174808 0 63353 0 111455 0 111455 0 32206 79249 2194165 0 1898179 0 295986 0 295986 0 0 295986 9488 48660 32859 -23371 0 -23371 0 92880289 92054047 32206 458190 0 44975460 36457317 8501600 16543 295278 235570 59708 5205441 4335752 867661 2028 3355067 2765886 587919 1262 210000 210000 135485 9880 125605 142502 142502 27562223 26021031 1541192 317148 317148 2207839 1257615 947711 2513 420333 43968 376365 1726352 801790 924562 2129735 1949349 180386 52574 14088 38486 925796 635796 290000 3406 3406 Other Expenses 783083 102919 680164 0 Bad Debt Expense 496976 496976 0 0 Employee Referrals 300408 0 300408 0 91245106 75341343 15881417 22346 3950 3950 7751949 6323197 50208 0 11328513 14289771 0 0 0 0 801030 783788 8111287 3168470 6584687 4942817 2859401 1621722 0 0 5109000 6409000 11243739 12861217 45732477 47235462 19953107 19225396 775160 1069003 454984 2049704 2893028 23232955 23187427 X 22499522 24048035 0 0 0 0 22499522 24048035 45732477 47235462 1635183 -86670 0 0 0 0 X 0 1 X 1 0 X 632547 514705 1174423 376385 345334 3043394 66098769 70539281 75931112 83718775 92054047 388341984 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66731316 71053986 77105535 84095160 92399381 391385378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391385378 162761 -39911 252788 151535 185575 712748 26165 93354 71827 55760 32206 279312 188926 53443 324615 207295 217781 992060 0 0 0 0 0 0 0 0 0 0 0 0 66920242 71107429 77430150 84302455 92617162 392377438 0.99747 0.99644 0.00253 0.00356 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7277 7277 0 SchC_P2B_S00_L01 Schedule C, Part II-B, Line 1 Dues paid to membership associations are partially used for the purpose of lobbying by those associations. 0 0 0 0 3367170 460909 2906261 0 766342 202359 563983 0 3977775 2505202 1472573 0 0 0 0 4942817 Due from Sibley Nursing Personnel 3254347 Due from Genesee Region Home Care of Ontario County, Inc. 9606870 12861217 Defined contribution pension obligation 350000 Due to Excellus Health Plan, Inc. 2543028 2893028 X SchD_P10_S00_L02 Schedule D, Part X, Line 2 FASB ASC Topic 740, Income Taxes provides that a tax benefit from an uncertain tax position may be recognized when it is more likely than not that the position will be sustained upon examination, including resolutions of any related appeals or litigation processes, based on the technical merits. Income tax positions must meet a more likely than not recognition threshold at the effective date to be recognized upon the adoption of this interpretation and in subsequent periods. This Topic also provides guidance on measurement, derecognition, classification, interest and penalties, accounting in interim periods, disclosure and transition. The Company recognizes any interest and penalties related to unrecognized tax benefits within the income tax expense line in the accompanying statements of activities and changes in net assets. Accrued interest and penalties are included within the related tax liability line in the consolidated balance sheet. There were no interest and penalties recognized for 2012 or 2011. The Company does not anticipate significant increases or decreases in its uncertain tax positions within the next twelve months. Hospice Regatta 58148 48660 9488 0 3520 5282 10271 700 13086 0 0 58148 48660 9488 0 3520 5282 10271 700 13086 32859 -23371 X 1 1 X 0 1 1 0 1 1 1 0 0 David Klein 0 1068774 0 2092480 0 17545037 0 14169 0 9560 0 20730020 0 0 Patricia Heffernan 0 255481 0 72579 0 14744 0 47671 0 12485 0 402960 0 0 Margaret Cassady 0 239208 0 49001 0 1723 0 25812 0 9578 0 325322 0 0 Terrence Tehan 0 221242 0 67320 0 3722 0 37636 0 17896 0 347816 0 0 James Wood 181036 0 0 0 2497 0 0 0 1934 0 185467 0 0 0 David Wastowicz 120038 0 21503 0 253 0 0 0 26327 0 168121 0 0 0 Jeanne Chirico 139774 0 0 0 424 0 0 0 7513 0 147711 0 0 0 Barbara Giehl 136097 0 0 0 996 0 0 0 8216 0 145309 0 0 0 Nancy Horn 134469 0 0 0 649 0 0 0 15878 0 150996 0 0 0 Suzanne Brown 0 89309 0 13892 0 2997 0 9988 0 19625 0 135811 0 0 Casper Sedgwick 0 14428 0 45810 0 8204 0 0 0 0 0 68442 0 0 SchJ_P01_S00_L01a Schedule J, Part I, Line 1a A portion of club dues were paid for the president and are included in taxable compensation. SchJ_P01_S00_L04 Schedule J, Part I, Line 4 The CEO, President and CFO/COO participated in a supplemental non-qualified retirement plan of a related entity. No payments were made under the plan in the year. Additionally, David Klein participated in an equity-based compensation arrangement of a related organization. Payments of 336,460 were made under this arrangement in 2012. SchJ_P01_S00_L05 Schedule J, Part I, Line 5 Some officers and key employees participate in a company incentive program. Bonuses are established from the Board approved strategic operating plan of the company or related company. Performance against prescribed goals is utilized in determining incentive awards. SchJ_P01_S00_L06 Schedule J, Part I, Line 6 Some officers and key employees participate in a company incentive program. Bonuses are established from the Board approved strategic operating plan of the company or related company. Performance against prescribed goals is utilized in determining incentive awards. SchJ_P02_S00_L00 Schedule J, Part II The amount of $17,545,037 reported for David Klein includes a total of $16,918,124 of imputed income which was not actually received by Mr. Klein in 2012. The imputed income for Mr. Klein includes the entire amount of the present value of the non-qualified retirement plan benefits that will be paid to Mr. Klein over his lifetime as an annuity. This benefit was earned by Mr. Klein based upon his length of service and compensation according to provisions of the retirement plan. Mr. Klein did not actually receive any portion of this benefit in 2012. As required by IRC Section 3121 regulations, the entire value of the lifetime benefit is recognized in 2012 and applicable FICA and FUTA taxeas are paid. Excellus Health Plan Inc Parent 26864000 Mangement Fees and Purchased Helath Services 0 MedAmerica Insurance Company of New York Under Common Control 1990000 Sale of Building 0 Sibley Nursing Personnel Service Inc Under Common Control 1662000 Management Fee and Purchased Helath Services 0 MedAmerica Insurance Company of New York Under Common Control 93000 Rental of Space 0 F990_P06_S0A_L02 Form 990, Part VI, Section A, Line 2 Hank Stuart and Joseph Kurnath MD were board members of a related for-profit entity. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b A copy of the Form 990 was provided to the Board of Directors prior to filing allowing the opportunity for review. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c All employees review the Code of Conduct at an annual mandatory training. Directors and above also complete an annual questionnaire to identify potential conflicts of interest. Any potential violations are investigated by compliance personnel and corrective measures are taken as appropriate. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 a) In determining compensation of the organization's CEO, the organization depended on compensation surveys and studies that are completed by Human Resources annually. b) In determining compensation of the organization's other officers, the organization depended on compensation surveys and studies that are completed by Human Resources annually. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 Governing documents, conflict of interest policies, and financial statements are available to the public upon request. F990_P07_S0A_L01b Form 990, Part VII, Section A, Line 1b David Klein is an Officer of several entities, some of which are listed in Schedule R. Genesee Region Home Care Association is charged for 1% of his salary. F990_P07_S0B_L01C Form 990, Part VII, Section B, Line 1(C) Compensation of Lechase Construction reported on Form 990, Part VII, and Section B includes compensation for both services and materials and two amounts cannot be separated. Lifetime Pharmacy LLC 165 Court Street Rochester NY 14647 264629835 Pharmacy NY 7769353 1671488 Genesee Region Home Care Association Inc Genesee Region Home Care of Ontario County Inc 165 Court Street Rochester NY 14647 223257719 Provide Home Health Services NY 501(c)(3) 509(a)(2) North Star Home Health Management Inc 1 Genesee Valley Group Health Association Inc 165 Court Street Rochester NY 14647 161005419 Provide Health Services NY 501(c)(3) 170(b)(1)(A)(iii) Excellus Health Plan Inc 1 Univera Community Health Inc 165 Court Street Rochester NY 14647 161500379 Health Insurer NY 501(c)(3) 509(a)(2) Excellus Health Plan Inc 1 Univera IPA LLC 165 Court Street Rochester NY 14647 454058523 Independent Practice Association NY N/A Excellus Health Plan Inc 165 Court Street Rochester NY 14647 150329043 Health Insurer NY N/A C North Star Home Health Management Inc 165 Court Street Rochester NY 14647 161548051 Holding Company NY N/A C Lifetime Healthcare Inc 165 Court Street Rochester NY 14647 161514675 Holding Company NY N/A C Excellus Acquisition Inc 165 Court Street Rochester NY 14647 061680689 Holding Company NY N/A C MedAmerica Inc 165 Court Street Rochester NY 14647 161581817 Holding Company NY N/A C Excellus Ventures Inc 165 Court Street Rochester NY 14647 161550984 Holding Company NY N/A C Upstate Professional Liability Corporation 165 Court Street Rochester NY 14647 141783968 Inactive NY N/A C Sibley Nursing Personnel Service Inc 165 Court Street Rochester NY 14647 161447472 Provide Home Health Services NY N/A C Support Services Alliance Inc 165 Court Street Rochester NY 14647 133033862 Benefit Plan Administrator NY N/A C Beacon Network Services Inc 165 Court Street Rochester NY 14647 141830065 Inactive NY N/A C EBS-RMSCO Inc 165 Court Street Rochester NY 14647 161171765 Third Party Administrator NY N/A C 344 South Warren Street Corporation 165 Court Street Rochester NY 14647 010718849 Real Estate Holding Company NY N/A C MedAmerica Insurance Company of New York 165 Court Street Rochester NY 14647 161310986 Long Term Care Insurance NY N/A C MedAmerica Insurance Company 165 Court Street Rochester NY 14647 340977231 Long Term Care Insurance PA N/A C MedAmerica Insurance Company of Florida 165 Court Street Rochester NY 14647 141993330 Long Term Care Insurance FL N/A C Excellus Insurance Agency Inc 165 Court Street Rochester NY 14647 161588653 Insurance Agency NY N/A C MIG Assurance 165 Court Street Rochester NY 14647 980210843 Long Term Care Insurer CJ N/A C Charles A Walker 165 Court Street Rochester NY 14647 150483335 Broker NY N/A C EBS-RMSCO Insurance Agency Inc 165 Court Street Rochester NY 14647 161611043 Inactive NY N/A C Human Care Consortium I Inc 165 Court Street Rochester NY 14647 454039701 Inactive NY N/A C Human Care Consortium II Inc 165 Court Street Rochester NY 14647 454039630 Inactive NY N/A C 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 0 0 Sibley Nursing Personnel Service Inc l 1662000 Arm's Length Excellus Health Plan Inc m 26864000 Arm's Length MedAmerica Insurance Company of New York j 93000 Arm's Length Genesee Region Home Care of Ontario County Inc m 5776359 Arm's Length MedAmerica Insurance Company of New York g 1990000 Arm's Length