GRHS FOUNDATION INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
GRHS FOUNDATION INC (EIN 22-3378111)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-14
IRS object ID
201333189349303948
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-14T15:04:50-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN161226221EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1FUST CHARLES CHAMBERS LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line15784 WIDEWATERS PARKWAYAddressLine1
CitySYRACUSECity
StateNYState
ZIP Code13214ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN223378111EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GRHS FOUNDATION INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGRHSNameControl
Phone5859221743Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 KINGS HIGHWAY SOUTHAddressLine1
CityROCHESTERCity
StateNYState
ZIP Code14617ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NamePAULA TINCHName
TitleSVP FINANCE & CFOTitle
Phone5859221743Phone
Date Signed2013-11-11DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameANGELA M FRANCOName
PTINP00589741PTIN
Phone3154463600Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARK C CLEMENTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1100 KINGS HIGHWAY SOUTHAddressLine1
CityROCHESTERCity
StateNYState
ZIP Code14617ZIPCode
FieldValueIRS element (for citing)
Gross Receipts14645109GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.ROCHSTERGENERAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1995YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTHE FOUNDATION IS ORGANIZED AND OPERATED EXCLUSIVELY TO BENEFIT ROCHESTER GENERAL HOSPITAL, NEWARK-WAYNE COMMUNITY HOSPITAL, ROCHESTER MENTAL HEALTH CENTER AND ROCHESTER GENERAL LONG TERM CARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI75913TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year4209000ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1380682ProgramServiceRevenuePriorYear
Program Service Revenue CY9682311ProgramServiceRevenueCY
Investment Income Prior Year125InvestmentIncomePriorYear
Investment Income Current Year402InvestmentIncomeCurrentYear
Other Revenue Prior Year204771OtherRevenuePriorYear
Other Revenue Current Year315052OtherRevenueCurrentYear
Total Revenue Prior Year1585578TotalRevenuePriorYear
Total Revenue Current Year14206765TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year56395SalariesEtcPriorYear
Salaries Etc Current Year2344302SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1033629OtherExpensePriorYear
Other Expenses Current Year6716373OtherExpensesCurrentYear
Total Expenses Prior Year1090024TotalExpensesPriorYear
Total Expenses Current Year9060675TotalExpensesCurrentYear
Revenues Less Expenses Prior Year495554RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5146090RevenuesLessExpensesCY
Total Assets BOY14962493TotalAssetsBOY
Total Assets EOY51883789TotalAssetsEOY
Total Liabilities BOY11180621TotalLiabilitiesBOY
Total Liabilities EOY42955827TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY3781872NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY8927962NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO BENEFIT ROCHESTER GENERAL HOSPITAL, NEWARK-WAYNE COMMUNITY HOSPITAL, ROCHESTER MENTAL HEALTH CENTER AND ROCHESTER GENERAL LONG TERM CARE.TO ACCEPT, HOLD, INVEST, REINVEST AND ADMINISTER GIFTS, GRANTS, BEQUESTS, CONTRIBUTIONS, DEVISES, BENEFITS OF TRUSTS, ENDOWMENTS AND PROPERTY OF ANY KIND, WITHOUT LIMITATION AS TO AMOUNT OR VALUE FOR THE FOREGOING PURPOSES.TO USE, DISBURSE OR PAY THE INCOME AND/OR PRINCIPAL THEREOF EXCLUSIVELY FOR THE FOREGOING PURPOSES. TO DO ANY OTHER ACT OR THING INCIDENTAL TO OR CONNECTED WITH THE FOREGOING PURPOSES OR IN ADVANCEMENT THEREOF, BUT NOT FOR THE PECUNIARY PROFIT OR FINANCIAL GAIN OF ITS MEMBERS, DIRECTORS, OFFICERS OR ANY OTHER PRIVATE PERSON.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense3205173Expense
Revenue4087692Revenue
DescriptionOPERATING REAL PROPERTY INVESTMENTS, INCLUDING MEDICAL/OFFICE BUILDINGS, A PARKING GARAGE, AN ADULT DAYCARE FACILITY AND PARCELS OF LAND, AS WELL AS MAINTAINING FINANCIAL INVESTMENTS ON BEHALF OF AFFILIATES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense3761702Expense
Revenue5598876Revenue
DescriptionAMBULATORY SURGERY CENTERDescription
FieldValueIRS element (for citing)
Total Program Service Expense6966875TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10963NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Excess Business Holdings0ExcessBusinessHoldings
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1RITA SZMIGELBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5859221737TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 KINGS HIGHWAY SOUTHAddressLine1
CityROCHESTERCity
StateNYState
ZIP Code14617ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (4 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
HUGH THOMAS
DIRECTOR/SVP & CORPORATE COUNSEL1.0054.00X0581709170710
MARK C CLEMENT
DIRECTOR/PRESIDENT & CEO1.0054.00X01385174712572X
RICHARD GANGEMI
DIRECTOR/SVP ACADEMIC & MEDICAL AFFAIRS0.0055.00X0577058129455X
PAULA TINCH
SVP FINANCE & CFO1.0054.00026115757140X
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2805098TotalReportableCompFrmRltdOrgs
Total Other Compensation1069877TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
All Other Contributions4209000AllOtherContributions
Total Contributions4209000TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
LATTIMORE PATIENT REV62149355968305596830
HAGEN DRIVE RENTAL INCOME53200028979922897992
GARAGE RENTAL532000633668633668
CARTER STREET RENTAL INCOME532000250191250191
OFFICE/DAY CARE532000241830241830

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column61800TotalRevenueColumn
Related Or Exempt Function Income61800RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue9682311TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column402TotalRevenueColumn
Exclusion$402ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real673226Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real438344Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real234882Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column234882TotalRevenueColumn
Exclusion$234,882ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
JANITORIAL CLEANING REVENUE8129007591375913
MISCELLANEOUS REVENUE90009942574257
FieldValueIRS element (for citing)
Total Other Revenue80170TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14206765TotalRevenueColumn
Related Or Exempt Function Income9686568RelatedOrExemptFunctionIncome
Unrelated Business Revenue75913UnrelatedBusinessRevenue
Exclusion$235,284ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2011357Total
Program Services1285091ProgramServices
Management And General726266ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total44033Total
Program Services28991ProgramServices
Management And General15042ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total125870Total
Program Services71275ProgramServices
Management And General54595ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total163042Total
Program Services107347ProgramServices
Management And General55695ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total721836Total
Program Services421026ProgramServices
Management And General300810ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total109574Total
Program Services194ProgramServices
Management And General109380ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total55200Total
Program Services36344ProgramServices
Management And General18856ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total391660Total
Program Services321614ProgramServices
Management And General70046ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total97390Total
Program Services59999ProgramServices
Management And General37391ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total327781Total
Program Services215811ProgramServices
Management And General111970ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total11117Total
Program Services7319ProgramServices
Management And General3798ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1018388Total
Program Services1018388ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1127365Total
Program Services1127365ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total67867Total
Program Services67867ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
LATTIMORE EXPENSES17270221137071589951
LICENSE FEES AND TAXES411696411696
HAGEN DRIVE EXPENSES262060262060
PARNALL EXPENSES201575201575

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total185842Total
Program Services185842ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total9060675Total
Program Services6966875ProgramServices
Management And General2093800ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY582382BOY
EOY2832357EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY218417BOY
EOY703977EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY270808BOY
EOY464407EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis59512309LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec14385197LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3919582BOY
EOY45127112EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY9971304BOY
EOY2755936EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY14962493BOY
EOY51883789EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY477626BOY
EOY941940EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY902995BOY
EOY30091257EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY9800000BOY
EOY11922630EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY11180621BOY
EOY42955827EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY3781872BOY
EOY8927962EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY3781872BOY
EOY8927962EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14962493BOY
EOY51883789EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses5146090ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (4 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
THE ROCHESTER GENERAL HOSPITAL
1607431343111$0
NEWARK WAYNE COMMUNITY HOSPITAL
1505841883111$0
ROCHESTER MENTAL HEALTH CENTER
1660691319111$0
ROCHESTER GENERAL LONG TERM CARE
2231871409111$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs4TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts
General ExplanationSCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SCHEDULE A, PART I, LINE 11(H)(VII): DURING 2012, GRHS FOUNDATION PROVIDED NON-MONETARY SUPPORT TO ITS SUPPORTED ORGANIZATION, ROCHESTER GENERAL HOSPITAL, BY LEASING FACILITIES TO RGH FOR $153,586.98GeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2352207OtherCostOrOtherBasis
Book Value2352207BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis57160102OtherCostOrOtherBasis
Depreciation14385197Depreciation
Book Value42774905BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings45127112TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATE528650
INVESTMENT LATTIMORE1840572
LINDEN OAKS UNAMORTIZED386714
FieldValueIRS element (for citing)
Total Book Value Other Assets2755936TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO AFFILIATEDescription
Amount$11,922,630Amount
FieldValueIRS element (for citing)
Total Of Amounts11922630TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt14645109TotRevenueEtcAuditedFinclStmt
Other Revenues438344OtherRevenues
Revenue Not Rptd F990438344RevenueNotRptdF990
Revenue Subtotal14206765RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99014206765TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt9499019TotExpensesEtcAuditedFinclStmt
Other Expenses Included438344OtherExpensesIncluded
Expenses Not Rptd F990438344ExpensesNotRptdF990
Expenses Subtotal9060675ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9909060675TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierExplanationExplanation
PART XI, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES 438,344.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES 438,344.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
HUGH THOMAS
DIRECTOR/SVP & CORPORATE COUNSEL0328234019743105604401637930691707524190100627
MARK C CLEMENT
DIRECTOR/PRESIDENT & CEO07053110633799046064070765504917020977460397500
RICHARD GANGEMI
DIRECTOR/SVP ACADEMIC & MEDICAL AFFA0315582020813905333701251740428107065130123660
PAULA TINCH
SVP FINANCE & CFO019038804317202759705268504455031829700

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 3THE FILING ORGANIZATION'S RELATED NON-PROFIT ORGANIZATION, ROCHESTER GENERAL HEALTH SYSTEM, UTILIZES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4BRGHS MAINTAINS A SECTION 457(F) PLAN WHICH WOULD BE CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. DURING 2012, NO DISTRIBUTIONS WERE PAID OUT. THE FOLLOWING OFFICERS AND KEY EMPLOYEES LISTED ON FORM 990, PART VII, SECTION A WOULD BE ELIGIBLE PARTICIPANTS IN THE PLAN SINCE THEY WOULD BE ENTITLED TO A DISTRIBUTION UPON SEPARATION FROM SERVICE: HUGH THOMAS MARK CLEMENT RICHARD GANGEMI

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION IS A MEMBERSHIP (NOT A STOCK) CORPORATION UNDER NEW YORK STATE LAW. THE ORGANIZATION'S SOLE CORPORATE MEMBER IS ROCHESTER GENERAL HEALTH SYSTEM (RGHS), A RELATED NOT-FOR-PROFIT ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7AIN ACCORDANCE WITH THE TERMS AND REQUIREMENTS OF ITS GOVERNING DOCUMENTS (I.E. BYLAWS), THE ORGANIZATION'S DIRECTORS ARE DIVIDED INTO THREE CLASSES, AND THE CLASSES SERVE FOR STAGGERED THREE-YEAR TERMS. AT EACH ANNUAL MEETING, DIRECTORS IN A CLASS ARE ELECTED BY A MAJORITY VOTE OF THE DIRECTORS THEN IN OFFICE. DIRECTORS ARE ELECTED FROM AMONG NOMINEES CHOSEN BY THE GOVERNANCE AND NOMINATING COMMITTEE OF THE FILING ORGANIZATION'S SOLE CORPORATE MEMBER, ROCHESTER GENERAL HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7BRGHS, AS THE SOLE CORPORATE MEMBER, ALSO HAS THE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY INCLUDING THE AMENDMENT OF BYLAWS AND CHARTERS, REMOVAL OF MEMBERS OF THE GOVERNING BODY, AND THE DECISION TO DISSOLVE THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 11PRIOR TO FILING, A COPY OF THE FORM 990 IS PROVIDED TO, AND REVIEWED WITH, ALL MEMBERS OF THE EXECUTIVE COMPENSATION COMMITTEE. THIS REVIEW IS PERFORMED IN CONSULTATION WITH THE ORGANIZATION'S TAX ADVISORS, AND IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS AND OTHER RELEVANT INFORMATION FOR THE APPROPRIATE TIME PERIOD.
FORM 990, PART VI, SECTION B, LINE 12CUPON EMPLOYMENT, ALL EMPLOYEES RECEIVE THE ETHICAL STANDARD OF CONDUCT BOOKLET FOR WHICH THEY SIGN A RECEIPT OF ACKNOWLEDGEMENT. CONFLICT OF INTEREST IS DEFINED, AS IS MANAGEMENT OF A CONFLICT OF INTEREST. EMPLOYEES ARE REQUIRED TO DISCLOSE AND SEEK RESOLUTION TO ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST BEFORE TAKING A POTENTIALLY IMPROPER ACTION AND THEREAFTER, ANNUALLY, EACH KEY EMPLOYEE AND OFFICER OF THE ORGANIZATION IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM, PROVIDING MANAGEMENT WITH SUFFICIENT INFORMATION ABOUT HIS/HER PERSONAL INTERESTS AND RELATIONSHIPS SO THAT MANAGEMENT CAN (1) DETERMINE WHETHER ANY ACTUAL OR PERCEIVED CONFLICT OF INTEREST EXISTS, AND (2) MONITOR WORK ASSIGNMENTS TO AVOID PLACING THE KEY EMPLOYEE OR OFFICER IN A POSITION WHERE THERE MAY BE A QUESTION AS TO HIS/HER OBJECTIVITY AS WELL AS TO AVOID ANY APPEARANCE OF IMPROPRIETY. THROUGHOUT THE YEAR, KEY EMPLOYEES AND OFFICERS OF THE ORGANIZATION ARE ALSO REQUIRED TO NOTIFY MANAGEMENT PROMPTLY IF ANY CHANGE TO THEIR DISCLOSURES OCCURS. BOARD MEMBERS LEAVE THE ROOM DURING DISCUSSIONS AND ABSTAIN FROM VOTING WHEN THEY HAVE A CONFLICT OF INTEREST. IN ADDITION, EACH MEMBER OF THE BOARD OF DIRECTORS MUST ALSO COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE FORM, WHICH MUST BE SUBMITTED TO THE GENERAL COUNSEL.
FORM 990, PART VI, SECTION B, LINE 15THE ORGANIZATION'S OFFICER AND KEY EMPLOYEE COMPENSATION ARRANGEMENTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF ROCHESTER GENERAL HEALTH SYSTEM, A RELATED NOT-FOR-PROFIT ORGANIZATION. INFORMATION REVIEWED FOR THE OFFICER/KEY EMPLOYEE INCLUDES COMPARABLE DATA FROM SIMILAR SIZE TAX EXEMPT ORGANIZATIONS IN THE WESTERN/CENTRAL NY COMMUNITY AS WELL AS COMPENSATION FOR THESE POSITIONS (AS DISCLOSED ON FORM 990) WITH OTHER ORGANIZATIONS IN THE INSURANCE INDUSTRY THAT ARE OF SIMILAR SIZE, DEMOGRAPHICS AND GEOGRAPHY. REVIEW AND APPROVAL OF THE COMPENSATION ARRANGEMENT BY THE COMPENSATION COMMITTEE IS DOCUMENTED.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ADMINISTRATIVE OFFICES OF THE AFFLILIATED HEALTH SYSTEM AT 100 KINGS HIGHWAY SOUTH ROCHESTER, NY 14617 AND THE ADMINSTRATIVE OFFICES OF THE FILING ORGANIZATION. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED.
FORM 990, PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (15 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
ROCHESTER GENERAL HEALTH SYSTEM
100 KINGS HIGHWAY SOUTHROCHESTERNY14617222551509SYSTEM PARENTNY501(C)(3)LINE 11B, IIN/A1
THE ROCHESTER GENERAL HOSPITAL FOUNDATION
100 KINGS HIGHWAY SOUTH STE 2300ROCHESTERNY14617222229425FUNDRAISINGNY501(C)(3)LINE 11B, II1RGHS
NEWARK WAYNE COMMUNITY HOSPITAL
DRIVING PARK AVENUENEWARKNY14513150584188HOSPITALNY501(C)(3)LINE 31RGHS
RGHS WORKERS' COMPENSATION TRUST
1425 PORTLAND AVENUEROCHESTERNY14621169429300SEE PART VIINY501(C)(3)LINE 11B, II1RGHS
CONTINUING CARE NETWORK INC (CCN)
100 KINGS HIGHWAY SOUTHROCHESTERNY14617222963016SUPPORT RGHNY501(C)(3)LINE 11B, II1RGHS
ROCHESTER GENERAL HUDSON HOUSING
2066 HUDSON AVENUEROCHESTERNY14617223210351LOW INC HOUSINGNY501(C)(3)LINE 91RGHS
INDEPENDENT LIVING FOR SENIORS
2066 HUDSON AVENUEROCHESTERNY14617161491059ADULT DAY CARENY501(C)(3)LINE 91RGHS
ROCHESTER GENERAL LONG TERM CARE
1550 EMPIRE BLVDWEBSTERNY14580223187140NH & REHABNY501(C)(3)LINE 91RGHS
WESTERN NEW YORK MEDICAL PRACTICE PC
1425 PORTLAND AVENUEROCHESTERNY14621611654232PHYS PRACNY501(C)(3)LINE 31RGHS
ROCHESTER MENTAL HEALTH CENTER
490 EAST RIDGE ROADROCHESTERNY14621166069131MENTAL HEALTHNY501(C)(3)LINE 91RGHS
THE ROCHESTER GENERAL HOSPITAL
1425 PORTLAND AVENUEROCHESTERNY14621160743134HOSPITALNY501(C)(3)LINE 3N/A1
GRHS LLC
125 LATTIMORE ROADROCHESTERNY14620453685937AMBULATORY SURGERY CENTERNY501(C)(3)LINE 11B, II1GRSHF INC
NEWARK WAYNE COMMUNITY HOSPITAL FOUNDATION
DRIVING PARK AVENUEROCHESTERNY14513222963015FUNDRAISINGNY501(C)(3)LINE 11B, II1NWCH
VIA HEALTH HOME CARE I
100 KINGS HIGHWAY SOUTHROCHESTERNY14617161504370HOME HEALTHNY501(C)(3)LINE 91CCN
VIA HEALTH HOMECARE II
100 KINGS HIGHWAY SOUTHROCHESTERNY14617161538727HOME HEALTHNY501(C)(3)LINE 91CCN

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1NW ASSOCIATES LPBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 111 DRIVING PARK AVENUEAddressLine1
CityNEWARKCity
StateNYState
ZIP Code14513ZIPCode
FieldValueIRS element (for citing)
EIN141674119EIN
Primary ActivityR/E LEASINGPrimaryActivity
Legal Domicile StateNYLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NWCHBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeType
Share Of Total Income159237ShareOfTotalIncome
Share Of EOY Assets654465ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner
Percentage Ownership0.52570PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryPrimary ActivityPrimaryActivityLegal Domicile Foreign CountryLegalDomicileForeignCountryDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipControlled OrgControlledOrgAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
GREATER ROCHESTER ASSURANCE COMPANY LTD
GEORGE TOWNGRAND CAYMANCJINSURANCECJN/AC7565885666384881.000001
GRACO RISK RETENTION GROUP INC
INSURANCEC1603050115589601.0000011425 PORTLAND AVENUEROCHESTERNY14621710933967NYRGH
NWA INC
R/E LEASINGC46798113983181.000001DRIVING PARK AVENUENEWALKNY14513141667339NYNWCH
GREATER ROCHESTER INDEPENDENT PRACTICE ASSOCIATION INC
INDEPENDENT PRACTICE ASSOCIATIONC-9276379482700.500001100 KINGS HIGHWAY SOUTH STE 2500ROCHESTERNY14617161507171NYRGHS
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1ROCHESTER GENERAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypePTransactionType
Amount Involved2397281AmountInvolved
Method Of Amt DeterminationFMVMethodOfAmtDetermination

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierRELATED TAX-EXEMPT ORGANIZATION - PRIMARY ACTIVITYIdentifier
Return ReferenceFORM 990, SCHEDULE R, PART II, COLUMN B:ReturnReference
ExplanationRGHS WORKERS' COMPENSATION TRUST SUPPORTS THE GENESEE HOSPITAL, ROCHESTER GENERAL HOSPITAL, ROCHESTER GENERAL HOSPITAL FOUNDATION, NEWARK WAYNE COMMUNITY HOSPITAL, NEWARK COMMUNITY HOSPITAL FOUNDATION, INDEPENDENT LIVING FOR SENIORS, ROCHESTER GENERAL LONG TERM CARE, ROCHESTER GENERAL HUDSON HOUSING, GRHS FOUNDATION, BEHAVIORAL HEALTH NETWORK, AND ROCHESTER GENERAL HEALTH SYSTEMS.Explanation

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.