2011-11-14T08:14:00-05:00 2010-12-31 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1700 PHILADELPHIA PA 19103 990 2010-01-01 160743037 HIGHLAND HOSPITAL OF ROCHESTER HIGH 5853416686 1000 SOUTH AVENUE ROCHESTER NY 14620 LEONARD SHUTE 2011-11-11 true 2673303000 2010 2016-03-07 17:11:31Z LEONARD J SHUTE 1000 SOUTH AVENUE ROCHESTER NY 14620 266729240 false X http://www.urmc.rochester.edu/hh/ X 1889 NY OPERATION OF AN ACUTE CARE HOSPITAL COMMITTED TO SERVICE EXCELLENCE IN THE HEALTHCARE INDUSTRY. 17 13 2789 280 0 0 242187 489037 249947374 259454591 648763 963235 4591122 5822377 255429446 266729240 0 0 0 0 143332681 149718904 0 0 0 101209381 100284789 244542062 250003693 10887384 16725547 204810744 231155069 104156569 118794191 100654175 112360878 X HIGHLAND HOSPITAL OF ROCHESTER ("HIGHLAND") PROVIDES INPATIENT AND OUTPATIENT HEALTHCARE SERVICES WITHOUT REGARD TO A PATIENT'S ABILITY TO PAY. HIGHLAND OPERATES A 261 BED ACUTE CARE HOSPITAL, AS WELL AS 13 PRIMARY CARE SATELLITE CLINICS, AN OB/MIDWIFERY CLINIC, BREASTCARE CLINIC AND THREE RADIATION ONCOLOGY TREATMENT CENTERS. HIGHLAND IS ALSO A TEACHING AFFILIATE OF THE UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY. HIGHLAND'S SERVICE AREA INCLUDES MONROE COUNTY, NEW YORK, AS WELL AS SEVERAL COUNTIES SURROUNDING THE ROCHESTER, NEW YORK REGION. IN 2010, HIGHLAND HAD 16,007 ADULT ADMISSIONS, DELIVERED 3,057 NEWBORNS AND HAD 32,696 PATIENTS TREATED IN ITS EMERGENCY DEPARTMENT. HIGHLAND IS COMMITTED TO SERVICE EXCELLENCE IN HEALTHCARE- ONE PERSON AT A TIME. HIGHLAND'S MISSION IS TO BE THE COMMUNITY HEALTHCARE PROVIDER RENOWNED FOR UNMATCHED SERVICE, EXCELLENCE AND BEST PATIENT OUTCOMES. HIGHLAND'S POLICY IS TO TREAT PATIENTS IN NEED OF MEDICAL SERVICES WITHOUT REGARD TO THEIR A false false 215723966 0 264879786 PROVISION OF HEALTHCARE SERVICES, INCLUDING INPATIENT SERVICES, ANCILLARY SERVICES AND ED/CLINIC/AMBULATORY SERVICES. ALSO SEE ATTACHMENT 1. 215723966 true true true true false false false false true true false false true true false false true false false false false false false false false true false false false true true false false false false false false false false false false false false false false false true true true false false true 200 0 true 2789 true false false false false false false false false false false X 17 13 false false false false true true true true true false false true true true true true true true true false NY X LEONARD J SHUTE 5852753033 1000 SOUTH AVENUE ROCHESTER NY 14620 STEVEN GOLDSTEIN 8.0 X X 0 873182 162555 ROBERT MCCANN MD 40.0 X 0 308499 27782 AMY KATES 2.0 X X 44482 0 9497 JOHN BARR 2.0 X 0 0 0 MICHAEL BUCKLEY 2.0 X X 0 0 0 JEAN CLOSE 2.0 X 0 0 0 DAVID DEJOY 2.0 X X 0 0 0 JOSEPH JOHNSON MD 2.0 X 0 642827 46771 HOWARD KONAR 2.0 X 0 0 0 RICHARD LEFROIS 2.0 X 0 0 0 GEORGE LORD 2.0 X 0 0 0 LISA HARRIS MD 2.0 X 0 0 0 ANIL SHARMA MD 2.0 X 7500 0 0 HON FRANCIS AFFRONTI 2.0 X 0 0 0 GERARD GUERINOT 2.0 X 0 0 0 MARK EIDLIN 2.0 X 0 0 0 RAPHAEL TSHIBANGU 2.0 X 0 0 0 LEONARD SHUTE 12.0 X 0 445350 178689 CINDY BECKER 40.0 X 239708 0 60309 RAYMOND MAYEWSKI MD 9.0 X 0 508997 115827 LORI FERRIS MD 40.0 X 374948 0 44063 JULIETTA FISCELLA MD 40.0 X 318602 0 49866 JEFFREY HANSON MD 40.0 X 310478 0 40135 GREGORY RYAN MD 40.0 X 282934 0 42511 CHARLES MASKIELL MD 40.0 X 205741 0 79014 1784393 2778855 857019 39 false true false BETH PLATT AND ASSOCIATES 2100 PENFIELD RD BOX 29 WALWORTH NY 14568 BILLING SERVICES 303549 HOLDSWORTH KLOMOWSKI CONSTRUCTION L 51 GOODWAY DR SOUTH ROCHESTER NY 14623 GENERAL CONSTRUCTION 1741293 MEDSTAFF INC 453 BACKUS RD WEBSTER NY 14580 TEMPORARY STAFFING 244193 NEW YORK DIALYSIS SERVICES NORTH PO BOX 27731 NEW YORK NY 10087 DIALYSIS TREATMENTS 643731 CAREFUSION 1952 Solutions Center CHICAGO IL 606771009 equipment rental 387642 19 489037 489037 PATIENT SERVICE REVENUE 900099 259454591 259454591 259454591 963235 963235 0 0 350450 350450 350450 350450 0 0 0 0 CAFETERIA REVENUE 900099 708332 708332 PARKING REVENUE 900099 1107044 1107044 MEDICAL ADMIN ASSOCIATES MGMT FEE 900099 701608 701608 2954943 2954943 0 5471927 266729240 264926518 0 1313685 0 0 0 0 291690 0 291690 0 0 117771360 101888360 15883000 0 6590311 5687438 902873 0 17844175 15399523 2444652 0 7221368 6232040 989328 0 0 223133 0 223133 0 185961 0 185961 0 0 0 0 0 0 0 0 0 3014366 3014366 0 0 203015 203015 0 0 0 0 1564596 0 1564596 0 0 12918981 9976324 2942657 0 2217642 0 2217642 0 PHARMA & MED SUPPLIES 44935251 44935251 0 0 MISCELLANEOUS EXPENSES 9483729 6638610 2845119 0 LAB OUTSIDE PROCESSING 4186121 4186121 0 0 PROVISION FOR BAD DEBTS 4365265 4365265 0 0 EQUIPMENT MAINT/REPAIRS 1240338 930254 310084 0 15746391 12267399 3478992 0 250003693 215723966 34279727 0 49179611 53819862 16494849 16654478 3607310 3699863 1426541 1125066 248451469 136175838 106550166 112275631 27552267 43580169 204810744 231155069 22421555 20065721 477922 328292 31282206 41561283 2453170 1923495 47521716 54915400 104156569 118794191 X 100654175 112360878 100654175 112360878 204810744 231155069 X 16725547 -5018844 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 false false false false false true 32586 false false false 32586 false 2985938 2390 55193 3043521 3156954 2205 -173221 2985938 3177416 2709 -23171 3156954 0.00000 1.00000 0.00000 false true true 207769 207769 125384730 61327735 64056995 690686 489806 200880 110504529 74358297 36146232 11663755 0 11663755 112275631 OTHER RECEIVABLES 21489037 ASSETS WHOSE USE IS LIMITED 12626006 DEFERRED AND OTHER INTANGIBLES 2034231 EST. THIRD PARTY SETTLEMENTS 10612 OTHER ASSETS 2369468 LIVING CENTER, INC. 1000508 AT WESTFALL, INC. 547733 COMMUNITY DEVELOPMENT CORP. 145084 ROCHESTER 1155258 INVESTMENT HELD FOR LT PURPOSE 2202232 43580169 0 ACCRUED PENSION LIABILITY 37269975 EST. PROFESSIONAL LIABILITY 3957614 ACCRUED WORKERS' COMP LIABILIT 6070418 EST. THIRD PARTY SETTLEMENTS 7617393 54915400 ENDOWMENT FUNDS PART V line 3a ALL ENDOWMENT FUNDS ARE HELD AND ADMINISTERED BY HIGHLAND FOUNDATION INC., A RELATED IRC SECTION 501(c)(3) ORGANIZATION, FOR THE BENEFIT OF HIGHLAND HOSPITAL IN FURTHERANCE OF ITS CHARITABLE HEALTH CARE SERVICES. true true true X true X true true true false true true 2376891 1731976 644915 0.00260 40957355 40228960 728395 0.00300 43334246 41960936 1373310 0.00560 9294067 2585286 6708781 0.02730 30300574 22693001 7607573 0.03100 35625 0 35625 0.00010 39630266 25278287 14351979 0.05840 82964512 67239223 15725289 0.06400 true 2394947 584606 98533051 95607898 2925153 true true 1 1 HIGHLAND HOSPITAL

1000 SOUTH AVENUE ROCHESTER NY 14620

X X X X HIGHLAND HOSPITAL 1 18 DAISY MARQUIS JONES RADIATION ONCOLOGY

1561 LONG POND ROAD ROCHESTER NY 14626

RADIATION ONCOLOGY CENTER HIGHLAND FAMILY MEDICINE CENTER

777 SOUTH CLINTON AVENUE ROCHESTER NY 14620

FAMILY MEDICINE CLINIC SANDS CANCER CENTER

350 PARRISH STREET CANANDAIGUA NY 14424

RADIATION ONCOLOGY CENTER CULVER MEDICAL GROUP

913 CULVER ROAD ROCHESTER NY 14609

PRIMARY CARE CLINIC CALEDONIA FAMILY MEDICINE

3350 BROWN ROAD CALEDONIA NY 14423

PRIMARY CARE CLINIC PENFIELD FAMILY MEDICINE

2212 PENFIELD ROAD PENFIELD NY 14526

PRIMARY CARE CLINIC EAST RIDGE FAMILY MEDICINE

809 EAST RIDGE ROAD ROCHESTER NY 14621

PRIMARY CARE CLINIC FAMILY MEDICINE OF WEBSTER

1672 EMPIRE BLVD WEBSTER NY 14580

PRIMARY CARE CLINIC HIGHLAND BREAST CARE CENTER

500 RED CREEK DRIVE ROCHESTER NY 14623

BREAST CARE DIAGNOSTIC SERVICE RUSH FAMILY MEDICINE

15 HIGH TECH DRIVE RUSH NY 14543

PRIMARY CARE CLINIC AVON FAMILY MEDICINE

470 COLLINS STREET AVON NY 14414

PRIMARY CARE CLINIC GREECE MEDICAL GROUP

2300 WEST RIDGE ROAD ROCHESTER NY 14626

PRIMARY CARE CLINIC CORNHILL INTERNAL MEDICINE

777 SOUTH AVENUE SUITE 200 ROCHESTER NY 14620

PRIMARY CARE CLINIC GENESEE VALLEY FAMILY MEDICINE

118 MAIN STREET PO BOX 99 MOUNT MORRIS NY 14510

PRIMARY CARE CLINIC GENESEE VALEY FAMILY MEDICINE LAKEVILLE

3509 THOMAS DRIVE SUITE 4 LAKEVILLE NY 14480

PRIMARY CARE CLINIC STRONG HEALTH MIDWIFERY GROUP

905 CULVER ROAD ROCHESTER NY 14620

OB/GYN CLINIC PENFIELD MEDICAL IMAGING

2212 PENFIELD ROAD SUITE 300 PENFIELD NY 14526

OUTPATIENT DIAGNOSTIC RADIOLOGY SERVICES GENESEE VALLEY FAMILY MEDICINE GENESEO

4400 LAKEVILLE ROAD GENESEO NY 14454

PRIMARY CARE CLINIC SUPPLEMENTAL DISCLSOURES PART I, LINE 7 (BAD DEBT EXPENSE, COSTING METHODOLOGY USED) THE BAD DEBT EXPENSE AMOUNT INCLUDED ON FORM 990, PART IX, COLUMN 25(A) WAS $4,365,265 FOR THE YEAR ENDED DECEMBER 30, 2010. THIS AMOUNT HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES REPORTED ON THE SCHEDULE H, PART I, LINE 7 TABLE. THE COSTING METHODOLOGY USED IN CALCULATING THE AMOUNTS REPORTED ON THE LINE 7 TABLE ARE BASED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2. PART III, SECTION A, LINE 4 (BAD DEBT EXPENSE) HIGHLAND HOSPITAL OF ROCHESTER (THE "HOSPITAL") GRANTS CREDIT WITHOUT COLLATERAL TO PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY ARRANGEMENTS. ADDITIONS TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS ARE MADE BY MEANS OF THE PROVISION FOR BAD DEBTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE AND SUBSEQUENT RECOVERIES ARE ADDED. THE AMOUNT OF THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS. THE COSTING METHODOLOGY FOR DETERMINING BAD DEBT EXPENSE (AT COST) WAS TO APPLY AN OVERALL HOSPITAL RATIO OF TOTAL COSTS TO TOTAL CHARGES, AND APPLY TO CHARGES WRITTEN OFF AS BAD DEBTS. PART III, SECTION B, LINE 8 (COSTING METHODOLOGY, MEDICARE SHORTFALL) THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS BASED ON THE HOSPITAL'S MEDICARE COST REPORT FILING FOR THE YEAR. CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF THE HOSPITAL AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, THE HOSPITAL PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY THE HOSPITAL TO PROVIDE SUCH SERVICES. AS A RESULT, THE HOSPITAL VIEWS ANY SHORTFALL REPORTED IN LINE 7 AS AN ADDITIONAL ITEM OF COMMUNITY BENEFIT PROVIDED BY THE ORGANIZATION. PART III, SECTION C, LINE 9B (COLLECTION PRACTICES) HIGHLAND HOSPITAL'S MISSION IS OUR COMMITTMENT TO EXCELLENCE IN HEALTH CARE, WITH PATIENTS AND THEIR FAMILIES AT THE HEART OF ALL THAT WE DO. LAWS, REGULATIONS, CATASTROPHIC ILLNESSES AND THE RISING COSTS OF NEW TECHNOLOGY HAVE CREATED A CATEGORY OF PATIENTS WHO ARE EITHER UNINSURED OR UNDERINSURED. THIS CHARITY CARE PROGRAM HAS BEEN DEVELOPED TO HELP THE HOSPITAL MEET THE NEEDS OF THESE PATIENTS AND, CONCURRENTLY, MAINTAIN THE FINANCIAL VIABILITY OF THE HOSPITAL FOR FUTURE GENERATIONS. THIS CHARITY CARE POLICY EXPLAINS HOW THE HOSPITAL ASSISTS PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE ESSENTIAL MEDICAL CARE THEY RECEIVE. PRINCIPLES: HIGHLAND HOSPITAL PROACTIVELY CONVEYS INFORMATION ABOUT THIS CHARITY CARE POLICY TO PATIENTS AND THEIR FAMILIES. - WE BELIEVE THAT FEAR OF A HOSPITAL BILL SHOULD NEVER GET IN THE WAY OF ESSENTIAL HEALTH SERVICES. THE PROVISION OF URGENT OR EMERGENT HEALTHCARE IS NEVER DELAYED PENDING A FINANCIAL ASSISTANCE DETERMINATION. SIGNS ANNOUNCING THE CHARITY CARE PROGRAM ARE POSTED IN THE HOSPITAL (E.G. EMERGENCY DEPARTMENT, ADMITTING OFFICE) TO PROACTIVELY CONVEY THIS MESSAGE TO PROSPECTIVE PATIENTS AND THE PUBLIC IN GENERAL. - WE MAINTAIN FINANCIAL AID POLICIES THAT ARE CONSISTENT WITH THE MISSION, VALUES AND CAPACITY OF THE HOSPITAL AND THAT TAKE INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. - WE COMMUNICATE THE AVAILABILITY OF FINANCIAL AID IN A MANNER THAT IS CLEAR, UNDERSTANDABLE, SENSITIVE TO THE PATIENT'S DIGNITY, AND IN MULTIPLE LANGUAGES. A NOTICE IS AVAILABLE AT REGISTRATION SITES THAT INFORMS PATIENTS OF THIS PROGRAM AND PROVIDES THE PHONE NUMBER TO CALL TO OBTAIN MORE INFORMATION AND TO APPLY FOR THIS PROGRAM. DESIGNATED STAFF ARE PROVIDED DETAILED TRAINING SO THAT THEY CAN PROVIDE INFORMATION AND ANSWER QUESTIONS ABOUT THE CHARITY CARE PROGRAM. INFORMATION IS GENERALLY AVAILABLE IN BOTH ENGLISH AND SPANISH. WHEN REQUESTED, IT WILL ALSO BE MADE AVAILABLE IN OTHER LANGUAGES. - WE IMPLEMENT FINANCIAL AID PROCEDURES THAT ARE CONSUMER-FRIENDLY, RESPECTFUL, AND CONFIDENTIAL, AS WELL AS DEBT COLLECTION POLICIES THAT REFLECT THE MISSION AND VALUES OF THIS HOSPITAL. - WE WORK WITH GOVERNMENT, PAYERS, BUSINESS, CONSUMER GROUPS AND OTHERS TO ADDRESS THE UNDERLYING PROBLEM THAT TOO MANY NEW YORKERS LACK HEALTH INSURANCE. GENERAL GUIDELINES: AS PART OF FINANCIAL PLANNING ASSISTANCE, WE PROVIDE PATIENTS, AND/OR THEIR LEGAL REPRESENTATIVE, WITH INFORMATION ABOUT THE CRITERIA THAT MUST BE MET IN ORDER TO OBTAIN MEDICAID, MEDICARE, OR OTHER HEALTH INSURANCES. PATIENTS ARE ASSISTED IN MAKING APPLICATIONS FOR ANY OF THESE INSURANCES OR DISCOUNTED FEE PLANS. PATIENTS ARE EXPECTED TO PARTICIPATE FULLY IN ALL EFFORTS TO OBTAIN ANY INSURANCE FOR WHICH THEY MAY QUALIFY. UNDER CERTAIN CIRCUMSTANCES, AS DETERMINED BY THE FINANCIAL CASE MANAGERS OR OTHER HOSPITAL SENIOR ADMINISTRATORS, APPLICATIONS FOR MEDICAID, MEDICARE OR OTHER INSURANCE PROGRAMS MAY BE WAIVED WHEN DEEMED UNNECESSARY. IF AVAILABLE INSURANCE BENEFITS ARE NOT SUFFICIENT TO COVER THE COST OF THEIR CARE, PATIENTS MAY THEN APPLY FOR ASSISTANCE FROM THE CHARITY CARE PROGRAM. CHARITY CARE APPLICATIONS MUST BE COMPLETED AND RETURNED TO THE HOSPITAL WITH THE REQUESTED INCOME DOCUMENTATION. PATIENTS WILL NOT RECEIVE CHARITY CARE ASSISTANCE IF THEY (A) DO NOT COMPLETE THE APPLICATION PROCESS FOR MEDICAID OR OTHER INSURANCE FOR WHICH THEY MAY QUALIFY, (B) ELECT NOT TO MAKE APPLICATION FOR CHARITY CARE, OR (C) HAVE ADEQUATE RESOURCES OR INCOME TO PAY PRIVATELY FOR THEIR CARE. IN THESE SITUATIONS, THEY WILL REMAIN FINANCIALLY RESPONSIBLE FOR FULL PAYMENT OF THEIR HOSPITAL BILLS. CHARITY CARE ASSISTANCE IS AVAILABLE FOR PATIENTS WHO RESIDE IN NEW YORK STATE AND RECEIVE EMERGENCY HOSPITAL SERVICES, INCLUDING EMERGENCY TRANSFERS, AND TO PATIENTS WHO RESIDE IN HIGHLAND HOSPITAL'S PRIMARY SERVICE AREA IN NEW YORK STATE WHO RECEIVE SERVICES IN DESIGNATED HIGHLAND HOSPITAL PROGRAMS, INCLUDING MOST INPATIENT AND OUTPATIENT SERVICES. IN ADDITION, THE HOSPITAL MAY, IN ITS DISCRETION, GRANT CHARITY CARE TO INDIVIDUALS WHO RESIDE OUTSIDE OF NEW YORK STATE. CHARITY CARE ASSISTANCE DOES NOT COVER MEDICALLY UNNECESSARY CARE, COSMETIC ALTERATION, TELEPHONE, TELEVISION AND PRIVATE ROOM CHARGES. IT DOES NOT COVER SERVICES GENERATED BY AN INSURED PATIENT WHO CHOOSES TO RECEIVE CARE AT AN OUT-OF-NETWORK HOSPITAL, OR WHO FAILS TO COMPLY WITH INSURANCE POLICY REQUIREMENTS (E.G. UNAUTHORIZED SERVICES) NOR DOES IT APPLY TO NON-RESIDENT ALIENS (UNLESS APPROVED IN ADVANCE OF CARE BEING PROVIDED), TO DRUGS NOT ADMINISTERED IN THE HOSPITAL, TO TRANSPORTATION FURNISHED BY THIRD PARTY VENDORS, OR TO CARE, SERVICES, DRUGS OR SUPPLIES FOR THE PURPOSE OF GENDER RE-ASSIGNMENT. SPECIFIC QUESTIONS ABOUT SERVICES THAT ARE NOT COVERED SHOULD BE DIRECTED TO THE PATIENT ACCOUNTS MANAGER OR HER DELEGATE. FINANCIAL GUIDELINES: FINANCIAL AID IS INTENDED TO ASSIST THOSE INDIVIDUALS WHO CANNOT AFFORD TO PAY IN PART OR IN FULL FOR THEIR CARE. IT SHOULD TAKE INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. HOSPITAL FINANCIAL AID SHOULD NOT BE VIEWED AS A SUBSTITUTE FOR EMPLOYER-SPONSORED OR INDIVIDUALLY PURCHASED INSURANCE. PATIENTS WITHOUT INSURANCE AND WITH INCOME THAT WOULD QUALIFY THEM FOR THE CHARITY CARE PROGRAM BUT ALSO HAVE SUBSTANTIAL RESOURCES (OTHER THAN TAX-DEFERRED OR COMPARABLE RETIREMENT SAVINGS OR COLLEGE SAVINGS ACCOUNTS) MAY BE EXPECTED TO PAY PART OF THEIR BILLS(S). CHARITY CARE ASSISTANCE IS GENERALLY AVAILABLE TO INDIVIDUALS WHOSE INCOME IS LESS THAN OR EQUAL TO 400% OF THE FEDERAL POVERTY LEVEL. HOWEVER, PATIENTS WHO HAVE EXHAUSTED THEIR INSURANCE BENEFITS, EXCEEDED FINANCIAL ELIGIBILITY CRITERIA, FACE EXTRAORDINARY MEDICAL COSTS, OR WHO HAVE OTHER UNIQUE CIRCUMSTANCES MAY BE CONSIDERED FOR CHARITY CARE APPROVAL IN THE HOSPITAL'S SOLE DISCRETION. WHILE APPLICATION FOR MEDICAID OR OTHER INSURANCE IS USUALLY REQUIRED, THE HOSPITAL MAY, AT ITS SOLE DISCRETION, IN APPROPRIATE CASES, ALSO CONSIDER PATIENTS FOR CHARITY CARE WHEN THEY MEET THE FINANCIAL CRITERIA OF THIS PROGRAM, BUT HAVE NOT SATISFACTORILY COMPLETED ALL THE REQUIREMENTS OF THE CHARITY CARE APPLICATION PROCESS. THIS MAY INCLUDE PATIENTS WHO HAVE BEEN SANCTIONED BY MEDICAID, HAVE FILED BANKRUPTCY OR APPEAR TO BE ELIGIBLE FOR CHARITY CARE ASSISTANCE BASED ON AVAILABLE INFORMATION. ELIGIBILITY DETERMINATIONS IN COMPLEX CASE CIRCUMSTANCES WILL BE MADE AFTER CONSIDERATION BY THE CHARITY CARE REVIEW TEAM THAT INCLUDES THE CHARITY CARE OFFICER, FINANCIAL CASE MANAGER AND/OR THEIR MANAGERS, OR MAY BE MADE BY SENIOR HOSPITAL ADMINISTRATORS. THE AMOUNT OF THE DISCOUNT AFFORDED TO QUALIFIED CHARITY CARE PATIENTS WILL BE DETERMINED THROUGH ASSESSMENT OF THE RESPONSIBLE PARTY'S ANNUAL HOUSEHOLD INCOME AND THE NUMBER OF PEOPLE IN THE HOME, AS A PERCENTAGE OF THE FEDERAL POVERTY GUIDELINE AMOUNTS FOR SAME SIZE HOUSEHOLDS. THE FINANCIAL GUIDELINES WILL BE UPDATED ANNUALLY IN CONJUNCTION WITH THE FEDERAL POVERTY UPDATES PUBLISHED BY CMS. PATIENTS MAY RECEIVE FULL OR PARTIAL DISCOUNT FROM THE COST OF CARE, DEPENDING ON THE PERCENTAGE OF THE GUIDELINES MATCHED BY THE PATIENT'S HOUSEHOLD INCOME. ANY BILL AMOUNT REMAINING AFTER APPLICATION OF A PARTIAL CHARITY CARE DISCOUNT IS THE RESPONSIBILITY OF THE PATIENT. THE AMOUNT AN APPROVED CHARITY CARE PATIENT WILL GENERALLY BE EXPECTED TO PAY FOR SERVICES COVERED BY THE POLICY WILL BE LIMITED TO THE LOWER OF THE AMOUNT THAT THE HOSPITAL WOULD HAVE RECEIVED FOR THE SAME SERVICE UNDER MEDICARE PARTS A AND B, (INCLUDING COINSURANCE, CO-PAYMENTS AND DEDUCTIBLES) OR THE USUAL AND CUSTOMARY CHARGES. THE PATIENT WILL BE ASSISTED BY THE HOSPITAL IN MAKING ARRANGEMENTS TO SATISFY ANY BALANCE REMAINING ON THE ACCOUNT(S) AFTER THE APPLICATION OF THE APPROPRIATE CHARITY CARE DISCOUNT BY USE OF A PAYMENT PLAN. THE MONTHLY PAYMENTS UNDER SUCH PLANS SHALL NOT EXCEED TEN PERCENT (10%) OF THE ELIGIBLE PATIENT'S GROSS MONTHLY INCOME. THE RATE OF INTEREST ON UNPAID BALANCES SHALL NOT EXCEED THE US TREASURY RATE FOR 90 DAY SECURITIES PLUS 0.5%. HOSPITAL PATIENT FINANCIAL AID STATUTE DISCOUNTING REQUIREMENTS DISCOUNT / GROSS INCOME AS % OF FEDERAL POVERTY LEVEL 100% / UP TO 200% 80 / BETWEEN 201-250% 60% / BETWEEN 251-300% 40% / BETWEEN PART VI, LINE 2 (NEEDS ASSESSMENT) THE NEEDS OF MONROE COUNTY ARE ASSESSED THROUGH HEALTH ACTION, A ROBUST COMMUNITY-WIDE PROCESS ESTABLISHED 12 YEARS AGO THAT IS LED BY THE MONROE COUNTY DEPARTMENT OF PUBLIC HEALTH (MCDPH). IT INVOLVES ALL FOUR LOCAL HEALTH SYSTEMS, LOCAL INSURERS, AND OTHER KEY COMMUNITY STAKEHOLDERS. THROUGH THIS PROCESS, COMMUNITY PRIORITIES, GOALS, AND INTERVENTIONS ARE IDENTIFIED AND IMPLEMENTED. THESE PRIORITIES ALIGN WITH THE HEALTH PRIORITIES AND INDICATORS AS PUBLISHED BY NEW YORK STATE'S DEPARTMENT OF HEALTH (DOH) AND INCLUDE ACCESS TO QUALITY HEALTH CARE AND SERVICES THAT ADDRESS TOBACCO USE, HEALTHY MOTHERS/HEALTHY BABIES/HEALTHY CHILDREN, PHYSICAL ACTIVITY/NUTRITION, UNINTENTIONAL INJURY, HEALTHY ENVIRONMENTS, CHRONIC DISEASE, AND MENTAL HEALTH/ SUBSTANCE ABUSE. FIVE HEALTH STATUS "REPORT CARDS" IN SPECIFIC AGE GROUPS AND CATEGORIES ARE USED TO MEASURE PROGRESS TOWARDS HEALTH STATUS IMPROVEMENT. THEY INCLUDE MATERNAL AND CHILD HEALTH, ADOLESCENT HEALTH, ADULT HEALTH, OLDER ADULT HEALTH AND ENVIRONMENTAL HEALTH, EACH OF WHICH CONTAIN GOALS FOR IMPROVING HEALTH. PRIORITIES FOR EACH AREA ARE SELECTED BASED ON INPUT FROM COMMUNITY SURVEYS, FOCUS GROUPS AND INFORMATION FROM HEALTH CARE PROVIDERS. UPDATED REPORT CARDS ARE PRODUCED AND DISTRIBUTED EVERY 6-8 YEARS FOR EACH SPECIFIC AGE GROUP. THE MONROE COUNTY ADULT HEALTH STATUS SURVEY IS SCHEDULED FOR 2012. THESE PRIORITIES SERVE AS A FOUNDATION FOR COMMUNITY HEALTH IMPROVEMENT AND COMMUNITY BUILDING EFFORTS AND HELP TO ENSURE COLLABORATIVE AND COORDINATED USE OF HEALTH SYSTEM RESOURCES TO ADDRESS THE MOST PRESSING NEEDS. THE PRIORITY SETTING PROCESS IS A SIX-STEP PROCESS THAT INCLUDES: 1. ASSESS HEALTH STATUS: DATA DETAILING HEALTH STATUS, ACCESS TO HEALTH CARE AND HEALTH BEHAVIORS ARE COMPILED AND ANALYZED TO IDENTIFY TRENDS AND DISPARITIES AND TO COMPARE OUR COUNTY TO OTHER COMMUNITIES. THE HEALTH SYSTEM PARTNERS WITH THE COUNTY TO CONDUCT PERIODIC HEALTH ASSESSMENTS. 2. CHOOSE PRIORITY GOALS: THE ADVISORY COMMITTEE, CO-FOUNDED BY THE MEDICAL CENTER, HOSTS COMMUNITY FORUMS TO ADDRESS HEALTH IMPROVEMENT PRIORITIES. THE ADVISORY COMMITTEE RECOMMENDS PRIORITIES OVER THE NEXT 4-5 YEARS TO THE MCDPH BOARD OF HEALTH. 3. DEFINE THE LEADERSHIP: PARTNERS ARE IDENTIFIED TO SUPPORT THE PRIORITIES FOR ACTION. THE MEDICAL CENTER PROVIDES SALARY SUPPORT FOR FACULTY AND STAFF TO CONTRIBUTE THEIR ACADEMIC AND CLINICAL EXPERTISE TO HELP IDENTIFY AND IMPLEMENT THE MOST EFFECTIVE INTERVENTIONS ON THE HEALTH PRIORITIES. 4. DEVELOP IMPROVEMENT PLANS: EACH PARTNERSHIP DEVELOPS IMPROVEMENT PLANS TO ADDRESS HEALTH GOALS. 5. PERFORM INTERVENTIONS: EACH PARTNERSHIP, ALONG WITH THE STEERING COMMITTEE, WHICH INCLUDES THE MEDICAL CENTER, OVERSEES THE IMPLEMENTATION OF INTERVENTIONS IN VARIOUS VENUES THAT INCLUDE SCHOOLS, DAY CARE CENTERS, PLACES OF WORSHIP, COMMUNITY BASED ORGANIZATIONS AND WITHIN THE HEALTH SYSTEMS. 6. MEASURE THE IMPACT: EACH PARTNERSHIP EVALUATES THE INTERVENTION. PART VI, LINE 3 (PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE) INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IS POSTED IN ALL AREAS OF HIGHLAND HOSPITAL AND ITS OFF-SITE LOCATIONS. CHARITY CARE INFORMATION IS POSTED IN INPATIENT AND OUTPATIENT REGISTRATION AREAS; THE EMERGENCY DEPARTMENT; ADMITTING; HIGHLAND FAMILY MEDICINE; AND ALL PRIMARY CARE SITES. THE HOSPITAL PROVIDES A COPY OF THE CHARITY CARE POLICY AND FINANCIAL ASSISTANCE CONTACTS TO PATIENTS AS PART OF ITS ADMITTING PROCESS. HIGHLAND ALSO PROVIDES PRINTED INFORMATION ABOUT CHARITY CARE ASSISTANCE WITH DISCHARGE MATERIALS WHEN IT HAS BEEN DETERMINED THAT A PATIENT IS IN FINANCIAL NEED; THIS IS DONE AS A FOLLOW-UP TO A PERSONAL CONTACT BY A HOSPITAL SOCIAL WORKER SPECIALIZING IN COUNSELING PATIENTS WHO NEED TO QUALIFY FOR MEDICAID, AND ASSISTING THEM WITH THE QUALIFICATION PROCESS. PART VI, LINE 4 (COMMUNITY INFORMATION) THE HOSPITAL SERVES THE URBAN ROCHESTER AREA AND SURROUNDING COUNTIES (MONROE, GENESEE, LIVINGSTON, ONTARIO, ORLEANS AND WAYNE). PATIENTS ALSO TRAVEL TO HIGHLAND FROM THE UPSTATE NEW YORK REGION, PENNSYLVANIA AND CANADA FOR ITS SPECIALTY SERVICES, WHICH INCLUDE: ORTHOPAEDICS/ JOINT REPLACEMENT; BARIATRIC SURGERY; GERIATRICS; WOMEN'S SERVICES. THE AREA IS ALSO SERVED BY THREE OTHER HOSPITALS: STRONG MEMORIAL HOSPITAL, AN AFFILIATE OF THE UNIVERSITY OF ROCHESTER MEDICAL CENTER; ROCHESTER GENERAL HOSPITAL; AND UNITY HOSPITAL. MONROE COUNTY'S POPULATION, ACCORDING TO 2010 U.S. CENSUS FIGURES, WAS 744,344. MEDIAN HOUSEHOLD INCOME WAS $50,265. PERCENT OF PERSONS BELOW THE POVERTY LEVEL, 2009 DATA: 13.4%. PERCENT OF COMMUNITY RESIDENTS UNDER AGE 65 WHO ARE UNINSURED: 8.8 PERCENT. (DATA COMES FROM ROCHESTER AND MONROE COUNTY PARTNERSHIP ON THE UNINSURED, THE SURVEY OF HEALTH CARE COVERAGE AND ACCESS IN MONROE COUNTY, ROCHESTER, NY, 2000 (NON-ELDERLY ADULTS)). PART VI, LINE 5 (PROMOTION OF COMMUNITY HEALTH) HIGHLAND HOSPITAL CONDUCTS MANY EVENTS THROUGHOUT THE YEAR. EXAMPLES INCLUDE FREE OR LOW-COST HEALTH EDUCATION PROGRAMS ON TOPICS RELATED TO GERIATRIC HEALTH, DIABETES MANAGEMENT, JOINT PAIN/JOINT REPLACEMENT, AND BARIATRIC SURGERY. HIGHLAND'S BREAST IMAGING CENTER SPONSORS FREE MAMMOGRAPHY SCREENING DAYS SEVERAL TIMES A YEAR FOR UNINSURED/UNDERINSURED WOMEN. THESE EVENTS SERVE SEVERAL PURPOSES: THEY RAISE AWARENESS OF THE BREADTH OF SERVICES OFFERED BY HIGHLAND TO THE COMMUNITY, ESPECIALLY THOSE IN THE URBAN AREA OF ROCHESTER FOR WHOM HIGHLAND IS THEIR CLOSEST HOSPITAL; THEY ENCOURAGE COMMUNITY MEMBERS TO ENGAGE IN PROACTIVE WELLNESS EFFORTS, SUCH AS RECOMMENDED ANNUAL MAMMOGRAMS FOR WOMEN OVER 40 AND THOSE AT RISK; AND THEY EDUCATE COMMUNITY MEMBERS ON STEPS THEY CAN TAKE TO LEAD HEALTHY LIVES THROUGH POSITIVE LIFESTYLE CHOICES. HIGHLAND STAFF PROVIDE HEALTH INFORMATION AND WELLNESS SCREENINGS AT NUMEROUS COMMUNITY EVENTS SUCH AS ANNUAL HEALTH FAIRS -- THE ALESI WELLNESS FAIR HELD EVERY OCTOBER IN ROCHESTER DRAWS SEVERAL THOUSAND PEOPLE. OTHER EXAMPLES INCLUDE A HIGHLAND-STAFFED BOOTH AT ROCHESTER'S LILAC FESTIVAL IN MAY, ATTENDED BY THOUSANDS OF PEOPLE, WHERE STAFF PROVIDE INFORMATION AND SCREENINGS, AS WELL AS REFERRALS TO HIGHLAND PATIENT EDUCATION OPPORTUNITIES. HIGHLAND ALSO SUPPORTS OTHER COMMUNITY ORGANIZATIONS THAT SHARE THE HOSPITAL'S MISSION OF IMPROVING COMMUNITY HEALTH. EXAMPLES INCLUDE PHYSICIAN AND CLINICAL STAFF VOLUNTEERING AT ST. JOSEPH'S NEIGHBORHOOD CLINIC TO PROVIDE ACCESS TO MEDICAL CARE TO THE UNINSURED. PART VI, LINE 5 (PROMOTION OF COMMUNITY HEALTH- OTHER INFORMATION) HIGHLAND'S BOARD OF DIRECTORS IS COMPRISED OF A DIVERSE GROUP OF MEMBERS OF THE ROCHESTER COMMUNITY. THE BOARD INCLUDES URMC AND HIGHLAND SENIOR LEADERS; EMPLOYED URMC FACULTY BASED AT HIGHLAND HOSPITAL AND PRIVATE COMMUNITY PHYSICIANS; MEMBERS OF THE BUSINESS COMMUNITY AND LOCAL PHILANTHROPISTS WITH AN INTEREST IN ADVOCATING FOR HEALTH CARE. HIGHLAND EXTENDS MEDICAL STAFF PRIVILEGES TO EMPLOYED HIGHLAND PHYSICIANS; URMC FACULTY PHYSICIANS; AND ALL ELIGIBLE PRIVATE PHYSICIANS WHO PRACTICE AT HIGHLAND AND/OR ADMIT PATIENTS TO THE HOSPITAL. HIGHLAND USES SURPLUS FUNDS TO CONTINUALLY REINVEST IN ITS FACILITY; THE 121-YEAR-OLD HOSPITAL HAS IN RECENT YEARS RENOVATED ITS EMERGENCY DEPARTMENT IN RESPONSE TO RISING PATIENT VOLUMES, VIRTUALLY DOUBLING ITS CAPACITY TO MEET CURRENT AND FUTURE PATIENT NEEDS. OTHER ENHANCEMENTS INCLUDE THE ADDITION OF A NEW OUTPATIENT PHARMACY AND EXPANDED LOBBY/SURGICAL WAITING AREA TO ACCOMMODATE SURGICAL VOLUME GROWTH. THE HOSPITAL HAS BEGUN CONSTRUCTION OF A NEW NEUROMEDICINE UNIT TO PROVIDE INTEGRATED NEUROLOGY/NEUROSURGERY CARE TO STROKE, HEAD INJURY AND NEUROSURGERY PATIENTS. AND, IT HAS BEGUN CONSTRUCTION OF TWO NEW OPERATING ROOMS AND EXPANSION OF ITS PERIOPERATIVE SERVICES AREA TO MEET DEMAND FOR OR USAGE. PART VI, LINE 6 (DETAIL REGARDING AFFILIATED HEALTH CARE SYSTEM ROLES) THE UNIVERSITY OF ROCHESTER MEDICAL CENTER IS AN INTEGRATED ACADEMIC HEALTH CENTER THAT COMPRISES THE SCHOOL OF MEDICINE AND DENTISTRY, INCLUDING ITS FACULTY PRACTICE (UNIVERSITY OF ROCHESTER MEDICAL FACULTY GROUP); STRONG MEMORIAL HOSPITAL; GOLISANO CHILDREN'S HOSPITAL; JAMES P. WILMOT CANCER CENTER; SCHOOL OF NURSING; EASTMAN DENTAL CENTER; AND ITS AFFILIATES, HIGHLAND HOSPITAL, VISITING NURSE SERVICE, HIGHLANDS LIVING CENTER, HIGHLAND COMMUNITY DEVELOPMENT CORPORATION (D/B/A THE HIGHLANDS AT PITTSFORD), AND HIGHLANDS AT BRIGHTON. - ONE OF THE NATION'S TOP ACADEMIC MEDICAL CENTERS, THE UNIVERSITY OF ROCHESTER MEDICAL CENTER FORMS THE CENTERPIECE OF THE UNIVERSITY'S HEALTH RESEARCH, TEACHING, PATIENT CARE, AND COMMUNITY OUTREACH MISSIONS. WITH MORE THAN $145 MILLION IN FEDERAL RESEARCH FUNDING, UR SCHOOL OF MEDICINE RESEARCH FUNDING RANKS IN THE TOP ONE-QUARTER OF U.S. MEDICAL CENTERS, WHILE THE SCHOOL OF NURSING RANKS 12TH HIGHEST IN FUNDING. THE UNIVERSITY'S HEALTH CARE DELIVERY NETWORK IS ANCHORED BY STRONG MEMORIAL HOSPITAL-A 739-BED, UNIVERSITY-OWNED TEACHING HOSPITAL. PATIENTS BENEFIT FROM THE MEDICAL CENTER'S ROBUST TEACHING AND BIOMEDICAL RESEARCH PROGRAMS. ITS RESEARCH FACULTY HAVE ATTRACTED EXTERNAL FUNDING TOTALING APPROXIMATELY $300 MILLION DURING THE LAST FISCAL YEAR. THE MEDICAL CENTER HAS ACHIEVED TOP-15 RANKINGS IN NIH FUNDING IN BIOCHEMISTRY, MICROBIOLOGY AND IMMUNOLOGY, NEUROLOGY, OBSTETRICS AND GYNECOLOGY, ORAL BIOLOGY, AND MUSCULOSKELETAL RESEARCH. STUDENT ROSTERS INCLUDE APPROXIMATELY 400 MEDICAL STUDENTS, 550 GRADUATE STUDENTS, AND 600 RESIDENTS AND FELLOWS. - GOLISANO CHILDREN'S HOSPITAL, HOUSED IN STRONG MEMORIAL HOSPITAL, IS A 124-BED CHILDREN'S HOSPITAL THAT SERVES AS THE REFERRAL CENTER FOR UPSTATE NEW YORK, SURROUNDING STATES AND CANADA. IT COMBINES AWARD-WINNING RESEARCH, INTERNATIONALLY ACCLAIMED EDUCATION AND COMPASSIONATE CARE TO SERVE CHILDREN AND FAMILIES. PEDIATRIC SPECIALTIES INCLUDE ORTHOPAEDICS, NEUROLOGY/NEUROSURGERY, CANCER AND NEONATAL CARE. - THE JAMES P. WILMOT CANCER CENTER IS ORGANIZED AROUND A MULTIDISCIPLINARY CARE MODEL, WHICH LEADING CANCER EXPERTS BELIEVE IS THE GOLD STANDARD IN CANCER CARE IN THE 21ST CENTURY. ITS MODEL UNDERSCORES A COMMITMENT TO PROVIDE PATIENTS IN THE ROCHESTER AREA WITH THE MOST UP-TO-DATE INFORMATION AND AVAILABLE TREATMENTS, BASING OUR RECOMMENDATIONS ON THE BEST EVIDENCE. IT IS ONE OF THE ONLY CENTERS IN WESTERN NEW YORK OFFERING THIS TEAM APPROACH TO CARE. - EASTMAN DENTAL CENTER PROVIDES COMMUNITY DENTAL CARE IN A NUMBER OF CLINICS AS WELL AS CLINICAL EDUCATION TO DENTAL STUDENTS ENROLLED AT THE UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY. IT OFFERS GENERAL DENTISTRY, PEDIATRIC AND ORTHODONTIC CLINICS AND HAS RECENTLY ADDED AN URGENT CARE DENTAL CLINIC THAT SEES APPROXIMATELY 50 PATIENTS A DAY. - HIGHLAND HOSPITAL IS A FULL-SERVICES COMMUNITY HOSPITAL THAT ALSO OFFERS NUMEROUS SPECIALTY SERVICES THAT DRAW PATIENTS FROM THE REGION AND CANADA: BARIATRIC SURGERY, JOINT REPLACEMENT, GERIATRICS, WOMEN'S SERVICES AND MATERNITY. HIGHLAND HOSPITAL'S EVOLUTION AS A FULL-SERVICES COMMUNITY HOSPITAL, WITH A FULL COMPLEMENT OF SUBSPECIALTY SERVICES, ENABLES THE HOSPITAL TO ACCEPT PATIENTS FROM STRONG MEMORIAL'S ED AND INPATIENT FLOORS - IMPORTANT TO ASSURING ACCESS OF CARE, SINCE STRONG IS OFTEN AT OR NEAR FULL CAPACITY. - VISITING NURSE SERVICE OFFERS COMPLETE HOME HEALTH CARE SERVICES FOR NEWBORNS TO SENIORS. - THE HIGHLANDS LIVING CENTER OFFERS SKILLED NURSING CARE. - HIGHLAND COMMUNITY DEVELOPMENT CORPORATION (D/B/A THE HIGHLANDS AT PITTSFORD) OFFERS ENRICHMENT AND INDEPENDENT LIVING OPTIONS FOR SENIORS. - THE HIGHLANDS AT BRIGHTON IS A SKILLED NURSING FACILITY THAT SPECIALIZES IN CARE FOR THE MOST MEDICALLY COMPLEX CASES. BOTH NURSING HOMES REFER TO HIGHLAND FOR THE QUALITY AND BREADTH OF ITS GERIATRIC CARE. MANY HIGHLAND GERIATRICIANS SERVE A DUAL ROLE WITH THESE AGENCIES, PROVIDING SERVICE AS A MEDICAL DIRECTOR AND/OR ATTENDING PHYSICIAN, WHICH STRENGTHENS THE COLLABORATION BETWEEN HOSPITAL, NURSING HOME, HOME NURSING CARE, PATIENT AND FAMILY. THIS LINKAGE STRENGTHENS PRACTITIONERS' KNOWLEDGE OF EACH OTHER AND LEVEL OF COLLABORATION, PRODUCING A HIGH QUALITY OF CARE AND SMOOTHER TRANSITIONS FOR PATIENTS WHO MAY NEED ANY OR ALL OF THESE SERVICES AS THEY AGE. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI NY, false true false false false false false false false STEVEN GOLDSTEIN 0 831072 0 0 0 42110 0 158596 0 3959 0 1035737 0 0 ROBERT MCCANN MD 0 308499 0 0 0 0 0 26339 0 1443 0 336281 0 0 JOSEPH JOHNSON MD 0 626227 0 0 0 16600 0 0 0 0 0 642827 0 0 LEONARD SHUTE 0 418271 0 0 0 27079 0 0 0 0 0 445350 0 0 CINDY BECKER 239708 0 0 0 0 0 0 0 0 0 239708 0 0 0 LORI FERRIS MD 374948 0 0 0 0 0 0 0 0 0 374948 0 0 0 JULIETTA FISCELLA MD 318602 0 0 0 0 0 0 0 0 0 318602 0 0 0 JEFFREY HANSON MD 310478 0 0 0 0 0 0 0 0 0 310478 0 0 0 GREGORY RYAN MD 282934 0 0 0 0 0 0 0 0 0 282934 0 0 0 RAYMOND MAYEWSKI MD 0 477012 0 0 0 31985 0 0 0 0 0 508997 0 0 CHARLES MASKIELL MD 205741 0 0 0 0 0 0 0 0 0 205741 0 0 0 TOP MANAGEMENT COMPENSATION FORM 990, SCHEDULE J, LINE 3 AS PROVIDED IN THE FORM 990, SCHEDULE J INSTRUCTIONS, SINCE THE ORGANIZATION RELIES ON A RELATED ORGANIZATION WHICH USES ONE OR MORE OF THE METHODS DESCRIBED IN LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION, THIS QUESTION HAS BEEN LEFT UNANSWERED. REFER TO SCHEDULE O, DESCRIPTION OF COMPENSATION REVIEW AND APPROVAL PROCESS. PARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FORM 990, SCHEDULE J, LINE 4B BOX 4(B) HAS BEEN CHECKED YES, SINCE CERTAIN OFFICERS OF HIGHLAND HOSPITAL OF ROCHESTER PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PROVIDED BY THE UNIVERSITY OF ROCHESTER, A RELATED IRC SECTION 501(C) (3) ORGANIZATION. tHESE AMOUNTS ARE INCUDED IN DEFERRED COMPENSATION, FOR THE FOLLOWING INDIVIDUALS: STEVEN GOLDSTEIN SERP PLAN $135,000 LEONARD SHUTE SERP PLAN $50,000 LEONARD SHUTE 457(F) PLAN $81,250 RAYMOND MAYEWSKI SERP PLAN $89,010 COUNTY OF MONROE INDUSTRIAL DEVELOPMENT AGENCY 161005429 610752DY0 2005-06-23 36194096 REFUND 1997 BONDS/ BLDING & EQUIP false false false DORMITORY AUTHORITY OF STATE OF NEW YORK 146000293 649905W93 2010-06-25 10932064 MEDICAL FACILTY, EQUIP & TECHNLGY false false false 5632814 0 30561282 3358494 0 0 323708 0 0 14228315 0 0 2006 false true true true 0 0 10932064 428710 0 0 218641 0 0 10284713 0 0 2011 false false true true false false false false true 0.00000 0.00000 0.00000 true false false false false true 0.00000 0.00000 0.00000 true false true false false false true false true false false false true SUPPLEMENTAL INFORMATION FORM 990, SCHEDULE K, PART III, LINE 3C HIGHLAND HOSPITAL DOES NOT HAVE ANY MANAGEMENT OR SERVICE CONTRACTS OR RESEARCH AGREEMENTS BUT WOULD ENGAGE BOND COUNSEL OR OTHER OUTSIDE COUNSEL TO REVIEW BEFORE ENTERING INTO ANY SUCH AGREEMENTS. FORM 990 REVIEW PROCESS FORM 990, PART VI, SECTION B, LINE 11 The Form 990 of Highland Hospital is prepared by Finance staff and provided to PricewaterhouseCoopers LLP and senior management for review prior to filing. The Form 990 wAS ALSO PROVIDED to the Hospital's Joint Audit and Finance Committee prior to filing. The Committee's questions and comments WERE addressed at a Committee meeting prior to filing. The 2010 Form 990 was presented to the Joint Audit and Finance Committee by PriceWaterhouseCoopers LLP prior to filing. The Form 990 was also provided to the entire Board of Directors prior to filing. CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C Directors, committee members, officers and key employees are required to disclose a conflict of interest: (a) prior to voting on or otherwise discharging their duties with respect to any matter involving the conflict which comes before the Board or any committee; (b) prior to entering into any contract or transaction involving the conflict; (c) as soon as possible after the director, committee member or officer learns of the conflict; and (d) on an annual conflict of interest disclosure form. The form is distributed annually and requires disclosure of all conflicts of interest, including specific information concerning the terms of any contract or transaction with the Hospital that involves a potential conflict of interest for the individual. The forms are reviewed by the Board Chair and legal counsel, and conflicts disclosed on the forms or on an ad hoc basis are reviewed by a Board committee. The Committee considers the material facts concerning any proposed contract or transaction, including the process by which the decision was made to approve or recommend entering into the arrangement on the terms proposed, and approves such contracts or transactions only if the terms are fair and reasonable to the Hospital and the arrangements are consistent with the best interests of the Hospital. COMPENSATION REVIEW AND APPROVAL FORM 990, PART VI, SECTION B, LINE 15 Written self-evaluations and performance evaluations for Highland Hospital's officers and key employees annually are reviewed by the Committee on Compliance and Compensation of the University of Rochester Medical Center Board. The Committee has available the evaluations from Highland Hospital's board, as well as from the CEO of URMC health system and in some cases Highland's CEO. The Committee reviews and approves total compensation for officers and key employees and considers, in addition to the evaluations, the scope of the individual's job responsibilities, previous compensation and comparable compensation paid to people with similar responsibilities at comparable institutions. The comparable information is provided by an independent consultant and is based on local, regional and national compensation surveys. GOVERNING DOCUMENTS FORM 990, PART VI, SECTION C, LINE 19 Highland Hospital's FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. Highland Hospital's GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE NOT ROUTINELY MADE AVAILABLE TO THE PUBLIC. COMPENSATION INFORMATION FORM 990, PART VII AND SCHEDULE J-2 CERTAIN OFFICERS, DIRECTORS AND KEY EMPLOYEES OF HIGHLAND HOSPITAL RECEIVE COMPENSATION FROM THE UNIVERSITY OF ROCHESTER, A RELATED IRC SECTION 501(C)(3) ORGANIZATION. A PORTION OF THE SALARIES OF THESE INDIVIDUALS IS ALLOCATED TO HIGHLAND HOSPITAL AND IS INCLUDED AS A PART OF OTHER SALARY AND WAGES ON THE STATEMENT OF FUNCTIONAL EXPENSES. CERTAIN OFFICERS AND KEY EMPLOYEES OF HIGHLAND HOSPITAL ALSO DEVOTE SIGNIFICANT TIME EACH WEEK TO OTHER RELATED ORGANIZATIONS, AS FOLLOWS: - STEVEN GOLDSTEIN DEVOTES APPROXIMATELY 55 HRS TO THE STRONG MEMORIAL HOSPITAL DIVISION OF THE UNIVERSITY OF ROCHESTER; 1 HR TO THE HIGHLAND HOSPITAL FOUNDATION; 1 HR TO HIGHLAND COMMUNITY DEVELOPMENT CORPORATION; 1 HR TO THE MEADOWS AT WESTFALL, INC.; AND 1 HR TO THE HIGHLANDS LIVING CENTER, INC. - LEONARD SHUTE DEVOTES APPROXIMATELY 45 HRS TO THE STRONG MEMORIAL HOSPITAL DIVISION OF THE UNIVERSITY OF ROCHESTER; 1 HR TO HIGHLAND COMMUNITY DEVELOPMENT CORPORATION; 1 HR TO THE MEADOWS AT WESTFALL, INC.; AND 1 HR TO THE HIGHLANDS LIVING CENTER, INC. - RAYMOND MAYEWSKI MD DEVOTES APPROXIMATELY 51 HRS TO THE STRONG MEMORIAL HOSPITAL DIVISION OF THE UNIVERSITY OF ROCHESTER. - ROBERT MCCANN, MD CURRENTLY SERVES AS THE CHIEF OF MEDICINE AT HIGHLAND HOSPITAL. A PORTION OF THE TOTAL COMPENSATION REPORTED RELATES TO HIS SERVICES PERFORMED IN THIS ROLE. - JOSEPH JOHNSON, MD CURRENTLY SERVES AS THE CHIEF OF SURGERY AT HIGHLAND HOSPITAL. A PORTION OF THE TOTAL COMPENSATION REPORTED RELATES TO HIS SERVICES PERFORMED IN THIS ROLE. - ANIL SHARMA, MD CURRENTLY SERVES AS THE CHIEF OF GASTROENTEROLOGY AT HIGHLAND HOSPITAL. THE COMPENSATION REPORTED RELATES TO HIS SERVICES PERFORMED IN THIS ROLE. NONE OF THE BOARD MEMBERS OF HIGHLAND HOSPITAL ARE COMPENSATED FOR THEIR BOARD SERVICE. HIGHLAND HOSPITAL OF ROCHESTER MAINTAINS A DEFINED BENEFIT RETIREMENT PLAN (THE "PLAN") WHICH COVERS EMPLOYEES OF THE HOSPITAL THAT HAVE COMPLETED TWO YEARS OF CONTINUOUS EMPLOYMENT. THE DEFERRED COMPENSATION AMOUNTS REPORTED FOR CINDY BECKER, CHOLPADY KAMATH MD, JULIETTA FISCELLA MD, LORI FERRIS MD, JEFFREY HANSON MD, AND GREGORY RYAN MD REPRESENT THE ACTUARIAL PRESENT VALUE OF THE BENEFITS ATTRIBUTED BY THE PLAN'S BENEFIT FORMULA TO SERVICES RENDERED BY THESE INDIVIDUALS DURING 2010. THE PRESENT VALUES ARE BASED UPON MANDATED IRS INTEREST AND MORTALITY ASSUMPTIONS AS DETAILED IN THE PLAN'S 2010 ACTUARIAL VALUATION REPORT. THE PENSION PLAN FORMULA CALCULATES A BENEFIT BASED UPON THE PARTICIPANT'S SERVICE AND 5 YEAR AVERAGE COMPENSATION. THE PRESENT VALUES OF THE BENEFITS ARE DEPENDENT UPON THE PARTICIPANT'S AGE AND THE INTEREST AND MORTALITY ASSUMPTIONS. MEMBERSHIP INFORMATION FORM 990, PART VI, SECTION A, LINES 6, 7A & 7B The sole member of Highland Hospital is Strong Partners Health System, Inc. ("SPHS"). SPHS, acting through its Board of Directors, has the authority to elect the governing body of Highland Hospital, and certain decisions of the Highland Hospital Board are subject to the approval of the SPHS Board. Such decisions include appointment of the Highland Hospital President and CEO, amendment of the Certificate of Incorporation and Bylaws, approval of extraordinary corporate actions such as merger or dissolution, and approval of capital and operating budgets, strategic plans, and incurrence of certain debt. DETAIL OF OTHER CHANGES IN NET ASSETS PART XI, LINE 5 OTHER CHANGES IN NET ASSESTS IS COMPRISED OF THE FOLLOWING ITEMS: -CHANGE IN ACCRUED PENSION LIABILITY ($4,634,844) -TRANSFERS TO AFFILIATES - HIGHLANDS AT BRIGHTON ($384,000) ----------- ($5,018,844) UNIVERSITY OF ROCHESTER 910 GENESEE STREET STE 200 ROCHESTER NY 14611 160743209 SCHOOL NY 501(C)(3) 2 NA THE HIGHLAND FOUNDATION INC 1000 SOUTH AVENUE ROCHESTER NY 14620 237310662 FUNDRAISING NY 501(C)(3) 7 HIGHLD HOSP HIGHLAND FACILITIES DEVELOPMENT CORP 1000 SOUTH AVENUE ROCHESTER NY 14620 223039077 MEDICAL BLDG NY 501(C)(3) 9 HIGHLD HOSP STRONG PARTNERS HEALTH SYSTEM INC 601 ELMWOOD AVENUE BOX 706 ROCHESTER NY 14642 161499099 SUPPORT ORG NY 501(C)(3) 11A, 1 UNIV OF ROCH THE MEADOWS AT WESTFALL INC 5901 LAC DE VILLE BLVD ROCHESTER NY 14618 161502303 HEALTHCARE NY 501(C)(3) 9 SPHS THE HIGHLANDS LIVING CENTER INC 500 HAHNEMANN TRAIL PITTSFORD NY 14534 223240227 HEALTHCARE NY 501(C)(3) 9 SPHS HIGHLAND COMMUNITY DEVELOPMENT CORP 100 HAHNEMANN TRAIL PITTSFORD NY 14534 223154715 ELDER CARE NY 501(C)(3) 9 SPHS STRONG HOME CARE GROUP 2180 EMPIRE BOULEVARD WEBSTER NY 14580 222577664 FUNDRAISING NY 501(C)(3) 7 UNIV OF ROCH VISITING NURSE SRVC OF ROCHESTER & MONRO 2180 EMPIRE BOULEVARD WEBSTER NY 14580 160743215 HEALTHCARE NY 501(C)(3) 9 SHCG COMMUNITY CARE OF ROCHESTER 2180 EMPIRE BOULEVARD WEBSTER NY 14580 161561691 HEALTHCARE NY 501(C)(3) 9 SHCG EXCELL PARTNERS INC 160 LINDEN OAKS SUITE E ROCHESTER NY 14625 201862628 ECONOMIC DEV NY 501(C)(4) N/A UNIV OF ROCH ROCHESTER BIOVENTURE CENTER INC 601 ELMWOOD AVENUE BOX 706 ROCHESTER NY 14642 202485999 BIOTECH INCUB NY 501(C)(3) 11A, 1 UNIV OF ROCH HIGH TECH ROCHESTER INC 150 LUCIUS GORDON DRIVE SUITE 100 WEST HENRIETTA NY 14586 161195028 BUSINESS INCU NY 501(C)(3) 7 UNIV OF ROCH CRITTENDEN BOULEVARD HOUSING CO INC 249 NORTON VILLAGE LANE ROCHESTER NY 14609 237035414 SUPPORT ORG NY 501(C)(3) 11B, II UNIV OF ROCH UNIVERSITY OF ROCHESTER EMPLOYEE BEN TRS 910 GENESEE STREET SUITE 200 ROCHESTER NY 14611 161600112 EMPL BEN TRST NY 501(C)(9) N/A UNIV OF ROCH U OF R BROADCASTING CORPORATION 201 WILSON COMMONS ROCHESTER NY 14627 160743209 BROADCAST LIC NY 501(C)(4) N/A UNIV OF ROCH UR REAL ESTATE CORPORATION 263 WALLIS HALL ROCHESTER NY 14627 271140014 SUPPORT ORG NY 501(C)(3) 11D, III-OT UNIV OF ROCH FRAMEMED FOUNDATION INC 263 WALLIS HALL ROCHESTER NY 14627 161490497 SUPPORT ORG NY 501(C)(3) 7 UNIV OF ROCH MEDICAL ADMINISTRATIVE ASSOCIATES INC 777 SOUTH CLINTON AVENUE ROCHESTER NY 14620 161354319 RETAIL PHARMACY NY HIGHLAND HOSPIT C CORP -740218 3374767 1.00000 UR EQUITY HOLDINGS INC 110 OFFICE PARK WAY PITTSFORD NY 14534 273040889 HOLDING CO NY UNIV ROCH C CORP false true true true false false false false false true true true true true true true false true THE HIGHLAND FOUNDATION INC C,R 489037 MEDICAL ADMINISTRATIVE ASSOCIATES INC K,N,P 701609 HIGHLAND FACILITIES DEVELOPMENT CORPORATION J,K,N 461600