Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 01-01-2018 , and ending 12-31-2018
BCheck if applicable:
CName of organization
NEWARK-WAYNE COMMUNITY HOSPITAL
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
PO BOX 111
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
NEWARK, NY14513
D Employer identification number

15-0584188
E Telephone number

G Gross receipts $ 151,626,416
F Name and address of principal officer:
ERIC J BIEBER MD
100 KINGS HIGHWAY S
ROCHESTER,NY14617
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.ROCHESTERGENERAL.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1952
M State of legal domicile: NY
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: TO OPERATE AN INPATIENT AND OUTPATIENT HOSPITAL, CLINICS AND TREATMENT CENTERS FOR THE DELIVERY OF ACUTE MEDICAL, SURGICAL AND PREVENTATIVE HEALTH CARE SERVICES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 11
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 10
5 Total number of individuals employed in calendar year 2018 (Part V, line 2a) ...... 5 1,130
6 Total number of volunteers (estimate if necessary) ............. 6 220
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 1,103
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 2,614,960 903,862
9 Program service revenue (Part VIII, line 2g) ......... 101,310,870 103,568,301
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 3,244,792 1,524,246
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 978,880 1,331,454
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 108,149,502 107,327,863
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 56,400,042 59,559,757
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 41,975,178 44,809,682
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 98,375,220 104,369,439
19 Revenue less expenses. Subtract line 18 from line 12....... 9,774,282 2,958,424
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 125,942,522 121,783,902
21 Total liabilities (Part X, line 26)............. 54,565,804 50,238,614
22 Net assets or fund balances. Subtract line 21 from line 20..... 71,376,718 71,545,288
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2018)
Form 990 (2018)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: SEE SCHEDULE O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 92,152,152 including grants of $   ) (Revenue $ 104,775,256 )
THE ORGANIZATION HAS 2 COMPONENTS; 1) A TAX EXEMPT HOSPITAL THAT PROVIDES INPATIENT AND OUTPATIENT HEALTH CARE SERVICES TO ROCHESTER AND THE SURROUNDING COMMUNITY AND 2) THE DEMAY NURSING HOME WHICH IS A 180 SKILLED NURSING FACILITY OFFERING 24 HOUR NURSING CARE, VENTILATOR DEPENDENT CARE AND SPECIALIZED CARE FOR INDIVIDUALS IN THE EARLY AND MID STAGES OF ALZHEIMER'S AND OTHER COGNITIVE DISORDERS OF AGING. SEE SCHEDULE H FOR CHARITY CARE DETAIL.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet92,152,152
Form 990 (2018)
Form 990 (2018)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment..............
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part IIIClick to see attachment.............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
Yes
 
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
Form 990 (2018)
Form 990 (2018)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV
........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV...
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
62
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2018)
Form 990 (2018)
Page 5
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
1,130
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? If "Yes," see instructions and file Form 4720, Schedule N .....
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income?
If "Yes," complete Form 4720, Schedule O ................
16
 
No
Form 990 (2018)
Form 990 (2018)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
11
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
10
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
NY
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletHUGH CHISHOLM100 KINGS HIGHWAY SOUTH   ROCHESTER,NY14617 (585) 922-1221
Form 990 (2018)
Form 990 (2018)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) ERIC BIEBER MD......................................................................
CEO
6.00
.................
49.00
X   X       238,564 1,948,270 1,074,266
(2) HARVEY FOWLER......................................................................
DIRECTOR
1.00
.................
0.00
X           0 0 0
(3) JEFFREY LEENHOUTS......................................................................
DIRECTOR
1.00
.................
0.00
X           0 0 0
(4) MARGARET CHURCHILL......................................................................
SECRETARY
1.00
.................
0.00
X   X       0 0 0
(5) MICHAEL JANKOWSKI......................................................................
TREASURER
1.00
.................
0.00
X   X       0 0 0
(6) ROBERT HUTTEMAN......................................................................
DIRECTOR
1.00
.................
0.00
X           0 0 0
(7) SCOTT HEALY......................................................................
CHAIR OF THE BOARD
1.00
.................
0.00
X   X       0 0 0
(8) STEVE TAYLOR......................................................................
VICE CHAIR
1.00
.................
0.00
X   X       0 0 0
(9) EDWARD LEROUX......................................................................
DIRECTOR
1.00
.................
0.00
X           0 0 0
(10) TARA GELLASCH MD......................................................................
DIRECTOR
1.00
.................
54.00
X           0 308,953 9,764
(11) PAUL JOHNSON......................................................................
DIRECTOR
1.00
.................
0.00
X           0 0 0
(12) THOMAS R CRILLY......................................................................
CFO
6.00
.................
49.00
    X       90,847 741,923 285,969
(13) ROBERT NESSELBUSH......................................................................
COO
7.00
.................
48.00
    X       178,073 1,221,070 555,078
(14) HUGH THOMAS......................................................................
CAO
6.00
.................
49.00
    X       108,210 883,716 412,117
(15) DUSTIN RICCIO......................................................................
PRESIDENT, EASTERN REGION
30.00
.................
25.00
    X       223,008 185,841 87,295
(16) MICHAEL CUNNINGHAM......................................................................
PHYSICIAN
40.00
.................
 
        X   395,191 0 7,375
(17) EVE M WILLIAMS......................................................................
PHYSICIAN
40.00
.................
 
        X   422,107 0 36,304
Form 990 (2018)
Form 990 (2018)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) MARITA MICHELIN........................................................................
PHYSICIAN
40.00
.......................  
        X   401,311 0 30,894
(19) CYNTHIA MARTINEZ-CAPOLINO........................................................................
PHYSICIAN
40.00
.......................  
        X   362,496 0 921
(20) YULIYA REHAB........................................................................
PHYSICIAN
40.00
.......................  
        X   445,912 0 6,302
(21) WARREN HERN........................................................................
FORMER CEO
0.00
.......................  
          X 0 250,000 0


















1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 2,865,719 5,539,773 2,506,285
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet22
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
DGA BUILDERS

1170 PITTSFORD VICTOR RD
PITTSFORD,NY14534
CONSTRUCTION SERVICES 575,261
SCRIBEAMERICA LLC

PO BOX 417756
BOSTON,MA02241
AGENCY SERVICES 211,078
SPECIAL CARE SYSTEMS LLC

1450 E RIDGE RD
ROCHESTER,NY146100759
COMMUNICATION SERVICES 110,422
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet3
Form 990 (2018)
Form 990 (2018)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 559,784
e Government grants (contributions)1e 335,628
f All other contributions, gifts, grants, and similar amounts not included above1f 8,450
g Noncash contributions included in lines 1a - 1f:$  
h Total. Add lines 1a-1f.......MediumBullet 903,862
 Program Service RevenueAmt Business Code
2a NET PATIENT REVENUE 621110 103,568,301 103,568,301    
b
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f ....MediumBullet 103,568,301
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 1,253,976     1,253,976
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   124,499
b Less: rental expenses   0
c Rental income or (loss)   124,499
d Net rental income or (loss)......MediumBullet 124,499     124,499
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   44,568,823
b Less: cost or other basis and sales expenses   44,298,553
c Gain or (loss)   270,270
d Net gain or (loss).....MediumBullet 270,270     270,270
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a CAFETERIA SALES 445110 424,778 424,778    
b            
c            
d All other revenue .... 782,177 782,177    
e Total. Add lines 11a–11d ...... MediumBullet 1,206,955
12 Total revenue. See Instructions......MediumBullet 107,327,863 104,775,256 0 1,648,745
Form 990 (2018)
Form 990 (2018)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21    
2 Grants and other assistance to domestic individuals. See Part IV, line 22    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 1,150,312 981,917 168,395  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 47,883,013 41,932,049 5,950,964  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 2,212,684 1,563,127 649,557  
9 Other employee benefits ....... 5,498,207 4,213,651 1,284,556  
10 Payroll taxes ........... 2,815,541 2,092,792 722,749  
11 Fees for services (non-employees):        
a Management ...... 7,657,854 6,943,376 714,478  
b Legal ......... 102,299 92,755 9,544  
c Accounting ........... 7,500 6,800 700  
d Lobbying ........... 9,954 9,954    
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 12,757,653 11,566,435 1,191,218  
12 Advertising and promotion .... 3,486 3,161 325  
13 Office expenses ....... 234,564 230,553 4,011  
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 1,658,257 1,629,901 28,356  
17 Travel ............ 70,392 69,188 1,204  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings ....        
20 Interest ........... 503,295 386,983 116,312  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 3,991,863 3,069,344 922,519  
23 Insurance ... 532,605 452,647 79,958  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 12,645,226 12,428,993 216,233  
b LICENSES AND TAXES 1,347,858 1,324,810 23,048  
c SHARED SERVICES 1,233,085 1,211,999 21,086  
d BAD DEBT EXPENSE 870,499 870,499    
e All other expenses 1,183,292 1,071,218 112,074  
25 Total functional expenses. Add lines 1 through 24e 104,369,439 92,152,152 12,217,287 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2018)
Form 990 (2018)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 12,276,376 1 12,334,079
2 Savings and temporary cash investments ......... 2,011,394 2 3,747,271
3 Pledges and grants receivable, net ...... 134,055 3 136,004
4 Accounts receivable, net ............. 7,403,769 4 6,972,828
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
  6  
7 Notes and loans receivable, net ....   7  
8 Inventories for sale or use ........ 112,625 8 107,924
9 Prepaid expenses and deferred charges ...... 100,298 9 144,003
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 105,895,820
b Less: accumulated depreciation 10b 72,236,818 35,409,480 10c 33,659,002
11 Investments—publicly traded securities . 15,093,666 11 15,314,663
12 Investments—other securities. See Part IV, line 11 ..... 35,976,448 12 34,714,127
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 17,424,411 15 14,654,001
16 Total assets. Add lines 1 through 15 (must equal line 34)... 125,942,522 16 121,783,902
Liabilities 17 Accounts payable and accrued expenses ..... 8,744,336 17 8,946,955
18 Grants payable ...   18  
19 Deferred revenue ......... 3,591 19 2
20 Tax-exempt bond liabilities ......... 11,603,404 20 10,842,767
21 Escrow or custodial account liability. Complete Part IV of Schedule D 130,170 21 197,310
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 34,084,303 25 30,251,580
26 Total liabilities. Add lines 17 through 25.. 54,565,804 26 50,238,614
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets 69,750,317 27 70,362,581
28 Temporarily restricted net assets ........... 1,224,086 28 780,392
29 Permanently restricted net assets 402,315 29 402,315
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund ...   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 71,376,718 33 71,545,288
34 Total liabilities and net assets/fund balances ........ 125,942,522 34 121,783,902
Form 990 (2018)
Form 990 (2018)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
107,327,863
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
104,369,439
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
2,958,424
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
71,376,718
5
Net unrealized gains (losses) on investments ...............
5
-1,782,430
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-1,007,424
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
71,545,288
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2018)
Form 990 (2018)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
NEWARK-WAYNE COMMUNITY HOSPITAL
 
Employer identification number

15-0584188
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9

10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2014 (b) 2015 (c) 2016 (d) 2017 (e) 2018 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2018

Schedule A (Form 990 or 990-EZ) 2018
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
 
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions
 
9 Distributable amount for 2018 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2018
(iii)
Distributable
Amount for 2018
1 Distributable amount for 2018 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2018:
a From 2013.......  
b From 2014.......  
c From 2015.......  
d From 2016.......  
e From 2017.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2018 distributable amount  
i Carryover from 2013 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2018 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2018 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2018, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.
 
6 Remaining underdistributions for 2018. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.
 
7 Excess distributions carryover to 2019. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2014......  
b Excess from 2015.....  
c Excess from 2016.....  
d Excess from 2017.....  
e Excess from 2018.....  
Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2018


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Name of the organization
NEWARK-WAYNE COMMUNITY HOSPITAL
 
Employer identification number

15-0584188
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2
Name of organization
NEWARK-WAYNE COMMUNITY HOSPITAL
 
Employer identification number
15-0584188
Part I
Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 3
Name of organization
NEWARK-WAYNE COMMUNITY HOSPITAL
 
Employer identification number

15-0584188
Part II
Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)
Page 4
Name of organization
NEWARK-WAYNE COMMUNITY HOSPITAL
 
Employer identification number

15-0584188
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
NEWARK-WAYNE COMMUNITY HOSPITAL
 
Employer identification number

15-0584188
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2018

Schedule C (Form 990 or 990-EZ) 2018
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................    
c Total lobbying expenditures (add lines 1a and 1b) ...................................................................    
d Other exempt purpose expenditures ........................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2018


Schedule C (Form 990 or 990-EZ) 2018
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
9,954
j
Total. Add lines 1c through 1i ....................................................................................................
9,954
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: THE AMOUNT REFLECTED ON PART II-B, LINE 1I REPRESENTS THE PORTION OF MEMBERSHIP DUES PAID TO GREATER NY HOSPITAL ASSOCIATION, HEALTH CARE ASSOCIATION OF NYS (HANYS), AND THE AMERICAN HOSPITAL ASSOCIATION (AHA) ATTRIBUTABLE TO LOBBYING ACTIVITIES.
Schedule C (Form 990 or 990EZ) 2018


Additional Data


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SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
NEWARK-WAYNE COMMUNITY HOSPITAL
 
Employer identification number

15-0584188
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c 130,170
d Additions during the year ............................ 1d 776,708
e Distributions during the year .......................... 1e 709,568
f Ending balance ................................ 1f 197,310
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 402,315 402,315 402,315 402,315 402,315
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ...... 402,315 402,315 402,315 402,315 402,315
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
 
No
(ii) related organizations .................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   56,981 56,981
b Buildings ....   67,664,770 42,328,169 25,336,601
c Leasehold improvements        
d Equipment ....   34,602,792 28,745,340 5,857,452
e Other .....   3,571,277 1,163,309 2,407,968
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 33,659,002
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3) Other
(A) COMMON COLLECTIVE TRUSTS
2,999,599 C

(B) LIMITED PARTNERSHIP HEDGE FUND
28,504,277 C

(C) LIMITED PARTNERSHIP
3,210,251 C
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 34,714,127
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) ESTIMATED 3RD PARTY RECEIVABLE 631,161
(2) INTEREST IN ASSETS OF FOUNDATIONS 5,291,622
(3) OTHER INVESTMENTS 767,440
(4) INSURANCE RECOVERIES RECEIVABLE 6,767,964
(5) DUE FROM AFFILIATES 796,452
(6) OTHER RECEIVABLES 399,362
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 14,654,001
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
ESTIMATED 3RD PARTY PAYABLES 15,407,656
ACCRUED SELF-INSURED LIABILITIES 14,550,437
DUE TO AFFILIATES 293,487
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 30,251,580
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2018

Schedule D (Form 990) 2018
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART IV, LINE 2B: RESIDENTS HAVE AUTHORIZED DEMAY LIVING CENTER, ATTACHED TO AND A PART OF NEWARK WAYNE COMMUNITY HOSPITAL, TO MANAGE THEIR PERSONAL FINANCES. THE FACILITY HOLDS, SAFEGUARDS, MANAGES, AND ACCOUNTS FOR PERSONAL FUNDS OF THE RESIDENTS DEPOSITED WITH THE FACILITY. INDIVIDUAL RESIDENT FUNDS ARE DEPOSITED INTO AN INTEREST-BEARING ACCOUNT AND EACH RESIDENT HAS AN INTERNAL ACCOUNTING OF THE BALANCE OF THEIR FUND. EACH RESIDENT IS PROVIDED ON A MONTHLY BASIS AN ACCOUNTING OF THEIR FUND BALANCE.
PART V, LINE 4: INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS INCLUDE: 1) CAPITAL EXPANSION 2) ADVANCEMENT OF MEDICAL EDUCATION AND RESEARCH AND HEALTH CARE SERVICES
Schedule D (Form 990) 2018


Additional Data


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Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
NEWARK-WAYNE COMMUNITY HOSPITAL
 
Employer identification number

15-0584188
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
    4,320,608 1,993,228 2,327,380 2.250 %
b Medicaid (from Worksheet 3, column a) . . . . .     19,061,124 10,089,860 8,971,264 8.670 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     6,012,025 3,002,335 3,009,690 2.910 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     29,393,757 15,085,423 14,308,334 13.830 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     28,440   28,440 0.030 %
f Health professions education (from Worksheet 5) . . .            
g Subsidized health services (from Worksheet 6) . . . .     58,095,755 43,487,314 14,608,441 14.110 %
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .            
j Total. Other Benefits . .     58,124,195 43,487,314 14,636,881 14.140 %
k Total. Add lines 7d and 7j .     87,517,952 58,572,737 28,945,215 27.970 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members
           
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
870,499
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
429,672
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
15,683,110
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
17,386,694
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-1,703,584
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
11 NW ASSOCIATES LP
 
LEASING 75.100 %   24.900 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 NEWARK-WAYNE COMMUNITY HOSPITAL
1200 DRIVING PARK AVENUE
NEWARK,NY14513
X X     X   X      
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
NEWARK-WAYNE COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 16
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): WWW.ROCHESTERREGIONAL.ORG
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
NEWARK-WAYNE COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.ROCHESTERREGIONAL.ORG
b
WWW.ROCHESTERREGIONAL.ORG
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 6
Part VFacility Information (continued)

Billing and Collections
NEWARK-WAYNE COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
NEWARK-WAYNE COMMUNITY HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
NEWARK-WAYNE COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED IN PARTNERSHIP BETWEEN NEWARK WAYNE COMMUNITY HOSPITAL SERVING WAYNE COUNTY, NY IN COLLABORATION WITH WAYNE COUNTY PUBLIC HEALTH AND THE COMMUNITY PLANNING AGENCY, FINGER LAKES HEALTH SYSTEM AGENCY (FLHSA). REPRESENTATIVES FROM EACH OF THESE ORGANIZATIONS AS WELL AS REPRESENTATIVES FROM A VARIETY OF OTHER COMMUNITY ORGANIZATIONS CONSTITUTE THE WAYNE HEALTH IMPROVEMENT PARTNERSHIP (WHIP), THE OVERSIGHT BODY FOR THE DEVELOPMENT OF THE CHNA. INFORMATION DISCUSSED BY THE WHIP IS SHARED, AS IS APPROPRIATE, WITH HOSPITAL LEADERSHIP AND TO VARIOUS COMMUNITY GROUPS FOR INPUT AND COMMENT.
NEWARK-WAYNE COMMUNITY HOSPITAL PART V, SECTION B, LINE 6B: WAYNE COUNTY PUBLIC HEALTH AND FINGER LAKES HEALTH SYSTEM AGENCY
NEWARK-WAYNE COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE MOST RECENTLY CONDUCTED CHNA ARE ALL BEING ADDRESSED BY THE HOSPITAL FACILITY. SEE THE DISCLOSURES IN PART VI AS WELL AS THE HOSPITAL FACILITY'S IMPLEMENTATION PLAN FOUND AT WWW.ROCHESTERREGIONAL.ORG FOR MORE INFORMATION.
NEWARK-WAYNE COMMUNITY HOSPITAL PART V, SECTION B, LINE 16J: ALSO LOCATED IN OUTPATIENT SETTINGS.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?4
Name and address Type of Facility (describe)
1 1 - DEMAY LIVING CENTER
100 SUNSET DRIVE
NEWARK,NY14513
SKILLED NURSING FACILITY
2 2 - MYERS LAB
6692 MIDDLE ROAD SUITE 1100
SODUS,NY14551
LABORATORY
3 3 - NEWARK HOSPITAL LAB
1200 DRIVING PARK AVENUE
NEWARK,NY14513
LABORATORY
4 4 - WILLIAMSON LAB
4425 OLD RIDGE ROAD
WILLIAMSON,NY14589
LABORATORY
5
6
7
8
9
10
Schedule H (Form 990) 2018
Schedule H (Form 990) 2018
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 6A: NEWARK WAYNE COMMUNITY HOSPITAL'S COMMUNITY BENEFIT REPORT IS INCLUDED IN THE COMMUNITY BENEFIT REPORT FOR ROCHESTER REGIONAL HEALTH, A RELATED NOT-FOR-PROFIT ORGANIZATION, AS PART OF THE JOINT COMMUNITY BENEFIT REPORT DISTRIBUTED BY WAYNE COUNTY, NY.
PART I, LINE 7: THE COSTING METHODOLOGY USED FOR LINES 7A, B, C AND F WAS FROM BOTH THE HOSPITAL'S 2018 MEDICAID ICR, UTILIZING EXHIBIT 46, AND THE 2018 MEDICARE MCR, UTILIZING WORKSHEETS S-10 AND B, PART I. WORKSHEET 2 WAS USED TO CALCULATE THE RATIO OF PATIENT CARE COST-TO-CHARGES. EXHIBITS 11 AND 46 FROM THE 2018 MEDICAID ICR WERE UTILIZED TO COMPLETE THE CALCULATIONS.
PART I, LINE 7G: NO PHYSICIAN CLINIC COSTS WERE INCLUDED ON LINE 7G.
PART I, LN 7 COL(F): TOTAL EXPENSES ON FORM 990, PART IX, LINE 25, COLUMN (A) ARE $104,369,439. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT IS $870,499. AFTER BAD DEBT WAS DEDUCTED FROM TOTAL EXPENSES, THE AMOUNT OF TOTAL EXPENSES USED TO CALCULATE THE PERCENT IN LINE 7, COLUMN (F) WAS $103,498,940.
PART I, LINE 7E: DURING 2018, NEWARK WAYNE COMMUNITY HOSPITAL (NWCH) SPONSORED THE FOLLOWING EVENTS AND ACTIVITIES TO PROMOTE COMMUNITY HEALTH IMPROVEMENT THAT MET THE DEFINITION FOR DISCLOSURE ON SCHEDULE H, PART I, LINE 7E (COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS). NEWARK WAYNE COMMUNITY HOSPITAL SUMMERFEST - IN PARTNERSHIP WITH THE NEWARK POLICE DEPARTMENT AND ALL THREE NEWARK ELEMENTARY SCHOOLS, NEWARK-WAYNE HOSPITAL HOSTED ITS ANNUAL SUMMERFEST HEALTH FAIR OFFERING COMMUNITY MEMBERS MANY HEALTH AND SAFETY RELATED SERVICES INCLUDING: FITTING OF FREE BIKE HELMETS (DONATED BY PHYSICIANS) TO OVER 200 CHILDREN; CHILDREN'S CAR SEAT SAFETY CHECKS; A BIKE RODEO TO TEACH CHILDREN ABOUT BIKE SAFETY; BLOOD PRESSURE AND GLUCOSE SCREENINGS; AND INFORMATION ON MANY HEALTH-RELATED TOPICS FROM NWCH AND PARTNER HEALTH AGENCIES FROM AROUND WAYNE COUNTY. ADDITIONALLY, THE CANCER SERVICES PROGRAM (CSP) PROVIDED INFORMATION AND EDUCATION ABOUT THE IMPORTANCE OF GETTING SCREENED. WAYNE COUNTY FAIR - RRH PRESENCE COVERED INFORMATION AND EMPLOYEE VOLUNTEERS FROM SURGICAL SERVICES, LAB SERVICES, NICHE/HEALTH FIRST FAMILY MEDICINE, STROKE, ICU, CARDIAC REHAB, WOMEN'S CARE, ENDOCRINOLOGY, RESPIRATORY THERAPY, ORTHOPEDICS, PHYSICAL AND OCCUPATIONAL THERAPY AND SPEECH THERAPY.CAMP MEDQUEST - CAMP MEDQUEST IS A DAY CAMP FOR HIGH SCHOOL STUDENTS TO EXPERIENCE THE OPPORTUNITIES AVAILABLE IN HEALTHCARE. STUDENTS LEARN FROM A VARIETY OF HEALTH PROFESSIONALS THROUGH ONE-ON-ONE AND HANDS-ON ACTIVITIES. THE GOOD LIFE, A 10-WEEK HEALTH AND WEIGHT-LOSS PROGRAM WAS SPONSORED BY THE WAYNE COUNTY RURAL HEALTH NETWORK, CORNELL COOPERATIVE EXTENSION AND NEWARK-WAYNE COMMUNITY HOSPITAL, OFFERING INCENTIVES, EDUCATION AND OPTIONS FOR FAMILIES TO BECOME HEALTHIER. MEASUREMENTS OF WEIGHT, HEIGHT AND BLOOD PRESSURE WERE TAKEN AS A BASELINE TO HELP TRACK SUCCESS. PARTICIPANTS ALSO RECEIVE A PEDOMETER, TRACKING TOOLS AND INFORMATION ABOUT HOW TO ACHIEVE GOALS. THE CLASSES TAUGHT STEP-BY-STEP TOOLS ABOUT HOW TO STAY GOAL-FOCUSED.2018 SENIOR EXPO AT LYONS, NY. CO-SPONSORED BY WAYNE COUNTY RURAL HEALTH NETWORK, WAYNE COUNTY DEPARTMENT OF AGING AND NEWARK WAYNE COMMUNITY HOSPITAL PROVIDED INFORMATION TO ABOUT 75 SENIORS ON MANY HEALTH TOPICS INCLUDING OBESITY AND DISEASE PREVENTION (DIABETES, HEART, STROKE AND MORE).THE WAYNE COUNTY RURAL HEALTH NETWORK (OF WHICH NWCH IS A PARTNER) RAN THE WAYNE COUNTY WORKSITE WELLNESS COALITION AND LEARNING COLLABORATIVE TO EDUCATE EMPLOYERS IN WAYNE COUNTY ABOUT HOW TO DEVELOP WORKSITE WELLNESS PROGRAMS, SHARE AVAILABLE RESOURCES, AND DEVELOP A LOCALLY AVAILABLE TOOLKIT AND WEBSITE PAGE. NWCH IS A SPONSOR OF THIS PROGRAM AND PROVIDES SPACE AND RESOURCES TO ITS EFFORT.CANCER SERVICES PROGRAM COLLABORATED WITH LOCAL YMCAS TO PROMOTE CANCER SCREENINGS. APPROXIMATELY 160 SCREENINGS FOR BREAST, CERVICAL AND COLORECTAL CANCER WERE CONDUCTED THROUGH COLLABORATION BETWEEN THE NWCH CANCER SERVICES PROGRAM AND LOCAL YMCAS. MANY OTHER SERVICES WERE PROVIDED SUCH AS CONSULTS AND PATHOLOGY. IN MARCH DURING COLORECTAL CANCER AWARENESS MONTH, THE CSP PARTNERED WITH THE GI OFFICES IN THE GO BLUE (COLORECTAL CANCER - CRC) CAMPAIGN. CSP INVITED GI PROVIDERS, LOCAL OFFICIALS AND LEGISLATORS TO SPEAK AT A PRESENTATION SUPPORTING CRC AWARENESS AND OUR INITIATIVE TO ACHIEVE 80% OF NEW YORKERS BE SCREENED FOR CRC BY 2018. NATIONAL HEALTH-RELATED HOLIDAYS - NEWARK-WAYNE COMMUNITY HOSPITAL STAFF PROVIDED HEALTH EDUCATION INFORMATION TO STAFF AND VISITORS ON NATIONAL HEALTH-RELATED HOLIDAYS. IN 2018, RECOGNITIONS INCLUDED EDUCATIONAL MATERIALS, SOCIAL MEDIA OUTREACH, MEDIA PITCHES AND GIVEAWAYS. SOME TOPICS INCLUDED: HEART, BRAIN INJURY AWARENESS, DIABETES, BREAST CANCER, COLORECTAL CANCER, MELANOMA, CONCUSSION, CHOLESTEROL EDUCATION, MEN'S HEALTH, BETTER SLEEP AND DEPRESSION. THE NEW VISIONS HEALTH PROFESSIONS PROGRAM IS A CAREER EXPLORATION PROGRAM, THROUGH WAYNE FINGER LAKES BOCES, DESIGNED FOR HIGH SCHOOL SENIORS INTERESTED IN MEDICAL AND HEALTH-RELATED PROFESSIONS. THE GOAL IS TO PROVIDE STUDENTS WITH AN EXPOSURE TO THE VARIED CAREERS IN MEDICINE. NEWARK WAYNE HOSPITAL PROVIDES CLASSROOM SPACE AND STUDENTS WITH SHADOWING OPPORTUNITIES TO APPROXIMATELY 25 STUDENTS THROUGHOUT THE SCHOOL YEAR. SPONSORSHIPS - ROCHESTER REGIONAL HEALTH, AS A SYSTEM, INCLUDING NEWARK WAYNE COMMUNITY HOSPITAL, IS COMMITTED TO GIVING BACK TO THE COMMUNITY BY SUPPORTING THE MANY ORGANIZATIONS THAT ARE ALREADY WORKING SO HARD TO IMPROVE COMMUNITY HEALTH. AS SUCH, WE PROVIDE SERVICES AND STAFF TO LOCAL ORGANIZATIONS AND COMMUNITY EVENTS INCLUDING THE AMERICAN HEART WALK, THE AMERICAN CANCER SOCIETY, THE MARCH OF DIMES, THE JUVENILE DIABETES FOUNDATION, THE AMERICAN DIABETES ASSOCIATION, TOUR DE CURE, GREECE REGIONAL CHAMBER OF COMMERCE, AND THE UNITED WAY.
PART III, LINE 4: IN 2018, THE ORGANIZATION CONTINUED ITS ENHANCED PROCESS FOR OBTAINING ADDITIONAL FINANCIAL INFORMATION FOR UNINSURED AND UNDER-INSURED PATIENTS WHO HAVE NOT SUPPLIED THE REQUISITE INFORMATION TO DETERMINE IF THEY QUALIFY FOR CHARITY CARE. THE ADDITIONAL INFORMATION OBTAINED WAS USED BY THE ORGANIZATION TO DETERMINE WHETHER TO QUALIFY PATIENTS FOR CHARITY CARE IN ACCORDANCE WITH THE ORGANIZATION'S POLICY. THE APPLICATION OF THIS ADDITIONAL INFORMATION IN 2018 RESULTED IN ADDITIONAL PATIENTS QUALIFYING FOR CHARITY CARE AND THUS RE-CLASSIFYING THIS AMOUNT FROM BAD DEBT EXPENSE. BAD DEBT EXPENSE ON PART III, LINE 2 REPRESENTS ESTIMATED UNCOLLECTIBLE CHARGES FOR THOSE PATIENTS UNWILLING OR UNABLE TO PAY.BAD DEBT COSTING METHODOLOGY:THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE HOSPITAL FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE HOSPITAL. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE HOSPITAL'S POLICIES.BAD DEBT EXPENSE IS RECORDED USING THE VALUATION METHOD AS OUTLINED IN HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) STATEMENT 15, WHICH REQUIRES BAD DEBT EXPENSE TO BE RECORDED AT THE AMOUNT THAT THE PAYER IS EXPECTED TO PAY. THE PROVISION FOR BAD DEBTS REPRESENTS ESTIMATED UNCOLLECTIBLE CHARGES OF PATIENTS UNWILLING TO PAY. IN 2018, THE ORGANIZATION CONTINUED ITS ENHANCED PROCESS FOR OBTAINING ADDITIONAL FINANCIAL INFORMATION FOR UNINSURED AND UNDERINSURED PATIENTS WHO HAVE NOT SUPPLIED THE REQUISITE INFORMATION TO DETERMINE IF THEY QUALIFY FOR CHARITY CARE. THE APPLICATION OF THIS ADDITIONAL INFORMATION IN 2018 RESULTED IN ADDITIONAL PATIENTS QUALIFYING FOR CHARITY CARE AND A REDUCTION TO BAD DEBT EXPENSE.
PART III, LINE 8: MEDICARE COSTING METHODOLOGY: THE ORGANIZATION USED THE FILED 2018 CMS COST REPORT TO DETERMINE THE MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENTS RECEIVED FROM MEDICARE. MEDICARE SHORTFALLS, WHICH ARE COSTS INCURRED BY THE HOSPITAL TO PROVIDE QUALITY CARE AND TREATMENT TO ITS PATIENTS, SHOULD BE TREATED AS A COMMUNITY BENEFIT. TO NOT INCUR THESE COSTS WOULD POTENTIALLY LIMIT OR EVEN COMPROMISE THE QUALITY OF SERVICE PROVIDED.
PART III, LINE 9B: AT SUCH TIME THAT A PATIENT EXPRESSES A FINANCIAL CONCERN, THE PATIENT WILL BE OFFERED THE OPPORTUNITY TO APPLY FOR CHARITY CARE. ONCE THE PATIENT SUBMITS THE COMPLETED CHARITY CARE APPLICATION, THE ACCOUNT IS PLACED ON HOLD AND ALL COLLECTION ACTIVITIES ARE SUSPENDED UNTIL AN ELIGIBILITY DETERMINATION IS MADE. IF THE PATIENT IS ELIGIBLE FOR CHARITY CARE, THEN THE PATIENT IS NOTIFIED OF THE LEVEL OF CHARITY CARE AWARDED. IF 100% CHARITY CARE IS AWARDED, THEN NO BILL IS SENT TO THE PATIENT. IF LESS THAN 100% CHARITY CARE IS AWARDED, THEN THE PATIENT WILL RECEIVE A BILL PURSUANT TO THE PRIVATE PAY COLLECTION POLICY. ONLY AFTER PATIENT'S LIABILITY HAS BEEN DETERMINED FOLLOWING PROCESSING OF APPLICATIONS FOR GOVERNMENT ASSISTANCE, CHARITY CARE, AND/OR INSURANCE CARRIER REMITTANCE WILL THE PATIENT STATEMENT BE MAILED FOR PAYMENT RECOVERY. THE HOSPITAL'S COLLECTION PRACTICES SET FORTH IN ITS WRITTEN DEBT COLLECTION POLICY APPLY TO ALL PATIENT TYPES OF THE HOSPITAL.
PART VI, LINE 2: THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED IN PARTNERSHIP BETWEEN NEWARK WAYNE COMMUNITY HOSPITAL SERVING WAYNE COUNTY, NY IN COLLABORATION WITH WAYNE COUNTY PUBLIC HEALTH AND THE COMMUNITY PLANNING AGENCY, FINGER LAKES HEALTH SYSTEM AGENCY (FLHSA). REPRESENTATIVES FROM EACH OF THESE ORGANIZATIONS AS WELL AS REPRESENTATIVES FROM A VARIETY OF OTHER COMMUNITY ORGANIZATIONS CONSTITUTE THE WAYNE HEALTH IMPROVEMENT PARTNERSHIP (WHIP), THE OVERSIGHT BODY FOR THE DEVELOPMENT OF THE CHNA. INFORMATION DISCUSSED BY THE WHIP IS SHARED, AS IS APPROPRIATE, WITH HOSPITAL LEADERSHIP AND TO VARIOUS COMMUNITY GROUPS FOR INPUT AND COMMENT.THE WHIP CONTRACTED WITH S2AY TO AID IN FACILITATION AND PREPARATION OF THIS REPORT. S2AY BEGAN ITS DATA COLLECTION AND ANALYSIS EFFORTS BY FOCUSING ON DATA RELATED TO THE PRIOR CHNA FOR THE REGION AS WELL AS EMERGING ISSUES AS IDENTIFIED BY HOSPITALS AND PUBLIC HEALTH EXPERTS AS WAS REVEALED IN THE NEEDS ASSESSMENT FOR THE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP). THE PRIMARY AND CONSISTENT SOURCE OF DATA USED TO PRIORITIZE THE HEALTH NEEDS OF OUR COMMUNITY WAS THE COUNTY LEVEL DASHBOARDS OF THE NEW YORK STATE PREVENTION AGENDA. IN ADDITION, OTHER KEY SOURCES OF DATA INCLUDED:- 2013-2014 EXPANDED BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY (EBRFSS)- CENSUS BUREAU (2010 CENSUS AND 2015 AMERICAN COMMUNITY SURVEY ESTIMATES)- 2010-2014 STATEWIDE PLANNING AND RESEARCH COOPERATIVE SYSTEMS (SPARCS) DATA- NYS PREVENTION AGENDA DATA SET (UPDATED 2016)- 2014 AGGREGATED CLAIMS DATA- 2014 NYS VITAL STATISTICS- 2015 REGIONAL HIGH BLOOD PRESSURE REGISTRY- COUNTY PREVENTION AGENDA DASHBOARD (UPDATED 2016)- 2010-2014 COMMUNITY HEALTH INDICATOR REPORTS- SUB-COUNTY DATA REPORTS (2016 REPORT)- 2012-2014 LEADING CAUSES OF DEATH INDICATORS- COUNTY HEALTH RANKINGS (2016 REPORT)THE WHIP REVIEWED DATA FROM EACH OF THESE SOURCES AND IN CONJUNCTION WITH S2AY THEY DEVELOPED A PRESENTATION OUTLINING THE HIGHEST NEEDS IN WAYNE COUNTY. S2AY SHARED THIS DATA WITH EIGHT SEPARATE AND DIVERSE FOCUS GROUPS THROUGHOUT THE COMMUNITY. THESE MEETINGS WERE USED TO NOT ONLY REVIEW THE DATA BUT ALSO TO GAIN AN UNDERSTANDING OF THE PERCEPTIONS REGARDING THE NEEDS OF THE COMMUNITY. THE PROCESS FOR PRIORITIZING COMMUNITY HEALTH NEEDS AND SERVICES WAS DETERMINED THROUGH LISTENING TO THE OPINIONS OF MEMBERS OF WHIP AS WELL AS LEADERS FROM DSRIP, SEVERAL COMMUNITY HEALTH EXPERTS AS WELL AS THE FOCUS GROUPS. MEMBERS OF EACH FOCUS GROUP WERE INVITED TO ATTEND THE PRIORITY SETTING MEETING. AFTER THE PRELIMINARY PRIORITY SETTING MEETING WAS HELD, ANOTHER OPPORTUNITY FOR INPUT FROM THE GENERAL PUBLIC WAS PROVIDED. PRELIMINARY PRIORITIES WERE LISTED IN A MEDIA RELEASE AS WELL AS WEBSITES OF THE HOSPITAL AND PUBLIC HEALTH OFFICES. OVERALL, AFTER CONSIDERING THE OPINIONS OF THE WHIP MEMBERS, THE COMMUNITY, THE STATE OF NEW YORK AND THE HEALTH DATA, THE FOLLOWING PRIORITIES WERE IDENTIFIED: PREVENT CHRONIC DISEASE:1. REDUCE OBESITY IN CHILDREN AND ADULTS2. REDUCE ILLNESS, DISABILITY AND DEATH RELATED TO TOBACCO USE AND SECONDHAND SMOKE EXPOSURE3. INCREASE ACCESS TO HIGH QUALITY CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT IN BOTH CLINICAL AND COMMUNITY SETTINGSPROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN4. CHILD HEALTHPROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE5. PROMOTE MENTAL, EMOTIONAL AND BEHAVIORAL WELL-BEINGADDITIONALLY, WAYNE COUNTY IS FOCUSING ON THE FOLLOWING DISPARITIES IN THIS COMMUNITY HEALTH IMPROVEMENT PLAN. 1. LOWER RATES OF BREASTFEEDING AMONG WOMEN OF LOWER SOCIO-ECONOMIC STATUS2. DECREASING SMOKING RATES IN THE LOWER SOCIO-ECONOMIC STATUS AND THOSE REPORTING POOR MENTAL HEALTH CONDITIONS THE 2016-2018 COMMUNITY HEALTH IMPROVEMENT PLAN OUTLINES THE PRIORITIES IDENTIFIED IN THE CHNA AND PROVIDES INTERVENTIONS TO IMPACT THE HEALTH PRIORITIES AS FOLLOWS: PRIORITY 1: PREVENT CHRONIC DISEASE: REDUCE OBESITY IN CHILDREN AND ADULTS - NWCH WILL ADOPT POLICIES AND PRACTICES TO CREATE AN ENVIRONMENT THAT PROMOTES AND SUPPORTS HEALTHY FOOD AND BEVERAGE CHOICES AND PHYSICAL ACTIVITY. NWCH WILL WORK TO INCREASE THE PERCENTAGE OF INFANTS BORN WHO ARE EXCLUSIVELY BREASTFEED DURING THE BIRTH HOSPITALIZATION AND WILL MAINTAIN ITS WHO BABY FRIENDLY DESIGNATION. PRIORITY 2: PREVENT CHRONIC DISEASE: REDUCE ILLNESS, DISABILITY AND DEATH RELATED TO TOBACCO USE AND SECONDHAND SMOKE EXPOSURE - NWCH WILL PROMOTE USE OF EVIDENCE-BASED TOBACCO DEPENDENCY TREATMENTS BY INCREASING THE NUMBER OF PROVIDERS USING OPTI-QUIT AND BABY AND ME TOBACCO FREE. PRIORITY 3: PREVENT CHRONIC DISEASE: INCREASE ACCESS TO HIGH QUALITY CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT IN BOTH CLINICAL AND COMMUNITY SETTINGS - INCREASE PERCENTAGE OF THOSE WITH HYPERTENSION WHO HAVE CONTROLLED THEIR BLOOD PRESSURE. ADDITIONALLY, INCREASE THE PERCENTAGE OF ADULTS WITH CHRONIC DISEASE WHO HAVE TAKEN A COURSE OR CLASS TO LEARN HOW TO MANAGE THEIR CONDITION. PRIORITY 4: PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN: CHILD HEALTH - INCREASE THE PERCENTAGE OF CHILDREN WHO RECEIVE REGULAR DENTAL CARE THROUGH REFERRALS AND THE OFFERING OF FLUORIDE VARNISH TRAINING TO PRACTICES.PRIORITY 5: PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE: PROMOTE MENTAL, EMOTIONAL AND BEHAVIORAL WELL-BEING - INCREASE PARTICIPATION IN SAFE OPIATE DISPOSAL PROGRAMS THROUGH THE PLACEMENT OF A PRESCRIPTION DROP BOX AT NWCH. INVESTIGATE, COORDINATE AND BUILD PARTNERSHIPS TO DEVELOP A COMPREHENSIVE APPROACH TO PREVENT SUBSTANCE ABUSE AND OVERDOSE DEATHS. INCREASE PUBLIC AWARENESS, OUTREACH AND EDUCATIONAL EFFORTS.
PART VI, LINE 3: ROCHESTER REGIONAL INFORMS INDIVIDUALS OF AVAILABLE FREE OR REDUCED PRICE SERVICES AT THE TIME OF REGISTRATION INTO INPATIENT, OUTPATIENT, AND EMERGENCY DEPARTMENTS. POSTERS INFORMING THE PATIENT/FAMILY OF ASSISTANCE ARE POSTED IN BOTH ENGLISH AND SPANISH AND AVAILABLE THROUGHOUT ROCHESTER REGIONAL LOCATIONS. BROCHURES AND PAMPHLETS, IN BOTH ENGLISH AND SPANISH, INFORMING THE COMMUNITY ARE WIDELY DISTRIBUTED IN THE COMMUNITY AT HEALTH FAIRS, CHURCHES, SCHOOLS AND OTHER PUBLIC LOCATIONS. INFORMATION REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE IS ALSO AVAILABLE THROUGH ROCHESTER REGIONAL'S WEBSITE AND PATIENTS WITH A SELF-PAY BALANCE ARE NOTIFIED OF OUR FINANCIAL ASSISTANCE PROGRAM VIA THE PATIENT'S STATEMENT. ROCHESTER REGIONAL OFFERS SEVERAL INITIATIVES TO HELP INDIVIDUALS IN OUR COMMUNITY ACCESS AFFORDABLE HEALTH CARE, INCLUDING:- FACILITATED ENROLLMENT - TO ASSIST ELIGIBLE INDIVIDUALS WITH HEALTH INSURANCE ENROLLMENT BY OFFERING EDUCATION AND APPLICATION ASSISTANCE FOR MEDICAID, CHILD HEALTH PLUS, FAMILY HEALTH PLUS, PRENATAL CARE ASSISTANCE PROGRAM, AND STATE AID FOR CHILDREN WITH SPECIAL NEEDS. A DEDICATED TELEPHONE NUMBER IS AVAILABLE AND INFORMATION IS PUBLISHED IN PAMPHLETS AT RRH SITES AND AT VARIOUS LOCATIONS THROUGHOUT THE COMMUNITY.- FINANCIAL ASSISTANCE PROGRAM - THE ROCHESTER REGIONAL FINANCIAL ASSISTANCE PROGRAM OFFERS FREE OR REDUCED-PRICES FOR PATIENTS TREATED AT A ROCHESTER REGIONAL HOSPITAL, OUTPATIENT, EMERGENCY ROOM, OR LONG-TERM CARE FACILITY. DISCOUNTS ARE AWARDED BASED UPON INCOME AND ASSET VERIFICATION. INDIVIDUALS WHO DO NOT QUALIFY FOR MEDICAID, CHILD HEALTH PLUS, FAMILY HEALTH PLUS, PRENATAL CARE ASSISTANCE PROGRAM, AND/OR STATE AID FOR CHILDREN WITH SPECIAL NEEDS ARE CONSIDERED FOR FINANCIAL ASSISTANCE (CHARITY CARE).
PART VI, LINE 4: NEWARK WAYNE COMMUNITY HOSPITAL IS THE ONLY HOSPITAL IN WAYNE COUNTY AND SERVES A POPULATION PRIMARILY FROM TOWNS AND VILLAGES WITHIN WAYNE COUNTY INCLUDING THE TOWNS OF ARCADIA, ONTARIO, WALWORTH, MACEDON, WILLIAMSON, MARION, PALMYRA, SODUS, SODUS POINT, LYONS, HURON, ROSE, GALEN, SAVANNAH, BUTLER, AND WOLCOTT IN WAYNE COUNTY, AND AREAS OF ONTARIO COUNTY INCLUDING MANCHESTER AND PHELPS. THE MAJORITY OF WAYNE COUNTY IS A SUBSTANTIALLY RURAL LANDSCAPE WITH A LARGE AGRICULTURAL PRESENCE. IN 2018, NWCH PROVIDED CARE TO OVER 20,450 PATIENTS WHO VISITED THE EMERGENCY DEPARTMENT, EXPERIENCED MORE THAN 6,800 INPATIENT/OBSERVATION DISCHARGES AND 153,000 OUTPATIENT ENCOUNTERS. ACCORDING TO THE US CENSUS BUREAU, WAYNE COUNTY IS HOME TO OVER 91,000 RESIDENTS. THE COUNTY POVERTY RATE IS 12.9% WITH 18.4% OF CHILDREN 0-17 YEARS LIVING IN POVERTY. ADDITIONALLY, WAYNE COUNTY IS MORE DIVERSE THAN SURROUNDING COUNTIES WITH 93.6% OF THE POPULATION IS WHITE, 3.3% IS BLACK/AFRICAN AMERICAN AND THE REMAINDER OTHER OR MULTI-RACIAL. THE REGION IS ALSO HOME TO THE LARGEST SEASONAL POPULATION OF MIGRANT AND SEASONAL FARM WORKERS IN NEW YORK STATE, DUE TO THE FACT THAT WAYNE COUNTY IS THE SECOND LARGEST APPLE-PRODUCING COUNTY IN THE NATION. DURING THE MIGRANT FARM SEASON THE POPULATION OF MIGRANT FARM WORKERS - PRIMARILY LATINO AND HISPANIC - SWELLS BY MORE THAN 7,000 ADDITIONAL RESIDENTS. THE WAYNE COUNTY PUBLIC HEALTH DEPARTMENT ESTIMATES THAT APPROXIMATELY 9.4% OF THE COUNTY'S ENTIRE POPULATION IS UNINSURED. HEALTHCARE DELIVERY IN THE COMMUNITY IS ALSO COMPLICATED BY TRANSPORTATION ISSUES, AN AGING POPULATION BASE, AND RURAL ECONOMIC DECLINE.
PART VI, LINE 5: DELIVERY SYSTEM REFORM INCENTIVE PAYMENT PROGRAM (DSRIP) NWCH HAD A DSRIP FUNDED PROJECT UNDERWAY IN 2018. THIS PROJECT WORKS TO ENHANCE THE DELIVERY AND INTEGRATION OF HEALTH CARE SERVICES TO THE COMMUNITY. THE PROJECT DESCRIPTION IS AS FOLLOWS: -ED TRIAGE: DEVELOP AN EVIDENCE-BASED CARE COORDINATION AND TRANSITIONAL CARE PROGRAM THAT WILL ASSIST PATIENTS TO LINK WITH A PRIMARY CARE PHYSICIAN/PRACTITIONER, SUPPORT PATIENT CONFIDENCE IN UNDERSTANDING AND SELF-MANAGEMENT OF HEALTH CONDITION, IMPROVE PROVIDER TO PROVIDER COMMUNICATION, AND PROVIDE SUPPORTIVE ASSISTANCE TO TRANSITIONING MEMBERS IN THE LEAST RESTRICTIVE ENVIRONMENT.MEDICAL STAFFNWCH MEDICAL STAFF HAS MORE THAN 550 CURRENTLY ACTIVE STAFF MEMBERS. THESE PHYSICIANS REPRESENT A BROAD SPECTRUM OF PRIMARY CARE AND SPECIALTY SERVICES. AS AN AFFILIATE OF ROCHESTER REGIONAL HEALTH, OUR PATIENTS HAVE SEAMLESS ACCESS TO ADDITIONAL SPECIALISTS INCLUDING THE WORLD-CLASS PROVIDERS AT THE ROCHESTER HEART INSTITUTE AND THE LIPSON CANCER CENTER BOTH IN PENFIELD AND ROCHESTER.VOLUNTEERS/AUXILIANSMEMBERS OF COMMUNITIES FROM ACROSS WAYNE AND SURROUNDING COUNTIES HAVE ALWAYS PLAYED AN IMPORTANT ROLE IN ADVOCATING FOR, AND OFFERING ASSISTANCE AT NEWARK-WAYNE COMMUNITY HOSPITAL AND DEMAY LIVING CENTER. IN 2018, 220 VOLUNTEERS PROVIDED MORE THAN 20,000 HOURS OF SERVICE AT NEWARK-WAYNE COMMUNITY HOSPITAL/DEMAY LIVING CENTER. ADDITIONALLY, A FACILITIES ADVISORY COUNCIL AND A COMMUNITY ADVISORY COUNCIL WERE FORMED TO GARNER COMMUNITY FEEDBACK ON SIGNIFICANT CAMPUS CHANGES AND PROGRAMS BEING OFFERED IN THE COMMUNITY.BOARD OF DIRECTORS AND COMMUNITY GUIDANCENWCH ENSURES COMMUNITY CONTROL OVER THE CORPORATION THROUGH ITS BOARD OF DIRECTORS, COMPRISED OF COMMUNITY AND FAITH LEADERS, AND LEADERS IN BUSINESS AND INDUSTRY, HEALTHCARE, AND PHYSICIANS REPRESENTING THE MEDICAL STAFF OF THE ORGANIZATION. THE MAJORITY OF THE DIRECTORS RESIDE IN THE ROCHESTER AREA AND EACH DIRECTOR SERVES A THREE-YEAR TERM.USE OF SURPLUS FUNDSSURPLUS FUNDS ARE USED TO FURTHER THE MISSION AND OPERATIONS OF THE ORGANIZATION, SUCH AS REINVESTING IN COMMUNITY BENEFIT PROGRAMS, AND MAKING IMPROVEMENTS IN FACILITIES, PATIENT CARE, MEDICAL, NURSING AND ALLIED HEALTH TRAINING, EDUCATION AND RESEARCH IN SUPPORT OF THE HEALTH NEEDS OF THE COMMUNITY AS WELL AS USED FOR CHARITY CARE.
PART VI, LINE 7, REPORTS FILED WITH STATES NY
PART VI, LINE 6: ROCHESTER REGIONAL HEALTH (ROCHESTER REGIONAL) (I.E. THE PARENT ORGANIZATION AND ITS RELATED AFFILIATES) HAS PROVIDED HIGH QUALITY HEALTHCARE SERVICES TO THE GREATER ROCHESTER NY AREA AND SURROUNDING REGIONS FOR MORE THAN 160 YEARS. IT IS THE SECOND LARGEST EMPLOYER IN ROCHESTER AND AN INTEGRAL PART OF THE COMMUNITY. ROCHESTER REGIONAL HAS A NATIONALLY RECOGNIZED HEART PROGRAM AND A NATIONALLY ACCREDITED CANCER CENTER, AND OFFERS PATIENTS MANY OF THE SAME LEADING EDGE TREATMENT OPTIONS FOUND AT THE COUNTRY'S FINEST MEDICAL CENTERS. FROM SURGERY TO ORTHOPEDICS, WOMEN'S HEALTH TO EMERGENCY CARE, PEOPLE ALL ACROSS WESTERN NY TURN TO ROCHESTER REGIONAL FOR THEIR EXPERIENCE, COMPASSION AND EXPERTISE IN HELPING THEM GET BACK TO LIVING THEIR LIVES. POVERTY TRENDS, COMMUNITY HEALTH RESEARCH AND NEEDS ASSESSMENTS ARE REVIEWED ON A REGULAR BASIS WHILE PLANNING COMMUNITY HEALTH PROGRAMS. ROCHESTER REGIONAL REPRESENTATIVES ARE ACTIVELY ENGAGED IN VARIOUS COMMUNITY HEALTH COLLABORATIONS WITH THE LOCAL HEALTH DEPARTMENTS, STATE HEALTH DEPARTMENT, AND LOCAL NOT-FOR-PROFIT HEALTH AND HUMAN SERVICE AGENCIES, AND ACTIVELY WORK TO RESPOND TO COMMUNITY PRIORITIES AND DEVELOP PROGRAMS AND SERVICES THAT FILL A GAP OR SUPPLEMENT AN EXISTING PROGRAM. MOST ROCHESTER REGIONAL COMMUNITY HEALTH OUTREACH PROGRAMS ARE OFFERED IN PARTNERSHIP WITH OTHER COMMUNITY ORGANIZATIONS OR GOVERNMENTAL AGENCIES, IN ORDER TO LEVERAGE RESOURCES TO MEET COMMUNITY NEEDS. INFORMATION REGARDING THE AVAILABILITY OF COMMUNITY HEALTH PROGRAMS, ASSISTANCE WITH HEALTH INSURANCE ENROLLMENT AND FINANCIAL ASSISTANCE FOR MEDICAL CARE RECEIVED AT ROCHESTER REGIONAL HOSPITALS, EMERGENCY DEPARTMENTS, OUTPATIENT DEPARTMENTS OR LONG-TERM CARE FACILITIES ARE DISSEMINATED TO THE PUBLIC IN ELECTRONIC (WEBSITE) FORM.ROCHESTER GENERAL HOSPITAL (RGH), THE FLAGSHIP OF ROCHESTER REGIONAL HEALTH, IS A REGIONAL LEADER IN HEALTH CARE. THIS 528-BED ACUTE CARE, TEACHING HOSPITAL SERVES THE GREATER ROCHESTER, NY REGION AND BEYOND. ROCHESTER GENERAL HOSPITAL'S NATIONALLY RECOGNIZED PROGRAMS HAVE CONSISTENTLY DEMONSTRATED QUALITY OUTCOMES THAT POSITIVELY IMPACT PATIENTS, THEIR FAMILIES AND THE ENTIRE COMMUNITY. ROCHESTER GENERAL PROVIDES CARE TO MORE MONROE COUNTY RESIDENTS THAN ANY OTHER HOSPITAL IN THE REGION AND, AS A TERTIARY CARE FACILITY, HAS STRONG REFERRAL RELATIONSHIPS WITH SEVERAL REGIONAL HOSPITALS. ROCHESTER GENERAL OFFERS A FULL ARRAY OF SERVICES TO MEET THE MEDICAL NEEDS OF UPSTATE NEW YORK, INCLUDING NATIONALLY RECOGNIZED PROGRAMS IN CARDIAC, CANCER, ORTHOPEDIC, VASCULAR, SURGICAL AND DIABETES CARE. RGH IS HOME TO A NUMBER OF CENTERS OF EXCELLENCE INCLUDING THE LIPSON CANCER INSTITUTE AND THE SANDS-CONSTELLATION HEART INSTITUTE. ROCHESTER GENERAL IS A CERTIFIED QUALITY BREAST CENTER OF EXCELLENCE BY THE NATIONAL QUALITY MEASURES FOR BREAST CENTERS PROGRAM FROM THE NATIONAL CONSORTIUM OF BREAST CENTER, INC.; A NEW YORK STATE-DESIGNATED STROKE CENTER AND A BARIATRIC SURGERY CENTER OF EXCELLENCE BY THE AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY. DISTINCTIONS FOR QUALITY INCLUDE DESIGNATIONS AS ONE OF AMERICA'S 100 BEST HOSPITALS AND DISTINGUISHED HOSPITAL FOR CLINICAL EXCELLENCE BY HEALTHGRADES; THE SURGICAL INTENSIVE CARE UNIT EARNED THE GOLD-LEVEL AND THE MEDICAL INTENSIVE CARE UNIT, NEONATAL INTENSIVE CARE UNIT AND CARDIOTHORACIC INTENSIVE CARE UNIT EARNED THE SILVER-LEVEL OF THE BEACON AWARD FOR EXCELLENCE FROM AMERICAN ASSOCIATION OF CRITICAL CARE NURSES. HIGH QUALITY CLINICAL CARE PROVIDED AT ROCHESTER GENERAL IS AMPLIFIED BY RELATIONSHIPS AND AFFILIATIONS WITH NATIONALLY RENOWNED INSTITUTIONS SUCH AS THE CLEVELAND CLINIC (FOR CARDIAC CARE) AND ROSWELL PARK CANCER INSTITUTE.ROCHESTER GENERAL MEDICAL GROUP (RGMG) OPERATES AS A DIVISION OF RGH. RGMG HAS MORE THAN 50 PRACTICES IN MONROE AND WAYNE COUNTIES WITH SPECIALTIES IN ALLERGY/RHEUMATOLOGY, DERMATOLOGY, DIABETES/ENDOCRINOLOGY, FAMILY MEDICINE, GERIATRICS, INTERNAL MEDICINE, NUTRITION & WEIGHT MANAGEMENT, ORTHOPEDICS, PEDIATRICS, PHYSICAL MEDICINE & REHABILITATION, VASCULAR SURGERY & VEIN CARE AND WOMEN'S HEALTH (OB/GYN). IN ADDITION TO HOSPITAL LOCATIONS, RGMG ALSO OPERATES TWO FULL-SERVICE OUTREACH CAMPUSES AT ALEXANDER PARK AND LINDEN OAKS.UNITY HOSPITAL IS A 287-BED RECENTLY RENOVATED HOSPITAL LOCATED IN THE TOWN OF GREECE. KEY PROGRAMS AND CENTERS INCLUDE CHEMICAL DEPENDENCY, BRAIN INJURY & REHABILITATION, JOINT REPLACEMENT CENTER, FAMILY BIRTH PLACE, SPINE CENTER, DIABETES CENTER, STROKE CENTER, AND EMERGENCY CENTER. ITS AWARDS AND DESIGNATIONS INCLUDE: EXCELLUS BLUECROSS BLUESHIELD BLUE DISTINCTION CENTER FOR KNEE AND HIP REPLACEMENT AND FOR SPINE SURGERY; EXCELLUS BLUECROSS BLUESHIELD BLUE DISTINCTION CENTER FOR MATERNITY CARE AT THE AUGUST FAMILY BIRTH PLACE AT UNITY HOSPITAL; AMERICAN ASSOCIATION OF CRITICAL CARE NURSES (AACN) SILVER-LEVEL BEACON AWARD FOR EXCELLENCE IN PROFESSIONAL PRACTICE (INTENSIVE CARE UNIT), PATIENT CARE AND OUTCOMES; COMMISSION ON THE ACCREDITATION OF REHABILITATION FACILITIES (CARF) ACCREDITATION FOR ACUTE REHABILITATION AND BRAIN INJURY REHABILITATION AT THE GOLISANO RESTORATIVE NEUROLOGY & REHABILITATION CENTER; JOINT COMMISSION GOLD SEAL OF APPROVAL DESIGNATION FOR HEALTH CARE QUALITY; JOINT COMMISSION GOLD SEAL OF APPROVAL AT THE CHARLES J. AUGUST JOINT REPLACEMENT CENTER; ADVANCED CERTIFICATION FROM THE JOINT COMMISSION FOR PALLIATIVE CARE; STAR RATING ON FACILITY COMPARE REPORTS FROM CMS ON 3 OUT OF 4 DIALYSIS UNITS; CMS 4-STAR RATING; AND AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION'S GET WITH THE GUIDELINES-STROKE GOLD PLUS ACHIEVEMENT AWARD WITH TARGET: STROKE HONOR ROLL ELITE PLUS AWARD RECOGNITION FOR STROKE CARE.UNITY MEDICAL GROUP OPERATES AS A DIVISION OF UNITY HOSPITAL. UNITY MEDICAL GROUP HAS MORE THAN 30 OFFICE- AND HOSPITAL-BASED LOCATIONS IN MONROE AND GENESEE COUNTY. THE SERVICES OFFERED BY UNITY MEDICAL GROUP INCLUDE GERIATRICS, PALLIATIVE CARE, SKILLED NURSING HOME SUPPORT, ENDOCRINOLOGY, DENTAL CARE, INTERNAL MEDICINE, PEDIATRICS, FAMILY MEDICINE, OBSTETRICS, GYNECOLOGY, PULMONARY SERVICES, SLEEP SERVICES, INFECTIOUS DISEASE TREATMENT, ORTHOPEDIC SPINE TREATMENT, PROGRESSIVE NEUROVASCULAR SERVICE WITH NEUROLOGY SPECIALTY OUTPATIENT CARE AND ENDOVASCULAR SURGICAL ACUTE CARE. THERE ARE ALSO A SPECIALIZED VASCULAR SURGERY GROUP AND NEPHROLOGY WITH COMPREHENSIVE DIALYSIS SERVICES. NEWARK-WAYNE COMMUNITY HOSPITAL (NWCH) HAS SERVED GENERATIONS OF WAYNE COUNTY RESIDENTS SINCE 1957, AND MANY HAVE BECOME MEMBERS OF OUR GROWING HEALTHCARE FAMILY. WITH NEW, LEADING-EDGE MEDICAL TECHNOLOGY, A DIRECT PARTNERSHIP WITH ROCHESTER REGIONAL HEALTH, AND HIGHLY TRAINED STAFF, NWCH CONTINUES TO GROW IN EVERY ASPECT OF ITS HEALTHCARE DELIVERY. THE HOSPITAL IS LICENSED TO OPERATE 300 BEDS OFFERING SERVICES INCLUDING CARDIOLOGY, OBSTETRICS AND GYNECOLOGY, ORTHOPAEDICS AND PULMONARY CARE, AS WELL AS AN INNOVATIVE TELEMEDICINE PROGRAM. NWCH ALSO OFFERS A FULL ARRAY OF OUTPATIENT SERVICES INCLUDING AN EMERGENCY DEPARTMENT, CARDIAC REHABILITATION, LAB SERVICES, DIAGNOSTIC IMAGING, REHABILITATION SERVICES, AND LAB DRAW STATIONS AND PATIENT IMAGING UNITS IN OTHER PARTS OF WAYNE COUNTY. IN 1997, NWCH ESTABLISHED THE WAYNE COUNTY RURAL HEALTH NETWORK (WCRHN) TO ENCOURAGE GREATER COLLABORATION AMONG HEALTH AND SOCIAL SERVICE AGENCIES WITHIN WAYNE COUNTY IN ORDER TO PROVIDE GREATER ACCESS TO NEEDED SERVICES AND TO DEVELOP INNOVATIVE PROGRAMS TO BETTER MEET IDENTIFIED NEEDS. WCRHN IS ONE OF 35 SUCH NETWORKS IN NYS. NWCH WAS CHOSEN AS A BENCHMARK IN THE SOCIOECONOMIC FACTORS CATEGORY OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) PUBLICATION, COMMUNITY CONNECTIONS: IDEAS & INNOVATIONS FOR HOSPITAL LEADERS: CASE EXAMPLES. DISTINCTIONS FOR QUALITY INCLUDE EARNING THE GOLD SEAL OF APPROVAL FOR KNEE AND HIP REPLACEMENTS BY THE JOINT COMMISSION, THE SILVER-LEVEL OF THE BEACON AWARD FOR EXCELLENCE FROM AMERICAN ASSOCIATION OF CRITICAL CARE NURSES AT ITS INTENSIVE CARE UNIT AND THE AWARD FOR EXCELLENCE FROM HEALTHGRADES FOR PATIENT SAFETY. ADDITIONALLY, NEWARK-WAYNE IS A NEW YORK STATE-DESIGNATED STROKE CENTER, A NICHE (NURSES IMPROVING CARE FOR HEALTHSYSTEM ELDERS) EXEMPLAR HOSPITAL AND A RECENT RECIPIENT OF THE WORLD HEALTH ORGANIZATION BABY-FRIENDLY DESIGNATION. REHABILITATIVE AND LONG-TERM CARE SERVICES ARE PROVIDED THROUGH DEMAY LIVING CENTER, AN ATTACHED FACILITY.
PART VI, LINE 6 (CON'T): CLIFTON SPRINGS HOSPITAL AND CLINIC (CSHC) IS A 262-BED HOSPITAL WITH A LEVEL OF TECHNOLOGY CONSISTENT WITH THAT OF LARGE URBAN HOSPITALS. THE MAIN HOSPITAL IS PHYSICALLY LOCATED IN CLIFTON SPRINGS, MIDWAY BETWEEN (BUT NORTH OF) GENEVA AND CANANDAIGUA. CSHC'S PRIMARY SERVICE AREA CONSISTS OF FOUR COUNTIES IN THE CENTRAL FINGER LAKES REGION OF UPSTATE NEW YORK: ONTARIO, WAYNE, SENECA AND YATES. CLIFTON SPRINGS HOSPITAL & CLINIC IS A NOT-FOR-PROFIT HEALTH CARE SYSTEM PROVIDING GENERAL ACUTE CARE, PRIMARY CARE, NURSING HOME CARE, CANCER CARE, PROGRAMS FOR BEHAVIORAL HEALTH AND ADDICTION RECOVERY, AND SPECIALTY CARE TO RESIDENTS OF AND VISITORS TO THE CENTRAL FINGER LAKES REGION. THE FINGER LAKES COMMUNITY CANCER CENTER (FLCCC) IS LOCATED ON THE MAIN CAMPUS AND WAS THE FIRST FULL TREATMENT CANCER CENTER IN THE FINGER LAKES REGION. FLCCC PARTICIPATES IN CLINICAL TRIALS, OFFERS MONTHLY CANCER CONFERENCES, YEARLY SYMPOSIUMS AND SUPPORT GROUPS. THE FINGER LAKES RADIATION ONCOLOGY HAS ONE OF FIVE INTENSITY MODULATED RADIATION THERAPY UNITS IN NEW YORK STATE FOR TREATING PROSTATE CANCER. THE RADIOLOGY DEPARTMENT HAS THE LATEST TECHNOLOGY AND SOPHISTICATED EQUIPMENT FOR THE EARLY DETECTION OF CANCER AND OTHER DISEASES. THE BEHAVIORAL HEALTH DEPARTMENT IS THE AREA'S LARGEST AND HAS OFFERED MENTAL HEALTH AND ADDICTION RECOVERY SERVICES LONGER THAN ANY OTHER ORGANIZATION IN THE REGION. CSHC OFFERS NUMEROUS SUBSPECIALTIES INCLUDING BLOOD DISORDERS, RENAL DISEASE, DIABETES, AND REHABILITATION. IN ADDITION, THE SPRINGS OF CLIFTON IS AN INTEGRATED HEALTH CARE PROGRAM, COMBINING BOTH CONVENTIONAL AND ALTERNATIVE/COMPLEMENTARY MEDICINE. COMPLEMENTARY THERAPIES SUPPORT THE MAINTENANCE OF HEALTH AND WELL-BEING AND THE PROCESS OF HEALING AND INCLUDE ACUPUNCTURE, CHIROPRACTIC SERVICES, HYDROTHERAPY, MASSAGE THERAPY, NATUROPATHY, CHINESE MEDICINE, QI GONG, HERBOLOGY, AND REIKI THERAPEUTIC TOUCH. UNITED MEMORIAL MEDICAL CENTER (UMMC) SERVES RESIDENTS OF GENESEE COUNTY AND SURROUNDING RURAL COMMUNITIES. THE 133-BED HOSPITAL IN BATAVIA FEATURES A NEW, STATE-OF-ART SURGICAL DEPARTMENT, A WOUND CARE CENTER, A TELEMEDICINE PROGRAM FOR INTENSIVE CARE, A JOINT REPLACEMENT CENTER OF EXCELLENCE, TWO URGENT CARE CENTERS AND A NUMBER OF PRIMARY AND SPECIALTY PHYSICIAN OFFICES. UNITED MEMORIAL IS A NICHE (NURSES IMPROVING CARE FOR HEALTHSYSTEM ELDERS) HOSPITAL AND A NEW YORK STATE-DESIGNATED STROKE CENTER. UNITED MEMORIAL IS THE SOLE MATERNITY SERVICES PROVIDER FOR GENESEE AND ORLEANS COUNTIES. IT MANAGES THE NEW YORK STATE CANCER SERVICES PARTNERSHIP GRANT FOR ORLEANS AND GENESEE COUNTIES AND PROVIDES ORTHOPEDIC SERVICES IN GENESEE, ORLEANS AND WYOMING COUNTIES. DISTINCTIONS FOR QUALITY INCLUDE EARNING THE SILVER-LEVEL BEACON AWARD FOR ICU EXCELLENCE FROM AMERICAN ASSOCIATION OF CRITICAL CARE NURSES, BRONZE STROKE AWARD BY THE AMERICAN HEART ASSOCIATION, GOLD SEAL OF APPROVAL FOR KNEE AND HIP REPLACEMENTS BY THE JOINT COMMISSION, THE CERTIFICATE OF EXCELLENCE FROM UNIVERA HEALTHCARE FOR INFECTION PREVENTION, FIVE STAR RATINGS BY HEALTHGRADES FOR TOTAL HIP REPLACEMENT, TOTAL KNEE REPLACEMENT, AND VAGINAL DELIVERY, AND A CENTER OF EXCELLENCE BY HEALOGICS FOR WOUND CARE.ROCHESTER MENTAL HEALTH CENTER (RMHC) HAS NINE LOCATIONS ACROSS THE COMMUNITY, INCLUDING TWO OF THE AREA'S BEST MENTAL HEALTH CENTERS, GENESEE MENTAL HEALTH CENTER AND ROCHESTER MENTAL HEALTH CENTER, AND OVER 40 YEARS OF EXPERIENCE AND TRADITION. RMHC HAS COMPREHENSIVE SERVICES AND DEDICATED MENTAL HEALTH AND SUBSTANCE ABUSE PROFESSIONALS, WORKING TO HELP PATIENTS ACHIEVE THEIR FULL POTENTIAL TO LIVE AND WORK AS PRODUCTIVE MEMBERS OF THE COMMUNITY. THEY OFFER:- A COMPREHENSIVE SYSTEM OF CLINICAL MENTAL HEALTH SERVICES- READILY-ACCESSIBLE, CULTURALLY-SENSITIVE SERVICES UNIQUELY MATCHED TO THE INDIVIDUAL NEEDS OF EACH PATIENT AND THEIR FAMILY- CONVENIENT ACCESS TO MENTAL HEALTH OUTPATIENT SERVICES WITH LOCATIONS THROUGHOUT THE GREATER ROCHESTER AREA- AN UNWAVERING COMMITMENT TO SERVE THOSE IN THE COMMUNITY WHO HAVE EMOTIONAL NEEDS.PRCD, INC. OFFERS TWO COMMUNITY RESIDENCES THAT ARE UNIQUE TO UPSTATE NEW YORK, ONE FOR ADOLESCENT MALES AND THE OTHER FOR WOMEN. THESE RESIDENTS PROVIDE A STABLE HOUSING ENVIRONMENT DURING CHEMICAL DEPENDENCY TREATMENT.INDEPENDENT LIVING FOR SENIORS, (ILS) OFFERS A PROGRAM THAT GIVES THE FRAIL ELDERLY AN ALTERNATIVE TO NURSING HOME PLACEMENT. IT IS DESIGNED TO ENABLE SENIORS TO LIVE IN THEIR OWN HOME SERVED BY A NETWORK OF SUPPORTIVE SERVICES. THE ILS PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) HAS PROVEN THAT INTEGRATING HEALTH CARE SERVICES CAN HAVE A POWERFUL AND BENEFICIAL IMPACT ON INDIVIDUAL HEALTH AND WELL-BEING. SENIORS NOW HAVE A CHOICE TO LIVE OUT THEIR LIVES IN THEIR COMMUNITY - ENJOYING FAMILY, MANAGING THEIR HEALTH, MAKING NEW FRIENDS - SIMPLIFYING HOW THEY CHOOSE AND PAY FOR NEEDED LONG-TERM CARE. ILS OFFERS ALL OF THE HEALTH, MEDICAL AND SOCIAL SERVICES NEEDED TO HELP AN AGING LOVED ONE MAINTAIN THEIR INDEPENDENCE, DIGNITY AND QUALITY OF LIFE. A RANGE OF SERVICES ARE AVAILABLE TO AN ILS PARTICIPANT, INCLUDING ADULT DAY CARE; PRIMARY CARE; LABORATORY, X-RAY AND AMBULANCE SERVICES; REHABILITATIVE AND SUPPORT SERVICES; MEDICAL SPECIALTY SERVICES; SKILLED NURSING CARE; ACUTE HOSPITAL CARE; IN-HOME SERVICES; INTERDISCIPLINARY CONSULTATION; AND NURSING HOME CARE SHOULD THE NEED ARISE.CLIFTON SPRINGS LIVING CENTER IS A 108-BED SKILLED NURSING FACILITY LOCATED IN CLIFTON SPRINGS, NY. THE 108-BED FACILITY PROVIDES SPECIALIZED SERVICES INCLUDING TRADITIONAL SNF CARE, AS WELL AS SPECIALTY UNITS FOR RESIDENTS WHO REQUIRE POST-ACUTE CARE, VENTILATOR CARE, AND DEMENTIA CARE. THE SERVICES OF REIKI AND HEALING TOUCH THERAPIES ARE OFFERED BY THE NURSING HOME, AND ADDITIONAL SERVICES INCLUDING ACUPUNCTURE, HYDROTHERAPY, MASSAGE THERAPY, AND NATUROPATHY ARE AVAILABLE THROUGH THE SPRINGS INTEGRATIVE MEDICINE CENTER AND SPA. DEMAY LIVING CENTER LOCATED IN NEWARK IS A 180-BED SKILLED NURSING RESIDENCE THAT PROVIDES BOTH CALM AND STIMULATING ATMOSPHERES FOR RESIDENTS. SERVICES INCLUDE: POST-ACUTE CARE, SHORT-TERM REHABILITATION, VENTILATOR CARE, DEMENTIA CARE, PERITONEAL DIALYSIS, WOUND CARE, TELEMEDICINE, NEUROBEHAVIORAL CARE, LONG TERM SKILLED NURSING CARE AND ADULT DAY CARE.EDNA TINA WILSON LIVING CENTER IN ROCHESTER IS A 120-BED SKILLED NURSING FACILITY THAT USES INNOVATIVE NEIGHBORHOOD DESIGN, WITH RESIDENT ROOMS CLUSTERED AROUND THE ACTIVITY CENTER AND THE LIVING AND DINING AREAS TO PROMOTE MORE SOCIAL AND INTERACTIVE LIVING. THE CENTER SPECIALIZES IN LONG-TERM CARE, REHABILITATIVE SERVICES, PAIN MANAGEMENT, RESPIRATORY THERAPY, IV THERAPY, PERITONEAL DIALYSIS SERVICES, RESPITE AND HOSPICE CARE.HILL HAVEN LIVING AND NURSING CENTER IN WEBSTER IS A 288-BED FACILITY WITH A COMPREHENSIVE RANGE OF MEDICAL AND ASSISTED LIVING SENIOR SERVICES, INCLUDING SHORT-TERM REHABILITATION, SKILLED NURSING, RESPIRATORY, IV THERAPY, CENTRAL LINE MEDICATIONS AND MAINTENANCE, POST-SURGICAL WOUND CARE, ON-SITE HEMODIALYSIS, PERITONEAL DIALYSIS, TELEMEDICINE, DEMENTIA, ALZHEIMER'S, AND HOSPICE CARE.PARK RIDGE LIVING CENTER IS LOCATED IN ROCHESTER. IT RECEIVED A FIVE-STAR RATING FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS), A DESIGNATION GIVEN TO ONLY 10 PERCENT OF NURSING HOMES NATIONWIDE AND IS THE FIRST LONG TERM CARE FACILITY IN NEW YORK STATE TO EARN THE PATHWAY TO EXCELLENCE DESIGNATION FOR THE AMERICAN NURSES CREDENTIALING CENTER. THIS 120 BED FACILITY IS HOME TO THE 40-BED TIMOTHY R. MCCORMICK TRANSITIONAL CARE CENTER, SPECIALIZING IN JOINT REPLACEMENT AND COMPLEX FRACTURE RECOVERY, STROKE AND NEUROLOGICAL REHABILITATION, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, IV THERAPY, AND CENTRAL LINE MEDICATIONS. THE FACILITY'S WEGMAN FAMILY COTTAGES SERVES 80 ELDERS. THE COTTAGES ALLOW ELDERS TO LIVE IN A HOME-LIKE ENVIRONMENT WHILE RECEIVING SKILLED NURSING CARE. UNITY LIVING CENTER IN ROCHESTER IS A 120-BED STATE-OF-THE-ART SKILLED NURSING FACILITY FOCUSED ON TREATMENT AND REHABILITATIVE CARE FOR PATIENTS WITH MEDICALLY COMPLEX NEEDS, DEMENTIA, AND BEHAVIORAL CHALLENGES. SPECIAL SERVICES INCLUDE SHORT-TERM REHABILITATION, PULMONOLOGY, RESPIRATORY THERAPY, TRACHEOTOMY CARE, WOUND CARE, PAIN CONTROL, AND IV THERAPY, AND PERITONEAL DIALYSIS, ACCESS TO HEMODIALYSIS, VENTILATOR BEDS, BARIATRIC CARE AND RELAXATION THERAPY TO MEET THE NEEDS OF THOSE WITH CHRONIC DISEASES.UNITY'S HOUSING GROUP OFFERS 262 AFFORDABLE AND SUBSIDIZED APARTMENTS IN FIVE LOCATIONS. THE AFFORDABLE SENIOR LIVING COMMUNITIES OFFER COMFORTABLE AND CONVENIENT HOUSING OPERATIONS FOR ADULTS AGES 55 AND OLDER.PARK RIDGE CHILD CARE CENTER CARES FOR NEARLY 140 CHILDREN OF THE COMMUNITY PER DAY, AND IN 2016, THE CENTER WAS NAMED A HEALTHY WAY TO GROW SILVER CENTER BY THE AMERICAN HEART ASSOCIATION.
PART VI, LINE 6 (CON'T): ROCHESTER AMBULATORY SURGERY CENTER IS A 29,000 SQUARE-FOOT FACILITY THAT INCLUDES SIX OPERATING ROOMS AND TWO MINOR PROCEDURE ROOMS EQUIPPED WITH STATE OF THE ART EQUIPMENT AND INSTRUMENTATION.LINDEN OAKS SURGERY CENTER IS A FREESTANDING, MULTISPECIALTY AMBULATORY SURGERY CENTER WHERE A BROAD RANGE OF OUTPATIENT SURGICAL PROCEDURES ARE PERFORMED. THE CENTER OFFERS FOUR OPERATING ROOMS AND TWO PROCEDURE ROOMS WHICH ARE FULLY EQUIPPED WITH PREOPERATIVE AND POST-ANESTHESIA CARE AREAS IN ORDER TO PROVIDE HIGH QUALITY CARE AND SAFETY IN A CONVENIENT OUTPATIENT SURGERY CENTER. ROCHESTER REGIONAL HEALTH IMMEDIATE CARE OPERATES FIVE LOCATIONS IN MONROE COUNTY, AND OFFERS FULL-SERVICE URGENT CARE WITH PHYSICIANS, DIAGNOSTIC TOOLS, AND LABS ON-SITE. ACM MEDICAL LABORATORY IS A FULL SERVICE CLINICAL AND PATHOLOGY LABORATORY CONDUCTING MORE THAN 20 MILLION TESTS EVERY YEAR FOR PHYSICIANS, NURSING HOMES AND HOSPITALS; PHARMACEUTICAL, BIOTECH AND RESEARCH ORGANIZATIONS; COLLEGES AND UNIVERSITY HEALTH CENTERS AND OCCUPATIONAL HEALTH GROUPS. ACM HAS OPERATIONS IN THE U.S., U.K., INDIA, CHINA AND SINGAPORE. OPERATIONS EXTEND TO MORE THAN 60 COUNTRIES AND OFFER A BROAD MENU OF CLINICAL, PATHOLOGY AND MOLECULAR TESTING. ACM IS ONE OF THE LARGEST REGIONAL REFERENCE LABORATORIES IN NEW YORK STATE.ROCHESTER REGIONAL HEALTH FOUNDATION, NEWARK WAYNE COMMUNITY HOSPITAL FOUNDATION, CLIFTON SPRINGS HOSPITAL FOUNDATION AND UNITED MEMORIAL MEDICAL CENTER FOUNDATION: THE VITAL SERVICES THAT ROCHESTER REGIONAL PROVIDES TO THE COMMUNITY WOULD NOT BE POSSIBLE WITHOUT THE SUPPORT OF THE FOUNDATIONS. IN THE NONPROFIT ORGANIZATIONAL STRUCTURE THE FOUNDATIONS ARE CRITICAL TO THE ABILITY TO MAKE ONGOING INVESTMENTS IN STATE-OF-THE-ART MEDICAL TECHNOLOGY, CLINICAL PROGRAMS, FACILITIES, RESEARCH, AND EDUCATION THAT BENEFIT THE COMMUNITY AS A WHOLE. THE IMPACTS OF THE FOUNDATIONS' EFFORTS ARE VISIBLE THROUGHOUT THE HOSPITALS, AND IN THEIR DISTINGUISHED CENTERS OF EXCELLENCE. THE FOUNDATIONS' FUNDRAISING PROGRAMS DIRECTLY BENEFIT THE ONGOING NEEDS OF THE COMMUNITY THROUGH IMPROVED AND EXPANDED PATIENT CARE PROGRAMS, SERVICES, AND FACILITIES AND HELP PURCHASE EQUIPMENT. THIS ENHANCES THE HIGH-TOUCH AND COMPASSIONATE CARE AVAILABLE TO ALL WHO ARE SERVED IN THE COMMUNITY.
Schedule H (Form 990) 2018
Additional Data


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Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
NEWARK-WAYNE COMMUNITY HOSPITAL
 
Employer identification number

15-0584188
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
 
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1ERIC BIEBER MD
CEO
(i)

(ii)
119,402
-------------
975,113
107,674
-------------
879,335
11,488
-------------
93,822
115,960
-------------
947,010
1,232
-------------
10,064
355,756
-------------
2,905,344
153,673
-------------
902,827
2TARA GELLASCH MD
DIRECTOR
(i)

(ii)
0
-------------
240,398
0
-------------
68,555
0
-------------
0
0
-------------
0
0
-------------
9,764
0
-------------
318,717
0
-------------
0
3THOMAS R CRILLY
CFO
(i)

(ii)
53,147
-------------
434,034
35,126
-------------
286,864
2,574
-------------
21,025
29,964
-------------
244,709
1,232
-------------
10,064
122,043
-------------
996,696
66,395
-------------
390,074
4ROBERT NESSELBUSH
COO
(i)

(ii)
106,637
-------------
731,223
71,436
-------------
489,847
0
-------------
0
69,340
-------------
475,477
1,306
-------------
8,955
248,719
-------------
1,705,502
135,749
-------------
610,869
5HUGH THOMAS
CAO
(i)

(ii)
64,534
-------------
527,026
43,676
-------------
356,690
0
-------------
0
43,740
-------------
357,206
1,219
-------------
9,952
153,169
-------------
1,250,874
77,598
-------------
455,890
6DUSTIN RICCIO
PRESIDENT, EASTERN REGION
(i)

(ii)
169,474
-------------
141,229
53,534
-------------
44,612
0
-------------
0
45,471
-------------
37,893
2,144
-------------
1,787
270,623
-------------
225,521
109,002
-------------
40,876
7MICHAEL CUNNINGHAM
PHYSICIAN
(i)

(ii)
395,191
-------------
0
0
-------------
0
0
-------------
0
-2,014
-------------
0
9,389
-------------
0
402,566
-------------
0
103,126
-------------
0
8EVE M WILLIAMS
PHYSICIAN
(i)

(ii)
361,909
-------------
0
60,198
-------------
0
0
-------------
0
29,190
-------------
0
7,114
-------------
0
458,411
-------------
0
118,046
-------------
0
9MARITA MICHELIN
PHYSICIAN
(i)

(ii)
314,292
-------------
0
87,019
-------------
0
0
-------------
0
23,780
-------------
0
7,114
-------------
0
432,205
-------------
0
31,628
-------------
0
10CYNTHIA MARTINEZ-CAPOLINO
PHYSICIAN
(i)

(ii)
249,256
-------------
0
113,240
-------------
0
0
-------------
0
-5,434
-------------
0
6,355
-------------
0
363,417
-------------
0
59,748
-------------
0
11YULIYA REHAB
PHYSICIAN
(i)

(ii)
414,943
-------------
0
30,969
-------------
0
0
-------------
0
-2,492
-------------
0
8,794
-------------
0
452,214
-------------
0
0
-------------
0
12WARREN HERN
FORMER CEO
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
250,000
0
-------------
0
0
-------------
0
0
-------------
250,000
0
-------------
250,000
Schedule J (Form 990) 2018

Schedule J (Form 990) 2018
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 3 COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS IS ESTABLISHED USING THE FOLLOWING: -COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - COMPENSATION SURVEYS AND STUDIES - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE ON AN ANNUAL BASIS, THE ORGANIZATION USES AN INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE SALARIES FOR ALL EXECUTIVES TO ENSURE SUCH SALARIES ARE CONSISTENT WITH MARKET SALARIES PAID TO SIMILARLY SITUATED EXECUTIVES. IN ADDITION, A COMPENSATION COMMITTEE REVIEWS THIS INFORMATION ANNUALLY AND IT IS THEN APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. FINALLY, EXECUTIVES RECEIVE A WRITTEN LETTER OUTLINING THE SPECIFICS OF THE COMPENSATION AGREEMENT AND THEIR EXPECTED PERFORMANCE.
PART I, LINE 4B SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS PROVIDE BENEFITS TO CERTAIN KEY EXECUTIVE EMPLOYEES OF ROCHESTER REGIONAL HEALTH. THE ORGANIZATION MAINTAINS A SECTION 457(F) PLAN WHICH WOULD BE CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THERE WERE NO DISTIBUTIONS PAID FROM THIS PLAN IN 2018. THE TOTAL COMPENSATION PAID TO THE FORMER CEO REPRESENTED A DISTRIBUTION OF DEFERRED COMPENSATION FROM A 457(B) PLAN. THIS DISTRIBUTION TO THE FORMER CEO SHOWN IN THE 2018 TAX RETURN REPRESENTS COMPENSATION WHICH WAS RECOGNIZED IN PREVIOUS TAX YEARS. THERE WAS NO INCREMENTAL EXPENSE RECOGNIZED BY THE ORGANIZATION IN 2018 FOR PAYMENTS MADE TO THE FORMER CEO.
Schedule J (Form 990) 2018
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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part , line 24a. Provide descriptions,
explanations, and any additional information in Part .
SchKMediumBullet Attach to Form 990.

SchKMediumBulletGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
NEWARK-WAYNE COMMUNITY HOSPITAL
 
Employer identification number
15-0584188
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A WAYNE COUNTY CIVIC FACILITY DEVELOPMENT CORP
 
32-0345910   11-17-2011 19,775,000 TO DEFEASE OUTSTANDING 1993 BONDS & FINANCE HOSPITAL RENOVATIONS/EXPANSION X     X   X
Part
Proceeds
A B C D
1 Amount of bonds retired ..................        
2 Amount of bonds legally defeased .............. 8,564,845      
3 Total proceeds of issue .................. 19,775,000      
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ............... 6,164,943      
7 Issuance costs from proceeds ............... 395,500      
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 13,214,557      
11 Other spent proceeds .............        
12 Other unspent proceeds .............        
13 Year of substantial completion .............
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? .... X              
15 Were the bonds issued as part of an advance refunding issue? .....   X            
16 Has the final allocation of proceeds been made? ..........   X            
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X              
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   X            
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2018

Schedule K (Form 990) 2018
Page 2
Part
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............   X            
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? .............   X            
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet        
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet        
6 Total of lines 4 and 5 .............        
7 Does the bond issue meet the private security or payment test? ...   X            
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X            
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X              
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X            
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X            
b Exception to rebate? ........   X            
c No rebate due? .........   X            
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? .....   X            
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X            
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of hedge .........        
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
Schedule K (Form 990) 2018

Schedule K (Form 990) 2018
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X            
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period?   X            
7 Has the organization established written procedures to monitor the requirements of section 148? ...   X            
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?   X            
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K, PART V WRITTEN PROCEDURES ARE IN PROGRESS.
Schedule K (Form 990) 2018

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SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2018
Open to Public
Inspection
Name of the organization
NEWARK-WAYNE COMMUNITY HOSPITAL
 
Employer identification number

15-0584188
Return Reference Explanation
FORM 990, PART III, LINE 1: ORGANIZATION'S MISSION THE PURPOSES FOR WHICH THE CORPORATION IS FORMED ARE: (A) TO PLAN, DEVELOP, ESTABLISH, ORGANIZE, CONSTRUCT, ERECT, BUILD, ACQUIRE, ALTER, RECONSTRUCT, REHABILITATE, OWN, OPERATE, MAINTAIN, AND MANAGE ALL TYPES OF INPATIENT AND OUTPATIENT HOSPITALS, HOSPITAL FACILITIES, CLINICS, TREATMENT CENTERS, SERVICES, AND PROGRAMS FOR THE DELIVERY OF ACUTE MEDICAL, SURGICAL AND PREVENTIVE HEALTH CARE SERVICES, IN ACCORDANCE WITH THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK; (B) TO PLAN, DEVELOP, ESTABLISH, ORGANIZE, CONSTRUCT, ERECT, BUILD, ACQUIRE, ALTER, RECONSTRUCT, REHABILITATE, OWN, OPERATE, MAINTAIN AND MANAGE NURSING HOMES AND ALL TYPES OF LONG TERM INPATIENT, OUTPATIENT AND RESIDENTIAL HEALTH CARE FACILITIES, SERVICES, AND PROGRAMS FOR ELDERLY, SICK, INVALID, INFIRM, DISABLED AND CONVALESCENT PERSONS, IN ACCORDANCE WITH THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK; (C) TO PLAN, DEVELOP, ESTABLISH, ORGANIZE, CONSTRUCT, ERECT, BUILD, ACQUIRE, ALTER, RECONSTRUCT, REHABILITATE, OWN OPERATE MAINTAIN, AND MANAGE ALL TYPES OF FAMILY PLANNING FACILITIES, CLINICS, TREATMENT CENTER SERVICES, AND PROGRAMS FOR THE DELIVERY OF ACUTE MEDICAL, SURGICAL AND PREVENTIVE HEALTH CARE SERVICES FOR INDIVIDUALS AND FAMILIES, IN ACCORDANCE WITH THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK; (D) TO PARTICIPATE IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH AND WELFARE OF THE COMMUNITY IN WHICH THE CORPORATION IS LOCATED; (E) TO SOLICIT, 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, FROM PRIVATE TO PUBLIC SOURCES, IN FURTHERANCE OF ITS CORPORATE PURPOSES; AND (F) TO DO ANY ACT OR THING INCIDENTAL TO OR CONNECT WITH THE FOREGOING PURPOSES OR IN ADVANCEMENT THEREOF, BUT NOT FOR THE PECUNIARY PROFIT OR FINANCIAL GAIN OF ITS MEMBERS, DIRECTORS, OFFICERS OR ANY PRIVATE PERSON.
FORM 990, PART VI, SECTION A, LINE 1 EACH BOARD HAS AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD PLUS THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION AND SUCH OTHER DIRECTORS AS THE CHAIR MAY NOMINATE FROM TIME TO TIME FOR APPOINTMENT BY A MAJORITY VOTE OF THE ENTIRE BOARD. BETWEEN MEETINGS OF THE BOARD, AND TO THE EXTENT PERMITTED BY LAW, THE EXECUTIVE COMMITTEE SHALL POSSESS THE POWERS OF THE BOARD WITH RESPECT TO MANAGING AND CONDUCTING THE AFFAIRS OF THE CORPORATION, EXCEPT AS OTHERWISE PROVIDED BY LAW OR WITHIN CERTAIN BY-LAWS.
FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A MEMBERSHIP (NOT A STOCK) CORPORATION UNDER NEW YORK STATE LAW. THE ORGANIZATION'S SOLE CORPORATE MEMBER IS ROCHESTER REGIONAL HEALTH, A RELATED NOT-FOR-PROFIT ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7B ROCHESTER REGIONAL HEALTH, AS THE SOLE CORPORATE MEMBER, ALSO HAS THE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY, INCLUDING 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 11B PRIOR TO FILING, A COPY OF THE FORM 990 IS PROVIDED TO, AND REVIEWED WITH, ALL MEMBERS OF THE AUDIT AND COMPLIANCE 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 12C UPON EMPLOYMENT, ALL EMPLOYEES RECEIVE THE ETHICAL STANDARD OF CONDUCT BOOKLET FOR WHICH THEY SIGN A RECEIPT OF ACKNOWLEDGEMENT. CONFLICT OF INTEREST EDUCATION IS CONDUCTED ANNUALLY FOR ALL EMPLOYEES. 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. ANNUALLY, EACH KEY PERSON, DIRECTOR AND OFFICER OF THE ORGANIZATION IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE 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, OFFICERS AND DIRECTORS OF THE ORGANIZATION ARE ALSO REQUIRED TO NOTIFY MANAGEMENT PROMPTLY IF ANY CHANGE TO THEIR DISCLOSURES OCCURS. 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. BOARD MEMBERS LEAVE THE ROOM DURING DISCUSSIONS AND ABSTAIN FROM VOTING WHEN THEY HAVE A CONFLICT OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S OFFICER AND KEY EMPLOYEE COMPENSATION ARRANGEMENTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE. INFORMATION REVIEWED FOR THE OFFICER/KEY EMPLOYEE INCLUDES COMPARABLE DATA FROM SIMILAR SIZE TAX-EXEMPT ORGANIZATIONS AS WELL AS COMPENSATION FOR THESE POSITIONS (AS DISCLOSED ON FORM 990) WITH OTHER ORGANIZATIONS IN THE HEALTHCARE INDUSTRY THAT ARE OF SIMILAR SIZE. REVIEW AND APPROVAL OF THE COMPENSATION ARRANGEMENT BY THE COMPENSATION COMMITTEE IS DOCUMENTED.
FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ADMINISTRATIVE OFFICES OF THE AFFILIATED HEALTH SYSTEM AT 100 KINGS HIGHWAY SOUTH, ROCHESTER, NY 14617. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED.
FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 3,330,206. MANAGEMENT AND GENERAL EXPENSES 342,681. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,672,887. SHARED SERVICE ALLOCATION: PROGRAM SERVICE EXPENSES 4,015,485. MANAGEMENT AND GENERAL EXPENSES 413,197. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,428,682. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 1,073,123. MANAGEMENT AND GENERAL EXPENSES 110,425. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,183,548. OTHER: PROGRAM SERVICE EXPENSES 3,147,621. MANAGEMENT AND GENERAL EXPENSES 324,915. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,472,536.
FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN NEWARK WAYNE COMMUNITY HOSPITAL FOUNDATION -697,697. CHANGE IN ACCOUNTING ESTIMATES -309,727.
FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR.
FORM 5471 FILED ON BEHALF STATEMENT STATEMENT PURSUANT TO TREAS. REG. SEC. 1.6038-2(J)(3): THE FOLLOWING INFORMATION IS SUBMITTED WITH RESPECT TO NEWARK-WAYNE COMMUNITY HOSPITAL'S FORM 5471 (INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS) FILING REQUIREMENT FOR THE ENTITY BELOW: NAME OF FOREIGN CORPORATION: GREATER ROCHESTER ASSURANCE COMPANY, LTD. BEGINNING TAX YEAR OF FOREIGN CORPORATION: JANUARY 1, 2018 ENDING TAX YEAR OF FOREIGN CORPORATION: DECEMBER 31, 2018 THE FORM 5471 FILING REQUIREMENT FOR THIS FOREIGN CORPORATION FOR CATEGORIES 4 AND 5 HAVE BEEN SATISFIED BY INCLUSION IN THE FOLLOWING U.S. FILER'S TAX RETURN: NAME OF U.S. FILER: ROCHESTER REGIONAL HEALTH ADDRESS OF U.S. FILER: 100 KINGS HIGHWAY SOUTH, ROCHESTER, NY 14617 EIN: 47-1234999 ENDING TAX YEAR OF U.S. FILER: DECEMBER 31, 2018 TYPE OF RETURN FILED: 990 IRS SERVICE CENTER WHERE RETURN FILED: OGDEN, UTAH 84201-0027
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2018


Additional Data


Software ID:  
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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2018
Open to Public Inspection
Name of the organization
NEWARK-WAYNE COMMUNITY HOSPITAL
 
Employer identification number

15-0584188
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity











Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)THE ROCHESTER GENERAL HOSPITAL
1425 PORTLAND AVENUE

ROCHESTER,NY14621
16-0743134
HOSPITAL NY 501(C)(3) LINE 3 ROCHESTER REGIONAL HEALTH
 
Yes
 
(2)GRHS FOUNDATION
100 KINGS HIGHWAY SOUTH

ROCHESTER,NY14617
22-3378111
R/E INV MGMT NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH
 
Yes
 
(3)ROCHESTER REGIONAL HEALTH FOUNDATION
100 KINGS HIGHWAY SOUTH

ROCHESTER,NY14617
22-2229425
FUNDRAISING NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH
 
Yes
 
(4)NEWARK WAYNE COMMUNITY HOSPITAL FOUNDATION
DRIVING PARK AVENUE

NEWARK,NY14513
22-2963015
FUNDRAISING NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH
 
Yes
 
(5)RGHS WORKERS' COMPENSATION TRUST
1425 PORTLAND AVENUE

ROCHESTER,NY14621
16-6429300
SEE PART VII NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH
 
Yes
 
(6)CONTINUING CARE NETWORK INC (CCN)
100 KINGS HIGHWAY SOUTH

ROCHESTER,NY14617
22-2963016
SUPPORT RGH NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH
 
Yes
 
(7)ROCHESTER GENERAL HUDSON HOUSING
2066 HUDSON AVENUE

ROCHESTER,NY14621
22-3210351
LOW INC HOUSING NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(8)VIA HEALTH HOME CARE I
100 KINGS HIGHWAY SOUTH

ROCHESTER,NY14617
16-1504370
HOME HEALTH NY 501(C)(3) LINE 10 CCN
 
Yes
 
(9)VIA HEALTH HOMECARE II
100 KINGS HIGHWAY SOUTH

ROCHESTER,NY14617
16-1538727
HOME HEALTH NY 501(C)(3) LINE 10 CCN
 
Yes
 
(10)INDEPENDENT LIVING FOR SENIORS
2066 HUDSON AVENUE

ROCHESTER,NY14617
16-1491059
ADULT DAY HC NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(11)ROCHESTER GENERAL LONG TERM CARE
1550 EMPIRE BLVD

WEBSTER,NY14580
22-3187140
NH & REHAB NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(12)WESTERN NEW YORK MEDICAL PRACTICE PC
1425 PORTLAND AVENUE

ROCHESTER,NY14621
61-1654232
PHYS PRAC NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(13)THE UNITY HOSPITAL OF ROCHESTER
1555 LONG POND RD

ROCHESTER,NY14626
23-7221763
HOSPITAL NY 501(C)(3) LINE 3 ROCHESTER REGIONAL HEALTH
 
Yes
 
(14)NORTH PARK NURSING HOME INC
1555 LONG POND RD

ROCHESTER,NY14626
22-3159644
LONG TERM CARE FACILITY NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(15)PARK RIDGE NURSING HOME INC
1555 LONG POND RD

ROCHESTER,NY14626
16-0978184
LONG TERM CARE FACILITY NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(16)PARK RIDGE CHILD CARE CENTER INC
1555 LONG POND RD

ROCHESTER,NY14626
22-2918126
CHILD DAY CARE SERVICES NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(17)PARK RIDGE HOUSING DEVELOPMENT FUND
1555 LONG POND RD

ROCHESTER,NY14626
22-2608311
LOW INCOME HOUSING PROJECT FOR ELDERLY NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(18)PARK RIDGE HOUSING INC
1555 LONG POND RD

ROCHESTER,NY14626
22-2570457
SENIOR APARTMENT COMPLEX NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(19)PARKWAY COMMONS HOUSING DEVELOPMENT
1555 LONG POND RD

ROCHESTER,NY14626
22-3130818
LOW INCOME HOUSING FOR ELDERLY/HANDICAPPED NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(20)UNITY AGING SERVICES INC
1555 LONG POND RD

ROCHESTER,NY14626
84-1684195
MANAGEMENT AND DEVELOPMENT CO NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(21)UNITY HOUSING DEVELOPMENT FUND CORP
1555 LONG POND RD

ROCHESTER,NY14626
30-0068596
RECEIPT AND DISBURSEMENTS OF SUBSIDIES NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(22)WOODLAND VILLAGE INC
1555 LONG POND RD

ROCHESTER,NY14626
16-1588242
SENIOR APARTMENT COMPLEX NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(23)UNITY AMBULATORY SURGERY CENTER INC
1555 LONG POND RD

ROCHESTER,NY14626
38-3871383
OUTPATIENT SURGERY NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(24)UNITY HEALTH SYSTEM INC
1555 LONG POND ROAD

ROCHESTER,NY14626
22-2572873
SYSTEM SUPPORT NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH
 
Yes
 
(25)ROCHESTER REGIONAL HEALTH
100 KINGS HIGHWAY SOUTH

ROCHESTER,NY14617
47-1234999
SYSTEM PARENT NY 501(C)(3) LINE 12B, II N/A
Yes
 
(26)UNITED MEMORIAL MEDICAL CENTER
127 NORTH STREET

BATAVIA,NY14020
16-0743029
HOSPITAL NY 501(C)(3) LINE 3 ROCHESTER REGIONAL HEALTH
 
Yes
 
(27)CLIFTON SPRINGS HOSPITAL AND CLINIC
2 COULTER ROAD

CLIFTON SPRINGS,NY14432
16-0743966
HOSPITAL NY 501(C)(3) LINE 3 ROCHESTER REGIONAL HEALTH
 
Yes
 
(28)BEHAVIORAL HEALTH NETWORK INC
490 EAST RIDGE ROAD

ROCHESTER,NY14621
16-6069131
MENTAL HEALTH NY 501(C)(3) LINE 10 ROCHESTER REGIONAL HEALTH
 
Yes
 
(29)PRCD INC
1555 LONG POND RD

ROCHESTER,NY14626
16-1311581
SUBSTANCE ABUSE TREATMENT & REHAB. NY 501(C)(3) LINE 7 ROCHESTER REGIONAL HEALTH
 
Yes
 
(30)ROCHESTER GENERAL HEALTH SYSTEM
100 KINGS HIGHWAY SOUTH

ROCHESTER,NY14617
22-2551509
SYSTEM SUPPORT NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH
 
Yes
 
(31)UNITED MEMORIAL MEDICAL CENTER FOUNDATION
127 NORTH STREET

BATAVIA,NY14020
22-2611543
FUNDRAISING NY 501(C)(3) LINE 12B, II UNITED MEMORIAL MEDICAL CENTER
 
Yes
 
(32)CLIFTON SPRINGS HOSPITAL & CLINIC FOUNDATION
2 COULTER ROAD

CLIFTON SPRINGS,NY14432
16-1560033
FUNDRAISING NY 501(C)(3) LINE 12B, II ROCHESTER REGIONAL HEALTH
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) NW ASSOCIATES LP

PO BOX 111 DRIVING PARK AVENUE
NEWARK,NY14513
14-1674119
R/E LEASING NY NWCH
 
RELATED       No     No 75.100 %
(2) PARMA SENIOR HOUSING

1555 LONG POND RD
ROCHESTER,NY14626
43-2082116
HILTON PROJ NY N/A
        No     No  
(3) UNITY SENIOR HOUSING

1555 LONG POND RD
ROCHESTER,NY14626
06-1709927
MOORE PK NY N/A
        No     No  








Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) GREATER ROCHESTER ASSURANCE COMPANY LTD

GEORGE TOWN
GRAND CAYMAN    
CJ
INSURANCE CJ N/A
C     100.000 %   No
(2) GRACO RISK RETENTION GROUP INC

1425 PORTLAND AVENUE
ROCHESTER,NY14621
71-0933967
INSURANCE SC RGH
 
C     100.000 %   No
(3) NWA INC

DRIVING PARK AVENUE
NEWARK,NY14513
14-1667339
R/E LEASING NY NWCH
 
C     100.000 %   No
(4) GREATER ROCHESTER INDEPENDENT PRACTICE ASSOCIATION INC

100 KINGS HWY S SUITE 2500
ROCHESTER,NY14617
16-1507171
INDEPENDENT PRACTICE ASSOCIATION NY N/A
C     50.000 %   No
(5) ROCHESTER GENERAL HEALTH SYSTEM DIALYSIS INC

1425 PORTLAND AVENUE
ROCHESTER,NY14621
38-3912199
DIALYSIS NY RGHS
 
C     100.000 %   No
(6) ACM MEDICAL LABORATORY INC

160 ELMGROVE PARK
ROCHESTER,NY14624
16-1059691
CLINICAL LAB NY PRH INC
 
C         No
(7) PRH INC

1555 LONG POND ROAD
ROCHESTER,NY14626
16-1329632
MEDICAL LAB NY ROCHESTER REGIONAL HEALTH
 
C         No
(8) GREATER ROCHESTER IMMEDIATE MEDICAL CARE PLLC DBA ROCHESTER IMMEDIATE CARE

265 BROOKVIEW CENTRE WAY SUITE 400
KNOXVILLE,TN37919
27-1453784
URGENT CARE CENTERS TN WESTERN NEW YORK MEDICAL PC
 
C         No
(9) ROCHESTER MEDICINE PLLC

265 BROOKVIEW CENTRE WAY SUITE 400
KNOXVILLE,TN37919
81-2625325
OCCUPATIONAL MEDICINE TN WESTERN NEW YORK MEDICAL PC
 
C         No
(10) PARMA SENIOR HOUSING LLC

1555 LONG POND ROAD
ROCHESTER,NY14626
81-0671687
SENIOR HOUSING NY ROCHESTER REGIONAL HEALTH
 
C         No
(11) UNITY SENIOR HOUSING CORP

1555 LONG POND ROAD
ROCHESTER,NY14624
06-1709925
SENIOR HOUSING NY ROCHESTER REGIONAL HEALTH
 
C         No
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) ROCHESTER GENERAL HOSPITAL

P 12,499,537 FMV
(2) GREATER ROCHESTER ASSUANCE COMPANY LTD

P 417,995 FMV
(3) ROCHESTER REGIONAL HEALTH

P 2,544,837 FMV
(4) NEWARK-WAYNE COMMUNITY HOSPITAL FOUNDATION

C 574,499 FMV
(5) INDEPENDENT LIVING FOR SENIORS

L 476,015 FMV
(6) INDEPENDENT LIVING FOR SENIORS

L 294,068 FMV
(7) RGHS WORKERS COMPENSATION TRUST

P 645,836 FMV
Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2018
Schedule R (Form 990) 2018
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
SCHEDULE R, PART II, COLUMN B: RELATED TAX-EXEMPT ORGANIZATION - PRIMARY ACTIVITY: RGHS WORKERS' COMPENSATION TRUST SUPPORTS THE ROCHESTER GENERAL HOSPITAL, NEWARK WAYNE COMMUNITY HOSPITAL, INDEPENDENT LIVING FOR SENIORS, ROCHESTER GENERAL LONG TERM CARE, ROCHESTER GENERAL HUDSON HOUSING, VIAHEALTH HOMECARE I, VIAHEALTH HOMECARE II, BEHAVIORAL HEALTH NETWORK, INC, CLIFTON SPRINGS HOSPITAL & CLINIC AND UNITED MEMORIAL MEDICAL CENTER.
Schedule R (Form 990) 2018

Additional Data


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