TY 2019 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) STEVEN I GOLDSTEIN...................................................................... CEO	8.0 ................. 63.0	X	X				0	1,232,162	505,762
(2) BRENT DUBESHTER MD...................................................................... BOARD MEMBER	2.0 ................. 60.0	X					0	1,105,071	49,279
(3) ADAM ANOLIK...................................................................... FORMER CFO	0.0 ................. 64.0					X	0	721,744	151,089
(4) MICHAEL APOSTOLAKIS MD...................................................................... CHIEF MEDICAL OFFICER	1.0 ................. 63.0			X			0	661,347	76,522
(5) ROBERT MCCANN MD...................................................................... BOARD MEMBER	2.0 ................. 0.0	X					0	610,788	65,990
(6) RAYMOND MAYEWSKI MD...................................................................... BOARD MEMBER	2.0 ................. 57.0	X					0	551,109	43,216
(7) CARRIE FULLER SPENCER...................................................................... CFO	9.0 ................. 55.0		X				0	445,805	77,031
(8) LORI FERRIS MD...................................................................... PHYSICIAN	40.0 ................. 0.0				X		411,071	0	100,614
(9) JULIETTA FISCELLA MD...................................................................... PHYSICIAN	40.0 ................. 0.0				X		410,692	0	98,423
(10) CINDY BECKER...................................................................... COO	40.0 ................. 1.0		X				374,933	0	121,143
(11) JEFFREY HANSON MD...................................................................... PHYSICIAN	40.0 ................. 0.0				X		379,264	0	107,032
(12) GREGORY RYAN MD...................................................................... PHYSICIAN	40.0 ................. 0.0				X		369,876	0	102,535
(13) MAUREEN PERRY...................................................................... PHYSICIAN	40.0 ................. 0.0				X		273,489	0	91,667
(14) MELISSA DERLETH...................................................................... CNO	40.0 ................. 0.0			X			186,661	0	22,043
(15) STEVEN BURKHART MD...................................................................... BOARD MEMBER	2.0 ................. 0.0	X					21,250	0	0
(16) ANN MARIE COOK...................................................................... BOARD MEMBER	2.0 ................. 0.0	X					0	0	0
(17) BELINDA LISCHERELLI...................................................................... TREASURER	2.0 ................. 0.0	X	X				0	0	0

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(18) KAREN LAMY........................................................................ BOARD MEMBER	2.0 .......................0.0	X		0	0	0
(19) THOMAS GREINER........................................................................ BOARD MEMBER	2.0 .......................0.0	X		0	0	0
(20) CHRISTIAN MODESTI........................................................................ BOARD MEMBER	2.0 .......................0.0	X		0	0	0
(21) RICHARD LEFROIS........................................................................ CHAIR	2.0 .......................0.0	X	X	0	0	0
(22) THEODORE HIROKAWA MD........................................................................ BOARD MEMBER	2.0 .......................0.0	X		0	0	0
(23) MARK EIDLIN........................................................................ VICE CHAIR	2.0 .......................0.0	X	X	0	0	0
(24) CORAL SURGEON MD........................................................................ BOARD MEMBER	2.0 .......................0.0	X		0	0	0
(25) MICHAEL RIORDAN........................................................................ BOARD MEMBER	2.0 .......................0.0	X		0	0	0
(26) KATHLEEN WHELEHAN........................................................................ SECRETARY	2.0 .......................0.0	X	X	0	0	0
(27) NICHOLAS NICOSIA........................................................................ BOARD MEMBER	2.0 .......................0.0	X		0	0	0
(28) WILLIAM KREIENBERG........................................................................ BOARD MEMBER	2.0 .......................0.0	X		0	0	0
(29) JEROME UNDERWOOD........................................................................ BOARD MEMBER	2.0 .......................0.0	X		0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
DGA BUILDERS LLC, ONE CORPORATE PLACE STE 100 PITTSFORD,NY14534	GENERAL CONSTRUCTION	5,584,338
LECHASE CONSTRUCTION, 205 INDIGO CREEK DR ROCHESTER,NY14626	GENERAL CONSTRUCTION	1,685,466
TRUSTED NURSE STAFFING LLC, BUFFALO STATION BUFFALO,NY14240	TEMPORARY SERVICES	1,487,046
SUPPLEMENTAL HEALTHCARE SVCS LTD, PO BOX 677896 DALLAS,TX75267	TEMPORARY SERVICES	1,309,691
SUNBBELT STAFFING SOLUTIONS LLC, DEPT CH 14430 PALATINE,IL60055	TEMPORARY SERVICES	402,644
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 15

- TIN:

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 instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

HIGHLAND HOSPITAL OF ROCHESTER

Employer identification number

16-0743037

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


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) 2019

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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

Gross receipts from related activities, etc. (see instructions) ..................

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

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2019

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)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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.)..

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

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

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

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

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.

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.

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.

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.

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

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).

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.

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.

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.

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

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) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

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

A family member of a person described in (a) above?

11b

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

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

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.

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.

Parent of Supported Organizations. Answer (a) and (b) below.

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.

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.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, 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 2019. 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 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

HIGHLAND HOSPITAL OF ROCHESTER

Employer identification number

16-0743037

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... 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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization HIGHLAND HOSPITAL OF ROCHESTER

Part I Contributors	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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization HIGHLAND HOSPITAL OF ROCHESTER		Employer identification number 16-0743037

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization HIGHLAND HOSPITAL OF ROCHESTER			Employer identification number 16-0743037
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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

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 Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

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

HIGHLAND HOSPITAL OF ROCHESTER

Employer identification number

16-0743037

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

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

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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) 2019

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ...................................................................................................................	Yes No

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) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

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)

Yes|No

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Yes

30,582

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Total. Add lines 1c through 1i ....................................................................................................

30,582

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

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
SCHEDULE C, PART II-B, LINE 1(F)	DETAIL OF LOBBYING HIGHLAND HOSPITAL IS A MEMBER OF REGIONAL, STATE AND FEDERAL HEALTHCARE ORGANIZATIONS AND PAYS DUES ON AN ANNUAL BASIS. A PORTION OF THESE DUES HAS BEEN DETERMINED TO HAVE BEEN ALLOCATED BY THESE ORGANIZATIONS TO SUPPORT LOBBYING ACTIVITIES. THE TOTAL AMOUNT ALLOCATED FROM HIGHLAND HOSPITAL'S DUES IN FY 2020 WAS ESTIMATED TO BE $30,582.

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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 instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

HIGHLAND HOSPITAL OF ROCHESTER

Employer identification number

16-0743037

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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 ....	3,413,941	3,443,290	3,418,895	3,145,208	3,318,012
b	Contributions ...	25,229	100	26	50	2,986
c	Net investment earnings, gains, and losses	-43,551	-29,449	24,369	273,637	-175,790
d	Grants or scholarships ...	0	0	0	0	0
e	Other expenditures for facilities and programs ...	0	0	0	0	0
f	Administrative expenses ....	0	0	0	0	0
g	End of year balance ......	3,395,619	3,413,941	3,443,290	3,418,895	3,145,208

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100.000 %

Term endowment SchDMd Bullet

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

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 .....	207,769		207,769
b	Buildings ....	208,191,545	105,604,860	102,586,685
c	Leasehold improvements	9,497,353	3,900,378	5,596,975
d	Equipment ....	209,380,251	151,369,168	58,011,083
e	Other .....	11,122,331		11,122,331
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				177,524,843

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther 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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram 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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

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)OTHER RECEIVABLES				32,118,085
(2)ASSETS WHOSE USE IS LIMITED				2,225,195
(3)DEFERRED AND OTHER INTANGIBLES				170,000
(4)OTHER ASSETS				3,152,232
(5)AFFILIATE RECEIVABLES				17,748,154
(6)INSURANCE CLAIMS RECEIVABLE				7,925,698
(7)OPERATING LEASE ASSETS				12,404,325
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				75,743,689

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	0
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	158,726,776
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) 2019

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
FORM 990, SCHEDULE D, PART V, LINES 3A & 4	DETAIL OF ENDOWMENT FUNDS ALL ENDOWMENT FUNDS ARE HELD AND ADMINISTERED BY HIGHLAND FOUNDATION INC., A RELATED IRC SECTION 501(c)(3) ORGANIZATION, FOR THE BENEFIT OF HIGHLAND HOSPITAL IN FURTHERANCE OF ITS CHARITABLE HEALTH CARE SERVICES.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

2019

Open to Public Inspection

Name of the organization

HIGHLAND HOSPITAL OF ROCHESTER

Employer identification number

16-0743037

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other %

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	7,360,159	4,707,919	2,652,240	0.680 %
b	Medicaid (from Worksheet 3, column a) . . . . .	50,544,454	41,759,289	8,785,165	2.260 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	57,904,613	46,467,208	11,437,405	2.940 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).
f	Health professions education (from Worksheet 5) . . .	10,539,209	2,892,561	7,646,648	1.970 %
g	Subsidized health services (from Worksheet 6) . . . .	54,827,592	42,104,938	12,722,654	3.270 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	73,650		73,650	0.020 %
j	Total. Other Benefits . .	65,440,451	44,997,499	20,442,952	5.260 %
k	Total. Add lines 7d and 7j .	123,345,064	91,464,707	31,880,357	8.200 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

8,006,511

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. ......

97,961

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

Enter total revenue received from Medicare (including DSH and IME).....

162,028,988

Enter Medicare allowable costs of care relating to payments on line 5.....

156,706,495

Subtract line 6 from line 5. This is the surplus (or shortfall)........

5,322,493

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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 %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

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)
1	HIGHLAND HOSPITAL 1000 SOUTH AVENUE ROCHESTER,NY14620 http://www.urmc.rochester.edu/hh/ LICENSE #2701001H	X	X	X	X

Schedule H (Form 990) 2019

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)

	HIGHLAND 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):

Yes

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

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 .................

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..................................

Yes

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. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE SUPPLEMENTAL DISCLOSURE

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE SUPPLEMENTAL DISCLOSURE

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	HIGHLAND HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.%
and FPG family income limit for eligibility for discounted care of 400.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SUPPLEMENTAL DISCLOSURE

The FAP application form was widely available on a website (list url):

SEE SUPPLEMENTAL DISCLOSURE

A plain language summary of the FAP was widely available on a website (list url):
SEE SUPPLEMENTAL DISCLOSURE

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	HIGHLAND HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	HIGHLAND HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

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, 20a, 20b, 20c, 20d, 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
PART V, SECTION B, LINE 5- INPUT FROM COMMUNITY	HIGHLAND HOSPITAL CONDUCTED ITS CHNA COLLABORATION WITH OTHER HOSPITALS AND AGENCIES IN MONROE COUNTY. THIS GROUP, CALLED THE COMMUNITY HEALTH IMPROVEMENT WORKGROUP (CHIW) MEETS MONTHLY TO CONDUCT THE CHNA WHEN INDICATED AND TO IMPLEMENT THE COMMUNITY-WIDE IMPROBMENT STRATEGY. COMMUNITY INPUT IS CRITICAL THROUGHOUT THE CHNA PROCESS, THE IMPROVEMENT PLANNING PROCESS, AND THE IMPLEMENATION PROCESS. ONGOING COMMUNITY ENGAGEMENT IS VITAL TO INFORM OUR AGENDA. EACH OF THE HOSPITAL SYSTEMS INCLUDED IN THE CHNA: UNIVERSITY OF ROCHESTER STRONG MEMORIAL HOSPITAL, HIGHLAND HOSPITAL, AND ROCHESTER REGIONAL HEALTH (INCLUDING ROCHESTER GENERAL HOSPITAL AND UNITY HOSPITAL) TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY. THE MONROE COUNTY DEPARTMENT OF PUBLIC HEALTH WAS REPRESENTED AT EACH COMMUNITY BENEFITS MEETING BY ANNE KERN, PUBLIC HEALTH PROGRAM COORDINATOR, AND KATHY CARELOCK, MANAGER OF THE DIVISION OF EPIDEMIOLOGY. BOTH ARE AWARE OF COMMUNITY NEEDS, OVERSEE THE ADULT HEALTH SURVEY AND ARE EXPERTS IN EFFECTIVE PUBLIC HEALTH ASSESSMENT AND INTERVENTION. THERESA GREEN, DIRECTOR OF COMMUNITY HEALTH POLICY AND SHANNON KLYMOCHKO, HEALTH POLICY COORDINATOR, BOTH FOR THE URMC CENTER FOR COMMUNITY HEALTH AND PREVENTION, PROVIDED EXPERT ADVICE ON COMMUNITY ENGAGEMENT AND EVIDENCE BASED INTERVENTIONS. IN ADDITION,COMMON GROUND HEALTH (FORMERLY KNOWN AS FINGER LAKES HEALTH SYSTEM AGENCY), WHO REPRESENTS THE COMMUNITY VOICE AND WHO MANAGES BOTH THE AFRICAN AMERICAN HEALTH COALITION AND THE LATINO HEALTH COALITION AND THE BLOOD PRESSURE COLLABORATIVE FOR MONROE COUNTY, WAS REPRESENTED AT EACH MEETING BY EITHER DINA FATICONE, DIRECTOR OF COMMUNITY HEALTH AND ENGAGEMENT OR SEVERAL OF THEIR OTHER REPRESENTATIVES. SPECIFICALLY FOR THE 2019 CHNA, COMMUNITY INPUT WAS ACQUIRED BY REVIEWING EXITING COMMUNITY REPORTS AND BY DISCUSSIONS WITH EXISTING COMMUNITY BASED GROUPS ABOUT THE DATA-IDENTIFIED NEEDS. IN 2018, COMMON GROUND HEALTH CONDUCTED A REGIONAL SURVEY OF COMMUNITY MEMBERS TO LEARN MORE ABOUT HEALTH BEHAVIORS AND BARRIERS TO HEALTHY LIVES. WITH PARTICULAR ATTENTIAON TO GATHERING INPUT FROM A DIVERSE GROUP OF PARTICIPATNS, OVER 4,000 PEOPLE WERE SURVERYED. ALTHOUGH RESULTS WERE NOT FULLY ANALYZED AT THE TIME OF THE CHNA DEVELOPMENT, COMMON GROUND HEALTH SHARED SEVERAL PRELIMINARY RESULTS OF THE SURVEY WITH THE CHIW. THE SURVEY ASKED ABOUT A WIDE RANGE OF TOPICS FROM ACCESS TO MEDICAL AND DENTAL CARE TO PERCEPTIONS OF PERSONAL SAFETY AND SATISFACTION WITH WORK. TO CAPTURE EACH INDIVIDUAL'S UNIQUE STORY, SEVERAL QUESTIONS WERE OPEN-ENDED WITH AN OPPORTUNITY FOR UNSTRUCTURED FEEDBACK. THE RESULTS OF THE SURVEY INDICATED THAT THE TOP CONCERN FOR ADULTS IN MONROE COUNTY ACROSS ALL RACES, GEOGRAPHIES, AND SOCIOECONOMIC STATUS LEVELS WAS MENTAL HEALTH. BEYOND THE MY HEALTH SURVEY INFORMATION, THE CHIW MET WITH SEVERAL COMMUNITY GROUPS INCLUDING THE AFRICAN AMERICAN HEALTH COALITION, THE LATINO HEALTH COALITION, THE MATERNAL CHILD HEALTH ADVISORY GROUP AND THE COMMUNITY ADVISORY COUNCIL. THIS HIGH LEVEL COLLABORATION AMONG COMMUNITY MEMBERS, PUBLIC HEALTH PROVIDERS AND HOSPITAL SYSTEMS, ALONG WITH THE ROBUST PROCESS OF COMMUNITY INPUT GATHERING, PROVIDES A TRULY COMMUNITY BASED HEALTH NEEDS ASSESSMENT AND IMPROVEMENT PLAN. -------------------- PART V, SECTION B, LINE 6A- JOINT CHNA THE CHNA WAS CONDUCTED WITH SEVERAL OTHER HOSPITAL FACILITIES. AN ASSESSMENT OF MONROE COUNTY WAS CONDUCTED JOINTLY BY THE UNIVERSITY OF ROCHESTER STRONG MEMORIAL HOSPITAL AND HIGHLAND HOSPITAL, AND ROCHESTER REGIONAL HEALTH INCLUDING ROCHESTER GENERAL HOSPITAL AND UNITY HOSPITAL. -------------------- PART V, SECTION B, LINE 6B- CHNA CONDUCTED WITH NON-HOSPITAL FACILITIES THE CHNA WAS CONDUCTED WITH SEVERAL OTHER ORGANIZATIONS BESIDES THE HOSPITAL FACILITIES. THE MONROE COUNTY DEPARTMENT OF PUBLIC HEALTH WAS VERY ENGAGED IN THE CHNA PROCESS, WAS PRESENT AT EACH MEETING AND SASSISTED WITH DATA ANALYSIS AND IMPROVEMENT PLANNING. COMMON GROUND HEALTH IS THE REGIONAL PLANNING AGENCY AND IS REPRESENTED AT ALMOST EVERY MEETING OF THE COMMUNITY HEALTH IMPROVEMENT WORKGROUP (CHIW), AND WAS INSTRUMENTAL IN DEVELOPING THE CHNA, BOTH BY PROVIDING DATA AND ASSISTING WITH COMMUNITY ENGAGEMENT. OUR REGIONAL DSRIP AGENCY ALSO ATTENDS THE CHIW MEETINGS AND GAVE INPUT TO THE CHNA PROCESS. THE REGIONAL HEALTH INFORMATION ORGANIZATION (RHIO) HAS BEEN TO MOST CHIW MEETINGS AND WAS ENGAGED IN THE CHNA PROCESS. IN ADDITION, SINCE THE 2019 CHNA FOCUSED ON MENTAL HEALTH, THE MONROE COUNTY OFFICE OF MENTAL HEALTH GAVE INPUT TO THE CHNA AND ATTENDS THE CHIW MEETINGS DURING THE IMPLEMENTATION PHASE OF THE ASSESSMENT. -------------------- PART V, SECTION B, LINE 7A&D, 10- CHNA & IMP PLAN PUBLIC AVAILABILITY THE CHNA REPORT AND IMPLEMENTATION PLAN ARE MADE WIDELY AVAILABLE TO THE PUBLIC. A COPY OF THE ORGANIZATION'S CHNA AND IMPLEMENTATION/IMPROVEMENT PLAN CAN BE FOUND AT: HTTPS://WWW.URMC.ROCHESTER.EDU/COMMUNITY.ASPX CLICK: "VIEW THE IMPROVEMENT PLANS" -------------------- PART V, SECTION B, LINE 11- ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA FOR A COMPLETE DESCRIPTION ON HOW THE ORGANIZATION IS ADDRESSING THE NEEDS IDENTIFIED IN THE MOST RECENTLY COMPLETED CHNA, SEE THE FOLLOWING: HTTPS://WWW.URMC.ROCHESTER.EDU/COMMUNITY.ASPX CLICK: "VIEW THE IMPROVEMENT PLANS" -------------------- PART V, SECTION B, LINE 16A- AVAILABILITY OF FINANCIAL ASSISTANCE POLICY HIGHLAND HOSPITAL'S CURRENT FINANCIAL ASSISTANCE POLICY CAN BE FOUND AT: https://www.urmc.rochester.edu/highland/patients-visitors/billing- insurance/financial-assistance.aspx -------------------- PART V, SECTION B, LINE 16B- AVAILABILITY OF FINANCIAL ASSISTANCE APPLICATION HIGHLAND HOSPITAL'S CURRENT FINANCIAL ASSISTANCE POLICY APPLICATION CAN BE FOUND AT: https://www.urmc.rochester.edu/highland/patients-visitors/billing-insuranc e/financial-assistance.aspx -------------------- PART V, SECTION B, LINE 16C- AVAILABILITY OF FINANCIAL ASSISTANCE POLICY PLAIN LANGUAGE SUMMARY HIGHLAND HOSPITAL'S CURRENT PLAIN LANGUAGE SUMMARY CAN BE FOUND AT: https://www.urmc.rochester.edu/highland/patients-visitors/billing-insuranc e/financial-assistance.aspx --------------------

Schedule H (Form 990) 2019

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?26
Name and address		Type of Facility (describe)
1	DAISY MARQUIS JONES RADIATION ONCOLOGY 155 BELLWOOD DRIVE ROCHESTER,NY14606	RADIATION ONCOLOGY CENTER
2	HIGHLAND FAMILY MEDICINE CENTER 777 SOUTH CLINTON AVENUE ROCHESTER,NY14620	FAMILY MEDICINE CLINIC
3	SANDS CANCER CENTER 395 WEST STREET CANANDAIGUA,NY14424	RADIATION ONCOLOGY CENTER
4	CULVER MEDICAL GROUP 913 CULVER ROAD ROCHESTER,NY14609	PRIMARY CARE CLINIC
5	CALEDONIA FAMILY MEDICINE 3350 BROWN ROAD CALEDONIA,NY14423	PRIMARY CARE CLINIC
6	PENFIELD FAMILY MEDICINE 2212 PENFIELD ROAD PENFIELD,NY14526	PRIMARY CARE CLINIC
7	EAST RIDGE FAMILY MEDICINE 999 EAST RIDGE ROAD ROCHESTER,NY14621	PRIMARY CARE CLINIC
8	WEBSTER FAMILY MEDICINE 1900 EMPIRE BLVD WEBSTER,NY14580	PRIMARY CARE CLINIC
9	HIGHLAND BREAST CARE CENTER 500 RED CREEK DRIVE ROCHESTER,NY14623	BREAST CARE DIAGNOSTIC SERVICE
10	CALKINS CREEK FAMILY MEDICINE 200 RED CREEK DRIVE SUITE 100 ROCHESTER,NY14623	PRIMARY CARE CLINIC
11	AVON FAMILY MEDICINE 470 COLLINS STREET AVON,NY14414	PRIMARY CARE CLINIC
12	GREECE MEDICAL GROUP 10 SOUTH POINTE LANDING ROCHESTER,NY14606	PRIMARY CARE CLINIC
13	GENESEE VALLEY FAMILY MEDICINE 118 MAIN STREET PO BOX 99 MOUNT MORRIS,NY14510	PRIMARY CARE CLINIC
14	GENESEE VALLEY FAMILY MEDICINE LAKEVILLE 3509 THOMAS DRIVE SUITE 4 LAKEVILLE,NY14480	PRIMARY CARE CLINIC
15	STRONG HEALTH MIDWIFERY GROUP 909 CULVER ROAD ROCHESTER,NY14609	OB/GYN CLINIC
16	PENFIELD MEDICAL IMAGING 2212 PENFIELD ROAD SUITE 300 PENFIELD,NY14526	OUTPATIENT DIAGNOSTIC RADIOLOGY SERVICES
17	GENESEE VALLEY FAMILY MEDICINE GENESEO 4400 LAKEVILLE ROAD GENESEO,NY14454	PRIMARY CARE CLINIC
18	HIGHLAND BREAST IMAGING 2212 PENFIELD ROAD SUITE 500 PENFIELD,NY14526	BREAST CARE DIAGNOSTIC SERVICE
19	HIGHLAND WOMEN'S HEALTH 990 SOUTH AVENUE SUITE 103 ROCHESTER,NY14620	OB/GYN CLINIC
20	HIGHLAND BREAST IMAGING AT AJHC 82 HOLLAND STREET ROCHESTER,NY14605	BREAST CARE DIAGNOSTIC SERVICE
21	HIGHLAND MEDICAL IMAGING AT AJHC 82 HOLLAND STREET ROCHESTER,NY14605	OUTPATIENT DIAGNOSTIC RADIOLOGY SERVICE
22	HIGHLAND CARDIOLOGY AT RED CREEK 600 RED CREEK DRIVE ROCHESTER,NY14623	OUTPATIENT CARDIOLOGY SERVICES
23	HIGHLAND DIABETES HEALTH SOURCE 2400 SOUTH CLINTON AVENUE BUILDING ROCHESTER,NY14618	DIABETES HEALTH SOURCE
24	HIGHLAND FAMILY MEDICINE EXTENSION 757 SOUTH CLINTON AVENUE ROCHESTER,NY14620	FAMILY MEDICINE CLINIC
25	HIGHLAND WOMEN'S HEALTH - PERINTON 800 AYRAULT ROAD FAIRPORT,NY14450	OB/GYN CLINIC
26	HIGHLAND WOMEN'S HEALTH - PITTSFORD 2300 JEFFERSON ROAD PITTSFORD,NY14534	OB/GYN CLINIC

Schedule H (Form 990) 2019

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
SUPPLEMENTAL DISCLOSURES	PART I, LINE 7- COSTING METHODOLOGY USED, BAD DEBT EXPENSE THE COSTING METHODOLOGY USED IN CALCULATING THE AMOUNTS REPORTED ON THE LINE 7 TABLE ARE BASED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 OF THE FORM 990, SCHEDULE H INSTRUCTIONS. CONSISTENT WITH PRIOR YEAR, DUE TO THE ADOPTION OF ACCOUNTING PRONOUNCEMENT ASC 606, IMPLICIT PRICE CONCESSIONS ARE TREATED AS A CONTRA-REVENUE ITEM ON THE STATEMENT OF REVENUE. -------------------- PART III, SECTION A, LINE 2- IMPLICIT PRICE CONCESSIONS/BAD DEBT EXPENSE THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON ACTUAL CHARGES WRITTEN OFF (AMOUNTS THAT ARE DEEMED TO BE UNCOLLECTIBLE AND RECORDED AS IMPLICIT PRICE CONCESSIONS UNDER ACCOUNTING PRONOUNCEMENT ASC 606). -------------------- PART III, SECTION A, LINE 4- IMPLICIT PRICE CONCESSION FOOTNOTE THE TEXT OF THE IMPLICIT PRICE CONCESSION (BAD DEBT EXPENSE) FOOTNOTE CAN BE FOUND ON PAGES 11-12 OF THE ELECTRONICALLY ATTACHED AUDITED FINANCIAL STATEMENTS. --------------------
PART III, SECTION B, LINE 8- COSTING METHODOLOGY, MEDICARE SHORTFALL	THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS BASED ON AN OVERALL RCC METHODOLOGY PER THE HOSPITAL'S MEDICARE COST REPORT FILING FOR THE YEAR. CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF THE HOSPITAL AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, THE HOSPITAL PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY THE HOSPITAL TO PROVIDE SUCH SERVICES. AS A RESULT, THE HOSPITAL VIEWS ANY SHORTFALL REPORTED IN LINE 7 AS AN ADDITIONAL ITEM OF COMMUNITY BENEFIT PROVIDED BY THE ORGANIZATION. -------------------- PART III, SECTION C, LINE 9B- COLLECTION PRACTICES HIGHLAND HOSPITAL'S MISSION IS OUR COMMITTMENT TO EXCELLENCE IN HEALTH CARE, WITH PATIENTS AND THEIR FAMILIES AT THE HEART OF ALL THAT WE DO. LAWS, REGULATIONS, CATASTROPHIC ILLNESSES AND THE RISING COSTS OF NEW TECHNOLOGY HAVE CREATED A CATEGORY OF PATIENTS WHO ARE EITHER UNINSURED OR UNDERINSURED. THIS FINANCIAL ASSISTANCE PROGRAM HAS BEEN DEVELOPED TO HELP THE HOSPITAL MEET THE NEEDS OF THESE PATIENTS AND, CONCURRENTLY, MAINTAIN THE FINANCIAL VIABILITY OF THE HOSPITAL FOR FUTURE GENERATIONS. THIS FINANCIAL ASSISTANCE POLICY EXPLAINS HOW THE HOSPITAL ASSISTS PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE ESSENTIAL MEDICAL CARE THEY RECEIVE. PRINCIPLES: HIGHLAND HOSPITAL PROACTIVELY CONVEYS INFORMATION ABOUT THIS FINANCIAL ASSISTANCE POLICY TO PATIENTS AND THEIR FAMILIES. - WE BELIEVE THAT FEAR OF A HOSPITAL BILL SHOULD NEVER GET IN THE WAY OF ESSENTIAL HEALTH SERVICES. THE PROVISION OF URGENT OR EMERGENT HEALTHCARE IS NEVER DELAYED PENDING A FINANCIAL ASSISTANCE DETERMINATION. SIGNS ANNOUNCING THE FINANCIAL ASSISTANCE PROGRAM ARE POSTED IN THE HOSPITAL (E.G. EMERGENCY DEPARTMENT, ADMITTING OFFICE) TO PROACTIVELY CONVEY THIS MESSAGE TO PROSPECTIVE PATIENTS AND THE PUBLIC IN GENERAL. - WE MAINTAIN FINANCIAL AID POLICIES THAT ARE CONSISTENT WITH THE MISSION, VALUES AND CAPACITY OF THE HOSPITAL AND THAT TAKE INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. - WE COMMUNICATE THE AVAILABILITY OF FINANCIAL AID IN A MANNER THAT IS CLEAR, UNDERSTANDABLE, SENSITIVE TO THE PATIENT'S DIGNITY, AND IN MULTIPLE LANGUAGES. A NOTICE IS AVAILABLE AT REGISTRATION SITES THAT INFORMS PATIENTS OF THIS PROGRAM AND PROVIDES THE PHONE NUMBER TO CALL TO OBTAIN MORE INFORMATION AND TO APPLY FOR THIS PROGRAM. DESIGNATED STAFF ARE PROVIDED DETAILED TRAINING SO THAT THEY CAN PROVIDE INFORMATION AND ANSWER QUESTIONS ABOUT THE FINANCIAL ASSISTANCE PROGRAM. INFORMATION IS GENERALLY AVAILABLE IN BOTH ENGLISH AND SPANISH. WHEN REQUESTED, IT WILL ALSO BE MADE AVAILABLE IN OTHER LANGUAGES. - WE IMPLEMENT FINANCIAL AID PROCEDURES THAT ARE CONSUMER-FRIENDLY, RESPECTFUL, AND CONFIDENTIAL, AS WELL AS DEBT COLLECTION POLICIES THAT REFLECT THE MISSION AND VALUES OF THIS HOSPITAL. - WE WORK WITH GOVERNMENT, PAYERS, BUSINESS, CONSUMER GROUPS AND OTHERS TO ADDRESS THE UNDERLYING PROBLEM THAT TOO MANY NEW YORKERS LACK HEALTH INSURANCE. GENERAL GUIDELINES: AS PART OF FINANCIAL PLANNING ASSISTANCE, WE PROVIDE PATIENTS, AND/OR THEIR LEGAL REPRESENTATIVE, WITH INFORMATION ABOUT THE CRITERIA THAT MUST BE MET IN ORDER TO OBTAIN MEDICAID, MEDICARE, OR OTHER HEALTH INSURANCES. PATIENTS ARE ASSISTED IN MAKING APPLICATIONS FOR ANY OF THESE INSURANCES OR DISCOUNTED FEE PLANS. PATIENTS ARE EXPECTED TO PARTICIPATE FULLY IN ALL EFFORTS TO OBTAIN ANY INSURANCE FOR WHICH THEY MAY QUALIFY. UNDER CERTAIN CIRCUMSTANCES, AS DETERMINED BY THE FINANCIAL CASE MANAGERS OR OTHER HOSPITAL SENIOR ADMINISTRATORS, APPLICATIONS FOR MEDICAID, MEDICARE OR OTHER INSURANCE PROGRAMS MAY BE WAIVED WHEN DEEMED UNNECESSARY. IF AVAILABLE INSURANCE BENEFITS ARE NOT SUFFICIENT TO COVER THE COST OF THEIR CARE, PATIENTS MAY THEN APPLY FOR ASSISTANCE FROM THE FINANCIAL ASSISTANCE PROGRAM. FINANCIAL ASSISTANCE APPLICATIONS MUST BE COMPLETED AND RETURNED TO THE HOSPITAL WITH THE REQUESTED INCOME DOCUMENTATION. PATIENTS WILL NOT RECEIVE FINANCIAL ASSISTANCE IF THEY (A) DO NOT COMPLETE THE APPLICATION PROCESS FOR MEDICAID OR OTHER INSURANCE FOR WHICH THEY MAY QUALIFY, (B) ELECT NOT TO MAKE APPLICATION FOR FINANCIAL ASSISTANCE, OR (C) HAVE ADEQUATE RESOURCES OR INCOME TO PAY PRIVATELY FOR THEIR CARE. IN THESE SITUATIONS, THEY WILL REMAIN FINANCIALLY RESPONSIBLE FOR FULL PAYMENT OF THEIR HOSPITAL BILLS. FINANCIAL ASSISTANCE IS AVAILABLE FOR PATIENTS WHO RESIDE IN NEW YORK STATE AND RECEIVE EMERGENCY HOSPITAL SERVICES, INCLUDING EMERGENCY TRANSFERS, AND TO PATIENTS WHO RESIDE IN HIGHLAND HOSPITAL'S PRIMARY SERVICE AREA IN NEW YORK STATE WHO RECEIVE SERVICES IN DESIGNATED HIGHLAND HOSPITAL PROGRAMS, INCLUDING MOST INPATIENT AND OUTPATIENT SERVICES. IN ADDITION, THE HOSPITAL MAY, IN ITS DISCRETION, GRANT FINANCIAL ASSISTANCE TO INDIVIDUALS WHO RESIDE OUTSIDE OF NEW YORK STATE. FINANCIAL ASSISTANCE DOES NOT COVER MEDICALLY UNNECESSARY CARE, COSMETIC ALTERATION, TELEPHONE, TELEVISION AND PRIVATE ROOM CHARGES. IT DOES NOT COVER SERVICES GENERATED BY AN INSURED PATIENT WHO CHOOSES TO RECEIVE CARE AT AN OUT-OF-NETWORK HOSPITAL, OR WHO FAILS TO COMPLY WITH INSURANCE POLICY REQUIREMENTS (E.G. UNAUTHORIZED SERVICES) NOR DOES IT APPLY TO NON-RESIDENT ALIENS (UNLESS APPROVED IN ADVANCE OF CARE BEING PROVIDED), TO DRUGS NOT ADMINISTERED IN THE HOSPITAL, TO TRANSPORTATION FURNISHED BY THIRD PARTY VENDORS, OR TO CARE, SERVICES, DRUGS OR SUPPLIES FOR THE PURPOSE OF GENDER RE-ASSIGNMENT. SPECIFIC QUESTIONS ABOUT SERVICES THAT ARE NOT COVERED SHOULD BE DIRECTED TO THE PATIENT ACCOUNTS MANAGER OR THEIR DELEGATE. FINANCIAL GUIDELINES: FINANCIAL AID IS INTENDED TO ASSIST THOSE INDIVIDUALS WHO CANNOT AFFORD TO PAY IN PART OR IN FULL FOR THEIR CARE. IT SHOULD TAKE INTO ACCOUNT EACH INDIVIDUAL'S ABILITY TO CONTRIBUTE TO THE COST OF HIS OR HER CARE. HOSPITAL FINANCIAL AID SHOULD NOT BE VIEWED AS A SUBSTITUTE FOR EMPLOYER-SPONSORED OR INDIVIDUALLY PURCHASED INSURANCE. PATIENTS WITHOUT INSURANCE AND WITH INCOME THAT WOULD QUALIFY THEM FOR THE FINANCIAL ASSISTANCE PROGRAM BUT ALSO HAVE SUBSTANTIAL RESOURCES (OTHER THAN TAX-DEFERRED OR COMPARABLE RETIREMENT SAVINGS OR COLLEGE SAVINGS ACCOUNTS) MAY BE EXPECTED TO PAY PART OF THEIR BILLS(S). FINANCIAL ASSISTANCE IS GENERALLY AVAILABLE TO INDIVIDUALS WHOSE INCOME IS LESS THAN OR EQUAL TO 400% OF THE FEDERAL POVERTY LEVEL. HOWEVER, PATIENTS WHO HAVE EXHAUSTED THEIR INSURANCE BENEFITS, EXCEEDED FINANCIAL ELIGIBILITY CRITERIA, FACE EXTRAORDINARY MEDICAL COSTS, OR WHO HAVE OTHER UNIQUE CIRCUMSTANCES MAY BE CONSIDERED FOR FINANCIAL ASSISTANCE APPROVAL IN THE HOSPITAL'S SOLE DISCRETION. WHILE APPLICATION FOR MEDICAID OR OTHER INSURANCE IS USUALLY REQUIRED, THE HOSPITAL MAY, AT ITS SOLE DISCRETION, IN APPROPRIATE CASES, ALSO CONSIDER PATIENTS FOR FINANCIAL ASSISTANCE WHEN THEY MEET THE FINANCIAL CRITERIA OF THIS PROGRAM, BUT HAVE NOT SATISFACTORILY COMPLETED ALL THE REQUIREMENTS OF THE FINANCIAL ASSISTANCE APPLICATION PROCESS. THIS MAY INCLUDE PATIENTS WHO HAVE BEEN SANCTIONED BY MEDICAID, HAVE FILED BANKRUPTCY OR APPEAR TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON AVAILABLE INFORMATION. ELIGIBILITY DETERMINATIONS IN COMPLEX CASE CIRCUMSTANCES WILL BE MADE AFTER CONSIDERATION BY THE FINANCIAL ASSISTANCE REVIEW TEAM THAT INCLUDES THE FINANCIAL ASSISTANCE OFFICER, FINANCIAL CASE MANAGER AND/OR THEIR MANAGERS, OR MAY BE MADE BY SENIOR HOSPITAL ADMINISTRATORS. THE AMOUNT OF THE DISCOUNT AFFORDED TO QUALIFIED FINANCIAL ASSISTANCE PATIENTS WILL BE DETERMINED THROUGH ASSESSMENT OF THE RESPONSIBLE PARTY'S ANNUAL HOUSEHOLD INCOME AND THE NUMBER OF PEOPLE IN THE HOME, AS A PERCENTAGE OF THE FEDERAL POVERTY GUIDELINE AMOUNTS FOR SAME SIZE HOUSEHOLDS. THE FINANCIAL GUIDELINES WILL BE UPDATED ANNUALLY IN CONJUNCTION WITH THE FEDERAL POVERTY UPDATES PUBLISHED BY CMS. PATIENTS MAY RECEIVE FULL OR PARTIAL DISCOUNT FROM THE COST OF CARE, DEPENDING ON THE PERCENTAGE OF THE GUIDELINES MATCHED BY THE PATIENT'S HOUSEHOLD INCOME. ANY BILL AMOUNT REMAINING AFTER APPLICATION OF A PARTIAL FINANCIAL ASSISTANCE DISCOUNT IS THE RESPONSIBILITY OF THE PATIENT. THE AMOUNT AN APPROVED FINANCIAL ASSISTANCE PATIENT WILL GENERALLY BE EXPECTED TO PAY FOR SERVICES COVERED BY THE POLICY WILL BE LIMITED TO THE LOWER OF THE AMOUNT THAT THE HOSPITAL WOULD HAVE RECEIVED FOR THE SAME SERVICE UNDER MEDICARE PARTS A AND B, (INCLUDING COINSURANCE, CO-PAYMENTS AND DEDUCTIBLES) OR THE USUAL AND CUSTOMARY CHARGES. THE PATIENT WILL BE ASSISTED BY THE HOSPITAL IN MAKING ARRANGEMENTS TO SATISFY ANY BALANCE REMAINING ON THE ACCOUNT(S) AFTER THE APPLICATION OF THE APPROPRIATE FINANCIAL ASSISTANCE DISCOUNT BY USE OF A PAYMENT PLAN. THE MONTHLY PAYMENTS UNDER SUCH PLANS SHALL NOT EXCEED TEN PERCENT (10%) OF THE ELIGIBLE PATIENT'S GROSS MONTHLY INCOME. THE RATE OF INTEREST ON UNPAID BALANCES SHALL NOT EXCEED THE US TREASURY RATE FOR 90 DAY SECURITIES PLUS 0.5%. HOSP
PART VI, LINE 2- NEEDS ASSESSMENT	THE NEEDS OF MONROE COUNTY ARE ASSESSED THROUGH HEALTH ACTION, A ROBUST COMMUNITY-WIDE PROCESS ESTABLISHED IN 1995 THAT IS LED BY THE MONROE COUNTY DEPARTMENT OF PUBLIC HEALTH (MCDPH). IT INVOLVES ALL FOUR LOCAL HEALTH SYSTEMS, LOCAL INSURERS, AND OTHER KEY COMMUNITY STAKEHOLDERS. THROUGH THIS PROCESS, COMMUNITY PRIORITIES, GOALS, AND INTERVENTIONS ARE IDENTIFIED AND IMPLEMENTED. THESE PRIORITIES ALIGN WITH THE HEALTH PRIORITIES AND INDICATORS AS PUBLISHED BY NEW YORK STATE'S DEPARTMENT OF HEALTH (DOH) AND INCLUDE ACCESS TO QUALITY HEALTH CARE, TOBACCO USE, HEALTHY MOTHERS/HEALTHY BABIES/HEALTHY CHILDREN, PHYSICAL ACTIVITY/NUTRITION, UNINTENTIONAL INJURY, HEALTHY ENVIRONMENTS, CHRONIC DISEASE, AND MENTAL HEALTH/SUBSTANCE ABUSE. FIVE HEALTH STATUS "REPORT CARDS" IN SPECIFIC AGE GROUPS AND CATEGORIES ARE USED TO MEASURE PROGRESS TOWARDS HEALTH STATUS IMPROVEMENT. THEY INCLUDE MATERNAL AND CHILD HEALTH, ADOLESCENT HEALTH, ADULT HEALTH, OLDER ADULT HEALTH AND ENVIRONMENTAL HEALTH, EACH OF WHICH CONTAIN GOALS FOR IMPROVING HEALTH. PRIORITIES FOR EACH AREA ARE SELECTED BASED ON INPUT FROM FOCUS GROUPS WITH RESIDENTS, AND HEALTH AND SOCIAL SERVICE PROFESSIONALS. UPDATED REPORT CARDS ARE PRODUCED AND DISTRIBUTED ON AVERAGE EVERY 4-6 YEARS FOR EACH SPECIFIC AGE GROUP. THESE PRIORITIES SERVE AS A FOUNDATION FOR COMMUNITY HEALTH IMPROVEMENT AND COMMUNITY BUILDING EFFORTS AND HELP TO ENSURE COLLABORATIVE AND COORDINATED USE OF HEALTH SYSTEM RESOURCES TO ADDRESS THE MOST PRESSING NEEDS. THE PRIORITY SETTING PROCESS IS A SIX-STEP PROCESS THAT INCLUDES: 1. ASSESS HEALTH STATUS: DATA DETAILING HEALTH STATUS, ACCESS TO HEALTH CARE AND HEALTH BEHAVIORS ARE COMPILED AND ANALYZED TO IDENTIFY TRENDS AND DISPARITIES AND TO COMPARE OUR COUNTY TO OTHER COMMUNITIES. FOR EACH LIFECYCLE GROUP, AN ADVISORY COMMITTEE, WITH REPRESENTATION FROM AREA HOSPITALS, HELPS TO INTERPRET THE DATA AND DEVELOP HEALTH GOALS BASED ON THE DATA. A REPORT CARD CONTAINING THE DATA AND HEALTH GOALS IS PUBLISHED. 2. CHOOSE PRIORITY GOALS: THE ADVISORY COMMITTEE HOSTS COMMUNITY FORUMS TO ADDRESS HEALTH IMPROVEMENT PRIORITIES. THE ADVISORY COMMITTEE THEN MAKES RECOMMENDATIONS TO THE MONROE COUNTY DEPARTMENT OF PUBLIC HEALTH ON PRIORITIES. 3. DEFINE THE LEADERSHIP: PARTNERS ARE IDENTIFIED TO SUPPORT THE PRIORITIES FOR ACTION. THE MEDICAL CENTER PROVIDES SALARY SUPPORT FOR FACULTY AND STAFF TO CONTRIBUTE THEIR ACADEMIC AND CLINICAL EXPERTISE TO HELP IDENTIFY AND IMPLEMENT THE MOST EFFECTIVE INTERVENTIONS ON THE HEALTH PRIORITIES. 4. DEVELOP IMPROVEMENT PLANS: EACH PARTNERSHIP DEVELOPS IMPROVEMENT PLANS TO ADDRESS HEALTH GOALS. 5. PERFORM INTERVENTIONS: EACH PARTNERSHIP, ALONG WITH THE STEERING COMMITTEE, WHICH INCLUDES THE MEDICAL CENTER, OVERSEES THE IMPLEMENTATION OF INTERVENTIONS IN VARIOUS VENUES THAT INCLUDE SCHOOLS, DAY CARE CENTERS, PLACES OF WORSHIP, COMMUNITY BASED ORGANIZATIONS AND WITHIN THE HEALTH SYSTEMS. 6. MEASURE THE IMPACT: EACH PARTNERSHIP EVALUATES THE INTERVENTION. --------------------
PART VI, LINE 3- PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IS POSTED IN ALL AREAS OF HIGHLAND HOSPITAL AND ITS OFF-SITE LOCATIONS. CHARITY CARE INFORMATION IS POSTED IN INPATIENT AND OUTPATIENT REGISTRATION AREAS; THE EMERGENCY DEPARTMENT; ADMITTING; HIGHLAND FAMILY MEDICINE; AND ALL PRIMARY CARE SITES. THE HOSPITAL PROVIDES A COPY OF THE CHARITY CARE POLICY AND FINANCIAL ASSISTANCE CONTACTS TO PATIENTS AS PART OF ITS ADMITTING PROCESS. HIGHLAND ALSO PROVIDES PRINTED INFORMATION ABOUT CHARITY CARE ASSISTANCE WITH DISCHARGE MATERIALS WHEN IT HAS BEEN DETERMINED THAT A PATIENT IS IN FINANCIAL NEED. OUR CHARITY CARE POLICY IS ONLINE AS WELL, ON THE HOSPITAL WEBSITE. AS PART OF FINANCIAL PLANNING ASSISTANCE, WE PROVIDE PATIENTS OR THEIR LEGAL REPRESENTATIVE, WITH INFORMATION ABOUT THE CRITERIA THAT MUST BE MET IN ORDER TO OBTAIN MEDICAID, MEDICARE, OR OTHER HEALTH INSURANCES. PATIENTS ARE ASSISTED IN MAKING APPLICATIONS FOR ANY OF THESE INSURANCES OR DISCOUNTED FEE PLANS. PATIENTS ARE EXPECTED TO PARTICIPATE FULLY IN ALL EFFORTS TO OBTAIN ANY INSURANCE FOR WHICH THEY MAY QUALIFY. UNDER CERTAIN CIRCUMSTANCES, AS DETERMINED BY THE FINANCIAL CASE COUNSELOR OR OTHER HOSPITAL SENIOR ADMINISTRATOR, APPLICATIONS FOR MEDICAID, MEDICARE OR OTHER INSURANCE PROGRAMS MAY BE WAIVED WHEN DEEMED UNNECESSARY. IF AVAILABLE INSURANCE BENEFITS ARE NOT SUFFICIENT TO COVER THE COST OF THEIR CARE, PATIENTS MAY THEN APPLY FOR ASSISTANCE FROM THE CHARITY CARE PROGRAM. ---------------
PART VI, LINE 4- COMMUNITY INFORMATION	HIGHLAND HOSPITAL IS LOCATED IN THE CITY OF ROCHESTER, COUNTY OF MONROE (POPULATION 741,770) IN THE FINGER LAKES REGION OF NEW YORK STATE. THE FINGER LAKES REGION EXTENDS APPROXIMATELY 100 MILES NORTH TO SOUTH AND 100 MILES EAST TO WEST. THE REGION ENCOMPASSES URBAN, SUBURBAN AND RURAL COMMUNITIES WITHIN NEW YORK STATE. THE REGION (INCLUDING MONROE COUNTY) HAS A POPULATION OF 1,788,323. HIGHLAND HOSPITAL'S PRIMARY SERVICE AREA (PSA) IS MONROE COUNTY AND THE SECONDARY SERVICE AREA (SSA) ENCOMPASSES THE 15 COUNTIES SURROUNDING MONROE INCLUDING: ALLEGANY, CATTARAUGUS, CAYUGA, CHEMUNG, GENESEE, LIVINGSTON, ONTARIO, ORLEANS, SCHUYLER, SENECA, STEUBEN, TOMPKINS, WAYNE, WYOMING, AND YATES. HEALTH CARE ENVIRONMENT- THE PRIMARY SERVICE AREA IS HOME TO TWO MULTI-HOSPITAL SYSTEMS EACH WITH SEVERAL LONG-TERM CARE, HOME CARE AND OTHER TYPES OF AFFILIATES. THE UNIVERSITY OF ROCHESTER MEDICAL CENTER CONSISTS OF STRONG MEMORIAL HOSPITAL AND AFFILIATES HIGHLAND HOSPITAL, FF THOMPSON HEALTH SYSTEM, ST JAMES HOSPITAL, NICHOLAS NOYES AND JONES MEMORIAL HOSPITALS. ROCHESTER REGIONAL HEALTH SYSTEM CONSISTS OF ROCHESTER GENERAL HOSPITAL, NEWARK WAYNE COMMUNITY HOSPITAL, UNITY HEALTH SYSTEM, CLIFTON SPRINGS HOSPITAL, AND UNITED MEMORIAL MEDICAL CENTER. THERE ARE SMALLER COMMUNITY HOSPITALS THAT OPERATE IN THE FIFTEEN COUNTIES SURROUNDING MONROE COUNTY WITH BED CAPACITY RANGING FROM AS FEW AS 25 BEDS TO AS MANY AS 224 BEDS. OVER 50 RESIDENTIAL HEALTH CARE FACILITIES; MANY PUBLIC AND PRIVATE AGENCIES PROVIDING COMMUNITY AND HOME HEALTH SERVICES; SEVERAL STATE AND FEDERAL FACILITIES; AND A FULL RANGE OF HEALTH CARE PROFESSIONALS, INCLUDING THOUSANDS OF PHYSICIANS, DENTISTS, NURSES, TECHNICIANS, ADMINISTRATORS, EDUCATORS, AND SUPPORT PERSONNEL PROVIDE SERVICES WITHIN THE SIXTEEN COUNTY SERVICE AREA. DEMOGRAPHIC ANALYSIS- HISTORICALLY UNDER REPRESENTED ETHNIC GROUPS INCLUDING BLACK NON-HISPANIC, HISPANIC AND OTHER POPULATIONS COMPRISE ROUGHLY 29.7% OF THE POPULATION OF MONROE COUNTY. MEDIAN HOUSEHOLD INCOME FOR MONROE COUNTY IS $57,479 VERSUS THE NATIONAL MEDIAN OF $60,293. ACCORDING TO THE US CENSUS, 14.4% OF INDIVIDUALS IN MONROE COUNTY WERE CONSIDERED BELOW THE POVERTY LEVEL. MORE THAN 50% OF CHILDREN IN ROCHESTER LIVE IN POVERTY, WHICH IS HIGH FOR ANY COMPARABLY SIZED CITY IN THE US. THE PERCENTAGE OF THE MONROE COUNTY POPULATION AGE 65 AND OLDER WAS 17.2% IN 2019. MONROE COUNTY'S POPULATION OF SENIORS OUTPACES THE NATIONAL AVERAGE OF 16.0%. THE RATE OF UNINSURED (INDIVIDUALS UNDER 65 YEARS OLD) IN MONROE COUNTY IS 4.3%, COMPARED TO 10.0% US AVERAGE. OF THE 3,287,846 INDIVIDUALS ENROLLED IN MEDICAID IN NEW YORK STATE, 3.3% RESIDE IN MONROE COUNTY. --------------------
PART VI, LINE 5- PROMOTION OF COMMUNITY HEALTH	HIGHLAND HOSPITAL CONDUCTS MANY COMMUNITY HEALTH INITIATIVES THROUGHOUT THE YEAR. EXAMPLES INCLUDE FREE OR LOW-COST HEALTH EDUCATION PROGRAMS ON TOPICS RELATED TO NUTRITION AND BARIATRIC SURGERY. ALSO, HIGHLAND'S BREAST IMAGING CENTER SPONSORS A FREE MAMMOGRAPHY SCREENING DAY FOR UNINSURED/UNDERINSURED WOMEN. THE HOSPITAL ALSO OFFERS SEMINARS FOR EMS PERSONNEL TO FURTHER THEIR MEDICAL EDUCATION. HIGHLAND HAS ALSO PROVIDED FREE HEALTH INFORMATION TO THE COMMUNITY THROUGH VIDEOS ON OUR SOCIAL MEDIA CHANNELS TO EDUCATE THE PUBLIC ABOUT COVID-19 DURING THE PANDEMIC. THESE EVENTS SERVE SEVERAL PURPOSES: THEY RAISE AWARENESS OF THE BREADTH OF SERVICES OFFERED BY HIGHLAND TO THE COMMUNITY, ESPECIALLY THOSE IN THE URBAN AREA OF ROCHESTER FOR WHOM HIGHLAND IS THEIR CLOSEST HOSPITAL; THEY ENCOURAGE COMMUNITY MEMBERS TO ENGAGE IN PROACTIVE WELLNESS EFFORTS, SUCH AS RECOMMENDED ANNUAL MAMMOGRAMS FOR WOMEN OVER 40 AND THOSE AT RISK; AND THEY EDUCATE COMMUNITY MEMBERS ON STEPS THEY CAN TAKE TO LEAD HEALTHY LIVES THROUGH POSITIVE LIFESTYLE CHOICES. IN ADDITION, HIGHLAND COLLABORATES WITH OTHER HOSPITALS IN WESTERN NEW YORK, INCLUDING STRONG MEMORIAL HOSPITAL, IN JOINTLY FILING A COMMUNITY SERVICE PLAN TO THE NEW YORK STATE DEPARTMENT OF HEALTH. THIS UNIQUE EFFORT, DONE IN COLLABORATION WITH THE MONROE COUNTY DEPARTMENT OF PUBLIC HEALTH AND THE FINGER LAKES HEALTH SYSTEM AGENCY, DEMONSTRATES TRUE COMMUNITY ASSESSMENT AND IMPROVEMENT PLANNING FOR MONROE COUNTY AND ITS SURROUNDING NEIGHBORHOODS. THE JOINT COMMUNITY SERVICE PLAN IS FOCUSING ON REDUCING OBESITY, REDUCING ILLNESS RELATED TO TOBACCO, AND INCREASING ACCESS TO CHRONIC DISEASE PREVENTION. THE UNIVERSITY OF ROCHESTER CENTER FOR COMMUNITY HEALTH SERVES AS A FACILITATING AGENCY. --------------------
PART VI, LINE 5- PROMOTION OF COMMUNITY HEALTH- OTHER INFORMATION	HIGHLAND'S BOARD OF DIRECTORS IS COMPRISED OF A DIVERSE GROUP OF MEMBERS OF THE ROCHESTER COMMUNITY. THE BOARD INCLUDES URMC AND HIGHLAND SENIOR LEADERS; EMPLOYED URMC FACULTY BASED AT HIGHLAND HOSPITAL AND PRIVATE COMMUNITY PHYSICIANS; MEMBERS OF THE BUSINESS COMMUNITY AND LOCAL PHILANTHROPISTS WITH AN INTEREST IN ADVOCATING FOR HEALTH CARE. HIGHLAND EXTENDS MEDICAL STAFF PRIVILEGES TO EMPLOYED HIGHLAND PHYSICIANS; URMC FACULTY PHYSICIANS; AND ALL ELIGIBLE PRIVATE PHYSICIANS WHO PRACTICE AT HIGHLAND AND/OR ADMIT PATIENTS TO THE HOSPITAL. HIGHLAND USES SURPLUS FUNDS TO CONTINUALLY REINVEST IN ITS FACILITY; THE 131-YEAR-OLD HOSPITAL HAS IN RECENT YEARS MADE MANY CAPITAL UPDATES TO ITS FACILITY, INCLUDING: ITS EMERGENCY DEPARTMENT IN RESPONSE TO RISING PATIENT VOLUMES, VIRTUALLY DOUBLING ITS CAPACITY TO MEET CURRENT AND FUTURE PATIENT NEEDS, RADIATION ONCOLOGY DEPARTMENT, SEVERAL INPATIENT CARE UNITS AND THE COMMUNITY OB/GYN CLINIC. OTHER ENHANCEMENTS INCLUDE THE ADDITION OF A NEW OUTPATIENT PHARMACY AND EXPANDED LOBBY/SURGICAL WAITING AREA TO ACCOMMODATE SURGICAL VOLUME GROWTH. THE HOSPITAL HAS COMPLETED CONSTRUCTION OF A NEW NEUROMEDICINE UNIT TO PROVIDE INTEGRATED NEUROLOGY/NEUROSURGERY CARE TO STROKE, HEAD INJURY AND NEUROSURGERY PATIENTS. IT HAS COMPLETED CONSTRUCTION OF TWO NEW OPERATING ROOMS AND EXPANSION OF ITS PERIOPERATIVE SERVICES AREA TO MEET DEMAND FOR OR USAGE. MAJOR CAPITAL EQUIPMENT ACQUISITIONS TO MEET COMMUNITY NEEDS INCLUDE AN UPGRADED LINEAR ACCELERATOR AND DAVINCI ROBOTIC SURGICAL SYSTEM. THE HOSPITAL CONTINUES TO REVIEW AND UPGRADE ALL KEY INFORMATION TECHNOLOGY SYSTEMS, INCLUDING THE ELECTRONIC MEDICAL RECORD. FINALLY, THE HOSPITAL COMPLETED THE FIRST PHASE OF ITS $28M MASTER FACILITY PLAN IN JUNE 2017, TO CONSTRUCT A DEDICATED 26 BED OBSERVATION UNIT, ALONG WITH A STATE OF THE ART PERIOPERATIVE UNIT. --------------------
PART VI, LINE 6- DETAIL REGARDING AFFILIATED HEALTH CARE SYSTEM ROLES	THE UNIVERSITY OF ROCHESTER MEDICAL CENTER IS AN INTEGRATED ACADEMIC HEALTH CENTER THAT COMPRISES THE SCHOOL OF MEDICINE AND DENTISTRY, INCLUDING ITS FACULTY PRACTICE (UNIVERSITY OF ROCHESTER MEDICAL FACULTY GROUP); STRONG MEMORIAL HOSPITAL; HIGHLAND HOSPITAL; GOLISANO CHILDREN'S HOSPITAL; JAMES P. WILMOT CANCER CENTER; STRONG WEST; SCHOOL OF NURSING; EASTMAN INSTITUTE FOR ORAL HEALTH AND ITS AFFILIATED HEALTH CARE ENTITIES ARE UR MEDICINE HOME CARE; HIGHLANDS AT PITTSFORD; THE HIGHLANDS LIVING CENTER, INC.; HIGHLANDS AT BRIGHTON, FF THOMPSON HEALTH SYSTEM, INC., JONES MEMORIAL HOSPITAL, NOYES HEALTH, ST. JAMES HOSPITAL AND ACCOUNTABLE HEALTH PARTNERS, LLC. UR MEDICAL CENTER AND THE AFFILIATED HEALTH CARE ENTITIES HAVE EMBRACED A COMPREHENSIVE APPROACH TO COMMUNITY HEALTH, WHICH EMPLOYS THE MULTIDISCIPLINARY SKILLS FOUND IN AN ACADEMIC MEDICAL CENTER TO BOTH PROVIDE IMPORTANT COMMUNITY SERVICES AND CONDUCT COMMUNITY-BASED RESEARCH. THESE ACTIVITIES HELP INFORM POLICYMAKERS AND THE COMMUNITY ABOUT LOCAL HEALTH CHALLENGES, EVALUATE THE EFFECTIVENESS OF INTERVENTIONS, AND SERVE AS A FOUNDATION FOR EVIDENCE-BASED PRACTICES TO IMPROVE HEALTH AND OVERALL QUALITY OF LIFE. - THE UNIVERSITY'S HEALTH CARE DELIVERY NETWORK IS ANCHORED BY STRONG MEMORIAL HOSPITAL, AN 838 BED TEACHING HOSPITAL, WHICH INCLUDES A CHILDREN'S HOSPITAL-GOLISANO CHILDREN'S HOSPITAL. PATIENTS BENEFIT FROM THE MEDICAL CENTER'S ROBUST TEACHING AND BIOMEDICAL RESEARCH PROGRAMS. STUDENT ROSTERS INCLUDE APPROXIMATELY 400 MEDICAL STUDENTS, 500 GRADUATE STUDENTS, AND 890 RESIDENTS AND FELLOWS WHO ARE ENGAGED IN COMMUNITY SERVICE THROUGHOUT THEIR EDUCATION. - EASTMAN INSTITUTE FOR ORAL HEALTH PROVIDES COMMUNITY DENTAL CARE IN A NUMBER OF CLINICS, AS WELL AS CLINICAL EDUCATION TO DENTAL STUDENTS ENROLLED AT THE UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY. IT OFFERS GENERAL DENTISTRY, PEDIATRIC AND ORTHODONTIC CLINICS, AND AN URGENT CARE DENTAL CLINIC THAT SEES 10 - 50 PATIENTS PER DAY. IT OPERATES LOW-INCOME CLINICS AT SCHOOLS AND A DOWNTOWN LOCATION. ADDITIONALLY, FOUR SMILEMOBILES PROVIDE A DENTAL OFFICE ON WHEELS, ALLOWING THE CITY'S CHILDREN INCREASED ACCESS TO MUCH NEEDED DENTAL CARE. - THE JAMES P. WILMOT CANCER CENTER IS ORGANIZED AROUND A MULTIDISCIPLINARY CARE MODEL, WHICH LEADING CANCER EXPERTS BELIEVE IS THE GOLD STANDARD IN CANCER CARE IN THE 21ST CENTURY. ITS MODEL UNDERSCORES A COMMITMENT TO PROVIDE PATIENTS IN THE ROCHESTER AREA WITH THE MOST UP-TO-DATE INFORMATION AND AVAILABLE TREATMENTS, BASING OUR RECOMMENDATIONS ON THE BEST EVIDENCE. IT IS THE ONLY CENTER IN THE ROCHESTER AND FINGER LAKES REGION OFFERING THIS TEAM APPROACH TO CARE. A VARIETY OF FREE PREVENTIVE EDUCATION EVENTS ARE HELD THROUGHOUT THE YEAR, INCLUDING MEN'S HEALTH DAY, WHICH INCLUDES NUMEROUS FREE HEALTH SCREENINGS; FREE SKIN CANCER SCREENINGS; AND BREAST CANCER SCREENINGS FOR THE UNINSURED AND UNDERINSURED. - GOLISANO CHILDREN'S HOSPITAL, HOUSED IN STRONG MEMORIAL HOSPITAL, IS A 124-BED CHILDREN'S HOSPITAL THAT SERVES AS THE REFERRAL CENTER FOR ALL SERIOUSLY ILL OR INJURED CHILDREN FROM THE 17-COUNTY FINGER LAKES REGION. IT COMBINES AWARD-WINNING RESEARCH, INTERNATIONALLY ACCLAIMED EDUCATION AND COMPASSIONATE CARE TO SERVE CHILDREN AND FAMILIES. PEDIATRIC SPECIALTIES INCLUDE ORTHOPAEDICS, NEUROLOGY/NEUROSURGERY, CANCER AND NEONATAL CARE. IN ADDITION TO THESE TRADITIONAL MEDICAL SERVICES, GOLISANO CHILDREN'S HOSPITAL IS THE NATION'S MODEL FOR "COMMUNITY PEDIATRICS", A PHILOSOPHY THAT EMBRACES THE IDEA THAT A CHILD'S COMMUNITY AND ENVIRONMENT AFFECT HIS HEALTH AND, THEREFORE, HE CANNOT BE TREATED SOLELY IN AN EXAM ROOM. THE HOSPITAL ENCOURAGES PHYSICIANS AND STAFF TO PARTNER WITH COMMUNTIY ORGANIZAITONS TO IMPROVE VACCINATION RATES, EDUCATIONAL OPPORTUNITIES, SAFETY AT HOME AND ON PLAYGROUNDS, AND HEALTH INSURANCE AND HEALTH CARE ACCESS. - THE STRONG WEST CAMPUS, WHICH IS LOCATED APPROXIMATELY 20 MILES WEST OF ROCHESTER IN BROCKPORT, NY WAS ACQUIRED BY THE UNIVERSITY IN 2013. IT IS THE SITE OF THE FORMER 61 BED LAKESIDE MEMORIAL HOSPITAL, WHICH ANNOUNCED IT WAS CLOSING IN APRIL, 2013, LEAVING THE COMMUNITY WITHOUT AN EMERGENCY ROOM AND LOCAL ACCESS TO OTHER HEALTH CARE SERVICES. STRONG MEMORIAL HOSPITAL NOW OPERATES A FREE-STANDING EMERGENCY ROOM ON THE STRONG WEST CAMPUS, IN ADDITION TO OFFERING AMBULATORY SURGERY, HEALTH IMAGING, LABORATORY SERVICES, PRIMARY CARE, ORTHOPAEDICS, CARDIAC CARE, ONCOLOGY AND HEMATOLOGY, SLEEP MEDICINE, NEUROLOGY, AND UROLOGY SERVICES. THE UNIVERSITY'S WHOLLY OWNED HEALTH CARE AFFILIATES ARE: STRONG PARTNERS HEALTH SYSTEM, INC. AND AFFILIATES IN JUNE 1997, HIGHLAND HOSPITAL AND ITS AFFILIATES AND THE UNIVERSITY BECAME AFFILIATED THROUGH THE RESTRUCTURING OF A CORPORATION NOW KNOWN AS STRONG PARTNERS HEALTH SYSTEM, INC. ("SPHS"), OF WHICH THE UNIVERSITY IS THE SOLE MEMBER. SPHS, A NOT-FOR-PROFIT CORPORATION, NOW SERVES AS THE CORPORATE PARENT OF HIGHLAND HOSPITAL AND THE UNIVERSITY'S LONG TERM CARE AFFILIATES. A BRIEF DESCRIPTION OF THE SPHS AFFILIATES FOLLOWS: HIGHLAND HOSPITAL OF ROCHESTER HIGHLAND HOSPITAL OF ROCHESTER IS A 261-BED NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN ROCHESTER, NEW YORK. THE HOSPITAL'S SERVICES INCLUDE MEDICAL/SURGICAL CARE, INTENSIVE CARE, MATERNITY AND EMERGENCY CARE. IN ADDITION, THE HOSPITAL OWNS AND OPERATES 21 OUTPATIENT EXTENSION CLINICS, PROVIDING PRIMARY CARE, PRENATAL CARE, RADIOLOGY, AND/OR THERAPEUTIC RADIOLOGY SERVICES. HIGHLAND COMMUNITY DEVELOPMENT CORPORATION HIGHLAND COMMUNITY DEVELOPMENT CORPORATION ("HCDC") IS A NOT-FOR-PROFIT CORPORATION WHICH OWNS AND OPERATES THE HIGHLANDS AT PITTSFORD, A RETIREMENT COMMUNITY LOCATED IN PITTSFORD, MONROE COUNTY, NEW YORK. THE RETIREMENT COMMUNITY INCLUDES 130 INDEPENDENT LIVING APARTMENTS, 36 INDEPENDENT LIVING COTTAGES, 60 ENRICHED HOUSING UNITS, A COMMUNITY COMMON AREA, A DINING ROOM, SITTING AREAS, RECREATIONAL AREAS, A WELLNESS CENTER, AND A COMMUNITY CENTER. HCDC ALSO OWNS AND OPERATES LAURELWOOD AT THE HIGHLANDS, AN ASSISTED LIVING FACILITY INCLUDING 68 APARTMENTS LOCATED ON THE SAME CAMPUS AS THE HIGHLANDS AT PITTSFORD. THE HIGHLANDS LIVING CENTER, INC. THE HIGHLANDS LIVING CENTER, INC. IS A NOT-FOR-PROFIT CORPORATION WHICH OWNS AND OPERATES A 122-BED SKILLED NURSING FACILITY AND AN ADULT DAY CARE HEALTH PROGRAM FOR SENIORS IN PITTSFORD, MONROE COUNTY, NEW YORK. THE SKILLED NURSING FACILITY IS ADJACENT TO THE HIGHLANDS AT PITTSFORD. THE HIGHLANDS AT BRIGHTON THE MEADOWS AT WESTFALL, INC. D/B/A/ THE HIGHLANDS AT BRIGHTON ("HAB") IS A NOT-FOR-PROFIT CORPORATION WHICH OWNS AND OPERATES A 145-BED SKILLED NURSING FACILITY IN BRIGHTON, MONROE COUNTY, NEW YORK. HIGHLAND FACILITIES DEVELOPMENT CORPORATION HIGHLAND FACILITIES DEVELOPMENT CORPORATION ("HFDC") IS A NOT-FOR-PROFIT CORPORATION WHOSE PRIMARY PURPOSE IS TO PROVIDE SERVICES THAT ARE SUBSTANTIALLY RELATED TO THE CHARITABLE PURPOSES OF HIGHLAND HOSPITAL BUT DO NOT INVOLVE THE PROVISION OF HEALTH CARE SERVICES. HFDC OWNS AND OPERATES A MEDICAL OFFICE BUILDING AND A PARKING GARAGE ON THE HOSPITAL CAMPUS. MEDICAL ADMINISTRATIVE ASSOCIATES, INC. HIGHLAND HOSPITAL IS THE SOLE SHAREHOLDER OF MEDICAL ADMINISTRATIVE ASSOCIATES, INC., D/B/A HIGHLAND SOUTH WEDGE PHARMACY, WHICH IS A FOR-PROFIT CORPORATION WHICH OWNS AND OPERATES A RETAIL PHARMACY IN ROCHESTER, NEW YORK. THE HIGHLAND FOUNDATION, INC. THE HIGHLAND FOUNDATION, INC. IS A NOT-FOR-PROFIT CORPORATION CONTROLLED BY HIGHLAND HOSPITAL WHICH SOLICITS, RECEIVES AND MAINTAINS FUNDS FOR THE SUPPORT OF HIGHLAND HOSPITAL AND THE LONG TERM CARE AFFILIATES. STRONG HOME CARE GROUP AND AFFILIATES THE UNIVERSITY AFFILIATED WITH VISITING NURSE FOUNDATION, INC. IN APRIL 1999, WHICH IS A NOT-FOR-PROFIT CORPORATION NOW KNOWN AS UR MEDICINE HOME CARE,INC. ("URMHC"). THE UNIVERSITY IS THE SOLE CORPORATE MEMBER OF URMHC. URMHC SERVES AS THE CORPORATE PARENT OF THE UNIVERSITY'S HOME HEALTH CARE AFFILIATES. URMHC IS THE CORPORATE PARENT OF TWO NOT-FOR-PROFIT HOME HEALTH CARE PROVIDERS, UR MEDICINE HOME CARE, CERTIFIED SERVICES, INC. ("CERTIFIED SERVICES") (FORMERLY NAMED VISITING NURSE SERVICE OF ROCHESTER AND MONROE COUNTY, INC.), WHICH OPERATES A CERTIFIED HOME HEALTH AGENCY AND A HOSPICE, AND UR MEDICINE HOME CARE, LICENSED SERVICES, INC., WHICH OPERATES A LICENSED HOME CARE SERVICES AGENCY. IN OCTOBER 2014, FINGER LAKES VISITING NURSE SERVICE, INC., WHICH OPERATES A NOT-FOR-PROFIT CERTIFIED HOME HEALTH AGENCY AND A HOSPICE, FINGER LAKES HOME CARE, INC., WHICH OPERATES A NOT-FOR-PROFIT LICENSED HOME CARE SERVICES AGENCY, BECAME UNIVERSITY AFFILIATES. CERTIFIED SERVICES IS THE SOLE CORPORATE MEMBER OF THE FINGER LAKES HOME CARE, INC. AND FINGER LAKES VISITING NURSE SERVICE, INC. MERGED INTO CERTIFIED SERVICES IN NOVEMBER 2020. IN 2018, URMHC FORMED TWO NEW WHOLLY CONTROLLED, NOT-FOR-PROFIT SUBSIDIARIES: UR MEDICINE HOME CARE, COMMUNITY SERVICES, INC., WHICH OPERATES CERTAIN COMMUNITY-BASED PROGRAMS THAT PROVIDE HOME-BASED SERVICES THAT ARE NOT REGULATED BY THE DEPARTMENT OF HEAL

Schedule H (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

2019

Open to Public Inspection

Name of the organization

HIGHLAND HOSPITAL OF ROCHESTER

Employer identification number

16-0743037

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on 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 .........

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 on Line 1a? ..

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

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:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

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 ............

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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2019

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1STEVEN I GOLDSTEIN CEO	(i) (ii)	0 ------------- 1,143,063	0 ------------- 5,000	0 ------------- 84,099	0 ------------- 486,254	0 ------------- 19,508	0 ------------- 1,737,924	0 ------------- 0
2BRENT DUBESHTER MD BOARD MEMBER	(i) (ii)	0 ------------- 1,105,071	0 ------------- 0	0 ------------- 0	0 ------------- 26,854	0 ------------- 22,425	0 ------------- 1,154,350	0 ------------- 0
3ROBERT MCCANN MD BOARD MEMBER	(i) (ii)	0 ------------- 596,094	0 ------------- 0	0 ------------- 14,694	0 ------------- 39,154	0 ------------- 26,836	0 ------------- 676,778	0 ------------- 0
4CINDY BECKER COO	(i) (ii)	374,933 ------------- 0	0 ------------- 0	0 ------------- 0	89,022 ------------- 0	32,121 ------------- 0	496,076 ------------- 0	0 ------------- 0
5LORI FERRIS MD PHYSICIAN	(i) (ii)	411,071 ------------- 0	0 ------------- 0	0 ------------- 0	64,513 ------------- 0	36,101 ------------- 0	511,685 ------------- 0	0 ------------- 0
6JULIETTA FISCELLA MD PHYSICIAN	(i) (ii)	410,692 ------------- 0	0 ------------- 0	0 ------------- 0	80,953 ------------- 0	17,470 ------------- 0	509,115 ------------- 0	0 ------------- 0
7GREGORY RYAN MD PHYSICIAN	(i) (ii)	369,876 ------------- 0	0 ------------- 0	0 ------------- 0	65,021 ------------- 0	37,514 ------------- 0	472,411 ------------- 0	0 ------------- 0
8JEFFREY HANSON MD PHYSICIAN	(i) (ii)	379,264 ------------- 0	0 ------------- 0	0 ------------- 0	80,060 ------------- 0	26,972 ------------- 0	486,296 ------------- 0	0 ------------- 0
9RAYMOND MAYEWSKI MD BOARD MEMBER	(i) (ii)	0 ------------- 520,982	0 ------------- 0	0 ------------- 30,127	0 ------------- 27,135	0 ------------- 16,081	0 ------------- 594,325	0 ------------- 0
10ADAM ANOLIK FORMER CFO	(i) (ii)	0 ------------- 714,726	0 ------------- 0	0 ------------- 7,018	0 ------------- 126,854	0 ------------- 24,235	0 ------------- 872,833	0 ------------- 0
11MAUREEN PERRY PHYSICIAN	(i) (ii)	273,489 ------------- 0	0 ------------- 0	0 ------------- 0	65,578 ------------- 0	26,089 ------------- 0	365,156 ------------- 0	0 ------------- 0
12MICHAEL APOSTOLAKIS MD CHIEF MEDICAL OFFICER	(i) (ii)	0 ------------- 642,347	0 ------------- 0	0 ------------- 19,000	0 ------------- 51,854	0 ------------- 24,668	0 ------------- 737,869	0 ------------- 0
13CARRIE FULLER SPENCER CFO	(i) (ii)	0 ------------- 445,805	0 ------------- 0	0 ------------- 0	0 ------------- 52,795	0 ------------- 24,236	0 ------------- 522,836	0 ------------- 0
14MELISSA DERLETH CNO	(i) (ii)	186,661 ------------- 0	0 ------------- 0	0 ------------- 0	9,883 ------------- 0	12,160 ------------- 0	208,704 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

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

FORM 990, SCHEDULE J, PART I, LINE 3

TOP MANAGEMENT COMPENSATION AS PROVIDED IN THE FORM 990, SCHEDULE J INSTRUCTIONS, SINCE THE ORGANIZATION RELIES ON A RELATED ORGANIZATION WHICH USES ONE OR MORE OF THE METHODS DESCRIBED IN LINE 3 TO ESTABLISH THE TOP MANAGEMENT OFFICIALS' COMPENSATION, THIS QUESTION HAS BEEN LEFT UNANSWERED. REFER TO SCHEDULE O, DESCRIPTION OF COMPENSATION REVIEW AND APPROVAL PROCESS. --------------------

FORM 990, SCHEDULE J, PART I, LINE 4B

PARTICIPATION IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN BOX 4(B) HAS BEEN CHECKED YES, SINCE CERTAIN OFFICERS OF HIGHLAND HOSPITAL OF ROCHESTER PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PROVIDED BY THE UNIVERSITY OF ROCHESTER, A RELATED IRC SECTION 501(C)(3) ORGANIZATION. THESE AMOUNTS ARE INCUDED IN DEFERRED COMPENSATION, FOR THE FOLLOWING INDIVIDUALS: STEVEN I. GOLDSTEIN SERP PLAN $159,400 STEVEN I. GOLDSTEIN 457(F) PLAN $300,000 ADAM ANOLIK SERP PLAN $100,000 ROBERT MCCANN, MD SERP PLAN $12,300 MICHAEL APOSTOLAKOS, MD SERP PLAN $25,000 CARRIE FULLER SPENCER SERP PLAN $25,000 --------------------

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
HIGHLAND HOSPITAL OF ROCHESTER

Employer identification number
16-0743037

Part Ⅰ

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
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	DORMITORY AUTHORITY OF STATE OF NEW YORK	14-6000293	649905W93	06-25-2010	10,932,064	MEDICAL FACILTY, EQUIP & TECHNLGY		X		X		X
B	MONROE COUNTY INDUSTRIAL DEVELOPMENT CORPORATION	51-0188852	61075TPC6	09-24-2015	40,469,568	MEDICAL FACILTY, EQUIP & TECHNLGY		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	2,627,064		3,995,000
2 Amount of bonds legally defeased ..............	0		0
3 Total proceeds of issue ..................	10,932,064		40,469,568
4 Gross proceeds in reserve funds .............	428,710		0
5 Capitalized interest from proceeds .............	0		0
6 Proceeds in refunding escrows ...............	0		15,192,904
7 Issuance costs from proceeds ...............	218,641		572,717
8 Credit enhancement from proceeds .............	0		0
9 Working capital expenditures from proceeds .............	0		0
10 Capital expenditures from proceeds .............	10,284,713		24,703,947
11 Other spent proceeds .............	0		0
12 Other unspent proceeds .............	0		0
13 Year of substantial completion .............	2011		2017
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........		X	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........		X		X
16 Has the final allocation of proceeds been made? ..........	X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

Part Ⅲ

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		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2019

Page 2

Part Ⅲ

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		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		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 ....	0 %		0 %
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 .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X		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		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? .............		X		X
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		X

Part Ⅳ

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		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X
b Exception to rebate? ........	X		X
c No rebate due? .........		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........	0		0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2019

Page 3

Part Ⅳ

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		X
b Name of provider ..........	0		0
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		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X

Part Ⅴ

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		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
FORM 990, SCHEDULE K, PART III, LINES 3B & 3D	SUPPLEMENTAL INFORMATION HIGHLAND HOSPITAL DOES NOT HAVE ANY MANAGEMENT CONTRACTS, SERVICE CONTRACTS OR RESEARCH AGREEMENTS BUT WOULD ENGAGE BOND COUNSEL OR OTHER OUTSIDE COUNSEL TO REVIEW BEFORE ENTERING INTO ANY SUCH AGREEMENTS.

Schedule K (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

2019

Open to Public
Inspection

Name of the organization

HIGHLAND HOSPITAL OF ROCHESTER

Employer identification number

16-0743037

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11	FORM 990 REVIEW PROCESS THE FORM 990 OF HIGHLAND HOSPITAL IS PREPARED BY FINANCE STAFF AND PROVIDED TO PRICEWATERHOUSECOOPERS LLP AND SENIOR MANAGEMENT FOR REVIEW PRIOR TO FILING. THE FORM 990 FOR THE YEAR ENDED JUNE 30, 2020 WAS REVIEWED WITH THE FINANCE COMMITTEE BY PRICEWATERHOUSECOOPERS LLP PRIOR TO FILING. THE FORM 990 WAS ALSO PROVIDED TO THE ENTIRE BOARD OF DIRECTORS PRIOR TO FILING. --------------------
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY DIRECTORS, COMMITTEE MEMBERS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE A CONFLICT OF INTEREST: (A) PRIOR TO VOTING ON OR OTHERWISE DISCHARGING THEIR DUTIES WITH RESPECT TO ANY MATTER INVOLVING THE CONFLICT WHICH COMES BEFORE THE BOARD OR ANY COMMITTEE; (B) PRIOR TO ENTERING INTO ANY CONTRACT OR TRANSACTION INVOLVING THE CONFLICT; (C) AS SOON AS POSSIBLE AFTER THE DIRECTOR, COMMITTEE MEMBER OR OFFICER LEARNS OF THE CONFLICT; AND (D) ON AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. THE FORM IS DISTRIBUTED ANNUALLY AND REQUIRES DISCLOSURE OF ALL CONFLICTS OF INTEREST, INCLUDING SPECIFIC INFORMATION CONCERNING THE TERMS OF ANY CONTRACT OR TRANSACTION WITH THE HOSPITAL THAT INVOLVES A POTENTIAL CONFLICT OF INTEREST FOR THE INDIVIDUAL. THE FORMS ARE REVIEWED BY THE BOARD CHAIR AND LEGAL COUNSEL, ANY CONFLICTS DISCLOSED ON THE FORMS OR ON AN AD HOC BASIS ARE REVIEWED BY A BOARD COMMITTEE. THE COMMITTEE CONSIDERS THE MATERIAL FACTS CONCERNING ANY PROPOSED CONTRACT OR TRANSACTION, INCLUDING THE PROCESS BY WHICH THE DECISION WAS MADE TO APPROVE OR RECOMMEND ENTERING INTO THE ARRANGEMENT ON THE TERMS PROPOSED, AND APPROVES SUCH CONTRACTS OR TRANSACTIONS ONLY IF THE TERMS ARE FAIR AND REASONABLE TO THE HOSPITAL AND THE ARRANGEMENTS ARE CONSISTENT WITH THE BEST INTERESTS OF THE HOSPITAL. --------------------
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION REVIEW AND APPROVAL WRITTEN SELF-EVALUATIONS AND PERFORMANCE EVALUATIONS FOR HIGHLAND HOSPITAL'S OFFICERS AND KEY EMPLOYEES ANNUALLY ARE REVIEWED BY THE COMMITTEE ON COMPLIANCE AND COMPENSATION OF THE UNIVERSITY OF ROCHESTER MEDICAL CENTER BOARD. THE COMMITTEE HAS AVAILABLE THE EVALUATIONS FROM HIGHLAND HOSPITAL'S BOARD, AS WELL AS FROM THE CEO OF URMC HEALTH SYSTEM AND IN SOME CASES HIGHLAND'S CEO. THE COMMITTEE REVIEWS AND APPROVES TOTAL COMPENSATION FOR OFFICERS AND KEY EMPLOYEES AND CONSIDERS, IN ADDITION TO THE EVALUATIONS, THE SCOPE OF THE INDIVIDUAL'S JOB RESPONSIBILITIES, PREVIOUS COMPENSATION AND COMPARABLE COMPENSATION PAID TO PEOPLE WITH SIMILAR RESPONSIBILITIES AT COMPARABLE INSTITUTIONS. THE COMPARABLE INFORMATION IS PROVIDED BY AN INDEPENDENT CONSULTANT AND IS BASED ON LOCAL, REGIONAL AND NATIONAL COMPENSATION SURVEYS. --------------------
FORM 990, PART VI, SECTION C, LINE 19	GOVERNING DOCUMENTS HIGHLAND HOSPITAL'S FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. HIGHLAND HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE NOT ROUTINELY MADE AVAILABLE TO THE PUBLIC. --------------------
FORM 990, PART VII & FORM 990, SCHEDULE J, PART II	COMPENSATION INFORMATION CERTAIN OFFICERS, DIRECTORS AND KEY EMPLOYEES OF HIGHLAND HOSPITAL RECEIVE COMPENSATION FROM THE UNIVERSITY OF ROCHESTER, A RELATED IRC SECTION 501(C)(3) ORGANIZATION. A PORTION OF THE SALARIES OF THESE INDIVIDUALS IS ALLOCATED TO HIGHLAND HOSPITAL AND IS INCLUDED AS A PART OF OTHER SALARY AND WAGES ON THE STATEMENT OF FUNCTIONAL EXPENSES. CERTAIN OFFICERS AND KEY EMPLOYEES OF HIGHLAND HOSPITAL ALSO DEVOTE SIGNIFICANT TIME EACH WEEK TO OTHER RELATED ORGANIZATIONS. NONE OF THE BOARD MEMBERS OF HIGHLAND HOSPITAL ARE COMPENSATED FOR THEIR BOARD SERVICE. --------------------
FORM 990, PART VI, SECTION A, LINES 6, 7A, & 7B	MEMBERSHIP INFORMATION THE SOLE MEMBER OF HIGHLAND HOSPITAL IS STRONG PARTNERS HEALTH SYSTEM, INC. ("SPHS"). SPHS, ACTING THROUGH ITS BOARD OF DIRECTORS, HAS THE AUTHORITY TO ELECT THE GOVERNING BODY OF HIGHLAND HOSPITAL, AND CERTAIN DECISIONS OF THE HIGHLAND HOSPITAL BOARD ARE SUBJECT TO THE APPROVAL OF THE SPHS BOARD. SUCH DECISIONS INCLUDE APPOINTMENT OF THE HIGHLAND HOSPITAL PRESIDENT AND CEO, AMENDMENT OF THE CERTIFICATE OF INCORPORATION AND BYLAWS, APPROVAL OF EXTRAORDINARY CORPORATE ACTIONS SUCH AS MERGER OR DISSOLUTION, AND APPROVAL OF CAPITAL AND OPERATING BUDGETS, STRATEGIC PLANS, AND INCURRENCE OF CERTAIN DEBT. --------------------
FORM 990, PART XI, LINE 9	DETAIL OF OTHER CHANGES IN NET ASSETS OR FUND BALANCES CHANGE IN ACCRUED PENSION LIABILITY ($23,784,100) ----------- TOTAL CHANGES IN NET ASSETS ($23,784,100) --------------------

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

HIGHLAND HOSPITAL OF ROCHESTER

Employer identification number

16-0743037

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?
(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	Yes	No
(1)UNIVERSITY OF ROCHESTER 910 GENESEE STREET STE 200 ROCHESTER,NY14611 16-0743209	SCHOOL	NY	501(C)(3)	2	NA		No
(2)THE HIGHLAND FOUNDATION INC 1000 SOUTH AVENUE ROCHESTER,NY14620 23-7310662	FUNDRAISING	NY	501(c)(3)	12A, I	HIGHLD HOSP	Yes
(3)HIGHLAND FACILITIES DEVELOPMENT CORP 1000 SOUTH AVENUE ROCHESTER,NY14620 22-3039077	MEDICAL BLDG	NY	501(C)(3)	10	HIGHLD HOSP	Yes
(4)STRONG PARTNERS HEALTH SYSTEM INC 601 ELMWOOD AVENUE BOX 706 ROCHESTER,NY14642 16-1499099	SUPPORT ORG	NY	501(C)(3)	12A, I	UNIV OF ROCH		No
(5)THE MEADOWS AT WESTFALL INC 5901 LAC DE VILLE BLVD ROCHESTER,NY14618 16-1502303	HEALTHCARE	NY	501(C)(3)	10	SPHS		No
(6)THE HIGHLANDS LIVING CENTER INC 500 HAHNEMANN TRAIL PITTSFORD,NY14534 22-3240227	HEALTHCARE	NY	501(C)(3)	10	SPHS		No
(7)HIGHLAND COMMUNITY DEVELOPMENT CORP 100 HAHNEMANN TRAIL PITTSFORD,NY14534 22-3154715	ELDER CARE	NY	501(C)(3)	1	SPHS		No
(8)STRONG HOME CARE GROUP 2180 EMPIRE BOULEVARD WEBSTER,NY14580 22-2577664	FUNDRAISING	NY	501(C)(3)	7	UNIV OF ROCH		No
(9)UR MEDICINE HOME CARE CERTIFIED SRV INC 2180 EMPIRE BOULEVARD WEBSTER,NY14580 16-0743215	HEALTHCARE	NY	501(C)(3)	10	SHCG		No
(10)COMMUNITY CARE OF ROCHESTER 2180 EMPIRE BOULEVARD WEBSTER,NY14580 16-1561691	HEALTHCARE	NY	501(C)(3)	10	SHCG		No
(11)EXCELL PARTNERS INC 343 STATE STREET KODAK TOWER 2ND ROCHESTER,NY14650 20-1862628	ECONOMIC DEV	NY	501(C)(4)	N/A	UNIV OF ROCH		No
(12)ROCHESTER BIOVENTURE CENTER INC 601 ELMWOOD AVENUE BOX 706 ROCHESTER,NY14642 20-2485999	BIOTECH INCUB	NY	501(C)(3)	12A, I	UNIV OF ROCH		No
(13)NEXTCORPS INC 260 EAST MAIN STREET SUITE 6000 ROCHESTER,NY14604 16-1195028	BUSINESS INCU	NY	501(C)(3)	7	UNIV OF ROCH		No
(14)UNIVERSITY OF ROCHESTER EMPLOYEE BEN TRS 910 GENESEE STREET SUITE 200 ROCHESTER,NY14611 16-1600112	EMPL BEN TRST	NY	501(C)(9)	N/A	UNIV OF ROCH		No
(15)U OF R BROADCASTING CORPORATION 201 WILSON COMMONS ROCHESTER,NY14627 16-0743209	BROADCAST LIC	NY	501(C)(4)	N/A	UNIV OF ROCH		No
(16)UR REAL ESTATE CORPORATION 263 WALLIS HALL ROCHESTER,NY14627 27-1140014	SUPPORT ORG	NY	501(c)(3)	12A, I	UNIV OF ROCH		No
(17)MELIORA REAL ESTATE CORPORATION 263 WALLIS HALL ROCHESTER,NY14627 45-2464788	SUPPORT ORG	NY	501(C)(3)	12A, I	UNIV OF ROCH		No
(18)FF THOMPSON HEALTH SYSTEM INC 350 PARRISH STREET CANANDAIGUA,NY14424 22-2959987	SUPPORT ORG	NY	501(C)(3)	12A, I	UNIV OF ROCH		No
(19)THE FREDERICK FERRIS THOMPSON HOSPITAL 350 PARRISH STREET CANANDAIGUA,NY14424 16-0743024	HOSPITAL	NY	501(C)(3)	3	THS		No
(20)MM EWING CONTINUING CARE CENTER 350 PARRISH STREET CANANDAIGUA,NY14424 23-7046583	HEALTHCARE	NY	501(C)(3)	3	THS		No
(21)FFT SENIOR COMMUNITIES INC 1 FERRIS HILLS CANANDAIGUA,NY14424 16-1557494	ELDER CARE	NY	501(C)(3)	10	THS		No
(22)THE FF THOMPSON FOUNDATION INC 350 PARRISH STREET CANANDAIGUA,NY14424 22-2959984	FUNDRAISING	NY	501(C)(3)	7	THS		No
(23)FINGER LAKES HOMECARE INC 756 PRE-EMPTION ROAD GENEVA,NY14456 16-1489133	HEALTHCARE	NY	501(C)(3)	10	URM HOMECARE		No
(24)FINGER LAKES VISITING NURSE SERVICE INC 756 PRE-EMPTION ROAD GENEVA,NY14456 22-3067627	HEALTHCARE	NY	501(C)(3)	10	URM HOMECARE		No
(25)THE MEMORIAL HOSPITAL OF WILLIAM F AND 191 NORTH MAIN STREET WELLSVILLE,NY14895 22-2807681	HOSPITAL	NY	501(C)(3)	3	UNIV OF ROCH		No
(26)LIVINGSTON HEALTH CARE SYSTEM INC 111 CLARA BARTON STREET DANSVILLE,NY14427 16-1455240	SUPPORT ORG	NY	501(C)(3)	12A, I	UNIV OF ROCH		No
(27)NICHOLAS H NOYES MEMORIAL HOSPITAL INC 111 CLARA BARTON STREET DANSVILLE,NY14427 16-0743979	HOSPITAL	NY	501(C)(3)	3	LHCS		No
(28)RED JACKET CENTER INC 111 CLARA BARTON STREET DANSVILLE,NY14427 16-1037658	MED OFF BLDG	NY	501(C)(3)	12A, I	LHCS		No
(29)THE FOUNDATION FOR NOYES MEMORIAL HEALTH 111 CLARA BARTON STREET DANSVILLE,NY14427 16-1584778	FUNDRAISING	NY	501(C)(3)	7	LHCS		No
(30)JONES MEMORIAL HOSPITAL FOUNDATION 191 NORTH MAIN STREET WELLSVILLE,NY14895 47-3763374	SUPPORT ORG	NY	501(C)(3)	7	JONES		No
(31)JONES MEDICAL SERVICES PC 191 NORTH MAIN STREET WELLSVILLE,NY14895 46-5210222	MEDICAL CLINI	NY	501(C)(3)	3	JONES		No
(32)ST JAMES HOSPITAL 411 CANISTEO STREET HORNELL,NY14844 16-0743310	HOSPITAL	NY	501(C)(3)	3	UNIV OF ROCH		No
(33)ST JAMES FOUNDATION 411 CANISTEO STREET HORNELL,NY14844 16-1486437	FUNDRAISING	NY	501(C)(3)	7	ST JAMES		No
(34)UR MEDICINE HOME CARE COMMUNITY SRVCS 2180 EMPIRE BOULEVARD WEBSTER,NY14580 82-5091873	HEALTHCARE	NY	501(C)(3)	10	SHCG		No
(35)UR MEDICINE HOME CARE FOUNDATION INC 2180 EMPIRE BOULEVARD WEBSTER,NY14580 83-1912967	SUPPORT ORG	NY	501(C)(3)	12A, I	SHCG		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

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	(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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) EXCELL INNOVATE NY FUND LP 343 STATE STREET KODAK TOWER 2ND ROCHESTER,NY14650 46-2405519	INVESTMENT FUND	NY	ETV INC
(2) EXCELL MINORITY & WOMEN OWNED BUS INV 343 STATE STREET KODAK TOWER 2ND ROCHESTER,NY14650 81-0723223	INVESTMENT FUND	NY	ETV INC
(3) EXCELL PARTNERS INNOVATIVE TC FUND LP 343 STATE STREET KODAK TOWER 2ND ROCHESTER,NY14650 81-0711015	INVESTMENT FUND	NY	ETV INC

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?
(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		Yes	No
(1) MEDICAL ADMINISTRATIVE ASSOCIATES INC 777 SOUTH CLINTON AVENUE ROCHESTER,NY14620 16-1354319	RETAIL PHARMACY	NY	HIGHLAND HOSP	C CORP	388,479	2,992,350	100.000 %	Yes
(2) UR EQUITY HOLDINGS INC 110 OFFICE PARK WAY PITTSFORD,NY14534 27-3040889	HOLDING COMPANY	DE	UNIV OF ROCH	C CORP					No
(3) FFTH PROPERTIES AND SERVICES INC 350 PARRISH STREET CANANDAIGUA,NY14424 16-1286518	HOLDING COMPANY	NY	THS	C CORP					No
(4) EXCELL TECHNOLOGY VENTURES INC 343 STATE STREET KODAK TOWER 2ND ROCHESTER,NY14650 80-0909149	BIOTECH INCUB	NY	ROCH BIOVENTURE	C CORP					No
(5) FINGER LAKES COMUNITY CARE NETWORK INC 350 PARRISH STREET CANANDAIGUA,NY14424 16-1423442	INACTIVE	NY	THS	C CORP					No
(6) ACCOUNTABLE HEALTH PARTNERS LLC 135 CORPORATE WOODS STE 320 ROCHESTER,NY14623 30-0787967	ACCT CARE NETWORK	NY	UNIV OF ROCH	C CORP					No
(7) ACCOUNTABLE HEALTH PARTNERS IPA LLC 135 CORPORATE WOODS SUITE 320 ROCHESTER,NY14623 37-1746016	INDEP PRACT ASSOC	NY	AHP LLC	C CORP					No
(8) AHP INSURANCE COMPANY 76 ST PAUL STREET SUITE 500 BURLINGTON,VT05401 81-4644839	CAPTIVE INS CO	VT	AHP LLC	C CORP					No
(9) LUMINATE VENTURE CHALLENGE CORP 260 EAST MAIN STREET SUITE 6000 ROCHESTER,NY14604 82-3954131	BUSINESS INCUBATO	NY	NEXTCORPS INC	C CORP					No
(10) HORNELL MEDICAL VILLAGE LLC 7100 ROUTE 70A HORNELL,NY14843 61-1886763	HOLD REAL ESTATE	NY	ST JAMES	C CORP					No

Schedule R (Form 990) 2019

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

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) THE HIGHLAND FOUNDATION INC	C,M,N	654,179	FMV GIFT
(2) MEDICAL ADMINISTRATIVE ASSOCIATES INC	J,O,Q	868,429	SERVICE COST
(3) HIGHLAND FACILITIES DEVELOPMENT CORPORATION	K,L,O	402,230	NET EXPENSES

Schedule R (Form 990) 2019

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: OPERATION OF AN ACUTE CARE HOSPITAL COMMITTED TO SERVICE EXCELLENCE IN THE HEALTHCARE INDUSTRY
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	19
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	14
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	3,662
6	Total number of volunteers (estimate if necessary) .............	6	212
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 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,847,286	17,998,355
9	Program service revenue (Part VIII, line 2g) .........	370,962,972	368,247,700
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	4,479,868	3,754,250
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	22,106,875	26,962,233
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	400,397,001	416,962,538
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)	241,004,180	251,238,273
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	139,238,914	137,888,278
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	380,243,094	389,126,551
19	Revenue less expenses. Subtract line 18 from line 12.......	20,153,907	27,835,987
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	431,871,239	515,976,149
21	Total liabilities (Part X, line 26).............	205,506,959	285,559,982
22	Net assets or fund balances. Subtract line 21 from line 20.....	226,364,280	230,416,167

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 332,913,678 including grants of $ 0 ) (Revenue $ 395,209,933 )
	PROVISION OF HEALTHCARE SERVICES, INCLUDING INPATIENT SERVICES, ANCILLARY SERVICES AND ED/CLINIC/AMBULATORY SERVICES. ALSO SEE ATTACHMENT 1.

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 expenses332,913,678

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	2,427,236	5,328,026	1,612,346

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	654,179
e	Government grants (contributions)		1e	17,344,176

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		17,998,355

		Business Code
2a	NET PATIENT SERVICE REVENUES	622110	368,247,700	368,247,700
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		368,247,700

3 Investment income (including dividends, interest, and othersimilar amounts) ......			3,754,250			3,754,250
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	0	6c
d	Net rental income or (loss).......			0
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)			7c
d	Net gain or (loss).........			0
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	CAFETERIA REVENUE		900099	1,426,523	1,426,523
b	PARKING REVENUE		900099	1,490,627	1,490,627
c	CONTRACT PHARMACY REVENUE		900099	13,462,350	13,462,350
d	All other revenue ....			10,582,733	10,582,733
e	Total. Add lines 11a–11d ......			26,962,233
12	Total revenue. See instructions.....			416,962,538	395,209,933		3,754,250

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	0
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	580,215		580,215
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0
7	Other salaries and wages........	193,061,575	163,962,302	29,099,273
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	15,344,054	13,042,446	2,301,608
9	Other employee benefits .......	30,928,016	26,288,814	4,639,202
10	Payroll taxes ...........	11,324,413	9,625,751	1,698,662
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	295,858		295,858
c	Accounting ...........	287,817		287,817
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	2,031,870	1,625,496	406,374
12	Advertising and promotion ....	385,000		385,000
13	Office expenses .......	3,641,536	2,913,013	728,523
14	Information technology ......	3,964,402	2,378,641	1,585,761
15	Royalties ..	0
16	Occupancy ...........	4,398,941	4,398,941
17	Travel ............	153,795	146,105	7,690
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	1,740,437		1,740,437
21	Payments to affiliates .......	379,002		379,002
22	Depreciation, depletion, and amortization ..	24,128,936	14,091,634	10,037,302
23	Insurance ...	0
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	PHARMA & MED SUPPLIES	54,883,166	54,883,166	0	0
b	MISCELLANEOUS EXPENSES	13,612,026	13,612,026	0	0
c	SERVICE CONTRACTS	4,921,772	4,921,772	0	0
d	OTHER FEES	4,323,974	3,459,179	864,795	0
e	All other expenses	18,739,746	17,564,392	1,175,354
25	Total functional expenses. Add lines 1 through 24e	389,126,551	332,913,678	56,212,873	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			54,357,114	1	158,259,039
2	Savings and temporary cash investments .........			107,475,435	2	74,602,027
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			27,254,849	4	21,479,309
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			5,753,400	8	6,538,581
9	Prepaid expenses and deferred charges ......			1,783,072	9	1,828,661
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	438,399,249
b	Less: accumulated depreciation	10b	260,874,406	175,237,161	10c	177,524,843
11	Investments—publicly traded securities .			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			60,010,208	15	75,743,689
16	Total assets. Add lines 1 through 15 (must equal line 33)...			431,871,239	16	515,976,149

17	Accounts payable and accrued expenses .....	41,120,936	17	82,894,754
18	Grants payable ...	0	18	0
19	Deferred revenue .........	1,050,242	19	1,222,304
20	Tax-exempt bond liabilities .........	44,373,252	20	42,716,148
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
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	118,962,529	25	158,726,776
26	Total liabilities. Add lines 17 through 25..	205,506,959	26	285,559,982

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	226,364,280	27	230,416,167
28	Net assets with donor restrictions ...........	0	28	0
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	226,364,280	32	230,416,167
33	Total liabilities and net assets/fund balances ........	431,871,239	33	515,976,149