| FORM 990, PART III, LINE 1: |
ORGANIZATION'S MISSION THE PURPOSES FOR WHICH THE CORPORATION IS FORMED ARE: (A) TO PLAN, DEVELOP, ESTABLISH, ORGANIZE, CONSTRUCT, ERECT, BUILD, ACQUIRE, ALTER, RECONSTRUCT, REHABILITATE, OWN, OPERATE, MAINTAIN, AND MANAGE ALL TYPES OF INPATIENT AND OUTPATIENT HOSPITALS, HOSPITAL FACILITIES, CLINICS, TREATMENT CENTERS, SERVICES, AND PROGRAMS FOR THE DELIVERY OF ACUTE MEDICAL, SURGICAL AND PREVENTIVE HEALTH CARE SERVICES, IN ACCORDANCE WITH THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK; (B) TO PLAN, DEVELOP, ESTABLISH, ORGANIZE, CONSTRUCT, ERECT, BUILD, ACQUIRE, ALTER, RECONSTRUCT, REHABILITATE, OWN, OPERATE, MAINTAIN AND MANAGE NURSING HOMES AND ALL TYPES OF LONG TERM INPATIENT, OUTPATIENT AND RESIDENTIAL HEALTH CARE FACILITIES, SERVICES, AND PROGRAMS FOR ELDERLY, SICK, INVALID, INFIRM, DISABLED AND CONVALESCENT PERSONS, IN ACCORDANCE WITH THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK; (C) TO PLAN, DEVELOP, ESTABLISH, ORGANIZE, CONSTRUCT, ERECT, BUILD, ACQUIRE, ALTER, RECONSTRUCT, REHABILITATE, OWN OPERATE MAINTAIN, AND MANAGE ALL TYPES OF FAMILY PLANNING FACILITIES, CLINICS, TREATMENT CENTER SERVICES, AND PROGRAMS FOR THE DELIVERY OF ACUTE MEDICAL, SURGICAL AND PREVENTIVE HEALTH CARE SERVICES FOR INDIVIDUALS AND FAMILIES, IN ACCORDANCE WITH THE PUBLIC HEALTH LAW OF THE STATE OF NEW YORK; (D) TO PARTICIPATE IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH AND WELFARE OF THE COMMUNITY IN WHICH THE CORPORATION IS LOCATED; (E) TO SOLICIT, ACCEPT, HOLD, INVEST, REINVEST AND ADMINISTER GIFTS, GRANTS, BEQUESTS, CONTRIBUTIONS, DEVISES, BENEFITS OF TRUSTS, ENDOWMENTS AND PROPERTY OF ANY KIND, WITHOUT LIMITATION AS TO AMOUNT OR VALUE, FROM PRIVATE TO PUBLIC SOURCES, IN FURTHERANCE OF ITS CORPORATE PURPOSES; AND (F) TO DO ANY ACT OR THING INCIDENTAL TO OR CONNECT WITH THE FOREGOING PURPOSES OR IN ADVANCEMENT THEREOF, BUT NOT FOR THE PECUNIARY PROFIT OR FINANCIAL GAIN OF ITS MEMBERS, DIRECTORS, OFFICERS OR ANY PRIVATE PERSON. |
| FORM 990, PART VI, SECTION A, LINE 1 |
EACH BOARD HAS AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD PLUS THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION AND SUCH OTHER DIRECTORS AS THE CHAIR MAY NOMINATE FROM TIME TO TIME FOR APPOINTMENT BY A MAJORITY VOTE OF THE ENTIRE BOARD. BETWEEN MEETINGS OF THE BOARD, AND TO THE EXTENT PERMITTED BY LAW, THE EXECUTIVE COMMITTEE SHALL POSSESS THE POWERS OF THE BOARD WITH RESPECT TO MANAGING AND CONDUCTING THE AFFAIRS OF THE CORPORATION, EXCEPT AS OTHERWISE PROVIDED BY LAW OR WITHIN CERTAIN BY-LAWS. |
| FORM 990, PART VI, SECTION A, LINE 6 |
THE ORGANIZATION IS A MEMBERSHIP (NOT A STOCK) CORPORATION UNDER NEW YORK STATE LAW. THE ORGANIZATION'S SOLE CORPORATE MEMBER IS ROCHESTER REGIONAL HEALTH, A RELATED NOT-FOR-PROFIT ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7B |
ROCHESTER REGIONAL HEALTH, AS THE SOLE CORPORATE MEMBER, ALSO HAS THE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY, INCLUDING AMENDMENT OF BYLAWS AND CHARTERS, REMOVAL OF MEMBERS OF THE GOVERNING BODY, AND THE DECISION TO DISSOLVE THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B |
PRIOR TO FILING, A COPY OF THE FORM 990 IS PROVIDED TO, AND REVIEWED WITH, ALL MEMBERS OF THE AUDIT AND COMPLIANCE COMMITTEE. THIS REVIEW IS PERFORMED IN CONSULTATION WITH THE ORGANIZATION'S TAX ADVISORS, AND IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS AND OTHER RELEVANT INFORMATION FOR THE APPROPRIATE TIME PERIOD. |
| FORM 990, PART VI, SECTION B, LINE 12C |
UPON EMPLOYMENT, ALL EMPLOYEES RECEIVE THE ETHICAL STANDARD OF CONDUCT BOOKLET FOR WHICH THEY SIGN A RECEIPT OF ACKNOWLEDGEMENT. CONFLICT OF INTEREST IS DEFINED, AS IS MANAGEMENT OF A CONFLICT OF INTEREST. EMPLOYEES ARE REQUIRED TO DISCLOSE AND SEEK RESOLUTION TO ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST BEFORE TAKING A POTENTIALLY IMPROPER ACTION AND THEREAFTER, ANNUALLY, EACH KEY EMPLOYEE AND OFFICER OF THE ORGANIZATION IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST FORM, PROVIDING MANAGEMENT WITH SUFFICIENT INFORMATION ABOUT HIS/HER PERSONAL INTERESTS AND RELATIONSHIPS SO THAT MANAGEMENT CAN (1) DETERMINE WHETHER ANY ACTUAL OR PERCEIVED CONFLICT OF INTEREST EXISTS, AND (2) MONITOR WORK ASSIGNMENTS TO AVOID PLACING THE KEY EMPLOYEE OR OFFICER IN A POSITION WHERE THERE MAY BE A QUESTION AS TO HIS/HER OBJECTIVITY AS WELL AS TO AVOID ANY APPEARANCE OF IMPROPRIETY. THROUGHOUT THE YEAR, KEY EMPLOYEES AND OFFICERS OF THE ORGANIZATION ARE ALSO REQUIRED TO NOTIFY MANAGEMENT PROMPTLY IF ANY CHANGE TO THEIR DISCLOSURES OCCURS. BOARD MEMBERS LEAVE THE ROOM DURING DISCUSSIONS AND ABSTAIN FROM VOTING WHEN THEY HAVE A CONFLICT OF INTEREST. IN ADDITION, EACH MEMBER OF THE BOARD OF DIRECTORS MUST ALSO COMPLETE A CONFLICT OF INTEREST AND DISCLOSURE FORM, WHICH MUST BE SUBMITTED TO THE GENERAL COUNSEL. |
| FORM 990, PART VI, SECTION B, LINE 15 |
THE ORGANIZATION'S OFFICER AND KEY EMPLOYEE COMPENSATION ARRANGEMENTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF ROCHESTER REGIONAL HEALTH, A RELATED NOT-FOR-PROFIT ORGANIZATION. INFORMATION REVIEWED FOR THE OFFICER/KEY EMPLOYEE INCLUDES COMPARABLE DATA FROM SIMILAR SIZE TAX EXEMPT ORGANIZATIONS IN THE WESTERN / CENTRAL NY COMMUNITY AS WELL AS COMPENSATION FOR THESE POSITIONS (AS DISCLOSED ON FORM 990) WITH OTHER ORGANIZATIONS IN THE HEALTH CARE INDUSTRY THAT ARE OF SIMILAR SIZE, DEMOGRAPHICS AND GEOGRAPHY. REVIEW AND APPROVAL OF THE COMPENSATION ARRANGEMENT BY THE COMPENSATION COMMITTEE IS DOCUMENTED. |
| FORM 990, PART VI, SECTION C, LINE 19 |
THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ADMINISTRATIVE OFFICES OF THE AFFILIATED HEALTH SYSTEM LOCATED AT 100 KINGS HIGHWAY SOUTH, ROCHESTER, NY 14617. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED. |
| FORM 990, PART IX, LINE 11G |
ALL OTHER EXPENSES: PROGRAM SERVICE EXPENSES 13,832,440. MANAGEMENT AND GENERAL EXPENSES 2,559,145. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,391,585. |
| FORM 990, PART XI, LINE 9: |
CHANGE IN INTEREST IN NEWARK WAYNE COMMUNITY HOSPITAL FOUNDATION 345,337. |
| FORM 990, PART XII, LINE 2C: |
THE AUDIT COMMITTEE IS RESPONSIBLE FOR OVERSEEING THE ACCOUNTING AND FINANCIAL REPORTING PROCESS OF THE ORGANIZATION AND THE AUDIT OF ITS FINANCIAL STATEMENTS. THE BOARD OF DIRECTORS SELECTS THE INDEPENDENT AUDITORS BASED ON THE RECOMMENDATIONS OF THE AUDIT COMMITTEE. |
| FORM 5471 FILED ON BEHALF STATEMENT |
STATEMENT PURSUANT TO TREAS. REG. SEC. 1.6038-2(J)(3): THE FOLLOWING INFORMATION IS SUBMITTED WITH RESPECT TO NEWARK-WAYNE COMMUNITY HOSPITAL'S FORM 5471 (INFORMATION RETURN OF U.S. PERSONS WITH RESPECT TO CERTAIN FOREIGN CORPORATIONS) FILING REQUIREMENT FOR THE ENTITY BELOW: NAME OF FOREIGN CORPORATION: GREATER ROCHESTER ASSURANCE COMPANY, LTD. BEGINNING TAX YEAR OF FOREIGN CORPORATION: JANUARY 1, 2016 ENDING TAX YEAR OF FOREIGN CORPORATION: DECEMBER 31, 2016 THE FORM 5471 FILING REQUIREMENT FOR THIS FOREIGN CORPORATION FOR CATEGORIES 4 AND 5 HAVE BEEN SATISFIED BY INCLUSION IN THE FOLLOWING U.S. FILER'S TAX RETURN: NAME OF U.S. FILER: ROCHESTER REGIONAL HEALTH ADDRESS OF U.S. FILER: 100 KINGS HIGHWAY SOUTH, ROCHESTER, NY 14617 EIN: 47-1234999 ENDING TAX YEAR OF U.S. FILER: DECEMBER 31, 2016 TYPE OF RETURN FILED: 990 IRS SERVICE CENTER WHERE RETURN FILED: OGDEN, UTAH 84201-0027 |
Attach to Form 990 or 990-EZ.