SCHEDULE R
(Form 990)

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

OMB No. 1545-0047
2017
Open to Public Inspection
Name of the organization
KALEIDA HEALTH
 
Employer identification number

16-1533232
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

(1) KALEIDA MCO LLC
726 EXCHANGE STREET SUITE 200
BUFFALO,NY14210
16-1570311
DORMANT NY 0 0 KH
 
(2) KALEIDA IPA LLC
726 EXCHANGE STREET SUITE 200
BUFFALO,NY14210
16-1570380
DORMANT NY 0 0 KH
 
(3) KALEIDA WNYI LLC
726 EXCHANGE STREET SUITE 200
BUFFALO,NY14210
45-3189404
HEALTH CARE NY -15,380 2,644,416 KH
 
(4) KALEIDA SERVICES LLC
2100 WEHRLE DRIVE
WILLIAMSVILLE,NY14221
47-2284036
ADULT DAYCARE NY 136,033 419,217 KH
 




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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)MILLARD FILLMORE AMBULATORY SURGER CTR
726 EXCHANGE STREET SUITE 200

BUFFALO,NY14210
16-1307129
SUPPORT ORG NY 501(C)(3) 12A KH
 
Yes
 
(2)VNA HOME CARE SERVICES
726 EXCHANGE STREET SUITE 200

BUFFALO,NY14210
16-1491203
HOME HLTHCARE NY 501(C)(3) 10 KH
 
Yes
 
(3)VNA OF WESTERN NEW YORK
726 EXCHANGE STREET SUITE 200

BUFFALO,NY14210
16-0743214
HOME HLTHCARE NY 501(C)(3) 10 KH
 
Yes
 
(4)VISK INC
726 EXCHANGE STREET SUITE 200

BUFFALO,NY14210
22-2738425
SUPPORT ORG NY 501(C)(3) 10 KH
 
Yes
 
(5)KALEIDA HEALTH FOUNDATION
726 EXCHANGE STREET SUITE 200

BUFFALO,NY14210
16-1579143
FUNDRAISING NY 501(C)(3) 7 KH
 
Yes
 
(6)THE WOMEN & CHILDREN'S HOSP OF BFLO FDN
726 EXCHANGE STREET SUITE 200

BUFFALO,NY14210
16-1332044
FUNDRAISING NY 501(C)(3) 7 KH
 
Yes
 
(7)CHILDREN'S HEALTH HOME OF WNY INC
726 EXCHANGE STREET SUITE 200

BUFFALO,NY14210
81-4086046
PED HOME HLTH NY 501(C)(3) 10 KH
 
Yes
 
(8)UPPER ALLEGHENY HEALTH SYSTEM INC
515 MAIN STREET

OLEAN,NY14760
27-1255425
SUPPORT ORG NY 501(C)(3) 12A KH
 
Yes
 
(9)BRADFORD REGIONAL MEDICAL CENTER
116 INTERSTATE PARKWAY

BRADFORD,PA16701
25-0965270
HOSPITAL PA 501(c)(3) 3 UAHS
 
Yes
 
(10)OLEAN GENERAL HOSPITAL
515 MAIN STREET

OLEAN,NY14760
16-0743102
HOSPITAL NY 501(C)(3) 3 UAHS
 
Yes
 
(11)BRADFORD REGIONAL MED SVCS
116 INTERSTATE PARKWAY

BRADFORD,PA16701
23-2875157
PHYS. GROUP PA 501(C)(3) 3 BRMC
 
Yes
 
(12)HEALTH SYSTEM PHYSICIAN PC
130 SOUTH UNION STREET

OLEAN,NY14760
46-4304317
PHYS. GROUP NY 501(C)(3) 10 OGH
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2017
Page 2
Schedule R (Form 990) 2017
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) HARLEM ROAD LEASING LLC

3435 MAIN STREET
BUFFALO,NY14214
20-5588135
EQUIPMENT LEASING NY KALEIDA HEALTH
 
UNRELATED 107,784 114,480   No   Yes   50.000 %
(2) AMTON IMAGING LLC

199 PARK CLUB LANE SUITE 300
WILLIAMSVILLE,NY14221
26-2925470
HEALTH CARE NY KALEIDA WNYI
 
RELATED 390,940 692,602   No   Yes   50.000 %
(3) SITE E LLC

726 EXCHANGE STREET SUITE 200
BUFFALO,NY14210
27-2124795
REAL ESTATE MGMT NY KPI
 
EXCLUDED 113,242 1,755,913   No     No 50.148 %
(4) MSFC LLC

726 EXCHANGE STREET SUITE 200
BUFFALO,NY14210
26-1582864
HEALTH CARE NY KALEIDA HEALTH
 
EXCLUDED -152,618 1,766,921   No     No 63.464 %
(5) SOUTHTOWNS IMAGING LLC

5959 BIG TREE ROAD SUITE 105
ORCHARD PARK,NY14127
47-1123230
EQUIPMENT LEASING NY KALEIDA WNYI
 
UNRELATED 144,409 2,253,893   No   Yes   70.000 %
(6) COLLABORATIVE CARE VENTURES LLC

726 EXCHANGE STREET SUITE 200
BUFFALO,NY14210
47-2365690
HEALTH CARE NY KALEIDA HEALTH
 
EXCLUDED       No     No 50.000 %
(7) GREAT LAKES MEDICAL BILLING SVCS LLC

199 PARK CLUB LANE SUITE 300
WILLIAMSVILLE,NY14221
46-1668448
MEDICAL BILLING NY KALEIDA WNYI
 
UNRELATED -550,729 0   No     No 50.000 %
(8) ALTUS MANAGEMENT LLC

840 AERO DRIVE SUITE 150
CHEEKTOWAGA,NY14225
90-0149133
GROUP PURCHASING NY KALEIDA HEALTH
 
EXCLUDED 168,076 1,882,216   No     No 51.194 %
(9) SOUTHTOWNS SURGERY CENTER LLC

726 EXCHANGE STREET SUITE 200
BUFFALO,NY14210
46-4742028
HEALTH CARE NY KALEIDA HEALTH
 
EXCLUDED -1,558,130 3,537,208   No   Yes   63.171 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) KALEIDA PROPERTIES INC

726 EXCHANGE STREET SUITE 200
BUFFALO,NY14210
22-2738483
PROP MGMT SVCS NY KALEIDA HEALTH
 
C Corp 223,659 18,393,409 100.000 % Yes  
(2) WESTLINK CORPORATION

726 EXCHANGE STREET SUITE 200
BUFFALO,NY14210
16-1354421
MED & DIAGN SVCS NY KALEIDA HEALTH
 
C Corp -312 100,640 100.000 % Yes  
(3) KALEIDA HEALTHNOW INC

257 WEST GENESEE STREET
BUFFALO,NY14202
46-2164089
HEALTH CARE NY KALEIDA HEALTH
 
C Corp 4,883 3,645,060 0 %   No
(4) GREAT LAKES INTEGRATED NETWORK INC

726 EXCHANGE STREET SUITE 200
BUFFALO,NY14210
82-3184375
HEALTH CARE NY KALEIDA HEALTH
 
C Corp     100.000 % Yes  






Schedule R (Form 990) 2017
Page 3
Schedule R (Form 990) 2017
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
Yes
 
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) VNA HOME CARE SERVICES

q 1,053,079 ACTUAL COST
(2) VNA HOME CARE SERVICES

e 88,072 ACTUAL COST
(3) VNA OF WESTERN NEW YORK

q 16,599,202 ACTUAL COST
(4) VNA OF WESTERN NEW YORK

d 439,283 ACTUAL COST
(5) MFSC LLC

j 520,700 ACTUAL COST
(6) MFSC LLC

q 87,972 ACTUAL COST
(7) MFSC LLC

d 50,376 ACTUAL COST
(8) KALEIDA PROPERTIES INC

q 112,926 ACTUAL COST
(9) KALEIDA PROPERTIES INC

d 4,809,213 ACTUAL COST
(10) SITE E LLC

k 233,450 ACTUAL COST
(11) WCHOB FOUNDATION

c 2,553,175 ACTUAL COST
(12) WCHOB FOUNDATION

s 15,385,756 ACTUAL COST
(13) WCHOB FOUNDATION

d 9,894,580 ACTUAL COST
(14) KALEIDA HEALTH FOUNDATION

c 3,727,546 ACTUAL COST
(15) KALEIDA HEALTH FOUNDATION

s 2,067,518 ACTUAL COST
(16) KALEIDA HEALTH FOUNDATION

d 707,574 ACTUAL COST
(17) SOUTHTOWNS IMAGING LLC

d 727,437 ACTUAL COST
(18) VNA OF WESTERN NEW YORK

o 277,559 ACTUAL COST
(19) VNA OF WESTERN NEW YORK

l 358,004 ACTUAL COST
(20) MFSC LLC

l 132,000 ACTUAL COST
(21) VISK

d 300,200 ACTUAL COST
(22) SOUTHTOWNS IMAGING LLC

j 251,434 ACTUAL COST
(23) SOUTHTOWNS IMAGING LLC

q 123,931 ACTUAL COST
(24) SOUTHTOWNS SURGERY CENTER LLC

l 519,836 ACTUAL COST
(25) SOUTHTOWNS SURGERY CENTER LLC

j 797,072 ACTUAL COST
(26) SOUTHTOWNS SURGERY CENTER LLC

q 52,878 ACTUAL COST
(27) SOUTHTOWNS SURGERY CENTER LLC

d 1,668,217 ACTUAL COST
(28) COLLABORATIVE CARE VENTURES LLC

q 170,063 ACTUAL COST
(29) COLLABORATIVE CARE VENTURES LLC

d 1,221,167 ACTUAL COST
(30) CHILDREN'S HOME HEALTH OF WNY INC

q 118,384 ACTUAL COST
(31) CHILDREN'S HOME HEALTH OF WNY INC

d 150,682 ACTUAL COST
(32) MILLARD FILLMORE AMBULATORY SURGERY CENTER

c 486,700 ACTUAL COST
(33) OLEAN GENERAL HOSPITAL

A 1,256,000 ACTUAL COST
Schedule R (Form 990) 2017
Page 4
Schedule R (Form 990) 2017
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




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


Yes No Yes No Yes No






























Schedule R (Form 990) 2017
Page 5
Schedule R (Form 990) 2017
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) 2017

Additional Data


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