FORM
LM-20 - AGREEMENT
& ACTIVITIES REPORT
OMB No. 1245-0003 . Expires 01-31-2025 .
IMPORTANT: This report is mandatory under P.L. 86-257, as amended. Failure to comply may result in criminal prosecution, fines, or civil penalties as provided by 29 U.S.C. 439 or 440. Required of persons, including Labor Relations Consultants and Other Individuals and Organizations, under Section 203(b) of the Labor-Management Reporting and Disclosure Act of 1959, as amended (LMRDA).
Office of Labor-Management Standards
U.S. Department of Labor
For Official Use Only
E
OLMS
Read the instructions carefully before completing this report.
1.a. File Number: C-755
Amended: X
2.
Name and mailing address (including Zip Code):
Name:DEBORAH LONG
Title:President
Organization:HEALTHCARE LABOR SOLUTIONS
P.O. Box., Bldg., Room No., if any:Suite 504-741
Street:2121 Lohmans Crossing Rd
City:LakewayState:TX
ZIP code:78734
3.
Other address where records necessary to verify this report are kept:
Name:
Title:
Organization:
P.O. Box., Bldg., Room No., if any:
Street:
City:State:
ZIP code:
4.
Date fiscal year ends:Dec /31
5.
Type of person
a. Individual       b. Partnership
c. X Corporation C d. Other
Specify:

  Nature of Agreement or Arrangement
6.
Full name and address of employer with whom made (include ZIP Code):
Name:Erin Heintz
Organization:Rochester Regional Health
Trade Name, if any:
P.O. Box., Bldg., Room No., if any:
Street:1360 Portland Avenue
City:RochesterState:NY
ZIP code:14621
7.
Date entered into03/15/2022

8.
Name of person(s) through whom made:
Name:Deborah Long
Signature and Verification
Each of the undersigned declares, under penalty of perjury and other applicable penalties of law, that all of the information submitted in this report (including the information contained in any accompanying documents) has been examined by the signatory and is, to the best of the undersigned's knowledge and belief, true, correct, and complete. (See Section VII on penalties in the instructions.)
13.
SIGNED: Deborah Long
Title: PRESIDENT
Date: May 11, 2022
Telephone Number: 877-424-9799
14.
SIGNED: Deborah Long
Title: TREASURER
Date: May 11, 2022
Telephone Number: 877-424-9799
Form LM-20 (2003)
9.
Check the appropriate box(es) to indicate whether an object of the activities undertaken is directly or indirectly:
a.
X
To persuade employees to exercise or not to exercise, or persuade employees as to the manner of exercising, the right to organize and bargain collectively through representatives of their own choosing.
b.
To supply an employer with information concerning the activities of employees or a labor organization in connection with a labor dispute involving such employer, except information for use solely in conjunction with an administrative or arbitral proceeding or a criminal or civil judicial proceeding.
10.
Terms and conditions. (Explain in detail; see instructions. Written agreements must be attached.):
Written Agreement/Arrangement
All services shall be performed on an hourly fee basis. Expenses in connection with the performance of such services as accommodations, meals, travel, etc. will be billed at cost and reimbursed to Healthcare Labor Solutions.
Specific Activities to be performed
Activity1
11. For each activity, separately list in detail the information required. (See instructions.)
a. Nature of activity:Healthcare Labor Solutions has been retained to assist the employer named above in communicating with its employees, when management is unable to do so, with regard to the manner in which they may exercise their rights to organize and bargain collectively under the National Labor Relations Act.
11.b.Period during which activities performed:
04/10/2022
11.c. Extent of performance:
04/15/2022
11.d.
Name and address of person(s) through whom activities were performed or will be performed:
  Name:Kim Bradshaw         Organization:Healthcare Labor Solutions
  P.O. Box, Bldg., Room No., If any:Suite 504-741Street:2121 Lohmans Crossing RdCity:LakewayState:TXZip:78734
12.a. Identify subject groups of employees:
Full-Time and Part-Time Employees
12.b. Identify subject labor organizations:
Unknown
Form LM-20 (2003)
Activity2
11. For each activity, separately list in detail the information required. (See instructions.)
a. Nature of activity:Healthcare Labor Solutions has been retained to assist the employer named above in communicating with its employees, when management is unable to do so, with regard to the manner in which they may exercise their rights to organize and bargain collectively under the National Labor Relations Act.
11.b.Period during which activities performed:
04/11/2022
11.c. Extent of performance:
On Going
11.d.
Name and address of person(s) through whom activities were performed or will be performed:
  Name:Ricardo Pasalagua         Organization:Healthcare Labor Solutions
  P.O. Box, Bldg., Room No., If any:Suite 504-741Street:2121 Lohmans Crossing RdCity:LakewayState:TXZip:78734
12.a. Identify subject groups of employees:
Full-Time and Part-Time Employees
12.b. Identify subject labor organizations:
Unknown
Form LM-20 (2003)