LITTLE FALLS HOSPITAL: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- LITTLE FALLS HOSPITAL (EIN 15-0533578)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202213199349321771
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-15T15:53:08-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 BROADWAY 4TH FLOOR | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 122072974 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 150533578 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LITTLE FALLS HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LITT | BusinessNameControlTxt |
| Phone | 3158231000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 BURWELL STREET | AddressLine1Txt |
| City | LITTLE FALLS | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13365 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ERIC STEIN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3158231000 | PhoneNum |
| Signature | 2022-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ERIC | PersonFirstNm |
| Person Last | STEIN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | GENEVA FURLANO | PreparerPersonNm |
| PTIN | P01877392 | PTIN |
| Phone | 5184274600 | PhoneNum |
| Preparation | 2022-11-11 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ERIC STEIN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 BURWELL STREET | AddressLine1Txt |
| City | LITTLE FALLS | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13365 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $41,909,970 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BASSETT.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1893 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | CRITICAL ACCESS HOSPITAL PROVIDING ACCESS TO HEALTH CARE SERVICES TO RESIDENTS OF HERKIMER COUNTY, AND WESTERN PORTIONS OF MONTGOMERY AND FULTON COUNTIES. LITTLE FALLS HOSPITAL EMERGENCY DEPARTMENT IS STAFFED WITH PHYSICIANS ON A 24/7 BASIS. TWENTY FIVE BEDS ARE USED FOR INPATIENT AND SKILLED NURSING CARE. AMBULATORY SURGERY SERVICES ARE PROVIDED FOR A VARIETY OF PROCEDURE SPECIALTIES. PERFORMANCE IMPROVEMENT AND HIGH QUALITY OF CARE IS DEMONSTRATED WITHIN THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) AS REPORTED ON MEDICARE.GOV HOSPITAL COMPARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 353 | TotalEmployeeCnt |
| Total Volunteers | 18 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $8,464,504 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,304,794 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $32,582,919 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $39,866,823 | CYProgramServiceRevenueAmt |
| PY Investment Income | $310,963 | PYInvestmentIncomeAmt |
| CY Investment Income | $654,328 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $41,358,386 | PYTotalRevenueAmt |
| CY Total Revenue | $41,825,945 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $15,306,004 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,264,808 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $38,265 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $25,233,817 | PYOtherExpensesAmt |
| CY Other Expenses | $22,479,232 | CYOtherExpensesAmt |
| PY Total Expenses | $40,539,821 | PYTotalExpensesAmt |
| CY Total Expenses | $37,744,040 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $818,565 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,081,905 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $40,044,586 | TotalAssetsBOYAmt |
| Total Assets EOY | $49,578,750 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,265,197 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $19,467,046 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $24,779,389 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $30,111,704 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | LITTLE FALLS HOSPITAL IS A VOLUNTARY, NOT-FOR-PROFIT COMMUNITY HEALTHCARE SYSTEM WHOSE MISSION IS TO OFFER QUALITY CARE WITH COMPASSION, TO ALL WHO NEED OUR SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,546,679 | ExpenseAmt |
| Revenue | $7,716,574 | RevenueAmt |
| Desc | INPATIENT SERVICES64% OCCUPANCY FOR AN AVERAGE DAILY INPATIENT DAILY CENSUS OF 16 PATIENTS. AS A CRITICAL ACCESS HOSPITAL (CAH) PROVIDER, OUR INPATIENT DAILY SERVICES INCLUDE; OBSERVATION CARE, EXTENDED SWINGBED REHAB SERVICES, AND ACUTE CARE SERVICES. THIS DIVERSITY OF PATIENT CARE ALLOWS FOR OUR RESIDENTS TO REMAIN LOCAL FOR MEDICALLY APPROPRIATE SERVICES. IN 2021, ACUTE CARE LENGTH OF STAY WAS 4.2 DAYS COMPARED WITH 3.3 IN 2020. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $12,465,983 | ExpenseAmt |
| Revenue | $11,663,086 | RevenueAmt |
| Desc | LITTLE FALLS HOSPITAL OPERATES AN EMERGENCY DEPARTMENT WITH TWENTY FOUR HOURS OF PHYSICIAN COVERAGE, SEVEN DAYS PER WEEK. THE EMERGENCY DEPARTMENT PROVIDED ACCESS TO CARE FOR APPROXIMATELY 13,832 PATIENTS IN 2021. LITTLE FALLS HOSPITAL EXPANDED THE EMERGENCY DEPARTMENT PARTICIPATED IN A NYS MEDICAID ACCELERATED EXCHANGE (MAX) PROGRAM TO REDUCE AVOIDABLE VISITS TO AN EMERGENCY DEPARTMENT. IN ADDITION A PARTNERSHIP WITH SALVATION ARMY AND THEIR COMMUNITY "PATHWAY TO HOPE" PROGRAM WAS FORMALIZED TO ASSIST IN PATIENT CARE MANAGMENT ACTIVITIES. THESE SERVCIES EMBEDDED IN OUR EMERGENCY ROOM PROVIDES ASSITANCE FOR PATIENTS TO MAKE MEDICAL APPOINTMENTS, OBTAIN INSURANCE COVERAGE, OR APPLY FOR COMMUNITY ASSISTANCE PROGRAMS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $11,275,768 | ExpenseAmt |
| Revenue | $20,487,163 | RevenueAmt |
| Desc | TOTAL AMBULATORY OUTPATIENT SERVICE VISITS WERE APPROXIMATELY 29,848 IN 2021. OUR AMBULATORY SERVICES INCLUDE REHAB / WELLNESS PROGRAM, AMBULATORY SURGERY / GI SERVICES, WOMENS IMAGING SERVICE, DIAGNOSTIC IMAGING SERVICES, RURAL HEALTH CLINIC RIMARY CARE SERVICES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $32,288,430 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 32 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 353 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAMES G VIELKIND | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3158235281 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 BURWELL STREET | AddressLine1Txt |
| City | LITTLE FALLS | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13365 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| TIMOTHY DALY | ||||||||
| CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ANTHONY DELUCA | ||||||||
| FIRST VICE CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JUSTIN HUMMEL | ||||||||
| SECOND VICE CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CHRISTINE REYNOLDS | ||||||||
| THIRD VICE CHAIRMAN | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| GERARD SNYDER | ||||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAVID CASULLO | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| LAURA POWERS | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | 0.00 | ||
| PHYLLIS SPINNER | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHLEEN SELLERS MD | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| CARLTON RULE MD | ||||||||
| MEDICAL DIRECTOR | 2.00 | Yes (X) | $0 | $385,987 | $25,730 | 40.00 | ||
| AMY GRACE MD | ||||||||
| PRESIDENT OF MEDICAL STAFF | 2.00 | Yes (X) | $0 | $274,014 | $26,349 | 40.00 | ||
| LISA BETRUS LEFT 32021 | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $314,645 | $20,545 | 40.00 | ||
| KATE READ LAVALLA LEFT 32021 | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| WILLIAM LECATES MD | ||||||||
| PRESIDENT | 10.00 | Yes (X) | $0 | $585,656 | $37,114 | 30.00 | ||
| JAMES G VIELKIND | ||||||||
| CHIEF FINANCIAL OFFICER | 30.00 | Yes (X) | $0 | $219,342 | $12,157 | 10.00 | ||
| MICHAEL OGDEN LEFT 72021 | ||||||||
| FORMER PRESIDENT & CEO | 40.00 | Yes (X) | $0 | $147,807 | $9,999 | |||
| DIANE DICOB | ||||||||
| NURSE | 40.00 | $177,240 | $0 | $4,591 | 0.00 | Yes (X) | ||
| HEIDI CAMARDELLO | ||||||||
| CHIEF NURSING OFFICER | 40.00 | $163,012 | $0 | $5,721 | Yes (X) | |||
| LOREEN SHEPARDSON | ||||||||
| DIRECTOR OF PHARMACY | 40.00 | $152,071 | $0 | $5,143 | Yes (X) | |||
| JAMIE CARMARDELLO | ||||||||
| PHARMACIST | 40.00 | $142,553 | $0 | $2,851 | Yes (X) | |||
| JODI POLLITT | ||||||||
| NIGHT SUPERVISOR | 40.00 | $127,751 | $0 | $5,601 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $762,627 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,927,451 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $155,801 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MAYO COLLABORATIVE SERVICES | |||||
| 200 FIRST STREET SOUTHWEST | ROCHESTER | MN | 55905 | REFERENCE LAB | $125,312 |
| WESTWAYS STAFFING SERVICES INC | |||||
| 500 CITY PARKWAY WEST SUITE 130 | ORANGE | CA | 92868 | AGENCY STAFF | $104,164 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $76,420 | RelatedOrganizationsAmt |
| Government Grants | $1,228,374 | GovernmentGrantsAmt |
| Total Contributions | $1,304,794 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOSPITAL - OUTPATIENT | 623000 | $25,265,009 | $25,265,009 |
| HOSPITAL - INPATIENT | 621930 | $11,848,668 | $11,848,668 |
| OTHER OPERATING REVENUE | 900099 | $2,205,934 | $2,205,934 |
| PROGRAM SERVICE LEASE | 532000 | $442,185 | $442,185 |
| HOSPITAL CAFETERIA | 900099 | $105,027 | $105,027 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $39,866,823 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $641,353 | TotalRevenueColumnAmt |
| Exclusion | $641,353 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $97,000 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $84,025 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,975 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,975 | TotalRevenueColumnAmt |
| Exclusion | $12,975 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $41,825,945 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $39,866,823 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $654,328 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,544,794 | TotalAmt |
| Program Services | $10,698,169 | ProgramServicesAmt |
| Management And General | $1,827,761 | ManagementAndGeneralAmt |
| Fundraising | $18,864 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,541 | TotalAmt |
| Program Services | $136,909 | ProgramServicesAmt |
| Management And General | $23,391 | ManagementAndGeneralAmt |
| Fundraising | $241 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,432,661 | TotalAmt |
| Program Services | $1,221,769 | ProgramServicesAmt |
| Management And General | $208,738 | ManagementAndGeneralAmt |
| Fundraising | $2,154 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,126,812 | TotalAmt |
| Program Services | $959,631 | ProgramServicesAmt |
| Management And General | $165,644 | ManagementAndGeneralAmt |
| Fundraising | $1,537 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,861 | TotalAmt |
| Management And General | $1,861 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,052 | TotalAmt |
| Management And General | $11,052 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,154 | TotalAmt |
| Program Services | $20,154 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,782,117 | TotalAmt |
| Program Services | $4,930,975 | ProgramServicesAmt |
| Management And General | $851,142 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,715,566 | TotalAmt |
| Program Services | $1,463,030 | ProgramServicesAmt |
| Management And General | $252,536 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $896,203 | TotalAmt |
| Program Services | $764,280 | ProgramServicesAmt |
| Management And General | $131,923 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,348 | TotalAmt |
| Program Services | $9,678 | ProgramServicesAmt |
| Management And General | $1,670 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,859 | TotalAmt |
| Program Services | $6,702 | ProgramServicesAmt |
| Management And General | $1,157 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,174 | TotalAmt |
| Program Services | $67,519 | ProgramServicesAmt |
| Management And General | $11,655 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,278,986 | TotalAmt |
| Program Services | $1,943,514 | ProgramServicesAmt |
| Management And General | $335,472 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $242,292 | TotalAmt |
| Program Services | $206,626 | ProgramServicesAmt |
| Management And General | $35,666 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| PURCHASED SERVICES | $9,524,978 | $7,951,832 | $1,557,677 | $15,469 |
| BAD DEBT | $1,659,099 | $1,659,099 | ||
| NYS ASSESSMENT | $143,929 | $143,929 | ||
| CHARITY CARE | $104,614 | $104,614 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,744,040 | TotalAmt |
| Program Services | $32,288,430 | ProgramServicesAmt |
| Management And General | $5,417,345 | ManagementAndGeneralAmt |
| Fundraising | $38,265 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,028,994 | BOYAmt |
| EOY | $21,159,958 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,089,576 | BOYAmt |
| EOY | $54,710 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $284,877 | BOYAmt |
| EOY | $621,025 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,167,412 | BOYAmt |
| EOY | $3,779,714 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $678,934 | BOYAmt |
| EOY | $575,329 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $622,870 | BOYAmt |
| EOY | $197,139 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $47,278,684 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $32,400,315 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,689,964 | BOYAmt |
| EOY | $14,878,369 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,128,206 | BOYAmt |
| EOY | $7,881,825 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,981,753 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,372,000 | BOYAmt |
| EOY | $430,681 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,044,586 | BOYAmt |
| EOY | $49,578,750 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,383,596 | BOYAmt |
| EOY | $3,115,030 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,451,495 | BOYAmt |
| EOY | $234,930 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,847,880 | BOYAmt |
| EOY | $1,216,555 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,582,226 | BOYAmt |
| EOY | $14,900,531 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,265,197 | BOYAmt |
| EOY | $19,467,046 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,070,096 | BOYAmt |
| EOY | $23,728,529 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,709,293 | BOYAmt |
| EOY | $6,383,175 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,779,389 | BOYAmt |
| EOY | $30,111,704 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,044,586 | BOYAmt |
| EOY | $49,578,750 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,081,905 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$90,863 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $1,341,273 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $11,052 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $11,052 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | AMOUNTS FOR GENERAL LOBBYING ACTIVITIES ARE $11,052 COMPRISED FROM THE HEALTHCARE ASSOCIATION MEMBERSHIPS AS FOLLOWS: HEALTHCARE ASSOCIATION OF NEW YORK STATE 14.13% OF DUES PAID OF $7,203. AMERICAN HOSPITAL ASSOCIATION 26.47% OF DUES PAID OF $17,325. IROQUOIS HEALTHCARE ALLIANCE 57% OF DUES PAID OF $9,559. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,709,293 | BeginningYearBalanceAmt |
| Contributions | $16,952 | ContributionsAmt |
| Investment Earnings Or Losses | $204,782 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | -$4,000 | GrantsOrScholarshipsAmt |
| End Year Balance | $5,935,027 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,742,017 | BeginningYearBalanceAmt |
| Contributions | $75,000 | ContributionsAmt |
| Investment Earnings Or Losses | -$117,041 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | -$84,317 | GrantsOrScholarshipsAmt |
| Other Expenditures | $75,000 | OtherExpendituresAmt |
| End Year Balance | $5,709,293 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,913,759 | BeginningYearBalanceAmt |
| Contributions | $482,000 | ContributionsAmt |
| Investment Earnings Or Losses | $87,791 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $3,771 | GrantsOrScholarshipsAmt |
| Other Expenditures | $737,762 | OtherExpendituresAmt |
| End Year Balance | $5,742,017 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,914,943 | BeginningYearBalanceAmt |
| Contributions | $487,332 | ContributionsAmt |
| Investment Earnings Or Losses | $512,484 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $1,000 | GrantsOrScholarshipsAmt |
| End Year Balance | $5,913,759 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,609,617 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $305,326 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $4,914,943 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.21620 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.78380 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $402,942 | OtherCostOrOtherBasisAmt |
| Book Value | $402,942 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,174,669 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,635,570 | DepreciationAmt |
| Book Value | $10,539,099 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,628,707 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,764,745 | DepreciationAmt |
| Book Value | $2,863,962 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,072,366 | OtherCostOrOtherBasisAmt |
| Book Value | $1,072,366 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,878,369 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| CMS CARES ACT | $2,397,757 |
| DUE TO RELATED PARTIES | $9,573,437 |
| 3RD PARTY PAYABLES | $3,641,206 |
| ACCRUED PENSION OBLIGATION | -$711,869 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $14,900,531 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | ENDOWMENT FUNDS DISTRIBUTE INCOME FOR PURPOSES OF CAPITAL INVESTMENT. TEMPORARY ENDOWMENTS ARE USED BASED ON THE INTENT OF THE DONATION, WHICH IS TYPICALLY FOR CAPITAL INVESTMENTS. |
| PART X, LINE 2: | FIN 48 FOOTNOTE LITTLE FALLS HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF BASSETT HEALTHCARE NETWORK (THE NETWORK). THE TEXT OF THE FIN 48 FOOTNOTE FROM THE CONSOLIDATED FINANCIAL STATEMENTS IS AS FOLLOWS: THE NETWORK'S VARIOUS SUBSIDIARIES GENERALLY CONSIST OF NOT-FOR-PROFIT CORPORATIONS ORGANIZED IN ACCORDANCE WITH SECTION 501(C)(3) OF THE IRC AND THEREFORE ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE IRC. THE NETWORK RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE-LIKELY THAN-NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL TAX LIABILITIES OR UNCERTAIN TAX POSITIONS THAT NEED TO BE RECORDED. FOR TAXABLE SUBSIDIARIES OR INVESTMENTS, INCLUDING CCE, DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES OF TEMPORARY DIFFERENCES BY APPLYING ENACTED STATUTORY TAX RATES APPLICABLE TO FUTURE YEARS FOR THE DIFFERENCES BETWEEN THE CONSOLIDATED FINANCIAL STATEMENTS AND TAX BASIS OF EXISTING ASSETS AND LIABILITIES. SUCH DEFERRED TAX ASSETS AND LIABILITIES WERE NOT MATERIAL AS OF DECEMBER 31, 2021 AND 2020. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 142 | PersonsServedCnt |
| Total Community Benefit Expns | $182,514 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,987 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $176,527 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00470 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 14748 | PersonsServedCnt |
| Total Community Benefit Expns | $7,909,026 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,832,953 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,076,073 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08160 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 14890 | PersonsServedCnt |
| Total Community Benefit Expns | $8,091,540 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,838,940 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,252,600 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08630 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,563 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $18,563 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7 | PersonsServedCnt |
| Total Community Benefit Expns | $4,479 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,479 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 7 | PersonsServedCnt |
| Total Community Benefit Expns | $23,042 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $23,042 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 14897 | PersonsServedCnt |
| Total Community Benefit Expns | $8,114,582 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,838,940 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,275,642 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08690 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $50,448 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $50,448 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $50,448 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $50,448 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Reimbursed By Medicare | $8,614,924 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,629,141 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$14,217 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LITTLE FALLS HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 BURWELL STREET | AddressLine1Txt |
| City | LITTLE FALLS | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13365 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.BASSETT.ORG/LOCATIONS/LITTLE-FALLS | WebsiteAddressTxt |
| State License | 2129700H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | INCLUDES 25 INPATIENT BEDS | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LITTLE FALLS HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SECTION C | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | SEE SECTION C | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.BASSETT.ORG | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| LITTLE FALLS HOSPITAL | PART V, SECTION B, LINE 5: LITTLE FALLS HOSPITAL COLLABORATED WITH BASSETT RESEARCH INSTITUTE'S MOHAWK VALLEY POPULATION HEALTH IMPROVEMENT PROGRAM AND HERKIMER COUNTY PUBLIC HEALTH TO IDENTIFY STAKEHOLDERS FOR COMPLETING THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT. THE COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES THE HOSPITAL, LOCAL COUNTY HEALTH DEPARTMENT, AND KEY INFORMANTS WITH DATA AND RESPONSES SO THAT THEY MAY IDENTIFY, PRIORITIZE, AND ADDRESS HEALTH CARE CHALLENGES FACING THEIR COMMUNITIES. MVPHIP COLLABORATED WITH HERKIMER COUNTY PUBLIC HEALTH, HERKIMER COUNTY OFFICE FOR THE AGING, AND LITTLE FALLS HOSPITAL TO COMPILE A LIST OF KEY INFORMANTS IN THE SERVICE REGION. THOSE KEY INFORMANTS REPRESENT A BROAD RANGE OF SECTORS, COMMUNITY INTERESTS, AND INCLUDED ORGANIZATIONS THAT REPRESENT THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. LITTLE FALLS HOSPITAL, HERKIMER COUNTY OFFICE FOR THE AGING, AND HERKIMER COUNTY PUBLIC HEALTH INVITED KEY INFORMANTS TO ATTEND A HERKIMER COUNTY DATA PRESENTATION AND TO GIVE FEEDBACK ON THEIR PRIORITY FOCUS AREAS BASED ON THE 2019-2024 NEW YORK STATE PREVENTION AGENDA ACTION PLANS. THOSE KEY INFORMANTS WHO WERE UNABLE TO ATTEND IN PERSON WERE SENT THE INFORMATION ELECTRONICALLY AND ASKED TO FILL OUT A SHORT SURVEY.HERKIMER COUNTY OFFICE OF THE AGINGHERKIMER COUNTY OFA'S ADVISORY COUNCILHERKIMER COUNT LEGISLATORSHERKIMER COUNTY ADMINISTRATORBRIAN MILLER, NYS ASSEMBLYLITTLE FALLS COMMUNITY OUTREACHHERKIMER COUNTY WORKFORCE DEVELOPMENTCENTRAL ASSOCIATIONS OF THE BLINDHERKIMER COUNTY HOUSING AUTHORITYHOSPICE OF HERKIMER & ONEIDA COUNTIESCOMMUNITY FOUNDATION OF HERKIMER & ONEIDA COUNTIESTOWN OF HERKIMERHERKIMER COUNTY CLERKCHRIS REYNOLDS, PRESIDENT HEALTHNETVALLEY HEALTH SERVICESMOHAWK VALLEY COMMUNITY ACTION AGENCYARC HERKIMERHERKIMER COUNTY PUBLIC HEALTHLITTLE FALLS HOSPITAL 15-0533578REGIONAL PRIMARY CARE NETWORKCORNELL COOPERATIVE EXTENSION OF HERKIMER COUNTYRCIL (LIFE@RCIL)JOHN SCARANO COMMUNITY MEMBERSHERKIMER COUNTY BOCESBRIDGES TO PREVENT TOBACCOHERKIMER COUNTY DSS COMMISSIONERLITTLE FALLS HOSPITALHERKIMER COUNTY MENTAL HEALTH SERVICESCATHOLIC CHARITIES OF HERKIMER COUNTY |
| LITTLE FALLS HOSPITAL | PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS DEVELOPED AS PART OF A MULTI-HOSPITAL PLANNING PROCESS IN COORDINATION WITH BASSETT HEALTHCARE RESEARCH, BASSETT HEALTHCARE NETWORK, AND BASSETT MEDICAL CENTER AND LITTLE FALLS HOSPITAL. LEAD COMMUNITY AGENCY WAS HERKIMER COUNTY PUBLIC HEALTH. |
| LITTLE FALLS HOSPITAL | PART V, SECTION B, LINE 6B: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INLCUDED COMMUNITY ORGANIZATIONS SUCH AS: HERKIMER COUNTY PUBLIC HEALTH, HERKIMER HEALTHNET, HERKIMER COUNTY MENTAL HEALTH, BASSETT MEDICAL CENTER, LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS, MOHAWK VALLEY POPULATION HEALTH IMPROVEMENT PROGRAM, AND CANCER CENTER SERVICES OF ONEIDA, MADISON, AND HERKIMER COUNTY. |
| LITTLE FALLS HOSPITAL | PART V, SECTION B, LINE 11: THE LITTLE FALLS HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WORKING WITH COMMUNITY STAKEHOLDERS WILL CONTINUE TO FOCUS ON PREVENTING CHRONIC DISEASE, WELL BEING FOR LIMITING MENTAL HEALTH EPISODIC EVENTS, AND IMPROVING A HEALTH SAFETY LIFESTYLE.THE CHRONIC CARE DISEASE MANAGEMENT WILL USE MORE METHODS TO COMMUNICATE WITH RESIDENTS AND PROVIDERS FOR TRACKING PREVENTATIVE HEALTH SCREENINGS FOR PREVENTATIVE WOMEN'S HEALTH CARE. THE WELL BEING INITIATIVES WILL UNITE EFFORTS TO BUILD TRUSTWORTHY RELATIONSHIPS FOR PATIENTS REQUIRING SUPPORTS LEVELS FOR MENTAL HEALTH SERVICES. OUR INITIATIVE TO HAVE A HEALTHIER AND SAFER LIVING ENVIRONMENT EXTENDS TO MANY OPPORTUNITIES OF HEALTH CARE INTERACTIONS. WE WILL FOCUS ON EDUCATION OF AGE COHORTS TO HAVE A HEALTHIER AND SAFER HOME, AND LIFESTYLE. THESE THREE INITIATIVES ARE SUPPORTED BY THE COLLECTIVE COMMUNITY ASSETS OF COMMUNITY-BASED ORGANIZATIONS WHO HAVE ADOPTED AND PARTNERED WITH LITTLE FALLS HOSPITAL AND HERKIMER COUNTY HEALTH DEPARTMENT.THE ESTABLISHED WORKPLAN WILL BE THE GUIDELINES FOR MONITORING PROGRESS AND ALIGNMENT OF SERVICES TO MEET THESE OBJECTIVES. THE COMMUNITY HEALTH NEEDS ASSESSMENT BUILDS UPON THE PRIOR PLAN OF 2016 - 2018. THESE INITIATIVES INCLUDED PROMOTING MENTAL, EMOTIONAL AND BEHAVIORAL HEALTH, PREVENTING SUBSTANCE ABUSE, REDUCING OBESITY IN ADULTS AND CHILDREN, PREVENTING DIABETES, AND PREVENTING HEART DISEASE. THE PROGRESS TO DATE REFLECTS THE STRONG COMMITMENT OF SUPPORT FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT ACROSS MANY STAKEHOLDERS. LITTLE FALLS HOSPITAL, BASSETT MEDICAL CENTER, AND OTHER LOCAL HEALTH PROVIDERS HAVE INCREASED USE OF MEDIA TO IMPROVE PUBLIC AWARENESS OF ACCESS FOR SCREENING SERVICES, USE OF CLINICAL EDUCATORS ON THE BENEFITS OF HEALTH SCREENINGS, AND PARTNERING WITH PROVIDERS TO IMPROVE THEIR USE OF SCREENINGS FOR CHRONIC CARE ILLNESS.LITTLE FALLS HOSPITAL WILL PARTNER WITH HERKIMER COUNTY PUBLIC HEALTH ON STRENGTHENING RESOURCES AVAILABLE FOR MENTAL HEALTH BEHAVIORAL PATIENTS. MENTAL HEALTH SERVICES ARE CURRENTLY UNDERSTAFFED WITH CLINICAL PROVIDERS IN OUR SERVICE AREA. WORKING WITH THE LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS, PRIMARY CARE PROVIDERS ARE PERFORMING MENTAL HEALTH SCREENINGS AND TRACKING INFORMATION IN THE ELECTRONIC HEALTH RECORD. THIS ALLOWS FOR PRIMARY CARE AND MENTAL HEALTH PROVIDERS TO COLLABORATE ON MEDICAL AND MENTAL HEALTH CARE PLANS. LITTLE FALLS HOSPITAL, BASSETT MEDICAL CENTER, AND HERKIMER COUNTY PUBLIC HEALTH ARE COORDINATING RECRUITMENT OF ADDITIONAL MENTAL HEALTH PROVIDERS.LITTLE FALLS HOSPITAL IS A PARTNER IN THE LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS (LHCP), LLC. THIS ORGANIZATION REPRESENTS A REGIONAL ORGANIZATION, ESTABLISHED IN PARTNERSHIP WITH NYS DEPARTMENT OF HEALTH, UNDER A CMS REFERENCED DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) PROGRAM. WHILE THIS PROGRAM ENDED IN 2019, BASSETT HEALTHCARE NETWORK CONTINUES TO SUPPORT THE HERKIMER COUNTY HUB FOR PLANNING AND ORGANIZING HEALTH IMPROVEMENT RESOURCES. SOME CURRENT ON-GOING INITIATIVES ARE AS FOLLOWS:1.) COORDINATED ADMINISTRATION OF VACCINES IN OUR FIVE RURAL HEALTH CLINICS. ALSO PERFORMED LABORATORY COVID TESTING AND RESULTS REPORTING FOR PURPOSES OF MITIGATION OF THE SPREAD OF COVID. IN LITTLE FALLS HOSPITAL IN COORDINATION WITH BASSETT HEALTHCARE NETWORK COORDINATEED COMMUNITY EDUCATION ON CONTROLLING SPREAD OF COVID. 2 .) CONTINUED THE NYS MEDICAID ACCELERATED EXCHANGE (MAX) PROCESS TO USE PATIENT CENTERED PROCESSES TO REDUCE USE OF EMERGENCY DEPARTMENT BY CHRONIC CARE PATIENTS. LITTLE FALLS HEALTH CENTERS IN DOLGEVILLE AND NEWPORT PARTICIPATED IN THIS PROJECT AND IMPROVED THEIR CARE MANAGEMENT PLANS TO REDUCE EMERGENCY DEPARTMENT VISITS.3 .) THE SALVATION ARMY, LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS, AND LITTLE FALLS HOSPITAL DEVELOPED A CARE NAVIGATION PROGRAM TO ASSIST PATIENTS AND FAMILIES WITH HEALTH CARE DECISIONS.LIMITATIONS ON PROGRESSWE HAVE IDENTIFIED THE DIFFICULTY IN RECRUITING PRIMARY CARE AND UNDERSTAFFED MENTAL HEALTH PROVIDERS IN OUR REGION AS A BARRIER TO MEETING OUR CHNA GOALS. THIS SHORTAGE OF PROVIDERS IS BEING ADDRESSED IN RECRUITMENT PLANS IN COORDINATION WITH BASSETT MEDICAL CENTER, HERKIMER COUNTY PUBLIC HEALTH, AND LITTLE FALLS HOSPITAL. DUE TO THE COVID-19 PANDEMIC, THE HOSPITAL CANCELED ALL ELECTIVE PROCEDURES AND NON URGENT AMBULATORY VISITS WHICH RESULTED IN A SIGNIFICANT REDUCTION IN PATIENT VOLUMES. IN ADDITION TO THE LOST REVENUE THAT ACCOMPANIED THE LOWER PATIENT VOLUMES THE HOSPITAL EXPERIENCED A SIGNIFICANT INCREASE IN OPERATING EXPENSES ASSOCIATED WITH THE PURCHASE OF PERSONAL PROTECTIVE EQUIPMENT, CERTAIN PHARMACEUTICALS, COVID 19 TESTING SUPPLIES, AND OTHER OVERHEAD AND PATIENT SPECIFIC COSTS. ADMISSIONS FELL 11% FROM 2019 TO 2020 WHILE ER VISITS DECREASED 2% FROM 2019 TO 2020. THE IMPACT FROM THE COVID PANDEMIC CONTINUED IN 2021 CAUSING COST INCREASES TO RETAIN AND RECRUIT LABOR AND CONTINUED LOWER PATIENT VOLUMES COMPARED TO PRE-PANDEMIC LEVELS. TOTAL FUNDING FROM PANDEMIC FUNDING WAS $371,685. |
| LITTLE FALLS HOSPITAL | PART V, SECTION B, LINE 20E: LITTLE FALLS HOSPITAL PROVIDED MAILING INFORMATION TO UNINSURED PATIENTS FOR ENROLLING IN AN AFFORDABLE CARE ACT INSURANCE PRODUCT SPONSORED BY THE NYS HEALTH MARKETPLACE. LITTLE FALLS HOSPITAL ALSO ASSISTED PATIENTS WITH THE COMPLETION OF APPLICATIONS FOR ENROLLMENT INTO NYS MARKETPLACE PLANS. IN 2021, 127 PATIENTS WERE ENROLLED BY A LITTLE FALLS HOSPITAL EMPLOYED FACILITATOR INTO A NYS MARKETPLACE PLAN. |
| PART V, LINE 7A AND 10A | LITTLE FALLS HOSPITAL:THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE MADE AVAILABLE ON THE HOSPITAL'S WEBSITE:HTTPS://WWW.BASSETT.ORG/LOCATIONS/LITTLE-FALLS-HOSPITAL |
| PART V, LINE 16A, 16B, AND 16C | LITTLE FALLS HOSPITAL:THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE MADE AVAILABLE ON THE HOSPITAL'S WEBSITE:HTTPS://WWW.BASSETT.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE |
| LITTLE FALLS HOSPITAL | PART VBILLING AND COLLECTIONSBEGINNING IN 2021, BASSETT HEALTHCARE NETWORK, THE PARENT ORGANIZATION OF LITTLE FALLS HOSPITAL, ENTERED INTO A SERVICE AGREEMENT WITH OPTUM INSIGHT. THIS AGREEMENT RESULTED IN VARIOUS INFORMATION TECHNOLOGY, REVENUE CYCLE, AND BUSINESS ANALYTIC SERVICES ONCE PERFORMED BY BASSETT HEALTHCARE NETWORK BEING TRANSITIONED TO OPTUM INSIGHT, ALONG WITH THE FORMER BASSETT EMPLOYEES WHO PROVIDED THEM. THE TRANSITION INCLUDED PORTIONS OF THE BILLING AND COLLECTION ACTIVITIES FOR THE HOSPITALS IN THE NETWORK. HOWEVER, DESPITE THE CHANGE IN SERVICE PROVIDER, THE BILLING AND COLLECTION POLICIES OF THE HOSPITAL HAVE NOT CHANGED AS A RESULT OF THE TRANSITION. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - DOLGEVILLE HEALTH CENTER | ||||
| 36 SLAWSON STREET | DOLGEVILLE | NY | 13329 | CLINIC |
| 2 - NEWPORT HEALTH CENTER | ||||
| BRIDGE STREET | NEWPORT | NY | 13416 | CLINIC |
| 3 - LITTLE FALLS HEALTH CENTER | ||||
| 170 BURWELL STREET | LITTLE FALLS | NY | 13365 | CLINIC |
| 4 - RICHFIELD SPRINGS HEALTH CENTER | ||||
| 8550 STATE HIGHWAY 28 | RICHFIELD SPRINGS | NY | 13439 | CLINIC |
| 5 - WEST WINFIELD HEALTH CENTER | ||||
| 544 E MAIN STREET | WEST WINFIELD | NY | 13491 | CLINIC |
| 6 - ST JOHNSVILLE HEALTH CENTER | ||||
| 8 PARK PLACE | ST JOHNSVILLE | NY | 13452 | CLINIC |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | LITTLE FALLS HOSPITAL PROVIDES SERVICES TO ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. THE COMMUNITY SERVICE PROGRAM (CSP) IS AVAILABLE FOR PATIENTS WITHOUT INSURANCE COVERAGE FOR INCOMES UP TO 300% OF THE FEDERAL POVERTY INCOME GUIDELINES. OUR CSP COORDINATOR IS AN AUTHORIZED ENROLLMENT FACILITATOR FOR MEDICAID AND NEW YORK STATE INSURANCE EXCHANGE INSURANCE COVERAGES. |
| PART I, LINE 6A: | AS A MEMBER OF THE BASSETT HEALTHCARE NETWORK, LITTLE FALLS HOSPITAL JOINES IN THE BASSETT HEALTHCARE NETWORK ANNUAL COMMUNITY REPORT, WHICH IS AVAILABLE WWW.BASSETT.ORG/ABOUT-BASSETT-HEALTHCARE-NETWORK/ANNUAL-REPORTS. IT DOES NOT PREPARE A SEPARATE COMMUNITY BENEFIT REPORT. |
| PART I, LINE 7: | COST FOR CHARITY CARE PATIENTS WAS CALCULATED USING RATIO OF COST TO CHARGES. COST ASSOCIATED WITH MEDICAID AND MEDICAID HMO PROGRAMS REPRESENTS AGGREGATE ALLOWABLE COST AND TOTAL GROSS CHARGES USED TO CALCULATE A FACILITY LEVEL COST TO CHARGE RATIO. THIS FACILITY LEVEL COST TO CHARGE RATIO WAS APPLIED TO TOTAL MEDICAID AND MEDICAID HMO CHARGES TO ARRIVE AT TOTAL MEDICAID COST. FOR SUBSIDIZED HEALTH SERVICES, THE LOSS DOES NOT INCLUDE GOVERNMENT PAYERS LOSS INFORMATION IS REPORTED IN AGGREGATE AMOUNTS. |
| PART I, LINE 7, COLUMN F | LITTLE FALLS HOSPITAL EXCLUDED $1,659,099 OF BAD DEBT EXPENSE TO CALCULATE COST OF PATIENT CARE. BAD DEBT IS REPORTED AS A FUNCTIONAL PROGRAM EXPENSE. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | COMMUNITY BUILDING ACTIVITIES ARE ASSOCIATED WITH LITTLE FALLS HOSPITAL WORKING WITH COMMUNITY BUSINESSES THROUGH OUR MEMBERSHIP WITH LOCAL AGENCIES, SUCH AS HERKIMER COUNTY HEALTHNET, AMERICAN HEART ASSOCIATION, HOSPICE AND PALLIATIVE CARE INC. . THESE ACTIVITIES ALLOW FOR DIALOG ON CURRENT HEALTHCARE TOPICS, INSURANCE PROGRAMS, AND RECRUITMENT OF FUTURE EMPLOYEES. LITTLE FALLS HOSPITAL COLLABORATES WITH BASSETT MEDICAL CENTER ON RECRUITMENT INITIATIVES FOCUSING ON PRIMARY CARE. HERKIMER COUNTY HAS ONE OF THE LOWEST RATIOS OF PRIMARY CARE PROVIDERS TO RESIDENTS IN NEW YORK STATE. IN 2021, LITTLE FALLS HOSPITAL WAS A LICENSED PRACTICAL NURSES (LPN)PRECEPTOR TRAINING LOCATION SPONSORED WITH THE MOHAWK VALLEY BOARDS OF COOPERATIVE EDUCATIONAL SERVICES (BOCES). THIS TRAINING PROGRAM ENABLES FOR THE DEVELOPMENT OF FRONT-LINE HEALTH CARE WORKERS. IN 2021 THIS PROGRAM SUPPORTED THE CLINICAL DEVELOPMENT OF 6 LPN'S. |
| PART III, LINE 2: | BAD DEBT EXPENSEDUE TO THE ADOPTION OF ASU NO. 2014-09, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606), BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENTS. RATHER IT IS TREATED AS A PRICE CONCESSION. THE BAD DEBT EXPENSE FOR 2021 WAS $1,659,099. |
| PART III, LINE 3: | CHARITY CAREFOOTNOTE (3) FROM THE CONSOLIDATED FINANCIALSTHE COST OF CHARITY CARE PROVIDED IS DETERMINED BASED ON THE APPLICATION OF A COST TO GROSS CHARGE RATIO TO THE TOTAL CHARITY CARE CHARGES FOREGONE. INCLUDED IN NET PATIENT SERVICE REVENUE ARE AMOUNTS PAID INTO AND RECEIVED FROM STATEWIDE UNCOMPENSATED CARE POOLS. THESE UNCOMPENSATED CARE POOLS ARE DESIGNED TO HELP OFFSET THE COST OF CHARITY CARE AND UNREIMBURSED MEDICAID SERVICES.BAD DEBT EXPENSEDUE TO THE ADOPTION OF ASU NO. 2014-09 REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENT. RATHER IT IS TREATED AS A PRICE CONCESSION. |
| PART III, LINE 8: | IN 2021 OUR OPERATING INCOME WAS UNFAVORABLE, WITH MEDICARE PART A AND B PROGRAMS, RECOGNIZING ($14,217) . MEDICARE REPRESENTS APPROXIMATELY 31% OF TOTAL PATIENT SERVICE REVENUES. LITTLE FALLS HOSPITAL IS A CRITICAL ACCESS HOSPITAL (CAH) WHICH IS PAID BY MEDICARE BASED ON COST OF CARE. OUR SAFETY NET HOSPITAL STATUS INDICATES WE ARE A NYS RURAL PROVIDER WITH A GREATER THAN 30% THRESHOLD FOR MEDICAID SERVICES. THE SHORTFALL IS TREATED AS A COMMUNITY BENEFIT AS THE SERVICES SUPPORT SIGNIFICANT HEALTH NEEDS FROM THE COMMUNITY. |
| PART III, LINE 9B: | OUR COLLECTION AND CHARITY CARE POLICY SPECIFIES THAT ACCOUNTS WITH ACTIVE CHARITY CARE APPLICATIONS WILL NOT GO TO COLLECTION AGENCIES WHILE APPLICATIONS ARE IN REVIEW. WHILE A REQUEST FOR CHARITY CARE ASSISTANCE IS IN PROCESS, THESE ACCOUNTS ARE PLACED ON HOLD IN OUR BILLING SYSTEM. WE COMMUNICATE INFORMATION ON REQUIREMENTS FOR ASSISTANCE AND WILL COUNSEL PATIENTS ON PROVIDING THE INCOME INFORMATION TO DETERMINE IF THEY QUALIFY FOR CHARITY CARE USING 300% OF THE FEDERAL POVERTY INCOME GUIDELINES. (NOTE: OUR CHARITY CARE PROGRAM IS FOR THE UNINSURED PATIENT.) |
| PART VI, LINE 2: | IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), A VARIETY OF DATA ARE USED REGULARLY TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITYSERVED BY LITTLE FALLS HOSPITAL, INCLUDING DATA FROM PATIENT SATISFACTION SURVEYS, THE NYS DEPARTMENT OF HEALTH, THE HERKIMER COUNTY COMMUNITY HEALTH ASSESSMENT, AND THE NYS PREVENTION AGENDA, WHICH IDENTIFIED PRIORITY HEALTH INDICATORS TO BE USED BY NYS HOSPITALS, PROVIDERS, AND COUNTY HEALTH DEPARTMENTS IN ASSESSING AND SETTINGLOCAL/REGIONAL PRIORITIES. LITTLE FALLS HOSPITAL USES AN HEALTHCARE INDUSTRY SPECIALITY EXPERT IN PATIENT DATA ANALYTICS, PRESS GANEY TO OBTAIN BENCHMARKING DATA ON PATIENT SATISFACTION IN ORDER TO ASSESS HOW THE HOSPITAL IS PERCEIVED TO BE MEETING PATIENT NEEDS. DATA FROM ONGOING MAIL SURVEYS CARRIED OUT AMONG A STATISTICALLY SIGNIFICANT RANDOM SAMPLE OF INPATIENTS AND OUTPATIENTS IS USED TO IMPROVE PATIENT CARE AND INFORM OFFICIAL QUALITY IMPROVEMENT ACTIVITIES. DATA COLLECTED FROM THIS INSTRUMENT INCLUDE A COMPREHENSIVE OVERVIEW OF KEY, EVIDENCE-BASED QUALITY INDICATORS -- FROM TIMELINESS OF CARE TO COMMUNICATIONS, PATIENT SAFETY, DISCHARGE INSTRUCTION, MEDICATION ISSUES, AND MORE. THE HOSPITAL RECEIVES REPORTS QUARTERLY. THE HOSPITAL ALSO UTILIZES INFORMATION FROM THE STANDARDIZED, PUBLICLY REPORTED HCAHPS (HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS) SURVEY OF PATIENTS' PERSPECTIVES OF HOSPITAL CARE. THE HCAHPS REPORTING AND SURVEY ARE REQUIRED BY THE CENTER FOR MEDICARE SERVICES (CMS) TO ALLOW STANDARD, OBJECTIVE, VALID COMPARISONS TO BE MADE ACROSS HOSPITALS NATIONALLY, REGIONALLY, AND LOCALLY REPORTS ARE RECEIVE QUARTERLY AND SINCE 2008 HAVE BEEN PUBLISHED NATIONALLY ON THE CMS AND NYS DEPARTMENT OF HEALTH WEBSITES. THE SURVEY METHODOLOGY AND RESULTS ARE IN THE PUBLIC DOMAIN. (WWW.HCAHPSONLINE.ORG).ADDITIONALLY, THE HOSPITAL'S NEEDS ASSESSMENT ACTIVITIES ARE INFORMED BY INITIATIVES AND STUDIES CARRIED OUT BY THE BASSETT HEALTHCARE NETWORK RESEARCH INSTITUTE, INCLUDING THE UPSTATE HEALTH AND WELLNESS STUDY 2009. THIS PROJECT ASSESSED HEALTH INDICATORS, IDENTIFIED RURAL-URBAN HEALTH DISPARITIES, AND PROVIDED BASELINE DATA TO ASSIST COMMUNITY HEALTHCARE PLANNING IN THE RURAL REGION SERVED BY BASSETT, INCLUDING SCHOHARIE COUNTY. IT IS A COLLABORATIVE EFFORT BETWEEN THE RESEARCH INSTITUTE, COUNTY HEALTH DEPARTMENTS, AND REGIONAL COMMUNITY SERVICES ORGANIZATIONS. IN COORNDATION WITH BASSETT RESEARCH INSTITUTE'S MOHAWK VALLEY POPULATION HEALTH IMPROVEMENT PROGRAM (MVPHIP), A GRANT FUNDED PROGRAM FROM NEW YORK STATE DEPARTMENT OF HEALTH, WHO COORDINATES ASSESSMENT ON BEHALF OF BASSETT HEALTHCARE NETWORK'S LITTLE FALLS HOSPITAL AND THE HERKIMER COUNTY PUBLIC HEALTH. |
| PART VI, LINE 3: | LITTLE FALLS HOSPITAL PROVIDES ACCESS AND EDUCATION ON THE COMMUNITY SERVICE PROGRAM WITH CONTACT INFORMATION FOR PATIENTS TO CALL AND MAKE APPOINTMENTS FOR COMPLETING APPLICATIONS FOR FINANCIAL ASSISTANCE. AT ALL PATIENT ACCESS LOCATIONS, APPLICATIONS FOR CHARITY CARE ASSISTANCE ARE AVAILABLE. THE WWW.BASSETT.ORG WEBSITE INCLUDES A LINK ON INFORMATION FOR COMPLETING AN APPLICATION AND OTHER RESOURCES CALLED "FINANCIAL ASSISTANCE RESOURCE GUIDE". OUR FINANCIAL ASSISTANCE COORDINATOR PROVIDES INSURANCE COVERAGE NAVIGATION SERVICES TO ASSIST RESIDENTS WITH ENROLLMENT IN GOVERNMENT SPONSORED HEALTH CARE COVERAGE PROGRAMS. A COMMUNITY NAVIGATOR IS ALSO PRESENT IN THE EMERGENCY DEPARTMENT TO ASSIST WITH APPLICATIONS FOR GOVERNMENT SPONSORED HEALTH CARE COVERAGE PROGRAMS OR TO COMPLETE APPLICATIONS FOR OUR FINANCIAL ASSISTANCE PROGRAM. OUR APPLICATION ALSO SPECIFIES ON-SITE PROVIDERS WHO DO NOT PARTICIPATE IN LITTLE FALLS HOSPITAL FINANCIAL ASSISTANCE PROGRAM. |
| PART VI, LINE 4: | LITTLE FALLS HOSPITAL SERVES AN ESTIMATED POPULATION OF OVER 62,000 PEOPLE IN 17 COMMUNITIES THROUGHOUT HERKIMER COUNTY, AND SECTIONS OF FULTON AND MONTGOMERY COUNTIES. THE SERVICE AREA POPULATION IS COMPRISED OF INDIVIDUALS AND FAMILIES FROM ALL SOCIO-ECONOMIC AND EDUCATIONAL LEVELS. THE POPULATION IS 96 PERCENT WHITE, 51 PERCENT FEMALE AND 49 PERCENT MALE. THE AGE DISTRIBUTION OF THE POPULATION IS SIMILAR TO OTHER UPSTATE NEW YORK AREAS WITH 5.4 PERCENT OF THE POPULATION UNDER 5 YEARS OF AGE, 24 PERCENT UNDER THE AGE OF 18, AND 22.2 PERCENT AGED 65 AND OLDER. NEARLY 89 PERCENT OF THE POPULATION OVER AGE OF 25 HAS GRADUATED FROM HIGH SCHOOL. MEDIAN HOUSEHOLD INCOME OF $54,794 IS BELOW THE STATE MEDIAN OF $71,855. IT'S ESTIMATED THAT 10 PERCENT OF THE POPULATION IS BELOW THE FEDERAL POVERTY LEVEL. APPROXIMATELY 93% OF RESIDENTS HAVE HEALTH COVERAGE, AN IMPROVEMENT OF 6% SINCE 2013. |
| PART VI, LINE 5: | LITTLE FALLS HOSPITAL IMPLEMENTS COORDINATED HEALTH CARE RESOURCES WITH BASSETT HEALTHCARE NETWORK. THIS COLLABORATION INCLUDED PLANNING AND IMPLEMENTING INITIATIVES UNDER A NEW YORK STATE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) PROJECT. DSRIP ACTIVITIES ARE COORDINATED WITH COMMUNITY BASED ORGANIZATIONS TO DEVELOP CARE IMPROVEMENT PROGRAMS IN A COORDINATED MANNER. THE HERKIMER COUNTY HUB WAS ORGANIZED SO COMMUNITY AGENCIES COULD DEVELOP INITIATIVES FOR IMPROVING COMMUNICATIONS FOR REFERRALS TO PROGRAMS FOR HIGH NEED PATIENTS. WITH THESE COMMUNITY AGENCIES ENGAGED A HIGHER DEGREE OF PATIENT INTERACTION IS POSSIBLE TO ACHIEVE POSITIVE IMPACTS ON IMPROVING THEIR HEALTH CARE. LITTLE FALLS HOSPITAL PARTNERED WITH SALVATION ARMY FOR THEIR ASSISTANCE IN PROVIDING PATIENT NAVIGATION SERVICES. THESE NAVIGATION SERVICES PROVIDE PATIENTS AND FAMILY SUPPORT FOR MEDICAL AND SOCIAL ASSISTANCE TO IMPROVE A HEALTHIER LIFESTYLE. |
| PART VI, LINE 6: | LITTLE FALLS HOSPITAL COLLABORATES WITH BASSETT HEALTHCARE NETWORK AND BASSETT MEDICAL CENTER TO COORDNATE THE EFFICIENT DELIVERY OF HEALTHCARE IN OUR SERVICE AREA. THIS RELATIONSHIP HAS DEVELOPED OVER A PERIOD OF FIFTEEN YEARS AND CONTINUES TO PROVIDE RESIDENTS ACCESS TO A HIGH-QUALITY HEALTHCARE SYSTEM. OUR INTEGRATED ELECTRONIC HEALTH RECORD HAS ENABLED OUR PATIENTS TO RECEIVE IMPROVED COORDINATED CARE AND ACCESS TO THEIR HEALTH INFORMATION NOT ROUTINELY SEEN IN RURAL HEALTH NETWORKS. OUR COLLABORATIVE PLANNING ON PROJECTS SUCH AS THE NYS DELIVERY SYSTEM REFORM INCENTIVE PAYMENT SYSTEM (DSRIP) AND RELATED MOHAWK VALLEY POPULATION HEALTH IMPROVEMENT PROGRAM ARE EXAMPLES OF OUR COLLABORATION TO IMPROVE THE HEALTHCARE SYSTEMS IN OUR SERVICE AREA.LITTLE FALLS HOSPITAL AS A LEADER WITH BASSETT HEALTHCARE NETWORK IN COORDINATION OF PATIENT ADVOCATE GROUPS IS MAKING A DIFFERENCE FOR IMPROVING HEALTHCARE. THESE INITIATIVES WITHIN THE DSRIP PROGRAM CONTINUE TO IMPROVE IN PATIENT INTERACTIONS TO SUPPORT ACCESS TO CARE, AND PREVENTATIVE CARE PLANS. THIS IS A NEW AREA OF EMPHASIS WITH CARE INNOVATION MODELS WHICH CREATE LEARNING PARTNERSHIPS WITH PATIENTS AND PROVIDERS. |
| PART VI, LINE 7 | STATE FILING OF COMMUNITY BENEFIT REPORTNEW YORK |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM LECATES MD | ||||||||||||||
| PRESIDENT | $0 | $582,406 | $0 | $3,250 | $0 | $0 | $0 | $26,188 | $0 | $10,926 | $0 | $622,770 | $0 | $0 |
| CARLTON RULE MD | ||||||||||||||
| MEDICAL DIRECTOR | $0 | $382,987 | $0 | $3,000 | $0 | $0 | $0 | $20,388 | $0 | $5,342 | $0 | $411,717 | $0 | $0 |
| LISA BETRUS LEFT 32021 | ||||||||||||||
| TRUSTEE | $0 | $314,645 | $0 | $0 | $0 | $0 | $0 | $14,490 | $0 | $6,055 | $0 | $335,190 | $0 | $0 |
| AMY GRACE MD | ||||||||||||||
| PRESIDENT OF MEDICAL STAFF | $0 | $271,014 | $0 | $3,000 | $0 | $0 | $0 | $18,063 | $0 | $8,286 | $0 | $300,363 | $0 | $0 |
| JAMES G VIELKIND | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $216,342 | $0 | $3,000 | $0 | $0 | $0 | $11,243 | $0 | $914 | $0 | $231,499 | $0 | $0 |
| DIANE DICOB | ||||||||||||||
| NURSE | $177,240 | $0 | $0 | $0 | $0 | $0 | $3,545 | $0 | $1,046 | $0 | $181,831 | $0 | $0 | $0 |
| HEIDI CAMARDELLO | ||||||||||||||
| CHIEF NURSING OFFICER | $163,012 | $0 | $0 | $0 | $0 | $0 | $3,260 | $0 | $2,461 | $0 | $168,733 | $0 | $0 | $0 |
| MICHAEL OGDEN LEFT 72021 | ||||||||||||||
| FORMER PRESIDENT & CEO | $0 | $147,807 | $0 | $0 | $0 | $0 | $0 | $8,753 | $0 | $1,246 | $0 | $157,806 | $0 | $0 |
| LOREEN SHEPARDSON | ||||||||||||||
| DIRECTOR OF PHARMACY | $152,071 | $0 | $0 | $0 | $0 | $0 | $3,041 | $0 | $2,102 | $0 | $157,214 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE COMPENSATION PROCESS FOR TOP OFFICIAL THE CHIEF EXECUTIVE OFFICER'S SALARY IS PAID BY A RELATED ORGANIZATION UNDER A MANAGEMENT SERVICES AGREEMENT. THE LITTLE FALLS HOSPITAL BOARD OF TRUSTEES REVIEWS THE FORMAL PROCESS THAT IS USED TO DETERMINE THE BASE COMPENSATION OF THE CEO. THE CEO'S WORK PLAN AND ACCOMPLISHMENTS FOR THE YEAR ARE REVIEWED. SALARY CHANGES ARE BASED ON MARKET, WORKPLAN, AND ACCOMPLISHMENTS. THE CEO'S SALARY IS SUBMITTED AS PART OF THE MANAGEMENT SERVICES AGREEMENT WHICH IS APPROVED BY THE BOARD. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | BASSETT HEALTHCARE NETWORK IS THE PARENT AND SOLE MEMBER TO EACH OF THE FOLLOWING RELATED PARTIES. FRIENDS OF BASSETT, AO FOX MEMORIAL HOSPITAL, BASSETT HOSPITAL OF SCHOHARIE COUNTY, LITTLE FALLS HOSPITAL, O'CONNOR HOSPITAL, TEMPLETON FOUNDATION, VALLEY HEALTH SERVICES, VALLEY RESIDENTIAL SERVICES, TRI-TOWN REGIONAL HOSPITAL, AND MARY IMOGENE BASSETT HOSPITAL. AS PARENT AND SOLE MEMBER, BASSETT HEALTHCARE NETWORK HAS THE RIGHT TO APPOINT AND REMOVE MEMBERS OF THE GOVERNING BOARDS OF ITS SUBSIDIARIES AND APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BOARDS, INCLUDING, BUT NOT LIMITED TO, APPROVAL OF OPERATING AND CAPITAL BUDGETS, CERTAIN CAPITAL EXPENDITURES, INDEBTEDNESS NOT CONTAINED IN THE APPROVED BUDGETS, SUBSTANTIVE CHANGES IN CLINICAL PROGRAMS, MERGERS, CONSOLIDATIONS, LIQUIDATIONS AND DISSOLUTIONS INVOLVING ITS SUBSIDIARIES AND CERTIFICATE OF NEED APPLICATIONS. |
| FORM 990, PART VI, SECTION A, LINE 7A | SEE DISCLOSURE FOR PART VI, SECTION A, LINE 6 |
| FORM 990, PART VI, SECTION A, LINE 7B | SEE DISCLOSURE FOR PART VI, SECTION A, LINE 6 |
| FORM 990, PART VI, SECTION B, LINE 11B | LITTLE FALLS HOSPITAL PRESENTS THE DRAFT 990 TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS PRIOR TO FILING. ANY QUESTIONS ARE RAISED AND ONCE APPROVED, THE 990 CAN BE FILED. A COMPLETE COPY OF THE ORGANIZATION'S FINAL FORM 990, INCLUDING ALL REQUIRED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, IS PROVIDED TO EACH MEMBER OF THE BOARD BEFORE ITS FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST STATEMENTS ARE MADE ANNUALLY. NEW BOARD MEMBERS ARE REQUIRED TO DISCLOSE ON THEIR RESUME ALL AFFILIATED ORGANIZATIONS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CHIEF EXECUTIVE OFFICER'S SALARY IS PAID BY A RELATED ORGANIZATION UNDER A MANAGEMENT SERVICES AGREEMENT. THE LITTLE FALLS HOSPITAL BOARD OF TRUSTEES REVIEWS THE FORMAL PROCESS THAT IS USED TO DETERMINE THE BASE COMPENSATION OF THE CEO. THE CEO'S WORK PLAN AND ACCOMPLISHMENTS FOR THE YEAR ARE REVIEWED. SALARY CHANGES ARE BASED ON MARKET, WORKPLAN, AND ACCOMPLISHMENTS. THE CEO'S SALARY IS SUBMITTED AS PART OF THE MANAGEMENT SERVICES AGREEMENT WHICH IS APPROVED BY THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | LITTLE FALLS HOSPITAL MAKES AVAILABLE THE IRS FROM 990 UPON REQUEST ALONG WITH INFORMATION INCLUDED WITHIN THE 990 SUCH AS FINANCIAL REPORTS, CONFLICT OF INTEREST POLICY, AND CODE OF CONDUCT. THE HOSPITAL ALSO PROVIDES THE ANNUAL OPERATING PLAN AND CORPORATE VALUES IN PUBLIC AREAS OF THE FACILITY. |
| FORM 990, PART XI, LINE 9: | CHANGE IN PENSION OBLIGATIONS 1,341,273. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| BASSETT HEALTHCARE NETWORK | ||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 133218680 | SUPPORT | NY | 501C3 | 12C | NONE | 0 |
| FRIENDS OF BASSETT | ||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 237041610 | FUNDRAISER | NY | 501C3 | 7 | BHN | 0 |
| O'CONNOR HOSPITAL | ||||||||||
| 460 ANDES ROAD | DELHI | NY | 13753 | 161540394 | HEALTHCARE | NY | 501C3 | 3 | BHN | 0 |
| MARY IMOGENE BASSETT HOSPITAL | ||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 135596796 | HEALTHCARE | NY | 501C3 | 3 | BHN | 0 |
| TEMPLETON FOUNDATION | ||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 133317084 | LANDLORD | NY | 501C3 | 10 | BHN | 0 |
| VALLEY HEALTH SERVICES | ||||||||||
| 690 WEST GERMAN STREET | HERKIMER | NY | 13350 | 222511614 | ELDER CARE | NY | 501C3 | 3 | BHN | 0 |
| BASSETT PPS LLC | ||||||||||
| 6181 STATE HIGHWAY 7 | ONEONTA | NY | 13820 | 811749905 | HEALTHCARE | NY | 501C3 | 12A | MIBH | 0 |
| TRI TOWN REGIONAL HEALTHCARE | ||||||||||
| 43 PEARL STREET | SIDNEY | NY | 13838 | 260169584 | HEALTHCARE | NY | 501C3 | 3 | BHN | 0 |
| VALLEY RESIDENTIAL SERVICES | ||||||||||
| 690 WEST GERMAN STREET | HERKIMER | NY | 13350 | 463703838 | ELDER CARE | NY | 501C3 | 10 | BHN | 0 |
| AT HOME CARE PARTNERS | ||||||||||
| 25 ELM STREET | ONEONTA | NY | 13820 | 562397098 | HEALTHCARE | NY | 501C3 | 10 | AHC INC | 0 |
| AT HOME CARE INC | ||||||||||
| 25 ELM STREET | ONEONTA | NY | 13820 | 161287069 | HEALTHCARE | NY | 501C3 | 10 | BHN | 0 |
| BASSETT HOSPITAL SCHOHARIE COUNTY | ||||||||||
| 178 GRANDVIEW DRIVE | COBLESKILL | NY | 12043 | 141772971 | HEALTHCARE | NY | 501C3 | 3 | BHN | 0 |
| AO FOX FOUNDATION | ||||||||||
| 1 NORTON AVE | ONEONTA | NY | 13820 | 222871993 | FUNDRAISER | NY | 501C3 | 9 | AO FOX MEMORIAL HOSPITAL | 0 |
| AO FOX MEMORIAL HOSPITAL | ||||||||||
| ONE NORTON AVENUE | ONEONTA | NY | 13820 | 150539039 | HEALTHCARE | NY | 501C3 | 3 | BHN | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| STAMFORD PROFESSIONAL ASSOCIATES | |||||||||
| 1 NORTON AVE | ONEONTA | NY | 13820 | 161322304 | RENTAL | NY | N/A | 0 | 0 |
| FIRST COMMUNITY CARE OF BASSETT | |||||||||
| 60 NORTHPOINTE PARKWAY | AMHERST | NY | 14228 | 161504464 | HEALTHCARE | NY | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| CATSKILL CARE ENTERPRISES | |||||||||
| 1 NORTON AVE | ONEONTA | NY | 13820 | 161236590 | RETAIL PHARMACY & FITNESS CENTER | NY | N/A | C | 0 |
| LEATHERSTOCKING PHYSICIANS PC | |||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 364864562 | HEALTHCARE SERVICES | NY | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |