BASSETT HOSPITAL OF SCHOHARIE COUNTY: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- BASSETT HOSPITAL OF SCHOHARIE COUNTY (EIN 14-1772971)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-12-20
- IRS object ID
- 201743549349300019
- Schema version
- 2016v3.0
- 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 | 2017-12-20T13:31:30-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | 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 FL | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12207 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141772971 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BASSETT HOSPITAL OF SCHOHARIE CTY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BASS | BusinessNameControlTxt |
| Phone | 5182543456 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 178 GRANDVIEW DRIVE | AddressLine1Txt |
| City | COBLESKILL | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12043 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ERIC STEIN | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 5182543456 | PhoneNum |
| Signature | 2016-12-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TODD TERESCO | PreparerPersonNm |
| PTIN | P00247720 | PTIN |
| Phone | 5184274600 | PhoneNum |
| Preparation | 2017-12-20 | PreparationDt |
Filing Security Information FilingSecurityInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| At Submission Creation Device Id | ACF3C5308765E7619AA5A0EE970EEE9F6E9B392B | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | ACF3C5308765E7619AA5A0EE970EEE9F6E9B392B | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2018-03-14 21:41:22Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COBLESKILL REGIONAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ERIC STEIN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 178 GRANDVIEW DRIVE | AddressLine1Txt |
| City | COBLESKILL | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12043 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $32,196,724 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.COBLESKILLHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | PROVISION OF HEALTH CARE SERVICES TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 293 | TotalEmployeeCnt |
| Total Volunteers | 49 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $528,676 | PYContributionsGrantsAmt |
| CY Contributions Grants | $441,543 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $28,289,321 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $31,015,577 | CYProgramServiceRevenueAmt |
| PY Investment Income | $13,081 | PYInvestmentIncomeAmt |
| CY Investment Income | -$9,455 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,092,688 | PYOtherRevenueAmt |
| CY Other Revenue | $673,586 | CYOtherRevenueAmt |
| PY Total Revenue | $29,923,766 | PYTotalRevenueAmt |
| CY Total Revenue | $32,121,251 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $16,101,631 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,125,017 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,765,176 | PYOtherExpensesAmt |
| CY Other Expenses | $14,233,037 | CYOtherExpensesAmt |
| PY Total Expenses | $28,866,807 | PYTotalExpensesAmt |
| CY Total Expenses | $31,358,054 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,056,959 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $763,197 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,009,180 | TotalAssetsBOYAmt |
| Total Assets EOY | $26,924,570 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,447,751 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,601,753 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,561,429 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $20,322,817 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVISION OF HEALTH CARE SERVICES TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $22,547,421 | ExpenseAmt |
| Revenue | $31,015,577 | RevenueAmt |
| Desc | PROVISION OF HOSPITAL CARE TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. IN 2016, THE NUMBER OF INPATIENTS CARED FOR WAS 658 AND AND THE NUMBER OF OUTPATIENTS CARED FOR WAS 57,584. | Desc |
| Total Program Service Expenses | $22,547,421 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 107 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 293 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ERIC H STEIN | PersonNm |
| Phone | 5182543456 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 178 GRANDVIEW DRIVE | AddressLine1Txt |
| City | COBLESKILL | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12043 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MICHAEL TENGERES | ||||||||
| TRUSTEE | 2.00 | 40.00 | Yes (X) | $0 | $429,917 | $1,157 | ||
| JOSEPH SELLERS MD | ||||||||
| TRUSTEE | 0.50 | 40.00 | Yes (X) | $0 | $278,540 | $30,770 | ||
| BARBARA DICOCCO | ||||||||
| CHAIRMAN | 1.00 | 2.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ANNE C MYERS | ||||||||
| VICE CHAIRMA | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| GLENN A PERRONE | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| GEORGE P KONTA | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| NANCY BELLINGER | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PAUL BRADY | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL BREEN | ||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| EDWARD KINTZ | ||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| STEVEN KROLL | ||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| HENRY LAMONT | ||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| PETER LOPEZ | ||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| CARL MUMMENTHEY | ||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| GARTH ROBERTS | ||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| RENEE SCIALDO SHEVAT PHD | ||||||||
| TRUSTEE | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| ERIC STEIN | ||||||||
| PRESIDENT & | 38.00 | $0 | $196,079 | $21,030 | Yes (X) | |||
| SUSAN OAKES FERRUCCI | ||||||||
| VICE PRESIDE | 38.00 | $153,003 | $0 | $13,542 | Yes (X) | |||
| LEANNA JENSEN | ||||||||
| VICE PRESIDE | 38.00 | $161,004 | $0 | $3,220 | Yes (X) | |||
| DAVID DESANDO | ||||||||
| DIRECTOR OF | 38.00 | $142,741 | $0 | $4,787 | Yes (X) | |||
| CHRISTINE PIRRI | ||||||||
| VP, HUMAN RE | 38.00 | $128,674 | $0 | $3,731 | Yes (X) | |||
| JACQUELINE KAVOURAS | ||||||||
| VP, QUALITY | 38.00 | $125,440 | $0 | $555 | Yes (X) | |||
| CHRISTOPHER MANLEY | ||||||||
| STAFF PHARMA | 38.00 | $105,556 | $0 | $7,270 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $816,418 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $904,536 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $86,062 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| MEDICAL STAFFING NETWORK HEALTHCARE | ||||||
| 6551 PARK OF COMMERCE BLVD | BOCA RATON | FL | 33487 | STAFFING AGENCY | $410,415 | |
| STAT STAFF PROFESSIONALS INC | ||||||
| 18 DIVISION ST | SARATOGA SPRINGS | NY | 12866 | STAFFING AGENCY | $282,958 | SUITE 311 |
| MCCARTHY HOLDINGS INC | ||||||
| 1341 NORTH ROCK HILL RD | ST LOUIS | MO | 63123 | CONSTRUCTION | $254,741 | |
| AMN HEALTHCARE INC | ||||||
| 12400 HIGH BLUFF DR | SAN DIEGO | CA | 92130 | STAFFING AGENCY | $225,846 | |
| FUSION MEDICAL STAFFING LLC | ||||||
| 11808 GRANT ST | OMAHA | NE | 68164 | STAFFING AGENCY | $133,992 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $196,733 | RelatedOrganizationsAmt |
| Government Grants | $244,810 | GovernmentGrantsAmt |
| Total Contributions | $441,543 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $31,015,577 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $31,015,577 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $31,015,577 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,929 | TotalRevenueColumnAmt |
| Exclusion | $17,929 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $48,089 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $75,473 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$27,384 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$27,384 | TotalRevenueColumnAmt |
| Exclusion | -$27,384 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|
| OTHER OPERATING REVENUE | $504,268 | $504,268 |
| COFFEE SHOP REVENUE | $65,290 | $65,290 |
| LIFELINE REVENUE | $58,351 | $58,351 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,677 | TotalRevenueColumnAmt |
| Exclusion | $45,677 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $673,586 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,121,251 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $31,015,577 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $664,131 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,551,507 | TotalAmt |
| Program Services | $10,740,147 | ProgramServicesAmt |
| Management And General | $3,811,360 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191,026 | TotalAmt |
| Program Services | $132,500 | ProgramServicesAmt |
| Management And General | $58,526 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,586,704 | TotalAmt |
| Program Services | $1,096,370 | ProgramServicesAmt |
| Management And General | $490,334 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $795,780 | TotalAmt |
| Program Services | $556,174 | ProgramServicesAmt |
| Management And General | $239,606 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $677,002 | TotalAmt |
| Program Services | $55,151 | ProgramServicesAmt |
| Management And General | $621,851 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,807 | TotalAmt |
| Management And General | $55,807 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,331 | TotalAmt |
| Management And General | $130,331 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,954 | TotalAmt |
| Management And General | $7,954 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,503 | TotalAmt |
| Program Services | $65,277 | ProgramServicesAmt |
| Management And General | $54,226 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,451 | TotalAmt |
| Management And General | $57,451 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,953,250 | TotalAmt |
| Program Services | $2,630,168 | ProgramServicesAmt |
| Management And General | $323,082 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,397,495 | TotalAmt |
| Program Services | $558,998 | ProgramServicesAmt |
| Management And General | $838,497 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,310 | TotalAmt |
| Program Services | $13,765 | ProgramServicesAmt |
| Management And General | $19,545 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,989 | TotalAmt |
| Program Services | $9,223 | ProgramServicesAmt |
| Management And General | $17,766 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $181,644 | TotalAmt |
| Management And General | $181,644 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,617,908 | TotalAmt |
| Program Services | $877,939 | ProgramServicesAmt |
| Management And General | $739,969 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,001 | TotalAmt |
| Management And General | $164,001 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PURCHASED SERVICES | $4,343,641 | $3,688,593 | $655,048 |
| BAD DEBT | $1,655,943 | $1,655,943 | |
| UTILITIES | $536,823 | $429,955 | $106,868 |
| OTHER DIRECT EXPENSE | $273,985 | $37,218 | $236,767 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,358,054 | TotalAmt |
| Program Services | $22,547,421 | ProgramServicesAmt |
| Management And General | $8,810,633 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,913,547 | BOYAmt |
| EOY | $9,578,353 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,022 | BOYAmt |
| EOY | $125,369 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $905,491 | BOYAmt |
| EOY | $501,666 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,218,737 | BOYAmt |
| EOY | $3,103,267 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $275,386 | BOYAmt |
| EOY | $333,081 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,152 | BOYAmt |
| EOY | $222,850 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $27,345,336 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $14,473,155 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,256,929 | BOYAmt |
| EOY | $12,872,181 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,916 | BOYAmt |
| EOY | $187,803 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,009,180 | BOYAmt |
| EOY | $26,924,570 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,906,580 | BOYAmt |
| EOY | $2,083,755 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,484,450 | BOYAmt |
| EOY | $4,013,879 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,023,963 | BOYAmt |
| EOY | $471,361 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,758 | BOYAmt |
| EOY | $32,758 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,447,751 | BOYAmt |
| EOY | $6,601,753 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,323,712 | BOYAmt |
| EOY | $20,089,702 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,027 | BOYAmt |
| EOY | $54,425 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $178,690 | BOYAmt |
| EOY | $178,690 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,561,429 | BOYAmt |
| EOY | $20,322,817 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,009,180 | BOYAmt |
| EOY | $26,924,570 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $763,197 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$1,809 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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 | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $7,954 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,954 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | IROQUOIS HEALTHCARE ALLIANCE ALLOCATED 36.5% OF DUES TOWARDS GENERAL LOBBYING ACTIVITIES. TOTAL DUES PAID IN 2016 WERE 8,286 HEALTHCARE ASSOCIATION OF NEW YORK ALLOCATED 23.7% OF DUES TOWARDS GENERAL LOBBYING ACTIVITIES. TOTAL DUES PAID IN 2016 WERE 6,577 AMERICAN HOSPITAL ASSOCIATION ALLOCATED 21.8% OF DUES TOWARDS GENERAL LOBBYING ACTIVITIES. TOTAL DUES PAID IN 2016 WERE 15,475 | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $303,712 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $348 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $304,059 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $303,365 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $347 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $303,712 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $302,994 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $371 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $303,365 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $302,360 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $634 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $302,994 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $301,615 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $745 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $302,360 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $33,584 | OtherCostOrOtherBasisAmt |
| Book Value | $33,584 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,458,869 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,762,246 | DepreciationAmt |
| Book Value | $9,696,623 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,852,883 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,710,909 | DepreciationAmt |
| Book Value | $3,141,974 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,872,181 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ASSET RETIREMENT OBLIGATIONS | Desc |
| Amt | $32,758 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $32,758 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $30,463,499 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$1,657,752 | OtherRevenueAmt |
| Revenue Not Reported | -$1,657,752 | RevenueNotReportedAmt |
| Revenue Subtotal | $32,121,251 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $32,121,251 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $29,702,111 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $29,702,111 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,655,943 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,655,943 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $31,358,054 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 2, PART V, LINE 4 | ENDOWMENT FUNDS OF 261,230 HELD WITH INTEREST EARNED ARE UNRESTRICTED FOR GENERAL HOSPITAL EXPENDITURES. ENDOWMENT FUNDS OF 42,829 WITH INTEREST EARNED ARE RESTRICTED TO NURSING SCHOLARSHIPS. |
| SCHEDULE D, PAGE 3, PART X | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE IRC. THE HOSPITAL RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE-LIKELY THAN-NOT THAT THE POSITION WILL SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL TAX LIABILITIES THAT NEED TO BE RECORDED AS OF DECEMBER 31, 2016 AND 2015. |
| SCHEDULE D, PAGE 4, PART XI, LINE 2D | BAD DEBT -1,655,943 CHANGE IN FOB -1,809 |
| SCHEDULE D, PAGE 4, PART XII, LINE 4B | BAD DEBT 1,655,943 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 3.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $135,940 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $76,706 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $59,234 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,884,751 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,050,535 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,834,216 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09040 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,020,691 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,127,241 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,893,450 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09230 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,487 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,487 | NetCommunityBenefitExpnsAmt |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,446,188 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,137,030 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $309,158 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00990 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,968 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $21,968 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,469,643 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,137,030 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $332,613 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01060 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,490,334 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,264,271 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,226,063 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10290 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $516,055 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $35,501 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,498,949 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,084,614 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$585,665 | 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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | 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 | BASSETT HOSPITAL OF SCHOHARIE CTY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 178 GRANDVIEW DRIVE | AddressLine1Txt |
| City | COBLESKILL | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12043 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 4720001H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BASSETT HOSPITAL OF SCHOHARIE CTY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.COBLESKILLHOSPITAL.ORG | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | WWW.BASSETT.ORG | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.COBLESKILLHOSPITAL.ORG | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | 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 (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.COBLESKILLHOSPITAL.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.COBLESKILLHOSPITAL.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.COBLESKILLHOSPITAL.ORG | 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 |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | 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 |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, BASSETT HOSPITAL OF SCHOHARIE CTY - PART V, LINE 5 | THIS COMMUNITY HEALTH NEEDS ASSESSMENT HAS TAKEN INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED BY BASSETT HOSPITAL OF SCHOHARIE COUNTY (BHSC). THIS INCLUDES INPUT FROM INDIVIDUALS WITH EXPERTISE IN PUBLIC HEALTH, SPECIFICALLY, THE DIRECTOR OF THE SCHOHARIE COUNTY DEPARTMENT OF HEALTH. IN ADDITION TO COMMUNITY COMMENTS AND INPUT GATHERED IN RESPONSE TO POSTING OF THE COMMUNITY HEALTH NEEDS ASSESSMENT ON THE HOSPITAL'S WEBSITE, THE PRIMARY PROACTIVE MEANS FOR RECEIVING COMMUNITY INPUT WAS THROUGH A COMMUNITY-WIDE STAKEHOLDER MEETING HELD AND HOSTED BY BHSC ON MARCH 15, 2015. THE PURPOSE OF THE STAKEHOLDER MEETING WAS THREEFOLD: 1) TO ELICIT GENERAL COMMENTS ON THE DRAFT CHNA; 2) TO SEEK COMMUNITY INPUT ON THE PRIORITY HEALTH NEEDS IDENTIFIED BY THE CHNA; AND 3) TO SEEK COMMUNITY INPUT ON POTENTIAL IMPLEMENTATION STRATEGIES. TWENTY-SIX INDIVIDUALS REPRESENTING 17 AREA HEALTH PROVIDER AND COMMUNITY SERVICE ORGANIZATIONS ATTENDED THE SESSION. IN ADDITION TO THE PROCESS AND COMMUNITY PARTICIPATION SPECIFICALLY USED IN DEVELOPING THIS COMMUNITY HEALTH ASSESSMENT, SIGNIFICANT PROCESSES AND COMMUNITY PARTICIPATION WERE INVOLVED IN COMPILING THE BHSC COMMUNITY SERVICE PLAN AND THE SCHOHARIE COUNTY HEALTH ASSESSMENT. EACH OF THESE EFFORTS INCLUDED THEIR OWN PROCESS AND METHODS OF IDENTIFYING COMMUNITY HEALTH NEEDS. EACH ALSO PROVIDED NUMEROUS OPPORTUNITIES FOR COMMUNITY INPUT AND PARTICIPATION IN REVIEWING AND INFLUENCING THE SELECTION OF PRIORITY HEALTH NEEDS. THE 2016-2018 COMMUNITY SERVICES PLAN (CSP) FOR BHSC WAS DEVELOPED AS PART OF A MULTI-HOSPITAL PLANNING PROCESS AMONG SIX HOSPITALS IN THE BASSETT HEALTHCARE NETWORK. THE DEVELOPMENT OF THE SCHOHARIE COUNTY COMMUNITY HEALTH ASSESSMENT (CCHA) 2016-2018 WAS COMPLETED IN CONJUNCTION WITH THE DEVELOPMENT OF THE COMMUNITY SERVICES PLAN BY BHSC. A WORK GROUP WAS FORMED WITH SEVERAL MEMBERS FROM BOTH THE HEALTH DEPARTMENT AND THE HOSPITAL, AS WELL AS COMMUNITY MEMBERS FORM OTHER AGENCIES, TO REVIEW DEMOGRAPHIC AND HEALTH STATUS INFORMATION, ASSESS COMMUNITY SERVICES AND ULTIMATELY SELECT PRIORITY AREAS FOR IMPROVING THE HEALTH STATUS OF SCHOHARIE COUNTY RESIDENTS. |
| FACILITY 1, BASSETT HOSPITAL OF SCHOHARIE CTY - PART V, LINE 6A | BASSETT MEDICAL CENTER, TRI TOWN REGIONAL HOSPITAL, COBLESKILL REGIONAL HOSPITAL, O'CONNOR HOSPITAL, LITTLE FALLS HOSPITAL, AND AO FOX MEMORIAL HOSPITAL. |
| FACILITY 1, BASSETT HOSPITAL OF SCHOHARIE CTY - PART V, LINE 6B | BASSETT MEDICAL CENTER, TRI TOWN REGIONAL HOSPITAL, COBLESKILL REGIONAL HOSPITAL, O'CONNOR HOSPITAL, LITTLE FALLS HOSPITAL, AND AO FOX MEMORIAL HOSPITAL. |
| FACILITY 1, BASSETT HOSPITAL OF SCHOHARIE CTY - PART V, LINE 11 | THE ORGANIZATION ADDRESSED SIGNIFICANT, PRIORITIZED HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA BY ADOPTION OF A BUDGET FOR PROVISION OF SERVICES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA, PRIORITIZATION OF HEALTH NEEDS IN ITS COMMUNITY, AND PRIORITIZATION OF SERVICES THAT THE HOSPITAL FACILITY WILL UNDERTAKE TO MEET HEALTH NEEDS IN ITS COMMUNITY. FOR NEEDS NOT ADDRESSED AS A COLLABORATIVE, WE ADDRESS SOME AS AN INDIVIDUAL ORGANIZATION AND ALSO CONTINUE TO REPRIORITIZE HIGHEST DEMAND. |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE | BASSETT HOSPITAL OF SCHOHARIE COUNTY (BHSC) IS A NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT RENDERS MEDICAL CARE TO ALL PERSONS IN NEED OF SUCH CARE, REGARDLESS OF THEIR ABILITY TO PAY. TO SUPPORT PATIENTS WHO MAY HAVE DIFFICULTY PAYING THEIR MEDICAL BILLS, THE COMMUNITY SERVICE PROGRAM (CSP) IS AVAILABLE. UNDER THE HOSPITAL POLICY GOVERNING THE CSP, BASSETT HOSPITAL OF SCHOHARIE COUNTY PROVIDES A LEVEL OF UNCOMPENSATED CARE EACH YEAR TO PERSONS UNABLE TO PAY THE TOTAL COST OF THE HOSPITAL SERVICES RENDERED. CSP ELIGIBILITY IS LIMITED TO SERVICES FOR THOSE PERSONS WHO ARE DETERMINED INELIGIBLE FOR MEDICAID WITHIN 60 DAYS PRIOR TO THE APPLICATION AND WHOSE ANNUAL FAMILY GROSS INCOME, AS DETERMINED BY AN APPLICATION FOR MEDICAID WITHIN THE SIX MONTHS PRIOR TO AN APPLICATION, DOES NOT EXCEED 300% OF THE FEDERAL POVERTY INCOME GUIDELINES, WHICH ARE UPDATED ANNUALLY. AN APPLICATION FOR THE CSP FREE CARE REQUIRES VERIFICATION OF INCOME FOR THE SIX MONTHS IMMEDIATELY PRECEDING THE APPLICATION AND, IF FAMILY INCOME IS BELOW THE MEDICAID GUIDELINES, A MEDICAID APPLICATION IS ALSO REQUIRED. |
| PART I, LINE 6A - RELATED ORGANIZATION INFORMATION | THE BASSETT HOSPITAL OF SCHOHARIE COUNTY COMMUNITY BENEFITS REPORT IS CONTAINED IN A REPORT PREPARED BY BASSETT HEALTHCARE NETWORK. |
| PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION | FOR PATIENTS, OR GUARANTORS , WHO DO NOT QUALIFY FOR COMPLETE CHARITY CARE ASSISTANCE, THE HOSPITAL MUST UNDERTAKE TO ENSURE UNDERSTANDING OF OBLIGATIONS AND SATISFACTION OF OBLIGATIONS. THE HOSPITAL EMPLOYS A THIRD-PARTY SELF-PAY BILLING AGENCY, IN COMPLIANCE WITH EXISTING LAWS AND REGULATIONS, TO RECOVER SELF-PAY ACCOUNTS RECEIVABLE, PRESERVE THE PATIENT-PROVIDER RELATIONSHIP TO THE MAXIMUM EXTENT POSSIBLE, AND KEEP THE NECESSITY OF REFERRING ACCOUNTS TO THIRD PARTY BAD DEBT COLLECTION OR LAW FIRMS TO A MINIMUM. THIS AGENCY IS MEDICAL SELF-PAY ACCOUNTS RECEIVABLE SERVICES, LLC (MEDSPAR). AS A STRICTURE OF THE HOSPITAL'S UNIFIED CHARITY CARE, SELF-PAY BILLING & COLLECTION POLICY, BASSETT HOSPITAL OF SCHOHARIE COUNTY MUST ENSURE THAT BAD DEBT COLLECTION POLICIES OF ANY THIRD-PARTY AGENCY RETAINED FOR OUTSIDE DEBT COLLECTION REFLECT THE MISSION AND VALUES OF THE HOSPITAL, AS WELL AS REFRAIN FROM ANY CONDUCT THAT VIOLATES THE FAIR DEBT COLLECTION PRACTICES ACT, THE FAIR CREDIT REPORTING ACT, AS WELL AS ANY APPLICABLE STATE LAW OR REGULATIONS. UNDER THE MEDSPAR CREDIT AND COLLECTION POLICY (DOC. NO. 1), RESPONSIBLE PARTIES PLEADING INDIGENCE OR INABILITY TO ESTABLISH AN INSTALLMENT PLAN MUST COMPLETE AN APPLICATION FOR THE HOSPITAL'S CHARITY CARE OR COMMUNITY SERVICES PROGRAM. THE PATIENT WILL BE FORWARDED THE APPLICATION AND INFORMED THAT THEIR ACCOUNTS WILL BE TEMPORARILY SUSPENDED FROM FURTHER BILLING FOR 30 DAYS. THE RESPONSIBLE PARTY MAY MAKE INTEREST FREE MONTHLY INSTALLMENT PAYMENTS NOT TO EXCEED 10 PERCENT OF GROSS MONTHLY INCOME (WHICH MUST BE VERIFIED BY A COPY OF A CURRENT PAYSTUB OR EQUIVALENT PROOF OF INCOME), ACCORDING TO A SET SCHEDULE BASED ON ACCOUNT BALANCE AND MAXIMUM NUMBER OF MONTHS IN WHICH INSTALLMENTS MUST BE MADE. |
| ADDITIONAL INFORMATION | PART I, LINE 7 FOR SECTIONS (A) CHARITY CARE AT COST, (B) UNREIMBURSED MEDICAID, (F) HEALTH PROFESSIONS EDUCATION, THE COSTING METHODOLOGY APPLIED IS A COST-TO-CHARGE RATIO CALCULATION, AS USED ON FILED STATE AND FEDERAL COST REPORTS. INDIRECT COSTS WERE APPLIED TO SUBSIDIZED HEALTH SERVICES, SECTIONS (E)COMMUNITY HEALTH IMPROVEMENT; PORTIONS OF (F) HEALTH PROFESSIONS EDUCATION, AND (I) CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS, WHICH INCLUDE THE DIRECT SALARY COSTS FOR HOSPITAL STAFF WHOSE TIME WAS COMPENSATED BY THE HOSPITAL FOR TIME SPENT PARTICIPATING IN ACTIVITIES THAT QUALIFY AS COMMUNITY BENEFITS PLUS THE CURRENT FISCAL YEAR FICA RATE. PART I, LINE 7, COLUMN (F) IS CALCULATED BY DIVIDING COLUMN (E), NET COMMUNITY BENEFIT EXPENSE, BY TOTAL EXPENSE. THE BAD DEBT EXPENSE OF 1,655,943 WAS SUBTRACTED FROM THE TOTAL EXPENSE VALUE USED TO CALCULATE THE PERCENTAGES IN PART 1, LINE 7, COLUMN F. PART II ALL COMMUNITY BUILDING ACTIVITIES COULD BE CLASSIFIED UNDER PART I, LINE 7 AND ARE HIGHLIGHTED IN ITEM NUMBER 1 ABOVE. THE HOSPITAL HAS REPRESENTATION ON THE BOARD OF DIRECTORS FOR THE MOHAWK VALLEY POPULATION HEALTH IMPROVEMENT PROGRAM (PHIP) WHICH SERVES SCHOHARIE, FULTON, MONTGOMERY, HERKIMER, AND OTSEGO COUNTIES. THE MOHAWK VALLEY PHIP PROVIDES A FORUM IN WHICH STAKEHOLDERS INCLUDING COUNTY HEALTH DEPARTMENTS, HOSPITALS, INSURERS, AGENCIES AND A WIDE RANGE OF OTHER INTERESTED PARTIES CAN REVIEW THE REGION'S HEALTH STATUS AND DEFINE KEY PRIORITY AREAS. DECISIONS ARE BASED UPON INFORMATION RELATING TO THESE COUNTIES DERIVED FROM EXTENSIVE DATA GATHERING AND ANALYSES BY BASSETT HEALTHCARE NETWORK'S RESEARCH INSTITUTE. THE MOHAWK VALLEY PHIP PROMOTES THE TRIPLE AIM THROUGH REGIONAL EFFORTS THAT REFLECT LOCAL NEEDS, ASSETS AND CAPABILITIES. THE GOAL IS TO IMPROVE POPULATION HEALTH THROUGH STAKEHOLDER COLLABORATION, DATA-DRIVEN PRIORITIZATION , AND REGIONAL OR LOCAL STRATEGIES FOR ADDRESSING HEALTH DISPARITIES THAT ARE CONSISTENT WITH THE GOALS OF THE STATEWIDE PREVENTION AGENDA AND THE STATE HEALTH IMPROVEMENT PLAN. THE MOHAWK VALLEY PHIP STIMULATES AND SUPPORTS STRATEGIC PLANNING FOR IDENTIFYING, SHARING, DISSEMINATING AND HELPING TO IMPLEMENT BEST PRACTICES AND LOCAL STRATEGIES THAT PROMOTE POPULATION HEALTH AND REDUCE HEALTH CARE DISPARITIES IN THE FIVE COUNTY REGION. ADDITIONALLY, THE HOSPITAL HAS A PARTICIPATING ROLE WITH THE LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS, A NEW YORK STATE INITIATIVE TO BETTER THE HEALTH CARE DELIVERY, WHICH WAS FORMED BY PROVIDERS FROM SCHOHARIE, OTSEGO, MADISON, HERKIMER AND DELAWARE COUNTIES. THE MISSION IS TO BUILD A HIGH-PERFORMING INTEGRATED DELIVERY SYSTEM AND TRANSFORM HEALTH CARE DELIVERY IN THE REGION TO ACHIEVE DELIVERY SYSTEM REFORM INCENTIVE (DSRIP) PROGRAM GOALS. OF SPECIFIC FOCUS IS THE TOBACCO CESSATION PROJECT (PROJECT ID: 4.B .I) THAT PROMOTES TOBACCO USE CESSATION , ESPECIALLY AMONG LOW SES POPULATIONS AND THOSE WITH POOR MENTAL HEALTH (FOCUS AREA 2: GOAL 2.2). THE OBJECTIVE IS TO DECREASE THE PREVALENCE OF CIGARETTE SMOKING BY ADULTS 18 AND OLDER, AND INCREASE USE OF TOBACCO CESSATION SERVICES INCLUDING NYS SMOKERS' QUITLINE AND NICOTINE REPLACEMENT PRODUCTS. THE HOSPITAL'S COMMUNITY BUILDING ACTIVITIES ALSO FOCUSED ON REPRESENTATION TO COMMUNITY COALITIONS RELATED TO IDENTIFIED COMMUNITY HEALTH PRIORITIES; ON COSTS OF COALITION MEETINGS; AND ON PARTICIPATION WITH A SMALL BUSINESS/ECONOMIC DEVELOPMENT ORGANIZATION CALLED COBLESKILL PARTNERSHIP INC. (CPI), WHICH ADDRESSES THE HOSPITAL NEIGHBORHOOD IN DOWNTOWN COBLESKILL. PART III, LINES 2, 3 & 4 BASSETT HOSPITAL OF SCHOHARIE COUNTY USES THE RATIO OF COST-TO-CHARGES METHODOLOGY FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES . THE DESCRIPTION OF HOW THE ORGANIZATION ACCOUNTS FOR DISCOUNTS AND FOR PAYMENTS ON PATIENT ACCOUNTS IN DETERMINING BAD DEBT EXPENSE IS CONTAINED IN THE TEXT OF THE FOLLOWING AUDITED FINANCIAL STATEMENT FOOTNOTE; ALSO INCLUDED IN THIS FOOTNOTE IS THE DESCRIPTION OF THE METHOD THE ORGANIZATION USES TO DETERMINE THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY, IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO MAKE A DETERMINATION OF THEIR ELIGIBILITY. FOOTNOTE TEXT: THE HOSPITAL HAS ADOPTED A FORMAL CHARITY CARE POLICY WHEREBY PATIENTS IN NEED OF MEDICAL SERVICES, WHO MEET CERTAIN CRITERIA UNDER THE POLICY, ARE TREATED WITHOUT REGARD TO THEIR ABILITY TO PAY FOR SUCH SERVICES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THE LEVEL OF CHARITY CARE, MEASURED ON THE BASIS OF ESTABLISHED COSTS, IS APPROXIMATELY 59,000 AND 58,000 FOR 2016 AND 2015, RESPECTIVELY. THE COST OF CHARITY CARE PROVIDED WAS DETERMINED BASED ON THE APPLICATION OF A RATIO TO OVERALL HOSPITAL COSTS TO PATIENT CHARGES. IN ADDITION, THE COST OF UNREIMBURSED MEDICAID SERVICES WAS APPROXIMATELY 2,834,000 IN 2016 AND 2,089,000 IN 2015. THE COST OF UNREIMBURSED MEDICAID IS DETERMINED BASED ON THE APPLICATION OF A COST TO GROSS CHARGE RATIO TO TOTAL MEDICAID CHARGES. INCLUDED IN NET PATIENT SERVICE REVENUE FOR 2016 AND 2015 IS APPROXIMATELY 767,000 AND 843,000, RESPECTIVELY, FROM STATEWIDE UNCOMPENSATED CARE POOLS AND INCOME FROM RESTRICTED ENDOWMENTS TO OFFSET A PORTION OF THE COST OF CHARITY CARE. THESE UNCOMPENSATED CARE POOLS ARE DESIGNED TO HELP OFFSET THE COST OF CHARITY CARE AND UNREIMBURSED MEDICAID SERVICES. PART III, LINE 8 BASSETT HOSPITAL OF SCHOHARIE COUNTY USED MEDICARE-APPROVED COSTS FROM THE 2016 MEDICARE COST REPORT, WHICH EMPLOY A COST-TO-CHARGE RATIO METHODOLOGY. THE HOSPITAL DID NOT DESIGNATE THE SHORTFALL REPORTED IN PART III, LINE 7 TOWARD COMMUNITY BENEFIT. PART VI - QUESTION 2 - NEED ASSESSMENT IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), A VARIETY OF DATA ARE USED REGULARLY TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITY SERVED BY BASSETT HOSPITAL OF SCHOHARIE COUNTY, INCLUDING DATA FROM PATIENT SATISFACTION SURVEYS, THE NYS DEPARTMENT OF HEALTH, THE SCHOHAR IE COUNTY BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, THE SCHOHARIE 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 SETTING LOCAL/REGIONAL PRIORITIES. THE PREVENTION AGENDA ALSO IDENTIFIES A COMMON SET OF HEALTHCARE PRIORITIES FROM WHICH HOSPITALS AND COUNTY HEALTH DEPARTMENTS IN NEW YORK STATE ARE EXPECTED TO CHOOSE WHEN DEVELOPING IMPLEMENTATION STRATEGIES FOR ADDRESSING COMMUNITY HEALTHCARE NEEDS. COMMUNITY PARTNERS INVOLVED IN ASSESSING COMMUNITY HEALTH NEEDS IN SCHOHARIE COUNTY INCLUDED: SCHOHARIE COUNTY HEALTH DEPARTMENT; BASSETT PRIMARY CARE GROUP; COMMUNITY-BASED ORGANIZATIONS; AND COUNTY SOCIAL SERVICE, MENTAL HEALTH, YOUTH AND AGING AGENCIES. BASSETT HOSPITAL OF SCHOHARIE COUNTY CONTRACTS WITH 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 RECEIVED 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 SCHOHAR IE COUNTY. IT IS A COLLABORATIVE EFFORT BETWEEN THE RESEARCH INSTITUTE, COUNTY HEALTH DEPARTMENTS, AND REGIONAL COMMUNITY SERVICES ORGANIZATIONS. PART VI - QUESTION 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE BASSETT HOSPITAL OF SCHOHARIE COUNTY (BHSC) IS A NOT-FOR-PROFIT HEALTHCARE O |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL TENGERES | |||||||||||
| TRUSTEE | $399,917 | $30,000 | $1,157 | $431,074 | |||||||
| JOSEPH SELLERS MD | |||||||||||
| TRUSTEE | $267,175 | $9,405 | $1,064 | $309,310 | $1,960 | $29,706 | |||||
| ERIC STEIN | |||||||||||
| PRESIDENT & CEO | $181,423 | $14,656 | $4,862 | $217,109 | $16,168 | ||||||
| SUSAN OAKES FERRUCCI | |||||||||||
| VICE PRESIDENT & CNO | $153,003 | $3,266 | $10,276 | $166,545 | |||||||
| LEANNA JENSEN | |||||||||||
| VICE PRESIDENT & CFO | $160,230 | $3,220 | $164,224 | $774 | |||||||
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PAGE 1, PART I, LINE 3 | THE CHIEF EXECUTIVE OFFICER'S SALARY IS PAID BY A RELATED ORGANIZATION UNDER A MANAGEMENT SERVICES AGREEMENT. THE BASSETT HOSPITAL OF SCHOHARIE COUNTY REVIEWS THE FORMAL PROCESS THAT IS USED TO DETERMINE THE BASE COMPENSATION OF THE CEO. THE CEO WORK PLAN AND ACCOMPLISHMENTS FOR THE YEAR ARE REVIEWED. SALARY CHANGES ARE BASED ON MARKET, WORK PLAN, AND ACCOMPLISHMENTS. THE CEO'S SALARY IS SUBMITTED AS PART OF THE MANAGEMENT SERVICES AGREEMENT WHICH IS APPROVED BY THE BOARD. |
| SCHEDULE J, PAGE 1, PART I, LINE 7 | NON FIXED PAYMENTS ARE MADE BASED ON THE SUCCESS IN MEETING PERFORMANCE CRITERIA THAT ARE PROSPECTIVELY AGREED UPON AS GOALS FOR THE OFFICERS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 IS REVIEWED BY THE EXECUTIVE FINANCE COMMITTEE, WHICH HAS BEEN ASSIGNED THAT RESPONSIBILITY BY THE BOARD OF TRUSTEES. ALL TRUSTEES ARE MADE AWARE THAT THE 990 IS AVAILABLE FOR REVIEW IN THE ADMINISTRAIVE OFFICE UPON REQUEST. |
| FORM 990, PAGE 6, PART VI, LINE 12C | MEMBERS OF THE BOARD COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. A SUMMARY OF RESULTS IS REPORTED EACH YEAR AT THE ANNUAL MEETING OF THE BOARD OF TRUSTEES. |
| FORM 990, PAGE 6, PART VI, LINE 15A | ANNUAL REVIEW IS DONE BY THE ASSESSMENT OF PRESIDENT/CEO'S PERFORMANCE BY EACH MEMBER OF THE BOARD OF TRUSTEES, SENIOR MANAGEMENT, ADMINISTRATIVE AND CLINICAL LEADERSHIP, AND ACTIVE MEDICAL STAFF. THE ASSESSMENT TOOL ADDRESSES PERFORMANCE MEASURES THAT RELATE TO THE ORGANIZATION'S MISSION AND STRATEGY THAT IS IDENTIFIED IN THE INSTITUTION'S ANNUAL OPERATING PLAN AND BY SPECIFIC ITERATION BY THE BOARD OF TRUSTEES. INFORMATION RECEIVED IS SUMMARIZED AND PRESENTED TO THE EXECUTIVE AND FINANCE COMMITTEE FOR REVIEW AND CONCLUSION. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC BY REQUEST OF THE ADMINISTRATIVE OFFICE. |
| FORM 990, PART XI, LINE 9 | BAD DEBT -1,655,943 CHANGE IN FOB -1,809 BAD DEBT 1,655,943 TOTAL -1,809 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 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 OR | NY | 501C3 | 12C | NA | false |
| FRIENDS OF BASSETT | ||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 237041610 | CONTRIBUTI | NY | 501C3 | 7 | BHN | false |
| MARY IMOGENE BASSETT HOSPITAL | ||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 135596796 | HEALTHCARE | NY | 501C3 | 3 | BHN | false |
| AO FOX MEMORIAL HOSPITAL | ||||||||||
| ONE NORTON AVE | ONEONTA | NY | 13820 | 150539039 | HEALTHCARE | NY | 501C3 | 3 | BHN | false |
| TEMPLETON FOUNDATION | ||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 133317084 | REAL ESTAT | NY | 501C3 | 10 | BHN | false |
| BASSETT REGIONAL CORPORATION | ||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 133522783 | POLICIES | NY | 501C3 | 12B | BHN | false |
| O'CONNOR HOSPITAL | ||||||||||
| 460 ANDES ROAD | DELHI | NY | 13753 | 161540394 | HEALTHCARE | NY | 501C3 | 3 | BRC | false |
| TRI TOWN REGIONAL HEALTHCARE | ||||||||||
| 43 PEARL STREET | SIDNEY | NY | 13838 | 260169584 | HEALTHCARE | NY | 501C3 | 3 | BRC | false |
| LITTLE FALLS HOSPITAL | ||||||||||
| 140 BURWELL STREET | LITTLE FALLS | NY | 13365 | 150533578 | HEALTHCARE | NY | 501C3 | 3 | BRC | false |
| VALLEY HEALTH SERVICES | ||||||||||
| 690 WEST GERMAN STREET | HERKIMER | NY | 13350 | 222511614 | HEALTHCARE | NY | 501C3 | 3 | BRC | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (true) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R | FormAndLineReferenceDesc |
| Explanation | BASSETT REGIONAL CORPORATION IS LISTED AS BRC FOR THE CONTROLLING ENTITY DUE TO SPACE CONTRAINTS. IN 2017, THURSTON CORPORATION COMPLETED A NAME CHANGE TO BASSETT HEALTHCARE NETWORK AND IS LISTED AS BHN FOR THE CONTROLLING ENTITY DUE TO SPACE CONSTRAINTS. | ExplanationTxt |