BASSETT HOSPITAL OF SCHOHARIE COUNTY: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: BASSETT HOSPITAL OF SCHOHARIE COUNTY (EIN 14-1772971)
Tax period: 2015-01-01 to 2015-12-31
Filed: 2016-11-14
IRS object ID: 201623199349308192
Schema version: 2015v2.1
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	2016-11-14T14:43:47-06:00	ReturnTs
Tax Period End	2015-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

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	2015-01-01	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 County	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% LEANNA JENSEN VP FINANCE/CF	InCareOfNm
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 H STEIN	PersonNm
Person Title	PRESIDENT/CEO	PersonTitleTxt
Phone	5182543456	PhoneNum
Signature	2016-11-14	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	todd p teresco	PreparerPersonNm
PTIN	P00247720	PTIN
Phone	5184274600	PhoneNum

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2017-02-10 21:41:12Z	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 h stein presidentceo	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	$29,944,030	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	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	303	TotalEmployeeCnt
Total Volunteers	35	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$548,272	PYContributionsGrantsAmt
CY Contributions Grants	$528,676	CYContributionsGrantsAmt
PY Program Service Revenue	$28,803,991	PYProgramServiceRevenueAmt
CY Program Service Revenue	$28,289,321	CYProgramServiceRevenueAmt
PY Investment Income	$24,951	PYInvestmentIncomeAmt
CY Investment Income	$13,081	CYInvestmentIncomeAmt
PY Other Revenue	$1,524,298	PYOtherRevenueAmt
CY Other Revenue	$1,092,688	CYOtherRevenueAmt
PY Total Revenue	$30,901,512	PYTotalRevenueAmt
CY Total Revenue	$29,923,766	CYTotalRevenueAmt
PY Grants And Similar Paid	$2,000	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	$15,920,410	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$16,101,631	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$12,809,719	PYOtherExpensesAmt
CY Other Expenses	$12,765,176	CYOtherExpensesAmt
PY Total Expenses	$28,732,129	PYTotalExpensesAmt
CY Total Expenses	$28,866,807	CYTotalExpensesAmt
PY Revenues Less Expenses	$2,169,383	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$1,056,959	CYRevenuesLessExpensesAmt
Total Assets BOY	$22,474,508	TotalAssetsBOYAmt
Total Assets EOY	$27,009,180	TotalAssetsEOYAmt
Total Liabilities BOY	$3,936,969	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$7,447,751	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$18,537,539	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$19,561,429	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	$20,353,361	ExpenseAmt
Revenue	$28,289,321	RevenueAmt
Desc	PROVISION OF HOSPITAL CARE TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING AREA. IN 2015, THE NUMBER OF INPATIENTS CARED FOR WAS 663 AND THE NUMBER OF OUTPATIENTS CARED FOR WAS 66,192.	Desc
Total Program Service Expenses	$20,353,361	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	103	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	303	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	LEANNA JENSEN VP FINANCECF	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	120435144	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (25 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
NANCY BELLINGER
Trustee	1.0	0.0	Yes (X)	$0	$0	$0
PAUL J BRADY
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
MICHAEL BREEN
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
EDWIN KINTZ
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
STEVEN KROLL
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
HENRY LAMONT
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
PETER D LOPEZ
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
CARL J MUMMENTHY
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
GARTH ROBERTS
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
RENEE SCIALDO SHEVAT PHD
TRUSTEE	1.0	0.0	Yes (X)	$0	$0	$0
JOSEPH R SELLERS MD FACP
TRUSTEE	1.0	40.0	Yes (X)	$0	$266,762	$17,669
MICHAEL J TENGERES
TRUSTEE	2.0	40.0	Yes (X)	$0	$316,107	$1,538
MACDONALD J HOLMES DVM
TRUSTEE EMERITUS	1.0	0.0	Yes (X)	$0	$0	$0
SUSAN K MCGIVER
TRUSTEE EMERITA	1.0	0.0	Yes (X)	$0	$0	$0
TIMOTHY H SWEENEY
TRUSEE EMERITUS	1.0	0.0	Yes (X)	$0	$0	$0
BARBARA E DICOCCO
CHAIR	1.0	2.5	Yes (X)	$0	$0	$0	Yes (X)
ANNE CALDWELL MYERS PHD
VICE CHAIR	1.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
GEORGE P KONTA
TREASURER	1.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
GLENN A PERRONE
SECRETARY	1.0	0.0	Yes (X)	$0	$0	$0	Yes (X)
ERIC H STEIN
PRESIDENT/CEO	0.0	40.0		$0	$192,681	$16,837	Yes (X)
LEANA I JENSEN
VP FINANCE/CFO	38.0	0.0		$139,505	$0	$9,320		Yes (X)
SUSAN OAKES-FERRUCCI
VP PATIENT SERVICES/CNO	38.0	0.0		$154,240	$0	$15,409		Yes (X)
MARY MALOY
DIRECTOR OF REVENUE CYCLE	38.0	0.0		$106,718	$0	$8,663		Yes (X)
DAVID DESANDO
DIRECTOR OF PHARMACY	38.0	0.0		$137,207	$0	$9,113		Yes (X)
CHRISTOPHER MANLEY
STAFF PHARMACIST	38.0	0.0		$108,361	$0	$14,491		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$646,031	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$775,550	TotReportableCompRltdOrgAmt
Total Other Compensation	$93,040	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	7	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
MCCARTHY HOLDINGS
1341 NORTH ROCK HILL ROAD	ST LOUIS	MO	63124	CONSTRUCTION SVCS.	$3,732,676
MEDICAL STAFFING NETWORK
6551 PARK OF COMMERCE BLVD	BOCA RATON	FL	33487	CONTRACT STAFFING	$360,836
STAT STAFF PROFESSIONALS
18 DIVISION ST SUITE 311	BALLSTON SPA	NY	12866	CONTRACT STAFFING	$243,523
TOP ECHELON CONTRACTING INC
4883 DRESLER RD NW SUITE 200	CANTON	OH	47718	CONTRACT STAFFING	$229,479
ATRION NETWORKING CORPORATION
125 METRO CENTER BLVD	WARWICK	RI	02886	IT SERVICES	$126,734

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	5	CntrctRcvdGreaterThan100KCnt
Related Organizations	$286,878	RelatedOrganizationsAmt
Government Grants	$240,845	GovernmentGrantsAmt
All Other Contributions	$953	AllOtherContributionsAmt
Total Contributions	$528,676	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	NET PATIENT SERVICE REVENUE	Desc
Business	900099	BusinessCd
Total Revenue Column	$28,289,321	TotalRevenueColumnAmt
Related Or Exempt Func Income	$28,289,321	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$28,289,321	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$14,631	TotalRevenueColumnAmt
Exclusion	$14,631	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$18,714	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$20,264	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$1,550	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$1,550	TotalRevenueColumnAmt
Exclusion	-$1,550	ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
OTHER OPERATING REVENUE	900099	$873,773	$873,773
COFFEE SHOP REVENUE	900099	$69,430	$69,430
LIFELINE REVENUE	900099	$93,435	$93,435

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$56,050	TotalRevenueColumnAmt
Exclusion	$56,050	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,092,688	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$29,923,766	TotalRevenueColumnAmt
Related Or Exempt Func Income	$28,289,321	RelatedOrExemptFuncIncomeAmt
Exclusion	$1,105,769	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$13,674,444	TotalAmt
Program Services	$10,008,311	ProgramServicesAmt
Management And General	$3,666,133	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$180,166	TotalAmt
Program Services	$124,967	ProgramServicesAmt
Management And General	$55,199	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,496,488	TotalAmt
Program Services	$1,034,033	ProgramServicesAmt
Management And General	$462,455	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$750,533	TotalAmt
Program Services	$524,551	ProgramServicesAmt
Management And General	$225,982	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$658,856	TotalAmt
Program Services	$53,049	ProgramServicesAmt
Management And General	$605,807	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$53,681	TotalAmt
Management And General	$53,681	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$125,365	TotalAmt
Management And General	$125,365	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$8,614	TotalAmt
Management And General	$8,614	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$114,950	TotalAmt
Program Services	$62,790	ProgramServicesAmt
Management And General	$52,160	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$55,048	TotalAmt
Management And General	$55,048	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,682,915	TotalAmt
Program Services	$2,289,304	ProgramServicesAmt
Management And General	$393,611	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,313,339	TotalAmt
Program Services	$523,383	ProgramServicesAmt
Management And General	$789,956	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$59,566	TotalAmt
Program Services	$10,616	ProgramServicesAmt
Management And General	$48,950	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$39,085	TotalAmt
Program Services	$8,129	ProgramServicesAmt
Management And General	$30,956	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$76,337	TotalAmt
Management And General	$76,337	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,507,555	TotalAmt
Program Services	$818,057	ProgramServicesAmt
Management And General	$689,498	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$163,648	TotalAmt
Management And General	$163,648	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
BAD DEBTS	$1,194,180	$1,194,180
PURCHASED SERVICES	$3,830,871	$3,176,442	$654,429
UTILITIES	$610,055	$501,701	$108,354
OTHER DIRECT EXPENSES	$78,569	$8,226	$70,343

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$192,542	TotalAmt
Program Services	$15,622	ProgramServicesAmt
Management And General	$176,920	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$28,866,807	TotalAmt
Program Services	$20,353,361	ProgramServicesAmt
Management And General	$8,513,446	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$9,341,260	BOYAmt
EOY	$9,913,547	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$124,675	BOYAmt
EOY	$125,022	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$326,320	BOYAmt
EOY	$905,491	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$2,650,080	BOYAmt
EOY	$2,218,737	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	$190,141	BOYAmt
EOY	$275,386	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$166,920	BOYAmt
EOY	$125,152	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$26,668,316	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$13,411,387	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$9,460,799	BOYAmt
EOY	$13,256,929	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	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	$214,313	BOYAmt
EOY	$188,916	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$22,474,508	BOYAmt
EOY	$27,009,180	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$2,518,694	BOYAmt
EOY	$1,906,580	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	$153,225	BOYAmt
EOY	$4,484,450	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$1,232,292	BOYAmt
EOY	$1,023,963	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	$3,936,969	BOYAmt
EOY	$7,447,751	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$18,241,356	BOYAmt
EOY	$19,323,712	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$117,493	BOYAmt
EOY	$59,027	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	$18,537,539	BOYAmt
EOY	$19,561,429	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$22,474,508	BOYAmt
EOY	$27,009,180	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$1,056,959	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$33,069	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
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)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
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	$8,614	OtherActivitiesAmt
Total Lobbying Expenditures	$8,614	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind
Form4720 Filed4912 Tax	false	Form4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Number 1i	FormAndLineReferenceDesc
Explanation	Iroquois Healthcare Alliance dues allocate 36.3% towards general lobbying activities. Total dues paid in 2015 - $7,773.00. Healthcare Association of New York State dues allocate 28.03% towards general lobbying activities. Total dues paid in 2015 - $15,936.00. American Hospital Association dues allocate 22.12% towards general lobbying activities. Total dues paid in 2015 - $5,992.70.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$301,615	BeginningYearBalanceAmt
Investment Earnings Or Losses	$745	InvestmentEarningsOrLossesAmt
End Year Balance	$302,360	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$300,787	BeginningYearBalanceAmt
Investment Earnings Or Losses	$828	InvestmentEarningsOrLossesAmt
End Year Balance	$301,615	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	$17,236,314	OtherCostOrOtherBasisAmt
Depreciation	$7,025,249	DepreciationAmt
Book Value	$10,211,065	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$9,398,418	OtherCostOrOtherBasisAmt
Depreciation	$6,386,138	DepreciationAmt
Book Value	$3,012,280	BookValueAmt

Field	Value	IRS element (for citing)
Other Land Buildings		OtherLandBuildingsGrp
Total Book Value Land Buildings	$13,256,929	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

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	$28,729,586	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	-$1,194,180	OtherRevenueAmt
Revenue Not Reported	-$1,194,180	RevenueNotReportedAmt
Revenue Subtotal	$29,923,766	RevenueSubtotalAmt
Total Revenue Per Form990	$29,923,766	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$27,705,696	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$33,069	OtherExpensesIncludedAmt
Expenses Not Reported	$33,069	ExpensesNotReportedAmt
Expenses Subtotal	$27,672,627	ExpensesSubtotalAmt
Other Expenses Not Included	$1,194,180	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$1,194,180	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$28,866,807	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part V, Line 4	ENDOWMENT FUNDS OF $260,969 HELD WITH INTEREST EARNED UNRESTRICTED FOR GENERAL HOSPITAL EXPENDITURES. ENDOWMENT FUNDS OF $42,743 WITH INTEREST EARNED TO BE USED FOR NURSING SCHOLARSHIPS.
Part X, Line 2	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 be 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, 2015 and 2014.
Part XI, Line 2d	BAD DEBT - $1,194,180
Part XII, line 2d	CHANGE IN INTEREST IN NET ASSETS OF FRIENDS OF BASSET - $33,069
Part XII, Line 4b	BAD DEBT - $1,194,180

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	300.	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	$153,467	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$83,519	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$69,948	NetCommunityBenefitExpnsAmt
Total Expense	0.00250	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,678,912	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,559,035	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,119,877	NetCommunityBenefitExpnsAmt
Total Expense	0.07660	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,832,379	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,642,554	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,189,825	NetCommunityBenefitExpnsAmt
Total Expense	0.07910	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,414	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,414	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,079,935	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,785,973	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$293,962	NetCommunityBenefitExpnsAmt
Total Expense	0.01060	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,520	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$21,520	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,102,869	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,785,973	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$316,896	NetCommunityBenefitExpnsAmt
Total Expense	0.01140	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,935,248	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,428,527	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,506,721	NetCommunityBenefitExpnsAmt
Total Expense	0.09050	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,778	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,778	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,778	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,778	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$531,381	BadDebtExpenseAmt
Bad Debt Expense Attributable	$37,710	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$6,248,882	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$6,812,012	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$563,130	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 COUNTY	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
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	BASSETT HOSPITAL OF SCHOHARIE COUNTY	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
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	13	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	13	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	www.cobleskillhospital.org	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
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.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	0.	FPGFamilyIncmLmtDscntCarePct
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
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
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION B, QUESTION 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 NOVEMBER 15, 2012. 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 SPECIFIALLY 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 2010-2012 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) 2010-2013 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.
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.
Part V, Line 11	ALL OF THE COMMUNITY HEALTH ASSESSMENT NEEDS ARE LONG TERM GOALS AND ARE ACTIVELY BEING WORKED ON.
PART I, LINE 22	BASSETT HOSPITAL OF SCHOHARIE COUNTY RECOGNIZES THAT SERVICES WILL BE PROVIDED EQUALLY TO ALL PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY FOR SUCH SERVICES. CHARGE SCHEDULES ARE, THEREFORE, UNIFORM. BILLINGS TO PATIENTS ARE BASED ON THESE CHARGE SCHEDULES.

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 3C	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	The Bassett Hospital of Schoharie County community benefits report is contained in a report prepared by Bassett Healthcare Network.
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 1, Line 7, column (f) is calculated by dividing column (e), net community benefit expense, by total expense. The bad debt expense of $1,194,180 was subtracted from the total expense value used to calculate the percentages in Part 1, Line 7, Column f.
Part II	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 charges foregone for services and supplies furnished during 2015 were approximately $130,000. The Hospital grants credit without collateral to patients, most of whom are local residents and are insured under third-party agreements. Additions to the allowance for estimated uncol/ectible accounts are made by means of the provision for bad debts. Accounts written off as uncol/ectible are deducted from the allowance and subsequent recoveries are added. The amount of the provision for bad debts is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in federal and state governmental health care coverage and other collection indicators . Services rendered to individuals when payment is expected and ultimately not received are written off to the allowance for estimated uncollectible accounts. Accounts receivable are presented net of allowances for estimated uncollectible accounts of approximately $1,425,000.
Part III, Line 8	Bassett Hospital of Schoharie County used Medicare-approved costs from the 2015 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 III, Line 9b	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.
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 organization that renders medical care to all persons in need of such care, regardless of their ability to pay. As required by NYS Department of Health, the hospital prominently posts notices throughout the facility stating clearly that emergency care is to be provided regardless of ability to pay. The list of patient rights is also posted throughout the hospital. Information about federal and state government health coverage plans and how to access them is also posted and is readily available at key points of patient contact, including , but not limited to, registration stations. Bassett Hospital of Schoharie County offers a Community Service Plan to patients who need financial assistance. A major component of the program is to actively identify patients who may be eligible for charity care. The process begins with an organizational policy and procedure that defines the program and serves as an education tool for all BHSC employees. The policy is updated annually, distributed to key personnel, and is posted in the online policy and procedure manual that is accessible to all employees. As part of the intake process, patients receive a BHSC-specific financial aid brochure describing financial assistance options. The brochure describes federal and state government programs, as well as the hospital's Community Service Plan, and is written in plain language that addresses low literacy levels in the county (1 in 5 county residents read at the 3rd grade level or lower according to Literacy Volunteers of Schoharie County). It is also available at key points of service, including nurse's stations, waiting rooms, the ER, and other high-traffic public areas. In addition to postings containing contact information and the distribution of the BHSC-specific financial aid brochure, patient education is supported by a four-page , plain-language brochure that is included with the Community Service Plan application itself. Community Service Plan Brochure/Applications are readily available at all facilities in the Bassett Healthcare Network and all clinics. Clinical and support staff are made aware of the program and are able to direct patients to specialists who can assist in the application process. All patients who are registered as "self pay" are provided a Community Services Plan Brochure/Application in person. A listing of all self-pay accounts is produced and reviewed daily to ensure that a Community Services Plan Brochure/Application has been provided.The self-pay billing office identifies patients who may require additional help understanding the program during the billing and collections process. Contact information for the Community Service Plan is included in patient bills. Self-pay accounts for patients who have been approved for Community Services within the prior 120 days are automatically included with prior approval. In Schoharie County, facilitated enrollment in government health insurance programs is handled by several community agencies/organizations (Schoharie County Community Action Program (SCCAP), FidelisCare, as well as Bassett Medical Center. BHSC makes referrals to them by means of a form that can be signed by the patient and faxed. Patient registrars and customer serv ice providers from the Business Office are trained to understand these programs and the process for helping patients access them. They provide one-on-one assistance with access, information , and appointment scheduling for facilitated enrollment. Additionally, the hospital's Business Services Manager provides one-on-one counseling to patients who need help paying their bills, including referral to facilitated enrollment for Medicaid and other government programs.
PART VI - QUESTION 4 - COMMUNITY INFORMATION	BASSETT HOSPITAL OF SCHOHARIE COUNTY'S PRIMARY SERVICE AREA ENCOMPASSES ALL OF SCHOHARIE COUNTY, WITH A POPULATION OF 31,566 (U.S. CENSUS 2014 ESTIMATE), AND A PORTION OF NEIGHBORING SCHENECTADY COUNTY, INCLUDING THE TOWNS OF DELANSON AND DUANESBURG. LOCATED IN COBLESKILL, NY, BASSETT HOSPITAL OF SCHOHARIE COUNTY IS THE ONLY HOSPITAL IN SCHOHARIE COUNTY. SCHOHARIE COUNTY IS LOCATED AT THE FAR WESTERN EDGE OF NEW YORK STATE'S CAPITAL DISTRICT. A PRIMARILY RURAL AREA, SCHOHARIE COUNTY COVERS A LAND AREA OF APPROXIMATELY 622 SQUARE MILES, WITH A POPULATION DENSITY OF JUST 52.7 PERSONS PER SQUARE MILE (U.S. CENSUS 2010). SCHOHARIE COUNTY HAS A STRONG AGRICULTURAL HERITAGE, AND FARMING REMAINS A DOMINANT SECTOR OF ITS ECONOMY, WITH AGRICULTURAL SALES TOTALING $30 MILLION PER YEAR (SCHOHARIE COUNTY CHAMBER OF COMMERCE). PEOPLE AGE 65 AND OVER MAKE UP 13.4 PERCENT OF THE POPULATION, WHILE THE NEW YORK STATE AVERAGE IS 14 PERCENT (U.S. CENSUS BUREAU, CURRENT POPULATION SURVEY, ANNUAL SOCIAL AND ECONOMIC SUPPLEMENT, 2012). NINETY-SIX PERCENT OF THE POPULATION IS WHITE, WITH HISPANICS MAKING UP 2.9 OF THE POPULATION AND BLACKS 1.3 PERCENT. AMERICAN INDICAN AND ASIAN PERSONS TOGETHER PRESENT 1.1 PERCENT OF THE POPULATION, AT 0.3 PERCENT AND 0.8 PERCENT, RESPECTIVELY, AND PERSONS OF TOW OR MORE RACES MAKE UP 1.3 PERCENT (U.S. CENSUS BUREAU, CURRENT POPULATION SURVEY, ANNUAL SOCIAL AND ECONOMIC SUPPLEMENT, 2012.) EDUCATIONAL LEVELS, UNEMPLOYMENT, AND POVERTY ARE IDENTIFIED BARRIERS TO THE HEALTH OF RESIDENTS OF SCHOHARIE COUNTY (SCHOHARIE COUNTY HEALTH ASSESSMENT 2010-13, SCHOHARIE COUNTY DEPT. OF HEALTH). WITH AN UNEMPLOYEMENT RATE OF 8.5 PERCENT IN NY STATE (HTTP://WWW.BIS/GOV.LAU.LASTRK12.HTM), THE MEDIAN HOUSEHOLD INCOME IN SCHOHARIE COUNTY IS $47.851 (HTTPS://WWW.HEALTH.NY.GOV/STATISTICS/CHAC/GENERAL/G100)43.HTM), WHICH IS $8,867 LESS THAN THE NEW YORK STATE MEDIAN (HTTPS://WWW.CENSUS.GOV/PROD/2013PUBS/ACSBR12-02.PDF). THE PERCENTAGE OF RESIDENTS WITH INCOMES BLOW THE FEDERAL POVERTY GUIDELINES IS 14.4 PERCENT (2012 POVERTY AND MEDICAN HOUSEHOLD INCOME ESTIMATES COUNTIES, STATES, AND NATIONAL SOURCE: U.S. CENSUS BUREAU, SMALL AREA INCOME AND POVERTY ESTIMATES (SAIPE) PROGRAM RELEASE DATE: DECEMBER 2013) SEVENTEEN PERCENT OF SCHOHARIE COUNTY RESIDENTS LACK HEALTH INSURANCE (SCHOHARIE COUNTY COMMUNITY HEALTH ASSESSMENT 2010-2013). OF THE HOSPITALS PATIENTS, 14% WERE MEDICAID PATIENTS IN 2013. SCHOHARIE COUNTY IS A FEDERALLY DESIGNATED HEALTH PROFESSIONAL SHORTAGE AREA IN THE DISCIPLINES OF PRIMARY CARE, MENTAL HEALTH, AND DENTAL (HRSA.GOV). THE PERCENTAGE OF THE POPULATION WITH A HIGH SCHOOL DEGREE IS SLIGHLY HIGHER THAN THE NEW YORK STATE AVERAGE: 87.7 PERCENT FOR SCHOHARIE COUNTY COMPARED TO 84.9 PERCENT FOR THE STATE. HOWEVER, THE PERCENTAGE OF THE POPULATION WITH A COLLEGE DEGREE OR HIGHER IS 12.9 PERCENT LOWER THAN THE NEW YORK STATE AVERAGE: 19.9 PERCENT FOR SCHOHARIE COUNTY COMPARED TO 32.8 PERCENT FOR THE STATE (U.S. CENSUS 2013 ESTIMATE). ONE IN FIVE RESIDENTS IS ABLE TO READ ONLY AT A LVEL THAT MAKES IT IMPOSSIBLE TO READ AND UNDERSTAND HEALTHCARE INSTRUCTIONS AND THE INFORMATION NEEDED TO FIND EMPOYMENT (LITERACY VOLUNTEERS AT SCHOARIE COUNTY).
PART VI - QUESTION 5 - PROMOTION OF COMMUNITY HEALTH	A majority of the Bassett Hospital of Schoharie County Board of Trustees is comprised of community volunteers who reside in the hospital's primary service area and who are neither employees nor contractors of the organization, nor family members thereof. In 2015, there were a total of 16 members on the Bassett Hospital of Schoharie County Board of Trustees, of whom 15 were community volunteer board members. One board member was an executive-level employee of the Bassett Healthcare Network (BHN). As a not-for-profit hospital, Bassett Hospial of Schoharie County reinvests surplus funds toward equipment/technology improvements in patient care and patient safety, as well as infrastructure upgrades mandated by Joint Commission and government/regulatory requirements and deemed necessary to keep the hospital accredited and able to continue serving the health needs. In 2015, these projects totaled approximately $7,230,000. In September 2015, the hospital completed a 12 month expansion and renovation project for the Emergency Services department that cost $6,247,873 . The investment resulted in the addition of 2,200 square feet of space to the emergency department, as well as state-of-the-art emergency services technology, an indoor decontamination room, eight new private treatment rooms, and new, confidential registration and consultation areas. Additional investments were made throughout 2015 to improve the hospital's ability to provide quality patient care to the residents of Schoharie County. A digital Mobile X-Ray machine was purchased for $79,050, and a new EPIQ Ultrasound system was purchased for $142,463. New colonoscopes (used in endoscopic examinations) were purchased for $120,660, and patient beds, totaling $30,792 were added to the inventory. Infrastructure improvements in 2015 cost $107 ,840, and the hospital's server was replaced for a price-tag of $63,587 . A balance of $202,000 was spent on routine clinical equipment replacement in 2015. A separate business office was purchased for the hospital for $235,300, it is located on Legion Drive in Cobleskill. Community health improvement and education are key strategies in the hospital's plan of response to the community's health priorities and needs. The hospital's initiatives are largely guided by the New York State Department of Health Public Health Prevention Agenda . They are chosen and coordinated in close collaboration with the Schoharie County Department of Health and Bassett Healthcare Network, in particular reflecting the county's health assessment and the Bassett Health and Wellness Survey. Strategies focus on access, education and awareness. Hospital programs and efforts that address Prevention Agenda-related community health improvement and education priorities include follow ing: - Diabetes community education and evidence-based support program - Lunch and Learn educational programs on Fire Safety, Food and Nutrition, Schoharie Fresh (locally grown produce, dairy, meats, etc.); Fall Prevention, New Emergency Dep't; At Home Care; "Diabetes, Are you at risk? "5-2-1-0 Childhood Obesity Prevention Program Schoharie County Mental Health; Women's Wellness ; and Schoharie County Office for the Aging" - Stroke Support Group - Space and in-kind contribution of professional services for cancer and Alzheimer's support groups; contributions to non-profit community organizations; in-kind services contributed by staff to not-for-profit organizations and community groups; staff time spend coordinating events not sponsored by the hospital, such as blood drives and employee time spent on community health related boards and other community involvement. - The hospital helps to protect the health access, safety , and independence of vulnerable populations living in poverty through financially supported provision of the Lifeline personal response system The hospital also provides community benefits services not easily counted or portrayed quantitatively. In 20'15 a "Healthy Decisions" newsletter dedicated in large part to educational messages intended to improve health knowledge, attitudes, skill/behaviors related to prevention priorities; and hundreds of hours of staff volunteer time in a wide-range of activities, including Blood Drives, that promote the health of the community .
PART VI - QUESTION 6 - AFFILIATED HEALTHCARE SYSTEM	Bassett Hospital of Schoharie County is part of Bassett Healthcare Network, which provides services in more than 20 communities spanning 5,600 square miles and eight counties. The network focuses its community services programs in the counties where the six affiliated hospitals and greatest patient populations are located. Otsego County - population 61,917; Delaware County - population 47,559; Herkimer County population 64,160 (according to the 2011 U.S. Census estimates); and Schoharie County - population 31,556 (U.S. Census 2014 estimate), a. Bassett - an acute care inpatient teaching facility, an outpatient primary and specialty care center, a regional network of 26 community-based outpatient health centers, 20 school-based health centers, 2 ambulatory surgery centers, and a fully salaried medical staff in Cooperstown, Otsego County b. O'Connor Hospital - critical access hospital in Delhi, Delaware County c. Bassett Hospital of Schoharie County (dba Cobleskill Regional Hospital) - acute care facility in Cobleskill, Schoharie County d. Little Falls Hospital - critical access hospital in Little Falls, Herkimer County e. Tri-Town Regional Hospital - 2417 emergency care facility in Sidney, Delaware County f. A.O. Fox Hospital -- acute care facility in Oneonta, Otsego County g. Valley Health Services - residential health care and rehabilitation facility h. At Home Care - certified home care agency i. First Community Care of Bassett - medical supply company All of the above (a-1) make up Bassett Healthcare Network and provide health services to this eight-county region in central New York .
QUESTION 7 STATE FILING OF COMMUNITY BENEFIT REPORT	New York State

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	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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
JOSEPH R SELLERS MD FACP
TRUSTEE	$0	$243,782	$0	$22,980	$0	$0	$0	$16,504	$0	$1,165	$0	$284,431	$0	$0
MICHAEL J TENGERES
TRUSTEE	$0	$293,607	$0	$22,500	$0	$0	$0	$0	$0	$1,538	$0	$317,645	$0	$0
ERIC H STEIN
PRESIDENT/CEO	$0	$181,689	$0	$10,992	$0	$0	$0	$10,992	$0	$5,845	$0	$209,518	$0	$0
SUSAN OAKES-FERRUCCI
VP PATIENT SERVICES/CNO	$154,240	$0	$0	$0	$0	$0	$3,085	$0	$12,324	$0	$169,649	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 3	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part VI - Section B, Line 11A	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 Administrative Office upon request.
Part VI - Section B - Line 12C	Members of the board of trustees complete a conflict of interest questionnaire annually. A summary of results is reported each year at the annual meeting of the board of trustees.
Part VI, Section B, Line 15B	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.
Part VI, Section C, Line 19	Governing documents, conflict of interest policy, and financial statements are made available to the public by request of the administrative office.
Part XI, Line 9	CHANGE IN INTEREST IN ASSETS OF FRIENDS OF BASSETT - ($33,069.00)

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
Thurston Corporation
One Atwell Road	Cooperstown	NY	13326	133218680	supportingorg	NY	501(c)(3)	11c	NA	false
FRIENDS OF BASSETT
ONE ATWELL ROAD	COOPERSTOWN	NY	13326	237041610	SOLICITS CONT	NY	501(c)(3)	7	THURSTON	false
MARY IMOGENE BASSETT HOSPITAL
ONE ATWELL ROAD	COOPERSTOWN	NY	13326	135596796	HEALTH CARE	NY	501(c)(3)	3	THURSTON	false
AURELIA OSBORNE FOX MEMORIAL HOSPITAL SO
ONE NORTON AVENUE	ONEONTA	NY	13820	150539039	HEALTH CARE	NY	501(c)(3)	3	THURSTON	false
TEMPLETON FOUNDATION
ONE ATWELL ROAD	COOPERSTOWN	NY	13326	133317084	REAL ESTATE	NY	501(c)(3)	9	THURSTON	false
BASSETT REGIONAL CORPORATION
ONE ATWELL ROAD	COOPERSTOWN	NY	13326	133522783	PLAN & POLICY	NY	501(c)(3)	11B	THURSTON	false
O'CONNOR HOSPITAL
460 ANDES ROAD	DELHI	NY	13753	161540394	HEALTH CARE	NY	501(c)(3)	3	BRC	false
TRI TOWN REGIONAL HEALTHCARE
43 PEARL STREET	SIDNEY	NY	13838	260169584	HEALTH CARE	NY	501(c)(3)	3	BRC	false
LITTLE FALLS HOSPITAL
140 BURWELL STREET	LITTLE FALLS	NY	13365	150533578	HEALTH CARE	NY	501(c)(3)	3	BRC	false
VALLEY HEALTH SERVICES
690 WEST GERMAN STREET	HERKIMER	NY	13350	222511614	HEALTH CARE	NY	501(c)(3)	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	false	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