2016-11-14T14:43:47-06:00 2015-12-31 KPMG LLP 515 Broadway 4th Floor Albany NY 122072974 990 2015-01-01 141772971 Bassett Hospital of Schoharie County % LEANNA JENSEN VP FINANCE/CF BASS 5182543456 178 Grandview Drive Cobleskill NY 12043 ERIC H STEIN PRESIDENT/CEO 5182543456 2016-11-14 true todd p teresco P00247720 5184274600 2015 2017-02-10 21:41:12Z Cobleskill Regional Hospital Eric h stein presidentceo 178 Grandview Drive Cobleskill NY 12043 29944030 false X cobleskillhospital.org X 1994 NY PRovision of health care services to residents of schoharie county and the surrounding region. 16 14 303 35 0 548272 528676 28803991 28289321 24951 13081 1524298 1092688 30901512 29923766 2000 0 0 0 15920410 16101631 0 0 0 12809719 12765176 28732129 28866807 2169383 1056959 22474508 27009180 3936969 7447751 18537539 19561429 PROVISION OF HEALTH CARE SERVICES TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. false false 20353361 28289321 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. 20353361 true true false true false false false false false true true false false false true true true false false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 103 0 true 303 true false false false false false false false false false false X 16 14 false false false false false false false true true false false false true true true true true true false false NY X LEANNA JENSEN VP FINANCECF 5182543456 178 GRANDVIEW DRIVE COBLESKILL NY 120435144 NANCY BELLINGER Trustee 1.0 0.0 X 0 0 0 PAUL J BRADY TRUSTEE 1.0 0.0 X 0 0 0 MICHAEL BREEN TRUSTEE 1.0 0.0 X 0 0 0 EDWIN KINTZ TRUSTEE 1.0 0.0 X 0 0 0 STEVEN KROLL TRUSTEE 1.0 0.0 X 0 0 0 HENRY LAMONT TRUSTEE 1.0 0.0 X 0 0 0 PETER D LOPEZ TRUSTEE 1.0 0.0 X 0 0 0 CARL J MUMMENTHY TRUSTEE 1.0 0.0 X 0 0 0 GARTH ROBERTS TRUSTEE 1.0 0.0 X 0 0 0 RENEE SCIALDO SHEVAT PHD TRUSTEE 1.0 0.0 X 0 0 0 JOSEPH R SELLERS MD FACP TRUSTEE 1.0 40.0 X 0 266762 17669 MICHAEL J TENGERES TRUSTEE 2.0 40.0 X 0 316107 1538 MACDONALD J HOLMES DVM TRUSTEE EMERITUS 1.0 0.0 X 0 0 0 SUSAN K MCGIVER TRUSTEE EMERITA 1.0 0.0 X 0 0 0 TIMOTHY H SWEENEY TRUSEE EMERITUS 1.0 0.0 X 0 0 0 BARBARA E DICOCCO CHAIR 1.0 2.5 X X 0 0 0 ANNE CALDWELL MYERS PHD VICE CHAIR 1.0 0.0 X X 0 0 0 GEORGE P KONTA TREASURER 1.0 0.0 X X 0 0 0 GLENN A PERRONE SECRETARY 1.0 0.0 X X 0 0 0 ERIC H STEIN PRESIDENT/CEO 0.0 40.0 X 0 192681 16837 LEANA I JENSEN VP FINANCE/CFO 38.0 0.0 X 139505 0 9320 SUSAN OAKES-FERRUCCI VP PATIENT SERVICES/CNO 38.0 0.0 X 154240 0 15409 MARY MALOY DIRECTOR OF REVENUE CYCLE 38.0 0.0 X 106718 0 8663 DAVID DESANDO DIRECTOR OF PHARMACY 38.0 0.0 X 137207 0 9113 CHRISTOPHER MANLEY STAFF PHARMACIST 38.0 0.0 X 108361 0 14491 646031 775550 93040 7 false true false MCCARTHY HOLDINGS 1341 NORTH ROCK HILL ROAD ST LOUIS MO 63124 CONSTRUCTION SVCS. 3732676 MEDICAL STAFFING NETWORK 6551 PARK OF COMMERCE BLVD BOCA RATON FL 33487 CONTRACT STAFFING 360836 STAT STAFF PROFESSIONALS 18 DIVISION ST SUITE 311 BALLSTON SPA NY 12866 CONTRACT STAFFING 243523 TOP ECHELON CONTRACTING INC 4883 DRESLER RD NW SUITE 200 CANTON OH 47718 CONTRACT STAFFING 229479 ATRION NETWORKING CORPORATION 125 METRO CENTER BLVD WARWICK RI 02886 IT SERVICES 126734 5 286878 240845 953 528676 NET PATIENT SERVICE REVENUE 900099 28289321 28289321 28289321 14631 14631 0 0 0 0 0 18714 20264 -1550 -1550 -1550 0 0 0 OTHER OPERATING REVENUE 900099 873773 873773 COFFEE SHOP REVENUE 900099 69430 69430 LIFELINE REVENUE 900099 93435 93435 56050 56050 1092688 29923766 28289321 1105769 0 0 0 0 0 0 13674444 10008311 3666133 180166 124967 55199 1496488 1034033 462455 750533 524551 225982 658856 53049 605807 53681 53681 125365 125365 8614 8614 0 0 114950 62790 52160 55048 55048 2682915 2289304 393611 1313339 523383 789956 0 0 59566 10616 48950 0 39085 8129 30956 76337 76337 0 1507555 818057 689498 163648 163648 BAD DEBTS 1194180 1194180 PURCHASED SERVICES 3830871 3176442 654429 UTILITIES 610055 501701 108354 OTHER DIRECT EXPENSES 78569 8226 70343 192542 15622 176920 28866807 20353361 8513446 0 9341260 9913547 124675 125022 326320 905491 2650080 2218737 0 0 0 0 0 0 190141 275386 166920 125152 26668316 13411387 9460799 13256929 0 0 0 0 0 0 0 0 214313 188916 22474508 27009180 2518694 1906580 0 0 0 0 0 0 0 0 0 0 153225 4484450 1232292 1023963 32758 32758 3936969 7447751 X 18241356 19323712 117493 59027 178690 178690 18537539 19561429 22474508 27009180 X 1056959 -33069 X X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 8614 8614 false false Schedule C, Part II-B, Number 1i 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. 303365 347 303712 302994 371 303365 302360 634 302994 301615 745 302360 300787 828 301615 1.00000 false false 33584 33584 17236314 7025249 10211065 9398418 6386138 3012280 13256929 0 ASSET RETIREMENT OBLIGATIONS 32758 32758 X 28729586 -1194180 -1194180 29923766 29923766 27705696 33069 33069 27672627 1194180 1194180 28866807 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 true true true X 300. false true true false true true 153467 83519 69948 0.00250 4678912 2559035 2119877 0.07660 4832379 2642554 2189825 0.07910 1414 1414 0.00010 5079935 4785973 293962 0.01060 21520 21520 0.00070 5102869 4785973 316896 0.01140 9935248 7428527 2506721 0.09050 3778 3778 0.00010 3778 3778 0.00010 true 531381 37710 6248882 6812012 -563130 X true true 1 1 BASSETT HOSPITAL OF SCHOHARIE COUNTY 178 Grandview Drive Cobleskill NY 12043 4720001H X BASSETT HOSPITAL OF SCHOHARIE COUNTY 1 false false true X X X X X X X X X 13 true true false true X www.cobleskillhospital.org X www.bassett.org X true 13 true www.cobleskillhospital.org false false true X 300. 0. true true X true X www.cobleskillhospital.org X www.cobleskillhospital.org X www.cobleskillhospital.org X X X X true X false X X X X true X false false 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. 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 X X false false false false false false false false false JOSEPH R SELLERS MD FACP TRUSTEE 0 243782 0 22980 0 0 0 16504 0 1165 0 284431 0 0 MICHAEL J TENGERES TRUSTEE 0 293607 0 22500 0 0 0 0 0 1538 0 317645 0 0 ERIC H STEIN PRESIDENT/CEO 0 181689 0 10992 0 0 0 10992 0 5845 0 209518 0 0 SUSAN OAKES-FERRUCCI VP PATIENT SERVICES/CNO 154240 0 0 0 0 0 3085 0 12324 0 169649 0 0 0 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. 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) 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 false false false false false false false true false true true false true true true true true true true