BASSETT HOSPITAL OF SCHOHARIE COUNTY: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- BASSETT HOSPITAL OF SCHOHARIE COUNTY (EIN 14-1772971)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-09
- IRS object ID
- 201233149349302023
- Schema version
- 2011v1.3
- 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 G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-09T14:26:13-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 Broadway 4th Floor | AddressLine1 |
| City | Albany | City |
| State | NY | State |
| ZIP Code | 122072974 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141772971 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Bassett Hospital of Schoharie County | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % LEANNA JENSEN VP FINANCE/CF | InCareOfName |
| Name Control | BASS | NameControl |
| Phone | 5182543456 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 178 Grandview Drive | AddressLine1 |
| City | Cobleskill | City |
| State | NY | State |
| ZIP Code | 120435144 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Eric Stein | Name |
| Title | President/CEO | Title |
| Date Signed | 2012-11-07 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5184274600 | Phone |
| Date Prepared | 2012-11-06 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Cobleskill Regional Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Eric h stein presidentceo | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 178 Grandview Drive | AddressLine1 |
| City | Cobleskill | City |
| State | NY | State |
| ZIP Code | 12043 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 26287580 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | cobleskillhospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1994 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | PROVISION OF HEALTH CARE SERVICES TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 318 | TotalNbrEmployees |
| Total Nbr Volunteers | 48 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 497496 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 780348 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 25923423 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 25216492 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 62548 | InvestmentIncomePriorYear |
| Investment Income Current Year | 21487 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 270830 | OtherRevenuePriorYear |
| Other Revenue Current Year | 267037 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 26754297 | TotalRevenuePriorYear |
| Total Revenue Current Year | 26285364 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 12142147 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 12054484 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 16500 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 16500 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 14087562 | OtherExpensePriorYear |
| Other Expenses Current Year | 13437979 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 26229709 | TotalExpensesPriorYear |
| Total Expenses Current Year | 25508963 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 524588 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 776401 | RevenuesLessExpensesCY |
| Total Assets BOY | 18722421 | TotalAssetsBOY |
| Total Assets EOY | 18768245 | TotalAssetsEOY |
| Total Liabilities BOY | 5477680 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 5178620 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 13244741 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 13589625 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROVISION OF HEALTH CARE SERVICES TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 18219972 | Expense |
| Revenue | 25216492 | Revenue |
| Description | PROVISION OF HOSPITAL CARE TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING AREA. IN 2011, THE NUMBER OF INPATIENTS CARED FOR WAS 684 AND THE NUMBER OF OUTPATIENTS CARED FOR WAS 67,219. | Description |
| Total Program Service Expense | 18219972 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | true | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 58 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 318 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LEANNA JENSEN VP FINANCECF | NamePerson |
| Telephone Number | 5182543456 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 178 GRANDVIEW DRIVE | AddressLine1 |
| City | COBLESKILL | City |
| State | NY | State |
| ZIP Code | 120435144 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (24 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| NANCY S BELLINGER | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| STEVEN C COLE | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| MACDONALD J HOLMES DVM | |||||||
| TRUSTEE EMERITUS | 1.0 | X | 0 | 0 | 0 | ||
| STEVEN KROLL | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| HENRY LAMONT PC | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| PETER D LOPEZ | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| SUSAN K MCGIVER | |||||||
| TRUSTEE EMERITA | 1.0 | X | 0 | 0 | 0 | ||
| RENEE SCIALDO SHEVAT PHD | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| RANDY L CRAPSER | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| ANNE CALDWELL MYERS PHD | |||||||
| TRUSTEE | 1.0 | X | 0 | 0 | 0 | ||
| NICHOLAS J NICOLETTA | |||||||
| TREASURER | 2.0 | X | 0 | 368286 | 15739 | X | |
| JEFFREY J WOEPPEL | |||||||
| VICE CHAIR | 2.0 | X | 0 | 208073 | 13168 | X | |
| GERALD D GROFF MD | |||||||
| TRUSTEE | 1.0 | X | 0 | 376359 | 13078 | ||
| JOSEPH R SELLERS MD | |||||||
| TRUSTEE | 1.0 | X | 0 | 207542 | 10096 | ||
| EDWIN KINTZ | |||||||
| Trustee | 1.0 | X | 0 | 0 | 0 | ||
| GEORGE KONTA CPA | |||||||
| Trustee | 1.0 | X | 0 | 0 | 0 | ||
| ERIC H STEIN | |||||||
| PRESIDENT/CEO | 40.0 | 0 | 163260 | 8702 | X | ||
| BARBARA E DICOCCO | |||||||
| CHAIR | 1.0 | 0 | 0 | X | |||
| GLENN A PERRONE | |||||||
| SECRETARY | 1.0 | 0 | 0 | X | |||
| TIMOTHY M HISER | |||||||
| STAFF PHARMACIST | 38.0 | 104274 | 0 | 11334 | X | ||
| LEANNA I JENSEN | |||||||
| VICE PRESIDENT FINANCE/CFO | 38.0 | 120512 | 0 | 6871 | X | ||
| JOAN MILLER | |||||||
| SENIOR DIRECTOR QUALITY RES | 38.0 | 106999 | 0 | 6748 | X | ||
| SUSAN OAKES-FERRUCCI | |||||||
| VICE PRESIDENT PATIENT SVC/CNO | 38.0 | 126960 | 0 | 11653 | X | ||
| DAVID DE SANDO | |||||||
| DIRECTOR OF PHARMACY | 38.0 | 133046 | 0 | 6755 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 591791 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1323520 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 104144 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| BENNETT CONTRACTING | |||||
| 693 PEARL STREET | ALBANY | NY | 12202 | CONSTRUCTION | 199614 |
| MEDICAL STAFFING NETWORK | |||||
| PO BOX 202996 | DALLAS | TX | 753202996 | STAFF NURSE SERVICES | 183633 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Related Organizations | 92759 | RelatedOrganizations |
| Government Grants | 669973 | GovernmentGrants |
| All Other Contributions | 17616 | AllOtherContributions |
| Total Contributions | 780348 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 25216492 | TotalRevenueColumn |
| Related Or Exempt Function Income | 25216492 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 25216492 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 18310 | TotalRevenueColumn |
| Exclusion | $18,310 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 5393 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2216 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3177 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3177 | TotalRevenueColumn |
| Exclusion | $3,177 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| CAFETERIA SALES | 900099 | 42334 | $42,334 |
| COFFEE SHOP REVENUE | 900099 | 69527 | $69,527 |
| LIFELINE REVENUE | 900099 | 119422 | $119,422 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 35754 | TotalRevenueColumn |
| Exclusion | $35,754 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 267037 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 26285364 | TotalRevenueColumn |
| Related Or Exempt Function Income | 25216492 | RelatedOrExemptFunctionIncome |
| Exclusion | $288,524 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9824276 | Total |
| Program Services | 6703397 | ProgramServices |
| Management And General | 3120879 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75482 | Total |
| Program Services | 53551 | ProgramServices |
| Management And General | 21931 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1399623 | Total |
| Program Services | 951965 | ProgramServices |
| Management And General | 447658 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 755103 | Total |
| Program Services | 518821 | ProgramServices |
| Management And General | 236282 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 380905 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 380905 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13620 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 13620 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 101000 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 101000 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4133 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 4133 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16500 | Total |
| Fundraising | 16500 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2366901 | Total |
| Program Services | 2261244 | ProgramServices |
| Management And General | 105657 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61993 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 61993 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2461885 | Total |
| Program Services | 2050864 | ProgramServices |
| Management And General | 411021 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 868748 | Total |
| Program Services | 269237 | ProgramServices |
| Management And General | 599511 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26117 | Total |
| Program Services | 7500 | ProgramServices |
| Management And General | 18617 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9026 | Total |
| Program Services | 1844 | ProgramServices |
| Management And General | 7182 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 91511 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 91511 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1247892 | Total |
| Program Services | 624880 | ProgramServices |
| Management And General | 623012 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 138774 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 138774 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| PURCHASED SERVICES | 3108658 | 2500010 | 608648 | 0 |
| BAD DEBTS | 1782980 | 1782980 | 0 | 0 |
| UTILITIES | 552121 | 475380 | 76741 | 0 |
| OTHER DIRECT EXPENSES | 75583 | 3429 | 72154 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 146132 | Total |
| Program Services | 14870 | ProgramServices |
| Management And General | 131262 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25508963 | Total |
| Program Services | 18219972 | ProgramServices |
| Management And General | 7272491 | ManagementAndGeneral |
| Fundraising | 16500 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5675463 | BOY |
| EOY | 6103758 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 122097 | BOY |
| EOY | 122925 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 69467 | BOY |
| EOY | 68983 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2441322 | BOY |
| EOY | 3042254 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 125779 | BOY |
| EOY | 158889 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 139583 | BOY |
| EOY | 146416 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 18560159 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 9657023 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9939890 | BOY |
| EOY | 8903136 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 208820 | BOY |
| EOY | 221884 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18722421 | BOY |
| EOY | 18768245 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1979491 | BOY |
| EOY | 1757128 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1705000 | BOY |
| EOY | 1590000 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 231374 | BOY |
| EOY | 162195 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1561815 | BOY |
| EOY | 1669297 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5477680 | BOY |
| EOY | 5178620 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13034038 | BOY |
| EOY | 13365019 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32013 | BOY |
| EOY | 45916 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 178690 | BOY |
| EOY | 178690 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13244741 | BOY |
| EOY | 13589625 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18722421 | BOY |
| EOY | 18768245 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 776401 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -431517 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $4,133 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 4133 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule C, Part II-B, LIne 11 | Identifier |
| Explanation | Iroquois Healthcare Alliance dues allocate 45% towards general lobbying activities. Total dues paid in 2011 = $5,053. Healthcare Association of New York State dues allocate 30.30% towards general lobbying activities. Total dues paid in 2011 = $6,136. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 300787 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 828 | InvestmentEarningsOrLosses |
| End Of Year Balance | 301615 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 299789 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 998 | InvestmentEarningsOrLosses |
| End Of Year Balance | 300787 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 298476 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 1313 | InvestmentEarningsOrLosses |
| End Of Year Balance | 299789 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 293947 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 4529 | InvestmentEarningsOrLosses |
| End Of Year Balance | 298476 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 335214 | OtherCostOrOtherBasis |
| Book Value | 335214 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10921549 | OtherCostOrOtherBasis |
| Depreciation | 4985143 | Depreciation |
| Book Value | 5936406 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 7303396 | OtherCostOrOtherBasis |
| Depreciation | 4671880 | Depreciation |
| Book Value | 2631516 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 8903136 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO THIRD PARTIES | $1,357,569 |
| INTEREST RATE SWAP AGREEMENT | $278,970 |
| ASSET RETIREMENT OBLIGATIONS | $32,758 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1669297 | TotalOfAmounts |
| Total Revenue | 26285364 | TotalRevenue |
| Total Expenses | 25508963 | TotalExpenses |
| Excess Or Deficit For Year | 776401 | ExcessOrDeficitForYear |
| Other | -$431,517 | OtherAmount |
| Total Adjustments | -431517 | TotalAdjustments |
| Excess Or Deficit Per FS | 344884 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 24502384 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | -1782980 | OtherRevenues |
| Revenue Not Rptd F990 | -1782980 | RevenueNotRptdF990 |
| Revenue Subtotal | 26285364 | RevenueSubtotal |
| Total Revenue Per Form990 | 26285364 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 24157500 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 431517 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 431517 | ExpensesNotRptdF990 |
| Expenses Subtotal | 23725983 | ExpensesSubtotal |
| Other Expenses Not Included | 1782980 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 1782980 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 25508963 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART V, Line 4 | ENDOWMENT FUNDS OF $178,690 HELD WITH INTEREST EARNED UNRESTRICTED FOR GENERAL HOSPITAL EXPENDITURES. ENDOWMENT FUNDS OF $37,500 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 code. In 2007 the Hospital adopted the provision of Financial Accounting Standards Board (FASB) Interpretation No. 48, Accounting for Uncertainty in Income Taxes, an Interpretation of FASB Statement No. 109 (FIN 48). There was no impact to the Hospital's financial statements for the years ended December 31, 2011, 2010, 2009, 2008 and 2007 as a result of applying FIN 48. |
| Part XI, line 8 | ADDITION TO INTEREST EXPENSE DUE TO NEGATIVE ADJUSTMENT ON INTEREST RATE SWAP AGREEMENT OF $30,193. ADDITION TO DEPRECIATION EXPENSE DUE TO NEGATIVE ADJUSTMENT ON LOSS ON ASSET IMPAIRMENT OF 398,388. CHANGE IN INTEREST IN NET ASSETS OF FRIENDS OF BASSETT, INC. OF $2,936. |
| Part XII, line 2d | Bad Debt $-1,782,980 |
| Part XIII, Line 2d | ADDITION TO INTEREST EXPENSE DUE TO NEGATIVE ADJUSTMENT ON INTEREST RATE SWAP AGREEMENT OF $30,193. ADDITION TO DEPRECIATION EXPENSE DUE TO NEGATIVE ADJUSTMENT ON LOSS ON ASSET IMPAIRMENT OF 398,388. CHANGE IN INTEREST IN NET ASSETS OF FRIENDS OF BASSETT, INC. OF $2,936. |
| Part XIII, line 4b | Bad Debt $-1,782,980 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | X | MailSolicitations |
| Agreement Ref Fundraising | true | AgreementRefFundraising |
Fundraiser Activity Information FundraiserActivityInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Individual | JAMES BOYLE | NameOfIndividual |
| Activity | FEASIB STUD | Activity |
| Fundraiser Control Of Funds | false | FundraiserControlOfFunds |
| Gross Receipts | 0 | GrossReceipts |
| Amount Retained By Contractor | 16500 | AmountRetainedByContractor |
| Net To Organization | 0 | NetToOrganization |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | 0 | TotalGrossReceipts |
| Total Retained By Contractors | 16500 | TotalRetainedByContractors |
| Total Net To Organization | 0 | TotalNetToOrganization |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 300. | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 194622 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 84295 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 110327 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00460 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3181937 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3517370 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -335433 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01410 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3376559 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3601665 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -225106 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00950 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12402 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 12402 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1523 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1523 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5273318 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3422103 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1851215 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07800 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10140 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 10140 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5297383 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3422103 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1875280 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07900 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8673942 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7023768 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1650174 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06950 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $908,271 | BadDebtExpenseAmount |
| Amount Attributable To | 46866 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5208256 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5931079 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -722823 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BASSETT HOSPITAL OF SCHOHARIE COUNTY | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 178 GRANDVIEW DRIVE | AddressLine1 |
| City | COBLESKILL | City |
| State | NY | State |
| ZIP Code | 12043 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BASSETT HOSPITAL OF SCHOHARIE COUNTY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 300. | FPGFreePercent |
| Uses FPG Discounted | false | UsesFPGDiscounted |
| Explains Basis | false | ExplainsBasis |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | true | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | true | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Part I, Line 3C | Cobleskill Regional Hospital (CRH) 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 is available. Under the hospital policy governing the Community Services Program, Cobleskill Regional Hospital 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 (FPIG), 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 Cobleskill Regional Hospital 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 are comprised of 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 $1,782,980 was subtracted from the total expense value used to calculate the percentages in Part 1, Line 7, Column f. |
| Part III, Line 4 | Cobleskill Regional Hospital 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 2011 were approximately $225,000. 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 uncollectible accounts are made by means of the provision for bad debts. Accounts written off as uncollectible 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 $1,250,000. |
| Part III, Line 8 | Cobleskill Regional Hospital used Medicare-approved costs from the 2011 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 structure 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 V, Section B, Question 10 | The Hospital did not provide any discounted care. |
| Part V, Section B, line 19d | Cobleskill Regional Hospital 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 V, Section B, line 21 | The hospital's Charge Description Master, which includes a separate gross charge for all services, is what is used to bill all patients when a service is rendered. |
| Part VI, Question 2 | Needs Assessment: A variety of data are used regularly to assess the healthcare needs of the community served by Cobleskill Regional Hospital, including data from Patient Satisfaction Surveys, the NYS Department of Health, the Schoharie County Behavioral Risk Factor Surveillance Survey, the Schoharie County Community Health Assessment, and the NYS Prevention Agenda, which identified 27 priority health indicators to be used by NYS hospitals, providers, and county health departments in assessing and setting local/regional priorities. Community partners involved in assessing community health needs in Schoharie County included: Schoharie County Health Department; Bassett primary care group; community-based organizations; county social service, mental health, youth and aging agencies; EMS coordinator; SUNY Cobleskill; Cornell University Cooperative Extension. Cobleskill Regional Hospital contracts with Health Stream Research to obtain benchmarking data on patient satisfaction in order to assess how the hospital is perceived to be meeting patient needs. Data from ongoing phone 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 twice yearly. Health Stream Research is a national leader in providing customized patient satisfaction data to more than 1000 hospitals in the United States. (www.healthstreamresearch.com). The hospital also utilizes information from the standardized, publicly reported HCAHPS (Hospital Care Quality Information from the Consumer Perspective) 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 Schoharie 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: Cobleskill Regional Hospital (CRH) 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. Cobleskill Regional Hospital 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 CRH-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 CRH-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 insure 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 (SCCAP, FidelisCare), as well as Bassett Medical Center. CRH makes referrals to them by means of a form that can be signed by the patient and faxed. Additionally, a representative from FidelisCare was available one day per week on-site at the hospital throughout 2011. Patient registrars and customer service 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: Cobleskill Regional Hospital's primary service area encompasses all of Schoharie County, with a population of 32,578 (U.S. Census 2011 estimate), and a portion of neighboring Schenectady County, including the towns of Delanson and Duanesburg. Located in Cobleskill, NY, Cobleskill Regional Hospital 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 16.2 percent of the population, while the New York State average is 13.7 percent (U.S. Census 2011). Ninety-six percent of the population is white, with Hispanics making up 2.9 percent of the population and Blacks 1.6 percent (U.S. Census 2011). American Indian and Asian persons together represent 1 percent of the population, at 0.3 percent and 0.7 percent, respectively (U.S. Census 2011). 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 unemployment rate of 10 percent (June 2012, U.S. Bureau of Labor Statistics), the median household income in Schoharie County is $50,864 (US Census 2006-2010), which is nearly $5,000 less than the New York State median. The percentage of residents with incomes below the federal poverty guidelines is 11.4 percent (US Census State 2006-2010). Seventeen percent of Schoharie County residents lack health insurance (Schoharie County Community Health Assessment 2010 - 2013). Of the hospital's patients, 9% were Medicaid patients in 2010. 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 slightly higher than the New York State average: 86.5 percent for Schoharie County compared to 84.4 percent for the state. The percentage of the population with a college degree or higher is 11 percent lower than the New York State average: 21 percent for Schoharie County compared to 32 percent for the state (U.S. Census 2006-2010). One in five residents is able to read only at a level that makes it impossible to read and understand healthcare instructions and the information needed to find employment (Literacy Volunteers of Schoharie County). |
| Part VI, Question 5 | Promotion of Community Health: A majority of the Cobleskill Regional Hospital 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. Currently there are a total of 16 members on the Cobleskill Regional Hospital Board of Trustees, of whom 11 are community volunteer board members who live in the service area. Four board members are executive-level employees of the Bassett Healthcare Network (BHN). One board member, who is trust advisor of The Clark Estates, Inc., holds a place on the various boards of BHN entities. As a not-for-profit hospital, Cobleskill Regional Hospital 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 2011, these projects totaled approximately $760,000. For example, in 2011, work continued on a 10-year project (2004 - 2014) that will enhance building systems and meet standards set by the Joint Commission, which is the accreditation entity for hospitals nationwide. The project involved extension of sprinklers, heating and cooling improvements, and asbestos abatement, all targeted to enhance patient safety. Similarly, other investments were made to replace aging, increasingly unreliable equipment and to secure medical technology and equipment advances that will insure that the only hospital in the county continues to offer its patients safe, quality patient care that meets accepted standards of care. This included the 2011 hospital purchase and installation of a new emergency backup generator. The new backup generator, which carried a price tag of $81,000, actually cost the hospital $184,000, when engineering design, permits, site preparation, and installation were factored in. It replaced a 46-year-old piece of equipment that had exhausted its useful life and was no longer a completely reliable source of backup power for the county's only hospital. This new backup generator will protect ongoing patient safety and services by ensuring continuity of operations -- 24 hours a day, 7 days a week, 365 days a year. Other examples of equipment/technology improvements made to improve health care in 2011 include: new beds that provide for enhanced patient safety and OR equipment. The hospital also invested $34,000 in essential repairs and infrastructure replacements for its aging facility. Moreover, over the past 5 years, the hospital has invested more than $1 million dollars in much-needed upgrades to medical imaging technology alone - to replace aging equipment that has reached the limits of its useful life and to bring up-to-date, safe medical imaging to a rural community in which the hospital offers the only access to radiology services/imaging diagnostics and testing. This has included an investment of $377,619 to bring a new 64-slice low-dose CT scanner to Schoharie County. The only CT scanner in Schoharie County, the new low-dose 64-slice scanner will improve quality and provide a higher level of care for residents of this rural region by allowing for use of new protocols that have been developed since the existing equipment was acquired and by improving patient safety. It is specially equipped to reduce radiation exposure from 40 to 60 percent. The new scanner enables the hospital to continue to deliver appropriate, high-quality, safe emergency, preventive, inpatient, and outpatient healthcare to our patients and to our rural, aging community (portions of the county are a federally designated rural area). In the area of community health improvement, many of the hospital's initiatives are guided by the New York State Department of Health Public Health Agenda and top-two county priorities identified in the Schoharie County Department of Health County Health Assessment: tobacco and physical activity/nutrition. The hospital regularly offers a diabetes education, prevention, and support groups, as well as a Stroke Support Group. The hospital also participated in a community partnership between Schoharie County Health Department, Cornell University Cooperative Extension, Schoharie County Community Action Program and BHSC was expanded and formalized to form the Healthier Lifestyles Coalition of Schoharie County. This group met regularly to establish and offer community improvement activities focused on improving nutrition and increasing physical activity. The hospital's Senior Lunch and Learn program targets the community's elderly population with free educational programming on topics ranging from disease prevention and wellness, to safety, to ways to stay more active and independent. Other programs that address non-Prevention Agenda-related priorities include: - Cancer Services Program of Delaware, Otsego and Schoharie County - 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 Marathon for a Better Life for the benefit of cancer patients/survivors in the community; and employee time spent on community health-related boards and other community involvement. The hospital also provides community benefits services not easily counted or portrayed quantitatively. In 2011, these included public Fire Prevention Week activities carried out by the Plant Operations Department to promote and educate about home safety; a 6-month physical therapy project that worked with outpatients past and present to enable them to make and complete a charitable walk; regular educational displays in public areas of the hospital on a variety of health/wellness; private, individual staff donations to specific patients in need; and hundreds of hours of staff volunteer time in a wide-range of activities that promote the health of the community. |
| Part VI, Question 6 | Affiliated Health Care System: Cobleskill Regional Hospital 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 32,578 (U.S. Census 2011 estimate), a. Bassett Medical Center - an acute care inpatient teaching facility, an outpatient primary and specialty care center, a regional network of 26 community-based outpatient health centers, 18 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 - 24/7 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-i) make up Bassett Healthcare Network and provide health services to this eight-county region in central New York. |
| Part VI, Question 7 | State Filing of Community Benefit Report: New York State |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NICHOLAS J NICOLETTA | |||||||||||||
| 0 | 368286 | 0 | 0 | 0 | 0 | 0 | 11339 | 0 | 4400 | 0 | 384025 | 0 | 0 |
| JEFFREY J WOEPPEL | |||||||||||||
| 0 | 208000 | 0 | 0 | 0 | 73 | 0 | 8864 | 0 | 4304 | 0 | 221241 | 0 | 0 |
| GERALD D GROFF MD | |||||||||||||
| 0 | 372650 | 0 | 0 | 0 | 3709 | 0 | 11339 | 0 | 1739 | 0 | 389437 | 0 | 0 |
| JOSEPH R SELLERS MD | |||||||||||||
| 0 | 205500 | 0 | 0 | 0 | 2042 | 0 | 9167 | 0 | 929 | 0 | 217638 | 0 | 0 |
| ERIC H STEIN | |||||||||||||
| 0 | 163000 | 0 | 0 | 0 | 260 | 0 | 5199 | 0 | 3503 | 0 | 171962 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part I, Line 3 | Identifier |
| Explanation | THE PRESIDENT/CEO'S COMPENSATION IS REVIEWED BY THE ORGANIZATION'S BOARD OF TRUSTEES AND HIS COMPENSATION IS PAID BY A RELATED ENTITY - MARY IMOGENE BASSETT HOSPITAL. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| PART VI-SECTION B - NUMBER 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 - NUMBER 12C | MEMBERS OF THE BOARD OF TRUSTEES COMPLETE CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. A SUMMARY OF RESULTS IS REPORTED EACH YEAR AT ANNUAL MEETING OF THE BOARD OF TRUSTEES. | |
| PART VI-SECTION B - NUMBER 15A | ANNUAL REVIEW IS DONE BY THE ASSESSMENT OF PRESIDENT/CEO'S PERFORMANCE BY EACH MEMBER OF THE BOARD OF TRUSTEES,SENIOR MANAGEMENT,ADMINISTRATIVE AND CLINICAL LEADERSHIP, AND ACTIVE MEDICAL STAFF. THE ASSESSMENT TOOL ADDRESSES PERFORMANCE MEASURES THAT RELATE TO THE ORGANIZATION'S MISSION AND STRATEGY THAT IS IDENTIFIED IN THE INSTITUTION'S ANNUAL OPERATING PLAN AND BY SPECIFIC ITERATION BY THE BOARD OF TRUSTEES. INFORMATION RECEIVED IS SUMMARIZED AND PRESENTED TO THE EXECUTIVE AND FINANACE COMMITTEE FOR REVIEW AND CONCLUSION. | |
| PART VI-SECTION C - NUMBER 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC BY REQUEST OF THE ADMINISTRATIVE OFFICE. | |
| PART XI - NUMBER 5 | NEGATIVE ADJUSTMENT INTEREST RATE SWAP AGREEMNET (30,193) LOSS ON IMPAIRMENT OF ASSETS (398,388) CHANGE IN INTEREST IN NET ASSETS OF FRIENDS OF BASSETT (2,936) TOTAL CHANGE IN NET ASSETS OR FUND BALANCE (431,517) | CHANGES IN NET ASSETS OR FUND BALANCE |
| Part VII | Barbara DiCocco Hours worked for related corporation: Bassett Regional Corporation - .50 Bassett Medical Center - 1.00 Total hours worked at related organizations = 1.50 Gerald Groff MD Hours worked for related corporation: Bassett Medical Center - 40.00 Tri Town Regional - 1.00 Total hours worked at related organizations = 41.00 Nicholas J Nicoletta Hours worked for related organizations: Thurston Corporation - 2.00 Templeton Foundation - 1.00 Bassett Regional Corporation - 2.00 Bassett Medical Center - 40.00 O'Connor Hospital - 2.00 Tri Town Regional - 2.00 AO Fox Memorial Hospital - .50 Little Falls Hospital - 2.00 Total hours worked for related organizations = 51.50 Glenn A Perrone Hours worked for related organizations: Templeton Foundation - .50 Bassett Regional Corporation - 1.00 Bassett Medical Center - 2.00 Total hours worked for related organizations = 3.50 Renee Scialdo Shevat PhD Hours worked for related organizations: Friends of Bassett, Inc - 1.00 Jeffrey J Woeppel Hours worked for related organizations: Bassett Regional Corporation - 1.50 Bassett Medical Center - 40.00 O'Connor Hospital - 1.50 Tri Town Regional - 2.00 Little Falls Hospital - 2.00 Valley Health Services - 1.00 Total hours worked for related organizations = 48.00 Joseph R Sellers MD Hours worked for related organizations: Bassett Medical Center - 40.00 | Compensation Explanation |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |