2012-11-09T14:26:13-06:00 2011-12-31 KPMG LLP 515 Broadway 4th Floor Albany NY 122072974 990 2011-01-01 141772971 Bassett Hospital of Schoharie County % LEANNA JENSEN VP FINANCE/CF BASS 5182543456 178 Grandview Drive Cobleskill NY 120435144 Eric Stein 2012-11-07 true 5184274600 2012-11-06 2011 2016-02-24 21:20:13Z Cobleskill Regional Hospital Eric h stein presidentceo 178 Grandview Drive Cobleskill NY 12043 26287580 false X cobleskillhospital.org X 1994 NY PROVISION OF HEALTH CARE SERVICES TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. 16 12 318 48 0 0 497496 780348 25923423 25216492 62548 21487 270830 267037 26754297 26285364 0 0 0 0 12142147 12054484 0 16500 16500 14087562 13437979 26229709 25508963 524588 776401 18722421 18768245 5477680 5178620 13244741 13589625 PROVISION OF HEALTH CARE SERVICES TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. false false 18219972 25216492 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. 18219972 true true false true false false false false false true true false false false true true true false false false false false false true false false true true false false true false false false false false false false false false false false false false true false false false false true 58 0 true 318 true false false false false false false false false false false X 16 12 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 S BELLINGER 1.0 X 0 0 0 STEVEN C COLE 1.0 X 0 0 0 MACDONALD J HOLMES DVM 1.0 X 0 0 0 STEVEN KROLL 1.0 X 0 0 0 HENRY LAMONT PC 1.0 X 0 0 0 PETER D LOPEZ 1.0 X 0 0 0 SUSAN K MCGIVER 1.0 X 0 0 0 RENEE SCIALDO SHEVAT PHD 1.0 X 0 0 0 RANDY L CRAPSER 1.0 X 0 0 0 ANNE CALDWELL MYERS PHD 1.0 X 0 0 0 NICHOLAS J NICOLETTA 2.0 X X 0 368286 15739 JEFFREY J WOEPPEL 2.0 X X 0 208073 13168 GERALD D GROFF MD 1.0 X 0 376359 13078 JOSEPH R SELLERS MD 1.0 X 0 207542 10096 EDWIN KINTZ 1.0 X 0 0 0 GEORGE KONTA CPA 1.0 X 0 0 0 ERIC H STEIN 40.0 X 0 163260 8702 BARBARA E DICOCCO 1.0 X 0 0 GLENN A PERRONE 1.0 X 0 0 TIMOTHY M HISER 38.0 X 104274 0 11334 LEANNA I JENSEN 38.0 X 120512 0 6871 JOAN MILLER 38.0 X 106999 0 6748 SUSAN OAKES-FERRUCCI 38.0 X 126960 0 11653 DAVID DE SANDO 38.0 X 133046 0 6755 591791 1323520 104144 5 false true false BENNETT CONTRACTING 693 PEARL STREET ALBANY NY 12202 CONSTRUCTION 199614 MEDICAL STAFFING NETWORK PO BOX 202996 DALLAS TX 753202996 STAFF NURSE SERVICES 183633 2 92759 669973 17616 780348 NET PATIENT SERVICE REVENUE 900099 25216492 25216492 25216492 18310 18310 0 0 5393 2216 3177 3177 3177 0 0 0 CAFETERIA SALES 900099 42334 42334 COFFEE SHOP REVENUE 900099 69527 69527 LIFELINE REVENUE 900099 119422 119422 35754 35754 267037 26285364 25216492 288524 0 0 0 0 0 0 9824276 6703397 3120879 0 75482 53551 21931 0 1399623 951965 447658 0 755103 518821 236282 0 380905 0 380905 0 13620 0 13620 0 101000 0 101000 0 4133 0 4133 0 16500 16500 0 0 0 0 2366901 2261244 105657 0 61993 0 61993 0 2461885 2050864 411021 0 868748 269237 599511 0 0 0 0 0 0 0 0 0 26117 7500 18617 0 0 0 0 0 9026 1844 7182 0 91511 0 91511 0 0 0 0 0 1247892 624880 623012 0 138774 0 138774 0 PURCHASED SERVICES 3108658 2500010 608648 0 BAD DEBTS 1782980 1782980 0 0 UTILITIES 552121 475380 76741 0 OTHER DIRECT EXPENSES 75583 3429 72154 0 146132 14870 131262 25508963 18219972 7272491 16500 5675463 6103758 122097 122925 69467 68983 2441322 3042254 0 0 0 0 0 0 125779 158889 139583 146416 18560159 9657023 9939890 8903136 0 0 0 0 0 0 0 0 208820 221884 18722421 18768245 1979491 1757128 0 0 0 0 1705000 1590000 0 0 0 0 231374 162195 0 0 1561815 1669297 5477680 5178620 X 13034038 13365019 32013 45916 178690 178690 13244741 13589625 18722421 18768245 X 776401 -431517 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4133 4133 false false Schedule C, Part II-B, LIne 11 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. 300787 828 301615 299789 998 300787 298476 1313 299789 293947 4529 298476 1.00000 false false 335214 335214 10921549 4985143 5936406 7303396 4671880 2631516 8903136 0 DUE TO THIRD PARTIES 1357569 INTEREST RATE SWAP AGREEMENT 278970 ASSET RETIREMENT OBLIGATIONS 32758 1669297 26285364 25508963 776401 -431517 -431517 344884 24502384 -1782980 -1782980 26285364 26285364 24157500 431517 431517 23725983 1782980 1782980 25508963 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 X true JAMES BOYLE FEASIB STUD false 0 16500 0 0 16500 0 true true true X 300. false true true false true true 194622 84295 110327 0.00460 3181937 3517370 -335433 0.01410 3376559 3601665 -225106 0.00950 12402 12402 0.00050 1523 1523 0.00010 5273318 3422103 1851215 0.07800 10140 10140 0.00040 5297383 3422103 1875280 0.07900 8673942 7023768 1650174 0.06950 true 908271 46866 5208256 5931079 -722823 X true true 1 1 BASSETT HOSPITAL OF SCHOHARIE COUNTY

178 GRANDVIEW DRIVE COBLESKILL NY 12043

X X X BASSETT HOSPITAL OF SCHOHARIE COUNTY 1 true true 300. false false true true X X X X true X X X true X X X X X X X true X false true 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 X X false false false false false false false false false 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 Part I, Line 3 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. 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 CHANGES IN NET ASSETS OR FUND BALANCE 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) Part VII Compensation Explanation 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 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 true false false false false false true true false true true false true true false true