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MARY IMOGENE BASSETT HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MARY IMOGENE BASSETT HOSPITAL (EIN 13-5596796)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-14
IRS object ID
201243199349304509
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-14T15:45:58-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1515 Broadway 4th FloorAddressLine1
CityAlbanyCity
StateNYState
ZIP Code122072974ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN135596796EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1The Mary Imogene Bassett HospitalBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% NICHOLAS J NICOLETTAInCareOfName
Name ControlMARYNameControl
Phone6075473635Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE ATWELL ROADAddressLine1
CityCooperstownCity
StateNYState
ZIP Code13326ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameNicholas J NicolettaName
TitleCorporate VP/CFOTitle
Date Signed2012-11-13DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone5184274600Phone
Date Prepared2012-11-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1Bassett Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonNicholas J NicolettaNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1One Atwell RoadAddressLine1
CityCooperstownCity
StateNYState
ZIP Code13326ZIPCode
FieldValueIRS element (for citing)
Gross Receipts437486268GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.bassett.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1921YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionSee Schedule O.ActivityOrMissionDescription
Nbr Voting Members Governing Body21NbrVotingMembersGoverningBody
Nbr Independent Voting Members19NbrIndependentVotingMembers
Total Nbr Employees3835TotalNbrEmployees
Total Nbr Volunteers145TotalNbrVolunteers
Total Gross UBI31127TotalGrossUBI
Contributions Grants Prior Year6857245ContributionsGrantsPriorYear
Contributions Grants Current Year7712078ContributionsGrantsCurrentYear
Program Service Revenue Prior Year393100520ProgramServiceRevenuePriorYear
Program Service Revenue CY399868572ProgramServiceRevenueCY
Investment Income Prior Year2543350InvestmentIncomePriorYear
Investment Income Current Year4865736InvestmentIncomeCurrentYear
Other Revenue Prior Year1590743OtherRevenuePriorYear
Other Revenue Current Year40575OtherRevenueCurrentYear
Total Revenue Prior Year404091858TotalRevenuePriorYear
Total Revenue Current Year412486961TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year228854646SalariesEtcPriorYear
Salaries Etc Current Year237833788SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year999428TotalFundrsngExpCurrentYear
Other Expense Prior Year174044275OtherExpensePriorYear
Other Expenses Current Year177222598OtherExpensesCurrentYear
Total Expenses Prior Year402898921TotalExpensesPriorYear
Total Expenses Current Year415056386TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1192937RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2569425RevenuesLessExpensesCY
Total Assets BOY323618053TotalAssetsBOY
Total Assets EOY343191925TotalAssetsEOY
Total Liabilities BOY95941047TotalLiabilitiesBOY
Total Liabilities EOY122504389TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY227677006NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY220687536NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionMIBH IS A RURAL ACADEMIC MEDICAL CENTER COMMITTED TO PROVIDING EXCELLENCE IN HEALTH CARE SERVICES, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROFESSIONALS, AND PURSUING HEALTH RESEARCH.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense331221622Expense
Revenue399868572Revenue
DescriptionINPATIENT AND OUTPATIENT SERVICES PROVIDED TO OUR PATIENTS RESULTED IN: 12,775 HOSPITALIZATIONS (INCLUSIVE OF OPEN HEART SURGERIES) 50,055 PATIENT DAYS 694,986 CLINIC VISITS 24,684 RENAL TREATMENTS 9,572 SURGICAL CASESDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense5699087Expense
DescriptionCommunity involvement has been linked to Bassett's mission, vision, and values since we first opened in 1922. Whether it is strengthening our community relationships for health and wellness, communicating ideas for improving our services to our region, or providing a forum for Bassett to learn and listen, we are working with our community to improve the quality of life for the people of our region. Our community services program provides free services to persons who cannot afford to pay, who do not qualify for Medicaid, and who fall within the established income guidelines. In 2011, we provided $5,699,087 in free care. Bassett's community health education programs include lectures, presentations, health fairs, and other group programs apart from the clinical and diagnostic services offered. Clinical services offered includes screenings, health tests and health risk appraisals including blood pressure, lipid profile, cholesterol screenings, cardiology risk factor screenings, and all cancer screenings. Our community building activities include philanthropic support for health initiatives and community health and welfare projects including promoting healthy lifestyles, disease prevention, and community awareness initiatives. Our doors are open 24 hours a day, 7 days a week, 365 days a year. We are proud to provide care to our communities. Not only did we provide $5.4M in charity care, bad debt expense was $14.5M, Medicaid payments below cost to provide services were $33.3M.Description
FieldValueIRS element (for citing)
Total Program Service Expense336920709TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096254NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees3835NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members21NbrVotingGoverningBodyMembers
Number Independent Voting Members19NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonNICHOLAS J NICOLETTANamePerson
Telephone Number6075473635TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE ATWELL ROADAddressLine1
CityCOOPERSTOWNCity
StateNYState
ZIP Code13326ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (31 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
Thomas Q Morris MD
Chairman1.0XX000
Kevin S Moore
Vice Chairman3.0XX000
William T Burdick
Secretary8.0XX000
Jane Forbes Clark
Trustee1.0X000
Edward W Stack
Trustee1.0X000
Vanness D Robinson
Trustee1.0X000
Barbara Dicocco
Trustee1.0X000
Ralph H Meyer
Trustee1.0X000
Donald O Pollock MD
Trustee1.0X000
Donald O Quest MD
Trustee1.0X000
Peter J Hamilton
Trustee1.0X000
Douglas B Willies
Trustee1.0X000
Terry Fulmer PHD RN
Trustee1.0X000
J Michael Moffat
Trustee1.0X000
Katherine D Nickerson
Trustee1.0X000
Timothy A Pedley MD
Vice Chairman1.0XX000
Clifton R WhartonJRPHD
Trustee1.0X000
John D Bullis
Trustee1.0X000
Michael Getman
Trustee1.0X000
Charles B Kieler
Trustee1.0X000
Michael S Gold MD
Trustee1.0X000
William F Streck MD
President & CEO40.0X656951017949
Bertine Colombo Mckenna PHD
Executive VP & COO40.0X369024012712
Nicholas J Nicoletta
Corporate VP & CFO40.0X368286015739
Richard C Vanison
Treasurer4.0X000
Glenn A Perrone
Assistant Secretary2.0X000
Steven J Heneghan MD
Attending Physician40.0579331017506X
Joseph Schmer MD
Attending Physician40.0528631011876X
James C Peters MD
Attending Physician40.0508989024832X
Jonathan Richman Md
Attending Physician40.0527196018275X
ROBERT LANCEY MD
ATTENDING PHYSICIAN40.0520879021396X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4059287TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation140285TotalOtherCompensation
Number Individuals GT100 K395NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcestrueCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MCCARTHY
1341 North Rock Hill RoadST LOUISMO63124CONSTRUCTION5978297
NURSEFINDERS
PO BOX 910738DALLASTX75391AGENCY SERVICES3014979
MEDQUIST TRANSCRIPTION
1000 BISHOPS GATE BLVD SMT LAURELNJ08054TRANSCRIPTION2513882
STAFF CARE INC
5001 STATESMAN DRIVEIRVINGTX75063AGENCY SERVICES1740863
VITALIZE CONSULTING
248 MAIN STREET STE 101BALTIMOREMD21279CONSULTING1562330
FieldValueIRS element (for citing)
Number Of Contractors GT100 K19NumberOfContractorsGT100K
Related Organizations1269834RelatedOrganizations
Government Grants5492550GovernmentGrants
All Other Contributions949694AllOtherContributions
Total Contributions7712078TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
DIRECT PATIENT SERVICES900099376743704376743704
OTHER PROGRAM SERVICE REVENUE9000992312486823124868
FieldValueIRS element (for citing)
Total Program Service Revenue399868572TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column924390TotalRevenueColumn
Exclusion$924,390ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities28882695Securities
Other57958Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities24925485Securities
Other73822Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities3957210Securities
Other-15864Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column3941346TotalRevenueColumn
Exclusion$3,941,346ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
PARTNERSHIP INCOME62150022657531127$195,448
INVESTMENT IN JOINT VENTURES621610-186000-$186,000
FieldValueIRS element (for citing)
Total Other Revenue40575TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column412486961TotalRevenueColumn
Related Or Exempt Function Income399868572RelatedOrExemptFunctionIncome
Unrelated Business Revenue31127UnrelatedBusinessRevenue
Exclusion$4,875,184ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1440661Total
Program Services0ProgramServices
Management And General1440661ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total207487525Total
Program Services157964427ProgramServices
Management And General49026337ManagementAndGeneral
Fundraising496761Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4811485Total
Program Services3663601ProgramServices
Management And General1138344ManagementAndGeneral
Fundraising9540Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total11415100Total
Program Services8631917ProgramServices
Management And General2756038ManagementAndGeneral
Fundraising27145Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total12679017Total
Program Services9584576ProgramServices
Management And General3060208ManagementAndGeneral
Fundraising34233Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total53278Total
Management And General53278ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total33231501Total
Program Services27396460ProgramServices
Management And General5608483ManagementAndGeneral
Fundraising226558Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2123226Total
Program Services1577118ProgramServices
Management And General503549ManagementAndGeneral
Fundraising42559Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total13254620Total
Program Services10030529ProgramServices
Management And General3202594ManagementAndGeneral
Fundraising21497Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total1673956Total
Program Services1265819ProgramServices
Management And General404156ManagementAndGeneral
Fundraising3981Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total19401620Total
Program Services14705044ProgramServices
Management And General4695094ManagementAndGeneral
Fundraising1482Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total3373543Total
Program Services2551020ProgramServices
Management And General814501ManagementAndGeneral
Fundraising8022Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
PATIENT CARE SUPPLIES3248104032481040
DRUGS AND REAGENTS3024939930249399
BAD DEBT1451394714513947
RENTAL EQUIPMENT & SPACE8872818672454921470451224

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total17993650Total
Program Services15581263ProgramServices
Management And General2285961ManagementAndGeneral
Fundraising126426Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total415056386Total
Program Services336920709ProgramServices
Management And General77136249ManagementAndGeneral
Fundraising999428Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY14917654BOY
EOY7155225EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY10834542BOY
EOY9860464EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY44601331BOY
EOY51797404EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3083021BOY
EOY3305577EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3053540BOY
EOY2457985EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis358055061LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec216610596LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY141174956BOY
EOY141444465EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY68045275BOY
EOY85442703EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY30936393BOY
EOY33634077EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY6971341BOY
EOY8094025EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY323618053BOY
EOY343191925EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY38862456BOY
EOY38850570EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY33385000BOY
EOY56570000EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY23693591BOY
EOY27083819EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY95941047BOY
EOY122504389EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY169040821BOY
EOY163124202EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY44847111BOY
EOY43733963EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY13789074BOY
EOY13829371EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY227677006BOY
EOY220687536EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY323618053BOY
EOY343191925EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-2569425ReconcilationRevenueExpenses
Reconcilation Other Changes-4420045ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$53,278OtherActivitiesAmount
Total Lobbying Expenditures IIB53278TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B - Description of Lobbying ActivityIdentifier
ExplanationAMERICAN HOSPITAL ASSOCIATION ALLOCATES 24.6% OF DUES TOWARDS GENERAL LOBBYING ACTIVITIES. TOTAL DUES PAID IN 2011 = $39,909 IROQUOIS HEALTHCARE ALLIANCE DUES ALLOCATES 45% OF DUES TOWARDS GENERAL LOBBYING ACTIVITIES. TOTAL DUES PAID IN 2011 : $31,469 HANYS ALLOCATES 30.3% OF DUES TOWARDS GENERAL LOBBYING ACTIVITIES. TOTAL DUES PAID IN 2011 : $96,697 THE CLARK ESTATES CONDUCTS LOBBYING ACTIVITIES ON BEHALF OF THE MARY IMOGENE BASSETT HOSPITAL. LOBBYING ACTIVITIES ARE LIMITED TO OFFICER DISCUSSIONS WITH CONSULTANTS AND LEGISLATORS TO OBTAIN FUNDING FOR CHARITABLE MISSIONS. NO FUNDS WERE EXPENDED.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance13789074BeginningOfYearBalance
Contributions40297Contributions
End Of Year Balance13829371EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance16734461BeginningOfYearBalance
Contributions54613Contributions
Investment Earnings Or Losses199921InvestmentEarningsOrLosses
Other Expenditures3000000OtherExpenditures
Administrative Expenses199921AdministrativeExpenses
End Of Year Balance13789074EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance13825685BeginningOfYearBalance
Contributions2908776Contributions
Investment Earnings Or Losses189138InvestmentEarningsOrLosses
Administrative Expenses189138AdministrativeExpenses
End Of Year Balance16734461EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance13511047BeginningOfYearBalance
Contributions314638Contributions
Investment Earnings Or Losses445038InvestmentEarningsOrLosses
Administrative Expenses445038AdministrativeExpenses
End Of Year Balance13825685EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgstrueEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis233974OtherCostOrOtherBasis
Book Value233974BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis184709902OtherCostOrOtherBasis
Depreciation94226662Depreciation
Book Value90483240BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis159276890OtherCostOrOtherBasis
Depreciation122383934Depreciation
Book Value36892956BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis13834295OtherCostOrOtherBasis
Book Value13834295BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings141444465TotalOfBookValueLandBuildings
Financial DerivativesFinancialDerivatives
Closely Held Equity InterestsCloselyHeldEquityInterests

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
LIMITED PARTNERSHIPS32662519C
LIMITED PARTNERSHIPS971558C
FieldValueIRS element (for citing)
Total Of Book Value Securities33634077TotalOfBookValueSecurities
Total Revenue412486961TotalRevenue
Total Expenses415056386TotalExpenses
Excess Or Deficit For Year-2569425ExcessOrDeficitForYear
Net Unrealized GL On Investments-3296601NetUnrealizedGLOnInvestments
Other-$1,123,444OtherAmount
Total Adjustments-4420045TotalAdjustments
Excess Or Deficit Per FS-6989470ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt387853882TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-3296601NetUnrealizedGainsInvestments
Other Revenues-21336478OtherRevenues
Revenue Not Rptd F990-24633079RevenueNotRptdF990
Revenue Subtotal412486961RevenueSubtotal
Total Revenue Per Form990412486961TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt394843352TotExpensesEtcAuditedFinclStmt
Expenses Subtotal394843352ExpensesSubtotal
Other Expenses Not Included20213034OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt20213034ExpensesNotRptdOnFinStmt
Total Expenses Per Form990415056386TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Part V, Line 4Permanently restricted endowment funds are held in perpetuity with restrictions on income for health services, medical research, medical education, and indigent care.
Part XI, Line 8POST RETIREMENT BENEIFT RELATED CHANGES -698,689 PROJECT ABANDONMENT (PATIENT KEEPER) -424,755 --------- TOTAL -1,123,444OTHER CHANGES IN NET ASSETS OR FUND BALANCES
Part XII, Line 2dBAD DEBT -14,513,947 CHARITY CARE -5,699,087 POST RETIREMENT BENEIFT RELATED CHANGES -698,689 PROJECT ABANDONMENT (PATIENT KEEPER) -424,755 --------- TOTAL -21,336,478OTHER REVENUE INCLUDED IN F/S BUT NOT INCLUDED ON FORM 990
Part XIII, Line 4bBAD DEBT 14,513,947 CHARITY CARE 5,699,087 ---------- Total 20,213,034Other Expenses Included on Form 990 but not included in F/S

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage300.FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CarefalseFPGReferenceDiscountedCare
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3563479TotalCommunityBenefitExpense
Direct Offsetting Revenue269165DirectOffsettingRevenue
Net Community Benefit Expense3294314NetCommunityBenefitExpense
Percent Of Total Expense0.00790PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense48341819TotalCommunityBenefitExpense
Direct Offsetting Revenue33350141DirectOffsettingRevenue
Net Community Benefit Expense14991678NetCommunityBenefitExpense
Percent Of Total Expense0.03610PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense51905298TotalCommunityBenefitExpense
Direct Offsetting Revenue33619306DirectOffsettingRevenue
Net Community Benefit Expense18285992NetCommunityBenefitExpense
Percent Of Total Expense0.04400PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense50666TotalCommunityBenefitExpense
Net Community Benefit Expense50666NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense15207172TotalCommunityBenefitExpense
Direct Offsetting Revenue4351640DirectOffsettingRevenue
Net Community Benefit Expense10855532NetCommunityBenefitExpense
Percent Of Total Expense0.02620PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense8154970TotalCommunityBenefitExpense
Direct Offsetting Revenue317280DirectOffsettingRevenue
Net Community Benefit Expense7837690NetCommunityBenefitExpense
Percent Of Total Expense0.01890PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense494136TotalCommunityBenefitExpense
Net Community Benefit Expense494136NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense23906944TotalCommunityBenefitExpense
Direct Offsetting Revenue4668920DirectOffsettingRevenue
Net Community Benefit Expense19238024NetCommunityBenefitExpense
Percent Of Total Expense0.04640PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense75812242TotalCommunityBenefitExpense
Direct Offsetting Revenue38288226DirectOffsettingRevenue
Net Community Benefit Expense37524016NetCommunityBenefitExpense
Percent Of Total Expense0.09040PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$6,468,132BadDebtExpenseAmount
Amount Attributable To996503AmountAttributableTo
Amount Reimbursed By Medicare96155735AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare85668387CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall10487348MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1At home care incBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityHome healthcare agencyDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.50000OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership0.00000OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership0.00000PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Mary Imogene Bassett HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1one atwell roadAddressLine1
CitycooperstownCity
StateNYState
ZIP Code13326ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Research FacilityXResearchFacility
Er24 HoursXEr24Hours
OtherOutpatient primary & Specialty ClinicsOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Mary Imogene Bassett HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedfalseCHNAConducted
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent300.FPGFreePercent
Uses FPG DiscountedfalseUsesFPGDiscounted
Explains BasisfalseExplainsBasis
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Permit Other ActionsXPermitOtherActions
Collection ActivitiestrueCollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Lien On ResidenceXLienOnResidence
Other ActionsXOtherActions
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargestrueGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities50NumberOfOtherFacilities

Other Facilities OtherFacilities (50 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
AC CLARK GYMNASIUM
SUSQUEHANA AVENUECOOPERSTOWNNY13326OUTPATIENT PHYSICAL THERAPY SERVICES
BASSETT HEALTHCARE HAMILTON SURGICAL SER
10 EATON STREETHAMILTONNY13346OUTPATIENT SPECIALTY CARE
BASSETT HEALTHCARE HERKIMER CARDIAC REHA
690 WEST GERMAN STREETHERKIMERNY13350OUTPATIENT REHAB SERVICES
BASSETT HEALTHCARE CLINTON
34 CHENANGO AVENUECLINTONNY13323OUTPATIENT PRIMARY CARE PRIMARY CARE
BASSETT HEALTHCARE CANAJOHARIE
56 MONTGOMERY STREETCANAJOHARIENY13317OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE COBLESKILL
121 LEGION DRIVECOBLESKILLNY12043OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE DELANSON
1 COOLEY HEIGHTSDELANSONNY12053OUTPATIENT PRIMARY CARE PRIMARY CARE
BASSETT HEALTHCARE DELHI
460 ANDES ROADDELHINY13753OUTPATIENT DENTAL AND PRIMARY
BASSETT HEALTHCARE EDMESTON
ROUTE 80 PO BOX 15EDMESTONNY13335OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE HAMILTON
160 BROAD STREETHAMILTONNY13346OUTPATIENT DENTAL AND PRIMARY CARE
BASSETT HEALTHCARE HERKIMER
321 EAST ALBANY STREETHERKIMERNY13350OUTPATIENT PRIMARY, SPECIALTY, SPECIALTY, AND URGENT CARE
BASSETT HEALTHCARE MIDDLEBURGH
109 BAKER AVENUEMIDDLEBURGHNY12122OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE MORRIS
93 MAIN STREETMORRISNY13808OUTPATIENT SPECIALTY CARE
BASSETT HEALTHCARE ONEONTA SURGICAL ASSO
449 MAIN STREETONEONTANY13820OUTPATIENT SPECIALTY CARE
BASSETT HEALTHCARE NORWICH
55 CALVARY DRIVENORWICHNY13815OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE ONEONTA
125 MAIN STREETONEONTANY13820OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE ONEONTA SPECIALTY SER
ONE ASSOCIATE DRIVEONEONTANY13820OUTPATIENT PRIMARY, SPECIALTY, SPECIALTY, AND URGENT CARE
BASSETT HEALTHCARE PHYSICAL THERAPY
21 RAILROAD AVENUECOOPERSTOWNNY13326OUTPATIENT SPECIALTY CARE
BASSETT HEALTHCARE RICHFIELD SPRINGS
8550 STATE HIGHWAY 28RICHFIELD SPRINGSNY13439OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE SCHOHARIE
111 BARTON HILL ROADSCHOHARIENY12157OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE SHARON SPRINGS
ROUTE 20 PO BOX 275SHARON SPRINGSNY13459OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE SHERBOURNE
20 CHAPEL STREETSHERBOURNENY13460OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE SIDNEY
39 PEARL STREET WESTSIDNEYNY13838OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE ST JOHNSVILLE
8 PARK PLACEST JOHNSVILLENY13452OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE STAMFORD
28650 STATE HIGHWAY 23STAMFORDNY12167OUTPATIENT PRIMARY CARE
BASSETT HEALTH WALTON
130 NORTH STREETWALTONNY13856OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE WEST WINFIELD
544 EAST MAIN STREETWEST WINFIELDNY13491OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE AT FOX CARE
1 FOX CARE DRIVEONEONTANY13820OUTPATIENT SPECIALTY SERVICES
BASSETT HEALTHCARE AT LITTLE FALLS
170 BURWELL STREETLITTLE FALLSNY13365OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE UNADILLA
16 CLIFTON STREETUNADILLANY13849OUTPATIENT PRIMARY CARE
BASSETT REGIONAL CANCER CENTER
7 ASSOCIATE DRIVEONEONTANY13820OUTPATIENT SPECIALTY CARE
HARTWICK SEMINARY SPECIALTY SERVICES
4580 ROUTE 28MILFORDNY13807OUTPATIENT PRIMARY AND specialty care
SBHC COOPERSTOWN ELEMENTARY
21 WALNUT STREETCOOPERSTOWNNY13326OUTPATIENT PRIMARY CARE
SBHC COOPERSTOWN MIDDLE & HIGH SCHOOL
39 LINDEN AVENUECOOPERSTOWNNY13326OUTPATIENT PRIMARY CARE
SBHC DELHI ELEMENTARY
2 SHELDON DRIVEDELHINY13753OUTPATIENT PRIMARY CARE
SBHC DELHI MIDDLE & HIGH SCHOOL
2 SHELDON DRIVEDELHINY13753OUTPATIENT PRIMARY CARE
SBHC EDMESTON CENTRAL SCHOOL
11 NORTH STREETEDMESTONNY13335OUTPATIENT PRIMARY CARE
SBHC LAURENS CENTRAL SCHOOL
55 MAIN STREETLAURENSNY13796OUTPATIENT PRIMARY CARE
SBHC MIDDLEBURGH ELEMENTARY
245-I MAIN STREETMIDDLEBURGHNY12122OUTPATIENT PRIMARY CARE
SBHC MIDDLEBURGH MIDDLE & HIGH SCHOOL
291 MAIN STREETMIDDLEBURGHNY12122OUTPATIENT PRIMARY CARE
SBHC MILFORD CENTRAL SCHOOL
42 WEST MAIN STREETMILFORDNY13807OUTPATIENT PRIMARY CARE
SBHC MORRIS CENTRAL SCHOOL
65 MAIN STREETMORRISNY13808OUTPATIENT PRIMARY CARE
SBHC ORAL HEALTH MOBILE EQUIPMENT PROGRA
ONE ATWELL ROADCOOPERSTOWNNY13326OUTPATIENT SPECIALTY CARE
SBHC SCHENEVUS CENTRAL SCHOOL
159 MAIN STREETSCHENEVUSNY12155OUTPATIENT PRIMARY CARE
SBHC SHERBURNEEARLVILLE ELEMENTARY
13 SCHOOL STREETSHERBURNENY13460OUTPATIENT PRIMARY CARE
SBHC SHERBURNEEARLVILLE MIDDLE & HIGH S
13 SCHOOL STREETSHERBURNENY13460OUTPATIENT PRIMARY CARE
SBHC SIDNEY CENTRAL SCHOOL
95 WEST MAIN STREETSIDNEYNY13838OUTPATIENT PRIMARY CARE
SBHC SOUTH KORTRIGHT CENTRAL SCHOOL
PO BOX 113SOUTH KORTRIGHTNY13842OUTPATIENT PRIMARY CARE
SBHC STAMFORD CENTRAL SCHOOL
ONE RIVER STREETSTAMFORDNY12167OUTPATIENT PRIMARY CARE
SBHC WORCESTER CENTRAL SCHOOL
195 MAIN STREETWORCESTERNY12197OUTPATIENT PRIMARY CARE

Form990 Schedule H Part VI Form990ScheduleHPartVI (19 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part I, Line 3cCharity Care Eligibility Criteria (FPG is Not Used)The CSP (community services program) application specifies family income limits and other requirements for services to be eligible for Bassett Medical Center's CSP/free care program.
Part I, Line 6aRelated Organization Community Benefit ReportTHE MARY IMOGENE BASSETT HOSPITAL, D/B/A BASSETT MEDICAL CENTER (BASSETT), COMPREHENSIVE THREE-YEAR COMMUNITY SERVICE PLAN WAS SUMMARIZED IN AN ANNUAL COMMUNITY REPORT. PRINTED COPIES WERE AVAILABLE TO THE PUBLIC IN PATIENT WAITING ROOMS AND AT INFORMATION KIOSKS. THE REPORT IS ALSO POSTED ON THE BASSETT WEBSITE, WWW.BASSETT.ORG.
Part I, Line 7Explanation of Costing MethodologySECTIONS (A) CHARITY CARE AT COST, (B) UNREIMBURSED MEDICAID, (F) HEALTH PROFESSIONS EDUCATION, THE COSTING METHODOLOGY USED IS A COST-TO-CHARGE RATIO CALCULATION UTILIZED ON FILED STATE AND FEDERAL COST REPORTS AS THE SOURCE. INDIRECT COSTS WERE APPLIED TO SECTIONS (E) COMMUNITY HEALTH IMPROVEMENT, PORTIONS OF (F) HEALTH PROFESSIONS EDUCATION, (H) RESEARCH, AND (I) CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS 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 FRINGE BENEFIT RATE. INDIRECT COSTS WERE ONLY APPLIED TO SELECT SALARIES AND SERVICES UNDER COMMUNITY HEALTH IMPROVEMENT AND RESEARCH AND NOT BROADLY ACROSS ALL COMMUNITY BENEFIT ACTIVITY ENTRIES.
Part I, Line 7, Column FExplanation of Bad Debt ExpenseTHE PERCENT OF TOTAL EXPENSE IS CALCULATED BY DIVIDING COLUMN (E), NET COMMUNITY BENEFIT EXPENSE, BY TOTAL EXPENSE. THE BAD DEBT EXPENSE OF $14,513,947 WAS SUBTRACTED FROM THE TOTAL EXPENSE VALUE USED TO CALCULATE THE PERCENTAGES IN PART 1, LINE 7, COLUMN F.
Part III, Line 4Bad Debt ExpenseWORKSHEET 2 COST TO CHARGE RATIO WAS USED TO DETERMINE THE AMOUNT REPORTED IN PART III, LINES 2 AND 3. Provision for Uncollectible Patient Accounts Receivable text within Financial Statements Footnotes: "The Hospital grants credit without collateral to patients, most of who are local residents and are insured under third party agreements. Services rendered to individuals when payment is expected and ultimately not received are written off to the allowance for estimated uncollectible accounts. Additions to the allowance for estimated uncollectible accounts are made by means of the provisions for uncollectible accounts. Accounts written off as uncollectible are deducted from the allowance and subsequent recoveries are added. The amount of the provision for uncollectible accounts is based upon management's assessment of historical expected collections, business and economic conditions, trends in federal and state healthcare coverage, and other collection indicators." Provision for Charity and Uncompensated Care text within Financial Statements Footnotes: "The Hospital's general policy statement on charity care requires that medical care be rendered to all persons in need of such care regardless of their ability to pay. 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. These records include the amount of charges forgone for services furnished under its charity care policy. The hospital's charity care policy has not changed during fiscal years 2010 or 2011." DURING 2011 AND 2010, THE TOTAL CHARGES FORGONE FOR Bad Debt WERE APPROXIMATELY $14,513,947 AND $15,329,504 RESPECTIVELY.
Part III, Line 9bProvisions on Collection Practices for Qualified PatientsFor patients or guarantors who do not qualify for financial assistance, Bassett must undertake to ensure an adequate understanding on the part of the patients and those responsible for their care of their financial obligations to Bassett. Bassett will in compliance with all existing laws and regulations take the steps necessary to recover self-pay accounts receivable as well as preserve the patient-provider relationship and keep the necessity of referring accounts to third party bad debt collection agencies or law firms to a minimum. It is expected that any third party collection agency or law firm retained by Bassett will 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. The arrest or body attachment of a judgment debtor on contempt proceedings, or foreclosure of a judgment debtor's principal residence will never be considered appropriate pursuit of an open balance in the name of Bassett Medical Center. Liens or garnishments upon the personal assets of a judgment debtor will be pursued only after individual case review by counsel to ensure that such action is not only consistent with Bassett's interests, but also the only feasible recovery mechanism from a judgment debtor capable of responding to his or her obligations, but otherwise unwilling to do so.
Part V, line 10Discounted CareBassett Medical Center does not provide discounted care.
Part V, Line 15eOther Collection Actions Against a PatientBassett engages with a third party to perform collection actions.
Part V, Line 16eOther Collection Actions by Facility or Third Party EngagedOther actions taken include claims on estates, claims on bankruptcies, and wage garnishments.
Part V, Line 19dOther Billing Determination of Individuals Without InsuranceBassett 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. All charges to individuals that qualify for charity care are written off completely.
Part V, Line 21Charge Patients Amount Equal Gross Charge for ServicesTHE 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. All charges to individuals that qualify for charity care are written off completely.
Part VI, Line 2Needs AssessmentIn addition to public and agency input, a variety of data from the NYS Department of Health, Otsego County Behavioral Risk Factor Surveillance System, Otsego Co. Department of Health Community Assessment and other sources were used to assess priorities, including: A) Percentage of Otsego Co. adults who visited a dentist in the past years. B) Prevalence of tooth decay in third-grade children. C) Percentage of adults reporting binge drinking D) Heavy drinking E) Percentage of overweight adults in Otsego Co. Based on the outcomes of the focus groups and strategic planning sessions prevention agenda priorities throughout the county were identified. Access to quality healthcare and Mental Health and Substance Abuse were identified as the top priorities. Physical Activity and Nutrition was ranked third. Subsequent strategic planning sessions related to the two top priorities were held to identify service barriers and gaps as well as brainstorm for collaborative efforts to address these priorities. Strategies for the selected priorities: 1) Access to dental health care a) Bassett will support Otsego Co. Dept. of Health efforts to re-establish the Otsego Co. Oral Health Coalition as a mechanism for bringing community partners together on advocacy efforts aimed at attracting more dentists to our rural area, and for tracking progress in improving access to dental services b) Bassett will work to expand comprehensive preventive dental health services to all School-Based Health Centers in the county and to provide sealant services to non-SBHC schools. Bassett will work with the Otsego Co. Dept. of Health and RHENDOMS to make more schools aware of RHENDOMS services to increase participation. c) Bassett will work with the Otsego Co. Dept. of Health and A.O. Fox Hospital to educate primary care and SBHC providers about dental practices available for referral. The Otsego Co. Dept. of Health will educate dental providers about Medicaid reimbursements. d) Bassett will work with the health department and other community partners to educate the public about dental health in fairs and other community events. 2. Mental Health and Substance Abuse a) In a new initiative Bassett will work with A.O. Fox Hospital and Leatherstocking Education on Alcoholism/Addictions Foundations, Inc. (LEAF) to provide continuing medical education training on substance abuse screening and referral to primary care providers and surgeons in the county. b) Bassett will work with the health department and LEAF to complete and distribute an updated list of mental health and substance abuse resources to primary care providers. c) Bassett will collaborate with LEAF and the health department on public health campaign about the risk factors associated with binge drinking and prescription drug abuse. 3. Physical Activity and Nutrition a) Bassett will continue to collaborate with the health department and other community partners on efforts to provide early education about the importance of physical activity and nutrition throughout life, including during pregnancy and to prevent chronic disease. b) Bassett will work with the health department, schools and other community partners to improve continuity of care between families, schools and primary care providers for the treatment of childhood obesity. Overall goals will be to increase the percentage of Otsego County adults who have seen a dentist in the past year, work toward a 2013 prevention agenda objective of 83%, reducing the rate of alcohol abuse in Otsego County and reducing the rate of obesity in Otsego County.
Part VI, Line 3Patient Education of Eligibility for AssistanceA MAJOR COMPONENT OF THE BASSETT MEDICAL CENTER COMMUNITY SERVICES 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 BASSETT EMPLOYEES. THE POLICY IS UPDATED ANNUALLY, DISTRIBUTED TO KEY PERSONNEL AND POSTED IN THE ONLINE POLICY AND PROCEDURE MANUAL THAT IS ACCESSIBLE TO ALL EMPLOYEES. THE PROGRAM IS SUPPORTED BY A FOUR PAGE PLAIN LANGUAGE BROCHURE THAT INCLUDES AN APPLICATION. BROCHURES ARE PROMINENTLY DISPLAYED AND AVAILABLE AT ALL FACILITIES AND ALL CLINIC LOCATIONS. CLINICAL AND SUPPORT STAFF ARE MADE AWARE OF THE PROGRAM AND ABLE TO DIRECT PATIENTS TO SPECIALISTS WHO CAN ASSIST IN THE APPLICATION PROCESS. ALL PATIENTS WHO ARE REGISTERED AS 'SELF PAY' ARE PROVIDED A BROCHURE EITHER IN PERSON OR BY MAIL. PATIENTS WHO ARE IN THE HOSPITAL RECEIVE INFORMATION AS PART OF A PERSONAL VISIT GEARED TO HELP THE PATIENT NAVIGATE FINANCIAL ASSISTANCE INCLUDING, BUT NOT LIMITED TO, THE COMMUNITY SERVICES PROGRAM. GOVERNMENT PROGRAM OPPORTUNITIES ARE ALSO REFERENCED AND A DIRECTORY OF LOCAL SOCIAL SERVICES AGENCIES IS PROVIDED BASED ON THE PATIENT'S COUNTY OF RESIDENCE. REFERRAL TO AN ONSITE OTSEGO COUNTY MEDICAID EXAMINER IS AVAILABLE AT THE COOPERSTOWN CAMPUS. A LISTING OF ALL SELF-PAY ACCOUNTS IS PRODUCED AND REVIEWED DAILY TO INSURE THAT A COMMUNITY SERVICES BROCHURE HAS BEEN PROVIDED. THE SELF-PAY BILLING OFFICE IDENTIFIES PATIENTS DURING THE BILLING AND COLLECTIONS PROCESS THAT MAY REQUIRE ADDITIONAL HELP UNDERSTANDING THE PROGRAM. SELF-PAY ACCOUNTS FOR PATIENTS WHO HAVE BEEN APPROVED FOR COMMUNITY SERVICES WITHIN THE PRIOR 120 DAYS ARE AUTOMATICALLY INCLUDED WITH THE PRIOR APPROVAL.
Part VI, Line 4Community InformationTHE SERVICE AREA OF BASSETT ENCOMPASSES A EIGHT COUNTY REGION IN UPSTATE NEW YORK. WHILE THE ECONOMY OF COOPERSTOWN IS BASED ON TOURISM AND HEALTH CARE, THE REST OF THE REGION IS LARGELY AGRICULTURAL. THERE ARE A FEW LARGER EMPLOYERS IN THE REGION SUCH AS LOCAL SCHOOL DISTRICTS, COMMUNITY, STATE AND PRIVATE UNIVERSITIES, THE MAJORITY OF EMPLOYERS ARE SMALL BUSINESSES. IN THE EIGHT COUNTY REGIONS, THE MEDIAN HOUSEHOLD INCOME RANGES BETWEEN $37,000 AND $40,000. 12-14 % OF THE COMMUNITY RESIDENTS HAVE INCOMES BELOW THE FEDERAL POVERTY GUIDELINES. THE FOLLOWING AREAS HAVE BEEN FEDERALLY DESIGNATED AS BEING MEDICALLY UNDERSERVED: A) IN HERKIMER COUNTY THE CITY OF HERKIMER. B) IN DELAWARE COUNTY THE TOWNS OF MIDDLETOWN, MARGARETVILLE, ANDES AND DEPOSIT.
Part VI, Line 5Community Building ActivitiesBASSETT SERVES AS THE FOUNDATION FOR THE THURSTON CORPORATION (DBA BASSETT HEALTHCARE NETWORK) AND IS A 180-BED ACUTE CARE INPATIENT TEACHING FACILITY LOCATED IN COOPERSTOWN, NEW YORK. PROVIDING A WIDE RANGE OF SPECIALTY CARE, BASSETT MAINTAINS A STRONG ACADEMIC PROGRAM THROUGH ITS AFFILIATION WITH COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS, AN AFFILIATION HIGHLIGHTED BY THE ESTABLISHMENT OF A COLUMBIA MEDICAL SCHOOL CAMPUS AT BASSETT IN 2009. BASSETT HAS A NETWORK OF 29 COMMUNITY BASED OUTPATIENT HEALTH CENTERS, 18 SCHOOL-BASED HEALTH CENTERS, TWO AMBULATORY SURGERY CENTERS AND IS A LEVEL II TRAUMA CENTER AS DESIGNATED BY NEW YORK STATE. IN ADDITION, THE RESEARCH PROGRAMS AT BASSETT INCLUDE THE NEW YORK CENTER FOR AGRICULTURAL MEDICINE AND HEALTH. COMMUNITY BASED PARTNERSHIPS AS PART OF THE NORTHEAST CENTER FOR AGRICULTURAL HEALTH ARE ADDRESSING IMPORTANT HEALTH AND SAFETY ISSUES IN DIVERSE AGRICULTURAL POPULATIONS AT SEVERAL SITES ACROSS NEW YORK STATE. HEALTH WORKS OCCUPATIONAL HEALTH SERVICES PROGRAM CONTINUES TO MEET THE HEALTH, SAFETY AND WELLNESS NEEDS OF THE BUSINESS COMMUNITY. PROVIDING NEEDED OCCUPATIONAL HEALTH SERVICES BENEFITS AND IMPROVING EMPLOYEE HEALTH THROUGHOUT THE BASSETT HEALTHCARE NETWORK EIGHT-COUNTY REGION. BASSETT IS WORKING TO RE-ESTABLISH THE OTSEGO COUNTY ORAL HEALTH COALITION AS A MECHANISM FOR BRINGING COMMUNITY PARTNERS TOGETHER AROUND A SHARED VISION IN AN EFFORT TO ATTRACT MORE DENTISTS TO OUR RURAL AREA. THE SIZE AND DEPTH OF BASSETT WITH ITS MORE THAN TWO DOZEN COMMUNITY HEALTH CENTERS AND 18 SCHOOL BASED HEALTH CENTERS MAKES IT IDEAL FOR A NEW INITIATIVE TO TRAIN PRIMARY CARE PRACTITIONERS AND SURGEONS IN SUBSTANCE ABUSE SCREENING AND REFERRAL. THE GOAL IS TO ALSO TRAIN PRACTITIONERS OUTSIDE BASSETT HOSPITAL, BUT BASSETT PROVIDES THE IDEAL PLATFORM FROM WHICH TO PILOT THIS INITIATIVE. BASSETT IS ALSO ADDRESSING THE RATE OF OBESITY WITHIN ITS REGION REACHING OUT TO SCHOOLS TO PROVIDE RESOURCES, GUIDANCE AND TECHNICAL ASSISTANCE IN THE AREAS OF TOBACCO USE, NUTRITION AND PHYSICAL ACTIVITY. BASSETT CONTINUES TO COMBINE HEALTH CARE WITH COMMUNITY SERVICE. OUR PROGRAM "CONNECTING COMMUNITIES FOR HEALTH & WELLNESS" IS ABOUT COLLABORATIVE EFFORTS TO PROVIDE TREATMENT AND/OR TO PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. COMMUNITY HEALTH IMPROVEMENT INITIATIVES HAVE TARGETED THE NEW YORK STATE DEPARTMENT OF HEALTH NEW PUBLIC HEALTH PREVENTION AGENDA. IN ADDITION TO HOSPITAL PUBLIC HEALTH PROGRAMS RELATED TO THE THREE PRIORITY PREVENTION AGENDA ITEMS, PROGRAMS ADDRESSING CHRONIC DISEASE MANAGEMENT AND PREVENTION AND UNINTENTIONAL INJURY WERE CONSIDERED. BASSETT PUBLIC HEALTH PROGRAMS THAT ADDRESS THESE AREAS INCLUDE: A) SCHOOL-BASED HEALTH CENTER DENTAL SEALANT PROGRAM. A REGISTERED DENTAL HYGIENIST PROVIDES PREVENTIVE CARE, INCLUDING EDUCATION, CLEANINGS, FLUORIDE TREATMENT, SEALANT AND REFERRALS IN THIS GRANT FUNDED PROGRAM. B) RHENDOMS (RURAL HEALTH EDUCATION NETWORK OF DELAWARE, OTSEGO, MONTGOMERY AND SCHOHARIE COUNTIES) - DENTAL HEALTH EDUCATION IS OFFERED TO ELEMENTARY SCHOOL STUDENTS, AND PARENTS OF NEWBORNS ARE EDUCATED ABOUT BABY-BOTTLE TOOTH DECAY. C) BASSETT PSYCHIATRIC CRISIS CENTER - THE COOPERSTOWN CENTER OPENED IN FEBRUARY 2008, FILLING A VOID CREATED BY THE TERMINATION OF PSYCHIATRIC SERVICES AT A.O. FOX HOSPITAL IN ONEONTA MONTHS EARLIER. IN ITS FIRST YEAR, BASSETT'S PSYCHIATRIC CRISIS CENTER HELPED MORE THAN 1,200 PATIENTS. OF THOSE, 52 WERE CHILDREN 12 OR YOUNGER AND 154 WERE ADOLESCENTS. D) PARENT HANDBOOK - THIS FAMILY RESOURCE WAS CREATED BY THE OTSEGO CO. COMMITTEE ON CHILD ABUSE AND NEGLECT AND UNDERWRITTEN BY BASSETT HEALTHCARE AND A.O. FOX HOSPITAL. IT'S GOAL IS TO GIVE PARENTS AND PROFESSIONALS A PLACE TO TURN FOR HELP IN DEALING WITH THE STRESSES OF FAMILY LIFE. E) KICKSTART - A PROGRAM DESIGNED TO HELP COMBAT CHILDHOOD OBESITY THROUGH COLLABORATIVE PARTNERSHIPS WITH BASSETT HEALTH CENTERS AND LOCAL RECREATIONAL AND FITNESS GROUPS. F) BASSETT CANCER INSTITUTE MEDICAL SCREENING COACH - A NEW, CUSTOM-BUILT MEDICAL COACH EQUIPPED WITH DIGITAL TECHNOLOGY FOR MAMMOGRAPHY AND OTHER CANCER SCREENINGS FOR MEN AND WOMEN. THE COACH WAS PLACED IN SERVICE IN 2008 WITH THE GOAL OF REDUCING THE NUMBER OF CANCER DEATHS BY INCREASING ACCESS TO SCREENING SERVICES IN RURAL AREAS. G) CANCER SERVICES PROGRAM OF DELAWARE, OTSEGO AND SCHOHARIE COUNTIES A NEW YORK STATE DEPARTMENT OF HEALTH PARTNERSHIP ADMINISTERED THROUGH BASSETT OFFERING FREE BREAST, CERVICAL AND COLORECTAL SCREENINGS TO PEOPLE WHO QUALIFY. H) HEALTHY START BREAKFAST - A PARTNERSHIP BETWEEN COMMUNITY SERVICE ORGANIZATIONS AND BASSETT FOR DIABETES DETECTION, EDUCATION AND PREVENTION. I) SAFE KIDS COALITION OF OTSEGO COUNTY - AN ORGANIZATION WHOSE MISSION IS TO PREVENT UNINTENTIONAL INJURIES TO CHILDREN THROUGH EDUCATION. PROGRAMS AND SERVICES INCLUDE SAFETY SEAT EVENTS, EDUCATIONAL RESOURCES ON BICYCLE, IN-LINE SKATE AND SKATEBOARD SAFETY, HOME SAFETY, FIRE AND BURN PREVENTION, ROAD SAFETY AND PEDESTRIAN SAFETY. THE REGIONAL PRIMARY AND SPECIALTY CARE CLINICS AND THE SCHOOL-BASED HEALTH CENTERS WERE ESTABLISHED IN RESPONSE TO COMMUNITY NEED. BASSETT IS CONTINUALLY ENGAGING IN QUALITY IMPROVEMENT INITIATIVES TO ENSURE THAT QUALITY HEALTH CARE AND PROGRAMS ARE BROUGHT TO CENTRAL NEW YORK. A CORE PART OF BASSETT IS RESEARCH AND EDUCATION. BASSETT'S VALUE TO THE COMMUNITIES IT SERVES IS COMPOUNDED BY PROVIDING PHYSICIANS THE ABILITY TO PRACTICE QUALITY MEDICINE IN A COLLEGIAL ENVIRONMENT IN A RURAL SETTING. THERE IS A TREMENDOUS COLLABORATION BETWEEN PHYSICIANS WITHIN BASSETT TO ENSURE A BETTER OUTCOME FOR THE PATIENT. BASSETT CONTINUALLY INVESTS IN PROGRAMS, EQUIPMENT AND PEOPLE TO ENSURE QUALITY SERVICE TO THE COMMUNITIES IN WHICH WE SERVE.
Part VI, Line 6Affilated Health Care System Roles and PromotionBASSETT IS PART OF THE BASSETT HEALTHCARE NETWORK THAT PROVIDES HEALTH 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 62,200; SCHOHARIE COUNTY - POPULATION 31,910 (ACCORDING TO THE 2008 U.S. CENSUS ESTIMATES). A) BASSETT - AN ACUTE CARE INPATIENT TEACHING FACILITY, AN OUTPATIENT PRIMARY AND SPECIALTY CARE CENTER, A REGIONAL NETWORK OF 26 COMMUNITY BASED OUTPATIENT HEALTH CENTERS, 18 SCHOOL BASED HEALTH CENTERS, TWO AMBULATORY SURGERY CENTERS AND A FULLY SALARIED MEDICAL STAFF IN COOPERSTOWN, OTSEGO COUNTY B) O'CONNOR HOSPITAL - A CRITICAL ACCESS HOSPITAL IN DELHI, DELAWARE COUNTY C. COBLESKILL REGIONAL HOSPITAL - AN ACUTE CARE FACILITY IN COBLESKILL, SCHOHARIE COUNTY D) LITTLE FALLS HOSPITAL - A CRITICAL ACCESS HOSPITAL IN LITTLE FALLS, HERKIMER COUNTY E) TRI-TOWN REGIONAL HOSPITAL - A 24/7 EMERGENCY CARE FACILITY IN SIDNEY, DELAWARE COUNTY F) A.O. FOX MEMORIAL HOSPITAL - AN 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 THE ABOVE (A-I) MAKE UP THE BASSETT HEALTHCARE NETWORK AND PROVIDE HEALTH SERVICES TO THIS EIGHT COUNTY REGION IN CENTRAL NEW YORK.
Part VI, Line 7States Where Community Benefit Report FiledNY
Additional InformationPart II - All Bassett community building activities could be classified under item 1 and highlighted in Part I.
Part III, line 8Explanation of Shortfall as community benefitAmounts were derived as follows: charges times cost to charge ratio versus reimbursement on the Medicare PS&R report.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
William F Streck MD
6516680005283011339066100674900000
Bertine Colombo Mckenna PHD
369024000008709040030381736000
Nicholas J Nicoletta
3682860000011339044000384025000
Steven J Heneghan MD
5793310000011339061670596837000
Joseph Schmer MD
4503500759160236508709031670540507000
James C Peters MD
484616024373000101140147180533821000
Jonathan Richman Md
5271960000011339069360545471000
ROBERT LANCEY MD
5208790000087090126870542275000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
PART I, LINE 7NON-FIXED PAYMENTS ARE MADE BASED ON THE SUCCESS IN MEETING PERFORMANCE CRITERIA THAT ARE PROSPECTIVELY AGREED UPON AS GOALS FOR THE OFFICERS. PHYSICIAN CHIEFS MAY RECEIVE NON-FIXED PAYMENTS BASED ON PERFORMANCE AND COMPARATIVE MARKET DATA
Part VII, Line 5NAME : WILLIAM F STRECK, MD NAME OF UNRELATED ORGANIZATION : COLUMBIA UNIVERSITY TYPE OF COMPENSATION : SALARY AMOUNT OF COMPENSATION : $228,798Compensation from Unrelated ORganizations

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Otsego Cty Capital Resour
2636615932011-11-0325000000Building & Structuresfalsefalsefalse
Otsego Cty Capital Resour
2636615932011-11-0319200000Refund of prior issuancefalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Amount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindYear Of Subst CompletionYearOfSubstCompletion
002500000000702000500000002379800000falsefalsefalsetrue
191250000192000000007500000000truefalsetruetrue2009

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalse0true
falsefalsefalsefalse0true

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
0
falsetruefalsefalse0falsefalse
0
falsetruefalsefalse0falsefalse
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Schedule K IRS990ScheduleK

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
The Clark Estates
Part V418421Investment mgmt feesfalse
Jane Hamilton
Part V65514wagesfalse

Form990 Schedule L Part V Form990ScheduleLPartV (2 entries)

IdentifierIdentifierExplanationExplanation
Part IV, Line 1More than 35% of The Clark Estates is owned by trustee Jane Forbes Clark
Part IV, Line 2Jane Hamilton is family member of trustee Peter Hamilton

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Part I, Summary, Line 1MIBH is a 180 bed acute care facility that serves Cooperstown and an 8 county region through its regional health center network. MIBH offers 24 hour emergency/trauma care, cancer and heart care, dialysis, and most medical and surgical specialties, and conducts research and education programs.
Part VI, Section A, Question 2Trustees Kevin S Moore, William T Burdick, Jane Forbes clark, Richard C Vanison, and glenn a perrone have a business relationship.
Part VI, Section B, Line 11bBassett distributes the draft 990 to the audit committee of the board of trustees prior to filing. any questions are raised and answered. the audit committee then presents its review findings to the full board of trustees. Copies are distributed to all Bassett's other trustees at their request. once approved, the 990 can be electronically filed.Form 990 Review Process
Part VI, Section B, Question 12cThe organization's Conflict of interest Policy applies to the board of Trustees, including any committees of the Board, individual members of the Board, officers of the hospital (CEO,COO,CFO), Vice presidents, and all Directors serving as directors team members. Upon the commencement of an individual serving in the roles defined above, and thereafter annually by january 1, a conflict of interest questionnaire which is prescribed by the audit committee of the Board of trustees must be completed. All completed questionnaires are reviewed by the Compliance Officer for the organization. Any potential conflict of interest will be discussed with the individual and/or with legal counsel. The Compliance Officer will take action to eliminate the potential conflict of Interest, if deemed appropriate. After investigation if it is deemed that the individual has failed to comply with such policies and directives, appropriate corrective action will be taken. The audit committee of the board of Trustees may determine whether the corrective action is satisfactory and, if not, shall require further action.Explanation of Monitoring and Enforcement of Conflicts
Part VI, Section B, Question 15aBassett has a formal process that is used to determine the base compensation of the CEO on an annual basis. This process includes a compensation committee of the board of Trustees, an independent compensation consultant, compensation survey or study, and approval by the Board of trustees or the compensation committee. Bassett pays non-fixed earnings based on the success in meeting performance criteria that are prospectively agreed upon as goals for the CEO.Compensation Review & Approval Process for CEO, Exec. Dir., or Top Mgtment
Part VI, Section B, Question 15bThe same formal process noted in Question 15(a) above, is used to determine the base compensation of the other officers. Non fixed earnings of other officers are based on the success in meeting performance criteria and comparative market data.Compensation Review & Approval Process for Officers & Key Employees
Part VI, Section C, Question 19Bassett makes it's governing documents, conflicts of interest policy, and financial statements available to the public upon written request. Parties desiring to obtain copies of such must present themselves at the Administrative Offices of Bassett or by sending a self-addressed stamped envelope and payment for copying of the requested material to Bassett Administrative Offices. The cost of copying shall be equal to the costs imposed by the IRS for copying of public documents.Other Organization Documents Publicly Available
Part VII - Compensation ExplanationThomas Q Morris, MD Hours worked for related organizations: Thurston Corporation - 1.25 Bassett Regional Corporation - 2.00 Total hours worked for related organizations = 3.25 Kevin S Moore Hours worked for related organizations: Thurston Corporation - 1.50 Templeton Foundation - .50 Bassett Regional Corporation - .50 Total hours worked for related organizations = 2.50 Timothy A Pedly, MD Hours worked for related organizations: Thurston Corporation - 1.00 William F Streck, MD Hours worked for related organizations: Thurston Corporation - 1.00 Templeton Foundation - .20 Bassett Regional Corporation - 1.00 Total hours worked for related organizations = 2.20 Bertine Colombo McKenna, PhD Hours worked for related organizations: Thurston Corporation - 1.00 Bassett Regional Corporation - .50 Total hours worked for related organizations = 1.50 Nicholas J Nicoletta Hours worked for related organizations: Thurston Corporation - 2.00 Templeton Foundation - 1.00 Bassett Regional Corporation - 2.00 O'Connor Hospital - 2.00 Tri Town Regional - 2.00 Bassett Hospital of Schoharie County - 2.00 AO Fox Memorial Hospital - .50 Little Falls Hospital - 2.00 Total hours worked for related organizations = 13.50 William T Burdick Hours worked for related organizations: Thurston Corporation - 1.50 Templeton Foundation - .50 Bassett Regional Corporation - 1.00 Total hours worked for related organizations = 3.00 Richard C Vanison Hours worked for related organizations: Thurston Corporation - 1.50 Friends of Bassett, Inc. - 1.00 Total hours worked for related organizations = 2.50 Glenn A Perrone Hours worked for related organizations: Templeton Foundation - .50 Bassett Regional Corporation - 1.00 Bassett Hospital of Schoharie County - 1.00 Total hours worked for related organizations = 2.50 John D Bullis Hours worked for related organizations: Bassett Regional Corporation - .50 Little Falls Hospital - 2.00 Total hours worked for related organizations = 2.50 Barbara DiCocco Hours worked for related corporation: Bassett Regional Corporation - .50 Bassett Hospital of Schoharie County - 1.00 Total hours worked at related organizations = 1.50 Michael Getman Hours worked at related organization: AO Fox Memorial Hospital - .50 Michael S Gold, MD Hours worked for related organizations: Friends of Bassett, Inc. - .20 Peter J Hamilton Hours worked for related organizations: Templeton Foundation - .50 Bassett Regional Corporation - .50 O'Connor Hospital - 1.00 Friends of Bassett, Inc - .50 Total hours worked for related organizations = 2.50 Charles B Kieler Hours worked for related organizations: Friends of Bassett, Inc - 3.00 Ralph H Meyer Hours worked for related organizations: Thurston Corporation - 1.00 Katherine D Nickerson Hours worked for related organizations: Thurston Corporation - 1.00 Edward W Stack Hours worked for related organizations: Thurston Corporation - 1.00 Templeton Foundation - .50 Bassett Regional Corporation - .50 Friends of Bassett, Inc - .20 Total hours worked for related organizations = 2.20 Douglas B Willies Hours worked for related organizations: Templeton Foundation - .50 James C Peters, MD Hours worked for related organizations: O'Connor Hospital - 1.00
Part XI, Line 5NET UNREALIZED GAINS OR LOSSES ON INVESTMENTS -3,296,601 POST RETIREMENT BENEIFT RELATED CHANGES. -698,689 PROJECT ABANDONMENT (PATIENT KEEPER) -424,755 ----------- TOTAL -4,420,045Other Changes in Net Assets or Fund Balances

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Thurston Corporation
one atwell roadcooperstownNY13326133218680supportingorgNY501(c)311cNAfalse
Friends of Bassett
one atwell roadcooperstownNY13326237041610solicits contNY501(c)37THURSTONfalse
Templeton Foundation
one atwell roadcooperstownNY13326133317084Health careNY501(c)39THURSTONfalse
Bassett Regional corporation
ONE ATWELL ROADCOOPERSTOWNNY13326133522783Plan & PolicyNY501(c)311bTHURSTONfalse
Bassett Hospital of Schoharie Co
178 grandview drivecobleskillNY12043141772971health careNY501(c)33BRCfalse
O Connor Hospital
460 andes roaddelhiNY13753161540394health careNY501(c)33BRCfalse
Tri Town Regional Healthcare
43 pearl streetsidneyNY13838260169584health careNY501(c)33BRCfalse
Little falls hospital
140 Burwell Streetlittle fallsNY13365150533578health careNY501(c)33BRCfalse
Valley Health Services
690 W GERMAN streetherkimerNY13350222511614health careNY501(c)33BRCfalse
Aurelia Osborn Fox Memorial Hospsociety
1 Norton avenueOneontaNY13820150539039Health careNY501(c)33Thurstonfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetstrueExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg