OCONNOR HOSPITAL: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
OCONNOR HOSPITAL (EIN 16-1540394)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-14
IRS object ID
202323189349315652
Schema version
2022v5.0
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)
Return2023-11-14T16:16:50-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135565207PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1515 BROADWAY 4TH FLOORAddressLine1Txt
CityALBANYCityNm
State AbbreviationNYStateAbbreviationCd
ZIP122072974ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN161540394EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1O'CONNOR HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlOCONBusinessNameControlTxt
Phone6077460326PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1460 ANDES ROADAddressLine1Txt
CityDELHICityNm
State AbbreviationNYStateAbbreviationCd
ZIP13753ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTOMMY IBRAHIMPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone6077460326PhoneNum
Signature2023-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstTOMMYPersonFirstNm
Person LastIBRAHIMPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonGENEVA FURLANOPreparerPersonNm
PTINP01877392PTIN
Phone5184274600PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTOMMY IBRAHIMPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1460 ANDES ROADAddressLine1Txt
CityDELHICityNm
State AbbreviationNYStateAbbreviationCd
ZIP13753ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$23,502,173GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.OCONNORHOSP.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionO'CONNOR HOSPITAL IS A 23 BED CRITICAL ACCESS HOSPITAL WHICH SERVES THE COMMUNITY IN NEED OF MEDICAL SERVICES WITHOUT REGARD TO THEIR ABILITY TO PAY FOR SUCH SERVICES.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee166TotalEmployeeCnt
Total Volunteers40TotalVolunteersCnt
Total Gross UBI$749,904TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$353,025PYContributionsGrantsAmt
CY Contributions Grants$593,241CYContributionsGrantsAmt
PY Program Service Revenue$25,297,479PYProgramServiceRevenueAmt
CY Program Service Revenue$22,554,481CYProgramServiceRevenueAmt
PY Investment Income$24,624PYInvestmentIncomeAmt
CY Investment Income$6,388CYInvestmentIncomeAmt
PY Other Revenue$341,838PYOtherRevenueAmt
CY Other Revenue$348,063CYOtherRevenueAmt
PY Total Revenue$26,016,966PYTotalRevenueAmt
CY Total Revenue$23,502,173CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,530,637PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,593,580CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$38,412CYTotalFundraisingExpenseAmt
PY Other Expenses$10,882,087PYOtherExpensesAmt
CY Other Expenses$13,411,374CYOtherExpensesAmt
PY Total Expenses$21,412,724PYTotalExpensesAmt
CY Total Expenses$23,004,954CYTotalExpensesAmt
PY Revenues Less Expenses$4,604,242PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$497,219CYRevenuesLessExpensesAmt
Total Assets BOY$43,191,746TotalAssetsBOYAmt
Total Assets EOY$39,449,351TotalAssetsEOYAmt
Total Liabilities BOY$7,997,137TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,441,241TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$35,194,609NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$36,008,110NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionIMPROVING THE HEALTH OF OUR PATIENTS AND WELL-BEING OF OUR COMMUNITIES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$19,618,064ExpenseAmt
Grant$0GrantAmt
Revenue$22,554,481RevenueAmt
DescINPATIENT AND OUTPATIENT SERVICES PROVIDED TO OUR PATIENTS RESULTED IN:HOSPITALIZATIONS: 512PATIENT DAYS: 3,332CLINIC VISITS: 7,391Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$87,108ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescCOMMUNITY INVOLVEMENT HAS BEEN LINKED TO O'CONNOR HOSPITAL'S MISSION AND VALUES SINCE IT FIRST OPENED. WE ARE WORKING WITH OUR COMMUNITY TO IMPROVE THE QUALITY OF LIFE FOR THE PEOPLE OF OUR REGION. OUR COMMUNITY SERVICES PROGRAMS PROVIDE FREE SERVICES TO PERSONS WHO CANNOT AFFORD TO PAY, WHO DO NOT QUALIFY FOR MEDICAID, AND WHO FALL WITHIN THE ESTABLISHED INCOME GUIDELINES. IN 2022, WE PROVIDED $87,108 IN FREE CARE. OUR DOORS ARE OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS A YEAR. WE ARE PROUD TO PROVIDE THIS CARE TO OUR COMMUNITIES. NOT ONLY DID WE PROVIDE $87,108 IN CHARITY CARE, $532,629 IN PATIENT ACCOUNTS WERE RECORDED AS BAD DEBT IN 2022.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$19,705,172TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document33IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee166EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GUY DISTEFANOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6077460326PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line131 BEAVER STREETAddressLine1Txt
CityCOOPERSTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13326ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
PETER HAMILTON
CHAIRMAN4.000.00Yes (X)Yes (X)$0$0$0
BRUCE MCKEEGAN
VICE CHAIRMAN1.000.00Yes (X)Yes (X)$0$0$0
JOHN JACK LYNCH
SECRETARY1.000.00Yes (X)Yes (X)$0$0$0
SUE E ANDREWS
TREASURER1.000.00Yes (X)Yes (X)$0$0$0
JOYCE BARBER
TRUSTEE1.000.00Yes (X)$0$0$0
POLLY DELLACROSSE
TRUSTEE1.000.00Yes (X)$0$0$0
DONALD HARRIS PHD
TRUSTEE1.000.00Yes (X)$0$0$0
CHARLOTTE HILL
TRUSTEE1.000.00Yes (X)$0$0$0
FRANK SILAGY MD
TRUSTEE1.000.00Yes (X)$0$0$0
PETER SOSNOW MD
TRUSTEE1.000.00Yes (X)$0$0$0
PAMELA VOGT
TRUSTEE1.000.00Yes (X)$0$0$0
CHRISTOPHER GRAHAM LEFT 622
VP OF FINANCE40.000.00Yes (X)$0$147,500$11,591
ERIC H STEIN
PRESIDENT24.0016.00Yes (X)$0$327,021$34,191
ANDREA BARCOMB
PHARMACIST40.000.00$161,891$0$6,983Yes (X)
LAURIE BURNS
RN40.000.00$146,521$0$10,902Yes (X)
ERIN E KINGSBURY
PHARMACIST40.000.00$170,085$0$15,888Yes (X)
ASHLEY SCOBIE
RN40.000.00$160,399$0$5,971Yes (X)
DANIEL ENDRESS
DIR OF OPS/NURSING40.000.00$154,492$0$7,840Yes (X)
SCOTT BONDEROFF
FORMER CEO1.000.00$0$276,831$15,009Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$793,388TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$751,352TotReportableCompRltdOrgAmt
Total Other Compensation$108,375TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K21IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
MEDEFIS
PO BOX 5068NEW YORKNY10087AGENCY$652,173
AYA HEALTHCARE
5930 CORNERSTONE COURT W 300SAN DIEGOCA92121AGENCY$352,113
ALLIANCE HEALCARE SERVICE
1900 S STATE COLLEGE BLVD SUITE 60ANAHEIMCA92806PET / CT SERVICES$263,264
MORRISON MANAGEMENT SPECIALISTS
5801 PACHTREE DUNWOODY ROADATLANTAGA30342FOOD SERVICES$225,192
CROTHALL FACILITIES MANAGEMENT
1500 LIBERTY RIDGE DRIVEWAYNEPA19087FACILITY SERVICES$191,950
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
Related Organizations$239,589RelatedOrganizationsAmt
Government Grants$353,652GovernmentGrantsAmt
Total Contributions$593,241TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
DIRECT PATIENT SERVICES621990$21,256,939$21,256,939
OUTPATIENT PHARMACY456110$749,904$749,904
OTHER PROGRAM SERVICE REVENUE621990$547,638$547,638
FieldValueIRS element (for citing)
Total Program Service Revenue$22,554,481TotalProgramServiceRevenueAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$348,063RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$348,063RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$348,063TotalRevenueColumnAmt
Exclusion$348,063ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$6,388OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$6,388OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,388TotalRevenueColumnAmt
Exclusion$6,388ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,502,173TotalRevenueColumnAmt
Related Or Exempt Func Income$21,804,577RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$749,904UnrelatedBusinessRevenueAmt
Exclusion$354,451ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,747,199TotalAmt
Program Services$6,417,661ProgramServicesAmt
Management And General$1,299,040ManagementAndGeneralAmt
Fundraising$30,498FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$286,369TotalAmt
Program Services$233,821ProgramServicesAmt
Management And General$47,315ManagementAndGeneralAmt
Fundraising$5,233FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$936,746TotalAmt
Program Services$779,092ProgramServicesAmt
Management And General$157,654ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$623,266TotalAmt
Program Services$516,226ProgramServicesAmt
Management And General$104,462ManagementAndGeneralAmt
Fundraising$2,578FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$5,324,036TotalAmt
Program Services$4,428,001ProgramServicesAmt
Management And General$896,035ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$7,862TotalAmt
Management And General$7,862ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,389,980TotalAmt
Program Services$1,156,046ProgramServicesAmt
Management And General$233,934ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$12,115TotalAmt
Program Services$10,076ProgramServicesAmt
Management And General$2,039ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$41,315TotalAmt
Program Services$34,300ProgramServicesAmt
Management And General$6,941ManagementAndGeneralAmt
Fundraising$74FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$291,028TotalAmt
Program Services$242,048ProgramServicesAmt
Management And General$48,980ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$25,171TotalAmt
Program Services$20,935ProgramServicesAmt
Management And General$4,236ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$18,082TotalAmt
Program Services$15,039ProgramServicesAmt
Management And General$3,043ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,212,815TotalAmt
Program Services$1,008,674ProgramServicesAmt
Management And General$204,112ManagementAndGeneralAmt
Fundraising$29FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$76,900TotalAmt
Program Services$63,958ProgramServicesAmt
Management And General$12,942ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
DRUGS AND REAGENTS$2,382,799$2,382,799
PATIENT CARE SUPPLIES$626,440$626,440
BAD DEBT$532,629$532,629
CHARITY CARE$87,108$87,108

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,383,094TotalAmt
Program Services$1,150,319ProgramServicesAmt
Management And General$232,775ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$23,004,954TotalAmt
Program Services$19,705,172ProgramServicesAmt
Management And General$3,261,370ManagementAndGeneralAmt
Fundraising$38,412FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$15,708BOYAmt
EOY$13,108,786EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$14,854,595BOYAmt
EOY$13,781,999EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$96,386BOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,444,209BOYAmt
EOY$2,824,849EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$579,822BOYAmt
EOY$271,404EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$28,431BOYAmt
EOY$92,942EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$22,743,869LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$15,062,381LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$8,258,347BOYAmt
EOY$7,681,488EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$15,415,803BOYAmt
EOY$275,798EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$250,000EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,498,445BOYAmt
EOY$1,162,085EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$43,191,746BOYAmt
EOY$39,449,351EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,000,867BOYAmt
EOY$917,095EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$509,922BOYAmt
EOY$342,070EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,486,348BOYAmt
EOY$2,182,076EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,997,137BOYAmt
EOY$3,441,241EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$34,462,574BOYAmt
EOY$34,959,793EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$732,035BOYAmt
EOY$1,048,317EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$35,194,609BOYAmt
EOY$36,008,110EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$43,191,746BOYAmt
EOY$39,449,351EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$497,219ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$316,282NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit Committee0AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$7,862OtherActivitiesAmt
Total Lobbying Expenditures$7,862TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationSCHEDULE C, PART II-B, LINE 1 - AMERICAN HOSPITAL ASSOCIATION MEMBERSHIP DUES ALLOCATE 27.29% TOWARDS LOBBYING ACTIVITIES. IROQUOIS MEMBERSHIP DUES ALLOCATE 52% TOWARDS GENERAL LOBBY ACTIVITIES. THE TOTAL DUES PAID BY BOTH ORGANIZATIONS DURING 2022 WERE $13,035.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$251,917BeginningYearBalanceAmt
Contributions$23,881ContributionsAmt
End Year Balance$275,798EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Contributions$251,917ContributionsAmt
End Year Balance$251,917EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$99,400OtherCostOrOtherBasisAmt
Book Value$99,400BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,799,344OtherCostOrOtherBasisAmt
Depreciation$9,351,383DepreciationAmt
Book Value$1,447,961BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$872,181OtherCostOrOtherBasisAmt
Depreciation$547,505DepreciationAmt
Book Value$324,676BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,932,740OtherCostOrOtherBasisAmt
Depreciation$5,163,493DepreciationAmt
Book Value$5,769,247BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$40,204OtherCostOrOtherBasisAmt
Book Value$40,204BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$7,681,488TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
MEDICARE ADVANCE (CARES ACT)$442,126
DUE TO RELATED PARTIES$1,252,291
OPERATING LEASE RIGHT OF USE$487,659
FieldValueIRS element (for citing)
Total Liability$2,182,076TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:INTENDED USES FOR ENDOWMENT FUNDS PERMANENTLY RESTRICTED ENDOWMENT FUNDS ARE HELD IN PERPETUITY WITH RESTRICTIONS ON INCOME FOR MEDICAL EDUCATION.
PART X, LINE 2:O'CONNOR HOSPITAL IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF BASSETT HEALTHCARE NETWORK (THE NETWORK). THE TEXT OF THE FIN 48 FOOTNOTE FROM THE CONSOLIDATED FINANCIAL STATEMENTS IS AS FOLLOWS: THE NETWORK'S VARIOUS SUBSIDIARIES GENERALLY CONSIST OF NOT-FOR-PROFIT CORPORATIONS ORGANIZED IN ACCORDANCE WITH SECTION 501(C)(3) OF THE IRC AND THEREFORE ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE IRC. THE NETWORK RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE-LIKELY THAN-NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL TAX LIABILITIES OR UNCERTAIN TAX POSITIONS THAT NEED TO BE RECORDED. FOR TAXABLE SUBSIDIARIES OR INVESTMENTS, INCLUDING CCE, DEFERRED TAX ASSETS AND LIABILITIES ARE RECOGNIZED FOR THE FUTURE TAX CONSEQUENCES OF TEMPORARY DIFFERENCES BY APPLYING ENACTED STATUTORY TAX RATES APPLICABLE TO FUTURE YEARS FOR THE DIFFERENCES BETWEEN THE CONSOLIDATED FINANCIAL STATEMENTS AND TAX BASIS OF EXISTING ASSETS AND LIABILITIES. SUCH DEFERRED TAX ASSETS AND LIABILITIES WERE NOT MATERIAL AS OF DECEMBER 31, 2022 AND 2021.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted Care0FPGReferenceDiscountedCareInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$68,018TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$68,018NetCommunityBenefitExpnsAmt
Total Expense0.00300TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,457,869TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,174,556DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,283,313NetCommunityBenefitExpnsAmt
Total Expense0.05580TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,525,887TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,174,556DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,351,331NetCommunityBenefitExpnsAmt
Total Expense0.05880TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$112,097TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$112,097NetCommunityBenefitExpnsAmt
Total Expense0.00490TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$112,097TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$112,097NetCommunityBenefitExpnsAmt
Total Expense0.00490TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$224,194TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$224,194NetCommunityBenefitExpnsAmt
Total Expense0.00980TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,750,081TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,174,556DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,575,525NetCommunityBenefitExpnsAmt
Total Expense0.06860TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Reimbursed By Medicare$6,049,112ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$5,872,174CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$176,938MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1O'CONNOR HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1460 ANDES ROADAddressLine1Txt
CityDELHICityNm
State AbbreviationNYStateAbbreviationCd
ZIP13753ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.OCONNORHOSP.ORGWebsiteAddressTxt
State License1254700CStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherOUTPATIENT PRIMARY & SPECIALITYOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1O'CONNOR HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
OtherYes (X)OtherInd
CHNA Conducted22CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE SECTION COwnWebsiteURLTxt
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE SECTION CStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care0.000000000000FPGFamilyIncmLmtDscntCarePct
Explained Basis0ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
O'CONNOR HOSPITALPART V, SECTION B, LINE 3J: BASSETT HEALTHCARE NETWORK, O'CONNOR HOSPITAL, IN COLLABORATION WITH DELAWARE COUNTY PUBLIC HEALTH, MARGARETVILLE MEMORIAL HOSPITAL, AND UHS DELAWARE VALLEY HOSPITAL, DEVELOPED A COMMUNITY SERVICE PLAN TO ADDRESS THE HEALTH INEQUITIES DEFINED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR DELAWARE COUNTY, NY, ALSO A COLLABORATIVE EFFORT.
O'CONNOR HOSPITALPART V, SECTION B, LINE 5: THE COMMUNITY SERVICE PLAN IS A COMPREHENSIVE 3-YEAR PLAN TO ADDRESS THE HEALTH EQUITY DISPARITIES FOUND IN THE CHNA THROUGH COLLABORATIVE COMMUNITY HEALTH INITIATIVES. NEW YORK STATE PREVENTION AGENDA 2019-2024 ORGANIZATIONS CREATING THE CSP ARE PROVIDED THE NYS PREVENTION AGENDA 2019-2024, WHICH IS A BLUEPRINT FOR NEW YORK STATE'S HEALTH IMPROVEMENT PLAN FOR STATE AND LOCAL ACTION TO IMPROVE THE HEALTH AND WELL-BEING OF ALL NEW YORKERS AND PROMOTE HEALTH EQUITY ACROSS POPULATIONS WHO EXPERIENCE DISPARITIES. THE BLUEPRINT PROVIDES ACCEPTABLE PRIORITY AREAS TO FOCUS ON BASED ON THE EVIDENCE FOUND. THERE ARE FIVE MAIN PRIORITY AREAS IN THE NYSDOH PREVENTION AGENDA 2019-2024. - PREVENT CHRONIC DISEASE - PROMOTE A HEALTHY AND SAFE ENVIRONMENT - PROMOTE HEALTH FOR WOMEN, INFANTS, AND CHILDREN - PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS - PREVENT COMMUNICABLE DISEASE DATA MINING OF PRIMARY AND SECONDARY DATA SOURCES WAS CONDUCTED THROUGHOUT THE PROCESS AND PRESENTED TO THE CORE GROUP OF STAKEHOLDERS FOR DISCUSSION AND REVIEW. REPRESENTATIVES FROM DELAWARE COUNTY PUBLIC HEALTH, DELAWARE VALLEY HOSPITAL, MARGARETVILLE MEMORIAL HOSPITAL, AND O'CONNOR HOSPITAL HELD SEVERAL COUNTY, REGIONAL, AND STATE-LEVEL MEETINGS TO GATHER ADDITIONAL INPUT ON THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE LIST OF COALITIONS, WORK GROUPS, AND TASK FORCES IS PROVIDED IN THE CHNA.A CRUCIAL PART OF ASSESSING THE HEALTH OF OUR COMMUNITIES IS NOT ONLY COLLECTING OBJECTIVE DATA BUT ALSO SUBJECTIVE PERCEPTIONS OF THE COUNTY'S HEALTH STATUS (CHNA) FROM THE COMMUNITY MEMBER AND STAKEHOLDERS. THE DELAWARE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT LEVERAGED ELECTRONIC SURVEYS TARGETED AT COMMUNITY MEMBERS AND STAKEHOLDERS. A WEB LINK WAS DISTRIBUTED THROUGH EMAIL AND SOCIAL MEDIA, INVITING PARTICIPANTS TO PARTICIPATE.ON MAY 17, 2022, THE COMMUNITY ENGAGEMENT SURVEY WAS POSTED ONLINE. THE SURVEY WAS CLOSED ON JUNE 23, 2022, AFTER RECEIVING 442 RESPONSES. RESPONDENT DEMOGRAPHICS: - LIVE IN DELAWARE COUNTY (99.77%) - PRIMARILY FEMALE (80.54%) - PRIMARILY WHITE (92.99%) AND NOT HISPANIC OR LATINO (90.93%) - HIGHEST AGE GROUP REPRESENTATION: 50-64 YRS OF AGE (38.32%), 35-49 (26.08%), AND OVER 65 (24.94%) THERE WERE A VERY LARGE NUMBER OF WRITTEN COMMENTS THAT INDICATED THE NEED FOR A COMMUNITY THAT COMES TOGETHER, THE IMPORTANCE OF MENTAL HEALTH SERVICES, A NEED FOR COMMUNITY PROGRAMS AND RECREATIONAL EVENTS, SOCIOECONOMIC STRUGGLES, ACCESS TO HEALTHCARE, AND LACK OF TRANSPORTATION.
O'CONNOR HOSPITALPART V, SECTION B, LINE 6A: UHS DELAWARE VALLEY HOSPITAL AND MARGARETVILLE MEMORIAL HOSPITAL
O'CONNOR HOSPITALPART V, SECTION B, LINE 6B: DELAWARE COUNTY PUBLIC HEALTH
O'CONNOR HOSPITALPART V, SECTION B, LINE 11: THE ORGANIZATION ADDRESSED SIGNIFICANT, PRIORITIZED HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA BY ADOPTION OF A BUDGET FOR PROVISION OF SERVICES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA, PRIORITIZATION OF HEALTH NEEDS IN ITS COMMUNITY, AND PRIORITIZATION OF SERVICES THAT THE HOSPITAL FACILITY WILL UNDERTAKE TO MEET HEALTH NEEDS IN ITS COMMUNITY. FOR NEEDS NOT ADDRESSED AS A COLLABORATIVE, WE ADDRESS SOME AS AN INDIVIDUAL ORGANIZATION, AND ALSO CONTINUE TO REPRIORITIZE HIGHEST DEMAND OF NEEDS.
PART V, LINE 7A AND 10A, FACILITY 1, O'CONNOR HOSPITALTHE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE MADE AVAILABLE ON THE HOSPITAL'S WEBSITE: HTTPS://WWW.BASSETT.ORG/SITES/DEFAULT/FILES/2023-03/DELAWARE_COUNTY_COMMUNITY_HEALTH_ASSESSMENT_2022-2024.PDF
PART V, LINE 16A, 16B, & 16C, FACILITY 1, O'CONNOR HOSPITALTHE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE MADE AVAIALBLE ON THE HOSPITAL'S WEBSITE: HTTPS://WWW.BASSETT.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE
O'CONNOR HOSPITALPART VBILLING AND COLLECTIONSBEGINNING IN JULY 2021, BASSETT HEALTHCARE NETWORK, THE PARENT ORGANIZATION OF O'CONNOR HOSPITAL, ENTERED INTO A SERVICE AGREEMENT WITH OPTUM INSIGHT. THIS AGREEMENT RESULTED IN VARIOUS INFORMATION TECHNOLOGY, REVENUE CYCLE, AND BUSINESS ANALYTIC SERVICES ONCE PERFORMED BY BASSETT HEALTHCARE NETWORK BEING TRANSITIONED TO OPTUM INSIGHT, ALONG WITH THE FORMER BASSETT EMPLOYEES WHO PROVIDED THEM. THE TRANSITION INCLUDED PORTIONS OF THE BILLING AND COLLECTION ACTIVITIES FOR THE HOSPITALS IN THE NETWORK. HOWEVER, DESPITE THE CHANGE IN SERVICE PROVIDER, THE BILLING AND COLLECTION POLICIES OF THE HOSPITAL DID NOT CHANGE AS A RESULT OF THE TRANSITION.

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARETHE CSP (COMMUNITY SERVICES PROGRAM) APPLICATION SPECIFIES FAMILY INCOME LIMITS AND OTHER REQUIREMENTS FOR SERVICES TO BE ELIGIBLE FOR O'CONNOR HOSPITAL'S CSP/FREE CARE PROGRAM.
PART I, LINE 6A:RELATED ORGANIZATION INFORMATIONO'CONNOR HOSPITAL'S COMPREHENSIVE COMMUNITY SERVICE PLAN IS SUMMARIZED IN AN ANNUAL REPORT AND POSTED ON THE O'CONNOR HOSPITAL WEBSITE, WWW.BASSETT.ORG/LOCATIONS/OCONNOR-HOSPITAL. PRINTED COPIES ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
PART I, LINE 7:COSTING METHODOLOGY EXPLANATIONWORKSHEET 2 WAS USED TO DEVELOP A COST-TO-CHARGE RATIO. IT WAS USED FOR PATIENT CARE SERVICES. FOR NON- PATIENT CARE SERVICES, CHARGES WERE REDUCED TO COST FOR THOSE SERVICES TO NON-PATIENTS WHERE A MARK-UP IS READILY IDENTIFIABLE.LINE 7B MEDICAID SHORTFALLTHE MEDICAID SHORTFALL IS INCLUDED IN THIS LINE IN THE AMOUNT OF $1,283,313.
PART I, LINE 7, COLUMN (F)EXCLUSIONS FROM PERCENT OF TOTAL EXPENSETHE PERCENT OF TOTAL EXPENSE IN PART 1, LINE 7, COLUMN (F) IS CALCULATED BY DIVIDING COLUMN (E), NET COMMUNITY BENEFIT EXPENSE, BY TOTAL EXPENSE. THE BAD DEBT EXPENSE OF $532,629 WAS SUBTRACTED FROM THE TOTAL VALUE USED TO CALCULATE THE PERCENTAGES IN PART 1, LINE 7, COLUMN F.
PART II, COMMUNITY BUILDING ACTIVITIES:COMMUNITY BUILDING ACTIVITIESALL O'CONNOR COMMUNITY BUILDING ACTIVITIES ARE INCLUDED IN PART I AND DESCRIBED ABOVE.
PART III, LINE 2:BAD DEBT EXPENSEDUE TO THE ADOPTION OF ASU NO. 2014-09 - REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENT. RATHER IT IS TREATED AS A NON-VOLUNTARY PRICE CONCESSION.
PART III, LINE 4:FOOTNOTE (3) FROM THE AUDITED FINANCIAL STATEMENTSCHARITY CARE:THE COST OF CHARITY CARE PROVIDED IS DETERMINED BASED ON THE APPLICATION OF A COST TO GROSS CHARGE RATIO TO THE TOTAL CHARITY CARE CHARGES FOREGONE. INCLUDED IN NET PATIENT SERVICE REVENUE ARE AMOUNTS PAID INTO AND RECEIVED FROM STATEWIDE UNCOMPENSATED CARE POOLS. THESE UNCOMPENSATED CARE POOLS ARE DESIGNED TO HELP OFFSET THE COST OF CHARITY CARE AND UNREIMBURSED MEDICAID SERVICES.
PART III, LINE 8:MEDICARE EXPLANATIONO'CONNOR IS A CRITICAL ACCESS HOSPITAL, SO COST IS CALCULATED ON THE SETTLEMENT SHEETS OF THE COST REPORT. IT WAS COMPARED TO MEDICARE REIMBURSEMENT, WHICH IS ALSO CALCULATED ON THE COST REPORT.
PART III, LINE 9B:COLLECTION PRACTICES EXPLANATIONPATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE CONTACTED BY THE FINANCIAL COUNSELING TEAM THAT SENDS A LETTER OF APPROVAL AND TIME-FRAME FOR WHICH THE PATIENT IS APPROVED.
PART VI, LINE 2:BASSETT HEALTHCARE NETWORK, O'CONNOR HOSPITAL, IN COLLABORATION WITH DELAWARE COUNTY PUBLIC HEALTH, MARGARETVILLE MEMORIAL HOSPITAL, AND UHS DELAWARE VALLEY HOSPITAL, DEVELOPED A COMMUNITY SERVICE PLAN TO ADDRESS THE HEALTH INEQUITIES DEFINED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR DELAWARE COUNTY, NY, ALSO A COLLABORATIVE EFFORT.
PART VI, LINE 3:PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEA MAJOR COMPONENT OF THE O'CONNOR HOSPITAL 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 O'CONNOR EMPLOYEES. THE POLICY IS UPDATED ANNUALLY, DISTRIBUTED TO KEY PERSONNEL AND 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. 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. PATIENT REFERRAL TO THE DELAWARE COUNTY MEDICAID EXAMINER IS FACILITATED BY THE FINANCE DIRECTOR AT THE O'CONNOR HOSPITAL.A LISTING OF ALL SELF-PAY ACCOUNTS IS PRODUCED AND REVIEWED DAILY TO ENSURE 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 4:COMMUNITY INFORMATIONO'CONNOR HOSPITAL'S SERVICE AREA INCLUDES MUCH OF DELAWARE COUNTY, NY. THE PRIMARY SERVICE AREA OF 11 ZIP CODES INCLUDES ANDES, BLOOMVILLE, BOVINA CENTER, DELANCEY, DELHI, HAMDEN, HOBART, MARGARETVILLE, SOUTH KORTRIGHT, STAMFORD, AND WALTON. THE SECONDARY SERVICE AREA IS REFLECTIVE OF 12 ZIP CODES AND INCLUDES DENVER, DOWNSVILLE, EAST BRANCH, EAST MEREDITH, FLEISHMANS, FRANKLIN, HANCOCK, HARPERSFIELD, LONG EDDY, MERIDALE, PRATTSVILLE, AND ROXBURY.
PART VI, LINE 5:PROMOTION OF COMMUNITY HEALTHO'CONNOR HOSPITAL IS A CRITICAL ACCESS HOSPITAL IN DELHI, NEW YORK PROVIDING A FULL RANGE OF ACUTE AND PREVENTATIVE HEALTH CARE SERVICES, INCLUDING ACUTE INPATIENT CARE, RESTORATIVE/REHABILITATIVE (SWING BED) CARE, AN EMERGENCY SERVICES DEPARTMENT (WHERE PRACTITIONERS HAVE THE ABILITY TO INTERFACE WITH BOARD-CERTIFIED PRACTITIONERS IN COOPERSTOWN AND PRACTITIONERS IN ROCHESTER THROUGH TELEMEDICINE CONNECTIONS), A STATE-OF-THE-ART MEDICAL IMAGING SUITE, LABORATORY SERVICES, AN OUTPATIENT PHARMACY, PHYSICAL AND OCCUPATIONAL THERAPY, DIETARY CONSULTATIONS, A DENTAL CLINIC AND A WIDE RANGE OF SPECIALTY SERVICES.O'CONNOR HAS SERVED THE DELHI COMMUNITY SINCE 1922 AND HAS BEEN AFFILIATED WITH THE MARY IMOGENE BASSETT HOSPITAL (DBA BASSETT MEDICAL CENTER) SINCE 1988. O'CONNOR IS AN ENTITY OF THE BASSETT HEALTHCARE NETWORK. IT IS GOVERNED BY A 12 MEMBER BOARD OF TRUSTEES CONSISTING OF COMMUNITY VOLUNTEERS. O'CONNOR HOSPITAL COMMUNITY SERVICE PROGRAMS ADDRESS CHRONIC DISEASE MANAGEMENT, PROMOTE WELL-BEING AND MENTAL HEALTH, AND PREVENT SUBSTANCE ABUSE DISORDERS. THEY INCLUDE:1. O'CONNOR HOSPITAL PROVIDES SPACE FOR DIABETES, MENTAL HEALTH AND PARKINSON'S SUPPORT GROUPS ON A MONTHLY BASIS.2. O'CONNOR OFFERS FALL FLU SHOT CLINICS.3. PROMOTED PLACES FOR PHYSICAL ACTIVITY, HIKING, PADDLING AND BIKING.4. TRACKED TRAIL USE ON TWO LOCAL HIKING TRAILS.5. MAINTAINED GETOUTANDWALK.ORG WEBSITE.6. ENCOURAGED MUNICIPALITIES TO SIGN COMPLETE STREET POLICIES AND AGE-FRIENDLY STRUCTURAL IMPROVEMENTS.7. BUILT AND MAINTAINED O'CONNOR HOSPITAL .5 MILE FITNESS TRAIL COMPLETE WITH FIVE FITNESS STATIONS AND OPEN TO THE COMMUNITY.8. SUBMITTED DSRIP PROPOSAL TO FUND A PRESCRIBING MENTAL HEALTH PROVIDER TO WORK IN LOCAL HEALTH CENTER.9. SUBMITTED GRANT PROPOSAL TO FUND PROVIDER RECRUITMENT AND RETENTION EFFORTS IN THE O'CONNOR HOSPITAL SERVICE AREA.10. CONDUCTED PERFORMANCE IMPROVEMENT PROJECT TO REFER E.D. PATIENTS TO MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES AND COMMUNITY RESOURCES.11. COMPLETED PERFORMANCE IMPROVEMENT PROJECT TO INCREASE PATIENT REFERRALS TO CARE NAVIGATOR PROGRAM.12. PARTICIPATED IN PILOT DRUG TAKE BACK PROGRAM.13. PARTICIPATED IN LOCAL COMMUNITY COALITIONS AND COMMITTEES FORMED TO ADDRESS MENTAL HEALTH ISSUES IN THE COUNTY.14. PARTICIPATED IN SUICIDE PREVENTION COALITION.15. SUPPORTED TWO NURSES TO COMPLETE SEXUAL ASSAULT NURSE EXAMINER TRAINING COURSES.16. COMPLETED AND PARTICIPATED IN COUNTY AND REGIONAL EMERGENCY PREPAREDNESS PROGRAMS AND DRILLS.17. CONDUCTED PERFORMANCE IMPROVEMENT PROJECT ADDRESSING STANDARD PRECAUTIONS FOR MRSA/ VRE OF INPATIENTS.18. HOSTED FIRST GRADERS FOR AN EDUCATIONAL PROGRAM OF THE EMERGENCY DEPARTMENT.19. SPONSORED COMMUNITY WELLNESS EVENTS SUCH AS ROAD RACES, SUICIDE AWARENESS ACTIVITIES, AND EMS TEACHING EVENTS.O'CONNOR HAS A COMMUNITY BOARD WHO ARE ACTIVELY ENGAGED IN THE HOSPITAL BOTH SUPPORTING THE GROWTH AND THE INVESTMENT IN PROGRAMS THAT BRING HEALTH AND WELLNESS BENEFITS TO THE COMMUNITY. O'CONNOR CONTINUALLY INVESTS SURPLUS FUNDS IN PROGRAMS, EQUIPMENT AND PEOPLE TO ENSURE HIGH QUALITY SERVICE IS AVAILABLE IN THE COMMUNITY THEY SERVE. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS WHO ARE EMPLOYED BY BASSETT MEDICAL CENTER. THE HOSPITAL OPERATES AN EMERGENCY ROOM WHICH IS OPEN TO ALL, REGARDLESS OF ABILITY TO PAY.
PART VI, LINE 6:AFFILIATED HEALTH CARE SYSTEMO'CONNOR HOSPITAL IS PART OF THE BASSETT HEALTHCARE NETWORK THAT PROVIDES HEALTH SERVICES IN MORE THAN 20 COMMUNITIES SPANNING 5,600 SQUARE MILES AND SEVEN COUNTIES. BASSETT HEALTHCARE NETWORK HAS FOUR AREA COMMUNITY HOSPITALS, INCLUDING BASSETT MEDICAL CENTER AND A.O. FOX HOSPITAL IN OTSEGO COUNTY, O'CONNOR HOSPITAL IN DELAWARE COUNTY, COBLESKILL REGIONAL HOSPITAL IN SCHOHARIE COUNTY, AND LITTLE FALLS HOSPITAL IN HERKIMER COUNTY. ANOTHER HOSPITAL, A.O. FOX HOSPITAL - TRI-TOWN CAMPUS IN DELAWARE COUNTY, PROVIDES A 24/7 EMERGENCY CARE FACILITY IN SIDNEY. THE NETWORK ALSO SUPPORTS OVER 30 COMMUNITY-BASED OUTPATIENT HEALTH CENTERS, 21 SCHOOL-BASED HEALTH CENTERS; TWO AMBULATORY SURGERY CENTERS; VALLEY HEALTH SERVICES, A RESIDENTIAL HEALTH CARE, AND REHABILITATION FACILITY; AT HOME CARE, A CERTIFIED HOME CARE AGENCY; AND FIRST COMMUNITY CARE OF BASSETT, A MEDICAL SUPPLY COMPANY.A) O'CONNOR HOSPITAL, A CRITICAL ACCESS HOSPITAL IN DELHI, DELAWARE COUNTYB) THE MARY IMOGENE BASSETT HOSPITAL - AN ACUTE CARE INPATIENT TEACHING FACILITY, AN OUTPATIENT PRIMARY AND SPECIALTY CARE CENTER, A REGIONAL NETWORK OF 34 COMMUNITY BASED OUTPATIENT HEALTH CENTERS, 21 SCHOOL BASED HEALTH CENTERS, TWO AMBULATORY SURGERY CENTERS, AND A FULLY SALARIED MEDICAL STAFF IN COOPERSTOWN, OTSEGO COUNTYC) COBLESKILL REGIONAL HOSPITAL, A CRITICAL ACCESS HOSPITAL IN COBLESKILL, SCHOHARIE COUNTYD) LITTLE FALLS HOSPITAL, A CRITICAL ACCESS HOSPITAL IN LITTLE FALLS, HERKIMER COUNTYE) A.O. FOX HOSPITAL TRI-TOWN CAMPUS, A 24/7 EMERGENCY CARE FACILITY IN SIDNEY, DELAWARE COUNTYF) A.O. FOX MEMORIAL HOSPITAL, AN ACUTE CARE FACILITY IN ONEONTA, OTSEGO COUNTYG) VALLEY HEALTH SERVICES, A RESIDENTIAL HEALTH CARE AND REHABILITATION FACILITYH) AT HOME CARE, A CERTIFIED HOME CARE AGENCYI) FIRST COMMUNITY CARE OF BASSETT, A MEDICAL SUPPLY COMPANY ALL OF THE ABOVE MAKE UP THE BASSETT HEALTHCARE NETWORK AND PROVIDE HEALTH SERVICES TO THIS SEVEN COUNTY REGION IN CENTRAL NEW YORK.
PART VI, LINE 7STATE FILING OF COMMUNITY BENEFIT REPORTNEW YORK

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ERIC H STEIN
PRESIDENT$0$284,968$0$42,053$0$0$0$27,670$0$6,521$0$361,212$0$0
SCOTT BONDEROFF
FORMER CEO$0$239,888$0$36,943$0$0$0$14,032$0$977$0$291,840$0$0
ERIN E KINGSBURY
PHARMACIST$170,085$0$0$0$0$0$9,673$0$6,215$0$185,973$0$0$0
ANDREA BARCOMB
PHARMACIST$161,891$0$0$0$0$0$5,761$0$1,222$0$168,874$0$0$0
ASHLEY SCOBIE
RN$160,399$0$0$0$0$0$5,971$0$0$0$166,370$0$0$0
DANIEL ENDRESS
DIR OF OPS/NURSING$154,492$0$0$0$0$0$7,156$0$684$0$162,332$0$0$0
CHRISTOPHER GRAHAM LEFT 622
VP OF FINANCE$0$118,013$0$29,487$0$0$0$8,462$0$3,129$0$159,091$0$0
LAURIE BURNS
RN$146,521$0$0$0$0$0$4,547$0$6,355$0$157,423$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFORM 990, SCHEDULE J, PART I, LINE 3FormAndLineReferenceDesc
ExplanationRELATED ORG METHODS USED FOR COMPENSATION EXPLANATION THE MARY IMOGENE BASSETT HOSPITAL (DBA BASSETT MEDICAL CENTER) PROVIDES THE COMPENSATION FOR THE PRESIDENTS OF O'CONNOR HOSPITAL, A.O. FOX MEMORIAL HOSPITAL, COBLESKILL REGIONAL HOSPITAL, AND LITTLE FALLS HOSPITAL. BASSETT MEDICAL CENTER USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR SAID INDIVIDUALS: A) COMPENSATION COMMITTEE, B) INDEPENDENT COMPENSATION CONSULTANT, C) WRITTEN EMPLOYMENT CONTRACT, D) COMPENSATION SURVEY OR STUDY AND, E) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6BASSETT HEALTHCARE NETWORK IS THE PARENT AND SOLE MEMBER TO EACH OF THE FOLLOWING RELATED PARTIES. FRIENDS OF BASSETT, AO FOX MEMORIAL HOSPITAL, BASSETT HOSPITAL OF SCHOHARIE COUNTY, LITTLE FALLS HOSPITAL, O'CONNOR HOSPITAL, TEMPLETON FOUNDATION, VALLEY HEALTH SERVICES, AND MARY IMOGENE BASSETT HOSPITAL. AS PARENT AND SOLE MEMBER, BASSETT HEALTHCARE NETWORK HAS THE RIGHT TO APPOINT AND REMOVE MEMBERS OF THE GOVERNING BOARDS OF ITS SUBSIDIARIES AND APPROVE SIGNIFICANT DECISIONS OF THE GOVERNING BOARDS, INCLUDING, BUT NOT LIMITED TO, APPROVAL OF OPERATING AND CAPITAL BUDGETS, CERTAIN CAPITAL EXPENDITURES, INDEBTEDNESS NOT CONTAINED IN THE APPROVED BUDGETS, SUBSTANTIVE CHANGES IN CLINICAL PROGRAMS, MERGERS, CONSOLIDATIONS, LIQUIDATIONS AND DISSOLUTIONS INVOLVING ITS SUBSIDIARIES AND CERTIFICATE OF NEED APPLICATIONS.
FORM 990, PART VI, SECTION A, LINE 7ASEE FORM 990, PART VI, SECTION A, LINE 6 ABOVE.
FORM 990, PART VI, SECTION A, LINE 7BSEE FORM 990, PART VI, SECTION A, LINE 6 ABOVE.
FORM 990, PART VI, SECTION B, LINE 11BORGANIZATION'S PROCESS TO REVIEW FORM 990 THE VP OF FINANCE OPERATIONS, BMC, PRESENTS THE DRAFT 990 TO THE EXECUTIVE AND FINANCE COMMITTEE OF THE BOARD PRIOR TO ANY FILING. ANY QUESTIONS RAISED ARE ANSWERED AND ONCE APPROVED BY THE COMMITTEE, COPIES OF THE TAX RETURN ARE DISTRIBUTED TO EACH MEMBER OF THE BOARD PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CENFORCEMENT OF CONFLICTS POLICY THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO THE BOARD OF DIRECTORS, BOARD MEMBERS, AND KEY PERSONS SUCH AS THE PRESIDENT. EACH BOARD MEMBER, OFFICER, OR KEY PERSON OF THE HOSPITAL SHALL COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. ALL COMPLETED QUESTIONNAIRES ARE REVIEWED AND ALL DISCLOSURES OF POTENTIAL CONFLICTS WILL BE BROUGHT TO THE PRESIDENT. THE PRESIDENT OR HIS/HER DESIGNEE WILL TAKE ACTION TO ELIMINATE THE POTENTIAL CONFLICT OF INTEREST. ALL DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST IN THE COMPLETED QUESTIONNAIRES SHALL BE COMPILED AND REPORTED BY THE ASSISTANT TREASURER TO THE EXECUTIVE AND FINANCE COMMITTEE OF THE BOARD TO DETERMINE IF THE REPORTED DISCLOSURE AND RESOLUTION IS SATISFACTORY. IF THE ACTIONS TAKEN ARE NOT SATISFACTORY, THE EXECUTIVE AND FINANCE COMMITTEE SHALL DETERMINE FURTHER ACTION AS IT DEEMS APPROPRIATE.
FORM 990, PART VI, SECTION B, LINE 15ACOMPENSATION PROCESS FOR TOP OFFICIAL THE PRESIDENT'S SALARY IS PAID BY A RELATED ORGANIZATION UNDER A MANAGEMENT SERVICES AGREEMENT. THE PRESIDENT'S WORKPLAN AND ACCOMPLISHMENTS FOR THE YEAR ARE OVERSEEN BY THE NETWORK LEADERSHIP AND REVIEWABLE BY THE BOARD. THE PRESIDENT'S SALARY IS SUBMITTED AS PART OF THE MANAGEMENT SERVICES AGREEMENT
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS DISCLOSURE EXPLANATION O'CONNOR HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT 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 O'CONNOR HOSPITAL OR BY SENDING A SELF-ADDRESSED STAMPED ENVELOPE AND PAYMENT FOR COPYING OF THE REQUESTED MATERIAL TO O'CONNOR HOSPITAL ADMINISTRATIVE OFFICES. THE COST OF COPYING SHALL BE EQUAL TO THE COSTS IMPOSED BY THE IRS FOR COPYING PUBLIC DOCUMENTS.
FORM 990, PART XII, LINE 2CTHE CONSOLIDATED AUDIT REPORT IS REVIEWED AT A NETWORK LEVEL, BY THE BASSETT HEALTHCARE NETWORK AUDIT COMMITTEE.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (13 entries)

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BASSETT HEALTHCARE NETWORK
ONE ATWELL ROADCOOPERSTOWNNY13326133218680SUPPORTNY501C312CNONE0
FRIENDS OF BASSETT
ONE ATWELL ROADCOOPERSTOWNNY13326237041610FUNDRAISERNY501C37BHN0
AO FOX MEMORIAL HOSPITAL
ONE NORTON AVENUEONEONTANY13820150539039HEALTHCARENY501C33BHN0
BASSETT HOSPITAL SCHOHARIE COUNTY
178 GRANDVIEW DRIVECOBLESKILLNY12043141772971HEALTHCARENY501C33BHN0
LITTLE FALLS HOSPITAL
140 BURWELL STREETLITTLE FALLSNY13365150533578HEALTHCARENY501C33BHN0
MARY IMOGENE BASSETT HOSPITAL
ONE ATWELL ROADCOOPERSTOWNNY13326135596796HEALTHCARENY501C33BHN0
TEMPLETON FOUNDATION
ONE ATWELL ROADCOOPERSTOWNNY13326133317084LANDLORDNY501C310BHN0
VALLEY HEALTH SERVICES
690 WEST GERMAN STREETHERKIMERNY13350222511614ELDER CARENY501C33BHN0
BASSETT PPS LLC
6181 STATE HIGHWAY 7ONEONTANY13820811749905HEALTHCARENY501C312AMIBH0
VALLEY RESIDENTIAL SERVICES
690 WEST GERMAN STREETHERKIMERNY13350463703838ELDER CARENY501C33BHN0
AT HOME CARE PARTNERS
25 ELM STREETONEONTANY13820562397098HEALTHCARENY501C33AHC INC0
AT HOME CARE INC
25 ELM STREETONEONTANY13820161287069HEALTHCARENY501C33BHN0
AO FOX FOUNDATION
ONE NORTON AVENUEONEONTANY13820222871993FUNDRAISERNY501C39AO FOX0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

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STAMFORD PROFESSIONAL ASSOCIATES
1 NORTON AVENUEONEONTANY13820161322304RENTALNYN/A00
FIRST COMMUNITY CARE OF BASSETT
60 NORTHPOINTE PARKWAYAMHERSTMA14228161504464HEALTHCARENYN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

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CATSKILL CARE ENTERPRISES
1 NORTON AVENUEONEONTANY13820161236590RETAIL PHARMACYNYN/AC0
LEATHERSTOCKING PHYSICIANS PC
ONE ATWELL ROADCOOPERSTOWNNY13326364864562HEALTHCARENYN/A0
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Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
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Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
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Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
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