OCONNOR HOSPITAL: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- OCONNOR HOSPITAL (EIN 16-1540394)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202223199349323822
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-15T16:08:43-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 BROADWAY 4TH FLOOR | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 122072974 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161540394 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | O'CONNOR HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OCON | BusinessNameControlTxt |
| Phone | 6077460326 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 460 ANDES ROAD | AddressLine1Txt |
| City | DELHI | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13753 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ERIC STEIN | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 6077460326 | PhoneNum |
| Signature | 2022-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ERIC | PersonFirstNm |
| Person Last | STEIN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | GENEVA FURLANO | PreparerPersonNm |
| PTIN | P01877392 | PTIN |
| Phone | 5184274600 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ERIC STEIN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 460 ANDES ROAD | AddressLine1Txt |
| City | DELHI | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13753 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $26,016,966 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.OCONNORHOSP.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | O'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 Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 189 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $1,525,963 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,826,119 | PYContributionsGrantsAmt |
| CY Contributions Grants | $353,025 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,887,114 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $25,297,479 | CYProgramServiceRevenueAmt |
| PY Investment Income | $278,550 | PYInvestmentIncomeAmt |
| CY Investment Income | $24,624 | CYInvestmentIncomeAmt |
| PY Other Revenue | $335,105 | PYOtherRevenueAmt |
| CY Other Revenue | $341,838 | CYOtherRevenueAmt |
| PY Total Revenue | $25,326,888 | PYTotalRevenueAmt |
| CY Total Revenue | $26,016,966 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,625,459 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,530,637 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $38,412 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,615,790 | PYOtherExpensesAmt |
| CY Other Expenses | $10,882,087 | CYOtherExpensesAmt |
| PY Total Expenses | $22,241,249 | PYTotalExpensesAmt |
| CY Total Expenses | $21,412,724 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,085,639 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,604,242 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $40,495,677 | TotalAssetsBOYAmt |
| Total Assets EOY | $43,191,746 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,361,356 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,997,137 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $30,134,321 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $35,194,609 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | O'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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $17,690,919 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $25,297,479 | RevenueAmt |
| Desc | INPATIENT AND OUTPATIENT SERVICES PROVIDED TO OUR PATIENTS RESULTED IN:HOSPITALIZATIONS: 434PATIENT DAYS: 2,718CLINIC VISITS: 13,282 | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $72,231 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | COMMUNITY 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 2021, WE PROVIDED $72,231 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 $72,231 IN CHARITY CARE, $530,972 IN PATIENT ACCOUNTS WERE RECORDED AS BAD DEBT IN 2021. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $17,763,150 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 189 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | O'CONNOR HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6077460326 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 460 ANDES ROAD | AddressLine1Txt |
| City | DELHI | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13753 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| PETER HAMILTON | |||||||||
| CHAIRMAN | 4.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BRUCE MCKEEGAN | |||||||||
| VICE CHAIRMAN | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOHN JACK LYNCH | |||||||||
| SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SUE E ANDREWS | |||||||||
| TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CHARLOTTE HILL | |||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DONALD HARRIS PHD | |||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| FRANK SILAGY MD | |||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| PETER SOSNOW MD | |||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHELE DEFREECE | |||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| PAMELA VOGT | |||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| POLLY DELLACROSSE | |||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JOYCE BARBER | |||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES PETERS LEFT 1121 | |||||||||
| TRUSTEE | 1.00 | 0.00 | Yes (X) | $0 | $707,456 | $43,241 | |||
| ERIC H STEIN | |||||||||
| PRESIDENT | 24.00 | 16.00 | Yes (X) | $0 | $249,537 | $37,287 | |||
| CHRISTOPHER GRAHAM | |||||||||
| VP OF FINANCE | 40.00 | 0.00 | Yes (X) | $0 | $205,473 | $30,205 | |||
| AMY BEVERIDGE | |||||||||
| DIR. OF OPERATIONAL SUPP. | 40.00 | 0.00 | $138,388 | $0 | $10,320 | Yes (X) | |||
| ANDREA BARCOMB | |||||||||
| PHARMACIST | 40.00 | 0.00 | $148,877 | $0 | $6,027 | Yes (X) | |||
| ERIN E KINGSBURY | |||||||||
| PHARMACIST | 40.00 | 0.00 | $175,309 | $0 | $14,481 | Yes (X) | |||
| KONSTANTIN VLAHOS | |||||||||
| NURSE MANAGER | 40.00 | 0.00 | $133,139 | $0 | $2,463 | Yes (X) | |||
| BARBARA GARCIA | |||||||||
| INPATIENT NURSE MANAGER | 40.00 | 0.00 | $125,260 | $0 | $8,632 | Yes (X) | |||
| SCOTT BONDEROFF | |||||||||
| PRESIDENT | 1.00 | 0.00 | $0 | $244,283 | $23,819 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $720,973 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,406,749 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $176,475 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MAYO MEDICAL LABORATORIES | |||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55903 | LAB SERVICES | $277,955 |
| ALLIANCE HEALCARE SERVICE | |||||
| 1900 S STATE COLLEGE BLVD SUITE 60 | ANAHEIM | CA | 92806 | PET / CT SERVICES | $190,304 |
| MEDEFIS | |||||
| PO BOX 5068 | NEW YORK | NY | 10087 | AGENCY | $128,323 |
| US FOODSERVICE | |||||
| PO BOX 371285 | PITTSBURGH | PA | 15601 | FOOD SERVICES | $125,355 |
| MAYO CLINICAL | |||||
| 200 FIRST STREET SW | ROCHESTER | MN | 55903 | LAB SERVICES | $125,229 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $153,836 | RelatedOrganizationsAmt |
| Government Grants | $199,189 | GovernmentGrantsAmt |
| Total Contributions | $353,025 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| DIRECT PATIENT SERVICES | 621990 | $23,456,029 | $23,456,029 | |
| OUTPATIENT PHARMACY | 446110 | $1,525,963 | $1,525,963 | |
| OTHER PROGRAM SERVICE REVENUE | 621990 | $315,487 | $315,487 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $25,297,479 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,747 | TotalRevenueColumnAmt |
| Exclusion | $12,747 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $341,838 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $341,838 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $341,838 | TotalRevenueColumnAmt |
| Exclusion | $341,838 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $11,877 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $11,877 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,877 | TotalRevenueColumnAmt |
| Exclusion | $11,877 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,016,966 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,771,516 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,525,963 | UnrelatedBusinessRevenueAmt |
| Exclusion | $366,462 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,294,331 | TotalAmt |
| Program Services | $6,483,612 | ProgramServicesAmt |
| Management And General | $1,780,221 | ManagementAndGeneralAmt |
| Fundraising | $30,498 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $305,640 | TotalAmt |
| Program Services | $235,699 | ProgramServicesAmt |
| Management And General | $64,708 | ManagementAndGeneralAmt |
| Fundraising | $5,233 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,359,456 | TotalAmt |
| Program Services | $1,066,629 | ProgramServicesAmt |
| Management And General | $292,827 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $571,210 | TotalAmt |
| Program Services | $446,149 | ProgramServicesAmt |
| Management And General | $122,483 | ManagementAndGeneralAmt |
| Fundraising | $2,578 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,624,769 | TotalAmt |
| Program Services | $2,843,994 | ProgramServicesAmt |
| Management And General | $780,775 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,845 | TotalAmt |
| Management And General | $8,845 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $941,234 | TotalAmt |
| Program Services | $738,492 | ProgramServicesAmt |
| Management And General | $202,742 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,058 | TotalAmt |
| Program Services | $7,892 | ProgramServicesAmt |
| Management And General | $2,166 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,213 | TotalAmt |
| Program Services | $39,339 | ProgramServicesAmt |
| Management And General | $10,800 | ManagementAndGeneralAmt |
| Fundraising | $74 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $307,477 | TotalAmt |
| Program Services | $241,246 | ProgramServicesAmt |
| Management And General | $66,231 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,907 | TotalAmt |
| Program Services | $26,603 | ProgramServicesAmt |
| Management And General | $7,304 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,207 | TotalAmt |
| Program Services | $18,208 | ProgramServicesAmt |
| Management And General | $4,999 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,157,080 | TotalAmt |
| Program Services | $907,822 | ProgramServicesAmt |
| Management And General | $249,229 | ManagementAndGeneralAmt |
| Fundraising | $29 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,786 | TotalAmt |
| Program Services | $64,954 | ProgramServicesAmt |
| Management And General | $17,832 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| DRUGS AND REAGENTS | $2,443,903 | $2,443,903 |
| PATIENT CARE SUPPLIES | $740,615 | $740,615 |
| BAD DEBT | $530,972 | $530,972 |
| CHARITY CARE | $72,231 | $72,231 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $854,790 | TotalAmt |
| Program Services | $854,790 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,412,724 | TotalAmt |
| Program Services | $17,763,150 | ProgramServicesAmt |
| Management And General | $3,611,162 | ManagementAndGeneralAmt |
| Fundraising | $38,412 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,777 | BOYAmt |
| EOY | $15,708 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,795,671 | BOYAmt |
| EOY | $14,854,595 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $155,545 | BOYAmt |
| EOY | $96,386 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,851,819 | BOYAmt |
| EOY | $2,444,209 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $579,927 | BOYAmt |
| EOY | $579,822 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,603 | BOYAmt |
| EOY | $28,431 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $23,436,910 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $15,178,563 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,048,788 | BOYAmt |
| EOY | $8,258,347 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,334,339 | BOYAmt |
| EOY | $15,415,803 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,638,208 | BOYAmt |
| EOY | $1,498,445 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,495,677 | BOYAmt |
| EOY | $43,191,746 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,270,504 | BOYAmt |
| EOY | $1,000,867 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $701,937 | BOYAmt |
| EOY | $509,922 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,388,915 | BOYAmt |
| EOY | $6,486,348 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,361,356 | BOYAmt |
| EOY | $7,997,137 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,836,705 | BOYAmt |
| EOY | $34,462,574 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $297,616 | BOYAmt |
| EOY | $732,035 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,134,321 | BOYAmt |
| EOY | $35,194,609 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,495,677 | BOYAmt |
| EOY | $43,191,746 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $4,604,242 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $456,046 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $8,845 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $8,845 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | SCHEDULE C, PART II-B, LINE 1 - AMERICAN HOSPITAL ASSOCIATION MEMBERSHIP DUES ALLOCATE 26.47% TOWARDS LOBBYING ACTIVITIES. TOTAL DUES PAID IN 2021 = $12,843. HANYS MEMBERSHIP DUES ALLOCATE 14.13% TOWARDS GENERAL LOBBYING ACTIVITIES. TOTAL DUES PAID IN 2021 = $7,203. IROQUOIS MEMBERSHIP DUES ALLOCATE 57% TOWARDS GENERAL LOBBY ACTIVITIES. TOTAL DUES PAID IN 2021 = $7,767. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | $251,917 | ContributionsAmt |
| End Year Balance | $251,917 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $99,400 | OtherCostOrOtherBasisAmt |
| Book Value | $99,400 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,660,969 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,145,708 | DepreciationAmt |
| Book Value | $1,515,261 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $820,881 | OtherCostOrOtherBasisAmt |
| Book Value | $820,881 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,257,418 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,032,855 | DepreciationAmt |
| Book Value | $5,224,563 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $598,242 | OtherCostOrOtherBasisAmt |
| Book Value | $598,242 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,258,347 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| MEDICARE ADVANCE (CARES ACT) | $1,628,885 |
| 3RD PARTY PAYABLES | $2,991,494 |
| DUE TO RELATED PARTIES | $1,865,969 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,486,348 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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, 2021 AND 2020. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 25 | PersonsServedCnt |
| Total Community Benefit Expns | $69,023 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $69,023 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00330 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,964,338 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,660,480 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,303,858 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06270 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 25 | PersonsServedCnt |
| Total Community Benefit Expns | $3,033,361 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,660,480 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,372,881 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06600 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $185,942 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $185,942 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00890 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $4,192,454 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,053,945 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $138,509 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00670 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $30,254 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $30,254 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 12 | ActivitiesOrProgramsCnt |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 18 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $4,408,650 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,053,945 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $354,705 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01710 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 19 | ActivitiesOrProgramsCnt |
| Persons Served | 25 | PersonsServedCnt |
| Total Community Benefit Expns | $7,442,011 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,714,425 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,727,586 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08310 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Reimbursed By Medicare | $6,386,462 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,323,230 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $63,232 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | O'CONNOR HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 460 ANDES ROAD | AddressLine1Txt |
| City | DELHI | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13753 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.OCONNORHOSP.ORG | WebsiteAddressTxt |
| State License | 1254700C | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | OUTPATIENT PRIMARY & SPECIALITY | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | O'CONNOR HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SECTION C | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | 0 | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| O'CONNOR HOSPITAL | PART V, SECTION B, LINE 3J: CONTINUING PRIOR CHNA WORK ON PREVENTING CHRONIC DISEASES, PROMOTING MENTAL HEALTH, AND PREVENTING SUBSTANCE ABUSE. |
| O'CONNOR HOSPITAL | PART V, SECTION B, LINE 5: REPRESENTATIVES FROM DELAWARE COUNTY PUBLIC HEALTH, O'CONNOR HOSPITAL, DELAWARE VALLEY HOSPITAL, MARGARETVILLE HOSPITAL, AND THE SOUTHERN TIER POPULATION HEALTH IMPROVEMENT PROGRAM (PHIP) MET IN FALL OF 2018 TO BEGIN DISCUSSING THE NEXT FULL DELAWARE COUNTY COMMUNITY HEALTH ASSESSMENT, COMMUNITY HEALTH IMPROVEMENT PLAN, AND THE HOSPITAL COMMUNITY SERVICE PLANS, AND SET UP A MONTHLY MEETING SCHEDULE TO CONTINUE UNTIL SUBMISSION OF THE FULL DOCUMENT IN DECEMBER 2019.A REVIEW AND UPDATE OF DATA IN THE COMMUNITY HEALTH ASSESSMENT WAS COMPLETED IN JULY 2019, USING COUNTY, REGIONAL AND NEW YORK STATE SECONDARY DATA SOURCES INCLUDING BRFSS, CENSUS DATA, AND LOCAL DATA SOURCES INCLUDING THE DELAWARE COUNTY PUBLIC HEALTH ANNUAL REPORT, THE DELAWARE COUNTY OFFICE FOR AGING'S ANNUAL ASSESSMENT AND REPORT THE DELAWARE COUNTY COMMUNITY SERVICES ANNUAL ASSESSMENT AND PLAN.AS A METHOD TO COLLECT PRIMARY DATA FROM THE COUNTY AT LARGE, TWO SURVEYS WERE DEVELOPED: THE FIRST WAS SENT ELECTRONICALLY TO DELAWARE COUNTY HEALTH AND HUMAN SERVICES PROVIDERS TO GAIN THEIR PERSPECTIVES ON THE PREVENTION AGENDA PRIORITY AREAS AND THE ASSOCIATED FOCUS AREAS MOST IN NEED OF IMPROVEMENT. THE SECOND SURVEY WAS SENT ELECTRONICALLY TO COMMUNITY MEMBERS TO IDENTIFY PRIMARY STRENGTHS AND WEAKNESSES OF SERVICE PROVISION, SOCIAL DETERMINANTS OF HEALTH IN NEED OF ADDRESSING, AND GENERAL QUALITY OF HEALTH AND LIFE IN THE COUNTY.PRELIMINARY FINDINGS ALLOWED THE GROUP TO: 1) UNDERSTAND WHICH DATA SOURCES AND INFORMATION WOULD BE MOST USEFUL, 2) DETERMINE COMMUNITY PARTNERS, ORGANIZATIONS, AND OTHER EXISTING ASSESSMENTS TO INCLUDE IN THE PROCESS, 3) EXPLORE BEST PRACTICE ACTIVITIES AND INTERVENTIONS TO INCLUDE IN THE COMMUNITY SERVICE PLAN.IN MAY OF 2019, THE PHIP POPULATION HEALTH COORDINATORS WORKED WITH THE DELAWARE COUNTY COMMITTEE TO HOLD A COMMUNITY ROUNDTABLE EVENT AT THE STATE UNIVERSITY OF NEW YORK (SUNY) DELHI, LOCATED IN DELHI NY, DELAWARE COUNTY. ALL HEALTH AND HUMAN SERVICES PROVIDERS THAT RECEIVED THE SURVEY WERE INVITED, AS WELL AS THE COMMUNITY RESIDENTS WHO PROVIDED THEIR NAMES AND CONTACT INFORMATION ELECTRONICALLY VIA THE SURVEY. THE EVENT WAS ALSO PROMOTED VIA EMAIL AND SOCIAL MEDIA COMMUNICATIONS. HOSPITAL AND PUBLIC HEALTH REPRESENTATIVES SHARED THE INVITATION WITH THEIR BOARDS OF DIRECTORS. THE ROUNDTABLE EVENT WAS ATTENDED BY 40 PEOPLE, AND INCLUDED A PRESENTATION ON THE SURVEY DATA BY THE PHIP COORDINATORS. IN ADDITION, DELAWARE COUNTY'S DIRECTOR OF PUBLIC HEALTH AND THE DIRECTOR OF OPERATIONAL SUPPORT FROM O'CONNOR HOSPITAL (LOCATED IN DELHI AND AFFILIATED WITH THE BASSETT HEALTHCARE SYSTEM) PRESENTED ON THE NY STATE AND FEDERAL REQUIREMENTS FOR COMPLETION OF THE COMMUNITY HEALTH ASSESSMENT, COMMUNITY HEALTH IMPROVEMENT PLAN, AND THE HOSPITALS' COMMUNITY SERVICE PLANS.THE ROUNDTABLE EVENT INCLUDED BREAKOUT GROUPS FOR THE CHOSEN PREVENTION AGENDA PRIORITY AREAS TO GIVE ATTENDEES FURTHER OPPORTUNITY TO PROVIDE INPUT ON THE INTERVENTIONS AND ACTIVITIES TO PLACE IN THE NEXT 3-YEAR CYCLE.O'CONNOR HOSPITAL INVOLVED ITS SENIOR OPERATIONS TEAM (OPS) AND THREE MEMBERS OF THE HOSPITAL BOARD OF TRUSTEES IN THE ASSESSMENT AND SELECTION OF ITS HEALTH PRIORITIES. ON MAY 30TH, THREE BOARD MEMBERS AND TWO OPS MEMBERS PARTICIPATED IN THE DELAWARE COUNTY HEALTH ASSESSMENT ROUNDTABLE AND DISCUSSION, DESCRIBED ABOVE. FOLLOWING THE ROUNDTABLE, THE THREE BOARD MEMBERS AND THE OPS TEAM MET TO DISCUSS THE HOSPITAL'S OPERATIONAL STRATEGIES AND AVAILABLE RESOURCES FOR ADDRESSING HEALTH PRIORITIES IN DELAWARE COUNTY. |
| O'CONNOR HOSPITAL | PART V, SECTION B, LINE 6A: UHS DELAWARE VALLEY HOSPITAL AND MARGARETVILLE MEMORIAL HOSPITAL |
| O'CONNOR HOSPITAL | PART V, SECTION B, LINE 6B: DELAWARE COUNTY PUBLIC HEALTH |
| O'CONNOR HOSPITAL | PART 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.DUE TO THE COVID-19 PANDEMIC, DURING 2020, THE HOSPITAL CANCELED ALL ELECTIVE PROCEDURES AND NON-URGENT AMBULATORY VISITS WHICH RESULTED IN A SIGNIFICANT REDUCTION IN PATIENT VOLUMES. IN ADDITION TO THE LOST REVENUE THAT ACCOMPANIED THE LOWER PATIENT VOLUMES THE HOSPITAL EXPERIENCED A SIGNIFICANT INCREASE IN OPERATING EXPENSES ASSOCIATED WITH THE PURCHASE OF PERSONAL PROTECTIVE EQUIPMENT, CERTAIN PHARMACEUTICALS, COVID 19 TESTING SUPPLIES, AND OTHER OVERHEAD AND PATIENT SPECIFIC COSTS. ADMISSIONS FELL 10% FROM 2019 TO 2020 WHILE OUTPATIENT CLINIC AND ER VISITS DECREASED 11% FROM 2019 TO 2020.DURING 2021 THE HOSPITAL CONTINUED TO CARE FOR PATIENTS AFFECTED BY THE COVID-19 PANDEMIC. IN RETURN, THE HOSPITAL REALIZED $199,189 OF CARES ACT FUNDS IN RELATION TO THE SALARIES AND SUPPLIES EXPENDED TO CARE FOR THESE PATIENTS. |
| PART V, LINE 7A AND 10A, FACILITY 1, O'CONNOR HOSPITAL | THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE MADE AVAILABLE ON THE HOSPITAL'S WEBSITE:WWW.BASSETT.ORG/LOCATIONS/OCONNOR-HOSPITAL |
| PART V, LINE 16A, 16B, & 16C, FACILITY 1, O'CONNOR HOSPITAL | THE 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 HOSPITAL | PART 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 HAVE NOT CHANGED AS A RESULT OF THE TRANSITION. |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. |
| 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 $530,972 WAS SUBTRACTED FROM THE TOTAL VALUE USED TO CALCULATE THE PERCENTAGES IN PART 1, LINE 7, COLUMN F. |
| PART I, LINE 7, COLUMN (D) | DIRECT OFFSETTING REVENUEDURING 2021, THE HOSPITAL RECORDED PROVIDER RELIEF FUNDS THAT WERE USED AS REIMBURSEMENT FOR COMMUNITY BENEFIT EXPENSES THE HOSPITAL INCURRED AS A RESULT OF THE COVID-19 PANDEMIC. SUCH EXPENSES ARE CURRENTLY REPORTED IN PART I, LINE 7, COLUMN (C) BUT THE HOSPITAL HAS NOT INCLUDED THE PROVIDER RELIEF FUNDS AS DIRECT OFFSETTING REVENUE IN COLUMN (D) PENDING FURTHER GUIDANCE FROM THE IRS AS TO WHETHER PROVIDER RELIEF GRANTS ARE CONSIDERED RESTRICTED GRANTS FOR THE PURPOSES OF LINE 7. |
| 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 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.BAD DEBT:DUE 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 PRICE CONCESSION. |
| 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: | NEEDS ASSESSMENTFOLLOWING THE PUBLIC PARTICIPATION AND INPUT PERIOD THE HEALTH PRIORITIESWERE CHOSEN BASED UPON THE APPLICATION OF THE FOLLOWING SIX CRITERIA:1. THE PRIORITY AREA WAS IDENTIFIED IN THE PRIMARY INFORMATION SOURCES.2. THE PRIORITY AREA WAS CONSISTENT WITH THE CURRENT NYS DEPARTMENT OFHEALTH PREVENTION AGENDA AREAS;3. THE PRIORITY AREA WAS SUPPORTED BY DATA SHOWING HEALTH STATUSINDICATORS OR HEALTH NEEDS WERE EITHER BELOW THE AVERAGES FOR NEW YORKSTATE, CONTIGUOUS COUNTIES, OR AVERAGES FOR UPSTATE NEW YORK4. THE PRIORITY AREA WAS IDENTIFIED/ RECOMMENDED DURING THE PUBLIC INPUT PROCESS.5. THE AVAILABILITY OF RESOURCES FOR THE HOSPITAL TO COMMIT TO THE PRIORITY6. OPPORTUNITY FOR DEVELOPMENT OF COLLABORATIVE INTERVENTIONS BY O'CONNOR HOSPITAL, DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT AND ITS OTHER COMMUNITY WORK GROUP PARTNERS WAS ALSO CONSIDERED. O'CONNOR HOSPITAL HAS SELECTED TWO HEALTH PRIORITIES WHICH ARE ALSOADDRESSED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATIONSTRATEGY 2013, 2016, AND 2019 REPORTS:A. PREVENT CHRONIC DISEASESB. PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERSBOTH OF THESE COMMUNITY SERVICE PLAN PRIORITIES ARE FROM THE NEW YORK STATE PREVENTION AGENDA 2019-2024. |
| 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 INFORMATIONACCORDING TO THE 2017 UNITED STATES CENSUS ESTIMATE, DELAWARE COUNTY, NEW YORK, HAS A POPULATION OF 45,001 AND IS APPROXIMATELY THE SIZE OF THE STATE OF RHODE ISLAND. THE COUNTY HAS FOUR HOSPITALS COVERING AN AREA OF 1,442.44 SQUARE MILES WITH 33.3 PEOPLE PER SQUARE MILE. O'CONNOR'S SERVICE AREA INCLUDES THE DELHI COMMUNITY, AS WELL AS, SURROUNDING COMMUNITIES STRETCHING FROM GRAND GORGE, THROUGH STAMFORD, SOUTH KORTRIGHT, BOVINA, ANDES, BLOOMVILLE, HAMDEN AND FRANKLIN TO TREADWELL, AND COVERING MANY HAMLETS IN BETWEEN. |
| 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 NEUROLOGISTS IN COOPERSTOWN AND NEUROSURGEONS 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 BRINGHEALTH AND WELLNESS BENEFITS TO THE COMMUNITY. O'CONNOR CONTINUALLY INVESTS IN PROGRAMS, EQUIPMENT AND PEOPLE TO ENSURE HIGH QUALITY SERVICE IS AVAILABLE IN THE COMMUNITY THEY SERVE. |
| 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. THE NETWORK FOCUSES ITS COMMUNITY SERVICES PROGRAMS IN THE COUNTIES WHERE THE SIX AFFILIATED HOSPITALS AND GREATEST PATIENT POPULATIONS ARE LOCATED. OTSEGO COUNTY - POPULATION 60,094; DELAWARE COUNTY - POPULATION 45,001; HERKIMER COUNTY - POPULATION 62,240; SCHOHARIE COUNTY - POPULATION 31,420 (ACCORDING TO THE 2017 U.S. CENSUS ESTIMATES).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, 20 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 7 | STATE FILING OF COMMUNITY BENEFIT REPORTNEW YORK |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES PETERS LEFT 1121 | ||||||||||||||
| TRUSTEE | $0 | $644,981 | $0 | $62,475 | $0 | $0 | $0 | $26,188 | $0 | $17,053 | $0 | $750,697 | $0 | $0 |
| ERIC H STEIN | ||||||||||||||
| PRESIDENT | $0 | $249,537 | $0 | $0 | $0 | $0 | $0 | $20,960 | $0 | $16,327 | $0 | $286,824 | $0 | $0 |
| SCOTT BONDEROFF | ||||||||||||||
| PRESIDENT | $0 | $244,283 | $0 | $0 | $0 | $0 | $0 | $23,380 | $0 | $439 | $0 | $268,102 | $0 | $0 |
| CHRISTOPHER GRAHAM | ||||||||||||||
| VP OF FINANCE | $0 | $205,473 | $0 | $0 | $0 | $0 | $0 | $15,902 | $0 | $14,303 | $0 | $235,678 | $0 | $0 |
| ERIN E KINGSBURY | ||||||||||||||
| PHARMACIST | $175,309 | $0 | $0 | $0 | $0 | $0 | $9,649 | $0 | $4,832 | $0 | $189,790 | $0 | $0 | $0 |
| ANDREA BARCOMB | ||||||||||||||
| PHARMACIST | $148,877 | $0 | $0 | $0 | $0 | $0 | $5,232 | $0 | $795 | $0 | $154,904 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE J, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | RELATED 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 (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | BASSETT 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, TRI-TOWN REGIONAL HOSPITAL, 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 7A | SEE FORM 990, PART VI, SECTION A, LINE 6 ABOVE. |
| FORM 990, PART VI, SECTION A, LINE 7B | SEE FORM 990, PART VI, SECTION A, LINE 6 ABOVE. |
| FORM 990, PART VI, SECTION B, LINE 11B | ORGANIZATION'S PROCESS TO REVIEW FORM 990 THE VP OF FINANCE, O'CONNOR HOSPITAL, 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 12C | ENFORCEMENT 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 15A | COMPENSATION PROCESS FOR TOP OFFICIAL THE PRESIDENT'S SALARY IS PAID BY A RELATED ORGANIZATION UNDER A MANAGEMENT SERVICES AGREEMENT. O'CONNOR HOSPITAL REVIEWS THE FORMAL PROCESS THAT IS USED TO DETERMINE THE BASE COMPENSATION OF THE PRESIDENT. THE PRESIDENT'S WORKPLAN AND ACCOMPLISHMENTS FOR THE YEAR ARE REVIEWED. THE PRESIDENT'S SALARY IS SUBMITTED AS PART OF THE MANAGEMENT SERVICES AGREEMENT, WHICH IS APPROVED BY THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING 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. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| BASSETT HEALTHCARE NETWORK | ||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 133218680 | SUPPORT | NY | 501C3 | 12C | NONE | 0 |
| FRIENDS OF BASSETT | ||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 237041610 | FUNDRAISER | NY | 501C3 | 7 | BHN | 0 |
| AO FOX MEMORIAL HOSPITAL | ||||||||||
| ONE NORTON AVENUE | ONEONTA | NY | 13820 | 150539039 | HEALTHCARE | NY | 501C3 | 3 | BHN | 0 |
| BASSETT HOSPITAL SCHOHARIE COUNTY | ||||||||||
| 178 GRANDVIEW DRIVE | COBLESKILL | NY | 12043 | 141772971 | HEALTHCARE | NY | 501C3 | 3 | BHN | 0 |
| LITTLE FALLS HOSPITAL | ||||||||||
| 140 BURWELL STREET | LITTLE FALLS | NY | 13365 | 150533578 | HEALTHCARE | NY | 501C3 | 3 | BHN | 0 |
| MARY IMOGENE BASSETT HOSPITAL | ||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 135596796 | HEALTHCARE | NY | 501C3 | 3 | BHN | 0 |
| TEMPLETON FOUNDATION | ||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 133317084 | LANDLORD | NY | 501C3 | 10 | BHN | 0 |
| VALLEY HEALTH SERVICES | ||||||||||
| 690 WEST GERMAN STREET | HERKIMER | NY | 13350 | 222511614 | ELDER CARE | NY | 501C3 | 3 | BHN | 0 |
| BASSETT PPS LLC | ||||||||||
| 6181 STATE HIGHWAY 7 | ONEONTA | NY | 13820 | 811749905 | HEALTHCARE | NY | 501C3 | 12A | MIBH | 0 |
| TRI TOWN REGIONAL HEALTHCARE | ||||||||||
| 43 PEARL STREET | SIDNEY | NY | 13838 | 260169584 | HEALTHCARE | NY | 501C3 | 3 | BHN | 0 |
| VALLEY RESIDENTIAL SERVICES | ||||||||||
| 690 WEST GERMAN STREET | HERKIMER | NY | 13350 | 463703838 | ELDER CARE | NY | 501C3 | 3 | BHN | 0 |
| AT HOME CARE PARTNERS | ||||||||||
| 25 ELM STREET | ONEONTA | NY | 13820 | 562397098 | HEALTHCARE | NY | 501C3 | 3 | AHC INC | 0 |
| AT HOME CARE INC | ||||||||||
| 25 ELM STREET | ONEONTA | NY | 13820 | 161287069 | HEALTHCARE | NY | 501C3 | 3 | BHN | 0 |
| AO FOX FOUNDATION | ||||||||||
| 1 NORTON AVE | ONEONTA | NY | 13820 | 222871993 | FUNDRAISER | NY | 501C3 | 9 | AO FOX | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| STAMFORD PROFESSIONAL ASSOCIATES | |||||||||
| 1 NORTON AVE | ONEONTA | NY | 13820 | 161322304 | RENTAL | NY | N/A | 0 | 0 |
| FIRST COMMUNITY CARE OF BASSETT | |||||||||
| 60 NORTHPOINTE PARKWAY | AMHERST | MA | 14228 | 161504464 | HEALTCARE | NY | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| CATSKILL CARE ENTERPRISES | |||||||||
| 1 NORTON AVE | ONEONTA | NY | 13820 | 161236590 | RETAIL PHARMACY & FITNESS CENTER | NY | N/A | C | 0 |
| LEATHERSTOCKING PHYSICIANS PC | |||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 364864562 | HEALTHCARE SERVICES | NY | N/A | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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