2021-11-15T17:00:08-06:00 2020-12-31 135565207 KPMG LLP 515 BROADWAY 4TH FLOOR ALBANY NY 122072974 990 2020-01-01 150533578 LITTLE FALLS HOSPITAL LITT 3158231000 140 BURWELL STREET LITTLE FALLS NY 13365 JAMES VIELKIND CFO 3158231000 2021-11-12 1 JAMES VIELKIND 999009999 GENEVA FURLANO P01877392 5184274600 2021-11-15 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z JAMES VIELKIND 140 BURWELL STREET LITTLE FALLS NY 13365 42501855 0 X WWW.BASSETT.ORG X 1893 NY CRITICAL ACCESS HOSPITAL PROVIDING ACCESS TO HEALTH CARE SERVICES TO RESIDENTS OF HERKIMER COUNTY, AND WESTERN PORTIONS OF MONTGOMERY AND FULTON COUNTIES. LITTLE FALLS HOSPITAL EMERGENCY DEPARTMENT IS STAFFED WITH PHYSICIANS ON A 24/7 BASIS. TWENTY FIVE BEDS ARE USED FOR INPATIENT AND SKILLED NURSING CARE. AMBULATORY SURGERY SERVICES ARE PROVIDED FOR A VARIETY OF PROCEDURE SPECIALTIES. PERFORMANCE IMPROVEMENT AND HIGH QUALITY OF CARE IS DEMONSTRATED WITHIN THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) AS REPORTED ON MEDICARE.GOV HOSPITAL COMPARE. 13 11 379 18 0 0 1265539 8464504 33439501 32582919 438892 310963 0 0 35143932 41358386 0 0 0 0 15784280 15306004 0 0 63999 18099302 25233817 33883582 40539821 1260350 818565 33323096 40044586 9825312 15265197 23497784 24779389 X LITTLE FALLS HOSPITAL IS A VOLUNTARY, NOT-FOR-PROFIT COMMUNITY HEALTHCARE SYSTEM WHOSE MISSION IS TO OFFER QUALITY CARE WITH COMPASSION, TO ALL WHO NEED OUR SERVICES. 0 0 10689878 9345469 INPATIENT SERVICES56% FOR AN AVERAGE DAILY INPATIENT DAILY CENSUS OF 15 PATIENTS. AS A CRITICAL ACCESS HOSPITAL (CAH) PROVIDER, OUR INPATIENT DAILY SERVICES INCLUDE; OBSERVATION CARE, EXTENDED SWINGBED REHAB SERVICES, AND ACUTE CARE SERVICES. THIS DIVERSITY OF PATIENT CARE ALLOWS FOR OUR RESIDENTS TO REMAIN LOCAL FOR MEDICALLY APPROPRIATE SERVICES. IN 2020, ACUTE CARE LENGTH OF STAY WAS 3.3 DAYS COMPARED WITH 3.4 IN 2019. THIS LOWER LENGTH OF STAY HIGHLIGHTS THE QUALITY AND COORDINATION OF CARE FOR PATIENTS AT LITTLE FALLS HOSPITAL.IN JANUARY 2020, THE SECRETARY OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) DECLARED A NATIONAL PUBLIC HEALTH EMERGENCY DUE TO A NOVEL STRAIN OF CORONAVIRUS (COVID 19) AND IN MARCH 2020 THE WORLD HEALTH ORGANIZATION DECLARED THE SPREAD OF THE VIRUS TO BE A PANDEMIC. IN COORDINATION WITH STATE HEALTH AUTHORITIES, LITTLE FALLS HOSPITAL INITIATED EMERGENCY MEASURES TO PREVENT AVOIDABLE TRANSMISSION OF THE ILLNESS, INCLUDING CANCELING NON URGENT ELECTIVE PROCEDURES AND CLINIC VISITS. 11046207 10399685 LITTLE FALLS HOSPITAL OPERATES AN EMERGENCY DEPARTMENT WITH TWENTY-FOUR HOURS OF PHYSICIAN COVERAGE, SEVEN DAYS PER WEEK. THE EMERGENCY DEPARTMENT PROVIDED ACCESS TO CARE FOR APPROXIMATELY 11,400 PATIENTS IN 2020. LITTLE FALLS HOSPITAL EXPANDED THE EMERGENCY DEPARTMENT PARTICIPATED IN A NYS MEDICAID ACCELERATED EXCHANGE (MAX) PROGRAM TO REDUCE AVOIDABLE VISITS TO AN EMERGENCY DEPARTMENT. IN ADDITION, A PARTNERSHIP WITH SALVATION ARMY AND THEIR COMMUNITY "PATHWAY TO HOPE" PROGRAM WAS FORMALIZED TO ASSIST IN PATIENT CARE MANAGEMENT ACTIVITIES. THESE SERVICES EMBEDDED IN OUR EMERGENCY ROOM PROVIDES ASSITANCE FOR PATIENTS TO MAKE MEDICAL APPOINTMENTS, OBTAIN INSURANCE COVERAGE, OR APPLY FOR COMMUNITY ASSISTANCE PROGRAMS. 13896842 12837765 TOTAL AMBULATORY OUTPATIENT SERVICE VISITS WERE APPROXIMATELY 39,400 IN 2020. OUR AMBULATORY SERVICES INCLUDE REHAB / WELLNESS PROGRAM, AMBULATORY SURGERY / GI SERVICES, WOMENS IMAGING SERVICE, DIAGNOSTIC IMAGING SERVICES, RURAL HEALTH CLINIC PRIMARY CARE SERVICES. 35632927 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 61 0 1 379 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X JAMES G VIELKIND 3158235281 140 BURWELL STREET LITTLE FALLS NY 13365 CHRISTINE REYNOLDS THIRD VICE CHAIRMAN 2.00 0.00 X X 0 0 0 PHYLLIS SPINNER TRUSTEE 2.00 0.00 X 0 0 0 TIMOTHY DALY CHAIRMAN 2.00 0.00 X X 0 0 0 ANTHONY DELUCA FIRST VICE CHAIRMAN 2.00 0.00 X X 0 0 0 GERARD J SNYDER SECRETARY 2.00 0.00 X X 0 0 0 KEVIN CROSLEY LEFT 42020 TRUSTEE 2.00 0.00 X 0 0 0 JUSTIN R HUMMEL SECOND VICE CHAIRMAN 2.00 0.00 X X 0 0 0 AMY GRACE PRESIDENT OF MEDICAL STAFF 2.00 40.00 X X 0 244657 20241 KATE READ LAVALLA TRUSTEE 2.00 0.00 X 0 0 0 LISA BETRUS TRUSTEE 2.00 40.00 X 0 310496 18814 KATHLEEN SELLERS TRUSTEE 2.00 0.00 X 0 0 0 CHRISTINA CAIN LEFT 52020 TRUSTEE 2.00 0.00 X 0 0 0 DAVID CASULLO TRUSTEE 2.00 0.00 X 0 0 0 LAURA POWERS TRUSTEE 2.00 0.00 X 0 0 0 CARLTON RULE SENIOR VP MEDICAL STAFF 2.00 40.00 X 0 379965 26341 MICHAEL OGDEN PRESIDENT & CEO 40.00 0.00 X 0 220562 12732 JAMES G VIELKIND CHIEF FINANCIAL OFFICER 40.00 0.00 X 0 210836 914 HEIDI CAMARDELLO DIRECTOR OF NURSING 40.00 0.00 X 145518 0 5772 LOREEN E SHEPARDSON DIRECTOR OF PHARMACY 40.00 0.00 X 144973 0 4745 JAMIE CARMARDELLO PHARMACIST 40.00 0.00 X 128102 0 2562 VIRGINIA CLIVE ADVANCED CARE PRACTITIONER 40.00 0.00 X 120398 0 7476 JODI POLLITT NURSE SUPERVISOR 40.00 0.00 X 117519 0 6079 656510 1366516 105676 13 0 1 0 SUNBELT STAFFING PO BOX 934411 ATLANTA GA 311934411 AGENCY STAFFING 269142 DM CONSULTING PO BOX 4715 UTICA NY 13504 INFORMATION TECH 117832 2 530025 7779912 154567 8464504 HOSPITAL - OUTPATIENT 623000 23518493 23518493 HOSPITAL - INPATIENT 621930 7791260 7791260 OTHER OPERATING REVENUE 900099 711126 711126 PROGRAM SERVICE LEASE 532000 442590 442590 HOSPITAL CAFETERIA 900099 119450 119450 32582919 223919 223919 1230513 1143469 87044 87044 87044 41358386 32582919 0 310963 12554006 11056450 1478343 19213 432581 402630 29567 384 1389542 1205669 181559 2314 929875 815958 112484 1433 107849 107849 82132 82132 7237 7237 1145916 318545 827371 37450 37450 7238692 7132402 106290 1883714 1750338 133376 641586 571040 66975 3571 25364 14867 9994 503 23821 16107 7638 76 104379 15983 88396 2413459 2043904 369555 244343 233435 10908 PURCHASED SERVICES 9124491 7864765 1223221 36505 BAD DEBT 1999247 1999247 0 NYS ASSESSMENT 114152 114152 0 CHARITY CARE 39985 39985 0 40539821 35632927 4842895 63999 2342352 11028994 1761517 2089576 936170 284877 2723301 3167412 0 0 0 0 0 0 637130 678934 966166 622870 46024637 30334673 17584190 15689964 2875766 3128206 1789027 1981753 940883 0 0 0 766594 1372000 33323096 40044586 3758010 4383596 0 0 397112 0 0 0 0 0 0 0 1683693 1451495 2388724 1847880 1597773 7582226 9825312 15265197 X 17755767 19070096 5742017 5709293 23497784 24779389 33323096 40044586 X 818565 446442 16598 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7237 7237 0 PART II-B, LINE 1: AMOUNTS FOR GENERAL LOBBYING ACTIVITIES ARE $7,237 COMPRISED FROM THE HEALTHCARE ASSOCIATION MEMBERSHIPS AS FOLLOWS: HEALTHCARE ASSOCIATION OF NEW YORK STATE 20.44% OF DUES PAID OF $6,842. AMERICAN HOSPITAL ASSOCIATION 25.56% OF DUES PAID OF $17,325. IROQUOIS HEALTHCARE ALLIANCE 59% OF DUES PAID OF $2,390. 5742017 75000 -117041 -84317 75000 5709293 5913759 482000 87791 3771 737762 5742017 4914943 487332 512484 1000 5913759 4609617 305326 4914943 4460686 148931 4609617 0.20720 0.79280 0 1 1 402942 402942 32818879 20203151 12615728 12802816 10131522 2671294 15689964 CMS CARES ACT 4000000 DUE TO RELATED PARTIES 2517759 3RD PARTY PAYABLES 202880 ACCRUED PENSION OBLIGATION 861587 7582226 X PART V, LINE 4: ENDOWMENT FUNDS DISTRIBUTE INCOME FOR PURPOSES OF CAPITAL INVESTMENT. TEMPORARY ENDOWMENTS ARE USED BASED ON THE INTENT OF THE DONATION, WHICH IS TYPICALLY FOR CAPITAL INVESTMENTS. PART X, LINE 2: FIN 48 FOOTNOTE LITTLE FALLS 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, 2020. 1 1 1 X 300.000000000000 0 1 1 0 1 1 70 162095 23102 138993 0.00360 19264 8460061 4232519 4227542 0.11010 19334 8622156 4255621 4366535 0.11370 17751 17751 0.00050 9 9555 9555 0.00020 0.00000 0.00000 0.00000 9 27306 27306 0.00070 19343 8649462 4255621 4393841 0.11440 2 6720 6720 0.00020 51523 51523 0.00130 2 58243 58243 0.00150 1 10228818 10216107 12711 X 1 1 1 1 LITTLE FALLS HOSPITAL 140 BURWELL STREET LITTLE FALLS NY 13365 WWW.BASSETT.ORG/LOCATIONS/LITTLE-FALLS 2129700H X X X INCLUDES 25 INPATIENT BEDS LITTLE FALLS HOSPITAL 1 0 0 1 X X X X X X X X X 19 1 1 1 1 X SEE SECTION C X 1 19 1 SEE SECTION C 0 1 X 300.000000000000 1 1 X X X X 1 X SEE SECTION C X SEE SECTION C X SEE SECTION C X X X X X 1 X 0 X X X X X 1 X 0 0 LITTLE FALLS HOSPITAL PART V, SECTION B, LINE 5: LITTLE FALLS HOSPITAL COLLABORATED WITH BASSETT RESEARCH INSTITUTE'S MOHAWK VALLEY POPULATION HEALTH IMPROVEMENT PROGRAM AND HERKIMER COUNTY PUBLIC HEALTH TO IDENTIFY STAKEHOLDERS FOR COMPLETING THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT. THE COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES THE HOSPITAL, LOCAL COUNTY HEALTH DEPARTMENT, AND KEY INFORMANTS WITH DATA AND RESPONSES SO THAT THEY MAY IDENTIFY, PRIORITIZE, AND ADDRESS HEALTH CARE CHALLENGES FACING THEIR COMMUNITIES. MVPHIP COLLABORATED WITH HERKIMER COUNTY PUBLIC HEALTH, HERKIMER COUNTY OFFICE FOR THE AGING, AND LITTLE FALLS HOSPITAL TO COMPILE A LIST OF KEY INFORMANTS IN THE SERVICE REGION. THOSE KEY INFORMANTS REPRESENT A BROAD RANGE OF SECTORS, COMMUNITY INTERESTS, AND INCLUDED ORGANIZATIONS THAT REPRESENT THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. LITTLE FALLS HOSPITAL, HERKIMER COUNTY OFFICE FOR THE AGING, AND HERKIMER COUNTY PUBLIC HEALTH INVITED KEY INFORMANTS TO ATTEND A HERKIMER COUNTY DATA PRESENTATION AND TO GIVE FEEDBACK ON THEIR PRIORITY FOCUS AREAS BASED ON THE 2019-2024 NEW YORK STATE PREVENTION AGENDA ACTION PLANS. THOSE KEY INFORMANTS WHO WERE UNABLE TO ATTEND IN PERSON WERE SENT THE INFORMATION ELECTRONICALLY AND ASKED TO FILL OUT A SHORT SURVEY.HERKIMER COUNTY OFFICE OF THE AGINGHERKIMER COUNTY OFA'S ADVISORY COUNCILHERKIMER COUNT LEGISLATORSHERKIMER COUNTY ADMINISTRATORBRIAN MILLER, NYS ASSEMBLYLITTLE FALLS COMMUNITY OUTREACHHERKIMER COUNTY WORKFORCE DEVELOPMENTCENTRAL ASSOCIATIONS OF THE BLINDHERKIMER COUNTY HOUSING AUTHORITYHOSPICE OF HERKIMER & ONEIDA COUNTIESCOMMUNITY FOUNDATION OF HERKIMER & ONEIDA COUNTIESTOWN OF HERKIMERHERKIMER COUNTY CLERKCHRIS REYNOLDS, PRESIDENT HEALTHNETVALLEY HEALTH SERVICESMOHAWK VALLEY COMMUNITY ACTION AGENCYARC HERKIMERHERKIMER COUNTY PUBLIC HEALTHLITTLE FALLS HOSPITAL 15-0533578REGIONAL PRIMARY CARE NETWORKCORNELL COOPERATIVE EXTENSION OF HERKIMER COUNTYRCIL (LIFE@RCIL)JOHN SCARANO COMMUNITY MEMBERSHERKIMER COUNTY BOCESBRIDGES TO PREVENT TOBACCOHERKIMER COUNTY DSS COMMISSIONERLITTLE FALLS HOSPITALHERKIMER COUNTY MENTAL HEALTH SERVICESCATHOLIC CHARITIES OF HERKIMER COUNTY LITTLE FALLS HOSPITAL PART V, SECTION B, LINE 6A: PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS DEVELOPED AS PART OF A MULTI-HOSPITAL PLANNING PROCESS IN COORDINATION WITH BASSETT HEALTHCARE RESEARCH, BASSETT HEALTHCARE NETWORK, AND BASSETT MEDICAL CENTER AND LITTLE FALLS HOSPITAL. LEAD COMMUNITY AGENCY WAS HERKIMER COUNTY PUBLIC HEALTH. LITTLE FALLS HOSPITAL PART V, SECTION B, LINE 6B: PART V, SECTION B, LINE 6B: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INLCUDED COMMUNITY ORGANIZATIONS SUCH AS: HERKIMER COUNTY PUBLIC HEALTH, HERKIMER HEALTHNET, HERKIMER COUNTY MENTAL HEALTH, BASSETT MEDICAL CENTER, LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS, MOHAWK VALLEY POPULATION HEALTH IMPROVEMENT PROGRAM, AND CANCER CENTER SERVICES OF ONEIDA, MADISON, AND HERKIMER COUNTY. LITTLE FALLS HOSPITAL PART V, SECTION B, LINE 11: THE LITTLE FALLS HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WORKING WITH COMMUNITY STAKEHOLDERS WILL CONTINUE TO FOCUS ON PREVENTING CHRONIC DISEASE, WELL BEING FOR LIMITING MENTAL HEALTH EPISODIC EVENTS, AND IMPROVING A HEALTH SAFETY LIFESTYLE.THE CHRONIC CARE DISEASE MANAGEMENT WILL USE MORE METHODS TO COMMUNICATE WITH RESIDENTS AND PROVIDERS FOR TRACKING PREVENTATIVE HEALTH SCREENINGS FOR PREVENTATIVE WOMEN'S HEALTH CARE. THE WELL BEING INITIATIVES WILL UNITE EFFORTS TO BUILD TRUSTWORTHY RELATIONSHIPS FOR PATIENTS REQUIRING SUPPORTS LEVELS FOR MENTAL HEALTH SERVICES. OUR INITIATIVE TO HAVE A HEALTHIER AND SAFER LIVING ENVIRONMENT EXTENDS TO MANY OPPORTUNITIES OF HEALTH CARE INTERACTIONS. WE WILL FOCUS ON EDUCATION OF AGE COHORTS TO HAVE A HEALTHIER AND SAFER HOME, AND LIFESTYLE. THESE THREE INITIATIVES ARE SUPPORTED BY THE COLLECTIVE COMMUNITY ASSETS OF COMMUNITY-BASED ORGANIZATIONS WHO HAVE ADOPTED AND PARTNERED WITH LITTLE FALLS HOSPITAL AND HERKIMER COUNTY HEALTH DEPARTMENT.THE ESTABLISHED WORKPLAN WILL BE THE GUIDELINES FOR MONITORING PROGRESS AND ALIGNMENT OF SERVICES TO MEET THESE OBJECTIVES. THE COMMUNITY HEALTH NEEDS ASSESSMENT BUILDS UPON THE PRIOR PLAN OF 2016 - 2018. THESE INITIATIVES INCLUDED PROMOTING MENTAL, EMOTIONAL AND BEHAVIORAL HEALTH, PREVENTING SUBSTANCE ABUSE, REDUCING OBESITY IN ADULTS AND CHILDREN, PREVENTING DIABETES, AND PREVENTING HEART DISEASE. THE PROGRESS TO DATE REFLECTS THE STRONG COMMITMENT OF SUPPORT FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT ACROSS MANY STAKEHOLDERS. LITTLE FALLS HOSPITAL, BASSETT MEDICAL CENTER, AND OTHER LOCAL HEALTH PROVIDERS HAVE INCREASED USE OF MEDIA TO IMPROVE PUBLIC AWARENESS OF ACCESS FOR SCREENING SERVICES, USE OF CLINICAL EDUCATORS ON THE BENEFITS OF HEALTH SCREENINGS, AND PARTNERING WITH PROVIDERS TO IMPROVE THEIR USE OF SCREENINGS FOR CHRONIC CARE ILLNESS.LITTLE FALLS HOSPITAL WILL PARTNER WITH HERKIMER COUNTY PUBLIC HEALTH ON STRENGTHENING RESOURCES AVAILABLE FOR MENTAL HEALTH BEHAVIORAL PATIENTS. MENTAL HEALTH SERVICES ARE CURRENTLY UNDERSTAFFED WITH CLINICAL PROVIDERS IN OUR SERVICE AREA. WORKING WITH THE LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS, PRIMARY CARE PROVIDERS ARE PERFORMING MENTAL HEALTH SCREENINGS AND TRACKING INFORMATION IN THE ELECTRONIC HEALTH RECORD. THIS ALLOWS FOR PRIMARY CARE AND MENTAL HEALTH PROVIDERS TO COLLABORATE ON MEDICAL AND MENTAL HEALTH CARE PLANS. LITTLE FALLS HOSPITAL, BASSETT MEDICAL CENTER, AND HERKIMER COUNTY PUBLIC HEALTH ARE COORDINATING RECRUITMENT OF ADDITIONAL MENTAL HEALTH PROVIDERS.LITTLE FALLS HOSPITAL IS A PARTNER IN THE LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS (LHCP), LLC. THIS ORGANIZATION REPRESENTS A REGIONAL ORGANIZATION, ESTABLISHED IN PARTNERSHIP WITH NYS DEPARTMENT OF HEALTH, UNDER A CMS REFERENCED DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) PROGRAM. WHILE THIS PROGRAM ENDED IN 2019, BASSETT HEALTHCARE NETWORK CONTINUES TO SUPPORT THE HERKIMER COUNTY HUB FOR PLANNING AND ORGANIZING HEALTH IMPROVEMENT RESOURCES. SOME CURRENT ON-GOING INITIATIVES ARE AS FOLLOWS:1.) COORDINATED ADMINISTRATION OF VACCINES IN OUR FIVE RURAL HEALTH CLINICS. ALSO PERFORMED LABORATORY COVID TESTING AND RESULTS REPORTING FOR PURPOSES OF MITIGATION OF THE SPREAD OF COVID. IN LITTLE FALLS HOSPITAL IN COORDINATION WITH BASSETT HEALTHCARE NETWORK COORDINATEED COMMUNITY EDUCATION ON CONTROLLING SPREAD OF COVID. 2 .) CONTINUED THE NYS MEDICAID ACCELERATED EXCHANGE (MAX) PROCESS TO USE PATIENT CENTERED PROCESSES TO REDUCE USE OF EMERGENCY DEPARTMENT BY CHRONIC CARE PATIENTS. LITTLE FALLS HEALTH CENTERS IN DOLGEVILLE AND NEWPORT PARTICIPATED IN THIS PROJECT AND IMPROVED THEIR CARE MANAGEMENT PLANS TO REDUCE EMERGENCY DEPARTMENT VISITS.3 .) THE SALVATION ARMY, LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS, AND LITTLE FALLS HOSPITAL DEVELOPED A CARE NAVIGATION PROGRAM TO ASSIST PATIENTS AND FAMILIES WITH HEALTH CARE DECISIONS.LIMITATIONS ON PROGRESSWE HAVE IDENTIFIED THE DIFFICULTY IN RECRUITING PRIMARY CARE AND UNDERSTAFFED MENTAL HEALTH PROVIDERS IN OUR REGION AS A BARRIER TO MEETING OUR CHNA GOALS. THIS SHORTAGE OF PROVIDERS IS BEING ADDRESSED IN RECRUITMENT PLANS IN COORDINATION WITH BASSETT MEDICAL CENTER, HERKIMER COUNTY PUBLIC HEALTH, AND LITTLE FALLS HOSPITAL. DUE TO THE COVID-19 PANDEMIC, 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 11% FROM 2019 TO 2020 WHILE ER VISITS DECREASED 2% FROM 2019 TO 2020. LITTLE FALLS HOSPITAL PART V, SECTION B, LINE 20E: LITTLE FALLS HOSPITAL PROVIDED MAILING INFORMATION TO UNINSURED PATIENTS FOR ENROLLING IN AN AFFORDABLE CARE ACT INSURANCE PRODUCT SPONSORED BY THE NYS HEALTH MARKETPLACE. LITTLE FALLS HOSPITAL ALSO ASSISTED PATIENTS WITH THE COMPLETION OF APPLICATIONS FOR ENROLLMENT INTO NYS MARKETPLACE PLANS. IN 2020, 20 PATIENTS WERE ENROLLED BY A LITTLE FALLS HOSPITAL EMPLOYED FACILITATOR INTO A NYS MARKETPLACE PLAN. PART V, LINE 7A AND 10A LITTLE FALLS HOSPITAL:THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE MADE AVAILABLE ON THE HOSPITAL'S WEBSITE:HTTPS://WWW.BASSETT.ORG/LOCATIONS/LITTLE-FALLS-HOSPITAL PART V, LINE 16A, 16B, AND 16C LITTLE FALLS HOSPITAL:THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE MADE AVAILABLE ON THE HOSPITAL'S WEBSITE:HTTPS://WWW.BASSETT.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE 6 1 - DOLGEVILLE HEALTH CENTER 9 GIBSON STREET DOLGEVILLE NY 13329 CLINIC 2 - NEWPORT HEALTH CENTER BRIDGE STREET NEWPORT NY 13416 CLINIC 3 - LITTLE FALLS HEALTH CENTER 170 BURWELL STREET LITTLE FALLS NY 13365 CLINIC 4 - RICHFIELD SPRINGS HEALTH CENTER 8550 STATE HIGHWAY 28 RICHFIELD SPRINGS NY 13439 CLINIC 5 - WEST WINFIELD HEALTH CENTER 544 E MAIN STREET WEST WINFIELD NY 13491 CLINIC 6 - ST JOHNSVILLE HEALTH CENTER 8 PARK PLACE ST JOHNSVILLE NY 13452 CLINIC PART I, LINE 3C: LITTLE FALLS HOSPITAL PROVIDES SERVICES TO ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. THE COMMUNITY SERVICE PROGRAM (CSP) IS AVAILABLE FOR PATIENTS WITHOUT INSURANCE COVERAGE FOR INCOMES UP TO 300% OF THE FEDERAL POVERTY INCOME GUIDELINES. OUR CSP COORDINATOR IS AN AUTHORIZED ENROLLMENT FACILITATOR FOR MEDICAID AND NEW YORK STATE INSURANCE EXCHANGE INSURANCE COVERAGES. PART I, LINE 6A: LITTLE FALLS HOSPITAL HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE PERIOD OF 2019 - 2021 IS COORDINATED WITH BASSETT HEALTHCARE NETWORK. BASSETT'S RESEARCH INSITITUTE'S MOHAWK VALLEY POPULATION IMPROVEMENT PROGRAM (MVPHIP) RECEIVED A GRANT FROM NEW YORK STATE DEPARTMENT OF HEALTH TO CONDUCT THE ASSESSMENT ON BEHALF OF BASSETT HEALTHCARE NETWORK'S LITTLE FALLS HOSPITAL AND THE HERKIMER COUNTY PUBLIC HEALTH. MVPHIP COLLABORATED WITH AGENCIES SUCH AS HERKIMER COUNTY PUBLIC HEALTH, HERKIMER COUNTY OFFICE FOR THE AGING, AND LITTLE FALLS HOSPITAL. THIS COORDINATED GROUP OF INTERESTED PARTIES ALSO INVITED KEY STAKEHOLDERS INTO THE DEVELOPMENT PROCESS OF THE COMMUNITY NEEDS ASSESSMENT FOR 2019 - 2021. PART I, LINE 7: COST FOR CHARITY CARE PATIENTS WAS CALCULATED USING RATIO OF COST TO CHARGES. COST ASSOCIATED WITH MEDICAID AND MEDICAID HMO PROGRAMS REPRESENTS AGGREGATE ALLOWABLE COST AND TOTAL GROSS CHARGES USED TO CALCULATE A FACILITY LEVEL COST TO CHARGE RATIO. THIS FACILITY LEVEL COST TO CHARGE RATIO WAS APPLIED TO TOTAL MEDICAID AND MEDICAID HMO CHARGES TO ARRIVE AT TOTAL MEDICAID COST. FOR SUBSIDIZED HEALTH SERVICES, THE LOSS DOES NOT INCLUDE GOVERNMENT PAYERS LOSS INFORMATION IS REPORTED IN AGGREGATE AMOUNTS. PART I, LINE 7, COLUMN F LITTLE FALLS HOSPITAL EXCLUDED $1,999,247 OF BAD DEBT EXPENSE TO CALCULATE COST OF PATIENT CARE. BAD DEBT IS REPORTED AS A FUNCTIONAL PROGRAM EXPENSE. PART I, LINE 7, COLUMN D DIRECT OFFSETTING REVENUEDURING 2020, THE HOSPITAL RECEIVED PROVIDER RELIEF FUNDS THAT MAY BE 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 ACTIVITIES ARE ASSOCIATED WITH LITTLE FALLS HOSPITAL WORKING WITH COMMUNITY BUSINESSES THROUGH OUR MEMBERSHIP WITH LOCAL AGENCIES, SUCH AS HERKIMER COUNTY HEALTHNET, AMERICAN HEART ASSOCIATION, HOSPICE AND PALLIATIVE CARE INC. . THESE ACTIVITIES ALLOW FOR DIALOG ON CURRENT HEALTHCARE TOPICS, INSURANCE PROGRAMS, AND RECRUITMENT OF FUTURE EMPLOYEES. LITTLE FALLS HOSPITAL COLLABORATES WITH BASSETT MEDICAL CENTER ON RECRUITMENT INITIATIVES FOCUSING ON PRIMARY CARE. HERKIMER COUNTY HAS ONE OF THE LOWEST RATIOS OF PRIMARY CARE PROVIDERS TO RESIDENTS IN NEW YORK STATE. IN 2020, LITTLE FALLS HOSPITAL WAS A LICENSED PRACTICAL NURSES (LPN)PRECEPTOR TRAINING LOCATION SPONSORED WITH THE MOHAWK VALLEY BOARDS OF COOPERATIVE EDUCATIONAL SERVICES (BOCES). THIS TRAINING PROGRAM ENABLES FOR THE DEVELOPMENT OF FRONT-LINE HEALTH CARE WORKERS. IN 2020 THIS PROGRAM SUPPORTED THE CLINICAL DEVELOPMENT OF 8 LPN'S. 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 STATEMENTS. RATHER IT IS TREATED AS A PRICE CONCESSION. THE BAD DEBT EXPENSE FOR 2020 WAS $1,999,247. PART III, LINE 3: CHARITY CAREFOOTNOTE (3) FROM THE CONSOLIDATED FINANCIALSTHE 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 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 8: IN 2020, OUR OPERATING INCOME WAS FAVORABLE , WITH THE MEDICARE PART A & B PROGRAMS, RECOGNIZING $12,711 . MEDICARE REPRESENTS APPROXIMATELY 31% OF OUR TOTAL PATIENT REVENUE. LITTLE FALLS HOSPITAL IS A CRITICAL ACCESS HOSPITAL (CAH) WHICH IS PAID BY MEDICARE BASED ON COST OF CARE. . OUR SAFETY NET HOSPITAL STATUS INDICATES WE ARE A NYS RURAL PROVIDER WITH A GREATER THAN 30% THRESHOLD FOR MEDICAID UTILIZATION OF OUR SERVICES. OUR HIGH VOLUME OF MEDICAID IS REPRESENTED ON IRS FORM 990 SCHEDULE H LINE 7B. PART III, LINE 9B: OUR COLLECTION AND CHARITY CARE POLICY SPECIFIES THAT ACCOUNTS WITH ACTIVE CHARITY CARE APPLICATIONS WILL NOT GO TO COLLECTION AGENCIES WHILE APPLICATIONS ARE IN REVIEW. WHILE A REQUEST FOR CHARITY CARE ASSISTANCE IS IN PROCESS, THESE ACCOUNTS ARE PLACED ON HOLD IN OUR BILLING SYSTEM. WE COMMUNICATE INFORMATION ON REQUIREMENTS FOR ASSISTANCE AND WILL COUNSEL PATIENTS ON PROVIDING THE INCOME INFORMATION TO DETERMINE IF THEY QUALIFY FOR CHARITY CARE USING 300% OF THE FEDERAL POVERTY INCOME GUIDELINES. (NOTE: OUR CHARITY CARE PROGRAM IS FOR THE UNINSURED PATIENT.) PART VI, LINE 2: LITTLE FALLS HOSPITAL PARTNERED WITH BASSETT RESEARCH INSTITUTE'S MOHAWK VALLEY POPULATION HEALTH IMPROVEMENT PROGRAM (MVPHIP), A GRANT FUNDED PROGRAM FROM NEW YORK STATE DEPARTMENT OF HEALTH, WHO CONDUCTED AN ASSESSMENT ON BEHALF OF BASSETT HEALTHCARE NETWORK'S LITTLE FALLS HOSPITAL AND THE HERKIMER COUNTY PUBLIC HEALTH. THE COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES THE HOSPITAL, LOCAL COUNTY HEALTH DEPARTMENT AND STAKEHOLDERS WITH DATA AND KEY INFORMANT SURVEY RESPONSES SO THAT THEY MAY IDENTIFY, PRIORITIZE AND ADDRESS HEALTH CARE CHALLENGES FACING THEIR COMMUNITIES. UTILIZING THE NEW YORK STATE'S PREVENTION AGENDA.MVPHIP COLLABORATED WITH THE LOCAL HEALTH DEPARTMENT AND LITTLE FALLS HOSPITAL TO COMPILE A LIST OF KEY INFORMANTS IN THE SERVICE REGION. THOSE TWENTY-NINE KEY INFORMANTS REPRESENT A BROAD RANGE OF SECTORS, COMMUNITY INTERESTS AND INCLUDED ORGANIZATIONS WHICH REPRESENT THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. THE KEY INFORMANTS PARTICIPATED AT A CONFERENCE ON JUNE 20, 2019 TO DEVELOP PRIORITIES FOR COMMUNITY HEALTH IMPROVEMENT PROGRAMS FOR 2019 - 2021. BASED ON THE KEY INFORMANT SURVEY RESULTS, PARTICIPANTS RANKED PROMOTION OF MENTAL HEALTH AND PREVENTION OF SUBSTANCE ABUSE NUMBER ONE AND PREVENTION OF CHRONIC DISEASE RANKED NUMBER TWO. AFTER SELECTING THE PRIORITIES, SURVEY PARTICIPANTS WERE ASKED TO RANKED THEIR TOP FIVE FOCUS AREAS FROM ALL OF THE PREVENTION AGENDA PRIORITIES. BASED ON THE SURVEY RESULTS, THE FOLLOWING TOP SIX FOCUS AREAS ARE TIED TO THE TOP TWO SELECTED PRIORITIES FOR LITTLE FALLS HOSPITAL WERE APPROVED.PRIORITIES:1. PREVENT MENTAL HEALTH AND SUBSTANCE USE DISORDERS2. PROMOTE WELL BEING3. TOBACCO PREVENTION4. CHILD AND ADOLESCENT HEALTH5. PREVENTATIVE CARE MANAGEMENT6. INJURIES, VIOLENCE OCCUPATIONAL HEALTHCOORDINATED ACTION PLANS WERE DEVELOPED WITH USE OF COMMUNITY RESOURCES TO ADDRESS THE SIX IDENTIFIED AREAS FOR HEALTH IMPROVEMENT. LITTLE FALLS HOSPITAL IMPLEMENTED ACTION PLANS ADDRESSING PROMOTION OF WELL BEING, PREVENTATIVE CARE AND MANAGEMENT, AND INJURIES, VIOLENCE & OCCUPATIONAL HEALTH.EACH ACTION PLAN INCLUDES, GOALS AND INTERVENTIONS, PROCESS MEASURES, AND PARTNER ROLES AND RESOURCES. GOALS ARE MEASURED FROM THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT TO ADDRESS IDENITIFIED DISPARATE POPULATIONS. ALONG WITH HEALTH INDICATORS TO MEASURE PROGRESS TOWARD ACHIEVING THE GOALS, INCLUDING REDUCING HEALTH DISPARITIES FOR INDIVIDUALS WITH LOW SOCIO-ECONOMIC STATUS, DISABILITIES, RACIAL AND ETHNIC GROUPS, AS WELL AS OTHER POPULATIONS WHO EXPERIENCE THEM.MEASUREMENT FOR PRIOR TOPICS OF THE LITTLE FALLS HOSPITAL AND HERKIMER COUNTY PUBLIC HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT CONTINUES AS BEING A PART OF THE NEW SIX HEALTH PRIORITIES FOR 2019 2021. THESE CONTINUED ACTIVITIES ARE TO MEASURE PREVENTATIVE HEALTH SCREENINGS FOR BREAST AND CERVICAL CANCER, COLORECTAL TESTING SCREENINGS, AND BLOOD GLUCOSE MONITORING.THESE COORDINATED HEALTH INTERVENTIONS ARE ALSO SUPPORTED WITH EDUCATION WITH MEDICAL PROVIDERS TO SUPPORT THEIR ROLE IN IDENTIFYING PATIENTS REQUIRING SERVICES TO SUPPORT HEALTHIER LIFE STYLES. INCREASES IN USE OF MEDIA FOR POPULATION AWARENESS OF PROGRAMS WAS ALSO EXTENDED USING MORE ELECTRONIC MEDIA.DURING THE PERIOD OF 2016 - 2018 MANY OF THE HEALTH EDUCATION AND SCREENING ASSESSMENTS ACCOMPLISHED HIGHER RATES OF PARTICIAPTION. THESE INITIATIVES WILL CONTINUE TO SUPPORT OUR NEEDS ASSESSMENT FOR THE CURRENT PERIOD OF 2019 - 2021. PART VI, LINE 3: LITTLE FALLS HOSPITAL PROVIDES ACCESS AND EDUCATION ON THE COMMUNITY SERVICE PROGRAM WITH CONTACT INFORMATION FOR PATIENTS TO CALL AND MAKE APPOINTMENTS FOR COMPLETING APPLICATIONS FOR FINANCIAL ASSISTANCE. AT ALL PATIENT ACCESS LOCATIONS, APPLICATIONS FOR CHARITY CARE ASSISTANCE ARE AVAILABLE. THE WWW.BASSETT.ORG WEBSITE INCLUDES A LINK ON INFORMATION FOR COMPLETING AN APPLICATION AND OTHER RESOURCES CALLED "FINANCIAL ASSISTANCE RESOURCE GUIDE". OUR FINANCIAL ASSISTANCE COORDINATOR PROVIDES INSURANCE COVERAGE NAVIGATION SERVICES TO ASSIST RESIDENTS WITH ENROLLMENT IN GOVERNMENT SPONSORED HEALTH CARE COVERAGE PROGRAMS. A COMMUNITY NAVIGATOR IS ALSO PRESENT IN THE EMERGENCY DEPARTMENT TO ASSIST WITH APPLICATIONS FOR GOVERNMENT SPONSORED HEALTH CARE COVERAGE PROGRAMS OR TO COMPLETE APPLICATIONS FOR OUR FINANCIAL ASSISTANCE PROGRAM. OUR APPLICATION ALSO SPECIFIES ON-SITE PROVIDERS WHO DO NOT PARTICIPATE IN LITTLE FALLS HOSPITAL FINANCIAL ASSISTANCE PROGRAM. PART VI, LINE 4: LITTLE FALLS HOSPITAL SERVES AN ESTIMATED POPULATION OF OVER 62,000 PEOPLE IN 17 COMMUNITIES THROUGHOUT HERKIMER COUNTY, AND SECTIONS OF FULTON AND MONTGOMERY COUNTIES. THE SERVICE AREA POPULATION IS COMPRISED OF INDIVIDUALS AND FAMILIES FROM ALL SOCIO-ECONOMIC AND EDUCATIONAL LEVELS. THE POPULATION IS 96 PERCENT WHITE, 51 PERCENT FEMALE AND 49 PERCENT MALE. THE AGE DISTRIBUTION OF THE POPULATION IS SIMILAR TO OTHER UPSTATE NEW YORK AREAS WITH 5.4 PERCENT OF THE POPULATION UNDER 5 YEARS OF AGE, 24 PERCENT UNDER THE AGE OF 18, AND 22.2 PERCENT AGED 65 AND OLDER. NEARLY 89 PERCENT OF THE POPULATION OVER AGE OF 25 HAS GRADUATED FROM HIGH SCHOOL. MEDIAN HOUSEHOLD INCOME OF $54,794 IS BELOW THE STATE MEDIAN OF $71,855. IT'S ESTIMATED THAT 10 PERCENT OF THE POPULATION IS BELOW THE FEDERAL POVERTY LEVEL. APPROXIMATELY 93% OF RESIDENTS HAVE HEALTH COVERAGE, AN IMPROVEMENT OF 6% SINCE 2013. PART VI, LINE 5: LITTLE FALLS HOSPITAL IMPLEMENTS COORDINATED HEALTH CARE RESOURCES WITH BASSETT HEALTHCARE NETWORK. THIS COLLABORATION INCLUDED PLANNING AND IMPLEMENTING INITIATIVES UNDER A NEW YORK STATE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) PROJECT. DSRIP ACTIVITIES ARE COORDINATED WITH COMMUNITY BASED ORGANIZATIONS TO DEVELOP CARE IMPROVEMENT PROGRAMS IN A COORDINATED MANNER. THE HERKIMER COUNTY HUB WAS ORGANIZED SO COMMUNITY AGENCIES COULD DEVELOP INITIATIVES FOR IMPROVING COMMUNICATIONS FOR REFERRALS TO PROGRAMS FOR HIGH NEED PATIENTS. WITH THESE COMMUNITY AGENCIES ENGAGED A HIGHER DEGREE OF PATIENT INTERACTION IS POSSIBLE TO ACHIEVE POSITIVE IMPACTS ON IMPROVING THEIR HEALTH CARE. LITTLE FALLS HOSPITAL PARTNERED WITH SALVATION ARMY FOR THEIR ASSISTANCE IN PROVIDING PATIENT NAVIGATION SERVICES. THESE NAVIGATION SERVICES PROVIDE PATIENTS AND FAMILY SUPPORT FOR MEDICAL AND SOCIAL ASSISTANCE TO IMPROVE A HEALTHIER LIFESTYLE. PART VI, LINE 6: LITTLE FALLS HOSPITAL IS A SUBSIDIARY OF 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 FIVE 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.)THE MARY IMOGENE BASSETT HOSPITAL, AN ACUTE CARE INPATIENT TEACHING FACILITY IN COOPERSTOWN, NEW YORK. RELATED SERVICES IS A REGIONAL NETWORK CONSISTING OF 29 LOCATIONS FOR PRIMARY AND SPECIALTY CARE SERVICES, TWENTY SCHOOL BASED HEALTH CENTERS, AND TWO AMBULATORY SURGERY CENTERS.B.) O'CONNOR HOSPITAL, IS A CRITICAL ACCESS HOSPITAL IN DELHI, NEW YORK LOCATED IN DELAWARE COUNTY.C.) COBLESKILL REGIONAL HOSPITAL, IS A CRITICAL ACCESS HOSPITAL IN COBLESKILL, NEW YORK LOCATED IN SCHOHARIE COUNTY.D.) LITTLE FALLS HOSPITAL, IS A CRITICAL ACCESS HOSPITAL IN LITTLE FALLS, NEW YORK LOCATED IN HERKIMER COUNTY. LITTLE FALLS HOSPITAL INCLUDES FIVE RURAL HEALTH CLINICS AND ONE OUTPATIENT PRIMARY CARE CENTER.E.) TRI TOWN REGIONAL HOSPITAL A 24/7 EMERGENCY CARE FACILITY IN SIDNEY, DELAWARE COUNTY, OPERATING AS A DEPARTMENT OF AURELIA OSBORN FOX MEMORIAL HOSPITAL, AN ACUTE CARE FACILITY IN ONEONTA, OTSEGO COUNTY.F.) AURELIA OSBORN FOX HOSPITAL A SOLE COMMUNITY PROVIDER IN ONEONTA NEW YORK LOCATED IN OTSEGO COUNTY.G.) VALLEY HEALTH SERVICES A RESIDENTIAL HEALTH CARE AND REHABILITATION FACILITY LOCATED IN HERKIMER, NEW YORKOTHER COMPONENTS OF THE NETWORK, INCLUDES AT HOME CARE, A CERTIFIED HOME CARE AGENCY AND FIRST COMMUNITY CARE OF BASSETT, AND A MEDICAL SUPPLY COMPANY, ALL OF WHICH MAKE UP THE BASSETT HEALTHCARE NETWORK AND PROVIDE HEALTH SERVICES TO THIS NINE COUNTY REGION IN CENTRAL NEW YORK.LITTLE FALLS HOSPITAL COLLABORATES WITH BASSETT HEALTHCARE NETWORK AND BASSETT MEDICAL CENTER TO COORDNATE THE EFFICIENT DELIVERY OF HEALTHCARE IN OUR SERVICE AREA. THIS RELATIONSHIP HAS DEVELOPED OVER A PERIOD OF FIFTEEN YEARS AND CONTINUES TO PROVIDE RESIDENTS ACCESS TO A HIGH-QUALITY HEALTHCARE SYSTEM. OUR INTEGRATED ELECTRONIC HEALTH RECORD HAS ENABLED OUR PATIENTS TO RECEIVE IMPROVED COORDINATED CARE AND ACCESS TO THEIR HEALTH INFORMATION NOT ROUTINELY SEEN IN RURAL HEALTH NETWORKS. OUR COLLABORATIVE PLANNING ON PROJECTS SUCH AS THE NYS DELIVERY SYSTEM REFORM INCENTIVE PAYMENT SYSTEM (DSRIP) AND RELATED MOHAWK VALLEY POPULATION HEALTH IMPROVEMENT PROGRAM ARE EXAMPLES OF OUR COLLABORATION TO IMPROVE THE HEALTHCARE SYSTEMS IN OUR SERVICE AREA.LITTLE FALLS HOSPITAL AS A LEADER WITH BASSETT HEALTHCARE NETWORK IN COORDINATION OF PATIENT ADVOCATE GROUPS IS MAKING A DIFFERENCE FOR IMPROVING HEALTHCARE. THESE INITIATIVES WITHIN THE DSRIP PROGRAM CONTINUE TO IMPROVE IN PATIENT INTERACTIONS TO SUPPORT ACCESS TO CARE, AND PREVENTATIVE CARE PLANS. THIS IS A NEW AREA OF EMPHASIS WITH CARE INNOVATION MODELS WHICH CREATE LEARNING PARTNERSHIPS WITH PATIENTS AND PROVIDERS. PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORTNEW YORK X X X X 0 0 0 0 0 0 0 0 0 CARLTON RULE SENIOR VP MEDICAL STAFF 0 369965 0 10000 0 0 0 19804 0 6537 0 406306 0 0 LISA BETRUS TRUSTEE 0 280201 0 30295 0 0 0 12467 0 6347 0 329310 0 0 AMY GRACE PRESIDENT OF MEDICAL STAFF 0 230239 0 14418 0 0 0 12246 0 7995 0 264898 0 0 MICHAEL OGDEN PRESIDENT & CEO 0 209846 0 10716 0 0 0 10356 0 2376 0 233294 0 0 JAMES G VIELKIND CHIEF FINANCIAL OFFICER 0 210836 0 0 0 0 0 0 0 914 0 211750 0 0 HEIDI CAMARDELLO DIRECTOR OF NURSING 145518 0 0 0 0 0 2910 0 2862 0 151290 0 0 0 PART I, LINE 3 THE COMPENSATION PROCESS FOR TOP OFFICIAL THE CHIEF EXECUTIVE OFFICER'S SALARY IS PAID BY A RELATED ORGANIZATION UNDER A MANAGEMENT SERVICES AGREEMENT. THE LITTLE FALLS HOSPITAL BOARD OF TRUSTEES REVIEWS THE FORMAL PROCESS THAT IS USED TO DETERMINE THE BASE COMPENSATION OF THE CEO. THE CEO'S WORK PLAN AND ACCOMPLISHMENTS FOR THE YEAR ARE REVIEWED. SALARY CHANGES ARE BASED ON MARKET, WORKPLAN, AND ACCOMPLISHMENTS. THE CEO'S SALARY IS SUBMITTED AS PART OF THE MANAGEMENT SERVICES AGREEMENT WHICH IS APPROVED BY THE BOARD. 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, 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 7A SEE DISCLOSURE FOR PART VI, SECTION A, LINE 6 FORM 990, PART VI, SECTION A, LINE 7B SEE DISCLOSURE FOR PART VI, SECTION A, LINE 6 FORM 990, PART VI, SECTION B, LINE 11B LITTLE FALLS HOSPITAL PRESENTS THE DRAFT 990 TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS PRIOR TO FILING. ANY QUESTIONS ARE RAISED AND ONCE APPROVED, THE 990 CAN BE FILED. A COMPLETE COPY OF THE ORGANIZATION'S FINAL FORM 990, INCLUDING ALL REQUIRED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, IS PROVIDED TO EACH MEMBER OF THE BOARD BEFORE ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE MADE ANNUALLY. NEW BOARD MEMBERS ARE REQUIRED TO DISCLOSE ON THEIR RESUME ALL AFFILIATED ORGANIZATIONS. FORM 990, PART VI, SECTION B, LINE 15 THE CHIEF EXECUTIVE OFFICER'S SALARY IS PAID BY A RELATED ORGANIZATION UNDER A MANAGEMENT SERVICES AGREEMENT. THE LITTLE FALLS HOSPITAL BOARD OF TRUSTEES REVIEWS THE FORMAL PROCESS THAT IS USED TO DETERMINE THE BASE COMPENSATION OF THE CEO. THE CEO'S WORK PLAN AND ACCOMPLISHMENTS FOR THE YEAR ARE REVIEWED. SALARY CHANGES ARE BASED ON MARKET, WORKPLAN, AND ACCOMPLISHMENTS. THE CEO'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 LITTLE FALLS HOSPITAL MAKES AVAILABLE THE IRS FROM 990 UPON REQUEST ALONG WITH INFORMATION INCLUDED WITHIN THE 990 SUCH AS FINANCIAL REPORTS, CONFLICT OF INTEREST POLICY, AND CODE OF CONDUCT. THE HOSPITAL ALSO PROVIDES THE ANNUAL OPERATING PLAN AND CORPORATE VALUES IN PUBLIC AREAS OF THE FACILITY. FORM 990, PART XI, LINE 9: CHANGE IN PENSION BENEFIT OBLIGATION 49,322. OTHER CHANGES TO BEGINNING OF YEAR NET ASSETS -32,724. 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 O'CONNOR HOSPITAL 460 ANDES ROAD DELHI NY 13753 161540394 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 10 BHN 0 AT HOME CARE PARTNERS 25 ELM STREET ONEONTA NY 13820 562397098 HEALTHCARE NY 501C3 10 AHC INC 0 AT HOME CARE INC 25 ELM STREET ONEONTA NY 13820 161287069 HEALTHCARE NY 501C3 10 BHN 0 BASSETT HOSPITAL SCHOHARIE COUNTY 178 GRANDVIEW DRIVE COBLESKILL NY 12043 141772971 HEALTHCARE NY 501C3 3 BHN 0 AO FOX FOUNDATION 1 NORTON AVE ONEONTA NY 13820 222871993 FUNDRAISER NY 501C3 9 AO FOX MEMORIAL HOSPITAL 0 AO FOX MEMORIAL HOSPITAL ONE NORTON AVENUE ONEONTA NY 13820 150539039 HEALTHCARE NY 501C3 3 BHN 0 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 NY 14228 161504464 HEALTHCARE NY N/A 0 0 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 C 0 0 0 1 0 0 0 0 0 0 1 0 1 1 0 1 0 1 0 0