AURELIA OSBORN FOX MEMORIAL HOSPITAL: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- AURELIA OSBORN FOX MEMORIAL HOSPITAL (EIN 15-0539039)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-15
- IRS object ID
- 202143199349324249
- Schema version
- 2020v4.1
- 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 M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-15T17:20:20-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | 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 | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 150539039 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AURELIA OSBORN FOX MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AURE | BusinessNameControlTxt |
| Phone | 6074315900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 NORTON AVE | AddressLine1Txt |
| City | ONEONTA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13820 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHRISTOPHER GRAHAM | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 6074315900 | PhoneNum |
| Signature | 2021-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | CHRISTOPHER | PersonFirstNm |
| Person Last | GRAHAM | 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 |
| Preparation | 2021-11-15 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AO FOX MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHRISTOPHER GRAHAM | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 NORTON AVE | AddressLine1Txt |
| City | ONEONTA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13820 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $88,170,458 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AOFOXHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1900 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | HEALTH CARE DELIVERY: INCLUDES: UNCOMPENSATED CARE, PAYMENTS INTO BAD DEBT AND CHARITY CARE POOLS, NYS HEALTH FACILITIES ASSESSMENT, COMMUNITY EDUCATION, MATERNAL CARE PROGRAM, COST OF PROVIDING SERVICES TO GOVERNMENT PAYORS. HEALTH/WELLNESS AND EDUCATIONAL SERVICES TO THE GENERAL PUBLIC. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 945 | TotalEmployeeCnt |
| Total Volunteers | 83 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,591,542 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,847,865 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $78,078,716 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $75,543,780 | CYProgramServiceRevenueAmt |
| PY Investment Income | $236,577 | PYInvestmentIncomeAmt |
| CY Investment Income | $210,507 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,287,987 | PYOtherRevenueAmt |
| CY Other Revenue | $376,350 | CYOtherRevenueAmt |
| PY Total Revenue | $83,194,822 | PYTotalRevenueAmt |
| CY Total Revenue | $86,978,502 | 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 | $41,459,908 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $41,760,863 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $44,994,484 | PYOtherExpensesAmt |
| CY Other Expenses | $45,066,338 | CYOtherExpensesAmt |
| PY Total Expenses | $86,454,392 | PYTotalExpensesAmt |
| CY Total Expenses | $86,827,201 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$3,259,570 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $151,301 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $59,990,112 | TotalAssetsBOYAmt |
| Total Assets EOY | $58,781,143 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $27,720,154 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $25,015,265 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $32,269,958 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $33,765,878 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | HEALTH CARE DELIVERY: INCLUDES: UNCOMPENSATED CARE, PAYMENTS INTO BAD DEBT AND CHARITY CARE POOLS, NYS HEALTH FACILITIES ASSESSMENT, COMMUNITY EDUCATION, MATERNAL CARE PROGRAM, COST OF PROVIDING SERVICES TO GOVERNMENT PAYORS. HEALTH/WELLNESS AND EDUCATIONAL SERVICES TO THE GENERAL PUBLIC. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $68,211,854 | ExpenseAmt |
| Revenue | $63,800,932 | RevenueAmt |
| Desc | HEALTH CARE DELIVERY: INCLUDES: UNCOMPENSATED CARE, PAYMENTS INTO BAD DEBT AND CHARITY POOLS, NYS HEALTH FACILITIES ASSESSMENT, COMMUNITY EDUCATION, MATERNAL CARE PROGRAM, COST OF PROVIDING SERVICES TO GOVERNMENT PAYORS. HEALTH/WELLNESS AND EDUCATIONAL SERVICES TO THE GENERAL PUBLIC. IN 2020 THE HOSPITAL HAD 7,364 PATIENT DAYS 18,728 EMERGENCY ROOM VISITS AND 116,517 OUTPATIENT VISITS.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, AO FOX HOSPITAL INITIATED EMERGENCY MEASURES TO PREVENT AVOIDABLE TRANSMISSION OF THE ILLNESS, INCLUDING CANCELING NON URGENT ELECTIVE PROCEDURES AND CLINIC VISITS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $12,357,623 | ExpenseAmt |
| Revenue | $11,742,848 | RevenueAmt |
| Desc | NURSING HOME CARE - NURSING HOME FACILITY- SKILLED NURSING, HEALTH AND RESPITE CARE. IN 2020 THE NURSING HOME HAD 45,766 PATIENT DAYS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $80,569,477 | 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 | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 61 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 945 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | 0 | 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 | Yes (1) | 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 | CHRISTOPHER GRAHAM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6074315900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 NORTON AVENUE | AddressLine1Txt |
| City | ONEONTA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13820 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| DAVID DUGAN | |||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| CHRISTY COE | |||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS BRINDLEY | |||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| CHERYL ROBINSON | |||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| GENNARO FALCO MD | |||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| LORRAINE ZIMNIEWICZ | |||||||||
| CHAIRMAN | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| NOEL GOODSPEED | |||||||||
| TREASURER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JEFFREY LORD | |||||||||
| VICE CHAIRMAN | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| SCOTT MCLEAN | |||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| LUIGIA MONTANTI | |||||||||
| SECRETARY | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ERIC JERVIS | |||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN RYLAND | |||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| LYNN GLUECKERT | |||||||||
| DIRECTOR | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JEFF JOYNER | |||||||||
| PRESIDENT (UNTIL 12/2020) | 40.00 | 0.00 | $0 | $373,627 | $26,012 | Yes (X) | |||
| CHRISTOPHER GRAHAM | |||||||||
| CFO | 20.00 | 20.00 | $0 | $159,999 | $12,428 | Yes (X) | |||
| JOAN MACDONALD | |||||||||
| VP NURSING | 40.00 | 0.00 | $144,389 | $0 | $7,772 | Yes (X) | |||
| REGINALD KNIGHT | |||||||||
| VP MEDICAL AFFAIRS | 24.00 | 16.00 | $371,225 | $0 | $31,159 | Yes (X) | |||
| GARY SMITH | |||||||||
| VP OPERATIONS | 40.00 | 0.00 | $154,561 | $0 | $31,065 | Yes (X) | |||
| ERIC STEIN | |||||||||
| PRESIDENT (START 12/2020) | 20.00 | 20.00 | $0 | $227,201 | $26,664 | Yes (X) | |||
| KAREN MOWERS | |||||||||
| DIRECTOR NURSING SVCS | 40.00 | 0.00 | $154,315 | $0 | $29,406 | Yes (X) | |||
| JEFFREY EMHOFF | |||||||||
| DIRECTOR NURSING HOME | 40.00 | 0.00 | $140,244 | $0 | $27,211 | Yes (X) | |||
| MAIA DECKER | |||||||||
| DIRECTOR PHARMACY | 40.00 | 0.00 | $137,834 | $0 | $31,055 | Yes (X) | |||
| MARGARET WIKOFF | |||||||||
| MANAGER NURSING CARE | 40.00 | 0.00 | $121,488 | $0 | $22,178 | Yes (X) | |||
| ROBERT PAVELKA | |||||||||
| PHARMACIST | 40.00 | 0.00 | $119,277 | $0 | $14,603 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,343,333 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $760,827 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $259,553 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 20 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GATEWOOD NY EMERGENCY PHYSICIAN SERVICES | |||||
| 7082 COLL CTR DR | CHICAGO | NY | 60698 | EMERGENCY PHYSICIANS | $2,795,064 |
| STAT STAFF PROFESSIONALS INC | |||||
| 18 DIVISION ST SUITE 311 | SARATOGA SPRINGS | NY | 12866 | LOCUM EMPLOYEES | $929,691 |
| CHANGE HEALTHCARE LLC | |||||
| CHANGE HEALTHCARE TECHNOLOGIES LLC | ALPHARETTA | GA | 30005 | IT SERVICE CONTRACT | $145,319 |
| FUST CHARLES CHAMBERS LLP | |||||
| 5784 WIDEWATERS PARKWAY | SYRACUSE | NY | 13214 | AUDIT/ACCOUNTING | $118,339 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $591,903 | RelatedOrganizationsAmt |
| Government Grants | $9,368,787 | GovernmentGrantsAmt |
| All Other Contributions | $887,175 | AllOtherContributionsAmt |
| Noncash Contributions | $130,000 | NoncashContributionsAmt |
| Total Contributions | $10,847,865 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HOSPITAL | 621990 | $63,692,079 | $63,692,079 |
| NURSING HOME | 623990 | $11,742,808 | $11,742,808 |
| OTHER | 621400 | $108,893 | $108,893 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $75,543,780 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,419 | TotalRevenueColumnAmt |
| Exclusion | $7,419 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $832,127 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $455,777 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $376,350 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $376,350 | TotalRevenueColumnAmt |
| Exclusion | $376,350 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $795,387 | SecuritiesAmt |
| Other | $143,880 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $736,179 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $59,208 | SecuritiesAmt |
| Other | $143,880 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $203,088 | TotalRevenueColumnAmt |
| Exclusion | $203,088 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $86,978,502 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $75,543,780 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $586,857 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $740,170 | TotalAmt |
| Management And General | $740,170 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,668,126 | TotalAmt |
| Program Services | $27,614,469 | ProgramServicesAmt |
| Management And General | $3,053,657 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,757,212 | TotalAmt |
| Program Services | $1,584,009 | ProgramServicesAmt |
| Management And General | $173,203 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,385,005 | TotalAmt |
| Program Services | $5,753,467 | ProgramServicesAmt |
| Management And General | $631,538 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,210,350 | TotalAmt |
| Program Services | $1,992,483 | ProgramServicesAmt |
| Management And General | $217,867 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $572,066 | TotalAmt |
| Management And General | $572,066 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $227,306 | TotalAmt |
| Program Services | $227,306 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,625 | TotalAmt |
| Program Services | $87,625 | ProgramServicesAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,883 | TotalAmt |
| Program Services | $11,883 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,659,623 | TotalAmt |
| Program Services | $22,659,623 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,818 | TotalAmt |
| Management And General | $48,818 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,054,107 | TotalAmt |
| Program Services | $3,527,073 | ProgramServicesAmt |
| Management And General | $527,034 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,439,760 | TotalAmt |
| Program Services | $1,252,591 | ProgramServicesAmt |
| Management And General | $187,169 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,752 | TotalAmt |
| Program Services | $24,752 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,070 | TotalAmt |
| Program Services | $79,231 | ProgramServicesAmt |
| Management And General | $11,839 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,438,443 | TotalAmt |
| Program Services | $3,438,443 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,609,214 | TotalAmt |
| Program Services | $1,609,214 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $4,038,636 | $4,038,636 | $0 |
| OTHER EXPENSES | $3,334,336 | $3,334,336 | |
| BAD DEBT | $2,992,361 | $2,992,361 | $0 |
| CHARITY CARE | $341,975 | $341,975 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,363 | TotalAmt |
| Management And General | $94,363 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,827,201 | TotalAmt |
| Program Services | $80,569,477 | ProgramServicesAmt |
| Management And General | $6,257,724 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,506,730 | BOYAmt |
| EOY | $8,525,803 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,206,880 | BOYAmt |
| EOY | $2,182,635 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,945,684 | BOYAmt |
| EOY | $8,667,764 | 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 | $1,685,464 | BOYAmt |
| EOY | $1,268,845 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $546,842 | BOYAmt |
| EOY | $470,508 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $127,740,100 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $98,368,928 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,306,422 | BOYAmt |
| EOY | $29,371,172 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,169,067 | BOYAmt |
| EOY | $4,068,397 | 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 | $9,623,023 | BOYAmt |
| EOY | $4,226,019 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,990,112 | BOYAmt |
| EOY | $58,781,143 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,259,055 | BOYAmt |
| EOY | $12,837,142 | 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 | $603,885 | BOYAmt |
| EOY | $587,921 | 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 | $16,857,214 | BOYAmt |
| EOY | $11,590,202 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,720,154 | BOYAmt |
| EOY | $25,015,265 | 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 | $26,618,819 | BOYAmt |
| EOY | $27,730,964 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,651,139 | BOYAmt |
| EOY | $6,034,914 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,269,958 | BOYAmt |
| EOY | $33,765,878 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,990,112 | BOYAmt |
| EOY | $58,781,143 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $151,301 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $471,245 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $873,374 | 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 | $11,883 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $11,883 | 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 | A PERCENTAGE OF MEMBERSHIP DUES PAID TO HEALTHCARE ASSOCIATION OF NEW YORK STATE (20.44%), IROQUOIS HEALTHCARE ALLIANCE (59.00%) AND AMERICAN HOSPITAL ASSOCIATION (25.56%) ARE USED SPECIFICALLY FOR LOBBYING PURPOSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,481,701 | BeginningYearBalanceAmt |
| Contributions | $451,384 | ContributionsAmt |
| Investment Earnings Or Losses | $377,261 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $432,088 | OtherExpendituresAmt |
| End Year Balance | $6,878,258 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,930,166 | BeginningYearBalanceAmt |
| Contributions | $1,473,157 | ContributionsAmt |
| Investment Earnings Or Losses | $468,717 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,390,339 | OtherExpendituresAmt |
| End Year Balance | $6,481,701 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,141,540 | BeginningYearBalanceAmt |
| Contributions | $1,699,636 | ContributionsAmt |
| Investment Earnings Or Losses | -$11,630 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,899,380 | OtherExpendituresAmt |
| End Year Balance | $6,930,166 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,971,037 | BeginningYearBalanceAmt |
| Contributions | $1,021,527 | ContributionsAmt |
| Investment Earnings Or Losses | $357,468 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,208,492 | OtherExpendituresAmt |
| End Year Balance | $7,141,540 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,654,824 | BeginningYearBalanceAmt |
| Contributions | $3,186,220 | ContributionsAmt |
| Investment Earnings Or Losses | $226,472 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,096,479 | OtherExpendituresAmt |
| End Year Balance | $6,971,037 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.12260 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.52680 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.35060 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,504,269 | OtherCostOrOtherBasisAmt |
| Book Value | $4,504,269 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $55,811,620 | OtherCostOrOtherBasisAmt |
| Depreciation | $38,847,450 | DepreciationAmt |
| Book Value | $16,964,170 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $67,105,410 | OtherCostOrOtherBasisAmt |
| Depreciation | $59,521,478 | DepreciationAmt |
| Book Value | $7,583,932 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $318,801 | OtherCostOrOtherBasisAmt |
| Book Value | $318,801 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $29,371,172 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM RELATED PARTIES | $1,686,441 |
| ESTIMATED THIRD PARTY RECEIVABLE | $1,529,479 |
| OTHER ASSETS | $1,010,099 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,226,019 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED THIRD PARTY PAYABLES | $9,215,344 |
| ACCRUED PENSION LIBILITY | $2,374,858 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,590,202 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | PERMANENT ENDOWMENTS: THE INTENDED USE OF THE INCOME FROM THESE FUNDS IS TO SUPPORT OPERATIONS AND TO FUND THE ANNUAL PHYSICIANS LECTURES AND DINNERS. BOARD DESIGNATED OR QUASI ENDOWMENTS: THE INTENDED USE OF INCOME FROM THESE FUNDS IS TO SUPPORT OPERATIONS OR FOR FUTURE CAPITAL NEEDS. TERM ENDOWMENTS: THE INTENDED USE OF THESE FUNDS IS DETERMINED BY THE VARIOUS DONORS, AND TO PROVIDE FOR THE NEEDS OF NURSING HOME PATIENTS. |
| PART X, LINE 2: | FIN 48 FOOTNOTE AURELIA OSBORN FOX MEMORIAL 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. |
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 | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| 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) |
|---|---|---|
| Total Community Benefit Expns | $341,975 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $184,029 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $241,982 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00280 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,389,342 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,773,124 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,616,217 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09920 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $751,583 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $388,147 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $363,436 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00420 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,482,900 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,345,300 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,221,635 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10620 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,755 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,755 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,755 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,755 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,497,655 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,345,300 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,236,390 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10640 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Reimbursed By Medicare | $17,349,386 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $19,173,733 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,824,347 | 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 | 0 | WrittenDebtCollectionPolicyInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 AT HOME CARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | REGIONAL HOME HEALTH AGENCY | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.50000 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.00000 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.00000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | AURELIA OSBORN FOX MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 NORTON AVENUE | AddressLine1Txt |
| City | ONEONTA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13820 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AURELIA OSBORN FOX MEMORIAL 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 |
| 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 |
| Other Website URL | SEE SECTION C | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| 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 | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (1) | 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 |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| None Made | Yes (X) | NoneMadeInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| AURELIA OSBORN FOX MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5: AURELIA OSBORN FOX MEMORIAL HOSPITAL:THIS COMMUNITY HEALTH NEEDS ASSESSMENT HAS TAKEN INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD RANGE OF SECTORS AND INTERESTS OF THE COMMUNITY INCLUDING ORGANIZATIONS THAT REPRESENT THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS SERVED BY BASSETT MEDICAL CENTER. ALL ORGANIZATIONS PROVIDING INPUT INTO THIS ASSESSMENT, INCLUDING THE NAME AND TITLE OF THOSE INDIVIDUALS REPRESENTATIVE OF THE ORGANIZATION, IS PROVIDED BELOW. THIS INCLUDED INPUT FROM INDIVIDUALS WITH EXPERTISE IN PUBLIC HEALTH, SPECIFICALLY, HEIDI BOND, DIRECTOR OF THE OTSEGO COUNTY HEALTH DEPARTMENT.A) HEIDI BOND, DIRECTOR AT OTSEGO COUNTY HEALTH DEPARTMENTB) PATRICIA KNUTH, EXECUTIVE DIRECTOR AT THE ARC OTSEGOC) AMEEN ASWAD, EXECUTIVE DIRECTOR OF JAIL MINISTRY OF OTSEGO COUNTYD) TREENA HALSTEAD, BUILDING HEALTHY FAMILIES PROGRAM MANAGER AT OPPORTUNITIES FOR OTSEGOE) MARGARET AVRITT, ONEONTA COMMUNITY HEALTH CENTERF) TOM HOHENSEE, CREATING HEALTHY SCHOOLS AND COMMUNITIES SCHOOLCOORDINATOR BASSETT RESEARCH INSTITUTE AT BASSETT MEDICAL CENTERAURELIA OSBORN FOX MEMORIAL HOSPITAL 15-0539039G) SARAH BUTTICE, DIRECTOR OF EDUCATION/EMPLOYEE WELLNESS AT A.O. FOX HOSPITALH) CALI RIESE, PUBLIC EDUCATION & COMMUNITY OUTREACH SPECIALIST CANCER SERVICES PROGRAM OF THE CENTRAL REGION AT BASSETT HEALTHCARE NETWORKI) TAMIE MACDONALD, DIRECTOR AT OTSEGO COUNTY OFFICE FOR THE AGINGJ) CHERILYN LACY, COORDINATOR OF THE PUBLIC HEALTH PROGRAM AT HARTWICK COLLEGEK) VERA SOSNOWSKI, BOARD MEMBER AT THE TOWN OF MILFORDL) CHRISTY HOUCK, CATHOLIC CHARITIES DELAWARE, OTSEGO & SCHOHARIEM) LYNAE WYCKOFF, LIVING WELL PROGRAM MANAGER BASSETT RESEARCH INSTITUTE AT BASSETT MEDICAL CENTERN) DAN MASKIN, EXECUTIVE DIRECTOR AT OPPORTUNITIES FOR OTSEGOO) LUCINDA LEVENE, ENGAGEMENT MANAGER AT LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERSP) DEBRA MARCUS, EXECUTIVE DIRECTOR AT FAMILY PLANNING OF SOUTH CENTRAL NEW YORKQ) SUSAN MATT, DIRECTOR AT OTSEGO COUNTY COMMUNITY SERVICESR) DAVE RICHARDS, SUPERINTENDENT OF SCHOOLS AT UNATEGO CENTRAL SCHOOL DISTRICTS) ARLANA YOUNG, BOARD OF DIRECTORS MEMBER AT ONEONTA COMMUNITY HEALTH CENTERT) STEPHEN CLARK, ADMINISTRATIVE DIRECTOR BASSETT RESEARCH INSTITUTE AT BASSETT MEDICAL CENTERU) MATHEW JOHNSON, HEALTH EDUCATOR AT OTSEGO COUNTY HEALTH DEPARTMENTV) LAURA BRYANT, RABIES COORDINATOR AT OTSEGO COUNTY HEALTH DEPARTMENTW) KIM SCHLOSSER, ASSISTANT DIRECTOR AT OTSEGO COUNTY HEALTH DEPARTMENTX) MARION MANLIUS, BOARD MEMBER AT THE TOWN OF MILFORDY) MAUREEN BLANCHARD, CREATING HEALTHY SCHOOLS AND COMMUNITIES COMMUNITY COORDINATOR RESEARCH FOUNDATION AT SUNY COBLESKILLZ) MARION MOSSMAN, PROJECT DIRECTOR AT OTSEGO COUNTY SYSTEM OF CARE AA) JULIE SORENSEN, DIRECTOR AT THE NEW YORK CENTER OF AGRICULTURAL MEDICINE AND HEALTH/NORTHEAST CENTER FOR OCCUPATIONAL HEALTH AND SAFETYBB) ANNE GADOMSKI, ATTENDING PEDIATRIC PHYSICIAN AND DIRECTOR OF THE BASSETT RESEARCH INSTITUTE AT BASSETT MEDICAL CENTERCC) LYNN GLUECKERT, EXECUTIVE DIRECTOR AT CATHOLIC CHARITIES DELAWARE, OTSEGO & SCHOHARIEDD) TERESA SEARS, CLERK AT THE TOWN OF OTEGOEE) GARY FURMAN, SUPERINTENDENT OF SCHOOLS AT EDMESTON CENTRAL SCHOOL DISTRICTFF) JULIE DOSTAL, EXECUTIVE DIRECTOR AT LEATHERSTOCKING EDUCATION ON ALCOHOLISM/ADDICTIONS FOUNDATIONFOLLOWING A REVIEW OF DATA FROM BASSETT MEDICAL CENTER'S, A.O. FOX MEMORIAL HOSPITAL'S AND OTSEGO COUNTY HEALTH DEPARTMENT'S 2019 JOINT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND INPUT FROM KEY INFORMANTS, BASSETT MEDICAL CENTER, A.O. FOX MEMORIAL HOSPITAL AND OTSEGO COUNTY HEALTH DEPARTMENT WILL COLLABORATE ON THE NEW YORK STATE PREVENTION AGENDA PRIORITIES OF PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS' FOCUS AREA OF 'PREVENT MENTAL AND SUBSTANCE USE DISORDERS' WITH THE GOALS TO PREVENT OPIOID AND OTHER SUBSTANCE MISUSE AND DEATH, AND PREVENT CHRONIC DISEASES' FOCUS AREA OF 'TOBACCO PREVENTION' WITH THE GOAL TO PREVENT INITIATION OF TOBACCO USE. BASSETT MEDICAL CENTER, A.O. FOX MEMORIAL HOSPITAL, AND OTSEGO COUNTY HEALTH DEPARTMENT ENGAGED STAKEHOLDERS TO WORK WITH THEM ON THEIR 2013 AND 2016 PRIORITIES AND STAKEHOLDERS WERE ENGAGED FOR THE 2019 PRIORITIES. THESE STAKEHOLDERS, ALONG WITH INDIVIDUALS AND ORGANIZATIONS FOCUSED ON THE HEALTH OF THE COMMUNITY, HAD AN OPPORTUNITY TO INDICATE THEIR PRIORITIES DURING A COMMUNITY DATA PRESENTATION AND THOSE INDIVIDUALS UNABLE TO ATTEND HAD THE OPPORTUNITY TO COMPLETE A SURVEY INDICATING THEIR PRIORITIES.IN ORDER TO ADDRESS THE COMBINED FOCUS AREA OF 'PREVENT MENTAL AND SUBSTANCE USE DISORDERS' BASSETT MEDICAL CENTER, A.O. FOX MEMORIAL HOSPITAL, AND OTSEGO COUNTY HEALTH DEPARTMENT WILL INCREASE THE AVAILABILITY OF/ACCESS AND LINKAGES TO MEDICATION-ASSISTED TREATMENT (MAT) INCLUDING BUPRENORPHINE; PROMOTE AND ENCOURAGE PRESCRIBER EDUCATION AND FAMILIARITY WITH OPIOID PRESCRIBING GUIDELINES, AND LIMITS AS IMPOSED BY NEW YORK STATE STATUTES AND REGULATION; AND BUILD SUPPORT SYSTEMS TO CARE FOR OPIOID USERS WHO ARE AT RISK OF AN OVERDOSE.FOR 'TOBACCO PREVENTION' BASSETT MEDICAL CENTER, A.O. FOX MEMORIAL HOSPITAL, AND OTSEGO COUNTY HEALTH DEPARTMENT WILL USE MEDIA AND HEALTH COMMUNICATIONS TO HIGHLIGHT THE DANGERS OF TOBACCO/VAPING IN THE PEDIATRIC CLINICS, SCHOOL BASED HEALTH CENTERS AND COMMUNITY. BASSETT MEDICAL CENTER, A.O. FOX MEMORIAL HOSPITAL, AND OTSEGO COUNTY HEALTH DEPARTMENT WILL UTILIZE THE RECOMMENDED PROCESS MEASURES LISTED IN THE NEW YORK STATE PREVENTION AGENDA ACTION PLAN TO TRACK PROGRESS OF ALL PRIORITIES AND FOCUS AREAS. YEARLY PROGRESS TOWARDS THOSE MEASURES WILL BE DISSEMINATED TO THE NEW YORK STATE DEPARTMENT OF HEALTH AND WILL BE INCLUDED ON THE BASSETT HEALTHCARE NETWORKS AND OTSEGO COUNTY HEALTH DEPARTMENTS WEBSITE. |
| AURELIA OSBORN FOX MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6A: MARY IMOGENE BASSETT HOSPITAL |
| AURELIA OSBORN FOX MEMORIAL HOSPITAL | PART V, SECTION B, LINE 6B: OTSEGO COUNTY DEPARTMENT OF HEALTH |
| AURELIA OSBORN FOX MEMORIAL 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 IDENTIFICATION 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, 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 22% FROM 2019 TO 2020 WHILE OUTPATIENT CLINIC AND ER VISITS DECREASED 21% FROM 2019 TO 2020. |
| PART V, LINE 7A AND 10A | AURELIA OSBORN FOX MEMORIAL HOSPITAL:THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE MADE AVAILABLE ON THE HOSPITAL'S WEBSITE:HTTPS://WWW.BASSETT.ORG/LOCATIONS/AO-FOX-HOSPITAL |
| PART V, LINE 16A, 16B, AND 16C | AURELIA OSBORN FOX MEMORIAL 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 10 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - AURELIA OSBORN FOX MEMORIAL HOSPITAL | ||||
| 1 NORTON AVENUE | ONEONTA | NY | 13820 | NURSING HOME |
| 2 - CHILD AND ADOLESCENT HEALTHCARE | ||||
| 1 FOXCARE DRIVE SUITE 213 | ONEONTA | NY | 13820 | PEDIATRIC CLINIC |
| 3 - ONEONTA FAMILY PRACTICE | ||||
| 1 FOXCARE DRIVE SUITE 308 | ONEONTA | NY | 13820 | FAMILY MEDICINE CLINIC |
| 4 - FOXCARE WOMENS WELLNESS | ||||
| 1 FOXCARE DRIVE SUITE 303 | ONEONTA | NY | 13820 | OB/GYN CLINIC |
| 5 - SUSQUEHANNA FAMILY PRACTICE | ||||
| 1 FOXCARE DRIVE SUITE 103 | ONEONTA | NY | 13820 | FAMILY MEDICINE CLINIC |
| 6 - FOX INTERNAL MEDICINE | ||||
| 1 FOXCARE DRIVE SUITE 103 | ONEONTA | NY | 13820 | INTERNAL MEDICINE CLINIC |
| 7 - FOXCARE DENTAL | ||||
| 1 FOXCARE DRIVE SUITE 304 | ONEONTA | NY | 13820 | DENTAL CLINIC |
| 8 - SIDNEY PRIMARY CARE CLINIC | ||||
| 59 RIVER STREET | SIDNEY | NY | 13838 | FAMILY MEDICINE CLINIC |
| 9 - STAMFORD FAMILY PRACTICE | ||||
| 32-34 MAIN STREET | STAMFORD | NY | 12167 | FAMILY MEDICINE CLINIC |
| 10 - FOX TRI TOWN CAMPUS | ||||
| 43 PEARL STREET WEST | SIDNEY | NY | 13838 | OUTPATIENT SERVICES |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | COSTING METHODOLOGY EXPLANATIONTHE COST METHODOLOGY USED FOR TABLE 7 IS THE RATIO OF COST TO CHARGES FROM 12/31/2020 MEDICARE FORM 2552. |
| SCHEDULE H, PART I, LINE 6A | AURELIA OSBORN FOX MEMORIAL HOSPITAL'S COMPREHENSIVE THREE YEAR COMMUNITY SERVICE PLAN WAS SUMMARIZED IN AN ANNUAL COMMUNITY REPORT. PRINTED COPIES WERE AVAILABLE TO THE PUBLIC IN PATIENT WAITING ROOMS AND AT INFORMATION KIOSKS. THE REPORT IS ALSO POSTED ON THE BASSETT WEBSITE, WWW.BASSETT.ORG/LOCATIONS/AO-FOX-HOSPITAL. |
| SCHEDULE H, 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: | WE HELP PROMOTE THE HEALTH OF THE COMMUNITY THROUGH MAINTAINING AN ACTIVE OPEN MEDICAL STAFF, SUPPORTING THE ANCILLARY NEEDS OF THE LOCAL FREE CLINIC AND HOSTING A CHILD BIRTH FAIR. WE ALSO PROVIDE MEETING SPACE FOR LOCAL COMMUNITY ORGANIZATIONS AT NO CHARGE. OUR BOARD IS COMPRISED OF LOCAL COMMUNITY MEMBERS WHO ADVOCATE FOR THE HEALTH INTEREST OF THE COMMUNITY. |
| 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 $2,992,361. |
| PART III, LINE 4: | 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 REIMBURSED 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 STATEMENTS. RATHER IT IS TREATED AS A PRICE CONCESSION. THE BAD DEBT EXPENSE FOR 2020 WAS $2,992,361. |
| PART III, LINE 8: | WHEN MEDICARE PATIENTS PRESENT WE ARE AWARE THAT THERE IS A PREDETERMINED REIMBURSEMENT THAT IS BELOW OUR HOSPITAL'S COST. THE PORTION THAT WE ARE NOT REIMBURSED THEREFORE WOULD BE CONSIDERED A COMMUNITY BENEFIT. |
| PART III, LINE 9B: | IT IS A.O. FOX MEMORIAL HOSPITAL'S POLICY TO DELAY FINAL COLLECTION EFFORTS WHILE AN APPLICATION IS IN PROCESS UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. COLLECTION EFFORTS ARE NOT INITIATED UNTIL THE FINAL DETERMINATION OF ELIGIBILITY UNDER THE FINANCIAL ASSISTANCE POLICY. |
| PART VI, LINE 2: | NEEDS ASSESSMENTIN ADDITION TO PUBLIC AND AGENCY INPUT, A VARIETY OF DATA FROM THE NYS DEPARTMENT OF HEALTH, OTSEGO COUNTY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, OTSEGO CO. DEPARTMENT OF HEALTH COMMUNITY ASSESSMENT AND OTHER SOURCES WERE USED TO ASSESS PRIORITIES, INCLUDING: A) PERCENTAGE OF OTSEGO CO. ADULTS WHO VISITED A DENTIST IN THE PAST YEARSB) PREVALENCE OF TOOTH DECAY IN THIRD-GRADE CHILDRENC) PERCENTAGE OF ADULTS REPORTING BINGE DRINKINGD) HEAVY DRINKINGE) PERCENTAGE OF OVERWEIGHT ADULTS IN OTSEGO CO. BASED ON THE OUTCOMES OF THE FOCUS GROUPS AND STRATEGIC PLANNING SESSIONS PREVENTION AGENDA PRIORITIES THROUGHOUT THE COUNTY WERE IDENTIFIED. ACCESS TO QUALITY HEALTHCARE AND MENTAL HEALTH & SUBSTANCE ABUSE WERE IDENTIFIED AS THE TOP PRIORITIES. PHYSICAL ACTIVITY AND NUTRITION WAS RANKED THIRD.SUBSEQUENT STRATEGIC PLANNING SESSIONS RELATED TO THE TWO TOP PRIORITIES WERE HELD TO IDENTIFY SERVICE BARRIERS AND GAPS AS WELL AS BRAINSTORM FOR COLLABORATIVE EFFORTS TO ADDRESS THESE PRIORITIES. STRATEGIES FOR THE SELECTED PRIORITIES:1) ACCESS TO DENTAL HEALTH CAREA. AURELIA OSBORN FOX MEMORIAL HOSPITAL (A.O. FOX) WILL SUPPORT OTSEGO CO. DEPT. OF HEALTH EFFORTS TO RE-ESTABLISH THE OTSEGO CO. ORAL HEALTH COALITION AS A MECHANISM FOR BRINGING COMMUNITY PARTNERS TOGETHER ON ADVOCACY EFFORTS AIMED AT ATTRACTING MORE DENTISTS TO OUR RURAL AREA, AND FOR TRACKING PROGRESS IN IMPROVING ACCESS TO DENTAL SERVICESB. A.O. FOX WILL WORK TO EXPAND COMPREHENSIVE PREVENTIVE DENTAL HEALTH SERVICES TO ALL SCHOOL-BASED HEALTH CENTERS IN THE COUNTY AND TO PROVIDE SEALANT SERVICES TO NON-SBHC SCHOOLS. BASSETT WILL WORK WITH THE OTSEGO CO. DEPT. OF HEALTH AND RURAL HEALTH EDUCATION NETWORK OF DELAWARE, OTSEGO, MONTGOMERY (RHENDOMS) TO MAKE MORE SCHOOLS AWARE OF RHENDOMS SERVICES TO INCREASE PARTICIPATIONC. A.O. FOX WILL WORK WITH THE OTSEGO CO. DEPT. OF HEALTH AND A.O. FOX HOSPITAL TO EDUCATE PRIMARY CARE AND SBHC PROVIDERS ABOUT DENTAL PRACTICES AVAILABLE FOR REFERRAL. THE OTSEGO CO. DEPT. OF HEALTH WILL EDUCATE DENTAL PROVIDERS ABOUT MEDICAID REIMBURSEMENTSD. A.O. FOX WILL WORK WITH THE HEALTH DEPARTMENT AND OTHER COMMUNITY PARTNERS TO EDUCATE THE PUBLIC ABOUT DENTAL HEALTH IN FAIRS AND OTHER COMMUNITY EVENTS.2) MENTAL HEALTH AND SUBSTANCE ABUSEA. IN A NEW INITIATIVE, A.O. FOX WILL WORK WITH BASSETT MEDICAL CENTER AND LEATHERSTOCKING EDUCATION ON ALCOHOLISM/ADDICTIONS FOUNDATIONS, INC. (LEAF) TO PROVIDE CONTINUING MEDICAL EDUCATION TRAINING ON SUBSTANCE ABUSE SCREENING AND REFERRAL TO PRIMARY CARE PROVIDERS AND SURGEONS IN THE COUNTY.B. A.O. FOX WILL WORK WITH THE HEALTH DEPARTMENT AND LEAF TO COMPLETE AND DISTRIBUTE AN UPDATED LIST OF MENTAL HEALTH AND SUBSTANCE ABUSE RESOURCES TO PRIMARY CARE PROVIDERSC. A.O. FOX WILL COLLABORATE WITH LEAF AND THE HEALTH DEPARTMENT ON PUBLIC HEALTH CAMPAIGN ABOUT THE RISK FACTORS ASSOCIATED WITH BINGE DRINKING AND PRESCRIPTION DRUG ABUSE3) PHYSICAL ACTIVITY AND NUTRITIONA. A.O. FOX WILL CONTINUE TO COLLABORATE WITH THE HEALTH DEPARTMENT AND OTHER COMMUNITY PARTNERS ON EFFORTS TO PROVIDE EARLY EDUCATION ABOUT THE IMPORTANCE OF PHYSICAL ACTIVITY AND NUTRITION THROUGHOUT LIFE, INCLUDING DURING PREGNANCY AND TO PREVENT CHRONIC DISEASEB. A.O. FOX WILL WORK WITH THE HEALTH DEPARTMENT, SCHOOLS, AND OTHER COMMUNITY PARTNERS TO IMPROVE CONTINUITY OF CARE BETWEEN FAMILIES, SCHOOLS, AND PRIMARY CARE PROVIDERS FOR THE TREATMENT OF CHILDHOOD OBESITY OVERALL GOALS WILL BE TO INCREASE THE PERCENTAGE OF OTSEGO COUNTY ADULTS WHO HAVE SEEN A DENTIST IN THE PAST YEAR, WORK TOWARD A 2013 PREVENTION AGENDA OBJECTIVE OF 83%, REDUCING THE RATE OF ALCOHOL ABUSE IN OTSEGO COUNTY AND REDUCING THE RATE OF OBESITY IN OTSEGO COUNTY. |
| PART VI, LINE 3: | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEA MAJOR COMPONENT OF AURELIA OSBORN FOX MEMORIAL HOSPITAL'S COMMUNITY SERVICES PROGRAM IS TO ACTIVELY IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR CHARITY CARE. THE PROCESS BEGINS WITH AN ORGANIZATIONAL POLICY AND PROCEDURE THAT DEFINES THE PROGRAM AND SERVES AS AN EDUCATION TOOL FOR ALL BASSETT EMPLOYEES. THE POLICY IS UPDATED ANNUALLY, DISTRIBUTED TO KEY PERSONNEL AND POSTED IN THE ONLINE POLICY AND PROCEDURE MANUAL THAT IS ACCESSIBLE TO ALL EMPLOYEES. THE PROGRAM IS SUPPORTED BY A FOUR PAGE PLAIN LANGUAGE BROCHURE THAT INCLUDES AN APPLICATION. BROCHURES ARE PROMINENTLY DISPLAYED AND AVAILABLE AT ALL FACILITIES AND ALL CLINIC LOCATIONS. CLINICAL AND SUPPORT STAFF ARE MADE AWARE OF THE PROGRAM AND ABLE TO DIRECT PATIENTS TO SPECIALISTS WHO CAN ASSIST IN THE APPLICATION PROCESS.ALL PATIENTS WHO ARE REGISTERED AS SELF-PAY ARE PROVIDED A BROCHURE EITHER IN PERSON OR BY MAIL. PATIENTS WHO ARE IN THE HOSPITAL RECEIVE INFORMATION AS PART OF A PERSONAL VISIT GEARED TO HELP THE PATIENT NAVIGATE FINANCIAL ASSISTANCE INCLUDING, BUT NOT LIMITED TO, THE COMMUNITY SERVICES PROGRAM. GOVERNMENT PROGRAM OPPORTUNITIES ARE ALSO REFERENCED AND A DIRECTORY OF LOCAL SOCIAL SERVICES AGENCIES IS PROVIDED BASED ON THE PATIENT'S COUNTY OF RESIDENCE. REFERRAL TO AN ONSITE MEDICAID EXAMINER IS AVAILABLE.A LISTING OF ALL SELF-PAY ACCOUNTS IS PRODUCED AND REVIEWED DAILY TO INSURE THAT A COMMUNITY SERVICES BROCHURE HAS BEEN PROVIDED. THE SELF-PAY BILLING OFFICE IDENTIFIES PATIENTS DURING THE BILLING AND COLLECTIONS PROCESS THAT MAY REQUIRE ADDITIONAL HELP UNDERSTANDING THE PROGRAM.SELF-PAY ACCOUNTS FOR PATIENTS WHO HAVE BEEN APPROVED FOR COMMUNITY SERVICES WITHIN THE PRIOR 120 DAYS ARE AUTOMATICALLY INCLUDED WITH THE PRIOR APPROVAL. |
| PART VI, LINE 4: | COMMUNITY INFORMATIONAURELIA OSBORN FOX MEMORIAL 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. IN THE SEVEN COUNTY REGIONS, THE MEDIAN HOUSEHOLD INCOME RANGES BETWEEN $43,000 AND $48,000. 13-18 % OF THE COMMUNITY RESIDENTS HAVE INCOMES BELOW THE FEDERAL POVERTY GUIDELINES. THE FOLLOWING AREAS HAVE BEEN FEDERALLY DESIGNATED AS BEING MEDICALLY UNDERSERVED:A) HERKIMER COUNTYB) FULTON COUNTY, TOWN OF OPPENHEIMC) MONTGOMERY COUNTY, CITY OF AMSTERDAMD) OTSEGO COUNTY, NORTH OTSEGO SERVICE AREA, TOWN OF PLAINFIELD, TOWN OF DECATURE) DELAWARE COUNTY, TOWNS OF DEPOSIT, COLCHESTER, MIDDLETOWN |
| PART VI, LINE 6: | AURELIA OSBORN FOX MEMORIAL 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) BASSETT - AN ACUTE CARE INPATIENT TEACHING FACILITY, AN OUTPATIENT PRIMARY AND SPECIALTY CARE CENTER, A REGIONAL NETWORK OF 29 COMMUNITY BASED OUTPATIENT HEALTH CENTERS, 20 SCHOOL BASED HEALTH CENTERS, TWO AMBULATORY SURGERY CENTERS AND A FULLY SALARIED MEDICAL STAFF IN COOPERSTOWN, OTSEGO COUNTYB) O'CONNOR HOSPITAL - CRITICAL ACCESS HOSPITAL IN DELHI, DELAWARE COUNTYC) COBLESKILL REGIONAL HOSPITAL - ACUTE CARE FACILITY IN COBLESKILL, SCHOHARIE COUNTYD) LITTLE FALLS HOSPITAL - CRITICAL ACCESS HOSPITAL IN LITTLE FALLS, HERKIMER COUNTYE) FOX TRI-TOWN CAMPUS- 24/7 EMERGENCY CARE FACILITY IN SIDNEY, DELAWARE COUNTYF) A.O. FOX MEMORIAL HOSPITAL - ACUTE CARE FACILITY IN ONEONTA, OTSEGO COUNTYG) VALLEY HEALTH SERVICES - RESIDENTIAL HEALTH CARE AND REHABILITATION FACILITYH) AT HOME CARE - CERTIFIED HOME CARE AGENCYI) FIRST COMMUNITY CARE OF BASSETT - MEDICAL SUPPLY COMPANY ALL THE ABOVE (A-I) MAKE UP THE BASSETT HEALTHCARE NETWORK AND PROVIDE HEALTH SERVICES TO THIS 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) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| REGINALD KNIGHT | ||||||||||||||
| VP MEDICAL AFFAIRS | $371,225 | $0 | $0 | $0 | $0 | $0 | $14,250 | $0 | $16,909 | $0 | $402,384 | $0 | $0 | $0 |
| JEFF JOYNER | ||||||||||||||
| PRESIDENT (UNTIL 12/2020) | $0 | $373,627 | $0 | $0 | $0 | $0 | $0 | $26,012 | $0 | $0 | $0 | $399,639 | $0 | $0 |
| ERIC STEIN | ||||||||||||||
| PRESIDENT (START 12/2020) | $0 | $217,097 | $0 | $10,104 | $0 | $0 | $0 | $18,042 | $0 | $8,622 | $0 | $253,865 | $0 | $0 |
| GARY SMITH | ||||||||||||||
| VP OPERATIONS | $154,561 | $0 | $0 | $0 | $0 | $0 | $11,856 | $0 | $19,209 | $0 | $185,626 | $0 | $0 | $0 |
| KAREN MOWERS | ||||||||||||||
| DIRECTOR NURSING SVCS | $154,315 | $0 | $0 | $0 | $0 | $0 | $11,113 | $0 | $18,293 | $0 | $183,721 | $0 | $0 | $0 |
| CHRISTOPHER GRAHAM | ||||||||||||||
| CFO | $0 | $159,999 | $0 | $0 | $0 | $0 | $0 | $12,428 | $0 | $0 | $0 | $172,427 | $0 | $0 |
| MAIA DECKER | ||||||||||||||
| DIRECTOR PHARMACY | $137,834 | $0 | $0 | $0 | $0 | $0 | $10,664 | $0 | $20,391 | $0 | $168,889 | $0 | $0 | $0 |
| JEFFREY EMHOFF | ||||||||||||||
| DIRECTOR NURSING HOME | $140,244 | $0 | $0 | $0 | $0 | $0 | $7,251 | $0 | $19,960 | $0 | $167,455 | $0 | $0 | $0 |
| JOAN MACDONALD | ||||||||||||||
| VP NURSING | $144,389 | $0 | $0 | $0 | $0 | $0 | $7,204 | $0 | $568 | $0 | $152,161 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Real Estate Other RealEstateOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $130,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | BASSETT HEALTHCARE NETWORK IS THE SOLE MEMBER OF A.O. FOX MEMORIAL HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | BASSETT HEALTHCARE NETWORK IS THE PARENT AND SOLE MEMBER TO EACH OF THE FOLLOWING RELATED PARTIES: FRIENDS OF BASSETT, AURELIA OSBORN FOX MEMORIAL HOSPITAL, BASSETT HOSPITAL OF SCHOHARIE COUNTY, LITTLE FALLS HOSPITAL, O'CONNER HOSPITAL, TEMPLETON FOUNDATION, VALLEY HEALTH SERVICES, TRI-TOWN REGIONAL HOSPITAL, AND THE MARY IMOGENE BASSETT HOSPITAL. AS PARENT AND SOLE MEMBER, BASSETT HEATHCARE NETWORK HAS THE RIGHT TO APPONT AND REMOVE MEMBERS 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 7B | SEE DISCLOSURE FOR PART VI, SECTION A, LINE 6. |
| FORM 990, PART VI, SECTION B, LINE 11B | AURELIA OSBORN FOX MEMORIAL HOSPITAL PRESENTS THE DRAFT 990 TO THE FINANCE/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 AVAILABLE TO EACH MEMBER OF THE BOARD BEFORE ITS FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY HOSPITAL ADMINISTRATION AND IF NECESSARY ARE REFERRED TO THE BOARD EXECUTIVE COMMITTEE TO BE HANDLED APPROPRIATELY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD EXECUTIVE COMMITTEE DETERMINES COMPENSATION FOR THE CEO BASED ON THE, "SURVEY OF THE INDUSTRIES C0MPENSATION DATA" SUPPLIED BY HANYS. THE CEO TAKES RECOMMENDATIONS TO THE BOARD EXECUTIVE COMMITTEE BASED ON HANYS COMPENSATION SURVEY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTATION, CONFLICTS OF INTEREST POLICIES, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. SOME INFORMATION IS ALSO AVAILABLE THROUGH THE DEPARTMENT OF HEALTH. THE DOH REQUIRES THE INFORMATION FOR PUBLIC AVAILABILITY. |
| FORM 990, PART IX, LINE 11G | AGENCY: PROGRAM SERVICE EXPENSES 749,870. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 749,870. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 9,066,459. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,066,459. CONSULTING: PROGRAM SERVICE EXPENSES 338,370. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 338,370. NETWORK SHARED SVCS: PROGRAM SERVICE EXPENSES 12,257,079. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,257,079. TAXES: PROGRAM SERVICE EXPENSES 247,845. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 247,845. |
| FORM 990, PART XI, LINE 9: | CHANGE IN POST RETIREMENT VALUATION 411,961. OTHER CHANGES TO BEGINNING OF YEAR NET ASSETS 461,413. |
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 |
| O'CONNOR HOSPITAL | ||||||||||
| 460 ANDES ROAD | DELHI | NY | 13753 | 161540394 | 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 | 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 | Yes (1) |
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 | NY | 14228 | 161504464 | HEALTHCARE | 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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CATSKILL CARE ENTERPRISES | |||||||||||||
| 1 NORTON AVE | ONEONTA | NY | 13820 | 161236590 | RETAIL PHARMACY & FITNESS CENTER | NY | AO FOX | C | $299,480 | $503,726 | 1.00000 | Yes (1) | |
| LEATHERSTOCKING PHYSICIANS PC | |||||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 364864562 | HEALTHCARE SERVICES | NY | C | 0 | N/A | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | 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 | Yes (1) | 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 | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CATSKILL CARE ENTERPRISES | ||
| J | $360,481 | FMV |
| CATSKILL CARE ENTERPRISES | ||
| P | $258,715 | FMV |
| CATSKILL CARE ENTERPRISES | ||
| Q | $93,096 | FMV |
| CATSKILL CARE ENTERPRISES | ||
| D | $50,000 | FMV |
| AO FOX FOUNDATION | ||
| C | $220,735 | FMV |