OCONNOR HOSPITAL: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- OCONNOR HOSPITAL (EIN 16-1540394)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-13
- IRS object ID
- 202013189349307876
- Schema version
- 2019v5.1
- 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 O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-13T13:07:37-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
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 | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161540394 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | O'Connor Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % O'CONNOR HOSPITAL | InCareOfNm |
| Business Name Control | OCON | BusinessNameControlTxt |
| Phone | 6077460326 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 460 Andes Road | AddressLine1Txt |
| City | Delhi | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13753 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SCOTT J BONDEROFF | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6077460326 | PhoneNum |
| Signature | 2020-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TODD P TERESCO | PreparerPersonNm |
| PTIN | P00247720 | PTIN |
| Phone | 5184274600 | PhoneNum |
| Preparation | 2020-11-11 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 199.207.253.96 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 14012520203185000009 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2020-11-13 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 5313285F0E1D25F59368B523AF2DDFEB3B5C8477 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | EC4CAE4DABBF2D41825E3CF88D329D8D98EEF318 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Scott Bonderoff | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 460 Andes Road | AddressLine1Txt |
| City | Delhi | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13753 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $23,206,826 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | bassett.org/locations/oconnor-hospital | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | O'Connor Hospital is a 23 bed critical access hospital which serves the community in need of medical services without regard to their ability to pay for such services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 207 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $2,202,611 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$968,903 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $494,617 | PYContributionsGrantsAmt |
| CY Contributions Grants | $640,162 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $21,196,479 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,862,423 | CYProgramServiceRevenueAmt |
| PY Investment Income | $183,329 | PYInvestmentIncomeAmt |
| CY Investment Income | $330,430 | CYInvestmentIncomeAmt |
| PY Other Revenue | $328,011 | PYOtherRevenueAmt |
| CY Other Revenue | $332,158 | CYOtherRevenueAmt |
| PY Total Revenue | $22,202,436 | PYTotalRevenueAmt |
| CY Total Revenue | $23,165,173 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,214,583 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,320,295 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $93,588 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,273,305 | PYOtherExpensesAmt |
| CY Other Expenses | $12,744,468 | CYOtherExpensesAmt |
| PY Total Expenses | $21,487,888 | PYTotalExpensesAmt |
| CY Total Expenses | $23,064,763 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $714,548 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $100,410 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $29,230,749 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,607,734 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,655,453 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,618,210 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $26,575,296 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $26,989,524 | NetAssetsOrFundBalancesEOYAmt |
| Mission | O'connor Hospital is a 23 bed critical access hospital which serves the community in need of medical services without regard to their ability to pay for such services | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $17,038,241 | ExpenseAmt |
| Revenue | $21,862,423 | RevenueAmt |
| Desc | Inpatient and Outpatient services provided to our patients resulted in: Hospitalizations: 429 Patient Days: 2,118 Clinic Visits: 14,042 Procedures: 695 | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $96,903 | ExpenseAmt |
| Desc | Community involvement has been linked to O'Connor hospital's mission and values since it first opened. We are working with our community to improve the quality of life for the people of our region. Our community services programs provide free services to persons who cannot afford to pay, who do not qualify for medicaid, and who fall within the established income guidelines. In 2019, we provided $96,603 in free care. Our doors are open 24 hours a day, 7 days a week, 365 days a year. We are proud to provide this care to our communities. Not only did we provide $96,603 in charity care, $682,768 in patient accounts were recorded as bad debt in 2019. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $17,135,144 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 33 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 207 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | O'CONNOR HOSPITAL | PersonNm |
| Phone | 6077460326 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 460 ANDES ROAD | AddressLine1Txt |
| City | DELHI | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13753 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| James Peters | ||||||||
| Trustee | 1.0 | 40.0 | Yes (X) | $0 | $637,101 | $33,597 | ||
| Scott Bonderoff | ||||||||
| President | 24.0 | 16.0 | $0 | $245,982 | $15,329 | Yes (X) | ||
| Erin E Kingsbury | ||||||||
| Pharmacist | 40.0 | 0.0 | $158,172 | $0 | $13,595 | Yes (X) | ||
| Michael Viafore | ||||||||
| Radiology | 40.0 | 0.0 | $131,103 | $0 | $6,443 | Yes (X) | ||
| Andrea Barcomb | ||||||||
| Pharmacist | 40.0 | 0.0 | $128,068 | $0 | $5,876 | Yes (X) | ||
| Debra J Neale | ||||||||
| Chief Nursing Officer | 40.0 | 0.0 | $124,145 | $0 | $9,606 | Yes (X) | ||
| Connie Finkle | ||||||||
| Nurse Manager | 40.0 | 0.0 | $117,710 | $0 | $7,111 | Yes (X) | ||
| Sue E Andrews | ||||||||
| Treasurer | 5.0 | 55.0 | Yes (X) | $0 | $84,907 | $4,894 | Yes (X) | |
| Bruce McKeegan | ||||||||
| Vice Chairman | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Connie Pellegrino | ||||||||
| Secretary | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Peter Hamilton | ||||||||
| Chairman | 1.0 | 3.5 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Charlotte Hill | ||||||||
| Trustee | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Dennis N Marsh | ||||||||
| Trustee (until 5/19) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Donald Harris PHD | ||||||||
| Trustee | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| John Jack Lynch | ||||||||
| Trustee | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Michelle DeFreece | ||||||||
| Trustee | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Pamela Vogt | ||||||||
| Trustee | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Polly DellaCrosse | ||||||||
| Trustee | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $659,198 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $967,990 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $96,451 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Alliance Healcare Service | |||||
| 1900 S State College Blvd Suite 60 | Anaheim | CA | 92806 | PET / CT Services | $243,000 |
| Mayo Medical Laboratories | |||||
| 200 First Street SW | Rochester | MN | 55903 | Lab Services | $149,645 |
| Medefis | |||||
| PO Box 5068 | New York | NY | 10087 | Agency | $309,289 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $106,068 | RelatedOrganizationsAmt |
| Government Grants | $392,463 | GovernmentGrantsAmt |
| All Other Contributions | $141,631 | AllOtherContributionsAmt |
| Total Contributions | $640,162 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Direct patient services | 621990 | $17,764,486 | $17,764,486 | |
| Other program service revenue | 621990 | $1,895,326 | $1,895,326 | |
| Outpatient pharmacy | 446110 | $2,202,611 | $2,202,611 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,862,423 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $325,480 | TotalRevenueColumnAmt |
| Exclusion | $325,480 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $332,158 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $332,158 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $332,158 | TotalRevenueColumnAmt |
| Exclusion | $332,158 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $46,603 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $41,653 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $4,950 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,950 | TotalRevenueColumnAmt |
| Exclusion | $4,950 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,165,173 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,659,812 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,202,611 | UnrelatedBusinessRevenueAmt |
| Exclusion | $662,588 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,945,140 | TotalAmt |
| Program Services | $5,848,650 | ProgramServicesAmt |
| Management And General | $2,061,372 | ManagementAndGeneralAmt |
| Fundraising | $35,118 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $321,155 | TotalAmt |
| Program Services | $234,011 | ProgramServicesAmt |
| Management And General | $82,477 | ManagementAndGeneralAmt |
| Fundraising | $4,667 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,503,339 | TotalAmt |
| Program Services | $1,105,747 | ProgramServicesAmt |
| Management And General | $391,770 | ManagementAndGeneralAmt |
| Fundraising | $5,822 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $550,661 | TotalAmt |
| Program Services | $405,420 | ProgramServicesAmt |
| Management And General | $142,890 | ManagementAndGeneralAmt |
| Fundraising | $2,351 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,928,952 | TotalAmt |
| Program Services | $1,095,464 | ProgramServicesAmt |
| Management And General | $1,798,488 | ManagementAndGeneralAmt |
| Fundraising | $35,000 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,725 | TotalAmt |
| Management And General | $6,725 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $920,225 | TotalAmt |
| Program Services | $680,414 | ProgramServicesAmt |
| Management And General | $239,811 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $251,641 | TotalAmt |
| Program Services | $184,154 | ProgramServicesAmt |
| Management And General | $64,904 | ManagementAndGeneralAmt |
| Fundraising | $2,583 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,791 | TotalAmt |
| Program Services | $49,127 | ProgramServicesAmt |
| Management And General | $17,315 | ManagementAndGeneralAmt |
| Fundraising | $1,349 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $335,543 | TotalAmt |
| Program Services | $248,100 | ProgramServicesAmt |
| Management And General | $87,443 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,220 | TotalAmt |
| Program Services | $48,179 | ProgramServicesAmt |
| Management And General | $16,981 | ManagementAndGeneralAmt |
| Fundraising | $60 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,526 | TotalAmt |
| Program Services | $24,789 | ProgramServicesAmt |
| Management And General | $8,737 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,252,725 | TotalAmt |
| Program Services | $926,243 | ProgramServicesAmt |
| Management And General | $326,453 | ManagementAndGeneralAmt |
| Fundraising | $29 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,710 | TotalAmt |
| Program Services | $55,241 | ProgramServicesAmt |
| Management And General | $19,469 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Drugs and reagents | $3,227,520 | $3,227,520 |
| Bad debt | $682,768 | $682,768 |
| Patient care supplies | $540,510 | $540,510 |
| Charity care | $96,603 | $96,603 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,260,009 | TotalAmt |
| Program Services | $1,682,204 | ProgramServicesAmt |
| Management And General | $571,196 | ManagementAndGeneralAmt |
| Fundraising | $6,609 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,064,763 | TotalAmt |
| Program Services | $17,135,144 | ProgramServicesAmt |
| Management And General | $5,836,031 | ManagementAndGeneralAmt |
| Fundraising | $93,588 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,178 | BOYAmt |
| EOY | $18,023 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,180,319 | BOYAmt |
| EOY | $3,115,713 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $422,993 | BOYAmt |
| EOY | $775,237 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,509,659 | BOYAmt |
| EOY | $2,762,407 | 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 | $620,464 | BOYAmt |
| EOY | $571,167 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,079 | BOYAmt |
| EOY | $86,597 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $26,326,677 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $17,003,782 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,000,655 | BOYAmt |
| EOY | $9,322,895 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,303,322 | BOYAmt |
| EOY | $12,871,824 | 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 | $81,080 | BOYAmt |
| EOY | $83,871 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,230,749 | BOYAmt |
| EOY | $29,607,734 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,163,031 | BOYAmt |
| EOY | $1,207,384 | 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 | $1,151,959 | BOYAmt |
| EOY | $903,030 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $340,463 | BOYAmt |
| EOY | $507,796 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,655,453 | BOYAmt |
| EOY | $2,618,210 | 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 | $26,159,774 | BOYAmt |
| EOY | $26,619,904 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $415,522 | BOYAmt |
| EOY | $369,620 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,575,296 | BOYAmt |
| EOY | $26,989,524 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,230,749 | BOYAmt |
| EOY | $29,607,734 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $100,410 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $316,609 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$2,791 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $6,725 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $6,725 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | American Hospital Association membership dues allocate 22.32% towards lobbying activities. Total dues paid in 2019 = $12,469. HANY's membership dues allocate 17.97% towards general lobbying activities. Total dues paid in 2019 = $4,584. Iroquois Healthcare Alliance membership dues allocate 39.7% towards general lobbying activities. Total dues paid in 2019 = $7,540. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $989,771 | OtherCostOrOtherBasisAmt |
| Book Value | $989,771 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,938,250 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,250,826 | DepreciationAmt |
| Book Value | $6,687,424 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,168,995 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,752,956 | DepreciationAmt |
| Book Value | $1,416,039 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $229,661 | OtherCostOrOtherBasisAmt |
| Book Value | $229,661 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,322,895 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
| Total Liability | $0 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $22,699,620 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $316,609 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$782,162 | OtherRevenueAmt |
| Revenue Not Reported | -$465,553 | RevenueNotReportedAmt |
| Revenue Subtotal | $23,165,173 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $23,165,173 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $22,285,392 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $22,285,392 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $779,371 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $779,371 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $23,064,763 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART X | FIN 48 FOOTNOTE The Hospital is a not-for-profit corporation as described in Section 501 (c)(3) of the Internal Revenue Code (the Code) and is exempt from federal income taxes pursuant to Section 501(a) of the Code. The Hospital 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 as of December 31, 2019 and 2018. |
| SCHEDULE D, PART XI, LINE 2D | BAD DEBT $(682,768) CHARITY CARE $ (96,603) UNDISTRIBUTED INTEREST IN FRIENDS OF BASSETT $ (2,791) --------------- TOTAL $(782,162) |
| SCHEDULE D, PART XII, LINE 4B | BAD DEBT $ 682,768 CHARITY CARE $ 96,603 --------------- TOTAL $ 779,371 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 38 | PersonsServedCnt |
| Total Community Benefit Expns | $104,737 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30,805 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $73,931 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00330 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,097,559 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,776,574 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $320,985 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01440 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $251,423 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $140,401 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $111,022 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 38 | PersonsServedCnt |
| Total Community Benefit Expns | $2,453,719 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,947,780 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $505,938 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02270 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $76,552 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $76,552 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00340 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $4,448,256 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,075,049 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $373,208 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01680 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $194,694 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $194,694 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00930 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $26,418 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $26,335 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $4,745,920 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,075,049 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $670,789 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03070 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Persons Served | 38 | PersonsServedCnt |
| Total Community Benefit Expns | $7,199,639 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,022,829 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,176,727 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05340 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Reimbursed By Medicare | $7,000,164 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,930,855 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $69,309 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | O'CONNOR HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 460 ANDES ROAD | AddressLine1Txt |
| City | DELHI | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13753 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | bassett.org/locations/oconnor-hospital | WebsiteAddressTxt |
| State License | 1254700C | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | OUTPATIENT PRIMARY & SPECIALITY | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | O'CONNOR HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| Other | Yes (X) | OtherInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SECTION C | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SECTION C | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 0. | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | false | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | 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 (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE SECTION C | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE SECTION C | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE SECTION C | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, LINE 3J, FACILITY 1, OCONNOR HOSPITAL | Continuing prior CHNA work on preventing chronic diseases, promoting mental health, and preventing substance abuse. |
| SCHEDULE H, PART V, LINE 5, FACILITY 1, OCONNOR HOSPITAL | Representatives from Delaware County Public Health, OConnor Hospital, Delaware Valley Hospital, Margaretville Hospital, and the Southern Tier Population Health Improvement Program (PHIP) met in fall of 2018 to begin discussing the next full Delaware County Community Health Assessment, Community Health Improvement Plan, and the hospital Community Service Plans, and set up a monthly meeting schedule to continue until submission of the full document in December 2019. A review and update of data in the Community Health Assessment was completed in July 2019, using county, regional and New York state secondary data sources including BRFSS, Census data, and local data sources including the Delaware County Public Health Annual Report, the Delaware County Office for Agings Annual Assessment and Report the Delaware County Community Services Annual Assessment and Plan. As a method to collect primary data from the county at large, two surveys were developed: the first was sent electronically to Delaware County health and human services providers to gain their perspectives on the Prevention Agenda Priority Areas and the associated focus areas most in need of improvement. The second survey was sent electronically to community members to identify primary strengths and weaknesses of service provision, social determinants of health in need of addressing, and general quality of health and life in the county. Preliminary findings allowed the group to: 1) understand which data sources and information would be most useful, 2) determine community partners, organizations, and other existing assessments to include in the process, 3) explore best practice activities and interventions to include in the Community Service Plan. In May of 2019, the PHIP Population Health Coordinators worked with the Delaware County committee to hold a community roundtable event at the State University of New York (SUNY) Delhi, located in Delhi NY, Delaware County. All Health and Human Services providers that received the survey were invited, as well as the community residents who provided their names and contact information electronically via the survey. The event was also promoted via email and social media communications. Hospital and Public Health representatives shared the invitation with their Boards of Directors. The roundtable event was attended by 40 people, and included a presentation on the survey data by the PHIP Coordinators. In addition, Delaware Countys Director of Public Health and the Director of Operational Support from OConnor Hospital (located in Delhi and affiliated with the Bassett Healthcare system) presented on the NY State and Federal requirements for completion of the Community Health Assessment, Community Health Improvement Plan, and the hospitals Community Service Plans. The roundtable event included breakout groups for the chosen Prevention Agenda priority areas to give attendees further opportunity to provide input on the interventions and activities to place in the next 3-year cycle. OConnor Hospital involved its Senior Operations Team (OPS) and three members of the hospital Board of Trustees in the assessment and selection of its health priorities. On May 30th, three board members and two OPS members participated in the Delaware County Health Assessment Roundtable and discussion, described above. Following the roundtable, the three board members and the OPS team met to discuss the hospitals operational strategies and available resources for addressing health priorities in Delaware County. |
| SCHEDULE H, PART V, LINE 6A AND 6B, FACILITY 1, OCONNOR HOSPITAL | Hospital Facilities UHS Delaware Valley Hospital and Margaretville Memorial Hospital Other Organizations Delaware County Public Health |
| SCHEDULE H, PART V, LINE 7a AND 10a, FACILITY 1, OCONNOR HOSPITAL | The Hospital's Community Health Needs Assessment and Implementation Strategy are made avaialble on the Hospital's website: www.bassett.org/locations/oconnor-hospital |
| SCHEDULE H, PART V, LINE 11, FACILITY 1, O'CONNOR HOSPITAL | The organization addressed significant, prioritized health needs identified in its most recently conducted CHNA by adoption of a budget for provision of services that address the needs identified in the CHNA, prioritization of health needs in its community, and prioritization of services that the hospital facility will undertake to meet health needs in its community. For needs not addressed as a collaborative, we address some as an individual organization, and also continue to reprioritize highest demand of needs. |
| SCHEDULE H, PART V, LINE 16A, 16B, & 16C, FACILITY 1, O'CONNOR HOSPITAL | The Hospital's Financial Assistance Policy, application, and plain language summary are made avaialble on the Hospital's website: https://www.bassett.org/patients-visitors/billing-insurance/financial-assi stance |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 3C | OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE THE CSP (community services program) application specifies family income limits and other requirements for services to be eligible for O'Connor Hospital's CSP/free care program. |
| SCHEDULE H, PART I, LINE 6A | RELATED ORGANIZATION INFORMATION O'Connor Hospital's comprehensive Community Service Plan is summarized in an annual report and posted on the O'Connor Hospital website, www.bassett.org/locations/oconnor-hospital. Printed copies are available to the public upon request. |
| SCHEDULE H, PART I, LINE 7, COLUMN (F) | EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE The percent of total expense in Part 1, Line 7, column (f) is calculated by dividing column (e), net community benefit expense, by total expense. The bad debt expense of $682,768 was subtracted from the total expense value used to calculate the percentages in Part 1, Line 7, Column f. |
| SCHEDULE H, PART I, LINE 7 | COSTING METHODOLOGY EXPLANATION Worksheet 2 was used to develop a cost-to-charge ratio. It was used for patient care services. For non- patient care services, charges were reduced to cost for those services to non-patients where a mark-up is readily identifiable. |
| SCHEDULE H, PART II | COMMUNITY BUILDING ACTIVITIES All O'Connor Community Building Activities are included in Part I and described above. |
| SCHEDULE H, PART III, LINE 2 | BAD DEBT EXPENSE DUE TO THE ADOPTION OF ASU NO. 2014-09 REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENT. RATHER IT IS TREATED AS A PRICE CONCESSION. |
| SCHEDULE H, PART III, LINE 4 | FOOTNOTE 1(j) from the Audited Financial Statements Charity Care: The Hospitals general policy statement on charity care requires that medical care be rendered to all persons in need of such care regardless of their ability to pay. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, and therefore historical evidence demonstrates no payments are made by such patients, the Hospital does not report these services as revenue. The Hospital maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services furnished under its charity care policy. |
| SCHEDULE H, PART III, LINE 8 | MEDICARE EXPLANATION O'Connor is a critical access hospital, so cost is calculated on the settlement sheets of the cost report. It was compared to Medicare reimbursement, which is also calculated on the cost report. |
| SCHEDULE H, PART III, LINE 9B | COLLECTION PRACTICES EXPLANATION For patients or guarantors who do not qualify for financial assistance, O'Connor Hospital must undertake to ensure an adequate understanding on the part of the patients and those responsible for their care of their financial obligations to OConnor Hospital. OConnor Hospital will, in compliance with all existing laws and regulations, take the necessary steps to recover self-pay accounts receivable as well preserve the patient-provider relationship and keep the necessity of referring accounts to third party bad debt collection agencies or law firms to a minimum. It is expected that any third party collection agency or law firm retained by O'connor Hospital will refrain from any conduct that violates the Fair Debt Collection Practices Act, as well as any applicable state law or regulations. The arrest or body attachment of a judgement debtor on contempt proceedings, or foreclosure of a judgement debtor's principal residence will never be considered appropriate pursuit of an open balance in the name of OConnor Hospital. |
| SCHEDULE H, PART VI, LINE 2 | NEEDS ASSESSMENT Following the public participation and input period the health priorities were chosen based upon the application of the following six criteria: 1. The priority area was identified in the primary information sources. 2. The priority area was consistent with the current NYS Department of Health Prevention Agenda Areas; 3. The priority area was supported by data showing health status indicators or health needs were either below the averages for New York State, contiguous counties, or averages for upstate New York 4. The priority area was identified/ recommended during the public input process. 5. The availability of resources for the hospital to commit to the priority 6. Opportunity for development of collaborative interventions by OConnor Hospital, Delaware County Public Health Department and its other community work group partners was also considered. OConnor Hospital has selected two health priorities which are also addressed in the Community Health Needs Assessment (CHNA) Implementation Strategy 2013 and 2016 reports: a. Prevent Chronic Diseases b. Promote Well-Being and Prevent Mental and Substance Use Disorders Both of these Community Service Plan priorities are from the New York State Prevention Agenda 2019-2024. |
| SCHEDULE H, PART VI, LINE 3 | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE A major component of the O'Connor Hospital Community Services program is to actively identify patients who may be eligible for charity care. The process begins with an organizational policy and procedure that defines the program and serves as an education tool for all O'Connor employees. The policy is updated annually, distributed to key personnel and is accessible to all employees. The program is supported by a four page plain language brochure that includes an application. Brochures are prominently displayed and available. Clinical and support staff are made aware of the program and able to direct patients to specialists who can assist in the application process. All patients who are registered as self-pay are provided a brochure either in person or by mail. Patients who are in the hospital receive information as part of a personal visit geared to help the patient navigate financial assistance including, but not limited to, the Community Services Program. Government program opportunities are also referenced and a directory of local social services agencies is provided based on the patient's county of residence. Patient referral to the Delaware County Medicaid Examiner is facilitated by the Finance Director at the O'Connor Hospital. A listing of all self-pay accounts is produced and reviewed daily to 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. |
| SCHEDULE H, PART VI, LINE 4 | COMMUNITY INFORMATION According to the 2017 United States census estimate, Delaware County, New York, has a population of 45,001 and is approximately the size of the state of Rhode Island. The county has four hospitals covering an area of 1,442.44 square miles with 33.3 people per square mile. O'Connor's service area includes the Delhi community, as well as, surrounding communities stretching from Grand Gorge, through Stamford, South Kortright, Bovina, Andes, Bloomville, Hamden and Franklin to Treadwell, and covering many hamlets in between. |
| SCHEDULE H, PART VI, LINE 5 | PROMOTION OF COMMUNITY HEALTH O'Connor Hospital is a critical access hospital in Delhi, New York providing a full range of acute and preventative health care services, including acute inpatient care, restorative/rehabilitative (swing bed) care, an emergency services department (where practitioners have the ability to interface with board-certified neurologists in Cooperstown and neurosurgeons in Rochester through telemedicine connections), same-day surgery, a state-of-the-art medical imaging suite, laboratory services, an outpatient pharmacy, physical and occupational therapy, dietary consultations, an Eye Wear Center, a dental clinic and a wide range of specialty services. O'Connor has served the Delhi Community since 1922 and has been affiliated with The Mary Imogene Bassett Hospital (dba Bassett Medical Center) since 1988. O'Connor is an entity of the Bassett Healthcare Network. It is governed by a 11 member Board of Trustees consisting of community volunteers. O'Connor Hospital community service programs address chronic disease management, promote well-being and mental health, and prevent substance abuse disorders. They include: 1. O'Connor Hospital provides space for diabetes, mental health and Parkinson's support groups on a monthly basis. 2. O'Connor offers fall flu shot clinics. 3. Promoted places for physical activity, hiking, paddling and biking. 4. Tracked trail use on two local hiking trails. 5. Maintained getoutandwalk.org website. 6. Encouraged municipalities to sign Complete Street policies and age-friendly structural improvements. 7. Built and maintained OConnor Hospital .5 mile Fitness Trail complete with five fitness stations and open to the community. 8. Submitted DISRIP proposal to fund a prescribing mental health provider to work in local health center. 9. Submitted grant proposal to fund provider recruitment and retention efforts in the OConnor Hospital service area. 10. Conducted performance improvement project to refer E.D. patients to mental health and substance abuse services and community resources. 11. Completed performance improvement project to increase patient referrals to care navigator program. 12. Participated in pilot drug take back program. 13. Participated in local community coalitions and committees formed to address mental health issues in the county. 14. Participated in suicide prevention coalition. 15. Supported two nurses to complete Sexual Assault Nurse Examiner training courses. 16. Completed and participated in county and regional Emergency Preparedness programs and drills. 17. Conducted performance improvement project addressing standard precautions for MRSA/ VRE of inpatients. 18. Hosted first graders for an educational program of the emergency department. 19. Sponsored community wellness events such as road races, suicide awareness activities, and EMS teaching events. O'Connor has a community board who are actively engaged in the hospital both supporting the growth and the investment in programs that bring health and wellness benefits to the community. O'Connor continually invests in programs, equipment and people to ensure high quality service is available in the community they serve. |
| SCHEDULE H, PART VI, LINE 6 | AFFILIATED HEALTH CARE SYSTEM O'Connor Hospital is part of the Bassett Healthcare Network that provides health services in more than 20 communities spanning 5,600 square miles and seven counties. The network focuses its community services programs in the counties where the six affiliated hospitals and greatest patient populations are located. Otsego County - population 60,094; Delaware County - population 45,001; Herkimer County - population 62,240; Schoharie County - population 31,420 (according to the 2017 U.S. Census estimates). a) O'Connor Hospital, a critical access hospital in Delhi, Delaware County b) The Mary Imogene Bassett Hospital - an acute care inpatient teaching facility, an outpatient primary and specialty care center, a regional network of 34 community based outpatient health centers, 20 school based health centers, two ambulatory surgery centers, and a fully salaried medical staff in Cooperstown, Otsego County c) Cobleskill Regional Hospital, a critical access hospital in Cobleskill, Schoharie County d) Little Falls Hospital, a critical access hospital in Little Falls, Herkimer County e) A.O. Fox Hospital Tri-Town Campus, a 24/7 emergency care facility in Sidney, Delaware County f) A.O. Fox Memorial Hospital, an acute care facility in Oneonta, Otsego County g) Valley Health Services, a residential health care and rehabilitation facility h) At Home Care, a certified home care agency i) First Community Care of Bassett, a medical supply company All of the above make up the Bassett Healthcare Network and provide health services to this seven county region in central New York. |
| SCHEDULE H, PART VI, LINE 7 | STATE FILING OF COMMUNITY BENEFIT REPORT New York |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| James Peters | ||||||||||||||
| Trustee | $0 | $610,583 | $0 | $25,000 | $0 | $1,518 | $0 | $25,484 | $0 | $8,113 | $0 | $670,698 | $0 | $0 |
| Scott Bonderoff | ||||||||||||||
| President | $0 | $230,771 | $0 | $15,211 | $0 | $0 | $0 | $14,034 | $0 | $1,295 | $0 | $261,311 | $0 | $0 |
| Erin E Kingsbury | ||||||||||||||
| Pharmacist | $158,172 | $0 | $0 | $0 | $0 | $0 | $8,923 | $0 | $4,672 | $0 | $171,767 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | RELATED ORG METHODS USED FOR COMPENSATION EXPLANATION The Mary Imogene Bassett Hospital (dba Bassett Medical Center) provides the compensation for the Presidents of O'Connor Hospital, A.O. Fox Memorial Hospital, Cobleskill Regional Hospital, and Little Falls Hospital. Bassett Medical Center uses the following methods to establish compensation for said individuals: A) compensation committee, B) independent compensation consultant, C) written employment contract, D) compensation survey or study and, E) approval by the board or compensation committee. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, LINE 6, 7A, AND 7B | 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, OConnor Hospital, Templeton Foundation, Valley Health Services, Tri-Town Regional Hospital, Mary Imogene Bassett Hospital. As parent and sole member, Bassett Healthcare Network has the right to appoint and remove members of the governing boards of its subsidiaries and approve significant decisions of the governing boards, including, but not limited to, approval of operating and capital budgets, certain capital expenditures, indebtedness not contained in the approved budgets, substantive changes in clinical programs, mergers, consolidations, liquidations and dissolutions involving its subsidiaries and certificate of need applications. |
| FORM 990, PART VI, LINE 11B | ORGANIZATIONS PROCESS TO REVIEW FORM 990 The VP of Finance, O'Connor Hospital, presents the draft 990 to the Executive and Finance Committee of the Board prior to any filing. Any member of the Board who wishes to attend this presentation may attend. Any questions raised are answered and once approved, the 990 can be electronically filed. Copies of the Tax return were distributed to each member of the audit committee prior to filing. |
| FORM 990, PART VI, LINE 12C | ENFORCEMENT OF CONFLICTS POLICY The organization's conflict of interest policy applies to the Board of Directors, board members, and key persons such as the President. Each board member, officer, or key person of the hospital shall complete a conflict of interest questionnaire annually. All completed questionnaires are reviewed and all disclosures of potential conflicts will be brought to the President. The President or his/her designee will take action to eliminate the potential conflict of interest. All disclosures of potential conflicts of interest in the completed questionnaires shall be compiled and reported by the Assistant Treasurer to the Executive and Finance Committee of the board to determine if the reported disclosure and resolution is satisfactory. If the actions taken are not satisfactory, the Executive and Finance Committee shall determine further action as it deems appropriate. |
| FORM 990, PART VI, LINE 15A | COMPENSATION PROCESS FOR TOP OFFICIAL The President's salary is paid by a related organization under a management services agreement. O'Connor Hospital reviews the formal process that is used to determine the base compensation of the President. The President's workplan and accomplishments for the year are reviewed. The President's salary is submitted as part of the management services agreement, which is approved by the board. |
| FORM 990, PART VI, LINE 19 | GOVERNING DOCUMENTS DISCLOSURE EXPLANATION O'Connor Hospital makes its governing documents, conflict of interest policy, and financial statements available to the public upon written request. Parties desiring to obtain copies of such must present themselves at the administrative offices of O'Connor Hospital or by sending a self-addressed stamped envelope and payment for copying of the requested material to O'Connor Hospital Administrative offices. The cost of copying shall be equal to the costs imposed by the IRS for copying public documents. |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS UNDISTRIBUTED INTEREST IN FRIENDS OF BASSETT $( 2,791) |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (13 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 | false |
| Friends of Bassett | ||||||||||
| One Atwell Road | Cooperstown | NY | 13326 | 237041610 | Fundraiser | NY | 501c3 | 7 | BHN | false |
| AO Fox Memorial Hospital | ||||||||||
| One Norton Avenue | Oneonta | NY | 13820 | 150539039 | Healthcare | NY | 501c3 | 3 | BHN | false |
| Bassett Hospital Schoharie County | ||||||||||
| 178 Grandview Drive | Cobleskill | NY | 12043 | 141772971 | Healthcare | NY | 501c3 | 3 | BHN | false |
| Little Falls Hospital | ||||||||||
| 140 Burwell Street | Little Falls | NY | 13365 | 150533578 | Healthcare | NY | 501c3 | 3 | BHN | false |
| Mary Imogene Bassett Hospital | ||||||||||
| One Atwell Road | Cooperstown | NY | 13326 | 135596796 | Healthcare | NY | 501c3 | 3 | BHN | false |
| Templeton Foundation | ||||||||||
| One Atwell Road | Cooperstown | NY | 13326 | 133317084 | Landlord | NY | 501c3 | 10 | BHN | false |
| Valley Health Services | ||||||||||
| 690 West German Street | Herkimer | NY | 13350 | 222511614 | Elder Care | NY | 501c3 | 3 | BHN | false |
| Bassett PPS LLC | ||||||||||
| 6181 State Highway 7 | Oneonta | NY | 13820 | 811749905 | Healthcare | NY | 501c3 | 12A | MIBH | false |
| Tri Town Regional Healthcare | ||||||||||
| 43 Pearl Street | Sidney | NY | 13838 | 260169584 | Healthcare | NY | 501c3 | 3 | BHN | false |
| Valley Residential Services | ||||||||||
| 690 WEST GERMAN STREET | HERKIMER | NY | 13350 | 463703838 | ELDER CARE | NY | 501C3 | 3 | BHN | false |
| At Home Care Partners | ||||||||||
| 25 ELM STREET | ONEONTA | NY | 13820 | 562397098 | HEALTHCARE | NY | 501C3 | 10 | AHC INC | false |
| AT HOME CARE INC | ||||||||||
| 25 ELM STREET | ONEONTA | NY | 13820 | 161287069 | HEALTHCARE | NY | 501C3 | 3 | BHN | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
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