OCONNOR HOSPITAL: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
OCONNOR HOSPITAL (EIN 16-1540394)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-15
IRS object ID
201913199349314566
Schema version
2018v3.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-15T15:36:42-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1515 Broadway 4th FloorAddressLine1Txt
CityAlbanyCityNm
State AbbreviationNYStateAbbreviationCd
ZIP122072974ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN161540394EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1O'Connor HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% O'CONNOR HOSPITALInCareOfNm
Business Name ControlOCONBusinessNameControlTxt
Phone6077460326PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1460 Andes RoadAddressLine1Txt
CityDelhiCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13753ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSCOTT BONDEROFFPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone6077460326PhoneNum
Signature2019-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTODD P TERESCOPreparerPersonNm
PTINP00247720PTIN
Phone5184274600PhoneNum
Preparation2019-11-15PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.102.5IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id14012520193195000020FederalOriginalSubmissionId
Federal Original Submission Id2019-11-15FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id61534EC9BCA1C3D89F6EB9A5054E4B493C585575AtSubmissionCreationDeviceId
At Submission Filing Device Id7B5190DACD7950FB62E11B317DAE60956DD6A6E7AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSCOTT BONDEROFFPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1460 Andes RoadAddressLine1Txt
CityDelhiCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13753ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$22,202,436GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.oconnorhosp.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionO'Connor Hospital is a 23 bed critical access hospital which serves the community in need of medical services without regard to their ability to pay for such services.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee209TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$2,259,369TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$342,668NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$575,025PYContributionsGrantsAmt
CY Contributions Grants$494,617CYContributionsGrantsAmt
PY Program Service Revenue$21,447,436PYProgramServiceRevenueAmt
CY Program Service Revenue$21,196,479CYProgramServiceRevenueAmt
PY Investment Income$153,829PYInvestmentIncomeAmt
CY Investment Income$183,329CYInvestmentIncomeAmt
PY Other Revenue$279,168PYOtherRevenueAmt
CY Other Revenue$328,011CYOtherRevenueAmt
PY Total Revenue$22,455,458PYTotalRevenueAmt
CY Total Revenue$22,202,436CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,126,434PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,214,583CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$108,755CYTotalFundraisingExpenseAmt
PY Other Expenses$11,489,294PYOtherExpensesAmt
CY Other Expenses$11,273,305CYOtherExpensesAmt
PY Total Expenses$21,615,728PYTotalExpensesAmt
CY Total Expenses$21,487,888CYTotalExpensesAmt
PY Revenues Less Expenses$839,730PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$714,548CYRevenuesLessExpensesAmt
Total Assets BOY$29,819,865TotalAssetsBOYAmt
Total Assets EOY$29,230,749TotalAssetsEOYAmt
Total Liabilities BOY$3,825,853TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,655,453TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$25,994,012NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$26,575,296NetAssetsOrFundBalancesEOYAmt
MissionO'CONNOR HOSPITAL IS A 23 BED CRITICAL ACCESS HOSPITAL WHICH SERVES THE COMMUNITY IN NEED OF MEDICAL SERVICES WITHOUT REGARD TO THEIR ABILITY TO PAY FOR SUCH SERVICES.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$15,654,287ExpenseAmt
Revenue$21,196,479RevenueAmt
DescInpatient and Outpatient Services provided to our patients resulted in: Hospitalizations: 440 Patient Days: 2,323 Clinic Visits: 13,818 Surgical Cases: 5Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$48,532ExpenseAmt
DescCommunity involvement has been linked to O'Connor Hospital's mission and values since it first opened. We are working with our community to improve the quality of life for the people of our region. Our community services programs provide free services to persons who cannot afford to pay, who do not qualify for Medicaid, and who fall within the established income guidelines. In 2018, we provided $48,532 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 $48,532 in charity care, $540,442 in patient accounts were recorded as bad debt in 2018.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$15,702,819TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemYes (true)BusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document32IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee209EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonO'CONNOR HOSPITALPersonNm
Phone6077460326PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
James Peters
Trustee1.040.0Yes (X)$0$616,475$33,010
MIchael J Tengeres
Trustee (Until 4/2018)1.046.5Yes (X)$0$147,340$6,966
Sue E Andrews
Treasurer5.055.0Yes (X)$0$326,328$26,471Yes (X)
Peter Hamilton
Chairman1.03.5Yes (X)$0$0$0Yes (X)
Bruce McKeegan
Vice Chairman1.00.0Yes (X)$0$0$0Yes (X)
Connie Pellegrino
Secretary1.00.0Yes (X)$0$0$0Yes (X)
Donald Harris PHD
Trustee1.00.0Yes (X)$0$0$0
Charlotte Hill
Trustee1.00.0Yes (X)$0$0$0
Dennis N Marsh
Trustee1.00.0Yes (X)$0$0$0
John Nader
Trustee (until 8/2018)1.00.0Yes (X)$0$0$0
Polly DellaCrosse
Trustee1.00.0Yes (X)$0$0$0
Carol Spinelli
Trustee (until 8/2018)1.00.0Yes (X)$0$0$0
Michael Stein
Trustee (until 8/2018)1.00.0Yes (X)$0$0$0
Michelle DeFreece
Trustee1.00.0Yes (X)$0$0$0
John Jack Lynch
Trustee1.00.0Yes (X)$0$0$0
Scott Bonderoff
President24.016.0$0$223,936$23,893Yes (X)
Pamela Vogt
Asst. Secretary (until 9/2018)40.00.0$31,828$0$2,161Yes (X)
Erin E Kingsbury
Pharmacist40.00.0$150,232$0$13,184Yes (X)
Michael Viafore
Radiology40.00.0$154,997$0$6,261Yes (X)
Benjamin R Wood
Pharmacist40.00.0$123,039$0$10,287Yes (X)
Debra J Neale
Chief Nursing Officer40.00.0$120,412$0$9,315Yes (X)
Andrea Barcomb
Pharmacist40.00.0$125,682$0$1,645Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$706,190TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,314,079TotReportableCompRltdOrgAmt
Total Other Compensation$133,193TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K7IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Alliance Healcare Service
1900 S State College Blvd Suite 60AnaheimCA92806PET / CT Services$209,952
Mayo Medical Laboratories
200 First Street SWRochesterMN55903Lab Services$113,632
Delaware Bulldozing Corp
5700 County Highway 18BloomvilleNY13739Construction Svcs$202,157
Medefis
PO Box 5068New YorkNY10087Agency$194,155
Louis N Picciano Son
320 N Jensen RdRochesterMN55903Construction Svcs$105,710
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Related Organizations$137,921RelatedOrganizationsAmt
Government Grants$235,462GovernmentGrantsAmt
All Other Contributions$121,234AllOtherContributionsAmt
Total Contributions$494,617TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtBusinessBusinessCdUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Direct patient services$17,951,829$17,951,829
Other program service revenue$985,281$985,281
Outpatient pharmacy$2,259,369446110$2,259,369
FieldValueIRS element (for citing)
Total Program Service Revenue$21,196,479TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$183,329TotalRevenueColumnAmt
Exclusion$183,329ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$328,011RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$328,011RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$328,011TotalRevenueColumnAmt
Exclusion$328,011ExclusionAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$22,202,436TotalRevenueColumnAmt
Related Or Exempt Func Income$18,937,110RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$2,259,369UnrelatedBusinessRevenueAmt
Exclusion$511,340ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$34,312TotalAmt
Management And General$34,312ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,517,939TotalAmt
Program Services$5,517,582ProgramServicesAmt
Management And General$1,961,081ManagementAndGeneralAmt
Fundraising$39,276FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$307,333TotalAmt
Program Services$223,695ProgramServicesAmt
Management And General$79,497ManagementAndGeneralAmt
Fundraising$4,141FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,803,601TotalAmt
Program Services$1,330,697ProgramServicesAmt
Management And General$464,681ManagementAndGeneralAmt
Fundraising$8,223FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$551,398TotalAmt
Program Services$405,127ProgramServicesAmt
Management And General$143,974ManagementAndGeneralAmt
Fundraising$2,297FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,740,080TotalAmt
Program Services$849,972ProgramServicesAmt
Management And General$1,855,108ManagementAndGeneralAmt
Fundraising$35,000FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$7,920TotalAmt
Management And General$7,920ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$786,421TotalAmt
Program Services$580,221ProgramServicesAmt
Management And General$206,200ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$96,756TotalAmt
Program Services$67,306ProgramServicesAmt
Management And General$23,919ManagementAndGeneralAmt
Fundraising$5,531FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$64,193TotalAmt
Program Services$47,309ProgramServicesAmt
Management And General$16,813ManagementAndGeneralAmt
Fundraising$71FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$327,391TotalAmt
Program Services$241,549ProgramServicesAmt
Management And General$85,842ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$63,321TotalAmt
Program Services$46,634ProgramServicesAmt
Management And General$16,573ManagementAndGeneralAmt
Fundraising$114FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$41,015TotalAmt
Program Services$30,261ProgramServicesAmt
Management And General$10,754ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,161,300TotalAmt
Program Services$856,796ProgramServicesAmt
Management And General$304,489ManagementAndGeneralAmt
Fundraising$15FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$77,157TotalAmt
Program Services$56,926ProgramServicesAmt
Management And General$20,231ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Drugs and reagents$3,093,879$3,093,879
Bad debt$540,442$540,442
Patient care supplies$432,136$432,136
Charity care$48,532$48,532

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,792,762TotalAmt
Program Services$1,333,755ProgramServicesAmt
Management And General$444,920ManagementAndGeneralAmt
Fundraising$14,087FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$21,487,888TotalAmt
Program Services$15,702,819ProgramServicesAmt
Management And General$5,676,314ManagementAndGeneralAmt
Fundraising$108,755FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$16,920BOYAmt
EOY$19,178EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$8,434,184BOYAmt
EOY$3,180,319EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$637,941BOYAmt
EOY$422,993EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,020,194BOYAmt
EOY$2,509,659EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$576,483BOYAmt
EOY$620,464EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$70,097BOYAmt
EOY$93,079EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$25,792,493LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$15,791,838LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$9,755,610BOYAmt
EOY$10,000,655EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$8,249,052BOYAmt
EOY$12,303,322EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$59,384BOYAmt
EOY$81,080EOYAmt

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

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

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$29,819,865BOYAmt
EOY$29,230,749EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,407,297BOYAmt
EOY$1,163,031EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,393,400BOYAmt
EOY$1,151,959EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$1,025,156BOYAmt
EOY$340,463EOYAmt

Other Liabilities OtherLiabilitiesGrp

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

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,825,853BOYAmt
EOY$2,655,453EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$25,665,764BOYAmt
EOY$26,159,774EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$328,248BOYAmt
EOY$415,522EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$25,994,012BOYAmt
EOY$26,575,296EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$29,819,865BOYAmt
EOY$29,230,749EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$714,548ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$111,568NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$21,696OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$7,920OtherActivitiesAmt
Total Lobbying Expenditures$7,920TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1FormAndLineReferenceDesc
ExplanationAmerican Hospital Association membership dues allocate 22.73% towards lobbying activities. Total dues paid in 2018 = $12,106. HANY's membership dues allocate 17.51% towards general lobbying activities. Total dues paid in 2018 = $8,362. Iroquois Healthcare Alliance membership dues allocate 39.30% towards general lobbying activities. Total dues paid in 2018 = $9,425.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,217,313OtherCostOrOtherBasisAmt
Depreciation$7,536,728DepreciationAmt
Book Value$7,680,585BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,753,101OtherCostOrOtherBasisAmt
Depreciation$8,255,110DepreciationAmt
Book Value$1,497,991BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$722,679OtherCostOrOtherBasisAmt
Book Value$722,679BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$10,000,655TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt
Total Liability$0TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$21,480,198TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$111,568NetUnrealizedGainsInvstAmt
Other Revenue-$610,670OtherRevenueAmt
Revenue Not Reported-$722,238RevenueNotReportedAmt
Revenue Subtotal$22,202,436RevenueSubtotalAmt
Total Revenue Per Form990$22,202,436TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$20,898,914TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$20,898,914ExpensesSubtotalAmt
Other Expenses Not Included$588,974OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$588,974ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$21,487,888TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART XFIN 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, 2018 and 2017.
SCHEDULE D, PART XI, LINE 2DBAD DEBT $(540,442) CHARITY CARE $ (48,532) UNDISTRIBUTED INTEREST IN FRIENDS OF BASSETT $ (21,696) --------------- TOTAL $(610,670)
SCHEDULE D, PART XII, LINE 4BBAD DEBT $ 540,442 CHARITY CARE $ 48,532 --------------- TOTAL $ 588,974

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served23PersonsServedCnt
Total Community Benefit Expns$91,895TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$41,761DirectOffsettingRevenueAmt
Net Community Benefit Expns$50,134NetCommunityBenefitExpnsAmt
Total Expense0.00240TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,908,287TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,424,187DirectOffsettingRevenueAmt
Net Community Benefit Expns$484,100NetCommunityBenefitExpnsAmt
Total Expense0.02320TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$266,255TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$142,237DirectOffsettingRevenueAmt
Net Community Benefit Expns$124,018NetCommunityBenefitExpnsAmt
Total Expense0.00590TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served23PersonsServedCnt
Total Community Benefit Expns$2,266,437TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,608,185DirectOffsettingRevenueAmt
Net Community Benefit Expns$658,252NetCommunityBenefitExpnsAmt
Total Expense0.03150TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$87,160TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$87,160NetCommunityBenefitExpnsAmt
Total Expense0.00420TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$4,266,227TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,947,482DirectOffsettingRevenueAmt
Net Community Benefit Expns$318,746NetCommunityBenefitExpnsAmt
Total Expense0.01520TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$242,019TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$242,019NetCommunityBenefitExpnsAmt
Total Expense0.01160TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,703TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$7,703NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Total Community Benefit Expns$4,603,109TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,947,482DirectOffsettingRevenueAmt
Net Community Benefit Expns$655,628NetCommunityBenefitExpnsAmt
Total Expense0.03140TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served23PersonsServedCnt
Total Community Benefit Expns$6,869,546TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,555,667DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,313,880NetCommunityBenefitExpnsAmt
Total Expense0.06290TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Reimbursed By Medicare$6,519,610ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$6,455,059CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$64,551MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

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

US Address USAddress

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

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1O'CONNOR HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
OtherYes (X)OtherInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE SECTION COwnWebsiteURLTxt
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSEE SECTION CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care0.FPGFamilyIncmLmtDscntCarePct
Explained BasisfalseExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART V, LINE 3J, FACILITY 1, OCONNOR HOSPITALContinuing prior CHNA work on preventing chronic diseases, promoting mental health, and preventing substance abuse.
SCHEDULE H, PART V, LINE 5, FACILITY 1, OCONNOR HOSPITALThis Community Health Needs Assessment has taken into account input from persons who represent the broad interests of the community served by O'Connor Hospital. All organizations providing input into this assessment, including the name and title of those individuals representative of the organization, is provided below. A) Amy Beveridge, Director of Operational Support B) Debra Neale, CNO at O'Connor Hospital C) Pamela Vogt, Administrative Manager at O'Connor Hospital D) Amanda Walsh, Epidemiologist at Delaware County Public Health E) Regina Krzyston, Quality Consultant at O'Connor Hospitals F) Karen Huxtable-Hooker, Director Public & Media at Bassett Medical Center Relations G) Dotti Kruppo, Community Relations Director at UHS Hospital H) Laurie Mozian, Community Health Coordinator at Margaretville Hospital I) Mark Pohar, Executive Director at Margaretville Hospital The Community Service Plan (also referred to as the Implementation Strategy) has taken into account input from persons who represent the broad interests of the community served by O'Connor Hospital. The primary proactive means for receiving community input was through the Regional Assessment conducted by the Southern Tier Population Health Improvement Program (PHIP). In the Southern Tier, PHIP covers five counties including Delaware County. In order to inform the direction of the Southern Tier PHIP, also known as HealthlinkNY Community Network, the team conducted a regional health assessment utilizing stakeholder interviews and consumer focus groups. The information from this assessment that specifically refers to Delaware County was utilized to direct the selection of the public health priorities for OConnor Hospital. From June 2015 through January 2016, a total of 43 one-on-one structured interviews in Delaware County were conducted with professionals working in diverse fields such as health care, education, transportation, economic development, mental health, law enforcement, public office, among others. The interview questions, 10 key questions and 5 secondary questions, centered on health disparities, key barriers to addressing them, and gaps in service provision. Consumers input was sought through focus groups which were conducted from January through March of 2016. Population Health Coordinators met with pre-existing groups including support groups, service clubs, parent groups, and senior meal sites. HealthlinkNY Community Network conducted five focus groups with 37 participants in Delaware County; they were asked about their experiences with health and health care delivery. Responses from the focus groups were collected by note-takers and summarized qualitatively by the Population Health Coordinators. In addition, OConnor Hospital is an active participant in Delaware Countys Community Health Improvement Plan process. This process included input and suggestions from Delaware County Public Health, Delaware Valley Hospital, Margaretville Hospital, Tri Town Regional Campus, and HealthlinkNY Community Network.
SCHEDULE H, PART V, LINE 6A, FACILITY 1, OCONNOR HOSPITALBassett Medical Center, Tri Town Regional Campus, Cobleskill Regional Hospital, Little Falls Hospital, AO Fox Memorial Hospital
SCHEDULE H, PART V, LINE 7a AND 10a, FACILITY 1, OCONNOR HOSPITALThe Hospital's Community Health Needs Assessment and Implementation Strategy are made avaialble on the Hospital's website: www.bassett.org/medical/locations/hospitals/oconnor-hospital
SCHEDULE H, PART V, LINE 11, FACILITY 1, O'CONNOR HOSPITALThe 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 HOSPITALThe Hospital's Financial Assistance Policy, application, and plain language summary are made avaialble on the Hospital's website: www.bassett.org/medical/patients-visitors/billing-insurance/financial-assi stance/plain-language-summary-pls

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3COTHER 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 6ARELATED 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.oconnorhosp.org. 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 $540,442 was subtracted from the total expense value used to calculate the percentages in Part 1, Line 7, Column f.
SCHEDULE H, PART I, LINE 7COSTING 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 IICOMMUNITY BUILDING ACTIVITIES All O'Connor Community Building Activities are included in Part I and described above.
SCHEDULE H, PART III, LINE 2BAD 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. PLEASE SEE THE FOLLOWING AUDITED FINANCIAL STATEMENT FOOTNOTE WHICH DESCRIBES THIS PROUNONCEMENT. RECENT ACCOUNTING PRONOUNCEMENTS - FOOTNOTE 2(n)(ii) from the Audited Financial Statements (ii) Revenue from contracts with customers Adoption of ASC 606 Upon adoption, the majority of what is currently classified as provision for uncollectible accounts and presented as a reduction to net patient service revenue on the statements of operations and changes in net assets is treated as a price concession that reduces the transaction price, which is reported as net patient service revenue. During 2018 and 2017, the Hospital incurred $540,442 and $561,121 in provisions for uncollectible accounts, respectively.
SCHEDULE H, PART III, LINE 4FOOTNOTE 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 8MEDICARE 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 9BCOLLECTION 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 2NEEDS ASSESSMENT In addition to public and agency input, a variety of data from the NYS Department of Health, Delaware County Public Health Nursing Services Community Health Assessment, Leatherstocking Collaborative Health Partners Community Needs Assessments, priority area consistent with the New York State Department of Health Prevention Agenda, the degree of aberration from National Healthy People 2020 goals and/or from the NYS Prevention Agenda objectives, the available resources and capacity to address priorities and other data lead to the selection of priority items including: a. Prevention Chronic Disease and b. Promoting Mental Health and Preventing Substance Abuse. Based on the priority items, the following strategies were identified: 1. Prevent Chronic Diseases Focus Area 1: Reduce obesity in children and adults Goal: Create community environments that promote and support healthy food and beverage choices and physical activity Objective 1.0.1: Three municipalities will pass Complete Streets policies by 12/31/18. Objective 1.0.2: One municipality will complete a Complete Streets project by 12/31/18. Objective 1.0.3: Increase percentage of adults that participate in leisure time physical activity from 75% to 76% by 12/31/18. Focus Area 3: Increase Access to High Quality Chronic Disease Preventive Care and Management in both Clinical and Community Settings Goal: Promote culturally relevant chronic disease self-management education Objective 3.0.1: Two (2) six-week Chronic Disease Self-Management Programs will be offered in Delaware County annually in 2017 and 2018. 2. Promote Mental Health and Prevent Substance Abuse Focus Area 2: Prevent Substance Abuse and other Mental Emotional Behavioral Disorders Goal: Prevent suicides among youth and adults Objective 2.0.1: Decrease the age-adjusted suicide rate in Delaware County by 10% from 17.2 to 15.5 per 100,000 by 12/31/2018. Objective 2.0.2: Decrease the number of suicide attempts in Delaware County by 12/31/2018. Goal: Prevent underage drinking, non-medical use of prescription pain relievers by youth, and excessive alcohol consumption by adults Objective 2.1.1: Promote community activation and coalition building by participating in newly formed heroin and substance abuse coalitions. 3. OVERALL GOALS A.) Create Community environments that promote and support healthy food and beverages choices and physical activity. B.) Promote culturally relevant chronic disease self-management education. C.) Prevent suicides among youth and adults. D.) Prevent underage drinking, non-medical use of prescription pain relievers by youth and excessive alcohol consumption by adults.
SCHEDULE H, PART VI, LINE 3PATIENT 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 4COMMUNITY 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. This large service area represents the eastern branch and areas of the northeastern part of Delaware County.
SCHEDULE H, PART VI, LINE 5PROMOTION 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 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 13 member Board of Trustees consisting of community volunteers. O'Connor Hospital programs address chronic disease management and prevention and Promoting Mental Health and Preventing Substance Abuse. They include: 1. Cancer Services Program of Delaware, Otsego and Schoharie Counties 2. O'Connor Dental Clinic operating since 2005 through a partnership with Bassett Medical Center 3. O'Connor Hospital provides space for diabetes, mental health and Parkinson's support groups on a monthly basis. 4. O'Connor offers fall flu shot clinics. 5. O'Connor provides free community assessments, screenings and educational events including health fairs and free lunch and learn workshops throughout the year. 6. Promoted places for physical activity, hiking, paddling and biking. 7. Tracked trail use on two local hiking trails. 8. Maintained getoutandwalk.org website. 9. Encouraged municipalities to sign Complete Street policies. 10. Built and maintained OConnor Hospital .5 mile Fitness Trail complete with five fitness stations and open to the community. 11. Conducted QPR (question, persuade, refer) training. 12. Submitted DISRIP proposal to fund a prescribing mental health provider to work in local health center. 13. Submitted grant proposal to fund provider recruitment and retention efforts in the OConnor Hospital service area. 14. Conducted performance improvement project to refer E.D. patients to mental health and substance abuse services and community resources. 15. Completed performance improvement project to increase patient referrals to care navigator program. 16. Participated in pilot drug take back program. 17. Participated in local community coalitions and committees formed to address mental health issues in the county. 18. Participated in suicide prevention coalition. 19. Supported two nurses to complete Sexual Assault Nurse Examiner training courses. 20. Completed and participated in county and regional Emergency Preparedness programs and drills. 21. Conducted performance improvement project addressing standard precautions for MRSA/ VRE of inpatients. 22. Hosted 40 first graders for an educational program of the emergency department. 23. Encouraged employees and the community to make tobacco cessation attempts. 24. 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 6AFFILIATED 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 7STATE FILING OF COMMUNITY BENEFIT REPORT New York

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
James Peters
Trustee$0$586,475$0$30,000$0$0$0$25,114$0$7,896$0$649,485$0$0
MIchael J Tengeres
Trustee (Until 4/2018)$0$147,340$0$0$0$0$0$6,246$0$720$0$154,306$0$0
Sue E Andrews
Treasurer$0$326,328$0$0$0$0$0$21,402$0$5,069$0$352,799$0$0
Scott Bonderoff
President$0$223,936$0$0$0$0$0$19,948$0$3,945$0$247,829$0$0
Erin E Kingsbury
Pharmacist$150,232$0$0$0$0$0$8,705$0$4,479$0$163,416$0$0$0
Michael Viafore
Radiology$154,997$0$0$0$0$0$6,261$0$0$0$161,258$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 3FormAndLineReferenceDesc
ExplanationRELATED ORG METHODS USED FOR COMPENSATION EXPLANATION The Mary Imogene Bassett Hospital (dba Bassett Medical Center) provides the compensation for the Presidents of O'Connor Hospital, A.O. Fox Memorial Hospital, Cobleskill Regional Hospital, and Little Falls Hospital. Bassett Medical Center uses the following methods to establish compensation for said individuals: A) compensation committee, B) independent compensation consultant, C) written employment contract, D) compensation survey or study and, E) approval by the board or compensation committee.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonDELHI MOTOR COMPANY INCPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionSEE PART VRelationshipDescriptionTxt
Transaction$36,598TransactionAmt
TransactionVEHICLE PURCHASETransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART VI COLUMN BFormAndLineReferenceDesc
ExplanationDELHI MOTOR COMPANY INC IS A 35%-OR-MORE CONTROLLED COMPANY OF PETER HAMILTON, AN OFFICER AND DIRECTOR OF THE HOSPITAL.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, LINES 6, 7A, AND 7BBassett 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. 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 Treasurer of the Board 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. A complete copy of the organization's final form 990, including all required schedules, as ultimately filed with the IRS, is made available, upon request, to each member of the Board before it's filing with the IRS.
FORM 990, PART VI, LINE 12CENFORCEMENT OF CONFLICTS POLICY The organization's conflict of interest policy applies to the Board of Directors, board members, and key persons such as the President. Each board member, officer, or key person of the hospital shall complete a conflict of interest questionnaire annually. All completed questionnaires are reviewed and all disclosures of potential conflicts will be brought to the President. The President or his/her designee will take action to eliminate the potential conflict of interest. All disclosures of potential conflicts of interest in the completed questionnaires shall be compiled and reported by the Assistant Treasurer to the Executive and Finance Committee of the board to determine if the reported disclosure and resolution is satisfactory. If the actions taken are not satisfactory, the Executive and Finance Committee shall determine further action as it deems appropriate.
FORM 990, PART VI, LINE 15ACOMPENSATION 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 19GOVERNING DOCUMENTS DISCLOSURE EXPLANATION O'Connor Hospital makes its governing documents, conflict of interest policy, and financial statements available to the public upon written request. Parties desiring to obtain copies of such must present themselves at the administrative offices of O'Connor Hospital or by sending a self-addressed stamped envelope and payment for copying of the requested material to O'Connor Hospital Administrative offices. The cost of copying shall be equal to the costs imposed by the IRS for copying public documents.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS UNDISTRIBUTED INTEREST IN FRIENDS OF BASSETT $(21,696)
FORM 990, PART I, LINE 7BUNRELATED BUSINESS TAXABLE INCOME O'CONNOR HOSPITAL'S UNRELATED BUSINESS TAXABLE INCOME FOR TAX YEAR 2018 INCLUDED $7,722 IN EXPENSES INCURRED TO MAINTAIN EMPLOYEE PARKING SPACES. UNDER INTERNAL REVENUE CODE SECTION 512(A)(7), SUCH EXPENSES ARE INCLUDED IN UNRELATED BUSINESS TAXABLE INCOME AS AMOUNTS PAID FOR DISALLOWED FRINGES AND ARE THEREFORE RELFECTED IN PART I, LINE 7B. PART I, LINE 7A INCLUDES ONLY REVENUES REPORTED ON PART VIII, COLUMN (C) AS UNRELATED BUSINESS REVENUE.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Bassett Healthcare Network
One Atwell RoadCooperstownNY13326133218680SupportNY501c312cNonefalse
Bassett Regional Corporation (BRC)
One Atwell RoadCooperstownNY13326133522783SupportNY501c3N/ABHNfalse
Friends of Bassett
One Atwell RoadCooperstownNY13326237041610FundraiserNY501c37BHNfalse
AO Fox Memorial Hospital
One Norton AvenueOneontaNY13820150539039HealthcareNY501c33BHNfalse
Bassett Hospital Schoharie County
178 Grandview DriveCobleskillNY12043141772971HealthcareNY501c33BHNfalse
Little Falls Hospital
140 Burwell StreetLittle FallsNY13365150533578HealthcareNY501c33BHNfalse
Mary Imogene Bassett Hospital
One Atwell RoadCooperstownNY13326135596796HealthcareNY501c33BHNfalse
Templeton Foundation
One Atwell RoadCooperstownNY13326133317084LandlordNY501c310BHNfalse
Tri Town Regional Healthcare
43 Pearl StreetSidneyNY13838260169584HealthcareNY501c33BHNfalse
Valley Health Services
690 West German StreetHerkimerNY13350222511614Elder CareNY501c33BHNfalse
Bassett PPS LLC
6181 State Highway 7OneontaNY13820811749905HealthcareNY501c312AMIBHfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

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