LITTLE FALLS HOSPITAL: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: LITTLE FALLS HOSPITAL (EIN 15-0533578)
Tax period: 2016-01-01 to 2016-12-31
Filed: 2017-11-15
IRS object ID: 201743199349310249
Schema version: 2016v3.0
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	2017-11-15T13:40:48-06:00	ReturnTs
Tax Period End	2016-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	161226221	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	FUST CHARLES CHAMBERS LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	5784 WIDEWATERS PARKWAY	AddressLine1Txt
City	SYRACUSE	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13214	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	150533578	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LITTLE FALLS HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	LITT	BusinessNameControlTxt
Phone	3158231000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	140 BURWELL STREET	AddressLine1Txt
City	LITTLE FALLS	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13365	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JAMES VIELKIND	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	3158231000	PhoneNum
Signature	2017-11-14	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	KELLY A REDMOND	PreparerPersonNm
PTIN	P00443718	PTIN
Phone	3154463600	PhoneNum
Preparation	2017-11-14	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	24.39.85.114	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2017-11-14	IPDt
IP Tm	13:34:22	IPTm
IP Timezone	ES	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	517AEBE328CBAAA90E396C2FD1060AA56161F780	AtSubmissionCreationDeviceId
At Submission Filing Device Id	517AEBE328CBAAA90E396C2FD1060AA56161F780	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2017-02-10 21:41:12Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JAMES VIELKIND	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	140 BURWELL STREET	AddressLine1Txt
City	LITTLE FALLS	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13365	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$33,119,187	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.BASSETT.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1893	FormationYr
Legal Domicile State	NY	LegalDomicileStateCd
Activity Or Mission	LITTLE FALLS HOSPITAL IS A CRITICAL ACCESS HOSPITAL PROVIDING ACCESS TO HEALTH CARE SERVICES TO RESIDENTS OF HERKIMER COUNTY, AND WESTERN PORTIONS OF MONTGOMERY AND FULTON COUNTIES. LITTLE FALLS HOSPITAL EMERGENCY DEPARTMENT IS STAFFED WITH PHYSICIANS ON A 24/7 BASIS. TWENTY FIVE BEDS ARE USED FOR INPATIENT AND SKILLED NURSING CARE. AMBULATORY SURGERY SERVICES ARE PROVIDED FOR A VARIETY OF PROCEDURE SPECIALTIES. PERFORMANCE IMPROVEMENT AND HIGH QUALITY OF CARE IS DEMONSTRATED WITHIN THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) AS REPORTED ON MEDICARE.GOV HOSPITAL COMPARE.	ActivityOrMissionDesc
Voting Members Governing Body	16	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	358	TotalEmployeeCnt
Total Volunteers	20	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$292,825	PYContributionsGrantsAmt
CY Contributions Grants	$309,381	CYContributionsGrantsAmt
PY Program Service Revenue	$30,806,653	PYProgramServiceRevenueAmt
CY Program Service Revenue	$30,848,771	CYProgramServiceRevenueAmt
PY Investment Income	$121,364	PYInvestmentIncomeAmt
CY Investment Income	$180,893	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$31,220,842	PYTotalRevenueAmt
CY Total Revenue	$31,339,045	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	$14,552,467	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$14,924,210	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$149,736	CYTotalFundraisingExpenseAmt
PY Other Expenses	$17,660,445	PYOtherExpensesAmt
CY Other Expenses	$17,248,475	CYOtherExpensesAmt
PY Total Expenses	$32,212,912	PYTotalExpensesAmt
CY Total Expenses	$32,172,685	CYTotalExpensesAmt
PY Revenues Less Expenses	-$992,070	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$833,640	CYRevenuesLessExpensesAmt
Total Assets BOY	$33,563,535	TotalAssetsBOYAmt
Total Assets EOY	$32,596,371	TotalAssetsEOYAmt
Total Liabilities BOY	$11,695,823	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$10,781,061	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$21,867,712	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$21,815,310	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	LITTLE FALLS HOSPITAL IS A VOLUNTARY, NOT-FOR-PROFIT COMMUNITY HEALTHCARE SYSTEM WHOSE MISSION IS TO OFFER QUALITY CARE WITH COMPASSION, TO ALL WHO NEED OUR SERVICES.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$7,807,783	ExpenseAmt
Revenue	$8,158,386	RevenueAmt
Desc	INPATIENT SERVICESTHE INPATIENT OCCUPANCY RATE FOR INPATIENT AND OBSERVATION SERVICES WAS 65% FOR AN AVERAGE DAILY INPATIENT DAILY CENSUS OF 17 PATIENTS. AS A CRITICAL ACCESS HOSPITAL (CAH) PROVIDER, OUR INPATIENT DAILY SERVICES INCLUDE; OBSERVATION CARE, EXTENDED SWINGBED REHAB SERVICES, AND ACUTE CARE SERVICES. THIS DIVERSITY OF PATIENT CARE ALLOWS FOR OUR RESIDENTS TO REMAIN LOCAL FOR MEDICALLY APPROPRIATE SERVICES. IN 2016, LITTLE FALLS HOSPITAL WAS ALSO RATED A FOUR STAR (****) HOSPITAL BY "HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS" (HCAHPS). A FOUR STAR RATING INDICATES HIGH PATIENT SATISFACTION IN THEIR PATIENT CARE AS MEASURED BY PATIENT SURVEY INSTRUMENTS.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$8,878,761	ExpenseAmt
Revenue	$9,360,195	RevenueAmt
Desc	LITTLE FALLS HOSPITAL OPERATES AN EMERGENCY DEPARTMENT WITH TWENTY FOUR HOURS OF PHYSICIAN COVERAGE, SEVEN DAYS PER WEEK. THE EMERGENCY DEPARTMENT PROVIDED ACCESS TO CARE FOR APPROXIMATELY 15,000 PATIENTS IN 2016. THE EMERGENCY DEPARTMENT PARTICIPATED IN A NYS MEDICAID ACCELERATED EXCHANGE (MAX) PROGRAM TO REDUCE AVOIDABLE VISITS TO AN EMERGENCY DEPARTMENT. OUR SUCCESS WAS A 39% REDUCTION FOR THE PATIENTS SELECTED FOR THE PROGRAM REDUCING EMERGENCY DEPARTMENT VISITS BY 225. THE MAX PROGRAM IS CONSISTENT WITH THE CHANGING PAYMENT SYSTEMS TO TRANSFORM TO A "PAY FOR PERFORMANCE" INSTEAD OF THE CURRENT STATUS OF REIMBURSEMENT RECOGNIZED AS "FEE FOR SERVICE". THESE CARE RE-DESIGN MEASURES ARE CONSISTENT WITH NYS DEPARTMENT OF HEALTH MEDICAID CARE RE-DESIGN INITIATIVES, ADMINISTERED UNDER THE "DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) PROGRAM". A GOAL OF THIS PROGRAM IS TO REDUCE BY 25% OVER FIVE YEARS, AVOIDABLE HOSPITAL EMERGENCY DEPARTMENT VISITS AND HOSPITAL ADMISSIONS.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$8,850,037	ExpenseAmt
Revenue	$11,765,227	RevenueAmt
Desc	TOTAL AMBULATORY OUTPATIENT SERVICE VISITS WERE APPROXIMATELY 33,000 IN 2016. OUR AMBULATORY SERVICES INCLUDE REHAB / WELLNESS PROGRAM, AMBULATORY SURGERY / GI SERVICES, WOMENS IMAGING SERVICE, DIAGNOSTIC IMAGING SERVICES, AND PRIMARY CARE SERVICES. OUR DOLGEVILLE AND NEWPORT HEALTH CENTERS AND AMBULATORY SURGERY PROGRAM WERE RECOGNIZED AS "GUARDIAN OF EXCELLENCE AWARD" BY PRESS GANEY. THIS AWARD RECOGNIZES SERVICE PERFORMANCE WHEREBY PATIENT SATISFACTION WAS MEASURED AT A LEVEL OF 95% OF PEERS WITHIN A FOUR QUARTER MEASUREMENT PERIOD. OUR WOMEN'S IMAGING CENTER INLCUDES NEWLY PURCHASED STATE-OF-THE-ART 3D DIGITAL MAMMOGRAPHY TO IMPROVE DIAGNOSTIC TESTING FOR BREAST CANCER SCREENINGS.	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$2,063,251	ExpenseAmt
Revenue	$1,564,963	RevenueAmt
Desc	THE HOSPITAL CONTINUED EFFORTS WITH SUPPORTING OUR ROLE AS A NYS DEFINED SAFETY-NET PROVIDER. IN 2016 WE RECEIVED VITAL ACCESS PROVIDER (VAP) AWARDS TO STRENGTHEN OUR PATIENT DELIVERY SYSTEMS. SOME OF THESE INITIATIVES CONTINUE TO RELY ON RECRUITMENT OF PRIMARY CARE PROVIDERS TO OUR REGION. WE ARE ALSO A PARTNER IN THE LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS (LCHP), LLC WHOSE ACTIVITIES ARE ASSOCIATED WITH COORDINATING IMPROVEMENTS IN POPULATION HEALTH OUTCOMES OUTLINED IN THE NYS DEPARTMENT OF HEALTH "DELIVERY SYSTEM REFORM INCENTIVE PAYMENT" (DSRIP) PROGRAM. IN 2016 LITTLE FALLS HOSPITAL RECEIVED FUNDING FOR OUR DSRIP INITIATIVES OF $83,000. OUR ACTIVITIES FOR IMPROVING POPULATION HEALTH INCLUDED INCREASING WELLNESS VISITS IN OUR HEALTH CENTERS, EDUCATION PROTOCOLS USED FOR ASTHMATIC PATIENTS, AND INCREASING MENTAL HEALTH SCREENS.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$2,063,251	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue	$1,564,963	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$27,599,832	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	Yes (1)	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	25	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	358	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	16	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (1)	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	NY	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	JAMES G VIELKIND	PersonNm
Phone	3158235281	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	140 BURWELL STREET	AddressLine1Txt
City	LITTLE FALLS	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13365	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
JOHN D BULLIS
CHAIRMAN	2.00	1.50	Yes (X)	Yes (X)	$0	$0	$0
PHYLLIS SPINNER
TRUSTEE	2.00		Yes (X)		$0	$0	$0
TIMOTHY DALY
SECOND VICE CHAIRMAN	2.00		Yes (X)	Yes (X)	$0	$0	$0
ANTHONY DELUCA
FIRST VICE CHAIRMAN	2.00		Yes (X)	Yes (X)	$0	$0	$0
JOY MALONE
TRUSTEE	2.00		Yes (X)		$0	$0	$0
GERARD J SNYDER
SECRETARY	2.00		Yes (X)	Yes (X)	$0	$0	$0
RANBIR SODHI MD
TRUSTEE	2.00		Yes (X)		$0	$0	$0
AUGUST LEINHART MD
TRUSTEE	2.00	40.00	Yes (X)		$0	$403,925	$33,458
KEVIN CROSLEY
TRUSTEE	2.00		Yes (X)		$0	$0	$0
JUSTIN R HUMMEL
TRUSTEE	2.00		Yes (X)		$0	$0	$0
AMY GRACE MD
PRESIDENT OF MEDICAL STAFF	2.00	40.00	Yes (X)	Yes (X)	$0	$210,318	$20,238
ROBERT CASULLO
TRUSTEE	2.00		Yes (X)		$0	$0	$0
DUANE SIDNEY
TRUSTEE	2.00		Yes (X)		$0	$0	$0
LISA BETRUS
THIRD VICE CHAIRMAN	2.00		Yes (X)	Yes (X)	$0	$188,229	$16,335
KATHLEEN SELLERS
TRUSTEE	2.00		Yes (X)		$0	$0	$0
MICHAEL TENGERES
TREASURER	1.00	40.00	Yes (X)	Yes (X)	$0	$429,917	$1,157
MICHAEL OGDEN
PRESIDENT & CEO	40.00			Yes (X)	$0	$179,064	$16,203
JAMES G VIELKIND
CHIEF FINANCIAL OFFICER	40.00			Yes (X)	$137,685	$0	$5,930
RICHARD NOCELLA
PRIMARY CARE PHYSICIAN	40.00				$160,259	$0	$5,289	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$297,944	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,411,453	TotReportableCompRltdOrgAmt
Total Other Compensation	$98,610	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	2	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
SUNBELT STAFFING
LOCKBOX DEPT CH 14430	PALATINE	IL	60055	TEMPORARY STAFFING AGENCY	$185,919
DM CONSULTING
PO BOX 4715	UTICA	NY	13504	INFORMATION TECHNOLOGY	$108,768

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
Related Organizations	$87,357	RelatedOrganizationsAmt
Government Grants	$222,024	GovernmentGrantsAmt
Total Contributions	$309,381	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
OUTPATIENT SERVICES	623000	$21,125,422	$21,125,422
INPATIENT HOSPITAL	621930	$8,158,386	$8,158,386
OTHER OPERATING REVENUE	900099	$990,120	$990,120
PROGRAM SERVICE LEASE	532000	$442,590	$442,590
HOSPITAL CAFETERIA	900099	$132,253	$132,253

Field	Value	IRS element (for citing)
Total Program Service Revenue	$30,848,771	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$52,639	TotalRevenueColumnAmt
Exclusion	$52,639	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$1,908,396	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$1,780,142	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$128,254	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$128,254	TotalRevenueColumnAmt
Exclusion	$128,254	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$31,339,045	TotalRevenueColumnAmt
Related Or Exempt Func Income	$30,848,771	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$180,893	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$143,615	TotalAmt
Management And General	$143,615	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$11,659,380	TotalAmt
Program Services	$10,087,151	ProgramServicesAmt
Management And General	$1,512,683	ManagementAndGeneralAmt
Fundraising	$59,546	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$696,838	TotalAmt
Program Services	$600,545	ProgramServicesAmt
Management And General	$92,748	ManagementAndGeneralAmt
Fundraising	$3,545	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,555,215	TotalAmt
Program Services	$1,330,157	ProgramServicesAmt
Management And General	$217,206	ManagementAndGeneralAmt
Fundraising	$7,852	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$869,162	TotalAmt
Program Services	$743,182	ProgramServicesAmt
Management And General	$121,593	ManagementAndGeneralAmt
Fundraising	$4,387	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$28,662	TotalAmt
Management And General	$28,662	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$58,232	TotalAmt
Management And General	$58,232	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$8,635	TotalAmt
Management And General	$8,635	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$302,379	TotalAmt
Program Services	$284,640	ProgramServicesAmt
Management And General	$17,739	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$34,236	TotalAmt
Program Services	$16,736	ProgramServicesAmt
Management And General	$17,500	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,680,123	TotalAmt
Program Services	$2,572,107	ProgramServicesAmt
Management And General	$100,716	ManagementAndGeneralAmt
Fundraising	$7,300	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$996,261	TotalAmt
Program Services	$887,493	ProgramServicesAmt
Management And General	$108,768	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$585,772	TotalAmt
Program Services	$511,941	ProgramServicesAmt
Management And General	$72,705	ManagementAndGeneralAmt
Fundraising	$1,126	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$20,764	TotalAmt
Program Services	$10,594	ProgramServicesAmt
Management And General	$8,693	ManagementAndGeneralAmt
Fundraising	$1,477	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$29,249	TotalAmt
Program Services	$5,422	ProgramServicesAmt
Management And General	$23,292	ManagementAndGeneralAmt
Fundraising	$535	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$223,266	TotalAmt
Program Services	$187,402	ProgramServicesAmt
Management And General	$35,848	ManagementAndGeneralAmt
Fundraising	$16	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$2,292,471	TotalAmt
Program Services	$1,924,225	ProgramServicesAmt
Management And General	$368,080	ManagementAndGeneralAmt
Fundraising	$166	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$274,427	TotalAmt
Program Services	$259,671	ProgramServicesAmt
Management And General	$14,756	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
ADMINISTRATIVE SERVICES	$6,935,683	$5,721,843	$1,178,840	$35,000
PROVISION FOR BAD DEBT	$1,696,598	$1,696,598
NEW YORK STATE ASSESSME	$93,939	$93,939

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$987,778	TotalAmt
Program Services	$666,186	ProgramServicesAmt
Management And General	$292,806	ManagementAndGeneralAmt
Fundraising	$28,786	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$32,172,685	TotalAmt
Program Services	$27,599,832	ProgramServicesAmt
Management And General	$4,423,117	ManagementAndGeneralAmt
Fundraising	$149,736	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$551,280	BOYAmt
EOY	$2,096,685	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,431,115	BOYAmt
EOY	$1,665,331	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$426,099	BOYAmt
EOY	$276,691	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$3,250,169	BOYAmt
EOY	$2,887,853	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$473,166	BOYAmt
EOY	$477,268	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$333,851	BOYAmt
EOY	$493,366	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$42,539,032	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$25,233,803	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$18,815,928	BOYAmt
EOY	$17,305,229	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$2,145,739	BOYAmt
EOY	$3,194,590	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$2,843,182	BOYAmt
EOY	$1,597,978	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$1,726,281	BOYAmt
EOY	$1,800,536	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$1,566,725	BOYAmt
EOY	$800,844	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$33,563,535	BOYAmt
EOY	$32,596,371	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$3,211,744	BOYAmt
EOY	$3,333,248	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$655,303	BOYAmt
EOY	$697,744	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$5,387,347	BOYAmt
EOY	$4,782,163	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,441,429	BOYAmt
EOY	$1,967,906	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$11,695,823	BOYAmt
EOY	$10,781,061	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$17,407,027	BOYAmt
EOY	$17,205,693	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,595,399	BOYAmt
EOY	$3,706,536	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$865,286	BOYAmt
EOY	$903,081	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$21,867,712	BOYAmt
EOY	$21,815,310	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$33,563,535	BOYAmt
EOY	$32,596,371	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$833,640	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$49,281	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$731,957	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$8,635	OtherActivitiesAmt
Total Lobbying Expenditures	$8,635	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	A PERCENTAGE OF MEMBERSHIP DUES PAID TO HEALTHCARE ASSOCIATION OF NEW YORK STATE (23.71%), IROQUOIS HEALTHCARE ALLIANCE (36.5%), AND AMERICAN HOSPITAL ASSOCIATION (21.78%)	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,460,686	BeginningYearBalanceAmt
Investment Earnings Or Losses	$148,931	InvestmentEarningsOrLossesAmt
End Year Balance	$4,609,617	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,590,711	BeginningYearBalanceAmt
Contributions	$14,514	ContributionsAmt
Investment Earnings Or Losses	-$144,539	InvestmentEarningsOrLossesAmt
End Year Balance	$4,460,686	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,263,576	BeginningYearBalanceAmt
Contributions	$137	ContributionsAmt
Investment Earnings Or Losses	$326,998	InvestmentEarningsOrLossesAmt
End Year Balance	$4,590,711	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$10,099,410	BeginningYearBalanceAmt
Contributions	$720	ContributionsAmt
Investment Earnings Or Losses	$361,656	InvestmentEarningsOrLossesAmt
Other Expenditures	$6,198,210	OtherExpendituresAmt
End Year Balance	$4,263,576	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$12,753,313	BeginningYearBalanceAmt
Contributions	$12,870	ContributionsAmt
Investment Earnings Or Losses	$1,085,526	InvestmentEarningsOrLossesAmt
Other Expenditures	$3,752,299	OtherExpendituresAmt
End Year Balance	$10,099,410	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.19600	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.80400	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$380,386	OtherCostOrOtherBasisAmt
Book Value	$380,386	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$29,157,474	OtherCostOrOtherBasisAmt
Depreciation	$14,928,573	DepreciationAmt
Book Value	$14,228,901	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$12,698,589	OtherCostOrOtherBasisAmt
Depreciation	$10,305,230	DepreciationAmt
Book Value	$2,393,359	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$302,583	OtherCostOrOtherBasisAmt
Book Value	$302,583	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$17,305,229	TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

Field	Value	IRS element (for citing)
Desc	DIRECT FINANCE LEASE	Desc
Book Value	$1,800,536	BookValueAmt
Method Valuation	C	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Program Rltd	$1,800,536	TotalBookValueProgramRltdAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
ACCRUED PENSION LIABILITY	$1,648,499
OTHER LIABILITIES	$376,701
DEBT ISSUNANCE COST	-$57,294

Field	Value	IRS element (for citing)
Total Liability	$1,967,906	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$31,339,045	TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported	$0	RevenueNotReportedAmt
Revenue Subtotal	$31,339,045	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$31,339,045	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$32,172,685	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$32,172,685	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$32,172,685	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, LINE 4:	ENDOWMENT FUNDS DISTRIBUTE INCOME FOR PURPOSES OF CAPITAL INVESTMENT. TEMPORARY ENDOWMENTS ARE USED BASED ON THE INTENT OF THE DONATION WHICH IS TYPICALLY FOR CAPITAL INVESTMENTS.
PART X, LINE 2:	THE HOSPITAL QUALIFIES AS AN ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2016 AND 2015, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND NEW YORK STATE TAXING AUTHORITIES ARE 2013 THROUGH 2016.
PART VI, LINE 1E	OTHER INCLUDES $302,583 FOR ITEMS NOT PLACED IN SERVICE ON 12/31/2016.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	300.000000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	0	FPGReferenceDiscountedCareInd
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	179	PersonsServedCnt
Total Community Benefit Expns	$204,955	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$112,945	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$92,010	NetCommunityBenefitExpnsAmt
Total Expense	0.00300	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	14510	PersonsServedCnt
Total Community Benefit Expns	$6,704,007	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,245,687	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,458,320	NetCommunityBenefitExpnsAmt
Total Expense	0.08070	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Persons Served	14689	PersonsServedCnt
Total Community Benefit Expns	$6,908,962	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,358,632	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,550,330	NetCommunityBenefitExpnsAmt
Total Expense	0.08370	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$50,109	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$554	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$49,555	NetCommunityBenefitExpnsAmt
Total Expense	0.00160	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Persons Served	33	PersonsServedCnt
Total Community Benefit Expns	$42,122	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$42,122	NetCommunityBenefitExpnsAmt
Total Expense	0.00140	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Persons Served	2823	PersonsServedCnt
Total Community Benefit Expns	$673,044	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$336,096	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$336,948	NetCommunityBenefitExpnsAmt
Total Expense	0.01110	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Persons Served	2856	PersonsServedCnt
Total Community Benefit Expns	$765,275	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$336,650	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$428,625	NetCommunityBenefitExpnsAmt
Total Expense	0.01410	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Persons Served	17545	PersonsServedCnt
Total Community Benefit Expns	$7,674,237	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,695,282	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,978,955	NetCommunityBenefitExpnsAmt
Total Expense	0.09780	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,560	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,560	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$52,497	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$52,497	NetCommunityBenefitExpnsAmt
Total Expense	0.00170	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$57,057	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$57,057	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,696,598	BadDebtExpenseAmt
Bad Debt Expense Attributable	$6,504	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$8,388,923	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$8,579,823	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$190,900	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LITTLE FALLS HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	140 BURWELL STREET	AddressLine1Txt
City	LITTLE FALLS	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13365	ZIPCd

Field	Value	IRS element (for citing)
Website Address	BASSETT.ORG	WebsiteAddressTxt
State License	2129700H	StateLicenseNum
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	INCLUDES 25 INPATIENT BEDS,	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	LITTLE FALLS HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	16	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.BASSETT.ORG	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	WWW.BASSETT.ORG	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.BASSETT.ORG	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	300.000000000000	FPGFamilyIncmLmtFreeCarePct
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	LFHNY.ORG	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	LFHNY.ORG	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	LFHNY.ORG	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION A:	LITTLE FALLS HOSPITAL HAS PRIMARY CARE HEALTH CENTERS IN DOLGEVILLE, NY (ZIP CODE 13329) AND NEWPORT, NY (ZIP CODE 13416). EXTENDED EVENING HOURS ARE PROVIDED TWO NIGHTS PER WEEK IN THE DOLGEVILLE, NY PRIMARY CARE CENTER.
LITTLE FALLS HOSPITAL	PART V, SECTION B, LINE 5: LITTLE FALLS HOSPITAL COLLABORATED WITH BASSETT RESEARCH INSTITUTE'S MOHAWK VALLEY POPULATION HEALTH IMPROVEMENT PROGRAM AND HERKIMER COUNTY PUBLIC HEALTH TO IDENTIFY STAKEHOLDERS FOR COMPLETING THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT. THE RESULT WAS 135 REPRESENTATIVES FROM VARIOUS CONSTITUENCIES WERE INCLUDED IN A SURVEY PROCESS TO IDENTIFY THEIR TOP TWO HEALTH PRIORITIES. THE PARTICIPANTS WERE SENIOR SERVICES, BEHAVIORAL SERVICES, LOCAL BUSINESS'S, EARLY CHILDHOOD SERVICES, EDUCATION, EMPLOYMENT TRAINING, FAITH BASED ORGANIZATIONS, HEALTH CARE PROVIDERS, HOUSING SERVICES, IMMIGRANT AND REFUGEE SERVICES, DEVELOPMENTAL DISABILITIES, LAW ENFORCEMENT, MUNICIPAL GOVERNMENTS, SOCIAL SERVICES, AND STI/HIV PREVENTION.
LITTLE FALLS HOSPITAL	PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS DEVELOPED AS PART OF A MULTI-HOSPITAL PLANNING PROCESS. THE HOSPITALS INCLUDED IN THIS PLANNING PROCESS ARE: BASSETT MEDICAL CENTER AND LITTLE FALLS HOSPITAL.
LITTLE FALLS HOSPITAL	PART V, SECTION B, LINE 6B: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) INLCUDED COMMUNITY ORGANIZATIONS SUCH AS: HERKIMER COUNTY PUBLIC HEALTH, HERKIMER HEALTHNET, HERKIMER COUNTY MENTAL HEALTH, BASSETT MEDICAL CENTER, LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS, MOHAWK VALLEY POPULATION HEALTH IMPROVEMENT PROGRAM, AND CANCER CENTER SERVICES OF ONEIDA, MADISON, AND HERKIMER COUNTY.
LITTLE FALLS HOSPITAL	PART V, SECTION B, LINE 11: LITTLE FALLS HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WORKING WITH COMMUNITY STAKEHOLDERS WILL CONTINUE TO FOCUS ON PREVENTING CHRONIC DISEASE WITH AN EMPHASIS ON PREVENTATIVE CARE MANAGEMENT IN BOTH CLINICAL AND COMMUNITY SETTINGS. SPECIFIC FOCUS FOR INTERVENTIONS IS ON DIABETES AND HEART DISEASE CHRONIC CARE CONDITIONS. ADDITIONALLY, LITTLE FALLS HOSPITAL WILL ADDRESS REDUCING OBESITY IN ADULTS AND CHILDREN. LITTLE FALLS HOSPITAL WILL ALSO PARTNER WITH HERKIMER COUNTY PUBLIC HEALTH TO STRENGTHEN MENTAL HEALTH AND SUBSTANCE ABUSE PREVENTION SERVICES. CHRONIC CARE PREVENTION PLAN ENCOMPASSES INCREASING SCREENING RATES BY 5% FOR CARDIOVASCULAR DISEASE, DIABETES, BREAST, CERVICAL, AND COLORECTAL CANCERS, ESPECIALLY AMONG LOWER INCOME POPULATIONS. TO ACCOMPLISH THESE RESULTS, INCREASES OF AWARENESS FOR SCREENINGS IS A PRIORITY. COLLABORATION AMONG COMMUNITY BASED ORGANIZATIONS AND INCREASING THE NUMBER OF SCREENING PROGRAMS HAVE BEEN IDENTIFIED AS KEY COMPONENTS TO MEET THE TARGET PERFORMANCE INCREASE OF 5% RECEIVING SCREENING SERVICES. THESE EFFORTS INCLUDE USE OF MEDIA TO IMPROVE PUBLIC AWARENESS OF ACCESS FOR SCREENING SERVICES, USE OF CLINICAL EDUCATORS ON THE BENFITS OF HEALTH SCREENINGS, AND PARTNERING WITH PROVIDERS TO IMPROVE THEIR USE OF SCREENINGS FOR CHRONIC CARE ILLNESS. THE INCREASE IN FOCUS OF REDUCING CHILD AND ADULT OBESITY WAS ALSO IDENFIED AS A PRIORITY IN THE 2016 CHNA. THE TARGET OBJECTIVE IS A 5% INCREASE FOR CLINICAL PROVIDERS TO PERFORM WEIGHT ASSESSMENTS TO IDENTIFY PATIENTS AT RISK FOR OBESITY. PRIMARY CARE PROVIDERS WILL BE TRAINED ON APPROACHES FOR WEIGHT IMPROVEMENT PROGRAMS. LITTLE FALLS HOSPITAL WILL PARTNER WITH HERKIMER COUNTY PUBLIC HEALTH ON STRENGTHENING RESOURCES AVAILABLE FOR MENTAL HEALTH BEHAVIORAL PATIENTS. MENTAL HEALTH SERVICES ARE CURRENTLY UNDERSTAFFED WITH CLINICAL PROVIDERS IN OUR SERVICE AREA. WORKING WITH THE LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS, PRIMARY CARE PROVIDERS ARE PERFORMING MENTAL HEALTH SCREENINGS AND TRACKING INFORMATION IN THE ELECTRONIC HEALTH RECORD. THIS ALLOWS FOR PRIMARY CARE AND MENTAL HEALTH PROVIDERS TO COLLABORATE ON MEDICAL AND MENTAL HEALTH CARE PLANS. LITTLE FALLS HOSPITAL, BASSETT MEDICAL CENTER, AND HERKIMER COUNTY PUBLIC HEALTH ARE COORDIANTING RECRUITMENT OF ADDITIONAL MENTAL HEALTH PROVIDERS. LITTLE FALLS HOSPITAL IS A PARTNER IN THE LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS (LHCP), LLC. THIS ORGANIZATION REPRESENTS A REGIONAL ORGANIZATION, ESTABLISHED IN PARTNERSHIP WITH NYS DEPARTMENT OF HEALTH, UNDER A CMS REFERENCED DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) PROGRAM. THIS PROGRAM IS DESIGNED FOR CARE TRANSITION TEAMS TO WORK ON ELEVEN PROJECTS FOR THE PURPOSE OF REDUCING UNNECCESSARY VISITS TO EMERGENCY DEPARTMENTS AND UNNECCESSARY INPATIENT ADMISSIONS. IN 2016, OUR INTIATIVES FOR THE CHNA AND DSRIP WERE AS FOLLOWS:1.)ORGANIZING THE DOLGEVILLE AND NEWPORT HEALTH CENTERS AS "PATIENT CENTERED MEDICAL HOMES" (PCMH). ACHIEVING PCMH WILL BE COMPLETED IN 2017 BASED ON AN APPLICATION PROCESS AND APPROVAL BY A NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA). DURING THIS APPLICATION PROCESS, FOCUS ON PATIENT CASE MANAGEMENT, CARE COORDINATION, TEAM-BASED CARE, AND IMPROVING USES OF THE ELECTRONIC HEALTH RECORD, ARE MAJOR PERFORMANCE IMPROVEMENTS FOR PATIENT CARE. IN 2016, OUR HEALTH CENTERS PERFORMED APPROXIMATELY 1,000 WELLNESS VISITS FOR PATIENTS IN ALL AGE CLASSIFICATIONS. 2.)EDUCATING HEALTH CENTER PROVIDERS ON USING ASTHMA TREATMENT PLANS TO SUPPORT PATIENTS. IMPROVE ACCESS TO ASTHMA SPECIALISTS WITH THE ELECTRONIC HEALTH RECORD FOR SHARING CARE PLANS. IN 2016, THE ELECTRONIC HEALTH RECORD ASTHMA TREATMENT TEMPLATES ARE BEING TRACKED FOR COMPLIANCE WITH PROTOCOLS. 3.) INTRODUCED THE NYS MEDICAID ACCELERATED EXCHANGE (MAX) PROCESS TO USE PATIENT CENTERED PROCESS'S TO REDUCE USE OF EMEGENCY DEPARTMENT BY CHRONIC CARE PATIENTS. LITTLE FALLS HEALTH CENTERS IN DOLGEVILLE AND NEWPORT PARTICIPATED IN THIS PROJECT AND IMPROVED THEIR CARE MANAGEMENT PLANS TO REDUCE EMERGENCY DEPARTMENT VISITS. WE HAVE IDENTIFIED THE DIFFICULTY IN RECRUITING PRIMARY CARE AND UNDERSTAFFED MENTAL HEALTH PROVIDERS IN OUR REGION AS A BARRIER TO MEETING OUR CHNA GOALS. THIS SHORTAGE OF PROVIDERS IS BEING ADDRESSED IN RECRUIMENT PLANS IN COORDINATION WITH BASSETT MEDICAL CENTER, HERKIMER COUNTY PUBLIC HEALTH, AND LITTLE FALLS HOSPITAL.
LITTLE FALLS HOSPITAL	PART V, SECTION B, LINE 20E: LITTLE FALLS HOSPITAL PROVIDED MAILING INFORMATION TO UNINSURED PATIENTS FOR ENROLLING IN AN AFFORDABLE CARE ACT INSURANCE PRODUCT SPONSORED BY THE NYS HEALTH MARKETPLACE. LITTLE FALLS HOSPITAL ALSO ASSISTED PATIENTS WITH THE COMPLETION OF APPLICATIONS FOR ENROLLMENT INTO NYS MARKETPLACE PLANS. IN 2016, 35 PATIENTS WERE ENROLLED BY A LITTLE FALLS HOSPITAL EMPLOYED FACILITATOR INTO A NYS MARKETPLACE PLAN.

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - DOLGEVILLE HEALTH CENTER
9 GIBSON STREET	DOLGEVILLE	NY	13329	CLINIC
2 - NEWPORT HEALTH CENTER
BRIDGE STREET	NEWPORT	NY	13416	CLINIC

Supplemental Information Detail SupplementalInformationDetail (15 entries)

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PART I, LINE 3C:	LITTLE FALLS HOSPITAL DID NOT PROVIDE CHARITY CARE OR DISCOUNTED CARE TO PATIENTS WITH INSURANCE BENEFITS.
PART I, LINE 7:	COST FOR CHARITY CARE PATIENTS WAS CALCULATED USING RATIO OF COST TO CHARGES. COST ASSOCIATED WITH MEDICAID AND MEDICAID HMO PROGRAMS REPRESENTS AGGREGATE ALLOWABLE COST AND TOTAL GROSS CHARGES USED TO CALCULATE A FACILITY LEVEL COST TO CHARGE RATIO. THIS FACILITY LEVEL COST TO CHARGE RATIO WAS APPLIED TO TOTAL MEDICAID AND MEDICAID HMO CHARGES TO ARRIVE AT TOTAL MEDICAID COST.
PART I, LINE 7G:	LITTLE FALLS HOSPITAL OPERATES TWO PRIMARY CARE HEALTH CENTERS LOCATED IN DOLGEVILLE AND NEWPORT NEW YORK. THESE CENTERS PROVIDE PRIMARY CARE SERVICES INCLUDING VACCINATIONS, WELL CARE VISITS, AND PRIMARY CARE FOLLOW-UP APPOINTMENTS. USING AN ELECTRONIC HEALTH RECORD ENABLES PATIENTS TO HAVE ACCESS TO THEIR PERSONAL HEALTH INFORMATION IN A TIMELY MANNER. THROUGH AN ELECTONIC HEALTH RECORD SYSTEM, PATIENTS CAN ELECT TO HAVE PORTAL ACCESS FOR PORTIONS OF THEIR PERSONAL HEALTH INFORMATION. IN 2016, THESE HEALTH CENTERS BEGAN AN APPLICATION TO BE RECOGNIZED AS PATIENT CENTERED MEDICAL HOME UNDER THE NATIONAL COMMITTEE OF QUALITY ASSURANCE (NCQA) STANDARDS.
PART I, LN 7 COL(F):	LITTLE FALLS HOSPITAL EXCLUDED $1,696,598 OF BAD DEBT EXPENSE TO CALCULATE COST OF PATIENT CARE. BAD DEBT IS REPORTED AS A FUNCTIONAL PROGRAM EXPENSE.
PART II, COMMUNITY BUILDING ACTIVITIES:	COMMUNITY BUILDING ACTIVITIES ARE ASSOCIATED WITH LITTLE FALLS HOSPITAL WORKING WITH COMMUNITY BUSINESSES THROUGH OUR MEMBERSHIP WITH LOCAL AGENCIES, SUCH AS THE HERKIMER CHAMBER OF COMMERCE, HERKIMER COUNTY HEALTHNET, AMERICAN HEART ASSOCIAITON AND THE AREA HEALTH EDUCATION CENTERS (AHEC). THESE ACTIVITIES ALLOW FOR DIALOG ON CURRENT HEALTHCARE TOPICS, INSURANCE PROGRAMS, AND RECRUITMENT OF FUTURE EMPLOYEES. LITTLE FALLS HOSPITAL COLLABORATES WITH BASSETT MEDICAL CENTER ON RECRUITMENT INITIATIVES FOCUSING ON PRIMARY CARE. HERKIMER COUNTY HAS ONE OF THE LOWEST RATIO'S OF PRIMARY CARE PROVIDERS TO RESIDENTS IN NEW YORK STATE. IN 2016, WE HAD SUCCESS IN RECRUITING ONE NEW PHYSICIAN. LITTLE FALLS HOSPITAL ALSO SUPPORTED TWO EMPLOYEES TO BECOME NURSE PRACTITIONERS AND WHO WILL REMAIN IN OUR SERVICE AREA WHEN TRAINING IS COMPLETED.
PART III, LINE 3:	AN ESTIMATE FOR POTENTIAL CHARITY CARE WAS BASED ON THE DENIED APPLICATIONS PROCESSED IN 2016 COMPARED WITH THOSE APPROVED APPLICATIONS. THIS AMOUNTED TO A 5.5% DENIAL RATE FOR CHARITY CARE APPLICATIONS WHICH IF APPROVED WOULD HAVE INCREASED THE AMOUNT OF CHARITY CARE AT COSTED AMOUNTS BY $6,504.
PART III, LINE 4:	THE HOSPITAL FOOTNOTE DESCRIBING PATIENT ACCOUNTS RECEIVABLES IS IN THE ATTACHED AUDITED FINANCIAL STATEMENTS NOTE (1)(L) PAGES 8 - 10.
PART III, LINE 8:	IN 2016, OUR OPERATING DEFICIT, WITH THE MEDICARE PART A&B PROGRAMS, WAS $190,900. MEDICARE REPRESENTS APPROXIMATELY 33% OF OUR TOTAL REVENUE. (NOTE: EXCLUDING MEDICARE PART C AND D) LITTLE FALLS HOSPITAL IS A CRITICAL ACCESS HOSPITAL (CAH) WHICH IS PAID BY MEDICARE BASED ON COST OF CARE. THIS SHORTFALL IS DIFFICULT TO FUND WHEN CONSIDERING OUR ADDITIONAL MEDICAID DEFICIT OF APPROXMIATELY $2.5M. OUR SAFETY NET HOSPITAL STATUS INDICATES WE ARE A NYS RURAL PROVIDER WITH A GREATER THAN 30% THRESHOLD FOR MEDICAID UTILIZATION OF OUR SERVICES. OUR HIGH VOLUME OF MEDICAID IS REPRESENTED ON IRS FORM 990 SCHEDULE H LINE 7B.
PART III, LINE 9B:	OUR COLLECTION AND CHARITY CARE POLICY SPECIFIES THAT ACCOUNTS WITH ACTIVE CHARITY CARE APPLICATIONS WILL NOT GO TO COLLECTION AGENCIES WHILE IN REVIEW.
PART VI, LINE 2:	BASSETT RESEARCH INSTITUTE'S MOHAWK VALLEY POPULATION HEALTH IMPROVEMENT PROGRAM (MVPHIP), A GRANT FUNDED PROGRAM FROM NEW YORK STATE DEPARTMENT OF HEALTH, CONDUCTED AN ASSESSMENT ON BEHALF OF BASSETT HEALTHCARE NETWORK'S LITTLE FALLS HOSPITAL AND THE HERKIMER COUNTY PUBLIC HEALTH. THE COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES THE HOSPITAL, LOCAL COUNTY HEALTH DEPARTMENT AND STAKEHOLDERS WITH DATA AND KEY INFORMANT SURVEY RESPONSES SO THAT THEY MAY IDENTIFY, PRIORITIZE AND ADDRESS HEALTH CARE CHALLENGES FACING THEIR COMMUNITIES. UTILIZING THE NEW YORK STATE'S PREVENTION AGENDA 2013-2018 THE HOSPITALS, LOCAL COUNTY HEALTH DEPARTMENT AND STAKEHOLDERS CAN SELECT INTERVENTIONS WHICH TARGET THOSE IDENTIFIED NEEDS.THE HERKIMER COUNTY PUBLIC HEALTH TEAM IS DEDICATED TO THE PROTECTION AND PROMOTION OF RESIDENT'S HEALTH THROUGH THE PROVISION OF HIGH QUALITY, COMPREHENSIVE, INDIVIDUALIZED SERVICES, IN ALL PHASES OF THE LIFE CYCLE. OBJECTIVES SHALL INCLUDE SURPASSING COMMUNITY STANDARDS AND STRIVING TO MEET THE NEEDS AND EXPECTATIONS OF THE PEOPLE IN HERKIMER COUNTY. ALL AVAILABLE RESOURCES WILL BE UTILIZED TO INSURE THE MISSION STATEMENT IS CARRIED OUT. STAFF, PATIENT AND FAMILY EDUCATION WILL BE PROVIDED WHILE OPEN AND CONTINUOUS QUALITY IMPROVEMENT WILL BE ENCOURAGED AND RECOGNIZED.MVPHIP COLLABORATED WITH THE LOCAL HEALTH DEPARTMENT AND HOSPITAL TO COMPILE A LIST OF KEY INFORMANTS IN THE SERVICE REGION. THOSE KEY INFORMANTS REPRESENT A BROAD RANGE OF SECTORS, COMMUNITY INTERESTS AND INCLUDED ORGANIZATIONS WHICH REPRESENT THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. THE KEY INFORMANTS WERE INVITED TO PARTICIPATE IN ONLINE SURVEY FROM JULY THROUGH SEPTEMBER 9, 2016.IN ADDITION TO THE KEY INFORMANT RESPONSES, THE ASSESSMENT INCLUDES QUANTITATIVE DATA SOURCES FROM OVER 300 DIFFERENT HEALTH INDICATORS COLLECTED AND PUBLISHED BY NEW YORK STATE, AS WELL AS, 175 HEALTH INDICATORS INCLUDED ON THE MVPHIP WEBSITE COMPILED BY HEALTHY COMMUNITIES INSTITUTE. THE MVPHIP WEBSITE BRINGS NON-BIASED DATA, LOCAL RESOURCES, AND REPORTING TOOLS TO ONE ACCESSIBLE, USER-FRIENDLY LOCATION. THE SITE INCLUDES A COMPREHENSIVE DASHBOARD OF COMMUNITY INDICATORS COVERING OVER 20 TOPICS IN THE AREAS OF HEALTH, SOCIAL DETERMINANTS OF HEALTH, AND QUALITY OF LIFE.STAKEHOLDERS HAD TWO OPPORTUNITIES TO IDENTIFY HEALTH PRIORITIES. FIRST IN COLLABORATION WITH LITTLE FALLS HOSPITAL AND THE HERKIMER COUNTY PUBLIC HEALTH, THE MVPHIP CONVENED A LOCAL STAKEHOLDER MEETING IN SEPTEMBER 2016 TO EXAMINE THE DATA AND TO SELECT THE TOP TWO PREVENTION AGENDA PRIORITIES FOR THE SERVICE REGION. DURING THE MEETING STAKEHOLDERS RANKED THE HEALTH CARE PRIORITIES FIRST BY THE NUMBER OF PEOPLE AFFECTED AND THEN BY THE AVAILABLE COMMUNITY RESOURCES TO IMPACT THESE IDENTIFIED NEEDS. SECOND, PRIOR TO THE STAKEHOLDER MEETING KEY INFORMANTS RANKED THEIR PRIORITIES IN THE SURVEY.BASED ON THE KEY INFORMANT SURVEY RESULTS, PARTICIPANTS RANKED PROMOTION OF MENTAL HEALTH AND PREVENTION OF SUBSTANCE ABUSE NUMBER ONE AND PREVENTION OF CHRONIC DISEASE RANKED NUMBER TWO. AFTER SELECTING THE PRIORITIES, SURVEY PARTICIPANTS WERE ASKED TO RANKED THEIR TOP FIVE FOCUS AREAS FROM ALL OF THE PREVENTION AGENDA PRIORITIES.BASED ON THE SURVEY RESULTS, THE FOLLOWING TOP FIVE FOCUS AREAS ARE TIED TO THE TOP TWO SELECTEDPRIORITIES:1. PROMOTING MENTAL, EMOTIONAL AND BEHAVIORAL HEALTH2. PREVENTING SUBSTANCE ABUSE3. REDUCING OBESITY IN ADULTS AND CHILDREN4. PREVENTING DIABETES AND RELATED RISK FACTORS5. PREVENTING HEART DISEASEIN 2012, THE NEW YORK STATE PUBLIC HEALTH AND HEALTH PLANNING COUNCIL'S PUBLIC HEALTH COMMITTEE SET UP AN AD HOC COMMITTEE TO DEVELOP A FIVE YEAR STATE HEALTH IMPROVEMENT PLAN. THE COMMITTEE ASSESSED THE CURRENT HEALTH STATUS OF NEW YORK STATE'S POPULATION, AND THE PROGRESS TO DATE ON PREVENTION AGENDA 2008-2012 GOALS. THE COMMITTEE DEVELOPED FIVE PRIORITY SPECIFIC ACTION PLANS TO BE USED AS THE BLUEPRINT BY LOCAL HEALTH DEPARTMENTS AND HOSPITALS TO IMPROVE THE HEALTH OF NEW YORKERS AND MARCH 15, 2015 AN ADDITIONAL ACTION PLAN WAS ADDED TO IMPROVE HEALTH AND REDUCE HEALTH DISPARITIES. THE SIX ACTION PLANS PRIORITIES ARE:1. IMPROVE HEALTH STATUS AND REDUCE HEALTH DISPARITIES2. PREVENT CHRONIC DISEASES3. PROMOTE A HEALTHY AND SAFE ENVIRONMENT4. PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN5. PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE6. PREVENT HIV, SEXUALLY TRANSMITTED DISEASES, VACCINE-PREVENTABLE DISEASES AND HEALTHCARE-ASSOCIATED INFECTIONSEACH ACTION PLAN INCLUDES SPECIFIC FOCUS AREAS, GOALS AND INTERVENTIONS ALONG WITH HEALTH INDICATORS TO MEASURE PROGRESS TOWARD ACHIEVING THE GOALS, INCLUDING REDUCING HEALTH DISPARITIES FOR INDIVIDUALS WITH LOW SOCIO-ECONOMIC STATUS, DISABILITIES, RACIAL AND ETHNIC GROUPS, AS WELL AS OTHER POPULATIONS WHO EXPERIENCE THEM.COMMUNITY ASSETS AND RESOURCES:A. NEW YORK STATE HEALTH CARE TRANSFORMATION INITIATIVES:NEW YORK STATE DEPARTMENT OF HEALTH HAS MULTIPLE INITIATIVES TO ACHIEVE THE "TRIPLE AIM." THE TRIPLE AIM FOCUSES ON THREE DIMENSIONS: IMPROVING PATIENT EXPERIENCE, IMPROVING POPULATION HEALTH AND REDUCING HEALTH CARE COSTS. EACH OF THESE INITIATIVES CONTRIBUTES TO THE PURSUIT OF THOSE DIMENSIONS.ACCOUNTABLE CARE ORGANIZATIONS:ACCOUNTABLE CARE ORGANIZATIONS (ACOS) ARE GROUPS OF DOCTORS, HOSPITALS, AND OTHER HEALTH CARE PROVIDERS, WORKING TOGETHER TO PROVIDE HIGHER-QUALITY COORDINATED CARE TO THEIR PATIENTS, WHILE HELPING TO SLOW HEALTH CARE COST GROWTH. ACOS SHARE WITH MEDICARE SAVINGS GENERATED FROM LOWERING THE GROWTH IN HEALTH CARE COSTS WHEN THEY MEET STANDARDS FOR HIGH QUALITY CARE. BASSETT HEALTHCARE NETWORK'S BASSETT ACCOUNTABLE CARE PARTNERS, LLC WAS SELECTED AS ONE OF 89 NEW MEDICARE SHARED SAVING PROGRAMS BEGINNING JANUARY 1, 2015. LITTLE FALLS HOSPITAL IS A BASSETT ACCOUNTABLE CARE PARTNERS, LLC PARTICIPANT.DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) PROGRAMSON APRIL 14, 2014 GOVERNOR CUOMO ANNOUNCED THAT CENTER OF MEDICAID AND MEDICARE SERVICES APPROVED NEW YORK'S WAIVER REQUEST TO REINVEST THE $8 BILLION GENERATED BY MEDICAID REDESIGN TEAM (MRT) REFORMS. DSRIP'S PURPOSE IS TO FUNDAMENTALLY RESTRUCTURE THE HEALTH CARE DELIVERY SYSTEM BY REINVESTING IN THE MEDICAID PROGRAM, WITH THE PRIMARY GOAL OF REDUCING AVOIDABLE HOSPITAL USE BY 25% OVER 5 YEARS. EACH DSRIP PROJECT HAS SPECIFIC MILESTONES AND METRICS WITH AN INCENTIVE BASED PAYMENT MODEL THAT ALLOCATES PAYOUT UPON ACHIEVING PREDEFINED RESULTS IN SYSTEM TRANSFORMATION, CLINICAL MANAGEMENT AND POPULATION HEALTH. ADDITIONALLY, A NUMBER OF QUALITY GOALS MUST BE ACHIEVED INCLUDING ACCESS MEASURES, PREVENTIVE CARE AND CARE COORDINATION. THE DSRIP PROGRAM COVERS A FIVE-YEAR PERIOD BEGINNING APRIL 1, 2015 AND ENDING MARCH 31, 2020.LITTLE FALLS HOSPITAL AND HERKIMER COUNTY PUBLIC HEALTH ARE PARTICIPATING PARTNERS IN BASSETT HEALTHCARE NETWORK'S LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS (LCHP) PPS. LCHP INCLUDES PROVIDERS AND COMMUNITY BASED ORGANIZATIONS FROM DELAWARE, HERKIMER, MADISON, OTSEGO AND SCHOHARIE COUNTIES.POPULATION HEALTH IMPROVEMENT PROGRAMS:THE POPULATION HEALTH IMPROVEMENT PROGRAMS (PHIP) WILL PROMOTE THE TRIPLE AIM OF: BETTER CARE, BETTER POPULATION HEALTH AND LOWER HEALTH CARE COSTS BY CONVENING REGIONAL STAKEHOLDERS AND ESTABLISHING NEUTRAL FORUMS FOR IDENTIFYING, DISSEMINATING, AND IMPLEMENTING BEST PRACTICES AND STRATEGIES TO PROMOTE POPULATION HEALTH AND REDUCE HEALTH CARE DISPARITIES IN THEIR RESPECTIVE REGIONS. THE PHIP WILL HELP ACHIEVE IMPROVEMENTS IN POPULATION HEALTH THROUGH STAKEHOLDER COLLABORATION, DATA-DRIVEN PRIORITIZATION, AND REGIONAL STRATEGIES FOR ADDRESSING HEALTH DISPARITIES. THE PHIP SUPPORTS AND ADVANCES THE ONGOING ACTIVITIES OF NEW YORK STATE PREVENTION AGENDA AND THE STATE HEALTH INNOVATION PLAN, AS WELL AS, SERVES AS A RESOURCE FOR THE LOCAL PERFORMING PROVIDERS SYSTEMS.LITTLE FALLS HOSPITAL AND HERKIMER COUNTY PUBLIC HEALTH ARE ACTIVE MEMBERS OF THE MOHAWK VALLEY PHIP BOARD. THE BASSETT HEALTHCARE NETWORK'S BASSETT RESEARCH INSTITUTE IS THE CONTRACTOR FOR THE MOHAWK VALLEY PHIP WHICH COMPRISES FULTON, HERKIMER, MONTGOMERY, OTSEGO AND SCHOHARIE COUNTIES. FOLLOWING A CAREFUL REVIEW OF LOCAL HEALTH DATA AND EXTENSIVE DISCUSSION, THE MOHAWK VALLEY PHIP BOARD AND STAKEHOLDERS HAVE IDENTIFIED TWO REGIONAL POPULATION HEALTH PRIORITIES OF BEHAVIORAL HEALTH AND OBESITY. WORKGROUPS WERE FORMED TO TACKLE THESE HEALTH PRIORITIES.NY STATE HEALTH INNOVATION PLAN AND STATE INNOVATION MODEL:STATE HEALTH INNOVATION PLAN (SHIP) DRIVES THE EVOLUTION OF HEALTH DELIVERY AND PAYMENT SYSTEMS. THE GOAL IS TO IDENTIFY AND STIMULATE PROMISING INNOVATIONS IN HEALTH CARE DELIVERY AND PAYMENT WHICH RESULT IN OPTIMAL HEALTH OUTCOMES FOR ALL NEW YORKERS.THIS INFORMATION IS FROM LITTLE FALLS HOSPITAL 2016 COMMUNITY HEALTH NEEDS ASSESSMENT.
PART VI, LINE 3:	LITTLE FALLS HOSPITAL PROVIDES ACCESS AND EDUCATION ON THE COMMUNITY SERVICE PROGRAM WITH CONTACT INFORMATION FOR PATIENTS TO CALL AND MAKE APPOINTMENTS FOR COMPLETING INFORMATION FOR CHARITY CARE. AT ALL PATIENT ACCESS LOCATIONS, APPLICATIONS FOR CHARITY CARE ASSISTANCE ARE AVAILABLE. THE WWW.BASSETT.ORG WEBSITE INCLUDES A LINK ON INFORMATION FOR COMPLETING AN APPLICATION AND OTHER RESOURCES CALLED "FINANCIAL ASSISTANCE RESOURCE GUIDE". OUR FINANCIAL ASSISTANCE COORDINATOR PROVIDES INSURANCE COVERAGE NAVIGAITON SERVICES TO ASSIT RESIDENTS WITH ENROLLMENT IN GOVERMENT SPONSORED HEALTH CARE COVERAGE PROGRAMS. A COMMUNITY NAVIGATOR IS ALSO PRESENT IN THE EMERGENCY DEPARTMENT TO ASSIST WITH APPLICATIONS FOR GOVERMENT SPONSORED HEALTH CARE COVERAGE PROGRAMS OR TO COMPLETE APPLICATIONS FOR OUR CHARITY CARE PROGRAM.
PART VI, LINE 4:	LITTLE FALLS HOSPITAL SERVES AN ESTIMATED POPULATION OF OVER 54,000 PEOPLE IN 10 COMMUNITIES THROUGHOUT HERKIMER COUNTY, AND SECTIONS OF FULTON AND MONTGOMERY COUNTIES. THE SERVICE AREA POPULATION IS COMPRISED OF INDIVIDUALS AND FAMILIES FROM ALL SOCIO-ECONOMIC AND EDUCATIONAL LEVELS. THE POPULATION IS 96 PERCENT WHITE, 51 PERCENT FEMALE AND 49 PERCENT MALE. THE AGE DISTRIBUTION OF THE POPULATION IS SIMILAR TO OTHER UPSTATE NEW YORK AREAS WITH 5.4 PERCENT OF THE POPULATION UNDER 5 YEARS OF AGE, 21 PERCENT UNDER THE AGE OF 18, AND 19.2 PERCENT AGED 65 AND OLDER. NEARLY 89 PERCENT OF THE POPULATION OVER 25 HAS GRADUATED FROM HIGH SCHOOL. PER CAPITA INCOME LEVELS ARE $16,141, LOWER THAN NEW YORK STATE'S AVERAGE OF $23,389 AND MEDIAN HOUSEHOLD INCOME OF $40,106 ARE ALSO BELOW THE STATE MEDIAN OF $55,980. IT'S ESTIMATED THAT 16 PERCENT OF THE POPULATION IS BELOW THE FEDERAL POVERTY LEVEL. HEALTH CARE DELIVERY IS NEGATIVELY AFFECTED BY THE LACK OF PRIMARY CARE PROVIDERS. THERE IS CURRENTLY 41 PRIMARY CARE PROVIDERS PER 100,000 POPULATION IN HERKIMER COUNTY COMPARED WITH NYS AVERAGE OF 83 PROVIDERS PER 100,000 POPULATION. THIS SHORTAGE CONTRIBUTES TO LOWER HEALTH CARE STATUS INDICATORS OF, INCREASES IN RESPIRATORY DISEASE, HIGHER CANCER RATES AND MORE PREVALANCE OF ARTHRITUS. THE HIGHER USE OF TOBACCO AND ALCOHOL ALSO ARE ATTRIBUTES FOR THESE HEALTH INDICATORS.
PART VI, LINE 5:	LITTLE FALLS HOSPITAL IMPLEMENTS COORDINATED HEALTH CARE RESOURCES WITH BASSETT HEALTHCARE NETWORK. THIS COLLABORATION INCLUDED PLANNING AND IMPLEMENTING INITIATIVES UNDER A NEW YORK STATE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) PROJECT. DSRIP ACTIVITIES ARE COORDINATED WITH COMMUNITY BASED ORGANIZATIONS TO DEVELOP CARE IMPROVEMENT PROGRAMS IN A COORDINATED MANNER. IN 2016, LITTLE FALLS HOSPITAL WAS THE LEAD AGENCY IN DEVELOPING CARE INTERVENTIONS FOR REDUCING THE USE OF EMERGENCY DEPARTMENT. THE PROGRAM TITLED MEDICAID ACCELERATED EXCHANGE IS TO DEVELOP INNOVATIVE CARE INTERVENTIONS TO PROVIDE SUPPORT TO PATIENTS HIGH DEPENDENCY UPON EMERGENCY DEPARTMENT SERVICES FOR CARE MORE APPROPRIATE IN A PRIMARY CARE CSETTING. THIS PROGRAM RESULTED IN A REDUCTION FOR EMERGENCY DEPARTMENT USAGE OF APPROXIMATELY 39% FOR PATIENTS IN THIS REVIEW REPRESENTING 225 FEWER EMERGENCY DEPARTMENT VISITS ON AN ANNUAL BASIS. THIS PROGRAM SUCCESS IS ATRIBUTABLE TO COMMUNITY AGENCIES AND HEALTHCARE PROVIDERS COLLABORATING TO SUPPORT SUSTAINABLE IMPROVEMENTS IN CARE DELIVERY MODELS.
PART VI, LINE 6:	LITTLE FALLS HOSPITAL IS A SUBSIDIARY OF BASSETT HEALTHCARE NETWORK THAT PROVIDES HEALTH SERVICES IN MORE THAN 20 COMMUNITIES SPANNING 5,600 SQUARE MILES AND SEVEN COUNTIES. THE NETWORK FOCUSES ITS COMMUNITY SERVICES PROGRAMS IN THE COUNTIES WHERE THE SIX AFFILIATED HOSPITALS AND GREATEST PATIENT POPULATIONS ARE LOCATED. OTSEGO COUNTY - POPULATION 61,709; DELAWARE COUNTY - POPULATION 47,276; HERKIMER COUNTY - POPULATION 64,508; SCHOHARIE COUNTY - POPULATION 32,099 (ACCORDING TO THE 2012 U.S. CENSUS ESTIMATES). THE MARY IMOGENE BASSETT HOSPITAL, AN ACUTE CARE INPATIENT TEACHING FACILITY IN COOPERSTOWN, OTSEGO COUNTY, O'CONNOR HOSPITAL, A CRITICAL ACCESS HOSPITAL IN DELHI, DELAWARE COUNTY, COBLESKILL REGIONAL HOSPITAL, AN ACUTE CARE FACILITY IN COBLESKILL, SCHOHARIE COUNTY, LITTLE FALLS HOSPITAL, A CRITICAL ACCESS HOSPITAL IN LITTLE FALLS, HERKIMER COUNTY, TRI TOWN REGIONAL HOSPITAL A 24/7 EMERGENCY CARE FACILITY IN SIDNEY, DELAWARE COUNTY, AUREILA OSBORN FOX MEMORIAL HOSPITAL, AN ACUTE CARE FACILITY IN ONEONTA, OTSEGO COUNTY, THE BASSETT CLINIC, AN OUTPATIENT PRIMARY AND SPECIALTY CARE CENTER IN COOPERSTOWN, A REGIONAL NETWORK OF OVER TWO DOZEN COMMUNITY BASED HEALTH CENTERS, 20 SCHOOL BASED HEALTH CENTERS, TWO AMBULATORY SURGERY CENTERS, VALLEY HEALTH SERVICES A RESIDENTIAL HEALTH CARE AND REHABILITATION FACILITY, AT HOME CARE, A CERTIFIED HOME CARE AGENCY AND FIRST COMMUNITY CARE OF BASSETT, AND A MEDICAL SUPPLY COMPANY, ALL OF WHICH MAKE UP THE BASSETT HEALTHCARE NETWORK AND PROVIDE HEALTH SERVICES TO THIS NINE COUNTY REGION IN CENTRAL NEW YORK.LITTLE FALLS HOSPITAL COLLABORATES WITH BASSETT HEALTHCARE NETWORK AND BASSETT MEDICAL CENTER TO COORDIANTE THE EFFICIENT DELIVERY OF HEALTHCARE IN OUR SERVICE AREA. THIS RELATIONSHIP HAS DEVELOPED OVER A PERIOD OF TWELVE YEARS AND CONTINUES TO PROVIDE RESIDENTS ACCESS TO A HIGH QUALITY CARE HEALTHCARE SYSTEM. OUR INTEGRATED ELECTRONIC HEALTH RECORD HAS ENABLED OUR PATIENTS TO RECEIVE IMPROVED COORDINDATED CARE AND ACCESS TO THEIR HEALTH INFORMATION NOT ROUTINELY SEEN IN RURAL HEALTH NETWORKS. OUR COLLABORTIVE PLANNING ON PROJECTS SUCH AS THE NYS DELIVERY SYSTEM REFORM INCENTIVE PAYMENT SYSTEM (DSRIP) AND RELATED MOHAWK VALLEY POPULATION HEALTH IMPROVEMENT PROGRAM ARE EXAMPLES OF OUR COLLABORATION TO IMPROVE THE HEALTHCARE SYSTEMS IN OUR SERVICE AREA. THE "TRIPLE AIM" FOR IMPROVING HEALTHCARE OF THE POPULATION, REDUCING HEALTHCARE COST, ENHANCING HEALTH ENCOUNTER EXPERIENCES, AND SUPPORTING HEALTHCARE WORKERS ENHANCES THIS COORDINATED HEALTH DELIVERY SYSTEM. THE "TRIPLE AIM" IS THE OUTLINE FOR THE DEVELOPMENT OF STRATEGIES AND ANNUAL OPERATING PLANS DEVELOPED BY BASSETT HEALTHCARE NETWORK.
PART VI, LINE 7, REPORTS FILED WITH STATES	NY

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
First Class Or Charter Travel	Yes (X)	FirstClassOrCharterTravelInd
Written Policy Ref T And E Expnss	0	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	0	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
AUGUST LEINHART MD
TRUSTEE	$0	$400,120	$0	$1,650	$0	$2,155	$0	$30,270	$0	$3,188	$0	$437,383	$0	$0
AMY GRACE MD
PRESIDENT OF MEDICAL STAFF	$0	$198,463	$0	$11,855	$0	$0	$0	$15,060	$0	$5,178	$0	$230,556	$0	$0
LISA BETRUS
THIRD VICE CHAIRMAN	$0	$188,229	$0	$0	$0	$0	$0	$9,558	$0	$6,777	$0	$204,564	$0	$0
MICHAEL TENGERES
TREASURER	$0	$399,917	$0	$30,000	$0	$0	$0	$0	$0	$1,157	$0	$431,074	$0	$0
MICHAEL OGDEN
PRESIDENT & CEO	$0	$178,000	$0	$0	$0	$1,064	$0	$15,440	$0	$763	$0	$195,267	$0	$0
RICHARD NOCELLA
PRIMARY CARE PHYSICIAN	$160,259	$0	$0	$0	$0	$0	$4,808	$0	$481	$0	$165,548	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 3	FormAndLineReferenceDesc
Explanation	THE COMPENSATION PROCESS FOR TOP OFFICIAL THE CHIEF EXECUTIVE OFFICER'S SALARY IS PAID BY A RELATED ORGANIZATION UNDER A MANAGEMENT SERVICES AGREEMENT. THE LITTLE FALLS HOSPITAL BOARD OF TRUSTEE'S REVIEWS THE FORMAL PROCESS THAT IS USED TO DETERMINE THE BASE COMPENSATION OF THE CEO. THE CEO WORK PLAN AND ACCOMPLISHMENTS FOR THE YEAR ARE REVIEWED. SALARY CHANGES ARE BASED ON MARKET, WORK PLAN, AND ACCOMPLISHMENTS. THE CEO'S SALARY IS SUBMITTED AS PART OF THE MANAGEMENT SERVICES AGREEMENT WHICH IS APPROVED BY THE BOARD OF TRUSTEES.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART V, LINE 3B	LITTLE FALLS HOSPITAL DID NOT HAVE ACTIVITY ASSOCIATED WITH UNRELATED BUSINESS INCOME.
FORM 990, PART VI, SECTION A, LINE 4	CHANGE IN OWNER OR SOLE CORPORATE MEMBER TO BASSETT HEALTHCARE NETWORK FROM BASSETT REGIONAL CORPORATION.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF THE HOSPITAL IS BASSETT HEALTHCARE NETWORK.
FORM 990, PART VI, SECTION A, LINE 7A	BASSETT HEALTHCARE NETWORK, AS THE SOLE MEMBER, HAS THE POWER TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11B	LITTLE FALLS HOSPITAL PRESENTS THE DRAFT 990 TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS PRIOR TO FILING. ANY QUESTIONS ARE RAISED AND ONCE APPROVED, THE 990 CAN BE FILED. A COMPLETE COPY OF THE ORGANIZATION'S FINAL FORM 990, INCLUDING ALL REQUIRED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, IS AVAILABLE TO EACH MEMBER OF THE BOARD BEFORE ITS FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST STATEMENTS ARE MADE ANNUALLY. NEW BOARD MEMBERS ARE REQUIRED TO DISCLOSE ON THEIR RESUME ALL AFFILIATED ORGANIZATIONS.
FORM 990, PART VI, SECTION B, LINE 15	THE CHIEF EXECUTIVE OFFICER'S SALARY IS PAID BY A RELATED ORGANIZATION UNDER A MANAGEMENT SERVICES AGREEMENT. THE LITTLE FALLS HOSPITAL BOARD OF TRUSTEES REVIEWS THE FORMAL PROCESS THAT IS USED TO DETERMINE THE BASE COMPENSATION OF THE CEO. THE CEO'S WORK PLAN AND ACCOMPLISHMENTS FOR THE YEAR ARE REVIEWED. SALARY CHANGES ARE BASED ON MARKET, WORKPLAN, AND ACCOMPLISHMENTS. THE CEO'S SALARY IS SUBMITTED AS PART OF THE MANAGEMENT SERVICES AGREEMENT WHICH IS APPROVED BY THE BOARD.
FORM 990, PART VI, SECTION C, LINE 19	LITTLE FALLS HOSPITAL MAKES AVAILABLE THE IRS FROM 990 UPON REQUEST ALONG WITH INFORMATION INCLUDED WITHIN THE 990 SUCH AS FINANCIAL REPORTS, CONFLICT OF INTEREST POLICY, AND CODE OF CONDUCT. THE HOSPITAL ALSO PROVIDES THE ANNUAL OPERATING PLAN AND CORPORATE VALUES IN PUBLIC AREAS OF THE FACILITY.
FORM 990, PART XI, LINE 9:	PENSION RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST 607,012. CHANGE IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST 99,945. CHANGE IN FRIENDS OF BASSETT 25,000.
FORM 990, PART XII, LINE 2C:	THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (10 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
BASSETT HEALTHCARE NETWORK
ONE ROCKEFELLER PLAZA 31ST FLOOR	NEW YORK	NY	10020	133218680	SUPPORTING ORGANIZATION	NY	501 (C) 3	11 C	N/A	0
FRIENDS OF BASSETT
ONE ATWELL ROAD	COOPERSTOWN	NY	13326	237041610	FUND RAISING ORGANIZATION	NY	501 (C) 3	7		0	BASSETT HEALTHCARE NETWORK
MARY IMOGENE BASSETT HOSPITAL
ONE ATWELL ROAD	COOPERSTOWN	NY	13326	135596796	HEALTH CARE ORGANIZATION OFFERING INPATIENT AND OUTPATIENT SERVICES	NY	501 (C) 3	3		0	BASSETT HEALTHCARE NETWORK
AURELIA OSBORN FOX MEMORIAL HOSPITAL SOCIETY
ONE NORTON AVENUE	ONEONTA	NY	13820	150539039	HEALTH CARE ORGANIZATION OFFERING INPATIENT AND OUTPATIENT SERVICES	NY	501 (C) 3	3		0	BASSETT HEALTHCARE NETWORK
TEMPLETON FOUNDATION
ONE ATWELL ROAD	COOPERSTOWN	NY	13326	133317084	FACILITIES / OFFICE SPACE	NY	501 (C) 3	9		0	BASSETT HEALTHCARE NETWORK
BASSETT REGIONAL CORPORATION
ONE ATWELL ROAD	COOPERSTOWN	NY	13326	133522783	PROVIDES EXCELLENCE IN THE COORDINATION PLANNING AND POLICY DIRECTION FOR	NY	501 (C) 3	11 (B)		0	BASSETT HEALTHCARE NETWORK
COBLESKILL REGIONAL HOSPITAL
178 GRANDVIEW DRIVE	COBLESKILL	NY	12043	141772971	HEALTHCARE SERVICES OFFERING INPATEINT AND OUTPATIENT SERVICES	NY	501 (C) 3	3		0	BASSETT REGIONAL CORPORATION
O'CONNOR HOSPITAL
460 ANDES ROAD	DELHI	NY	13753	161540394	HEALTH CARE ORGANIZATION OFFERING INPATIENT AND OUTPATIENT SERVICES	NY	501 (C) 3	3		0	BASSETT REGIONAL CORPORATION
TRI TOWN REGIONAL HEALTHCARE
43 PEARL STREET	SYNDEY	NY	13838	260169584	HEALTHCARE SERVICES OFFERING OUTPATIENT SERVICES	NY	501 (C) 3	3		0	BASSETT REGIONAL CORPORATION
VALLEY HEALTH SERVICES
690 GERMAN STREET	HERKIMER	NY	13350	222511614	NURSING HOME	NY	501 (C) 3	3		0	BASSETT REGIONAL CORPORATION

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd