2017-11-15T13:40:48-06:00 2016-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2016-01-01 150533578 LITTLE FALLS HOSPITAL LITT 3158231000 140 BURWELL STREET LITTLE FALLS NY 13365 JAMES VIELKIND CFO 3158231000 2017-11-14 1 KELLY A REDMOND P00443718 3154463600 2017-11-14 24.39.85.114 2017-11-14 13:34:22 ES P 517AEBE328CBAAA90E396C2FD1060AA56161F780 517AEBE328CBAAA90E396C2FD1060AA56161F780 2016 2017-02-10 21:41:12Z JAMES VIELKIND 140 BURWELL STREET LITTLE FALLS NY 13365 33119187 0 X WWW.BASSETT.ORG X 1893 NY 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. 16 12 358 20 0 0 292825 309381 30806653 30848771 121364 180893 0 0 31220842 31339045 0 0 0 0 14552467 14924210 0 0 149736 17660445 17248475 32212912 32172685 -992070 -833640 33563535 32596371 11695823 10781061 21867712 21815310 X LITTLE FALLS HOSPITAL IS A VOLUNTARY, NOT-FOR-PROFIT COMMUNITY HEALTHCARE SYSTEM WHOSE MISSION IS TO OFFER QUALITY CARE WITH COMPASSION, TO ALL WHO NEED OUR SERVICES. 0 0 7807783 8158386 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. 8878761 9360195 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. 8850037 11765227 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. 2063251 1564963 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. 2063251 1564963 27599832 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 25 0 1 358 1 0 0 0 0 0 0 0 0 X 16 12 0 0 1 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X JAMES G VIELKIND 3158235281 140 BURWELL STREET LITTLE FALLS NY 13365 JOHN D BULLIS CHAIRMAN 2.00 1.50 X X 0 0 0 PHYLLIS SPINNER TRUSTEE 2.00 X 0 0 0 TIMOTHY DALY SECOND VICE CHAIRMAN 2.00 X X 0 0 0 ANTHONY DELUCA FIRST VICE CHAIRMAN 2.00 X X 0 0 0 JOY MALONE TRUSTEE 2.00 X 0 0 0 GERARD J SNYDER SECRETARY 2.00 X X 0 0 0 RANBIR SODHI MD TRUSTEE 2.00 X 0 0 0 AUGUST LEINHART MD TRUSTEE 2.00 40.00 X 0 403925 33458 KEVIN CROSLEY TRUSTEE 2.00 X 0 0 0 JUSTIN R HUMMEL TRUSTEE 2.00 X 0 0 0 AMY GRACE MD PRESIDENT OF MEDICAL STAFF 2.00 40.00 X X 0 210318 20238 ROBERT CASULLO TRUSTEE 2.00 X 0 0 0 DUANE SIDNEY TRUSTEE 2.00 X 0 0 0 LISA BETRUS THIRD VICE CHAIRMAN 2.00 X X 0 188229 16335 KATHLEEN SELLERS TRUSTEE 2.00 X 0 0 0 MICHAEL TENGERES TREASURER 1.00 40.00 X X 0 429917 1157 MICHAEL OGDEN PRESIDENT & CEO 40.00 X 0 179064 16203 JAMES G VIELKIND CHIEF FINANCIAL OFFICER 40.00 X 137685 0 5930 RICHARD NOCELLA PRIMARY CARE PHYSICIAN 40.00 X 160259 0 5289 297944 1411453 98610 2 0 1 0 SUNBELT STAFFING LOCKBOX DEPT CH 14430 PALATINE IL 60055 TEMPORARY STAFFING AGENCY 185919 DM CONSULTING PO BOX 4715 UTICA NY 13504 INFORMATION TECHNOLOGY 108768 1 87357 222024 309381 OUTPATIENT SERVICES 623000 21125422 21125422 INPATIENT HOSPITAL 621930 8158386 8158386 OTHER OPERATING REVENUE 900099 990120 990120 PROGRAM SERVICE LEASE 532000 442590 442590 HOSPITAL CAFETERIA 900099 132253 132253 30848771 52639 52639 1908396 1780142 128254 128254 128254 31339045 30848771 0 180893 143615 143615 11659380 10087151 1512683 59546 696838 600545 92748 3545 1555215 1330157 217206 7852 869162 743182 121593 4387 28662 28662 58232 58232 8635 8635 302379 284640 17739 34236 16736 17500 2680123 2572107 100716 7300 996261 887493 108768 585772 511941 72705 1126 20764 10594 8693 1477 29249 5422 23292 535 223266 187402 35848 16 2292471 1924225 368080 166 274427 259671 14756 ADMINISTRATIVE SERVICES 6935683 5721843 1178840 35000 PROVISION FOR BAD DEBT 1696598 1696598 NEW YORK STATE ASSESSME 93939 93939 987778 666186 292806 28786 32172685 27599832 4423117 149736 551280 2096685 1431115 1665331 426099 276691 3250169 2887853 473166 477268 333851 493366 42539032 25233803 18815928 17305229 2145739 3194590 2843182 1597978 1726281 1800536 1566725 800844 33563535 32596371 3211744 3333248 655303 697744 5387347 4782163 2441429 1967906 11695823 10781061 X 17407027 17205693 3595399 3706536 865286 903081 21867712 21815310 33563535 32596371 X -833640 49281 731957 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 8635 8635 0 PART II-B, LINE 1: 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%) 4460686 148931 4609617 4590711 14514 -144539 4460686 4263576 137 326998 4590711 10099410 720 361656 6198210 4263576 12753313 12870 1085526 3752299 10099410 0.19600 0.80400 0 1 1 380386 380386 29157474 14928573 14228901 12698589 10305230 2393359 302583 302583 17305229 DIRECT FINANCE LEASE 1800536 C 1800536 ACCRUED PENSION LIABILITY 1648499 OTHER LIABILITIES 376701 DEBT ISSUNANCE COST -57294 1967906 X 31339045 0 31339045 0 31339045 32172685 0 32172685 0 32172685 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. 1 1 1 X 300.000000000000 0 1 1 0 1 1 179 204955 112945 92010 0.00300 14510 6704007 4245687 2458320 0.08070 14689 6908962 4358632 2550330 0.08370 50109 554 49555 0.00160 33 42122 42122 0.00140 2823 673044 336096 336948 0.01110 2856 765275 336650 428625 0.01410 17545 7674237 4695282 2978955 0.09780 4560 4560 0.00010 52497 52497 0.00170 57057 57057 0.00180 1 1696598 6504 8388923 8579823 -190900 X 1 1 1 1 LITTLE FALLS HOSPITAL 140 BURWELL STREET LITTLE FALLS NY 13365 BASSETT.ORG 2129700H X X INCLUDES 25 INPATIENT BEDS, LITTLE FALLS HOSPITAL 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X WWW.BASSETT.ORG X WWW.BASSETT.ORG X 1 16 1 WWW.BASSETT.ORG 0 1 X 300.000000000000 1 1 X X X X 1 X LFHNY.ORG X LFHNY.ORG X LFHNY.ORG X X X X X 1 X 0 X X X 1 X 0 0 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. 2 1 - DOLGEVILLE HEALTH CENTER 9 GIBSON STREET DOLGEVILLE NY 13329 CLINIC 2 - NEWPORT HEALTH CENTER BRIDGE STREET NEWPORT NY 13416 CLINIC 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 X 0 0 X X X X 0 0 0 0 0 0 0 0 0 AUGUST LEINHART MD TRUSTEE 0 400120 0 1650 0 2155 0 30270 0 3188 0 437383 0 0 AMY GRACE MD PRESIDENT OF MEDICAL STAFF 0 198463 0 11855 0 0 0 15060 0 5178 0 230556 0 0 LISA BETRUS THIRD VICE CHAIRMAN 0 188229 0 0 0 0 0 9558 0 6777 0 204564 0 0 MICHAEL TENGERES TREASURER 0 399917 0 30000 0 0 0 0 0 1157 0 431074 0 0 MICHAEL OGDEN PRESIDENT & CEO 0 178000 0 0 0 1064 0 15440 0 763 0 195267 0 0 RICHARD NOCELLA PRIMARY CARE PHYSICIAN 160259 0 0 0 0 0 4808 0 481 0 165548 0 0 0 PART I, LINE 3 THE COMPENSATION PROCESS FOR TOP OFFICIAL THE CHIEF EXECUTIVE OFFICER'S SALARY IS PAID BY A RELATED ORGANIZATION UNDER A MANAGEMENT SERVICES AGREEMENT. THE LITTLE FALLS HOSPITAL BOARD OF 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. 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. 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 BASSETT HEALTHCARE NETWORK 0 MARY IMOGENE BASSETT HOSPITAL ONE ATWELL ROAD COOPERSTOWN NY 13326 135596796 HEALTH CARE ORGANIZATION OFFERING INPATIENT AND OUTPATIENT SERVICES NY 501 (C) 3 3 BASSETT HEALTHCARE NETWORK 0 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 BASSETT HEALTHCARE NETWORK 0 TEMPLETON FOUNDATION ONE ATWELL ROAD COOPERSTOWN NY 13326 133317084 FACILITIES / OFFICE SPACE NY 501 (C) 3 9 BASSETT HEALTHCARE NETWORK 0 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) BASSETT HEALTHCARE NETWORK 0 COBLESKILL REGIONAL HOSPITAL 178 GRANDVIEW DRIVE COBLESKILL NY 12043 141772971 HEALTHCARE SERVICES OFFERING INPATEINT AND OUTPATIENT SERVICES NY 501 (C) 3 3 BASSETT REGIONAL CORPORATION 0 O'CONNOR HOSPITAL 460 ANDES ROAD DELHI NY 13753 161540394 HEALTH CARE ORGANIZATION OFFERING INPATIENT AND OUTPATIENT SERVICES NY 501 (C) 3 3 BASSETT REGIONAL CORPORATION 0 TRI TOWN REGIONAL HEALTHCARE 43 PEARL STREET SYNDEY NY 13838 260169584 HEALTHCARE SERVICES OFFERING OUTPATIENT SERVICES NY 501 (C) 3 3 BASSETT REGIONAL CORPORATION 0 VALLEY HEALTH SERVICES 690 GERMAN STREET HERKIMER NY 13350 222511614 NURSING HOME NY 501 (C) 3 3 BASSETT REGIONAL CORPORATION 0 0 0 1 0 0 0 0 0 0 1 0 1 1 0 1 0 1 0 0