2017-12-20T13:31:30-05:00 2016-12-31 135565207 KPMG LLP 515 BROADWAY 4TH FL ALBANY NY 12207 990 2016-01-01 141772971 BASSETT HOSPITAL OF SCHOHARIE CTY BASS 5182543456 178 GRANDVIEW DRIVE COBLESKILL NY 12043 ERIC STEIN PRESIDENT & CEO 5182543456 2016-12-20 true TODD TERESCO P00247720 5184274600 2017-12-20 ACF3C5308765E7619AA5A0EE970EEE9F6E9B392B ACF3C5308765E7619AA5A0EE970EEE9F6E9B392B 2016 2018-03-14 21:41:22Z COBLESKILL REGIONAL HOSPITAL ERIC STEIN 178 GRANDVIEW DRIVE COBLESKILL NY 12043 32196724 false X WWW.COBLESKILLHOSPITAL.ORG X 1994 NY PROVISION OF HEALTH CARE SERVICES TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. 16 14 293 49 0 528676 441543 28289321 31015577 13081 -9455 1092688 673586 29923766 32121251 0 0 16101631 17125017 0 0 12765176 14233037 28866807 31358054 1056959 763197 27009180 26924570 7447751 6601753 19561429 20322817 PROVISION OF HEALTH CARE SERVICES TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. false false 22547421 31015577 PROVISION OF HOSPITAL CARE TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. IN 2016, THE NUMBER OF INPATIENTS CARED FOR WAS 658 AND AND THE NUMBER OF OUTPATIENTS CARED FOR WAS 57,584. 22547421 true true false true false false false false false true true false false false true true true false false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 107 0 true 293 true false false false false false false false false false false X 16 14 false false false false false false false true true false false false true true true true true true false false NY X ERIC H STEIN 5182543456 178 GRANDVIEW DRIVE COBLESKILL NY 12043 MICHAEL TENGERES TRUSTEE 2.00 40.00 X 0 429917 1157 JOSEPH SELLERS MD TRUSTEE 0.50 40.00 X 0 278540 30770 BARBARA DICOCCO CHAIRMAN 1.00 2.50 X X 0 0 0 ANNE C MYERS VICE CHAIRMA 1.00 X X 0 0 0 GLENN A PERRONE SECRETARY 1.00 X X 0 0 0 GEORGE P KONTA TREASURER 1.00 X X 0 0 0 NANCY BELLINGER TRUSTEE 1.00 X 0 0 0 PAUL BRADY TRUSTEE 1.00 X 0 0 0 MICHAEL BREEN TRUSTEE 0.50 X 0 0 0 EDWARD KINTZ TRUSTEE 0.50 X X 0 0 0 STEVEN KROLL TRUSTEE 0.50 X 0 0 0 HENRY LAMONT TRUSTEE 0.50 X 0 0 0 PETER LOPEZ TRUSTEE 0.50 X 0 0 0 CARL MUMMENTHEY TRUSTEE 0.50 X 0 0 0 GARTH ROBERTS TRUSTEE 0.50 X 0 0 0 RENEE SCIALDO SHEVAT PHD TRUSTEE 0.50 X 0 0 0 ERIC STEIN PRESIDENT & 38.00 X 0 196079 21030 SUSAN OAKES FERRUCCI VICE PRESIDE 38.00 X 153003 0 13542 LEANNA JENSEN VICE PRESIDE 38.00 X 161004 0 3220 DAVID DESANDO DIRECTOR OF 38.00 X 142741 0 4787 CHRISTINE PIRRI VP, HUMAN RE 38.00 X 128674 0 3731 JACQUELINE KAVOURAS VP, QUALITY 38.00 X 125440 0 555 CHRISTOPHER MANLEY STAFF PHARMA 38.00 X 105556 0 7270 816418 904536 86062 6 false true false MEDICAL STAFFING NETWORK HEALTHCARE 6551 PARK OF COMMERCE BLVD BOCA RATON FL 33487 STAFFING AGENCY 410415 STAT STAFF PROFESSIONALS INC 18 DIVISION ST SUITE 311 SARATOGA SPRINGS NY 12866 STAFFING AGENCY 282958 MCCARTHY HOLDINGS INC 1341 NORTH ROCK HILL RD ST LOUIS MO 63123 CONSTRUCTION 254741 AMN HEALTHCARE INC 12400 HIGH BLUFF DR SAN DIEGO CA 92130 STAFFING AGENCY 225846 FUSION MEDICAL STAFFING LLC 11808 GRANT ST OMAHA NE 68164 STAFFING AGENCY 133992 7 196733 244810 441543 NET PATIENT SERVICE REVENUE 900099 31015577 31015577 31015577 17929 17929 48089 75473 -27384 -27384 -27384 OTHER OPERATING REVENUE 504268 504268 COFFEE SHOP REVENUE 65290 65290 LIFELINE REVENUE 58351 58351 45677 45677 673586 32121251 31015577 664131 14551507 10740147 3811360 191026 132500 58526 1586704 1096370 490334 795780 556174 239606 677002 55151 621851 55807 55807 130331 130331 7954 7954 119503 65277 54226 57451 57451 2953250 2630168 323082 1397495 558998 838497 33310 13765 19545 26989 9223 17766 181644 181644 1617908 877939 739969 164001 164001 PURCHASED SERVICES 4343641 3688593 655048 BAD DEBT 1655943 1655943 UTILITIES 536823 429955 106868 OTHER DIRECT EXPENSE 273985 37218 236767 31358054 22547421 8810633 0 9913547 9578353 125022 125369 905491 501666 2218737 3103267 275386 333081 125152 222850 27345336 14473155 13256929 12872181 188916 187803 27009180 26924570 1906580 2083755 4484450 4013879 1023963 471361 32758 32758 7447751 6601753 X 19323712 20089702 59027 54425 178690 178690 19561429 20322817 27009180 26924570 763197 -1809 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 7954 7954 false SCHEDULE C, PART II-B, LINE 1 IROQUOIS HEALTHCARE ALLIANCE ALLOCATED 36.5% OF DUES TOWARDS GENERAL LOBBYING ACTIVITIES. TOTAL DUES PAID IN 2016 WERE 8,286 HEALTHCARE ASSOCIATION OF NEW YORK ALLOCATED 23.7% OF DUES TOWARDS GENERAL LOBBYING ACTIVITIES. TOTAL DUES PAID IN 2016 WERE 6,577 AMERICAN HOSPITAL ASSOCIATION ALLOCATED 21.8% OF DUES TOWARDS GENERAL LOBBYING ACTIVITIES. TOTAL DUES PAID IN 2016 WERE 15,475 303712 348 304059 303365 347 303712 302994 371 303365 302360 634 302994 301615 745 302360 1.00000 false false 33584 33584 17458869 7762246 9696623 9852883 6710909 3141974 12872181 ASSET RETIREMENT OBLIGATIONS 32758 32758 X 30463499 -1657752 -1657752 32121251 32121251 29702111 29702111 1655943 1655943 31358054 SCHEDULE D, PAGE 2, PART V, LINE 4 ENDOWMENT FUNDS OF 261,230 HELD WITH INTEREST EARNED ARE UNRESTRICTED FOR GENERAL HOSPITAL EXPENDITURES. ENDOWMENT FUNDS OF 42,829 WITH INTEREST EARNED ARE RESTRICTED TO NURSING SCHOLARSHIPS. SCHEDULE D, PAGE 3, PART X THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE IRC. THE HOSPITAL RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE-LIKELY THAN-NOT THAT THE POSITION WILL SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL TAX LIABILITIES THAT NEED TO BE RECORDED AS OF DECEMBER 31, 2016 AND 2015. SCHEDULE D, PAGE 4, PART XI, LINE 2D BAD DEBT -1,655,943 CHANGE IN FOB -1,809 SCHEDULE D, PAGE 4, PART XII, LINE 4B BAD DEBT 1,655,943 true true true X 3.000000000000 false true true false true true 135940 76706 59234 0.00190 4884751 2050535 2834216 0.09040 5020691 2127241 2893450 0.09230 1487 1487 5446188 5137030 309158 0.00990 21968 21968 0.00070 5469643 5137030 332613 0.01060 10490334 7264271 3226063 0.10290 true 516055 35501 6498949 7084614 -585665 X true true 1 1 BASSETT HOSPITAL OF SCHOHARIE CTY 178 GRANDVIEW DRIVE COBLESKILL NY 12043 4720001H X X X BASSETT HOSPITAL OF SCHOHARIE CTY 1 false false true X X X X X X X X X 16 true true false true X WWW.COBLESKILLHOSPITAL.ORG X WWW.BASSETT.ORG X true 16 true WWW.COBLESKILLHOSPITAL.ORG false true X 300.000000000000 true true X X X X true X WWW.COBLESKILLHOSPITAL.ORG X WWW.COBLESKILLHOSPITAL.ORG X WWW.COBLESKILLHOSPITAL.ORG X X X X X true X false X X X X true X false false FACILITY 1, BASSETT HOSPITAL OF SCHOHARIE CTY - PART V, LINE 5 THIS COMMUNITY HEALTH NEEDS ASSESSMENT HAS TAKEN INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY SERVED BY BASSETT HOSPITAL OF SCHOHARIE COUNTY (BHSC). THIS INCLUDES INPUT FROM INDIVIDUALS WITH EXPERTISE IN PUBLIC HEALTH, SPECIFICALLY, THE DIRECTOR OF THE SCHOHARIE COUNTY DEPARTMENT OF HEALTH. IN ADDITION TO COMMUNITY COMMENTS AND INPUT GATHERED IN RESPONSE TO POSTING OF THE COMMUNITY HEALTH NEEDS ASSESSMENT ON THE HOSPITAL'S WEBSITE, THE PRIMARY PROACTIVE MEANS FOR RECEIVING COMMUNITY INPUT WAS THROUGH A COMMUNITY-WIDE STAKEHOLDER MEETING HELD AND HOSTED BY BHSC ON MARCH 15, 2015. THE PURPOSE OF THE STAKEHOLDER MEETING WAS THREEFOLD: 1) TO ELICIT GENERAL COMMENTS ON THE DRAFT CHNA; 2) TO SEEK COMMUNITY INPUT ON THE PRIORITY HEALTH NEEDS IDENTIFIED BY THE CHNA; AND 3) TO SEEK COMMUNITY INPUT ON POTENTIAL IMPLEMENTATION STRATEGIES. TWENTY-SIX INDIVIDUALS REPRESENTING 17 AREA HEALTH PROVIDER AND COMMUNITY SERVICE ORGANIZATIONS ATTENDED THE SESSION. IN ADDITION TO THE PROCESS AND COMMUNITY PARTICIPATION SPECIFICALLY USED IN DEVELOPING THIS COMMUNITY HEALTH ASSESSMENT, SIGNIFICANT PROCESSES AND COMMUNITY PARTICIPATION WERE INVOLVED IN COMPILING THE BHSC COMMUNITY SERVICE PLAN AND THE SCHOHARIE COUNTY HEALTH ASSESSMENT. EACH OF THESE EFFORTS INCLUDED THEIR OWN PROCESS AND METHODS OF IDENTIFYING COMMUNITY HEALTH NEEDS. EACH ALSO PROVIDED NUMEROUS OPPORTUNITIES FOR COMMUNITY INPUT AND PARTICIPATION IN REVIEWING AND INFLUENCING THE SELECTION OF PRIORITY HEALTH NEEDS. THE 2016-2018 COMMUNITY SERVICES PLAN (CSP) FOR BHSC WAS DEVELOPED AS PART OF A MULTI-HOSPITAL PLANNING PROCESS AMONG SIX HOSPITALS IN THE BASSETT HEALTHCARE NETWORK. THE DEVELOPMENT OF THE SCHOHARIE COUNTY COMMUNITY HEALTH ASSESSMENT (CCHA) 2016-2018 WAS COMPLETED IN CONJUNCTION WITH THE DEVELOPMENT OF THE COMMUNITY SERVICES PLAN BY BHSC. A WORK GROUP WAS FORMED WITH SEVERAL MEMBERS FROM BOTH THE HEALTH DEPARTMENT AND THE HOSPITAL, AS WELL AS COMMUNITY MEMBERS FORM OTHER AGENCIES, TO REVIEW DEMOGRAPHIC AND HEALTH STATUS INFORMATION, ASSESS COMMUNITY SERVICES AND ULTIMATELY SELECT PRIORITY AREAS FOR IMPROVING THE HEALTH STATUS OF SCHOHARIE COUNTY RESIDENTS. FACILITY 1, BASSETT HOSPITAL OF SCHOHARIE CTY - PART V, LINE 6A BASSETT MEDICAL CENTER, TRI TOWN REGIONAL HOSPITAL, COBLESKILL REGIONAL HOSPITAL, O'CONNOR HOSPITAL, LITTLE FALLS HOSPITAL, AND AO FOX MEMORIAL HOSPITAL. FACILITY 1, BASSETT HOSPITAL OF SCHOHARIE CTY - PART V, LINE 6B BASSETT MEDICAL CENTER, TRI TOWN REGIONAL HOSPITAL, COBLESKILL REGIONAL HOSPITAL, O'CONNOR HOSPITAL, LITTLE FALLS HOSPITAL, AND AO FOX MEMORIAL HOSPITAL. FACILITY 1, BASSETT HOSPITAL OF SCHOHARIE CTY - PART V, LINE 11 THE ORGANIZATION ADDRESSED SIGNIFICANT, PRIORITIZED HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA BY ADOPTION OF A BUDGET FOR PROVISION OF SERVICES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA, PRIORITIZATION OF HEALTH NEEDS IN ITS COMMUNITY, AND PRIORITIZATION OF SERVICES THAT THE HOSPITAL FACILITY WILL UNDERTAKE TO MEET HEALTH NEEDS IN ITS COMMUNITY. FOR NEEDS NOT ADDRESSED AS A COLLABORATIVE, WE ADDRESS SOME AS AN INDIVIDUAL ORGANIZATION AND ALSO CONTINUE TO REPRIORITIZE HIGHEST DEMAND. PART I, LINE 3C - OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARE BASSETT HOSPITAL OF SCHOHARIE COUNTY (BHSC) IS A NOT-FOR-PROFIT HEALTHCARE ORGANIZATION THAT RENDERS MEDICAL CARE TO ALL PERSONS IN NEED OF SUCH CARE, REGARDLESS OF THEIR ABILITY TO PAY. TO SUPPORT PATIENTS WHO MAY HAVE DIFFICULTY PAYING THEIR MEDICAL BILLS, THE COMMUNITY SERVICE PROGRAM (CSP) IS AVAILABLE. UNDER THE HOSPITAL POLICY GOVERNING THE CSP, BASSETT HOSPITAL OF SCHOHARIE COUNTY PROVIDES A LEVEL OF UNCOMPENSATED CARE EACH YEAR TO PERSONS UNABLE TO PAY THE TOTAL COST OF THE HOSPITAL SERVICES RENDERED. CSP ELIGIBILITY IS LIMITED TO SERVICES FOR THOSE PERSONS WHO ARE DETERMINED INELIGIBLE FOR MEDICAID WITHIN 60 DAYS PRIOR TO THE APPLICATION AND WHOSE ANNUAL FAMILY GROSS INCOME, AS DETERMINED BY AN APPLICATION FOR MEDICAID WITHIN THE SIX MONTHS PRIOR TO AN APPLICATION, DOES NOT EXCEED 300% OF THE FEDERAL POVERTY INCOME GUIDELINES, WHICH ARE UPDATED ANNUALLY. AN APPLICATION FOR THE CSP FREE CARE REQUIRES VERIFICATION OF INCOME FOR THE SIX MONTHS IMMEDIATELY PRECEDING THE APPLICATION AND, IF FAMILY INCOME IS BELOW THE MEDICAID GUIDELINES, A MEDICAID APPLICATION IS ALSO REQUIRED. PART I, LINE 6A - RELATED ORGANIZATION INFORMATION THE BASSETT HOSPITAL OF SCHOHARIE COUNTY COMMUNITY BENEFITS REPORT IS CONTAINED IN A REPORT PREPARED BY BASSETT HEALTHCARE NETWORK. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION FOR PATIENTS, OR GUARANTORS , WHO DO NOT QUALIFY FOR COMPLETE CHARITY CARE ASSISTANCE, THE HOSPITAL MUST UNDERTAKE TO ENSURE UNDERSTANDING OF OBLIGATIONS AND SATISFACTION OF OBLIGATIONS. THE HOSPITAL EMPLOYS A THIRD-PARTY SELF-PAY BILLING AGENCY, IN COMPLIANCE WITH EXISTING LAWS AND REGULATIONS, TO RECOVER SELF-PAY ACCOUNTS RECEIVABLE, PRESERVE THE PATIENT-PROVIDER RELATIONSHIP TO THE MAXIMUM EXTENT POSSIBLE, AND KEEP THE NECESSITY OF REFERRING ACCOUNTS TO THIRD PARTY BAD DEBT COLLECTION OR LAW FIRMS TO A MINIMUM. THIS AGENCY IS MEDICAL SELF-PAY ACCOUNTS RECEIVABLE SERVICES, LLC (MEDSPAR). AS A STRICTURE OF THE HOSPITAL'S UNIFIED CHARITY CARE, SELF-PAY BILLING & COLLECTION POLICY, BASSETT HOSPITAL OF SCHOHARIE COUNTY MUST ENSURE THAT BAD DEBT COLLECTION POLICIES OF ANY THIRD-PARTY AGENCY RETAINED FOR OUTSIDE DEBT COLLECTION REFLECT THE MISSION AND VALUES OF THE HOSPITAL, AS WELL AS REFRAIN FROM ANY CONDUCT THAT VIOLATES THE FAIR DEBT COLLECTION PRACTICES ACT, THE FAIR CREDIT REPORTING ACT, AS WELL AS ANY APPLICABLE STATE LAW OR REGULATIONS. UNDER THE MEDSPAR CREDIT AND COLLECTION POLICY (DOC. NO. 1), RESPONSIBLE PARTIES PLEADING INDIGENCE OR INABILITY TO ESTABLISH AN INSTALLMENT PLAN MUST COMPLETE AN APPLICATION FOR THE HOSPITAL'S CHARITY CARE OR COMMUNITY SERVICES PROGRAM. THE PATIENT WILL BE FORWARDED THE APPLICATION AND INFORMED THAT THEIR ACCOUNTS WILL BE TEMPORARILY SUSPENDED FROM FURTHER BILLING FOR 30 DAYS. THE RESPONSIBLE PARTY MAY MAKE INTEREST FREE MONTHLY INSTALLMENT PAYMENTS NOT TO EXCEED 10 PERCENT OF GROSS MONTHLY INCOME (WHICH MUST BE VERIFIED BY A COPY OF A CURRENT PAYSTUB OR EQUIVALENT PROOF OF INCOME), ACCORDING TO A SET SCHEDULE BASED ON ACCOUNT BALANCE AND MAXIMUM NUMBER OF MONTHS IN WHICH INSTALLMENTS MUST BE MADE. ADDITIONAL INFORMATION PART I, LINE 7 FOR SECTIONS (A) CHARITY CARE AT COST, (B) UNREIMBURSED MEDICAID, (F) HEALTH PROFESSIONS EDUCATION, THE COSTING METHODOLOGY APPLIED IS A COST-TO-CHARGE RATIO CALCULATION, AS USED ON FILED STATE AND FEDERAL COST REPORTS. INDIRECT COSTS WERE APPLIED TO SUBSIDIZED HEALTH SERVICES, SECTIONS (E)COMMUNITY HEALTH IMPROVEMENT; PORTIONS OF (F) HEALTH PROFESSIONS EDUCATION, AND (I) CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS, WHICH INCLUDE THE DIRECT SALARY COSTS FOR HOSPITAL STAFF WHOSE TIME WAS COMPENSATED BY THE HOSPITAL FOR TIME SPENT PARTICIPATING IN ACTIVITIES THAT QUALIFY AS COMMUNITY BENEFITS PLUS THE CURRENT FISCAL YEAR FICA RATE. PART I, LINE 7, COLUMN (F) IS CALCULATED BY DIVIDING COLUMN (E), NET COMMUNITY BENEFIT EXPENSE, BY TOTAL EXPENSE. THE BAD DEBT EXPENSE OF 1,655,943 WAS SUBTRACTED FROM THE TOTAL EXPENSE VALUE USED TO CALCULATE THE PERCENTAGES IN PART 1, LINE 7, COLUMN F. PART II ALL COMMUNITY BUILDING ACTIVITIES COULD BE CLASSIFIED UNDER PART I, LINE 7 AND ARE HIGHLIGHTED IN ITEM NUMBER 1 ABOVE. THE HOSPITAL HAS REPRESENTATION ON THE BOARD OF DIRECTORS FOR THE MOHAWK VALLEY POPULATION HEALTH IMPROVEMENT PROGRAM (PHIP) WHICH SERVES SCHOHARIE, FULTON, MONTGOMERY, HERKIMER, AND OTSEGO COUNTIES. THE MOHAWK VALLEY PHIP PROVIDES A FORUM IN WHICH STAKEHOLDERS INCLUDING COUNTY HEALTH DEPARTMENTS, HOSPITALS, INSURERS, AGENCIES AND A WIDE RANGE OF OTHER INTERESTED PARTIES CAN REVIEW THE REGION'S HEALTH STATUS AND DEFINE KEY PRIORITY AREAS. DECISIONS ARE BASED UPON INFORMATION RELATING TO THESE COUNTIES DERIVED FROM EXTENSIVE DATA GATHERING AND ANALYSES BY BASSETT HEALTHCARE NETWORK'S RESEARCH INSTITUTE. THE MOHAWK VALLEY PHIP PROMOTES THE TRIPLE AIM THROUGH REGIONAL EFFORTS THAT REFLECT LOCAL NEEDS, ASSETS AND CAPABILITIES. THE GOAL IS TO IMPROVE POPULATION HEALTH THROUGH STAKEHOLDER COLLABORATION, DATA-DRIVEN PRIORITIZATION , AND REGIONAL OR LOCAL STRATEGIES FOR ADDRESSING HEALTH DISPARITIES THAT ARE CONSISTENT WITH THE GOALS OF THE STATEWIDE PREVENTION AGENDA AND THE STATE HEALTH IMPROVEMENT PLAN. THE MOHAWK VALLEY PHIP STIMULATES AND SUPPORTS STRATEGIC PLANNING FOR IDENTIFYING, SHARING, DISSEMINATING AND HELPING TO IMPLEMENT BEST PRACTICES AND LOCAL STRATEGIES THAT PROMOTE POPULATION HEALTH AND REDUCE HEALTH CARE DISPARITIES IN THE FIVE COUNTY REGION. ADDITIONALLY, THE HOSPITAL HAS A PARTICIPATING ROLE WITH THE LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS, A NEW YORK STATE INITIATIVE TO BETTER THE HEALTH CARE DELIVERY, WHICH WAS FORMED BY PROVIDERS FROM SCHOHARIE, OTSEGO, MADISON, HERKIMER AND DELAWARE COUNTIES. THE MISSION IS TO BUILD A HIGH-PERFORMING INTEGRATED DELIVERY SYSTEM AND TRANSFORM HEALTH CARE DELIVERY IN THE REGION TO ACHIEVE DELIVERY SYSTEM REFORM INCENTIVE (DSRIP) PROGRAM GOALS. OF SPECIFIC FOCUS IS THE TOBACCO CESSATION PROJECT (PROJECT ID: 4.B .I) THAT PROMOTES TOBACCO USE CESSATION , ESPECIALLY AMONG LOW SES POPULATIONS AND THOSE WITH POOR MENTAL HEALTH (FOCUS AREA 2: GOAL 2.2). THE OBJECTIVE IS TO DECREASE THE PREVALENCE OF CIGARETTE SMOKING BY ADULTS 18 AND OLDER, AND INCREASE USE OF TOBACCO CESSATION SERVICES INCLUDING NYS SMOKERS' QUITLINE AND NICOTINE REPLACEMENT PRODUCTS. THE HOSPITAL'S COMMUNITY BUILDING ACTIVITIES ALSO FOCUSED ON REPRESENTATION TO COMMUNITY COALITIONS RELATED TO IDENTIFIED COMMUNITY HEALTH PRIORITIES; ON COSTS OF COALITION MEETINGS; AND ON PARTICIPATION WITH A SMALL BUSINESS/ECONOMIC DEVELOPMENT ORGANIZATION CALLED COBLESKILL PARTNERSHIP INC. (CPI), WHICH ADDRESSES THE HOSPITAL NEIGHBORHOOD IN DOWNTOWN COBLESKILL. PART III, LINES 2, 3 & 4 BASSETT HOSPITAL OF SCHOHARIE COUNTY USES THE RATIO OF COST-TO-CHARGES METHODOLOGY FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES . THE DESCRIPTION OF HOW THE ORGANIZATION ACCOUNTS FOR DISCOUNTS AND FOR PAYMENTS ON PATIENT ACCOUNTS IN DETERMINING BAD DEBT EXPENSE IS CONTAINED IN THE TEXT OF THE FOLLOWING AUDITED FINANCIAL STATEMENT FOOTNOTE; ALSO INCLUDED IN THIS FOOTNOTE IS THE DESCRIPTION OF THE METHOD THE ORGANIZATION USES TO DETERMINE THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTABLE TO PATIENTS WHO LIKELY WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY, IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO MAKE A DETERMINATION OF THEIR ELIGIBILITY. FOOTNOTE TEXT: THE HOSPITAL HAS ADOPTED A FORMAL CHARITY CARE POLICY WHEREBY PATIENTS IN NEED OF MEDICAL SERVICES, WHO MEET CERTAIN CRITERIA UNDER THE POLICY, ARE TREATED WITHOUT REGARD TO THEIR ABILITY TO PAY FOR SUCH SERVICES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THE LEVEL OF CHARITY CARE, MEASURED ON THE BASIS OF ESTABLISHED COSTS, IS APPROXIMATELY 59,000 AND 58,000 FOR 2016 AND 2015, RESPECTIVELY. THE COST OF CHARITY CARE PROVIDED WAS DETERMINED BASED ON THE APPLICATION OF A RATIO TO OVERALL HOSPITAL COSTS TO PATIENT CHARGES. IN ADDITION, THE COST OF UNREIMBURSED MEDICAID SERVICES WAS APPROXIMATELY 2,834,000 IN 2016 AND 2,089,000 IN 2015. THE COST OF UNREIMBURSED MEDICAID IS DETERMINED BASED ON THE APPLICATION OF A COST TO GROSS CHARGE RATIO TO TOTAL MEDICAID CHARGES. INCLUDED IN NET PATIENT SERVICE REVENUE FOR 2016 AND 2015 IS APPROXIMATELY 767,000 AND 843,000, RESPECTIVELY, FROM STATEWIDE UNCOMPENSATED CARE POOLS AND INCOME FROM RESTRICTED ENDOWMENTS TO OFFSET A PORTION OF THE COST OF CHARITY CARE. THESE UNCOMPENSATED CARE POOLS ARE DESIGNED TO HELP OFFSET THE COST OF CHARITY CARE AND UNREIMBURSED MEDICAID SERVICES. PART III, LINE 8 BASSETT HOSPITAL OF SCHOHARIE COUNTY USED MEDICARE-APPROVED COSTS FROM THE 2016 MEDICARE COST REPORT, WHICH EMPLOY A COST-TO-CHARGE RATIO METHODOLOGY. THE HOSPITAL DID NOT DESIGNATE THE SHORTFALL REPORTED IN PART III, LINE 7 TOWARD COMMUNITY BENEFIT. PART VI - QUESTION 2 - NEED ASSESSMENT IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), A VARIETY OF DATA ARE USED REGULARLY TO ASSESS THE HEALTHCARE NEEDS OF THE COMMUNITY SERVED BY BASSETT HOSPITAL OF SCHOHARIE COUNTY, INCLUDING DATA FROM PATIENT SATISFACTION SURVEYS, THE NYS DEPARTMENT OF HEALTH, THE SCHOHAR IE COUNTY BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, THE SCHOHARIE COUNTY COMMUNITY HEALTH ASSESSMENT , AND THE NYS PREVENTION AGENDA, WHICH IDENTIFIED PRIORITY HEALTH INDICATORS TO BE USED BY NYS HOSPITALS, PROVIDERS, AND COUNTY HEALTH DEPARTMENTS IN ASSESSING AND SETTING LOCAL/REGIONAL PRIORITIES. THE PREVENTION AGENDA ALSO IDENTIFIES A COMMON SET OF HEALTHCARE PRIORITIES FROM WHICH HOSPITALS AND COUNTY HEALTH DEPARTMENTS IN NEW YORK STATE ARE EXPECTED TO CHOOSE WHEN DEVELOPING IMPLEMENTATION STRATEGIES FOR ADDRESSING COMMUNITY HEALTHCARE NEEDS. COMMUNITY PARTNERS INVOLVED IN ASSESSING COMMUNITY HEALTH NEEDS IN SCHOHARIE COUNTY INCLUDED: SCHOHARIE COUNTY HEALTH DEPARTMENT; BASSETT PRIMARY CARE GROUP; COMMUNITY-BASED ORGANIZATIONS; AND COUNTY SOCIAL SERVICE, MENTAL HEALTH, YOUTH AND AGING AGENCIES. BASSETT HOSPITAL OF SCHOHARIE COUNTY CONTRACTS WITH PRESS GANEY TO OBTAIN BENCHMARKING DATA ON PATIENT SATISFACTION IN ORDER TO ASSESS HOW THE HOSPITAL IS PERCEIVED TO BE MEETING PATIENT NEEDS. DATA FROM ONGOING MAIL SURVEYS CARRIED OUT AMONG A STATISTICALLY SIGNIFICANT RANDOM SAMPLE OF INPATIENTS AND OUTPATIENTS IS USED TO IMPROVE PATIENT CARE AND INFORM OFFICIAL QUALITY IMPROVEMENT ACTIVITIES. DATA COLLECTED FROM THIS INSTRUMENT INCLUDE A COMPREHENSIVE OVERVIEW OF KEY, EVIDENCE-BASED QUALITY INDICATORS -- FROM TIMELINESS OF CARE TO COMMUNICATIONS, PATIENT SAFETY, DISCHARGE INSTRUCTION, MEDICATION ISSUES, AND MORE. THE HOSPITAL RECEIVES REPORTS QUARTERLY. THE HOSPITAL ALSO UTILIZES INFORMATION FROM THE STANDARDIZED, PUBLICLY REPORTED HCAHPS (HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS) SURVEY OF PATIENTS' PERSPECTIVES OF HOSPITAL CARE. THE HCAHPS REPORTING AND SURVEY ARE REQUIRED BY THE CENTER FOR MEDICARE SERVICES (CMS) TO ALLOW STANDARD, OBJECTIVE, VALID COMPARISONS TO BE MADE ACROSS HOSPITALS NATIONALLY, REGIONALLY, AND LOCALLY REPORTS ARE RECEIVED QUARTERLY AND SINCE 2008 HAVE BEEN PUBLISHED NATIONALLY ON THE CMS AND NYS DEPARTMENT OF HEALTH WEBSITES. THE SURVEY METHODOLOGY AND RESULTS ARE IN THE PUBLIC DOMAIN. (WWW.HCAHPSONLINE.ORG). ADDITIONALLY, THE HOSPITAL'S NEEDS ASSESSMENT ACTIVITIES ARE INFORMED BY INITIATIVES AND STUDIES CARRIED OUT BY THE BASSETT HEALTHCARE NETWORK RESEARCH INSTITUTE, INCLUDING THE UPSTATE HEALTH AND WELLNESS STUDY 2009. THIS PROJECT ASSESSED HEALTH INDICATORS, IDENTIFIED RURAL-URBAN HEALTH DISPARITIES, AND PROVIDED BASELINE DATA TO ASSIST COMMUNITY HEALTHCARE PLANNING IN THE RURAL REGION SERVED BY BASSETT, INCLUDING SCHOHAR IE COUNTY. IT IS A COLLABORATIVE EFFORT BETWEEN THE RESEARCH INSTITUTE, COUNTY HEALTH DEPARTMENTS, AND REGIONAL COMMUNITY SERVICES ORGANIZATIONS. PART VI - QUESTION 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE BASSETT HOSPITAL OF SCHOHARIE COUNTY (BHSC) IS A NOT-FOR-PROFIT HEALTHCARE O X X false false false false false false false true false MICHAEL TENGERES TRUSTEE 399917 30000 1157 431074 JOSEPH SELLERS MD TRUSTEE 267175 9405 1960 29706 1064 309310 ERIC STEIN PRESIDENT & CEO 181423 14656 16168 4862 217109 SUSAN OAKES FERRUCCI VICE PRESIDENT & CNO 153003 3266 10276 166545 LEANNA JENSEN VICE PRESIDENT & CFO 160230 774 3220 164224 SCHEDULE J, PAGE 1, PART I, LINE 3 THE CHIEF EXECUTIVE OFFICER'S SALARY IS PAID BY A RELATED ORGANIZATION UNDER A MANAGEMENT SERVICES AGREEMENT. THE BASSETT HOSPITAL OF SCHOHARIE COUNTY 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. SCHEDULE J, PAGE 1, PART I, LINE 7 NON FIXED PAYMENTS ARE MADE BASED ON THE SUCCESS IN MEETING PERFORMANCE CRITERIA THAT ARE PROSPECTIVELY AGREED UPON AS GOALS FOR THE OFFICERS. FORM 990, PAGE 6, PART VI, LINE 11B THE 990 IS REVIEWED BY THE EXECUTIVE FINANCE COMMITTEE, WHICH HAS BEEN ASSIGNED THAT RESPONSIBILITY BY THE BOARD OF TRUSTEES. ALL TRUSTEES ARE MADE AWARE THAT THE 990 IS AVAILABLE FOR REVIEW IN THE ADMINISTRAIVE OFFICE UPON REQUEST. FORM 990, PAGE 6, PART VI, LINE 12C MEMBERS OF THE BOARD COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. A SUMMARY OF RESULTS IS REPORTED EACH YEAR AT THE ANNUAL MEETING OF THE BOARD OF TRUSTEES. FORM 990, PAGE 6, PART VI, LINE 15A ANNUAL REVIEW IS DONE BY THE ASSESSMENT OF PRESIDENT/CEO'S PERFORMANCE BY EACH MEMBER OF THE BOARD OF TRUSTEES, SENIOR MANAGEMENT, ADMINISTRATIVE AND CLINICAL LEADERSHIP, AND ACTIVE MEDICAL STAFF. THE ASSESSMENT TOOL ADDRESSES PERFORMANCE MEASURES THAT RELATE TO THE ORGANIZATION'S MISSION AND STRATEGY THAT IS IDENTIFIED IN THE INSTITUTION'S ANNUAL OPERATING PLAN AND BY SPECIFIC ITERATION BY THE BOARD OF TRUSTEES. INFORMATION RECEIVED IS SUMMARIZED AND PRESENTED TO THE EXECUTIVE AND FINANCE COMMITTEE FOR REVIEW AND CONCLUSION. FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC BY REQUEST OF THE ADMINISTRATIVE OFFICE. FORM 990, PART XI, LINE 9 BAD DEBT -1,655,943 CHANGE IN FOB -1,809 BAD DEBT 1,655,943 TOTAL -1,809 BASSETT HEALTHCARE NETWORK ONE ATWELL ROAD COOPERSTOWN NY 13326 133218680 SUPPORT OR NY 501C3 12C NA false FRIENDS OF BASSETT ONE ATWELL ROAD COOPERSTOWN NY 13326 237041610 CONTRIBUTI NY 501C3 7 BHN false MARY IMOGENE BASSETT HOSPITAL ONE ATWELL ROAD COOPERSTOWN NY 13326 135596796 HEALTHCARE NY 501C3 3 BHN false AO FOX MEMORIAL HOSPITAL ONE NORTON AVE ONEONTA NY 13820 150539039 HEALTHCARE NY 501C3 3 BHN false TEMPLETON FOUNDATION ONE ATWELL ROAD COOPERSTOWN NY 13326 133317084 REAL ESTAT NY 501C3 10 BHN false BASSETT REGIONAL CORPORATION ONE ATWELL ROAD COOPERSTOWN NY 13326 133522783 POLICIES NY 501C3 12B BHN false O'CONNOR HOSPITAL 460 ANDES ROAD DELHI NY 13753 161540394 HEALTHCARE NY 501C3 3 BRC false TRI TOWN REGIONAL HEALTHCARE 43 PEARL STREET SIDNEY NY 13838 260169584 HEALTHCARE NY 501C3 3 BRC false LITTLE FALLS HOSPITAL 140 BURWELL STREET LITTLE FALLS NY 13365 150533578 HEALTHCARE NY 501C3 3 BRC false VALLEY HEALTH SERVICES 690 WEST GERMAN STREET HERKIMER NY 13350 222511614 HEALTHCARE NY 501C3 3 BRC false false false false false false false false true false true true true true true true true true true true SCHEDULE R BASSETT REGIONAL CORPORATION IS LISTED AS BRC FOR THE CONTROLLING ENTITY DUE TO SPACE CONTRAINTS. IN 2017, THURSTON CORPORATION COMPLETED A NAME CHANGE TO BASSETT HEALTHCARE NETWORK AND IS LISTED AS BHN FOR THE CONTROLLING ENTITY DUE TO SPACE CONSTRAINTS.