LITTLE FALLS HOSPITAL: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- LITTLE FALLS HOSPITAL (EIN 15-0533578)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-12
- IRS object ID
- 201513169349305506
- Schema version
- 2014v5.0
- 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 | 2015-11-12T16:08:18-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | 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 | 2014-01-01 | 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 | 2015-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOSEPH J SCHLEGEL | PreparerPersonNm |
| PTIN | P00301329 | PTIN |
| Phone | 3154463600 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | 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 | $32,086,037 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | LFHNY.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 SERVCIES 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 SERVCIES ARE PROVIDED FOR A VARIETY OF SPECIALTIES. PERFORMANCE IMPROVEMENT AND HIGH QUALITY OF CARE IS DEMOSTRATED WITHIN THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) AS REPORTED IN HOSPITAL COMPARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 350 | TotalEmployeeCnt |
| Total Volunteers | 22 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $411,685 | PYContributionsGrantsAmt |
| CY Contributions Grants | $444,943 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $29,807,878 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $30,787,727 | CYProgramServiceRevenueAmt |
| PY Investment Income | $460,212 | PYInvestmentIncomeAmt |
| CY Investment Income | $188,122 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $30,679,775 | PYTotalRevenueAmt |
| CY Total Revenue | $31,420,792 | 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 | $14,777,416 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,488,258 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $64,435 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,316,593 | PYOtherExpensesAmt |
| CY Other Expenses | $16,701,974 | CYOtherExpensesAmt |
| PY Total Expenses | $30,094,009 | PYTotalExpensesAmt |
| CY Total Expenses | $31,190,232 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $585,766 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $230,560 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $34,633,842 | TotalAssetsBOYAmt |
| Total Assets EOY | $35,894,698 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,534,264 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $12,574,417 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $23,099,578 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,320,281 | 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 | $8,676,538 | ExpenseAmt |
| Revenue | $8,537,631 | RevenueAmt |
| Desc | INPATIENT SERVICESLITTLE FALLS HOSPITAL EXPANDED THE HOSPITALIST PROGRAM TO PROVIDE INPATIENT MEDICAL PROVIDER COVERAGE FOR ACUTE CARE SERVICES AS ONE GROUP OF PROVIDERS. THE HOSPITALIST PROGRAM ALLOWS FOR MORE EFFICIENT USE OF RESOURCES OF THE MEDICAL STAFF AND IMPROVES QUALITY OF CARE WITH PATIENTS. THE INPATIENT OCUPANCY RATE FOR INPATIENT AND OBSERVAITON SERVICES WAS 72% FOR AN AVERAGE DAILY INPATIENT DAILY CENSUS OF 18 PATIENTS. AS A CRITIACL ACCESS HOSPITAL (CAH) PROVIDER OUR INPATIENT DAILY CENSUS IS LIMITED TO 25 PATIENTS PER DAY. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,212,326 | ExpenseAmt |
| Revenue | $8,802,347 | 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 2014. THESE SERVCIES ARE PROVIDED TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. THE HOSPITAL WAS AWARDED NEW YORK STATE VITAL ACCESS PROVIDER DESIGNATION BASED ON THE HIGH SAFETY NEED OF THE SERVICE AREA. INITIATIVES WITH MEDICAID HMO'S AND CONSUMER EDUCATION ON ALTERNATIVE SERVICE LOCATIONS INSTEAD OF THE EMERGENCY DEPARTMENT WERE IMPLEMENTED IN 2014. THESE CARE RE-DESIGN MEASURES ARE CONSISTENT WITH NYS DEPARTMENT OF HEALTH MEDICAID CARE RE-DESIGN INITIATIVES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $7,968,367 | ExpenseAmt |
| Revenue | $10,418,549 | RevenueAmt |
| Desc | TOTAL AMBULATORY OUTPATIENT SERVICE VISITS WERE APPROXIMATELY 34,000 IN 2014. THESE AMBULATORY SERVICE SERVICES INCLUDE REHAB / WELLNESS PROGRAM, AMBULATORY SURGERY / GI SERVIES, WOMENS IMAGING SERVICE, DIAGNOSTIC IMAGING SERVICES, AND PRIMARY CARE SERVICES. OUR DOLGEVILLE AND NEWPORT PRIMARY CARE CENTERS WERE RECONIZED AS HIGH PERFORMING CONSUMER SERVICE OPERATIONS AS MEASURED BY PRESS GANEY SURVERY RESULTS WITH A 95 PERCENTILE RANKING FOR CONSUMER SATISFACTION. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,338,492 | ExpenseAmt |
| Revenue | $3,029,200 | RevenueAmt |
| Desc | THE HOSPITAL RECEIVED NYS MEDICAID AND CMS MEDICARE FUNDS FOR "MEANINGFUL USE" ASSOCIATED WITH IMPLEMENTATION OF THE ELECTRONIC HEALTH RECORD OF $260,222 IN 2014. THERE IS CONTINUED IMPLENTATION PLANS FOR EXPANDING THE ELECTRONIC MEDICAL RECORD INTO A MORE INTERACTIVE RESOURCE FOR PROVIDERS AND PATIENTS OPERATING WITHIN A SECURED DOMAIN. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,338,492 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $3,029,200 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $26,195,723 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | Yes (1) | 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 |
| IRP Document | 44 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 350 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 (20 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 BULLIS | ||||||||
| CHAIRMAN | 2.00 | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOAN S CONBOY | ||||||||
| 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 | ||
| JENNIFER VANWAGONER | ||||||||
| TRUSTEE | 2.00 | 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 | $412,571 | $26,968 | ||
| NICHOLAS J NICOLETTA | ||||||||
| TREASURER | 2.00 | 51.50 | Yes (X) | Yes (X) | $0 | $476,485 | $29,490 | |
| JEFFREY WOEPPEL | ||||||||
| TRUSTEE, THROUGH APRIL 2014 | 2.00 | 48.00 | Yes (X) | $0 | $120,196 | $19,665 | ||
| KEVIN CROSLEY | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JUSTIN HUMMEL | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| AMY GRACE MD | ||||||||
| PRESIDENT OF MEDICAL STAFF | 2.00 | 40.00 | Yes (X) | $19,000 | $179,939 | $16,390 | ||
| 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 | $164,986 | $14,099 | ||
| MICHAEL OGDEN | ||||||||
| PRESIDENT & CEO | 40.00 | Yes (X) | $0 | $183,294 | $10,512 | |||
| JAMES G VIELKIND | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $139,962 | $0 | $4,468 | |||
| RICHARD NOCELLA | ||||||||
| PRIMARY CARE PHYSICIAN | 40.00 | $163,364 | $0 | $5,195 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $322,326 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,537,471 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $126,787 | 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 (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BIVENS & ASSOCIATES ARCHITECTS | |||||
| 528 PLUM STREET SUITE 200 | SYRACUSE | NY | 132041473 | ARCHITECT SERVICES | $173,400 |
| MEDSPAR LLC | |||||
| PO BOX 830 | BINGHAMTON | NY | 139020830 | BILLING SERVICES | $148,316 |
| DM CONSULTING | |||||
| PO BOX 4715 | UTICA | NY | 13504 | INFORMATION TECHNOLOGY | $123,264 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $141,754 | RelatedOrganizationsAmt |
| Government Grants | $303,189 | GovernmentGrantsAmt |
| Total Contributions | $444,943 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OUTPATIENT SERVICES | 623000 | $21,136,348 | $21,136,348 |
| INPATIENT HOSPITAL | 621930 | $8,537,631 | $8,537,631 |
| OTHER OPERATING REVENUE | 900099 | $541,421 | $541,421 |
| PROGRAM SERVICE LEASE | 532000 | $446,833 | $446,833 |
| HOSPITAL CAFETERIA | 900099 | $125,494 | $125,494 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $30,787,727 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $82,813 | TotalRevenueColumnAmt |
| Exclusion | $82,813 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $770,554 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $665,245 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $105,309 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $105,309 | TotalRevenueColumnAmt |
| Exclusion | $105,309 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,420,792 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $30,787,727 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $188,122 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,430 | TotalAmt |
| Program Services | $19,000 | ProgramServicesAmt |
| Management And General | $144,430 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,548,828 | TotalAmt |
| Program Services | $10,007,217 | ProgramServicesAmt |
| Management And General | $1,493,439 | ManagementAndGeneralAmt |
| Fundraising | $48,172 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $440,435 | TotalAmt |
| Program Services | $380,671 | ProgramServicesAmt |
| Management And General | $57,932 | ManagementAndGeneralAmt |
| Fundraising | $1,832 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,471,587 | TotalAmt |
| Program Services | $1,260,109 | ProgramServicesAmt |
| Management And General | $205,412 | ManagementAndGeneralAmt |
| Fundraising | $6,066 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $863,978 | TotalAmt |
| Program Services | $739,684 | ProgramServicesAmt |
| Management And General | $120,733 | ManagementAndGeneralAmt |
| Fundraising | $3,561 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,794 | TotalAmt |
| Management And General | $36,794 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,030 | TotalAmt |
| Program Services | $35,953 | ProgramServicesAmt |
| Management And General | $21,077 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,734 | TotalAmt |
| Management And General | $71,734 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $434,223 | TotalAmt |
| Program Services | $213,370 | ProgramServicesAmt |
| Management And General | $220,853 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,215 | TotalAmt |
| Program Services | $43,215 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,373,268 | TotalAmt |
| Program Services | $2,292,369 | ProgramServicesAmt |
| Management And General | $79,737 | ManagementAndGeneralAmt |
| Fundraising | $1,162 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,112,332 | TotalAmt |
| Program Services | $938,907 | ProgramServicesAmt |
| Management And General | $173,425 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $640,553 | TotalAmt |
| Program Services | $561,101 | ProgramServicesAmt |
| Management And General | $78,899 | ManagementAndGeneralAmt |
| Fundraising | $553 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,418 | TotalAmt |
| Program Services | $15,320 | ProgramServicesAmt |
| Management And General | $37,028 | ManagementAndGeneralAmt |
| Fundraising | $70 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,016 | TotalAmt |
| Program Services | $12,614 | ProgramServicesAmt |
| Management And General | $8,844 | ManagementAndGeneralAmt |
| Fundraising | $558 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,095 | TotalAmt |
| Program Services | $158,732 | ProgramServicesAmt |
| Management And General | $13,350 | ManagementAndGeneralAmt |
| Fundraising | $13 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,277,971 | TotalAmt |
| Program Services | $2,101,090 | ProgramServicesAmt |
| Management And General | $176,715 | ManagementAndGeneralAmt |
| Fundraising | $166 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $279,868 | TotalAmt |
| Program Services | $270,832 | ProgramServicesAmt |
| Management And General | $9,036 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PURCHASED MEDICAL SERVI | $5,027,661 | $5,027,661 | |
| PROVISION FOR BAD DEBT | $1,783,252 | $1,783,252 | |
| ADMINISTRATIVE SERVICES | $1,700,875 | $1,700,875 | |
| NEW YORK STATE ASSESSME | $87,076 | $87,076 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $529,593 | TotalAmt |
| Program Services | $247,550 | ProgramServicesAmt |
| Management And General | $279,761 | ManagementAndGeneralAmt |
| Fundraising | $2,282 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,190,232 | TotalAmt |
| Program Services | $26,195,723 | ProgramServicesAmt |
| Management And General | $4,930,074 | ManagementAndGeneralAmt |
| Fundraising | $64,435 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $748,500 | BOYAmt |
| EOY | $303,056 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,406,653 | BOYAmt |
| EOY | $1,520,456 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $448,936 | BOYAmt |
| EOY | $384,934 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,074,852 | BOYAmt |
| EOY | $3,119,017 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $480,659 | BOYAmt |
| EOY | $467,466 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $746,146 | BOYAmt |
| EOY | $1,431,115 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $41,155,946 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $21,326,770 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,187,909 | BOYAmt |
| EOY | $19,829,176 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,936,332 | BOYAmt |
| EOY | $2,653,184 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,651,120 | BOYAmt |
| EOY | $2,948,053 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,091,047 | BOYAmt |
| EOY | $1,908,664 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $861,688 | BOYAmt |
| EOY | $1,329,577 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,633,842 | BOYAmt |
| EOY | $35,894,698 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,133,077 | BOYAmt |
| EOY | $2,943,565 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $266,146 | BOYAmt |
| EOY | $593,821 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,583,864 | BOYAmt |
| EOY | $6,008,689 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,551,177 | BOYAmt |
| EOY | $3,028,342 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,534,264 | BOYAmt |
| EOY | $12,574,417 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,836,002 | BOYAmt |
| EOY | $18,729,570 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,381,689 | BOYAmt |
| EOY | $3,691,012 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $881,887 | BOYAmt |
| EOY | $899,699 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,099,578 | BOYAmt |
| EOY | $23,320,281 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,633,842 | BOYAmt |
| EOY | $35,894,698 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $230,560 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$63,121 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $53,264 | 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 | $8,339 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $8,339 | 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 (24.6%), IROQUOIS HEALTHCARE ALLIANCE (38.8%) AND AMERICAN HOSPITAL ASSOCIATION (22.8%) ARE USED SPECIFICALLY FOR LOBBYING PURPOSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| 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 Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| 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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| 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 |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $12,156,996 | BeginningYearBalanceAmt |
| Contributions | $623,347 | ContributionsAmt |
| Investment Earnings Or Losses | -$27,030 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $12,753,313 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,547,082 | BeginningYearBalanceAmt |
| Contributions | $5,230,555 | ContributionsAmt |
| Investment Earnings Or Losses | $1,782,439 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $403,080 | OtherExpendituresAmt |
| End Year Balance | $12,156,996 | 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 | $25,105,729 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,308,962 | DepreciationAmt |
| Book Value | $12,796,767 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,669,831 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,017,808 | DepreciationAmt |
| Book Value | $6,652,023 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $19,829,176 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| MARY LEARY CHARITABLE REMAINDER TR | $1,399,412 | F |
| ELSA O'BRIEN CHARITABLE REMAINER TR | $1,548,641 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $2,948,053 | TotalBookValueSecuritiesAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DIRECT FINANCE LEASE | Desc |
| Book Value | $1,908,664 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $1,908,664 | TotalBookValueProgramRltdAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED PENSION LIABILITY | $2,267,860 |
| ACCRUED SALARIES, PAYROLL TAXES AND FRINGE BENEFITS | $522,262 |
| OTHER LIABILITIES | $238,220 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,028,342 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $31,420,792 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $31,420,792 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $31,420,792 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $31,190,232 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $31,190,232 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $31,190,232 | 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. |
| 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, 2014 AND 2013, 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 2011 THROUGH 2014. |
| PART VI, LINE 1B | BUILDINGS INCLUDES CONSTRUCTION IN PROGRESS OF $1,246,876 FOR 2014 AND $284,582 FOR 2013. |
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 | 215 | PersonsServedCnt |
| Total Community Benefit Expns | $235,587 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $121,170 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $114,417 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 12595 | PersonsServedCnt |
| Total Community Benefit Expns | $6,300,678 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,999,140 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,301,538 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07830 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 12810 | PersonsServedCnt |
| Total Community Benefit Expns | $6,536,265 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,120,310 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,415,955 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08220 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $36,269 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,330 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $33,939 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 25 | PersonsServedCnt |
| Total Community Benefit Expns | $37,651 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $37,651 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4246 | PersonsServedCnt |
| Total Community Benefit Expns | $618,882 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $514,090 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $104,792 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 4271 | PersonsServedCnt |
| Total Community Benefit Expns | $692,802 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $516,420 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $176,382 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00610 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 17081 | PersonsServedCnt |
| Total Community Benefit Expns | $7,229,067 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,636,730 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,592,337 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08830 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,420 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,420 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $59,750 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $59,750 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00200 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $63,170 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $63,170 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,783,252 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $22,651 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,185,256 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,295,203 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$109,947 | 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 | LFHNY.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 |
| CHNA Conducted | 13 | 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.LFHNY.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 | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.LFHNY.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| 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 App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION A: | LITTLE FALLS HOSPITAL HAS PRIMARY CARE CLINICS IN DOLGEVILLE, NY AND NEWPORT,NY. EXTENDED EVENING HOURS ARE PROVIDED ONE NIGHT PER WEEK IN THE DOLGEVILLE, NY PRIMARY CARE CENTER. |
| LITTLE FALLS HOSPITAL | PART V, SECTION B, LINE 6A: THIS 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, COOPERSTOWN NEW YORK; AUREILA OSBORN FOX MEMORIAL HOSPITAL, ONEONTA NEW YORK; TRI TOWN REGIONAL HOSPITAL, SYNDEY NEW YORK; COBLESKILL REGIONAL HOSPITAL, COBLESKILL NEW YORK; O'CONNOR HOSPITAL, DELHI NEW YORK. |
| LITTLE FALLS HOSPITAL | PART V, SECTION B, LINE 11: OUR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOCUSED ON NEEDS TO PREVENTING CHRONIC DISEASE AND IMPROVING ACCESS FOR PRIMARY CARE. IN 2014 TWO NEW PRIMARY CARE PROVIDERS WERE RECRUITED ONE IN HERKIMER NY AND ONE IN ST. JOHNSVILLE. A NEED FOR THREE MORE PRIMARY PROVIDERS IS PLANNED TO CREATE THE CRITICAL MASS OF PROVIDERS TO MANAGE PATIENT NEEDS. THE DEVELOPMENT OF PRIMARY CARE IN OUR SERVICE AREA IS IN COLLABORATION WITH THE BASSETT HEALTHCARE NETWORK.PREVENTION OF CHRONIC DISEASE WAS IDENTIFIED AS A SECOND GOAL IN OUR 2013 COMMUNITY HEALTH NEEDS ASSESSMENT. FOR THIS PROJECT WE HAVE COMMENCED WITH OTHER COMMUNITY ORGANIZATIONS TO COLLABORATE AND SHARE INFORMATION. THESE PROGRAMS INCLUDE HERKIMER COUNTY RURAL NETWORK, NYS DIABETES PREVENTION PROGRAM, HERKIMER/ONEIDA/MADISON COUNTIES CANCER SERVICE PROGRAM, AND AMERICAN HEART ASSOCIATION. THESE COLLABORATIONS HAVE RESULTED IN INITIATIVES AND RESOURCES TO ADMINISTERED HEALTH STLYE PROGRAMS FOR PATIENTS. THESE PROGRAMS INCLUDE THERAPUDIC AND EDUCATIONAL COMPONENTS. LITTLE FALLS HOSPITAL ALSO BECAME A PARTNER IN THE LEATHERSTOCKING COLLABORATIVE HEALTH PARTNERS. THIS ORGANIZATION REPRESENTS A REGIONAL ORGANIZATION ESTABLISHED IN PARTNERSHIP WITH NYS DEPARTMENT OF HEALTH UNDER A CMS APPROVED REFERENCED AS DELIVERY SYSTEM REFORM INCENTIVE PAYMENT. 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 2015 THIS PROGRAM WAS ACTIVATED AND WILL CONTINUE TO BE A MAJOR COMPONENT OF OUR COMMUNITY HEALTH IMPLEMENTATION PLAN. WE HAVE IDENTIFIED THE DIFFICULTY IN RECRUITING PRIMARY CARE PROVIDERS TO OUR REGION AS A POTENTIAL BARRIER TO MEETING OUR GOALS. THERE REMAINS A SHORTAGE OF AVAILABLE PRIMARY CARE PROVIDERS AND ATTRITION WITH AGING OF PROVIDERS REMAINS A CHALLENGE IN OUR PLANNING. AS NOTED ABOVE, WE ARE IN NEED OF THREE ADDITIONAL PRIMARY CARE PHYSICIANS. |
| 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. ALSO ASSISTED PATIENTS IN COMPLETION OF APPLICATIONS FOR ENROLLMENT INTO NYS MARKETPLACE PLANS. |
| LITTLE FALLS HOSPITAL | PART V, SECTION B, LINE 22D: LITTLE FALLS HOSPITAL CHARGES UNIFORM CHARGES TO ALL PAYERS REGARDLESS OF RESPONSIBLE PARTY FOR THE BILL. FOR QUALIFIED UNINSURED WITHIN 300% OF FEDERAL POVERTY GUIDELINES A 100% DISCOUNT FROM CHARGES IS APPLIED. |
| PART V, SECTION B, LINE 14 | LITTLE FALLS HOSPITAL CHARGES FOR SERVICES BASED ON RELATIONSHIPS OF COST OF SERVICES, AND AGGREGATE MARGINS REQUIRED FOR HEALTHCARE SERVICES. |
| PART V, SECTION B, LINE 16 | FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY |
| LITTLE FALLS HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: | LFHNY.ORG |
| LITTLE FALLS HOSPITAL PART V, SECTION B, LINE 16B WEBSITE: | LFHNY.ORG |
| LITTLE FALLS HOSPITAL PART V, SECTION B, LINE 16C WEBSITE: | LFHNY.ORG |
| 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 |
|---|---|---|---|---|
| DOLGEVILLE | ||||
| 9 GIBSON STREET | DOLGEVILLE | NY | 13329 | CLINIC |
| NEWPORT | ||||
| BRIDGE STREET | NEWPORT | NY | 13416 | CLINIC |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 CENTERS LOCATED IN DOLGEVILLE AND NEWPORT NEW YORK. THESE CENTERS PROVIDE PRIMARY CARE SERVICES INCLUDING VACCINATIONS, WELL CARE VISITS, 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. |
| PART I, LN 7 COL(F): | LITTLE FALLS HOSPITAL EXCLUDED $1,783,252 OF BAD DEBT EXPENSE TO CALCULATE COST OF PATIENT CARE. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | COMMUNITY BUILDING ACTIVITIES ARE ASSOCIATED WITH LITTLE FALLS HOSPITAL WORKING WITH COMMUNITY BUSINESS'S THRU OUR MEMBERSHIP WITH LOCAL AGENCIES SUCH AS THE HERKIMER CHAMBER OF COMMERCE AND THE AREA HEALTH EDUCATION CENTERS (AHEC). THESE ACTIVITIES ALLOW FOR DIALOG ON CURRENT HEALTHCARE TOPICS, INSURANCE PROGRAMS, AND RECRUITMENT OF FUTURE EMPLOYEES. IN 2014 LITTLE FALLS HOSPITAL FUNDED A RURAL IMMERSION PROGRAM WITH AHEC TO PROVIDE FUTURE MEDICAL SCHOOL STUDENTS EXPOSURE TO RURAL HEALTHCARE. THESE STUDENTS WERE ALL FROM LARGER URBAN COMMUNITIES AND HAD VOLUNTEERED FOR THIS LEARNING EXPERIENCE. THIS EXPERIENCE EXPOSED STUDENTS TO RURAL MEDICAL CARE CHALLENGES SUCH AS GEOGRAPHIC DISTANCE BETWEEN PROVIDERS WITH THEIR PATIENTS AND IMPORTANCE OF THE ELECTRONIC HEALTH RECORD TO HAVE EFFICIENT HEALTHCARE SERVICES. LITTLE FALLS HOSPITAL COLLABORATED 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. |
| PART III, LINE 2: | BAD DEBT IS RECORDED BASED ON UNCOLLECTED AMOUNTS FROM PATIENTS WITHOUT INSURANCE AND AMOUNTS DUE AFTER INSURANCE BENEFITS ARE APPLIED. BAD DEBT WAS $1,783,252 IN 2014 COMPARED TO $2,319,023 IN 2013. WE ATTRIBUTE THIS DECLINE TO FEWER UN-INSURED PATIENTS RESULTING FROM IMPLEMENTATION OF THE AFFORDABLE CARE ACT AND NYS HEALTH BENEFITS EXCHANGE. LITTLE FALLS HOSPITAL ASSISTED PATIENTS WITH ENROLLMENT WITH HEALTH INSURANCE COVERAGE AS A NYS MARKETPLACE FACILITATED ENROLLER. |
| PART III, LINE 3: | AN ESTIMATE FOR POTENTIAL CHARITY CARE WAS BASED ON THE DENIED APPLICATIONS PROCESSED IN 2014 COMPARED WITH THOSE APPROVED APPLICATIONS. THIS AMOUNTED TO A 14.6% DENIAL RATE FOR CHARITY CARE APPLICATIONS WHICH IF APPROVED WOULD HAVE INCREASED THE AMOUNT OF CHARITY CARE AT COSTED AMOUNTS BY $22,651. |
| PART III, LINE 4: | THE HOSPITAL FOOTNOTE DESCRIBING PATIENT ACCOUNTS RECEIVABLES IS IN THE ATTACHED AUDITED FINANCIAL STATEMENTS NOTE (1)(J) PAGES 7 - 9. |
| PART III, LINE 8: | LITTLE FALLS HOSPITAL COSTING METHODOLOGY CONSISTS OF INFORMATION FROM MEDICARE COST REPORT. AS A CRITICAL ACCESS HOSPITAL PAYMENT IS BASED ON 101 % OF MEDICARE ALLOWABLE COST. THE AMOUNTS REFLECT 2% REDUCTION FOR SEQUESTRATION POLICY EFFECTIVE FOR APRIL 1, 2013. PAYMENTS FROM MEDICARE BAD DEBTS ARE INCLUDED BASED ON MEDICARE PAYMENT RULES. |
| PART III, LINE 9B: | COLLECTION AND CHARITY CARE POLICY SPECIFY ACCOUNTS WITH ACTIVE CARE APPLICATIONS WILL NOT GO TO COLLECTION AGENCIES WHILE IN REVIEW. |
| PART VI, LINE 2: | A. COMMUNITY HEALTH NEEDS ASSESSMENT DEVELOPMENT PROCESSTHE PROCESS FOR DEVELOPING THIS COMMUNITY HEALTH NEEDS ASSESSMENT ENTAILED THE COMPLETION OF A FOURTEEN-STEP PROCESS OVER A PERIOD FROM APRIL 2012 TO MARCH 2013. THE PROCESS BEGAN WITH THE DEVELOPMENT AND AGREEMENT ON A WORK PLAN FOR THE PROJECT THAT DEFINED BOTH ITS SCOPE AND TIME FRAME. IT INVOLVED GAINING A COMMON UNDERSTANDING OF THE PROJECT AND THE NECESSARY BUY-IN FOR ITS COMPLETION AND INCLUDED CHARGING A BASSETT NETWORK-WIDE ADVISORY GROUP WITH PROVIDING OVERALL GUIDANCE FOR DEVELOPING THE CHNA. THIS GROUP INCLUDED REPRESENTATION FROM EACH OF THE SIX HOSPITALS. IN ADDITION TO PROVIDING OVERALL GUIDANCE DURING THE PROCESS, THE ADVISORY GROUP WAS CHARGED WITH: - AGREEING ON A COMMON TEMPLATE FOR A COMMUNITY HEALTH NEEDS ASSESSMENT AS A METHOD FOR INTEGRATING THE DATA AND INFORMATION FROM THE COMMUNITY SERVICE PLAN AND COUNTY COMMUNITY HEALTH ASSESSMENTS;- CONSIDERING CURRENT HEALTH PRIORITIES OF THE COMMUNITY SERVICE PLAN AND RELATED COMMUNITY HEALTH ASSESSMENTS;- CONSIDERING THE DATA AND FINDINGS FROM THE UPSTATE HEALTH AND WELLNESS SURVEY;- SELECTION OF FUTURE HEALTH PRIORITIES FOR THIS COMMUNITY HEALTH NEEDS ASSESSMENT;- IDENTIFYING TARGETED OBJECTIVES FOR ADDRESSING SELECTED HEALTH PRIORITIES;- APPROVING THE CHNA AND RECOMMENDATION FOR PUBLICATION AND DISSEMINATION;- CONSIDERING PUBLIC AND KEY STAKEHOLDER INPUT ON THE CHNA;- REVIEWING AND ADVISING ON IMPLEMENTATION STRATEGIES BASED ON THE CHNA; AND - APPROVING A FINAL CHNA AND IS REPORT FOR SUBMISSION TO THE RESPECTIVE BOARDS OF THE SIX BASSETT HEALTHCARE NETWORK HOSPITALSONCE THE DRAFT CHNA WAS APPROVED BY THE BASSETT NETWORK-WIDE ADVISORY GROUP, IT WAS PUBLISHED ON EACH RESPECTIVE HOSPITAL'S WEBSITE, AS WELL AS ON THE BASSETT HEALTHCARE NETWORK WEBSITE. IT WAS ALSO DISTRIBUTED TO KEY STAKEHOLDERS IN THE AREA. THIS WAS FOLLOWED BY A MEETING WITH KEY STAKEHOLDERS IN THE LITTLE FALLS HOSPITAL SERVICE AREA. KEY STAKEHOLDERS INCLUDED REPRESENTATIVES OF AREA COMMUNITIES, SOCIAL SERVICES, PUBLIC HEALTH, HOSPITALS AND OTHER AREA HEALTH PROVIDERS. B. PRIMARY INFORMATION AND DATA SOURCESTHIS COMMUNITY HEALTH NEEDS ASSESSMENT IS BASED ON AND INCORPORATES EFFORTS OF LITTLE FALLS HOSPITAL, BASSETT HEALTHCARE AND SERVICE AREA COUNTY HEALTH DEPARTMENTS TO IDENTIFY COMMUNITY HEALTH NEEDS AS REQUIRED BY THE NEW YORK STATE DEPARTMENT OF HEALTH. SPECIFICALLY THROUGH LITTLE FALLS HOSPITAL'S COMMUNITY SERVICE PLAN FOR 2011-12 AND HERKIMER, FULTON AND MONTGOMERY COUNTIES' COMMUNITY HEALTH ASSESSMENT FOR 2010-2013. IT ALSO DRAWS UPON THE UPSTATE HEALTH AND WELLNESS SURVEY CONDUCTED IN 2009 BY BASSETT'S RURAL RESEARCH INSTITUTE. THE UPSTATE HEALTH AND WELLNESS SURVEY PROVIDES A PRIMARY DATA SOURCE FOR IDENTIFYING THE HEALTH STATUS OF RESIDENTS IN A SEVEN-COUNTY AREA SERVED BY BASSETT HEALTHCARE NETWORK AND ITS AFFILIATE HOSPITALS AND OTHER PROVIDERS (CHENANGO, DELAWARE, HERKIMER, MADISON, MONTGOMERY, OTSEGO AND SCHOHARIE). THE UPSTATE HEALTH & WELLNESS SURVEY, CONDUCTED IN 2009 BY THE BASSETT'S RURAL RESEARCH INSTITUTE, CONSISTED OF SEPARATE SURVEYS COVERING THE TOPICS OF: (1) HOUSEHOLD HEALTH; (2) ACCESS TO HEALTH CARE; (3) CHILD LIFESTYLE AND BEHAVIOR CHOICES; (4) ADULT LIFESTYLE AND BEHAVIOR CHOICES; AND (5) HEALTH AND HEALTH NEEDS OF THE RURAL ELDERLY. THE SURVEY WAS DESIGNED TO PROVIDE BASELINE DATA TO: 1) ASSESS THE RURAL REGION IN TERMS OF 27 PRIORITY HEALTH INDICATORS ESTABLISHED IN 2008 BY THE COMMISSIONER OF THE NEW YORK STATE DEPARTMENT OF HEALTH; 2) IDENTIFY KEY GEOSPATIAL, SOCIAL AND DEMOGRAPHIC FACTORS RELATED TO LIVING IN RURAL AREAS THAT MAY EXPLAIN RURAL-URBAN HEALTH DIFFERENCES; AND 3) IDENTIFY THE NEED FOR EXISTING AND NEW COMMUNITY HEALTH PROMOTION PROGRAMS THROUGHOUT THE REGION. THE FIVE SEPARATE SURVEYS WERE EACH DESIGNED TO MEET ADDITIONAL AIMS. DIFFERENT SAMPLING FRAMES WERE USED FOR THE FIVE SURVEYS CONDUCTED IN 2009. THREE OF THE SURVEYS (HOUSEHOLD HEALTH; ACCESS TO HEALTH CARE; CHILD LIFESTYLE AND BEHAVIOR CHOICES) WERE ADMINISTERED TO RANDOM SAMPLES OF HOUSEHOLDS IN THE SEVEN-COUNTY STUDY REGION BASED ON A LIST OF HOUSEHOLD ADDRESSES. THE SAMPLING FRAMES FOR THE OTHER TWO SURVEYS (ADULT LIFESTYLE AND BEHAVIOR CHOICES; HEALTH AND HEALTH NEEDS OF THE RURAL ELDERLY) WERE DERIVED FROM A RANDOM SAMPLE OF THE ROSTER OF PARTICIPANTS IN A PREVIOUS HEALTH CENSUS CONDUCTED IN 1999. A RANDOM SAMPLE OF INDIVIDUALS WITH A BMI VALUE FROM THE 1999 HEALTH CENSUS WAS SELECTED FOR THE SURVEY ON ADULT LIFESTYLE AND BEHAVIOR CHOICES. THE SAMPLE FOR THE SURVEY ON THE RURAL ELDERLY INCLUDED ALL FARMERS FROM PRIOR HEALTH CENSUSES CONDUCTED IN 1989 AND 1999 WHO WOULD BE AT LEAST 50 YEARS OF AGE IN 2009 AND A RANDOM SAMPLE OF NON-FARMERS FROM THE 1989 OR 1999 HEALTH CENSUS WHO MET THE SAME AGE CRITERION. THE RANDOM HOUSEHOLD SURVEYS CONDUCTED IN EACH OF THE SEVEN COUNTIES OF BASSETT'S SERVICE AREA ARE SHOWN IN THE TABLE BELOW. THE SURVEYS CONDUCTED IN HERKIMER AND MONTGOMERY COUNTIES (WITHIN LITTLE FALLS HOSPITAL SERVICE AREA) INCLUDED 1,822, AND 1,692 RESPONDENTS RESPECTIVELY FOR THE HOUSEHOLD SURVEY, 92 AND 80 RESPONDENTS RESPECTIVELY FOR THE ACCESS SURVEY AND 153 AND 107 RESPONDENTS RESPECTIVELY FOR THE CHILD LIFESTYLE AND BEHAVIORAL CHOICES SURVEY. THE SURVEY WAS NOT CONDUCTED IN FULTON COUNTY WHICH ALSO INCLUDES SOME OF LITTLE FALLS SERVICE AREA. IN ADDITION, FOR THE PURPOSES OF THIS ASSESSMENT, THE SURVEY DATA WAS RE-AGGREGATED ALONG THE SERVICE AREA FOR LITTLE FALLS HOSPITAL AS DEFINED BY ZIP-CODES. A) - REGION, B) - HOUSEHOLD HEALTH (ALL RESPONDENTS/RESPONDENTS 18+), C) - ACCESS TO CARE (PRIMARY RESPONDENT), D) - CHILD LIFESTYLE (KIDS 2-18) A B C DALL REGIONS 13,226/11,009 1,784 979 SCOHARIE 1,847/1,542 95 144OTSEGO 2,663/2,235 80 163MONTGOMERY 1,692/1,386 80 107MADISON 1,840/1,478 412 138HERKIMER 1,822/1,548 92 153DELAWARE 1,373/1,153 545 125CHENANGO 1,989/1,667 480 149WHILE THE OVERALL GOAL OF DETERMINING THE GENERAL HEALTH STATUS OF BASSETT'S RURAL SERVICE REGION REMAINED CONSTANT, THE 2009 UPSTATE HEALTH & WELLNESS SURVEY EXPANDED ON PREVIOUS EFFORTS BY: 1) UNDERTAKING AN EXTENSIVE PRE-STUDY COLLABORATIVE PLANNING PROCESS WITH LOCAL HEALTH DEPARTMENTS AND THE PUBLIC; 2) COLLABORATING WITH PUBLIC HEALTH RESEARCHERS FROM AREA UNIVERSITIES; AND 3) INCLUDING PHYSICAL MEASUREMENTS ON SOME PARTICIPANTS TO CONFIRM THE VALIDITY OF SELF-REPORTS. IN ADDITION TO PROVIDING DESCRIPTIVE EPIDEMIOLOGIC DATA ON THE PREVALENCE OF HEALTH BEHAVIORS AND CONDITIONS, THE 2009 SURVEY WAS DESIGNED TO TEST A NUMBER OF HYPOTHESES IN THE AREAS OF OBESITY, AGING, HEALTH CARE ACCESS, CHRONIC DISEASE, MENTAL HEALTH, AND OTHER CONCERNS IDENTIFIED BY THE COMMUNITY.THIS INFORMATION IS FROM LITTLE FALLS HOSPITAL 2013 COMMUNITY HEALTH NEEDS ASSESSMENT PAGES 4-6. |
| 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 POINTS WHERE SERVICES ARE PROVIDED APPLICATIONS FOR ASSISTANCE ARE AVAILABLE. THE WWW.LFHNY.ORG WEBSITE INCLUDES A LINK ON INFORMATION FOR COMPLETING AN APPLICATION AND OTHER RESOURCES CALLED "FINANCIAL ASSISTANCE RESOURCE GUIDE". IN 2014 LITTLE FALLS HOSPITAL ASSISTED PATIENTS FOR ENROLLMENT WITH THE NYS HEALTH MARKETPLACE PORTAL. |
| 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 97 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 16.2 PERCENT AGED 65 AND OLDER. NEARLY 80 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 AT $40,106 ARE ALSO BELOW THE STATE MEDIAN OF $55,980. IT ESTIMATED THAT 14 PERCENT OF THE POPULATION IS BELOW THE FEDERAL POVERTY LEVEL, HIGHER THAN BOTH THE STATE (13.7) AND U.S. (13.3) AVERAGES AND AN ESTIMATED 14.4 PERCENT OF THE COUNTY'S POPULATION IS UNINSURED. IN ADDITION, THERE ARE NUMEROUS HEALTH STATUS INDICATORS THAT SHOW THAT MANY PRIMARY CARE NEEDS OF THE POPULATION RESIDING IN AREA REMAIN UNMET. THESE INCLUDE COMPARATIVELY: LOWER PERCENTAGES OF PREGNANT WOMEN WITH EARLY PRENATAL CARE, ANEMIA AND OBESITY; HIGHER PERCENTAGES OF CHILDREN WITH ANEMIA; HIGHER PERCENTAGES OF ADULTS WHO ARE OVERWEIGHT, SMOKE AND DRINK EXCESSIVELY; HIGHER RATES OF DEATH AND HOSPITALIZATION FROM CARDIOVASCULAR AND HEART DISEASES; A HIGHER INCIDENCE OF CANCER OF THE LUNGS; HIGHER DEATH RATES DUE TO CIRRHOSIS AND DIABETES; HIGHER HOSPITALIZATIONS DUE TO PNEUMONIA AND FLU; AND HIGHER RATES OF DEATH AND HOSPITALIZATION FROM SUICIDE, SELF INFLICTED AND UNINTENTIONAL INJURIES. |
| PART VI, LINE 5: | LITTLE FALLS HOSPITAL IMPLEMENTS COORDINATED HEALTH CARE RESOURCES WITH BASSETT HEALTHCARE NETWORK. MAJOR AREAS OF CONCENTRATION FOR 2014 INCLUDED IMPLEMENTATION OF PROGRAMS TO PROVIDE ADDITIONAL ACCESS FOR PATIENTS AS AN ALTERNATIVE TO AN EMERGENCY DEPARTMENT VISIT. THIS ALTERNATIVE WAS TO PROVIDE SERVICES AT A CONVENIENT CARE CENTER IN HERKIMER NY AS AN ALTERNATIVE FOR EMERGENCY DEPARTMENT SERVICES. THIS EFFORT IS CONSISTENT WITH NYS DELIVERY SYSTEM IMPROVEMENT GOALS TO REDUCE BY 25% UNNECESSARY EMERGENCY DEPARTMENT VISITS. LITTLE FALLS HOSPITAL ALSO BEGAN A CARE TRANSITION PROGRAM TO REDUCE THE NUMBER OF READMISSIONS. THE CARE TRANSITION PROGRAM PROTOCOL IS TO WORK IN COLLABORATION WITH PATIENT AND FAMILY ON FOLLOWING PATIENT DISCHARGE INSTRUCTIONS TO REDUCE RISK OF READMISSION. WE ARE EXPECTING A REDUCTION IN OUR THIRTY-DAY READMISSION RATE FROM 10% - 7% OVER THE NEXT SEVERAL YEARS. |
| PART VI, LINE 6: | LITTLE FALLS HOSPITAL IS A MEMBER OF THURSTON CORPORATION (DBA 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 26 COMMUNITY BASED HEALTH CENTERS, 19 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, 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. |
| 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 | $339,350 | $0 | $3,931 | $0 | $69,290 | $0 | $23,920 | $0 | $3,048 | $0 | $439,539 | $0 | $0 |
| NICHOLAS J NICOLETTA | ||||||||||||||
| TREASURER | $0 | $471,310 | $0 | $5,175 | $0 | $0 | $0 | $23,920 | $0 | $5,570 | $0 | $505,975 | $0 | $0 |
| AMY GRACE MD | ||||||||||||||
| PRESIDENT OF MEDICAL STAFF | $19,000 | $176,042 | $0 | $3,897 | $0 | $0 | $0 | $11,520 | $0 | $4,870 | $19,000 | $196,329 | $0 | $0 |
| LISA BETRUS | ||||||||||||||
| THIRD VICE CHAIRMAN | $0 | $164,986 | $0 | $0 | $0 | $0 | $0 | $8,375 | $0 | $5,724 | $0 | $179,085 | $0 | $0 |
| MICHAEL OGDEN | ||||||||||||||
| PRESIDENT & CEO | $0 | $174,500 | $0 | $8,560 | $0 | $234 | $0 | $9,280 | $0 | $1,232 | $0 | $193,806 | $0 | $0 |
| RICHARD NOCELLA | ||||||||||||||
| PRIMARY CARE PHYSICIAN | $163,364 | $0 | $0 | $0 | $0 | $0 | $4,901 | $0 | $294 | $0 | $168,559 | $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 (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | AMENDED THE BYLAWS IN 2014 TO COMPLY WITH THE NEW YORK STATE NON-PROFIT REVITALIZATION ACT. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE HOSPITAL IS BASSETT REGIONAL CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | BASSETT REGIONAL CORPORATION, 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 11 | 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 -289,610. CHANGE IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST 296,933. CHANGE IN FRIENDS OF BASSETT 45,941. |
| FORM 990, PART XII, LINE 2C | THE 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| THURSTON CORPORATION | |||||||||||
| 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 | THURSTON CORPORATION | |
| 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 | THURSTON CORPORATION | |
| 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 | THURSTON CORPORATION | |
| TEMPLETON FOUNDATION | |||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 133317084 | FACILITIES / OFFICE SPACE | NY | 501 (C) 3 | 9 | 0 | THURSTON CORPORATION | |
| 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 | THURSTON CORPORATION | |
| 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 |
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