2015-11-12T16:08:18-06:00 2014-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2014-01-01 150533578 LITTLE FALLS HOSPITAL LITT 3158231000 140 BURWELL STREET LITTLE FALLS NY 13365 JAMES VIELKIND CFO 3158231000 2015-11-11 1 JOSEPH J SCHLEGEL P00301329 3154463600 2014 2016-02-25 16:41:14Z JAMES VIELKIND 140 BURWELL STREET LITTLE FALLS NY 13365 32086037 0 X LFHNY.ORG X 1893 NY 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. 16 12 350 22 0 0 411685 444943 29807878 30787727 460212 188122 0 0 30679775 31420792 0 0 0 0 14777416 14488258 0 0 64435 15316593 16701974 30094009 31190232 585766 230560 34633842 35894698 11534264 12574417 23099578 23320281 X LITTLE FALLS HOSPITAL IS A VOLUNTARY, NOT-FOR-PROFIT COMMUNITY HEALTHCARE SYSTEM WHOSE MISSION IS TO OFFER QUALITY CARE WITH COMPASSION, TO ALL WHO NEED OUR SERVICES. 0 0 8676538 8537631 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. 8212326 8802347 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. 7968367 10418549 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. 1338492 3029200 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. 1338492 3029200 26195723 1 1 0 0 0 0 0 0 0 1 1 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 44 0 1 350 1 0 0 0 0 0 0 0 0 0 0 X 16 12 0 0 1 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X JAMES G VIELKIND 3158235281 140 BURWELL STREET LITTLE FALLS NY 13365 JOHN BULLIS CHAIRMAN 2.00 1.50 X X 0 0 0 JOAN S CONBOY TRUSTEE 2.00 X 0 0 0 TIMOTHY DALY SECOND VICE CHAIRMAN 2.00 X X 0 0 0 ANTHONY DELUCA FIRST VICE CHAIRMAN 2.00 X X 0 0 0 JOY MALONE TRUSTEE 2.00 X 0 0 0 GERARD J SNYDER SECRETARY 2.00 X X 0 0 0 JENNIFER VANWAGONER TRUSTEE 2.00 X 0 0 0 RANBIR SODHI MD TRUSTEE 2.00 X 0 0 0 AUGUST LEINHART MD TRUSTEE 2.00 40.00 X 0 412571 26968 NICHOLAS J NICOLETTA TREASURER 2.00 51.50 X X 0 476485 29490 JEFFREY WOEPPEL TRUSTEE, THROUGH APRIL 2014 2.00 48.00 X 0 120196 19665 KEVIN CROSLEY TRUSTEE 2.00 X 0 0 0 JUSTIN HUMMEL TRUSTEE 2.00 X 0 0 0 AMY GRACE MD PRESIDENT OF MEDICAL STAFF 2.00 40.00 X 19000 179939 16390 ROBERT CASULLO TRUSTEE 2.00 X 0 0 0 DUANE SIDNEY TRUSTEE 2.00 X 0 0 0 LISA BETRUS THIRD VICE CHAIRMAN 2.00 X X 0 164986 14099 MICHAEL OGDEN PRESIDENT & CEO 40.00 X 0 183294 10512 JAMES G VIELKIND CHIEF FINANCIAL OFFICER 40.00 X 139962 0 4468 RICHARD NOCELLA PRIMARY CARE PHYSICIAN 40.00 X 163364 0 5195 322326 1537471 126787 2 0 1 0 BIVENS & ASSOCIATES ARCHITECTS 528 PLUM STREET SUITE 200 SYRACUSE NY 132041473 ARCHITECT SERVICES 173400 MEDSPAR LLC PO BOX 830 BINGHAMTON NY 139020830 BILLING SERVICES 148316 DM CONSULTING PO BOX 4715 UTICA NY 13504 INFORMATION TECHNOLOGY 123264 3 141754 303189 444943 OUTPATIENT SERVICES 623000 21136348 21136348 INPATIENT HOSPITAL 621930 8537631 8537631 OTHER OPERATING REVENUE 900099 541421 541421 PROGRAM SERVICE LEASE 532000 446833 446833 HOSPITAL CAFETERIA 900099 125494 125494 30787727 82813 82813 770554 665245 105309 105309 105309 31420792 30787727 0 188122 163430 19000 144430 11548828 10007217 1493439 48172 440435 380671 57932 1832 1471587 1260109 205412 6066 863978 739684 120733 3561 36794 36794 57030 35953 21077 71734 71734 434223 213370 220853 43215 43215 2373268 2292369 79737 1162 1112332 938907 173425 640553 561101 78899 553 52418 15320 37028 70 22016 12614 8844 558 172095 158732 13350 13 2277971 2101090 176715 166 279868 270832 9036 PURCHASED MEDICAL SERVI 5027661 5027661 PROVISION FOR BAD DEBT 1783252 1783252 ADMINISTRATIVE SERVICES 1700875 1700875 NEW YORK STATE ASSESSME 87076 87076 529593 247550 279761 2282 31190232 26195723 4930074 64435 748500 303056 1406653 1520456 448936 384934 3074852 3119017 480659 467466 746146 1431115 41155946 21326770 20187909 19829176 1936332 2653184 2651120 2948053 2091047 1908664 861688 1329577 34633842 35894698 3133077 2943565 266146 593821 4583864 6008689 3551177 3028342 11534264 12574417 X 18836002 18729570 3381689 3691012 881887 899699 23099578 23320281 34633842 35894698 X 230560 -63121 53264 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 8339 8339 0 PART II-B, LINE 1: 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. 4263576 137 326998 4590711 10099410 720 361656 6198210 4263576 12753313 12870 1085526 3752299 10099410 12156996 623347 -27030 12753313 5547082 5230555 1782439 403080 12156996 0.19600 0.80400 0 1 1 380386 380386 25105729 12308962 12796767 15669831 9017808 6652023 19829176 MARY LEARY CHARITABLE REMAINDER TR 1399412 F ELSA O'BRIEN CHARITABLE REMAINER TR 1548641 F 2948053 DIRECT FINANCE LEASE 1908664 C 1908664 ACCRUED PENSION LIABILITY 2267860 ACCRUED SALARIES, PAYROLL TAXES AND FRINGE BENEFITS 522262 OTHER LIABILITIES 238220 3028342 X 31420792 0 31420792 0 31420792 31190232 0 31190232 0 31190232 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. 1 1 1 X 300.000000000000 0 1 1 0 1 1 215 235587 121170 114417 0.00390 12595 6300678 3999140 2301538 0.07830 12810 6536265 4120310 2415955 0.08220 36269 2330 33939 0.00120 25 37651 37651 0.00130 4246 618882 514090 104792 0.00360 4271 692802 516420 176382 0.00610 17081 7229067 4636730 2592337 0.08830 3420 3420 0.00010 59750 59750 0.00200 63170 63170 0.00210 1 1783252 22651 9185256 9295203 -109947 X 1 1 1 1 LITTLE FALLS HOSPITAL 140 BURWELL STREET LITTLE FALLS NY 13365 LFHNY.ORG 2129700H X X INCLUDES 25 INPATIENT BEDS, LITTLE FALLS HOSPITAL 1 0 0 1 X X X X X X X X 13 1 1 1 1 X WWW.LFHNY.ORG X WWW.BASSETT.ORG X 1 13 1 WWW.LFHNY.ORG 0 0 1 X 300.000000000000 1 1 X X X X 1 X X X X X X X X 1 X 0 X X X X X 1 X 0 0 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 2 DOLGEVILLE 9 GIBSON STREET DOLGEVILLE NY 13329 CLINIC NEWPORT BRIDGE STREET NEWPORT NY 13416 CLINIC PART I, LINE 3C: LITTLE FALLS HOSPITAL DID NOT PROVIDE CHARITY CARE OR DISCOUNTED CARE TO PATIENTS WITH INSURANCE BENEFITS. PART I, LINE 7: COST FOR CHARITY CARE PATIENTS WAS CALCULATED USING RATIO OF COST TO CHARGES. COST ASSOCIATED WITH MEDICAID AND MEDICAID HMO PROGRAMS REPRESENTS AGGREGATE ALLOWABLE COST AND TOTAL GROSS CHARGES USED TO CALCULATE A FACILITY LEVEL COST TO CHARGE RATIO. THIS FACILITY LEVEL COST TO CHARGE RATIO WAS APPLIED TO TOTAL MEDICAID AND MEDICAID HMO CHARGES TO ARRIVE AT TOTAL MEDICAID COST. PART I, LINE 7G: LITTLE FALLS HOSPITAL OPERATES TWO PRIMARY CARE 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 X 0 0 X X X X 0 0 0 0 0 0 0 0 0 AUGUST LEINHART MD TRUSTEE 0 339350 0 3931 0 69290 0 23920 0 3048 0 439539 0 0 NICHOLAS J NICOLETTA TREASURER 0 471310 0 5175 0 0 0 23920 0 5570 0 505975 0 0 AMY GRACE MD PRESIDENT OF MEDICAL STAFF 19000 176042 0 3897 0 0 0 11520 0 4870 19000 196329 0 0 LISA BETRUS THIRD VICE CHAIRMAN 0 164986 0 0 0 0 0 8375 0 5724 0 179085 0 0 MICHAEL OGDEN PRESIDENT & CEO 0 174500 0 8560 0 234 0 9280 0 1232 0 193806 0 0 RICHARD NOCELLA PRIMARY CARE PHYSICIAN 163364 0 0 0 0 0 4901 0 294 0 168559 0 0 0 PART I, LINE 3 THE COMPENSATION PROCESS FOR TOP OFFICIAL THE CHIEF EXECUTIVE OFFICER'S SALARY IS PAID BY A RELATED ORGANIZATION UNDER A MANAGEMENT SERVICES AGREEMENT. THE LITTLE FALLS HOSPITAL BOARD OF TRUSTEE'S REVIEWS THE FORMAL PROCESS THAT IS USED TO DETERMINE THE BASE COMPENSATION OF THE CEO. THE CEO WORK PLAN AND ACCOMPLISHMENTS FOR THE YEAR ARE REVIEWED. SALARY CHANGES ARE BASED ON MARKET, WORK PLAN, AND ACCOMPLISHMENTS. THE CEO'S SALARY IS SUBMITTED AS PART OF THE MANAGEMENT SERVICES AGREEMENT WHICH IS APPROVED BY THE BOARD OF TRUSTEES. FORM 990, PART 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. 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 THURSTON CORPORATION 0 MARY IMOGENE BASSETT HOSPITAL ONE ATWELL ROAD COOPERSTOWN NY 13326 135596796 HEALTH CARE ORGANIZATION OFFERING INPATIENT AND OUTPATIENT SERVICES NY 501 (C) 3 3 THURSTON CORPORATION 0 AURELIA OSBORN FOX MEMORIAL HOSPITAL SOCIETY ONE NORTON AVENUE ONEONTA NY 13820 150539039 HEALTH CARE ORGANIZATION OFFERING INPATIENT AND OUTPATIENT SERVICES NY 501 (C) 3 3 THURSTON CORPORATION 0 TEMPLETON FOUNDATION ONE ATWELL ROAD COOPERSTOWN NY 13326 133317084 FACILITIES / OFFICE SPACE NY 501 (C) 3 9 THURSTON CORPORATION 0 BASSETT REGIONAL CORPORATION ONE ATWELL ROAD COOPERSTOWN NY 13326 133522783 PROVIDES EXCELLENCE IN THE COORDINATION PLANNING AND POLICY DIRECTION FOR NY 501 (C) 3 11 (B) THURSTON CORPORATION 0 COBLESKILL REGIONAL HOSPITAL 178 GRANDVIEW DRIVE COBLESKILL NY 12043 141772971 HEALTHCARE SERVICES OFFERING INPATEINT AND OUTPATIENT SERVICES NY 501 (C) 3 3 BASSETT REGIONAL CORPORATION 0 O'CONNOR HOSPITAL 460 ANDES ROAD DELHI NY 13753 161540394 HEALTH CARE ORGANIZATION OFFERING INPATIENT AND OUTPATIENT SERVICES NY 501 (C) 3 3 BASSETT REGIONAL CORPORATION 0 TRI TOWN REGIONAL HEALTHCARE 43 PEARL STREET SYNDEY NY 13838 260169584 HEALTHCARE SERVICES OFFERING OUTPATIENT SERVICES NY 501 (C) 3 3 BASSETT REGIONAL CORPORATION 0 VALLEY HEALTH SERVICES 690 GERMAN STREET HERKIMER NY 13350 222511614 NURSING HOME NY 501 (C) 3 3 BASSETT REGIONAL CORPORATION 0 0 0 1 0 0 0 0 0 0 1 0 1 1 0 1 0 1 0 0