AURELIA OSBORN FOX MEMORIAL HOSPITAL: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
AURELIA OSBORN FOX MEMORIAL HOSPITAL (EIN 15-0539039)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-11
IRS object ID
201413159349301836
Schema version
2013v3.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2014-11-11T14:19:41-06:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN161226221PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FUST CHARLES CHAMBERS LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15784 WIDEWATERS PARKWAYAddressLine1
CitySYRACUSECity
StateNYState
ZIP Code13214ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN150539039EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AURELIA OSBORN FOX MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlAUREBusinessNameControlTxt
Phone6074315900PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 NORTON AVEAddressLine1
CityONEONTACity
StateNYState
ZIP Code13820ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK J WRIGHTPersonNm
Person TitleCFOPersonTitleTxt
Phone6074315900PhoneNum
Signature2014-11-05SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOSEPH J SCHLEGELPreparerPersonNm
PTINP00301329PTIN
Phone3154463600PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1AO FOX MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Principal OfficerMARK J WRIGHTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 NORTON AVEAddressLine1
CityONEONTACity
StateNYState
ZIP Code13820ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$92,709,446GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.AOFOXHOSPITAL.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1900FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionHEALTH CARE DELIVERY: INCLUDES: UNCOMPENSATED CARE, PAYMENTS INTO BAD DEBT AND CHARITY CARE POOLS, NYS HEALTH FACILITIES ASSESSMENT, COMMUNITY EDUCATION, MATERNAL CARE PROGRAM, COST OF PROVIDING SERVICES TO GOVERNMENT PAYORS. HEALTH/WELLNESS AND EDUCATIONAL SERVICES TO THE GENERAL PUBLIC.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee1100TotalEmployeeCnt
Total Volunteers123TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,282,230PYContributionsGrantsAmt
CY Contributions Grants$13,407,601CYContributionsGrantsAmt
PY Program Service Revenue$83,273,542PYProgramServiceRevenueAmt
CY Program Service Revenue$75,150,303CYProgramServiceRevenueAmt
PY Investment Income$93,613PYInvestmentIncomeAmt
CY Investment Income$650,506CYInvestmentIncomeAmt
PY Other Revenue$612,984PYOtherRevenueAmt
CY Other Revenue$949,068CYOtherRevenueAmt
PY Total Revenue$85,262,369PYTotalRevenueAmt
CY Total Revenue$90,157,478CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$49,710,620PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$48,038,468CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$37,686,114PYOtherExpensesAmt
CY Other Expenses$38,235,818CYOtherExpensesAmt
PY Total Expenses$87,396,734PYTotalExpensesAmt
CY Total Expenses$86,274,286CYTotalExpensesAmt
PY Revenues Less Expenses-$2,134,365PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,883,192CYRevenuesLessExpensesAmt
Total Assets BOY$77,786,230TotalAssetsBOYAmt
Total Assets EOY$79,782,149TotalAssetsEOYAmt
Total Liabilities BOY$38,765,974TotalLiabilitiesBOYAmt
Total Liabilities EOY$38,577,719TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$39,020,256NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$41,204,430NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionHEALTH CARE DELIVERY: INCLUDES: UNCOMPENSATED CARE, PAYMENTS INTO BAD DEBT AND CHARITY POOLS, NYS HEALTH FACILITIES ASSESMENT, COMMUNITY EDUCATION, MATERNAL CARE PROGRAM, COST OF PROVIDING SERVICES TO GOVERNMENT PAYORS. HEALTH/WELLNESS AND EDUCATIONAL SERVICES TO THE GENERAL PUBLIC.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$67,316,679ExpenseAmt
Revenue$64,524,553RevenueAmt
DescHEALTH CARE DELIVERY: INCLUDES: UNCOMPENSATED CARE, PAYMENTS INTO BAD DEBT AND CHARITY POOLS, NYS HEALTH FACILITIES ASSESSMENT, COMMUNITY EDUCATION, MATERNAL CARE PROGRAM, COST OF PROVIDING SERVICES TO GOVERNMENT PAYORS. HEALTH/WELLNESS AND EDUCATIONAL SERVICES TO THE GENERAL PUBLIC. IN 2013 THE HOSPITAL HAD 13108 PATIENT DAYS 12795 EMERGENCY ROOM VISITS AND 208461 OUTPATIENT VISITS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$9,131,428ExpenseAmt
Revenue$9,068,991RevenueAmt
DescNURSING HOME CARE - NURSING HOME FACILITY- SKILLED NURSING, HEALTH AND RESPITE CARE. IN 2013 THE NURSING HOME HAD 46664 PATIENT DAYSDesc
FieldValueIRS element (for citing)
Total Program Service Expenses$76,448,107TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document100IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1100EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AURELIA OSBORN FOX MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Phone6074315900PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 NORTON AVEAddressLine1
CityONEONTACity
StateNYState
ZIP Code13820ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
TODD BITTERMAN
DIRECTOR24.00Yes (X)$65,040$0$25
BRIAN D BURNS
DIRECTOR0.50Yes (X)$0$0$0
ROSEMARY HOLBROOK
SECRETARY0.50Yes (X)$0$0$0Yes (X)
MAUREEN HULBERT
DIRECTOR0.50Yes (X)$0$0$0
NANCY KLENIEWSKI
CHAIRMAN0.50Yes (X)$0$0$0Yes (X)
WILLIAM MIRABITO
DIRECTOR0.50Yes (X)$0$0$0
SARAH PATTERSON
VICE CHAIRMAN0.50Yes (X)$0$0$0Yes (X)
NICHOLAS J NICOLETTA
TREASURER0.50Yes (X)$0$427,411$29,283Yes (X)
SETH HAIGHT
DIRECTOR0.50Yes (X)$0$0$0
JEANNE HAVENER
DIRECTOR0.50Yes (X)$0$0$0
KEVIN KURKOWSKI
DIRECTOR0.50Yes (X)$0$0$0
V DANIEL ROBINSON
DIRECTOR0.50Yes (X)$0$0$0
JEFFREY WOEPPEL
DIRECTOR0.50Yes (X)$0$215,179$24,045
GENNARO FALCO
MD40.00Yes (X)$251,225$0$28,772
LORRAINE ZIMNIEWICZ
DIRECTOR0.50Yes (X)$0$0$0
JOSEPH FORGIANO
DIRECTOR0.50Yes (X)$0$0$0
JOHN REMILLARD
PRESIDENT40.00$0$286,511$17,029Yes (X)
MARK WRIGHT
CFO40.00$156,278$0$27,955Yes (X)
BENJAMIN FRIEDELL
VP MEDICAL AFFAIRS40.00$270,087$0$25,173Yes (X)
MACIEJ NOWAKOWSKI
MD40.00$355,574$0$26,301Yes (X)
PATRICK GERMAIN
MD40.00$357,547$0$28,772Yes (X)
SARBJIT VILKHU
MD40.00$329,719$0$25,386Yes (X)
MARIO VILLARINI
MD40.00$311,987$0$28,639Yes (X)
BLAINE JONES
MD40.00$320,284$0$32,342Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,417,741TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$929,101TotReportableCompRltdOrgAmt
Total Other Compensation$293,722TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K42IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
LECHASE CONSTRUCTION SERVICES
205 INDIGO CREEK DRIVEROCHESTERNY14626CONSTRUCTION COMPANY$5,040,101
PEGASUS MEDICINE GROUP
1007 E MAIN STREET SUITE 300BOZEMANMT59715CONTRACTED MEDICAL SERVICES$930,296
MORRIS SWITZER
185 TALCOTT ROADWILLISTONVT05495ARCHITECT$753,947
FUST CHARLES CHAMBERS
5784 WIDEWATERS PARKWAYSYRACUSENY13214AUDITING, TAX AND CONSULTING SERVICES$245,585
FUSION MEDICAL STAFFING LLC
11506 NICHOLAS STREETOMAHANE68154MEDICAL LOCUM SERVICES$221,601
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
Related Organizations$4,157,444RelatedOrganizationsAmt
Government Grants$8,972,206GovernmentGrantsAmt
All Other Contributions$277,951AllOtherContributionsAmt
Total Contributions$13,407,601TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
HOSPITAL621990$64,178,691$64,178,691
NURSING HOME623990$9,236,029$9,236,029

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,735,583TotalRevenueColumnAmt
Exclusion$1,735,583ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$75,150,303TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$127,767TotalRevenueColumnAmt
Exclusion$127,767ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$608,910RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real-$250,948RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$357,962RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$357,962TotalRevenueColumnAmt
Exclusion$357,962ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,911,979SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,112,806SecuritiesAmt
Other$276,434OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$799,173SecuritiesAmt
Other-$276,434OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$522,739TotalRevenueColumnAmt
Exclusion$522,739ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$592,500GrossSalesOfInventoryAmt
Cost Of Goods Sold$413,676CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$178,824TotalRevenueColumnAmt
Related Or Exempt Func Income$178,824RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
EXPENSE REIMBURSEMENT621910$402,187$402,187
CONVENIENCE SERVICES621910$10,095$10,095
FieldValueIRS element (for citing)
Other Revenue Total$412,282OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$90,157,478TotalRevenueColumnAmt
Related Or Exempt Func Income$73,593,544RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$3,156,333ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,230,140TotalAmt
Program Services$581,931ProgramServicesAmt
Management And General$648,209ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$35,910,172TotalAmt
Program Services$30,750,839ProgramServicesAmt
Management And General$5,159,333ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,071,701TotalAmt
Program Services$1,774,053ProgramServicesAmt
Management And General$297,648ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,150,573TotalAmt
Program Services$5,266,900ProgramServicesAmt
Management And General$883,673ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,675,882TotalAmt
Program Services$2,291,429ProgramServicesAmt
Management And General$384,453ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$322,696TotalAmt
Management And General$322,696ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$168,103TotalAmt
Management And General$168,103ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$188,509TotalAmt
Management And General$188,509ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$20,824TotalAmt
Management And General$20,824ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$12,849,961TotalAmt
Program Services$12,849,961ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$69,583TotalAmt
Program Services$59,586ProgramServicesAmt
Management And General$9,997ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$2,202,518TotalAmt
Program Services$1,886,075ProgramServicesAmt
Management And General$316,443ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,617,092TotalAmt
Program Services$1,325,705ProgramServicesAmt
Management And General$291,387ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$192,361TotalAmt
Program Services$164,724ProgramServicesAmt
Management And General$27,637ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,179,950TotalAmt
Program Services$967,332ProgramServicesAmt
Management And General$212,618ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$6,192,873TotalAmt
Program Services$5,420,527ProgramServicesAmt
Management And General$772,346ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,083,248TotalAmt
Program Services$1,083,248ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$7,728,106$7,728,106
BAD DEBT$3,847,924$3,847,924
MISC EXPENSE$449,767$449,767
DUES & SUBSCRIPTIONS$122,303$122,303

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$86,274,286TotalAmt
Program Services$76,448,107ProgramServicesAmt
Management And General$9,826,179ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,017,422BOYAmt
EOY$728,347EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,064,303BOYAmt
EOY$2,717,773EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$13,779,393BOYAmt
EOY$13,711,979EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,160,913BOYAmt
EOY$1,258,726EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$684,703BOYAmt
EOY$496,326EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$145,045,679LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$104,305,881LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$33,919,923BOYAmt
EOY$40,739,798EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$8,422,570BOYAmt
EOY$7,320,161EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$14,737,003BOYAmt
EOY$12,809,039EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$77,786,230BOYAmt
EOY$79,782,149EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$11,827,233BOYAmt
EOY$17,272,149EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,130,205BOYAmt
EOY$12,057,236EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$7,585,254BOYAmt
EOY$6,561,058EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,223,282BOYAmt
EOY$2,687,276EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$38,765,974BOYAmt
EOY$38,577,719EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$33,646,238BOYAmt
EOY$35,637,010EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,759,164BOYAmt
EOY$1,951,988EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,614,854BOYAmt
EOY$3,615,432EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$39,020,256BOYAmt
EOY$41,204,430EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$77,786,230BOYAmt
EOY$79,782,149EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,883,192ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$93,819NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$1,792,837OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$20,824OtherActivitiesAmt
Total Lobbying Expenditures$20,824TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationA PERCENTAGE OF MEMBERSHIP DUES PAID TO HEALTHCARE ASSOCIATION OF NEW YORK STATE (28%), IROQUOIS HEALTHCARE ALLIANCE (42.8%) AND AMERICAN HOSPITAL ASSOCIATION (23.65%) ARE USED SPECIFICALLY FOR LOBBYING PURPOSESExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$11,422,949BeginningYearBalanceAmt
Contributions$12,698,274ContributionsAmt
Investment Earnings Or Losses$203,520InvestmentEarningsOrLossesAmt
Other Expenditures$13,742,134OtherExpendituresAmt
End Year Balance$10,582,609EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,767,313BeginningYearBalanceAmt
Contributions$2,686,662ContributionsAmt
Investment Earnings Or Losses$837,450InvestmentEarningsOrLossesAmt
Other Expenditures$2,868,476OtherExpendituresAmt
End Year Balance$11,422,949EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$11,139,059BeginningYearBalanceAmt
Contributions$2,001,098ContributionsAmt
Investment Earnings Or Losses-$182,685InvestmentEarningsOrLossesAmt
Other Expenditures$2,190,159OtherExpendituresAmt
End Year Balance$10,767,313EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$11,610,765BeginningYearBalanceAmt
Contributions$3,686,076ContributionsAmt
Investment Earnings Or Losses-$251,191InvestmentEarningsOrLossesAmt
Other Expenditures$3,906,591OtherExpendituresAmt
End Year Balance$11,139,059EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,855,572BeginningYearBalanceAmt
Contributions$1,372,068ContributionsAmt
Investment Earnings Or Losses$1,107,836InvestmentEarningsOrLossesAmt
Other Expenditures$1,724,711OtherExpendituresAmt
End Year Balance$11,610,764EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.35260BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.34160PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.30580TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,175,883OtherCostOrOtherBasisAmt
Book Value$4,175,883BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$49,586,005OtherCostOrOtherBasisAmt
Depreciation$29,498,313DepreciationAmt
Book Value$20,087,692BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$84,964,398OtherCostOrOtherBasisAmt
Depreciation$74,807,568DepreciationAmt
Book Value$10,156,830BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,319,393OtherCostOrOtherBasisAmt
Book Value$6,319,393BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$40,739,798TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (8 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATES$2,344,170
BENEFICIAL INTEREST IN NET ASSETS OF A.O. FOX FOUNDATION$4,835,984
BENEFICIAL INTEREST IN NET ASSETS OF AT HOME CARE INC.$1,624,183
OTHER ASSETS$109,285
DEFFERRED FINANCING COSTS, NET OF ACC. DEPRECIATION$380,625
SETTLEMENT AMOUNTS DUE FORM 3RD PARTY PAYORS , NET$2,789,807
GRANTS AND OTHER RECEIVABLES$486,158
INSURANCE RECEIVABLE$238,827
FieldValueIRS element (for citing)
Total Book Value Other Assets$12,809,039TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
COMPENSATED ABSENCES$451,285
LONG TERM (HUM)$524,123
LPN PENSION PAYABLE$725,964
WORKERS COMP AMD MLMIC (HUM) LIABILITY$585,904
INSURANCE LIABILITY CLAIMS$400,000
FieldValueIRS element (for citing)
Total Liability$2,687,276TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE HOSPITAL AND FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX EXEMPT ORGANIZATIONS PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31,2013 AND 2012, THE HOSPITAL AND FOUNDATION 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 2010 THROUGH 2013. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS.
PART V QUESTION 4PERMANENT ENDOWMENTS: THE INTENDED USE OF THE INCOME FROM THESE FUNDS IS TO SUPPORT OPERATIONS, FUND THE ANNUAL PHYSICIANS LECTURES AND DINNERS. BOARD DESIGNATED OR QUASI ENDOWMENTS: THE INTENDED USE OF INCOME FROM THESE FUNDS IS TO SUPPORT OPERATIONS OR FOR THE FUTURE CAPITAL NEEDS. TERM ENDOWMENTS: THE INTENDED USE OF THESE FUNDS IS DETERMINED BY THE VARIOUS DONORS, AND TO PROVIDE FOR THE NEEDS OF NURSING HOME PATIENTS.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,490,803TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$189,467DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,301,336NetCommunityBenefitExpnsAmt
Total Expense0.01510TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,984,536TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,116,352DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,868,184NetCommunityBenefitExpnsAmt
Total Expense0.04650TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$202,380TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$102,634DirectOffsettingRevenueAmt
Net Community Benefit Expns$99,746NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,677,719TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,408,453DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,269,266NetCommunityBenefitExpnsAmt
Total Expense0.06280TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$66,655TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$66,655NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$66,655TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$66,655NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,744,374TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$14,408,453DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,335,921NetCommunityBenefitExpnsAmt
Total Expense0.06360TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$2,057,538BadDebtExpenseAmt
Reimbursed By Medicare$18,911,458ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$22,869,670CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$3,958,212MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line11 AT HOME CAREBusinessNameLine1
FieldValueIRS element (for citing)
Primary ActivitiesREGIONAL HOME HEALTH AGENCYPrimaryActivitiesTxt
Org Profit Or Ownership0.50000OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership0.00000OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership0.00000PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AURELIA OSBORN FOX MEMORIAL HOSPITALBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 NORTON AVEAddressLine1
CityONEONTACity
StateNYState
ZIP Code13820ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1AURELIA OSBORN FOX MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.BASSETT.ORG/AO-FOX-HOSPITAL/OwnWebsiteURLTxt
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Exec Implementation StrategyYes (X)ExecImplementationStrategyInd
Develop Community Wide PlanYes (X)DevelopCommunityWidePlanInd
Exec Community Wide PlanYes (X)ExecCommunityWidePlanInd
Include Operational PlanYes (X)IncludeOperationalPlanInd
Adopt BudgetYes (X)AdoptBudgetInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
Prioritize ServicesYes (X)PrioritizeServicesInd
All Needs Addressed0AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (1)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care300.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (1)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Medical IndigencyYes (X)MedicalIndigencyInd
Insurance StatusYes (X)InsuranceStatusInd
Medicaid MedicareYes (X)MedicaidMedicareInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Posted On WebsiteYes (X)PostedOnWebsiteInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Provided On AdmissionYes (X)ProvidedOnAdmissionInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
AURELIA OSBORN FOX MEMORIAL HOSPITALPART V, SECTION B, LINE 3: THIS COMMUNITY HEALTH NEEDS ASSESSMENT HAS TAKEN INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY A.O. FOX MEMORIAL HOSPITAL. ALL ORGANIZATIONS PROVIDING INPUT INTO THIS ASSESSMENT, INCLUDING THE NAME AND TITLE OF THOSE INDIVIDUALS REPRESENTATIVE OF THE ORGANIZATION, IS PROVIDED BELOW. THIS INCLUDED INPUT FROM INDIVIDUALS WITH EXPERTISE IN PUBLIC HEALTH, SPECIFICALLY THERESA OELLRICH FROM THE OTSEGO COUNTY HEALTH DEPARTMENT. JOHN REMILLARD, PRESIDENT AURELIA OSBORN FOX MEMORIAL HOSPITAL FELECIA EMILIO, DIRECTOR MANDATORY EDUCATION & DIABETES EDUCATOR ROBERT LANCEY MD, NETWORK MEDICAL DIRECTOR BASSETT MEDICAL CENTER WILLIAM STAMP, EXECUTIVE DIRECTORMARKETING BASSETT MEDICAL CENTER PAUL G. FITZPATRICK PRESIDENT RURAL HEALTH DEVELOPMENT SARAH PATTERSON, VICE-CHAIR AURELIA OSBORN HOSPITAL BOARD BECKY DRAKE RD, CHAIRPERSON GET FIT OTSEGO SUSAN KURKOWSKI, YMCA AND ONEONTA SCHOOL BOARD MEMBER FRANK RUSSO, DIRECTOR YMCA BARBARA SPERLING, ONEONTA COMMUNITY HEALTH CENTER THERESA OELLRICH, DIRECTOR OTSEGO CO. HEALTH DEPARTMENT JULIE DOSTAL, EXECUTIVE DIRECTOR LEAF COUNCILIN ADDITION TO COMMUNITY COMMENTS AND INPUT GATHERED IN RESPONSE TO POSTING OF THECOMMUNITY HEALTH NEEDS ASSESSMENT OF BOTH THE HOSPITAL'S AND BASSETT HEALTHCARE NETWORK'S WEBSITES, THE PRIMARY PROACTIVE MEANS FOR RECEIVING COMMUNITY INPUT WAS THROUGH A COMMUNITY-WIDE STAKEHOLDER MEETING HOSTED BY A.O. FOX MEMORIAL HOSPITAL ON OCTOBER 31, 2012. THE PURPOSE OF THE STAKEHOLDER MEETING WAS THREEFOLD: 1) TO ELICIT GENERAL COMMENTS ON THE DRAFT CHNA; 2) TO SEEK COMMUNITY INPUT ON THE PRIORITY HEALTH NEEDS IDENTIFIED BY THE CHNA; AND 3) TO SEEK COMMUNITY INPUT ON POTENTIAL IMPLEMENTATION STRATEGIES. A SUMMARY OF THE STAKEHOLDER SESSION IS PROVIDED IN APPENDIX 2. THIRTEEN INDIVIDUALS REPRESENTING 9 AREA HEALTH PROVIDERS AND COMMUNITY SERVICES ORGANIZATIONS ATTENDED THE SESSION.IN ADDITION TO THE PROCESS AND COMMUNITY PARTICIPATION SPECIFICALLY USED IN DEVELOPING THIS COMMUNITY HEALTH NEEDS ASSESSMENT, SIGNIFICANT PROCESSES AND COMMUNITY PARTICIPATION WERE INVOLVED IN COMPILING THE 2010-2012 A.O. FOX MEMORIAL HOSPITAL COMMUNITY SERVICES PLAN AND THE 2010-2013 OTSEGO AND DELAWARE COUNTIES' HEALTH ASSESSMENTS. EACH OF THESE EFFORTS INCLUDED THEIR OWN PROCESS AND METHODS FOR IDENTIFYING COMMUNITY HEALTH NEEDS. EACH ALSO PROVIDED NUMEROUS OPPORTUNITIES FOR COMMUNITY INPUT AND PARTICIPATION IN REVIEWING AND INFLUENCING THE SELECTION OF PRIORITY HEALTH NEEDS.THE 2010- 2012 COMMUNITY SERVICE PLAN FOR A.O. FOX HOSPITAL AND THE 2010-2013 COMMUNITY HEALTH ASSESSMENT FOR OTSEGO COUNTY WERE DEVELOPED IN TANDEM. THE DEVELOPMENT PROCESS INVOLVED A RANGE OF COMMUNITY PARTNERS INCLUDING COUNTY DEPARTMENTS (HEALTH, SOCIAL SERVICES, AND EMERGENCY SERVICES), AS WELL AS COUNTY, TOWN AND CITY REPRESENTATIVES; OPPORTUNITIES FOR OTSEGO; NEW YORK CONNECTS OF OTSEGO COUNTY; PLANNED PARENTHOOD; SAFE KIDS; TWO CENTRAL SCHOOLS; CORNELL COOPERATIVE EXTENSION; RURAL THREE FOR TOBACCO FREE; CATSKILL AREA HOSPICE; SPRINGBROOK; THE ARC OTSEGO; UNITED WAY; AT HOME CARE, INC.; BASSETT MEDICAL CENTER; AND AO FOX HOSPITAL. A DETAILED DESCRIPTION OF THE PROCESS AND LEVEL OF COMMUNITY PARTICIPATION IN THEDEVELOPMENT OF THE COMMUNITY SERVICES PLAN IS PROVIDED IN APPENDIX 3.THE 2010-2013 DELAWARE COUNTY COMMUNITY HEALTH ASSESSMENT WAS PREPARED BY THE DELAWARE COUNTY PUBLIC HEALTH SERVICE (DCPH). DCPH CONDUCTED A COUNTYWIDE INFORMATION GATHERING INITIATIVE WITH THE GOAL OF UNDERSTANDING PUBLIC HEALTH PRIORITIES. THIS INVOLVED COLLABORATIVE EFFORTS AMONG DELAWARE COUNTY PUBLIC HEALTH NURSING SERVICES (DCPH), HOSPITALS, HEALTHCARE PROVIDERS, OTHER COMMUNITY-BASED ORGANIZATIONS, AND CONSUMERS. A DETAILED DESCRIPTION OF THE PROCESS AND LEVEL OF COMMUNITY PARTICIPATION IN THE DEVELOPMENT OF THE COUNTY COMMUNITY HEALTH ASSESSMENT IS PROVIDED IN APPENDIX 3.
AURELIA OSBORN FOX MEMORIAL HOSPITALPART V, SECTION B, LINE 4: MARY IMOGENE BASSETT HOSPITALO'CONNER HOSPITALCOBLESKILL REGIONAL HOSPITALLITTLE FALLS HOSPITALTRI TOWN REGIONAL HEALTHCARE
AURELIA OSBORN FOX MEMORIAL HOSPITALPART V, SECTION B, LINE 7: ALL OF THE COMMUNITY HEALTH ASSESMENT NEEDS ARE LONG TERM GOALS AND ACTIVELY BEING WORKED ON.
AURELIA OSBORN FOX MEMORIAL HOSPITALPART V, SECTION B, LINE 20D: IF PATIENTS MEET FINACIAL ASSISTANCE CRITERIA, THEIR EMERGENCY AND MEDICALLY NECESSARY CARE ARE EITHER DISCOUNTED OR FREE OF CHARGE.
FieldValueIRS element (for citing)
Facility12FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (12 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
AURELIA OSBORN FOX MEMORIAL HOSPITAL
1 NORTON AVEONEONTANY13820NURSING HOME
NORTHERN CATSKILL UROLOGY
438 MAIN STONEONTANY13820UROLOGY CLINIC
CHILD AND ADOLESCENT HEALTHCARE
1 FOXCARE DRIVE SUITE 213ONEONTANY13820PEDIATRIC CLINIC
ONEONTA FAMILY PRACTICE
1 FOXCARE DRIVE SUITE 308ONEONTANY13820FAMILY MEDICINE CLINIC
FOXCARE WOMENS WELLNESS
1 FOXCARE DRIVE SUITE 303ONEONTANY13820OB/GYN CLINIC
SUSQUEHANNA FAMILY PRACTICE
1 FOXCARE DRIVE SUITE 103ONEONTANY13820FAMILY MEDICINE CLINIC
FOXCARE DENTAL
1 FOXCARE DRIVE SUITE 304ONEONTANY13820DENTAL CLINIC
SIDNEY PRIMARY CARE CLINIC
59 RIVER STSIDNEYNY13838FAMILY MEDICINE CLINIC
FOXNOW
1 FOXCARE DRIVE SUITE 402ONEONTANY13820WALK-IN CLINIC
FOX INTERNAL MEDICINE
1 FOXCARE DRIVE SUITE 302ONEONTANY13820INTERNAL MEDICINE CLINIC
STAMFORD FAMILY PRACTICE
32-34 MAIN STREETSTAMFORDNY12167FAMILY MEDICINE CLINIC
SOUTHEASTERN HEALTH CENTER
4 DECATUR STWORCESTERNY12197FAMILY MEDICINE CLINIC

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:PART 1 LINE 7 THE COST METHODOLOGY USED FOR TABLE 7 IS THE RATIO OF COST TO CHARGES FROM 12/31/2013 MEDICARE FORM 2552.
PART 1 LINE 6AWE COMPILE AND SUBMIT AN ANNUAL COMMUNITY SERVICE PLAN TO THE NEW YORK STATE DEPARTMENT OF HEALTH.
PART III, LINE 4:PART III, LINE 4 PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS 13% AND 10% OF THE RELATED PATIENT ACCOUNTS RECEIVABLE, NET OF CONTRACTUAL ALLOWANCES AT DECEMBER 31, 2013 AND 2012, RESPECTIVELY.
PART III, LINE 8:WE DO NOT CONSIDER ANY OF THE SHORTFALLS TO BE A COMMUNITY BENEFIT.THE SOURCE USED FOR THE MEDICARE ALLOWABLE COST IS FROM THE SETTLEMENT PAGES OF THE 12/31/2013 FILED MEDICARE FORM 2552.
PART III, LINE 9B:IF A PATIENT IS 100% CHARITY CARE, THEY ARE REMOVED FROM THE COLLECTION PROCESS. IF LESS THAN 100% CHARITY CARE THEY FOLLOW THE NORMAL COLLECTION PROCEDURES.
PART VI, LINE 2:WE ASSESS THE COMMUNITIES HEALTHCARE NEEDS BASED UPON INPUT FROM THE COMMUNITY BOARD MEMBERS, MEDICAL STAFF AND BY HOSTING COMMUNITY FORUMS. IN ADDITION WE REVIEW TRENDS IN UTILIZATION OF OUR SERVICES PROVIDED.
PART VI, LINE 3:WE INFORM PATIENTS THROUGH SIGNAGE, PAMPHLETS AND PROVIDE INFORMATIONAL PACKETS TO PATIENTS THAT INDICATE THEY HAVE NO INSURANCE COVERAGE.
PART VI, LINE 4:WE SERVE RESIDENTS OF OTSEGO AND DELAWARE COUNTIES LOCATED IN RURAL UPSTATE NY.
PART VI, LINE 5:WE HELP PROMOTE THE HEALTH OF THE COMMUNITY THROUGH MAINTAINING AN ACTIVE OPEN MEDICAL STAFF, SUPPORTING THE ANCILLARY NEEDS OF THE LOCAL FREE CLINIC AND HOSTING A CHILD BIRTH FAIR. WE ALSO PROVIDE MEETING SPACE FOR LOCAL COMMUNITY ORGANIZATIONS AT NO CHARGE. OUR BOARD IS COMPRISED OF LOCAL COMMUNITY MEMBERS WHO ADVOCATE FOR THE HEALTH INTEREST OF THE COMMUNITY.
PART VI, LINE 6:AURELIA OSBORN FOX MEMORIAL 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 HOSPTITALS AND GREATEST PATIENT POPULATIONS ARE LOCATED. OTSEGO COUNTY - POPULATION 61683; DELAWARE COUNTY - POPULATION 46722; HERKIMER COUNTY - POPULATION 64181; SCHOHARIE COUNTY - POPULATION 31844(ACCORDING TO THE 2013 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 HOSPTAL, 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 RESIDUAL 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 STATESNY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
NICHOLAS J NICOLETTA
TREASURER$0$397,411$0$30,000$0$0$0$23,502$0$5,781$0$456,694$0$0
JEFFREY WOEPPEL
DIRECTOR$0$207,179$0$8,000$0$0$0$18,552$0$5,493$0$239,224$0$0
GENNARO FALCO
MD$251,225$0$0$0$0$0$12,750$0$16,022$0$279,997$0$0$0
JOHN REMILLARD
PRESIDENT$0$284,743$0$0$0$1,768$0$15,852$0$1,177$0$303,540$0$0
MARK WRIGHT
CFO$156,278$0$0$0$0$0$11,843$0$16,112$0$184,233$0$0$0
BENJAMIN FRIEDELL
VP MEDICAL AFFAIRS$270,087$0$0$0$0$0$13,247$0$11,926$0$295,260$0$0$0
MACIEJ NOWAKOWSKI
MD$355,574$0$0$0$0$0$10,580$0$15,721$0$381,875$0$0$0
PATRICK GERMAIN
MD$357,547$0$0$0$0$0$12,750$0$16,022$0$386,319$0$0$0
SARBJIT VILKHU
MD$329,719$0$0$0$0$0$12,750$0$12,636$0$355,105$0$0$0
MARIO VILLARINI
MD$311,987$0$0$0$0$0$12,750$0$15,889$0$340,626$0$0$0
BLAINE JONES
MD$320,284$0$0$0$0$0$16,573$0$15,769$0$352,626$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1COUNTY OF OTSEGO INDUSTRIAL DEVELOPMENTBusinessNameLine1
FieldValueIRS element (for citing)
Bond Issuer EIN166198451BondIssuerEIN
Bond Issued2004-12-13BondIssuedDt
Issue Price$6,900,000IssuePriceAmt
PurposeBUILDING PROJECTPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$6,900,000TotalProceedsAmt
Substantial Completion2006SubstantialCompletionYr
Current Refunding0CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THURSTON CORPORATION IS THE SOLE MEMBER OF A.O. FOX MEMORIAL HOSPITAL
FORM 990, PART VI, SECTION A, LINE 7AALL A.O. FOX MEMORIAL HOSPITAL BOARD MEMBERS ARE ELECTED BY THE SOLE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7BTHE HOSPITALS SOLE MEMBER HAS POWER TO APPROVE BOARD NOMINATIONS AND BYLAW CHANGES.
FORM 990, PART VI, SECTION B, LINE 11AURELIA OSBORN FOX MEMORIAL 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 12CPOTENTIAL CONFLICTS OF INTEREST ARE REVIEWED BY HOSPITAL ADMINISTRATION AND IF NECESSARY ARE REFERRED TO THE BOARD EXECUTIVE COMMITTEE TO BE HANDLED APPROPRIATELY.
FORM 990, PART VI, SECTION B, LINE 15PART VI SECTION B 15A THE BOARD EXECUTIVE COMMITTEE DETERMINES COMPENSATION FOR THE CEO BASED ON THE, "SURVEY OF THE INDUSTRIES C0MPENSATION DATA" SUPPLIED BY HANYS PART VI SECTION B 15B THE CEO TAKES RECOMMENDATIONS TO THE BOARD EXECUTIVE COMMITTEE BASED ON HANYS COMPENSATION SURVEY.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTATION, CONFLICTS OF INTEREST POLICIES, AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. SOME INFORMATION IS ALSO AVAILABLE THROUGH THE DEPARTMENT OF HEALTH. THE DOH REQUIRES THE INFORMATION FOR PUBLIC AVAILABILITY.
FORM 990, PART IX, LINE 11GTELEPHONE: PROGRAM SERVICE EXPENSES 459,600. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 459,600. POSTAGE: PROGRAM SERVICE EXPENSES 115,894. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 115,894. EQUIPMENT RENTAL MAINTENANCE: PROGRAM SERVICE EXPENSES 204,413. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 204,413. PRINTING: PROGRAM SERVICE EXPENSES 123,212. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 123,212. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 953,809. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 953,809. PHYSICIAN RECRUITMENT: PROGRAM SERVICE EXPENSES 128,487. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 128,487. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 430,726. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 430,726. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 10,433,820. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,433,820.
FORM 990, PART XI, LINE 9:CHANGE ON BENEFICIAL INTEREST IN NET ASSETS OF A.O. FOX FOUNDATION -2,367,805. CHANGE IN BENEFICIAL INTEREST IN AT HOME CARE -60,353. PENSION RELATED CHANGES 635,321.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationInd
THURSTON CORPORATION
ONE ATWELL ROADCOOPERSTOWNNY13326133218680SUPPORTING ORGANIZATIONNY501(C)311CNONE0
BASSETT REGIONAL CORPORATION
ONE ATWELL ROADCOOPERSTOWNNY13326133522783PLANNING AND POLICY SERVICESNY501(C)311BTHURSTON CORPORATION0
FRIENDS OF BASSETT
ONE ATWELL ROADCOOPERSTOWNNY13326237041610FUNDRAISINGNY501(C)37THURSTON CORPORATION0
MARY IMOGENE BASSETT HOSPITAL
ONE ATWELL ROADCOOPERSTOWNNY13326135596796HOSPITALNY501(C)33THURSTON CORPORATION0
BASSETT HOSPITAL OF SCHOHARIE CO
178 GRANDVIEW DRIVECOBLESKILLNY12043141772971HOSPITALNY501(C)33BASSETT REGIONAL CORP0
LITTLE FALLS HOSPITAL
140 BURWELL STREETLITTLE FALLSNY13365150533578HOSPITALNY501(C)33BASSETT REGIONAL CORP0
O'CONNOR HOSPITAL
460 ANDES ROADDELHINY13753161540394HOSPITALNY501(C)33BASSETT REGIONAL CORP0
TEMPLETON FOUNDATION
ONE ATWELL ROADCOOPERSTOWNNY13326133317084OUTPATIENT SERVICESNY501(C)39THURSTON CORPORATION0
TRI TOWN REGIONAL HEALTHCARE
43 PEARL STREETSIDNEYNY13838260169584HOSPITALNY501(C)33BASSETT REGIONAL CORP0
VALLEY HEALTH SERVICES
690 W GERMAN STREETHERKIMERNY13350222511614NOT-FOR-PROFIT SKILLED NURSING FACILITYNY501(C)33BASSETT REGIONAL CORP0
AO FOX FOUNDATION
1 NORTON AVENUEONEONTANY13820222871993SOLICITS CONTRIBUTIONS FOR AURELIA OSBORN FOX MEMORIAL HOSPITALNY501(C)39AURELIA OSBORN FOX MEMORIAL HOSPITAL SOCIETY0
AT HOME CARE
297 MAIN STREETONEONTANY13820161287069HOME HEALTH CARENY501(C)390

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CATSKILL CARE ENTERPRISESBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 NORTON AVEAddressLine1
CityONEONTACity
StateNYState
ZIP Code13820ZIPCode
FieldValueIRS element (for citing)
EIN161236590EIN
Primary ActivitiesRETAIL PHARMACY AND FITNESS CENTERPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1AURELIA OSBORN FOX MEMORIAL HOSPITAL SOCIETYBusinessNameLine1
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income$1,604,015ShareOfTotalIncomeAmt
Share Of EOY Assets$933,920ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
CATSKILL CARE ENTERPRISES
J$390,718
CATSKILL CARE ENTERPRISES
P$1,113,102
CATSKILL CARE ENTERPRISES
Q$1,630,461
CATSKILL CARE ENTERPRISES
D$180,113

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