MARY IMOGENE BASSETT HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MARY IMOGENE BASSETT HOSPITAL (EIN 13-5596796)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-12
IRS object ID
201333169349303738
Schema version
2012v2.3
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)
Timestamp2013-11-12T11:47:06-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1515 BROADWAY 4TH FLAddressLine1
CityALBANYCity
StateNYState
ZIP Code12207ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN135596796EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MARY IMOGENE BASSETT HOSPITALBusinessNameLine1
Business Name Line2DBA BASSETT MEDICAL CENTERBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlMARYNameControl
Phone6075473635Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE ATWELL ROADAddressLine1
CityCOOPERSTOWNCity
StateNYState
ZIP Code13326ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameNICHOLAS J NICOLETTAName
TitleCHIEF FINANCIAL OFFICERTitle
Phone6075473635Phone
Date Signed2013-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMARY-EVELYN ANTONETTIName
Phone5184274600Phone
Date Prepared2013-11-12DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1BASSETT MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonNICHOLAS J NICOLETTANameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE ATWELL ROADAddressLine1
CityCOOPERSTOWNCity
StateNYState
ZIP Code13326ZIPCode
FieldValueIRS element (for citing)
Gross Receipts454579097GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.BASSETT.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1921YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionMARY IMOGENE BASSETT HOSPITAL IS A RURAL ACADEMIC CENTER COMMITTED TO PROVIDING EXCELLENCE IN HEALTH CARE SERVICES, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROFESSIONALS, AND PURSUING HEALTH RESEARCH.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members18NbrIndependentVotingMembers
Total Nbr Employees3926TotalNbrEmployees
Total Nbr Volunteers155TotalNbrVolunteers
Total Gross UBI24333TotalGrossUBI
Contributions Grants Prior Year7712078ContributionsGrantsPriorYear
Contributions Grants Current Year15144838ContributionsGrantsCurrentYear
Program Service Revenue Prior Year399868572ProgramServiceRevenuePriorYear
Program Service Revenue CY413231887ProgramServiceRevenueCY
Investment Income Prior Year4865736InvestmentIncomePriorYear
Investment Income Current Year1833345InvestmentIncomeCurrentYear
Other Revenue Prior Year40575OtherRevenuePriorYear
Other Revenue Current Year-523561OtherRevenueCurrentYear
Total Revenue Prior Year412486961TotalRevenuePriorYear
Total Revenue Current Year429686509TotalRevenueCurrentYear
Grants And Similar Amnts CY50825GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year237833788SalariesEtcPriorYear
Salaries Etc Current Year243007003SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1066287TotalFundrsngExpCurrentYear
Other Expense Prior Year177222598OtherExpensePriorYear
Other Expenses Current Year184364624OtherExpensesCurrentYear
Total Expenses Prior Year415056386TotalExpensesPriorYear
Total Expenses Current Year427422452TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2569425RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2264057RevenuesLessExpensesCY
Total Assets BOY343191925TotalAssetsBOY
Total Assets EOY357225149TotalAssetsEOY
Total Liabilities BOY122504389TotalLiabilitiesBOY
Total Liabilities EOY124215669TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY220687536NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY233009480NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionMARY IMOGENE BASSETT HOSPITAL IS A RURAL ACADEMIC CENTER COMMITTED TO PROVIDING EXCELLENCE IN HEALTH CARE SERVICES, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROFESSIONALS, AND PURSUING HEALTH RESEARCH.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense344458318Expense
Grants50825Grants
Revenue413231887Revenue
DescriptionINPATIENT AND OUTPATIENT SERVICES PROVIDED TO OUR PATIENTS RESULTED IN: 12,708 HOSPITALIZATIONS (INCLUSIVE OF OPEN HEART SURGERIES) 50,711 PATIENT DAYS 699,970 CLINIC VISITS 24,144 RENAL TREATMENTS 9,410 SURGICAL CASESDescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense5433926Expense
DescriptionSEE SCHEDULE O COMMUNITY INVOLVEMENT HAS BEEN LINKED TO BASSETT'S MISSION, VISION, AND VALUES SINCE WE FIRST OPENED IN 1921. WHETHER IT IS STRENGTHENING OUR COMMUNITY RELATIONSHIPS FOR HEALTH AND WELLNESS, COMMUNICATING IDEAS FOR IMPROVING OUR SERVICES TO OUR REGION, OR PROVIDING A FORUM FOR BASSETT TO LEARN AND LISTEN, WE ARE WORKING WITH OUR COMMUNITY TO IMPROVE THE QUALITY OF LIFE FOR THE PEOPLE OF OUR REGION. OUR COMMUNITY SERVICES PROGRAM PROVIDES FREE SERVICES TO PERSONS WHO CANNOT AFFORD TO PAY, WHO DO NOT QUALIFY FOR MEDICAID, AND WHO FALL WITHIN THE ESTABLISHED INCOME GUIDELINES. IN 2012, WE PROVIDED 5,433,926 IN FREE CARE. BASSETT'S COMMUNITY HEALTH EDUCATION PROGRAMS INCLUDE LECTURES, PRESENTATIONS, HEALTH FAIRS, AND OTHER GROUP PROGRAMS APART FROM THE CLINICAL AND DIAGNOSTIC SERVICES OFFERED. CLINICAL SERVICES OFFERED INCLUDES SCREENINGS, HEALTH TESTS AND HEALTH RISK APPRAISALS INCLUDING BLOOD PRESSURE, LIPID PROFILE, CHOLESTEROL SCREENINGS, CARDIOLOGY RISK FACTOR SCREENINGS, AND ALL CANCER SCREENINGS. OUR COMMUNITY BUILDING ACTIVITIES INCLUDE PHILANTHROPIC SUPPORT FOR HEALTH INITIATIVES AND COMMUNITY HEALTH AND WELFARE PROJECTS INCLUDING PROMOTING HEALTHY LIFESTYLES, DISEASE PREVENTION, AND COMMUNITY AWARENESS INITIATIVES. OUR DOORS ARE OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS A YEAR. WE ARE PROUD TO PROVIDE CARE TO OUR COMMUNITIES. NOT ONLY DID WE PROVIDE 5.4M IN CHARITY CARE, BAD DEBT EXPENSE WAS 15M, MEDICAID PAYMENTS BELOW COST TO PROVIDE SERVICES WERE 27.2M.Description
FieldValueIRS element (for citing)
Total Program Service Expense349892244TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096244NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees3926NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members18NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1NICHOLAS J NICOLETTABusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6075473635TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE ATWELL ROADAddressLine1
CityCOOPERSTOWNCity
StateNYState
ZIP Code13326ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (30 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
THOMAS Q MORRIS MD
CHAIRMAN1.003.25XX000
KEVIN S MOORE
VICE CHAIRMA3.002.50XX000
TIMOTHY A PEDLEY MD
VICE CHAIRMA1.001.00XX000
WILLIAM T BURDICK
SECRETARY8.003.00XX000
JOHN D BULLIS
TRUSTEE1.002.50X000
JANE FORBES CLARK
TRUSTEE1.000.00X000
BARBARA DICOCCO
TRUSTEE1.001.50X000
TERRY FULMER PHD
TRUSTEE1.000.00X000
MICHAEL S GOLD MD
TRUSTEE1.000.20X000
PETER J HAMILTON
TRUSTEE1.002.50X000
NANCY KLENIEWSKI
TRUSTEE1.000.00X000
RALPH H MEYER
TRUSTEE1.001.00X000
J MICHAEL MOFFAT
TRUSTEE1.000.00X000
KATHERINE D NICKERSON
TRUSTEE1.001.00X000
DONALD O QUEST MD
TRUSTEE1.000.00X000
VANNESS D ROBINSON
TRUSTEE1.000.00X000
RENEE SCIALDO SHEVAT
TRUSTEE1.000.00X000
EDWARD W STACK
TRUSTEE1.002.20X000
CLIFTON WHARTON JR PHD
TRUSTEE1.000.00X000
DOUGLAS B WILLIES
TRUSTEE1.000.50X000
WILLIAM F STRECK MD
PRESIDENT, C40.002.20X786435027775
BERTINE MCKENNA PHD
EXECUTIVE VP40.001.50X489159022919
NICHOLAS J NICOLETTA
CORPORATE VP40.0013.50X483575026532
RICHARD C VANISON
TREASURER4.002.50X000
GLENN A PERRONE
ASSISTANT SE2.002.50X000
PASCALE G RAYMOND MD
ATTENDING PH40.000.00585972018096X
STEVEN J HENEGHAN MD
ATTENDING PH40.000.00578884029710X
JONATHAN RICHMAN MD
ATTENDING PH40.000.00524765032663X
ROBERT A LANCEY MD
ATTENDING PH40.000.00524074032658X
TALLY E LASSITER MD
ATTENDING PH40.000.00500127012538X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4472991TotalReportableCompFromOrg
Total Other Compensation202891TotalOtherCompensation
Number Individuals GT100 K8NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcestrueCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1Address Line2AddressOfContractor/AddressUS/AddressLine2CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
STAT STAFF
258 USHERS ROADSUITE 10CLIFTON PARKNY12065AGENCY5924304
COMP HEALTH
6440 MILLROCK DRIVESUITE 175SALT LAKE CITYUT84121AGENCY1721455
STAFF CARE INC
5001 STATESMAN DRIVEIRVINGTX75063AGENCY1675433
ANGELICA TEXTILE SERVICES
424 S WOODS MILL ROADCHESTERFIELDMO63017LINEN SERVICE1404413
MAYO MEDICAL LABORATORIES
200 FIRST STREET SWROCHESTERMN55903LAB SERVICES1380072
FieldValueIRS element (for citing)
Number Of Contractors GT100 K16NumberOfContractorsGT100K
Related Organizations1477780RelatedOrganizations
Government Grants10731189GovernmentGrants
All Other Contributions2935869AllOtherContributions
Total Contributions15144838TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
DIRECT PATIENT SERVICES900099385399702385399702
OTHER PROGRAM SERVICE REVENUE9000992783218527832185
FieldValueIRS element (for citing)
Total Program Service Revenue413231887TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column720378TotalRevenueColumn
Exclusion$720,378ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities25805046Securities
Other200509Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities24276047Securities
Other616541Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1528999Securities
Other-416032Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1112967TotalRevenueColumn
Exclusion$1,112,967ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
INVESTMENT IN JOINT VENTURE62161070134$70,134
PARTNERSHIP INCOME6215002433324333
PARTNERSHIP INCOME-618028-$618,028
FieldValueIRS element (for citing)
Total Other Revenue-523561TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column429686509TotalRevenueColumn
Related Or Exempt Function Income413231887RelatedOrExemptFunctionIncome
Unrelated Business Revenue24333UnrelatedBusinessRevenue
Exclusion$1,285,451ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total50825Total
Program Services50825ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1836394Total
Management And General1836394ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total84335Total
Management And General84335ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total209127528Total
Program Services161636755ProgramServices
Management And General47020228ManagementAndGeneral
Fundraising470545Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total8640033Total
Program Services6668020ProgramServices
Management And General1946770ManagementAndGeneral
Fundraising25243Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total10430259Total
Program Services7991963ProgramServices
Management And General2415030ManagementAndGeneral
Fundraising23266Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total12888454Total
Program Services9884044ProgramServices
Management And General2973002ManagementAndGeneral
Fundraising31408Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total62494Total
Management And General62494ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total38009036Total
Program Services31709051ProgramServices
Management And General5987935ManagementAndGeneral
Fundraising312050Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1970959Total
Program Services1502800ProgramServices
Management And General454242ManagementAndGeneral
Fundraising13917Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total14144531Total
Program Services10845370ProgramServices
Management And General3278166ManagementAndGeneral
Fundraising20995Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total1689230Total
Program Services1294255ProgramServices
Management And General391207ManagementAndGeneral
Fundraising3768Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total19571177Total
Program Services15027131ProgramServices
Management And General4542162ManagementAndGeneral
Fundraising1884Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total3334332Total
Program Services2554701ProgramServices
Management And General772194ManagementAndGeneral
Fundraising7437Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
DRUGS AND REAGENTS3197698231976982
PATIENT CARE SUPPLIES3090891530908915
BAD DEBT1498520814985208
CHARITY CARE54339265433926

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total22277834Total
Program Services17422298ProgramServices
Management And General4699762ManagementAndGeneral
Fundraising155774Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total427422452Total
Program Services349892244ProgramServices
Management And General76463921ManagementAndGeneral
Fundraising1066287Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY7155225BOY
EOY15653880EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY9860464BOY
EOY14856350EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY51797404BOY
EOY44119304EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3305577BOY
EOY3425444EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2457985BOY
EOY2640600EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis380220889LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec233912362LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY141444465BOY
EOY146308527EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY85442703BOY
EOY84878064EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY33634077BOY
EOY36797740EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY8094025BOY
EOY8545240EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY343191925BOY
EOY357225149EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY38850570BOY
EOY39628165EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY56570000BOY
EOY54590000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY27083819BOY
EOY29997504EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY122504389BOY
EOY124215669EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY163124202BOY
EOY163196856EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY43733963BOY
EOY55962893EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY13829371BOY
EOY13849731EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY220687536BOY
EOY233009480EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY343191925BOY
EOY357225149EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses2264057ReconcilationRevenueExpenses
Reconciliation Unrealized Invest9883165ReconciliationUnrealizedInvest
Reconcilation Other Changes174722ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$62,494OtherActivitiesAmount
Total Lobbying Expenditures IIB62494TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
Return ReferenceSCHEDULE C, PART II-B, LINE 1ReturnReference
ExplanationAMERICAN HOSPITAL ASSOCIATION ALLOCATES 23.98% OF DUES TOWARDS GENERAL LOBBYING ACTIVITIES. TOTAL DUES PAID IN 2012 = 51,536 HANYS ALLOCATES 28.60% OF DUES TOWARDS GENERAL LOBBYING ACTIVITIES. TOTAL DUES PAID IN 2012 = 121,790 IROQUOIS HEALTHCARE ALLIANCE ALLOCATES 44.40% OF DUES TOWARDS GENERAL LOBBYING ACTIVITES. TOTAL DUES PAID IN 2012 = 34,469 THE CLARK ESTATES CONDUCTS LOBBYING ACTIVITIES ON BEHALF OF THE MARY IMOGENE BASSETT HOSPITAL. LOBBYING ACTIVITES ARE LIMITED TO OFFICER DISCUSSIONS WITH CONSULTANTS AND LEGISLATORS TO OBTAIN FUNDING FOR CHARITABLE MISSIONS. NO FUNDS WERE EXPENDED.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance13829371BeginningOfYearBalance
Contributions20360Contributions
End Of Year Balance13849731EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance13789074BeginningOfYearBalance
Contributions40297Contributions
End Of Year Balance13829371EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance16734461BeginningOfYearBalance
Contributions54613Contributions
Investment Earnings Or Losses199921InvestmentEarningsOrLosses
Other Expenditures3000000OtherExpenditures
Administrative Expenses199921AdministrativeExpenses
End Of Year Balance13789074EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance13825685BeginningOfYearBalance
Contributions2908776Contributions
Investment Earnings Or Losses189138InvestmentEarningsOrLosses
Administrative Expenses189138AdministrativeExpenses
End Of Year Balance16734461EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance13511047BeginningOfYearBalance
Contributions314638Contributions
Investment Earnings Or Losses445038InvestmentEarningsOrLosses
Administrative Expenses445038AdministrativeExpenses
End Of Year Balance13825685EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgstrueEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis207928OtherCostOrOtherBasis
Book Value207928BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis187848195OtherCostOrOtherBasis
Depreciation100929403Depreciation
Book Value86918792BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis172044677OtherCostOrOtherBasis
Depreciation132982959Depreciation
Book Value39061718BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis20120089OtherCostOrOtherBasis
Book Value20120089BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings146308527TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
LIMITED PARTNERSHIP32584778C
LIMITED PARTNERSHIP4212962C
FieldValueIRS element (for citing)
Total Of Book Value Securities36797740TotalOfBookValueSecurities
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt419325262TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments9883165NetUnrealizedGainsInvestments
Other Revenues-20244412OtherRevenues
Revenue Not Rptd F990-10361247RevenueNotRptdF990
Revenue Subtotal429686509RevenueSubtotal
Total Revenue Per Form990429686509TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt407003318TotExpensesEtcAuditedFinclStmt
Expenses Subtotal407003318ExpensesSubtotal
Other Expenses Not Included20419134OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt20419134ExpensesNotRptdOnFinStmt
Total Expenses Per Form990427422452TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
INTENDED USES FOR ENDOWMENT FUNDSSCHEDULE D, PAGE 2, PART V, LINE 4PERMANENTLY RESTRICTED ENDOWMENT FUNDS ARE HELD IN PERPETUITY WITH RESTRICTIONS ON INCOME FOR HEALTH SERVICES, MEDICAL RESEARCH, MEDICAL EDUCATION, AND INDIGENT CARE.
LIABILITY UNDER FIN 48 FOOTNOTESCHEDULE D, PAGE 3, PART XPER AUDITED FINANCIAL STATEMENTS: "THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE IRC. THE HOSPITAL RECOGNIZES TAX POSITIONS WHEN IT IS MORE-LIKELY-THAN-NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL TAX LIABILITIES OR UNCERTAIN TAX POSITIONS THAT NEED TO BE RECORDED."
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 2DPOST RETIREMENT BENEFIT CHANGE 174,722 BAD DEBT -14,985,208 CHARITY CARE -5,433,926
EXPENSE AMOUNTS INCLUDED ON RETURN - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 4BBAD DEBT 14,985,208 CHARITY CARE 5,433,926

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage3.00000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CarefalseFPGReferenceDiscountedCare
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3494935TotalCommunityBenefitExpense
Direct Offsetting Revenue291950DirectOffsettingRevenue
Net Community Benefit Expense3202985NetCommunityBenefitExpense
Percent Of Total Expense0.00750PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense52353300TotalCommunityBenefitExpense
Direct Offsetting Revenue38212851DirectOffsettingRevenue
Net Community Benefit Expense14140449NetCommunityBenefitExpense
Percent Of Total Expense0.03310PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense55848235TotalCommunityBenefitExpense
Direct Offsetting Revenue38504801DirectOffsettingRevenue
Net Community Benefit Expense17343434NetCommunityBenefitExpense
Percent Of Total Expense0.04060PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense48571TotalCommunityBenefitExpense
Net Community Benefit Expense48571NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense16222165TotalCommunityBenefitExpense
Direct Offsetting Revenue3952243DirectOffsettingRevenue
Net Community Benefit Expense12269922NetCommunityBenefitExpense
Percent Of Total Expense0.02870PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense7872642TotalCommunityBenefitExpense
Direct Offsetting Revenue358478DirectOffsettingRevenue
Net Community Benefit Expense7514164NetCommunityBenefitExpense
Percent Of Total Expense0.01760PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense703459TotalCommunityBenefitExpense
Net Community Benefit Expense703459NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense24846837TotalCommunityBenefitExpense
Direct Offsetting Revenue4310721DirectOffsettingRevenue
Net Community Benefit Expense20536116NetCommunityBenefitExpense
Percent Of Total Expense0.04800PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense80695072TotalCommunityBenefitExpense
Direct Offsetting Revenue42815522DirectOffsettingRevenue
Net Community Benefit Expense37879550NetCommunityBenefitExpense
Percent Of Total Expense0.08860PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$6,527,921BadDebtExpenseAmount
Amount Attributable To788659AmountAttributableTo
Amount Reimbursed By Medicare97679871AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare82507115CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall15172756MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1AT HOME CARE INCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityHOME HEALTHCARE AGENCYDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.50000OrganizationProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1MARY IMOGENE BASSETT HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1ONE ATWELL ROADAddressLine1
CityCOOPERSTOWNCity
StateNYState
ZIP Code13326ZIPCode
FieldValueIRS element (for citing)
Website AddressWWWBASSETTORGWebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Research FacilityXResearchFacility
Er24 HoursXEr24Hours
OtherOUTPATIENT PRIMARY & SPECIALTYOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MARY IMOGENE BASSETT HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedfalseCHNAConducted
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent300.0FPGFreePercent
Uses FPG DiscountedfalseUsesFPGDiscounted
Explains BasisfalseExplainsBasis
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Permit Other ActionsXPermitOtherActions
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities51NumberOfOtherFacilities

Other Facilities OtherFacilities (51 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityTypeAddress Line2Address/AddressLine2
AC CLARK GYMNASIUM
124 COUNTY ROAD 52COOPERSTOWNNY13326OUTPATIENT PHYSICAL THERAPY SERVICES
BASSETT HEALTHCARE HAMILTON SURGICA
10 EATON STREETHAMILTONNY13346OUTPATIENT SPECIALTY CARE
BASSETT HEALTHCARE HERKIMER CARDIAC
690 WEST GERMAN STREETHERKIMERNY13350OUTPATIENT REHAB SERVICES
BASSETT HEALTHCARE CLINTON
34 CHENANGO AVENUECLINTONNY13323OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE CANAJOHARIE
56 MONTGOMERY STREETCANAJOHARIENY13317OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE COBLESKILL
121 LEGION DRIVECOBLESKILLNY12043OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE DELANSON
1 COOLEY HEIGHTSDELANSONNY12053OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE DELHI
460 ANDES ROADDELHINY13753OUTPATIENT PRIMARY CARE AND DENTAL
BASSETT HEALTHCARE EDMESTON
ROUTE 80EDMESTONNY13335OUTPATIENT PRIMARY CAREPO BOX 15
BASSETT HEALTHCARE HAMILTON
160 BROAD STREETHAMILTONNY13346OUTPATIENT PRIMARY CARE AND DENTAL
BASSETT HEALTHCARE HERKIMER
321 EAST ALBANY STREETHERKIMERNY13350OUTPATIENT PRIME, SPECIALTY, URGENT CARE
BASSETT HEALTHCARE MIDDLEBURGH
109 BAKER AVENUEMIDDLEBURGHNY12122OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE MORRIS
93 MAIN STREETMORRISNY13808OUTPATIENT SPECIALTY CARE
BASSETT HEALTHCARE ONEONTA SURGICAL
449 MAIN STREETONEONTANY13820OUTPATIENT SPECIALTY CARE
BASSETT HEALTHCARE NORWICH
55 CALVARY DRIVENORWICHNY13815OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE ONEONTA
125 MAIN STREETONEONTANY13820OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE ONEONTA SPECIAL
ONE ASSOCIATE DRIVEONEONTANY13820OUTPATIENT PRIME, SPECIALTY, URGENT CARE
BASSETT HEALTHCARE PHYSICAL THERAPY
21 RAILTOAD AVENUECOOPERSTOWNNY13326OUTPATIENT SPECIALTY CARE
BASSETT HEALTHCARE RICHFIELD SPRING
8550 STATE HIGHWAY 28RICHFIELD SPRINGSNY13439OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE SCHOHARIE
111 BARTON HILL ROADSCHOHARIENY12157OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE SHARON SPRINGS
ROUTE 20SHARON SPRINGSNY13459OUTPATIENT PRIMARY CAREPO BOX 275
BASSETT HEALTHCARE SHERBURNE
20 CHAPEL STREETSHERBURNENY13460OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE SIDNEY
39 PEARL STREETSIDNEYNY13838OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE ST JOHNSVILLE
8 PARK PLACEST JOHNSVILLENY13452OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE STAMFORD
28650 STATE HIGHWAY 23STAMFORDNY12167OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE WALTON
130 NORTH STREETWALTONNY13856OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE WEST WINFIELD
544 EAST MAIN STREETWEST WINFIELDNY13491OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE AT FOXCARE
1 FOXCARE DRIVEONEONTANY13820OUTPATIENT SPECIALTY CARE
BASSETT HEALTHCARE AT LITTLE FALLS
170 BURWELL STREETLITTLE FALLSNY13365OUTPATIENT PRIMARY CARE
BASSETT HEALTHCARE UNADILLA
16 CLIFTON STREETUNADILLANY13849OUTPATIENT PRIMARY CARE
BASSETT REGIONAL CANCER CENTER
7 ASSOCIATE DRIVEONEONTANY13820OUTPATIENT SPECIALTY CARE
HARTWICK SEMINARY SPECIALTY SERVICE
4580 ROUTE 28MILFORDNY13807OUTPATIENT PRIMARY AND SPECIALTY CARE
SBHC - COOPERSTOWN ELEMENTARY
21 WALNUT STREETCOOPERSTOWNNY13326OUTPATIENT PRIMARY CARE
SBHC - COOPERSTOWN MIDDLE AND HIGH
39 LINDEN AVENUECOOPERSTOWNNY13326OUTPATIENT PRIMARY CARE
SBHC - DELHI ELEMENTARY
2 SHELDON DRIVEDELHINY13753OUTPATIENT PRIMARY CARE
SBHC - DELHI MIDDLE AND HIGH
2 SHELDON DRIVEDELHINY13753OUTPATIENT PRIMARY CARE
SBHC - EDMESTON CENTRAL SCHOOL
11 NORTH STREETEDMESTONNY13335OUTPATIENT PRIMARY CARE
SBHC - LAURENS CENTRAL SCHOOL
55 MAIN STREETLAURENSNY13796OUTPATIENT PRIMARY CARE
SBHC - MIDDLEBURGH ELEMENTARY
245-I MAIN STREETMIDDLEBURGHNY12122OUTPATIENT PRIMARY CARE
SBHC - MIDDLEBURGH MIDDLE AND HIGH
291 MAIN STREETMIDDLEBURGHNY12122OUTPATIENT PRIMARY CARE
SBHC - MILFORD CENTRAL SCHOOL
42 WEST MAIN STREETMILFORDNY13807OUTPATIENT PRIMARY CARE
SBHC - MORRIS CENTRAL SCHOOL
65 MAIN STREETMORRISNY13808OUTPATIENT PRIMARY CARE
SBHC - ORAL HEALTH MOBILE PROGRAM
ONE ATWELL ROADCOOPERSTOWNNY13326OUTPATIENT SPECIALTY CARE
SBHC - SCHENEVUS CENTRAL SCHOOL
159 MAIN STREETSCHENEVUSNY12155OUTPATIENT PRIMARY CARE
SBHC - SHERBURNEEARLVILLE ELEMEN
13 SCHOOL STREETSHERBURNENY13460OUTPATIENT PRIMARY CARE
SBHC - SHERBURNEEARLVILLE MID & HI
13 SCHOOL STREETSHERBURNENY13460OUTPATIENT PRIMARY CARE
SBHC - SIDNEY CENTRAL SCHOOL
95 WEST MAIN STREETSIDNEYNY13838OUTPATIENT PRIMARY CARE
SBHC - SOUTH KORTRIGHT CENTRAL
PO BOX 113SOUTH KORTRIGHTNY13842OUTPATIENT PRIMARY CARE
SBHC - STAMFORD CENTRAL SCHOOL
ONE RIVER STREETSTAMFORDNY12167OUTPATIENT PRIMARY CARE
SBHC - UNADILLA VALLEY CENTRAL
PO BOX FNEW BERLINNY13411OUTPATIENT PRIMARY CARE4238 STATE HIGHWAY 8
SBHC - WORCESTER CENTRAL SCHOOL
195 MAIN STREETWORCESTERNY12197OUTPATIENT PRIMARY CARE

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
OTHER TESTING METHODS FOR FREE OR DISCOUNTED CAREPART I LINE 3CTHE CSP COMMUNITY SERVICES PROGRAM APPLICATION SPECIFIES FAMILY INCOME LIMITS AND OTHER REQUIREMENTS FOR SERVICES TO BE ELIGIBLE FOR BASSETT MEDICAL CENTERS CSPFREE CARE PROGRAM
RELATED ORGANIZATION INFORMATIONPART I LINE 6ATHE MARY IMOGENE BASSETT HOSPITALS DBA BASSETT MEDICAL CENTER BASSETT COMPREHENSIVE THREE YEAR COMMUNITY SERVICE PLAN WAS SUMMARIZED IN AN ANNUAL COMMUNITY REPORT PRINTED COPIES WERE AVAILABLE TO THE PUBLIC IN PATIENT WAITING ROOMS AND AT INFORMATION KIOSKS THE REPORT IS ALSO POSTED ON THE BASSETT WEBSITE WWWBASSETTORG
EXCLUSIONS FROM PERCENT OF TOTAL EXPENSEPART I LINE 7 COLUMN FTHE PERCENT OF TOTAL EXPENSE IS CALCULATED BY DIVIDING COLUMN E NET COMMUNITY BENEFIT EXPENSE BY TOTAL EXPENSE THE BAD DEBT EXPENSE OF 14985208 WAS SUBTRACTED FROM THE TOTAL EXPENSE VALUE USED TO CALCULATE THE PERCENTAGES IN PART 1 LINE 7 COLUMN F
COSTING METHODOLOGY EXPLANATIONPART I LINE 7SECTIONS A CHARITY CARE AT COST B UNREIMBURSED MEDICAID F HEALTH PROFESSIONS EDUCATION THE COSTING METHODOLOGY USED IS A COSTTOCHARGE RATIO CALCULATION UTILIZED ON FILED STATE AND FEDERAL COST REPORTS AS THE SOURCE INDIRECT COSTS WERE APPLIED TO SECTIONS E COMMUNITY HEALTH IMPROVEMENT PORTIONS OF F HEALTH PROFESSIONS EDUCATION H RESEARCH AND I CASH AND INKIND CONTRIBUTIONS TO COMMUNITY GROUPS ARE COMPRISED OF THE DIRECT SALARY COSTS FOR HOSPITAL STAFF WHOSE TIME WAS COMPENSATED BY THE HOSPITAL FOR TIME SPENT PARTICIPATING IN ACTIVITIES THAT QUALIFY AS COMMUNITY BENEFITS PLUS THE CURRENT FISCAL YEAR FRINGE BENEFIT RATE INDIRECT COSTS WERE ONLY APPLIED TO SELECT SALARIES AND SERVICES UNDER COMMUNITY HEALTH IMPROVEMENT AND RESEARCH AND NOT BROADLY ACROSS ALL COMMUNITY BENEFIT ACTIVITY ENTRIES
COMMUNITY BUILDING ACTIVITIESPART IIALL BASSETT COMMUNITY BUILDING ACTIVITIES COULD BE CLASSIFIED UNDER ITEM 1 AND HIGHLIGHTED IN NUMBER 1 ABOVE
BAD DEBT EXPENSE EXPLANATIONPART III LINE 4WORKSHEET 2 COST TO CHARGE RATIO WAS USED TO DETERMINE THE AMOUNT REPORTED IN PART III LINES 2 AND 3 PROVISION FOR UNCOLLECTIBLE PATIENT ACCOUNTS RECEIVABLE FROM THE FINANCIAL STATEMENTS NOTES I THE HOSPITAL GRANTS CREDIT WITHOUT COLLATERAL TO PATIENTS MOST OF WHO ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD PARTY AGREEMENTS SERVICES RENDERED TO INDIVIDUALS WHEN PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED ARE WRITTEN OFF TO THE ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ADDITIONS TO THE ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE MADE BY MEANS OF THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE AND SUBSEQUENT RECOVERIES ARE ADDED THE AMOUNT OF THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENTS ASSESSMENT OF HISTORICAL EXPECTED COLLECTIONS BUSINESS AND ECONOMIC CONDITIONS TRENDS IN FEDERAL AND STATE HEALTHCARE COVERAGE AND OTHER COLLECTION INDICATORS PROVISION FOR CHARITY AND UNCOMPENSATED CARE FROM THE FINANCIAL STATEMENT FOOTNOTES J THE HOSPITALS GENERAL POLICY STATEMENT ON CHARITY CARE REQUIRES THAT MEDICAL CARE BE RENDERED TO ALL PERSONS IN NEED OF SUCH CARE REGARDLESS OF THEIR ABILITY TO PAY BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE THEY ARE NOT REPORTED AS REVENUE THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES FURNISHED UNDER ITS CHARITY CARER POLICY THE HOSPITALS CHARITY CARE POLICY HAS NOT CHANGED DURING FISCAL YEARS 2011 OR 2012 DURING 2012 AND 2011 THE TOTAL CHARGES FORGONE FOR BAD DEBT WERE APPROXIMATELY 14985208 AND 14513947 RESPECTIVELY
MEDICARE EXPLANATIONPART III LINE 8AMOUNTS WERE DERIVED AS FOLLOWS CHARGE TIMES COST TO CHARGE RATIO VERSUS REIMBURSEMENT ON THE MEDICARE PSR REPORT
COLLECTION PRACTICES EXPLANATIONPART III LINE 9BFOR PATIENTS OR GUARANTORS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE BASSETT MUST UNDERTAKE TO ENSURE AN ADEQUATE UNDERSTANDING ON THE PART OF THE PATIENTS AND THOSE RESPONSIBLE FOR THEIR CARE OF THEIR FINANCIAL OBLIGATIONS TO BASSETT BASSETT WILL IN COMPLIANCE WITH ALL EXISTING LAWS AND REGULATIONS TAKE THE NECESSARY STEPS TO RECOVER SELFPAY ACCOUNTS RECEIVABLE AS WELL PRESERVE THE PATIENTPROVIDER RELATIONSHIP AND KEEP THE NECESSITY OF REFERRING ACCOUNTS TO THIRD PARTY BAD DEBT COLLECTION AGENCIES OR LAW FIRMS TO A MINIMUM IT IS EXPECTED THAT ANY THIRD PARTY COLLECTION AGENCY OR LAW FIRM RETAINED BY BASSETT WILL REFRAIN FROM ANY CONDUCT THAT VIOLATES THE FAIR DEBT COLLECTION PRACTICES ACT AS WELL AS ANY APPLICABLE STATE LAW OR REGULATIONS THE ARREST OR BODY ATTACHMENT OF A JUDGEMENT DEBTOR ON CONTEMPT PROCEEDINGS OR FORECLOSURE OF A JUDGEMENT DEBTORS PRINCIPAL RESIDENCE WILL NEVER BE CONSIDERED APPROPRIATE PURSUIT OF AN OPEN BALANCE IN THE NAME OF BASSETT MEDICAL CENTER LIENS OR GARNISHMENTS UPON THE PERSONAL ASSETS OF A JUDGEMENT DEBTOR WILL BE PURSUED ONLY AFTER INDIVIDUAL CASE REVIEW BY COUNSEL TO ENSURE THAT SUCH ACTION IS NOT ONLY CONSISTENT WITH BASSETTS INTERESTS BUT ALSO THE ONLY FEASIBLE RECOVERY MECHANISM FROM A JUDGEMENT DEBTOR CAPABLE OF RESPONDING TO HIS OR HER OBLIGATIONS BUT OTHERWISE UNWILLING TO DO SO
NEEDS ASSESSMENTPART VIIN ADDITION TO PUBLIC AND AGENCY INPUT A VARIETY OF DATA FROM THE NYS DEPARTMENT OF HEALTH OTSEGO COUNTY BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM OTSEGO CO DEPARTMENT OF HEALTH COMMUNITY ASSESSMENT AND OTHER SOURCES WERE USED TO ASSESS PRIORITIES INCLUDING APERCENTAGE OF OTSEGO CO ADULTS WHO VISITED A DENTIST IN THE PAST YEARS BPREVALENCE OF TOOTH DECAY IN THIRDGRADE CHILDREN CPERCENTAGE OF ADULTS REPORTING BINGE DRINKING DHEAVY DRINKING EPERCENTAGE OF OVERWEIGHT ADULTS IN OTSEGO CO BASED ON THE OUTCOMES OF THE FOCUS GROUPS AND STRATEGIC PLANNING SESSIONS PREVENTION AGENDA PRIORITIES THROUGHOUT THE COUNTY WERE IDENTIFIED ACCESS TO QUALITY HEALTHCARE AND MENTAL HEALTH SUBSTANCE ABUSE WERE IDENTIFIED AS THE TOP PRIORITIES PHYSICAL ACTIVITY AND NUTRITION WAS RANKED THIRD SUBSEQUENT STRATEGIC PLANNING SESSIONS RELATED TO THE TWO TOP PRIORITIES WERE HELD TO IDENTIFY SERVICE BARRIERS AND GAPS AS WELL AS BRAINSTORM FOR COLLABORATIVE EFFORTS TO ADDRESS THESE PRIORITIES STRATEGIES FOR THE SELECTED PRIORITIES 1ACCESS TO DENTAL HEALTH CARE ABASSETT WILL SUPPORT OTSEGO CO DEPT OF HEALTH EFFORTS TO REESTABLISH THE OTSEGO CO ORAL HEALTH COALITION AS A MECHANISM FOR BRINGING COMMUNITY PARTNERS TOGETHER ON ADVOCACY EFFORTS AIMED AT ATTRACTING MORE DENTISTS TO OUR RURAL AREA AND FOR TRACKING PROGRESS IN IMPROVING ACCESS TO DENTAL SERVICES BBASSETT WILL WORK TO EXPAND COMPREHENSIVE PREVENTIVE DENTAL HEALTH SERVICES TO ALL SCHOOLBASED HEALTH CENTERS IN THE COUNTY AND TO PROVIDE SEALANT SERVICES TO NONSBHC SCHOOLS BASSETT WILL WORK WITH THE OTSEGO CO DEPT OF HEALTH AND RHENDOMS TO MAKE MORE SCHOOLS AWARE OF RHENDOMS SERVICES TO INCREASE PARTICIPATION CBASSETT WILL WORK WITH THE OTSEGO CO DEPT OF HEALTH AND AO FOX HOSPITAL TO EDUCATE PRIMARY CARE AND SBHC PROVIDERS ABOUT DENTAL PRACTICES AVAILABLE FOR REFERRAL THE OTSEGO CO DEPT OF HEALTH WILL EDUCATE DENTAL PROVIDERS ABOUT MEDICAID REIMBURSEMENTS DBASSETT WILL WORK WITH THE HEALTH DEPARTMENT AND OTHER COMMUNITY PARTNERS TO EDUCATE THE PUBLIC ABOUT DENTAL HEALTH IN FAIRS AND OTHER COMMUNITY EVENTS 2MENTAL HEALTH AND SUBSTANCE ABUSE AIN A NEW INITITATIVE BASSETT WILL WORK WITH AO FOX HOSPITAL AND LEATHERSTOCKING EDUCATION ON ALCOHOLISMADDICTIONS FOUNDATIONS INC LEAF TO PROVIDE CONTINUING MEDICAL EDUCATION TRAINING ON SUBSTANCE ABUSE SCREENING AND REFERRAL TO PRIMARY CARE PROVIDERS AND SURGEONS IN THE COUNTY BBASSETT WILL WORK WITH THE HEALTH DEPARTMENT AND LEAF TO COMPLETE AND DISTRIBUTE AN UPDATED LIST OF MENTAL HEALTH AND SUBSTANCE ABUSE RESOURCES TO PRIMARY CARE PROVIDERS CBASSETT WILL COLLABORATE WITH LEAF AND THE HEALTH DEPARTMENT ON PUBLIC HEALTH CAMPAIGN ABOUT THE RISK FACTORS ASSOCIATED WITH BINGE DRINKING AND PRESCRIPTION DRUG ABUSE 3PHYSICAL ACTIVITY AND NUTRITION ABASSETT WILL CONTINUE TO COLLABORATE WITH THE HEALTH DEPARTMENT AND OTHER COMMUNITY PARTNERS ON EFFORTS TO PROVIDE EARLY EDUCATION ABOUT THE IMPORTANCE OF PHYSICAL ACTIVITY AND NUTRITION THROUGHOUT LIFE INCLUDING DURING PREGNANCY AND TO PREVENT CHRONIC DISEASE BBASSETT WILL WORK WITH THE HEALTH DEPARTMENT SCHOOLS AND OTHER COMMUNITY PARTNERS TO IMPROVE CONTINUITY OF CARE BETWEEN FAMILIES SCHOOLS AND PRIMARY CARE PROVIDERS FOR THE TREATMENT OF CHILDHOOD OBESITY OVERALL GOALS WILL BE TO INCREASE THE PERCENTAGE OF OTSEGO COUNTY ADULTS WHO HAVE SEEN A DENTIST IN THE PAST YEAR WORK TOWARD A 2013 PREVENTION AGENDA OBJECTIVE OF 83 REDUCING THE RATE OF ALCOHOL ABUSE IN OTSEGO COUNTY AND REDUCING THE RATE OF OBESITY IN OTSEGO COUNTY
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VIA MAJOR COMPONENT OF BASSETTS COMMUNITY SERVICES PROGRAM IS TO ACTIVELY IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR CHARITY CARE THE PROCESS BEGINS WITH AN ORGANIZATIONAL POLICY AND PROCEDURE THAT DEFINES THE PROGRAM AND SERVES AS AN EDUCATION TOOL FOR ALL BASSETT EMPLOYEES THE POLICY IS UPDATED ANNUALLY DISTRIBUTED TO KEY PERSONNEL AND POSTED IN THE ONLINE POLICY AND PROCEDURE MANUAL THAT IS ACCESSIBLE TO ALL EMPLOYEES THE PROGRAM IS SUPPORTED BY A FOUR PAGE PLAIN LANGUAGE BROCHURE THAT INCLUDES AN APPLICATION BROCHURES ARE PROMINENTLY DISPLAYED AND AVAILABLE AT ALL FACILITIES AND ALL CLINIC LOCATIONS CLINICAL AND SUPPORT STAFF ARE MADE AWARE OF THE PROGRAM AND ABLE TO DIRECT PATIENTS TO SPECIALISTS WHO CAN ASSIST IN THE APPLICATION PROCESS ALL PATIENTS WHO ARE REGISTERED AS SELF PAY ARE PROVIDED A BROCHURE EITHER IN PERSON OR BY MAIL PATIENTS WHO ARE IN THE HOSPITAL RECEIVE INFORMATION AS PART OF A PERSONAL VISIT GEARED TO HELP THE PATIENT NAVIGATE FINANCIAL ASSISTANCE INCLUDING BUT NOT LIMITED TO THE COMMUNITY SERVICES PROGRAM GOVERNMENT PROGRAM OPPORTUNITIES ARE ALSO REFERENCED AND A DIRECTORY OF LOCAL SOCIAL SERVICES AGENCIES IS PROVIDED BASED ON THE PATIENTS COUNTY OF RESIDENCE REFERRAL TO AN ONSITE OTSEGO COUNTY MEDICAID EXAMINER IS AVAILABLE AT THE COOPERSTOWN CAMPUS A LISTING OF ALL SELFPAY ACCOUNTS IS PRODUCED AND REVIEWED DAILY TO INSURE THAT A COMMUNITY SERVICES BROCHURE HAS BEEN PROVIDED THE SELFPAY BILLING OFFICE IDENTIFIES PATIENTS DURING THE BILLING AND COLLECTIONS PROCESS THAT MAY REQUIRE ADDITIONAL HELP UNDERSTANDING THE PROGRAM SELFPAY ACCOUNTS FOR PATIENTS WHO HAVE BEEN APPROVED FOR COMMUNITY SERVICES WITHIN THE PRIOR 120 DAYS ARE AUTOMATICALLY INCLUDED WITH THE PRIOR APPROVAL
COMMUNITY INFORMATIONPART VITHE SERVICE AREA OF BASSETT ENCOMPASSES AN SEVEN COUNTY REGION IN UPSTATE NEW YORK WHILE THE ECONOMY OF COOPERSTOWN IS BASED ON TOURISM AND HEALTH CARE THE REST OF THE REGION IS LARGELY AGRICULTURAL THERE ARE A FEW LARGER EMPLOYERS IN THE REGION SUCH AS LOCAL SCHOOL DISTRICTS COMMUNITY STATE AND PRIVATE UNIVERSITIES THE MAJORITY OF EMPLOYERS ARE SMALL BUSINESSES IN THE SEVEN COUNTY REGIONS THE MEDIAN HOUSEHOLD INCOME RANGES BETWEEN 37000 AND 40000 1214 OF THE COMMUNITY RESIDENTS HAVE INCOMES BELOW THE FEDERAL POVERTY GUIDELINES THE FOLLOWING AREAS HAVE BEEN FEDERALLY DESIGNATED AS BEING MEDICALLY UNDERSERVED A HERKIMER COUNTY B FULTON COUNTY TOWN OF OPPENHEIM C MONTGOMERY COUNTY CITY OF AMSTERDAM D OTSEGO COUNTY NORTH OTSEGO SERVICE AREA TOWN OF PLAINFIELD TOWN OF DECATUR E DELAWARE COUNTY TOWNS OF DEPOSIT COLCHESTER MIDDLETOWN
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VIBASSETTS SOLE MEMBER IS THURSTON CORPORATION DBA BASSETT HEALTHCARE NETWORK AND IS A 180 BED ACUTE CARE INPATIENT TEACHING FACILITY LOCATED IN RURAL COOPERSTOWN NEW YORK BASSETT HAS A FULLY SALARIED MEDICAL STAFF AND ADVANCED PRACTITIONER STAFF PROVIDING A WIDE VARIETY OF SERVICES INCLUDING A WIDE RANGE OF SPECIALTY CARE BASSETT MAINTAINS A STRONG ACADEMIC PROGRAM THROUGH ITS AFFILIATION WITH COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS AN AFFILIATION HIGHLIGHTED BY THE ESTABLISHMENT OF A COLUMBIA MEDICAL SCHOOL CAMPUS AT BASSETT IN 2009 BASSETT HAS A NETWORK OF 29 COMMUNITY BASED OUTPATIENT HEALTH CENTERS 19 SCHOOLBASED HEALTH CENTERS TWO AMBULATORY SURGERY CENTERS AND IS A LEVEL II TRAUMA CENTER AS DESIGNATED BY NEW YORK STATE IN ADDITION THE RESEARCH PROGRAMS AT BASSETT INCLUDE THE NEW YORK CENTER FOR AGRICULTURAL MEDICINE AND HEALTH COMMUNITY BASED PARTNERSHIPS AS PART OF THE NORTHEAST CENTER FOR AGRICULTURAL HEALTH ARE ADDRESSING IMPORTANT HEALTH AND SAFETY ISSUES IN DIVERSE AGRICULTURAL POPULATIONS AT SEVERAL SITES ACROSS NEW YORK STATE HEALTH WORKS OCCUPATIONAL HEALTH SERVICES PROGRAM CONTINUES TO MEET THE HEALTH SAFETY AND WELLNESS NEEDS OF THE BUSINESS COMMUNITY PROVIDING NEEDED OCCUPATIONAL HEALTH SERVICES BENEFITS AND IMPROVING EMPLOYEE HEALTH THROUGHOUT THE BASSETT HEALTHCARE NETWORK SEVEN COUNTY REGION BASSETT IS WORKING TO REESTABLISH THE OTSEGO COUNTY ORAL HEALTH COALITION AS A MECHANISM FOR BRINGING COMMUNITY PARTNERS TOGETHER AROUND A SHARED VISION IN AN EFFORT TO ATTRACT MORE DENTISTS TO OUR RURAL AREA THE SIZE AND DEPTH OF BASSETT WITH ITS MORE THAN TWO DOZEN COMMUNITY HEALTH CENTERS AND 19 SCHOOL BASED HEALTH CENTERS MAKES IT IDEAL FOR A NEW INITIATIVE TO TRAIN PRIMARY CARE PRACTITIONERS AND SURGEONS IN SUBSTANCE ABUSE SCREENING AND REFERRAL THE GOAL IS TO ALSO TRAIN PRACTITIONERS OUTSIDE BASSETT HOSPITAL BUT BASSETT PROVIDES THE IDEAL PLATFORM FROM WHICH TO PILOT THIS INITIATIVE BASSETT IS ALSO ADDRESSING THE RATE OF OBESITY WITHIN ITS REGION REACHING OUT TO SCHOOLS TO PROVIDE RESOURCES GUIDANCE AND TECHNICAL ASSISTANCE IN THE AREAS OF TOBACCO USE NUTRITION AND PHYSICAL ACTIVITY BASSETT CONTINUES TO COMBINE HEALTH CARE WITH COMMUNITY SERVICE OUR PROGRAM CONNECTING COMMUNITIES FOR HEALTH WELLNESS IS ABOUT COLLABORATIVE EFFORTS TO PROVIDE TREATMENT ANDOR TO PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS COMMUNITY HEALTH IMPROVEMENT INITIATIVES HAVE TARGETED THE NEW YORK STATE DEPARTMENT OF HEALTH NEW PUBLIC HEALTH PREVENTION AGENDA IN ADDITION TO HOSPITAL PUBLIC HEALTH PROGRAMS RELATED TO THE THREE PRIORITY PREVENTION AGENDA ITEMS PROGRAMS ADDRESSING CHRONIC DISEASE MANAGEMENT AND PREVENTION AND UNINTENTIONAL INJURY WERE CONSIDERED BASSETT PUBLIC HEALTH PROGRAMS THAT ADDRESS THESE AREAS INCLUDE ASCHOOLBASED HEALTH CENTER DENTAL SEALANT PROGRAM A REGISTERED DENTAL HYGIENIST PROVIDES PREVENTIVE CARE INCLUDING EDUCATION CLEANINGS FLUORIDE TREATMENT SEALANT AND REFERRALS IN THIS GRANT FUNDED PROGRAM BRHENDOMS RURAL HEALTH EDUCATION NETWORK OF DELAWARE OTSEGO MONTGOMERY AND SCHOHARIE COUNTIES DENTAL HEALTH EDUCATION IS OFFERED TO ELEMENTARY SCHOOL STUDENTS AND PARENTS OF NEWBORNS ARE EDUCATED ABOUT BABYBOTTLE TOOTH DECAY CBASSETT PSYCHIATRIC CRISIS CENTER THE COOPERSTOWN CENTER OPENED IN FEBRUARY 2008 FILLING A VOID CREATED BY THE TERMINATION OF PSYCHIATRIC SERVICES AT AO FOX HOSPITAL IN ONEONTA MONTHS EARLIER IN ITS FIRST YEAR BASSETTS PSYCHIATRIC CRISIS CENTER HELPED MORE THAN 1200 PATIENTS OF THOSE 52 WERE CHILDREN 12 OR YOUNGER AND 154 WERE ADOLESCENTS DPARENT HANYBOOK THIS FAMILY RESOURCE WAS CREATED BY THE OTSEGO CO COMMITTEE ON CHILD ABUSE AND NEGLECT AND UNDERWRITTEN BY BASSETT AND AO FOX HOSPITAL ITS GOAL IS TO GIVE PARENTS AND PROFESSIONALS A PLACE TO TURN FOR HELP IN DEALING WITH THE STRESSES OF FAMILY LIFE EKICKSTART A PROGRAM DESIGNED TO HELP COMBAT CHILDHOOD OBESITY THROUGH COLLABORATIVE PARTNERSHIPS WITH BASSETT HEALTH CENTERS AND LOCAL RECREATIONAL AND FITNESS GROUPS FBASSETT CANCER INSTITUTE MEDICAL SCREENING COACH A NEW CUSTOMBUILT MEDICAL COACH EQUIPPED WITH DIGITAL TECHNOLOGY FOR MAMMOGRAPHY AND OTHER CANCER SCREENINGS FOR MEN AND WOMEN THE COACH WAS PLACED IN SERVICE IN 2008 WITH THE GOAL OF REDUCING THE NUMBER OF CANCER DEATHS BY INCREASING ACCESS TO SCREENING SERVICES IN RURAL AREAS GCANCER SERVICES PROGRAM OF DELAWARE OTSEGO AND SCHOHARIE COUNTIES A NEW YORK STATE DEPARTMENT OF HEALTH PARTNERSHIP ADMINISTERED THROUGH BASSETT OFFERING FREE BREAST CERVICAL AND COLORECTAL SCREENINGS TO PEOPLE WHO QUALIFY HHEALTHY START BREAKFAST A PARTNERSHIP BETWEEN COMMUNITY SERVICE ORGANIZATIONS AND BASSETT FOR DIABETES DETECTION EDUCATION AND PREVENTION ISAFE KIDS COALITION OF OTSEGO COUNTY AN ORGANIZATION WHOSE MISSION IS TO PREVENT UNINTENTIONAL INJURIES TO CHILDREN THROUGH EDUCATION PROGRAMS AND SERVICES INCLUDE SAFETY SEAT EVENTS EDUCATIONAL RESOURCES ON BICYCLING INLINE SKATE AND SKATEBOARD SAFETY HOME SAFETY FIRE AND BURN PREVENTION ROAD SAFETY AND PEDESTRIAN SAFETY THE REGIONAL PRIMARY AND SPECIALTY CARE CLINICS AND THE SCHOOLBASED HEALTH CENTERS WERE ESTABLISHED IN RESPONSE TO COMMUNITY NEED BASSETT IS CONTINUALLY ENGAGING IN QUALITY IMPROVEMENT INITIATIVES TO ENSURE THAT QUALITY HEALTH CARE AND PROGRAMS ARE BROUGHT TO CENTRAL NEW YORK A CORE PART OF BASSETT IS RESEARCH AND EDUCATION BASSETTS VALUE TO THE COMMUNITIES IT SERVES IS COMPOUNDED BY PROVIDING PHYSICIANS THE ABILITY TO PRACTICE QUALITY MEDICINE IN A COLLEGIAL ENVIRONMENT IN A RURAL SETTING THERE IS A TREMENDOUS COLLABORATION BETWEEN PHYSICIANS WITHIN BASSETT TO ENSURE A BETTER OUTCOME FOR THE PATIENT BASSETT CONTINUALLY INVESTS IN PROGRAMS EQUIPMENT AND PEOPLE TO ENSURE QUALITY SERVICE TO THE COMMUNITIES IN WHICH WE SERVE
AFFILIATED HEALTH CARE INFORMATIONPART VIBASSETT IS PART OF THE BASSETT HEALTHCARE NETWORK THAT PROVIDES HEALTH SERVICES IN MORE THAN 20 COMMUNITIES SPANNING 5600 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 61709 DELAWARE COUNTY POPULATION 47276 HERKIMER COUNTY POPULATION 64508 SCHOHARIE COUNTY POPULATION 32099 ACCORDING TO THE 2012 US CENSUS ESTIMATES ABASSETT AN ACUTE CARE INPATIENT TEACHING FACILITY AN OUTPATIENT PRIMARY AND SPECIALTY CARE CENTER A REGIONAL NETWORK OF 26 COMMUNITY BASED OUTPATIENT HEALTH CENTERS 19 SCHOOL BASED HEALTH CENTERS TWO AMBULATORY SURGERY CENTERS AND A FULLY SALARIED MEDICAL STAFF IN COOPERSTOWN OTSEGO COUNTY BOCONNOR HOSPITAL CRITICAL ACCESS HOSPITAL IN DELHI DELAWARE COUNTY CCOBLESKILL REGIONAL HOSPITAL ACUTE CARE FACILITY IN COBLESKILL SCHOHARIE COUNTY DLITTLE FALLS HOSPITAL CRITICAL ACCESS HOSPITAL IN LITTLE FALLS HERKIMER COUNTY ETRITOWN REGIONAL HOSPITAL 247 EMERGENCY CARE FACILITY IN SIDNEY DELAWARE COUNTY FAO FOX MEMORIAL HOSPITAL ACUTE CARE FACILITY IN ONEONTA OTSEGO COUNTY GVALLEY HEALTH SERVICES RESIDENTIAL HEALTH CARE AND REHABILITATION FACILITY HAT HOME CARE CERTIFIED HOME CARE AGENCY IFIRST COMMUNITY CARE OF BASSETT MEDICAL SUPPLY COMPANY ALL THE ABOVE AI MAKE UP THE BASSETT HEALTHCARE NETWORK AND PROVIDE HEALTH SERVICES TO THIS SEVEN COUNTY REGION IN CENTRAL NEW YORK
LIST OF STATES WHERE COMMUNITY BENEFIT REPORT IS FILEDPART VINEW YORK
ADDITIONAL INFORMATIONPART VIPART V SECTION B LINE 11 BASSETT MEDICAL CENTER DOES NOT PROVIDE DISCOUNTED CARE
MARY IMOGENE BASSETT HOSPITAL LINE NUMBER 1 PART V LINE 16EPART V LINE 16EBASSETT ENGAGES WITH A THIRD PARTY TO PERFORM COLLECTION ACTIONS
MARY IMOGENE BASSETT HOSPITAL LINE NUMBER 1 PART V LINE 20DPART V LINE 20DBASSETT RECOGNIZES THAT SERVICES WILL BE PROVIDED EQUALLY TO ALL PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY FOR SUCH SERVICES CHARGE SCHEDULES ARE THEREFORE UNIFORM BILLINGS TO PATIENTS ARE BASED ON THESE CHARGE SCHEDULES ALL CHARGES TO INDIVIDUALS THAT QUALIFY FOR CHARITY CARE ARE WRITTEN OFF COMPLETELY

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantMethod Of ValuationMethodOfValuationPurpose Of GrantPurposeOfGrant
AMERICAN CANCER SOCIETY
250 WILLIAMS ST NWATLANTAGA3030313178849137500CASHSUPPORT
AMERICAN HEART ASSOCIATION
7272 GREENVILLE AVEDALLASTX75231135613797325000CASHSUPPORT
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgBonus Filing OrgBonusFilingOrg
WILLIAM F STRECK MD
PRESIDENT CEO77397512460230964679814210
BERTINE MCKENNA PHD
EXECUTIVE VP & CFO3804371722180964823512078107000
NICHOLAS J NICOLETTA
CORPORATE VP & CFO376575230963436510107107000
PASCALE G RAYMOND MD
ATTENDING PHYSICIAN415000181318096604068169159
STEVEN J HENEGHAN MD
ATTENDING PHYSICIAN578884230966614608594
JONATHAN RICHMAN MD
ATTENDING PHYSICIAN5215652309695675574283200
ROBERT A LANCEY MD
ATTENDING PHYSICIAN52155418096145625567322520
TALLY E LASSITER MD
ATTENDING PHYSICIAN50000012789243614512665

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NON-FIXED PAYMENTS PROVIDEDSCHEDULE J, PAGE 1, PART I, LINE 7NON FIXED PAYMENTS ARE MADE BASED ON THE SUCCESS IN MEETING PERFORMANCE CRITERIA THAT ARE PROSPECTIVELY AGREED UPON AS GOALS FOR THE OFFICERS. PHYSICIANS MAY RECEIVE NON FIXED PAYMENTS BASED ON PERFORMANCE CRITERIA THAT ARE PROSPECTIVELY AGREED UPON.
OTHER ADDITIONAL INFORMATIONSCHEDULE J, PART IIIPART VII, LINE 5 COMPENSATION FROM UNRELATED ORGANIZATIONS NAME : WILLIAM F STRECK, MD NAME OF UNRELATED ORGANIZATION : COLUMBIA UNIVERSITY TYPE OF COMPENSATION : SALARY AMOUNT OF COMPENSATION : 306,000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
OTSEGO COUNTY CAPITAL RESOURCES
A2636615932011-11-0325000000PART VIfalsefalsefalse
OTSEGO COUNTY CAPITAL RESOURCES
B2636615932011-11-0319200000PART VIfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletion
A2500000070200050000023798000falsefalsefalsetrue
B1920000075000truefalsetruetrue191250002009

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropRemedial Action TakenRemedialActionTakenNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
Afalsefalsefalsefalsefalsefalsefalsetrue
Bfalsefalsefalsefalsefalsefalsefalsetrue

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
Afalsefalsefalsefalsetruefalsefalsefalsefalse
Bfalsefalsefalsefalsetruefalsefalsefalsefalse

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective ActionfalseProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE KReturnReference
ExplanationOTSEGO COUNTY CAPITAL RESOURCES PART I LINE A COLUMN F BUILDING AND STRUCTURES OTSEGO COUNTY CAPITAL RESOURCES PART I LINE B COLUMN F REFUND OF PRIOR ISSUANCEExplanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
THE CLARK ESTATES
PART V449096INVESTMENT MGMT FEESfalse
JANE HAMILTON
PART V84335WAGESfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE L PART VReturnReference
ExplanationPART IV LINE 1 MORE THAN 35 OF THE CLARK ESTATES IS OWNED BY TRUSTEE JANE FORBES CLARK PART IV LINE 2 JANE HAMILTON IS FAMILY MEMBER OF TRUSTEE PETER HAMILTONExplanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SECOND ACCOMPLISHMENT DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4BCOMMUNITY INVOLVEMENT HAS BEEN LINKED TO BASSETT'S MISSION, VISION, AND VALUES SINCE WE FIRST OPENED IN 1921. WHETHER IT IS STRENGTHENING OUR COMMUNITY RELATIONSHIPS FOR HEALTH AND WELLNESS, COMMUNICATING IDEAS FOR IMPROVING OUR SERVICES TO OUR REGION, OR PROVIDING A FORUM FOR BASSETT TO LEARN AND LISTEN, WE ARE WORKING WITH OUR COMMUNITY TO IMPROVE THE QUALITY OF LIFE FOR THE PEOPLE OF OUR REGION. OUR COMMUNITY SERVICES PROGRAM PROVIDES FREE SERVICES TO PERSONS WHO CANNOT AFFORD TO PAY, WHO DO NOT QUALIFY FOR MEDICAID, AND WHO FALL WITHIN THE ESTABLISHED INCOME GUIDELINES. IN 2012, WE PROVIDED 5,433,926 IN FREE CARE. BASSETT'S COMMUNITY HEALTH EDUCATION PROGRAMS INCLUDE LECTURES, PRESENTATIONS, HEALTH FAIRS, AND OTHER GROUP PROGRAMS APART FROM THE CLINICAL AND DIAGNOSTIC SERVICES OFFERED. CLINICAL SERVICES OFFERED INCLUDES SCREENINGS, HEALTH TESTS AND HEALTH RISK APPRAISALS INCLUDING BLOOD PRESSURE, LIPID PROFILE, CHOLESTEROL SCREENINGS, CARDIOLOGY RISK FACTOR SCREENINGS, AND ALL CANCER SCREENINGS. OUR COMMUNITY BUILDING ACTIVITIES INCLUDE PHILANTHROPIC SUPPORT FOR HEALTH INITIATIVES AND COMMUNITY HEALTH AND WELFARE PROJECTS INCLUDING PROMOTING HEALTHY LIFESTYLES, DISEASE PREVENTION, AND COMMUNITY AWARENESS INITIATIVES. OUR DOORS ARE OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS A YEAR. WE ARE PROUD TO PROVIDE CARE TO OUR COMMUNITIES. NOT ONLY DID WE PROVIDE 5.4M IN CHARITY CARE, BAD DEBT EXPENSE WAS 15M, MEDICAID PAYMENTS BELOW COST TO PROVIDE SERVICES WERE 27.2M.
RELATED PARTY INFORMATION AMONG OFFICERSFORM 990, PAGE 6, PART VI, LINE 2KEVIN S MOORE WILLIAM T BURDICK TRUSTEE TRUSTEE BUSINESS KEVIN S MOORE JANE FORBES CLARK TRUSTEE TRUSTEE BUSINESS KEVIN S MOORE RICHARD C VANISON TRUSTEE TREASURER BUSINESS KEVIN S MOORE GLENN A PERRONE TRUSTEE ASST. SEC. BUSINESS WILLIAM T BURDICK KEVIN S MOORE TRUSTEE TRUSTEE BUSINESS WILLIAM T BURDICK JANE FORBES CLARK TRUSTEE TRUSTEE BUSINESS WILLIAM T BURDICK RICHARD C VANISON TRUSTEE TREASURER BUSINESS WILLIAM T BURDICK GLENN A PERRONE TRUSTEE ASST. SEC. BUSINESS JANE FORBES CLARK KEVIN S MOORE TRUSTEE TRUSTEE BUSINESS JANE FORBES CLARK WILLIAM T BURDICK TRUSTEE TRUSTEE BUSINESS JANE FORBES CLARK RICHARD C VANISON TRUSTEE TREASURER BUSINESS JANE FORBES CLARK GLENN A PERRONE TRUSTEE ASST. SEC. BUSINESS RICHARD C VANISON KEVIN S MOORE TREASURER TRUSTEE BUSINESS RICHARD C VANISON WILLIAM T BURDICK TREASURER TRUSTEE BUSINESS RICHARD C VANISON JANE FORBES CLARK TREASURER TRUSTEE BUSINESS RICHARD C VANISON GLENN A PERRONE TREASURER ASST. SEC. BUSINESS GLENN A PERRONE KEVIN S MOORE ASST. SEC. TRUSTEE BUSINESS GLENN A PERRONE WILLIAM T BURDICK ASST. SEC. TRUSTEE BUSINESS GLENN A PERRONE JANE FORBES CLARK ASST. SEC. TRUSTEE BUSINESS GLENN A PERRONE RICHARD C VANISON ASST. SEC. TREASURER BUSINESS
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE MARY IMOGENE BASSETT HOSPITAL DISTRIBUTES THE DRAFT 990 TO THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES PRIOR TO FILING. ANY QUESTIONS ARE RAISED AND ANSWERED. THE AUDIT COMMITTEE THEN PRESENTS ITS REVIEW FINDINGS TO THE FULL BOARD OF TRUSTEES. ONCE APPROVED, THE 990 CAN BE ELECTRONICALLY FILED. A COMPLETE COPY OF THE ORGANIZATION'S FINAL FORM 990, INCLUDING ALL REQUIRED SCHEDULES, AS ULTIMATELY FILED WITH THE IRS, IS AVAILABLE FOR EACH MEMBER OF THE BOARD BEFORE IT'S FILING WITH THE IRS.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CTHE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO THE BOARD OF TRUSTEES, INCLUDING ANY COMMITTEES OF THE BOARD, INDIVIDUAL MEMBERS OF THE BOARD, OFFICERS OF THE HOSPITAL (CEO, COO, CFO), VICE PRESIDENTS, AND ALL DIRECTORS SERVING AS DIRECTORS TEAM MEMBERS. UPON THE COMMENCEMENT OF AN INDIVIDUAL SERVING IN THE ROLES PREVIOUSLY DEFINED, AND THEREAFTER ANNUALLY BY JANUARY 1, A CONFLICT OF INTEREST QUESTIONNAIRE WHICH IS PRESCRIBED BY THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES MUST BE COMPLETED. ALL COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE COMPLIANCE OFFICER OF THE ORGANIZATION. ANY POTENTIAL CONFLICT OF INTEREST WILL BE DISCUSSED WITH THE INDIVIDUAL AND/OR WITH LEGAL COUNSEL. THE COMPLIANCE OFFICER WILL TAKE ACTION TO ELIMINATE THE POTENTIAL CONFLICT OF INTEREST, IF DEEMED APPROPRIATE. AFTER INVESTIGATION IF IT IS DEEMED THAT THE INDIVIDUAL HAS FAILED TO COMPLY WITH SUCH POLICIES AND DIRECTIVES, APPROPRIATE CORRECTIVE ACTION WILL BE TAKEN. THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES MAY DETERMINE WHETHER THE CORRECTIVE ACTION IS SATISFACTORY AND, IF NOT, SHALL REQUIRE FURTHER ACTION.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ABASSETT MEDICAL CENTER HAS A FORMAL PROCESS THAT IS USED TO DETERMINE THE BASE COMPENSATION OF THE CEO ON AN ANNUAL BASIS. THIS PROCESS INCLUDES A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, AND INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OF TRUSTEES OR THE COMPENSATION COMMITTEE. BASSETT MEDICAL CENTER PAYS NON-FIXED EARNINGS BASED ON THE SUCCESS IN MEETING PERFORMANCE CRITERIA THAT ARE PROSPECTIVELY AGREED UPON AS GOALS FOR THE CEO.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BTHE SAME FORMAL PROCESS NOTED ABOVE (PART VI, SECTION B, LINE 15A), IS USED TO DETERMINE THE BASE COMPENSATION OF THE OTHER OFFICERS. NON FIXED EARNINGS OF OTHER OFFICERS ARE BASED ON THE SUCCESS IN MEETING PERFORMACE CRITERIA AND COMPARATIVE MARKET DATA. FOR KEY EMPLOYEES, COMPENSATION IS DELEGATED BY THE BAORD TO THE DISCRETION OF THE OFFICERS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19THE MARY IMOGENE BASSETT HOSPITAL MAKES IT'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. PARTIES DESIRING TO OBTAIN COPIES OF SUCH MUST PRESENT THEMSELVES AT THE ADMINISTRATIVE OFFICES OF THE HOSPITAL OR BY SENDING A SELF-ADDRESSED STAMPLED ENVELOPE ALONG WITH PAYMENT FOR COPYING OF THE REQUESTED MATERIAL TO THE ADMINISTRATIVE OFFICE OF THE HOSPITAL. THE COST OF COPYING SHALL BE EQUAL TO THE COSTS IMPOSED BY THE IRS FOR COPYING OF PUBLIC DOCUMENTS.
RECONCILIATION OF CHANGES - OTHERFORM 990, PART XI, LINE 9POST RETIREMENT BENEFIT CHANGE 174,722 BAD DEBT -14,985,208 CHARITY CARE -5,433,926 BAD DEBT 14,985,208 CHARITY CARE 5,433,926

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
THURSTON CORPORATION
ONE ATWELL ROADCOOPERSTOWNNY13326133218680SUPPORTNY501C311CNONEfalse
BASSETT REGIONAL CORPORATION (BRC)
ONE ATWELL ROADCOOPERSTOWNNY13326133522783SUPPORTNY501C311BTHURSTONfalse
TEMPLETON FOUNDATION
ONE ATWELL ROADCOOPERSTOWNNY13326133317084LANDLORDNY501C39THURSTONfalse
FRIENDS OF BASSETT
ONE ATWELL ROADCOOPERSTOWNNY13326237041610FUNDRAISENY501C37THURSTONfalse
AO FOX MEMORIAL HOSPITAL
ONE NORTON AVENUEONEONTANY13820150539039HEALTHCARENY501C33THURSTONfalse
BASSETT HOSPITAL SCHOHARIE COUNTY
178 GRANDVIEW DRIVECOBLESKILLNY12043141772971HEALTHCARENY501C33BRCfalse
LITTLE FALLS HOSPITAL
140 BURWELL STREETLITTLE FALLSNY13365150533578HEALTHCARENY501C33BRCfalse
O'CONNOR HOSPITAL
460 ANDES ROADDELHINY13753161540394HEALTHCARENY501C33BRCfalse
TRI TOWN REGIONAL HEALTHCARE
43 PEARL STREETSIDNEYNY13838260169584HEALTHCARENY501C33BRCfalse
VALLEY HEALTH SERVICES
690 WEST GERMAN STREETHERKIMERNY13350222511614ELDER CARENY501C33BRCfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetstrueExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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