2013-11-12T13:01:46-06:00 2012-12-31 KPMG LLP 515 Broadway 4th Floor Albany NY 122072974 990 2012-01-01 141772971 Bassett Hospital of Schoharie County % LEANNA JENSEN VP FINANCE/CF BASS 5182543456 178 Grandview Drive Suite Cobleskill NY 120435144 Eric Stein 5182543233 2013-11-11 true 5184274600 2013-11-08 2012 2016-03-07 17:11:31Z Cobleskill Regional Hospital Eric h stein presidentceo 178 Grandview Drive Cobleskill NY 12043 27182844 false X cobleskillhospital.org X 1994 NY PROVISION OF HEALTH CARE SERVICES TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. 16 12 306 55 0 780348 408922 25216492 26272938 21487 -139819 267037 443874 26285364 26985915 0 0 0 0 12054484 11924961 16500 0 0 13437979 13941004 25508963 25865965 776401 1119950 18768245 20713005 5178620 5977167 13589625 14735838 PROVISION OF HEALTH CARE SERVICES TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. false false 18822742 26272938 PROVISION OF HOSPITAL CARE TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING AREA. IN 2012, THE NUMBER OF INPATIENTS CARED FOR WAS 748 AND THE NUMBER OF OUTPATIENTS CARED FOR WAS 66,763. 18822742 true true false true false false false false false true true false false false true true true false false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 70 0 true 306 true false false false false false false false false false false X 16 12 false false false false false false false true true false false false true true true true true true false false NY X LEANNA JENSEN VP FINANCECF 5182543456 178 GRANDVIEW DRIVE COBLESKILL NY 120435144 Nancy S Bellinger 1.0 X 0 0 0 STEVEN C COLE 1.0 X 0 MACDONALD J HOLMES DVM 1.0 X 0 STEVEN KROLL 1.0 X 0 HENRY LAMONT PE 1.0 X 0 PETER D LOPEZ 1.0 X 0 SUSAN K MCGIVER 1.0 X 0 RENEE SCIALDO SHEVAT PHD 1.0 1.0 X 0 RANDY L CRAPSER 1.0 X 0 ANNE CALDWELL MYERS PHD 1.0 X X 0 NICHOLAS J NICOLETTA 2.0 51.5 X X 483575 26532 JEFFREY J WOEPPEL 2.0 48.0 X X 197600 22077 JOSEPH R SELLERS MD 1.0 40.0 X 206009 19187 EDWIN KINTZ 1.0 X 0 GEORGE KONTA CPA 1.0 X 0 ROBERT A LANCEY MD MBA 1.0 40.0 X 524074 32658 ERIC H STEIN 40.0 X 164410 14089 BARBARA E DICOCCO 1.0 2.5 X 0 GLENN A PERRONE 1.0 3.5 X 0 LEANNA I JENSEN 38.0 X 125398 8083 JOAN MILLER 38.0 X 111542 6960 SUSAN OAKES-FERRUCCI 38.0 4.0 X 131736 12035 DAVID DE SANDO 38.0 X 142420 6967 GERALD D GROFF MD 42.0 X 376299 25275 511096 1951967 173863 4 true true false BENNETT CONTRACTING 693 PEARL STREET ALBANY NY 12202 CONSTRUCTION 210880 MEDICAL STAFFING NETWORK 901 Yamato Rd Suite 110 BOCO RATON FL 33431 STAFF NURSE SERVICES 127774 ATLAS HEALTHCARE LINEN 414 WEST TAYLOR STREET SYRACUSE NY 132023441 LAUNDRY SERVICE 115788 3 215381 189586 3955 408922 NET PATIENT SERVICE REVENUE 900099 26272938 26272938 26272938 30460 30460 0 0 0 0 0 26650 196929 -170279 -170279 -170279 0 0 0 OTHER OPERATING REVENUE 900099 214143 214143 COFFEE SHOP REVENUE 900099 68542 68542 LIFELINE REVENUE 900099 110472 110472 50717 50717 443874 26985915 26272938 304055 0 0 0 0 0 0 9770855 6851943 2918912 66152 50329 15823 1370652 930076 440576 717302 504281 213021 446685 23500 423185 51614 51614 100500 100500 7830 7830 0 0 2242320 2105812 136508 0 53337 53337 2413518 2135173 278345 903518 306277 597241 0 0 36287 7158 29129 0 7650 2432 5218 79541 79541 0 1330629 626823 703806 135270 135270 PURCHASED SERVICES 3221453 2649805 571648 BAD DEBTS 2183780 2183780 UTILITIES 504314 430573 73741 OTHER DIRECT EXPENSES 66322 738 65584 156436 14042 142394 25865965 18822742 7043223 0 6103758 9407974 122925 123670 68983 73155 3042254 2572908 0 0 0 0 0 0 158889 151843 146416 147352 18692606 10774848 8903136 7917758 0 0 0 0 0 0 0 0 221884 318345 18768245 20713005 1757128 1736366 0 0 0 0 1590000 1470000 0 0 0 0 162195 206131 1357569 2280714 311728 283956 5178620 5977167 X 13365019 14416279 45916 140869 178690 178690 13589625 14735838 18768245 20713005 X 1119950 26263 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 7830 7830 false false Schedule C, Part II-B, LIne 11 Iroquois Healthcare Alliance dues allocate 44.4% towards general lobbying activities. Total dues paid in 2012 = $8,053. Healthcare Association of New York State dues allocate 28.6% towards general lobbying activities. Total dues paid in 2012 = $14,875. 301615 745 302360 300787 828 301615 299789 998 300787 298476 1313 299789 293947 4529 298476 1.00000 false false 10214 10214 11148204 5593748 5554456 7534188 5181100 2353088 7917758 0 INTEREST RATE SWAP AGREEMENT 251198 ASSET RETIREMENT OBLIGATIONS 32758 283956 X 24802135 -2183780 -2183780 26985915 26985915 23655922 -26263 -26263 23682185 2183780 2183780 25865965 Part V, Line 4 ENDOWMENT FUNDS OF $178,690 HELD WITH INTEREST EARNED UNRESTRICTED FOR GENERAL HOSPITAL EXPENDITURES. ENDOWMENT FUNDS OF $37,500 WITH INTEREST EARNED TO BE USED FOR NURSING SCHOLARSHIPS. Part X, Line 2 The hospital is a not-for-profit corporation as described in section 501(c)(3) of the Internal Revenue Code and is exempt from Federal income taxes pursuant to section 501(a) of the IRC. The Hospital recognizes income tax positions when it is more-likely than-not that the position will be sustainable based on the merits of the position. Management has concluded that there are no material tax liabilities that need to be recorded. Part XI, Line 2d BAD DEBT $2,183,780 Part XII, line 2d INTEREST EXPENSE DUE TO POSITIVE ADJUSTMENT ON INTEREST RATE SWAP AGREEMENT OF ($27,772). CHANGE IN INTEREST IN NET ASSETS OF FRIENDS OF BASSETT, INC. OF $1,509. Part XII, Line 4b BAD DEBT $2,183,780 true true true X 300. false true true false true true 187905 74089 113816 0.00480 3259974 892513 2367461 0.09990 3447879 966602 2481277 0.10470 10542 10542 0.00040 1179 1179 0.00010 5138638 4614019 524619 0.02220 8884 8884 0.00030 5159243 4614019 545224 0.02300 8607122 5580621 3026501 0.12770 5949 5949 0.00020 5949 5949 0.00020 true 985938 51425 5429006 6193059 -764053 X true true 1 1 BASSETT HOSPITAL OF SCHOHARIE COUNTY

178 Grandview Drive Cobleskill NY 12043

X X X BASSETT HOSPITAL OF SCHOHARIE COUNTY 1 false true true 300. false false true true X X X X true X X X false X X X X true X false false Part I, Line 3C Bassett Hospital of Schoharie County (BHSC) is a not-for-profit healthcare organization that renders medical care to all persons in need of such care, regardless of their ability to pay. To support patients who may have difficulty paying their medical bills, the Community Service Program is available. Under the hospital policy governing the Community Services Program, Bassett Hospital of Schoharie County provides a level of uncompensated care each year to persons unable to pay the total cost of the hospital services rendered. CSP eligibility is limited to services for those persons who are determined ineligible for Medicaid within 60 days prior to the application and whose annual family gross income, as determined by an application for Medicaid within the six months prior to an application, does not exceed 300% of the Federal Poverty Income Guidelines (FPIG), which are updated annually. An application for the CSP Free Care requires verification of income for the six months immediately preceding the application and, if family income is below the Medicaid guidelines, a Medicaid application is also required. Part I, line 6a The Bassett Hospital of Schoharie County community benefits report is contained in a report prepared by Bassett Healthcare Network. Part I, Line 7 For sections (a) charity care at cost, (b) unreimbursed Medicaid, (f) health professions education, the costing methodology applied is a cost-to-charge ratio calculation, as used on filed state and federal cost reports. Indirect costs were applied to subsidized health services, sections (e) community health improvement; portions of (f) health professions education, and (i) cash and in-kind contributions to community groups, which 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 FICA rate. Part 1, Line 7, column (f) is calculated by dividing column (e), net community benefit expense, by total expense. The bad debt expense of $2,183,780 was subtracted from the total expense value used to calculate the percentages in Part 1, Line 7, Column f. Part II The hospital's community building activities focused on representation to community coalitions related to identified community health priorities; on costs of coalition meetings; and on participation with a small business/economic development organization called Cobleskill Partnership Inc. (CPI), which addresses the hospital neighborhood in downtown Cobleskill. The hospital participated in a community partnership between Schoharie County Health Department, Cornell University Cooperative Extension, Schoharie County Community Action Program and BHSC was expanded and formalized to form the Healthier Lifestyles Coalition of Schoharie County. This group met regularly to establish and offer community improvement activities focused on improving nutrition and increasing physical activity. The hospital has also played a leadership role, together with the county health department, in the formation and implementation of a new collaborative coalition, called Healthy Families Schoharie, which involves community health efforts aimed at women, babies, and children. Among the services provided are education, links to community health resources, car seat safety checks, and an extended home visiting program to follow children from birth through age 5. The hospital also plays a leadership role in the Creating Healthy Places Partnership, which is an advisory board comprised of agencies throughout Schoharie County that direct the planning and implementation of a 5-year, $875,000 New York State Department of Health Creating Healthy Places Grant. The hospital receives no portion of these grant funds but provides representation on the advisory board. The mission of the grant is to make Schoharie County a healthier place to live, work, and play by implementing policy, systems, and environmental change that will promote increased access to fresh fruits and vegetables and support a more active lifestyle for all community members, which is in alignment with prevention and health priorities identified in the hospital's community health assessment. Also in line with the identified priorities in the assessment is hospital representation on the NY Connects coalition committee, which works to improve access to health services and resources for the elderly in our rural communities with a goal to promote independent living, access to quality healthcare, and the appropriate utilization of institution-based services. Part III, Line 4 Bassett Hospital of Schoharie County uses the ratio of cost-to-charges methodology from Worksheet 2, Ratio of Patient Care Cost-to-Charges. The description of how the organization accounts for discounts and for payments on patient accounts in determining bad debt expense is contained in the text of the following audited financial statement footnote; also included in this footnote is the description of the method the organization uses to determine the amount that reasonably could be attributable to patients who likely would qualify for financial assistance under the hospital's charity care policy, if sufficient information had been available to make a determination of their eligibility. Footnote text: The Hospital has adopted a formal charity care policy whereby patients in need of medical services, who meet certain criteria under the policy, are treated without regard to their ability to pay for such services. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. The Hospital maintains records to identify and monitor the level of charity care it provides. The level of charity care, measured on the basis of established costs, is approximately $101,000 and $113,000 for 2012 and 2011, respectively. The cost of charity care provided was determined based on the application of a ratio of overall Hospital costs to patient charges. Included in net patient service revenue for 2012 and 2011 is approximately $755,000 and $591,000, respectively, from uncompensated care pools and income from restricted endowments to offset a portion of the cost of charity care. The Hospital grants credit without collateral to patients, most of whom 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 bad debts. Accounts written off as uncollectible are deducted from the allowance and subsequent recoveries are added. The amount of the provision for bad debts is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in federal and state governmental health care coverage and other collection indicators. Accounts receivable are presented net of allowances for estimated uncollectible accounts of approximately $1,710,000. Part III, Line 8 Bassett Hospital of Schoharie County used Medicare-approved costs from the 2012 Medicare Cost Report, which employ a cost-to-charge ratio methodology. The hospital believes it is part of its charitable purpose to provide medical services to the elderly population even if the costs of the services are not fully covered by Medicare. Therefore, the hospital believes the shortfall on Part III, Line 7 should be considered as part of its community benefit. Part III, Line 9b For patients, or guarantors, who do not qualify for complete charity care assistance, the hospital must undertake to ensure understanding of obligations and satisfaction of obligations. The hospital employs a third-party self-pay billing agency, in compliance with existing laws and regulations, to recover self-pay accounts receivable, preserve the patient-provider relationship to the maximum extent possible, and keep the necessity of referring accounts to third party bad debt collection or law firms to a minimum. This agency is Medical Self-Pay Accounts Receivable Services, LLC (MedSPAR). As a structure of the hospital's Unified Charity Care, Self-Pay Billing & Collection Policy, Bassett Hospital of Schoharie County must ensure that bad debt collection policies of any third-party agency retained for outside debt collection reflect the mission and values of the hospital, as well as refrain from any conduct that violates the Fair Debt Collection Practices Act, the Fair Credit Reporting Act, as well as any applicable state law or regulations. Under the MedSPAR Credit and Collection Policy (Doc. No. 1), responsible parties pleading indigence or inability to establish an installment plan must complete an application for the hospital's charity care or Community Services Program. The patient will be forwarded the application and informed that their accounts will be temporarily suspended from further billing for 30 days. The responsible party may make interest-free monthly installment payments not to exceed 10 percent of gross monthly income (which must be verified by a copy of a current paystub or equivalent proof of income), according to a set schedule based on account balance and maximum number of months in which installments must be made. Part V, Section B, Line 20d Bassett Hospital of Schoharie County 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. Part VI, Question 2 Needs Assessment: A variety of data are used regularly to assess the healthcare needs of the community served by Bassett Hospital of Schoharie County, including data from Patient Satisfaction Surveys, the NYS Department of Health, the Schoharie County Behavioral Risk Factor Surveillance Survey, the Schoharie County Community Health Assessment, and the NYS Prevention Agenda, which identified priority health indicators to be used by NYS hospitals, providers, and county health departments in assessing and setting local/regional priorities. The Prevention Agenda also identifies a common set of healthcare priorities from which hospitals and county health departments in New York State are expected to choose when developing implementation strategies for addressing community healthcare needs. Community partners involved in assessing community health needs in Schoharie County included: Schoharie County Health Department; Bassett primary care group; community-based organizations; and county social service, mental health, youth and aging agencies. Bassett Hospital of Schoharie County contracts with Health Stream Research to obtain benchmarking data on patient satisfaction in order to assess how the hospital is perceived to be meeting patient needs. Data from written surveys carried out among a statistically significant random sample of inpatients and outpatients is used to improve patient care and inform official quality improvement activities. Data collected from this instrument include a comprehensive overview of key, evidence-based quality indicators -- from timeliness of care to communications, patient safety, discharge instruction, medication issues, and more. The hospital receives quarterly reports. Health Stream Research is a national leader in providing customized patient satisfaction data to more than 1000 hospitals in the United States. (www.healthstreamresearch.com). The hospital also utilizes information from the standardized, publicly reported HCAHPS (Hospital Care Quality Information from the Consumer Perspective) survey of patients' perspectives of hospital care. The HCAHPS reporting and survey are required by the Center for Medicare Services (CMS) to allow standard, objective, valid comparisons to be made across hospitals nationally, regionally, and locally. Reports are received quarterly and since 2008 have been published nationally on the CMS and NYS Department of Health websites. The survey methodology and results are in the public domain. (www.hcahpsonline.org). Additionally, the hospital's needs assessment activities are informed by initiatives and studies carried out by the Bassett Healthcare Network Research Institute, including the Upstate Health and Wellness Study 2009. This project assessed health indicators, identified rural-urban health disparities, and provided baseline data to assist community healthcare planning in the rural region served by Bassett, including Schoharie County. It is a collaborative effort between the Research Institute, county health departments, and regional community services organizations. Part VI, Question 3 Patient Education of Eligibility for Assistance: Bassett Hospital of Schoharie County (BHSC) is a not-for-profit healthcare organization that renders medical care to all persons in need of such care, regardless of their ability to pay. As required by NYS Department of Health, the hospital prominently posts notices throughout the facility stating clearly that emergency care is to be provided regardless of ability to pay. The list of patient rights is also posted throughout the hospital. Information about federal and state government health coverage plans and how to access them is also posted and is readily available at key points of patient contact, including, but not limited to, registration stations. Bassett Hospital of Schoharie County offers a Community Service Plan to patients who need financial assistance. A major component of the 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 BHSC employees. The policy is updated annually, distributed to key personnel, and is posted in the online policy and procedure manual that is accessible to all employees. As part of the intake process, patients receive a CRH-specific financial aid brochure describing financial assistance options. The brochure describes federal and state government programs, as well as the hospital's Community Service Plan, and is written in plain language that addresses low literacy levels in the county (1 in 5 county residents read at the 3rd grade level or lower according to Literacy Volunteers of Schoharie County). It is also available at key points of service, including nurse's stations, waiting rooms, the ER, and other high-traffic public areas. In addition to postings containing contact information and the distribution of the BHSC-specific financial aid brochure, patient education is supported by a four-page, plain-language brochure that is included with the Community Service Plan application itself. Community Service Plan Brochure/Applications are readily available at all facilities in the Bassett Healthcare Network and all clinics. Clinical and support staff are made aware of the program and are able to direct patients to specialists who can assist in the application process. All patients who are registered as "self pay" are provided a Community Services Plan Brochure/Application in person. A listing of all self-pay accounts is produced and reviewed daily to insure that a Community Services Plan Brochure/Application has been provided. The self-pay billing office identifies patients who may require additional help understanding the program during the billing and collections process. Contact information for the Community Service Plan is included in patient bills. Self-pay accounts for patients who have been approved for Community Services within the prior 120 days are automatically included with prior approval. In Schoharie County, facilitated enrollment in government health insurance programs is handled by several community agencies/organizations (SCCAP, FidelisCare), as well as Bassett Medical Center. BHSC makes referrals to them by means of a form that can be signed by the patient and faxed. Additionally, a representative from FidelisCare was available one day per week on-site at the hospital throughout 2012. Patient registrars and customer service providers from the Business Office are trained to understand these programs and the process for helping patients access them. They provide one-on-one assistance with access, information, and appointment scheduling for facilitated enrollment. Additionally, the hospital's Business Services Manager provides one-on-one counseling to patients who need help paying their bills, including referral to facilitated enrollment for Medicaid and other government programs. Part VI, Question 4 Community Information: Bassett Hospital of Schoharie County's primary service area encompasses all of Schoharie County, with a population of 32,099 (U.S. Census 2012 estimate), and a portion of neighboring Schenectady County, including the towns of Delanson and Duanesburg. Located in Cobleskill, NY, Bassett Hospital of Schoharie County is the only hospital in Schoharie County. Schoharie County is located at the far western edge of New York State's Capital District. A primarily rural area, Schoharie County covers a land area of approximately 622 square miles, with a population density of just 52.7 persons per square mile (U.S. Census 2010). Schoharie County has a strong agricultural heritage, and farming remains a dominant sector of its economy, with agricultural sales totaling $30 million per year (Schoharie County Chamber of Commerce). People age 65 and over make up 17.5 percent of the population, while the New York State average is 14.1 percent (U.S. Census 2012). Ninety-six percent of the population is white, with Hispanics making up 2.9 percent of the population and Blacks 1.3 percent (U.S. Census 2012). American Indian and Asian persons together represent 1.1 percent of the population, at 0.3 percent and 0.8 percent, respectively, and persons of two or more races make up 1.3 percent (U.S. Census 2012). Educational levels, unemployment, and poverty are identified barriers to the health of residents of Schoharie County (Schoharie County Health Assessment 2010-13, Schoharie County Dept. of Health). With an unemployment rate of 9 percent (April 2013, U.S. Bureau of Labor Statistics), the median household income in Schoharie County is $50,795 (US Census 2007-2011), which is nearly $6,156 less than the New York State median. The percentage of residents with incomes below the federal poverty guidelines is 10.7 percent (US Census State 2007-2011). Seventeen percent of Schoharie County residents lack health insurance (Schoharie County Community Health Assessment 2010 - 2013). Of the hospital's patients, 14% were Medicaid patients in 2012. Schoharie County is a federally designated Health Professional Shortage Area in the disciplines of Primary Care, Mental Health, and Dental (hrsa.gov). The percentage of the population with a high school degree is slightly higher than the New York State average: 87.2 percent for Schoharie County compared to 84.6 percent for the state. However, the percentage of the population with a college degree or higher is 12 percent lower than the New York State average: 20.5 percent for Schoharie County compared to 32.5 percent for the state (U.S. Census 2007-2011). One in five residents is able to read only at a level that makes it impossible to read and understand healthcare instructions and the information needed to find employment (Literacy Volunteers of Schoharie County). Part VI, Question 5 Promotion of Community Health: A majority of the Basset Hospital of Schoharie County Board of Trustees is comprised of community volunteers who reside in the hospital's primary service area and who are neither employees nor contractors of the organization, nor family members thereof. Currently there are a total of 16 members on the Basset Hospital of Schoharie County Board of Trustees, of whom 11 are community volunteer board members who live in the service area. Four board members are executive-level employees of the Bassett Healthcare Network (BHN). One board member, who is trust advisor of The Clark Estates, Inc., holds a place on the various boards of BHN entities. As a not-for-profit hospital, Bassett Hospital of Schoharie County reinvests surplus funds toward equipment/technology improvements in patient care and patient safety, as well as infrastructure upgrades mandated by Joint Commission and government/regulatory requirements and deemed necessary to keep the hospital accredited and able to continue serving the health needs. In 2012, these projects totaled approximately $226,000. For example, in 2012, work continued on a 10-year project (2004 - 2014) that will enhance building systems and meet standards set by the Joint Commission, which is the accreditation entity for hospitals nationwide. The project involved extension of sprinklers, heating and cooling improvements, and asbestos abatement, all targeted to enhance patient safety. Similarly, other investments were made to replace aging, increasingly unreliable equipment and to secure medical technology and equipment advances that will insure that the only hospital in the county continues to offer its patients safe, quality patient care that meets accepted standards of care. This included the 2012 implementation of the Electronic Medical Record. The new system means a BHSC patient's information will be readily and accurately available to the appropriate healthcare providers throughout the Bassett network. Moreover, electronic medical record systems nationally are expected to lead to significant improvements in patient safety and quality of care, along with improvements in efficiency and coordination of care among multiple providers. Other examples of equipment/technology improvements made to improve health care in 2012 include new ultrasound equipment with 3D and 4D imaging to help doctors to diagnose and treat a variety of conditions, with a pricetag of $150,000. This equipment will help enable the hospital to continue to deliver appropriate, high-quality, safe emergency, preventitive, inpatient, and outpatient healthcare to our patients and to our rural, aging community (portions of the county are a federally designated rural area). Additionally, renovations in the hospital inpatient area will ensure ADA compliance and further the goals of the hospital's NICHE designation, which was attained in 2011 (Nurses Improving Care for Health System Elders). Community health improvement and education are key strategies in the hospital's plan of response to the community's health priorities and needs. The hospital's initiatives are largely guided by the New York State Department of Health Public Health Prevention Agenda. They are chosen and coordinated in close collaboration with the Schoharie County Department of Health and Bassett Healthcare Network, in particular reflecting the county's health assessment and the Bassett Health and Wellness Survey. Strategies focus on access, education and awareness. Hospital programs and efforts that address Prevention Agenda-related community health improvement and education priorities include the following: Diabetes community education and evidence-based support program; Senior Lunch and Learn education series; Stroke Support Group; Space and in-kind contribution of professional services for cancer and Alzheimer's support groups; contributions to non-profit community organizations; in-kind services contributed by staff to not-for-profit organizations and community groups; staff time spent coordinating events not sponsored by the hospital, such as blood drives and Marathon for a Better Life for the benefit of cancer patients/survivors in the community; and employee time spent on community health-related boards and other community involvement; The hospital helps to protect the health access, safety, and independence of vulnerable populations living in poverty through financially supported provision of the Lifeline personal response system; Provision of a program specifically requested by the Middleburgh Central School District to acclimate kindergarten students to the emergency room, medical imaging, and other hospital services which they may encounter. The hospital also provides community benefits services not easily counted or portrayed quantitatively. In 2012, these included regular educational displays in public areas of the hospital on a variety of health/wellness; a community newsletter dedicated in large part to educational messages intended to improve health knowledge, attitudes, skills/behaviors related to prevention priorities; private, individual staff donations to specific patients in need; and hundreds of hours of staff volunteer time in a wide-range of activities that promote the health of the community. Part VI, Question 6 Affiliated Health Care System: Bassett Hospital of Schoharie County is part of Bassett Healthcare Network, which provides services in more than 20 communities spanning 5,600 square miles and seven counties. The network focuses its community services programs in the counties where the six affiliated hospitals and greatest patient populations are located. Otsego County - population 61,917; Delaware County - population 47,559; Herkimer County - population 64,160 (according to the 2011 U.S. Census estimates); and Schoharie County - population 32,578 (U.S. Census 2011 estimate), a. Bassett - 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, 2 ambulatory surgery centers, and a fully salaried medical staff in Cooperstown, Otsego County b. O'Connor Hospital - critical access hospital in Delhi, Delaware County c. Bassett Hospital of Schoharie County (dba Cobleskill Regional Hospital) - acute care facility in Cobleskill, Schoharie County d. Little Falls Hospital - critical access hospital in Little Falls, Herkimer County e. Tri-Town Regional Hospital - 24/7 emergency care facility in Sidney, Delaware County f. A.O. Fox Hospital -- acute care facility in Oneonta, Otsego County g. Valley Health Services - residential health care and rehabilitation facility h. At Home Care - certified home care agency i. First Community Care of Bassett - medical supply company All of the above (a-i) make up Bassett Healthcare Network and provide health services to this seven-county region in central New York. Part VI, Question 7 State Filing of Community Benefit Report: New York State X X false false false false false false false false false NICHOLAS J NICOLETTA 376575 107000 23096 3436 510107 JEFFREY J WOEPPEL 197600 17596 4481 219677 GERALD D GROFF MD 372650 3649 23096 2179 401574 JOSEPH R SELLERS MD 205500 509 18201 986 225196 ERIC H STEIN 164410 10266 3823 178499 ROBERT A LANCEY MD MBA 521554 2520 18096 14562 556732 Part I, Line 3 The Chief executive officer's salary is paid by a related organization under a management services agreement. The bassett hospital of schoharie county reviews the formal process that is used to determine the base compensation of the ceo. The ceo work plan and accomplishments for the year are reviewed. Salary changes are based on market, work plan and accomplishments. The ceo's salary is submitted as part of the management services agreement which is approved by the board. PART VI - SECTION B - NUMBER 11A The 990 is reviewed by the Executive Finance Committee, which has been assigned that responsibility by the Board of Trustees. All trustees are made aware that the 990 is available for review in the Administrative Office upon request. PART VI-SECTION B - NUMBER 12C MEMBERS OF THE BOARD OF TRUSTEES COMPLETE CONFLICT OF INTEREST QUESTIONNAIRE ANNUALLY. A SUMMARY OF RESULTS IS REPORTED EACH YEAR AT THE ANNUAL MEETING OF THE BOARD OF TRUSTEES. PART VI-SECTION B - NUMBER 15A ANNUAL REVIEW IS DONE BY THE ASSESSMENT OF PRESIDENT/CEO'S PERFORMANCE BY EACH MEMBER OF THE BOARD OF TRUSTEES,SENIOR MANAGEMENT,ADMINISTRATIVE AND CLINICAL LEADERSHIP, AND ACTIVE MEDICAL STAFF. THE ASSESSMENT TOOL ADDRESSES PERFORMANCE MEASURES THAT RELATE TO THE ORGANIZATION'S MISSION AND STRATEGY THAT IS IDENTIFIED IN THE INSTITUTION'S ANNUAL OPERATING PLAN AND BY SPECIFIC ITERATION BY THE BOARD OF TRUSTEES. INFORMATION RECEIVED IS SUMMARIZED AND PRESENTED TO THE EXECUTIVE AND FINANACE COMMITTEE FOR REVIEW AND CONCLUSION. PART VI-SECTION C - NUMBER 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC BY REQUEST OF THE ADMINISTRATIVE OFFICE. PART XI - NUMBER 5 CHANGES IN NET ASSETS OR FUND BALANCE $27,772 INTEREST RATE SWAP AGREEMENT (1,509) CHANGE IN INTEREST IN NET ASSETS OF FRIENDS OF BASSETT $26,263 TOTAL CHANGE IN NET ASSETS OR FUND BALANCE FORM 990, PART X - PREPAID EXPENSES AND DEFERRED CHARGES PREPAID EXPENSES 147,352 Thurston Corporation One Atwell Road Cooperstown NY 13326 133218680 supportingorg NY 501(c)(3) 11c NA false FRIENDS OF BASSETT ONE ATWELL ROAD COOPERSTOWN NY 13326 237041610 SOLICITS CONT NY 501(c)(3) 7 THURSTON false MARY IMOGENE BASSETT HOSPITAL ONE ATWELL ROAD COOPERSTOWN NY 13326 135596796 HEALTH CARE NY 501(c)(3) 3 THURSTON false AURELIA OSBORNE FOX MEMORIAL HOSPITAL SO ONE NORTON AVENUE ONEONTA NY 13820 150539039 HEALTH CARE NY 501(c)(3) 3 THURSTON false TEMPLETON FOUNDATION ONE ATWELL ROAD COOPERSTOWN NY 13326 133317084 REAL ESTATE NY 501(c)(3) 9 THURSTON false BASSETT REGIONAL CORPORATION ONE ATWELL ROAD COOPERSTOWN NY 13326 133522783 PLAN & POLICY NY 501(c)(3) 11B THURSTON false O'CONNOR HOSPITAL 460 ANDES ROAD DELHI NY 13753 161540394 HEALTH CARE NY 501(c)(3) 3 BRC false TRI TOWN REGIONAL HEALTHCARE 43 PEARL STREET SIDNEY NY 13838 260169584 HEALTH CARE NY 501(c)(3) 3 BRC false LITTLE FALLS HOSPITAL 140 BURWELL STREET LITTLE FALLS NY 13365 150533578 HEALTH CARE NY 501(c)(3) 3 BRC false VALLEY HEALTH SERVICES 690 WEST GERMAN STREET HERKIMER NY 13350 222511614 HEALTH CARE NY 501(c)(3) 3 BRC false false false true false false false false false true false false true false false true true false true BASSETT REGIONAL CORPORATION C 100000 CASH