LITTLE FALLS HOSPITAL: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- LITTLE FALLS HOSPITAL (EIN 15-0533578)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-14
- IRS object ID
- 201203199349305025
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-14T14:57:36-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161226221 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FUST CHARLES CHAMBERS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5784 WIDEWATERS PARKWAY | AddressLine1 |
| City | SYRACUSE | City |
| State | NY | State |
| ZIP Code | 13214 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 150533578 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LITTLE FALLS HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LITT | NameControl |
| Phone | 3158231000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 BURWELL STREET | AddressLine1 |
| City | LITTLE FALLS | City |
| State | NY | State |
| ZIP Code | 13365 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES VIELKIND | Name |
| Title | CFO | Title |
| Phone | 3158231000 | Phone |
| Date Signed | 2012-11-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOSEPH J SCHLEGEL | Name |
| PTIN | P00301329 | PTIN |
| Phone | 3154463600 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JAMES VIELKIND | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 BURWELL STREET | AddressLine1 |
| City | LITTLE FALLS | City |
| State | NY | State |
| ZIP Code | 13365 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 28768863 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | LFHNY.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1893 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | LITTLE FALLS HOSPITAL IS A CRITICAL ACCESS HOSPITAL PROVIDING ACCESS TO HEALTH CARE SERVCIES TO RESIDENTS OF HERKIMER COUNTY, AND WESTERN PORTIONS OF MONTGOMERY AND FULTON COUNTIES. LITTLE FALLS HOSPITAL EMERGENCY DEPARTMENT IS STAFFED WITH PHYSICIANS ON A 24/7 BASIS. TWENTY FIVE BEDS ARE USED FOR INPATIENT AND SKILLED NURSING CARE. AMBULATORY SURGERY SERVCIES ARE PROVIDED FOR A VARIETY OF SPECIALTIES, PERFORMANCE IMPROVEMENT AND HIGH QUALITY OF CARE IS DEMOSTRATED WITHIN THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) AS REPORTED IN HOSPITAL COMPARE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 337 | TotalNbrEmployees |
| Total Nbr Volunteers | 18 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 5752533 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 856607 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 25897565 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 26972536 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 87394 | InvestmentIncomePriorYear |
| Investment Income Current Year | 196800 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 31737492 | TotalRevenuePriorYear |
| Total Revenue Current Year | 28025943 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 12649682 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 13528783 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 9250 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 43646 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 13563673 | OtherExpensePriorYear |
| Other Expenses Current Year | 13425422 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 26213355 | TotalExpensesPriorYear |
| Total Expenses Current Year | 26963455 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 5524137 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1062488 | RevenuesLessExpensesCY |
| Total Assets BOY | 29965668 | TotalAssetsBOY |
| Total Assets EOY | 30895128 | TotalAssetsEOY |
| Total Liabilities BOY | 11102428 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 13134431 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 18863240 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 17760697 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | LITTLE FALLS HOSPITAL IS A VOLUNTARY, NOT-FOR-PROFIT COMMUNITY HEALTHCARE SYSTEM WHOSE MISSION IS TO OFFER QUALITY CARE WITH COMPASSION, TO ALL WHO NEED OUR SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 7822849 | Expense |
| Revenue | 7231919 | Revenue |
| Description | INPATIENT SERVICESLITTLE FALLS HOSPITAL SERVICES FOR SWING BED WERE BROADENED BY THE TRAINING OF NURSES TO HANDLE SWING BED PATIENTS WITH WOUND CARE AILMENTS. THE NEED FOR WOUND CARE HAS RISEN WITH PATIENTS WITH CHRONIC LONG TERM AILMENTS WITH LIMITED ABILITY TO AMBULATE. LITTLE FALLS HOSPITAL NURSING UNIT WAS AWARDED THE NICHE (NURSES IMPROVING CARE FOR HEALTHSYSTEM ELDERS) DESIGNATION FOR PROVIDING PATIENT CENTERED CARE FOR OUR ELDERLY PATIENTS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6717513 | Expense |
| Revenue | 6005183 | Revenue |
| Description | LITTLE FALLS HOSPITAL OPERATES AN EMERGENCY DEPARTMENT WITH TWENTY FOUR HOURS OF PHYSICIAN COVERAGE SEVEN DAYS PER WEEK. THE EMERGENCY DEPARTMENT PROVIDES ACCESS TO CARE FOR APPROXIMATELY 15,000 PATIENTS IN 2011. THE NUMBER OF PATIENTS REQUIRING INPATIENT HOSPITAL CARE AS RESULT OF THE VISIT TO THE EMERGENCY DEPARTMENT WAS APPROXIMATELY 1,800. THESE SERVCIES ARE PROVIDED TO ALL PATIENTS REGARDLESS OF ABILITY TO PAY. IN 2011 THE EMERGENCY ROOM TRIAGE SYSTEM WAS IMPROVED TO INCLUDE ENTRY OF INFORMATION INTO AN ELECTRONIC HEALTH RECORD. THIS IS THE FIRST PHASE OF A LARGER FULLY ELECTRONIC MEDICAL RECORD TO BE IMPLEMENTED ON A WIDER SCALE IN 2012 - 2013. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 7874974 | Expense |
| Revenue | 9258077 | Revenue |
| Description | TOTAL AMBULATORY OUTPATIENT VISITS WERE APPROXIMATELY 34,000 VISITS IN 2011. OUTPATIENT ANCILLARY DEPARTMENTS BEGAN TO RECEIVE ELECTRONIC ORDERS FOR OUTPATIENT SERVICES FROM BASSETT MEDICAL CENTER PHYSICIANS AS PART OF THE IMPLEMENTATION OF THE ELECTRONIC HEALTH RECORD. EXPANDED USE OF PROCESSING ORDERS ELECTRONICALLY WILL BE IMPLEMENTED IN 2012 - 2013. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 639102 | Expense |
| Revenue | 801851 | Revenue |
| Description | BASSETT MEDICAL CENTER HAD ITS FIRST FULL YEAR OF PROVIDING DIALYSIS TREATMENTS TO RESIDENTS OF HERKIMER COUNTY AT A FACILITY LOCATED ON THE CAMPUS OF LITTLE FALLS HOSPITAL. PLANNING IN 2011 WILL RESULT IN A NEW PRIMARY CARE FACILITY TO BE LOCATED ON THE CAMPUS OF LITTLE FALLS HOSPITAL AND OPERATED BY BASSETT MEDICAL CENTER. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 639102 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 801851 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 23054438 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 1 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 41 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 337 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JAMES G VIELKIND | NamePerson |
| Telephone Number | 3158235281 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 BURWELL STREET | AddressLine1 |
| City | LITTLE FALLS | City |
| State | NY | State |
| ZIP Code | 13365 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JOHN BULLIS | |||||||
| CHAIRMAN | 2.00 | X | 0 | 0 | 0 | ||
| JOAN S CONBOY | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| TIMOTHY DALY | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| ANTHONY DELUCA | |||||||
| FIRST VICE CHAIRMAN | 2.00 | X | 0 | 0 | 0 | X | |
| STAN DICKSON | |||||||
| SECOND VICE CHAIRMAN | 2.00 | X | 0 | 0 | 0 | X | |
| JOY MALONE | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| MARSHA MASON | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| GERALD J SNYDER | |||||||
| SECRETARY | 2.00 | X | 0 | 0 | 0 | X | |
| JENNIFER VANWAGONER | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| RANBIR SODHI MD | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| AUGUST LEINHART MD | |||||||
| TRUSTEE | 2.00 | X | 0 | 408359 | 12909 | ||
| NICHOLAS J NICOLETTA | |||||||
| TREASURER | 2.00 | X | 0 | 368286 | 15739 | X | |
| JEFFREY WOEPPEL | |||||||
| THIRD VICE CHAIRMAN | 2.00 | X | 0 | 208073 | 13168 | X | |
| KEVIN CROSLEY | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| JUSTIN HUMMEL | |||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||
| DALE ADAMSON MD | |||||||
| PRESIDENT OF MEDICAL STAFF | 2.00 | X | 0 | 168671 | 7531 | ||
| MICHAEL OGDEN | |||||||
| PRESIDENT & CEO | 40.00 | 0 | 149581 | 462 | X | ||
| JAMES G VIELKIND | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | 128368 | 0 | 4045 | X | ||
| RICHARD NOCELLA | |||||||
| PRIMARY CARE PHYSICIAN | 40.00 | 160765 | 0 | 15453 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 289133 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1302970 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 69307 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| BIVENS & ASSOCIATES ARCHITECTS | |||||
| 528 PLUM STREET SUITE 200 | SYRACUSE | NY | 132041473 | ARCHITECT SERVICES | 901953 |
| MEDSPAR LLC | |||||
| PO BOX 830 | BINGHAMTON | NY | 139020830 | BILLING SERVICES | 149836 |
| FUST CHARLES CHAMBERS | |||||
| 5784 WIDEWATER PARKWAY | SYRACUSE | NY | 13214 | AUDITING SERVICES | 123288 |
| DM CONSULTING | |||||
| PO BOX 4715 | UTICA | NY | 13504 | INFORMATION TECHNOLOGY | 110610 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Related Organizations | 117708 | RelatedOrganizations |
| Government Grants | 303899 | GovernmentGrants |
| All Other Contributions | 435000 | AllOtherContributions |
| Total Contributions | 856607 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| OUTPATIENT SERVICES | 623000 | 17777160 | 17777160 |
| INPATIENT HOSPITAL | 621930 | 8583389 | 8583389 |
| PROGRAM SERVICE LEASE | 532000 | 432986 | 432986 |
| HOSPITAL CAFETERIA | 900099 | 139867 | 139867 |
| OTHER OPERATING REVENU | 900099 | 39134 | 39134 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 26972536 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 95733 | TotalRevenueColumn |
| Exclusion | $95,733 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 843987 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 742920 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 101067 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 101067 | TotalRevenueColumn |
| Exclusion | $101,067 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 28025943 | TotalRevenueColumn |
| Related Or Exempt Function Income | 26972536 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $196,800 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 308632 | Total |
| Program Services | 176218 | ProgramServices |
| Management And General | 132414 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10502652 | Total |
| Program Services | 9040139 | ProgramServices |
| Management And General | 1439245 | ManagementAndGeneral |
| Fundraising | 23268 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 580005 | Total |
| Program Services | 497170 | ProgramServices |
| Management And General | 81567 | ManagementAndGeneral |
| Fundraising | 1268 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1342489 | Total |
| Program Services | 1142344 | ProgramServices |
| Management And General | 197215 | ManagementAndGeneral |
| Fundraising | 2930 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 795005 | Total |
| Program Services | 677503 | ProgramServices |
| Management And General | 115783 | ManagementAndGeneral |
| Fundraising | 1719 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88910 | Total |
| Management And General | 88910 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17730 | Total |
| Program Services | 4096 | ProgramServices |
| Management And General | 13634 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87189 | Total |
| Management And General | 87189 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9250 | Total |
| Fundraising | 9250 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 441172 | Total |
| Program Services | 239790 | ProgramServices |
| Management And General | 201382 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29722 | Total |
| Program Services | 29722 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2428336 | Total |
| Program Services | 2350545 | ProgramServices |
| Management And General | 76516 | ManagementAndGeneral |
| Fundraising | 1275 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 727034 | Total |
| Program Services | 556408 | ProgramServices |
| Management And General | 170626 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 738434 | Total |
| Program Services | 625930 | ProgramServices |
| Management And General | 111901 | ManagementAndGeneral |
| Fundraising | 603 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21403 | Total |
| Program Services | 14537 | ProgramServices |
| Management And General | 6469 | ManagementAndGeneral |
| Fundraising | 397 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26144 | Total |
| Program Services | 19970 | ProgramServices |
| Management And General | 6174 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 152048 | Total |
| Program Services | 132447 | ProgramServices |
| Management And General | 19582 | ManagementAndGeneral |
| Fundraising | 19 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1474325 | Total |
| Program Services | 1284271 | ProgramServices |
| Management And General | 189872 | ManagementAndGeneral |
| Fundraising | 182 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 246312 | Total |
| Program Services | 231433 | ProgramServices |
| Management And General | 14879 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PURCHASED MEDICAL SERVI | 3505495 | 3505495 | |
| PROVISION FOR BAD DEBT | 2184712 | 2184712 | |
| ADMINISTRATIVE SERVICES | 677779 | 677779 | |
| NEW YORK STATE ASSESSME | 80962 | 80962 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 497715 | Total |
| Program Services | 260746 | ProgramServices |
| Management And General | 234234 | ManagementAndGeneral |
| Fundraising | 2735 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26963455 | Total |
| Program Services | 23054438 | ProgramServices |
| Management And General | 3865371 | ManagementAndGeneral |
| Fundraising | 43646 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 598947 | BOY |
| EOY | 348968 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1061327 | BOY |
| EOY | 1039532 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5258493 | BOY |
| EOY | 5437347 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2860833 | BOY |
| EOY | 3484074 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 369023 | BOY |
| EOY | 382900 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 166266 | BOY |
| EOY | 1215888 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 25874137 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 16911156 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8757597 | BOY |
| EOY | 8962981 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1539459 | BOY |
| EOY | 1915088 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5482641 | BOY |
| EOY | 5478882 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2472438 | BOY |
| EOY | 2455626 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1398644 | BOY |
| EOY | 173842 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29965668 | BOY |
| EOY | 30895128 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2968638 | BOY |
| EOY | 3217283 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20668 | BOY |
| EOY | 39912 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4117756 | BOY |
| EOY | 3937377 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3995366 | BOY |
| EOY | 5939859 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11102428 | BOY |
| EOY | 13134431 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6706244 | BOY |
| EOY | 5007384 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11408912 | BOY |
| EOY | 12028938 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 748084 | BOY |
| EOY | 724375 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18863240 | BOY |
| EOY | 17760697 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29965668 | BOY |
| EOY | 30895128 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1062488 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -2165031 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 12156996 | BeginningOfYearBalance |
| Contributions | 623347 | Contributions |
| Investment Earnings Or Losses | -27030 | InvestmentEarningsOrLosses |
| End Of Year Balance | 12753313 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 5547082 | BeginningOfYearBalance |
| Contributions | 5230555 | Contributions |
| Investment Earnings Or Losses | 1782439 | InvestmentEarningsOrLosses |
| Other Expenditures | 403080 | OtherExpenditures |
| End Of Year Balance | 12156996 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2664349 | BeginningOfYearBalance |
| Contributions | 174329 | Contributions |
| Investment Earnings Or Losses | 3874661 | InvestmentEarningsOrLosses |
| Other Expenditures | 1166257 | OtherExpenditures |
| End Of Year Balance | 5547082 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4951188 | BeginningOfYearBalance |
| Contributions | 327877 | Contributions |
| Investment Earnings Or Losses | -202282 | InvestmentEarningsOrLosses |
| Other Expenditures | 2412434 | OtherExpenditures |
| End Of Year Balance | 2664349 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.05680 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.94320 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 356392 | OtherCostOrOtherBasis |
| Book Value | 356392 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15882128 | OtherCostOrOtherBasis |
| Depreciation | 9643608 | Depreciation |
| Book Value | 6238520 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9635617 | OtherCostOrOtherBasis |
| Depreciation | 7267548 | Depreciation |
| Book Value | 2368069 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 8962981 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| MARY LEARY CHARITABLE REMAINDER TR | 2007963 | F |
| ELSA O'BRIEN CHARITABLE REMAINER TR | 3470919 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 5478882 | TotalOfBookValueSecurities |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DIRECT FINANCE LEASE | Description |
| Book Value | 2455626 | BookValue |
| Method Of Valuation | C | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 2455626 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED PENSION LIABILITY | $5,014,244 |
| ACCRUED SALARIES, PAYROLL TAXES AND FRINGE BENEFITS | $809,115 |
| OTHER LIABILITIES | $116,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 5939859 | TotalOfAmounts |
| Total Revenue | 28025943 | TotalRevenue |
| Total Expenses | 26963455 | TotalExpenses |
| Excess Or Deficit For Year | 1062488 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -245363 | NetUnrealizedGLOnInvestments |
| Other | -$1,919,668 | OtherAmount |
| Total Adjustments | -2165031 | TotalAdjustments |
| Excess Or Deficit Per FS | -1102543 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 25860912 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -245363 | NetUnrealizedGainsInvestments |
| Other Revenues | -1919668 | OtherRevenues |
| Revenue Not Rptd F990 | -2165031 | RevenueNotRptdF990 |
| Revenue Subtotal | 28025943 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 28025943 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 26963455 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 26963455 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 26963455 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | ENDOWMENT FUNDS DISTRIBUTE INCOME FOR PURPOSES OF CAPITAL INVESTMENT. TEMPORARY ENDOWMENTS ARE USED BASED ON THE INTENT OF THE DONATION. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE HOSPITAL QUALIFIES AS AN ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE STANDARDS FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ESTABLISH A RECOGNITION THRESHOLD AND MEASUREMENT FOR INCOME TAX POSITIONS RECOGNIZED IN A HOSPITAL'S FINANCIAL STATEMENTS. THESE STANDARDS HAD NO IMPACT ON THE ACCOMPANYING FINANCIAL STATEMENTS. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND NEW YORK STATE TAXING AUTHORITIES ARE 2007 THROUGH 2011. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | PENSION RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST -1,915,909. CHANGES IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST -3,759. TOTAL TO SCHEDULE D, PART XI, LINE 8: -1,919,668. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | PENSION RELATED CHANGES OTHER THAN NET PERIODIC BEBEFIT COST -1,915,909. CHANGES IN VALUE OF BENEFICIAL REMAINDER TRUST -3,759. | |
| BUILDINGS INCLUDES CONSTRUCTION IN PROGRESS OF $1,115,093 AS OF 12/31/2011 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Email Solicitations | X | EmailSolicitations |
| Solicitation Of Non Govt Grants | X | SolicitationOfNonGovtGrants |
| Solicitation Of Govt Grants | X | SolicitationOfGovtGrants |
| Special Fundraising Events | X | SpecialFundraisingEvents |
| Agreement Ref Fundraising | 1 | AgreementRefFundraising |
Fundraiser Activity Information FundraiserActivityInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Individual | JAMES BOYLE | NameOfIndividual |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 27 140 MOODY HEIGHTS | AddressLine1 |
| City | MOODY | City |
| State | ME | State |
| ZIP Code | 040540027 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | FEASABILITY STUDY | Activity |
| Fundraiser Control Of Funds | 0 | FundraiserControlOfFunds |
| Gross Receipts | 0 | GrossReceipts |
| Amount Retained By Contractor | 9250 | AmountRetainedByContractor |
| Net To Organization | -9250 | NetToOrganization |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Retained By Contractors | 9250 | TotalRetainedByContractors |
| Total Net To Organization | -9250 | TotalNetToOrganization |
| Licensed States | NY | LicensedStates |
Form990 Schedule G Part IV Form990ScheduleGPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF FUNDRAISING PAYMENTS | Identifier |
| Return Reference | SCHEDULE G, PART I, LINE 2B, COLUMN (V) | ReturnReference |
| Explanation | IN 2011 JAMES BOYLE WAS RETAINED TO COMPLETE A FEASABILITY STUDY AS PART OF AN EFFORT TO IDENTIFY POTENTIAL FUND RAISING AMOUNTS FOR A SPECIAL CAPITAL CAMPAIGN. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 300.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 165 | PersonsServed |
| Total Community Benefit Expense | 116746 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 77281 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 39465 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2084 | PersonsServed |
| Total Community Benefit Expense | 1271058 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1157760 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 113298 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00420 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 9945 | PersonsServed |
| Total Community Benefit Expense | 3601404 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2157228 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1444176 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05360 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 12194 | PersonsServed |
| Total Community Benefit Expense | 4989208 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3392269 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1596939 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05930 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 67751 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3416 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 64335 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00240 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 67751 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3416 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 64335 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00240 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 12194 | PersonsServed |
| Total Community Benefit Expense | 5056959 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3395685 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1661274 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06170 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $874,397 | BadDebtExpenseAmount |
| Amount Attributable To | 76613 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 8581184 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 8496212 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 84972 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LITTLE FALLS HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 BURWELL STREET | AddressLine1 |
| City | LITTLE FALLS | City |
| State | NY | State |
| ZIP Code | 13365 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
| Other | INCLUDES 25 INPATIENT BEDS, | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LITTLE FALLS HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 300.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| Explains Basis | 1 | ExplainsBasis |
| Other Factors | X | OtherFactors |
| Explains Application Method | 0 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 1 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: LITTLE FALLS HOSPITAL DID NOT PROVIDE CHARITY CARE OR DISCOUNTED CARE TO PATIENTS WITH INSURANCE BENEFITS. | ||
| PART I, LINE 7: COST FOR CHARITY CARE PATIENTS WAS CALCULATED USING RATIO OF COST TO CHARGES. COST ASSOCIATED WITH MEDICAID AND MEDICAID HMO PROGRAMS REPRESENTS AGGREGATE ALLOWABLE COST AND TOTAL GROSS CHARGES USED TO CALCULATE A FACILITY LEVEL OF COST TO CHARGE RATIO. THIS FACILITY LEVEL COST TO CHARGE RATIO WAS APPLIED TO TOTAL MEDICAID AND MEDICAID HMO CHARGES TO ARRIVE AT TOTAL MEDICAID COST. COST OF OTHER MEANS TESTED PROGRAMS IS COMPRISED OF MEDICAID HMO AND NYS FAMILY HEALTH PLUS INSURANCE PROGRAMS. | ||
| PART I, LINE 7G: LITTLE FALLS HOSPITAL DOES NOT PROVIDE DISCOUNTED CARE FOR PATIENTS WITH INSURANCE. HARDSHIP CASES ARE REVIEWED ON AN INDIVIDUAL BASIS. | ||
| PART I, L7 COL(F): LITTLE FALLS HOSPITAL REMOVED $2,184,712 OF BAD DEBT EXPENSE TO CALCULATE COST OF PATIENT CARE. | ||
| PART III, LINE 4: NOTE (1) (K) NET PATIENT SERVICE REVENUE AND RELATED RECEIVABLESTHE HOSPITAL IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL BY MEDICARE AND MEDICAID. THESE THIRD-PARTY PAYORS REIMBURSE THE HOSPITAL ON A COST BASIS. THE HOSPITAL ALSO HAS AGREEMENTS WITH OTHER THIRD-PARTY PAYORS. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, COST-BASED REIMBURSEMENT, DISCOUNTED CHARGES AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE AND THE RELATED PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS AND INVESTIGATIONS.AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS ESTIMATED BY MANAGEMENT BASED ON PERIODIC REVIEWS OF THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE CONSIDERING HISTORICAL EXPERIENCE AND PREVAILING ECONOMIC CONDITIONS.REVENUE FROM THE MEDICARE AND MEDICAID PROGRAMS, INCLUDING THE HMO PROGRAMS OFFERED BY THESE PAYORS, ACCOUNTED FOR APPROXIMATELY 59% AND 69% OF THE HOSPITALS NET PATIENT SERVICE REVENUE FOR THE YEARS 2011 AND 2010, RESPECTIVELY. LAWS AND REGULATIONS GOVERNING THE MEDICARE AND MEDICAID PROGRAMS ARE EXTREMELY COMPLEX AND SUBJECT TO INTERPRETATION.AS A RESULT, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR TERM. IN 2011 AND 2010, NET PATIENT SERVICE REVENUE INCREASED (DECREASED) BY APPROXIMATELY $(150,000) AND $137,000, RESPECTIVELY, RELATED TO EITHER SETTLEMENT OF PRIOR YEAR ISSUES OR CHANGES IN ESTIMATES ASSOCIATED WITH THIRD-PARTY ISSUES.THE HOSPITAL GRANTS UNSECURED CREDIT TO ITS PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS. THE MIX OF RECEIVABLES FROM PATIENTS AND THIRD-PARTY PAYORS AT DECEMBER 31 WAS AS FOLLOWS: 2011 2010 MEDICARE 43% 39%MEDICAID 13% 16%PRIVATE PAYORS 11% 16%INSURANCE AND ALL OTHERS 33% 29% 100% 100%AS A RESULT OF THE IMPLEMENTATION OF NEWLY ISSUED ELECTRONIC BILLING SPECIFICATIONS, CERTAIN OF THE HOSPITALS GOVERNMENT-RELATED AND INSURANCE PAYORS WERE UNABLE TO PROPERLY ADJUDICATE HOSPITAL CLAIMS FOR SERVICES RENDERED UNTIL EARLY JANUARY 2012. THIS TECHNICAL OCCURRENCE CREATED GROWTH OF APPROXIMATELY $425,000 IN PATIENT ACCOUNTS RECEIVABLE AT DECEMBER 31, 2011 COMPARED WITH 2010 AS WELL AS AN INCREASE IN THE CONCENTRATION OF THE RELATED ACCOUNTS RECEIVABLE AT DECEMBER 31, 2011.COSTING RATIONALELITTLE FALLS HOSPITAL INCURRED BAD DEBT EXPENSE OF $2,184,712 IN 2011 CONSISTING OF SERVICES UNPAID BY UNINSURED AND UNDERINSURED PATIENTS, THE COSTING OF BAD DEBT REPRESENTS USING RCC PERCENTAGES BY PATIENT SERVICE TYPE AGAINST THE SAME SERVICE TYPES INCURRING BAD DEBTS. IN 2011 THE RCC PERCENTAGE USED WAS 40.02%. | ||
| PART III, LINE 8: LITTLE FALLS HOSPITAL COSTING METHODOLOGY CONSIST OF INFORMATION FROM MEDICARE COST REPORT. AS A CRITICAL ACCESS HOSPITAL PAYMENT IS BASED ON 101 % OF MEDICARE ALLOWABLE COST. | ||
| PART III, LINE 9B: COLLECTION AND CHARITY CARE POLICY SPECIFY ACCOUNTS WITH ACTIVE CARE APPLICATIONS WILL NOT GO TO COLLECTION AGENCIES WHILE IN REVIEW. | ||
| PART V, SECTION B, LINE 11H: LITTLE FALLS HOSPITAL CHARGES FOR SERVICES BASED ON RELATIONSHIPS OF COST OF SERVICES, AND AGGREGATE MARGINS REQUIRED FOR HEALTHCARE SERVICES. | LITTLE FALLS HOSPITAL | |
| PART V, SECTION B, LINE 13G: LITTLE FALLS HOSPITAL BILLING FORMS INCLUDE A STATEMENT TO INQUIRE ABOUT FINANCIAL ASSISTANCE WITH A PHONE NUMBER TO CALL. UNINSURED PATEINTS ARE MAILED AN APPLICATION FOR THEIR COMPLETION. | LITTLE FALLS HOSPITAL | |
| PART V, SECTION B, LINE 15E: THE HOSPITAL REFERRED COLLECTION MATTERS TO A THIRD PARTY AGENCY. | LITTLE FALLS HOSPITAL | |
| PART V, SECTION B, LINE 19D: LITTLE FALLS HOSPITAL CHARGES UNIFORM CHARGES TO ALL PAYERS REGARDLESS OF RESPONSIBLE PARTY FOR THE BILL. | LITTLE FALLS HOSPITAL | |
| PART V, SECTION B, LINE 21: LITTLE FALLS HOSPITAL CHARGES UNIFORM CHARGES TO ALL PAYERS REGARDLESS OF RESPONSIBLE PARTY FOR THE BILL. | LITTLE FALLS HOSPITAL | |
| PART VI, LINE 5: LITTLE FALLS HOSPITAL ACTIVELY PLANS AND IMPLEMENTS COORDINATED HEALTH CARE RESOURCES WITH BASSETT HEALTHCARE NETWORK. THIS SYNERGY ALLOWS FOR GREATER ACCESS, MINIMIZES DUPLICATION OF SERVICES, AND RESULTS WITH HIGH QUALITY CARE. LITTLE FALLS HOSPITAL SERVES ALL PATIENTS WITHOUT CONSIDERATION OF PAYMENT SOURCES. IN 2011 THE AGGREGATE OUTPATIENT GOVERMENT AND UNINSURED SPONSORED PAYMENT PERCENTAGE WAS 63.9%. THIS MEANS 63.9% OF PATIENTS ARE COVERED BY MEDICAID, MEDICARE, GOVERMENT SPONSORED HMO PROGRAMS OR ARE UNINSURED. TO MANAGE CARE MORE APPROPRATELY EMPHASIS HAS BEEN PREVALENT IN QUALITY OF CARE MEASUREMENTS. THIS HAS RESULTED IN IMPROVING FEWER PATIENTS REQUIRING RE-ADMISSION TO THE HOSPITAL AFTER 30 DAYS. IN ADDITION THE NUMBER OF PATIENTS CONNECTED WITH FOLLOW - UP COMMUNICATIONS HAS SHOWN IMPROVED SHORT AND LONG TERM HEALTH STATUS BENEFITS. CONTINUED EFFORTS TO EXPAND THE PRIMARY CARE PROVIDER BASE WILL FURTHER IMPROVE ACCESS TO PRIMARY CARE RESULTING IN A MORE PATIENT CENTERED DELIVERY OF CARE MODEL. IN 2012 THE IMPLEMENTATION OF THE "ELECTRONIC HEALTH RECORD" WILL RESULT IN A MORE SIGNIFICANT ADOPTION OF CARE DOCUMENTATION PROTOCOLS TO FURTHER IMPROVE THE HEALTH STATUS OF OUR PATIENTS. | ||
| PART VI, LINE 6: LITTLE FALLS HOSPITAL IS A MEMBER OF THURSTON CORPORATION (DBA BASSETT HEALTHCARE NETWORK)THAT PROVIDES HEALTH SERVICES IN MORE THAN 20 COMMUNITIES SPANNING 5,600 SQUARE MILES AND NINE COUNTIES. THE NETWORK FOCUSES ITS COMMUNITY SERVICES PROGRAMS IN THE COUNTIES WHERE THE SIX AFFILIATED HOSPTITALS AND GREATEST PATIENT POPULATIONS ARE LOCATED. OTSEGO COUNTY - POPULATION 61,917; DELAWARE COUNTY - POPULATION 47,559; HERKIMER COUNTY - POPULATION 64,160; SCHOHARIE COUNTY - POPULATION 32,578 (ACCORDING TO THE 2011 U.S. CENSUS ESTIMATES). THE MARY IMOGENE BASSETT HOSPITAL, AN ACUTE CARE INPATIENT TECHING FACILITY IN COOPERSTOWN, OTSEGO COUNTY, O'CONNOR HOSPITAL, A CRITICAL ACCESS HOSPITAL IN DELHI, DELAWARE COUNTY, COBLESKILL REGIONAL HOSPITAL, AN ACUTE CARE FACILITY IN COBLESKILL, SCHOHARIE COUNTY, LITTLE FALLS HOSPTAL, A CRITICAL ACCESS HOSPITAL IN LITTLE FALLS, HERKIMER COUNTY, TRI TOWN REGIOANL HOSPITAL A 24/7 EMERGENCY CARE FACILITY IN SIDNEY, DELAWARE COUNTY, AUREILA OSBORN FOX MEMORIAL HOSPITAL, AN ACUTE CARE FAILITY IN ONEONTA, OTSEGO COUNTY, THE BASSETT CLINIC, AN OUTPATIENT PRIMARY AND SPECIALTY CARE CENTER IN COOPERSTOWN, A REGIONAL NETWORK OF 26 COMMUNITY BASED HEALTH CENTERS, 18 SCHOOL BASED HEALTH CENTERS, TWO AMBULATORY SURGERY CENTERS, VALLEY HEALTH SERVICES A RESIDUAL HEALTH CARE AND REHABBILATION FACILITY, AT HOME CARE, A CERTIFIED HOME CARE AGENCY AND FIRST COMMUNITY CARE OF BASSETT A MEDICAL SUPPLY COMPANY, ALL OF WHICH MAKE UP THE BASSETT HEALTHCARE NETWORK AND PROVIDE HEALTH SERVICES TO THIS NINE COUNTY REGION IN CENTRAL NEW YORK. | ||
| NY | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AUGUST LEINHART MD | |||||||||||||
| 0 | 330000 | 0 | 3947 | 0 | 74412 | 0 | 11339 | 0 | 1570 | 0 | 421268 | 0 | 0 |
| NICHOLAS J NICOLETTA | |||||||||||||
| 0 | 368286 | 0 | 0 | 0 | 0 | 0 | 11339 | 0 | 4400 | 0 | 384025 | 0 | 0 |
| JEFFREY WOEPPEL | |||||||||||||
| 0 | 208000 | 0 | 73 | 0 | 0 | 0 | 8864 | 0 | 4304 | 0 | 221241 | 0 | 0 |
| DALE ADAMSON MD | |||||||||||||
| 0 | 167000 | 0 | 1671 | 0 | 0 | 0 | 4544 | 0 | 2987 | 0 | 176202 | 0 | 0 |
| MICHAEL OGDEN | |||||||||||||
| 0 | 148000 | 0 | 1581 | 0 | 0 | 0 | 0 | 0 | 462 | 0 | 150043 | 0 | 0 |
| RICHARD NOCELLA | |||||||||||||
| 160765 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 15453 | 0 | 176218 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | LITTLE FALLS EXECUTIVE & FINANCE COMMITTEE OF THE BOARD OF TRUSTEES REVIEWS FORM 990 AND INVITES ALL BOARD OF TRUSTEE MEMEBERS TO ATTEND. | |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST STATEMENTS ARE MADE ANNUALLY. NEW BOARD MEMEBERS ARE REQUIRED TO DISCLOSE ON THEIR RESUME ALL AFFILIATED ORGANIZATIONS. | |
| FORM 990, PART VI, SECTION B, LINE 15A | BOARD OF TRUSTEES COMPLETES A CEO EVALUATION ANNUALLY AND MAKES ADJUSTMENTS TO COMPENSATION ACCORDING TO PERFORMANCE AND INDUSTRY COMPENSATION LEVELS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | LITTLE FALLS HOSPITAL MAKES AVAILABLE THE IRS FROM 990 UPON REQUEST ALONG WITH INFORMATION INCLUDED WITHIN THE 990 SUCH AS FINANCIAL REPORTS, CONFLICT OF INTEREST POLICY,AND CODE OF CONDUCT. THE HOSPITAL ALSO PROVIDES THE ANNUAL OPERATING PLAN, CORPORATE VLAUES, IN PUBLIC AREAS OF THE FACILITY. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -245,363. PENSION RELATED CHANGES OTHER THAN NET PERIODIC BENEFIT COST -1,915,909. CHANGES IN VALUE OF BENEFICIAL INTEREST IN CHARITABLE REMAINDER TRUST -3,759. TOTAL TO FORM 990, PART XI, LINE 5: -2,165,031. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| PART XII, LINE 2C | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| THURSTON CORPORATION | |||||||||||
| ONE ROCKEFELLER PLAZA 31ST FLOOR | NEW YORK | NY | 10020 | 133218680 | SUPPORTING ORGANIZATION | NY | 501 (C) 3 | 11 C | N/A | 0 | |
| FRIENDS OF BASSETT | |||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 237041610 | FUND RAISING ORGANIZATION | NY | 501 (C) 3 | 7 | 0 | THURSTON CORPORATION | |
| MARY IMOGENE BASSETT HOSPITAL | |||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 135596796 | HEALTH CARE ORGANIZATION OFFERING INPATIENT AND OUTPATIENT SERVICES | NY | 501 (C) 3 | 3 | 0 | THURSTON CORPORATION | |
| AURELIA OSBORN FOX MEMORIAL HOSPITAL SOCIETY | |||||||||||
| ONE NORTON AVENUE | ONEONTA | NY | 13820 | 150539039 | HEALTH CARE ORGANIZATION OFFERING INPATIENT AND OUTPATIENT SERVICES | NY | 501 (C) 3 | 3 | 0 | THURSTON CORPORATION | |
| TEMPLETON FOUNDATION | |||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 133317084 | FACILITIES / OFFICE SPACE | NY | 501 (C) 3 | 9 | 0 | THURSTON CORPORATION | |
| BASSETT REGIONAL CORPORATION | |||||||||||
| ONE ATWELL ROAD | COOPERSTOWN | NY | 13326 | 133522783 | PROVIDES EXCELLENCE IN THE COORDINATION PLANNING AND POLICY DIRECTION FOR | NY | 501 (C) 3 | 11 (B) | 0 | THURSTON CORPORATION | |
| COBLESKILL REGIONAL HOSPITAL | |||||||||||
| 178 GRANDVIEW DRIVE | COBLESKILL | NY | 12043 | 141772971 | HEALTHCARE SERVICES OFFERING INPATEINT AND OUTPATIENT SERVICES | NY | 501 (C) 3 | 3 | 0 | BASSETT REGIONAL CORPORATION | |
| O'CONNOR HOSPITAL | |||||||||||
| 460 ANDES ROAD | DELHI | NY | 13753 | 161540394 | HEALTH CARE ORGANIZATION OFFERING INPATIENT AND OUTPATIENT SERVICES | NY | 501 (C) 3 | 3 | 0 | BASSETT REGIONAL CORPORATION | |
| TRI TOWN REGIONAL HEALTHCARE | |||||||||||
| 43 PEARL STREET | SYNDEY | NY | 13838 | 260169584 | HEALTHCARE SERVICES OFFERING OUTPATIENT SERVICES | NY | 501 (C) 3 | 3 | 0 | BASSETT REGIONAL CORPORATION | |
| VALLEY HEALTH SERVICES | |||||||||||
| 690 GERMAN STREET | HERKIMER | NY | 13350 | 222511614 | NURSING HOME | NY | 501 (C) 3 | 3 | 0 | BASSETT REGIONAL CORPORATION | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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