2011-11-11T16:07:36-05:00 2010-12-31 KPMG LLP 515 Broadway 4th Floor Albany NY 122072974 990 2010-01-01 141772971 Bassett Hospital of Schoharie County BASS 5182543456 178 Grandview Drive Cobleskill NY 120435144 Eric Stein 2011-11-11 5184274600 2011-11-10 2010 2016-02-24 21:20:13Z Cobleskill Regional Hospital Eric h stein presidentceo 178 Grandview Drive Cobleskill NY 12043 26769856 false X cobleskillhospital.org X 1994 NY PROVISION OF HEALTH CARE SERVICES TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. 17 13 325 71 0 0 550983 497496 25956308 25923423 20235 62548 273286 270830 26800812 26754297 0 0 0 0 11626581 12142147 0 0 0 13935608 14087562 25562189 26229709 1238623 524588 18681734 18722421 5940463 5477680 12741271 13244741 PROVISION OF HEALTH CARE SERVICES TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING REGION. false false 18709300 25923423 PROVISION OF HOSPITAL CARE TO RESIDENTS OF SCHOHARIE COUNTY AND THE SURROUNDING AREA. IN 2010, THE NUMBER OF INPATIENTS CARED FOR WAS 752 AND THE NUMBER OF OUTPATIENTS CARED FOR WAS 70,885. 18709300 true true false true false false false false true true false false false true true true false false false false false false false false false true false false false true false false false false false false false false false false false false false true false false false false true 52 0 true 325 true false false false false false false false false false false X 17 13 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 FINANCECFO 5182543456 178 GRANDVIEW DRIVE COBLESKILL NY 120435144 NANCY S BELLINGER 1.0 X 0 0 0 STEVEN C COLE 1.0 X 0 0 0 MACDONALD J HOLMES DVM 1.0 X 0 0 0 STEVEN KROLL 1.0 X 0 0 0 HENRY LAMOT PE 1.0 X 0 0 0 PETER D LOPEZ 1.0 X 0 0 0 SUSAN K MCGIVER 1.0 X 0 0 0 JANE H PATRICK 1.0 X 0 0 0 RENEE SCIALDO SHEVAT PHD 1.0 X 0 0 0 TIMOTHY J SWEENY CPA 1.0 X 0 0 0 RANDY L CRAPSER 1.0 X 0 0 0 ANNE CALDWELL MYERS PHD 1.0 X 0 0 0 NICHOLAS J NICOLETTA 2.0 X X 0 371809 26961 JEFFREY J WOEPPEL 2.0 X X 0 188872 20998 GERALD D GROFF MD 1.0 X 0 387850 24349 JOSEPH R SELLERS MD 1.0 X 0 203328 18251 EDWIN KINTZ 1.0 X 0 0 0 GEORGE KONTA CPA 1.0 X 0 0 0 ERIC H STEIN 40.0 X 0 181855 13833 BARBARA E DICOCCO 1.0 X 0 0 0 GLENN A PERRONE 1.0 X 0 0 0 LEANNA I JENSEN 38.0 X 117725 0 6250 JOAN MILLER 38.0 X 105802 0 6234 SUSAN OAKES-FERRUCCI 38.0 X 125830 0 10200 DAVID DESANDO 38.0 X 146432 0 6133 GAYLE JONES 38.0 X 114965 0 3937 610754 1333714 137146 5 true true false BENNETT CONTRACTING 693 PEARL STREET ALBANY NY 12202 CONSTRUCTION 443598 KPMG LLP PO BOX 12001 DALLAS TX 753120541 AUDIT 100900 2 103120 394376 497496 NET PATIENT SERVICE REVENUE 900099 25923423 25923423 25923423 21607 21607 0 0 56500 15559 40941 40941 40941 0 0 0 CAFETERIA SALES 900099 57423 57423 COFFEE SHOP REVENUE 900099 75938 75938 LIFELINE REVENUE 900099 111021 111021 26448 26448 270830 26754297 25923423 0 333378 0 0 0 0 0 0 10015519 6785084 3230435 78625 51423 27202 1311170 889744 421426 736833 506453 230380 370694 0 370694 56684 0 56684 125700 0 125700 3404 0 3404 0 0 2402788 2280293 122495 55769 0 55769 2681524 2209539 471985 910514 273727 636787 0 0 23207 7103 16104 0 16532 7101 9431 102822 102822 0 1253191 521415 731776 142658 0 142658 PURCHASED SERVICES 3369645 2831819 537826 BAD DEBTS 1784685 1784685 0 UTILITIES 623314 535088 88226 OTHER DIRECT EXPENSES 68959 2316 66643 LICENSES 48427 18340 30087 47045 5170 41875 26229709 18709300 7520409 0 6015377 5675463 121099 122097 168115 69467 2390753 2441322 137730 125779 89910 139583 18018907 8079017 9549930 9939890 208820 208820 18681734 18722421 1891842 1979491 1805000 1705000 299161 231374 1944460 1561815 5940463 5477680 X 12530402 13034038 32179 32013 178690 178690 12741271 13244741 18681734 18722421 X 524588 -21118 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 3404 3404 false false Schedule C, Part II-B, LIne 1I Iroquois Healthcare Alliance dues allocate 46.48% towards general lobbying activities. Total dues paid in 2010 = $5,054. Healthcare Association of New York State dues allocate 30.20% towards general lobbying activities. Total dues paid in 2010 = $3,493. 299789 998 300787 298476 1313 299789 293947 4529 298476 1.00000 false false 325000 10214 335214 605000 10148550 4069357 6684193 6930143 4009660 2920483 9939890 0 DUE TO THIRD PARTIES 1150280 INTEREST RATE SWAP AGREEMENT 248777 ASSET RETIREMENT OBLIGATIONS 162758 1561815 26754297 26229709 524588 -21118 -21118 503470 26754297 26754297 26754297 26250827 21118 21118 26229709 26229709 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 code. In 2007 the Hospital adopted the provision of Financial Accounting Standards Board (FASB) Interpretation No. 48, Accounting for Uncertainty in Income Taxes, an Interpretation of FASB Statement No. 109 (FIN 48). There was no impact to the Hospital's financial statements for the years ended December 31, 2010, 2009, 2008, and 2007 as a result of applying FIN 48. PART XIII, LINE 2D ADDITION TO INTEREST EXPENSE DUE TO NEGATIVE ADJUSTMENT ON INTEREST RATE SWAP AGREEMENT OF $21,118. Part XI, line 8 ADDITION TO INTEREST EXPENSE DUE TO NEGATIVE ADJUSTMENT ON INTEREST RATE SWAP AGREEMENT OF $21,118. true true true X 300. false true true true false true true 218573 109437 109136 0.00440 3162524 3258139 -95615 0.00390 3381097 3367576 13521 0.00050 24542 0 24542 0.00100 1163 0 1163 0.00010 5243078 3999637 1243441 0.05090 5984 0 5984 0.00020 5274767 3999637 1275130 0.05220 8655864 7367213 1288651 0.05270 970 0 970 241 0 241 2352 0 2352 0.00010 3563 0 3563 0.00010 true 888757 47207 5300490 5636506 -336016 X true true 1 1 BASSETT HOSPITAL OF SCHOHARIE COUNTRY

178 GRANDVIEW DRIVE COBLESKILL NY 12043

X X X BASSETT HOSPITAL OF SCHOHARIE COUNTRY 1 true true 300. false false true true X X X X true X X X true X X X X X X X true X false true 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 $1,784,685 was subtracted from the total expense value used to calculate the percentages in Part 1, Line 7, Column f. Part II Community Building Activities promoted the health of the community by addressing root causes of health problems, through the offering of expertise and resources in the areas of community support, community health improvement advocacy, and workforce development. Line 3: Community Support: 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). The percentage of residents with incomes below the federal poverty guidelines is 11.9% (US Census State and County Quickfacts). In 2010, Schoharie County was consistently ranked in the 10 New York State counties with the highest unemployment (U.S. Bureau of Labor Statistics). Only 18.9 percent of residents have college education with a bachelor's degree or higher, compared with 31.8 percent for all of New York State (US Census State and County Quickfacts). One in five residents are able to read only at a level that makes it impossible for them to read and understand healthcare instructions and information and also to find employment (Literacy Volunteers of Schoharie County). As one means to address these barriers, the hospital's environmental services staff took part in a mentoring program for other than the health professions. One-on-one mentoring was provided during a 4-week Summer Youth Program sponsored by Workforce Solutions System, Fulton-Montgomery-Schoharie Counties - a program designed for economically disadvantaged youth. Line 7: Community Health Improvement Advocacy included advocacy on behalf of access to healthcare for victims of sexual violence, as follows: Rape Crisis Sexual Assault Support Services. The hospital's Social Work Liaison served as a counselor/advocate, representing this organization during meetings to plan and participate in advocacy activities. This activity also included training of advocates, who work with victims to assist them with access to services, support, and recovery. Line 8: Workforce Development: Several activities supported community-wide health-related workforce issues, including partnering with Albany County BOCES to provide coordination and a setting for a Certified Nurse Assistant Program, which addresses a specific local workforce shortage and drives entry into health careers; a one-on-one mentoring activity provided by the hospital's CEO to a SUNY Cobleskill student interested in healthcare administration; participation in SUNY Cobleskill's healthcare Career Day by a variety of hospital professionals who provided education and information to 50 students in areas ranging from the laboratory to physical therapy, from nursing to respiratory therapy. Additionally, the hospital coordinated and provided a shadowing experience to a SUNY Cobleskill international student interested in the healthcare professions, including shadowing experience in the Emergency Department, Operating Room, Physical Therapy, Laboratory, and Medical Imaging. 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 charges foregone for services and supplies furnished during 2010 were approximately $273,000. The Hospital grants credit without collateral to patients, most of whom are local residents and are insured under third-party agreements. 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. Services rendered to individuals when payment is expected and ultimately not received are written off to the allowance for estimated uncollectible accounts. Accounts receivable are presented net of allowances for estimated uncollectible accounts of approximately $1,300,000. Part III, Line 8 Bassett Hospital of Schoharie County used Medicare-approved costs from the 2010 Medicare Cost Report, which employ a cost-to-charge ratio methodology. The hospital did not designate the shortfall reported in Part III, Line 7 toward 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 stricture 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 19d 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 V, Section B, line 21 The hospital's Charge Description Master, which includes a separate gross charge for all services, is what is used to bill all patients when a service is rendered. 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 identifies 27 priority health indicators to be used by NYS hospitals, providers, and county health departments in assessing and setting local/regional priorities. Community partners involved in assessing community health needs in Schoharie County included: Schoharie County Health Department; Bassett primary care group; community based organizations; county social service, mental health, youth and aging agencies; EMS coordinator; SUNY Cobleskill; Cornell University Cooperative Extension. 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 ongoing phone 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 reports twice yearly. 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 BHSC-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. 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 Director of Revenue Cycle Management 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 primary service area encompasses all of Schoharie County, with a population of 32,749 (according to a U.S. Census 2010 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 52.6 persons per square mile (according to U.S. Census 2010 data). With an unemployment rate of 10.6 percent (March 2011, U.S. Bureau of Labor Statistics), the median household income in Schoharie County is $48,640 (US Census 2009), which is nearly $8,000 less the average in New York State. The percentage of residents with incomes below the federal poverty guidelines is 11.9% (US Census State and County Quickfacts). Seventeen percent of Schoharie County residents lack health insurance (Schoharie County Community Health Assessment 2010 - 2013). Of the hospital's patients, 9% were Medicaid patients in 2010. Schoharie County is a federally designated Health Professional Shortage Area in the disciplines of Primary Care, Mental Health, and Dental (hrsa.gov). People age 65 and over make up 15.5 percent of the population, while the New York State average is 13.4 percent (U.S. Census 2009). Nearly 96 percent of the population is white (95.9 percent), with Hispanics making up 2.8 percent of the population and Blacks 1.3 percent (U.S. Census 2010). American Indian and Asian persons together represent less than 1 percent of the population, at 0.2 percent and 0.7 percent, respectively (U.S. Census 2010). The percentage of the population with a high school degree is slightly higher than the New York State average: 85.1 percent for Schoharie County compared to 84.2 percent for the state. The percentage of the population with a college degree or higher is 12.9 percent lower than the New York State average: 18.9 percent for Schoharie County compared to 36.8 percent for the state (U.S. Census Bureau Quickfacts 2011). 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). Part VI, Question 5 Promotion of Community Health: A majority of the Bassett 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 17 members on the Bassett Hospital of Schoharie County Board of Trustees, of whom 12 are community volunteer board members who live in the service area. Four board members are executive-level employees of the Bassett Medical Center. One board member, who is trust advisor of The Clark Estates, Inc., holds a place on the various boards of Bassett Healthcare Network (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 2010, these projects totaled approximately $1million. For example, in 2010, 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. Moreover, over the past 6 years, the hospital has invested more than $1 million dollars in much -needed upgrades to medical imaging technology alone - to replace aging equipment that has reached the limits of its useful life and to bring up-to-date, safe medical imaging to a rural community in which the hospital offers the only access to radiology services/imaging diagnostics and testing. In 2010, the hospital invested $377,619 to bring a new 64-slice low-dose CT scanner to Schoharie County. The only CT scanner in Schoharie County, the new low-dose 64-slice scanner will improve quality and provide a higher level of care for residents of this rural region by allowing for use of new protocols that have been developed since the existing equipment was acquired and by improving patient safety. It is specially equipped to reduce radiation exposure from 40 to 60 percent. The delivery of lower radiation dosage will be especially important for the safe diagnosis and treatment of pediatric patients and those who may need multiple scans, including cancer patients. In addition, its enhanced imaging capabilities, shorter exam time, and faster speed will greatly benefit elderly and other high-risk patients, potentially eliminating the need for more invasive diagnostic procedures. The new scanner is also vital to the quick, accurate, non-invasive diagnosis of preventable and chronic diseases in support of quality, community-based primary care services. The new scanner will enable the hospital to continue to deliver appropriate, high-quality, safe emergency, preventive, inpatient, and outpatient healthcare to our patients and to our rural, aging community (portions of the county are a federally designated rural area). 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. Examples include: equipment to perform cataract surgery, new beds that provide for enhanced patient safety, and OR equipment. The hospital also invested $247,000 in essential repairs and infrastructure replacements for its aging facility. In the area of community health improvement, many hospital initiatives are guided by the New York State Department of Health Public Health Agenda and top-three county priorities identified in the Schoharie County Department of Health County Health Assessment: tobacco, physical activity, nutrition and chronic disease. Overall county-wide goals adopted by the hospital's Community Service Plan and to be achieved through collaborative efforts with other organizations as part of the NYS Prevention Agenda are as follows: - Improve the percentage of adults in Schoharie County who increase their levels of regular physical activity, working toward a goal of three days per week; - Increase the percentage of adults who eat five servings of fruits and vegetables daily from the current level in Schoharie County of 25 percent toward the Healthy People 2010 objective of 75 percent - Reduce the percentage of Schoharie County adults who smoke, working toward the state's Prevention Agenda objective of 12 percent A major year-long community health initiative in was 2010 was the hospital's "Healthier You Day by Day," which was targeted at helping adults make small changes to achieve big results in the areas of nutrition and fitness, as well as with preventing chronic diseases including heart disease and obesity. Additionally, the hospital regularly offers a diabetes education, prevention, and support groups. The hospital also 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 Healthy Lifestyles Coalition of Schoharie County. This group met regularly to establish mission, objective, priorities, target population, and strategies, with a focus on influencing systems and populations to achieve change. Other programs that address non-Prevention Agenda-related priorities include: - Cancer Services Program of Delaware, Otsego and Schoharie County - Space and in-kind professional for Cancer, Stroke, and Alzheimer's support groups The hospital also provides community benefits services not easily counted or portrayed quantitatively. In 2010, these included 2 Teddy Bear Clinics for kindergarten students in two different county school districts; public Fire Prevention Week activities carried out by the Plant Operations Department to promote and educate about home safety; a 6-month physical therapy project that worked with outpatients past and present to enable them to make and complete a charitable walk; regular educational displays in public areas of the hospital on topics ranging from nutrition to domestic abuse to food safety to chronic disease prevention; private, individual staff donations to specific patients in need; multiple health fairs at the request of community presenters; 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 eight 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 61,962; Delaware County - population 46,085; Herkimer County - population 62,200 (according to the 2008 U.S. Census estimates); and Schoharie County - population 32,749 (according to U.S. Census 2010 estimate). a. Bassett Medical Center - an acute care inpatient teaching facility, an outpatient primary and specialty care center, a regional network of 26 community-based outpatient health centers, 18 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-1) make up Bassett Healthcare Network and provide health services to this eight-county region in central New York. Part VI, Question 7 State Filing of Community Benefit Report: New York State X X true false false false false false false false false NICHOLAS J NICOLETTA 0 341809 0 30000 0 0 0 22678 0 4283 0 398770 0 0 JEFFREY J WOEPPEL 0 188872 0 0 0 0 0 16811 0 4187 0 209870 0 0 GERALD D GROFF MD 0 356000 0 30000 0 1850 0 22678 0 1671 0 412199 0 0 JOSEPH R SELLERS MD 0 198000 0 5000 0 328 0 17416 0 835 0 221579 0 0 ERIC H STEIN 0 163000 0 16300 0 2555 0 10398 0 3435 0 195688 0 0 GAYLE JONES 114384 0 0 0 581 0 0 0 4344 0 119309 0 0 0 DAVID DESANDO 145244 0 0 0 1188 0 1184 0 4949 0 152565 0 0 0 Part I, Line 3 THE PRESIDENT/CEO'S COMPEnSATION IS REVIEWED BY THE ORGANIZATION'S BOARD OF TRUSTEES AND HIS COMPENSATION IS PAID BY A RELATED ENTITY - MARY IMOGENE BASSETT HOSPITAL. Part II, Line 4a Gayle Jones - $23,982 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. A COPY OF THE 990 IS AVAILABLE IN THE ADMINISTRATIVE OFFICE FOR REVIEW BY BOARD MEMBERS 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 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 NEGATIVE ADJUSTMENT INTEREST RATE SWAP AGREEMNET (21,118) Thurston Corporation One Atwell Road Cooperstown NY 13326 133218680 supportingorg NY 501(C)(3) 11c NA FRIENDS OF BASSETT ONE ATWELL ROAD COOPERSTOWN NY 13326 237041610 SOLICITS CONT NY 501(C)(3) 7 THURSTON MARY IMOGENE BASSETT HOSPITAL ONE ATWELL ROAD COOPERSTOWN NY 13326 135596796 HEALTH CARE NY 501(C)(3) 3 THURSTON AURELIA OSBORNE FOX MEMORIAL HOSPITAL SO ONE NORTON AVENUE ONEONTA NY 13326 150539039 HEALTH CARE NY 501(C)(3) 3 THURSTON TEMPLETON FOUNDATION ONE ATWELL ROAD COOPERSTOWN NY 13326 133317084 REAL ESTATE NY 501(C)(3) 9 THURSTON BASSETT REGIONAL CORPORATION ONE ATWELL ROAD COOPERSTOWN NY 13326 133522783 PLAN & POLICY NY 501(C)(3) 11B THURSTON O'CONNOR HOSPITAL 460 ANDES ROAD DELHI NY 13753 161540394 HEALTH CARE NY 501(C)(3) 3 BRC TRI TOWN REGIONAL HEALTHCARE 43 PEARL STREET SIDNEY NY 13838 260169584 HEALTH CARE NY 501(C)(3) 3 BRC LITTLE FALLS HOSPITAL 140 BURWELL STREET LITTLE FALLS NY 13365 150533578 HEALTH CARE NY 501(C)(3) 3 BRC VALLEY HEALTH SERVICES 690 WEST GERMAN STREET HERKIMER NY 13350 222511614 HEALTH CARE NY 501(C)(3) 3 BRC false false true false false false false false true true false true true false true true false true