2011-11-08T12:23:21-05:00 2010-12-31 KPMG LLP 515 Broadway 4th Floor Albany NY 122072974 990 2010-01-01 135596796 The Mary Imogene Bassett Hospital MARY 6075473635 One Atwell Road Cooperstown NY 13326 Nicholas Nicoletta 2011-11-04 5184274600 2011-11-02 2010 2016-02-24 21:20:13Z Bassett Medical Center Address same as above 437358870 false X www.bassett.org X 1921 NY See Schedule O. 20 18 3761 163 -47404 -47654 14770702 6857245 359058510 393100520 -7133492 2543350 -667338 1590743 366028382 404091858 0 0 0 0 209457039 228854646 0 0 930401 154744050 174044275 364201089 402898921 1827293 1192937 309347815 323618053 86959195 95941047 222388620 227677006 MIBH IS A RURAL ACADEMIC MEDICAL CENTER COMMITTED TO PROVIDING EXCELLENCE IN HEALTH CARE SERVICES, EDUCATING PHYSICIANS AND OTHER HEALTH CARE PROFESSIONALS, AND PURSUING HEALTH RESEARCH. false false 326451771 393100520 INPATIENT AND OUTPATIENT SERVICES PROVIDED TO OUR PATIENTS RESULTED IN: 12,775 HOSPITALIZATIONS (INCLUSIVE OF OPEN HEART SURGERIES) 50,055 PATIENT DAYS 694,986 CLINIC VISITS 24,684 RENAL TREATMENTS 9,572 SURGICAL CASES 5416029 Community involvement has been linked to Bassett's mission, vision, and values since we first opened in 1922. Whether it is strengthening our community relationships for health and wellness, communicating ideas for improving our services to our region, or providing a forum for Bassett to learn and listen, we are working with our community to improve the quality of life for the people of our region. Our community services program provides free services to persons who cannot afford to pay, who do not qualify for Medicaid, and who fall within the established income guidelines. In 2010, we provided $5,416,029 in free care. Bassett's community health education programs include lectures, presentations, health fairs, and other group programs apart from the clinical and diagnostic services offered. Clinical services offered includes screenings, health tests and health risk appraisals including blood pressure, lipid profile, cholesterol screenings, cardiology risk factor screenings, and all cancer screenings. Our community building activities include philanthropic support for health initiatives and community health and welfare projects including promoting healthy lifestyles, disease prevention, and community awareness initiatives. Our doors are open 24 hours a day, 7 days a week, 365 days a year. We are proud to provide care to our communities. Not only did we provide $5.4M in charity care, bad debt expense was $15.3M, Medicaid payments below cost to provide services were $37.2M. 331867800 true true false true false false false false true true true false false false false true false false false false false false false false false true false false false true true false false false false false false false false true true false false false false false true false false false false true 258 0 true 3761 true true true false false false false false false false false false X 20 18 true false false false false false false true true false false false true true true true true true true true false NY X NICHOLAS J NICOLETTA 6075473635 ONE ATWELL ROAD COOPERSTOWN NY 13326 Thomas Q Morris MD 1.0 X X 0 0 0 Kevin S Moore 3.0 X X 0 0 0 William T Burdick 8.0 X X 0 0 0 Jane Forbes Clark 1.0 X 0 0 0 Edward W Stack 1.0 X 0 0 0 Vanness D Robinson 1.0 X 0 0 0 Barbara Dicocco 1.0 X 0 0 0 Ralph H Meyer 1.0 X 0 0 0 Donald O Pollock MD 1.0 X 0 0 0 Donald O Quest MD 1.0 X 0 0 0 Peter J Hamilton 1.0 X 0 0 0 Douglas B Willies 1.0 X 0 0 0 Terry Fulmer PHD RN 1.0 X 0 0 0 J Michael Moffat 1.0 X 0 0 0 Katherine D Nickerson 1.0 X 0 0 0 Timothy A Pedley 1.0 X 0 0 0 Clifton R WhartonJRPHD 1.0 X 0 0 0 John D Bullis 1.0 X 0 0 0 Michael Getman 1.0 X 0 0 0 Charles B Kieler 1.0 X 0 0 0 William F Streck MD 40.0 X 690293 0 25969 Bertine Mckenna PHD 40.0 X 376614 0 21353 Nicholas J Nicoletta 40.0 X 371809 0 26961 Richard C Vanison 4.0 X 0 0 0 Glenn A Perrone 2.0 X 0 0 0 Steven J Heneghan MD 40.0 X 583735 0 28728 Joseph Schmer MD 40.0 X 609607 0 20600 James C Peters MD 40.0 X 548377 0 34239 Jonathan Richman Md 40.0 X 567173 0 30845 Timothy J Campbell MD 40.0 X 584507 0 26862 4332115 0 215557 369 false true true MCCARTHY 1341 North Rock Hill Road ST LOUIS MO 63124 CONSTRUCTION 6741695 Mayo Medical Laboratories 200 First St SW ROCHESTER MN 55903 Lab Services 1225012 Angelica Textile Services 424 S Woods Mill Road CHESTERFIELD MO 63017 Linen Services 1306810 MedSpar PO BOX 830 BINGHAMTON NY 13902 Collection Service 859643 Medquist Transcriptions 1000 Bishops Gate Blvd MT LAUREL NJ 08054 Transcription Servic 4432624 14 2653929 3318184 885132 6857245 DIRECT PATIENT SERVICES 900099 369797493 369797493 OTHER PROGRAM SERVICE REVENUE 900099 23303027 23303027 393100520 845054 845054 0 0 34815015 150293 33058361 208651 1756654 -58358 1698296 1698296 0 0 0 PARTNERSHIP INCOME 621500 1678451 20094 1658357 INVESTMENT IN JOINT VENTURES 621610 -87708 -67498 -20210 1590743 404091858 393100520 -47404 4181497 0 0 0 0 1512999 1512999 0 197751349 153479518 43810349 461482 9186068 7127320 2039048 19700 9044798 6968776 2055068 20954 11359432 8747426 2579586 32420 0 0 0 48828 48828 0 0 33817803 28264749 5351687 201367 0 2107777 1595420 470484 41873 0 0 12439835 9590531 2828214 21090 0 0 0 1580294 1217575 359058 3661 0 18049343 13937707 4110181 1455 3554883 2738943 807705 8235 DRUGS AND REAGENTS 30560178 30560178 PATIENT CARE SUPPLIES 30406124 30406124 BAD DEBTS 15286626 15286626 CHARITY CARE 5416029 5416029 FOOD - RAW 1552764 1552764 19223791 14978114 4127513 118164 402898921 331867800 70100720 930401 12912273 14917654 11210335 10834542 41048639 44601331 3277542 3083021 2425765 3053540 338995302 197820346 132960903 141174956 75548036 68045275 23402118 30936393 6562204 6971341 309347815 323618053 35302923 38862456 34430000 33385000 17226272 23693591 86959195 95941047 X 163177543 169040821 42476616 44847111 16734461 13789074 222388620 227677006 309347815 323618053 X 1192937 4095449 X false true true X true true X false false false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 48828 48828 false Part II-B, Line 1i HANYS membership dues allocate 30.2% towards general lobbying activities. Total dues paid in 2010 = $81,299 Iroquois Healthcare Alliance membership dues allocate 46.48% towards general lobbying activities. Total dues paid in 2010 = $31,469 AHA membership dues allocate 24.42% towards general lobbying activities. Total dues paid in 2010 = $39,514 The Clark Estates conducts lobbying activities on behalf of The Mary Imogene Bassett Hospital. Lobbying activities are limited to officer discussions with consultants and legislators to obtain funding for charitable missions. No funds were expended. 16734461 54613 199921 3000000 199921 13789074 13825685 2908776 189138 189138 16734461 13511047 314638 445038 445038 13825685 1.00000 true false 233974 233974 174463 87274504 87189344 0 145094035 110545842 34548193 19203445 19203445 141174956 LIMITED PARTNERSHIPS 957833 C LIMITED PARTNERSHIPS 29978560 C 30936393 404091858 402898921 1192937 3625611 469838 4095449 5288386 408187307 3625611 469838 4095449 404091858 404091858 402898921 402898921 402898921 Part V, Line 4 Permanently restricted endowment funds are held in perpetuity with restrictions on income for health services, medical research, medical education, and indigent care. Part XI, Line 8 Includes post retirement benefit related changes other than net periodic benefit cost $519,682 and investment loss on joint venture $199,609, and project abandonment ($249,453) = total $469,838 Part XII, Line 2d Includes post retirement benefit related changes other than net periodic benefit cost $519,682 and investment loss on joint venture $199,609, and project abandonment ($249,453) = total $469,838 true true true X 300. true true true false true true 3394312 387894 3006418 0.00780 47488068 39848789 7639279 0.01970 0 0 0 50882380 40236683 10645697 0.02750 37408 0 37408 0.00010 16278188 3620311 12657877 0.03270 0 0 0 8971433 367117 8604316 0.02220 439393 0 439393 0.00110 25726422 3987428 21738994 0.05610 76608802 44224111 32384691 0.08360 true 6883308 911741 94304682 80551227 13753455 X true true At home care inc Home healthcare agency 0.50000 0.00000 0.00000 UNI Imaging holdings Diagnostic Imaging office 0.40000 0.00000 0.00000 LLC 1 1 Mary Imogene Bassett Hospital

one atwell road cooperstown NY 13326

X X X X X Outpatient primary & Specialty Clinics Mary Imogene Bassett Hospital 1 true X X X X X X X 10 true true true X X X X X X X X X false true true 300. false false true true X X X X true X true X X X X X X X X true X false true 43 Basset Healthcare Canajoharie

56 Montgomery Street Canajoharie NY 13317

Outpatient Primary Care Bassett healthcare cobleskill

121 legion drive cobleskill NY 12043

outpatient primary care Bassett healthcare delanson

one colley heights delanson NY 12053

outpatient primary care Bassett healthcare Delhi

flint office building delhi NY 13753

outpatient dental & primary care Bassett healthcare edmeston-burlington

1 route 80 edmeston NY 13335

outpatient primary care Bassett healthcare gloversville

99 east state street gloversville NY 12078

outpatient primary care Bassett healthcare hamilton

160 broad street hamilton NY 13346

outpatient dental & primary care Bassett healthcare hamilton OBGYN

10 eaton street suite 201 hamilton NY 13346

outpatient specialty care bassett healthcare hamilton spclty serv

10 eaton street suite 200 202 hamilton NY 13346

outpatient specialty care bassett healthcare herkimer

321 easT albany street herkimer NY 13350

outpatient primary, specialty & urgent care Bassett healthcare little falls

140 burwell street little falls NY 13365

outpatient primary care Bassett healthcare middleburg

109 baker ave middleburgh NY 12122

outpatient primary care Bassett healthcare morris

93 main street morris NY 13808

outpatient primary care Bassett healthcare norwich

55 calvary drive norwich NY 13815

outpatient primary care Bassett healthcare oneonta

125 main street oneonta NY 13820

outpatient primary care Bassett healthcare oneonta spclty serv

one associate drive oneonta NY 13820

outpatient primary, specialty & urgent care Bassett healthcare oneonta radiation trt

seven asSociate drive oneonta NY 13820

outpatient specialty care Bassett healthcare physcial therapy

21 railroad avenue cooperstown NY 13326

outpatient specialty care Bassett healthcare richfield springs

8550 state hwy rt 28 richfield springs NY 13439

outpatient primary care Bassett healthcare sidney

39 pearl street west sidney NY 13838

outpatient primary care Bassett healthcare schoharie

111 barton hill road schoharie NY 12157

outpatient primary care Bassett healthcare sharon springs

route 20 sharon springs NY 13459

outpatient primary care Bassett healthcare sherburne

20 chapel street sherburne NY 13460

outpatient primary care Bassett healthcare st johnsville

8 park place street st johnsville NY 13452

outpatient primary care Bassett healthcare stamford

28650 state hwy 23 stamford NY 12167

outpatient primary care Bassett healthcare unadilla

16 clifton street unadilla NY 13849

outpatient primary care Bassett healthcare walton

130 north street walton NY 13856

outpatient primary care Bassett healthcare west winfield

544 east main street west winfield NY 13491

outpatient primary care SBHC Laurens central school

main street laurens NY 13796

outpatient primary care SBHC morris central school

west maiN street morris NY 13808

outpatient primary care SBHC Edmeston Central School

11 north street edmeston NY 13335

outpatient primary care SBHC COOPERSTOWN CENTRAL SCHOOL

39 LINDEN AVENUE COOPERSTOWN NY 13326

outpatient primary care SBHC WORCESTER CENTRAL SCHOOL

195 MAIN STREET WORCESTER NY 12197

outpatient primary care SBHC MIDDLEBURGH CENTRAL SCHOOL

291 MAIN STREET MIDDLEBURGH NY 12122

outpatient primary care SBHC SOUTH KORTRIGHT CENTRAL SCHOOL SHAK

58200 STATE HWY 10 SOUTH KORTRIGHT NY 13842

outpatient primary care SBHC SHERBURNE EARLVILLE CENTRAL SCHOOL

15 SCHOOL STREET SHERBURNE NY 13460

outpatient primary care SBHC DELHI ELEMENTARY MIDDLE HIGH SCHOOL

2 SHELDON DRIVE DELHI NY 13753

outpatient primary care Hartwick seminary specialty services

4580 state highway 28 milford NY 13807

outpatient primary care SBHC Sidney

95 West Main Street Sidney NY 13838

Outpatient Primary Care SBHC Stamford

1 River Street Stamford NY 12167

Outpatient Primary Care SBHC Milford

42 West Main Street Milford NY 13807

Outpatient Primary Care SBHC Schenevus

159 Main Street Schenevus NY 12155

Outpatient Primary Care Oneonta Surgical Associates

449 Main Street Oneonta NY 13820

Outpatient Specialty Care Schedule H, Part I, line 6a The Mary Imogene Bassett Hospital, d/b/a Bassett Medical Center (Bassett), Comprehensive Three-Year Community Service Plan was summarized in an annual community report. Printed copies were available to the public in patient waiting rooms and at information kiosks. The report is also posted on the Bassett website, www.bassett.org. Schedule H, Part I, line 7 Sections (a) charity care at cost, (b) unreimbursed Medicaid, (f) health professions education, the costing methodology used is a cost-to-charge ratio calculation utilized on filed state and federal cost reports as the source. Indirect costs were applied to subsidized health services, sections (e) community health improvement; portions of (f) health professions education, (h) research, and (i) cash and in-kind contributions to community groups are comprised of the direct salary costs for Hospital staff whose time was compensated by the Hospital for time spent participating in activities that qualify as community benefits plus the current fiscal year fringe benefit rate. Indirect costs were only applied to select salaries and services under community health improvement and research and not broadly across all community benefit activity entries Part I, Line 7, column (f) is calculated by dividing column (e), net community benefit expense, by total expense. The bad debt expense of $15,286,626 was subtracted from the total expense value used to calculate the percentages in Part 1, Line 7, Column f. Schedule H, Part II All Bassett Community Building Activities could be classified under item 1 and highlighted in number 1 above. Schedule H, Part III, line 4 Worksheet 2 cost to charge ratio was used to determine the amount reported in Part III, lines 2 and 3. The Charity Care and Provision for Uncollectible Accounts text within Financial Statements Footnotes: The Hospital's general policy statement on charity care requires that medical care be rendered to all persons in need of such care regardless of their ability to pay. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. The Hospital maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services furnished under its charity care policy. During 2010 and 2009, the total charges forgone for charity care were approximately $5,416,000 and $4,477,000 respectively. The Hospital grants credit without collateral to patients, most of who 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 uncollectible accounts. Accounts written off as uncollectible are deducted from the allowance and subsequent recoveries are added. The amount of the provision for uncollectible accounts is based upon management's assessment of historical expected collections, business and economic conditions, trends in federal and state healthcare 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 $8,601,000 and $7,510,000 at December 31, 2010 and 2009, respectively. Schedule H, Part III, line 8 Amounts were derived as follows: Charges times cost to charge ratio versus reimbursement on the Medicare PS&R report. Schedule H, Part III, line 9b Bassett renders medical care to all persons in need of such care, regardless of their ability to pay. We offer the following assistance programs to support patients who may have a difficulty paying their medical bills: Community Services Program, Tribute Fund, Orange L. VanHorne Fund and Eye Care Fund. Bassett will communicate the availability of its charity care assistance programs in a manner that is clear and understandable to its patients and implement such programs in a manner that is sensitive to the patients' dignity. Bassett's charity care programs are not intended to eliminate personal responsibility but rather to ensure that patients are encouraged to access public or private insurance options or otherwise contribute to their care based on the individual's ability to pay. All hospital personnel are expected to refer those patients or guarantors who express an inability to pay or a need for charity care services to the Patient Financial Services Advisors. All clinics can offer applications for charity care directly to patients. Bassett has a strong commitment to provide financial assistance to those in need to ensure they receive quality health care. To that end, we continuously review our Community Services Program to ensure it provides free care to patients who do not qualify for Medicaid or other insurance programs and who meet program guidelines. The program offers assistance well beyond the state required income guidelines and is easy to understand. The single page application is part of a two-page brochure that answers frequently asked questions and provides contact information for additional one-on-one guidance. All Bassett personnel are educated about the availability of the Community Services Program, and brochures are prominent and visible at all patient locations throughout Bassett. For patients or guarantors who do not qualify for complete charity care assistance, Bassett must nevertheless undertake to ensure an adequate understanding on the part of patients and those responsible for their care, of their financial obligations to Bassett, and timely satisfaction of those obligations. To meet this policy objective, Bassett, either directly or through Medical Self Pay Accounts Receivable Services, LLC ("MedSPAR), a third party self-pay billing agency, will take all necessary steps, in compliance with existing laws and regulations, to recover self-pay accounts receivable, preserve the patient-provider relationship to maximum extent possible and keep the necessity of referring accounts to third-party debt collection agencies or law firms to a minimum. Finally, Bassett will ensure that bad debt collection policies of any third-party collection agency or law firm retained for outside debt collection reflect the mission and values of the organization. Schedule H, Part V, Section B Line 1j:Other: Outpatient Primary & Specialty Care Article 28 Hospital Based Clinics Line 3:Community partners involved with Bassett in assessing community health needs include: Otsego Co. Dept. of Health, County Human Service, Emergency Services and Aging agencies, SUNY Oneonta, Hartwick College, Opportunities for Otsego Inc., Planned Parenthood, Safe Kids of Otsego Co., officials from the county and towns within the service area, Town of Pittsfield, At Home Care, Inc., the City of Oneonta, Springbrook, Head Start, Catskill Area Hospice and Palliative Care, NY Connects of Otsego Co., Otsego County Board, United Way, Cherry Valley Central School, A.O.Fox Hosptial, The Arc Otsego, Rural Three for Tobacco Free Communities, school districts throughout the region, and the Town of Richfield Springs. Bassett also solicits feedback from community partners through its Connecting Communities Advisory Group. Representatives from all of these groups were invited to participate in the Community Health Assessment focus group and strategic planning sessions. Line 4: A. O. Fox Hospital Line 5c: Participation was solicited through letters, emails, human resource service agencies and organizations, county government and elected officials. Line 7: The hospital identified the top priorities set by community needs assessment group in order to impact those priority areas. In addition to those priority items, increasing immunizations, emergency preparedness education, unintentional injury, and tobacco use were discussed during the needs assessment. These were not considered top priorities. However, it was felt that these could be incorporated with the top priority initiatives. Line 15e: Bassett engages with a third party to perform collection actions. Line 16e: Other actions taken include claims on estates, claims on bankruptcies, and wage garnishments. Line 19d: Mary Imogene Bassett Hospital 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. 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. Schedule H, Part VI, line 2 In addition to public and agency input, a variety of data from the NYS Department of Health, Otsego County Behavioral Risk Factor Surveillance System, Otsego Co. Department of Health Community Assessment and other sources were used to assess priorities, including: - Percentage of Otsego Co. adults who visited a dentist in the past years. - Prevalence of tooth decay in third-grade children. - Percentage of adults reporting binge drinking - Heavy drinking - Percentage of overweight adults in Otsego Co. Based on the outcomes of the focus groups and strategic planning sessions prevention agenda priorities throughout the county were identified. Access to quality healthcare and Mental Health and Substance Abuse were identified as the top priorities. Physical Activity and Nutrition was ranked third. Subsequent strategic planning sessions related to the two top priorities were held to identify service barriers and gaps as well as brainstorm for collaborative efforts to address these priorities. Strategies for the selected priorities: 1. Access to dental health care - Bassett will support Otsego Co. Dept. of Health efforts to re-establish the Otsego Co. Oral Health Coalition as a mechanism for bringing community partners together on advocacy efforts aimed at attracting more dentists to our rural area, and for tracking progress in improving access to dental services - Bassett will work to expand comprehensive preventive dental health services to all School-Based Health Centers in the county and to provide sealant services to non-SBHC schools. - Bassett will work with the Otsego Co. Dept. of Health and RHENDOMS to make more schools aware of RHENDOMS services to increase participation. - Bassett will work with the Otsego Co. Dept. of Health and A.O. Fox Hospital to educate primary care and SBHC providers about dental practices available for referral. - The Otsego Co. Dept. of Health will educate dental providers about Medicaid reimbursements. Bassett will work with the health department and other community partners to educate the public about dental health in fairs and other community events. 2. Mental Health and Substance Abuse - In a new initiative Bassett will work with A.O. Fox Hospital and Leatherstocking Education on Alcoholism/Addictions Foundations, Inc. (LEAF) to provide continuing medical education training on substance abuse screening and referral to primary care providers and surgeons in the county. - Bassett will work with the health department and LEAF to complete and distribute an updated list of mental health and substance abuse resources to primary care providers. - Bassett will collaborate with LEAF and the health department on public health campaign about the risk factors associated with binge drinking and prescription drug abuse. 3. Physical Activity and Nutrition - Bassett will continue to collaborate with the health department and other community partners on efforts to provide early education about the importance of physical activity and nutrition throughout life, including during pregnancy and to prevent chronic disease. - Bassett will work with the health department, schools and other community partners to improve continuity of care between families, schools and primary care providers for the treatment of childhood obesity. Overall goals will be to increase the percentage of Otsego County adults who have seen a dentist in the past year, work toward a 2013 prevention agenda objective of 83%, reducing the rate of alcohol abuse in Otsego County and reducing the rate of obesity in Otsego County. Schedule H, Part VI, line 3 A major component of the Bassett Medical Center Community Services program is to actively identify patients who may be eligible for charity care. The process begins with an organizational policy and procedure that defines the program and serves as an education tool for all Bassett employees. The policy is updated annually, distributed to key personnel and posted in the online policy and procedure manual that is accessible to all employees. The program is supported by a four page plain language brochure that includes an application. Brochures are prominently displayed and available at all facilities and all clinic locations. Clinical and support staff are made aware of the program and able to direct patients to specialists who can assist in the application process. All patients who are registered as 'self pay' are provided a brochure either in person or by mail. Patients who are in the hospital receive information as part of a personal visit geared to help the patient navigate financial assistance including, but not limited to, the Community Services Program. Government program opportunities are also referenced and a directory of local social services agencies is provided based on the patient's county of residence. Referral to an onsite Otsego County Medicaid Examiner is available at the Cooperstown campus. A listing of all self-pay accounts is produced and reviewed daily to insure that a Community Services brochure has been provided. The self-pay billing office identifies patients during the billing and collections process that may require additional help understanding the program. Self-pay accounts for patients who have been approved for Community Services within the prior 120 days are automatically included with the prior approval. Schedule H, Part VI, line 4 4. The service area of Bassett encompasses a eight county region in upstate New York. While the economy of Cooperstown is based on tourism and health care, the rest of the region is largely agricultural. There are a few larger employers in the region such as local school districts, community, state and private universities, the majority of employers are small businesses. In the eight county regions, the median household income ranges between $37,000 and $40,000. 12-14 % of the community residents have incomes below the federal poverty guidelines. The following areas have been federally designated as being medically underserved: In Herkimer County the city of Herkimer. In Delaware County the towns of Middletown, Margaretville, Andes and Deposit. Schedule H, Part VI, line 5 Bassett serves as the foundation for the Thurston Corporation (dba Bassett Healthcare Network) and is a 180-bed acute care inpatient teaching facility located in Cooperstown, New York. Providing a wide range of specialty care, Bassett maintains a strong academic program through its affiliation with Columbia University College of Physicians and Surgeons, an affiliation highlighted by the establishment of a Columbia medical school campus at Bassett in 2009. Bassett has a network of 29 community based outpatient health centers, 18 school-based health centers, two ambulatory surgery centers and is a Level II Trauma Center as designated by New York State. In addition, the research programs at Bassett include the New York Center for Agricultural Medicine and Health. Community based partnerships as part of the Northeast Center for Agricultural Health are addressing important health and safety issues in diverse agricultural populations at several sites across New York state. Health Works Occupational Health Services program continues to meet the health, safety and wellness needs of the business community. Providing needed occupational health services benefits and improving employee health throughout the Bassett Healthcare Network eight-county region. Bassett is working to re-establish the Otsego County Oral Health Coalition as a mechanism for bringing community partners together around a shared vision in an effort to attract more dentists to our rural area. The size and depth of Bassett with its more than two dozen community health centers and 18 school based health centers makes it ideal for a new initiative to train primary care practitioners and surgeons in substance abuse screening and referral. The goal is to also train practitioners outside Bassett hospital, but Bassett provides the ideal platform from which to pilot this initiative. Bassett is also addressing the rate of obesity within its region reaching out to schools to provide resources, guidance and technical assistance in the areas of tobacco use, nutrition and physical activity. Bassett continues to combine health care with community service. Our program "Connecting Communities for Health & Wellness" is about collaborative efforts to provide treatment and/or to promote health and healing as a response to identified community needs. Community health improvement initiatives have targeted the New York State Department of Health new Public Health Prevention Agenda. In addition to hospital public health programs related to the three priority prevention agenda items, programs addressing chronic disease management and prevention and unintentional injury were considered. Bassett public health programs that address these areas include: - School-Based Health center Dental sealant program. A registered dental hygienist provides preventive care, including education, cleanings, fluoride treatment, sealant and referrals in this grant funded program. - RHENDOMS (Rural Health Education Network of Delaware, Otsego, Montgomery and Schoharie Counties) - Dental health education is offered to elementary school students, and parents of newborns are educated about baby-bottle tooth decay. - Bassett Psychiatric Crisis Center - The Cooperstown center opened in February 2008, filling a void created by the termination of psychiatric services at A.O. Fox Hospital in Oneonta months earlier. In its first year, Bassett's psychiatric crisis center helped more than 1,200 patients. Of those, 52 were children 12 or younger and 154 were adolescents. - Parent HandBook - This family resource was created by the Otsego Co. Committee on Child Abuse and Neglect and underwritten by Bassett Healthcare and A.O. Fox Hospital. It's goal is to give parents and professionals a place to turn for help in dealing with the stresses of family life. - KickStart - a program designed to help combat childhood obesity through collaborative partnerships with Bassett health centers and local recreational and fitness groups. - Bassett Cancer Institute Medical Screening Coach - a new, custom-built medical coach equipped with digital technology for mammography and other cancer screenings for men and women. The coach was placed in service in 2008 with the goal of reducing the number of cancer deaths by increasing access to screening services in rural areas. - Cancer Services Program of Delaware, Otsego and Schoharie Counties - a New York State Department of Health partnership administered through Bassett offering free breast, cervical and colorectal screenings to people who qualify. - Healthy Start Breakfast - a partnership between community service organizations and Bassett for diabetes detection, education and prevention. - Safe Kids Coalition of Otsego County - An Organization whose mission is to prevent unintentional injuries to children through education. Programs and services include safety seat events, educational resources on bicycle, in-line skate and skateboard safety, home safety, fire and burn prevention, road safety and pedestrian safety. The regional primary and specialty care clinics and the school-based health centers were established in response to community need. Bassett is continually engaging in quality improvement initiatives to ensure that quality health care and programs are brought to central New York. A core part of Bassett is research and education. Bassett's value to the communities it serves is compounded by providing physicians the ability to practice quality medicine in a collegial environment in a rural setting. There is a tremendous collaboration between physicians within Bassett to ensure a better outcome for the patient. Bassett continually invests in programs, equipment and people to ensure quality service to the communities in which we serve. Schedule H, Part VI, line 6 Bassett is part of the Bassett Healthcare Network that provides health 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; Schoharie County - population 31,910 (according to the 2008 U.S. Census estimates). a. Bassett - an acute care inpatient teaching facility, an outpatient primary and specialty care center, a regional network of 26 community based outpatient health centers, 18 school based health centers, two ambulatory surgery centers and a fully salaried medical staff in Cooperstown, Otsego County b. O'Connor Hospital - a critical access hospital in Delhi, Delaware County c. Cobleskill Regional Hospital - an acute care facility in Cobleskill, Schoharie County d. Little Falls Hospital - a critical access hospital in Little Falls, Herkimer County e. Tri-Town Regional Hospital - a 24/7 emergency care facility in Sidney, Delaware County f. A.O. Fox Memorial Hospital - an 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 the above (a-i) make up the Bassett Healthcare Network and provide health services to this eight county region in central New York. Schedule H, Part VI, line 7 New York State X X X X false false false false false false false true false William F Streck MD 313887 0 372727 0 3679 0 22678 0 3291 0 716262 0 0 Bertine Mckenna PHD 342680 0 30000 0 3934 0 17418 0 3935 0 397967 0 0 0 Nicholas J Nicoletta 341809 0 30000 0 0 0 22678 0 4283 0 398770 0 0 0 Steven J Heneghan MD 558735 0 25000 0 0 0 22678 0 6050 0 612463 0 0 0 Joseph Schmer MD 450350 0 154350 0 4907 0 17418 0 3182 0 630207 0 0 0 James C Peters MD 485323 0 63054 0 0 0 20228 0 14011 0 582616 0 0 0 Jonathan Richman Md 507173 0 60000 0 0 0 22678 0 8167 0 598018 0 0 0 Timothy J Campbell MD 469507 0 115000 0 0 0 15851 0 11011 0 611369 0 0 0 Part I, Line 7 Non-fixed payments are made based on the success in meeting performance criteria that are prospectively agreed upon as goals for the officers. Physician chiefs may receive non-fixed payments based on performance and comparative market data. Part VII, Line 5 Name of Unrelated Organization = Columbia University Type of Compensation = Salary Amount of Compensation = $272,523 Person Receiving = William F. Streck, M.D. Otsego County Industrial Dev Agency 166198451 689091de3 2007-11-30 20000000 Inpatient Building Renovations false false false 0 0 20000000 0 0 0 639767 363858 0 18996375 0 0 2009 false false false true false false false false 0.00000 0.00000 0.00000 true false true false false false The Clark Estates >35% owned by crnt truste 395052 Investment mgmt fees false Jane Hamilton Fmly mbr of crnt trustee 62868 wages false Part I, Summary, Line 1 MIBH is a 180 bed acute care facility that serves the community of Cooperstown, and an 8 county surrounding region, through it's regional health center network. MIBH offers 24 hours emergency and trauma care, comprehensive cancer and heart care, dialysis, and most medical and surgical specialties, and conducts research and education programs. Part VI, Section A, Question 2 Trustees Kevin S Moore, William T Burdlck, Jane Forbes clark, Richard C Vanison, and glenn a perrone have a business relationship. Part VI, Section B, Line 11b Bassett distributes the draft 990 to the audit committee of the board of trustees prior to filing. any questions are raised and answered. the audit committee then presents its review findings to the full board of trustees. Copies are distributed to all Bassett's other trustees at their request. once approved, the 990 can be electronically filed. Part VI, Section B, Question 12c The organization's Conflict of interest Policy applies to the board of Trustees, including any committees of the Board, individual members of the Board, officers of the hospital (CEO,COO,CFO), Vice presidents, and all Directors serving as directors team members. Upon the commencement of an individual serving in the roles defined above, and thereafter annually by january 1, a conflict of interest questionnaire which is prescribed by the audit committee of the Board of trustees must be completed. All completed questionnaires are reviewed by the Compliance Officer for the organization. Any potential conflict of interest will be discussed with the individual and/or with legal counsel. The Compliance Officer will take action to eliminate the potential conflict of Interest, if deemed appropriate. After investigation if it is deemed that the individual has failed to comply with such policies and directives, appropriate corrective action will be taken. The audit committee of the board of Trustees may determine whether the corrective action is satisfactory and, if not, shall require further action. Part VI, Section B, Question 15a Bassett has a formal process that is used to determine the base compensation of the CEO on an annual basis. This process includes a compensation committee of the board of Trustees, an independent compensation consultant, compensation survey or study, and approval by the Board of trustees or the compensation committee. Bassett pays non-fixed earnings based on the success in meeting performance criteria that are prospectively agreed upon as goals for the CEO. Part VI, Section B, Question 15b The same formal process noted in Question 15(a) above, is used to determine the base compensation of the other officers. Non fixed earnings of other officers are based on the success in meeting performance criteria and comparative market data. Part VI, Section B, Question 16b Although a written policy or procedure has not been adopted, it is the organization's practice to seek legal opinion in evaluation of participation in joint venture arrangements. Part VI, Section C, Question 19 Bassett makes it's governing documents, conflicts of interest policy, and financial statements available to the public upon written request. Parties desiring to obtain copies of such must present themselves at the Administrative Offices of Bassett or by sending a self-addressed stamped envelope and payment for copying of the requested material to Bassett Administrative Offices. The cost of copying shall be equal to the costs imposed by the IRS for copying of public documents. Part X, line 5 Other changes in net assets are comprised of $3,625,611 net unrealized gains on investments, $199,609 investment loss on joint venture, post retirement benefit related changes other than net periodic benefit costs $519,682, and abandonment of project ($249,453)for a total of $4,095,449. 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 Templeton Foundation one atwell road cooperstown NY 13326 133317084 Health care NY 501 (c ) 3 9 THURSTON Bassett Regional corporation ONE ATWELL ROAD COOPERSTOWN NY 13326 133522783 Plan & Policy NY 501 (c ) 3 11b THURSTON Bassett Hospital of Schoharie Co 178 grandview drive cobleskill NY 12043 141772971 health care NY 501 (c ) 3 3 BRC 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 W GERMAN street herkimer NY 13350 222511614 health care NY 501(C)3 3 BRC Aurelia Osborn Fox Memorial Hospsociety 1 Norton avenue Oneonta NY 13820 150539039 Health care NY 501(C)3 3 Thurston false false true false false false false true true true true true false false true true false false