Community Benefit Insight - Tax-exempt hospital

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O'connor Hospital

Oconnor Hospital

460 Andes Road
Delhi, NY 13753

Bed count	25	Medicare provider number	331305	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 161540394

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

8.07%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 69,023 0.32 %
Medicaid as % of operating expenses	$ 1,303,858 6.09 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 0 0 %
Subsidized health services as % of operating expenses	$ 138,509 0.65 %
Research as % of operating expenses	$ 30,254 0.14 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 185,942 0.87 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 0 0 %
Community building* as % of operating expenses	$ 0 0 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	Not available
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 0 0 %
Physical improvements and housing as % of community building expenses	$ 0
Economic development as % of community building expenses	$ 0
Community support as % of community building expenses	$ 0
Environmental improvements as % of community building expenses	$ 0
Leadership development and training for community members as % of community building expenses	$ 0
Coalition building as % of community building expenses	$ 0
Community health improvement advocacy as % of community building expenses	$ 0
Workforce development as % of community building expenses	$ 0
Other as % of community building expenses	$ 0
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 0 0 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 0 0 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 17690919 including grants of $ 0) (Revenue $ 25297479)
INPATIENT AND OUTPATIENT SERVICES PROVIDED TO OUR PATIENTS RESULTED IN:HOSPITALIZATIONS: 434PATIENT DAYS: 2,718CLINIC VISITS: 13,282

4B (Expenses $ 72231 including grants of $ 0) (Revenue $ 0)
COMMUNITY INVOLVEMENT HAS BEEN LINKED TO O'CONNOR HOSPITAL'S MISSION AND VALUES SINCE IT FIRST OPENED. WE ARE WORKING WITH OUR COMMUNITY TO IMPROVE THE QUALITY OF LIFE FOR THE PEOPLE OF OUR REGION. OUR COMMUNITY SERVICES PROGRAMS PROVIDE FREE SERVICES TO PERSONS WHO CANNOT AFFORD TO PAY, WHO DO NOT QUALIFY FOR MEDICAID, AND WHO FALL WITHIN THE ESTABLISHED INCOME GUIDELINES. IN 2021, WE PROVIDED $72,231 IN FREE CARE. OUR DOORS ARE OPEN 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS A YEAR. WE ARE PROUD TO PROVIDE THIS CARE TO OUR COMMUNITIES. NOT ONLY DID WE PROVIDE $72,231 IN CHARITY CARE, $530,972 IN PATIENT ACCOUNTS WERE RECORDED AS BAD DEBT IN 2021.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

O'CONNOR HOSPITAL
PART V, SECTION B, LINE 3J: CONTINUING PRIOR CHNA WORK ON PREVENTING CHRONIC DISEASES, PROMOTING MENTAL HEALTH, AND PREVENTING SUBSTANCE ABUSE.

O'CONNOR HOSPITAL
PART V, SECTION B, LINE 5: REPRESENTATIVES FROM DELAWARE COUNTY PUBLIC HEALTH, O'CONNOR HOSPITAL, DELAWARE VALLEY HOSPITAL, MARGARETVILLE HOSPITAL, AND THE SOUTHERN TIER POPULATION HEALTH IMPROVEMENT PROGRAM (PHIP) MET IN FALL OF 2018 TO BEGIN DISCUSSING THE NEXT FULL DELAWARE COUNTY COMMUNITY HEALTH ASSESSMENT, COMMUNITY HEALTH IMPROVEMENT PLAN, AND THE HOSPITAL COMMUNITY SERVICE PLANS, AND SET UP A MONTHLY MEETING SCHEDULE TO CONTINUE UNTIL SUBMISSION OF THE FULL DOCUMENT IN DECEMBER 2019.A REVIEW AND UPDATE OF DATA IN THE COMMUNITY HEALTH ASSESSMENT WAS COMPLETED IN JULY 2019, USING COUNTY, REGIONAL AND NEW YORK STATE SECONDARY DATA SOURCES INCLUDING BRFSS, CENSUS DATA, AND LOCAL DATA SOURCES INCLUDING THE DELAWARE COUNTY PUBLIC HEALTH ANNUAL REPORT, THE DELAWARE COUNTY OFFICE FOR AGING'S ANNUAL ASSESSMENT AND REPORT THE DELAWARE COUNTY COMMUNITY SERVICES ANNUAL ASSESSMENT AND PLAN.AS A METHOD TO COLLECT PRIMARY DATA FROM THE COUNTY AT LARGE, TWO SURVEYS WERE DEVELOPED: THE FIRST WAS SENT ELECTRONICALLY TO DELAWARE COUNTY HEALTH AND HUMAN SERVICES PROVIDERS TO GAIN THEIR PERSPECTIVES ON THE PREVENTION AGENDA PRIORITY AREAS AND THE ASSOCIATED FOCUS AREAS MOST IN NEED OF IMPROVEMENT. THE SECOND SURVEY WAS SENT ELECTRONICALLY TO COMMUNITY MEMBERS TO IDENTIFY PRIMARY STRENGTHS AND WEAKNESSES OF SERVICE PROVISION, SOCIAL DETERMINANTS OF HEALTH IN NEED OF ADDRESSING, AND GENERAL QUALITY OF HEALTH AND LIFE IN THE COUNTY.PRELIMINARY FINDINGS ALLOWED THE GROUP TO: 1) UNDERSTAND WHICH DATA SOURCES AND INFORMATION WOULD BE MOST USEFUL, 2) DETERMINE COMMUNITY PARTNERS, ORGANIZATIONS, AND OTHER EXISTING ASSESSMENTS TO INCLUDE IN THE PROCESS, 3) EXPLORE BEST PRACTICE ACTIVITIES AND INTERVENTIONS TO INCLUDE IN THE COMMUNITY SERVICE PLAN.IN MAY OF 2019, THE PHIP POPULATION HEALTH COORDINATORS WORKED WITH THE DELAWARE COUNTY COMMITTEE TO HOLD A COMMUNITY ROUNDTABLE EVENT AT THE STATE UNIVERSITY OF NEW YORK (SUNY) DELHI, LOCATED IN DELHI NY, DELAWARE COUNTY. ALL HEALTH AND HUMAN SERVICES PROVIDERS THAT RECEIVED THE SURVEY WERE INVITED, AS WELL AS THE COMMUNITY RESIDENTS WHO PROVIDED THEIR NAMES AND CONTACT INFORMATION ELECTRONICALLY VIA THE SURVEY. THE EVENT WAS ALSO PROMOTED VIA EMAIL AND SOCIAL MEDIA COMMUNICATIONS. HOSPITAL AND PUBLIC HEALTH REPRESENTATIVES SHARED THE INVITATION WITH THEIR BOARDS OF DIRECTORS. THE ROUNDTABLE EVENT WAS ATTENDED BY 40 PEOPLE, AND INCLUDED A PRESENTATION ON THE SURVEY DATA BY THE PHIP COORDINATORS. IN ADDITION, DELAWARE COUNTY'S DIRECTOR OF PUBLIC HEALTH AND THE DIRECTOR OF OPERATIONAL SUPPORT FROM O'CONNOR HOSPITAL (LOCATED IN DELHI AND AFFILIATED WITH THE BASSETT HEALTHCARE SYSTEM) PRESENTED ON THE NY STATE AND FEDERAL REQUIREMENTS FOR COMPLETION OF THE COMMUNITY HEALTH ASSESSMENT, COMMUNITY HEALTH IMPROVEMENT PLAN, AND THE HOSPITALS' COMMUNITY SERVICE PLANS.THE ROUNDTABLE EVENT INCLUDED BREAKOUT GROUPS FOR THE CHOSEN PREVENTION AGENDA PRIORITY AREAS TO GIVE ATTENDEES FURTHER OPPORTUNITY TO PROVIDE INPUT ON THE INTERVENTIONS AND ACTIVITIES TO PLACE IN THE NEXT 3-YEAR CYCLE.O'CONNOR HOSPITAL INVOLVED ITS SENIOR OPERATIONS TEAM (OPS) AND THREE MEMBERS OF THE HOSPITAL BOARD OF TRUSTEES IN THE ASSESSMENT AND SELECTION OF ITS HEALTH PRIORITIES. ON MAY 30TH, THREE BOARD MEMBERS AND TWO OPS MEMBERS PARTICIPATED IN THE DELAWARE COUNTY HEALTH ASSESSMENT ROUNDTABLE AND DISCUSSION, DESCRIBED ABOVE. FOLLOWING THE ROUNDTABLE, THE THREE BOARD MEMBERS AND THE OPS TEAM MET TO DISCUSS THE HOSPITAL'S OPERATIONAL STRATEGIES AND AVAILABLE RESOURCES FOR ADDRESSING HEALTH PRIORITIES IN DELAWARE COUNTY.

O'CONNOR HOSPITAL
PART V, SECTION B, LINE 6A: UHS DELAWARE VALLEY HOSPITAL AND MARGARETVILLE MEMORIAL HOSPITAL

O'CONNOR HOSPITAL
PART V, SECTION B, LINE 6B: DELAWARE COUNTY PUBLIC HEALTH

O'CONNOR HOSPITAL
PART V, SECTION B, LINE 11: THE ORGANIZATION ADDRESSED SIGNIFICANT, PRIORITIZED HEALTH NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA BY ADOPTION OF A BUDGET FOR PROVISION OF SERVICES THAT ADDRESS THE NEEDS IDENTIFIED IN THE CHNA, PRIORITIZATION OF HEALTH NEEDS IN ITS COMMUNITY, AND PRIORITIZATION OF SERVICES THAT THE HOSPITAL FACILITY WILL UNDERTAKE TO MEET HEALTH NEEDS IN ITS COMMUNITY. FOR NEEDS NOT ADDRESSED AS A COLLABORATIVE, WE ADDRESS SOME AS AN INDIVIDUAL ORGANIZATION, AND ALSO CONTINUE TO REPRIORITIZE HIGHEST DEMAND OF NEEDS.DUE TO THE COVID-19 PANDEMIC, DURING 2020, THE HOSPITAL CANCELED ALL ELECTIVE PROCEDURES AND NON-URGENT AMBULATORY VISITS WHICH RESULTED IN A SIGNIFICANT REDUCTION IN PATIENT VOLUMES. IN ADDITION TO THE LOST REVENUE THAT ACCOMPANIED THE LOWER PATIENT VOLUMES THE HOSPITAL EXPERIENCED A SIGNIFICANT INCREASE IN OPERATING EXPENSES ASSOCIATED WITH THE PURCHASE OF PERSONAL PROTECTIVE EQUIPMENT, CERTAIN PHARMACEUTICALS, COVID 19 TESTING SUPPLIES, AND OTHER OVERHEAD AND PATIENT SPECIFIC COSTS. ADMISSIONS FELL 10% FROM 2019 TO 2020 WHILE OUTPATIENT CLINIC AND ER VISITS DECREASED 11% FROM 2019 TO 2020.DURING 2021 THE HOSPITAL CONTINUED TO CARE FOR PATIENTS AFFECTED BY THE COVID-19 PANDEMIC. IN RETURN, THE HOSPITAL REALIZED $199,189 OF CARES ACT FUNDS IN RELATION TO THE SALARIES AND SUPPLIES EXPENDED TO CARE FOR THESE PATIENTS.

PART V, LINE 7A AND 10A, FACILITY 1, O'CONNOR HOSPITAL
THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE MADE AVAILABLE ON THE HOSPITAL'S WEBSITE:WWW.BASSETT.ORG/LOCATIONS/OCONNOR-HOSPITAL

PART V, LINE 16A, 16B, & 16C, FACILITY 1, O'CONNOR HOSPITAL
THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE MADE AVAIALBLE ON THE HOSPITAL'S WEBSITE:HTTPS://WWW.BASSETT.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE

O'CONNOR HOSPITAL
PART VBILLING AND COLLECTIONSBEGINNING IN JULY 2021, BASSETT HEALTHCARE NETWORK, THE PARENT ORGANIZATION OF O'CONNOR HOSPITAL, ENTERED INTO A SERVICE AGREEMENT WITH OPTUM INSIGHT. THIS AGREEMENT RESULTED IN VARIOUS INFORMATION TECHNOLOGY, REVENUE CYCLE, AND BUSINESS ANALYTIC SERVICES ONCE PERFORMED BY BASSETT HEALTHCARE NETWORK BEING TRANSITIONED TO OPTUM INSIGHT, ALONG WITH THE FORMER BASSETT EMPLOYEES WHO PROVIDED THEM. THE TRANSITION INCLUDED PORTIONS OF THE BILLING AND COLLECTION ACTIVITIES FOR THE HOSPITALS IN THE NETWORK. HOWEVER, DESPITE THE CHANGE IN SERVICE PROVIDER, THE BILLING AND COLLECTION POLICIES OF THE HOSPITAL HAVE NOT CHANGED AS A RESULT OF THE TRANSITION.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
OTHER INCOME BASED CRITERIA FOR FREE OR DISCOUNTED CARETHE CSP (COMMUNITY SERVICES PROGRAM) APPLICATION SPECIFIES FAMILY INCOME LIMITS AND OTHER REQUIREMENTS FOR SERVICES TO BE ELIGIBLE FOR O'CONNOR HOSPITAL'S CSP/FREE CARE PROGRAM.

PART I, LINE 6A:
RELATED ORGANIZATION INFORMATIONO'CONNOR HOSPITAL'S COMPREHENSIVE COMMUNITY SERVICE PLAN IS SUMMARIZED IN AN ANNUAL REPORT AND POSTED ON THE O'CONNOR HOSPITAL WEBSITE, WWW.BASSETT.ORG/LOCATIONS/OCONNOR-HOSPITAL. PRINTED COPIES ARE AVAILABLE TO THE PUBLIC UPON REQUEST.

PART I, LINE 7:
COSTING METHODOLOGY EXPLANATIONWORKSHEET 2 WAS USED TO DEVELOP A COST-TO-CHARGE RATIO. IT WAS USED FOR PATIENT CARE SERVICES. FOR NON- PATIENT CARE SERVICES, CHARGES WERE REDUCED TO COST FOR THOSE SERVICES TO NON-PATIENTS WHERE A MARK-UP IS READILY IDENTIFIABLE.

PART I, LINE 7, COLUMN (F)
EXCLUSIONS FROM PERCENT OF TOTAL EXPENSETHE PERCENT OF TOTAL EXPENSE IN PART 1, LINE 7, COLUMN (F) IS CALCULATED BY DIVIDING COLUMN (E), NET COMMUNITY BENEFIT EXPENSE, BY TOTAL EXPENSE. THE BAD DEBT EXPENSE OF $530,972 WAS SUBTRACTED FROM THE TOTAL VALUE USED TO CALCULATE THE PERCENTAGES IN PART 1, LINE 7, COLUMN F.

PART I, LINE 7, COLUMN (D)
DIRECT OFFSETTING REVENUEDURING 2021, THE HOSPITAL RECORDED PROVIDER RELIEF FUNDS THAT WERE USED AS REIMBURSEMENT FOR COMMUNITY BENEFIT EXPENSES THE HOSPITAL INCURRED AS A RESULT OF THE COVID-19 PANDEMIC. SUCH EXPENSES ARE CURRENTLY REPORTED IN PART I, LINE 7, COLUMN (C) BUT THE HOSPITAL HAS NOT INCLUDED THE PROVIDER RELIEF FUNDS AS DIRECT OFFSETTING REVENUE IN COLUMN (D) PENDING FURTHER GUIDANCE FROM THE IRS AS TO WHETHER PROVIDER RELIEF GRANTS ARE CONSIDERED RESTRICTED GRANTS FOR THE PURPOSES OF LINE 7.

PART II, COMMUNITY BUILDING ACTIVITIES:
COMMUNITY BUILDING ACTIVITIESALL O'CONNOR COMMUNITY BUILDING ACTIVITIES ARE INCLUDED IN PART I AND DESCRIBED ABOVE.

PART III, LINE 2:
BAD DEBT EXPENSEDUE TO THE ADOPTION OF ASU NO. 2014-09 - REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENT. RATHER IT IS TREATED AS A PRICE CONCESSION.

PART III, LINE 4:
FOOTNOTE (3) FROM THE AUDITED FINANCIAL STATEMENTSCHARITY CARE:THE COST OF CHARITY CARE PROVIDED IS DETERMINED BASED ON THE APPLICATION OF A COST TO GROSS CHARGE RATIO TO THE TOTAL CHARITY CARE CHARGES FOREGONE. INCLUDED IN NET PATIENT SERVICE REVENUE ARE AMOUNTS PAID INTO AND RECEIVED FROM STATEWIDE UNCOMPENSATED CARE POOLS. THESE UNCOMPENSATED CARE POOLS ARE DESIGNED TO HELP OFFSET THE COST OF CHARITY CARE AND UNREIMBURSED MEDICAID SERVICES.BAD DEBT:DUE TO THE ADOPTION OF ASU NO. 2014-09 - REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENT. RATHER IT IS TREATED AS A PRICE CONCESSION.

PART III, LINE 8:
MEDICARE EXPLANATIONO'CONNOR IS A CRITICAL ACCESS HOSPITAL, SO COST IS CALCULATED ON THE SETTLEMENT SHEETS OF THE COST REPORT. IT WAS COMPARED TO MEDICARE REIMBURSEMENT, WHICH IS ALSO CALCULATED ON THE COST REPORT.

PART III, LINE 9B:
COLLECTION PRACTICES EXPLANATIONPATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE CONTACTED BY THE FINANCIAL COUNSELING TEAM THAT SENDS A LETTER OF APPROVAL AND TIME-FRAME FOR WHICH THE PATIENT IS APPROVED.

PART VI, LINE 2:
NEEDS ASSESSMENTFOLLOWING THE PUBLIC PARTICIPATION AND INPUT PERIOD THE HEALTH PRIORITIESWERE CHOSEN BASED UPON THE APPLICATION OF THE FOLLOWING SIX CRITERIA:1. THE PRIORITY AREA WAS IDENTIFIED IN THE PRIMARY INFORMATION SOURCES.2. THE PRIORITY AREA WAS CONSISTENT WITH THE CURRENT NYS DEPARTMENT OFHEALTH PREVENTION AGENDA AREAS;3. THE PRIORITY AREA WAS SUPPORTED BY DATA SHOWING HEALTH STATUSINDICATORS OR HEALTH NEEDS WERE EITHER BELOW THE AVERAGES FOR NEW YORKSTATE, CONTIGUOUS COUNTIES, OR AVERAGES FOR UPSTATE NEW YORK4. THE PRIORITY AREA WAS IDENTIFIED/ RECOMMENDED DURING THE PUBLIC INPUT PROCESS.5. THE AVAILABILITY OF RESOURCES FOR THE HOSPITAL TO COMMIT TO THE PRIORITY6. OPPORTUNITY FOR DEVELOPMENT OF COLLABORATIVE INTERVENTIONS BY O'CONNOR HOSPITAL, DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT AND ITS OTHER COMMUNITY WORK GROUP PARTNERS WAS ALSO CONSIDERED. O'CONNOR HOSPITAL HAS SELECTED TWO HEALTH PRIORITIES WHICH ARE ALSOADDRESSED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATIONSTRATEGY 2013, 2016, AND 2019 REPORTS:A. PREVENT CHRONIC DISEASESB. PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERSBOTH OF THESE COMMUNITY SERVICE PLAN PRIORITIES ARE FROM THE NEW YORK STATE PREVENTION AGENDA 2019-2024.

PART VI, LINE 3:
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEA MAJOR COMPONENT OF THE O'CONNOR HOSPITAL 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 O'CONNOR EMPLOYEES. THE POLICY IS UPDATED ANNUALLY, DISTRIBUTED TO KEY PERSONNEL AND 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. 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. PATIENT REFERRAL TO THE DELAWARE COUNTY MEDICAID EXAMINER IS FACILITATED BY THE FINANCE DIRECTOR AT THE O'CONNOR HOSPITAL.A LISTING OF ALL SELF-PAY ACCOUNTS IS PRODUCED AND REVIEWED DAILY TO ENSURE 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.

PART VI, LINE 4:
COMMUNITY INFORMATIONACCORDING TO THE 2017 UNITED STATES CENSUS ESTIMATE, DELAWARE COUNTY, NEW YORK, HAS A POPULATION OF 45,001 AND IS APPROXIMATELY THE SIZE OF THE STATE OF RHODE ISLAND. THE COUNTY HAS FOUR HOSPITALS COVERING AN AREA OF 1,442.44 SQUARE MILES WITH 33.3 PEOPLE PER SQUARE MILE. O'CONNOR'S SERVICE AREA INCLUDES THE DELHI COMMUNITY, AS WELL AS, SURROUNDING COMMUNITIES STRETCHING FROM GRAND GORGE, THROUGH STAMFORD, SOUTH KORTRIGHT, BOVINA, ANDES, BLOOMVILLE, HAMDEN AND FRANKLIN TO TREADWELL, AND COVERING MANY HAMLETS IN BETWEEN.

PART VI, LINE 7
STATE FILING OF COMMUNITY BENEFIT REPORTNEW YORK

PART VI, LINE 5:
PROMOTION OF COMMUNITY HEALTHO'CONNOR HOSPITAL IS A CRITICAL ACCESS HOSPITAL IN DELHI, NEW YORK PROVIDING A FULL RANGE OF ACUTE AND PREVENTATIVE HEALTH CARE SERVICES, INCLUDING ACUTE INPATIENT CARE, RESTORATIVE/REHABILITATIVE (SWING BED) CARE, AN EMERGENCY SERVICES DEPARTMENT (WHERE PRACTITIONERS HAVE THE ABILITY TO INTERFACE WITH BOARD-CERTIFIED NEUROLOGISTS IN COOPERSTOWN AND NEUROSURGEONS IN ROCHESTER THROUGH TELEMEDICINE CONNECTIONS), A STATE-OF-THE-ART MEDICAL IMAGING SUITE, LABORATORY SERVICES, AN OUTPATIENT PHARMACY, PHYSICAL AND OCCUPATIONAL THERAPY, DIETARY CONSULTATIONS, A DENTAL CLINIC AND A WIDE RANGE OF SPECIALTY SERVICES.O'CONNOR HAS SERVED THE DELHI COMMUNITY SINCE 1922 AND HAS BEEN AFFILIATED WITH THE MARY IMOGENE BASSETT HOSPITAL (DBA BASSETT MEDICAL CENTER) SINCE 1988. O'CONNOR IS AN ENTITY OF THE BASSETT HEALTHCARE NETWORK. IT IS GOVERNED BY A 12 MEMBER BOARD OF TRUSTEES CONSISTING OF COMMUNITY VOLUNTEERS. O'CONNOR HOSPITAL COMMUNITY SERVICE PROGRAMS ADDRESS CHRONIC DISEASE MANAGEMENT, PROMOTE WELL-BEING AND MENTAL HEALTH, AND PREVENT SUBSTANCE ABUSE DISORDERS. THEY INCLUDE:1. O'CONNOR HOSPITAL PROVIDES SPACE FOR DIABETES, MENTAL HEALTH AND PARKINSON'S SUPPORT GROUPS ON A MONTHLY BASIS.2. O'CONNOR OFFERS FALL FLU SHOT CLINICS.3. PROMOTED PLACES FOR PHYSICAL ACTIVITY, HIKING, PADDLING AND BIKING.4. TRACKED TRAIL USE ON TWO LOCAL HIKING TRAILS.5. MAINTAINED GETOUTANDWALK.ORG WEBSITE.6. ENCOURAGED MUNICIPALITIES TO SIGN COMPLETE STREET POLICIES AND AGE-FRIENDLY STRUCTURAL IMPROVEMENTS.7. BUILT AND MAINTAINED O'CONNOR HOSPITAL .5 MILE FITNESS TRAIL COMPLETE WITH FIVE FITNESS STATIONS AND OPEN TO THE COMMUNITY.8. SUBMITTED DSRIP PROPOSAL TO FUND A PRESCRIBING MENTAL HEALTH PROVIDER TO WORK IN LOCAL HEALTH CENTER.9. SUBMITTED GRANT PROPOSAL TO FUND PROVIDER RECRUITMENT AND RETENTION EFFORTS IN THE O'CONNOR HOSPITAL SERVICE AREA.10. CONDUCTED PERFORMANCE IMPROVEMENT PROJECT TO REFER E.D. PATIENTS TO MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES AND COMMUNITY RESOURCES.11. COMPLETED PERFORMANCE IMPROVEMENT PROJECT TO INCREASE PATIENT REFERRALS TO CARE NAVIGATOR PROGRAM.12. PARTICIPATED IN PILOT DRUG TAKE BACK PROGRAM.13. PARTICIPATED IN LOCAL COMMUNITY COALITIONS AND COMMITTEES FORMED TO ADDRESS MENTAL HEALTH ISSUES IN THE COUNTY.14. PARTICIPATED IN SUICIDE PREVENTION COALITION.15. SUPPORTED TWO NURSES TO COMPLETE SEXUAL ASSAULT NURSE EXAMINER TRAINING COURSES.16. COMPLETED AND PARTICIPATED IN COUNTY AND REGIONAL EMERGENCY PREPAREDNESS PROGRAMS AND DRILLS.17. CONDUCTED PERFORMANCE IMPROVEMENT PROJECT ADDRESSING STANDARD PRECAUTIONS FOR MRSA/ VRE OF INPATIENTS.18. HOSTED FIRST GRADERS FOR AN EDUCATIONAL PROGRAM OF THE EMERGENCY DEPARTMENT.19. SPONSORED COMMUNITY WELLNESS EVENTS SUCH AS ROAD RACES, SUICIDE AWARENESS ACTIVITIES, AND EMS TEACHING EVENTS.O'CONNOR HAS A COMMUNITY BOARD WHO ARE ACTIVELY ENGAGED IN THE HOSPITAL BOTH SUPPORTING THE GROWTH AND THE INVESTMENT IN PROGRAMS THAT BRINGHEALTH AND WELLNESS BENEFITS TO THE COMMUNITY. O'CONNOR CONTINUALLY INVESTS IN PROGRAMS, EQUIPMENT AND PEOPLE TO ENSURE HIGH QUALITY SERVICE IS AVAILABLE IN THE COMMUNITY THEY SERVE.

PART VI, LINE 6:
AFFILIATED HEALTH CARE SYSTEMO'CONNOR HOSPITAL IS PART OF THE BASSETT HEALTHCARE NETWORK THAT PROVIDES HEALTH SERVICES IN MORE THAN 20 COMMUNITIES SPANNING 5,600 SQUARE MILES AND SEVEN COUNTIES. THE NETWORK FOCUSES ITS COMMUNITY SERVICES PROGRAMS IN THE COUNTIES WHERE THE SIX AFFILIATED HOSPITALS AND GREATEST PATIENT POPULATIONS ARE LOCATED. OTSEGO COUNTY - POPULATION 60,094; DELAWARE COUNTY - POPULATION 45,001; HERKIMER COUNTY - POPULATION 62,240; SCHOHARIE COUNTY - POPULATION 31,420 (ACCORDING TO THE 2017 U.S. CENSUS ESTIMATES).A) O'CONNOR HOSPITAL, A CRITICAL ACCESS HOSPITAL IN DELHI, DELAWARE COUNTYB) THE MARY IMOGENE BASSETT HOSPITAL - AN ACUTE CARE INPATIENT TEACHING FACILITY, AN OUTPATIENT PRIMARY AND SPECIALTY CARE CENTER, A REGIONAL NETWORK OF 34 COMMUNITY BASED OUTPATIENT HEALTH CENTERS, 20 SCHOOL BASED HEALTH CENTERS, TWO AMBULATORY SURGERY CENTERS, AND A FULLY SALARIED MEDICAL STAFF IN COOPERSTOWN, OTSEGO COUNTYC) COBLESKILL REGIONAL HOSPITAL, A CRITICAL ACCESS HOSPITAL IN COBLESKILL, SCHOHARIE COUNTYD) LITTLE FALLS HOSPITAL, A CRITICAL ACCESS HOSPITAL IN LITTLE FALLS, HERKIMER COUNTYE) A.O. FOX HOSPITAL TRI-TOWN CAMPUS, A 24/7 EMERGENCY CARE FACILITY IN SIDNEY, DELAWARE COUNTYF) A.O. FOX MEMORIAL HOSPITAL, AN ACUTE CARE FACILITY IN ONEONTA, OTSEGO COUNTYG) VALLEY HEALTH SERVICES, A RESIDENTIAL HEALTH CARE AND REHABILITATION FACILITYH) AT HOME CARE, A CERTIFIED HOME CARE AGENCYI) FIRST COMMUNITY CARE OF BASSETT, A MEDICAL SUPPLY COMPANY ALL OF THE ABOVE MAKE UP THE BASSETT HEALTHCARE NETWORK AND PROVIDE HEALTH SERVICES TO THIS SEVEN COUNTY REGION IN CENTRAL NEW YORK.

Operating expenses	$ 21,412,724
Total amount spent on community benefits as % of operating expenses	$ 1,727,586 8.07 %