2024-04-29T14:46:30-05:00 2023-06-30 410746749 CLIFTONLARSONALLEN LLP 370 INTERLOCKEN BLVD SUITE 500 BROOMFIELD CO 80021 990 2022-07-01 850220875 LA FAMILIA MEDICAL CENTER LAFA 5059824425 1035 ALTO STREET SANTA FE NM 87501 BRANDY VAN PELT-RAMIREZ CEO 5059824425 2024-04-26 1 BRANDY VAN PELT-RAMIREZ XXX-XX-XXXX 1 SARAH HINTZ P00492291 3034668822 2024-04-26 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z LA FAMILIA HEALTH BRANDY VAN PELT-RAMIREZ 1035 ALTO STREET SANTA FE NM 87501 19245083 0 X WWW.LAFAMILIASF.ORG X 1972 NM PROVIDE EXCELLENT, ACCESSIBLE, FAMILY-CENTERED MEDICAL, DENTAL AND BEHAVIORAL HEALTH CARE. 15 15 224 25 0 0 8397236 9181159 9070003 9959832 81057 -113960 14858 12544 17563154 19039575 801192 1435834 0 0 12370142 13785061 0 0 120317 5016339 5259876 18187673 20480771 -624519 -1441196 7913452 7010501 1579094 1770721 6334358 5239780 X OUR MISSION IS TO FOSTER COMMUNITY WELL-BEING IN PARTNERSHIP WITH OUR PATIENTS BY PROVIDING EXCELLENT, ACCESSIBLE, FAMILY-CENTERED MEDICAL, DENTAL, AND BEHAVIORAL HEALTH CARE. OUR VISION IS "HEALTHY LIVES FOR ALL IN A HEALTHY SANTA FE" (CONTINUED ON SCHEDULE O)AND OUR VALUES ARE COMPASSION, RESPECT, INTEGRITY, QUALITY, ACCOUNTABILITY AND TEAMWORK. 0 0 16115683 1435834 9959832 LA FAMILIA MEDICAL CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) PROVIDING HIGH QUALITY, COMPREHENSIVE, MEDICAL, DENTAL, BEHAVIORAL HEALTH, OBSTETRICS, AND HEALTH EDUCATION SERVICES TO EVERYONE IN THE COMMUNITY, REGARDLESS OF ABILITY TO PAY. 15,218 INDIVIDUAL PATIENTS WERE SERVED IN CALENDAR YEAR 2023 ACROSS ALL SERVICES. THERE WERE 59,421 PATIENT ENCOUNTERS IN 2023 INCLUDING 41,181 IN-CLINIC AND 3,806 VIRTUAL MEDICAL VISITS, 10,922 DENTAL VISITS AND 1,914 IN CLINIC AND 1,598 VIRTUAL BEHAVIORAL HEALTH VISITS.BEHAVIORAL HEALTH SERVICES ARE AVAILABLE TO ALL PATIENTS THROUGH INTERNAL PROVIDER REFERRALS AND ARE A REGULAR PART OF MANY PROGRAM PROTOCOLS. ALL SERVICES ARE OFFERED IN (CONTINUED ON SCHEDULE O)A MANNER THAT IS CULTURALLY SENSITIVE AND RESPECTFUL OF PATIENT RIGHTS, DIGNITY, AND PRIVACY. LA FAMILIA HAS ALSO BEEN RECOGNIZED IN RECENT YEARS AS AMONG THE TOP 30% OF FQHCS NATIONALLY BASED ON QUALITY SCORES. WITHIN THE SERVICE CATEGORIES LISTED ABOVE ARE SUPPORTING PROGRAMS TARGETED TO CARE FOR THE HOMELESS POPULATION IN SANTA FE, MEDICATION ASSISTED TREATMENT FOR INDIVIDUALS WITH A SUBSTANCE USE DISORDER, AND CASE MANAGEMENT AND NAVIGATION SERVICES FOR PATIENTS REQUIRING ASSISTANCE TO IDENTIFY AND ACCESS A RANGE OF SOCIAL SERVICES, ESTABLISH ELIGIBILITY FOR INSURANCE OR OTHER FUNDING SUPPORTS, AND MANAGE THE VARIOUS ELEMENTS OF THEIR CARE. IN ADDITION, LA FAMILIA PROVIDES VACCINES TO AT-RISK POPULATIONS UNDER SEVERAL PROGRAMS THAT ENSURE EVERYONE CAN GET THE VACCINES THEY NEED. INFLUENZA AND PNEUMONIA ARE AMONG THE MOST COMMONLY GIVEN TO PATIENTS. LA FAMILIA PARTICIPATES IN THE VACCINES FOR CHILDREN (VFC) PROGRAM, A TITLE X PROGRAM OFFERED THROUGH THE NEW MEXICO DEPARTMENT OF HEALTH. IN ADDITION TO VFC, TITLE X VACCINES COVER BOTH INFLUENZA AND PNEUMONIA FOR ADULTS, AS WELL AS DIRECT PURCHASE AND ADMINISTRATION SERVICES FOR FLU AND OTHER COMMONLY RECOMMENDED VACCINES FOR SCHOOL, ELDERLY PATIENTS, AND OTHERS.LA FAMILIA PHYSICIANS DELIVERED 169 BABIES. LA FAMILIA OB PATIENTS BENEFIT FROM PRE-NATAL CARE AND COUNSELING, POST-DELIVERY HOSPITAL VISITS (SUSPENDED DURING THE COVID PUBLIC HEALTH EMERGENCY), ACCESS TO BREAST FEEDING ASSISTANCE FROM CERTIFIED LACTATION COUNSELORS, AND THE OPPORTUNITY TO OBTAIN A CAR SEAT FOR THEIR INFANT AT NOMINAL COST, INCLUDING INSTRUCTION AND TRAINING IN ITS USE, THROUGH A CERTIFIED CAR SEAT SAFETY PROGRAM. RELATED WOMEN'S HEALTH SERVICES INCLUDE CONTRACEPTIVE COUNSELING AND SERVICES, INCLUDING ACCESS TO LARCS AT REDUCED COST, AND MEDICALLY INDICATED REFERRALS TO A CONTRACTED OB/GYN SPECIALIST SEVERAL TIMES A YEAR. MEDICATION ASSISTED TREATMENT IS OFFERED WITHIN THE CONTEXT OF A TRADITIONAL PRIMARY CARE PATIENT-PROVIDER RELATIONSHIP AND NOT AS A STAND-ALONE PROGRAM. PATIENTS SIGN A CONTRACT COMMITTING TO THE PLAN OF CARE AND AGREE TO A HIGHLY STRUCTURED SET OF REQUIREMENTS AND TREATMENT GOALS TO MANAGE THEIR SUBSTANCE USE CHALLENGES AND ACHIEVE AND MAINTAIN SOBRIETY. THE PROGRAM HAS SOLID FUNDING SUPPORT FROM FEDERAL, STATE, AND LOCAL GOVERNMENT RESOURCES. PROGRAM SUCCESS OVER THE NINE YEARS OF EXISTENCE INCLUDES NOT JUST THE PRIMARY PATIENT, BUT MAY EXTEND TO PARTNERS AND OTHER FAMILY MEMBERS. OF PARTICULAR NOTE ARE THE NUMEROUS OB PATIENTS WHO ENTER INTO THE PROGRAM TO ACHIEVE SOBRIETY FOR THEMSELVES BUT ALSO TO PREVENT HARM TO THEIR UNBORN CHILD. MANY WOMEN HAVE COME THROUGH THE PROGRAM WHOSE INFANTS HAVE AVOIDED NEONATAL ABSTINENCE SYNDROME BECAUSE THEY WERE SUCCESSFULLY MANAGING THEIR SUBSTANCE USE DISORDER. LA FAMILIA MEDICAL CENTER ALSO HAS AN ACTIVE SYRINGE EXCHANGE PROGRAM WITH FUNDING SUPPORT FROM THE STATE OF NEW MEXICO.DENTAL SERVICES GO WELL BEYOND THE PRIMARILY PREVENTIVE RANGE OF SERVICES REQUIRED OF ALL FQHCS. ADDITIONAL SERVICES INCLUDE FILLINGS, EXTRACTIONS, CROWNS, DENTURES, AND LIMITED ROOT CANALS. LA FAMILIA DENTAL CLINIC IS THE ONLY OPTION FOR MANY RESIDENTS OF SANTA FE COUNTY WHO ARE UNINSURED. THE LA FAMILIA DENTAL CLINIC IS A CODA-ACCREDITED RESIDENCY PROGRAM FOR NYU LANGONE SCHOOL OF DENTISTRY. PATIENT EDUCATION ON A VARIETY OF TOPICS PROVIDES TOOLS TO ASSIST AND TEACH PATIENTS TO MANAGE THEIR OWN CARE MORE EFFECTIVELY. THESE INCLUDE NUTRITION COUNSELING, FOOD SELECTION AND PREPARATION INSTRUCTION BY A LICENSED DIETITIAN, DIABETES MONITORING AND MANAGEMENT PROVIDED BY A CERTIFIED DIABETIC EDUCATOR WITH PHYSICIAN BACKUP AND ASSISTANCE, AND SUPPORT IN ADDRESSING SOCIAL DETERMINANTS OF HEALTH THAT ARE BARRIERS TO BETTER OVERALL HEALTH STATUS. SINCE MARCH 2020, WHEN THE FIRST COVID-19 CASES WERE CONFIRMED IN NEW MEXICO, LA FAMILIA HAS BEEN IN THE FOREFRONT OF THE RESPONSE BY THE CITY OF SANTA FE AND THE MEDICAL COMMUNITY. AS THE LARGEST PRIMARY CARE PRACTICE IN SANTA FE IT WAS IMPORTANT FOR LA FAMILIA TO MAINTAIN SERVICES TO THE EXTENT RESOURCES WOULD PERMIT. IT DID SO BY:- PROVIDING COVID-19 SCREENINGS AND VACCINES, COVID-19 EDUCATION, AND REFERRAL SERVICES. 9% OF THE TOTAL ENCOUNTERS WERE HELD THROUGH TELEMEDICINE ENCOUNTERS AS OF CALENDAR YEAR 2023.- SCREENING AND TEMPERATURE MONITORING OF ALL PATIENTS, STAFF, AND ANY OTHER VISITORS TO LA FAMILIA CLINIC SITES TO MINIMIZE THE CHANCE OF AN INFECTED INDIVIDUAL ENTERING ONE OF THE CLINICS.- SHIFTING A SIGNIFICANT PART OF THE WORKFORCE TO REMOTE WORK TO REDUCE THE NUMBER OF PEOPLE ROUTINELY IN THE CLINICS, INCLUDING NOT JUST ADMINISTRATIVE STAFF BUT SEVERAL MEDICAL ASSISTANTS.- TRAINING STAFF ON PROPER SAFETY PRECAUTIONS TO ENABLE WORKING WITH PATIENTS WHOSE CONDITIONS REQUIRED AN ON-SITE VISIT.- BUILDING UP A STOCKPILE OF PERSONAL PROTECTIVE EQUIPMENT (PPE) OVER TIME.- ENSURING THAT EVERYONE WHO ENTERS A LA FAMILIA CLINIC SITE MUST BE MASKED AT ALL TIMES AND MAINTAIN APPROPRIATE DISTANCING FROM ALL OTHER PEOPLE.- IMPLEMENTING A PHARMACY CALL-IN NUMBER FOR PATIENTS TO CALL WHEN ARRIVING AT THE CLINIC SO THEIR PRESCRIPTION CAN BE BROUGHT OUT TO THEM AT THEIR CAR IN THE PARKING LOT. - LA FAMILIA PROVIDED COVID-19 VACCINATIONS TO EMPLOYEES AND PATIENTS. LA FAMILIA PROVIDED VACCINES TO 1,696 PATIENTS IN CALENDAR YEAR 2023.AS A RESULT, LA FAMILIA MAINTAINED 95% OR HIGHER OF ITS PRE-COVID PATIENT ENCOUNTERS AFTER THE FIRST TWO MONTHS AND CONTINUES TO MAINTAIN BUSY SCHEDULES EVEN AS THE RATE OF COVID INFECTIONS INCLUDING VARIANTS FLUCTUATES IN SANTA FE COUNTY. IN ADDITION, LA FAMILIA WORKED CLOSELY WITH THE CITY OF SANTA FE TO HELP DEVELOP A PLAN TO MOVE AS MANY HOMELESS PEOPLE AS POSSIBLE INTO TEMPORARY SHELTER TO REDUCE THEIR RISK, AND LA FAMILIA ADDED CLINIC OUTREACH SERVICES TO THESE TEMPORARY SITES TO ENSURE RESIDENTS AT THE SHELTERS COULD BE SCREENED REGULARLY AND HAVE A MEDICAL PROFESSIONAL AVAILABLE TO SPEAK TO ABOUT ANY HEALTH CONCERNS. IN SEPTEMBER, 2020, LA FAMILIA OPENED A TEMPORARY DEDICATED TESTING SITE TO ENABLE TESTING AND SCREENING OF POTENTIALLY INFECTED PATIENTS OUTSIDE LA FAMILIA MEDICAL CENTER AND REDUCE THE CHANCE OF AN INFECTED INDIVIDUAL ENTERING THE SPACE WHERE NON-INFECTED PATIENTS ARE COMING FOR THEIR NON-COVID RELATED HEALTH CARE NEEDS. THIS SITE WAS ALSO USED IN COLLABORATION WITH THE NMDOH AS A PUBLIC COVID VACCINATION SITE IN MID-2021 AND WAS CLOSED IN THE FALL 2021. 16115683 1 1 0 0 0 0 0 1 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 31 0 1 224 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 0 0 NM X X X BRANDY VAN PELT 5059824425 1035 ALTO STREET SANTA FE NM 87501 WENDY JOHNSON MD PHYSICIAN 40.00 X 210505 0 16690 SUE KATZ MD MPH PHYSICIAN 40.00 X 199016 0 27176 EMMA GOODSTEIN MD PHYSICIAN 40.00 X 183542 0 30264 LAUREN WALTERSDORF MD CHIEF MEDICAL OFFICER 50.00 X 186168 0 22005 ALICE SHALLCROSS MD PHYSICIAN 40.00 X 187245 0 8395 KRISTINA SINNOTT MD PHYSICIAN 40.00 X 159347 0 31641 JAY JOLLY FACHE CEO (THROUGH FEB. 2023) 50.00 X 153089 0 17055 CECILIA KURZWEG JD GENERAL COUNSEL & COMPLIANCE OFFICER 50.00 X 120352 0 14558 LYDIA GONZALEZ-SCIARRINO CFO 50.00 X 110911 0 10924 JEANELL ABEYTA CAO 50.00 X 106277 0 5931 JULIE WRIGHT CEO (AS OF FEB. 2023) 50.00 X 0 0 0 DEBORAH WEISS PRESIDENT 4.00 X X 0 0 0 PRISCILLA DAKIN VICE PRESIDENT 4.00 X X 0 0 0 RICHARD DEPIPPO TREASURER 4.00 X X 0 0 0 THOMAS OLSON SECRETARY 4.00 X X 0 0 0 JENNIFER BOLEN DIRECTOR 1.00 X 0 0 0 MARIA JOSE RODRIGUEZ CADIZ DIRECTOR 1.00 X 0 0 0 RAMONA FLORES-LOPEZ DIRECTOR 2.00 X 0 0 0 HILARY KILPATRIC DIRECTOR 1.00 X 0 0 0 FRED KULLMAN MD DIRECTOR 2.00 X 0 0 0 MADELAINE LEYBA DIRECTOR 1.00 X 0 0 0 GLORIA MARTINEZ DIRECTOR 1.00 X 0 0 0 DIANA PACHECO DIRECTOR 2.00 X 0 0 0 MARIO PACHECO MD DIRECTOR 1.00 X 0 0 0 SHARON TISON DIRECTOR 2.00 X 0 0 0 ALFREDO VIGIL MD DIRECTOR 1.00 X 0 0 0 1616452 0 184639 30 0 1 0 EDDIE ROSS-RIVERA PO BOX 4356 SANTA FE NM 87502 SECURITY SERVICES 299910 NEW MEXICO CARE PARTNERS 4206 LOUISIANA BLVD NE ALBUQUERQUE NM 87109 ASO AND MSO SERVICES 247526 ECLINICAL WORKS PO BOX 847950 BOSTON MA 02284 EMR 206207 MODY LLC 364 JUNIPER HILL ROAD ALBUQUERQUE NM 87122 ACCOUNTING 109686 4 8601325 579834 142723 9181159 NET PATIENT REVENUE 621110 9085666 9085666 CLINICALLY INTEGRATED 621110 466459 466459 RESIDENCY PROGRAM 621110 235222 235222 INCENTIVE INCOME 621110 172485 172485 9959832 91548 91548 205508 -205508 -205508 -205508 MERCHANT REBATE PMNTS 900099 7944 7944 MEDICAL RECORDS REV. 900099 2533 2533 OTHER REVENUE 900099 2067 2067 12544 19039575 9959832 0 -101416 1435834 1435834 820502 189252 631250 11108324 9264854 1746805 96665 104160 99486 3466 1208 877418 709755 160392 7271 874657 695324 172210 7123 50615 50615 73562 73562 26661 26661 1399038 765429 633609 93667 50163 42606 898 432867 416162 16705 402422 215517 183049 3856 733533 703054 30479 19879 19112 767 37805 36346 1459 2446 2446 582188 167601 414587 102172 98229 3943 MEDICAL SUPPLIES 1090323 1048244 42079 DUES & SUBSCRIPTIONS 209402 201321 8081 FUNDRAISING EXPENSES 3296 3296 20480771 16115683 4244771 120317 748401 315693 540028 1249430 171768 249256 866328 946033 138739 51516 80944 11597 8723156 7921601 1207768 801555 3750163 2981403 240000 240000 169313 164018 7913452 7010501 1503670 1596360 75424 123320 0 51041 1579094 1770721 X 6165045 5126803 169313 112977 6334358 5239780 7913452 7010501 X -1441196 346733 -115 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 X 0 56870 -115 56755 66559 -9689 56870 56277 10282 66559 57732 -1455 56277 58561 -829 57732 0.00000 1.00000 0.00000 1 0 4921643 4461305 460338 3801513 3460296 341217 801555 OPERATING LEASE LIABILITY 51041 51041 X 18657780 346733 600008 -115 946626 17711154 1328421 1328421 19039575 19752358 600008 600008 19152350 1328421 1328421 20480771 PART III, LINE 4: THE ORGANIZATION HOLDS DONATED WORKS OF ART FROM A WELL-KNOWN NEW MEXICO ARTIST'S ESTATE. THE ARTWORK IS DISPLAYED IN THE LOBBY OF ONE OF OUR CLINICS. PART V, LINE 4: THE ORGANIZATION HAS A PERMANENTLY RESTRICTED ENDOWMENT HELD BY THE SANTA FE COMMUNITY FOUNDATION. THE EARNINGS MAY BE USED FOR GENERAL OPERATING SUPPORT. PART X, LINE 2: THE ORGANIZATION HAS PREVIOUSLY RECEIVED NOTICE OF EXEMPTION OF INCOME TAX FROM THE INTERNAL REVENUE SERVICE (IRS) UNDER SECTION 501(C)(3) OF THE FEDERAL INTERNAL REVENUE CODE. THE ORGANIZATION IS NOT A PRIVATE FOUNDATION, AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFY AS CHARITABLE TAX DEDUCTIONS BY THE CONTRIBUTOR. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARDS REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX PROVISIONS. THE IMPLEMENTATION OF THE ACCOUNTING STANDARDS REGARDING UNCERTAIN TAX PROVISIONS HAD NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS OR AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN ASSETS HELD BY SANTA FE COMMUNITY FDTN. -115. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHARITABLE SLIDING FEE ADJUSTMENT 1,328,421. PART XII, LINE 4B - OTHER ADJUSTMENTS: CHARITABLE SLIDING FEE ADJUSTMENT 1,328,421. 1 SLIDING FEE ADJUSTMENTS TO PATIENTS 3955 1328421 0 N/A N/A PATIENT SUPPORT SERVICES 54 107413 0 N/A N PART I, LINE 2: ALL PAYMENTS ON BEHALF OF INDIVIDUALS ARE MADE DIRECTLY TO THE CREDITOR/COMPANY, RATHER THAN TO THE INDIVIDUAL. FORM 990, SCHEDULE I, PART III PATIENTS APPLYING FOR THE SLIDING FEE DISCOUNT PROGRAM MUST SUBMIT AN APPLICATION, IN WRITING, PROVIDING VERIFICATION OF INCOME AND FAMILY SIZE. THE APPLICATION IS AVAILABLE IN ENGLISH OR SPANISH AND REQUESTS INFORMATION DOCUMENTING PATIENT IDENTIFICATION, HOUSEHOLD SIZE, INCOME, AND OTHER INFORMATION TO SUPPORT A DETERMINATION OF ELIGIBILITY FOR DISCOUNTED CARE. PER THE U.S. CENSUS BUREAU, INCOME IS DEFINED AS THE AMOUNT OF MONEY INCOME RECEIVED IN THE PRECEDING CALENDAR YEAR BEFORE PAYMENTS FOR PERSONAL INCOME TAXES, SOCIAL SECURITY, UNION DUES, MEDICARE DEDUCTIONS, AND OTHER ALLOWABLE DEDUCTIONS. "FAMILY SIZE" SHALL BE DETERMINED BY CONSIDERING, AS A GROUP, ANY RELATED OR NON-RELATED INDIVIDUALS LIVING TOGETHER WHOSE PRODUCTION OF INCOME AND CONSUMPTION OF GOODS ARE CO-MINGLED. FOR PURPOSES OF THE SLIDING FEE DISCOUNT PROGRAM, HOWEVER, FAMILY MAY INCLUDE A SINGLE INDIVIDUAL WHO IS COUNTED AS ONE PERSON FOR "FAMILY SIZE." EXAMPLES OF WRITTEN VERIFICATION MAY INCLUDE PRIOR YEAR'S W-2 FORMS, MOST RECENT PAY STUBS FOR THE MONTH, SOCIAL SECURITY ADMINISTRATION AWARD LETTER, PENSION PAY STUBS, UNEMPLOYMENT COMPENSATION AWARD LETTER, CHILD SUPPORT VERIFICATION LETTER, MONTHLY BANK STATEMENTS OR THE PRIOR YEAR INCOME TAX RETURN. PATIENTS PROVIDING THIS LEVEL OF INCOME DOCUMENTATION WILL HAVE THEIR INCOME VERIFIED NO LESS THAN ANNUALLY. THE APPLICATION AND SUPPORTING INFORMATION IS SCANNED INTO THE PATIENT'S INFORMATION FILE. IN THE ELECTRONIC MEDICAL RECORD, AND RETAINED INDEFINITELY. X X X 0 0 0 1 0 1 0 0 0 WENDY JOHNSON MD PHYSICIAN 209863 0 642 0 0 0 6411 0 10279 0 227195 0 0 0 SUE KATZ MD MPH PHYSICIAN 197784 0 1232 0 0 0 6195 0 20981 0 226192 0 0 0 EMMA GOODSTEIN MD PHYSICIAN 177712 0 872 0 4958 0 3864 0 26400 0 213806 0 0 0 LAUREN WALTERSDORF MD CHIEF MEDICAL OFFICER 185664 0 504 0 0 0 4954 0 17051 0 208173 0 0 0 ALICE SHALLCROSS MD PHYSICIAN 166644 0 20601 0 0 0 0 0 8395 0 195640 0 0 0 KRISTINA SINNOTT MD PHYSICIAN 157535 0 1812 0 0 0 5021 0 26620 0 190988 0 0 0 JAY JOLLY FACHE CEO (THROUGH FEB. 2023) 152981 0 108 0 0 0 0 0 17055 0 170144 0 0 0 PART I, LINE 5 LA FAMILIA MEDICAL CENTER HAS A BONUS COMPENSATION ARRANGEMENT WITH THE CEO BASED ON MULTIPLE FACTORS THAT INCLUDED (A) DEVELOPING A PLAN TO PARTICIPATE IN A NMPCA-SPONSORED CLINICALLY INTEGRATED NETWORK, (B) IMPROVEMENTS IN FINANCIAL PERFORMANCE, INCLUDING REVENUES AND NET INCOME, (C) OPERATIONAL IMPROVEMENTS, AND (D) IMPROVEMENTS IN SPECIFIC PATIENT SERVICE QUALITY METRICS. PART I, LINE 6 SEE PART I, LINE 5 NARRATIVE. ANDREW ABEYTA SON OF JEANELL ABEYTA, CHIEF ADMINISTRATIVE OFFICER 55598 EMPLOYEE COMPENSATION 0 X 1 142723 FMV 0 0 1 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTORS IN PART I COLUMN (B). FORM 990, PART VI, SECTION A, LINE 1A THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE THAT CONSISTS OF THE OFFICERS OF THE BOARD AND ONE OTHER DIRECTOR. THE EXECUTIVE COMMITTEE ACTS AS THE LIAISON WITH THE CEO; SETS THE AGENDA FOR MEETINGS OF THE BOARD OF DIRECTORS; ADVISES AND ASSISTS THE BOARD IN MATTERS RELATED TO THE SELECTION, EVALUATION, AND TERMINATION OR DISMISSAL OF THE CEO AND THE COMPLIANCE OFFICER; AND ADVISES AND ASSISTS THE BOARD IN POLICIES AND MATTERS RELATED TO PERSONNEL AND HUMAN RESOURCES, EXCEPT THOSE RELATED TO EMPLOYEE COMPENSATION AND SALARY AND BENEFITS SCALES. THE BOARD MAY, FROM TIME TO TIME, SPECIFY MATTERS ON WHICH THE EXECUTIVE COMMITTEE MAY ACT BETWEEN MEETINGS OF THE BOARD. THE EXECUTIVE COMMITTEE RECORDS ALL ACTIONS TAKEN AND REPORTS BACK TO THE BOARD AT ITS NEXT REGULAR MEETING. THE BOARD MAY NOT DELEGATE ANY OF THE FOLLOWING MATTERS TO THE EXECUTIVE COMMITTEE: AMENDING, ALTERING OR REPEALING THE BYLAWS; ELECTING, APPOINTING OR REMOVING ANY MEMBER OF ANY COMMITTEE OR ANY DIRECTOR OR OFFICER; AMENDING OR RESTATING THE ARTICLES OF INCORPORATION; ADOPTING A PLAN OF MERGER OR A PLAN OF CONSOLIDATION; AUTHORIZING THE SALE, LEASE, EXCHANGE OR MORTGAGE OF ALL OR SUBSTANTIALLY ALL OF THE ORGANIZATION'S PROPERTY AND ASSETS; AUTHORIZING THE VOLUNTARY DISSOLUTION OF THE ORGANIZATION OR REVOKING PROCEEDINGS THEREOF; ADOPTING A PLAN FOR THE DISTRIBUTION OF THE ORGANIZATION'S ASSETS; OR AMENDING, ALTERING OR REPEALING ANY RESOLUTION OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY A THIRD PARTY PREPARER. IT WAS THEN REVIEWED BY THE CEO AND FINANCE DIRECTOR OF THE ORGANIZATION WITH A SECONDARY REVIEW BEING DONE BY THE AUDIT COMMITTEE. IT WAS THEN DISTRIBUTED TO THE BOARD OF DIRECTORS FOR A FINAL REVIEW AND APPROVAL BY THE BOARD PRIOR TO BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ALL DIRECTORS AND SUCH MANAGEMENT PERSONNEL AS MAY BE DESIGNATED BY THE BOARD MUST SIGN A CONFLICT OF INTEREST POLICY AND DISCLOSURE STATEMENT AT THE TIME OF ELECTION OR EMPLOYMENT, AND ANNUALLY THEREAFTER, DISCLOSING ANY SITUATION IN WHICH THEY ARE INVOLVED WHICH COULD BE CONSTRUED AS PLACING THEM IN A POSITION OF HAVING A CONFLICT OF INTEREST WITH LA FAMILIA MEDICAL CENTER AS A CORPORATE ENTITY. IN THE EXERCISE OF VOTING RIGHTS BY THE BOARD OF DIRECTORS OF THE CORPORATION, NO INDIVIDUAL MAY VOTE ON ANY ISSUE, MOTION OR RESOLUTION WHICH INURES TO HIS/HER BENEFIT OR HIS/HER IMMEDIATE FAMILY'S BENEFIT, FINANCIALLY OR OTHERWISE, EXCEPT THAT SAID INDIVIDUAL MAY BE COUNTED IN ORDER TO ESTABLISH A QUORUM AND MAY PARTICIPATE, AT THE DISCRETION OF THE REMAINING DIRECTORS THERE PRESENT, IN THE DISCUSSION OF SUCH ISSUE, MOTION OR RESOLUTION. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS CONDUCTS THE CEO'S REVIEW. THE CEO PERFORMS THE SALARY REVIEWS FOR ALL OTHER OFFICERS AND PROGRAM MANAGERS. THE COMPENSATION IS BASED ON EXPERIENCE AND MARKET DATA FOR COMPARABLE POSITIONS IN THE REGION. THIS PROCESS WAS LAST COMPLETED IN 2023. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FORMS 990 ARE AVAILABLE UPON REQUEST, THE ORGANIZATION'S OWN WEBSITE, ONLINE AT WWW.GUIDESTAR.ORG AND ON THE NEW MEXICO ATTORNEY GENERAL'S WEBSITE. THE ORGANIZATION'S FORM 1023 IS AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 LA FAMILIA MEDICAL CENTER INCLUDES THE YEAR-END AUDITED FINANCIAL STATEMENTS ON ITS WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST AT THE ADMINISTRATION BUILDING. FORM 990, PART XI, LINE 9: CHANGE IN BENEFICIAL INTEREST IN ASSETS HELD BY SANTA FE COMMUNITY FDTN. -115. FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.