2024-07-16T00:14:16-05:00 2021-12-31 850203431 REDW LLC 8801 Horizon Blvd NE Suite 401 Albuquerque NM 87113 990 2021-01-01 850313268 Rehoboth McKinley Christian Healthcare Services REHO 5058637000 1901 Red Rock Drive Gallup NM 87301 Chris Dover CFO 5058637000 2024-07-11 1 Chris Dover 999009999 Jamie S Fridley CPA P00380605 5059983200 2024-07-11 0 AAL1 IAL1 2021 2023-04-26 12:10:37Z Don Smithburg 1901 Red Rock Drive Gallup NM 87301 70425107 0 X www.rmch.org X 1985 NM REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES, INC. (RMCHCS) WILL BE THE PREFERRED HEALTH CARE PROVIDER ORGANIZATION FOR MCKINLEY COUNTY AND THE SURROUNDING COMMUNITIES. RMCHCS WILLBE RESPONSIVE TO THE HEALTHCARE NEEDS OF THE ENTIRE COMMUNITY. RMCHCS IMPROVING FINANCIAL AND OPERATIONAL PERFORMANCE WHILE SOLIDIFYING OURSELVES AS AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. WE WILL BE DISTINGUISHED BY:1) DEMONSTRATED QUALITY, CUSTOMER SERVICE, AND VALUE,2) SUPERIOR ACCESS,3) CLINICAL SPECIALTY SERVICES,4) STRONG HUMAN AND TECHNOLOGICAL RESOURCES, AND5) A MULTI-CULTURAL ORIENTATION. 9 7 700 0 0 0 21799240 3401966 57806002 67409201 25876 56033 4039193 -452425 83670311 70414775 9122 0 0 0 38189404 44793011 0 0 0 40141680 37738225 78340206 82531236 5330105 -12116461 42937497 34587674 26141459 29239884 16796038 5347790 X REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES, INC. (RMCHCS) WILL BE THE PREFERRED HEALTH CARE PROVIDER ORGANIZATION FOR MCKINLEY COUNTY AND THE SURROUNDING COMMUNITIES. RMCHCS WILLBE RESPONSIVE TO THE HEALTHCARE NEEDS OF THE ENTIRE COMMUNITY. RMCHCS IMPROVING FINANCIAL AND OPERATIONAL PERFORMANCE WHILE SOLIDIFYING OURSELVES AS AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. WE WILL BE DISTINGUISHED BY:1) DEMONSTRATED QUALITY, CUSTOMER SERVICE, AND VALUE,2) SUPERIOR ACCESS,3) CLINICAL SPECIALTY SERVICES,4) STRONG HUMAN AND TECHNOLOGICAL RESOURCES, AND5) A MULTI-CULTURAL ORIENTATION. 0 0 49360073 37631959 Hospital inpatient services include a medical surgical unit, women's health, pediatric and newborn nursery units, intensive and critical care units, and an inpatient dialysis unit. Hospital ancillary services include a cardiopulmonary rehabilitation unit, diagnostic imaging and laboratory services, as well as physical surgical services unit and the emergency department. 5583050 22905570 Provides primary care services to patients through multi-specialty clinics. 199395 1145279 Behavioral health services offers high quality, comprehensive behavioral healthcare to those of all races who need it. We believe in a humanistic approach that meets the individual needs of clients and their families with a spirit of dignity and confidentiality. 1395763 5726393 Home health is interim care to help patients transition from an acute illness to care at home. During the episode of the care, home health staff provide care for patients with a disease or long-term health issues. Hospice is a program for patients who have terminal illness. The program provides support and guidance to the end of life patients. Staff members see an average of five patients a day, with care focused on the family. The home care service area covers a distance of about 30 miles in all directions surrounding Gallup. 1395763 5726393 56538281 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 0 0 0 1 109 0 1 700 1 0 0 0 0 0 0 0 0 0 0 X 9 7 0 1 0 0 0 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 NM X The Organization 5058637000 1901 Red Rock Drive Gallup NM 87301 Laura Hammons MD Trustee 1.00 X 0 0 0 Pastor John Luginbuhl Trustee 1.00 X 0 0 0 Klo Abeita Trustee 1.00 X 0 0 0 Brian Money Trustee 1.00 X 0 0 0 Cynthia Poblano Trustee 1.00 X 0 0 0 Sara Saucedo Trustee 1.00 X 0 0 0 Ayodele Erinle MD Trustee 1.00 X 0 0 0 George Munoz Trustee 1.00 X 0 0 0 Reverend Lorelei Kay Trustee 1.00 X 0 0 0 David Dallago Trustee 1.00 X 0 0 0 Michael S Nye COO 40.00 X 60712 0 197 Mary K Bevier CFO 40.00 X 159903 0 0 Adrienne Patel CQO 40.00 X 143459 0 19500 Don Smithburg CEO 40.00 1.00 X 0 0 0 Rebecca Martell CHRO 40.00 X 106623 0 1760 JOHN YORK Orthopedic Surgeon 40.00 X 592307 0 0 CHARLES J S GUIMARAES General Surgeon 40.00 X 536330 0 26000 BRANDON MURGUIA Physician Intensivist 40.00 X 369982 0 0 VALORY WANGLER Physician Residency Program 40.00 X 344513 0 19500 NEIL JACKSON Physician 40.00 X 323867 0 19500 Mary L Poel Physician 40.00 X 163375 0 0 Christopher Gonzaga Physician 40.00 X 209511 0 0 3010582 0 86457 65 0 1 0 TRS Managed Services PO Box 6419 Siloam Springs AR 72761 Medical Services 4507982 American Physician Partners 5121 Maryland Way Brentwood TN 37027 Medical Services 1523330 Community Hospital Consulting 7950 Legacy Dr STE 1000 Plano TX 75024 Staff/ Consulting 700754 Pinpoint HC Holdings LLC 1200 E Collins Blvd Richardson TX 75081 Medical Services 592688 High Desert Surgery 1514 Plateau Dr Gallup NM 87301 Medical Services 415952 23 111499 3153246 137221 3401966 Net Patient Service Revenue 621110 57622454 57622454 Other Operating Revenue 621110 9528423 9528423 Medical Office Rental Revenue 531120 258324 258324 67409201 66365 66365 10332 -10332 -10332 -10332 Investment in Risk Retention Grou 900099 -452425 -452425 -452425 70414775 67409201 0 -396392 X 2903959 2302558 601401 37261226 29544546 7716680 2355806 1960965 394841 2272020 1891221 380799 714692 382096 332596 47892 25605 22287 16226245 8675042 7551203 421509 121863 299646 834392 241232 593160 430859 124566 306293 4143465 1197922 2945543 354973 102627 252346 385544 55679 329865 1895236 1129078 766158 956881 276645 680236 Supplies & Pharmaceutic 8970901 7825595 1145306 Other Taxes 1055326 305107 750219 Repairs & Maintenance 1032346 298463 733883 Bank Fees 150782 43593 107189 117182 33878 83304 82531236 56538281 25992955 0 5242242 1062907 10032609 5731871 529 9749856 9645225 1121106 1440932 1347137 423433 657743 68990794 56303631 12328843 12687163 2404281 1265974 50000 50000 1264772 1018548 42937497 34587674 12285842 12474006 3053246 3289642 5008640 8699176 5793731 4777060 26141459 29239884 X 16670825 4679331 125213 668459 16796038 5347790 42937497 34587674 -12116461 668213 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 788219 788219 32316769 27465179 4851590 1989226 1877539 111687 33889859 26960913 6928946 6721 6721 12687163 Estimated Amount Due to Third Party 3758512 Deferred Comp Liability 1018548 4777060 X 70414775 0 70414775 0 70414775 82531236 0 82531236 0 82531236 Part X, Line 2: The Hospital and the Foundation have been recognized as exempt from income taxes under Section 501 of the Internal Revenue Code and a similar provision of state law. However, the entities are subject to federal income tax on any unrelated business taxable income. The Hospital and the Foundation file an exempt organization return, and if applicable, unrelated business income tax or other returns with U.S. Internal Revenue Service, New Mexico Attorney General and New Mexico Department of Taxation and Revenue. The Hospital and Foundation are no longer subject to income tax examinations by taxing authorities for years before fiscal year 2018 for its federal and state filings. 1 1 X 1 X 300.000000000000 1 X 500.000000000000 1 1 0 0 425030 425030 0.00510 28691519 17370902 11320617 0.13720 29116549 17370902 11745647 0.14230 145800 145800 0.00180 345743 315121 30622 0.00040 491543 315121 176422 0.00220 29608092 17686023 11922069 0.14450 1 528233 211294 13337785 19998638 -6660853 X 1 1 1 1 RMCHCS HOSPITAL 1901 Red Rock Drive Gallup NM 87301 RMCH.ORG 6267 X X X RMCHCS HOSPITAL 0 0 1 X X X X X X X X X 19 1 0 0 1 X HTTP://WWW.RMCH.ORG/GETPAGE.PHP?NAME=COMMUNITY_HEALTH_NEEDS X 1 20 1 HTTP://WWW.RMCH.ORG/GETPAGE.PHP?NAME=COMMUNITY_HEALTH_NEEDS 0 1 X 300.000000000000 500.000000000000 X X X 1 1 X X X 1 X HTTP://WWW.RMCH.ORG/GETPAGE.PHP?NAME=FINANCIAL_SERVICES&SUB=OUR%20SERVICES X HTTP://WWW.RMCH.ORG/GETPAGE.PHP?NAME=FINANCIAL_SERVICES&SUB=OUR%20SERVICES X HTTP://WWW.RMCH.ORG/GETPAGE.PHP?NAME=FINANCIAL_SERVICES&SUB=OUR%20SERVICES X X X X X X X 1 X 0 X X X X 1 X 0 0 RMCHCS HOSPITAL Part V, Section B, Line 3j: REPRESENTATIVES OF THE COMMUNITY:OVER ONE HUNDRED PRIMARY SOURCES WERE INTERVIEWED AND EIGHT FOCUS GROUPS SESSIONS WERE CONDUCTED WITH A RANGE OF COMMUNITY STAKEHOLDERS FOR THIS REPORT. THESE INCLUDED; HEALTHCARE PROVIDERS, SOCIAL SERVICE PROVIDERS, GOVERNMENTAL AGENCY REPRESENTATIVES, EDUCATORS, COUNSELORS, COMMUNITY ACTIVISTS, ADVOCACY GROUPS, COALITIONS, CLIENTS AND PATIENTS. MANY NATIVEAMERICANS AS WELL AS OTHER ETHNIC GROUPS WERE INCLUDED, WITH PRIMARY PARTICIPATION FROM THE NAVAJO NATION AND PUEBLO OF ZUNI, THE TWO TRIBAL ENTITIES WHO MAKE UP THE MAJORITY OF THIS NATIVE AMERICAN POPULATION IN MCKINLEY COUNTY.PERSONS THE HOSPITAL CONSULTED: (THESE ARE FOLKS THAT WERE CONSULTED FOR THE 2019 NEEDS ASSESSMENT)THERESA ALONZO, ADMINISTRATIVE SPECIALIST, GALLUP HEAD START PROGRAMSHANA ARVISO, INVESTIGATION CASE WORKER PROTECTIVE SERVICES, CHILDREN, YOUTH & FAMILIES DEPARTMENTKATHERINE BABCOCK, COUNSELOR, OFF BROADWAY FAMILY OUTREACHADRIAN BALBOA, EXECUTIVE DIRECTOR, STRONG FAMILIES NEW MEXICO-GALLUPLISA BLANCO, TITLE 1 COORDINATOR, MCKINNEY-VENTO LIAISON FOR HOMELESSSTUDENTS, GALLUP MCKINLEY COUNTY PUBLIC SCHOOLSWILLIAM CAMAROTA, AFTERCARE WORK PROGRAM, WELLSPRING RECOVERY CENTER, RMCHCSJASON CARLISLE, FIRE CHIEF, MCKINLEY COUNTY FIRE AND EMSMARIA CASSIDY BEGAY, NEW MEXICO BREASTFEEDING TASK FORCEPAUL CHARLTON MD, EMERGENCY DEPARTMENT PHYSICIAN, GALLUP INDIAN MEDICALCENTER (GIMC)BEN CHAVEZ, HEARING AUTHORITY/ATHLETIC DIRECTOR, GALLUP MCKINLEY COUNTYPUBLIC SCHOOLSBRITTANY CHIAPETTI, MCKINLEY COUNTY COORDINATOR, SNAPS SA COMMUNITYSERVICES DEPARTMENTMARK CLARK, HEALTH PROMOTION TEAM, NEW MEXICO DEPARTMENT OF HEALTHLARRY CURLEY, DIRECTOR OF PROGRAM DEVELOPMENT, RMCHCSJULIANA DOOLEY, COORDINATOR, RMCHCS BEHAVIORAL HEALTH COLLABORATIVEWILLARD EASTMAN, EXECUTIVE DIRECTOR, BATTERED FAMILIES & MY SISTER'SHOUSEKEVIN FOLEY, PHD, EXECUTIVE DIRECTOR, NA'NIZHOOZHI CENTER, GALLUP DETOXCENTERMYRA FRANCISCO, INDIAN HEALTH SERVICE/CENTER FOR DISEASE CONTROL, JOHNSHOPKINS - NAVAJO BIRTH COHORT STUDYMARY GAUL, HEALTH EDUCATION SPECIALIST, COMMUNITY OUTREACH PATIENTEMPOWERMENT (COPE)CHRISTOPHER GONZAGA MD, INTERNAL MEDICINE, INFECTIOUS DISEASES PHYSICIAN,RMCHCSNAOMI GREEN, EPIDEMIOLOGY, NEW MEXICO DEPARTMENT OF HEALTH, ALCOHOLOUTLET DENSITY STUDYREBA GROTEN, DIRECTOR, PUBLIC HEALTH NURSES, GIMCERIKA HAYES, BSW, LMSW, MAIS, PHD, TREATMENT PROGRAM MANAGER, MCKINLEYCOUNTY ADULT DETENTION CENTERTHOMAS HERR MD, PEDIATRICIAN RMCHCSCOLLEEN HOSKIE, HEALTH PROMOTION SPECIALIST, GIMCCHRISTOPHER HUDSON, COORDINATOR, MCKINLEY COUNTY HEALTH ALLIANCEREGINA HUFFMAN, DIRECTOR, AVENUES EARLY CHILDHOOD SERVICESHANK HUGHES, EXECUTIVE DIRECTOR, NEW MEXICO COALITION TO END HOMELESSNESSMIKE HYATT, SUPERINTENDENT, GALLUP MCKINLEY PUBLIC SCHOOLSMARY IPPEL RN, LABOR & DELIVERY, OB-GYN RMCHCSRACHAEL KILGORE LPCC, MENTAL HEALTH THERAPIST, SEXUAL ASSAULT SERVICES OFNORTHWEST NEW MEXICOGAYLA KOFLER RN, CASE MANAGER/NURSE NAVIGATOR RMCHCSTERRI LAUGHLIN, PFCE SPECIALIST, GALLUP HEAD START PROGRAMLAURA LESLIE, COMMUNITY JUSTICE WORKER, NEW MEXICO LEGAL AID, MCKINLEYCOUNTYMARY LINDENMEYER, COORDINATOR OF COUNSELING, MEDIA & HEALTH SAFETY,GALLUP MCKINLEY COUNTY PUBLIC SCHOOLSSHERYL LIVINGSTON LADAC, LPCC, BEHAVIORAL HEALTH SPECIALIST, EMERGENCYDEPT. GIMCELSA LOPEZ, PROGRAM MANAGER, SOMOS UN PUEBLO UNIDOYVONNE MANDAGARAN LPCC, COORDINATOR RMCHCS OUTPATIENT BEHAVIORAL HEALTHSERVICESKATRINA MARTI, CASE MANAGER, TREATMENT PROGRAM, MCKINLEY COUNTY ADULTDETENTION CENTERSTELLA ELISE MARTIN, DIRECTOR, FIRST NATIONS HEALTH CLINICBERNICE MARTINEZ, ADMINISTRATIVE DIRECTOR, RMCHCS WELLSPRING RECOVERYCENTERDEBORAH MARTINEZ, BEHAVIORAL HEALTH PROGRAM MANAGER, BEHAVIORAL HEALTHINVESTMENT ZONE, CITY OF GALLUPJASON MARTINEZ, STATISTICIAN, NEW MEXICO HUMAN SERVICES DEPARTMENTBEHAVIORAL HEALTH SERVICESWILLIAM MCCARTHY, EXECUTIVE DIRECTOR, SOUTHWEST INDIAN FOUNDATIONBRIAN MCPHEE MD, PSYCHIATRIST, GALLUP INDIAN MEDICAL CENTERJERRY MONTOYA, NEW MEXICO DEPARTMENT OF HEALTH-HEALTH PROMOTIONRACHELLE MORRIS PHN, PUBLIC HEALTH NURSE TOHATCHI, INDIAN HEALTH SERVICESBEATRICE NUNUZ RN, LABOR & DELIVERY, OB-GYN, RMCHCSCHRISTINA NYE, GUIDANCE COUNSELOR, GALLUP MCKINLEY COUNTY PUBLIC SCHOOLSALICE PEREZ, EXECUTIVE DIRECTOR, COMMUNITY PANTY, GALLUP AND GRANTSMARILEE PETRONOVICH, SENIOR PUBLIC RELATIONS SPECIALIST, UNIVERSITY OFNEW MEXICO, GALLUPCURTIS PHILLIPS, EXECUTIVE DIRECTOR, HOZHO CENTERJEAN PHILLIPS, DIRECTOR, NEW MEXICO LEGAL AID, MCKINLEY COUNTYKRISTEN PIKAART, CHAPLAIN RMCHCSSARA PIKAART RN, LABOR & DELIVERY, OB-GYN RMCHCSJOHN RATMEYER MD, PEDIATRICS, GIMCCHARLES READO, MANAGER, COUNTY OF PROTECTIVE SERVICES, NEW MEXICOCHILDREN, YOUTH AND FAMILIESOPHELIA REEDER, EXECUTIVE DIRECTOR, RMCHCS WELLSPRING RECOVERY CENTERNATALIE RIVERA, PROGRAM MANAGER, BEHAVIORAL HEALTH PLANNING COUNCIL,STATE OF NEW MEXICOCOLLEEN ROAN, DIRECTOR, GROWING IN BEAUTY/HOZHOGO JINOOSEE, EARLYCHILDHOOD INTERVENTION FOR CHILDREN WITH DISABILITIESANNA RONDON, EXECUTIVE DIRECTOR, NEW MEXICO SOCIAL JUSTICE & EQUITYINSTITUTE, MCKINLEY COLLABORATIVE FOR HEALTH EQUITYSOFIA RUBAII MD, EMERGENCY DEPARTMENT, GIMCERICK SANDERS, ASSISTANT, STORY GARDEN PROJECT, ATD FOURTH WORLDMAURA SCHANEFELT, EXECUTIVE DIRECTOR, MCKINLEY COUNTY DWI PROGRAMWILLIAM SHUNKAMOLOA PHD, THERAPIST/DIRECTOR 4-DIRECTIONS BEHAVIORALHEALTH SERVICES, GIMCHELEN SILVA RN, HEALTH SPECIALIST, GALLUP HEAD START PROGRAMSAVANAH SIX MPH, MSPI, HPDP, SPECIALIST/MANAGER, METHAMPHETAMINE &SUICIDE PREVENTION INTERVENTION GIMCTINA SPENCER, INTAKE COORDINATOR, RMCHCS WELLSPRING RECOVERY CENTERKAREN STORNELLI, DIRECTOR, STORY GARDEN PROJECT, ATD FOURTH WORLDPHRIYA SUDARSANAM, DIRECTOR, AVENUES EALLY CHILDHOOD SERVICESEMERSON TOLEDO, HEALTH PROMOTION SPECIALIST, BLUE CROSS BLUE SHIELD OFNEW MEXICOLAURA TOMEDI MD, ALCOHOL EPIDEMIOLOGIST, NEW MEXICO DEPARTMENT OF HEALTHVALORY WANGLER MD, CHIEF MEDICAL OFFICER RMCHCSGERALD WATCHMAN, CLINICAL DIRECTOR, RMCHCS WELLSPRING RECOVERY CENTERJENNIE WEI MD INTERNAL MEDICINE, ALCOHOL TASK FORCE, GIMCGRETCHEN WOODS NP, APN, THERAPIST, OUTPATIENT BEHAVIORAL HEALTH, RMCHCS RMCHCS HOSPITAL Part V, Section B, Line 11: NEEDS ADDRESSED AND NOT ADDRESSED:THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED THE FOLLOWING PRIORITY COMMUNITY HEALTH CONCERNS FOR MCKINLEY COUNTY:- SUBSTANCE ABUSE-ALCOHOL AND OPIODS- SOCIAL AND ENVIRONMENTAL CONDITIONS-POVERTY, ECONOMIC EQUITY, EMPLOYMENT, HOUSING, ACCESS TO SERVICES, TRANSPORTATION AND SAFETY- EDUCATION-EARLY EDUCATION, EARLY INTERVENTION, ELEMENTARY EDUCATION, MIDDLE SCHOOL, HIGH SCHOOL, HIGHER EDUCATION, CAREER TRAINING, MEDICALEDUCATION- COLLABORATION AND COMMUNICATION- REPRODUCTIVE HEALTHRMCHCS IS ADDRESSING A NUMBER OF THE PRIORITIES FOUND IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENTS, EITHER THROUGH ITS OWN PROGRAMS OR BY SUPPORTING COMMUNITY-WIDE EFFORTS TO ADDRESS ISSUES. RMCHCS FOCUS IS ON PRIMARY AND SPECIALTY MEDICAL CARE SERVICES AND BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDERS SERVICES. SUBSTANCE ABUSE IS A SIGNIFICANT HEALTH ISSUE IN THIS REGION. RMCHCSCONTINUED TO GROW ITS RESIDENTIAL ALCOHOL AND SUBSTANCE USE DISORDERTREATMENT PROGRAM AT WELLSPRING RECOVERY CENTER AND FURTHER DEVELOP ITSAFTERCARE PROGRAM. IN 2019 WELLSPRING GREW ITS CAPACITY TO 69 BEDS FORADULT MEN AND WOMEN AND WORKED TO ACHIEVE ACCREDITATION FROM THECOMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES (CARF). THIS WASACHIEVED IN 2020. RMCHC HAS AN AGREEMENT WITH THE MCKINLEY COUNTY DRUGCOURT TO PROVIDE EARLY INTERVENTION FOR OFFENDERS THROUGH THE INTENSIVEOUTPATIENT PROGRAM. IN 2019 RMCHCS RECEIVED A PLANNING GRANT FOR OPIOIDTREATMENT AND WE CONTINUE PROVIDING EDUCATION TO ITS PROVIDERS IN ORDERTO GROW THIS SERVICE AT RMCHCS. IN 2020, AT A COMMUNITY LEVEL, RMCHCSPARTICIPATED IN THE COMMUNITY ALCOHOL TASK FORCE WHICH ADDRESSES MEDICALDETOX AND ESTABLISHES A STANDARDIZED PROCESS FOR ALL HOSPITALS, CLINICSAND PROVIDERS. WE RECEIVED A PSYCHIATRY RESIDENCY PROGRAM GRANT AND AREEXPLORING ESTABLISHING A PROGRAM IN PARTNERSHIP WITH A UNIVERSITYPROGRAM.SOCIAL AND ENVIRONMENTAL CONDITIONS: THIS AREA COVERS A WIDE RANGE OFISSUES FROM POVERTY, ECONOMIC EQUALITY, EMPLOYMENT, HOUSING, ACCESS TOSERVICES, TRANSPORTATION ETC. RMCHCS IS A PARTICIPANT IN COMMUNITYEFFORTS TO DEAL WITH HOUSING ISSUES FOR HOMELESS INDIVIDUALS, INPARTICULAR A HOUSING FIRST PROGRAM FOR CHRONICALLY HOMELESS INDIVIDUALS.RMCHCS IS AN ACTIVE PARTICIPANT IN A COMMUNITY GROUP MADE UP OFREPRESENTATIVES FROM THE CITY OF GALLUP, MCKINLEY COUNTY, NEW MEXICODEPARTMENT OF HEALTH AND HUMAN SERVICES AND GIMC THAT DEVELOPED A MOTEL RESPIRATORY PROGRAM FOR UNSHELTERED INDIVIDUALS NEEDING A SAFE PLACE TOQUARANTINE AND RECOVER FROM COVID-19. THE GALLUP HOTEL/MOTEL ISOLATIONPROGRAM OPENED IN MARCH 2020 AND PROVIDED COVID/ISOLATION/QUARANTINE FOROVER 1,675 INDIVIDUALS. RMCHCS PROVIDED MEDICAL OVERSIGHT FOR INDIVIDUALSTHAT WERE REFERED TO THE PROGRAM.ACCESS TO MEDICAL CARE IS ONE OF RMCHCS' FOCUS AREAS. RMCHCS HASINCREASED ACCESS TO SERVICES BY OPENING AN URGENT CARE CENTER ANDDEVELOPING A MOBILE HEALTH CLINIC PROGRAM. IN 2020 RMCHCS POSTPONEDWOMEN'S HEALTH SERVICES THROUGH ITS MOBILE HEALTH UNIT DUE TO THEPANDEMIC.RMCHCS' FAMILY MEDICINE RESIDENCY PROGRAM ADDRESSES THE NEED FOR MOREPRIMARY CARE PROVIDERS IN THE REGION AND ACCESS TO CARE. IN 2019 THEPROGRAM ACHIEVED ACCREDITATION AS A SPONSORING INSTITUTION AND IN 2020 ITACHIEVED ACCREDITATION FOR THE PROGRAM. THE PROGRAM BEGAN IN JULY 2021WITH THE INTAKE OF ITS FIRST FOUR RESIDENTS. PALLIATIVE CARE, A SPECIFICNEED MENTIONED IN THE COMMUNITY NEEDS ASSESSMENT, IS INCLUDED AS ARESIDENCY PROGRAM ROTATION. RMCHCS CONTINUES TO RECRUIT ADDITIONALPROVIDERS TO INCREASE ACCESS TO CARE AND IN 2020 IT ADDED TWOHOSPITALISTS, 1 OB/GYN, AND 2 ORTHOPEDISTS. RMCHCS BROUGHT IN NEWSERVICES SUCH AS HAND AND SPINE CARE AND STABILIZED ITS WOMEN'S HEALTH,PODIATRY, AND WOUND CARE PROGRAMS IN 2020. RMCHCS HAS BEGUN TO USE MORETELEMEDICINE AND WILL BE FURTHER DEVELOPING THAT PROGRAM TO INCREASEACCESS TO CARE. EDUCATION: AS A HEALTHCARE SYSTEM, RMCHCS' INVOLVEMENT IN EDUCATION ISFOCUSED ON HIGHER EDUCATION AND GRADUATE EDUCATION. RMCHCS WILL CONTINUETO STRENGTHEN ITS CONNECTION WITH UNIVERSITY OF NEW MEXICO (UNM),GALLUP'S NURSING PROGRAM AS WELL AS OTHER HEALTH-RELATED PROGRAMS ANDPROVIDE LEARNING OPPORTUNITIES FOR STUDENTS. RMCHCS PROVIDESOPPORTUNITIES FOR COLLEGE STUDENTS WHO ARE IN THE UNM BA/MD PROGRAM ANDMEDICAL STUDENTS FROM VARIOUS INSTITUTIONS TO WORK WITH OUR MEDICALSTAFF. RMCHCS NOW SERVES AS A PRIMARY "HUB" FOR BURELL COLLEGE OFMEDICINE IN LAS CRUCES, NM, MARKED BY INCREASING MEDICAL STUDENTENGAGEMENT IN THE COMMUNITY. WITH THE ADDITION OF THE FAMILY MEDICINERESIDENCY PROGRAM, RMCHCS IS ALSO LOOKING INTO CONNECTING WITH MIDDLESCHOOL AND HIGH SCHOOL STUDENTS TO ENCOURAGE THEM TO CONSIDER A CAREER INMEDICINE. RMCHCS ALSO HAS A ROBUST CONTINUING MEDICAL EDUCATION PROGRAMTHAT PROVIDES TRAININGS FOR CLINICAL STAFF AND PHYSICIANS BEYOND RMCHCS.COLLABORATION AND COMMUNICATION: RMCHCS IS INVOLVED IN A NUMBER OFHEALTH-RELATED COLLABORATIVE COMMITTEES AND GROUPS THAT ADDRESS VARIOUSCOMMUNITY HEALTH NEEDS. RMCHCS COLLABORATION WITH GIMC CONTINUES TO GROW,THOUGH THEY ARE TWO VERY DIFFERENT SYSTEMS. GIMC AND ZUNI HOSPITAL AREINVOLVED WITH THE FAMILY MEDICINE RESIDENCY PROGRAM AND WILL SERVE ASTRAINING SITES FOR RESIDENT ROTATIONS. RMCHCS HOSPITAL Part V, Section B, Line 16j: OTHER METHOD FOR PUBLICIZING FINANCIAL ASSISTANCE POLICY:ALL SELF-PAY PATIENTS WILL BE INFORMED AT, OR BEFORE, THE TIME OF ADMISSION OF THE AVAILABILITY OF ALTERNATIVE RESOURCES BASED ON FINANCIAL MEANS. 6 1 - RMCHCS COLLEGE CLINIC 211 COLLEGE DRIVE Gallup NM 87301 PEDIATRICS, INTERNAL AND FAMILY CARE 2 - RMCHCS RED ROCK CLINIC 1900 RED ROCK DRIVE Gallup NM 87301 OB/GYN ORTHOPEDICS 3 - RMCH BEHAVIORAL HEALTH SVC 650 VANDEN BOSCH PKWY Gallup NM 87301 ADDICTION AND PSYCHIATRIC SERVICES 4 - RMCH HOME HEALTHHOSPICE 211 E AZTEC DRIVE Gallup NM 87301 HOME HEALTH/HOSPICE 5 - RMCHCS URGENT CARE LLC 520 HWY 564 Gallup NM 87301 URGENT CARE 6 - RMCH CARE SERVICES 1910 RED ROCK DR Gallup NM 87301 WELLNESS CENTER Part I, Line 7: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THECALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. COST COMPUTED ON IRSWORKSHEETS 4 AND 5 WAS COMPUTED FROM THE MEDICARE COST REPORT, INCLUDINGDIRECT COSTS PLUS OVERHEAD ALLOCATIONS COMPUTED IN THE COST REPORT. THECOST COMPUTED ON WORKSHEET 8 WAS FROM THE HOSPITAL'S INCOME STATEMENT ANDGRANT SCHEDULE. Part II, Community Building Activities: REHOBOTH MCKINLEY CHRISTIAN HOSPITAL IS THE MAIN CAMPUS. THIS 60-BEDGENERAL ACUTE INPATIENT FACILITY OFFERS A WIDE RANGE OF MEDICAL ANDDIAGNOSTIC SERVICES. HOSPITAL INPATIENT SERVICES INCLUDE A MEDICALSURGICAL UNIT, WOMEN'S HEALTH, PEDIATRIC, AND NEWBORN NURSERY UNITS,INTENSIVE AND CRITICAL CARE UNITS. HOSPITAL ANCILLARY SERVICES INCLUDE ACARDIOPULMONARY REHABILITATION UNIT, DIAGNOSTIC IMAGING AND LABORATORYSERVICES, AS WELL AS PHYSICAL REHABILITATION SERVICES. THE MAIN CAMPUS ISALSO HOME TO THE SURGICAL SERVICES UNIT AND THE EMERGENCY DEPARTMENT.THE MISSION OF THE REHOBOTH MCKINLEY CHRISTIAN HEALTHCARE SERVICES IS TOSERVE GOD BY PROVIDING HEALTH CARE AND PROMOTING WELLNESS FOR ALL PEOPLE.STATEMENT OF PHILOSOPHY - REHOBOTH MCKINLEY CHRISTIAN HEALTHCARE SERVICESORIGINATES AND EXISTS ON THE BASIS OF THE BIBLICAL COMMAND TO LOVE GODAND TO LOVE OUR NEIGHBOR. REALIZING THAT HUMAN BEINGS ARE PLAGUED WITHMIND, BODY, AND SPIRIT, THIS INSTITUTION IS DEDICATED TO THEIR DIAGNOSIS,TREATMENT AND PREVENTION. IT IS THE GOAL OF THE CORPORATION TO EMBODY THE MEDICAL FACILITIES WITH A SPIRIT OF MERCY THAT RESULTS IN PHYSICALHEALING. MEDICAL KNOWLEDGE, SKILL, AND HEALING ARE GIFTS FROM GOD; AND,TO WHATEVER EXTENT, THEY ARE EFFECTED AT REHOBOTH MCKINLEY CHRISTIANHEALTHCARE SERVICES, INC., HIS NAME IS GLORIFIED AND HIS PURPOSE SERVED.IT IS THE COMPASSION AND LOVE OF CHRIST WHICH SET THE EXAMPLE FOR THESTAFF; AND IT IS HOPED THAT THIS PROVISION OF A CHRISTIAN SETTING WILLPROVIDE PATIENTS AN OPPORTUNITY TO ENCOUNTER CHRIST, THE GREAT PHYSICIAN.FOR ADDITIONAL INFORMATION SEE SCHEDULE H, PART V, LINE 11 DISCLOSURE Part III, Line 2: THIS IS BASED ON ACTUAL WRITE-OFFS AFTER ALL COLLECTION EFFORTS AREEXHAUSTED AND ESTIMATED BASED ON AGE OF THE ACCOUNT PER POLICY. Part III, Line 3: MANY PATIENTS THAT WOULD OTHERWISE QUALIFY FOR CHARITY CARE, FAIL TOCOMPLETE THE REQUIRED DOCUMENTATION AND INSTEAD LET THE ACCOUNTS GO TOCOLLECTIONS AND ULTIMATELY TO BAD DEBT. THE BAD DEBT RELATED TO PATIENTSWHO MAY MEET CERTAIN CRITERIA UNDER THE HOSPITAL'S CHARITY CARE POLICYARE ESTIMATED AT 40% OF TOTAL BAD DEBT. Part III, Line 4: NOT APPLICABLE DUE TO ADOPTION OF ASU 606 REVENUE FROM CONTRACTS WITHCUSTOMERS. Part III, Line 8: THE HOSPITAL USES COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTSBASED ON MEDICARE OR MEDICAID DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARYCOSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES.THE ORGANIZATION HAD A MEDICARE SHORTFALL IN THE AMOUNT OF $6,660,853.THE HOSPITAL TREATS MEDICARE SHORTFALL AS COMMUNITY BENEFIT FOR MEETINGCHARITY CARE AND COMMUNITY BENEFITS Part III, Line 9b: A. IN COMPLIANCE WITH RELEVANT STATE AND FEDERAL LAWS, AND IN ACCORDANCEWITH THE PROVISIONS OUTLINED IN THIS BILLING AND COLLECTIONS POLICY,RMCHCS MAY ENGAGE IN COLLECTION ACTIVITIES-INCLUDING EXTRAORDINARYCOLLECTION ACTIONS (ECAS)-TO COLLECT OUTSTANDING PATIENT BALANCES.GENERAL COLLECTION ACTIVITIES MAY INCLUDE [FOLLOW-UP CALLS ON STATEMENTS]PATIENT BALANCES MAY BE REFERRED TO A THIRD PARTY FOR COLLECTION AT THEDISCRETION OF RMCHCS. ACCOUNTS WILL BE REFERRED FOR COLLECTIONS ONLY WITHTHE FOLLOWING CAVEATS:THERE IS A REASONABLE BASIS TO BELIEVE THE PATIENT OWES THE DEBT.ALL THIRD-PARTY PAYERS HAVE BEEN PROPERLY BILLED, AND THE REMAINING DEBTIS THE FINANCIAL RESPONSIBILITY OF THE PATIENT. RMCHCS SHALL NOT BILL APATIENT FOR ANY AMOUNT THAT AN INSURANCE COMPANY IS OBLIGATED TO PAY.RMCHCS WILL NOT REFER ACCOUNTS FOR COLLECTION WHILE A CLAIM ON THEACCOUNT IS STILL PENDING PAYER PAYMENT. HOWEVER RMCHCS MAY CLASSIFYCERTAIN CLAIMS AS "DENIED" IF SUCH CLAIMS ARE STUCK IN "PENDING" MODE FORAN UNREASONABLE LENGTH OF TIME DESPITE EFFORTS TO FACILITATE RESOLUTION.RMCHCS WILL NOT REFER ACCOUNTS FOR COLLECTION WHERE THE CLAIM WAS DENIEDDUE TO A RMCHCS ERROR. HOWEVER, RMCHCS MAY STILL REFER THE PATIENTLIABILITY PORTION OF SUCH CLAIMS FOR COLLECTION IF UNPAID.RMCHCS WILL NOT REFER ACCOUNTS FOR COLLECTION WHERE THE PATIENT HASINITIALLY APPLIED FOR FINANCIAL ASSISTANCE OR OTHER RMCHCS SPONSOREDPROGRAM AND RMCHCS HAS NOT YET NOTIFIED THE PATIENT OF ITS DETERMINATION(PROVIDED THE PATIENT HAS COMPLIED WITH THE TIMELINE AND INFORMATIONREQUESTS DELINEATED DURING THE APPLICATION PROCESS).B. REASONABLE EFFORTS AND EXTRAORDINARY COLLECTION ACTIONS (ECAS)BEFORE ENGAGING IN ECAS TO OBTAIN PAYMENT FOR CARE RMCHCS MUST MAKECERTAIN REASONABLE EFFORTS TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLEFOR FINANCIAL ASSISTANCE UNDER OUR FINANCIAL ASSISTANCE POLICY:ECAS MAY BEGIN ONLY WHEN 90 DAYS HAVE PASSED SINCE THE FIRSTPOST-DISCHARGE STATEMENT WAS PROVIDED.HOWEVER, AT LEAST 30 DAYS BEFORE INITIATING ECAS TO OBTAIN PAYMENT, RMCHCS SHALL DO THE FOLLOWING:-PROVIDE THE INDIVIDUAL WITH A WRITTEN NOTICE THAT INDICATES THEAVAILABILITY OF FINANCIAL ASSISTANCE, LISTS POTENTIAL ECAS THAT MAY BETAKEN TO OBTAIN PAYMENT FOR CARE, AND GIVES A DEADLINE AFTER WHICH ECASMAY BE INITIATED (NO SOONER THAN 90 DAYS AFTER THE FIRST POST-DISCHARGEBILLING STATEMENT AND 30 DAYS AFTER THE WRITTEN NOTICE)-PROVIDE A PLAIN-LANGUAGE SUMMARY OF THE FAP ALONG WITH THE NOTICEDESCRIBED ABOVE-ATTEMPT TO NOTIFY THE INDIVIDUAL ORALLY ABOUT THE FAP AND HOW HE OR SHEMAY GET ASSISTANCE WITH THE APPLICATION PROCESS AFTER MAKING REASONABLEEFFORTS TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY AS OUTLINED ABOVERMCHCS (OR ITS AUTHORIZED BUSINESS PARTNERS) MAY TAKE THE FOLLOWING ECATO OBTAIN PAYMENT FOR CARE:REPORT ADVERSE INFORMATION TO CREDIT REPORTING AGENCIES AND/OR CREDITBUREAUSIF A PATIENT HAS AN OUTSTANDING BALANCE FOR PREVIOUSLY PROVIDED CARE, RMCHCS MAY ENGAGE IN THE ECA OF DEFERRING, DENYING, OR REQUIRING PAYMENTBEFORE PROVIDING ADDITIONAL MEDICALLY NECESSARY (BUT NON-EMERGENT) CAREONLY WHEN THE FOLLOWING STEPS ARE TAKEN:-RMCHCS PROVIDES THE PATIENT WITH AN FAP APPLICATION AND A PLAIN LANGUAGESUMMARY OF THE FAPRMCHCS PROVIDES A WRITTEN NOTICE INDICATING THE AVAILABILITY OF FINANCIALASSISTANCE AND SPECIFYING ANY DEADLINE AFTER WHICH A COMPLETEDAPPLICATION FOR ASSISTANCE FOR THE PREVIOUS CARE EPISODE WILL NO LONGERBE ACCEPTED. THIS DEADLINE MUST BE AT LEAST 30 DAYS AFTER THE NOTICE DATEOR 211 DAYS AFTER THE FIRST POST-DISCHARGE BILLING STATEMENT FOR PRIORCARE, WHICHEVER IS LATER.-RMCHCS MAKES A REASONABLE EFFORT TO ORALLY NOTIFY THE INDIVIDUAL ABOUTTHE FINANCIAL ASSISTANCE POLICY AND EXPLAIN HOW TO RECEIVE ASSISTANCEWITH THE APPLICATION PROCESS.-RMCHCS PROCESSES ON AN EXPEDITED BASIS ANY FAP APPLICATIONS FOR PREVIOUSCARE RECEIVED WITHIN THE STATED DEADLINEPATIENT FINANCIAL SERVICES IS ULTIMATELY RESPONSIBLE FOR DETERMINING IFAN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. THIS BODY ALSO HAS FINAL AUTHORITY FOR DECIDING WHETHER THE ORGANIZATION MAY PROCEED WITHANY OF THE ECAS OUTLINED IN THIS POLICY. Part VI, Line 2: WE HAVE HAD MEETINGS WITH CHAPTER HOUSES IN THE NAVAJO RESERVATION INRELATION TO THE MOBILE HEALTH CLINIC TO GET INPUT ON THEIR NEEDS. INPREPARATION FOR THE RENOVATIONS OF OUR WOMEN'S HEALTH AND BIRTHING CENTERUNIT WE HAVE MET WITH A FOCUS GROUP OF FEMALE NATIVE AMERICANS TO BETTERUNDERSTAND AND MEET THEIR NEEDS SURROUNDING PRENATAL, BIRTH ANDPOSTPARTUM CARE NEEDS. WE ARE IMPLEMENTING A PLAN TO ADDRESS THE OPIOID CRISIS AND ARE TRAINING OUR PROVIDERS ON MAT. WE MEET WITH COUNTY, CITYAND STATE LEGISLATIVE BODIES TO GIVE THEM UPDATES ON OUR WORK. WE AREREGULAR PARTICIPANTS ON THE GALLUP EXECUTIVE DIRECTORS ALLIANCE (GEDA)MADE UP OF AREA LEADERS AND PROVIDER MONTHLY REPORTS ON WORK, PROGRESSAND ANY CHANGES AT RMCHCS. THROUGH GEDA WE MEET WITH CEO'S IN THE CITY TOKEEP THEM INFORMED ON THE PROGRESS AND CHANGES THAT RMCHCS IS MAKING. Part VI, Line 3: THE FINANCIAL ADVISOR GIVES ASSISTANCE TO THE PATIENT AT REGISTRATION, ATBEDSIDE OR AFTER DISCHARGE AS NEEDED FOR FINANCIAL COUNSELING, CHARITYAPPLICATIONS, MEDICAID ELIGIBILITY AND ENROLLMENT AS WELL AS ANY OTHERPROGRAMS AVAILABLE. THIS IS ALSO AVAILABLE ON OUR WEBSITE ATWWW.RMCH.ORG/GETPAGE.PHP?NAME=FINANCIAL_SERVICESANDSUB=OUR+SERVICES Part VI, Line 4: GALLUP, WHICH IS THE COUNTY SEAT OF MCKINLEY COUNTY, IS THE HEART OF THE INDIAN SOUTHWEST. SEVENTY-THREE PERCENT OF THE RESIDENTS ARE OF AMERICANINDIAN DESCENT. GALLUP IS THE ECONOMIC CENTER OF THREE MAJOR INDIANTRIBES, ZUNI, HOPI, AND NAVAJO AND SERVES THE SURROUNDING AREAS OF NEWMEXICO AND ARIZONA. THE PRIMARY SERVICE AREA (GALLUP) HAS A POPULATION OF22,000 WITH A SECONDARY SERVICE AREA OF APPROXIMATELY 90,000 PEOPLE.GALLUP IS SITUATED AT 6,515 FEET AND HAS A MILD AND COMFORTABLEFOUR-SEASON CLIMATE. THE LANDSCAPE IS BEAUTIFUL, WITH RED MESASSURROUNDING THE CITY. GALLUP HAS A UNIQUE BLEND OF INDIGENOUS CULTURE,WITH GENUINE AMERICAN INDIAN AND SOUTHWEST-HISPANIC ARTS AND CRAFTS INRICH ABUNDANCE.THE MEDIAN AGE IN MCKINLEY COUNTRY IS 30.7 YEARS. THAT IS SIX YEARSYOUNGER THAN THE MEDIAN AGE IN THE UNITED STATES. HOWEVER, THE LIFE SPANOF THE POPULATION IN MCKINLEY COUNTY IS FOUR YEARS LESS THAN THE AVERAGEAMERICAN. THE AVERAGE LIFE SPAN IN MCKINLEY COUNTY IS 74.4 YEARS VERSUSTHE NATIONAL AVERAGE OF 78.8 YEARS. Part VI, Line 6: PROMOTION OF COMMUNITY HEALTH:REHOBOTH MCKINLEY CHRISTIAN HOSPITAL IS THE MAIN CAMPUS. THIS 60-BEDGENERAL ACUTE INPATIENT FACILITY OFFERS A WIDE RANGE OF MEDICAL ANDDIAGNOSTIC SERVICES. HOSPITAL INPATIENT SERVICES INCLUDE A MEDICALSURGICAL UNIT, WOMEN'S HEALTH, PEDIATRIC, AND NEWBORN NURSERY UNITS,INTENSIVE AND CRITICAL CARE UNITS. HOSPITAL ANCILLARY SERVICES INCLUDE ACARDIOPULMONARY REHABILITATION UNIT, DIAGNOSTIC IMAGING AND LABORATORYSERVICES, AS WELL AS PHYSICAL REHABILITATION SERVICES. THE MAIN CAMPUS ISALSO HOME TO THE SURGICAL SERVICES UNIT AND THE EMERGENCY DEPARTMENT.THE MISSION OF THE REHOBOTH MCKINLEY CHRISTIAN HEALTHCARE SERVICES IS TOSERVE GOD BY PROVIDING HEALTH CARE AND PROMOTING WELLNESS FOR ALL PEOPLE.STATEMENT OF PHILOSOPHY - REHOBOTH MCKINLEY CHRISTIAN HEALTHCARE SERVICESORIGINATES AND EXISTS ON THE BASIS OF THE BIBLICAL COMMAND TO LOVE GODAND TO LOVE OUR NEIGHBOR. REALIZING THAT HUMAN BEINGS ARE PLAGUED WITHMIND, BODY, AND SPIRIT, THIS INSTITUTION IS DEDICATED TO THEIR DIAGNOSIS,TREATMENT AND PREVENTION. IT IS THE GOAL OF THE CORPORATION TO EMBODY THE MEDICAL FACILITIES WITH A SPIRIT OF MERCY THAT RESULTS IN PHYSICALHEALING. MEDICAL KNOWLEDGE, SKILL, AND HEALING ARE GIFTS FROM GOD; AND,TO WHATEVER EXTENT, THEY ARE EFFECTED AT REHOBOTH MCKINLEY CHRISTIANHEALTHCARE SERVICES, INC., HIS NAME IS GLORIFIED AND HIS PURPOSE SERVED.IT IS THE COMPASSION AND LOVE OF CHRIST WHICH SET THE EXAMPLE FOR THESTAFF; AND IT IS HOPED THAT THIS PROVISION OF A CHRISTIAN SETTING WILLPROVIDE PATIENTS AN OPPORTUNITY TO ENCOUNTER CHRIST, THE GREAT PHYSICIAN.FOR ADDITIONAL INFORMATION SEE SCHEDULE H, PART V, LINE 11 DISCLOSURE. Part VI, Line 7, Reports Filed With States NM X X 0 0 X X 1 0 0 0 0 0 0 1 0 JOHN YORK Orthopedic Surgeon 592307 0 0 0 0 0 0 0 0 0 592307 0 0 0 CHARLES J S GUIMARAES General Surgeon 536330 0 0 0 0 0 26000 0 0 0 562330 0 0 0 BRANDON MURGUIA Physician Intensivist 369982 0 0 0 0 0 0 0 0 0 369982 0 0 0 VALORY WANGLER Physician Residency Program 344513 0 0 0 0 0 19500 0 0 0 364013 0 0 0 NEIL JACKSON Physician 312198 0 11669 0 0 0 19500 0 0 0 343367 0 0 0 Christopher Gonzaga Physician 209511 0 0 0 0 0 0 0 0 0 209511 0 0 0 Mary L Poel Physician 163375 0 0 0 0 0 0 0 0 0 163375 0 0 0 Adrienne Patel CQO 143459 0 0 0 0 0 19500 0 0 0 162959 0 0 0 Mary K Bevier CFO 159903 0 0 0 0 0 0 0 0 0 159903 0 0 0 Part I, Line 1a MARY BEVIER RECEIVED HOUSING ALLOWANCE AND GROSS UP OF CERTAIN RELOCATION EXPENSES, ALL INCLUDED IN TAXABLE COMPENSATION. VALORY WANGLER RECEIVED GROSS UP OF CERTAIN RELOCATION EXPENSES INCLUDED IN HER TAXABLE COMPENSATION. Part I, Line 4a SEVERANCE PAY: SEVERANCE IS A VOLUNTARY AGREEMENT THAT SET FORTH THE AGREED UPON SEPARATION DATE FOR EMPLOYMENT AND BENEFITS COVERAGE, THE AMOUNT OF PAYMENT, A CONFIDENTIALITY AGREEMENT CONCERNING COMPANY INFORMATION AND MATERIALS, RETURN OF COMPANY MATERIALS, AND COOPERATION CONCERNING BUSINESS MATTERS. SEVERANCE WAS PAID TO THE FOLLOWING INDIVIDUALS: MICHAEL S. NYE, $ Part I, Line 7 THE BONUSES OF THE PHYSICIANS LISTED ARE DETERMINED BY A JOINT CONSULTATION BETWEEN THE CEO, CMO, CFO AND THE HR DIRECTOR. THIS IS INCORPORATED WITH MGMA DATA AND OTHER DATA SOURCES. Chad Martell Family member of Officer Rebecca Martell 15444 Salaries/Wages 0 HEALTHCARE INTEGRITY LLC Officer David Conejo Owns 100% 53434 Management Services 0 X 1 37586 FMV 0 1 0 Part I, Column (b): NUMBER OF CONTRIBUTIONS OR ITEMS CONTRIBUTED: THE AMOUNTS REPORTED IN THIS COLUMN REFLECT THE NUMBER OF CONTRIBUTIONS RECEIVED. Form 990, Part VI, Section A, line 1a THE ORGANIZATION HAS AN EXECUTIVE COMMITTEE THAT HAS THE POWER TO TRANSACT ALL REGULAR AND ROUTINE BUSINESS OF THE HOSPITAL BETWEEN BOARD MEETINGS. Form 990, Part VI, Section A, line 3 BEGINNING IN SEP 2020, RMCH ENTERED INTO AGREEMENT WITH COMMUNITY HOSPITAL CONSULTING (CHC) FOR THE PROVISION OF INTERIM CEO SERVICES BY MR. DON SMITHBURG. CHC WAS PAID A TOTAL OF $100,000 FOR THE SERVICES OF MR SMITHBURG IN 2021. Form 990, Part VI, Section A, line 7a THE MCKINLEY COUNTY COMMISSIONERS APPOINT 4 VOTING MEMBERS OF THE RMCHCS BOARD OF TRUSTEES. THE REMAINING POSITIONS ON THE BOARD OF TRUSTEES ARE ELECTED ON A ROTATING SCHEDULE BY ALL OF THE VOTING MEMBERS OF THE BOARD. Form 990, Part VI, Section B, line 11b THE CFO REVIEWS THE FORM 990 PREPARED BY THE INDEPENDENT ACCOUNTING FIRM WHICH ALSO PERFORMED THE ANNUAL AUDIT IN COMPLIANCE WITH GAAP. THE CFO PRESENTS THE 990 TO THE CEO FOR REVIEW AND APPROVAL FOR SUBMISSION. Form 990, Part VI, Section B, line 12c PROCESS TO MONITOR COMPLIANCE WITH CONFLICT OF INTEREST POLICY: RMCHCS FOLLOWS ITS ADOPTED CONFLICT OF INTEREST POLICY, WHICH MANDATES: -ALL OFFICERS AND BOARD MEMBERS MUST DISCLOSE POTENTIAL CONFLICTS OF INTEREST WHEN APPOINTED, AND THEN SUBSEQUENTLY IF NEW CONFLICTS ARISE, THROUGH A DISCLOSURE QUESTIONNAIRE. -THE COMPLIANCE OFFICER REVIEWS AND ANALYZES ALL POTENTIAL CONFLICTS OF INTERESTS AND REPORTS THEM TO THE COMPLIANCE COMMITTEE -THE COMPLIANCE COMMITTEE REVIEWS POTENTIAL CONFLICTS AND REPORTS TO THE BOARD OF TRUSTEES -THE BOARD RECORDS NOTICE OF ALL CONFLICTS IN BOARD MINUTES -THE BOARD ENFORCES THE RECUSAL OF ANY BOARD MEMBER OR OFFICER FROM ANY DELIBERATIONS WHERE THEY HAVE A POTENTIAL CONFLICT OF INTEREST Form 990, Part VI, Section B, line 15 COMPENSATION REVIEW BY AN INDEPENDENT COMPANY BEGAN IN 2019 BUT WAS NOT FINISHED PRIOR TO THE CEO CHANGE MADE IN 2020. THE GOVERNING BODY WILL WORK WITH AN INDEPENDENT COMPANY FOR CEO COMPENSATION FMV AT LEAST EVERY 3 YEARS AND WILL REVIEW AND APPROVE COMPENSATION ANNUALLY. ALL REVIEWS WILL BE DOCUMENTED IN BOARD MEETING MINUTES. COMPENSATION OF THE OTHER OFFICERS AND KEY EMPLOYEES WAS REVIEWED USING 2018/2019 NEW MEXICO STATE COMPDATA SALARY SURVEY DATA. Form 990, Part VI, Section C, line 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS OF RMCHCS ARE ALL AVAILABLE UPON REQUEST AT THE ADMINISTRATIVE OFFICES, 1901 RED ROCK DRIVE, GALLUP, NEW MEXICO. Form 990, Part IX, line 11g Other Services: Program service expenses 8,675,042. Management and general expenses 7,551,203. Fundraising expenses 0. Total expenses 16,226,245. WESTERN HEALTH FOUNDATION 1901 RED ROCK DRIVE Gallup NM 87301 850349559 Support NM 501(c)(3) Line 7 RMCHCS 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 WESTERN HEALTH FOUNDATION C FMV