2019-05-07T10:41:21-05:00 2018-06-30 BKD LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2017-07-01 840255530 Lutheran Hospital Association of the San Luis Valley % THE ORGANIZATION LUTH 7195892511 106 BLANCA AVENUE ALAMOSA CO 81101 KONNIE MARTIN CEO 7195892511 2019-05-15 true Adam R Smith CPA P00958966 7194714290 167.68.126.162 84022720191275000017 2019-05-07 P 19466AA61A357D31F4873695DF4DFE6460C1305A 19466AA61A357D31F4873695DF4DFE6460C1305A 2017 2019-02-21 02:37:17Z San Luis Valley Health KONNIE MARTIN 106 BLANCA AVENUE ALAMOSA CO 81101 104684277 false X WWW.SANLUISVALLEYHEALTH.ORG X 1928 CO TO BE A PREMIER, FULLY INTEGRATED RURAL HEALTH CARE SYSTEM PROVIDING EXCEPTIONAL PATIENT-CENTERED SERVICES TO THE SAN LUIS VALLEY. 14 9 831 14 0 422 891320 2374616 87415565 101536528 200051 -234833 411125 525190 88918061 104201501 78942 89352 0 0 50204609 51454230 0 0 275224 36347411 46797574 86630962 98341156 2287099 5860345 89586153 95190560 33678186 33582836 55907967 61607724 X AN UNCONDITIONAL COMMITMENT TO EXCELLENCE BY PROVIDING QUALITY, COMPASSIONATE CARE GUIDED BY OUR VALUES. WE ACCEPT RESPONSIBILITY FOR PROVIDING SERVICES TO OUR COMMUNITY THAT ARE OF THE HIGHEST CALIBER OF SERVICE AND STANDARD PERFORMANCE, WHILE DEMONSTRATING OUR ADOPTED VALUES. false false 76784714 89352 101731912 SAN LUIS VALLEY HEALTH WAS FORMED JULY 1, 2013. PRIOR TO THE MERGER THAT CREATED SAN LUIS VALLEY HEALTH, THE HOSPITAL OPERATED AS AN INDEPENDENT, NOT-FORPROFIT HOSPITAL FOR OVER 83 YEARS. THE MERGER BROUGHT TOGETHER SAN LUIS VALLEY REGIONAL MEDICAL CENTER AND CONEJOS COUNTY HOSPITAL. PRIOR TO THE MERGER, CONEJOS COUNTY HOSPITAL HAD BEEN MANAGED BY SAN LUIS VALLEY REGIONAL MEDICAL CENTER SINCE 2003. SLV HEALTH SERVES THE SIX COUNTIES OF THE SAN LUIS VALLEY WITH A POPULATION OF JUST UNDER 50,000 AND AN AREA OF OVER 8,200 SQUARE MILES; LARGER THAN THE STATE OF NEW JERSEY. SLV HEALTH EMPLOYS OVER 650 EMPLOYEES AND IS THE LARGEST EMPLOYER IN THE SAN LUIS VALLEY. THE TRUSTEES, PROVIDERS AND STAFF OF SLV HEALTH ARE UNDERSTANDABLY PROUD OF THEIR TRADITION FOR PROVIDING CARE AND SERVICE TO OUR COMMUNITIES. SERVING OUR LOW-INCOME COMMUNITY MEANS THAT WE HAVE A CHALLENGING PAYER MIX WITH HIGH MEDICAID, UNINSURED AND RELATIVELY LOW COMMERCIAL PERCENTAGES. THIS HAS LED TO OUR ORGANIZATION BEING RESOURCEFUL, CREATIVE AND INNOVATIVE IN ORDER TO CONTINUE SERVICE WITH POSITIVE OPERATING MARGINS. OVER THE LAST TEN YEARS, OUR GROSS REVENUE HAS INCREASED FROM $20M TO IN EXCESS OF $100M AND THE NUMBER OF PATIENTS SERVED HAS EXPANDED SEVERAL FOLD. NEW SERVICES HAVE BEEN ADDED IN MEDICATION ONCOLOGY, INPATIENT REHABILITATION, SLEEP DISORDERS, WOMEN'S IMAGING CENTER, FIXED WING MEDICAL TRANSPORTATION, GENETIC COUNSELING, BEHAVIORAL HEALTH, CARDIOLOGY, CHIROPRACTIC, ONCOLOGY/INFUSION THERAPY, UROLOGY AND MORE. 76784714 true true false true false false false false false true true false false false true false false true false false false false false false false false true true true false true false false false false false false true false false false false false false true true false false true 99 0 831 true true true false false false false false false false false false X 14 9 true false false false false false false true true false false true true true true true true true true false X THE ORGANIZATION 7195892511 106 BLANCA AVENUE ALAMOSA CO 81101 X Karla Hardesty President 2.0 0.0 X X 2900 0 0 Jim Ehrlich Vice President 2.0 0.0 X X 600 0 0 Kendall Knaus Secretary/Treasurer 30.0 0.0 X X 51400 0 0 Jan Gay Trustee 2.0 1.0 X 800 0 0 Patrick Crowder Trustee 2.0 0.0 X 1000 0 0 Kathy Lorenz Trustee 2.0 1.0 X 800 0 0 Cheri Crowder Trustee 2.0 1.0 X 1000 0 0 Rosalie Martinez Trustee 2.0 2.0 X 900 0 0 Donald Shawcroft Trustee 2.0 1.0 X 700 0 0 Kasey Russell Trustee 2.0 0.0 X 1100 0 0 Susan Geiger Trustee, Physician 20.0 0.0 X 102609 0 5088 Dennard Ellison Trustee, Physician 40.0 0.0 X 456126 0 32742 Nuwan Pilapitiya Trustee, Physician 40.0 0.0 X 227264 0 31669 CArmelo Hernandez Trustee, Physician 40.0 0.0 X 334996 0 32936 Konnie Martin CEO 40.0 2.0 X 422275 0 36064 Shane Mortensen CFO 40.0 2.0 X 205168 0 32059 Patti Thompson COO 40.0 0.0 X 221146 0 20627 Greg McAuliffe CMO - Through 3/18 25.0 0.0 X 263090 0 11875 Kelly Gallegos CCH Administrator 40.0 0.0 X 171191 0 27806 Antonio Gurule Clinic Administrator 40.0 0.0 X 179608 0 20518 David Geiger Interim CMO 38.0 0.0 X 394421 0 33362 Maureen Cooper Physician 40.0 0.0 X 448467 0 20682 Carissa Tripi Physician 40.0 0.0 X 532792 0 26494 James Grigsby Physician 40.0 0.0 X 405860 0 34988 Jason Defee Physician 40.0 0.0 X 478024 0 27539 Donna Nelson Physician 40.0 0.0 X 392057 0 33047 5296294 0 427496 74 false true false CARETECH SOLUTIONS INC PO Box 674271 DETROIT MI 48267 IT Support 1560983 WEATHERBY LOCUMS PO Box 972633 DALLAS TX 75397 Locum Physicians 347875 INNOVA EMERGENCY MEDICAL ASSOCIATES PO Box 912601 DENVER CO 802912601 Locum Physcians 2395215 All Star Recruiting Locums LLC PO Box 823424 PHILADELPHIA PA 191823424 Locum Physicians 332175 Medical Solutions INc 1010 N 102nd Street Suite 300 OMAHA NE 68114 Locum NUrses 206083 8 1524430 521103 329083 2374616 PATIENT SERVICE REVENUE 561110 41581841 41581841 MEDICARE/MEDICAID 561110 58022363 58022363 ELECTRONIC HEALTH RECORD PAYMENTS 900099 276731 276731 AMBULANCE DISTRICT REVENUE 621910 548293 548293 340B PAYMENTS 900099 657438 657438 449862 449862 101536528 213009 213009 0 0 32172 34934 -2762 0 -2762 -2762 447842 -447842 -447842 -447842 0 0 0 0 0 0 0 0 0 CAFETERIA SALES 722514 244283 244283 ABSTRACTS REVENUE 900099 33405 2111 31294 MISCELLANEOUS REVENUE 900099 250264 193273 56991 527952 104201501 101731912 94973 89352 89352 0 0 0 3177885 1484815 1677203 15867 0 39422726 32348799 6903734 170193 1409371 1144554 258810 6007 4749508 3782285 946820 20403 2694740 2131128 552004 11608 0 88229 88229 117407 117407 6274 6274 0 0 10056936 6185892 3871044 139387 137738 1649 1522685 337476 1179392 5817 1741058 775239 965819 0 876042 517370 358672 422117 277941 144096 80 0 21682 21682 671116 671116 0 2911612 2192717 718895 1027203 515397 510688 1118 MEDICAL SUPPLIES 13130232 13130232 PROVIDER FEES 2972333 2972333 BAD DEBT 6943596 6943596 REPAIRS & MAINTENANCE 1572868 1420676 152192 2576797 534912 1999403 42482 98341156 76784714 21281218 275224 993780 1379188 12372909 14128047 7861 7245 11808096 11510059 0 0 0 0 0 0 1710359 1949447 2078969 2486884 80508056 42974166 32770311 37533890 21627042 22031034 12100 12100 759406 359913 0 0 5445320 3792753 89586153 95190560 12488811 13055923 0 0 171139 244538 0 0 0 0 0 0 20743030 20011550 0 0 275206 270825 33678186 33582836 X 55148569 61247809 759398 359915 0 0 55907967 61607724 89586153 95190560 X 5860345 238897 -399485 X false true X true true true X false false false false false false false false true 6274 6274 false schedule c, Part II-B, Line 1i Description of lobbying activities: San Luis Valley Health received correspondence from the Colorado Health and Hospital Association and the American Hospital Association regarding their membership dues. A portion of their dues were attributable to lobbying and appear on line 1i. 46368 9194 38 40000 15600 35345 10980 43 46368 24766 10547 32 35345 10388 14360 18 24766 4373 6009 6 10388 1.00000 false true true 3432682 3432682 45405489 22254492 23150997 25428450 19888434 5540016 6241435 831240 5410195 37533890 0 ASSET RETIREMENT OBLIGATION 270531 OTHER LIABILITY 294 270825 97470070 238897 -474574 -235677 97705747 6495754 6495754 104201501 91770313 -75089 -75089 91845402 6495754 6495754 98341156 SCHEDULE D, PART V, LINE 4 Describe the intended uses of the organization's endowment funds: SAN LUIS VALLEY HEALTH FOUNDATION (THE FOUNDATION) AND THE MEDICAL CENTER ARE FINANCIALLY INTERRELATED ORGANIZATIONS. THE MISSION OF THE FOUNDATION IS TO SUPPORT THE HEALTH CARE SERVICES OF THE MEDICAL CENTER AND THE COMMUNITIES IT SERVES. THE MEDICAL CENTER ACCOUNTS FOR ITS INTEREST IN THE NET ASSETS OF THE FOUNDATION IN A MANNER SIMILAR TO THE EQUITY METHOD. THE TEMPORARILY RESTRICTED NET ASSETS REPRESENTS THE INTEREST IN THE NET ASSETS OF THE FOUNDATION. WHEN ASSETS ARE TRANSFERRED TO THE SLVH BY THE FOUNDATION, THE CONTRIBUTIONS ARE RESTRICTED TO THE PURCHASE OF EQUIPMENT AND FACILITY EXPANSION. Schedule D, Part X, Line 2 Uncertain Tax Positions: Management has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements. SCHEDULE D, PART XI, LINE 2D REVENUE ON BOOKS, NOT ON RETURN: change in investment in foundation (399,485) Change in SSA Account (110,023) rental expenses reclassed from expense to revenue 34,934 Total (474,574) SCHEDULE D, PART XI, LINE 4B REVENUE ON RETURN, NOT ON BOOKS: BAD DEBT EXPENSE RECLASSED FROM EXPENSE TO REVENUE 6,943,596 Loss on Sale of Assets (447,842) Total 6,495,754 SCHEDULE D, PART XII, LINE 2D EXPENSE ON BOOKS, NOT ON RETURN: RENTAL EXPENSES RECLASSED FROM EXPENSE TO REVENUE 34,934 Change in SSA Account (110,023) Total ( 75,089) SCHEDULE D, PART XII, LINE 4B EXPENSE ON RETURN, NOT ON BOOKS: BAD DEBT EXPENSE RECLASSED FROM EXPENSE TO REVENUE 6,943,596 Loss on Sale of Assets (447,842) TOTAL 6,495,754 true true X true X true X true true true false false 627747 51180 576567 0.00630 31179492 25962259 5217233 0.05710 631428 957596 32438667 26971035 5793800 0.06340 197199 8426 188774 0.00210 343406 343406 0.00380 1252663 995999 256664 0.00280 27280 27280 0.00030 1820548 1004425 816124 0.00900 34259215 27975460 6609924 0.07240 2773 2773 24722 24722 5572 5572 13096 13096 3275 3275 16612 16612 66050 66050 true 6943596 23325451 21156797 2168654 X true true 2 1 Lutheran Hospital of SLV 106 Blanca Avenue Alamosa CO 81101 www.sanluisvalleyhealth.org 011001 X X X X 1 2 Conejos County Hospital 19021 US Hwy 285 La Jara CO 81140 www.sanluisvalleyhealth.org 011020 X X X 1 1 false false true X X X X X X X X X 15 true false false true X SEE PART V, SECTION C FOR URL X true 15 true SEE PART V, SECTION C FOR URL false true X 100 200. X X X true true X X X X true X part v, section c for url X part v, section c for url X part v, section c for url X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 INPUT FROM REPRESENTATIVES OF THE COMMUNITY: SLVH LEADERSHIP REPRESENTATIVES, IN COLLABORATION WITH COLORADO RURAL HEALTH CENTER, CONDUCTED A SURVEY OF INTERESTED SAN LUIS VALLEY RESIDENTS. THE SURVEY INCLUDED 44 QUESTIONS ON A VARIETY OF HEALTH AND PROVIDER ISSUES. THE HEALTH QUESTIONNAIRE FOR SLVH WAS DISTRIBUTED BY THE HOSPITAL AND THE COMMUNITY GROUP MEMBERS USING PAPER AND WEB-BASED SURVEYS. THEY WERE GIVEN TO THE COMMUNITY GROUP FOLLOWING THE FIRST MEETING AND PARTICIPANTS WERE ENCOURAGED TO HAVE THEIR COLLEAGUES, FRIENDS, AND FAMILY COMPLETE THE SURVEY AS WELL. TO AID LEADERSHIP REPRESENTATIVES IN THE ASSESSMENT OF THE COMMUNITYS HEALTH NEEDS, THE COMMUNITY GROUP WAS COMPRISED OF INTERESTED AGENCIES AND ORGANIZATIONS SERVING HEALTH, EDUCATION, COMMERCIAL AND GOVERNMENT INTERESTS IN THE SAN LUIS VALLEY. - ADAMS STATE UNIVERSITY - ADAMS STATE UNIVERSITY VETERANS PROGRAM - BLUE PEAKS DEVELOPMENTAL SERVICES - CITY OF ALAMOSA AND CITY COUNCIL - CITY OF MONTE VISTA AND CITY COUNCIL - RIO GRANDE COUNTY PUBLIC HEALTH - SAN LUIS VALLEY BEHAVIORAL HEALTH GROUP - SAN LUIS VALLEY DEVELOPMENT RESOURCE GROUP - SAN LUIS VALLEY PUBLIC HEALTH PARTNERSHIPS - SAN LUIS VALLEY SMALL BUSINESS DEVELOPMENT CENTER - VALLEY WIDE HEALTH SYSTEMS - VALLEY WIDE HEALTH SYSTEMS, NURSE -FAMILY PARTNERSHIPS SCHEDULE H, PART V, SECTION B, LINE 7A Hospital facility's website where CHNA is made Widely Available: http://www.sanluisvalleyhealth.org/sites/default/files/images/chna_final_r eport-slvh-6-16.pdf The CHNA can also be found by going to the home page of organization's website under quick links, click on "get financial assistancea link to the most recent CHNA is listed under the community needs assessment heading. SCHEDULE H, PART V, SECTION B, LINE 10A Website where the Implementation strategy is made widely available: HTTP://WWW.SANLUISVALLEYHEALTH.ORG/SITES/DEFAULT/FILES/IMAGES/CHNA_FINAL_R EPORT-SLVH-6-16.PDF THE IMPLEMENTATION STRATEGY IS LOCATED ON PAGE 10 OF THE CHNA EXECUTIVE SUMMARY WHICH CAN BE FOUND by going to the home page of organization's website, under quick links click on "get financial assistance," click on the "2016 executive summary." SCHEDULE H, PART V, SECTION B, LINE 11 SAN LUIS VALLEY HEALTH (SLVH) DEVELOPED RESPONSES TO IDENTIFIED COMMUNITY NEEDS BASED ON ORGANIZATIONAL CAPACITY AND MISSION OF THE CORPORATION. THE PRIMARY NEED IDENTIFIED BY THE SURVEY WAS FOR SUBSTANCE ABUSE SERVICES. SLVH HAS HIRED AN ADDITIONAL BEHAVIORAL HEALTH THERAPIST AND HAS INCREASED CARE COORDINATION SERVICES IN ITS BUSIEST PRIMARY HEALTH CARE CLINIC WHERE SCREENING BRIEF INTERVENTION AND REFERRAL TO TREATMENT (SBIRT) SCREENINGS ARE COMPLETED. SLVH HAS ALSO COORDINATED CASE CONFERENCES AND COMMUNITY DIALOGUES WITH SAN LUIS VALLEY BEHAVIORAL HEALTH GROUP TO WORK ON IDENTIFIED CHALLENGES AND OPPORTUNITIES FOR IMPROVEMENT ON AN ONGOING AND AS NEEDED BASIS. HOSPITAL AND CLINIC STAFF PARTICIPATE IN THE SLV NEONATAL TASK FORCE, AND RECENTLY THE OUTPATIENT QUALITY IMPROVEMENT COMMITTEE HAS BEGUN WORK TO UPDATE OPIOID PAIN MANAGEMENT GUIDELINES FOR THE ORGANIZATION. SLVH DEVELOPED STRATEGIES, OR IS ALREADY ADDRESSING ALL OTHER NEEDS IDENTIFIED IN THE 2016 CHNA. SAN LUIS VALLEY HEALTH CONTINUED TO WORK ON THE NEEDS IDENTIFIED IN THE 2016 CHNA IN 2018 THROUGH THE FOLLOWING INITIATIVES. THE PRIMARY NEED IDENTIFIED IN THE 2016 NEED ASSESSMENT WAS FOR SUBSTANCE ABUSE SERVICES AND MENTAL HEALTH CARE. All SLVH primary care clinics provide Screening Brief Intervention Referral and Treatment, Drug Abuse Screening Tests (DAST), Pain Management Agreements, prescription drug monitoring, referral to Medication Assistance Treatment, social supports and care coordination for patients at risk or using substances. Other ancillary supports include physical therapy and chiropractic treatment. SLVH Emergency Departments are implementing clinical guidelines for alternatives to opioids to help address the opioid epidemic. Implementation of The Colorado Health Foundation Grant, Advancement of Integrated Behavioral Health, supported hiring seven full-time staff and the opportunity to recruit an Advanced Practice Psychiatric Nurse; this position is currently pending. SLVH joined the Colorado Health Associations Alternatives to Long Term Opioid Use Initiative in its two emergency departments helping address substance use disorders, particularly with opioids and their cheaper street alternatives. The principles of this initiative encourage the use of alternative practices as a first line treatment for pain management. SLVH aims to expand these efforts in the inpatient setting. SLVH was awarded a grant from The Colorado Health Foundation to advance behavioral health and care coordination in the SLVH system of care. Two FTE staff have been hired and a third position is in process. These staff will participate in the development of integrated behavioral health treatment plans and follow up on emergency room and hospital utilization in order to positively impact clinical outcomes, patient/provider satisfaction, and cost of care. Implementation of The Colorado Health Foundation Grant, Advancement of Integrated Behavioral Health, supported hiring seven full-time staff and the opportunity to recruit an Advanced Practice Psychiatric Nurse; this position is currently pending. the Second need ientified in the 2017 Need Assessment was for wellness San Luis Valley Health continued to work on these needs in the following areas. SLVH continues to participate in several initiatives aimed at improving clinic access and provider/health team availability - Team-based Care, CPC+, and TCPI. An organizational area of focus has been the correct identification and documentation of patients primary care providers in order to facilitate patient care services and follow up appropriately and in a timely manner. SLVH has collaborated with other San Luis Valley health care organizations in this effort. SLVH has continued other collaborative efforts such as the Rural Residency Training Program, sponsoring Lids for Kids, and is currently participating in a School-Based Health Clinic planning process. SLVH participated in a School-Based Health Clinic planning process with the local the Federally Qualified Health Center. Schedule H, Part V, Section B, Line 16a URL where FAP is made widely available on a website: http://www.sanluisvalleyhealth.org/sites/default/files/images/financial_as sistance_policy_0.pdf The financial assistance policy can also be found by going to the home page of organization's website, under quick links click on "get financial assistancethere will be a "Financial Assistance policy" hyperlink. Schedule H, Part V, Section B, Line 16B URL where FAP application form is made widely available on a website: http://www.sanluisvalleyhealth.org/sites/default/files/images/charity_care _application.pdf The FAP Application form can also be found by going to the home page of organization's website, under quick links click on "get financial assistancethere will be an "application" hyperlink. Schedule H, Part V, Section B, Line 16C URL where the plain language summary of the fap is made widely available on a website: http://www.sanluisvalleyhealth.org/sites/default/files/images/plain_langua ge_summary_3252016.pdf The plain language summary can also be found by going to the home page of organization's website, under quick links click on "get financial assistancethere will be a "plain language summary" hyperlink. 5 Stuart Avenue Clinic 2115 Stuart St Alamosa CO 81101 Physician Clinic Rural Health Clinic - Antonito 115 Main St Antonito CO 81120 Rural Health Clinic Rural Health Clinic - La Jara 509 Main St La Jara CO 81140 Rural Health Clinic Rural Health Clinic - Monte Vista 103 Chico Court Monte Vista CO 81144 Rural Health Clinic Monte Vista Pro Therapy 2360 Sherman Avenue Monte Vista CO 81144 sports medicine physical therapy SCHEDULE H, Part I, Line 7 THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINES 7A,7B & 7C. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.THE INFORMATION FOR LINES 7E THROUGH 7I WAS DERIVED FROM INFORMATION IN THE GENERAL LEDGER AND OTHER FINANCIAL DATA RELATED SPECIFICALLY TO THE VARIOUS TYPES OF COMMUNITY BENEFITS. SCHEDULE H, Part I, Line 7, Column (f) TOTAL BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR PRIOR TO THE PERCENTAGE CALCULATION = 6,943,596. SCHEDULE H, PART II EACH ACTIVITY AND EXPENSE IN THIS CATEGORY IS RELATED TO THE LOCAL COMMUNITY BY PROMOTING OR SUPPORTING HABITAT FOR HUMANITY, PLAYGROUND CONSTRUCTION, SERVING AT THE LOCAL HOMELESS SHELTER, VOLUNTEERING AT THE LOCAL FOOD BANK, RAISING FUNDS FOR SCHOOL SUPPLIES, TRAUMA PREPARATION, WORKFORCE DEVELOPMENT, AND SAFETY OF FAMILIES AND CHILDREN THROUGH A BIKE/HELMET SAFETY EVENT. SCHEDULE H, PART III, Section A, LINE 2 THE ORGANIZATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SCHEDULE H, PART III, Section A, LINE 3 THE ORGANIZATION DOES NOT CONSIDER ANY OF ITS BAD DEBT EXPENSE TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART III, Section A, LINE 4 THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSES IS LOCATED IN FOOTNOTE 1 ON PAGE 9 OF THE ATTACHED FINANCIAL STATEMENTS. SCHEDULE H, PART III, Section B, LINE 8 THE COSTING METHODOLOGY TO DETERMINE LINE 6 WAS THE OVERALL FACILITY COST-TO-CHARGE RATIO. THE TIMING OF REVENUES FROM MEDICARE WILL NOT ALWAYS CORRESPOND TO THE TIMING OF THE EXPENSES. BASED ON MEDICARE COST REPORTS FILED. SUBSEQUENT TO YEAR END, THERE MAY BE ADDITIONAL REVENUES DUE THE HOSPITAL OR AMOUNTS DUE BACK TO MEDICARE. THE DOLLAR AMOUNT PAID TO MEDICARE WITH THE 6/30/18 COST REPORTS WAS $1,780,422. SCHEDULE H, PART III, Section C, LINE 9b FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE, THE COLLECTION PROCESS FOLLOWS THESE STEPS: A. PATIENTS ARE CONTACTED BY BROCHURE, MAIL AND PHONE CALLS FROM A FINANCIAL COUNSELOR, OR THE PATIENT ACCESS MANAGER. LETTERS SENT, BROCHURES GIVEN AND OUTBOUND PHONE CALLS AND RESPONSES ARE NOTED IN PATIENT NOTES IN THE PATIENT'S PROFILE. B. PATIENTS WHO QUALIFY FOR ASSISTANCE WILL PRESENT INFORMATION TO THE FINANCIAL COUNSELORS WHO WILL UPDATE THE REGISTRATION SECTION OF THE PATIENT PROFILE. BILINGUAL COUNSELORS OR INTERPRETERS ARE AVAILABLE. C. PATIENTS WILL BE INFORMED OF THEIR RESPONSIBILITY TO PAY CO-PAYMENTS OR OTHER SLIDING FEE PATIENT RESPONSIBILITY AMOUNTS. THEY WILL BE INFORMED IN PERSON AND BY PHONE WHENEVER POSSIBLE. PAYMENT PLANS ARE ALWAYS OFFERED FOR PATIENTS WHO CANNOT AFFORD THEIR PORTION. D. PATIENTS WHO DO NOT PAY THEIR PORTION OR COPAYMENT WILL RECEIVE AN INVOICE, PRINTED IN ENGLISH AND SPANISH, DIRECTING THEM TO PAY OR TO CALL. IF THE PATIENT CALLS AND REQUESTS ASSISTANCE FROM THE FINANCIAL COUNSELOR, THEY WILL BE DIRECTED TO THE CUSTOMER SERVICE PHONE NUMBER. E. PATIENTS WILL RECEIVE UP TO 3 LETTERS AND 2 PHONE CALLS FROM A CONTRACTED, 3RD PARTY VENDOR WHO HAVE BILINGUAL SPECIALISTS. WHEN 90 DAYS HAVE PASSED WITHOUT ANY RESPONSE FROM THE PATIENT, THE ACCOUNT WILL BE REVIEWED BY THE PATIENT ACCESS MANAGER AS WELL AS THE PATIENT ACCOUNT MANAGER-CASH POSTING, BOTH MEMBERS OF THE BUSINESS REVENUE CYCLE TEAM. F. UPON REVIEW, IF THE PORTION IS DEEMED TO BE THE RESPONSIBILITY OF THE PATIENT, THE PROCESS TOWARD COLLECTIONS WILL BEGIN. A LETTER IS SENT TO THE PATIENT FROM THE THIRD PARTY COMPANY. THE THIRD PARTY COLLECTION COMPANY FOLLOWS LEGAL PROCEEDINGS AT THIS POINT. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: SLV HEALTH SUBMITS MANY GRANTS EVERY YEAR TO IMPROVE COMMUNITY HEALTH. EACH GRANT INCLUDES A SUMMARY OF KNOWN HEALTH DATA TO JUSTIFY THE NEED FOR THE FUNDS. AS A CONSEQUENCE WE ARE VERY ATTUNED TO OUR COMMUNITY HEALTH NEEDS. THROUGH COMMUICATION WITH PROVIDERS AND COMMUNITY NON-PROFITS, THIS NEED IS ADDRESSED AS REQURIRED. SAMPLE CURRENT AND PAST PROGRAMMING HAVE INCLUDED FREE COLONOSCOPIES, BREAST HEALTH RELATED TESTING, PSA TESTING AND MUCH MORE. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SLV HEALTH PROVIDES A PATIENT FINANCIAL COUNSELOR WHO IDENTIFIES RESOURCES AND ELIGIBILITY ASSESMENT FOR PROGRAMS THROUGH FEDERAL AND STATE GOVERNMENT PROGRAMS, AS WELL AS GRANT FUNDED PROGRAM. WE ALSO PROVIDE A SLIDING FEE SCALE FOR SERVICE FOR THOSE SELF PAY PATIENTS NOT FITTING WITHIN ANY OF THESE PROGRAMS. PAY PLANS ARE ALSO SET UP FOR SELF PAY PATIENTS. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: FIVE OUT OF SIX COUNTIES SERVED BY SLVH ARE DESIGNATED AS A MEDICALLY UNDERSERVED AREA AND AS HEALTH PROFESSIONAL SHORTAGE AREAS, AND HAVE ONE OF THE HIGHEST MEDICAID POPULATIONS IN THE STATE. WITH AN AVERAGE HOUSEHOLD INCOME 1/2 THAT OF COLORADOS AVERAGE, THE CHALLENGES ARE DAUNTING IN PROVIDING HEALTHCARE IN A LOW INCOME, MEDICALLY UNDERSERVED AREA. INDIVIDUALS BELOW POVERTY LEVEL IN THE SLV REGION AVERAGE 20.2% WHICH IS HIGHER THAN THE STATE AVERAGE (12.7%) AND RANK AMONG THE HIGHEST IN PERCENTAGE OF POVERTY IN THE STATE; MEDIAN HOUSEHOLD INCOMES ($36,926) ARE FAR SHORT OF COLORADOS $60,629 [2011-2015 AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES]. THE MAJORITY OF SLVH PATIENTS ARE REPRESENTATIVE OF LOW-INCOME POPULATIONS WITH NEARLY 71% OF PATIENTS ENROLLED IN MEDICARE AND/OR MEDICAID IN 2016. THE SLV ALSO HAS POCKETS OF DIVERSE POPULATIONS INCLUDING COLLEGE STUDENTS, GUATEMALAN, AMISH, SEASONAL AND MIGRANT FARMWORKERS, AND OTHER INTERNATIONAL RELIGIOUS SECTORS THAT ALL HAVE UNIQUE NEEDS. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: SLVH IS ACTIVE IN THE COMMUNITY AND SUPPORTS STAFF WHO PROVIDE COMMUNITY RESOURCES IN AREAS THAT INCLUDE HEALTH EDUCATION AND INFORMATION, PROMOTING SAFETY AND WELLNESS TO THE GENERAL POPULATION, AND SPONSORS BEHAVIORAL HEALTH SUPPORT GROUPS. HOSPITAL LEADERSHIP AND CLINICAL PROVIDERS CONDUCT HEALTH EDUCATION INFORMATION IN THE AREAS OF ADOLESCENT HEALTH, CARE FOR PATIENTS WITH DEMENTIA, SKIN CARE, AND WOMENS HEALTH. SLVH STAFF ALSO PARTICIPATE IN COMMUNITY HEALTH INITIATIVES SUCH AS ADOLESCENT PREVENTION COALITIONS, OPIOID USE/ABUSE TASK FORCE, A NEONATAL TASK FORCE, COORDINATION OF HEALTH CARE SERVICES ACROSS THE CONTINUUM, AND WORKFORCE DEVELOPMENT ISSUES. PATIENT AND FAMILY ADVISORY COUNCILS HAVE ALSO BEEN ESTABLISHED TO BRING THE VOICE OF PATIENTS AND THEIR FAMILIES INTO PROGRAM DESIGN AND IMPROVEMENT PROCESSES. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: SLV HEALTH HAS A PROFESSIONAL AFFILIATION WITH CENTURA HEALTH SYSTEMS TO COORDINATE CARE FOR OUR SHARED PATIENTS. Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT: THE COMMUNITY BENEFIT REPORT IS FILED IN COLORADO. true ADAMS STATE University Foundation 208 EDGEMONT BLVD ALAMOSA CO 81101 846027518 501(c)(3) 8230 EDUCATION 1 Schedule I, Part I, Line 2 Organization's procedures for monitoring the use of grant funds: FUNDS YRE PROVIDED TO BE USED FOR DESIGNATED PURPOSES ONLY. ALL GRANTEES ARE SELECTED AND STRICTLY SCREENED BY THE MEDICAL CENTER. MULTI-YEAR AGREEMENTS ARE MADE WITH THE RECIPIENT ORGANIZATIONS AND ARE EVALUATED ON AN ANNUAL BASIS BEFORE FUNDING IS CONTINUED. X X false false false false false false false true false Dennard Ellison Trustee, Physician 393714 60000 2412 9954 22788 488868 Nuwan Pilapitiya Trustee, Physician 226769 495 11650 20019 258933 Konnie Martin CEO 323864 95999 2412 13500 22564 458339 Shane Mortensen CFO 170009 33525 1634 10613 21446 237227 Patti Thompson COO 184083 35334 1729 10437 10190 241773 Greg McAuliffe CMO - Through 3/18 208610 48149 6331 11875 274965 Kelly Gallegos CCH Administrator 142875 27844 472 5415 22391 198997 Antonio Gurule Clinic Administrator 150276 28592 740 8602 11916 200126 Maureen Cooper Physician 441609 6858 13500 7182 469149 David Geiger Interim CMO 354068 36789 3564 13500 19862 427783 Carissa Tripi Physician 512306 20000 486 13500 12994 559286 James Grigsby Physician 402295 3565 13500 21488 440848 CArmelo Hernandez Trustee, Physician 292170 41584 1242 13500 19436 367932 Jason Defee Physician 427370 50000 654 27539 505563 Donna Nelson Physician 386493 2000 3564 13500 19547 425104 SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: PHYSICIANS MAY EARN A PRODUCTIVITY BONUS. SENIOR MANAGEMENT IS ELIGIBLE FOR ANNUAL VARIABLE PAY UP TO 35% FOR CEO AND 20% FOR ALL OTHER SENIOR MANAGEMENT BASED UPON CRITERIA INCLUDING HOSPITAL WIDE MEASURES AND POSITION SPECIFIC GOALS. VARIABLE PAY IS AWARDED AT THE DISCRETION OF THE BOARD FOR THE CEO AND THE CEO FOR ALL OTHER SENIOR MANAGEMENT. DAVID GEIGER See Part V 467652 employment wages false Susan Geiger See Part V 108730 Employment Wages false SCHEDULE L, PART IV, COLUMN B Relationship between interest person and the organization: BOARD MEMBER SUSAN GEIGER HAS A FAMILY RELATIONSHIP WITH Interim Chief Medical Officer DAVID GEIGER, WHO RECEIVED EMPLOYMENT WAGES FROM THE ORGANIZATION DURING THE YEAR. Interim Chief Medical Officer David Geiger has a family relationship with Board Member Susan Geiger, Who Received Employment Wages from the Organization during the year. FORM 990, PART VI, SECTION A, LINE 2 FAMILY/BUSINESS RELATIONSHIPS: BOARD OF DIRECTOR MEMBERS CHERI CROWDER AND PATRICK CROWDER HAVE A FAMILY RELATIONSHIP. BOARD MEMBER SUSAN GEIGER IS MARRIED TO DAVID GEIGER, INTERIM CHIEF MEDICAL OFFICER. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990: THE 990 IS PREPARED BY A THIRD PARTY ORGANIZATION, REVIEWED BY THE CFO AND CEO, AND APPROVED BY THE FINANCE COMMITTEE. THE BOARD OF DIRECTORS IS ALSO PROVIDED A COPY OF THE 990 FOR REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: SAN LUIS VALLEY HEALTH HAS ACURRENT CONFLICT OF INTEREST POLICY THAT IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES AND THE CEO. THE REVIEW PROCESS IS CONDUCTED FIRST WITH THE CEO AND THEN THE BOARD OF TRUSTEES. WHEN NECESSARY, THE POLICY HAS BEEN REVIEWED BY LEGAL COUNSEL. EACH YEAR, TRUSTEES ARE ASKED TO REVIEW THE POLICY AND CONFIRM AND AMEND ANY POTENTIAL CONFLICT. THESE CONFLICTS ARE REVIEWED BY THE CEO AND THE ENTIRE BOARD. CONFLICTS ARE ROUTINELY DISCUSSED AND ARE THE RESPONSIBILITY OF ALL BOARD MEMBERS TO DISCLOSE; EITHER FOR THEMSELVES OR OTHERS. THE BOARD CHAIRMAN WILL MAKE A DECISION AS TO THE NATURE OF THE CONFLICT AND THE APPROPRIATE ACTION ACCORDING TO THE POLICY. FORM 990, PART VI, SECTION B, LINE 15A REVIEW OF CEO OR TOP MANAGEMENT OFFICIAL COMPENSATION: HUMAN RESOURCES PROVIDES THE EXECUTIVE COMMITTEE OF THE BOARD WITH SALARY SURVEY DATA FROM CHA, AHA, AND HFMA. AFTER STUDYING THE DATA, THE EXECUTIVE COMMITTEE MAKES RECOMMENDATIONS TO THE FULL BOARD IN EXECUTIVE SESSION. THE FULL BOARD APPROVES THE CEO'S COMPENSATION. SLVH CONDUCTS AN ANNUAL EVALUATION AND QUARTERLY REVIEWS OF THE CEO'S PERFORMANCE, WHICH IS DOCUMENTED. COMPENSATION FOR THE CEO IS DETERMINED ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15B REVIEW OF OTHER OFFICER OR KEY EMPLOYEES COMPENSATION: HUMAN RESOURCES GATHERS COMPENSATION SURVEY DATA FROM CHA, AHA, AND HFMA. HUMAN RESOURCES MAKES RECOMMENDATIONS FOR OTHER OFFICERS' COMPENSATION AND PROVIDES SURVEY DATA TO THE CEO. THE CEO PERFORMS EVALUATIONS AND DETERMINES ALL OF THE WAGE CHANGES FOR THE OTHER OFFICERS ON AN ANNUAL BASIS. ALL CHANGES ARE DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 DESCRIBE HOW GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 Other changes in net assets: change in investment in foundation (399,485) FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT LABOR TOTAL FEES:5178337 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT SERVICES TOTAL FEES:2766623 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING TOTAL FEES:568150 FORM 990 PART IX LINE 11G DESCRIPTION:LAB TESTING TOTAL FEES:434239 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL PROFESSIONSALS TOTAL FEES:21280 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTIONS TOTAL FEES:841383 FORM 990 PART IX LINE 11G DESCRIPTION:LAUNDRY SERVICE TOTAL FEES:246924 SAN LUIS VALLEY HEALTH FOUNDATION 106 BLANCA AVENUE ALAMOSA CO 81101 203799814 FUNDRAISING CO 501(C)(3) LINE 7 SLVH true CONEJOS COUNTY HOSPITAL FOUNDATION 19021 US HWY 285 LA JARA CO 81140 320379184 FUNDRAISING CO 501(C)(3) LINE 7 SLVH true false false true false false false false false false false false true true true true true true false false SAN LUIS Valley Health FOUNDATION C 1391845 Interco Amount Conejos Country Hospital Foundation C 153995 Interco Amount