2015-05-15T16:49:48-05:00 2014-06-30 BKD LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2013-07-01 840255530 Lutheran Hosp Assoc of the San Luis Valley % THE ORGANIZATION LUTH 7195892511 106 Blanca Avenue Suite Alamosa CO 81101 Shane Mortensen CFO 7194714290 2015-05-15 true Rita F Worster CPA P00290681 7194714290 2013 2016-02-25 16:41:14Z San Luis Valley Health Konnie Martin CEO 106 Blanca Avenue Alamosa CO 81101 74843283 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 9 726 14 0 0 710660 1346376 62005021 72868307 211199 200907 62734 369334 62989614 74784924 7000 7000 0 0 33753674 41213971 0 0 257046 29548314 32701431 63308988 73922402 -319374 862522 66066389 69310715 24928623 23646974 41137766 45663741 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. true false 55935591 7000 72977801 San Luis Valley Health was formed July 1, 2013. Prior to the merge that created San Luis Valley Health it operated as an independent, not-for-profit hospital for over 83 years. The merge brought together, San Luis Valley Regional Medical Center and Conejos County Hospital. Prior to the merge, 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 almost 600 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. SLV Health's operating expense per adjusted patient day is $2,999 compared to a Colorado average of $3,367 and a rural hospital average of $3,753. Over the last nine years, our gross revenue has increased from $20M to $60M 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 and more. 55935591 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 true false false false false false false false false true false false false false false false true true false true false true 99 0 true 726 true false 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 JAN GAY trustee 2.0 2.0 X 3000 karla hardesty president 2.0 X X 1000 KENDAL KNAUS MD SECRETARY/TREASURER 2.0 X X 54400 JIM EHRLICH vice president 2.0 X X PATRICK CROWDER TRUSTEE 2.0 X 957 KATHY LORENZ TRUSTEE 2.0 2.0 X 1022 cheri crowder TRUSTEE 2.0 2.0 X 1200 ROSALIE MARTINEZ TRUSTEE 2.0 2.0 X 900 steven w kitchen physician 40.0 X 508749 31675 nuwan pilapitiya physician 40.0 X 203476 27649 susan geiger physician 40.0 X 107591 5341 dennard ellison physician 40.0 X 408503 31350 donald shawcroft trustee 2.0 2.0 X richard martin trustee 2.0 X henry garvin cch administrator - former 40.0 X 190511 79477 konnie martin ceo 40.0 2.0 X 222212 31787 patti thompson cno 40.0 X 156137 20075 greg mcauliffe md cmo 40.0 X 253770 33250 shane mortensen cfo 40.0 1.0 X 146467 24612 kelly gallegos cch administrator 40.0 X 100982 23628 robert marshall physician 40.0 X 345512 31703 david geiger PHYSICIAN 40.0 X 374977 31675 clifford robbins PHYSICIAN 40.0 X 343479 0 21360 carissa tripi physician 40.0 X 521149 15713 james grigsby physician 40.0 X 398883 15308 4344877 0 424603 51 false true false caretech solutions inc po box 674271 DETROIT MI 48267 CONTRACT SERVICES 1517640 weatherby locums po box 972633 DALLAS TX 75397 contract labor 442229 comphealth po box 972651 DALLAS TX 75397 contract labor 281581 nuance communications po box 2561 CAROL STREAM IL 60132 contract services 166081 medical solutions 9101 western ave OMAHA NE 68114 contract labor 161208 10 43734 716524 586118 1346376 PATIENT SERVICE REVENUE 900099 32460563 32460563 MEDICARE/MEDICAID 900099 36689526 36689526 ELECTRONIC HEALTH RECORD PAYMENTS 900099 2826356 2826356 AMBULANCE DISTRICT REVENUE 621910 439889 439889 340B PAYMENTS 900099 213969 213969 238004 238004 72868307 194621 194621 0 0 92029 48491 43538 0 43538 43538 16154 9868 6286 6286 6286 0 0 0 CAFETERIA SALES 900099 174069 174069 LAUNDRY 900099 24448 24448 ABSTRACTS 900099 22482 22482 104797 87012 17785 325796 74784924 72977801 0 460747 7000 7000 0 0 0 2669725 2083078 572127 14520 0 31500176 24572882 6755771 171523 1103480 862851 234704 5925 3745972 2926591 799128 20253 2194618 1626384 554129 14105 0 66720 66720 147205 147205 8200 8200 0 0 5475750 2697987 2777763 144586 116663 27923 2454384 925205 1526942 2237 1425124 712562 712562 0 1992311 1816685 175626 299943 194092 105291 560 0 14540 8998 5542 729696 729696 0 3662485 2194880 1467605 527235 375519 151716 MEDICAL SUPPLIES 6367423 6303225 64198 PROVIDER FEES 3330816 3330816 BAD DEBT 5273259 5273259 COLLECTION EXPENSE 395474 395474 386280 23577 362703 73922402 55935591 17729765 257046 1069989 397727 10897195 13290216 117248 144538 9316217 10319292 0 0 0 0 0 0 887822 1112397 1113349 1676455 67927464 36965506 30912692 30961958 9973969 10088991 100 100 134718 197866 0 0 1643090 1121175 66066389 69310715 6170511 5978683 0 0 18210 2081 14345000 13770000 0 0 0 0 2797593 2399493 0 0 1597309 1496717 24928623 23646974 X 41003048 45465875 134718 197866 0 0 41137766 45663741 66066389 69310715 X 862522 -22448 3685901 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 6150 false false 6150 false Dir. contact with legislators, their staff, gov't officials, etc. 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. 134718 63148 197866 94572 40146 134718 86517 8055 94572 133304 46787 86517 76317 56987 133304 1.00000 false true true 3432682 3432682 37754901 17975101 19779800 24807123 18407010 6400113 1932758 583395 1349363 30961958 0 ASSET RETIREMENT OBLIGATION 270531 INTEREST RATE SWAP AGREEMENT 1198689 RELATED PARTY PAYABLE 27497 1496717 74914737 -22448 227312 204864 74709873 75051 75051 74784924 73883428 36077 36077 73847351 75051 75051 73922402 Schedule D, Part V, Line 4 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 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 change in fair market value of interest rate swap 128,089 change in fair market value of investment in foundation 63,146 rental expenses reclassed to income 36,077 Schedule D, Part XII, Line 2d rental expenses reclassed to income 36,077 schedule d, part xi, line 4b grant revenue classed as expense on financial statements 75,051 schedule d, part xii, line 4b grant revenue classed as expense on financial statements 75,051 true true X true X 40. true X true true false false 142072 142072 0.00210 20399094 17967902 2431193 0.03550 1678349 2604804 -926455 22219515 20572706 1646810 0.03760 103859 103859 0.00150 238477 56782 181695 0.00260 1993 1993 82663 82663 0.00120 426992 56782 370210 0.00530 22646507 20629488 2017020 0.04290 6420 6420 0.00010 4209 4209 0.00010 9709 9709 0.00010 20338 20338 0.00030 true 5273259 12017823 13221636 -1203813 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 true X X X X X X X X X 12 true true true X see part v, section c for url X X X X X X X X X true false true true 40. true 250. true X X X X true true X X X X X true false X X X true X false false input from representatives of the community part v, section b, line 3 In February 2013 evening meetings in Alamosa and in Conejos County were held. Community members were given time to share and prioritize the health issues that they see in the San Luis Valley. The Project Management met with the various Public Health agencies to discuss strategies to address the identified priority areas. Suggestions made were integrated into the CHNA. other hospital facilities involved with chna part v, section b, line 4 the chna for SLV Health was conducted with conejos county hospital. describe how chna is made widely available to the public part v, section b, line 5 the CHNA executive summary for SLV Health is available at: http://www.sanluisvalleyhealth.org/sites/default/files/documents/Executive Summary_0.pdf implementation strategy for chna part v, section b, line 6 the implementation strategy to address each community health need identified through the chna is available on the CHNA executive summary at: http://www.sanluisvalleyhealth.org/sites/default/files/documents/Executive Summary_0.pdf 4 Lutheran Hospital of SLV 2115 Stuart St Alamosa CO 81101 Physician Clinic Lutheran Hospital of SLV 103 Chico Ct Monte Vista CO 81144 Physician Clinic Lutheran Hospital of SLV - RHC 115 Main St Antonito CO 81120 Rural Health Clinic Lutheran Hospital of SLV - RHC 509 Main St La Jara CO 81140 Rural Health Clinic Free and discounted care Part I Line 3c The hospital uses a sliding scale based on family income to determine eligibility for free and discounted care. The sliding scale provides free care and discounted care up to 40% and 250%, respectively, of the Federal Poverty Guidelines. Part I Line 7 Total bad debt expense removed from the denominator prior to the percentage calculation = 5,273,259. 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. PART III, LINE 4 Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, 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. For receivables associated with services provided to patients who have third-party coverage, the organization analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the organization records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or provided by policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. THE ADMINISTRATIVE REQUIREMENTS TO DETERMINE WHETHER PATIENTS WHO DO NOT COOPERATE WITH THE FINANCIAL ASSISTANCE PROCESS WOULD HAVE QUALIFIED FOR CHARITY CAN BE BURDENSOME, PARTICULARLY FOR SMALL BALANCES, SO A REASONABLE ESTIMATE, BASED ON BROAD DEMOGRAPHIC DATA, SHOULD BE SUFFICIENT TO JUSTIFY COMMUNITY BENEFIT TREATMENT. Medicare PART III, 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 after the end of the year there may be additional revenues due the hospital or amounts due back to Medicare. The surplus or (shortfall) for the last three years is as follows: 6/30/12 3,092,126 6/30/13 (2,322,085) 6/30/14 (1,203,813) 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. 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. COMMUNITY INFORMATION SLV Health SERVICES THE ENTIRE SAN LUIS VALLEY WHICH HAS A POPULATION OF NEARLY 50,000 RESIDENTS WITHIN 6 COUNTIES. THE SLV IS GEOGRAPHICALLY LIMITED DUE TO ITS SURROUNDING MOUNTAIN PASSES THAT SOMETIMES MAKES IT DIFFICULT TO TRAVEL ELSEWHERE WHEN CARE ISN'T AVAILABLE HERE. THE AVERAGE POVERTY LEVEL IS APPROXIMATELY 23.05% COMPARED TO COLORADO AVERAGE OF 12.9%. MEDIAN INCOME LEVELS ARE APPROXIMATELY $35,457 COMPARED TO $58,433 STATEWIDE. 61% OF HOUSEHOLDS IN THE SIX COUNTY AREA ARE MODERATE TO LOW INCOME. APPROXIMATELY 69% OF OUR PAYER MIX COMES FROM UNINSURED, MEDICARE/MEDICAID PATIENTS, CICP, OR SELF-PAY. PROMOTION OF COMMUNITY HEALTH SLV Health is very active in the community in providing resources, information and donations to promote healthy living in school, business' and the general population. SLV Health provides free or reduced rate physicals for students and other programs. SLV Health staff is very active in the community serving on related boards and providing other community benefit while on the hospital payroll. SLV Health provides many speaking tours on health related topics all over the San Luis Valley to inform and instruct residents on various issues. SLV Health HAS INITIATED THE GETHEALTHYSLV.ORG WEBSITE TO INFORM COMMUNITY MEMBERS OF THEIR HEALTH CARE RESOURCES AND TO LEARN ABOUT HEALTHY HABITS. SLV Health HAS ALSO ESTABLISHED THREE PATIENT ADVISORY COUNCILS TO HELP US IMPROVE OUR HEALTHCARE SERVICES FOR DIABETES, HEALTH DISEASE AND CANCER. AFFILIATED HEALTH CARE SYSTEM SLV Health HAS A PROFESSIONAL AFFILIATION WITH CENTURA HEALTH SYSTEMS TO COORDINATE CARE FOR OUR SHARED PATIENTS. true ADAMS STATE COLLEGE 208 EDGEMONT BLVD ALAMOSA CO 81102 846000542 GOVERNMENT 7000 EDUCATION 1 schedule i, part i, line 2 FUNDS ARE 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 X true false false false false false false true false steven w kitchen physician 505204 3545 12750 18925 540424 nuwan pilapitiya physician 203058 250 168 10463 17186 231125 henry garvin cch administrator - former 155845 34666 63465 16012 269988 konnie martin ceo 221731 481 11495 20292 253999 robert marshall physician 327581 16473 1458 12664 19039 377215 patti thompson cno 155842 295 2584 17491 176212 greg mcauliffe md cmo 252110 1660 12750 20500 287020 shane mortensen cfo 146199 268 7650 16962 171079 dennard ellison physician 390004 18499 12311 19039 439853 david geiger PHYSICIAN 337976 17904 19097 12750 18925 406652 clifford robbins PHYSICIAN 336106 0 6708 0 665 0 12750 0 8610 0 364839 0 0 0 carissa tripi physician 495717 25000 432 3462 12251 536862 james grigsby physician 379571 19312 5590 9718 414191 schedule j, PART I, LINE 4A THE FOLLOWING AMOUNTS LISTED ARE SEVERANCE PAYMENTS: - HENRY GARVIN $90,131 $34,666 of this amount will be reported on henry garvin's 2013 w-2 and $55,465 will be reported on his 2014 w-2. schedule j, part i, line 7 CLINICAL KEY EMPLOYEES 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 AWARED AT THE DISCRETION OF THE BOARD FOR THE CEO AND THE CEO FOR ALL OTHER SENIOR MANAGEMENT. A ALAMOSA COUNTY STATE OF COLORADO 846000733 011583AA9 2005-02-17 11355000 HOSPITAL IMPROVEMENTS false false false B ALAMOSA COUNTY STATE OF COLORADO 846000733 011583AB7 2007-04-26 6505000 PURCHASE 2115 STUART & IMPROVEMENT false false false A 2840000 0 11355000 157158 0 0 362859 0 0 10992141 0 0 2005 false false true true B 1250000 0 6505000 31610 0 0 130100 81852 0 6293048 0 0 2007 false false true true A false true false false 0.01000 0.00000 0.01000 true false 0.00000 false true B false true false false 0.02690 0.00000 0.02690 true false 0.00000 false true A false false false true true true MORGAN STANLEY CAP 20.282 false false false 0 false true B false false false true true true MORGAN STANLEY CAP 15. false false false 0 false true A true B true schedule k, part iv, question 2c THE ALAMOSA COUNTY, CO SERIES 2005 BOND ARBITRAGE REBATE LIABILITY CALCULATION WAS PERFORMED ON SEPTEMBER 29, 2011. THE ALAMOSA COUNTY, CO SERIES 2007 BOND ARBITRAGE REBATE LIABILITY CALCULATION WAS PERFORMED ON MAY 15, 2012. DAVID GEIGER EMPLOYEE WAGES false BUSINESS TRANSACTIONS WITH INTERESTED PERSONS BOARD MEMBER SUSAN GEIGER HAS A FAMILY RELATIONSHIP WITH HIGHEST COMPENSATED EMPLOYEE DAVID GEIGER. THE AMOUNT OF WAGES PAID CAN BE FOUND ON SCHEDULE J, PART II, LINE 9. form 990, Part VI, Question 11b 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, Question 12c San Luis Valley Health has a current 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, Question 15a 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, Question 15b 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, Question 19 The governing documents, conflict of interest policy, and financial statements are available to the public upon request. form 990, PART XI, LINE 9 CHANGE IN FAIR MARKET VALUE OF INTEREST RATE SWAP 128,089 CHANGE IN FAIR MARKET VALUE OF INVESTMENT IN FOUNDATION 63,146 CONEJOS COUNTY HOSPITAL NET ASSETS - MERGER 3,494,666 TOTAL OTHER CHANGES TO NET ASSETS 3,685,901 form 990, PART VI, question 2 BOARD OF DIRECTOR MEMBERS CHERI CROWDER AND PATRICK CROWDER HAVE A FAMILY RELATIONSHIP. form 990, part iii, question 2 lutheran hospital association of the san luis valley, dba san luis valley regional medical center and conejos county hospital corporation merged in 2013. conejos county hospital corporation activities will now be reflected on the lutheran hospital association of the san luis valley form 990. SAN LUIS VALLEY HEALTH FOUNDATION 106 BLANCA AVENUE ALAMOSA CO 81101 203799814 FUNDRAISING CO 501(c)(3) LINE 7 SLVRMC true CONEJOS COUNTY HOSPITAL FOUNDATION 19021 US HWY 285 LA JARA CO 81140 320379184 FUNDRAISING CO 501(c)(3) LINE 7 SLVRMC true SLV MEDICAL CTR EMPLOYEE BEN TRUST 106 BLANCA AVENUE ALAMOSA CO 81101 840909851 HEALTH PLAN CO 501(c)(9) na false false false true true false false false false false false true true false true false true false false SLVRMC EMPLOYEE BENEFIT TRUST M 2160955 CASH PAID