2013-05-08T17:44:26-05:00 2012-06-30 ERNST & YOUNG US LLP TWO NORTH CENTRAL AVENUE STE 2300 PHOENIX AZ 85004 990 2011-07-01 850127924 SAN JUAN REGIONAL MEDICAL CENTER % J MICHAEL PHILIPS SANJ 5056096110 801 WEST MAPLE STREET FARMINGTON NM 87401 RICK WALLACE 2013-05-02 6023223000 2011 2016-02-25 16:41:14Z RICK WALLACE 801 WEST MAPLE STREET FARMINGTON NM 87401 250913779 false X WWW.SANJUANREGIONAL.COM X 1953 NM SAN JUAN REGIONAL MEDICAL CENTER'S MISSION IS TO PERSONALIZE HEALTH CARE AND CREATE ENTHUSIASM AND VITALITY IN HEALING. 12 10 2027 200 0 0 3330805 4078279 263233116 242701524 5289552 4133976 0 0 271853473 250913779 545532 448500 0 0 139489221 147758101 0 0 0 120915820 93565003 260950573 241771604 10902900 9142175 333796571 351253027 106809500 118166894 226987071 233086133 X SAN JUAN REGIONAL MEDICAL CENTER'S MISSION IS TO PERSONALIZE HEALTH CARE AND CREATE ENTHUSIASM AND VITALITY IN HEALING. false false 223407247 448500 242701524 ALL ACTIVITY IS DIRECTLY RELATED TO PROVIDING PATIENT MEDICAL SERVICES AND QUALITY HEALTH CARE TO THE COMMUNITY AND SURROUNDING RURAL AREAS. SEE SCHEDULE O FOR OVERVIEW AND PROGRAMS. 223407247 true true false true false false false false false false true false false false true true 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 true false false false false true true true false false true 121 0 true 2027 true false false false false false false false false false false X 12 10 true false false false true true false true true false false true true true true true true true true true true NM X J MICHAEL PHILIPS 5056096025 801 WEST MAPLE STREET FARMINGTON NM 87401 X MICHAEL A JAKINO 6.0 X X 0 0 0 SANDY WILLIAMS 6.0 X X 0 0 0 JAMES SHAHEEN 6.0 X X 0 0 0 RONALD CALCOTE MD 6.0 X X 7700 0 0 PAUL DESHAYES 6.0 X X 0 0 0 JOSEPH RASOR 6.0 X 0 0 0 JEFF BOWMAN 6.0 X 0 0 0 CHARLENE SCOTT 6.0 X 0 0 0 CHRISTIAN MOORE 6.0 X 0 0 0 DWAYNE GIBBS MD 6.0 X 111840 0 0 CHARLES HOFFMAN MD 40.0 X 384414 0 25950 RICHARD MENNING 6.0 X 0 0 0 RICK WALLACE 40.0 X 543600 0 47078 JOHN BUFFINGTON 40.0 X 369287 0 41084 J MICHAEL PHILIPS 40.0 X 449385 0 32296 SUZANNE SMITH 40.0 X 253299 0 34736 EDWARD MAURIN 40.0 X 651524 0 26804 TIBOR BOCO 40.0 X 613053 0 21346 CHARLES E WILKINS 40.0 X 584420 0 26198 MARC A FLITTER 40.0 X 576615 0 28354 LUTHER B WEATHERS III 40.0 X 547956 0 18477 5093093 0 302323 220 false true false ARAMARK CLINICAL TECHNOLOGIES PO BOX 100401 PASADENA CA 91189 BOP-MED/HOUSEKEEPING 1784004 TOTAL RENAL CARE INC 6000 FELDWOOD COLLEGE PARK GA 30349 DIALYSIS SERVICES 1552815 RESOURCE ANESTHESIOLOGY 10 COMMERCE DRIVE NEW ROCHELLE NY 10801 ANESTHESIA SERVICES 1364609 QUEST DIAGNOSTICS INC 3924 COLLECTION CENTER CHICAGO IL 60693 CLINICAL LAB SERVICE 983184 FOUR CORNERS ANESTHESIA 1515 E 20TH ST FARMINGTON NM 87401 ANESTHESIA SERVICES 505004 14 4012279 66000 1074609 4078279 NET PATIENT SERVICES REVENUE 622110 238627030 238627030 CAFETERIA 722210 1186531 1186531 MEDICAL OFFICE BLDG. RENTAL 531120 422482 422482 ALL OTHER PROGRAM SERVICE REVENUE 900099 2465481 2465481 242701524 4012677 4012677 0 0 101721 19578 0 0 101721 19578 121299 121299 0 0 0 0 250913779 242701524 0 4133976 448500 448500 0 0 0 3199001 3199001 171296 171296 110334964 105538232 4796732 5289582 4910591 378991 21245692 19700110 1545582 7517566 7044514 473052 0 134976 47762 87214 300000 270080 29920 55910 55910 0 558937 558937 19711619 19561116 150503 691161 691161 36963921 36733738 230183 3251060 3251060 0 3636675 3438126 198549 343389 219124 124265 0 1017555 793871 223684 2868574 2582485 286089 0 13494165 12148362 1345803 3310956 2933801 377155 EQUIPMENT RENTAL & MAINTENANCE 7226105 6865539 360566 241771604 223407247 18364357 0 15379305 18918429 7205526 6962125 336523 268472 28548327 32551914 0 0 0 0 2696387 1771655 3562331 3590660 3158268 3906581 295514083 139651162 156919300 155862921 106815387 109468043 7365653 7489563 0 0 0 0 1809564 10462664 333796571 351253027 26039957 28784451 0 0 0 0 67636747 64049445 0 0 0 0 10791375 9064974 0 0 2341421 16268024 106809500 118166894 X 226987071 233086133 0 0 0 0 226987071 233086133 333796571 351253027 X 9142175 -3043113 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 39838 false true 16072 55910 false LOBBYING ACTIVITIES SCHEDULE C, PART II-B LINE 1 G - SAN JUAN REGIONAL MEDICAL CENTER PAID NEW MEXICO GOVERNMENT AFFAIRS $39,838 FOR A LOBBYIST IN SANTA FE, NEW MEXICO WHO MONITORS NEW MEXICO STATE LEGISLATIVE ISSUES WITH REGARD TO HOSPITAL ISSUES, KEEPS SAN JUAN REGIONAL MEDICAL CENTER APPRISED OF THOSE ISSUES AND TAKES FEEDBACK TO THE STATE LEGISLATURE. LINE 1I - A PORTION OF THE DUES PAID TO HEALTHCARE ASSOCIATIONS BY SAN JUAN REGIONAL MEDICAL CENTER WAS ALLOCATED TO LOBBYING ACTIVITIES: 1. NEW MEXICO HOSPITAL AND HEALTH SYSTEMS - $9,276 2. AMERICAN HOSPITAL ASSOCIATION - $6,796 5914671 5914671 109144188 30409349 78734839 69477063 36167389 33309674 108565758 73074424 35491334 2412403 0 2412403 155862921 0 PROF. & GENERAL INSURANCE LIABILITY 12474000 DUE TO THIRD PARTY PAYORS 3313427 457(F) EXECUTIVE PENSION LIABILITY 480597 16268024 ASC 740 FOOTNOTE SCHEDULE D, PART X, LINE 2 ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, PRESCRIBES CRITERIA FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE, AND TRANSITION. IN ACCORDANCE WITH THIS ACCOUNTING GUIDANCE, MANAGEMENT HAS REVIEWED ALL OPEN TAX YEARS AND HAS DETERMINED THAT THE COMPANY HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS. true true X true X true X true true true false true true 692 2477586 1406872 1070714 0.00440 692 2477586 1406872 1070714 0.00440 11682 454952 0 454952 0.00190 77 1453420 0 1453420 0.00600 170348 155145335 120957570 34187765 0.14140 10652 241791 250 241541 0.00100 192759 157295498 120957820 36337678 0.15030 193451 159773084 122364692 37408392 0.15470 1104 0 1104 0.00000 1434976 0 1434976 0.00590 1436080 0 1436080 0.00590 true 25552890 6388223 60018319 67898087 -7879768 X true true FOUR CORNERS ASC AMBULATORY SURGERY CENTER 0.38000 0.00000 0.62000 1 1 SAN JUAN REGIONAL MEDICAL CENTER

801 West Maple Street Farmington NM 87401

X X X SAN JUAN REGIONAL MEDICAL CENTER 1 true true 200. true 400. true X X X X X X true true X X X X X true false true X false false 21 SJRMC CARDIOLOGY

407 S SCHWARTZ SUITE 201 FARMINGTON NM 87401

MEDICAL CLINIC SJRMC INTERNAL MEDICINE

407 S SCHWARTZ SUITE 101 FARMINGTON NM 87401

MEDICAL CLINIC SJRMC BLOOMFIELD CLINIC

100 N CHURCH STREET BLOOMFIELD NM 87413

MEDICAL CLINIC SAN JUAN NEURODIAGNOSTIC CENTER

407 S SCHWARTZ SUITE 202 FARMINGTON NM 87401

MEDICAL CLINIC SAN JUAN PEDIATRICS

407 S SCHWARTZ SUITE 102 FARMINGTON NM 87401

MEDICAL CLINIC FOUR CORNERS NEUROSURGERY

407 S SCHWARTZ SUITE 202 FARMINGTON NM 87401

MEDICAL CLINIC SJRMC MIDWIFERY CLINIC

655 WEST PINON FARMINGTON NM 87401

MEDICAL CLINIC OUTPATIENT BEHAVIORAL HEALTH CLINIC

555 S SCHWARTZ FARMINGTON NM 87401

MEDICAL CLINIC URGENT CARE CENTER

4820 E MAIN STREET FARMINGTON NM 87402

URGENT CARE CENTER SJR WOUND CARE CENTER

4251 ENGLISH ROAD FARMINGTON NM 87402

WOUND CARE CENTER SJR CANCER TREATMENT CENTER

731 W ANIMAS STREET FARMINGTON NM 87401

CANCER TREATMENT SJRMC OUTPATIENT DIAGNOSTIC CENTER

2300 E 30TH STREET - BLDG C FARMINGTON NM 87401

DIAGNOSTIC CENTER SJRMC EMS STATION - MEDIC #1

730 S LAKE STREET FARMINGTON NM 87401

EMS STATION SJRMC EMS STATION - MEDIC #2

902 W BROADWAY FARMINGTON NM 87401

EMS STATION SJRMC EMS STATION - MEDIC #3

484 S OLIVER STREET AZTEC NM 87410

EMS STATION SJRMC EMS STATION - MEDIC #4

4 CR 3660 KIRTLAND NM 87117

EMS STATION SJRMC EMS STATION - MEDIC #5

3782 ENGLISH ROAD FARMINGTON NM 87402

EMS STATION SJRMC EMS STATION - MEDIC #6

2014 E 16TH STREET FARMINGTON NM 87401

EMS STATION SJRMC EMS STATION - MEDIC #10

737 W ANIMAS STREET FARMINGTON NM 87401

EMS STATION SJRMC AZTEC CLINIC

120 LLANO AZTEC NM 87410

CLINIC GENERAL SURGERY CLINIC

630 WEST MAPLE FARMINGTON NM 87401

CLINIC SCHEDULE H, PART I, LINE 6A: AN ANNUAL REPORT IS PREPARED AND MAILED TO THE CITIZENS OF FARMINGTON, NM AND THE SURROUNDING COMMUNITIES. IN THE ANNUAL REPORT IS FINANCIAL INFORMATION FOR THE HOSPITAL, STORIES OF CARE, AND INFORMATION ABOUT NEW PROGRAMS OR SERVICES PROVIDED BY THE HOSPITAL. SCHEDULE H, PART I, LINE 7: SJRMC USES A COST ACCOUNTING SYSTEM WHICH IS A PART OF ITS HOSPITAL INFORMATION SYSTEM. THE SYSTEM ADDRESSES ALL PATIENT SEGMENTS. SCHEDULE H, PART I, LINE 7E: THE AMOUNTS SUMMARIZED INCLUDE PROGRAMS FOR COMMUNITY HEALTH EDUCATION WHICH INCLUDES: HEALTH FAIRS AND HEALTH EDUCATION SEMINARS LACTATION CONSULTATION AND OUTPATIENT DIETITIAN SERVICES SCHEDULE H, PART I, LINE 7G: SAN JUAN REGIONAL MEDICAL CENTER PROVIDES NUMEROUS SUBSIDIZED HEALTH SERVICES TO THE COMMUNITY. THESE SUBSIDIZED HEALTH SERVICES ARE: EMERGENCY AND TRAUMA SERVICES 3,923,510 AMBULATORY CARE CENTERS 17,201,622 ORTHOPEDICS 1,928,927 ONCOLOGY 632,855 BEHAVIORAL HEALTH-IP 1,128,705 CARDIAC REHAB 299,617 OUTPATIENT NURSING/WOUND CARE 2,352,534 OUTPATIENT THERAPIES 1,637,090 OBSTETRIC/NURSERY 2,246,090 OTHER 2,836,815 -------------- TOTAL 34,187,765 COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II THE FEDERAL GOVERNMENT THROUGH HRSA HAS DESIGNATED SAN JUAN COUNTY AS A SHORTAGE AREA FOR PHYSICIANS. IN ORDER TO REDUCE THIS SHORTAGE SAN JUAN REGIONAL MEDICAL CENTER HAS BEEN RECRUITING FOR PHYSICIANS AND IN THIS EFFORT SPENT $1,434,976 IN FY 2012. SCHEDULE H, PART III, LINE 4: THE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE IS LOCATED ON PAGE 7 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. THE AMOUNT ON LINE 3 IS AN ESTIMATE BASED ON MANAGEMENT'S BELIEF OF THE PERCENTAGE OF ADDITIONAL FINANCIAL ASSISTANCE COST IF THE PATIENTS WOULD COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. THIS AMOUNT IS CURRENTLY ESTIMATED AT 25% THAT IS INCLUDED IN OUR BAD DEBT. SCHEDULE H, PART III, LINE 8: THE AMOUNT OF MEDICARE SHORTFALL REPORTED ON LINE 7 IS $(7,879,768). THIS AMOUNT IS A RESULT OF THE TOTAL REVENUE AND ALLOWABLE COST CALCULATION ON OUR FY 12 COST REPORT. THE HOSPITAL'S ACTUAL EXPENSES ARE ENTERED INTO THE COST REPORT SOFTWARE AND THE ALLOWABLE COSTS ARE DETERMINED BY THE MEDICARE REGULATIONS. THIS MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE, ABSENT THIS PROGRAM, MANY INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE AND OTHER NEEDS-BASED PROGRAMS. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF THE GOVERNMENT ARE RELIEVED, AND THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS. SCHEDULE H, PART III, LINE 9B: SJRMC POLICY ON PATIENT ACCOUNT COLLECTIONS STATES "SJRMC WILL NOT ATTEMPT TO COLLECT FROM A PATIENT WHO IS APPLYING FOR THE SAN JUAN COUNTY INDIGENT FUND AS LONG AS THE PATIENT IS COOPERATING WITH THE APPLICATION PROCESS." THE POLICY ALSO STATES "SJRMC WILL NOT COLLECT FROM A PATIENT APPLYING FOR THE COMMUNITY SERVICE FUND (FINANCIAL ASSISTANCE) AS LONG AS THE PATIENT IS COOPERATING WITH THE APPLICATION PROCESS." NEEDS ASSESSMENT: SCHEDULE H, PART VI, LINE 2 A COMMUNITY NEEDS ASSESSMENT IS CONDUCTED BY SAN JUAN REGIONAL MEDICAL CENTER TO DETERMINE THE HEALTH NEEDS FOR SAN JUAN COUNTY-AND THE FOUR CORNERS REGION-AS PERCEIVED BY THOSE SERVED BY THE HOSPITAL. THE NEEDS ASSESSMENT IS CONDUCTED VIA TELEPHONE SURVEYS IN BOTH ENGLISH AND SPANISH; INTERVIEWS CONDUCTED WITH NATIVE AMERICAN RESPONDENTS; AND A SERIES OF FOCUS GROUPS. THE SURVEY IS ALSO SHARED WITH KEY COMMUNITY GROUPS IN A SERIES OF OPEN FORUMS. THE MOST RECENT ASSESSMENT OCCURRED IN CY 2011 (FY 2012). THE NEEDS WHICH WERE IDENTIFIED FROM THIS SURVEY INCLUDE: CANCER BARRIERS TO ACCESSING HEALTHCARE SERVICES IMMUNIZATION & INFECTIOUS DISEASES DIABETES MENTAL HEALTH OBESITY AND WEIGHT LOSS ORAL HEALTH PRENATAL CARE RESPIRATORY DISEASE ROUTINE CHECKUPS AND PREVENTIVE SCREENINGS SEXUALLY TRANSMITTED DISEASES TEEN BIRTHS AND UNWED MOTHERS UNINTENTIONAL INJURY SUBSTANCE/TOBACCO USE THE SAN JUAN REGIONAL MEDICAL CENTER BOARD OF DIRECTORS AND HOSPITAL ADMINISTRATION CONDUCTS THE SURVEY FOR THE PURPOSE OF DETERMINING HOW BEST TO DIRECT RESOURCES TO IMPROVE THE HEALTH OF THE FOUR CORNERS WITH THREE GOALS IN MIND: - TO IMPROVE RESIDENTS' HEALTH STATUS, INCREASE THEIR LIFE SPANS, AND ELEVATE THEIR OVERALL QUALITY OF LIFE. - TO REDUCE HEALTH DISPARITIES AMONG RESIDENTS BY IDENTIFYING POPULATION SEGMENTS WHO ARE MOST AT-RISK FOR VARIOUS DISEASES AND INJURIES. INTERVENTION PLANS AIMED AT TARGETING THESE INDIVIDUALS ARE ALSO DEVELOPED TO COMBAT SOME OF THE SOCIO-ECONOMIC FACTORS WHICH HAVE HISTORICALLY HAD A NEGATIVE IMPACT ON RESIDENTS' HEALTH. - TO INCREASE ACCESSIBILITY TO PREVENTIVE SERVICES FOR ALL COMMUNITY RESIDENTS. MORE ACCESSIBLE PREVENTIVE SERVICES WILL PROVE BENEFICIAL IN ACCOMPLISHING THE FIRST GOAL (IMPROVING HEALTH STATUS, INCREASING LIFE SPANS, AND ELEVATING QUALITY OF LIFE), AS WELL AS LOWERING THE COSTS ASSOCIATED WITH CARING FOR LATE-STAGE DISEASES RESULTING FROM A LACK OF PREVENTIVE CARE. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: SCHEDULE H, PART VI, LINE 3 POLICY: SAN JUAN REGIONAL MEDICAL CENTER (SJRMC) WILL RENDER FINANCIAL ASSISTANCE TO PERSONS WITH A DEMONSTRATED INABILITY TO PAY, REGARDLESS OF RACE, COLOR OR CREED. FINANCIAL ASSISTANCE REPRESENTS MEDICAL SERVICES PROVIDED TO A PERSON FOR WHICH THE HOSPITAL HAS NO EXPECTATION OF RECEIVING FULL PAYMENT. FINANCIAL ASSISTANCE ELIGIBILITY DOES NOT ALWAYS MEAN THAT A MEDICAL DEBT OWED TO THE HOSPITAL IS COMPLETELY ELIMINATED. THERE MAY BE A RESIDUAL AMOUNT THE PATIENT OR HOUSEHOLD IS EXPECTED TO PAY. PURPOSE: WE RECOGNIZE THAT IT WILL BE NECESSARY TO IDENTIFY THE MEDICAL INDIGENT PATIENT AND ESTABLISH THE AMOUNT OF FINANCIAL ASSISTANCE TO BE RENDERED IN A MANNER MOST RESPONSIVE TO THE NEEDS OF THE COMMUNITY. SJRMC WILL CLEARLY DISTINGUISH IT FROM BAD DEBT. FINANCIAL ASSISTANCE WILL BE IDENTIFIED AND RECORDED AS SUCH, AS EARLY AS POSSIBLE IN THE REGISTRATION AND COLLECTION PROCESS. AN INDIVIDUAL WHO IS TOO POOR TO MEET HIS OR HER MEDICAL EXPENSES IS GENERALLY CATEGORIZED AS MEDICALLY INDIGENT. THE TERM INCLUDES PEOPLE WHOSE INCOME IS SUFFICIENT TO PAY FOR BASIC LIVING EXPENSES BUT NOT ADEQUATE TO PAY FOR UNEXPECTED OR LARGE MEDICAL BILLS. ELIGIBILITY WILL BE DECIDED ON A CASE-BY-CASE BASIS. WHILE FAMILY SIZE AND HOUSEHOLD INCOME ARE THE PRIMARY DETERMINANTS, OTHER FACTORS, SUCH AS ASSETS NOT REQUIRED TO MAINTAIN A BASIC STANDARD OF LIVING, MAY BE CONSIDERED. FUTURE EARNING CAPACITY MAY ALSO BE CONSIDERED. GENERAL INFORMATION: ELIGIBILITY REQUIREMENTS (ROUTINE DETERMINATIONS) SJRMC WILL USE THE FOLLOWING ELIGIBILITY CRITERIA TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE AT SJRMC. 1. THE PATIENT'S HOUSEHOLD AVERAGE MONTHLY INCOME AND/OR ASSISTANCE FROM ALL SOURCES FOR THE 12-MONTH PERIOD PRIOR TO RECEIVING SERVICES AT SJRMC, DID NOT EXCEED 400% OF THE MONTHLY FEDERAL POVERTY INCOME GUIDELINES. THE NUMBER OF DEPENDENTS AND OTHERS IN THE HOUSEHOLD MUST BE TAKEN INTO ACCOUNT IN MAKING THIS DETERMINATION. * "PATIENT'S HOUSEHOLD INCOME AND/OR ASSISTANCE" INCLUDES ALL FUNDS RECEIVED BY ALL MEMBERS OF THE PATIENT'S HOUSEHOLD THAT SUPPORT THE HOUSEHOLD. SPECIAL RULES PERTAINING TO HOUSEHOLD INCOME APPLY IN SITUATIONS WHERE AN UNMARRIED ADULT IS LIVING IN THE SAME HOME WITH ANOTHER ADULT. * "HOUSEHOLD" IS DEFINED AS ALL DEPENDENTS AND OTHERS WHO LIVE IN THE SAME RESIDENCE AS THE PATIENT AND/OR GUARANTOR. * A "DEPENDENT" IS DEFINED AS A PERSON WHO CAN BE CLAIMED BY THE GUARANTOR AND/OR PATIENT AS A DEPENDENT ON THEIR FEDERAL TAX RETURN. * "OTHERS" IS DEFINED AS A PERSON WHO RESIDES IN THE GUARANTOR AND/OR PATIENT'S RESIDENCE FOR A MINIMUM OF SIX CONSECUTIVE MONTHS DURING A 12-MONTH PERIOD. THE GUARANTOR AND/OR PATIENT MAY OR MAY NOT BE ABLE TO CLAIM THIS PERSON AS A DEPENDENT ON THEIR FEDERAL TAX RETURN. 2. THE PATIENT HAS NO MEDICAL INSURANCE, LIABILITY OR OTHER THIRD-PARTY COVERAGE THAT WILL PAY FOR THE SERVICES THE PATIENT RECEIVED AT SJRMC. RESIDUAL AMOUNTS AFTER ANY THIRD-PARTY PAYMENTS, SUCH AS DEDUCTIBLES, NON-COVERED AMOUNTS, CO-PAYMENTS AND CO-INSURANCE MAY BE CONSIDERED FOR FINANCIAL ASSISTANCE. THE PATIENT MUST BE PERSONALLY RESPONSIBLE FOR PAYING ANY RESIDUAL AMOUNTS NOT COVERED BY A THIRD PARTY. MEDICARE DEDUCTIBLES AND COINSURANCE MAY BE CONSIDERED FOR FINANCIAL ASSISTANCE. 3. THE PATIENT HAS ASSETS AND RESOURCES, EXCLUDING THEIR PRIMARY RESIDENCE AND AUTOMOBILE(S) OF $5,000 OR LESS. RETIREMENT FUNDS WILL NORMALLY BE EXCLUDED AS ASSETS. SJRMC RESERVES THE RIGHT TO REQUIRE THE PATIENT TO BORROW AGAINST OR EVEN LIQUIDATE SOME OR ALL FUNDS EARMARKED FOR RETIREMENT TO SATISFY THE DEBT OWED TO SJRMC. ELIGIBILITY CRITERIA (PRESUMPTIVE DETERMINATIONS): 1. KNOWN CIRCUMSTANCES SURROUNDING A PATIENT'S PERSONAL SITUATION SUPPORT THE CONCLUSION THAT THEY ARE MEDICALLY INDIGENT. IN ADDITION, THE PATIENT IS EITHER UNABLE TO APPLY FOR THE FINANCIAL ASSISTANCE AND/OR TO PROVIDE REQUIRED SUPPORTING DOCUMENTATION TO MAKE A ROUTINE DETERMINATION OF ELIGIBILITY. 2. PRESUMPTIVE FINANCIAL ASSISTANCE MAY ALSO BE APPROVED IN SITUATIONS WHERE THE PATIENT HAS A "MEDICAL HARDSHIP". A MEDICAL HARDSHIP IS WHERE THE PATIENT DOES NOT MEET THE USUAL CRITERIA TO QUALIFY FOR A FINANCIAL ASSISTANCE ADJUSTMENT BASED ON BEING MEDICALLY INDIGENT. HOWEVER, THEIR DEBT FOR A PARTICULAR MEDICAL EVENT, TO INCLUDE THE DEBT OF OTHER PROVIDERS BESIDES SJRMC, IS PROHIBITIVE BASED ON THEIR AVAILABLE INCOME AND ASSETS AS WELL AS THEIR FUTURE EARNING CAPACITY. MEDICAL HARDSHIP IS DEFINED AS A SITUATION WHERE THE CUMULATIVE MEDICAL DEBTS FOR ONE EPISODE OF CARE EXCEEDS 30% OF THE VALUE OF THE PATIENT'S (OR GUARANTOR, IF PATIENT IS A MINOR OR INCOMPETENT) AVAILABLE INCOME AND ASSETS NOT ESSENTIAL TO A BASIC LIFESTYLE FOR THE 12 MONTHS PRIOR TO THE MEDICAL EVENT. AN "EPISODE OF CARE" BEGINS WITH SERVICES BEING PERFORMED AT SJRMC AND ENDS THE SOONER OF A) SIX MONTHS AFTER THE INITIAL DATE OR B) DISCHARGE FROM AN INPATIENT STAY. THE SERVICES PROVIDED MAY BE FOR MORE THAN ONE ILLNESS OR INJURY AS LONG AS THE SERVICES ARE FOR THE SAME PATIENT. PROCEDURE: 1. A REPRESENTATIVE FROM THE BILLING DEPARTMENT WILL REVIEW THE APPLICATION AND SUBMIT ACCOUNTS FOR REVIEW THAT MEET THE ELIGIBILITY REQUIREMENTS. 2. REVIEW WILL BE PROVIDED BY THE EXECUTIVE DIRECTOR, COORDINATOR OF CASE MANAGEMENT, AND A REPRESENTATIVE FROM THE FINANCIAL DEPARTMENT. ALL ELIGIBLE APPLICATIONS FOR FINANCIAL ASSISTANCE WILL BE CONSIDERED BASED ON INDIVIDUAL MERITS. A. APPROVAL FOR LESS THAN $20,000 WILL BE DECIDED AT THIS LEVEL. B. CASES WITH AMOUNTS GREATER THAN $20,000 WILL BE SUBMITTED WITH COMMITTEE RECOMMENDATIONS FOR APPROVAL OR DENIAL OF FINANCIAL ASSISTANCE FUNDS TO THE BOARD OF DIRECTORS FOR THEIR FINAL DECISION. 3. APPROVED FINANCIAL ASSISTANCE ALLOWANCES WILL BE REPORTED TO THE BOARD OF DIRECTORS. 4. THE FINANCE DEPARTMENT WILL DO THE NECESSARY ADJUSTMENTS AND NOTIFICATIONS TO THE PATIENT. SAN JUAN REGIONAL MEDICAL CENTER EMPLOYS A NUMBER OF FINANCIAL COUNSELORS AND CUSTOMER SERVICE REPRESENTATIVES WHO WORK ALONGSIDE PATIENTS TO HELP THEM NAVIGATE THEIR PAYMENT, BILLING, AND ASSISTANCE OPTIONS. INFORMATION IS DISSEMINATED TO PATIENTS THROUGH ONLINE AND PAPER RESOURCES LOCATED THROUGHOUT THE HOSPITAL. A WIDELY DISTRIBUTED BROCHURE TITLED, "PAYING FOR HOSPITAL SERVICES AT SAN JUAN REGIONAL MEDICAL CENTER," IS SPECIFICALLY DESIGNED TO HELP PATIENTS UNDERSTAND THEIR HOSPITAL BILL AND INFORM THEM OF THEIR OPTIONS FOR PAYMENT AND ASSISTANCE, INCLUDING INFORMATION ON THE AVAILABILITY OF INDIAN HEALTH SERVICE ASSISTANCE, CASH DISCOUNTS, BILL REDUCTION THROUGH A COMMUNITY SERVICE FUND, SPECIAL FUNDS THROUGH THE SAN JUAN COUNTY INDIGENT FUND, OR MEDICAL HARDSHIP WAIVERS. THE HOSPITAL'S VISION IS TO BE KNOWN AS THE MOST PERSONALIZED QUALITY HEALTHCARE PROVIDER. SAN JUAN REGIONAL MEDICAL CENTER IS ALSO A VALUES-DRIVEN ORGANIZATION WITH A CENTURY OF SERVICE TO THE FOUR CORNERS REGION-DRIVEN BY A SIMPLE YET POWERFUL PRINCIPLE: DO THE RIGHT THING FOR THE PATIENT NO MATTER WHAT. AN INTEGRAL PART OF THIS SACRED TRUST THE COMMUNITY HAS IN ITS HOSPITAL IS ENSURING THAT NO PATIENT FEELS ALONE AND DISCONNECTED DURING AND AFTER THEIR TREATMENT. THEREFORE, IT IS IN THE SPIRIT OF THE HOSPITAL'S VISION AND MISSION TO ENSURE THAT PATIENTS RECEIVE A HIGH LEVEL OF ASSISTANCE WHEN FIGURING OUT THEIR BILL AND OPTIONS. NOT ONLY DOES THE HOSPITAL HAVE FINANCIAL COUNSELORS TO EDUCATE ITS PATIENTS, IT HAS AN IN-HOUSE MASH PROGRAM FOR SELF-PAY INDIVIDUALS. THROUGH THE MASH PROGRAM, PATIENT ADVOCATES STAND HAND-IN-HAND WITH PATIENTS TO EXPLORE EVERY POSSIBILITY OF ASSISTANCE. COMMUNITY INFORMATION: SCHEDULE H, PART VI, LINE 4 SAN JUAN REGIONAL MEDICAL CENTER SERVES THE FOUR CORNERS REGION OF THE UNITED STATES, WHICH IS MOSTLY RURAL. THE HOSPITAL IS LOCATED IN THE REGION'S LARGEST CITY AND ONLY METROPOLITAN AREA, WHICH IS FARMINGTON, NEW MEXICO. OTHER CITIES IN THE REGION INCLUDE CORTEZ AND DURANGO IN COLORADO; MONTICELLO AND BLANDING IN UTAH; KAYENTA AND CHINLE IN ARIZONA; AND SHIPROCK, AZTEC, AND BLOOMFIELD IN NEW MEXICO. THIS REGION ALSO INCLUDES THE NAVAJO NATION. STATISTICS GATHERED FOR THE HOSPITAL'S COMMUNITY NEEDS ASSESSMENT IN 2011 FOR SAN JUAN COUNTY (POPULATION 130,044)-WHICH IS THE PRINCIPAL COUNTY SERVED BY SAN JUAN REGIONAL MEDICAL CENTER-INDICATE THE FOLLOWING POPULATION CHARACTERISTICS: MEN: 49.6% WOMEN: 50.4% AGES 18 AND UNDER: 29% AGES 65+: 10.8% WHITE: 51.6% AMERICAN INDIAN & ALASKA NATIVE: 36.6% HISPANIC: 19.1% THE MEDIAN HOUSEHOLD INCOME FOR SAN JUAN COUNTY IS $46,007. PROMOTION OF COMMUNITY HEALTH: SCHEDULE H, PART VI, LINE 5 IN THE CONSTANT EFFORT TO MEET COMMUNITY NEED, SJRMC SEEKS TO IMPROVE PHYSICIAN ACCESS THROUGH A VIGOROUS RECRUITING PROGRAM AND TO PROVIDE COMMUNITY EDUCATION AND MANY OTHER COMMUNITY BENEFIT PROGRAMS. IN FISCAL YEAR 2012, SAN JUAN REGIONAL MEDICAL CENTER PROVIDED BENEFITS TO THE POOR AND THE BROADER COMMUNITY OF OVER $38 MILLION. PROGRAM PERSONS SERVED COMMUNITY BENEFIT TRADITIONAL FINANCIAL ASSISTANCE 692 1,070,714 COMMUNITY HEALTH EDUCATION 11,594 191,107 DIABETES EDUCATION AND SUPPORT PROGRAMS 1,325 212,598 COMMUNITY FLU VACCINES 791 10,802 HEALTH CARE SUPPORT SERVICES 40,444 HEALTH PROFESSIONS EDUCATION: PHYSICIANS AND MEDICAL STUDENTS 29 943,484 NURSES/NURSING STUDENTS 48 389,063 FUNDING FOR PROFESSIONAL EDUCATION 120,873 SUBSIDIZED HEALTH SERVICES: EMERGENCY SERVICES 10,182 3,923,510 WOMEN'S AND CHILDREN SERVICES 2,113 2,246,090 BEHAVIORAL HEALTH SERVICES 856 1,128,705 OUTPATIENT SERVICES 142,779 21,191,246 OTHER SUBSIDIZED HEALTH SERVICES 12,390 5,698,214 SAN JUAN UNITED WAY (CORPORATE MATCH) 111,297 FINANCIAL AND IN-KIND CONTRIBUTIONS 10,652 130,244* OTHER COMMUNITY SERVICES 1,436,081 --------- ------------- TOTAL 193,451 38,844,472 * OUR FINANCIAL AND IN-KIND CONTRIBUTIONS WENT TO VARIOUS LOCAL CHARITIES SUCH AS NAVAJO MINISTRIES, AND LOCAL SCHOOL DISTRICTS. true SAN JUAN COLLEGE 4601 COLLEGE BLVD FARMINGTON NM 87402 850295969 SCHOOL 55000 NURSING PROGRAM GRANT SAN JUAN COLLEGE 4601 COLLEGE BLVD FARMINGTON NM 87402 850295969 SCHOOL 69949 COMMUNITY REINVESTMENT - WORKFORCE PROGRAM SAN JUAN UNITED WAY 903 W APACHE ST FARMINGTON NM 87401 850165322 501(C)(3) 111297 UNITED WAY CONTRIBUTION - MATCH EMPLOYEE DONATIONS SAN JUAN UNITED WAY 903 W APACHE ST FARMINGTON NM 87401 850165322 501(C)(3) 12500 UNITED WAY - PROPANE PROJECT SAN JUAN ECONOMIC DEVELOPMENT SERVICE 5101 COLLEGE BLVD FARMINGTON NM 87402 850171302 501(C)(3) 10000 MOVING FORWARD CAMPAIGN - ANNUAL INVESTMENT CHILDHAVEN FOUNDATION 807 W APACHE ST FARMINGTON NM 87401 270048264 501(C)(3) 18500 GRANT FOR SHELTER REMODEL RIVER REACH FOUNDATION 400 E 38TH ST FARMINGTON NM 87401 200350883 501(C)(3) 20000 DONATION FOR FOUNDATION CITY OF FARMINGTON 901 FAIRGROUNDS RD FARMINGTON NM 87401 856000129 GOVERNMENT 7000 MEDIAN MAINTENANCE SPONSORSHIP SANE 812 W MAPLE FARMINGTON NM 87401 203187125 501(C)(3) 43610 PROVIDE BUILDING AND BUILDING EXPENSE 7 0 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS SCHEDULE I, PART I, LINE 2 EVENT FUNDING/SPONSORSHIP REQUEST GUIDELINES SAN JUAN REGIONAL MEDICAL CENTER (SJRMC) RECOGNIZES THE VALUE OF COMMUNITY PARTNERSHIPS AND, ON A LIMITED BASIS, OFFERS SUPPORT TO ITS COMMUNITY PARTNERS BY SHARING OUR RESOURCES INCLUDING THE TIME AND TALENT OF OUR PHYSICIANS AND EMPLOYEES, AS WELL AS OUR FINANCIAL AND IN-KIND SUPPORT. SAN JUAN REGIONAL MEDICAL CENTER HAS ESTABLISHED CRITERIA TO ENSURE ALIGNMENT WITH OUR MISSION AND TO ALLOW US TO STRATEGICALLY FOCUS OUR LIMITED RESOURCES IN ORDER TO MAXIMIZE THEIR IMPACT. SPONSORSHIP REQUESTS ARE EVALUATED BASED ON, BUT NOT LIMITED TO, THE FOLLOWING CRITERIA: - ALIGNMENT WITH SJRMC'S MISSION: TO PERSONALIZE HEALTHCARE AND CREATE ENTHUSIASM AND VITALITY IN HEALING. - ALIGNMENT AND OPPORTUNITY TO PROMOTE STRATEGIC SERVICE LINES AND BUSINESS OBJECTIVES - COMMUNITY AND NEIGHBORHOOD DEVELOPMENT - MAGNITUDE OF IMPACT AND REACH (NUMBER OF INDIVIDUALS SERVED) - DEPTH AND BREADTH OF PARTNERSHIP WITH REQUESTING ORGANIZATION ALL REQUESTS MUST BE RECEIVED AT LEAST 4 WEEKS IN ADVANCE OF THE SPONSORSHIP DEADLINE. SPONSORSHIP REQUESTS ARE REVIEWED THROUGH OUR MARKETING DEPARTMENT. THE REQUEST SHOULD PROVIDE APPROPRIATE AND COMPLETE DETAILS REGARDING THE SPONSORSHIP REQUEST. PLEASE BE PREPARED TO PROVIDE THE ADDITIONAL INFORMATION ABOUT YOUR REQUEST, IF NEEDED. SPONSORSHIP REQUESTS OF MORE THAN $3,000 MUST BE REVIEWED BY THE PARTNERSHIP COMMITTEE OF SJRMC'S BOARD OF DIRECTORS. I. APPLICANT INFORMATION: - MUST BE WRITTEN ON OFFICIAL LETTERHEAD - NAME OF PERSON OR ORGANIZATION REQUESTING FUNDING AND/OR SPONSORSHIP - NAME, EMAIL ADDRESS, AND PHONE NUMBER OF PRIMARY CONTACT FOR THE REQUEST/ INDIVIDUAL FILLING OUT THE REQUEST II. EVENT DETAILS: 1. DESCRIPTION (250 WORDS MAXIMUM): - DESCRIBE HOW THE EVENT BEING SPONSORED RELATES TO SJRMC'S MISSION - DESCRIBE THE PURPOSE OF THE EVENT BEING SPONSORED AND THE TARGET AUDIENCE 2. LOGISTICS: - IF AVAILABLE, PROVIDE THE TITLE, DATE, AND TIME OF THE EVENT - IF AVAILABLE AND APPLICABLE, LIST THE PROPOSED EVENT LAYOUT (E.G., PANEL, CONFERENCE, SEMINAR, ETC.) AND AGENDA FOR THE EVENT 3. FUNDING: - INDICATE AMOUNT REQUESTED FROM SJRMC - DESCRIBE THE EXPENSES SJRMC'S FUNDS WILL BE USED TO COVER - PROVIDE WHAT OTHER ORGANIZATIONS ARE SUPPORTING YOUR EVENT (INDICATING AMOUNTS REQUESTED, WHICH ARE PENDING, AND WHICH ARE CONFIRMED) - WHAT WILL SJRMC RECEIVE IN EXCHANGE FOR ITS CONTRIBUTION PLEASE SUBMIT ALL MATERIALS TO: ROBERTA ROGERS, MARKETING MANAGER C/O SAN JUAN REGIONAL MEDICAL CENTER 657 WEST MAPLE STREET FARMINGTON, NM 87401 E-MAIL: RROGERS@SJRMC.NET (505) 609-2240 X X X X false true false false false false false false false CHARLES HOFFMAN MD 380271 0 4108 0 35 0 7396 0 18554 0 410364 0 0 0 RICK WALLACE 410539 0 116401 0 16660 0 28608 0 18470 0 590678 0 0 0 JOHN BUFFINGTON 268535 0 84146 0 16606 0 22530 0 18554 0 410371 0 0 0 J MICHAEL PHILIPS 344855 0 87859 0 16671 0 13742 0 18554 0 481681 0 0 0 SUZANNE SMITH 195307 0 57957 0 35 0 16182 0 18554 0 288035 0 0 0 EDWARD MAURIN 616604 0 23280 0 11640 0 8250 0 18554 0 678328 0 0 0 TIBOR BOCO 588011 0 25000 0 42 0 2792 0 18554 0 634399 0 0 0 CHARLES E WILKINS 566785 0 819 0 16816 0 7644 0 18554 0 610618 0 0 0 MARC A FLITTER 556041 0 3390 0 17184 0 9800 0 18554 0 604969 0 0 0 LUTHER B WEATHERS III 547670 0 176 0 110 0 0 0 18477 0 566433 0 0 0 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B SAN JUAN REGIONAL MEDICAL CENTER HAS A 457(F) DEFERRED COMPENSATION PLAN THAT ALLOWS CERTAIN EXECUTIVES TO CONTRIBUTE MONEY ON A PRE-TAX BASIS INTO INVESTMENTS AND TO ACCUMULATE TAX-DEFERRED EARNINGS. THE FOLLOWING PRE-TAX CALENDAR YEAR 2011 CONTRIBUTIONS TO THE 457(F) PLAN ARE INCLUDED IN SCHEDULE J, PART II, COL C AS DEFERRED COMPENSATION: JOHN BUFFINGTON $12,730 J. MICHAEL PHILIPS $ 3,942 SUZANNE SMITH $ 8,786 RICK WALLACE $19,108 SUPPLEMENTAL COMPENSATION INFORMATION MANAGEMENT INCENTIVE PLAN SAN JUAN REGIONAL MEDICAL CENTER (SJRMC) HAS A SENIOR MANAGEMENT INCENTIVE COMPENSATION PLAN FOR SELECTED SENIOR MANAGEMENT POSITIONS. AN AWARD TARGET IS ESTABLISHED FOR EACH PARTICIPANT. PERFORMANCE IS BASED ON EIGHT GOALS, TWO OF WHICH ARE HOSPITAL EXCESS OF REVENUES OVER EXPENSES PERCENTAGE AND TOTAL HOSPITAL EARNINGS. THE AWARD IS A PERCENTAGE OF BASE PAY IF CERTAIN TARGETS ARE MET. SUPPLEMENTAL COMPENSATION INFORMATION THE COMPENSATION REPORTED IN PART VII FOR DWAYNE GIBBS MD IS FOR A DIRECTORSHIP STIPEND, NOT FOR SERVICES RENDERED AS A BOARD MEMBER. THE COMPENSATION REPORTED IN PART VII FOR RONALD CALCOTE MD IS FOR A MEDICAL DIRECTOR FET PROGRAM, NOT FOR SERVICES RENDERED AS A BOARD MEMBER. THE COMPENSATION REPORTED FOR CHARLES HOFFMAN MD IS FROM HIS CURRENT EMPLOYMENT, NOT FOR SERVICES RENDERED AS A BOARD MEMBER. CITY OF FARMINGTON NM - 2007A 856000129 311428BN5 2007-06-28 12290518 CONSTRUCTION OF CANCER TRMT CENTER false false false CITY OF FARMINGTON - 2004A 856000129 311428AZ9 2004-03-25 16982883 CONSTRUCTION OF TOWER/NEW EQUIP false false false NM HOSPITAL EQUIPMENT LOAN COUNCIL - 2010A2010 840426875 2010-12-21 25773000 REFUND 2004B; FINANCE EQUP & CONST false false false NM HOSPITAL EQUIPMENT LOAN COUNCIL - 2010B 840426875 647370FK6 2010-12-21 8800000 CONST MOB PEDS/NEURO RETIRE 07B false false false 1605000 0 12457932 0 151201 0 245810 0 0 12212122 0 0 2010 false false true true 1090000 0 17087788 0 0 0 339658 0 0 16748130 0 0 2007 false false true true 2698376 0 25773063 0 0 0 205429 0 0 25567634 0 0 2011 false false true true 320000 0 8800248 0 13498 0 13200 0 0 8800495 0 0 2011 true false true true false false false false 0.00000 0.00000 0.00000 true false false false false 0.00000 0.00000 0.00000 true false false false false 0.00000 0.00000 0.00000 true false false false false 0.00000 0.00000 0.00000 true false false false 0 false 0 false false true false false 0 false 0 false false false false false 0 false 0 false false false true false 0 false 0 false false X SCHEDULE K, PART II, LINE 3, COLUMNS A-D 0 THE EXCESS OF "TOTAL PROCEEDS" OVER "ISSUE PRICE" IS DUE TO INVESTMENT EARNINGS. SCHEDULE K, PART I, LINE C 0 THE 2010 LEASE PROJECT OBLIGATION PORTION OF THIS ISSUE IN THE AMOUNT OF $8,103,000 HAS NOT BEEN DESIGNATED AS A QUALIFIED TAX-EXEMPT OBLIGATION. ANNA BUFFINGTON JOHN BUFFINGTON / COO 119267 EMPLOYEE PAY false ERIC BUFFINGTON JOHN BUFFINGTON / COO 52030 EMPLOYEE PAY false X FIXED ASSETS - SAN JUAN 3 1074609 COST/SELLING PRICE 0 false true false VOLUNTEERS FORM 990, PART I, LINE 6 SJRMC HAS A TOTAL OF 200 VOLUNTEERS THAT PROVIDE SERVICE TO THE FOLLOWING AREAS: ADMINISTRATIVE SUPPORT, CANCER TREATMENT CENTER, CARDIAC REHABILITATION, COURIER/PATIENT TRANSPORT, CRAFTY CREATIONS, DIETARY, GIFT MARKET, INFORMATION DESK, MAIL CALL, MEDICAL RECORDS AND AUXILIARY MEMBERSHIP. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4 SAN JUAN REGIONAL MEDICAL CENTER (SJRMC) IS A MODERN ACUTE-CARE HOSPITAL LOCATED IN ONE OF THE MOST RURAL AREAS OF THE AMERICAN SOUTHWEST: SAN JUAN COUNTY, NM. A 2010 ESTIMATE OF THE POPULATION OF SAN JUAN COUNTY SHOWS THE COUNTY POPULATION HAS GROWN 14.3% FROM THE YEAR 2000 TO 2010 AND NOW NUMBERS APPROXIMATELY 130,044; 37% OF WHICH IS AMERICAN INDIAN AND ALASKA NATIVE PERSONS. SJRMC IS A SOLE COMMUNITY PROVIDER AND DISPROPORTIONATE SHARE HOSPITAL PROVIDING NEEDED HEALTHCARE TO RESIDENTS OF THE FOUR CORNERS REGION OF NEW MEXICO, ARIZONA, UTAH AND COLORADO. SAN JUAN REGIONAL MEDICAL CENTER'S MISSION IS TO PERSONALIZE HEALTHCARE AND CREATE ENTHUSIASM AND VITALITY IN HEALING. OUR CORE VALUES ARE ACTIVELY TAUGHT, AND REINFORCED, TO STAFF, MANAGEMENT AND PHYSICIANS SO THAT THE ORGANIZATION MAY ACHIEVE EXCELLENCE AND CONSISTENCY IN PATIENT CARE. SJRMC IS A COMMUNITY GOVERNED HOSPITAL THAT WAS FOUNDED IN 1910 BY DRS. A. M. SMITH AND G. W. SAMMONS. THE HOSPITAL CORPORATION IS AN ADVISORY BODY COMPOSED OF UP TO THREE REPRESENTATIVES FROM EACH OF 90 NON-PROFIT ORGANIZATIONS IN SAN JUAN COUNTY. THE CORPORATION MEETS QUARTERLY, AND, AT THEIR ANNUAL MEETING, THEY NOMINATE AND ELECT 9 MEMBERS TO THE GOVERNING BOARD OF DIRECTORS. THE CORPORATION RECEIVES REPORTS FROM THE BOARD OF DIRECTORS AND HOSPITAL ADMINISTRATION ON HOSPITAL OPERATIONS INCLUDING QUALITY AND FINANCE AND PROVIDES FEEDBACK ON COMMUNITY HEALTH ISSUES. SJRMC PROVIDES MEDICAL, SURGICAL, PEDIATRICS, ONCOLOGY, OBSTETRICS, CARDIOLOGY, AND BEHAVIORAL HEALTH INPATIENT CARE. AMBULATORY CARE INCLUDES DAY SURGERY, URGENT CARE, OUTPATIENT DIAGNOSTIC AND TREATMENT SERVICES. SJRMC IS A LEVEL III TRAUMA CENTER THAT PROVIDES GROUND AMBULANCE AND AIR AMBULANCE SERVICE WITH A HELICOPTER AND A FIXED WING AIRCRAFT AS WELL AS SERVICES THROUGH ITS EMERGENCY DEPARTMENT TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY. SOME OF OUR OUTPATIENT SERVICES ARE PHYSICIAN CLINICS SPECIALIZING IN CARDIOLOGY, BEHAVIORAL HEALTH, INTERNAL MEDICINE, NEUROSURGERY, NEURODIAGNOSTICS, URGENT CARE CENTER AND PEDIATRICS. OUR FINANCIAL AND IN-KIND CONTRIBUTIONS WENT TO VARIOUS LOCAL CHARITIES SUCH AS NAVAJO MINISTRIES, FAMILY CRISIS CENTER, LOCAL SCHOOL DISTRICTS, SENIOR CENTERS AND TOTAH BEHAVIORAL HEALTH. THE OTHER COMMUNITY SERVICES NOTED ABOVE PROVIDE CARE FOR: SURGERY, GASTROINTESTINAL, ORTHOPEDICS, ONCOLOGY, NEURO AND CARDIAC REHAB. BUSINESS AND FAMILY RELATIONSHIPS FORM 990, PART VI, LINE 2 DWAYNE GIBBS, M.D. AND RONALD CALCOTE, M.D. HAVE A BUSINESS RELATIONSHIP. MEMBERS AND THEIR RIGHTS FORM 990, PART VI, LINES 6 AND 7A SAN JUAN REGIONAL MEDICAL CENTER IS A COMMUNITY-GOVERNED HOSPITAL. THE HOSPITAL CORPORATION IS AN ADVISORY BODY COMPOSED OF TWO REPRESENTATIVES FROM ABOUT 90 NON-PROFIT ORGANIZATION MEMBERS IN SAN JUAN COUNTY. AFTER TEN YEARS OF SERVICE AS A REPRESENTATIVE, AN INDIVIDUAL MAY BE DESIGNATED BY THE CORPORATION AS A SENIOR CORPORATE DELEGATE AND SHALL NO LONGER BE CONSIDERED TO BE THE REPRESENTATIVE OF THE MEMBER ORGANIZATION. THE MEMBER ORGANIZATION MAY THEN DESIGNATE ANOTHER REPRESENTATIVE IN ADDITION TO THE SENIOR CORPORATE DELEGATE. THE HOSPITAL CORPORATION MEETS QUARTERLY. AT THEIR ANNUAL MEETING, THEY NOMINATE AND ELECT NINE VOTING MEMBERS TO SJRMC'S BOARD OF DIRECTORS. OF THE NINE, THREE MUST BE ELECTED FROM THE MEMBER REPRESENTATIVES OR SENIOR CORPORATE DELEGATES. IN ADDITION TO THE NINE ELECTED DIRECTORS, THE SJRMC CHIEF OF THE STAFF AND VICE CHIEF OF STAFF AND A HOSPITAL AUXILIARY APPOINTEE ALSO SERVE AS SJRMC DIRECTORS FOR A TOTAL OF TWELVE VOTING MEMBERS OF THE BOARD OF DIRECTORS. DESCRIPTION OF PROCESS USED BY MANAGEMENT AND/OR GOVERNING BODY TO REVIEW FORM 990 FORM 990, PART VI, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM BASED ON DATA PROVIDED BY MANAGEMENT. A DRAFT COPY OF THE 990 IS PROVIDED TO MANAGEMENT FOR REVIEW. A MEETING IS CONDUCTED BY THE ACCOUNTING FIRM TO REVIEW THE RETURN IN DETAIL WITH MANAGEMENT. ANY QUESTIONS ARE ADDRESSED AND ANY NECESSARY CHANGES ARE MADE TO THE RETURN. THE FINAL DRAFT OF THE FORM 990 IS PROVIDED TO THE AUDIT COMMITTEE ALONG WITH A BRIEF EDUCATION SESSION CONDUCTED BY THE ACCOUNTING FIRM TO DISCUSS THE HIGHLIGHTS OF THE FORM. THE FINAL DRAFT OF THE FORM 990 IS THEN PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C SAN JUAN REGIONAL MEDICAL CENTER HAS A CONFLICT OF INTEREST POLICY THAT EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE IS REQUIRED TO FILL OUT ON AN ANNUAL BASIS. THIS CONFLICT OF INTEREST POLICY SPECIFICALLY ASKS QUESTIONS REGARDING BUSINESS AND PERSONAL RELATIONSHIPS THAT THEY MAY HAVE WITH ANY OTHER BOARD MEMBER, OFFICER AND KEY EMPLOYEE OF ANY BUSINESS THAT DEALS WITH SAN JUAN REGIONAL MEDICAL CENTER OR ANY OF ITS AFFILIATES. IF A CONFLICT IS IDENTIFIED, IT MUST BE REPORTED TO THE COMPLIANCE OFFICER, AND IF IT CONSTITUTES A BREACH OF EMPLOYMENT, IT MAY LEAD TO DISCIPLINARY ACTION. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, LINES 15A & 15B THE BOARD OF DIRECTORS FOR SAN JUAN REGIONAL MEDICAL CENTER USES THE FOLLOWING COMPARABLE DATA WHEN DETERMINING THE COMPENSATION FOR THE CEO AND SENIOR MANAGEMENT; REGIONAL / LOCAL AREA NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS OF COMPARABLE SIZE, NATIONAL NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS OF COMPARABLE SIZE, AND OTHER RELEVANT COMPARATORS (E.G., FOR PROFIT HEALTHCARE AND/OR GENERAL INDUSTRY ORGANIZATIONS) OF COMPARABLE SIZE AND COMPLEXITY, ONLY WHEN COMPETITIVE CIRCUMSTANCES WARRANT THESE MARKETS. ADDITIONALLY, THE BOARD BI-ANNUALLY HAS AN INDEPENDENT OUTSIDE FIRM COMPARE THE CEO'S COMPENSATION WITH OTHER HEALTHCARE ORGANIZATIONS TO REMAIN COMPETITIVE. THE PROCESS WAS LAST COMPLETED IN 2012. THE PROCESS IS DOCUMENTED IN THE BOARD MINUTES WHEN PRESENTED TO THEM. AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS TO THE GENERAL PUBLIC FORM 990, PART VI, LINE 19 SAN JUAN REGIONAL MEDICAL CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. HOURS DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII JOSEPH RASOR AND RICHARD MENNING EACH DEVOTED 2 HOURS PER WEEK AS BOARD MEMBERS TO SAN JUAN REGIONAL REHABILITATION HOSPITAL INC, A RELATED TAX-EXEMPT ORGANIZATION. RICHARD MENNING ALSO DEVOTES TIME TO THE SJRMC AUXILIARY. OTHER CHANGES IN FUND BALANCE FORM 990, PART XI, LINE 5 NET UNREALIZED LOSSES $(3,043,113) SAN JUAN HEALTH PARTNERS INC 801 WEST MAPLE FARMINGTON NM 87401 272367549 HEALTHCARE NM 501(C)(3) 3 SJRMC true SAN JUAN REGIONAL REHABILITATION HOSP 525 SOUTH SCHWARTZ 2 FARMINGTON NM 87401 850441767 HEALTHCARE NM 501(C)(3) 3 SJRMC true SJR HOLDING COMPANY INC 801 W MAPLE STREET FARMINGTON NM 87401 201126483 SUPPORT SERVICES NM SJRMC C-CORP 581548 1537960 1.00000 false false true false false false false false false false false false false false false true false false SJR HOLDING COMPANY INC C 350000 CASH SAN JUAN REGIONAL REHABILITATION HOSPITAL P 112524 FAIR VALUE SAN JUAN REGIONAL REHABILITATION HOSPITAL P 281828 COST