SAN LUIS VALLEY REGIONAL MEDICAL CENTER: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- SAN LUIS VALLEY REGIONAL MEDICAL CENTER (EIN 84-0255530)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-14
- IRS object ID
- 201311349349306271
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-14T16:13:18-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 South Tejon Suite 800 | AddressLine1 |
| City | Colorado Springs | City |
| State | CO | State |
| ZIP Code | 809039848 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 840255530 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lutheran Hosp Assoc of the San Luis Valley | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % THE ORGANIZATION | InCareOfName |
| Name Control | LUTH | NameControl |
| Phone | 7195892511 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 106 Blanca Avenue | AddressLine1 |
| City | Alamosa | City |
| State | CO | State |
| ZIP Code | 81101 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Russell Johnson | Name |
| Title | CEO | Title |
| Date Signed | 2013-05-15 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7194714290 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Russell Johnson CEO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 106 Blanca Avenue | AddressLine1 |
| City | Alamosa | City |
| State | CO | State |
| ZIP Code | 81101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 64570467 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.slvrmc.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1928 | YearFormation |
| State Legal Domicile | CO | StateLegalDomicile |
| Activity Or Mission Description | The hospital provides inpatient, outpatient, and emergency care services to patients in the San Luis Valley. In addition, they also sponsor community programs, such as a weight loss program. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 640 | TotalNbrEmployees |
| Total Nbr Volunteers | 63 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 898158 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 767665 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 58667969 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 63284527 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 294336 | InvestmentIncomePriorYear |
| Investment Income Current Year | 316205 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 133370 | OtherRevenuePriorYear |
| Other Revenue Current Year | 121112 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 59993833 | TotalRevenuePriorYear |
| Total Revenue Current Year | 64489509 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 83543 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 23865 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 30935359 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 32513132 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 349132 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 28460191 | OtherExpensePriorYear |
| Other Expenses Current Year | 30350344 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 59479093 | TotalExpensesPriorYear |
| Total Expenses Current Year | 62887341 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 514740 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1602168 | RevenuesLessExpensesCY |
| Total Assets BOY | 65370183 | TotalAssetsBOY |
| Total Assets EOY | 68010817 | TotalAssetsEOY |
| Total Liabilities BOY | 25518781 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 27164301 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 39851402 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 40846516 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | 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. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 46373146 | Expense |
| Revenue | 63226301 | Revenue |
| Description | San Luis Valley Regional Medical Center (SLVRMC) has operated as an independent, not-for-profit hospital for over 83 years. SLVRMC 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. Including our relationship with Conejos County Hospital, SLVRMC employs almost 600 and is the largest employer in the San Luis Valley. The trustees, providers and staff of SLVRMC 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. SLVRMC's operating expense per adjusted patient day is $2,523 compared to a Colorado average of $3,348 and a rural hospital average of $3,665. Over the last eight 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, dialysis, sleep disorders, women's imaging center, fixed wing medical transportation, genetic counseling, behavioral health, Psychiatry, chiropractic, oncology/infusion therapy and more. | Description |
| Total Program Service Expense | 46373146 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 98 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 640 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | THE ORGANIZATION | NamePerson |
| Telephone Number | 7195892511 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 106 BLANCA AVENUE | AddressLine1 |
| City | Alamosa | City |
| State | CO | State |
| ZIP Code | 81101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (25 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JAN GAY | |||||||
| PRESIDENT | 2.0 | X | X | 2850 | 0 | 0 | |
| CHERI CROWDER | |||||||
| VICE PRESIDENT | 2.0 | X | X | 1200 | 0 | ||
| KENDAL KNAUS MD | |||||||
| SECRETARY/TREASURER | 2.0 | X | X | 33500 | 0 | ||
| JIM EHRLICH | |||||||
| TRUSTEE | 2.0 | X | 0 | 0 | |||
| PATRICK CROWDER | |||||||
| TRUSTEE | 2.0 | X | 0 | 0 | |||
| KATHY LORENZ | |||||||
| TRUSTEE | 2.0 | X | 1009 | 0 | |||
| KARLA HARDESTY | |||||||
| TRUSTEE | 2.0 | X | 1200 | 0 | |||
| ROSALIE MARTINEZ | |||||||
| TRUSTEE | 2.0 | X | 1100 | 0 | |||
| STEVEN W KITCHEN | |||||||
| PHYSICIAN | 40.0 | X | 652813 | 29822 | |||
| DAVID FROW | |||||||
| PHYSICIAN | 40.0 | X | 601632 | 27808 | |||
| SUSAN GEIGER | |||||||
| PHYSICIAN | 40.0 | X | 107720 | 6463 | |||
| RUSSELL JOHNSON | |||||||
| CEO | 38.0 | X | 261777 | 25081 | |||
| HENRY GARVIN | |||||||
| CEO - CONEJOS COUNTY HOSPITAL | 8.0 | X | 157778 | 14123 | |||
| konnie martin | |||||||
| COO | 40.0 | X | 166671 | 7002 | |||
| KATHY ROGERS | |||||||
| VP SERVICE & DEVELOPMENT | 40.0 | X | 77866 | 9218 | |||
| GWEN HELLER | |||||||
| VP HR/BUS DEVELOPMENT | 40.0 | X | 151409 | 80699 | |||
| HELEN LESTER | |||||||
| CNO | 40.0 | X | 107360 | 48377 | |||
| THOMAS HENTON | |||||||
| ADMIN. OF CONEJOS CO. HOSPITAL | X | 121812 | 11530 | ||||
| GREG MCAULIFFE MD | |||||||
| CMO | 40.0 | X | 237707 | 19141 | |||
| SHANE MORTENSEN | |||||||
| CFO | 38.0 | X | 99370 | 11805 | |||
| DAVID GEIGER | |||||||
| PHYSICIAN | 40.0 | 422088 | 26580 | X | |||
| clifford robins | |||||||
| physician | 40.0 | 329701 | 21813 | X | |||
| DENNARD ELLISON | |||||||
| PHYSICIAN | 40.0 | 391123 | 5383 | X | |||
| ROBERT MARSHALL | |||||||
| PHYSICIAN | 40.0 | 318810 | 20128 | X | |||
| alan taylor | |||||||
| physician | 40.0 | 238003 | 24922 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 4484499 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 389895 | TotalOtherCompensation |
| Number Individuals GT100 K | 40 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ARUP LABORATORIES | |||||
| PO BOX 27964 | SALT LAKE CITY | UT | 84127 | CONTRACT SERVICES | 165533 |
| CARETECH SOLUTIONS INC | |||||
| PO BOX 674271 | DETROIT | MI | 48267 | CONTRACT SERVICES | 1052287 |
| NUANCE COMMUNICATIONS | |||||
| PO BOX 2561 | CAROL STREAM | IL | 60132 | CONTRACT SERVICES | 607031 |
| WEATHERBY LOCUMS | |||||
| PO BOX 972633 | DALLAS | TX | 75397 | CONTRACT LABOR | 476910 |
| CHG COMPANIES INC | |||||
| PO BOX 972651 | DALLAS | TX | 75397 | DATA PROCESSING | 185256 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 12 | NumberOfContractorsGT100K |
| Related Organizations | 80000 | RelatedOrganizations |
| Government Grants | 178468 | GovernmentGrants |
| All Other Contributions | 509197 | AllOtherContributions |
| Total Contributions | 767665 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 900099 | 33468051 | 33468051 | |
| MEDICARE/MEDICAID | 900099 | 28117718 | 28117718 | |
| AMBULANCE DISTRICT REVENUE | 621910 | 339868 | 339868 | |
| MANAGEMENT FEES | 900099 | 840450 | 840450 | |
| OTHER PROGRAM SERVICE REVENUE | 900099 | 518440 | 355111 | $163,329 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 63284527 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 309788 | TotalRevenueColumn |
| Exclusion | $309,788 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 93013 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 78180 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 14833 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14833 | TotalRevenueColumn |
| Exclusion | $14,833 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 9195 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2778 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 6417 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6417 | TotalRevenueColumn |
| Exclusion | $6,417 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| OTHER REVENUE | 900099 | 105103 | 105103 | |
| DRUGS- NON PATIENT | 900099 | 1176 | $1,176 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 106279 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 64489509 | TotalRevenueColumn |
| Related Or Exempt Function Income | 63226301 | RelatedOrExemptFunctionIncome |
| Exclusion | $495,543 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23865 | Total |
| Program Services | 23865 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1544286 | Total |
| Program Services | 1159227 | ProgramServices |
| Management And General | 371810 | ManagementAndGeneral |
| Fundraising | 13249 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26041513 | Total |
| Program Services | 19547578 | ProgramServices |
| Management And General | 6270516 | ManagementAndGeneral |
| Fundraising | 223419 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 987606 | Total |
| Program Services | 741620 | ProgramServices |
| Management And General | 237510 | ManagementAndGeneral |
| Fundraising | 8476 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2222523 | Total |
| Program Services | 1668952 | ProgramServices |
| Management And General | 534496 | ManagementAndGeneral |
| Fundraising | 19075 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1717204 | Total |
| Program Services | 1194169 | ProgramServices |
| Management And General | 505012 | ManagementAndGeneral |
| Fundraising | 18023 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 94804 | Total |
| Management And General | 94804 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89241 | Total |
| Management And General | 89241 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4034 | Total |
| Management And General | 4034 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4788120 | Total |
| Program Services | 1979992 | ProgramServices |
| Management And General | 2765628 | ManagementAndGeneral |
| Fundraising | 42500 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 110752 | Total |
| Program Services | 2764 | ProgramServices |
| Management And General | 99027 | ManagementAndGeneral |
| Fundraising | 8961 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2488737 | Total |
| Program Services | 938394 | ProgramServices |
| Management And General | 1540876 | ManagementAndGeneral |
| Fundraising | 9467 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 759948 | Total |
| Management And General | 759948 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1547112 | Total |
| Program Services | 1534003 | ProgramServices |
| Management And General | 13109 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 293983 | Total |
| Program Services | 176711 | ProgramServices |
| Management And General | 111533 | ManagementAndGeneral |
| Fundraising | 5739 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5864 | Total |
| Management And General | 5864 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 695268 | Total |
| Management And General | 695268 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3072110 | Total |
| Program Services | 1843266 | ProgramServices |
| Management And General | 1228844 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 329424 | Total |
| Program Services | 212542 | ProgramServices |
| Management And General | 116882 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 5262143 | 5220901 | 41242 |
| PROVIDER FEES | 4247060 | 4247060 | |
| BAD DEBT | 5886120 | 5886120 | |
| COLLECTION EXPENSE | 388964 | 388964 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 286660 | Total |
| Program Services | -4018 | ProgramServices |
| Management And General | 290455 | ManagementAndGeneral |
| Fundraising | 223 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 62887341 | Total |
| Program Services | 46373146 | ProgramServices |
| Management And General | 16165063 | ManagementAndGeneral |
| Fundraising | 349132 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 701146 | BOY |
| EOY | 737138 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11555913 | BOY |
| EOY | 14162280 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46826 | BOY |
| EOY | 47326 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6511416 | BOY |
| EOY | 8541292 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 951492 | BOY |
| EOY | 882684 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1065771 | BOY |
| EOY | 1078526 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 57159645 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 26195423 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32299620 | BOY |
| EOY | 30964222 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10786538 | BOY |
| EOY | 9873090 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 191667 | BOY |
| EOY | 191667 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 86517 | BOY |
| EOY | 94572 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1173277 | BOY |
| EOY | 1438020 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65370183 | BOY |
| EOY | 68010817 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7111949 | BOY |
| EOY | 6815807 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 113905 | BOY |
| EOY | 61713 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15425000 | BOY |
| EOY | 14895000 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1450808 | BOY |
| EOY | 3215410 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1417119 | BOY |
| EOY | 2176371 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25518781 | BOY |
| EOY | 27164301 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39764885 | BOY |
| EOY | 40751944 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 86517 | BOY |
| EOY | 94572 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39851402 | BOY |
| EOY | 40846516 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 65370183 | BOY |
| EOY | 68010817 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1602168 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -607054 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | true | DirectContactLegislators |
| Direct Contact Legislators | $4,034 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 4034 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1g | Identifier |
| Return Reference | Dir. contact with legislators, their staff, gov't officials, etc. | ReturnReference |
| Explanation | San Luis Valley Regional Medical Center 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. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 86517 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 8055 | InvestmentEarningsOrLosses |
| End Of Year Balance | 94572 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 133304 | BeginningOfYearBalance |
| Other Expenditures | 46787 | OtherExpenditures |
| End Of Year Balance | 86517 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 76317 | BeginningOfYearBalance |
| Contributions | 56987 | Contributions |
| End Of Year Balance | 133304 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 117490 | BeginningOfYearBalance |
| Other Expenditures | 41173 | OtherExpenditures |
| End Of Year Balance | 76317 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.00000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 1.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | true | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | true | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3284829 | OtherCostOrOtherBasis |
| Book Value | 3284829 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 33733660 | OtherCostOrOtherBasis |
| Depreciation | 13109012 | Depreciation |
| Book Value | 20624648 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovements |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 18254854 | OtherCostOrOtherBasis |
| Depreciation | 12731371 | Depreciation |
| Book Value | 5523483 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1886302 | OtherCostOrOtherBasis |
| Depreciation | 355040 | Depreciation |
| Book Value | 1531262 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 30964222 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ASSET RETIREMENT OBLIGATION | $244,004 |
| INTEREST RATE SWAP AGREEMENT | $1,932,367 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2176371 | TotalOfAmounts |
| Total Revenue | 64489509 | TotalRevenue |
| Total Expenses | 62887341 | TotalExpenses |
| Excess Or Deficit For Year | 1602168 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 144143 | NetUnrealizedGLOnInvestments |
| Other | -$751,197 | OtherAmount |
| Total Adjustments | -607054 | TotalAdjustments |
| Excess Or Deficit Per FS | 995114 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 63954218 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 144143 | NetUnrealizedGainsInvestments |
| Other Revenues | -687489 | OtherRevenues |
| Revenue Not Rptd F990 | -543346 | RevenueNotRptdF990 |
| Revenue Subtotal | 64497564 | RevenueSubtotal |
| Other Revenues Not Included | -8055 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -8055 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 64489509 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 62959104 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 71763 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 71763 | ExpensesNotRptdF990 |
| Expenses Subtotal | 62887341 | ExpensesSubtotal |
| Total Expenses Per Form990 | 62887341 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Schedule D, Part V, Line 4 | Intended Uses of Endowment Funds | San Luis Valley Regional Medical Center 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 Medical Center 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 8 | other changes in net assets | change in fair market value of interest rate swap (759,252) change in fair market value of investment in foundation 8,055 |
| Schedule D, Part XII, Line 2d | Other revenue on books not on return | change in fair market value of interest rate swap (759,252) gain on sale of assets reclassed from expense to income (6,417) rental expenses reclassed to income 78,180 |
| Schedule D, Part XII, Line 4b | other revenue on return not on books | change in fair market value of investment in foundation (8,055) |
| Schedule D, Part XII, Line 2d | Other expense on books not on return | gain on sale of assets reclassed from expense to income (6,417) rental expenses reclassed to income 78,180 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 250. | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent250 | X | Pcent250 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 182447 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 102774 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 79673 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00140 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15325774 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14753193 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 572580 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01000 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3464010 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1810241 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1653769 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02900 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18972231 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 16666208 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2306022 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04040 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 126760 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 126760 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 27848 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 27848 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6092 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 6092 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 74199 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 74199 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 234899 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 234899 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00410 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 19207130 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 16666208 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2540921 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04450 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $5,886,120 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 13229601 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 10137475 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 3092126 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | false | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lutheran Hospital Association of SLV | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 106 Blanca Avenue | AddressLine1 |
| City | Alamosa | City |
| State | CO | State |
| ZIP Code | 81101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lutheran Hospital Association of SLV | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | false | CHNAConducted |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 250. | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 250. | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Medicare Rate | X | MedicareRate |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| 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 |
Form990 Schedule H Part VI Form990ScheduleHPartVI (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Free and discounted care | Part I Line 6 | The hospital uses a sliding scale based on family income to determine eligibility for free and discounted care. The sliding scale provides free and discounted care up to 250% of the Federal Poverty Guidelines. |
| Part I Line 7 | Total bad debt expense removed from the denominator prior to the percentage calculation = 5,886,120. The organization used a cost-to charge ratio for lines 7a, 7b, and 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. | |
| PART III, LINE 4 | Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Medical Center 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 Medical Center 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 Medical Center 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 ORGANIZATION USED A COST-TO-CHARGE RATIO FOR THE COMPUTATION OF BAD DEBT EXPENSE AT COST. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. 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 two years is as follows: 6/30/11 (3,610,290) 6/30/12 3,092,126 |
| NEEDS ASSESSMENT | SLVRMC 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 | SLVRMC 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 | SLVRMC 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 21.6% compared to Colorado's average of 9.3%. Median income levels are approximately $26,210 compared to $47,203 statewide. 61% of households in the six county area are moderate to low income. Approximately 72% or our payer mix comes from uninsured, Medicare, Medicaid, CICP, or self-pay. | |
| PROMOTION OF COMMUNITY HEALTH | SLVRMC is very active in the community in providing resources, information and donations to promote healthy living in school, business' and the general population. SLVRMC provides free or reduced rate physicals for students and other programs. SLVRMC staff is very active in the community serving on related boards and providing other community benefit while on the hospital payroll. SLVRMC provides many speaking tours on health related topics all over the San Luis Valley to inform and instruct residents on various issues. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADAMS STATE COLLEGE | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 208 EDGEMONT BLVD | AddressLine1 |
| City | ALAMOSA | City |
| State | CO | State |
| ZIP Code | 81102 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 846000542 | EINOfRecipient |
| IRC Section | GOVERNMENT | IRCSection |
| Amount Of Cash Grant | 7000 | AmountOfCashGrant |
| Purpose Of Grant | EDUCATION | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S. | Identifier |
| Return Reference | PART I, LINE 2 | ReturnReference |
| Explanation | FUNDS ARE PROVIDED TO BE USED FOR DESIGNATED PURPOSES ONLY. ALL GRANTEES ARE SEYECTED 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. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg |
|---|---|---|---|---|---|---|
| RUSSELL JOHNSON | ||||||
| 248478 | 0 | 13299 | 16167 | 8914 | 286858 | 0 |
| HENRY GARVIN | ||||||
| 157450 | 0 | 328 | 9712 | 4411 | 171901 | 0 |
| konnie martin | ||||||
| 166135 | 0 | 536 | 0 | 7002 | 173673 | 0 |
| GWEN HELLER | ||||||
| 145139 | 0 | 6270 | 74913 | 5786 | 232108 | 0 |
| HELEN LESTER | ||||||
| 105984 | 0 | 1376 | 43284 | 5093 | 155737 | 0 |
| GREG MCAULIFFE MD | ||||||
| 234460 | 0 | 3247 | 14356 | 4785 | 256848 | 0 |
| STEVEN W KITCHEN | ||||||
| 650491 | 0 | 2322 | 23459 | 6363 | 682635 | 0 |
| DAVID GEIGER | ||||||
| 419766 | 0 | 2322 | 20064 | 6516 | 448668 | 0 |
| DAVID FROW | ||||||
| 599310 | 0 | 2322 | 22685 | 5123 | 629440 | 0 |
| clifford robins | ||||||
| 328891 | 0 | 810 | 19246 | 2567 | 351514 | 0 |
| DENNARD ELLISON | ||||||
| 389881 | 0 | 1242 | 0 | 5383 | 396506 | 0 |
| ROBERT MARSHALL | ||||||
| 317568 | 0 | 1242 | 14573 | 5555 | 338938 | 0 |
| alan taylor | ||||||
| 237595 | 0 | 408 | 15130 | 9792 | 262925 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SEVERANCE PAYMENTS | PART I, LINE 4A | THE FOLLOWING AMOUNTS LISTED ARE SEVERANCE PAYMENTS: HELEN LESTER $36,552 GWEN HELLER $71,502 THOMAS HENTON $62,504 THE AMOUNT LISTED FOR THOMAS HENTON INCLUDES $14,424 PREVIOUSLY REPORTED ON THE 2010 FORM 990 AS REPORTABLE COMPENSATION FROM THE ORGANIZATION. |
| NON-FIXED PAYMENTS | 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. THERE WERE NO BONUSES FOR 2011. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| ALAMOSA COUNTY STATE OF COLORADO | |||||||
| 846000733 | 011583AA9 | 2005-02-17 | 11355000 | HOSPITAL IMPROVEMENTS | false | false | false |
| ALAMOSA COUNTY STATE OF COLORADO | |||||||
| 846000733 | 011583AB7 | 2007-04-26 | 6505000 | PURCHASE 2115 STUART & IMPROVEMENT | false | false | false |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Amount RetiredAmountRetired | Amount Bond DefeasedAmountBondDefeased | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Capitalized InterestCapitalizedInterest | Refunding EscrowRefundingEscrow | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Credit EnhancementCreditEnhancement | Working Capital ExpendituresWorkingCapitalExpenditures | Capital ExpendituresCapitalExpenditures | Other Spent ProceedsOtherSpentProceeds | Amount UnspentAmountUnspent | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2105000 | 0 | 11355000 | 157158 | 0 | 0 | 362859 | 0 | 0 | 10992141 | 0 | 0 | 2005 | false | false | true | true |
| 860000 | 0 | 6505000 | 31610 | 0 | 0 | 130100 | 81852 | 0 | 6293048 | 0 | 0 | 2007 | false | false | true | true |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|
| false | true | false | false | 0.01000 | 0.00000 | 0.01000 | true |
| false | true | false | false | 0.02000 | 0.00000 | 0.02000 | true |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Term Of HedgeTermOfHedge | Superintegrated HedgeSuperintegratedHedge | Hedge TerminatedHedgeTerminated | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Business Name Line1NameOfGICProvider/BusinessNameLine1 | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|---|---|---|---|
| MORGAN STANLEY CAP | |||||||||
| false | true | true | 20.28 | false | false | false | 0 | false | false |
| MORGAN STANLEY CAP | |||||||||
| false | true | true | 15. | false | false | false | 0 | false | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fed Tax Requirements Compliance | X | FedTaxRequirementsCompliance |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DAVID GEIGER | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | EMPLOYEE | Relationship |
| Amount Of Transaction | 0 | AmountOfTransaction |
| Description Of Transaction | WAGES | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PART IV, COLUMN C | Identifier |
| Return Reference | BUSINESS TRANSACTIONS WITH INTERESTED PERSONS | ReturnReference |
| Explanation | 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 8. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (18 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part VI, Question 11b | Describe process to review 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. |
| Part VI, Question 12c | Monitoring of the the conflict of interest policy | San Luis Valley Regional Medical Center 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. |
| Part VI, Question 15a | Executive 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. SLVRMC conducts an annual evaluation and quarterly reviews of the CEO's performance, which is documented. Compensation for the CEO is determined annually. |
| Part VI, Question 15b | Other officer 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. |
| Part VI, Question 19 | Describe how documents are made available to the public | The governing documents, conflict of interest policy, and financial statements are available to the public upon request. |
| SCHEDULE B | GRANTS FROM SLVRMC FOUNDATION | THE SLVRMC FOUNDATION, A RELATED ORGANIZATION, RECORDED TOTAL GRANTS TO THE MEDICAL CENTER OF $100,922. HOWEVER, THE MEDICAL CENTER HAS ONLY RECORDED GRANTS RECEIVED FROM THE FOUNDATION OF $80,000. THIS DISCREPANCY IS RELATED TO IN-KIND GRANTS FROM SLVRMC FOUNDATION WHICH ARE IMMATERIAL TO THE MEDICAL CENTER AND NEVER RECORDED. |
| Part VII | Compensation of Former Officer | The compensation for Leonard Snow is for a position that is not in an officer capacity. |
| PART XI, LINE 5 | OTHER CHANGES IN NET ASSETS | UNREALIZED GAIN 144,143 CHANGE IN FAIR MARKET VALUE OF INTEREST RATE SWAP (759,252) CHANGE IN FAIR MARKET VALUE OF INVESTMENT IN FOUNDATION 8,055 TOTAL OTHER CHANGES TO NET ASSETS (607,054) |
| PART VI, question 4 | SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS | IN 2011, THE BYLAWS WERE AMENDED TO ALLOW THE FOUR PHYSICIANS ON THE BOARD OF TRUSTEES FULL RIGHTS AND RESPONSIBILITIES WHICH INCLUDES VOTING RIGHTS. |
| PART VI, question 2 | OFFICER, DIRECTOR, TRUSTEE FAMILY/BUSINESS RELATIONSHIP | BOARD OF DIRECTOR MEMBERS CHERI CROWDER AND PATRICK CROWDER HAVE A FAMILY RELATIONSHIP. |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:JAN GAY TITLE:PRESIDENT HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:CHERI CROWDER TITLE:VICE PRESIDENT HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:KATHY LORENZ TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:KARLA HARDESTY TITLE:TRUSTEE HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:RUSSELL JOHNSON TITLE:CEO HOURS:2 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:HENRY GARVIN TITLE:CEO - CONEJOS COUNTY HOSPITAL HOURS:32 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:THOMAS HENTON TITLE:ADMIN. OF CONEJOS CO. HOSPITAL HOURS:40 |
| HOURS DEVOTED FOR RELATED ORGANIZATION | FORM 990 PART VII | NAME:SHANE MORTENSEN TITLE:CFO HOURS:2 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| SLVRMC FOUNDATION | ||||||||||
| 106 BLANCA AVENUE | ALAMOSA | CO | 81101 | 203799814 | FUNDRAISING | CO | 501(C)(3) | LINE 7 | NA | true |
| CONEJOS COUNTY HOSPITAL CORPORATION | ||||||||||
| PO BOX 639 | LA JARA | CO | 81140 | 710947623 | HOSPITAL | CO | 501(C)(3) | LINE 3 | NA | true |
| SLV MEDICAL CTR EMPLOYEE BEN TRUST | ||||||||||
| 106 BLANCA AVENUE | ALAMOSA | CO | 81101 | 840909851 | HEALTH PLAN | CO | 501(C)(3) | Line 9 | na | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | true | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| SAN LUIS VALLEY REGIONAL MEDICAL CENTER FDN | ||
| C | 80000 | CASH PAID |
| CONEJOS COUNTY HOSPITAL CORPORATION | ||
| K | 840450 | CASH RECEIVED |
| CONEJOS COUNTY HOSPITAL CORPORATION | ||
| D | 200726 | LOAN AMOUNT |
| CONEJOS COUNTY HOSPITAL CORPORATION | ||
| P | 876095 | INVOICES |
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