SAN LUIS VALLEY REGIONAL MEDICAL CENTER: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
SAN LUIS VALLEY REGIONAL MEDICAL CENTER (EIN 84-0255530)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-21
IRS object ID
201241429349300564
Schema version
2010v3.7
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-21T14:43:19-04:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 South Tejon Suite 800AddressLine1
CityColorado SpringsCity
StateCOState
ZIP Code809039848ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN840255530EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Lutheran Hosp Assoc of the San Luis ValleyBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLUTHNameControl
Phone7195892511Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1106 Blanca AvenueAddressLine1
CityAlamosaCity
StateCOState
ZIP Code81101ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRussell JohnsonName
TitleCEOTitle
Phone7195892511Phone
Date Signed2012-05-15DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameRita F Worster CPAName
Phone7194714290Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1San Luis Valley Regional Medical CtrBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonRussell Johnson CEONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1106 Blanca AvenueAddressLine1
CityAlamosaCity
StateCOState
ZIP Code81101ZIPCode
FieldValueIRS element (for citing)
Gross Receipts60191698GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.slvrmc.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1928YearFormation
State Legal DomicileCOStateLegalDomicile
Activity Or Mission DescriptionThe 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 Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees637TotalNbrEmployees
Total Nbr Volunteers73TotalNbrVolunteers
Total Gross UBI809TotalGrossUBI
Contributions Grants Prior Year679080ContributionsGrantsPriorYear
Contributions Grants Current Year898158ContributionsGrantsCurrentYear
Program Service Revenue Prior Year57837158ProgramServiceRevenuePriorYear
Program Service Revenue CY58667969ProgramServiceRevenueCY
Investment Income Prior Year318949InvestmentIncomePriorYear
Investment Income Current Year294336InvestmentIncomeCurrentYear
Other Revenue Prior Year124110OtherRevenuePriorYear
Other Revenue Current Year133370OtherRevenueCurrentYear
Total Revenue Prior Year58959297TotalRevenuePriorYear
Total Revenue Current Year59993833TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year149432GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY83543GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year31611955SalariesEtcPriorYear
Salaries Etc Current Year30935359SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year263644TotalFundrsngExpCurrentYear
Other Expense Prior Year26741591OtherExpensePriorYear
Other Expenses Current Year28460191OtherExpensesCurrentYear
Total Expenses Prior Year58502978TotalExpensesPriorYear
Total Expenses Current Year59479093TotalExpensesCurrentYear
Revenues Less Expenses Prior Year456319RevenuesLessExpensesPriorYear
Revenues Less Expenses CY514740RevenuesLessExpensesCY
Total Assets BOY64873443TotalAssetsBOY
Total Assets EOY65370183TotalAssetsEOY
Total Liabilities BOY25521522TotalLiabilitiesBOY
Total Liabilities EOY25518781TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY39351921NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY39851402NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionAN 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 ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense43604347Expense
Grants83543Grants
Revenue58589681Revenue
DescriptionSan 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 Expense43604347TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096108NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees637NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonTHE ORGANIZATIONNamePerson
Telephone Number7195892511TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1106 BLANCA AVENUEAddressLine1
CityAlamosaCity
StateCOState
ZIP Code81101ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
JAN GAY
PRESIDENT2.0XX300000
CHERI CROWDER
VICE PRESIDENT2.0XX120000
KENDAL KNAUS MD
SECRETARY/TREASURER2.0XX3360000
ROBERT HAGEDORN
TRUSTEE2.0X133600
GARY WUCKERT
TRUSTEE2.0X120000
KATHY LORENZ
TRUSTEE2.0X132200
KARLA HARDESTY
TRUSTEE2.0X120000
ROSALIE MARTINEZ
TRUSTEE2.0X120000
RUSSELL JOHNSON
CEO38.0X356820025953
HENRY GARVIN
VP OPERATIONS38.0X181005015562
KATHY ROGERS
VP SERVICE & DEVELOPMENT40.0X107531011336
GWEN HELLER
VP HR/BUS DEVELOPMENT40.0X159622018547
HELEN LESTER
CNO40.0X116395012515
THOMAS HENTON
ADMINISTRATOR OF CONEJOS CO. H0.0X146771013519
GREG MCAULIFFE MD
CMO20.0X24691404337
KONNIE MARTIN
CFO38.0X5551002271
STEVEN W KITCHEN
PHYSICIAN40.0699241020521X
DAVID GEIGER
PHYSICIAN40.0402085021333X
DAVID FROW
PHYSICIAN40.0384483019910X
DENNARD ELLISON
PHYSICIAN40.031186903507X
ROBERT MARSHALL
PHYSICIAN40.031074005699X
DAVID FRESHOUR
CFO40.0197753016810X
LEONARD SNOW
VP QUALITY40.0108494017831X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3829291TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation209651TotalOtherCompensation
Number Individuals GT100 K41NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ALPINE ELECTRIC INC
82 CONEJOS AVEALAMOSACO81101CONTRACT SERVICES590299
CARETECH SOLUTIONS INC
PO BOX 674271DETROITMI48267CONTRACT SERVICES573381
NUANCE COMMUNICATIONS
PO BOX 2561CAROL STREAMIL60132CONTRACT SERVICES550378
WEATHERBY LOCUMS
PO BOX 972633DALLASTX75397CONTRACT LABOR535278
CHG COMPANIES INC
PO BOX 972651DALLASTX75397DATA PROCESSING372711
FieldValueIRS element (for citing)
Number Of Contractors GT100 K14NumberOfContractorsGT100K
Related Organizations109663RelatedOrganizations
Government Grants194219GovernmentGrants
All Other Contributions594276AllOtherContributions
Total Contributions898158TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
PATIENT SERVICE REVENUE9000993267841132678411
MEDICARE/MEDICAID9000992434194024341940
AMBULANCE DISTRICT REVENUE621910345269345269
MANAGEMENT FEES900099840450840450
OTHER PROGRAM SERVICE REVENUE900099461899284987$176,912
FieldValueIRS element (for citing)
Total Program Service Revenue58667969TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column386619TotalRevenueColumn
Exclusion$386,619ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real103886Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real71982Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real31904Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column31904TotalRevenueColumn
Unrelated Business Revenue809UnrelatedBusinessRevenue
Exclusion$31,095ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other33600Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other125883Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-92283Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-92283TotalRevenueColumn
Exclusion-$92,283ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
OTHER REVENUE9000999862498624
DRUGS- NON PATIENT9000992842$2,842
FieldValueIRS element (for citing)
Total Other Revenue101466TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column59993833TotalRevenueColumn
Related Or Exempt Function Income58589681RelatedOrExemptFunctionIncome
Unrelated Business Revenue809UnrelatedBusinessRevenue
Exclusion$505,185ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total83543Total
Program Services83543ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1518667Total
Program Services1131153ProgramServices
Management And General376946ManagementAndGeneral
Fundraising10568Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total93888Total
Program Services69933ProgramServices
Management And General23306ManagementAndGeneral
Fundraising649Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total24439746Total
Program Services18204034ProgramServices
Management And General6066752ManagementAndGeneral
Fundraising168960Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1041566Total
Program Services774969ProgramServices
Management And General258178ManagementAndGeneral
Fundraising8419Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2176996Total
Program Services1622316ProgramServices
Management And General539623ManagementAndGeneral
Fundraising15057Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1664496Total
Program Services1158965ProgramServices
Management And General491808ManagementAndGeneral
Fundraising13723Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total129191Total
Management And General129191ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total93004Total
Management And General93004ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total5157Total
Management And General5157ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4510472Total
Program Services2365620ProgramServices
Management And General2116769ManagementAndGeneral
Fundraising28083Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total91106Total
Program Services1332ProgramServices
Management And General88928ManagementAndGeneral
Fundraising846Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2322448Total
Program Services770450ProgramServices
Management And General1535775ManagementAndGeneral
Fundraising16223Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total561168Total
Management And General561168ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1338525Total
Program Services1047358ProgramServices
Management And General291167ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total246917Total
Program Services134457ProgramServices
Management And General111517ManagementAndGeneral
Fundraising943Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total5919Total
Management And General5919ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total622451Total
Management And General622451ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2905370Total
Program Services1743222ProgramServices
Management And General1162148ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total182142Total
Management And General182142ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES5274592523485839734
PROVIDER FEES31992093199209
BAD DEBT60546276054627
COLLECTION EXPENSE391528391528
OTHER5263658301517891173

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total59479093Total
Program Services43604347ProgramServices
Management And General15611102ManagementAndGeneral
Fundraising263644Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY421289BOY
EOY701146EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY9307578BOY
EOY11555913EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY23857BOY
EOY46826EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7589026BOY
EOY6511416EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY996269BOY
EOY951492EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1101249BOY
EOY1065771EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis55971413LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec23671793LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY31684074BOY
EOY32299620EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY12523463BOY
EOY10786538EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY191667BOY
EOY191667EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY133304BOY
EOY86517EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY901667BOY
EOY1173277EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY64873443BOY
EOY65370183EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6939490BOY
EOY7111949EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY93943BOY
EOY113905EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY15940000BOY
EOY15425000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1050011BOY
EOY1450808EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1498078BOY
EOY1417119EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY25521522BOY
EOY25518781EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY39218617BOY
EOY39764885EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY133304BOY
EOY86517EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY39351921BOY
EOY39851402EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY64873443BOY
EOY65370183EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses514740ReconcilationRevenueExpenses
Reconcilation Other Changes-15259ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$5,157DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB5157TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1gIdentifier
Return ReferenceDir. contact with legislators, their staff, gov't officials, etc.ReturnReference
ExplanationSan 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

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance133304BeginningOfYearBalance
Other Expenditures46787OtherExpenditures
End Of Year Balance86517EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance76317BeginningOfYearBalance
Contributions56987Contributions
End Of Year Balance133304EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance117490BeginningOfYearBalance
Other Expenditures41173OtherExpenditures
End Of Year Balance76317EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3284829OtherCostOrOtherBasis
Book Value3284829BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis33555374OtherCostOrOtherBasis
Depreciation11841577Depreciation
Book Value21713797BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis5165OtherCostOrOtherBasis
Depreciation4289Depreciation
Book Value876BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis17628703OtherCostOrOtherBasis
Depreciation11545336Depreciation
Book Value6083367BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1497342OtherCostOrOtherBasis
Depreciation280591Depreciation
Book Value1216751BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings32299620TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ASSET RETIREMENT OBLIGATION$244,004
INTEREST RATE SWAP AGREEMENT$1,173,115
FieldValueIRS element (for citing)
Total Of Amounts1417119TotalOfAmounts
Total Revenue59993833TotalRevenue
Total Expenses59479093TotalExpenses
Excess Or Deficit For Year514740ExcessOrDeficitForYear
Net Unrealized GL On Investments-49431NetUnrealizedGLOnInvestments
Other$34,172OtherAmount
Total Adjustments-15259TotalAdjustments
Excess Or Deficit Per FS499481ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt60142839TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-49431NetUnrealizedGainsInvestments
Other Revenues245224OtherRevenues
Revenue Not Rptd F990195793RevenueNotRptdF990
Revenue Subtotal59947046RevenueSubtotal
Other Revenues Not Included46787OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt46787RevenueNotRptdOnFinStmt
Total Revenue Per Form99059993833TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt59643358TotExpensesEtcAuditedFinclStmt
Other Expenses Included164265OtherExpensesIncluded
Expenses Not Rptd F990164265ExpensesNotRptdF990
Expenses Subtotal59479093ExpensesSubtotal
Total Expenses Per Form99059479093TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Schedule D, Part V, Line 4Intended Uses of Endowment FundsSan 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 2Uncertain Tax PositionsManagement 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 8other changes in net assetschange in fair market value of interest rate swap 80,959 change in fair market value of investment in foundation (46,787)
Schedule D, Part XII, Line 2dOther revenue on books not on returnchange in fair market value of interest rate swap 80,959 loss on sale of assets reclassed from expense to income 92,283 rental expenses reclassed to income 71,982
Schedule D, Part XII, Line 4bother revenue on return not on bookschange in fair market value of investment in foundation 46,787
Schedule D, Part XII, Line 2dOther expense on books not on returnloss on sale of assets reclassed from expense to income 92,283 rental expenses reclassed to income 71,982

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage250.FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense281553TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense281553NetCommunityBenefitExpense
Percent Of Total Expense0.00530PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense14357791TotalCommunityBenefitExpense
Direct Offsetting Revenue11106182DirectOffsettingRevenue
Net Community Benefit Expense3251609NetCommunityBenefitExpense
Percent Of Total Expense0.06090PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense2300954TotalCommunityBenefitExpense
Direct Offsetting Revenue2059274DirectOffsettingRevenue
Net Community Benefit Expense241680NetCommunityBenefitExpense
Percent Of Total Expense0.00450PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense16940298TotalCommunityBenefitExpense
Direct Offsetting Revenue13165456DirectOffsettingRevenue
Net Community Benefit Expense3774842NetCommunityBenefitExpense
Percent Of Total Expense0.07070PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense33356TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense33356NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense40692TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense40692NetCommunityBenefitExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense2393TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2393NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense14726TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense14726NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense91167TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense91167NetCommunityBenefitExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense17031465TotalCommunityBenefitExpense
Direct Offsetting Revenue13165456DirectOffsettingRevenue
Net Community Benefit Expense3866009NetCommunityBenefitExpense
Percent Of Total Expense0.07240PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense13820TotalCommunityBuildingExpense
Net Community Building Expense13820NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense1218TotalCommunityBuildingExpense
Net Community Building Expense1218NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense41598TotalCommunityBuildingExpense
Net Community Building Expense41598NetCommunityBuildingExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense9693TotalCommunityBuildingExpense
Net Community Building Expense9693NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense2493TotalCommunityBuildingExpense
Net Community Building Expense2493NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense10523TotalCommunityBuildingExpense
Net Community Building Expense10523NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense6538TotalCommunityBuildingExpense
Net Community Building Expense6538NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense85883TotalCommunityBuildingExpense
Net Community Building Expense85883NetCommunityBuildingExpense
Percent Of Total Expense0.00160PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$2,485,794BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare11976226AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare15586516CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-3610290MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Lutheran Hospital Association of SLVBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1106 Blanca AvenueAddressLine1
CityAlamosaCity
StateCOState
ZIP Code81101ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Lutheran Hospital Association of SLVBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Lutheran Hospital of SLV
2115 Stuart StAlamosaCO81101Physician Clinic
Lutheran Hospital of SLV
103 Chico CtMonte VistaCO81144Physician Clinic

Form990 Schedule H Part VI Form990ScheduleHPartVI (8 entries)

IdentifierIdentifierExplanationExplanation
PART I, LINE 7, COLUMN FTotal bad debt expense removed from the denominator prior to the percentage calculation = 6,054,627.
PART I, LINE 7The 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 4The Medical Center reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The Medical Center provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information, and existing economic conditions. As a service to the patient, the Medical Center bills third-party payers directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. 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.
PART III, LINE 8The total shortfall on Line 7 should be treated as community benefit. The costing methodology to determine Line 6 was the overall facility cost-to-charge ratio. The timing of settlements with Medicare makes a comparison to only current year costs difficult. A surplus of $5,193,160 was recorded on the 2009 Schedule H. The net for 2009 and 2010 results in a combined surplus of $1,582,870. IRS Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospitals, states that if a hospital serves patients with government health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. This implies that treating Medicare patients is a community benefit.
NEEDS ASSESSMENTSLVRMC 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 ASSISTANCESLVRMC 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 INFORMATIONSLVRMC 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 HEALTHSLVRMC 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

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
TRINIDAD STATE JUNIOR COLLEGE
1011 MAIN STALAMOSACO81101840644739GOVERNMENT30000EDUCATION
ADAMS STATE COLLEGE
208 EDGEMONT BLVDALAMOSACO81102846000542GOVERNMENT37000EDUCATION
CITY OF ALAMOSA
300 HUNT AVEALAMOSACO81101846000560GOVERNMENT8820SUPPORT OF CITY
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.Identifier
Return ReferencePART I, LINE 2ReturnReference
ExplanationFUNDS ARE PROVIDED TO BE USED FOR DESIGNATED PURPOSES ONLY. ALL GRANTEES ARE SELECTED AND STRICTLY SCREENED BY THE MEDICAL CENTER. MULTI-YEAR AGREEMENTS ARE MADE WITH THE RECIPIENT ORGANIZATIONS AND ARE EVALUATED ON AN ANNUAL BASIS BEFORE FUNDING IS CONTINUED.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RUSSELL JOHNSON
25266008103402312601470001125303827730482340
HENRY GARVIN
154970022627034080111260443601965670162530
DAVID FRESHOUR
6662001524601158870121450466502145630173240
GWEN HELLER
136414019272039360100850846201781690146000
THOMAS HENTON
13234700014424090730444601602900125010
GREG MCAULIFFE MD
2261160180000279800043370251251000
STEVEN W KITCHEN
68351701411101613014700058210719762000
DAVID GEIGER
3871110141110863014700066330423418000
DAVID FROW
36875301411101619014700052100404393000
LEONARD SNOW
993100385005334071500106810126325038500
DENNARD ELLISON
31113700073200035070315376000
ROBERT MARSHALL
30983600090400056990316439000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SEVERANCE PAYMENTSPART I, LINE 4ADAVE FRESHOUR 93,888 THOMAS HENTON 14,424
NON-FIXED PAYMENTSPART I, LINE 7CLINICAL 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.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
ALAMOSA COUNTY STATE OF COLORADO
846000733011583AA92005-02-1711355000HOSPITAL IMPROVEMENTSfalsefalsefalse
ALAMOSA COUNTY STATE OF COLORADO
846000733011583AB72007-04-266505000PURCHASE 2115 STUART & IMPROVEMENTfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Amount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
1760000011355000150933003628590010992141002005falsefalsetruetrue
6750000650500030779001301008185206293048002007falsefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsetruefalsefalsefalse0.010000.000000.01000true
falsetruefalsefalsefalse0.020000.000000.02000

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
MORGAN STANLEY CAP
falsetruetrue20.28falsefalsefalsefalsefalse
MORGAN STANLEY CAP
falsetruetrue15.falsefalsefalsefalsefalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (17 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part VI, Question 11bDescribe process to review 990The 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 12cMonitoring of the the conflict of interest policySan Luis Valley Regional Medical Center has a current Conflict of Interest Policy that is reveiwed 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 reveiwed 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 15aExecutive CompensationHuman 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 15bOther officer compensationHuman 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 19Describe how documents are made available to the publicThe governing documents, conflict of interest policy, and financial statements are available to the public upon request.
SCHEDULE BGRANTS FROM SLVRMC FOUNDATIONTHE SLVRMC FOUNDATION, A RELATED ORGANIZATION, RECORDED TOTAL GRANTS TO THE MEDICAL CENTER OF 128,717. HOWEVER, THE MEDICAL CENTER HAS ONLY RECORDED GRANTS RECEIVED FROM THE FOUNDATION OF 109,663. THIS DISCREPANCY IS RELATED TO IN-KIND GRANTS FROM SLVRMC FOUNDATION WHICH ARE IMMATERIAL TO THE MEDICAL CENTER AND NEVER RECORDED.
Part VIICompensation of Former OfficerThe compensation for Leonard Snow is for a position that is not in an officer capacity.
PART XI, LINE 5OTHER CHANGES IN NET ASSETSUNREALIZED LOSS (49,431) CHANGE IN FAIR MARKET VALUE OF INTEREST RATE SWAP 80,959 CHANGE IN FAIR MARKET VALUE OF INVESTMENT IN FOUNDATION . (46,787) TOTAL OTHER CHANGES TO NET ASSETS (15,259)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JAN GAY TITLE:PRESIDENT HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:CHERI CROWDER TITLE:VICE PRESIDENT HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:ROBERT HAGEDORN TITLE:TRUSTEE HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:KATHY LORENZ TITLE:TRUSTEE HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:KARLA HARDESTY TITLE:TRUSTEE HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:RUSSELL JOHNSON TITLE:CEO HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:HENRY GARVIN TITLE:VP OPERATIONS HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:THOMAS HENTON TITLE:ADMINISTRATOR OF CONEJOS CO. H HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:KONNIE MARTIN TITLE:CFO HOURS:2

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
SLVRMC FOUNDATION
106 BLANCA AVENUEALAMOSACO81101203799814FUNDRAISINGCO501(c)(3)LINE 7NA
CONEJOS COUNTY HOSPITAL CORPORATION
PO BOX 639LA JARACO81140710947623HOSPITALCO501(c)(3)LINE 3NA
SLV MEDICAL CTR EMPLOYEE BEN TRUST
106 BLANCA AVENUEALAMOSACO81101840909851HEALTH PLANCO501(C)(9)Line 9na
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
SAN LUIS VALLEY REGIONAL MEDICAL CENTER FDN
C109663
CONEJOS COUNTY HOSPITAL CORPORATION
K840450
CONEJOS COUNTY HOSPITAL CORPORATION
D603021

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