2012-05-21T14:43:19-04:00 2011-06-30 BKD LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2010-07-01 840255530 Lutheran Hosp Assoc of the San Luis Valley LUTH 7195892511 106 Blanca Avenue Alamosa CO 81101 Russell Johnson 7195892511 2012-05-15 Rita F Worster CPA 7194714290 2010 2016-02-24 21:20:13Z San Luis Valley Regional Medical Ctr Russell Johnson CEO 106 Blanca Avenue Alamosa CO 81101 60191698 false X www.slvrmc.org X 1928 CO 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. 7 6 637 73 809 679080 898158 57837158 58667969 318949 294336 124110 133370 58959297 59993833 149432 83543 0 0 31611955 30935359 0 0 263644 26741591 28460191 58502978 59479093 456319 514740 64873443 65370183 25521522 25518781 39351921 39851402 X AN UNCONDITIONAL COMMITMENT TO EXCELLENCE BY PROVIDING QUALITY, COMPASSIONATE CARE GUIDED BY OUR VALUES. WE ACCEPT RESPONSIBILITY FOR PROVIDING SERVICES TO OUR COMMUNITY THAT ARE OF THE HIGHEST CALIBER OF SERVICE AND STANDARD PERFORMANCE, WHILE DEMONSTRATING OUR ADOPTED VALUES. false false 43604347 83543 58589681 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. 43604347 true true false true false false false false true true false false false true false true false false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true true false false false true 108 0 true 637 true true true false false false false false false false false false X 7 6 false false false false false false false true true false false true true true true true true true true false X THE ORGANIZATION 7195892511 106 BLANCA AVENUE Alamosa CO 81101 X JAN GAY 2.0 X X 3000 0 0 CHERI CROWDER 2.0 X X 1200 0 0 KENDAL KNAUS MD 2.0 X X 33600 0 0 ROBERT HAGEDORN 2.0 X 1336 0 0 GARY WUCKERT 2.0 X 1200 0 0 KATHY LORENZ 2.0 X 1322 0 0 KARLA HARDESTY 2.0 X 1200 0 0 ROSALIE MARTINEZ 2.0 X 1200 0 0 RUSSELL JOHNSON 38.0 X 356820 0 25953 HENRY GARVIN 38.0 X 181005 0 15562 KATHY ROGERS 40.0 X 107531 0 11336 GWEN HELLER 40.0 X 159622 0 18547 HELEN LESTER 40.0 X 116395 0 12515 THOMAS HENTON 0.0 X 146771 0 13519 GREG MCAULIFFE MD 20.0 X 246914 0 4337 KONNIE MARTIN 38.0 X 55510 0 2271 STEVEN W KITCHEN 40.0 X 699241 0 20521 DAVID GEIGER 40.0 X 402085 0 21333 DAVID FROW 40.0 X 384483 0 19910 DENNARD ELLISON 40.0 X 311869 0 3507 ROBERT MARSHALL 40.0 X 310740 0 5699 DAVID FRESHOUR 40.0 X 197753 0 16810 LEONARD SNOW 40.0 X 108494 0 17831 3829291 0 209651 41 true true false ALPINE ELECTRIC INC 82 CONEJOS AVE ALAMOSA CO 81101 CONTRACT SERVICES 590299 CARETECH SOLUTIONS INC PO BOX 674271 DETROIT MI 48267 CONTRACT SERVICES 573381 NUANCE COMMUNICATIONS PO BOX 2561 CAROL STREAM IL 60132 CONTRACT SERVICES 550378 WEATHERBY LOCUMS PO BOX 972633 DALLAS TX 75397 CONTRACT LABOR 535278 CHG COMPANIES INC PO BOX 972651 DALLAS TX 75397 DATA PROCESSING 372711 14 109663 194219 594276 898158 PATIENT SERVICE REVENUE 900099 32678411 32678411 MEDICARE/MEDICAID 900099 24341940 24341940 AMBULANCE DISTRICT REVENUE 621910 345269 345269 MANAGEMENT FEES 900099 840450 840450 OTHER PROGRAM SERVICE REVENUE 900099 461899 284987 176912 58667969 386619 386619 0 0 103886 71982 31904 31904 809 31095 33600 125883 -92283 -92283 -92283 0 0 0 OTHER REVENUE 900099 98624 98624 DRUGS- NON PATIENT 900099 2842 2842 101466 59993833 58589681 809 505185 83543 83543 0 0 0 1518667 1131153 376946 10568 93888 69933 23306 649 24439746 18204034 6066752 168960 1041566 774969 258178 8419 2176996 1622316 539623 15057 1664496 1158965 491808 13723 0 129191 129191 93004 93004 5157 5157 0 0 4510472 2365620 2116769 28083 91106 1332 88928 846 2322448 770450 1535775 16223 561168 561168 0 1338525 1047358 291167 246917 134457 111517 943 0 5919 5919 622451 622451 0 2905370 1743222 1162148 182142 182142 MEDICAL SUPPLIES 5274592 5234858 39734 PROVIDER FEES 3199209 3199209 BAD DEBT 6054627 6054627 COLLECTION EXPENSE 391528 391528 OTHER 526365 8301 517891 173 59479093 43604347 15611102 263644 421289 701146 9307578 11555913 23857 46826 7589026 6511416 996269 951492 1101249 1065771 55971413 23671793 31684074 32299620 12523463 10786538 191667 191667 133304 86517 901667 1173277 64873443 65370183 6939490 7111949 93943 113905 15940000 15425000 1050011 1450808 1498078 1417119 25521522 25518781 X 39218617 39764885 133304 86517 39351921 39851402 64873443 65370183 X 514740 -15259 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 5157 false false 5157 false Part II-B, Line 1g Dir. contact with legislators, their staff, gov't officials, etc. 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. 133304 46787 86517 76317 56987 133304 117490 41173 76317 0.00000 0.00000 1.00000 false true true 3284829 3284829 33555374 11841577 21713797 5165 4289 876 17628703 11545336 6083367 1497342 280591 1216751 32299620 0 ASSET RETIREMENT OBLIGATION 244004 INTEREST RATE SWAP AGREEMENT 1173115 1417119 59993833 59479093 514740 -49431 34172 -15259 499481 60142839 -49431 245224 195793 59947046 46787 46787 59993833 59643358 164265 164265 59479093 59479093 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 80,959 change in fair market value of investment in foundation (46,787) Schedule D, Part XII, Line 2d Other revenue on books not on return change 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 4b other revenue on return not on books change in fair market value of investment in foundation 46,787 Schedule D, Part XII, Line 2d Other expense on books not on return loss on sale of assets reclassed from expense to income 92,283 rental expenses reclassed to income 71,982 true true true X 250. true X true true false false 281553 0 281553 0.00530 14357791 11106182 3251609 0.06090 2300954 2059274 241680 0.00450 16940298 13165456 3774842 0.07070 33356 0 33356 0.00060 40692 0 40692 0.00080 0 0 0 0.00000 2393 0 2393 0.00000 14726 0 14726 0.00030 91167 0 91167 0.00170 17031465 13165456 3866009 0.07240 13820 13820 0.00030 1218 1218 0.00000 41598 41598 0.00080 0 0 0.00000 0 0 0.00000 9693 9693 0.00020 2493 2493 0.00000 10523 10523 0.00020 6538 6538 0.00010 85883 85883 0.00160 true 2485794 0 11976226 15586516 -3610290 X true false 1 1 Lutheran Hospital Association of SLV

106 Blanca Avenue Alamosa CO 81101

X X Lutheran Hospital Association of SLV 1 2 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 PART I, LINE 7, COLUMN F Total bad debt expense removed from the denominator prior to the percentage calculation = 6,054,627. PART I, LINE 7 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 The 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 8 The 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 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. true TRINIDAD STATE JUNIOR COLLEGE 1011 MAIN ST ALAMOSA CO 81101 840644739 GOVERNMENT 30000 EDUCATION ADAMS STATE COLLEGE 208 EDGEMONT BLVD ALAMOSA CO 81102 846000542 GOVERNMENT 37000 EDUCATION CITY OF ALAMOSA 300 HUNT AVE ALAMOSA CO 81101 846000560 GOVERNMENT 8820 SUPPORT OF CITY 3 0 PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S. PART I, LINE 2 FUNDS ARE PROVIDED TO BE USED FOR DESIGNATED PURPOSES ONLY. ALL GRANTEES ARE SELECTED AND STRICTLY SCREENED BY THE MEDICAL CENTER. MULTI-YEAR AGREEMENTS ARE MADE WITH THE RECIPIENT ORGANIZATIONS AND ARE EVALUATED ON AN ANNUAL BASIS BEFORE FUNDING IS CONTINUED. X X X true false false false false false false true false RUSSELL JOHNSON 252660 0 81034 0 23126 0 14700 0 11253 0 382773 0 48234 0 HENRY GARVIN 154970 0 22627 0 3408 0 11126 0 4436 0 196567 0 16253 0 DAVID FRESHOUR 66620 0 15246 0 115887 0 12145 0 4665 0 214563 0 17324 0 GWEN HELLER 136414 0 19272 0 3936 0 10085 0 8462 0 178169 0 14600 0 THOMAS HENTON 132347 0 0 0 14424 0 9073 0 4446 0 160290 0 12501 0 GREG MCAULIFFE MD 226116 0 18000 0 2798 0 0 0 4337 0 251251 0 0 0 STEVEN W KITCHEN 683517 0 14111 0 1613 0 14700 0 5821 0 719762 0 0 0 DAVID GEIGER 387111 0 14111 0 863 0 14700 0 6633 0 423418 0 0 0 DAVID FROW 368753 0 14111 0 1619 0 14700 0 5210 0 404393 0 0 0 LEONARD SNOW 99310 0 3850 0 5334 0 7150 0 10681 0 126325 0 3850 0 DENNARD ELLISON 311137 0 0 0 732 0 0 0 3507 0 315376 0 0 0 ROBERT MARSHALL 309836 0 0 0 904 0 0 0 5699 0 316439 0 0 0 SEVERANCE PAYMENTS PART I, LINE 4A DAVE FRESHOUR 93,888 THOMAS HENTON 14,424 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. 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 1760000 0 11355000 150933 0 0 362859 0 0 10992141 0 0 2005 false false true true 675000 0 6505000 30779 0 0 130100 81852 0 6293048 0 0 2007 false false true true false true false false false 0.01000 0.00000 0.01000 true false true false false false 0.02000 0.00000 0.02000 false true true MORGAN STANLEY CAP 20.28 false false false false false false true true MORGAN STANLEY CAP 15. false false false false false 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 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 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 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 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 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 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:ROBERT HAGEDORN TITLE:TRUSTEE 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:VP OPERATIONS HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:THOMAS HENTON TITLE:ADMINISTRATOR OF CONEJOS CO. H HOURS:40 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KONNIE MARTIN TITLE:CFO HOURS:2 SLVRMC FOUNDATION 106 BLANCA AVENUE ALAMOSA CO 81101 203799814 FUNDRAISING CO 501(c)(3) LINE 7 NA CONEJOS COUNTY HOSPITAL CORPORATION PO BOX 639 LA JARA CO 81140 710947623 HOSPITAL CO 501(c)(3) LINE 3 NA SLV MEDICAL CTR EMPLOYEE BEN TRUST 106 BLANCA AVENUE ALAMOSA CO 81101 840909851 HEALTH PLAN CO 501(C)(9) Line 9 na false false true true false false false false false false true true false true false false false false SAN LUIS VALLEY REGIONAL MEDICAL CENTER FDN C 109663 CONEJOS COUNTY HOSPITAL CORPORATION K 840450 CONEJOS COUNTY HOSPITAL CORPORATION D 603021