2011-05-16T13:47:51-05:00 2010-06-30 BKD LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2009-07-01 840255530 Lutheran Hosp Assoc of the San Luis Valley LUTH 7195892511 106 Blanca Avenue Alamosa CO 81101 Russell Johnson 2011-05-15 true Rita F Worster CPA 7194714290 2009 2016-02-24 21:20:13Z San Luis Valley Regional Medical Ctr Russell Johnson CEO 106 Blanca Avenue Alamosa CO 81101 59142427 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. 8 7 621 59 -2915 -3875 1299485 679080 57851219 57837158 638549 318949 158757 124110 59948010 58959297 152883 149432 0 0 30632838 31611955 0 0 165230 25544753 26741591 56330474 58502978 3617536 456319 61891974 64873443 22623695 25521522 39268279 39351921 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 42038831 149432 57694630 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. 42038831 true true true true false false false false true true true false false false false false false false false false true true false true true false false false false false false false false false false false false false false false true true false false true 107 0 true 621 true true true false false false false false false false false 8 7 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 JAN GAY 2.0 X X 2700 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 1200 0 0 GARY WUCKERT 2.0 X 1200 0 0 KATHY LORENZ 2.0 X 1200 0 0 KARLA HADESTY 2.0 X 1200 0 0 ROSALIE MARTINEZ 2.0 X 1200 0 0 RUSSELL JOHNSON 40.0 X 361805 0 72917 HENRY GARVIN 40.0 X 171536 0 30617 DAVID FRESHOUR 40.0 X 201246 0 34199 KATHY ROGERS 40.0 X 114753 0 17178 GWEN HELLER 40.0 X 161496 0 30754 HELEN LESTER 40.0 X 118976 0 23350 THOMAS HENTON 40.0 X 137178 0 19186 GREG MCAULIFFE MD 20.0 X 225934 0 4008 LEONARD SNOW 40.0 X 133382 0 22816 STEVEN W KITCHEN 40.0 X 588631 0 19993 GLEN A GAUNT 40.0 X 337470 0 19684 DAVID GEIGER 40.0 X 299590 0 20984 DAVID FROW 40.0 X 288551 0 19576 CLIFFORD ROBINS 40.0 X 271745 0 16544 3455793 0 351806 41 false true false DANIEL YEAGER PO BOX 635715 CINCINNATI OH 452635715 CONTRACT LABOR 529463 NUANCE COMMUNICATIONS PO BOX 2561 CAROL STREAM IL 60132 CONTRACT SERVICES 472976 CHG COMPANIES INC PO BOX 972651 DALLAS TX 753972651 DATA PROCESSING 366920 ON ASSIGNMENT STAFFING SERVICES FILE 50730 LOS ANGELES CA 900744318 CONTRACT LABOR 249278 VISTA STAFFING SOLUTIONS INC FILE 50834 LOS ANGELES CA 900740834 CONTRACT LABOR 222146 7 40000 451462 187618 10000 679080 PATIENT SERVICE REVENUE 900099 33272284 33272284 MEDICARE/MEDICAID 900099 22181522 22181522 AMBULANCE DISTRICT REVENUE 621910 343807 343807 MANAGEMENT FEES 900099 962590 962590 BAD DEBT RECOVERIES 900099 655351 655351 421604 196670 224934 57837158 438333 438333 0 0 95152 57024 38128 38128 -2915 41043 6722 126106 -119384 -119384 -119384 0 0 0 OTHER REVENUE 900099 82406 82406 DRUGS- NON PATIENT 900099 3576 3576 85982 58959297 57694630 -2915 588502 149432 149432 0 0 0 1829018 1305564 514621 8833 0 24791234 17695928 6977097 118209 976989 696372 274469 6148 2302281 1644507 646789 10985 1712433 1184661 518154 9618 0 64560 64560 98004 98004 4690 4690 0 0 3557977 1874624 1678080 5273 118839 118839 2260132 869960 1388527 1645 622204 622204 0 1406451 1036311 370140 393781 239713 151185 2883 0 5850 5850 598314 598314 0 2721509 1632905 1088604 287642 287642 MEDICAL SUPPLIES 5515641 5460458 55183 0 PROVIDER FEES 2167799 2167799 0 0 BAD DEBT 6073933 6073933 0 0 COLLECTION EXPENSE 401910 0 401910 0 UBI TAXES 1427 0 1427 0 440928 6664 432628 1636 58502978 42038831 16298917 165230 633615 421289 8762703 9307578 134888 23857 5103638 7589026 956635 996269 1278471 1101249 53458870 21774796 31971870 31684074 12098024 12523463 191667 191667 76317 133304 684146 901667 61891974 64873443 4211190 6939490 368708 93943 16430000 15940000 618469 1050011 995328 1498078 22623695 25521522 X 39191962 39218617 76317 133304 39268279 39351921 61891974 64873443 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 false false false false false false true 4690 false false 4690 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. Part I-A, Line 1 organization's direct and indirect political campaign activities Russell Johnson, CEO, sent out an email from his SLVRMC account to the employees of SLVRMC endorsing another SLVRMC employee, Kathy Rogers, for mayor. This was an unintentional political campaign activity. The IRS was made aware of the activity and contacted SLVRMC for response. SLVRMC has responded to the IRS' inquiry and has taken steps to ensure that an incident like this never happens again. 76317 56987 133304 117490 41173 76317 0.00000 0.00000 1.00000 false true true 3152829 3152829 31123151 10664319 20458832 5165 3811 1354 16464003 10900675 5563328 2713722 205991 2507731 31684074 0 ASSET RETIREMENT OBLIGATION 244004 INTEREST RATE SWAP AGREEMENT 1254074 1498078 58959297 58502978 456319 73086 -445763 -372677 83642 58762753 73086 233395 306481 58456272 503025 503025 58959297 58679111 176408 176408 58502703 275 275 58502978 Schedule D, Part XI, Line 8 Other changes to Net Assets Change in Fair Market Value of Interest Rate Swap (486,526) Change in Fair Market Value of Investment in Foundation 56,987 ARO Accretion (16,224) Total Other Changes to Net Assets (445,763) Schedule D, Part XII, Line 2d Other Revenue on Books not on return Change in Fair Market Value of Investment in Foundation 56,987 Loss on sale of assets reclassed from expense to income 119,384 Rental Expenses reclassed to income 57,024 Total Other revenue on books not on return 233,395 Schedule D, Part XII, Line 4b Other Revenue on return not on books Change in Fair Market Value of Interest Rate Swap 486,526 ARO Accretion 16,224 Grant Revenue reclassed from expense to revenue 275 Total Other revenue on return not on books 503,025 Schedule D, Part XIII, Line 2d Other expense on books not on return Loss on sale of assets reclassed from expense to income 119,384 Rental Expenses reclassed to income 57,024 Other expense on books not on return 176,408 Schedule D, Part XIII, Line 4b Other expense on return not on books Grant Revenue reclassed from expense to revenue 275 Schedule D, Part X, Line 10 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 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. true true false true X true true false false 509439 509439 0.00970 10760869 4707647 6053222 0.11550 2135895 1889815 246080 0.00470 13406203 6597462 6808741 0.12990 19505 19505 0.00040 4072 4072 0.00010 139000 139000 0.00270 162577 162577 0.00320 13568780 6597462 6971318 0.13310 148 0.00000 1418 0.00000 8604 0.00020 1183 0.00000 11353 0.00020 true 2439700 0 10902876 5709716 5193160 X true false Lutheran Hospital Association of SLV

106 Blanca Avenue Alamosa CO 81101

X Lutheran Hospital Association of SLV

2115 Stuart St Alamosa CO 81101

Physician Clinic 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. Total bad debt expense removed from the denominator prior to the percentage calculation = 6,073,933. 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. Line 6 was computed using allowable costs as reported on the San Luis Valley Regional Medical Center's 2009 Medicare Cost Report. 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. SLVRMC has its finger on the pulse of the community through various community involvements. Through communication with providers and community non-profits, this need is addressed as required. Sample current and past programming have included free colonoscopies, breast health related testing, PSA testing, and much more. SLVRMC provides a Patient Financial Counselor who identifies resources and eligibility assessment for programs through Federal and State government programs, as well as grant funded programs. 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. SLVRMC serves 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 make 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% of our payer mix comes from uninsured, Medicaid/Medicare patients, CICP or self-pay. SLVRMC provides resources and staff Healthcare Coalitions, Emergency Preparedness, All Hazard Committee, Trauma Meetings, Street Lights for Ambulance & HUD meeting. SLVRMC is very active in the community when it comes to providing resources, information, and donations to promote healthy living in schools, businesses, and the general population. During specific health concern periods, SLVRMC provides resources at many levels to help inform and protect the community. Alamosa had a salmonella outbreak and SLVRMC staff was active in providing resources and help to the entire community. During flu outbreaks we provide necessary information through ads and articles to assure community awareness to assist in limiting exposure. 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 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. N/A true TRINIDAD STATE JUNIOR COLLEGE 1011 MAIN ST ALAMOSA CO 81101 840644739 GOVERNMENT 60000 EDUCATION ADAMS STATE COLLEGE 208 EDGEMONT BLVD ALAMOSA CO 81102 846000542 GOVERNMENT 60000 EDUCATION CROSSROADS TURNING POINTS INC 4 MONTEBELLO RD PUEBLO CO 81001 840810723 501(c)(3) 12000 COMMUNITY SUPPORT ADAMS STATE COLLEGE FOUNDATION 208 EDGEMONT BLVD ALAMOSA CO 81102 846027518 501(c)(3) 7000 SUPPORT OF COLLEGE 4 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 253706 0 69458 0 38642 0 62934 0 9983 0 434722 0 0 0 HENRY GARVIN 151874 0 16254 0 3408 0 26768 0 3849 0 202153 0 0 0 DAVID FRESHOUR 163588 0 16830 0 20828 0 29491 0 4708 0 235445 0 0 0 GWEN HELLER 136976 0 14851 0 9669 0 24648 0 6106 0 192250 0 0 0 THOMAS HENTON 124209 0 12006 0 963 0 15165 0 4021 0 156364 0 0 0 GREG MCAULIFFE MD 223558 0 0 0 2376 0 0 0 4008 0 229942 0 0 0 STEVEN W KITCHEN 587083 0 0 0 1548 0 14700 0 5293 0 608624 0 0 0 GLEN A GAUNT 336642 0 0 0 828 0 14700 0 4984 0 357154 0 0 0 DAVID GEIGER 298762 0 0 0 828 0 14700 0 6284 0 320574 0 0 0 DAVID FROW 287003 0 0 0 1548 0 14700 0 4876 0 308127 0 0 0 CLIFFORD ROBINS 271205 0 0 0 540 0 14483 0 2061 0 288289 0 0 0 LEONARD SNOW 102633 0 13200 0 17549 0 12466 0 10350 0 156198 0 0 0 NON-FIXED PAYMENTS FOR OFFICERS OR DIRECTORS PART 1 QUESTION 7 OFFICER BONUSES ARE DEPENDENT ON MEETING BUDGETED PROJECTIONS. SEVERANCE PAYMENTS PART I, LINE 4A David Freshour, CFO, left at the end of May 2010. His severance package included 6 months of wages payable in the amount of $6,663.20 every two weeks, health benefits, and participation in the year end bonus. By the end of the fiscal year, only 2 of the 13 severance payments had been made. ALAMOSA COUNTY STATE OF COLORADO 846000733 011583AA9 2005-02-17 11355000 HOSPITAL IMPROVEMENTS false false ALAMOSA COUNTY STATE OF COLORADO 846000733 011583AB7 2007-04-26 6505000 PURCHASE 2115 STUART & IMPROVEMENT false false 11355000 148816 362859 10992141 2005 false false true true 6505000 29946 211952 6293048 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 true false true true MORGAN STANLEY CAP 20.28 false false false false true true MORGAN STANLEY CAP 15. false false false Part VI, Question 11A 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 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 Grant from SLVRMC Foundation The SLVMRC Foundation, a related organization, recorded total grants to the medical center of 47,383. However, the Medical Center has only recorded grants received from the foundation of 40,000. This discrepancy is related to in-kind grants from SLVRMC Foundation which are immaterial to the Medical Center and never recorded. 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. 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. Part VI, Question 12 Monitoring of 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. Schedule K, Part II, Line 5 Issuance Costs From Proceeds A portion of the issuance costs for the Series 2005 bonds was used for credit enhancement. Of the total $362,859 issuance costs, $135,759 were used for credit enhancement and $227,100 were used for other issuance costs. A portion of the issuance costs for the Series 2007 bonds was used for credit enhancement. Of the total $211,952 issuance costs, $81,852 were used for credit enhancement and $130,100 were used for other issuance costs. 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 false false true true false false false false false false true false false true false true false false CONEJOS COUNTY HOSPITAL CORPORATION D 709887 CONEJOS COUNTY HOSPITAL CORPORATION K 962590 CONEJOS COUNTY HOSPITAL CORPORATION N 285513 CONEJOS COUNTY HOSPITAL CORPORATION P 488451