2020-06-30T19:43:55-05:00 2019-06-30 910189318 MOSS ADAMS LLP 6565 AMERICAS PARKWAY NE STE 600 ALBUQUERQUE NM 87110 990 2018-07-01 850138775 OTERO COUNTY HOSPITAL ASSOCIATION OTER 5754396100 2669 SCENIC DRIVE ALAMOGORDO NM 883110597 BASHAR NASER CHIEF FINANCIAL OFFICER 5754396100 2020-06-23 1 PAMELA ALEXANDERSON P01218925 5058787200 2020-06-23 97.33.192.46 2020-06-23 16:52:41 MD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 794856F77D80C61DE78743BDB3D2DAA753D74C24 2018 2021-01-29 14:40:06Z GERALD CHAMPION REGIONAL MEDICAL CENTER ROBERT JAMES HECKERT 2669 SCENIC DRIVE ALAMOGORDO NM 883110597 261081606 0 X WWW.GCRMC.ORG X 1947 NM PROVISION OF HEALTH CARE SERVICES 13 8 1138 140 -123544 0 274027 260016 175196342 179169526 7774058 5414706 -316874 -824023 182927553 184020225 792806 806913 0 0 63681782 69300665 0 0 0 84790426 88316491 149265014 158424069 33662539 25596156 241933471 263140688 84119138 78517833 157814333 184622855 X TO BE THE ORGANIZATION WHERE PATIENTS CHOOSE TO COME, PHYSICIANS WANT TO PRACTICE, AND PEOPLE WANT TO WORK. 0 0 114065901 806913 179060405 OTERO COUNTY HOSPITAL ASSOCIATION, D/B/A GERALD CHAMPION REGIONAL MEDICAL CENTER (GCRMC), PROVIDES COMPREHENSIVE HEALTH-CARE SERVICES THROUGH ITS 100-BED HOSPITAL, OUTPATIENT AMBULATORY CARE FACILITIES, AND A MULTI-SPECIALTY PHYSICIAN GROUP. GCRMC RECEIVES 80% OF ITS ADMISSIONS FROM OTERO COUNTY. THE GCRMC'S PRIMARY MARKETS ARE THE CITIES OF ALAMOGORDO AND TULAROSA WITH SECONDARY MARKETS EXPANDING TO MORE REMOTE AREAS OF OTERO COUNTY, LINCOLN COUNTY, CHAVEZ COUNTY, AND BEYOND. THE ORIGINAL FACILITY OPENED IN AUGUST 1949, AND THE CURRENT MEDICAL CENTER IS A STATE-OF-THE-ART ACUTE CARE FACILITY THAT OPENED IN DECEMBER 1999.THE ORIGINAL HOSPITAL OPENED IN 1949 WITH 26 BEDS. TODAY, GCRMC IS PROUD TO BE A 100-BED ACUTE CARE FACILITY ACCREDITED BY DNV, INCLUDING TWO DISTINCT PPS UNITS: LIFE TRANSITIONS (AKA BEHAVIORAL MEDICINE - TOTAL 36 BEDS) AND INPATIENT REHABILITATION (12 BEDS). GCRMC SHARES A UNIQUE RELATIONSHIP WITH HOLLOMAN AIR FORCE BASE AS THE FIRST HOSPITAL IN THE UNITED STATES WHERE ACTIVE-DUTY MILITARY PHYSICIANS PRACTICE IN A CIVILIAN HOSPITAL. THIS SPECIAL ARRANGEMENT ALLOWS ONE FACILITY TO MEET THE COMBINED COMMUNITY AND MILITARY NEEDS, WHILE SERVING AS A MODEL FOR THE DEPARTMENT OF DEFENSE IN CONSERVING RESOURCES.THE DELIVERY MECHANISMS OF CARE AT THE HOSPITAL INCLUDE BOTH INPATIENT AND OUTPATIENT SERVICES; ACUTE CARE INPATIENT THROUGH MEDICAL/SURGICAL, TELEMETRY, MATERNAL CHILD AND 10-BED INTENSIVE CARE UNITS; SURGERY DEPARTMENT SUPPORTED BY PRE-ADMIT, OUTPATIENT CARE UNIT AND POST-ANESTHESIA CARE UNIT; OUTPATIENT SURGERY CENTER; PROVIDER-BASED PHYSICIAN PRACTICES IN THE AREAS OF FAMILY PRACTICE, WOMEN'S SERVICES INCLUDING OBSTETRICS, MEDICAL AND RADIATION ONCOLOGY, MEDICAL CARDIOLOGY, GASTROENTEROLOGY AND ENDOCRINOLOGY, INTERNAL MEDICINE, ORTHOPEDICS AND GENERAL SURGERY; INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES; CARDIAC CATH LAB; INPATIENT REHABILITATION SERVICES, INCLUDING PHYSICAL AND OCCUPATIONAL REHAB SERVICES; INPATIENT AND OUTPATIENT CAP-CERTIFIED LABORATORY SERVICES WITH THE CAPABILITY TO PERFORM OVER 225 DIFFERENT PROFILES AND TESTS IN-HOUSE; INPATIENT AND OUTPATIENT DIAGNOSTIC IMAGING SERVICES, INCLUDING X-RAY, 64-SLICE CT AND PET SCAN, MRI, ULTRASOUND, INTERVENTIONAL RADIOLOGY, RADIOFREQUENCY ABLATION AND NUCLEAR MEDICINE; INPATIENT AND OUTPATIENT COMPREHENSIVE CARDIOPULMONARY SERVICES, INCLUDING BEHAVIOR SLEEP MEDICINE, HOLTER MONITORING, EVENT MONITORING, AND IMPEDANCE CARDIOGRAPHY. BY THE END OF 2019, GCRMC EMPLOYED APPROXIMATELY 930 PEOPLE. IN ADDITION TO THOSE EMPLOYEES, GCRMC CONTRACTS FOR SERVICES IN VARIOUS DEPARTMENTS SUCH AS PHARMACY, ANESTHESIA, EMERGENCY DEPARTMENT, AND HOSPITALIST PROVIDERS. THE MEDICAL STAFF OF GCRMC HAS 269 MEDICAL STAFF, CONSISTING OF 94 ACTIVE MEMBERS, OF WHOM 59 ARE EMPLOYED PROVIDERS.GCRMC CONTINUES TO SEEK OPPORTUNITIES TO EXPAND SERVICES AND IMPROVE QUALITY, WITH THE PHILOSOPHY OF NOT LIMITING ITS POTENTIAL BY THE DESIGNATION OF "RURAL HOSPITAL," BUT RATHER IDENTIFYING ITS SCOPE OF SERVICE BASED ON COMMUNITY NEEDS AS A REGIONAL MEDICAL CENTER. CONTINUED PROGRESS AND EXPANSION HAS ENHANCED GCRMC'S COMMITMENT TO STRIVE FOR OUTSTANDING SERVICE AND QUALITY, ACKNOWLEDGING THAT ITS FUTURE IS NOT IN ITS BUILDING OR TECHNOLOGY, BUT RATHER ITS PEOPLE. TO THIS END, WE SUPPORT THE PEOPLE OF OTERO COUNTY AND OUTLYING SERVICE AREAS WITH OUR EXPANDED SERVICES AND OUR FINANCIAL CONTRIBUTIONS. GCRMC HAS, SINCE ITS INCEPTION IN 1949, PROVIDED QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATIONS AND STABILITY OF GCRMC, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND, FURTHER, THAT OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTH-CARE SERVICES AND HEALTH-CARE EDUCATION. THEREFORE, IN KEEPING WITH GCRMC'S COMMITMENT TO SERVE OUR COMMUNITY, WE PROVIDE: FREE CARE AND/OR SUBSIDIZED CARE - CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST; AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S ABILITY TO PAY COEXIST. MANAGEMENT EXPANDED THE FINANCIAL ASSISTANCE PROGRAM FROM 200% TO 300% OF FPL EFFECTIVE JULY 1, 2015. GCRMC MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. 114065901 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 1 1 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 100 0 1 1138 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 8 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 1 1 NM X X BASHAR NASER 5754437848 2669 SCENIC DRIVE ALAMOGORDO NM 883110597 NORM ARNOLD CHAIRMAN 10.00 0.10 X X 24000 0 0 BILL MERSHON VICE PRESIDENT 5.00 0.10 X X 0 0 0 BILL MAYTON SECRETARY 5.00 0.10 X X 0 0 0 GREG RICHARDSON MD DIRECTOR/PHYSICIAN 40.00 X 341497 0 48199 ANDREW LANCASTER MD DIRECTOR/PHYSICIAN 40.00 X 256698 0 30604 POLLY HICKMAN DIRECTOR 40.00 X 125552 0 25603 FRED BAKER DIRECTOR (THROUGH 11/18/18) 5.00 X 0 0 0 ROBIN FRENCH DIRECTOR 3.00 X 0 0 0 BART GARRISON DIRECTOR 3.00 X 0 0 0 GARY JACKSON DIRECTOR 3.00 X 0 0 0 KATHY FULLER DIRECTOR 3.00 X 0 0 0 ROBERT MARTINEZ DIRECTOR 3.00 X 0 0 0 REX WILLSON DIRECTOR 3.00 X 0 0 0 JULIE GRINDER DIRECTOR 3.00 X 0 0 0 BASHAR NASER CFO 40.00 X 612549 0 30921 WILLIAM POLLARD CMO 40.00 X 496002 0 29699 ROBERT JAMES HECKERT CEO 40.00 X 414307 0 28209 ROBERT MIDDLETON VP OF PHYSICIAN CARE/CNO 40.00 X 243112 0 30205 PETER SEAMAN VP OF FINANCE 40.00 X 227324 0 40163 ALBERT ESPARSEN VP OF PHYSICIAN PRACTICE 40.00 X 192745 0 21105 CHARLES RACE PHYSICIAN 40.00 X 917900 0 48199 FERIAL ABOOD PHYSICIAN 40.00 X 798115 0 36330 CHRIS DAVIS PHYSICIAN 40.00 X 721466 0 22898 KATRINA ROLEN PHYSICIAN 40.00 X 560202 0 23761 GURDIAL DHILLON PHYSICIAN 40.00 X 513253 0 17830 6444722 0 433726 85 0 1 0 EMCARE INC 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 INPATIENT MD, EMERGENCY & ANESTHESIA STA 2780498 COMPLETERX LTD 3100 SOUTH GESSNER SUITE 640 HOUSTON TX 77063 PHARMACY MANAGEMENT SERVICES 1953251 SOUTHWEST HEART PC 2525 S TELESHOR BLVD STE 102 LAS CRUCES NM 88011 MANAGEMENT CONSULTING 1372430 COMPHEALTH ASSOCIATES INC PO BOX 972651 DALLAS TX 75397 CONTRACT MEDICAL STAFF 955378 DIAMOND HEALTHCARE CORP PO BOX 85050 RICHMOND VA 23285 BEHAVIORAL HEALTH MANAGEMENT 892327 16 20174 103884 135958 260016 NET PATIENT SERVICE REVENUE 621110 172088164 172088164 340B PHARMACY REVENUE 446110 3990730 3990730 CAFETERIA/CATERING 722320 889218 838560 50658 OTHER PROGRAM REVENUE 900099 858146 858146 CARDIAC CATH LAB LLC 621400 785862 785862 557406 498943 58463 179169526 2871285 2871285 1070780 1896757 -825977 -825977 -232665 -593312 77270523 420276 74735960 411418 2534563 8858 2543421 2543421 19200 20174 17246 1954 1954 184020225 179060405 -123544 4823348 X 666820 666820 18916 18916 121177 121177 3488426 1051312 2437114 95295 95295 54445450 37816238 16629212 1321606 947032 374574 6141465 2665807 3475658 3808423 1058414 2750009 669593 669593 259714 259714 5123 5123 231021 231021 42497715 35898744 6598971 446408 446408 3868056 2198194 1669862 785933 173935 611998 2099249 552940 1546309 229306 74428 154878 427941 177267 250674 3302324 3302324 10233736 10233736 3586689 324040 3262649 MEDICAL SUPPLIES/DRUGS 16528275 16528275 DIETARY SUPPLIES 1260151 1260151 REPAIRS 824983 824983 GROSS RECEIPTS TAXES 411464 411464 648810 161007 487803 158424069 114065901 44358168 0 10103956 4952151 5513718 5911923 21226046 22024187 5944917 5916629 3600014 3698462 224359761 139815930 85567321 84543831 104558975 120000980 3871574 4368672 749179 745147 797771 10978706 241933471 263140688 16329594 14962637 718682 536726 64447361 63018470 2623501 0 84119138 78517833 X 157814333 184622855 157814333 184622855 241933471 263140688 25596156 1212366 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 5123 0 0 5123 0 PART II-B, LINE 1: THE ORGANIZATION'S CEO AND VICE PRESIDENT OF FINANCE ATTENDED A 340(B) CONFERENCE IN WASHINGTON AND AMERICAN HOSPITAL ASSOCIATION/NEW MEXICO HOSPITAL ASSOCIATION MEETINGS, IN WHICH DISCUSSIONS ON LEGISLATION WERE HELD WITH LEGISLATORS. 3580825 3580825 117768949 63172854 54596095 94160774 73119880 21040894 8849213 3523196 5326017 84543831 X PART X, LINE 2: THE MEDICAL CENTER IS ORGANIZED AS A NEW MEXICO NONPROFIT CORPORATION AND HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). THE MEDICAL CENTER IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE MEDICAL CENTER IS SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. THE MEDICAL CENTER FILES AN EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN (FORM 990-T) WITH THE IRS TO REPORT ITS UNRELATED BUSINESS TAXABLE INCOME. THE ASV AND GCSP CATH LAB ARE LIMITED LIABILITY COMPANIES FOR WHICH THE INCOME IS TAXED TO THE RESPECTIVE MEMBERS IN THEIR TAX RETURNS. THE MEDICAL CENTER BELIEVES IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS, AND, AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE MEDICAL CENTER WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE, IF SUCH INTEREST AND PENALTIES ARE INCURRED. THE MEDICAL CENTER'S FEDERAL FORM 990-T FILINGS ARE NO LONGER SUBJECT TO FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2015. 0 NORTH AMERICA (CANADA AND MEXICO 0 0 DONATION OF MEDICAL SUPPLIES 121177 0 0 0 0 0 0 121177 0 121177 NORTH AMERICA (CANADA AND MEXICO MEDICAL ASSISTANCE N/A 121177 DONATED MEDICAL SUPPLIES BOOK VALUE 0 1 0 0 0 0 0 0 GOLF CENTER FUNDRAISER 28750 9550 19200 927 16000 319 PERSONALITIES FUNDRAISER 10624 10624 39374 20174 19200 927 16000 319 17246 1954 1 1 1 X 300.000000000000 1 X 1 1 0 1 1 502931 36242 466689 0.00290 33122874 19735168 13387706 0.08450 33625805 19771410 13854395 0.08740 216234 216234 0.00140 56561762 16102444 40459318 0.25540 420004 420004 0.00270 57198000 16102444 41095556 0.25950 90823805 35873854 54949951 0.34690 5700 0 5700 0.00000 201189 0 201189 0.00130 819136 0 819136 0.00520 1026025 1026025 0.00650 0 7322633 2289000 41334104 44545686 -3211582 X 1 1 1 ALAMOGORDO SURGERY VENTURES OUTPATIENT SURGERY CENTER 0.45500 0.08000 0.46500 2 ALAMOGORDO IMAGING CENTER OUTPATIENT RADIOLOGY CENTER 0.29790 0.00000 0.70210 3 WHITE SANDS HEALTHCARE SYSTEMS LLC PHYSICIAN HOSPITAL ORGANIZATION 0.50000 0.00000 0.50000 1 1 GERALD CHAMPION REGIONAL MEDICAL CENTER 2669 SCENIC DR ALAMOGORDO NM 88311 WWW.GCRMC.ORG 6016 X X X 28 PROVIDER CLINICS GERALD CHAMPION REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X X 18 1 0 1 1 X HTTPS://WWW.GCRMC.ORG/ X 1 18 1 SEE SUPPLEMENTAL INFORMATION 0 1 X 300.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X HTTP://WWW.GCRMC.ORG X HTTP://WWW.GCRMC.ORG X HTTP://WWW.GCRMC.ORG X X X X X X 1 X 0 X X X X 1 X 0 0 GERALD CHAMPION REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 3J: CHARTS RELATED TO AGE, GENDER, GENERAL LIFESTYLES, HEALTH-CARE METRICS GERALD CHAMPION REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: THE MEDICAL CENTER CONDUCTED FOCUS GROUPS AND INDIVIDUAL INTERVIEWS. THE MEDICAL CENTER SOLICITED INPUT FROM MORE THAN 20 REPRESENTATIVES FROM THE COMMUNITY, INCLUDING EDUCATORS, LOCAL GOVERNMENT OFFICIALS, LOCAL HEALTH OFFICIALS, FINANCIAL ADVISORS, CHAPLAINS, NURSES, AND MILITARY PERSONNEL. GERALD CHAMPION REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6B: OTERO COUNTY COMMUNITY HEALTH COUNCILPRESBYTERIAN MEDICAL SERVICESALAMOGORDO PUBLIC SCHOOLSDEPARTMENT OF PUBLIC SAFETYALAMOGORDO CHAMBER OF COMMERCECOPE OUTREACHALAMOGORDO SENIOR CENTERTHE COUNSELING CENTER GERALD CHAMPION REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: THE HOSPITAL'S WRITTEN IMPLEMENTATION STRATEGY IS INCLUDED IN THE FACILITY'S CHNA DOCUMENT. THIS DOCUMENT WAS REVIEWED BY THE HOSPITAL'S CPA AUDITORS AND BUSINESS ADVISORS. BASED ON THE RESULTS OF THIS REVIEW, ALL SIGNIFICANT NEEDS ARE BEING ADDRESSED IN THE ASSESSMENT. THE NEEDS IDENTIFIED INCLUDE: ACCESS TO PRIMARY CARE, INSURANCE-AFFORDABILITY, OBESITY, DIABETES, CANCER, MENTAL HEALTH CARE, HEART DISEASE, AND HEALTH EDUCATION. THE STRATEGY TO RESOLVE THESE ISSUES INCLUDES EXPANDED HOSPITAL RESOURCES, SUCH AS ESTABLISHMENT OF A CARDIAC REHABILITATION PROGRAM, AND COLLABORATION BETWEEN THE HOSPITAL AND OTHER FACILITIES TO ADDRESS THE NEEDS. FOR EXAMPLE, LENDING SUPPORT TO THE AREA MENTAL HEALTH COUNSELING CENTER TO RECRUIT QUALIFIED, LICENSED MENTAL HEALTH PROFESSIONALS. PART V, SECTION B, LINE 10A: HTTPS://WWW.GCRMC.ORG/WP-CONTENT/UPLOADS/2018/10/10.15.18-CHNA-IMPLEMENTATION-REPORT-FINAL-GERALD-CHAMPION.PDF PART V, LINE 14 CHARGE CALCULATIONS ARE BASED ON A VARIETY OF FACTORS, INCLUDING THE COST OF SUPPLIES, LABOR AND OVERHEAD NEEDED TO PROVIDE THE SERVICE. OTHER FACTORS INCLUDE THE MEDICARE ALLOWABLE FEE SCHEDULE, AND COMPARISON OF THE ORGANIZATION WITH THE IMMEDIATE COMPETITION'S CHARGEMASTERS. CHARGE PRICES ARE REVIEWED BY THE ORGANIZATION ON AN ANNUAL BASIS. 3 1 - ASV DBA SCENIC VIEW OUTPATIENT SURGERY C 2351 25TH STREET ALAMOGORDO NM 88311 OUTPATIENT SURGERY 2 - ALAMOGORDO IMAGING CENTER 2539 MEDICAL DR STE 1010 ALAMOGORDO NM 88310 OUTPATIENT RADIOLOGY 3 - GERALD CHAMPION-SIERRA PROVIDENCE CARDIA 2669 SCENIC DRIVE ALAMOGORDO NM 88310 CARDIAC CATH LAB PART I, LINE 3C: THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES WHEN DETERMINING FREE CARE. PATIENTS WHO HAVE HOUSEHOLD INCOME AT OR BELOW 300% OF THE FPG ARE ELIGIBLE TO RECEIVE FREE CARE. THE ORGANIZATION OFFERS AN AUTOMATIC 25% DISCOUNT TO SELF-PAY PATIENTS AND WILL OFFER AN ADDITIONAL 10% DISCOUNT TO SELF-PAY PATIENTS WHO PAY THE BALANCE OF THEIR BILL WITHIN 30 DAYS OF THE BILLING DATE. IN ADDITION, THE FACILITY WILL WORK WITH PATIENTS ON SETTLEMENTS ON A CASE-BY-CASE BASIS BASED ON SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF GCRMC. DETERMINING FAMILY NEED IS ALSO BASED ON AN APPLICATION PROCESS WHICH TAKES INTO ACCOUNT THE PATIENT'S AVAILABLE ASSETS AND ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT. PART I, LINE 7: THE HOSPITAL'S COSTING METHODOLOGY IS BASED ON COST TO CHARGE RATIOS IN THE MEDICARE COST REPORT. IT CURRENT DOES NOT USE A COST ACCOUNTING SYSTEM. PART I, LINE 7G: AMOUNTS REPORTED ARE BASED ON THE MEDICARE COST REPORT FIGURES. LINE 7G INCLUDES $38,451,065 OF COSTS ATTRIBUTABLE TO PHYSICIANS' CLINICS. PART II, LINE 2 THE ORGANIZATION SUPPORTS THE CHAMBER OF COMMERCE AND ITS ECONOMIC DEVELOPMENT COUNCIL THAT WORKS TO FACILITATE THE CREATION AND PROMOTION OF NEW INDUSTRIES, AND ASSISTS IN THE RETENTION AND EXPANSION OF EXISTING BUSINESSES IN THE HOSPITAL'S SERVICE AREA. PART II, LINE 3 THE ORGANIZATION OFFERS ECONOMIC SUPPORT TO VARIOUS ORGANIZATIONS THAT: PROVIDE ASSISTANCE TO INDIVIDUALS IN NEED OF BASIC MEDICAL OR OTHER ASSISTANCE, FOR RESEARCH IN HEALTH-RELATED CONDITIONS, AND TO PROMOTE CULTURAL ACTIVITIES AND EVENTS FOR THE BENEFIT OF THE COMMUNITY. PART II, LINE 8 THE ORGANIZATION RELIES ON WORKFORCE DEVELOPMENT, I.E. RECRUITMENT OF DOCTORS TO MEET THE NEED FOR MAINTAINING ADEQUATE MEDICAL STAFF. THE HOSPITAL'S SERVICE AREA FACES A CRITICAL SHORTAGE OF PRIMARY CARE PHYSICIANS. OTERO COUNTY IS DESIGNATED BY THE US CENSUS BUREAU AS A MEDICALLY UNDERSERVED AREA. RECENT DATA SUGGESTS THAT THERE WILL BE A SHORTAGE OF 40 PRIMARY CARE PHYSICIANS NEEDED TO SERVE THE HEALTHCARE NEEDS OF THE TOTAL SERVICE AREA BY 2023. THERE ARE A NUMBER OF FACTORS THAT HAVE CREATED THIS SHORTAGE. THESE INCLUDE THE AGING POPULATION OF PROVIDERS IN OUR MARKET. THE AVERAGE AGE OF THE ORGANIZATION'S PHYSICIAN STAFF IS NOW OVER 60 YEARS OF AGE. NEW MEXICO HAS THE HIGHEST PERCENTAGE IN THE COUNTRY OF PHYSICIANS APPROACHING RETIREMENT AGE. IN ADDITION, NEW MEXICO'S GEOGRAPHICALLY SPARSE, AGING AND RACIALLY DIVERSE POPULATION PUTS PRESSURE ON ITS HEALTH CARE SYSTEMS. EXCESS MORTALITY FROM ALL CAUSES IN NON-METROPOLITAN AREAS CONTINUES TO RISE. THE ORGANIZATION STRIVES TO INCREASE ACCESS TO COMPREHENSIVE QUALITY HEALTH CARE SERVICES; TO PROMOTE HEALTH, PREVENT AND MANAGE DISEASES, AND REDUCE DISABILITY AND PREMATURE DEATH BY ELIMINATING THE INADEQUATE SUPPLY AND UNEVEN DISTRIBUTION OF PRIMARY CARE AND SPECIALTY PROVIDERS THROUGH CONTINUED WORKFORCE DEVELOPMENT. PART III, LINE 2: DISCOUNTS AND PAYMENTS ARE TAKEN INTO CONSIDERATION WHEN DETERMINING BAD DEBT. PAYMENTS APPLIED TO PATIENT ACCOUNTS OFFSET ACCOUNTS RECEIVABLE AND ARE ELIMINATED FROM THE CALCULATION OF BAD DEBT, WHICH IS DETERMINED BASED ON AGING OF ACCOUNTS RECEIVABLE AFTER PATIENT DISCHARGE.IN CERTAIN CIRCUMSTANCES, GCRMC WILL NEGOTIATE PAYMENT TERMS FOR PATIENTS WHOSE FAMILY INCOME EXCEEDS THE INCOME GUIDELINES OF THE FINANCIAL ASSISTANCE AND UNINSURED POLICY. THIS IS APPLICABLE TO PATIENTS WITH CATASTROPHIC ILLNESSES OR UNUSUAL CIRCUMSTANCES. SUCH DETERMINATIONS ARE MADE BY THE PATIENT FINANCIAL SERVICES DEPARTMENT WORKING WITH GCRMC MANAGEMENT. SEE ALSO THE DISCLOSURE IN THE AUDITED FINANCIAL STATEMENTS REGARDING BAD DEBT.PATIENTS WHOSE FAMILY INCOME IS AT OR BELOW 300% OF THE FPL ARE ELIGIBLE TO RECEIVE FREE CARE. PART III, LINE 3: THE ORGANIZATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. PATIENT CHARGES FOR SERVICES PROVIDED UNDER THE CHARITY POLICY ARE WRITTEN OFF. THE AMOUNT OF THESE SERVICES PROVIDED IN THE YEAR ENDED JUNE 30, 2019, WERE APPROXIMATELY $2,289,000.MEDICAL CARE IS GIVEN TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY, AND THEREFORE, THIS IS A COMMUNITY BENEFIT. PART III, LINE 4: FROM NOTE 1, PAGE 9 OF THE AUDITED FINANCIAL STATEMENTS:PATIENT RECEIVABLES - PATIENT RECEIVABLES ARE UNCOLLATERALIZED PATIENT AND THIRD-PARTY PAYER OBLIGATIONS. PAYMENTS OF PATIENT RECEIVABLES ARE ALLOCATED TO THE SPECIFIC CLAIMS IDENTIFIED IN THE REMITTANCE ADVICE OR, IF UNSPECIFIED, ARE APPLIED TO THE EARLIEST UNPAID CLAIM. PATIENT RECEIVABLES ARE REDUCED BY IMPLICIT AND EXPLICIT PRICE CONCESSIONS THAT REFLECTS MANAGEMENT'S ESTIMATE OF AMOUNTS THAT WILL NOT BE COLLECTED FROM PATIENTS AND THIRD-PARTY PAYERS.RECEIVABLES ARE REDUCED BY AN ESTIMATED IMPLICIT PRICE CONCESSION. IN EVALUATING THE COLLECTIBILITY OF RECEIVABLES, THE MEDICAL CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ESTIMATED IMPLICIT PRICE CONCESSION. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ESTIMATED IMPLICIT PRICE CONCESSION. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE MEDICAL CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ESTIMATED IMPLICIT PRICE CONCESSION, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE MEDICAL CENTER RECORDS A SIGNIFICANT IMPLICIT PRICE CONCESSION IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES, IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ESTIMATED IMPLICIT PRICE CONCESSION.THE MEDICAL CENTER'S ESTIMATED IMPLICIT PRICE CONCESSION IS 89% OF THE RELATED SELF-PAY RECEIVABLES AT JUNE 30, 2019, COMPARED TO 90% OF SELF-PAY RECEIVABLES AT JUNE 30, 2018. IN ADDITION, SELF-PAY IMPLICIT PRICE CONCESSIONS INCREASED $1,000,000 FROM APPROXIMATELY $7,323,000 FOR THE YEAR ENDED JUNE 30, 2018, TO $8,323,000 FOR THE YEAR ENDED JUNE 30, 2019. PART III, LINE 8: MEDICARE ALLOWABLE COST IS BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. FORM III, LINE 9B: GCRMC HAS IMPLEMENTED A NUMBER OF DIFFERENT POLICY AND PROCEDURE STATEMENTS TO GOVERN THE DETAILS OF HOW ITS COLLECTION PRACTICES ARE IMPLEMENTED AND HOW DISCOUNTING AND COLLECTION POLICIES APPLY TO VARIOUS CLASSES OF PATIENTS. IN GENERAL, ALL PATIENT ACCOUNT GUARANTORS WHO REQUEST FINANCIAL ASSISTANCE OR A PAYMENT PLAN ARE ASKED TO PROVIDE DETAILED INFORMATION REGARDING THEIR INCOME AND ASSETS.FOR PATIENTS WHO QUALIFY FOR CHARITY, GCRMC WILL NOT IMPOSE WAGE GARNISHMENTS OR LIENS ON PRIMARY RESIDENCES, WILL NOT SEND UNPAID BILLS TO COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS. PART VI, LINE 2: IN 2018, MANAGEMENT AT GCRMC ENLISTED THE SERVICES OF QUORUM HEALTH RESOURCES TO DEVELOP A COMMUNITY HEALTH NEEDS ASSESSMENT AND TO PROVIDE INFORMATION FROM SECONDARY DATA SOURCES TO ASSIST IN IDENTIFYING NEEDS THAT EXIST IN THE COMMUNITY. THIS INCLUDES DATA FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION TO EXAMINE TRENDS FOR STROKE, DIABETES, HEART DISEASE AND CANCER. IT ALSO INCLUDES DATA THAT IDENTIFY SHORTAGES IN HEALTH-CARE PROFESSIONALS BY LOCATION. THE HEALTH NEEDS IDENTIFIED AS SIGNIFICANT IN THIS ASSESSMENT INCLUDED CANCER, ACCESS TO PRIMARY CARE, DIABETES, OBESITY, AND BEHAVIORAL HEALTH. THE CONCLUSIONS REACHED IN THIS ASSESSMENT WERE IMPLEMENTED IN OCTOBER 2018. PART VI, LINE 3: THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY - GERALD CHAMPION REGIONAL MEDICAL CENTER (GCRMC) WILL PROVIDE UNDERSTANDABLE, WRITTEN GUIDELINES TO STAFF AND PATIENTS RELATIVE TO HOW THE HOSPITAL EVALUATES AND DETERMINES: 1) A PATIENT'S ELIGIBILITY FOR CHARITY CARE; 2) AN UNINSURED PATIENT'S ELIGIBILITY FOR DISCOUNTS; AND 3) A PATIENT'S ELIGIBILITY FOR ALTERNATE PAYMENT PLANS. A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN THE EMERGENCY ROOM AND THROUGHOUT THE ENTIRE HOSPITAL. THE PATIENTS ARE ALSO INFORMED THROUGH DIRECT COMMUNICATION WITH FINANCIAL COUNSELORS, AND THESE POLICIES ARE EXPLAINED IN DETAIL TO GUARANTORS WHO ADVISE GCRMC THAT THEY ARE UNABLE TO PAY THEIR ACCOUNT OR NEED HELP IN STRUCTURING AN AFFORDABLE PAYMENT PLAN FOR THEIR ACCOUNT.THE HOSPITAL PROVIDES SERVICES TO ANYONE IN NEED OF MEDICAL CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR SUCH SERVICES. CHARITY CARE AND DISCOUNTS FOR THE UNINSURED WILL BE AVAILABLE FOR MEDICALLY NECESSARY HOSPITAL CARE PROVIDED TO PERSONS WHO MEET THE FINANCIAL AND DOCUMENTATION CRITERIA DEFINED IN THIS POLICY. DETERMINATIONS HEREUNDER WILL BE BASED SOLELY ON THE PATIENT'S ABILITY TO PAY AND WILL NOT BE MADE ON THE BASIS OF AGE, SEX, RACE, CREED, DISABILITY, SEXUAL ORIENTATION OR NATIONAL ORIGIN.GCRMC PROVIDES FINANCIAL ASSISTANCE TO PATIENTS BASED ON THEIR INCOME, ASSETS, AND NEEDS. THROUGH OUR FINANCIAL COUNSELING SERVICES, WE ASSIST PATIENTS WITH MEDICAID ELIGIBILITY OR LOW-COST HEALTH INSURANCE THROUGH THE EXCHANGE (BE WELL NEW MEXICO), OR WORK WITH PATIENTS TO ARRANGE A MANAGEABLE PAYMENT PLAN.UNINSURED PATIENTS ARE ELIGIBLE FOR A 25% DISCOUNT. A 25% DISCOUNT IS APPLIED TO THE TOTAL CHARGES OF A SELF-PAY PATIENT AT THE TIME OF SERVICE OR THE FIRST BILLING. NOTICE WILL BE SENT AT THE TIME OF THE FIRST BILLING INFORMING THE PATIENT/GUARANTOR THAT AN ADDITIONAL 10% WILL BE DEDUCTED IF THE ACCOUNT IS PAID WITHIN 30 DAYS OF THE DATE OF SERVICE. PART VI, LINE 4: OTERO COUNTY HOSPITAL ASSOCIATION D/B/A GERALD CHAMPION REGIONAL MEDICAL CENTER ("GCRMC") ACTIVITIES ARE CONDUCTED ON ITS 66-ACRE CAMPUS LOCATED IN ALAMOGORDO, NEW MEXICO. ALAMOGORDO IS APPROXIMATELY 89 MILES NORTH OF EL PASO, TEXAS, AND 209 MILES SOUTHEAST OF ALBUQUERQUE, NEW MEXICO. GCRMC OWNS AND OPERATES A 100-BED CARE HOSPITAL (THE "HOSPITAL") ON THE CAMPUS. IN ADDITION TO THE MAIN CAMPUS, THE HOSPITAL HAS SATELLITE LOCATIONS INCLUDING CLINICS AND PHYSICIAN OFFICES THROUGHOUT THE CITY. THE COMBINED OPERATING SPACE OF THE MAIN CAMPUS AND THESE ADDITIONAL OFFICES TOTALS APPROXIMATELY 432,000 SQUARE FEET. OTHER FACILITIES THAT THE HOSPITAL OWNS LOCATED ON THE MAIN CAMPUS INCLUDE TWO MEDICAL OFFICE BUILDINGS, COMPLEX A AND B THAT HAVE AN OUTPATIENT SURGERY CENTER AND AN IMAGING CENTER OWNED AND OPERATED BY LIMITED LIABILITY COMPANIES IN WHICH GCRMC HAS AN INTEREST. GCRMC ALSO OWNS SIX FACILITIES LOCATED OFF THE MAIN CAMPUS THAT ARE EITHER LEASED TO INDEPENDENT PRIMARY CARE/SPECIALTY CARE PROVIDERS OR OCCUPIED BY EMPLOYED PHYSICIANS. GCRMC'S PRIMARY SERVICE AREA IS NORTHWESTERN OTERO COUNTY FROM WHICH 84% OF ITS ADMISSIONS ORIGINATE. GCRMC IS THE SOLE COMMUNITY PROVIDER IN ITS PRIMARY SERVICE AREA WITH THE NEAREST TERTIARY CARE HOSPITAL LOCATED APPROXIMATELY 70 MILES FROM THE HOSPITAL. THE DELIVERY MECHANISMS OF CARE AT THE HOSPITAL INCLUDE BOTH INPATIENT AND OUTPATIENT SERVICES: 24-HOUR STAFFED LEVEL III TRAUMA EMERGENCY DEPARTMENT; ACUTE CARE INPATIENT THROUGH MEDICAL/SURGICAL, INTENSIVE CARE, TELEMETRY, MATERNAL CHILD, 36-BED BEHAVIORAL MEDICINE, AND 12-BED INPATIENT REHABILITATION; SURGERY DEPARTMENT SUPPORTED BY PRE-ADMIT, OUTPATIENT CARE UNIT AND POST-ANESTHESIA CARE UNIT; HOSPITAL-OWNED PHYSICIAN PRACTICES IN THE AREAS OF FAMILY PRACTICE, WOMEN'S SERVICES INCLUDING OBSTETRICS, ORTHOPEDICS, NEPHROLOGY, INTERNAL MEDICINE, OUTPATIENT BEHAVIORAL MEDICINE, PEDIATRICS, GASTROENTEROLOGY AND ENDOCRINOLOGY; PATHOLOGIST; CAP CERTIFIED LABORATORY SERVICES WITH THE CAPABILITY TO PERFORM OVER 225 DIFFERENT PROFILES AND TESTS IN-HOUSE; INPATIENT AND OUTPATIENT DIAGNOSTIC IMAGING SERVICES, INCLUDING X-RAY, 64-SLICE/CT AND PET/CT WITH 20 SLICE CT SCAN, MRI, ULTRASOUND, INTERVENTIONAL RADIOLOGY, RADIOFREQUENCY ABLATION AND NUCLEAR MEDICINE; INPATIENT AND OUTPATIENT COMPREHENSIVE CARDIOPULMONARY SERVICES INCLUDING BEHAVIOR SLEEP MEDICINE, HOLTER MONITORING, EVENT MONITORING AND IMPEDANCE CARDIOGRAPHY. GCRMC AND THE HOLLOMAN AIR FORCE BASE (HAFB) 49TH MEDICAL GROUP, A GROUP OF APPROXIMATELY 15 MILITARY PROVIDERS AND SUPPORT STAFF FROM THE HAFB, HAVE ENJOYED A CLOSE WORKING RELATIONSHIP, AND HAVE HAD SHARED COVERAGE ARRANGEMENTS. SUCH ARRANGEMENTS INCLUDED LABORATORY AND X-RAY SERVICES IN A DISASTER, OBSTETRICAL COVERAGE, AND COVERAGE FOR THE HAFB 49TH MEDICAL GROUP WHEN THEY WERE DEPLOYED FOR DESERT STORM IN 1991. FOLLOWING DESERT STORM AND THE RETURN OF THE HAFB 49TH MEDICAL GROUP, THE DEPARTMENT OF DEFENSE MADE THE DECISION TO LEAVE ALL THE OBSTETRICAL SERVICES WITH GCRMC AND THE LOCAL OBSTETRICIANS. AS OF 2017, HOLLOMAN SUPPORTS ABOUT 21,000 ACTIVE DUTY, GUARD, RESERVE, RETIREES, DEPARTMENT OF DEFENSE CIVILIANS AND THEIR FAMILY MEMBERS. GCRMC'S PRIMARY SERVICE AREA (THE "PSA") IS IN NORTHWESTERN OTERO COUNTY, FROM WHICH MOST OF GCRMC'S ADMISSIONS ORIGINATE. LOCATED IN SOUTHEASTERN NEW MEXICO, OTERO COUNTY ENCOMPASSES 6,627 SQUARE MILES AND INCLUDES THE CITIES OF ALAMOGORDO AND TULAROSA. ACCORDING TO THE U.S. CENSUS BUREAU, THE POPULATION OF OTERO COUNTY IN 2017 WAS 65,130. THE HOSPITAL IS THE ONLY ACUTE CARE HOSPITAL WITHIN THE PSA AND IS A SOLE COMMUNITY PROVIDER. THE ACUTE CARE HOSPITALS THAT GCRMC CONSIDERS ITS MAIN COMPETITORS THAT DRAW FROM THE PSA ARE MOUNTAIN VIEW REGIONAL MEDICAL CENTER AND MEMORIAL MEDICAL CENTER, BOTH LOCATED APPROXIMATELY 75 MILES WEST OF ALAMOGORDO IN LAS CRUCES, NEW MEXICO. MANAGEMENT OF GCRMC ESTIMATES THAT THE MARKET SHARE OF ADMISSIONS TO THE MOUNTAIN VIEW REGIONAL MEDICAL CENTER AND MEMORIAL MEDICAL CENTER FROM THE PSA AVERAGES 10% AND 5%, RESPECTIVELY. THE SECONDARY SERVICE AREA COVERS A SUBSTANTIAL PORTION OF THE REMAINDER OF OTERO COUNTY, AS WELL AS THE SOUTH CENTRAL PORTION OF LINCOLN COUNTY. THE SECONDARY SERVICE AREA INCLUDES RUIDOSO, THE POPULATION OF WHICH WAS 8,029 IN 2010, ACCORDING TO THE U.S. CENSUS BUREAU. THE TERTIARY SERVICE AREA COVERS A SMALL PORTION OF OTERO COUNTY AND CHAVES COUNTY. THERE ARE NO OTHER MAJOR MEDICAL CENTERS WITHIN OTERO COUNTY. PART VI, LINE 5: THE BUSINESS AND AFFAIRS OF GCRMC ARE SUBJECT TO THE OVERALL GOVERNANCE AND DIRECTION OF ITS BOARD OF DIRECTORS. THE BOARD OF DIRECTORS CURRENTLY INCLUDES 13 MEMBERS. EACH MEMBER IS APPOINTED BY THE BOARD OF DIRECTORS AND SERVES A THREE-YEAR TERM IN A SELF-PERPETUATING BOARD. THE BOARD OF DIRECTORS FILLS VACANCIES THAT MAY OCCUR. OFFICERS OF THE BOARD OF DIRECTORS INCLUDE A CHAIRMAN, VICE CHAIRMAN, AND SECRETARY/TREASURER. MOST OF THE BOARD OF DIRECTORS ARE BUSINESS PEOPLE OF THE PRIMARY SERVICE AREA, WITH NO OTHER CONNECTION. TWO OF THE CURRENT BOARD MEMBERS ARE PHYSICIANS AT THE MEDICAL CENTER.GCRMC'S MEDICAL STAFF IS ORGANIZED INTO DIVISIONS OF MEDICINE, MEDICAL SUBSPECIALTIES, SURGERY AND OUTPATIENT SERVICES. IN ADDITION TO SPECIALIZED MEDICAL/SURGICAL SERVICES PROVIDED BY BOTH EMPLOYED AND CONTRACTED PHYSICIANS AND MEDICAL GROUPS, GCRMC ALSO OFFERS EMERGENCY MEDICAL SERVICES, INCLUDING A HELICOPTER SERVICE WHICH IS NOT OWNED BY GCRMC BUT IS ON-SITE 24 HOURS A DAY. GCRMC EMPLOYS AROUND-THE-CLOCK HOSPITALISTS (I.E., PHYSICIANS WHO DEVOTE THEIR PROFESSIONAL TIME TO THE CARE OF HOSPITALIZED PATIENTS). THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. SURPLUS FUNDS ARE RE-INVESTED INTO THE PURCHASE OF CAPITAL EQUIPMENT, ELECTRONIC MEDICAL RECORD SOFTWARE, CONTINUING EDUCATION FOR CLINICAL STAFF INCLUDING PHYSICIANS, AND A PROFESSIONALLY MANAGED DIVERSIFIED PORTFOLIO OF MARKETABLE SECURITIES. GCRMC VIEWS THE POSITION OF SOLE PROVIDER AS A SIGNIFICANT COMMITMENT TO THE OVERALL HEALTH AND WELL-BEING OF THE COMMUNITY. IN ADDITION TO ITS FOCUS ON PROVIDING QUALITY HEALTHCARE, THE ORGANIZATION STRIVES TO FACILITATE AND SHARE OPPORTUNITIES TO EDUCATE AND MOTIVATE A PHILOSOPHY OF WELLNESS IN THE COMMUNITY. THE PRIMARY TARGET IS THE DISEASE PROCESS THAT WE KNOW CAN BE ELIMINATED OR IMPROVED BY CHANGING OR MODIFYING HUMAN BEHAVIOR. AS WITH ANY COMMUNITY, THE POPULATION HAS A VARIETY OF EDUCATIONAL BACKGROUNDS. THE GOAL IS TO DEVELOP PROGRAMS THAT TARGET THE NEEDS AND UNDERSTANDING OF THE COMMUNITY. PHYSICIANS/PROVIDERS ARE UTILIZED TO PROVIDE OPEN FORUMS THAT PRESENT HEALTH-RELATED ISSUES, I.E. ARTHRITIS, NEPHROLOGY, NEUROLOGY, ORTHOPEDIC ISSUES, ETC., FOLLOWED BY QUESTIONS AND TIME FOR INDIVIDUAL DISCUSSION. THIS TYPE OF PROGRAM IS OFFERED WITH A FREE LUNCH, EDUCATIONAL MATERIALS, AND IF APPROPRIATE, FREE SCREENINGS, SUCH AS GLUCOSE OR BLOOD PRESSURE. THERE IS AN AVERAGE OF 90 PARTICIPANTS IN EACH OF THESE SEMINARS. THE ORGANIZATION IS VERY COMMUNITY-MINDED IN ITS EFFORTS TO PROMOTE HEALTH. STAFF PARTICIPATES IN HEALTH FAIRS IN THE PUBLIC SCHOOLS, AND HOSTS AN ANNUAL FREE SPORTS PHYSICAL CLINIC FOR SCHOOL-AGE CHILDREN. AT GCRMC, WE FEEL IT IS IMPORTANT TO EMBRACE COMMUNITY NEEDS THAT PROMOTE GOOD CITIZENSHIP. AS AN ORGANIZATION WE SUPPORT EMPLOYEE INVOLVEMENT IN OUTSIDE ACTIVITIES THROUGH CONTRIBUTIONS, DEDICATED TIME AND SPONSORSHIP. ADMINISTRATION AND STAFF MEMBERS SERVE ON COMMUNITY BOARDS, DEDICATING MANY HOURS OF SUPPORT TO THOSE ORGANIZATIONS. THE FOLLOWING CLASSES ARE PROVIDED FOR THE COMMUNITY IN OUR CONFERENCE ROOM CENTER: DIABETIC EDUCATION, NARCOTICS ANONYMOUS, CHILDBIRTH CLASSES, NEW BABY CLASS AND CPR/BASIC LIFE SUPPORT TO NAME A FEW. GCRMC HAS BEEN A TOP SUPPORTER OF THE UNITED WAY, WHICH PROVIDES MONEY FOR MANY OF THE LOCAL COMMUNITY ORGANIZATIONS. AN ANNUAL HEALTH FAIR IS HELD AT THE HOSPITAL EACH YEAR. WE AUGMENT THE ANNUAL HEALTH FAIR WITH ONSITE MINI HEALTH SCREENINGS THROUGHOUT THE YEAR. THIS IS OFFERED TO BUSINESSES, CIVIC ORGANIZATIONS AND CHURCHES WITH MINIMAL TO NO CHARGE. WE OFFER FREE BLOOD PRESSURE SCREENINGS ON A WALK-IN BASIS WITH EDUCATIONAL MATERIALS IN BOTH SPANISH AND ENGLISH. THIS ALLOWS US TO ADDRESS THE HIGH RATE OF HYPERTENSION IN OUR COMMUNITY, ITS SIGNIFICANT EFFECT ON OTHER DISEASES, AND AN OVERALL WELLNESS PICTURE. GCRMC PARTNERS WITH THE AMERICAN CANCER SOCIETY TO OFFER THE LOOK GOOD FEEL GOOD PROGRAM AND THE GIFT CLOSET. THE PROGRAM IS HOUSED OFF CAMPUS IN A LEASED BUILDING AND HAS BROUGHT A HIGHLY VALUED SERVICE TO OUR COMMUNITY. THE GIFT CLOSET PROVIDES FREE WIGS, PROSTHESES, SUPPLIES, EDUCATION AND SUPPORT TO CANCER PATIENTS AND THEIR FAMILIES. THE OPPORTUNITY TO UTILIZE OUR SPEAKER'S BUREAU IS AVAILABLE TO ANY ORGANIZATION IN THE COMMUNITY. A PRESENTATION REGARDING HEALTH-RELATED TOPICS CAN BE PREPARED WITH LIMITED NOTICE TO MEET THE NEEDS OF THE ORGANIZATION. THE WEALTH OF KNOWLEDGE IN OUR ORGANIZATION ALLOWS US TO CREATE AN APPROPRIATE FIT FOR THE REQUESTED NEED. PART VI, LINE 7, REPORTS FILED WITH STATES NM 1 ALAMOGORDO CHAMBER OF COMMERCE 1301 N WHITE SANDS ALAMOGORDO NM 88310 850109297 501(C)(6) 7856 SPONSORSHIP LEADERSHIP OTERO CLASS, ANNUAL BANQUET SPONSOR. AMERICAN CANCER SOCIETY 2120 FIRST AVE ALAMOGORDO NM 88310 841316555 501(C)(3) 12446 PUBLIC HEALTH, BUILDING RENT. OTERO COUNTY ECONOMIC DEVELOPMENT COUNCIL 2400 NSCENIC DR ALAMOGORDO NM 88310 850304073 501(C)(3) 12000 ANNUAL CONTRIBUTION. OTERO COUNTY FAIR ASSOCIATION 401 FAIRGROUNDS ROADS ALAMOGORDO NM 88310 856011829 501(C)(3) 45488 PUBLIC HEALTH. PMS ALAMOGORDO 1501 TENTH STREET ALAMOGORDO NM 88310 850206810 501(C)(3) 120000 PUBLIC HEALTH. PMS CHAPARRAL NM CLINIC 204 ANGELINA CHAPARRAL NM 88081 850206810 501(C)(3) 200004 PUBLIC HEALTH. PMS SACRAMENTO MOUNTAIN CENTER PO BOX 686 CLOUDCROFT NM 88317 850206810 501(C)(3) 100000 PUBLIC HEALTH. THRIVE PO BOX 14 ALAMOGORDO NM 88311 850197559 501(C)(3) 77555 CORPORATE MATCH, SPONSOR GOLF TOURNAMENT, CAMPAIGN HOSPITAL MATCH. 7 1 EMPLOYEE ASSISTANCE PAYMENTS 45 18916 PART I, LINE 2: THE ORGANIZATION GAVE GRANTS TO GOVERNMENT ORGANIZATIONS AND TAX-EXEMPT ORGANIZATIONS. IN ADDITION, THE ORGANIZATION BEGAN PROVIDING EMPLOYEE ASSISTANCE PAYMENTS IN THIS FISCAL YEAR; THESE PAYMENTS ARE MADE BASED ON THE POLICY ESTABLISHED FOR THE EMPLOYEE EMERGENCY ASSISTANCE FUND. 1 X X X 0 1 0 0 0 1 1 1 0 GREG RICHARDSON MD DIRECTOR/PHYSICIAN 338735 0 2000 0 762 0 28125 0 20074 0 389696 0 0 0 ANDREW LANCASTER MD DIRECTOR/PHYSICIAN 234882 0 14775 0 7041 0 9308 0 21296 0 287302 0 0 0 POLLY HICKMAN DIRECTOR 120000 0 2000 0 3552 0 4391 0 21212 0 151155 0 0 0 BASHAR NASER CFO 296311 0 315962 0 276 0 9625 0 21296 0 643470 0 0 0 WILLIAM POLLARD CMO 449006 0 46738 0 258 0 9625 0 20074 0 525701 0 0 0 ROBERT JAMES HECKERT CEO 403183 0 9600 0 1524 0 28125 0 84 0 442516 0 0 0 ROBERT MIDDLETON VP OF PHYSICIAN CARE/CNO 187706 0 49600 0 5806 0 8941 0 21264 0 273317 0 0 0 PETER SEAMAN VP OF FINANCE 173892 0 46600 0 6832 0 26890 0 13273 0 267487 0 0 0 ALBERT ESPARSEN VP OF PHYSICIAN PRACTICE 157353 0 34600 0 792 0 6969 0 14136 0 213850 0 0 0 CHARLES RACE PHYSICIAN 832186 0 68000 0 17714 0 28125 0 20074 0 966099 0 0 0 FERIAL ABOOD PHYSICIAN 355861 0 441858 0 396 0 28125 0 8205 0 834445 0 0 0 CHRIS DAVIS PHYSICIAN 576751 0 144319 0 396 0 9625 0 13273 0 744364 0 0 0 KATRINA ROLEN PHYSICIAN 480845 0 65190 0 14167 0 9625 0 14136 0 583963 0 0 0 GURDIAL DHILLON PHYSICIAN 299250 0 204976 0 9027 0 9625 0 8205 0 531083 0 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS CONTRIBUTED TO THE HOSPITAL'S 457(F) DEFERRED COMPENSATION PLAN IN FY 2019: ROBERT JAMES HECKERT - $263,205 PART I, LINE 6 THE ORGANIZATION'S OFFICERS LISTED IN PART VII, SECTION A, ARE EVALUATED ANNUALLY BASED ON A SET OF EVIDENCE-BASED GOALS THAT DETERMINE THEIR ELIGIBILITY FOR ADDITIONAL COMPENSATION. THE SELECT GOALS ARE WEIGHTED IN A HIERARCHY OF CORE AND JOB-SPECIFIC COMPETENCIES, WHICH INCLUDE QUALITY OF CARE, FINANCIAL PERFORMANCE, AND PATIENT PERCEPTION OF CARE MEASURE. ONE OF THE CRITERIA DESIGNED TO ENHANCE ALIGNMENT OF THE ORGANIZATION'S GOAL FOR CONTINUED FINANCIAL STABILITY IS IMPROVEMENT OF NET EARNINGS OF BOTH THE HOSPITAL AND ITS RELATED ORGANIZATIONS. PART I, LINE 7 BONUSES WERE AWARDED FOR MEETING ORGANIZATIONAL GOALS AND WERE APPROVED BY THE BOARD. A NEW MEXICO HOSPITAL EQUIPMENT LOAN COUNCIL 850426875 647370FS9 2012-09-19 70004797 HOSPITAL IMPROVEMENTS, REFUND BONDS ISSUED 11/15/07 0 0 0 A 5805000 70011320 5651760 1400096 32310994 31075969 2012 1 0 1 1 A 0 1 0 0 0.02560 0.00000 0.02560 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 SCHEDULE K, PART II, LINE 3 THE DIFFERENCE BETWEEN THE ISSUE PRICE AT PART I COLUMN (E) AND THE TOTAL PROCEEDS OF THE ISSUE AT PART II LINE 3 IS DUE TO INVESTMENT EARNINGS ON THE RESERVE FUNDS. SCHEDULE K, PART IV, ARBITRAGE, LINE 2C (A) ISSUER NAME: NEW MEXICO HOSPITAL EQUIPMENT LOAN COUNCIL DATE THE REBATE COMPUTATION WAS PERFORMED: 01/09/2014 SCHEDULE K, PART II, LINE 11 THE OTHER SPENT PROCEEDS WAS THE AMOUNT USED TO RETIRE THE BONDS ISSUED IN 2007. AMY GRAHAM DAUGHTER-IN-LAW OF BOARD MEMBER BILL MERSHON 95295 EMPLOYMENT 0 FORM 990, PART VI, SECTION A, LINE 1 THE JOINT FINANCE AND EXECUTIVE COMMITTEE IS CHAIRED BY THE VICE CHAIRMAN OF THE BOARD OF DIRECTORS. IN THE ABSENCE OF THE VICE CHAIRMAN, THE CHAIRMAN OF THE BOARD OR SECRETARY OF THE BOARD SHALL CHAIR THE COMMITTEE IN THAT ORDER. THE COMPOSITION OF THE JOINT FINANCE AND EXECUTIVE COMMITTEE SHALL BE DETERMINED BY THE BOARD OF DIRECTORS AT THE ANNUAL MEETING. THE POWERS AND RESPONSIBILITIES OF THE COMMITTEE SHALL INCLUDE: SCREEN BOARD BUSINESS AND MAKE RECOMMENDATIONS FOR APPROVAL IN ORDER TO ENABLE THE FULL BOARD TO EFFECTIVELY UTILIZE ITS DISCUSSION TIME; EXERCISE EMERGENCY POWERS IN EXTRAORDINARY CIRCUMSTANCES AND MAKE DECISIONS OTHERWISE RESERVED TO THE BOARD OF DIRECTORS WHEN THE BOARD IS NOT IN SESSION; EXERCISE THE POWER AND AUTHORITY TO TRANSACT CORPORATION BUSINESS THAT REQUIRES IMMEDIATE ACTION; SERVE AS THE AUDIT COMMITTEE FOR THE CORPORATION; SERVE AS THE ETHICS COMMITTEE FOR THE CORPORATION AND BE PRIMARILY RESPONSIBLE FOR IMPLEMENTING THE CONFLICTS OF INTEREST POLICY OF THE CORPORATION; REVIEW AND MAKE RECOMMENDATIONS TO THE BOARD OF DIRECTORS CONCERNING THE PERFORMANCE, COMPETENCE AND TERMS OF EMPLOYMENT OF THE CHIEF EXECUTIVE OFFICER; AND ACT IN SUCH OTHER SITUATIONS AND CAPACITIES AS THE BOARD OF DIRECTORS MAY DESIGNATE OR SPECIFY. FORM 990, PART VI, SECTION A, LINE 3 COMPLETERX MANAGES THE PHARMACY DEPARTMENT AT GERALD CHAMPION REGIONAL MEDICAL CENTER, AND DIAMOND HEALTHCARE MANAGES THE MEDICAL CENTER'S BEHAVIORAL HEALTH DEPARTMENT. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN IS REVIEWED BY THE CEO AND CFO PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE IS REQUIRED TO FILL OUT A CONFLICT OF INTEREST DISCLOSURE ANNUALLY. THE FORMS ARE INITIALLY REVIEWED BY THE CFO. IF ANY CONFLICTS EXIST, THEY ARE REVIEWED BY THE BOARD OF DIRECTORS. A PERSON WITH A CONFLICT IS RESTRICTED FROM VOTING ON RELATED MATTERS. FORM 990, PART VI, SECTION B, LINE 15 THE CEO AND CFO REPORT TO THE GCRMC BOARD OF DIRECTORS, AND THEIR COMPENSATION PACKAGE IS DETERMINED BY THE BOARD. THE BOARD USES AN INDEPENDENT THIRD-PARTY CONSULTANT, THE COKER GROUP, TO EVALUATE THE COMPENSATION. THE BOARD OBTAINED COMPARATIVE SALARY DATA FROM THE COKER GROUP TO ASSESS THE FMV OF COMPENSATION. COMPENSATION WAS LAST DETERMINED IN 2019. A FULL COMPENSATION REVIEW OF ALL OFFICERS WAS PROVIDED BY THE COKER GROUP AT THAT TIME. GCRMC USES THE MGMA DATA THAT IS PUBLISHED ANNUALLY TO DETERMINE PHYSICIAN SALARIES LINKED TO THEIR PRODUCTIVITY LEVEL. THE SALARIES OF ALL NEWLY HIRED PHYSICIANS ARE APPROVED BY THE BOARD OF DIRECTORS. IN ADDITION, ANY MODIFICATION TO EMPLOYED PHYSICIAN SALARY IS APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE ALL AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONSULTANTS: PROGRAM SERVICE EXPENSES 1,586,908. MANAGEMENT AND GENERAL EXPENSES 714,980. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,301,888. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 1,208,072. MANAGEMENT AND GENERAL EXPENSES 2,829,730. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,037,802. PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 10,577,360. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,577,360. AGENCY PERSONNEL: PROGRAM SERVICE EXPENSES 4,080,217. MANAGEMENT AND GENERAL EXPENSES 498,281. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,578,498. CONTRACT DEPARTMENT FEES: PROGRAM SERVICE EXPENSES 1,537,473. MANAGEMENT AND GENERAL EXPENSES 1,090,714. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,628,187. SURGERY CENTER FEES: PROGRAM SERVICE EXPENSES 5,535,640. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,535,640. GC-SP CATH LAB CLINICAL SERVICE FEES: PROGRAM SERVICE EXPENSES 6,541,784. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,541,784. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,484,223. MANAGEMENT AND GENERAL EXPENSES 1,465,266. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,949,489. 340(B) PROCESSING FEES: PROGRAM SERVICE EXPENSES 347,067. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 347,067. GERALD CHAMPION REGIONAL MEDICAL CENTER FOUNDATION 2669 SCENIC DRIVE ALAMOGORDO NM 88310 850352051 TO DIRECTLY SUPPORT THE MISSION OF THE OTERO COUNTY HOSPITAL ASSOCIATION NM 501(C)(3) LINE 12A, I OTERO COUNTY HOSPITAL ASSOCIATION 1 ALAMOGORDO SURGERY VENTURES LLC 2351 25TH STREET ALAMOGORDO NM 88310 061791828 OUTPATIENT SURGERY CENTER NM N/A RELATED 483798 314572 0 1 0.45500 GERALD CHAMPION-SIERRA PROVIDENCE CARDIAC CATH LAB 2669 SCENIC DRIVE ALAMOGORDO NM 88310 611753921 CARDIAC CATH LAB NM N/A RELATED 917886 3694833 0 1 0.51000 WHITE SANDS HEALTH CARE SYSTEMS LP 3310 N WHITE SANDS BLVD ALAMOGORDO NM 88310 850438529 PROVIDER NETWORK NM N/A RELATED -16791 212804 0 1 0.50000 1 1 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 GERALD CHAMPION-SIERRA PROVIDENCE CARDIAC CATH LAB LLC A 175380 FAIR MARKET VALUE GERALD CHAMPION-SIERRA PROVIDENCE CARDIAC CATH LAB LLC F 650250 FAIR MARKET VALUE GERALD CHAMPION-SIERRA PROVIDENCE CARDIAC CATH LAB LLC M 6541784 FAIR MARKET VALUE