2018-12-17T12:07:40-07:00 2018-06-30 200079326 DINGUS ZARECOR & ASSOCIATES PLLC 12015 E MAIN AVE SPOKANE VALLEY WA 99206 990 2017-07-01 742851819 ARTESIA GENERAL HOSPITAL ARTE 5757488300 702 N 13TH STREET ARTESIA NM 88210 CORINA YATES CFO 5757488300 2018-12-12 true LUKE ZARECOR P02161725 5092420874 2018-12-17 63.131.236.90 2018-12-17 13:07:40 CS P 2474EFBFE268E1323248D70D812BABF32F861C74 2474EFBFE268E1323248D70D812BABF32F861C74 2017 2019-02-21 02:37:17Z CORINA YATES 702 N 13TH STREET ARTESIA NM 88210 68653708 false X WWW.ARTESIAGENERAL.COM X 1997 NM TO PROVIDE HEALTH CARE TO THE FAMILIES OF ARTESIA AND SURROUNDING COMMUNITIES WHILE CONTINUALLY IMPROVING QUALITY OF PATIENT CARE AND UTILIZING RESOURCES EFFECTIVELY AND EFFICIENTLY. 8 7 574 25 0 4283190 4111010 62512644 64139603 35644 5765 380773 397330 67212251 68653708 75000 1557200 0 33294279 39981136 0 137513 30619782 30713438 63989061 72251774 3223190 -3598066 66049387 65169306 7199823 8807118 58849564 56362188 X TO PROVIDE HEALTH CARE TO THE FAMILIES OF ARTESIA AND SURROUNDING COMMUNITIES WHILE CONTINUALLY IMPROVING QUALITY OF PATIENT CARE AND UTILIZING RESOURCES EFFECTIVELY AND EFFICIENTLY. false false 62280197 1557200 64139603 ARTESIA GENERAL HOSPITAL IS A 49-BED SOLE COMMUNITY HEALTH PROVIDER THAT SERVES ARTESIA AND SOUTHEASTERN NEW MEXICO PROVIDING GENERAL ACUTE CARE, CARDIOLOGY, PSYCHIATRIC, MEDICAL AND SURGICAL SERVICES INCLUDING OUTPATIENT AND EMERGENCY CARE SERVICES. DURING THE TAX YEAR, THE HOSPITAL HAD 1,057 ADMISSIONS OF WHICH 146 WERE GERI-PSYCH, 3,540 PATIENT DAYS, 1,826 SURGERIES, 13,306 EMERGENCY ROOM VISITS, 20,882 OUTPATIENT DIAGNOSTIC VISITS AND 60,343 CLINIC VISITS. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT OR BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED CHARGES OF PROVIDING CARE TO THESE PATIENTS WERE 1,667,416 FOR CHARITY CARE, 54,406,832 FOR MEDICARE, 33,760,319 FOR MEDICAID AND 23,101,317 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR. 62280197 true false false true false false false false false false true false false false false true true false false false false false false false false false true true true false true false false false false false false false false false false false false false false false false false true 192 0 true 574 true false false false false false false false false false false X 8 7 false false false false true true true true true false false true true true true true true true true false NM X CORINA YATES 5757488300 702 N 13TH STREET ARTESIA NM 88210 JOE SALGADO CHIEF OF STA 40.00 X 343004 0 35494 ANNA BYERS CHAIR 2.00 X X 0 0 0 MELANIE HALL BOARD MEMBER 2.00 X 0 0 0 DENNIS MAUPIN BOARD MEMBER 2.00 X 0 0 0 PAM HORNER BOARD MEMBER 2.00 X 0 0 0 MIKE PHIPPS BOARD MEMBER 2.00 X 0 0 0 BEN HARVEY BOARD MEMBER 2.00 X 0 0 0 MIKE DEANS BOARD MEMBER 2.00 X 0 0 0 KENNETH RANDALL CEO THRU APR 40.00 X 558809 0 42251 ROBERT TYK CEO 40.00 X 259971 0 30697 CORINA YATES CFO 40.00 X 115760 0 16039 FRANK POWELL INTERIM CFO 40.00 X 16846 0 0 JOHN MCMULLIN CFO THRU MAY 40.00 X 0 0 0 ELIZABETH SELLERS COO 40.00 X 198884 0 3524 CHARLES ELLIS COO THRU APR 40.00 X 152805 0 496 SHAHRIAR ANOUSHFAR PHYSICIAN 40.00 X 937597 0 39452 MARSHALL BACA SR PHYSICIAN 40.00 X 883806 0 46105 ZHINIAN WAN PHYSICIAN 40.00 X 686822 0 42512 THOMAS REICH PHYSICIAN 40.00 X 501254 0 40323 KAY JENKINS CHIEF LEGAL 40.00 X 233241 0 23697 4888799 320590 52 false true false MEDEFIS INC PO BOX 5068 NEW YORK NY 10087 NURSING STAFF 327036 APF FBO WORKBEAST LLC PO BOX 823473 PHILADELPHIA PA 19182 CODER 266986 THERAPY SOLUTIONS OF NW LLC PO BOX 213 DEXTER NM 88230 THERAPIST 198960 CARDINAL HEALTH PHARMACY PO BOX 730112 DALLAS TX 75397 PHARMACIST 136018 4 4111010 4111010 NET PATIENT SERVICE REVENUE 622110 57785796 57785796 SAFETY NET CARE POOL 622110 6293446 6293446 APD/JAIL REVENUE 622110 33704 33704 MEALS ON WHEELS 624210 26657 26657 64139603 5765 5765 74472 74472 74472 74472 COMMUNITY MEALS 722514 158264 158264 OTHER REVENUE 900099 82166 82166 PATIENT ACCOUNT INTEREST 900099 73808 73808 8620 8620 322858 68653708 64139603 403095 X 1557200 1557200 1522444 358912 1163532 32953491 28829163 4069149 55179 429328 402662 25877 789 2754738 2351268 399001 4469 2321135 1968712 348698 3725 144059 144059 21340 21340 8192135 5640794 2501914 49427 342603 18268 324335 5086120 4682726 402804 590 774037 739358 34679 2158723 1447372 710545 806 303689 182202 108235 13252 247860 151641 95549 670 4155268 3842209 309982 3077 1195812 1036966 158800 46 MEDICAL SUPPLIES & DRUGS 4081349 4081349 REPAIRS & MAINTENANCE 2011420 1553844 455083 2493 OTHER EXPENSES 1334299 344512 988887 900 RECRUITMENT 664724 481927 182797 2609112 -2611202 2090 72251774 62280197 9834064 137513 15972469 10890182 864132 838104 5283242 6342468 1326681 1503211 1638602 1392603 45486100 18244683 24914528 27241417 14688094 15110947 1361639 1850374 66049387 65169306 6462222 8807118 737601 7199823 8807118 X 58849564 56362188 58849564 56362188 66049387 65169306 -3598066 391060 719630 X false true X true false X false false false false false false false false true 4297 4297 false SCHEDULE C, PART II-B, LINE 1 THE HOSPITAL DOES NOT DIRECTLY PERFORM ANY LOBBYING ACTIVITIES. THE HOSPITAL PAYS MEMBERSHIP DUES TO STATE AND NATIONAL HOSPITAL ASSOCIATIONS. THE ASSOCIATIONS USE A PORTION OF SUCH DUES TO CARRY OUT LOBBYING ACTIVITIES. 130270 130270 11284209 1454721 9829488 1365246 296770 1068476 29293547 16493192 12800355 3412828 3412828 27241417 X 69764398 391060 719630 1110690 68653708 68653708 72251774 72251774 72251774 SCHEDULE D, PAGE 3, PART X THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE HOSPITAL EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF JUNE 30, 2018 AND 2017, THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. SCHEDULE D, PAGE 4, PART XI, LINE 2D GAIN ON INSURANCE SETTLEMENT 719,630 true true true X true X true true false true true 616944 616944 0.00850 15357954 14041110 1316844 0.01820 15974898 14041110 1933788 0.02680 64 2669 82316 82316 0.00110 53 1597401 1597401 0.02210 117 2669 1679717 1679717 0.02320 117 2669 17654615 14041110 3613505 0.05000 271173 271173 0.00380 271173 271173 0.00380 true 15353747 1667416 13715820 25082951 -11367131 X true true 1 1 ARTESIA GENERAL HOSPITAL 702 NORTH 13TH STREET ARTESIA NM 88210 WWW.ARTESIAGENERAL.COM 006788 X X X ARTESIA GENERAL HOSPITAL 1 false false true X X X X X X X X X X 16 true false false true X WWW.ARTESIAGENERAL.COM X true 16 true WWW.ARTESIAGENERAL.COM false false true X 200.000000000000 400.000000000000 X X X X true true X X X X true X WWW.ARTESIAGENERAL.COM X WWW.ARTESIAGENERAL.COM X X X X X true X false X X X X true X false false FACILITY 1, ARTESIA GENERAL HOSPITAL - PART V, LINE 3E IDENTIFICATION AND PRIORITIZATION OF HEALTH NEEDS ARE ADDRESSED ON PAGE 46, OF THE CHNA LOCATED ON THE HOSPITAL'S WEBSITE. FACILITY 1, ARTESIA GENERAL HOSPITAL - PART V, LINE 5 OVER TWENTY COMMUNITY STAKEHOLDERS PARTICIPATED IN INTERVIEWS AND AN ONLINE SURVEY FOR THEIR INPUT INTO THE COMMUNITY'S HEALTH. THERE WAS BROAD COMMUNITY PARTICIPATION IN THE INTERVIEWS REPRESENTING A RANGE OF INTERESTS AND BACKGROUNDS INCLUSIVE OF THE FOLLOWING: EMPLOYERS, NOT-FOR-PROFIT ORGANIZATIONS (REPRESENTING LOW-INCOME, MINORITY, AND CHILDREN), SCHOOLS, HEALTH PROVIDERS, ELDERLY, AND GOVERNMENT REPRESENTATIVES. THESE INDIVIDUALS COLLABORATED TO IMPLEMENT A COMPREHENSIVE CHNA PROCESS FOCUSED ON IDENTIFYING AND DEFINING SIGNIFICANT HEALTH NEEDS, ISSUES, AND CONCERNS OF THE ARTESIA GENERAL HOSPITAL. THE THREE-MONTH PROCESS CENTERED ON GATHERING AND ANALYZING DATA AS WELL AS RECEIVING INPUT FROM PERSONS WHO REPRESENTED THE BROAD INTERESTS OF THE COMMUNITY AND HAD SPECIAL KNOWLEDGE OF OR EXPERTISE IN PUBLIC HEALTH TO PROVIDE DIRECTION FOR THE COMMUNITY AND HOSPITAL TO CREATE A PLAN TO IMPROVE THE HEALTH OF THE COMMUNITY. FACILITY 1, ARTESIA GENERAL HOSPITAL - PART V, LINE 11 THE MOST RECENT CHNA IDENTIFIED THE FOLLOWING SIGNIFICANT HEALTH NEEDS: ACCESS TO HEALTHCARE/PHYSICIANS, CHRONIC DISEASES (DIABETES, CANCER, ALLERGIES/ASTHMA), SUBSTANCE ABUSE AND MENTAL HEALTH, DENTAL AND VISION CARE, PREVENTION/EDUCATION/DIET, AND OTHER MINOR NEEDS. THE HOSPITAL LEADERSHIP TEAM PRIORITIZED THE HEALTH ISSUES AS FOLLOWS: ACCESS TO CARE; CHRONIC DISEASES; OBESITY; SMOKING; AND MENTAL HEALTH. THE HOSPITAL HAS AN IMPLEMENTATION STRATEGY AND ASSOCIATED COMMUNITY BENEFIT PLAN WITH OBJECTIVES TO ADDRESS THESE PRIORITIES. THE HOSPITAL IS A RURAL HOSPITAL WITH LIMITED RESOURCES. THE RURAL AREA THAT THE HOSPITAL IS LOCATED IN MAKES IT DIFFICULT FOR RECRUITING PROVIDERS AND STAFF. SOME TYPES OF PROVIDERS ARE EXCESSIVELY MORE DIFFICULT TO RECRUIT THAN OTHERS TO RURAL AREAS. IN ORDER TO ACHIEVE THE COMMUNITY'S NEEDS LISTED IN THE ASSESSMENT, WITH LIMITED RESOURCES, THE HOSPITAL FORMS A COLLABORATIVE VENTURE WITH OTHER PROVIDERS, CITIZENS, LOCAL GOVERNMENT, SCHOOLS, CHURCHES, OTHER NON-PROFIT ORGANIZATIONS, AND LOCAL BUSINESSES. AT THIS TIME, THE HOSPITAL IS UNABLE TO ADDRESS SUBSTANCE ABUSE DUE TO LACK OF EXPERTISE IN THE FIELD AND HOSPITAL RESOURCES AVAILABLE. THE HOSPITAL PROVIDES VACCINATIONS TO PEOPLE IN THE COMMUNITY AND GAVE EQUIPMENT TO THE CITY TO PROVIDE EXERCISE FOR PEOPLE WALKING AND USING THE GREEN BELT. THEY ROUTINELY MEET WITH VARIOUS GROUPS IN THE CITY AND HOSPITAL DISTRICT TO DISCUSS NEEDS AND HOW THE HOSPITAL CAN HELP MEET THOSE NEEDS. THESE DISCUSSIONS OFTEN RESULT IN AN UNDERSTANDING BY THE COMMUNITY OF WHAT IS PROVIDED BY THE HOSPITAL. THE HOSPITAL OFFERS ARTHRITIS, DIABETES, CARDIOLOGY, AND OTHER CLASSES FOR GROUPS OF INDIVIDUAL COMMUNITY MEMBERS AND FOR BUSINESSES THAT REQUEST THEM. THE HOSPITAL HAS ADDED A SIGNIFICANT NUMBER OF SPECIALTY CLINICS THE LAST YEAR SUCH AS ORTHOPEDIC, UROLOGY, AND BEHAVIORAL HEALTH AND PROVIDERS CONTINUE TO BE RECRUITED. 6 ARTESIA HEALTH PROFESSIONALS 612 N 13TH STREET ARTESIA NM 88210 PHYSICIAN CLINIC MEMORIAL FAMILY PRACTICE 702 N 13TH STREET ARTESIA NM 88210 RURAL HEALTH CLINIC ORTHOPEDIC SPECIALISTS 2411 OSBORNE DRIVE CARLSBAD NM 88220 GENERAL CLINIC ADVANCED PRACTICE PROFESSIONALS 914 N CANAL CARLSBAD NM 88220 GENERAL CLINIC RYBKA SERGIO J MD - UROLOGY 1031 N THOMAS CARLSBAD NM 88220 GENERAL CLINIC DR MARTA GALLEGOS 201 N ALAMEDA STREET CARLSBAD NM 88210 GENERAL CLINIC PART II - COMMUNITY BUILDING ACTIVITIES EDDY COUNTY IS DESIGNATED AS MEDICALLY UNDERSERVED AND HAS A SHORTAGE IN THE AREA OF HEALTH PROFESSIONALS. THE HOSPITAL IS CONTINUALLY RECRUITING PHYSICIANS AND OTHER HEALTH PROFESSIONALS TO ITS RURAL SERVICE AREA TO HELP IMPROVE ACCESS TO HEALTHCARE SERVICES AS IDENTIFIED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT. PART III, LINE 2 - BAD DEBT EXPENSE METHODOLOGY THE HOSPITAL REPORTED ACTUAL BAD DEBTS FROM THE AUDITED FINANCIALS. PART III, LINE 3 BAD DEBT EXPENSE, PATIENTS ELIGIBLE FOR ASSISTANCE THE HOSPITAL SHALL LIMIT ITS CHARGES TO UNINSURED PATIENTS BY EXTENDING A SELF PAY DISCOUNT PERCENTAGE EQUAL TO THE HOSPITAL'S BLENDED AVERAGE OF COMMERCIAL MANAGED CARE CONTRACT DISCOUNTED RATES FOR INPATIENT, OUTPATIENT AND CLINIC SERVICES FROM THE PRIOR FISCAL YEAR. THE HOSPITAL SHALL REVIEW AND UPDATE THIS BLENDED AVERAGE DISCOUNT ANNUALLY. THE HOSPITAL REPORTED ACTUAL CHARITY CARE FROM THE AUDITED FINANCIALS. BAD DEBT EXPENSE FOOTNOTE TO FINANCIAL STATEMENTS THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 4 ON PAGE 12 OF THE AUDITED FINANCIAL STATEMENTS AND ALSO INCLUDES THE PROVISION FOR BAD DEBTS. PART III, LINE 8 - MEDICARE EXPLANATION ANY MEDICARE ALLOWABLE COSTS OF PATIENT CARE SHORTFALLS IS THE AMOUNT OF COST THAT THE HOSPITAL DID NOT RECOVER FROM THE MEDICARE PROGRAM AND ARE NOT COUNTED AS COMMUNITY BENEFIT. AS SUCH, THE HOSPITAL ABSORBED THE COST FOR THE BENEFIT OF THE PATIENT AND THE COMMUNITY IT SERVES. WITHOUT THIS ACTION, THE PATIENTS COULD NOT HAVE BEEN TREATED AT THE HOSPITAL. THESE ALLOWABLE COSTS ARE OBTAINED FROM THE MEDICARE COST REPORT FOR THE YEAR. PART III, LINE 9B - COLLECTION PRACTICES EXPLANATION THE HOSPITAL USES STANDARD BUSINESS PRACTICES TO DETERMINE BAD DEBT AND MEDICALLY INDIGENT PATIENTS. IF A PATIENT CANNOT PAY THE ENTIRE BILL WITHIN THE TIMELINE SPECIFIED IN THE BILLING/COLLECTION POLICY, AN INTERVIEW WITH THE PATIENT IS CONDUCTED. EACH PERSON THAT PRESENTED OR WAS CALLED ABOUT THEIR ACCOUNT WAS PROVIDED WITH A FINANCIAL ASSISTANCE QUESTIONNAIRE. THE HOSPITAL PROVIDED SPECIALLY TRAINED EMPLOYEES TO WORK WITH PATIENTS TO HELP DETERMINE ELIGIBILITY. COLLECTION PRACTICES WERE APPROACHED WITH HELPING THE PATIENT AND DETERMINING THEIR ABILITY OR INABILITY TO PAY FOR THEIR SERVICES. PART VI, LINE 2 - NEEDS ASSESSMENT THE HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES THROUGH REGULAR SEMINARS AND MEETINGS WITH LOCAL AND COUNTY OFFICIALS. THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY AND COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT THE FOLLOWING URL: HTTP://WWW.ARTESIAGENERAL.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FINANCIAL ASSISTANCE POLICIES ARE DISTRIBUTED TO THE COMMUNITY IN A VARIETY OF WAYS. PEOPLE ARE INFORMED THROUGH OUR WEBSITE, UPON ADMISSION AND DISCHARGE, AND LATER THROUGH PHONE CALLS OR LETTERS. PART VI, LINE 4 - COMMUNITY INFORMATION THE COMMUNITY SERVED IS RURAL AND IS HEAVILY RELIANT ON OIL AND GAS PRODUCTION. EDDY COUNTY IS DESIGNATED AS MEDICALLY UNDERSERVED AND HAS A SHORTAGE IN THE AREA OF HEALTH PROFESSIONALS. THE SERVICE AREA POPULATION IS ESTIMATED AT APPROXIMATELY 190,000 AND IS PROJECTED TO GROW BY 1.37% THROUGH 2020. THE MEDIAN HOUSEHOLD INCOME IN THE SERVICE AREA IS 52,945 AND THE MEDIAN AGE IS 38 YEARS. AREAS OF HEALTH IMPROVEMENT ARE MAMMOGRAPHY SCREENING, OBESITY EDUCATION, SMOKING CESSATION AND INCREASE THE NUMBER OF PRIMARY CARE PHYSICIANS. PERCENT UNINSURED OR UNDERINSURED IS ESTIMATED AT 48%. THE NUMBER OF RESIDENTS ELIGIBLE FOR MEDICAID AND SELF-PAY PATIENTS CONTINUES TO GROW WITH THE DECLINE IN OIL AND GAS REVENUES AND JOBS. 25% OF THE POPULATION IS IN THE LOWER INCOME BRACKET AND MAKES LESS THAN 15,000. APPROXIMATELY 500 HOUSEHOLDS MAKE LESS THAN 37,945 PER YEAR. THESE STATISTICS ARE BEFORE THE DECLINE IN OIL AND GAS JOBS. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH THE BOARD OF DIRECTORS IS COMPRISED OF COMMUNITY MEMBERS REPRESENTING MULTIPLE FACETS OF OUR COMMUNITY FROM BUSINESS OWNERS TO HOMEMAKERS TO RETIREES. THIS VOLUNTEER BOARD HAS DEDICATED THEIR TIME TO ENSURING THEY UNDERSTAND THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY. MEDICAL STAFF PRIVILEGES AT THE HOSPITAL ARE AVAILABLE TO QUALIFIED AND INTERESTED PHYSICIANS IN THE COMMUNITY WE SERVE. WE ENCOURAGE PRACTITIONERS FROM NUMEROUS SPECIALTIES TO MEET THE EVER GROWING HEALTHCARE NEEDS OF THE COMMUNITY. ANY SURPLUS FUNDS ARE REINVESTED INTO OUR FACILITIES, EQUIPMENT, AND PROFESSIONAL EDUCATION OF OUR EMPLOYEES IN ORDER TO PROVIDE THE HIGHEST QUALITY HEALTHCARE POSSIBLE. THE HOSPITAL ALSO ASSESSES THE HEALTH AND WELFARE NEEDS OF OUR COMMUNITY TO DETERMINE IF ADDITIONAL SERVICES TO OUR PATIENTS ARE NEEDED. THE HOSPITAL PROVIDED "LUNCH AND LEARN", RADIO HEALTH EDUCATION, ACTIVITIES AT SEVERAL AREA BUSINESSES, SCHOOLS, AND SENIOR CENTERS EDUCATIONAL CONTENT. THE HOSPITAL GOES TO VARIOUS BUSINESSES TO CONDUCT EDUCATION FOR EMPLOYEES AND HOLD VARIOUS EDUCATIONAL CLASSES DURING THE YEAR. THE HOSPITAL WORKED WITH THE SCHOOL SYSTEM TO DEVELOP INFORMATIONAL SESSIONS FOR STUDENTS. THE HOSPITAL WORKED WITH UNITED WAY AND OTHER ORGANIZATIONS IN COMMUNITY ACTIVITIES. THE HOSPITAL PROVIDED PHYSICAL EXAMINATIONS AT REDUCED RATES FOR STUDENT ATHLETES AND WORKED IN VARIOUS COMMUNITY ACTIVITIES, HEALTH WALK, AND OTHERS. THE HOSPITAL ALSO PROMOTES HEALTH IN THE COMMUNITY BY PARTICIPATING IN MANY ACTIVITIES THAT INCLUDE THE FOLLOWING: 1. THE HOSPITAL RAISES MONEY AND PARTICIPATES IN THE ANNUAL RELAY FOR LIFE WALK THAT RAISES MONEY FOR THE AMERICAN CANCER SOCIETY AND RAISES COMMUNITY AWARENESS 2. EACH SUMMER THE HOSPITAL PROVIDES SPACE, FOOD AND VOLUNTEERS AND NURSING STAFF FOR A FREE BACK-TO-SCHOOL PHYSICAL EVENT FOR ARTESIA AND LAKE ARTHUR 3. EACH OCTOBER THE HOSPITAL OFFERS DISCOUNTED MAMMOGRAM SCREENINGS AS PART OF BREAST CANCER AWARENESS MONTH 4. THE HOSPITAL PREPARES AND DONATES A PORTION OF THE COST OF THE MEALS FOR AREA MEALS ON WHEELS PROGRAM 5. THE HOSPITAL STAFF, PARTICULARLY THE GERI-PSYCH PROGRAM, ORGANIZES AND PRESENTS FREE EDUCATIONAL SEMINARS FOR THE AREA RETIREMENT CENTERS, LOCAL CHURCHES, THE ROTARY CLUB AND OTHER COMMUNITY ORGANIZATIONS 6. THE HOSPITAL HOSTS AN ANNUAL HEALTH FAIR AND QUARTERLY HEALTH SCREENINGS FOR RESIDENTS OF THE SURROUNDING AREAS SCREENINGS INCLUDE BLOOD PRESSURE, CHOLESTEROL AND GLUCOSE 7. THE HOSPITAL SPONSORS MONTHLY HEALTH RELATED EDUCATIONAL TOPICS VIA RADIO AND TELEVISION TOPICS INCLUDE ASTHMA, SUICIDE PREVENTION, WOMEN'S HEALTH SCREENINGS AND SMOKING CESSATION, AS WELL AS OTHER HEALTH AWARENESS TOPICS 8. ARTHRITIS SEMINARS ARE CONDUCTED ROUTINELY TO BRING AWARENESS OF TREATMENT AVAILABLE. THE HOSPITAL IS WORKING CONTINUALLY WITH LOCAL OFFICIALS TO PROVIDE NEEDED SERVICES AND DONATE TIME AND EFFORT TO THE COMMUNITY. WE PROVIDE SUBSTANTIAL AMOUNTS OF UNCOMPENSATED CARE TO INDIVIDUALS THAT ARE IN NEED. PART VI, LINE 6 - AFFILIATED HEALTH CARE SYSTEM THE HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH SYSTEM. PART VI, LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT NEW MEXICO true ASSISTANCE LEAGUE OF CARLSBAD PO BOX 465 CARLSBAD NM 88221 856014382 501C3 28000 FINANCIAL ASSISTANCE UNITED WAY PO BOX 990 ARTESIA NM 88210 850164907 501C3 10000 FINANCIAL ASSISTANCE EDDY COUNTY FAIR ASSOCIATION PO BOX 3273 ARTESIA NM 88211 821675007 501C3 9200 FINANCIAL ASSISTANCE ARTESIA ARTS COUNCIL PO BOX 782 ARTESIA NM 88210 510140418 501C3 10000 FINANCIAL ASSISTANCE AQUATIC CENTER FOUNDATION PO BOX 508 ARTESIA NM 88211 822382577 501C3 1500000 ACQUATIC CENTER 5 SCHEDULE I, PAGE 1, PART I, LINE 2 THE HOSPITAL IDENTIFIES AND PRIORITIZES COMMUNITY NEEDS; SOLICITS, RECEIVES, AND PRIORITIZES APPLICATIONS FOR FUNDING AND APPROVES BENEFICIARY FUNDING. FUNDED ORGANIZATIONS ARE ASKED TO SUBMIT A SUMMARY REPORT OF THE PROJECT AND ITS OUTCOMES TO THE HOSPITAL BOARD. X X X X X true false false false false false false true false JOE SALGADO CHIEF OF STAFF 321892 20727 385 10800 24694 378498 KENNETH RANDALL CEO THRU APRIL 313358 245451 8873 33378 601060 ROBERT TYK CEO 257319 102 2550 7497 23200 290668 ELIZABETH SELLERS COO 188067 10101 716 2093 1431 202408 CHARLES ELLIS COO THRU APRIL 152557 248 496 153301 SHAHRIAR ANOUSHFAR PHYSICIAN 909460 27333 804 10800 28652 977049 MARSHALL BACA SR PHYSICIAN 803850 72987 6969 10800 35305 929911 ZHINIAN WAN PHYSICIAN 621456 64952 414 10800 31712 729334 THOMAS REICH PHYSICIAN 491699 3844 5711 10800 29523 541577 KAY JENKINS CHIEF LEGAL OFFICER 231720 102 1419 23697 256938 SCHEDULE J, PAGE 1, PART I, LINE 4 KENNETH RANDALL 245,451 0 0 SCHEDULE J, PAGE 1, PART I, LINE 7 CERTAIN MEDICAL PROVIDERS ARE COMPENSATED BASED ON THE GROSS PROFESSIONAL CHARGES GENERATED BY THEIR SERVICES. FORM 990, PAGE 2, PART III, LINE 4A CARE, 54,406,832 FOR MEDICARE, 33,760,319 FOR MEDICAID AND 23,101,317 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR. FORM 990, PAGE 6, PART VI, LINE 6 ARTESIA SPECIAL HOSPITAL DISTRICT IS THE SOLE MEMBER OF THE HOSPITAL. FORM 990, PAGE 6, PART VI, LINE 7A TWO DIRECTORS OF THE BOARD ARE APPOINTED BY THE SOLE MEMBER OF THE HOSPITAL. FORM 990, PAGE 6, PART VI, LINE 7B THE BOARD OF DIRECTORS MAY AUTHORIZE AND THE HOSPITAL MAY MAKE DISTRIBUTIONS, SUBJECT TO THE APPROVAL OF THE SOLE MEMBER. FORM 990, PAGE 6, PART VI, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE CEO, CFO AND THE BOARD SECRETARY/TREASURER, WHO REVIEW THE FORM, SCHEDULES, AND RELATED ATTACHMENTS. THE 990 IS ALSO PRESENTED TO THE ENTIRE BOARD. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CEO SIGNS OFF ON THE FORM 8879-EO BEFORE THE RETURN IS E-FILED BY THE PREPARER. FORM 990, PAGE 6, PART VI, LINE 12C ALL OFFICERS, DIRECTORS, KEY EMPLOYEES, HIGHLY COMPENSATED EMPLOYEES AND OTHER MANAGEMENT OFFICIALS (COVERED PERSONS) ARE REQUIRED TO COMPLETE AN ANNUAL DISCLOSURE STATEMENT IDENTIFYING ANY POTENTIAL CONFLICT OF INTEREST. COVERED PERSONS ARE ALSO ENCOURAGED TO NOTIFY THE BOARD, APPROPRIATE MANAGEMENT PERSONNEL, CHIEF COMPLIANCE OFFICER, GENERAL COUNSEL, OR THE AUDIT AND COMPLIANCE COMMITTEE OF THE GOVERNING BODY AS NECESSARY. WHEN NECESSARY, THE BOARD CHAIR OR APPROPRIATE BOARD COMMITTEE MAY APPOINT A DISINTERESTED PERSON(S) OR COMMITTEE TO INVESTIGATE THE POTENTIAL CONFLICT OF INTEREST AND RECOMMEND ALTERNATIVES TO THE APPLICABLE TRANSACTION OR ARRANGEMENT OR OTHERWISE DETERMINE IF THE CONFLICT CAN BE RESOLVED. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER THE CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF THE ORGANIZATION, FOR ITS OWN BENEFIT, AND WHETHER IT IS REASONABLE. THE GOVERNING BOARD OR COMMITTEE MAKES THE DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. ANY MEMBER OF THE BOARD OPERATING UNDER A CONFLICT IS NOT PERMITTED TO BE PRESENT OR OTHERWISE PARTICIPATE IN THE VOTE ON ANY MATTER TO WHICH THE CONFLICT RELATES. IF THE GOVERNING BOARD OR COMMITTEE OF THE ORGANIZATION HAS REASONABLE CAUSE TO BELIEVE THAT A COVERED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST AND AFTER INVESTIGATION THE BOARD OR COMMITTEE DETERMINES THAT THE COVERED PERSON FAILED TO DISCLOSE A CONFLICT OF INTEREST, THE ORGANIZATION TAKES APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION, WHICH MAY INCLUDE, TERMINATION OF THE INDIVIDUAL'S MEMBERSHIP, EMPLOYMENT, OR CONTRACT. FORM 990, PAGE 6, PART VI, LINE 15A THE SOURCE UTILIZED BY THE HOSPITAL IN REGARDS TO FAIR MARKET VALUE IN SALARIES IS SULLIVAN COTTER. COTTER GATHERS DATA RELATED TO JOB DESCRIPTIONS, SCOPE OF RESPONSIBILITY, AND CURRENT INCUMBENTS' COMPENSATION. COTTER RECOMMENDS APPROPRIATE COMPARISON DATA AND UTILIZES SURVEY DATA FORM FOUR MAJOR EXECUTIVE COMPENSATION SURVEY PROVIDERS TO PROVIDE MARKET DATA AND EXECUTIVE COMPENSATION RECOMMENDATIONS THAT MEET THE HOSPITAL'S COMPENSATION PHILOSOPHY. THE BOARD THEN REVIEWS WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. FORM 990, PAGE 6, PART VI, LINE 15B SEE FORM 990, PART VI, LINE 15A. FORM 990, PAGE 6, PART VI, LINE 19 THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G 5,640,794 2,501,914 49,427 FORM 990, PART XI, LINE 9 GAIN ON INSURANCE SETTLEMENT 719,630