2017-04-04T17:47:13-05:00 2016-06-30 BKD LLP 111 South Tejon Suite 800 Colorado Springs CO 809039848 990 2015-07-01 850127924 San Juan Regional Medical Center % KAREN S MILLER SANJ 5056096114 801 West Maple Street Farmington NM 87401 KAREN S MILLER CFO 5056096114 2017-03-30 true David S Mason CPA P00137279 7194714290 2015 2021-01-29 14:40:06Z X JEFF BOURGEOIS CEO 801 West Maple Street Farmington NM 87401 345559645 false X WWW.SANJUANREGIONAL.COM X 1953 NM SAN JUAN REGIONAL MEDICAL CENTER'S MISSION IS TO PERSONALIZE HEALTH CARE AND CREATE ENTHUSIASM AND VITALITY IN HEALING. 10 9 2155 200 0 3189992 4384776 294059331 315171857 5435156 372035 1511030 2125593 304195509 322054261 235365 250000 0 0 157376012 178190790 0 0 0 127157225 127936837 284768602 306377627 19426907 15676634 363971457 372716270 98778805 91134040 265192652 281582230 X SAN JUAN REGIONAL MEDICAL CENTER'S MISSION IS TO PERSONALIZE HEALTH CARE AND CREATE ENTHUSIASM AND VITALITY IN HEALING. false false 283057168 250000 315182598 ALL ACTIVITY IS DIRECTLY RELATED TO PROVIDING PATIENT MEDICAL SERVICES AND QUALITY HEALTH CARE TO THE COMMUNITY AND SURROUNDING RURAL AREAS. SEE SCHEDULE O FOR OVERVIEW AND PROGRAMS. 283057168 true true false true false false false false false false true false false false true false false true false false false false false false false false true true true false true true false false false false false false false false true false true false false false false true true true false true 84 0 true 2155 true false false false false false false false false false false X 10 9 false false false false true true false true true false false true true true true true true true true false NM X KAREN S MILLER 5056096114 801 WEST MAPLE STREET FARMINGTON NM 87401 X JANEL M RYAN CHAIRMAN 6.0 0.0 X X 0 0 0 CHARLENE SCOTT CHAIRMAN UNTIL 1/28/16 6.0 0.0 X X 0 0 0 RONALD ROSEN 1ST VICE CHAIRMAN 6.0 0.0 X X 0 0 0 TONY ATKINSON TREASURER 6.0 0.0 X X 0 0 0 SANDY WILLIAMS SECRETARY 6.0 0.0 X X 0 0 0 HOLLY ABERNETHY CHIEF OF STAFF 6.0 0.0 X 0 0 0 KRISTEAN THORPE - VICE CHIEF OF STAFF UNTIL 1/4/16 6.0 0.0 X 0 0 0 DAMON KALCICH VICE CHIEF OF STAFF 40.0 0.0 X 452232 0 34036 KAREN MORRISON DIRECTOR - AUX. 6.0 0.0 X 0 0 0 BRUCE BLACK DIRECTOR until 1/28/16 6.0 0.0 X 0 0 0 TERRI FORTNER DIRECTOR 6.0 0.0 X 0 0 0 RUSSELL FLOREZ DIRECTOR UNTIL 1/28/16 6.0 0.0 X 0 0 0 JAMES SPENCE DIRECTOR 6.0 0.0 X 0 0 0 BRUCE GLADE DIRECTOR 6.0 0.0 X 0 0 0 JAMES SHAHEEN DIRECTOR UNTIL 1/28/16 6.0 0.0 X 0 0 0 RICK WALLACE CEO 38.0 2.0 X 714465 0 76506 JEFF EGBERT INTERIM CEO 38.0 2.0 X 0 0 0 JOHN BUFFINGTON COO 40.0 0.0 X 509993 0 59940 KAREN MILLER CFO 38.0 2.0 X 194874 0 12364 SUZANNE SMITH CHIEF NURSING OFFICER 40.0 0.0 X 272269 0 48705 KOIJAN KAINTH PHYSICIAN 40.0 0.0 X 1129000 0 12639 FARAZ SANDHU PHYSICIAN 40.0 0.0 X 861103 0 38294 CHARLES WILKINS PHYSICIAN 40.0 0.0 X 653517 0 39037 VERRAD NYAME PHYSICIAN 40.0 0.0 X 431648 0 13295 MICHAEL WEST PHYSICIAN 40.0 0.0 X 639964 0 23238 5859065 0 358054 308 false true false Aramark 12483 Collections Center Drive CHICAGO IL 60693 HOUSEKEEPING SERVICE 1731146 Resource Anesthesiology 10 Commerce Drive NE ROCHELLE NY 10801 Anesthesiology SVCS 1243166 Total Renal Care Inc 6000 Feldwood Road COLLEGE PARK GA 30349 Renal Dialysis 1548425 Midland Capital Resources 5020 Bob Billings Parkway LAWRENCE KS 66049 COLLECTIONS 1310565 Jacobus Consulting 15375 Barranca Parkway IRVINE CA 92618 CONSULTING 1165999 27 83912 3663877 636987 372472 4384776 NET PATIENT SERVICE REVENUE 621110 309660274 309660274 OTHER PROGRAM SERVICE REVENUE 900099 3317009 3317009 MEANINGFUL USE REVENUE 900099 1186697 1186697 EQUITY IN SJR REHAB & SJR HOLDING 900099 700653 700653 PROGRAM RELATED RENTAL INCOME 900099 307224 307224 315171857 2430410 2430410 0 0 41253 41253 0 41253 41253 21447009 23493094 12290 -2046085 -12290 -2058375 -2058375 0 0 0 CAFETERIA 722514 1432599 1432599 OTHER REVENUE 900099 651741 10741 641000 2084340 322054261 315182598 2486887 250000 250000 0 0 0 2425807 825455 1600352 152304 0 152304 0 136065216 127432349 8632867 4913668 4655727 257941 26081281 24333512 1747769 8552514 8089893 462621 0 574295 18210 556085 171155 171155 60212 60212 0 329257 329257 23435445 21965965 1469480 1174052 1174052 30730938 29308887 1422051 7912676 7272111 640565 0 3476605 3371376 105229 458579 270269 188310 0 908948 823807 85141 1885443 1732808 152635 0 12945220 11897248 1047972 3958481 1403815 2554666 BAD DEBT EXPENSE 16269543 16269543 MEDICAL SUPPLIES 13221047 13219068 1979 EQUIP RENTAL & MAINTENANCE 10424941 9917125 507816 306377627 283057168 23320459 0 44108291 46864240 4591153 12536414 0 0 38302072 39856000 0 0 0 0 685995 167067 4351031 4904346 4671695 3181332 329451260 190578151 136120018 138873109 113513332 106161459 1489772 2260406 7097077 7027096 0 0 9041021 10884801 363971457 372716270 38252156 31677749 0 0 0 0 36505156 34207565 0 0 0 0 5303052 4105406 0 0 18718441 21143320 98778805 91134040 X 265192652 281582230 0 0 0 0 265192652 281582230 363971457 372716270 15676634 712944 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 60212 false false 60212 false Schedule C, Part II-B, Line 1g Lobbying: San Juan Regional Medical Center paid New Mexico Government Affairs $50,390 for a lobbyist in Santa Fe, New Mexico who monitors New Mexico state legislative issues with regard to hospital issues, keeps San Juan Regional Medical Center apprised of those issues and takes feedback to the state legislature. A portion of the dues paid to the healthcare associations by san juan regional medical center was allocable to lobbying activities. The amount for FY16 was $9,822. 9086901 9086901 173631370 83190805 90440565 89427 89427 0 120369497 99109566 21259931 26274065 8188353 18085712 138873109 0 DUE TO MEDICARE/MEDICAID 5606826 MALPRACTICE LIABILITY 15118000 BOND INTEREST PAYABLE 418494 21143320 306458761 712944 712944 305745817 16308444 16308444 322054261 290069183 290069183 16308444 16308444 306377627 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 4b Revenue on return, not on books: bad debt expense net with revenue on financials, reclassified to expense for tax purposes 16,269,543 Other expenses net with revenue 38,901 Total 16,308,444 Schedule D, Part XII, Line 4b Expense on return, not on books: bad debt expense net with revenue on financials, reclassified to expense for tax purposes 16,269,543 Other expenses net with revenue 38,901 Total 16,308,444 true true X true X true X true true true false false 1369040 1369040 0.00470 75888921 61677692 14211229 0.04900 2587215 1480131 1107084 0.00380 79845176 63157823 16687353 0.05750 13433 467609 467609 0.00160 67 905344 905344 0.00310 198208 52744888 39090366 13654522 0.04710 1130 167685 167685 0.00060 212838 54285526 39090366 15195160 0.05240 212838 134130702 102248189 31882513 0.10990 true 16269543 7321294 73050149 82005458 -8955309 X true true 1 1 SAN JUAN REGIONAL MEDICAL CENTER 801 West Maple Street Farmington NM 87401 WWW.SANJUANREGIONAL.COM 6291 X X 1 SAN JUAN REGIONAL MEDICAL CENTER 1 false false true X X X X X X X X X 14 true true false true X SEE PART V, SECTION C FOR URL X true 14 false true false true X 200. 400. X X X X X true true X X X X true X PART V, SECTION C FOR URL X PART V, SECTION C FOR URL X PART V, SECTION C FOR URL X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, FIVE FOCUS GROUPS WERE HELD JUNE 3 THROUGH JUNE 5, 2014. FOCUS GROUP PARTICIPANTS INCLUDED 39 KEY INFORMANTS, INCLUDING PUBLIC HEALTH REPRESENTATIVES; PHYSICIANS; OTHER HEALTH PROFESSIONALS; BUSINESS LEADERS; AND ELECTED OFFICIALS. ONE OF THE FOCUS GROUPS PRIMARILY RELATED TO THE HEALTH CONCERNS OF THE AREA'S NATIVE AMERICAN POPULATION. THE REMAINING FOUR FOCUS GROUPS WERE UNDERTAKEN TO SPECIFICALLY ADDRESS THE FOUR HEALTHCARE CONCERNS IDENTIFIED IN PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENTS : 1) WEIGHT STATUS, 2) DIABETES, 3) PRENATAL CARE AND TEEN PREGNANCY AND 4) ACCESS TO HEALTHCARE SERVICES. KEY INFORMANT FOCUS GROUP, NATIVE AMERICAN SERVICES: - NAVAJO NATION, COUNSELOR CHAPTER - NAVAJO NATION, HUERFANO CHAPTER - NAVAJO NATION, NAGEEZI CHAPTER - NAVAJO NATION, TSE DAA K'AAN CHAPTER - SHIPROCK NAVAJO AREA AGENCY ON AGING (SRNAAA) KEY INFORMANT FOCUS GROUP, BUSINESS LEADERS: - FARMINGTON CHAMBER OF COMMERCE - CENTURY 21 SOWESCO - COMFORT KEEPERS - PARKER'S OFFICE PRODUCTS - HARMONY NAPRAPATHIC - SYLVAN LEARNING CENTER - CITIZENS TRUST CORPORATION KEY INFORMANT FOCUS GROUP, OTHER HEALTH PROVIDERS: - PARTNERS ASSISTED LIVING SERVICE - NEW MEXICO DEPARTMENT OF HEALTH - LIFECARE CENTER - NORTHWEST NEW MEXICO HOME HEALTH AND HOSPICE - ADULT PROTECTIVE SERVICES - SAN JUAN REHABILITATION HOSPITAL - ECHO FOOD BANK - SJCI BLOOMFIELD PHO - BASIN HOME HEALTH AND HOSPICE KEY INFORMANT FOCUS GROUP, ELECTED OFFICIALS: - CITY OF FARMINGTON - SAN JUAN COUNTY KEY INFORMANT FOCUS GROUP, PHYSICIANS: - SAN JUAN REGIONAL MEDICAL CENTER - VARIOUS PRIVATE PRACTICES SCHEDULE H, PART V, SECTION B, LINE 6a THE CHNA WAS CONDUCTED WITH San Juan Regional Rehabilitation Hospital. SCHEDULE H, PART V, SECTION B, LINE 7a direct url for community health needs assessment on hospital's website: http://www.sanjuanregional.com/community-assessment SCHEDULE H, PART V, SECTION B, LINE 11 San Juan Regional Medical Center has conducted three Community Health Needs Assessments since 2008 and every assessment identified the following as top issues: - Chronic Disease, especially diabetes and heart disease; - Culturally sensitive communication and health information; - Greater public outreach; - Suicide Prevention. The Board of Directors, through the Partnership sub-committee of the Board, provides grants to other not for profit organizations through its Community Reinvestment Fund. The Board made the decision to limit the grants to organizations that address the top issues in the Community Health Needs Assessment. We also match the donations of our employees-dollar for dollar-to the United Way of San Juan County through the Community Reinvestment Fund. Furthermore, we address these top issues through activities within the hospital. Outreach - Flu Clinics - Health Fairs - Low Cost Blood Screenings Culturally sensitive communication and health information - Spanish translation of health information - Health information spots on KNDN, the Navajo radio station - Translation of signage - Translator services Chronic Disease Management - Diabetes Education and Lifestyle Balance - Dietary Consults - Outreach and education of children through Mr. Juan Hart and Healthy FET Kids - Low Cost Blood Screenings San Juan Regional Medical Center has expanded mental health services to improve access to behavioral health care. It is not possible, from a financial or human resource standpoint to address all the issues in the CHNA therefore we chose the top issues that we felt we could impact. THE NEEDS NOT BEING ADDRESSED ARE SUICIDE PREVENTION. SCHEDULE H, PART V, SECTION B, LINE 16A-16C WEBSITE URL WHERE YOU CAN FIND THE FAP, FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP: http://www.sanjuanregional.com/EnglishForms SCHEDULE H, PART V, SECTION B, LINE 22D Patients who are eligible for assistance under the financial assistance policy will not be charged more than the amounts generally billed (AGB) for a Medicare fee-for-service beneficiary. AGB is determined by multiplying the gross charges for any emergency or other medically necessary care it provides by AGB percentages, which are based on claims allowed by Medicaid, in combination with Medicare fee-for-service and all private health insurers. 23 SJRMC Cardiology 407 S Schwartz Suite 202 Farmington NM 87401 Medical Clinic SJRMC Internal Medicine 407 S Schwartz Suite 201 Farmington NM 87401 Medical Clinic San Juan Neurodiagnostic Center 407 S Schwartz Suite 101 Farmington NM 87401 Medical Clinic San Juan Pediatrics 407 S Schwartz Suite 102 Farmington NM 87401 Medical Clinic Four Corners Neurosurgery 407 S Schwartz Suite 101 Farmington NM 87401 Medical Clinic SJRMC Midwifery Clinic 655 West Pinon Farmington NM 87401 Medical Clinic Outpatient Behavioral Health Clinic 555 S Schwartz Farmington NM 87401 Medical Clinic Urgent Care Center 4820 E Main Street Farmington NM 87402 Medical Clinic SJR Wound Care Center 4251 English Road Farmington NM 87402 Medical Clinic SJR Cancer Treatment Center 731 W Animas Street Farmington NM 87401 Medical Clinic SJRMC Outpatient Diagnostic Center 2300 E 30th Street Bldg C Farmington NM 87401 Medical Clinic SJRMC EMS Station- Medic #1 730 S Lake Street Farmington NM 87401 Medical Clinic SJRMC EMS Station- Medic #2 902 W Broadway Bloomfield NM 87412 Medical Clinic SJRMC EMS Station- Medic #3 484 S Oliver Street Aztec NM 87410 Medical Clinic SJRMC EMS Station- Medic #4 4 CR 3660 Kirtland NM 87117 Medical Clinic SJRMC EMS Station- Medic #5 3782 English Road Farmington NM 87402 Medical Clinic SJRMC EMS Station- Medic #6 2014 E 16th Street Farmington NM 87401 Medical Clinic SJRMC EMS Station- Medic #10 737 W Animas Street Farmington NM 87401 Medical Clinic SJRMC Aztec Clinic 120 Llano Street Aztec NM 87410 Medical Clinic General Surgery Clinic 630 W Maple Farmington NM 87401 Medical Clinic SJRMC Audiology 816 W Maple Farmington NM 87401 Medical Clinic SJRMC Outpatient Rehabilitation 301 S Auburn Ave Farmington NM 87401 Medical Clinic SJRMC Pediatric Outpatient Rehab 810 W Maple Farmington NM 87401 Medical Clinic SCHEDULE H, PART I, LINE 7 THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINES 7A - 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. SCHEDULE H, PART I, LINE 7G San Juan Regional Medical Center (SJRMC) provides numerous subsidized health services to the community. Included in the subsidized services are freestanding physician clinics which allow sjrmc to bring in more specialties and better serve the community. the nearest city that would have similar services that the clinics offer would be about an hour away. there are some independently owned clinics within this community, but have very stringent guidelines on which patients they will take. The total costs related to the physician clinics included on line 7g are $33,927,217 with direct offsetting revenue of $21,487,861, resulting in a net community benefit expense of $12,439,356. SCHEDULE H, PART I, LINE 7, COLUMN F BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 BUT EXCLUDED FOR PURPOSES OF CALCULATING PERCENTAGES IN THIS COLUMN EQUAL $16,269,543. SCHEDULE H, PART III, Section A, LINE 2 The Organization analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. SCHEDULE H, PART III, Section A, LINE 3 The amount on line 3 is an estimate based on management's belief of the percentage of additional financial assistance cost if the patients would complete the financial assistance application. This amount is currently estimated between 45-60%, what is included in our bad debt. SCHEDULE H, PART III, Section A, LINE 4 The footnote to the organization's financial statements that describes bad debt expenses is located in footnote 1 on page 7 of the attached financial statements. SCHEDULE H, PART III, Section B, LINE 8 The amount of Medicare shortfall reported on Line 7 is $8,955,309. This amount is a result of the total revenue and allowable cost calculation on our FY 16 cost report. The hospital's actual expenses are entered into the cost report software and the allowable costs are determined by Medicare Regulations. This Medicare shortfall should be treated as community benefit because, absent this program, many individuals would qualify for financial assistance and other needs- based programs. By accepting payments below cost to treat these individuals, the burdens of the government are relieved, and the amount spent to cover the Medicare shortfall is money not available to cover financial assistance and other community benefit needs. SCHEDULE H, PART III, Section C, LINE 9b San Juan Regional Medical Center's (SJRMC) policy on patient account collections states "SJRMC will not attempt to collect from a patient who is applying for the San Juan County Indigent Fund as long as the patient is cooperating with the application process". The policy also states "SJRMC will not collect from a patient applying for the community service fund (Financial Assistance) as long as the patient is cooperating with the application process." SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: A community health needs assessment (CHNA) is conducted by San Juan Regional Medical Center to determine the health needs for San Juan County and the four corners region as perceived by those served by the hospital. The CHNA is conducted via telephone surveys in both English and Spanish, interviews conducted with Native American respondents, key shareholders in the provision of health care in San Juan County, and a series of focus groups. The survey is also shared with key community groups in a series of open forums. The most recent CHNA occurred in CY 2014 (FY 2015). The needs which were identified from this survey include access to health care services, cancer, dementias, including Alzheimer's disease, diabetes, disability, family planning & infant health, heart disease & stroke, immunization & infectious diseases, injury & violence prevention, mental health & mental disorders, nutrition, physical activity & weight, oral health, respiratory diseases, sexually transmitted diseases, substance abuse, and tobacco use. The San Juan Regional Medical Center Board of Directors and Hospital Administration conducts the survey for the purpose of determining how best to direct resources to improve the health of the four corners with three goals in mind -to improve residents' health status, increase their life spans, and elevate their overall quality of life - to reduce health disparities among residents by identifying population segments who are most at-risk for various diseases and injuries. Intervention plans aimed at targeting these individuals are also developed to combat some of the socio-economic factors which have historically had a negative impact on residents' health - to increase accessibility to preventative services for all community residents, more accessible preventive services will prove beneficial in accomplishing the first goal (improving health status, increasing life spans, and elevating quality of life), as well as lowering the costs associated with caring for late-stage diseases resulting from a lack of preventive care. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: San Juan Regional Medical Center employs a number of financial counselors and customer service representatives who work alongside patients to help them navigate their payment, billing and assistance options. Information is disseminated to patients through online and paper resources located throughout the hospital. A widely distributed brochure titled "Paying for Hospital Services at San Juan Regional Medical Center" is specifically designed to help patients understand their hospital bill and inform them of their options for payment and assistance including information on the availability of Indian Health Service Assistance, cash discounts, bill reduction through a Community service fund, special funds through the San Juan County Indignant Fund, or Medical Hardship Waivers. The Hospital's vision is to be known as the most personalized quality healthcare provider. San Juan Regional Medical Center is also a values-driven organization with a century of service to the Four Corners Region- driven by a simple, yet powerful principle, do the right thing for the patient, no matter what. An integral part of this sacred trust the community has in its hospital is ensuring that no patient feels alone and disconnected during and after their treatment. Therefore, it is in the spirit of the hospital's vision and mission to ensure that patients receive a high level of assistance when figuring out their bill and options. Not only does the hospital have financial counselors to educate its patients, it has an in-house medical advocacy service for healthcare program ("MASH") for self-pay individuals. Through the MASH program, patient advocates stand hand-in-hand with patients to explore every possibility of assistance policy. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: San Juan Regional Medical Center serves the Four Corners Region of the United States, which is mostly rural. The hospital is located in the region's largest city and only metropolitan area, which is Farmington, New Mexico. Other cities in the region include Cortez and Durango in Colorado, Monticello and Blanding in Utah, Kayenta and Chinle in Arizona, and Shiprock, Aztec, and Bloomfield in New Mexico. This region also includes the Navajo Nation. Statistics gathered for the hospital's community needs assessment in 2011 for San Juan County (Population 130,044)- which is the principal county served by San Juan Regional Medical Center- indicate the following population characteristics: Men 49.6%, Women 50.4%, Ages 18 and Under 29%, Ages 65+ 10.8%, White 51.6% American Indian and Alaka Native 36.6% Hispanic 19.1%. The median household income for San Juan County is $46,007. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: In the constant effort to meet community needs, SJRMC seeks to improve physician access through a vigorous recruiting program and to provide community education and many other community benefit programs. In Fiscal Year 2016, San Juan Regional Medical Center provided benefits to the indigent and broader community of over $26 million. true SEXUAL ASSAULT SERVICES 622 W MAPLE STE H FARMINGTON NM 87401 203187125 501(C)(3) 35000 program support SAN JUAN UNITED WAY 903 W APACHE FARMINGTON NM 87401 850165322 501(C)(3) 109915 program support SAN JUAN COLLEGE FDN - NURSING PROGRM 4601 COLLEGE BLVD FARMINGTON NM 87401 237272197 501(C)(3) 155000 bring health education to the local area San Juan County Partnership 3535 E 30th St 239 Farmington NM 87401 850408661 501(c)(3) 10000 4 Schedule I, Part I, Question 2 Organization's procedures for monitoring the use of grant funds: Event Funding/Sponsorship request guidelines: San Juan Regional Medical Center (SJRMC) recognizes the value of community partnerships and, on a limited basis, offers support to its community partners by sharing our resources including the time and talent of our physicians and employees, as well as our financial and in-kind support. San Juan Regional Medical Center has established criteria to ensure alignment with our mission and to allow us to strategically focus our limited resources in order to maximize their impact. Sponsorship requests are evaluated based on, but not limited to, the following criteria: - alignment with SJRMC's mission to personalize healthcare and create enthusiasm and vitality in healing - alignment and opportunity to promote strategic service lines and business objectives - community and neighborhood development - magnitude of impact and reach (number of individuals served) - depth and breadth of partnership with requesting organization. X true true X X X X false true false false false false false true false DAMON KALCICH VICE CHIEF OF STAFF 362437 0 89664 0 131 0 12257 0 21779 0 486268 0 0 0 RICK WALLACE CEO 453082 0 113568 0 147815 0 54811 0 21695 0 790971 0 134535 0 JOHN BUFFINGTON COO 315844 0 82020 0 112129 0 38245 0 21695 0 569933 0 96972 0 KAREN MILLER CFO 177241 0 17500 0 133 0 3390 0 8974 0 207238 0 0 0 KOIJAN KAINTH PHYSICIAN 1048053 0 80770 0 177 0 3965 0 8674 0 1141639 0 0 0 FARAZ SANDHU PHYSICIAN 577274 0 282779 0 1050 0 16750 0 21544 0 899397 0 0 0 CHARLES WILKINS PHYSICIAN 621886 0 30281 0 1350 0 18550 0 20487 0 692554 0 0 0 VERRAD NYAME PHYSICIAN 396517 0 35000 0 131 0 0 0 13295 0 444943 0 0 0 MICHAEL WEST PHYSICIAN 609615 0 30000 0 349 0 1459 0 21779 0 663202 0 0 0 SUZANNE SMITH CHIEF NURSING OFFICER 214737 0 56489 0 1043 0 26926 0 21779 0 320974 0 0 0 SCHEDULE J, PART I, LINE 1a Information Regarding Benefits Provided: The CEO is reimbursed for country club dues which are used for business purposes and are nontaxable. SCHEDULE J, PART I, LINE 4B Supplemental nonqualified plan: San Juan Regional Medical Center (sjrmc) has a 457(F) deferred compensation plan that allows certain executives to contribute money on a pre-tax basis into investments and to accumulate tax-deferred earnings. The following pre-tax calendar year 2015 contributions to the 457(F) plan are included in schedule J, Part II, column (C) as deferred compensation: John Buffington $19,695 Karen Miller $2,760 Suzanne Smith $10,921 Rick Wallace $36,261 During 2015, the following individuals became fully vested and received a distribution from the 457(F) plan. The distributions are included in schedule J, Part II, column (B)(iii) as other reportable compensation. John Buffington $110,977 Rick Wallace $134,535 Schedule J, Part I, line 7 Explanation of non-fixed payments: Management incentive plan- sjrmc has a senior management incentive compensation plan for selected senior management positions. An award target is established for each participant. Performance is based on eight goals, two of which are hospital excess of revenues over expenses percentage and total hospital earnings. The award is a percentage of base pay if certain targets are met. Physician incentive plan- Physicians incentives are performance based and Relative Value Units are used as a measure. A CITY FARMINGTON NEW MEXICO 856000129 311428AZ9 2004-03-25 16982883 CONSTRUCTION OF TOWER/NEW EQUIP false false false B CITY FARMINGTON NEW MEXICO 856000129 311428BNS 2007-06-28 12290518 CONSTRUCTION OF CANCER TRMT CTR false false false C NEW MEXICO HOSPITAL EQUIPMENT LOAN COUNCIL 840426875 2010-12-21 25773000 REFUND 2004B, FINANCE EQUIP/COST false false false A 3854830 0 17087788 0 0 0 339658 0 0 16748130 0 0 2007 false false true true B 3869256 0 12457932 0 151201 0 245810 0 0 12060921 0 0 2010 false false true true C 13114750 0 25773063 0 0 0 205429 0 0 10565327 15002307 0 2011 true false true true A false false false false 0.00000 0.00000 0.00000 false false 0.00000 false true B false false false false 0.00000 0.00000 0.00000 false false 0.00000 false true C false false false false 0.00000 0.00000 0.00000 false false 0.00000 false true A true false false 0 false 0 false true B true false false 0 false 0 false true C false false false false true false 0 false 0 false true A true B true C true schedule k, part ii, line 3 THE EXCESS OF THE TOTAL PROCEEDS ON PART II, LINE 3 OVER ISSUE PRICE ON PART I, COLUMN E IS DUE TO INVESTMENT EARNINGS. schedule k, part I, LINE C THE 2010A LEASE PROJECT OBLIGATION PORTION OF THIS ISSUE IN THE AMOUNT OF $8,103,000 HAS NOT BEEN DESIGNATED AS A QUALIFIED TAX-EXEMPT OBLIGATION. THESE ARE BUILD AMERICA BONDS. anna buffington family member of officer 152304 employee pay false X 1 372472 fair market value false true false Schedule M, Part I, Column B Non-cash contributions: The number in column (b) represents the number of contributions received. FORM 990, PART I, LINE 6 VOLUNTEERS: SJRMC HAS A TOTAL OF 200 VOLUNTEERS THAT PROVIDE SERVICE TO THE FOLLOWING AREAS: ADMINISTRATIVE SUPPORT, CANCER TREATMENT CENTER, CARDIAC REHABILITATION, COURIER/PATIENT TRANSPORT, CRAFTY CREATIONS, DIETARY, GIFT MARKET, INFORMATION DESK, MAIL CALL, MEDICAL RECORDS AND AUXILIARY MEMBERSHIP. FORM 990, PART III, LINE 4A Program Service cont. San Juan Regional Medical center (sjrmc) is a modern acute-care hospital located in one of the most rural areas of the American southwest, San Juan County, New Mexico. A 2010 estimate of the population of San Juan county shows the county population has grown 14.3% from the year 2000 to 2010 and now numbers approximately 130,044, 37% of which is American Indian and alaska native persons. SJRMC is a sole community provider and disproportionate share hospital providing needed healthcare to residents of the four corners region of New Mexico, Arizona, Utah and Colorado. San Juan Regional Medical Center's mission is to personalize healthcare and create enthusiasm and vitality in healing. Our core values are actively taught, and reinforced to staff, management, and physicians so that the organization may achieve excellence and consistency in patient care. SJRMC is a community governed hospital that was founded in 1910 by Doctors A M Smith and G W Sammons. The hospital corporation is an advisory body composed of up to three representatives from each of 90 non-profit organizations in San Juan County. The corporation meets quarterly, and at their annual meeting, they nominate and elect 9 members to the governing board of directors. the corporation receives reports from the board of directors and hospital administration on hospital operations, including quality and finance and provides feedback on community health issues. SJRMC provides medical, surgical, pediatrics, oncology, obstetrics, cardiology, and behavioral health inpatient care. Ambulatory care includes day surgery, urgent care, outpatient diagnostic and treatment services. SJRMC is a level III trauma center that provides ground ambulance and air ambulance service with a helicopter and a fixed wing aircraft as well as services through its emergency department to all persons regardless of their ability to pay. Some of our outpatient Services are physician clinics specializing in cardiology, behavioral health, internal medicine, neurosurgery, neurodiagnostics, urgent care center and pediatrics. our financial and in-kind contributions went to various local charities such as navajo ministries, family crisis center, local school districts, senior centers and totah behavioral health. The other community services noted above provide care for surgery, gastrointestinal, orthopedics, oncology, neuro and cardiac rehab. Form 990, Part VI, Section A, Line 6 & 7A CLASSES OF MEMBERS OR STOCKHOLDERS: SAN JUAN REGIONAL MEDICAL CENTER IS A COMMUNITY-GOVERNED HOSPITAL. THE HOSPITAL CORPORATION IS AN ADVISORY BODY COMPOSED OF TWO REPRESENTATIVES FROM ABOUT 90 NON-PROFIT ORGANIZATION MEMBERS IN SAN JUAN COUNTY. AFTER TEN YEARS OF SERVICE AS A REPRESENTATIVE, AN INDIVIDUAL MAY BE DESIGNATED BY THE CORPORATION AS A SENIOR CORPORATE DELEGATE AND SHALL NO LONGER BE CONSIDERED TO BE THE REPRESENTATIVE OF THE MEMBER ORGANIZATION. THE MEMBER ORGANIZATION MAY THEN DESIGNATE ANOTHER REPRESENTATIVE IN ADDITION TO THE SENIOR CORPORATE DELEGATE. THE HOSPITAL CORPORATION MEETS QUARTERLY AT THEIR ANNUAL MEETING, IN WHICH THEY NOMINATE AND ELECT NINE VOTING MEMBERS TO SJRMC'S BOARD OF DIRECTORS. OF THE NINE, THREE MUST BE ELECTED FROM THE MEMBER REPRESENTATIVES OR SENIOR CORPORATE DELEGATES. IN ADDITION TO THE NINE ELECTED DIRECTORS, THE SJRMC CHIEF OF THE STAFF AND VICE CHIEF OF STAFF AND A HOSPITAL AUXILIARY APPOINTEE ALSO SERVE AS SJRMC DIRECTORS FOR A TOTAL OF TWELVE VOTING MEMBERS OF THE BOARD OF DIRECTORS. Form 990, Part VI, Section B, line 11b PROCESS TO REVIEW THE FORM 990: THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM BASED ON DATA PROVIDED BY MANAGEMENT. A DRAFT COPY OF THE 990 IS PROVIDED TO MANAGEMENT FOR REVIEW AND A MEETING IS CONDUCTED BY THE ACCOUNTING FIRM TO REVIEW THE RETURN IN DETAIL. ANY QUESTIONS ARE ADDRESSED AND ANY NECESSARY CHANGES ARE MADE TO THE RETURN. THE FINAL DRAFT OF THE FORM 990 IS PROVIDED TO THE AUDIT COMMITIEE ALONG WITH A BRIEF EDUCATION SESSION CONDUCTED BY THE ACCOUNTING FIRM TO DISCUSS THE HIGHLIGHTS OF THE FORM. THE FINAL DRAFT OF THE FORM 990 IS THEN PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING. Form 990, Part VI, Section B, line 12c PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: SAN JUAN REGIONAL MEDICAL CENTER HAS A CONFLICT OF INTEREST POLICY THAT EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE IS REQUIRED TO FILL OUT ON AN ANNUAL BASIS. THIS CONFLICT OF INTEREST POLICY SPECIFICALLY ASKS QUESTIONS REGARDING BUSINESS AND PERSONAL RELATIONSHIPS THAT THEY MAY HAVE WITH ANY OTHER BOARD MEMBER, OFFICER AND KEY EMPLOYEE OF ANY BUSINESS THAT DEALS WITH SAN JUAN REGIONAL MEDICAL CENTER OR ANY OF ITS AFFILIATES. IF A CONFLICT IS IDENTIFIED, IT MUST BE REPORTED TO THE COMPLIANCE OFFICER, AND IF IT CONSTITUTES A BREACH OF EMPLOYMENT, IT MAY LEAD TO DISCIPLINARY ACTION. Form 990, Part VI, Section B, line 15a & 15b DESCRIBE PROCESS FOR DETERMINING COMPENSATION: THE BOARD OF DIRECTORS FOR SAN JUAN REGIONAL MEDICAL CENTER USES THE FOLLOWING COMPARABILITY DATA WHEN DETERMINING THE COMPENSATION FOR THE CEO AND SENIOR MANAGEMENT. REGIONAL/LOCAL AREA NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS OF COMPARABLE SIZE, NATIONAL NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS OF COMPARABLE SIZE, AND OTHER RELEVANT COMPARATORS (EG, FOR PROFIT HEALTHCARE AND/OR GENERAL INDUSTRY ORGANIZATIONS) OF COMPARABLE SIZE AND COMPLEXITY. ADDITIONALLY, THE BOARD BI-ANNUALLY HAS AN INDEPENDENT OUTSIDE FIRM COMPARE THE CEO'S COMPENSATION WITH OTHER HEALTHCARE ORGANIZATIONS TO REMAIN COMPETITIVE. THE PROCESS WAS LAST COMPLETED ON JULY 10, 2015. THE PROCESS IS DOCUMENTED IN THE BOARD MINUTES WHEN PRESENTED TO THE INDIVIDUALS. Form 990, Part VI, Section C, line 19 GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC: SAN JUAN REGIONAL MEDICAL CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. Form 990, Part VII The compensation reported on Part VII, line 1 for Damon Kalcich is from his current employment with sjrmc, not for services rendered as a board member. AMENDED RETURN THE 2015 990 IS BEING AMENDED TO INCLUDE ADDITIONAL COMMUNITY BENEFIT EXPENSE ON FORM 990, SCHEDULE H, PART I, LINE 7. PRIOR TO THE AMENDMENT, THE PHYSICIAN CLINICS WERE NOT INCLUDED AS A SUBSIDIZED SERVICE ON SCHEDULE H, PART I, LINE 7G. THE COSTS, DIRECT OFFSETTING REVENUE AND NUMBER OF PERSONS SERVED ARE NOW PROPERLY REFLECTED ON LINE 7G. A NARRATIVE HAS ALSO BEEN ADDED TO FORM 990, SCHEDULE H, PART VI TO DESCRIBE THE PHYSICIAN CLINICS THAT ARE INCLUDED AS A SUBSIDIZED HEALTH SERVICE AND THE COSTS ATTRIBUTABLE TO THE CLINIC. SAN JUAN HEALTH PARTNERS INC 801 WEST MAPLE STREET FARMINGTON NM 87401 272367549 HEALTHCARE NM 501(C)(3) LINE 3 SJRMC true SAN JUAN REGIONAL REHABILITATION HOSP 525 SOUTH SCHWARTZ 2 FARMINGTON NM 87401 850441767 HEALTHCARE NM 501(C)(3) LINE 3 SJRMC true AUXILIARY OF SAN JUAN REGIONAL MED CTR 801 WEST MAPLE STREET FARMINGTON NM 87401 237164296 HOSP SUPPORT NM 501(C)(3) LINE 11C NA false SJR HOLDING COMPANY INC 801 W MAPLE STREET FARMINGTON NM 87401 201126483 SUPPORT SERVICES NM SJRMC C-CORP 1104373 2469792 1.00000 true false false true true false false false false false false false false false true false false true false false AUXILIARY OF SAN JUAN REGIONAL MED CTR C 83912 financials SAN JUAN REGIONAL REHABILITATION HOSPITAL D 114325 interco amount SAN JUAN REGIONAL REHABILITATION HOSPITAL Q 144000 interco amount