SAN LUIS VALLEY REGIONAL MEDICAL CENTER: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- SAN LUIS VALLEY REGIONAL MEDICAL CENTER (EIN 84-0255530)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-11
- IRS object ID
- 201641329349303554
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-11T14:31:45-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 South Tejon Suite 800 | AddressLine1Txt |
| City | Colorado Springs | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 809039848 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 840255530 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LUTHERAN HOSP ASSOC OF THE SAN LUIS VALLEY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % THE ORGANIZATION | InCareOfNm |
| Business Name Control | LUTH | BusinessNameControlTxt |
| Phone | 7195892511 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 106 BLANCA AVENUE | AddressLine1Txt |
| City | ALAMOSA | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 81101 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KONNIE MARTIN | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7195892511 | PhoneNum |
| Signature | 2016-05-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Rita F Worster CPA | PreparerPersonNm |
| PTIN | P00290681 | PTIN |
| Phone | 7194714290 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAN LUIS VALLEY HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KONNIE MARTIN CEO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 106 BLANCA AVENUE | AddressLine1Txt |
| City | ALAMOSA | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 81101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $80,512,717 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SANLUISVALLEYHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1928 | FormationYr |
| Legal Domicile State | CO | LegalDomicileStateCd |
| Activity Or Mission | TO BE A PREMIER, FULLY INTEGRATED RURAL HEALTH CARE SYSTEM PROVIDING EXCEPTIONAL PATIENT-CENTERED SERVICES TO THE SAN LUIS VALLEY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 788 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,346,376 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,350,586 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $72,868,307 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $78,441,288 | CYProgramServiceRevenueAmt |
| PY Investment Income | $200,907 | PYInvestmentIncomeAmt |
| CY Investment Income | $54,705 | CYInvestmentIncomeAmt |
| PY Other Revenue | $369,334 | PYOtherRevenueAmt |
| CY Other Revenue | $405,530 | CYOtherRevenueAmt |
| PY Total Revenue | $74,784,924 | PYTotalRevenueAmt |
| CY Total Revenue | $80,252,109 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $7,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $21,072 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $41,213,971 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $42,467,097 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $225,353 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $32,701,431 | PYOtherExpensesAmt |
| CY Other Expenses | $34,501,920 | CYOtherExpensesAmt |
| PY Total Expenses | $73,922,402 | PYTotalExpensesAmt |
| CY Total Expenses | $76,990,089 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $862,522 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,262,020 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $69,310,715 | TotalAssetsBOYAmt |
| Total Assets EOY | $73,754,094 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $23,646,974 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $24,770,669 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $45,663,741 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $48,983,425 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AN UNCONDITIONAL COMMITMENT TO EXCELLENCE BY PROVIDING QUALITY, COMPASSIONATE CARE GUIDED BY OUR VALUES. WE ACCEPT RESPONSIBILITY FOR PROVIDING SERVICES TO OUR COMMUNITY THAT ARE OF THE HIGHEST CALIBER OF SERVICE AND STANDARD PERFORMANCE, WHILE DEMONSTRATING OUR ADOPTED VALUES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $61,148,976 | ExpenseAmt |
| Grant | $21,072 | GrantAmt |
| Revenue | $78,618,216 | RevenueAmt |
| Desc | SAN LUIS VALLEY HEALTH WAS FORMED JULY 1, 2013. PRIOR TO THE MERGER THAT CREATED SAN LUIS VALLEY HEALTH IT OPERATED AS AN INDEPENDENT, NOT-FOR-PROFIT HOSPITAL FOR OVER 83 YEARS. THE MERGER BROUGHT TOGETHER SAN LUIS VALLEY REGIONAL MEDICAL CENTER AND CONEJOS COUNTY HOSPITAL. PRIOR TO THE MERGER, CONEJOS COUNTY HOSPITAL HAD BEEN MANAGED BY SAN LUIS VALLEY REGIONAL MEDICAL CENTER SINCE 2003. SLV HEALTH SERVES THE SIX COUNTIES OF THE SAN LUIS VALLEY WITH A POPULATION OF JUST UNDER 50,000 AND AN AREA OF OVER 8,200 SQUARE MILES; LARGER THAN THE STATE OF NEW JERSEY. SLV HEALTH EMPLOYS ALMOST 600 AND IS THE LARGEST EMPLOYER IN THE SAN LUIS VALLEY. THE TRUSTEES, PROVIDERS AND STAFF OF SLV HEALTH ARE UNDERSTANDABLY PROUD OF THEIR TRADITION FOR PROVIDING CARE AND SERVICE TO OUR COMMUNITIES. SERVING OUR LOW-INCOME COMMUNITY MEANS THAT WE HAVE A CHALLENGING PAYER MIX WITH HIGH MEDICAID, UNINSURED AND RELATIVELY LOW COMMERCIAL PERCENTAGES. THIS HAS LED TO OUR ORGANIZATION BEING RESOURCEFUL, CREATIVE AND INNOVATIVE IN ORDER TO CONTINUE SERVICE WITH POSITIVE OPERATING MARGINS. SLV HEALTH'S OPERATING EXPENSE PER ADJUSTED PATIENT DAY IS $2,999 COMPARED TO A COLORADO AVERAGE OF $3,367 AND A RURAL HOSPITAL AVERAGE OF $3,753. OVER THE LAST NINE YEARS, OUR GROSS REVENUE HAS INCREASED FROM $20M TO $60M AND THE NUMBER OF PATIENTS SERVED HAS EXPANDED SEVERAL FOLD. NEW SERVICES HAVE BEEN ADDED IN MEDICATION ONCOLOGY, INPATIENT REHABILITATION, SLEEP DISORDERS, WOMEN'S IMAGING CENTER, FIXED WING MEDICAL TRANSPORTATION, GENETIC COUNSELING, BEHAVIORAL HEALTH, CARDIOLOGY, CHIROPRACTIC, ONCOLOGY/INFUSION THERAPY AND MORE. | Desc |
| Total Program Service Expenses | $61,148,976 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 94 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 788 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THE ORGANIZATION | PersonNm |
| Phone | 7195892511 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 106 BLANCA AVENUE | AddressLine1Txt |
| City | ALAMOSA | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 81101 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JAN GAY | ||||||||
| TRUSTEE | 2.0 | 2.0 | Yes (X) | $1,000 | $0 | $0 | ||
| KARLA HARDESTY | ||||||||
| PRESIDENT | 2.0 | 0.0 | Yes (X) | $2,250 | $0 | $0 | Yes (X) | |
| KENDAL KNAUS MD | ||||||||
| SECRETARY/TREASURER | 2.0 | 0.0 | Yes (X) | $53,600 | $0 | $0 | Yes (X) | |
| JIM EHRLICH | ||||||||
| VICE PRESIDENT | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| PATRICK CROWDER | ||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $800 | $0 | $0 | ||
| KATHY LORENZ | ||||||||
| TRUSTEE | 2.0 | 2.0 | Yes (X) | $600 | $0 | $0 | ||
| CHERI CROWDER | ||||||||
| TRUSTEE | 2.0 | 2.0 | Yes (X) | $1,000 | $0 | $0 | ||
| ROSALIE MARTINEZ | ||||||||
| TRUSTEE | 2.0 | 2.0 | Yes (X) | $800 | $0 | $0 | ||
| STEVEN W KITCHEN | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $458,425 | $0 | $27,252 | ||
| NUWAN PILAPITIYA | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $209,502 | $0 | $24,397 | ||
| SUSAN GEIGER | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $110,349 | $0 | $3,258 | ||
| DENNARD ELLISON | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $400,095 | $0 | $27,267 | ||
| DONALD SHAWCROFT | ||||||||
| TRUSTEE | 2.0 | 2.0 | Yes (X) | $600 | $0 | $0 | ||
| RICHARD MARTIN | ||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| KONNIE MARTIN | ||||||||
| CEO | 40.0 | 2.0 | $304,787 | $0 | $28,766 | Yes (X) | ||
| PATTI THOMPSON | ||||||||
| CNO | 40.0 | 0.0 | $182,968 | $0 | $14,885 | Yes (X) | ||
| GREG MCAULIFFE MD | ||||||||
| CMO | 40.0 | 0.0 | $293,393 | $0 | $28,225 | Yes (X) | ||
| SHANE MORTENSEN | ||||||||
| CFO | 40.0 | 1.0 | $171,740 | $0 | $25,008 | Yes (X) | ||
| KELLY GALLEGOS | ||||||||
| CCH ADMINISTRATOR | 40.0 | 0.0 | $129,520 | $0 | $25,338 | Yes (X) | ||
| ROBERT MARSHALL | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $370,595 | $0 | $26,877 | Yes (X) | ||
| DAVID GEIGER | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $392,774 | $0 | $27,252 | Yes (X) | ||
| CLIFFORD ROBBINS | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $332,502 | $0 | $15,938 | Yes (X) | ||
| CARISSA TRIPI | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $524,193 | $0 | $26,216 | Yes (X) | ||
| JAMES GRIGSBY | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $397,959 | $0 | $27,880 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,339,452 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $328,559 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 61 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CARETECH SOLUTIONS INC | |||||
| PO BOX 674271 | DETROIT | MI | 48267 | CONTRACT SERVICES | $1,321,077 |
| WEATHERBY LOCUMS | |||||
| PO BOX 972633 | DALLAS | TX | 75397 | CONTRACT LABOR | $562,711 |
| COMPHEALTH | |||||
| PO BOX 972651 | DALLAS | TX | 75397 | CONTRACT LABOR | $294,020 |
| MEDICUS HOSPITALISTS WEST LLC | |||||
| 22 ROULSTON ROAD | WINDHAM | NH | 03087 | CONTRACT SERVICES | $984,388 |
| INNOVA EMERGENCY MEDICAL ASSOCIATES | |||||
| PO BOX 912601 | DENVER | CO | 802912601 | CONTRACT LABOR | $739,503 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $9,085 | RelatedOrganizationsAmt |
| Government Grants | $678,647 | GovernmentGrantsAmt |
| All Other Contributions | $662,854 | AllOtherContributionsAmt |
| Total Contributions | $1,350,586 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 900099 | $32,138,339 | $32,138,339 |
| MEDICARE/MEDICAID | 900099 | $44,536,790 | $44,536,790 |
| ELECTRONIC HEALTH RECORD PAYMENTS | 900099 | $611,391 | $611,391 |
| AMBULANCE DISTRICT REVENUE | 621910 | $374,005 | $374,005 |
| 340B PAYMENTS | 900099 | $307,948 | $307,948 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $472,815 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $472,815 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $78,441,288 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $232,652 | TotalRevenueColumnAmt |
| Exclusion | $232,652 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $78,747 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $82,661 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$3,914 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,914 | TotalRevenueColumnAmt |
| Exclusion | -$3,914 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $177,947 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$177,947 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$177,947 | TotalRevenueColumnAmt |
| Exclusion | -$177,947 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| CAFETERIA SALES | 900099 | $179,077 | $179,077 | |
| LAUNDRY | 900099 | $33,522 | $33,522 | |
| ABSTRACTS | 900099 | $21,810 | $21,810 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $175,035 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $155,118 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $19,917 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $409,444 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $80,252,109 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $78,618,216 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $283,307 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,072 | TotalAmt |
| Program Services | $21,072 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,522,352 | TotalAmt |
| Program Services | $1,967,932 | ProgramServicesAmt |
| Management And General | $540,695 | ManagementAndGeneralAmt |
| Fundraising | $13,725 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,790,640 | TotalAmt |
| Program Services | $25,547,496 | ProgramServicesAmt |
| Management And General | $7,105,628 | ManagementAndGeneralAmt |
| Fundraising | $137,516 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,172,409 | TotalAmt |
| Program Services | $915,335 | ProgramServicesAmt |
| Management And General | $251,802 | ManagementAndGeneralAmt |
| Fundraising | $5,272 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,736,352 | TotalAmt |
| Program Services | $2,912,102 | ProgramServicesAmt |
| Management And General | $807,183 | ManagementAndGeneralAmt |
| Fundraising | $17,067 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,245,344 | TotalAmt |
| Program Services | $1,653,374 | ProgramServicesAmt |
| Management And General | $579,620 | ManagementAndGeneralAmt |
| Fundraising | $12,350 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,476 | TotalAmt |
| Management And General | $93,476 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,741 | TotalAmt |
| Management And General | $188,741 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,225 | TotalAmt |
| Management And General | $8,225 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,845,174 | TotalAmt |
| Program Services | $5,709,296 | ProgramServicesAmt |
| Management And General | $1,135,878 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,542 | TotalAmt |
| Management And General | $99,494 | ManagementAndGeneralAmt |
| Fundraising | $26,048 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,590,393 | TotalAmt |
| Program Services | $973,054 | ProgramServicesAmt |
| Management And General | $1,605,304 | ManagementAndGeneralAmt |
| Fundraising | $12,035 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,212,290 | TotalAmt |
| Program Services | $606,145 | ProgramServicesAmt |
| Management And General | $606,145 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,225,310 | TotalAmt |
| Program Services | $1,820,078 | ProgramServicesAmt |
| Management And General | $405,232 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $234,426 | TotalAmt |
| Program Services | $145,439 | ProgramServicesAmt |
| Management And General | $87,647 | ManagementAndGeneralAmt |
| Fundraising | $1,340 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,605 | TotalAmt |
| Program Services | $5,992 | ProgramServicesAmt |
| Management And General | $4,613 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $685,595 | TotalAmt |
| Program Services | $67,467 | ProgramServicesAmt |
| Management And General | $618,128 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,528,348 | TotalAmt |
| Program Services | $3,050,541 | ProgramServicesAmt |
| Management And General | $477,807 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $704,411 | TotalAmt |
| Program Services | $528,128 | ProgramServicesAmt |
| Management And General | $176,283 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $7,408,105 | $7,340,593 | $67,512 |
| PROVIDER FEES | $3,595,155 | $3,595,155 | |
| BAD DEBT | $4,269,693 | $4,269,693 | |
| COLLECTION EXPENSE | $376,128 | $376,128 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $400,303 | TotalAmt |
| Program Services | $20,084 | ProgramServicesAmt |
| Management And General | $380,219 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,990,089 | TotalAmt |
| Program Services | $61,148,976 | ProgramServicesAmt |
| Management And General | $15,615,760 | ManagementAndGeneralAmt |
| Fundraising | $225,353 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $397,727 | BOYAmt |
| EOY | $850,351 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,290,216 | BOYAmt |
| EOY | $15,884,099 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $144,538 | BOYAmt |
| EOY | $99,859 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,319,292 | BOYAmt |
| EOY | $12,308,490 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,112,397 | BOYAmt |
| EOY | $1,293,568 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,676,455 | BOYAmt |
| EOY | $1,661,158 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $67,890,805 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $37,759,464 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,961,958 | BOYAmt |
| EOY | $30,131,341 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,088,991 | BOYAmt |
| EOY | $10,107,403 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100 | BOYAmt |
| EOY | $100 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $197,866 | BOYAmt |
| EOY | $290,970 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,121,175 | BOYAmt |
| EOY | $1,126,755 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,310,715 | BOYAmt |
| EOY | $73,754,094 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,978,683 | BOYAmt |
| EOY | $7,818,653 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,081 | BOYAmt |
| EOY | $81,102 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,770,000 | BOYAmt |
| EOY | $13,175,000 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,399,493 | BOYAmt |
| EOY | $2,277,299 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,496,717 | BOYAmt |
| EOY | $1,418,615 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,646,974 | BOYAmt |
| EOY | $24,770,669 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,465,875 | BOYAmt |
| EOY | $48,692,461 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $197,866 | BOYAmt |
| EOY | $290,964 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,663,741 | BOYAmt |
| EOY | $48,983,425 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,310,715 | BOYAmt |
| EOY | $73,754,094 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,262,020 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$110,191 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $167,855 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (true) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $8,225 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $8,225 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | schedule c, Part II-B, Line 1g | FormAndLineReferenceDesc |
| Explanation | San Luis Valley Health received correspondence from the Colorado Health and Hospital Association and the American Hospital Association regarding their membership dues. A portion of their dues were attributable to lobbying. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $197,866 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $93,098 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $290,964 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $134,718 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $63,148 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $197,866 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $94,572 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $40,146 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $134,718 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $86,517 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $8,055 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $94,572 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $133,304 | BeginningYearBalanceAmt |
| Other Expenditures | $46,787 | OtherExpendituresAmt |
| End Year Balance | $86,517 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,432,682 | OtherCostOrOtherBasisAmt |
| Book Value | $3,432,682 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $37,475,856 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,756,701 | DepreciationAmt |
| Book Value | $18,719,155 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,162,158 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,414,569 | DepreciationAmt |
| Book Value | $5,747,589 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,820,109 | OtherCostOrOtherBasisAmt |
| Depreciation | $588,194 | DepreciationAmt |
| Book Value | $2,231,915 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $30,131,341 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT OBLIGATION | $270,531 |
| INTEREST RATE SWAP AGREEMENT | $1,123,934 |
| RELATED PARTY PAYABLE | $24,150 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,418,615 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $80,531,205 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$110,191 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $428,463 | OtherRevenueAmt |
| Revenue Not Reported | $318,272 | RevenueNotReportedAmt |
| Revenue Subtotal | $80,212,933 | RevenueSubtotalAmt |
| Other Revenues Not Included | $39,176 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $39,176 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $80,252,109 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $77,211,521 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $260,608 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $260,608 | ExpensesNotReportedAmt |
| Expenses Subtotal | $76,950,913 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $39,176 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $39,176 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $76,990,089 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART V, LINE 4 | SAN LUIS VALLEY HEALTH FOUNDATION (THE FOUNDATION) AND THE MEDICAL CENTER ARE FINANCIALLY INTERRELATED ORGANIZATIONS. THE MISSION OF THE FOUNDATION IS TO SUPPORT THE HEALTH CARE SERVICES OF THE MEDICAL CENTER AND THE COMMUNITIES IT SERVES. THE MEDICAL CENTER ACCOUNTS FOR ITS INTEREST IN THE NET ASSETS OF THE FOUNDATION IN A MANNER SIMILAR TO THE EQUITY METHOD. THE TEMPORARILY RESTRICTED NET ASSETS REPRESENTS THE INTEREST IN THE NET ASSETS OF THE FOUNDATION. WHEN ASSETS ARE TRANSFERRED TO THE SLVH BY THE FOUNDATION, THE CONTRIBUTIONS ARE RESTRICTED TO THE PURCHASE OF EQUIPMENT AND FACILITY EXPANSION. |
| Schedule D, Part X, Line 2 | 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 2d | change in fair market value of interest rate swap 74,755 change in fair market value of investment in foundation 93,100 rental expenses reclassed from expense to revenue 82,661 asset disposal reclassed from expense to revenue 177,947 Total 428,463 |
| Schedule D, Part XII, Line 2d | rental expenses reclassed from expense to revenue 82,661 asset disposal reclassed from expense to revenue 177,947 Total 260,608 |
| schedule d, part xi, line 4b | grant revenue classed as expense on financial statements 39,176 |
| schedule d, part xii, line 4b | grant revenue classed as expense on financial statements 39,176 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 40. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | false | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $154,861 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,706 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $141,155 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,792,863 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $25,793,887 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $998,976 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01370 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $594,822 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,030,920 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | -$436,098 | NetCommunityBenefitExpnsAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,542,546 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $26,838,513 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $704,033 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01560 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $150,658 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $150,658 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $223,044 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $223,044 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,879 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,879 | NetCommunityBenefitExpnsAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $91,883 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $91,883 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $467,464 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $467,464 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00650 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,010,010 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $26,838,513 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,171,497 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02210 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $75 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $75 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $223 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $223 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $535 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $535 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,169 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,169 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,002 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,002 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,269,693 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $13,941,423 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,855,583 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $85,840 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Teaching HospitalTeachingHospitalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | Facility Reporting GroupFacilityReportingGroupCd | Critical Access HospitalCriticalAccessHospitalInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Lutheran Hospital of SLV | |||||||||||
| 1 | 106 Blanca Avenue | Alamosa | CO | 81101 | www.sanluisvalleyhealth.org | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 1 | |
| Conejos County Hospital | |||||||||||
| 2 | 19021 US Hwy 285 | La Jara | CO | 81140 | www.sanluisvalleyhealth.org | Yes (X) | Yes (X) | 1 | Yes (X) | ||
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C FOR URL | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C FOR URL | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Care | 40. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250. | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | see part v, sec. c for url | FAPAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | see part v, sec. c for url | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART V, SECTION B, LINE 5 | Input from Representatives of the Community IN FEBRUARY 2013 EVENING MEETINGS IN ALAMOSA AND IN CONEJOS COUNTY WERE HELD. COMMUNITY MEMBERS WERE GIVEN TIME TO SHARE AND PRIORITIZE THE HEALTH ISSUES THAT THEY SEE IN THE SAN LUIS VALLEY. THE PROJECT MANAGEMENT MET WITH THE VARIOUS PUBLIC HEALTH AGENCIES TO DISCUSS STRATEGIES TO ADDRESS THE IDENTIFIED PRIORITY AREAS. SUGGESTIONS MADE WERE INTEGRATED INTO THE CHNA. |
| SCHEDULE H, PART V, SECTION B, LINE 6A | Other facilities involved with the CHNA THE CHNA FOR SLV HEALTH WAS CONDUCTED WITH CONEJOS COUNTY HOSPITAL (CCH). At the time of the CHNA, SLV Health and CCH were separate legal entities. The two entities merged July 1, 2013. |
| SCHEDULE H, PART V, SECTION B, LINE 7A | Describe how the CHNA is made Widely Available to the Public THE CHNA EXECUTIVE SUMMARY FOR SLV HEALTH IS AVAILABLE AT: http://www.sanluisvalleyhealth.org/sites/default/files/documents/Executive Summary_0.pdf |
| SCHEDULE H, PART V, SECTION B, LINE 10A | Implementation strategy for chna THE IMPLEMENTATION STRATEGY TO ADDRESS EACH COMMUNITY HEALTH NEED IDENTIFIED THROUGH THE CHNA IS AVAILABLE ON THE CHNA EXECUTIVE SUMMARY AT: http://www.sanluisvalleyhealth.org/sites/default/files/documents/Executive Summary_0.pdf |
| SCHEDULE H, PART V, SECTION B, LINE 11 | Needs Addressed from CHNA the most significant need addressed in the latest community health needs assessment was outreach to spanish speaking individuals in the community. Approximately 28.35% of the identified community speaks spanish and the hospital addressed this need by translating the financial assistance policy, brochures, signage and posters in the clinic and hospital into spanish. additionally, spanish language pamphlets are distributed in various public facilities, such as child care centers and food banks. |
| Schedule H, Part V, Section B, Line 16a | Describe how the FAP is made widely available to the public: The FAP for SLV Health is available at: http://www.sanluisvalleyhealth.org/sites/default/files/images/charity%20ca re%20english.pdf |
| Schedule H, Part V, Section B, Line 16C | Describe how a plain language summary of the fap is made widely available: A Plain Language Summary of the FAP for SLV Health is made available at: http://www.sanluisvalleyhealth.org/sites/default/files/images/charity%20ca re%20english.pdf |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Lutheran Hospital of SLV | ||||
| 2115 Stuart St | Alamosa | CO | 81101 | Physician Clinic |
| Lutheran Hospital of SLV | ||||
| 103 Chico Ct | Monte Vista | CO | 81144 | Physician Clinic |
| Lutheran Hospital of SLV - RHC | ||||
| 115 Main St | Antonito | CO | 81120 | Rural Health Clinic |
| Lutheran Hospital of SLV - RHC | ||||
| 509 Main St | La Jara | CO | 81140 | Rural Health Clinic |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 7 | Bad Debt Expense TOTAL BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR PRIOR TO THE PERCENTAGE CALCULATION = 4,269,693. 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 III, SECTION A, LINE 4 | Accounts Receivable ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, 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 UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS 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 ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS 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 OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE ADMINISTRATIVE REQUIREMENTS TO DETERMINE WHETHER PATIENTS WHO DO NOT COOPERATE WITH THE FINANCIAL ASSISTANCE PROCESS WOULD HAVE QUALIFIED FOR CHARITY CAN BE BURDENSOME, PARTICULARLY FOR SMALL BALANCES, SO A REASONABLE ESTIMATE, BASED ON BROAD DEMOGRAPHIC DATA, SHOULD BE SUFFICIENT TO JUSTIFY COMMUNITY BENEFIT TREATMENT. |
| SCHEDULE H, PART III, SECTION B, LINE 8 | Medicare THE COSTING METHODOLOGY TO DETERMINE LINE 6 WAS THE OVERALL FACILITY COST-TO-CHARGE RATIO. THE TIMING OF REVENUES FROM MEDICARE WILL NOT ALWAYS CORRESPOND TO THE TIMING OF THE EXPENSES. BASED ON MEDICARE COST REPORTS FILED AFTER THE END OF THE YEAR THERE MAY BE ADDITIONAL REVENUES DUE THE HOSPITAL OR AMOUNTS DUE BACK TO MEDICARE. THE SURPLUS OR (SHORTFALL) FOR THE LAST THREE YEARS IS AS FOLLOWS: 6/30/13 (2,322,085) 6/30/14 (1,203,813) 6/30/15 85,840 |
| SCHEDULE H, PART III, SECTION C, LINE 9B | Collections Process For patients who are known to qualify for financial assistance, the collection process follows these steps: a. Patients are contacted by brochure, mail and phone calls from a Financial Counselor, or the Patient Access Manager. Letters sent, brochures given and outbound phone calls and responses are noted in patient notes in the patient's profile. b. Patients who qualify for assistance will present information to the Financial Counselors who will update the registration section of the patient profile. Bilingual counselors or interpreters are available. c. Patients will be informed of their responsibility to pay co-payments or other sliding fee patient responsibility amounts. They will be informed in person and by phone whenever possible. Payment plans are always offered for patients who cannot afford their portion. d. Patients who do not pay their portion or co-payment will receive an invoice, printed in English and Spanish, directing them to pay or to call. If the patient calls and requests assistance from the Financial Counselor, they will be directed to the customer service phone number. e. Patients will receive up to 3 letters and 2 phone calls from a contracted, 3rd party vendor who have bilingual specialists. When 90 days have passed without any response from the patient, the account will be reviewed by the Patient Access Manager as well as the Patient Account Manager-Cash Posting, both members of the Business Revenue Cycle team. f. Upon review, if the portion is deemed to be the responsibility of the patient, the process toward collections will begin. A letter is sent to the patient from the third party company. The third party collection company follows legal proceedings at this point. |
| SCHEDULE H, PART VI, LINE 2 | Needs Assessment SLV HEALTH SUBMITS MANY GRANTS EVERY YEAR TO IMPROVE COMMUNITY HEALTH. EACH GRANT INCLUDES A SUMMARY OF KNOWN HEALTH DATA TO JUSTIFY THE NEED FOR THE FUNDS. AS A CONSEQUENCE WE ARE VERY ATTUNED TO OUR COMMUNITY HEALTH NEEDS. THROUGH COMMUICATION WITH PROVIDERS AND COMMUNITY NON-PROFITS, THIS NEED IS ADDRESSED AS REQURIRED. SAMPLE CURRENT AND PAST PROGRAMMING HAVE INCLUDED FREE COLONOSCOPIES, BREAST HEALTH RELATED TESTING, PSA TESTING AND MUCH MORE. |
| SCHEDULE H, PART VI, LINE 3 | Patient Education of Eligibility for Assistance SLV HEALTH PROVIDES A PATIENT FINANCIAL COUNSELOR WHO IDENTIFIES RESOURCES AND ELIGIBILITY ASSESMENT FOR PROGRAMS THROUGH FEDERAL AND STATE GOVERNMENT PROGRAMS, AS WELL AS GRANT FUNDED PROGRAM. WE ALSO PROVIDE A SLIDING FEE SCALE FOR SERVICE FOR THOSE SELF PAY PATIENTS NOT FITTING WITHIN ANY OF THESE PROGRAMS. PAY PLANS ARE ALSO SET UP FOR SELF PAY PATIENTS. |
| SCHEDULE H, PART VI, LINE 4 | Community Information SLV HEALTH SERVICES THE ENTIRE SAN LUIS VALLEY WHICH HAS A POPULATION OF NEARLY 50,000 RESIDENTS WITHIN 6 COUNTIES. THE SLV IS GEOGRAPHICALLY LIMITED DUE TO ITS SURROUNDING MOUNTAIN PASSES THAT SOMETIMES MAKES IT DIFFICULT TO TRAVEL ELSEWHERE WHEN CARE ISN'T AVAILABLE HERE. THE AVERAGE POVERTY LEVEL IS APPROXIMATELY 23.05% COMPARED TO COLORADO AVERAGE OF 12.9%. MEDIAN INCOME LEVELS ARE APPROXIMATELY $35,457 COMPARED TO $58,433 STATEWIDE. 61% OF HOUSEHOLDS IN THE SIX COUNTY AREA ARE MODERATE TO LOW INCOME. APPROXIMATELY 69% OF OUR PAYER MIX COMES FROM UNINSURED, MEDICARE/MEDICAID PATIENTS, CICP, OR SELF-PAY. |
| SCHEDULE H, PART VI, LINE 5 | Promotion of Community Health SLV HEALTH IS VERY ACTIVE IN THE COMMUNITY IN PROVIDING RESOURCES, INFORMATION AND DONATIONS TO PROMOTE HEALTHY LIVING IN SCHOOL, BUSINESS' AND THE GENERAL POPULATION. SLV Health Provides free or reduced rate physicals for students and other programs. SLV Health staff is very active in the community serving on related boards and providing other community benefit while on the hospital payroll. SLV Health provides many speaking tours on health related topics all over the San Luis Valley to inform and instruct residents on various issues. SLV Health has initiated teh GetHealthySLV.org website to inform community members of their health care resources and to learn about healthy habits. SLV health has also established three patient advisory councils to help us improve our healthcare services for diabetes, health disease and cancer. |
| SCHEDULE H, PART VI, LINE 6 | Affiliated Health Care System SLV HEALTH HAS A PROFESSIONAL AFFILIATION WITH CENTURA HEALTH SYSTEMS TO COORDINATE CARE FOR OUR SHARED PATIENTS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEVEN W KITCHEN | ||||||||||||||
| PHYSICIAN | $455,217 | $0 | $0 | $0 | $3,208 | $0 | $7,800 | $0 | $19,452 | $0 | $485,677 | $0 | $0 | $0 |
| NUWAN PILAPITIYA | ||||||||||||||
| PHYSICIAN | $209,340 | $0 | $0 | $0 | $162 | $0 | $6,438 | $0 | $17,959 | $0 | $233,899 | $0 | $0 | $0 |
| KONNIE MARTIN | ||||||||||||||
| CEO | $234,727 | $0 | $51,957 | $0 | $18,103 | $0 | $7,800 | $0 | $20,966 | $0 | $333,553 | $0 | $0 | $0 |
| PATTI THOMPSON | ||||||||||||||
| CNO | $166,615 | $0 | $16,012 | $0 | $341 | $0 | $5,577 | $0 | $9,308 | $0 | $197,853 | $0 | $0 | $0 |
| GREG MCAULIFFE MD | ||||||||||||||
| CMO | $263,830 | $0 | $26,055 | $0 | $3,508 | $0 | $7,800 | $0 | $20,425 | $0 | $321,618 | $0 | $0 | $0 |
| SHANE MORTENSEN | ||||||||||||||
| CFO | $156,221 | $0 | $15,200 | $0 | $319 | $0 | $5,365 | $0 | $19,643 | $0 | $196,748 | $0 | $0 | $0 |
| DENNARD ELLISON | ||||||||||||||
| PHYSICIAN | $381,619 | $0 | $0 | $0 | $18,476 | $0 | $7,800 | $0 | $19,467 | $0 | $427,362 | $0 | $0 | $0 |
| KELLY GALLEGOS | ||||||||||||||
| CCH ADMINISTRATOR | $117,456 | $0 | $11,969 | $0 | $95 | $0 | $4,151 | $0 | $21,187 | $0 | $154,858 | $0 | $0 | $0 |
| ROBERT MARSHALL | ||||||||||||||
| PHYSICIAN | $340,125 | $0 | $28,940 | $0 | $1,530 | $0 | $7,800 | $0 | $19,077 | $0 | $397,472 | $0 | $0 | $0 |
| DAVID GEIGER | ||||||||||||||
| PHYSICIAN | $342,823 | $0 | $30,823 | $0 | $19,128 | $0 | $7,800 | $0 | $19,452 | $0 | $420,026 | $0 | $0 | $0 |
| CLIFFORD ROBBINS | ||||||||||||||
| PHYSICIAN | $330,397 | $0 | $1,440 | $0 | $665 | $0 | $7,800 | $0 | $8,138 | $0 | $348,440 | $0 | $0 | $0 |
| CARISSA TRIPI | ||||||||||||||
| PHYSICIAN | $493,707 | $0 | $30,000 | $0 | $486 | $0 | $7,800 | $0 | $18,416 | $0 | $550,409 | $0 | $0 | $0 |
| JAMES GRIGSBY | ||||||||||||||
| PHYSICIAN | $378,629 | $0 | $0 | $0 | $19,330 | $0 | $7,800 | $0 | $20,080 | $0 | $425,839 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | CLINICAL KEY EMPLOYEES MAY EARN A PRODUCTIVITY BONUS. SENIOR MANAGEMENT IS ELIGIBLE FOR ANNUAL VARIABLE PAY UP TO 35% FOR CEO AND 20% FOR ALL OTHER SENIOR MANAGEMENT BASED UPON CRITERIA INCLUDING HOSPITAL WIDE MEASURES AND POSITION SPECIFIC GOALS. VARIABLE PAY IS AWARED AT THE DISCRETION OF THE BOARD FOR THE CEO AND THE CEO FOR ALL OTHER SENIOR MANAGEMENT. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| ALAMOSA COUNTY STATE OF COLORADO | ||||||||
| A | 846000733 | 011583AB7 | 2005-02-17 | $11,355,000 | HOSPITAL IMPROVEMENTS | false | false | false |
| ALAMOSA COUNTY STATE OF COLORADO | ||||||||
| B | 846000733 | 011583ab7 | 2007-04-26 | $6,505,000 | PURCHASE 2115 STUART&IMPROVEMENTS | false | false | false |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Bond DefeasedBondDefeasedAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Credit EnhancementCreditEnhancementAmt | Working Capital ExpendituresWorkingCapitalExpendituresAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | UnspentUnspentAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $3,230,000 | $0 | $11,565,184 | $0 | $0 | $0 | $362,859 | $0 | $0 | $11,202,325 | $0 | $0 | 2007 | false | false | Yes (true) | Yes (true) |
| B | $1,455,000 | $0 | $6,597,643 | $0 | $0 | $0 | $130,100 | $81,852 | $0 | $6,385,691 | $0 | $0 | 2009 | false | false | Yes (true) | Yes (true) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropPct | Remedial Action TakenRemedialActionTakenInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | false | Yes (true) | false | false | 0.01000 | 0.00000 | 0.01000 | Yes (true) | false | 0.00000 | false | Yes (true) |
| B | false | Yes (true) | false | false | 0.02414 | 0.00000 | 0.02414 | Yes (true) | false | 0.00000 | false | Yes (true) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Term Of HedgeTermOfHedgePct | Superintegrated HedgeSuperintegratedHedgeInd | Hedge TerminatedHedgeTerminatedInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Business Name Line1GICProviderName/BusinessNameLine1Txt | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MORGAN STANLEY CAP | |||||||||||||
| A | false | false | false | Yes (true) | Yes (true) | Yes (true) | 20.282 | false | false | false | 0 | false | Yes (true) |
| MORGAN STANLEY CAP | |||||||||||||
| B | false | false | false | Yes (true) | Yes (true) | Yes (true) | 15. | false | false | false | 0 | false | Yes (true) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (true) |
| B | Yes (true) |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PART IV, LINE 2C | FormAndLineReferenceDesc |
| Explanation | THE ALAMOSA COUNTY, CO SERIES 2005 BOND ARBITRAGE REBATE LIABILITY CALCULATION WAS PERFORMED ON SEPTEMBER 29, 2011. THE ALAMOSA COUNTY, CO SERIES 2007 BOND ARBITRAGE REBATE LIABILITY CALCULATION WAS PERFORMED ON MAY 15, 2012. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID GEIGER | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | EMPLOYEE | RelationshipDescriptionTxt |
| Transaction | WAGES | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART IV, COLUMN C | FormAndLineReferenceDesc |
| Explanation | BOARD MEMBER SUSAN GEIGER HAS A FAMILY RELATIONSHIP WITH HIGHEST COMPENSATED EMPLOYEE DAVID GEIGER. THE AMOUNT OF WAGES PAID CAN BE FOUND ON SCHEDULE J, PART II, LINE 10. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | BOARD OF DIRECTOR MEMBERS CHERI CROWDER AND PATRICK CROWDER HAVE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS PREPARED BY A THIRD PARTY ORGANIZATION, REVIEWED BY THE CFO AND CEO, AND APPROVED BY THE FINANCE COMMITTEE. THE BOARD OF DIRECTORS IS ALSO PROVIDED A COPY OF THE 990 FOR REVIEW PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | SAN LUIS VALLEY HEALTH HAS A CURRENT CONFLICT OF INTEREST POLICY THAT IS REVIEWED ANNUALLY BY THE BOARD OF TRUSTEES AND THE CEO. THE REVIEW PROCESS IS CONDUCTED FIRST WITH THE CEO AND THEN THE BOARD OF TRUSTEES. WHEN NECESSARY, THE POLICY HAS BEEN REVIEWED BY LEGAL COUNSEL. EACH YEAR TRUSTEES ARE ASKED TO REVIEW THE POLICY AND CONFIRM AND AMEND ANY POTENTIAL CONFLICT. THESE CONFLICTS ARE REVIEWED BY THE CEO AND THE ENTIRE BOARD. CONFLICTS ARE ROUTINELY DISCUSSED AND ARE THE RESPONSIBILITY OF ALL BOARD MEMBERS TO DISCLOSE; EITHER FOR THEMSELVES OR OTHERS. THE BOARD CHAIRMAN WILL MAKE A DECISION AS TO THE NATURE OF THE CONFLICT AND THE APPROPRIATE ACTION ACCORDING TO THE POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15A | HUMAN RESOURCES PROVIDES THE EXECUTIVE COMMITTEE OF THE BOARD WITH SALARY SURVEY DATA FROM CHA, AHA, AND HFMA. AFTER STUDYING THE DATA, THE EXECUTIVE COMMITTEE MAKES RECOMMENDATIONS TO THE FULL BOARD IN EXECUTIVE SESSION. THE FULL BOARD APPROVES THE CEO'S COMPENSATION. SLVH CONDUCTS AN ANNUAL EVALUATION AND QUARTERLY REVIEWS OF THE CEO'S PERFORMANCE, WHICH IS DOCUMENTED. COMPENSATION FOR THE CEO IS DETERMINED ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15B | HUMAN RESOURCES GATHERS COMPENSATION SURVEY DATA FROM CHA, AHA, AND HFMA. HUMAN RESOURCES MAKES RECOMMENDATIONS FOR OTHER OFFICERS' COMPENSATION AND PROVIDES SURVEY DATA TO THE CEO. THE CEO PERFORMS EVALUATIONS AND DETERMINES ALL OF THE WAGE CHANGES FOR THE OTHER OFFICERS ON AN ANNUAL BASIS. ALL CHANGES ARE DOCUMENTED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9 | CHANGE IN FAIR MARKET VALUE OF INTEREST RATE SWAP 74,755 CHANGE IN FAIR MARKET VALUE OF INVESTMENT IN FOUNDATION 93,100 Total 167,855 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SAN LUIS VALLEY HEALTH FOUNDATION | ||||||||||
| 106 BLANCA AVENUE | ALAMOSA | CO | 81101 | 203799814 | FUNDRAISING | CO | 501(C)(3) | LINE 7 | SLVH | Yes (true) |
| CONEJOS COUNTY HOSPITAL FOUNDATION | ||||||||||
| 19021 US HWY 285 | LA JARA | CO | 81140 | 320379184 | FUNDRAISING | CO | 501(C)(3) | LINE 7 | SLVH | Yes (true) |
| SLV MEDICAL CTR EMPLOYEE BEN TRUST | ||||||||||
| 106 BLANCA AVENUE | ALAMOSA | CO | 81101 | 840909851 | HEALTH PLAN | CO | 501(C)(9) | NA | false | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SLVRMC EMPLOYEE BENEFIT TRUST | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | M | TransactionTypeTxt |
| Involved | $3,659,274 | InvolvedAmt |
| Method Of Amount Determination | CASH PAID | MethodOfAmountDeterminationTxt |