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SAN LUIS VALLEY REGIONAL MEDICAL CENTER: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
SAN LUIS VALLEY REGIONAL MEDICAL CENTER (EIN 84-0255530)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-05-15
IRS object ID
201521359349307597
Schema version
2013v4.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2015-05-15T16:49:48-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1111 South Tejon Suite 800AddressLine1
CityColorado SpringsCity
StateCOState
ZIP Code809039848ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN840255530EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Lutheran Hosp Assoc of the San Luis ValleyBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of% THE ORGANIZATIONInCareOfNm
Business Name ControlLUTHBusinessNameControlTxt
Phone7195892511PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1106 Blanca AvenueAddressLine1
Address Line2SuiteAddressLine2
CityAlamosaCity
StateCOState
ZIP Code81101ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonShane MortensenPersonNm
Person TitleCFOPersonTitleTxt
Phone7194714290PhoneNum
Signature2015-05-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRita F Worster CPAPreparerPersonNm
PTINP00290681PTIN
Phone7194714290PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1San Luis Valley HealthBusinessNameLine1
FieldValueIRS element (for citing)
Principal OfficerKonnie Martin CEOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1106 Blanca AvenueAddressLine1
CityAlamosaCity
StateCOState
ZIP Code81101ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$74,843,283GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.sanluisvalleyhealth.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1928FormationYr
Legal Domicile StateCOLegalDomicileStateCd
Activity Or Missionto be a premier, fully integrated rural health care system providing exceptional patient-centered services to the san luis valley.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee726TotalEmployeeCnt
Total Volunteers14TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$710,660PYContributionsGrantsAmt
CY Contributions Grants$1,346,376CYContributionsGrantsAmt
PY Program Service Revenue$62,005,021PYProgramServiceRevenueAmt
CY Program Service Revenue$72,868,307CYProgramServiceRevenueAmt
PY Investment Income$211,199PYInvestmentIncomeAmt
CY Investment Income$200,907CYInvestmentIncomeAmt
PY Other Revenue$62,734PYOtherRevenueAmt
CY Other Revenue$369,334CYOtherRevenueAmt
PY Total Revenue$62,989,614PYTotalRevenueAmt
CY Total Revenue$74,784,924CYTotalRevenueAmt
PY Grants And Similar Paid$7,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$7,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$33,753,674PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$41,213,971CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$257,046CYTotalFundraisingExpenseAmt
PY Other Expenses$29,548,314PYOtherExpensesAmt
CY Other Expenses$32,701,431CYOtherExpensesAmt
PY Total Expenses$63,308,988PYTotalExpensesAmt
CY Total Expenses$73,922,402CYTotalExpensesAmt
PY Revenues Less Expenses-$319,374PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$862,522CYRevenuesLessExpensesAmt
Total Assets BOY$66,066,389TotalAssetsBOYAmt
Total Assets EOY$69,310,715TotalAssetsEOYAmt
Total Liabilities BOY$24,928,623TotalLiabilitiesBOYAmt
Total Liabilities EOY$23,646,974TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$41,137,766NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$45,663,741NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionAN 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 SrvcYes (true)SignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$55,935,591ExpenseAmt
Grant$7,000GrantAmt
Revenue$72,977,801RevenueAmt
DescSan Luis Valley Health was formed July 1, 2013. Prior to the merge that created San Luis Valley Health it operated as an independent, not-for-profit hospital for over 83 years. The merge brought together, San Luis Valley Regional Medical Center and Conejos County Hospital. Prior to the merge, 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$55,935,591TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (true)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document99IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee726EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonTHE ORGANIZATIONPersonNm
Phone7195892511PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1106 BLANCA AVENUEAddressLine1
CityAlamosaCity
StateCOState
ZIP Code81101ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtOfficerOfficerIndOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From Rltd OrgReportableCompFromRltdOrgAmt
JAN GAY
trustee2.02.0Yes (X)$3,000
karla hardesty
president2.0Yes (X)$1,000Yes (X)
KENDAL KNAUS MD
SECRETARY/TREASURER2.0Yes (X)$54,400Yes (X)
JIM EHRLICH
vice president2.0Yes (X)Yes (X)
PATRICK CROWDER
TRUSTEE2.0Yes (X)$957
KATHY LORENZ
TRUSTEE2.02.0Yes (X)$1,022
cheri crowder
TRUSTEE2.02.0Yes (X)$1,200
ROSALIE MARTINEZ
TRUSTEE2.02.0Yes (X)$900
steven w kitchen
physician40.0Yes (X)$508,749$31,675
nuwan pilapitiya
physician40.0Yes (X)$203,476$27,649
susan geiger
physician40.0Yes (X)$107,591$5,341
dennard ellison
physician40.0Yes (X)$408,503$31,350
donald shawcroft
trustee2.02.0Yes (X)
richard martin
trustee2.0Yes (X)
henry garvin
cch administrator - former40.0$190,511Yes (X)$79,477
konnie martin
ceo40.02.0$222,212Yes (X)$31,787
patti thompson
cno40.0$156,137Yes (X)$20,075
greg mcauliffe md
cmo40.0$253,770Yes (X)$33,250
shane mortensen
cfo40.01.0$146,467Yes (X)$24,612
kelly gallegos
cch administrator40.0$100,982Yes (X)$23,628
robert marshall
physician40.0$345,512$31,703Yes (X)
david geiger
PHYSICIAN40.0$374,977$31,675Yes (X)
clifford robbins
PHYSICIAN40.0$343,479$21,360Yes (X)$0
carissa tripi
physician40.0$521,149$15,713Yes (X)
james grigsby
physician40.0$398,883$15,308Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,344,877TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$424,603TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K51IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
caretech solutions inc
po box 674271DETROITMI48267CONTRACT SERVICES$1,517,640
weatherby locums
po box 972633DALLASTX75397contract labor$442,229
comphealth
po box 972651DALLASTX75397contract labor$281,581
nuance communications
po box 2561CAROL STREAMIL60132contract services$166,081
medical solutions
9101 western aveOMAHANE68114contract labor$161,208
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K10CntrctRcvdGreaterThan100KCnt
Related Organizations$43,734RelatedOrganizationsAmt
Government Grants$716,524GovernmentGrantsAmt
All Other Contributions$586,118AllOtherContributionsAmt
Total Contributions$1,346,376TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE900099$32,460,563$32,460,563
MEDICARE/MEDICAID900099$36,689,526$36,689,526
ELECTRONIC HEALTH RECORD PAYMENTS900099$2,826,356$2,826,356
AMBULANCE DISTRICT REVENUE621910$439,889$439,889
340B PAYMENTS900099$213,969$213,969

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$238,004TotalRevenueColumnAmt
Related Or Exempt Func Income$238,004RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$72,868,307TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$194,621TotalRevenueColumnAmt
Exclusion$194,621ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$92,029RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$48,491RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$43,538RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$43,538TotalRevenueColumnAmt
Exclusion$43,538ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$16,154OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$9,868OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$6,286OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,286TotalRevenueColumnAmt
Exclusion$6,286ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
CAFETERIA SALES900099$174,069$174,069
LAUNDRY900099$24,448$24,448
ABSTRACTS900099$22,482$22,482

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$104,797TotalRevenueColumnAmt
Related Or Exempt Func Income$87,012RelatedOrExemptFuncIncomeAmt
Exclusion$17,785ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$325,796OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$74,784,924TotalRevenueColumnAmt
Related Or Exempt Func Income$72,977,801RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$460,747ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$7,000TotalAmt
Program Services$7,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,669,725TotalAmt
Program Services$2,083,078ProgramServicesAmt
Management And General$572,127ManagementAndGeneralAmt
Fundraising$14,520FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$31,500,176TotalAmt
Program Services$24,572,882ProgramServicesAmt
Management And General$6,755,771ManagementAndGeneralAmt
Fundraising$171,523FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,103,480TotalAmt
Program Services$862,851ProgramServicesAmt
Management And General$234,704ManagementAndGeneralAmt
Fundraising$5,925FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,745,972TotalAmt
Program Services$2,926,591ProgramServicesAmt
Management And General$799,128ManagementAndGeneralAmt
Fundraising$20,253FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,194,618TotalAmt
Program Services$1,626,384ProgramServicesAmt
Management And General$554,129ManagementAndGeneralAmt
Fundraising$14,105FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$66,720TotalAmt
Management And General$66,720ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$147,205TotalAmt
Management And General$147,205ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$8,200TotalAmt
Management And General$8,200ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,475,750TotalAmt
Program Services$2,697,987ProgramServicesAmt
Management And General$2,777,763ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$144,586TotalAmt
Management And General$116,663ManagementAndGeneralAmt
Fundraising$27,923FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,454,384TotalAmt
Program Services$925,205ProgramServicesAmt
Management And General$1,526,942ManagementAndGeneralAmt
Fundraising$2,237FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,425,124TotalAmt
Program Services$712,562ProgramServicesAmt
Management And General$712,562ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,992,311TotalAmt
Program Services$1,816,685ProgramServicesAmt
Management And General$175,626ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$299,943TotalAmt
Program Services$194,092ProgramServicesAmt
Management And General$105,291ManagementAndGeneralAmt
Fundraising$560FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$14,540TotalAmt
Program Services$8,998ProgramServicesAmt
Management And General$5,542ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$729,696TotalAmt
Management And General$729,696ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,662,485TotalAmt
Program Services$2,194,880ProgramServicesAmt
Management And General$1,467,605ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$527,235TotalAmt
Program Services$375,519ProgramServicesAmt
Management And General$151,716ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$6,367,423$6,303,225$64,198
PROVIDER FEES$3,330,816$3,330,816
BAD DEBT$5,273,259$5,273,259
COLLECTION EXPENSE$395,474$395,474

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$386,280TotalAmt
Program Services$23,577ProgramServicesAmt
Management And General$362,703ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$73,922,402TotalAmt
Program Services$55,935,591ProgramServicesAmt
Management And General$17,729,765ManagementAndGeneralAmt
Fundraising$257,046FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,069,989BOYAmt
EOY$397,727EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$10,897,195BOYAmt
EOY$13,290,216EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$117,248BOYAmt
EOY$144,538EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,316,217BOYAmt
EOY$10,319,292EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$887,822BOYAmt
EOY$1,112,397EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,113,349BOYAmt
EOY$1,676,455EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$67,927,464LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$36,965,506LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$30,912,692BOYAmt
EOY$30,961,958EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$9,973,969BOYAmt
EOY$10,088,991EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$100BOYAmt
EOY$100EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$134,718BOYAmt
EOY$197,866EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,643,090BOYAmt
EOY$1,121,175EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$66,066,389BOYAmt
EOY$69,310,715EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,170,511BOYAmt
EOY$5,978,683EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$18,210BOYAmt
EOY$2,081EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,345,000BOYAmt
EOY$13,770,000EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,797,593BOYAmt
EOY$2,399,493EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,597,309BOYAmt
EOY$1,496,717EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$24,928,623BOYAmt
EOY$23,646,974EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$41,003,048BOYAmt
EOY$45,465,875EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$134,718BOYAmt
EOY$197,866EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$41,137,766BOYAmt
EOY$45,663,741EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$66,066,389BOYAmt
EOY$69,310,715EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$862,522ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$22,448NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$3,685,901OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (true)DirectContactLegislatorsInd
Direct Contact Legislators$6,150DirectContactLegislatorsAmt
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Total Lobbying Expenditures$6,150TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceDir. contact with legislators, their staff, gov't officials, etc.FormAndLineReferenceDesc
ExplanationSan 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

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$134,718BeginningYearBalanceAmt
Investment Earnings Or Losses$63,148InvestmentEarningsOrLossesAmt
End Year Balance$197,866EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$94,572BeginningYearBalanceAmt
Investment Earnings Or Losses$40,146InvestmentEarningsOrLossesAmt
End Year Balance$134,718EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$86,517BeginningYearBalanceAmt
Investment Earnings Or Losses$8,055InvestmentEarningsOrLossesAmt
End Year Balance$94,572EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$133,304BeginningYearBalanceAmt
Other Expenditures$46,787OtherExpendituresAmt
End Year Balance$86,517EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$76,317BeginningYearBalanceAmt
Contributions$56,987ContributionsAmt
End Year Balance$133,304EndYearBalanceAmt
FieldValueIRS element (for citing)
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,432,682OtherCostOrOtherBasisAmt
Book Value$3,432,682BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$37,754,901OtherCostOrOtherBasisAmt
Depreciation$17,975,101DepreciationAmt
Book Value$19,779,800BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$24,807,123OtherCostOrOtherBasisAmt
Depreciation$18,407,010DepreciationAmt
Book Value$6,400,113BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,932,758OtherCostOrOtherBasisAmt
Depreciation$583,395DepreciationAmt
Book Value$1,349,363BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$30,961,958TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
ASSET RETIREMENT OBLIGATION$270,531
INTEREST RATE SWAP AGREEMENT$1,198,689
RELATED PARTY PAYABLE$27,497
FieldValueIRS element (for citing)
Total Liability$1,496,717TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$74,914,737TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$22,448NetUnrealizedGainsInvstAmt
Other Revenue$227,312OtherRevenueAmt
Revenue Not Reported$204,864RevenueNotReportedAmt
Revenue Subtotal$74,709,873RevenueSubtotalAmt
Other Revenues Not Included$75,051OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$75,051RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$74,784,924TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$73,883,428TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$36,077OtherExpensesIncludedAmt
Expenses Not Reported$36,077ExpensesNotReportedAmt
Expenses Subtotal$73,847,351ExpensesSubtotalAmt
Other Expenses Not Included$75,051OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$75,051ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$73,922,402TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part V, Line 4San 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 2Management 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 2dchange in fair market value of interest rate swap 128,089 change in fair market value of investment in foundation 63,146 rental expenses reclassed to income 36,077
Schedule D, Part XII, Line 2drental expenses reclassed to income 36,077
schedule d, part xi, line 4bgrant revenue classed as expense on financial statements 75,051
schedule d, part xii, line 4bgrant revenue classed as expense on financial statements 75,051

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other40.FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent250Yes (X)Percent250Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportfalseAnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$142,072TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$142,072NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$20,399,094TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,967,902DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,431,193NetCommunityBenefitExpnsAmt
Total Expense0.03550TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,678,349TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,604,804DirectOffsettingRevenueAmt
Net Community Benefit Expns-$926,455NetCommunityBenefitExpnsAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,219,515TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,572,706DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,646,810NetCommunityBenefitExpnsAmt
Total Expense0.03760TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$103,859TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$103,859NetCommunityBenefitExpnsAmt
Total Expense0.00150TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$238,477TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$56,782DirectOffsettingRevenueAmt
Net Community Benefit Expns$181,695NetCommunityBenefitExpnsAmt
Total Expense0.00260TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,993TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,993NetCommunityBenefitExpnsAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$82,663TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$82,663NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$426,992TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$56,782DirectOffsettingRevenueAmt
Net Community Benefit Expns$370,210NetCommunityBenefitExpnsAmt
Total Expense0.00530TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,646,507TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$20,629,488DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,017,020NetCommunityBenefitExpnsAmt
Total Expense0.04290TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,420TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$6,420NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,209TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,209NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,709TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,709NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$20,338TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$20,338NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$5,273,259BadDebtExpenseAmt
Reimbursed By Medicare$12,017,823ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$13,221,636CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,203,813MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities2HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndTeaching HospitalTeachingHospitalIndEmergency Room24 HrsEmergencyRoom24HrsIndFacility Reporting GroupFacilityReportingGroupCdCritical Access HospitalCriticalAccessHospitalInd
Lutheran Hospital of SLV
1106 Blanca AvenueAlamosaCO81101www.sanluisvalleyhealth.org011001Yes (X)Yes (X)Yes (X)Yes (X)1
Conejos County Hospital
219021 US Hwy 285La JaraCO81140www.sanluisvalleyhealth.org011020Yes (X)Yes (X)1Yes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line11BusinessNameLine1
FieldValueIRS element (for citing)
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted12CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLsee part v, section c for urlOwnWebsiteURLTxt
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Exec Implementation StrategyYes (X)ExecImplementationStrategyInd
Develop Community Wide PlanYes (X)DevelopCommunityWidePlanInd
Exec Community Wide PlanYes (X)ExecCommunityWidePlanInd
Include Operational PlanYes (X)IncludeOperationalPlanInd
Adopt BudgetYes (X)AdoptBudgetInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
Prioritize ServicesYes (X)PrioritizeServicesInd
All Needs AddressedYes (true)AllNeedsAddressedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (true)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care40.FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (true)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care250.FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (true)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Insurance StatusYes (X)InsuranceStatusInd
Medicaid MedicareYes (X)MedicaidMedicareInd
ResidencyYes (X)ResidencyInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
Posted On WebsiteYes (X)PostedOnWebsiteInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Provided On AdmissionYes (X)ProvidedOnAdmissionInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Medicare RatesYes (X)MedicareRatesInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
input from representatives of the communitypart v, section b, line 3 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.
other hospital facilities involved with chnapart v, section b, line 4 the chna for SLV Health was conducted with conejos county hospital.
describe how chna is made widely available to the publicpart v, section b, line 5 the CHNA executive summary for SLV Health is available at: http://www.sanluisvalleyhealth.org/sites/default/files/documents/Executive Summary_0.pdf
implementation strategy for chnapart v, section b, line 6 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
FieldValueIRS element (for citing)
Facility4FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeFacilityFacilityTxt
Lutheran Hospital of SLV
2115 Stuart StAlamosaCO81101Physician Clinic
Lutheran Hospital of SLV
103 Chico CtMonte VistaCO81144Physician Clinic
Lutheran Hospital of SLV - RHC
115 Main StAntonitoCO81120Rural Health Clinic
Lutheran Hospital of SLV - RHC
509 Main StLa JaraCO81140Rural Health Clinic

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Free and discounted carePart I Line 3c The hospital uses a sliding scale based on family income to determine eligibility for free and discounted care. The sliding scale provides free care and discounted care up to 40% and 250%, respectively, of the Federal Poverty Guidelines.
Part I Line 7Total bad debt expense removed from the denominator prior to the percentage calculation = 5,273,259. 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.
PART III, LINE 4Accounts 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.
MedicarePART III, LINE 8 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: 6/30/12 3,092,126 6/30/13 (2,322,085) 6/30/14 (1,203,813)
NEEDS ASSESSMENTSLV 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.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCESLV 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.
COMMUNITY INFORMATIONSLV 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.
PROMOTION OF COMMUNITY HEALTHSLV 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 THE 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.
AFFILIATED HEALTH CARE SYSTEMSLV Health HAS A PROFESSIONAL AFFILIATION WITH CENTURA HEALTH SYSTEMS TO COORDINATE CARE FOR OUR SHARED PATIENTS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1ADAMS STATE COLLEGEBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1208 EDGEMONT BLVDAddressLine1
CityALAMOSACity
StateCOState
ZIP Code81102ZIPCode
FieldValueIRS element (for citing)
Recipient EIN846000542RecipientEIN
IRC SectionGOVERNMENTIRCSectionDesc
Cash Grant$7,000CashGrantAmt
Purpose Of GrantEDUCATIONPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line Referenceschedule i, part i, line 2FormAndLineReferenceDesc
ExplanationFUNDS ARE PROVIDED TO BE USED FOR DESIGNATED PURPOSES ONLY. ALL GRANTEES ARE SELECTED AND STRICTLY SCREENED BY THE MEDICAL CENTER. MULTI-YEAR AGREEMENTS ARE MADE WITH THE RECIPIENT ORGANIZATIONS AND ARE EVALUATED ON AN ANNUAL BASIS BEFORE FUNDING IS CONTINUED.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
steven w kitchen
physician$505,204$3,545$12,750$18,925$540,424
nuwan pilapitiya
physician$203,058$168$10,463$17,186$231,125$250
henry garvin
cch administrator - former$155,845$34,666$63,465$16,012$269,988
konnie martin
ceo$221,731$481$11,495$20,292$253,999
robert marshall
physician$327,581$1,458$12,664$19,039$377,215$16,473
patti thompson
cno$155,842$295$2,584$17,491$176,212
greg mcauliffe md
cmo$252,110$1,660$12,750$20,500$287,020
shane mortensen
cfo$146,199$268$7,650$16,962$171,079
dennard ellison
physician$390,004$18,499$12,311$19,039$439,853
david geiger
PHYSICIAN$337,976$19,097$12,750$18,925$406,652$17,904
clifford robbins
PHYSICIAN$336,106$665$12,750$8,610$364,839$6,708$0$0$0$0$0$0$0$0
carissa tripi
physician$495,717$432$3,462$12,251$536,862$25,000
james grigsby
physician$379,571$19,312$5,590$9,718$414,191

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
schedule j, PART I, LINE 4ATHE FOLLOWING AMOUNTS LISTED ARE SEVERANCE PAYMENTS: - HENRY GARVIN $90,131 $34,666 of this amount will be reported on henry garvin's 2013 w-2 and $55,465 will be reported on his 2014 w-2.
schedule j, part i, line 7CLINICAL 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.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
ALAMOSA COUNTY STATE OF COLORADO
A846000733011583AA92005-02-17$11,355,000HOSPITAL IMPROVEMENTSfalsefalsefalse
ALAMOSA COUNTY STATE OF COLORADO
B846000733011583AB72007-04-26$6,505,000PURCHASE 2115 STUART & IMPROVEMENTfalsefalsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtUnspentUnspentAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$2,840,000$0$11,355,000$157,158$0$0$362,859$0$0$10,992,141$0$02005falsefalseYes (true)Yes (true)
B$1,250,000$0$6,505,000$31,610$0$0$130,100$81,852$0$6,293,048$0$02007falsefalseYes (true)Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndChange In Use Bond Financed PropChangeInUseBondFinancedPropPctRemedial Action TakenRemedialActionTakenIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
AfalseYes (true)falsefalse0.010000.000000.01000Yes (true)false0.00000falseYes (true)
BfalseYes (true)falsefalse0.026900.000000.02690Yes (true)false0.00000falseYes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndBusiness Name Line1GICProviderName/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
MORGAN STANLEY CAP
AfalsefalsefalseYes (true)Yes (true)Yes (true)20.282falsefalsefalse0falseYes (true)
MORGAN STANLEY CAP
BfalsefalsefalseYes (true)Yes (true)Yes (true)15.falsefalsefalse0falseYes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (true)
BYes (true)

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line Referenceschedule k, part iv, question 2cFormAndLineReferenceDesc
ExplanationTHE 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

FieldValueIRS element (for citing)
PersonDAVID GEIGERPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionEMPLOYEERelationshipDescriptionTxt
TransactionWAGESTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceBUSINESS TRANSACTIONS WITH INTERESTED PERSONSFormAndLineReferenceDesc
ExplanationBOARD 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 9.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
form 990, Part VI, Question 11bThe 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, Question 12cSan 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, Question 15aHuman 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, Question 15bHuman 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, Question 19The governing documents, conflict of interest policy, and financial statements are available to the public upon request.
form 990, PART XI, LINE 9CHANGE IN FAIR MARKET VALUE OF INTEREST RATE SWAP 128,089 CHANGE IN FAIR MARKET VALUE OF INVESTMENT IN FOUNDATION 63,146 CONEJOS COUNTY HOSPITAL NET ASSETS - MERGER 3,494,666 TOTAL OTHER CHANGES TO NET ASSETS 3,685,901
form 990, PART VI, question 2BOARD OF DIRECTOR MEMBERS CHERI CROWDER AND PATRICK CROWDER HAVE A FAMILY RELATIONSHIP.
form 990, part iii, question 2lutheran hospital association of the san luis valley, dba san luis valley regional medical center and conejos county hospital corporation merged in 2013. conejos county hospital corporation activities will now be reflected on the lutheran hospital association of the san luis valley form 990.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationInd
SAN LUIS VALLEY HEALTH FOUNDATION
106 BLANCA AVENUEALAMOSACO81101203799814FUNDRAISINGCO501(c)(3)LINE 7SLVRMCYes (true)
CONEJOS COUNTY HOSPITAL FOUNDATION
19021 US HWY 285LA JARACO81140320379184FUNDRAISINGCO501(c)(3)LINE 7SLVRMCYes (true)
SLV MEDICAL CTR EMPLOYEE BEN TRUST
106 BLANCA AVENUEALAMOSACO81101840909851HEALTH PLANCO501(c)(9)nafalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SLVRMC EMPLOYEE BENEFIT TRUSTBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeMTransactionTypeTxt
Involved$2,160,955InvolvedAmt
Method Of Amount DeterminationCASH PAIDMethodOfAmountDeterminationTxt