2015-02-13T17:49:40-06:00 2014-03-31 STOCKMAN KAST RYAN & CO LLP 102 N CASCADE AVENUE SUITE 400 COLORADO SPRINGS CO 80903 990 2013-04-01 841465990 Arkansas Valley Regional Medical Center % JANETTE BENDER ARKA 7193836026 1100 Carson Avenue Suite La Junta CO 81050 JANETTE BENDER CFO 7193836026 2015-02-16 true DOREEN B MERZ P00841439 7193836026 2013 2016-02-25 16:41:14Z Lynn Crowell 1100 carson avenue la junta CO 81050 43814749 false X WWW.avrmc.org X 1998 CO THE CENTER IS A COMMUNITY-OWNED ORGANIZATION PROVIDING HIGH QUALITY, RESPECTFUL, AND COMPASSIONATE HEALTH CARE SERVICES TO INDIVIDUALS & FAMILIES IN SOUTHEAST COLORADO. 11 11 502 80 0 12559 80835 40094373 40474058 95970 64969 363593 1502955 40566495 42122817 0 0 0 0 21173561 20036870 0 0 0 23199446 22805381 44373007 42842251 -3806512 -719434 36398149 34508649 5431649 4276723 30966500 30231926 THE CENTER IS A COMMUNITY-OWNED ORGANIZATION THAT WILL WORK IN PARTNERSHIP WITH THE COMMUNITIES WE SERVE TO PROMOTE THE HEALTH AND WELL-BEING OF INDIVIDUALS AND FAMILES IN SOUTHEASTERN COLORADO. false false 32772844 41977013 The Medical Center operates as an acute-care hospital and long-term care nursing home and PROVIDes inpatient, outpatient, and emergency HEALTH CARE SERVICES TO THE COMMUNITY REGARDLESS OF RACE AND INSURANCE. 32772844 true true false true false false false false false true true false false false false true true false false false false false false false false false true true false false true false false false false false true false true false false false false false false false false false true X 201 0 502 true false false false false false false false false false false false false false false X 11 11 false true false false false false false false false false false true true true true true true true true false X JANETTE BENDER 7193836001 1100 CARSON AVENUE la junta CO 81050 Robert W Blair Board Chairman 1.0 X X 0 0 0 Evan Gamboa Board Secretary/Treasurer 1.0 X X Jim Clawson Board Vice-Chairman 1.0 X X Ron Davis Board Member 1.0 X Betty Velasquez Board Member 1.0 X Rob Pickering Board Member 1.0 X Margie Gardner Board Member 1.0 X H Randolph Frank MD Board Member 1.0 X Dale L Leighty Board Member 1.0 X Patrick Hancock Board Member 1.0 X Richard A Shand MD Board Member 1.0 X Lynn CROWELL CEO- See Sch O 40.0 X 0 0 Janette Bender CFO 40.0 X 108490 26674 Carrie Cutrell CNO 40.0 X 127319 31035 Michael Morley Ortho Physician 40.0 X 647123 9108 Jesus Carale Gastro Physician 40.0 X 448075 42094 Thomas M Jackson Surgeon 40.0 X 305482 30235 Kent E Gay Surgeon 40.0 X 279483 25669 James S Brady Physician 45.0 X 374234 32472 2290206 0 197287 15 false true false QUORUM HEALTH 105 Continental Pl BRENTWOOD TN 370271018 Management Services 613700 Arthur J Gallagher 6399 S Fiddlers Green GREENWOOD CO 80111 Risk Management 372760 GE Healthcare 373 Inverness Dr ENGLEWOOD CO 80112 Equip. Maintenance 311202 Maxim Staffing Solutions 12558 Collections Ctr Dr CHICAGO IL 60693 Staffing 300962 Delta Locum Tenens 1755 Wittington Pl DALLAS TX 75234 Locum coverage 681283 22 63380 17455 80835 PATIENT SERVICE REVENUE 900099 40474058 40474058 40474058 54210 54210 0 0 153895 115892 38003 0 38003 38003 1586799 1576040 10759 10759 10759 0 0 37007 37007 37007 CAFETERIA 900099 148000 148000 MEDICAL RECORDS 900099 12222 12222 RECOVERY OF COSTS 900099 1266517 1266517 1206 1206 1427945 42122817 41977013 64969 0 0 0 0 552251 552251 0 0 15855938 11694359 4161579 0 3628681 3003089 625592 0 613700 613700 42908 42908 53650 53650 3531 3531 0 0 7364579 6743059 621520 0 5472385 3923370 1549015 0 0 436679 280268 156411 0 0 0 17437 12501 4936 0 2247687 1611456 636231 0 BAD DEBT EXPENSE 2850143 2850143 REPAIRS & MAINTENANCE 1334188 956532 377656 OTHER OPERATING EXPENSES 1223332 877055 346277 UTILITIES 1145162 821012 324150 42842251 32772844 10069407 0 287275 54436 2744144 2460451 0 0 4489962 5614578 0 0 0 0 0 0 1593344 1592503 680133 933664 55286329 32496094 24388809 22790235 1557547 508143 0 0 0 0 0 0 656935 554639 36398149 34508649 4773265 3920389 0 0 0 0 0 0 0 0 0 0 560576 356334 0 0 97808 0 5431649 4276723 X 30407373 29677287 0 0 559127 554639 30966500 30231926 36398149 34508649 -719434 -15140 X false true X false false X false false false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true 3531 3531 Other Activities ALLOCABLE PORTION OF DUES PAID TO CHA AND AHA DESIGNATED AS LOBBYING EXPENSES 559127 -4488 554639 557188 1939 559127 560041 -2853 557188 563460 -3419 560041 1.00000 true false 9546 9546 30548708 13052893 17495815 871752 678803 192949 23035523 18764398 4271125 820800 820800 22790235 0 0 X 39373426 -15140 115892 100752 39272674 2850143 2850143 42122817 40108000 115892 115892 39992108 2850143 2850143 42842251 PART V, Line 4 The Medical Center is the sole beneficiary of the Bertha Elrod Copeland and James Evan Copeland Hospital Trust (the Trust), a charitable trust whose principal is to be held in perpetuity. Assets of the Trust are invested and administered by a trustee and distributions are made to the Medical Center. The use of the distributions received from the Trust is restricted to the purchase of equipment. PART X, LINE 2 The Medical Center is exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code. In addition, the Medical Center qualifies for the charitable contribution deduction. The Medical Center believes that it does not have any uncertain tax positions that are material to the financial statements. The Medical Centers income tax returns for 2011 through the current period remain open to examination by the Internal Revenue Service and relevant state authorities. PART XI, LINE 2D RENTAL EXPENSES OF $115,892 WAS RECLASSED FROM EXPENSES TO BE SHOWN NET AGAINST RENTAL INCOME ON PAGE 9 OF THE TAX RETURN. PART XI, LINE 4B BAD DEBT EXPENSE WAS TAKEN AGAINST PATIENT REVENUE PER THE AUDIT, BUT RECLASSED AS AN EXPENSE IN THE AMOUNT OF $2,850,143 FOR THE TAX RETURN. PART XII, LINE 2D RENTAL EXPENSES OF $115,892 WAS RECLASSED FROM EXPENSES TO BE SHOWN NET AGAINST RENTAL INCOME ON PAGE 9 OF THE TAX RETURN. PART XII, LINE 4B BAD DEBT EXPENSE WAS TAKEN AGAINST PATIENT REVENUE PER THE AUDIT, BUT RECLASSED AS AN EXPENSE IN THE AMOUNT OF $2,850,143 FOR THE TAX RETURN. true true true X true X true true true false true true 1817966 600000 1217966 0.03050 9929811 4447679 5482132 0.13710 11747777 5047679 6700098 0.16760 6834 6834 0.00020 6834 6834 0.00020 11754611 5047679 6706932 0.16780 3 208000 208000 0.00520 46 83506 83506 0.00210 49 291506 291506 0.00730 true 2850143 9666055 10368883 -702828 X true NONE NONE 1 1 ARKANSAS VALLEY REGIONAL MEDICAL CTR 1100 CARSON AVENUE LA JUNTA CO 81050 State Lic. #010210 X X X LONG-TERM NURSING State Lic. #020211 ARKANSAS VALLEY REGIONAL MEDICAL CTR 1 true X X X X X X X X X 13 true false true X www.avrmc.org X X X X X X false false true false true 250. true X true true X X X X X true X X true X X X X true X false false SUPPLEMENTAL INFORMATION SCHEDULE H, PART V, SECTION B, LINE 3 In the AVRMC process, each local expert allocated 100 points among all identified needs, having the opportunity to introduce needs previously unidentified and to challenge conclusions developed from the data analysis. A rank order of priorities emerged, with some needs receiving virtually no support and other needs receiving identical point allocations. We received community input from 104 area residents from a survey completed online during the period April 1, 2012 through June 30, 2012; The terms of gaining input stipulated each respondent would remain anonymous; The internet-based survey was promoted through a paid advertisement in a local newspaper, at a health fair, and distributed to local civic and health organizations with a request for participation. Preliminary conclusions were presented to a local group of experts who were asked to validate prior assessments and to establish priority among various identified health and medical issues. When the analysis was complete, we put the information and summary conclusions before a local group of experts who were asked to agree or disagree with the summary conclusions. SCHEDULE H, PART V, SECTION B, LINE 7 We do not have adequate resources to solve all the problems identified. Some issues are beyond the mission of the hospital and action is best suited for a response by others. Some improvements will require personal actions by individuals rather than the response of an organization. We view this as a plan for how we, along with other organizations and agencies, can collaborate to bring the best each has to offer to address the more pressing identified needs. By definition, the needs identified as LOW Priority and for which AVRMC holds LOW RESPONSIBILITY for implementation are needs to which the hospital may devote resources while (in most cases) monitoring but otherwise not addressing. Reasons for this response: Actions required are beyond the mission of AVRMC; AVRMC can be more effective applying its resources to higher priority needs; The hospital does not possess the expertise necessary for substantive positive improvement; Actions contemplated for implementation fall more appropriately to the responsibility of others; Other than providing encouragement, implementation efforts for some needs require appropriate actions by individuals modifying their personal habits rather than a response by an organization or the Health System; The best use of AVRMC resources is to focus on resolving or improving higher priority needs rather than attempting to respond to everything with small, perhaps ineffective, efforts. SCHEDULE H, PART V, SECTION B, LINE 10 The only Charity Care defined for AVRMC's purpose is patients that qualify for Colorado Indigent Care. SCHEDULE H, PART V, SECTION B, LINE 17E THE CENTER ATTEMPTS TO OBTAIN COLLECTIONS THROUGH THE USE OF GARNISHING WAGES FROM CLIENTS WITH OUTSTANDING BALANCES. SUPPLEMENTAL INFORMATION SCHEDULE H, PART III, LINE 2 THE COST METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED AS BAD DEBT EXPENSE IS USING A COST-TO-CHARGE RATIO. THE AMOUNT OF BAD DEBTS ATTRIBUTABLE TO PATIENT ACCOUNTS IS MULTIPLIED BY THE RATIO OF PATIENT CARE COST TO CHARGES CALCULATE THE ESTIMATED COST OF BAD DEBTS ATTRIBUTABLE TO PATIENT ACCOUNTS. A number of patients are truly unable to pay their out-of-pocket liability, but do not complete the process required to apply for financial assistance under the Hospital's charity care policy. These patients would qualify for charity care if they completed the paperwork, so the bad debt expense associated with treating them should be treated as community benefit. Sch H Part III, Section A, line 4. SEE PAGE 7,11, and 12 OF THE ATTACHED AUDIT REPORT FOR DESCRIPTION FROM THE AUDIT OF BAD DEBT EXPENSE. SCHEDULE H, PART III, LINE 8 MEDICARE COSTS WERE CALCULATED FROM THE MEDICARE COST REPORT FOR THE FYE MARCH 31, 2014. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. SCHEDULE H, PART VI, LINE 2 We deployed a Community Health Need Assessment survey within the local population for any resident to complete. We received community input from 104 area residents from a survey completed online during the period April 1, 2012 through June 30, 2012; The terms of gaining input stipulated each respondent would remain anonymous; The internet-based survey was promoted through a paid advertisement in a local newspaper, at a health fair, and distributed to local civic and health organizations with a request for participation. Preliminary conclusions were presented to a local group of experts who were asked to validate prior assessments and to establish priority among various identified health and medical issues; and Information analysis augmented by local opinions showed how Otero County relates among its peers in terms of primary and chronic needs, as well as other issues of uninsured persons, low-income persons, and minority groups; respondents commented on if they believe certain population groups (or people with certain situations) need help to improve their condition and if so, who needs to do what. When the analysis was complete, we put the information and summary conclusions before a local group of experts who were asked to agree or disagree with the summary conclusions. They were free to augment potential conclusions with additional statements of need; new needs could, and did, emerge from this exchange. Consultation with local experts was accomplished by having the local experts complete a survey individually. The survey identifying potential community needs the local experts participated in was a structured communication Delphi method technique, originally developed as a systematic, interactive forecasting method which relies on a panel of experts. The process encourages experts to revise their earlier answers in light of the replies of other members of their panel. Typically, this process decreases the range of answers and moves the expert opinions toward a consensus "correct" answer. The process was completed in one round which identified the most pressing, highest priority community needs. In the AVRMC process, each local expert allocated 100 points among all identified needs, having the opportunity to introduce needs previously unidentified and to challenge conclusions developed from the data analysis. A rank order of priorities emerged, with some needs receiving virtually no support and other needs receiving identical point allocations. We dichotomized the rank order into two groups: high priority needs and low priority needs. The determination of the break point, high as opposed to low, was a qualitative interpretation by QHR and the AVRMC executive team. When presented to the AVRMC executive team, the dichotomized need rank order identified which needs the hospital considered high responsibility to respond vs. low responsibility to respond. The result provided a matrix of needs and guided the hospital in developing its implementation response. Leading issues seem to relate to a lack of affordable health insurance coverage and the cost of medical care. Responses noted four topics as their most serious concerns: No health insurance is a major concern to 76% of respondents; Teen birth/pregnancy is a major concern to 63% of respondents; Diabetes is a major concern to 59% of respondents; and unhealthy food choices and obesity are major concerns to 55% of respondents. Mental health issues present as a focus on alcohol use, drug abuse, and smoking among youth as well as adult abuse of alcohol and drugs. Regardless of age, prescription abuse is also present as a focus; and Comments about individual, family, and healthy living concerns revolve around healthy living and healthcare availability. SCHEDULE H, PART VI, LINE 3 THE ORGANIZATION PROVIDES A BROCHURE TO EACH PATIENT OUTLINING THE GUIDELINES USED TO DETERMINE ELIGIBILITY FOR ASSISTANCE. SCHEDULE H, PART VI, LINE 4 In 2010, the Medical Center received 82.4% of its patients from the hospital's Primary Service Area. The Otero County 81050 and 81067 zip codes comprise 64.8% of all patients. County data is used as most information is not available at the geographic level of a zip code. The 2011 population for Otero County is estimated to be 18,345, but is expected to decline at a rate of 4%, projecting a 2016 population of 17,607. The population loss is in contrast to the Colorado state average rate of population increase of +7.2% and the national growth rate of +4%. The 65+ population of Otero County is 18.6% of the total population compared to the overall U.S. at 13.3%. The number of child-bearing-age females in the U.S. is expected to decrease 5.5%, while in Colorado it is expected to increase 2.1% by 2015. The Otero County 2011 Median Household Income is $42,283, which is considerably lower than the national median income of $67,529. Otero County's unemployment rate as of April 2012 is 9.2%, larger than the national unemployment rate of 8.1%. SCHEDULE H, PART VI, LINE 5 Arkansas Valley Regional Medical Center's board of directors is comprised of persons who reside in the La Junta, Colorado area. The majority of the organization's board members are neither employees nor contractors of the medical center. The board of directors is made mostly of community business people interested in maintaining quality health care in La Junta. SCHEDULE H, PART VI, LINE 6 N/A SCHEDULE H, PART VI, LINE 7 N/A X false false false false false false false true false Carrie Cutrell CNO 127319 23000 8035 158354 Michael Morley Ortho Physician 647123 9108 656231 Jesus Carale Gastro Physician 448075 17500 24594 490169 Thomas M Jackson Surgeon 305482 15478 14757 335717 Kent E Gay Surgeon 279483 18642 7027 305152 James S Brady Physician 374234 15600 16872 406706 PART I, LINE 7 The physician contracts allow for a QUARTERLY BONUS IF THEIR RELATIVE VALUE UNITS charged exceed quarterly benchmark standards. DALE LEIGHTY BOARD MEMBER 250000 CD'S HELD AT BANK false BOB BLAIR BOARD MEMBER 183743 CD'S HELD AT BANK false Roy Trivett Brother-in-law of CFO 19783 Contractor Services false PART IV, LINE 1 DALE LEIGHTY IS A MEMBER ON THE BOARD OF DIRECTORS AND ALSO THE PRESIDENT OF FIRST NATIONAL BANK OF LAS ANIMAS WHERE THE MEDICAL CENTER Holds a certificate of Deposit. PART IV, LINE 2 BOB BLAIR IS A MEMBER ON THE BOARD OF DIRECTORS AND ALSO THE PRESIDENT OF COLORADO EAST BANK WHERE THE MEDICAL CENTER holds a certificate of deposit. PART IV, LINE 3 CFO Janette Benders brother-in-law, Roy Trivett, owns Royal Electrical Services. The hospital uses them for various services. The hospital paid them $19,783 during the fiscal year ended 03/31/2014. SUPPLEMENTAL INFORMATION PART VI, SECTION A, LINE 3 THE ORGANIZATION CONTRACTS WITH QUORUM HEALTH RESOURCES, A HEALTHCARE MANAGEMENT COMPANY, TO PROVIDE SPECIALIZED HEALTHCARE SERVICES. THE CEO IS AN EMPLOYEE OF THE HEALTHCARE MANAGEMENT COMPANY. THE BOARD OF DIRECTORS WORKS IN CONJUNCTION WITH THE MANAGEMENT COMPANY AND THE BOARD HAS ULTIMATE AUTHORITY AND RESPONSIBILITY FOR THE ORGANIZATION. For the period ended March 31, 2014 the following are deemed officers of Arkansas Valley Regional Medical Center: Lynn Crowell, CEO Compensation: 208,858 Benefits: 72,459 PART VI, SECTION B, LINE 11B THE 990 is reviewed by the CEO, CFO, approved and signed by them. Then the Board is informed that the Form has been submitted. PART VI, SECTION B, LINE 12C EACH YEAR ALL KEY MEMBERS AND BOARD MEMBERS SUBMIT CONFLICTS OF INTEREST TO REGULARLY REVIEW ANY POSSIBLE CONFLICTS WITH THE WRITTEN CONFLICT OF INTEREST POLICY. PART VI, SECTION B, LINE 15C THE BOARD EVALUATES AND APPROVES WAGE PARAMETERS TO DETERMINE THE COMPENSATION OF INDEPENDENT PERSONS AND MANAGEMENT. PART VI, SECTION C, LINE 19 ORGANIZATIONAL DOCUMENTS ARE AVAILABLE AT PUBLIC BOARD MEETINGS AND UPON REQUEST. FORM 990 PART IX LINE 11G DESCRIPTION:PROVIDER FEES TOTAL FEES:3360966 FORM 990 PART IX LINE 11G DESCRIPTION:CONTR. LABOR & PHYSICIAN FEES TOTAL FEES:4003613