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SAN JUAN REGIONAL MEDICAL CENTER INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SAN JUAN REGIONAL MEDICAL CENTER INC (EIN 85-0127924)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-13
IRS object ID
201411339349301231
Schema version
2012v2.3
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)
Timestamp2014-05-13T08:56:58-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1TWO NORTH CENTRAL AVENUE STE 2300AddressLine1
CityPHOENIXCity
StateAZState
ZIP Code85004ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN850127924EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SAN JUAN REGIONAL MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% J MICHAEL PHILIPSInCareOfName
Name ControlSANJNameControl
Phone5056096110Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1801 WEST MAPLE STREETAddressLine1
Address Line2SuiteAddressLine2
CityFARMINGTONCity
StateNMState
ZIP Code87401ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJ Michael PhilipsName
TitleChief Strategy OfficerTitle
Date Signed2014-05-12DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameBRENDA D GRIESEMERName
Phone6023223000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRICK WALLACENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1801 WEST MAPLE STREETAddressLine1
CityFARMINGTONCity
StateNMState
ZIP Code87401ZIPCode
FieldValueIRS element (for citing)
Gross Receipts250632057GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.SANJUANREGIONAL.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1953YearFormation
State Legal DomicileNMStateLegalDomicile
Activity Or Mission DescriptionSAN JUAN REGIONAL MEDICAL CENTER'S MISSION IS TO PERSONALIZE HEALTH CARE AND CREATE ENTHUSIASM AND VITALITY IN HEALING.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees2020TotalNbrEmployees
Total Nbr Volunteers200TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4078279ContributionsGrantsPriorYear
Contributions Grants Current Year3035644ContributionsGrantsCurrentYear
Program Service Revenue Prior Year242701524ProgramServiceRevenuePriorYear
Program Service Revenue CY242954451ProgramServiceRevenueCY
Investment Income Prior Year4133976InvestmentIncomePriorYear
Investment Income Current Year4641962InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year250913779TotalRevenuePriorYear
Total Revenue Current Year250632057TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year448500GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY240526GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year147758101SalariesEtcPriorYear
Salaries Etc Current Year149743126SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year93565003OtherExpensePriorYear
Other Expenses Current Year94412672OtherExpensesCurrentYear
Total Expenses Prior Year241771604TotalExpensesPriorYear
Total Expenses Current Year244396324TotalExpensesCurrentYear
Revenues Less Expenses Prior Year9142175RevenuesLessExpensesPriorYear
Revenues Less Expenses CY6235733RevenuesLessExpensesCY
Total Assets BOY351253027TotalAssetsBOY
Total Assets EOY354024369TotalAssetsEOY
Total Liabilities BOY118166894TotalLiabilitiesBOY
Total Liabilities EOY114456461TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY233086133NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY239567908NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSAN JUAN REGIONAL MEDICAL CENTER'S MISSION IS TO PERSONALIZE HEALTH CARE AND CREATE ENTHUSIASM AND VITALITY IN HEALING.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense227198593Expense
Grants240526Grants
Revenue242954451Revenue
DescriptionALL ACTIVITY IS DIRECTLY RELATED TO PROVIDING PATIENT MEDICAL SERVICES AND QUALITY HEALTH CARE TO THE COMMUNITY AND SURROUNDING RURAL AREAS. SEE SCHEDULE O FOR OVERVIEW AND PROGRAMS.Description
Total Program Service Expense227198593TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096105NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2020NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNMStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJ MICHAEL PHILIPSNamePerson
Telephone Number5056096025TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1801 WEST MAPLE STREETAddressLine1
CityFARMINGTONCity
StateNMState
ZIP Code87401ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
SANDY WILLIAMS
CHAIRMAN6.00.0XX000
JEFF BOWMAN
2ND VICE-CHAIRMAN6.00.0XX000
JOSEPH RASOR
SECRETARY6.06.0XX000
JAMES SHAHEEN
TREASURER6.00.0XX000
CHARLENE SCOTT
DIRECTOR6.00.0X000
CHRISTIAN MOORE
DIRECTOR6.00.0X000
JACK EBERHART MD
DIRECTOR6.00.0X000
JANEL M RYAN
DIRECTOR6.00.0X000
DWAYNE GIBBS
DIRECTOR/CHIEF OF STAFF6.00.0X10871500
CHARLES HOFFMAN
DIRECTOR/VICE CHIEF OF STAFF40.00.0X361253028873
RICHARD MENNING
DIRECTOR/AUXILIARY REP.6.06.0X000
RICK WALLACE
PRESIDENT/CEO40.02.0X5468820106643
JOHN BUFFINGTON
COO40.00.0X378683086311
J MICHAEL PHILIPS
CSO40.00.0X3825810111881
SUZANNE SMITH
CHIEF NURSING OFFICER40.00.0257714056475X
TIBOR BOCO
DOCTOR40.00.0677398037196X
EDWARD MAURIN
DOCTOR40.00.0673888037373X
CHARLES E WILKINS
DOCTOR40.00.0661111036258X
MARC A FLITTER
DOCTOR40.00.0612726038873X
LUTHER B WEATHERS III
DOCTOR40.00.0566568028873X
FieldValueIRS element (for citing)
Total Reportable Comp From Org5227519TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation568756TotalOtherCompensation
Number Individuals GT100 K227NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ARAMARK CLINICAL TECHNOLOGIES
PO BOX 100401PASEDENACA91189BIO-MED/HOUSEKEEPING1795633
TOTAL RENAL CARE INC
6000 FELDWOODCOLLEGE PARKGA30349DIALYSIS SERVICES1480600
RESOURCE ANESTHESIOLOGY
10 COMMERCE DRIVENEW ROCHELLENY10801ANESTHESIA SERVICES1086566
QUEST DIAGNOSTICS INC
3924 COLLECTION CENTERCHICAGOIL60693CLINICAL LAB SERVICE965285
ORTHOPEDIC ASSOCIATES
2300 EAST MAIN ST BLDG D STE 101FARMINGTONNM87401ORTHOPEDIC SERVICES539232
FieldValueIRS element (for citing)
Number Of Contractors GT100 K17NumberOfContractorsGT100K
Government Grants2969644GovernmentGrants
All Other Contributions66000AllOtherContributions
Total Contributions3035644TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICES REVENUE622110238798734238798734
CAFETERIA72221011852661185266
MEDICAL OFFICE BLDG. RENTAL531120395867395867
ALL OTHER PROGRAM SERVICE REVENUE90009925745842574584
FieldValueIRS element (for citing)
Total Program Service Revenue242954451TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2930251TotalRevenueColumn
Exclusion$2,930,251ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1707611Securities
Other4100Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1707611Securities
Other4100Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1711711TotalRevenueColumn
Exclusion$1,711,711ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column250632057TotalRevenueColumn
Related Or Exempt Function Income242954451RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$4,641,962ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total240526Total
Program Services240526ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2647677Total
Management And General2647677ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total168742Total
Program Services168742ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total110901656Total
Program Services105689292ProgramServices
Management And General5212364ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4945838Total
Program Services4581393ProgramServices
Management And General364445ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total23136783Total
Program Services21497322ProgramServices
Management And General1639461ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total7942430Total
Program Services7440206ProgramServices
Management And General502224ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total238375Total
Program Services80701ProgramServices
Management And General157674ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total409552Total
Program Services377145ProgramServices
Management And General32407ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total53485Total
Management And General53485ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total558937Total
Management And General558937ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total21004455Total
Program Services20412351ProgramServices
Management And General592104ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1032283Total
Management And General1032283ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total26463124Total
Program Services24884710ProgramServices
Management And General1578414ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4495094Total
Program Services4139410ProgramServices
Management And General355684ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3546698Total
Program Services3393814ProgramServices
Management And General152884ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total360333Total
Program Services240479ProgramServices
Management And General119854ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total919737Total
Program Services825760ProgramServices
Management And General93977ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2507905Total
Program Services2309461ProgramServices
Management And General198444ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total13460990Total
Program Services12395860ProgramServices
Management And General1065130ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total3518192Total
Program Services2991638ProgramServices
Management And General526554ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
EQUIP. RENTAL & MAINTENANCE74706497158135312514
MEDICAL SUPPLIES837286383716481215

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total244396324Total
Program Services227198593ProgramServices
Management And General17197731ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY18918429BOY
EOY24670405EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY6962125BOY
EOY5460974EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY268472BOY
EOY268630EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY32551914BOY
EOY32411098EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY1771655BOY
EOY1280416EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3590660BOY
EOY3725408EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3906581BOY
EOY4036014EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis303224086LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec152884456LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY155862921BOY
EOY150339630EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY109468043BOY
EOY115090897EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY7489563BOY
EOY8180149EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY10462664BOY
EOY8560748EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY351253027BOY
EOY354024369EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY28784451BOY
EOY27447743EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY64049445BOY
EOY57865446EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY9064974BOY
EOY7826941EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY16268024BOY
EOY21316331EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY118166894BOY
EOY114456461EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY233086133BOY
EOY239567908EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY233086133BOY
EOY239567908EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY351253027BOY
EOY354024369EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses6235733ReconcilationRevenueExpenses
Reconciliation Unrealized Invest246042ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$43,640DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$9,845OtherActivitiesAmount
Total Lobbying Expenditures IIB53485TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLOBBYING ACTIVITIESIdentifier
Return ReferenceSCHEDULE C, PART II-BReturnReference
ExplanationLINE 1G - SAN JUAN REGIONAL MEDICAL CENTER PAID NEW MEXICO GOVERNMENT AFFAIRS $43,640 FOR A LOBBYIST IN SANTA FE, NEW MEXICO WHO MONITORS NEW MEXICO STATE LEGISLATIVE ISSUES WITH REGARD TO HOSPITAL ISSUES, KEEPS SAN JUAN REGIONAL MEDICAL CENTER APPRISED OF THOSE ISSUES AND TAKES FEEDBACK TO THE STATE LEGISLATURE. LINE 1I - A PORTION OF THE DUES PAID TO HEALTHCARE ASSOCIATIONS BY SAN JUAN REGIONAL MEDICAL CENTER WAS ALLOCABLE TO LOBBYING ACTIVITIES: 1) NEW MEXICO HOSPITALS AND HEALTH SYSTEMS ASSOCIATION - $9,845Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis5914671OtherCostOrOtherBasis
Book Value5914671BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis109150946OtherCostOrOtherBasis
Depreciation33568717Depreciation
Book Value75582229BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis69707858OtherCostOrOtherBasis
Depreciation38816666Depreciation
Book Value30891192BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis113508412OtherCostOrOtherBasis
Depreciation80499073Depreciation
Book Value33009339BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4942199OtherCostOrOtherBasis
Book Value4942199BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings150339630TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
PROFESSIONAL AND GENERAL INSURANCE LIABILITY$11,272,000
DUE TO THIRD PARTY PAYORS$6,008,739
ANESTHESIA LIABILITY$3,402,609
457(F) EXECUTIVE PENSION LIABILITY$632,983
FieldValueIRS element (for citing)
Total Of Amounts21316331TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierASC 740 FOOTNOTEIdentifier
Return ReferenceSCHEDULE D, PART X, LINE 2ReturnReference
ExplanationACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, PRESCRIBES CRITERIA FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. ASC 740 ALSO PROVIDES GUIDANCE ON DE-RECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE, AND TRANSITION. IN ACCORDANCE WITH THIS ACCOUNTING GUIDANCE, MANAGEMENT HAS REVIEWED ITS TAX POSITIONS AND HAS DETERMINED THAT THE COMPANY HAS NO SIGNIFICANT UNCERTAIN TAX POSITIONS.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served351PersonsServed
Total Community Benefit Expense544532TotalCommunityBenefitExpense
Net Community Benefit Expense544532NetCommunityBenefitExpense
Percent Of Total Expense0.00220PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served351PersonsServed
Total Community Benefit Expense544532TotalCommunityBenefitExpense
Net Community Benefit Expense544532NetCommunityBenefitExpense
Percent Of Total Expense0.00220PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served21533PersonsServed
Total Community Benefit Expense214939TotalCommunityBenefitExpense
Net Community Benefit Expense214939NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Persons Served1079PersonsServed
Total Community Benefit Expense1662917TotalCommunityBenefitExpense
Net Community Benefit Expense1662917NetCommunityBenefitExpense
Percent Of Total Expense0.00680PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Persons Served128957PersonsServed
Total Community Benefit Expense129655183TotalCommunityBenefitExpense
Direct Offsetting Revenue100972407DirectOffsettingRevenue
Net Community Benefit Expense28682776NetCommunityBenefitExpense
Percent Of Total Expense0.11740PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Persons Served13548PersonsServed
Total Community Benefit Expense628983TotalCommunityBenefitExpense
Net Community Benefit Expense628983NetCommunityBenefitExpense
Percent Of Total Expense0.00260PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served165117PersonsServed
Total Community Benefit Expense132162022TotalCommunityBenefitExpense
Direct Offsetting Revenue100972407DirectOffsettingRevenue
Net Community Benefit Expense31189615NetCommunityBenefitExpense
Percent Of Total Expense0.12770PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served165468PersonsServed
Total Community Benefit Expense132706554TotalCommunityBenefitExpense
Direct Offsetting Revenue100972407DirectOffsettingRevenue
Net Community Benefit Expense31734147NetCommunityBenefitExpense
Percent Of Total Expense0.12990PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense1136736TotalCommunityBuildingExpense
Net Community Building Expense1136736NetCommunityBuildingExpense
Percent Of Total Expense0.00470PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense1136736TotalCommunityBuildingExpense
Net Community Building Expense1136736NetCommunityBuildingExpense
Percent Of Total Expense0.00470PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$30,672,635BadDebtExpenseAmount
Amount Attributable To7668159AmountAttributableTo
Amount Reimbursed By Medicare62142534AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare66859357CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-4716823MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost Accounting SystemXCostAccountingSystem
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1FOUR CORNERS ASCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityAMBULATORY SURGERY CENTERDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.38000OrganizationProfitOrOwnership
Physicans Profit Or Ownership0.62000PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1SAN JUAN REGIONAL MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1801 WEST MAPLE STREETAddressLine1
CityFARMINGTONCity
StateNMState
ZIP Code87401ZIPCode
FieldValueIRS element (for citing)
Website Addresswww.sanjuanregional.comWebsiteAddress
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SAN JUAN REGIONAL MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted11NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiestrueOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
Other Needs AddressedXOtherNeedsAddressed
All Needs AddressedfalseAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Medicare RateXMedicareRate
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities24NumberOfOtherFacilities

Other Facilities OtherFacilities (24 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
SJRMC CARDIOLOGY
407 S SCHWARTZ SUITE 201FARMINGTONNM87401MEDICAL CLINIC
SJRMC INTERNAL MEDICINE
407 S SCHWARTZ SUITE 101FARMINGTONNM87401MEDICAL CLINIC
SJRMC BLOOMFIELD CLINIC
100 N CHURCH STREETBLOOMFIELDNM87413MEDICAL CLINIC
SAN JUAN NEURODIAGNOSTIC CENTER
407 S SCHWARTZ STE 202FARMINGTONNM87401MEDICAL CLINIC
SAN JUAN PEDIATRICS
407 S SCHWARTZ STE 102FARMINGTONNM87401MEDICAL CLINIC
FOUR CORNERS NEUROSURGERY
407 S SCHWARTZ STE 202FARMINGTONNM87401MEDICAL CLINIC
SJRMC MIDWIFERY CLINIC
655 WEST PINONFARMINGTONNM87401MEDICAL CLINIC
OUTPATIENT BEHAVIORAL HEALTH CLINIC
555 S SCHWARTZFARMINGTONNM87401MEDICAL CLINIC
URGENT CARE CENTER
4820 E MAIN STREETFARMINGTONNM87402URGENT CARE CENTER
SJR WOUND CARE CENTER
4251 ENGLISH ROADFARMINGTONNM87402CLINIC
SJR CANCER TREATMENT CENTER
731 W ANIMAS STREETFARMINGTONNM87401CANCER TREATMENT
SJRMC OUTPATIENT DIAGNOSTIC CENTER
2300 E 30TH STREET BLDG CFARMINGTONNM87401DIAGNOSTIC CENTER
SJRMC EMS STATION - MEDIC #1
730 S LAKE STREETFARMINGTONNM87401EMS STATION
SJRMC EMS STATION - MEDIC #2
902 W BROADWAYBLOOMFIELDNM87412EMS STATION
SJRMC EMS STATION - MEDIC #3
484 S OLIVER STREETAZTECNM87410EMS STATION
SJRMC EMS STATION - MEDIC #4
4 CR 3660KIRTLANDNM87117EMS STATION
SJRMC EMS STATION - MEDIC #5
3782 ENGLISH RDFARMINGTONNM87402EMS STATION
SJRMC EMS STATION - MEDIC #6
2014 E 16TH STREETFARMINGTONNM87401EMS STATION
SJRMC EMS STATION - MEDIC #10
737 W ANIMAS STREETFARMINGTONNM87401EMS STATION
SJRMC AZTEC CLINIC
120 LlanoAZTECNM87410CLINIC
GENERAL SURGERY CLINIC
630 W MAPLEFARMINGTONNM87401CLINIC
SJRMC AUDIOLOGY
816 W MAPLEFARMINGTONNM87401AUDIOLOGY CARE AND SERVICES
SJRMC OUTPATIENT REHABILITATION
301 S AUBURN AVEFARMINGTONNM87401REHABILITATION
SJRMC PEDIATRIC OUTPATIENT REHAB
810 W MAPLEFARMINGTONNM87401REHABILITATION

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
SCHEDULE H, PART I, LINE 6AAN ANNUAL REPORT IS PREPARED AND MAILED TO THE CITIZENS OF FARMINGTON, AZTEC, AND BLOOMFIELD, NM AS WELL AS THE SURROUNDING COMMUNITIES. IN THE ANNUAL REPORT IS FINANCIAL INFORMATION FOR THE HOSPITAL, STORIES OF CARE, AND INFORMATION ABOUT NEW PROGRAMS OR SERVICES PROVIDED BY THE HOSPITAL.
SCHEDULE H, PART I, LINE 7SJRMC USES A COST ACCOUNTING SYSTEM WHICH IS A PART OF ITS HOSPITAL INFORMATION SYSTEM. THE SYSTEM ADDRESSES ALL PATIENT SEGMENTS. SCHEDULE H, PART II, LINE 7E THE AMOUNTS SUMMARIZED INCLUDE PROGRAMS FOR COMMUNITY HEALTH EDUCATION WHICH INCLUDES: HEALTH FAIRS AND HEALTH EDUCATION SEMINARS LACTATION CONSULTATION AND OUTPATIENT DIETITIAN SERVICES SCHEDULE H, PART I, LINE 7G SAN JUAN REGIONAL MEDICAL CENTER PROVIDES NUMEROUS SUBSIDIZED HEALTH SERVICES TO THE COMMUNITY. THESE SUBSIDIZED HEALTH SERVICES ARE: EMERGENCY AND TRAUMA SERVICES 2,909,970 AMBULATORY CARE CENTERS 14,998,771 ORTHOPEDICS 1,053,312 BEHAVIORAL HEALTH-IP 1,172,006 OUTPATIENT NURSING/WOUND CARE 2,497,851 OUTPATIENT THERAPIES 1,630,343 OBSTETRIC/NURSERY 1,300,684 OTHER 3,013,522 ---------- TOTAL 28,576,459 SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES THE FEDERAL GOVERNMENT THROUGH HRSA HAS DESIGNATED SAN JUAN COUNTY AS A SHORTAGE AREA FOR PHYSICIANS. IN ORDER TO REDUCE THIS SHORTAGE SAN JUAN REGIONAL MEDICAL CENTER HAS BEEN RECRUITING FOR PHYSICIANS AND IN THIS EFFORT SPENT $1,478,273 IN FY 2013.
SCHEDULE H, PART III, LINE 2THE FOOTNOTE THAT DESCRIBES THE METHODOLOGY USED IN CALCULATING THE BAD DEBT AMOUNT REPORTED ON LINE 2 IS LOCATED ON PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, LINE 3THE AMOUNT ON LINE 3 IS AN ESTIMATE BASED ON MANAGEMENT'S BELIEF OF THE PERCENTAGE OF ADDITIONAL FINANCIAL ASSISTANCE COST IF THE PATIENTS WOULD COMPLETE THE FINANCIAL ASSISTANCE APPLICATION. THIS AMOUNT IS CURRENTLY ESTIMATED AT 25% THAT IS INCLUDED IN OUR BAD DEBT.
SCHEDULE H, PART III, LINE 4THE FOOTNOTE THAT DESCRIBES BAD DEBT IS ON PAGE 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, LINE 8THE AMOUNT OF MEDICARE SHORTFALL REPORTED ON LINE 7 IS $(4,716,823). THIS AMOUNT IS A RESULT OF THE TOTAL REVENUE AND ALLOWABLE COST CALCULATION ON OUR FY 13 COST REPORT. THE HOSPITAL'S ACTUAL EXPENSES ARE ENTERED INTO THE COST REPORT SOFTWARE AND THE ALLOWABLE COSTS ARE DETERMINED BY THE MEDICARE REGULATIONS. THIS MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE, ABSENT THIS PROGRAM, MANY INDIVIDUALS WOULD QUALIFY FOR FINANCIAL ASSISTANCE AND OTHER NEEDS-BASED PROGRAMS. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF THE GOVERNMENT ARE RELIEVED, AND THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFIT NEEDS.
SCHEDULE H, PART III, LINE 9BSAN JUAN REGIONAL MEDICAL CENTER'S (SJRMC) POLICY ON PATIENT ACCOUNT COLLECTIONS STATES "SJRMC WILL NOT ATTEMPT TO COLLECT FROM A PATIENT WHO IS APPLYING FOR THE SAN JUAN COUNTY INDIGENT FUND AS LONG AS THE PATIENT IS COOPERATING WITH THE APPLICATION PROCESS." THE POLICY ALSO STATES "SJRMC WILL NOT COLLECT FROM A PATIENT APPLYING FOR THE COMMUNITY SERVICE FUND (FINANCIAL ASSISTANCE) AS LONG AS THE PATIENT IS COOPERATING WITH THE APPLICATION PROCESS."
SCHEDULE H, PART V, SECTION B, LINE 3AS PART OF THE COMMUNITY HEALTH ASSESSMENT, THERE WERE FIVE FOCUS GROUPS HELD AUGUST 17-19TH, 2011. THE FOCUS GROUP PARTICIPANTS INCLUDED 49 KEY INFORMANTS, INCLUDING PHYSICIANS, OTHER HEALTH PROFESSIONALS, BUSINESS LEADERS, AND OTHER COMMUNITY LEADERS. IN ADDITION, ONE GROUP WAS DEDICATED SPECIFICALLY TO THOSE WHO PROVIDE SERVICES TO NATIVE AMERICANS IN THE COMMUNITY. A LIST OF RECOMMENDED PARTICIPANTS FOR THE FOCUS GROUPS WAS PROVIDED BY SAN JUAN REGIONAL MEDICAL CENTER. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. PARTICIPANTS INCLUDED SEVERAL INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS, AND THOSE WHO WORK WITH PERSONS WITH CHRONIC DISEASE CONDITIONS.
SCHEDULE H, PART V, SECTION B, LINE 4SAN JUAN REGIONAL REHABILITATION HOSPITAL INC
SCHEDULE H, PART V, SECTION B, LINE 5ATHIS COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE TO THE PUBLIC USING THE FOLLOWING URL: HTTP://SANJUANCOUNTY.HEALTHFORECAST.NET SCHEDULE H, PART V, SECTION B, LINE 6I SAN JUAN REGIONAL MEDICAL CENTER HELD A MEETING OF KEY COMMUNITY LEADERS WHO VOTED ON THE TOP SIX HEALTH PRIORITIES: (1) ACCESS TO HEALTHCARE, (2) CANCER, (3) DIABETES, (4) MATERNAL - INFANT - CHILD HEALTH, (5) MENTAL HEALTH, AND (6) NUTRITION & WEIGHT STATUS. THROUGH THE PARTNERSHIP COMMITTEE OF THE BOARD OF DIRECTORS OF SAN JUAN REGIONAL MEDICAL CENTER, ALL PROJECTS FUNDED BY THE COMMITTEE THROUGH THE COMMUNITY REINVESTMENT FUND MUST TIE TO ONE OF THE TOP SIX PRIORITIES IDENTIFIED IN THE CHNA AND PRIORITIZED BY THE KEY COMMUNITY LEADERS. SCHEDULE H, PART V, SECTION B, LINE 7 THE ENTIRE CHNA IDENTIFIED 28 SPECIFIC HEALTH ISSUES. BUDGETARY CONSTRAINTS, TIME AND LACK OF OTHER NECESSARY RESOURCES PREVENTED US FROM ADDRESSING ALL OF THE ISSUES IN THE REPORT. THROUGH THE PARTNERSHIP COMMITTEE OF THE BOARD OF DIRECTORS OF SAN JUAN REGIONAL MEDICAL CENTER, ALL PROJECTS FUNDED BY THE COMMITTEE THROUGH THE COMMUNITY REINVESTMENT FUND MUST TIE TO ONE OF THE TOP 6 PRIORITIES IDENTIFIED IN THE CHNA AND PRIORITIZED BY THE KEY COMMUNITY LEADERS.
NEEDS ASSESSMENTA COMMUNITY NEEDS ASSESSMENT IS CONDUCTED BY SAN JUAN REGIONAL MEDICAL CENTER TO DETERMINE THE HEALTH NEEDS FOR SAN JUAN COUNTY-AND THE FOUR CORNERS REGION-AS PERCEIVED BY THOSE SERVED BY THE HOSPITAL. THE NEEDS ASSESSMENT IS CONDUCTED VIA TELEPHONE SURVEYS IN BOTH ENGLISH AND SPANISH; INTERVIEWS CONDUCTED WITH NATIVE AMERICAN RESPONDENTS; KEY SHAREHOLDERS IN THE PROVISION OF HEALTH CARE IN SAN JUAN COUNTY; AND A SERIES OF FOCUS GROUPS. THE SURVEY IS ALSO SHARED WITH KEY COMMUNITY GROUPS IN A SERIES OF OPEN FORUMS. THE MOST RECENT ASSESSMENT OCCURRED IN CY 2011 (FY 2012). THE NEEDS WHICH WERE IDENTIFIED FROM THIS SURVEY INCLUDE: CANCER BARRIERS TO ACCESSING HEALTHCARE SERVICES IMMUNIZATION & INFECTIOUS DISEASES DIABETES MENTAL HEALTH OBESITY AND WEIGHT LOSS ORAL HEALTH PRENATAL CARE RESPIRATORY DISEASE ROUTINE CHECKUPS AND PREVENTIVE SCREENINGS SEXUALLY TRANSMITTED DISEASES TEEN BIRTHS AND UNWED MOTHERS UNINTENTIONAL INJURY SUBSTANCE/TOBACCO USE THE SAN JUAN REGIONAL MEDICAL CENTER BOARD OF DIRECTORS AND HOSPITAL ADMINISTRATION CONDUCTS THE SURVEY FOR THE PURPOSE OF DETERMINING HOW BEST TO DIRECT RESOURCES TO IMPROVE THE HEALTH OF THE FOUR CORNERS WITH THREE GOALS IN MIND: - TO IMPROVE RESIDENTS' HEALTH STATUS, INCREASE THEIR LIFE SPANS, AND ELEVATE THEIR OVERALL QUALITY OF LIFE. - TO REDUCE HEALTH DISPARITIES AMONG RESIDENTS BY IDENTIFYING POPULATION SEGMENTS WHO ARE MOST AT-RISK FOR VARIOUS DISEASES AND INJURIES. INTERVENTION PLANS AIMED AT TARGETING THESE INDIVIDUALS ARE ALSO DEVELOPED TO COMBAT SOME OF THE SOCIO-ECONOMIC FACTORS WHICH HAVE HISTORICALLY HAD A NEGATIVE IMPACT ON RESIDENTS' HEALTH. - TO INCREASE ACCESSIBILITY TO PREVENTIVE SERVICES FOR ALL COMMUNITY RESIDENTS. MORE ACCESSIBLE PREVENTIVE SERVICES WILL PROVE BENEFICIAL IN ACCOMPLISHING THE FIRST GOAL (IMPROVING HEALTH STATUS, INCREASING LIFE SPANS, AND ELEVATING QUALITY OF LIFE), AS WELL AS LOWERING THE COSTS ASSOCIATED WITH CARING FOR LATE-STAGE DISEASES RESULTING FROM A LACK OF PREVENTIVE CARE.SCHEDULE H, PART VI, LINE 2
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPOLICY: SAN JUAN REGIONAL MEDICAL CENTER (SJRMC) WILL RENDER FINANCIAL ASSISTANCE TO PERSONS WITH A DEMONSTRATED INABILITY TO PAY, REGARDLESS OF RACE, COLOR OR CREED. FINANCIAL ASSISTANCE REPRESENTS MEDICAL SERVICES PROVIDED TO A PERSON FOR WHICH THE HOSPITAL HAS NO EXPECTATION OF RECEIVING FULL PAYMENT. FINANCIAL ASSISTANCE ELIGIBILITY DOES NOT ALWAYS MEAN THAT A MEDICAL DEBT OWED TO THE HOSPITAL IS COMPLETELY ELIMINATED. THERE MAY BE A RESIDUAL AMOUNT THE PATIENT OR HOUSEHOLD IS EXPECTED TO PAY. PURPOSE: WE RECOGNIZE THAT IT WILL BE NECESSARY TO IDENTIFY THE MEDICAL INDIGENT PATIENT AND ESTABLISH THE AMOUNT OF FINANCIAL ASSISTANCE TO BE RENDERED IN A MANNER MOST RESPONSIVE TO THE NEEDS OF THE COMMUNITY. SJRMC WILL CLEARLY DISTINGUISH IT FROM BAD DEBT. FINANCIAL ASSISTANCE WILL BE IDENTIFIED AND RECORDED AS SUCH, AS EARLY AS POSSIBLE IN THE REGISTRATION AND COLLECTION PROCESS. AN INDIVIDUAL WHO IS TOO POOR TO MEET HIS OR HER MEDICAL EXPENSES IS GENERALLY CATEGORIZED AS MEDICALLY INDIGENT. THE TERM INCLUDES PEOPLE WHOSE INCOME IS SUFFICIENT TO PAY FOR BASIC LIVING EXPENSES BUT NOT ADEQUATE TO PAY FOR UNEXPECTED OR LARGE MEDICAL BILLS. ELIGIBILITY WILL BE DECIDED ON A CASE-BY-CASE BASIS. WHILE FAMILY SIZE AND HOUSEHOLD INCOME ARE THE PRIMARY DETERMINANTS, OTHER FACTORS, SUCH AS ASSETS NOT REQUIRED TO MAINTAIN A BASIC STANDARD OF LIVING, MAY BE CONSIDERED. FUTURE EARNING CAPACITY MAY ALSO BE CONSIDERED. GENERAL INFORMATION: ELIGIBILITY REQUIREMENTS (ROUTINE DETERMINATIONS) SJRMC WILL USE THE FOLLOWING ELIGIBILITY CRITERIA TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE AT SJRMC. 1. THE PATIENT'S HOUSEHOLD AVERAGE MONTHLY INCOME AND/OR ASSISTANCE FROM ALL SOURCES FOR THE 12-MONTH PERIOD PRIOR TO RECEIVING SERVICES AT SJRMC, DID NOT EXCEED 400% OF THE MONTHLY FEDERAL POVERTY INCOME GUIDELINES. THE NUMBER OF DEPENDENTS AND OTHERS IN THE HOUSEHOLD MUST BE TAKEN INTO ACCOUNT IN MAKING THIS DETERMINATION. * "PATIENT'S HOUSEHOLD INCOME AND/OR ASSISTANCE" INCLUDES ALL FUNDS RECEIVED BY ALL MEMBERS OF THE PATIENT'S HOUSEHOLD THAT SUPPORT THE HOUSEHOLD. SPECIAL RULES PERTAINING TO HOUSEHOLD INCOME APPLY IN SITUATIONS WHERE AN UNMARRIED ADULT IS LIVING IN THE SAME HOME WITH ANOTHER ADULT. * "HOUSEHOLD" IS DEFINED AS ALL DEPENDENTS AND OTHERS WHO LIVE IN THE SAME RESIDENCE AS THE PATIENT AND/OR GUARANTOR. * A "DEPENDENT" IS DEFINED AS A PERSON WHO CAN BE CLAIMED BY THE GUARANTOR AND/OR PATIENT AS A DEPENDENT ON THEIR FEDERAL TAX RETURN. * "OTHERS" IS DEFINED AS A PERSON WHO RESIDES IN THE GUARANTOR AND/OR PATIENT'S RESIDENCE FOR A MINIMUM OF SIX CONSECUTIVE MONTHS DURING A 12-MONTH PERIOD. THE GUARANTOR AND/OR PATIENT MAY OR MAY NOT BE ABLE TO CLAIM THIS PERSON AS A DEPENDENT ON THEIR FEDERAL TAX RETURN. 2. THE PATIENT HAS NO MEDICAL INSURANCE, LIABILITY OR OTHER THIRD-PARTY COVERAGE THAT WILL PAY FOR THE SERVICES THE PATIENT RECEIVED AT SJRMC. RESIDUAL AMOUNTS AFTER ANY THIRD-PARTY PAYMENTS, SUCH AS DEDUCTIBLES, NON-COVERED AMOUNTS, CO-PAYMENTS AND CO-INSURANCE MAY BE CONSIDERED FOR FINANCIAL ASSISTANCE. THE PATIENT MUST BE PERSONALLY RESPONSIBLE FOR PAYING ANY RESIDUAL AMOUNTS NOT COVERED BY A THIRD PARTY. MEDICARE DEDUCTIBLES AND COINSURANCE MAY BE CONSIDERED FOR FINANCIAL ASSISTANCE. 3. THE PATIENT HAS ASSETS AND RESOURCES, EXCLUDING THEIR PRIMARY RESIDENCE AND AUTOMOBILE(S) OF $5,000 OR LESS. RETIREMENT FUNDS WILL NORMALLY BE EXCLUDED AS ASSETS. SJRMC RESERVES THE RIGHT TO REQUIRE THE PATIENT TO BORROW AGAINST OR EVEN LIQUIDATE SOME OR ALL FUNDS EARMARKED FOR RETIREMENT TO SATISFY THE DEBT OWED TO SJRMC. ELIGIBILITY CRITERIA (PRESUMPTIVE DETERMINATIONS): 1. KNOWN CIRCUMSTANCES SURROUNDING A PATIENT'S PERSONAL SITUATION SUPPORT THE CONCLUSION THAT THEY ARE MEDICALLY INDIGENT. IN ADDITION, THE PATIENT IS EITHER UNABLE TO APPLY FOR THE FINANCIAL ASSISTANCE AND/OR TO PROVIDE REQUIRED SUPPORTING DOCUMENTATION TO MAKE A ROUTINE DETERMINATION OF ELIGIBILITY. 2. PRESUMPTIVE FINANCIAL ASSISTANCE MAY ALSO BE APPROVED IN SITUATIONS WHERE THE PATIENT HAS A "MEDICAL HARDSHIP". A MEDICAL HARDSHIP IS WHERE THE PATIENT DOES NOT MEET THE USUAL CRITERIA TO QUALIFY FOR A FINANCIAL ASSISTANCE ADJUSTMENT BASED ON BEING MEDICALLY INDIGENT. HOWEVER, THEIR DEBT FOR A PARTICULAR MEDICAL EVENT, TO INCLUDE THE DEBT OF OTHER PROVIDERS BESIDES SJRMC, IS PROHIBITIVE BASED ON THEIR AVAILABLE INCOME AND ASSETS AS WELL AS THEIR FUTURE EARNING CAPACITY. MEDICAL HARDSHIP IS DEFINED AS A SITUATION WHERE THE CUMULATIVE MEDICAL DEBTS FOR ONE EPISODE OF CARE EXCEEDS 30% OF THE VALUE OF THE PATIENT'S (OR GUARANTOR, IF PATIENT IS A MINOR OR INCOMPETENT) AVAILABLE INCOME AND ASSETS NOT ESSENTIAL TO A BASIC LIFESTYLE FOR THE 12 MONTHS PRIOR TO THE MEDICAL EVENT. AN "EPISODE OF CARE" BEGINS WITH SERVICES BEING PERFORMED AT SJRMC AND ENDS THE SOONER OF A) SIX MONTHS AFTER THE INITIAL DATE OR B) DISCHARGE FROM AN INPATIENT STAY. THE SERVICES PROVIDED MAY BE FOR MORE THAN ONE ILLNESS OR INJURY AS LONG AS THE SERVICES ARE FOR THE SAME PATIENT. PROCEDURE: 1. A REPRESENTATIVE FROM THE BILLING DEPARTMENT WILL REVIEW THE APPLICATION AND SUBMIT ACCOUNTS FOR REVIEW THAT MEET THE ELIGIBILITY REQUIREMENTS. 2. REVIEW WILL BE PROVIDED BY THE EXECUTIVE DIRECTOR, COORDINATOR OF CASE MANAGEMENT, AND A REPRESENTATIVE FROM THE FINANCIAL DEPARTMENT. ALL ELIGIBLE APPLICATIONS FOR FINANCIAL ASSISTANCE WILL BE CONSIDERED BASED ON INDIVIDUAL MERITS. A. APPROVAL FOR LESS THAN $20,000 WILL BE DECIDED AT THIS LEVEL. B. CASES WITH AMOUNTS GREATER THAN $20,000 WILL BE SUBMITTED WITH COMMITTEE RECOMMENDATIONS FOR APPROVAL OR DENIAL OF FINANCIAL ASSISTANCE FUNDS TO THE BOARD OF DIRECTORS FOR THEIR FINAL DECISION. 3. APPROVED FINANCIAL ASSISTANCE ALLOWANCES WILL BE REPORTED TO THE BOARD OF DIRECTORS. 4. THE FINANCE DEPARTMENT WILL DO THE NECESSARY ADJUSTMENTS AND NOTIFICATIONS TO THE PATIENT. SAN JUAN REGIONAL MEDICAL CENTER EMPLOYS A NUMBER OF FINANCIAL COUNSELORS AND CUSTOMER SERVICE REPRESENTATIVES WHO WORK ALONGSIDE PATIENTS TO HELP THEM NAVIGATE THEIR PAYMENT, BILLING, AND ASSISTANCE OPTIONS. INFORMATION IS DISSEMINATED TO PATIENTS THROUGH ONLINE AND PAPER RESOURCES LOCATED THROUGHOUT THE HOSPITAL. A WIDELY DISTRIBUTED BROCHURE TITLED, "PAYING FOR HOSPITAL SERVICES AT SAN JUAN REGIONAL MEDICAL CENTER," IS SPECIFICALLY DESIGNED TO HELP PATIENTS UNDERSTAND THEIR HOSPITAL BILL AND INFORM THEM OF THEIR OPTIONS FOR PAYMENT AND ASSISTANCE, INCLUDING INFORMATION ON THE AVAILABILITY OF INDIAN HEALTH SERVICE ASSISTANCE, CASH DISCOUNTS, BILL REDUCTION THROUGH A COMMUNITY SERVICE FUND, SPECIAL FUNDS THROUGH THE SAN JUAN COUNTY INDIGENT FUND, OR MEDICAL HARDSHIP WAIVERS. THE HOSPITAL'S VISION IS TO BE KNOWN AS THE MOST PERSONALIZED QUALITY HEALTHCARE PROVIDER. SAN JUAN REGIONAL MEDICAL CENTER IS ALSO A VALUES-DRIVEN ORGANIZATION WITH A CENTURY OF SERVICE TO THE FOUR CORNERS REGION-DRIVEN BY A SIMPLE YET POWERFUL PRINCIPLE: DO THE RIGHT THING FOR THE PATIENT NO MATTER WHAT. AN INTEGRAL PART OF THIS SACRED TRUST THE COMMUNITY HAS IN ITS HOSPITAL IS ENSURING THAT NO PATIENT FEELS ALONE AND DISCONNECTED DURING AND AFTER THEIR TREATMENT. THEREFORE, IT IS IN THE SPIRIT OF THE HOSPITAL'S VISION AND MISSION TO ENSURE THAT PATIENTS RECEIVE A HIGH LEVEL OF ASSISTANCE WHEN FIGURING OUT THEIR BILL AND OPTIONS. NOT ONLY DOES THE HOSPITAL HAVE FINANCIAL COUNSELORS TO EDUCATE ITS PATIENTS, IT HAS AN IN-HOUSE MEDICAL ADVOCACY SERVICES FOR HEALTHCARE PROGRAM ("MASH") FOR SELF-PAY INDIVIDUALS. THROUGH THE MASH PROGRAM, PATIENT ADVOCATES STAND HAND-IN-HAND WITH PATIENTS TO EXPLORE EVERY POSSIBILITY OF ASSISTANCE.SCHEDULE H, PART VI, LINE 3
COMMUNITY INFORMATIONSAN JUAN REGIONAL MEDICAL CENTER SERVES THE FOUR CORNERS REGION OF THE UNITED STATES, WHICH IS MOSTLY RURAL. THE HOSPITAL IS LOCATED IN THE REGION'S LARGEST CITY AND ONLY METROPOLITAN AREA, WHICH IS FARMINGTON, NEW MEXICO. OTHER CITIES IN THE REGION INCLUDE CORTEZ AND DURANGO IN COLORADO; MONTICELLO AND BLANDING IN UTAH; KAYENTA AND CHINLE IN ARIZONA; AND SHIPROCK, AZTEC, AND BLOOMFIELD IN NEW MEXICO. THIS REGION ALSO INCLUDES THE NAVAJO NATION. STATISTICS GATHERED FOR THE HOSPITAL'S COMMUNITY NEEDS ASSESSMENT IN 2011 FOR SAN JUAN COUNTY (POPULATION 130,044)-WHICH IS THE PRINCIPAL COUNTY SERVED BY SAN JUAN REGIONAL MEDICAL CENTER-INDICATE THE FOLLOWING POPULATION CHARACTERISTICS: MEN: 49.6% WOMEN: 50.4% AGES 18 AND UNDER: 29% AGES 65+: 10.8% WHITE: 51.6% AMERICAN INDIAN & ALASKA NATIVE: 36.6% HISPANIC: 19.1% THE MEDIAN HOUSEHOLD INCOME FOR SAN JUAN COUNTY IS $46,007.SCHEDULE H, PART VI, LINE 4
PROMOTION OF COMMUNITY HEALTHIN THE CONSTANT EFFORT TO MEET COMMUNITY NEED, SJRMC SEEKS TO IMPROVE PHYSICIAN ACCESS THROUGH A VIGOROUS RECRUITING PROGRAM AND TO PROVIDE COMMUNITY EDUCATION AND MANY OTHER COMMUNITY BENEFIT PROGRAMS. IN FISCAL YEAR 2013, SAN JUAN REGIONAL MEDICAL CENTER PROVIDED BENEFITS TO THE POOR AND THE BROADER COMMUNITY OF OVER $31 MILLION. PROGRAM PERSONS SERVED COMMUNITY BENEFIT TRADITIONAL FINANCIAL ASSISTANCE 351 544,532 COMMUNITY HEALTH EDUCATION 19,835 66,454 DIABETES EDUCATION AND SUPPORT PROGRAMS 811 43,330 COMMUNITY FLU VACCINES 887 11,689 HEALTH PROFESSIONS EDUCATION: PHYSICIANS AND MEDICAL STUDENTS 1,052 1,444,325 NURSES/NURSING STUDENTS 27 218,592 SUBSIDIZED HEALTH SERVICES: EMERGENCY SERVICES 10,202 2,909,970 WOMEN'S AND CHILDREN SERVICES 3,657 1,628,257 BEHAVIORAL HEALTH SERVICES 733 1,172,006 OUTPATIENT SERVICES 111,195 19,126,965 OTHER SUBSIDIZED HEALTH SERVICES 3,170 3,739,261 SAN JUAN UNITED WAY (CORPORATE MATCH) 53,997 FINANCIAL CONTRIBUTIONS 13,548 574,986 OTHER COMMUNITY SERVICES 93,446 --------- ------------- TOTAL 165,468 31,627,830SCHEDULE H, PART VI, LINE 5

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
SAN JUAN UNITED WAY
903 W APACHEFARMINGTONNM87401850165322501(C)(3)53997MATCHING EMPLOYEE CONTRIBUTIONS
SAN JUAN COLLEGE FOUNDATION
4601 College BlvdFARMINGTONNM87401237272197501(c)(3)101800CERTIFIED OCCUPATIONAL THERAPY ASSISTANT PROGRAM
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTSIdentifier
Return ReferenceFORM 990, SCHEDULE I, PART 1, LINE 2ReturnReference
ExplanationEVENT FUNDING/SPONSORSHIP REQUEST GUIDELINES SAN JUAN REGIONAL MEDICAL CENTER (SJRMC) RECOGNIZES THE VALUE OF COMMUNITY PARTNERSHIPS AND, ON A LIMITED BASIS, OFFERS SUPPORT TO ITS COMMUNITY PARTNERS BY SHARING OUR RESOURCES INCLUDING THE TIME AND TALENT OF OUR PHYSICIANS AND EMPLOYEES, AS WELL AS OUR FINANCIAL AND IN-KIND SUPPORT. SAN JUAN REGIONAL MEDICAL CENTER HAS ESTABLISHED CRITERIA TO ENSURE ALIGNMENT WITH OUR MISSION AND TO ALLOW US TO STRATEGICALLY FOCUS OUR LIMITED RESOURCES IN ORDER TO MAXIMIZE THEIR IMPACT. SPONSORSHIP REQUESTS ARE EVALUATED BASED ON, BUT NOT LIMITED TO, THE FOLLOWING CRITERIA: - ALIGNMENT WITH SJRMC'S MISSION: TO PERSONALIZE HEALTHCARE AND CREATE ENTHUSIASM AND VITALITY IN HEALING. - ALIGNMENT AND OPPORTUNITY TO PROMOTE STRATEGIC SERVICE LINES AND BUSINESS OBJECTIVES - COMMUNITY AND NEIGHBORHOOD DEVELOPMENT - MAGNITUDE OF IMPACT AND REACH (NUMBER OF INDIVIDUALS SERVED) - DEPTH AND BREADTH OF PARTNERSHIP WITH REQUESTING ORGANIZATION ALL REQUESTS MUST BE RECEIVED AT LEAST 4 WEEKS IN ADVANCE OF THE SPONSORSHIP DEADLINE. SPONSORSHIP REQUESTS ARE REVIEWED THROUGH OUR MARKETING DEPARTMENT. THE REQUEST SHOULD PROVIDE APPROPRIATE AND COMPLETE DETAILS REGARDING THE SPONSORSHIP REQUEST. PLEASE BE PREPARED TO PROVIDE THE ADDITIONAL INFORMATION ABOUT YOUR REQUEST, IF NEEDED. SPONSORSHIP REQUESTS OF MORE THAN $3,000 MUST BE REVIEWED BY THE PARTNERSHIP COMMITTEE OF SJRMC'S BOARD OF DIRECTORS. I. APPLICANT INFORMATION: - MUST BE WRITTEN ON OFFICIAL LETTERHEAD - NAME OF PERSON OR ORGANIZATION REQUESTING FUNDING AND/OR SPONSORSHIP - NAME, EMAIL ADDRESS, AND PHONE NUMBER OF PRIMARY CONTACT FOR THE REQUEST/ INDIVIDUAL FILLING OUT THE REQUEST II. EVENT DETAILS: 1. DESCRIPTION (250 WORDS MAXIMUM): - DESCRIBE HOW THE EVENT BEING SPONSORED RELATES TO SJRMC'S MISSION - DESCRIBE THE PURPOSE OF THE EVENT BEING SPONSORED AND THE TARGET AUDIENCE 2. LOGISTICS: - IF AVAILABLE, PROVIDE THE TITLE, DATE, AND TIME OF THE EVENT - IF AVAILABLE AND APPLICABLE, LIST THE PROPOSED EVENT LAYOUT (E.G., PANEL, CONFERENCE, SEMINAR, ETC.) AND AGENDA FOR THE EVENT 3. FUNDING: - INDICATE AMOUNT REQUESTED FROM SJRMC - DESCRIBE THE EXPENSES SJRMC'S FUNDS WILL BE USED TO COVER - PROVIDE WHAT OTHER ORGANIZATIONS ARE SUPPORTING YOUR EVENT (INDICATING AMOUNTS REQUESTED, WHICH ARE PENDING, AND WHICH ARE CONFIRMED) - WHAT WILL SJRMC RECEIVE IN EXCHANGE FOR ITS CONTRIBUTION PLEASE SUBMIT ALL MATERIALS TO: MARKETING MANAGER C/O SAN JUAN REGIONAL MEDICAL CENTER 657 WEST MAPLE STREET FARMINGTON, NM 87401Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
CHARLES HOFFMAN
DIRECTOR/VICE CHIEF OF STAFF3574730378000075000213730390126000
RICK WALLACE
PRESIDENT/CEO41412801155500172040953690112740653525000
JOHN BUFFINGTON
COO2786640834100166090649380213730464994000
J MICHAEL PHILIPS
CSO2869670784370171770905080213730494462000
SUZANNE SMITH
CHIEF NURSING OFFICER1839820574450162870351020213730314189000
TIBOR BOCO
DOCTOR6107030500000166950158230213730714594000
EDWARD MAURIN
DOCTOR66319807127035630160000213730711261000
CHARLES E WILKINS
DOCTOR6216530227550167030156870205710697369000
MARC A FLITTER
DOCTOR591963030500177130175000213730651599000
LUTHER B WEATHERS III
DOCTOR5464530200000115075000213730595441000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANSCHEDULE J, PART I, LINE 4BSAN JUAN REGIONAL MEDICAL CENTER HAS A 457(F) DEFERRED COMPENSATION PLAN THAT ALLOWS CERTAIN EXECUTIVES TO CONTRIBUTE MONEY ON A PRE-TAX BASIS INTO INVESTMENTS AND TO ACCUMULATE TAX-DEFERRED EARNINGS. THE FOLLOWING PRE-TAX CALENDAR YEAR 2012 CONTRIBUTIONS TO THE 457(F) PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AS DEFERRED COMPENSATION: JOHN BUFFINGTON $ 23,719 J. MICHAEL PHILIPS $ 36,504 SUZANNE SMITH $ 10,025 RICK WALLACE $ 38,934
SUPPLEMENTAL COMPENSATION INFORMATIONMANAGEMENT INCENTIVE PLANSAN JUAN REGIONAL MEDICAL CENTER (SJRMC) HAS A SENIOR MANAGEMENT INCENTIVE COMPENSATION PLAN FOR SELECTED SENIOR MANAGEMENT POSITIONS. AN AWARD TARGET IS ESTABLISHED FOR EACH PARTICIPANT. PERFORMANCE IS BASED ON EIGHT GOALS, TWO OF WHICH ARE HOSPITAL EXCESS OF REVENUES OVER EXPENSES PERCENTAGE AND TOTAL HOSPITAL EARNINGS. THE AWARD IS A PERCENTAGE OF BASE PAY IF CERTAIN TARGETS ARE MET.
SUPPLEMENTAL COMPENSATION INFORMATIONTHE COMPENSATION REPORTED IN PART VII FOR DWAYNE GIBBS MD IS FOR A DIRECTORSHIP, NOT FOR SERVICES RENDERED AS A BOARD MEMBER. THE COMPENSATION REPORTED FOR CHARLES HOFFMAN MD IS FROM HIS CURRENT EMPLOYMENT, NOT FOR SERVICES RENDERED AS A BOARD MEMBER.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
CITY OF FARMINGTON NM - 2004A
A856000129311428AZ92004-03-2516982883CONSTRUCTION OF TOWER/NEW EQUIPfalsefalsefalse
CITY OF FARMINGTON NM - 2007A
B856000129311428BN52007-06-2812290518CONSTRUCTION OF CANCER TRMT CENTERfalsefalsefalse
NM HOSPITAL EQUIPMENT LOAN COUNCIL - 2010A2010
C8404268752010-12-2125773000REFUND 2004B; FINANCE EQUIP/CONSTfalsefalsefalse
NM HOSPITAL EQUIPMENT LOAN COUNCIL - 2010B
D840426875647370FK62010-12-218800000CONST MOB PERD/NEUROfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A16600000170877880003396580016748130002007falsefalsetruetrue
B2095000012457932015120102458100012212122002010falsefalsetruetrue
C26983760257730630002054290025567634002011truefalsetruetrue
D32000008800248013498013200008800495002011falsefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropPrcntge Bond Financed PropPrcntgeBondFinancedPropRemedial Action TakenRemedialActionTakenNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
Afalsefalsefalsefalse0.000000.000000.00000falsefalse0.00000falsetrue
Bfalsefalsefalsefalse0.000000.000000.00000falsefalse0.00000falsetrue
Cfalsefalsefalsefalse0.000000.000000.00000falsefalse0.00000falsetrue
Dfalsefalsefalsefalse0.000000.000000.00000falsefalse0.00000falsetrue

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqsRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDue
0
Atruefalsefalsefalse0falsetrue
0
Btruefalsefalsefalse0falsetrue
0
Cfalsefalsefalsefalse0falsetruetruefalsefalse
0
Dfalsetruefalsefalse0falsetruetruefalsefalse

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
Atrue
Btrue
Ctrue
Dtrue

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSCHEDULE K, PART II, LINE 3, COLUMN A-DIdentifier
Return Reference0ReturnReference
ExplanationTHE EXCESS OF "TOTAL PROCEEDS" OVER "ISSUE PRICE" IS DUE TO INVESTMENT EARNINGS. SCHEDULE K, PART I, LINE C THE 2010 LEASE PROJECT OBLIGATION PORTION OF THIS ISSUE IN THE AMOUNT OF $8,103,000 HAS NOT BEEN DESIGNATED AS A QUALIFIED TAX-EXEMPT OBLIGATION. THESE ARE BUILD AMERICA BONDS.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
ANNA BUFFINGTON
JOHN BUFFINGTON / COO115042EMPLOYEE PAYfalse
ERIC BUFFINGTON
JOHN BUFFINGTON / COO53700EMPLOYEE PAYfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
VOLUNTEERSFORM 990, PART I, LINE 6SJRMC HAS A TOTAL OF 200 VOLUNTEERS THAT PROVIDE SERVICE TO THE FOLLOWING AREAS: ADMINISTRATIVE SUPPORT, CANCER TREATMENT CENTER, CARDIAC REHABILITATION, COURIER/PATIENT TRANSPORT, CRAFTY CREATIONS, DIETARY, GIFT MARKET, INFORMATION DESK, MAIL CALL, MEDICAL RECORDS AND AUXILIARY MEMBERSHIP.
PROGRAM SERVICE ACCOMPLISHMENTSFORM 990, PART III, LINE 4SAN JUAN REGIONAL MEDICAL CENTER (SJRMC) IS A MODERN ACUTE-CARE HOSPITAL LOCATED IN ONE OF THE MOST RURAL AREAS OF THE AMERICAN SOUTHWEST: SAN JUAN COUNTY, NM. A 2010 ESTIMATE OF THE POPULATION OF SAN JUAN COUNTY SHOWS THE COUNTY POPULATION HAS GROWN 14.3% FROM THE YEAR 2000 TO 2010 AND NOW NUMBERS APPROXIMATELY 130,044; 37% OF WHICH IS AMERICAN INDIAN AND ALASKA NATIVE PERSONS. SJRMC IS A SOLE COMMUNITY PROVIDER AND DISPROPORTIONATE SHARE HOSPITAL PROVIDING NEEDED HEALTHCARE TO RESIDENTS OF THE FOUR CORNERS REGION OF NEW MEXICO, ARIZONA, UTAH AND COLORADO. SAN JUAN REGIONAL MEDICAL CENTER'S MISSION IS TO PERSONALIZE HEALTHCARE AND CREATE ENTHUSIASM AND VITALITY IN HEALING. OUR CORE VALUES ARE ACTIVELY TAUGHT, AND REINFORCED, TO STAFF, MANAGEMENT AND PHYSICIANS SO THAT THE ORGANIZATION MAY ACHIEVE EXCELLENCE AND CONSISTENCY IN PATIENT CARE. SJRMC IS A COMMUNITY GOVERNED HOSPITAL THAT WAS FOUNDED IN 1910 BY DRS. A. M. SMITH AND G. W. SAMMONS. THE HOSPITAL CORPORATION IS AN ADVISORY BODY COMPOSED OF UP TO THREE REPRESENTATIVES FROM EACH OF 90 NON-PROFIT ORGANIZATIONS IN SAN JUAN COUNTY. THE CORPORATION MEETS QUARTERLY, AND, AT THEIR ANNUAL MEETING, THEY NOMINATE AND ELECT 9 MEMBERS TO THE GOVERNING BOARD OF DIRECTORS. THE CORPORATION RECEIVES REPORTS FROM THE BOARD OF DIRECTORS AND HOSPITAL ADMINISTRATION ON HOSPITAL OPERATIONS INCLUDING QUALITY AND FINANCE AND PROVIDES FEEDBACK ON COMMUNITY HEALTH ISSUES. SJRMC PROVIDES MEDICAL, SURGICAL, PEDIATRICS, ONCOLOGY, OBSTETRICS, CARDIOLOGY, AND BEHAVIORAL HEALTH INPATIENT CARE. AMBULATORY CARE INCLUDES DAY SURGERY, URGENT CARE, OUTPATIENT DIAGNOSTIC AND TREATMENT SERVICES. SJRMC IS A LEVEL III TRAUMA CENTER THAT PROVIDES GROUND AMBULANCE AND AIR AMBULANCE SERVICE WITH A HELICOPTER AND A FIXED WING AIRCRAFT AS WELL AS SERVICES THROUGH ITS EMERGENCY DEPARTMENT TO ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY. SOME OF OUR OUTPATIENT SERVICES ARE PHYSICIAN CLINICS SPECIALIZING IN CARDIOLOGY, BEHAVIORAL HEALTH, INTERNAL MEDICINE, NEUROSURGERY, NEURODIAGNOSTICS, URGENT CARE CENTER AND PEDIATRICS. OUR FINANCIAL AND IN-KIND CONTRIBUTIONS WENT TO VARIOUS LOCAL CHARITIES SUCH AS NAVAJO MINISTRIES, FAMILY CRISIS CENTER, LOCAL SCHOOL DISTRICTS, SENIOR CENTERS AND TOTAL BEHAVIORAL HEALTH. THE OTHER COMMUNITY SERVICES NOTED ABOVE PROVIDE CARE FOR: SURGERY, GASTROINTESTINAL, ORTHOPEDICS, ONCOLOGY, NEURO AND CARDIAC REHAB.
MEMBERS AND THEIR RIGHTSFORM 990, PART VI, LINES 6 AND 7ASAN JUAN REGIONAL MEDICAL CENTER IS A COMMUNITY-GOVERNED HOSPITAL. THE HOSPITAL CORPORATION IS AN ADVISORY BODY COMPOSED OF TWO REPRESENTATIVES FROM ABOUT 90 NON-PROFIT ORGANIZATION MEMBERS IN SAN JUAN COUNTY. AFTER TEN YEARS OF SERVICE AS A REPRESENTATIVE, AN INDIVIDUAL MAY BE DESIGNATED BY THE CORPORATION AS A SENIOR CORPORATE DELEGATE AND SHALL NO LONGER BE CONSIDERED TO BE THE REPRESENTATIVE OF THE MEMBER ORGANIZATION. THE MEMBER ORGANIZATION MAY THEN DESIGNATE ANOTHER REPRESENTATIVE IN ADDITION TO THE SENIOR CORPORATE DELEGATE. THE HOSPITAL CORPORATION MEETS QUARTERLY. AT THEIR ANNUAL MEETING, THEY NOMINATE AND ELECT NINE VOTING MEMBERS TO SJRMC'S BOARD OF DIRECTORS. OF THE NINE, THREE MUST BE ELECTED FROM THE MEMBER REPRESENTATIVES OR SENIOR CORPORATE DELEGATES. IN ADDITION TO THE NINE ELECTED DIRECTORS, THE SJRMC CHIEF OF THE STAFF AND VICE CHIEF OF STAFF AND A HOSPITAL AUXILIARY APPOINTEE ALSO SERVE AS SJRMC DIRECTORS FOR A TOTAL OF TWELVE VOTING MEMBERS OF THE BOARD OF DIRECTORS. IN FISCAL YEAR 2012 THERE WAS A VACANCY ON THE BOARD OF DIRECTORS, RESULTING IN ONLY ELEVEN VOTING DIRECTORS FOR THE YEAR.
PROCESS USED BY MANAGEMENT AND/OR GOVERNING BODY TO REVIEW 990FORM 990, PART VI, LINE 11BTHE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM BASED ON DATA PROVIDED BY MANAGEMENT. A DRAFT COPY OF THE 990 IS PROVIDED TO MANAGEMENT FOR REVIEW. A MEETING IS CONDUCTED BY THE ACCOUNTING FIRM TO REVIEW THE RETURN IN DETAIL WITH MANAGEMENT. ANY QUESTIONS ARE ADDRESSED AND ANY NECESSARY CHANGES ARE MADE TO THE RETURN. THE FINAL DRAFT OF THE FORM 990 IS PROVIDED TO THE AUDIT COMMITTEE ALONG WITH A BRIEF EDUCATION SESSION CONDUCTED BY THE ACCOUNTING FIRM TO DISCUSS THE HIGHLIGHTS OF THE FORM. THE FINAL DRAFT OF THE FORM 990 IS THEN PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTERESTFORM 990, PART VI, LINE 12CSAN JUAN REGIONAL MEDICAL CENTER HAS A CONFLICT OF INTEREST POLICY THAT EACH BOARD MEMBER, OFFICER AND KEY EMPLOYEE IS REQUIRED TO FILL OUT ON AN ANNUAL BASIS. THIS CONFLICT OF INTEREST POLICY SPECIFICALLY ASKS QUESTIONS REGARDING BUSINESS AND PERSONAL RELATIONSHIPS THAT THEY MAY HAVE WITH ANY OTHER BOARD MEMBER, OFFICER AND KEY EMPLOYEE OF ANY BUSINESS THAT DEALS WITH SAN JUAN REGIONAL MEDICAL CENTER OR ANY OF ITS AFFILIATES. IF A CONFLICT IS IDENTIFIED, IT MUST BE REPORTED TO THE COMPLIANCE OFFICER, AND IF IT CONSTITUTES A BREACH OF EMPLOYMENT, IT MAY LEAD TO DISCIPLINARY ACTION.
PROCESS FOR DETERMINING COMPENSATIONFORM 990, PART VI, LINES 15A & 15BTHE BOARD OF DIRECTORS FOR SAN JUAN REGIONAL MEDICAL CENTER USES THE FOLLOWING COMPARABLE DATA WHEN DETERMINING THE COMPENSATION FOR THE CEO AND SENIOR MANAGEMENT; REGIONAL / LOCAL AREA NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS OF COMPARABLE SIZE, NATIONAL NOT-FOR-PROFIT HEALTHCARE ORGANIZATIONS OF COMPARABLE SIZE, AND OTHER RELEVANT COMPARATORS (E.G., FOR PROFIT HEALTHCARE AND/OR GENERAL INDUSTRY ORGANIZATIONS) OF COMPARABLE SIZE AND COMPLEXITY, ONLY WHEN COMPETITIVE CIRCUMSTANCES WARRANT THESE MARKETS. ADDITIONALLY, THE BOARD BI-ANNUALLY HAS AN INDEPENDENT OUTSIDE FIRM COMPARE THE CEO'S COMPENSATION WITH OTHER HEALTHCARE ORGANIZATIONS TO REMAIN COMPETITIVE. THE PROCESS WAS LAST COMPLETED IN 2012. THE PROCESS IS DOCUMENTED IN THE BOARD MINUTES WHEN PRESENTED TO THEM.
AVAILABILITY OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, ANDFINANCIAL STATEMENTS TO THE GENERAL PUBLICFORM 990, PART VI, LINE 19 SAN JUAN REGIONAL MEDICAL CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
SAN JUAN HEALTH PARTNERS INC
801 WEST MAPLE STREETFARMINGTONNM87401272367549HEALTHCARENM501(C)(3)3SJRMCtrue
SAN JUAN REGIONAL REHABILITATION HOSP
525 SOUTH SCHWARTZ 2FARMINGTONNM87401850441767HEALTHCARENM501(C)(3)3SJRMCtrue

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1SJR HOLDING COMPANY INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1801 W MAPLE STREETAddressLine1
CityFARMINGTONCity
StateNMState
ZIP Code87401ZIPCode
FieldValueIRS element (for citing)
EIN201126483EIN
Primary ActivitySUPPORT SERVICESPrimaryActivity
Legal Domicile StateNMLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SJRMCBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC-CORPTypeOfEntity
Share Of Total Income583156ShareOfTotalIncome
Share Of EOY Assets1585789ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
Controlled OrgtrueControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationtrueDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
SJR HOLDING COMPANY INC
F300000CASH
SAN JUAN REGIONAL REHABILITATION HOSPITAL
Q120000FAIR VALUE
SAN JUAN REGIONAL REHABILITATION HOSPITAL
Q317661COST