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SAN LUIS VALLEY REGIONAL MEDICAL CENTER: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
SAN LUIS VALLEY REGIONAL MEDICAL CENTER (EIN 84-0255530)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-16
IRS object ID
201101369349304610
Schema version
2009v1.7
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)
Timestamp2011-05-16T13:47:51-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 South Tejon Suite 800AddressLine1
CityColorado SpringsCity
StateCOState
ZIP Code809039848ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN840255530EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Lutheran Hosp Assoc of the San Luis ValleyBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLUTHNameControl
Phone7195892511Phone

US Address USAddress

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

Officer Officer

FieldValueIRS element (for citing)
NameRussell JohnsonName
TitleCEOTitle
Date Signed2011-05-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRita F Worster CPAName
Phone7194714290Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1San Luis Valley Regional Medical CtrBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonRussell Johnson CEONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1106 Blanca AvenueAddressLine1
CityAlamosaCity
StateCOState
ZIP Code81101ZIPCode
FieldValueIRS element (for citing)
Gross Receipts59142427GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.slvrmc.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1928YearFormation
State Legal DomicileCOStateLegalDomicile
Activity Or Mission DescriptionThe hospital provides inpatient, outpatient, and emergency care services to patients in the San Luis Valley. In addition, they also sponsor community programs, such as a weight loss program.ActivityOrMissionDescription
Nbr Voting Members Governing Body8NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees621TotalNbrEmployees
Total Nbr Volunteers59TotalNbrVolunteers
Total Gross UBI-2915TotalGrossUBI
Net Unrelated Business Txbl Income-3875NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1299485ContributionsGrantsPriorYear
Contributions Grants Current Year679080ContributionsGrantsCurrentYear
Program Service Revenue Prior Year57851219ProgramServiceRevenuePriorYear
Program Service Revenue CY57837158ProgramServiceRevenueCY
Investment Income Prior Year638549InvestmentIncomePriorYear
Investment Income Current Year318949InvestmentIncomeCurrentYear
Other Revenue Prior Year158757OtherRevenuePriorYear
Other Revenue Current Year124110OtherRevenueCurrentYear
Total Revenue Prior Year59948010TotalRevenuePriorYear
Total Revenue Current Year58959297TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year152883GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY149432GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year30632838SalariesEtcPriorYear
Salaries Etc Current Year31611955SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year165230TotalFundrsngExpCurrentYear
Other Expense Prior Year25544753OtherExpensePriorYear
Other Expenses Current Year26741591OtherExpensesCurrentYear
Total Expenses Prior Year56330474TotalExpensesPriorYear
Total Expenses Current Year58502978TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3617536RevenuesLessExpensesPriorYear
Revenues Less Expenses CY456319RevenuesLessExpensesCY
Total Assets BOY61891974TotalAssetsBOY
Total Assets EOY64873443TotalAssetsEOY
Total Liabilities BOY22623695TotalLiabilitiesBOY
Total Liabilities EOY25521522TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY39268279NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY39351921NetAssetsOrFundBalancesEOY
Mission DescriptionAN UNCONDITIONAL COMMITMENT TO EXCELLENCE BY PROVIDING QUALITY, COMPASSIONATE CARE GUIDED BY OUR VALUES. WE ACCEPT RESPONSIBILITY FOR PROVIDING SERVICES TO OUR COMMUNITY THAT ARE OF THE HIGHEST CALIBER OF SERVICE AND STANDARD PERFORMANCE, WHILE DEMONSTRATING OUR ADOPTED VALUES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense42038831Expense
Grants149432Grants
Revenue57694630Revenue
DescriptionSan Luis Valley Regional Medical Center (SLVRMC) has operated as an independent, not-for-profit hospital for over 83 years. SLVRMC serves the six counties of the San Luis Valley with a population of just under 50,000 and an area of over 8,200 square miles; larger than the state of New Jersey. Including our relationship with Conejos County Hospital, SLVRMC employs almost 600 and is the largest employer in the San Luis Valley. The trustees, providers and staff of SLVRMC are understandably proud of their tradition for providing care and service to our communities. Serving our low-income community means that we have a challenging payer mix with high Medicaid, uninsured and relatively low commercial percentages. This has led to our organization being resourceful, creative and innovative in order to continue service with positive operating margins. SLVRMC's operating expense per adjusted patient day is $2,523 compared to a Colorado average of $3,348 and a rural hospital average of $3,665. Over the last eight years, our gross revenue has increased from $20M to $60M and the number of patients served has expanded several fold. New services have been added in medication oncology, inpatient rehabilitation, dialysis, sleep disorders, women's imaging center, fixed wing medical transportation, genetic counseling, behavioral health, Psychiatry, chiropractic, oncology/infusion therapy and more.Description
Total Program Service Expense42038831TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiestruePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
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 MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096107NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees621NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
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
Nbr Voting Governing Body Members8NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
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 VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonTHE ORGANIZATIONNamePerson
Telephone Number7195892511TelephoneNumber

Address US AddressUS

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

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
JAN GAY
PRESIDENT2.0XX270000
CHERI CROWDER
VICE PRESIDENT2.0XX120000
KENDAL KNAUS MD
SECRETARY/TREASURER2.0XX3360000
ROBERT HAGEDORN
TRUSTEE2.0X120000
GARY WUCKERT
TRUSTEE2.0X120000
KATHY LORENZ
TRUSTEE2.0X120000
KARLA HADESTY
TRUSTEE2.0X120000
ROSALIE MARTINEZ
TRUSTEE2.0X120000
RUSSELL JOHNSON
CEO40.0X361805072917
HENRY GARVIN
VP OPERATIONS40.0X171536030617
DAVID FRESHOUR
CFO40.0X201246034199
KATHY ROGERS
VP SERVICE & DEVELOPMENT40.0X114753017178
GWEN HELLER
VP HR/BUS DEVELOPMENT40.0X161496030754
HELEN LESTER
CNO40.0X118976023350
THOMAS HENTON
ADMINISTRATOR OF CONEJOS CO. H40.0X137178019186
GREG MCAULIFFE MD
CMO20.0X22593404008
LEONARD SNOW
VP QUALITY40.0X133382022816
STEVEN W KITCHEN
PHYSICIAN40.0588631019993X
GLEN A GAUNT
PHYSICIAN40.0337470019684X
DAVID GEIGER
PHYSICIAN40.0299590020984X
DAVID FROW
PHYSICIAN40.0288551019576X
CLIFFORD ROBINS
PHYSICIAN40.0271745016544X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3455793TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation351806TotalOtherCompensation
Number Individuals GT100 K41NumberIndividualsGT100K
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
DANIEL YEAGER
PO BOX 635715CINCINNATIOH452635715CONTRACT LABOR529463
NUANCE COMMUNICATIONS
PO BOX 2561CAROL STREAMIL60132CONTRACT SERVICES472976
CHG COMPANIES INC
PO BOX 972651DALLASTX753972651DATA PROCESSING366920
ON ASSIGNMENT STAFFING SERVICES
FILE 50730LOS ANGELESCA900744318CONTRACT LABOR249278
VISTA STAFFING SOLUTIONS INC
FILE 50834LOS ANGELESCA900740834CONTRACT LABOR222146
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K
Related Organizations40000RelatedOrganizations
Government Grants451462GovernmentGrants
All Other Contributions187618AllOtherContributions
Noncash Contributions10000NoncashContributions
Total Contributions679080TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICE REVENUE9000993327228433272284
MEDICARE/MEDICAID9000992218152222181522
AMBULANCE DISTRICT REVENUE621910343807343807
MANAGEMENT FEES900099962590962590
BAD DEBT RECOVERIES900099655351655351

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column421604TotalRevenueColumn
Related Or Exempt Function Income196670RelatedOrExemptFunctionIncome
Exclusion$224,934ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue57837158TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column438333TotalRevenueColumn
Exclusion$438,333ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real95152Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real57024Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real38128Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column38128TotalRevenueColumn
Unrelated Business Revenue-2915UnrelatedBusinessRevenue
Exclusion$41,043ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other6722Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other126106Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-119384Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-119384TotalRevenueColumn
Exclusion-$119,384ExclusionAmount

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

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
OTHER REVENUE9000998240682406
DRUGS- NON PATIENT9000993576$3,576
FieldValueIRS element (for citing)
Total Other Revenue85982TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column58959297TotalRevenueColumn
Related Or Exempt Function Income57694630RelatedOrExemptFunctionIncome
Unrelated Business Revenue-2915UnrelatedBusinessRevenue
Exclusion$588,502ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total149432Total
Program Services149432ProgramServices

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)
Total1829018Total
Program Services1305564ProgramServices
Management And General514621ManagementAndGeneral
Fundraising8833Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total24791234Total
Program Services17695928ProgramServices
Management And General6977097ManagementAndGeneral
Fundraising118209Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total976989Total
Program Services696372ProgramServices
Management And General274469ManagementAndGeneral
Fundraising6148Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2302281Total
Program Services1644507ProgramServices
Management And General646789ManagementAndGeneral
Fundraising10985Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1712433Total
Program Services1184661ProgramServices
Management And General518154ManagementAndGeneral
Fundraising9618Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total64560Total
Management And General64560ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total98004Total
Management And General98004ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total4690Total
Management And General4690ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total3557977Total
Program Services1874624ProgramServices
Management And General1678080ManagementAndGeneral
Fundraising5273Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total118839Total
Management And General118839ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2260132Total
Program Services869960ProgramServices
Management And General1388527ManagementAndGeneral
Fundraising1645Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total622204Total
Management And General622204ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1406451Total
Program Services1036311ProgramServices
Management And General370140ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total393781Total
Program Services239713ProgramServices
Management And General151185ManagementAndGeneral
Fundraising2883Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total5850Total
Management And General5850ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total598314Total
Management And General598314ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2721509Total
Program Services1632905ProgramServices
Management And General1088604ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total287642Total
Management And General287642ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES55156415460458551830
PROVIDER FEES2167799216779900
BAD DEBT6073933607393300
COLLECTION EXPENSE40191004019100
UBI TAXES1427014270

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total440928Total
Program Services6664ProgramServices
Management And General432628ManagementAndGeneral
Fundraising1636Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total58502978Total
Program Services42038831ProgramServices
Management And General16298917ManagementAndGeneral
Fundraising165230Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY633615BOY
EOY421289EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY8762703BOY
EOY9307578EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY134888BOY
EOY23857EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5103638BOY
EOY7589026EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY956635BOY
EOY996269EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1278471BOY
EOY1101249EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis53458870LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec21774796LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY31971870BOY
EOY31684074EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY12098024BOY
EOY12523463EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY191667BOY
EOY191667EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY76317BOY
EOY133304EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY684146BOY
EOY901667EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY61891974BOY
EOY64873443EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4211190BOY
EOY6939490EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY368708BOY
EOY93943EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY16430000BOY
EOY15940000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY618469BOY
EOY1050011EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY995328BOY
EOY1498078EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY22623695BOY
EOY25521522EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY39191962BOY
EOY39218617EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY76317BOY
EOY133304EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY39268279BOY
EOY39351921EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY61891974BOY
EOY64873443EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
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)
Political Expenditures0PoliticalExpenditures
Volunteer Hours0VolunteerHours
Amt Of4955 Tax0AmtOf4955Tax
Amt Of4955 Tax On Managers0AmtOf4955TaxOnManagers
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$4,690DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB4690TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part II-B, Line 1gDir. contact with legislators, their staff, gov't officials, etc.San Luis Valley Regional Medical Center received correspondence from the Colorado Health and Hospital Association and the American Hospital Association regarding their membership dues. A portion of their dues were attributable to lobbying.
Part I-A, Line 1organization's direct and indirect political campaign activitiesRussell Johnson, CEO, sent out an email from his SLVRMC account to the employees of SLVRMC endorsing another SLVRMC employee, Kathy Rogers, for mayor. This was an unintentional political campaign activity. The IRS was made aware of the activity and contacted SLVRMC for response. SLVRMC has responded to the IRS' inquiry and has taken steps to ensure that an incident like this never happens again.

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance76317BeginningOfYearBalance
Contributions56987Contributions
End Of Year Balance133304EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance117490BeginningOfYearBalance
Other Expenditures41173OtherExpenditures
End Of Year Balance76317EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance1.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3152829OtherCostOrOtherBasis
Book Value3152829BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis31123151OtherCostOrOtherBasis
Depreciation10664319Depreciation
Book Value20458832BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis5165OtherCostOrOtherBasis
Depreciation3811Depreciation
Book Value1354BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis16464003OtherCostOrOtherBasis
Depreciation10900675Depreciation
Book Value5563328BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2713722OtherCostOrOtherBasis
Depreciation205991Depreciation
Book Value2507731BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings31684074TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
ASSET RETIREMENT OBLIGATION$244,004
INTEREST RATE SWAP AGREEMENT$1,254,074
FieldValueIRS element (for citing)
Total Of Amounts1498078TotalOfAmounts
Total Revenue58959297TotalRevenue
Total Expenses58502978TotalExpenses
Excess Or Deficit For Year456319ExcessOrDeficitForYear
Net Unrealized GL On Investments73086NetUnrealizedGLOnInvestments
Other-$445,763OtherAmount
Total Adjustments-372677TotalAdjustments
Excess Or Deficit Per FS83642ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt58762753TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments73086NetUnrealizedGainsInvestments
Other Revenues233395OtherRevenues
Revenue Not Rptd F990306481RevenueNotRptdF990
Revenue Subtotal58456272RevenueSubtotal
Other Revenues Not Included503025OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt503025RevenueNotRptdOnFinStmt
Total Revenue Per Form99058959297TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt58679111TotExpensesEtcAuditedFinclStmt
Other Expenses Included176408OtherExpensesIncluded
Expenses Not Rptd F990176408ExpensesNotRptdF990
Expenses Subtotal58502703ExpensesSubtotal
Other Expenses Not Included275OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt275ExpensesNotRptdOnFinStmt
Total Expenses Per Form99058502978TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Schedule D, Part XI, Line 8Other changes to Net AssetsChange in Fair Market Value of Interest Rate Swap (486,526) Change in Fair Market Value of Investment in Foundation 56,987 ARO Accretion (16,224) Total Other Changes to Net Assets (445,763)
Schedule D, Part XII, Line 2dOther Revenue on Books not on returnChange in Fair Market Value of Investment in Foundation 56,987 Loss on sale of assets reclassed from expense to income 119,384 Rental Expenses reclassed to income 57,024 Total Other revenue on books not on return 233,395
Schedule D, Part XII, Line 4bOther Revenue on return not on booksChange in Fair Market Value of Interest Rate Swap 486,526 ARO Accretion 16,224 Grant Revenue reclassed from expense to revenue 275 Total Other revenue on return not on books 503,025
Schedule D, Part XIII, Line 2dOther expense on books not on returnLoss on sale of assets reclassed from expense to income 119,384 Rental Expenses reclassed to income 57,024 Other expense on books not on return 176,408
Schedule D, Part XIII, Line 4bOther expense on return not on booksGrant Revenue reclassed from expense to revenue 275
Schedule D, Part X, Line 10Uncertain Tax PositionsManagement has evaluated their income tax positions under the guidance included in ASC 740. Based on their review, management has not identified any material uncertain tax positions to be recorded or disclosed in the financial statements.
Schedule D, Part V, Line 4Intended Uses of Endowment FundsSan Luis Valley Regional Medical Center Foundation (the Foundation) and the Medical Center are financially interrelated organizations. The mission of the foundation is to support the health care services of the Medical Center and the communities it serves. The Medical Center accounts for its interest in the net assets of the Foundation in a manner similar to the equity method. The temporarily restricted net assets represents the interest in the net assets of the Foundation. When assets are transferred to the Medical Center by the Foundation, the contributions are restricted to the purchase of equipment and facility expansion.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CarefalseFPGReferenceFreeCare
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense509439TotalCommunityBenefitExpense
Net Community Benefit Expense509439NetCommunityBenefitExpense
Percent Of Total Expense0.00970PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense10760869TotalCommunityBenefitExpense
Direct Offsetting Revenue4707647DirectOffsettingRevenue
Net Community Benefit Expense6053222NetCommunityBenefitExpense
Percent Of Total Expense0.11550PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense2135895TotalCommunityBenefitExpense
Direct Offsetting Revenue1889815DirectOffsettingRevenue
Net Community Benefit Expense246080NetCommunityBenefitExpense
Percent Of Total Expense0.00470PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense13406203TotalCommunityBenefitExpense
Direct Offsetting Revenue6597462DirectOffsettingRevenue
Net Community Benefit Expense6808741NetCommunityBenefitExpense
Percent Of Total Expense0.12990PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense19505TotalCommunityBenefitExpense
Net Community Benefit Expense19505NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense4072TotalCommunityBenefitExpense
Net Community Benefit Expense4072NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense139000TotalCommunityBenefitExpense
Net Community Benefit Expense139000NetCommunityBenefitExpense
Percent Of Total Expense0.00270PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense162577TotalCommunityBenefitExpense
Net Community Benefit Expense162577NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense13568780TotalCommunityBenefitExpense
Direct Offsetting Revenue6597462DirectOffsettingRevenue
Net Community Benefit Expense6971318NetCommunityBenefitExpense
Percent Of Total Expense0.13310PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense148TotalCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Total Community Building Expense1418TotalCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense8604TotalCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense1183TotalCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense11353TotalCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$2,439,700BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare10902876AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare5709716CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall5193160MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalOtherOther
Lutheran Hospital Association of SLV
106 Blanca AvenueAlamosaCO81101X
Lutheran Hospital Association of SLV
2115 Stuart StAlamosaCO81101Physician Clinic

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Costing Method UsedThe organization used a cost-to charge ratio for lines 7a, 7b, and 7c. The cost-to-charge ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. The information for lines 7e through 7i was derived from information in the general ledger and other financial data related specifically to the various types of community benefits.CostingMethodUsed
Percent Of Total Expense ExplnTotal bad debt expense removed from the denominator prior to the percentage calculation = 6,073,933.PercentOfTotalExpenseExpln
Bad Debt FootnoteThe Medical Center reports patient accounts receivable for services rendered at net realizable amounts from third-party payers, patients and others. The Medical Center provides an allowance for doubtful accounts based upon a review of outstanding receivables, historical collection information, and existing economic conditions. As a service to the patient, the Medical Center bills third-party payers directly and bills the patient when the patient's liability is determined. Patient accounts receivable are due in full when billed. Accounts are considered delinquent and subsequently written off as bad debts based on individual credit evaluation and specific circumstances of the account. The organization used a cost-to charge ratio for the computation of bad debt expense at cost. The cost-to-charge ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges. The administrative requirements to determine whether patients who do not cooperate with the financial assistance process would have qualified for charity can be burdensome, particularly for small balances, so a reasonable estimate, based on broad demographic data, should be sufficient to justify community benefit treatment.BadDebtFootnote
Shortfall As Community BenefitLine 6 was computed using allowable costs as reported on the San Luis Valley Regional Medical Center's 2009 Medicare Cost Report. 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.ShortfallAsCommunityBenefit
Needs AssessmentSLVRMC has its finger on the pulse of the community through various community involvements. Through communication with providers and community non-profits, this need is addressed as required. Sample current and past programming have included free colonoscopies, breast health related testing, PSA testing, and much more.NeedsAssessment
Patient Education AssistanceSLVRMC provides a Patient Financial Counselor who identifies resources and eligibility assessment for programs through Federal and State government programs, as well as grant funded programs. We also provide a sliding fee scale for service for those self pay patients not fitting within any of these programs. Pay plans are also set up for self pay patients.PatientEducationAssistance
Community InformationSLVRMC serves the entire San Luis Valley which has a population of nearly 50,000 residents within 6 counties. The SLV is geographically limited due to its surrounding mountain passes that sometimes make it difficult to travel elsewhere when care isn't available here. The average poverty level is approximately 21.6% compared to Colorado's average of 9.3%. Median income levels are approximately $26,210 compared to $47,203 statewide. 61% of households in the six county area are moderate to low income. Approximately 72% of our payer mix comes from uninsured, Medicaid/Medicare patients, CICP or self-pay.CommunityInformation
Community Building ActivitiesSLVRMC provides resources and staff Healthcare Coalitions, Emergency Preparedness, All Hazard Committee, Trauma Meetings, Street Lights for Ambulance & HUD meeting. SLVRMC is very active in the community when it comes to providing resources, information, and donations to promote healthy living in schools, businesses, and the general population. During specific health concern periods, SLVRMC provides resources at many levels to help inform and protect the community. Alamosa had a salmonella outbreak and SLVRMC staff was active in providing resources and help to the entire community. During flu outbreaks we provide necessary information through ads and articles to assure community awareness to assist in limiting exposure. SLVRMC provides free or reduced rate physicals for students and other programs. SLVRMC staff is very active in the community serving on related boards and providing other community benefit while on hospital payroll. SLVRMC provides many speaking tours on health related topics all over the San Luis Valley to inform and instruct residents on various issues.CommunityBuildingActivities
Affiliated Health Care SystemN/AAffiliatedHealthCareSystem

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Non Cash AssistanceAmountOfNonCashAssistancePurpose Of GrantPurposeOfGrant
TRINIDAD STATE JUNIOR COLLEGE
1011 MAIN STALAMOSACO81101840644739GOVERNMENT60000EDUCATION
ADAMS STATE COLLEGE
208 EDGEMONT BLVDALAMOSACO81102846000542GOVERNMENT60000EDUCATION
CROSSROADS TURNING POINTS INC
4 MONTEBELLO RDPUEBLOCO81001840810723501(c)(3)12000COMMUNITY SUPPORT
ADAMS STATE COLLEGE FOUNDATION
208 EDGEMONT BLVDALAMOSACO81102846027518501(c)(3)7000SUPPORT OF COLLEGE
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants4TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE U.S.Identifier
Return ReferencePART I, LINE 2ReturnReference
ExplanationFUNDS ARE PROVIDED TO BE USED FOR DESIGNATED PURPOSES ONLY. ALL GRANTEES ARE SELECTED AND STRICTLY SCREENED BY THE MEDICAL CENTER. MULTI-YEAR AGREEMENTS ARE MADE WITH THE RECIPIENT ORGANIZATIONS AND ARE EVALUATED ON AN ANNUAL BASIS BEFORE FUNDING IS CONTINUED.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
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 PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

Base 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
RUSSELL JOHNSON
253706069458038642062934099830434722000
HENRY GARVIN
15187401625403408026768038490202153000
DAVID FRESHOUR
163588016830020828029491047080235445000
GWEN HELLER
13697601485109669024648061060192250000
THOMAS HENTON
1242090120060963015165040210156364000
GREG MCAULIFFE MD
223558000237600040080229942000
STEVEN W KITCHEN
5870830001548014700052930608624000
GLEN A GAUNT
336642000828014700049840357154000
DAVID GEIGER
298762000828014700062840320574000
DAVID FROW
2870030001548014700048760308127000
CLIFFORD ROBINS
271205000540014483020610288289000
LEONARD SNOW
1026330132000175490124660103500156198000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
NON-FIXED PAYMENTS FOR OFFICERS OR DIRECTORSPART 1 QUESTION 7OFFICER BONUSES ARE DEPENDENT ON MEETING BUDGETED PROJECTIONS.
SEVERANCE PAYMENTSPART I, LINE 4ADavid Freshour, CFO, left at the end of May 2010. His severance package included 6 months of wages payable in the amount of $6,663.20 every two weeks, health benefits, and participation in the year end bonus. By the end of the fiscal year, only 2 of the 13 severance payments had been made.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuer
ALAMOSA COUNTY STATE OF COLORADO
846000733011583AA92005-02-1711355000HOSPITAL IMPROVEMENTSfalsefalse
ALAMOSA COUNTY STATE OF COLORADO
846000733011583AB72007-04-266505000PURCHASE 2115 STUART & IMPROVEMENTfalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
11355000148816362859109921412005falsefalsetruetrue
65050002994621195262930482007falsefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsetruefalsefalsefalse0.010000.000000.01000true
falsetruefalsefalsefalse0.020000.000000.02000true

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsTerm Of HedgeTermOfHedgeGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
MORGAN STANLEY CAP
falsetruetrue20.28falsefalsefalse
MORGAN STANLEY CAP
falsetruetrue15.falsefalsefalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part VI, Question 11ADescribe process to review 990The 990 is prepared by a third party organization, reviewed by the CFO and CEO, and approved by the finance committee. The Board of directors is also provided a copy of the 990 for review prior to filing with the IRS.
Part VI, Question 19Describe how documents are made available to the publicThe governing documents, conflict of interest policy, and financial statements are available to the public upon request.
Schedule BGrant from SLVRMC FoundationThe SLVMRC Foundation, a related organization, recorded total grants to the medical center of 47,383. However, the Medical Center has only recorded grants received from the foundation of 40,000. This discrepancy is related to in-kind grants from SLVRMC Foundation which are immaterial to the Medical Center and never recorded.
Part VI, Question 15aExecutive CompensationHuman resources provides the Executive Committee of the Board with salary survey data from CHA, AHA, and HFMA. After studying the data, the executive committee makes recommendations to the full board in executive session. The full board approves the CEO's compensation. SLVRMC conducts an annual evaluation and quarterly reviews of the CEO's performance. Compensation for the CEO is determined annually.
Part VI, Question 15bOther officer compensationHuman resources gathers compensation survey data from CHA, AHA, and HFMA. Human resources makes recommendations for other officers' compensation and provides survey data to the CEO. The CEO performs evaluations and determines all of the wage changes for the other officers on an annual basis.
Part VI, Question 12Monitoring of conflict of interest policySan Luis Valley Regional Medical Center has a current Conflict of Interest Policy that is reveiwed annually by the Board of Trustees and the CEO. The review process is conducted first with the CEO and then the Board of Trustees. When necessary, the policy has been reviewed by legal counsel. Each year Trustees are asked to review the policy and confirm and amend any potential conflict. These conflicts are reveiwed by the CEO and the entire board. Conflicts are routinely discussed and are the responsibility of all board members to disclose; either for themselves or others. The board chairman will make a decision as to the nature of the conflict and the appropriate action according to the policy.
Schedule K, Part II, Line 5Issuance Costs From ProceedsA portion of the issuance costs for the Series 2005 bonds was used for credit enhancement. Of the total $362,859 issuance costs, $135,759 were used for credit enhancement and $227,100 were used for other issuance costs. A portion of the issuance costs for the Series 2007 bonds was used for credit enhancement. Of the total $211,952 issuance costs, $81,852 were used for credit enhancement and $130,100 were used for other issuance costs.

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/BusinessNameLine1
SLVRMC FOUNDATION
106 BLANCA AVENUEALAMOSACO81101203799814FUNDRAISINGCO501(C)(3)LINE 7NA
CONEJOS COUNTY HOSPITAL CORPORATION
PO BOX 639LA JARACO81140710947623HOSPITALCO501(C)(3)LINE 3NA
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 OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
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 OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
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 (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
CONEJOS COUNTY HOSPITAL CORPORATION
D709887
CONEJOS COUNTY HOSPITAL CORPORATION
K962590
CONEJOS COUNTY HOSPITAL CORPORATION
N285513
CONEJOS COUNTY HOSPITAL CORPORATION
P488451