SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
ARKANSAS VALLEY REGIONAL MEDICAL
CENTER
Employer identification number

84-1465990
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    184,232   184,232 0.490 %
b Medicaid (from Worksheet 3, column a) . . . . .     12,297,221 8,962,407 3,334,814 8.800 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     12,481,453 8,962,407 3,519,046 9.290 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 24 75 2,083   2,083 0.010 %
f Health professions education (from Worksheet 5) . . .            
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .            
j Total. Other Benefits . . 24 75 2,083   2,083 0.010 %
k Total. Add lines 7d and 7j . 24 75 12,483,536 8,962,407 3,521,129 9.290 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total            
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
3,553,643
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
9,701,669
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
9,652,810
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
48,859
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

 

No
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2020
Schedule H (Form 990) 2020
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 ARKANSAS VALLEY REGIONAL MEDICAL
CENTER
1100 CARSON AVENUE
LA JUNTA,CO81050
WWW.AVRMC.ORG
010210 		X X     X   X      
Schedule H (Form 990) 2020
Page 4
Schedule H (Form 990) 2020
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
ARKANSAS VALLEY REGIONAL MEDICAL
Name of hospital facility or letter of facility reporting group CENTER
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 19
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): WWW.AVRMC.ORG
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2020
Page 5
Schedule H (Form 990) 2020
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
ARKANSAS VALLEY REGIONAL MEDICAL
Name of hospital facility or letter of facility reporting group CENTER
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
WWW.AVRMC.ORG/
b
 
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2020
Page 6
Schedule H (Form 990) 2020
Page 6
Part VFacility Information (continued)

Billing and Collections
ARKANSAS VALLEY REGIONAL MEDICAL
Name of hospital facility or letter of facility reporting group CENTER
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2020
Page 7
Schedule H (Form 990) 2020
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
ARKANSAS VALLEY REGIONAL MEDICAL
Name of hospital facility or letter of facility reporting group CENTER
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2020
Page 8
Schedule H (Form 990) 2020
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
FACILITY 1, ARKANSAS VALLEY REGIONAL MEDICAL - PART V, LINE 3E IDENTIFICATION AND PRIORITIZATION OF HEALTH NEEDS ARE ADDRESSED BEGINNING ON PAGE 49, OF THE LATEST CHNA LOCATED ON THE WEBSITE.
FACILITY 1, ARKANSAS VALLEY REGIONAL MEDICAL - PART V, LINE 5 A CHNA SURVEY WAS DEPLOYED TO THE HOSPITAL'S LOCAL EXPERT ADVISORS TO GAIN INPUT ON LOCAL HEALTH NEEDS AND THE NEEDS OF PRIORITY POPULATIONS. LOCAL EXPERT ADVISORS WERE LOCAL INDIVIDUALS SELECTED ACCORDING TO CRITERIA REQUIRED BY THE FEDERAL GUIDELINES AND REGULATIONS AND THE HOSPITAL'S DESIRE TO REPRESENT THE REGION'S GEOGRAPHICALLY AND ETHNICALLY DIVERSE POPULATION. COMMUNITY INPUT FROM 15 LOCAL EXPERT ADVISORS WAS RECEIVED. SURVEY RESPONSES STARTED DECEMBER 18, 2018, AND ENDED WITH THE LAST RESPONSE ON JANUARY 11, 2019. INFORMATION ANALYSIS AUGMENTED BY LOCAL OPINIONS SHOWED HOW OTERO, CROWLEY AND BENT COUNTIES RELATE TO THEIR PEERS IN TERMS OF PRIMARY AND CHRONIC NEEDS AND OTHER ISSUES OF UNINSURED PERSONS, LOW-INCOME PERSONS, AND MINORITY GROUPS. RESPONDENTS COMMENTED ON WHETHER THEY BELIEVE CERTAIN POPULATION GROUPS ("PRIORITY POPULATIONS") NEED HELP TO IMPROVE THEIR CONDITION, AND IF SO, WHO NEEDS TO DO WHAT TO IMPROVE THE CONDITIONS OF THESE GROUPS. LOCAL OPINIONS OF THE NEEDS OF PRIORITY POPULATIONS, WHILE PRESENTED IN ITS ENTIRETY IN THE APPENDIX, ARE SUMMARIZED AS LOW-INCOME GROUPS, OLDER ADULTS, RACIAL AND ETHNIC MINORITY GROUPS, AND RESIDENTS OF RURAL AREAS. ADDITIONALLY, THE INFORMATION AND SUMMARY CONCLUSIONS WERE PUT BEFORE THE HOSPITAL'S LOCAL EXPERT ADVISORS WHO WERE ASKED TO AGREE OR DISAGREE WITH THE SUMMARY CONCLUSIONS. THEY WERE FREE TO AUGMENT POTENTIAL CONCLUSIONS WITH ADDITIONAL COMMENTS OF NEED. HAVING TAKEN STEPS TO IDENTIFY POTENTIAL COMMUNITY NEEDS, THE LOCAL EXPERTS THEN PARTICIPATED IN A STRUCTURED COMMUNICATION TECHNIQUE CALLED A "WISDOM OF CROWDS" METHOD. THE PREMISE OF THIS APPROACH RELIES ON A PANEL OF EXPERTS WITH THE ASSUMPTION THAT THE COLLECTIVE WISDOM OF PARTICIPANTS IS SUPERIOR TO THE OPINION OF ANY ONE INDIVIDUAL, REGARDLESS OF THEIR PROFESSIONAL CREDENTIALS. IN THE AVRMC PROCESS, EACH LOCAL EXPERT HAD THE OPPORTUNITY TO INTRODUCE NEEDS PREVIOUSLY UNIDENTIFIED AND TO CHALLENGE CONCLUSIONS DEVELOPED FROM THE DATA ANALYSIS. WHILE THERE WERE A FEW OPINIONS OF THE DATA CONCLUSIONS NOT BEING COMPLETELY ACCURATE, MOST OF THE COMMENTS AGREED WITH THE FINDINGS. A LIST OF ALL NEEDS IDENTIFIED BY ANY OF THE ANALYZED DATA WAS DEVELOPED. THE LOCAL EXPERTS THEN ALLOCATED 100 POINTS AMONG THE LIST OF HEALTH NEEDS, INCLUDING THE OPPORTUNITY TO LIST ADDITIONAL NEEDS THAT WERE NOT IDENTIFIED FROM THE DATA. THE RANKED NEEDS WERE DIVIDED INTO TWO GROUPS: "SIGNIFICANT- AND "OTHER IDENTIFIED NEEDS." THE SIGNIFICANT NEEDS WERE PRIORITIZED BASED ON TOTAL POINTS CAST BY THE LOCAL EXPERTS IN DESCENDING ORDER, FURTHER RANKED BY THE NUMBER OF LOCAL EXPERTS CASTING ANY POINTS FOR THE NEED. BY DEFINITION, A SIGNIFICANT NEED HAD TO INCLUDE ALL RANK ORDERED NEEDS UNTIL AT LEAST SIXTY PERCENT (60%) OF ALL POINTS WERE INCLUDED AND TO THE EXTENT POSSIBLE, REPRESENTED POINTS ALLOCATED BY A MAJORITY OF VOTING LOCAL EXPERTS. THE DETERMINATION OF THE BREAK POINT - "SIGNIFICANT" AS OPPOSED TO "OTHER" - WAS A QUALITATIVE INTERPRETATION WHERE A REASONABLE BREAK POINT IN RANK ORDER OCCURRED. INDIVIDUALS PARTICIPATING AS LOCAL EXPERT ADVISORS INCLUDED INDIVIDUALS WITH PUBLIC HEALTH EXPERTISE, DEPARTMENTS AND AGENCIES WITH RELEVANT INFORMATION REGARDING HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL, PRIORITY POPULATIONS, AND REPRESENTATIVES OF CHRONIC DISEASE GROUPS OR ORGANIZATIONS.
FACILITY 1, ARKANSAS VALLEY REGIONAL MEDICAL - PART V, LINE 6B THE HOSPITAL COLLABORATED WITH AND OBTAINED ASSISTANCE IN CONDUCTING THIS CHNA FROM QUORUM HEALTH RESOURCES (QHR).
FACILITY 1, ARKANSAS VALLEY REGIONAL MEDICAL - PART V, LINE 11 THE MOST RECENT CHNA IDENTIFIED THE FOLLOWING SIGNIFICANT HEALTH NEEDS: ACCESS TO HEALTHCARE/PHYSICIAN, ALCOHOL USE/SUBSTANCE ABUSE, CANCER, DIABETES, AND OBESITY. AVRMC SERVICES, PROGRAMS, AND RESOURCES AVAILABLE TO RESPOND TO THESE NEEDS INCLUDE: O A STRONG MIX OF SPECIALTY CARE PROVIDERS ALLOWS FOR REASONABLE ACCESS TO THOSE NEEDED SERVICES IN THE COMMUNITY O IN PRIMARY CARE PRACTICES OWNED BY AVRMC, THERE ARE CALL BACK PROTOCOLS IN PLACE TO PROVIDE APPOINTMENT REMINDERS O A NURSE THAT DOES ANNUAL WELLNESS VISITS PERFORMS FOLLOW-UPS AND CALLS O WORK WITH THE COLORADO HOSPITAL ASSOCIATION IN OFFERING THE ALTO PROJECT, WHICH IS GEARED TOWARD REDUCING THE ADMINISTRATION OF OPIOIDS PRESCRIBED THROUGH EMERGENCY DEPARTMENTS O WORK CLOSELY WITH SOUTHEAST HEALTH GROUP WHICH PROVIDES MENTAL HEALTH, SUBSTANCE USE DISORDER, PRIMARY CARE AND WELLNESS SERVICES TO SIX RURAL AND FRONTIER COLORADO COUNTIES-BACA, BENT, CROWLEY, KIOWA, OTERO, AND PROWERS O AVRMC IS AN ACTIVE MEMBER OF THE SOUTH EAST HEALTHCARE COALITION, WHICH EXISTS TO COLLABORATE TO PROVIDE EDUCATION OPPORTUNITIES TO ITS MEMBERS O ROTATING ONCOLOGY SPECIALISTS COME IN AND PROVIDE SERVICES TO THE COMMUNITY FROM PUEBLO O OFFER CHEMOTHERAPY INJECTIONS (NO IV RUNS) IN THAT PHASE OF TREATMENT O WORK WITH THE COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT IN SUPPORT OF THE COLORADO QUITLINE O EDUCATION ON RELATED DISEASES AND SERVICES AVAILABLE O PROVIDE SCREENING OPPORTUNITIES AT THE COMMUNITY HEALTH FAIR THAT IS DRIVEN BY AVRMC SUCH AS PSA SCREENINGS AND PULMONARY FUNCTION TEST O OFFER AND MARKET MAMMOGRAPHY SCANS O EMPLOY A FULL TIME CERTIFIED DIABETIC EDUCATOR (CDE) O OFFER DIABETES SELF-MANAGEMENT EDUCATION EACH MONTH O HAVE A STRONG PRESENCE WITH DIABETES EDUCATION AT THE COMMUNITY HEALTH FAIR O EMPLOY A DIETICIAN THAT WORKS CLOSELY WITH THE CDE O OFFER MONTHLY MEETINGS FOR A DIABETES SUPPORT GROUP O CDE SPEAKS WITH CIVIC ORGANIZATIONS, CHURCH GROUPS, THE LOWER ARKANSAS VALLEY AREA AGENCY ON AGING, AND AT THE LA JUNTA SENIOR CENTER O DIABETES EDUCATOR WORKS WITH PATIENTS WHO ARE AT RISK OF OBESITY OR ALREADY ARE OBESE O EVANGELIZE AND SUPPORT SEVERAL WEIGHT CONTROL GROUPS IN TOWN SUCH AS TOPS AND WEIGHT WATCHERS O PROVIDE BMI TESTING AT THE HEALTH FAIR O A PATIENT SCREENING WITH A HIGH BMI RECEIVES A REFERRAL TO THE AVRMC DIETICIAN O DIETICIAN WILL EDUCATE OF OPPORTUNITIES/PROGRAMS IN THE COMMUNITY OTHER NEEDS IDENTIFIED DURING CHNA PROCESS INCLUDE HEART DISEASE, MENTAL HEALTH/SUICIDE, WOMEN'S HEALTH, ACCIDENTS, PREVENTION/WELLNESS EDUCATION, CHRONIC PAIN MANAGEMENT, HYPERTENSION, LUNG DISEASE, PHYSICAL ACTIVITY, STROKE, LIVER DISEASE, KIDNEY DISEASE, ALZHEIMER'S, AND FLU/PNEUMONIA. WE DO NOT HAVE ADEQUATE RESOURCES TO SOLVE ALL THE PROBLEMS IDENTIFIED. SOME ISSUES ARE BEYOND THE MISSION OF THE HOSPITAL AND ACTION IS BEST SUITED FOR A RESPONSE BY OTHERS. SOME IMPROVEMENTS WILL REQUIRE PERSONAL ACTIONS BY INDIVIDUALS RATHER THAN THE RESPONSE OF AN ORGANIZATION. WE VIEW THIS AS A PLAN FOR HOW WE, ALONG WITH OTHER ORGANIZATIONS AND AGENCIES, CAN COLLABORATE TO BRING THE BEST EACH HAS TO OFFER TO ADDRESS THE MORE PRESSING IDENTIFIED NEEDS. BY DEFINITION, THE NEEDS IDENTIFIED AS LOW PRIORITY AND FOR WHICH AVRMC HOLDS LOW RESPONSILBILITY FOR IMPLEMENTATION ARE NEEDS TO WHICH THE HOSPITAL MAY DEVOTE RESOURCES WHILE (IN MOST CASES) MONITORING BUT OTHERWISE NOT ADDRESSING. REASONS FOR THIS RESPONSE INCLUDE THE FOLLOWING: ACTIONS REQUIRED ARE BEYOND THE MISSION OF AVRMC, AVRMC CAN BE MORE EFFECTIVE APPLYING ITS RESOURCES TO HIGHER PRIORITY NEEDS, THE HOSPITAL DOES NOT POSSESS THE EXPERTISE NECESSARY FOR SUBSTANTIVE POSITIVE IMPROVEMENT, ACTIONS CONTEMPLATED FOR IMPLEMENTATION FALL MORE APPROPRIATELY TO THE RESPONSIBILITY OF OTHERS OTHER THAN PROVIDING ENCOURAGEMENT, AND IMPLEMENTATION EFFORTS FOR SOME NEEDS REQUIRE APPROPRIATE ACTIONS BY INDIVIDUALS MODIFYING THEIR PERSONAL HABITS RATHER THAN A RESPONSE BY AN ORGANIZATION OR THE HEALTH SYSTEM. THE BEST USE OF AVRMC RESOURCES IS TO FOCUS ON RESOLVING OR IMPROVING HIGHER PRIORITY NEEDS RATHER THAN ATTEMPTING TO RESPOND TO EVERYTHING WITH SMALL, PERHAPS INEFFECTIVE, EFFORTS.
FACILITY 1, ARKANSAS VALLEY REGIONAL MEDICAL - PART V, LINE 13B THE ONLY CHARITY CARE DEFINED BY AVRMC'S PURPOSE IS PATIENTS THAT QUALIFY FOR COLORADO INDIGENT CARE.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2020
Page 9
Schedule H (Form 990) 2020
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?1
Name and address Type of Facility (describe)
1 ARKANSAS VALLEY REGIONAL MEDICAL
1100 CARSON AVENUE
LA JUNTA,CO81050 		LONG-TERM NURSING HOME
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2020
Page 10
Schedule H (Form 990) 2020
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY USED TO DETERMINE THE FINANCIAL ASSISTANCE IS THE COST TO CHARGE RATIO.
SCHEDULE H, PART III, LINE 2 THE COST METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED AS BAD DEBT EXPENSE IS USING A COST-TO-CHARGE RATIO. THE AMOUNT OF BAD DEBTS ATTRIBUTABLE TO PATIENT ACCOUNTS IS MULTIPLIED BY THE RATIO OF PATIENT CARE COST TO CHARGES CALCULATE THE ESTIMATED COST OF BAD DEBTS ATTRIBUTABLE TO PATIENT ACCOUNTS. A NUMBER OF PATIENTS ARE TRULY UNABLE TO PAY THEIR OUT-OF-POCKET LIABILITY, BUT DO NOT COMPLETE THE PROCESS REQUIRED TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY. THESE PATIENTS WOULD QUALIFY FOR CHARITY CARE IF THEY COMPLETED THE PAPERWORK, SO THE BAD DEBT EXPENSE ASSOCIATED WITH TREATING THEM SHOULD BE TREATED AS A COMMUNITY BENEFIT.
SCHEDULE H, PART III, LINE 4 THE PATIENT ACCOUNTS RECEIVABLE FOOTNOTE OF THE AUDITED FINANCIAL STATEMENTS IS FOUND IN FOOTNOTE 4 ON PAGE 12 OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS INCLUDED IN FOOTNOTE 10 BEGINNING ON PAGE 14 OF THE AUDITED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, LINE 8 MEDICARE SHORTFALL WAS CALCULATED USING THE MEDICARE COST REPORT FOR THE YEAR. 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 SHOULD BE INCLUDED AS A COMMUNITY BENEFIT.
SCHEDULE H, PART III, LINE 9B PATIENTS ARE NOTIFIED OF THE FINANCIAL ASSISTANCE PROGRAM VIA PATIENT FINANCIAL COUNSELORS, BROCHURES AVAILABLE IN THE ADMISSION AND BUSINESS OFFICE AREAS OF THE HOSPITAL, AND ON OUR WEBSITE AT THE FOLLOWING URL: HTTP://WWW.AVRMC.ORG/GETPAGE.PHP?NAME=FINANCIAL- ASSISTANCE-PRGRAM&SUB=FOR%20PATIENTS
SCHEDULE H, PART VI, LINE 2 THE CHNA IS THE PRIMARY METHOD TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY SERVED. HOSPITAL DEPARTMENT MANAGERS, MANAGEMENT, AND THE BOARD OF DIRECTORS ARE COMPRISED OF MEMBERS WITHIN THE COMMUNITY. THEY ARE ABLE TO GATHER AND COMMUNICATE THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES AND CONTINUALLY ADDRESS THEM AT STAFF AND BOARD MEETINGS. THE MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY AND COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE FOUND AT THE FOLLOWING URL: HTTP://WWW.AVRMC.ORG/GETPAGE.PHP?NAME=COMMUNITY-HEALTH- NEEDS&CHILD=COMMUNITY+HEALTH+NEEDS
SCHEDULE H, PART VI, LINE 3 THE MEDICAL CENTER PROVIDES A BROCHURE TO EACH PATIENT OUTLINING THE GUIDELINES TO DETERMINE ELIGIBILITY FOR ASSISTANCE. IF APPROPRIATE, WE GET THEM AN APPOINTMENT WITH A FINANCIAL COUNSELOR. THE BROCHURE CAN BE FOUND ON OUR WEBSITE AT THE FOLLOWING URL: HTTP://WWW.AVRMC.ORG/GETPAGE.PHP?NAME=FINANCIAL-ASSISTANCE-PRGRAM&SUB=FOR %20PATIENTS
SCHEDULE H, PART VI, LINE 4 AVRMC, IN CONJUNCTION WITH QUORUM, DEFINES ITS SERVICE AREA AS OTERO COUNTY IN COLORADO, WHICH INCLUDES THE FOLLOWING ZIP CODES: 81039 FOWLER, 81050 LA JUNTA, 81058 MANZANOLA, AND 81067 ROCKY FORD. IN 2014, THE HOSPITAL RECEIVED 72.0% OF ITS PATIENTS FROM THIS AREA. COUNTY DATA IS USED AS MOST INFORMATION IS NOT AVAILABLE AT THE GEOGRAPHIC LEVEL OF A ZIP CODE. THE 2015 POPULATION FOR OTERO COUNTY IS ESTIMATED TO BE 19,013, AND IS EXPECTED TO INCREASE AT A RATE OF 0.5%, PROJECTING A 2020 POPULATION OF 19,100. THE POPULATION INCREASE IS IN CONTRAST TO THE COLORADO STATE AVERAGE RATE OF POPULATION INCREASE OF 6.3% AND THE NATIONAL GROWTH RATE OF 3.5%. APPROXIMATELY 55.1 % OF THE OTERO COUNTY POPULATION IS OF WHITE, NON-HISPANIC ETHNIC ORIGIN, COMPARED TO THE U S POPULATION PERCENTAGE OF 61.8%. THE HISPANIC POPULATION OF OTERO COUNTY IS 41.2%, COMPARED TO 17.6% NATIONALLY. THE 65+ POPULATION OF OTERO COUNTY 1S 19.7% OF THE TOTAL POPULATION COMPARED TO THE OVERALL US AT 14.7%. THE 2015 PERCENTAGE OF CHILD-BEARING-AGE FEMALES IN OTERO COUNTY IS 17.0%, WHILE IN COLORADO AS A WHOLE IT IS 19.9%, AND FOR THE US 19.7%. THE 2015 OTERO COUNTY MEDIAN HOUSEHOLD INCOME IS 34,037, WHICH IS CONSIDERABLY LOWER THAN THE NATIONAL MEDIAN HOUSEHOLD INCOME OF 53,375. OTERO COUNTY'S UNEMPLOYMENT RATE AS OF 2015 IS 4.7%. THIS IS LESS THAN THE NATIONAL UNEMPLOYMENT RATE OF 5.1%.
SCHEDULE H, PART VI, LINE 5 THE MEDICAL CENTER'S BOARD OF DIRECTORS IS COMPRISED OF PERSONS WHO RESIDE IN THE LA JUNTA, COLORADO AREA. THE MAJORITY OF THE ORGANIZATION'S BOARD MEMBERS ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE MEDICAL CENTER. THE BOARD OF DIRECTORS IS MADE MOSTLY OF COMMUNITY BUSINESS PEOPLE INTERESTED IN MAINTAINING QUALITY HEALTH CARE IN LA JUNTA. MEDICAL STAFF PRIVILEGES ARE OPEN TO ALL MEDICAL PROVIDERS WITH ACTIVE LICENSURE. WE ENCOURAGE PRACTITIONERS FROM NUMEROUS SPECIALTIES TO MEET THE EVER EXPANDING HEALTHCARE NEEDS OF THE COMMUNITY. ANY SURPLUS FUNDS ARE REINVESTED INTO OUR FACILITIES, EQUIPMENT, AND EMPLOYEE EDUCATION.
SCHEDULE H, PART VI, LINE 6 N/A
SCHEDULE H, PART VI, LINE 7 COLORADO
Schedule H (Form 990) 2020
Additional Data


Software ID:  
Software Version: