SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
Medium right arrow Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow Attach to Form 990.
Medium right arrow Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2022
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) . . . 		    245,518   245,518 0.630 %
b Medicaid (from Worksheet 3, column a) . . . . .     15,668,052 15,668,052    
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     15,913,570 15,668,052 245,518 0.630 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).            
f Health professions education (from Worksheet 5) . . .     43,465   43,465 0.110 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     690   690  
j Total. Other Benefits . .     44,155   44,155 0.110 %
k Total. Add lines 7d and 7j .     15,957,725 15,668,052 289,673 0.750 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
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     64,799   64,799 0.170 %
9 Other            
10 Total     64,799   64,799 0.170 %
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
1,836,591
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
5,798,513
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
5,802,562
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-4,049
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) 2022
Schedule H (Form 990) 2022
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 and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research 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) 2022
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Schedule H (Form 990) 2022
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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 22
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 22
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) 2022
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Schedule H (Form 990) 2022
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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) 2022
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Schedule H (Form 990) 2022
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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) 2022
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Schedule H (Form 990) 2022
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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) 2022
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Schedule H (Form 990) 2022
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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 126 OF THE LATEST CHNA LOCATED ON THE WEBSITE.
FACILITY 1, ARKANSAS VALLEY REGIONAL MEDICAL - PART V, LINE 5 THE MEDICAL CENTER TOOK INTO ACCOUNT INPUT FROM REPRESENTATIVES OF THE COMMUNITY BY INTERVIEWING LOCAL EXPERT ADVISORS WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH IN BENT, OTERO AND CROWLEY COUNTIES REPRESENTING VARIOUS ORGANIZATIONS AND POPULATIONS WITHIN THE COMMUNITY INCLUDING PUBLIC HEALTH REPRESENTATIVES AND OTHER INDIVIDUALS WHO FOCUS SPECIFICALLY ON UNDERREPRESENTED GROUPS. COMMUNITY INPUT WAS COLLECTED IN NOVEMBER 2021 FROM 16 LOCAL EXPERT ADVISORS. THE LOCAL EXPERT ADVISORS ARE A DIVERSE GROUP OF COMMUNITY MEMBERS UTILIZED TO GAIN INPUT ON LOCAL HEALTH NEEDS AND THE NEEDS OF PRIORITY POPULATIONS. THESE LOCAL INDIVIDUALS WERE 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. THE STUDY AREA IS BASED ON HOSPITAL INPATIENT DISCHARGE DATA FROM APRIL 1, 2019 TO MARCH 31, 2020 AND DISCUSSIONS WITH HOSPITAL STAFF. 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 MEDICAL CENTER COLLABORATED WITH AND OBTAINED ASSISTANCE FROM COMMUNITY HOSPITAL CONSULTING (CHC CONSULTING) TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT TO IMPROVE THE UNDERSTANDING OF THE HEALTH STATUS OF ITS SERVICE AREA.
FACILITY 1, ARKANSAS VALLEY REGIONAL MEDICAL - PART V, LINE 11 THE MOST RECENT CHNA IDENTIFIED THE FOLLOWING SIGNIFICANT HEALTH NEEDS: 1. ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS ACCESS TO PRIMARY AND SPECIALTY CARE SERVICES AND PROVIDERS 2. PREVENTION, EDUCATION AND SERVICES TO ADDRESS HIGH MORTALITY RATES, CHRONIC DISEASES, PREVENTABLE CONDITIONS AND UNHEALTHY LIFESTYLES 3. ACCESS TO AFFORDABLE CARE AND REDUCING HEALTH DISPARITIES AMONG SPECIFIC POPULATIONS 4. ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES AND PROVIDERS 5. CONTINUED FOCUS ON COVID19 PREVENTION AND RESPONSE 6. NEED FOR INCREASED EMPHASIS ON HOUSING & TRANSPORTATION WHILE THE MEDICAL CENTER ACKNOWLEDGES THAT THE NEED FOR HOUSING AND TRANSPORTATION IS A SIGNIFICANT NEED IN THE COMMUNITY, THIS NEED WILL NOT BE DIRECTLY ADDRESSED BY THE HOSPITAL SINCE IT IS NOT A CORE BUSINESS FUNCTION OF THE HOSPITAL AND THE LEADERSHIP TEAM FELT THAT RESOURCES AND EFFORTS WOULD BE BETTER SPENT ADDRESSING THE REMAINING PRIORITIZED NEEDS. AVRMC WILL HOWEVER WORK INDIRECTLY WITH LOCAL COMMUNITY ORGANIZATIONS TO SEE HOW THE FACILITY CAN ASSIST IN THESE AREAS. THE MEDICAL CENTER IS ADDRESSING THE TOP FIVE PRIORITIES USING THE FOLLOWING STRATEGIES: 1. IMPLEMENT AND OFFER PROGRAMS THAT AIM TO ADDRESS ACCESS TO PRIMARY AND SPECIALTY CARE SERVICES IN THE COMMUNITY THROUGH RECRUITMENT AND RETENTION EFFORTS SUCH AS OFFERING A VARIETY OF PRIMARY AND SPECIALTY SERVICES AND EXPLORING THE FEASIBILITY OF EXPANDING SERVICES AS OPPORTUNITIES ARISE; INCREASING AWARENESS OF PRIMARY AND SPECIALTY CARE SERVICES OFFERED IN THE COMMUNITY THROUGH VARIOUS MEDIA OUTLETS AND ADVERTISEMENTS; SERVING AS A TEACHING FACILITY FOR LOCAL RN, LAB, RESPIRATORY THERAPY, PHYSICAL THERAPY, ANCILLARY STUDENTS AND RESIDENTS; MAINTAINING AND PROVIDING A LIST OF REFERRAL SERVICES TO PATIENTS WHO REQUIRE SPECIALTY CARE; COLLABORATING AND COMMUNICATING WITH THE LOCAL URGENT CARE FACILITY TO ENSURE PATIENTS ARE APPROPRIATELY TRIAGED; SERVING AS AN ACTIVE MEMBER OF THE SOUTH EAST HEALTHCARE COALITION, WHICH EXISTS TO COLLABORATE TO PROVIDE EDUCATION OPPORTUNITIES TO ITS MEMBERS; MAINTAINING A WALK-IN CLINIC TO HANDLE NON-EMERGENT PATIENT VISITS THAT ARE NOT ABLE TO OTHERWISE ACCESS A SAME-DAY APPOINTMENT. PATIENTS ARE ALSO SCREENED FOR EMERGENT NEEDS; FOLLOWING UP ON WELLNESS VISITS WITH MEDICARE AND MEDICAID PATIENTS IN ORDER TO STRENGTHEN THEIR CONTINUUM OF CARE; EXTENDING HOURS IN THE CLINIC AND TELEHEALTH SERVICES. 2. IMPLEMENT PROGRAMS AND PROVIDE EDUCATIONAL OPPORTUNITIES THAT SEEK TO ADDRESS UNHEALTHY LIFESTYLES AND BEHAVIORS IN THE COMMUNITY SUCH AS OFFERING A VARIETY OF HEALTH SCREENINGS TO THE COMMUNITY; EDUCATIONAL OPPORTUNITIES FOR THE PUBLIC CONCERNING WELLNESS TOPICS AND HEALTH RISK CONCERNS; SERVING IN LEADERSHIP AND VOLUNTEER ROLES WITH AGENCIES AND COMMITTEES IN THE COMMUNITY; PROVIDING SPEAKERS FOR CIVIC GROUPS, INDUSTRIAL PARTNERS, FOR MEDIA APPEARANCES AND HEALTH FAIRS TO ADDRESS HEALTH CARE TOPICS OF CONCERN TO THE PUBLIC; PARTICIPATING IN CONFERENCES FOCUSED AROUND PATIENT POPULATION'S NEEDS; WORKING WITH THE COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT IN SUPPORT OF THE COLORADO QUITLINE. 3. IMPLEMENT AND OFFER PROGRAMS THAT AIM TO REDUCE HEALTH DISPARITIES BY TARGETING SPECIFIC POPULATIONS SUCH AS OFFERING AND PROMOTING THE COLORADO MEDICAID NURSE ADVICE LINE, WHICH PROVIDES MEDICAID MEMBERS FREE AROUND-THE CLOCK ACCESS TO MEDICAL INFORMATION AND ADVICE. NURSES WILL ANSWER PATIENT MEDICAL QUESTIONS, PROVIDE CARE ADVICE AND HELP PATIENTS DETERMINE IF THEY SHOULD BE SEEN BY A DOCTOR RIGHT AWAY; OFFERING FINANCIAL ASSISTANCE AND PAYMENT PLAN EDUCATION TO PATIENTS WHO HAVE AN ECONOMIC NEED AND MEET THE QUALIFICATIONS OF THE FINANCIAL ASSISTANCE POLICY. IF FINANCIAL ASSISTANCE IS NEEDED, AVRMC ENCOURAGES PATIENTS TO COMPLETE AN APPLICATION TO SEE IF THEY QUALIFY; PROVIDING A TELEPHONE LANGUAGE LINE AND MY ACCESSIBLE REAL TIME TRUSTED INTERPRETER (MARTTI) SYSTEM TO PROVIDE TRANSLATION SERVICES FOR NON-ENGLISH SPEAKING PATIENTS AND FAMILIES AS NEEDED, AS WELL AS VIDEO SERVICES FOR SIGN LANGUAGE COMMUNICATION; SUPPORTING FUNDRAISING EVENTS AND DONATION DRIVES TO BENEFIT UNDERSERVED ORGANIZATIONS IN THE COMMUNITY; CASE MANAGEMENT SERVICES TO CONNECT PATIENTS WITH APPROPRIATE, AFFORDABLE RESOURCES UPON DISCHARGE AND AS OPPORTUNITIES ARISE; PARTICIPATING IN BLOOD DRIVES FOR THE COMMUNITY; PARTNERING WITH LOCAL NURSING HOMES TO PROVIDE LAB SERVICES; PARTNERING WITH VALLEY WIDE HEALTH SYSTEM TO COORDINATE PRENATAL VISITS AND SHARE APPROPRIATE INFORMATION AS NEEDED FOR OB/GYN PATIENTS AT THE CLINIC; PARTICIPATING IN THE 340B PHARMACY PROGRAM WHICH PROVIDES DISCOUNTED PHARMACY PRICING TO INDIGENT PATIENTS. 4. IMPLEMENT AND OFFER PROGRAMS THAT AIM TO ADDRESS ACCESS TO MENTAL AND BEHAVIORAL HEALTH CARE SERVICES IN THE COMMUNITY THROUGH RECRUITMENT AND RETENTION EFFORTS SUCH AS WORKING WITH THE COLORADO HOSPITAL ASSOCIATION TO OFFER THE ALTO PROJECT, WHICH IS GEARED TOWARD REDUCING THE ADMINISTRATION OF OPIOIDS PRESCRIBED THROUGH EMERGENCY DEPARTMENTS; WORKING CLOSELY WITH SOUTHEAST MENTAL HEALTH GROUP TO PROVIDE PLACEMENT OF APPROPRIATE PATIENTS AT STATE FACILITIES, EVALUATIONS, ADMISSIONS IF WITHDRAWAL SYMPTOMS ARE PRESENT AND COUNSELORS AND THERAPISTS FOR PATIENTS WITHIN A SIX-COUNTY REGION (BACA, BENT, CROWLEY, KIOWA, OTERO AND PROWERS COUNTIES, CO; PARTICIPATING IN COMMUNITY COALITIONS CENTERED AROUND MENTAL AND BEHAVIORAL HEALTH; COLLABORATING WITH THE REGION SIX ALCOHOL & DRUG ABUSE, CO. (RESADA) ON APPROPRIATE EMERGENCY DEPARTMENT TRANSFERS TO ASSIST INDIVIDUALS AFFECTED BY SUBSTANCE USE ISSUES, PROBLEMS, AND CONCERNS BY OFFERING A CLEAN AND SAFE ENVIRONMENT WHILE FOSTERING PROGRESS, ENRICHING LIVES, AND ENHANCING THE RECOVERY PROCESS. 5. IMPLEMENT AND OFFER PROGRAMS THAT AIM TO REDUCE THE IMPACT OF THE COVID-19 PANDEMIC SUCH AS PROVIDING EDUCATION ON COVID-19; FOLLOWING CDC GUIDELINES AND COMMUNITY STANDARDS TO CONTROL THE SPREAD AND REDUCE RISK OF COVID-19 INFECTION WHEN DISCHARGING PATIENTS TO A LOWER LEVEL OF CARE AND THEIR HOME ENVIRONMENT; DONATING PPE (EX. MASKS, FACE SHIELDS, SURGICAL GOWNS, ETC.) TO LOCAL ORGANIZATIONS TO HELP CONTROL THE SPREAD AND REDUCE RISK OF COVID-19 INFECTION AS OPPORTUNITIES ARISE; REPORTING COVID-19 TEST AND PATIENT ADMISSIONS DATA TO THE STATE AND CENTERS FOR DISEASE CONTROL (CDC) IN AN ONGOING EFFORT TO SHARE TIMELY INFORMATION AND RESEARCH REGARDING THE PANDEMIC; PROVIDING VACCINATIONS. THE MEDICAL CENTER IS CONTINUALLY ASSESSING THE HEALTH NEEDS OF OUR COMMUNITY AND DECIDING HOW THE HOSPITAL CAN BETTER SERVE THE COMMUNITY BASED ON NEED.
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) 2022
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Schedule H (Form 990) 2022
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?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2022
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Schedule H (Form 990) 2022
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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 II BENT, CROWLEY, AND OTERO COUNTIES ARE DESIGNATED AS MEDICALLY UNDERSERVED AND A HIGH NEEDS GEOGRAPHIC AREA FOR MENTAL HEALTH WITH A SHORTAGE IN THE AREA OF HEALTH PROFESSIONALS. THE MEDICAL CENTER IS CONTINUALLY RECRUITING PHYSICIANS AND OTHER HEALTH PROFESSIONALS TO ITS RURAL SERVICE AREA TO HELP IMPROVE ACCESS TO HEALTHCARE SERVICES AS IDENTIFIED IN ITS COMMUNITY HEALTH NEEDS ASSESSMENT.
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 13 OF THE AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR BAD DEBTS IS INCLUDED IN FOOTNOTE 8 BEGINNING ON PAGE 18 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. MEDICAL CENTER 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 RECENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY 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 THE MEDICAL CENTER'S PRIMARY SERVICE AREA IS OTERO COUNTY IN COLORADO, RECEIVING 63.9% OF ITS PATIENTS FROM THIS AREA IN 2020, WITH BENT AND CROWLEY COUNTIES MAKING UP AN ADDITIONAL 27%. THESE COUNTIES ARE DESIGNATED BY HPSA AS A LOW INCOME POPULATION. THE 2020 CENSUS IS 18,665 FOR OTERO COUNTY, 5,861 FOR BENT COUNTY, AND 6,018 FOR CROWLEY COUNTY. IN 2020, OTERO COUNTY (6.2) HAD A HIGHER UNEMPLOYMENT RATE THAN THE STATE (6.1) WHILE BENT COUNTY (4.4) AND CROWLEY COUNTY (5.4) HAD A LOWER UNEMPLOYMENT RATE THAN THE STATE. AS OF 2021, OTERO COUNTY (42.4 YEARS) HAS AN OLDER MEDIAN AGE THAN BENT COUNTY (41.2 YEARS), CROWLEY COUNTY (39.4 YEARS) AND THE STATE (37.8 YEARS). THE 65+ POPULATION IS 22.8% FOR OTERO COUNTY, 18.2% FOR BENT COUNTY, AND 13.8% FOR CROWLEY COUNTY. APPROXIMATELY 75.9% OF THE OTERO COUNTY POPULATION IS OF WHITE, NON-HISPANIC ETHNIC ORIGIN, COMPARED TO THE STATE POPULATION PERCENTAGE OF 79%. THE BLACK, ASIAN, AND AMERICAN INDIAN POPULATION OF OTERO COUNTY IS 4.7%, COMPARED TO 9.2% STATE WIDE. BENT COUNTY (35.8%) HAS THE HIGHEST PERCENTAGE OF FAMILIES LIVING BELOW THE POVERTY LEVEL AS COMPARED TO CROWLEY COUNTY (24.2%), OTERO COUNTY (33.1%) AND THE STATE (13.7%). THE MEDIAN HOUSEHOLD INCOMES IN BENT (31,365), CROWLEY (42,290), AND OTERO (39,369) COUNTIES ARE LOWER THAN THAT OF THE STATE (77,265).
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. THE MEDICAL CENTER PARTICIPATES IN VARIOUS ACTIVITIES WITHIN ITS COMMUNITY TO PROMOTE THE HEALTH OF THE COMMUNITY IT SERVES INCLUDING THE FOLLOWING: SERVE AS A TEACHING FACILITY FOR LOCAL RN, LAB, RESPIRATORY THERAPY, PHYSICAL THERAPY, ANCILLARY STUDENTS AND RESIDENTS PARTICIPATE WITH LOCAL SCHOOLS TO EDUCATE AREA RESIDENTS PURSUING FUTURE HEALTH CARE CAREERS ACTIVE MEMBER OF THE SOUTH EAST HEALTHCARE COALITION, WHICH EXISTS TO COLLABORATE TO PROVIDE EDUCATION OPPORTUNITIES TO ITS MEMBERS OFFER A VARIETY OF HEALTH SCREENINGS TO THE COMMUNITY PARTNER WITH LOCAL ORGANIZATIONS TO IMPROVE COMMUNITY HEALTH AS OPPORTUNITIES ARISE EDUCATIONAL OPPORTUNITIES FOR THE PUBLIC CONCERNING WELLNESS TOPICS AND HEALTH RISK CONCERNS SUCH AS DIABETIC EDUCATION, SELF-MANAGEMENT CLASSES, PRESENTATIONS TO CIVIC ORGANIZATIONS, CHURCH GROUPS, LOWER ARKANSAS VALLEY AREA AGENCY ON AGING, LA JUNTA SENIOR CENTER, FALL PREVENTION EDUCATION AT THE SENIOR CENTER, CANCER RELATED EDUCATION, LUNCH & LEARN SESSIONS, SUPPORT GROUPS (DIABETES SUPPORT GROUP), AND PREVENTATIVE EDUCATION PRESENTATIONS IN THE SCHOOL SYSTEM. LEADERSHIP AND VOLUNTEER ROLES WITH MANY AGENCIES AND COMMITTEES IN THE COMMUNITY WORK WITH THE COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT IN SUPPORT OF THE COLORADO QUITLINE. MANY OF THESE ACTIVITIES WERE LIMITED DUE TO COVID RESTRICTIONS DURING THE YEAR BUT PLAN TO GET THEM BACK TO FULL CAPACITY AS RESTRICTIONS ARE LIFTED. IN ADDITION, THE MEDICAL CENTER IS CONTINUALLY WORKING WITH LOCAL OFFICIALS TO PROVIDE NEEDED SERVICES AND DONATE TIME AND EFFORT TO THE COMMUNITY. WE PROVIDE SUBSTANTIAL AMOUNTS OF UNCOMPENSATED CARE TO INDIVIDUALS THAT ARE IN NEED. THE MEDICAL CENTER ALSO PROVIDES ASSISTANCE WITH ENROLLMENT ASSISTANCE FOR GOVERNMENT-FUNDED HEALTH PROGRAMS FOR UNINSURED WHEN NECESSARY.
SCHEDULE H, PART VI, LINE 6 N/A
SCHEDULE H, PART VI, LINE 7 COLORADO
Schedule H (Form 990) 2022
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