Community Benefit Insight - Tax-exempt hospital

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Otero County Hospital Association

Gerald Champion Regional Medical Ctr

2669 N Scenic Dr
Alamogordo, NM 83310

Bed count	94	Medicare provider number	320004	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

EIN: 850138775

Display data for year:

Community Benefit Spending- 2021
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

41.28%

Spending by Community Benefit Category- 2021
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2021

Additional data

Community Benefit Expenditures: 2021

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 4,495,259 2.18 %
Medicaid as % of operating expenses	$ 17,100,568 8.30 %
Costs of other means-tested government programs as % of operating expenses	$ 0 0 %
Health professions education as % of operating expenses	$ 760,083 0.37 %
Subsidized health services as % of operating expenses	$ 62,228,667 30.22 %
Research as % of operating expenses	$ 0 0 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 0 0 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 420,004 0.20 %
Community building* as % of operating expenses	$ 1,369,056 0.66 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
Number of activities or programs (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Persons served (optional)	0
Physical improvements and housing	0
Economic development	0
Community support	0
Environmental improvements	0
Leadership development and training for community members	0
Coalition building	0
Community health improvement advocacy	0
Workforce development	0
Other	0
Community building expense as % of operating expenses	$ 1,369,056 0.66 %
Physical improvements and housing as % of community building expenses	$ 0 0 %
Economic development as % of community building expenses	$ 10,600 0.77 %
Community support as % of community building expenses	$ 743,417 54.30 %
Environmental improvements as % of community building expenses	$ 0 0 %
Leadership development and training for community members as % of community building expenses	$ 5,000 0.37 %
Coalition building as % of community building expenses	$ 0 0 %
Community health improvement advocacy as % of community building expenses	$ 0 0 %
Workforce development as % of community building expenses	$ 610,039 44.56 %
Other as % of community building expenses	$ 0 0 %
Direct offsetting revenue	$ 0
Physical improvements and housing	$ 0
Economic development	$ 0
Community support	$ 0
Environmental improvements	$ 0
Leadership development and training for community members	$ 0
Coalition building	$ 0
Community health improvement advocacy	$ 0
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2021

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 8,210,856 3.99 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 246,326 3.00 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:
Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2021

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES

Supplemental Information: 2021

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 139753446 including grants of $ 970930) (Revenue $ 222490350)
"OTERO COUNTY HOSPITAL ASSOCIATION, D/B/A GERALD CHAMPION REGIONAL MEDICAL CENTER (GCRMC), PROVIDES COMPREHENSIVE HEALTH-CARE SERVICES THROUGH ITS 98-BED HOSPITAL, OUTPATIENT AMBULATORY CARE FACILITIES, AND A MULTI-SPECIALTY PHYSICIAN GROUP. GCRMC RECEIVES 80% OF ITS ADMISSIONS FROM OTERO COUNTY. THE GCRMC'S PRIMARY MARKETS ARE THE CITIES OF ALAMOGORDO AND TULAROSA WITH SECONDARY MARKETS EXPANDING TO MORE REMOTE AREAS OF OTERO COUNTY, LINCOLN COUNTY, CHAVEZ COUNTY, AND BEYOND. THE ORIGINAL FACILITY OPENED IN AUGUST 1949, AND THE CURRENT MEDICAL CENTER IS A STATE-OF-THE-ART ACUTE CARE FACILITY THAT OPENED IN DECEMBER 1999.THE ORIGINAL HOSPITAL OPENED IN 1949 WITH 26 BEDS. TODAY, GCRMC IS PROUD TO BE A 98-BED ACUTE CARE FACILITY ACCREDITED BY DNV, INCLUDING TWO DISTINCT PPS UNITS: LIFE TRANSITIONS (AKA BEHAVIORAL MEDICINE - TOTAL 36 BEDS) AND INPATIENT REHABILITATION (12 BEDS). GCRMC SHARES A UNIQUE RELATIONSHIP WITH HOLLOMAN AIR FORCE BASE AS THE FIRST HOSPITAL IN THE UNITED STATES WHERE ACTIVE-DUTY MILITARY PHYSICIANS PRACTICE IN A CIVILIAN HOSPITAL. THIS SPECIAL ARRANGEMENT ALLOWS ONE FACILITY TO MEET THE COMBINED COMMUNITY AND MILITARY NEEDS, WHILE SERVING AS A MODEL FOR THE DEPARTMENT OF DEFENSE IN CONSERVING RESOURCES.THE DELIVERY MECHANISMS OF CARE AT THE HOSPITAL INCLUDE BOTH INPATIENT AND OUTPATIENT SERVICES; ACUTE CARE INPATIENT THROUGH MEDICAL/SURGICAL, TELEMETRY, MATERNAL CHILD AND 10-BED INTENSIVE CARE UNITS; SURGERY DEPARTMENT SUPPORTED BY PRE-ADMIT, OUTPATIENT CARE UNIT AND POST-ANESTHESIA CARE UNIT; OUTPATIENT SURGERY CENTER; PROVIDER-BASED PHYSICIAN PRACTICES IN THE AREAS OF FAMILY PRACTICE, WOMEN'S SERVICES INCLUDING OBSTETRICS, MEDICAL AND RADIATION ONCOLOGY, MEDICAL CARDIOLOGY, GASTROENTEROLOGY AND ENDOCRINOLOGY, INTERNAL MEDICINE, ORTHOPEDICS, GENERAL SURGERY, PAIN MANAGEMENT AND NEUROLOGY; INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICES; CARDIAC CATH LAB; INPATIENT REHABILITATION SERVICES, INCLUDING PHYSICAL AND OCCUPATIONAL REHAB SERVICES; INPATIENT AND OUTPATIENT CAP-CERTIFIED LABORATORY SERVICES WITH THE CAPABILITY TO PERFORM OVER 225 DIFFERENT PROFILES AND TESTS IN-HOUSE; INPATIENT AND OUTPATIENT DIAGNOSTIC IMAGING SERVICES, INCLUDING X-RAY, 64-SLICE CT AND PET SCAN, MRI, ULTRASOUND, INTERVENTIONAL RADIOLOGY, RADIOFREQUENCY ABLATION AND NUCLEAR MEDICINE; INPATIENT AND OUTPATIENT COMPREHENSIVE CARDIOPULMONARY SERVICES, INCLUDING BEHAVIOR SLEEP MEDICINE, HOLTER MONITORING, EVENT MONITORING, AND IMPEDANCE CARDIOGRAPHY. BY THE END OF 2022, GCRMC EMPLOYED APPROXIMATELY 1,158 PEOPLE. OF THESE EMPLOYEES THERE ARE APPROXIMATELY 208 ACTIVE MEDICAL STAFF MEMBERS, CONSISTING OF 38 PROVIDERS AND 35 NURSE PRACTITIONERS. IN ADDITION TO THOSE EMPLOYEES, GCRMC CONTRACTS FOR SERVICES IN VARIOUS DEPARTMENTS SUCH AS PHARMACY, ANESTHESIA, EMERGENCY DEPARTMENT, AND HOSPITALIST PROVIDERS.GCRMC CONTINUES TO SEEK OPPORTUNITIES TO EXPAND SERVICES AND IMPROVE QUALITY, WITH THE PHILOSOPHY OF NOT LIMITING ITS POTENTIAL BY THE DESIGNATION OF ""RURAL HOSPITAL,"" BUT RATHER IDENTIFYING ITS SCOPE OF SERVICE BASED ON COMMUNITY NEEDS AS A REGIONAL MEDICAL CENTER. CONTINUED PROGRESS AND EXPANSION HAS ENHANCED GCRMC'S COMMITMENT TO STRIVE FOR OUTSTANDING SERVICE AND QUALITY, ACKNOWLEDGING THAT ITS FUTURE IS NOT IN ITS BUILDING OR TECHNOLOGY, BUT RATHER ITS PEOPLE. TO THIS END, WE SUPPORT THE PEOPLE OF OTERO COUNTY AND OUTLYING SERVICE AREAS WITH OUR EXPANDED SERVICES AND OUR FINANCIAL CONTRIBUTIONS. GCRMC HAS, SINCE ITS INCEPTION IN 1949, PROVIDED QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATIONS AND STABILITY OF GCRMC, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND, FURTHER, THAT OUR MISSION IS TO SERVE THE COMMUNITY WITH RESPECT TO PROVIDING HEALTH-CARE SERVICES AND HEALTH-CARE EDUCATION. THEREFORE, IN KEEPING WITH GCRMC'S COMMITMENT TO SERVE OUR COMMUNITY, WE PROVIDE: FREE CARE AND/OR SUBSIDIZED CARE - CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST; AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S ABILITY TO PAY COEXIST. MANAGEMENT EXPANDED THE FINANCIAL ASSISTANCE PROGRAM FROM 200% TO 300% OF FPL EFFECTIVE JULY 1, 2015. GCRMC MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY."

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

GERALD CHAMPION REGIONAL MEDICAL CENTER
PART V, SECTION B, LINE 3J: CHARTS RELATED TO AGE, GENDER, GENERAL LIFESTYLES, HEALTH-CARE METRICS. INFORMATION GAPS THAT LIMIT THE HOSPITAL FACILITY'S ABILITY TO ASSESS THE COMMUNITY'S HEALTH NEEDS.

GERALD CHAMPION REGIONAL MEDICAL CENTER
PART V, SECTION B, LINE 5: THE MEDICAL CENTER CONDUCTED FOCUS GROUPS AND INDIVIDUAL INTERVIEWS. THE MEDICAL CENTER SOLICITED INPUT FROM MORE THAN 20 REPRESENTATIVES FROM THE COMMUNITY, INCLUDING EDUCATORS, LOCAL GOVERNMENT OFFICIALS, LOCAL HEALTH OFFICIALS, FINANCIAL ADVISORS, CHAPLAINS, NURSES, AND MILITARY PERSONNEL.

GERALD CHAMPION REGIONAL MEDICAL CENTER
PART V, SECTION B, LINE 6B: OTERO COUNTY COMMUNITY HEALTH COUNCILPRESBYTERIAN MEDICAL SERVICESALAMOGORDO PUBLIC SCHOOLSCITY OF ALAMOGORDOCOPE OUTREACHCHINS OF ALAMOGORDO

GERALD CHAMPION REGIONAL MEDICAL CENTER
PART V, SECTION B, LINE 11: THE HOSPITAL'S WRITTEN IMPLEMENTATION STRATEGY IS INCLUDED IN THE FACILITY'S CHNA DOCUMENT. THIS DOCUMENT WAS REVIEWED BY THE HOSPITAL'S CPA AUDITORS AND BUSINESS ADVISORS. BASED ON THE RESULTS OF THIS REVIEW, MOST SIGNIFICANT NEEDS ARE BEING ADDRESSED IN THE ASSESSMENT. THE NEEDS IDENTIFIED INCLUDE: ACCESS TO AFFORDABLE PRIMARY CARE INSURANCE AND CHARITY CARE, OBESITY, DIABETES, CANCER, BEHAVIORAL HEALTHCARE, HEART DISEASE, AND HEALTH EDUCATION. THE STRATEGY TO ADDRESS THESE ISSUES INCLUDES EXPANDED HOSPITAL RESOURCES, SUCH AS ESTABLISHMENT OF A CARDIAC REHABILITATION PROGRAM, AND COLLABORATION BETWEEN THE HOSPITAL AND OTHER FACILITIES TO ADDRESS THE NEEDS. FOR EXAMPLE, GCRMC PROVIDES $450,000 A YEAR IN FINANCIAL SUPPORT TO PRESBYTERIAN MEDICAL SERVICES, WHICH OPERATES FOUR FQHCS IN OTERO COUNTY, TO ASSIST IN RECRUITING QUALIFIED, LICENSED BEHAVIORAL AND OTHER HEALTH PROFESSIONALS.

PART V, SECTION B, LINE 10A:
"HTTPS://WWW.GCRMC.ORG/WP-CONTENT/UPLOADS/2021/11/GERALD-CHAMPION-REGIONAL-MEDICAL-CENTER-CHNA-IMPLEMENTATION-FINAL-REPORT.PDFURL ABOVE IS CASE SENSITIVE. ALTERNATIVELY, REPORT IS FOUND AT HTTPS://WWW.GCRMC.ORG IN THE ""ABOUT US"" SECTION."

PART V, LINE 14:
CHARGE CALCULATIONS ARE BASED ON A VARIETY OF FACTORS, INCLUDING THE COST OF SUPPLIES, LABOR AND OVERHEAD NEEDED TO PROVIDE THE SERVICE. OTHER FACTORS INCLUDE THE MEDICARE ALLOWABLE FEE SCHEDULE, AND COMPARISON OF THE ORGANIZATION WITH THE IMMEDIATE COMPETITION'S CHARGE MASTERS. CHARGE PRICES ARE REVIEWED BY THE ORGANIZATION ON AN ANNUAL BASIS.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINE 3C:
THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINES WHEN DETERMINING FREE CARE. PATIENTS WHO HAVE HOUSEHOLD INCOME AT OR BELOW 300% OF THE FPG ARE ELIGIBLE TO RECEIVE FREE CARE. THE ORGANIZATION OFFERS AN AUTOMATIC 25% DISCOUNT TO SELF-PAY PATIENTS AND WILL OFFER AN ADDITIONAL 10% DISCOUNT TO SELF-PAY PATIENTS WHO PAY THE BALANCE OF THEIR BILL WITHIN 30 DAYS OF THE BILLING DATE. IN ADDITION, THE FACILITY WILL WORK WITH PATIENTS ON SETTLEMENTS ON A CASE-BY-CASE BASIS BASED ON SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF GCRMC. DETERMINING FAMILY NEED IS ALSO BASED ON AN APPLICATION PROCESS WHICH TAKES INTO ACCOUNT THE PATIENT'S AVAILABLE ASSETS AND ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT.

PART I, LINE 7:
THE HOSPITAL'S COSTING METHODOLOGY IS BASED ON COST TO CHARGE RATIOS IN THE MEDICARE COST REPORT. IT CURRENTLY DOES NOT USE A COST ACCOUNTING SYSTEM.

PART I, LINE 7G:
AMOUNTS REPORTED ARE BASED ON THE MEDICARE COST REPORT FIGURES. LINE 7G INCLUDES $56,040,057 OF COSTS ATTRIBUTABLE TO PHYSICIANS' CLINICS.

PART II, LINE 2:
THE ORGANIZATION SUPPORTS THE ALAMOGORDO CHAMBER OF COMMERCE AND THE OTERO COUNTY ECONOMIC DEVELOPMENT COUNCIL, WHICH WORK TO FACILITATE THE CREATION AND PROMOTION OF NEW INDUSTRIES, AND ASSIST IN THE RETENTION AND EXPANSION OF EXISTING BUSINESSES IN THE HOSPITAL'S SERVICE AREA.

PART II, LINE 3:
THE ORGANIZATION OFFERS ECONOMIC SUPPORT TO VARIOUS ORGANIZATIONS THAT: PROVIDE ASSISTANCE TO INDIVIDUALS IN NEED OF BASIC MEDICAL ASSISTANCE, FOR RESEARCH IN HEALTH-RELATED CONDITIONS, AND TO PROMOTE CULTURAL ACTIVITIES AND EVENTS FOR THE BENEFIT OF THE COMMUNITY.

PART II, LINE 5:
THE ORGANIZATION SUPPORTS THE ALAMOGORDO ROTARY CLUB, WHICH WORKS TO TRAIN AND PROMOTE LEADERS IN THE COMMUNITY.

PART II, LINE 8:
THE ORGANIZATION RELIES ON WORKFORCE DEVELOPMENT, I.E. RECRUITMENT OF DOCTORS TO MEET THE NEED FOR MAINTAINING ADEQUATE MEDICAL STAFF. THE HOSPITAL'S SERVICE AREA FACES A CRITICAL SHORTAGE OF PRIMARY CARE PHYSICIANS. OTERO COUNTY IS DESIGNATED BY THE US CENSUS BUREAU AS A MEDICALLY UNDERSERVED AREA. RECENT DATA SUGGESTS THAT THERE WILL BE A SHORTAGE OF 40 PRIMARY CARE PHYSICIANS NEEDED TO SERVE THE HEALTHCARE NEEDS OF THE TOTAL SERVICE AREA BY 2023. THERE ARE A NUMBER OF FACTORS THAT HAVE CREATED THIS SHORTAGE. THESE INCLUDE THE AGING POPULATION OF PROVIDERS IN OUR MARKET. THE AVERAGE AGE OF THE ORGANIZATION'S PHYSICIAN STAFF IS NOW OVER 60 YEARS OF AGE. NEW MEXICO HAS THE HIGHEST PERCENTAGE IN THE COUNTRY OF PHYSICIANS APPROACHING RETIREMENT AGE. IN ADDITION, NEW MEXICO'S GEOGRAPHICALLY SPARSE, AGING AND RACIALLY DIVERSE POPULATION PUTS PRESSURE ON ITS HEALTH CARE SYSTEMS. EXCESS MORTALITY FROM ALL CAUSES IN NON-METROPOLITAN AREAS CONTINUES TO RISE. THE ORGANIZATION STRIVES TO INCREASE ACCESS TO COMPREHENSIVE QUALITY HEALTH CARE SERVICES; TO PROMOTE HEALTH, PREVENT AND MANAGE DISEASES, AND REDUCE DISABILITY AND PREMATURE DEATH BY ELIMINATING THE INADEQUATE SUPPLY AND UNEVEN DISTRIBUTION OF PRIMARY CARE AND SPECIALTY PROVIDERS THROUGH CONTINUED WORKFORCE DEVELOPMENT.

PART III, LINE 2:
DISCOUNTS AND PAYMENTS ARE TAKEN INTO CONSIDERATION WHEN DETERMINING BAD DEBT. PAYMENTS APPLIED TO PATIENT ACCOUNTS OFFSET ACCOUNTS RECEIVABLE AND ARE ELIMINATED FROM THE CALCULATION OF BAD DEBT, WHICH IS DETERMINED BASED ON AGING OF ACCOUNTS RECEIVABLE AFTER PATIENT DISCHARGE.IN CERTAIN CIRCUMSTANCES, GCRMC WILL NEGOTIATE PAYMENT TERMS FOR PATIENTS WHOSE FAMILY INCOME EXCEEDS THE INCOME GUIDELINES OF THE FINANCIAL ASSISTANCE AND UNINSURED POLICY. THIS IS APPLICABLE TO PATIENTS WITH CATASTROPHIC ILLNESSES OR UNUSUAL CIRCUMSTANCES. SUCH DETERMINATIONS ARE MADE BY THE PATIENT FINANCIAL SERVICES DEPARTMENT WORKING WITH GCRMC MANAGEMENT. SEE ALSO THE DISCLOSURE IN THE AUDITED FINANCIAL STATEMENTS REGARDING BAD DEBT.PATIENTS WHOSE FAMILY INCOME IS AT OR BELOW 300% OF THE FPL ARE ELIGIBLE TO RECEIVE FREE CARE.

PART III, LINE 3:
THE ORGANIZATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. PATIENT CHARGES FOR SERVICES PROVIDED UNDER THE CHARITY POLICY ARE WRITTEN OFF. THE AMOUNT OF THESE SERVICES PROVIDED IN THE YEAR ENDED JUNE 30, 2022, WERE APPROXIMATELY $5,230,000.MEDICAL CARE IS GIVEN TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY, AND THEREFORE, THIS IS A COMMUNITY BENEFIT.

PART III, LINE 4:
FROM NOTE 1, PAGE 9 OF THE AUDITED FINANCIAL STATEMENTS:PATIENT RECEIVABLES - PATIENT RECEIVABLES ARE UNCOLLATERALIZED PATIENT AND THIRD-PARTY PAYOR OBLIGATIONS. PAYMENTS OF PATIENT RECEIVABLES ARE ALLOCATED TO THE SPECIFIC CLAIMS IDENTIFIED IN THE REMITTANCE ADVICE OR, IF UNSPECIFIED, ARE APPLIED TO THE EARLIEST UNPAID CLAIM.

PART III, LINE 8:
MEDICARE ALLOWABLE COST IS BASED ON THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES.

PART III, LINE 9B
GCRMC HAS IMPLEMENTED A NUMBER OF DIFFERENT POLICY AND PROCEDURE STATEMENTS TO GOVERN THE DETAILS OF HOW ITS COLLECTION PRACTICES ARE IMPLEMENTED AND HOW DISCOUNTING AND COLLECTION POLICIES APPLY TO VARIOUS CLASSES OF PATIENTS. IN GENERAL, ALL PATIENT ACCOUNT GUARANTORS WHO REQUEST FINANCIAL ASSISTANCE OR A PAYMENT PLAN ARE ASKED TO PROVIDE DETAILED INFORMATION REGARDING THEIR INCOME AND ASSETS.FOR PATIENTS WHO QUALIFY FOR CHARITY, GCRMC WILL NOT IMPOSE WAGE GARNISHMENTS OR LIENS ON PRIMARY RESIDENCES, WILL NOT SEND UNPAID BILLS TO COLLECTION AGENCIES, AND WILL CEASE ALL COLLECTION EFFORTS.

PART VI, LINE 2:
IN 2021, MANAGEMENT AT GCRMC ENLISTED THE SERVICES OF QUORUM HEALTH RESOURCES TO DEVELOP A COMMUNITY HEALTH NEEDS ASSESSMENT AND TO PROVIDE INFORMATION FROM SECONDARY DATA SOURCES TO ASSIST IN IDENTIFYING NEEDS THAT EXIST IN THE COMMUNITY. THIS INCLUDES DATA FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION TO EXAMINE TRENDS FOR STROKE, DIABETES, HEART DISEASE AND CANCER. IT ALSO INCLUDES DATA THAT IDENTIFY SHORTAGES IN HEALTH-CARE PROFESSIONALS BY LOCATION. THE HEALTH NEEDS IDENTIFIED AS SIGNIFICANT IN THIS ASSESSMENT INCLUDED CANCER, ACCESS TO PRIMARY CARE, DIABETES, OBESITY, AND BEHAVIORAL HEALTH. THE CONCLUSIONS REACHED IN THIS ASSESSMENT WERE IMPLEMENTED IN 2021.

PART VI, LINE 7, REPORTS FILED WITH STATES
NM

PART VI, LINE 3:
THE HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY - GERALD CHAMPION REGIONAL MEDICAL CENTER (GCRMC) WILL PROVIDE UNDERSTANDABLE, WRITTEN GUIDELINES TO STAFF AND PATIENTS RELATIVE TO HOW THE HOSPITAL EVALUATES AND DETERMINES: 1) A PATIENT'S ELIGIBILITY FOR CHARITY CARE; 2) AN UNINSURED PATIENT'S ELIGIBILITY FOR DISCOUNTS; AND 3) A PATIENT'S ELIGIBILITY FOR ALTERNATE PAYMENT PLANS. A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN THE EMERGENCY ROOM AND THROUGHOUT THE ENTIRE HOSPITAL. THE PATIENTS ARE ALSO INFORMED THROUGH DIRECT COMMUNICATION WITH FINANCIAL COUNSELORS, AND THESE POLICIES ARE EXPLAINED IN DETAIL TO GUARANTORS WHO ADVISE GCRMC THAT THEY ARE UNABLE TO PAY THEIR ACCOUNT OR NEED HELP IN STRUCTURING AN AFFORDABLE PAYMENT PLAN FOR THEIR ACCOUNT.THE HOSPITAL PROVIDES SERVICES TO ANYONE IN NEED OF MEDICAL CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR SUCH SERVICES. CHARITY CARE AND DISCOUNTS FOR THE UNINSURED WILL BE AVAILABLE FOR MEDICALLY NECESSARY HOSPITAL CARE PROVIDED TO PERSONS WHO MEET THE FINANCIAL AND DOCUMENTATION CRITERIA DEFINED IN THIS POLICY. DETERMINATIONS HEREUNDER WILL BE BASED SOLELY ON THE PATIENT'S ABILITY TO PAY AND WILL NOT BE MADE ON THE BASIS OF AGE, SEX, RACE, CREED, DISABILITY, SEXUAL ORIENTATION OR NATIONAL ORIGIN.GCRMC PROVIDES FINANCIAL ASSISTANCE TO PATIENTS BASED ON THEIR INCOME, ASSETS, AND NEEDS. THROUGH OUR FINANCIAL COUNSELING SERVICES, WE ASSIST PATIENTS WITH MEDICAID ELIGIBILITY OR LOW-COST HEALTH INSURANCE THROUGH THE EXCHANGE (BE WELL NEW MEXICO), OR WORK WITH PATIENTS TO ARRANGE A MANAGEABLE PAYMENT PLAN.UNINSURED PATIENTS ARE ELIGIBLE FOR A 25% DISCOUNT. A 25% DISCOUNT IS APPLIED TO THE TOTAL CHARGES OF A SELF-PAY PATIENT AT THE TIME OF SERVICE OR THE FIRST BILLING. NOTICE WILL BE SENT AT THE TIME OF THE FIRST BILLING INFORMING THE PATIENT/GUARANTOR THAT AN ADDITIONAL 10% WILL BE DEDUCTED IF THE ACCOUNT IS PAID WITHIN 30 DAYS OF THE DATE OF SERVICE.

PART VI, LINE 4:
"OTERO COUNTY HOSPITAL ASSOCIATION D/B/A GERALD CHAMPION REGIONAL MEDICAL CENTER (""GCRMC"") ACTIVITIES ARE CONDUCTED ON ITS 66-ACRE CAMPUS LOCATED IN ALAMOGORDO, NEW MEXICO. ALAMOGORDO IS APPROXIMATELY 89 MILES NORTH OF EL PASO, TEXAS, AND 209 MILES SOUTHEAST OF ALBUQUERQUE, NEW MEXICO. GCRMC OWNS AND OPERATES A 98-BED CARE HOSPITAL (THE ""HOSPITAL"") ON THE CAMPUS. IN ADDITION TO THE MAIN CAMPUS, THE HOSPITAL HAS SATELLITE LOCATIONS INCLUDING CLINICS AND PHYSICIAN OFFICES THROUGHOUT THE CITY. THE COMBINED OPERATING SPACE OF THE MAIN CAMPUS AND THESE ADDITIONAL OFFICES TOTALS APPROXIMATELY 432,000 SQUARE FEET. OTHER FACILITIES THAT THE HOSPITAL OWNS LOCATED ON THE MAIN CAMPUS INCLUDE TWO MEDICAL OFFICE BUILDINGS, COMPLEX A AND B THAT HAVE AN OUTPATIENT SURGERY CENTER AND AN IMAGING CENTER OWNED AND OPERATED BY LIMITED LIABILITY COMPANIES IN WHICH GCRMC HAS AN INTEREST. GCRMC ALSO OWNS SIX FACILITIES LOCATED OFF THE MAIN CAMPUS THAT ARE EITHER LEASED TO INDEPENDENT PRIMARY CARE/SPECIALTY CARE PROVIDERS OR OCCUPIED BY EMPLOYED PHYSICIANS. GCRMC'S PRIMARY SERVICE AREA IS NORTHWESTERN OTERO COUNTY FROM WHICH 84% OF ITS ADMISSIONS ORIGINATE. GCRMC IS THE SOLE COMMUNITY PROVIDER IN ITS PRIMARY SERVICE AREA WITH THE NEAREST TERTIARY CARE HOSPITAL LOCATED APPROXIMATELY 70 MILES FROM THE HOSPITAL. THE DELIVERY MECHANISMS OF CARE AT THE HOSPITAL INCLUDE BOTH INPATIENT AND OUTPATIENT SERVICES: 24-HOUR STAFFED LEVEL III TRAUMA EMERGENCY DEPARTMENT; ACUTE CARE INPATIENT THROUGH MEDICAL/SURGICAL, INTENSIVE CARE, TELEMETRY, MATERNAL CHILD, 36-BED BEHAVIORAL MEDICINE, AND 12-BED INPATIENT REHABILITATION; SURGERY DEPARTMENT SUPPORTED BY PRE-ADMIT, OUTPATIENT CARE UNIT AND POST-ANESTHESIA CARE UNIT; HOSPITAL-OWNED PHYSICIAN PRACTICES IN THE AREAS OF FAMILY PRACTICE, WOMEN'S SERVICES INCLUDING OBSTETRICS, ORTHOPEDICS, NEPHROLOGY, INTERNAL MEDICINE, OUTPATIENT BEHAVIORAL MEDICINE, PEDIATRICS, GASTROENTEROLOGY, ENDOCRINOLOGY, PAIN MANAGEMENT AND NEUROLOGY; PATHOLOGIST; CAP CERTIFIED LABORATORY SERVICES WITH THE CAPABILITY TO PERFORM OVER 225 DIFFERENT PROFILES AND TESTS IN-HOUSE; INPATIENT AND OUTPATIENT DIAGNOSTIC IMAGING SERVICES, INCLUDING X-RAY, 64-SLICE/CT AND PET/CT WITH 20 SLICE CT SCAN, MRI, ULTRASOUND, INTERVENTIONAL RADIOLOGY, RADIOFREQUENCY ABLATION AND NUCLEAR MEDICINE; INPATIENT AND OUTPATIENT COMPREHENSIVE CARDIOPULMONARY SERVICES INCLUDING BEHAVIOR SLEEP MEDICINE, HOLTER MONITORING, EVENT MONITORING AND IMPEDANCE CARDIOGRAPHY. GCRMC AND THE HOLLOMAN AIR FORCE BASE (HAFB) 49TH MEDICAL GROUP, A GROUP OF APPROXIMATELY 15 MILITARY PROVIDERS AND SUPPORT STAFF FROM THE HAFB, HAVE ENJOYED A CLOSE WORKING RELATIONSHIP, AND HAVE HAD SHARED COVERAGE ARRANGEMENTS. SUCH ARRANGEMENTS INCLUDED LABORATORY AND X-RAY SERVICES IN A DISASTER, OBSTETRICAL COVERAGE, AND COVERAGE FOR THE HAFB 49TH MEDICAL GROUP WHEN THEY WERE DEPLOYED FOR DESERT STORM IN 1991. FOLLOWING DESERT STORM AND THE RETURN OF THE HAFB 49TH MEDICAL GROUP, THE DEPARTMENT OF DEFENSE MADE THE DECISION TO LEAVE ALL THE OBSTETRICAL SERVICES WITH GCRMC AND THE LOCAL OBSTETRICIANS. AS OF 2017, HOLLOMAN SUPPORTS ABOUT 21,000 ACTIVE DUTY, GUARD, RESERVE, RETIREES, DEPARTMENT OF DEFENSE CIVILIANS AND THEIR FAMILY MEMBERS. GCRMC'S PRIMARY SERVICE AREA (THE ""PSA"") IS IN NORTHWESTERN OTERO COUNTY, FROM WHICH MOST OF GCRMC'S ADMISSIONS ORIGINATE. LOCATED IN SOUTHEASTERN NEW MEXICO, OTERO COUNTY ENCOMPASSES 6,627 SQUARE MILES AND INCLUDES THE CITIES OF ALAMOGORDO AND TULAROSA. ACCORDING TO THE U.S. CENSUS BUREAU, THE POPULATION OF OTERO COUNTY IN 2020 WAS 68,853. THE HOSPITAL IS THE ONLY ACUTE CARE HOSPITAL WITHIN THE PSA AND IS A SOLE COMMUNITY PROVIDER. THE ACUTE CARE HOSPITALS THAT GCRMC CONSIDERS ITS MAIN COMPETITORS THAT DRAW FROM THE PSA ARE MOUNTAIN VIEW REGIONAL MEDICAL CENTER AND MEMORIAL MEDICAL CENTER, BOTH LOCATED APPROXIMATELY 75 MILES WEST OF ALAMOGORDO IN LAS CRUCES, NEW MEXICO. MANAGEMENT OF GCRMC ESTIMATES THAT THE MARKET SHARE OF ADMISSIONS TO THE MOUNTAIN VIEW REGIONAL MEDICAL CENTER AND MEMORIAL MEDICAL CENTER FROM THE PSA AVERAGES 10% AND 5%, RESPECTIVELY. THE SECONDARY SERVICE AREA COVERS A SUBSTANTIAL PORTION OF THE REMAINDER OF OTERO COUNTY, AS WELL AS THE SOUTH CENTRAL PORTION OF LINCOLN COUNTY. THE SECONDARY SERVICE AREA INCLUDES RUIDOSO, THE POPULATION OF WHICH WAS 8,377 IN 2021. THE TERTIARY SERVICE AREA COVERS A SMALL PORTION OF OTERO COUNTY AND CHAVES COUNTY. THERE ARE NO OTHER MAJOR MEDICAL CENTERS WITHIN OTERO COUNTY."

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THE BUSINESS AND AFFAIRS OF GCRMC ARE SUBJECT TO THE OVERALL GOVERNANCE AND DIRECTION OF ITS BOARD OF DIRECTORS. THE BOARD OF DIRECTORS CONSISTED OF 7 MEMBERS AS OF JUNE 30, 2022. EACH MEMBER IS APPOINTED BY THE BOARD OF DIRECTORS AND SERVES A THREE-YEAR TERM IN A SELF-PERPETUATING BOARD. THE BOARD OF DIRECTORS FILLS VACANCIES THAT MAY OCCUR. OFFICERS OF THE BOARD OF DIRECTORS INCLUDE A CHAIRMAN, VICE CHAIRMAN, AND SECRETARY/TREASURER. MOST OF THE BOARD OF DIRECTORS ARE BUSINESS PEOPLE OF THE PRIMARY SERVICE AREA, WITH NO OTHER CONNECTION. ONE CURRENT BOARD MEMBER IS A PHYSICIAN AT THE MEDICAL CENTER; ANOTHER CURRENT BOARD MEMBER IS A NURSE PRACTITIONER AT THE MEDICAL CENTER.GCRMC'S MEDICAL STAFF IS ORGANIZED INTO DIVISIONS OF MEDICINE, MEDICAL SUBSPECIALTIES, SURGERY AND OUTPATIENT SERVICES. IN ADDITION TO SPECIALIZED MEDICAL/SURGICAL SERVICES PROVIDED BY BOTH EMPLOYED AND CONTRACTED PHYSICIANS AND MEDICAL GROUPS, GCRMC ALSO OFFERS EMERGENCY MEDICAL SERVICES, INCLUDING A HELICOPTER SERVICE WHICH IS NOT OWNED BY GCRMC BUT IS ON-SITE 24 HOURS A DAY. GCRMC EMPLOYS AROUND-THE-CLOCK HOSPITALISTS (I.E., PHYSICIANS WHO DEVOTE THEIR PROFESSIONAL TIME TO THE CARE OF HOSPITALIZED PATIENTS). THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. A PORTION OF RETAINED EARNINGS ARE RE-INVESTED INTO THE PURCHASE OF CAPITAL EQUIPMENT, ELECTRONIC MEDICAL RECORD SOFTWARE, CONTINUING EDUCATION FOR CLINICAL STAFF INCLUDING PHYSICIANS, AND A PROFESSIONALLY MANAGED DIVERSIFIED PORTFOLIO OF MARKETABLE SECURITIES. GCRMC VIEWS THE POSITION OF SOLE PROVIDER AS A SIGNIFICANT COMMITMENT TO THE OVERALL HEALTH AND WELL-BEING OF THE COMMUNITY. IN ADDITION TO ITS FOCUS ON PROVIDING QUALITY HEALTHCARE, THE ORGANIZATION STRIVES TO FACILITATE AND SHARE OPPORTUNITIES TO EDUCATE AND MOTIVATE A PHILOSOPHY OF WELLNESS IN THE COMMUNITY. THE PRIMARY TARGET IS THE DISEASE PROCESS THAT WE KNOW CAN BE ELIMINATED OR IMPROVED BY CHANGING OR MODIFYING HUMAN BEHAVIOR. AS WITH ANY COMMUNITY, THE POPULATION HAS A VARIETY OF EDUCATIONAL BACKGROUNDS. THE GOAL IS TO DEVELOP PROGRAMS THAT TARGET THE NEEDS AND UNDERSTANDING OF THE COMMUNITY. PHYSICIANS/PROVIDERS ARE UTILIZED TO PROVIDE OPEN FORUMS THAT PRESENT HEALTH-RELATED ISSUES, I.E. ARTHRITIS, NEPHROLOGY, NEUROLOGY, ORTHOPEDIC ISSUES, ETC., FOLLOWED BY QUESTIONS AND TIME FOR INDIVIDUAL DISCUSSION. THIS TYPE OF PROGRAM IS OFFERED WITH A FREE LUNCH, EDUCATIONAL MATERIALS, AND IF APPROPRIATE, FREE SCREENINGS, SUCH AS GLUCOSE OR BLOOD PRESSURE. THERE IS AN AVERAGE OF 90 PARTICIPANTS IN EACH OF THESE SEMINARS. THE ORGANIZATION IS VERY COMMUNITY-MINDED IN ITS EFFORTS TO PROMOTE HEALTH. STAFF PARTICIPATES IN HEALTH FAIRS IN THE PUBLIC SCHOOLS, AND HOSTS AN ANNUAL FREE SPORTS PHYSICAL CLINIC FOR SCHOOL-AGE CHILDREN. AT GCRMC, WE FEEL IT IS IMPORTANT TO EMBRACE COMMUNITY NEEDS THAT PROMOTE GOOD CITIZENSHIP. AS AN ORGANIZATION WE SUPPORT EMPLOYEE INVOLVEMENT IN OUTSIDE ACTIVITIES THROUGH CONTRIBUTIONS, DEDICATED TIME AND SPONSORSHIP. ADMINISTRATION AND STAFF MEMBERS SERVE ON COMMUNITY BOARDS, DEDICATING MANY HOURS OF SUPPORT TO THOSE ORGANIZATIONS. THE FOLLOWING CLASSES ARE PROVIDED FOR THE COMMUNITY IN OUR CONFERENCE ROOM CENTER: DIABETIC EDUCATION, NARCOTICS ANONYMOUS, CHILDBIRTH CLASSES, NEW BABY CLASS AND CPR/BASIC LIFE SUPPORT TO NAME A FEW. GCRMC HAS BEEN A TOP SUPPORTER OF THE THRIVE, WHICH PROVIDES MONEY FOR MANY OF THE LOCAL COMMUNITY ORGANIZATIONS. AN ANNUAL HEALTH FAIR IS HELD AT THE HOSPITAL EACH YEAR. WE AUGMENT THE ANNUAL HEALTH FAIR WITH ONSITE MINI HEALTH SCREENINGS THROUGHOUT THE YEAR. THIS IS OFFERED TO BUSINESSES, CIVIC ORGANIZATIONS AND CHURCHES WITH MINIMAL TO NO CHARGE. WE OFFER FREE BLOOD PRESSURE SCREENINGS ON A WALK-IN BASIS WITH EDUCATIONAL MATERIALS IN BOTH SPANISH AND ENGLISH. THIS ALLOWS US TO ADDRESS THE HIGH RATE OF HYPERTENSION IN OUR COMMUNITY, ITS SIGNIFICANT EFFECT ON OTHER DISEASES, AND AN OVERALL WELLNESS PICTURE. GCRMC PARTNERS WITH THE AMERICAN CANCER SOCIETY TO OFFER THE LOOK GOOD FEEL GOOD PROGRAM AND THE GIFT CLOSET. THE PROGRAM IS HOUSED OFF CAMPUS IN A LEASED BUILDING AND HAS BROUGHT A HIGHLY VALUED SERVICE TO OUR COMMUNITY. THE GIFT CLOSET PROVIDES FREE WIGS, PROSTHESES, SUPPLIES, EDUCATION AND SUPPORT TO CANCER PATIENTS AND THEIR FAMILIES. THE OPPORTUNITY TO UTILIZE OUR SPEAKER'S BUREAU IS AVAILABLE TO ANY ORGANIZATION IN THE COMMUNITY. A PRESENTATION REGARDING HEALTH-RELATED TOPICS CAN BE PREPARED WITH LIMITED NOTICE TO MEET THE NEEDS OF THE ORGANIZATION. THE WEALTH OF KNOWLEDGE IN OUR ORGANIZATION ALLOWS US TO CREATE AN APPROPRIATE FIT FOR THE REQUESTED NEED.

Operating expenses	$ 205,924,988
Total amount spent on community benefits as % of operating expenses	$ 85,004,581 41.28 %