TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Norm Arnold...................................................................... Chairman of the Board	10.00 .................	X	X		24,000	0
(2) Bill Mershon...................................................................... Vice President	5.00 .................	X	X		0	0
(3) Bill Mayton...................................................................... Secretary	5.00 .................	X	X		0	0
(4) Fred Baker...................................................................... Director	5.00 .................	X			0	0
(5) James Harris...................................................................... Director	3.00 .................	X			0	0
(6) Greg Richardson MD...................................................................... Director	40.00 .................	X			357,232	32,800
(7) Robin French...................................................................... Director	3.00 .................	X			0	0
(8) Lisa Thomassie...................................................................... Director	3.00 .................	X			0	0
(9) Gary Jackson DO...................................................................... Director	3.00 .................	X			0	0
(10) Andrew Lancaster MD...................................................................... Director/Physician	40.00 .................	X			213,811	30,073
(11) Kathy Fuller...................................................................... Director	3.00 .................	X			0	0
(12) Robert Martinez...................................................................... Director	3.00 .................	X			0	0
(13) Robert James Heckert...................................................................... CEO	40.00 .................		X		357,931	20,020
(14) Bashar Naser...................................................................... CFO	40.00 .................		X		367,517	26,642
(15) Robert Middleton...................................................................... VP of Patient Care/CNO	40.00 .................		X		105,790	11,204
(16) Arthur Austin MD...................................................................... Director/VP of Medical Affairs	40.00 .................			X	293,147	27,760
(17) Albert Esparsen...................................................................... VP of Physician Practice	40.00 .................			X	173,760	14,457

(A) Name and business address	(B) Description of services	(C) Compensation
Jack Wayte Construction Co PO Box 648 Alamogordo,NM88310	Construction Contractor	1,987,327
Complete Rx 3100 South Gessner Ste 640 Houston,TX77063	Pharmacy Management Services	1,757,437
Emcare-Inpatient Services 7032 Collection Center Drive Chicago,IL60693	Inpatient MD Management	1,650,000
Diamond Healthcare Corporation PO Box 85050 Richmond,VA232855050	Behavioral Health Management	1,014,320
Emcare-Anesthesiacare 7032 Collection Center Drive Chicago,IL60693	Anesthesia Management Services	750,000
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 60

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

Otero County Hospital Association

Employer identification number

85-0138775

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Otero County Hospital Association

Employer identification number

85-0138775

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	3,237,050		3,237,050
b	Buildings	106,727,007	47,815,443	58,911,564
c	Leasehold improvements
d	Equipment ...	73,213,418	58,218,849	14,994,569
e	Other ...	8,620,409	2,881,913	5,738,496
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				82,881,679

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Estimated Third-Party Payor Settlements	1,949,907
Insurance Claim Liability	1,000,000
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	2,949,907
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	158,369,240
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	907,457
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-5,786,496
e	Add lines 2a through 2d .....................			2e	-4,879,039
3	Subtract line 2e from line 1..................			3	163,248,279
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b	-616,713
c	Add lines 4a and 4b....................			4c	-616,713
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	162,631,566

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	123,077,537
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	616,713
e	Add lines 2a through 2d....................			2e	616,713
3	Subtract line 2e from line 1...................			3	122,460,824
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b	5,786,496
c	Add lines 4a and 4b.....................			4c	5,786,496
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	128,247,320

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Part X, Line 2:	The Medical Center is organized as a New Mexico nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Medical Center is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Medical Center is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Medical Center files an Exempt Organization Business Income Tax Return (Form 990-T) with the IRS to report its unrelated business taxable income. The Medical Center believes it has appropriate support for any tax positions taken affecting its annual filing requirement, and, as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Medical Center would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense, if such interest and penalties are incurred. The Medical Center's federal Form 990-T filings are no longer subject to federal tax examinations by tax authorities for years before 2013.
Part XI, Line 2d - Other Adjustments:	Provision for Bad Debts Recorded as Income for F/S -5,660,918. Reorganization Costs Recorded as Income for F/S -125,578.
Part XI, Line 4b - Other Adjustments:	Rental Expenses Recorded as Expense for F/S -616,713.
Part XII, Line 2d - Other Adjustments:	Rental Expenses Recorded as Expense for F/S 616,713.
Part XII, Line 4b - Other Adjustments:	Provision for Bad Debts Recorded as Income for F/S 5,660,918. Reorganization Costs Recorded as Income for F/S 125,578.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Otero County Hospital Association

Employer identification number

85-0138775

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other 30000.0000000000 %

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: . . . . . . . .

200% 250% 300% 350% 400% Other %

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.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	492,000		492,000	0.400 %
b	Medicaid (from Worksheet 3, column a) . . . . .	26,551,887	19,319,016	7,232,871	5.900 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	27,043,887	19,319,016	7,724,871	6.300 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).
f	Health professions education (from Worksheet 5) . . .	81,723		81,723	0.070 %
g	Subsidized health services (from Worksheet 6) . . . .	34,211,063	13,159,523	21,051,540	17.170 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	34,292,786	13,159,523	21,133,263	17.240 %
k	Total. Add lines 7d and 7j .	61,336,673	32,478,539	28,858,134	23.540 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

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.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	17,500	17,500	0.010 %
3	Community support	838,617	838,617	0.680 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	211,833	211,833	0.170 %
8	Workforce development	851,694	851,694	0.690 %
9	Other
10	Total	1,919,644	1,919,644	1.550 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

5,660,918

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. ......

23,567

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

Enter total revenue received from Medicare (including DSH and IME).....

29,938,338

Enter Medicare allowable costs of care relating to payments on line 5.....

30,695,831

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-757,493

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

Yes

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 %
11 Alamogordo Surgery Ventures	Outpatient Surgery Center	40.500 %	8.000 %	51.500 %
22 Alamogordo Imaging Center	Outpatient Radiology Center	29.790 %	0 %	70.210 %
33 White Sands Health Care Systems LLC	Physician Hospital Organization	50.000 %	0 %	50.000 %
44 Gerald Champion-Sierra Providence Cardiac Cath Lab LLC	Cardiac Cath Lab	51.000 %	0 %	0 %
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

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?1 Name, 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)					Other (Describe)
1	Gerald Champion Regional Medical Center 2669 North Scenic Drive Alamogordo,NM88311 www.gcrmc.org 6016	X	X	X	18 Provider Clinics

Schedule H (Form 990) 2015

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)

	Gerald Champion Regional Medical Center
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

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 .................

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..................................

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. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): http://www.gcrmc.org/upload/docs/Community%20Needs%20Assessment%202015.pdf

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): http://www.gcrmc.org/upload/docs/Community%20Needs%20Assessment%202015.pdf

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

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) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Gerald Champion Regional Medical Center
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 300.000000000000% and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

http://www.gcrmc.org/News/CharityCare

The FAP application form was widely available on a website (list url):

http://www.gcrmc.org/News/CharityCare

A plain language summary of the FAP was widely available on a website (list url):

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

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 non-payment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	Gerald Champion Regional Medical Center
Name of hospital facility or letter of facility reporting group

Yes

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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

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, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 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
Gerald Champion Regional Medical Center	Part V, Section B, Line 3j: Charts related to age, gender, general lifestyles, healthcare metrics.
Gerald Champion Regional Medical Center	Part V, Section B, Line 5: Conducted focus groups and individual interviews.
Gerald Champion Regional Medical Center	Part V, Section B, Line 6b: Otero County Community Health CouncilPresbyterian Medical ServicesAlamogordo Public SchoolsDepartment of Public SafetyAlamogordo Chamber of CommerceCOPE OutreachAlamogordo Senior CenterThe Counseling Center
Gerald Champion Regional Medical Center	Part V, Section B, Line 11: The hospital's written implementation strategy is included in the facility CHNA document. This document was reviewed by the hospital's CPA auditors and business advisors. Based on the results of this review, all significant needs are being addressed in the assessment. The needs identified include: Access to primary care, access to affordable insurance, obesity, diabetes, cancer, mental healthcare, heart disease, and health education. The strategy to resolve these issues include 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, lending support to the area mental health counseling center to recruit qualified, licensed mental health professionals.
Gerald Champion Regional Medical Center	Part V, Section B, Line 22d: Patients who have household income at or below 300% of the FPG are eligible to receive free care. The organization also offers a 25% discount to self-pay patients. 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.

Schedule H (Form 990) 2015

Page 8

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?3
Name and address		Type of Facility (describe)
1	1 - ASV dba Scenic View Outpatient Surg Cr 2351 25th Street Alamogordo,NM88311	Outpatient Surgery
2	2 - Alamogordo Imaging Center 2539 Medical Dr Ste 1010 Alamogordo,NM883108720	Outpatient Radiology
3	3 - Gerald Champ-Sierra Provid Cardiac Cath 2669 North Scenic Drive Alamogordo,NM88310	Cardiac Cath Lab
4
5
6
7
8
9
10

Schedule H (Form 990) 2015

Page 9

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
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 eigible to receive free care. The organizationn also offers a 25% discount to self-pay patients. 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 organization used the following to determine the costs for Part I, Line 7:Row a: Charity Care was converted to cost using a cost to charge ratio from the cost accounting system. The cost accounting system addresses all patient segments.Row b : Amounts were calculated from internal records.Row g: Amounts reported are based on the Medicare Cost Report figures.Row i: Amount reported is based on the actual dollars spent in the activities reported.
Part I, Line 7g:	Part I, Line 7g includes $27,213,573 of costs attributable to a Physician Clinic.
Part I, Ln 7 Col(f):	The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $5,660,918.
Part III, Line 2:	Discounts and payments are taken into account when determining bad debt expense.
Part III, Line 3:	The Organization estimated the percentage of bad debt that is attributed to charity care by applying the percentage of charity care to total revenues to total bad debt at cost. Therefore the organization estimates that 0.42% of the bad debt expense at cost is attributable to patients eligible under the organization's charity care policy. Care is given to individuals regardless of their ability to pay, and therefore this is a community benefit.
Part III, Line 4:	Footnote from organization's financial statements: The footnote that describes bad debt expense is found on page 8 of the attached audit report.
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 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 are asked to provide detailed information regarding their income and assets. For patients who qualify for charity and who are cooperating in good faith to resolve their hospital bills, GCRMC may offer extended payment plans to eligible patients, 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 2015, Management at GCRMC enlisted the services of MJ Philps to develop a Community Heath 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 Center for Disease Control and Prevention to examine trends for stroke, diabetes, heart disease and cancer. It also includes data that identify shortages in healthcare professionals by location.
Part VI, Line 3:	The hospital has a Charity Care 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 Charity Care 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 obtaining financial coverage or low-cost health insurance, 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 1st billing. Notice will be sent at the time of the 1st 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 130-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 100 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, 19-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 including ECT, pediatrics, gastroenterology and endocrinology; Pathologist; 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 and 16-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 DoD made the decision to leave all the obstetrical services with GCRMC and the local obstetricians. As of 2016, Holliman employed 1,621 civilians. There are 3,720 active military and 4,826 dependents located at the base. 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 U.S. Census, the population of Otero County has grown by 2.5% since 2010 with 65,410 estimated in 2016.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 average 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 estimated to be 8,029 in 2010 according to the U.S. Census Bureau. The tertiary service area covers a small portion of Otero County and Chaves County. There are no other major medical centers within Otero County.
Part VI, Line 5:	The business and affairs of GCRMC are subject to the overall governance and direction of its Board of Directors. The Board of Directors currently includes 12 Directors. Each Director is appointed by the Board 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. The Board of Directors are business people of the primary service area, with no other connection. 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 GCMRC 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. Surplus funds 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 served has a variety of educational background. The drive 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 United Way 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 hospital provided space, free of charge and has brought a highly valued service to our community. The Gift Closet provides free wigs, prosthesis, supplies, education and support to cancer patients and their families.Added a social media program including web access to Fast Health which provides health related information to patients. 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.
Part VI, Line 6:	n/a
Part VI, Line 7, Reports Filed With States	NM

Schedule H (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
Otero County Hospital Association

Employer identification number
85-0138775

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

(1) American Cancer Society 2120 First Avenue Alamogordo,NM88310	84-1316555	501(c)(3)	15,566	Public Health
(2) Otero County Economic Development Council 1301 N White Sands Boulevard Alamogordo,NM88310	85-0304073	501(c)(3)	10,000	Public Health
(3) PMS Alamogordo 1501 Tenth Street Alamogordo,NM88310	85-0206810	501(c)(3)	120,000	Public Health
(4) PMS Chaparral NM Clinic 204 Angelina Chaparral,NM88081	85-0206810	501(c)(3)	200,006	Public Health
(5) PMS Sacramento Mountain Center PO Box 686 Cloudcroft,NM88317	85-0206810	501(c)(3)	133,333	Public Health
(6) United Way 1501 E Tenth Street Suite B Alamogordo,NM88310	85-0197559	501(c)(3)	27,458	Public Health
(7) Zia Therapy-Ztrans 900 First Street Alamogordo,NM88310	85-0199165	501(c)(3)	30,375	Public Health
(8) Otero County Fair Association 401 Fairgrounds Road Alamogordo,NM88310	85-6011829	501(c)(3)	27,319	Public Health
(9) Flickinger Center 1110 N New York Avenue Alamogordo,NM88310	85-0326369	501(c)(3)	7,500	Public Health

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of non-cash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of non-cash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
Part I, Line 2:	The organization only gave grants to government organizations and tax exempt organizations.

Schedule I (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Otero County Hospital Association

Employer identification number

85-0138775

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Yes

Any related organization? .........................

Yes

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Greg Richardson MDDirector	(i) (ii)	350,970 ------------- 0	5,500 ------------- 0	762 ------------- 0	8,400 ------------- 0	24,781 ------------- 0	390,413 ------------- 0	0 ------------- 0
2Andrew Lancaster MDDirector/Physician	(i) (ii)	212,757 ------------- 0	1,000 ------------- 0	54 ------------- 0	6,300 ------------- 0	23,800 ------------- 0	243,911 ------------- 0	0 ------------- 0
3Robert James HeckertCEO	(i) (ii)	356,407 ------------- 0	0 ------------- 0	1,524 ------------- 0	18,000 ------------- 0	2,203 ------------- 0	378,134 ------------- 0	0 ------------- 0
4Bashar NaserCFO	(i) (ii)	358,037 ------------- 0	4,800 ------------- 0	4,680 ------------- 0	6,000 ------------- 0	22,659 ------------- 0	396,176 ------------- 0	0 ------------- 0
5Arthur Austin MDDirector/VP of Medical Affairs	(i) (ii)	291,373 ------------- 0	250 ------------- 0	1,524 ------------- 0	9,000 ------------- 0	18,943 ------------- 0	321,090 ------------- 0	0 ------------- 0
6Albert EsparsenVP of Physician Practice	(i) (ii)	148,487 ------------- 0	24,800 ------------- 0	473 ------------- 0	0 ------------- 0	14,518 ------------- 0	188,278 ------------- 0	0 ------------- 0
7Peter SeamanVP of Finance	(i) (ii)	161,132 ------------- 0	24,900 ------------- 0	953 ------------- 0	5,848 ------------- 0	16,006 ------------- 0	208,839 ------------- 0	0 ------------- 0
8Dennis WorthingtonPhysician	(i) (ii)	410,316 ------------- 0	10,792 ------------- 0	762 ------------- 0	10,320 ------------- 0	19,125 ------------- 0	451,315 ------------- 0	0 ------------- 0
9Charles RacePhysician	(i) (ii)	808,409 ------------- 0	1,000 ------------- 0	396 ------------- 0	9,533 ------------- 0	21,531 ------------- 0	840,869 ------------- 0	0 ------------- 0
10Donald SchuwargerPhysician	(i) (ii)	345,526 ------------- 0	59,959 ------------- 0	258 ------------- 0	24,473 ------------- 0	20,888 ------------- 0	451,104 ------------- 0	0 ------------- 0
11William PollardPhysician	(i) (ii)	468,471 ------------- 0	53,256 ------------- 0	27,420 ------------- 0	10,320 ------------- 0	25,654 ------------- 0	585,121 ------------- 0	0 ------------- 0
12George MassoudPhysician	(i) (ii)	408,810 ------------- 0	1,000 ------------- 0	371 ------------- 0	10,320 ------------- 0	18,428 ------------- 0	438,929 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Part I, Line 1a	Residence was provided to persons listed in Part VII until permanent housing was arranged. Benefit was reported as taxable income to recipients.
Part I, Line 4b	The following individuals contributed to the hospital's 457(b) Deferred Compensation Plan in FY 2016. The amounts contributed are listed next to the individual's name. The hospital did not match any employee, officer or director contributions. Robert Heckert-$18,250 George Massoud-$18,000 Gregory Richardson-$18,429 Donald Shuwarger-$9,979
Part I, Line 6	The organization's officers listed in Part VII, Section A are evaluated annually based on a set of evidence based goals that determine their eligibility for additional compensation. The select goals are weighted in a hierarchy of core and job specific competencies, which include quality of care, financial performance and patient perception of care measures. One of the criteria designed to enhance alignment of the organization's goal for continued financial stability is improvement of net earnings of both the hospital, and its related organizations.

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
Otero County Hospital Association

Employer identification number
85-0138775

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	New Mexico Hospital Equipment Loan Council	85-0426875	647370FS9	09-19-2012	70,004,797	Hospital imp. including new patient tower; refund bonds issued 11/15/07		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	1,350,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	70,011,320
4 Gross proceeds in reserve funds .............	5,283,184
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	1,400,096
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	32,310,994
11 Other spent proceeds .............	31,075,969
12 Other unspent proceeds .............
13 Year of substantial completion .............	2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X
15 Were the bonds issued as part of an advance refunding issue? .....		X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2015

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	2.560 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %
6 Total of lines 4 and 5 .............	2.560 %
7 Does the bond issue meet the private security or payment test? ...		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X
b Exception to rebate? ........		X
c No rebate due? .........	X
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2015

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
Date Rebate Computation Performed	Issuer Name: New Mexico Hospital Equipment Loan Council Date the Rebate Computation was Performed: 01/09/2014
Schedule K, Part II, Line 11:	The other spent proceeds was the amount used to retire the bonds issued in 2007.
Schedule K, Part I, Column (e) and Part II, Line 3:	The difference between the issue price at Part I Column (e) and the total proceeds of the issue at Part II Line 3 is due to investment earnings on the reserve funds.

Schedule K (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Otero County Hospital Association

Employer identification number

85-0138775

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No










Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2015

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Gregory Richardson	Board member Gregory Richardson is the President of the ASV, LLC board	5,988,420	Gerald Champion performs services for ASV, LLC		No
(2) Amy Graham	Daughter-in-law of board member William Mershon	78,668	Compensation		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

Otero County Hospital Association

Employer identification number

85-0138775

Return Reference	Explanation
Form 990, Part III, line 2	Osteo Clinic, April 2016 Wellness Clinic, February 2016 New internal med clinic (Dr. Singh) February 2016 Allergy Clinic, January 2016 In July 2015, the Joint Venture operating a Cardiac Cath Lab opened two days per week. April 2016, the Cardiac Cath Lab was staffed 24/7, and the Cardiology Clinic opened. Expansion of Inpatient Behavioral Medicine from 12 beds to 19 beds.
Form 990, Part III, line 3	Closed the Downtown Pediatrics office, August 2015.
Form 990, Part III, Line 4a, Description of Program Service (continued):	GCRMC has, since its inception in 1949, provided quality medical healthcare 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 healthcare services and healthcare education. Therefore, in keeping the 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 inability 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.
Form 990, Part VI, Section A, line 1	The Joint Finance and Executive Committee is chaired by the Vice Chairman of the Board of Directors. In absence of the Vice Chairman, the Chairman of the Board or Secretary of the Board shall chair the committee in that order. The composition of the Joint Finance/Executive Committee shall be determined by the Board of Directors at the annual meeting. The powers and responsibilities of the Committee shall include: Screen Board business and make recommendations for approval in order to enable the full Board to effectively utilize its discussion time; Exercise emergency powers in extraordinary circumstances and make decisions otherwise reserved to the Board of Directors when the Board is not in session; Exercise the power and authority to transact Corporation business which requires immediate action; Serve as audit committee for the Corporation; Serve as ethics committee for the Corporation and be primarily responsible for implementing the conflicts of interest policy of the Corporation; review and make recommendations to the Board of Directors concerning the performance, competence and terms of employment of the Chief Executive Officer; and act in such other situations and capacities as the Board of Directors may designate or specify.
Form 990, Part VI, Section A, line 4	At a duly called meeting of the voting members of Otero County Hospital Association, the membership voted to convert the corporation into a non-membership corporation with a self-perpetuating board composed of not less than (7) nor more than (15) members. The Board of Directors ratified this decision of the membership and, by a super majority vote of the directors at a meeting duly called for such purpose, voted to amend the Articles of Incorporation of the Corporation accordingly. Restated Articles of Incorporation were then submitted to the New Mexico Secretary of State who accepted the same and issued a Restated Certificate of Incorporation. Upon the Secretary of State's issuance of the Restated Certificate of Incorporation, the Bylaws of the Corporation were amended to reflect this change in governance.
Form 990, Part VI, Section A, line 7a	At their annual meeting, the Board of Directors shall elect persons to fill such vacancies as may exist to a maximum of 15 Directors.
Form 990, Part VI, Section B, line 11	The return is reviewed by the CEO and CFO prior to filing.
Form 990, Part VI, Section B, line 12c	Each officer, director, and key employee is required to fill out a conflict of interest disclosure annually. The forms are initially reviewed by the CFO. If any conflicts exist, they are reviewed by the Board of Directors. A person with a conflict is restricted from voting on related matters.
Form 990, Part VI, Section B, line 15	The CEO reports to GCRMC Board of Directors and his salary is determined by the Board of Directors. The Board used comparative salary data obtained from QHR as well as the Modern Healthcare CEO Salary Survey to access the reasonableness of the compensation. Compensation was last determined June 2015 for FY16. Annually GCRMC has a compensation review performed by an independent consulting firm, Coker Group. This review includes compensation of officers as well as physicians. The results of the compensation study are presented to and reviewed by the Board.
Form 990, Part VI, Section C, line 19	The governing documents, conflict of interest policy and financial statement are all available upon request.
Form 990, Part IX, line 11g	Consultants: Program service expenses 1,225,773. Management and general expenses 755,331. Fundraising expenses 0. Total expenses 1,981,104. Maintenance Contracts: Program service expenses 1,238,248. Management and general expenses 1,752,528. Fundraising expenses 0. Total expenses 2,990,776. Physician Fees: Program service expenses 3,763,655. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,763,655. Agency Personnel: Program service expenses 2,536,636. Management and general expenses 8,352. Fundraising expenses 0. Total expenses 2,544,988. Contract Dept Fees: Program service expenses 2,728,746. Management and general expenses 3,397,899. Fundraising expenses 0. Total expenses 6,126,645. Surgery Center Fee: Program service expenses 5,988,420. Management and general expenses 0. Fundraising expenses 0. Total expenses 5,988,420. Miscellaneous Fees: Program service expenses 2,386,226. Management and general expenses 1,442,394. Fundraising expenses 0. Total expenses 3,828,620. GCSP Cath Lab Fee: Program service expenses 3,354,283. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,354,283.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Otero County Hospital Association

Employer identification number

85-0138775

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) Alamogordo Surgery Venture LLC 2351 25th Street Alamogordo,NM88310 06-1791828	Outpatient Surgery Center	NM	N/A	Related	502,695	89,719	Yes				No	40.500 %
(2) Gerald Champion-Sierra Providence Cardiac Cath Lab LLC 2669 N Scenic Drive Alamogordo,NM88310 61-1753921	Cardiac Cath Lab	NM	N/A	Related	-486,599	3,139,912	Yes				No	51.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

Yes

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

Yes

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Alamogordo Surgery Venture LLC	F	648,000	General Ledger
(2) Alamogordo Surgery Venture LLC	A	456,680	General Ledger
(3) Alamogordo Surgery Venture LLC	L	5,988,420	General Ledger
(4) Alamogordo Surgery Venture LLC	Q	107,471	General Ledger
(5) Gerald Champion-Sierra Providence Cardiac Cath Lab LLC	F	102,000	General Ledger
(6) Gerald Champion-Sierra Providence Cardiac Cath Lab LLC	A	157,038	General Ledger
(7) Gerald Champion-Sierra Providence Cardiac Cath Lab LLC	L	3,354,283	General Ledger
(8) Gerald Champion-Sierra Providence Cardiac Cath Lab LLC	Q	582,878	General Ledger
(9) Gerald Champion-Sierra Providence Cardiac Cath Lab LLC	R	909,375	General Ledger

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: Provision of health care services
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	8
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	818
6	Total number of volunteers (estimate if necessary) .............	6	144
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	-15,650
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	-15,650

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	274,839	148,883
9	Program service revenue (Part VIII, line 2g) .........	134,815,955	162,037,774
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	56,421	174,913
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	24,576	269,996
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	135,171,791	162,631,566
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	749,793	579,464
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	42,083,053	48,621,322
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	77,162,054	79,046,534
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	119,994,900	128,247,320
19	Revenue less expenses. Subtract line 18 from line 12.......	15,176,891	34,384,246
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	153,340,242	185,079,319
21	Total liabilities (Part X, line 26).............	89,064,319	85,511,693
22	Net assets or fund balances. Subtract line 21 from line 20.....	64,275,923	99,567,626

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 99,470,365 including grants of $ 579,464 ) (Revenue $ 162,037,774 )
	Otero County Hospital Association d/b/a Gerald Champion Regional Medical Center (GCRMC) provides comprehensive healthcare services through its 100-bed hospital (effective January 1, 2017), 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 100-bed acute care facility accredited by DNV, including two distinct PPS units: Life Transitions (aka Behavioral Medicine - total 19 beds) and Inpatient Rehabilitation (12 beds starting July 1, 2011). 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 12-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 and general surgery; inpatient and outpatient behavioral health services; 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, 128-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. In July 2015, a successful joint venture with the Hospitals of Providence was launched with the opening of the Cardiac Cath Lab. In the first 12 months of operation ended June 2016, a total of 280 interventional cases were done.By the end of 2016, GCRMC employed approximately 724 people. In addition to those employees, GCMRC contracts for services in various departments such as Food Services, Environmental Services, Pharmacy, Anesthesia, Emergency Department and Hospitalist Providers. The medical staff of GCRMC has 221 medical members consisting of 90 active members of whom 38 are employed 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 buildings 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.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses99,470,365

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Peter Seaman........................................................................ VP of Finance	40.00 .......................	X		186,985	0	21,303
(19) Dennis Worthington........................................................................ Physician	40.00 .......................		X	421,870	0	28,683
(20) Charles Race........................................................................ Physician	40.00 .......................		X	809,805	0	30,668
(21) Donald Schuwarger........................................................................ Physician	40.00 .......................		X	405,743	0	45,103
(22) William Pollard........................................................................ Physician	40.00 .......................		X	549,147	0	35,871
(23) George Massoud........................................................................ Physician	40.00 .......................		X	410,181	0	28,377

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	4,676,919	0	352,961

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	132,760

f	All other contributions, gifts, grants, and similar amounts not included above		1f	16,123

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		148,883

		Business Code
2a	Net Patient Service Revenue	900099	156,996,750	156,996,750
b	Other Revenue	900099	3,041,009	3,041,009
c	Cafeteria/Catering	722320	921,898	915,647	6,251
d	Alamogordo Surgery Venture, LLC	621400	582,658	582,658
e	Cardiac Cath Lab LLC	621400	347,993	347,993
f	All other program service revenue.			147,466	147,466
g Total.Add lines 2a–2f.....			162,037,774

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			202,409			202,409
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		886,709
b	Less: rental expenses		616,713
c	Rental income or (loss)		269,996
d	Net rental income or (loss)......			269,996		-21,901	291,897
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses	15,480	12,016
c	Gain or (loss)	-15,480	-12,016
d	Net gain or (loss).....			-27,496			-27,496
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See Instructions......			162,631,566	162,031,523	-15,650	466,810

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	579,464	579,464
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	2,317,877	645,255	1,672,622
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	78,668	78,668
7	Other salaries and wages	39,075,532	27,485,878	11,589,654
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	748,656	627,349	121,307
9	Other employee benefits .......	3,689,057	3,083,552	605,505
10	Payroll taxes ...........	2,711,532	1,880,762	830,770
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	350,866		350,866
c	Accounting ...........	266,280		266,280
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	62,352		62,352
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	30,578,491	23,221,987	7,356,504
12	Advertising and promotion ....	236,013	30	235,983
13	Office expenses .......	8,969,913	5,597,506	3,372,407
14	Information technology ......	274,120	63,934	210,186
15	Royalties ..
16	Occupancy ...........	1,964,297	481,378	1,482,919
17	Travel ............	253,493	103,253	150,240
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	353,152	177,622	175,530
20	Interest ...........	3,759,314	3,759,314
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	10,101,879	10,101,879
23	Insurance ...	2,641,217	2,641,217
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Medical Supplies	12,761,736	12,761,736
b	Provision for Bad Debts	5,660,918	5,660,918
c	Taxes	187,676	187,676
d	Reorganization Costs	125,578	125,578
e	All other expenses	499,239	205,409	293,830
25	Total functional expenses. Add lines 1 through 24e	128,247,320	99,470,365	28,776,955	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1
2	Savings and temporary cash investments .........			32,133,927	2	24,490,670
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			13,227,056	4	14,609,024
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			3,872,092	8	4,543,515
9	Prepaid expenses and deferred charges ......			1,322,894	9	2,020,419
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	191,797,884
b	Less: accumulated depreciation	10b	108,916,205	81,899,647	10c	82,881,679
11	Investments—publicly traded securities .			15,283,184	11	50,569,117
12	Investments—other securities. See Part IV, line 11 .....			2,597,264	12	3,636,059
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............			931,198	14	857,241
15	Other assets. See Part IV, line 11 ...........			2,072,980	15	1,471,595
16	Total assets. Add lines 1 through 15 (must equal line 34)...			153,340,242	16	185,079,319

17	Accounts payable and accrued expenses .....	17,344,983	17	14,292,319
18	Grants payable ...		18
19	Deferred revenue .........	1,226,018	19	1,063,094
20	Tax-exempt bond liabilities .........	68,319,032	20	67,095,142
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..	1,051,579	23	111,231
24	Unsecured notes and loans payable to unrelated third parties ..	416,667	24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	706,040	25	2,949,907
26	Total liabilities. Add lines 17 through 25..	89,064,319	26	85,511,693

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	64,275,923	27	99,567,626
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	64,275,923	33	99,567,626
34	Total liabilities and net assets/fund balances ........	153,340,242	34	185,079,319