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  5. LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY

LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY

Company Details

Name: LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Jurisdiction: Colorado
Legal type: Domestic nonprofit corporation
Status: Good Standing
Date of registration: 29 Jan 1928 (97 years ago)
Entity Number: 19871250684
ZIP code: 81101
County: Alamosa County
Place of Formation: COLORADO
Principal Address: 106 Blanca Ave Alamosa CO 81101 US

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
FN8KZ1SWYYA5 2024-12-05 106 BLANCA AVE, ALAMOSA, CO, 81101, 2340, USA 106 BLANCA AVENUE, ALAMOSA, CO, 81101, 2393, USA

Business Information
URL https://sanluisvalleyhealth.org/
Congressional District 03
State/Country of Incorporation CO, USA
Activation Date 2023-12-08
Initial Registration Date 2005-09-16
Entity Start Date 1928-01-29
Fiscal Year End Close Date Jun 30

Points of Contacts
Electronic Business
Title PRIMARY POC
Name MANDI WEED
Role DIRECTOR OF FINANCE
Address 106 BLANCA AVENUE, ALAMOSA, CO, 81101, 2393, USA
Title ALTERNATE POC
Name SHANE MORTENSEN
Role CFO
Address 106 BLANCA AVENUE, ALAMOSA, CO, 81101, 2393, USA
Government Business
Title PRIMARY POC
Name MANDI WEED
Role DIRECTOR OF FINANCE
Address 106 BLANCA AVENUE, ALAMOSA, CO, 81101, 2393, USA
Title ALTERNATE POC
Name SHANE MORTENSEN
Role CFO
Address 106 BLANCA AVENUE, ALAMOSA, CO, 81101, 2393, USA
Past Performance Information not Available

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
44VV6 Obsolete Non-Manufacturer 2005-09-16 2023-12-08 No data 2024-12-05

Contact Information
POC MANDI WEED
Phone +1 719-587-6388
Address 106 BLANCA AVE, ALAMOSA, CO, 81101 2340, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SAN LUIS VALLEY HEALTH'S EMPLOYEE LIFE/AD&D/LTD PLAN FKA SAN LUIS VALLEY REGIONAL MEDICAL CENTER'S EMPLOYEE LIFE/AD&D/LTD PLAN 2015 840255530 2016-05-10 LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY 512
Three-digit plan number (PN) 520
Effective date of plan 2009-12-01
Business code 622000
Sponsor’s telephone number 7195871419
Plan sponsor’s DBA name SAN LUIS VALLEY HEALTH
Plan sponsor’s mailing address 106 BLANCA AVE, ALAMOSA, CO, 811012340
Plan sponsor’s address 106 BLANCA AVE, ALAMOSA, CO, 811012340

Number of participants as of the end of the plan year
Active participants 523
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2016-05-10
Name of individual signing KATE RUYBAL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-05-10
Name of individual signing KATE RUYBAL
Valid signature Filed with authorized/valid electronic signature
SAN LUIS VALLEY HEALTH'S EMPLOYEE LIFE/AD&D/LTD PLAN FKA SAN LUIS VALLEY REGIONAL MEDICAL CENTER'S EMPLOYEE LIFE/AD&D/LTD PLAN 2014 840255530 2015-06-19 LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY 507
File View Page
Three-digit plan number (PN) 520
Effective date of plan 2009-12-01
Business code 622000
Sponsor’s telephone number 7195871419
Plan sponsor’s DBA name SAN LUIS VALLEY HEALTH
Plan sponsor’s mailing address 106 BLANCA AVENUE, ALAMOSA, CO, 81101
Plan sponsor’s address 106 BLANCA AVENUE, ALAMOSA, CO, 81101

Number of participants as of the end of the plan year
Active participants 517
Retired or separated participants receiving benefits 2
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2015-06-19
Name of individual signing KATE RUYBAL
Valid signature Filed with authorized/valid electronic signature
SAN LUIS VALLEY HEALTH'S EMPLOYEE LIFE/AD&D/LTD PLAN FKA SAN LUIS VALLEY REGIONAL MEDICAL CENTER'S EMPLOYEE LIFE/AD&D/LTD PLAN 2013 840255530 2014-06-25 LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY 438
File View Page
Three-digit plan number (PN) 520
Effective date of plan 2009-12-01
Business code 622000
Sponsor’s telephone number 7195871419
Plan sponsor’s DBA name SAN LUIS VALLEY HEALTH
Plan sponsor’s mailing address 106 BLANCA AVENUE, ALAMOSA, CO, 81101
Plan sponsor’s address 106 BLANCA AVENUE, ALAMOSA, CO, 81101

Number of participants as of the end of the plan year
Active participants 503
Retired or separated participants receiving benefits 4
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2014-06-25
Name of individual signing KATE RUYBAL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-06-25
Name of individual signing KATE RUYBAL
Valid signature Filed with authorized/valid electronic signature
SAN LUIS VALLEY REGIONAL MEDICAL CENTER'S EMPLOYEE LIFE/AD&D/LTD PLAN 2013 840255530 2014-06-24 LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY 0
File View Page
Three-digit plan number (PN) 520
Effective date of plan 2009-12-01
Business code 622000
Sponsor’s telephone number 7195871419
Plan sponsor’s DBA name SAN LUIS VALLEY REGIONAL MEDICAL CENTER
Plan sponsor’s mailing address 106 BLANCA AVENUE, ALAMOSA, CO, 81101
Plan sponsor’s address 106 BLANCA AVENUE, ALAMOSA, CO, 81101

Number of participants as of the end of the plan year
Active participants 421
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2014-06-24
Name of individual signing KATE RUYBAL
Valid signature Filed with authorized/valid electronic signature
SAN LUIS VALLEY REGIONAL MEDICAL CENTER'S EMPLOYEE LIFE/AD&D/LTD PLAN 2012 840255530 2014-06-24 LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY 423
File View Page
Three-digit plan number (PN) 520
Effective date of plan 2009-12-01
Business code 622000
Sponsor’s telephone number 7195871419
Plan sponsor’s DBA name SAN LUIS VALLEY REGIONAL MEDICAL CENTER
Plan sponsor’s mailing address 106 BLANCA AVENUE, ALAMOSA, CO, 81101
Plan sponsor’s address 106 BLANCA AVENUE, ALAMOSA, CO, 81101

Number of participants as of the end of the plan year
Active participants 436
Retired or separated participants receiving benefits 2
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2014-06-24
Name of individual signing KATE RUYBAL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-06-24
Name of individual signing KATE RUYBAL
Valid signature Filed with authorized/valid electronic signature
SAN LUIS VALLEY REGIONAL MEDICAL CENTER'S EMPLOYEE LIFE/AD&D/LTD PLAN 2011 840255530 2014-06-24 LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY 435
File View Page
Three-digit plan number (PN) 520
Effective date of plan 2009-12-01
Business code 622000
Sponsor’s telephone number 7195871419
Plan sponsor’s DBA name SAN LUIS VALLEY REGIONAL MEDICAL CENTER
Plan sponsor’s mailing address 106 BLANCA AVENUE, ALAMOSA, CO, 81101
Plan sponsor’s address 106 BLANCA AVENUE, ALAMOSA, CO, 81101

Plan administrator’s name and address
Administrator’s EIN 840255530
Plan administrator’s name LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Plan administrator’s address 106 BLANCA AVENUE, ALAMOSA, CO, 81101
Administrator’s telephone number 7195871419

Number of participants as of the end of the plan year
Active participants 423
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2014-06-24
Name of individual signing KATE RUYBAL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-06-24
Name of individual signing KATE RUYBAL
Valid signature Filed with authorized/valid electronic signature
SAN LUIS VALLEY REGIONAL MEDICAL CENTER'S EMPLOYEE LIFE/AD&D/LTD PLAN 2010 840255530 2014-06-24 LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY 421
File View Page
Three-digit plan number (PN) 520
Effective date of plan 2009-12-01
Business code 622000
Sponsor’s telephone number 7195871419
Plan sponsor’s DBA name SAN LUIS VALLEY REGIONAL MEDICAL CENTER
Plan sponsor’s mailing address 106 BLANCA AVENUE, ALAMOSA, CO, 81101
Plan sponsor’s address 106 BLANCA AVENUE, ALAMOSA, CO, 81101

Plan administrator’s name and address
Administrator’s EIN 840255530
Plan administrator’s name LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Plan administrator’s address 106 BLANCA AVENUE, ALAMOSA, CO, 81101
Administrator’s telephone number 7195871419

Number of participants as of the end of the plan year
Active participants 435
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2014-06-24
Name of individual signing KATE RUYBAL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-06-24
Name of individual signing KATE RUYBAL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
KONNIE MARTIN Agent 106 Blanca Ave Alamosa CO 81101 US

Transaction History

Transaction ID Type Date Effective date Name Comment
20248351356 File Report 2024-12-23 2024-12-23 No data Principal address changed
20238342530 File Report 2023-12-27 2023-12-27 No data Principal address changed, Change in registered agent information
20228244465 File Report 2022-12-23 2022-12-23 No data Change in registered agent information
20221306113 File Report 2022-03-24 2022-03-24 No data No data
20208127045 File Report 2020-12-29 2020-12-29 No data No data
20201009883 File Report 2020-01-03 2020-01-03 No data No data
20188023956 File Report 2018-12-26 2018-12-26 No data No data
20181008936 File Report 2018-01-03 2018-01-03 No data No data
20171229894 File Report 2017-03-24 2017-03-24 No data No data
20161010325 File Report 2016-01-05 2016-01-05 No data No data

USAspending Awards. Financial Assistance

FAIN Awarding Agency Assistance Listings Start Date End Date Description
G20RH19274 Department of Health and Human Services 93.912 - RURAL HEALTH CARE SERVICES OUTREACH, RURAL HEALTH NETWORK DEVELOPMENT AND SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT PROGRAM 2010-08-01 2013-07-31 SMALL HEALTH CARE PROVIDER QUALITY IMPROVEMENT
Recipient LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Recipient Name Raw SAN LUIS VALLEY REGIONAL MEDICAL CENTER
Recipient UEI FN8KZ1SWYYA5
Recipient DUNS 085277044
Recipient Address 106 BLANCA AVE, ALAMOSA, ALAMOSA, COLORADO, 81101, UNITED STATES
Obligated Amount 296292.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page
D1BIT10846 Department of Health and Human Services 93.888 - SPECIALLY SELECTED HEALTH PROJECTS 2008-09-01 2009-08-31 CONGRESSIONALLY-MANDATED HEALTH INFORMATION TECHNOLOGY GRANTS
Recipient LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Recipient Name Raw SAN LUIS VALLEY REGIONAL MEDICAL CENTER
Recipient UEI FN8KZ1SWYYA5
Recipient DUNS 085277044
Recipient Address 106 BLANCA AVE, ALAMOSA, ALAMOSA, COLORADO, 81101
Obligated Amount 160469.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page

Related by officers

No related officers

Related by address

106 Blanca Ave Alamosa CO 81101 US

San Luis Valley Health Foundation

Date of last update: 10 Mar 2025

Sources: Colorado's Secretary of State

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