2022-05-11T09:10:21-05:00 2021-06-30 381357951 PLANTE & MORAN PLLC 8181 E TUFTS AVE SUITE 600 DENVER CO 80237 990 2020-07-01 800348943 POUDRE VALLEY MEDICAL GROUP LLC POUD 9702377000 2315 E HARMONY ROAD NO 200 FORT COLLINS CO 80528 STEVE SCHWARTZ CFO 9702377000 2022-05-06 1 STEVE SCHWARTZ 999009999 RYAN C HARRIS P00614618 3037409400 2022-05-06 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z UCHEALTH MEDICAL GROUP DR MIKE RANDLE 2315 E HARMONY ROAD NO 200 FORT COLLINS CO 80528 598730635 0 X N/A X 2013 CO WE IMPROVE LIVES. IN BIG WAYS THROUGH LEARNING, HEALING AND DISCOVERY. IN SMALL, PERSONAL WAYS THROUGH HUMAN CONNECTION. BUT IN ALL WAYS, WE IMPROVE LIVES. 5 4 3499 4 0 0 129810764 125265328 412723151 473354517 74258 -113186 0 0 542608173 598506659 1671725 3817479 0 0 501297215 536450383 0 0 0 166515461 181699780 669484401 721967642 -126876228 -123460983 64694969 73202044 589585684 721553742 -524890715 -648351698 WE IMPROVE LIVES. IN BIG WAYS THROUGH LEARNING, HEALING AND DISCOVERY. IN SMALL, PERSONAL WAYS THROUGH HUMAN CONNECTION. BUT IN ALL WAYS, WE IMPROVE LIVES. 0 0 646878610 3817479 473354517 UCHEALTH MEDICAL GROUP (UCHMG) OPERATES MORE THAN 280 CLINICS ACROSS COLORADO, NEBRASKA AND WYOMING. UCHMG PROVIDES A FULL CONTINUUM OF MEDICAL CARE THROUGH AN INTEGRATED, MULTI-SPECIALTY PHYSICIAN GROUP. IN FISICAL YEAR 2021, THE GROUP HAD 2,002,507 OUTPATIENT VISITS AND 208,102 URGENT CARE VISITS. AT YEAR-END, UCHMG WAS COMPRISED OF MORE THAN 565 EMPLOYED PHYSICIANS AND 350 ADVANCED PRACTICE PROVIDERS REPRESENTING 48 SPECIALTIES. 646878610 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 282 0 1 3499 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X STEVE SCHWARTZ 9702377000 2315 E HARMONY ROAD SUITE 200 FORT COLLINS CO 80528 X CHRIS OSBORN BOARD CHAIR 1.00 X 0 0 0 DR TODD WHITSITT BOARD MEMBER/ PHYSICIAN 40.00 X 636996 0 44321 LAURIE STEELE BOARD MEMBER 1.00 X 0 0 0 GENE RENUART END 092020 BOARD MEMBER 1.00 X 0 0 0 DR WILLIAM NEFF END 112020 BOARD MEMBER 1.00 X 0 0 0 DR MIKE RANDLE PRESIDENT AND CEO 40.00 X 750291 0 110880 STEVE SCHWARTZ CFO 40.00 X 349699 0 47580 DONNA LANKFORD VP REGIONAL PRACTICE MGMT 40.00 X 245467 0 38304 MARY YANTIS VP REGIONAL PRACTICE MGMT 40.00 X 325249 0 46028 SCOTT HURLBERT VP CHIEF QUALITY OFFICER 40.00 X 393732 0 21830 DIANA BREYER VP CHIEF QUALITY OFFICER 40.00 X 204764 350455 43558 JENNY BAJAJ CHIEF MEDICAL OFFICER 40.00 X 434304 0 56146 TIMOTHY GRAMANN CHIEF OPERATING OFFICER 40.00 X 338450 0 53947 HANS COESTER MEDICAL DIRECTOR 40.00 X 1987724 0 49710 PETER WALINSKY PHYSICIAN 40.00 X 1577959 0 52780 FREDERIC DELEYIANNIS PHYSICIAN 40.00 X 1464288 0 58370 JOSHUA PETIT PHYSICIAN 40.00 X 1443026 0 52790 ARTHUR LIU PHYSICIAN 40.00 X 1395488 0 52790 11547437 350455 729034 999 0 1 0 UNIVERSITY PHYSICIANS INC 13199 E MONTVIEW BLVD AURORA CO 80045 MEDICAL 4342936 ASPEN CREEK MEDICAL ASSOCIATES 9480 BRIAR VILLAGE POINT DR SUITE COLORADO SPRINGS CO 80920 MEDICAL 2712809 WEATHERBY LOCUMS INC 7259 S BINGHAM JUNCTION BLVD MIDVALE UT 84047 MEDICAL 1487895 AMERICAN HEALTH STAFFING GROUP PO BOX 670529 DALLAS TX 75267 MEDICAL 1374398 HEALTH CAROUSEL LLC 3805 EDWARDS ROAD SUITE 700 CINCINNATI OH 45209 MEDICAL 1129994 28 115357444 9903904 3980 3980 125265328 NET PATIENT SVC REV 621110 406434121 406434121 COST REIMBURSEMENT 621110 63815514 63815514 OTHER PROGRAM REVENUE 621110 3104882 3104882 473354517 110790 110790 223976 -223976 -223976 -223976 598506659 473354517 0 -113186 3817479 3817479 4109370 1313025 2796345 459065380 417435224 41630156 18350267 16686181 1664086 49285845 44816378 4469467 5639521 5128103 511418 363924 2541 361383 66826 66826 20402 20402 24463742 11009273 13454469 2714926 2714926 3249351 2938051 311300 6294266 5411084 883182 35337116 34870763 466353 610358 550511 59847 14083092 13502699 580393 3642478 3642478 12956099 11021083 1935016 4615998 4538154 77844 MEDICAL SUPPLIES 53979232 52451619 1527613 BAD DEBT 12506674 12506674 LAUNDRY 1195801 1192465 3336 REPAIRS & MAINTENANCE 847126 846511 615 4752369 483388 4268981 721967642 646878610 75089032 0 36985 38450 32677938 35466277 311636 443685 1167510 816256 71818133 37039562 30148536 34778571 352364 1658805 64694969 73202044 77398974 93410720 902409 0 1827 0 511282474 628143022 589585684 721553742 X -524890715 -648351698 -524890715 -648351698 64694969 73202044 -123460983 0 X 0 1 X 1 0 X 38714496 97680190 108683182 129810764 125265328 500153960 107918948 308551632 373117654 412723151 473354517 1675665902 146633444 406231822 481800836 542533915 598619845 2175819862 0 0 0 2175819862 31573 71189 64386 74258 110790 352196 31573 71189 64386 74258 110790 352196 146665017 406303011 481865222 542608173 598730635 2176172058 X PART III, LINE 14 2017 WAS THE ORGANIZATION'S FIRST TAX YEAR AS A SECTION 501(C)(3) ORGANIZATION. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 20402 0 0 20402 0 10573953 4853345 5720608 12352736 5109886 7242850 41986043 22345221 19640822 6905401 4731110 2174291 34778571 PAYABLES TO AFFILIATES 622514715 COMP BAL-AUTHORITY 1055113 COPIC TAIL ACCRUAL 4573194 628143022 576321306 0 576321306 22185353 22185353 598506659 699782289 0 699782289 22185353 22185353 721967642 PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 12,506,675. CARES ACT GRANT 9,902,654. LOSS ON SALE OF ASSETS -223,976. PART XII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON SALE OF ASSETS -223,976. CARES ACT GRANT 9,902,654. PROVISION FOR UNCOLLECTIBLE ACCOUNTS 12,506,675. 1 UNIVERSITY OF COLORADO SCHOOL OF MEDICINE 13001 17TH PLACE AURORA CO 80045 846000055 501(C)(3) 3709486 COMMUNITY HEALTHCARE CITY OF FORT COLLINS 300 WEST LAPORTE AVE FORT COLLINS CO 80522 846000587 GOVERNMENT 10541 COMMUNITY HEALTHCARE ESTES PARK HEALTH FOUNDATION 555 PROSPECT PARK ESTES PARK CO 80517 742411016 501(C)(3) 11858 COMMUNITY HEALTHCARE FRONT RANGE COMMUNITY COLLEGE 3645 W 112TH AVENUE WESTMINSTER CO 80031 383721881 GOVERNMENT 13176 COMMUNITY HEALTHCARE FOOD BANK OF LARIMER COUNTY 1301 BLUE SPRUCE DRIVE FORT COLLINS CO 80524 742336171 501(C)(3) 5439 COMMUNITY HEALTHCARE COLORADO ROCKIES FOUNDATION 2001 BLAKE ST DENVER CO 80205 841178557 501(C)(3) 7298 COMMUNITY HEALTHCARE 6 PART I, LINE 2: THE ORGANIZATION AWARDS GRANTS BASED ON THE BENEFIT TO THE COMMUNITY. THE ORGANIZATION REQUESTS INFORMATION FROM THE GRANTEES TO ENSURE THAT THE FUNDS WILL BE USED FOR THE SPECIFIED PURPOSE. X X X 0 0 0 0 0 0 0 1 0 HANS COESTER MEDICAL DIRECTOR 1977460 0 0 0 10264 0 26733 0 22977 0 2037434 0 0 0 PETER WALINSKY PHYSICIAN 1492863 0 80000 0 5096 0 26733 0 26047 0 1630739 0 0 0 FREDERIC DELEYIANNIS PHYSICIAN 1461392 0 0 0 2896 0 26733 0 31637 0 1522658 0 0 0 JOSHUA PETIT PHYSICIAN 1441673 0 0 0 1353 0 26733 0 26057 0 1495816 0 0 0 ARTHUR LIU PHYSICIAN 1394118 0 0 0 1370 0 26733 0 26057 0 1448278 0 0 0 DR MIKE RANDLE PRESIDENT AND CEO 555927 0 186063 0 8301 0 86555 0 24325 0 861171 0 0 0 DR TODD WHITSITT BOARD MEMBER/ PHYSICIAN 633947 0 0 0 3049 0 26733 0 17588 0 681317 0 0 0 DIANA BREYER VP CHIEF QUALITY OFFICER 204764 348353 0 0 0 2102 3467 23266 7915 8910 216146 382631 0 0 JENNY BAJAJ CHIEF MEDICAL OFFICER 361573 0 70844 0 1887 0 37682 0 18464 0 490450 0 0 0 SCOTT HURLBERT VP CHIEF QUALITY OFFICER 355850 0 36942 0 940 0 3520 0 18310 0 415562 0 0 0 STEVE SCHWARTZ CFO 288671 0 56804 0 4224 0 31559 0 16021 0 397279 0 0 0 TIMOTHY GRAMANN CHIEF OPERATING OFFICER 281380 0 55619 0 1451 0 31042 0 22905 0 392397 0 0 0 MARY YANTIS VP REGIONAL PRACTICE MGMT 269430 0 53235 0 2584 0 30002 0 16026 0 371277 0 0 0 DONNA LANKFORD VP REGIONAL PRACTICE MGMT 202438 0 41125 0 1904 0 23315 0 14989 0 283771 0 0 0 PART I, LINE 7 UCHEALTH IS PROUD TO OFFER A BONUS PLAN THAT PAYS A PERCENTAGE OF AN EMPLOYEE'S BASE PAY. THE INTENT OF THE PLAN IS TO REWARD AN EMPLOYEE'S PERFORMANCE TOWARDS ACHIEVEMENT OF STRATEGIC GOALS DURING THE FISCAL YEAR. SUCCESSFUL ACCOMPLISHMENT OF GOALS THAT CONTRIBUTE TO OUR ORGANIZATION'S OVERALL STRATEGIC DIRECTION RESULT IN VARIABLE PAYMENTS ALIGNED TO OUR TOTAL COMPENSATION STRATEGY. THIS PROGRAM REWARDS EMPLOYEES BASED ON ORGANIZATIONAL PERFORMANCE MEASURES AND INDIVIDUAL EMPLOYEE GOAL PERFORMANCE. THE ANNUAL PERFORMANCE BONUS IS GENERALLY PAID OUT IN OCTOBER. ALL PAYOUTS ARE CONTINGENT BASED ON UCHEALTH BOARD OF DIRECTORS APPROVAL EACH FISCAL YEAR. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY INDEPENDENT CPAS. A PRELIMINARY DRAFT IS REVIEWED BY THE INTERNAL FINANCE DEPARTMENT. THE FINAL COPY OF THE FORM 990 IS PROVIDED IN AN ELECTRONIC FORMAT TO ALL BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY REQUIRES COMPLETION OF THE FORM ON AN ANNUAL BASIS BY THE BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. COMPLETED FORMS ARE SUBMITTED AND REVIEWED BY THE INTERNAL COMPLIANCE DEPARTMENT TO ENSURE COMPLIANCE WITH THE WRITTEN POLICY. ANY QUESTIONS OR ULTIMATE ENFORCEMENT WOULD BE HANDLED BY THE COMPLIANCE DEPARTMENT. FORM 990, PART VI, SECTION B, LINE 15 UCHEALTH CONTRACTS WITH SULLIVAN COTTER FOR EXECUTIVE COMPENSATION CONSULTING SERVICES. ON OUR BEHALF, SULLIVAN COTTER COLLECTS AND REVIEWS COMPENSATION LEVELS FROM LIKE-ORGANIZATION FOR LIKE-JOBS AND PROVIDES UCHEALTH WITH THE COMPARATIVE MARKET DATA. THE DATA IS SUBMITTED TO THE CHIEF HUMAN RESOURCES OFFICER, WHO ADVISES THE SYSTEM PRESIDENT AND CEO ON COMPENSATION DECISIONS FOR SENIOR EXECUTIVES. BASED ON THE MARKET DATA, THE SYSTEM PRESIDENT AND CEO DETERMINES THE SALARY OF THE ENTITY CEO'S COMPENSATION ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC BASED ON THE BUSINESS PURPOSE FOR THE REQUEST. THESE REQUESTS ARE ADDRESSED BY THE SENIOR MANAGEMENT TEAM ON A CASE-BY-CASE BASIS. FORM 990 PART VII SECTION A DR. TODD WHITSITT IS COMPENSATED FOR PHYSICIAN SERVICES HE PROVIDES TO THE ORGANIZATION AND NOT FOR SERVING AS A BOARD MEMBER. POUDRE VALLEY HEALTHCARE INC 2315 E HARMONY ROAD SUITE 200 FORT COLLINS CO 80528 841262971 TERTIARY CARE CO 501(C)(3) LINE 3 0 UNIVERSITY OF COLORADO HEALTH 7901 E LOWRY BLVD SUITE 350 DENVER CO 80230 454552631 HEALTHCARE MANAGEMENT CO 501(C)(3) LINE 7 0 MEDICAL CENTER OF THE ROCKIES 2315 E HARMONY RD STE 200 FORT COLLINS CO 80528 043730045 TERTIARY CARE CO 501(C)(3) LINE 3 PVHC INC 0 UCHEALTH NORTHERN COLORADO FOUNDATION 2315 E HARMONY RD STE 200 FORT COLLINS CO 80528 741894581 BENEFIT HEALTH CO 501(C)(3) LINE 7 PVHC INC 0 0 0 1 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0