FURP.ORG / PUBLIC DATA EXPLORER

POUDRE VALLEY HEALTH CARE INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
POUDRE VALLEY HEALTH CARE INC (EIN 84-1262971)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-14
IRS object ID
202101349349306835
Schema version
2019v5.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-05-14T16:53:22-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN381357951PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line18181 E TUFTS AVE SUITE 600AddressLine1Txt
CityDENVERCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80237ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN841262971EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1POUDRE VALLEY HEALTH CARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPOUDBusinessNameControlTxt
Phone9702377000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12315 E HARMONY ROAD NO 200AddressLine1Txt
CityFORT COLLINSCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80528ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID THOMPSONPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone9702377000PhoneNum
Signature2021-05-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDORI J EGGETTPreparerPersonNm
PTINP00645252PTIN
Phone3037409400PhoneNum
Preparation2021-05-13PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKEVIN UNGERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12315 E HARMONY RD 200AddressLine1Txt
CityFT COLLINSCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80528ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,243,704,203GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.UCHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateCOLegalDomicileStateCd
Activity Or MissionWE IMPROVE LIVES THROUGH LEARNING, HEALING, DISCOVERY, AND THROUGH HUMAN CONNECTION.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee4408TotalEmployeeCnt
Total Volunteers463TotalVolunteersCnt
Total Gross UBI$5,396,341TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$4,450,589NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,525,135PYContributionsGrantsAmt
CY Contributions Grants$16,035,676CYContributionsGrantsAmt
PY Program Service Revenue$708,240,921PYProgramServiceRevenueAmt
CY Program Service Revenue$666,720,548CYProgramServiceRevenueAmt
PY Investment Income$62,737,119PYInvestmentIncomeAmt
CY Investment Income$79,358,572CYInvestmentIncomeAmt
PY Other Revenue$13,290,404PYOtherRevenueAmt
CY Other Revenue$10,963,095CYOtherRevenueAmt
PY Total Revenue$786,793,579PYTotalRevenueAmt
CY Total Revenue$773,077,891CYTotalRevenueAmt
PY Grants And Similar Paid$39,643,462PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$43,827,300CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$245,900,138PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$254,274,947CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$285,144,951PYOtherExpensesAmt
CY Other Expenses$293,586,946CYOtherExpensesAmt
PY Total Expenses$570,688,551PYTotalExpensesAmt
CY Total Expenses$591,689,193CYTotalExpensesAmt
PY Revenues Less Expenses$216,105,028PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$181,388,698CYRevenuesLessExpensesAmt
Total Assets BOY$6,985,306,171TotalAssetsBOYAmt
Total Assets EOY$8,208,338,177TotalAssetsEOYAmt
Total Liabilities BOY$5,067,119,966TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,044,794,608TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,918,186,205NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,163,543,569NetAssetsOrFundBalancesEOYAmt
MissionWE IMPROVE LIVES. IN BIG WAYS THROUGH LEARNING, HEALING AND DISCOVERY. IN SMALL, PERSONAL WAYS THROUGH HUMAN CONNECTION. BUT IN ALL WAYS, WE IMPROVE LIVES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$536,471,917ExpenseAmt
Grant$43,827,300GrantAmt
Revenue$665,077,506RevenueAmt
DescPOUDRE VALLEY HEALTH CARE INC. (PVHC) PROVIDES TERTIARY, ACUTE, INPATIENT, OUTPATIENT AS WELL AS EMERGENCY CARE. PVHC SERVICES COMMUNITIES IN NORTHERN COLORADO, SOUTHWESTERN NEBRASKA, AND SOUTHEASTERN WYOMING. DURING FISCAL YEAR 2020, PVHC RECORDED 62,964 PATIENT DAYS, 13,958 ADMISSIONS, 298,737 OUTPATIENT VISITS, 63,840 EMERGENCY VISITS, 1,841 DELIVERIES, 3,433 INPATIENT SURGERIES, AND 4,541 OUTPATIENT SURGERIES.Desc
Total Program Service Expenses$536,471,917TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document292IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee4408EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DAVID THOMPSONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9702377000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12315 E HARMONY ROAD SUITE 200AddressLine1Txt
CityFORT COLLINSCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80528ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
MIKE DELLENBACH
DIRECTOR1.002.00Yes (X)$0$0$0
STEPHANIE LOCKWOOD
DIRECTOR1.002.00Yes (X)$0$0$0
CHRIS OSBORN
DIRECTOR1.002.00Yes (X)$0$0$0
JIM PARKE
DIRECTOR1.002.00Yes (X)$0$0$0
DENNIS HOUSKA
BOARD CHAIR1.002.00Yes (X)$96$0$0Yes (X)
DAN STROH
DIRECTOR1.002.00Yes (X)$108$0$0
FARAZ NAQVI
DIRECTOR1.002.00Yes (X)$331$0$0
DOUG ERION
DIRECTOR1.002.00Yes (X)$339$0$0
LISA CLAY
VICE CHAIR1.002.00Yes (X)$360$0$0Yes (X)
CHRISTINE CHIN
DIRECTOR1.002.00Yes (X)$910$0$0
KEVIN UNGER
CEO19.0025.00Yes (X)$438,774$578,132$111,187Yes (X)
DAVID THOMPSON
CFO/TREASURER17.0022.00$68,534$90,301$20,737Yes (X)
MICHELLE ALBRIGHT
SECRETARY40.00$6,468$0$1,862Yes (X)
ASHLEY BRUNING
SENIOR CLINICAL DIRECTOR29.0021.00$113,815$82,199$42,883Yes (X)
ROBERT WAGNER
MEDICAL DIRECTOR22.0029.00$92,135$120,522$38,749Yes (X)
RODNEY GOOD
CLINICAL DIRECTOR29.0021.00$127,381$91,996$43,958Yes (X)
JULIE NUNLEY
CHIEF NURSING OFFICER50.00$287,128$0$36,232Yes (X)
RYAN ROHMAN
CHIEF OPERATING OFFICER29.0021.00$196,045$141,586$32,969Yes (X)
GRACE KOWALSHYN-TAYLOR
VP OPERATIONS29.0021.00$193,019$139,399$57,020Yes (X)
DIANA BREYER
CHIEF QUALITY OFFICER11.0039.00$120,776$403,430$41,412Yes (X)
THOMAS DOWNES
CHIEF MEDICAL OFFICER27.0019.00$324,592$234,424$54,888Yes (X)
JILLIAN BUSCH
PSYCHIATRIST50.00$280,418$0$47,039Yes (X)
HERMANN MORENO
PSYCHIATRIST50.00$297,123$0$50,822Yes (X)
DAVID SEHR
MEDICAL DIRECTOR50.00$316,100$0$50,862Yes (X)
JANELL WOZNIAK
PROGRAM DIRECTOR50.00$322,984$0$45,334Yes (X)
KENNETH WTANABE
MEDICAL DIRECTOR50.00$346,526$0$50,975Yes (X)
STEPHANIE DOUGHTY
FORMER CFO, LEFT MARCH 201922.0015.00$241,111$317,690$25,376Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,775,073TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,199,679TotReportableCompRltdOrgAmt
Total Other Compensation$752,305TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K243IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ALLIED BARTON SECURITY
PO BOX 31001-2374PASADENACA91110SECURITY$3,285,784
NORTHERN COLORADO HOSPITALISTS
2121 E HARMONY RD STE 300FORT COLLINSCO80528MEDICAL$2,462,358
ORTHOPAEDIC & SPINE CENTER OF THE ROCKIE
2500 E PROSPECT RDFORT COLLINSCO80525MEDICAL$2,133,290
FORT COLLINS WOMEN'S CLINIC
1107 S LEMAY AVE STE 300FORT COLLINSCO80524MEDICAL$1,974,500
SUMMIT PATHOLOGY
5802 WRIGHT DRLOVELANDCO80538MEDICAL$1,930,815
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K52CntrctRcvdGreaterThan100KCnt
Related Organizations$688,580RelatedOrganizationsAmt
Government Grants$14,532,477GovernmentGrantsAmt
All Other Contributions$814,619AllOtherContributionsAmt
Noncash Contributions$666,020NoncashContributionsAmt
Total Contributions$16,035,676TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SVC REV900099$623,874,640$623,874,640
PROVIDER FEE INCOME621400$36,312,765$36,312,765
RENT INCOME - AFFILIAT900099$2,471,789$2,471,789
DIETARY SVC INCOME900099$2,117,531$2,117,531
JOINT VENTURE621400$1,918,200$2,436,758-$518,558

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,623TotalRevenueColumnAmt
Related Or Exempt Func Income-$18,446RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$44,069UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$666,720,548TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$35,897,052TotalRevenueColumnAmt
Exclusion$35,897,052ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$9,579,173RealAmt
Personal$7,405PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$2,917,278RealAmt
Personal$7,405PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$6,661,895RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,661,895TotalRevenueColumnAmt
Unrelated Business Revenue$5,870,830UnrelatedBusinessRevenueAmt
Exclusion$791,065ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,510,943,041SecuritiesAmt
Other$104,046OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,467,498,982SecuritiesAmt
Other$86,585OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$43,444,059SecuritiesAmt
Other$17,461OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$43,461,520TotalRevenueColumnAmt
Exclusion$43,461,520ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$289,031GrossSalesOfInventoryAmt
Cost Of Goods Sold$116,062CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$172,969TotalRevenueColumnAmt
Exclusion$172,969ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
LAB SERVICES624100$2,429,865$2,429,865
MISCELLANEOUS REVENUE621400$1,655,866$1,655,866
EHR REVENUE624100$42,500$42,500
FieldValueIRS element (for citing)
Other Revenue Total$4,128,231OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$773,077,891TotalRevenueColumnAmt
Related Or Exempt Func Income$669,205,737RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$5,396,341UnrelatedBusinessRevenueAmt
Exclusion$82,440,137ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$43,827,300TotalAmt
Program Services$43,827,300ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$4,284,326TotalAmt
Program Services$2,670,256ProgramServicesAmt
Management And General$1,614,070ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$192,478,388TotalAmt
Program Services$164,611,731ProgramServicesAmt
Management And General$27,866,657ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$18,785,337TotalAmt
Program Services$15,879,916ProgramServicesAmt
Management And General$2,905,421ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$36,218,666TotalAmt
Program Services$30,616,932ProgramServicesAmt
Management And General$5,601,734ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,508,230TotalAmt
Program Services$2,120,296ProgramServicesAmt
Management And General$387,934ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$339,640TotalAmt
Management And General$339,640ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$70,440TotalAmt
Management And General$70,440ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$32,012TotalAmt
Management And General$32,012ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$2,415,580TotalAmt
Management And General$2,415,580ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$28,861,135TotalAmt
Program Services$22,885,306ProgramServicesAmt
Management And General$5,975,829ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,432,652TotalAmt
Program Services$2,379,484ProgramServicesAmt
Management And General$53,168ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$4,561,925TotalAmt
Program Services$4,154,939ProgramServicesAmt
Management And General$406,986ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$9,638,803TotalAmt
Program Services$8,770,144ProgramServicesAmt
Management And General$868,659ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,154,022TotalAmt
Program Services$988,227ProgramServicesAmt
Management And General$1,165,795ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$934,998TotalAmt
Program Services$714,762ProgramServicesAmt
Management And General$220,236ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$315,859TotalAmt
Program Services$185,527ProgramServicesAmt
Management And General$130,332ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$4,652,832TotalAmt
Program Services$4,652,832ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$23,797,676TotalAmt
Program Services$20,975,033ProgramServicesAmt
Management And General$2,822,643ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,000,881TotalAmt
Program Services$932,560ProgramServicesAmt
Management And General$68,321ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$132,304,730$131,949,715$355,015
PROVIDER FEE EXPENSE$32,166,608$32,166,608
BAD DEBT$27,242,507$27,242,507
UBIT TAXES$892,925$892,925

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$19,771,721TotalAmt
Program Services$18,747,842ProgramServicesAmt
Management And General$1,023,879ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$591,689,193TotalAmt
Program Services$536,471,917ProgramServicesAmt
Management And General$55,217,276ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$74,136,456BOYAmt
EOY$325,230,320EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,188,059BOYAmt
EOY$2,322,230EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$74,134,294BOYAmt
EOY$67,322,566EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$38,940BOYAmt
EOY$38,807EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$10,670,379BOYAmt
EOY$10,605,724EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$8,976,517BOYAmt
EOY$9,279,967EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$719,837,187LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$437,298,502LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$283,533,370BOYAmt
EOY$282,538,685EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,365,355,373BOYAmt
EOY$1,416,743,053EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$26,820,617BOYAmt
EOY$26,914,617EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,139,452,166BOYAmt
EOY$6,067,342,208EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,985,306,171BOYAmt
EOY$8,208,338,177EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$101,121,830BOYAmt
EOY$155,316,490EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$1,653,143BOYAmt
EOY$1,638,362EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$171,510,928BOYAmt
EOY$164,523,500EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$14,836,844BOYAmt
EOY$12,088,598EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$59,989BOYAmt
EOY$47,076EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,777,937,232BOYAmt
EOY$5,711,180,582EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,067,119,966BOYAmt
EOY$6,044,794,608EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,918,186,205BOYAmt
EOY$2,163,543,569EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,918,186,205BOYAmt
EOY$2,163,543,569EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,985,306,171BOYAmt
EOY$8,208,338,177EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$181,388,698ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$13,273,007NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$77,241,673OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Direct Contact Legislators$32,012DirectContactLegislatorsAmt
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$32,012TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationPORTION OF DUES FROM MEMBERSHIP IN CHA AND AHA THAT ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,552,046BeginningYearBalanceAmt
Contributions$76,521ContributionsAmt
Investment Earnings Or Losses$186,928InvestmentEarningsOrLossesAmt
Grants Or Scholarships$28,707GrantsOrScholarshipsAmt
Other Expenditures$55,954OtherExpendituresAmt
Administrative Expenses$34,791AdministrativeExpensesAmt
End Year Balance$7,696,043EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,528,946BeginningYearBalanceAmt
Contributions$61,289ContributionsAmt
Investment Earnings Or Losses$260,065InvestmentEarningsOrLossesAmt
Grants Or Scholarships$33,759GrantsOrScholarshipsAmt
Other Expenditures$234,908OtherExpendituresAmt
Administrative Expenses$29,587AdministrativeExpensesAmt
End Year Balance$7,552,046EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,098,243BeginningYearBalanceAmt
Contributions$34,394ContributionsAmt
Investment Earnings Or Losses$536,004InvestmentEarningsOrLossesAmt
Grants Or Scholarships$4,257GrantsOrScholarshipsAmt
Other Expenditures$100,183OtherExpendituresAmt
Administrative Expenses$35,255AdministrativeExpensesAmt
End Year Balance$7,528,946EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,872,466BeginningYearBalanceAmt
Contributions$76,668ContributionsAmt
Investment Earnings Or Losses$163,048InvestmentEarningsOrLossesAmt
Grants Or Scholarships-$6,188GrantsOrScholarshipsAmt
Other Expenditures-$12,899OtherExpendituresAmt
Administrative Expenses$33,026AdministrativeExpensesAmt
End Year Balance$7,098,243EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,151,577BeginningYearBalanceAmt
Contributions$39,217ContributionsAmt
Investment Earnings Or Losses$55,040InvestmentEarningsOrLossesAmt
Grants Or Scholarships$19,049GrantsOrScholarshipsAmt
Other Expenditures$317,893OtherExpendituresAmt
Administrative Expenses$36,426AdministrativeExpensesAmt
End Year Balance$6,872,466EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.06050BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.86740PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.07210TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$58,504,543OtherCostOrOtherBasisAmt
Book Value$58,504,543BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$301,539,227OtherCostOrOtherBasisAmt
Depreciation$148,404,993DepreciationAmt
Book Value$153,134,234BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$99,989,388OtherCostOrOtherBasisAmt
Depreciation$83,857,876DepreciationAmt
Book Value$16,131,512BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$199,972,260OtherCostOrOtherBasisAmt
Depreciation$158,199,636DepreciationAmt
Book Value$41,772,624BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$59,831,769OtherCostOrOtherBasisAmt
Depreciation$46,835,997DepreciationAmt
Book Value$12,995,772BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$282,538,685TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
INTERCOMPANY RECEIVABLE$6,044,849,227
DEFERRED PENSION OUTFLOW COSTS$19,551,692
OTHER RECEIVABLES$2,941,289
FieldValueIRS element (for citing)
Total Book Value Other Assets$6,067,342,208TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
INTERCOMPANY PAYABLES$5,677,120,601
ACCRUED INTEREST PAYABLE$419,771
OTHER DEFERRED EXPENSES$3,234,152
PENSION LIABILITIES$30,406,058
FieldValueIRS element (for citing)
Total Liability$5,711,180,582TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$727,136,679TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$13,273,007NetUnrealizedGainsInvstAmt
Other Revenue$3,040,745OtherRevenueAmt
Revenue Not Reported-$10,232,262RevenueNotReportedAmt
Revenue Subtotal$737,368,941RevenueSubtotalAmt
Investment Expenses Not Incld$2,415,580InvestmentExpensesNotIncldAmt
Other Revenues Not Included$33,293,370OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$35,708,950RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$773,077,891TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$560,271,061TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$3,040,745OtherExpensesIncludedAmt
Expenses Not Reported$3,040,745ExpensesNotReportedAmt
Expenses Subtotal$557,230,316ExpensesSubtotalAmt
Investment Expenses Not Incld2$2,415,580InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$32,043,297OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$34,458,877ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$591,689,193TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:ENDOWMENT FUNDS ARE USED FOR THE INTENDED PURPOSE TO FUND SCHOLARSHIPS, EDUCATION, PROGRAMS, AND COMMUNITY BENEFIT. TEMPORARILY RESTRICTED NET ASSETS ARE THOSE WHOSE USE BY THE FOUNDATION HAVE BEEN LIMITED BY THE DONOR TO A SPECIFIC TIME PERIOD OR PURPOSE. THESE NET ASSETS ARE AVAILABLE FOR VARIOUS HEALTH CARE PURPOSES AS DEFINED BY DONORS. THE ENDOWMENT FUND IS OWNED BY UCHEALTH NORTHERN COLORADO FOUNDATION.
PART XI, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSE INCLUDED IN EXPENSE ON AFS 2,924,683. COGS REPORTED AS EXPENSE ON AFS 116,062.
PART XI, LINE 4B - OTHER ADJUSTMENTS:PROVISION FOR BAD DEBT IN AFS INCOME 27,242,507. CONTRIBUTIONS FROM FOUNDATION NOT IN AFS INCOME 22,560. RENTAL EXP AS INCOME ON 990 1,411,370. PHARMACY SALES INCLUDED IN EXPENSE ON AFS 44,069. INTERCOMPANY EXPENSE ALLOCATIONS 3,322,791. BOOK VS. TAX ADJUSTMENT IN EQUITY EARNINGS 1,250,073.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSE INCLUDED IN EXPENSE ON AFS 2,924,683. COGS REPORTED AS EXPENSE ON AFS 116,062.
PART XII, LINE 4B - OTHER ADJUSTMENTS:PROVISION FOR BAD DEBT IN AFS INCOME 27,242,507. RENTAL EXP AS INCOME ON 990 1,411,370. PHARMACY SALES INCLUDED IN EXPENSE ON AFS 44,069. CASH CONTRIBUTIONS FROM FOUNDATION NOT IN AFS REVENUE 22,560. INTERCOMPANY EXPENSES ALLOCATION RECLASS 3,322,791.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
Most Hospitals PolicyYes (X)MostHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other250.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance Budget0FinancialAssistanceBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,875,792TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,875,792NetCommunityBenefitExpnsAmt
Total Expense0.00490TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$101,073,734TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$69,693,155DirectOffsettingRevenueAmt
Net Community Benefit Expns$31,380,579NetCommunityBenefitExpnsAmt
Total Expense0.05300TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,308,312TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,362,666DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,945,646NetCommunityBenefitExpnsAmt
Total Expense0.00330TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$111,257,838TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$75,055,821DirectOffsettingRevenueAmt
Net Community Benefit Expns$36,202,017NetCommunityBenefitExpnsAmt
Total Expense0.06120TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,888,265TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$207,372DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,680,893NetCommunityBenefitExpnsAmt
Total Expense0.00620TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,156,943TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$915,934DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,241,009NetCommunityBenefitExpnsAmt
Total Expense0.00890TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,137,042TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,771,524DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,365,518NetCommunityBenefitExpnsAmt
Total Expense0.00740TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,568TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$594DirectOffsettingRevenueAmt
Net Community Benefit Expns$14,974NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$43,795,611TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$43,795,611NetCommunityBenefitExpnsAmt
Total Expense0.07400TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$63,993,429TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,895,424DirectOffsettingRevenueAmt
Net Community Benefit Expns$57,098,005NetCommunityBenefitExpnsAmt
Total Expense0.09650TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$175,251,267TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$81,951,245DirectOffsettingRevenueAmt
Net Community Benefit Expns$93,300,022NetCommunityBenefitExpnsAmt
Total Expense0.15770TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,750TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,750NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$106,121TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$106,121NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$196TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$196NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$108,067TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$108,067NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$27,522,038BadDebtExpenseAmt
Reimbursed By Medicare$124,871,984ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$149,127,468CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$24,255,484MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (7 entries)

Primary ActivitiesPrimaryActivitiesTxtOrg Profit Or OwnershipOrgProfitOrOwnershipPctPhysicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 HARMONY SURGERY CENTER LLC
AMBULATORY SURG0.500000.50000
2 PEAK SURGICAL MANAGEMENT
MANAGEMENT SERVICES0.140000.86000
3 HARMONY IMAGING CENTER LLC
MEDICAL IMAGING0.460000.54000
4 SURGERY CENTER OF FORT COLLINS
AMBULATORY SURG0.260000.49000
5 GATEWAY MEDICAL SERVICES
REAL ESTATE/MEDICAL EQUIPMENT0.500000.50000
8 PVHS-ICM EHW LLC
MEDICAL CLINIC0.500000.50000
9 OCR OF LOVELAND LLC
AMBULATORY SURG0.100000.90000
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1POUDRE VALLEY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11024 S LEMAYAddressLine1Txt
CityFORT COLLINSCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80524ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Research FacilityYes (X)ResearchFacilityInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherPHARMACY, LAB, IMAGING, BIRTH CENTER, HEART AND VASCULAROtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1POUDRE VALLEY HEALTH CAREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTPS://WWW.UCHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTPS://WWW.UCHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care250.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://WWW.UCHEALTH.ORG/BILLING-AND-PRICING/FINANCIAL-ASSISTANCE/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://WWW.UCHEALTH.ORG/BILLING-AND-PRICING/FINANCIAL-ASSISTANCE/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://WWW.UCHEALTH.ORG/BILLING-AND-PRICING/FINANCIAL-ASSISTANCE/FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
POUDRE VALLEY HEALTH CAREPART V, SECTION B, LINE 5: PVH/MCR COLLABORATED WITH THE LARIMER AND WELD COUNTY HEALTH DEPARTMENTS DURING THEIR MOST RECENT COMMUNITY HEALTH IMPROVEMENT PLANNING PROCESSES. IN NOVEMBER 2017 AND JANUARY 2018, PVH/MCR PARTICIPATED IN COMMUNITY HEALTH SUMMITS DURING WHICH LOCAL HEALTH INDICATOR DATA WAS REVIEWED, AGENCY RESOURCES WERE DESCRIBED (INCLUDING A SPECIFIC PRESENTATION BY PVH/MCR) AND PRIORITY ISSUES FOR ACTION WERE IDENTIFIED. OVER 180 AGENCIES ATTENDED THESE EVENTS, MANY OF WHICH SERVE LOW-INCOME, VULNERABLE POPULATIONS. KELSEY LYON, HEALTH PLANNER AT THE LARIMER COUNTY HEALTH DEPARTMENT AND DR. MARK WALLACE FROM THE WELD COUNTY HEALTH DEPARTMENT WERE THE EVENT ORGANIZERS AND THE MAIN POINTS OF CONTACT FOR PVH/MCR.
POUDRE VALLEY HEALTH CAREPART V, SECTION B, LINE 6A: POUDRE VALLEY HOSPITAL (PVH) AND MEDICAL CENTER OF THE ROCKIES (MCR) PREPARED A JOINT CHNA AS BOTH HOSPITALS SERVE RESIDENTS FROM THE SAME GEOGRAPHIC LOCATIONS.
POUDRE VALLEY HEALTH CAREPART V, SECTION B, LINE 6B: IN 2019, THE CHNA PROCESS FOR MEDICAL CENTER OF THE ROCKIES (MCR) AND POUDRE VALLEY HOSPITAL (PVH) WAS PREPARED IN CONJUNCTION WITH LARIMER AND WELD COUNTY HEALTH DEPARTMENTS. COMMUNITY-WIDE SUMMITS WERE FACILITATED BY COUNTY HEALTH DEPARTMENT STAFF, WITH MCR AND PVH PROVIDING SUBSTANTIAL INPUT INTO THE PLANNING AND EXECUTION OF THE SUMMITS. THESE SUMMITS INCLUDED APPROXIMATELY 150 REPRESENTATIVES OF COMMUNITY ORGANIZATIONS IN EACH COUNTY WHO ACTIVELY PROVIDED INPUT.FOLLOWING THE COMMUNITY SUMMIT MEETINGS LEADERSHIP TEAMS WERE ESTABLISHED BY THE COUNTY HEALTH DEPARTMENTS, PVH AND MCR TO CONTINUE THE CHNA PROCESS. THIS SMALLER LEADERSHIP TEAM INCLUDED REPRESENTATION BY: CITY OF FORT COLLINS, CITY OF GREELEY, CITY OF LOVELAND, COLORADO SCHOOL OF PUBLIC HEALTH, EARLY CHILDHOOD COUNCIL OF LARIMER COUNTY, HEALTH DISTRICT OF NORTHERN LARIMER COUNTY, LARIMER COUNTY DEPARTMENT OF HEALTH AND ENVIRONMENT, NORTH COLORADO HEALTH ALLIANCE, POUDRE SCHOOL DISTRICT, THOMPSON SCHOOL DISTRICT, THE FAMILY CENTER/LA FAMILIA, LARIMER COUNTY OFFICE ON AGING, NORTH RANGE BEHAVIORAL HEALTH, SUMMITSTONE HEALTH PARTNERS, SUNRISE LOVELAND COMMUNITY HEALTH CENTER, UNITED WAY OF LARIMER AND WELD COUNTIES, WELD COUNTY AREA AGENCY ON AGING, WELD COUNTY DEPARTMENT OF PUBLIC HEALTH, WELD COUNTY SCHOOL DISTRICTS.
POUDRE VALLEY HEALTH CAREPART V, SECTION B, LINE 11: EXAMPLES OF HOW PVH/MCR IS ADDRESSING ISSUES RELATED TO ACCESS TO CARE FOR VULNERABLE INDIVIDUALS INCLUDES STAFFING A RN HOME VISIT PROGRAM FOR POSTPARTUM WOMEN WHO ARE ELIGIBLE FOR OR ENROLLED IN MEDICAID. NURSES ASSESS THE NEWBORN, PROVIDE THE MOTHER WITH LACTATION COUNSELING, SELF-CARE GUIDELINES AND ACHIEVE AN INCREASE IN THE MOTHER'S CONFIDENCE TO CARE FOR HER NEWBORN. ADDITIONALLY, COMPREHENSIVE CARE COORDINATION SERVICES ASSIST FAMILIES OF CHILDREN WITH SPECIAL HEALTH CARE NEEDS AS WELL AS VULNERABLE ADULTS WITH MEDICALLY COMPLEX, CHRONIC CONDITIONS. TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES, PVH/MCR IS EXPANDING THE USE OF TECHNOLOGY TO PROVIDE TELE-PSYCH SERVICES TO RESIDENTS WHO ARE NOT ABLE TO ACCESS A LOCAL MENTAL HEALTH PROVIDER OR TO BRIDGE GAPS IN PROVIDER AVAILABILITY. FOR PERSONS WITH SUBSTANCE USE DISORDERS, PVH/MCR DIRECTS RESOURCES TO PROVIDING MEDICALLY ASSISTED ADDICTION TREATMENT AS WELL AS PARTICIPATING IN THE COLORADO ALTERNATIVES TO OPIOIDS TREATMENT PROTOCOLS. INCREASED SCREENING AND REFERRAL TO TREATMENT FOR PERSONS USING ALCOHOL HAS ALSO BEEN IMPLEMENTED. THE FULL SPECTRUM OF SERVICES AND PROGRAMS ADDRESSING IDENTIFIED HEALTH ISSUES IS DESCRIBED IN THE 2020-22 IMPLEMENTATION STRATEGY REPORT POSTED TO THE UCHEALTH WEBSITE: HTTPS://WWW.UCHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
FieldValueIRS element (for citing)
Facility7FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - UCHEALTH HARMONY CAMPUS AMBULATORY CARE
2127 E HARMONY RDFORT COLLINSCO80528SURGERY CENTER, IMAGING
2 - CENTRE AVE HEALTH AND REHAB - JV
915 CENTRE AVEFORT COLLINSCO80526REHABILITATION
3 - SURGERY CENTER OF FT COLLINS - JV
1100 E PROSPECTFORT COLLINSCO80524SURGERY CENTER
4 - COLUMBINE POUDRE HOMECARE - JV
915 CENTRE AVEFORT COLLINSCO80526HOME HEALTHCARE
5 - THE VEIN AND LASER CENTER - JV
2008 CARIBOU DRFORT COLLINSCO80525SURGERY CENTER
6 - OCR LOVELAND
3470 E 15TH STREETLOVELANDCO80538SURGERY CENTER
7 - UCHEALTH WATER VALLEY
1870 MARINA PLAZA DRIVEWINDSORCO80550MEDICAL FITNESS, REHABILITATION

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:LINE 7A LINE 7A WAS DERIVED USING A COST-TO-CHARGE RATIO FROM THE COST REPORT.THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINE 7B AND 7C. THE COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE TO COST-TO-CHARGES.
PART I, LINE 7G:INCLUDES PHYSICIAN GROUPS AS A SUBSIDIZED SERVICE. THESE CLINICS PROVIDE SERVICES IN UNDERSERVED AREAS IN COLORADO, NEBRASKA AND WYOMING.
PART I, LN 7 COL(F):TOTAL BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR PRIOR TO THE PERCENTAGE CALCULATION = $27,522,038
PART III, LINE 2:ACCOUNTS WITH UNRESOLVED PATIENT LIABILITY AFTER REASONABLE COLLECTION EFFORTS, SET BY POLICY AND IN CONJUNCTION WITH FEDERAL, STATE, AND PAYOR SPECIFIC REGULATIONS, WILL BE ASSIGNED TO BAD DEBT. THESE ACCOUNTS SHALL BE REFERRED TO AN OUTSIDE COLLECTION AGENCY, OR IN SELECTED INSTANCES, ATTORNEYS, FOR ADDITIONAL COLLECTION ACTIVITIES.
PART III, LINE 4:PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF ALLOWANCES FOR DOUBTFUL ACCOUNTS, CONTRACTUAL ADJUSTMENTS, AND MEDICALLY INDIGENT ALLOWANCES.PART III, LINE 5: MEDICARE REVENUE WAS COMPUTED AS FOLLOWS:PVHC COST REPORT: $111,408,758CENTER AVE COST REPORT: $2,910,479COLUMBINE HOMECARE COST REPORT: $1,476,953PVHC DISALLOWED PROGRAMS: $3,676,286JOINT VENTURES: $5,399,508TOTAL TO LINE 5: $124,871,984PART III, LINE 6: ALLOWABLE COSTS AS REPORTED ON THE POUDRE VALLEY HEALTH CARE INC. FY20 COST REPORT AGGREGATED WITH DISREGARDED ENTITIES AND OWNERSHIP PORTIONS OF JOINT VENTURES. PART III, LINE 6: MEDICARE ALLOWABLE COSTS OF CARE RELATING TO PAYMENTS WAS COMPUTED AS FOLLOWS:PVHC COST REPORT: $131,802,624CENTRE AVE COST REPORT: $7,375,812COLUMBINE HOMECARE COST REPORT: $1,946,403PVHC DISALLOWED PROGRAMS: $2,138,689JOINT VENTURES: $5,863,940TOTAL TO LINE 6: $149,127,468
PART III, LINE 8:APPROXIMATELY 28.54% OF NET PATIENT SERVICE REVENUE IS FROM PARTICIPATION IN THE MEDICARE PROGRAM, THUS PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES TO A SIGNIFICANT PORTION OF THE COMMUNITY POPULATION.
PART III, LINE 9B:IF UCHEALTH DETERMINES THAT AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE FOLLOWING UCHEALTH'S REVIEW OF A COMPLETE APPLICATION, UCHEALTH WILL REVERSE ECAS (IF ANY) AND WILL REFUND AMOUNTS PREVIOUSLY PAID FOR CARE COVERED BY THIS POLICY IN EXCESS OF THE AMOUNT OWED, EXCEPT OVERPAYMENTS THAT ARE $5 OR LESS. IF THE GUARANTOR STILL OWES ANY AMOUNT, UCHEALTH WILL PROVIDE AN UPDATED BILLING STATEMENT SHOWING HOW THE ADJUSTED AMOUNT WAS DETERMINED.
PART VI, LINE 2:SEE NARATIVES FOR PART V, SECTION B, LINES 5 AND 6B.
PART VI, LINE 3:THERE ARE SEVERAL WAYS WE NOTIFY THE PATIENT AND ATTEMPT TO ASSIST THEM. FOR SURGERIES AND HIGH DOLLAR SCHEDULED PROCEDURES, WE PROVIDE THEM WITH AN ESTIMATE AT REGISTRATION AND GO OVER ALL FINANCIAL ASSISTANCE OPTIONS AVAILABLE IF THEY ARE INTERESTED. WE ALSO HAVE FINANCIAL COUNSELORS AVAILABLE EACH DAY THAT CAN ANSWER QUESTIONS AND HELP THEM FILL OUT CHARITY APPLICATIONS. ONCE A PERSON HAS RECEIVED CARE IN THE ED, WE ALSO HAVE EDUCATED STAFF THAT ASSISTS THEM AND EDUCATES THEM OF WHAT IS AVAILABLE FOR FINANCIAL ASSISTANCE. IN ADDITION, ONCE A PATIENT DOES RECEIVE A STATEMENT OR BILL, THERE IS INFORMATION ON THE BILL OF WHO THEY CAN CALL TO GET INFORMATION ON FINANCIAL ASSISTANCE. ADDITIONALLY, WE WIDELY PUBLICIZE OUR FINANCIAL ASSISTANCE POLICY AS REQUIRED BY LAW, INCLUDING A PLAIN LANGUAGE SUMMARY.
PART VI, LINE 4:POUDRE VALLEY HEALTH CARE INC. IS A LOCALLY OWNED, PRIVATE, NON-PROFIT ORGANIZATION WITH A STRONG VISION: FROM HEALTHCARE TO HEALTH. BASED IN NORTHERN COLORADO, PVH PROVIDES EVIDENCE-BASED HEALTHCARE AND WELLNESS SERVICES AND PRODUCTS IN COLORADO, NEBRASKA AND WYOMING, ACROSS A SERVICE AREA COVERING MORE THAN 50,000 SQUARE MILES. PVH IS A PART OF THE UCHEALTH WHICH AIMS TO DELIVER THE HIGHEST QUALITY PATIENT CARE WITH THE HIGHEST QUALITY PATIENT EXPERIENCE. THE PARTNERSHIP COMBINES POUDRE VALLEY HOSPITAL, MEDICAL CENTER OF THE ROCKIES, UCHEALTH GREELEY HOSPITAL, UCHEALTH MEDICAL GROUP, UNIVERSITY OF COLORADO HOSPITAL AND MEMORIAL HEALTH SYSTEM INTO AN ORGANIZATION DEDICATED TO BUILDING HEALTHIER COMMUNITIES AND PROVIDING UNMATCHED PATIENT CARE IN THE ROCKY MOUNTAIN WEST. THE ORGANIZATION'S MISSION IS 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
PART VI, LINE 5:WE HAVE IMPLEMENTED A MULTITUDE OF PROGRAMS AND SERVICES THAT ADDRESS THE HEALTH NEEDS OF OUR BROADER COMMUNITY TARGETING ALL AGE GROUPS WHILE MAINTAINING A SPECIAL FOCUS ON SERVING VULNERABLE POPULATIONS. WE ALSO GIVE DOLLARS TO OTHER ENTITIES THAT WORK TO IMPROVE THE HEALTH OF OUR COMMUNITY. EXAMPLES ARE: TEEN PREGNANCY PREVENTION EDUCATION; SUBSTANCE ABUSE PREVENTION EDUCATION FOR YOUTH AND YOUNG ADULTS; OBESITY PREVENTION; IMPROVED FOOD SECURITY FOR LOW INCOME RESIDENTS; AND MENTAL HEALTH SERVICES FOR THE UNDERSERVED.
PART VI, LINE 6:ALL THE SERVICES WE OFFER ARE AVAILABLE TO ANYONE THAT USES ANY OF OUR FACILITIES IN THE HEALTH SYSTEM. OUR GEOGRAPHY IS NOT THAT LARGE SO WE ARE ABLE TO ACCOMMODATE THE DIFFERENT COMMUNITIES THAT UTILIZE OUR SERVICES WITH THE SAME LEVEL OF COMMUNITY HEALTH PROGRAMMING.
PART VI, LINE 7, REPORTS FILED WITH STATESCO

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
UCHEALTH MEDICAL GROUP
2315 E HARMONY RD 200FT COLLINSCO80528800348943501(C)(3)$38,391,256SEE SCH I, PART IV
UNIVERSITY SCHOOL OF MEDICINE
13001 17TH PLACEAURORACO80045846000555501(C)(3)$3,126,274SEE SCH I, PART IV
UCHEALTH NORTHERN COLORADO FOUNDATION
2315 E HARMONY RD 200FT COLLINSCO80528741894581501(C)(3)$1,193,668SEE SCH I, PART IV
CHEYENNE REGIONAL MEDICAL CENTER FDN
214 E 23RD STCHEYENNEWY82001830236858501(C)(3)$10,000SEE SCH I, PART IV
COLORADO STATE UNIVERSITY
6003 CAMPUS DELIVERYFT COLLINSCO80523846005450GOVERNMENT$893,458SEE SCH I, PART IV
FRONT RANGE COMMUNITY COLLEGE FOUNDATION
3645 W 112TH AVENUEWESTMINSTERCO80031383721881GOVERNMENT$50,000SEE SCH I, PART IV
UNITED WAY OF LARIMER COUNTY
424 PINE ST 102FT COLLINSCO80524846031503501(C)(3)$29,282SEE SCH I, PART IV
AMERICAN HEART ASSOCIATION
7272 GREENVILLE AVENUEDALLASTX75231135613797501(C)(3)$8,442SEE SCH I, PART IV
FOOD BANK OF LARIMER COUNTY
1301 BLUE SPRUCE DRIVEFORT COLLINSCO80524742336171501(C)(3)$25,000SEE SCH I, PART IV
SUMMITSTONE HEALTH PARTNERS
4856 INNOVATION DRIVE BFORT COLLINSCO80525841512383501(C)(3)$5,625SEE SCH I, PART IV
UNITED WAY OF WELD COUNTY
PO BOX 1944GREELEYCO80632846011918501(C)(3)$12,500SEE SCH I, PART IV
FieldValueIRS element (for citing)
Total501c3 Org11Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE 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. QUESTION I, PART II, COLUMN H PURPOSE OF GRANT OR ASSISTANCE FOR RELATED ENTITIES, THE GRANTS ARE RELATED TO SPECIFIC REQUESTS. THE FUNDS ARE TO BE USED TO BENEFIT THE HEALTHCARE COMMUNITY OF NORTHERN COLORADO. EACH REQUEST IS EVALUATED ON AN INDIVIDUAL BASIS. FOR NON-RELATED COMMUNITY AND GOVERNMENTAL ORGANIZATIONS, THE GRANTS ARE MADE AT THE DISCRETION OF THE ORGANIZATION. THESE DISCRETIONARY GRANTS ARE TO BE USED TO BENEFIT THE HEALTHCARE COMMUNITY OF NORTHERN COLORADO.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KEVIN UNGER
CEO$234,196$308,578$196,240$258,568$8,338$10,986$39,015$51,406$8,960$11,806$486,749$641,344$0$0
DAVID THOMPSON
CFO/TREASURER$54,943$72,394$8,366$11,023$5,225$6,884$5,751$7,578$3,196$4,212$77,481$102,091$0$0
ASHLEY BRUNING
SENIOR CLINICAL DIRECTOR$101,485$73,293$12,195$8,808$135$98$10,427$7,531$14,473$10,452$138,715$100,182$0$0
ROBERT WAGNER
MEDICAL DIRECTOR$82,053$107,334$10,006$13,089$76$99$8,440$11,041$8,348$10,920$108,923$142,483$0$0
RODNEY GOOD
CLINICAL DIRECTOR$113,364$81,873$13,779$9,951$238$172$10,972$7,924$14,552$10,510$152,905$110,430$0$0
JULIE NUNLEY
CHIEF NURSING OFFICER$220,559$0$64,534$0$2,035$0$25,424$0$10,808$0$323,360$0$0$0
RYAN ROHMAN
CHIEF OPERATING OFFICER$152,580$110,195$43,135$31,152$330$239$17,069$12,327$2,075$1,498$215,189$155,411$0$0
GRACE KOWALSHYN-TAYLOR
VP OPERATIONS$149,002$107,610$43,682$31,547$335$242$17,244$12,454$15,864$11,458$226,127$163,311$0$0
DIANA BREYER
CHIEF QUALITY OFFICER$119,623$402,598$0$0$1,153$832$12,795$12,629$4,599$11,389$138,170$427,448$0$0
THOMAS DOWNES
CHIEF MEDICAL OFFICER$249,236$180,001$71,815$51,866$3,541$2,557$24,922$17,999$6,948$5,019$356,462$257,442$0$0
JILLIAN BUSCH
PSYCHIATRIST$273,025$0$7,139$0$254$0$25,424$0$21,615$0$327,457$0$0$0
HERMANN MORENO
PSYCHIATRIST$288,667$0$7,839$0$617$0$25,424$0$25,398$0$347,945$0$0$0
DAVID SEHR
MEDICAL DIRECTOR$291,795$0$23,869$0$436$0$25,424$0$25,438$0$366,962$0$0$0
JANELL WOZNIAK
PROGRAM DIRECTOR$288,806$0$33,747$0$431$0$25,424$0$19,910$0$368,318$0$0$0
KENNETH WTANABE
MEDICAL DIRECTOR$309,138$0$36,672$0$716$0$25,424$0$25,551$0$397,501$0$0$0
STEPHANIE DOUGHTY
FORMER CFO, LEFT MARCH 2019$43,721$57,607$0$0$197,390$260,083$9,564$12,601$1,386$1,825$252,061$332,116$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AGROSS-UP PAYMENTS: GROSS UP PAYROLL IS CALCULATED AT YEAR END FOR SPECIAL CHECKS CREATED TO ADD SPECIFIC ITEMS TO EMPLOYEE'S FORM W-2 WAGES INCLUDING COUNTRY CLUB DUES, SPOUSE TRAVEL FOR ANNUAL BOARD RETREAT AND SELECT CONFERENCES, AND IMPUTED INCOME ON LIFE INSURANCE POLICIES. CLUB DUES: THE HEALTH SYSTEM EXPECTS THE HOSPITAL MANAGEMENT TO PARTICIPATE IN COMMUNITY LIFE AND THEREFORE THE SYSTEM PAYS SOCIAL CLUB DUES FOR SPECIFIC MEMBERS OF THE SENIOR MANAGEMENT GROUP. THE CLUB DUES ARE ADDED TO THE SENIOR MANAGEMENT'S FORM W-2 ON AN ANNUAL BASIS.
PART I, LINE 4AFORMER CFO STEPHANIE DOUGHTY RECEIVED SEVERANCE OF $163,738 FROM THE ORGANIZATION AND $215,742 FROM RELATED ORGANIZATIONS.
PART I, LINE 7THE ORGANIZATION OFFERS 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 THE ORGANIZATION'S OVERALL STRATEGIC DIRECTION RESULT IN VARIABLE PAYMENTS ALIGNED WITH THE ORGANIZATION'S TOTAL COMPENSATION STRATEGY. THIS PROGRAM REWARDS EMPLOYEES BASED ON ORGANIZATIONAL PERFORMANCE MEASURES AND INDIVIDUAL EMPLOYEE GOAL PERFORMANCE. ALL PAYOUTS ARE CONTINGENT BASED ON THE UCHEALTH BOARD OF DIRECTORS APPROVAL EACH FISCAL YEAR.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2018 SERIES A
A841179794914183BH02018-07-26$45,915,000REFUNDING 2005A BONDS000
UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2018 SERIES B
B841179794914183BJ62018-07-26$24,374,400REFUNDING 2005B BONDS000
UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2017 SERIES A
C841179794914183BB32017-02-16$43,493,450REFUNDING 2015A BONDS000
UNIVERISTY OF COLORADO HOSPITAL AUTHORITY 2017 SERIES B1B2
D841179794914183BC12017-02-16$37,955,000REFUNDING 2015BC BONDS000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$45,915,000$318,692$45,596,3082018Yes (1)0Yes (1)Yes (1)
B$24,374,400$169,360$24,205,0402018Yes (1)0Yes (1)Yes (1)
C$43,493,450$213,070$43,280,3802017Yes (1)0Yes (1)Yes (1)
D$37,955,000$546,939$37,408,0612017Yes (1)0Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0Yes (1)0000Yes (1)
B0Yes (1)0000Yes (1)
C0Yes (1)0000Yes (1)
D0Yes (1)0000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
CITI
A0Yes (1)00Yes (1)Yes (1)21.5000000000000000Yes (1)
CITI
B0Yes (1)00Yes (1)Yes (1)21.5000000000000000Yes (1)
CITI
C0Yes (1)000Yes (1)10.0000000000000000Yes (1)
(no name)
D0Yes (1)00Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)
DYes (1)

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
UNIVERISTY OF COLORADO HOSPITAL AUTHORITY 2017 SERIES C2
A841179794914183AZ12017-02-16$6,393,411NEW CONSTRUCTION ON PVH000
UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2019 SERIES C
B841179794914183BP22019-10-30$6,392,239REFUNDING 2017C1 BONDS000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndOther Spent ProceedsOtherSpentProceedsAmt
A$6,393,411$25,352$6,368,059201700Yes (1)Yes (1)
B$6,392,239$42,9012019Yes (1)0Yes (1)Yes (1)$6,349,338

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0Yes (1)0000Yes (1)
B0Yes (1)0000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A0Yes (1)000000Yes (1)
B0Yes (1)0000000

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescMEDICAL EQUIPMENTDesc
Contribution31ContributionCnt
Noncash Contributions Rpt F990$666,020NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 6POUDRE VALLEY HOSPITAL (PVH) HAD 463 ACTIVE VOLUNTEERS IN FISCAL YEAR 2020. AT PVH, IN A NORMAL YEAR, VOLUNTEERS PLAY AN INTEGRAL ROLE IN PROVIDING MUCH NEEDED SUPPORT FOR PATIENTS, VISITORS, PHYSICIANS, AND STAFF. FROM ASSISTING IN SURGERY AND CARDIAC WAITING ROOMS, INFORMATION DESK, GIFT SHOP, VOLUNTEER PATIENT LIAISONS, BABY KNITTERS, VOLUNTEENS, AND PET THERAPY TO NAME JUST A FEW OF THE MANY PROGRAMS, EVERY VOLUNTEER CONTRIBUTES TO THE SUCCESS OF THE UCHEALTH NORTH TO ENHANCE THE COMFORT AND CARE OF THE PATIENTS AND THEIR FAMILIES. DURING THE COVID-19 PANDEMIC THE VOLUNTEER PROGRAM HAS BEEN FORCED TO TEMPORAILY PAUSE. THE ORGANIZATION HAS THE INTENT TO RESTART THE VOLUNTEER PROGRAM AT THE CONCLUSION OF THE PANDMIC.
FORM 990, PART VI, SECTION A, LINE 4PVHC'S BYLAWS WERE CHANGED TO REMOVE THE YVMC BOARD MEMBER SLOT. PREVIOUSLY YAMPA VALLEY MEDICAL CENTER WAS ABLE TO APPOINT ONE BOARD MEMBER TO THE PVHC BOARD. YVMC DECIDED THEY NO LONGER NEEDED THAT REPRESENTATION/CONNECTION, SO THE BYLAWS WERE AMENDED TO REMOVE THAT APPOINTED BOARD POSITION FROM THE PVHC BOARD.
FORM 990, PART VI, SECTION B, LINE 11BTHE 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 12CTHE 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 15UCHEALTH CONTRACTS WITH SULLIVAN COTTER FOR EXECUTIVE COMPENSATION CONSULTING SERVICES. ON OUR BEHALF, THE SULLIVAN COTTER COLLECTS AND REVIEWS COMPENSATION LEVELS FROM LIKE ORGANIZATIONS 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 DETERMINE THE SALARY OF THE ENTITY CEO'S COMPENSATION ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING 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 XI, LINE 9:MCR DISTRIBUTIONS TO PVH 78,491,746. BOOK VS. TAX ADJUSTMENT IN EQUITY EARNINGS -1,250,073.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
TIMBERLINE MEDICAL CLINIC
131 STANLEY AVEESTES PARKCO80517043772090OUTPATIENTCO$0-$16,785PVHC INC
LAKOTA LAKE LLC
2315 E HARMONY RD STE 200FORT COLLINSCO80528841447761OUTPATIENTCO$3,383,639$49,181,732PVHC INC
HERON LAKE LLC
2315 E HARMONY RD STE 200FORT COLLINSCO80528264189163OUTPATIENTCO$0$657,338PVHC INC

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
MEDICAL CENTER OF THE ROCKIES
2315 E HARMONY RD STE 200FORT COLLINSCO80528043730045TERTIARY CARECO501(C)(3)LINE 3PVHC INCYes (1)
UCHEALTH NORTHERN COLORADO FOUNDATION
2315 E HARMONY RD STE 200FORT COLLINSCO80528741894581BENEFIT HEALTHCO501(C)(3)LINE 7PVHC INCYes (1)
POUDRE VALLEY MEDICAL GROUP
2315 E HARMONY RD STE 200FORT COLLINSCO80528800348943MEDICAL SERVICESCO501(C)(3)LINE 10PVH INCYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdPredominant Income TypePredominantIncomeTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndOwnershipOwnershipPct
HARMONY SURGERY CENTER
2127 E HARMONY RD 200FT COLLINSCO80528841479751AMBULATORY SURGERYCON/ARELATED$2,560,463$3,449,140000.50000
CENTRE AVENUE HEALTH & REHAB FACILITY
947 WORTHINGTON CIRCLEFT COLLINSCO80526841560494NURSING FACILITYCON/ARELATED-$926,980$826,223000.50000
COLUMBINE POUDRE HOME CARE
947 WORTHINGTON CIRCLEFT COLLINSCO80526841529817NURSING CARECON/ARELATED$252,999$692,555000.50000
GATEWAY MEDICAL SERVICES
2500 E PROSPECT RDFT COLLINSCO80525841427970REAL EST/MEDCON/AUNRELATED$6,527,561$10,009,775000.50000
PVHS HOME MEDICAL SUPPLY
6820 N COUNTY RD 13LOVELANDCO80538202034599MEDICAL SUPPLYCON/AUNRELATED$118,030$414,0330Yes (1)0.50000
THE VEIN AND LASER CENTER OF NO COLORADO
2008 CARIBOU DRIVEFT COLLINSCO80525204943970MEDICAL SERVICESCON/AUNRELATED-$26,68500
HARMONY IMAGING CENTER
1951 WILMINGTON DRIVEFT COLLINSCO80528582479187MEDICAL IMAGINGCON/ARELATED$466,029$2,232,325000.46000
SURGERY CENTER OF FORT COLLINS
1100 E PROSPECT ROADFT COLLINSCO80525841541559SURGICAL PROCCON/AUNRELATED$103,858$937,747000.26000
OCR LOVELAND
2500 E PROSPECT RDFT COLLINSCO80525301069701AMBULATORY SURGCON/AUNRELATED-$605,486$2,862,292000.10000
PVHS-ICM EHW
2315 E HARMONY RD STE 200FT COLLINSCO80528463311308MEDICAL SERVICESCON/ARELATED$74,900$509,755000.50000
PEAK SURGICAL MANAGEMENT
2127 E HARMONY RD 200FT COLLINSCO80528260899618SURGICAL MGMTCON/AUNRELATED$155,106$40,629000.14290

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1INNOVATION ENTERPRISESBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12315 E HARMONY RD STE 200AddressLine1Txt
CityFORT COLLINSCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80528ZIPCd
FieldValueIRS element (for citing)
EIN202036774EIN
Primary ActivitiesIT CONSULTINGPrimaryActivitiesTxt
Legal Domicile StateCOLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PVHCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of Total Income$38,425ShareOfTotalIncomeAmt
Share Of EOY Assets$1,643,842ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (18 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
HARMONY SURGERY CENTER
A$1,041,681TRANSACTION TOTAL
HARMONY SURGERY CENTER
Q$659,851TRANSACTION TOTAL
HARMONY SURGERY CENTER
S$1,875,000TRANSACTION TOTAL
CENTRE AVE HEALTH & REHAB LLC
B$575,000TRANSACTION TOTAL
COLUMBINE POUDRE HOMECARE
S$200,000TRANSACTION TOTAL
GATEWAY MEDICAL SERVICES
S$3,231,729TRANSACTION TOTAL
PVHS HOME MEDICAL SUPPLY LLC
S$736,067TRANSACTION TOTAL
MEDICAL CENTER OF THE ROCKIES
L$10,759,902TRANSACTION TOTAL
MEDICAL CENTER OF THE ROCKIES
N$2,642,530TRANSACTION TOTAL
MEDICAL CENTER OF THE ROCKIES
S$78,491,746TRANSACTION TOTAL
UCHEALTH NORTHERN COLORADO FOUNDATION
B$1,193,668TRANSACTION TOTAL
UCHEALTH NORTHERN COLORADO FOUNDATION
C$688,580TRANSACTION TOTAL
INNOVATION ENTERPRISES
A$360,315TRANSACTION TOTAL
POUDRE VALLEY MEDICAL GROUP
B$38,391,256TRANSACTION TOTAL
POUDRE VALLEY MEDICAL GROUP
J$2,159,531TRANSACTION TOTAL
POUDRE VALLEY MEDICAL GROUP
L$9,439,052TRANSACTION TOTAL
POUDRE VALLEY MEDICAL GROUP
M$5,636,240TRANSACTION TOTAL
POUDRE VALLEY MEDICAL GROUP
N$2,130,840TRANSACTION TOTAL