2021-05-14T16:53:22-05:00 2020-06-30 381357951 PLANTE & MORAN PLLC 8181 E TUFTS AVE SUITE 600 DENVER CO 80237 990 2019-07-01 841262971 POUDRE VALLEY HEALTH CARE INC POUD 9702377000 2315 E HARMONY ROAD NO 200 FORT COLLINS CO 80528 DAVID THOMPSON CHIEF FINANCIAL OFFICER 9702377000 2021-05-13 1 DORI J EGGETT P00645252 3037409400 2021-05-13 2019 2022-09-23 18:48:47Z KEVIN UNGER 2315 E HARMONY RD 200 FT COLLINS CO 80528 2243704203 0 X WWW.UCHEALTH.ORG X 1994 CO WE IMPROVE LIVES THROUGH LEARNING, HEALING, DISCOVERY, AND THROUGH HUMAN CONNECTION. 11 10 4408 463 5396341 4450589 2525135 16035676 708240921 666720548 62737119 79358572 13290404 10963095 786793579 773077891 39643462 43827300 0 0 245900138 254274947 0 0 0 285144951 293586946 570688551 591689193 216105028 181388698 6985306171 8208338177 5067119966 6044794608 1918186205 2163543569 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 536471917 43827300 665077506 POUDRE 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. 536471917 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 292 0 1 4408 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X DAVID THOMPSON 9702377000 2315 E HARMONY ROAD SUITE 200 FORT COLLINS CO 80528 MIKE DELLENBACH DIRECTOR 1.00 2.00 X 0 0 0 STEPHANIE LOCKWOOD DIRECTOR 1.00 2.00 X 0 0 0 CHRIS OSBORN DIRECTOR 1.00 2.00 X 0 0 0 JIM PARKE DIRECTOR 1.00 2.00 X 0 0 0 DENNIS HOUSKA BOARD CHAIR 1.00 2.00 X X 96 0 0 DAN STROH DIRECTOR 1.00 2.00 X 108 0 0 FARAZ NAQVI DIRECTOR 1.00 2.00 X 331 0 0 DOUG ERION DIRECTOR 1.00 2.00 X 339 0 0 LISA CLAY VICE CHAIR 1.00 2.00 X X 360 0 0 CHRISTINE CHIN DIRECTOR 1.00 2.00 X 910 0 0 KEVIN UNGER CEO 19.00 25.00 X X 438774 578132 111187 DAVID THOMPSON CFO/TREASURER 17.00 22.00 X 68534 90301 20737 MICHELLE ALBRIGHT SECRETARY 40.00 X 6468 0 1862 ASHLEY BRUNING SENIOR CLINICAL DIRECTOR 29.00 21.00 X 113815 82199 42883 ROBERT WAGNER MEDICAL DIRECTOR 22.00 29.00 X 92135 120522 38749 RODNEY GOOD CLINICAL DIRECTOR 29.00 21.00 X 127381 91996 43958 JULIE NUNLEY CHIEF NURSING OFFICER 50.00 X 287128 0 36232 RYAN ROHMAN CHIEF OPERATING OFFICER 29.00 21.00 X 196045 141586 32969 GRACE KOWALSHYN-TAYLOR VP OPERATIONS 29.00 21.00 X 193019 139399 57020 DIANA BREYER CHIEF QUALITY OFFICER 11.00 39.00 X 120776 403430 41412 THOMAS DOWNES CHIEF MEDICAL OFFICER 27.00 19.00 X 324592 234424 54888 JILLIAN BUSCH PSYCHIATRIST 50.00 X 280418 0 47039 HERMANN MORENO PSYCHIATRIST 50.00 X 297123 0 50822 DAVID SEHR MEDICAL DIRECTOR 50.00 X 316100 0 50862 JANELL WOZNIAK PROGRAM DIRECTOR 50.00 X 322984 0 45334 KENNETH WTANABE MEDICAL DIRECTOR 50.00 X 346526 0 50975 STEPHANIE DOUGHTY FORMER CFO, LEFT MARCH 2019 22.00 15.00 X 241111 317690 25376 3775073 2199679 752305 243 1 1 0 ALLIED BARTON SECURITY PO BOX 31001-2374 PASADENA CA 91110 SECURITY 3285784 NORTHERN COLORADO HOSPITALISTS 2121 E HARMONY RD STE 300 FORT COLLINS CO 80528 MEDICAL 2462358 ORTHOPAEDIC & SPINE CENTER OF THE ROCKIE 2500 E PROSPECT RD FORT COLLINS CO 80525 MEDICAL 2133290 FORT COLLINS WOMEN'S CLINIC 1107 S LEMAY AVE STE 300 FORT COLLINS CO 80524 MEDICAL 1974500 SUMMIT PATHOLOGY 5802 WRIGHT DR LOVELAND CO 80538 MEDICAL 1930815 52 688580 14532477 814619 666020 16035676 NET PATIENT SVC REV 900099 623874640 623874640 PROVIDER FEE INCOME 621400 36312765 36312765 RENT INCOME - AFFILIAT 900099 2471789 2471789 DIETARY SVC INCOME 900099 2117531 2117531 JOINT VENTURE 621400 1918200 2436758 -518558 25623 -18446 44069 666720548 35897052 35897052 9579173 7405 2917278 7405 6661895 0 6661895 5870830 791065 1510943041 104046 1467498982 86585 43444059 17461 43461520 43461520 289031 116062 172969 172969 LAB SERVICES 624100 2429865 2429865 MISCELLANEOUS REVENUE 621400 1655866 1655866 EHR REVENUE 624100 42500 42500 4128231 773077891 669205737 5396341 82440137 43827300 43827300 4284326 2670256 1614070 192478388 164611731 27866657 18785337 15879916 2905421 36218666 30616932 5601734 2508230 2120296 387934 339640 339640 70440 70440 32012 32012 2415580 2415580 28861135 22885306 5975829 2432652 2379484 53168 4561925 4154939 406986 9638803 8770144 868659 2154022 988227 1165795 934998 714762 220236 315859 185527 130332 4652832 4652832 23797676 20975033 2822643 1000881 932560 68321 MEDICAL SUPPLIES 132304730 131949715 355015 PROVIDER FEE EXPENSE 32166608 32166608 BAD DEBT 27242507 27242507 UBIT TAXES 892925 892925 19771721 18747842 1023879 591689193 536471917 55217276 0 74136456 325230320 2188059 2322230 74134294 67322566 38940 38807 10670379 10605724 8976517 9279967 719837187 437298502 283533370 282538685 1365355373 1416743053 26820617 26914617 5139452166 6067342208 6985306171 8208338177 101121830 155316490 1653143 1638362 171510928 164523500 14836844 12088598 59989 47076 4777937232 5711180582 5067119966 6044794608 X 1918186205 2163543569 1918186205 2163543569 6985306171 8208338177 X 181388698 -13273007 77241673 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 32012 0 0 32012 0 PART II-B, LINE 1: PORTION OF DUES FROM MEMBERSHIP IN CHA AND AHA THAT ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. 7552046 76521 186928 28707 55954 34791 7696043 7528946 61289 260065 33759 234908 29587 7552046 7098243 34394 536004 4257 100183 35255 7528946 6872466 76668 163048 -6188 -12899 33026 7098243 7151577 39217 55040 19049 317893 36426 6872466 0.06050 0.86740 0.07210 1 1 1 58504543 58504543 301539227 148404993 153134234 99989388 83857876 16131512 199972260 158199636 41772624 59831769 46835997 12995772 282538685 INTERCOMPANY RECEIVABLE 6044849227 DEFERRED PENSION OUTFLOW COSTS 19551692 OTHER RECEIVABLES 2941289 6067342208 INTERCOMPANY PAYABLES 5677120601 ACCRUED INTEREST PAYABLE 419771 OTHER DEFERRED EXPENSES 3234152 PENSION LIABILITIES 30406058 5711180582 727136679 -13273007 3040745 -10232262 737368941 2415580 33293370 35708950 773077891 560271061 3040745 3040745 557230316 2415580 32043297 34458877 591689193 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. 1 1 X 1 X 250.000000000000 1 X 1 0 1 1 2875792 2875792 0.00490 101073734 69693155 31380579 0.05300 7308312 5362666 1945646 0.00330 111257838 75055821 36202017 0.06120 3888265 207372 3680893 0.00620 6156943 915934 5241009 0.00890 10137042 5771524 4365518 0.00740 15568 594 14974 0.00000 43795611 43795611 0.07400 63993429 6895424 57098005 0.09650 175251267 81951245 93300022 0.15770 1750 1750 0.00000 106121 106121 0.00020 196 196 0.00000 108067 108067 0.00020 1 27522038 124871984 149127468 -24255484 X 1 1 1 HARMONY SURGERY CENTER LLC AMBULATORY SURG 0.50000 0.50000 2 PEAK SURGICAL MANAGEMENT MANAGEMENT SERVICES 0.14000 0.86000 3 HARMONY IMAGING CENTER LLC MEDICAL IMAGING 0.46000 0.54000 4 SURGERY CENTER OF FORT COLLINS AMBULATORY SURG 0.26000 0.49000 5 GATEWAY MEDICAL SERVICES REAL ESTATE/MEDICAL EQUIPMENT 0.50000 0.50000 8 PVHS-ICM EHW LLC MEDICAL CLINIC 0.50000 0.50000 9 OCR OF LOVELAND LLC AMBULATORY SURG 0.10000 0.90000 1 1 POUDRE VALLEY HOSPITAL 1024 S LEMAY FORT COLLINS CO 80524 X X X X X PHARMACY, LAB, IMAGING, BIRTH CENTER, HEART AND VASCULAR POUDRE VALLEY HEALTH CARE 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X HTTPS://WWW.UCHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X 1 18 1 HTTPS://WWW.UCHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 1 X 250.000000000000 400.000000000000 X X X 1 1 X X X 1 X HTTPS://WWW.UCHEALTH.ORG/BILLING-AND-PRICING/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.UCHEALTH.ORG/BILLING-AND-PRICING/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.UCHEALTH.ORG/BILLING-AND-PRICING/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X 1 X 0 0 POUDRE VALLEY HEALTH CARE PART 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 CARE PART 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 CARE PART 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 CARE PART 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/ 7 1 - UCHEALTH HARMONY CAMPUS AMBULATORY CARE 2127 E HARMONY RD FORT COLLINS CO 80528 SURGERY CENTER, IMAGING 2 - CENTRE AVE HEALTH AND REHAB - JV 915 CENTRE AVE FORT COLLINS CO 80526 REHABILITATION 3 - SURGERY CENTER OF FT COLLINS - JV 1100 E PROSPECT FORT COLLINS CO 80524 SURGERY CENTER 4 - COLUMBINE POUDRE HOMECARE - JV 915 CENTRE AVE FORT COLLINS CO 80526 HOME HEALTHCARE 5 - THE VEIN AND LASER CENTER - JV 2008 CARIBOU DR FORT COLLINS CO 80525 SURGERY CENTER 6 - OCR LOVELAND 3470 E 15TH STREET LOVELAND CO 80538 SURGERY CENTER 7 - UCHEALTH WATER VALLEY 1870 MARINA PLAZA DRIVE WINDSOR CO 80550 MEDICAL FITNESS, REHABILITATION 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 STATES CO 1 UCHEALTH MEDICAL GROUP 2315 E HARMONY RD 200 FT COLLINS CO 80528 800348943 501(C)(3) 38391256 SEE SCH I, PART IV UNIVERSITY SCHOOL OF MEDICINE 13001 17TH PLACE AURORA CO 80045 846000555 501(C)(3) 3126274 SEE SCH I, PART IV UCHEALTH NORTHERN COLORADO FOUNDATION 2315 E HARMONY RD 200 FT COLLINS CO 80528 741894581 501(C)(3) 1193668 SEE SCH I, PART IV CHEYENNE REGIONAL MEDICAL CENTER FDN 214 E 23RD ST CHEYENNE WY 82001 830236858 501(C)(3) 10000 SEE SCH I, PART IV COLORADO STATE UNIVERSITY 6003 CAMPUS DELIVERY FT COLLINS CO 80523 846005450 GOVERNMENT 893458 SEE SCH I, PART IV FRONT RANGE COMMUNITY COLLEGE FOUNDATION 3645 W 112TH AVENUE WESTMINSTER CO 80031 383721881 GOVERNMENT 50000 SEE SCH I, PART IV UNITED WAY OF LARIMER COUNTY 424 PINE ST 102 FT COLLINS CO 80524 846031503 501(C)(3) 29282 SEE SCH I, PART IV AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVENUE DALLAS TX 75231 135613797 501(C)(3) 8442 SEE SCH I, PART IV FOOD BANK OF LARIMER COUNTY 1301 BLUE SPRUCE DRIVE FORT COLLINS CO 80524 742336171 501(C)(3) 25000 SEE SCH I, PART IV SUMMITSTONE HEALTH PARTNERS 4856 INNOVATION DRIVE B FORT COLLINS CO 80525 841512383 501(C)(3) 5625 SEE SCH I, PART IV UNITED WAY OF WELD COUNTY PO BOX 1944 GREELEY CO 80632 846011918 501(C)(3) 12500 SEE SCH I, PART IV 11 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. 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. X X 1 1 X X X X 1 0 0 0 0 0 0 1 0 KEVIN UNGER CEO 234196 308578 196240 258568 8338 10986 39015 51406 8960 11806 486749 641344 0 0 DAVID THOMPSON CFO/TREASURER 54943 72394 8366 11023 5225 6884 5751 7578 3196 4212 77481 102091 0 0 ASHLEY BRUNING SENIOR CLINICAL DIRECTOR 101485 73293 12195 8808 135 98 10427 7531 14473 10452 138715 100182 0 0 ROBERT WAGNER MEDICAL DIRECTOR 82053 107334 10006 13089 76 99 8440 11041 8348 10920 108923 142483 0 0 RODNEY GOOD CLINICAL DIRECTOR 113364 81873 13779 9951 238 172 10972 7924 14552 10510 152905 110430 0 0 JULIE NUNLEY CHIEF NURSING OFFICER 220559 0 64534 0 2035 0 25424 0 10808 0 323360 0 0 0 RYAN ROHMAN CHIEF OPERATING OFFICER 152580 110195 43135 31152 330 239 17069 12327 2075 1498 215189 155411 0 0 GRACE KOWALSHYN-TAYLOR VP OPERATIONS 149002 107610 43682 31547 335 242 17244 12454 15864 11458 226127 163311 0 0 DIANA BREYER CHIEF QUALITY OFFICER 119623 402598 0 0 1153 832 12795 12629 4599 11389 138170 427448 0 0 THOMAS DOWNES CHIEF MEDICAL OFFICER 249236 180001 71815 51866 3541 2557 24922 17999 6948 5019 356462 257442 0 0 JILLIAN BUSCH PSYCHIATRIST 273025 0 7139 0 254 0 25424 0 21615 0 327457 0 0 0 HERMANN MORENO PSYCHIATRIST 288667 0 7839 0 617 0 25424 0 25398 0 347945 0 0 0 DAVID SEHR MEDICAL DIRECTOR 291795 0 23869 0 436 0 25424 0 25438 0 366962 0 0 0 JANELL WOZNIAK PROGRAM DIRECTOR 288806 0 33747 0 431 0 25424 0 19910 0 368318 0 0 0 KENNETH WTANABE MEDICAL DIRECTOR 309138 0 36672 0 716 0 25424 0 25551 0 397501 0 0 0 STEPHANIE DOUGHTY FORMER CFO, LEFT MARCH 2019 43721 57607 0 0 197390 260083 9564 12601 1386 1825 252061 332116 0 0 PART I, LINE 1A GROSS-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 4A FORMER CFO STEPHANIE DOUGHTY RECEIVED SEVERANCE OF $163,738 FROM THE ORGANIZATION AND $215,742 FROM RELATED ORGANIZATIONS. PART I, LINE 7 THE 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. A UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2018 SERIES A 841179794 914183BH0 2018-07-26 45915000 REFUNDING 2005A BONDS 0 0 0 B UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2018 SERIES B 841179794 914183BJ6 2018-07-26 24374400 REFUNDING 2005B BONDS 0 0 0 C UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2017 SERIES A 841179794 914183BB3 2017-02-16 43493450 REFUNDING 2015A BONDS 0 0 0 D UNIVERISTY OF COLORADO HOSPITAL AUTHORITY 2017 SERIES B1B2 841179794 914183BC1 2017-02-16 37955000 REFUNDING 2015BC BONDS 0 0 0 A 45915000 318692 45596308 2018 1 0 1 1 B 24374400 169360 24205040 2018 1 0 1 1 C 43493450 213070 43280380 2017 1 0 1 1 D 37955000 546939 37408061 2017 1 0 1 1 A 0 1 0 0 0 0 1 B 0 1 0 0 0 0 1 C 0 1 0 0 0 0 1 D 0 1 0 0 0 0 1 A 0 1 0 0 1 1 CITI 21.500000000000 0 0 0 0 1 B 0 1 0 0 1 1 CITI 21.500000000000 0 0 0 0 1 C 0 1 0 0 0 1 CITI 10.000000000000 0 0 0 0 1 D 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 D 1 A UNIVERISTY OF COLORADO HOSPITAL AUTHORITY 2017 SERIES C2 841179794 914183AZ1 2017-02-16 6393411 NEW CONSTRUCTION ON PVH 0 0 0 B UNIVERSITY OF COLORADO HOSPITAL AUTHORITY 2019 SERIES C 841179794 914183BP2 2019-10-30 6392239 REFUNDING 2017C1 BONDS 0 0 0 A 6393411 25352 6368059 2017 0 0 1 1 B 6392239 42901 6349338 2019 1 0 1 1 A 0 1 0 0 0 0 1 B 0 1 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 0 A 1 X MEDICAL EQUIPMENT 31 666020 FMV 0 1 0 FORM 990, PART I, LINE 6 POUDRE 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 4 PVHC'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 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, 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 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 XI, LINE 9: MCR DISTRIBUTIONS TO PVH 78,491,746. BOOK VS. TAX ADJUSTMENT IN EQUITY EARNINGS -1,250,073. TIMBERLINE MEDICAL CLINIC 131 STANLEY AVE ESTES PARK CO 80517 043772090 OUTPATIENT CO 0 -16785 PVHC INC LAKOTA LAKE LLC 2315 E HARMONY RD STE 200 FORT COLLINS CO 80528 841447761 OUTPATIENT CO 3383639 49181732 PVHC INC HERON LAKE LLC 2315 E HARMONY RD STE 200 FORT COLLINS CO 80528 264189163 OUTPATIENT CO 0 657338 PVHC INC 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 1 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 1 POUDRE VALLEY MEDICAL GROUP 2315 E HARMONY RD STE 200 FORT COLLINS CO 80528 800348943 MEDICAL SERVICES CO 501(C)(3) LINE 10 PVH INC 1 HARMONY SURGERY CENTER 2127 E HARMONY RD 200 FT COLLINS CO 80528 841479751 AMBULATORY SURGERY CO N/A RELATED 2560463 3449140 0 0 0.50000 CENTRE AVENUE HEALTH & REHAB FACILITY 947 WORTHINGTON CIRCLE FT COLLINS CO 80526 841560494 NURSING FACILITY CO N/A RELATED -926980 826223 0 0 0.50000 COLUMBINE POUDRE HOME CARE 947 WORTHINGTON CIRCLE FT COLLINS CO 80526 841529817 NURSING CARE CO N/A RELATED 252999 692555 0 0 0.50000 GATEWAY MEDICAL SERVICES 2500 E PROSPECT RD FT COLLINS CO 80525 841427970 REAL EST/MED CO N/A UNRELATED 6527561 10009775 0 0 0.50000 PVHS HOME MEDICAL SUPPLY 6820 N COUNTY RD 13 LOVELAND CO 80538 202034599 MEDICAL SUPPLY CO N/A UNRELATED 118030 414033 0 1 0.50000 THE VEIN AND LASER CENTER OF NO COLORADO 2008 CARIBOU DRIVE FT COLLINS CO 80525 204943970 MEDICAL SERVICES CO N/A UNRELATED -26685 0 0 HARMONY IMAGING CENTER 1951 WILMINGTON DRIVE FT COLLINS CO 80528 582479187 MEDICAL IMAGING CO N/A RELATED 466029 2232325 0 0 0.46000 SURGERY CENTER OF FORT COLLINS 1100 E PROSPECT ROAD FT COLLINS CO 80525 841541559 SURGICAL PROC CO N/A UNRELATED 103858 937747 0 0 0.26000 OCR LOVELAND 2500 E PROSPECT RD FT COLLINS CO 80525 301069701 AMBULATORY SURG CO N/A UNRELATED -605486 2862292 0 0 0.10000 PVHS-ICM EHW 2315 E HARMONY RD STE 200 FT COLLINS CO 80528 463311308 MEDICAL SERVICES CO N/A RELATED 74900 509755 0 0 0.50000 PEAK SURGICAL MANAGEMENT 2127 E HARMONY RD 200 FT COLLINS CO 80528 260899618 SURGICAL MGMT CO N/A UNRELATED 155106 40629 0 0 0.14290 INNOVATION ENTERPRISES 2315 E HARMONY RD STE 200 FORT COLLINS CO 80528 202036774 IT CONSULTING CO PVHC C 38425 1643842 1.00000 1 1 1 1 1 0 0 0 0 0 1 0 1 1 1 1 1 1 0 1 HARMONY SURGERY CENTER A 1041681 TRANSACTION TOTAL HARMONY SURGERY CENTER Q 659851 TRANSACTION TOTAL HARMONY SURGERY CENTER S 1875000 TRANSACTION TOTAL CENTRE AVE HEALTH & REHAB LLC B 575000 TRANSACTION TOTAL COLUMBINE POUDRE HOMECARE S 200000 TRANSACTION TOTAL GATEWAY MEDICAL SERVICES S 3231729 TRANSACTION TOTAL PVHS HOME MEDICAL SUPPLY LLC S 736067 TRANSACTION TOTAL MEDICAL CENTER OF THE ROCKIES L 10759902 TRANSACTION TOTAL MEDICAL CENTER OF THE ROCKIES N 2642530 TRANSACTION TOTAL MEDICAL CENTER OF THE ROCKIES S 78491746 TRANSACTION TOTAL UCHEALTH NORTHERN COLORADO FOUNDATION B 1193668 TRANSACTION TOTAL UCHEALTH NORTHERN COLORADO FOUNDATION C 688580 TRANSACTION TOTAL INNOVATION ENTERPRISES A 360315 TRANSACTION TOTAL POUDRE VALLEY MEDICAL GROUP B 38391256 TRANSACTION TOTAL POUDRE VALLEY MEDICAL GROUP J 2159531 TRANSACTION TOTAL POUDRE VALLEY MEDICAL GROUP L 9439052 TRANSACTION TOTAL POUDRE VALLEY MEDICAL GROUP M 5636240 TRANSACTION TOTAL POUDRE VALLEY MEDICAL GROUP N 2130840 TRANSACTION TOTAL