2020-07-15T17:00:36-05:00 2019-06-30 350921680 CROWE LLP 401 East Las Olas Blvd Suite 1100 Fort Lauderdale FL 333014230 990 2018-07-01 840460697 Longmont United Hospital LONG 3036515023 1950 W Mountain View Ave Longmont CO 80501 CHRISTINA JOHNSON MD CEO 2020-07-15 true BRITTNEY KOCAJ P01320603 9542028600 2018 2021-01-29 14:40:06Z CHRISTINA JOHNSON MD 1950 W Mountain View Ave Longmont CO 80501 160746614 false X https://www.centura.org/locations/longmont-united-hospital X 1955 CO DEDICATED TO IMPROVING THE HEALTH OF OUR PATIENTS AND THE COMMUNITIES WE SERVE. 12 11 983 495 4598 0 0 0 155365443 157547727 9685849 1049596 1448118 2145235 166499410 160742558 370196 155884 0 69618620 65808232 0 0 0 100976692 99265905 170965508 165230021 -4466098 -4487463 239269104 224843249 131745899 123919292 107523205 100923957 WE EXTEND THE HEALING MINISTRY OF CHRIST BY CARING FOR THOSE WHO ARE ILL AND BY NURTURING THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES. false false 139507541 155884 159158798 WE ARE A DIVERSE COMMUNITY OF CAREGIVERS CONNECTED AND FUELED BY OUR INDIVIDUAL PASSIONS AND PURPOSES TO CHANGE THE WORLD AROUND US. WHILE INDIVIDUALLY INSPIRED, WE ARE COLLECTIVELY UNIFIED BY OUR MISSION. THIS PROCESS PRESENTS AN OPPORTUNITY TO FULFILL OUR COMMITMENT TO OUR ORGANIZATIONAL MISSION TO "EXTEND THE HEALING MINISTRY OF CHRIST BY CARING FOR THOSE WHO ARE ILL AND BY NURTURING THE HEALTH OF THE PEOPLE IN OUR COMMUNITIES. 139507541 true false false true false false false false false true true false true true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false true true true true false false true 0 0 983 true true false false false false false true false false false false false X 12 11 false false false false false false false true true false false false true true true true true false false true true X Erin Ward 3036515023 1950 West Mountain View Ave Longmont CO 80501 CHRISTINA JOHNSON MD Ex-officio; President & CEO 40.0 0 X X 346759 0 29463 CHARLOTTE TYSON CHAIR 1.0 0 X X 0 0 0 TONY DWORAK VICE CHAIR 1.0 0 X X 0 0 0 MIKE KIRKLAND SECRETARY 1.0 0 X X 0 0 0 HAL BAGLEY TREASURER 1.0 0 X X 0 0 0 MONICA BALDWIN BOARD MEMBER 1.0 0 X 0 0 0 SALLY BARBE BOARD MEMBER 1.0 0 X 0 0 0 Marta Loachamin BOARD MEMBER 1.0 0 X 0 0 0 HERBERT OGDEN MD BOARD MEMBER 1.0 0 X 0 0 0 NICK ROBLES BOARD MEMBER 1.0 0 X 0 0 0 PETER Schmidt MD BOARD MEMBER 1.0 0 X 0 0 0 Thomas Gessel EX-OFFICIO; CEO MERCY REGIONAL MEDICAL CENTER 1.0 0 X 0 0 0 DAN FRANK CFO 45.0 0 X 241748 0 45549 Rebecca Herman COO 45.0 0 X 130841 0 7405 NANCY DRISCOLL CNO 45.0 0 X 250532 0 24577 WARREN LAUGHLIN VP HR 45.0 0 X 194431 0 9660 HILARIE GUTIERREZ CLINIC PHYSICIAN 45.0 0 X 840489 0 48269 Horacio Gutierrez CLINIC PHYSICIAN 45.0 0 X 792493 0 16796 ELLIOT MORRIS CLINIC PHYSICIAN 45.0 0 X 555942 0 34858 BRIAN POTTORF CLINIC PHYSICIAN 45.0 0 X 803008 0 43697 GERLINDE TYNAN CLINIC PHYSICIAN 45.0 0 X 402564 0 49641 PETER POWERS Former COO 45.0 0 X 367754 0 66888 Joseph Tasse Former Interim President & CEO 0.0 0 X 280500 0 0 Mitchell Carson Former President & CEO 0.0 0 X 756287 0 24577 5963349 0 401380 78 true true true Longmont Hospitalist Group PLLC 2030 Mountain View Ave Longmont CO 80501 Medical Services 1264409 Rocky Mountain Cancer Centers 7951 E Maplewood Ave Suite 300 Greenwood Village CO 80111 Medical Services 840006 USACS of Colorado Inc 4535 Dressler Rd NW Canton OH 44718 Contract Labor 812498 Childrens Hospital PO Box 912732 Denver CO 80291 Medical Services 805896 Boulder Neurosurgical Assoc 4743 Arapahoe Ave STE 202 Boulder CO 80303 Medical Services 673200 12 X 0 PATIENT REVENUE 621990 154119134 154119134 MOB RENTAL INCOME 531120 3357949 3357949 340B REVENUE 621990 70644 70644 0 0 0 0 157547727 1053652 4598 1049054 0 0 0 4056 0 -4056 -4056 -4056 CAFETERIA 722210 481089 481089 MEDICAL RECORDS REVENUE 621990 191347 191347 PARKING REVENUE 900099 53075 53075 1419724 1419724 0 0 2145235 160742558 159158798 4598 1579162 X 155884 155884 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52974168 45822655 7151513 2514914 2175401 339513 6531669 5552074 979595 3787481 3276171 511310 12400 12400 589465 589465 26078803 24241449 1837354 0 3570566 2952140 618426 3517979 3517979 14362138 12094700 2267438 1374864 687432 687432 SUPPLIES 19425108 19425108 BAD DEBT 9819729 9819729 Support Allocation Fee 13753926 8043098 5710828 Restructuring & Impairment 568101 568101 6192826 4693599 1499227 0 165230021 139507541 25722480 0 15587214 7812854 26417011 19720747 0 0 4746041 2737352 3769557 4019913 1623042 1484123 178869402 42124510 136575399 136744892 1035945 1037776 37235149 39382979 0 12279746 11902613 239269104 224843249 45397508 43159434 37458401 35795465 0 43081576 40802281 3928397 3610172 1880017 551940 131745899 123919292 X 107372285 100773037 150920 150920 107523205 100923957 239269104 224843249 X -4487463 1269625 -3381410 X false true X true false X false false false false false false false false true 3038 3038 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Centura paid annual dues to various membership organizations, a portion of which is allocated to lobbying. The amount that represents this entity's share of the allocated lobbying expenses is as follows: Colorado Health Association - $3,038 13384218 13384218 85508643 14011127 71497516 22103322 5521165 16582157 53895235 22592218 31303017 3977984 3977984 136744892 CHI OIP 39382979 F 39382979 Investment in LLC's 4417079 Bond Indenture Funds 1375816 Board Designated Funds 6109718 11902613 Medicare Settlement 551940 551940 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote LONGMONT UNITED HOSPITAL'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH, AN AFFILIATED ORGANIZATION. THE FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED JUNE 30, 2019, READS AS FOLLOWS: "COMMONSPIRIT HAS ESTABLISHED ITS STATUS AS AN ORGANIZATION EXEMPT FROM INCOME TAXES UNDER THE INTERNAL REVENUE CODE SECTION 501(C)(3) AND THE LAWS OF THE STATES IN WHICH IT OPERATES, AND AS SUCH, IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, COMMONSPIRIT'S EXEMPT ORGANIZATIONS ARE SUBJECT TO INCOME TAXES ON NET INCOME DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, WHICH DOES NOT FURTHER THE ORGANIZATIONS' EXEMPT PURPOSES. NO SIGNIFICANT INCOME TAX PROVISION HAS BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR NET INCOME DERIVED FROM UNRELATED TRADE OR BUSINESS. COMMONSPIRIT'S FOR-PROFIT SUBSIDIARIES ACCOUNT FOR INCOME TAXES RELATED TO THEIR OPERATIONS. THE FOR-PROFIT SUBSIDIARIES RECOGNIZE DEFERRED TAX ASSETS AND LIABILITIES FOR TEMPORARY DIFFERENCES BETWEEN THE FINANCIAL REPORTING BASIS AND THE TAX BASIS OF THEIR ASSETS AND LIABILITIES, ALONG WITH NET OPERATING LOSS AND TAX CREDIT CARRYOVERS, FOR TAX POSITIONS THAT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION CRITERIA. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGEMENT OCCURS. INCOME TAX INTEREST AND PENALTIES ARE RECORDED AS INCOME TAX EXPENSE. FOR THE YEARS ENDED JUNE 30, 2019 AND 2018, COMMONSPIRIT'S TAXABLE ENTITIES RECORDED AN IMMATERIAL AMOUNT OF INTEREST AND PENALTIES AS PART OF THE PROVISION FOR INCOME TAXES. COMMONSPIRIT'S TAXABLE ENTITIES DID NOT HAVE ANY MATERIAL UNRECOGNIZED INCOME TAX BENEFITS AS OF JUNE 30, 2019 AND 2018. COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS" true true X true X 250 true X true true true false true true 2340044 2340044 0.0151 44259152 30558930 13700222 0.0882 0 0.0 0 0 46599196 30558930 16040266 0.1032 34298 34298 0.0002 204611 204611 0.0013 0 0.0 0 0.0 850 850 0.0000 0 0 239759 0 239759 0.0015 0 0 46838955 30558930 16280025 0.1048 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 9819729 0 41731351 69409430 -27678079 X true true TWIN PEAKS MEDICAL IMAGING LLC provision of Diag. Imaging 0.5 0.5 LUH Orthopedic & Spine Co-Mgt Management services 0.3846 0.6154 1 1 Longmont United Hospital 1950 Mountain View Ave Longmont CO 80501 HTTPS://WWW.CENTURA.ORG/LOCATIONS/LONGMONT-UNITED-HOSPITAL 010350 X X X Longmont United Hospital 1 false false true X X X X X X X X X 18 true false false true X https://www.centura.org/community-programs/community-benefit X true 18 true https://www.centura.org/community-programs/community-benefit false true X 250.0 400.0 X X X X X true true X X X X true X HTTPS://WWW.CENTURA.ORG/PATIENTS-AND-FAMILIES/BILLING-AND-FINANCIAL-SERVICES/FINANCIAL-HELP X HTTPS://WWW.CENTURA.ORG/PATIENTS-AND-FAMILIES/BILLING-AND-FINANCIAL-SERVICES/FINANCIAL-HELP X HTTPS://WWW.CENTURA.ORG/PATIENTS-AND-FAMILIES/BILLING-AND-FINANCIAL-SERVICES/FINANCIAL-HELP X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. TWO NEEDS LONGMONT UNITED HOSPITAL (LUH) FOCUSED ON WERE: (1) BEHAVIORAL HEALTH: THIS WAS PRIORITIZED DUE TO THE INCIDENCE AND PREVALENCE OF ISSUES RELATED TO BEHAVIORAL HEALTH AND THE NEED FOR A MORE COORDINATED EFFORT TO ENSURE SUFFICIENT RESOURCES TO ADDRESS THE NEED. (2) OBESITY: THIS WAS PRIORITIZED AS AN URGENT ISSUE IN THE COMMUNITY. THE HOSPITAL DEVELOPED AN IMPLEMENTATION PLAN TO REDUCE CHILDHOOD OBESITY AND PROMOTE LIFELONG WELLNESS STRATEGIES. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - LONGMONT UNITED HOSPITAL. BROAD INPUT WAS RECEIVED FROM THE COMMUNITY IN MULTIPLE FORMS AND VENUES. EXAMPLES OF THIS INPUT INCLUDE THE EXECUTIVE DIRECTOR OF THE LONGMONT COMMUNITY FOUNDATION, THE EXECUTIVE DIRECTOR OF THE OUR CENTER (AN ORGANIZATION THAT PROVIDES EMERGENCY SERVICES TO HELP PEOPLE THROUGH SHORT-TERM FINANCIAL CRISES AND ALSO WORKS IN PARTNERSHIP WITH OUR CLIENTS TO DEVELOP CASE PLANS FOR THOSE NEEDING LONGER-TERM ASSISTANCE WITH A MOVEMENT TOWARDS SELF-SUFFICIENCY), SEVERAL MEMBERS OF THE LONGMONT SENIOR CENTER INCLUDING SOCIAL WORKERS AND CENTER COORDINATORS, A FOCUS GROUP OF 17 RANDOMLY SELECTED COMMUNITY MEMBERS FROM THE LONGMONT UNITED HOSPITAL SERVICE AREA, ETC. THE INPUT WE RECEIVED WAS USED TO IDENTIFY COMMUNITY HEALTH NEEDS AND ITEMS TO PRIORITIZE OUR EFFORTS TO IMPROVE OUR OUTREACH. SPECIFIC INDIVIDUALS ARE LISTED BELOW: * SHANNON BREITZMAN, BRANCH DIRECTOR, INJURY, SUICIDE AND VIOLENCE PREVENTION, CDPHE * DOUG MUIR, DIRECTOR OF BEHAVIORAL HEALTH SERVICE LINE, PORTER ADVENTIST HOSPITAL * SARAH KURZ, VP OF POLICY AND COMMUNICATION, LIVEWELL COLORADO * KIM PATTON, HRSA, ACTING DEPUTY REGIONAL ADMINISTRATOR, MENTAL HEALTH * REG COX, SENIOR MINISTER, LAKEWOOD CHURCH OF CHRIST * ANDREA BON-WILSON, PSYCHOLOGICAL AND BEHAVIORAL COUNSELOR, CARDIAC REHABILITATION AND HEALTH WELLNESS, HELP FOR DIABETES PROGRAM, ST. ANTHONY HOSPITAL * NAMINO GLANTZ, HEALTH PLANNING & EPIDEMIOLOGY MANAGER, BOULDER COUNTY PUBLIC HEALTH DEPARTMENT * NANCY DRISCOLL, CHIEF NURSING OFFICER * PETER POWERS, VICE PRESIDENT, OPERATIONS * REED CALDWELL, MD, EMERGENCY DEPARTMENT * DARLENE SAVAGE, DIRECTOR, CARE COORDINATION * MICHELLE WHITMORE, DIRECTOR, PATIENT CARE * BARB TURNEY, MARKETING MANAGER * EDWINA SALAZAR, EXECUTIVE DIRECTOR, THE OUR CENTER * DAN EAMON, CITY OF LONGMONT EMERGENCY MANAGER, LONGMONT COMMUNITY HEALTH NETWORK COORDINATOR * ERIC HOZEMPA, EXECUTIVE DIRECTOR, THE LONGMONT COMMUNITY FOUNDATION * CHRIS MARCHIONI, MD, EXECUTIVE DIRECTOR, HEALTHY LEARNING PATHS FURTHER INFORMATION ON THE OUR CENTER CAN BE FOUND AT: HTTP://WWW.OURCENTER.ORG/ Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - LONGMONT UNITED HOSPITAL. Longmont United Hospital (LUH) and community stakeholders identified three significant needs in their community which they prioritized and focused on. The prioritized needs were Behavioral Health, Adult and Childhood Obesity and Access to Care. The process followed to address the needs, was to create several goals for each need, and then implementing specific activities and metrics to measure progress of address the need. Specifically, LUH wanted to improve the overall behavioral health status of Boulder residents by leveraging the strengths of the hospital and community partners to fill gaps and meet community needs. They focused and implemented on the following three goals of reducing the number of people inappropriately utilizing the LUH Emergency Department (ER) as the primary access point for behavioral health access; increased awareness of behavioral health issues among community members to increase capacity to identify and address behavioral health needs within the community through Mental Health First Aid (MHFA) for adults and youth; and increased access to psychiatric and counseling appointments for Boulder County residents. To name a few of the numerous activities used: educated the community, engaged community members, provided training and followed-up with patients were just a few activities which supported the need of improving behavioral health in the community. Healthy Eating Active Living/Obesity: the objective was to reduce childhood obesity and promote lifelong wellness. LUH provides training through Healthy Learning Paths Be Well, Learn Well curriculum to children and parents. Serve on HLP Coalition; also LUH provided free health screenings for children and their families with a particular focus on weight and body mass index; and had the goal to reduce computer/TV screen time in elementary and middle-school children. 12 CHPG - OBGYN 2030 Mountain View Ave Suite 400 Longmont CO 80501 Physician Practice CHPG - General Surgery 2030 Mountain View Ave Suite 310 Longmont CO 80501 Physician Practice CHPG - Cardiology 2030 Mountain View Ave Suite 310 Longmont CO 80501 Physician Practice CHPG - Gastoenterology 2030 Mountain View Ave Suite 310 Longmont CO 80501 Physician Practice CHPG - Breast Imaging 1950 Mountain View Ave Longmont CO 80501 Physician Practice CHPG - NIWOT 6800 79th St Suite 102 Niwot CO 80503 Physician Practice CHPG - Lyons 303 Main St Unit C Lyons CO 80540 Physician Practice CHPG - Bethoud 649 Mountain Ave Berthoud CO 80513 Physician Practice CHPG - Internal Medicine 2030 Mountain View Ave Suite 310 Longmont CO 80501 Physician Practice CHPG - Longmont 2030 Montain View Ave Suite 310 Longmont CO 80501 Physician Practice CHPG - Firestone 6600 Firestone blvd Firestone CO 80520 Physician Practice CHPG - Travel Medicine 2535 S Downing St Denver CO 80210 Physician Practice Schedule H, Part I, Line 7g Subsidized Health Services There are no physician clinics included in subsidized health services. Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 9819729 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance A COST ACCOUNTING SYSTEM WAS NOT USED TO COMPUTE AMOUNTS IN THE TABLE; RATHER COSTS IN THE TABLE WERE COMPUTED USING THE ORGANIZATION'S COST-TO-CHARGE RATIO. THE COST-TOCHARGE RATIO COVERS ALL PATIENT SEGMENTS. THE COST-TO-CHARGE RATIO FOR THE YEAR ENDED 6/30/2019 WAS COMPUTED USING THE FOLLOWING FORMULA: OPERATING EXPENSE (BEFORE RESTRUCTURING, IMPAIRMENT AND OTHER LOSSES) DIVIDED BY GROSS PATIENT REVENUE. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Longmont United Hospital uses the overall cost to gross charge ratio applicable to each facility to determine the costs in Part III, Lines 2 and 3. Longmont United Hospital automatically discounts all self-pay patient accounts by 30% and also offers a prompt pay discount. This allowance is not included in the calculation of the cost of bad debts in instances where a patient does not pay his or her bill. Schedule H, Part III, Line 3 Bad Debt Expense Methodology Longmont United Hospital does not include any portion of bad debt as community benefit. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote LONGMONT UNITED HOSPITAL DOES NOT ISSUE SEPARATE COMPANY AUDITED FINANCIAL STATEMENTS. HOWEVER, THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF COMMONSPIRIT HEALTH. THE CONSOLIDATED FOOTNOTE READS AS FOLLOWS: COMMONSPIRIT RELIES ON THE RESULTS OF DETAILED REVIEWS OF HISTORICAL WRITE-OFFS AND COLLECTIONS IN ESTIMATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE. UPDATES TO THE HINDSIGHT ANALYSIS IS PERFORMED AT LEAST QUARTERLY USING PRIMARILY A ROLLING EIGHTEENMONTH COLLECTION HISTORY AND WRITE-OFF DATA. SUBSEQUENT CHANGES TO ESTIMATES OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT REVENUE IN THE PERIOD OF CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN A THIRD-PARTY PAYOR'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE IN PURCHASED SERVICES AND OTHER IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS AND CHANGE IN NET ASSETS. BAD DEBT EXPENSE FOR 2019 WAS NOT SIGNIFICANT. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE ORGANIZATION APPLIES THE COST TO CHARGE RATIO CALCULATED IN IRS WORKSHEET 2 TO DETERMINE THE COST OF CARE PROVIDED TO MEDICARE PATIENTS. THE COST IS THEN EVALUATED AND ALL NON-ALLOWABLE COST IS REMOVED VIA ADJUSTMENTS. THE REMAINING ALLOWABLE COST IS THEN ALLOCATED TO APPROPRIATE PATIENT CARE AND NON-PATIENT CARE COST CENTERS BASED ON MEDICARE ALLOCATION PRINCIPLES. LONGMONT UNITED HOSPITAL (LUH) DOES NOT TREAT MEDICARE SHORTFALLS AS COMMUNITY BENEFIT. MEDICARE IS NOT A DIFFERENTIATING FEATURE OF TAX-EXEMPT HEALTH CARE ORGANIZATIONS; FOR-PROFIT HOSPITALS TREAT AND ATTEMPT TO ATTRACT MEDICARE BENEFICIARIES. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Longmont United Hospital's debt collection policy provides for the performance of a reasonable review of each patient's account prior to turning an account over to a third-party collection agent and prior to instituting any legal action for non-payment. The review of patient accounts is done to assure that the patient or their guarantor is not eligible for assistance through Longmont United Hospital's charity care policy, uninsured discount policy, or another financial assistance program (i.e. Medicaid). Longmont United Hospital requires the following of its third-party collection agencies: * Neither Longmont United Hospital or their collection agencies will request bench or arrest warrants as a result of non-payment; * Neither Longmont United Hospital or their collection agencies will seek liens that would require the sale or foreclosure of a primary residence; and * No Longmont United Hospital collection agency may seek court action without hospital approval. Once a patient is known to qualify for financial assistance, collection actions are then suspended. Schedule H, Part V, Section B, Line 16a FAP website - Longmont United Hospital: Line 16a URL: HTTPS://WWW.CENTURA.ORG/PATIENTS-AND-FAMILIES/BILLING-AND-FINANCIAL-SERVICES/FINANCIAL-HELP; Schedule H, Part V, Section B, Line 16b FAP Application website - Longmont United Hospital: Line 16b URL: HTTPS://WWW.CENTURA.ORG/PATIENTS-AND-FAMILIES/BILLING-AND-FINANCIAL-SERVICES/FINANCIAL-HELP; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Longmont United Hospital: Line 16c URL: HTTPS://WWW.CENTURA.ORG/PATIENTS-AND-FAMILIES/BILLING-AND-FINANCIAL-SERVICES/FINANCIAL-HELP; Schedule H, Part VI, Line 2 Needs assessment Longmont United Hospital provides several services and resources to the communities it serves beyond the prioritized needs specifically identified in the Community Health Needs Assessment. They sponsor wellness events such as breast feeding education, asthma screenings, and financially supports wellness initiatives of cities and public schools. They also provides transportation for low income patients and housing at no cost or very low cost for the families of low income patients of the hospital that are far from their residence. They also supports, financially and through volunteerism, initiatives such as soup kitchens and meals on wheels to provide food and nutrition education to address hunger issues. Hospital staff also volunteer to serve as preceptors for students of local health professional programs and serve on boards of local community organizations that provide social services to populations in need. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Longmont United Hospital is operated as part of Centura Health Corporation (Centura). Information concerning financial assistance is included on Centura's website. The website not only lists phone numbers for patients to call to discuss financial assistance, but also includes Centura's policy for charity care and its policies related to uninsured patients. In addition, at the time of registration, uninsured patients are screened to determine if the patients qualify for any Federal, State or County programs. Uninsured patients are also sent a letter requesting that the patient call to determine eligibility for various assistance programs, including charity. Schedule H, Part VI, Line 4 Community information THE COMMUNITIES THAT LONGMONT UNITED HOSPITAL SERVES ARE DESCRIBED AS FOLLOWS: *GEOGRAPHIC AREA COMMUNITY BENEFIT IS PROVIDED TO COMMUNITIES IN OUR PRIMARY AND SECONDARY SERVICE AREAS. THESE SERVICE AREAS REPRESENT ROUGHLY A 20-MILE RADIUS AROUND THE HOSPITAL AND ENCOMPASS MOUNTAIN TOWNS, SUBURBAN CITIES, AND RURAL PLAINS COMMUNITIES. LONGMONT UNITED HOSPITAL, A COMMUNITY NON-FOR-PROFIT HOSPITAL, IS THE ONLY HOSPITAL IN THE PRIMARY SERVICE AREA. ZIP CODES: 80501 LONGMONT PSA 80503 LONGMONT PSA 80504 LONGMONT PSA 80513 BERTHOUD PSA 80530 FREDERICK PSA 80540 LYONS PSA 80520 FIRESTONE (80504) PSA 80502 LONGMONT (80501) PSA 80533 HYGIENE (80503) PSA 80544 NIWOT (80503) PSA 80514 DACONO PSA 80542 MEAD PSA 80516 ERIE PSA 80534 JOHNSTOWN SSA 80026 LAFAYETTE SSA 80651 PLATTEVILLE SSA 80621 FORT LUPTON SSA 80538 LOVELAND SSA 80301 BOULDER SSA 80623 PLATTEVILLE (80651) SSA 80541 LOVELAND (80537) SSA 80537 LOVELAND SSA *DEMOGRAPHIC PROFILE INFORMATION CITY OF LONGMONT/ BOULDER COUNTY = 2010 US CENSUS BOULDER COUNTY: HTTP://QUICKFACTS.CENSUS.GOV/QFD/STATES/08/08013.HTML LONGMONT: HTTP://WWW.CI.LONGMONT.CO.US/PLANNING/CENSUS/ STATISTICS FROM BOULDER COMMUNITY FOUNDATION: BOULDER COUNTY TRENDS REPORT 2013 REPORT: HTTP://WWW.COMMFOUND.ORG/TRENDSMAGAZINE *RACIAL/ETHNIC - BOULDER COUNTY 2012 *87% WHITE *14% LATINO (ANY RACE) *4% ASIAN *1% AFRICAN AMERICAN *.4% NATIVE AMERICAN *3% TWO OR MORE RACES *5% SOME OTHER RACE *HEALTH COVERAGE IN BOULDER COUNTY: *RACE: 52% OF LATINOS AND 91% NON-HISPANIC WHITE HAVE HEALTHCARE COVERAGE *GENDER: WOMEN 91%, MEN 81% HAVE HEALTHCARE ANNUAL INCOME: 95% $50K+, 81% $25K-50K, 61% <25K HAVE HEALTHCARE *88% OF THE CHILDREN HAVE HEALTH COVERAGE IN 2012. *2012 EDUCATION IN BOULDER COUNTY *A SIGNIFICANT GAP IN HIGH SCHOOL GRADUATION RATES BETWEEN NON-HISPANIC WHITE AND LATINO STUDENTS EXISTS: 90% VS. 61% IN BOULDER VALLEY SCHOOL DISTRICT (BVSD) AND 84% VS. 56% IN ST. VRAIN VALLEY SCHOOL DISTRICT (SVVSD) *LESS THAN HALF OF LATINO MALES IN THE ST. VRAIN VALLEY SCHOOL DISTRICT GRADUATED IN 2010 (48%) *38% OF SVVSD STUDENTS ARE ON THE FREE OR REDUCED LUNCH PROGRAM, 37% OF BVSD QUALIFY IN 2012. *ECONOMY IN BOULDER COUNTY *INDIVIDUALS BELOW POVERTY 14% *FAMILIES BELOW POVERTY 8% *CHILDREN BELOW POVERTY 13% *AN INCREASE AT THE YOUNG OR OLDER END WILL CAUSE MEDIAN HOUSEHOLD INCOME TO FALL. *GROWING POVERTY AND INCOME INEQUALITY. *YOUTH UNEMPLOYMENT - LONG TERM PERMANENT IMPACT ON EARNINGS. *HEALTH RELATED INFORMATION STATISTICS FROM BOULDER COMMUNITY FOUNDATION: BOULDER COUNTY TRENDS REPORT 2011 & 2012 PREGNANCY *23% OF WOMEN RECEIVE INITIAL PRENATAL CARE LATER THAN THE FIRST TRIMESTER OR NOT AT ALL *90% OF WOMEN ABSTAIN FROM CIGARETTE SMOKING DURING THE LAST THREE MONTHS OF PREGNANCY *9% OF BABIES ARE BORN WITH A LOW BIRTH WEIGHT (LESS THAN 5 POUNDS, 9 OUNCES) *INFANT MORTALITY RATE (5.8 INFANT DEATHS PER 1,000 LIVE BIRTHS) *65% OF PRESCHOOL-AGE CHILDREN RECEIVED ALL RECOMMENDED DOSES OF SIX KEY VACCINES: CHILDREN *12% OF CHILDREN ARE NOT COVERED BY PRIVATE OR PUBLIC HEALTH INSURANCE *16% OF CHILDREN LIVE IN FAMILIES WITH INCOMES BELOW THE FEDERAL POVERTY LEVEL *59% OF CHILDREN HAVE A MEDICAL HOME *77% OF CHILDREN RECEIVED ALL THE ROUTINE DENTAL PREVENTIVE CARE NEEDED IN THE PAST 12 MONTHS *64% OF SCHOOL-AGE CHILDREN PARTICIPATED IN VIGOROUS PHYSICAL ACTIVITY FOR FOUR OR MORE DAYS PER WEEK *14% OF CHILDREN ARE OBESE ADOLESCENTS *11% OF ADOLESCENTS ARE NOT COVERED BY PRIVATE OR PUBLIC HEALTH INSURANCE *12% OF ADOLESCENTS LIVE IN FAMILIES WITH INCOMES BELOW THE FEDERAL POVERTY LEVEL *24% OF ADOLESCENTS ATE FIVE OR MORE SERVINGS PER DAY OF FRUITS AND/OR VEGETABLES DURING THE PAST SEVEN DAYS *47% OF ADOLESCENTS PARTICIPATED IN VIGOROUS PHYSICAL ACTIVITY ON FIVE OR MORE OF THE PAST SEVEN DAYS *25% OF ADOLESCENTS HAD FIVE OR MORE DRINKS OF ALCOHOL IN A ROW ON ONE OR MORE OF THE PAST 30 DAYS *18% OF ADOLESCENTS SMOKED CIGARETTES OF ONE OR MORE OF THE PAST 30 DAYS *25% OF ADOLESCENTS FELT SO SAD OR HOPELESS ALMOST EVERY DAY FOR TWO CONSECUTIVE WEEKS DURING THE PAST 12 MONTHS THAT THEY STOPPED DOING SOME USUAL ACTIVITIES *8% OF ADOLESCENTS ATTEMPTED SUICIDE ONE OR MORE TIMES DURING THE PAST 12 MONTHS *27% OF ADOLESCENTS WERE SEXUALLY ACTIVE IN THE PAST THREE MONTHS *AMONG STUDENTS WHO HAD SEXUAL INTERCOURSE DURING THE PAST THREE MONTHS, 63% PERCENT REPORTED USING A CONDOM DURING LAST SEXUAL INTERCOURSE *TEEN FERTILITY RATE (43.4 BIRTHS TO TEEN MOTHERS PER 1,000 TEENAGE WOMEN) ADULTS *20% OF WORKING-AGE ADULTS ARE NOT COVERED BY PRIVATE OR PUBLIC HEALTH INSURANCE *77% OF ADULTS HAVE ONE (OR MORE) PERSON(S) THEY THINK OF AS THEIR PERSONAL DOCTOR OR HEALTH CARE PROVIDER *22% OF ADULTS CONSUMED FIVE OR MORE FRUITS AND/OR VEGETABLES PER DAY WITHIN THE PAST WEEK *84% OF ADULTS PARTICIPATED IN ANY PHYSICAL ACTIVITY WITHIN THE PAST MONTH *19% OF ADULTS ARE OBESE *19% OF ADULTS CURRENTLY SMOKE CIGARETTES *19% OF ADULTS BINGE DRANK (MALES HAVING FIVE OR MORE DRINKS ON ONE OCCASION, FEMALES HAVING FOUR OR MORE DRINKS ON ONE OCCASION) IN THE PAST MONTH *13% OF ADULTS REPORT THAT THEIR MENTAL HEALTH WAS NOT GOOD EIGHT OR MORE DAYS IN THE PAST MONTH *4% OF ADULTS REPORTED THAT THEY WERE DIAGNOSED WITH DIABETES *17% OF ADULTS REPORTED THAT THEY WERE DIAGNOSED WITH HIGH BLOOD PRESSURE HEALTHY AGING *95% OF OLDER ADULTS HAVE ONE (OR MORE) PERSON(S) THEY THINK OF AS THEIR PERSONAL DOCTOR OR HEALTH CARE PROVIDER *60% OF OLDER ADULTS HAVE HAD A FLU SHOT DURING THE PAST 12 MONTHS AND HAVE HAD A PNEUMONIA VACCINATION *75% OF OLDER ADULTS PARTICIPATED IN ANY PHYSICAL ACTIVITY IN THE PAST 30 DAYS *18% OF OLDER ADULTS REPORT THAT THEIR PHYSICAL HEALTH WAS NOT GOOD EIGHT OR MORE DAYS IN THE PAST MONTH *6% OF OLDER ADULTS REPORT THAT THEIR MENTAL HEALTH WAS NOT GOOD EIGHT OR MORE DAYS IN THE PAST MONTH *20% OF OLDER ADULTS REPORTED EIGHT OR MORE DAYS OF LIMITED ACTIVITY IN THE PAST MONTH DUE TO POOR PHYSICAL OR MENTAL HEALTH STATISTICS CENTER OF DISEASE CONTROL AND PREVENTION *HEART DISEASE 2009 AGE OVER 35 DEATH RATES PER 100,000: BOULDER COUNTY 263, 3% DECREASE SINCE 2007 LARIMER 258, 4% DECREASE SINCE 2007 WELD 308, 13% DECREASE SINCE 2007 *CANCER 2008 TOP THREE INCIDENT RATES PER 100,000 IN CO PROSTATE 145, 10% DECREASE SINCE 2006 FEMALE BREAST 124, 2% INCREASE SINCE 2006 LUNG AND BRONCHUS 50, 3% INCREASE SINCE 2006 *DIABETES 2009 ADULTS DIAGNOSED DIABETES: BOULDER COUNTY 4%, 22% INCREASE SINCE 2007 LARIMER 5%, 11% INCREASE SINCE 2007 WELD 6%, 9% CHANGE SINCE 2007 HTTP://APPS.NCCD.CDC.GOV/DDT_STRS2/COUNTYPREVALENCEDATA.ASPX?STATEID=8&MODE=DBT *ARTHRITIS: 24% OF ADULTS IN CO REPORTED BEING DIAGNOSED WITH ARTHRITIS. NO INCREASE SINCE 2007. *IN CO, 16% OF THE ADULT POPULATION (AGED 18+ YEARS) ARE CURRENT CIGARETTE SMOKERS CONTINUING A DOWNWARD TREND SINCE 1996. *21% OF ADULTS IN CO WERE OVERWEIGHT OR OBESE. PROVISIONS FOR UNINSURED *LONGMONT UNITED HOSPITAL PROVIDES A SAFETY NET FOR UNINSURED PERSONS THROUGH THE FOLLOWING: *LONGMONT UNITED HOSPITAL PROVIDES THE HIGHEST PERCENTAGE OF CHARITY CARE IN BOULDER COUNTY. *SUBSIDIZING AND SUPPORTING THE SALUD FAMILY HEALTH CENTERS, A LOW-INCOME PRIMARY HEALTHCARE SERVICE *SUPPORTING BOULDER VALLEY WOMEN'S HEALTH CENTER WHO PROVIDES QUALITY HEALTHCARE AND SERVICES REGARDLESS OF A CLIENT'S INSURED STATUS, ECONOMIC CIRCUMSTANCES OR IMMIGRATION STATUS Schedule H, Part VI, Line 5 Promotion of community health The organization's hospital facilities promote health for the benefit of the community. Medical staff privileges in the hospital are available to all qualified physicians in the area, consistent with the size and nature of its facilities. The organization's hospital facilities have an open medical staff. Its board of trustees is composed of prominent citizens in the community. Excess funds are generally applied to expansion and replacement of existing facilities and equipment, amortization of indebtedness, improvement in patient care, and medical training, education, and research. The facilities treat persons paying their bills with the aid of public programs like Medicare and Medicaid. All patients presenting at the hospital for emergency and other medically necessary care are treated regardless of their ability to pay for such treatment. Schedule H, Part VI, Line 6 Affiliated health care system ON AUGUST 1, 2015, LUH ENTERED INTO A FOUR-PARTY AFFILIATION AGREEMENT AND JOINT OPERATING AND MANAGEMENT AGREEMENT (JOA) WITH CENTURA HEALTH CORPORATION, CATHOLIC HEALTH INITIATIVES COLORADO (CHIC), AND COMMONSPIRIT HEALTH (CSH). UNDER THIS AGREEMENT, LUH WILL BE OPERATED AND MANAGED BY CENTURA. CSH WILL PROVIDE THE HOSPITAL WITH SIGNIFICANT CAPITAL SUPPORT OVER THE NEXT SEVEN YEARS, AND MAY PROVIDE OPERATING SUPPORT AS NECESSARY. Schedule H, Part VI, Line 7 State filing of community benefit report CO true JUSTIN PARKER NEUROLOGICAL 4743 Arapahoe Ave Boulder CO 80303 263588986 501(C)(3) 7500 0 N/A N/A SPONSORSHIP LONGMONT ECONOMIC DEVELOPMENT PO Box 1203 Longmont CO 80502 840840120 501(C)(6) 6500 0 N/A N/A SPONSORSHIP VIA MOBILITY SERVICES 2855 No 63rd St Boulder CO 803012959 840777296 501(C)(3) 20000 0 N/A N/A SPONSORSHIP 2 1 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. GRANTS ARE GIVEN AT THE DISCRETION OF THE LONGMONT UNITED HOSPITAL CEO. THE CEO MAKES REQUESTS FOR FUNDING, WHICH IS PAID OUT IN THE FORM OF A DONATION TO THE ENTITY OR USED TO REIMBURSE AN INVOICE SUBMITTED FOR AN EXPENSE FOR A SPECIFIC PURPOSE. THE MAJORITY OF THE DONEES ARE 501(C)(3) ORGANIZATIONS THAT ASSUME RESPONSIBILITY FOR ENSURING THAT THE FUNDS ARE USED IN FURTHERANCE OF THE PURPOSE OF THE GRANT. true true false false false false false false false Joseph Tasse Former Interim President & CEO 280500 0 0 0 0 0 0 0 0 0 280500 0 0 0 Mitchell Carson Former President & CEO 0 0 0 0 756287 0 0 0 24577 0 780864 0 0 0 CHRISTINA JOHNSON MD Ex-officio; President & CEO 344971 0 0 0 1788 0 28335 0 1128 0 376222 0 0 0 DAN FRANK CFO 193798 0 46968 0 982 0 8743 0 36806 0 287296 0 0 0 Rebecca Herman COO 130841 0 0 0 0 0 0 0 7405 0 138246 0 0 0 PETER POWERS Former COO 300850 0 61815 0 5090 0 34679 0 32210 0 434643 0 0 0 NANCY DRISCOLL CNO 250532 0 0 0 0 0 0 0 24577 0 275108 0 0 0 WARREN LAUGHLIN VP HR 194431 0 0 0 0 0 0 0 9660 0 204091 0 0 0 HILARIE GUTIERREZ CLINIC PHYSICIAN 268334 0 562824 0 9331 0 9625 0 38644 0 888758 0 0 0 Horacio Gutierrez CLINIC PHYSICIAN 280012 0 503309 0 9172 0 9625 0 7171 0 809290 0 0 0 ELLIOT MORRIS CLINIC PHYSICIAN 496454 0 15118 0 44370 0 9028 0 25830 0 590800 0 0 0 BRIAN POTTORF CLINIC PHYSICIAN 657422 0 109441 0 36144 0 7207 0 36490 0 846705 0 0 0 GERLINDE TYNAN CLINIC PHYSICIAN 278056 0 115236 0 9272 0 9261 0 40380 0 452206 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation OUTSIDE CONSULTANTS ARE ENGAGED TO PROVIDE RECOMMENDATIONS TO CENTURA'S COMPENSATION COMMITTEE REGARDING THE COMPENSATION OF FACILITY CEOS AND CENTURA SENIOR EXECUTIVES. THE CONSULTANT'S RECOMMENDATIONS ARE THEN PRESENTED TO AND APPROVED BY THE COMPENSATION COMMITTEE. CENTURA'S HUMAN RESOURCES DEPARTMENT PERFORMS AN ANNUAL ANALYSIS OF THE MARKET TO DETERMINE COMPENSATION RANGES FOR THE REMAINDER OF CENTURA EXECUTIVES WHICH ARE REVIEWED AND APPROVED BY CENTURA'S SENIOR LEADERSHIP. Schedule J, Part I, Line 4a Severance or change-of-control payment MITCHELL CARSON RECEIVED SEVERANCE IN THE AMOUNT OF $756,287 IN 2018. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan CENTURA HEALTH CORPORATION, AN UNRELATED TAX EXEMPT ORGANIZATION, PROVIDES SENIOR EXECUTIVES OF THE FILING ORGANIZATION'S MANAGEMENT TEAM THAT HOLD THE POSITION OF VICE PRESIDENT OR ABOVE AN ALLOWANCE EQUIVALENT TO 10% OF BASE SALARY TO PURCHASE INSURANCE PRODUCTS OR CONTRIBUTE INTO A DEFERRED NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). IN ADDITION, A PENSION RESTORATION BENEFIT (PRB) IS PROVIDED WHICH CREDITS PARTICIPANTS WITH A BENEFIT THAT IS CALCULATED BASED ON THE EXCESS OF THE PARTICIPANT'S COMPENSATION OVER THE MAXIMUM ALLOWED FOR PENSION CONTRIBUTIONS. AMOUNTS DEFERRED ARE NOT REPORTED AS TAXABLE INCOME UNTIL/UNLESS A TRIGGERING EVENT OCCURS. THESE DEFERRED COMPENSATION PLANS HAVE A SUBSTANTIAL RISK OF FORFEITURE PROVISIONS AND AN ELECTED VESTING SCHEDULE. DURING THE CALENDAR YEAR 2018, THE FOLLOWING INDIVIDUALS PARTICIPATED IN AND RECEIVED THE FOLLOWING AMOUNTS FROM THE SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLANS: SERP & PENSION RESTORATION CREDIT: CHRISTINA JOHNSON, MD - $26,667 PETER POWERS - $27,600 Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - JOSEPH TASSE, COMPENSATION FROM UNRELATED ORGANIZATION - 280500.000000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION , TYPE OF COMPENSATION - WAGES AND BENEFITS Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - MITCHELL CARSON, COMPENSATION FROM UNRELATED ORGANIZATION - 780863.850000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION , TYPE OF COMPENSATION - WAGES AND BENEFITS Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - CHRISTINA JOHNSON, MD, COMPENSATION FROM UNRELATED ORGANIZATION - 376222.000000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION, TYPE OF COMPENSATION - WAGES AND BENEFITS Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - DAN FRANK, COMPENSATION FROM UNRELATED ORGANIZATION - 287296.350000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION, TYPE OF COMPENSATION - WAGES AND BENEFITS Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - REBECCA HERMAN , COMPENSATION FROM UNRELATED ORGANIZATION - 138246.000000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION, TYPE OF COMPENSATION - WAGES AND BENEFITS Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - PETER POWERS, COMPENSATION FROM UNRELATED ORGANIZATION - 434642.630000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION, TYPE OF COMPENSATION - WAGES AND BENEFITS Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - NANCY DRISCOLL, COMPENSATION FROM UNRELATED ORGANIZATION - 275108.210000, NAME OF UNRELATED ORGANIZATION - CENTURA HEALTH CORPORATION, TYPE OF COMPENSATION - WAGES AND BENEFITS A COLORADO HEALTH FACILITIES AUTHORITY 840752932 000000000 2013-12-19 17225000 REFUND SERIES 2003 & PORTION OF 2006A BONDS false false false B COLORADO HEALTH FACILITIES AUTHORITY 840752932 000000000 2006-06-12 40000000 HOSPITAL CONSTRUCTION & EQUIPMENT false false false A 6400000 17225000 150832 170741169 0 2013 true false true true B 15885000 40000000 652846 174400 39172754 2008 false false true true A false true true true false 0.0 false false true B false true true true false 0.0 false false true A false false false false false false false false true B false true false false false false true A true B true Schedule K, Part III, Line 7 Bonds - 2006A and 2013A LONGMONT MONITORS THE PRIVATE BUSINESS USE PERCENTAGE FOR EACH BOND ISSUE, AND THEREFORE HAS NOT CALCULATED THE AMOUNT OF PRIVATE PAYMENTS . BECAUSE LONGMONT HAS NOT CALCULATED THE AMOUNT OF PRIVATE PAYMENTS, SOLELY FOR SCHEDULE K REPORTING PURPOSES, WE HAVE ASSUMED THAT THE PRIVATE PAYMENT TEST HAS NOT BEEN MET. Schedule K, Part IV, Line 2c COLUMN B Issuer name: COLORADO HEALTH FACILITIES AUTHORITY The calculation for computing no rebate due was performed on 01/15/2016 Form 990, Part III, Line 1 MISSION STATEMENT THE MISSION OF THE CORPORATION IS TO NURTURE THE HEALING MINISTRY OF THE CHURCH, SUPPORTED BY EDUCATION AND RESEARCH. FIDELITY TO THE GOSPEL URGES THE CORPORATION TO EMPHASIZE HUMAN DIGNITY AND SOCIAL JUSTICE AS IT CREATES HEALTHIER COMMUNITIES. THE CORPORATION, SPONSORED BY A LAY-RELIGIOUS PARTNERSHIP, CALLS OTHER CATHOLIC SPONSORS AND SYSTEMS TO UNITE TO ENSURE THE FUTURE OF CATHOLIC HEALTH CARE. TO FULFILL THIS MISSION, THE CORPORATION, AS A VALUES-BASED ORGANIZATION, WILL ASSURE THE INTEGRITY OF THE MINISTRY IN BOTH CURRENT AND DEVELOPING ORGANIZATIONS AND ACTIVITIES; RESEARCH AND DEVELOP NEW MINISTRIES THAT INTEGRATE HEALTH, EDUCATION, PASTORAL, AND SOCIAL SERVICES; PROMOTE LEADERSHIP DEVELOPMENT AND FORMATION FOR MINISTRY THROUGHOUT THE ENTIRE ORGANIZATION; ADVOCATE FOR SYSTEMIC CHANGES WITH SPECIFIC CONCERN FOR PERSONS WHO ARE POOR, ALIENATED, AND UNDERSERVED; AND STEWARD RESOURCES BY GENERAL OVERSIGHT OF THE ENTIRE ORGANIZATION. Form 990, Part VI, Line 15 PROCESS USED TO ESTABLISH COMPENSATION OF CEO & OTHER OFFICERS THE CEO OF LONGMONT HOSPITAL IS COMPENSATED BY CENTURA HEALTH CORPORATION, WHO MANAGES THE DAILY ACTIVITIES OF THE HOSPITAL UNDER A JOINT OPERATING AGREEMENT BETWEEN THE ADVENTIST HEALTHCARE SYSTEM AND CATHOLIC HEALTH INITIATIVES. AS SUCH, THEIR SALARIES ARE PAID TO THEM BY CENTURA, AN UNRELATED ORGANIZATION, FOR SERVICES RENDERED IN THEIR CAPACITY AS OFFICERS OF THE HOSPITAL. ALL OF THEIR REPORTABLE COMPENSATION IS DISCLOSED IN FULL ON FORM 990, SCHEDULE J, PART II, ROW (I) AND FORM 990, PART VII, COLUMN (D) AS REPORTING ORGANIZATION COMPENSATION (REGARDLESS OF WHETHER THEY PERFORM SIMILAR DUTIES AT ANOTHER FACILITY) OUTSIDE CONSULTANTS ARE ENGAGED TO PROVIDE RECOMMENDATIONS TO CENTURA'S COMPENSATION COMMITTEE REGARDING THE COMPENSATION OF FACILITY CEOS AND CENTURA EXECUTIVES, SUCH AS THE CFO. THE CONSULTANT'S RECOMMENDATIONS ARE THEN PRESENTED TO AND APPROVED BY THE COMPENSATION COMMITTEE. CENTURA'S HUMAN RESOURCES DEPARTMENT PERFORMS AN ANNUAL ANALYSIS OF THE MARKET TO DETERMINE COMPENSATION RANGES FOR THE REMAINDER OF CENTURA EXECUTIVES WHICH ARE REVIEWED AND APPROVED BY CENTURA'S SENIOR LEADERSHIP. Form 990, Part VI, Line 1a Delegate broad authority to a committee THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRPERSON OF THE BOARD, AS CHAIRPERSON, THE VICE-CHAIRPERSON, THE TREASURER, THE SECRETARY, THE ASSISTANT SECRETARY-TREASURER, AND THE PRESIDENT AND CEO. THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS AND OTHER CONFIDENTIAL MATTERS OF THE HOSPITAL DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT ANY ACTION TAKEN SHALL NOT CONFLICT WITH POLICIES AND EXPRESSED WISHES OF THE BOARD OF DIRECTORS, THAT THERE ARE AT LEAST THREE (3) AFFIRMATIVE VOTES TO INITIATE ANY ACTION, AND ALL MATTERS OF MAJOR IMPORTANCE SHOULD BE REFERRED TO THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL REVIEW PROPOSALS AND ADVISE, AS NECESSARY, REGARDING PLANNING AND DEVELOPMENT OF THE HOSPITAL PHYSICAL PLANT, PROGRAMS, AND SERVICES. IT SHALL ALSO BE THE RESPONSIBILITY OF THE EXECUTIVE COMMITTEE TO NOMINATE CANDIDATES FOR OFFICERS AND MEMBERS OF THE BOARD WHEN VACANCIES ARE TO BE FILLED. SUCH NOMINATIONS FOR CANDIDATES SHALL BE SUBMITTED IN WRITING TO THE SECRETARY OF THE BOARD AT LEAST THIRTY (30) DAYS PRIOR TO THE DATE OF THE MEETING AT WHICH CANDIDATES SHALL BE ELECTED. SPECIFICALLY, THIS COMMITTEE SHALL BE RESPONSIBLE FOR THE ANNUAL PERFORMANCE EVALUATION OF THE PRESIDENT AND CEO. THIS COMMITTEE, MINUS THE PRESIDENT AND CEO, WILL ALSO SERVE AS THE EXECUTIVE COMPENSATION COMMITTEE. THIS COMMITTEE SHALL MEET AT LEAST QUARTERLY. Form 990, Part VI, Line 11b Review of form 990 by governing body A DRAFT OF THE FORM 990 IS REVIEWED BY MANAGEMENT AND MADE AVAILABLE TO THE TOP FINANCIAL OFFICIAL FOR CONSIDERATION AND REVIEW PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy 1.1 CONSISTENT WITH CENTURA INTEGRITY STANDARDS, IT IS POLICY THAT EACH BOARD OF TRUSTEE MEMBER, CORPORATE OFFICER, AND KEY EMPLOYEE ACT AT ALL TIMES IN A MANNER THAT IS CONSISTENT WITH CENTURA'S MISSION AND VALUES BASED SERVICE TO THE COMMUNITY AND EXERCISE CARE THAT HE OR SHE DOES NOT HAVE ANY PERSONAL INTEREST WHICH MIGHT CONFLICT WITH OR APPEAR TO CONFLICT WITH THE INTEREST OF CENTURA OR WHICH MIGHT INFLUENCE THEIR JUDGMENT OR ACTIONS IN PERFORMING THEIR DUTIES. 1.1.1 IN CONNECTION WITH AN ACTUAL OR POSSIBLE TRANSACTION OR ARRANGEMENT INVOLVING CENTURA, ANY BOARD MEMBER, CORPORATE OFFICER, OR KEY EMPLOYEE WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST MUST DISCLOSE AND BE GIVEN THE OPPORTUNITY TO SHARE ALL MATERIAL FACTS WITH THE BOARD CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. 1.1.2 BOARD MEMBERS, CORPORATE OFFICERS, AND KEY EMPLOYEES ARE ALSOREQUIRED TO DISCLOSE ANY POSSIBLE CONFLICTS ON AN ANNUAL BASIS THROUGH THE CONFLICT OF INTEREST QUESTIONNAIRE. 2. PROCEDURE FOR DISCLOSING AND REVIEWING TRANSACTION OR ARRANGEMENT CONFLICT OF INTERESTS: 2.1 BOARD MEMBERS, CORPORATE OFFICERS, AND KEY EMPLOYEES THAT HAVE A FINANCIAL INTEREST IN ANY ACTUAL OR POSSIBLE TRANSACTION INVOLVING CENTURA ARE REQUIRED TO DISCLOSE THE FINANCIAL INTEREST. 2.1.1 IN ORDER TO DETERMINE IF A CONFLICT OF INTEREST EXISTS, THE INDIVIDUAL WHO IS CONSIDERED TO HAVE A FINANCIAL INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR BOARD COMMITTEE MEETING. AFTER SUCH PRESENTATION, THE INDIVIDUAL SHALL LEAVE THE MEETING FOR DISCUSSION AND A VOTE ON THE ISSUE. 2.1.2 AFTER EXERCISING DUE DILLEGENCE, THE BOARD OR BOARD COMMITTEE SHALL DETERMINE WHETHER CENTURA CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION WITH REASONABLE EFFORTS FROM ANOTHER PERSON OR ENTITY. IF A MORE ADVANTAGEOUS TRANSACTION IS NOT REASONABLY ATTAINABLE, THE BOARD OR BOARD COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED MEMBERS WHETHER THE TRANSACTION IS IN CENTURA'S BEST INTEREST AND IS FAIR. 3. PROCEDURE FOR DISCLOSING AND REVIEWING OTHER CONFLICT OF INTERESTS: 3.1 BOARD MEMBERS, CORPORATE OFFICERS, AND KEY EMPLOYEES SHALL ALSO DISCLOSE IN ADVANCE TO CENTURA LEADERS ANY NON-TRANSACTIONAL ACTIONS OR RELATIONSHIPS THAT HAVE THE POTENTIAL TO CREATE A CONFLICT OF INTEREST. 3.1.1 THE BOARD OR BOARD COMMITTEE SHALL CAREFULLY REVIEW AND SCRUTINIZE ANY CONFLICT OF INTEREST. BY A MAJORITY VOTE OF THE DISINTERESTED MEMBERS, THE BOARD SHALL TAKE WHATEVER ACTION IS DEEMED APPROPRIATE WITH RESPECT TO THE BOARD MEMBER, CORPORATE OFFICER, OR KEY EMPLOYEE UNDER THE CIRCUMSTANCES, INCLUDING POSSIBLE CORRECTIVE ACTION, IN ORDER TO BEST PROTECT THE INTERESTS OF CENTURA. 3.1.2 ON AN ANNUAL BASIS, BOARD MEMBERS, CORPORATE OFFICERS, AND KEY EMPLOYEES WILL ALSO BE SENT AN EMAIL REQUESTING THEY COMPLETE THE BOARD MEMBER AND CORPORATE OFFICER CONFLICT OF INTEREST QUESTIONNAIRE BY THE SPECIFIED DUE DATE IN THE EMAIL. 3.1.3 THE CORPORATE RESPONSIBILITY DEPARTMENT SHALL NOTIFY THE CHAIRPERSON OF THE BOARD OF ANY POTENTIAL CONFLICTS AND THE CHAIRPERSON, OR DESIGNEE, SHALL PERFORM FURTHER INVESTIGATION AS HE OR SHE DEEMS APPROPRIATE. 4. RECORD OF PROCEEDINGS: 4.1 THE MINUTES OF THE BOARD AND BOARD COMMITTEE SHALL CONTAIN: 4.1.1 THE NAMES OF PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST AND THE NATURE OF THE FINANCIAL INTEREST. 4.1.2 THE NAMES OF PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO ANY FINANCIAL INTEREST, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES, AND A RECORD OF THE BOARD OR BOARD COMMITTEE DECISION. 5. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY: 5.1 IF THE BOARD OR BOARD COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT AN INDIVIDUAL HAS FAILED TO DISCLOSE EITHER AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, OR ALL MATERIAL FACTS SURROUNDING AN ACTUAL OR POSSIBLE CONFLICT, THE INDIVIDUAL WILL BE GIVEN A CHANCE TO EXPLAIN. 5.1.1 AFTER HEARING THE RESPONSE, THE BOARD WILL CONDUCT SUCH ADDITIONAL INVESTIGATION AS APPROPRIATE. IF THE BOARD DETERMINES THAT THE INDIVIDUAL HAS IN FACT FAILED TO DISCLOSE AS REQUIRED BY THE CONFLICT OF INTEREST POLICY, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTION. Form 990, Part VI, Line 19 Required documents available to the public The organization's financial statements, conflict of interest policy and governing documents are available to the public upon request. The organization's financial statements are included in COMMONSPIRIT HEALTH's consolidated audited financial statements that are available at commonspirit.org. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Ortho Incentive Revenue - Total Revenue: 72562, Related or Exempt Function Revenue: 72562, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Hospital Based Massage - Total Revenue: 103143, Related or Exempt Function Revenue: 103143, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; CHER - Total Revenue: 242802, Related or Exempt Function Revenue: 242802, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Education Revenue - Total Revenue: 13297, Related or Exempt Function Revenue: 13297, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; CHPG Incentive Revenue - Total Revenue: 256124, Related or Exempt Function Revenue: 256124, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Purchase Discounts - Total Revenue: 15791, Related or Exempt Function Revenue: 15791, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Miscellaneous Revenue - Total Revenue: 108844, Related or Exempt Function Revenue: 108844, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Health Club Membership - Total Revenue: 24608, Related or Exempt Function Revenue: 24608, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Integrated Medicine - Total Revenue: 435133, Related or Exempt Function Revenue: 435133, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Gift Shop - Total Revenue: 147420, Related or Exempt Function Revenue: 147420, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees Contract Labor & Regional Pool - Total Expense: 1891292, Program Service Expense: 1891292, Management and General Expenses: , Fundraising Expenses: ; PHYSICIAN FEES - Total Expense: 7499223, Program Service Expense: 7230861, Management and General Expenses: 268362, Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 16688288, Program Service Expense: 15119296, Management and General Expenses: 1568992, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances TRANSFERS TO AFFILIATES - -3381410; Schedule J, Part II COMPENSATION FROM AN UNRELATED ORGANIZATION OR INDIVIDUAL NAME - WARREN LAUGHLIN, COMPENSATION FROM UNRELATED ORGANIZATION - 204091.040000, NAME OF UNRELATED ORGANIZATION - CHI COLORADO, TYPE OF COMPENSATION - WAGES AND BENEFITS LONGMONT UNITED LAND HOLDING LLC 1950 W MOUNTAIN VIEW AVE LONGMONT CO 80501 841554099 REAL ESTATE CO 202169 59353215 LUH LE DEAUVILLE LLC 1950 W MOUNTAIN VIEW AVE LONGMONT CO 80501 204781464 RENTAL CO 0 1123297 LUH MILESTONE MEDICAL GROUP 1950 W MOUNTAIN VIEW AVE LONGMONT CO 80501 383842918 MEDICAL SERVICES CO 4111735 24332201 LUH CARBON VALLEY HEALTHCARE HOLDINGS CORPORATION 1950 MOUNTAIN VIEW AVENUE LONGMONT CO 80501 273769602 LAND HOLDING COMPANY CO 501(c)(3) 3 NA true Longmont United Hospital Foundation 1950 Mountain View Avenue Longmont CO 80501 840852084 FUNDRAISING CO 501(c)(3) 5 NA true TWIN PEAKS MEDICAL IMAGING LLC 1950 WEST MOUNTAIN VIEW AVE LONGMONT CO 80501 731656489 IMAGING CO LUH Related 913 5775 false true 0.5 LUH ORTHOPEDIC AND SPINE CO-MANAGEMENT COMPANY LLC 1950 W MTN VIEW AVE LONGMONT CO 80501 454432224 MANAGEMENT SERVICES CO LUH Related 142261 53121 false false 0.3846 UNITED MEDICAL BLDG CONDOMINIUM ASSOC 1950 WEST MOUNTAIN VIEW AVE LONGMONT CO 80501 841526130 CONDO ASSOCIATION CO LUH C Corporation 0 419571 0.9178 true false false false false false false false false false false false true true true true true true false true