2018-11-14T16:07:38-07:00 2017-12-31 990 2017-01-01 840175870 Boulder Community Health BOUL 3034155220 PO Box 9019 Boulder CO 803019019 William A Munson Jr CFO & Vice President 3034157433 2018-11-14 69.161.206.5 2017 2019-02-21 02:37:17Z Boulder Community Hospital Robert J Vissers President and CEO PO Box 9019 Boulder CO 803019019 928751968 0 X www.bch.org X 1922 CO Partnering to create and care for the healthiest community in the nation. 15 13 2954 504 2764929 0 2939283 3065359 335907255 340882255 5777488 44012052 16642920 20098039 361266946 408057705 237942 259639 0 0 174150321 192489117 0 0 453948 161625680 178480045 336013943 371228801 25253003 36828904 689859299 731524575 267329257 264712333 422530042 466812242 To provide our community the highest value healthcare in an innovative, patient-centered environment. 0 0 272592562 259639 357790273 Health Care Delivery of IP and OP medical care. In 2017, the hospital discharged 8,069 adult & pediatric patients with an average length of stay of 4.3 days. 41,393 patients were seen in our ER facilities and 10,871 in Urgent Care. 5,424 surgeries were performed. The hospital had adjusted patient days of 83,578. 0 0 0 272592562 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 1 1 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 232 0 1 2954 1 1 1 0 0 0 0 0 0 0 0 0 X 15 13 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X Lisa Rogowski Controller 3034155220 PO Box 9019 Boulder CO 803019019 X Bryan Pieper Board Member 2 0 X 0 0 0 Janet Martin Chairman 4 0 X X 0 0 0 Dee Perry Vice Chairman 4 0 X X 0 0 0 Susan Graf Secretary 4 0 X X 0 0 0 Jeff Morgan Treasurer 4 0 X X 0 0 0 Randy Bjerke MD Board Member/Employed Intensivist 2.00 0 X 38350 0 1879 Mako Shimoda MD Board Member 2 0 X 0 0 0 Steve Fries MD Board Member 2 0 X 0 0 0 Harold Flowers Board Member 2 0 X 0 0 0 Benita Duran Board Member 2 0 X 0 0 0 Suzy Ageton Board Member 2 0 X 0 0 0 Robert J Vissers Exec Director/CEO 40 0 X X 708363 0 205870 Rhonda Wallen Board Member 2 0 X 0 0 0 Phil DeStefano Board Member 2 0 X 0 0 0 George Karakehian Board Member 2 0 X 0 0 0 Paul Kenneth Lewis Jr VP & Chief Medical Officer 40 0 X 451104 0 94373 William A Munson Jr VP & CFO 40 0 X 354868 0 88005 Jacqueline M Attlesey-Pries VP , Chief Nursing Officer & Chief Operating Officer 40 0 X 351589 0 86494 Sarah E Meshak VP & General Counsel 40 0 X 286437 0 67628 Jamie D Jensen VP & Chief Population Health Officer 40 0 X 294152 0 65608 Michael J Jefferies VP & Chief Information Officer 40 0 X 284695 0 65151 Grant Besser Foundation President 0 40 X 188429 0 31475 Bryan Mahan Physician 40 0 X 880371 0 28180 Sameer A Oza Physician 40 0 X 717950 0 34182 Nelson P Trujillo Jr Physician 40 0 X 711577 0 33702 John A Schutz Physician 40 0 X 683012 0 36068 Charles Jones Physician 40 0 X 1246086 0 261437 Linda S Minghella VP & Chief Information Officer (former) 0 0 X 117141 0 0 7314124 0 1100052 246 1 1 0 Favorite Healthcare Staffing Inc PO Box 803356 Kansas City MO 641803356 agency nursing services 3065039 Boulder Emergency Physicians CarePoint PC 5600 S Quebec St Suite 312 A Greenwood Village CO 80111 CMC Emergency Room Coverage 1535090 Boulder Neurosurgical Assoc PLLC 4743 Arapahoe Ave Suite 202 Boulder CO 80303 trauma call 1333765 Boulder Valley Anesthesiology LLC c/o Wendll Walker & Assoc 1420 28th St Ste 100 Boulder CO 80303 Anesthesiology coverage 1001250 Courier Ventures DBA Action Stat Logistics 2032 35th Ave Suite A 104 Greeley CO 80634 Courier services 1001250 30 0 3335 0 2666870 386975 8179 0 3065359 Acute Care Hospital 622000 338395222 338286136 0 109086 Lab Service Revenue 621500 2487033 0 2487033 0 0 0 0 0 340882255 6645572 0 0 6645572 34985 0 0 34985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557817545 113572 520386506 213116 37431039 -99544 37331495 -99544 0 37431039 0 0 0 0 0 0 11240 436 10804 0 0 10804 148838 94205 54633 0 0 54633 Hospital Care Joint Ventures 621400 7172975 7172975 0 0 Misc Hospital Revenue 622000 12859627 12430706 277896 151025 0 0 0 0 20032602 408057705 357790273 2764929 44437144 167072 167072 87432 87432 5135 5135 0 0 3538375 29072 3279701 229602 0 0 0 0 150473113 113348319 36987645 137149 11291562 5076385 6215177 0 17061409 13523014 3504072 34323 10124658 7362372 2739441 22845 2767076 296762 2470314 0 262832 0 262832 0 92375 -6120 98495 0 13357 13357 0 0 0 0 333530 0 333530 0 23504053 18715254 4788799 0 984452 0 984452 0 5377326 2956700 2412717 7909 9868833 507263 9361570 0 0 0 0 0 8006573 4637197 3362176 7200 495020 207066 287954 0 0 0 0 0 301276 114020 187256 0 4479747 1962129 2517618 0 0 0 0 0 18608047 6916787 11682112 9148 1701433 1701433 0 0 Medical Supplies 53789463 53535254 254097 112 Repairs and Maintenance 6320933 4140061 2180722 150 Medicaid Provider Fee 19687533 19687533 0 0 Provision for Bad Debt 16062569 16062569 0 0 5823617 1546496 4271611 5510 371228801 272592562 98182291 453948 17878 291182 14383673 408897 0 0 47613011 45608961 0 0 0 0 0 0 3073782 3692934 6250212 5755202 397411881 162333378 224794715 235078503 240781362 367188689 101843185 12869172 4541047 5174473 209746 164326 46350688 55292236 689859299 731524575 42227215 48105693 0 0 0 0 173971658 161550892 0 0 0 0 0 0 72066 70000 51058318 54985748 267329257 264712333 X 387235977 426200786 28738751 32293404 6555314 8318052 422530042 466812242 689859299 731524575 X 36828904 2527215 0 0 0 4926081 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 13358 13358 0 Schedule C, Part II-B, Line 1 5.32% of dues paid to the Colorado Hospital Association are spent on lobbying activities, amounting to $$4,512.99. 22.98% of dues paid to the American Hospital Association are spent on lobbying activities, amounting to $8,844.77. 35294066 4976709 4478339 0 4150607 0 40598507 33808649 4348700 1349134 0 4212417 0 35294066 35750843 2706467 -402645 0 4119616 0 33935049 34604553 4337617 1664839 0 4856166 0 35750843 31318621 3221343 4678434 0 4613845 0 34604553 0 0.2 0.8 0 1 1 0 20151649 20151649 0 208309230 71125385 137183845 0 3145884 939586 2206298 0 149394376 90268407 59125969 0 16410742 0 16410742 235078503 Interest in Net Assets held by Foundation 40391511 Unamortized Swap Fees 86296 Unamortized BIC 1074155 Deferred Comp Investments 8673924 Deposits 3016 Misc Other A/R 5063334 55292236 0 Accrued Pension Liability 46111126 Deferred Compensation Liability 8874622 54985748 397595469 2527215 0 0 -12364558 -9837343 407432812 333530 291363 624893 408057705 349717351 0 0 0 0 0 349717351 333530 21177920 21511450 371228801 Schedule D, Part V, Line 4 Boulder Community Hospital Foundation, a related organization, holds permanent endowment funds. The income earned on these endowment funds is used to support hospital programs for diabetes, cancer, neonatology, heart and surgery center, healthcare scholarships, or for the foundation to direct if the endowment fund does not restrict how the income is to be spent. Temporarily restricted funds held by the Foundation include funds for the new Foothills medical office facilities, cancer center, as well as other hospital programs. Any Unrestricted funds held at the Foundation are for the hospital, but designation is decided by the Foundation board when granting to the hospital. Schedule D, Part XI, Line 2d Other of -12,364,558 included in tax return revenue but not in audited revenue includes Bad Debt Provision of -$16,062,569 + Change in Foundation Net Assets of $5,378,512 + Change in minimum pension liability of -$212,798 + Amortization of Effective Loss on Swap of -239,635 + Other Expenses shown net in FS rev and Gross in Tax return of -$1,299,091 + Ambassador component of Temp Rest Net Assets of $71,022. Schedule D, Part XI, Line 4b Other of $193,650 = Foundation In-Kind Gifts of $116,700 , Other cash from Foundation of $97,712 and Ambassador net revenues reflected as Restricted Contributions in Audit of $76,951. Schedule D, Part XII, Line 4b Other expenses of $21,177,920 included on TR but not on Audit = Bad Debt provision of $16,062,569 + Other non-op expenses shown in net revenue on audit of $1,299,091 + Ambassador expenses reflected as Restricted Contribution in Audit of $5,928 + Foundation Gifts In-Kind of $116,699 + Foundation Other cash of $97,712 + Non-Op Expenses for pension contributions of $3,595,920. 1 Central America and the Caribbean 0 0 Program Services The hospital participated in a medical mission to Haiti. 5135 Central America and the Caribbean 0 0 Investments Passive investments in Cayman Islands 13117442 Europe (including Iceland and Greenland) 0 0 Investments Passive investments in Ireland 23069 0 0 13145646 Central America and the Caribbean Medical mission to Haiti 0 5135 Airfare and medical supply expenses Cost 1 0 1 0 1 1 0 0 Schedule F, Part I, Line 2 The hospital participated in a medical mission to Haiti. The costs associated with this mission are stated by cost for various airfare and medical costs. 1 1 X 1 X 2.5 1 X 1 1 1 0 0 4684844 1611288 3073555 0.008 55844527 33111938 22732589 0.062 0 0 0 60529371 34723226 25806144 0.070 391254 62670 328284 0.001 318116 0 318116 0.001 567489 0 567489 0.002 0 0 1276859 62670 1213889 0.004 0 0 61806230 34785896 27020033 0.074 7778 7778 0 56975 56975 0 178059 178059 0 0 0 242812 0 242812 0 1 16211028 1 62317248 92152287 -29835039 X 1 1 Boulder Community Musculoskeletal Surgery Center LLC Outpatient Orthopedic Surgery Center 0.5 0 0.5 Endoscopy Center of the Rockies LLC Outpatient Endoscopy Center 0.5 0 0.5 Boulder MRI LLC outpatient MRI center 0.51 0 0.49 Foothills Surgery Center LLC Ambulatory Surgical Center 0.51 0 0.49 Riverbend Sleep LLC Property ownership and lease to Approved Entities 0.5 0 0.5 1 1 Boulder Community Foothills Hospital 4747 Arapahoe Avenue Boulder CO 80303 www.bch.org 010323 X X X Boulder Community Foothills Hospital 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X www.bch.org X 1 17 1 https://www.bch.org/documents/CHNA-Implementation-Strategy.pdf 0 0 1 X 250 400 X X X X X 1 1 X X X X 1 X See H, Part V, Section C X See H, Part V, Section C X See H, Part V, Section C X X X X X X 1 X 0 X X X X 1 X 1 0 Schedule H, Part V, Section B, Line 5-Boulder Community Foothills Hospital Please refer to pages 7 through 10 of the 2017-2019 CHNA. Schedule H, Part V, Section B, Line 7a-Boulder Community Foothills Hospital https://www.bch.org/documents/bch-community-health-needs-assessment-final-august-26-2016.pdf Schedule H, Part V, Section B, Line 11-Boulder Community Foothills Hospital BCH and its Board of Directors, is continually assessing the implementation of the CHNA through its strategic planning process. The strategies to address the community's health needs identified in the Hospital's 2017-2019 Community Health Needs Assessment and the activities undertaken by the Hospital as part of these strategies are as follows: 1. Chronic Disease Management . Chronic diseases and conditions such as heart disease, stroke, cancer, type 2 diabetes, obesity, and arthritis-are among the most common, costly, and preventable of all health problems. Chronic Disease Self-Management Support Groups, High Risk Patient Care Management and Registries, Diabetes and Pre-diabetes group classes and individual support are included within this commitment as well as RN Coordinators to educate and coach patients to better manage their chronic disease and to prevent complications. BCH hired its first ambulatory care pharmacist to focus on improving diabetes care and depression care for the community. To avoid readmissions back into the Hospital, BCH has two teams of transitional care nurses that provide education and support to our highest risk patients after a hospitalization and there is continuous collaboration across BCH departments and providers, community medical partners and agencies, skilled nursing facilities, and social support organizations to provide patients with coordinated care when and where they need it. BCH has continued to enhance the infrastructure of its transitional care program and coordinated patient care material across inpatient stays, specialties, and primary care so that all providers are teaching to the same material. 2. Mental Health. BCH has continued to expand our integrated behavioral health model into all of our 10 primary care clinics. This model adds social workers to address the behavioral health needs common in primary care, such as insomnia, anxiety, depression, and substance abuse. These licensed clinical social workers or masters of social work provide short term solution focused counseling, quick interventions for anxiety, depression and stress management. The practitioners perform depression screening and higher intensity follow up for newly diagnosed depressed patients. BCH primary care clinics are part of the State Innovation Model that is supporting advanced primary care and behavioral health integration across Colorado. Within this program, five primary clinics are in Cohort level 3 and five clinics are in Cohort level 1. Boulder Community Health is an active participant in a "Community Mental Health Initiative" to improve care with Mental Health Partners (MHP), the county's largest provider of mental health care. This effort includes the development of a "care compact" agreement between MHP and BCH Primary Care to improve communication about shared patients for the purpose of diagnosis, treatment recommendations and care continuity. BCH is the only provider of both inpatient and outpatient mental health services within Boulder County The new 70,000 s.f. BCH Riverbend building is now called the DellaCava Family Medical Pavilion and is nearing completion. The $40 million building includes an 18 bed inpatient behavioral health unit and outpatient behavioral therapy clinic in a beautiful new environment. The building is slated for completion in the first quarter of 2019. In addition, Boulder Community Health Foundation announced its intention to establish a $2 million endowment for mental health which will be used to enhance care. 3. Chronic Pain Management and Substance Abuse. Opioid deaths , meaning deaths from prescription painkillers or illegal opiates like heroin, have been climbing year-over-year in Colorado since at least 2000. BCH now has embedded Advanced Practice Clinicians within all of its 10 primary care clinics and has trained practitioners in Medication Assisted Treatment (MAT) techniques that reduce the use of opioids. In addition to its work within primary care, BCH enrolled in the Colorado Opioid Safety Pilot, a high-profile initiative intended to combat the national opioid epidemic by reducing the administration of opioid medications in emergency departments. Foothills Hospital was one of just 10 emergency departments across the state chosen to participate in a study that ran from June through November 2017. During that time, our ED and Community Medical Center ED staff utilized new treatment guidelines developed by the Colorado Chapter of the American College of Emergency Physicians that included specific recommendations for using alternatives to opioids (ALTOs) as the first option for treating pain rather than opioids with a goal of 15% reduction. BCH achieved a 32.9% reduction during the pilot. 4. Wellness and Preventative Health (including aging of the population and access to care). Our population health approach is focusing on our total panel of patients to address patients who have not been seen or have routine screening and preventive care services that need to be addressed. We have specific programs in place to improve Influenza Vaccination rates, HPV vaccination rates using data transparency, retina screening to assist in detecting diabetes, and process improvement to increase rates of screening examinations with the goal of beating national benchmarks. The Hospital is leading various programs such as the Walk with a Doc, which couples a healthy walk around various locations in the community with current health topics, blood pressure screenings, and healthy food. This partnership with the community serves to promote exercise and overall health to community members. Partners include City of Boulder Parks and Recreation, Area Agency on Aging, Boulder County Public Health, and the Boulder Valley School District. Programs particular to child and teen safety include education partnering with Lake Eldora Ski Race team, Emergency Family Assistance Association (Boulder), Community Cycles Kids and Adult Cycling Programs, and Boulder Valley School District. New programs include ThinkFirst (concussion awareness and injury prevention), distracted driving awareness and training, and Brain Injury Resource Team (BIRT). BCH assists adults and seniors through partnership with the City of Boulder Senior Services (Area Agency on Aging), Boulder Fire, and others in fall prevention day and other onsite programs at retirement communities. 800 bicycle helmets and 1200 medical identification tags were donated. Regular outreach to patients who have identified gaps in their care are performed electronically via a website portal, by phone call, or mail. During fire and poor air quality seasons, BCH staff reach out to respiratory compromised patients to assess needs for additional care. STOP the Bleed, a National evidence based program teaches laypersons to initiate lifesaving assistance to injured community members and BCH has led this educational program. The following areas of care within the organization have received significant resources to provide necessary care for our aging population: Heart and Lung Disease, Surgical Services, Joint Replacement, Palliative Care, and Home Visits. BCH has recently added another pulmonologist, a cardiac heart failure specialist, a cardiac structural heart specialist, and a second cardiac surgeon. BCH additionally added programs for TAVR and WATCHMAN implantation to better treat cardiac disease conditions. The Hospital has provided greater access to Health Care by expanding Hours of Service in all primary clinics and all family practice clinics having Saturday hours. BCH has also expanded the number of same day/next day appointments in all of its clinics and added an after-hours nurse triage line which allows 24x7 access to a nurse. A major scheduling change within our clinics increased the number of appointments dramatically, which has decreased wait times and allowed greater access to care. BCH opened an urgent care clinic in Superior which is coupled with a family medicine practice and in Erie, a medical office building which will have urgent care, specialty care, primary care, imaging and specimen collection is in the final phase of construction and will open in 2019. The hospital is partnering with the Community Foundation and other community partners including other hospitals, Clinica, Salud, housing, dental aid, Mental Health Partners, and Boulder County Health to improve access to specialists for patients with Medicaid under the Boulder County Health Improvement Collaborative (BCHIC). In addition to providing a significant sponsorship to the initiative, BCH spearheaded a specialty referral project for the Medicaid population which added 100 specialist appointments per month. Finally, BCH provides support through sponsorships and in-kind donations for community organizations that provide or participate in first order provision of health care in our community. Schedule H, Part V, Section B, Line 16a-Boulder Community Foothills Hospital https://www.bch.org/documents/Pay-My-Bill/fin-assist-patient-payment-resp-2015-2016.pdf Schedule H, Part V, Section B, Line 16b-Boulder Community Foothills Hospital https://www.bch.org/documents/Pay-My-Bill/Fin-Assis-Appl-English-2015.pdf Schedule H, Part V, Section B, Line 16c-Boulder Community Foothills Hospital https://www.bch.org/documents/Pay-My-Bill/BCH-Billing-Brochure-2017-v1.pdf Schedule H, Part V, Section B, Line 23-Boulder Community Foothills Hospital The hospital identified 7 instances where FAP-eligible patients were billed more that the amounts generally billed (AGB) to individuals who had insurance covering such care. Refunds of any payment in excess of the AGB were made to these patients in December, 2017. A multi-disciplinary team is meeting periodically to ensure compliance with 501r requirements and BCH procedures. 37 BCH Behavioral Health DPU 1100 Balsam Avenue Boulder CO 80304 Psych DPU BCH Rehabilitation DPU 1100 Balsam Avenue Boulder CO 80304 Rehab DPU Community Medical Center 1000 W South Boulder Road Lafayette CO 80026 Urgent-care center BCH at Boulder Medical Center 2750 Broadway Boulder CO 80304 laboratory and imaging services Boulder Community Musculoskeletal Surgery LLC 1136 Alpine Avenue Boulder CO 80304 Ambulatory Surgical Center Endoscopy Center of the Rockies in Lafayette 1000 W South Boulder Road Suite 202 Lafayette CO 80026 Endoscopic Ambulatory Surgery Center Endoscopy Center of the Rockies in Boulder 1755 48th Street Suite 110 Boulder CO 80303 Endoscopic Ambulatory Surgical Center Endoscopy Cener of the Rockies in Longmont 1551 Professional Lane Suite 295 Longmont CO 80501 Endoscopic Ambulatory Surgical Center Boulder MRI LLC 1000 W South Boulder Road Suite 105 Lafayette CO 80026 MRI Imaging Center Foothils Surgery Center LLC 4743 Arapahoe Avenue Suite 101 Boulder CO 80303 Ambulatory Surgical Center Boulder Heart 4743 Arapahoe Avenue Suite 201 Boulder CO 80303 Physician clinic Boulder Heart Lafayette 1000 W South boulder Road Suite 216 Lafayette CO 800262089 Physician clinic Boulder Heart Longmont 2101 Ken Pratt Blvd Suite 104 Longmont CO 805016568 Physician clinic Internal Medicine Associates 1155 Alpine Unite 360 Boulder CO 80304 Physician clinic Internal Medical Associates Foothills 4820 Riverbend Rd Boulder CO 80301 Physician clinic Boulder Valley Surgical Associates 4743 Arapahoe Avenue Boulder CO 80303 Surgical services Boulder Valley Pulmonology 1155 Alpine Unit 150 Boulder CO 80304 Physician clinic CU Sports Medicine and Performance Center 2150 Stadium Drive Second Floor Boulder CO 80309 outpatient sports medicine clinic Boulder Community Health Sports Medicine Imaging LLC 2150 Stadium Drive Boulder CO 80309 Imaging IDTF Beacon Clinic 4800 Riverbend Rd Boulder CO 80301 Infectious Disease Clinic Boulder Community Health Sleep Diagnostice 4895 Riverbend Rd Boulder CO 80301 Sleep study center Sleep Fit 13654 Xavier Lane Suite 210A Broomfield CO 80020 Sleep study center Internal Medical Associates of Lafayette 1000 W South Boulder Rd Suite 214 Lafayette CO 80026 Physician clinic Buffalo Ridge Medical Center 16677 Lowell Blvd Broomfield CO 80023 Physician clinic Center for Integrative Care 4715 Arapahoe Unit 100 Boulder CO 80303 Outpatient integrative care for cancer patients Broomfield Imaging 36 Garden Center Broomfield CO 80020 Laboratory and imaging services Frontier Internal Medicine 2101 Ken Pratt Blvd Ste 104 Longmont CO 80501 Physician clinic Holistic Family Practice 1155 Alpine Avenue Suite 360 Boulder CO 80304 Physician clinic Northwest Family Medicine 500 Discovery Parkway Suite 150 Superior CO 80027 Physician clinic Family Medical Associates 1000 W South Boulder Rd Suite 110 Lafayette CO 80026 Physician clinic Spruce Street Internal Medicine 2575 Spruce Street Boulder CO 80302 Physician clinic Boulder Creek Family Medicine 1755 48th St Suite 200 Boulder CO 80303 Physician clinic Associated Neurologists of Boulder 1155 Alpine Suite 180 Boulder CO 80304 Physician clinic Boulder Community Hospital Occupational Medicine 4745 Arapahoe Ave Suite G40 Boulder CO 80303 Occupational medicine clinic Dakota Ridge Medical Center 2995 Baseline Road Suite 210 Boulder CO 80303 Physician clinic Gunbarrel Medical Center 6685 Gunpark Drive Suite 110 Boulder CO 80301 Physician clinic BMC East Laboratory 80 Health Park Dr Louisville CO CO 80027 Laboratory draw station Schedule H, Part I, Line 7 The costing methodology used for Part 1, Lines 7a and 7b, is the Worksheet 2 Ratio of Patient Care Cost -to-Charges. The costs for Lines e, 7f and 7i are directly identifiable costs from our internal accounting records. Schedule H, Part I, Line 7, Column f 16,062,569 Schedule H, Part II Community Support Activities include diaster readiness training in conjunction with numerous local agencies (fire, police, sheriff, other counties, other hospitals) to ensure coordinated and effective response to a disaster. Coalition building includes the hospitals participation in the development of the Colorado Regional Health Information Organization (CORHIO) and Boulder County Health Improvement Collaborative (BCHIC), which are both electronic health exchanges aimed at promoting effective and efficient health care delivery as well as information for community health assessments. BCHIC also helps underinsured and uninsured patients in the county obtain specialist care. Workforce development includes physician recruitment expense. Boulder is a Medically Underserved Area for low income and Medicare. Schedule H, Part III, Section A, Line 2 The amount reported on Line 2 as bad debt is the actual balance on account written off to bad debt. It is not reduced to cost, since our system does not track what is a gross charge write-off versus what is a patient responsibility write -off after insurance and insurance discounts have been recognized. Schedule H, Part III, Section A, Line 3 The hospital does not have a mechanism to estimate the amount of bad debt cost that would reasonably relate to patients who would qualify for financial assistance under the hospital's financial assistance policy, but for whom sufficient information was not obtained to make a determination of their eligibility. However, surely there are significant bad debts that would qualify for charity if the patient had submitted FAP information. Schedule H, Part III, Section A, Line 4 Page 10 and 11 of the audited financial statements contain Note 2(f) which describes the significant accounting policies related to Patient Accounts Receivable. Schedule H, Part III, Section B, Line 8 100% and more of Line 7 Medicare shortfall should be treated as community benefit. Boulder County has a demonstrated community need for physicians who accept Medicare. (Many physician providers do not.) The hospital not only serves the Medicare population for hospital services, it also employs numerous primary care, internal medicine, surgeons, pulmonology and cardiology providers who accept Medicare in order to provide our community with adequate coverage. The Cost Report shortfall reported on Line 7 excludes Medicare HMO enrollee shortfalls, excludes shortfalls from ancillary procedures which are paid by fee schedule and are therefore not included in the Cost Report, and excludes the shortfall related to employed physicians serving the Medicare population. The hospitals total Medicare shortfall, including these programs, is actually $39,923,190. The source for Line 6 is the filed Medicare Cost Report. Schedule H, Part III, Section C, Line 9b The hospital employs financial counselors to assist patients in determining eligibility for Medicaid, Colorado Indigent Care Program (CICP), or the hospital's charity program (WeCare). Financial arrangements with Emergency Room patients are not discussed until the patient has been assessed and treated in accordance with EMTALA. The hospital's debt collection policy contains a Communications section addressing courtesy, confidentiality, cultural sensitivity, and primary language of a patient. It contains a section on Billing and Collection Practices which addresses when an account will be referred to a licensed collection agency and that those agencies will treat all patients with dignity, compassion and respect, as well as adhering to Colorado State Laws and the Fair Debt Collection Act. BCH will not knowingly send a patient's bill to a collection agency if they have an application pending for either government -sponsored coverage or for financial assistance. Patients may apply/reapply for financial assistance before, during or after care, or after collection agency assignment. Schedule H, Part VI, Line 2 In 2010, a comprehensive facilities study was performed to evaluate each of the existing hospital campuses and determine the most efficient and effective methods of delivering the safest, highest quality health care. The Planning Committee uses the Community Health Needs Assessment, the Comprehensive Facilities study, as well as market and demographic studies to ensure BCH meets the future health care needs of our community. BCH is in the midst of a 10 year transitional strategy to consolidate health care delivery in order to meet the needs of the community in a safe and sustainable manner. As of October, 2014 all acute care inpatient services have been consolidated at the Foothills campus. BCH is constructing a new facility adjacent to the Foothills hospital to move Behavioral Health services, and is expected to complete this facility in early 2019. Also BCH is planning on partnering with another provider to jointly provide Inpatient Rehabilitation services in Broomfield, CO, and is expected to open in mid 2019. Schedule H, Part VI, Line 3 The Hospital employs financial counselors to assist patients in determining eligibility for Medicaid, Colorado Indigent Care Program (CICP), or the Hospitals charity program (WeCare). The hospital employs Spanish speaking financial counselors and would utilize interpreter services for other languages. Financial Assistance programs are referenced in patient discharge information, billing statements, and on the hospitals web site. Schedule H, Part VI, Line 4 Please refer to pages 7 through 10 of the 2017-2019 CHNA. 1 Boulder County Fire Fighters Assoc Sunshine Fire Protection District PO Box 7461 Golden CO 80403 846000600 501(c)3 24000 0 FMV Support for local fire association Justin Parker Neurological Institute 4743 Arapahoe Ave Boulder CO 80303 263588986 501(c)3 10000 0 FMV To support education related to brain and trauma disorders Community Foundation 1123 Spruce St Boulder CO 80302 841171836 501(c)3 22000 0 FMV To support Boulder County collaborative services Boulder Valley School District 6500 E Arapahoe Ave Boulder CO 80303 846014683 501(c)3 0 73186 FMV Provide athletic trainer to school district To support high school athletics and help to reduce student athlete injuries 4 0 Assistance for IP rehab patients 8 4148 0 Cost Healthcare educational scholarships 20 42500 0 Cost Assistance with housing post-discharge for indigent patients 31 23089 0 Cost Assistance with food and transportation post-discharge for indigent patients 23 9364 0 Cost Assistance with RX post-discharge for indigent patients 60 0 8332 Cost Take home medications donated to indigent patients post-discharge Schedule I, Part I, Line 2 Grants are only made to non-profit organizations supporting our local community with health and welfare services. Grants in excess of $10,000 are specifically approved by the hospital board of directors during the budget process. The CEO has a discretionary budget allocation for which he may approve distributions less than $10,000. Monitoring of grants over $10,000 is done by having representation on their non-profit board. Scholarship applications for healthcare education are reviewed by a committee and payments are sent directly to the school on the student's behalf with a letter indicating the money should be returned to the hospital if the student does not register. X X X X X 0 1 0 0 0 0 0 1 0 Robert J Vissers Exec Director/CEO 603275 0 65500 0 39588 0 178553 0 28847 0 915763 0 65500 0 Paul Kenneth Lewis Jr VP & Chief Medical Officer 362947 0 47157 0 41000 0 74908 0 20995 0 547007 0 0 0 William A Munson Jr VP & CFO 253014 0 59854 0 42000 0 58088 0 31447 0 444403 0 0 0 Jacqueline M Attlesey-Pries VP , Chief Nursing Officer & Chief Operating Officer 270869 0 57034 0 23696 0 64921 0 23104 0 439624 0 0 0 Jamie D Jensen VP & Chief Population Health Officer 222318 0 47990 0 23845 0 46143 0 20740 0 361036 0 0 0 Sarah E Meshak VP & General Counsel 231064 0 28231 0 27152 0 58311 0 10643 0 355401 0 0 0 Michael J Jefferies VP & Chief Information Officer 240144 0 29169 0 15383 0 65151 0 1302 0 351149 0 0 0 Grant Besser Foundation President 171223 0 5871 0 11336 0 2194 0 29281 0 219905 0 0 0 Charles Jones Physician 881362 0 340724 0 24000 0 252244 0 10723 0 1509053 0 0 0 Bryan Mahan Physician 755694 0 70677 0 54000 0 2771 0 26939 0 910081 0 0 0 Sameer A Oza Physician 520388 0 161562 0 36000 0 7010 0 28702 0 753662 0 0 0 Nelson P Trujillo Jr Physician 544374 0 125203 0 42000 0 7010 0 28222 0 746809 0 0 0 John A Schutz Physician 522046 0 124966 0 36000 0 7010 0 31688 0 721710 0 0 0 Linda S Minghella VP & Chief Information Officer (former) 0 0 0 0 117141 0 0 0 0 0 117141 0 117141 0 Schedule J, Part I, Line 3 The Executive Committee of the Board serves as the compensation committee as specified by the bylaws of the hospital. The Executive Committee is comprised of the Chairman, Vice Chairman, Secretary , Treasurer, President/CEO and two at large members of the Board. The President/CEO does not participate in or vote on compensation matters related to his own compensation. The Executive Committee proposes an Executive Compensation Philosophy for approval by the board, which sets parameters for compensation of the CEO and the Vice Presidents. The Executive Committee (without the CEO) reviews the compensation and benefits of the CEO annually, subject to Board ratification. The CEO sets compensation for the Vice Presidents within the ranges established by the Compensation Philosophy. Compensation outside the approved ranges requires Executive Committee review and approval. The Executive Committee engages a consulting firm to provide comparative compensation studies for similarly qualified executives in functionally comparable positions at similarly situated organizations. Compensation study and performance review are considered in developing executive compensation decisions. Any benefits for executives beyond what is provided to all employees must be consistent with the Compensation Philosophy. All compensation-related meetings of the Executive Committee are formally documented. Schedule J, Part I, Line 4 Ln 4b--The hospital contributes to a nonqualified 457(f) plan for the benefit of its executive leadership. Participants include: Robert Vissers, Pres & CEO ($152,219 contributed, Paul Lewis Jr, VP & Chief Medical Officer ($52,945 contributed), , William Munson Jr, VP & CFO ($34,326 contributed), Sarah Meshak, VP & General Counsel ($35,362 contributed), Michael Jefferies, VP & CIO ($60,853 contributed), Jamie Jensen, VP & Chief Population Officer ($22,777 contributed), and Jacqueline Attlesey-Pries, VP ,COO & CNO ($57,911) contributed. Schedule J, Part I, Line 7 The hospital has an Incentive Compensation Plan for the President/CEO, Vice Presidents and Directors whereby a percentage of base salary is paid out if goals are met and if authorized by the Board of Directors. For the President/CEO, incentive goals are established each year by the Executive Committee. For Vice-Presidents, one-third of their incentive is based upon the Hospital meeting at least 85% of its budgeted net operating income before interest expense. One-third VP incentive is based on Safety goals and one-third is based on Performance Goals. The one-third financial goal for Directors is based on meeting their departmental financial targets, as well as a one-third safety goal and a one-third performance goal. A Colorado Health Facilities Authority 840752932 19648AVF9 2010-12-01 93535431 Foothills expansion; balance for debt refunding 0 0 0 B Colorado Health Facilities Authority 840752932 19648AZL2 2012-08-28 31748673 Foothills hospital expansion 0 0 0 C Colorado Health Facilities Authority 840752932 2014-12-30 30000000 acquiring,constructing & equipping Financed Facilities 0 0 0 A 29445000 310000 93716361 0 0 0 1080618 0 0 25180923 67458941 0 2014 1 0 1 1 B 2830000 0 31815214 0 0 0 452499 0 0 31362765 0 0 2014 0 0 1 1 C 0 0 30034171 4281548 0 0 153502 0 0 25599121 0 0 2018 0 0 0 1 A 0 0 1 1 0 0 0 0 0 1 0.00308 1 1 B 0 0 1 1 0 0 0 0 0 0 1 C 0 0 1 1 0 0 0 0 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 Schedule K, Part I, Column e-12/01/2010 93,535,431 Colorado Health Facilities Ln A(e) of $93,535,431 < Pt II Ln 3(A) of 93,716,361 by the cumulative trust fund interest income of $180,930. Schedule K, Part I, Column e-08/28/2012 31,748,673 Colorado Health Facilities Ln B(e) of $31,748,673 < than Pt II Ln 3(B) of 31,815,214 by the cumulative trust fund interest income of $66,541. Schedule K, Part I, Column e-12/30/2014 30,000,000 Colorado Health Facilities Authority Ln C(e) of $30,000,000 < Pt II Line 3(C) of 30,034,171 by the cumulative trust fund interest income of $34,171. Schedule K, Part II, Line 3-12/01/2010 93,535,431 Colorado Health Facilities Lines 4 through 12 > Ln 3 by 4,121 which is the amount transferred into the 2010 Cost of Issuance Bond Trust Account from the close-out of the 2003 Bond Fund. Schedule K, Part II, Line 11-12/01/2010 93,535,431 Colorado Health Facilities Other Spent Proceeds includes $14,546,298 to refund Series 1994B, $26,456,321 to refund Series 2003A and $26,456,321 to refund Series 2003B. Schedule K, Part IV, Line 2c-12/01/2010 93,535,431 Colorado Health Facilities Rebate calculation for Series 2010 performed by Kutak Rock Arbitrage Consulting LLC for the period 12/1/2010 to 10/01/2015, the end of the first five-year rebate calculation period. The report concludes that there is no arbitrage rebate liability as of 10/01/2015 and no federal reporting requirement. Schedule K, Part IV, Line 2c-08/28/2012 31,748,673 Colorado Health Facilities Rebate calculation for Series 2012 performed by Kutak Rock Arbitrage Consulting LLC for the period 08/28/2012 to 10/01/2016, the end of the first five-year rebate calculation period. The report concludes that there is no arbitrage rebate liability as of 10/01/2016 and no federal reporting requirement. Interface Communications Co Jeff Morgan, Boardmember, is a 75% owner of Interface Comm 102392 BCH paid Interface Communications for communications services 0 Form 990, Part VI, Section A, Line 4 Effective January 1, 2017, the Articles of Incorporation were revised to delete membership in the corporation. The corporation remains a nonprofit corporation, but without members, as permitted by Colorado law. Effective January 1, 2017 the Bylaws of the Organization were revised as follows: (1) removed the membership requirement; (2) deleted the compensation committee and assigned the duties of that committee to the Executive Committee; (3) created a governance committee charged with making officer and board member nominations and assuring appropriate governance structure; (4) provided for board adoption of executive compensation philosophy and ratification of CEO compensation as recommended by Executive Committee; (5) made minor changes to the processes for election of directors and officers. Form 990, Part VI, Section B, Line 11b Form 990 is prepared by the Controller based upon audited financial statements. The 990 is reviewed by the nonprofit tax manager of our external audit firm, by the CEO, CFO, VP & General Counsel, Compliance Officer, and the Audit and Compliance Committee of the Board of Directors. Final copies are provided to each voting Board member electronically before filing with the IRS. Form 990, Part VI, Section B, Line 12c The hospital has a conflict of interest policy for all staff, and requires that staff members director level and above complete an annual conflict of interest questionnaire that is reviewed by the compliance department. The hospital also has a conflict of interest policy for all medical staff members that requires disclosure on a conflict of interest statement form during the credentialing and/or re-credentialing periods. Board members complete an annual statement of interest form which discloses employment, family member employment, business relationships, service on other Boards or governance positions and identifies other conflicts of interest. The statement of interest also identifies transactions requiring disclosure. Form 990, Part VI, Section B, Line 15 The Executive Committee of the Board serves as the compensation committee as specified by the bylaws of the hospital. The Executive Committee is comprised of the Chairman, Vice Chairman, Secretary , Treasurer, President/CEO and two at large members of the Board. The President/CEO does not participate in or vote on compensation matters related to his own compensation. The Executive Committee proposes an Executive Compensation Philosophy for approval by the board, which sets parameters for compensation of the CEO and the Vice Presidents. The Executive Committee (without the CEO) reviews the compensation and benefits of the CEO annually, subject to Board ratification. The CEO sets compensation for the Vice Presidents within the ranges established by the Compensation Philosophy. Compensation outside the approved ranges requires Executive Committee review and approval. The Executive Committee engages a consulting firm to provide comparative compensation studies for similarly qualified executives in functionally comparable positions at similarly situated organizations. Compensation study and performance review are considered in developing executive compensation decisions. Any benefits for executives beyond what is provided to all employees must be consistent with the Compensation Philosophy. All compensation-related meetings of the Executive Committee are formally documented. Form 990, Part VI, Section C, Line 19 The hospital's web site is www.bch.org. The web site includes the hospital's Mission, Vision and Beliefs Statement, our financial assistance policies, the Community Health Needs Assessment, and the Board of Directors. The web site also has a section for Compliance policies including the Code of Conduct and Conflict of Interest. Annual audited financial statements are made available to the public at the Annual Meeting of Boulder Community Health. The tax return is made available to anyone who requests the return through our Public Information Office. Form 990, Part VII, Section A, Line 1a Randy Bjerke MD retired as an employed Intensivist in early 2017 , but continued as a Board Member. The Average hours per week of 2 reflects his Board Member time. The compensation reflected on Part VII represent 160 hours of paid employment for the year. Form 990, Part XI, Line 9 Other change in Net Assets of $4,926,081 = Change in Foundation Assets of $5,378,514 + Change in minimum pension liability of -$212,798 + Charge for amortization of ineffective loss on swap of -$239,635 Boulder Community Health Sports Medicine Imaging LLC 2150 Stadium Drive 2nd Floor Boulder CO 80309 474243430 imaging services CO 1147173 1848461 Boulder Communty Health Boulder Valley Care Network LLC 4141 Arapahoe Avenue Suite 200 Boulder CO 80303 821488664 Clincally Integrated Provider Network CO 40560 0 Boulder Community Health Boulder Community Hospital Foundation 4860 Riverbend Boulder CO 80301 840772664 Fundraising for Boulder Community Health CO 501(c)3 509(a)3 N/A 0 Boulder Community Musculoskeletal Surgery Center LLC 4740 Pearl Parkway Suite 100 Boulder CO 80301 201391702 Outpatient surgery center CO N/A Related 1825286 4216770 0 0 0 0.5 Endoscopy Center of the Rockies LLC 382 S Arthur Ave Ste 140 Louisville CO 80027 841562782 Outpatient Endoscopy CO N/A Related 5451621 1151246 0 0 0 0.5 Boulder MRI LLC 1000 W South Boulder Road Suite 105 Lafayette CO 80026 452676500 outpaient MRI center CO Boulder Community Health Related 417472 146967 0 0 0 0.51 Foothills Surgery Center LLC 4743 Arapahoe Avenue Suite 101 Boulder CO 80303 455328252 Ambulatory Surgical Center CO Boulder Community Health Related 1385436 2491846 0 0 0 0.51 Riverbend Sleep LLC 4895 Riverbend Road Boulder CO 80301 464514151 own building and lease to Approved Entities CO N/A Excluded 43507 1079162 0 33482 0 0.5 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 Boulder Community Musculoskeletal Surgery Center LLC c 1675000 K-1 Capital distribution Boulder Community Musculoskeletal Surgery Center LLC d 2125455 Loan guarantee document (not > ownership %) Endoscopy Center of the Rockies LLC c 5250000 K-1 capital distribution Boulder MRI LLC c 510505 K-1 Capital distribution Boulder MRI LLC j 55788 Property Manager Recap of Income Boulder MRI LLC q 172142 47,900 for PACS agreement + 124,242 for pass-thru of MRI service contract Riverbend Sleep LLC c 55000 K-1 Capital distribution Riverbend Sleep LLC k 161420 Vendor History recap Foothills Surgery Center LLC c 918000 K-1 Capital distribution Foothills Surgery Center LLC d 683064 Loan document guarantees 35% of Loan outstanding at YE Foothills Surgery Center LLC j 362497 Lease payments received CP211A dated May 21, 2018 grants a filing extension to November 15, 2018.