2017-10-02T16:05:43-05:00 2016-12-31 840930288 BROCK AND COMPANY CPAS PC 3711 JFK PARKWAY SUITE 315 FORT COLLINS CO 80525 990 2016-01-01 840852084 LONGMONT UNITED HOSPITAL FOUNDATION LONG 3036515021 1950 MOUNTAIN VIEW AVENUE LONGMONT CO 80501 CINDY NOBLE DIRECTOR 3036515021 2017-09-27 1 SID FAHSHOLTZ CPA P00779361 9702237855 104.153.159.2 2017-09-27 15:35:30 MD P F5B18CCADB1A7A724C189D35A1D508B57FA85F7E 7A75D9CA050A39D95DBF802D565E01278FEE8682 2016 2021-01-29 14:40:06Z X CINDY NOBLE 1950 MOUNTAIN VIEW AVENUE LONGMONT CO 80501 1189447 0 X WWW.LUHCARES.ORG X 1981 CO THE FOUNDATION IS DEDICATED TO ADMINISTERING ALL FUND RAISING METHODS THAT PROVIDE SUPPORT AND ADVANCE THE MISSION OF THE LONGMONT UNITED HOSPITAL. 12 12 0 12 0 0 157100 98801 0 0 74006 162874 251216 169497 482322 431172 101763 76036 0 0 273465 0 0 0 203547 114260 398513 489488 474549 -7166 -43377 4302871 4286248 889310 734376 3413561 3551872 X THE FOUNDATION'S MISSION IS TO ADMINISTER ALL FUND RAISING PROJECTS THAT PROVIDE SUPPORT AND ADVANCE THE MISSION OF THE HOSPITAL. THIS IS PART OF AN ONGOING COMMITMENT TO THE CONTINUOUS IMPROVEMENT OF THE HOSPITAL'S WORKING ENVIRONMENT AND SERVICE TO THE COMMUNITY. THE SOLE PURPOSE OF THE FOUNDATION IS TO BENEFIT THE PEOPLE, PROGRAMS AND FACILIITES OF THE HOSPITAL, AND THE COMMUNITIES IT SERVES. 0 0 76036 76036 THE FOUNDATION IS A NOT-FOR-PROFIT CORPORATION FORMED TO PLAN, ORGANIZE, INSTITUTE AND ADMINISTER PROJECTS THAT PROVIDE SUPPORT FOR LONGMONT UNITED HOSPITAL. THE FOUNDATION FINANCES ITS OPERATIONS THROUGH DONATIONS AND INVESTMENT EARNINGS. THE LARGEST PROJECT IN 2016 INCLUDES A SCHOLARSHIP PROGRAM, WHERE CAREER SCHOLARSHIPS ARE AWARDED TO INDIVIDUALS WHO ARE INTERESTED IN A CAREER IN THE HEALTH CARE FIELD. OTHER SIGNIFICANT PROJECTS INCLUDE GRANTS TO HELP PURCHASE EQUIPMENT AND CONSTRUCT BUILDINGS FOR VARIOUS DEPARTMENTS WITHIN THE HOSPITAL. 76036 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 1 0 X X THE FOUNDATION 3036515021 1950 MOUNTAIN VIEW AVENUE LONGMONT CO 80501 X JOHN FLANDERS CHAIRMAN 1.00 X X 0 0 0 DOUGLAS STAVER VICE-CHAIR 1.00 X X 0 0 0 MITCHELL CARSON SECRETARY 1.00 X X 0 0 0 CAROL YOAKUM TREASURER 1.00 X X 0 0 0 EDWINA SALAZAR HOSPITAL BOARD REP 1.00 X 0 0 0 FRANK BIGELOW MEMBER 1.00 X 0 0 0 ERIC DOERING MEMBER 1.00 X 0 0 0 ED KANEMOTO MEMBER 1.00 X 0 0 0 HERBERT OGDEN MD MEMBER 1.00 X 0 0 0 CL ROWLEY DDS MEMBER 1.00 X 0 0 0 GINNY SHAW MEMBER 1.00 X 0 0 0 BRENT WAHL MD MEMBER 1.00 X 0 0 0 0 0 0 0 0 0 0 LONGMONT UNITED HOSPITAL 1950 W MOUNTAIN VIEW AVENUE LONGMONT CO 80501 MANAGEMENT AND FUNDRAISING 160723 CATHOLIC HEALTH INITIATIVES 9100 EAST MINERAL CIRCLE CENTENNIAL CO 80112 MANAGEMENT AND FUNDRAISING 126021 2 98801 98801 108171 108171 167235 167235 812978 758275 54703 54703 54703 REFUNDS 900099 2262 2262 2262 431172 0 0 332371 21577 21577 54459 54459 286744 122871 163873 9900 9900 712 712 2046 2046 1146 1146 ROYALTY TAXES AND DEDUC 40875 40875 FIDUCIARY FEES 17624 17624 FOOD SERVICE 12977 12977 SPECIAL MARKETING 12168 12168 14321 1838 12483 474549 76036 194966 203547 165312 158907 47500 37000 4041729 4042011 48330 48330 4302871 4286248 44354 44621 844956 689755 889310 734376 X 2681723 2782541 731838 769331 3413561 3551872 4302871 4286248 X -43377 168672 13016 X 1 X 0 0 0 X 150643 228874 160493 157100 98801 795911 150643 228874 160493 157100 98801 795911 795911 286337 241525 204352 389078 275406 1396698 2358 1222 923 679 2262 7444 2200053 47957 0.36180 0.34680 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 CHARITABLE GIFT ANNUITY PAYABLE 57433 CONTRIBUTIONS PAYABLE 40000 AGENCY FUNDS DUE TO AFFILIATE 592322 689755 X PART X, LINE 2: THE FOUNDATION UTILIZES THE PROVISIONS OF ASC 740, PERTAINING TO ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE PRONOUNCEMENT REQUIRES THE USE OF A MORE-LIKELY-THAN-NOT RECOGNITION CRITERIA BEFORE AND SEPARATE FROM THE MEASUREMENT OF A TAX POSITION. AN ENTITY SHALL INITIALLY RECOGNIZE THE FINANCIAL STATEMENT EFFECTS OF A TAX POSITION WHEN IT IS MORE LIKELY THAN NOT, BASED ON THE TECHNICAL MERITS, THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION. WITH RESPECT TO THE FOUNDATION, THIS WOULD PRIMARILY RELATE TO THE DETERMINATION OF UNRELATED BUSINESS TAXABLE INCOME, LOBBYING EXPENSES, AND TO THE MAINTENANCE OF ITS TAX EXEMPT STATUS. MANAGEMENT HAS EVALUATED THE ADOPTED POLICIES AND PROCEDURES THAT HAVE BEEN IMPLEMENTED TO PROVIDE ASSURANCE THAT INCOME IS PROPERLY CHARACTERIZED AND ACTIVITIES THAT JEOPARDIZE ITS TAX EXEMPT STATUS ARE WITHIN LIMITS ESTABLISHED UNDER EXISTING TAX CODE AND REGULATIONS. MANAGEMENT HAS DETERMINED THE EFFECTS OF UNCERTAIN TAX POSITIONS ARE NOT MATERIAL TO THE FOUNDATION FOR RECOGNITION OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS AND, ACCORDINGLY, NO INCOME TAX LIABILITY HAS BEEN RECORDED FOR UNCERTAIN INCOME TAX POSITIONS IN THE ACCOMPANYING FINANCIAL STATEMENTS. ALL INCOME TAX YEARS OPEN FOR EXAMINATION ARE SUBJECT TO TAXATION AT CORPORATE TAX RATES. THE YEARS ENDED DECEMBER 31, 2015, 2014, AND 2013 ARE AVAILABLE FOR EXAMINATION AT DECEMBER 31, 2016. ADDITIONALLY, PENALTIES AND INTEREST MAY BE ASSESSED ON INCOME TAXES THAT ARE DELINQUENT. THE ASSESSMENT OF UNCERTAIN INCOME TAXES IS SUBJECT TO ESTIMATE, AND IT IS REASONABLY POSSIBLE THAT THE ESTIMATE MAY CHANGE IN THE NEAR TERM AND THE CHANGE MAY BE MATERIAL. 1 LONGMONT UNITED HOSPITAL 1950 W MOUNTAIN VIEW AVE LONGMONT CO 80501 840460697 501(C)(3) 21577 TO IMPROVE THE HOSPITAL'S ENVIRONMENT AND SERVICE TO THE COMMUNITY HEALTHCARE CAREER SCHOLARSHIP GRANTS TO ASSIST INDIVIDUALS WITH ACHIEVING A MEDICAL CAREER. 16 48550 CASH EMPLOYEE ASSISTANCE FUNDS 5 5909 CASH PART I, LINE 2: AMOUNTS GRANTED TO THE LONGMONT UNITED HOSPITAL - AREAS WITHIN THE HOSPITAL PREPARE FORMAL REQUESTS FOR GRANTS THAT ARE REVIEWED AND MONITORED BY THE FOUNDATION'S EXECUTIVE DIRECTOR. THE GRANTS ARE APPROVED BY THE BOARD PRIOR TO DISTRIBUTION TO THE HOSPITAL. THE FOUNDATION'S BOARD OF TRUSTEES ALSO MONITORS AWARDED GRANTS. AMOUNTS GRANTED FOR CAREER SCHOLARSHIPS - CHECKS FOR SCHOLARSHIPS ARE WRITTEN DIRECTLY TO THE SCHOOL FOR THE INDIVIDUAL RECIPIENT. THE FOUNDATION WORKS DIRECTLY WITH HUMAN RESOURCES TO INSURE THAT THE RECEIPIENT FULFILLS THEIR OBLIGATION TO A SIGNED CONTRACT. AMOUNTS GRANTED FOR EMPLOYEE ASSISTANCE - THE EMPLOYEE ASSISTANCE PROGRAM REQUIRES AN ASSESSMENT OF THE NEEDY OR DISTRESSED EMPLOYEE TO SEE IF HE/SHE QUALIFIES. UPON REVIEW BY THE FOUNDATION, THE TYPE AND AMOUNT OF SUPPORT IS DETERMINED AND DOCUMENTED. THE FOUNDATION WORKS DIRECTLY WITH HUMAN RESOURCES TO ENSURE THAT THE RECEIPIENT FULFILLS THEIR OBLIGATION TO A SIGNED CONTRACT. X X 0 0 0 0 0 0 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE CHAIRMAN OF THE BOARD PRESENTS THE FORM 990 AT THE REGULAR BOARD MEETING. THE BOARD MEETS QUARTERLY, SO GENERALLY, THE ENTIRE BOARD IS PRESENTED THE FORM 990 AFTER IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY AND ALL EMPLOYEES COMPLETE AND SIGN A DISCLOSURE FORM ONCE A YEAR. EMPLOYEES ARE REQUIRED TO NOTIFY THE BOARD IMMEDIATELY IF A SITUATION ARISES DURING THE YEAR THAT COULD GIVE RISE TO CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 THE HUMAN RESOURCES OFFICE OF THE HOSPITAL HANDLES COMPENSATION FOR THE FOUNDATION. THEY ARE RESPONSIBLE FOR PRESENTING THE COMPENSATION PACKAGE FOR THE DIRECTOR TO THE FOUNDATION'S BOARD FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE AT THE FOUNDATION FOR PUBLIC REVIEW UPON REQUEST. THE REVIEWED FINANCIAL STATEMENTS ARE PUBLISHED IN THE FOUNDATION'S NEWSLETTER AND ARE AVAILABLE TO THE PUBLIC UPON REQUEST FORM 990, PART XI, LINE 9: REVALUATION OF SPLIT ANNUITY -3,964. BOOK TO TAX INVESTMENT INCOME -2,240. BOOK TO TAX ROYALTY INCOME 19,220. LONGMONT UNITED HOSPITAL 1950 WEST MOUNTAIN VIEW AVE LONGMONT CO 80501 840460697 PROVIDING HEALTH CARE TO THE COMMUNITY CO 501(C)(3) SEC 170(B)(1)(A)(I) 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 LONGMONT UNITED HOSPITAL N 15393 FAIR MARKET VALUE OF RENT IN AREA LONGMONT UNITED HOSPITAL B 21577 CASH