2014-11-17T11:53:53-07:00 2013-12-31 990 2013-01-01 840175870 Boulder Community Health BOUL 3034402358 PO Box 9019 1100 Balsam Ave Boulder CO 803019019 William A Munson Jr CFO & Vice President 3034157433 2014-11-17 2013 2015-11-30 17:44:51Z Boulder Community Hospital David P Gehant PO Box 9019 Boulder CO 803019019 722557596 0 X www.bch.org X 1922 CO To provide our community with the safest and highest quality healthcare in an innovative, patient-centered environment. 15 12 2814 563 2214924 0 1170727 3358726 292245681 291528637 11821051 15680487 18580776 14726569 323818235 325294419 397939 363851 0 0 147908726 153542796 0 0 321261 151796746 156469324 300103411 310375971 23714824 14918448 584504013 627149726 279157334 253465927 305346679 373683799 To provide our community with the safest and highest quality healthcare in an innovative, patient-centered environment. 0 0 230067179 363851 305508083 Health Care Delivery of IP and OP medical care. In 2013, the hospital discharged 8,316 adult & pediatric patients with an average length of stay of 4.5 days. 49,411 patients were seen in our ER/Urgent Care facilities. 6,652 surgeries were performed. The hospital had adjusted patient days of 86,871. 0 0 0 230067179 1 1 0 1 0 0 0 0 0 1 1 1 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 0 1 0 0 0 1 257 0 1 2814 1 1 1 0 0 0 0 0 0 0 0 0 X 15 12 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 3034402358 PO Box 9019 1100 Balsam Ave Boulder CO 803019019 Lou DellaCava Chairman 4 0 X X 0 0 0 Richard Porreca Vice Chairman 4 0 X X 0 0 0 Jean Dubofsky Secretary 4 X X 0 0 0 R David Hoover Treasurer 4 0 X X 0 0 0 Randy Bjerke MD Board Member 2 0 X 0 0 0 Richard V Lopez Board Member 2 0 X 0 0 0 Jeff Morgan Board Member 2 0 X 0 0 0 David Gehant Exec Director/CEO 40 0 X X 908121 0 37793 Tom Metz Board Member 2 0 X 0 0 0 Janet Martin Board Member 2 0 X 0 0 0 Mako Shimoda MD Board Member 2 0 X 8550 0 0 Steve Fries MD Board Member 2 0 X 0 0 0 Harold Flowers Board Member 2 0 X 1399 0 0 Susan Graf Board Member 2 0 X 1025 0 0 Dee Perry Board Member 2 0 X 0 0 0 Paul Kenneth Lewis Jr VP & Chief Medical Officer 40 X 380118 0 104060 William A Munson Jr VP & CFO 40 0 X 363410 0 91251 Jacqueline M Attlesey-Pries VP & Chief Nursing Officer 40 0 X 258879 0 70761 Sarah E Meshak VP & General Counsel 40 0 X 253333 0 54800 James Peters VP 40 0 X 246433 0 59337 Linda S Minghella VP & Chief Information Officer 40 0 X 229679 0 50769 Ronald Secrist BCH Foundation President 40 0 X 208684 0 48231 Jamie D Jensen Physician Clinic COO 40 0 X 173643 0 37644 Sameer A Oza Physician 40 0 X 684106 0 53664 Jamie J Doucet Physician 40 0 X 633408 0 54376 Nelson P Trujillo Jr Physician 40 0 X 642717 0 53663 Daniel S White Physician 40 0 X 642375 0 55528 John A Schutz Physician 40 0 X 639830 0 54667 6275710 0 826544 162 0 1 0 Favorite Healthcare Staffing Inc PO Box 803356 Kansas City MO 641803356 agency nursing services 1858289 Colorado Cardiovascular Surgical Associates PC 950 E Harvard Ave Suite 550 Suite 203 Denver CO 80210 Cardiovascular surgery coverage and employee lease 1219392 Dr Laurie Coryell Community Medical Center 1000 W So Boulder Rd Suite 100 Lafayette CO 80026 Urgent Care Phys. Group 1169542 Boulder Valley Anesthesiology LLC c/o Wendll Walker & Assoc 1420 28th St Ste 100 Boulder CO 80303 Anesthesiology coverage 979585 Emergency Courier Services in care of Aaron Ramsey 7713 N 41st St Niwot CO 80503 medical courier service 734098 25 0 3665 0 2744953 580460 29648 0 3358726 Acute care hospital 622000 291528637 289641138 1820650 66849 0 0 0 0 291528637 3992776 0 0 3992776 72830 0 0 72830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 398656983 10148101 386854075 10336128 11802908 -188027 11614881 -188027 0 11802908 0 0 0 0 0 0 10005 215 9790 0 0 9790 106200 72759 33441 0 0 33441 Health Care Joint Ventures 621400 6152018 6152018 0 0 Misc Hospital Revenue 622000 8531320 7688030 394274 449016 0 0 0 0 14683338 325294419 303293159 2214924 16427610 189718 189718 85364 85364 88769 88769 0 0 3551536 0 3299751 251785 0 0 0 0 120632883 92964887 27641314 26682 12050011 9132420 2909178 8413 8735923 6744957 1990199 767 8572443 6385879 2173959 12605 2158759 219217 1939542 0 257283 0 257283 0 89234 4234 85000 0 0 0 0 0 0 0 626790 0 626790 0 21213918 17165779 4027570 20569 787829 0 787829 0 5583865 2332273 3240091 11501 8884665 489744 8394921 0 0 0 0 0 5839637 3652478 2185266 1893 500861 222917 277504 440 0 0 0 0 327646 121033 206613 0 2276265 997004 1279261 0 0 0 0 0 17715739 8159606 9542695 13438 1047881 540054 507827 0 Medical Supplies 44828762 44647989 180773 0 Provision for Bad Debts 17048384 17048384 0 0 Repairs & Maintenance 7157892 536176 6621343 373 Medicaid Provider Fee 17976220 17976220 0 0 2147694 362077 1812822 -27205 310375971 230067179 79987531 321261 976885 1389445 5771613 13817848 35303088 35009275 2241430 10156572 2871946 2688826 3638310 3934441 403970231 196269189 171335480 207701042 254533177 228890116 66215850 75764948 3325638 3072181 320020 424077 37970576 44300955 584504013 627149726 46848302 57490284 176359214 168701018 98599 86140 55851219 27188485 279157334 253465927 X 274028058 339079246 26307590 29432103 5011031 5172450 305346679 373683799 584504013 627149726 X 14918448 17762604 0 0 0 35656068 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 16050 0 0 0 16050 0 Schedule C, Part II-B, Line 1 11.45% of dues paid to the Colorado Hospital Association are spent on lobbying activities, amounting to $8,764. 23.65% of dues paid to the American Hospital Association are spent on lobbying activities, amounting to $8,472. 31318621 3221343 4678434 0 4613845 0 34604553 23522148 7987150 2442969 0 2633646 0 31318621 22231845 4805197 -332547 0 3182347 0 23522148 20637790 3702912 2390484 0 4499341 0 22231845 17569973 3021313 3252269 0 3205765 0 20637790 0 0.15 0.85 0 1 1 0 19801120 19801120 0 191801624 114471973 77329651 0 758406 486825 271581 0 112688238 81310391 31377847 0 78920843 0 78920843 207701042 -8155305 F 21386213 F Municipal bonds, infrequently traded 6043821 F Asset Backed Securitites, infrequently traded 11369815 F Long/Short Fixed Income Funds 35321122 F Fund of Hedge Funds 885051 F Real Assets, infrequently traded 8914231 F 75764948 Interest in Net Assets Held by Foundation 34277582 Unamortized Bond Issue Costs 1394537 Deferred Comp Investments 5236014 Misc Other AR 3256351 Unamortized Swap Fees 136471 44300955 0 Accrued Pension Liability 21952471 Deferred Compensation Liability 5236014 27188485 359975554 17762604 0 0 18565065 36327669 323647885 626790 1019744 1646534 325294419 291638434 0 0 0 0 0 291638434 626790 18110747 18737537 310375971 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 18,565,065 included in tax return revenue but not in audited revenue includes Bad Debt Provision of -17,048,384 + Change in Foundation Net Assets of 3,318,818 + Change in Minimum Pension Liability of 32,576,886+Amortization of Effective Loss on Swap of -239,635 + Other Expenses shown net in FS rev and Gross in Tax return of -113,441 + Auxiliary component of Temp Rest Net Assets of 70,821 Schedule D, Part XI, Line 4b Other of 1,019,744 = Flood Expenses of 930,805 related to the Sept 2013 Federally Declared Disaster and Auxiliary expenses reflected as Restricted Contributions in Audit of $88939. Schedule D, Part XII, Line 4b Other expenses of 18,110,747 included on TR but not on Audit = Bad Debt provision of 17,048,384 + Non - Op Flood Expenses shown in net revenue on audit of 930,805 + Other non-op expenses shown in net revenue on audit of 113,441 + Auxiliary expenses reflected as Restricted Contribution in Audit of 18,117. 1 Sub-Saharan Africa 0 0 Program Services The hospital is the recipient of a grant from the Department of Health and Human Services via the American International Health Alliance Training Center to help with the development of zonal laboratories in Tanzania, Africa in response to the HIV/AIDS crisis. 88769 Central America and the Caribbean 0 0 Investments Passive investments in Cayman Islands have a YE market value of $43,304,076 and incurred management fees of $584,289 43888365 0 0 43977134 Sub-Saharan Africa The hospital is the recipient of a grant from the Department of Health and Human Services via the American International Health Alliance Training Center to help with the development of zonal laboratories in Tanzania, Africa in response to the HIV/AIDS crisis. 0 88769 Airfare, in-country expenses for mission, and other expenses such as books and computer supplies which totalled $57,567. In-kind labor cost totalled $31,202. cost 1 0 1 0 1 1 0 0 Schedule F, Part I, Line 2 The Tanzania, Africa project is subject to American International Health Alliance monthly grant reporting requirements. The project requires work plans to be approved by AIHA, quarterly project reporting, and monthly financial reporting. 1 1 X 1 X 2.5 1 X 1 1 0 1 1 11830487 4362456 7468391 0.025 28277150 18735288 9541861 0.032 0 0 0 40107637 23097744 17010252 0.057 295729 55738 239991 0.001 302088 697 301391 0.001 772947 772947 0.003 0 0 1370764 56435 1314329 0.005 0 0 41478401 23154179 18324581 0.062 83590 86590 0 3247 3247 0 150073 150073 0.001 0 0 236910 0 239910 0.001 1 17048384 1 48540747 62802386 -14261639 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 Community Sleep Services LLC Sleep Lab Services 0.45 0 0.55 Boulder MRI LLC outpatient MRI center 0.51 0 0.49 Foothills Surgery Center LLC Ambulatory Surgical Center 0.51 0 0.49 2 1 Boulder Community Hospital 1100 Balsam Avenue Boulder CO 80304 www.bch.org 010323 X X X Rehab DPU, Psych DPU A 2 Boulder Community Foothills Hospital 4747 Arapahoe Avenue Boulder CO 80303 www.bch.org 01W737 X X X A A 1 X X X X X X X X 13 1 1 1 X www.bch.org X X X X X X X X X X X 1 0 1 1 250 1 400 1 X X X X X 1 1 X X X X X 1 0 X X X X 1 X 0 0 Schedule H, Part V, Section B, Line 3-Group A In preparing this Community Health Needs Assessment, BCH collaborated with a number of community service agencies and their staff. Focus groups were conducted, consisting of representatives from over 25 agencies and programs, primarily targeting and serving "traditionally under-served" populations within the hospitals service area. The Boulder County Public Health Department, the Community Foundation serving Boulder County, The Boulder County Planning Department and the Boulder Valley School District were important collaborators in the preparation of this report and we express the hospitals thanks to them for their cooperation and for the wonderful services they provide to our jointly-served citizens. Schedule H, Part V, Section B, Line 4-Group A The Community Health Needs Assessment includes both the Boulder Community Hospital and the Boulder Community Foothills Hospital. Schedule H, Part V, Section B, Line 5-Group A The Community Health Needs Assessment for 2014 to 2016 was reviewed and endorsed by the BCH Board of Directors at its meeting on November 19, 2013. Schedule H, Part V, Section B, Line 6-Group A The Hospital's 2010-2013 Community Health Needs Assessment identified four key strategies to guide Hospital leadership in addressing the community's health needs: 1. STRENGTHEN PARTNERSHIPS WITH KEY COMMUNITY HEALTH PROVIDERS 2. EXPAND PRIMARY CARE ACCESS 3. PREVENTATIVE CARE FOCUS 4. HEALTH INFORMATION EXCHANGE & INTEGRATED CARE A status report on each strategy follows: STRENGTHEN PARTNERSHIPS WITH KEY COMMUNITY HEALTH PROVIDERS Joint initiatives and direct support funding from BCH were provided to community organizations providing health care related services during 2011-2013. EXPAND PRIMARY CARE ACCESS Since January 1, 2011, Boulder Community Hospital has employed 18 additional Primary Care Providers and now employs 54 in 12 clinics located throughout the Hospital's service area. All BCH-owned clinics are accessible to Medicare patients and all also accept Medicaid patients. Through our collaborative efforts with direct community health service providers the Hospital is committed to improved access to primary care regardless of a patient's medical insurance status. In addition, during the term of this needs assessment, BCH employs 45 specialists in seven locations for a total of 99 physicians in 22 different locations throughout the Hospital's service area. PREVENTATIVE CARE FOCUS Certified Diabetes Educator Program: Since inception (and through April 30, 2013) the Diabetes Educator has served 709 patients and the program has been accredited by the American Association of Diabetes Education. Blood glucose levels of participants have decreased 26% since the program was initiated. Boulder Valley Care Network: BCH continues to be an active partner in this collaborative effort involving the Boulder Valley School District and Longmont United Hospital. Talks are underway to add the St. Vrain Valley School District as well. The Network submitted a major preventative care grant for funding consideration in 2012, however the grant was not funded. Anderson Medical Center: The new facility opened in early 2013 and offers, conveniently located and well designed facilities for out-patient, preventative care in cardiology, urology, general surgery, neurosurgery and spine care. In addition, the new state of the art facility includes an out-patient surgery center expected to perform 4,000 surgeries annually. Electroconvulsive Therapy (ECT): This new service targeted to patients with depression and other mental disorders began in 2011 and through April 30, 2013 performed 6,615 procedures. An estimated 25% of these procedures were covered by Medicare, Medicaid or charity care programs. HEALTH INFORMATION EXCHANGE & INTEGRATED CARE Colorado Regional Health Information Organization (CORHIO): BCH was the first hospital in the state to submit data to this health information exchange. Today, three of the four hospitals in Boulder County are connected to and are sending medical information to CORHIO. There are 40 hospitals and more than 1,000 physician offices across Colorado that are part of the network. In 2013, BCH rolled out the CORHIO Patient Care 360 Portal to all employed and contracted physicians, including emergency room and urgent care physicians. Physicians can now access any medical history information on presenting patients. BCH Home Care staff were the first participants with the CORHIO Long Term and Post Acute Care Pilot Program. Our hospital is pursuing efforts to increase the amount of information shared on CORHIO, including electronic orders for outpatient diagnostic services. Discharge Planning & Transitional Care: BCH has Case Manager RNs staff the Emergency Department seven days per week. These nurses have dramatically improved the patient intake and continuity of care for the uninsured population. They have partnered with the Hospital Medicine and key Medical Staff departments to closely monitor level of care, readmissions, Primary Care Physician assignment, as well as coupling with Boulder County resources to ensure continuity of care after discharge. The Case Management function has also been enhanced in the area of Utilization Review. A Complex Care and Coordination Team (CCCT-including Case Managers and ED Leadership) meets weekly. to analyze high risk, high duration, and high frequency hospital stays. Experts from clinical areas attend, including the Social Work Discharge Planning Coordinator, the Director of Hospital Medicine, Directors of Nursing Units and the Chief Medical Office. The hospital's Chief Revenue Officer, Financial Counseling and County Medicaid Specialist also attend this important weekly gathering, insuring that patients in our community are appropriately placed and transitioned to the optimal level of care. BCH is partnering with the Colorado Department of Public Health and Environment (CDPHE) in the Hospital Outstation Program. This partnership with the State affords uninsured patients quicker screening and enrollment into the State Insurance Programs such as Medicaid and CHP+. Through this program, there are also future plans to help patients navigate enrollment into the State Health Insurance Exchanges (under the ARRA), as well as provide assistance with food stamp and other State-held programs. BCH has partnered with Clinica Campesina/People's Clinic and the Boulder Shelter for the Homeless in a grassroots effort to create and sustain a Respite Program for underserved Boulder County Patients. The program allows for patients to be discharged earlier, and stay in local hotel/motels where Home Health RNs visit the patient daily. A follow-up visit is also scheduled for the patient with a Primary Care Physician at People's Clinic. Hospitalists Program: BCH assumed responsibility for the Hospitalist Program within the Hospital in 2011. The hospital medicine program has expanded over the ensuing years. Today, 17 physicians and three mid-level medical professionals serve hospital patents and are integrated into the discharge planning and the coordinated transitional care process. Recommendations and Action Plan from 2014-2016 CHNA: Given the demographic influences upon our region and the input from other non-profit organizations, providing services to targeted populations within our service area, Boulder Community Hospital commits to the following Health Needs Assessment Action Plan for 2014-2016. SUPPORT OF COMMUNITY ORGANIZATIONS ADDRESSING UNMET NEEDS Continue the funding of community organizations that provide direct health care services to the underserved and to residents of the Boulder Valley particularly in the areas of mental health, the homeless, aged, teens and immigrant populations. ill look to collaborate with these and other health care providers, particularly the Boulder County Public Health Department in doing our part in sponsoring and directly participating in community forums and discussion sessions pertaining to new health care laws and initiatives that will impact the communities we serve. We will continue to be an active supporter of the Community Foundation serving Boulder County in their on-going efforts to research and identify community trends and service gaps. This data is critical to assessing the outstanding health related needs in the communities we serve. MENTAL HEALTH Given the overarching impact a multitude of mental health issues have upon the targeted populations within the communities we serve, we wish to further strengthen our partnership and relationship with mental health service providers over the next three years. In addition, we will be examining and improving, where indicated, our internal care to patients who are waiting for behavioral health inpatient placement. In particular, we will target care of patients waiting in our Emergency Department to deescalate acute episodes to facilitate more timely and appropriate placement of patients. AWARENESS TRAINING We will provide training opportunities to the BCH medical staff in understanding the differing cultures and languages within the Boulder Valley and enriching our sensitivity in serving these residents. During the term of this assessment, we will annually sponsor a discussion group session with key health care partners to assess changing conditions and trends and demographics that are impacting the delivery of health care services in the communities we serve. PROGRAM SERVICES TO TARGETED POPULATIONS BCH intends to continue its Palliative Care Program in an effort to assist families with critical end of life decisions, the Transitional Care Program which addresses pre and post hospital care and reduces readmissions to the hospital and the Medical Respite Program which provides continuity of care for homeless and indigent patients, post hospital and recovery. Schedule H, Part V, Section B, Line 20-Group A All patients without insurance are eligible for a 60% prompt pay discount if payment made at time or service (or within 72 hours following discharge for emergencies) or a 50% discount if paid within 30 days for medically urgent, emergency, prenatal, and obstetric services. Those patients who qualify for financial assistance receive a discount rate that exceeds the lowest negotiated commercial discount rate. 35 Community Medical Center 1000 W South Boulder Road Lafayette CO 80026 Urgent-care center Mapleton Center 311 Mapleton Ave Boulder CO 80304 Outpatient clinic for rehabilitation, sports medicine, outpatient mental health and homecare. 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 Broomfield 16677 Lowell Blvd Broomfield CO 800238053 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 4745 Arapahoe Ave Unit G50 Boulder CO 80303 Physician clinic Beacon Clinic 1136 Alpine Ave Suite 205 Boulder CO 80304 Infectious Disease Clinic Boulder Community Sleep Services LLC 1000 Alpine Ave Suite 201 Boulder CO 80304 Sleep study center Boulder Community Sleep Services LLC 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 Sports Medicine East 1000 W South Boulder Rd Suite 212 220 226 Louisville CO 80026 Sports medicine 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 IMA at Balfour Clinic 1336 Hecla Drive Louisville CO 80027 physician clinic Community Medical Associates of Lafayette 401 E Cleveland Street Lafayette CO 80026 Physician clinic 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 Table Mesa Family Medicine 1755 48th St Suite 200 Boulder CO 80303 Physician clinic Boulder Community Hospital Occupational Medicine 4745 Arapahoe Ave Suite G40 Boulder CO 80303 Occupational medicine clinic Gunbarrel Medical Center 6685 Gunpark Drive Suite 110 Boulder CO 80301 Physician clinic Spruce Street Internal Medicine 2575 Spruce Street Boulder CO 80302 Physician clinic Associated Neurologists of Boulder 1155 Alpine Suite 320 Boulder CO 80304 Physician clinic Dakota Ridge Medical Center 2995 Baseline Road Suite 210 Boulder CO 80303 Physician clinic BMC East Laboratory 80 Health Park Dr Louisville CO CO 80027 Laboratory draw station Schedule H, Part I, Line 7 Ratio of Patient Care Costs to Patient Care Charges Schedule H, Part I, Line 7, Column f $17,048,384 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 Information Exchange (BCHIE), which are both electronic health exchanges aimed at promoting effective and efficient health care delivery as well as information for community health assessments. Workforce development includes physician recruitment for physicians not employed by the hospital. Boulder is a Medically Underserved Area for low income and Medicare. Schedule H, Part III, Section A, Line 4 2. See 4. for methodolog 3.The hospital does not have a mechanism to reasonable estimate the amount of bad debts which would reasonably relate to patients who would qualify for financial assistance under the hospitals 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 information were known. 4. Footnote 2 Summary of Significant Accounting Policies (f) Patient Accounts Receivable. Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which third party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third party coverage exists for part of the bill), the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or provided by policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. The Hospitals allowance for doubtful accounts for self-pay patients decreased from 112 percent of self-pay accounts receivable at December 31, 2012, to 108 percent of self-pay accounts receivable at December 31, 2013. The allowance includes a reserve for deductible and copayments classified within insured accounts receivable at year end. In addition, the Hospitals write-offs decreased approximately $4,409,000 from approximately $20,223,000 for the year ended December 31, 2012, to approximately $15,814,000 for the year ended December 31, 2013. The decrease in bad debt write offs results from a focused effort to identify patients eligible for charity care and an expansion of the Hospitals prompt pay discount program. 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 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 $33,998,573. 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 hospitals 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 hospitals 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. 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 and efficient health care. The Hospitals Board Planning Committee uses the Community Health Needs Assessment, the Comprehensive Facilities study, as well as market and demographic studies to ensure the Hospital meets the future health care needs of our community. The Hospital 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. 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 Age 50+ Schedule H, Part VI, Line 5 The Hospital is governed by a volunteer community board. The Hospital has an open medical staff. All surplus funds are reinvested in the hospital to fund charity, subsidize under performing health programs, develop new health programs, or as an investment in plant, equipment and technology. 1 Boulder County Fire Fighters Assoc Sunshine Fire Protection District po bOX 7461 Golden CO 80302 846000600 501 (c) 3 22000 0 FMV support for local fire association Boulder Valley Women's Health Center 2855 Valmont Rd Boulder CO 803011374 840645786 501 (c) 3 12500 0 FMV to support women's health Boulder Valley School District 6500 E Arapahoe Boulder CO 80303 846014683 501 (c) 3 0 68277 Cost Provide athletic trainer to school district Support high school athletics and help to reduce student athlete injuries. Boulder Chamber of Commerce dba Boulder Economic Council 2440 Pearl St Boulder CO 80302 840152700 501 (c) 6 5250 0 FMV to support the business sector necessary to sustain the cultural amenities, education, transit, open space and other facets of the Boulder community Boulder Shelter for the Homeless Inc 4869 N Broadway Boulder CO 80304 841041149 501 (c) 3 10000 0 FMV to support respite care for the homeless The Community Foundation 1123 Spruce St Boulder CO 80302 841171836 501 (c) 3 11000 0 FMV to support civic forum on health care and sponsorship of the Conversation project. Justin Parker Neurological Institue 4743 Arapahoe Ave Ste 202 Boulder CO 80303 263588986 501 (c) 3 10000 0 FMV To support education related to brain and trauma disorders Via 2855 N 63rd Street Boulder CO 80301 840777296 501 (c) 3 15000 0 FMV Support for transportaion of the disabled 7 1 Healthcare educational scholarships 24 36250 0 cost Assistance with chemotherapy treatment expenses, mammography expenses and other cancer related expenses 27 5911 0 cost Charity drugs given after discharge 24 5710 cost Pharmaceutical prescriptions filled at cost for patients discharged with inability to pay. Temporary housing for homeless post discharge 25 18354 cost Temporary housing provided to indigent for respite care. Transportation, meals, and cobra payments for indigant 446 14549 cost Assistance fund for IP rehab patients. 11 4605 cost Support for patients and family with living and medical expenses. Schedule I, Part I, Line 2 Grants are only made to non profit agencies 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 disbursements 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 schools on the students behalf with a letter indicating the money should be returned to the hospital if the student does not register. X 0 1 X X X X X 0 1 0 0 0 0 0 1 0 David Gehant Exec Director/CEO 867621 0 0 0 40500 0 20860 0 21593 0 950574 0 0 Paul Kenneth Lewis Jr VP & Chief Medical Officer 299989 0 45072 0 35058 0 82233 0 22547 0 484899 0 0 William A Munson Jr VP & CFO 257752 0 70658 0 35000 0 66406 0 25566 0 455382 0 0 Jacqueline M Attlesey-Pries VP & Chief Nursing Officer 210109 0 31105 0 17665 0 47985 0 23495 0 330359 0 0 0 Sarah E Meshak VP & General Counsel 168202 0 49878 0 35252 0 54300 0 1220 0 308852 0 0 0 James Peters VP 164757 0 41176 0 40500 0 41358 0 19800 0 307591 0 0 0 Ronald Secrist BCH Foundation President 167500 0 18183 0 23000 0 30085 0 18812 0 257580 0 0 0 Linda S Minghella VP & Chief Information Officer 151568 0 37611 0 40500 0 50789 0 689 0 281157 0 0 0 Jamie D Jensen Physician Clinic COO 132511 0 23650 0 17482 0 13125 0 25096 0 211864 0 0 0 Sameer A Oza Physician 483982 0 165124 0 35000 0 32785 0 21599 0 738490 0 28960 0 Jamie J Doucet Physician 484329 0 114080 0 35000 0 32785 0 22311 0 688505 0 0 Nelson P Trujillo Jr Physician 475865 0 126352 0 40500 0 32785 0 21599 0 697101 0 28960 0 Daniel S White Physician 478476 0 128902 0 35000 0 32785 0 23464 0 698627 0 28960 0 John A Schutz Physician 479459 0 125371 0 35000 0 32785 0 22602 0 695217 0 28960 0 Schedule J, Part I, Line 1a The hospital pays for board member companion travel at its annual educational conference. Companion travel is reported as Misc Income on the 1099 of the board member. Schedule J, Part I, Line 1b Travel for companions is only reimbursed for board members attending the annual educational conference. Companion travel is reimbursed based upon substantiated receipts and is reported as Miscellaneous Income on 1099 of the board member. In all other circumstances, companion travel is not reimbursable by the hospital. Schedule J, Part I, Line 3 The hospital has a Compensation Committee as specified by the bylaws of the hospital (Article V, D). The Compensation Committee is comprised of the Chairman, Vice Chairman, Secretary and a member of the Finance Committee. The committee meets approximately three times per year to review the CEO compensation and approve annual contract changes. Compensation and contract changes are reported to the Board. The Committee engages a consulting firm to provide comparative compensation studies for similarly qualified persons in functionally comparable positions at similarly situated organizations. Compensation study and performance review are considered in developing the compensation decision. Compensation ranges and Benefit changes for Vice President level employees are reviewed and approved by the Compensation Committee if the are outside of hospital wide treatment. Compensation studies are also used for VP level assessment. All Compensation Committee meetings are formally documented through minutes. 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: Paul Lewis Jr, VP & Chief Medical Officer ($61,373 contributed), William Munson Jr, VP & CFO ($45,546 contributed), Sarah Meshak, VP & General Counsel ($37,691 contributed), James Peters, VP ($24,220 contributed), Linda Minghella, VP & CIO ($35,115 contributed), Ron Secrist, Foundation President ($14,948 contributed), and Jacqueline Attlesey-Pries, VP & CNO ($44,442) contributed. Schedule J, Part I, Line 7 The hospital has an Incentive Compensation Plan for 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 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 A 5645000 0 93716361 0 0 0 1080618 0 0 25180893 67458941 30 2014 1 0 0 1 B 0 0 31816782 0 0 0 452449 0 0 29281683 0 2082651 2014 0 0 0 1 A 0 0 1 1 0 0 0 0 0 0 1 B 0 0 1 1 0 0 0 0 0 0 1 A 0 1 1 0 1 0 0 0 1 B 0 1 1 0 0 0 0 0 1 A 1 B 1 Schedule K, Part I, Column e-12/01/2010 93,535,431 Colorado Health Facilities Ln A(e) $93,535,431< Pt II Ln 3(A) 93,716,361 by the cum. trust fund interest inc of $180,930 Schedule K, Part I, Column e-08/28/2012 31,748,673 Colorado Health Facilities Ln B(e) $31,748,673 < Pt II Ln 3(B)of $31,816,782 by the cumulative trust fund interest inc of $68,109. Schedule K, Part II, Line 3-12/01/2010 93,535,431 Colorado Health Facilities Lns 4 thru 12>Ln 3 by 4,121= amount transferred to 2010 COI Fd from close-out of the 2003 Bond Fund Schedule K, Part II, Line 11-12/01/2010 93,535,431 Colorado Health Facilities Inculdes refunding amounts: 1994B $14,546,298, 2003A $26,456,321, 2003B $26,456,321 Boulder Valley Pulmonology PC Dr. Randal Bjerke,Boardmember, is a > 5% member of Boulder Valley Pulmonology PC 365507 Boulder Valley Pulmonology PC was paid $351,557 for the provision of intensivist coverage in the ICU , and $13,950 for trauma call coverage. 0 Boulder Medical Center PC (BMC) Dr. Fries, boardmember, is a board member of BMC and a pediatrician with BMC 650907 The hospital paid BMC $352,055for ER trauma call coverage provided by the physicians who are a part of BMC. The hospital paid BMC $298,852 under a lab and imaging space lease agreement. The hospital has an agreement with BMC to provide on-site lab and imaging services to BMC patients. All lab and imaging charges are billed directly to patients and third party insurances by the hospital. 0 Form 990, Part VI, Section A, Line 4 The name of the organization was changed to Boulder Community Health from The Community Hospital Association effective April 22,2014. The Articles of Amendment were filed with the Colorado Secretary of State. The Internal Revenue Service was notified of the name change on April 22, 2014 and a new determination letter reflecting exemption under section 501 (c) 3 under our new name has been received. 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, COO, CFO, VP & General Counsel, Compliance Officer, and the Audit 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 staff, A Conflict of Interest policy for Board Members, and a Conflict of Interest disclosure form for physicians serving on committees. Boardmembers 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 hospital has a Compensation Committee as specified by the bylaws of the hospital (Article V, D). The Compensation Committee is comprised of the Chairman, Vice Chairman, Secretary and a member of the Finance Committee. The committee meets approximately three times per year to review the CEO compensation and approve annual contract changes. Compensation and contract changes are reported to the Board. The Committee engages a consulting firm to provide comparative compensation studies for similarly qualified persons in functionally comparable positions at similarly situated organizations. Compensation study and performance review are considered in developing the compensation decision. Compensation ranges and Benefit changes for Vice President level employees are reviewed and approved by the Compensation Committee if they are outside of hospital wide treatment. Compensation studies are also used for VP level assessment. All Compensation Committee meetings are formally documented through minutes. Form 990, Part VI, Section C, Line 19 The hospitals web site is www.bch.org. The web site includes the hospitals Mission, Vision and Beliefs Statement. The web site. includes our Financial Assisstance policies. It also includes the Annual Report which contains the hospital Board members, key financial data, and information on new programs, patient safety and quality, and community benefits. 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 The Community Hospital Association. The tax return is made available to anyone who requests the return through our Public Information Office. Form 990, Part XI, Line 9 Other Change in Net Assets of $35,656,068 = Change in Foundation Assets of 3,318,818 plus Change in Minimum Pension Liability of 32,576,886 plus charge for amortization of ineffective loss on swap of -239,635 plus -1 rounding. Boulder Community Hospital Foundation 1155 Alpine Avenue Suite G40 Boulder CO 80304 840772664 Fundraising for hosp CO 501(c)3 509(a)3 N/A 0 Boulder Community Musculoskeletal Surgery Center LLC 1136 Alpine Avenue Boulder CO 80304 201391702 Outpatient surgery center CO N/A Related 1878894 1212487 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 4082493 923058 0 0 0 0.5 Boulder Community Sleep Services LLC 1100 Balsam Ave Boulder CO 80304 262429064 Sleep Lab Services CO N/A Related 150637 41484 0 0 1 0.45 Boulder MRI LLC 1000 W South Boulder Road Suite 105 Lafayette CO 80026 452676500 outpaient MRI center CO The Community Hospital Association dba Boulder Community Hospital Related 822845 387489 0 0 0 0.51 Foothills Surgery Center LLC 4743 Arapahoe Avenue Suite 101 Boulder CO 80303 455328252 Ambulatory Surgical Center CO N/A Related -561974 2993717 0 0 0 0.51 0 1 1 1 0 0 0 1 0 1 0 0 1 0 0 0 1 0 0 Boulder Community Musculoskeletal Surgery Center LLC c 1800000 K-1 Boulder Community Musculoskeletal Surgery Center LLC j 701205 Lease receipts Boulder Community Musculoskeletal Surgery Center LLC q 62151 Recap of expenditures reimbursed per contract Endoscopy Center of the Rockies LLC c 4200000 K-1 Boulder Community Sleep Services LLC c 134721 K-1 Boulder Community Sleep Services LLC q 453687 Reimbursement per Contract for Services Boulder Community Sleep Services LLC m 826500 Payment per Contract for Services Boulder MRI LLC c 1045000 K-1 Boulder MRI LLC d 1338750 Loan Guaranty document (not > ownership %). Boulder MRI LLC j 51305 Lease Agreement Boulder MRI LLC q 65550 Receipts from PACS agreement Foothills Surgery Center LLC b 725135 K-1 Foothills Surgery Center LLC d 1367298 Loan Document: 35% of Loan outstanding at YE Foothills Surgery Center LLC j 1817297 Review of Lease: $260,730 was received in monthly lease payments; $1,556,567 was received for Excess Tenant Finish above TI allowance. Boulder Community Sleep Services LLC h 112000 FMV