THE WELD TRUST: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
THE WELD TRUST (EIN 74-2358522)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-01
IRS object ID
201223069349301627
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-01T16:13:11-05:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN450250958EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14310 17TH AVE S PO BOX 2545AddressLine1
CityFARGOCity
StateNDState
ZIP Code581082545ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN742358522EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NCMC INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNCMCNameControl
Phone9703506052Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11801 16TH STREETAddressLine1
CityGREELEYCity
StateCOState
ZIP Code80631ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROBERT E MURPHYName
TitleTREASURERTitle
Phone9703506052Phone
Date Signed2012-11-01DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameLISA CHAFFEE CPAName
PTINP00193453PTIN
Phone7012398500Phone
Date Prepared2012-11-01DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKEN SCHULTZNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11801 16TH STREETAddressLine1
CityGREELEYCity
StateCOState
ZIP Code80631ZIPCode
FieldValueIRS element (for citing)
Gross Receipts148164179GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1984YearFormation
State Legal DomicileCOStateLegalDomicile
Activity Or Mission DescriptionLEASING OF HOSPITAL FACILITIES TO ORGANIZATIONS DESCRIBED IN SECTION 501(C)(3) OF THE IRS CODE FOR THE PROVISION OF HEALTH CARE SERVICES TO THE COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers11TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year326900ContributionsGrantsPriorYear
Contributions Grants Current Year602257ContributionsGrantsCurrentYear
Program Service Revenue Prior Year33884660ProgramServiceRevenuePriorYear
Program Service Revenue CY32193801ProgramServiceRevenueCY
Investment Income Prior Year14944522InvestmentIncomePriorYear
Investment Income Current Year8991371InvestmentIncomeCurrentYear
Other Revenue Prior Year-50426OtherRevenuePriorYear
Other Revenue Current Year297216OtherRevenueCurrentYear
Total Revenue Prior Year49105656TotalRevenuePriorYear
Total Revenue Current Year42084645TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year3650000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY3944150GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year724050SalariesEtcPriorYear
Salaries Etc Current Year1459420SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year30375381OtherExpensePriorYear
Other Expenses Current Year30983915OtherExpensesCurrentYear
Total Expenses Prior Year34749431TotalExpensesPriorYear
Total Expenses Current Year36387485TotalExpensesCurrentYear
Revenues Less Expenses Prior Year14356225RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5697160RevenuesLessExpensesCY
Total Assets BOY427798444TotalAssetsBOY
Total Assets EOY412072198TotalAssetsEOY
Total Liabilities BOY202837065TotalLiabilitiesBOY
Total Liabilities EOY203362140TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY224961379NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY208710058NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE QUALITY HEALTHCARE AT A REASONABLE COST TO THE NCMC SERVICE COMMUNITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense34725526Expense
Grants3944150Grants
Revenue32193801Revenue
DescriptionNCMC, INC OWNS A HOSPITAL BUILDING WHICH IT LEASES TO BANNER HEALTH SYSTEM (AN ARIZONA 501(C)(3) ORGANIZATION), WHO OPERATES THE HOSPITAL IN A CHARITABLE FASHION. NCMC, INC IS RESPONSIBLE FOR MAINTAINING THE PROPERTY AND EQUIPMENT FOR ITS USE BY BANNER HEALTH (NORTH COLORADO MEDICAL CENTER) TO PROVIDE ACUTE MEDICAL SERVICES.Description
Total Program Service Expense34725526TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109618NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Excess Business Holdings0ExcessBusinessHoldings
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1KEN SCHULTZBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9703506052TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11801 16TH STREETAddressLine1
CityGREELEYCity
StateCOState
ZIP Code80631ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (12 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
AL DOMINGUEZ SECRETARY JAN-MARCH
PRESIDENT & CHAIR (APRIL-DEC)1.00XX000
KEN SCHULTZ PRESIDENT CHAIR JAN-
MARCH) / BOARD EXECUTIVE (MAR-DEC)40.00XX000
ROBERT NOFFSINGER
VICE CHAIR1.00XX000
ROBERT E MURPHY
TREASURER1.00XX000
BRANDON HOUTCHENS
SECRETARY (APRIL - DEC)1.00XX000
RICHERT QUINN MD
DIRECTOR1.00X000
LINDA WINTER
DIRECTOR1.00X000
KAY KOSMICKI
DIRECTOR1.00X000
JEFFREY CARLSON
DIRECTOR1.00X000
VICKI WILSON PHD RN
DIRECTOR1.00X000
MICHAEL J GEILE
DIRECTOR1.00X000
WILLIAM HUGHES JAN-MARCH
ASST TREASURER/SECRETARY25.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
UBS FINANCIAL SERVICES INC
1901 56TH AVE SUITE 300GREELEYCO80634INVESTMENT MANAGEMENT FEES1074641
AT MOUNTAIN STATES
797 VENTURA STREETAURORACO80011GENERAL CONTRACTORS325318
COLORADO FINANCIAL MANAGEMENT INC
2725 ROCKY MOUNTAIN AVE STE 320LOVELANDCO80538INVESTMENT MANAGEMENT FEES190370
WELLS FARGO ADVISORS
1073 N LINCOLN AVELOVELANDCO80537INVESTMENT MANAGEMENT FEES145900
NORTHSTAR MANAGEMENT GROUP INC
2129 RESERVOIR ROADGREELEYCO80631CONSULTING140000
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
All Other Contributions602257AllOtherContributions
Total Contributions602257TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionHOSPITAL FACILITY RENTDescription
Business Code532000BusinessCode
Total Revenue Column32193801TotalRevenueColumn
Related Or Exempt Function Income32193801RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue32193801TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column8277343TotalRevenueColumn
Exclusion$8,277,343ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real508266Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real211050Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real297216Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column297216TotalRevenueColumn
Exclusion$297,216ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities106514403Securities
Other68109Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities105868484Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities645919Securities
Other68109Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column714028TotalRevenueColumn
Exclusion$714,028ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column42084645TotalRevenueColumn
Related Or Exempt Function Income32193801RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$9,288,587ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total3944150Total
Program Services3944150ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1459420Total
Program Services1459420ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total176015Total
Program Services11015ProgramServices
Management And General165000ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total9514Total
Management And General9514ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total39500Total
Management And General39500ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total1430732Total
Management And General1430732ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total59902Total
Program Services50398ProgramServices
Management And General9504ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total22510Total
Program Services14801ProgramServices
Management And General7709ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total387786Total
Program Services387786ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total1999Total
Program Services1999ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total11141Total
Program Services11141ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total7182374Total
Program Services7182374ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total20163259Total
Program Services20163259ProgramServices

Other Expenses OtherExpenses

FieldValueIRS element (for citing)
DescriptionBOND FEESDescription
Total1276508Total
Program Services1276508ProgramServices

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total222675Total
Program Services222675ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total36387485Total
Program Services34725526ProgramServices
Management And General1661959ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY6894781BOY
EOY3754142EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY82134BOY
EOY114982EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY27625BOY
EOY27625EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis400610533LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec225132441LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY178111848BOY
EOY175478092EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY236966973BOY
EOY227323053EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY211988BOY
EOY201438EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY5503095BOY
EOY5172866EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY427798444BOY
EOY412072198EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY12023510BOY
EOY13720151EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY182927112BOY
EOY177097520EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY7886443BOY
EOY12544469EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY202837065BOY
EOY203362140EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY224961379BOY
EOY208710058EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY224961379BOY
EOY208710058EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY427798444BOY
EOY412072198EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses5697160ReconcilationRevenueExpenses
Reconcilation Other Changes-21948481ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Certification CheckboxXCertificationCheckbox
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1NCMC BOARD OF TRUSTEESBusinessNameLine1
FieldValueIRS element (for citing)
EIN846000813EIN
Type Of Organization6TypeOfOrganization
Listed In Governing Doc1ListedInGoverningDoc
Supported Organization Notified1SupportedOrganizationNotified
Organized In US1OrganizedInUS
Amount$32,689,077Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts32689077SumOfAmounts

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis7557342OtherCostOrOtherBasis
Book Value7557342BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis18651492InvestmentCostOrOtherBasis
Other Cost Or Other Basis232540408OtherCostOrOtherBasis
Depreciation111560400Depreciation
Book Value139631500BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis138782591OtherCostOrOtherBasis
Depreciation113572041Depreciation
Book Value25210550BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3078700OtherCostOrOtherBasis
Book Value3078700BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings175478092TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionINTEREST RATE SWAPDescription
Amount$12,544,469Amount
FieldValueIRS element (for citing)
Total Of Amounts12544469TotalOfAmounts
Total Revenue42084645TotalRevenue
Total Expenses36387485TotalExpenses
Excess Or Deficit For Year5697160ExcessOrDeficitForYear
Net Unrealized GL On Investments-15279275NetUnrealizedGLOnInvestments
Other-$6,669,206OtherAmount
Total Adjustments-21948481TotalAdjustments
Excess Or Deficit Per FS-16251321ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt18330377TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-15279275NetUnrealizedGainsInvestments
Other Revenues-8644042OtherRevenues
Revenue Not Rptd F990-23923317RevenueNotRptdF990
Revenue Subtotal42253694RevenueSubtotal
Other Revenues Not Included-169049OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-169049RevenueNotRptdOnFinStmt
Total Revenue Per Form99042084645TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt34581698TotExpensesEtcAuditedFinclStmt
Other Expenses Included194213OtherExpensesIncluded
Expenses Not Rptd F990194213ExpensesNotRptdF990
Expenses Subtotal34387485ExpensesSubtotal
Other Expenses Not Included2000000OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt2000000ExpensesNotRptdOnFinStmt
Total Expenses Per Form99036387485TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:NCMC IS A COLORADO NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 509(A)(3) OF THE CODE. NCMC IS ANNUALLY REQUIRED TO FILE A RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) WITH THE IRS. IN ADDITION, THE CORPORATION MAY BE SUBJECT TO INCOME TAX ON NET INCOME THAT IS DERIVED FROM BUSINESS ACTIVITIES THAT ARE UNRELATED TO ITS EXEMPT PURPOSE. NCMC BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS AND, AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. NCMC WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE, IF SUCH INTEREST AND PENALTIES ARE INCURRED.
PART XI, LINE 8 - OTHER ADJUSTMENTS:REDUCTION IN FAIR VALUE OF INTEREST RATE SWAPS -4,658,026. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -1,986,016. K-1 INTEREST INCOME -164. ADJ FOR ORGANIZATIONAL GRANT RECORDED IN EXPENSE BUT VOIDED AFTER YEAR END -25,000. TOTAL TO SCHEDULE D, PART XI, LINE 8: -6,669,206.
PART XII, LINE 2D - OTHER ADJUSTMENTS:CHARITY CARE GRANT TO BANNER HEALTH SYSTEM -2,000,000. DECREASE IN FAIR VALUE OF INTEREST RATE SWAP -4,658,026. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -1,986,016.
PART XII, LINE 4B - OTHER ADJUSTMENTS:RENTAL EXPENSES INCLUDED IN REVENUES -169,213. K-1 TAX INCOME - POWERSHARES DB AGRICULTURE FUND 164.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES INCLUDED IN REVENUES 169,213. ADJ. FOR ORGANIZATIONAL GRANT RECORDED IN EXPENSE BUT VOIDED AFTER YEAR END 25,000.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:CHARITY CARE GRANT TO BANNER HEALTH SYSTEM 2,000,000.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
BANNER HEALTH SYSTEM
1801 16TH STREETGREELEYCO80631450233470501(C)(3)2000000CHARITY CARE
NCMC FOUNDATION
1802 16TH STREETGREELEYCO80632840718355501(C)(3)1679150OPERATIONAL ASSISTANCE AND CONTRIBUTION TO DONOR ADVISED FUND
UNIVERSITY OF NORTHERN COLORADO
501 20TH STREET CAMPUS BOX 128GREELEYCO80639846044833UNIV NORTHERN CO250000DONATION TO MONFORT SCHOOL OF BUSINESS
UNITED WAY OF WELD COUNTY
PO BOX 1944GREELEYCO80632846011918501(C)(3)15000WELD COUNTY PROJECT CONNECT - SPONSORSHIP OF MEDICAL SUPPLIES
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants4TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THERE IS CURRENTLY NO PROCESS IN PLACE THAT MONITORS THE USE OF GRANT FUNDS BY THE RECIPIENTS. MOST CHARITABLE CONTRIBUTIONS ARE MADE THROUGH NCMC INC'S DONOR ADVISED FUND AT NCMC FOUNDATION WHICH DOES VET RECIPIENTS PRIOR TO MAKING GRANTS, AND ALSO MONITORS THE USE OF PROCEEDS.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
COLORADO HEALTH FACILITIES AUTHORITY
840752932196474K252003-11-1398000000PARTIAL REFUND SERIES 2003,RENOVATE HOSPITAL & PAY 2003B ISSUANCE COSTS.000
COLORADO HEALTH FACILITIES AUTHORITY
84075293219648AMY82008-10-2755515000REFUND SERIES 1993 BONDS, FD IMPROVEMENT TO HOSPITAL FACILITY000
COLORADO HEALTH FACILITIES AUTHORITY
84075293219648ARR82009-11-1744800000REFUND ALL OUTSTANDING SERIES 2005 BONDS.000

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Amount RetiredAmountRetiredTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
3495000980000008845003759456769641791639186520061011
55515000250000003051500020111011
448000004433604435664020091011

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00000.000000.000000.000001
00000.000000.000000.000001
00000.000000.000000.000001

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line2NameOfGICProvider/BusinessNameLine2Term Of GICTermOfGICRegulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfiedGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebateTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminated
FSA CAPITAL
0001MANAGEMENT SERVICES2.000000000000100
CITIBANK NA
01100021.50000000000011
CITIBANK NA
11100014.50000000000011

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
ExplanationTHE AMOUNT REPORTED ON SCHEDULE K, PART II, LINE 11, COLUMN A, B AND C IS THE AMOUNT OF BOND PROCEEDS USED TO REFUND THE PRIOR BONDS ISSUED.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
WILLIAM HUGHES
WILLIAM HUGHES WAS THE BOARD EXECUTIVE FOR NCMC THROUGH MARCH OF 201167318WILLIAM HUGHES PROVIDES CONSULTING SERVICES AS AN INDEPENDENT CONTRACTOR FOR NCMC. FOR 2011 PAYMENTS MADE TO WILLIAM HUGHES CONSULTING ARE AS FOLLOWS: $65,000 FOR SERVICES, AND $2,318 FOR REIMBURSED EXPENSES.0
KEN SCHULTZ
KEN IS NCMC BOARD EXEC STARTING MARCH 2011/33.33% OWNER OF NORTHSTAR MGMT140000PAYMENTS MADE TO NORTHSTAR MANAGEMENT GROUP, INC IN 2011 WERE $140,000.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 3NORTHSTAR MANAGEMENT GROUP INC. IS THE MANAGEMENT COMPANY. KEN SCHULTZ IS A 33.33% OWNER OF THE MANAGEMENT COMPANY AND SUPERVISES ALL OF THE OPERATIONS OF NCMC, INC.
FORM 990, PART VI, SECTION A, LINE 7ATHE NCMC BOARD OF TRUSTEES IS ELIGIBLE TO APPOINT 3 OF THE BOARD MEMBERS OF NCMC, INC. NCMC, INC. IS A SUPPORTING ORGANIZATION OF NCMC BOARD OF TRUSTEES. NCMC BOARD OF TRUSTEES IS A GOVERNMENT BODY APPOINTED BY THE COUNTY COMMISSIONERS. WELD COUNTY OWNS THE LAND THAT THE HOSPITAL SITS ON.
FORM 990, PART VI, SECTION B, LINE 11KEN SCHULTZ AND THE FINANCE COMMITTEE WILL REVIEW A COPY OF THE DRAFT FORM 990 AND THEN PRESENT IT TO FULL BOARD FOR APPROVAL PRIOR TO FILING THE FINAL COPY.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY COVERS THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS RECEIVES THE CONFLICT OF INTEREST POLICY AT THE ANNUAL MEETING. KEN SCHULTZ RECEIVES THE RESPONSES AND FORWARDS THEM TO THE GENERAL COUNSEL OF THE BOARD. IF THERE ARE ANY ITEMS THAT COME UP FOR DISCUSSION IN WHICH A CONFLICT OF INTEREST IS PRESENT, THE BOARD MEMBER EXCUSES HIM OR HERSELF AND ABSTAINS FROM VOTING. THE BOARD HAS THE OPTION TO ALLOW THE MEMBER TO BE PART OF THE DISCUSSION.
FORM 990, PART VI, SECTION C, LINE 19THE GENERAL PUBLIC IS ALLOWED TO VIEW THE DOCUMENTS BUT NOT ALLOWED TO MAKE COPIES AND TAKE THEM OFF OF THE PREMISES.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -15,279,275. REDUCTION IN FAIR VALUE OF INTEREST RATE SWAPS -4,658,026. PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -1,986,016. K-1 INTEREST INCOME -164. ADJ FOR ORGANIZATIONAL GRANT RECORDED IN EXPENSE BUT VOIDED AFTER YEAR END -25,000. TOTAL TO FORM 990, PART XI, LINE 5: -21,948,481.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
SHEEP DRAW FARMS LLC
1801 16TH STREETGREELEYCO80631680540676HOLDS TITLE TO FARM RENT INCOMECO00NCMC INC
SOUTHSIDE INVESTMENTS
1801 16TH STREETGREELEYCO80631680611503OWNS HOUSES ADJACENT TO THE HOSPITALCO112000NCMC INC

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
NCMC BOARD OF TRUSTEES
1801 16TH STREETGREELEYCO80631846000813GOVERNMENTAL ACTIVITY - HOSPITALCOGOVERNMENTAL UNIT6WELD COUNTY BOARD OF COUNTY COMMISSIONERS0
NORMEDCO CARE INC
1801 16TH STREETGREELEYCO80631742354112REAL ESTATECO501(C)(3)9NCMC INC1

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1NMSI DBA NORTHCAREBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11801 16TH STREETAddressLine1
CityGREELEYCity
StateCOState
ZIP Code80634ZIPCode
FieldValueIRS element (for citing)
EIN742354291EIN
Primary ActivityMEDICAL CLAIMS PROCESSINGPrimaryActivity
Legal Domicile StateCOLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NCMC INCBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Share Of Total Income21394ShareOfTotalIncome
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1NORMEDCO CARE INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeETransactionType
Amount Involved175000AmountInvolved
Method Of Amt DeterminationLOAN AMOUNTMethodOfAmtDetermination

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