2024-05-15T14:04:16-05:00 2023-06-30 381357951 PLANTE & MORAN PLLC 8181 E TUFTS AVE SUITE 600 DENVER CO 80237 990 2022-07-01 043730045 MEDICAL CENTER OF THE ROCKIES MEDI 9702377000 2315 EAST HARMONY ROAD 200 FORT COLLINS CO 80528 DAVID THOMPSON CHIEF FINANCIAL OFFICER 9702377000 2024-05-14 1 DAVID THOMPSON 999009999 1 AMY CIMINELLO P00796388 3037409400 2024-05-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z KEVIN UNGER 2315 EAST HARMONY ROAD 200 FORT COLLINS CO 80528 760487545 0 X WWW.UCHEALTH.ORG X 2002 CO WE IMPROVE LIVES THROUGH LEARNING, HEALING, DISCOVERY, AND THROUGH HUMAN CONNECTION. 11 10 3384 129 11132 0 9554613 323077 565510971 592935480 16120423 5784714 4759915 5064265 595945922 604107536 69118222 75568528 0 0 189658826 209081715 0 0 0 273688212 293410886 532465260 578061129 63480662 26046407 578786363 629132901 269026743 266097369 309759620 363035532 WE IMPROVE LIVES. IN BIG WAYS THROUGH LEARNING, HEALING AND DISCOVERY. IN SMALL, PERSONAL WAYS THROUGH HUMAN CONNECTION. BUT IN ALL WAYS, WE IMPROVE LIVES. 0 0 483237760 75568528 596049429 MEDICAL CENTER OF THE ROCKIES (MCR) PROVIDES TERTIARY, ACUTE, INPATIENT, OUTPATIENT, AS WELL AS EMERGENCY CARE. MCR SERVICES COMMUNITIES IN NORTHERN COLORADO, SOUTHWESTERN NEBRASKA, AND SOUTHEASTERN WYOMING. DURING FISCAL YEAR 2023, MCR RECORDED 53,210 PATIENT DAYS; 10,696 INPATIENT ADMISSIONS; 2,750 OBSERVATION PATIENTS ADMISSIONS; 231,204 OUTPATIENT CLINIC VISITS; 60,218 EMERGENCY VISITS; 1,470 BIRTHS; 3,287 INPATIENT SURGERIES; 5,961 OUTPATIENT SURGERIES. 483237760 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 129 0 1 3384 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X DAVID THOMPSON 9702377000 2315 E HARMONY RD SUITE 200 FORT COLLINS CO 80528 KEVIN UNGER CHIEF EXECUTIVE OFFICER 16.00 22.00 X X 303627 412118 28148 CHRISTINE CHIN DIRECTOR 1.00 2.00 X 0 1404 0 LISA CLAY CHAIR 1.00 2.00 X X 0 2422 0 MIKE DELLENBACH DIRECTOR 1.00 2.00 X 0 101 0 DOUG ERION DIRECTOR 1.00 2.00 X 0 119 0 DENNIS HOUSKA DIRECTOR 1.00 2.00 X 0 1271 0 BRAD OLDEMEYER DIRECTOR 1.00 2.00 X 0 0 0 CHRIS OSBORN DIRECTOR 1.00 2.00 X 0 2424 0 JIM PARKE DIRECTOR 1.00 2.00 X 0 121 0 DAN STROH DIRECTOR 1.00 2.00 X 0 235 0 JIM TRUMBULL DIRECTOR 1.00 2.00 X 0 0 0 MEL MCNEA DIRECTOR 1.00 2.00 X 0 0 0 MICHELLE ALBRIGHT SECRETARY 16.00 22.00 X 23984 32554 12199 DAVID THOMPSON CHIEF FINANCIAL OFFICER 16.00 22.00 X 164505 223285 27212 DIANA BREYER CHIEF MEDICAL OFFICER 16.00 22.00 X 200854 271053 27629 ANDREW HARMON DIRECTOR OF PHARMACY 21.00 29.00 X 97481 131551 50691 GRACE KOWALYSHYN-TAYLOR VP OF OPERATIONS 16.00 22.00 X 108197 146857 45357 WILLIAM NEFF ASSOCIATE CHIEF MEDICAL OFFICER 16.00 22.00 X 93883 126696 12398 RYAN ROHMAN CHIEF OPERATING OFFICER 16.00 22.00 X 135239 183561 10330 ANNETTE VIZENA VP CHIEF QUALITY OFFICER 16.00 22.00 X 128160 172953 30942 ROBERT WAGNER JR SR DIRECTOR CARDIOVASCULAR 16.00 22.00 X 76514 103257 26206 JESSIE WILLARD CHIEF NURSING OFFICER MCR 50.00 0.00 X 258209 0 53003 ROBIN JOHNSON OPERATING ROOM RN 40.00 0.00 X 190264 0 29451 REBECCA NEMECHEK MANAGER OF PHARMACY 50.00 0.00 X 186299 0 32368 BARBARA OCHSNER CLINICAL DIRECTOR 50.00 0.00 X 187566 0 29617 TAMMY TRIPP-DANIELS CT TECHNOLOGIST 40.00 0.00 X 181494 0 44836 MONICA WINGARD CLINICAL MANAGER 50.00 0.00 X 187122 0 42061 2523398 1811982 502448 192 0 1 0 VAYA WORKFORCE SOLUTIONS 5930 CORNERSTONE CT WEST ST 300 SAN DIEGO CA 92121 CONTRACT LABOR 10957473 NORTHERN COLORADO ANESTHESIA 1236 E ELIZABETH ST STE 1 FORT COLLINS CO 80524 MEDICAL 3091068 NORTHERN COLORADO HOSPITALISTS 2121 E HARMONY RD STE 300 FORT COLLINS CO 80528 MEDICAL 3063636 THE NEPHROLOGY CLINIC 1600 SPECHT POINT RD STE 127 FORT COLLINS CO 80525 MEDICAL 1613568 HOSPITAL COOPERATIVE LAUNDRY 6225 EAST 38TH AVE DENVER CO 80207 LAUNDRY SERVICES 1361620 24 250164 72913 124628 323077 NET PATIENT SVC REV 900099 565025358 565025358 PROVIDER FEE REVENUE 900099 22514565 22514565 RESEARCH CONTRACT INCO 900099 2053972 2053972 DIETARY SVC INCOME 900099 1891998 1891998 LAB SERVICES 900099 1449587 1449587 592935480 8290277 8290277 60471 13285 47186 47186 47186 153581178 70714 156157455 0 -2576277 70714 -2505563 -2505563 368396 209269 159127 159127 OTHER REVENUE 900099 4846820 4846820 PHARMACY SALES 456110 11132 11132 4857952 604107536 596049429 11132 7723898 75568528 75568528 1837404 596466 1240938 161021342 122995516 38025826 11839780 8996478 2843302 32787246 24979393 7807853 1595943 1215890 380053 1017770 42 1017728 46359 46359 31195 31195 450422 450422 53304402 29095801 24208601 2333700 2333651 49 2221514 1949402 272112 9978247 8249585 1728662 4062106 4062106 75640 58713 16927 3755403 147953 3607450 4752832 4752832 17115464 13705605 3409859 653949 500 653449 MEDICAL SUPPLIES 128934048 128897608 36440 PROVIDER FEE EXPENSE 28305932 28305932 BAD DEBT 23976083 23947223 28860 REPAIRS 4164932 171751 3993181 8230888 3206785 5024103 578061129 483237760 94823369 0 13867249 10491476 69012003 73676859 11996266 12710765 2788817 3873603 379048176 266251248 107163277 112796928 100571842 273386909 415583270 578786363 629132901 51491255 47203945 51768 540037 214570600 214570600 2913120 3782787 269026743 266097369 X 309759620 363035532 309759620 363035532 578786363 629132901 X 26046407 35660406 -8430901 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 13513 0 1 17652 31165 0 PART II-B, LINE 1: PORTION OF DUES FROM MEMBERSHIP IN CHA AND AHA THAT ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES - $17,652. INTERNAL STAFF TIME AND EXPENSE SPENT ON DIRECT LOBBYING ACTIVITIES - $13,513. 7505139 15248 739495 51797 256647 7951438 8519574 80607 -772629 45447 242696 34270 7505139 7696043 67691 1053774 36975 222882 38077 8519574 7552046 76521 186928 28707 55954 34791 7696043 7528946 61289 260065 33759 234908 29587 7552046 0.05740 0.85410 0.08850 1 1 1 10973185 10973185 188569022 138093332 50475690 21761164 19981468 1779696 142912065 106910825 36001240 14832740 1265623 13567117 112796928 OTHER RECEIVABLES 1562 INTERCOMPANY RECEIVABLE 100720474 ASSETS DESIGNATED FOR LT PURPOSE (LEASES) 314527745 LEASE RECEIVABLE LT 333489 415583270 INTERCOMPANY PAYABLES 1520020 BOND INTEREST EXPENSE 70687 OTHER DEFERRED EXPENSES 950232 LEASE LIABILITY ST 579872 LEASE LIABILITY LT 399779 DEFERRRED INFLOW OF LEASES 262197 3782787 615456184 35660406 222555 35882961 579573223 450422 24083891 24534313 604107536 553749371 222555 222555 553526816 450422 24083891 24534313 578061129 PART V, LINE 4: ENDOWMENT FUNDS ARE USED FOR THE INTENDED PURPOSE TO FUND SCHOLARSHIPS, EDUCATION, PROGRAMS, AND COMMUNITY BENEFIT. TEMPORARILY RESTRICTED NET ASSETS ARE THOSE WHOSE USE BY THE FOUNDATION HAVE BEEN LIMITED BY THE DONOR TO A SPECIFIC TIME PERIOD OR PURPOSE. THESE NET ASSETS ARE AVAILABLE FOR VARIOUS HEALTH CARE PURPOSES AS DEFINED BY DONORS. THE ENDOWMENT FUND IS OWNED BY UCHEALTH NORTHERN COLORADO FOUNDATION. PART XI, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD IN EXPENSE ON AFS 209,270. RENTAL EXPENSES 13,285. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 23,947,223. UBI PHARMACY 11,132. CONTRIBUTIONS FROM FOUNDATION 125,536. PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD IN EXPENSE ON AFS 209,270. RENTAL EXPENSES 13,285. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 23,947,223. UBI PHARMACY 11,132. CONTRIBUTIONS FROM FOUNDATION 125,536. 1 1 X 1 X 250.000000000000 1 X 1 0 1 1 4014645 85670 3928975 0.00710 70056034 41344353 28711681 0.05180 12327982 9617124 2710858 0.00490 86398661 51047147 35351514 0.06380 932 932 0.00000 91044 559 90485 0.00020 230909 222693 8216 0.00000 385370 48900 336470 0.00060 75781855 75781855 0.13680 76490110 272152 76217958 0.13760 162888771 51319299 111569472 0.20140 1306 1306 0.00000 88436 88436 0.00020 89742 89742 0.00020 0 23976083 109246310 128801219 -19554909 X 1 1 1 1 MEDICAL CENTER OF THE ROCKIES 2500 ROCKY MOUNTAIN AVENUE LOVELAND CO 80538 X X X X X LAB, PHARMACY, CARDIOVASCULAR, TRAUMA MEDICAL CENTER OF THE ROCKIES 1 0 0 1 X X X X X X X X X 21 1 1 1 1 X HTTPS://WWW.UCHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X 1 22 1 HTTPS://WWW.UCHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 1 X 250.000000000000 400.000000000000 X X X 1 1 X X X 1 X HTTPS://WWW.UCHEALTH.ORG/BILLING-AND-PRICING/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.UCHEALTH.ORG/BILLING-AND-PRICING/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.UCHEALTH.ORG/BILLING-AND-PRICING/FINANCIAL-ASSISTANCE/ X X X X X X 1 X 0 X X X X 1 X 0 0 MEDICAL CENTER OF THE ROCKIES PART V, SECTION B, LINE 5: PVH/MCR ASKED MEMBERS OF THE LARIMER COUNTY COMMUNITY TO RESPOND TO THE SURVEY TO HELP SELECT IDENTIFIED HEALTH NEEDS IN LARIMER COUNTY. A SURVEY WAS SENT TO 50 IMPACTFUL COMMUNITY ORGANIZATIONS/PEOPLE, INCLUDING THOSE WHO REPRESENT UNDERSERVED POPULATIONS, HIGHER EDUCATION, LOCAL SCHOOL DISTRICT SUPERINTENDENTS, THE SHERIFF'S OFFICE, AND LARIMER COUNTY, INCLUDING THOSE WHO ARE ACTIVELY INVOLVED IN THE COMMUNITY HEALTH IMPROVEMENT PLAN FOR LARIMER COUNTY. RESPONSES WERE RECEIVED FROM 39 PEOPLE, A 78% RESPONSE RATE. MEDICAL CENTER OF THE ROCKIES PART V, SECTION B, LINE 6A: POUDRE VALLEY HOSPITAL (PVH) AND MEDICAL CENTER OF THE ROCKIES (MCR) PREPARED A JOINT CHNA AS BOTH HOSPITALS SERVE RESIDENTS FROM THE SAME GEOGRAPHIC LOCATIONS. MEDICAL CENTER OF THE ROCKIES PART V, SECTION B, LINE 6B: IN 2022, THE CHNA PROCESS FOR MEDICAL CENTER OF THE ROCKIES (MCR) AND POUDRE VALLEY HOSPITAL (PVH), INCLUDED A MULTI-PHASED APPROACH TO IDENTIFY THE TOP HEALTH PRIORITIES AND A COMPREHENSIVE ANALYSIS OF LOCAL POPULATION HEALTH INDICATORS, SOLICITATION OF COMMUNITY INPUT ON LOCAL HEALTH ISSUES THROUGH A WEB-BASED SURVEY AND A WEB-BASED SURVEY DISTRIBUTED TO HEALTH CARE PROVIDERS AT PVH AND MCR TO GATHER INPUT ON COMMUNITY HEALTH NEEDS. MEDICAL CENTER OF THE ROCKIES PART V, SECTION B, LINE 11: EXAMPLES OF HOW PVH/MCR IS ADDRESSING ISSUES RELATED TO ACCESS TO CARE FOR VULNERABLE INDIVIDUALS INCLUDES STAFFING A RN HOME VISIT PROGRAM FOR POSTPARTUM WOMEN WHO ARE ELIGIBLE FOR OR ENROLLED IN MEDICAID. NURSES ASSESS THE NEWBORN, PROVIDE THE MOTHER WITH LACTATION COUNSELING, SELF-CARE GUIDELINES AND ACHIEVE AN INCREASE IN THE MOTHER'S CONFIDENCE TO CARE FOR HER NEWBORN. ADDITIONALLY, COMPREHENSIVE CARE COORDINATION SERVICES ASSIST FAMILIES OF CHILDREN WITH SPECIAL HEALTH CARE NEEDS AS WELL AS VULNERABLE ADULTS WITH MEDICALLY COMPLEX, CHRONIC CONDITIONS. TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES, PVH/MCR IS EXPANDING THE USE OF TECHNOLOGY TO PROVIDE TELE-PSYCH SERVICES TO RESIDENTS WHO ARE NOT ABLE TO ACCESS A LOCAL MENTAL HEALTH PROVIDER OR TO BRIDGE GAPS IN PROVIDER AVAILABILITY. WE ARE ALSO EMBEDDING TEAMS OF LICENSED CLINICAL SOCIAL WORKERS AND PSYCHOLOGISTS INTO PRIMARY CARE PRACTICES. FOR PERSONS WITH SUBSTANCE USE DISORDERS, PVH/MCR DIRECTS RESOURCES TO PROVIDING MEDICALLY ASSISTED ADDICTION TREATMENT AS WELL AS PARTICIPATING IN THE COLORADO ALTERNATIVES TO OPIOIDS TREATMENT PROTOCOLS. INCREASED SCREENING AND REFERRAL TO TREATMENT FOR PERSONS USING ALCOHOL HAS ALSO BEEN IMPLEMENTED. THE IDENTIFIED HEALTH ISSUES ARE DESCRIBED IN THE 2022-24 COMMUNITY HEALTH NEEDS ASSESSMENT AND THE FULL SPECTRUM OF SERVICES AND PROGRAMS ARE NOTED IN THE 2023-25 IMPLEMENTATION STRATEGY REPORT POSTED TO THE UCHEALTH WEBSITE: HTTPS://WWW.UCHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PREVIOUS ASSESSMENTS AND IMPLEMENTATION STRATEGIES CAN BE FOUND THERE AS WELL. PART I, LINE 7: THE ORGANIZATION USED A COST-TO-CHARGE RATIO FOR LINE 7B AND 7C. THE COST-TO-CHARGE RATION WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE TO COST-TO-CHARGES. LINE 7A WAS DERIVED USING A COST-TO-CHARGE RATIO FROM THE COST REPORT.THE INFORMATION FOR LINES 7E THROUGH 7I WAS DERIVED FROM INFORMATION IN THE GENERAL LEDGER AND OTHER FINANCIAL DATA RELATED SPECIFICALLY TO THE VARIOUS TYPES OF COMMUNITY BENEFITS. PART I, LN 7 COL(F): TOTAL BAD DEBT EXPENSE REMOVED FROM THE DENOMINATOR PRIOR TO THE PERCENTAGE CALCULATION = $23,976,083PART III, LINE 2: ACCOUNTS WITH UNRESOLVED PATIENT LIABILITY AFTER REASONABLE COLLECTION EFFORTS, SET BY POLICY AND IN CONJUNCTIONS WITH FEDERAL, STATE AND PAYOR SPECIFIC REGULATIONS WILL BE ASSIGNED TO BAD DEBT. THESE ACCOUNTS SHALL BE REFERRED TO AN OUTSIDE COLLECTION AGENCY OR IN SELECTED INSTANCES, ATTORNEYS, FOR ADDITIONAL COLLECTIONS ACTIVITIES. PART III, LINE 4: THE PATIENT ACCOUNTS RECEIVABLE ARE REPORTED NET OF ALLOWANCES FOR DOUBTFUL ACCOUNTS, CONTRACTUAL ADJUSTMENTS, AND MEDICALLY INDIGENT ALLOWANCES.PART III, LINE 6: THE AMOUNT ON LINE 6 WAS DETERMINED BY ALLOWABLE COSTS AS REPORTED ON THE MEDICAL CENTER OF THE ROCKIES 2023 COST REPORT AGGREGATED WITH DISREGARDED ENTITIES AND OWNERSHIP PORTIONS OF JOINT VENTURES. PART III, LINE 8: APPROXIMATELY 33% OF NET PATIENT SERVICE REVENUE IS FROM PARTICIPATION IN THE MEDICARE PROGRAM, THUS PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES TO A SIGNIFICANT PORTION OF THE COMMUNITY POPULATION. PART III, LINE 9B: IF UCHEALTH DETERMINES THAT AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE FOLLOWING UCHEALTH'S REVIEW OF A COMPLETE APPLICATION, UCHEALTH WILL REVERSE ECAS (IF ANY) AND WILL REFUND AMOUNTS PREVIOUSLY PAID FOR CARE COVERED BY THIS POLICY IN EXCESS OF THE AMOUNT OWED, EXCEPT OVERPAYMENTS THAT ARE $5 OR LESS. IF THE GUARANTOR STILL OWES ANY AMOUNT, UCHEALTH WILL PROVIDE AN UPDATED BILLING STATEMENT SHOWING HOW THE ADJUSTED AMOUNT WAS DETERMINED. PART VI, LINE 2: SEE NARRATIVES FOR PART V, SECTION B, LINES 5 AND 6B. PART VI, LINE 3: THERE ARE SEVERAL WAYS WE NOTIFY THE PATIENT AND ATTEMPT TO ASSIST THEM. FOR SURGERIES AND HIGH DOLLAR SCHEDULED PROCEDURES, WE PROVIDE THEM WITH AN ESTIMATE AT REGISTRATION AND GO OVER ALL FINANCIAL ASSISTANCE OPTIONS AVAILABLE IF THEY ARE INTERESTED. WE ALSO HAVE FINANCIAL COUNSELORS AVAILABLE EACH DAY THAT CAN ANSWER QUESTIONS AND HELP THEM FILL OUT CHARITY APPLICATIONS. ONCE A PERSON HAS RECEIVED CARE IN THE ED, WE ALSO HAVE EDUCATED STAFF THAT ASSISTS THEM AND EDUCATES THEM OF WHAT IS AVAILABLE FOR FINANCIAL ASSISTANCE. IN ADDITION, ONCE A PATIENT DOES RECEIVE A STATEMENT OR BILL, THERE IS INFORMATION ON THE BILL OF WHO THEY CAN CALL TO GET INFORMATION ON FINANCIAL ASSISTANCE. ADDITIONALLY, WE WIDELY PUBLICIZE OUR FINANCIAL ASSISTANCE POLICY AS REQUIRED BY LAW, INCLUDING A PLAIN LANGUAGE SUMMARY. PART VI, LINE 4: MEDICAL CENTER OF THE ROCKIES IS A LOCALLY OWNED, PRIVATE, NON-PROFIT ORGANIZATION WITH A STRONG VISION: FROM HEALTHCARE TO HEALTH. BASED IN NORTHERN COLORADO, MCR PROVIDES EVIDENCE-BASED HEALTHCARE AND WELLNESS SERVICES AND PRODUCTS IN COLORADO, NEBRASKA AND WYOMING, ACROSS A SERVICE AREA COVERING MORE THAN 50,000 SQUARE MILES. MCR IS A PART OF THE UCHEALTH WHICH AIMS TO DELIVER THE HIGHEST QUALITY PATIENT CARE WITH THE HIGHEST QUALITY PATIENT EXPERIENCE. THE PARTNERSHIP COMBINES POUDRE VALLEY HOSPITAL, MEDICAL CENTER OF THE ROCKIES, UCHEALTH GREELEY HOSPITAL, UCHEALTH MEDICAL GROUP, UNIVERSITY OF COLORADO HOSPITAL AND MEMORIAL HEALTH SYSTEM INTO AN ORGANIZATION DEDICATED TO BUILDING HEALTHIER COMMUNITIES AND PROVIDING UNMATCHED PATIENT CARE IN THE ROCKY MOUNTAIN WEST. THE ORGANIZATION'S MISSION IS WE IMPROVE LIVES. IN BIG WAYS THROUGH LEARNING, HEALING AND DISCOVERY. IN SMALL, PERSONAL WAYS THROUGH HUMAN CONNECTION. BUT IN ALL WAYS WE IMPROVE LIVES. PART VI, LINE 5: WE HAVE IMPLEMENTED A MULTITUDE OF PROGRAMS AND SERVICES THAT ADDRESS THE HEALTH NEEDS OF OUR BROADER COMMUNITY TARGETING ALL AGE GROUPS WHILE MAINTAINING A SPECIAL FOCUS ON SERVING VULNERABLE POPULATIONS. WE ALSO GIVE FUNDING TO OTHER ENTITIES THAT WORK TO IMPROVE THE HEALTH OF OUR COMMUNITY. EXAMPLES INCLUDE: DEMENTIA RESOURCES, RESOURCES FOR THOSE WITH DISABILITIES, RESOURCES FOR THOSE EXPERIENCING HOMELESSNESS, HOUSING RESOURCES OFFERING HOMELESSNESS PREVENTION AND HOMEBUYER EDUCATION; IMPROVED FOOD SECURITY FOR LOW INCOME RESIDENTS; SUICIDE PREVENTION; PROGRAMS FOR CHILDREN WHO HAVE BEEN ABUSED AND NEGLECTED; HEART HEALTH, HEALTHY EATING AND SUBSTANCE ABUSE PREVENTION EDUCATION FOR YOUTH AND YOUNG ADULTS; AND MENTAL HEALTH SERVICES FOR THE UNDERSERVED. PART VI, LINE 6: ALL THE SERVICES WE OFFER ARE AVAILABLE TO ANYONE THAT USES ANY OF OUR FACILITIES IN THE HEALTH SYSTEM. OUR GEOGRAPHY IS NOT THAT LARGE SO WE ARE ABLE TO ACCOMMODATE THE DIFFERENT COMMUNITIES THAT UTILIZE OUR SERVICES WITH THE SAME LEVEL OF COMMUNITY HEALTH PROGRAMMING. PART VI, LINE 7, REPORTS FILED WITH STATES CO 1 UC HEALTH MEDICAL GROUP 2315 EAST HARMONY ROAD SUITE 200 FORT COLLINS CO 80528 800348943 501(C)(3) 72564667 0 COMMUNITY HEALTHCARE UNIVERSITY OF CO SCHOOL OF MEDICINE 13001 17TH PLACE AURORA CO 80045 846000555 501(C)(3) 2356820 0 HEALTHCARE EDUCATION UCHEALTH NORTHERN COLORADO FOUNDATION 2315 EAST HARMONY ROAD SUITE 200 FORT COLLINS CO 80528 741894581 501(C)(3) 525026 0 COMMUNITY HEALTHCARE UNITED WAY OF LARIMER COUNTY 424 PINE ST 102 FORT COLLINS CO 80524 846031503 501(C)(3) 6925 0 COMMUNITY ASSISTANCE FRONT RANGE COMMUNITY COLLEGE 3645 W 112TH AVENUE WESTMINSTER CO 80031 383721881 GOVERNMENT 16330 0 HEALTHCARE EDUCATION AMERICAN CANCER SOCIETY 3380 CHASTAIN MEADOWS PKY 200 KENNESAW GA 30144 131788491 501(C)(3) 9244 0 COMMUNITY HEALTHCARE FOOD FOR THOUGHT DENVER 3559 W 44TH AVE DENVER CO 80211 812971428 501(C)(3) 10995 0 COMMUNITY ASSISTANCE CHEYENEE REGIONAL MEDICAL CENTER FOUNDATION 214 E 23RD ST CHEYENNE WY 82001 830236858 501(C)(3) 14762 0 COMMUNITY ASSISTANCE GREELEY PHILHARMONIC ORCHESTRA PO BOX 1535 GREELEY CO 80632 846031376 501(C)(3) 5656 0 COMMUNITY ASSISTANCE 9 PART I, LINE 2: THE ORGANIZATION AWARDS GRANTS BASED ON THE BENEFIT TO THE COMMUNITY. THE ORGANIZATION REQUESTS INFORMATION FROM THE GRANTEES TO ENSURE THAT THE FUNDS WILL BE USED FOR THE SPECIFIED PURPOSE. QUESTION I, PART II, COLUMN H PURPOSE OF GRANT OR ASSISTANCE FOR RELATED ENTITIES, THE GRANTS ARE RELATED TO SPECIFIC REQUESTS. THE FUNDS ARE TO BE USED TO BENEFIT THE HEALTHCARE COMMUNITY OF NORTHERN COLORADO. EACH REQUEST IS EVALUATED ON AN INDIVIDUAL BASIS. FOR NON-RELATED COMMUNITY AND GOVERNMENTAL ORGANIZATIONS, THE GRANTS ARE MADE AT THE DISCRETION OF THE ORGANIZATION. THESE DISCRETIONARY GRANTS ARE TO BE USED TO BENEFIT THE HEALTHCARE COMMUNITY OF NORTHERN COLORADO. X X X 1 1 X X X X 0 0 0 0 0 0 0 1 0 KEVIN UNGER CHIEF EXECUTIVE OFFICER 223111 302832 73147 99284 7369 10002 2929 3975 9012 12232 315568 428325 0 0 DIANA BREYER CHIEF MEDICAL OFFICER 172423 232686 26938 36353 1493 2014 2770 3738 8990 12131 212614 286922 0 0 DAVID THOMPSON CHIEF FINANCIAL OFFICER 137646 186829 25497 34607 1362 1849 2899 3934 8645 11734 176049 238953 0 0 ANNETTE VIZENA VP CHIEF QUALITY OFFICER 111061 149878 16751 22606 348 469 10261 13848 2909 3924 141330 190725 0 0 RYAN ROHMAN CHIEF OPERATING OFFICER 114194 154996 20793 28223 252 342 2929 3975 1454 1972 139622 189508 0 0 JESSIE WILLARD CHIEF NURSING OFFICER MCR 217563 0 39938 0 708 0 23411 0 29592 0 311212 0 0 0 GRACE KOWALYSHYN-TAYLOR VP OF OPERATIONS 90899 123378 16991 23062 307 417 10157 13787 9084 12329 127438 172973 0 0 ANDREW HARMON DIRECTOR OF PHARMACY 88817 119859 8526 11505 138 187 9316 12572 12259 16544 119056 160667 0 0 WILLIAM NEFF ASSOCIATE CHIEF MEDICAL OFFICER 56040 75627 0 0 37843 51069 2837 3829 2440 3292 99160 133817 0 0 MONICA WINGARD CLINICAL MANAGER 177358 0 9482 0 282 0 18259 0 23802 0 229183 0 0 0 TAMMY TRIPP-DANIELS CT TECHNOLOGIST 173766 0 1995 0 5733 0 17399 0 27437 0 226330 0 0 0 ROBIN JOHNSON OPERATING ROOM RN 181350 0 1866 0 7048 0 12291 0 17160 0 219715 0 0 0 REBECCA NEMECHEK MANAGER OF PHARMACY 178088 0 7834 0 377 0 17714 0 14654 0 218667 0 0 0 BARBARA OCHSNER CLINICAL DIRECTOR 171788 0 15184 0 594 0 17382 0 12235 0 217183 0 0 0 ROBERT WAGNER JR SR DIRECTOR CARDIOVASCULAR 69719 94087 6634 8952 161 218 7295 5140 8080 5691 91889 114088 0 0 PART I, LINE 1A GROSS-UP PAYMENTS: GROSS UP PAYROLL IS CALCULATED AT YEAR END FOR SPECIAL CHECKS CREATED TO ADD SPECIFIC ITEMS TO EMPLOYEE'S FORM W-2 WAGES INCLUDING COUNTRY CLUB DUES, SPOUSE TRAVEL FOR ANNUAL BOARD RETREAT AND SELECT CONFERENCES, AND IMPUTED INCOME ON LIFE INSURANCE POLICIES. CLUB DUES: THE HEALTH SYSTEM EXPECTS THE HOSPITAL MANAGEMENT TO PARTICIPATE IN COMMUNITY LIFE AND THEREFORE THE SYSTEM PAYS SOCIAL CLUB DUES FOR SPECIFIC MEMBERS OF THE SENIOR MANAGEMENT GROUP. THE CLUB DUES ARE ADDED TO THE SENIOR MANAGEMENT'S FORM W-2 ON AN ANNUAL BASIS. PART I, LINE 7 THE ORGANIZATION OFFERS A BONUS PLAN THAT PAYS A PERCENTAGE OF AN EMPLOYEE'S BASE PAY. THE INTENT OF THE PLAN IS TO REWARD AN EMPLOYEE'S PERFORMANCE TOWARDS ACHIEVEMENT OF STRATEGIC GOALS DURING THE FISCAL YEAR. SUCCESSFUL ACCOMPLISHMENT OF GOALS THAT CONTRIBUTE TO THE ORGANIZATION'S OVERALL STRATEGIC DIRECTION RESULT IN VARIABLE PAYMENTS ALIGNED WITH THE ORGANIZATION'S TOTAL COMPENSATION STRATEGY. THIS PROGRAM REWARDS EMPLOYEES BASED ON ORGANIZATIONAL PERFORMANCE MEASURES AND INDIVIDUAL EMPLOYEE GOAL PERFORMANCE. ALL PAYOUTS ARE CONTINGENT BASED ON THE UCHEALTH BOARD OF DIRECTORS APPROVAL EACH FISCAL YEAR. A COLORADO HEALTH FACILITIES AUTHORITY - 2018 SERIES B 841179794 914183BJ6 2018-07-26 51795600 REFUNDING 2005B BONDS 0 0 0 B COLORADO HEALTH FACILITIES AUTHORITY - 2018 SERIES C 841179794 914183BL1 2018-07-26 75265000 REFUNDING 2005C BONDS 0 0 0 C UNIVERSITY OF COLORADO HOSPITAL AUTHORITY SERIES 2012C 841179794 914183AU2 2012-10-01 87510000 REFUND SERIES 2005D & 2005E BONDS 0 0 0 A 51795600 359891 51435709 2018 1 0 1 1 B 75265000 523373 74741627 2018 1 0 1 1 C 87510000 641020 86868980 2012 1 0 1 1 A 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 C 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 1 CITI 21.500000000000 0 0 0 0 1 B 0 1 0 0 1 1 CITI 21.500000000000 0 0 0 0 1 C 0 0 0 1 1 1 WELLS FARGO 5.000000000000 1 0 0 0 1 A 1 B 1 C 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: UNIVERSITY OF COLORADO HOSPITAL AUTHORITY SERIES 2012C DATE THE REBATE COMPUTATION WAS PERFORMED: 10/25/2017 X MEDICAL EQUIPMENT 7 124628 FMV 0 0 0 0 FORM 990, PART I, LINE 6 MEDICAL CENTER OF THE ROCKIES (MCR) HAD OVER 26,900 VOLUNTEER HOURS AT MCR DURING 2023. AT MCR, VOLUNTEERS PLAY AN INTEGRAL ROLE IN PROVIDING MUCH NEEDED SUPPORT FOR PATIENTS, VISITORS, PHYSICIANS, AND STAFF. FROM ASSISTING IN SURGERY AND CARDIAC WAITING ROOMS, INFORMATION DESK, GIFT SHOP, VOLUNTEER PATIENT LIAISONS, BABY KNITTERS, VOLUNTEENS, AND PET THERAPY TO NAME JUST A FEW OF THE MANY PROGRAMS, EVERY VOLUNTEER CONTRIBUTES TO THE SUCCESS OF THE UCHEALTH NORTH TO ENHANCE THE COMFORT AND CARE OF THE PATIENTS AND THEIR FAMILIES. FORM 990, PART VI, SECTION A, LINE 6 POUDRE VALLEY HEALTH CARE, INC & REGIONAL WEST HEALTH SERVICES, BOTH 501(C)(3) ORGANIZATIONS, ARE THE SOLE MEMBERS OF MEDICAL CENTER OF THE ROCKIES. FORM 990, PART VI, SECTION A, LINE 7A POUDRE VALLEY HEALTH CARE, INC & REGIONAL WEST HEALTH SERVICES, THE SOLE MEMBERS OF MEDICAL CENTER OF THE ROCKIES, APPOINT ALL BOARD MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B A UNANIMOUS VOTE OF THE MEMBERS IS REQUIRED FOR AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS, ACTION REGARDING DISSOLUTION, MERGER OR CONSOLIDATION, ACTION REGARDING SALE, LEASE, MORTGAGE OR TRANSFER OF SUBSTANTIALLY ALL ASSETS, OR ADMITTING A NEW MEMBER OR TRANSFER OF A MEMBER INTEREST. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY INDEPENDENT CPAS. A PRELIMINARY DRAFT IS REVIEWED BY THE INTERNAL FINANCE DEPARTMENT. THE FINAL COPY OF THE FORM 990 IS PROVIDED IN AN ELECTRONIC FORMAT TO ALL BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY REQUIRES COMPLETION OF THE FORM ON AN ANNUAL BASIS BY THE BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES OF THE ORGANIZATION. COMPLETED FORMS ARE SUBMITTED AND REVIEWED BY THE INTERNAL COMPLIANCE DEPARTMENT TO ENSURE COMPLIANCE WITH THE WRITTEN POLICY. ANY QUESTIONS OR ULTIMATE ENFORCEMENT WOULD BE HANDLED BY THE COMPLIANCE DEPARTMENT. FORM 990, PART VI, SECTION B, LINE 15 UCHEALTH CONTRACTS WITH SULLIVAN COTTER FOR SENIOR EXECUTIVE COMPENSATION CONSULTING SERVICES. ON OUR BEHALF, THE SULLIVAN COTTER COLLECTS AND REVIEWS COMPENSATION LEVELS FROM LIKE ORGANIZATIONS FOR LIKE JOBS AND PROVIDES UCHEALTH WITH THE COMPARATIVE MARKET DATA. THE DATA IS SUBMITTED TO THE CHIEF HUMAN RESOURCES OFFICER WHO ADVISES THE SYSTEM PRESIDENT AND CEO ON COMPENSATION DECISIONS FOR SENIOR EXECUTIVES. BASED ON THE MARKET DATA, THE SYSTEM PRESIDENT AND CEO DETERMINE THE SALARY OF THE ENTITY CEO'S COMPENSATION ANNUALLY. OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE REVIEWED ANNUALLY BY AN INTERNAL HUMAN RESOURCES COMPENSATION TEAM. PUBLISHED COMPENSATION REPORTS ARE UTILIZED TO COMPARE INCUMBENT PAY TO COMPARABLE ROLES IN LIKE-SIZED ORGANIZATIONS. THE DATA IS REVIEWED WITH THE CHIEF HUMAN RESOURCES OFFICER EACH YEAR AND RECOMMENDATIONS FOR CHANGES ARE INCLUDED IN THE FOLLOWING YEARS' BUDGET PLANNING PROCESS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE PROVIDED TO THE PUBLIC BASED ON THE BUSINESS PURPOSE FOR THE REQUEST. THESE REQUESTS ARE ADDRESSED BY THE SENIOR MANAGEMENT TEAM ON A CASE BY CASE BASIS. FORM 990, PART XI, LINE 9: DISTRIBUTION TO RWMC -1,011,708. DISTRIBUTION TO PVHC -7,419,193. POUDRE VALLEY HEALTHCARE INC 2315 E HARMONY RD 200 FORT COLLINS CO 80528 841262971 TERTIARY CARE CO 501(C)(3) LINE 3 N/A 0 UCHEALTH NORTHERN COLORADO FOUNDATION 2315 E HARMONY RD 200 FORT COLLINS CO 80528 741894581 FUNDRAISING CO 501(C)(3) LINE 7 N/A 0 INNOVATION ENTERPRISES 2315 E HARMONY RD 200 FORT COLLINS CO 80528 202036774 IT CONSULTING CO N/A C 0 0 1 1 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1