2021-05-10T13:56:33-05:00 2020-06-30 381357951 PLANTE & MORAN PLLC 8181 E TUFTS AVE SUITE 600 DENVER CO 80237 990 2019-07-01 800348943 POUDRE VALLEY MEDICAL GROUP LLC POUD 9702377000 2315 E HARMONY ROAD NO 200 FORT COLLINS CO 80528 STEVE SCHWARTZ CFO 9702377000 2021-05-03 1 DORI J EGGETT P00645252 3037409400 2021-05-03 2019 2022-09-23 18:48:47Z UCHEALTH MEDICAL GROUP DR MIKE RANDLE 2315 E HARMONY ROAD NO 200 FORT COLLINS CO 80528 542608173 0 X N/A X 2013 CO 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. 5 4 3323 5 0 0 108683182 129810764 373117654 412723151 53217 74258 0 0 481854053 542608173 2335262 1671725 0 0 438775384 501297215 0 0 0 145215724 166515461 586326370 669484401 -104472317 -126876228 59892582 64694969 457907069 589585684 -398014487 -524890715 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 582894273 1671725 412723151 UCHEALTH MEDICAL GROUP (UCHMG) OPERATES MORE THAN 200 CLINICS ACROSS COLORADO, NEBRASKA AND WYOMING. UCHMG PROVIDES A FULL CONTINUUM OF MEDICAL CARE THROUGH AN INTEGRATED, MULTI-SPECIALTY PHYSICIAN GROUP. IN FISICAL YEAR 2020, THE GROUP HAD 1,893,382 OUTPATIENT VISITS AND 44,993 URGENT CARE VISITS. AT YEAR-END, UCHMG WAS COMPRISED OF MORE THAN 542 EMPLOYED PHYSICIANS AND 311 ADVANCED PRACTICE PROVIDERS REPRESENTING 47 SPECIALTIES. 582894273 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 328 0 1 3323 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X STEVE SCHWARTZ 9702377000 2315 E HARMONY ROAD SUITE 200 FORT COLLINS CO 80528 X CHRIS OSBORN BOARD CHAIR 1.00 X 0 0 0 GENE RENUART BOARD MEMBER 1.00 X 0 0 0 DR WILLIAM NEFF BOARD MEMBER 1.00 X 0 0 0 DR TODD WHITSITT BOARD MEMBER/ PHYSICIAN 40.00 X 677093 0 42551 LAURIE STEELE BOARD MEMBER 1.00 X 0 0 0 DR MIKE RANDLE PRESIDENT AND CEO 40.00 X 721735 0 102695 STEVE SCHWARTZ CFO 40.00 X 336880 0 43850 DONNA LANKFORD VP REGIONAL PRACTICE MGMT 40.00 X 246894 0 36704 MARY YANTIS VP REGIONAL PRACTICE MGMT 40.00 X 322136 0 43764 SCOTT HURLBERT VP CHIEF QUALITY OFFICER 40.00 X 222978 0 15021 DIANA BREYER VP CHIEF QUALITY OFFICER 40.00 X 316204 208001 41270 TIMOTHY GRAMANN CHIEF OPERATING OFFICER 40.00 X 340012 0 51512 JENNY BAJAJ CHIEF MEDICAL OFFICER 40.00 X 433335 0 53800 JOSHUA PETIT PHYSICIAN 40.00 X 1474882 0 50195 HANS COESTER MEDICAL DIRECTOR 40.00 X 1821065 0 46677 LARS WIDDEL PHYSICIAN 40.00 X 1519097 0 49961 ARTHUR LIU PHYSICIAN 40.00 X 1427075 0 50209 PETER WALINSKY PHYSICIAN 40.00 X 1420080 0 50225 11279466 208001 678434 866 0 1 0 ASPEN CREEK MEDICAL ASSOCIATES 9480 BRIAR VILLAGE POINT DR SUITE COLORADO SPRINGS CO 80920 MEDICAL 2108922 AMERICAN HEALTHCARE STAFFING PO BOX 1928 EDMOND OK 730831929 MEDICAL 1951239 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 MEDICAL 1940076 ONYX HEALTHCARE INC PO BOX 5935 TROY MI 48007 MEDICAL 1578587 CHG COMPANIES DBA COMPHEALTH PO BOX 972651 DALLAS TX 753972651 MEDICAL 1496386 33 122348411 7462353 129810764 NET PATIENT SVC REV 621110 346300344 346300344 COST REIMBURSEMENT 621110 63469558 63469558 OTHER PROGRAM REVENUE 621110 2953249 2953249 412723151 74258 74258 542608173 412723151 0 74258 1671725 1671725 4048434 1315117 2733317 422967852 375977259 46990593 22745046 20218132 2526914 46329783 41182668 5147115 5206100 4627716 578384 76821 76821 18622 18622 28671139 13560934 15110205 2897273 2897273 2962588 2819439 143149 11193927 9578319 1615608 32016536 31588200 428336 1006373 831069 175304 9567834 8562143 1005691 3148293 3148293 12198674 8631169 3567505 4084645 4061124 23521 MEDICAL SUPPLIES 42655919 41586499 1069420 BAD DEBT 8032511 8032511 LAUNDRY 1094433 1091352 3081 REPAIRS & MAINTENANCE 926736 924836 1900 5963137 588495 5374642 669484401 582894273 86590128 0 38450 36985 29663256 32677938 310775 311636 1343588 1167510 59952613 29804077 28213163 30148536 323350 352364 59892582 64694969 52134515 77398974 902409 6290 1827 405766264 511282474 457907069 589585684 X -398014487 -524890715 -398014487 -524890715 59892582 64694969 -126876228 0 X 0 1 X 1 0 X 38714496 97680190 108683182 129810764 374888632 107918948 308551632 373117654 412723151 1202311385 146633444 406231822 481800836 542533915 1577200017 0 0 0 1577200017 31573 71189 64386 74258 241406 31573 71189 64386 74258 241406 146665017 406303011 481865222 542608173 1577441423 X PART III, LINE 14 2017 WAS THE ORGANIZATION'S FIRST TAX YEAR AS A SECTION 501(C)(3) ORGANIZATION. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 18622 0 0 18622 0 9597937 3944424 5653513 10657753 3656974 7000779 33838856 17863664 15975192 5858067 4339015 1519052 30148536 PAYABLES TO AFFILIATES 506114287 COMP BAL-AUTHORITY 950295 RETENTION PAYABLE 12599 A/P - CONSTRUCTION 113389 COPIC TAIL ACCRUAL 4091904 511282474 527113309 0 527113309 15494864 15494864 542608173 653989537 0 653989537 15494864 15494864 669484401 PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 8,032,511. CARES ACT GRANT 7,462,353. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 8,032,511. CARES ACT GRANT 7,462,353. 1 UNIVERSITY OF COLORADO SCHOOL OF MEDICINE 13001 17TH PLACE AURORA CO 80045 846000055 501(C)(3) 1669908 COMMUNITY HEALTHCARE 1 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. X X X 0 0 0 0 0 0 0 1 0 DR TODD WHITSITT BOARD MEMBER/ PHYSICIAN 673821 0 0 0 3272 0 25424 0 17127 0 719644 0 0 0 DR MIKE RANDLE PRESIDENT AND CEO 479620 0 235027 0 7088 0 79751 0 22944 0 824430 0 0 0 STEVE SCHWARTZ CFO 263226 0 71245 0 2409 0 29009 0 14841 0 380730 0 0 0 DONNA LANKFORD VP REGIONAL PRACTICE MGMT 190920 0 55010 0 964 0 22657 0 14047 0 283598 0 0 0 MARY YANTIS VP REGIONAL PRACTICE MGMT 251415 0 68300 0 2421 0 28694 0 15070 0 365900 0 0 0 SCOTT HURLBERT VP CHIEF QUALITY OFFICER 222978 0 0 0 0 0 2032 0 12989 0 237999 0 0 0 DIANA BREYER VP CHIEF QUALITY OFFICER 316204 206016 0 0 0 1985 3388 22036 7988 7858 327580 237895 0 0 TIMOTHY GRAMANN CHIEF OPERATING OFFICER 262233 0 76424 0 1355 0 30074 0 21438 0 391524 0 0 0 JENNY BAJAJ CHIEF MEDICAL OFFICER 336536 0 95067 0 1732 0 36486 0 17314 0 487135 0 0 0 JOSHUA PETIT PHYSICIAN 1473968 0 0 0 914 0 25424 0 24771 0 1525077 0 0 0 HANS COESTER MEDICAL DIRECTOR 1811181 0 0 0 9884 0 25424 0 21253 0 1867742 0 0 0 LARS WIDDEL PHYSICIAN 1518146 0 0 0 951 0 25424 0 24537 0 1569058 0 0 0 ARTHUR LIU PHYSICIAN 1425756 0 0 0 1319 0 25424 0 24785 0 1477284 0 0 0 PETER WALINSKY PHYSICIAN 1335052 0 80121 0 4907 0 25424 0 24801 0 1470305 0 0 0 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. 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 EXECUTIVE COMPENSATION CONSULTING SERVICES. ON OUR BEHALF, SULLIVAN COTTER COLLECTS AND REVIEWS COMPENSATION LEVELS FROM LIKE-ORGANIZATION 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 DETERMINES THE SALARY OF THE ENTITY CEO'S COMPENSATION ANNUALLY. 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 VII SECTION A DR. TODD WHITSITT IS COMPENSATED FOR PHYSICIAN SERVICES HE PROVIDES TO THE ORGANIZATION AND NOT FOR SERVING AS A BOARD MEMBER. POUDRE VALLEY HEALTHCARE INC 2315 E HARMONY ROAD SUITE 200 FORT COLLINS CO 80528 841262971 TERTIARY CARE CO 501(C)(3) LINE 3 0 UNIVERSITY OF COLORADO HEALTH 7901 E LOWRY BLVD SUITE 350 DENVER CO 80230 454552631 HEALTHCARE MANAGEMENT CO 501(C)(3) LINE 7 0 MEDICAL CENTER OF THE ROCKIES 2315 E HARMONY RD STE 200 FORT COLLINS CO 80528 043730045 TERTIARY CARE CO 501(C)(3) LINE 3 PVHC INC 0 PVHS FOUNDATION 2315 E HARMONY RD STE 200 FORT COLLINS CO 80528 741894581 BENEFIT HEALTH CO 501(C)(3) LINE 7 PVHC INC 0 0 0 1 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0